SIFSTAD 0.18mg Stella treats signs and symptoms of Parkinson's disease (3 blisters x 10 tablets)
Dosage form Box of 3 blisters x 10 tablets
Specifications Pramipexole
Ingredient
| Composition information | Content |
| Pramipexole | 0.18mg |
Uses
Indications
SIFSTAD drugs are indicated in the following cases:
Adult treatment to treat the signs and symptoms of idiopathic Parkinson's disease, use monomers (not with levodopa) or combine with Levodopa, which means it can be used during the treatment, until the late stage when the effect of Levodopa gradually becomes unstable and appears unstable in the treatment effect (at the end of the dose or oscillation. ")).
Treatment of symptoms in adults of non -base uneasy vacuum syndrome has been severe to a dose of up to 0.54mg of base (0.75mg of salt).
Pharmacokology
pramipexol is the non -derived dopamine owner of the mushroom of chicken spurs (nonergot) with high in vitro monitoring and has a complete internal activity with the Dopamine D2 receptor group, with priority for the D3 or D4 receptor group.
Parkinson's disease: Pramipexol's exact mechanism of impact in the treatment of Parkinson's disease is not known, maybe due to the ability to stimulate the dopamine receptors in the pattern.
Peaceful vacuum syndrome (HCCKY): Pramipexol's exact impact mechanism in the treatment of HCCKY has not been known. Although medical physiology of HCCKY is not well known, neuroscientific pharmacological evidence suggests that there is the main involvement of the dopaminergic system. A functional disorder of dopaminergic money Synap in the form of mild pattern may be related to the pathology of HCCKY.
pharmacokinetics
Pramipexol is easily absorbed through the gastrointestinal tract and the peak concentration in plasma is achieved within 2 hours in patients who are hungry and for about 3 hours when using the same food. Oral bioavailability is about 90%. Pramipexol is widely distributed throughout the body and binds to plasma proteins below 20%. Little metabolism and over 90% of doses are eliminated through the renal tubules into the urine in the form of non -metabolic. Selling time is from 8 to 12 hours. Mouse studies show that the drug is distributed into breast milk.
Before taking SIFSTAD 0.18mg Stella treats signs and symptoms of Parkinson's disease (3 blisters x 10 tablets)
How to use
SIFSTAD is used by water with water, or not with food.
Dosage
Parkinson's disease
Daily dose is divided equally to drink 3 times a day.
Starting treatment
The dose increases slowly, the starting dose is 0.264mg of base form (1 12 sifstad 0.18)/day, and then increasing the dose gradually every 5-7 days. If the patient does not have the side effects that cannot be tolerated, should increase the dose gradually until the maximum treatment is achieved.
week
Maintain treatment
Dosage for each patient should be in the range of 0.264mg of base form (1 12 sitstad 0.18 tablets) to a maximum of 3.3mg of base form (18 sitstad 0.18 tablets or 4 12 sifstad 0.7)/day. In the process of increasing the dose in key studies shows the effectiveness started from the dose of 1.1mg of base (6 sifstad 0.18 tablets or 12 sifstad 0.7).
Additional adjustment should be based on clinical response and the appearance of unwanted effects. Recommendations to reduce the dose of levodopa in both cases of increasing dose and maintenance treatment Pramipexol depending on the reaction of each patient.
Stop treatment
Sudden stopping dopaminergic therapy can lead to malignant neuroleptic syndrome, a decrease in pramipexol dose at a speed of 0.54mg of base form (3 SIFSTAD 0.18 or 34 Sitstad 0.7)/day until the daily dose reaches 0.54mg of base form (3 SIFSTAD 0.18 or 34 SIFSTAD 0.7 tablets). After that, it is necessary to reduce the dose to 0.264mg of base form (1 12 sitstad 0.18)/day.
Patients with renal failure
Pramipexol elimination depends on the kidney function. Below is a dosage suggested at the beginning of treatment:
Patients with liver failure
There is no need to adjust the dose in patients with liver failure.
Children
Safety and effectiveness of pramipexol in children under 18 have not been set up.
Something impatient syndrome
The recommended starting dose of Pramipexol is 0.088mg of base form (12 sitstad 0.18) x 1 time/day, use 2-3 hours before going to bed. For patients who need to reduce symptoms further, they can increase the dose every 4-7 days to a maximum of 0.54mg of base form (3 Sifstad 0.18 tablets or 34 Sitstad 0.7)/day (as the table below).
Stop treatment
Can stop using pramipexol without a slowly reduced dose due to daily dose of daily vacuum syndrome not exceeding 0.54mg of base form (3 sifstad 0.18 tablets or 34 SIFSTAD 0.7 tablets).
Patients with renal failure
Pramipexol elimination depends on the kidney function. Patients with creatinine clearance above 20ml/minute do not need to reduce daily dose.
The use of pramipexol in patients with hemorrhage or patients with severe renal impairment has not been studied.
Patients with liver failure
No need to reduce the dose in patients with liver failure.
Children
It is recommended not to use Pramipexol for children and teenagers under 18 years of age due to lack of data on safety and efficiency.
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
There is no clinical experience of serious overdose. Unwanted effects that can be encountered are manifestations related to pharmacological properties of dopamine, including nausea, vomiting, hyperactivity, hallucinations, agitation and hypotension.
