Bi-Xikam

Release form, composition and packing Bi-Xikam 
 
Pill light yellow, Valium. 1 tab. meloxicam 7.5 mg. Excipients: sodium citrate dihydrate, anhydrous lactose, microcrystalline cellulose, povidone (Kollidon, polyvinylpyrrolidone 25 000), colloidal silicon dioxide (Aerosil), crospovidone (poliplasdon VIC EL-10), magnesium stearate.

Pill light yellow, Valium. 1 tab. meloxicam 15 mg. Excipients: sodium citrate dihydrate, anhydrous lactose, microcrystalline cellulose, povidone (Kollidon, polyvinylpyrrolidone 25 000), colloidal silicon dioxide (Aerosil), crospovidone (poliplasdon VIC EL-10), magnesium stearate. Clinico-pharmacological group: NSAID. Selective COX-2 inhibitor.

Pharmacological action

NSAIDs. Has anti-inflammatory, analgesic and antipyretic effect. The mechanism of action is selective inhibition of enzymatic activity of COX-2 involved in the biosynthesis of prostaglandins in inflammation. In appointing the high-dose, long-term use and individual characteristics of the organism of COX-2 selectivity may be reduced. Inhibits the synthesis of prostaglandins in inflammation to a greater extent than in the mucosa of the gastrointestinal tract and kidneys.

Pharmacokinetics

Suction

After oral administration, is well absorbed from the gastrointestinal tract. The absolute bioavailability of meloxicam - 89%. Simultaneous ingestion does not alter absorption. While taking the drug orally at doses of 7.5 mg and 15 mg meloxicam concentration in plasma is proportional to dose. The vast differences between the Cmax and Cmin in plasma after a single dose is relatively small and at a dose of 7.5 mg of 0.4-1 mg / ml, a dose of 15 mg - 0.8-2 mg / ml, (presented, respectively, values and Cmin and Cmax ).

Distribution

Css achieved within 3-5 days. With prolonged use of the drug (more than 1 year) concentrations are similar to those that have been reported after first reaching an equilibrium state. Plasma protein binding of more than 99%. Vd is small and amounts to an average of 11 liters. Meloxicam crosses gistogematicheskie barriers, the concentration in the synovial fluid reaches 50% Cmax of the drug in blood plasma.

Metabolism

Meloxicam is almost completely metabolized in the liver with the formation of four pharmacologically inactive metabolites.

Breeding

T1 / 2 of meloxicam is 15-20 hours is derived equally from feces and urine, mostly as metabolites. With the feces as unchanged output of less than 5% of the daily dose in the urine as unchanged drug is found only in trace amounts. Plasma clearance is an average of 8 ml / min.

Pharmacokinetics in special clinical situations

In the elderly clearance of the drug decreases. Hepatic or renal failure of moderate severity did not significantly affect the pharmacokinetics of meloxicam.

Statement

Inflammatory and degenerative diseases of joints, accompanied by pain syndrome:
rheumatoid arthritis;
osteoarthritis;
Ankylosing spondylitis (ankylosing spondylitis).

Dosing regimen

The drug is taken orally during a meal one time per day. In rheumatoid arthritis the recommended dose is 15 mg / day. Depending on the therapeutic effect of the dose can be reduced to 7.5 mg / day. Osteoarthritis: The recommended dose - 7.5 mg / day. With the ineffectiveness of the dose may be increased to 15 mg / day.

If ankylosing spondylitis dose is 15 mg / day. The maximum daily dose should not exceed 15 mg. In patients with increased risk of side effects, as well as in patients with severe renal insufficiency on hemodialysis, the dose should not exceed 7.5 mg / day.

Side effect
From the digestive system: nausea, vomiting, abdominal pain, diarrhea, constipation, flatulence, erosive and ulcerative lesions of the gastrointestinal tract, perforation of stomach or intestinal ulcers, gastrointestinal bleeding (implicit or explicit), elevated liver enzymes, hepatitis, colitis, stomatitis , dry mouth, esophagitis, hyperbilirubinemia, belching.
Cardio-vascular system: tachycardia, increased blood pressure, feeling the tides.
With the respiratory system: exacerbation of bronchial asthma, cough.
CNS: headache, dizziness, tinnitus, disorientation, confusion, thoughts, sleep disturbance, drowsiness, emotional lability.
With the urinary system: edema, interstitial nephritis, renal medullary necrosis, urinary tract infection, proteinurniya, hematuria, renal failure, hypercreatininemia and / or an increase of urea in the blood serum.
On the part of the vision: conjunctivitis, blurred vision.
From the hemopoietic system: anemia, leukopenia, thrombocytopenia.
Dermatological reactions: itching, skin rash, increased photosensitivity.

Allergic reactions: urticaria, anaphylactoid reactions (including anaphylactic shock), angioedema, allergic vasculitis, erythema multiforme eksudativnaya (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

Other: fever.

Contraindications
"Aspirin" asthma;
gastric ulcer and duodenal ulcer in acute phase;
gastrointestinal, cerebrovascular or other bleeding;
severe renal insufficiency (unless hemodialysis);
severe hepatic impairment;
severe congestive heart failure;
Children up to age 15 years;
pregnancy;
Lactation (breastfeeding);
hypersensitivity to the drug.

Caution should be used on patients of advanced age, with erosive and ulcerative lesions of the gastrointestinal tract in history.

Pregnancy and lactation

The drug is contraindicated during pregnancy and lactation.

Use in hepatic dysfunction

Contraindicated in severe liver failure.

Use in renal impairment

In renal failure, if the spacecraft more than 25 ml / min correction dosing regimen is not required. In patients with increased risk of side effects, as well as in patients with severe renal insufficiency on hemodialysis, the dose should not exceed 7.5 mg / day. Contraindicated in severe renal failure if left hemodialysis.

Cautions

It should be used with caution on patients with an indication of a history of peptic ulcer of the stomach and duodenum, as well as in patients receiving anticoagulation therapy. In these patients at increased risk of erosive and ulcerative lesions of the gastrointestinal tract.

With care and control of indicators of kidney function should use the drug in elderly patients, patients with chronic heart failure with signs of circulatory failure in patients with cirrhosis and in patients with hypovolemia due to surgical interventions.

In renal failure, if CC> 25 ml / min correction dosing regimen is not required.

In patients on dialysis, the maximum dose is 7.5 mg / day.

Patients taking both diuretics and meloxicam, should get plenty of fluids.

If in the course of treatment have an allergic reaction (including itching, skin rash, urticaria) and photosensitivity, the patient should consult a doctor to solve the issue of termination of treatment.

Effects on ability to drive vehicles and management mechanisms

Use of the drug may cause unwanted effects in the form of headaches and dizziness, sleepiness. If you experience these phenomena should be abandoned vehicle, maintenance of machines and mechanisms.

Overdose

Symptoms: increased side effects.

Treatment: gastric lavage, activated charcoal reception (during the next hours after admission), the holding of symptomatic therapy. Kolestiramin accelerates the removal of meloxicam from the body. A specific antidote does not exist.

Drug Interactions

In an application with other NSAIDs (as well as of acetylsalicylic acid) and increased risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract. In an application with antihypertensive drugs may reduce the effectiveness of the latter.

In an application with lithium therapy may develop accumulation of lithium and increase its toxicity (recommended to control the concentration of lithium in the blood).

In an application with methotrexate increases the side effects of the latter on the hematopoietic system (risk of anemia and leukopenia, shows a periodic monitoring of blood count).

Betoptic

Release form, composition and packing Betoptic 

Eye drops 0.5% in a clear, colorless or slightly yellow solution. 1 ml of betaxolol hydrochloride 5.6 mg, which corresponds to the content betaxolol 5 mg Excipients: benzalkonium chloride, hydrochloric acid and / or sodium hydroxide solution (to maintain the pH), purified water.

Clinico-pharmacological group: antiglaucoma medication - beta-blocker.

Pharmacological action

Antiglaucoma medication. Selective beta1-blocker without intrinsic sympathomimetic activity. Has no membrane stabilizing (local-anesthetic) action. When topically applied betaxolol reduces intraocular pressure by decreasing production of intraocular fluid. The onset of hypotensive action observed within 30 min after instillation, the maximum effect develops in 2 hours

After a single instillation of an impact on ophthalmotonus stored for 12 hours betaxolol (compared with other beta-blockers) did not induce reduction of blood flow to the optic nerve. Application Betoptika did not cause miosis, spasm of accommodation, night blindness, the effect of "veil" in front of the eyes (unlike miotikov).

Pharmacokinetics

When topical treatment is possible systemic absorption of betaxolol hydrochloride.

Statement

The drug is used to reduce intraocular pressure as monotherapy or in combination with other medications for:
open-angle glaucoma;
ocular hypertension.

Betoptik be used to treat open-angle glaucoma or ocular hypertension in patients with diseases of the respiratory system.

Dosing regimen

The drug is instilled into the conjunctival sac 1-2 drops 2 times a day. In some patients, stabilization of intraocular pressure occurs within a few weeks, so it is recommended to control intraocular pressure during the first month of treatment. In case of insufficient clinical efficacy of monotherapy prescribe additional therapy.

Side effect
On the part of the vision: often - short-term discomfort in the eyes after instillation, tearing, and in some cases - reducing the sensitivity of the cornea, redness of the eye, point keratitis, photophobia, anisocoria, photophobia, itching, dryness of the eyes.
CNS: Rarely - insomnia, depressive neurosis.

Contraindications
hypersensitivity to the drug.

Precautions should be prescribed the drug for sinus bradycardia, AV-block II and III degree of cardiac failure, cardiogenic shock, myasthenia gravis, diabetes mellitus.

Pregnancy and lactation

Enough experience with the drug Betoptik during pregnancy and lactation no. Use of the drug during pregnancy and lactation (breastfeeding) is possible only when the intended benefits to the mother outweighs the potential risk to the fetus or child.

Cautions

With carefully administered to patients with diabetes, because beta-blockers may mask the symptoms of acute hypoglycemia.

With carefully administered to patients with thyrotoxicosis, because Beta-blockers may mask the symptoms of hyperthyroidism (eg tachycardia). In patients with suspected thyrotoxicosis should not be abruptly canceled beta-blockers, as it may cause increased symptoms.

Keep in mind that beta-blockers can cause symptoms similar to those in infants (diplopia, ptosis, generalized weakness). Precautions should be prescribed beta-blockers in patients with severe impairment of respiratory system.

Despite the fact that clinical studies have shown no effect of betaxolol on lung function, we can not exclude the possibility of hypersensitivity to the drug. Before elective surgery should be phased out of beta-blockers for 48 hours before general anesthesia because during general anesthesia, they can reduce the sensitivity of the myocardium to sympathetic stimulation. Patients who used beta-blockers, may have a history of atopy or anaphylactic reactions. In the case of repeated hypersensitivity reactions, such patients may not be sensitive to the usual doses of epinephrine (adrenaline), required for relief of anaphylaxis.

