активацию профибринолизина (плазминогена) и его превращение в фибринолизин
(плазмин). Обладает местным и системным гемостатическим действием при
кровотечениях, связанных с повышением фибринолиза (патология тромбоцитов,
меноррагии). Также транексамовая кислота за счет подавления образования кининов и
других активных пептидов, участвующих в аллергических и воспалительных реакциях,
обладает противоаллергическим и противовоспалительным действием.
Фармакокинетика
Абсорбция при пероральном приеме доз в диапазоне 0,5-2 г - 30-50%. Время достижения
максимальной концентрации при приеме внутрь 0,5, 1 и 2 г - 3 ч, максимальная
концентрация - 5, 8 и 15 мкг/мл соответственно. Связь с белками плазмы
(профибринолизином) - менее 3%.
Распределяется в тканях относительно равномерно (исключение - спинномозговая жидкость, где концентрация составляет 1/10 от плазменной); проникает через
плацентарный барьер, в грудное молоко (около 1% от концентрации в плазме матери).
Обнаруживается в семенной жидкости, где снижает фибринолитическую активность, но не
влияет на миграцию сперматозоидов. Начальный объем распределения - 9-12 л.
Антифибринолитическая концентрация в различных тканях сохраняется 17 ч, в плазме - до
7-8 ч.
Метаболизируется незначительная часть. Кривая «концентрация-время» имеет трехфазную
форму с периодом полувыведения в конечной фазе - 3 ч. Общий почечный клиренс равен
Наличие крови в полостях, например, в плевральной полости, полостях суставов и
мочевыводящих путях (в т. ч. в почечных лоханках и в мочевом пузыре) может приводить
к образованию в них «нерастворимого сгустка» вследствие внесосудистого свертывания
крови, который может быть устойчив к физиологическому фибринолизу.
Пациенткам с нерегулярным менструальным кровотечением не следует назначать
транексамовую кислоту до установления причины дисменореи. Если объем менструального
кровотечения неадекватно снижается на фоне лечения транексамовой кислотой,
необходимо рассмотреть возможность альтернативного лечения.
Данных по эффективности и безопасности применения транексамовой кислоты при
лечении меноррагий у пациенток младше 15 лет недостаточно, поэтому препарат следует
применять с осторожностью.
Следует с осторожностью применять транексамовую кислоту у женщин, одновременно
принимающих комбинированные пероральные контрацептивы, в связи с повышенным
риском развития тромбозов (См. раздел «Взаимодействие с другими лекарственными
средствами»).
У пациентов с ДВС-синдромом, которые нуждаются в лечении транексамовой кислотой, терапия должна осуществляться под тщательным контролем врача, имеющего опыт
лечения данного заболевания.
В связи с отсутствием адекватных клинических исследований, одновременное применение
транексамовой кислоты с антикоагулянтами должно осуществляться под тщательным
наблюдением специалиста, имеющего опыт лечения нарушений свертывания крови.
Если на фоне приема транексамовой кислоты отмечается нарушение зрения, необходимо
прекратить прием препарата и обратиться к врачу.
Влияние на способность управлять автомобилем и движущимися механизмами
Способность транексамовой кислоты влиять на скорость психомоторных реакций и на
способность управлять транспортными или другими механическими средствами не
изучалась. Транексамовая кислота может вызывать головокружение и нарушения зрения,
и, соответственно, может влиять на способность заниматься потенциально опасными
видами деятельности, требующими повышенной концентрации внимания и быстроты
психомоторных реакций.
Форма выпуска
Таблетки, покрытые пленочной оболочкой, 250 мг. По 10 таблеток в контурную ячейковую
упаковку из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной.
По 1, 2, 3, 5 контурных ячейковых упаковок вместе с инструкцией по медицинскому
применению лекарственного препарата в пачку из картона.
Условия хранения
При температуре не выше 30 °С.
Хранить в недоступном для детей месте.
Срок годности
3 года.
Не использовать по истечении срока годности.
Условия отпуска
Отпускают по рецепту.
