Stogurad medicine for short -term treatment of anxiety (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Sulpiride

Ingredient

Composition information	Content
Sulpiride	50mg

Uses

Indications

Sotgurad is indicated in the following cases:

Treatment of short -term symptoms anxiety in adults in case of failure with normal treatments. Benzamid, has anti -mental and anti -mental disorders effects through the selective block of Dopamine D2 receptors in the brain. Sulpidi can be considered as an intermediate medication between neuroleptic and antidepressants, because sulpides have both of these effects. Contrary to the majority of other neurolysis drugs, both the Dopamine D1 and D2 receptors, Sulpidi, have a more selective effect and are mainly a Dopamine D2 antagonist. Sulpidi proved not to work on norepinephrin receptors, acetylcholin, serotonin, histamine, or aminobutyric gamma acid (GABA).

pharmacokinetic

absorption

Sulpidi is slowly absorbed from the digestive tract. After taking a 200 mg tablet, or a 50 mg capsule, the peak concentration of sulpid in plasma is 0.73 mg/liter and 0.25 mg/l respectively from 3 to 6 hours. Oral use from 25% to 35%, many changes among patients. After taking the doses from 50 mg to 300 mg, the pharmacokinetics of the linear variable sulpid.

Distribution

Sulpidi is quickly distributed into tissues but absorbs less through the bloody barrier.

DISTRIBUTION: 0.94 l/kg. The ratio of protein is about 40%. Sulpidi is distributed into breast milk and through the placenta.

Metabolism

Sulpidi metabolizes less in humans. 92% of the dose of intramuscular sulpides in urine in the form of non -metabolic.

Elimination

Eliminate sulpidi mainly through glomerular filtration into the urine.

All clearance: 126 ml/min. Sell waste time in the plasma of the drug is about 8 - 9 hours.

Before taking Stogurad medicine for short -term treatment of anxiety (10 blisters x 10 tablets)

How to use

Sotgurad medicine is used orally. Drink whole tablet with water.

Dosage

always use minimum doses effectively. If the patient's clinical condition is allowed, the treatment should be started in low doses and gradually increased by step.

Adults

Treatment of short -term symptoms of anxiety in adults in case of failure with normal treatment.

Daily dose: Take 50 - 150 mg for up to 4 weeks.

Children

Severe behavioral disorders.

Daily dose: Take 5 - 10 mg/ kg. In children the form of oral solution will be more suitable.

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? When an overdose may be disturbed with muscular disorder in the tongue and jaw. Some patients have more severe Parkinson's syndrome, neuroleptic syndrome. Sulpidi eliminates partially through hemolysis.

There is no specific antidote. Symptomatic treatment. Cardiovascular respiratory resuscitation, continuous monitoring until recovery (prolonged QT risk and ventricular arrhythmia). If a severe surgeon syndrome appears, a cholinergic drug may appear.

What to do when you forget 1 dose? Do not drink twice as doses.

Side Effects

When using Sotgurad , you may experience unwanted effects (ADR).

Common, ADR ≥ 1/100

Endocrine: increased blood prolactin.

Mental: Insomnia.

nerve: sedation or drowsiness, permanent dysfunction (these symptoms often recover when using Parkinson's treatment), Parkinson, Run, do not sit still.

Skin and subcutaneous tissues: The rash.

Liver: Increased liver enzyme.

Genital and mammary glands: Breast pain, milk secretion.

Body: Weight gain.

Uncommon, 1/1,000 ≤ ADR

Blood and lymphatic system: leukopenia.

Neurological: Increase muscle tone, dysfunction, muscle tone disorders. blood vessels: Hypotension vertical.

digestion: Increase salivation.

Genital and mammary glands: big breasts, menstruation, orgasm, erectile dysfunction.

Rare, 1/10,000 ≤ ADR

Neurological: Eye of eye.

heart: ventricular arrhythmia, ventricular vibration, ventricular tachycardia.

Unknown frequency

Blood and lymphatic system: neutropenia, grain leukocytes.

