Mexidol

Mexidol - a drug that affects the work of the National Assembly.

[1], [2], [3]

Indications Mexidola

It is used for the following violations:

• acute forms of intracerebral blood flow disorders;
• TBI, as well as its consequences;
• brain DEP;
• ICD;
• having a light degree of intensity, cognitive disorders of atherosclerotic nature;
• anxiety disorders, marked against the background of neurosis-like or neurotic disorders;
• myocardial infarction in the acute stage (from the 1st day), in the combined treatment;
• the primary form of open-angle glaucoma at different stages (combined treatment);
• stopping the development of alcohol withdrawal (in the case of alcoholism, in which vegetative-vascular and neurosis-like disorders predominate);
• acute antipsychotic poisoning;
• acute stages of peritoneal lesions with a purulent-inflammatory nature (peritonitis or an acute form of necrotic pancreatitis) - for combined treatment.

[4], [5]

Release form

The release of the pharmaceutical element is in the form of liquid for i / m and / in injection, in ampoules with a capacity of 2 or 5 ml. Inside the box contains 5 such ampoules.

[6], [7], [8]

Pharmacodynamics

Mexidol is an agent that slows down the activity of free radicals, and besides it is a membrane protector and has nootropic, antihypoxic, anticonvulsant, stress-protective and anxiolytic properties.

The drug increases the body's resistance against the influence of various damaging factors and disease-dependent oxygen-related conditions (hypoxia, shock, alcohol poisoning or intoxication with antipsychotics (neuroleptics), ischemia and intracerebral blood flow disorders).

The drug helps to improve cerebral metabolism and its blood supply, and with it improves microcirculation processes and rheological parameters of blood; also weakens platelet aggregation. During hemolysis, the substance stabilizes the structures of the walls of blood cells (platelets with red blood cells). It demonstrates hypolipidemic activity and reduces the values of total cholesterol and LDL. Weakens enzyme toxemia and endogenous poisoning associated with the acute stage of pancreatitis.

The principle of influence of Mexidol is associated with its membrane-protective and antioxidant properties. It slows down peroxide lipid oxidation, increases the activity of superoxide dismutase and the proportions of lipids with proteins, and in addition reduces membrane viscosity, increasing its fluidity.

Modulates the activity of enzymes associated with membranes (calcium-independent PDE, as well as AC and AChE), and terminal complexes (GABA, benzodiazepine, and acetylcholine), thereby potentiating their ability to synthesize with ligands. Together with this, the drug helps to preserve the function and structure of biomembranes, promotes the movement of neurotransmitters and improves synaptic responses.

Mexidol increases the dopamine index inside the brain. It leads to the potentiation of the compensatory activity of glycolysis of aerobes and a decrease in the intensity of suppression of oxidation that develops within the Krebs cycle during hypoxia, accompanied by an increase in the level of ATP and phosphocreatine; In addition, it activates the energy-binding effect of mitochondria and normalizes the cell walls.

The drug stabilizes the metabolic processes within the ischemic myocardium, reduces the area of necrosis, improves and restores electrical activity with myocardial contractility, and at the same time potentiates the coronary circulation in the ischemia area and reduces the consequences of the reperfusion syndrome resulting from the acute stage of coronary insufficiency. Increases antianginal effects of nitropreparatov.

Mexidol helps preserve the retinal ganglion cells and optic nerve fibers during progressive neuropathy, resulting in hypoxia and ischemia of the chronic subtype. It contributes to the improvement of the functional activity of the optic nerve with the retina, increasing visual acuity.

[9], [10], [11]

Pharmacokinetics

After use, the drug is recorded inside the blood plasma after 4 hours from the moment of administration. To obtain Cmax values, 0.45-0.5 hours is required, while they amount (with the introduction of a portion of 0.4-0.5 g) to 3.5-4 μg / ml.

The substance at high speed passes from the bloodstream into tissues with organs and is rapidly excreted from the body. Excretion is performed with the urine, mostly in the glucuron-conjugated state, and only in small quantities - while remaining unchanged.

[12], [13], [14]

Dosing and administration

Mexidol is used in / in (through a dropper or jet) or in the / m method; portion sizes are selected individually.

In the case of the use of infusion, the drug is dissolved in the physiological fluid NaCl (0.2 l). Adults should first enter 50-100 mg of substance 1-3 times per day, gradually increasing the portion until the desired result is obtained. Jet drug is used at low speed for 5-7 minutes, and through the dropper - at a speed of 40-60 drops / minute. Per day is allowed to enter a maximum of 0.8 g of the drug.

During the acute stages of intracerebral blood flow disorder, the drug is used in a combination regimen - for the first 2-4 days, intravenous administration of 0.2-0.3 g of drug 1 time per day is required through an IV line, and later 0.1 g of the drug must be administered 3 - Once a day, in / m way. The duration of this cycle is 10-14 days.

For the treatment of TBI and its consequences, the drug is administered intravenously through an IV for 10-15 days - in a dose of 0.2-0.5 g, 2-4 times a day.

