Zalox

The medicine Zalox is an antidepressant with the active ingredient sertraline, which is a chemical compound that suppresses the reverse return of serotonin in neurons. This effective medicine from the Canadian corporation Pharmascience Inc. is widely used by modern psychiatrists.

Indications Zalox

The drug Zalox is released by the manufacturer as a strong remedy that prevents or relieves depressive states in patients. Hence the corresponding indications for the use of Zalox:

• Depressive psychosis accompanied by a feeling of anxiety.
• Manic manifestations of mental disorder.
• Preventive use of an antidepressant to prevent relapse of the disease.
• Treatment of obsessive-compulsive disorders.
• Agoraphobia is a panic fear of open spaces.
• Post-traumatic stress disorder.
• Prevention of depressive relapses.
• Other manifestations of psychosis.

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Release form

The medicine Zalox is produced in a single form. The form of the drug is capsules of white powder covered with a gelatin shell.

Pharmacodynamics

The mechanism on which the entire pharmacodynamics of Zalox is tied is that the dominant substance sertraline effectively slows down the ability of other chemical compounds to bind and remove serotonin from neurons, while dopamine and norepinephrine are not subject to such active influence. Blocking the return transport of serotonin, due to the active properties of sertraline, also occurs in thrombocytes.

Taking Zalox, like most antidepressants, leads to the suppression of the activity of brain receptors (serotonin and norepinephrine). As clinical studies have shown, the chemical substance sertraline has no radical points of contact with other receptors (such as histaminergic, cholinergic, dopaminergic, serotonergic, etc.)

Controlled placebo studies have shown that Zalox, with its active ingredient sertraline, does not exhibit sedative properties. It is inert to the effect on the patient's psychomotor skills.

Pharmacokinetics

The absorption capacity of sertraline can be called quite average. If the course of treatment with this drug provides for a long period of time, and the patient takes 200 mg daily orally, then the maximum amount of the substance in the blood plasma (which will be 0.19 mcg / ml) will be achieved 4.5 - 8.4 hours after the introduction of the drug into 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 body and his/her concomitant diseases. Due to the long half-life, the monitoring showed a two-fold accumulation of the drug, which allows achieving equilibrium concentrations observed after one week of administration, while the patient is administered the drug once a day.

The pharmacokinetics of Zalox, falling into the numerical range from 50 to 200 mg, largely depends on the dosage of the drug. A large percentage of sertraline is absorbed into the liver, degenerating into a derivative of N-demethylation. Subsequently, sertraline and its metabolites, which have low pharmacological activity, are excreted from the patient's body in equal quantities with feces and through the kidneys with urine. At the same time, sertraline itself (in unchanged form) is excreted in small quantities, since about 98% of it is with the protein component of blood plasma. To date, there are no reliable facts of the joint work of Zalox and other drugs that have similar highly active protein binding abilities.

The pharmacokinetics of Zalox does not depend on gender or age.

Dosing and administration

It is important to understand that the medicine Zalox should be taken only as prescribed by a doctor and in strictly specified dosages. As a rule, for adults and children over 13 years of age, the starting daily dose for the treatment of depressive states is prescribed in the amount of 50 mg. For nervous disorders characterized by panic symptoms, the starting daily dose is prescribed in the amount of 25 mg, and after a week of taking, the dosage is increased to 50 mg per day. You should not increase the amount of the drug taken on your own.

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 start of administration.

You should not stop taking the medication, even if you do not see a quick improvement in your health. This may take up to four weeks (about a month).

Method of administration and dosage: Zalox is supposed to be administered orally once a day (either in the morning or in the evening). The capsule of the medicine should be swallowed with some water. The capsule should be swallowed without chewing.

Only the attending physician has the right to cancel the use of Zalox. The duration of taking the drug can be up to several months. If for some reason one dose was missed, the next dose should not be moved anywhere (the drug must be administered at the scheduled time) and take a double dose of the same.

If an overdose of Zalox occurs (accidentally or intentionally), you should immediately contact a doctor, even if the patient feels quite well.

With long-term 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 a doctor so that the dosage can be adjusted if necessary. In cases where the patient's medical history is burdened with liver dysfunction, the drug Zalox should be prescribed with caution, the dosage should be reduced. If the pathology concerns the kidneys, due to the insignificant excretion of sertraline through them, there is no need to change the dosage.

Use Zalox during pregnancy

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

If the patient is of reproductive age, the doctor usually prescribes contraception for the period of treatment. Since there have been cases where the newborn showed deviations similar to such symptoms of withdrawal reaction (if his mother took drugs containing sertraline during pregnancy). This is especially true for the last third trimester of pregnancy. Against this background, the newborn may develop the following symptoms:

• Cyanosis is a bluish color of the skin and mucous membranes, especially pronounced in the area of the triangle of the upper lip.
• Convulsions and tremors.
• Respiratory distress syndrome.
• Apnea is a temporary cessation of breathing.
• Temperature fluctuations.
• Vomiting and feeding problems.
• Increased muscle tone.
• Hypoglycemia is a decrease in the concentration of glucose in the blood.
• And many others.

