Бензалкония хлорида раствор (50 %) соответствует бензапкония хлориду, повидон К 30, натрия дигидрофосфата дигидрат, натрия моногидрофосфата додекагидрат, динатрия эдетат дигидрат, вода для инъекций.
Фармакотерапевтическая группа
Противоглаукомное средство - бета-адренобпокатор.
Фармакологические свойства
Фармакодинамика
Тимолол является неселективным блокатором бета-1 и бета-2 адренорецепторов. Не обладает внутренней симпатомиметической и мембраностабилизирующей активностью.
При местном применении в виде глазных капель снижает как нормальное, так и повышенное внутриглазное давление за счет уменьшения образования внутриглазной жидкости. Не оказывает влияния на размер зрачка и аккомодацию.
Действие препарата проявляется через 20 минут после закапывания в конъюнктивальную полость. Максимальное снижение внутриглазного давления наступает через 1-2 часа и сохраняется в течение 24 часов.
Фармакокинетика
При местном применении тимолол быстро проникает через роговицу. После инстилляции глазных капель максимальная концентрация тимолола в водянистой влаге передней камеры глаза достигается через 1-2 часа.
80 % тимолола, применяемого в виде глазных капель, попадает в системный кровоток путем абсорбции через сосуды конъюнктивы, слизистой оболочки носа и слезного тракта. Выведение метаболитов тимолола осуществляется преимущественно почками.
У новорождённых и маленьких детей концентрация тимолола, как активного вещества, существенно превышает его максимальную концентрацию (Сmax) в плазме крови взрослых.
Показания к применению
Повышенное внутриглазное давление (глазная гипертензия);
открытоугольная глаукома;
афакическая глаукома и другие виды вторичной глаукомы;
в качестве дополнительного средства для снижения внутриглазного давления при закрытоугольной глаукоме (в комбинации с миотиками);
врожденная глаукома (при недостаточности прочих терапевтических мер).
Противопоказания
Бронхиальная астма или другие тяжелые хронические обструктивные заболевания дыхательных путей;
синусовая брадикардия;
кардиогенный шок;
атриовентрикулярная блокада II - III степени;
сердечная недостаточность;
дистрофические процессы в роговице;
тяжёлый атрофический ринит;
аллергические реакции на компоненты препарата;
беременность и период лактации;
детский возраст до 18 лет.
С осторожностью
У больных с лёгочной недостаточностью, тяжёлой цереброваскулярной недостаточностью, хронической сердечной недостаточностью, сахарным диабетом, гипогликемией, тиреотоксикозом, миастенией, синдромом Рейно, феохромоцитомой, а также при одновременном назначении других бета-адренобпокаторов. У пациентов с сахарным диабетом, принимающих инсулин или пероральные гипогликемические средства, тимолол может привести к гипогликемии.
Применение при беременности и в период грудного вскармливания
Противопоказан.
Способ применения и дозы
В начале терапии закапывают по 1 капле препарата Арутимол 2,5 мг/мл или 5 мг/мл в конъюнктивальный мешок 2 раза в день.
При нормализации внутриглазного давления поддерживающая доза -1 капля 2,5 мг/мл 1 раз в день.
Лечение Арутимопом 2,5 мг/мл или 5 мг/мл проводится, как правило, в течение продолжительного времени. Перерыв или изменение дозировки проводятся только по предписанию лечащего врача.
Побочное действие
Местные реакции: раздражение и гиперемия конъюнктивы, кожи век, жжение и зуд в глазах, слезотечение, светобоязнь, отёк эпителия роговицы, точечная поверхностная кератопатия, гипостезия роговицы, диплопия, птоз. При проведении фистулизирующих антиглаукоматозных операций возможно развитие отслойки сосудистой оболочки в послеоперационном периоде.
Системные реакции:
Со стороны сердечно-сосудистой системы: сердечная недостаточность, брадикардия, брадиаритмия, снижение артериального давления, коллапс, атриовентрикулярная блокада, остановка сердца, учащенное сердцебиение, гипоперфузия головного мозга, преходящие нарушения мозгового кровообращения.
Со стороны дыхательной системы: ринит, одышка, бронхоспазм, легочная недостаточность.
Со стороны центральной нервной системы: головная боль, головокружение, слабость, депрессия, парестезии.
