Zolomax

Zolomax is an anxiolytic and also a derivative of the benzodiazepine element.

Indications Zolomaxa

It is used for therapy of the following disorders:

• anxiety states;
• neurosis, in which the patient experiences a feeling of anxiety, danger and restlessness with tension and irritability, and in addition, sleep deterioration and somatic disorders;
• conditions of mixed anxiety-depressive nature;
• neurotic forms of disorders that have a reactive-depressive nature, against the background of which there is a decrease in mood, loss of interest in the surrounding world, sleep disorders, anxiety, somatic disorders and loss of appetite;
• depressions of neurotic genesis arising as a result of the impact of somatic diseases;
• panic disorders, combined with or without phobic manifestations.

Release form

The component is released in tablets, packaged in blister strips of 10 pieces. There are 3 such packages inside the box.

Pharmacodynamics

Alprazolam is a derivative of the benzodiazepine element, which is characterized by the presence of an intense anxiolytic effect. It has a hypnotic, muscle relaxant, sedative and anticonvulsant effect. The same tranquilizing effect is achieved by using ten times smaller portions of alprazolam compared to diazepam.

The drug has an antidepressant effect corresponding to the effects caused by the action of tricyclics. In the CNS, alprazolam interacts with special benzodiazepine endings, which have a close functional connection with the endings of the main inhibitory mediator of the CNS - the element GABA (γ-aminobutyric acid). Due to this, when exposed to drugs, potentiation of the inhibitory effect of GABA inside the CNS develops - by increasing the sensitivity of GABA endings relative to the mediator (by stimulating the activity of benzodiazepine endings).

Pharmacokinetics

Alprazolam is rapidly and completely absorbed when it enters the gastrointestinal tract. The values of drug bioavailability are at least 80%. After oral administration, the substance reaches blood Cmax after 1-2 hours. This indicator varies depending on the portion size within 7-40 ng/ml with a single use of 0.5-3 mg of the drug.

With repeated use of 1.5-10 mg of the component, the average equilibrium values in the plasma reach 18-100 ng/ml. In the case of continuous use of the drug, the substance reaches equilibrium values in the blood plasma in 3 days. The drug has an average half-life of the element (with 1-time use it is 12-15 hours).

Hepatic biotransformation of alprazolam occurs via an oxidative process. The major active metabolic product is α-hydroxyalprazolam, but its plasma levels are quite low, making it of little clinical significance. Other metabolic products are either weakly active or relatively inactive.

The half-life of the unchanged element and its metabolic products is approximately the same. Unchanged alprazolam (approximately 20%), as well as the metabolic products of the drug, are excreted in the urine.

Dosing and administration

The doses of the medication are selected individually, with adjustments being made during the therapy, taking into account the patient's tolerance to the drug and its medicinal efficacy. It is recommended to use the minimum effective doses.

The medicine should be taken orally, washed down with plain water.

Neuroses and anxiety states.

An adult should take 0.25-0.5 mg of the substance three times a day. If necessary, the dose is increased at intervals of 3-4 days by 0.25 mg, taking into account the severity of the manifestations of the disease and the patient's response to therapy. The dose should be increased starting with the evening dosage. If the signs of anxiety are more pronounced, treatment should be started with increased doses. The maximum permissible daily dose is 4 mg.

Elderly people or weakened patients should take 0.125-0.25 mg 2-3 times a day at the initial stage of therapy.

The therapeutic cycle, which includes the time required for gradual drug withdrawal, often does not exceed a period of 8-12 weeks. As for a longer period of therapy, the advisability of such a step should be seriously considered.

Panic disorders.

It is required to take 0.5 mg of the medicine three times a day. If necessary, the portion can be increased, but by a maximum of 1 mg with intervals of 3-4 days. The larger the portion sizes, the more gradually they need to be increased until the full medicinal effect of Zolomax is obtained. Often, the medicinal effect develops after taking 5-6 mg of the substance per day, but in severe forms of pathology, the dosage can reach 10 mg per day (the maximum size of the daily portion).

The duration of therapy is selected individually for each patient. Once the medicinal effect is achieved and the symptoms of the disease are eliminated, the dosage of the drug can be reduced, but not more than by 0.5 mg at intervals of 3 days. If withdrawal syndrome occurs, the dose should be increased again, and then the drug should be discontinued more gradually.

States of depression.

You should take 0.5 mg of the medication three times a day. If necessary, the total daily dosage can be increased to 4.5 mg. The initial dose should be taken before bedtime to minimize the likelihood of feeling sleepy during the day.

The therapeutic cycle, which includes the period required for gradual withdrawal of the drug, often lasts 2-3 months.

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Use Zolomaxa during pregnancy

Zolomax should not be prescribed to pregnant women (especially in the first trimester). It is also prohibited for use during breastfeeding.

