Anafranil

Анафранил Drug photo

The description is actual on 07.12.2014

  • Latin name: Anafranil
  • ATH code: N06AA04
  • Active ingredient: Klomipramin (Clomipramine)
  • Producer: AG Novartis of Farm, Switzerland

Structure

As a part of tablets there are 25 mg of a hydrochloride of a klopiramid + corn starch, stearic acid, glitserol 85%, talc, kopovidon, crystal sucrose, disperse yellow dye, microcrystallic cellulose, monohydrate of lactose, colloid silicon dioxide anhydrous, magnesium stearate, a gipromelloz, the titan dioxide, K30 polyvinylpirrolidone, polyethyleneglycol 8000.

One ampoule of solution for injections contains: 25 mg of a hydrochloride of a klopiramid, water, glitserol.

Release form

  • Drug is let out in the form of light yellow tablets, round, convex. On 10 pieces in the blister, on 2 or 3 blisters in a cardboard pack.
  • Also means is on sale in the form of transparent colourless solution for injections. In ampoules on 2 ml, 10 ampoules in a pack.

Pharmacological action

Antidepressant.

Pharmacodynamics and pharmacokinetics

Anafranil (Anafranil) – tricyclic antidepressant. Its main action consists in inhibition of the return capture of noradrenaline and serotonin. This process is carried out by change of concentration of monoamines in the central nervous system and blocking of n2-gistaimnovy receptors.

Klomipramin eliminates psychomotor block, uneasiness, bad mood. Active agent is capable to eliminate night enuresis which is not defined by disturbances in physiology, reduces appetite. There is an establishing process of transfer of serotonin and adrenaline. The therapeutic effect will be swept up after the first week of administration of drug, reaches the effective maximum in 2-3 weeks.

At introduction in oil drug is well and completely acquired. 97% of means contact proteins of a blood plasma.

Medicine reaches equilibrium maximum concentration in 2 weeks of systematic reception. About 2% of substance are found in cerebrospinal fluid. Drug well gets into breast milk.

Drug is metabolized by demethylation, with participation of CYP3A4, CYP2C19 enzymes, і CYP1A2 formed metabolites are active. The period of removal of means from an organism from 18 to 25 hours, depending on a way of introduction.

Metabolites with urine and a stake are removed.

At elderly patients plasma concentration of drug owing to the slowed-down metabolism can significantly differ.

Indications to use

Anafranil appoint:

  • for treatment of depressions of various origin (the endogenous, neurotic, masked, involutional, situational, organic depressions);
  • at depressions at the elderly people called by constant severe pains or somatopathies;
  • at depressions at psychopaths or schizophrenics;
  • at disturbances of mood of the neurotic, psychopathic or reactive nature;
  • for treatment of panic attacks and various phobias;
  • at a katalepsy (narcolepsy);
  • at a presenile and senile depression;
  • for prevention of migraine;
  • for treatment of the night enuresis which is not connected with other diseases.

Contraindications

Drug is not appointed:

  • at an allergy to tricyclic antidepressants, groups of dibenzazepine or a klomipramin;
  • if recently there was a myocardial infarction;
  • to children till 5 flyings;
  • to pregnant women and the feeding women;
  • at reception of MAO inhibitors (two weeks before and after), MAO-A inhibitors of reversible action;
  • at a syndrome of lengthening of an interval of QT.

It is necessary to be careful:

  • at brain injuries;
  • at epilepsy;
  • at a drug combination to neuroleptics;
  • to persons with cardiovascular insufficiency or arrhythmia;
  • at glaucoma or an ischuria;
  • to elderly people;
  • to teenagers;
  • at a tumor of a medulla of adrenal glands;
  • to people who have a tendency to emergence of locks, especially for lying or elderly people;
  • at serious diseases of a liver or a hyperthyroidism;
  • at a neuroblastoma or a pheochromocytoma.

When using medicine it is necessary to control constantly arterial pressure, to watch intraocular pressure.

If the patient uses contact lenses, it is necessary to remember that drug can reduce intensity of a slezootdeleniye. It can lead to damage of a cornea.

Extra care should be observed at intravenous administration of medicine, in order to avoid emergence of an acute anaphylaxis.

Side effects

Side effects of Anafranil are most often expressed poorly, something are similar to depression symptoms. As a rule, effects such pass in the course of treatment or after decrease and achievement of minimum active dosage.

If side reactions serious also threaten the patient's life, drug intake needs to be stopped.

Especially often and obviously side effects are shown at elderly people.

