Дексалгин Раствор, 10 шт, 2 мл, 25 мг/мл

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У лиц пожилого возраста наблюдается удлинение периода полувыведения (как после однократного, так и после повторного внутримышечного или внутривенного введения) в среднем до 48 % и снижение общего клиренса препарата."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["Купирование болевого синдрома различного генеза (в т.ч. послеоперационные боли, боль при метастазах в кости, посттравматические","боли, боль при почечных коликах, альгодисменорея, ишалгия, радикулит, невралгии, зубная боль);","симптоматическое лечение острых и хронических воспалительных, воспалительно-дегенеративных и метаболических заболеваний опорно-двигательного аппарата (в т.ч. ревматоидный артрит, спондилоартрит, артроз, остеохондроз)."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Повышенная чувствительность к декскетопрофену или другим НПВП или к любому из вспомогательных веществ, входящих в состав препарата (см. Состав);","язвенная болезнь желудка и двенадцатиперстной кишки;","желудочно-кишечные кровотечения в анамнезе, другие активные кровотечения (в т.ч. подозрение на внутричерепное кровотечение), антикоагулянтная терапия;","желудочно-кишечные заболевания (болезнь Крона, неспецифический язвенный колит);","тяжелые нарушения функции печени (10-15 баллов по шкале Чайлд-Пью);","тяжелые нарушения функции почек (клиренс креатинина","бронхиальная астма (в т.ч. в анамнезе);","тяжелая сердечная недостаточность;","лечение болевого синдрома при аортокоронарном шунтировании;","геморрагический диатез или другие нарушения коагуляции;","детский возраст."]}},{"type":"paragraph","data":{"text":"Дексалгин противопоказан для невраксиального (эпидурального или подоболочечного, внутриоболочечного) введения из-за входящего в состав препарата этанола."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"list","data":{"style":"ordered","items":["аллергические состояния в анамнезе;","нарушение системы кроветворения;","системная красная волчанка или смешанные заболевания соединительной ткани;","одновременная терапия другими лекарственными препаратами (см. Взаимодействие с другими лекарственными препаратами);","предрасположенность к гиповолемии;","ишемическая болезнь сердца;","Пожилой возраст (старше 65 лет)."]}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"  Применение препарата Дексалгин при беременности и в период лактации противопоказано.  "}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nДексалгин предназначен для внутривенного и внутримышечного введения. Рекомендуемая доза для взрослых: 50 мг каждые 8-12 ч. При необходимости возможно повторное введение препарата с 6-часовым интервалом. Суточная доза составляет 150 мг."}},{"type":"paragraph","data":{"text":"У пациентов пожилого возраста и пациентов с нарушением функции печени и/или почек терапию препаратом"}},{"type":"paragraph","data":{"text":"Дексалгин следует начинать с более низких доз; суточная доза составляет 50 мг."}},{"type":"paragraph","data":{"text":"Дексалгин предназначен для краткосрочного (не более 2-х дней) применения в период острого болевого синдрома. В дальнейшем возможен перевод пациента на пероральные анальгетики."}},{"type":"paragraph","data":{"text":"Техника проведения внутримышечной инъекции"}},{"type":"paragraph","data":{"text":"Содержимое одной ампулы (2 мл) медленно вводят глубоко внутримышечно."}},{"type":"paragraph","data":{"text":"Техника проведения внутривенной инъекции"}},{"type":"paragraph","data":{"text":"При необходимости, содержимое одной ампулы (2 мл) препарата Дексалгин можно ввести путем медленной внутривенной инъекции продолжительностью не менее 15 с."}},{"type":"paragraph","data":{"text":"Техника проведения внутривенной инфузии"}},{"type":"paragraph","data":{"text":"Содержимое одной ампулы (2 мл) разводят в 30-100 мл физиологического раствора, раствора глюкозы или раствора Рингера (лактата). Раствор следует готовить в асептических условиях и всегда защищать от воздействия дневного света. Разбавленный раствор (должен быть прозрачным) вводят путем медленной внутривенной инфузии продолжительностью 10-30 мин.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\n\nВозможные побочные эффекты при применении декскетопрофена трометамола, как и при применении других препаратов декскетопрофена, приведены ниже по нисходящей частоте возникновения: часто (1-10 % пациентов), нечасто (0,1-1 % пациентов) редко (0,01-0,1 % пациентов), очень редко (менее 0,01 % пациентов), включая отдельные сообщения."