Метаболический препарат. Тиоктовая (α-липоевая) кислота - эндогенный антиоксидант (связывает свободные радикалы), синтезируется в организме при окислительном декарбоксилировании альфа-кетокислот. В качестве коэнзима митохондриальных мультиферментных комплексов участвует в окислительном декарбоксилировании пировиноградной кислоты и альфа-кетокислот. Способствует снижению концентрации глюкозы в крови и увеличению содержания гликогена в печени, а также преодолению инсулинорезистентности. Участвует в регулировании липидного и углеводного обмена, влияет на обмен холестерина, улучшает функцию печени, оказывает дезинтоксикационное действие при отравлении солями тяжелых металлов и при других интоксикациях. Оказывает гепатопротекторное, гиполипидемическое, гипохолестеринемическое и гипогликемическое действие. Улучшает трофику нейронов. При сахарном диабете тиоктовая кислота улучшает эндоневральный кровоток, повышает содержание глутатиона до физиологического значения, что в результате приводит к улучшению функционального состояния периферических нервных волокон при диабетической полиневропатии.
Показания к применению
Диабетическая полиневропатия
Алкогольная полиневропатия
Противопоказания
Беременность
Период лактации (грудного вскармливания)
Детский возраст до 18 лет
Наследственная непереносимость галактозы, дефицит лактазы или глюкозо-галактозная мальабсорбция
Повышенная чувствительность к тиоктовой кислоте или другим компонентам препарата
Применение при беременности и в период грудного вскармливания
Применение препарата Тиогамма противопоказано при беременности и в период лактации (грудного вскармливания).
Способ применения и дозы
Назначают внутрь по 600 мг (1 таб.) 1 раз/сут. Таблетки принимают натощак, не разжевывая, запивая небольшим количеством жидкости. Длительность курса лечения составляет 30-60 дней в зависимости от степени тяжести заболевания. Возможны повторения курса лечения 2-3 раза в год.
Побочное действие
Частота проявления неблагоприятных побочных реакций приведена в соответствии с классификацией ВОЗ: Очень часто более чем у 1 из 10 проходящих лечение Часто менее чем у 1 из 10, но более чем у 1 из 100 проходящих лечение Нечасто менее чем у 1 из 100, но более чем у 1 из 1000 проходящих лечение Редко менее чем у 1 из 1000, но более чем у 1 из 10 000 проходящих лечение Очень редко менее чем у 1 из 10 000, включая отдельные случаи Очень редко (меньше1/10 000) развиваются следующие побочные эффекты: Со стороны пищеварительной системы: тошнота, рвота, абдоминальная боль, диарея. Аллергические реакции: системные реакции (вплоть до развития анафилактического шока), кожная сыпь, крапивница, зуд. Со стороны ЦНС: изменение или нарушение вкусовых ощущений. Со стороны эндокринной системы: в связи с улучшением усвоения глюкозы возможно снижение концентрации глюкозы в крови. При этом могут возникнуть симптомы гипогликемии - головокружение, повышенное потоотделение, головная боль, расстройства зрения.
Передозировка
Симптомы: тошнота, рвота, головная боль. В случае приема от 10 до 40 г тиоктовой кислоты в сочетании с алкоголем наблюдались случаи интоксикации, вплоть до летального исхода. Симптомы острой передозировки: психомоторное возбуждение или помрачение сознания, как правило, с последующим развитием генерализованных судорог и формированием лактоацидоза. Также описаны случаи гипогликемии, шока, рабдомиолиза, гемолиза, диссеминированного внутрисосудистого свертывания крови, угнетения костного мозга и мультиорганной недостаточности. Лечение: проводят симптоматическую терапию. Специфического антидота нет.
Особые указания
Пациенты с редкой наследственной непереносимостью фруктозы, синдромом мальабсорбции глюкозы/галактозы или дефицитом глюкозо-изомальтазы не должны принимать препарат Тиогамма. Пациентам с сахарным диабетом в период лечения препаратом Тиогамма, особенно в начале терапии, необходимо осуществлять контроль уровня глюкозы в крови. В некоторых случаях может потребоваться коррекция дозы инсулина или перорального гипогликемического препарата во избежание развития гипогликемии. Пациентам, принимающим препарат Тиогамма, следует воздерживаться от употребления алкоголя. Потребление алкоголя во время терапии препаратом Тиогамма снижает лечебный эффект и является фактором риска, способствующим развитию и прогрессированию невропатии. 1 таблетка препарата Тиогамма 600 мг содержит менее 0.0041 ХЕ. Влияние на способность к вождению автотранспорта и управлению механизмами Прием препарата Тиогамма не влияет на способность к управлению транспортными средствами и на работу с другими механизмами.
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