Гиперчувствительность, кровотечения из ЖКТ, механическая кишечная непроходимость, перфорация желудка или кишечника, пролактинома, детский возраст (до 5 лет и детям с массой тела до 20 кг).
Таблетки белого или почти белого цвета, круглые, двояковыпуклые с характерным запахом.
Фармакотерапевтическая группа
противорвотное средство – дофаминовых рецепторов блокатор центральный
Фармакологические свойства
Фармакологическое действие
Увеличивает продолжительность перистальтических сокращений антрального отдела желудка и двенадцатиперстной кишки, ускоряет опорожнение желудка в случае замедления этого процесса, повышает тонус нижнего пищеводного сфинктера, устраняет развитие тошноты и рвоты.
Домперидон плохо проникает через гематоэнцефалический барьер, поэтому применение домперидона редко сопровождается экстрапирамидными побочными эффектами, особенно у взрослых, но домперидон стимулирует выделение пролактина из гипофиза. Его противорвотное действие, возможно, обусловлено сочетанием периферического (гастрокинетического) действия и антагонизма к рецепторам дофамина в триггерной зоне хеморецепторов. Домперидон не оказывает действия на желудочную секрецию.
Фармакокинетика
Абсорбция после приема внутрь, натощак – быстрая (прием после еды, сниженная кислотность желудочного сока замедляют и уменьшают абсорбцию). Максимальная концентрация в плазме крови (ТСmax) – 1 ч. Биодоступность – 15% (эффект "первого прохождения" через печень). Связь с белками плазмы – 90%. Проникает в различные ткани, плохо проходит через гематоэнцефалический барьер (ГЭБ). Метаболизируется в печени и в стенке кишечника (путем гидроксилирования и N-дезалкилирования). Выводится через кишечник 66%, почками – 33%, в т.ч. в неизмененном виде – 10 и 1% соответственно. Период полувыведения (Т1/2) – 7-9 ч, при выраженной хронической почечной недостаточности (ХПН) – удлиняется.
Показания к применению
а) Компекс диспептических симптомов, часто ассоциирующийся с замедленным опорожнением желудка, желудочно – пищеводным рефлюксом, эзофагитом;
- чувство переполнения в эпигастрии, ощущение вздутия живота, боль в верхней части живота:
- отрыжка, метеоризм:
- изжога с забросом или без заброса желудочного содержимого в полость рта.
б) Тошнота и рвота функционального, органического, инфекционного происхождения, вызванные радиотерапией, лекарственной терапией или нарушениях диеты, а также на фоне агонистов дофамина в случае их применения при болезни Паркинсона (таким как L-допа и бромкриптин)
Противопоказания
Гиперчувствительность, кровотечения из ЖКТ, механическая кишечная непроходимость, перфорация желудка или кишечника, пролактинома, детский возраст (до 5 лет и детям с массой тела до 20 кг).
С осторожностью
Почечная/печеночная недостаточность, период лактации, беременность.
Применение при беременности и в период грудного вскармливания
Применение препарата в I триместре беременности возможно только в случаях, когда ожидаемая польза терапии для матери превосходит потенциальный риск для плода. К настоящему времени не имеется данных о повышении риска пороков развития у человека. У женщин концентрация домперидона в грудном молоке в 4 раза ниже, чем соответствующие концентрации в плазме. Неизвестно, оказывает ли домперидон в этой концентрации отрицательное влияние на новорожденных. Поэтому в период лактации (грудного вскармливания) применение Мотилака не рекомендуется, за исключением случаев, когда ожидаемая польза терапии для матери превосходит потенциальный риск для грудного ребенка.
Способ применения и дозы
Таблетки: следует рассасывать за 15-20 мин до еды. Взрослым и детям старше 5 лет при хронических диспепсических явлениях – по 10 мг 3-4 раза в сутки и в случае необходимости дополнительно перед сном. При выраженной тошноте и рвоте – по 20 мг 3-4 раза в день и перед сном.
Для больных с почечной недостаточностью необходима коррекция дозы, кратность приема не должна превышать 1-2 раз в течение дня.
Побочное действие
Со стороны пищеварительной системы: преходящие спазмы кишечника.
Со стороны нервной системы: экстрапирамидные расстройства (у детей и у лиц с повышенной проницаемостью ГЭБ).
Антихолинергические и антацидные лекарственные средства (ЛС) нейтрализуют действие домперидона.
Повышают концентрацию домперидона в плазме: противогрибковые лекарственные средства азолового ряда, антибиотики из группы макролидов, ингибиторы ВИЧ-протеазы, нефазодон (антидепрессант).
Одновременный прием с парацетамолом и дигоксином не оказывал влияния на концентрацию этих ЛС в крови.
Форма выпуска
По 10 таблеток в контурную ячейковую упаковку; по 1 или 3 контурные ячейковые упаковки вместе с инструкцией по применению в пачку. По 30 таблеток в банку светозащитного стекла. Каждую банку вместе с инструкцией по применению помещают пачку.
Условия хранения
При температуре не выше 30 °С.
Хранить в недоступном для детей месте.
Срок годности
3 года.
Не применять по истечении срока годности.
Условия отпуска
По рецепту.
