Рвота, тошнота, икота различного генеза (в некоторых случаях может быть эффективен при рвоте, вызванной лучевой или химиотерапией), атония и гипотония желудка и кишечника (в частности, послеоперационная); дискинезия желчевыводящих путей; рефлюкс-эзофагит, метеоризм, обострение язвенной болезни желудка и 12-перстной кишки (в составе комплексной терапии)....
Гиперчувствительность, желудочно-кишечное кровотечение, стеноз привратника желудка, механическая кишечная непроходимость, перфорация желудка или кишечника, 3-4 дня после операций на желудке и/или кишечнике, феохромоцитома, экстрапирамидные нарушения, эпилепсия, пролактинозависимые опухоли, беременности, детский возраст до 3-х лет, период лактации.
раствор для внутривенного и внутримышечного введения.
Состав
Действующее вещество:
Метоклопрамида гидрохлорид - 5 мг;
Вспомогательные вещества:
Натрия хлорид,
натрия сульфит безводный,
динатрия эдетат,
пропиленгликоль,
кислота хлористоводородная,
вода для инъекций.
Фармакологические свойства
Противорвотное средство, способствует уменьшению тошноты, икоты; стимулирует перистальтику верхнего отдела желудочно-кишечного тракта. Противорвотное действие обусловлено блокадой допаминовых рецепторов и повышением порога возбуждения хеморецепторов триггерной зоны. Полагают, что метоклопрамид ингибирует расслабление гладкой мускулатуры желудка, вызываемое допамином, усиливая таким образом холинергические реакции гладкой мускулатуры желудочно-кишечного тракта. Способствует ускорению опорожнения желудка путем предотвращения расслабления тела желудка и повышения фазовой активности антрального отдела желудка. При этом происходит расслабление верхних отделов тонкой кишки, что приводит к улучшению координации перистальтики тела и антрального отдела желудка и верхних отделов тонкой кишки. Уменьшает рефлюкс содержимого в пищевод за счет увеличения давления нижнего сфинктера пищевода в состоянии покоя и повышает клиренс кислоты из пищевода благодаря увеличению амплитуды его перистальтических сокращений.
Метоклопрамид стимулирует секрецию пролактина и вызывает транзиторное повышение уровня циркулирующего альдостерона, что может сопровождаться кратковременной задержкой жидкости
Фармакокинетика
Связывание с белками составляет около 30%. Проходит через плацентарный барьер и гематоэнцефалический барьер, проникает в материнское молоко. Эффект начинает развиваться через 10 – 15 минут после внутримышечного введения и через 1 – 3 мин после внутривенного введения. T1/2 - 3-5 ч, при нарушении функции почек - до 14 ч. Выведение препарата происходит в основном через почки (85% в течение 72 ч) в неизмененном виде и в виде сульфатного и глюкуронидного конъюгатов.
Показания к применению
Рвота, тошнота, икота различного генеза (в некоторых случаях может быть эффективен при рвоте, вызванной лучевой или химиотерапией), атония и гипотония желудка и кишечника (в частности, послеоперационная); дискинезия желчевыводящих путей; рефлюкс-эзофагит, метеоризм, обострение язвенной болезни желудка и 12-перстной кишки (в составе комплексной терапии).
Рентгеноконтрастные исследования ЖКТ (для усиления перистальтики).
Противопоказания
Гиперчувствительность, желудочно-кишечное кровотечение, стеноз привратника желудка, механическая кишечная непроходимость, перфорация желудка или кишечника, 3-4 дня после операций на желудке и/или кишечнике, феохромоцитома, экстрапирамидные нарушения, эпилепсия, пролактинозависимые опухоли, беременности, детский возраст до 3-х лет, период лактации.
В связи с содержанием сульфита натрия раствор метоклопрамида не следует назначать больным бронхиальной астмой с повышенной чувствительностью к сульфиту.
Способ применения и дозы
Раствор для инъекций вводят внутривенно или внутримышечно в течение 1-2 минут: взрослым в дозе 10 мг 3 – 4 раза в сутки (максимальная разовая доза – 20 мг, максимальная суточная доза - 60 мг); детям старше 6 лет - по 2,5 - 5 мг 1 - 3 раза в сутки; для детей в возрасте до 6 лет суточная доза составляет 0,5 - 1 мг/кг, кратность введения - 1-3 раза. Высшая суточная доза для детей – 0,5 мг/кг
Средняя продолжительность курса лечения – 4-6 недель, в отдельных случаях – до 6 мес.