}},{"type":"paragraph","data":{"text":"Со стороны кровеносной и лимфатической систем"}},{"type":"paragraph","data":{"text":"Редко: анемия."}},{"type":"paragraph","data":{"text":"Очень редко: нейтропения, тромбоцитопения."}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы"}},{"type":"paragraph","data":{"text":"Нечасто: головная боль, головокружение, бессонница, сонливость."}},{"type":"paragraph","data":{"text":"Редко: парестезия."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств"}},{"type":"paragraph","data":{"text":"Нечасто: нечеткость зрения."}},{"type":"paragraph","data":{"text":"Редко: шум в ушах."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы"}},{"type":"paragraph","data":{"text":"Нечасто: артериальная гипотензия, чувство жара, гиперемия кожных покровов."}},{"type":"paragraph","data":{"text":"Редко: экстрасистолия, тахикардия, артериальная гипертензия, периферический отек, поверхностный тромбофлебит."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы"}},{"type":"paragraph","data":{"text":"Редко: брадипноэ."}},{"type":"paragraph","data":{"text":"Очень редко: бронхоспазм, диспноэ."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта"}},{"type":"paragraph","data":{"text":"Часто: тошнота, рвота."}},{"type":"paragraph","data":{"text":"Нечасто: абдоминальная боль, диспепсия, диарея, запор, гематемезис, сухость во рту."}},{"type":"paragraph","data":{"text":"Редко: эрозивно-язвенные поражения органов ЖКТ, включая кровотечения и перфорации, анорексия."}},{"type":"paragraph","data":{"text":"Очень редко: поражение поджелудочной железы."}},{"type":"paragraph","data":{"text":"Со стороны печени и желчного пузыря"}},{"type":"paragraph","data":{"text":"Редко: повышение активности печеночных ферментов, желтуха."}},{"type":"paragraph","data":{"text":"Очень редко: поражение печени."}},{"type":"paragraph","data":{"text":"Со стороны мочевыделителъной системы"}},{"type":"paragraph","data":{"text":"Редко: полиурия, почечная колика."}},{"type":"paragraph","data":{"text":"Очень редко: нефрит или нефротический синдром."}},{"type":"paragraph","data":{"text":"Со стороны репродуктивной системы"}},{"type":"paragraph","data":{"text":"Редко: у женщин - нарушение менструального цикла, у мужчин - нарушение функции предстательной железы."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата"}},{"type":"paragraph","data":{"text":"Редко: мышечный спазм, затруднение движений в суставах."}},{"type":"paragraph","data":{"text":"Со стороны кожных покровов"}},{"type":"paragraph","data":{"text":"Нечасто: дерматит, сыпь, потливость."}},{"type":"paragraph","data":{"text":"Редко: крапивница, угревая сыпь."}},{"type":"paragraph","data":{"text":"Очень редко: тяжелые кожные реакции (синдром Стивенса-Джонсона, синдром Лайелла), ангионевротический отек, аллергический дерматит, фотосенсибилизация."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ"}},{"type":"paragraph","data":{"text":"Редко: гипергликемия, гипогликемия, гипертриглицеридемия."}},{"type":"paragraph","data":{"text":"Со стороны лабораторных показателей"}},{"type":"paragraph","data":{"text":"Редко: кетонурия, протеинурия."}},{"type":"paragraph","data":{"text":"Местная и общая реакции"}},{"type":"paragraph","data":{"text":"Часто: боль в месте инъекции."}},{"type":"paragraph","data":{"text":"Нечасто: воспалительная реакция, гематома, геморрагии в месте инъекции; чувство жара, озноб, утомление."}},{"type":"paragraph","data":{"text":"Редко: боль в спине, обморок, лихорадка."}},{"type":"paragraph","data":{"text":"Очень редко: анафилактический шок, отек лица."}},{"type":"paragraph","data":{"text":"Прочие нарушения: асептический менингит, возникающий преимущественно у пациентов с системной красной волчанкой или смешанными заболеваниями соединительной ткани, гематологические нарушения (пурпура, апластическая и гемолитическая анемии, редко - агранулоцитоз и гипоплазия костного мозга).\n\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\n\nСимптомы: тошнота, анорексия, абдоминальная боль, головная боль, головокружение, дезориентация, бессонница."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическая терапия; при необходимости - промывание желудка, диализ.\n\n"}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"шприце с раствором допамина, прометазина, пентазоцина, петидина или гидроксизина (образуется осадок). Дексалгин можно смешивать в одном шприце с раствором гепарина, лидокаина, морфина и теофиллина."