Zalox

The drug Zalox refers to antidepressants with an active active substance sertraline, which is a chemical compound that inhibits the reverse return of serotonin in neurons. This effective medication of the Canadian corporation Pharmasins Inc. Is widely used by modern psychiatrists.

Indications Zalox

The drug Zalox was released by the manufacturer as a strong remedy, preventing or reducing depressive conditions in patients. Hence the corresponding indications for the use of Zalox:

• Depressive psychosis, accompanied by a sense of anxiety.
• Manic manifestations of mental disorders.
• Prophylactic use of an antidepressant, preventing the resumption of the disease.
• Treatment of obsessive conditions, obsessive-compulsive disorders.
• Agoraphobia is a panic fear of open spaces.
• Post-traumatic stress disorder.
• Prevention of depressive relapse.
• Other manifestations of psychosis.

[1]

Release form

The drug Zalox is issued in a single form. The form of the preparation is capsules of white powder coated with gelatinous coating.

Pharmacodynamics

The mechanism on which all Zalox's pharmacodynamics is tied is that the dominant sertraline substance effectively slows down the ability of other chemical compounds to bind and withdraw serotonin from neurons, with dopamine and norepinephrine not responding to such an active effect. The blocking of the return transport of serotonin, due to the active properties of sertraline, occurs in platelets.

Receiving Zalox, as the majority of antidepressants, leads to inhibition of brain receptor activity (serotonin and norepinephrine). As shown by clinical studies, the chemical substance sertraline does not have radical points of contact with other receptors (such as histaminergic, cholinergic, dopaminergic, serotonergic, etc.)

Conducting controlled studies using placebo showed that Zalox, with its active substance sertraline, does not show sedative properties. He is inert to the effects on the psychomotor of the patient.

Pharmacokinetics

The absorption capacity of sertraline can be called fairly average. If the course of treatment of this drug provides a long period of time, while the patient takes 200 mg per day, the maximum amount of the substance in the blood plasma (which is 0.19 μg / ml) will be reached 4.5 to 8.4 hours after drug administration in the body.

The half-life of this substance from the body is also long-from 22 to 36 hours, depending on the individual characteristics of the patient's organism and its accompanying diseases. Due to the long half-life, the monitoring showed a two-fold accumulation of the drug, which allows reaching equilibrium concentrations observed after one week of admission, with the patient being administered once a day.

The pharmacokinetics of Zalox, falling within a numerical range of 50 to 200 mg, largely depends on the dosage taken. A large percentage of sertraline is absorbed into the liver, rebuilding into a derivative of N-demethylation. In consequence and sertraline, its metabolites, which have low pharmacological activity, are excreted from the body of the patient in equal quantities with fecal masses and through the kidneys with urine. In this case, sertraline itself (unchanged) is excreted in a small amount, since about 98% of it is from the protein component of the blood plasma. To date, there are no reliable facts of Zalox's collaboration with other drugs that have similar highly active ability to bind to proteins.

The pharmacokinetics of Zalox from sex and age qualification does not depend.

Dosing and administration

It is necessary to clearly understand that the Zalox drug should be taken only under the prescription of the doctor and in strictly specified dosages. As a rule, adults and children over the age of 13 years, the starting daily dose in the treatment of depressive states is prescribed at a rate of 50 mg. In nervous disorders characterized by panic symptoms, the starting daily dose is ascribed to 25 mg, and, after a week of taking, the dosage is raised to 50 mg per day. Independently increase the amount of the drug should not be taken.

If there is no improvement during treatment, the attending physician may increase the dosage of Zalox, but this amount should not exceed 200 mg daily. It should also be taken into account that the maximum concentration of sertraline, based on the pharmacokinetics of the drug, accumulates in the blood plasma after a week from the time of admission.

Taking medication should not be canceled, even if there is no rapid improvement in health. This can take up to four weeks (about a month).

Dosage and administration: it is suggested that Zalox is administered orally once a day (either in the morning or in the evening). The capsule should be swallowed with a certain amount of water. Swallow the capsule is necessary - not chewing.

