Neuromidine. 5 mg/ml 1 ml 10 pcs

Neuromidin^® has a direct stimulating effect on impulse conduction along the nerve fibers, inter-neuronal and neuromuscular synapses of CNS and peripheral nervous system. Pharmacological action of Neuromidin^® is based on combination of two mechanisms of action: blockade of potassium channels of neuronal and muscle cell membranes; reversible inhibition of cholinesterase in synapses.

Neuromidine^® enhances the effect on smooth muscles not only of acetylcholine but also of adrenaline, serotonin, histamine and oxytocin.

Neuromidine^® has the following pharmacological effects:

– improves and stimulates impulse conduction in the nervous system and neuromuscular transmission;

– Increases smooth muscle organ contractility under the influence of agonists of acetylcholine, adrenaline, serotonin, histamine and oxytocin receptors, except potassium chloride;

– improves memory, inhibits the progressive course of dementia.

In preclinical studies Neuromidine^® had no teratogenic, embryotoxic, mutagenic, carcinogenic and immunotoxic effects and did not affect the endocrine system.

Pharmacokinetics

After oral, intramuscular and subcutaneous administration, it is rapidly absorbed. C_max in plasma is reached 1 h after oral administration and 25-30 min after intramuscular or subcutaneous administration. Binding to plasma proteins is 40-50% of the active substance. It enters the tissues quickly, the half-life is 40 min. Metabolized in the liver. It is excreted through the kidneys (mainly by tubular secretion and only 1/3 by glomerular filtration) and extrarenal (through the gastrointestinal tract). T_1/2 Neuromidine^® in parenteral administration is 2-3 h. After parenteral administration 34.8% of the drug dose is excreted unchanged in the urine.

Indications

Active ingredient

Composition

1 ml of solution contains:

active ingredient:

ipidacrine hydrochloride monohydrate 5 mg (in terms of ipidacrine hydrochloride)

excipients:

Hydrochloric acid concentrated – to pH 3;

water for injection – to 1 ml

How to take, the dosage

Diseases of the peripheral nervous system:

– mono- and polyneuropathies of various genesis – p/k or v/m 5-15 mg 1-2 times a day, course – 10-15 days (in severe cases – up to 30 days); afterwards the treatment is continued with the tablet form of the drug;

Myasthenia gravis and myasthenic syndrome – with p/cm or intram 15-30 mg 1-3 times a day with further change to the tablet form. The total course of treatment is 1-2 months. If necessary, treatment can be repeated several times with a break between courses of 1-2 months.

Diseases of the central nervous system:

– bulbar paralysis and paresis – p/k or v/m 5-15 mg 1-2 times a day for 10-15 days; if possible, switch to tablet form;

– rehabilitation for organic lesions of the CNS – v/m 10-15 mg 1-2 times a day, course – up to 15 days, then, if possible, switch to tablet form.

If the next dose was not taken in time, it is not taken additionally.

The maximum daily dose is 200 mg.

Interaction

Neuromidine® increases the sedative effect in combination with CNS depressants.

The effects and side effects are increased when combined with other cholinesterase inhibitors and m-cholinomimetic agents. In patients with myasthenia gravis, the risk of cholinergic crisis increases when Neuromidine® is used concomitantly with other cholinergic agents.

The risk of bradycardia increases if β-adrenoblockers were used before starting treatment with Neuromidine®.

Neuromidine® may be used in combination with nootropic drugs.

Alcohol increases the side effects of the drug.

Limits the inhibitory effect on neuromuscular transmission and excitation along the peripheral nerves of local anesthetics, aminoglycosides, potassium chloride.

Special Instructions

There are no systematic data on the use of Neuromidin® in children.

Alcohol should be avoided during treatment (increases the side effects of the drug).

Impact on the ability to drive a car or perform work requiring increased speed of physical and mental reactions. During treatment, one should refrain from driving and engaging in potentially hazardous activities requiring increased concentration and rapid psychomotor reactions.

Contraindications

Side effects

Activated by excitation of m-cholinoreceptors: salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased discharge of bronchial secretion, bronchospasm, seizures. Salivation and bradycardia can be reduced with m-cholinoblockers (atropine, etc.). Increased uterine tone, skin allergic reactions.

Rarely (after using higher doses) dizziness, headache, pain behind the chest, vomiting, general weakness, drowsiness, skin reactions (itching, rash) have been observed. In these cases, the dose is reduced or the drug is interrupted for a short time (1-2 days). These side effects occur in less than 10% of patients.

Overdose

Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, constriction of pupils, nystagmus, increased peristalsis of the GI tract, spontaneous defecation and urination, vomiting, jaundice, bradycardia, intracardiac conduction disorders, arrhythmias, reduced BP, anxiety, anxiety, agitation, fear, ataxia, seizures, coma, speech disorders, drowsiness, general weakness.

Treatment: in case of overdose of tablets – gastric lavage. Administration of m-cholinolytics, including atropine, cyclodol, methacin, etc.; symptomatic therapy.

Similarities