Белые или слегка желтоватые свечи торпедообразной формы с гладкой или слегка маслянистой поверхностью и "сужением" в основании.
Фармакотерапевтическая группа
слабительное средство
Фармакологические свойства
Бисакодил - местное слабительное из группы производных дифенилметана с незначительным антирезорбтивным эффектом. После гидролиза в толстом кишечнике бисакодил- стимулирует его перистальтику и способствует накоплению воды и электролитов в просвете толстого кишечника. Это приводит к стимуляции дефекации, уменьшению времени эвакуации и размягчению стула.
Действие обусловлено прямой стимуляцией нервных окончаний в слизистой оболочке толстого кишечника.
Время развития слабительного эффекта препарата составляет 20 мин, в некоторых случаях - 45 мин.
Фармакокинетика
Абсорбция: незначительная. Метаболизм бисакодила с образованием активного метаболита, бис-(п-гидроксифенил)-пиридил-2-метана, происходит под действием ферментов (эстераз) слизистой оболочки толстого кишечника. Препарат практически полностью метаболизируется в стенке кишечника и печени до неактивного глюкуронида. Время полувыведения составляет около 16,5 ч. Максимальная концентрация активного метаболита в плазме после введения суппозитория достигается через 0,5-Зч. Взаимосвязь между слабительным эффектом бисакодила и концентрацией активного метаболита в плазме отсутствует.
Выведение активного метаболита происходит в основном кишечником (до 90% от общей экскреции), почками выделяется до 3,1%- Небольшое количество неизмененного препарата выводится кишечником.
Показания к применению
запоры, обусловленные гипотонией толстой кишки (в том числе хронические запоры, регулирование стула в послеродовом периоде, у лежачих больных),
подготовка к инструментальным и рентгенологическим исследованиям,
предоперационная подготовка, послеоперационный период.
Противопоказания
гиперчувствительность к активному ингредиенту или вспомогательным веществам,
кишечная непроходимость,
обструктивные заболевания кишечника
острые заболевания органов брюшной полости, включая аппендицит,
острые воспалительные заболевания кишечника,
сильные боли в животе, связанные с тошнотой и рвотой, что может быть признаком более тяжелого состояния,
Применение при беременности и в период грудного вскармливания
Клинических исследований влияния препарата на фертильность не проводилось. Данные о достоверных и хорошо контролируемых исследованиях у беременных женщин, отсутствуют. При этом длительный опыт применения не выявил отрицательного влияния препарата на беременность. В период беременности препарат может применяться только после консультации со специалистом в тех случаях, если потенциальная польза для матери превышает потенциальный риск для плода.
Бисакодил не проникает в грудное молоко. Поэтому препарат может применяться в период лактации.
Способ применения и дозы
При запорах
Взрослые и дети старше 10 лет — по 1 суппозиторию в сутки.
Суппозиторий вводится в прямую кишку заостренным концом вперед.
Действие наступает примерно через 20 мин (от 10 мин до 30 мин).
Не применять препарат ежедневно без консультации врача и установления причины запора более 10 дней.
При подготовке к исследованиям, пред- и послеоперационного лечения.
При подготовке к исследованиям, .пред- и послеоперационного лечения, медицинских состояниях, которые требуют облегчения дефекации, Дульколакс должен применяться под медицинским наблюдением.
Рекомендуется в комбинации с таблетками для достижения полного опорожнения. В дополнение к 2-4 таблеткам, принятым накануне, рекомендуется один суппозиторий утром. Решение о необходимом количестве таблеток Дульколакс для приема накануне исследования/ операции принимает лечащий врач, на основании клинического состояния пациента и объёма предстоящей манипуляции.
Побочное действие
Наиболее часто сообщающимися побочными реакциями в ходе применения препарата являются спастические боли в животе и диарея.
Со стороны желудочно-кишечного тракта: спастические боли или дискомфорт в области живота, диарея (обезвоживание, мышечная слабость, судороги, снижение артериального давления), тошнота, рвота, незначительное количество крови в кале, дискомфорт в области прямой кишки, колит. Использование суппозиториев может сопровождаться болью и местным раздражением, особенно при анальной трещине или язвенном проктите.
Со стороны нервной системы: головокружение, обморок. Данные побочные эффекты, возникающие после применения препарата, связаны с вазовагальной реакцией (т.е. вследствие кишечного спазма, напряжения при дефекации).
Со стороны иммунной системы: гиперчувствительность, ангионевротический отек, анафилактические реакции.
Передозировка
При передозировке возможны: диарея, обезвоживание, спазмы в области живота, нарушение водно-электролитного баланса, гипокалиемия.
Дульколакс как и другие слабительные, при хронической передозировке может приводить к хронической диарее, болях в области живота, гипокалиемии, вторичному, гиперальдостеронизму, мочекаменной болезни. В связи с хроническим злоупотреблением слабительными может развиться – повреждение почечных канальцев, метаболический алкалоз и мышечная слабость, связанная с гипокалиемией.
