Рвота тошнота икота различного генеза (в некоторых случаях может быть эффективен при рвоте вызванной приемом цитостатиков). Атония и гипотония желудка и кишечника (в частности послеоперационная); дискинезия желчевыводящих путей; рефлюкс-эзофагит; метеоризм; в составе комплексной терапии обострений язвенной болезни желудка и двенадцатиперстной кишки. ...
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Фармакотерапевтическая группа
Противорвотное средство - дофаминовых рецепторов блокатор центральный
Фармакологические свойства
Фармакодинамика:
Специфический блокатор дофаминовых (D2) и серотониновых (5-НТ3) рецепторов угнетает хеморецепторы триггерной зоны ствола мозга ослабляет чувствительность висцеральных нервов передающих импульсы от привратника и двенадцатиперстной кишки к рвотному центру. Через гипоталамус и парасимпатическую нервную систему (иннервация желудочно-кишечного тракта) оказывает регулирующее и координирующее влияние на тонус и двигательную активность верхнего отдела желудочно-кишечного тракта (в т.ч. тонус нижнего сфинктера пищевода). Повышает тонус желудка и кишечника ускоряет опорожнение желудка уменьшает гиперацидный стаз препятствует дуоденопилорическому и гастроэзофагеальному рефлюксу стимулирует перистальтику кишечника. Нормализует отделение желчи уменьшает спазм сфинктера Одди. Не изменяя его тонуса устраняет дискинезию желчного пузыря. Не влияет на тонус кровеносных сосудов мозга артериальное давление функцию дыхания а также почек и печени на кроветворение секрецию желудка и поджелудочной железы. Стимулирует секрецию пролактина. Увеличивает чувствительность тканей к ацетилхолину (действие не зависит от вагусной иннервации но устраняется м-холиноблокаторами). Стимулируя секрецию альдостерона усиливает задержку ионов натрия и выведение ионов калия.
Фармакокинетика:
Быстро всасывается из желудочно-кишечного тракта. В связи с частичным разрушением в печени после всасывания биодоступность - 75 %. Время достижения максимальной концентрации в плазме крови составляет 1-2 часа. Связь с белками плазмы - 13 - 30 %. Период полувыведения составляет от 25 до 6 часов при нарушении функции почек - до 14 часов. Выведение метоклопрамида происходит в основном через почки в течение 24 часов в неизмененном виде и в виде конъюгатов. Проходит через плацентарный и гематоэнцефалический барьеры и проникает в материнское молоко.
Показания к применению
Рвота тошнота икота различного генеза (в некоторых случаях может быть эффективен при рвоте вызванной приемом цитостатиков). Атония и гипотония желудка и кишечника (в частности послеоперационная); дискинезия желчевыводящих путей; рефлюкс-эзофагит; метеоризм; в составе комплексной терапии обострений язвенной болезни желудка и двенадцатиперстной кишки. Применяется для усиления перистальтики при проведении рентгеноконтрастных исследований желудочно-кишечного тракта.
Противопоказания
Повышенная чувствительность к компонентам препарата дефицит лактазы непереносимость лактозы глюкозо-галактозная недостаточность кровотечения из желудочно-кишечного тракта стеноз привратника желудка механическая кишечная непроходимость перфорация стенки желудка или кишечника феохромоцитома эпилепсия глаукома экстрапирамидные нарушения болезнь Паркинсона пролактинзависимые опухоли рвота на фоне лечения или передозировки нейролептиками и у больных раком молочной железы беременность (I триместр) период лактации детский возраст до 14 лет.
Не назначают после операций на желудочно-кишечном тракте (как пилоропластика или анастомоз кишечника) поскольку энергичные мышечные сокращения препятствуют заживлению.
С осторожностью
Детский и пожилой возраст почечная/печеночная недостаточность бронхиальная астма артериальная гипертензия беременность II и III триместр.
Применение при беременности и в период грудного вскармливания
Препарат противопоказан в I триместре беременности. Во II и III триместре беременности применение препарата возможно в том случае когда предполагаемая польза для матери превышает потенциальный риск для плода.
На время лечения следует прекратить грудное вскармливание т.к. препарат выделяется с грудным молоком.
