Sustanon 250 reviews trometamol – the active ingredient of the drug ® – a non-steroidal anti-inflammatory agent, has analgesic, anti-inflammatory and antipyretic action. The mechanism of action is related to the inhibition of prostaglandin synthesis at the level of cyclooxygenase 1 and 2. Analgesic effect occurs within 30 min after the parenteral administration. The duration of analgesic effect after the administration of 50 mg of 8.4 h. When combination therapy with an opioid analgesic Sustanon 250 reviews trometamol significant number (30-45%) reduces the need for opioid.
Pharmacokinetics. Absorption. The maximum concentration in serum (C max ) following intramuscular administration is achieved Sustanon 250 reviews trometamol average after 20 min (10-45 min). The area under the curve, “concentration-time” (AUC), after single administration at a dose of 25-50 mg dose proportional as intramuscular or intravenous administration. Relevant pharmacokinetic parameters were malay tiger similar after single and repeat intramuscular or intravenous administration, indicating that no drug accumulation. Distribution. For Sustanon 250 reviews trometamol characterized by high plasma protein binding (99%). Average value of volume of distribution (V d ) is less than 0.25 L / kg, poluraspredeleniya time of about 0.35 hours. Excretion. The main route of excretion is Sustanon 250 reviews its conjugation with glucuronic acid and subsequent isolation through the kidneys. The half-life (T1 / 2) is about Sustanon 250 reviews trometamol 1-2,7 hours. In the elderly elongation observed half-life (both after single and repeated after intravenous or intramuscular administration) to an average of 48% reduction of total clearance of the drug .
- Relief of pain of various origins (including post-operative pain, pain with bone metastases, post-traumatic
- the pain, the pain of renal colic, tuberculosis, ischialgia, sciatica, neuralgia, toothache);
- symptomatic treatment of acute and chronic inflammatory, inflammatory, degenerative and metabolic diseases of the musculoskeletal system (including rheumatoid arthritis, spondylitis, osteoarthritis, low back pain).
- Hypersensitivity to deksketoprofenu or other NSAID, or to any of the excipients included in the formulation (see. Composition );
- gastric ulcer and duodenal ulcer;
- gastrointestinal bleeding history, other active bleeding (including intracranial bleeding is suspected), anticoagulant therapy;
- gastrointestinal diseases (Crohn’s disease, ulcerative colitis);
- severe liver function abnormalities (10-15 points on a scale Child-Pugh);
- severe renal dysfunction (creatinine clearance <50 mL / min);
- asthma (including in history);
- severe heart failure;
- treatment of pain in coronary artery bypass surgery;
- hemorrhagic diathesis or other coagulation disorders;
Deksalgin ® is contraindicated for nevraksialnogo (epidural or intrathecal, intrathecal) administration due to a member of the ethanol product.
- a history of allergic conditions;
- hemodyscrasia system;
- systemic lupus erythematosus and mixed connective tissue disease;
- simultaneous therapy of other drugs (see. Interaction with other drugs );
- predisposition to hypovolemia;
- cardiac ischemia;
- Older age (over 65 years).
Pregnancy and lactation
Use of the drug Deksalgin ® during pregnancy and is contraindicated during lactation.
Dosing and Administration Deksalgin ® is intended for intravenous and intramuscular administration. The recommended dose for adults is 50 mg every 8-12 hours, if necessary possible re-introduction of the drug with a 6-hour intervals.. The daily dose is 150 mg. Elderly patients and patients with impaired liver and / or kidney therapy with Deksalgin ® should be initiated with lower doses; daily dose is 50 mg.Deksalgin ® is intended for short-term (no more than 2 days), use during acute pain. Further possible transfer of the patient to oral analgesics. Technique of intramuscular injection The contents of one ampoule (2 ml) was slowly injected by deep intramuscular injection. Technique of intravenous injection , if necessary, the contents of one vial (2 ml) of the drug Deksalgin ® can be entered by slow intravenous injection of no less than 15 seconds. Equipment intravenous infusion of contents of one vial (2 ml) was diluted in 30-100 ml saline, glucose solution or Ringer’s solution (lactate). The solution should be prepared under aseptic conditions and always be protected from exposure to daylight. The diluted solution (to be transparent) is administered by slow intravenous infusion lasting 10-30 min.