Производитель
ЗАО «Обнинская химико-фармацевтическая компания», Россия
249036, Калужская обл., г. Обнинск, ул. Королева, д. 4
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
Начните сравнивать цены и заказывать лекарства прямо в приложении
Наведите камеру на QR-код, чтобы скачать
Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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номер","slug":"","body":[{"type":"paragraph","data":{"text":"ЛС-001070"}}]},{"id":2,"name":"Торговое название препарата","slug":"","body":[{"type":"paragraph","data":{"text":"Транексам"}}]},{"id":3,"name":"Лекарственная форма","slug":"","body":[{"type":"paragraph","data":{"text":"таблетки, покрытые пленочной оболочкой"}}]},{"id":4,"name":"Состав","slug":"ingredients","body":[{"type":"paragraph","data":{"text":"Действующее вещество: транексамовая кислота 250,0 мг."}},{"type":"paragraph","data":{"text":"Вспомогательные вещества (ядро): целлюлоза микрокристаллическая, гипролоза,"}},{"type":"paragraph","data":{"text":"карбоксиметилкрахмал натрия, тальк, кремния диоксид коллоидный, стеарат кальция."}},{"type":"paragraph","data":{"text":"Вспомогательные вещества (оболочка): гипромеллоза, титана диоксид, тальк, макрогол."}}]},{"id":5,"name":"Описание","slug":"common_description","body":[{"type":"paragraph","data":{"text":"Круглые двояковыпуклые таблетки, покрытые пленочной оболочкой белого цвета. На"}},{"type":"paragraph","data":{"text":"поперечном разрезе ядро белого или белого с кремоватым или сероватым оттенком цвета."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"гемостатическое средство"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Фармакодинамика"}},{"type":"paragraph","data":{"text":"Антифибринолитическое средство. Транексамовая кислота специфически ингибирует"}},{"type":"paragraph","data":{"text":"активацию профибринолизина (плазминогена) и его превращение в фибринолизин"}},{"type":"paragraph","data":{"text":"(плазмин). Обладает местным и системным гемостатическим действием при"}},{"type":"paragraph","data":{"text":"кровотечениях, связанных с повышением фибринолиза (патология тромбоцитов,"}},{"type":"paragraph","data":{"text":"меноррагии). Также транексамовая кислота за счет подавления образования кининов и"}},{"type":"paragraph","data":{"text":"других активных пептидов, участвующих в аллергических и воспалительных реакциях,"}},{"type":"paragraph","data":{"text":"обладает противоаллергическим и противовоспалительным действием."}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"Абсорбция при пероральном приеме доз в диапазоне 0,5-2 г - 30-50%. Время достижения"}},{"type":"paragraph","data":{"text":"максимальной концентрации при приеме внутрь 0,5, 1 и 2 г - 3 ч, максимальная"}},{"type":"paragraph","data":{"text":"концентрация - 5, 8 и 15 мкг/мл соответственно. Связь с белками плазмы"}},{"type":"paragraph","data":{"text":"(профибринолизином) - менее 3%."}},{"type":"paragraph","data":{"text":"Распределяется в тканях относительно равномерно (исключение - спинномозговая жидкость, где концентрация составляет 1/10 от плазменной); проникает через"}},{"type":"paragraph","data":{"text":"плацентарный барьер, в грудное молоко (около 1% от концентрации в плазме матери)."}},{"type":"paragraph","data":{"text":"Обнаруживается в семенной жидкости, где снижает фибринолитическую активность, но не"}},{"type":"paragraph","data":{"text":"влияет на миграцию сперматозоидов. Начальный объем распределения - 9-12 л."}},{"type":"paragraph","data":{"text":"Антифибринолитическая концентрация в различных тканях сохраняется 17 ч, в плазме - до"}},{"type":"paragraph","data":{"text":"7-8 ч."}},{"type":"paragraph","data":{"text":"Метаболизируется незначительная часть. Кривая «концентрация-время» имеет трехфазную"}},{"type":"paragraph","data":{"text":"форму с периодом полувыведения в конечной фазе - 3 ч. Общий почечный клиренс равен"}},{"type":"paragraph","data":{"text":"плазменному (7 л/ч). Выводится почками (основной путь - гломерулярная фильтрация) -"}},{"type":"paragraph","data":{"text":"более 95% в неизмененном виде в течение первых 12 ч."}},{"type":"paragraph","data":{"text":"Идентифицировано 2 метаболита транексамовой кислоты: N-ацетилированное и"}},{"type":"paragraph","data":{"text":"дезаминированное производное. При нарушенной функции почек существует риск"}},{"type":"paragraph","data":{"text":"кумуляции транексамовой кислоты."