Способ применения и дозы
Внутрь за 30 минут до еды запивая небольшим количеством воды.
Для взрослых рекомендуемая разовая доза составляет 10 мг максимальная суточная доза составляет 30 мг (по 10 мг 3 раза в день) или 05 мг на 1 кг массы тела продолжительность лечения не должна быть более 5 дней.
Для детей старше 14 лет рекомендуемая доза 01-015 мг на 1 кг массы тела максимальная суточная доза 05 мг на 1 кг массы тела максимальная продолжительность применения 5 дней.
При почечной недостаточности: у пациентов с терминальной почечной недостаточностью (клиренс креатинина (КК) менее 15 мл/мин) - суточная доза должна быть снижена на 75%; у пациентов с умеренной и тяжелой почечной недостаточностью (КК 15-60 мл/мин) - доза должна быть снижена на 50%.
При печеночной недостаточности: у пациентов с тяжелой печеночной недостаточностью доза должна быть уменьшена на 50%.
Побочное действие
Препарат обычно хорошо переносится. Возможны расстройства:
Со стороны центральной нервной системы: экстрапирамидные расстройства сонливость утомляемость тревога головная боль шум в ушах депрессия беспокойство злокачественный нейролептический синдром; у детей может развиться дискинетический синдром (судорожное подергивание мышц лица шеи или плеч); поздняя дискинезия (при тяжелой почечной недостаточности и у пожилых людей); после длительного лечения у некоторых больных пожилого возраста могут развиться явления паркинсонизма (гиперкинез мышечная ригидность);
Со стороны пищеварительной системы: запор или диарея сухость во рту;
Со стороны эндокринной системы: (при длительном приеме в высоких дозах) - гинекомастия галакторея нарушение менструального цикла;
Со стороны сердечно-сосудистой системы: суправентрикулярная тахикардия повышение или понижение артериального давления.
Аллергические реакции: реакции гиперчувствительности крапивница;
Со стороны органов кроветворения: агранулоцитоз;
Прочие: при применении в высоких дозах - гиперемия слизистой оболочки полости носа;
Большинство побочных эффектов возникает в течение 36 часов от начала лечения и исчезает в течение 24 часов после отмены.
Передозировка
Симптомы передозировки: сонливость спутанность сознания раздражительность беспокойство судороги экстрапирамидные двигательные расстройства нарушения функции сердечно-сосудистой системы. Как правило симптомы исчезают после прекращения приема препарата через 24 часа.
Лечение: симптоматическое. Экстрапирамидные расстройства устраняют медленным введением биперидена; возможно применение диазепама.
Взаимодействие с другими лекарственными средствами
Усиливает действие этанола на центральную нервную систему седативный эффект снотворных средств повышает эффективность терапии блокаторами Н2 -гистаминовых рецепторов.Повышает всасывание тетрациклина ампициллина парацетамола ацетилсалициловой кислоты леводопы этанола биодоступность бро-мокриптина и циклоспорина (необходим контроль его концентрации в крови); замедляет всасывание дигоксина и циметидина; снижает эффективность перголида.Не рекомендуется одновременное применение с трициклическими антидепрессантами ингибиторами МАО симпатомиметиками (метоклопрамид способствует высвобождению катехоламинов из нервных окончаний) из-за возможности взаимного увеличения побочного действия и непредсказуемости изменения выраженности действия антидепрессантов и симпатомиметиков.При одновременном применении с ингибиторами обратного захвата серотонина как и с нейролептиками возрастает риск развития экстрапирамид-ных симптомов.Действие метоклопрамида могут ослабить антихолинэстеразные средства.
Особые указания
Не эффективен при рвоте вестибулярного генеза.
На фоне применения Метоклопрамида возможны искажения данных лабораторных показателей функции печени и определения концентрации альдостерона и пролактина в плазме.
В период лечения препаратом не рекомендовано употребление алкоголя.
Влияние на способность управлять автомобилем и движущимися механизмами
При приеме препарата следует избегать потенциально опасных видов деятельности требующих повышенной концентрации внимания быстрой психической и двигательной реакции (вождение транспортных средств и др.).
Форма выпуска
Таблетки 10 мг.
