В качестве слабительного
средства в следующих случаях:
- запоры, обусловленные
атонией и гипотонией толстой кишки (в том числе в пожилом возрасте, у лежачих
больных, после операций, после родов и в период лактации);
- кишечная
непроходимость или обструктивные заболевания кишечника;
- острые заболевания органов брюшной полости или сильная боль в животе,
которые могут сопровождаться тошнотой, рвотой, повышением температуры тела,
включая аппендицит;
- острые
воспалительные заболевания кишечника;
- повышенная
чувствительность к натрия пикосульфату или другим компонентам препарата;
Прозрачная слегка вязкая бесцветная
или слабо окрашенная жидкость.
Фармакотерапевтическая группа
Слабительное средство.
Фармакологические свойства
Фармакодинамика
Действующее вещество –
натрия пикосульфат представляет собой слабительное триарилметановой группы. Как
местное слабительное, натрия пикосульфат после бактериального расщепления в
толстом кишечнике оказывает стимулирующее действие на слизистую толстого
кишечника, увеличивая перистальтику, способствует накоплению воды и
электролитов в толстом кишечнике. Это приводит к стимуляции акта дефекации,
уменьшению времени эвакуации и размягчению стула.
Натрия пикосульфат,
являясь слабительным средством, действующим на уровне толстой кишки,
стимулирует естественный процесс эвакуации содержимого из нижних отделов
желудочно-кишечного тракта. Поэтому натрия пикосульфат не оказывает влияния на
переваривание или всасывание калорийной пищи или незаменимых питательных
веществ в тонком кишечнике.
Фармакокинетика
Абсорбция: незначительная, препарат
практически полностью метаболизируется в стенке кишечника и печени до
неактивного глюкуронида.
После перорального приема натрия
пикосульфат поступает в толстый кишечник; абсорбция препарата незначительна,
что исключает его энтерогепатическую циркуляцию. В дистальном отделе толстого
кишечника происходит расщепление натрия пикосульфата с образованием активного
метаболита, бис-(п-гидроксифенил)-пиридил-2-метана. Время развития
слабительного эффекта препарата определяется скоростью высвобождения активного
метаболита и составляет 6-12 часов.
В системный кровоток поступает
незначительная часть препарата. Взаимосвязь между слабительным эффектом
активного метаболита и его концентрацией в сыворотке крови отсутствует.
После приема 10 мг препарата внутрь
около 10,4 % от величины общей дозы выводится почками в виде глюкуронида через
48 часов. При применении более высоких доз препарата выведение его почками, в
целом, уменьшается.
Показания к применению
В качестве слабительного
средства в следующих случаях:
- запоры, обусловленные
атонией и гипотонией толстой кишки (в том числе в пожилом возрасте, у лежачих
больных, после операций, после родов и в период лактации);
- кишечная
непроходимость или обструктивные заболевания кишечника;
- острые заболевания органов брюшной полости или сильная боль в животе,
которые могут сопровождаться тошнотой, рвотой, повышением температуры тела,
включая аппендицит;
- острые
воспалительные заболевания кишечника;
- повышенная
чувствительность к натрия пикосульфату или другим компонентам препарата;
- тяжелая
дегидратация;
-
непереносимость фруктозы;
- беременность
(I триместр).
С осторожностью
Использовать с
осторожностью пожилым людям, при гипокалиемии, повышении концентрации магния в
крови, пациентам с астенией.
Применение препарата у
пациентов с почечной недостаточностью тяжелой степени только под наблюдением
врача.
Применение при беременности и в период грудного вскармливания
Данные о достоверных и хорошо
контролируемых исследованиях у беременных женщин отсутствуют. Длительный опыт
применения не выявил отрицательного влияния препарата на беременность. Прием
препарата в I триместре беременности противопоказан. Во II и III
триместрах беременности (как и при использовании других слабительных средств)
прием препарата возможен только по назначению врача.
Активный метаболит и его
глюкурониды не выделяются с грудным молоком. Таким образом, препарат может быть
использован в период грудного вскармливания.
Способ применения и дозы
Внутрь.
Рекомендуется следующий
режим дозирования:
Взрослые и дети старше 10 лет: 10-20 капель (5-10 мг) в
сутки.
Дети 4-10 лет: 5-10 капель (2,5-5 мг) в сутки.
Рекомендуется
начинать с наименьшей дозы. Для того чтобы достичь регулярного стула, доза
может повышаться до максимальной рекомендуемой. Не следует превышать
максимальную рекомендуемую суточную дозу.