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Краткосрочное лечение кровотечений, связанных с повышенным фибринолизом, при"}},{"type":"paragraph","data":{"text":"следующих патологических состояниях:"}},{"type":"paragraph","data":{"text":"• Простатэктомия; оперативные вмешательства на мочевом пузыре;"}},{"type":"paragraph","data":{"text":"• Меноррагия;"}},{"type":"paragraph","data":{"text":"• Носовое кровотечение;"}},{"type":"paragraph","data":{"text":"• Конизация шейки матки;"}},{"type":"paragraph","data":{"text":"• Травматическая гифема (кровоизлияние в переднюю камеру глаза)."}},{"type":"paragraph","data":{"text":"Профилактика и лечение кровотечений у пациентов с гемофилией, которые подвергаются"}},{"type":"paragraph","data":{"text":"малому оперативному вмешательству (в т. ч., экстракция зуба);"}},{"type":"paragraph","data":{"text":"Наследственный ангионевротический отек (профилактика обострений заболевания)."}},{"type":"paragraph","data":{"text":"Кровотечения при беременности."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к транексамовой кислоте или другим компонентам препарата;"}},{"type":"paragraph","data":{"text":"• Хроническая почечная недостаточность тяжелой степени (скорость клубочковой"}},{"type":"paragraph","data":{"text":"фильтрации [СКФ] менее 30 мг/мл/1,73м2"}},{"type":"paragraph","data":{"text":") в связи с риском кумуляции;"}},{"type":"paragraph","data":{"text":"• Венозный или артериальный тромбоз в настоящее время или в анамнезе (тромбоз"}},{"type":"paragraph","data":{"text":"глубоких вен ног, тромбоэмболия легочной артерии, тромбоз внутричерепных сосудов"}},{"type":"paragraph","data":{"text":"и др.) при невозможности одновременной терапии антикоагулянтами;"}},{"type":"paragraph","data":{"text":"• Фибринолиз вследствие коагулопатии потребления (гипокоагуляционная стадия синдрома диссеминированного внутрисосудистого свертывания [ДВС-синдром]);"}},{"type":"paragraph","data":{"text":"• Судороги в анамнезе;"}},{"type":"paragraph","data":{"text":"• Приобретенное нарушение цветового зрения;"}},{"type":"paragraph","data":{"text":"• Субарахноидальное кровоизлияние (в связи с риском развития отека мозга, ишемии и"}},{"type":"paragraph","data":{"text":"инфаркта головного мозга);"}},{"type":"paragraph","data":{"text":"• Детский возраст до 3 лет (твердая лекарственная форма)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Транексамовую кислоту следует применять с осторожностью в следующих ситуациях:"}},{"type":"paragraph","data":{"text":"• Гематурия, вызванная заболеваниями паренхимы почек, и кровотечения из верхних"}},{"type":"paragraph","data":{"text":"отделов мочевыводящих путей (риск вторичной механической обструкции"}},{"type":"paragraph","data":{"text":"мочевыводящих путей сгустком крови с развитием анурии) (См. раздел «Особые"}},{"type":"paragraph","data":{"text":"указания»);"}},{"type":"paragraph","data":{"text":"• Пациенты с высоким риском развития тромбоза (тромбоэмболические события в"}},{"type":"paragraph","data":{"text":"анамнезе или семейный анамнез тромбоэмболических заболеваний, верифицированный"}},{"type":"paragraph","data":{"text":"диагноз тромбофилии);"}},{"type":"paragraph","data":{"text":"• Синдром диссеминированного внутрисосудистого свертывания [ДВС-синдром]);"}},{"type":"paragraph","data":{"text":"• Наличие крови в полостях, например, в плевральной полости, полостях суставов и"}},{"type":"paragraph","data":{"text":"мочевыводящих путях;"}},{"type":"paragraph","data":{"text":"• Пациенты, получающие терапию антикоагулянтами (опыт применения ограничен);"}},{"type":"paragraph","data":{"text":"• Одновременное применение препаратов факторов свертывания крови II, VII, IX и X в"}},{"type":"paragraph","data":{"text":"комбинации [протромбинового комплекса] или антиингибиторного коагулянтного"}},{"type":"paragraph","data":{"text":"комплекса (См. раздел «Взаимодействие с другими лекарственными средствами»);"}},{"type":"paragraph","data":{"text":"• Лечение меноррагий у пациенток в возрасте младше 15 лет (опыт применения"}},{"type":"paragraph","data":{"text":"ограничен);"}},{"type":"paragraph","data":{"text":"• Пациентки, принимающие комбинированные пероральные контрацептивы (в связи с"}},{"type":"paragraph","data":{"text":"повышенным риском венозных тромбоэмболических осложнений и артериальных"}},{"type":"paragraph","data":{"text":"тромбозов) (См. раздел «Взаимодействие с другими лекарственными средствами»).