Повышенная чувствительность к никотиновой кислоте; атеросклероз, язвенная болезнь желудка и двенадцатиперстной кишки (в стадии обострения), подагра, гиперурикемия; тяжелая печеночная недостаточность, гепатит, цирроз печени; декомпенсированный сахарный диабет; детский возраст до 3 лет - для приема внутрь.
Инструкция
Состав
Вспомогательные вещества: натрия гидрокарбонат - до pH 5.0 -7.0, вода д/и - до 1 мл.
Фармакологические свойства
Витаминное и гиполипидемическое средство. В организме никотиновая кислота превращается в никотинамид, который связывается с коэнзимами кодегидрогеназы I и II (НАД и НАДФ), переносящими водород, участвует в метаболизме жиров, протеинов, аминокислот, пуринов, тканевом дыхании, гликогенолизе, синтетических процессах. Восполняет дефицит витамина РР (витамина В3), является специфическим противопеллагрическим средством (авитаминоз витамина РР). Нормализирует концентрацию липопротеинов крови; в высоких дозах (внутрь 3-4 г/сут) снижает концентрацию общего холестерина, ЛПНП, ТГ, уменьшает индекс холестерин/фосфолипиды, повышает содержание ЛПВП, обладающих антиатерогенным эффектом. Оказывает вазодилатирующее действие на уровне мелких сосудов (в т.ч. головного мозга), улучшает микроциркуляцию, оказывает слабое антикоагулянтное действие (повышает фибринолитическую активность крови).
Гипохолестеринемический эффект отмечается через несколько дней, снижение ТГ - через несколько часов после приема.
Фармакокинетика
После перорального приема быстро всасывается в желудке и верхних отделах двенадцатиперстной кишки. При парентеральном введении быстро распределяется в тканях организма. Накапливается, в основном, в печени, а также в жировой ткани и в почках. Метаболизируется в печени. T1/2 - 45 мин. Выводится из организма почками в неизмененной форме и в виде метаболитов, при приеме высоких доз - преимущественно в неизменном виде.
Показания к применению
Гиповитаминоз РР, авитаминоз РР (пеллагра). В составе комбинированной терапии ишемических нарушений мозгового кровообращения, заболеваний сосудов нижних конечностей (облитерирующий эндартериит, болезнь Рейно); спазмов сосудов конечностей, желче- и мочевыводящих путей; осложнений сахарного диабета (диабетическая полинейропатия и макроангиопатия); при гипоацидных гастритах, при невритах лицевого нерва, при длительно незаживающих ранах и трофических язвах кожи; при болезни Хартнупа (наследственное заболевание, сопровождающееся нарушением усвоения некоторых аминокислот, в т.ч. триптофана).
Противопоказания
Повышенная чувствительность к никотиновой кислоте; атеросклероз, язвенная болезнь желудка и двенадцатиперстной кишки (в стадии обострения), подагра, гиперурикемия; тяжелая печеночная недостаточность, гепатит, цирроз печени; декомпенсированный сахарный диабет; детский возраст до 3 лет - для приема внутрь.
С осторожностью
С осторожностью: геморрагии, глаукома, гиперацидный гастрит, язвенная болезнь желудка и двенадцатиперстной кишки (вне стадии обострения), артериальная гипотензия; беременность, период лактации (грудного вскармливания), детский возраст.
Применение при беременности и в период грудного вскармливания
При беременности и в период грудного вскармливания следует применять только после консультации с врачом, в тех случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода или младенца.
Способ применения и дозы
Применяют внутрь, в/в, в/м или п/к. Дозу, способ и схему применения, длительность терапии определяют индивидуально, в зависимости от показаний, возраста пациента и применяемой лекарственной формы.
Побочное действие
Со стороны сердечно-сосудистой системы: ощущение "прилива" крови к коже головы, гиперемия кожи лица и верхней половины туловища, ортостатическая гипотензия, коллапс, ощущение жара, головная боль. При быстром в/в введении возможно значительное снижение АД, головокружение.
Со стороны нервной системы: парестезии, головокружение.
Со стороны печени и желчевыводящих путей: при длительном применении - жировая дистрофия печени, повышение активности печеночных трансаминаз и ЩФ.
Со стороны обмена: при длительном применении - гиперурикемия, снижение толерантности к глюкозе, гипергликемия.
Аллергические реакции: кожная сыпь, кожный суд, стридорозное дыхание, крапивница.
Местные реакции: болезненность в месте введения при п/к и в/м инъекциях.
Прочие: астения, диспепсия.
Взаимодействие с другими лекарственными средствами
Необходимо соблюдать осторожность при комбинировании с гипотензивными средствами, антикоагулянтами и ацетилсалициловой кислотой.
Никотиновая кислота снижает токсичность неомицина и предотвращает индуцируемое им уменьшение концентрации холестерина и ЛПВП.
При совместном применении с препаратами сульфонилмочевины возможно увеличение уровня глюкозы в крови.
При одновременном применении с ловастатином повышается риск развития миопатии.
Особые указания
В процессе лечения необходимо контролировать функцию печени.
Нецелесообразно применять для коррекции дислипидемий у больных сахарным диабетом.
Для предупреждения осложнений со стороны печени рекомендуется включать в диету продукты, богатые метионином (творог) или применять метионин, липоевую кислоту и другие липотропные средства.