Со стороны желудочно-кишечного тракта: тошнота, диарея. Аллергические реакции: крапивница, экзема.
Мочеполовая система: нарушение половых функций,
Кожные покровы: алопеция.
В случае возникновения побочных эффектов, следует прекратить использовать препарат и как можно скорее обратиться к лечащему врачу (офтальмологу).
Передозировка
Возможно развитие системных эффектов, характерных для бета-адреноблокаторов: головокружение, головная боль, аритмия, брадикардия, снижение артериального давления, сердечная недостаточность, бронхоспазм, тошнота и рвота.
Лечение: немедленно промыть глаза водой или 0,9 % раствором натрия хлорида, симптоматическая терапия.
Взаимодействие с другими лекарственными средствами
Совместное использование тимолола с глазными каплями, содержащими эпинефрин, может вызвать расширение зрачка. Специфическое действие препарата - снижение внутриглазного давления усиливается при одновременном использовании глазных капель, содержащих эпинефрин и пилокарпин, закапывать в глаза два бета-адренобпокатора не следует.
Снижение артериального давления и замедление сердечного ритма могут потенцироваться при совместном применении препарата с антагонистами кальция, резерпином и бета-адреноблокаторами. Одновременное применение с инсулином или пероральными гипогликемическими средствами может привести к гипогликемии. Тимолол усиливает действие миорелаксантов, поэтому необходима отмена препарата за 48 часов до планируемого хирургического вмешательства с применением общей анестезии.
Эти данные могут относиться и к лекарственным препаратам, которые были применены незадолго до этого.
Особые указания
Необходимо регулярно посещать врача для измерения внутриглазного давления и обследования роговицы.
Если пациент носит мягкие контактные линзы, то ему не следует применять глазные капли Арутимол 2,5 мг/мл и 5 мг/мл, так как содержит консервант, который может адсорбироваться мягкими контактными линзами и оказать неблагоприятное воздействие на ткани глаза.
Сразу после закапывания возможно кратковременное снижение четкости зрения.
Следует снимать жесткие контактные линзы перед закапыванием препарата и одевать их вновь лишь спустя 15 минут после инстилляции. В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии др. потенциально опасными видами деятельности, требующими повышенной концентрации внимания, быстроты психомоторных реакций и хорошего зрения (в течение 30 минут после закапывания в глаз), так как препарат может способствовать снижению артериального давления, возникновению чувства усталости и головокружения. В ещё большей степени это имеет место при взаимодействии препарата с алкоголем.
При переводе больных на лечение глазными каплями Арутимол 2,5 мг/мл и 5 мг/мл может понадобиться коррекция рефракции после эффектов, вызванных применявшимися ранее миотиками.
В случае предстоящего оперативного вмешательства с применением общей анестезии, необходимо отменить препарат за 48 часов.
Влияние на способность управлять автомобилем и движущимися механизмами
В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии др. потенциально опасными видами деятельности, требующими повышенной концентрации внимания, быстроты психомоторных реакций и хорошего зрения (в течение 30 минут после закапывания в глаз), так как препарат может способствовать снижению артериального давления, возникновению чувства усталости и головокружения. В ещё большей степени это имеет место при взаимодействии препарата с алкоголем.
Условия хранения
Хранить в защищенном от света месте, при температуре не выше 25°С. Хранить в недоступном для детей месте.
Срок годности
3 года. 6 недель с момента вскрытия флакона.
Не использовать препарат после истечения срока годности.
Условия отпуска
По рецепту.
Производитель
Chauven. Страна производства: Германия.