The drug should be administered with caution in patients with Raynaud's syndrome or pheochromocytoma. When backfilling in the eye of beta-blockers may be absorbed into the systemic circulation.

At the same time may experience the same side effects as in the system application. There are cases of severe respiratory and cardiovascular disorders, including fatal bronchospasm in patients with bronchial asthma and death from heart failure. Betoptik has minimal effect on blood pressure and heart rate. However, caution should be exercised in the appointment of the drug to patients with AV-block or heart failure.

Treatment Betoptikom should immediately stop when the first symptoms of decompensation of the cardiovascular system.

Use caution when sharing application Betoptika and adrenergic psychotropic drugs. Eye drops Betoptik contain preservatives that may be deposited in soft contact lenses and have a damaging effect on the tissue of the eye. Therefore, patients who wear contact lenses should remove them before applying the drops and set back no earlier than 20 minutes after instillation.

Use in pediatrics

Enough experience with the drug Betoptik have no children.

Effects on ability to drive vehicles and management mechanisms

If, after drops in patients temporarily reduced clarity of vision, until its reconstruction is not recommended to drive and engage in activities that require attention and response.

Overdose

In eyes of excess drug should be flush eyes with lukewarm water.

Drug Interactions

With the simultaneous application of the drug Betoptik and beta-blockers for intake increases the risk of side effects (both local and systemic) due to the additive effect (so patients receiving this combination of drugs should be under medical supervision).

In applying Betoptika in combination with drugs, depletes catecholamines (such as reserpine), may see the decline of blood pressure and bradycardia.

Conditions and terms of

List B. The drug should be stored at a temperature of 8 ° to 30 ° C in places inaccessible to children. Shelf life - 3 years. After opening the bottle of medication must be used within 1 month.

Betaferon

Release form, composition and packing Betaferon 

Valium for a solution for subcutaneous injection in the form of freeze-dried mass of a white enclosed solvent transparent, almost colorless; prepared solution of slightly opalescent to opalescent, colorless or pale yellow. 1 vial. 1 ml of p-pa recombinant interferon beta-1b 9.6 mln.ME (300 mcg) 8 mln.ME (250 mcg). Excipients: human albumin, mannitol. Solvent: sterile rr sodium chloride 0.54% - 1.2 ml.

Clinico-pharmacological group: Interferon. Drug used in multiple sclerosis.

Pharmacological action

Interferon beta-1b, used in multiple sclerosis, has antiviral and immunoregulatory activity. Mechanisms of action of interferon beta-1b in multiple sclerosis is not definitely established. However, it is known that the biological effect of interferon beta-1b is mediated by its interaction with specific receptors that are found on the surface of human cells.

Binding of interferon beta-1b to these receptors induces the expression of a number of substances which are considered as mediators of biological effects of interferon beta-1b. The content of some of these substances were determined in serum and fractions of blood cells of patients treated with interferon beta-1b. Interferon beta-1b decreases the binding capacity and expression of receptors of gamma interferon enhances their dissolution. The drug increases the suppressive activity of peripheral blood mononuclear cells.

As for remitting, and at the secondary-progressive multiple sclerosis treatment Betaferon reduces the frequency (30%) and severity of clinical exacerbations of the disease, the number of hospitalizations and the need for steroid treatment, and lengthens the duration of remission.

In patients with secondary-progressive multiple sclerosis use of Betaseron will delay further progression of disease and disability (including severe when patients are forced to always use a wheelchair) for up to 12 months.

This effect was observed in patients with both acute exacerbations of the disease, with or without exacerbations, as well as with any index of disability (in the study included patients with an estimate from 3.0 to 6.5 points on the expanded disability scale, EDSS).

The results of magnetic resonance imaging (MRI) brain of patients with remitting and secondary-progressive multiple sclerosis patients receiving Betaferon showed a significant positive effect of the drug on the severity of the pathological process, as well as a significant decrease in the formation of new active lesions.

Pharmacokinetics

After subcutaneous injection of Betaseron at a dose of 0.25 mg concentration of interferon beta-1b in serum are low or not determined. In this regard, information on the pharmacokinetics of the drug in patients with multiple sclerosis treated with Betaferon ® at the recommended dose, no.

After subcutaneous injection of 0.5 mg dose to healthy volunteers Cmax is about 40 IU / ml achieved after 8.1 h after injection. The absolute bioavailability of Betaseron when s / c infusion was approximately 50%. With / in the introduction of interferon beta-1b serum clearance, and T1 / 2 are an average of 30 ml / min / kg and 5 h, respectively.

The introduction of Betaseron every other day does not lead to increased concentrations of interferon beta-1b in serum and its pharmacokinetic processes during the course of therapy, apparently, do not change.

When s / c infusion at a dose of Betaseron 0.25 mg a day in healthy volunteers, levels of biological response markers (neopterin, beta2-microglobulin and the immunosuppressive cytokine IL-10) significantly increased compared to benchmarks 6-12 hours after the first dose of the drug.

They reached a peak after 40-124 h and remained elevated throughout the 7-day (168 h) study period.

Statement
clinically isolated syndrome (CIS) (the only clinical demyelinating event suggestive of multiple sclerosis, subject to exclusion of alternative diagnoses) with sufficient severity of the inflammatory process for appointment / to SCS - for slowing the transition to a clinically reliable multiple sclerosis (KDRS) in patients with high risk of KDRS.

Universally accepted definition of high risk do not. According to a study by a group at high risk for KDRS include patients with monoochagovym CIS (clinical manifestations of a lesion in the CNS) and ≥ T2 foci on MRI and / or accumulated contrast agent centers.

Patients with multifocal CIS (clinical manifestations of> 1 lesion in the CNS) are at high risk of developing KDRS regardless of the number of lesions on MRI;
remitting multiple sclerosis - to reduce the frequency and severity of exacerbations of multiple sclerosis in ambulatory patients (ie patients could walk unaided) with a history of at least two exacerbations of the disease over the past 2 years and followed by complete or incomplete recovery of neurological symptoms;
secondary-progressive multiple sclerosis with active disease course characterized by relapses or marked deterioration of neurological functions during the last 2 years - to reduce the frequency and severity of exacerbations, as well as to slow the progression of the disease.

Dosing regimen

Betaseron treatment should be started under the supervision of a physician with experience treating this disease. At present, the question remains about the duration of treatment Betaferon. In clinical studies, the duration of therapy in patients with remitting and secondary-progressive multiple sclerosis as high as 5 and 3 years respectively.

The duration of therapy is determined by your doctor. Recommended dose of Betaseron 0.25 mg (8 mln.ME), which is contained in 1 ml of prepared solution, administered sc every other day. The patient should be informed that in case of missing injections, the drug should be introduced immediately, as soon as he remembers. Following an injection of doing in 48 hours

Rules for preparation of the solution:
A package containing vials and syringes with solvent. To dissolve the lyophilized powder for injection using a syringe attached finished with a solvent and a needle.
A package containing vials, syringes with solvent, the adapter with a needle to the vial and alcohol wipes. To dissolve the lyophilized powder for injection using a syringe made ready with a solvent and an adapter with a needle to the vial. 1.2 ml of solvent (sodium chloride 0.54%) injected into the vial with Betaseron.

The powder should dissolve completely without shaking. Before use, inspect a ready solution. In the presence of particles or changes in color of the solution can not be applied. 1 ml of final solution contains 0.25 mg (8 mln.ME) interferon beta-1b. The drug should be administered sc immediately after the preparation of the solution. If an injection is delayed, the solution should be refrigerated and used within 3 h. The solution must not be frozen.

Side effect

Below are the side effects observed with a frequency of 2% and higher than in the placebo group, patients who in the course of controlled clinical trials received Betaferon dose 0.25 mg / m 2 or 0.16 mg / m 2 every other day for up to 3 years.
From the body as a whole: the reaction at the injection site, fatigue, complex flu-like symptoms, headache, fever, chills, abdominal pain, chest pain, malaise, necrosis at the injection site, pain of various locations.
With the cardiovascular system: peripheral edema, vasodilatation, hypertension, peripheral vascular disease, palpitations, tachycardia.
From the digestive system: nausea, constipation, diarrhea, increased AST and ALT levels 5 times the original level, dyspepsia.
From the hematopoietic system: lymphocytes <1500/mkl, neutrophils <1500/mkl, leukocytes <3000/mkl, lymphadenopathy.
From a metabolism: an increase in body weight.
From the musculoskeletal system: myasthenia, myalgia, arthralgia, leg cramps.
The nervous system: hypertonicity, dizziness, insomnia, loss of coordination, anxiety, nervousness.
With the respiratory system: dyspnea.

Dermatological reactions: rash, skin diseases, increased sweating, alopecia.
With the urinary system: the imperative need to urinate, frequent urination.
From the sexual system: metrorrhagia (acyclic bleeding), menorrhagia, dysmenorrhea, in men - impotence, prostate diseases.

The following side effects are based on postmarketing monitoring the use of Betaferon, grouped by organs and systems are presented with the following frequency of occurrence: Very common (≥ 10%), relatively frequent (<10% - ≥ 1%), infrequent (<1% - ≥ 0.1%), rarely (<0.1% - ≥ 0.01%), very rare (<0.01%). General reaction: very often - flu-like symptoms (fever, chills, myalgia, headache, excessive sweating), the frequency of these symptoms decreased over time, rarely - malaise, chest pain.
From the hematopoietic system: Infrequent - leukopenia, anemia, thrombocytopenia, rarely - lymphadenopathy.
Cardio-vascular system: Infrequent - hypertension, rarely - cardiomyopathy, tachycardia, palpitations.
On the part of the endocrine system: rarely - dysfunction of the thyroid gland, hyperthyroidism, hypothyroidism.
CNS: Infrequent - muscular hypertonicity, depression, rarely - seizures, confusion, agitation, emotional lability, suicidal attempts.
Part of the respiratory system: rarely - dyspnea, bronchospasm.
From the digestive system: Infrequent: - nausea, vomiting, increased activity of ACT, ALT, rarely - increased levels of bilirubin and GGT activity, pancreatitis, anorexia.
From the musculoskeletal system: Infrequent - myalgia.
From the reproductive system: rarely - menstrual irregularities.

Allergic reactions: seldom - anaphylactic reactions.

Local reactions: very common - congestion, local swelling, inflammation, pain, rarely - skin necrosis (with time with continued treatment the frequency of reactions at the site of injection usually decreases).

