Суматриптан Таблетки, 2 шт, 100 мг, для взрослых, в пленочной оболочке

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Средняя величина абсолютной биодоступности составляет 14% частично вследствие пресистемного метаболизма частично из-за неполной абсорбции."}},{"type":"paragraph","data":{"text":"Распределение"}},{"type":"paragraph","data":{"text":"Суматриптан связывается с белками плазмы в незначительной степени (14-21%) средний общий объем распределения составляет 170 л."}},{"type":"paragraph","data":{"text":"Метаболизм"}},{"type":"paragraph","data":{"text":"Главный метаболит индолуксусный аналог суматриптана выводится преимущественно с мочой в виде свободной кислоты и глюкуронида. Этот метаболит не обладает активностью по отношению к 5-HT\u003csub\u003e1\u003c/sub\u003e и 5-НТ\u003csub\u003e2\u003c/sub\u003e-серотониновым рецепторам. Второстепенные метаболиты суматриптана не обнаружены."}},{"type":"paragraph","data":{"text":"Выведение"}},{"type":"paragraph","data":{"text":"Период полувыведения составляет приблизительно 2 ч. Средний общий плазменный клиренс составляет примерно 1160 мл/мин средний почечный клиренс составляет примерно 260 мл/мин внепочечный клиренс - около 80% от общего клиренса. Суматриптан метаболизируется под действием моноаминоксидазы А."}},{"type":"paragraph","data":{"text":"Особые группы пациентов"}},{"type":"paragraph","data":{"text":"Пациенты с нарушением функции печени"}},{"type":"paragraph","data":{"text":"Вследствие снижения пресистемного клиренса суматриптана у пациентов с нарушением функции печени повышается содержание суматриптана в плазме крови."}},{"type":"paragraph","data":{"text":"Пациенты разных возрастных групп"}},{"type":"paragraph","data":{"text":"Фармакокинетика у пациентов старше 65 лет значимо не отличается от таковой у пациентов более молодого возраста."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Купирование острых приступов мигрени с аурой или без нее включая приступы менструально-ассоциированной мигрени."}},{"type":"paragraph","data":{"text":"Суматриптан следует применять только у пациентов с установленным диагнозом мигрень."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Гиперчувствительность к суматриптану или любому из вспомогательных веществ препарата;"}},{"type":"paragraph","data":{"text":"- гемиплегическая базилярная и офтальмоплегическая формы мигрени;"}},{"type":"paragraph","data":{"text":"- перенесенный инфаркт миокарда ишемическая болезнь сердца коронарный вазоспазм (стенокардия Принцметала) заболевания периферических сосудов пациенты с симптомами и признаками ишемической болезни сердца;"}},{"type":"paragraph","data":{"text":"- инсульт или транзиторная ишемическая атака в анамнезе;"}},{"type":"paragraph","data":{"text":"- тяжелое нарушение функции печени;"}},{"type":"paragraph","data":{"text":"- артериальная гипертензия средней и тяжелой степени неконтролируемая артериальная гипертензия легкой степени;"}},{"type":"paragraph","data":{"text":"- одновременное применение эрготамина или производных эрготамина (включая метисергид) любых триптанов/агонистов 5-гидрокситриптаминовых\u003csub\u003e1\u003c/sub\u003e (5-НТ\u003csub\u003e1\u003c/sub\u003e) рецепторов (см. раздел \"Взаимодействие с другими лекарственными препаратами\");"}},{"type":"paragraph","data":{"text":"- одновременное применение с ингибиторами моноаминоксидазы (МАО) а также в течение двух недель после прекращения терапии ингибиторами МАО;"}},{"type":"paragraph","data":{"text":"- возраст до 18 лет и старше 65 лет;"}},{"type":"paragraph","data":{"text":"- дефицит лактазы непереносимость галактозы и глюкозо-галактозная мальабсорбция (в связи с наличием в составе препарата лактозы)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":" Контролируемая артериальная гипертензия легкой степени;"}},{"type":"paragraph","data":{"text":"- заболеваниями при которых могут изменяться всасывание метаболизм или выведение этого препарата (например нарушение функции почек или печени);"}},{"type":"paragraph","data":{"text":"- эпилепсия (в том числе любые состояния со снижением порога судорожной готовности);"}},{"type":"paragraph","data":{"text":"- у пациентов с повышенной чувствительностью к сульфаниламидам (прием суматриптана может вызвать аллергические реакции выраженность которых варьируется от кожных проявлений до анафилаксии). Данные о перекрестной чувствительности ограничены однако следует соблюдать осторожность при назначении суматриптана таким пациентам."