Neuromidine (Ipidakrin)15 mg / ml 1 ml, 10 pcs.

1 ml solution contains:

active substance:

ipidacrine hydrochloride monohydrate 15 mg (in terms of ipidacrine hydrochloride)

    
Excipients:

concentrated hydrochloric acid - up to pH 3;

water for injection - up to 1 ml

Neuromidin® has a direct stimulating effect on the conduction of an impulse along nerve fibers, interneuronal and neuromuscular synapses of the central nervous system and peripheral nervous system. The pharmacological action of Neuromidin® is based on a combination of two mechanisms of action: blockade of potassium channels of the membrane of neurons and muscle cells; reversible inhibition of cholinesterase in synapses.

Neuromidin® enhances the effect on smooth muscles not only of acetylcholine, but also of adrenaline, serotonin, histamine and oxytocin.

Neuromidin® has the following pharmacological effects:

- improves and stimulates the conduction of an impulse in the nervous system and neuromuscular transmission;

- enhances contractility of smooth muscle organs under the influence of agonists of acetylcholine, adrenaline, serotonin, histamine and oxytocin receptors, with the exception of potassium chloride;

- improves memory, inhibits the progressive course of dementia.

In preclinical studies, Neuromidin® did not exert teratogenic, embryotoxic, mutagenic, carcinogenic and immunotoxic effects, did not affect the endocrine system.

Pharmacokinetics

After oral administration, intramuscular and subcutaneous administration is rapidly absorbed. Cmax in blood plasma is achieved 1 hour after ingestion and 25-30 minutes after i / m or subcutaneous administration.

Binding to plasma proteins - 40-50% of the active substance. It quickly enters the tissue, the half-life is 40 minutes.

Metabolized in the liver. It is excreted through the kidneys (mainly by tubular secretion and only 1/3 by glomerular filtration) and extrarenal (via the gastrointestinal tract). T1 / 2 of Neuromidin® for parenteral administration is 2-3 hours. After parenteral administration, 34.8% of the dose is excreted unchanged in the urine.

• diseases of the peripheral nervous system (mono- and polyneuropathy, polyradiculopathy, myasthenia gravis and myasthenic syndrome of various etiologies);
• diseases of the central nervous system (bulbar paralysis and paresis; the recovery period of organic lesions of the central nervous system, accompanied by motor and / or cognitive impairment)

Contraindicated in pregnancy.

At the time of treatment should stop breastfeeding.

• hypersensitivity to any of the components of the drug;
• epilepsy;
• extrapyramidal diseases with hyperkinesis;
• angina pectoris;
• severe bradycardia;
• bronchial asthma;
• mechanical obstruction of the intestines or urinary tract;
• vestibular disorders;
• peptic ulcer of the stomach or duodenum in the acute stage;
• pregnancy (the drug increases the tone of the uterus);
• lactation period;
• children under 18 years of age (there is no systematic data on the use).

With caution: with peptic ulcer of the stomach and duodenum, thyrotoxicosis, CCC diseases, as well as in patients with a history of obstructive respiratory system diseases or with acute respiratory tract diseases.

Caused by the excitation of m-cholinergic receptors: salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, bronchospasm, convulsions. Salivation and bradycardia can be reduced with m-anticholinergics (atropine, etc.). Increased uterine tone, skin allergic reactions.

Rarely (after applying higher doses), dizziness, headache, chest pain, vomiting, general weakness, drowsiness, and skin reactions (itching, rash) were observed. In these cases, the dose is reduced or the drug is interrupted for a short time (1-2 days). These side effects are observed in less than 10% of patients.

Neuromidin® enhances the sedative effect in combination with central nervous system depressants.

The effect and side effects are enhanced when combined with other cholinesterase inhibitors and m-cholinomimetic agents. In patients with myasthenia gravis, the risk of developing a cholinergic crisis increases if Neuromidin® is used simultaneously with other cholinergic agents.

The risk of developing bradycardia increases if β-blockers were used before treatment with Neuromidin®.

Neuromidin® can be used in combination with nootropic drugs.

Alcohol enhances the side effects of the drug.

It attenuates the inhibitory effect on neuromuscular transmission and the excitation of peripheral nerves of local anesthetics, aminoglycosides, potassium chloride.

Diseases of the peripheral nervous system:

- mono-and polyneuropathies of various genesis - s / c or IM 5–15 mg 1-2 times a day, course - 10–15 days (in severe cases - up to 30 days); further treatment is continued with a tablet form of the drug;

- myasthenia gravis and myasthenic syndrome - subcutaneous or intramuscularly 15–30 mg 1-3 times a day with a further transition to the tablet form. The general course of treatment is 1-2 months. If necessary, treatment can be repeated several times with a break between courses of 1-2 months.

Diseases of the central nervous system:

- bulbar paralysis and paresis - sc or IM 5–15 mg 1-2 times a day for 10–15 days; if possible, switch to a tablet form;

- rehabilitation with organic lesions of the central nervous system - i / m 10-15 mg 1-2 times a day, course - up to 15 days, then, if possible, switch to the tablet form.

If the next dose was not taken on time, then it is not additionally taken.

The maximum daily dose is 200 mg.

Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, narrowing of the pupils, nystagmus, increased gastrointestinal motility, spontaneous bowel movements and urination, vomiting, jaundice, bradycardia, cardiac conduction disturbances, arrhythmias, anxiety, anxiety, anxiety, anxiety, anxiety ataxia, convulsions, coma, speech disorders, drowsiness, general weakness.

Treatment: with an overdose of tablets - gastric lavage. Appointment of m-anticholinergics, including atropine, cyclodol, metacin, etc. symptomatic therapy.

There is no systematic data on the use of the drug Neuromidin® in children.

At the time of treatment, alcohol should be excluded (enhances the side effects of the drug).

Influence on the ability to drive a car or perform work that requires an increased speed of physical and mental reactions.

During treatment, one should refrain from driving a car, as well as engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Solution for intramuscular and subcutaneous administration