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Вспомогательные вещества:"}},{"type":"paragraph","data":{"text":"Бензалкония хлорида раствор (50 %) соответствует бензалкония хлориду, повидон К 30, натрия дигидрофосфата дигидрат, натрия моногидрофосфата додекагидрат, динатрия эдетат дигидрат, вода для инъекций."}},{"type":"paragraph","data":{"text":"2,5 мг/мл:"}},{"type":"paragraph","data":{"text":"Активное вещество:"}},{"type":"paragraph","data":{"text":"Тимолола малеат - 3,42 мг (соответствует тимололу 2,50 мг). Вспомогательные вещества:"}},{"type":"paragraph","data":{"text":"Бензалкония хлорида раствор (50 %) соответствует бензапкония хлориду, повидон К 30, натрия дигидрофосфата дигидрат, натрия моногидрофосфата додекагидрат, динатрия эдетат дигидрат, вода для инъекций."}}]},{"name":"Фармакотерапевтическая группа","slug":"","id":13,"body":[{"type":"paragraph","data":{"text":"Противоглаукомное средство - бета-адренобпокатор."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Фармакодинамика"}},{"type":"paragraph","data":{"text":"Тимолол является неселективным блокатором бета-1 и бета-2 адренорецепторов. Не обладает внутренней симпатомиметической и мембраностабилизирующей активностью."}},{"type":"paragraph","data":{"text":"При местном применении в виде глазных капель снижает как нормальное, так и повышенное внутриглазное давление за счет уменьшения образования внутриглазной жидкости. Не оказывает влияния на размер зрачка и аккомодацию."}},{"type":"paragraph","data":{"text":"Действие препарата проявляется через 20 минут после закапывания в конъюнктивальную полость. Максимальное снижение внутриглазного давления наступает через 1-2 часа и сохраняется в течение 24 часов."}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"При местном применении тимолол быстро проникает через роговицу. После инстилляции глазных капель максимальная концентрация тимолола в водянистой влаге передней камеры глаза достигается через 1-2 часа."}},{"type":"paragraph","data":{"text":"80 % тимолола, применяемого в виде глазных капель, попадает в системный кровоток путем абсорбции через сосуды конъюнктивы, слизистой оболочки носа и слезного тракта. Выведение метаболитов тимолола осуществляется преимущественно почками."}},{"type":"paragraph","data":{"text":"У новорождённых и маленьких детей концентрация тимолола, как активного вещества, существенно превышает его максимальную концентрацию (Сmax) в плазме крови взрослых."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенное внутриглазное давление (глазная гипертензия);"}},{"type":"paragraph","data":{"text":"открытоугольная глаукома;"}},{"type":"paragraph","data":{"text":"афакическая глаукома и другие виды вторичной глаукомы;"}},{"type":"paragraph","data":{"text":"в качестве дополнительного средства для снижения внутриглазного давления при закрытоугольной глаукоме (в комбинации с миотиками);"}},{"type":"paragraph","data":{"text":"врожденная глаукома (при недостаточности прочих терапевтических мер)."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Бронхиальная астма или другие тяжелые хронические обструктивные заболевания дыхательных путей;"}},{"type":"paragraph","data":{"text":"синусовая брадикардия;"}},{"type":"paragraph","data":{"text":"кардиогенный шок;"}},{"type":"paragraph","data":{"text":"атриовентрикулярная блокада II - III степени;"}},{"type":"paragraph","data":{"text":"сердечная недостаточность;"}},{"type":"paragraph","data":{"text":"дистрофические процессы в роговице;"}},{"type":"paragraph","data":{"text":"тяжёлый атрофический ринит;"}},{"type":"paragraph","data":{"text":"аллергические реакции на компоненты препарата;"}},{"type":"paragraph","data":{"text":"беременность и период лактации;"}},{"type":"paragraph","data":{"text":"детский возраст до 18 лет."}}]},{"name":"С осторожностью","slug":"cautions","id":14,"body":[{"type":"paragraph","data":{"text":"У больных с лёгочной недостаточностью, тяжёлой цереброваскулярной недостаточностью, хронической сердечной недостаточностью, сахарным диабетом, гипогликемией, тиреотоксикозом, миастенией, синдромом Рейно, феохромоцитомой, а также при одновременном назначении других бета-адренобпокаторов. У пациентов с сахарным диабетом, принимающих инсулин или пероральные гипогликемические средства, тимолол может привести к гипогликемии."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Противопоказан."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В начале терапии закапывают по 1 капле препарата Арутимол 2,5 мг/мл или 5 мг/мл в конъюнктивальный мешок 2 раза в день."}},{"type":"paragraph","data":{"text":"При нормализации внутриглазного давления поддерживающая доза -1 капля 2,5 мг/мл 1 раз в день."}},{"type":"paragraph","data":{"text":"Лечение Арутимопом 2,5 мг/мл или 5 мг/мл проводится, как правило, в течение продолжительного времени. Перерыв или изменение дозировки проводятся только по предписанию лечащего врача."