Possible side effects when using Sustanon 250 reviews trometamol as the use of other drugs Sustanon 250 reviews, are listed below in descending frequency of occurrence: frequently (10.1% of patients), rare (0.1-1% of patients), rare (0.01 0.1% of patients), very rare (less than 0.01% of patients), including isolated reports. From the circulatory and lymphatic system rare: . anemia very rare: neutropenia, thrombocytopenia.On the part of the central nervous system Uncommon: headache, dizziness , insomnia, somnolence. rare: paresthesia. From the senses Uncommon: . blurred vision rare: tinnitus. On the part of the cardiovascular system Uncommon: hypotension, hot flashes, flushing of the skin. rare: arrythmia, tachycardia, hypertension , peripheral edema, superficial thrombophlebitis. The respiratory system rare: . bradypnea Very rare: bronchospasm, dyspnea. on the part of the gastrointestinal tract Common: nausea, vomiting. Uncommon: abdominal pain, dyspepsia, diarrhea, constipation, hematemesis, dry mouth .rare: . erosive and ulcerative lesions of the gastrointestinal tract, including bleeding and perforation, anorexia Very rare: failure of the pancreas. On the part of the liver and gall bladder rare: elevated liver enzymes, jaundice. Very rare: . liver From the mochevydelitelnoy system rarely : . polyuria, renal colic Very rare: nephritis or nephrotic syndrome. reproductive system rare: in women – menstrual disorders, men – a violation of the prostate gland. On the part of the musculoskeletal system rare: muscle spasms, difficulty of movement in the joints . For the skin Uncommon: dermatitis, rash, sweating. rare: rash, acne. Very rare: severe skin reactions (Stevens-Johnson syndrome, Lyell’s syndrome), angioneurotic edema, allergic dermatitis, photosensitivity. On the part of metabolism rare: hyperglycemia, hypoglycemia, hypertriglyceridemia. From the laboratory parameters rare: ketonuria, proteinuria. Local and general reaction is often: pain at the injection site. Uncommon: inflammatory reaction, hematoma, hemorrhage at the injection site; feeling of fever, chills, fatigue. Rare: . back pain, fainting, fever Very rare: anaphylactic shock, swelling of the face. Other disorders: aseptic meningitis occurring mainly in patients with systemic lupus erythematosus or mixed connective tissue diseases, hematologic disorders (purpura , aplastic and haemolytic anemia, rarely – agranulocytosis and bone marrow hypoplasia).
Overdosing Symptoms: nausea, anorexia, abdominal pain, headache, dizziness, disorientation, insomnia. Treatment: symptomatic therapy; if necessary – gastric lavage, dialysis.
Interaction with other drugs Deksalgin ® should not be mixed in the same syringe with a solution of dopamine, promethazine, pentazocine, pethidine or hydroxyzine (precipitate formed). Deksalgin ® can be mixed in the same syringe with a solution of heparin, lidocaine, morphine and theophylline. Deksalgin ® – diluted solution The infusion should not be mixed with promethazine or pentazocine. Deksalgin ® – diluted solution for infusion is compatible with the following solutions for injection: dopamine, heparin, hydroxyzine, lidocaine, morphine, pethidine and theophylline. When storing Deksalgin ® – diluted solutions for infusion in plastic containers or using infusion systems made of ethyl vinyl acetate, cellulose propionate, low density polyethylene or polyvinyl chloride, the absorption of the active substance listed materials does not occur. The following characteristic interactions of NSAIDs.
Unwanted combination with other NSAIDs, including salicylates in high doses (more than 3 g / day): co-administration of several NSAIDs due to the synergistic effect increases the risk of gastrointestinal bleeding and ulcers. With peroralnymi anticoagulants, heparin doses exceeding preventive and ticlopidine: increase of bleeding risk in connection with the inhibition of platelet aggregation and lesion of the mucosa of the gastrointestinal tract. with lithium preparations: NSAIDs increase the level of lithium in the blood up to the toxic, and therefore the active component is necessary to control the appointment, changing dose and then cancel . NSAIDs with methotrexate in high doses (15 mg / week or more): an increase of haematological toxicity of methotrexate due to the decrease in its renal clearance against the background of NSAID therapy. with hydantoin and sulfanilamidnymi drugs: risk of increased toxic effect of these drugs.
