Duzofarm

Duzopharm (active ingredient: naftidrofuryl) is a drug that is a vasodilator and is used to improve peripheral circulation. Naftidrofuryl improves blood supply to tissues and organs, which is especially important for diseases associated with impaired peripheral circulation.

Naftidrofuryl improves metabolism and energy supply to cells, dilates peripheral vessels, which leads to improved microcirculation and increased blood flow in tissues. It also has antiplatelet properties, which helps prevent blood clots.

Indications Duzopharma

1. Peripheral vascular diseases:

   • Obliterating endarteritis
   • Obliterating atherosclerosis
   • Raynaud's disease

2. Cerebrovascular diseases:

   • Chronic cerebrovascular disorders
   • Post-stroke conditions
   • Dementia of vascular origin

3. Syndromes associated with impaired peripheral circulation:

   • Intermittent claudication
   • Night pain in legs
   • Trophic ulcers of the lower extremities

Release form

1. Capsules:
   • Dosage: 100 mg, 200 mg or 400 mg naftidrofuryl in one capsule.
   • Packaging: blisters of 10 or 15 capsules per package, may contain from 30 to 120 capsules depending on the manufacturer and the specific packaging.

Pharmacodynamics

1. Vasodilation:

   • Naftidrofuril dilates peripheral vessels, which improves blood supply to tissues. This effect is due to inhibition of phosphodiesterase and an increase in the content of cyclic adenosine monophosphate (cAMP) in vascular smooth muscle cells, which leads to their relaxation.

2. Improving tissue metabolism:

   • The drug enhances metabolic processes in tissues, especially under conditions of hypoxia (lack of oxygen). This is achieved by improving aerobic metabolism and increasing energy levels in cells.

3. Antiplatelet effect:

   • Naftidrofuryl has the ability to reduce platelet aggregation, which reduces the risk of thrombosis. This is especially important for patients with peripheral vascular disease, where the risk of blood clots is increased.

4. Antioxidant effect:

   • Naftidrofuryl has an antioxidant effect, reducing the number of free radicals in tissues, which helps reduce cell damage and improve their functions.

5. Improving microcirculation:

   • The drug improves microcirculation by reducing blood viscosity and improving the deformability of red blood cells. This allows you to improve blood flow in the capillaries and increase the supply of tissues with oxygen and nutrients.

Clinical effects:

• Reduced symptoms of intermittent claudication: Patients with peripheral arterial occlusive disease report improved ability to walk long distances without pain.
• Reduced symptoms of chronic cerebrovascular disease: Patients with dementia of vascular origin and other chronic cerebrovascular disorders may experience improvements in cognitive function and general condition.

Pharmacokinetics

1. Suction:

   • Naftidrofuryl is rapidly and almost completely absorbed from the gastrointestinal tract after oral administration. The maximum concentration in blood plasma is achieved within 1-2 hours after administration.

2. Distribution:

   • The drug is well distributed throughout the tissues of the body. Plasma protein binding is about 80-90%, indicating a high degree of binding to blood proteins.
   • Naftidrofuryl penetrates the blood-brain barrier, which facilitates its use in the treatment of cerebrovascular diseases.

3. Metabolism:

   • Naftidrofuryl is actively metabolized in the liver with the formation of several metabolites. The main route of metabolism involves hydrolysis of the ester bond to form naftidrofurylic acid and other metabolites.

4. Withdrawal:

   • Naftidrofuryl and its metabolites are excreted mainly through the kidneys. About 60-70% of the dose taken is excreted in the urine, and only a small amount is excreted in feces.
   • The half-life is approximately 3-5 hours, which allows the drug to be taken several times a day to maintain therapeutic concentrations.

5. Pharmacokinetic features in special groups of patients:

   • In patients with impaired liver and kidney function, changes in the pharmacokinetics of naftidrofuril may occur, which requires dose adjustment and more careful monitoring.
   • In elderly patients, the metabolism and elimination of the drug may slow down, which may also require dosage adjustment.

Application features:

• Taking the drug with food may slow down absorption, but does not reduce the overall bioavailability of naftidrofuryl.
• It is necessary to follow the recommended dosage and dosage regimen specified by your doctor to ensure optimal therapeutic effect and minimize the risk of adverse reactions.

Dosing and administration

Recommended dosages:

Adults:

• Standard dose: 100 mg (1 capsule) 3 times a day.
• For more severe conditions: The dose may be increased to 200 mg (2 capsules) 3 times a day, depending on the severity of the disease and the individual response of the patient.

Method of application:

1. Oral administration:

   • Capsules should be taken orally with a sufficient amount of water (at least half a glass).
   • It is better to take capsules with meals to reduce the risk of gastrointestinal irritation.

2. Duration of treatment:

   • The duration of treatment is determined by the doctor individually depending on the nature of the disease, the clinical picture and the patient’s response to therapy.
   • In most cases, the course of treatment lasts from several weeks to several months.

Special instructions:

• Patients with renal failure:

  • Dosage adjustment may be required in patients with impaired renal function. The physician will evaluate the need for dosage changes based on creatinine clearance and the patient's general condition.

• Elderly patients:

  • Elderly patients may have slower metabolism and elimination of the drug, requiring careful monitoring and possible dosage adjustment.

• Missed dose:

  • If you miss a capsule, take it as soon as possible. If it is almost time for your next dose, do not double the dose, just continue taking it as usual.

• Cessation of treatment:

  • You should stop taking the drug gradually and under the supervision of a doctor to avoid a sharp deterioration of the condition.

Use Duzopharma during pregnancy

1. Lack of sufficient data:

   • Currently, there is insufficient clinical data on the safety of naftidrofuryl in pregnant women. Animal studies cannot always accurately predict reactions in humans, so the risks remain uncertain.

