EUROPOPLIN 25MG Treatment of depression (5 blisters x 10 tablets)

Dosage form Box of 5 blisters x 10 tablets
Specifications Amitriptyline

Ingredient

Composition information	Content
Amitriptyline	25mg

Uses

Indications

Europlin drug 25 mg is indicated in the following cases:

Treatment of depression, suitable for treating endogenous depression. The drug has little effect on response depression.

Treatment of some cases of bedwetting at night (after eliminating urinary tract physical complications with appropriate tests).

Amitriptylin is a three -round antidepressant, reducing anxiety and sedative effect. The mechanism of action of amitriptylin is to inhibit the re -import of monoamine, serotonin and noradrenalin in neuron cells. Noradrenalin re -entry effect is considered to be related to the antidepressant effect of the drug.

Amitriptylin also has anti -cholinergic effects in both central and peripheral nerves.

pharmacokinetic

absorption

Amitriptylin absorbs quickly and completely after intramuscular injection for 5-10 minutes and after 30-60 minutes after taking the usual doses, 30-50% of the drug is excreted within 24 hours.

Distribution

Amitriptylin passes through the bloody barrier, placental fence and excretion in breast milk. Amitriptylin is widely distributed throughout the body and binds a lot to plasma proteins and tissues.

Metabolism

Amitriptylin is metabolized in the liver (40%), metabolized by reducing N-methyl and hydroxylation. A very small amount of Amitriptylin is not metabolized in urine.

Amitriptylin's semi -exhaust time is about 22-40 hours and there is a difference in drug concentration in plasma between individuals after taking a normal dose.

The reason for this difference is that the semi -discharged time in the plasma of the drug varies from 9-50 hours between individuals.

Before taking EUROPOPLIN 25MG Treatment of depression (5 blisters x 10 tablets)

How to use

europlin 25 mg orally orally.

Dosage

This drug is only used as prescribed by a physician.

Adults

Treatment should be started in low doses and gradually increased.

Starting dose

Normally 75 mg/day is divided into several times. If necessary, it can be increased to 150 mg/day, additional dose should be used in the evening or before going to bed.

Anti -depression effect may appear within 3-4 days or it is likely to take up to 30 days to appear.

If the condition does not improve within 1 month, it is necessary to see a specialist.

Maintenance dose

Usually 50 - 100 mg/day. For maintenance treatment can be used a single dose in the evening or before going to bed.

When the condition has improved, the dosage should be reduced to the lowest possible to maintain the effect. Should continue treatment for 3 months or longer to reduce the risk of recurrence.

Stop treatment should gradually take steps and closely monitor because of the risk of recurrence.

Elderly people

Should be treated with low doses with the starting dose of 25 - 50 mg/day and increasing if necessary.

Can be divided into several times or use a single dose in the evening or before bed.

Children

Do not take medicine for children under 12 years of treatment of depression due to lack of clinical experience.

Children over 12 years old

Initial dose

10 mg/time, 3 times/day and 20 mg at bedtime. Necessity may gradually increase the dose.

EXTRACTIVE ON PEOPLE IN CHILDREN

Children from 6 - 10 years old: 10 - 20 mg orally before going to bed.

Children over 11 years old: 25 - 50 mg oral before going to bed. Treatment must not last more than 3 months.

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?

Expression

Sleeping, confusion, convulsions (epilepsy), distraction, pupils, fast, slow or abnormal heartbeat, hallucinations, agitation, shallow breathing, shortness of breath, weakness, vomiting.

Handling

mainly treat symptoms and support, including:

Stomach lavage: Use activated carbon in the form of mud many times.

Maintain respiratory function, circulation and body temperature. Or inhales anesthetics to control seizures.

What to do when forgetting a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using 25 mg Europlin, you may experience unwanted effects (ADR).

Unwanted effects mainly manifest the anti -cholinergic effect of the drug. These effects are usually controlled by dosage reduction. The most harmful reaction is excessive sedation (20%) and regulatory disorders (10%).

The most harmful reaction and side effects related to the cardiovascular system and the risk of seizures. The effect of Quinidin -style arrhythmia, slowing down and contraction. Hypersensitivity reactions also occur.

Common, ADR> 1/100

The whole body: Excessive sedative effect, loss of direction, sweating, increasing appetite, dizziness, headache.

circulating: tachycardia, brushing chest drum, changing electrocardiogram (flat or reversed wave), atrial block, lower blood pressure.

Endocrine: Reduce libido, impotence.

Digestive: Nausea, constipation, dry mouth, change taste.

Neurology: loss of transport.

