Производное адамантана. Является неконкурентным антагонистом... Инструкция
Показания к применению
Деменция альцгеймеровского типа умеренной и тяжелой степени.
Противопоказания
повышенная чувствительность к мемантину и другим компонентам препарата . тяжелая печеночная недостаточность (класс С по шкале Чайлд-Пью) . беременность . грудное вскармливание . возраст до 18 лет (эффективность и безопасность препарата не установлены). С осторожностью: эпилепсия . тиреотоксикоз . предрасположенность к развитию судорог . одновременное ...
Производное адамантана. Является неконкурентным антагонистом NMDA-рецепторов, оказывает модулирующее действие на глутаматергическую систему. Регулирует транспорт ионов, блокирует кальциевые каналы, нормализует мембранный потенциал, улучшает процесс передачи нервного импульса. Улучшает когнитивные процессы, повышает повседневную активность.
Показания к применению
Деменция альцгеймеровского типа умеренной и тяжелой степени.
Противопоказания
повышенная чувствительность к мемантину и другим компонентам препарата . тяжелая печеночная недостаточность (класс С по шкале Чайлд-Пью) . беременность . грудное вскармливание . возраст до 18 лет (эффективность и безопасность препарата не установлены). С осторожностью: эпилепсия . тиреотоксикоз . предрасположенность к развитию судорог . одновременное применение антагонистов NMDA-рецепторов (амантадин, кетамин, декстрометорфан) . факторы, повышающие рН мочи (резкая смена диеты, например переход на вегетарианскую, обильный прием щелочных желудочных буферов) . почечный канальцевый ацидоз . тяжелые инфекции мочевыводящих путей, вызванные Proteus spp., инфаркт миокарда (в анамнезе), сердечная недостаточность III–IV функционального класса по классификации NYHA, неконтролируемая артериальная гипертензия, почечная недостаточность, печеночная недостаточность.
Применение при беременности и в период грудного вскармливания
Мемантин обладает способностью замедлять развитие плода. На время лечения мемантином грудное вскармливание следует прервать. В связи с возможной задержкой внутриутробного развития препарат Нооджерон не применяется при беременности. Исследования, проведенные на животных, указывают на возможность препарата вызывать задержку внутриутробного развития при использовании в дозах, аналогичных терапевтическим у человека. Сведений о выведении мемантина с грудным молоком нет. Однако учитывая липофильность мемантина, выделение возможно. Поэтому на время лечения препаратом Нооджерон грудное вскармливание необходимо прекратить.
Способ применения и дозы
Внутрь, независимо от приема пищи, 1 раз в сутки, в одно и то же время каждый день. Переносимость и дозу препарата Нооджерон следует регулярно оценивать, преимущественно в течение 3 мес после начала терапии. Затем следует регулярно оценивать клиническую эффективность лекарственного препарата и переносимость терапии в соответствии с действующими клиническими рекомендациями. Поддерживающую терапию можно продолжать неопределенно долго при наличии терапевтического эффекта и хорошей переносимости препарата Нооджерон. Следует прекратить применение препарата Нооджерон, если терапевтический эффект более не наблюдается или пациент не переносит лечение. С целью уменьшения риска развития побочных эффектов рекомендуется постепенное увеличение дозы: 5 мг/нед в течение первых 3 нед терапии. Максимальная суточная доза — 20 мг/сут. Рекомендуемая поддерживающая доза препарата Нооджерон — 20 мг/сут. Рекомендуется следующий режим дозирования: 1-я нед (1–7-й день): суточная доза — 5 мг (по 1/2 табл. 10 мг). 2-я нед (8–14-й день): суточная доза — 10 мг (по 1 табл. 10 мг). 3-я нед (15–21-й день): суточная доза — 15 мг (по 1,5 табл. 10 мг). Начиная с 4-й нед: суточная доза — 20 мг (по 2 табл. 10 мг). Пациенты пожилого возраста (старше 65). Коррекция дозы не требуется. Нарушение функции почек. У пациентов с Cl креатинина 50–80 мл/мин коррекция дозы не требуется. Пациентам с умеренной почечной недостаточностью (Cl креатинина 30–49 мл/мин) рекомендуется 10 мг/сут. При хорошей переносимости препарата в течение 7 дней дозу можно увеличить до 20 мг/сут по стандартной схеме. У пациентов с тяжелой почечной недостаточностью (Cl креатинина 5–29 мл/мин) суточная доза не должна превышать 10 мг/сут. Нарушение функции печени. У пациентов с легким и умеренным нарушением функции печени (класс А и В по шкале Чайлд-Пью) коррекция дозы не требуется. Пациентам с тяжелой печеночной недостаточностью (класс С по шкале Чайлд-Пью) препарат Нооджерон противопоказан.