Treatment
There is no antidote for dopamine overdose. If there are signs of central nerve stimulation, sedative can be used. Overdose management by general support measures along with gastric wash, infusion, active carbon and electrocardiogram monitoring.
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 SIFSTAD, you may experience unwanted effects (ADR).
In Parkinson's patient
Common, ADR> 1/100
Body: Fatigue, peripheral edema. Other: Losing weight, even reducing appetite. Uncommon, 1/1000 Other: weight gain. Rare, 1/10000 In patients with unprinted accommodation Common, ADR> 1/100 Uncommon, 1/1000 Nervous system: Forgot, dysfunction, hyperactivity, fainting, fainting. Body: External edema. Other: Losing weight including reducing appetite, gaining weight. Instructions on how to handle ADR 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
SIFSTAD drugs are contraindicated in the following case: Hypersensitivity to pramipexol or any ingredients of the drug.
Precautions when using
illusion
The illusion is the known side effect of Dopamine and Levodopa. Patients need to be notified that the illusion may occur (mostly virtual market).
movement disorders
In Parkinson's disease progression, when treated in combination with Levodopa movement disorders may be encountered at the beginning of adjusting the pramipexol dose. If this happens, levodopa dose should be reduced.
Hung feeling and delirium
Patients should be monitored regularly the progression of manifestations of manic and delirium. Patients and caregivers should be aware of Hung Cam and delirium that can occur in patients treated with Pramipexol. Should consider reducing the dose/stop the drug slowly if these symptoms progress.
Eye check
Need to check the eye periodically or when there is an abnormal vision.
Sleep and falling asleep
Pramipexol is related to drowsiness and drowsiness, especially in Parkinson's patient. Draying in daily activities that in some cases do not know or have no signs of notice are rarely encountered. Patients need to be notified of this and be cautious when driving or operating machinery when treated with Pramipexol. Patients with drowsiness appearing or falling asleep need to limit driving or operating machinery. Besides, it is necessary to consider reducing the dose or stopping treatment. Due to the ability to have a combination effect, patients need to be cautious when using sedatives or alcohol (alcohol) with pramipexol.
Pulse control disorders
Patients should be monitored regularly the progression of impulse control disorders. Patients and caregivers should be aware of the symptoms of impulse control disorders including pathological gambling, increased libido, increased sexual activity, spending or excessive shopping, plenty of eating and incorrect eating may occur in patients treated with dopamine owners such as pramipexol. Should consider reducing the dose/stop the drug slowly if these symptoms progress.
Patients with mental disorders
Only treatment for domapin dominates for patients with mental disorders if the benefits are higher than the risk. Do not simultaneously use psychotic drugs with pramipexol.
Severe cardiovascular disease
It is necessary to be close in the case of severe cardiovascular disease. Blood pressure monitoring should be monitored, especially when starting to treat, because the general risk is hypotension posture related to dopaminergic therapy.
Malignant neuropular syndrome
The appearance of symptoms in malignant neuropular syndrome is also recorded when suddenly stopping dopaminergic therapy.
Increase phenomenon
The reports in the literature show that the treatment of dopaminergic dopaminergic medication may cause an increased impression syndrome.
The ability to drive and operate machinery
Pramipexol can affect the ability to drive and operate machinery. The illusion or sleeping may occur. If the patient uses PramipExol, there is a drowsiness or falling asleep, not to drive or participate in activities where the loss of awareness can cause serious injuries or death for themselves or others (such as operating machinery) until sleepiness and drowsiness are no more.
Pregnancy
The effect on pregnant and lactating women has not been studied in humans. PramipExol does not cause teratogen on rats and rabbits but has toxicity on mouse embryos when using toxic doses for mice. PramipExol should not be used during pregnancy unless it is really necessary, which is only treatment if the benefits are higher than the risk for the fetus.
Breastfeeding period
Because pramipexol inhibits prolactin secretion on humans, can inhibit milk secretion. Pramipexol excretion in breast milk has not been studied in humans. On rats, drug concentration has a higher radioactive activity in mouse milk than plasma concentrations.
Because there is no human data, Pramipexol should not be used during breastfeeding. However, if it is required to take the drug, should stop breastfeeding.
Medicinal interaction
Amantadin: may reduce the oral clearance of PRAMIPEXOL.
cimetidine: causing 50% increase in auc of pramipexol and an increase of 40% of the sale time (n = 12).
The excreted drugs in the kidneys: Used with drugs excreted by the cation transport system (e.g. cimetidin, ranitidin, diltiazem, triamteren, verapamil, quinidin, and quinin) reduce the oral clearance of PRAMIPEXOL about 20%, in, then shared with drugs excreted by the anion transport system (for example, the CEPHALSPORIN, CEPORIN penicillin, indomethacin, hydrodorothiazid, and chlorpropamid) have little effect on the oral clearance of pramipexol.
Dopamine antagonists: Because pramipexol is a dopamine owner, maybe dopamine antagonists, such as sedatives (phenothiazine, butyrophenones, thioxanthens) or metoclopramid, can reduce the effectiveness of pramipexol.
Should avoid simultaneous use of psychotic drugs with pramipexol if the antagonistic effects may occur.
Storage
In closed packaging, dry place. The temperature does not exceed 30 ° C.
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