Гранисетрон - селективный антагонист 5-гидрокситриптаминовых (5-НТ3) рецепторов, расположенных в окончаниях вагусного нерва и триггерной зоне дна IV желудочка мозга (практически не влияет на другие рецепторы серотонина), с выраженным противорвотным эффектом. Исследования показали, что у гранисетрона низкая аффинность к другим видам рецепторов, включая 5-НТ и места связывания дофамина Д2. Устраняет рвоту, возникающую при возбуждении парасимпатической нервной системы, вследствие высвобождения серотонина энтерохромаффинными клетками.; Гранисетрон устраняет тошноту и рвоту, вызванную цитотоксической химиотерапией, лучевой терапией, а также послеоперационную тошноту и рвоту.; Гранисетрон не влияет на концентрацию пролактина и альдостерона в плазме крови.
Показания к применению
— профилактика острой и отсроченной тошноты и рвоты, вызванных цитостатической химиотерапией и лучевой терапией у взрослых.
Противопоказания
Реакции гиперчувствительности к другим селективным антагонистам 5-НТ3 рецепторов в анамнезе
Беременность и период лактации
Детский возраст (сведения об эффективности и безопасности отсутствуют)
Повышенная чувствительность к гранисетрону или любому другому компоненту препарата
С осторожностью: частичная кишечная непроходимость.
Применение при беременности и в период грудного вскармливания
Противопоказания к применению во время беременности и в период лактации.
Способ применения и дозы
Внутрь по 1 мг 2 раза/сут или 2 мг 1 раз/сут (при цитостатической терапии) или 2 мг 1 раз/сут (при лучевой терапии), при этом первая доза должна быть принята за 1 ч до начала цитостатической или лучевой терапии. Прием Нотирола должен продолжаться не более 7 дней.; Пациенты с почечной или печеночной недостаточностью, пожилые пациенты; Коррекции дозы не требуется.
Побочное действие
В большинстве случаев побочные действия при применении гранисетрона не были тяжелыми и переносились пациентами без прерывания терапии. Отмечены редкие и иногда тяжелые случаи проявления повышенной чувствительности (например, анафилаксия).; Со стороны пищеварительной системы: боль в животе, запор, диарея, метеоризм, повышение активности "печеночных" трансаминаз (АЛТ, ACT ); диспепсия; редко - изжога, изменение вкусовых ощущений.; Со стороны нервной системы: головная боль, бессонница, сонливость (связь возникновения сонливости с приемом гранисетрона не установлена), слабость; редко - тревога, беспокойство, головокружение; Со стороны сердечно-сосудистой системы: аритмия, повышение или снижение артериального давления, боль в груди; Со стороны иммунной системы: кожная сыпь, гипертермия, бронхоспазм, крапивница, зуд; редко - реакции повышенной чувствительности.; Со стороны кожи и ее придатков: очень редко - кожная сыпь, отек/отек лица.; Прочие: очень редко - гриппоподобный синдром.
Передозировка
Специфический антидот для Нотирола не известен. В случае передозировки лечение симптоматическое.
Особые указания
Пациенты с признаками частичной непроходимости кишечника после введения Нотирола должны находиться под наблюдением врача, так как Нотирол может снижать моторику кишечника.; В связи с наличием в составе лактозы пациенты с редкими наследственными заболеваниями, такими как непереносимость галактозы, дефицит лактозы или глюкозно-галактозная мальабсорбция принимать препарат не рекомендуется.; Влияние на способность к вождению транспортных средств и работу с машинами и механизмами.; Данные о влиянии гранисетрона на способность к вождению транспортного средства отсутствуют.
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