Simbalta

Симбалта Drug photo

The description is actual on 16.02.2015

  • Latin name: Cymbalta
  • ATH code: N06AX21
  • Active ingredient: Duloksetin (Duloxetine)
  • Producer: ELI LILLY VOSTOK (Switzerland)

Structure

One capsule of drug of Simbalt includes 30 or 60 mg of a duloksetin.

Additional substances: a gipromelloza, triethyl citrate, sucrose, talc, the granulated sugar, gipromelloza acetate succinate, white dye.

Structure of a cover of a capsule: sodium lauryl sulfate, titanium dioxide, indigo carmine, gelatin.

Release form

Kishechnorastvorimy solid capsules with a blue cover and the white body with the put text of "60 mg" or "30 mg ", contain white granules inside. 14 tablets in the blister — one, six or two blisters in a cardboard pack.

Pharmacological action

Antidepressantny action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The blocker of the return capture of noradrenaline and serotonin, also slightly slows down capture of a dopamine; significant affinity to dopamine, histamine, well-cared and to adrenoceptors does not possess. The mechanism of action consists in braking or the termination of the return capture of noradrenaline and serotonin therefore noradrenergichesky and serotonergic neurotransmission in a head brain increases.

Has the central mechanism of weakening of a pain syndrome that is shown by increase of a pain threshold at a neurogenic pain syndrome.

Pharmacokinetics

It is well absorbed from intestines, the greatest concentration is reached in six hours after the use. Reception together with food indirectly reduces absorption by 11%.

Linkng with proteins of plasma reaches 90%. It is actively transformed with participation of CYP1A2 and CYP2D6 enzymes therefore two metabolites are synthesized (5 hydroxies, a 6-metoksiduloksetina sulfate, a 4-gidroksiduloksetin a glucuronide). Time of semi-removal reaches 12 hours. It is removed with urine.

Indications to use

  • painful form of a diabetic neuropathy;
  • depression;
  • chronic musculoskeletal pain syndrome;
  • alarming frustration of generalized type.

Contraindications

  • Sensitization to drug components.
  • Simultaneous use with MAO inhibitors.
  • Dekompensirovanny glaucoma of closed-angle type.
  • Age less than 18 years.
  • Intolerance of fructose, lack of invertase, glucose galactose malabsorption.
  • Serious illness of a liver.
  • Concomitant use of strong inhibitors of CYP1A2 enzyme.
  • Severe form of a chronic renal failure.
  • Arterial hypertension.
  • Age less than 18 years.

It is recommended to use with care Simbalt's drug at spasms, bipolar disorder and mania, intraocular hypertensia, the increased risk of a hyponatremia, suicide thoughts, disturbance of work of a liver and kidneys.

Side effects

  • To thicket of others the headache, nausea, drowsiness, dryness in a mouth, dizziness occur at the patients using duloksetin.
  • Infectious diseases: emergence of laryngitis is possible.
  • Changes from immunity: hypersensitivity, anaphylactic reaction.
  • Changes from the hormonal sphere: hypothyroidism.
  • Changes from a metabolism: dehydration, loss of appetite, hyperglycemia, hyponatremia, syndrome of paradoxical release of antidiuretic hormone.
  • Changes of mentality: alarm, sleeplessness, agitation, decrease in a libido, unusual dreams, disturbance of an orgasm, frustration of a dream, suicide thoughts, bruxism, disorientation, apathy, mania, aggression, hallucinations, hostility.
  • Changes from nervous activity: headache, dyskinesia, drowsiness, dizziness, tremor, dysgeusia, paresthesias, myoclonus, akathisia, lethargy, excitability, concentration disturbance, serotoninovy syndrome, psychomotor excitement, decline in quality of a dream, spasm, extrapyramidal frustration.
  • Changes from touch bodies: mydriasis, vertigo, sight illegibility, glaucoma, sonitus, xerophthalmus, ear pain.
  • Changes from blood circulation: supraventricular arrhythmia, tachycardia, hyperemia, hypertensia, orthostatic hypotension, cold snap of extremities, faints.
  • Changes from breath: pain in a stomatopharynx, yawning, nasal bleeding.
  • Changes from digestion: nausea, diarrhea, dryness in a mouth, vomiting, a lock, dyspepsia, an abdominal pain, a meteorism, a gastroenteritis, gastritis, an eructation, a dysphagy, a smell from a mouth, stomatitis, a gematokheziya, hepatitis, damage of a liver, jaundice.
  • Changes from skin: rash, the increased sweating, an itch, urticaria, night sweating, contact dermatitis, a photosensitization, cold sweat, Stephens-Johnson's syndrome, a Quincke's edema.
  • Changes from a musculoskeletal system: constraint of muscles, musculoskeletal pain, muscular spasms, spasms, lockjaw.
  • Changes from the urinogenital sphere: an ischuria, increase of an urination, a nocturia, a polyuria, a dysuria, disturbance of an ejaculation, erectile dysfunction, changes of a menstrual cycle, gynecologic bleedings, pain in testicles, a galactorrhoea, menopause symptoms, a giperprolaktinemiya.
  • General and local frustration: increased fatigue, disturbance of flavoring feelings, atypical feelings, stethalgia, cryesthesia, fever, thirst, indisposition, gait disturbance.
  • Laboratory and physical data: change of weight; increase of maintenance of ALT, ShchF, nuclear heating plant, bilirubin, GGT, KFK; increase of content of potassium and cholesterol in blood.

