Кансалазин Таблетки, 50 шт, 500 мг, для взрослых, в пленочной оболочке

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Время полувыведения составляет 0,7-2,4 часа (в среднем 1,4 ± 0,6 ч) при введении 500 мг месалазина три раза в день."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Лечение обострений и профилактика рецидивов при язвенном колите и болезни Крона."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к компонентам препарата и другим производным салициловой кислоты, заболевания крови, язвенная болезнь желудка и двенадцатиперстной кишки, дефицит глюкозо-6-фосфатдегидрогеназы, геморрагический диатез, тяжелая почечная/печеночная недостаточность, детский возраст до 18 лет."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Нарушение функции печени и почек легкой и средней степени тяжести, заболевания легких (особенно бронхиальная астма), пациентам с повышенной чувствительностью к сульфасалазину. Заболевания, предрасполагающие к развитию мио- или перикардита. Препарат с осторожностью назначают пациентам, имеющим аллергию на сульфасалазин, из-за возможной перекрестной гиперчувствительности к месалазину. Сопутствующие поражения кожи, такие как атопический дерматит и атопическая экзема, которые предрасполагают к более тяжелым реакциям фотосенсибилизации. Органическая или функциональная обструкция верхних отделов желудочно-кишечного тракта может замедлить начало действия препарата."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"\n\nБеременность"}},{"type":"paragraph","data":{"text":"Ограниченные данные о применении месалазина во время беременности не свидетельствуют о повышении риска врожденных пороков развития. Месалазин проникает через плацентарный барьер, но концентрация вещества у плода значительно ниже, чем у взрослых при применении в терапевтических дозах. Исследования на животных не выявили неблагоприятного действия месалазина на течение беременности, развития эмбриона/плода, роды или постнатальное развитие потомства. Месалазин следует применять во время беременности, только если возможная польза для матери превышает потенциальный риск для плода. Следует проявлять осторожность при назначении высоких доз препарата.\n\n"}},{"type":"paragraph","data":{"text":"\n\nГрудное вскармливание"}},{"type":"paragraph","data":{"text":"Клинические данные о применении препарата у кормящих женщин ограничены. Месалазин выделяется в грудное молоко в небольшом количестве, метаболит в более высокой концентрации. У детей, получающих грудное вскармливание, были описаны случаи спорадической диареи. Риск для ребенка не исключен. Вопрос о целесообразности применения препарата в период грудного вскармливания должен решаться индивидуально после консультации врача, если потенциальная польза для матери превосходит возможный риск для ребенка. При необходимости следует решить вопрос о прекращении грудного вскармливания.\n\n"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Прием препарата строго по назначению врача."}},{"type":"paragraph","data":{"text":"Взрослые. При язвенном колите для лечения обострения в зависимости от тяжести заболевания внутрь по 1-2 таблетки 500 мг 3 раза в сутки (суточная доза от 1,5 до 3,0 г месалазина). При болезни Крона для лечения обострения в зависимости от тяжести заболевания по 1-3 таблетки 500 мг 3 раза в сутки (суточная доза от 1,5 до 4,5 г месалазина)."}},{"type":"paragraph","data":{"text":"Для профилактики рецидивов при язвенном колите и болезни Крона препарат назначают по 500 мг 3 раза в сутки, при необходимости в течение нескольких лет."}},{"type":"paragraph","data":{"text":"Таблетки следует принимать целиком, не разжевывая, утром, днем и вечером за 1 час до еды и запивать большим количеством воды. При дистальных формах язвенного колита предпочтительно одновременное ректальное введение препарата в виде свечей или клизм, пены."