To cancel reception of a preparation Zaloks in the right only the attending physician. The duration of the drug may last up to several months. If, for some reason, one reception was missed, the next step should not be moved anywhere (the medicine must be entered at the scheduled time) and take the same dosage twice.

If there is an overdose of Zalox (accidentally or intentionally), you need to urgently consult a doctor, even if the patient feels well enough.

With prolonged use of the drug, the therapeutic dosage should be kept at the minimum effective dose. In this case, the patient's condition should be constantly monitored by the doctor, so that, if necessary, the dosage can be adjusted. In cases where the patient's history is burdened by impaired liver function, Zalox medication should be administered cautiously, dosage should be reduced. If the pathology affects the kidneys, due to the insignificant release of sertraline through them, dosage adjustment is not necessary.

Use Zalox during pregnancy

If a woman already knows about her pregnancy or plans to become pregnant in the near future, she must certainly notify her doctor about this. Due to the fact that there is no great experience in which the use of Zalox during pregnancy would be recorded and analyzed, no, the use of this drug during the period when a woman plans to become a mother is not recommended. An exception can be cases of severe clinical condition of the patient, when the expected effect of Zalox application is significantly more significant for a woman's health than the alleged harm to her and her future child.

If the patient is in reproductive age, the doctor usually prescribes contraception to her during the treatment period. Since there were cases when the newborn showed abnormalities similar to such symptoms of the withdrawal reaction (if his mother during pregnancy was taking medications that included sertraline). This especially applies to the last third trimester of pregnancy. Against this background, the following symptoms may appear in a newborn:

• Cyanosis is a cyanotic color of the skin and mucous membranes, especially pronounced in the region of the triangle of the upper lip.
• Cramps and tremors.
• Respiratory distress syndrome.
• Apnea - temporary respiratory arrest
• Temperature jumps.
• Vomiting and feeding problems.
• Increased muscle tone.
• Hypoglycemia - a decrease in the concentration of glucose in the blood.
• And many others.

In most cases, these changes can be noticed immediately after the birth of the baby or during the first 24 hours of life.

Based on the published data, it can be argued that the quantitative component of the active substance of Zalox and its metabolites in the milk of a woman during lactation is not significant. Clinical analyzes have also shown their small doses in the blood of the newborn, in the case when the nursing mother took this medication. However, a significant concentration of sertraline (approximately 50%) is recorded in the child's blood. True, there was no significant effect on the baby's health. To date, it is impossible to completely eliminate the risk of a side pathology. Therefore, if possible, it is worthwhile to spread on time taking the drug and feeding the baby (at the time of treatment, Zalox needs to stop feeding).

Contraindications

Contraindications to the use of Zalox:

• Individual hypersensitivity to the constituent components of the drug.
• It is not necessary to ascribe to children, exceptions can only be obsessive-compulsive disorders in children over the age of six.
• Contraindicated in the use of Zalox and in conjunction with MAOI (monoamine oxidase inhibitors are biologically active substances capable of inhibiting the enzyme monoamine oxidase).

Side effects Zalox

Conducted laboratory and clinical studies under placebo control revealed such side effects of Zalox:

• Nausea, vomiting.
• Diarrhea (a liquid, watery stool).
• Insomnia.
• Dyspepsia (painful digestion).
• Anorexia (mental illness of the digestive tract).
• Skin on the skin.
• Increased work of the sweat glands.
• Dryness of the oral cavity.
• Dizziness.
• Failure in the reproductive capabilities of men.
• Tremor.
• Tachycardia.
• Increased fatigue.
• Violation of the function of platelets.
• Arterial hypertension.
• And many other deviations.

The dependence of the manifestations of Zalox's side effects on the dosage taken is revealed. A "dangerous" amount of the drug was a dose of 200 mg daily.

[2], [3]

Overdose

In the case of Zalox as a monotherapy, an overdose of sertraline gives the following symptomatology:

• Nausea, resulting in vomiting.
• Drowsiness and apathy.
• Dilation of pupils.
• Strengthening of tachycardia.
• Change in the indication of the electrocardiogram.
• Feeling of anxiety.

In case of manifestation of this symptomatology, the doctor prescribes maintenance therapy:

• Activated carbon reception.
• Appointment of laxative drugs.
• Rinsing of the stomach and intestines.
• Constant monitoring of cardiac activity.
• Control of all system physiological indicators.

