Ишемическая болезнь сердца: Профилактика приступов стабильной стенокардии (в составе комбинированной терапии).
Противопоказания
Повышенная чувствительность к любому из компонентов препарата. Тяжелая почечная недостаточность (КК менее 30 мл/мин). Болезнь Паркинсона, симптомы паркинсонизма, тремор, синдром «беспокойных» ног и другие, связанные с ними двигательные нарушения. Беременность. Период грудного вскармливания. Возраст до 18 лет (эффективность и безопасность не установлены)....
Препарат, улучшающий метаболизм миокарда. Оказывает антигипоксическое действие. Триметазидин предотвращает снижение внутриклеточной концентрации АТФ путем сохранения энергетического метаболизма клеток в состоянии гипоксии. Таким образом, препарат обеспечивает нормальное функционирование мембранных ионных каналов, трансмембранный перенос ионов калия и натрия и сохранение клеточного гомеостаза. Триметазидин замедляет окисление жирных кислот за счет селективного ингибирования фермента 3-кетоацил-КоА-тиолазы (3-КАТ), что приводит к усилению окисления глюкозы, ускорению гликолиза с окислением глюкозы, и обусловливает защиту миокарда от ишемии. Переключение энергетического метаболизма с окисления жирных кислот на окисление глюкозы лежит в основе фармакологических свойств триметазидина. Экспериментально подтверждено, что триметазидин обладает следующими свойствами: поддерживает энергетический метаболизм сердца и нейросенсорных тканей во время ишемии . уменьшает выраженность внутриклеточного ацидоза и степень изменений в трансмембранном ионного потоке, возникающих при ишемии . понижает уровень миграции и инфильтрации полинуклеарных нейтрофилов в ишемизированных и реперфузионных тканях сердца . уменьшает размер повреждения миокарда . не оказывает прямого воздействия на показатели гемодинамики. У пациентов со стенокардией триметазидин увеличивает коронарный резерв, тем самым замедляя наступление ишемии, вызванной физической нагрузкой, начиная с 15-го дня терапии . ограничивает колебания АД, вызванные физической нагрузкой, без значительных изменений ЧСС . снижает частоту приступов стенокардии и потребность в приеме нитроглицерина короткого действия . улучшает сократительную функцию левого желудочка у больных с ишемической дисфункцией.
Показания к применению
Ишемическая болезнь сердца: Профилактика приступов стабильной стенокардии (в составе комбинированной терапии).
Противопоказания
Повышенная чувствительность к любому из компонентов препарата. Тяжелая почечная недостаточность (КК менее 30 мл/мин). Болезнь Паркинсона, симптомы паркинсонизма, тремор, синдром «беспокойных» ног и другие, связанные с ними двигательные нарушения. Беременность. Период грудного вскармливания. Возраст до 18 лет (эффективность и безопасность не установлены).
Применение при беременности и в период грудного вскармливания
Данные о применении препарата Депренорм . МВ у беременных женщин отсутствуют. Экспериментальные исследования на животных не выявили наличие прямой или непрямой репродуктивной токсичности. Исследования не показали влияния триметазидина на репродуктивную функцию у крыс обоего пола. Препарат противопоказан при беременности из-за отсутствия клинических данных о безопасности его применения. Данные о выделении триметазидина или его метаболитов с грудным молоком отсутствуют. Риск для новорожденного/ребенка не может быть исключен. Не следует применять препарат Депренорм . МВ в период грудного вскармливания.
Способ применения и дозы
Внутрь, во время еды. Депренорм MB принимают по 1 таблетке 70 мг 1 раз в сутки (утром). Курс лечения - по рекомендации врача.
Побочное действие
Частота побочных эффектов, отмеченных при приеме триметазидина, приведена в следующей градации: очень часто (более 1/10).часто (более 1/100, менее 1/10).нечасто (более 1/1000, менее 1/100).редко (более 1/10000, менее 1/1000).очень редко (менее 1/10000, в том числе отдельные сообщения).неуточненной частоты (частота не может быть подсчитана по доступным данным). Со стороны центральной нервной системы: часто - головокружение, головная боль. Неуточненной частоты - симптомы паркинсонизма (тремор, акинезия, повышение тонуса), неустойчивость в позе Ромберга и «шаткость» походки, синдром «беспокойных» ног, другие связанные с ними двигательные нарушения, обычно обратимые после прекращения терапии. Нарушения сна (бессонница, сонливость). Со стороны сердечно-сосудистой системы: редко - ортостатическая гипотензия, «приливы» крови к коже лица, ощущение сердцебиения, экстрасистолия, тахикардия, выраженное снижение АД. Со стороны кровеносной и лимфатической системы: неуточненной частоты - агранулоцитоз, тромбоцитопения, тромбоцитопеническая пурпура. Со стороны пищеварительной системы: часто - боль в животе, диарея, диспепсия, тошнота, рвота. Неуточненной частоты - запор. Со стороны печени и желчевыводящих путей: неуточненной частоты - гепатит. Со стороны кожных покровов: часто - кожная сыпь, зуд, крапивница. Неуточненной частоты - острый генерализованный экзантематозный пустулез, отек Квинке. Общие нарушения: часто - астения.