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Беременность"}},{"type":"paragraph","data":{"text":"Пострегистрационное применение препаратов содержащих суматриптан описано более чем у 1000 женщин в I триместре беременности. Несмотря на недостаточность сведений для составления однозначного заключения данные не предполагают увеличение риска врожденных аномалий развития."}},{"type":"paragraph","data":{"text":"Опыт применения суматриптана во II и III триместрах беременности ограничен."}},{"type":"paragraph","data":{"text":"Оценка экспериментальных исследований на животных не показала прямого тератогенного или неблагоприятного влияния на пренатальное и постнатальное развитие. Однако у кроликов наблюдалось влияние на эмбриофетальную жизнеспособность. Применение суматриптана возможно лишь если ожидаемая польза для матери будет превышать возможные риски для плода."}},{"type":"paragraph","data":{"text":"Период грудного вскармливания"}},{"type":"paragraph","data":{"text":"После подкожного введения суматриптан проникает в грудное молоко. Во избежание отрицательного воздействия на ребенка следует прекратить грудное вскармливание во время применения суматриптана и в течение 12 ч после окончания его применения в течение этого периода грудное молоко должно своевременно сцеживаться."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Таблетку следует проглатывать целиком запивая водой."}},{"type":"paragraph","data":{"text":"Взрослые"}},{"type":"paragraph","data":{"text":"Суматриптан применяется для интермиттирующей терапии приступов мигрени. Препарат не следует применять в профилактических целях."}},{"type":"paragraph","data":{"text":"Лечение суматриптаном следует начинать как можно раньше после возникновения приступа мигрени но препарат одинаково эффективен на любой стадии приступа."}},{"type":"paragraph","data":{"text":"Рекомендованная доза препарата Суматриптан - 50 мг в некоторых случаях доза может быть увеличена до 100 мг."}},{"type":"paragraph","data":{"text":"Если пациент почувствовал улучшение после первой дозы а затем симптомы возобновились можно принять вторую дозу в течение следующих 24 ч при условии соблюдения минимального временного интервала равного двум часам между двумя дозами."}},{"type":"paragraph","data":{"text":"Если у пациента первая доза суматриптана не оказала эффекта вторую дозу препарата для купирования этого же приступа мигрени применять не следует. В этом случае может назначаться парацетамол ацетилсалициловая кислота или нестероидные противовоспалительные препараты. Суматриптан может быть принят для купирования последующих приступов."}},{"type":"paragraph","data":{"text":"Суматриптан рекомендуется применять в качестве монотерапии мигрени не следует применять суматриптан одновременно с эрготамином или его производными (включая метисергид)."}},{"type":"paragraph","data":{"text":"Пациентам с нарушением функции печени: рекомендованная доза - 50 мг."}},{"type":"paragraph","data":{"text":"Дети"}},{"type":"paragraph","data":{"text":"Эффективность и безопасность суматриптана у детей в возрасте менее 10 лет не изучались. Нет доступных клинических данных для этой возрастной группы. Эффективность и безопасность суматриптана у детей от 10 до 17 лет не были продемонстрированы в клинических исследованиях проведенных в этой возрастной группе. Поэтому использование суматриптана у детей от 10 до 17 лет не рекомендовано."}},{"type":"paragraph","data":{"text":"Пожилые пациенты (старше 65 лет)"}},{"type":"paragraph","data":{"text":"Опыт использования суматриптана у пациентов в возрасте старше 65 лет ограничен. Фармакокинетика существенно не отличается от молодых но до получения соответствующих клинических данных использование суматриптана у пациентов в возрасте старше 65 лет не рекомендовано."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Нежелательные реакции перечислены ниже в зависимости от анатомо-физиологической классификации и частоты встречаемости."}},{"type":"paragraph","data":{"text":"Частота определена следующим образом: очень часто (>1/10); часто (>1/100 и <1/10); нечасто (>1/1000 и <1/100); редко (>1/10 000 и <1/1000); очень редко (<1/10 000) частота неизвестна (частота не может быть оценена по имеющимся данным). Некоторые из симптомов которые были описаны как нежелательные явления могут быть симптомами ассоциированными с мигренью."}},{"type":"paragraph","data":{"text":"Данные клинических исследований:"}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: часто - головокружение сонливость нарушения чувствительности включая парестезии и снижение чувствительности."}},{"type":"paragraph","data":{"text":"Со стороны сосудов:часто - преходящее повышение артериального давления (вскоре после приема препарата) приливы."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы и органов грудной клетки: часто - одышка."