Таблетки, покрытые пленочной оболочкой белого цвета, круглые, двояковыпуклые, с риской; на поперечном разрезе - ядро белого или почти белого цвета.
Состав
Циталопрама гидробромид
Фармакотерапевтическая группа
Антидепрессант
Фармакологические свойства
Циталопрам - антидепрессант из группы селективных ингибиторов обратного захвата серотонина (СИОЗС).
Циталопрам, обладая выраженной способностью подавлять обратный захват серотонина, не имеет или имеет очень слабую способность связываться с целым рядом рецепторов, включая гистаминовые, мускариновые и адренорецепторы. Циталопрам лишь в очень малой степени ингибирует изофермент CYP2D6 и, следовательно, не взаимодействует с лекарственными средствами, метаболизирующимися этим изоферментом. Таким образом, побочные эффекты и токсическое действие проявляется в значительно меньшей степени по сравнению с другими лекарственными средствами, ингибирующими изофермент CYP2D6.
Антидепрессивный эффект обычно развивается после 2-4 недель лечения.
Не оказывает влияния на массу тела, гематологические показатели, функцию печени и почек, репродуктивную функцию, не обладает тератогенным действием.
Нормализует эмоциональную сферу, улучшает патологически измененное настроение, устраняет тоску, меланхолию. Стимулирует двигательную активность и ускоряет процессы мышления при депрессии.
Показания к применению
лечение депрессивных расстройств и профилактика рецидивов;
лечение панического расстройства с /или без агорафобии;
одновременное применение с суматриптаном и другими серотонинергическими лекарственными средствами;
одновременное применение с пимозидом;
детский возраст (эффективность и безопасность применения не установлены);
гиперчувствительность к циталопраму или к любому компоненту, входящему в состав препарата.
Препарат не следует применять в сочетании с ингибиторами МАО, а также в течение 14 дней после прекращения их приема. Лечение ингибиторами МАО может быть начато не ранее, чем через 7 дней после прекращения приема циталопрама.
С осторожностью
Препарат следует применять с осторожностью при наличии лекарственной зависимости (в т.ч. в анамнезе), при недостаточной функции печени и/или почек, при мании, гипомании, при наличии судорожных расстройств в анамнезе, в пожилом возрасте, при беременности и в период лактации.
Применение при беременности и в период грудного вскармливания
Не следует назначать циталопрам беременным и кормящим грудью женщинам, если потенциальная клиническая польза не преобладает над теоретическим риском.
Циталопрам проникает в грудное молоко. Следует или прекратить кормление грудью, или отказаться от применения препарата в период грудного вскармливания.
Способ применения и дозы
Препарат принимают внутрь один раз в сутки в любое время суток, независимо от приема пищи.
Депрессии
Рекомендованная суточная доза составляет 20 мг циталопрама для приема один раз в сутки. В зависимости от индивидуального ответа пациента на лечение и тяжести заболевания дозу можно увеличить максимум до 60 мг в сутки.
Панические расстройства
Рекомендуется применять 10 мг циталопрама для приема один раз в сутки в течение первой недели лечения, после чего дозу увеличивают до 20 мг в сутки. В зависимости от индивидуального ответа пациента на лечение и тяжести заболевания дозу можно увеличить максимум до 60 мг в сутки.
Обсессивно-компульсивные расстройства
Рекомендованная суточная доза составляет 20 мг циталопрама для приема один раз в сутки. В зависимости от индивидуального ответа пациента на лечение дозу можно увеличивать на 20 мг максимум до 60 мг в сутки.
Пациенты в возрасте 65 лет и старше
Рекомендованная начальная доза может быть увеличена до 40 мг в сутки.
Недостаточность функции почек
Пациенты с незначительно или умеренно нарушенной функцией почек могут применять препарат в обычных дозах. Информации о лечении циталопрамом пациентов с тяжелой почечной недостаточностью (клиренс креатинина до 20 мл/мин) не имеется.
Недостаточность функции печени
Пациентам с нарушенной функцией печени не следует назначать более 30 мг в сутки.