Betaserc

Release form, composition and packing Betaserc 

The tablets are round, flat, white or nearly white, with beveled edges, labeled "256" on one side and "S" over "∇" - on the other side of the tablet. 1 tab. betahistine dihydrochloride 8 mg. Excipients: microcrystalline cellulose, mannitol, citric acid monohydrate, colloidal silicon dioxide, talc.

The tablets are round, biconvex, white or nearly white, with beveled edges, scored on one side and marked "267" on both sides of the risks and marked "S" over "∇" - on the other side of the tablet. 1 tab. betahistine dihydrochloride 16 mg. Excipients: microcrystalline cellulose, mannitol, citric acid monohydrate, colloidal silicon dioxide, talc.

The tablets are round, biconvex, white or nearly white, with beveled edges, scored on one side and marked "289" on both sides of the risks and marked "S" over "∇" - on the other side of the tablet. 1 tab. betahistine dihydrochloride 24 mg. Excipients: microcrystalline cellulose, mannitol, citric acid monohydrate, colloidal silicon dioxide, talc.

Clinico-pharmacological group: drug improving the microcirculation of the labyrinth that is used in the pathology of the vestibular apparatus.

Pharmacological action

Synthetic analogue of histamine. Acts primarily on the histamine H1-and H3-receptors of the inner ear and vestibular nuclei of the CNS. By direct agonistic effects on histamine H1-receptors in blood vessels of the inner ear, as well as indirectly through effects on the histamine H3-receptors improves microcirculation and capillary permeability of the inner ear, normalizes blood pressure of the endolymph in the labyrinth and cochlea.

Along with that betahistine increases blood flow in the basilar artery. Betaserc also has a strong central effect, as an inhibitor of histamine H3-receptors of the vestibular nerve nuclei. Normalizes conduction in neurons of the vestibular nuclei at the brainstem.

Clinical manifestations of these properties are to reduce the frequency and intensity of vertigo, noise reduction and tinnitus, improvement of hearing in the case of his slides.

Pharmacokinetics

Absorption and distribution

After oral betahistine dihydrochloride rapidly and almost completely absorbed from the gastrointestinal tract. Cmax in plasma is reached after 3 h. Plasma protein binding is low.

Breeding

T1 / 2 of 3-4 hours almost completely excreted by the kidneys as metabolites (2-peridiluksusnoy acid) for 24 h.

Statement
treatment and prophylaxis of vestibular vertigo of various origins;
syndromes characterized by dizziness, headache, tinnitus, progressive hearing loss, nausea and vomiting;
disease and Meniere's syndrome.

Dosing regimen

Drug is prescribed inside during the meal. Improving the condition stated in the beginning of therapy. Stable therapeutic effect is achieved within 2 weeks of Betaserc and can grow while taking the drug for several months.

Treatment of long-term. Duration of therapy set individually.

Side effect

Probably: violations of the gastrointestinal tract. In very rare cases: cutaneous manifestations of allergic reactions (skin rash, itching, hives), angioedema.

Contraindications
hypersensitivity to the drug.

Pregnancy and lactation

Insufficient data to assess the impact of the drug during pregnancy and lactation.

Use in hepatic dysfunction

Cautions

Precautions should be prescribed the drug to patients with gastric ulcer or duodenal ulcer history. During treatment, patients with pheochromocytoma and asthma should be under medical supervision.

Effects on ability to drive vehicles and management mechanisms

Betaserc has no sedative effect and does not affect ability to drive vehicles or operate machinery.

Overdose

Symptoms: nausea, vomiting at a dose of 728 mg, there were reports about the appearance of convulsions.

Treatment: symptomatic therapy.

Drug Interactions

Drug interactions drug Betaserc with other drugs has not been described. Incompatibilities are unknown.

Conditions and terms of

The drug should be stored in a dry place inaccessible to children at or above 25 ° C. Shelf life - 5 years.

Betaloc

Release form, composition and packing Betaloc 
 
Solution for injection in a clear, colorless. 1 ml 1 amp. metoprolol tartrate 1 mg 5 mg. Excipients: sodium chloride, water, d / and.

Clinico-pharmacological group: Beta1-blocker.

Pharmacological action

Cardioselective beta1-blocker without intrinsic sympathomimetic activity. Has little membrane-stabilizing action and does not exhibit partial agonist activity. Metoprolol suppresses or inhibits the stimulatory effect exerted by catecholamines on cardiac activity resulting from the nervous and physical stress.

This means that metoprolol has the ability to prevent an increase in heart rate, cardiac output and myocardial contractility, and increased blood pressure caused a sharp release of catecholamines. Patients with symptoms of obstructive lung disease and if you want to assign metoprolol in combination with beta2-adrenomimetikami.

In a joint application with the beta2-adrenomimetikami Betaloc in therapeutic doses, to a lesser extent affects they cause bronchodilation than nonselective beta-blockers. Metoprolol to a lesser extent than nonselective beta-blockers, affects the production of insulin and carbohydrate metabolism. The influence of the drug Betaloc on the reaction of the cardiovascular system in conditions of hypoglycemia is much less pronounced compared with nonselective beta-blockers.

In patients with myocardial infarction at high / vvvedenii metoprolol reduced chest pain, and reduced risk of developing atrial and atrial flutter. In the intravenous metoprolol at the first sign (within 24 hours after symptom onset) reduces the risk of myocardial infarction. Early treatment with metoprolol leads to further improvement of prognosis of myocardial infarction.

Improving quality of life in the treatment of drug Betaloc observed in patients after myocardial infarction. In paroxysmal tachycardia and atrial flutter () atrial Betaloc reduces heart rate.

Pharmacokinetics

Metabolism

Metoprolol undergoes oxidative metabolism in the liver with the formation of three major metabolites, none of which has no clinically significant beta-blocking effect.

Breeding

The average T1 / 2 of metoprolol from plasma is about 3-5 hours about 5% of the administered dose excreted in the urine in unchanged form.

Statement
supraventricular tachycardia;
Prevention and treatment of myocardial ischemia, tachycardia, and pain in myocardial infarction or suspected it.

Dosing regimen

When supraventricular tachycardia drug is administered IV at an initial dose of 5 mg (5 ml) at 1 - 2 mg / min. You can repeat administration with an interval of 5 min to achieve a therapeutic effect. Usually the total dose of 10-15 mg (10-15 ml). The recommended maximum dose of iv administration of 20 mg (20 ml). With a view to preventing and treating myocardial ischemia, tachycardia, and pain in myocardial infarction or suspected drug he administered iv at a dose of 5 mg (5 ml).

You can repeat administration with an interval of 2 min. The maximum dose - 15 mg (15 ml). 15 min after the last injection prescribed metoprolol (Betaloc ZOK) oral dose of 50 mg every 6 h for 48 h. In patients with impaired renal function, dosage adjustment is required.

Patients with impaired liver function is usually due to a low degree of binding to plasma proteins, dosage adjustment is required.

However, in severe liver dysfunction (patients with portokavalnymi anastomosis) may require a reduction in dose. Elderly patients dosage adjustment is required.

Side effect

To estimate the incidence used the following criteria: very common -> 10%, often - 1-9.9%, sometimes - 0.1-0.9%, rare - 0.01-0.09%, very rare - 0.01%.
With the cardiovascular system: often - bradycardia, postural hypotension (very rarely accompanied by fainting), cold extremities, a feeling the heartbeat, and sometimes - a temporary boost in heart failure symptoms, AV-block I degree, cardiogenic shock in patients with acute myocardial infarction; rarely - other conduction abnormalities, arrhythmias, very rarely - gangrene in patients with previous severe disorders of peripheral circulation.
CNS and peripheral nervous system: Very common - fatigue, often - dizziness, headache, and sometimes - paresthesia, cramps, depression, decreased ability to concentrate, drowsiness or insomnia, nightmares, rarely - increased nervous irritability, anxiety; very rare - impaired memory / amnesia, depression, hallucinations.
From the digestive system: frequent - nausea, abdominal pain, diarrhea, constipation, and sometimes - vomiting, rarely - dry mouth, liver function abnormalities.
From the hematopoietic system: very rarely - thrombocytopenia.
Part of the respiratory system: often - shortness of breath on exertion, and sometimes - bronchospasm in patients with asthma, rarely - rhinitis.
From the musculoskeletal system: very rarely - arthralgia.
From the sensory organs: rarely - blurred vision, dryness and / or eye irritation, conjunctivitis, is very rare - tinnitus, disorders of taste sensations.

Dermatological reactions: sometimes - a rash (in the form of hives), increased sweating, rarely - hair loss, very rarely - photosensitivity, exacerbation of psoriasis.

Other: rarely - impotence / sexual dysfunction, and sometimes - an increase of body weight. Betaloc is well tolerated, side effects are mostly mild and reversible.

In many cases, a causal relationship with the drug has not been established.

Contraindications
AV-block grade II and III;
heart failure in the stage of decompensation;
clinically significant sinus bradycardia;
SSS;
cardiogenic shock;
expressed by peripheral blood circulation disorders (including the threat of gangrene);
hypotension;
patients with acute myocardial infarction with heart rate below 45 beats / min, an interval of more than 0.24 with PQ or systolic blood pressure less than 100 mm Hg;
in the treatment of supraventricular tachycardia in patients with systolic blood pressure less than 110 mm Hg;
patients receiving beta-blockers were contraindicated in intravenous calcium channel blockers (including verapamil);
childhood and adolescence to 18 years (the effectiveness and safety of the drug not established);
hypersensitivity to the drug or other beta-blockers.

Be wary of a drug at AV-blockade of I degree, Prinzmetal angina, COPD (emphysema, chronic obstructive bronchitis, bronchial asthma), diabetes, kidney failure, severe.

Pregnancy and lactation

Like most medicines, Betaloc should not be administered during pregnancy and lactation (breastfeeding), except in cases where the expected benefit duration the mother outweighs the potential risk to the fetus. Like other antihypertensive drugs, beta-blockers can cause side effects such as bradycardia in the fetus, infants or children who are breastfed, and therefore require special care in the appointment of beta-blockers in the III trimester of pregnancy and immediately before delivery. When you receive the mother during lactation metoprolol in therapeutic doses of metoprolol, is excreted in breast milk, and beta-blocking effect of a child who is breastfed, are negligible. Use in hepatic dysfunction in patients with impaired liver function is usually due to a low degree of binding to plasma proteins, dosage adjustment is required.

However, in severe liver dysfunction (patients with portokavalnymi anastomosis) may require a reduction in dose.

Use in renal impairment

Patients with impaired renal function, dosage adjustment is required.

Cautions

Patients suffering from bronchial asthma or obstructive lung disease, should appoint a concomitant bronchodilatory therapy. If necessary, increase the dose of beta 2-adrenomimetic.