}},{"type":"paragraph","data":{"text":"Дексалгин - разбавленный раствор для инфузии нельзя смешивать с прометазином или пентазоцином."}},{"type":"paragraph","data":{"text":"Дексалгин - разбавленный раствор для инфузии совместим со следующими растворами для инъекций: дофамина, гепарина, гидроксизина, лидокаина, морфина, петидина и теофиллина."}},{"type":"paragraph","data":{"text":"При хранении Дексалгин - разбавленных растворов для инфузии в пластиковых контейнерах или при использовании инфузионных систем, изготовленных из этилвинилацетата, целлюлозы пропионата, полиэтилена низкой плотности или поливинилхлорида, абсорбции действующего вещества перечисленными материалами не происходит."}},{"type":"paragraph","data":{"text":"Нежелательные комбинации"}},{"type":"paragraph","data":{"text":"С другими НПВП, включая салицилаты в высоких дозах (более 3 г/сут): одновременное назначение нескольких НПВП вследствие синергического эффекта повышает риск возникновения желудочно-кишечных кровотечений и язвы."}},{"type":"paragraph","data":{"text":"С пероралъными антикоагулянтами, гепарином в дозах, превышающих профилактические, и тиклопидином: повышение риска возникновения кровотечений в связи с ингибированием агрегации тромбоцитов и поражением слизистой оболочки желудочно-кишечного тракта."}},{"type":"paragraph","data":{"text":"С препаратами лития: НПВП повышают уровень лития в крови, вплоть до токсического, в связи с чем данный показатель необходимо контролировать при назначении, изменении дозы и после отмены НПВП."}},{"type":"paragraph","data":{"text":"С метотрексатом в высоких дозах (15 мг/нед и более): повышение гематологической токсичности метотрексата в связи со снижением его почечного клиренса на фоне терапии НПВП."}},{"type":"paragraph","data":{"text":"Комбинации, требующие осторожности"}},{"type":"paragraph","data":{"text":"С диуретиками, ингибиторами ангиотензин-превращающего фермента: терапия НПВП связана с риском развития острой почечной недостаточности у обезвоженных пациентов (снижение гломерулярной фильтрации, обусловленное сниженным синтезом простагландинов). НПВП могут уменьшать гипотензивный эффект некоторых препаратов. При одновременном назначении с диуретиками необходимо убедиться в том, что водный баланс пациента адекватен, и провести контроль функции почек перед назначением НПВП."}},{"type":"paragraph","data":{"text":"С метотрексатом в низких дозах (менее 15 мг/нед): повышение гематологической токсичности метотрексата в связи со снижением его почечного клиренса на фоне терапии НПВП. Необходимо проводить еженедельный подсчет клеток крови в первые недели одновременной терапии. При наличии нарушения функции почек даже в легкой степени, а также у лиц пожилого возраста необходимо тщательное медицинское наблюдение."}},{"type":"paragraph","data":{"text":"С пентоксифиллином: повышение риска развития кровотечений. Необходим интенсивный клинический мониторинг и частая проверка времени кровотечения (времени свертываемости крови)."}},{"type":"paragraph","data":{"text":"С зидовудином: риск повышения токсического действия на эритроциты, обусловленного воздействием на ретикулоциты, с развитием тяжелой анемии через неделю после назначения НПВП. Необходимо провести подсчет всех клеток крови и ретикулоцитов через 1-2 нед после начала терапии НПВП."}},{"type":"paragraph","data":{"text":"С сульфаниламидными препаратами: НПВП могут усиливать гипогликемическое действие сульфонилмочевины вследствие вытеснения ее из мест связывания с белками плазмы."}},{"type":"paragraph","data":{"text":"Комбинации, которые необходимо принимать во внимание"}},{"type":"paragraph","data":{"text":"С β -адреноблокаторами: НПВП могут уменьшать гипотензивный эффект β-адреноблокаторов, что обусловлено ингибированием синтеза простагландинов."}},{"type":"paragraph","data":{"text":"С циклоспорином и такролимусом: НПВП могут увеличивать нефротоксичность, что опосредовано действием ренальных простагландинов. Во время проведения одновременной терапии необходимо контролировать функцию почек."}},{"type":"paragraph","data":{"text":"С тромболитиками: повышенный риск развития кровотечений."}},{"type":"paragraph","data":{"text":"С пробенецидом: концентрации НПВП в плазме могут повышаться, что может быть обусловлено ингибирующим эффектом на почечную тубулярную секрецию и/или конъюгацию с глюкуроновой кислотой, что требует коррекции дозы НПВП."}},{"type":"paragraph","data":{"text":"С сердечными гликозидами: НПВП могут приводить к повышению концентрации гликозидов в плазме."