1 таб. венлафаксин (в форме гидрохлорида) 37.5 мг. Вспомогательные вещества: кальция гидрофосфат безводный, лактоза безводная, карбоксиметилкрахмал натрия, магния стеарат, кремния диоксид коллоидный безводный, краситель железа оксид красный (Е172).
Фармакологические свойства
Антидепрессант. По химической структуре венлафаксин не относится ни к одному классу антидепрессантов (трициклические, тетрациклические или другие), является рацематом двух активных энантомеров. Механизм антидепрессивного действия препарата связан с его способностью потенциировать передачу нервного импульса в ЦНС. Венлафаксин и его основной метаболит О-десметилвенлафаксин (ОДВ) являются сильными ингибиторами обратного захвата серотонина и норадреналина и слабыми ингибиторами обратного захвата допамина. Кроме того, венлафаксин и ОДВ снижают бета-адренергическую реактивность как после однократного введения, так и при постоянном приеме. Венлафаксин и ОДВ одинаково эффективно влияют на обратный захват нейротрансмиттеров. Венлафаксин не обладает сродством к м-холинорецепторам, гистаминовым H1-рецепторам и α .1-адренорецепторам головного мозга. Венлафаксин не подавляет активность МАО. Не обладает сродством к опиоидным, бензодиазепиновым, фенциклидиновым или NMDA-рецепторам.
Показания к применению
— депрессии различной этиологии (лечение и профилактика).
Противопоказания
Тяжелые нарушения функции почек (СКФ менее 10 мл/мин)
Тяжелые нарушения функции печени
Одновременный прием ингибиторов МАО
Возраст до 18 лет (безопасность и эффективность для этой категории пациентов не доказана)
Установленная или предполагаемая беременность
Период лактации (грудное вскармливание)
Повышенная чувствительность к компонентам препарата. С осторожностью следует назначать препарат при недавно перенесенном инфаркте миокарда, нестабильной стенокардии, артериальной гипертензии, тахикардии, судорожном синдроме в анамнезе, повышении внутриглазного давления, закрытоугольной глаукоме, маниакальных состояниях в анамнезе, предрасположенности к кровотечениям со стороны кожных покровов и слизистых оболочек, исходно сниженной массе тела, гипонатриемии, гиповолемии, одновременном приеме диуретиков, суицидальных наклонностях, почечной или печеночной недостаточности
Применение при беременности и в период грудного вскармливания
Безопасность применения венлафаксина при беременности не доказана, поэтому применение препарата при беременности (или предполагаемой беременности) противопоказано. Женщины детородного возраста должны быть предупреждены об этом до начала лечения и должны немедленно обратиться к врачу в случае наступления беременности или планирования беременности в период лечения препаратом. Женщины детородного возраста должны применять соответствующие методы контрацепции во время приема венлафаксина. Если лечение матери было завершено незадолго до родов, у новорожденного могут возникнуть симптомы отмены препарата. Венлафаксин и его метаболит ОДВ выделяются с грудным молоком. Безопасность этих веществ для новорожденных детей не доказана, поэтому прием венлафаксина в период грудного вскармливания не рекомендуется. При необходимости приема препарата в период лактации следует решить вопрос о прекращении грудного вскармливания.