To date, there are no specific antidotes that stop the pharmacodynamics of Zalox, and in particular sertraline hydrochloride, have not been found. There were no lethal outcomes with an overdose of sertraline.

Interactions with other drugs

It is very cautious to combine various medications in complex therapy, as they are able, as well as enhance each other's action, which is often dangerous, and completely block the pharmacodynamics of its recipient.

In the process of work, some interactions of Zalox with other drugs that can not be discharged from the shields during treatment have been identified.

So, in the complex appointment of Zalox with psychotropic drugs (for example, such as phenytoin, haloperidol, carbamazepine), with a daily dosage of sertraline hydrochloride of 200 mg, there is no significant increase in the parameters of psychomotor and cognitive function. However, it is unequivocal to say that there is no risk with such a joint reception, it is impossible. Therefore, special care must be taken with this treatment protocol.

There is also no great experience in cases when it became necessary to transfer a patient from another serotonergic drug to Zalox. Therefore, before making such a transfer, it is necessary to weigh all the pros and cons. And only if you have won "for", observing all caution, you should change the medicine. This is especially true for long-term preparations, since the duration of "washing away" of the chemical is not established. It should be avoided and the combination of drugs, the active ingredient of which is sertraline hydrochloride.

In the course of clinical studies, no significant changes in the pharmacokinetics of lithium preparations were observed when they were combined with Zalox. Although this combination showed tremors compared with placebo. Still, you should be careful when they are taken.

The complex use of monoamine oxidase inhibitors (MAOI), with the drug under consideration, can lead to quite severe, sometimes fatal consequences. Often this is similar to serotonin syndrome. Similar manifestations are observed with simultaneous intake of two or more antidepressants with MAOI, or in patients who have started taking MAOI after antidepressants. After therapeutic treatment with inhibitors, you can switch to Zalox only two weeks (or 14 days). And vice versa. It is possible to start taking MAOI only two weeks after the end of the Zalox treatment course.

Most antidepressants work as antagonists of the biochemical mobility of the cytochrome isoenzyme, which occupies not the least place in the metabolism of pharmacological drugs. This circumstance promotes the growth of the quantitative index of the drugs taken in the blood. When combining such combinations at the same time, it is necessary to remember the decrease in their dosages.

Although there was no significant suppression of the cognitive and psychomotor functions of Zalox's drug when used together with alcoholic beverages, it is not worthwhile to experiment. During the treatment of a patient with a depressive syndrome, alcohol is better "excluded from the menu" of the patient. If it is necessary to use sertraline together with insulin (or other hypoglycemic drugs), you must constantly monitor the level of glycemia in the patient.

With the combined use of digoxin and Zalox, no significant changes in the pharmacodynamics of both drugs have been identified. But the intake of cimetidine is able to significantly block the metabolism of sertraline, which negatively affects its clearance. This, in turn, leads to an increase in the likelihood of side effects. The clinical consequences of the interaction of Zalox with diazepam are not thoroughly investigated, therefore it is necessary to use this combination very carefully.

There is a need for constant monitoring of the prothrombin time in the tandem of sertraline with warfarin, which is due to the fact that sertraline binds easily to the protein component of blood plasma (almost 98%), and Zaloxa, along with other drugs that have "abilities" similar to sertraline, can lead to an increase in the concentration of drugs in the blood, and hence the side effects.

There is no evidence that long-term use of Zalox can lead to addiction and addiction. However, this factor should not be neglected either, it is necessary to study more thoroughly the patient's anamnesis, the purpose of which is to identify other cases of drug dependence.

No cases of death were detected. Although with the overdose of sertraline hydrochloride, in combination with other drugs and alcohol, several deaths were still detected.

[4], [5], [6]

Storage conditions

Store in a dry place inaccessible to small children and young people. The temperature in the room should be in the range from 15 to 30 ° C - these are all Zalox storage conditions that are required.

Shelf life

Five years is the expiration date that the manufacturer indicates on the package of the drug. After its expiration, Zalox is not recommended for use by pharmacologists.