ФармакодинамикаДиосмин является производным бензпирона. Отно... Инструкция
Показания к применению
В составе комплексной терапии: для устранения симптомов варикозного расширения вен нижних конечностей; для устранения симптомов хронической лимфовенозной недостаточности нижних конечностей: ощущение тяжести или усталости в ногах, боль; при нарушении микроциркуляции для устранения симптомов острого геморроя.
Противопоказания
Повышенная чувствительность к компонентам препарата; I триместр беременности и период грудного вскармливания (опыт применения ограничен); возраст до 18 лет.
Инструкция
Состав
Одна таблетка, покрытая пленочной оболочкой, содержит: действующее вещество:
Диосмин является производным бензпирона. Относится к группе биофлавоноидов. Обладает флеботонизирующим действием (уменьшает растяжимость вен, повышает тонус вен (дозозависимый эффект), уменьшает венозный застой), улучшает лимфатический дренаж (повышает тонус и частоту сокращения лимфатических капилляров, увеличивает их функциональную плотность, снижает лимфатическое давление), улучшает микроциркуляцию (повышает резистентность капилляров (дозозависимый эффект), уменьшает их проницаемость), уменьшает адгезию лейкоцитов к венозной стенке и их миграцию в паравенозные ткани, улучшает диффузию кислорода и перфузию в кожной ткани, обладает противовоспалительным действием.
Усиливает сосудосуживающее действие адреналина, норадреналина, блокирует выработку свободных радикалов, синтез простагландинов и тромбоксана. Было показано, что диосмин снижает содержание в плазме крови ферментов, ответственных за метаболизм мукополисахаридов в венозной стенке.
В клинических исследованиях диосмин уменьшал емкость венозного русла и объем венозного застоя (по данным плетизмографии), снижал среднее давление в глубоких и поверхностных венах ног (по данным ультразвуковой допплерографии) и повышал систолическое и диастолическое артериальное давление у пациентов с послеоперационной ортостатической гипотензией. Фармакокинетика Всасывание Быстро всасывается из желудочно-кишечного тракта, обнаруживается в плазме крови через 2 часа после приема. Биодоступность диосмина после приема внутрь составляет примерно 40-57,9 %.
В кишечнике диосмин трансформируется кишечной микрофлорой в диосметин, гиппуровую и бензойную кислоту. Распределение Максимальная концентрация в плазме крови достигается через 5 часов после приема. Диосмин равномерно распределяется и накапливается во всех слоях стенки полых вен и подкожных вен нижних конечностей, в меньшей степени – в почках, печени, легких и других тканях.
Объем распределения составляет 62,1 л. Избирательное накопление диосмина и/или его метаболитов в венозных сосудах достигает максимума к девятому часу после приема и сохраняется в течение 96 часов. Метаболизм Диосмин метаболизируется в печени. Основной метаболит – гидроксифенилпропионовая кислота.
Метаболиты диосмина выводятся преимущественно почками в форме конъюгатов с глюкуроновой кислотой.
Выведение 79 % принятого диосмина выводится почками, через кишечник – 11 %, с желчью – 2,4 %. Отмечается энтерогепатическая циркуляция диосмина. После приема диосмина, меченого радиоактивным изотопом, примерно 86 % выводится почками и кишечником в течение 48 часов.
Показания к применению
В составе комплексной терапии: для устранения симптомов варикозного расширения вен нижних конечностей; для устранения симптомов хронической лимфовенозной недостаточности нижних конечностей: ощущение тяжести или усталости в ногах, боль; при нарушении микроциркуляции для устранения симптомов острого геморроя.
Противопоказания
Повышенная чувствительность к компонентам препарата; I триместр беременности и период грудного вскармливания (опыт применения ограничен); возраст до 18 лет.
Применение при беременности и в период грудного вскармливания
Беременность До сих пор в клинической практике не было сообщений о каких-либо побочных эффектах при применении препарата у беременных. Тем не менее, по соображениям безопасности не рекомендуется применять препарат в I триместре беременности.
Применение в период беременности во II и III триместрах возможно только по назначению врача в тех случаях, когда ожидаемая польза для матери превышает потенциальный риск для плода.
В экспериментальных исследованиях не было выявлено тератогенного действия диосмина на плод.