In applying the beta1-adrenergic blockers the risk of their influence on carbohydrate metabolism or the possibility of masking of hypoglycemia is much less than the nonselective beta-blockers. In patients with chronic heart failure in decompensated need to get the compensation stage, both before and during drug treatment.

Patients suffering from angina, Prinzmetal, not advisable to appoint non-selective beta-blockers. It is very rare in patients with impaired AV-conduction can occur impairment (a possible outcome - AV-block). If during treatment developed bradycardia, a dose of Betaloc should be reduced. Metoprolol can worsen the symptoms of disorders of the peripheral arterial circulation is mainly due to the reduction of blood pressure. Should be prescribed with care to patients suffering from severe renal insufficiency, metabolic acidosis, together with cardiac glycosides.

Patients taking beta-blockers, anaphylactic shock occurs in a more severe form. Patients suffering from pheochromocytoma, in parallel with the drug Betaloc should appoint an alpha-blocker. In the case of surgical intervention should inform the doctor-anesthesiologist that the patient takes a beta-blocker. Should not appoint a second dose of the drug (second or third) in heart rate below 40 beats / min, with a PQ interval of 0.26 s and systolic blood pressure less than 90 mm Hg

Betaleukin

Release form, composition and packing Betaleukin 

Powder for injection 1 amp. / 1 fl. interleukin-1β 0.05 mg - - 0.5 mg - - 1 mg.

Stabilizer: PVP low molecular weight.

Clinico-pharmacological group: Stimulant leykopoeza. Immunostimulating drug.

Pharmacological action

Stimulant leykopoeza. Has gemostimuliruyuschee and immunostimulatory effects. The drug increases leykopoez and restores the bone marrow hemopoiesis after the damaging effect of cytotoxic drugs and radiation, due to its ability to induce production of colony-stimulating factor and increase proliferation and differentiation of hematopoietic cells of various germs.

Immunostimulatory effect of the drug due to increased functional activity of neutrophils, induction of differentiation of precursors of immune cells, increased lymphocyte proliferation, activation of cytokine production and increased production of antibodies.

Pharmacokinetics

Data on the pharmacokinetics of the drug Betaleukin not given.

Statement
stimulation leykopoeza with toxic leukopenia 2.4 degree, complicating chemo-and radiotherapy of malignant tumors;
patronage leykopoeza when the need for chemotherapy for leukopenia (leukocyte count of peripheral blood at least 3h109 / l);
secondary immunodeficiency that develops after severe trauma, extensive surgery, resulting in septic, purulent-destructive, chronic septic processes.

Dosing regimen

Betaleukin injected sc or iv infusion. To stimulate leykopoeza drug is used at a dose of 15-20 ng / kg body weight, to stimulate the immune system - 5.8 ng / kg body weight. Course of treatment - 5 daily drip intravenous infusion or subcutaneous injection. If necessary to repeat treatments at intervals of 2 weeks. The duration of infusion - 120-180 min.

Rules for the preparation of solutions

For solution for IV infusion contents of the ampoule (vial) was dissolved immediately before use in 1 ml of sterile 0.9% p-ra sodium chloride or water, d / and and bring the total volume of 100 ml 0.9% p-rum sodium chloride.

To achieve the estimated dose infusion the solution was diluted in the required amount (depending on the initial dose of the drug in the vial or bottle, and, accordingly, its concentration in the resulting solution) in 500 ml of 0.9% p-ra sodium chloride or 5% dextrose p-pa .

To obtain a solution for subcutaneous injection contents ampoule (vial) is dissolved in 0.5-1 ml of sterile 0.9% p-ra sodium chloride or water, d / and.

Side effect

Systemic reactions: in some cases - fever, headache, increased body temperature. These reactions continue for 2-3 h after injection, after which the temperature drops and side effects disappear.

Listed side effects are not a contraindication for continuation of treatment. In isolated cases: possible allergic reactions.

Contraindications
hypersensitivity to the drug;
septic shock;
severe fever;
pregnancy.

Pregnancy and lactation

The drug is contraindicated in pregnancy.

Cautions

If you experience severe side effects prescribed paracetamol, metamizol sodium, diphenhydramine, or a combination, you can choose to use corticosteroids.

Overdose

Currently, cases of drug overdose Betaleukin were reported.

Drug Interactions

Drug interactions drug Betaleukin not described.

Conditions and terms of

List B. The drug must be stored and transported at a temperature not exceeding 15 ° C. Shelf life - 2 years.

Betalgon

Release form, composition and packing Betalgon 

Ointment for external use only white or white with a tinge of yellow to light brown in color, with a specific smell.

1 g nikoboksil (β-butoksietilovy ester of nicotinic acid) 25 mg nonivamid (vanililamid pelargonic acid) 4 mg.

Excipients: citral, purified water, beeswax, petroleum jelly.

Clinico-pharmacological group: preparation of local irritant and analgesic effect.

Pharmacological action

Combined preparation for topical use, contains 2 highly vasodilator component. Provides local irritating, distracting and antispasmodic effect, and also has anti-inflammatory, analgesic and warming effect and stimulates local blood circulation.

Improvement of blood circulation in the skin accompanied by increased blood flow in underlying tissues. Effect occurs within minutes after treatment and reaches a maximum within 20-30 min.

Pharmacokinetics

Data on the pharmacokinetics Betalgon not given.

Statement
myalgia and arthralgia;
contusions;
damage to muscles and ligaments;
neuralgia;
osteochondrosis with radicular syndrome;
lumbago;
sciatica;
sports injuries;
disorders of peripheral circulation.

Dosing regimen

Use of the drug Betalgon should begin with the use of very small quantities of ointments. Column ointment no longer than 0.5 cm (size of a pea) with the applicator is applied to the appropriate area of skin (area approximately corresponds to the area of the palm).

To enhance the therapeutic effect of the drug section of the application of ointment can be covered by a woolen cloth. The patient should be warned about the inadmissibility of the use of the drug for more than 10 days without consulting a doctor.

Side effect

Possible: an allergic reaction.

Contraindications
hypersensitivity to the drug. Betalgon should not be applied to the area of open wounds, as well as on irritated or damaged skin.

Pregnancy and lactation

With careful use of medication during pregnancy and lactation (breastfeeding).

Cautions

Avoid getting Betalgona the eyes and mucous membranes (nose and mouth), since when hit causes an unpleasant burning sensation (otherwise harmless). Patients with sensitive skin should not take a hot shower or bath before and after applying Betalgona. After applying Betalgona should wash your hands thoroughly with soap and water.

Use in pediatrics

Not intended for use in children. The appointment of the drug to children decided individually.

Overdose

When applying too much Betalgona effect of the drug can be relaxed, rubbing the skin with a tissue dampened with vegetable oil or nourishing cream.

Drug Interactions

Drug interactions drug Betalgon not described.

Conditions and terms of

The drug should be stored in a dry place, protected from light and away from children, at a temperature above 20 ° C. Shelf life - 2 years.

Betac

Release form, composition and packing Betac 
Tablets, coated in white or almost white, round, biconvex, with Valium on one side on a break - the core of a white or nearly white. 1 tab. betaxolol (as hydrochloride) 20 mg. Excipients: lactose monohydrate, microcrystalline cellulose, sodium starch glycolate, silica colloidal anhydrous, magnesium stearate, hydroxypropyl methylcellulose, titanium oxide, polyethylene glycol 400.

Clinico-pharmacological group: Beta1-blocker.

Pharmacological action

Cardioselective beta1-blocker without intrinsic sympathomimetic activity. Has a weak membrane stabilizing activity. Exerts antihypertensive effects due to reduced cardiac output and a decrease in sympathetic stimulation of peripheral vessels.

When used in therapeutic doses of drug has not expressed cardiodepressive action does not affect the exchange of glucose, does not diminish bronhorasshiryayuschego-acting beta-agonists, does not cause retention of sodium and water in the body.

Effect of the drug begins after 1-2 h, duration - 24 hours antihypertensive effect occurs within 2-5 days, maximum effect develops in 1-2 months.

Pharmacokinetics

Suction

After oral administration is completely absorbed from the gastrointestinal tract (100%). Bioavailability is 90%. Cmax achieved within 2-4 hours

Distribution

Associated with blood proteins by 55%. Vd - from 4.9 to 9.8 L / kg. Slightly penetrates the blood-brain barrier and placental barrier, little is excreted in breast milk.

Breeding

T1 / 2 of 14-22 hours is excreted in urine (15% unchanged). Ground clearance is 4.7 ml / min, clearance increases with age.

Statement
hypertension;
Coronary heart disease: angina and rest myocardial infarction (combined therapy);
hypertrophic cardiomyopathy;
cardiac arrhythmias (sinus tachycardia, supraventricular and ventricular tachyarrhythmia and beats, arrhythmia, combined mitral valve prolapse, hyperthyroidism).

Dosing regimen

Betacam take 1 time per day, regardless of the meal, washed down with water. Hypertension the initial dose is 5-10 mg / day. 1-2 weeks if necessary it was increased to 20 mg.

Side effect
Cardio-vascular system: bradycardia, AV-block, heart failure, orthostatic hypotension, deterioration of peripheral circulation (cold extremities, paresthesias, Raynaud's syndrome).
With the respiratory system: bronchospasm. Allergic reactions: skin rash, urticaria.
CNS: fatigue, depression, fatigue, drowsiness, confusion, hallucinations, dizziness, headache.
From the digestive system: nausea, rarely - vomiting, diarrhea or constipation, cholestasis.
By the authority of: dry eyes.
From the hemopoietic system: leucopenia, thrombocytopenia.

Other: exacerbation of psoriasis, impotency.

Contraindications
chronic heart failure II-III stage;
cardiogenic shock;
AV-block II or III degree;
sinoatrial block;
bradycardia;
Prinzmetal angina;
cardiomegaly;
hypotension (systolic blood pressure less than 100 mm Hg);
diabetes mellitus;
myasthenia gravis;
psoriasis;
Raynaud's syndrome;
endarteritis obliterans;
marked renal dysfunction;
bronchial asthma;
emphysema;
chronic obstructive bronchitis;
increased sensitivity to betaxolol and other ingredients.

Pregnancy and lactation

Use of the drug Betacam during pregnancy and lactation (breastfeeding) is possible with caution and only when the potential benefits of its application to the mother justifies the potential risk to the fetus.

Use in renal impairment

The drug is contraindicated in marked renal impairment.

Cautions

Precautions should be used in the preparation for pheochromocytoma. In the case of the need for routine surgical treatment of the abolition of the preparation is carried out for 48 hours before general anesthesia. Should take into account the possibility of heart failure in the first days of treatment with Betacam in patients with an appropriate disposition. Betaxolol may mask symptoms of hypoglycemia (eg, tachycardia), so that when applied to patients with diabetes should regularly monitor blood glucose levels.