Eyes: Difficult to regulate, blurred vision, dilated pupils.

Uncommon, 1/1000

circulatory: Hypertension Pressure.

Body: fainting, fever, edema, anorexia.

Blood: granulocytes, eosinophilia loves Eosin, leukopenia, platelets.

Endocrine: big breasts, testicular swelling, increase milk secretion, reduce ADH secretion.

Digestive: diarrhea, intestinal paralysis, gland inflammation.

Skin: Hair loss, urticaria, hemorrhage, sensitivity to light.

liver: jaundice, increased transaminase.

Neurological: seizures, speech disorders, foreign symptoms.

Mental: Illusion (Patients with schizophrenia), paranoia (elderly patients), need dose reduction.

Instructions on how to handle ADR

Rarely increases fatigue, drowsiness in the morning and hypotension standing in the morning if the patient takes a single dose at bed.

High fever occurred when using 3 -round antidepressants with anti -cholinergic drugs or neuroleptic drugs, especially when it was hot.

Elderly patients have dementia and brain damage tends to react to cholinergic resistance than middle -aged patients. Those patients need lower doses.

Peripheral neuropathy, coma and stroke are rare side effects.

Monitoring when stopping the drug: Stopping the drug suddenly after prolonged treatment can cause headaches, nausea, uncomfortable body. Slowly reducing the dose can cause fleeting symptoms such as stimulation, excitement, sleep disorders and dreams; These symptoms are usually over within 2 weeks.

A very few cases of colds occur from 2 to 7 days after long -term treatment with 3 -round antidepressants.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Europlin 25 mg contraindicated in the following cases:

Hypersensitivity to Amitriptylin or any ingredients of the drug.

must not be used simultaneously with monoamine oxydase inhibitors.

Not used in the recovery stage immediately after myocardial infarction.

Precautions when using

Warning

Depression is associated with the risk of suicide, self -harm and suicide. The risk of suicide is still in the course of treatment until the disease has been significantly improved.

The treatment of depression accompanied by schizophrenia must always be coordinated with neuroleptics because 3 -round antidepressants can make symptoms of psychosis worse.

In the patient Hung - depression, increasing the risk of occurring and prolonging the stage of manic.

For epilepsy, it is necessary to treat anti -epilepsy appropriately to compensate for the risk of increasing attacks during treatment.

Caution

Amitriptylin should be used carefully in patients with cardiovascular disease, hyperthyroidism or liver failure, and in patients with a history of epilepsy, untreated narrow -angle glucom, urinary retention, prostate hypertrophy or constipation.

Patients who tend to commit suicide should be carefully monitored during treatment.

Sugar levels may change in sensitive diabetics especially with the side effects of 3 -round antidepressants, need to reduce the dose.

The ability to drive and operate machinery

The drug can cause dizziness, headache, nausea, distraction so should not drive and operate machinery when taking the drug.

Pregnancy

Clinical experience of the use of amitriptylin during pregnancy is limited, so Amitriptylin is not recommended for use during pregnancy.

Breastfeeding period

Amitriptylin was detected in breast milk. Because of the risks for serious side effects in newborns, the doctor's opinion is needed to stop breastfeeding or stopping the drug.

Medicinal interaction

Interactions between 3 -round antidepressants and Monoamine oxidase inhibitors are the potential risk of death.

Coordinate with phenothiazine to increase the risk of seizures.

Because 3 -ring anti -depression drugs inhibit the liver enzyme, if combined with anticoagulants, there is a risk of increased anticoagulant effect to more than 300%.

Genital hormones, anti -pregnancy drugs increase the bioavailability of 3 -round antidepressants.

When using Physostigmin to reverse the effect of 3 -round antidepressants on the central nervous system (confusion, paranoia, coma) can cause heart blocking, impulse conduction disorders, causing arrhythmia.

With Levodopa, the anti -cholinergic anti -depression effect can cause the stomach to get food slowly, thus reducing Levodopa's bioactivity.

Cimetidine inhibits the metabolism of 3 -round antidepressants, increasing the concentration of these drugs in the blood that can lead to poisoning.

Clonidin, Guanethidin or Guanadrel are reduced blood pressure when used simultaneously with 3 -round antidepressants.

Concentrated with 3 -round antidepressants and sympathetic drugs that increase the effect of cardiovascular disease can lead to arrhythmia, tachycardia, severe hypertension or high fever.

Storage

Store in a cool dry place, no more than 30 ° C. Avoid light.

Expiry date: 36 months from the date of manufacture. Do not use overdue drugs stated on the packaging.

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