Pramipexole-Teva tablets 250 mg, 30 pcs. (Pramipexole)
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$22.10
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30 pcs Buy Pramipexole-Teva tablets 250 mg, 30 pcs. (Pramipexole) in newyork free shipping. Fast international shipping USA, AU, EU, UK and others.
30 pcs Buy Pramipexole-Teva tablets 250 mg, 30 pcs. (Pramipexole) in newyork free shipping. Fast international shipping USA, AU, EU, UK and others.
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30 pcs
Pharmacological action of
Pramipexole, a dopamine receptor agonist, binds to dopamine D2 receptors with high selectivity and specificity, and has a pronounced affinity for dopamine D3 receptors.
Reduces motor activity deficiency in Parkinson's disease by stimulating dopamine receptors in the striatum.
Pramipexole inhibits dopamine synthesis, release and metabolism, protects dopaminergic neurons from degeneration that occurs in response to ischemia or methamphetamine neurotoxicity.
Clinical studies have shown the efficacy of pramipexole therapy in the late stages of Parkinson's disease, in which there has been a significant decrease in the number of motor disorders and a much later development of complications compared with levodopa monotherapy.
Pharmacokinetics
Absorption. Pramipexole after oral administration is rapidly and completely absorbed, reaching Cmax in plasma after about 1-3 hours. The absolute bioavailability of pramipexole exceeds 90%. The rate of absorption decreases with food intake, however, the total intake is not affected by food intake. Pramipexole is characterized by linear kinetics and a relatively small concentration variability between individual patients.
distribution. Vd is 400 liters. Plasma protein binding is less than 20%.
Metabolism and excretion. Slightly metabolized in the body. About 90% of the dose is excreted by the kidneys (80% - unchanged) and less than 2% - with feces. The total clearance of pramipexole is about 500 ml / min, renal clearance is about 400 ml / min.
The final T1 / 2 is 8 hours in young healthy volunteers and about 12 hours in older people.
Indications
Symptomatic treatment of idiopathic Parkinson's disease (monotherapy or in combination with levodopa) and idiopathic restless legs syndrome.
Contraindications
hypersensitivity.
Restrictions on the use of: Renal failure, hypertension, severe cognitive impairment, pregnancy, breast-feeding.
Use during pregnancy and lactation
It is possible if the expected effect of therapy exceeds the potential risk to the fetus (adequate and well-controlled studies on the use during pregnancy have not been carried out).
FDA category of action on the fetus is C.
During treatment, breast-feeding should be discontinued (there are no data on penetration into breast milk in humans).
Special instructions
Patients should be warned about the risk of hallucinations (especially elderly patients), the possibility of developing orthostatic hypotension (at the beginning of treatment or with an increase in dose). It is prescribed with caution in patients with a history of renal failure. Pramipexole withdrawal is recommended to be carried out gradually (within 1 week).
It should not be used during operation by vehicle drivers and people whose profession is associated with increased concentration of attention.
Composition
Active ingredient: pramipexole dihydrochloride monohydrate 0.25 mg
Excipients: mannitol MCC carboxymethyl starch sodium povidone K25 silicon dioxide colloidal magnesium sodium stearate stearyl fumarate
Dosage and administration
Inside, 3 times a day. The initial dose at any stage of Parkinson's disease is 0.375 mg / day. If necessary, increase the dose, but not more often than every 5-7 days (until the optimal therapeutic effect is achieved, taking into account the occurrence of side effects): 2nd week of treatment - 0.75 mg / day, 3rd week - 1.5 mg / day and further, increasing dose of 0.75 mg per week to a maximum of 4.5 mg / day. The maintenance dose is 1.54.5 mg / day in 3 divided doses. When combined with levodopa, the dose of levodopa can be reduced.
In patients with renal failure, the dose depends on creatinine clearance: with Cl creatinine more than 60 ml / min - 0.125 mg 3 times a day (maximum dose - 1.5 mg 3 times a day), 3559 ml / min - 0.125 mg 2 times a day (maximum - 1.5 mg 2 times a day), 1534 ml / min - 0.125 mg 1 time per day (maximum - 1.5 mg 1 time per day).
Side effects of
From the nervous system and sensory organs: asthenia, drowsiness / insomnia, hallucinations, delirium, amnesia, confusion, dizziness, anxiety, depression, dysphagia, dystonia, akathisia, mental disorders, suicidal ideation extrapyramidal syndrome, dyskinesia, tremor, hyposthesia, hypokinesia, myoclonus, ataxia, impaired coordination of movements, diplopia, accommodation paralysis, conjunctivitis, hearing impairment in isolated cases (with a rapid decrease in dose or sharply cancellation) - malignant antipsychotic syndrome (hyperthermia, muscle rigidity, impaired consciousness, autonomic lability).