Рекомендуемая
доза для детей младше 4 лет составляет 0,25 мг/кг массы тела в сутки. Это
соответствует 1 капле препарата (0,5 мг натрия пикосульфата) на 2 кг массы тела
в сутки.
Для получения
слабительного эффекта в утренние часы следует принимать препарат накануне на
ночь.
Во время
применения флакон следует держать вертикально.
Препарат не
обязательно растворять в жидкости.
Побочное действие
При кратковременном приеме препарата
побочные эффекты наблюдаются редко.
Возможные побочные эффекты
классифицируются по частоте возникновения следующим образом: очень часто (≥ 1/10), часто (≥ 1/100, < 1/10),
нечасто (≥ 1/1000, < 1/100), редко
(≥ 1/10000, < 1/1000), очень редко (< 1/10000), частота неизвестна (в
настоящее время данные о распространенности побочных реакций отсутствуют).
При длительном применении
препарата в значительно повышенных дозах возможны следующие нарушения:
со стороны кожи и подкожных тканей
частота неизвестна: кожная сыпь,
крапивница, зуд;
со стороны обмена веществ и питания
частота неизвестна: повышенное
выведение калия, натрия и других электролитов, возможно развитие дегидратации;
со стороны желудочно-кишечного тракта
очень часто: диарея;
часто: диспептические явления, спазмы
и боль в животе, метеоризм;
нечасто: рвота, тошнота;
частота неизвестна: болевые ощущения
в области желудка и области ануса, усиление моторики кишечника, которые проходят
при уменьшении дозы препарата;
При приеме высоких доз возможны:
диарея, обезвоживание, снижение артериального давления, нарушение водно-электролитного
баланса, гипокалиемия, судороги.
Кроме того, имеются сообщения о
случаях ишемии мускулатуры толстого кишечника, связанных с приемом доз препарата,
значительно превышающих рекомендованные для обычного лечения запора.
Пикодинар, как и другие слабительные,
при хронической передозировке может привести 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
Для уменьшения абсорбции
препарата после приема внутрь можно вызвать рвоту или провести промывание
желудка. Может потребоваться восполнение жидкости и коррекция баланса
электролитов, а также назначение спазмолитических средств.
Взаимодействие с другими лекарственными средствами
Диуретики и глюкокортикостероиды
увеличивают риск нарушения электролитного баланса (гипокалиемии) при приеме
высоких доз препарата.
Нарушение электролитного баланса
может повышать чувствительность к сердечным гликозидам.
Совместное применение препарата и
антибиотиков может снижать послабляющий эффект препарата.
Особые указания
Как и другие слабительные
средства, препарат Пикодинар не следует принимать ежедневно без консультации
врача более 10 дней. При необходимости ежедневного приема слабительных средств
следует выяснить причину запоров.
Длительное применение слабительных
средств может привести к нарушению водного и электролитного баланса и гипокалиемии,
а также стать причиной «привыкания» и запоров вследствие эффекта «рикошета».
Пикодинар следует принимать под
медицинским наблюдением при состояниях, связанных с нарушением водного и
электролитного баланса (например, при тяжелом нарушении функции почек).
Сообщали о случаях головокружения
и/или обморока, которые по времени совпадали с применением натрия пикосульфата.
Анализ случаев показал, что эти состояния связаны с обмороком при дефекации
(или обмороком, вызванным напряжением при дефекации) или связаны с
вазовагальной реакцией на боль в животе, которая может быть обусловлена
запором, и не обязательно связана с приемом препарата.
Пикодинар эффективен в устранении
запоров у онкологических больных, получающих большие дозы опиоидов.
Исследования о влиянии препарата на
фертильность не проводились. В ходе доклини-ческих исследований тератогенных
эффектов на репродуктивность выявлено не было.
Препарат содержит сорбитол, поэтому
пациентам с редкой наследственной непереносимостью фруктозы принимать его не
рекомендуется.
Препарат не обладает вкусовыми
качествами, поэтому его можно добавлять детям в пищу. Дети должны принимать
препарат только по назначению врача.
Влияние на способность управлять автомобилем и движущимися механизмами
Специальных клинических исследований
влияния препарата на способность управлять транспортными средствами и работать
с другими механизмами не проводилось. Несмотря на это пациентов следует предупредить
о возможности развития вследствие вазовагальной реакции (в частности абдоминального
спазма) таких побочных реакций как головокружение и/или синкопе. В случае
возникновения абдоминального спазма пациенту следует избегать таких
потенциально опасных видов деятельности как управление транспортными средствами
или работа с другими механизмами.
