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В связи с этим рекомендуется контролировать функциональные печеночные пробы 1 раз в месяц в первые 4 месяца лечения у тех пациентов, которым назначается тизанидин в суточной дозе 12 мг и выше, а также в тех случаях, когда наблюдаются клинические признаки, позволяющие предположить нарушение функции печени такие как: необъяснимая тошнота, анорексия, чувство усталости. В случае, когда активность аспартатаминотрансферазы и аланикаминотрансферазы в сыворотке стойко превышают1 верхнюю границу нормы в 3 раза и более, применение Тизанила следует прекратить. Пациентам с синдромом врожденного удлинения интервала Q-T тизанидин следует назначать с осторожностью, так как в доклинических исследованиях хронической токсичности у животных (собаки) отмечено удлинение интервала Q-T при применении препарата в дозе, эквивалентной максимальной дозе для человека."}},{"type":"paragraph","data":{"text":"У пациентов с ишемической болезнью сердца и (или) сердечной недостаточностью следует регулярного контролировать ЭКГ."}},{"type":"paragraph","data":{"text":"У пациентов с миастенией следует применять с особой осторожностью только в случаях, когда ожидаемая польза существенно превышает возможный риск."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Поскольку контролируемые исследования применения тизанидипа у беременных женщин не проводились, его не следует применять при беременности, за исключением тех случаев, когда ожидаемая польза для матери превышает возможный риск для плода."}},{"type":"paragraph","data":{"text":"Тизанндин незначительно проникает в грудное молоко, поэтому в период грудного вскармливания прием препарата следует отменить."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Назначают внутрь."}},{"type":"paragraph","data":{"text":"Купирование болезненного мышечного спазма: но 2 4 мг 3 раза в сутки, в тяжелых случаях - дополнительно на ночь 2-4 мг."}},{"type":"paragraph","data":{"text":"Лечение спастичности скелетной мускулатуры при неврологических заболеваниях; начальная доза - 2 мг 3 раза в день, затем дозу постепенно увеличивают на 2-4 мг с интервалами 3-7 дней. Оптимальная, суточная доза 12-24 мг в 3-4 приема, максимальная суточная доза 36 мг."}},{"type":"paragraph","data":{"text":"Пациентам с почечной недостаточностью (при клиренсе креатинина"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны нервной системы: сопливость, головокружение, галлюцинации, бессонница, нарушение сна."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: брадикардия, снижение артериального давления (в отдельных случаях выраженное, вплоть до коллапса и потери сознания)."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: сухость во рту, тошнота, диспепсия, повышение активности \"печеночных\" трапсаминаз, гепатит, печеночная недостаточность."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата: мышечная слабость."}},{"type":"paragraph","data":{"text":"Прочие: повышенная утомляемость, гиперкреагининемия."}},{"type":"paragraph","data":{"text":"При резкой отмене препарата после продолжительного лечения и/ипи приема высоких доз препарата (а также после одновременного применения вместе с гипотензивными лекарственными средствами): тахикардия, повышение артериального давления, острое нарушение мозгового кровообращения."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: тошнота, рвота, снижение артериального давления, головокружение, сонливость, ажитация, удлинение интервала QT, миоз, тревога, нарушение дыхания, кома."}},{"type":"paragraph","data":{"text":"Лечение: промывание желудка, прием активированного угля, проведение форсированного диуреза, симптоматическая терапия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Одновременное применение тизанидина с флувоксамином или ципрофлоксашшом (ингибиторами изофермента CYP1A2), приводит к 33-кратному увеличению площади под кривой \"концентрация-время\" (AUC) тизанидина. В результате могут возникнуть клинически значимое и продолжительное снижение артериального давления, приводящее к сонливости, слабости и замедлению психомоторных реакций (в отдельных случаях к позере сознания); удлинение интервала QT."