2. Prescription only for strict indications:

   • The use of naftidrofuryl during pregnancy is possible only in cases where the potential benefit to the mother significantly outweighs the possible risk to the fetus. The decision to prescribe a drug is made by the doctor, carefully assessing all possible risks and benefits.

3. Use in the first trimester:

   • In the first trimester of pregnancy, when the formation of the main organs and systems of the fetus occurs, the use of naftidrofuryl should be avoided due to the potential risk of teratogenic effect.

4. Condition monitoring:

   • If the drug is prescribed to a pregnant woman, careful monitoring of the condition of the mother and fetus is required. The doctor may recommend regular examinations and monitoring of indicators to promptly identify possible side effects.

Alternative measures:

• In the presence of diseases associated with impaired peripheral or cerebrovascular circulation, the doctor may consider alternative treatment methods that have proven safety during pregnancy.
• Non-pharmacological methods such as physical therapy and lifestyle changes may also be considered as alternative or additional measures.

Lactation:

• There is insufficient information on the excretion of naftidrofuryl in human milk. If it is necessary to use the drug during lactation, it is necessary to consider stopping breastfeeding for the duration of treatment to avoid potential risk to the infant.

Contraindications

1. Hypersensitivity:

   • Hypersensitivity to naftidrofuryl or any of the auxiliary components of the drug.

2. Severe liver dysfunction:

   • The drug is metabolized in the liver, therefore, in severe liver dysfunction, the use of naftidrofuryl is contraindicated.

3. Severe renal impairment:

   • Since naftidrofuryl and its metabolites are excreted by the kidneys, the drug is contraindicated in severe renal impairment.

4. Acute myocardial infarction:

   • The drug is not recommended for use in the acute period of myocardial infarction.

5. Bradycardia:

   • The drug can affect the heart rhythm, so its use is contraindicated in cases of severe bradycardia (slow heart rate).

6. Severe forms of arterial hypotension:

   • The drug may lower blood pressure, which is dangerous if severe hypotension already exists.

7. Pregnancy and lactation:

   • As already mentioned, the use of naftidrofuryl during pregnancy and breastfeeding is contraindicated due to a lack of safety data.

8. Children's age:

   • The drug is contraindicated in children under 18 years of age, since safety and effectiveness for this group of patients have not been established.

Special warnings:

• Cardiovascular diseases: In the presence of diseases of the heart and blood vessels, caution and careful monitoring of the patient’s condition are required.
• Epilepsy: The drug may affect the central nervous system and should therefore be used with caution in patients with epilepsy.
• Possible interactions with other drugs: Possible drug interactions should be considered, especially with drugs that affect heart rate and blood pressure.

Side effects Duzopharma

Common side effects:

1. Gastrointestinal tract:

   • Nausea
   • Vomiting
   • Diarrhea
   • Stomach pain

2. On the part of the nervous system:

   • Headache
   • Dizziness
   • Insomnia
   • Agitation or irritability

3. Cardiovascular system:

   • Tachycardia (rapid heartbeat)
   • Arterial hypotension (low blood pressure)
   • Bradycardia (slow heartbeat)
   • Increased symptoms of angina (rare)

4. Allergic reactions:

   • Rash
   • Itching
   • Hives
   • Angioedema (very rare)

5. From the skin:

   • Skin redness
   • Rash
   • Sweating

6. From the respiratory system:

   • Shortness of breath
   • Bronchospasm (rare)

Less common side effects:

1. From the liver:

   • Increased levels of liver enzymes
   • Hepatitis (very rare)

2. On the part of the hematopoietic system:

   • Anemia
   • Leukopenia (decrease in the number of white blood cells)
   • Thrombocytopenia (low platelet count)

3. Mental disorders:

   • Depression
   • Anxiety

Overdose

1. Gastrointestinal tract:

   • Nausea
   • Vomiting
   • Diarrhea

2. Cardiovascular system:

   • Decreased blood pressure (hypotension)
   • Rapid heartbeat (tachycardia)
   • Heart rhythm disturbances (arrhythmias)

3. From the central nervous system:

   • Dizziness
   • Headache
   • Excitement or, conversely, depression of the central nervous system

4. Allergic reactions:

   • Skin rash
   • Itching
   • In rare cases, angioedema

Interactions with other drugs

Drug interactions:

1. Anticoagulants and antiplatelet agents:

   • Concomitant use with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin) may increase the risk of bleeding. It is necessary to monitor blood clotting parameters and adjust drug doses.

2. Antihypertensive drugs:

   • Naftidrofuryl may potentiate the effect of antihypertensive drugs, which may lead to an excessive decrease in blood pressure. Monitoring of blood pressure and, if necessary, adjustment of doses of antihypertensive drugs is required.

3. Cardiac glycosides:

   • Concomitant use with cardiac glycosides (for example, digoxin) may increase the risk of arrhythmias. Cardiac monitoring is recommended.

4. Drugs affecting the central nervous system:

   • Naftidrofuryl may interact with drugs that affect the central nervous system, such as sedatives and antipsychotics, enhancing or altering their effects.

5. Cytochrome P450:

   • Naftidrofuryl is metabolized in the liver with the participation of the cytochrome P450 system. Drugs that inhibit or induce this system (for example, rifampicin, ketoconazole) may alter the metabolism of naftidrofuryl, requiring dose adjustment.

Interactions with food and alcohol:

1. Food:

   • Food intake may slow down the absorption of naftidrofuryl but does not affect its overall bioavailability. It is recommended to take the drug with food to reduce the risk of gastrointestinal irritation.

2. Alcohol:

   • The combined use of alcohol and naftidrofuryl can increase the sedative effects and negative effects on the gastrointestinal tract. It is recommended to avoid drinking alcohol during treatment.