The immune system: anaphylactic reaction, urticaria , shortness of breath, hypotension and anaphylactic shock .

Mental: Confusion.

Neurological: Malignant neuroleptic syndrome, reduced mobility, late movement disorders (reported, like all other sedatives, after using sedatives for more than 3 months. Parkinson treatment is not effective and can increase symptoms), convulsions. Heart: extends the QT distance on the center of the center, cardiac arrest, twisting, sudden death. blood vessels: vein embolism, pulmonary embolism, deep vein thrombosis, hypertension.

Muscle and connective tissue: Crew, jaw hard.

Pregnancy, reproduction and infant: Symptoms of extracurricular, cessation syndrome in newborns.

Genital system and mammary glands: Big breasts in men.

Instructions on how to handle ADR

The drug can cause other unwanted effects. Notify the doctor the unwanted effects you encounter 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

Sotgurad contraindicated in the following cases:

Too hypersensitivity to sulpides or any ingredients of the drug.

Porphyrin metabolic disorders.

There is a tumor dependent on prolactin, such as pituitary tumor or breast cancer.

Chrome -preferred cells (adrenal pulp glands with severe hypertension).

The central nervous state is inhibited, comatose, alcohol poisoning and neurological inhibitors.

are taking Parkinson's medications such as Levodopa and Ropinirol or Cabergolin and Quinagolid (medications for milk disorders).

Precautions when using

Warning

The increase in movement stimulation has been reported when taking high doses in a small number of patients: During the stimulus, agitation or excitement of the disease, low -dose sulpides can aggravate the symptoms of the disease. Be careful when appearing.

The suburban reaction, mainly sitting restlessly is reported in a few cases. To ensure, Parkinson's treatment may be reduced.

Like other sedatives, malignant neurolithic syndrome has been reported, a syndrome that can be characterized by body temperature, stiffness, loss of autonomy, changing consciousness and increased CPK concentration. In such cases or cases of hyperthermia cannot diagnose the cause, should stop using all mental medications, including sulpides.

Elderly people are more sensitive to posture, sedation and extras.

In patients with agitation or impulsiveness, sulpides can be prescribed with a sedative.

Symptoms of acute cessation, including nausea, vomiting, sweat and insomnia have been described after sudden sedation stopped. Mental symptoms may recur, and there has been a report that appears uncontrolled movement disorders (such as restless sitting, increasing muscle tone and movement disorders). So stop the medicine slowly.

Increase the death rate in the elderly with dementia.

Information from two major observation studies shows that the elderly who suffer from dementia is treated with anti -psychotic drugs with a small increase in death rates when compared to those who do not use drugs. There is no information to make sure the accurate intensity of the risk and the cause of increasing the risk is still unclear.

Sulpidi is not used to treat behavioral disorders related to insurment.

Venous thrombosis

Cases of venous thrombosis when treated with anti -psychotic drugs have been reported. Because patients treated with psychotic drugs often have intravenous thrombosis factors, all possible risks of venous thrombosis should be determined before and during treatment with sulpides and should take preventive measures.

Breast cancer

Sulpidi may increase prolactin levels. So be careful when using the drug and patients with a history or family history of breast cancer should be carefully monitored when treated with sulpid.

Caution

In older patients, as well as with other sedatives, sulpides should be used carefully.

In children, the efficiency and safety of sulpides have not been carefully studied. So be cautious when taking medicine for children.

If treating with sedatives is necessary for Parkinson's patients, Sulpides can be used but need to be cautious.

Sedative can reduce epilepsy threshold. Cases of convulsions, sometimes on patients without a history of the disease that has been reported when using sulpides. Should be cautious when taking drugs for patients with epilepsy unstable and patients with a history of epilepsy should be carefully monitored during the treatment process with sulpides.

In patients who need to use sulpides while being treated with anti -epileptic drugs, do not change the anti -epileptic dosage.

Sulpidi has anti -anti -cholinergic effects and therefore be careful in patients with a history of glaucoma, intestinal obstruction, congenital gastrointestinal stenosis, urinary retention or prostate hyperplasia. Like all other renal elimination drugs, sulpided dose should be reduced and adjusted for small levels in case the patient impaired renal function.

extends the range of qt

Sulpidi touch extends QT. This effect is the potential risk of serious ventricular arrhythmia such as torsion.

