Jasnal

Yasnal is a drug that selectively inhibits brain acetylcholinesterase. As a rule, it is used to treat patients with dementia. We offer you the instructions for medical use of the drug Yasnal.

Indications Jasnal

The drug is used to relieve and reduce symptoms of type I Alzheimer's disease (senile dementia of the Alzheimer's type) - primary degenerative dementia of elderly patients of presenile and senile age, uncomplicated and moderate course of the disease.

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Release form

Yasnal is a tablet with an external protective coating (film). The active ingredient is donepezil hydrochloride.

The tablets are packed in blister packs and cardboard boxes, No. 7, No. 10, No. 28, No. 56, No. 60, No. 98 or No. 120.

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Pharmacodynamics

Acetylcholinesterase is the dominant cholinesterase type in the brain. The active ingredient in Yasnal is capable of inhibiting this substance a thousand times more than pseudocholinesterase, which is usually found outside the central nervous system.

After a single use of Yasnal in an amount of 5 to 10 mg, acetylcholinesterase activity decreases from 63 to 77%.

This drug is able to slow down the further development of dementia, smooth out some cognitive impairments, and often stimulate the activity of patients during daylight hours, which significantly simplifies the possibility of caring for them. The course of treatment with Yasnal helps eliminate behavioral disorders, improves mood, eliminates hallucinatory disorders and unconscious motor acts.

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Pharmacokinetics

After oral administration of the drug, the maximum level of the active substance in plasma can be observed after 3-4 hours. The amount of donepezil in plasma is higher, the higher the dose taken. The half-life from plasma can last up to 70 hours, so the equilibrium concentration of the drug is observed for 14-21 days from the start of treatment.

Food intake does not affect the absorption of the active ingredient of the drug.

The connection with plasma proteins is 95%. Experts believe that the active substance together with metabolites can remain in the body for 10 days or more.

The drug is metabolized in the liver and excreted through the urinary system, or to a lesser extent, in the bile.

After a single dose of 5 mg, the level of unchanged active substance in the blood serum may be 30% of the dose taken.

In patients with mild or minor impairment of liver function, plasma concentrations may increase.

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Dosing and administration

Adult patients receive the drug in an initial dosage of 5 mg per day, at one time. The patient should take such treatment from 1 to 1.5 months, until a stable level of the drug in the blood is established and the effectiveness of the drug is determined. Then, at the discretion of the doctor, the dosage can be increased to 10 mg per day: this amount of the drug is considered the maximum daily dosage.

The course of therapy can last quite a long time if the doctor sees positive dynamics from taking Yasnal.

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Use Jasnal during pregnancy

There are no special and confirmed studies regarding the use of Yasnal during pregnancy and breastfeeding. There is currently no information on the penetration of the active component of the drug into breast milk.

If possible, it is better to avoid using Yasnal during pregnancy and breastfeeding.

Contraindications

• Pregnancy and breastfeeding.
• Children under 18 years of age (no clinical data).
• Tendency to allergic reaction to any of the components of the drug.

The drug should be prescribed with caution to patients with obstructive processes in the respiratory system, asthmatic conditions, arrhythmia, ulcerative processes in the digestive tract or a tendency to them.

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Side effects Jasnal

• Slowing of the heart rate, in some cases – sinoatrial and atrioventricular blocks.
• Fainting, feeling of fatigue, sleep disturbances, hallucinations, irritability and aggression, headache, in some cases – convulsions.
• Dyspeptic disorders, attacks of nausea and vomiting, less often – the development of ulcerative processes in the digestive tract.
• Loss of control over urination.
• Skin rashes, possibly accompanied by itching.
• Muscle and joint pain, body aches, convulsive states.

Overdose

There is no information on cases of overdose with Yasnal. If an overdose is suspected, symptomatic therapy should be prescribed. There is no specific antidote to the drug.

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Interactions with other drugs

Due to the lack of complete information on the use of Yasnal, when prescribing the drug, it is necessary to assess the risk of the combined action of certain groups of drugs.

The active component of the drug is metabolized with the participation of the isoenzyme substance CYP3A4 and, less frequently, CYP2D6. Thus, drugs that inhibit these isoenzymes can inhibit the metabolic processes of Yasnal. Such drugs include quinidine, erythromycin, fluoxetine, and ketoconazole. The combined use of these drugs with Yasnal can increase the level of donepezil in plasma by approximately 25-30%.

Caution should be exercised when using Yasnal together with rifampicin, ethyl alcohol, carbamazepine and phenytoin, as such combinations may reduce the level of the active component of Yasnal in the blood. The extent of the reduction in the drug level is unknown.

The active component of Yasnal enhances the effect of muscle relaxants, as well as drugs that affect cardiac conduction.

When taking Yasnal in combination with other cholinomimetic and anticholinergic drugs, fluctuations in blood pressure and heart rate may occur.

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Storage conditions

The medicine Yasnal can be stored in a dark place, at a temperature of no more than +25°C. Children should never be allowed near places where medicines are stored.

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Shelf life

Shelf life: up to 36 months from the date of manufacture.