Форма выпуска
Капли для приема внутрь 7,5
мг/мл.
По 10, 15, 20, 25, 30 или 40
мл во флакон с капельницей из полиэтилена низкой плотности и крышкой с
контролем первого вскрытия.
По 1 флакону вместе с
инструкцией по применению в пачке из картона.
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флакон, 15 мл, 7.5 мг / мл, для приема внутрь","short":"Капли, 15 мл, 7.5 мг / мл","package":"15 мл, 7.5 мг / мл"},"prescription":false,"catalog_section_id":142,"manufacturer":{"id":2347,"title":"Гротекс","slug":"groteks_2347","logo":{"isTouch":{"retina":null,"default":null},"isFromTablet":{"retina":null,"default":null}}},"is_advert":false,"product_form":"Капли","slug":"139029-pikodinar","attributes":{"count":"","dose":"7.5 мг / мл","volume":"15 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внутрь"}}]},{"id":4,"name":"Состав","slug":"ingredients","body":[{"type":"paragraph","data":{"text":"1 мл препарата содержит:"}},{"type":"paragraph","data":{"text":"\u003ci\u003eДействующее вещество\u003c/i\u003e:\u003cb\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Натрия\n пикосульфата моногидрат 7,5 мг"}},{"type":"paragraph","data":{"text":"\u003ci\u003eВспомогательные вещества\u003c/i\u003e:"}},{"type":"paragraph","data":{"text":"Сорбитол\n жидкий (не кристаллизирующийся) 643,7 мг"}},{"type":"paragraph","data":{"text":"Натрия\n бензоат 2,0 мг"}},{"type":"paragraph","data":{"text":"Натрия\n цитрата дигидрат 1,5 мг"}},{"type":"paragraph","data":{"text":"Лимонная\n кислота безводная 1,28 мг"}},{"type":"paragraph","data":{"text":"10 М\n раствор натрия гидроксида до рН 4,5-7,5"}},{"type":"paragraph","data":{"text":"Вода для инъекций до 1,0 мл"}}]},{"id":1,"name":"Описание","slug":"common_description","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Прозрачная слегка вязкая бесцветная\nили слабо окрашенная жидкость."}}]},{"id":5,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"Слабительное средство."}}]},{"id":6,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакодинамика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Действующее вещество –\nнатрия пикосульфат представляет собой слабительное триарилметановой группы. Как\nместное слабительное, натрия пикосульфат после бактериального расщепления в\nтолстом кишечнике оказывает стимулирующее действие на слизистую толстого\nкишечника, увеличивая перистальтику, способствует накоплению воды и\nэлектролитов в толстом кишечнике. Это приводит к стимуляции акта дефекации,\nуменьшению времени эвакуации и размягчению стула."}},{"type":"paragraph","data":{"text":"Натрия пикосульфат,\nявляясь слабительным средством, действующим на уровне толстой кишки,\nстимулирует естественный процесс эвакуации содержимого из нижних отделов\nжелудочно-кишечного тракта. Поэтому натрия пикосульфат не оказывает влияния на\nпереваривание или всасывание калорийной пищи или незаменимых питательных\nвеществ в тонком кишечнике."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакокинетика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Абсорбция: незначительная, препарат\nпрактически полностью метаболизируется в стенке кишечника и печени до\nнеактивного глюкуронида."}},{"type":"paragraph","data":{"text":"После перорального приема натрия\nпикосульфат поступает в толстый кишечник; абсорбция препарата незначительна,\nчто исключает его энтерогепатическую циркуляцию. В дистальном отделе толстого\nкишечника происходит расщепление натрия пикосульфата с образованием активного\nметаболита, бис-(п-гидроксифенил)-пиридил-2-метана. Время развития\nслабительного эффекта препарата определяется скоростью высвобождения активного\nметаболита и составляет 6-12 часов."}},{"type":"paragraph","data":{"text":"В системный кровоток поступает\nнезначительная часть препарата. Взаимосвязь между слабительным эффектом\nактивного метаболита и его концентрацией в сыворотке крови отсутствует."}},{"type":"paragraph","data":{"text":"После приема 10 мг препарата внутрь\nоколо 10,4 % от величины общей дозы выводится почками в виде глюкуронида через\n48 часов. При применении более высоких доз препарата выведение его почками, в\nцелом, уменьшается."