Combinations requiring caution with diuretics, angiotensin-converting enzyme inhibitors: NSAIDs therapy is associated with the risk of acute renal failure in dehydrated patients (reduced glomerular filtration due to decreased synthesis of prostaglandins). NSAIDs may reduce the hypotensive effect of certain drugs. When concomitant administration of diuretics is necessary to make sure that the water balance of the patient is adequate, and to conduct monitoring of renal function before prescribing NSAIDs. With Methotrexate at low doses (less than 15 mg / week): increased haematological toxicity of methotrexate due to the decrease in its renal clearance on background NSAID therapy. It is necessary to carry out the weekly blood count during the first weeks of therapy simultaneously. In the presence of impaired renal function, even in mild as well as in the elderly requires careful medical supervision. Since pentoxifylline: increased risk of bleeding. It requires intensive clinical monitoring and frequent checks bleeding time (clotting time). With Zidovudine: risk of increased toxic effects on red blood cells due to action on reticulocytes, with severe anemia in a week after the appointment of NSAIDs. It is necessary to conduct a count of all blood cells and reticulocytes in 1-2 weeks after initiation of therapy NSAIDs. With sulfanilamidnymi drugs: NSAIDs may enhance the hypoglycemic effect of sulfonylureas due to the displacement of its binding sites to plasma proteins. With the drugs low molecular weight heparin: increased risk of bleeding.
Combinations to be taken into account With .beta. adrenoblokatorami: NSAIDs may reduce the hypotensive effect of β-blockers, which is due to inhibition of prostaglandin synthesis. With cyclosporine and tacrolimus: NSAIDs can increase the nephrotoxicity that is mediated by the action of renal prostaglandins. During concurrent therapy is necessary to monitor renal function. With thrombolytics: increased risk of bleeding. With probenecid: NSAID concentration in the plasma can be increased, which may be due to an inhibitory effect on renal tubular secretion and / or conjugation with glucuronic acid, which requires a dose adjustment NSAIDs. with cardiac glycosides: NSAIDs may lead to increased concentrations of glycosides in the plasma. with mifepristone: due to the theoretical risk of changes in the effectiveness of mifepristone under the influence of inhibitors of prostaglandin synthesis, NSAIDs should not be administered earlier than 8-12 days after mifepristone cancellation. with ciprofloxacin: data from experimental animal studies indicate a high risk of convulsions in the appointment of NSAIDs during therapy with ciprofloxacin at high doses.
Patients with disorders of the gastrointestinal tract or gastrointestinal diseases in history requires constant monitoring. In case of gastrointestinal bleeding or ulcer therapy with Deksalgin ® should be discontinued.
As all NSAIDs can inhibit platelet aggregation and prolong bleeding time due to slowing the synthesis of prostaglandins, in controlled clinical studies have investigated the simultaneous appointment of Sustanon 250 reviews trometamol and drugs of low molecular weight heparin in prophylactic doses in the postoperative period. No effects on coagulation parameters was not observed. However, while the appointment of the drug Deksalgin ® with other drugs that affect blood clotting, careful medical supervision.
As with other NSAIDs, Deksalgin ® can lead to increased levels of creatinine and nitrogen in the blood plasma. Like the other synthesis inhibitors, prostaglandins, Deksalgin ® can have side effects on the urinary system, which may lead to the development of glomerulonephritis, interstitial nephritis, papillary necrosis, nephrotic syndrome, and acute renal failure.
As with other NSAIDs, the therapy drug Deksalgin ® there may be a slight transient increase in some liver parameters, and also significant increase in aspartic and alaninovoi transaminases (AST and ALT) in serum. With this control hepatic and renal function is required in the elderly. In the event of a significant increase in relevant indicators Deksalgin ® should be discontinued. Like other NSAIDs, Sustanon 250 reviews trometamol may mask the symptoms of infectious diseases. In the event of signs of a bacterial infection or worsening of state of health on a background therapy with Deksalgin ® the patient should immediately consult a doctor. Each ampoule preparation Deksalgin ® contains 200 mg of ethanol.
Effects on ability to drive vehicles and management mechanisms
In connection with possible drowsiness and dizziness while taking the drug Deksalgin ® the ability to focus and speed of psychomotor reactions may be reduced in patients.
The solution for intravenous and intramuscular administration of 25 mg / ml. 2 ml of the product in dark glass vials (type I) with a white dot in the upper part of the ampoule. At 1, 5 or 10 vials in contour plastic packaging (pallet), together with instructions for use in a cardboard box.