Glockner-5 Davipharm tablets treat symptoms of hyperthyroidism (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Methimazole

Ingredient

Composition information	Content
Methimazole	5mg

Uses

indications

Glockner 5 drugs are indicated in the following cases:

Treatment of hyperthyroidism symptoms (including Graves-basedow). armor. Often used with a beta blocker, especially when there are cardiovascular symptoms (for example, tachycardia). Thiamazol inhibits the synthesis of thyroid hormones in the thyroid gland by making the substrate for the enzyme of the thyroid. This enzyme catalyzes the reaction that combines iodide to be oxidized into the tyrosine root of the thyroglobulin molecule and reacts the molecular pair iodotyrosin to iodotothyronin. Therefore, iodine is deviated from the synthesis of thyroid hormones.

Thiamazol does not inhibit the effects of thyroid hormones formed in the thyroid gland or during the circulation, does not inhibit the release of thyroid hormones, nor does it affect the effectiveness of the thyroid hormone from outside. Therefore, Thiamazol does not work in armor poisoning due to overdose of thyroid hormones.

In case the thyroid gland has a relatively high iodine concentration (due to the use of iodine before or due to radioactive iodine in diagnosis), the body will respond slowly to thiamazol.

Thiamazol does not cure the cause of hyperthyroidism and is often not used for prolonged treatment.

The use of thiamazol is too high and the time is too long, it is easy to reduce armor. The decrease in the concentration of thyroid hormone causes the pituitary to increase the secretion of TSH (thyreo-stimulating hormone). TSH stimulates the development of the thyroid gland, which can cause goiter. To avoid this phenomenon, when the armor function has returned to normal, must be used in moderate low doses, to only inhibit the production of thyroid hormones to a certain extent, or combine the use of synthetic thyroid hormones such as levothyroxin, so that the pituitary gland does not increase TSH secretion.

Different from the anti -thyroid drugs of the thyouracil derivative (benzylthiouracil, propylthiouracil, methylthiouracil), Thiamazol does not inhibit iodine reduction in the peripheral of Thyroxin into Triiodothyronin (the effect of triiodothyronin is much stronger than Thyroxin). Therefore, in the treatment of armor poisoning, propylthiouracil is often used more.

In mass, thiamazol is stronger than benzylthiouracil and propylthiouracil (10 times). In one study, the concentration of thyroxin and triiodothyronin in the blood decreases significant after 5 days of using thiamazol 40 mg daily. Maximum effect achieved after 4 - 7 weeks.

Pharmacokinetics

absorption

methimazol is quickly absorbed through the gastrointestinal tract. The peak concentration of plasma is achieved within 1 hour after drinking. Bioions reach 93%.

Distribution

methimazol focuses heavily on the thyroid. The drug is associated with negligible plasma proteins. Drugs can be fenced by placenta and breast milk.

Metabolism

Chemical drugs mainly in the liver. The sale time is 5 - 6 hours. When the liver and kidney failure is long -lasting.

Elimination

The drug is eliminated through urine in the form of 3-methyl-2-thiohydintin metabolites, which are the main metabolites of methimazol. Only less than 10% methimazol is eliminated in the formless form.

Before taking Glockner-5 Davipharm tablets treat symptoms of hyperthyroidism (10 blisters x 10 tablets)

How to use

tablets to take. The daily dose is usually divided into 3 times, drinking 8 hours apart. It can be taken once or divided into 2 times, the effect may be poor, but in some people, the effect is not desired and the patient is more acceptable.

stop thiamazol 2 - 4 days before using radioactive iodine therapy to avoid affecting this therapy. If necessary, continue to give thiamazol 3 - 7 days later, until radioactive iodine therapy works.

Time to use the medication for long -term regression disease, usually ranges from 6 months to 1-2 years. The drug does not cure the cause of hyperthyroidism.

Dosage

Adults and teenagers

hyperthyroidism: Initial dose: Light hyperthyroidism: Take 15 mg on 15 mg, divided equally into 3 times, 8 hours apart.

Moderate hyperthyroidism: Take 30 - 40 mg, divided equally into 3 times, 8 hours apart.

Heavy hyperthyroidism: Take 60 mg on 60 mg, divided equally into 3 times, 8 hours apart.

Maintenance dose: Take 5 - 15 mg, divided into 3 times, 8 hours apart.

Symptoms of hyperthyroidism usually support within 1-3 weeks and end within 1-2 months when the initial dose is used. Once the condition is achieved, the dosage reduces to the maintenance dose (5 - 15 mg).

Due to the high risk of granulocytes loss at a large dose of 40 mg per day, the dose should be lower than 30 mg/day when possible.

Armor poisoning: Take 15-20 mg, every 4 hours a day, accompanied by other treatments. The dose is adjusted depending on the response of the patient.

Children

hyperthyroidism:

Initial dose: Take 0.4 mg/kg (400 micrograms/kg), divided equally into 3 times.

Maintenance dose: Take 0.2 mg/kg (200 micrograms/kg) divided equally into 3 times, 8 hours apart.

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 do

do when overdose? The common manifestation is nausea, vomiting, epigastric pain, headache, fever, joint pain, itching, edema, reducing blood cells. But the most serious is the marrow failure, loss of leukocytes.