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"В качестве слабительного\nсредства в следующих случаях:"}},{"type":"paragraph","data":{"text":"- запоры, обусловленные\nатонией и гипотонией толстой кишки (в том числе в пожилом возрасте, у лежачих\nбольных, после операций, после родов и в период лактации);"}},{"type":"paragraph","data":{"text":"- запоры, вызванные\nприемом лекарственных средств;"}},{"type":"paragraph","data":{"text":"- для регулирования стула\nпри геморрое, проктите, анальных трещинах (для размягчения консистенции кала);"}},{"type":"paragraph","data":{"text":"- заболевания желчного\nпузыря, синдром раздраженной кишки с преобладанием запоров;"}},{"type":"paragraph","data":{"text":"- запор, обусловленный\nдисбактериозом кишечника, нарушениями диеты."}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- кишечная\nнепроходимость или обструктивные заболевания кишечника;"}},{"type":"paragraph","data":{"text":"- острые заболевания органов брюшной полости или сильная боль в животе,\nкоторые могут сопровождаться тошнотой, рвотой, повышением температуры тела,\nвключая аппендицит;"}},{"type":"paragraph","data":{"text":"- острые\nвоспалительные заболевания кишечника;"}},{"type":"paragraph","data":{"text":"- повышенная\nчувствительность к натрия пикосульфату или другим компонентам препарата;"}},{"type":"paragraph","data":{"text":"- тяжелая\nдегидратация;"}},{"type":"paragraph","data":{"text":"-\nнепереносимость фруктозы;"}},{"type":"paragraph","data":{"text":"- беременность\n(I триместр). "}}]},{"id":9,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Использовать с\nосторожностью пожилым людям, при гипокалиемии, повышении концентрации магния в\nкрови, пациентам с астенией."}},{"type":"paragraph","data":{"text":"Применение препарата у\nпациентов с почечной недостаточностью тяжелой степени только под наблюдением\nврача."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Данные о достоверных и хорошо\nконтролируемых исследованиях у беременных женщин отсутствуют. Длительный опыт\nприменения не выявил отрицательного влияния препарата на беременность. Прием\nпрепарата в I триместре беременности противопоказан. Во II и III\nтриместрах беременности (как и при использовании других слабительных средств)\nприем препарата возможен только по назначению врача."}},{"type":"paragraph","data":{"text":"Активный метаболит и его\nглюкурониды не выделяются с грудным молоком. Таким образом, препарат может быть\nиспользован в период грудного вскармливания."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь."}},{"type":"paragraph","data":{"text":"Рекомендуется следующий\nрежим дозирования:"}},{"type":"paragraph","data":{"text":"\u003ci\u003eВзрослые и дети старше 10 лет:\u003c/i\u003e 10-20 капель (5-10 мг) в\nсутки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети 4-10 лет:\u003c/i\u003e 5-10 капель (2,5-5 мг) в сутки."}},{"type":"paragraph","data":{"text":"Рекомендуется\nначинать с наименьшей дозы. Для того чтобы достичь регулярного стула, доза\nможет повышаться до максимальной рекомендуемой. Не следует превышать\nмаксимальную рекомендуемую суточную дозу."}},{"type":"paragraph","data":{"text":"Рекомендуемая\nдоза для детей младше 4 лет составляет 0,25 мг/кг массы тела в сутки. Это\nсоответствует 1 капле препарата (0,5 мг натрия пикосульфата) на 2 кг массы тела\nв сутки."}},{"type":"paragraph","data":{"text":"Для получения\nслабительного эффекта в утренние часы следует принимать препарат накануне на\nночь."}},{"type":"paragraph","data":{"text":"Во время\nприменения флакон следует держать вертикально."}},{"type":"paragraph","data":{"text":"Препарат не\nобязательно растворять в жидкости."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"При кратковременном приеме препарата\nпобочные эффекты наблюдаются редко."}},{"type":"paragraph","data":{"text":"Возможные побочные эффекты\nклассифицируются по частоте возникновения следующим образом: очень часто (≥ 1/10), часто (≥ 1/100, < 1/10),\nнечасто (≥ 1/1000, < 1/100), редко"}},{"type":"paragraph","data":{"text":"\n(≥ 1/10000, < 1/1000), очень редко (< 1/10000), частота неизвестна (в\nнастоящее время данные о распространенности побочных реакций отсутствуют)."