Segan

Segan is a pharmaceutical product used to treat Parkinson's disease. Let's consider its medicinal properties, dosage, and possible side effects.

The drug is used to treat a slowly progressing chronic neurological disease, typical for people of the elderly age category. Segan alleviates the symptoms of idiopathic Parkinsonism syndrome. Its use in the early stages of the disease slows down the development of the pathological process.

[ 1 ], [ 2 ]

Indications Segana

According to the instructions, Segan has the following indications for use:

• Parkinson's disease.
• Symptomatic shaking palsy.

The drug is used as an adjuvant therapy for patients with Parkinson's disease who take levodopa for a long period of time. And also for akinesia at night or early morning.

Release form

The medicine is available in tablet form. One package contains a blister of 20 capsules. Each tablet contains 5 mg of the active substance selegiline hydrochloride, as well as magnesium stearate, a mixture of lactose monohydrate, crospovidone and povidone K30.

Pharmacodynamics

The selective MAO-B inhibitor is involved in the metabolism of catecholamines, in particular dopamine. The pharmacodynamics of the active substance indicate the inhibition of the metabolism of neurotransmitters and their reuptake at the level of presynaptic endings. This leads to an increase in the concentration of the active substance in the brain regions and nuclei of the extrapyramidal system.

A single dose of 5 mg of the drug is capable of inhibiting about 50% of monoamine oxidase in the central nervous system. The enzyme recovery period takes 14 days. If the drug is used in therapeutic doses, it does not affect the MAO of the gastrointestinal tract and does not stop the breakdown of tyramine.

Selegiline prolongs and enhances the effect of levodopa. If Segan is used in the early stages of an idiopathic disorder, then the need for levodopa disappears. If the drug is used in combination therapy, then the dosage of levodopa is reduced by 30%.

Pharmacokinetics

After oral administration, selegiline is rapidly absorbed from the gastrointestinal tract, the maximum concentration occurs 30 minutes after administration. Pharmacokinetics indicates low bioavailability of the active component, it is about 10%. If the drug is used during meals, its bioavailability increases by 3-4 times. This is due to the fact that selegiline is a lipophilic substance with a weak alkaline reaction.

About 75-85% of the drug binds to plasma proteins. The active substance quickly penetrates the brain and spreads throughout all tissues of the body. It quickly metabolizes in the liver and small intestine to N-dimethylselegiline (MAO-B inhibitor). The highest concentration of metabolites is in plasma, which exceeds the maximum concentration of selegiline by 4-20 times. With repeated use, the concentration of metabolites of the active component increases.

The inhibitory effect on the activity of MAO-B enzymes develops after a single dose of 10 mg and lasts for 24 hours. Since the process of MAO-B inhibition by selegiline is irreversible, the restoration of MAO-B after discontinuation of the drug completely depends on the synthesis of the enzymatic protein. When taking a single dose, the half-life is 120 minutes, but in a steady state it can increase to 10 hours. The half-life of metabolites is about 20 hours. Metabolites are excreted in the urine, 15% is excreted in the feces.

Dosing and administration

The tablets are taken orally, without chewing and with water. The method of administration and dosage are prescribed by the attending physician. If Segan is used as monotherapy, then 5 mg is used 1-2 times a day, that is, before breakfast and before bedtime. In combination therapy with levodopa and carbidopa, 5-10 mg is prescribed. This dosage allows for a 10-30% reduction in the levodopa dose without disrupting the patient's motor functions.

If fluoxetine therapy is prescribed after Segan, it is necessary to wait at least 14 days. During therapy, you should refrain from driving a car and engaging in potentially dangerous activities that require increased attention, speed of motor and mental reactions.

[ 4 ]

Use Segana during pregnancy

To date, there is no reliable data on the safety of Segan for expectant mothers. That is, its use during pregnancy is not recommended. This is due to the risk of developing intrauterine anomalies in the fetus. If the drug is used during lactation, selegiline can penetrate into breast milk, which is also unsafe for the child.

Contraindications

The main contraindications to the use of the drug Segan are based on the activity of its active substance:

• Individual intolerance to the components of the product.
• Extrapyramidal disorders not associated with dopamine deficiency.
• Pregnancy and lactation.
• Huntington's chorea.
• Essential tremor.
• Progressive dementia.
• Tardive dyskinesia.
• Peptic ulcer of the gastrointestinal tract.
• Prostatic hyperplasia.
• Closed-angle glaucoma.
• Tachycardia and severe angina.
• Diffuse toxic goiter.
• Patients must be under 18 years of age.

If Segan is prescribed in combination with levodopa, the drugs are contraindicated in the following conditions: melanoma, CNS depression, bronchial asthma, renal or hepatic insufficiency, pulmonary emphysema, myocardial infarction, patients under 12 years of age.

Side effects Segana

In some cases, Segan may cause side effects. The most common painful symptoms are:

• Decreased appetite, nausea, vomiting, bowel disturbances and dry mouth.
• Increased fatigue, headaches and dizziness, sleep and wakefulness disturbances, hallucinations.
• Increased blood pressure, arrhythmia.
• Impaired visual acuity.
• Urinary retention, painful urination.
• Skin allergic reactions.

In rare cases, hypoglycemia and hair loss are observed. There is no specific antidote, treatment is symptomatic.

[ 3 ]

Overdose

Failure to comply with the dosage prescribed by the doctor causes various pathological reactions. Overdose is most often manifested by the following symptoms:

• Headaches and dizziness.
• Psychomotor agitation.
• Cramps.
• Arterial hypertension.
• Increased sweating.
• Heart rhythm disturbance.
• Respiratory depression.

Treatment includes inducing vomiting, using activated carbon, and gastric lavage. In case of convulsions, intravenous diazepam is necessary.

Interactions with other drugs

If Segan is used in combination therapy, it is necessary to monitor its interactions with other drugs. Selegiline enhances the effect of ethanol and levodopa, which increases the risk of side effects of amantadine. There is also an increase in the effect of adrenergic stimulants that depress the central nervous system.

The drug is incompatible with non-specific MAO inhibitors and opioid analgesics. When interacting with fluoxetine, the risk of developing serotonin syndrome increases, which is characterized by increased blood pressure and fever. Indirect-acting adrenergic stimulants increase the risk of increased blood pressure.

[ 5 ]

Storage conditions

The tablets must be stored in a dry place, protected from sunlight and out of reach of children. Storage conditions imply a temperature regime not exceeding 25 °C. Violation of these recommendations leads to deterioration of the medicine and loss of its pharmaceutical properties.

[ 6 ], [ 7 ]

Shelf life

Segan has a shelf life of 36 months from the date of manufacture (indicated on the packaging and blister with tablets). After this period, the drug must be disposed of. The shelf life is also affected by compliance with storage conditions. Therefore, if the tablets have changed color, acquired an unpleasant odor or began to crumble, you should not take them.