Zolomaks

Zolomax is an anxiolytic, as well as a derivative of the benzodiazepine element.

Indications Zolomaksa

It is used for therapy in such disorders:

• anxiety states ;
• neurosis, in which the patient is marked by a feeling of anxiety, danger and anxiety with tension and irritability, and in addition, deterioration of sleep and somatic disorders;
• states that have a mixed anxiety-depressive character;
• neurotic forms of disorders that have a reactive-depressive nature, against which there is a decrease in mood, loss of interest in the world around them, sleep disorder, anxiety, somatic disorders and deterioration of appetite;
• depression of neurotic genesis, arising from the impact of somatic diseases;
• panic disorders, combined with phobic manifestations or without them.

Release form

The component is released in tablets packed in blister plates of 10 pieces each. Inside the box there are 3 such packages.

Pharmacodynamics

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

The drug has an antidepressant effect corresponding to the effects caused by the action of tricyclics. Inside the CNS, alprazolam interacts with the special endings of benzodiazepine, which have a close functional relationship with the endings of the main inhibitory mediator of the central nervous system (GABA) element (γ-aminobutyric acid). Because of this, under the influence of drugs, the potentiation of the slowing effect of GABA within the CNS develops - by enhancing the sensitivity of GABA endings to the mediator (by stimulating the activity of the benzodiazepine endings).

Pharmacokinetics

Alprazolam at high speed and completely absorbed, getting inside the digestive tract. The values of drug bioavailability are at least 80%. After oral administration, the substance reaches the blood Cmax after 1-2 hours. This indicator varies depending on the size of the portion in the range of 7-40 ng / ml with a single use of 0.5-3 mg of medication.

With multiple use of 1.5-10 mg of the component, the average equilibrium values within the plasma reach 18-100 ng / ml. Equilibrium indicators within the blood plasma in the case of continuous use of drugs reaches the substance in 3 days. The medication has an average half-life of the element (for 1-time application it is 12-15 hours).

Hepatic biotransformation of alprazolam occurs during the oxidative process. The main active metabolic product is α-hydroxyalprasolam, but its plasma indices are rather low, which is why it does not have clinical significance. Other metabolic products either have weak activity, or are relatively inactive.

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

Dosing and administration

Portions of the drug are selected individually, with an adjustment in the process of therapy, which takes into account the tolerability of the drug and drug efficacy. It is recommended to use the minimum effective portions.

You need to consume the medicine orally, washing down with plain water.

Neuroses and anxiety states.

Adult person should three times a day to use 0.25-0.5 mg of the substance. If required, the portion is increased at intervals of 3-4 days by 0.25 mg given the severity of the manifestations of the disease and the response of the patient to therapy. Begin the increase in the portion should be from the evening dosage. If signs of anxiety are expressed more strongly, treatment should begin with increased portions. The maximum allowable dosage per day is 4 mg.

Elderly or weakened patients should take at the initial stage of therapy at 0,125-0,25 mg, 2-3 times a day.

The therapeutic cycle, which includes the time required for the gradual elimination of drugs, often does not exceed a stretch of 8-12 weeks. Regarding the longer term of therapy - the expediency of such a step should be seriously considered.

Panic disorders.

For a day it is required to use three times 0.5 mg of medicament. If required, the dose is allowed to be increased, but a maximum of 1 mg at intervals of 3-4 days. The more the sizes of portions, the more gradually it is necessary to raise them until the moment of receiving Zolomax's full medicamentous effect. Often, the drug effect develops after consuming 5-6 mg of the substance per day, but with severe forms of the pathology, the dosage can reach 10 mg per day (maximum daily dose).

The duration of therapy for each patient is selected separately. When the drug effect is achieved and the symptoms of the disease are eliminated, the dosage of the drug can be started to be lowered, but no more than 0.5 mg at intervals of 3 days. When there is withdrawal syndrome, you should again increase the dose, and then carry out the cancellation of drugs more gradually.

States of depression.

For a day, you need to use 0.5 mg of the medicine three times. If necessary, the total dosage for the day can be increased to 4.5 mg. The initial portion should be consumed before bedtime, so as to minimize the likelihood of a feeling of drowsiness during the day.

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

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Use Zolomaksa during pregnancy

Do not prescribe Zolomax to pregnant women (especially on the 1st trimester). Also forbidden to use when breastfeeding.

Contraindications

The main contraindications:

• presence of severe sensitivity relative to alprazolam or other derivatives of the benzodiazepine component and any elements of the drug;
• glaucoma, which has a sharp shape;
• myasthenia gravis in a difficult stage;
• severe respiratory failure;
• night apnea;
• psychosis, which is chronic;
• problems with hepatic activity in a serious degree.