Before using the drug and depending on the clinical condition of the patient, if possible, should monitor factors that favor the appearance of arrhythmia, such as:

Heart rate slower than 55 beats/minute.

Electrolyte imbalance, especially hypokalemia.

extends the congenital QT range.

Treatment with easy -to -slow drugs (

Sulpidi should be used carefully in patients with the above factors and patients with cardiovascular disorders that can lead to a extension of QT.

Avoid using sulpides with other neuroleptics.

stroke

In a random clinical trial compared to the placebo, in the group of elderly patients who have dementia is treated with typical anti -psychotic drugs, there is an increase in the risk of 3 times the risk of cerebrovascular events. The mechanism of increasing risk is still unknown. Increased risk when using other anti -psychotic drugs or other groups of patients cannot be excluded. Sulpides should be used cautiously in patients with stroke risk factors.

leukopenia, neutropenia and grain leukocytes have been reported when using anti -psychotic drugs, including sulpides. Fever or unexplained bacterial infection may be evidence of blood disorders and need to check blood immediately.

Sulpidi should be used cautiously in hypertension patients, especially in older patients, due to the risk of hypertension. Need to monitor the appropriate patient.

Must monitor blood glucose for people with diabetes or risk diabetes at the beginning of sulpided treatment.

In cases of renal failure, sulpider dose is needed and increased monitoring. If the renal failure is severe, it is recommended to treat each interrupt batch.

Need to increase monitoring in alcoholic patients or are taking alcohol -containing drugs because they increase drowsiness.

The ability to drive and operate machinery

Sulpidi has a sedative effect that affects the ability to drive and operate machinery.

Pregnancy

There is a decrease in fertility related to the pharmacological impact of the drug (impact through the intermediary ProLactin) has been observed when taking drugs in animals. Research in animals does not indicate the direct or indirect effects on pregnancy, the development of embryos and/or the development after birth. In humans, clinical information about exposure during pregnancy is limited. In most cases of disorders in the fetus or babies are reported when using sulpides during pregnancy, other explanations may be given and may be more reasonable. It is not recommended to use sulpidi during pregnancy because there is still lack of information.

Babies exposed to anti -psychotic drugs, including sulpides in the last 3 months of pregnancy, are at risk of unwanted effects including symptoms of outsider and/or symptoms of quitting drugs with many different levels and time. There have been reports of agitation, increased muscle tone, tremor, dreaming, respiratory failure or sensory disorders. Babies should be carefully monitored.

Breastfeeding period

Sulpides were found in women's milk for medication. So do not breastfeed when taking the drug.

Drug interaction

sedative

It is necessary to consider when used with sedation because when the central neurological inhibitor effects can be accumulated and reduces alertness. These drugs include Morphin's derivatives (painkillers, cough inhibitors and alternate medications), sedative drugs, barbiturat, benzodiazepin, other anxiety antiders (such as Meprobamat), sleeping pills, antidepressants with sedative effects (amitriptylin, doxepin, mianserin, mirtazapin, trimipramin drugs), hydrogen antihide drug) H1 has sedative effects, antihypertensive drugs acting on the central nervous system, Baclofen and thalidomid.

Popular drugs that are easy to cause torsion

Some drugs can cause this severe arrhythmia, may be anti -arrhythmia or not. Hypotension is an involved factor, such as a slow heartbeat or a long, congenital QT interval.

The drugs are mentioned especially in the anti -arrhyths group IA and III, some sedatives.

With erythromycin, spiramycin and vincamin, intravenously affected by this interaction.

According to the regulations, contraindicated use of two drugs can cause the peak together. However, methadon and some small groups are the exception of this regulation:

Parasitic drugs (halofantrin, lumefantrin, pentamidin) are not recommended for use with drugs that can cause torsion.

Sedative can cause torsion is not recommended, and not contraindicated, used with drugs that can cause torsion.