Продолжительность лечения
Обычно антидепрессивное действие препарата наблюдается после 2-4 недель лечения. Лечение антидепрессантами является симптоматическим и должно проводиться в течение продолжительного времени. Обычно для предупреждения рецидива лечение необходимо проводить в течение 6 месяцев или даже более продолжительный период времени. В случае пациентов с периодической (рекуррентной) депрессией поддерживающее лечение необходимо проводить в течение нескольких лет для предупреждения начала последующих фаз заболевания. В случае завершения лечения препарат необходимо отменять постепенно в течение нескольких недель.
При лечении панического расстройства максимальный эффект циталопрама наблюдается после 3 месяцев лечения. Этот эффект сохраняется в течение всего периода поддерживающей терапии.
При лечении обсессивно-компульсивного расстройства эффект препарата проявляется после 2-4 недель лечения; при дальнейшем продолжении лечения может наблюдаться дальнейшее улучшение.
Побочное действие
Со стороны нервной системы: головокружения, головная боль, тремор, сонливость, бессонница, возбуждение, нервозность, мигрень, парестезии; нарушение сна, нарушение концентрации внимания, амнезия, тревожность, снижение либидо, увеличение аппетита, анорексия, апатия, суицидальные попытки, спутанность мыслей, астения, изменение настроения, агрессивное поведение, эмоциональная лабильность, ажитация, мания, гипомания, паническое поведение, параноидная реакция, психоз, чрезмерная утомляемость, беспокойство, экстрапирамидные расстройства, судороги, эйфория, серотониновый синдром (ажитация, спутанность сознания, диарея, гипертермия, гиперрефлексия, атаксия, повышенное потоотделение, неконтролируемое поведение), галлюцинации, деперсонализация,
Со стороны сердечно-сосудистой системы: трепетание предсердий (нарушение сердечного ритма), тахикардия, брадикардия, ортостатическая гипотензия, повышение или снижение АД, суправентрикулярные и вентрикулярные аритмии.
Со стороны желудочно-кишечного тракта: тошнота, сухость во рту, запоры, диарея, диспепсия, рвота, боль в животе, метеоризм, анорексия, повышенное -слюноотделение, увеличение активности ферментов печени.
Со стороны мочевыводящей системы: учащенное мочеиспускание, полиурия.
Нарушения обмена веществ: снижение или увеличение массы тела.
Со стороны дыхательной системы: риниты, синуситы, кашель, одышка.
Со стороны репродуктивной системы: нарушения эякуляции, повышение или снижение либидо, женская аноргазмия, дисменорея, импотенция, нарушения менструального цикла, галакторея.
Со стороны кожи: повышенное потоотделение, сыпь, зуд, светочувствительность, эпидермальный некролиз, ангионевротический отек.
Со стороны органа зрения: нарушение аккомодации, нарушение зрения, мидриаз.
Со стороны органов чувств: нарушение вкуса.
Со стороны слухового и вестибулярного аппарата: шум в ушах.
Со стороны опорно-двигательного аппарата: миалгия, артралгия.
Со стороны органов кроветворения: редко возможно развитие кровотечений (например, кровотечения, обусловленные гинекологическими причинами, желудочно-кишечные кровотечения, экхимозы), тромбоцитопения.
Симптомы: головокружение, тремор, ажитация, усиление потоотделения, сонливость, угнетение сознания различной степени тяжести, судороги, синусовая тахикардия, изменения ЭКГ (изменение сегмента ST и зубца Т, расширение QRS, удлинение QT интервала), аритмия, желудочковая аритмия, цианоз, угнетение дыхательной деятельности, рвота, рабдомиолиз, метаболический ацидоз, гипокалиемия, очень редко - острая почечная недостаточность.
Лечение: симптоматическое и поддерживающее - промывание желудка, адекватная оксигенация. Мониторирование функции сердечно-сосудистой и дыхательной систем. Специфического антидота не существует.
Условия хранения
Хранить в сухом, защищенном от света, недоступном для детей месте при температуре не выше 25°С.
Срок годности
Срок годности - 3 года.
Условия отпуска
Препарат отпускается по рецепту.
