Моксонидин-СЗ Таблетки, 60 шт, 0.4 мг, для приема внутрь, в пленочной оболочке

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В стволовых структурах мозга (ростральный слой боковых желудочков) моксонидин селективно стимулирует имидазолин-чувствитeльные рецепторы, принимающие участие в тонической и рефлекторной регуляции симпатической нервной системы. Стимуляция имидазолиновыx рецепторов снижает периферическую симпатическую активность и артериальное давление (АД). Моксонидин отличается от других симпатолитических гипотензивных средств более низким сродством к α2-адренорецепторам, что объясняет меньшую вероятность развития седативного эффекта и сухости во рту. Прием моксонидина приводит к снижению системного сосудистого сопротивления и АД. Моксонидин улучшает на 21 % индекс чувствительности к инсулину (в сравнении с плацебо) у пациентов с ожирением, инсулинрезистентностью и умеренной степенью артериальной гипертензии."}},{"type":"paragraph","data":{"text":"\u003cb\u003eФармакокинетика \u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Всасывание: "}},{"type":"paragraph","data":{"text":"После приема внутрь моксонидин быстро и почти полностью абсорбируется в верхних отделах желудочно-кишечного тракта. Абсолютная биодоступность составляет приблизительно 88 %. Время достижения максимальной концентрации -; около 1 час. Приём пищи не оказывает влияние на фармакокинетику препарата. "}},{"type":"paragraph","data":{"text":"Распределение "}},{"type":"paragraph","data":{"text":"Связь с белками плазмы крови составляет 7,2 %. "}},{"type":"paragraph","data":{"text":"Метаболизм "}},{"type":"paragraph","data":{"text":"Основной метаболит -; дегидрированный моксонидин. Фармакодинамическая активность дегидрированного моксонидина -; около 10 % по сравнению с моксонидином. Выведение Период полувыведения (Т1/2) моксонидина и метаболита составляет 2,5 и 5 часов соответственно. В течение 24 часов свыше 90 % моксонидина выводится почками (около 78 % в неизмененном виде и 13 % в виде дегидри-ромоксонидина, другие метаболиты в моче не превышают 8 % от принятой дозы). Менее 1 % дозы выводится через кишечник. "}},{"type":"paragraph","data":{"text":"Фармакокинетика у пациентов с артериальной гипертензией: По сравнению со здоровыми добровольцами у пациентов с артериальной гипертензией не отмечается изменений фармакокинетики моксонидина. "}},{"type":"paragraph","data":{"text":"Фармакокинетика в пожилом возрасте "}},{"type":"paragraph","data":{"text":"Отмечены клинически незначимые изменения фармакокинетических показателей моксонидина у пожилых пациентов, вероятно обусловленные снижением интенсивности его метаболизма и/или несколько более высокой биодостyпностью. "}},{"type":"paragraph","data":{"text":"Фармакокинетика у детей "}},{"type":"paragraph","data":{"text":"Моксонидин не рекомендуется для применения у пациентов моложе 18 лет, в связи с чем в этой группе фармакокинетические исследования не проводились. Фармакокинетика при почечной недостаточности "}},{"type":"paragraph","data":{"text":"Выведение моксонидина в значительной степени коррелирует с клиренсом креатинина (КК). У пациентов с умеренной почечной недостаточностью (КК в интервале 30-60 мл/мин) равновесные концентрации в плазме крови и конечный Т1/2 приблизительно в 2 и l,5 раза выше, чем у пациентов с нормальной функцией почек (КК более 90 мл/мин.). "}},{"type":"paragraph","data":{"text":"У пациентов с тяжелой почечной недостаточностью (КК менее 30 мл/мин.), равновесные концентрации в плазме крови и конечный Т1/2 в 3 раза выше, чем у пациентов с нормальной функцией почек. Назначение многократных доз моксонидина приводит к предсказуемой кумуляции в организме пациентов с умеренной и тяжелой почечной недостаточностью. "}},{"type":"paragraph","data":{"text":"У пациентов с терминальной почечной недостаточностью (КК менее 10 мл/мин), находящихся на гемодиализе, равновесные концентрации в плазме крови и конечный Т1/2 соответственно в 6 и 4 раза выше, чем у пациентов с нормальной функцией почек. Во всех группах максимальная концентрация моксонидина в плазме крови выше в 1,5 - 2 раза. У пациентов с нарушениями функции почек дозировка должна подбираться индивидуально. Моксонидин в незначительной степени выводится при проведении гемодиализа."