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта:часто - тошнота рвота (причинно-следственная связь возникновения нежелательных реакций с приемом препарата не доказана)."}},{"type":"paragraph","data":{"text":"Со стороны скелетно-мышечной и соединительной ткани: часто - чувство тяжести (обычно преходящее может быть интенсивным и возникать в любой части тела включая грудную клетку и горло) миалгия."}},{"type":"paragraph","data":{"text":"Общие расстройства и нарушения в месте введения: часто - болевые ощущения чувство холода или жара чувство давления или стягивания (обычно преходящие могут быть интенсивными и возникать в любой части тела включая грудную клетку и горло) слабость утомляемость (обычно слабо или умеренно выражены преходящи)."}},{"type":"paragraph","data":{"text":"Лабораторные и инструментальные данные: очень редко - незначительные отклонения показателей печеночных проб."}},{"type":"paragraph","data":{"text":"Пострегистрационные данные"}},{"type":"paragraph","data":{"text":"Со стороны иммунной системы: частота неизвестна - реакции гиперчувствительности которые варьируют от кожных проявлений повышенной чувствительности до анафилаксии."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: частота неизвестна - судорожные припадки (в ряде случаев наблюдавшиеся у пациентов с судорожными приступами в анамнезе или при сопутствующих состояниях предрасполагающих к возникновению судорог; у части пациентов факторов риска не было выявлено) тремор дистония нистагм скотома."}},{"type":"paragraph","data":{"text":"Со стороны органа зрения: частота неизвестна - мелькание диплопия снижение остроты зрения. Потеря зрения (обычно преходящая). Однако расстройства зрения могут\u003csup\u003e-\u003c/sup\u003e быть обусловлены собственно приступом мигрени."}},{"type":"paragraph","data":{"text":"Со стороны сердца:частота неизвестна - брадикардия тахикардия ощущение сердцебиения аритмии ЭКГ-признаки транзиторной ишемии миокарда коронарный вазоспазм стенокардия инфаркт миокарда."}},{"type":"paragraph","data":{"text":"Со стороны сосудов: частота неизвестна - снижение артериального давления синдром Рейно."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: частота неизвестна - ишемический колит диарея."}},{"type":"paragraph","data":{"text":"Со стороны скелетно-мышечной и соединительной ткани: частота неизвестна - ригидность шеи артралгия."}},{"type":"paragraph","data":{"text":"Со стороны психики: частота неизвестна - тревога."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожных тканей: частота неизвестна - гипергидроз."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Прием суматриптана внутрь в дозе более 400 мг не вызывал каких-либо нежелательных реакций помимо перечисленных выше."}},{"type":"paragraph","data":{"text":"В случае передозировки суматриптана следует наблюдать за состоянием пациентов не менее 10 ч и при необходимости проводить симптоматическую терапию. Данные о влиянии гемодиализа или перитонеального диализа на плазменную концентрацию суматриптана отсутствуют."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Не отмечено взаимодействия суматриптана с пропранололом флунаризином пизотифеном и этиловым спиртом у здоровых добровольцев."}},{"type":"paragraph","data":{"text":"Противопоказано одновременное применение суматриптана и эрготамина или других триптанов/агонистов 5-НТ\u003csub\u003e1\u003c/sub\u003e-серотониновых рецепторов. Теоретически возможно повышение риска коронарного вазоспазма и совместное применение данных препаратов противопоказано (см. раздел \"Противопоказания\")."}},{"type":"paragraph","data":{"text":"Период времени который должен пройти между применением суматриптана и эрготамин-содержащих препаратов или другого триптана/агониста 5-HT\u003csub\u003e1\u003c/sub\u003e-рецепторов неизвестен. Он будет зависеть в том числе от дозы и типа назначаемых препаратов. Действие может носить аддитивный характер. Рекомендуется выдержать по меньшей мере 24 часа после применения препаратов содержащих эрготамин или другой триптан/агонист 5-НТ\u003csub\u003e1\u003c/sub\u003e-рецепторов перед применением суматриптана. И наоборот рекомендуется выждать по меньшей мере 6 часов после применения суматриптана перед применением препаратов содержащих эрготамин и как минимум 24 часа до применения другого триптана/5-HT\u003csub\u003e1\u003c/sub\u003e агониста рецепторов."}},{"type":"paragraph","data":{"text":"Возможно взаимодействие между суматриптаном и ингибиторами МАО их одновременное применение противопоказано (см. раздел \"Противопоказания\")."