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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Циталопрам лишь в очень малой степени ингибирует изофермент CYP2D6 и, следовательно, не взаимодействует с лекарственными средствами, метаболизирующимися этим изоферментом. Таким образом, побочные эффекты и токсическое действие проявляется в значительно меньшей степени по сравнению с другими лекарственными средствами, ингибирующими изофермент CYP2D6."}},{"type":"paragraph","data":{"text":"Антидепрессивный эффект обычно развивается после 2-4 недель лечения. "}},{"type":"paragraph","data":{"text":"Не оказывает влияния на массу тела, гематологические показатели, функцию печени и почек, репродуктивную функцию, не обладает тератогенным действием. "}},{"type":"paragraph","data":{"text":"Нормализует эмоциональную сферу, улучшает патологически измененное настроение, устраняет тоску, меланхолию. Стимулирует двигательную активность и ускоряет процессы мышления при депрессии."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["лечение депрессивных расстройств и профилактика рецидивов;","лечение панического расстройства с /или без агорафобии;","лечение обсессивно-компульсивного расстройства (невроза навязчивости)."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["одновременное применение с суматриптаном и другими серотонинергическими лекарственными средствами;","одновременное применение с пимозидом;","детский возраст (эффективность и безопасность применения не установлены);","гиперчувствительность к циталопраму или к любому компоненту, входящему в состав препарата."]}},{"type":"paragraph","data":{"text":"Препарат не следует применять в сочетании с ингибиторами МАО, а также в течение 14 дней после прекращения их приема. Лечение ингибиторами МАО может быть начато не ранее, чем через 7 дней после прекращения приема циталопрама."}},{"type":"paragraph","data":{"text":"С \u003ci\u003eосторожностью\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Препарат следует применять с осторожностью при наличии лекарственной зависимости (в т.ч. в анамнезе), при недостаточной функции печени и/или почек, при мании, гипомании, при наличии судорожных расстройств в анамнезе, в пожилом возрасте, при беременности и в период лактации."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Не следует назначать циталопрам беременным и кормящим грудью женщинам, если потенциальная клиническая польза не преобладает над теоретическим риском. "}},{"type":"paragraph","data":{"text":"Циталопрам проникает в грудное молоко. Следует или прекратить кормление грудью, или отказаться от применения препарата в период грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Препарат принимают внутрь один раз в сутки в любое время суток, независимо от приема пищи."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДепрессии\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Рекомендованная суточная доза составляет 20 мг циталопрама для приема один раз в сутки. В зависимости от индивидуального ответа пациента на лечение и тяжести заболевания дозу можно увеличить максимум до 60 мг в сутки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПанические расстройства\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Рекомендуется применять 10 мг циталопрама для приема один раз в сутки в течение первой недели лечения, после чего дозу увеличивают до 20 мг в сутки. В зависимости от индивидуального ответа пациента на лечение и тяжести заболевания дозу можно увеличить максимум до 60 мг в сутки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбсессивно-компульсивные расстройства\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Рекомендованная суточная доза составляет 20 мг циталопрама для приема один раз в сутки. В зависимости от индивидуального ответа пациента на лечение дозу можно увеличивать на 20 мг максимум до 60 мг в сутки. "}},{"type":"paragraph","data":{"text":"\u003cb\u003eПациенты в возрасте 65 лет и старше\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Рекомендованная начальная доза может быть увеличена до 40 мг в сутки."}},{"type":"paragraph","data":{"text":"\u003cb\u003eНедостаточность функции почек\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Пациенты с незначительно или умеренно нарушенной функцией почек могут применять препарат в обычных дозах. Информации о лечении циталопрамом пациентов с тяжелой почечной недостаточностью (клиренс креатинина до 20 мл/мин) не имеется."}},{"type":"paragraph","data":{"text":"\u003cb\u003eНедостаточность функции печени\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Пациентам с нарушенной функцией печени не следует назначать более 30 мг в сутки."}},{"type":"paragraph","data":{"text":"Продолжительность лечения"}},{"type":"paragraph","data":{"text":"Обычно антидепрессивное действие препарата наблюдается после 2-4 недель лечения. Лечение антидепрессантами является симптоматическим и должно проводиться в течение продолжительного времени. Обычно для предупреждения рецидива лечение необходимо проводить в течение 6 месяцев или даже более продолжительный период времени. В случае пациентов с периодической (рекуррентной) депрессией поддерживающее лечение необходимо проводить в течение нескольких лет для предупреждения начала последующих фаз заболевания. В случае завершения лечения препарат необходимо отменять постепенно в течение нескольких недель."