TISERCIN 25mg Egis treat kidney rebel (1 bottle x 50 tablets)

Dosage form Box of 50 capsules
Specifications Levomepromazine

Ingredient

Composition informationContent
Levomepromazine25mg

Uses

indicated

tisCin is indicated in the following cases:

  • Treatment of acute mental diseases accompanied by mental and serious mental anxiety including: acute schizophrenia and other acute mental disorders. A weak sedative belongs to the phenothiazin group. Levomepromazine is a isomer of chlorpromazin with a stronger mental inhibition effect than chlorpromazin. Due to the effects on dopamine receptors in the hill, under the hill, the mesh and the edge system, Levomepramazine inhibits sensory stimuli, reduces motor activity and strong sedation. In addition, the drug also has antagonistic effects on other neurotransmitters (norepinephrin secretion, serotonin secretion, histamine secretion, cholin secretion).

    The result is levomepromazine that has anti -vomiting, antihistamine, norepinephrin and cholin secretion. Side effects are lighter than other strong sedatives. The drug has a strong anti-secretion effect on Alpha-Norepinephrin

    levomepromazin increases the threshold of pain (pain relief is similar to that of morphine) and has a memory loss. Due to the ability to increase the effects of painkillers, the drug may be used to support in acute and chronic severe pain. The maximum pain relief effect is achieved after the injection of Levomepromazine 20 - 40 minutes and lasts for about 4 hours.

    Children: There is no pharmacological data of drugs in children.

    Pharmacokinetics

    absorption

    After intramuscularly and drink, the maximum concentration of drugs in plasma is reached within 30 - 90 minutes and 1-3 hours.

    Distribution

    Expression distribution is 23 - 42 l/kg body weight.

    Metabolism

    levomepromazine is strongly metabolized to produce sulphate and glucuronid complexes.

    Elimination

    The metabolites of levomepromazine are discharged through the kidneys. A small part of the dose (1%) is discharged through urine and feces in the form of non -variable drugs. The sale time is 15 - 30 hours.

    • Before taking TISERCIN 25mg Egis treat kidney rebel (1 bottle x 50 tablets)

    How to use

    Tablelcin film tablets are used by oral.

    Dosage

    Adults

    Must start treatment in low doses, then increase gradually depending on the patient tolerance. When there is improvement, the maintenance dose is determined for each individual.

    In mental disorders:

  • The starting dose is 25 - 50 mg (1-2 film tablets) per day, divided into twice.
  • If necessary, the starting dose may increase to 150 - 250 mg daily (divided into 2-3 times), then when starting to see the effect, it may be reduced to the maintenance dose. When taking the dose of 150 - 250 mg, it is necessary to stay in the bed for the first few days to avoid lowering blood pressure.

    • Children (children and teenagers under 12 years old)

    Children are very sensitive to the hypotension and sedative effect of levomepromazine.

    Due to the exact doses that cannot be divided from 25 mg TISCIN film tablets, it is not recommended to use this drug for children and teenagers under 18 years old.

    Older people

    The elderly is more sensitive to the effect of phenothiazin.

    Due to the exact dosage that cannot be divided from 25 mg Tintcin film tablets, it is not recommended to use this medication for the elderly over 65 years old.

    Patients with liver failure or kidney failure

    There is no data related to the use of drugs for patients with liver or kidney failure, but need to be cautious because the drug is metabolized in the liver and excreted through the urine.

    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

    Change of signs of survival (most commonly the lower blood pressure, high fever), heart-transmitting disorders (prolonged QT interval, tachycardia/ventricular vibration, peak twisting, atrial block), symptoms of extracurricular, sedation, central nervous system stimulation (epilepsy convulsing) and malignant sedative syndrome may occur.

    Handling

    It is necessary to monitor the following parameters: acid alkaline, water and electrolyte balance, kidney function, urine amount, concentration of liver enzymes, electrocardiograms, in patients with malignant sedative syndrome, monitor extra creatinine phosphokinase in serum and body temperature.

    Symptomatic treatment depends on the results of monitoring parameters. For hypotension, intravenous fluid can be added, lying in the trendelenburg posture, using dopamine and/or norepinephrin.

    Due to the easy -to -cause echoing effect of levomepromazine, the resuscitation kit must be available and need to monitor the electrocardiogram if there is dopamine and/or norepinephrine.

    Scratches are treated with diazepam, or if the convulsions recur, use phenytoin, or phenobarbital. Must for mannitol in the event of a muscle globin globin.

    There is no specific detoxification. Increases the amount of urine, hemolysis and blood transfusion is not beneficial.

    Do not cause vomiting during seizures, and tone of tone of tone and neck may lead to absorbing vomiting into the lungs. The gastric lavage - In addition to the monitoring of survival parameters - should be done even for 12 hours of medication because the stomach drum is reduced due to the anti -cholin effect of levomepromazine. Activated carbon and enema are recommended to reduce the absorption of drugs.

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

    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

    Common, ADR> 1/100

  • Pleeing disorders: Hypotenary pressure (accompanied by weak people, dizziness and fainting).