Side effects Zolomaksa

Many of the following negative manifestations depend on the size of the portion. Negative symptoms often appear at the beginning of the treatment course and take place during the first weeks of therapy. Often at the initial stage of treatment, dizziness, drowsiness and motor coordination disorder appear. Such reactions are of low intensity, disappearing with the continuation of therapy or a lowering of the portion. Occasionally, headaches develop, speech disorders, a sense of euphoria or confusion, and in addition there is depression and the level of IOP increases. Sometimes, mainly after a few hours after consuming large portions of medicament, there is amnesia of anterograde nature.

Single in people with depression, taking alprazolam can lead to the appearance of mania or hypomania. After therapy with alprazolam, vomiting, constipation or diarrhea, dryness of the oral mucosa, nausea, allergy symptoms (rashes and itching) and palpitation occur occasionally. In addition, there is urinary incontinence, a decrease in the level of pressure, suppression of the respiratory process, weakness or spasms in the musculature of the skeleton, weakening of the libido, weight and appetite changes, as well as disorders of the cycle of menstruation. Laboratory tests sometimes determine the presence of leukopenia, a decrease in hemoglobin and hematocrit, and in addition an increase in the values of liver enzymes (such as ALT, APF and AST) and plasma bilirubin, and in addition an increase or decrease in the blood glucose level.

In older people, the use of drugs can lead to paradoxical symptoms (feelings of excitement, anxiety or hostility, and in addition behavioral disorder, delirium and hallucinations).

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Overdose

During treatment of people who have experienced intoxication with benzodiazepine derivatives, one must constantly consider the risk that this disorder could be caused by taking the medication together with alcoholic beverages or by combining several drugs.

When an overdose develops weakness in the musculature, a pronounced sense of drowsiness, dysarthria with ataxia, and in addition there is sometimes a feeling of excitement. With severe poisoning, it is possible to suppress reflex reactions, the appearance of a feeling of confusion and the development of a coma.

In the situation with intoxication, the therapy should be stopped immediately, followed by symptomatic procedures (support of cardiac function, respiratory processes, stable blood pressure level, addition of infusion and, if need to increase the reduced pressure, use of vasoconstrictors). It is also necessary to induce vomiting in the patient, and if he has lost consciousness, then perform a gastric lavage.

To alleviate the suppression of the CNS function, an antagonist of the benzodiazepine endpoints of a specific character, the flumazenil element, can be used at the hospital. Conversations of hemodialysis or dialysis are ineffective for increasing the rate of elimination of drugs.

Interactions with other drugs

The combination of benzodiazepines and alcoholic beverages, as well as other drugs that depress the work of the central nervous system (substances for anesthesia, narcotic analgesics, tranquilizers with antidepressants, and in addition anticonvulsants, hypnotics, antihistamines and antipsychotics) can lead to potentiation of the overwhelming effect on the CNS.

Combination of the drug with narcotic analgesics increases the risk of a feeling of euphoria, as a result of which dependence can develop.

It is forbidden to use alprazolam in combination with antimycotics from the azole category (among them ketoconazole with itraconazole).

Combined use with drugs that suppress the action of enzymes of hepatic hemoprotein 450 (in this list, oral contraceptives, cimetidine, fluoxetine, macrolide antibiotics, non-oxodon with fluvoxamine and propoxyphene) may lead to a decrease in the rate of metabolic processes and elimination of alprazolam. Because of this, you need to use these tools with great care.

Carbamazepine is able to increase the rate of metabolic processes and excretion of Zolomax.

It was revealed that the combined administration of the drug with imipramine, tricyclics or desipramine results in an increase in the equilibrium plasma values of the latter, but the medication value of this fact could not be determined.

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Storage conditions

Zolomaks should be kept in a place that is closed from penetration of young 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 medication is not used in pediatrics - it is not prescribed for people who have not reached the age of 18. This is due to the fact that it is not proven that the medicine is effective and safe at this age.

Analogues

Analogues of the drug are drugs Alzolam, Zoldak, Lamoz with Alprazolam, Kassadan and Helex, and besides Alprox, Neurol and Frontin with Xanax, Neurol 0.25, Xanax retard and Helex CP.

Reviews

Zolomaks receives rather polar reviews from different patients. Some of them argue that the medicine had a very qualitative impact, but there is also a group of those who adhere to the opposite point of view and consider the drug useless.

When choosing a medicine, which should be done solely by the treating doctor, you need to take into account these reviews, but mostly based on the individual characteristics of the body and the scheme of therapy.