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средство – дофаминовых рецепторов блокатор центральный"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\n\nФармакологическое действие"}},{"type":"paragraph","data":{"text":"Увеличивает продолжительность перистальтических сокращений антрального отдела желудка и двенадцатиперстной кишки, ускоряет опорожнение желудка в случае замедления этого процесса, повышает тонус нижнего пищеводного сфинктера, устраняет развитие тошноты и рвоты."}},{"type":"paragraph","data":{"text":"Домперидон плохо проникает через гематоэнцефалический барьер, поэтому применение домперидона редко сопровождается экстрапирамидными побочными эффектами, особенно у взрослых, но домперидон стимулирует выделение пролактина из гипофиза. Его противорвотное действие, возможно, обусловлено сочетанием периферического (гастрокинетического) действия и антагонизма к рецепторам дофамина в триггерной зоне хеморецепторов. Домперидон не оказывает действия на желудочную секрецию."}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"Абсорбция после приема внутрь, натощак – быстрая (прием после еды, сниженная кислотность желудочного сока замедляют и уменьшают абсорбцию). Максимальная концентрация в плазме крови (ТСmax) – 1 ч. Биодоступность – 15% (эффект \"первого прохождения\" через печень). Связь с белками плазмы – 90%. Проникает в различные ткани, плохо проходит через гематоэнцефалический барьер (ГЭБ). Метаболизируется в печени и в стенке кишечника (путем гидроксилирования и N-дезалкилирования). Выводится через кишечник 66%, почками – 33%, в т.ч. в неизмененном виде – 10 и 1% соответственно. Период полувыведения (Т1/2) – 7-9 ч, при выраженной хронической почечной недостаточности (ХПН) – удлиняется.\n\n"}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"\n\nа) Компекс диспептических симптомов, часто ассоциирующийся с замедленным опорожнением желудка, желудочно – пищеводным рефлюксом, эзофагитом;"}},{"type":"paragraph","data":{"text":"- чувство переполнения в эпигастрии, ощущение вздутия живота, боль в верхней части живота:"}},{"type":"paragraph","data":{"text":"- отрыжка, метеоризм:"}},{"type":"paragraph","data":{"text":"- изжога с забросом или без заброса желудочного содержимого в полость рта."}},{"type":"paragraph","data":{"text":"б) Тошнота и рвота функционального, органического, инфекционного происхождения, вызванные радиотерапией, лекарственной терапией или нарушениях диеты, а также на фоне агонистов дофамина в случае их применения при болезни Паркинсона (таким как L-допа и бромкриптин)\n\n"}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность, кровотечения из ЖКТ, механическая кишечная непроходимость, перфорация желудка или кишечника, пролактинома, детский возраст (до 5 лет и детям с массой тела до 20 кг)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Почечная/печеночная недостаточность, период лактации, беременность."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение препарата в I триместре беременности возможно только в случаях, когда ожидаемая польза терапии для матери превосходит потенциальный риск для плода. К настоящему времени не имеется данных о повышении риска пороков развития у человека. У женщин концентрация домперидона в грудном молоке в 4 раза ниже, чем соответствующие концентрации в плазме. Неизвестно, оказывает ли домперидон в этой концентрации отрицательное влияние на новорожденных. Поэтому в период лактации (грудного вскармливания) применение Мотилака не рекомендуется, за исключением случаев, когда ожидаемая польза терапии для матери превосходит потенциальный риск для грудного ребенка."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nТаблетки: следует рассасывать за 15-20 мин до еды. Взрослым и детям старше 5 лет при хронических диспепсических явлениях – по 10 мг 3-4 раза в сутки и в случае необходимости дополнительно перед сном. При выраженной тошноте и рвоте – по 20 мг 3-4 раза в день и перед сном."}},{"type":"paragraph","data":{"text":"Для больных с почечной недостаточностью необходима коррекция дозы, кратность приема не должна превышать 1-2 раз в течение дня.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\n\nСо стороны пищеварительной системы: преходящие спазмы кишечника."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: экстрапирамидные расстройства (у детей и у лиц с повышенной проницаемостью ГЭБ)."}},{"type":"paragraph","data":{"text":"Аллергические реакции: кожная сыпь, крапивница."}},{"type":"paragraph","data":{"text":"Прочие: гиперпролактинемия (галакторея, гинекомастия).\n\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\n\nСимптомы: сонливость, дезориентация, экстрапирамидные расстройства (особенно у детей)."}},{"type":"paragraph","data":{"text":"Лечение: прием активированного угля, при экстрапирамидных нарушениях – антихолинергические ЛС, противопаркинсонические или антигистаминные ЛС с антихолинергическими свойствами.\n\n"}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nЦиметидин, натрия гидрокарбонат снижают биодоступность домперидона."}},{"type":"paragraph","data":{"text":"Антихолинергические и антацидные лекарственные средства (ЛС) нейтрализуют действие домперидона."}},{"type":"paragraph","data":{"text":"Повышают концентрацию домперидона в плазме: противогрибковые лекарственные средства азолового ряда, антибиотики из группы макролидов, ингибиторы ВИЧ-протеазы, нефазодон (антидепрессант)."}},{"type":"paragraph","data":{"text":"Совместим с приемом антипсихотических ЛС (нейролептиков), агонистами дофаминергических рецепторов (бромокриптин, L-допа)."}},{"type":"paragraph","data":{"text":"Одновременный прием с парацетамолом и дигоксином не оказывал влияния на концентрацию этих ЛС в крови.\n\n"}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"По 10 таблеток в контурную ячейковую упаковку; по 1 или 3 контурные ячейковые упаковки вместе с инструкцией по применению в пачку. По 30 таблеток в банку светозащитного стекла. 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Выводится через кишечник 66%, почками – 33%, в т.ч. в неизмененном виде – 10 и 1% соответственно. 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