Условия хранения
В сухом защищенном от света месте при температуре не выше 25 °С. Хранить в недоступном для детей месте.
Срок годности
2 года. Не применять по истечении срока годности указанного на упаковке.
Условия отпуска
По рецепту
Производитель
Открытое акционерное общество "Борисовский завод медицинских препаратов" (ОАО "БЗМП"), 222518, Минская обл., г. Борисов, ул. Чапаева, д. 64, Республика Беларусь
Организация, принимающая претензии потребителей
ОАО "БЗМП"
Для описания товара использована информация от партнера 36.6
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Через гипоталамус и парасимпатическую нервную систему (иннервация желудочно-кишечного тракта) оказывает регулирующее и координирующее влияние на тонус и двигательную активность верхнего отдела желудочно-кишечного тракта (в т.ч. тонус нижнего сфинктера пищевода). Повышает тонус желудка и кишечника ускоряет опорожнение желудка уменьшает гиперацидный стаз препятствует дуоденопилорическому и гастроэзофагеальному рефлюксу стимулирует перистальтику кишечника. Нормализует отделение желчи уменьшает спазм сфинктера Одди. Не изменяя его тонуса устраняет дискинезию желчного пузыря. Не влияет на тонус кровеносных сосудов мозга артериальное давление функцию дыхания а также почек и печени на кроветворение секрецию желудка и поджелудочной железы. Стимулирует секрецию пролактина. Увеличивает чувствительность тканей к ацетилхолину (действие не зависит от вагусной иннервации но устраняется м-холиноблокаторами). Стимулируя секрецию альдостерона усиливает задержку ионов натрия и выведение ионов калия."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"Быстро всасывается из желудочно-кишечного тракта. В связи с частичным разрушением в печени после всасывания биодоступность - 75 %. Время достижения максимальной концентрации в плазме крови составляет 1-2 часа. Связь с белками плазмы - 13 - 30 %. Период полувыведения составляет от 25 до 6 часов при нарушении функции почек - до 14 часов. Выведение метоклопрамида происходит в основном через почки в течение 24 часов в неизмененном виде и в виде конъюгатов. Проходит через плацентарный и гематоэнцефалический барьеры и проникает в материнское молоко."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Рвота тошнота икота различного генеза (в некоторых случаях может быть эффективен при рвоте вызванной приемом цитостатиков). Атония и гипотония желудка и кишечника (в частности послеоперационная); дискинезия желчевыводящих путей; рефлюкс-эзофагит; метеоризм; в составе комплексной терапии обострений язвенной болезни желудка и двенадцатиперстной кишки. Применяется для усиления перистальтики при проведении рентгеноконтрастных исследований желудочно-кишечного тракта."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к компонентам препарата дефицит лактазы непереносимость лактозы глюкозо-галактозная недостаточность кровотечения из желудочно-кишечного тракта стеноз привратника желудка механическая кишечная непроходимость перфорация стенки желудка или кишечника феохромоцитома эпилепсия глаукома экстрапирамидные нарушения болезнь Паркинсона пролактинзависимые опухоли рвота на фоне лечения или передозировки нейролептиками и у больных раком молочной железы беременность (I триместр) период лактации детский возраст до 14 лет."}},{"type":"paragraph","data":{"text":"Не назначают после операций на желудочно-кишечном тракте (как пилоропластика или анастомоз кишечника) поскольку энергичные мышечные сокращения препятствуют заживлению."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Детский и пожилой возраст почечная/печеночная недостаточность бронхиальная астма артериальная гипертензия беременность II и III триместр."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Препарат противопоказан в I триместре беременности. Во II и III триместре беременности применение препарата возможно в том случае когда предполагаемая польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"На время лечения следует прекратить грудное вскармливание т.к. препарат выделяется с грудным молоком."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь за 30 минут до еды запивая небольшим количеством воды."}},{"type":"paragraph","data":{"text":"Для взрослых рекомендуемая разовая доза составляет 10 мг максимальная суточная доза составляет 30 мг (по 10 мг 3 раза в день) или 05 мг на 1 кг массы тела продолжительность лечения не должна быть более 5 дней."}},{"type":"paragraph","data":{"text":"Для детей старше 14 лет рекомендуемая доза 01-015 мг на 1 кг массы тела максимальная суточная доза 05 мг на 1 кг массы тела максимальная продолжительность применения 5 дней."