}},{"type":"paragraph","data":{"text":"При длительном применении\nпрепарата в значительно повышенных дозах возможны следующие нарушения:"}},{"type":"paragraph","data":{"text":"\u003ci\u003eсо стороны кожи и подкожных тканей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"частота неизвестна: кожная сыпь,\nкрапивница, зуд;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eсо стороны обмена веществ и питания\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"частота неизвестна: повышенное\nвыведение калия, натрия и других электролитов, возможно развитие дегидратации;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eсо стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"очень часто: диарея;"}},{"type":"paragraph","data":{"text":"часто: диспептические явления, спазмы\nи боль в животе, метеоризм;"}},{"type":"paragraph","data":{"text":"нечасто: рвота, тошнота;"}},{"type":"paragraph","data":{"text":"частота неизвестна: болевые ощущения\nв области желудка и области ануса, усиление моторики кишечника, которые проходят\nпри уменьшении дозы препарата;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eсо стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"частота\nнеизвестна: аллергические реакции, ангионевротический отек, аллергический\nдерматит;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eсо стороны нервной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"нечасто:\u003ci\u003e \u003c/i\u003eголовокружение;"}},{"type":"paragraph","data":{"text":"частота неизвестна: головная боль,\nповышенная утомляемость, сонливость, судороги, обморок."}}]},{"id":13,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При приеме высоких доз возможны:\nдиарея, обезвоживание, снижение артериального давления, нарушение водно-электролитного\nбаланса, гипокалиемия, судороги."}},{"type":"paragraph","data":{"text":"Кроме того, имеются сообщения о\nслучаях ишемии мускулатуры толстого кишечника, связанных с приемом доз препарата,\nзначительно превышающих рекомендованные для обычного лечения запора."}},{"type":"paragraph","data":{"text":"Пикодинар, как и другие слабительные,\nпри хронической передозировке может привести к хронической диарее, болях в\nобласти живота, гипокалиемии, вторичному гиперальдостеронизму, мочекаменной\nболезни. В связи с хроническим злоупотреблением слабительными может развиться\nповреждение почечных канальцев, метаболический алкалоз и мышечная слабость,\nсвязанная с гипокалиемией."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Для уменьшения абсорбции\nпрепарата после приема внутрь можно вызвать рвоту или провести промывание\nжелудка. Может потребоваться восполнение жидкости и коррекция баланса\nэлектролитов, а также назначение спазмолитических средств."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Диуретики и глюкокортикостероиды\nувеличивают риск нарушения электролитного баланса (гипокалиемии) при приеме\nвысоких доз препарата."}},{"type":"paragraph","data":{"text":"Нарушение электролитного баланса\nможет повышать чувствительность к сердечным гликозидам."}},{"type":"paragraph","data":{"text":"Совместное применение препарата и\nантибиотиков может снижать послабляющий эффект препарата."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Как и другие слабительные\nсредства, препарат Пикодинар не следует принимать ежедневно без консультации\nврача более 10 дней. При необходимости ежедневного приема слабительных средств\nследует выяснить причину запоров."}},{"type":"paragraph","data":{"text":"Длительное применение слабительных\nсредств может привести к нарушению водного и электролитного баланса и гипокалиемии,\nа также стать причиной «привыкания» и запоров вследствие эффекта «рикошета»."}},{"type":"paragraph","data":{"text":"Пикодинар следует принимать под\nмедицинским наблюдением при состояниях, связанных с нарушением водного и\nэлектролитного баланса (например, при тяжелом нарушении функции почек)."}},{"type":"paragraph","data":{"text":"Сообщали о случаях головокружения\nи/или обморока, которые по времени совпадали с применением натрия пикосульфата.\nАнализ случаев показал, что эти состояния связаны с обмороком при дефекации\n(или обмороком, вызванным напряжением при дефекации) или связаны с\nвазовагальной реакцией на боль в животе, которая может быть обусловлена\nзапором, и не обязательно связана с приемом препарата."}},{"type":"paragraph","data":{"text":"Пикодинар эффективен в устранении\nзапоров у онкологических больных, получающих большие дозы опиоидов."}},{"type":"paragraph","data":{"text":"Исследования о влиянии препарата на\nфертильность не проводились. В ходе доклини-ческих исследований тератогенных\nэффектов на репродуктивность выявлено не было."}},{"type":"paragraph","data":{"text":"Препарат содержит сорбитол, поэтому\nпациентам с редкой наследственной непереносимостью фруктозы принимать его не\nрекомендуется."