Betacam drug use under control of HR. With the development of bradycardia dose reduce or cancel the product. Upon the termination of therapy with Betacam recommend a gradual reduction in dose (5 mg every 3-4 days) for 1-2 weeks in order to avoid withdrawal symptoms. The drug is not recommended concurrently with MAO inhibitors.

Use in pediatrics

It is not recommended to use the drug in children.

Effects on ability to drive vehicles and management mechanisms

Precautions should be administered to patients whose activities require increased attention and rapid psychomotor reactions.

Overdose

Symptoms: bradycardia, AV-block, falling blood pressure, fainting, heart failure, bronchospasm, seizures.

Treatment: symptomatic. When AV-blockade was shown to intravenous atropine alupenta or epinephrine (adrenaline), a temporary pacemaker. In arterial hypotension, if there are no signs of pulmonary edema, we recommend IV drip infusion of plasma substitutes, and inefficiency - epinephrine (adrenaline), dopamine, dobutamine. In the event of bronchospasm - an inhaled beta 2-adrenoceptor agonists, with cramps - diazepam.

Drug Interactions

In an application with Betacam amiodarone, calcium channel blockers (verapamil, diltiazem) and beta-blockers, used as eye drops for glaucoma, may increase the inhibitory effect of betaxolol on cardiac contractility and cardiac conduction.

In an application with Betacam cardiac glycosides increase the probability of AV-block. Antihypertensive drugs in a joint application with Betacam enhance its hypotensive action.

While the application Betacam with preparations for inhalation anesthesia increases the risk of depression of the myocardium and the development of arterial hypotension. Duration of action of nondepolarizing muscle relaxants may be increased against the background of the simultaneous reception of Betacam. NSAIDs, while the application weaken the hypotensive effect Betacam by retention of sodium and water and inhibition of prostaglandin synthesis in the kidneys. Estrogen also reduces the hypotensive effect Betacam (due to sodium retention). Cocaine, while the application may reduce the therapeutic effects of betaxolol.

The combined use of Betacam and agonists or xanthine their therapeutic effects are relatively weaker. Concomitant use of phenothiazines with Betacam leads to increased concentrations of each drug in blood plasma. Betaxolol slows the excretion of lidocaine and theophylline. Sulfasalazine improves betaxolol in blood serum.

Conditions and terms of

The drug should be stored in a dry place, protected from light and away from children at or above 25 ° C. Shelf life - 2 years.

Betasone

Release form, composition and packing Betasone 

Drops eye / ear in the form of transparent, colorless or slightly yellowish liquid. 1 mL betamethasone sodium phosphate (in terms of dry matter) 1 mg. Excipients: sodium phosphate dibasic, sodium chloride, Disodium EDTA (Trilon B), benzalkonium chloride, ortho-phosphoric acid (to pH 7.0-8.5), sodium hydroxide solution 1M, water d / and.

Clinico-pharmacological group: corticosteroids for topical use in ophthalmology and ENT practice.

Pharmacological action

Betamethasone - GCS provides local anti-inflammatory, antiallergic and vasoconstrictive action. Inhibits fibroblastic processes and the formation of collagen slows down the process of regeneration of the epithelium, inhibits the process of neovascularization in the inflammation, reduces the permeability of the vascular wall.

Statement

Eye diseases:
acute and chronic allergic and inflammatory diseases of the eye (including blepharitis, conjunctivitis, keratoconjunctivitis, scleritis, iritis, iridocyclitis);
Sympathetic ophthalmia;
Prevention and treatment of inflammatory complications after surgery on the eyeball and injuries.

Diseases of the ear:
allergic and inflammatory diseases of the external ear (including allergic otitis externa, chronic eczematous otitis externa, seborrheic otitis externa);
chronic skin disease ear canal, including Lichen simplex chronicus;
as an adjunct to therapy in infectious otitis (except otitis viral etiology).

Dosing regimen

In eye diseases at the beginning of drug therapy instill 1-2 drops into the lower conjunctival sac every 1-2 hours, followed by a gradual decrease in the multiplicity of applications, depending on the therapeutic effect.

In diseases of the ear medication is instilled with 3-4 drops into the ear canal every 2-3 hours after the desired effect should gradually reduce the multiplicity of the drug.

Side effect
On the part of the vision: the thinning or perforation of the cornea and sclera, increased intraocular pressure, posterior subcapsular cataract formation, secondary infection, the spread of Herpes simplex, dermatitis eyelid skin, itching, burning.
From the hearing organ: a burning sensation, pain and tingling in the ear, dermatitis, ear canal. Systemic reactions: suppression of adrenal function (when used in high doses).

Contraindications
fungal eye;
Acute viral infections of the eye (including acute superficial keratitis caused by Herpes simplex);
tuberculous eye disease;
thinning, or a defect of the epithelium of the cornea, sclera;
glaucoma;
fungal skin meatus;
tuberculous lesions ear;
Acute viral infections of the ear;
chronic otitis media or acute otitis media in history;
violation of the integrity of the eardrum;
Hypersensitivity to betamethasone or other ingredients.

Precautions should be used in the preparation for arterial hypertension, cardiac insufficiency, severe renal impairment and liver, nephrolithiasis.

Pregnancy and lactation

The drug during pregnancy is possible only if the expected benefits to the mother outweighs the potential risk to the fetus. If necessary, use during lactation breastfeeding should be discontinued.

Use in hepatic dysfunction

Caution should be used for drug violations expressed in liver function.

Use in renal impairment

Caution should be used for drug violations expressed in kidney function in nephrolithiasis.

Cautions

The drug Betazon should regularly monitor the intraocular pressure, lens status, since the possible development of steroid glaucoma and cataracts. Risk of side effects increases with duration of therapy, therefore use of the drug should be as short as possible (less than 5 days).

If you use contact lenses they must be removed before instillation of the drug and re-establish within 15 minutes after the procedure.

Use in pediatrics

The drug should be used with caution in children younger than 2 years, since the possible suppression of the adrenal cortex.

Effects on ability to drive vehicles and management mechanisms

Use caution when working with machinery and when driving.

Overdose

No cases of overdose Betazon were reported.

Drug Interactions

Drug interactions drug Betazon with other drugs has not been described.

Conditions and terms of

List B. The drug should be kept in the dark, place inaccessible to children, at temperatures from 0 ° to 25 ° C. Term life - 2 years.

Betadrin

Release form, composition and packing Betadrin 

Eye drops are transparent, colorless. 1 ml of diphenhydramine hydrochloride, 1 mg nafazolina nitrate 330 mg Inactive ingredients: boric acid, benzalkonium chloride, Disodium EDTA, purified water.

Clinico-pharmacological group: drug with antiallergic and vasoconstrictor action for local use in ophthalmology.

Pharmacological action

Combined preparation for topical use in ophthalmology. Diphenhydramine is an antagonist of histamine H1-receptors of the first generation. Reduces allergy symptoms caused by histamine release (including increased capillary permeability).

Nafazolin - alpha-adrenoceptor agonists, when applied topically has a vasoconstrictor effect. Therapeutic effect develops within 5 minutes after instillation of the drug and lasts up to 8 hours, with frequent use of the drug duration may be shortened to 6 hours

Pharmacokinetics

When applied topically nafazolin can be absorbed into the systemic circulation and provide a systemic effect. Most likely to develop systemic effects in children under 6 years of age and the elderly.

System action diphenhydramine unlikely.

Statement
exacerbation of seasonal allergic conjunctivitis;
exacerbation of perennial allergic conjunctivitis;
irritation of the conjunctiva in the application of contact lenses;
irritation of the conjunctiva under the influence of external factors (including sunlight, cigarette smoke, water in the swimming pool).

Dosing regimen

Adults and children over 2 years are designated 1-2 drops into the lower conjunctival sac, no more than every 6-8 hours Duration of treatment - 3-5 days. The need for more long-term treatment determined by the physician individually in each case.

Side effect
On the part of the vision: often - burning, itching, eye pain, blurred vision, redness of the conjunctiva; possible mydriasis, increased intraocular pressure.

A case of corneal opacity in the application Betadrina within 7 days of at least 10 times a day (after the drug haze has disappeared).

Systemic reactions: seldom - drowsiness, tachycardia, increased blood pressure, headaches, dizziness, and nausea.

Contraindications
angle-closure glaucoma;
hyperthyroidism;
Children up to age 2 years;
pregnancy;
lactation;
hypersensitivity to the drug.

Pregnancy and lactation

Betadrin contraindicated in pregnancy. It is not known whether diphenhydramine and allocated nafazolin with breast milk, so if you need to use during lactation should decide the issue of termination of breastfeeding.

Cautions

With carefully administered to patients with hypertension, atherosclerosis, arrhythmia, chronic rhinitis, bronchial asthma, as well as the elderly. If during treatment with long lasting symptoms of local irritation or the development of systemic reactions, the drug should be discontinued.

Patients should be warned that without a doctor's prescription should not use the drug for more than 5 days or at intervals of less than 3 hours

Patients should be warned about the need to repeal the drug when symptoms persist or irritation oftalmalgii on therapy for more than 72 hours System action components Betadrina unlikely, but it should be used with caution on patients with hypertension, and cardiac arrhythmia, heightened sensitivity to sympathomimetics ( including in hyperthyroidism, prostatic hypertrophy), as well as in elderly patients.

Patients should be warned that in case of any symptoms that indicate a systemic effect of the drug, you must stop using Betadrina and seek medical advice.

Using the drug is not recommended to wear soft contact lenses. Before the instillation of eye drops should be removed hard contact lenses, set them up again you can at least 15-20 minutes after treatment. It is not recommended to touch the tip of the dropper, as it can cause contamination of eye drops.

Effects on ability to drive vehicles and management mechanisms

Patients who after treatment temporarily lost visual acuity, you should not drive vehicles and working with machines immediately after the instillation of eye drops.

Overdose

Symptoms: Data on overdose at instillation of eye drops in the conjunctival sac absent. For prolonged or too frequent use of the drug in children under 6 years are possible functions of the central nervous system depression, prolonged mydriasis, hypothermia, increased blood pressure.

Treatment: symptomatic therapy of conduct.

Drug Interactions

In the application of preparations containing nafazolin, during treatment with tricyclic antidepressants may increase vasoconstrictive action nafazolina. While the application nafazolina with MAO inhibitors and in the period to 10 days after its cancellation may develop a hypertensive crisis.

Conditions and terms of

List B. The drug should be kept in the dark and away from children at a temperature of 15 ° to 25 ° C. Shelf life - 3 years. After opening the vial shelf life - 4 weeks.

Betadine

Release form, composition and packing Betadine 

Solution for local and topical application of 10% dark brown color that does not contain suspended or precipitated particles. 1 mL of povidone-iodine 100 mg. Other ingredients: glycerol, nonoxynol 9, citric acid (anhydrous), disodium hydrogen phosphate, sodium hydroxide, p-p 10% (to maintain the pH), purified water.

