Препарат отлично себя зарекомендовал в лечении алкогольной зависимости, успешно применяется в наркологической практике и обладает следующими качествами:
1 . Более высокая эффективность и безопасность в лечении мужского и женского алкоголизма
2. Совместимость с психоактивными препаратами, не усиливает и не ослабляет их действие
3. Безопасность при длительном амбулаторном применении (до 6 месяцев)
4. Более эффективные показатели лечения в амбулаторных условиях, по сравнению с другими препаратами
5.Более быстрая реакция на алкоголь, по сравнению с другими препаратами (в течение 15 мин)
6. Нейтральные органолептические свойства (без вкуса, без цвета, без запаха)
Фармакологические свойства
Средство для лечения хронического алкоголизма. Механизм действия обусловлен блокадой альдегиддегидрогеназы, участвующей в метаболизме этанола. Блокада этого фермента приводит к повышению концентрации метаболита этанола - ацетальдегида, вызывающего отрицательные ощущения (в т. ч. приливы крови к лицу, тошнота, тахикардия, одышка), которые делают чрезвычайно неприятным употребление алкоголя после приема цианамида. Это приводит к условно-рефлекторному отвращению ко вкусу и запаху спиртных напитков.
Сенсибилизирующее действие цианамида на алкоголь проявляется раньше (примерно через 45-60 мин) и длится короче (около 12 ч), чем действие дисульфирама.
В отличие от дисульфирама цианамид не обладает гипотензивным эффектом и имеет более низкую собственную токсичность. Кроме того, цианамид обладает большей специфичностью действия: в отличие от дисульфирама он блокирует только альдегиддегидрогеназу и не влияет на другие ферменты, в частности на допамин-бета-гидроксилазу.
Показания к применению
Лечение больных хроническим алкоголизмом; профилактика рецидивов хронического алкоголизма после лечения.
Способ применения и дозы
Цианамид назначают после тщательного обследования больного. Пациента необходимо предупредить о возможных осложнениях и последствиях проводимой терапии.
Назначают внутрь 2 раза/сут по индивидуальной схеме.
Взаимодействие с другими лекарственными средствами
Не следует применять цианамид одновременно с метронидазолом, изониазидом, фенитоином и другими ингибиторами альдегиддегидрогеназы - это может усилить реакцию на употребление алкоголя.
Между применением дисульфирама и назначением цианамида должен быть перерыв не менее 10 дней.
Цианамид не совместим с препаратами альдегидной группы (паральдегид и продукты хлорала).
Особые указания
Цианамид должен применяться только под наблюдением врача и при согласии пациента на проводимую терапию. Следует иметь в виду возможность реакции на этанол, содержащийся в некоторых лекарственных средствах и пищевых продуктах.
Лечение цианамидом следует начинать только по истечении 12 ч с момента последнего употребления алкоголя.
При одновременном приеме алкоголя возможны выраженная гиперемия кожных покровов, ощущение пульсации в голове и шее, тошнота, тахикардия, затруднение дыхания, слабость, нечеткость зрения, повышенное потоотделение, боли в груди. В наиболее тяжелых случаях: рвота, снижение АД, угнетение дыхания, коллаптоиодное состояние. Проявления и степень их тяжести зависят от дозы цианамида и количества принятого алкоголя. В тяжелых случаях проводят симптоматическую терапию, направленную на поддержание функций дыхательной и сердечно-сосудистой систем, в/в введение антигистаминных препаратов.
С осторожностью применяют цианамид в тех случаях, когда реакция пациента на одновременное употребление алкоголя может привести к риску для здоровья пациента: при гипертиреозе, сахарном диабете, эпилепсии, заболеваниях сердечно-сосудистой системы, заболеваниях почек.
При длительном приеме цианамида рекомендуется контролировать функцию щитовидной железы не реже одного раза в 6 мес.
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