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"На фоне применения месалазина наблюдались следующие побочные эффекты, систематизированные по системе органов и частоте встречаемости. Оценка нежелательных явлений основана на следующей классификации: очень частые (≥ 1/10), частые (≥ 1/100 - <1/10), нечастые (≥ 1/1000 - <1/100), редкие (≥ 1/10000 - <1/1000), очень редкие (< 1/10000), частота неизвестна (частоту возникновения побочных эффектов невозможно оценить на основании имеющихся данных)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны крови и лимфатической системы"}},{"type":"paragraph","data":{"text":"Очень редко: патологические показатели форменных элементов крови (апластическая анемия, агранулоцитоз, панцитопения, нейтропения, лейкопения, тромбоцитопения)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны нервной системы"}},{"type":"paragraph","data":{"text":"Нечасто: сонливость."}},{"type":"paragraph","data":{"text":"Редко: головная боль, головокружение."}},{"type":"paragraph","data":{"text":"Очень редко: периферическая нейропатия."}},{"type":"paragraph","data":{"text":"Нарушения со стороны сердца"}},{"type":"paragraph","data":{"text":"Нечасто: тахикардия."}},{"type":"paragraph","data":{"text":"Нарушения со стороны органов дыхания, грудной клетки и средостения"}},{"type":"paragraph","data":{"text":"Нарушения со стороны желудочно-кишечного тракта"}},{"type":"paragraph","data":{"text":"Редко: боль в животе, диарея, вздутие живота, тошнота, рвота."}},{"type":"paragraph","data":{"text":"Нарушения со стороны почек и мочевыводящих путей"}},{"type":"paragraph","data":{"text":"Очень редко: нарушения функции почек, в том числе - острый и хронический интерстициальный нефрит, почечная недостаточность."}},{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и подкожной клетчатки"}},{"type":"paragraph","data":{"text":"Редко: фоточувствительность."}},{"type":"paragraph","data":{"text":"Нарушения со стороны скелетно-мышечной системы и соединительной ткани"}},{"type":"paragraph","data":{"text":"Очень редко: миалгия, артралгия."}},{"type":"paragraph","data":{"text":"Нарушения со стороны иммунной системы"}},{"type":"paragraph","data":{"text":"Часто: гиперчувствительность (включая сыпь, зуд, крапивницу и отек лица)."}},{"type":"paragraph","data":{"text":"Нечасто: ангионевротический отек."}},{"type":"paragraph","data":{"text":"Очень редко: реакции гиперчувствительности, например —аллергическая экзантема, лекарственная лихорадка, волчаночный синдром, панколит."}},{"type":"paragraph","data":{"text":"Нарушения со стороны печени и желчевыводящих путей"}},{"type":"paragraph","data":{"text":"Очень редко: изменения функции печени (повышение активности трансаминаз и параметров холестаза), гепатит, холестатический гепатит."}},{"type":"paragraph","data":{"text":"Нарушения со стороны репродуктивной системы"}},{"type":"paragraph","data":{"text":"Очень редко: олигоспермия (обратимая)."}},{"type":"header","data":{"text":"Описание отдельных нежелательных реакций","level":3}},{"type":"paragraph","data":{"text":"Повышение внутричерепного давления"}},{"type":"paragraph","data":{"text":"При применении месалазина были зарегистрированы случаи повышения внутричерепного давления с отеком диска зрительного нерва (идиопатическая внутричерепная гипертензия или доброкачественная внутричерепная гипертензия). В случае несвоевременной диагностики это состояние может привести к сужению полей зрения и стойкой утрате зрения. При развитии этого синдрома, по возможности, прием месалазина необходимо прекратить."}},{"type":"paragraph","data":{"text":"Несахарный почечный диабет"}},{"type":"paragraph","data":{"text":"При применении месалазина были отмечены случаи развития несахарного почечного диабета."}},{"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."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Препарат Кансалазин - это аминосалицилат; признаки интоксикации салицилатами включают шум в ушах, вертиго, головную боль, спутанность сознания, сонливость, повышенное потоотделение, гипервентиляцию, рвоту и диарею. Тяжелая интоксикация может приводить к нарушению электролитного баланса и pH крови, гипертермии и обезвоживанию."