Dicetel

Dicetel (Pinaverium) is a drug used to treat functional digestive disorders such as dyspepsia (stomach upset) and irritable bowel syndrome (IBS). It has antispasmodic (relieves spasms) and carminative (helps get rid of gas) effects on the digestive tract.

Dicetel is an antispasmodic drug that helps to relieve spasms and cramps in the intestines, which can lead to relief of pain and discomfort in patients with various gastrointestinal problems. It can also help in reducing excess gas formation in the intestines.

Dicetel is usually available in tablet or capsule form for oral administration. The dosage and regimen are usually prescribed by a doctor depending on the patient’s specific condition.

Like any medication, Dicetel can cause side effects such as headache, nausea, vomiting, and rarely allergic reactions. It is important to use it only under the supervision of a doctor and to follow the dosage and administration recommendations.

Indications Dicetella

1. Dyspepsia: This is a condition characterized by a feeling of heaviness, discomfort, bloating, or pain in the upper abdomen after eating. Dicetel can help relieve these symptoms and improve stomach function.
2. Irritable bowel syndrome (IBS): This is a chronic gastrointestinal disorder that causes abdominal pain, constipation, diarrhea, bloating, and discomfort. Dicetel may help reduce intestinal spasms and relieve IBS symptoms.
3. Functional Dyspepsia in Pregnancy: Some pregnant women may experience dyspepsia due to changes in the body during pregnancy. Dicetel may be a safe and effective treatment for improving gastrointestinal comfort in such patients.
4. Gastroesophageal reflux disease (GERD): Dicetel may sometimes be recommended for the symptomatic treatment of GERD, especially if symptoms are associated with severe spasms of the esophagus.
5. Other gastrointestinal symptoms: Dicetel may be used to relieve various other gastrointestinal symptoms such as bloating, gas, fullness and discomfort.

Release form

1. Tablets: Dicetel is usually available as tablets for oral administration. Tablets may have different dosages, depending on the specific medical purpose.
2. Capsules: This medication also comes in capsule form, which is also taken by mouth.
3. Solution: Some dosage forms may be available as a solution for oral administration.

Pharmacodynamics

1. Myotropic action: Pinaverium has a direct effect on the smooth muscles of the gastrointestinal tract. It blocks calcium channels and reduces the penetration of calcium into muscle cells, which leads to their relaxation. This reduces intestinal contractile activity and spasms, which can lead to relief of pain symptoms and improvement of intestinal peristalsis.
2. Pain relief: Dicetel is used to reduce pain symptoms associated with various gastrointestinal diseases such as irritable bowel syndrome, spastic intestinal pain, colic, constipation and diarrhea.
3. Improving Gastrointestinal Function: In addition to reducing pain symptoms, pinaverium can also help improve intestinal functional activity, such as normalizing peristalsis and reducing discomfort.
4. Low CNS effects: Compared to some other antispasmodics, pinaverium does not generally cause drowsiness or central nervous system effects, making it safer to use without the risk of decreased alertness or decreased responsiveness.

Pharmacokinetics

1. Absorption: Pinaverium is generally well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are usually reached 1-2 hours after administration.
2. Distribution: Pinaverium has a high affinity for the gastrointestinal tissues where it exerts its therapeutic effects. It can also penetrate the blood-brain barrier and has the ability to accumulate in the tissues of the nervous system.
3. Metabolism: Pinaverium is metabolized in the liver to form active metabolites. One of the major metabolites is dihydropinaverium. The metabolites are excreted primarily in the urine.
4. Elimination: The elimination half-life of pinaverium is approximately 1-2 hours. About 70-80% of the dose is excreted via the kidneys, primarily as metabolites.

Dosing and administration

Dicetel (pinaverium bromide) is typically used at a dose of 50 mg three times daily to treat irritable bowel syndrome and other gastrointestinal spasms. The drug should be taken before meals for optimal effect. In a study of patients with irritable bowel syndrome, pinaverium bromide at a dose of 50 mg three times daily showed significant efficacy compared to placebo (Yalçın et al., 1992).