}},{"type":"paragraph","data":{"text":"Имеются редкие сообщения о развитии серотонинового синдрома (включая расстройства психики вегетативную лабильность и нервно-мышечные нарушения) в результате одновременного применения селективных ингибиторов обратного захвата серотонина (СИОЗС) и суматриптана. Также сообщалось о развитии серотонинового синдрома на фоне одновременного применения триптанов с селективными ингибиторами обратного захвата серотонина и норадреналина (СИОЗСН)."}},{"type":"paragraph","data":{"text":"Побочные реакции отмечаются чаще при одновременном применении триптанов с лекарственными средствами содержащими зверобой продырявленный."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Суматриптан следует применять только у пациентов с установленным диагнозом мигрень."}},{"type":"paragraph","data":{"text":"Не показано применение суматриптана при гемиплегической базилярной и офтальмоплегической мигрени."}},{"type":"paragraph","data":{"text":"Не следует превышать рекомендуемые дозы суматриптана. Как и в случае применения других лекарственных препаратов для лечения острых приступов мигрени перед лечением приступа головной боли у пациентов у которых ранее не диагностировалась мигрень или у пациентов с атипичной формой мигрени необходимо исключить другие потенциально серьезные виды неврологической патологии."}},{"type":"paragraph","data":{"text":"Следует отметить что у пациентов с мигренью повышен риск развития определенных цереброваскулярных нарушений (например инсульта или транзиторных ишемических атак (ТИА))."}},{"type":"paragraph","data":{"text":"После приема препарата Суматриптан могут возникнуть такие преходящие симптомы как боль и давящее чувство в груди. Симптомы могут носить интенсивный характер и распространяться на область шеи. Если есть основания полагать что эти симптомы являются проявлением ишемической болезни сердца (ИБС) дальнейшее применение суматриптана следует прекратить и провести соответствующее диагностическое обследование."}},{"type":"paragraph","data":{"text":"Пациентам с факторами риска развития ишемической болезни сердца в т.ч. заядлым курильщикам или пациентам использующим заместительную никотиновую терапию без предварительного обследования сердечно-сосудистой системы не следует назначать суматриптан."}},{"type":"paragraph","data":{"text":"Особое внимание следует уделять женщинам в постменопаузе и мужчинам в возрасте старше 40 лет имеющим перечисленные факторы риска. Однако обследование не всегда позволяет выявить заболевание сердца и в очень редких случаях серьезные кардиологические осложнения возникали у пациентов без сопутствующих сердечно-сосудистых заболеваний."}},{"type":"paragraph","data":{"text":"Препарат Суматриптан следует применять с осторожностью у пациентов с контролируемой артериальной гипертензией легкой степени так как у небольшого количества пациентов наблюдалось транзиторное повышение артериального давления и периферического сосудистого сопротивления."}},{"type":"paragraph","data":{"text":"Имеются редкие сообщения полученные в результате пострегистрационного наблюдения о развитии серотонинового синдрома (включая расстройства психического статуса вегетативную лабильность и нервно-мышечные нарушения) в результате одновременного применения селективных ингибиторов обратного захвата серотонина (СИОЗС) и суматриптана. Также сообщалось о развитии серотонинового синдрома на фоне одновременного применения суматриптана с триптанами и селективными ингибиторами обратного захвата норадреналина (СИОЗСН)."}},{"type":"paragraph","data":{"text":"Если у пациента клинически оправдано одновременное применение препаратов группы СИОЗС и/или СИОЗСН следует тщательно контролировать состояние пациента."}},{"type":"paragraph","data":{"text":"Препарат Суматриптан следует применять с осторожностью у пациентов у которых могут существенно изменяться всасывание метаболизм или экскреция суматриптана например у пациентов с печеночной недостаточностью или нарушением функции почек. У пациентов с печеночной недостаточностью начальная доза должна составлять 50 мг."}},{"type":"paragraph","data":{"text":"Препарат Суматриптан необходимо применять с осторожностью у пациентов с судорогами в анамнезе или другими факторами риска снижения порога судорожной готовности поскольку при приеме суматриптана были зарегистрированы случаи судорог."}},{"type":"paragraph","data":{"text":"У пациентов с установленной гиперчувствительностью к сульфаниламидам прием препарата Суматриптан может вызывать аллергические реакции которые варьируют от кожных реакций гиперчувствительности до анафилаксии. Данные о перекрестной чувствительности ограничены поэтому следует соблюдать осторожность перед применением препарата Суматриптан этими пациентами."