For the therapy of the DCE, which remains at the decompensation stage, the drug is used by the jet method or via an IV drip at a dosage of 0.1 g 2-3 times a day for a 2-week cycle. Later, the medication is used in the i / m way, at 0.1 g per day for 14 days.

In the prophylactic course of DCE, the drug is administered intramuscularly, at a dosage of 0.1 g, 2-fold per day over a 10–14-day cycle.

In the case of mild forms of cognitive impairment in the elderly or in anxiety states, Mexidol is used in the i / m method in a dose of 0.1-0.3 g per day, over a 0.5-1 month period.

In the case of acute myocardial infarction in the combined treatment, the drug is used intramuscularly or intravenously in a method during a 2-week cycle, together with a standard course of therapy - an ACE inhibitor, nitrates, thrombolytics with β-blockers, antiplatelet drugs, anticoagulants and substances according to indications.

For the first 5 days, in order to get maximum exposure, it is required to apply the medicine intravenously, and for the next 9 days it can be used intramuscularly. The drug is injected through an IV drip, at infusion rate, at low speed (to avoid negative symptoms) (you must use 0.9% NaCl or 5% glucose fluid in a 0.1-0.15 liter portion), for 0.5-1.5 hours. If required, a 5-minute jet injection of the drug can be carried out at a slow speed.

Use of the substance (in / m or / in) is made 3 times a day, with 8-hour time periods. During the day, 6–9 mg / kg of the drug are administered in this way, and for 1 injection, 2–3 mg / kg. For the day, a maximum of 0.8 g of the drug is allowed, and for 1-well injection - 0.25 g.

During open-angle glaucoma, occurring in different phases, in the combined treatment, the drug is used in the i / m method at a dosage of 0.1-0.3 g per day, with 1-3-fold use over a 2-week course.

In the case of alcohol withdrawal, the drug is applied in a dose of 0.1-0.2 g 2-3 times a day or through an IV drip 1-2 times a day for a 5-7 day term.

In case of acute antipsychotic poisoning, the drug is administered intravenously in a portion of 0.05-0.3 g per day for a 1-2-week period.

In the treatment of acute peritoneal lesions with purulent-inflammatory nature (peritonitis or acute necrotic pancreatitis), Mexidol is injected on the first day of the preoperative as well as the postoperative segment. Selection of portions is carried out taking into account the intensity of the disease and its form, the prevalence of the lesion and options for clinical course. The drug should be discontinued gradually, only after achieving a sustainable positive clinical and laboratory result.

During the acute stage of edematous pancreatitis, it is necessary to inject 0.1 g of the drug 3 times a day, via an IV drip, in the IV method (using an isotonic NaCl liquid) or intramuscularly.

With a necrotic variety of pancreatitis in the easy stage: 0.1-0.2 g of drug 3 times a day, in / in the method through the dropper (using isotonic NaCl liquid), or in / m.

At the moderate stage: 0.2 g 3 times a day, through an intravenous drip (isotonic NaCl liquid).

In severe form: for a pulse portion, 0.8 g per day with 2 times use, and later - 0.3 g 2 times per day with a gradual decrease in daily dosage.

In extremely severe cases: at first, they use 0.8 g per day until symptoms of pancreatogenic shock are consistently eliminated, and after the condition stabilizes, 0.3-0.4 g drug 2 times a day, through an IV line, in / in (isotonic NaCl liquid), with a further gradual decrease in daily portion.

[23], [24], [25], [26]

Use Mexidola during pregnancy

Adequate clinical tests to verify the safety of the use of drugs during lactation or pregnancy have not been performed, which is why they are not prescribed during these periods.

[15], [16], [17]

Contraindications

Among the contraindications:

• lack of kidney or liver in the acute stage;
• severe intolerance associated with drug elements.

[18]

Side effects Mexidola

Occasionally, the use of drugs leads to dryness of the oral mucosa or nausea, and in addition to a feeling of drowsiness or anxiety, upset sleep, and emotional reactivity. In addition, the symptoms of allergies, headaches, coordination disorders and the distal form of hyperhidrosis may occur, and with it an increase or decrease in blood pressure levels.

[19], [20], [21], [22]

Overdose

Poisoning medication leads to the development of feelings of drowsiness.

In such cases, carry out detoxification procedures.

[27],

Interactions with other drugs

Mexidol potentiates the effects of benzodiazepine anxiolytics, anti-parkinsonian drugs (levodopa) and anticonvulsants (carbamazepine).

Weakens the toxic activity of ethanol.

[28], [29]

Storage conditions

Mexidol must be kept in a dark and dry place closed from small children. Temperature indicators - a maximum of 25 ° C.

[30]

Shelf life

Mexidol can be used within a 3-year term since the release of the pharmaceutical.

[31]

Application for children

There is no information about whether Mexidol is safe for children, which is why it is not used in pediatrics.

[32], [33], [34], [35], [36]

Analogs

Analogues of drugs are the substances Neurox, Emoxibel, Cerecardum, Riluzole with Hypoxene and Vitagamma.

[37], [38], [39], [40], [41]