Шизофрения (купирование обострений, поддерживающая терапия) и другие психотические расстройства. С преобладанием продуктивной и/или негативной симптоматики. Биполярные расстройства при маниях. Аффективные расстройства при различных психических заболеваниях. Поведенческие расстройства у пациентов с деменцией при проявлении симптомов агрессивности. Нарушениях ...
Повышенная чувствительность к рисперидону или другим компонентам препарата. период лактации. С осторожностью: Тяжелая почечная и/или печеночная недостаточность. Сердечно-сосудистые заболевания (хроническая сердечная недостаточность, перенесенный инфаркт миокарда, AV блокада). Гиповолемия. Состояния, предрасполагающие к развитию тахикардии типа «пируэт» ...
Антипсихотический препарат (нейролептик), производное бензизоксазола. Оказывает также седативное, противорвотное и гипотермическое действие. Селективный моноаминергический антагонист, обладает высокой тропностью к серотонинергическим 5-НТ2-рецепторам и допаминергическим D2-рецепторам, связывается также с α1-адренорецепторами и несколько слабее с гистаминовыми Н1-рецепторами и α2-адренорецепторами. Не обладает тропностью к холинергическим рецепторам. Рисперидон особенно эффективен при лечении шизофрении с продуктивной симптоматикой (бред, галлюцинации, агрессивность), оказывает также положительное действие при негативной симптоматике. Сбалансированный центральный антагонизм к серотонину и допамину может уменьшать склонность к экстрапирамидным побочным действиям и расширять терапевтическое воздействие препарата с охватом негативных и аффективных симптомов шизофрении. Вызывает меньшее подавление моторной активности и в меньшей степени индуцирует каталепсию, чем классические антипсихотические нейролептики.
Показания к применению
Шизофрения (купирование обострений, поддерживающая терапия) и другие психотические расстройства. С преобладанием продуктивной и/или негативной симптоматики. Биполярные расстройства при маниях. Аффективные расстройства при различных психических заболеваниях. Поведенческие расстройства у пациентов с деменцией при проявлении симптомов агрессивности. Нарушениях деятельности (возбуждение, бред) или психотических симптомах. Поведенческие расстройства у пациентов со сниженным интеллектуальным уровнем или задержкой. Умственного развития, в т.ч. В качестве средства вспомогательной терапии для стабилизации. Настроения.
Противопоказания
Повышенная чувствительность к рисперидону или другим компонентам препарата. период лактации. С осторожностью: Тяжелая почечная и/или печеночная недостаточность. Сердечно-сосудистые заболевания (хроническая сердечная недостаточность, перенесенный инфаркт миокарда, AV блокада). Гиповолемия. Состояния, предрасполагающие к развитию тахикардии типа «пируэт» (брадикардия, нарушение электролитного баланса, сопутствующий прием препаратов, удлиняющих интервал ). Болезнь Паркинсона. Нарушение мозгового кровообращения. Синдром Рейе. Эпилепсия, судороги в анамнезе. Опухоль мозга. Острая передозировка лекарств, лекарственная зависимость. Дисфагия. Кишечная непроходимость. Детский возраст до 15 лет (опыт применения ограничен). Беременность.
Применение при беременности и в период грудного вскармливания
Применение рисперидона при беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. Препарат выделяется с грудным молоком, поэтому при приеме препарата необходимо прекратить грудное вскармливание.
Способ применения и дозы
Внутрь, независимо от приема пищи, запивая водой. Взрослые и дети старше 15 лет. Начальная доза препарата Рисполюкс для всех пациентов (при острых проявлениях болезни и хроническом течении) - 2 мг/сут (в 1 или 2 приема), на второй день - до 4 мг/сут; далее при необходимости доза может быть увеличена или уменьшена по 1–2 мг с недельными интервалами. Дозы выше 10 мг/сут не показали более высокой эффективности по сравнению с меньшими дозами и могут вызвать появление экстрапирамидных симптомов. Максимальная суточная доза - 16 мг. В случае необходимости достижения седативного действия одновременно с препаратом Рисполюкс можно назначать бензодиазепины. Почечная и/или печеночная недостаточность и пациенты старшей возрастной группы. Рекомендуемая начальная доза препарата Рисполюкс составляет по 0,5 мг 2 раза в сутки. Эта доза может быть постепенно (по 0,5 мг) увеличена до 1–2 мг на прием 2 раза в сутки. При переходе на лечение препаратом Рисполюкс рекомендуется постепенная отмена ранее принимавшегося нейролептика. Если ранее применялся нейролептик-депо для парентерального введения, первую дозу препарата Рисполюкс следует принять вместо инъекции в соответствии с режимом введения нейролептика-депо.