Побочное действие
Большинство побочных эффектов зависит от дозы. При длительном лечении тяжесть и частота большинства этих эффектов снижается, причем не возникает необходимость отмены терапии. Определение частоты побочных эффектов: часто (>1%), нечасто (0.1-1%), редко (0.01-0.1%), очень редко (меньше0.01%). Со стороны ЦНС: часто - головокружение, астения, бессонница, кошмарные сновидения, повышенная нервная возбудимость, парестезии, гипертонус мышц, тремор, седативный эффект . нечасто - апатия, галлюцинации, миоклонус, обморок . редко - судороги, маниакальные расстройства, ЗНС. Со стороны сердечно-сосудистой системы: часто - повышение АД, гиперемия кожных покровов . нечасто - снижение АД, постуральная гипотензия, тахикардия . очень редко - изменение интервала QT, фибрилляция желудочков, желудочковая тахикардия (в т.ч. мерцание желудочков). Со стороны пищеварительной системы: часто - снижение аппетита, тошнота, рвота . нечасто - бруксизм (непроизвольное скрежетание зубами), повышение активности печеночных трансаминаз . редко - гепатит. Со стороны мочевыделительной системы: часто - нарушение мочеиспускания . нечасто - задержка мочи. Со стороны половой системы: часто - снижение либидо, нарушение эрекции и/или эякуляции, аноргазмия, меноррагия . нечасто - нарушение оргазма у женщин. Со стороны органов чувств: часто - нарушение аккомодации, мидриаз, нарушение зрения . нечасто - нарушение вкусового восприятия. Со стороны системы кроветворения: частота неизвестна - агранулоцитоз, апластическая анемия, нейтропения, панцитопения. Аллергические реакции: нечасто - сыпь, фотосенсибилизация . очень редко - многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона), анафилаксия. Лабораторные показатели: нечасто - тромбоцитопения . редко - увеличение времени кровотечения, гипонатриемия . при длительном назначении и применении в высоких дозах - гиперхолестеринемия. Прочие: часто - потеря массы тела, потливость (в т.ч. ночная) . нечасто - экхимозы, увеличение массы тела . редко - синдром неадекватной секреции АДГ, серотониновый синдром (тошнота, рвота, боли в животе, диарея, метеоризм, психомоторное возбуждение, тахикардия, гипертермия, мышечная ригидность, судороги, миоклонус, потливость, угнетение сознания разной степени тяжести). При возникновении синдрома отмены: головокружение, головная боль, астения, повышенная утомляемость, нарушения сна (изменение характера сновидений, сонливость или бессонница, затруднение засыпания), гипомания, тревожность, повышенная нервная возбудимость, спутанность сознания, парестезии, повышенное потоотделение, сухость во рту, снижение аппетита, тошнота, рвота, диарея (большинство из этих реакций выражены незначительно и не требуют лечения).
Особые указания
Большинство побочных эффектов зависит от дозы. При длительном лечении тяжесть и частота большинства этих эффектов снижается, причем не возникает необходимость отмены терапии. Определение частоты побочных эффектов: часто (>1%), нечасто (0.1-1%), редко (0.01-0.1%), очень редко (меньше0.01%). Со стороны ЦНС: часто - головокружение, астения, бессонница, кошмарные сновидения, повышенная нервная возбудимость, парестезии, гипертонус мышц, тремор, седативный эффект . нечасто - апатия, галлюцинации, миоклонус, обморок . редко - судороги, маниакальные расстройства, ЗНС. Со стороны сердечно-сосудистой системы: часто - повышение АД, гиперемия кожных покровов . нечасто - снижение АД, постуральная гипотензия, тахикардия . очень редко - изменение интервала QT, фибрилляция желудочков, желудочковая тахикардия (в т.ч. мерцание желудочков). Со стороны пищеварительной системы: часто - снижение аппетита, тошнота, рвота . нечасто - бруксизм (непроизвольное скрежетание зубами), повышение активности печеночных трансаминаз . редко - гепатит. Со стороны мочевыделительной системы: часто - нарушение мочеиспускания . нечасто - задержка мочи. Со стороны половой системы: часто - снижение либидо, нарушение эрекции и/или эякуляции, аноргазмия, меноррагия . нечасто - нарушение оргазма у женщин. Со стороны органов чувств: часто - нарушение аккомодации, мидриаз, нарушение зрения . нечасто - нарушение вкусового восприятия. Со стороны системы кроветворения: частота неизвестна - агранулоцитоз, апластическая анемия, нейтропения, панцитопения. Аллергические реакции: нечасто - сыпь, фотосенсибилизация . очень редко - многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона), анафилаксия. Лабораторные показатели: нечасто - тромбоцитопения . редко - увеличение времени кровотечения, гипонатриемия . при длительном назначении и применении в высоких дозах - гиперхолестеринемия. Прочие: часто - потеря массы тела, потливость (в т.ч. ночная) . нечасто - экхимозы, увеличение массы тела . редко - синдром неадекватной секреции АДГ, серотониновый синдром (тошнота, рвота, боли в животе, диарея, метеоризм, психомоторное возбуждение, тахикардия, гипертермия, мышечная ригидность, судороги, миоклонус, потливость, угнетение сознания разной степени тяжести). При возникновении синдрома отмены: головокружение, головная боль, астения, повышенная утомляемость, нарушения сна (изменение характера сновидений, сонливость или бессонница, затруднение засыпания), гипомания, тревожность, повышенная нервная возбудимость, спутанность сознания, парестезии, повышенное потоотделение, сухость во рту, снижение аппетита, тошнота, рвота, диарея (большинство из этих реакций выражены незначительно и не требуют лечения).