Период грудного вскармливания Во время грудного вскармливания не рекомендуется прием препарата, так как отсутствуют данные о проникновении диосмина в грудное молоко.
Способ применения и дозы
Применяйте препарат только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции. Перед применением препарата следует проконсультироваться с врачом.
Препарат Диосмин предназначен для приема внутрь. При варикозном расширении вен нижних конечностей и хронической лимфовенозной недостаточности назначают по 1 таблетке в сутки утром натощак.
Продолжительность терапии обычно составляет 2 месяца. При тяжелых формах хронической лимфовенозной недостаточности (отеки, боль, судороги и так далее) лечение может быть более продолжительным (общая длительность непрерывной терапии не должна превышать 3-4 месяцев). Курсы лечения препаратом Диосмин повторяют через 2-3 месяца.
Для лечения хронической лимфовенозной недостаточности во время II и III триместра беременности препарат применяют по 1 таблетке 1 раз в день. Продолжительность терапии не более 30 дней.
Прием препарата необходимо прекратить за 2-3 недели до родов. При обострении геморроя препарат назначают по 2-3 таблетки в сутки во время еды в течение 7 дней. Далее при необходимости можно продолжать прием препарата по 1 таблетке 1 раз в день в течение 1-2 месяцев. При нарушениях микроциркуляции
Препарат назначают по 1 таблетке в сутки утром натощак. Продолжительность терапии обычно составляет 1-2 месяца. Если пропущен один или несколько приемов препарата, необходимо продолжать применение препарата в обычном режиме и в обычной дозе.
Побочное действие
Классификация частоты развития побочных эффектов согласно рекомендациям Всемирной организации здравоохранения (ВОЗ): очень часто ≥ 1/10; часто от ≥ 1/100 до < 1/10; нечасто от ≥ 1/1000 до < 1/100; редко от ≥ 1/10000 до < 1/1000; очень редко < 1/10000, включая отдельные сообщения; частота неизвестна – по имеющимся данным установить частоту возникновения не представляется возможным.
Со стороны желудочно-кишечного тракта: часто – тошнота, рвота, диарея, диспептические расстройства, изжога, запор; нечасто – колит.
Со стороны центральной нервной системы: редко – головная боль, недомогание, головокружение.
Со стороны кожи и подкожной жировой клетчатки: редко – кожные высыпания, кожный зуд.
Аллергические реакции: редко – крапивница; частота неизвестна – изолированный отек лица, губ, век; в исключительных случаях – ангионевротический отек (отек Квинке).
Если любые из указанных в инструкции побочных эффектов усугубляются, или Вы заметили любые другие побочные эффекты, не указанные в инструкции, сообщите об этом врачу.
Передозировка
Симптомы Симптомы передозировки не описаны.
Учитывая широкий терапевтический диапазон диосмина, риск интоксикации при передозировке представляется незначительным.
Лечение Специфический антидот неизвестен.
Особые указания
Лечение острого геморроя проводят в комплексе с другими препаратами. При отсутствии быстрого клинического эффекта необходимо провести дополнительное обследование и скорректировать проводимую терапию.
При нарушении венозного кровообращения (варикозное расширение вен нижних конечностей, хроническая лимфовенозная недостаточность нижних конечностей) максимальный эффект лечения обеспечивается сочетанием терапии с изменениями образа жизни: желательно избегать длительного пребывания в вертикальном положении, уменьшить избыточную массу тела.
В некоторых случаях улучшению циркуляции крови способствует ношение специальных чулок (компрессионного трикотажа). В случае отсутствия уменьшения или при утяжелении симптомов заболевания обратитесь к врачу.
Не превышайте максимальные сроки и рекомендованные дозы препарата без консультации врача.
Форма выпуска
Таблетки.