Clinico-pharmacological group: Antiseptic for external and local application.

Pharmacological action

Antiseptic drug. Extracted from the complex with polyvinylpyrrolidone in contact with skin and mucous membranes, iodine forms a protein bacterial cells yodaminy, coagulates it and causes the death of microorganisms. Provides rapid bactericidal action on gram-positive and gram-negative bacteria (excluding M. tuberculosis). Effective against fungi, viruses, protozoa.

Pharmacokinetics

Suction

When applied topically are absorbed almost no iodine.

Statement
treatment and prevention of wound infections in surgery, traumatology, Combustiology, dentistry;
treatment of bacterial, fungal and viral skin infections, prevention of superinfection in dermatological practice;
treatment of pressure sores, venous ulcers, diabetic foot;
Disinfection of the skin and mucous membranes of patients in preparation for surgery, invasive studies (including punctures, biopsies, injection);
Disinfection of the skin around the drains, catheters, probes;
disinfection of oral cavity in dental operations;
Disinfection of the birth canal, during the "small" gynecological surgery (including abortion, IUD insertion, coagulation and the erosion of the polyp).

Dosing regimen

For the treatment of skin and mucous Betadine solution is used undiluted for lubricating, washing or as a wet compress. For use in drainage systems, 10% solution was diluted from 10 to 100 times. The solution was prepared immediately before use, dilute solutions do not store.

Side effect

Allergic reactions: hypersensitivity reactions to the drug, requiring drug withdrawal manifestations of allergic reactions - redness, burning, itching, swelling, and pain.

Contraindications
dysfunction of the thyroid gland (hyperthyroidism);
thyroid adenoma;
Dermatitis herpetiformis Duhring;
simultaneous use of radioactive iodine;
premature and newborn babies;
Hypersensitivity to iodine and other ingredients.

With careful use of medication in chronic renal failure.

Pregnancy and lactation

Application of Betadine is not recommended to the third month of pregnancy and lactation (breastfeeding). If necessary, in these cases, treatment is possible for individual medical supervision.

Use in renal impairment

Caution must be exercised with regular use on damaged skin in patients with chronic renal failure.

Cautions

If you frequently use a large area of the wound surface and mucous membranes may occur systemic reabsorption of iodine, which can affect the tests of functional activity of the thyroid gland.

In violation of thyroid function to use the drug only under strict medical supervision. Use of the drug in newborn infants is possible only if necessary, after the study of thyroid function.

Caution must be exercised with regular use on damaged skin in patients with chronic renal failure. Care should be taken to a patient may not remain over the solution. Do not heat the solution before use.

In place of colored film is formed, continuing to release the total number of active iodine, which means the cessation of the drug. Coloration of the skin and tissues is easily washed off with water. Do not use insect stings, domestic and wild animals.

Overdose

Data on drug overdose Betadine is not available.

Drug Interactions

Betadine is incompatible with other antiseptics, particularly those containing alkali, enzymes and mercury. In the presence of blood bactericidal activity may decrease, but with increasing concentration, bactericidal activity can be increased.

Conditions and terms of

List B. The drug should be kept away from children, dry, dark place at temperatures from 5 ° to 15 ° C. Shelf life - 3 years.

Betagenot

Release form, composition and packing Betagenot 

Drops eye / ear in the form of transparent, colorless or slightly yellowish liquid. 1 mL betamethasone sodium phosphate (in terms of dry matter) 1.316 mg of gentamicin (in the form of sulphate) 3 mg. Excipients: sodium phosphate, monosodium, sodium phosphate dibasic, sodium tetraborate, sodium citrate, sodium chloride, Disodium EDTA (Trilon B), benzalkonium chloride, water, d / and.

Clinico-pharmacological group: drug with anti-bacterial and anti-inflammatory action for topical use in ophthalmology and ENT practice.

Pharmacological action

Combined medication with anti-bacterial and anti-inflammatory, containing betamethasone and gentamicin.

Gentamicin - a broad spectrum antibiotic aminoglycoside, bactericidal effect. Active against Staphylococcus aureus (coagulase-positive and coagulase-negative strains, as well as some strains of penicillinase producing), Pseudomonas aeruginosa, Proteus spp. (Indole-positive and indole-negative strains), Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Haemophilus aegypticus, Aerobacter atrogenes, Moraxella lacunata (wand-Morakca Aksenfelda), Neisseria spp. (Including Neisseria gonorrhoeae). Betamethasone - GCS provides local anti-inflammatory, vasoconstrictive and anti-allergic effect. Inhibits fibroblastic processes and the formation of collagen slows down the process of regeneration of the epithelium, inhibits the process of neovascularization in the inflammation, reduces the permeability of the vascular wall.

Statement

Eye diseases:
Allergy and Infectious Diseases of the anterior eye, caused by pathogens sensitive to gentamicin (including conjunctivitis, keratitis, blepharitis, barley);
Prevention and treatment of inflammatory complications in the postoperative period (removal of cataract surgery for glaucoma).

Diseases of the ear:
Allergic otitis externa;
infective otitis media caused by pathogens sensitive to gentamicin (except otitis viral etiology);
chronic eczematous otitis externa;
seborrheic otitis externa;
chronic skin disease ear canal, including Lichen simplex chronicus.

Dosing regimen

In eye diseases drug instill 1-2 drops into the lower conjunctival sac 4-6 times / day.

In diseases of the ear medication is instilled with 3-4 drops into the ear canal every 2-3 hours after achieving clinical improvement should gradually reduce the multiplicity of the drug to the required, provide control over symptoms.

Side effect

On the part of the vision: the extremely rare - the thinning or perforation of the cornea, sclera, increased intraocular pressure, posterior subcapsular cataract formation, secondary infection, the spread of Herpes simplex, a burning sensation, the narrowing field of vision, acute anterior uveitis, mydriasis, accommodation paresis, ptosis, allergic reactions.
From the hearing organ: a burning sensation, pain and tingling in the ear, dermatitis, ear canal. Systemic reactions: suppression of adrenal function.

Contraindications
fungal eye;
Acute viral infections of the eye (including acute superficial keratitis caused by Herpes simplex);
tuberculous eye disease;
thinning, or a defect of the epithelium of the cornea, sclera;
glaucoma;
trachoma;
fungal skin meatus;
tuberculous lesions ear;
Acute viral infections of the ear;
chronic otitis media or acute otitis media in history;
violating the integrity of the tympanic membrane (possibly the development of ototoxicity);
Infancy;
Hypersensitivity to betamethasone, gentamicin or other ingredients.

Caution should be used drug in heart failure, hypertension, marked renal impairment and liver, nephrolithiasis, diabetes mellitus, high myopia, open-angle glaucoma.

Pregnancy and lactation

The drug is not recommended during pregnancy and lactation.

Cautions

The drug Betagenot should control the intraocular pressure, lens status, since the possible development of steroid glaucoma and cataracts. If you use contact lenses they must be removed before instillation of the drug and re-establish within 15 minutes after the procedure.

Effects on ability to drive vehicles and management mechanisms

Use caution when working with machinery and driving.

Overdose

No cases of overdose Betagenot were reported.

Drug Interactions

Drug interactions drug Betagenot with other drugs has not been described.

Conditions and terms of

List B. The drug should be kept in the dark, place inaccessible to children, at temperatures from 0 ° to 25 ° C. Shelf life - 2 years

Betaver

Release form, composition and packing Betaver 

Of white or nearly white, Valium, with a facet. 1 tab. betahistine dihydrochloride 8 mg Inactive ingredients: microcrystalline cellulose, lactose, corn starch, polyvinylpyrrolidone (povidone), sodium carboxymethyl starch (primogel), talc, colloidal silicon dioxide (Aerosil).

Of white or nearly white, Valium, Bevel and risks. 1 tab. betahistine dihydrochloride 16 mg. Excipients: microcrystalline cellulose, lactose, corn starch, polyvinylpyrrolidone (povidone), sodium carboxymethyl starch (primogel), talc, colloidal silicon dioxide (Aerosil).

Clinico-pharmacological group: drug improving the microcirculation of the labyrinth that is used in the pathology of the vestibular apparatus.

Pharmacological action

Synthetic analogue of histamine. Acts primarily on the histamine H1-and H3-receptors of the inner ear and vestibular nuclei of the CNS. By direct agonistic effects on histamine H1-receptors in blood vessels of the inner ear, as well as indirectly through effects on the histamine H3-receptors improves microcirculation and capillary permeability of the inner ear, normalizes blood pressure of the endolymph in the labyrinth and cochlea. Along with that betahistine increases blood flow to the basilar artery. Possesses a strong central effect, as an inhibitor of histamine H3-receptors of the vestibular nerve nuclei.

Normalizes conduction in neurons of the vestibular nuclei at the brainstem. Clinical manifestations of these properties are to reduce the frequency and intensity of vertigo, noise reduction and tinnitus, improvement of hearing in the case of his slides.

Pharmacokinetics

Absorption and distribution after oral betahistine dihydrochloride rapidly and almost completely absorbed from the gastrointestinal tract. Cmax in plasma is reached after 3 h. Plasma protein binding is low.

Breeding

T1 / 2 of 3-4 hours almost completely excreted by the kidneys as metabolites (2-peridiluksusnoy acid) for 24 h.

Statement
treatment and prophylaxis of vestibular vertigo of various origins;
syndromes characterized by dizziness, headache, tinnitus, progressive hearing loss, nausea and vomiting;
disease and Meniere's syndrome.

Dosing regimen

Drug is prescribed inside during the meal. Improving the condition stated in the beginning of therapy. Stable therapeutic effect is achieved within 2 weeks of taking the drug and may increase when taking the drug for several months. Duration of therapy set individually.

Side effect

Probably: violations of the gastrointestinal tract. In very rare cases: cutaneous manifestations of allergic reactions (skin rash, itching, hives), angioedema.

Contraindications
pregnancy;
Lactation (breastfeeding);
hypersensitivity to the drug.

Precautions should be prescribed the drug to patients with gastric ulcer or duodenal ulcer (including history), patients with pheochromocytoma and bronchial asthma.

Pregnancy and lactation

Insufficient data to assess the impact of the drug during pregnancy and lactation, so its use is contraindicated in those periods.

Cautions

During treatment, patients with gastric ulcer or duodenal ulcer, with pheochromocytoma, with asthma should be under medical supervision. Effects on ability to drive vehicles and management mechanisms Betaver has no sedative effect and does not affect ability to drive vehicles or operate machinery.

Overdose

Symptoms: nausea, vomiting when receiving a dose exceeding 640 mg may cause seizures.

