Esperal

Эспераль Drug photo

The description is actual on 09.07.2014

  • Latin name: Esperal
  • ATH code: N07BB01
  • Active ingredient: Disulfiramum (Disulfiram)
  • Producer: Sanofi-Aventis France (France)

Structure

As a part of means Disulfiramum, and also additional ingredients contains: polividon K30, magnesium stearate, karmelloza of sodium, microcrystallic cellulose.

Release form

Drug is issued in tablets which have the round form, white color with a cream shade. On one party of a tablet — crosswise risk, on another — an engraving "ESPERAL ". Tablets are packed into polypropylene bottles with a stopper on 20 pieces. The bottle is packed into a cardboard pack.

Also medicine Esperal is issued in the form of special gel which is used for carrying out implantation under skin.

Pharmacological action

Tablets and gel Esperal are applied to treatment of alcoholism. Active agent Disulfiramum works, providing the blockade of an atsetaldegidrogenaza which is taking part in an ethanol metabolism. As a result, in an organism concentration of acetic aldehyde, an ethanol metabolite increases. It provokes manifestation at the person of negative feelings (tachycardia, pressure decrease, nausea, vomiting, etc.). Therefore, alcohol intake becomes for it a source of extremely negative feelings. As a result conditioned-reflex disgust for a smell and taste of alcohol is developed.

The greatest therapeutic effect is noted 12 hours later after the use of tablets. Effect of drug can remain for 10-14 days after treatment was stopped.

Esperal an implant gives the chance to support the constant level of Disulfiramum in a human body. It is important to meet the following condition: before implantation will be carried out, the person within several days should not take alcoholic beverages.

Pharmacodynamics and pharmacokinetics

Influence of Disulfiramum is based on blockade of the atsetaldegiddegidrogenaza participating in an alcohol metabolism.

After reception orally from a gastrointestinal tract from 70 to 90% of Disulfiramum are soaked up. Further fast process of a metabolism is noted, substance is recovered to dithiocarbamate which or is removed from an organism in a look a glucloss conjugate, or turns into diethyl amine and carbon sulfide. The last is partially brought through lungs of the person (from 4 to 53%).

Indications to use

Drug is used according to the following indications:

  • prevention and therapy of recurrence of an alcoholism;
  • as additional disintoxication tool at poisoning with nickel which has chronic character.

Contraindications

Categorical contraindication to administration of drug are the following diseases and states:

  • severe form of a liver failure;
  • diabetes mellitus;
  • epilepsy and spasms of any origin;
  • mental diseases;
  • pregnancy and lactation;
  • the expressed sensitivity to drug components.

Relative contraindications are:

Side effects

Before beginning treatment with this drug, the person has to realize accurately what is it and what side effects can be shown in the course of treatment.

Side effects which are shown in view of properties of Disulfiramum: feelings of metal smack in a mouth, manifestation of an unpleasant smell at people with colostomy. In rare instances the optic neuritis, hepatitis, a polyneuritis of the lower extremities, memory impairment, manifestation of confusion of consciousness, headaches, an adynamy, an allergy on skin can develop.

Side effects which are shown owing to Disulfiramum combination with ethanol: manifestation of respiratory insufficiency, collapse, disturbances of neurologic character, disturbance of a heart rhythm, stenocardia, wet brain.

At long treatment means can note: the psychoses similar on alcoholic, gastritis, hepatitis, a polyneuritis aggravation. At the people having cardiovascular diseases thrombosis of vessels of a brain can develop. At paresthesia in a face and extremities it is necessary to cancel means immediately.

If against reception of means the alcohol dose exceeding 50-80 ml (recalculating ethanol for 40%) was accepted, manifestation heavy disturbances in functions of respiratory and cardiovascular systems, spasms, hypostases is possible. Immediate disintoxication treatment is in that case carried out.

Application instruction of Esperal (Way and dosage)

Before therapy begins, the patient has to pass careful inspection. Besides, he has to understand accurately how drug and what effects and complications can be shown in the course of its reception works.

The instruction on Esperal following: a pill is taken inside on 500 mg. Reception is carried out once, in the morning, during food. The application instruction Esperal provides a gradual dose decline of drug to 250 mg or to 125 mg a day. How to accept means and to adjust a dose, the doctor will tell in more detail.