Combining coordination

Parkinson -non -resistant dopamin -operating masters (Cabergolin, Quinagolid) contraindicated in combination with sulpidi because of mutual opposition.

Unrecamentate coordination

Parasitic drugs can cause torsion (halofantrin, lumefantrin, pentamidin)

Increased risk of ventricular arrhythmia, including torsion. If possible, stop using antifungal drugs azol.

If combined use is inevitable, should check QT and monitor electrocardiograms before treatment.

Parkinson -resistant dopamin -resistant dopamin (Amantadin, Apomorphin, Bromocriptin, Entacapon, Lisurid, Pergolid, Piribedil, Pramipexol, Selegilin)

mutual opposition between dopamine and neuroleptics. Dopamine drugs can cause or worsen mental disorders. In case of necessity to treat neurolithic drugs for people with Parkinson's disease being treated with dopamine, dopamine dose must be reduced until it stops completely (if this drug is stopped suddenly, there is a risk of malignant syndrome caused by neurolithic drugs).

Other drugs that can cause the peak: IIA anti -arrhythmia (Quinidin, hydroquinidin, disopyramid) and group III (Amiodaron, Sotalol, Dofetilid, Ibutilid) and other drugs such as Bupridil, Cisaprid, Diphemanil, Erythromycin IV, Mizolastin, VinCamin IV, VinCamin IV, VinCamin IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN IV, VINCAMIN II moxifloxacin, spiramycin IV

Increased risk of ventricular arrhythmia, including peaks.

Sedative can cause torsion (Amisulprid, Chlorpromazin, Cyamemazin, Droperidol, Haloperidol, Levomepromazin, Pimozid, Pipotiazin, Servindol, SultoPrid, Tiaprid) increase the risk of ventricular arrhythmia, including torque.

alcohol

Alcohol increases the effects of sedatives. Reflective changes can make driving and operating more dangerous machinery. Avoid using alcohol and alcohol preparations while using sulpides.

methadon

Increased risk of ventricular arrhythmia, including peaks.

Caution should be cautious when using

Beta blockers for heart failure (Bisoprolol, Carvedilol, Metoprolol, Nebivolol)

Increased risk of ventricular arrhythmia, including torsion. Should monitor clinical and electrocardiograms.

Heartycardy drugs (including anti -arrhythmia Ia, beta blockers, some anti -arrhyths group III, calcium antiviral drugs, digitalis, pilocarpin, anti -cholinesterase)

Increased risk of ventricular arrhythmia, including torsion. Should monitor clinical and electrocardiograms.

Medications that lower potassium potassium (diuretics that lower potassium, use alone or combine, irritable laxatives, glucocorticoids, tetracosactids and amphotericin B IV)

Increased risk of ventricular arrhythmia, including torsion. Treatment of hypokalemia before taking sulpid, and should monitor clinical, electrolytes and electrocardiograms.

Sucralfat

Reduce the absorption in the gastrointestinal tract of sulpides. Sucralfat should be used away from sulpides (more than 2 hours apart if possible).

Medications have local impact on the gastrointestinal tract, acid resistance and activated carbon

Reduce the absorption in the gastrointestinal tract of sulpides. The drugs should be used as far as sulpides (more than 2 hours apart if possible).

Collaborate should pay attention

Hypertension treatment

Increased risk of hypotension, especially vertical hypotension.

Beta blockers (except Esmolol, Sotalol and Beta blockers for heart failure)

Vascular dilatation effects and the risk of hypotension, especially vertical hypotension.

nitrate derivatives and related substances

Increased risk of hypotension, especially vertical hypotension.

Other interactions

lithium

Increases the likelioma of Sulpidi's pagoda that can be caused by lithium, which increases the ability to attach sulpides to dopaminergic d2 receptors in the brain.

Storage

Keep the drug in the original packaging of the manufacturer, covered.

Put the drug in a dry place, avoid light, the temperature does not exceed 30 ° C, and out of the reach of children. Do not use the drug after the expiry date on the packaging (box and blister).

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