Can be observed:

  • drowsiness, dryness of mucous membranes, fatigue, perspiration, appetite increase, tremor;
  • lock, myoclonus, headache, vision disorders, nausea, weight set;
  • paresthesias, inflow, heartbeat, the raised muscle tone or weakness, disturbances of the speech, mydriasis;
  • tachycardia, strong decrease in the ABP, insignificant distortions on an ECG, vomiting, a diarrhea, pains in epigastriums, increase of activity of enzymes of a liver;
  • small tortoiseshell, galactorrhoea, sonitus, itch and enanthesis, increase in mammary glands, taste distortion;
  • disturbance of a sleep pattern, disorientation, hallucinations, uneasiness and aggression, delirium, problems with memory;
  • spasms, heat, ataxy, changes on the electroencephalogram;
  • glaucoma, disturbances of endocardiac conductivity, an ischuria, hypostases, burning and hypostases in a drug injection site;
  • pneumonitis, anaphylactic and anaphylactoid reactions, purpura, leukopenia, thrombocytopenia and td.

At sharp phase-out of means there is a withdrawal. There are nausea, diarrhea, vomiting, irritability and uneasiness, headaches and sleeplessness. The dosage should be reduced gradually.

Application instruction (Way and dosage)

If the patient has a hypopotassemia, then before administration of drug it needs to be eliminated.

The attending physician has to establish a dosage and a way of drug intake. It is necessary to appoint minimum active dosage and gradually to increase it until achievement of desirable effect. At elderly people and teenagers it is necessary to treat process with bigger care.

The instruction on Anafranil in tablets

Pill is taken inside.

At a depression, phobias and an obsessivno-compulsive syndrome appoint on one tablet 2-3 times a day. The dosage raises within 7 days, on a tablet each 2-3 days. It is necessary to reach a dosage of 100-150 mg. The maximum daily makes 250 mg. After achievement of necessary improvements in a condition of the patient, it is transferred to 2-4 tabeltka a day (50-100 mg).

At a chronic pain syndrome the dosage is established individually, for each patient (10-150 mg a day). At the same time it is necessary to reduce quantity of analgetics.

At fear of open spaces and panic attacks the initial dosage makes 10 mg a day. Further by continuous increase the daily dosage of 25-100 mg is reached. The minimum course of treatment – half a year (at the same time there is a decrease in a dosage).

At a katalepsy and a narcolepsy the recommended quantity of medicine in days – 25-75 mg.

For elderly patients the initial dosage is appointed by 10 mg, and then raise to 50 mg.

For children and teenagers an initial dosage – 25 mg a day. Anafranil's number is increased within 14 days to 100 mg. Further in 2 more weeks the dosage raises to 200 mg. Calculation of a daily dosage from the principle of 3 mg of active ingredient on weight kg is also possible.

At night enuresis: for children of 5-8 years a dosage – 20 or 30 mg a day, aged from 9 to 12 – 25 or 50 mg, is more than 12 years – to 75 mg. Further increase of a dosage is possible if after a week of reception of means of improvement did not come.

It is better to drink tablets before going to bed. A course of treatment – from 3 to three months. By the end of a course it is necessary to return gradually to an initial dosage and to stop reception.

The application instruction of Anafranil in pricks

Intramuscular injections

Treatment begins with introduction from 25 to 50 mg, that is 1-2 ampoules. Then the dosage can be increased every day by one ampoule, the maximum dosage – 6 ampoules a day. Then, after approach of improvements in a state, the dosage should be lowered and replaced with tablets.

Intravenous administration

In an initiation of treatment the drug is administered kapelno, on 2-3 ampoules a day, for once. Infusion duration from one to 3 hours, medicine is parted in 250-500 ml of solution of sodium chloride or glucose. During procedure for the patient it is necessary to watch closely, control the level of arterial pressure.

Treatment, even after approach of improvements it is necessary to continue 3-5 days, then the patient is transferred to tablets.

Children and teenagers are not recommended to appoint such way of administration of drug.

Overdose

Overdose by means can incur for itself serious effects, especially at children. Symptoms are similar for all drugs of group of tricyclic antidepressants.

Symptoms of overdose are shown within 4 hours after hit of means in an organism, their maximum quantity and expressiveness comes in a day. Within 5-6 days the patient has to be under supervision.

At overdose are observed: drowsiness, concern, an ataxy, spasms, fervescence, a coma, a delirium, vomiting, respiratory depression, fever, strong lowering of arterial pressure, arrhythmia and tachycardia, shock, a stupor, heart failure up to on full of a cardiac standstill. Are possible: anury, cyanosis or oliguria.