}}]},{"id":10,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Артериальная гипертензия."}}]},{"id":11,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Почечная недостаточность тяжелой степени (КК менее 30 мл/мин);","выраженные нарушения ритма сердца;","СССУ;","выраженная брадикардия (ЧСС в покое менее 50 уд./мин);","AV-блокада II и III степени;","острая и хроническая сердечная недостаточность (III-IV функциональный класс по классификации NYHA);","одновременное применение с трициклическими антидепрессантами;","гемодиализ;","период лактации;","возраст старше 75 лет;","возраст до 18 лет (в связи с отсутствием данных по безопасности и эффективности);","наследственная непереносимость лактозы, дефицит лактазы или мальабсорбция глюкозы-галактозы;","повышенная чувствительность к активному веществу и другим компонентам препарата."]}}]},{"id":12,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Необходимо соблюдать особую осторожность при применении моксонидина у пациентов с AV-блокадой I степени (риск развития брадикардии); тяжелым заболеванием коронарных сосудов, тяжелой ИБС или нестабильной стенокардией (опыт применения недостаточен), хронической сердечной недостаточностью, печеночной недостаточностью тяжелой степени, нарушениями функции почек (КК более 30 мл/мин)."}}]},{"id":13,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Клинические данные о применении Моксонидина у беременных отсутствуют."}},{"type":"paragraph","data":{"text":"В ходе исследований на животных было установлено эмбриотоксическое действие препарата. Моксонидин следует назначать беременным, только после тщательной оценки соотношения риска и пользы, когда польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Период лактации"}},{"type":"paragraph","data":{"text":"Моксонидин проникает в грудное молоко и поэтому не должен назначаться во время кормления грудью. При необходимости применения Моксонидина в период лактации, грудное вскармливание необходимо прекратить."}}]},{"id":14,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, независимо от приема пищи. В большинстве случаев начальная доза препарата"}},{"type":"paragraph","data":{"text":"Моксонидин составляет 0,2 мг в сутки. Максимальная разовая доза составляет 0,4 мг. Максимальная суточная доза, которую следует разделить на 2 приема, составляет 0,6 мг. "}},{"type":"paragraph","data":{"text":"Необходима индивидуальная коррекция суточной дозы в зависимости от переносимости пациентом проводимой терапии. Коррекция дозы для пациентов с печеночной недостаточностью не требуется. "}},{"type":"paragraph","data":{"text":"Начальная доза для пациентов с умеренной или тяжелой почечной недостаточностью составляет 0,2 мг/сутки. В случае необходимости и при хорошей переносимости суточная доза может быть увеличена до максимальной 0,4 мг."}}]},{"id":15,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота побочных эффектов, приведенных ниже, определялась соответственно следующему: очень часто (>1/10); часто (>1/100, < 1/10); нечасто (>1/1000, < 1/100); включая отдельные сообщения."}},{"type":"paragraph","data":{"text":"Со стороны ЦНС: часто - головная боль*, головокружение (вертиго), сонливость; нечасто - обморок*. Нарушения психики: часто - бессонница; нечасто - нервозность."}},{"type":"paragraph","data":{"text":"Со стороны органа слуха и лабиринтные нарушения: нечасто - звон в ушах."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: нечасто - выраженное снижение АД, ортостатическая гипотензия*, брадикардия."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: очень часто - сухость слизистой оболочки полости рта; часто - диарея, тошнота, рвота, диспепсия."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожных тканей: часто - кожная сыпь, зуд."}},{"type":"paragraph","data":{"text":"Со стороны костно-мышечной системы: часто - боль в спине; нечасто - боль в области шеи."