Для профилактики и лечения тошноты и рвоты, обусловленных приемом цитостатиков или лучевой терапией, препарат вводят:
- Прерывистая внутривенная инфузия (в течение не менее чем 15 минут) в дозе до 2 мг/кг за 30 мин до применения цитостатиков или облучения, а также спустя 1,5; 3,5; 5,5 и 8,5 часов после применения (максимальная суточная доза 10 мг/кг);
- Длительная внутривенная инфузия в дозе 1 (0,5) мг/кг массы тела в час, начиная за 2 часа до применения цитостатического средства и заканчивая в момент применения цитостатического средства, затем в дозе 0,5 (0,25) мг/кг массы тела в час в течение 12 - 24 часов после применения цитостатического средства (максимальная суточная доза 10 мг/кг).
Каждое непродолжительное (в течение 15 мин) внутривенное капельное вливание проводят после предварительного разведения однократной дозы в 50 мл инфузионного раствора. Раствор можно разводить изотоническим раствором хлорида натрия или раствором глюкозы 5%. Препарат нельзя смешивать со щелочными инфузионными растворами.
При пониженной функции почек препарат назначают:
- При клиренсе креатинина до 10 мл/мин - 10 мг 1 раз в день;
- При клиренсе креатинина от 11 до 60 мл/мин – 15 мг/сут, разделённые на 2 введения (10 мг и 5 мг).
Побочное действие
Со стороны пищеварительной системы: в начале лечения возможны запор, диарея; редко - сухость во рту.
Со стороны центральной НС: в начале лечения возможны чувство усталости, сонливость, головокружение, головная боль, депрессия, акатизия. Возможно возникновение экстрапирамидных симптомов у детей и лиц молодого возраста (даже после однократного применения метоклопрамида): спазм лицевой мускулатуры, гиперкинезы, спастическая кривошея (как правило, проходят сразу после прекращения приема метоклопрамида). При длительном применении, чаще у пациентов пожилого возраста, возможны явления паркинсонизма, дискинезии.
Со стороны системы кроветворения: в начале лечения возможен агранулоцитоз.
Со стороны эндокринной системы: редко, при длительном применении в высоких дозах - галакторея, гинекомастия, нарушения менструального цикла.
Аллергические реакции: редко - кожная сыпь.
Передозировка
Симптомы:
Гиперсомния, повышение или понижение артериального давления, нарушение функций сердечно-сосудистой системы с брадикардией, дезориентация и экстрапирамидные расстройства.
Симптоматика исчезает после прекращения приема препарата в течение 24 ч.
Лечение:
При тяжёлых отравлениях экстрапирамидные расстройства можно быстро устранить медленным внутривенным введением биперидена (дозы для взрослых составляют 2,5 – 5 мг, для детей 0,04 мг/кг массы тела).
Взаимодействие с другими лекарственными средствами
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препарата","slug":"","body":[{"type":"paragraph","data":{"text":"Метоклопрамид"}}]},{"id":3,"name":"Лекарственная форма","slug":"","body":[{"type":"paragraph","data":{"text":"раствор для внутривенного и внутримышечного введения."}}]},{"id":4,"name":"Состав","slug":"ingredients","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eДействующее вещество:\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Метоклопрамида гидрохлорид - 5 мг; "}},{"type":"paragraph","data":{"text":"\u003ci\u003eВспомогательные вещества: \u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Натрия хлорид,"}},{"type":"paragraph","data":{"text":"натрия сульфит безводный,"}},{"type":"paragraph","data":{"text":"динатрия эдетат,"}},{"type":"paragraph","data":{"text":"пропиленгликоль,"}},{"type":"paragraph","data":{"text":"кислота хлористоводородная,"}},{"type":"paragraph","data":{"text":"вода для инъекций."}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\n\nПротиворвотное средство, способствует уменьшению тошноты, икоты; стимулирует перистальтику верхнего отдела желудочно-кишечного тракта. Противорвотное действие обусловлено блокадой допаминовых рецепторов и повышением порога возбуждения хеморецепторов триггерной зоны. Полагают, что метоклопрамид ингибирует расслабление гладкой мускулатуры желудка, вызываемое допамином, усиливая таким образом холинергические реакции гладкой мускулатуры желудочно-кишечного тракта. Способствует ускорению опорожнения желудка путем предотвращения расслабления тела желудка и повышения фазовой активности антрального отдела желудка. При этом происходит расслабление верхних отделов тонкой кишки, что приводит к улучшению координации перистальтики тела и антрального отдела желудка и верхних отделов тонкой кишки. Уменьшает рефлюкс содержимого в пищевод за счет увеличения давления нижнего сфинктера пищевода в состоянии покоя и повышает клиренс кислоты из пищевода благодаря увеличению амплитуды его перистальтических сокращений."