MAFOXA 20mg Medboide Treatment of schizophrenia, Hung Cam (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Ziprasidone

Ingredient

Composition information	Content
Ziprasidone	20mg

Uses

indications

20mg mafoxa drug used in the treatment of schizophrenia, a mighty mental phase or acute mixture of bipolar disorder, with or without mental manifestations.

Pharmacological

in vitro, Ziprasidone shows high affinity for Dopamine D2 and D3 receptors, Serotonin 5HT2A, 5HT2C, 5HT1A, 5HTD1D and 1 -Drenergic receptor; and average affinity with H1 histamine receptors. Ziprasidone acts as a antagonist at the D2, SHT2A, SH1D receptor and as a fortune owner at 5HT1A receptor. Ziprasidone inhibits the reabsorption of serotonin and norepinephrin. Ziprasidone has no significant affinity for other receptors in tests, including Muscarinic Cholinergic receptors.

As other schizophrenia and bipolar disorders, Ziprasidone's action mechanisms are not well known. However, the effectiveness of Ziprasidone in the treatment of schizophrenia is proposed indirectly through antagonism at Dopamin Typ 2 receptors (D2) and Serotonin Typ 2 (5HT2).

The antagonism in receptors other than dopamine and 5HT2 with similar affinity can explain some of the treatment effects and side effects of Ziprasidone. Ziprasidone's antagonism with H1 H1 receptor and α1-adrenergic receptor can be explained for side effects that cause drowsiness and hypotension.

pharmacokinetics

absorption:

After drinking, Ziprasidone is absorbed well and reaches the peak concentration in plasma after 6-8 hours. Absolute bioavailability of 20 mg oral dose at meals is about 60%. Foods doubling the ability to absorb Ziprasidone.

Distribution:

The average distribution of ziprasidone is 1.5 l/kg. More than 99% associated with plasma proteins, mainly albumin and al-acid Glycoprotein. The cohesion with plasma proteins of ziprasidone in vitro is not replaced by warfarin or propranolol, two belonging to strongly cohesion with plasma proteins and vice versa. Therefore, the ability to interact with ziprasidone due to this replacement is very low.

Metabolism:

After drinking, Ziprasidone is metabolized mostly, only a small amount is excreted in the urine (

Era:

The half -life of ziprasidone is about 7 hours. Stable drug concentration is achieved after 1-3 days. The clearance of the drug is 7.5 ml/min/kg. About 20% of the dose is excreted in the urine and about 66% in feces.

Before taking MAFOXA 20mg Medboide Treatment of schizophrenia, Hung Cam (3 blisters x 10 tablets)

How to use

oral Mafoxa 20 mg.

Dosage

Dosage: Do not use Ziprasidone for children and teenagers under 18 years old.

schizophrenia:

Initial treatment: 20 mg x 2 times/day, drink immediately after meals. Depending on the patient's condition, the daily dose can be adjusted up to 80 mg 2 times/day. Only adjust the dose after at least 2 days. Monitor patients in a few weeks before increasing the dose to ensure the lowest dosage use effectively.

Maintain treatment: The effect of the drug can maintain up to 52 weeks of weight from 20-80 mothers, but the optimal treatment time is still unknown. Patients need to be periodically assessed the need for maintenance treatment.

bipolar disorder:

Initial treatment: 40 mg x 2 times/day, drink immediately after meals. Increase the dose to 60 or 80 mg x2 times/day on the second day of treatment. Adjust the next dose in the dose range of 40 - 80 mg x 2 and date based on the effectiveness of the drug and the patient's tolerance ability. Maintenance treatment: Effective when long -term use (for example, over 3 weeks) has not been systematically evaluated. Patients need to be periodically assessed the need for maintenance treatment.

Dosage for special subjects: No need to adjust the dose by age, gender, race or in patients with liver impairment for ziprasidone orally.

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 of overdose:

Symptoms that have been reported when using ziprasidone overdose include: foreign symptoms, drowsiness, tremor and anxiety.

Management:

In case of an overdose: Set, maintain airway and ensure adequate oxygen, ventilation. Intravenous and gastric intervention (after intubation, if the patient is unconscious) and simultaneously use activated carbon with laxative if necessary. Inanimate ability, epilepsy, or disorder reactions of the head and neck after overdose can lead to the risk of inhaling food when vomiting.

Cardiovascular monitoring should start immediately and should include continuous electrocardiography monitoring to detect arrhythmia. If anti -arrhythmia treatment is indicated, disopyramid, processaamid and quinidine may increase the long -lasting side effects in patients using ziprasidone.