}},{"type":"paragraph","data":{"text":"Побочные реакции могут отмечаться чаще при одновременном применении триптанов и лекарственных средств содержащих зверобой продырявленный."}},{"type":"paragraph","data":{"text":"Длительное применение любых типов болеутоляющих препаратов при головных болях может приводить к их усилению. При возникновении данной ситуации или подозрении на нее необходимо прекратить терапию и провести дополнительное обследование. Головная боль вызванная чрезмерным использованием лекарственных препаратов может быть заподозрена у пациентов страдающих периодическими или ежедневными головными болями несмотря на регулярный прием медикаментов от головной боли."}},{"type":"paragraph","data":{"text":"Пациенты с редкими наследственной непереносимостью лактозы дефицитом лактазы и глюкозо-галактозной мальабсорбцией не должны принимать препарат Суматриптан так как в его состав входит лактоза."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"У пациентов с мигренью может возникать сонливость связанная как с самим заболеванием так и с приемом препарата Суматриптан. Пациенты должны быть особенно осторожными при управлении автомобилем и работе с движущимися механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки покрытые пленочной оболочкой 50 мг и 100 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать препарат после истечения срока годности."}}]},{"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":"Общество с ограниченной ответственностью \"Озон\" (ООО \"Озон\"), 445351, Самарская обл., г. Жигулёвск, ул. Гидростроителей, д. 6, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ООО \"Атолл\""}}]}],"source":null},"description_toggle":false,"short_description":"Суматриптан - селективный агонист сосудистых 5-гидрокситринтамин-1-рецепторов (5-НТ1D) не влияет на другие подтипы 5-НТ-рецепторов (5-НТ2-5-НТ7). Рецепторы 5-НТ1Dрасположены главным образом в краниальных кровеносных сосудах головного мозга и их стимуляция приводит к сужению этих сосудов. У животных суматриптан избирательно действует на вазоконстрикцию ветвей сонной артерии не влияя на кровоток в сосудах головного мозга. Сосудистый бассейн сонной артерии кровоснабжает экстракраниальные и интракраниальные ткани (в том числе менингеальные оболочки) и считается что расширение этих сосудов и/или отек их стенок является основным механизмом возникновения мигрени у человека. Кроме того доклинические данные позволяют судить о том что суматриптан снижает чувствительность тройничного нерва. Оба эти эффекта могут лежать в основе противомигренозного действия суматриптана. Суматриптан эффективен при лечении менструальной мигрени т.е. мигрени без ауры которая возникает за 3 дня до - и 5 дней после менструального цикла. Клинический эффект отмечается обычно через 30 мин после перорального приема 100 мг препарата. Несмотря на то что рекомендованная доза при пероральном приеме составляет 50 мг приступы мигрени различаются по степени тяжести как у одного пациента так и у разных пациентов. Дозы от 25 мг до 100 мг показали большую эффективность по сравнению с плацебо в клинических исследованиях но доза 25 мг статистически значительно менее эффективна чем 50 мг и 100 мг. Приступы мигрени не оказывают существенного влияния на фармакокинетику суматриптана принимаемого внутрь. Всасывание После приема внутрь суматриптан быстро всасывается через 45 мин его концентрация в плазме достигает 70% от максимальной. После приема 100 мг среднее значение максимальной концентрации в плазме крови составляет 54 нг/мл. Средняя величина абсолютной биодоступности составляет 14% частично вследствие пресистемного метаболизма частично из-за неполной абсорбции. Распределение Суматриптан связывается с белками плазмы в незначительной степени (14-21%) средний общий объем распределения составляет 170 л. Метаболизм Главный метаболит индолуксусный аналог суматриптана выводится преимущественно с мочой в виде свободной кислоты и глюкуронида. Этот метаболит не обладает активностью по отношению к 5-HT1и 5-НТ2-серотониновым рецепторам. Второстепенные метаболиты суматриптана не обнаружены. Выведение Период полувыведения составляет приблизительно 2 ч. Средний общий плазменный клиренс составляет примерно 1160 мл/мин средний почечный клиренс составляет примерно 260 мл/мин внепочечный клиренс - около 80% от общего клиренса. Суматриптан метаболизируется под действием моноаминоксидазы А. Особые группы пациентов Пациенты с нарушением функции печени Вследствие снижения пресистемного клиренса суматриптана у пациентов с нарушением функции печени повышается содержание суматриптана в плазме крови. 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