}},{"type":"paragraph","data":{"text":"При острой передозировке необходимо применять стандартные методы лечения интоксикации салицилатами. Нарушение водно-электролитного баланса следует корректировать путем соответствующей внутривенной терапии. Следует поддерживать адекватную функцию почек."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nИсследований взаимодействия месалазина с другими лекарствами не проводилось."}},{"type":"paragraph","data":{"text":"У пациентов, которые одновременно получают лечение азатиоприном, 6-меркаптопурином, либо тиогуанином, следует помнить о возможном усилении миелосупрессивного эффекта азатиоприна и 6-меркаптопурина, либо тиогуанина. Применение месалазина вместе с антикоагулянтами, например, варфарином, может снижать антикоагулянтный эффект последнего.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Почечная или печеночная недостаточность"}},{"type":"paragraph","data":{"text":"Описаны случаи нарушения функции почек, включая развитие нефропатии с минимальными изменениями,острого/хронического интерстициального нефрита и почечной недостаточности при применении препаратов, содержащих месалазин или являющиеся пролекарствами месалазина. У пациентов с нарушением функции почек необходимо учитывать соотношение пользы и риска терапии месалазином, и препарат следует применять с осторожностью. Всем пациентам рекомендуется пройти исследование функции почек перед началом лечения и затем повторять его периодически в ходе лечения."}},{"type":"paragraph","data":{"text":"Препарат Кансалазин следует применять с осторожностью у пациентов с печеночной недостаточностью."}},{"type":"paragraph","data":{"text":"Реакции гиперчувствительности"}},{"type":"paragraph","data":{"text":"Большинство пациентов с гиперчувствительностью к сульфасалазину или его непереносимостью могут применять препараты месалазина без риска развития схожих реакций. Тем не менее, при лечении пациентов с аллергией к сульфасалазину следует соблюдать осторожность."}},{"type":"paragraph","data":{"text":"Реакции гиперчувствительности со стороны сердца"}},{"type":"paragraph","data":{"text":"  При применении препарата Кансалазин или других препаратов, содержащих месалазин, были описаны редкие случаи реакций гиперчувствительности со стороны сердца (миокардит и перикардит). Следует с осторожностью назначать этот препарат пациентам с заболеваниями, предрасполагающими к развитию миокардита или перикардита.  "}},{"type":"paragraph","data":{"text":"Синдром острой непереносимости"}},{"type":"paragraph","data":{"text":"Применение месалазина связывают с развитием синдрома острой непереносимости, который в некоторых случаях трудно отличить от обострения воспалительного заболевания кишечника. Хотя частота этого явления точно не установлена, в контролируемых клинических исследованиях месалазина или сульфасалазина она составляла 3%. Симптомы включают спазмы в животе, острую боль в животе, диарею с примесью крови, иногда повышение температуры, головную боль и сыпь. При подозрении на развитие синдрома острой непереносимости следует немедленно отменить препарат, содержащий месалазин."}},{"type":"paragraph","data":{"text":"Непроходимость верхних отделов желудочно-кишечного тракта"}},{"type":"paragraph","data":{"text":"Органическая или функциональная непроходимость верхних отделов желудочно-кишечного тракта может замедлять развитие эффекта препарата."}},{"type":"paragraph","data":{"text":"Фотосенсибилизация"}},{"type":"paragraph","data":{"text":"У пациентов с такими заболеваниями кожи как атопический дерматит и атопическая экзема были отмечены более тяжелые реакции фотосенсибилизации."}},{"type":"paragraph","data":{"text":"Взаимодействие с результатами лабораторных тестов"}},{"type":"paragraph","data":{"text":"Применение месалазина может приводить к ложному результату анализа, показывающему повышенное содержание норметанефрина в моче. Такие результаты возможны при применении жидкостной хроматографии с электрохимической детекцией из-за сходства хроматограмм норметанефрина и основного метаболита месалазина - N- ацетил-амино-салициловой кислоты (N-Ac-5-ACA). Поэтому для определения содержания норметанефрина в моче должен использоваться альтернативный селективный метод."