AMITRIPTILIN GRINDEKS tabletkalari 10mg N50
AMITRIPTILIN GRINDEKS tabletkalari 10mg N50 haqida qo'llanma
Farmakokinetikasi
Ichga qabul qilinganda uning biologik kira olishligi 33–62% ni tashkil qiladi, qon plazmasida Cmax ga 4–8 soatdan keyin erishiladi. Jigarda faol metabolit nortriptilin hosil bo'lishi bilan metabolizmga uchraydi. Amitriptilin va nortriptilin uchun qondagi terapevtik kontsentratsiyalar — 120–240 ng/ml. Ekskretsiya, asosan, buyrak orqali. To'liq chiqarilishi 7 kun ichida sodir bo'ladi. Amitriptilinning T1/2 10–28 soat, nortriptilinniki 16–80 soat. Amitriptilin yo'ldosh to'sig'i orqali o'tadi, ko'krak sutiga kiradi, plazmadagiga o'xshash kontsentratsiyalarni hosil qiladi.
Nojo'ya samaralari
Asab tizimi va sezgi a'zolari tomonidan: akkomodatsiyaning buzilishi, ko'z ichi bosimining oshishi, uyquchanlik.
Yurak-qon tomir tizimi va qon (qon yaratish, gemostaz) tomonidan: taxikardiya, aritmiya, ortostatik arterial gipertenziya, qon manzarasi o'zgarishi, shu jumladan agranulotsitoz.
OIT a'zolari tomonidan: stomatit, ta'm bilishning buzilishi, anoreksiya, ko'ngil aynishi, qusish, epigastriyada noqulaylik hissi, og'iz qurishi, ich tutilishi, ichak tutilishi, jigar funktsiyasining buzilishi (kam hollarda).
Boshqalar: teri toshmasi, soch to'kilishi, limfa tugunlarining kattalashishi, isitma, ginekomastiya, galaktoreya, ADG sekretsiyasining o'zgarishi, libidoning pasayishi, potentsiya, uzoq muddat qo'llanilganda tana vaznining oshishi, siydik tutilishi.
Qo'llanilishi mumkin bo'lmagan holatlar
Yuqori sezuvchanlik, MNT toksik susayishi, dekompensatsiyalangan yurak nuqsoni, miokard infarktining o'tkir va tiklanish davri, yurak mushagi o'tkazuvchanligining buzilishi, III darajali gipertoniya kasalligi, jigar va buyrakning o'tkir kasalliklari, qon kasalliklari, me'da va o'n ikki barmoqli ichak yara kasalligi zo'rayish bosqichida, glaukoma, prostata bezi gipertrofiyasi, qovuq atoniyasi, pilorostenoz, paralitik ichak tutilishi, MAO ingibitorlari bilan birga qo'llash, homiladorlik, emizish, 6 yoshgacha bo'lgan bolalar.
Dori vositalarining o'zaro ta'siri
Neyroleptiklar, sedativ va uxlatuvchi vositalar, tirishishga qarshi preparatlar, markaziy va narkotik analgetiklar, narkoz uchun vositalar, alkogol MAT ga susaytiruvchi ta'sirni kuchaytiradi. Katexolaminlarning gipertenziv samarasini kuchaytiradi, guanetidin va shunga o'xshash ta'sir mexanizmiga ega preparatlarning antigipertenziv ta'sirini bloklaydi. Simetidin plazmada amitriptilin konsentratsiyasini oshiradi.
Neyroleptiklar va/yoki antixolinergik preparatlar bilan kombinatsiyasi febril harorat reaksiyasini, paralitik ichak tutilishini chaqirishi mumkin.
Dozirovkasi
Ichga, ovqat vaqtida yoki undan keyin. Boshlang'ich sutkalik doza — 50–75 mg (25 mg dan 2–3 qabulda), zarurat bo'lganda doza asta-sekin (25–50 mg ga) optimalgacha oshiriladi — 150–200 mg/sut (sutkalik dozaning katta qismi uyqudan oldin qabul qilinadi).
Terapiyaga chidamli og'ir depressiyalarda: 300 mg va undan ortiq, maksimal o'zlashtiriladigan dozagacha. (Ambulator bemorlar uchun maksimal doza — 150 mg/sut). Turg'un antidepressiv samaraga erishilgandan so'ng 2–4 hafta o'tgach dozani asta-sekin kamaytiradilar (depressiya belgilari paydo bo'lgan taqdirda oldingi dozaga qaytish kerak).
Engil buzilishlarda, ambulator amaliyotda: keksa yoshdagi bemorlarga — 25–50 mg, maksimal — 100 mg bo'lingan dozalarda yoki bir marta uyqudan oldin.
Enurez: 6 yoshdan katta bolalarga — 12,5–25 mg uyqudan oldin (lekin 2,5 mg/kg dan oshmasligi kerak).
Migren profilaktikasi uchun, nevrogen xarakterdagi surunkali og'riqlarda (sh.j. uzoq muddatli bosh og'riqlarida): 12,5–25 mg dan 100 mg/sut gacha.
Hajm/og'irlik
AMITRIPTILIN GRINDEKS tabletkalari 10mg N50 o'xshash dorilari
Amitriptilin boshqa chiqarish shakllari
AMITRIPTILIN GRINDEKS tabletkalari 10mg N50 analoglari
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