}},{"type":"paragraph","data":{"text":"Метоклопрамид стимулирует секрецию пролактина и вызывает транзиторное повышение уровня циркулирующего альдостерона, что может сопровождаться кратковременной задержкой жидкости"}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"Связывание с белками составляет около 30%. Проходит через плацентарный барьер и гематоэнцефалический барьер, проникает в материнское молоко. Эффект начинает развиваться через 10 – 15 минут после внутримышечного введения и через 1 – 3 мин после внутривенного введения. T1/2 - 3-5 ч, при нарушении функции почек - до 14 ч. Выведение препарата происходит в основном через почки (85% в течение 72 ч) в неизмененном виде и в виде сульфатного и глюкуронидного конъюгатов.\n\n"}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"\n\nРвота, тошнота, икота различного генеза (в некоторых случаях может быть эффективен при рвоте, вызванной лучевой или химиотерапией), атония и гипотония желудка и кишечника (в частности, послеоперационная); дискинезия желчевыводящих путей; рефлюкс-эзофагит, метеоризм, обострение язвенной болезни желудка и 12-перстной кишки (в составе комплексной терапии)."}},{"type":"paragraph","data":{"text":"Рентгеноконтрастные исследования ЖКТ (для усиления перистальтики).\n\n"}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"\n\nГиперчувствительность, желудочно-кишечное кровотечение, стеноз привратника желудка, механическая кишечная непроходимость, перфорация желудка или кишечника, 3-4 дня после операций на желудке и/или кишечнике, феохромоцитома, экстрапирамидные нарушения, эпилепсия, пролактинозависимые опухоли, беременности, детский возраст до 3-х лет, период лактации."}},{"type":"paragraph","data":{"text":"В связи с содержанием сульфита натрия раствор метоклопрамида не следует назначать больным бронхиальной астмой с повышенной чувствительностью к сульфиту.\n\n"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Раствор для инъекций вводят внутривенно или внутримышечно в течение 1-2 минут: взрослым в дозе 10 мг 3 – 4 раза в сутки (максимальная разовая доза – 20 мг, максимальная суточная доза - 60 мг); детям старше 6 лет - по 2,5 - 5 мг 1 - 3 раза в сутки; для детей в возрасте до 6 лет суточная доза составляет 0,5 - 1 мг/кг, кратность введения - 1-3 раза. Высшая суточная доза для детей – 0,5 мг/кг"}},{"type":"paragraph","data":{"text":"Средняя продолжительность курса лечения – 4-6 недель, в отдельных случаях – до 6 мес."}},{"type":"paragraph","data":{"text":"Для профилактики и лечения тошноты и рвоты, обусловленных приемом цитостатиков или лучевой терапией, препарат вводят:"}},{"type":"paragraph","data":{"text":"- Прерывистая внутривенная инфузия (в течение не менее чем 15 минут) в дозе до 2 мг/кг за 30 мин до применения цитостатиков или облучения, а также спустя 1,5; 3,5; 5,5 и 8,5 часов после применения (максимальная суточная доза 10 мг/кг);"}},{"type":"paragraph","data":{"text":"- Длительная внутривенная инфузия в дозе 1 (0,5) мг/кг массы тела в час, начиная за 2 часа до применения цитостатического средства и заканчивая в момент применения цитостатического средства, затем в дозе 0,5 (0,25) мг/кг массы тела в час в течение 12 - 24 часов после применения цитостатического средства (максимальная суточная доза 10 мг/кг)."}},{"type":"paragraph","data":{"text":"Каждое непродолжительное (в течение 15 мин) внутривенное капельное вливание проводят после предварительного разведения однократной дозы в 50 мл инфузионного раствора. Раствор можно разводить изотоническим раствором хлорида натрия или раствором глюкозы 5%. Препарат нельзя смешивать со щелочными инфузионными растворами."}},{"type":"paragraph","data":{"text":"При пониженной функции почек препарат назначают:"}},{"type":"paragraph","data":{"text":"- При клиренсе креатинина до 10 мл/мин - 10 мг 1 раз в день;"}},{"type":"paragraph","data":{"text":"- При клиренсе креатинина от 11 до 60 мл/мин – 15 мг/сут, разделённые на 2 введения (10 мг и 5 мг)."