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таб. венлафаксин (в форме гидрохлорида) 37.5 мг. Вспомогательные вещества: кальция гидрофосфат безводный, лактоза безводная, карбоксиметилкрахмал натрия, магния стеарат, кремния диоксид коллоидный безводный, краситель железа оксид красный (Е172)."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Антидепрессант. По химической структуре венлафаксин не относится ни к одному классу антидепрессантов (трициклические, тетрациклические или другие), является рацематом двух активных энантомеров. Механизм антидепрессивного действия препарата связан с его способностью потенциировать передачу нервного импульса в ЦНС. Венлафаксин и его основной метаболит О-десметилвенлафаксин (ОДВ) являются сильными ингибиторами обратного захвата серотонина и норадреналина и слабыми ингибиторами обратного захвата допамина. Кроме того, венлафаксин и ОДВ снижают бета-адренергическую реактивность как после однократного введения, так и при постоянном приеме. Венлафаксин и ОДВ одинаково эффективно влияют на обратный захват нейротрансмиттеров. Венлафаксин не обладает сродством к м-холинорецепторам, гистаминовым H1-рецепторам и α .1-адренорецепторам головного мозга. Венлафаксин не подавляет активность МАО. Не обладает сродством к опиоидным, бензодиазепиновым, фенциклидиновым или NMDA-рецепторам."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"— депрессии различной этиологии (лечение и профилактика)."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Тяжелые нарушения функции почек (СКФ менее 10 мл/мин)","Тяжелые нарушения функции печени","Одновременный прием ингибиторов МАО","Возраст до 18 лет (безопасность и эффективность для этой категории пациентов не доказана)","Установленная или предполагаемая беременность","Период лактации (грудное вскармливание)","Повышенная чувствительность к компонентам препарата. С осторожностью следует назначать препарат при недавно перенесенном инфаркте миокарда, нестабильной стенокардии, артериальной гипертензии, тахикардии, судорожном синдроме в анамнезе, повышении внутриглазного давления, закрытоугольной глаукоме, маниакальных состояниях в анамнезе, предрасположенности к кровотечениям со стороны кожных покровов и слизистых оболочек, исходно сниженной массе тела, гипонатриемии, гиповолемии, одновременном приеме диуретиков, суицидальных наклонностях, почечной или печеночной недостаточности"]}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Безопасность применения венлафаксина при беременности не доказана, поэтому применение препарата при беременности (или предполагаемой беременности) противопоказано. Женщины детородного возраста должны быть предупреждены об этом до начала лечения и должны немедленно обратиться к врачу в случае наступления беременности или планирования беременности в период лечения препаратом. Женщины детородного возраста должны применять соответствующие методы контрацепции во время приема венлафаксина. Если лечение матери было завершено незадолго до родов, у новорожденного могут возникнуть симптомы отмены препарата. Венлафаксин и его метаболит ОДВ выделяются с грудным молоком. Безопасность этих веществ для новорожденных детей не доказана, поэтому прием венлафаксина в период грудного вскармливания не рекомендуется. При необходимости приема препарата в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":6,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Большинство побочных эффектов зависит от дозы. При длительном лечении тяжесть и частота большинства этих эффектов снижается, причем не возникает необходимость отмены терапии. Определение частоты побочных эффектов: часто (\u003e1%), нечасто (0.1-1%), редко (0.01-0.1%), очень редко (меньше0.01%). Со стороны ЦНС: часто - головокружение, астения, бессонница, кошмарные сновидения, повышенная нервная возбудимость, парестезии, гипертонус мышц, тремор, седативный эффект . нечасто - апатия, галлюцинации, миоклонус, обморок . редко - судороги, маниакальные расстройства, ЗНС. Со стороны сердечно-сосудистой системы: часто - повышение АД, гиперемия кожных покровов . нечасто - снижение АД, постуральная гипотензия, тахикардия . очень редко - изменение интервала QT, фибрилляция желудочков, желудочковая тахикардия (в т.