Побочное действие
Аллергические реакции кожная сыпь, ринит, кожный зуд, ангионевротический отек, анафилактическийшок, Со стороны CCC ортостатическая гипотензия, рефлекторная тахикардия, артериальная гипертензия, синусовая брадикардия, AV блокада I степени, фибрилляция предсердий, синкопе, периферические отеки. Со стороны ЖКТ сухость во рту, тошнота, рвота, дискинезия, диспепсия, анорексия, абдоминальные боли, запоры, гипо- или гиперсаливация, желтуха, дисфагия, гастрит, панкреатит. Со стороны нервной системы бессонница, головная боль, головокружение, возбуждение, беспокойство, сонливость, утомляемость, снижение способности к концентрации внимания, судороги. редко -экстрапирамидные расстройства (тремор, ригидность, гиперсаливация, брадикинезия, акатизия, остраядистония), нарушение координации, нарушение речи, гипочувствительность, нарушение сна. нарушениемозгового кровообращения (у пожилых больных с предрасполагающими факторами). У больных шизофренией поздняя дискинезия (непроизвольные движения языка и сокращения мышц лица), злокачественный нейролептический синдром (гипертермия, крайняя степень ригидности мышц, нарушениесознания, вегетативные расстройства, повышение активности креатинфосфокиназы, тахипноэ), эпилептические припадки. Со стороны мочеполовой системы приапизм, нарушение эрекции, аноргазмия, недержание мочи, нарушение эякуляции. Со стороны эндокринной системы галакторея, гинекомастия, нарушение менструального цикла, гипергликемия, гиперпролактинемия, нарушение выработки антидиуретического гормона. Лабораторные показатели нейтропения, тромбоцитопения, анемия, гранулоцитопения, агранулоцитоз, увеличение уровня АЛТ, эозинофилия, лейкопения, увеличение уровня АСТ. Прочие сухость кожи, гиперпигментация, фотосенсибилизация, гиперкератоз, повышенноепотоотделение, увеличение массы тела, артралгия, миалгия, нарушение зрения, мании, заложенностьноса, носовое кровотечение, апноэ во время сна, у пожилых пациентов с деменцией повышеннаявосприимчивость к инфекциям, полидипсия.
Передозировка
Симптомы: сонливость, седация, тахикардия, артериальная гипотензия, экстрапирамидные симптомы, редко - удлинение интервала QT. Лечение: при острой передозировке следует обеспечить свободную проходимость дыхательных путей для обеспечения адекватного снабжения кислородом и вентиляции, мониторирование ЭКГ, промывание желудка, назначение активированного угля и слабительных, симптоматической терапии, направленной на поддержание жизненно важных функций организма, при развитии экстрапирамидных симптомов назначение антихолинергических лекарственных средств. Постоянное медицинское наблюдение следует продолжать до полного исчезновения симптомов интоксикации. Специфического антидота нет.
