Круглые плоскоцилиндрические таблетки белого или почти белого цвета с фаской.
Фармакотерапевтическая группа
Противовирусное средство
Фармакологические свойства
Фармакодинамика:
Ремантадин активен в отношении различных штаммов вируса гриппа А (особенно А2 типа).
Являясь слабым основанием Ремантадин действует за счет повышения pH эндосом имеющих мембрану вакуолей которые окружают вирусные частицы после их проникновения в клетку. Предотвращение ацидификации в этих вакуолях блокирует слияние вирусной оболочки с мембраной эндосомы предотвращая таким образом передачу вирусного генетического материала в цитоплазму клетки. Ремантадин® также угнетает выход вирусных частиц из клетки т.е. прерывает транскрипцию вирусного генома.
Фармакокинетика:
После приема внутрь Ремантадин почти полностью всасывается в кишечнике.
Абсорбция - медленная. Связь с белками плазмы - около 40 %. Объем распределения: взрослые - 17-25 л/кг дети - 289 л/кг. Концентрация в носовом секрете на 50 % выше чем в плазме. Максимальная концентрация (Сmах) действующего вещества в плазме крови при дозе 100 мг один раз в сутки - 181 нг/мл при 100 мг два раза в сутки -416 нг/мл.
Метаболизируется в печени. Период полувыведения - 24-36 ч; 75-85 % от принятой дозы выводится почками в основном в виде метаболитов 15 % - в неизмененном виде.
При хронической почечной недостаточности период полувыведения увеличивается в 2 раза. .У лиц с почечной недостаточностью и у лиц пожилого возраста может накапливаться в токсических концентрациях если доза не корригируется пропорционально уменьшению клиренса креатинина (КК).
Показания к применению
Профилактика и раннее лечение гриппа А у взрослых и детей старше 7 лет.
Противопоказания
- Острые заболевания печени
- острые и хронические заболевания почек
- тиреотоксикоз
- повышенная чувствительность к римантадину
- беременность и период лактации
- дети до 7 лет.
С осторожностью
При артериальной гипертензии атеросклерозе сосудов головного мозга печеночной недостаточности эпилепсии заболеваниях желудочно-кишечного тракта.
Способ применения и дозы
Внутрь после еды запивая водой.
Лечение гриппа следует начинать в течение 24-48 ч после появления симптомов болезни.
Взрослым в первый день назначают по 100 мг 3 раза в день; во второй и третий дни по 100 мг 2 раза в день; в четвертый и пятый день по 100 мг один раз в день. В первый день заболевания возможно применение препарата однократно в дозе 300 мг.
Детям в возрасте от 7 до 10-ти лет назначают по 50 мг 2 раза в день; от 11 до 14 лет - 50 мг 3 раза в день. Старше 14 лет - дозы для взрослых. Принимают в течение 5-ти дней.
Для профилактики гриппа взрослым назначают 50 мг один раз в день в течение до 30-ти дней. Детям старше 7-ми лет - 50 мг 1 раз в день в течение до 15-ти дней.
Побочное действие
Ремантадин обычно хорошо переносится. Иногда наблюдается:
со стороны желудочно-кишечного тракта: сухость во рту тошнота рвота потеря аппетита боли в эпигастрии метеоризм;
со стороны центральной нервной системы: головная боль головокружение бессонница неврологические реакции нарушение концентрации внимания сонливость тревожность повышенная возбудимость усталость;
прочие:гипербилирубинемия аллергические реакции (кожная сыпь зуд крапивница).
Передозировка
Симптомы: возбуждение галлюцинации аритмия.
Лечение: промывание желудка симптоматическая терапия: мероприятия для поддержания жизненно важных функций. Римантадин частично выводится при гемодиализе.
Взаимодействие с другими лекарственными средствами
Парацетамол и кислота аскорбиновая снижают максимальную концентрацию римантадина в плазме крови на 11 %.
Циметидин снижает клиренс Ремантадина на 18 %.
Адсорбенты вяжущие и обволакивающие средства уменьшают всасывание Ремантадина. Защелачивающие мочу средства (ацетазоламид натрия гидрокарбонат и др.) усиливают эффективность Ремантадина вследствие уменьшения его выделения почками.
Закисляющие мочу средства (например кислота аскорбиновая) уменьшают эффективность Ремантадина вследствие усиления его выведения почками.
Особые указания
При применении Ремантадина возможно обострение хронических сопутствующих заболеваний. У пациентов пожилого возраста с артериальной гипертензией повышается риск развития геморрагического инсульта.
При указаниях в анамнезе на эпилепсию и проводящуюся противосудорожную терапию на фоне применения Ремантадина повышается риск развития эпилептического припадка. В таких случаях Ремантадин применяют в дозе 100 мг в сутки одновременно с противосудорожной терапией.
При гриппе вызванном вирусом В Ремантадин оказывает антитоксическое действие. Профилактический прием эффективен при контактах с заболевшими при распространении инфекции в замкнутых коллективах и при высоком риске возникновения заболевания во время эпидемии гриппа.
Возможно появление резистентных к препарату вирусов.
Влияние на способность управлять автомобилем и движущимися механизмами
Ремантадин не влияет на способность управлять транспортным средствам но лицам у которых возникают головокружение головная боль или другие побочные эффекты со стороны центральной нервной системы следует соблюдать осторожность.
С осторожностью принимать при лактазной недостаточности непереносимости лактозы синдроме мальабсорбции лактозы/изомальтозы т.к. в состав препарата входит лактоза.
Форма выпуска
Таблетки 50 мг.
Условия хранения
В защищенном от света месте при температуре не выше 25 °C.
Хранить в недоступном для детей месте.
Срок годности
5 лет. Не использовать по истечении срока годности.
Условия отпуска
Без рецепта
Производитель
АО "Олайнфарм", Rupnicu 5, Olaine, LV-2114, Latvia, Латвия
Организация, принимающая претензии потребителей
АО "Олайнфарм"
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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Защелачивающие мочу средства (ацетазоламид натрия гидрокарбонат и др.) усиливают эффективность Ремантадина вследствие уменьшения его выделения почками."}},{"type":"paragraph","data":{"text":"Закисляющие мочу средства (например кислота аскорбиновая) уменьшают эффективность Ремантадина вследствие усиления его выведения почками."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При применении Ремантадина возможно обострение хронических сопутствующих заболеваний. У пациентов пожилого возраста с артериальной гипертензией повышается риск развития геморрагического инсульта."}},{"type":"paragraph","data":{"text":"При указаниях в анамнезе на эпилепсию и проводящуюся противосудорожную терапию на фоне применения Ремантадина повышается риск развития эпилептического припадка. 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