Colchicine Capel 1mg Mayoly Spindler prevents and treats acute gout attacks (20 tablets)
Dosage form Box of 1 blister x 20 tablets
Specifications Colchicine
Ingredient Gout, calcification of articular cartilage, stagnant crystal
Ingredient
| Composition information | Content |
| Colchicine | 1mg |
Uses
Indications
Colchicine Capel 1mg is indicated in the following cases:
Pharmacy
Colchicin is a derivative of phenanthren, obtained from Colchicum (dog baits). Colchicin has the effect of preventing and treating acute gout attacks, other acid attacks of micronutrient arthritis due to anti -inflammatory inflammation. The drug does not work on the secretion of uric acid through urine as well as urate concentration.
The anti -gout effect of Colchicin has not been fully known, the drug reduces inflammation to the deposition of Mononatri Urat crystals on the joint tissue by inhibiting the dynamic and moving of neutrophil leukemia. Through this mechanism, Colchicin quickly interacted with tubulin and preventing the operation of the microscopic microeles that inhibit neutrophil leukemia and lead to immediate anti -inflammatory effects. Colchicin is also related to the formation of inflamasone, a protein complex related to the production of cytokines associated with inflammatory reaction. Colchicin is also effective on the acute gout in 90% of patients when taking the drug on the first day with a dose of 3mg (1mg x 3 times/day). However, Colchicin is toxic to high doses. It is possible to use drugs to treat acute gout when the patient does not respond or do not tolerate NSAID drugs (indomethacin, ibuprofen, naproxen).
Colchicin is an anti -cell agent that affects cell division in the middle stage (metaphase) of cell division by preventing the polymerization of tubulin into microeline and leading to cell death.
Colchicin can cause poorly absorbent vitamin B12 syndrome due to changes in the function of the ileum mucosa. Colchicin affects the absorption of fat, sodium, and potassium leads to a decrease in cholesterol and serum carotene. Colchicin reduces the activity of lactic dehydrogenase and increases the enzyme activity lysosome of the intestinal mucosa.
pharmacokinetic
absorption
After drinking, Colchicin is quickly absorbed from the rosar and ileum, according to the gut cycle. Oral absorption is very variable from 24 - 88% of the dose, an average of 45%.
After taking a single dose of 1 mg, TMAX is 30 - 90 minutes, with CMAX 5.64 ± 1.37 ng/ml. In a multi -dose study (1 mg/day for 15 days), the drug reaches a stable concentration on the 8th day of taking the drug, with a concentration of 0.3 - 2.5 ng/ml.
Distribution
The drug is linked to albumin in moderate level (40%). The distribution volume is 7 - 10 liters/kg, showing significant distribution in tissue. High levels of colchicin in leukocytes, kidneys, liver and spleen. Low concentration in the heart, muscular and lung muscle. The drug is attached to tissues, mainly the mucosa, liver, kidney and spleen, except for myocardial, muscular and lung muscle.
Colchicin accumulates at tissue as soon as daily dose exceeds 1mg, can be toxic.
Metabolism
PGP transports colchicin from the intestinal cell into the intestine and a part of the colchicin is metabolized in the intestine through CYP3A4 into 2 main metabolites are 2 - O - Demethylcolicin, 3 - O - DeMethylcolchicin (2 - DMC, 3 - DMC) and auxiliary substance of 10 - O - Demethylcolchicin. The concentration of plasma metabolites is very small (
Elimination
More than 2/3 of Colchicin is eliminated through feces (bile ducts), 15 - 30% are excreted in the urine for the first 24 hours, depending on glomerular filtration and excretion in the renal tubules. Selling time is from 20 - 40 hours.
Before taking Colchicine Capel 1mg Mayoly Spindler prevents and treats acute gout attacks (20 tablets)
How to use
Colchicine Capel drugs are taken orally.
Dosage
Gout acute
Dosage must be adjusted based on the achieved efficiency and the level of tolerance.