}},{"type":"paragraph","data":{"text":"С мифепристоном: в связи с теоретическим риском изменения эффективности мифепристона под влиянием ингибиторов синтеза простагландинов, НПВП не следует назначать ранее, чем через 8-12 сут после отмены мифепристона."}},{"type":"paragraph","data":{"text":"С ципрофлоксацином: данные, полученные в экспериментальных исследованиях на животных, указывают на высокий риск развития конвульсий при назначении НПВП на фоне терапии ципрофлоксацином в высоких дозах."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nУ пациентов с нарушениями со стороны желудочно-кишечного тракта или желудочно-кишечными заболеваниями в анамнезе необходим постоянный контроль. В случае возникновения желудочно-кишечного кровотечения или язвы терапию препаратом Дексалгин следует отменить."}},{"type":"paragraph","data":{"text":"Так как все НПВП могут ингибировать агрегацию тромбоцитов и увеличивать время кровотечения вследствие замедления синтеза простагландинов, в контролируемых клинических исследованиях было изучено одновременное назначение декскетопрофена трометамола и препаратов низкомолекулярного гепарина в профилактических дозах в послеоперационном периоде. Никакого воздействия на параметры коагуляции не наблюдалось. Тем не менее, при одновременном назначении препарата Дексалгин с другими препаратами, влияющими на свертываемость крови, необходим тщательный медицинский контроль."}},{"type":"paragraph","data":{"text":"Как и другие НПВП, Дексалгин может приводить к повышению уровня креатинина и азота в плазме крови. Как и другие ингибиторы синтеза простагландинов, Дексалгин может оказывать побочное действие на мочевыделительную систему, что может привести к развитию гломерулонефрита, интерстициального нефрита, папиллярного некроза, нефротического синдрома и острой почечной недостаточности."}},{"type":"paragraph","data":{"text":"Как и в случае других НПВП, на фоне терапии препаратом Дексалгин может наблюдаться небольшое преходящее повышение некоторых печеночных показателей, а также значительное повышение уровня аспарагиновой и аланиновои трансаминаз (АсТ и АлТ) в сыворотке крови. При этом контроль печеночной и почечной функций необходим у лиц пожилого возраста. В случае значительного повышения соответствующих показателей Дексалгин следует отменить. Как и другие НПВП, декскетопрофена трометамол может маскировать симптомы инфекционных заболеваний. В случае обнаружения признаков бактериальной инфекции или ухудшения самочувствия на фоне терапии препаратом"}},{"type":"paragraph","data":{"text":"Дексалгин пациенту необходимо сразу обратиться к врачу. В каждой ампуле препарата Дексалгин содержится 200 мг этанола.\n\n"}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"  В связи с возможным головокружением и сонливостью в период приема препарата Дексалгин способность к концентрации внимания и быстрота психомоторных реакций у пациентов могут снижаться.  "}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для внутривенного внутримышечного и введения 25 мг/мл. По 2 мл препарата в ампулы темного стекла (тип I) с белой точкой в верхней части ампулы. По 1, 5 или 10 ампул в упаковку контурную пластиковую (поддон), вместе с инструкцией по применению в картонную пачку."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"\n\nПри температуре не выше 25 °С в защищенном от света месте."}},{"type":"paragraph","data":{"text":"После разбавления раствор хранят в течение 24 ч при температуре от 2 до 8 С в защищенном от света месте."}},{"type":"paragraph","data":{"text":"Лекарственное средство хранить в недоступном для детей месте!\n\n"}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"\n\n5 лет."}},{"type":"paragraph","data":{"text":"Использовать только прозрачные и бесцветные растворы. Не применять после истечения срока годности.\n\n"}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"А. Менарини Мэнюфекчеринг Лоджистикс энд Сервисиз С.р.Л., Италия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Берлин-Хеми АГ, Германия"}}]}],"source":null},"description_toggle":false,"short_description":"Фармкодинамика. Декскетопрофена трометамол - действующее вещество препарата Дексалгин - нестероидное противовоспалительное средство, оказывающее анальгезирующее, противовоспалительное и жаропонижающие действия. Механизм действия связан с ингибированием синтеза простагландинов на уровне циклооксигеназы 1 и 2. Анальгезирующее действие наступает через 30 мин после парентерального введения. 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