Условия хранения
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коробка, 30 шт, 600 мг, для приема внутрь, покрытые оболочкой","short":"Таблетки, 30 шт, 600 мг","package":"30 шт, 600 мг"},"prescription":false,"catalog_section_id":100254,"manufacturer":{"id":127,"title":"Вертекс","slug":"verteks_127","logo":{"isTouch":{"retina":null,"default":null},"isFromTablet":{"retina":null,"default":null}}},"is_advert":false,"product_form":"Таблетки","slug":"160018-diosmin","attributes":{"count":"30 шт","dose":"600 мг","volume":"","spf":"","size":""},"image":{"isTouch":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/70279/phoneMedium_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/70279/phoneMedium_default/"},"isFromTablet":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/70279/tabletLarge_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/70279/tabletLarge_default/"}},"image_thumb":{"isTouch":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/70279/previewTouch_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/70279/previewTouch_default/"},"isFromTablet":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/70279/previewDesktopMedium_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/70279/previewDesktopMedium_default/"}},"available":true,"price":{"min":"746","max":"949"},"counters":null,"description":{"data":[{"id":4,"name":"Состав","slug":"ingredients","body":[{"type":"paragraph","data":{"text":"Одна таблетка, покрытая пленочной оболочкой, содержит: \u003ci\u003eдействующее вещество:\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"диосмин – 600,00 мг;"}},{"type":"paragraph","data":{"text":"\u003ci\u003e вспомогательные вещества:\u003c/i\u003e целлюлоза микрокристаллическая – 241,50 мг;"}},{"type":"paragraph","data":{"text":" тальк – 18,00 мг;"}},{"type":"paragraph","data":{"text":" гипролоза (гидроксипропилцеллюлоза) – 13,50 мг;"}},{"type":"paragraph","data":{"text":" кроскармеллоза натрия – 13,50 мг;"}},{"type":"paragraph","data":{"text":"магния стеарат – 9,00 мг;"}},{"type":"paragraph","data":{"text":" кремния диоксид коллоидный гидрофобный – 4,50 мг;"}},{"type":"paragraph","data":{"text":"\u003ci\u003e пленочная оболочка: \u003c/i\u003e[гипромеллоза – 16,20 мг, тальк – 5,40 мг, титана диоксид – 2,79 мг, макрогол 4000 (полиэтиленгликоль 4000) – 2,43 мг, краситель железа оксид красный (железа оксид) – 0,18 мг] или [сухая смесь для пленочного покрытия, содержащая гипромеллозу (60 %), тальк (20 %), титана диоксид (10,33 %), макрогол 4000 (полиэтиленгликоль 4000) (9 %), краситель железа оксид красный (железа оксид) (0,67 %)] – 27,00 мг.\n\n"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\u003cb\u003eФармакодинамика\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Диосмин является производным бензпирона. Относится к группе биофлавоноидов. Обладает флеботонизирующим действием (уменьшает растяжимость вен, повышает тонус вен (дозозависимый эффект), уменьшает венозный застой), улучшает лимфатический дренаж (повышает тонус и частоту сокращения лимфатических капилляров, увеличивает их функциональную плотность, снижает лимфатическое давление), улучшает микроциркуляцию (повышает резистентность капилляров (дозозависимый эффект), уменьшает их проницаемость), уменьшает адгезию лейкоцитов к венозной стенке и их миграцию в паравенозные ткани, улучшает диффузию кислорода и перфузию в кожной ткани, обладает противовоспалительным действием."}},{"type":"paragraph","data":{"text":" Усиливает сосудосуживающее действие адреналина, норадреналина, блокирует выработку свободных радикалов, синтез простагландинов и тромбоксана. Было показано, что диосмин снижает содержание в плазме крови ферментов, ответственных за метаболизм мукополисахаридов в венозной стенке."}},{"type":"paragraph","data":{"text":"В клинических исследованиях диосмин уменьшал емкость венозного русла и объем венозного застоя (по данным плетизмографии), снижал среднее давление в глубоких и поверхностных венах ног (по данным ультразвуковой допплерографии) и повышал систолическое и диастолическое артериальное давление у пациентов с послеоперационной ортостатической гипотензией. Фармакокинетика Всасывание Быстро всасывается из желудочно-кишечного тракта, обнаруживается в плазме крови через 2 часа после приема. Биодоступность диосмина после приема внутрь составляет примерно 40-57,9 %."}},{"type":"paragraph","data":{"text":"В кишечнике диосмин трансформируется кишечной микрофлорой в диосметин, гиппуровую и бензойную кислоту. Распределение Максимальная концентрация в плазме крови достигается через 5 часов после приема. Диосмин равномерно распределяется и накапливается во всех слоях стенки полых вен и подкожных вен нижних конечностей, в меньшей степени – в почках, печени, легких и других тканях."