Mestinon S.C. 60mg Menarini Treatment of muscle weakness, intestinal obstruction due to intestinal paralysis and after surgery (150 tablets)
Dosage form Box of 150 tablets
Specifications Pyridostigmin bromid
Ingredient
| Composition information | Content |
| Pyridostigmin bromid | 60mg |
Uses
Indications
Mestinon S.C . Used in the following cases:
Mestinon has a longer effect of prolonging prostigmin ( Neostigmine ) despite the slower onset (usually about 30-60 minutes). Because the drug has a weaker Muscarinic effect than Prostigmin, the drug is often tolerated in patients with better myasthenia gravis, when the prolonged effect of the drug is an advantage.
pharmacokinetic
absorption
Like other drugs of the same type, pyridostigmine is absorbed completely in the gastrointestinal tract. Born when used orally is about 3 - 8%. Therefore, the dosage of oral route is significantly higher when taking the drug by the intestine.
The peak concentration of plasma is achieved in a state of hunger about 1.5 - 2 hours after taking 120 mg of pyridostigmine.
The effect of the drug will appear later when used with the same food. For myasthenia gravis (Myasthenia Gravis), to have the effect of treatment, the concentration of drugs in plasma is 20 - 60 ng/ml.
Distribution
The average distribution volume is 1.4 l/kg. Pyridostigmine is negligible with plasma proteins and does not pass the brain barrier.
Metabolism
pyridostigmine is converted into 3 - hydroxy - n - methylpyridine and other metabolites.
Elimination
Mestinon's average selling time is 1.5 hours. However, this time may last 3 times depending on each separate case. The average value of plasma clearance is 0.36 - 0.65 l/kg/hour.
There is no evidence that the ability to accumulate drugs in the form of non -metabolic or active metabolites. A large amount of pyridostigmine (76 - 81%) is eliminated through the kidneys in non -metabolic form.
A small part (18 - 21%) appears in the urine in the form of metabolic 3 - hydroxy - n - methylpyridine. The metabolites are not recognized by about 1 - 4%.
impaired liver function does not affect the dynamics of pyridostigmine. The sale time can be 4 times increased and the clearance in plasma can be reduced to 1/5 in patients with impaired renal function.
Before taking Mestinon S.C. 60mg Menarini Treatment of muscle weakness, intestinal obstruction due to intestinal paralysis and after surgery (150 tablets)
How to use
Mestinon medicine is used orally.
It should be noted that Mestinon is only a 60 mg tablet and can not break.
Dosage
Magical diseases
Adults
Doses 30 - 120 mg divided into several times a day until the maximum effect of the drug (for example, taking the drug in the morning when waking up and taking before meals). The time to maintain the effect of a drug is usually 3-4 hours during the day but may last longer (about 6 hours) when taken before going to bed. Total daily dose is usually about 5-20 capsules but some patients may need higher doses.
Children
Children under 6 years of age should start the starting dose of 30 mg; Children 6 - 12 years old should use 60 mg. Should increase the dose slowly, every day increases 15 - 30 mg until the maximum efficiency is achieved. Total daily dose usually between 30 - 360 mg.
Other indications (intestinal obstruction due to intestinal paralysis and postoperative urinary retention)
Adults
The usual dose is 60 - 240 mg/day.
Children
The usual dose is 15 - 60 mg/day. The frequency of medication may vary depending on the needs of each patient.Special subjects
Elderly
No special dosage recommendations for the elderly.
kidney failure
mestinon is mainly excreted in the form of renal, so it is necessary to reduce the dose for patients with kidney disease and should adjust the dose to achieve treatment effect.
Hepatic failure
There is no recommendation for a special dosage for patients with liver failure.
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 using overdose?
Needs to respiration for patients if respiratory function is severely reduced.
intravenous injection 1 - 2 mg atropine sulfate helps reduce muscarinic symptoms. This dose can be repeated every 5 - 30 minutes if needed.