Особые указания
Частота побочных эффектов, отмеченных при приеме триметазидина, приведена в следующей градации: очень часто (более 1/10).часто (более 1/100, менее 1/10).нечасто (более 1/1000, менее 1/100).редко (более 1/10000, менее 1/1000).очень редко (менее 1/10000, в том числе отдельные сообщения).неуточненной частоты (частота не может быть подсчитана по доступным данным). Со стороны центральной нервной системы: часто - головокружение, головная боль. Неуточненной частоты - симптомы паркинсонизма (тремор, акинезия, повышение тонуса), неустойчивость в позе Ромберга и «шаткость» походки, синдром «беспокойных» ног, другие связанные с ними двигательные нарушения, обычно обратимые после прекращения терапии. Нарушения сна (бессонница, сонливость). Со стороны сердечно-сосудистой системы: редко - ортостатическая гипотензия, «приливы» крови к коже лица, ощущение сердцебиения, экстрасистолия, тахикардия, выраженное снижение АД. Со стороны кровеносной и лимфатической системы: неуточненной частоты - агранулоцитоз, тромбоцитопения, тромбоцитопеническая пурпура. Со стороны пищеварительной системы: часто - боль в животе, диарея, диспепсия, тошнота, рвота. Неуточненной частоты - запор. Со стороны печени и желчевыводящих путей: неуточненной частоты - гепатит. Со стороны кожных покровов: часто - кожная сыпь, зуд, крапивница. Неуточненной частоты - острый генерализованный экзантематозный пустулез, отек Квинке. Общие нарушения: часто - астения.
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Состав пленочной оболочкой: опадрай II розовый - 15 мг (поливиниловый спирт - 6 мг, полиэтиленгликоль (макрогол) - 3.03 мг, тальк - 2.22 мг, титана диоксид - 2.8395 мг, краситель солнечный закат желтый - 0.381 мг, краситель индигокармин - 0.2175 мг, краситель пунцовый (понсо 4R) - 0.312 мг)."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат, улучшающий метаболизм миокарда. Оказывает антигипоксическое действие. Триметазидин предотвращает снижение внутриклеточной концентрации АТФ путем сохранения энергетического метаболизма клеток в состоянии гипоксии. Таким образом, препарат обеспечивает нормальное функционирование мембранных ионных каналов, трансмембранный перенос ионов калия и натрия и сохранение клеточного гомеостаза. Триметазидин замедляет окисление жирных кислот за счет селективного ингибирования фермента 3-кетоацил-КоА-тиолазы (3-КАТ), что приводит к усилению окисления глюкозы, ускорению гликолиза с окислением глюкозы, и обусловливает защиту миокарда от ишемии. Переключение энергетического метаболизма с окисления жирных кислот на окисление глюкозы лежит в основе фармакологических свойств триметазидина. Экспериментально подтверждено, что триметазидин обладает следующими свойствами: поддерживает энергетический метаболизм сердца и нейросенсорных тканей во время ишемии . уменьшает выраженность внутриклеточного ацидоза и степень изменений в трансмембранном ионного потоке, возникающих при ишемии . понижает уровень миграции и инфильтрации полинуклеарных нейтрофилов в ишемизированных и реперфузионных тканях сердца . уменьшает размер повреждения миокарда . не оказывает прямого воздействия на показатели гемодинамики. У пациентов со стенокардией триметазидин увеличивает коронарный резерв, тем самым замедляя наступление ишемии, вызванной физической нагрузкой, начиная с 15-го дня терапии . ограничивает колебания АД, вызванные физической нагрузкой, без значительных изменений ЧСС . снижает частоту приступов стенокардии и потребность в приеме нитроглицерина короткого действия . улучшает сократительную функцию левого желудочка у больных с ишемической дисфункцией."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Ишемическая болезнь сердца: Профилактика приступов стабильной стенокардии (в составе комбинированной терапии)."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к любому из компонентов препарата. Тяжелая почечная недостаточность (КК менее 30 мл/мин). Болезнь Паркинсона, симптомы паркинсонизма, тремор, синдром «беспокойных» ног и другие, связанные с ними двигательные нарушения. Беременность. Период грудного вскармливания. Возраст до 18 лет (эффективность и безопасность не установлены)."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Данные о применении препарата Депренорм . МВ у беременных женщин отсутствуют. Экспериментальные исследования на животных не выявили наличие прямой или непрямой репродуктивной токсичности. Исследования не показали влияния триметазидина на репродуктивную функцию у крыс обоего пола. Препарат противопоказан при беременности из-за отсутствия клинических данных о безопасности его применения. Данные о выделении триметазидина или его метаболитов с грудным молоком отсутствуют. Риск для новорожденного/ребенка не может быть исключен. Не следует применять препарат Депренорм . 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