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Хлоропирамин процент в ампулах

СОДЕРЖАНИЕ
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17 августа 2019

Содержание

Содержание

Структурная формула

Русское название

Латинское название вещества Хлоропирамин

Химическое название

N-[(4-Хлорфенил)метил]-N’,N’-диметил-N-2-пиридинил-1,2-этандиамин (и в виде гидрохлорида)

Брутто-формула

Фармакологическая группа вещества Хлоропирамин

Нозологическая классификация (МКБ-10)

Код CAS

Характеристика вещества Хлоропирамин

Фармакология

Блокирует гистаминовые H1-рецепторы и м-холинорецепторы. Ослабляет спазмогенное действие гистамина на гладкую мускулатуру бронхов и кишечника, уменьшает его гипотензивный эффект и влияние на проницаемость сосудов. Предупреждает развитие и облегчает течение аллергических реакций немедленного типа. Оказывает противозудное, седативное и снотворное действие. Обладает умеренной периферической холинолитической и спазмолитической активностью.

При приеме внутрь полностью и быстро всасывается. Концентрация в крови достигает максимума в течение 2 ч и сохраняется на терапевтическом уровне на протяжении 4–6 ч. Равномерно распределяется в организме, проникает через ГЭБ . Метаболизируется в печени, выводится почками и кишечником.

Применение вещества Хлоропирамин

Аллергические заболевания (крапивница, ринит, конъюнктивит, поллиноз, ангионевротический отек, сывороточная болезнь), медикаментозная аллергия, кожные заболевания (экзема, контактный дерматит, нейродермит, кожный зуд, токсикодермия), начальные стадии бронхиальной астмы легкого течения (в составе комплексной терапии), острые респираторные заболевания и кишечные инфекции у детей (в сочетании с жаропонижающими средствами).

Противопоказания

Гиперчувствительность, в т.ч. к другим производным этилендиамина, закрытоугольная глаукома, аденома предстательной железы с выраженным нарушением уродинамики, беременность, кормление грудью, ранний грудной возраст (до 1 мес).

Ограничения к применению

Обострение эрозивно-язвенных заболеваний ЖКТ , задержка мочеиспускания.

Применение при беременности и кормлении грудью

Противопоказано. На время лечения следует прекратить грудное вскармливание.

Побочные действия вещества Хлоропирамин

Со стороны нервной системы и органов чувств: вялость, слабость, замедление психомоторных реакций, сонливость, головокружение, нарушение координации движений.

Со стороны органов ЖКТ : сухость во рту, тошнота, желудочно-кишечные расстройства; редко — гастралгия.

Взаимодействие

Средства, защелачивающие мочу, повышают, а закисляющие — ослабляют терапевтические и побочные эффекты. Увеличивает риск развития судорог на фоне аналептиков. Усиливает действие наркотических анальгетиков, общих и местных анестетиков, снотворных и седативных средств, этилового спирта. Трициклические антидепрессанты способствуют проявлению м-холинолитических эффектов и угнетающего действия на ЦНС . Барбитураты могут ускорять метаболизм и ослаблять эффекты. Депримирующее действие на ЦНС понижается кофеином и фенамином, усиливается — клофелином.

Передозировка

Симптомы: у взрослых — заторможенность, депрессия, нарушение сознания вплоть до комы, возможны психомоторное возбуждение, судороги, редко — гиперемия, гипертермия. У детей — мидриаз, гиперемия и гипертермия, беспокойство, возбуждение, галлюцинации, атаксия, атетоз, судороги, коллапс, кома.

Лечение: промывание желудка, назначение активированного угля, солевых слабительных, поддержание деятельности сердечной и дыхательной системы, при необходимости — противосудорожная терапия, ИВЛ .

Пути введения

Меры предосторожности вещества Хлоропирамин

При острых аллергических и анафилактических реакциях лечение начинают с в/в введения, затем переходят на в/м . При применении у детей необходим строгий врачебный контроль (возможно проявление повышенной чувствительности). В начальном периоде терапии запрещается вождение транспортных средств и занятие деятельностью, требующей быстрой психической и двигательной реакции. Следует исключить употребление спиртных напитков во время лечения.

Регистрационный номер:

Торговое название препарата:

Международное непатентованное название:

Лекарственная форма:

раствор для внутривенного и внутримышечного введения.

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Состав:

1 ампула (1 мл) содержит в качестве активного вещества хлоропирамина гидрохлорид (в пересчете на 100% вещество) – 20 мг; вспомогательные вещества: вода для инъекций – до 1 мл.

Описание:

бесцветная или слегка желтоватая, или слегка зеленоватая прозрачная жидкость с характерным запахом.

Фармакотерапевтическая группа:

противоаллергическое средство – Н1-гистаминовых рецепторов блокатор.