Colchicin is most effective when treated early (preferably within the first 12 hours to 36 hours after the onset of the acute attack) and the priority is given to low doses. Maximum doses for patients without toxic risk factors 1mg x 1 - 2 times/day 3mg DAY 2 1mg x 1 - 2 times/day 2mg Day 3 1mg x 1 - 2 times/day 2mg Day 4 onwards 1mg 1mg Do not exceed the dose of 3 mg and this dose is only for late treatment for acute gout on the first day of treatment. Should reduce the dose in all cases of diarrhea, adjust the dose in patients with renal failure and when there are risk factors for toxic. On the first day, you should not use more than 2mg of colchicin and must be divided into several times. Need to monitor the appearance of intolerance (especially diarrhea) of colchicin and reduce the dose if needed. Reduce the dose to 0.5 mg/day when diarrhea. Prevention of acute gout attacks, other levels of arthritis of crystal arthritis 1 mg/day. Should start at a dose of 0.5 mg/day and adjust the dose if needed depending on the clinical response. Dose dose to 0.5 mg/day in case of diarrhea. Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist. What to do when overdose? Symptoms Incubation time: 2 - 10 hours (slower when taken with stomach inhibitors). Gastrointestinal disorders: Dissating abdominal pain, vomiting, diarrhea sometimes bloody, dehydrated. cardiovascular disorders: lower blood pressure, cardiac shock. Multi -organ dysfunction usually occurs on the 2nd and 3rd poisoning. Hematological disorders: Reducing all hemorrhage due to bone marrow property (risk of infection, hemorrhage). Respiratory: regularly breathing. Hair loss on the 10th day, peripheral neuropathy, rare cases of SIADH (unsuitable ADH secretion syndrome). The bad prognosis factors: progress the glimpse of glimpse and pt Acute kidney toxicity, urinary and urinary hemorrhagic. Unpredictable results: Death, usually on the 2nd or 3rd day due to an imbalance of electrolyte water, infection or respiratory suspension (paralysis from low to high) or cardiovascular collapse. How to handle In case of acute overdose, removing toxins with active carbon or gastric lavage, depending on the situation. In all cases, it is necessary to constantly monitor the clinical situation and tests at the hospital and treat appropriate symptoms. There is no specific antidote for Colchicin. Hematoparoa is not effective. What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.
Side Effects
When using Colchicine Capel 1mg, you may experience unwanted effects (ADR).
Common, ADR> 1/100
Very rare
The most common side effects are nausea, abdominal pain, vomiting and diarrhea. It is necessary to stop the drug if the above symptoms are required because they are early alarming signs of the possibility of being worse. Therapy is only continued when the above symptoms, usually after 24 - 48 hours. Can use diarrhea or pills that slow down intestinal motility.
Long -term treatment: Need to monitor regularly whether the patient has side effects, regularly check blood cells, leukocytes.
When there are side effects, the first sign of poisoning. Stop using colchicin or have to reduce the dose.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Colchicine Capel 1mg contraindicated drug in the following cases:
Caution when using
Unknown use with Verapamil, Cyclosporine, TelapRevir, Protease inhibitors in combination with ritonavir, antifungal group Azol (iTraconazol, ketoconazol, voriconazole, posaconazole).
Before the beginning of colchicin treatment:
When prolonged treatment, blood count monitoring.
Instruct patients with the first signs of overdose (diarrhea, nausea, vomiting) and should contact the doctor immediately when these symptoms occur. Need to use the right dose by doctor.
Need to notify your doctor about being treated with colchicin before being prescribed any other drug.
The ability to drive and operate machinery
without or negligible impact on the ability to drive and operate machinery.
Pregnancy
Do not use colchicin for pregnant women.
Breastfeeding period
Colchicin eliminated through breast milk. There has been no report to the child who has been poisoned by milk sugar, but the mother can avoid high concentration of the drug in the milk by taking the drug in the evening before sleeping and breastfeeding after 8 hours.
Drug interaction
Contrain to use with macrolid (telithromycin, azithromycin, clarithromycin, dirithromycin, erythromycin, josamycin, Midecamycin, Roxithromycin), Prristinamycin due to the abundant effect Colchicin's desire and can be fatal.
There is no recommendation to combine with
Cyclosporin: The risk of increased muscle and muscle auxiliary effects and toxicity of colchicin due to overdose (cyclosporin inhibits colchicin excretion, especially in patients with renal failure).
Verapamil: Increases the plasma colchicin levels, increases side effects.
Protease inhibitors (ritonavir ...): The risk of increasing side effects of colchicin, can be fatal.
Telaprevir: The risk of increasing unwanted effects of colchicin due to decreased colchicin metabolism, especially in patients with liver/kidney failure.
Strong inhibitors CYP3A4: Increasing the concentration of colchicin in plasma, increasing side effects.
Be cautious when combined with
Vitamin K anti -vitamin K: The risk of increased anti -vitamin K and bleeding effects. Continuous monitoring of Inr, adjusting the dose of vitamin K drugs during treatment with colchicin and until 8 days after stopping treatment.
HMG inhibitors of COA Reductase (Atorvastatin, Fluvastatin, Pravastatin, Rosuvastatin, Simvastatin): The risk of increasing unwanted effect on these substances, especially muscle pattern. It is necessary to monitor clinical response and biological tests, especially at the beginning of combination of treatment.
Storage
Store in a dry place, avoid light, less than 30 ° C
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