Лечение: Специфического антидота- нет. Лечение должно быть, симптоматическим. Может потребоваться восполнение жидкости и коррекция баланса электролитов, что особенно важно для пожилых пациентов и детей. Также может потребоваться назначение спазмолитических средств.
Взаимодействие с другими лекарственными средствами
Диуретики или глюкокортикостероиды могут увеличить риск нарушений электролитного баланса: (гипокалиемии) при приеме чрезмерно высоких доз Дульколакса.
Нарушение электролитного баланса (гипокалиемия)- может приводить к повышенной чувствительности к действию сердечных гликозидов.
Особые указания
Длительный прием может привести к потере жидкости, нарушению баланса электролитов, гипокалиемии и к обезвоживанию, которое может сопровождаться такими симптомами, как жажда и олигурия. Обезвоживание может нанести вред организму (например, при почечной недостаточности, у пожилых пациентов), поэтому при вышеперечисленных симптомах прием препарата должен быть прекращен и может быть возобновлен только под наблюдением врача.
У пациентов могут наблюдаться следы крови в кале, это явление обычно слабо выражено и проходит самостоятельно.
Головокружение и обмороки наблюдались у пациентов принимавших препарат Дульколакс. Анализ показал, что эти случаи связаны с обмороком при дефекации (или обмороком, вызванным напряжением при дефекации), или с вазовагальной реакцией на боль в животе, которая может быть обусловлена запором, и не связана с приемом препарата.
Дети должны принимать препарат после консультации с врачом.
Влияние на способность управлять автомобилем и движущимися механизмами
Специальных клинических исследований влияния препарата на способность управлять автомобилем и механизмами не проводилось. Несмотря на. это пациентам следует сообщать, что у них вследствие вазовагальной реакции (т.е. во время спазма кишечника) могут возникать головокружение и/или обморок. Поэтому необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
Форма выпуска
Суппозитории ректальные 10 мг. 6 суппозиториев в стрип из алюминиевой фольги. Один стрип с инструкцией по применению в картонную пачку.
Условия хранения
Хранить в сухом месте, при температуре не выше +25°С.
Хранить в недоступном для детей месте.
Срок годности
5 лет.
Не применять после истечения срока годности.
Условия отпуска
Отпускается без рецепта.
Производитель
Институт де Ангели С.Р.Л., Италия 50066 Реггелло, Лок. Прулли, ЮЗ/С, Флоренция, Италия
Организация, принимающая претензии потребителей
АО «Санофи Россия», Россия
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Мобильное приложение «Все аптеки»
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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группы производных дифенилметана с незначительным антирезорбтивным эффектом. После гидролиза в толстом кишечнике бисакодил- стимулирует его перистальтику и способствует накоплению воды и электролитов в просвете толстого кишечника. Это приводит к стимуляции дефекации, уменьшению времени эвакуации и размягчению стула."}},{"type":"paragraph","data":{"text":"Действие обусловлено прямой стимуляцией нервных окончаний в слизистой оболочке толстого кишечника."}},{"type":"paragraph","data":{"text":"Время развития слабительного эффекта препарата составляет 20 мин, в некоторых случаях - 45 мин."}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"Абсорбция: незначительная. Метаболизм бисакодила с образованием активного метаболита, бис-(п-гидроксифенил)-пиридил-2-метана, происходит под действием ферментов (эстераз) слизистой оболочки толстого кишечника. Препарат практически полностью метаболизируется в стенке кишечника и печени до неактивного глюкуронида. Время полувыведения составляет около 16,5 ч. Максимальная концентрация активного метаболита в плазме после введения суппозитория достигается через 0,5-Зч. Взаимосвязь между слабительным эффектом бисакодила и концентрацией активного метаболита в плазме отсутствует.\u003ca\u003e\u003c/a\u003e"}},{"type":"paragraph","data":{"text":"Выведение активного метаболита происходит в основном кишечником (до 90% от общей экскреции), почками выделяется до 3,1%- Небольшое количество неизмененного препарата выводится кишечником."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["запоры, обусловленные гипотонией толстой кишки (в том числе хронические запоры, регулирование стула в послеродовом периоде, у лежачих больных),","подготовка к инструментальным и рентгенологическим исследованиям,","предоперационная подготовка, послеоперационный период."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["гиперчувствительность к активному ингредиенту или вспомогательным веществам,","кишечная непроходимость,","обструктивные заболевания кишечника","острые заболевания органов брюшной полости, включая аппендицит,","острые воспалительные заболевания кишечника,","сильные боли в животе, связанные с тошнотой и рвотой, что может быть признаком более тяжелого состояния,","тяжелая дегидратация,","детский возраст до 10 лет."]}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"печёночная и/или почечная недостаточность, пожилой возраст."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Клинических исследований влияния препарата на фертильность не проводилось. Данные о достоверных и хорошо контролируемых исследованиях у беременных женщин, отсутствуют. При этом длительный опыт применения не выявил отрицательного влияния препарата на беременность. \u003ca\u003e\u003c/a\u003eВ период беременности препарат может применяться только после консультации со специалистом в тех случаях, если потенциальная польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Бисакодил не проникает в грудное молоко. Поэтому препарат может применяться в период лактации."