}},{"type":"paragraph","data":{"text":"Объем распределения составляет 62,1 л. Избирательное накопление диосмина и/или его метаболитов в венозных сосудах достигает максимума к девятому часу после приема и сохраняется в течение 96 часов. Метаболизм Диосмин метаболизируется в печени. Основной метаболит – гидроксифенилпропионовая кислота."}},{"type":"paragraph","data":{"text":"Метаболиты диосмина выводятся преимущественно почками в форме конъюгатов с глюкуроновой кислотой."}},{"type":"paragraph","data":{"text":"Выведение 79 % принятого диосмина выводится почками, через кишечник – 11 %, с желчью – 2,4 %. Отмечается энтерогепатическая циркуляция диосмина. После приема диосмина, меченого радиоактивным изотопом, примерно 86 % выводится почками и кишечником в течение 48 часов.\n\n"}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"В составе комплексной терапии: для устранения симптомов варикозного расширения вен нижних конечностей; для устранения симптомов хронической лимфовенозной недостаточности нижних конечностей: ощущение тяжести или усталости в ногах, боль; при нарушении микроциркуляции для устранения симптомов острого геморроя."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к компонентам препарата; I триместр беременности и период грудного вскармливания (опыт применения ограничен); возраст до 18 лет."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"\n\nБеременность До сих пор в клинической практике не было сообщений о каких-либо побочных эффектах при применении препарата у беременных. Тем не менее, по соображениям безопасности не рекомендуется применять препарат в I триместре беременности."}},{"type":"paragraph","data":{"text":"Применение в период беременности во II и III триместрах возможно только по назначению врача в тех случаях, когда ожидаемая польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"В экспериментальных исследованиях не было выявлено тератогенного действия диосмина на плод."}},{"type":"paragraph","data":{"text":" Период грудного вскармливания Во время грудного вскармливания не рекомендуется прием препарата, так как отсутствуют данные о проникновении диосмина в грудное молоко.\n\n"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nПрименяйте препарат только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции. Перед применением препарата следует проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"Препарат Диосмин предназначен для приема внутрь. При варикозном расширении вен нижних конечностей и хронической лимфовенозной недостаточности назначают по 1 таблетке в сутки утром натощак."}},{"type":"paragraph","data":{"text":"Продолжительность терапии обычно составляет 2 месяца. При тяжелых формах хронической лимфовенозной недостаточности (отеки, боль, судороги и так далее) лечение может быть более продолжительным (общая длительность непрерывной терапии не должна превышать 3-4 месяцев). Курсы лечения препаратом Диосмин повторяют через 2-3 месяца."}},{"type":"paragraph","data":{"text":" Для лечения хронической лимфовенозной недостаточности во время II и III триместра беременности препарат применяют по 1 таблетке 1 раз в день. Продолжительность терапии не более 30 дней."}},{"type":"paragraph","data":{"text":"Прием препарата необходимо прекратить за 2-3 недели до родов. При обострении геморроя препарат назначают по 2-3 таблетки в сутки во время еды в течение 7 дней. Далее при необходимости можно продолжать прием препарата по 1 таблетке 1 раз в день в течение 1-2 месяцев. При нарушениях микроциркуляции"}},{"type":"paragraph","data":{"text":"Препарат назначают по 1 таблетке в сутки утром натощак. Продолжительность терапии обычно составляет 1-2 месяца. Если пропущен один или несколько приемов препарата, необходимо продолжать применение препарата в обычном режиме и в обычной дозе.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\n\nКлассификация частоты развития побочных эффектов согласно рекомендациям Всемирной организации здравоохранения (ВОЗ): очень часто ≥ 1/10; часто от ≥ 1/100 до < 1/10; нечасто от ≥ 1/1000 до < 1/100; редко от ≥ 1/10000 до < 1/1000; очень редко < 1/10000, включая отдельные сообщения; частота неизвестна – по имеющимся данным установить частоту возникновения не представляется возможным."}},{"type":"paragraph","data":{"text":" Со стороны желудочно-кишечного тракта: часто – тошнота, рвота, диарея, диспептические расстройства, изжога, запор; нечасто – колит."}},{"type":"paragraph","data":{"text":" Со стороны центральной нервной системы: редко – головная боль, недомогание, головокружение."