\n"}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В доклинических исследованиях транексамовая кислота не оказывала тератогенного"}},{"type":"paragraph","data":{"text":"воздействия. Адекватные и строго контролируемые исследования эффективности и"}},{"type":"paragraph","data":{"text":"безопасности применения препаратов транексамовой кислоты у беременных не"}},{"type":"paragraph","data":{"text":"проводились. Транексамовая кислота проникает через плаценту и может содержаться в"}},{"type":"paragraph","data":{"text":"пуповинной крови в концентрации, близкой к материнской."}},{"type":"paragraph","data":{"text":"Поскольку исследования репродуктивной функции у животных не всегда позволяют"}},{"type":"paragraph","data":{"text":"предсказать реакции у человека, транексамовую кислоту следует применять во время"}},{"type":"paragraph","data":{"text":"беременности только в случае крайней необходимости."}},{"type":"paragraph","data":{"text":"Транексамовая кислота проникает в грудное молоко (концентрация препарата в молоке"}},{"type":"paragraph","data":{"text":"составляет около 1% от концентрации в плазме крови матери). Развитие"}},{"type":"paragraph","data":{"text":"антифибринолитического эффекта у младенца маловероятно. Тем не менее, следует"}},{"type":"paragraph","data":{"text":"соблюдать осторожность при применении транексамовой кислоты у кормящих матерей."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, независимо от приема пищи."}},{"type":"paragraph","data":{"text":"Краткосрочное лечение кровотечений, обусловленных повышенным фибринолизом:"}},{"type":"paragraph","data":{"text":"рекомендуемая стандартная доза транексамовой кислоты составляет 15-25 мг/кг массы"}},{"type":"paragraph","data":{"text":"тела, в среднем 1000-1500 мг 2-3 раза в сутки."}},{"type":"paragraph","data":{"text":"• При простатэктомии и оперативных вмешательствах на мочевом пузыре: 1000 мг"}},{"type":"paragraph","data":{"text":"за 6 ч до операции, затем по 1000 мг 3-4 раз в сутки до исчезновения макрогематурии."}},{"type":"paragraph","data":{"text":"Не рекомендуется применение препарата более 2 недель после оперативного"}},{"type":"paragraph","data":{"text":"вмешательства."}},{"type":"paragraph","data":{"text":"• При меноррагии: рекомендуемая доза составляет 1000 мг 3 раза в сутки до прекращения"}},{"type":"paragraph","data":{"text":"меноррагии, но не более 4 суток. При профузном кровотечении доза препарата может"}},{"type":"paragraph","data":{"text":"быть увеличена, при этом общая суточная доза не должна превышать 4000 мг. Лечение"}},{"type":"paragraph","data":{"text":"транексамовой кислотой не следует начинать до возникновения менструального"}},{"type":"paragraph","data":{"text":"кровотечения. В клинических исследованиях транексамовая кислота не применялась"}},{"type":"paragraph","data":{"text":"более трех менструальных циклов подряд."}},{"type":"paragraph","data":{"text":"• При рецидивирующих носовых кровотечениях: по 1000 мг 3 раза в сутки в течение"}},{"type":"paragraph","data":{"text":"7 дней."}},{"type":"paragraph","data":{"text":"• После операции конизации шейки матки: по 1500 мг 3 раза в сутки в течение 12 дней"}},{"type":"paragraph","data":{"text":"после операции."}},{"type":"paragraph","data":{"text":"• При травматической гифеме: по 1000-1500 мг 3 раза в сутки (целевая доза 25 мг/кг"}},{"type":"paragraph","data":{"text":"массы тела) в течение 7 дней."}},{"type":"paragraph","data":{"text":"Пациенты с гемофилией: препарат назначают внутрь в дозе 25 мг/кг массы тела за 2 ч до"}},{"type":"paragraph","data":{"text":"экстракции зуба, и затем по 1000-1500 мг 3 раза в сутки в течение 6-8 дней. Следует"}},{"type":"paragraph","data":{"text":"одновременно назначить препараты факторов свертывания крови VIII или IX."}},{"type":"paragraph","data":{"text":"При наследственном ангионевротическом отеке: по 1000-1500 мг 2-3 раза в день. Если"}},{"type":"paragraph","data":{"text":"пациент может предвидеть обострение заболевания, препарат можно принимать с"}},{"type":"paragraph","data":{"text":"перерывами в зависимости от наличия продромальных симптомов. В остальных случаях препарат следует принимать постоянно."