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Rekvip
Last reviewed: 23.04.2024
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Rekvip is a drug used in the therapy of parkinsonism.
Indications It 's an excuse
It is used to treat trembling paralysis. Can be used in several different therapeutic regimens:
- monotherapy in the initial stages of the disease in people who need dopaminergic treatment (for delaying the use of drugs levodopa);
- complex treatment for people taking levodopa medicines - in order to strengthen the medicamental effect, to reduce the manifestations that develop with the withdrawal of levodopa, and in addition to adjusting the portions of levodopa.
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Release form
Release of the medication is realized in tablets with a volume of 2, 4 or 8 mg, in the amount of 14 pieces inside the blister pack. The box contains 2 or 6 such packages.
Pharmacodynamics
Rekvip has a central and peripheral effect in the therapy of tremor paralysis.
The substance ropinirole has an effect on the collapsing dopaminergic nerves of the black element, having a presynaptic character, which provides it with the role of an artificial neurotransmitter. The component lowers the indices of hypodynamia, and at the same time reduces the rigidity with tremor, which are the main signs of the disease.
In addition, the active element of the drug, by stimulating dopamine ends inside the striatum, compensates for the lack of dopamine inside the systems of this body and the black element.
Ropinirole has a stimulating effect on levodopa - among other things on the frequency of the on-off effect and the effect of withdrawal caused by the prolonged use of levodopa medications, which helps to reduce its dose. At the same time, the influence of the active ingredient develops in the hypophysis region with the hypothalamus, and against its background oppression of prolactin production occurs.
Pharmacokinetics
The absorption of ropinirole after ingestion of the drug inside occurs at a low speed - the plasma index Cmax is noted after the expiration of 6 hours. The level of bioavailability is rather low - on average about 50%. In the case of a combination of the drug with fat dishes, an increase in the systemic exposure of the drug is recorded and an increase in the values of Cmax and AUC by 44% and 20%, respectively. The duration of Tmax is increased by 3 hours.
The severity of the overall effect of the drug depends on the size of the dose - as the dosage increases, the effectiveness of the drug also increases.
Ropinirole is poorly synthesized with blood protein (about 10-40%), but due to its strong lipophilicity it has high Vd values (approximately 7 l / kg). Metabolism mainly occurs with the participation of isoenzyme CYP1A2.
The half-life of the substance is approximately 6 hours (with the involvement of the kidneys).
The values of clearance of ropinirole in the elderly are slightly reduced - by about 15%. But to change because of this dosage of drugs is not necessary.
In people with kidney failure in the chronic or acute stage, who are on hemodialysis, the level of drug clearance is reduced by 30%.
Dosing and administration
The size of portions is selected taking into account the individual characteristics of the patient - its tolerability, as well as the severity of the drug effect.
Tablets are used orally, without binding to the reception of food, once a day. They can not be chewed or crushed.
At the time of prescribing, it is necessary to take into account the possible need for titration of the dosage in the case of skipping the portion 1 + times.
Dosage reduction can be carried out exclusively in situations where the patient has a feeling of drowsiness or other negative manifestations. In the future, the portion should be increased again.
Mode of use during monotherapy.
The size of the optimal initial portion - 2 mg with a single use for the first 7 days of the course. After that, the gap should be reduced to less than 1 week and increase the dose (by 2 mg) every new week, during the first month. In the period of the 4th week the size of the maximum allowable daily dosage should be equal to 8 mg. If there is no result, you should continue to increase the dose (by 4 mg) at intervals of 1-2 weeks. A maximum of 24 mg of the drug is allowed per day.
The combined use of drugs.
Applying Rekvip in portions that are used in monotherapy, together with levodopa medicines, the dose size of the second drug is allowed to be gradually reduced in accordance with the medication being provided. During the clinical tests, it was found that with a reduction in the amount of levodopa up to 30%, no damage was observed to the medicinal effect.
The use of drugs in complex treatment during the titration phase of the dosage of ropinirole can lead to the appearance of dyskinesia. Reducing the portion of the drug levodopa can reduce the severity of these manifestations.
During the withdrawal of drug use it is necessary to follow the sequence, gradually reducing the daily portion in a period of at least 7 days. If you stop taking the medication for 1+ days, if you start the re-cycle, you need to consider the need for titration portion.
People with a severe form of renal disorder should start therapy with a single dose of 2 mg per day. Increase the portion should be, given the tolerability of the drug. For individuals on hemodialysis, the maximum daily dose is 18 mg. Prescribe maintenance dosages are not required.
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Use It 's an excuse during pregnancy
It is forbidden to prescribe the use of the Requiem to pregnant women.
Contraindications
Among the contraindications:
- acute form of psychosis;
- disorders of renal activity in severe degree (without regular sessions of hemodialysis);
- problems with liver function;
- hereditary diseases (such as hypolactasia, glucose-galactose malabsorption syndrome, and lactose deficiency);
- the period of breastfeeding;
- the presence of intolerance relative to the components of the drug.
Caution is required when using in people suffering from the failure of the CAS function in a severe degree.
Prescribe medication to people who have psychological abnormalities in the anamnesis is allowed only in situations where the possible benefit exceeds the likelihood of complications.
Side effects It 's an excuse
People with parkinsonism of progressive type may experience motor coordination disorder during therapy. To reduce the severity of these signs, it may be necessary to cancel the use of drugs levodopa. Among other negative symptoms:
- disruption of the CNS and PNS: visual impairment (except hallucinations), increased libido, psychotic conditions (including delirium with delirium), development of hypersexuality, increased impulsivity, severe drowsiness with the possibility of sudden falling asleep, and besides gambling. Such manifestations often pass after withdrawal of drug use. Also, therapy with sedative medications can be performed;
- problems with the function of SSS: orthostatic collapse or lowering blood pressure;
- allergy symptoms: the appearance of urticaria or rashes, and in addition the development of edema Quincke.
Interactions with other drugs
Typical neuroleptics with dopyramine antagonists weaken the medicinal properties of ropinirole.
The drug does not interact with domperidone, as well as levodopa, which allows you to refrain from adjusting portions when combining drug data. In general, the drug does not interact with most of the drugs used in parkinsonism.
Drugs that slow down the activity of the element CYP1A2 (among such enoxacin with ciprofloxacin, as well as fluvoxamine, etc.), increase the AUC and Cmax values of the active element by 84% and 60%, respectively. Because of this, when combining them, adjustment of the size of a portion of ropinirole is required.
Combination with large portions of estrogen may increase the indices of ropinirole, which is why at the beginning of hormonal treatment during the course of the course using the Requisition, it is necessary to revise the sizes of its portions.
Smoking people, or those who quit smoking, need to adjust the dosage of the drug, because nicotine has a stimulating effect on the isoenzyme CYP1A2.
Storage conditions
Rekvip is kept in a place that is closed from small children. Temperature values are a maximum of 25 ° C.
Shelf life
Rekvip in tablets, having a volume of 2 mg, can be used in the period of 24 months from the moment of its release. In tablets having a volume of 4 and 8 mg, the shelf life is 36 months.
Application for children
Do not apply the drug to children under the age of 18 years.
Analogues
An analogue of the drug is the drug Sindranol.
Attention!
To simplify the perception of information, this instruction for use of the drug "Rekvip" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.