Treatment: gastric lavage, taking activated charcoal, symptomatic therapy.

Drug Interactions

Drug interactions drug Betaver with other drugs has not been described. Incompatibilities are unknown.

Conditions and terms of

List B. The drug should be stored in a dry place, protected from light, place inaccessible to children at or above 25 ° C. Shelf life - 2 years.

Bezpa

Release forms - tablets (Valium) 40 mg Bezpa 

Pharmacotherapeutic group - antispasmodic

Pharmacological action
vasodilating
spasmolytic

Ingredients - drotaverine 40 mg, excipients (lactose, sodium metabilsulfit, povidone K 25, croscarmellose sodium, magnesium stearate, isopropyl alcohol, water)

Statement
Gastrojejunal ulcer
Arteritis unspecified
Pain in the abdomen and pelvis
Headache
Pain, unspecified
Pain, not elsewhere classified
Pain associated with urination
Pain and other conditions associated with female sexual organs and the menstrual cycle
Diseases of the gallbladder, biliary tract and pancreas
Painful urination, unspecified
Secondary dysmenorrhea
Constipation
Stones of the bile duct with cholecystitis
Common symptoms and signs
Miscarriage
Pilorospazme, not elsewhere classified
Unspecified renal colic
Acute cholecystitis
Noninfectious gastroenteritis and colitis, unspecified
Noninfectious enteritis and colitis
Peptic ulcer unspecified location
Spontaneous abortion
Symptoms and signs involving the urinary system
Symptoms and signs involving the digestive system and abdomen
Somatoform dysfunction of the autonomic nervous system
Somatoform disorders
Vascular headache, not elsewhere classified
Vascular diseases of intestines
Vascular disease intestine unspecified
Chronic cholecystitis
Chronic vascular disease
Cholecystitis
Cholecystitis, unspecified
Tenesmus of the bladder
Other diseases of anus and rectum
Other diseases of intestines
Other diseases of esophagus
Other diseases of stomach and duodenum
Other diseases of gallbladder
Other and unspecified abdominal pain
Other disorders of arteries and arterioles
Other noninfectious gastroenteritis and colitis
Other symptoms and signs involving the digestive system and abdomen
Other headache syndromes
Other forms of cholecystitis
Other functional intestinal disorders
Other specified diseases of the anus and rectum
Other specified diseases of gallbladder
Other specified non-infectious gastroenteritis and colitis
Dysuria
Dysmenorrhea, unspecified
Cholelithiasis
Ulcer of the esophagus
Duodenal ulcer
Gastric ulcer

The composition of the components
water
lactose
croscarmellose sodium
magnesium stearate
sodium metabisulfite
povidone
propyl alcohol
drotaverine

Pharmacodynamics

Myotropic antispasmodic. Lowers the tone of smooth muscles of internal organs, reducing their locomotor activity, dilates blood vessels. No effect on the autonomic nervous system, does not penetrate the CNS. In connection with the direct influence on smooth muscle, can be used as a spasmolytic in cases where the drugs are contraindicated in the group holinoblokatorov (glaucoma, prostatic hypertrophy). With / in the introduction beginning effect - after 2-4 minutes, with maximal effect develops after 30 minutes.

Pharmacokinetics

With oral absorption - high, period poluabsorbtsii - 12 min. Bioavailability - 100%.

Application

Prevention and treatment of functional states, and pain caused by spasm of smooth muscle: renal colic, pyelitis, spasm of the ureter, biliary colic, biliary dyskinesia gipermotornaya and gall bladder, cholecystitis, intestinal colic, spastic constipation, spastic colitis, proctitis, tenesmus, pilorospazme. Peptic ulcer and 12 duodenal ulcer in acute phase (in the complex therapy). Pain syndrome spasm of peripheral arteries (endarteritis), brain vessels, coronary arteries. Algomenorrhea, the threat of miscarriage and premature birth, spasm of the cervix during labor, prolonged opening the throat, afterpains. To conduct some instrumental studies, cholecystography.

Dosing regimen

Adults inside appoint 40-80 mg 3 times / day / m, n / k - by 40-80 mg 1-3 times / day. For relief of hepatic and renal colic is administered IV slowly 40-80 mg. When peripheral vascular spasm medication can be administered intraarterially. Children under the age of 6 years, to appoint a single dose of 10-20 mg, 6-12 years - 20 mg, the multiplicity of destination 1-2 times / day.

Side Effects

Dizziness, palpitations, hot flashes, sweating. With / in the introduction hypotension, collapse, AV block, arrhythmias, depression of the respiratory center.

Contraindications

Hypersensitivity, glaucoma, prostate adenoma. With care - patients with severe coronary atherosclerosis, and pregnancy.

Interaction

Reduces antiparkinsonian effect of levodopa.

Cautions

In the treatment of gastric ulcer and 12 duodenal ulcer is used in combination with other antiulcer agents.

Besalol

Release forms - tablets (Valium outline package) Besalol 

Pharmacotherapeutic group - antispasmodic

Pharmacological action
analgesic
antiinflammatory
antimicrobial
spasmolytic

Ingredients - belladonna extract 10 mg, 0.3 g fenilsalitsilat

Statement
Pain in the abdomen and pelvis
Diseases of the digestive
Diseases of the esophagus, stomach and duodenum
Liver disease
Diseases of the gallbladder, biliary tract and pancreas
Noninfectious enteritis and colitis
Other diseases of intestines
Other diseases of the digestive system
Other and unspecified abdominal pain
Cholelithiasis

The composition of the components
belladonna extract
fenilsalitsilat

Pharmacodynamics

Combined preparation has antispasmodic, antisecretory and pain (due to m-anticholinergic activity of herb extracts), antiseptic and anti-inflammatory (due fenilsalitsilata that breaks down in an alkaline medium to phenol and salicylic acid).

Application

Gastro-intestinal tract, accompanied by spasms of smooth muscles of the abdomen and bowel dysbiosis

Dosing regimen

Oral, 1 tablet 2-3 times daily.

Side Effects

Increased intraocular pressure, dry mouth, constipation, mydriasis, accommodation paresis, dizziness, urinary retention, allergic reactions.

Contraindications

Hypersensitivity, angle-closure glaucoma, prostate adenoma, and gastrointestinal bleeding.

Cautions

Avoid using drugs to persons whose work requires high visual acuity.

Berotec

Release form, composition and packing Berotec 
Solution for inhalation transparent, colorless or nearly colorless, free from particles, with an almost imperceptible odor. 1 ml (20 drops), fenoterol hydrobromide, 1 mg. Excipients: benzalkonium chloride, disodium edetate dihydrate, sodium chloride, hydrochloric acid, distilled water.

Clinico-pharmacological group: bronchodilator medication - beta 2-adrenoceptor agonists.

Pharmacological action

Bronchodilator medication, beta2-adrenoceptor agonists. Binding to β2-adrenoceptors, activates adenylyl cyclase via Gs-protein stimulyatorny with subsequent increase of cAMP formation, which in turn activates protein kinase A. The latter phosphorylates the target protein in the cells of smooth muscles, which in turn leads to phosphorylation of myosin light chain kinase, inhibition fosfoinozina hydrolysis and opening of calcium-activated potassium channels fast.

Thus, fenoterol, relaxes smooth muscles of the bronchi and vessels, and also prevents the development of bronchospasm due to the influence of such factors bronhokonstriktornyh as histamine, methacholine, cold air and allergies (immediate type reaction). After taking the drug inhibited the release of mast cell inflammatory mediators.

In addition, after receiving fenoterol at high doses there is increasing mucociliary transport. Fenoterol also shows properties of a stimulator of respiration. Beta-adrenergic effect of the drug on heart function, such as increasing the frequency and strength of heart contractions, due to the vascular action of fenoterol, stimulation of β2-adrenergic receptors of heart, and with the use of doses higher than therapeutic, the stimulation of β1-adrenergic receptors. While taking the drug at high doses the effect is observed at the level of metabolism: lipolysis, glycogenolysis, hyperglycemia, and hypokalemia (the latter is due to increased absorption of potassium of skeletal muscle).

Fenoterol (at high concentrations) inhibits the contractile activity of the uterus. There is insufficient data on the impact of fenoterol hydrobromide on metabolism in diabetes mellitus. Fenoterol alerts and quickly relieves bronchospasm various origins (physical exercise, cold air, the early response to exposure to the allergen). Onset of action of the drug after inhalation - 5 minutes, maximum action - through 30-90 minutes duration - 3-6 hours

Pharmacokinetics

Suction

Depending on the method of inhalation and the inhalation system used by about 10-30% of fenoterol hydrobromide reaches the lower respiratory tract, and the rest is deposited in the upper respiratory tract and swallowed. As a result, a number of inhaled fenoterol hydrobromide enters the gastrointestinal tract. After inhalation of one dose level of absorption is 17% of the dose. Absorption is biphasic: 30% of fenoterol hydrobromide sucked period poluabsorbtsii 11 min, 70% is absorbed slowly with a period poluabsorbtsii 120 min. There is no correlation between the values of the concentration of fenoterol in the blood plasma is reached after inhalation, and the pharmacodynamic curve "time effect".

Prolonged bronchodilatory effect of the drug (3-5 h) after inhalation, comparable with the corresponding effect is achieved after IV administration is not supported by high concentrations of the active substance in the systemic circulation. After oral administration, absorbed about 60% of an oral dose. This part of the active substance biotransformation due to the effect of "first passage" through the liver.

As a result, bioavailability after oral administration is reduced to 1.5%. This explains the fact that the amount of drug swallowed almost no effect on the concentration of the active substance in the blood plasma is reached after inhalation. Time to reach Cmax - 2 hours

Distribution

Plasma protein binding - 40-55%. Fenoterol hydrobromide crosses the placental barrier and is excreted in breast milk.

Metabolism

Biotransformed in the liver by conjugation with sulphates mainly in the intestinal wall.

Breeding

Excreted in the urine and bile as inactive sulphate conjugates.

Statement
relief of asthma attacks;
prevention of exercise-induced asthma;
symptomatic treatment of bronchial asthma or other conditions, accompanied by a reversible narrowing of the airways (including obstructive bronchitis). In patients with bronchial asthma and chronic obstructive pulmonary disease responding to therapy with corticosteroids should be considered the need for concomitant anti-inflammatory therapy;
As bronhorasshiryayuschego funds to inhalation of other drugs (antibiotics, mucolytics, corticosteroids);
for bronchodilation tests in the study of respiratory function.

Dosing regimen

Inhaled drug is prescribed. Keep in mind that 20 drops = 1 ml, 1 drop contains 50 micrograms of fenoterol hydrobromide.

