Parkopan

Parkopan has a muscle relaxant and m-anticholinergic effect.

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Indications Parkopana

It is used for the combined treatment of the following conditions:

• shaking palsy and spastic displegia;
• dystonia;
• secondary parkinsonism;
• movement or extrapyramidal disorders;
• hyperkinesis.

Release form

The substance is released in tablets of 2 or 5 mg; there are 100 tablets in a pack.

Pharmacodynamics

The drug has an antiparkinsonian effect and has muscle relaxant and m-cholinergic blocking properties. It is an antagonist of m-cholinergic receptors - it helps block the activity of synapses with the conductor acetylcholine, affecting the connection between dopamine and acetylcholine. This leads to a decrease in the cholinergic effect inside the central nervous system associated with a lack of dopamine.

The central anticholinergic effect prevails, due to which the drug weakens the severity or completely eliminates movement disorders that occur with extrapyramidal disorders. In addition, it also helps to weaken tremor at rest and has a weak effect on muscle rigidity.

The peripheral anticholinergic effect helps reduce salivation, and also slightly reduces the sebum glands and the intensity of sweating. In addition, the drug has antispasmodic properties due to myotropic effect.

As a monotherapeutic element, it is used for shaking palsy and secondary parkinsonism, as well as for extrapyramidal disorders; it weakens tone in case of paresis of pyramidal nature. The effect of the drug develops after 60 minutes; the maximum effect is observed for 2-3 hours, after which it begins to decrease. In total, the duration of the medicinal effect is within 6-12 hours.

Pharmacokinetics

After oral administration, the drug is absorbed from the gastrointestinal tract at high speed. It has high lipotropy. It is excreted with breast milk. Under the influence of esterases, it undergoes hydrolysis, transforming into organic acids and alcohol.

The half-life is in the range of 5-10 hours. A small part of the substance is excreted unchanged through the kidneys, and the rest is excreted in the form of metabolic products.

Dosing and administration

The drug must be taken orally, the initial dose is 1 mg per day. The tablets must be taken after meals (if dryness of the oral mucosa occurs after this, the drug is used before meals).

If the desired result is not achieved, the dosage is increased by 1 mg per day with 5-day intervals. The medication should be taken 3-5 times per day. For elderly people, the portion size is halved (this dosage is sufficient to achieve the medicinal effect).

For shaking palsy, take 5 or 10 mg of the substance per day (10 mg is the maximum permissible single dose). No more than 20 mg of the drug is allowed per day. If the drug is used together with levodopa, the dose should be reduced.

To correct extrapyramidal disorders, take 5 mg of the substance per day (maximum dose – 15 mg). Children aged 5-17 years can take 8-80 mg of the medication per day (3-4 doses).

The drug is discontinued gradually - over 7-14 days, because if the drug is stopped abruptly, the condition will rapidly worsen. It is also important to remember that there is a risk of developing drug dependence. During therapy, it is necessary to monitor the intraocular pressure indicators.

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Use Parkopana during pregnancy

It is prohibited to use Parkopan during pregnancy.

Contraindications

Main contraindications:

• the presence of intolerance to the components of the drug;
• glaucoma;
• atrial fibrillation;
• prostate adenoma;
• stenosis in the gastrointestinal tract of mechanical origin.

Caution is required when used by people with kidney or liver disease, severe atherosclerosis, high blood pressure, and the elderly.

Side effects Parkopana

The use of the medication may lead to the following side effects:

• feeling of nervousness, severe fatigue or drowsiness, increased intraocular pressure, delirium, dizziness, hallucinations or psychosis;
• vomiting, constipation, dry mouth, nausea;
• rashes on the epidermis, drug dependence;
• accommodative paresis, tachycardia, urinary retention and purulent parotitis.

Overdose

The first symptoms of intoxication include facial hyperemia, dry mucous membranes and epidermis, difficulty swallowing, dilated pupils, and fever. Severe overdose causes anxiety, muscle weakness, cramps, urinary disorders, heart rhythm, and consciousness, as well as weakened peristalsis and respiratory arrest.

Hemodialysis can be performed only in the first hours after intoxication. Sodium bicarbonate is infused, as well as physostigmine (intravenously through a dropper; a dose of 2-8 mg). In addition, constant ECG monitoring is required.

Interactions with other drugs

Use together with MAOIs leads to potentiation of the anticholinergic effect.

When using levodopa, the activity of the drug increases, which may require a reduction in its dosage.

Tricyclics, phenothiazine derivatives, and H1-histamine blockers potentiate the likelihood of negative symptoms (especially the peripheral anticholinergic effect).

Combination with reserpine weakens the effectiveness of the active element of Parkopan.

Use with chlorpromazine reduces plasma levels of the drug.

Trihexyphenidyl reduces the therapeutic effect of nitrates used sublingually.

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Storage conditions

Parkopan must be maintained at temperatures within 25°C.

Shelf life

Parkopan can be used within 5 years from the date of manufacture of the therapeutic agent.

Analogues

The following drugs are analogs of the medication: Anti-Spas, Pipanol, Cyclodol, Aparkan with Romparkin, and also Tremin, Artan, Parkan, Trixil with Antitrem, Trifenidyl with Peragit and Patsitan.

Reviews

Parkopan is not considered to be a very effective remedy for the treatment of shaking palsy. In this disease, anticholinergics are actively used, reducing the functional activity of the cholinergic system (it prevails over the dopaminergic system in people suffering from shaking palsy). The drug should restore the necessary balance between these systems, as a result of which the characteristic pathology signs disappear. This is precisely what Parkopan does not always cope with, judging by the comments on medical forums.

Nowadays, there is a tendency to limit the use of anticholinergics in older people, because they increase the likelihood of developing memory and mental disorders. The use of the drug is considered appropriate for younger people and only in situations where there is a noticeable improvement. It has been found that this category of drugs demonstrates effectiveness in only 20% of patients.

The use of individual neuroleptics (such as haloperidol with zuclopenthixol, as well as olanzapine with trifluoperazine) often causes extrapyramidal disorders, which necessitates the use of antiparkinsonian drugs that are correctors. It has been found that Parkopan with Akineton, used in small doses, demonstrate the highest efficiency. This is often mentioned in the comments.

Quite a large number of patients experience negative symptoms when using the medication - this is usually a feeling of irritability or drowsiness, dry mucous membranes and constipation. But with prolonged use, the severity of negative symptoms decreases.