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожной жировой клетчатки: редко – кожные высыпания, кожный зуд."}},{"type":"paragraph","data":{"text":" Аллергические реакции: редко – крапивница; частота неизвестна – изолированный отек лица, губ, век; в исключительных случаях – ангионевротический отек (отек Квинке)."}},{"type":"paragraph","data":{"text":" Если любые из указанных в инструкции побочных эффектов усугубляются, или Вы заметили любые другие побочные эффекты, не указанные в инструкции, сообщите об этом врачу.\n\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003cb\u003eСимптомы \u003c/b\u003eСимптомы передозировки не описаны."}},{"type":"paragraph","data":{"text":"Учитывая широкий терапевтический диапазон диосмина, риск интоксикации при передозировке представляется незначительным."}},{"type":"paragraph","data":{"text":"\u003cb\u003e Лечение\u003c/b\u003e Специфический антидот неизвестен.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nЛечение острого геморроя проводят в комплексе с другими препаратами. При отсутствии быстрого клинического эффекта необходимо провести дополнительное обследование и скорректировать проводимую терапию."}},{"type":"paragraph","data":{"text":" При нарушении венозного кровообращения (варикозное расширение вен нижних конечностей, хроническая лимфовенозная недостаточность нижних конечностей) максимальный эффект лечения обеспечивается сочетанием терапии с изменениями образа жизни: желательно избегать длительного пребывания в вертикальном положении, уменьшить избыточную массу тела."}},{"type":"paragraph","data":{"text":"В некоторых случаях улучшению циркуляции крови способствует ношение специальных чулок (компрессионного трикотажа). В случае отсутствия уменьшения или при утяжелении симптомов заболевания обратитесь к врачу."}},{"type":"paragraph","data":{"text":" Не превышайте максимальные сроки и рекомендованные дозы препарата без консультации врача.\n\n"}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте.\n\n"}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта."}}]},{"id":18,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/verteks/\"\u003eВертекс, Россия\u003c/a\u003e."}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаДиосмин является производным бензпирона. Относится к группе биофлавоноидов. Обладает флеботонизирующим действием (уменьшает растяжимость вен, повышает тонус вен (дозозависимый эффект), уменьшает венозный застой), улучшает лимфатический дренаж (повышает тонус и частоту сокращения лимфатических капилляров, увеличивает их функциональную плотность, снижает лимфатическое давление), улучшает микроциркуляцию (повышает резистентность капилляров (дозозависимый эффект), уменьшает их проницаемость), уменьшает адгезию лейкоцитов к венозной стенке и их миграцию в паравенозные ткани, улучшает диффузию кислорода и перфузию в кожной ткани, обладает противовоспалительным действием. Усиливает сосудосуживающее действие адреналина, норадреналина, блокирует выработку свободных радикалов, синтез простагландинов и тромбоксана. Было показано, что диосмин снижает содержание в плазме крови ферментов, ответственных за метаболизм мукополисахаридов в венозной стенке. В клинических исследованиях диосмин уменьшал емкость венозного русла и объем венозного застоя (по данным плетизмографии), снижал среднее давление в глубоких и поверхностных венах ног (по данным ультразвуковой допплерографии) и повышал систолическое и диастолическое артериальное давление у пациентов с послеоперационной ортостатической гипотензией. Фармакокинетика Всасывание Быстро всасывается из желудочно-кишечного тракта, обнаруживается в плазме крови через 2 часа после приема. Биодоступность диосмина после приема внутрь составляет примерно 40-57,9 %. В кишечнике диосмин трансформируется кишечной микрофлорой в диосметин, гиппуровую и бензойную кислоту. Распределение Максимальная концентрация в плазме крови достигается через 5 часов после приема. Диосмин равномерно распределяется и накапливается во всех слоях стенки полых вен и подкожных вен нижних конечностей, в меньшей степени – в почках, печени, легких и других тканях. Объем распределения составляет 62,1 л. Избирательное накопление диосмина и/или его метаболитов в венозных сосудах достигает максимума к девятому часу после приема и сохраняется в течение 96 часов. Метаболизм Диосмин метаболизируется в печени. Основной метаболит – гидроксифенилпропионовая кислота. Метаболиты диосмина выводятся преимущественно почками в форме конъюгатов с глюкуроновой кислотой. Выведение 79 % принятого диосмина выводится почками, через кишечник – 11 %, с желчью – 2,4 %. Отмечается энтерогепатическая циркуляция диосмина. 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