Depakin hrono

Roman name

Depakine chrono

The composition and the form of

Male Film-coated prolonged action, separable-1 tabl.valproeva acid + valproat sodium-300 mgwo polypropylene bottle for 50 pc. ; In the box two Flakona.tabletki covered liner separable-1 tabl.valproeva acid + valproat sodium-500 mgwo polypropylene bottles to 30 pcs. ; In a box one bottle.

Pharmacokinetics

Well drawn, bioavailability is about 100%. Many lack the latent removals extended removals, more linear correlation between dose and the concentration of plasma. Compared with depakinom enteric is lower (about 25%) and a stable concentration in plasma between 6700 and 1914 hrs, in order to create a more uniform concentration valproeva acid in the plasma during the day. It binds to plasma proteins. The therapeutic efficacy of the drug is in the concentration in plasma 40-100 mg / O Penetrates through the placenta appears in the breast milk in small amounts (1-10% of the total concentration in plasma). Sustainable concentration in plasma is quickly (in 3-4 days), the oral application. Is inducer of enzyme zitohroma P450. Write mainly in the urine kongugirovannom form. T_1/2 is 8-20 hours

Pregnancy and lactation

Perhaps if the effect of therapy outweighs the potential risk to the fetus. The risk of defects in women on valproatov in the first trimester of pregnancy has been a paramount consideration in the employment of other противоэпилептически х funds. Valproata are causing disruption of embryonic neural tube : myelomeningocele (frequency of such complications 1-2%). If treatment valproatami effectively, it should not be interrupted during pregnancy (should take a minimum daily dose of several receptions). The babies whose mothers took valproata, in a few cases were gipofibrinogenemia (relates to the decline in the coagulation factors), afibrinogenemia (can be fatal).

Contraindications

Hypersensitivity, hepatitis (acute and chronic, as well as in family or personal history, especially by taking drugs), porphyria, a children's age (up to 3 years).

Specific guidance

During treatment should refrain from activities requiring greater attention and speed of reaction (particularly in the case of combination therapy with benzodiazepines).

Patient interaction

Do the doses, MAO inhibitors, antidepressants, бензодиазепинов.Увел��чивает phenobarbital concentration in plasma (especially in children), primidona; potenziruet toxic effect carbamazepina and alone; reduces total concentration fenitoina plasma; metabolism slows lamotrigina and increases T_1/2. When coupled with the application-felbamatom more valproatov content in the cell, with fenitoinom, fenobarbitalom, carbamazepinom Collection; Essential increases metabolism valproeva acid and is sudorozhny effect. In the case of joint use with acetylsalicylic acid and zimetidine eritromitinom increasing free valproeva acid in the serum. Incompatible with salicilatami (risk of hepatotoxicity).

Precautions

The sudden emergence of fear, anorexia. lethargy, sleepiness, vomiting, pain in the abdomen, seizures recurrence attacks need to undertake a study of the liver (in the vast majority of cases, the reaction expressed by the liver are in the first 6 months of treatment). Prior to the commencement of treatment and for the first six months should check the liver (белково-синтетическу ю function and protrombinvi index). When evidence of abnormally low protrombina, treatment Depakinom ® hrono to interrupt. If treatment included salicilata, their use also need Priostanoviti.pered the treatment or surgery, it is recommended that a blood test (a formula including the number of platelets, the bleeding, koagulyaie tests). In patients with renal insufficiency may be a need to reduce the dose (it should be established through clinical manifestations). It should be borne in mind the potential for the development of the immune system (with a drug to patients with Red Lupus and other diseases). In acute bolevom abdominalnom syndrome that before the surgery to determine the extent of the pancreatic enzymes Jeleza.pri suspected deficit enzymes cycle urea before the treatment should undertake a study of enzyme activity due to the risk of Giperammoniemii.v pregnancy should not interrupt launched �ротивоэпилептическо��о valproatami treatment (if effective), but the mother should do a special prenatal study to identify any anomalies development of the nervous tubes or other Porokov.u newborns should koagulogrammou (the number of platelets, the level fibrinoguena in plasma, the bleeding and blood clotting). In the case of combination therapy with fenobarbitalom, it is necessary to monitor the patient's condition during the first 15 days, and to reduce the dose of phenobarbital in the case of a sedative effect (if necessary for the determination of the level of phenobarbital in the blood). Together with the application of indirect antikoagulyantami should be carefully monitored protrombinovy index.

Storage conditions

List B. At room temperature

Shelf life

3 years

The registration

013004/01-2001

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