    • Uncommon, 1/1000

  • No report.

    • Not determined frequency

  • Blood disorders and lymphatic systems: reducing all bloody hemorrhage, granulocytosis, leukopenia, thrombocytopenia, eosinophilia preferred eosin.

    • The immune system: Anaphylaxis, laryngeal, peripheral edema, asthma.

    Endocrine disorders: Pituitary gland.

  • Metabolic and nutrition disorders: weight loss, vitamin deficiency.
  • Mental disorders: recurring symptoms of mental disorders, reducing tone, confusion, loss of orientation, hallucinations, unclear speaking, sleeping.

    • Nervous disorders: epilepsy convulsions, increased intracranial pressure, pagoda symptoms (dysplasia, muscular dysplasia, Parkinson's syndrome, bend, increased reflexes), cessation syndrome.

  • Eye disorders: pigmentation disease, deposited in the lens and cornea.
  • Heart disorders: Adams-Stokes syndrome, prolonged QT interval (easily causing arrhythmia, torsional rhythm), tachycardia.

    • Vascular disorders: Venous thrombosis including pulmonary thrombosis and deep vein thrombosis.

    Gastrointestinal disorders: Nausea, vomiting, constipation, abdominal discomfort, dry mouth.

    Liver disorders: liver damage (jaundice, bile stasis).

  • Skin and subcutaneous tissue disorders: Dermatitis, itching, erythema, sensitive to light, pigmentation.
  • Kidney and urinary disorders: Difficult to urinate, discolor urine.

    • Pregnancy, childbirth and postpartum condition: Drug stop syndrome in newborns.

  • Breast disorders and reproductive systems: Increased milk secretion, menstrual disorders, uterine spasms.
  • Systemic disorders and at the position of using drugs: Malangary neuron syndrome, high fever.

    • 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

    contraindicated

    TISLCIN drugs contraindicated in the following cases:

  • Hypersensitivity to levomepromazine or with phenothiazine, or with any excipients of the drug.
  • Used with hypertension medications.
  • Simultaneously used with Mao inhibitors.
  • When overdose with central nervous system inhibitors (alcohol, body anesthesia, sleeping pills).

    • Glaucom disease narrow angle.

  • The urinary tract.
  • Parkinson's disease.
  • Scattered sclerosis.
  • Myasthenia gravis, hemiplegia.
  • Severe cardiomyopathy (circulatory disability).

    • Severe kidney failure or liver failure.

    Hypotension with clinical manifestations.

  • Hemorrhage disease.
  • Porphyrin metabolic disorders.
  • Lactating women.
  • Children under 12 years old.
  • Patients with coma.

    • Be cautious when using

    must immediately stop the drug if any hypersensitivity reaction occurs.

    Must consider the benefits before taking the drug for pregnant women.

    Particularly cautious when used simultaneously with central nervous system inhibitors, anti -secretion drugs.

    Pay special attention when taking medication for patients with renal impairment and/or liver failure because there is a risk of drug accumulation and toxicity.

    Increased risk of death in the elderly dementia.

    TisCin is not used to treat behavioral disorders associated with dementia. Elderly patients and especially those who are more likely to have posture hypotension and more sensitive to anti -cholin effects and sedative effects of phenothiazin. In addition, these patients are easy to have extra -tower side effects, so the starting dose is low and gradually increasing the dose is especially important in these people.

    Therefore, to avoid posture hypotension, the patient must rest for half an hour after taking the first dose. If you are dizzy after taking the medication, you should lie down in bed after each dose.

    Be cautious in patients with a history of cardiovascular disease and especially in the elderly and in patients with congestive heart failure, conduction disorders, arrhythmia, congenital QT syndrome, or unstable circulatory. Before starting tiscin treatment, electrocardiogram must be measured to eliminate cardiovascular diseases that can be contraindicated for treatment.

    Like other phenothiazin, the QT interval, the arrhythmia and very rarely torsion peaks have been recorded to be related to treatment with levomepromazin.

    Venous thrombosis has been reported when taking anti -psychotic drugs. Because patients are treated with anti -psychotic drugs, there are often risks of venous thrombosis, it is necessary to identify all risk factors for venous thrombosis before and during ticcin treatment, and apply appropriate preventive measures.

    If high fever occurs during mental disorders, it is necessary to eliminate the possibility that the neuroleptic malignant syndrome (NMS). NMS is a disease that is at risk of death with the following characteristics: hard muscle, high fever, confusion, plant nervous system disorders (unstable blood pressure, tachycardia, arrhythmia, sweating), reducing tone.

    Testing results: Increased creatinine phosphokinase (CPK), Myoglobin-Nurt (Mechanical Globin Mechanical Globin) and acute renal failure. All of these symptoms show that NMS occurs, so they must immediately stop the tiscin if they see these symptoms, and even when the clinical manifestations of the NMS are not seen but there is a high fever there is unknown reasons. If after recovery of NMS and the patient's condition requires psychotic treatment, it is necessary to consider carefully when choosing the drug.