Побочное действие
Нежелательные эффекты классифицированы в соответствии с частотой их развития: очень часто (≥ .1/10) . часто (≥ .1/100, <1/10) . нечасто (≥ .1/1000, <1/100) . редко (≥ .1/10000, <1/1000) . очень редко (<1/10000), неизвестная частота — имеющихся данных недостаточно для оценки частоты побочного эффекта. Инфекционные и паразитарные заболевания: нечасто — грибковые инфекции. Со стороны иммунной системы: часто — гиперчувствительность к компонентам препарата. Нарушения психики: часто — сонливость . нечасто — спутанность сознания, галлюцинации* . неизвестная частота — психотические реакции. Со стороны нервной системы: часто — головокружение, нарушения равновесия . нечасто — нарушение походки . очень редко — судороги. Со стороны сердца: нечасто — сердечная недостаточность. Со стороны сосудов: часто — повышение АД . нечасто — венозный тромбоз и/или тромбоэмболия. Со стороны ЖКТ: часто — запор . нечасто — рвота, тошнота . неизвестная частота — панкреатит. Со стороны печени и желчевыводящих путей: часто — повышенные показатели печеночных ферментов . неизвестная частота — гепатит. Со стороны дыхательной системы, органов грудной клетки и средостения: часто — одышка. Общие расстройства и нарушения в месте введения: часто — головная боль . нечасто — утомляемость. * Галлюцинации в основном наблюдались у пациентов с болезнью Альцгеймера на стадии тяжелой деменции. В постмаркетинговом периоде сообщалось о следующих нежелательных реакциях: агранулоцитоз, лейкопения (включая нейтропению), панцитопения, тромбоцитопения, тромбоцитопеническая пурпура, гепатит, острая почечная недостаточность, синдром Стивенса-Джонсона.
Особые указания
Нежелательные эффекты классифицированы в соответствии с частотой их развития: очень часто (≥ .1/10) . часто (≥ .1/100, <1/10) . нечасто (≥ .1/1000, <1/100) . редко (≥ .1/10000, <1/1000) . очень редко (<1/10000), неизвестная частота — имеющихся данных недостаточно для оценки частоты побочного эффекта. Инфекционные и паразитарные заболевания: нечасто — грибковые инфекции. Со стороны иммунной системы: часто — гиперчувствительность к компонентам препарата. Нарушения психики: часто — сонливость . нечасто — спутанность сознания, галлюцинации* . неизвестная частота — психотические реакции. Со стороны нервной системы: часто — головокружение, нарушения равновесия . нечасто — нарушение походки . очень редко — судороги. Со стороны сердца: нечасто — сердечная недостаточность. Со стороны сосудов: часто — повышение АД . нечасто — венозный тромбоз и/или тромбоэмболия. Со стороны ЖКТ: часто — запор . нечасто — рвота, тошнота . неизвестная частота — панкреатит. Со стороны печени и желчевыводящих путей: часто — повышенные показатели печеночных ферментов . неизвестная частота — гепатит. Со стороны дыхательной системы, органов грудной клетки и средостения: часто — одышка. Общие расстройства и нарушения в месте введения: часто — головная боль . нечасто — утомляемость. * Галлюцинации в основном наблюдались у пациентов с болезнью Альцгеймера на стадии тяжелой деменции. В постмаркетинговом периоде сообщалось о следующих нежелательных реакциях: агранулоцитоз, лейкопения (включая нейтропению), панцитопения, тромбоцитопения, тромбоцитопеническая пурпура, гепатит, острая почечная недостаточность, синдром Стивенса-Джонсона.
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В связи с возможной задержкой внутриутробного развития препарат Нооджерон не применяется при беременности. Исследования, проведенные на животных, указывают на возможность препарата вызывать задержку внутриутробного развития при использовании в дозах, аналогичных терапевтическим у человека. Сведений о выведении мемантина с грудным молоком нет. Однако учитывая липофильность мемантина, выделение возможно. Поэтому на время лечения препаратом Нооджерон грудное вскармливание необходимо прекратить."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь, независимо от приема пищи, 1 раз в сутки, в одно и то же время каждый день. Переносимость и дозу препарата Нооджерон следует регулярно оценивать, преимущественно в течение 3 мес после начала терапии. 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Со стороны сердца: нечасто — сердечная недостаточность. Со стороны сосудов: часто — повышение АД . нечасто — венозный тромбоз и/или тромбоэмболия. Со стороны ЖКТ: часто — запор . нечасто — рвота, тошнота . неизвестная частота — панкреатит. Со стороны печени и желчевыводящих путей: часто — повышенные показатели печеночных ферментов . неизвестная частота — гепатит. Со стороны дыхательной системы, органов грудной клетки и средостения: часто — одышка. Общие расстройства и нарушения в месте введения: часто — головная боль . нечасто — утомляемость. * Галлюцинации в основном наблюдались у пациентов с болезнью Альцгеймера на стадии тяжелой деменции. 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