From the cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension, tachycardia, arrhythmia.
From the respiratory system: shortness of breath, rhinitis, pharyngitis, sinusitis, flu-like syndrome, increased cough.
From the digestive tract: nausea, vomiting, dyspepsia, flatulence, diarrhea, dry mouth, anorexia, constipation.
From the musculoskeletal system: muscle hypertonicity, cramps in the muscles of the legs, muscle twitching, myasthenia gravis, arthritis, bursitis.
Other: fever, peripheral edema, sweating, increased intraocular pressure, decreased libido, impotence, decreased body weight, increased urination, urinary tract infections, pain, including chest pain, abdominal pain, pain in the lumbosacral spine, neck pain voice change increased activity of CPK allergic reactions.
Drug Interactions
Pramipexole increases Cmax of levodopa by 40% and decreases Tmax from 2.5 to 0.5 hours. Cimetidine increases AUC of pramipexole (by 50%) and T1 / 2 (by 40%). With the simultaneous administration of drugs that are secreted by the cationic transport system of the kidneys (including ranitidine, diltiazem, triamteren, verapamil, quinidine and quinine), the clearance of pramipexole decreases by about 20%. Dopamine antagonists, including antipsychotics (phenothiazines, butyrophenones, thioxanthenes) and metoclopramide may decrease effectiveness.
Interaction with anticonvulsants: A study in healthy volunteers (n = 10) showed that levodopa / carbidopa did not affect the pharmacokinetics of pramipexole. Pramipexole did not change the absorption (AUC) or elimination of levodopa / carbidopa, although it caused an increase in Cmax of about 40% and a decrease in Tmax of levodopa from 2.5 to 0.5 hours.
Selegiline and levodopa did not affect the pharmacokinetics of pramipexole.
The interaction of pramipexole with amantadine has not been studied. However, interaction with amantadine is possible, because these drugs have a similar excretion mechanism.
Overdose
Treatment: gastric lavage, maintenance therapy - iv fluid administration, ECG monitoring when signs of central nervous system excitement appear, antipsychotics (phenothiazines, butyrophenones) may be indicated. The specific antidote is unknown.
Deystvuyuschee substances
Pramypeksol
dosage form
tablets
Pramipexole-Teva tablets 250 mg, 30 pcs. (Pramipexole) newyork in pharmacy online. Cheap price, instruction, side effects, dosage. Pramipexole-Teva tablets 250 mg, 30 pcs. - Sale. PayPal accept. Free shipping newyork. Fast international shipping.
30 pcs
Pharmacological action of
Pramipexole, a dopamine receptor agonist, binds to dopamine D2 receptors with high selectivity and specificity, and has a pronounced affinity for dopamine D3 receptors.
Reduces motor activity deficiency in Parkinson's disease by stimulating dopamine receptors in the striatum.
Pramipexole inhibits dopamine synthesis, release and metabolism, protects dopaminergic neurons from degeneration that occurs in response to ischemia or methamphetamine neurotoxicity.
Clinical studies have shown the efficacy of pramipexole therapy in the late stages of Parkinson's disease, in which there has been a significant decrease in the number of motor disorders and a much later development of complications compared with levodopa monotherapy.
Pharmacokinetics
Absorption. Pramipexole after oral administration is rapidly and completely absorbed, reaching Cmax in plasma after about 1-3 hours. The absolute bioavailability of pramipexole exceeds 90%. The rate of absorption decreases with food intake, however, the total intake is not affected by food intake. Pramipexole is characterized by linear kinetics and a relatively small concentration variability between individual patients.
distribution. Vd is 400 liters. Plasma protein binding is less than 20%.
Metabolism and excretion. Slightly metabolized in the body. About 90% of the dose is excreted by the kidneys (80% - unchanged) and less than 2% - with feces. The total clearance of pramipexole is about 500 ml / min, renal clearance is about 400 ml / min.
The final T1 / 2 is 8 hours in young healthy volunteers and about 12 hours in older people.
Indications
Symptomatic treatment of idiopathic Parkinson's disease (monotherapy or in combination with levodopa) and idiopathic restless legs syndrome.
Contraindications
hypersensitivity.
Restrictions on the use of: Renal failure, hypertension, severe cognitive impairment, pregnancy, breast-feeding.
Use during pregnancy and lactation
It is possible if the expected effect of therapy exceeds the potential risk to the fetus (adequate and well-controlled studies on the use during pregnancy have not been carried out).
FDA category of action on the fetus is C.
During treatment, breast-feeding should be discontinued (there are no data on penetration into breast milk in humans).