}},{"type":"paragraph","data":{"text":"Аллергические реакции: нечасто - ангионевротический отек."}},{"type":"paragraph","data":{"text":"Общие расстройства и нарушения в месте введения: часто - астения; нечасто - периферические отеки. * - частота сопоставима с плацебо.\n\n"}}]},{"id":16,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Имеются сообщения о нескольких случаях передозировки без летального исхода, когда одномоментно применялись дозы до 19.6 мг."}},{"type":"paragraph","data":{"text":"Симптомы: головная боль, седативный эффект, чрезмерное снижение АД, головокружение, астения, брадикардия, сухость слизистой оболочки полости рта, рвота, повышенная утомляемость, боль в эпигастральной области, угнетение дыхания и нарушение сознания. Кроме того, возможны также кратковременное повышение АД, тахикардия и гипергликемия, как было показано в нескольких исследованиях по изучению применения препарата в высоких дозах у животных."}},{"type":"paragraph","data":{"text":"Лечение: специфического антидота не существует. В случае чрезмерного снижения АД может потребоваться восстановление ОЦК за счет введения жидкости и допамина (инъекционно). Брадикардия может быть купирована атропином (инъекционное введение). "}},{"type":"paragraph","data":{"text":"В тяжелых случаях передозировки рекомендуется тщательно контролировать нарушения сознания и не допускать угнетения дыхания. Антагонисты α-адренорецепторов могут уменьшать или устранять парадоксальные гипертензивные эффекты при передозировке моксонидином. Моксонидин в незначительной степени выводится при проведении гемодиализа."}}]},{"id":17,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Совместное применение моксонидина с другими гипотензивными средствами приводит к аддитивному эффекту. Трициклические антидепрессанты могут снижать эффективность гипотензивных средств центрального действия, в связи с чем не рекомендуется их прием совместно с моксонидином."}},{"type":"paragraph","data":{"text":"Моксонидин может усиливать действие трициклических антидепрессантов, транквилизаторов, этанола, седативных и снотворных средств. Моксонидин способен умеренно улучшать ослабленные когнитивные функции у пациентов, получающих лоразепам. Моксонидин может усиливать седативный эффект производных бензодиазепина при их одновременном назначении."}},{"type":"paragraph","data":{"text":"Моксонидин выделяется путем канальцевой секреции. Поэтому не исключено его взаимодействие с другими препаратами, выделяющимися путем канальцевой секреции. Бета-адреноблокаторы усиливают брадикардию, выраженность отрицательного ино- и дромотропного действия.\n\n"}}]},{"id":18,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При необходимости отмены одновременно принимаемых бета- адреноблокаторов и препарата Моксонидин-СЗ, сначала отменяют бета- адреноблокаторы и лишь через несколько дней Моксонидин-СЗ."}},{"type":"paragraph","data":{"text":"В настоящее время нет подтверждений того, что прекращение приема препарата Моксонидин-СЗ приводит к повышению АД. Однако не рекомендуется прекращать прием препарата Моксонидин-СЗ резко, вместо этого следует постепенно уменьшать дозу препарата в течение двух недель."}},{"type":"paragraph","data":{"text":"Во время лечения исключить употребление алкоголя. Во время лечения необходим регулярный контроль частоты сердечных сокращений и электрокардиографии.\n\n"}}]},{"id":20,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки."}}]},{"id":21,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом, защищенном от света месте, при температуре не выше 25 °С. Хранить в недоступном для детей месте."}}]},{"id":22,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}}]},{"id":23,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]},{"id":24,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/severnaya_zvezda/\"\u003eСеверная Звезда НАО, Россия\u003c/a\u003e."