As therapy it is necessary to make a gastric lavage in the emergency order. If the patient in consciousness – to cause vomiting if is not present, then before washing to make a trachea intubation. To call the ambulance, to give to the victim enterosorbents (absorbent carbon). It is reasonable to make the operations described above even if after overdose there passed more than 12 hours.

Drug has no specific antidote, the hemodialysis and a peritoneal dialysis do not apply. Therefore use modern methods of an intensive care, eliminate spasms, make artificial ventilation of the lungs.

Interaction

Estrogen, Cimetidinum and methylphenidate increase plasma concentration of a klomipramin.

At a drug combination to ephedrine and ethanol, their efficiency increases, but the number and frequency emergence of side reactions increases.

Carbamazepine, rifampicin, Phenytoinum and nicotine reduce concentration of a klomipramin in a blood plasma.

Medicine is capable to strengthen effects of protivoparkinsonichesky means.

At a combination to the following drugs there is a potentiation process:

  • with antitrombotichesky drugs;
  • beta-adrenergic agonists;
  • with antagonists of vitamin K;
  • with antihistaminic drugs;
  • with izoprenaliny and Biperidinum;
  • with Norepinephrinum;
  • with selective serotonin reuptake inhibitors.

Fenotiazina at a concomitant use with means strengthen load of the central nervous system, intestines and a bladder, increase probability of developing of spasms.

If to combine antidepressant with opioid analgeziruyushchy means, Zolpidem and other means, the oppressing TsNS, development of the patient of block, dangerous to life activity, is possible.

Medicine strengthens impact on an organism of drugs for anesthesia.

Hormonal contraceptives increase probability of development of a depression.

The levodopa and furasolidone at a combination to means can increase arterial pressure considerably.

Drugs of lithium lower a threshold of convulsive activity.

The concomitant use of drug with betanidiny, a clonidine can reduce efficiency of the last considerably.

Anafranil's combination and atropine increases efficiency and side reactions from m-holinoblokatorov.

With care it is necessary to combine antidepressant with Disulfiramum as it promotes development of a delirium.

MAO inhibitors, at a combination to medicine can cause a coma, fever, hypertensive crisis and spasms.

Procaineamide, quinidine and thyritropic drugs increase probability of disturbance of a cordial rhythm.

Solution for injections cannot be combined with reception of diclofenac in the same form.

At a combination to gepatotoksichny drugs Anafranil increases load of a liver.

Terms of sale

According to the recipe.

Storage conditions

Medicine is stored in the cool, dark place. Not to allow hit of means to children at all.

Period of validity

5 years.

Special instructions

In the persons predisposed to psychoses and elderly people drug can cause night delirious psychoses. After the termination of reception of means side effects such pass.

During treatment change of level of leukocytes is possible, in this regard it is necessary to control blood indicators.

Care should be shown if the patient has predisposition to locks.

At patients with panic attacks in the first days of treatment the aggravation of symptoms, as a rule, can be observed the health is adjusted in a week.

It is worth combining drug with electroconvulsive therapy in case of careful control over health of the patient.

Reception of antidepressants increases probability of emergence of suicide thoughts, attempts to a suicide. Family members and the patient's environment have to remember it (trustees). Also, if such bents at the patient were not observed earlier, then drug should be cancelled.

During a recipe extract, it is necessary to specify quantity of tablets minimum necessary at the moment, in order to avoid accidental overdose by means.

Analogs

Coincidence on the ATH code of the 4th level:

Analogs: Klofranil, Doksepin, Anafranil Sr, Amitriptyline, Melipraminum.

Zdravzona

  • Anafranil of 25 mg No. 30 tabletkinovartis Farm
  • Anafranil solution for injections 25mg/2ml No. 10 ampulynovartis Farm
  • Anafranil WEDNESDAY of 75 mg No. 20 tabletkinovartis Farm
  • Anafranil WEDNESDAY of 75 mg No. 10 tabletkinovartis Farm

Drugstore of IFC

  • Anafranil tbl p / about 25 mg No. 30, Novartis Pharmashveytsariya
  • Anafranil solution for in 25 mg 2 ml No. 10, Novartis Pharmashveytsariya
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Apteka24

  • Anafranilnovartis Pharma (Italy)
  • Anafranilnovartis Pharma Stein (Switzerland)

Paniapteka

  • Anafranil solution for infection. 25 mg of amp. 2 ml No. 10novartis
Section: For a nervous system
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