Product Overview
Composition
1 tablet contains:
active substance :
amantadine hydrochloride - 100 mg;
Excipients:
lactose monohydrate, starch 1500 (corn starch partially pregelatinized),
croscarmellose sodium
talc,
stearic acid
potato starch,
Opadry II (contains: polyvinyl alcohol, partially hydrolyzed, macrogol 3350, talc, titanium dioxide E 171, aluminum varnish based on yellow quinoline E 104, iron oxide yellow E 172).
pharmachologic effect
Midantan is an antiparkinsonian drug, a tricyclic symmetric adamantamine.
It blocks glutamate NMDA receptors (including in the substantia nigra), thereby reducing the excessive stimulating effect of cortical glutamate neurons on the neostriatum. developing against a background of insufficient excretion of dopamine. Reducing the flow of ionized Ca2 + into neurons, reduces the possibility of their destruction.
To a greater extent affects stiffness (rigidity and bradykieziyu).
Pharmacokinetics
After oral administration, it is well absorbed in the digestive tract. Cmax in plasma after 5 hours; T1 / 2 of amantadine sulfate - 12-13 hours, amantadine hydrochloride - 30 hours. It is excreted by the kidneys unchanged.
Indications
Parkinson's disease, Parkinson's syndrome.
Pregnancy and lactation
Contraindicated in pregnancy (I trimester) and in lactation. Take with caution in the second and third trimesters of pregnancy.
Contraindications
Hepatic insufficiency, chronic renal failure, psychosis (including a history), thyrotoxicosis, epilepsy, angle-closure glaucoma, prostatic hyperplasia, hypotension, chronic heart failure stage II – III, state of excitement, predelirium, delirious psychosis, pregnancy planning , pregnancy, lactation, simultaneous administration of triamteren and hydrochlorothiazide, a history of gastric or duodenal ulcer, hypersensitivity to amantadine or other components of the drug, children under 18 years of age.
Side effects
From the side of the nervous system: motor or mental agitation, cramps, headache, dizziness, irritability, insomnia, tremor, mental disorders, accompanied by visual hallucinations.
From the cardiovascular system: heart failure, tachycardia, orthostatic hypotension, arrhythmogenic effect.
From the digestive system: dry mouth, nausea, anorexia, dyspepsia.
From the urinary system: acute urinary retention in patients with prostatic hyperplasia, polyuria, nocturia.
Other: dermatosis, the appearance of a bluish color of the skin of the upper and lower extremities, a decrease in visual acuity.
Interaction
Central nervous system stimulating drugs and ethanol increase the risk of side effects. Enhances the effect of levodopa, psychostimulants. Compatible with central anticholinergics and other anti-Parkinsonian drugs.
How to take, course of administration and dosage
Parkinson's disease, Parkinson's syndrome: amantadine is prescribed in an initial dose of 100 mg daily for the first week, then the dose is increased to 100 mg twice a day.
The necessary dose should be established depending on the severity of the symptoms of parkinsinsonism and tolerance to the drug. A dose in excess of 200 mg per day may provide some additional effect, but is associated with an increased risk of toxicity. Do not exceed a dose of 400 mg per day.
The daily dose should be increased gradually, with an interval of at least one week. Since patients older than 65 years, as a rule, have reduced renal function and, therefore, higher plasma concentrations of amantadine, these patients should be assigned the lowest dose, leading to the desired effect.
The abolition of amantadine should be carried out gradually, that is, a dose reduction by half with an interval of one week. Abrupt withdrawal of amantadine can aggravate symptoms of parkinsonism, regardless of the patient's response to therapy.
Special instructions
Information about the effectiveness in the treatment of extrapyramidal disorders during treatment with antipsychotic drugs (drug parkinsonism) is contradictory. Therapy should not be stopped suddenly, because a sharp exacerbation of the disease is possible. The use of ethanol while taking the drug is contraindicated.
During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.
Release form
Pills