}},{"type":"paragraph","data":{"text":"Кровотечения при беременности: 250-500 мг 3-4 раза в сутки до полной остановки"}},{"type":"paragraph","data":{"text":"кровотечения. Средняя продолжительность курса лечения - 7 дней."}},{"type":"paragraph","data":{"text":"Применение препарата у особых групп пациентов"}},{"type":"paragraph","data":{"text":"Нарушение функции печени"}},{"type":"paragraph","data":{"text":"У пациентов с нарушением функции печени коррекция дозы не требуется."}},{"type":"paragraph","data":{"text":"Пожилой возраст"}},{"type":"paragraph","data":{"text":"У пожилых пациентов при отсутствии почечной недостаточности коррекция дозы не"}},{"type":"paragraph","data":{"text":"требуется."}},{"type":"paragraph","data":{"text":"Детский возраст"}},{"type":"paragraph","data":{"text":"Данные в отношении эффективности и безопасности применения препаратов"}},{"type":"paragraph","data":{"text":"транексамовой кислоты у детей ограничены."}},{"type":"paragraph","data":{"text":"У детей транексамовая кислота назначается из расчета 25 мг/кг массы тела 2-3 раза в сутки."}},{"type":"paragraph","data":{"text":"Действия при пропуске приема очередной дозы"}},{"type":"paragraph","data":{"text":"При пропуске приема одной дозы необходимо принять следующую дозу препарата в"}},{"type":"paragraph","data":{"text":"установленное время. Не следует принимать удвоенную дозу препарата после пропуска"}},{"type":"paragraph","data":{"text":"приема очередной дозы"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота возникновения нежелательных лекарственных реакций определена в соответствии"}},{"type":"paragraph","data":{"text":"с классификацией ВОЗ: очень часто (>1/10), часто (>1/100, ≤1/10), нечасто (>1/1000,"}},{"type":"paragraph","data":{"text":"≤1/100), редко (>1/10000, ≤1/1000), очень редко (менее 1/10000), частота неизвестна (не"}},{"type":"paragraph","data":{"text":"может быть установлена по имеющимся данным)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны желудочно-кишечного тракта: часто - тошнота, рвота, диарея"}},{"type":"paragraph","data":{"text":"(симптомы проходят при снижении дозы)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и подкожных тканей: редко - кожные аллергические"}},{"type":"paragraph","data":{"text":"реакции, в т. ч. аллергический дерматит."}},{"type":"paragraph","data":{"text":"Нарушения со стороны органа зрения: редко - нарушения зрения, в т. ч. нарушение"}},{"type":"paragraph","data":{"text":"цветового восприятия, тромбоз сосудов сетчатки."}},{"type":"paragraph","data":{"text":"Нарушения со стороны сосудов: редко - тромбоэмболические осложнения, выраженное"}},{"type":"paragraph","data":{"text":"снижение артериального давления (обычно вследствие чрезмерно быстрого внутривенного"}},{"type":"paragraph","data":{"text":"введения, в исключительных случаях после приема внутрь); очень редко - артериальные"}},{"type":"paragraph","data":{"text":"и венозные тромбозы различной локализации; частота неизвестна - острый инфаркт"}},{"type":"paragraph","data":{"text":"миокарда, тромбоз церебральных артерий, тромбоз сонных артерий, инсульт, тромбоз"}},{"type":"paragraph","data":{"text":"глубоких вен ног, тромбоэмболия легочной артерии, тромбоз почечной артерии с развитием"}},{"type":"paragraph","data":{"text":"кортикального некроза и острой почечной недостаточности, окклюзия аорто-коронарного"}},{"type":"paragraph","data":{"text":"шунта, тромбоз центральной артерии и вены сетчатки."}},{"type":"paragraph","data":{"text":"Нарушения со стороны иммунной системы: очень редко - реакции"}},{"type":"paragraph","data":{"text":"гиперчувствительности, в т. ч. анафилактический шок."}},{"type":"paragraph","data":{"text":"Нарушения со стороны нервной системы: редко - головокружение, судороги (обычно при"}},{"type":"paragraph","data":{"text":"внутривенном введении).\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Имеются ограниченные данные о случаях передозировки. Сообщается об одном случае"}},{"type":"paragraph","data":{"text":"передозировки (прием внутрь 37 г транексамовой кислоты)."