Комбинированный противоэпилептический препарат. Фенобарбитал взаимодействует с барбитуратным участком бензодиазепин-ГАМК-рецепторного комплекса, за счет чего повышает чувствительность ГАМК-рецепторов к ГАМК, приводит к раскрытию нейрональных каналов для ионов хлора, что приводит к увеличению их поступления в клетку. Снижает возбудимость нейронов эпилептогенного очага и распространение нервных импульсов. Проявляет антагонизм в отношении ряда возбуждающих медиаторов (глутамат и другие). Подавляет сенсорные зоны коры головного мозга, уменьшает моторную активность, угнетает церебральные функции, в т.ч. дыхательный центр. Снижает тонус гладкой мускулатуры ЖКТ. Обладает противосудорожным, седативным, снотворным и спазмолитическим действием. Кофеин повышает рефлекторную возбудимость спинного мозга, возбуждает дыхательный и сосудодвигательный центры, стимулирует метаболические процессы в органах и тканях, в т.ч. в мышечной ткани и ЦНС. Папаверина гидрохлорид является спазмолитиком, оказывает гипотензивное действие. Снижает тонус и расслабляет гладкие мышцы внутренних органов и сосудов. Кальция глюконат восполняет дефицит ионов кальция, необходимых для осуществления процесса передачи нервных импульсов. Бромизовал оказывает седативное и умеренное снотворное действие.
Показания к применению
Эпилепсия.
Противопоказания
Гиперчувствительность к любому из компонентов препарата; выраженная печеночная и/или почечная недостаточность; лекарственная зависимость (в т.ч. в анамнезе); гиперкинезы; миастения; выраженная анемия; порфирия; сахарный диабет; гипофункция надпочечников; гипертиреоз; депрессия; бронхообструктивные заболевания; активный алкоголизм; беременность; период лактации; детский возраст (до 7 лет).
Применение при беременности и в период грудного вскармливания
Препарат противопоказан к применению при беременности и в период лактации.
Способ применения и дозы
Взрослым и детям с 14 лет - по 2 табл. 2 раза в день. Детям 10–14 лет - по 1 табл. 2 раза в день; 7–9 лет - по 1,5 табл. 2 раза в день.
Побочное действие
Со стороны нервной системы: головокружение, общая слабость, атаксия, дизартрия, нистагм, парадоксальная реакция (особенно у пожилых и ослабленных больных - возбуждение), галлюцинации, нарушения сна. Со стороны пищеварительной системы: тошнота, рвота, запор или диарея, повышение активности печеночных трансаминаз. Со стороны кроветворной системы: агранулоцитоз, мегалобластная анемия, тромбоцитопения. Со стороны сердечно-сосудистой системы: снижение или повышение АД, тахикардия, аритмия (в т.ч. экстрасистолия), AV-блокада. Прочие: аллергические реакции, при длительном применении - лекарственная зависимость.
Больным с незначительной гиперкальциурией, снижением клубочковой фильтрации или с нефролитиазом в анамнезе назначение препарата должно проводиться под контролем содержания кальция в моче, что обусловлено наличием кальция глюконата в составе препарата. На фоне терапии не рекомендуется употребление алкоголя. Влияние на способность к вождению автотранспорта и управлению механизмамиВо время лечения следует воздержаться от выполнения работ, требующих быстроты психомоторных реакций (в т.ч. управления автомобилем).
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