Depakin

Depakin is an anticonvulsant, which is used to treat epilepsy of various pathological forms.

[1], [2]

Indications Depakin

The medication is indicated for the elimination of small as well as generalized seizures of epilepsy, and in addition to focal focal seizures in which there is a complex and simple symptomatology.

Highly effective is considered in the treatment of convulsive syndromes, which are observed in organic cerebrospinal pathologies, but also in behavior disorders (due to epilepsy).

It is also prescribed for children with teak or febrile seizures.

In psychiatry Depakin is used in bipolar affective disorder, which is resistant to lithium drugs and other drugs, and in addition to treatment of specific syndromes - Lennox-Gasto or West.

[3], [4]

Release form

Produced in tablet form for 40 tablets (volume 0.2 g) or 10 tablets (0.5 g) in 1 bottle. In addition, also in the form of a freeze-dried powder for solutions (for parenteral administration), capsules and syrup.

Depakin 400 is a powder for injectable solutions. Used as a temporary remedy for epilepsy in children, as well as adults - as a substitute for oral analogues, if temporarily there is no possibility to take the medicine inside.

Depakin enteric 300 is used with monotherapy to eliminate:

• the primary form of epilepsy of generalized type, clonic-tonic convulsive attacks (with the development of myoclonic seizures or not), separately myoclonic seizures, absences, combined form of tonic-clonic seizures - with absences;
• benign type of partial form of epilepsy (among these is temporal epilepsy).

With monotherapy or combined with other anticonvulsants - to eliminate:

• secondary type of epilepsy generalized type;
• partial seizures of epilepsy (complex or simple forms).

When the effectiveness of monotherapy is poor, it is recommended to take the medicine in combination with other anticonvulsants.

Tablets are produced in blisters (10 pieces each). One package contains 10 blister plates.

Depakin Chrono 300 is a tablet with a prolonged effect - it is used to eliminate manifestations of the primary stage of epilepsy of generalized form (it is recommended to use for monotherapy): small seizures of epilepsy / absence, marked bilateral myoclonic seizures, and also severe epileptic seizures (accompanied by myoclonus or not) and epilepsy of photosensitive type.

Manic manifestations that develop due to BAP - when the patient is intolerant (there are contraindications) lithium.

Prevention of recurrence of episodes of dysthymia in patients with bipolar disorders, in the treatment of manic syndromes in which there is a drug reaction to the use of valproate.

One tablet of this drug contains: 199.8 mg of Valproate sodium, and 87 mg of valproic acid - the sum of these components corresponds to 300 mg of sodium valproate in the first tablet.

The bottle containing the medicine contains 50 tablets. One package contains 2 bottles.

One tablet Depakin Chrono 500 contains: 333 mg of Valproate sodium, as well as 145 mg of valproic acid - in total, these 2 substances give 500 mg of Valproate sodium in the first tablet of drugs.

The medicine is contained in a vial (30 tablets). In one package - 1 bottle with the drug.

[5]

Pharmacodynamics

The drug has a sedative, as well as a central muscle relaxant effect on the body. There is no complete information on the mechanism of exposure to drugs. There is evidence that valproate, which is an active component of the drug, contributes to an increase in GABA in the central nervous system, and also slows the activity of the GABA-transferase enzyme. As a result, the convulsive alertness and excitability of the motor parts of the cerebral cortex decrease. Depakin has antiarrhythmic activity, it allows to increase the mood and improve the patient's mental state.

[6], [7], [8], [9]

Pharmacokinetics

The bioavailability index is about 100%. Valproates are able to pass through the BBB, penetrating into the cerebrospinal fluid, as well as the brain.

Depakin begins to exert a medicinal effect after reaching 40-100 mg / l plasma concentration of the substance. If this figure exceeds 200 mg / l, it is necessary to reduce the dose. The figure of the equilibrium concentration of the drug reaches 3-4 days after the constant use of tablets.

Excretion (in conjugated form) is mainly carried out together with urine.

[10], [11]

Dosing and administration

Tablets are taken orally - 2-3 times a day, while washing them with water. The medicine in the form of a syrup should be mixed before consumption with food or some liquid.

It is allowed to prescribe it for children weighing 25+ kg, as well as for adults. At the initial stage, the daily dosage is 5-15 mg / kg, and then it is gradually increased by 5-10 mg / kg weekly.