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\n\nСо стороны пищеварительной системы: в начале лечения возможны запор, диарея; редко - сухость во рту."}},{"type":"paragraph","data":{"text":"Со стороны центральной НС: в начале лечения возможны чувство усталости, сонливость, головокружение, головная боль, депрессия, акатизия. Возможно возникновение экстрапирамидных симптомов у детей и лиц молодого возраста (даже после однократного применения метоклопрамида): спазм лицевой мускулатуры, гиперкинезы, спастическая кривошея (как правило, проходят сразу после прекращения приема метоклопрамида). При длительном применении, чаще у пациентов пожилого возраста, возможны явления паркинсонизма, дискинезии."}},{"type":"paragraph","data":{"text":"Со стороны системы кроветворения: в начале лечения возможен агранулоцитоз."}},{"type":"paragraph","data":{"text":"Со стороны эндокринной системы: редко, при длительном применении в высоких дозах - галакторея, гинекомастия, нарушения менструального цикла."}},{"type":"paragraph","data":{"text":"Аллергические реакции: редко - кожная сыпь.\n\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: "}},{"type":"paragraph","data":{"text":"Гиперсомния, повышение или понижение артериального давления, нарушение функций сердечно-сосудистой системы с брадикардией, дезориентация и экстрапирамидные расстройства."}},{"type":"paragraph","data":{"text":"Симптоматика исчезает после прекращения приема препарата в течение 24 ч."}},{"type":"paragraph","data":{"text":"Лечение: "}},{"type":"paragraph","data":{"text":"При тяжёлых отравлениях экстрапирамидные расстройства можно быстро устранить медленным внутривенным введением биперидена (дозы для взрослых составляют 2,5 – 5 мг, для детей 0,04 мг/кг массы тела)."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nДействие могут ослабить ингибиторы холинэстеразы."}},{"type":"paragraph","data":{"text":"Препарат усиливает всасывание тетрациклина, ампициллина, парацетамола, ацетилсалициловой кислоты, леводопы, этанола; уменьшает всасывание дигоксина и циметидина."}},{"type":"paragraph","data":{"text":"Препарат не назначают одновременно с нейролептиками (повышается риск возникновения экстрапирамидных нарушений).\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения препаратом нельзя употреблять алкоголь и спиртосодержащие препараты."}}]},{"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":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/soteks/\"\u003eФармФирма Сотекс, Россия\u003c/a\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"Противорвотное средство, способствует уменьшению тошноты, икоты; стимулирует перистальтику верхнего отдела желудочно-кишечного тракта. Противорвотное действие обусловлено блокадой допаминовых рецепторов и повышением порога возбуждения хеморецепторов триггерной зоны. Полагают, что метоклопрамид ингибирует расслабление гладкой мускулатуры желудка, вызываемое допамином, усиливая таким образом холинергические реакции гладкой мускулатуры желудочно-кишечного тракта. Способствует ускорению опорожнения желудка путем предотвращения расслабления тела желудка и повышения фазовой активности антрального отдела желудка. При этом происходит расслабление верхних отделов тонкой кишки, что приводит к улучшению координации перистальтики тела и антрального отдела желудка и верхних отделов тонкой кишки. Уменьшает рефлюкс содержимого в пищевод за счет увеличения давления нижнего сфинктера пищевода в состоянии покоя и повышает клиренс кислоты из пищевода благодаря увеличению амплитуды его перистальтических сокращений. Метоклопрамид стимулирует секрецию пролактина и вызывает транзиторное повышение уровня циркулирующего альдостерона, что может сопровождаться кратковременной задержкой жидкости Фармакокинетика Связывание с белками составляет около 30%. Проходит через плацентарный барьер и гематоэнцефалический барьер, проникает в материнское молоко. Эффект начинает развиваться через 10 – 15 минут после внутримышечного введения и через 1 – 3 мин после внутривенного введения. T1/2 - 3-5 ч, при нарушении функции почек - до 14 ч. 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