Treatment is carried out under the supervision of a physician. For relief of asthma attacks for adults (including elderly patients) and children over 12 years, to appoint 0.5 ml (10 drops = 500 mg fenoterol hydrobromide). In severe cases, appoint 1-1.25 ml (20-25 drops = 1-1.25 mg fenoterol hydrobromide). In very severe cases, appoint 2 ml (40 drops = 2 mg fenoterol hydrobromide).

Children aged 6 to 12 years (body mass 22-36 kg) designate 0.25-0.5 ml (5-10 drops = 250-500 micrograms fenoterol hydrobromide). In severe cases, take 1 ml (20 drops = 1 mg fenoterol hydrobromide). In extreme cases prescribed 1.5 ml (30 drops = 1.5 mg fenoterol hydrobromide).

For the prevention of bronchial asthma of physical effort for adults (including elderly patients) and children aged 6 to 12 years (body mass 22-36 kg) to designate 0.5 ml (10 drops = 500 mg fenoterol hydrobromide), 4 times / day.

For the symptomatic treatment of bronchial asthma and other conditions involving a reversible narrowing of airways, adults (including elderly patients) and children aged 6 to 12 years (body mass 22-36 kg) to designate 0.5 ml (10 drops = 500 mg fenoterol hydrobromide), 4 times / day.

Children under 6 years of age (weighing less than 22 kg) due to the fact that information about the use of the drug in this age group is limited, we recommend the use of the next dose (only with medical supervision): 50 mg / kg (5-20 drops = 0.25-1 mg) 3 times a day.

Treatment is initiated with the lowest dose.

Terms of use of the drug

The recommended dose should be diluted with saline to a final volume of 3-4 mL, and apply (in full) with the help of an inhaler.

Solution for inhalation should not be diluted with distilled water. Dilution of the solution should be carried out each time before use; residues diluted solution should be destroyed. Dosing may depend on the method of inhalation and type of inhaler. The duration of inhalation can be controlled by spending diluted volume. Solution for inhalation can be applied using a commercially available inhalers. In the presence of oxygen breathing apparatus better solution inhaled at a flow rate of 8.6 l / min. If necessary, spend the next inhalation at intervals of not less than 4 hours

Side effect

The most common adverse effects are fine tremor of skeletal muscles, nervousness, headache, dizziness, tachycardia, increased heart rate.
With the cardiovascular system: rarely (when used in high doses) - decrease in diastolic pressure, increased systolic blood pressure, arrhythmia, angina.
From a metabolism: Hyperglycemia, hypokalemia expressed.
Co of the respiratory system: cough, local irritation, rarely - paradoxical bronchospasm.
From the digestive system: nausea, vomiting.

Other: possible increased sweating, fatigue, myalgia, muscle cramps, weakening of the motility of upper urinary tract is rare - the skin or allergic reactions (especially in patients with hypersensitivity).

Contraindications
tachyarrhythmia;
hypertrophic obstructive cardiomyopathy;
Hypersensitivity to fenoterol hydrobromide and other ingredients.

Precautions should be prescribed the drug in diabetes, recent myocardial infarction, severe diseases of the cardiovascular system, hypertension, hypotension, intestinal atony, hyperthyroidism, pheochromocytoma, hypokalemia.

Pregnancy, lactation

Revealed no adverse effects of the drug on pregnancy. Nevertheless, during pregnancy (especially in the I trimester) drug is given only in cases where the expected benefit to the mother justifies the potential risk to the fetus. Should be aware of the oppressive fenoterol on uterine contractile activity. It is known that fenoterol is excreted in breast milk. Safety of the drug during lactation is not established.

Cautions

In case of sudden appearance and rapid progression of dyspnea the patient should also consult a doctor immediately. Regular use berotek in increasing doses for relief of bronchial obstruction can cause uncontrolled deterioration of the disease.

In the event the bronchial obstruction simply increasing the dose

Berotek longer recommended for a long time not only justified, but also dangerous. To prevent life-threatening deterioration of the disease should consider revising the treatment plan the patient and an adequate anti-inflammatory therapy with inhaled corticosteroids. Other sympathomimetic bronchodilators should be administered simultaneously with berotek only under medical supervision. In the appointment of beta2-agonists may develop hypokalemia.

In this regard, special care is required in severe asthma, as In this case, hypokalemia may result from the simultaneous use of beta2-agonists, ksantinovyh derivatives, steroids and diuretics. In addition, hypoxia may increase the influence of hypokalemia on cardiac rhythm. It is recommended that monitoring of potassium levels in blood plasma.

Berocca Plus

Release form, composition and packing Berocca Plus 

Effervescent Tablets Valium, from pale orange to pale orange, with patches of darker and lighter in color, soluble in water, emitting bubbles forming a solution with the smell of oranges.

1 tab.

ascorbic acid (vit. C) 500 mg.

Thiamin (B1 vit.) 15 mg.

riboflavin (vit. B2) 15 mg.

pantothenic acid (B5 vit.) 23 mg.

pyridoxine hydrochloride (vit. B6) 10 mg.

Folic Acid (vit. Bc) 400 mcg.

cyanocobalamin (vit. B12) 10 mcg.

nicotinamide (vit. PP) 50 mg.

biotin (vit. H) 150 mcg.

Calcium 100 mg.

Magnesium 100 mg.

Zinc 10 mg.

Inactive ingredients: citric acid anhydrous, sodium bicarbonate, sodium carbonate anhydrous, sodium chloride, acesulfame potassium, aspartame, mannitol, polysorbate 60, betakaroten (E160a), beet red dye (E162), orange flavor.

Clinico-pharmacological group: Multivitamins with macro-and micronutrients.

Pharmacological action

Combination drug pharmacological effect which is due to its constituent complex of vitamins and minerals. B vitamins are involved in many metabolic reactions, including synthesis of neurotransmitters.

Vitamin C (ascorbic acid) is a biological antioxidant and plays an important role in the inactivation of free radicals, increases iron absorption in the intestine, affects the metabolism of folic acid and the function of leukocytes.

Stimulates the formation of connective tissue, bone, and normalizes capillary permeability.

Calcium is involved in many physiological processes, enzyme systems and transmission of nerve impulses in combination with magnesium and vitamin B6.

Magnesium is involved in various reactions, including protein synthesis, fatty acid metabolism, oxidation of sugars.

Zinc as a catalyst activates over 200 enzymes and is a component of many proteins, neuropeptides, hormone receptors, and also directly involved in the synthesis of coenzyme derivatives of vitamin B6. Vitamin content in the product Berezhko * Plus chosen for use in therapy and is used for conditions involving deficiency or an increased need for vitamins (increased exercise, a period of prolonged nervous strain, and stress, with defective and unbalanced diet (restricting diet) in the elderly people, chronic alcoholism, nicotine dependence (smokers), as well as use of oral contraceptives in women).

Water-soluble vitamins do not accumulate in the body, so when you state, accompanied by increased demand for vitamins and minerals, vitamins, arriving with food, may be inadequate.

Statement
Deficit or condition associated with an increased need for B vitamins, vitamin C and zinc.

Dosing regimen

The drug is taken orally, after dissolving the tablet in a glass of water.

Adults and children 15 years: 1 tablet per day.

Do not exceed recommended daily dose of the drug.

The recommended duration of treatment is 30 days. Repeated courses on the recommendation of a physician.

Side effect

Allergic reaction: In very rare cases (<1 / 10,000) may be hives, rashes, swelling of the throat.

Digestive system: less than 5% of patients may be slight transient gastrointestinal disturbances.

Blood and hematopoietic system: patients with deficiency of glucose-6-phosphate dehydrogenase deficiency ascorbic acid may cause hemolytic anemia.

Contraindications
hypersensitivity to the drug, hypercalcemia, gipermagniemiya, urolithiasis (nephrolithiasis, urolithiasis), hemochromatosis, hyperoxaluria, renal failure, deficiency of glucose-6-phosphate dehydrogenase, children under the age of 15 years.

With caution in atrophic gastritis, intestinal diseases, pancreatic insufficiency syndrome intake of vitamin B12 or congenital deficiency of intrinsic factor Castle.

Pregnancy and lactation

Using the drug Berokka Plus at the recommended dosage of data about the negative effects of the drug on pregnancy or the child's health is not revealed. However, during pregnancy, the drug should be taken strictly on medical grounds.

Vitamins and minerals contained in the drug Berokka Plus, get into breast milk. Data on the safety of the drug when applied during lactation no.

Cautions

Vitamin C may affect the test results to determine glucose in urine, despite the fact that it does not affect blood sugar levels. Vitamin C should be terminated within a few days before carrying out such tests.

Possible staining of urine into the yellow color that has no clinical significance and attributed to the presence in the preparation of riboflavin.

Product does not contain fat-soluble vitamins. One tablet of the drug contained a maximum daily dose of vitamin B6 (pyridoxine), and therefore should not exceed the recommended dose of medication.

One tablet contains 12,5% of the recommended daily intake of calcium and 33.3% of the recommended daily intake of magnesium. However, for the treatment of deficiency of calcium and magnesium receiving only drug Berokka * Plus is insufficient.

B Each tablet contains 272 mg of sodium, so patients that keep low-salt diet is recommended to take the drug Berokka "Plus, in the form of coated tablets.

Information for patients with diabetes diabetom.V one tablet preparation contains 276 mg of mannitol, which corresponds to 0.028 unit of grain (XE), and energy value of 0.66 kcal, and the drug can be administered to patients with diabetes mellitus. Patients taking other medications should consult with your doctor before you start taking the drug Berokka * Plus.

Effect on ability to drive a car or moving machinery. Not affected.

Overdose

Cases of overdose were reported.

Symptoms of overdose may include gastrointestinal disturbances such as diarrhea and discomfort in the stomach. Excessive intake of vitamin B6 (over 20 pills a day and within a few months) can lead to symptoms of neuropathy.

In case of overdose, discontinue the drug and consult a doctor.

Drug Interactions

Vitamin World Bank (pyridoxine) at a dose exceeding 5 mg, may neutralize the effect of levodopa in patients with Parkinson's disease. However, this antagonism does not occur if levodopa is used in combination with a decarboxylase inhibitor (eg, benserazide, arbidopa).

Thiosemicarbazone and 5-flyuorouratsil neutralize the action of vitamin B1.

Antacids inhibit the resorption of vitamin B1.

Neomycin, aminosalicylic acid, and H2-6lokatory reduce the absorption of vitamin B12.

Aspirin reduces the absorption of ascorbic acid by about a third.

Oral contraceptives can reduce the level of serum vitamin B12, folic acid, pyridoxine, ascorbic acid. Some patients take daily deferoxamine and vitamin C 500 mg, may experience transient left ventricular dysfunction.

Conditions and terms of

Keep out of reach of children. At a temperature not exceeding 25 ° C in tightly closed containers.

Shelf life - 2 years.