ч. мерцание желудочков). Со стороны пищеварительной системы: часто - снижение аппетита, тошнота, рвота . нечасто - бруксизм (непроизвольное скрежетание зубами), повышение активности печеночных трансаминаз . редко - гепатит. Со стороны мочевыделительной системы: часто - нарушение мочеиспускания . нечасто - задержка мочи. Со стороны половой системы: часто - снижение либидо, нарушение эрекции и/или эякуляции, аноргазмия, меноррагия . нечасто - нарушение оргазма у женщин. Со стороны органов чувств: часто - нарушение аккомодации, мидриаз, нарушение зрения . нечасто - нарушение вкусового восприятия. Со стороны системы кроветворения: частота неизвестна - агранулоцитоз, апластическая анемия, нейтропения, панцитопения. Аллергические реакции: нечасто - сыпь, фотосенсибилизация . очень редко - многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона), анафилаксия. Лабораторные показатели: нечасто - тромбоцитопения . редко - увеличение времени кровотечения, гипонатриемия . при длительном назначении и применении в высоких дозах - гиперхолестеринемия. Прочие: часто - потеря массы тела, потливость (в т.ч. ночная) . нечасто - экхимозы, увеличение массы тела . редко - синдром неадекватной секреции АДГ, серотониновый синдром (тошнота, рвота, боли в животе, диарея, метеоризм, психомоторное возбуждение, тахикардия, гипертермия, мышечная ригидность, судороги, миоклонус, потливость, угнетение сознания разной степени тяжести). При возникновении синдрома отмены: головокружение, головная боль, астения, повышенная утомляемость, нарушения сна (изменение характера сновидений, сонливость или бессонница, затруднение засыпания), гипомания, тревожность, повышенная нервная возбудимость, спутанность сознания, парестезии, повышенное потоотделение, сухость во рту, снижение аппетита, тошнота, рвота, диарея (большинство из этих реакций выражены незначительно и не требуют лечения)."}}]},{"id":7,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Большинство побочных эффектов зависит от дозы. При длительном лечении тяжесть и частота большинства этих эффектов снижается, причем не возникает необходимость отмены терапии. Определение частоты побочных эффектов: часто (\u003e1%), нечасто (0.1-1%), редко (0.01-0.1%), очень редко (меньше0.01%). Со стороны ЦНС: часто - головокружение, астения, бессонница, кошмарные сновидения, повышенная нервная возбудимость, парестезии, гипертонус мышц, тремор, седативный эффект . нечасто - апатия, галлюцинации, миоклонус, обморок . редко - судороги, маниакальные расстройства, ЗНС. Со стороны сердечно-сосудистой системы: часто - повышение АД, гиперемия кожных покровов . нечасто - снижение АД, постуральная гипотензия, тахикардия . очень редко - изменение интервала QT, фибрилляция желудочков, желудочковая тахикардия (в т.ч. мерцание желудочков). Со стороны пищеварительной системы: часто - снижение аппетита, тошнота, рвота . нечасто - бруксизм (непроизвольное скрежетание зубами), повышение активности печеночных трансаминаз . редко - гепатит. Со стороны мочевыделительной системы: часто - нарушение мочеиспускания . нечасто - задержка мочи. Со стороны половой системы: часто - снижение либидо, нарушение эрекции и/или эякуляции, аноргазмия, меноррагия . нечасто - нарушение оргазма у женщин. Со стороны органов чувств: часто - нарушение аккомодации, мидриаз, нарушение зрения . нечасто - нарушение вкусового восприятия. Со стороны системы кроветворения: частота неизвестна - агранулоцитоз, апластическая анемия, нейтропения, панцитопения. Аллергические реакции: нечасто - сыпь, фотосенсибилизация . очень редко - многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона), анафилаксия. Лабораторные показатели: нечасто - тромбоцитопения . редко - увеличение времени кровотечения, гипонатриемия . при длительном назначении и применении в высоких дозах - гиперхолестеринемия. 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