}},{"type":"paragraph","data":{"text":"Симптомы: головокружение, головная боль, тошнота, рвота, диарея, ортостатические"}},{"type":"paragraph","data":{"text":"симптомы (в т. ч., головокружение при переходе из горизонтального в вертикальное"}},{"type":"paragraph","data":{"text":"положение), ортостатическая артериальная гипотензия. У предрасположенных пациентов"}},{"type":"paragraph","data":{"text":"повышается риск тромбозов."}},{"type":"paragraph","data":{"text":"Лечение: антидот неизвестен. При подозрении на передозировку транексамовой кислоты"}},{"type":"paragraph","data":{"text":"необходима госпитализация. При оказании помощи следует вызвать рвоту, затем провести"}},{"type":"paragraph","data":{"text":"промывание желудка. Активированный уголь снижает абсорбцию транексамовой кислоты"}},{"type":"paragraph","data":{"text":"при приеме внутрь в течение первых 1-2 ч после передозировки. Если пациент находится в"}},{"type":"paragraph","data":{"text":"бессознательном состоянии или при нарушении глотания активированный уголь может"}},{"type":"paragraph","data":{"text":"быть введен через назогастральный зонд. Рекомендуется прием внутрь или парентеральное"}},{"type":"paragraph","data":{"text":"введение большого количества жидкости для усиления почечной экскреции,"}},{"type":"paragraph","data":{"text":"форсированный диурез, контроль количества выделяемой мочи. В некоторых случаях"}},{"type":"paragraph","data":{"text":"может быть оправданным применение антикоагулянтов."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Специальные клинические исследования, посвященные изучению взаимодействий"}},{"type":"paragraph","data":{"text":"транексамовой кислоты с другими лекарственными средствами, не проводились."}},{"type":"paragraph","data":{"text":"Транексамовая кислота препятствует развитию фармакологического эффекта"}},{"type":"paragraph","data":{"text":"фибринолитических (тромболитических) препаратов."}},{"type":"paragraph","data":{"text":"Комбинированные пероральные контрацептивы увеличивают риск венозных"}},{"type":"paragraph","data":{"text":"тромбоэмболических осложнений и артериальных тромбозов (в частности, ишемического"}},{"type":"paragraph","data":{"text":"инсульта и инфаркта миокарда). Опыт применения транексамовой кислоты у женщин,"}},{"type":"paragraph","data":{"text":"принимающих комбинированные пероральные контрацептивы, отсутствует. Поскольку"}},{"type":"paragraph","data":{"text":"транексамовая кислота обладает антифибринолитическим эффектом, одновременное"}},{"type":"paragraph","data":{"text":"применение с комбинированными пероральными контрацептивами может привести к"}},{"type":"paragraph","data":{"text":"дополнительному повышению риска тромботических осложнений."}},{"type":"paragraph","data":{"text":"Одновременное применение транексамовой кислоты с препаратами факторов свертывания"}},{"type":"paragraph","data":{"text":"крови II, VII, IX и X в комбинации [протромбиновым комплексом] или антиингибиторным"}},{"type":"paragraph","data":{"text":"коагулянтным комплексом повышает риск развития тромбоза."}},{"type":"paragraph","data":{"text":"Возможно повышение риска тромботических осложнений (в частности, инфаркта"}},{"type":"paragraph","data":{"text":"миокарда) при одновременном применении транексамовой кислоты с гидрохлоротиазидом,"}},{"type":"paragraph","data":{"text":"десмопрессином, ампициллином-сульбактамом, ранитидином и нитроглицерином."}},{"type":"paragraph","data":{"text":"При сочетанном применении с гемостатическими препаратами возможна активация"}},{"type":"paragraph","data":{"text":"тромбообразования."}},{"type":"paragraph","data":{"text":"Одновременный прием транексамовой кислоты с антикоагулянтами должен проводиться"}},{"type":"paragraph","data":{"text":"под строгим контролем врача (опыт применения ограничен)."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"У пациентов с наследственным ангионевротическим отеком перед началом лечения"}},{"type":"paragraph","data":{"text":"необходима консультация офтальмолога (определение остроты зрения, цветного зрения,"}},{"type":"paragraph","data":{"text":"состояние глазного дна). В процессе лечения необходимо регулярное офтальмологическое"}},{"type":"paragraph","data":{"text":"обследование (включающее оценку остроты зрения и цветовосприятия, осмотр глазного"}},{"type":"paragraph","data":{"text":"дна щелевой лампой, измерение внутриглазного давления, оценку полей зрения). При"}},{"type":"paragraph","data":{"text":"возникновении нарушений зрения на фоне лечения транексамовой кислотой, препарат"}},{"type":"paragraph","data":{"text":"необходимо отменить."