Повышенная чувствительность к компонентам препарата, одновременное применение с тизанидином, одновременное применение с ингибиторами МАО, беременность и период лактации. С осторожностью следует назначать препарат при печеночной и почечной недостаточности, судорогах в анамнезе, эпилепсии, пациентам со склонностью к кровотечениям (тромбоцитопения), при ...
Феварин – препарат из группы антидепрессантов, селективно ингибирующий обратный захват серотонина. Действующее вещество – флувоксамин – селективно блокирует захват серотонина нейронами головного мозга. Феварин практически не влияет на процессы обмена норадреналина, обладает слабым сродством к адренорецепторам, серотониновым, допаминовым, гистаминовым и холинорецепторам.
Фармакологические свойства
Механизм действия связан с избирательным ингибированием обратного захвата серотонина нейронами головного мозга и характеризуется минимальным влиянием на норадренергическую передачу. Феварин® обладает слабой способностью связываться с α- и β-адренорецепторами, гистаминовыми, м-холинорецепторами, допаминовыми и серотониновыми рецепторами.
Повышенная чувствительность к компонентам препарата, одновременное применение с тизанидином, одновременное применение с ингибиторами МАО, беременность и период лактации. С осторожностью следует назначать препарат при печеночной и почечной недостаточности, судорогах в анамнезе, эпилепсии, пациентам со склонностью к кровотечениям (тромбоцитопения), при беременности, а также пациентам пожилого возраста.
Применение при беременности и в период грудного вскармливания
Данные небольшого числа наблюдений не выявили неблагоприятного воздействия флувоксамина на беременность. Потенциальный риск неизвестен. Во время беременности следует соблюдать осторожность. Были описаны отдельные случаи синдрома отмены у новорожденных после использования флувоксамина во время беременности. Феварин проникает в небольших количествах в грудное молоко. В связи с этим его нельзя применять в период грудного вскармливания.
Способ применения и дозы
Рекомендуемая начальная доза при лечении депрессии составляет 50 мг или 100 мг 1 раз в сутки, вечером. Повышение дозы следует проводить постепенно. Эффективную дозу подбирают индивидуально в зависимости от реакции больного на лечение (обычно 100 мг/сутки), Суточная доза может достигать 300 мг. В соответствии с официальными рекомендациями ВОЗ лечение антидепрессантами следует продолжать, по крайней мере, в течение 6 месяцев после излечения депрессивного эпизода. Дозы более 150 мг/сутки следует распределять на несколько приемов.
Побочное действие
Наиболее часто наблюдаемым симптомом является тошнота, иногда сопровождающаяся рвотой. Этот побочный эффект, как правило, исчезает в течение первых двух недель лечения. Со стороны пищеварительной системы: часто - боль в животе, анорексия, запор, диарея, сухость во рту, диспепсия, редко - нарушение функции печени (повышение уровня печеночных трансаминаз). Со стороны ЦНС и периферической нервной системы: часто - астения, головная боль, недомогание, нервозность, тревога, ажитация, головокружение, бессонница или сонливость, тремор, иногда - атаксия, спутанность сознания, экстрапирамидные нарушения, галлюцинации, редко - судороги, маниакальный синдром, серотониновый синдром, состояние, подобное ЗНС, очень редко - парестезии, извращение вкуса. Со стороны обмена веществ: гипонатриемия, синдром недостаточной секреции АДГ.
Передозировка
Симптомы: наиболее характерны тошнота, рвота, диарея, сонливость, головокружение. Имеются сообщения о нарушениях сердечной деятельности (тахикардия, брадикардия, артериальная гипотензия), нарушениях функции печени, судорогах, коме.
Особые указания
До настоящего времени поступило свыше 300 сообщений о случаях преднамеренной передозировки Феварина. Наивысшая зарегистрированная доза Феварина, полученная одним больным, составила 12 г, этот больной был излечен в результате симптоматической терапии. Более серьезные осложнения наблюдались в случаях преднамеренной передозировки Феварина на фоне сопутствующей фармакотерапии. Лечение: промывание желудка, которое должно проводиться как можно раньше после приема препарата, а также симптоматическая терапия. Кроме того, рекомендуется многократный прием активированного угля. Усиленный диурез или диализ представляются неоправданными. Специфического антидота не существует.
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