What to do when you forget a dose? Do not take double the dose to compensate for the forgotten dose. If you forget two or more doses, please contact your doctor for instructions.
Side Effects
When using Mestinon S.C., you may experience unwanted effects (ADR).
Not determined frequency
Kidney and urinary: urine.
Instructions on how to handle ADR
Notify the doctor 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
Mestinon S.C . Contraindications in the following cases:
Precautions when using
It is necessary to be especially cautious when using mestinon for patients with respiratory obstruction such as bronchial asthma and chronic obstructive pulmonary disease (COPD).
Be cautious when taking the drug for the following objects:
Hypotension.
Patients with bodyburgery when taking a relatively large dose of mestinon may need to take extra atropine or other anti -cholinergic drugs to neutralize partially muscarinic effects. Reducing stomach - intestines by taking medicine can affect the absorption capacity of Mestinon.
In all patients, the possibility of the possibility of cholinergic symptoms due to mestinon overdose or more severe illness may occur (these symptoms are different from the symptoms of myasthenia gravis). Both of these symptoms have the same manifestation of increasing muscle weakness, but for symptoms of myasthenia gravis, it should be treated with more positive cholinesterase drugs. In the event of cholinergic symptoms, it is necessary to stop treating immediately and using appropriate support measures including respiratory support.
Mestinon demand is significantly reduced after the thymus removal surgery or when applying some other treatments (using steroids, immunosuppressants).
Patients with rare genetic pathologies such as galactose intolerance, lactase enamel deficiency, or malposure - Galactose should not be used.
The ability to drive and operate machinery
by pyridostigmine bromide or the treatment of unsatisfactory bodyholesia can cause narrowing pupils and eye -regulating disorders, so treatment with mestinon can impair vision, thus affecting driving capacity and using machines.
Pregnancy
Mestinon's safety when used for pregnant women has not been set.
Although the reaction is harmful to the mother and the baby compared to the potential benefits, it must be calculated in all cases, but has not detected any unwanted effects of the drug during pregnancy when taking drugs for pregnant women with muscular weakness.
pyridostigmine bromide through the placenta fence should avoid overdose of pyridostigmine bromide; Should check the unwanted effects that can occur with babies.
Using strong static injection pyridostigine can increase uterine contractions (especially the end of pregnancy).
The severity of my energy weakness changes significantly, so it is necessary to be especially cautious to avoid cholinergic symptoms due to overdose, but on the other hand, it is also necessary to be cautious in patients who are not pregnant women.
breastfeeding period
Mestinon's safety when used for breastfeeding women has not been set.
Observations indicate that only a very small amount of mestinon is secreted into breast milk. However, it is still necessary to pay attention to unwanted effects for breastfeeding.
Drug interaction
immunosuppressive drugs
Pyridostigmine bromide needs can be reduced when applying other treatments (such as immunosuppressive or steroid inhibitors) although the peak of plasma and AUCs of pyridostigmine may be reduced by high doses of corticosteroids.
methylcellulose
methylcellulose and drugs containing methylcellulose excipients can completely inhibit the absorption of pyridostigmine bromide.
Muscarinics resistance
Atropine and hyascine antagonistic effect Muscarine of pyridostigmine bromide. It should be noted that gastric - intestinal peristalsis is reduced by these drugs that can affect the absorption capacity of pyridostigmine bromide.
muscle relaxants
pyridostigmine optimizes the effect of non -reducing muscle relaxants (for example, pancuronium and vecuronium). Pyridostigmine can extend the effectiveness of reducing muscle relaxants (for example: suxamethonium ).
Other drugs
Aminoglycoside antibiotics, body anesthesia/body anesthetics, anti -arrhythmic drugs and some other drugs that affect neurotransmitter - muscle can affect pyridostigmine bromide.
Storage
Store drugs in a cool dry place, the temperature does not exceed 30ºC.
Other drugs
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