}},{"type":"paragraph","data":{"text":"У пациентов с наследственным ангионевротическим отеком, длительное время"}},{"type":"paragraph","data":{"text":"получающих препараты транексамовой кислоты, необходим регулярный лабораторный"}},{"type":"paragraph","data":{"text":"контроль функции печени."}},{"type":"paragraph","data":{"text":"Препараты транексамовой кислоты следует применять с осторожностью при гематурии,"}},{"type":"paragraph","data":{"text":"вызванной заболеваниями паренхимы почек, поскольку в этих условиях часто наблюдается"}},{"type":"paragraph","data":{"text":"внутрисосудистое осаждение фибрина, что может усугубить поражение почек. Кроме того,"}},{"type":"paragraph","data":{"text":"в случаях массивного кровотечения любой этиологии из верхних мочевыводящих путей,"}},{"type":"paragraph","data":{"text":"антифибринолитическая терапия повышает риск образования сгустков крови в почечной"}},{"type":"paragraph","data":{"text":"лоханке и/или мочеточнике и, соответственно, вторичной механической обструкции"}},{"type":"paragraph","data":{"text":"мочевыводящих путей и развития анурии."}},{"type":"paragraph","data":{"text":"Хотя проведенные клинические исследования не выявили значительного повышения"}},{"type":"paragraph","data":{"text":"частоты развития тромбозов, однако риск тромботических осложнений не может быть"}},{"type":"paragraph","data":{"text":"полностью исключен. Описаны случаи развития венозных и артериальных тромбозов и"}},{"type":"paragraph","data":{"text":"тромбоэмболии у пациентов, получавших транексамовую кислоту. Кроме того, сообщалось"}},{"type":"paragraph","data":{"text":"о случаях окклюзии центральной артерии сетчатки и центральной вены сетчатки. У"}},{"type":"paragraph","data":{"text":"нескольких пациентов развился внутричерепной тромбоз на фоне лечения транексамовой"}},{"type":"paragraph","data":{"text":"кислотой. Соответственно, у пациентов с высоким риском развития тромбоза"}},{"type":"paragraph","data":{"text":"(тромбоэмболические осложнения в анамнезе, случаи тромбоэмболии у родственников,"}},{"type":"paragraph","data":{"text":"верифицированный диагноз тромбофилии) следует применять транексамовую кислоту"}},{"type":"paragraph","data":{"text":"только в случае крайней необходимости и под строгим врачебным контролем. Перед"}},{"type":"paragraph","data":{"text":"применением транексамовой кислоты следует провести обследование, направленное на"}},{"type":"paragraph","data":{"text":"выявление факторов риска тромбоэмболических осложнений."}},{"type":"paragraph","data":{"text":"Наличие крови в полостях, например, в плевральной полости, полостях суставов и"}},{"type":"paragraph","data":{"text":"мочевыводящих путях (в т. ч. в почечных лоханках и в мочевом пузыре) может приводить"}},{"type":"paragraph","data":{"text":"к образованию в них «нерастворимого сгустка» вследствие внесосудистого свертывания"}},{"type":"paragraph","data":{"text":"крови, который может быть устойчив к физиологическому фибринолизу."}},{"type":"paragraph","data":{"text":"Пациенткам с нерегулярным менструальным кровотечением не следует назначать"}},{"type":"paragraph","data":{"text":"транексамовую кислоту до установления причины дисменореи. Если объем менструального"}},{"type":"paragraph","data":{"text":"кровотечения неадекватно снижается на фоне лечения транексамовой кислотой,"}},{"type":"paragraph","data":{"text":"необходимо рассмотреть возможность альтернативного лечения."}},{"type":"paragraph","data":{"text":"Данных по эффективности и безопасности применения транексамовой кислоты при"}},{"type":"paragraph","data":{"text":"лечении меноррагий у пациенток младше 15 лет недостаточно, поэтому препарат следует"}},{"type":"paragraph","data":{"text":"применять с осторожностью."}},{"type":"paragraph","data":{"text":"Следует с осторожностью применять транексамовую кислоту у женщин, одновременно"}},{"type":"paragraph","data":{"text":"принимающих комбинированные пероральные контрацептивы, в связи с повышенным"}},{"type":"paragraph","data":{"text":"риском развития тромбозов (См. раздел «Взаимодействие с другими лекарственными"}},{"type":"paragraph","data":{"text":"средствами»)."