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
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 1-адренорецепторами и несколько слабее с гистаминовыми Н1-рецепторами и 2-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 следует назначать препарат при следующих состояниях:
Состояния, предрасполагающие к развитию тахикардии типа "пируэт" (брадикардия, нарушение электролитного баланса, сопутствующий прием препаратов, удлиняющих интервал QT)
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
Препарат принимают внутрь, независимо от приема пищи, запивая водой.; Для взрослых и детей старше 15 лет начальная доза Рисполюкса при острых проявлениях болезни и хроническом течении составляет 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 Рисполюксом можно назначать бензодиазепины.; При почечной и/или печеночной недостаточности и для пациентов пожилого возраста рекомендуемая начальная доза Рисполюкса составляет по 500 мкг 2 раза/сут. Эта доза может быть постепенно (по 500 мкг) увеличена до 1-2 мг на прием 2 раза/сут.; При переходе на лечение Рисполюксом рекомендуется постепенная отмена ранее принимавшегося нейролептика. Если ранее применялся нейролептик-депо для парентерального введения, первую дозу Рисполюкса следует принять вместо инъекции в соответствии с режимом введения нейролептика-депо.
Побочное действие
Со стороны сердечно-сосудистой системы: ортостатическая гипотензия, рефлекторная тахикардия, артериальная гипертензия, синусовая брадикардия, AV-блокада 1 степени, фибрилляция предсердий, синкопе, периферические отеки.; Со стороны пищеварительной системы: сухость во рту, тошнота, рвота, дискинезия, диспепсия, анорексия, абдоминальные боли, запоры, гипо- или гиперсаливация, желтуха, дисфагия, гастрит, панкреатит, повышение уровня АЛТ, АСТ.; 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, острая дистония), нарушение мозгового кровообращения (у пожилых больных с предрасполагающими факторами), нарушение координации, нарушения речи, гипочувствительность, нарушения сна. У больных шизофренией отмечались поздняя дискинезия (непроизвольные движения языка и сокращения мышц лица), ЗНС (гипертермия, крайняя степень ригидности мышц, нарушение сознания, вегетативные расстройства, повышение активности креатинфосфокиназы, тахипноэ), эпилептические припадки.; Со стороны мочеполовой системы: приапизм, нарушения эрекции, аноргазмия, недержание мочи, нарушение эякуляции.; Со стороны эндокринной системы: галакторея, гинекомастия, нарушения менструального цикла, гипергликемия, гиперпролактинемия, нарушение выработки АДГ.; Аллергические реакции: кожная сыпь, ринит, кожный зуд, ангионевротический отек, анафилактический шок.; Лабораторные показатели: нейтропения, тромбоцитопения, анемия, гранулоцитопения, агранулоцитоз, эозинофилия, лейкопения.; Прочие: сухость кожи, гиперпигментация, фотосенсибилизация, гиперкератоз, повышенное потоотделение, увеличение массы тела, артралгия, миалгия, нарушения зрения, мании, заложенность носа, носовое кровотечение, апноэ во время сна, у пожилых пациентов с деменцией повышенная восприимчивость 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 1-адренорецепторами и несколько слабее с гистаминовыми Н1-рецепторами и 2-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":"list","data":{"style":"unordered","items":["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."}},{"type":"paragraph","data":{"text":"С осторожностью следует назначать препарат при следующих состояниях:"}},{"type":"list","data":{"style":"unordered","items":["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 QT)","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":"Препарат принимают внутрь, независимо от приема пищи, запивая водой.; Для взрослых и детей старше 15 лет начальная доза Рисполюкса при острых проявлениях болезни и хроническом течении составляет 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 Рисполюксом можно назначать бензодиазепины.; При почечной и/или печеночной недостаточности и для пациентов пожилого возраста рекомендуемая начальная доза Рисполюкса составляет по 500 мкг 2 раза/сут. Эта доза может быть постепенно (по 500 мкг) увеличена до 1-2 мг на прием 2 раза/сут.; При переходе на лечение Рисполюксом рекомендуется постепенная отмена ранее принимавшегося нейролептика. Если ранее применялся нейролептик-депо для парентерального введения, первую дозу Рисполюкса 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":"Со стороны сердечно-сосудистой системы: ортостатическая гипотензия, рефлекторная тахикардия, артериальная гипертензия, синусовая брадикардия, AV-блокада 1 степени, фибрилляция предсердий, синкопе, периферические отеки.; Со стороны пищеварительной системы: сухость во рту, тошнота, рвота, дискинезия, диспепсия, анорексия, абдоминальные боли, запоры, гипо- или гиперсаливация, желтуха, дисфагия, гастрит, панкреатит, повышение уровня АЛТ, АСТ.; 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, острая дистония), нарушение мозгового кровообращения (у пожилых больных с предрасполагающими факторами), нарушение координации, нарушения речи, гипочувствительность, нарушения сна. У больных шизофренией отмечались поздняя дискинезия (непроизвольные движения языка и сокращения мышц лица), ЗНС (гипертермия, крайняя степень ригидности мышц, нарушение сознания, вегетативные расстройства, повышение активности креатинфосфокиназы, тахипноэ), эпилептические припадки.; Со стороны мочеполовой системы: приапизм, нарушения эрекции, аноргазмия, недержание мочи, нарушение эякуляции.; Со стороны эндокринной системы: галакторея, гинекомастия, нарушения менструального цикла, гипергликемия, гиперпролактинемия, нарушение выработки АДГ.; Аллергические реакции: кожная сыпь, ринит, кожный зуд, ангионевротический отек, анафилактический шок.; Лабораторные показатели: нейтропения, тромбоцитопения, анемия, гранулоцитопения, агранулоцитоз, эозинофилия, лейкопения.; Прочие: сухость кожи, гиперпигментация, фотосенсибилизация, гиперкератоз, повышенное потоотделение, увеличение массы тела, артралгия, миалгия, нарушения зрения, мании, заложенность носа, носовое кровотечение, апноэ во время сна, у пожилых пациентов с деменцией повышенная восприимчивость 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).; 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."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Антипсихотический препарат (нейролептик), производное бензизоксазола. 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