    In literature, there is a tolerance of the sedative effects of phenothiazin and the diagonal tolerance between anti -mental drugs. This tolerance can explain the symptoms of dysfunction occurring when the drug is suddenly stopped while taking high and prolonged doses: nausea, vomiting, headache, trembling, sweating, tachycardia, insomnia, restlessness. Because of this phenomenon, it is always necessary to stop the drug slowly.

    Many anti -psychotic drugs, including levomepromazine, can reduce seizures threshold and cause epilepsy changes on the map. Therefore, in patients with epilepsy, clinical monitoring and brain testing are necessary when adjusting the doserin dose.

    The toxic reaction to the jaundice liver caused by cholestasis caused by chlorpromazin can also occur with other phenothiazin. This reaction depends on the sensitivity of the patient's individual and disappears completely after stopping treatment. Therefore, when using the drug for a long time, it is necessary to regularly do tests on liver function.

    granulocytes and leukopenia are also recorded in some patients treated with phenothiazin. Therefore, although they rarely occur, it is also necessary to regularly check hematology if long -term treatment.

    Prohibit the use of alcoholic beverages during treatment and until the effects of the drug remain (for 4-5 days after the takenin stops).

    Before starting to take the drug and during treatment, regular examination:

  • Blood pressure (especially in patients with unstable circulation and those who are prone to hypotension).

    • Liver function (especially in patients with liver failure).

  • Check the qualitative hematology (in case of fever, sore throat and if suspected of leukopenia or granulocytosis; when the treatment is started and while long -term use).
  • ECG (in cardiovascular diseases and in the elderly).
  • Measure blood potassium concentration. Periodically check electrolytes and special adjustments when prolonged treatment.

    • Symptoms such as recurrence of mental symptoms, suspense, anxiety, insomnia, nausea, vomiting, headache, tremor, sweating and fast heartbeat have been reported when stopping levomepromazine suddenly. Because the tablet tablets contain 40 mg of lactose monohydrate, patients do not tolerate galactose due to rare genetics, lactase deficiency or malcose-galactose malabsorption.

    Use drugs for children: Do not use this drug for children under 12 years old.

    The ability to drive and operate machinery

    The drug can cause drowsiness, disorientation, confusion or excessive blood pressure, which can affect the ability to drive or operate machinery. At the beginning of treatment, do not drive or do jobs at risk of accidents for a long time or short time depending on the response of the patient.

    Pregnancy

    birth defects were recorded in children with mothers using phenothiazin, but not yet proven the causal relationship due to phenothiazine. However, when there is no data from control clinical trials, do not take the drug when pregnant unless it is carefully considered.

    Babies born by pregnant women use anti -psychotic drugs (including levomepromazine) in the last 3 months of pregnancy are at risk of unwanted effects, including symptoms of pagoda and/or symptoms of quitting drugs in severity and prolonged time after birth.

    Unwanted effects are reported: stimulating, increasing tone, reducing tone, tremor, sleeping, acute respiratory failure, eating disorders. Therefore, babies need to be carefully monitored.

    Lactating period

    levomepromazin is secreted into tamarind milk, so contraindicated use when breastfeeding because there is no data from control tests.

    Interactive drug

    Not used with the following drugs

  • Anti -hypertension drugs, due to the risk of severe hypotension.

  • Milk inhibitors, because then the effects of tablecin can be prolonged and side effects may become worse.

    • Be cautious when coordinating with the following drugs

  • The drugs have anti -cholin secretion effect (3 -round antidepressants, H1 antihistamine, some Parkinson, Atropin, Scopolamine, Succinylcholin) drugs: due to the increase in anti -cholin secretions - such as paralysis, urinary tract, glaucoma. The expression of the pagoda is an unwanted effect recorded after coordinating with Scopolamine.
  • The central nervous system inhibitors (sleeping pills, systemic anesthesia, anti-anxiety drugs, painkillers, sleeping drugs, sedatives, 3-round antidepressants): because of increasing the effects on the central nervous system.
  • Medicines stimulating the central nervous system (such as amphetamine derivatives): because the stimulating effects will be reduced.
    • levodopa: Because the effect of this drug will be reduced.

    Oral diabetes medications: Because the effect of these drugs will be reduced and may occur hyperglycemia.

    The drugs extend the QT (some anti -arrhythmic drugs, macrolid antibiotics, some azol, cisaprid fungal drugs, some antidepressants, some antihistamine drugs, and indirect diuretics that have hypotension effects): Because of the effects that can add force and may increase the frequency of heart arrhythmia.

    dileevalol: Due to mutual metabolic inhibition, the effects of each drug will increase. If shared, may need to reduce the dose of one or both medications. It does not exclude similar interaction with other beta blockers.

  • Medications that work to be sensitive to light: because it can increase light sensitivity.

    • Alcohol: Inhibiting the central nervous system of both substances will increase and increase the likelihood of extra -tower side effects.

    Other drugs

    Concomitance of this drug with vitamin C will reduce the deficiency of vitamins caused by tablecin.

    Children

    Medicine interactions are only studied in adults.

    Storage

    Store at a temperature not exceeding 30 ° C.

    Other drugs

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