}},{"type":"paragraph","data":{"text":"Препарат не обладает вкусовыми\nкачествами, поэтому его можно добавлять детям в пищу. Дети должны принимать\nпрепарат только по назначению врача."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Специальных клинических исследований\nвлияния препарата на способность управлять транспортными средствами и работать\nс другими механизмами не проводилось. Несмотря на это пациентов следует предупредить\nо возможности развития вследствие вазовагальной реакции (в частности абдоминального\nспазма) таких побочных реакций как головокружение и/или синкопе. В случае\nвозникновения абдоминального спазма пациенту следует избегать таких\nпотенциально опасных видов деятельности как управление транспортными средствами\nили работа с другими механизмами."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Капли для приема внутрь 7,5\nмг/мл."}},{"type":"paragraph","data":{"text":"По 10, 15, 20, 25, 30 или 40\nмл во флакон с капельницей из полиэтилена низкой плотности и крышкой с\nконтролем первого вскрытия."}},{"type":"paragraph","data":{"text":"По 1 флакону вместе с\nинструкцией по применению в пачке из картона."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре не\nвыше 25 ºС. "}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей\nместе."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять после окончания\nсрока годности!"}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают без рецепта."}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ООО «Гротекс»"}},{"type":"paragraph","data":{"text":"Россия, 195279, Санкт-Петербург"}},{"type":"paragraph","data":{"text":"Индустриальный пр., д. 71, к. 2, лит. А"}},{"type":"paragraph","data":{"text":"Тел.: +7 812 385 47 87"}},{"type":"paragraph","data":{"text":"Факс: +7 812 385 47 88"}},{"type":"paragraph","data":{"text":"\u003ca href=\"http://www.solopharm.com\"\u003ewww.solopharm.com\u003c/a\u003e"}},{"type":"paragraph","data":{"text":"www.picodinar.ru"}}]}],"source":{"title":"ЗдравСити","url":"https://zdravcity.ru"}},"description_toggle":false,"short_description":"ФармакодинамикаДействующее вещество – натрия пикосульфат представляет собой слабительное триарилметановой группы. Как местное слабительное, натрия пикосульфат после бактериального расщепления в толстом кишечнике оказывает стимулирующее действие на слизистую толстого кишечника, увеличивая перистальтику, способствует накоплению воды и электролитов в толстом кишечнике. Это приводит к стимуляции акта дефекации, уменьшению времени эвакуации и размягчению стула. Натрия пикосульфат, являясь слабительным средством, действующим на уровне толстой кишки, стимулирует естественный процесс эвакуации содержимого из нижних отделов желудочно-кишечного тракта. Поэтому натрия пикосульфат не оказывает влияния на переваривание или всасывание калорийной пищи или незаменимых питательных веществ в тонком кишечнике.ФармакокинетикаАбсорбция: незначительная, препарат практически полностью метаболизируется в стенке кишечника и печени до неактивного глюкуронида. После перорального приема натрия пикосульфат поступает в толстый кишечник; абсорбция препарата незначительна, что исключает его энтерогепатическую циркуляцию. В дистальном отделе толстого кишечника происходит расщепление натрия пикосульфата с образованием активного метаболита, бис-(п-гидроксифенил)-пиридил-2-метана. Время развития слабительного эффекта препарата определяется скоростью высвобождения активного метаболита и составляет 6-12 часов. В системный кровоток поступает незначительная часть препарата. Взаимосвязь между слабительным эффектом активного метаболита и его концентрацией в сыворотке крови отсутствует. После приема 10 мг препарата внутрь около 10,4 % от величины общей дозы выводится почками в виде глюкуронида через 48 часов. При применении более высоких доз препарата выведение его почками, в целом, уменьшается.","substance":[{"id":470,"title":"Натрия пикосульфат","title_latin":"Natrii picosulfas","slug":"natriya_pikosulfat_470"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":true,"comments":null,"image_alt":"Пикодинар - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/62311/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/62311/share_default/"}},"diseases":[],"other_packages":[{"id":139030,"title":"Пикодинар","subtitle":{"full":"Капли, флакон, 30 мл, 7.5 мг / мл, для приема внутрь","short":"Капли, 30 мл, 7.5 мг / мл","package":"30 мл, 7.5 мг / 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