The daily dosage for adolescents with adults is 20-30 mg / kg. To obtain a stable medicinal effect, it is allowed to increase the dosage by 200 mg per day with an interval of 3-4 days. The maximum daily dosage is 50 mg / kg.

For small children and newborns, the dosage size is determined individually.

[15], [16], [17], [18]

Use Depakin during pregnancy

Depankin can not be used for pregnant women, because approximately in 1-2% of all cases the drug is able to provoke neon tube developmental defects in the fetus, as a result of which spinal fissure is formed, as well as spinal hernia.

Contraindications

Among the contraindications of drugs:

• patient intolerance to the drug;
• hepatitis (in acute or chronic stage);
• liver failure;
• disorders in the pancreas;
• porphyrin disease;
• severe form of thrombocytopenia;
• hemorrhagic diathesis;
• the period of breastfeeding;
• children age less than 3 years.

Be wary if the patient has signs of suppression of hematopoiesis in the bone marrow (such as thrombocyto or leukopenia, anemia and organic pathology of the central nervous system, and in addition kidney failure, child mental retardation, and congenital form of fermentopathy).

[12], [13]

Side effects Depakin

The use of the drug can cause such adverse reactions:

• organs of the digestive system: aching epigastric pain, nausea, impaired liver function, increased or worse appetite, development of a tendency to diarrhea (occasionally - to constipation), and in addition to this manifestation of pancreatitis, which can reach a severe stage of disruption in the pancreas;
• organs of the central nervous system: often there is a tremor, but in addition develop behavioral disorders, mood instability, sometimes reaching depressions, as well as aggressiveness. In addition, there are psychoses, hyperactivity, tonic-clonic seizures, hallucinations and isolated stupor. Among the symptoms are also possible dizziness with headaches, severe drowsiness, dysarthria with encephalopathies, and along with this, disorders of consciousness reaching the comatose state, and ataxia;
• organs of the hematopoietic system and homeostasis: prolongation of bleeding time, thrombocytopenia, decrease in the blood of fibrinogen. Single - leukopenia or anemia;
• Metabolism: decrease or increase in weight;
• organs of vision: can double in the eyes, appear "flies" or "stars in the eyes, but also develop nystagmus;
• skin: allergies in the form of urticaria, rashes, edema Quincke, and in addition to photosensitivity and Stevens-Johnson syndrome;
• organs of the endocrine system: a secondary form of amenorrhea, dysmenorrhea or galactorrhea, and in addition an increase in the size of the mammary glands;
• other: individually, hair loss can begin, which comes to the development of alopecia.

[14]

Overdose

As a result of an overdose, the patient may fall into a coma. In addition, a sharp decrease in blood pressure, a respiratory disorder, and the appearance of miosis or hyporeflexia are possible.

To eliminate these manifestations, gastric lavage should be performed (but only in case the drug was taken at most 10-12 hours before). In addition, osmotic diuresis is necessary, and it is also necessary to monitor the blood pressure, pulse rate and respiration rate, and at the same time to correct the function of the cardiovascular system (if necessary). Hemodialysis can be performed, but only according to the indications.

[19], [20], [21]

Interactions with other drugs

Because of the similarity of metabolic processes, it is not recommended to combine the drug with salicylates.

As a result of the simultaneous use of Depakin with antidepressants or antipsychotics, their effect on the body increases, as well as the symptoms of adverse reactions.

Combined reception with fentoin reduces the concentration of the latter, along with it increasing its concentration in a free form - this can provoke the development of overdose manifestations of the drug.

The use of anticonvulsants inducing microsomal hepatic enzymes reduces the concentration of the drug in the blood serum. If the patient requires a joint intake of such drugs, dosage adjustments should be adjusted in accordance with the concentration indices.

Depakin enhances the properties of antipsychotics, anticonvulsants, barbiturates, antidepressants, and in addition ethanol and MAO inhibitors. When combined with hepatotoxic drugs and ethanol, the risk of liver damage increases, resulting in liver failure.

Does not weaken the effectiveness of oral contraception.

The combination with myelotoxic drugs increases the risk of suppressing hematopoietic processes.

[22], [23], [24]

Storage conditions

The medication is kept under standard conditions - a dark, dry place. The temperature should not exceed 25 ° C.

[25], [26]

Shelf life

Depakin is suitable for use for 3 years from the date of manufacture, but after opening the bottle it can not be used for more than 1 month.

[27], [28]