Особые указания
В связи с тем, что прием Рисполюкса может приводить к увеличению массы тела, пациенту следует дать рекомендации по режиму питания. При возникновении ортостатической гипотензии, особенно в начале лечения, следует рассмотреть вопрос о снижении дозы. У пациентов с заболеваниями сердечно-сосудистой системы, а также при обезвоживании, гиповолемии или цереброваскулярных нарушениях дозу следует увеличивать постепенно. При отмене карбамазепина и других индукторов печеночных ферментов доза Рисполюкса должна быть снижена. При появлении симптомов поздней дискинезии или злокачественного нейролептического синдрома следует рассмотреть вопрос об отмене всех антипсихотических лекарственных средств, включая Рисполюкс. Рекомендуется постепенная отмена препарата, т.к. после резкого прекращения лечения высокими дозами нейролептиков возможно развитие синдрома отмены (рвота, тошнота, повышенное потоотделение, бессонница). Влияние на способность к вождению автотранспорта и управлению механизмами: Во время лечения рисперидоном следует соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенного внимания и быстроты психомоторных реакций.
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Оказывает также седативное, противорвотное и гипотермическое действие. Селективный моноаминергический антагонист, обладает высокой тропностью к серотонинергическим 5-НТ2-рецепторам и допаминергическим D2-рецепторам, связывается также с α1-адренорецепторами и несколько слабее с гистаминовыми Н1-рецепторами и α2-адренорецепторами. Не обладает тропностью к холинергическим рецепторам. Рисперидон особенно эффективен при лечении шизофрении с продуктивной симптоматикой (бред, галлюцинации, агрессивность), оказывает также положительное действие при негативной симптоматике. Сбалансированный центральный антагонизм к серотонину и допамину может уменьшать склонность к экстрапирамидным побочным действиям и расширять терапевтическое воздействие препарата с охватом негативных и аффективных симптомов шизофрении. Вызывает меньшее подавление моторной активности и в меньшей степени индуцирует каталепсию, чем классические антипсихотические нейролептики."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Шизофрения (купирование обострений, поддерживающая терапия) и другие психотические расстройства. С преобладанием продуктивной и/или негативной симптоматики. Биполярные расстройства при маниях. Аффективные расстройства при различных психических заболеваниях. Поведенческие расстройства у пациентов с деменцией при проявлении симптомов агрессивности. Нарушениях деятельности (возбуждение, бред) или психотических симптомах. Поведенческие расстройства у пациентов со сниженным интеллектуальным уровнем или задержкой. Умственного развития, в т.ч. В качестве средства вспомогательной терапии для стабилизации. Настроения."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к рисперидону или другим компонентам препарата. период лактации. С осторожностью: Тяжелая почечная и/или печеночная недостаточность. Сердечно-сосудистые заболевания (хроническая сердечная недостаточность, перенесенный инфаркт миокарда, AV блокада). Гиповолемия. Состояния, предрасполагающие к развитию тахикардии типа «пируэт» (брадикардия, нарушение электролитного баланса, сопутствующий прием препаратов, удлиняющих интервал ). Болезнь Паркинсона. Нарушение мозгового кровообращения. Синдром Рейе. Эпилепсия, судороги в анамнезе. Опухоль мозга. Острая передозировка лекарств, лекарственная зависимость. Дисфагия. Кишечная непроходимость. Детский возраст до 15 лет (опыт применения ограничен). Беременность."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение рисперидона при беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. Препарат выделяется с грудным молоком, поэтому при приеме препарата необходимо прекратить грудное вскармливание."