Use Dicetella during pregnancy

There is no information on the direct use of pinaverium bromide (Dicetel) during pregnancy in the available studies. However, it is important to consider the following aspects:

1. Pinaverium bromide is an antispasmodic agent that acts primarily in the gastrointestinal tract. It is used to treat irritable bowel symptoms and other functional gastrointestinal disorders. Pinaverium bromide remains primarily in the gastrointestinal tract due to low systemic absorption and rapid elimination, potentially reducing its risks to pregnant women (Christen, 1990).
2. Safety during pregnancy has not been established due to the lack of direct data on the effects on pregnant women or the fetus. Therefore, the use of pinaverium bromide should be discussed with a physician who can assess the potential benefits and risks.
3. In general, if a drug is needed to manage serious symptoms that cannot be controlled by other, safer methods, and if its use is approved by the treating physician, it may be used with due regard for all precautions.

Due to the lack of specific data, it is strongly recommended to consult a doctor before using pinaverium bromide during pregnancy to ensure the safety and effectiveness of treatment.

Contraindications

1. Hypersensitivity to pinaverium: People with known hypersensitivity to pinaverium or any of the components of the drug should avoid its use.
2. Paralytic ileus: Dicetel is contraindicated in paralytic ileus (physical blockage or difficulty in the passage of contents through the intestine) due to the risk of increased symptoms and complications.
3. Myasthenia gravis: In patients with myasthenia gravis (a chronic autoimmune disease characterized by weakness and rapid muscle fatigue), Dicetel may increase myasthenic symptoms and is not recommended for use.
4. Ureteral or biliary colic: The use of Dicetel in ureteral or biliary colic may be undesirable due to the risk of complications.
5. Pregnancy and breastfeeding: The use of Dicetel during pregnancy and breastfeeding should be discussed with a doctor, as there is limited data on its safety during these periods.
6. Childhood: Use of Dicetel in children requires special caution and should be carried out under the supervision of a physician.
7. Use with other medications: Before using Dicetel in combination with other medications, you should consult with your doctor to ensure there are no potential interactions.

Side effects Dicetella

1. Gastrointestinal symptoms: Although pinaverium bromide is intended to relieve gastrointestinal cramping and pain, in some cases it may cause mild abdominal discomfort, including bloating and nausea. These reactions are usually temporary and resolve after discontinuing the drug.
2. Dizziness and increased blood pressure: Cases of dizziness and mild increases in blood pressure have been reported in a small number of patients in studies (Zheng et al., 2015).
3. Skin reactions: Very rarely, pinaverium bromide may cause allergic reactions such as skin rash. If such symptoms occur, consult a doctor immediately.
4. Adverse effects on other body systems: Although pinaverium bromide usually acts locally in the gastrointestinal tract and is not absorbed into the systemic circulation, its effects on other systems are minimal.

Overdose

1. Increased side effects such as dizziness, headache, nausea or vomiting.
2. Increased pain symptoms in the abdomen.
3. More serious side effects such as diarrhea or drowsiness may occur.

Interactions with other drugs

1. Central nervous system depressants: Dicetel may increase the depressant effect on the central nervous system when taken with other drugs such as benzodiazepines, alcohol, sedatives and antidepressants. This may lead to increased sedation and decreased reaction time.
2. Drugs that speed up bowel movement: Since Dicetel is used to reduce the feeling of irritation in the intestines, its effect may be reduced when taken simultaneously with drugs that speed up bowel movement, such as prokinetics.
3. Drugs that affect gastrointestinal pH: Changes in gastrointestinal pH may affect the absorption of Dicetel. Drugs that increase pH (eg, antacids) may decrease its absorption, while drugs that decrease pH (eg, proton pumps or antacids) may increase its absorption.
4. Drugs Metabolized in the Liver: Dicetel may affect the metabolism of other drugs in the liver, which may change their effectiveness. For example, when taking drugs metabolized through cytochrome P450 enzymes at the same time, dosage adjustments may be required.

Storage conditions

1. Temperature: The product should be stored at room temperature, usually between 15°C and 30°C.
2. Humidity: Store Dicetel in a dry place to avoid damage.
3. Packaging: Before use, make sure that the packaging of the drug is intact. If the packaging is damaged or expired, the drug should be disposed of in accordance with local rules and regulations.
4. Child safety: Keep Dicetel out of reach of children to prevent accidental ingestion.