}},{"type":"paragraph","data":{"text":"Примечание"}},{"type":"paragraph","data":{"text":"1 таблетка препарата Кансалазин содержит 80 мг натрия. Если пациент находится на диете с контролем содержания солей натрия, следует принять это во внимание."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Исследований влияния препарата Кансалазин на способность управлять транспортными средствами и движущимися механизмами не проводилось. Считается, что препарат Кансалазин не оказывает влияние на эту способность. Однако, пациенты должны быть предупреждены о возможности развития головокружения и сонливости на фоне применения препарата. При появлении описанных нежелательных явлений следует воздержаться от выполнения указанных видов деятельности."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nТаблетки кишечнорастворимые, покрытые пленочной оболочкой, 500 мг."}},{"type":"paragraph","data":{"text":"По 10 таблеток в контурную ячейковую упаковку из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной. По 5 или 10 контурных ячейковых упаковок вместе с инструкцией по применению помещают в пачку из картона.\n\n"}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"\n\nПри температуре не выше 25 °С во вторичной упаковке (пачке картонной)."}},{"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":"\n\n3 года"}},{"type":"paragraph","data":{"text":"Не применять по истечении срока годности\n\n"}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.vidal.ru/drugs/firm/7396\"\u003eКРОНОФАРМ \u003c/a\u003e(Россия)  "}}]}],"source":null},"description_toggle":false,"short_description":"Обладает противовоспалительным действием. Ингибирует синтез метаболитов арахидоновой кислоты (простагландинов), активность нейтрофильной липооксигеназы, тормозит миграцию, дегрануляцию и фагоцитоз нейтрофилов, секрецию иммуноглобулинов лимфоцитами; связывает и разрушает свободные радикалы кислорода. Фармакокинетика Биотрансформация Месалазин метаболизируется как пресистемным путем в слизистой оболочке кишечника, так и системным путем в печени, превращаясь в фармакологически неактивную N-ацетил-5-аминосалициловую кислоту (N-Aц-5-АСК). Характер ацетилирования не зависит от ацетилирующего фенотипа пациента. В небольшой степени ацетилирование может осуществляться за счет действия бактериальной микрофлоры толстой кишки. Связь с белками плазмы месалазина и N-Aц-5-ACK составляет соответственно 43% и 78%. Распределение Комбинированное фармакосцинтиграфическое/фармакокинетическое исследование продемонстрировало, что при приеме с пищей таблетки месалазина, покрытые кишечнорастворимой оболочкой, растворяются приблизительно через 3-4 часа в подвздошной кишке. Среднее время эвакуации желудочного содержимого составило приблизительно 3 часа. После приблизительно 7 часов, таблетки достигли толстой кишки. Приблизительно 75% дозы месалазина достигают кишечника в неметаболизированном виде. Абсорбция Абсорбция месалазина максимальна в проксимальных отделах кишечника и минимальна в дистальных отделах. Наивысшая концентрация в плазме крови достигается после приблизительно 5 часов (в области подвздошной кишки) и при введении 500 мг месалазина три раза в день при условии установившегося равновесия составляет 2,1 ± 1,7 мкг/мл для месалазина и 2,8 ± 1,7 мкг/мл для его метаболита, N-Лц-5-ЛСК. Выведение Месалазин и его метаболит N-Лц-5-ЛСК выводятся с калом (основная часть), через почки (от 20% до 50%, в зависимости от способа применения, фармакологического препарата и пути высвобождения месалазина), а также с желчью. N-Лц-5-ЛСК преимущественно выделяется с почками. Около 1% принятой внутрь дозы месалазина выводится с грудным молоком, преимущественно в виде N-Лц-5-ЛСК. При длительном лечении с использованием таблеток месалазина при дневной дозе 500 мг (при условии установившегося равновесия) суммарная скорость выведения почками месалазина и N-Ац-5-ЛСК составила приблизительно 55% полученное в течение 24 часов после введения последней дозы). Доля неметаболизированного месалазина составляла приблизительно 5%. 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