Contraindications

Main contraindications:

• the presence of severe hypersensitivity to alprazolam or other derivatives of the benzodiazepine component and any components of the drug;
• glaucoma, which has an acute form;
• myasthenia in severe stage;
• severe respiratory failure;
• sleep apnea;
• psychosis of a chronic nature;
• severe liver problems.

Side effects Zolomaxa

Many of the adverse effects listed below are dose-size dependent. Adverse symptoms often appear early in the course of treatment and resolve within the first few weeks of therapy. Dizziness, drowsiness, and impaired motor coordination are common early in treatment. These reactions are mild and disappear with continued therapy or reduced doses. Headaches, speech disorders, feelings of euphoria or confusion, depression, and increased intraocular pressure may occasionally develop. Anterograde amnesia may occur, usually several hours after taking large doses of the medication.

Alprazolam may occasionally cause mania or hypomania in people with depression. Vomiting, constipation or diarrhea, dry mouth, nausea, allergic symptoms (rash and itching), and palpitations may occasionally occur after alprazolam therapy. In addition, urinary incontinence, decreased blood pressure, respiratory depression, weakness or spasms in the skeletal muscles, decreased libido, changes in weight and appetite, and menstrual irregularities may occur. Laboratory tests may sometimes reveal leukopenia, decreased hemoglobin and hematocrit levels, and increased liver enzymes (such as ALT, ALP, and AST) and plasma bilirubin levels, as well as increased or decreased blood glucose levels.

In older people, drug use may cause paradoxical symptoms (feelings of agitation, anxiety or hostility, as well as behavioral disturbances, delusions and hallucinations).

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Overdose

When treating people who have experienced benzodiazepine derivative intoxication, the risk that this disorder may have been caused by taking the drug with alcoholic beverages or a combination of several drugs must always be taken into account.

Overdose causes weakness in the musculature, a pronounced feeling of drowsiness, dysarthria with ataxia, and sometimes a feeling of excitement. In severe poisoning, reflex reactions may be suppressed, a feeling of confusion may appear, and a comatose state may develop.

In case of intoxication, therapy should be stopped immediately, and then symptomatic procedures should be performed (support of cardiac function, respiratory processes, stable blood pressure; in addition, administration of infusions and, if necessary, increasing low blood pressure, use of vasoconstrictors). Vomiting should also be induced in the patient, and if he has lost consciousness, gastric lavage should be performed.

To reduce the suppression of the central nervous system function, a specific benzodiazepine ending antagonist, the drug flumazenil, can be used in hospital. Hemodialysis or dialysis sessions are ineffective in increasing the rate of drug elimination.

Interactions with other drugs

The combination of benzodiazepines and alcoholic beverages, as well as other drugs that depress the central nervous system (anesthetics, narcotic analgesics, tranquilizers with antidepressants, and in addition anticonvulsants, sleeping pills, antihistamines and antipsychotics) can cause a potentiation of the suppressive effect on the central nervous system.

The combination of the drug with narcotic analgesics increases the risk of developing a feeling of euphoria, which may result in addiction.

It is prohibited to use alprazolam in combination with antifungal drugs from the azole category (including ketoconazole and itraconazole).

Combined use with drugs that inhibit the action of liver enzymes hemoprotein 450 (in this list are oral contraceptives, cimetidine, fluoxetine, macrolide antibiotics, nefaxodone with fluvoxamine and propoxyphene) can lead to a decrease in the rate of metabolic processes and elimination of alprazolam. Because of this, these drugs should be used simultaneously with great caution.

Carbamazepine can increase the rate of metabolic processes and excretion of Zolomax.

It was found that the combined use of the drug with imipramine, tricyclics or desipramine leads to an increase in the equilibrium plasma values of the latter, but the medicinal significance of this fact could not be determined.

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Storage conditions

Zolomax should be kept in a place closed to small children. Temperature indicators - up to 25°C.

Shelf life

Zolomax can be used within 36 months from the date of manufacture of the therapeutic drug.

Application for children

The drug is not used in pediatrics - it is not prescribed to people under 18 years of age. This is due to the fact that it has not been proven that the drug is effective and safe at this age.

Analogues

The analogs of the drug are Alzolam, Zoldak, Lamoz with Alprazolam, Kassadan and Helex, as well as Alproks, Neurol and Frontin with Xanax, Neurol 0.25, Xanax retard and Helex SR.

Reviews

Zolomax receives quite polar reviews from different patients. Some of them claim that the drug has had a very high-quality effect, but there is also a group of those who hold the opposite point of view and consider the drug useless.

When selecting a medicine, which should be carried out exclusively by the attending physician, it is necessary to take these reviews into account, but mainly to start from the individual characteristics of the body and the treatment regimen.