Special instructions
Patients should be warned about the risk of hallucinations (especially elderly patients), the possibility of developing orthostatic hypotension (at the beginning of treatment or with an increase in dose). It is prescribed with caution in patients with a history of renal failure. Pramipexole withdrawal is recommended to be carried out gradually (within 1 week).
It should not be used during operation by vehicle drivers and people whose profession is associated with increased concentration of attention.
Composition
Active ingredient: pramipexole dihydrochloride monohydrate 0.25 mg
Excipients: mannitol MCC carboxymethyl starch sodium povidone K25 silicon dioxide colloidal magnesium sodium stearate stearyl fumarate
Dosage and administration
Inside, 3 times a day. The initial dose at any stage of Parkinson's disease is 0.375 mg / day. If necessary, increase the dose, but not more often than every 5-7 days (until the optimal therapeutic effect is achieved, taking into account the occurrence of side effects): 2nd week of treatment - 0.75 mg / day, 3rd week - 1.5 mg / day and further, increasing dose of 0.75 mg per week to a maximum of 4.5 mg / day. The maintenance dose is 1.54.5 mg / day in 3 divided doses. When combined with levodopa, the dose of levodopa can be reduced.
In patients with renal failure, the dose depends on creatinine clearance: with Cl creatinine more than 60 ml / min - 0.125 mg 3 times a day (maximum dose - 1.5 mg 3 times a day), 3559 ml / min - 0.125 mg 2 times a day (maximum - 1.5 mg 2 times a day), 1534 ml / min - 0.125 mg 1 time per day (maximum - 1.5 mg 1 time per day).
Side effects of
From the nervous system and sensory organs: asthenia, drowsiness / insomnia, hallucinations, delirium, amnesia, confusion, dizziness, anxiety, depression, dysphagia, dystonia, akathisia, mental disorders, suicidal ideation extrapyramidal syndrome, dyskinesia, tremor, hyposthesia, hypokinesia, myoclonus, ataxia, impaired coordination of movements, diplopia, accommodation paralysis, conjunctivitis, hearing impairment in isolated cases (with a rapid decrease in dose or sharply cancellation) - malignant antipsychotic syndrome (hyperthermia, muscle rigidity, impaired consciousness, autonomic lability).
From the cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension, tachycardia, arrhythmia.
From the respiratory system: shortness of breath, rhinitis, pharyngitis, sinusitis, flu-like syndrome, increased cough.
From the digestive tract: nausea, vomiting, dyspepsia, flatulence, diarrhea, dry mouth, anorexia, constipation.
From the musculoskeletal system: muscle hypertonicity, cramps in the muscles of the legs, muscle twitching, myasthenia gravis, arthritis, bursitis.
Other: fever, peripheral edema, sweating, increased intraocular pressure, decreased libido, impotence, decreased body weight, increased urination, urinary tract infections, pain, including chest pain, abdominal pain, pain in the lumbosacral spine, neck pain voice change increased activity of CPK allergic reactions.
Drug Interactions
Pramipexole increases Cmax of levodopa by 40% and decreases Tmax from 2.5 to 0.5 hours. Cimetidine increases AUC of pramipexole (by 50%) and T1 / 2 (by 40%). With the simultaneous administration of drugs that are secreted by the cationic transport system of the kidneys (including ranitidine, diltiazem, triamteren, verapamil, quinidine and quinine), the clearance of pramipexole decreases by about 20%. Dopamine antagonists, including antipsychotics (phenothiazines, butyrophenones, thioxanthenes) and metoclopramide may decrease effectiveness.
Interaction with anticonvulsants: A study in healthy volunteers (n = 10) showed that levodopa / carbidopa did not affect the pharmacokinetics of pramipexole. Pramipexole did not change the absorption (AUC) or elimination of levodopa / carbidopa, although it caused an increase in Cmax of about 40% and a decrease in Tmax of levodopa from 2.5 to 0.5 hours.
Selegiline and levodopa did not affect the pharmacokinetics of pramipexole.
The interaction of pramipexole with amantadine has not been studied. However, interaction with amantadine is possible, because these drugs have a similar excretion mechanism.
Overdose
Treatment: gastric lavage, maintenance therapy - iv fluid administration, ECG monitoring when signs of central nervous system excitement appear, antipsychotics (phenothiazines, butyrophenones) may be indicated. The specific antidote is unknown.
Deystvuyuschee substances
Pramypeksol
dosage form
tablets
Pramipexole-Teva tablets 250 mg, 30 pcs. (Pramipexole) newyork in pharmacy online. Cheap price, instruction, side effects, dosage. Pramipexole-Teva tablets 250 mg, 30 pcs. - Sale. PayPal accept. Free shipping newyork. Fast international shipping.
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