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Местные реакции: раздражение и гиперемия конъюнктивы, кожи век, жжение и зуд в глазах, слезотечение, светобоязнь, отёк эпителия роговицы, точечная поверхностная кератопатия, гипостезия роговицы, диплопия, птоз. При проведении фистулизирующих антиглаукоматозных операций возможно развитие отслойки сосудистой оболочки в послеоперационном периоде."}},{"type":"paragraph","data":{"text":"Системные реакции:"}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: сердечная недостаточность, брадикардия, брадиаритмия, снижение артериального давления, коллапс, атриовентрикулярная блокада, остановка сердца, учащенное сердцебиение, гипоперфузия головного мозга, преходящие нарушения мозгового кровообращения."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы: ринит, одышка, бронхоспазм, легочная недостаточность."}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы: головная боль, головокружение, слабость, депрессия, парестезии."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: тошнота, диарея. Аллергические реакции: крапивница, экзема."}},{"type":"paragraph","data":{"text":"Мочеполовая система: нарушение половых функций,"}},{"type":"paragraph","data":{"text":"Кожные покровы: алопеция."}},{"type":"paragraph","data":{"text":"В случае возникновения побочных эффектов, следует прекратить использовать препарат и как можно скорее обратиться к лечащему врачу (офтальмологу)."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Возможно развитие системных эффектов, характерных для бета-адреноблокаторов: головокружение, головная боль, аритмия, брадикардия, снижение артериального давления, сердечная недостаточность, бронхоспазм, тошнота и рвота."}},{"type":"paragraph","data":{"text":"Лечение: немедленно промыть глаза водой или 0,9 % раствором натрия хлорида, симптоматическая терапия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Совместное использование тимолола с глазными каплями, содержащими эпинефрин, может вызвать расширение зрачка. Специфическое действие препарата - снижение внутриглазного давления усиливается при одновременном использовании глазных капель, содержащих эпинефрин и пилокарпин, закапывать в глаза два бета-адренобпокатора не следует."}},{"type":"paragraph","data":{"text":"Снижение артериального давления и замедление сердечного ритма могут потенцироваться при совместном применении препарата с антагонистами кальция, резерпином и бета-адреноблокаторами. Одновременное применение с инсулином или пероральными гипогликемическими средствами может привести к гипогликемии. Тимолол усиливает действие миорелаксантов, поэтому необходима отмена препарата за 48 часов до планируемого хирургического вмешательства с применением общей анестезии."}},{"type":"paragraph","data":{"text":"Эти данные могут относиться и к лекарственным препаратам, которые были применены незадолго до этого."}}]},{"id":9,"name":"Особые указания","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Необходимо регулярно посещать врача для измерения внутриглазного давления и обследования роговицы."}},{"type":"paragraph","data":{"text":"Если пациент носит мягкие контактные линзы, то ему не следует применять глазные капли Арутимол 2,5 мг/мл и 5 мг/мл, так как содержит консервант, который может адсорбироваться мягкими контактными линзами и оказать неблагоприятное воздействие на ткани глаза."}},{"type":"paragraph","data":{"text":"Сразу после закапывания возможно кратковременное снижение четкости зрения."}},{"type":"paragraph","data":{"text":"Следует снимать жесткие контактные линзы перед закапыванием препарата и одевать их вновь лишь спустя 15 минут после инстилляции. В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии др. потенциально опасными видами деятельности, требующими повышенной концентрации внимания, быстроты психомоторных реакций и хорошего зрения (в течение 30 минут после закапывания в глаз), так как препарат может способствовать снижению артериального давления, возникновению чувства усталости и головокружения. В ещё большей степени это имеет место при взаимодействии препарата с алкоголем."}},{"type":"paragraph","data":{"text":"При переводе больных на лечение глазными каплями Арутимол 2,5 мг/мл и 5 мг/мл может понадобиться коррекция рефракции после эффектов, вызванных применявшимися ранее миотиками."}},{"type":"paragraph","data":{"text":"В случае предстоящего оперативного вмешательства с применением общей анестезии, необходимо отменить препарат за 48 часов."}}],"slug":""},{"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","id":16,"body":[{"type":"paragraph","data":{"text":"В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии др. потенциально опасными видами деятельности, требующими повышенной концентрации внимания, быстроты психомоторных реакций и хорошего зрения (в течение 30 минут после закапывания в глаз), так как препарат может способствовать снижению артериального давления, возникновению чувства усталости и головокружения. 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