Код ATX:

Фармакологические свойства

Фармакодинамика
Хлоропирамин является блокатором Н1-гистаминовых рецепторов. По химическому строению относится к производным этилендиамина. Хлоропирамин селективно блокирует Н1-гистаминовые рецепторы и уменьшает проницаемость капилляров. Предупреждает развитие и облегчает течение аллергических реакций. Оказывает седативное, антигистаминное, м-холиноблокирующее и выраженное противозудное действие. Обладает умеренной спазмолитической активностью и противорвотным действием.
Фармакокинетика
Равномерно распределяется в организме, включая центральную нервную систему. Проникает через гематоэнцефалический барьер. Связь хлоропирамина с белками плазмы крови составляет 7,9%. Пик связывания отмечен при pH 6,8-7,4. Терапевтическая концентрация сохраняется 4-6 ч. Интенсивно метаболизируется в печени.
Выводится преимущественно через почки с мочой в виде метаболитов. Выведение хлоропирамина у детей может происходить быстрее, чем у взрослых.

Показания к применению

  • лечение симптомов круглогодичного и сезонного аллергического ринита и аллергического конъюнктивита;
  • поллиноз (сенная лихорадка);
  • крапивница;
  • аллергические дерматозы;
  • лекарственная аллергия;
  • аллергические реакции на укусы насекомых;
  • ангионевротический отек;
  • сывороточная болезнь.

Противопоказания

  • индивидуальная повышенная чувствительность к препарату или его компонентам;
  • острый приступ бронхиальной астмы;
  • одновременное применение ингибиторов моноаминоксидазы;
  • новорожденные дети (до 1 мес.);
  • беременность и период лактации;
  • язвенная болезнь желудка в стадии обострения;
  • гиперплазия предстательной железы;
  • выраженная дыхательная недостаточность.

С осторожностью

Препарат следует назначать с осторожностью пациентам пожилого возраста, при недостаточности функции печени и/или заболеваниях сердца, при язвенной болезни желудка и/или 12-перстной кишки, при приеме лекарственных средств, угнетающих центральную нервную систему (ЦНС), задержке мочи, закрытоугольной глаукоме.

Способ применения и дозы

Внутривенно или внутримышечно.
Взрослым назначают 20-40 мг в сутки (содержимое 1-2 ампул).
Лечение у детей начинают с дозы 5 мг (0,25 мл). В дальнейшем дозу повышают в зависимости от возраста ребенка.
Детям в возрасте 1-12 месяцев – 5 мг (0,25 мл).
Детям в возрасте 1-6 лет – 10 мг (0,5 мл).
Детям в возрасте 7-18 лет – 10-20 мг (0,5-1 мл).
Суточная доза не должна превышать 2 мг/кг массы тела.
При тяжелом течении аллергии лечение следует начинать с инъекционной формы хлоропирамина. Сначала его вводят внутривенно медленно, затем переходят на внутримышечное введение и в заключительной фазе лечения переходят на прием таблеток внутрь. Сроки лечения устанавливают индивидуально в зависимости от клинической симптоматики и состояния больного.

Особые группы пациентов
Пожилые, истощенные больные: применение препарата хлоропирамин требует особой осторожности, т.к. у этих больных антигистаминные препараты чаще вызывают побочные эффекты (головокружение, сонливость).
Пациенты с нарушением функции печени: может потребоваться снижение дозы в связи со снижением метаболизма активного компонента препарата при заболеваниях печени.
Пациенты с нарушением функции почек: может потребоваться изменение режима приема препарата и снижение дозы в связи с тем, что активный компонент в основном выделяется через почки.

Побочное действие

Со стороны центральной нервной системы: вялость, слабость, сонливость, головокружение, головная боль, эйфория, ощущение усталости, раздражительность, тремор, судороги, нарушение координации движений, нарушение зрения; у детей возможно некоторое стимулирующее действие на центральную нервную систему, проявляющееся беспокойством, повышенной раздражимостью, бессонницей.
Со стороны органов пищеварения: сухость во рту, тошнота, рвота, гастралгия, диарея/запор, потеря или повышение аппетита.
Со стороны мочеиспускательной системы: затруднение мочеиспускания.
Со стороны сердечно-сосудистой системы: снижение артериального давления (чаще у пожилых пациентов), тахикардия, аритмия.
Со стороны системы кроветворения: очень редко – лейкопения, агранулоцитоз.
Со стороны органов зрения повышение внутриглазного давления.
Аллергические реакции к препарату.
Прочие: фотосенсибилизация, мышечная слабость.

Передозировка

Симптомы: у детей – возбуждение, тревожность, галлюцинации, атетоз, атаксия, судороги, мидриаз, неподвижность зрачков, гиперемия кожи лица, гипертермия; затем – коллапс, кома. У взрослых – угнетение (заторможенность, депрессия) или возбуждение центральной нервной системы (психомоторное возбуждение), очень редко – галлюцинации, расстройство координации, расширение зрачков и отсутствие их реакции на свет, сухость во рту, гипертермия и гиперемия кожных покровов, судороги, в тяжелых случаях – коматозное состояние.
Лечение: симптоматическая терапия (включая назначение противоэпилептических средств, кофеина, фенамина), реанимационные мероприятия, искусственная вентиляция легких – по показаниям. Специфического антидота нет.