Hypotension and circulation should be treated with appropriate measures such as intravenous infusion. If you use sympathetic drugs to support blood vessels, epinephrin and dopamine should not be used because of the beta stimulation combined with the A1 antagonistic of Ziprasidone can worsen the lower blood pressure. Similarly, the Alpha-adrenergic receptor properties of Bretylium can cause more severe hypotension on Ziprasidone users.

In case of severe foreign symptoms, anti -antacidgic drugs should be taken. There is no specific antidote as well as ziprasidone separation. Should remind the ability to use many necessary drugs. Strict medical monitoring should be continued until the patient recovers.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using 20 mg mafoxa drugs often experience unwanted effects (ADR) such as:

Common

: ADR> 1/100

Body: Abdominal pain, influenza syndrome, fever, dizziness, face edema, chills, sensitive to light, hip pain, lower body heat. muscle tone, muscle tone, movement disorders, convulsions, abnormalities, confusion, dizziness, reduction of movement, increased movement, gait, blossoming, eye -catching, increasing sensation, loss of air conditioning, loss of memory, light, reducing muscle tone, losing movement, Disorders of the language, dancing syndrome, dancing, looking at double, loss of breathing. Mushroom.

Find a circuit: Slow heart rate, angina, atrial fibrillation. Phosphokinase, alkaline phosphatase, hypercholesterol, dehydration, lactic dehydrogenase, albuminuria, lower potassium. The skin is exposed, the rash Vesiculobullous. The senses: conjunctivitis, dry eyes, tinnitus, eyelid inflammation, cataract, fear of light.

Rare: ADR Find vessels: Block atria 1, branch block, intravenous inflammation, pulmonary embolism, large heart, cerebral infarction, stroke, cerebral vascular accident, deep vein inflammation, myocarditis, intravenous inflammation.

Gastrointestinal: gum bleeding, jaundice, blocking stool, getting gyt, vomiting blood, jaundice, hepatitis, liver, liver, mouth, black stool.

Endocrine: Hypothyroidism, hyperthyroidism, thyroid inflammation.

Blood and lymphatic system: thrombocytopenia, bloating anemia, giving lymphocytes, mononuclear leukemia, alkaline leukemia, lymphatic edema, red blood cells, platelets. Metabolic disorders and bun nutrients, increased creatinine, hyperlipidemia, hypoglycemia, hyperkalemia, hypoglycemia, hypoglycemia, hypoglycemia, hypoglycemia, glucose tolerance, hyperacture, hyperuricemia, blood calcium acid, reducing blood magnesium, blood magnesium, respiratory infections.

musculoskeletal: muscle disease.

Neurology: muscle vibration, eyeball, crooked neck, human body bent, increased reflexes, jaw hard.

Respiratory: coughing up blood, larynx.

Urinary - genital: Breast enlargement in men, vaginal bleeding, night urine, urinary decrease, female sexual dysfunction, uterine hemorrhage.

The senses: Eye bleeding, keratitis, conclusion - cornea.

Unwanted effects

When suspected unwanted effects occur, the patient needs to be examined to check the whole situation and review the medical record reflecting the treatment process. The necessary subclinical and exploration tests are carried out quickly, paying attention to the heart - vessel, digestive, kidney - urinary, blood, ... need to consider reducing the dose or stopping the drug immediately, and consulting with related specialties.

Patients need to be increased to rest, avoid sunshine, adequate water and sticky food, monitor body temperature, vessels, blood pressure are daily. Always prevent patients from stumbling due to movement disorders, visual disorders, posture hypotension.

In addition, when indicated for treatment with a new drug, you should be careful to probe doses and monitor patients during the use of the drug.

Warnings

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

Contraindicated

Mafoxa medicine 20mg contraindicated in the following cases:

Patients with a history of prolonged QT syndrome (including congenital cases).

Caution when using

leukopenia, neutropenia and grain leukocytes: Patients with a low history of the WBC or leukemia, neutropenia due to drugs that need to be monitored with regular blood index in the first few months of treatment and should stop ziprasidone when there are first signs of significant decline in the WBC without other causes. Patients with severe neutropenia (Number of neutrophils

rash and/or urticaria: The appearance of a rash may be related to the ziprasidone dose. Most patients are improved quickly when treated with anti -histamine or steroids and/or when stopping ziprasidone and recovering completely afterwards. When a rash appears without any other causes, Ziprasidone should be discontinued.