If the drug is used to overdose, it is necessary to cause vomiting or gastric wash. If the patient is in a coma, a convulsions or no vomiting, the stomach may be lavely after the intubation has a stretched endotroup to avoid inhaling the substances contained in the stomach. Need medical care, symptomatic treatment, may need antibiotics or corticosteroids, blood transfusion if the marrow failure and severe leukemia

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 Glockner, you may experience unwanted effects (ADR).

Unwanted effects occur depending on the dose. Most cases of grain leukemia, usually occurs in the first 4-8 weeks and rarely occur after 4 months of treatment.

Common, ADR> 1/100

Blood: Lose leukemia usually in 12% of adults and 25% of children. But about 10% of patients with non -treated hyperthyroidism, leukocytes often decreased to less than 4,000/mm3.

skin: skin, itching, hair loss (3 - 5%).

Systemic: headache, medium and transient fever.

Uncommon, 1/1,000

Blood: Neurosis (0.4%) manifests itself as a severe fever, chills, sore throat or other bacterial infections, cough, mouth pain, hoarseness. More often happens if an elderly patient or a dose of 40 mg/day or more.

Cardiovascular: Vascular inflammation, tachycardia.

joint muscle: joint pain, arthritis, muscle pain.

Peripheral neuritis: peripheral neuritis.

digestive: loss of taste, nausea, vomiting.

Rare, ADR

Blood: myeloma, granulocytes; Platelet reduction, hypotension of blood, manifested by hemorrhage, bruising, black stool, blood in urine or feces, red dots on the skin.

liver: jaundice, hepatitis, liver necrosis. kidney: Nephritis. lung: interstitial pneumonia.

Metabolic: Long -term use can produce thyroid reduction, increased goiter volume.

Instructions on how to handle ADR

rash, itching, usually in a burning form, often lost during treatment, or stopping the drug if the rash is severe.

When the patient sees sore throat, bacterial infection, skin rash, fever, chills, must go to the physician to check hematomy. If the grain leukemia is found, the marrow failure, the treatment must be stopped, taken care of, symptomatic treatment and the specific blood transfusion.

If you see signs of toxic to the liver such as jaundice, liver necrosis, and medication must be stopped. Although very rare, there has been a case of death. Jaundice can last more than 10 weeks after stopping thiamazol.

In the case of cardiovascular symptoms of outstanding armor poisoning, especially tachycardia, it is necessary to combine to use beta blockers such as propranolol, atenolol.

Notify the physician the unwanted effects when using the drug.

Warnings

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

Contraindicated

The anti -contraindication Glockner in the following cases:

Patients with hypersensitivity to any ingredients of the drug.

Women who breastfeed because of milk excretion.

Severe liver failure.

are suffering from severe blood diseases (marrow failure, granulocytosis).

Be cautious when using

must have a specialist physician that appoints treatment and monitoring during treatment.

Need to monitor the number of leukemia and leukemia before treatment and weekly in the first 6 months of treatment, because there may be leukopenia, marrow failure, especially elderly patients or dose of 40 mg per day or more.

Monitor Prothrombin before and during treatment if hemorrhage, especially before surgery.

To be out of reach of children.

The ability to drive and operate machinery

The drug can cause dizziness and drowsiness. Therefore, be cautious when driving or operating machinery

Pregnancy

Thiamazol passes through the placenta, so it can be harmful to the fetus (goiter, reduce armor, some birth defects), but the risk is often low, especially when using low doses.

It is necessary to consider the benefits/harms between treatment and no treatment. In case of treatment, propylthiouracil is often chosen to be used, as the drug through the placenta is less than thiamazol. When using Thiamazol, the lowest dose is effective to maintain the mother's armor function at a high level within the normal limit of normal pregnancy, especially in the last 3 months of pregnancy.

Reduce armor and goiter in the fetus often occurs when taking anti -thyroid medications near the date of birth, because the fetal thyroid has not produced thyroid hormone until the 11th week or 12 pregnancy. Increasing armor can decrease in the mother when the fetus progresses, so in some people may reduce the dose of Thiamazol, sometimes stop treatment for 2-3 months before giving birth.

Hormonal hormone through the placenta is very small, so it is less likely to protect the fetus. Thyroid hormones should not be used during pregnancy, as the drug can cover the signs of regression of hyperthyroidism, and avoid increasing the dose of Thiamazol in vain, causing more harm to the mother and fetus.

Lactation period

Not used for breastfeeding women because of milk excretion.

Drug interaction

with aminophylin, oxtriphylin or theophylin

When hyperthyroidism, the metabolism of these drugs increases. Use Thiamazol, if the thyroid gland returns to normal, it is necessary to reduce the dose of these drugs.

With Amiodaron, Iodoglycerol, iodine or Ki

drugs with iodine reduces the body's response to thiamazol. Therefore, thiamazol dose must be used (amiodaron has 37% iodine).

with anticoagulant drugs Coumarin or indandion

Thiamazol may reduce blood prothrombin, so the effects of anticoagulants increase oral medications. Therefore, it is necessary to adjust the anticoagulant dose based on prothrombin.

With beta blockers, cardiac glycosides

Hypothyroidism increases metabolism and eliminates Beta or cardiac blockers or cardiac glycosides, which need to reduce the dose of these drugs when the patient's thyroid gland returns to normal due to thiamazol.

With radioactive iodine 131i

Thiamazol reduces 131i to the thyroid. If the thiamazol stops suddenly, after about 5 days, the 131i collection will increase again.

Storage

Store in a dry place, avoid light, temperature not exceeding 30 ° C.

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