}},{"type":"paragraph","data":{"text":"У пациентов с ДВС-синдромом, которые нуждаются в лечении транексамовой кислотой, терапия должна осуществляться под тщательным контролем врача, имеющего опыт"}},{"type":"paragraph","data":{"text":"лечения данного заболевания."}},{"type":"paragraph","data":{"text":"В связи с отсутствием адекватных клинических исследований, одновременное применение"}},{"type":"paragraph","data":{"text":"транексамовой кислоты с антикоагулянтами должно осуществляться под тщательным"}},{"type":"paragraph","data":{"text":"наблюдением специалиста, имеющего опыт лечения нарушений свертывания крови."}},{"type":"paragraph","data":{"text":"Если на фоне приема транексамовой кислоты отмечается нарушение зрения, необходимо"}},{"type":"paragraph","data":{"text":"прекратить прием препарата и обратиться к врачу."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Способность транексамовой кислоты влиять на скорость психомоторных реакций и на"}},{"type":"paragraph","data":{"text":"способность управлять транспортными или другими механическими средствами не"}},{"type":"paragraph","data":{"text":"изучалась. Транексамовая кислота может вызывать головокружение и нарушения зрения,"}},{"type":"paragraph","data":{"text":"и, соответственно, может влиять на способность заниматься потенциально опасными"}},{"type":"paragraph","data":{"text":"видами деятельности, требующими повышенной концентрации внимания и быстроты"}},{"type":"paragraph","data":{"text":"психомоторных реакций.\n"}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки, покрытые пленочной оболочкой, 250 мг. По 10 таблеток в контурную ячейковую"}},{"type":"paragraph","data":{"text":"упаковку из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной."}},{"type":"paragraph","data":{"text":"По 1, 2, 3, 5 контурных ячейковых упаковок вместе с инструкцией по медицинскому"}},{"type":"paragraph","data":{"text":"применению лекарственного препарата в пачку из картона.\n"}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 30 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ЗАО «Обнинская химико-фармацевтическая компания», Россия"}},{"type":"paragraph","data":{"text":"249036, Калужская обл., г. Обнинск, ул. Королева, д. 4"}},{"type":"paragraph","data":{"text":"тел./факс: (484) 399-38-41"}},{"type":"paragraph","data":{"text":"Адрес места производства"}},{"type":"paragraph","data":{"text":"249036, Калужская обл., г. Обнинск, Киевское шоссе, зд. 103, зд. 107"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"АО «Нижфарм», Россия"}},{"type":"paragraph","data":{"text":"603950, г. Нижний Новгород, ул. Салганская, д. 7"}},{"type":"paragraph","data":{"text":"Тел.: (831) 278-80-88; факс: (831) 430-72-28"}},{"type":"paragraph","data":{"text":"E-mail: med@stada.ru"}}]}],"source":null},"description_toggle":false,"short_description":"Фармакодинамика Антифибринолитическое средство. Транексамовая кислота специфически ингибирует активацию профибринолизина (плазминогена) и его превращение в фибринолизин (плазмин). Обладает местным и системным гемостатическим действием при кровотечениях, связанных с повышением фибринолиза (патология тромбоцитов, меноррагии). Также транексамовая кислота за счет подавления образования кининов и других активных пептидов, участвующих в аллергических и воспалительных реакциях, обладает противоаллергическим и противовоспалительным действием. Фармакокинетика Абсорбция при пероральном приеме доз в диапазоне 0,5-2 г - 30-50%. Время достижения максимальной концентрации при приеме внутрь 0,5, 1 и 2 г - 3 ч, максимальная концентрация - 5, 8 и 15 мкг/мл соответственно. Связь с белками плазмы (профибринолизином) - менее 3%. Распределяется в тканях относительно равномерно (исключение - спинномозговая жидкость, где концентрация составляет 1/10 от плазменной); проникает через плацентарный барьер, в грудное молоко (около 1% от концентрации в плазме матери). Обнаруживается в семенной жидкости, где снижает фибринолитическую активность, но не влияет на миграцию сперматозоидов. 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