Противорвотное средство. Оказывает противорвотное действие,... Инструкция
Показания к применению
Диспептический синдром часто ассоциирующийся с замедленным опорожнением желудка желудочно-пищеводным рефлюксом эзофагитом: чувство переполнения в эпигастрии ощущение вздутия живота боли в верхней части живота отрыжка метеоризм изжога с забросом или без заброса содержимого желудка в полость рта; тошнота и рвота различного происхождения в том числе функционального ...
Круглые, слегка двояковыпуклые таблетки, без оболочки розовато-оранжевого цвета, с риской на одной стороне. Допускается незначительная мраморность.
Фармакотерапевтическая группа
противорвотное средство - дофаминовых рецепторов блокатор центральный
Фармакологические свойства
Противорвотное средство. Оказывает противорвотное действие, успокаивает икоту и устраняет в некоторых случаях тошноту. Действие обусловлено блокадой центральных допаминовых рецепторов. Благодаря этому устраняется ингибирующее влияние допамина на моторную функцию ЖКТ и повышается эвакуаторная и двигательная активность желудка.
Показания к применению
Диспептический синдром часто ассоциирующийся с замедленным опорожнением желудка желудочно-пищеводным рефлюксом эзофагитом: чувство переполнения в эпигастрии ощущение вздутия живота боли в верхней части живота отрыжка метеоризм изжога с забросом или без заброса содержимого желудка в полость рта; тошнота и рвота различного происхождения в том числе функционального органического инфекционного происхождения вызванная радиотерапией лекарственной терапией интоксикацией или нарушением диеты; тошнота и рвота вызванные на фоне лечения агонистами допамина (леводопа бромокриптин).
Противопоказания
Повышенная чувствительность к домперидону пролактин-секретирующая опухоль гипофиза (пролактинома) желудочно-кишечные кровотечения механическая непроходимость или перфорация кишечника.
В виде таблеток не назначают детям в возрасте до 5 лет и массой тела до 20 кг.
С осторожностью
Применение при печеночной недостаточности: домперидон активно метаболизируется в печени поэтому назначение препарата пациентам с печеночной недостаточностью не рекомендуется.
Применение при почечной недостаточности: при тяжелой форме почечной недостаточности (сывороточный креатинин > 6 мг/100 мл) период полувыведения домперидона увеличивается от 74 до 208 ч. В зависимости от степени тяжести рекомендуется коррекция дозы препарата а также уменьшение частоты приема препарата до 1-2 раз в сутки. При необходимости длительного лечения данная группа пациентов нуждается в тщательном контроле за уровнем домперидона в крови.
Применение при беременности и в период грудного вскармливания
Применение домперидона во время беременности возможно только в том случае когда ожидаемая польза для матери превышает потенциальный риск для плода.
При необходимости назначения препарата во время лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Внутрь за 15-20 мин до еды и при необходимости перед сном. Курс лечения составляет как правило четыре недели после чего рассматривается необходимость продолжения и прекращения лечения препаратом.
Взрослым и детям старше 5 лет и массой тела свыше 20 кг:
- при хронической диспепсии назначают по 10 мг 3 раза в сутки; при недостаточном эффекте указанную дозу удваивают;
- при острых и подострых состояниях прежде всего при тошноте и рвоте назначают по 20 мг 3-4 раза в сутки.
Максимальная суточная доза составляет 80 мг.
При почечной недостаточности:
В зависимости от степени тяжести рекомендуется коррекция дозы препарата а также уменьшение частоты приема препарата до 1 - 2 раз в сутки.
Побочное действие
Со стороны центральной нервной системы: *очень редко: экстрапирамидные расстройства (у детей и у лиц с повышенной проницаемостью ГЭБ).
Со стороны желудочно-кишечного тракта: *редко: преходящие спазмы кишечника.
Аллергические реакции: *очень редко: крапивница кожная сыпь.
*частота побочных эффектов: очень часто - ≥ 10%; часто - от ≥ 1% до <10%; иногда - от ≥ 01% до <1%; редко - от ≥ 001% до <01%; очень редко <001%.
Передозировка
Симптомы - сонливость дезориентация экстрапирамидные расстройства особенно у детей.
Лечение - промывание желудка назначение активированного угля. Антихолинергические средства препараты применяемые для лечения паркинсонизма или антигистаминные препараты могут оказаться эффективными при возникновении экстрапирамидных реакций.
Взаимодействие с другими лекарственными средствами
Основной путь метаболических превращений домперидона происходит при участии изофермента CYP3A4 системы цитохрома Р450. На основании исследованийin vitro можно предположить что совместный прием с препаратами ингибирующими данный фермент вызывает увеличение уровня домперидона в плазме крови. Примерами ингибиторов изофермента CYP3A4 являются следующие лекарственные средства: противогрибковые препараты группы азолов антибиотики группы макролидов ингибиторы ВИЧ-протеазы нефазодон.
Антисекреторные препараты могут снижать биодоступность домперидона поэтому их следует принимать после еды т.е. их не следует принимать одновременно с домперидоном.
При одновременном применении антихолинергические и антацидные препараты могут нейтрализовать действие домперидона.
Домперидон совместим с приемом нейролептиков агонистов дофаминергических рецепторов (бромокриптин леводопа).
Применение домперидона на фоне лечения парацетамолом или дигоксином не влияет на уровень этих препаратов в крови.
Влияние на способность управлять автомобилем и движущимися механизмами
Домперидон не нарушает скорость психомоторных реакций.
Форма выпуска
Таблетки 10 мг.
Условия хранения
В сухом защищенном от света месте при температуре не выше 25 °С.
Хранить в недоступном от детей месте.
Срок годности
3 года.
Не использовать по истечении срока годности указанного на упаковке.
Условия отпуска
Без рецепта
Производитель
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