Cymbalta
Cymbalta (Duloxetine)Pharmacological action
Antidepressant, inhibitor of return capture of a serotonin and Norepinephrinum (Noradrenalinum). Weakly suppresses Dopaminum capture, does not possess significant affinity to histaminic, to cholinergic and adrenergic receptors. The action Cymbalta mechanism consists in suppression of return capture of a serotonin and Norepinephrinum (Noradrenalinum).Cymbalta possesses the central mechanism of suppression of a painful syndrome, that first of all it is shown by rising of a threshold of painful sensitivity.
Indications
- Depression;
- The painful form of a diabetic neuropathy.
Dosage regimen
The recommended initial dose of a preparation makes 60 mg of 1 times/days
If necessary it is possible to enlarge a daily dose about 60 mg to the maximum dose of 120 mg/sut (parted on 2 receptions). The regular estimation of safety and efficiency of application of a preparation in a dose above 120 mg was not spent.
At patients with the expressed disturbances of function of kidneys (KK <30 ml/mines) the initial dose should make 30 mg of 1 times/days
At patients with disturbances of function of a liver it is necessary to lower an initial dose of a preparation or to reduce frequency rate of reception.
Clinical experience of application of a preparation at patients about 18 years are elderly are not present.
Capsules should be swallowed entirely, not chewing and not crushing. It is impossible to add a preparation in nutrition. The preparation can be accepted irrespective of food intake.
Side effect
By-effects are presented on systems of organs with the indicating of frequency of occurrence according to following criteria: often-> =10 %; sometimes-> =1 %, but <10 %.
From party TSNS: often - giddiness, dream disturbances (drowsiness or a sleeplessness), a headache (the headache became perceptible less often); sometimes - a tremor, delicacy, a sight illegibility.
From the alimentary system: often - dryness in a mouth, a nausea, a constipation; sometimes - a diarrhoeia, vomiting, appetite depression.
From sexual system: sometimes - a delay and ejaculation disturbance, erectile dysfunction.
The other: sometimes - depression of mass of the body, the raised diaphoresis, inflow. At preparation cancellation giddiness, a nausea, a headache often became perceptible. At patients with the painful form of a diabetic neuropathy the insignificant augmentation of a glucose in blood on an empty stomach can be observed.
Contraindications
- Simultaneous application with inhibitors MAO;
- Not compensated angle-closure glaucoma;
- A hypersensibility to a preparation
With care apply at an exacerbation of a maniacal/hypomaniacal condition, epileptic attacks, a mydriasis, disturbance of function of a liver or kidneys, at patients with predilection to suicidal attempts.
Pregnancy and lactemia
Preparation application at pregnancy is possible only in cases when the prospective advantage for mother exceeds potential risk for a foetus Cymbalta since at pregnancy it is not enough clinical experience of application.
In need of application of a preparation in a lactemia it is necessary to solve a question on the termination of thoracal feeding (in the absence of application experience).
Patients should be warned, that in case of offensive or planning of pregnancy in Cymbalta application is necessary for them to inform on it to the attending physician.
Special indicatings
At appointment of inhibitors of return capture of a serotonin in a combination with inhibitors MAO cases of serious reactions, sometimes with a lethal outcome (a hyperthermia, a rigidity, a myoclonus, various disturbances with possible sharp fluctuations of indicators of the vital functions of an organism and change of the mental status, including the expressed excitation with transition in a delirium and to whom) became perceptible. Such reactions are possible also in cases when the inhibitor of return capture of a serotonin has been excellent shortly before appointment of inhibitors MAO (probably development of symptoms, characteristic for a malignant antipsychotic syndrome).
Effects of the combined Cymbalta application and inhibitors MAO were not estimated neither at people, nor at animals.Cymbalta application simultaneously with inhibitors MAO or during the period till 14 days after their cancellation is not recommended.
Against preparation application probably development of a mydriasis, it is necessary to show care at Cymbalta appointment to patients with the raised ophthalmotonus or at persons with risk of development of an acute angle-closure glaucoma.
Against application of a preparation patients should be careful at the alcohol use.
Influence on ability to driving of motor transport and to management of mechanisms
The patients accepting Cymbalta, should be careful at employment by potentially dangerous kinds of activity (because of possible occurrence of drowsiness).
Overdosage
It was informed on several cases of an overdosage at single-step intake to 1.4 g a preparation, not led to a lethal outcome.
Symptoms: a tremor, clonic cramps, vomiting, appetite depression.
Treatment: recommend the control of a condition of cardiovascular system and other basic indicators of vital activity; if necessary spend symptomatic therapy. The specific antidote is not present.
Medicinal interaction
Simultaneous Cymbalta application (in a dose of 60 mg 2 times/sut) did not render appreciable influence on pharmacokinetics of Theophyllinum metabolized CYP1A2. Cymbalta clinically significant impact on a metabolism of other medical products - substrates CYP1A2 hardly makes.
Simultaneous Cymbalta reception with potential inhibitors CYP1A2 can lead to concentration rising Cymbalta since CYP1A2 participates in a Cymbalta metabolism (appointment of such combination demands care and depression of Cymbalta doses).
Conditions and periods of storage
B.Preparat's list should be stored in a place inaccessible to children at temperature from 15 C to 30 C. The Period of validity - 2 years.
Buy Cymbalta online
Here you can order Cymbalta online. Buy cheap Cymbalta just click the link below.
Drug Search
Certificates
We accept
Mastercard and other