}}]}],"source":{"title":"('Эркафарм/Столетов',)","url":"https://stoletov.ru/"}},"description_toggle":false,"short_description":"Моксонидин является гипотензивным средством с центральным механизмом действия. В стволовых структурах мозга (ростральный слой боковых желудочков) моксонидин селективно стимулирует имидазолин-чувствитeльные рецепторы, принимающие участие в тонической и рефлекторной регуляции симпатической нервной системы. Стимуляция имидазолиновыx рецепторов снижает периферическую симпатическую активность и артериальное давление (АД). Моксонидин отличается от других симпатолитических гипотензивных средств более низким сродством к α2-адренорецепторам, что объясняет меньшую вероятность развития седативного эффекта и сухости во рту. Прием моксонидина приводит к снижению системного сосудистого сопротивления и АД. Моксонидин улучшает на 21 % индекс чувствительности к инсулину (в сравнении с плацебо) у пациентов с ожирением, инсулинрезистентностью и умеренной степенью артериальной гипертензии.ФармакокинетикаВсасывание: После приема внутрь моксонидин быстро и почти полностью абсорбируется в верхних отделах желудочно-кишечного тракта. Абсолютная биодоступность составляет приблизительно 88 %. Время достижения максимальной концентрации -; около 1 час. Приём пищи не оказывает влияние на фармакокинетику препарата. Распределение Связь с белками плазмы крови составляет 7,2 %. Метаболизм Основной метаболит -; дегидрированный моксонидин. Фармакодинамическая активность дегидрированного моксонидина -; около 10 % по сравнению с моксонидином. Выведение Период полувыведения (Т1/2) моксонидина и метаболита составляет 2,5 и 5 часов соответственно. В течение 24 часов свыше 90 % моксонидина выводится почками (около 78 % в неизмененном виде и 13 % в виде дегидри-ромоксонидина, другие метаболиты в моче не превышают 8 % от принятой дозы). Менее 1 % дозы выводится через кишечник. Фармакокинетика у пациентов с артериальной гипертензией: По сравнению со здоровыми добровольцами у пациентов с артериальной гипертензией не отмечается изменений фармакокинетики моксонидина. Фармакокинетика в пожилом возрасте Отмечены клинически незначимые изменения фармакокинетических показателей моксонидина у пожилых пациентов, вероятно обусловленные снижением интенсивности его метаболизма и/или несколько более высокой биодостyпностью. Фармакокинетика у детей Моксонидин не рекомендуется для применения у пациентов моложе 18 лет, в связи с чем в этой группе фармакокинетические исследования не проводились. Фармакокинетика при почечной недостаточности Выведение моксонидина в значительной степени коррелирует с клиренсом креатинина (КК). У пациентов с умеренной почечной недостаточностью (КК в интервале 30-60 мл/мин) равновесные концентрации в плазме крови и конечный Т1/2 приблизительно в 2 и l,5 раза выше, чем у пациентов с нормальной функцией почек (КК более 90 мл/мин.). У пациентов с тяжелой почечной недостаточностью (КК менее 30 мл/мин.), равновесные концентрации в плазме крови и конечный Т1/2 в 3 раза выше, чем у пациентов с нормальной функцией почек. Назначение многократных доз моксонидина приводит к предсказуемой кумуляции в организме пациентов с умеренной и тяжелой почечной недостаточностью. У пациентов с терминальной почечной недостаточностью (КК менее 10 мл/мин), находящихся на гемодиализе, равновесные концентрации в плазме крови и конечный Т1/2 соответственно в 6 и 4 раза выше, чем у пациентов с нормальной функцией почек. Во всех группах максимальная концентрация моксонидина в плазме крови выше в 1,5 - 2 раза. У пациентов с нарушениями функции почек дозировка должна подбираться индивидуально. Моксонидин в незначительной степени выводится при проведении гемодиализа.","substance":[{"id":512,"title":"Моксонидин","title_latin":"Moxonidinum","slug":"moksonidin_512"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Моксонидин-СЗ - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/23939/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/23939/share_default/"}},"diseases":[],"other_packages":[{"id":102074,"title":"Моксонидин-СЗ","subtitle":{"full":"Таблетки, 14 шт, 0,4 мг, для приема внутрь","short":"Таблетки, 14 шт, 0,4 мг","package":"14 шт, 0,4 мг"},"prescription":true,"catalog_section_id":123,"manufacturer":{"id":183,"title":"Северная 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