Влияние на способность управлять автомобилем и движущимися механизмами
В период применения никотиновой кислоты пациентам следует соблюдать осторожность при управлении транспортными средствами и механизмами, а также при занятиях другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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В организме никотиновая кислота превращается в никотинамид, который связывается с коэнзимами кодегидрогеназы I и II (НАД и НАДФ), переносящими водород, участвует в метаболизме жиров, протеинов, аминокислот, пуринов, тканевом дыхании, гликогенолизе, синтетических процессах. Восполняет дефицит витамина РР (витамина В\u003csub\u003e3\u003c/sub\u003e), является специфическим противопеллагрическим средством (авитаминоз витамина РР). Нормализирует концентрацию липопротеинов крови; в высоких дозах (внутрь 3-4 г/сут) снижает концентрацию общего холестерина, ЛПНП, ТГ, уменьшает индекс холестерин/фосфолипиды, повышает содержание ЛПВП, обладающих антиатерогенным эффектом. Оказывает вазодилатирующее действие на уровне мелких сосудов (в т.ч. головного мозга), улучшает микроциркуляцию, оказывает слабое антикоагулянтное действие (повышает фибринолитическую активность крови)."}},{"type":"paragraph","data":{"text":"Гипохолестеринемический эффект отмечается через несколько дней, снижение ТГ - через несколько часов после приема."}},{"type":"header","data":{"text":"Фармакокинетика","level":4}},{"type":"paragraph","data":{"text":"После перорального приема быстро всасывается в желудке и верхних отделах двенадцатиперстной кишки. При парентеральном введении быстро распределяется в тканях организма. Накапливается, в основном, в печени, а также в жировой ткани и в почках. Метаболизируется в печени. T\u003csub\u003e1/2\u003c/sub\u003e - 45 мин. Выводится из организма почками в неизмененной форме и в виде метаболитов, при приеме высоких доз - преимущественно в неизменном виде."}}]},{"id":10,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Гиповитаминоз РР, авитаминоз РР (пеллагра). В составе комбинированной терапии ишемических нарушений мозгового кровообращения, заболеваний сосудов нижних конечностей (облитерирующий эндартериит, болезнь Рейно); спазмов сосудов конечностей, желче- и мочевыводящих путей; осложнений сахарного диабета (диабетическая полинейропатия и макроангиопатия); при гипоацидных гастритах, при невритах лицевого нерва, при длительно незаживающих ранах и трофических язвах кожи; при болезни Хартнупа (наследственное заболевание, сопровождающееся нарушением усвоения некоторых аминокислот, в т.ч. триптофана)."}}]},{"id":11,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к никотиновой кислоте; атеросклероз, язвенная болезнь желудка и двенадцатиперстной кишки (в стадии обострения), подагра, гиперурикемия; тяжелая печеночная недостаточность, гепатит, цирроз печени; декомпенсированный сахарный диабет; детский возраст до 3 лет - для приема внутрь."}}]},{"id":12,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eС осторожностью:\u003c/i\u003e геморрагии, глаукома, гиперацидный гастрит, язвенная болезнь желудка и двенадцатиперстной кишки (вне стадии обострения), артериальная гипотензия; беременность, период лактации (грудного вскармливания), детский возраст."}}]},{"id":13,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"При беременности и в период грудного вскармливания следует применять только после консультации с врачом, в тех случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода или младенца."}}]},{"id":14,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Применяют внутрь, в/в, в/м или п/к. Дозу, способ и схему применения, длительность терапии определяют индивидуально, в зависимости от показаний, возраста пациента и применяемой лекарственной формы."}}]},{"id":15,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы:\u003c/i\u003e ощущение \"прилива\" крови к коже головы, гиперемия кожи лица и верхней половины туловища, ортостатическая гипотензия, коллапс, ощущение жара, головная боль. При быстром в/в введении возможно значительное снижение АД, головокружение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы: \u003c/i\u003eпарестезии, головокружение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны печени и желчевыводящих путей:\u003c/i\u003e при длительном применении - жировая дистрофия печени, повышение активности печеночных трансаминаз и ЩФ."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны обмена:\u003c/i\u003e при длительном применении - гиперурикемия, снижение толерантности к глюкозе, гипергликемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e кожная сыпь, кожный суд, стридорозное дыхание, крапивница."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМестные реакции:\u003c/i\u003e болезненность в месте введения при п/к и в/м инъекциях."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e астения, диспепсия."}}]},{"id":17,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Необходимо соблюдать осторожность при комбинировании с гипотензивными средствами, антикоагулянтами и ацетилсалициловой кислотой."}},{"type":"paragraph","data":{"text":"Никотиновая кислота снижает токсичность неомицина и предотвращает индуцируемое им уменьшение концентрации холестерина и ЛПВП."}},{"type":"paragraph","data":{"text":"При совместном применении с препаратами сульфонилмочевины возможно увеличение уровня глюкозы в крови."}},{"type":"paragraph","data":{"text":"При одновременном применении с ловастатином повышается риск развития миопатии."}}]},{"id":18,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В процессе лечения необходимо контролировать функцию печени."}},{"type":"paragraph","data":{"text":"Нецелесообразно применять для коррекции дислипидемий у больных сахарным диабетом."}},{"type":"paragraph","data":{"text":"Для предупреждения осложнений со стороны печени рекомендуется включать в диету продукты, богатые метионином (творог) или применять метионин, липоевую кислоту и другие липотропные средства."}}]},{"id":19,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период применения никотиновой кислоты пациентам следует соблюдать осторожность при управлении транспортными средствами и механизмами, а также при занятиях другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":20,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Р\u003ca href=\"https://www.eapteka.ru/goods/vitaminy_i_bad/vitaminy_i_mineraly/vitamin_v/?drug_form=rastvor_dlya_inektsiy\"\u003eаствор для инъекций\u003c/a\u003e."}}]},{"id":23,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]}],"source":{"title":"('Эркафарм/Столетов',)","url":"https://stoletov.ru/"}},"description_toggle":false,"short_description":"Витаминное и гиполипидемическое средство. 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