Попадая в организм человека, валацикловир превращается в аци... Инструкция
Показания к применению
Терапия лабильного герпеса; терапия опоясывающего герпеса; профилактика и терапия рецидивов инфекций слизистых оболочек и кожи, которые вызваны вирусом простого герпеса; проявляет эффект при профилактике цитомегаловирусной инфекции, которая возникает при трансплантации органов; понижает инфицирование здорового партнера генитальным герпесом.
Противопоказания
Препарат не рекомендован к применению при трансплантации почек и костного мозга; при выраженной форме ВИЧ-инфекции; при наличии индивидуальной непереносимости к компонентам лекарства; детский возраст до 12 лет.
Попадая в организм человека, валацикловир превращается в ацикловир и L-валин. Ацикловир проявляет свою активность по отношению к вирусам, разрушая их ДНК. Пациенты, имеющие тяжелые нарушения иммунитета (получающие химиотерапию, ВИЧ-инфицированные, больные с трансплантатом костного мозга), вирусы имеют пониженную чувствительность к валацикловиру.
Показания к применению
Терапия лабильного герпеса; терапия опоясывающего герпеса; профилактика и терапия рецидивов инфекций слизистых оболочек и кожи, которые вызваны вирусом простого герпеса; проявляет эффект при профилактике цитомегаловирусной инфекции, которая возникает при трансплантации органов; понижает инфицирование здорового партнера генитальным герпесом.
Противопоказания
Препарат не рекомендован к применению при трансплантации почек и костного мозга; при выраженной форме ВИЧ-инфекции; при наличии индивидуальной непереносимости к компонентам лекарства; детский возраст до 12 лет.
Применение при беременности и в период грудного вскармливания
Опыта применения препарата в период беременности недостаточно. Назначение валацикловира рекомендовано только в том случае, когда терапевтический эффект для матери выше возможного риска для плода. Метаболит Валвира – ацикловир – выделяется с грудным молоком. Грудное вскармливание разрешено только тогда, когда эффект от лечения для матери значительно выше предполагаемого риска для ребенка.
Способ применения и дозы
Препарат предназначен для приема внутрь, назначают только взрослым при следующих заболеваниях: опоясывающий герпес – курс лечения 7 дней по 1 гр. 3 раза в день.простой герпес – по 0,5 гр. 2 раза в день. Рецидивы требуют курса лечения в 3-5 дней. Если терапия проводится впервые, то длительность приема лекарства должна составлять до 10 дней.лабиальный герпес – терапия должна проводиться по следующей схеме: 1 день – 2 г 2 раза, следующая доза принимается через 12 часов.профилактика рецидивов инфекций, которые вызваны вирусом простого герпеса – при сохраненном иммунитете назначают по 0,5 г 1 раз в день; при частых рецидивах (10 раз в год и больше) назначают по 0,25 г 2 раза в день; при иммунодефиците назначают по 0,5 г 2 раза в день. Длительность курса лечения составляет от 4 до 12 месяцев.профилактика инфицирования здорового партнера генитальным герпесом – если инфицирован гетеросексуальный взрослый, имеющий сохраненный иммунитет и число обострений 9 раз за год, то назначают по 0,5 г 1 раз в день в течение года. При регулярной половой жизни прием препарата необходимо осуществлять каждый день. Если половые контакты нерегулярные, то принимать Валвир следует за 3 суток до предполагаемого полового контакта.профилактика цитомегаловирусной инфекции – подросткам от 12 лет и взрослым назначают по 2 г 4 раза в день (лечение необходимо начать сразу после трансплантации). Длительность курса лечения 90 дней. У пациентов с высоким риском терапия может быть более длительной. Определение дозы препарата также зависят от показателя клиренса креатинина (КК). Больным, которые проходят гемодиализ, следует начать прием препарата как можно раньше после окончания процедуры. Если у пациента имеется умеренно или слабо выраженный цирроз печени при сохранении синтетической функции, не требуется коррекция дозировки препарата. Нет необходимости корректировать дозу и при тяжелом циррозе печени. Но следует учитывать, что опыт применения при этой патологи ограничен. В пожилом возрасте не требуется корректировка дозы. Исключением является значительное нарушение функции почек.
Побочное действие
Наиболее распространенные Побочное реакции – это тошнота и головная боль. К серьезным побочным эффектам относятся неврологические нарушения, острая почечная недостаточность, тромбоцитопеническая пурпура, уремический синдром. Со стороны лимфатической системы и крови: тромбоцитопения и лейкопения. Со стороны пищеварительной системы: дискомфорт или боль в животе, тошнота, рвота, диарея. Со стороны психики и нервной системы: агрессивное поведение, спутанность сознания, головокружение, снижение интеллектуальных способностей, галлюцинации. Очень редко возможны тремор, возбуждение, дизартрия, атаксия, депрессия, мания, кома, энцефалопатия, судороги. Данные симптомы являются обратимыми и возникают у больных, имеющих заболевания почек. Со стороны иммунной системы: анафилаксия. Со стороны подкожной клетчатки и кожи: зуд, высыпания. Со стороны дыхательной системы: диспноэ. Со стороны мочевыделительной системы: нарушение функции почек, почечная колика, острая почечная недостаточность. Аллергические реакции: ангионевротический отек, крапивница. Также возможно нарушение зрения, понижение гемоглобина, анемия, повышение АД, отек лица, инфекции дыхательных путей, утомляемость, тахикардия.
Передозировка
Сведений по передозировке валацикловиром в настоящее время недостаточно. При потреблении лекарства в дозах превышающих терапевтическую норму, могут проявиться следующие симптомы передозировки: если однократная доза выше нормы до 20 г, тогда препарат не оказывает токсическое действие; если сверхвысокая доза принимается несколько дней, тогда появляется головная боль, тошнота, рвота, спутанность сознания. В случае передозировки необходимо провести симптоматическое лечение.
Особые указания
При появлении побочного действия со стороны ЦНС (бред, галлюцинации, судороги) необходимо отменить препарат. При наличии почечной недостаточности повышается риск появления неврологических осложнений. Коррекцию дозы препарата можно не проводить при умеренном или слабом циррозе печени и других нарушениях функции печени. Также не требуется коррекция дозы пожилым больным. Исключением являются пожилые пациенты, имеющим значительное нарушение функции почек. Опыт клинического использования валацикловира в педиатрии нет. Если проявляются побочные действия лекарства, связанные с психомоторными реакциями, то необходимо быть осторожными при вождении автотранспортом и управлении механизмами.
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