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь, независимо от приема пищи, запивая водой. Взрослые и дети старше 15 лет. Начальная доза препарата Рисполюкс для всех пациентов (при острых проявлениях болезни и хроническом течении) - 2 мг/сут (в 1 или 2 приема), на второй день - до 4 мг/сут; далее при необходимости доза может быть увеличена или уменьшена по 1–2 мг с недельными интервалами. Дозы выше 10 мг/сут не показали более высокой эффективности по сравнению с меньшими дозами и могут вызвать появление экстрапирамидных симптомов. Максимальная суточная доза - 16 мг. В случае необходимости достижения седативного действия одновременно с препаратом Рисполюкс можно назначать бензодиазепины. Почечная и/или печеночная недостаточность и пациенты старшей возрастной группы. Рекомендуемая начальная доза препарата Рисполюкс составляет по 0,5 мг 2 раза в сутки. Эта доза может быть постепенно (по 0,5 мг) увеличена до 1–2 мг на прием 2 раза в сутки. При переходе на лечение препаратом Рисполюкс рекомендуется постепенная отмена ранее принимавшегося нейролептика. Если ранее применялся нейролептик-депо для парентерального введения, первую дозу препарата Рисполюкс следует принять вместо инъекции в соответствии с режимом введения нейролептика-депо."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Аллергические реакции кожная сыпь, ринит, кожный зуд, ангионевротический отек, анафилактическийшок, Со стороны CCC ортостатическая гипотензия, рефлекторная тахикардия, артериальная гипертензия, синусовая брадикардия, AV блокада I степени, фибрилляция предсердий, синкопе, периферические отеки. Со стороны ЖКТ сухость во рту, тошнота, рвота, дискинезия, диспепсия, анорексия, абдоминальные боли, запоры, гипо- или гиперсаливация, желтуха, дисфагия, гастрит, панкреатит. Со стороны нервной системы бессонница, головная боль, головокружение, возбуждение, беспокойство, сонливость, утомляемость, снижение способности к концентрации внимания, судороги. редко -экстрапирамидные расстройства (тремор, ригидность, гиперсаливация, брадикинезия, акатизия, остраядистония), нарушение координации, нарушение речи, гипочувствительность, нарушение сна. нарушениемозгового кровообращения (у пожилых больных с предрасполагающими факторами). У больных шизофренией поздняя дискинезия (непроизвольные движения языка и сокращения мышц лица), злокачественный нейролептический синдром (гипертермия, крайняя степень ригидности мышц, нарушениесознания, вегетативные расстройства, повышение активности креатинфосфокиназы, тахипноэ), эпилептические припадки. Со стороны мочеполовой системы приапизм, нарушение эрекции, аноргазмия, недержание мочи, нарушение эякуляции. Со стороны эндокринной системы галакторея, гинекомастия, нарушение менструального цикла, гипергликемия, гиперпролактинемия, нарушение выработки антидиуретического гормона. Лабораторные показатели нейтропения, тромбоцитопения, анемия, гранулоцитопения, агранулоцитоз, увеличение уровня АЛТ, эозинофилия, лейкопения, увеличение уровня АСТ. Прочие сухость кожи, гиперпигментация, фотосенсибилизация, гиперкератоз, повышенноепотоотделение, увеличение массы тела, артралгия, миалгия, нарушение зрения, мании, заложенностьноса, носовое кровотечение, апноэ во время сна, у пожилых пациентов с деменцией повышеннаявосприимчивость к инфекциям, полидипсия."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: сонливость, седация, тахикардия, артериальная гипотензия, экстрапирамидные симптомы, редко - удлинение интервала QT. Лечение: при острой передозировке следует обеспечить свободную проходимость дыхательных путей для обеспечения адекватного снабжения кислородом и вентиляции, мониторирование ЭКГ, промывание желудка, назначение активированного угля и слабительных, симптоматической терапии, направленной на поддержание жизненно важных функций организма, при развитии экстрапирамидных симптомов назначение антихолинергических лекарственных средств. Постоянное медицинское наблюдение следует продолжать до полного исчезновения симптомов интоксикации. Специфического антидота нет."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В связи с тем, что прием Рисполюкса может приводить к увеличению массы тела, пациенту следует дать рекомендации по режиму питания. При возникновении ортостатической гипотензии, особенно в начале лечения, следует рассмотреть вопрос о снижении дозы. У пациентов с заболеваниями сердечно-сосудистой системы, а также при обезвоживании, гиповолемии или цереброваскулярных нарушениях дозу следует увеличивать постепенно. При отмене карбамазепина и других индукторов печеночных ферментов доза Рисполюкса должна быть снижена. При появлении симптомов поздней дискинезии или злокачественного нейролептического синдрома следует рассмотреть вопрос об отмене всех антипсихотических лекарственных средств, включая Рисполюкс. Рекомендуется постепенная отмена препарата, т.к. после резкого прекращения лечения высокими дозами нейролептиков возможно развитие синдрома отмены (рвота, тошнота, повышенное потоотделение, бессонница). 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