After an initiation of treatment in 7-10 days alcoholic test is carried out: 20-30 ml of 40% of ethanol are accepted after the use of 500 mg of means Esperal. If reaction weak, then a dose of alcohol increases. At the same time the maximum dose can make 100-120 ml of 40% of alcohol. Further one more test in a hospital in 1-2 days is carried out and it is out-patient in 3-5 days. Later drug is used in a daily maintenance dose of 150-200 mg for 1-3 flyings.

Vshivaniye of implants is led to muscle tissue on four centimeters deep into. As a rule, filing is carried out to upper part of buttocks or to the left ileal area. Disinfection and anesthesia is initially carried out, the cut about 6 mm in size is made further. Hypodermic cellulose is moved apart by the special tool then the drug is administered. To in total patient 0,8 g of drug are entered. After implantation is complete, the stitch and a bandage is applied. After a podshivaniye Esperal can act of half a year till five years. Coding continues depending on that dose which was applied.

Overdose

At overdose (combination Disulfiramum ethanol) perhaps oppressions of consciousness, lump, cardiovascular collapse, complications of neurologic character. The symptomatic treatment is in that case carried out.

Interaction

Reception of means with alcohol as in this case there is a reaction of intolerance is contraindicated.

It is undesirable to combine Esperal with the Isoniazid as the behavior disorder and coordination is possible.

At simultaneous use of means with 5-nitro-imidazoles development of confusion of consciousness, delirious frustration is probable.

At a concomitant use with Phenytoinum fast increase in concentration of Phenytoinum in plasma, toxic symptoms can be noted.

With care with drug the following HP are applied:

  • Theophylline as Disulfiramum inhibits its metabolism. Therefore the dose of theophylline needs to be adjusted.
  • Warfarin and some other peroral anticoagulants. There is a danger of bleeding as efficiency of peroral anticoagulants increases. It is regularly necessary to control the level of maintenance of a prothrombin in blood and to adjust a dosage of anticoagulants for eight days after cancellation of Disulfiramum.
  • Benzodiazepines as Disulfiramum increases the level of sedative influence of benzodiazepines, inhibiting their oxidizing metabolism.
  • Tricyclic antidepressants at treatment by Disulfiramum considerably strengthen intolerance of alcohol.

Terms of sale

It is released according to the recipe of the doctor.

Storage conditions

Means needs to be protected from access for children, to store in dry places at the same time air temperature should not be above 25 °C.

Period of validity

It is possible to store Esperal 3 years.

Special instructions

Throughout that time while the person takes a pill Esperal, it is impossible to take alcoholic drinks, and also to accept any HP which contain alcohol.

If the patient uses gel Esperal, alcoholism pills, reaction of its organism to a concomitant use of alcohol can be both fast, and otstrochenny. In the latter case development of toxic hepatitis at which kidneys, a liver, a pancreas are surprised is possible.

Esperal's analogs

Analogs of drug on the main operating component are drugs the Torpedo, Antabusum, Disulfiramum, Lidevin, Teturamum, Tetlong-250. Whether it is reasonable to apply analogs, it is necessary to learn from the doctor surely.

That it is better: Esperal or Esperal Gel?

What form of drug it is reasonable to choose, depends on preferences of the patient. If tablets need to be used according to the scheme, then the vshivaniye of gel provides lasting effect without the need for further reception of means. Nevertheless, it is necessary to consider that the subcutaneous injection of Esperal provides constant high concentration of Disulfiramum in an organism. Therefore at alcohol intake intoxication is possible.

For elimination of drug from an organism neutralization has to be carried out, the antidote is for this purpose used.

Zdravzona

  • Esperal of 500 mg No. 20 tabletkisanofi-Aventis

Drugstore of IFC

  • Esperal tbl 500 mg No. 20, Sanofi-Winthropportugaliya
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Apteka24

  • Esperalsofarimex (Portugal)

Paniapteka

  • Esperal of the tab. of 500 mg No. 20

BIOSPHERE

  • Esperal of 500 mg No. 20 of the tab. of Sofarimeks Industria Kimik and Ld's (Portugal) Pharmaceutics
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Section: Others
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Education: "Pharmacy" graduated from the Rovno state basic medical college majoring in. Graduated from the Vinnytsia state medical university of M. I. Pirogov and internship on its base.

Experience: From 2003 to 2013 – worked at positions of the pharmacist and manager of a pharmaceutical booth. It is awarded by diplomas and distinctions for long-term and honest work. Articles on medical subject were published in local editions (newspaper) and on various Internet portals.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use Esperal surely consult with the attending physician.