}},{"type":"paragraph","data":{"text":"При лечении панического расстройства максимальный эффект циталопрама наблюдается после 3 месяцев лечения. Этот эффект сохраняется в течение всего периода поддерживающей терапии."}},{"type":"paragraph","data":{"text":"При лечении обсессивно-компульсивного расстройства эффект препарата проявляется после 2-4 недель лечения; при дальнейшем продолжении лечения может наблюдаться дальнейшее улучшение."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы:\u003c/i\u003e головокружения, головная боль, тремор, сонливость, бессонница, возбуждение, нервозность, мигрень, парестезии; нарушение сна, нарушение концентрации внимания, амнезия, тревожность, снижение либидо, увеличение аппетита, анорексия, апатия, суицидальные попытки, спутанность мыслей, астения, изменение настроения, агрессивное поведение, эмоциональная лабильность, ажитация, мания, гипомания, паническое поведение, параноидная реакция, психоз, чрезмерная утомляемость, беспокойство, экстрапирамидные расстройства, судороги, эйфория, серотониновый синдром (ажитация, спутанность сознания, диарея, гипертермия, гиперрефлексия, атаксия, повышенное потоотделение, неконтролируемое поведение), галлюцинации, деперсонализация,"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы:\u003c/i\u003e трепетание предсердий (нарушение сердечного ритма), тахикардия, брадикардия, ортостатическая гипотензия, повышение или снижение АД, суправентрикулярные и вентрикулярные аритмии."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны желудочно-кишечного тракта:\u003c/i\u003e тошнота, сухость во рту, запоры, диарея, диспепсия, рвота, боль в животе, метеоризм, анорексия, повышенное -слюноотделение, увеличение активности ферментов печени. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны мочевыводящей системы:\u003c/i\u003e учащенное мочеиспускание, полиурия. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения обмена веществ:\u003c/i\u003e снижение или увеличение массы тела."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны дыхательной системы:\u003c/i\u003e риниты, синуситы, кашель, одышка."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны репродуктивной системы:\u003c/i\u003e нарушения эякуляции, повышение или снижение либидо, женская аноргазмия, дисменорея, импотенция, нарушения менструального цикла, галакторея."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожи:\u003c/i\u003e повышенное потоотделение, сыпь, зуд, светочувствительность, эпидермальный некролиз, ангионевротический отек."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органа зрения:\u003c/i\u003e нарушение аккомодации, нарушение зрения, мидриаз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органов чувств:\u003c/i\u003e нарушение вкуса."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны слухового и вестибулярного аппарата:\u003c/i\u003e шум в ушах."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны опорно-двигательного аппарата:\u003c/i\u003e миалгия, артралгия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органов кроветворения:\u003c/i\u003e редко возможно развитие кровотечений (например, кровотечения, обусловленные гинекологическими причинами, желудочно-кишечные кровотечения, экхимозы), тромбоцитопения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e астения, усталость, аллергические реакции, обморок, недомогание, гипертермия, мастодиния, зевота, скрежет зубами, гипонатриемия, анафилактоидная реакция."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы:\u003c/i\u003e головокружение, тремор, ажитация, усиление потоотделения, сонливость, угнетение сознания различной степени тяжести, судороги, синусовая тахикардия, изменения ЭКГ (изменение сегмента ST и зубца Т, расширение QRS, удлинение QT интервала), аритмия, желудочковая аритмия, цианоз, угнетение дыхательной деятельности, рвота, рабдомиолиз, метаболический ацидоз, гипокалиемия, очень редко - острая почечная недостаточность."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e симптоматическое и поддерживающее - промывание желудка, адекватная оксигенация. Мониторирование функции сердечно-сосудистой и дыхательной систем. Специфического антидота не существует."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом, защищенном от света, недоступном для детей месте при температуре не выше 25°С."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"Срок годности - 3 года."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Препарат отпускается по рецепту."}}]}],"source":null},"description_toggle":false,"short_description":"Циталопрам - антидепрессант из группы селективных ингибиторов обратного захвата серотонина (СИОЗС). Циталопрам, обладая выраженной способностью подавлять обратный захват серотонина, не имеет или имеет очень слабую способность связываться с целым рядом рецепторов, включая гистаминовые, мускариновые и адренорецепторы. 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