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"При запорах"}},{"type":"paragraph","data":{"text":"Взрослые и дети старше 10 лет — по 1 суппозиторию в сутки."}},{"type":"paragraph","data":{"text":"Суппозиторий вводится в прямую кишку заостренным концом вперед."}},{"type":"paragraph","data":{"text":"Действие наступает примерно через 20 мин (от 10 мин до 30 мин)."}},{"type":"paragraph","data":{"text":"Не применять препарат ежедневно без консультации врача и установления причины запора более 10 дней."}},{"type":"paragraph","data":{"text":"При подготовке к исследованиям, пред- и послеоперационного лечения."}},{"type":"paragraph","data":{"text":"При подготовке к исследованиям, .пред- и послеоперационного лечения, медицинских состояниях, которые требуют облегчения дефекации, Дульколакс должен применяться под медицинским наблюдением."}},{"type":"paragraph","data":{"text":"Рекомендуется в комбинации с таблетками для достижения полного опорожнения. В дополнение к 2-4 таблеткам, \u003ca\u003e\u003c/a\u003eпринятым накануне, рекомендуется один суппозиторий утром. Решение о необходимом количестве таблеток Дульколакс для приема накануне исследования/ операции принимает лечащий врач, на основании клинического состояния пациента и объёма предстоящей манипуляции."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Наиболее часто сообщающимися побочными реакциями в ходе применения препарата являются спастические боли в животе и диарея."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: спастические боли или дискомфорт в области живота, диарея (обезвоживание, мышечная слабость, судороги, снижение артериального давления), тошнота, рвота, незначительное количество крови в кале, дискомфорт в области прямой кишки, колит. Использование суппозиториев может сопровождаться болью и местным раздражением, особенно при анальной трещине или язвенном проктите."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: головокружение, обморок. Данные побочные эффекты, возникающие после применения препарата, связаны с вазовагальной реакцией (т.е. вследствие кишечного спазма, напряжения при дефекации)."}},{"type":"paragraph","data":{"text":"Со стороны иммунной системы: гиперчувствительность, ангионевротический отек, анафилактические реакции."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"При передозировке возможны: диарея, обезвоживание, спазмы в области живота, нарушение водно-электролитного баланса, гипокалиемия."}},{"type":"paragraph","data":{"text":"Дульколакс как и другие слабительные, при хронической передозировке может приводить к хронической диарее, болях в области живота, гипокалиемии, вторичному, гиперальдостеронизму, мочекаменной болезни. В связи с хроническим злоупотреблением слабительными может развиться – повреждение почечных канальцев, метаболический алкалоз и мышечная слабость, связанная с гипокалиемией."}},{"type":"paragraph","data":{"text":"Лечение: Специфического антидота- нет. \u003ca\u003e\u003c/a\u003eЛечение должно быть, симптоматическим. Может потребоваться восполнение жидкости и коррекция баланса электролитов, что особенно важно для пожилых пациентов и детей. Также может потребоваться назначение спазмолитических средств."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Диуретики или глюкокортикостероиды могут увеличить риск нарушений электролитного баланса: (гипокалиемии) при приеме чрезмерно высоких доз Дульколакса."}},{"type":"paragraph","data":{"text":"Нарушение электролитного баланса (гипокалиемия)- может приводить к повышенной чувствительности к действию сердечных гликозидов."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Длительный прием может привести к потере жидкости, нарушению баланса электролитов, гипокалиемии и к обезвоживанию, которое может сопровождаться такими симптомами, как жажда и олигурия. Обезвоживание может нанести вред организму (например, при почечной недостаточности, у пожилых пациентов), поэтому при вышеперечисленных симптомах прием препарата должен быть прекращен и может быть возобновлен только под наблюдением врача."}},{"type":"paragraph","data":{"text":"У пациентов могут наблюдаться следы крови в кале, это явление обычно слабо выражено и проходит самостоятельно."}},{"type":"paragraph","data":{"text":"Головокружение и обмороки наблюдались у пациентов принимавших препарат Дульколакс. Анализ показал, что эти случаи связаны с обмороком при дефекации (или обмороком, вызванным напряжением при дефекации), или с вазовагальной реакцией на боль в животе, которая может быть обусловлена запором, и не связана с приемом препарата."}},{"type":"paragraph","data":{"text":"Дети должны принимать препарат после консультации с врачом."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Специальных клинических исследований влияния препарата на способность управлять автомобилем и механизмами не проводилось. Несмотря на. это пациентам следует сообщать, что у них вследствие вазовагальной реакции (т.е. во время спазма кишечника) могут возникать головокружение и/или обморок. Поэтому необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Суппозитории ректальные 10 мг. 6 суппозиториев в стрип из алюминиевой фольги. Один стрип с инструкцией по применению в картонную пачку."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом месте, при температуре не выше +25°С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"5 лет."}},{"type":"paragraph","data":{"text":"Не применять после истечения срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускается без рецепта."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Институт де Ангели С.Р.Л., Италия 50066 Реггелло, Лок. 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