}},{"type":"paragraph","data":{"text":"При почечной недостаточности: у пациентов с терминальной почечной недостаточностью (клиренс креатинина (КК) менее 15 мл/мин) - суточная доза должна быть снижена на 75%; у пациентов с умеренной и тяжелой почечной недостаточностью (КК 15-60 мл/мин) - доза должна быть снижена на 50%."}},{"type":"paragraph","data":{"text":"При печеночной недостаточности: у пациентов с тяжелой печеночной недостаточностью доза должна быть уменьшена на 50%."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Препарат обычно хорошо переносится. Возможны расстройства:"}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы: экстрапирамидные расстройства сонливость утомляемость тревога головная боль шум в ушах депрессия беспокойство злокачественный нейролептический синдром; у детей может развиться дискинетический синдром (судорожное подергивание мышц лица шеи или плеч); поздняя дискинезия (при тяжелой почечной недостаточности и у пожилых людей); после длительного лечения у некоторых больных пожилого возраста могут развиться явления паркинсонизма (гиперкинез мышечная ригидность);"}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: запор или диарея сухость во рту;"}},{"type":"paragraph","data":{"text":"Со стороны эндокринной системы: (при длительном приеме в высоких дозах) - гинекомастия галакторея нарушение менструального цикла;"}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: суправентрикулярная тахикардия повышение или понижение артериального давления."}},{"type":"paragraph","data":{"text":"Аллергические реакции: реакции гиперчувствительности крапивница;"}},{"type":"paragraph","data":{"text":"Со стороны органов кроветворения: агранулоцитоз;"}},{"type":"paragraph","data":{"text":"Прочие: при применении в высоких дозах - гиперемия слизистой оболочки полости носа;"}},{"type":"paragraph","data":{"text":"Большинство побочных эффектов возникает в течение 36 часов от начала лечения и исчезает в течение 24 часов после отмены."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы передозировки: сонливость спутанность сознания раздражительность беспокойство судороги экстрапирамидные двигательные расстройства нарушения функции сердечно-сосудистой системы. Как правило симптомы исчезают после прекращения приема препарата через 24 часа."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическое. Экстрапирамидные расстройства устраняют медленным введением биперидена; возможно применение диазепама."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Усиливает действие этанола на центральную нервную систему седативный эффект снотворных средств повышает эффективность терапии блокаторами Н2 -гистаминовых рецепторов.Повышает всасывание тетрациклина ампициллина парацетамола ацетилсалициловой кислоты леводопы этанола биодоступность бро-мокриптина и циклоспорина (необходим контроль его концентрации в крови); замедляет всасывание дигоксина и циметидина; снижает эффективность перголида.Не рекомендуется одновременное применение с трициклическими антидепрессантами ингибиторами МАО симпатомиметиками (метоклопрамид способствует высвобождению катехоламинов из нервных окончаний) из-за возможности взаимного увеличения побочного действия и непредсказуемости изменения выраженности действия антидепрессантов и симпатомиметиков.При одновременном применении с ингибиторами обратного захвата серотонина как и с нейролептиками возрастает риск развития экстрапирамид-ных симптомов.Действие метоклопрамида могут ослабить антихолинэстеразные средства."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Не эффективен при рвоте вестибулярного генеза."}},{"type":"paragraph","data":{"text":"На фоне применения Метоклопрамида возможны искажения данных лабораторных показателей функции печени и определения концентрации альдостерона и пролактина в плазме."}},{"type":"paragraph","data":{"text":"В период лечения препаратом не рекомендовано употребление алкоголя."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"При приеме препарата следует избегать потенциально опасных видов деятельности требующих повышенной концентрации внимания быстрой психической и двигательной реакции (вождение транспортных средств и др.)."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 10 мг."}}]},{"id":19,"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":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не применять по истечении срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество \"Борисовский завод медицинских препаратов\" (ОАО \"БЗМП\"), 222518, Минская обл., г. Борисов, ул. 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