Hypotension posture: Hypotension has been reported, especially during the initial dose. The use of particularly cautious drugs in patients with cardiovascular disease (a history of myocardial infarction or anemia, heart failure or abnormalities) or cerebrovascular disease and/or patients at risk of hypotension (dehydration, reduced circulatory volume, which is being treated for lowering blood pressure).

Epilepsy: Use ziprasidone carefully in patients with a history of epilepsy or risk factors for epilepsy such as dementia Alzheimer or patients over 65 years old.

suicide: Mental patients or bipolar disorders are always at risk of suicide. The close supervision of high -risk patients should be accompanied by drug therapy. Ziprasidone's lowest prescription should be used to reduce the risk of overdose.

The risk of death: Increasing when elderly patients with mental illness associated with dementia are treated with anti -psychotic drugs. Therefore, do not use ziprasidone to treat this patient.

extends the QT interval: Some drugs that extend the QT range are related to the appearance of the torsion and with unexpected sudden death. The risk of prolonged QT longer increases the risk of sudden death when using ziprasidone compared to other schizophrenia medications. Therefore, it is necessary to consider when choosing the appropriate treatment for patients. Ziprasidone should be avoided with other drugs known to extend the QT range. At the same time, avoid using ziprasidone in patients with congenital QT syndrome and in patients with a history of arrhythmia.

Malignant syndrome caused by sedation (NMS): A fatal syndrome has been reported related to the use of anti -psychotic drugs. The clinical manifestation of NMS is to increase body temperature, spastic muscle spasm, change the mental state and neurological disorders. Additional signs may include increased creatinine phosphokinase, muscle pattern and acute renal failure. The management of NMS includes anti -psychotic drugs and intensive symptomatic treatment. There is no unified treatment regimen for NMS.

Late movement disorders: Can occur in patients being treated with anti -psychotic drugs. If the signs and symptoms of late movement disorders in patients are using Ziprasidone, should consider stopping the drug.

Hyperglycemia and diabetes: severe hyperglycemia, sometimes combined with ceton acid infection, coma due to osmotic or death pressure, which has been reported in patients using typical anti -psychotic drugs. Closely monitor patients with diabetes before. Conducting blood sugar tests at the beginning of treatment and periodically for patients with risk factors for diabetes (for example: obesity, family history with diabetes).

The effect of the drug on the ability to drive and operate machinery

Because ziprasidone is at risk of reducing cognitive and movement ability, patients should be warned when driving or operating machinery until sure that Ziprasidone does not affect them adverse.

Using drugs for women during pregnancy and lactation

There is no adequate and controlled study with ziprasidone in pregnant women, should only use drugs during pregnancy when the benefit is better than the potential risks for the fetus.

It is unclear whether ziprasidone or metabolites are excreted into breast milk or not. Therefore, women are recommended not to breastfeed during the use of ziprasidone.

Drug interaction

pharmacokinetic interaction:

Do not coordinate ziprasidone with any drug that extends the QT range.

Be cautious when coordinating ziprasidone with drugs that affect other central nervous systems.

Due to the potential for hypotension, Ziprasidone may increase the effect of some high blood pressure medications.

Ziprasidone may cause insecurity with the levodopa and dopamine agonetic substances. Pharmacological interaction

The effect of drugs on ziprasidone:

Carbamazepine is a CYP3A4 stimulant, when taking a dose of 200 mg twice a day for 21 days, it reduces the AUC of Ziprasidone by about 35%. This effect may be larger when using a higher carbamazepine.

Ketoconazole is a strong CYP3A4 inhibitor, at a dose of 400 mg once a day for 5 days, increasing the AUC and CMAX of Ziprasidone about 35 - 40%. Other CYP3A4 inhibitors may have similar effects.

cimetidine at a dose of 800 mg once a day for 2 days does not affect the pharmacokinetics of ziprasidone.

The effect of ziprasidone on other drugs:

Lithium: Ziprasidone at a dose of 40 mg x 2 times/day to simultaneously use with lithium at 450 mg x 2 times/day for 7 days does not affect the stable state or elimination of lithium through the kidney.

Oral contraceptive: Ziprasidone at a dose of 20 mg twice a day when used at the same time does not affect the pharmacokinetics of oral contraceptive pills, ethinyl estradiol (0.03 mg) and levonorgestrel (0.15 mg).

dextromethorphan: Ziprasidone does not change the metabolism of dextromethorphan into major metabolites, dextrorphan. There is no significant change in the ratio of dextromethorphan/dextrorphan in the urine.

Storage

Leave a cool place, avoid light, temperatures below 30⁰C.

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