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

Based on the published data, it can be stated that the quantitative component of the active substance of the drug Zalox and its metabolites in the milk of a woman during lactation is not significant. The clinical tests showed their small doses in the blood of a newborn, in the case when a nursing mother took this medicine. But still, there is a known case when a significant concentration of sertraline (approximately 50%) was recorded in the child's blood. However, no noticeable effect on the health of the baby was detected. To date, the risk of side pathology cannot be completely excluded. Therefore, if possible, it is worthwhile to separate the time of taking the drug and breastfeeding the child (breastfeeding should be stopped during treatment with Zalox).

Contraindications

Contraindications for the use of Zalox:

• Individual hypersensitivity to the components of the drug.
• It should not be attributed to children, the only exception being obsessive-compulsive disorders in children over six years of age.
• Zalox is contraindicated for use in combination with MAOIs (monoamine oxidase inhibitors are biologically active substances that can inhibit the enzyme monoamine oxidase).

Side effects Zalox

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

• Nausea, vomiting.
• Diarrhea (loose, watery stools).
• Insomnia.
• Dyspepsia (painful digestion).
• Anorexia (mental disorder of the digestive tract).
• Stain on the skin.
• Increased activity of sweat glands.
• Dry mouth.
• Dizziness.
• A failure in a man's reproductive capabilities.
• Tremor.
• Tachycardia.
• Increased fatigue.
• Platelet dysfunction.
• Arterial hypertension.
• And many other deviations.

The dependence of the manifestation of side effects of Zalox on the dosage taken was revealed. The "dangerous" amount of the drug was a dose of 200 mg per day.

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Overdose

When using Zalox as a monotherapy drug, an overdose of sertraline produces the following symptoms:

• Nausea leading to vomiting.
• Drowsiness and apathy.
• Dilation of the pupils.
• Increased tachycardia.
• Change in electrocardiogram readings.
• Feeling of anxiety.

If these symptoms appear, the doctor prescribes supportive therapy:

• Taking activated charcoal.
• Prescribing laxatives.
• Gastric and intestinal lavage.
• Continuous monitoring of cardiac activity.
• Monitoring of all systemic physiological parameters.

To date, no specific antidotes have been found to stop the pharmacodynamics of Zalox, and in particular sertraline hydrochloride. No fatal outcomes have been reported with sertraline overdose.

Interactions with other drugs

It is necessary to combine various medical drugs in complex therapy very carefully, since they are capable of both enhancing each other’s effects, which is often dangerous, and completely blocking the pharmacodynamics of their recipient.

During the work, some interactions of Zalox with other drugs were identified, which cannot be dropped from the shields during the treatment process.

Thus, when Zalox is prescribed in combination with psychotropic drugs (such as phenytoin, haloperidol, carbamazepine), with a daily dose of sertraline hydrochloride of 200 mg, no significant increase in psychomotor and cognitive function indicators is observed. However, it is impossible to say unequivocally that there is absolutely no risk with such combined use. Therefore, special care must be taken with such a treatment protocol.

There is also no extensive experience in cases where 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 the pros win, observing all caution, should the drug be changed. This is especially true for long-term drugs, since the duration of the "washout" of the chemical substance has not been established. It is also necessary to avoid taking a combination of drugs whose active substance is sertraline hydrochloride.

In clinical studies, no significant changes in the pharmacokinetics of lithium preparations were found when they were used together with Zalox. Although cases of tremor were observed in this combination compared to placebo. Caution should still be exercised when taking them.

The combined use of monoamine oxidase inhibitors (MAOIs) with the drug in question can lead to quite severe, sometimes fatal consequences. Often, this is similar to serotonin syndrome. Similar manifestations are observed with the simultaneous use of two or more antidepressants with MAOIs, or in patients who suddenly began taking MAOIs after antidepressants. After therapeutic treatment with inhibitors, switching to Zalox is possible only after two weeks (or 14 days). And vice versa. It is possible to start taking MAOIs 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 plays an important role in the metabolism of pharmacological drugs. This circumstance contributes to the growth of the quantitative indicator of the drug taken in the blood. When combining such combinations at the same time, it is necessary to remember about reducing their dosages.

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

When digoxin and Zalox are used together, no significant changes in the pharmacodynamics of both drugs have been identified. However, taking cimetidine can significantly block the metabolism of sertraline, which negatively affects its clearance. This, in turn, leads to an increased likelihood of side effects. The clinical consequences of the interaction of Zalox with diazepam have not been thoroughly studied, so this combination should be used very carefully.

Constant monitoring of "prothrombin time" is necessary when sertraline is used in tandem with warfarin. This necessity follows from the fact that sertraline easily binds to the protein component of blood plasma (almost 98%). And the introduction of Zalox together with other drugs that have "abilities" similar to sertraline can lead to an increase in the concentration of drugs in the blood, and hence to side effects.

There is no evidence that long-term use of Zalox can lead to addiction and dependence. However, this factor should not be ignored either; the patient's medical history should be examined more thoroughly, the purpose of which is to identify other cases of drug dependence.

There have been no fatalities reported, although several deaths have been reported in cases of overdose of sertraline hydrochloride, in combination with other drugs and alcohol.

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Storage conditions

Store in a dry place, inaccessible to small children and teenagers. The room temperature should be between 15 and 30 °C - these are all the storage conditions required for Zalox.

Shelf life

Five years is the expiration date that the manufacturer indicates on the drug packaging. Pharmacologists do not recommend using the drug Zalox after its expiration.