}},{"type":"paragraph","data":{"text":"Не рекомендуется одновременное применение тизанидина с другими ингибиторами изофермента CYP1A2 - антиаритмическими препаратами (амиодарон, мсксилетин, пропафенон), циметидином, фторхиколонами (эноксацин, пефлоксацин, норфлоксацин), рофекоксибом, пероральными контрацептивами, тиклопидитшм."}},{"type":"paragraph","data":{"text":"Антигипертензивные лекарственные средства (ЛС) повышают риск выраженного снижения артериального давления и брадикардии."}},{"type":"paragraph","data":{"text":"Этанол, средства, угнетающие ЦНС, могут усиливать седативное действие тизанидина, поэтому не рекомендуется одновременное применение тизанидина со средствами, угнетающими ЦНС, и (или) алкоголем."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Влияние на способность к вождению автотранспорта и управлению механизмами"}},{"type":"paragraph","data":{"text":"При развитии сонливости, головокружения или снижения АД на фоне терапии Тизанилом следует воздержаться от видов работ, требующих высокой концентрации внимания и быстрой реакции, например, управления автотранспортом или работы с механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eТаблетки, 2 мг.\u003c/i\u003e По 10 табл. в блистере (ПВХ/ПЭ/ПВДХ/алюминий); по 3 блистера в пачке картонной."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТаблетки, 4 мг.\u003c/i\u003e По 10 табл. в блистере (ПВХ/ПЭ/ПВДХ/алюминий); по 1 или 3 блистера в пачке картонной."}},{"type":"paragraph","data":{"text":"\u003ci\u003eТаблетки, 6 мг.\u003c/i\u003e По 10 табл. в блистере (ПВХ/ПЭ/ПВДХ/алюминий); по 3 блистера в пачке картонной."}}]},{"id":16,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом, защищенном от света месте, при температуре не выше 30 °C."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять по истечении срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"по рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"«Симпекс Фарма Пвт. Лтд.», Индия. Б-4/160, Сафдарджанг Энклев, Нью Дели — 110029, Индия."}},{"type":"paragraph","data":{"text":"Адрес производственной площадки: С-7 по С-13 и С-59 по С-64, Центр Развития Сиггади (СИДКУЛ), Сиггади, Котдвар — 246149, Дистрикт Паури Гархвал, Уттарканд, Индия."}},{"type":"paragraph","data":{"text":"Претензии потребителей направлять в адрес поставщика: ЗАО «Корал-Мед». 119571, Москва, ул.26-ти Бакинских комиссаров, 9, оф. 62."}},{"type":"paragraph","data":{"text":"Тел.: (495) 935-76-65."}},{"type":"paragraph","data":{"text":"\u003ci\u003ee-mail: info@coralmed.ru\u003c/i\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"Миорелаксант центрального действия. Абсорбция высокая; время достижения максимальной плазменной концентрации (ТСmax) - 1 ч. Биодоступность - около 34 %. Прием пищи не влияет на фармакокинетику. Объем распределения в равновесном состоянии - 160 л. Связь с белками плазмы - 30 %, В диапазоне доз от 4 до 20 мг фармакокинетика имеет линейный характер. Метаболизируется быстро и в значительной степени в печени (95%) изоферментом CYP1A2 с образованием неактивных метаболитов. Выводится преимущественно почками (70 % дозы в виде метаболитов. 2,7 % в неизмененном виде). Выводится двухфазно: период пояувыведения (Т1/2) в первой фазе - 2,5 ч; конечный Т1/2 - 22 ч. Средний период полувыпедения неизмененного вещества - 2-4 ч. У больных с почечной недостаточностью (клиренс креатинина Тизанидин - миорелаксант центрального действия. Основная точка приложения его действия находится в спинном мозге. Стимулируя пресинаптические аг-адренорецепторы, тизанидин подавляет выделение возбуждающих аминокислот, которые стимулируют рецепторы к N-Memrf-D-acmpxaTy (NMDA-рецепторы). Вследствие этого на уровне промежуточных нейронов спинного мозга происходит подавление полисшшнтической передачи возбуждения. 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