Sharp drug withdrawal often causes a syndrome of "cancellation" which is shown: dizziness, headache, touch disturbances, tremor, diarrhea, sleep disorder, weakness, drowsiness, irritability, alarm, nausea.

Application instruction of Simbalta (Way and dosage)

The application instruction of Simbalta orders to swallow capsules entirely, without chewing. It is forbidden to add means to food and to mix with liquids.

The recommended initial dose makes 60 mg once a day. At a number of patients for achievement of the best result it is necessary to raise a dose to 120 mg a day divided into 2 receptions.

At patients with a renal failure of chronic type in an end-stage the initial dose makes 30 mg of drug once a day.

At patients with damages of a liver it is necessary to lower an initial dosage of drug or frequency rate of reception at patients with cirrhosis.

It is not necessary to cancel suddenly therapy by drug. At a treatment stop the dosage should be reduced slowly within 10-14 days to lower risk of emergence of a syndrome of "cancellation".

Overdose

Overdose symptoms: coma, drowsiness, clonic spasms, vomiting, serotoninovy syndrome, tachycardia.

Overdose treatment: a gastric lavage, reception of enterosorbents, at emergence of a serotoninovy syndrome correctional therapy is allowed by Cyproheptadine. It is recommended to carry out control of cordial activity together with purpose of a symptomatic treatment.

Interaction

Because of risk of emergence of a serotoninovy syndrome drug should not be used together with MAO inhibitors and two more weeks after the termination of reception of MAO inhibitors.

Joint reception with potential inhibitors of CYP1A2 and CYP1A2 enzymes can cause increase of content of drug.

It is necessary to be careful when using together with other drugs influencing a nervous system including alcohol.

In rare instances at simultaneous use with other inhibitors of serotonin reuptake and serotonergic drugs emergence of a serotoninovy syndrome is possible.

It is necessary to show attention at Simbalta's use with the drugs which are metabolized system of CYP2D6 enzyme.

Joint reception with anticoagulants can provoke developing of the bleedings connected with interaction of farmakodinamichesky character.

Terms of sale

It is possible to buy drug only according to the recipe.

Storage conditions

To store at a temperature of 15-30 degrees. To protect from children.

Period of validity

Three years.

Special instructions

During reception drowsiness, sedation and other side effects therefore it is necessary to show extra care at control of mobile mechanisms during this period can be observed.

Analogs

Duloksetin Kanon, Alventa, Velaksin, Venlift, Gelarium Giperikum, Deprim Forte, Koaksil, Melitor, Mirazep, Neyroplant, Trittico.

Zdravzona

  • Simbalta of 60 mg No. 14 of a kapsulyela Lille and company
  • Simbalta of 60 mg No. 28 of a kapsulyela Lille and company
  • Simbalta of 30 mg No. 14 of a kapsulyela Lille and company

Drugstore of IFC

  • Simbalta kaps 30 mg No. 14, Lilly S.A. Ispaniyaispaniya
  • Simbalta kaps 60 mg No. 28, Lilly S.A. Ispaniyaispaniya
  • Simbalta kaps 60 mg No. 14, Lilly S.A. Ispaniyaispaniya
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BIOSPHERE

  • Simbalta of 60 mg No. 28 kaps.eli Lilly (USA)
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Section: For a nervous system
in more detail

Education: Graduated from the Vitebsk state medical university majoring in "Surgery". At university headed Council of students' scientific society. Professional development in 2010 - in "Oncology" and in 2011 - in "A mammology, visual forms of oncology".

Experience: Work in an all-medical network 3 years the surgeon (The Vitebsk hospital of an emergency medical service, Lioznensky TsRB) and in combination the regional oncologist and the traumatologist. Work farm the representative within a year in the Rubicon company.

Provided 3 improvement suggestions on the subject "Optimization of an Antibioticotherapia depending on Species Composition of Microflora", 2 works took prizes in a republican competition review of student's scientific works (1 and 3 categories).
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