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Взаимодействие с другими лекарственными средствами

Усиливает действие лекарственных средств для общей анестезии, снотворных, седативных лекарственных средств, транквилизаторов, м-холиноблокаторов, опиоидных анальгетиков, местных анестетиков.
Трициклические антидепрессанты и ингибиторы моноаминоксидазы усиливают м-холиноблокирующее и угнетающее действие на центральную нервную систему.
Кофеин и фенамин уменьшают угнетающее действие на центральную нервную систему.
Одновременное применение с этанолом не рекомендуется (риск тяжелого угнетения ЦНС).

Особые указания

Во время лечения недопустимо употребление алкогольных напитков. Прием препарата на ночь может усилить симптомы рефлюкс-эзофагита. Если во время длительного приема препарата наблюдается беспричинное повышение температуры тела, ларингит, бледность кожных покровов, желтуха, образование язв слизистой оболочки полости рта, появление гематом, необычные и трудноостанавливаемые кровотечения, необходимо обратиться к врачу, так как пролонгированная терапия антигистаминными препаратами может привести к нарушениям гемопоэза. Антигистаминные средства могут искажать проявление реакции при постановке кожных аллергологических проб, поэтому за несколько дней до планируемого проведения теста применение препарата следует прекратить. При сочетании с ототоксичными препаратами хлоропирамин может маскировать ранние проявления ототоксичности.

Влияние на способность к управлению автотранспортом и механизмами

Больным, применяющим хлоропирамин, рекомендуется воздерживаться от вождения транспортных средств, работы с механизмами, а также от других видов деятельности, требующих повышенной концентрации внимания и быстроты психомоторных реакций.

Форма выпуска

Раствор для внутривенного и внутримышечного введения 20 мг/мл.
По 1 мл в ампулы бесцветного нейтрального стекла с цветным кольцом разлома или с цветной точкой и насечкой. На ампулы дополнительно наносят одно, два или три цветных кольца и/или двухмерный штрих-код, и/или буквенно-цифровую кодировку или без дополнительных цветных колец, двухмерного штрих-кода, буквенно-цифровой кодировки.
По 5 ампул в контурную ячейковую упаковку. По 1 или 2 контурные ячейковые упаковки вместе с инструкцией по применению в пачку из картона.

Срок годности

5 лет. Не использовать по истечении срока годности, указанного на упаковке.

Условия хранения

В защищенном от света месте при температуре не выше 25 °С.
Хранить в недоступном для детей месте.

Условия отпуска из аптек

Производитель

ЗАО «ФармФирма «Сотекс»
141345, Россия, Московская область, Сергиево-Посадский муниципальный район, сельское поселение Березняковское, пос. Беликово, д. 11

Антигистаминным лекарством, блокатором гистаминовых H1-рецепторов, является Хлоропирамин. Инструкция по применению сообщает, что таблетки 25 мг, уколы в ампулах для инъекций помогают при аллергии, крапивнице, сыпи у взрослых, детей и при беременности. Для чего назначают Хлоропирамин, цены, отзывы пациентов и врачей, а также аналоги препарата будут рассмотрены в статье.

Состав и форма выпуска

Хлоропирамин выпускают в двух формах: в виде раствора для внутримышечного и внутривенного введения, а также таблеток.

Раствор для внутривенного и внутримышечного введения – это прозрачная жидкость с едва заметным зеленоватым или желтоватым оттенком с характерным запахом. В каждой из ампул с раствором содержится активное вещество, масса которого составляет 20 мг. Существуют упаковки по пять или десять ампул.

Содержание активного вещества в таблетках Хлоропирамина – по 25 мг в каждой. В упаковке – 20 штук таблеток.

От чего помогает Хлоропирамин?

  • конъюнктивит и ринит аллергического типа;
  • сенная лихорадка и поллиноз;
  • ангионевротический отек;
  • дерматозы аллергического типа;
  • сывороточная болезнь;
  • аллергические реакции на укусы насекомых;
  • аллергия на лекарственные средства.

Важно! Принимать решение о необходимости курсовой фармакотерапии должен исключительно врач. Самолечение абсолютно недопустимо.

Инструкция по применению

Хлоропирамин при острой аллергической и анафилактической реакции сначала вводится внутривенно с постепенным переходом к внутримышечным инъекциям. Лечение ребенка должно проходить под наблюдением специалиста, имеется вероятность гиперчувствительности.

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На начальном этапе терапии, продолжительность которой индивидуальна, недопустимо занятие видами деятельности, требующими реакции и концентрации, в том числе, управление авто. На весь срок приема таблеток следует забыть о существовании алкогольных напитков. Согласно инструкции дозировка препарата следующая:

  • Доза для взрослых людей: не более 150 мг в день. Принимать таблетки следует 3-4 раза в сутки во время еды. Инъекции раствора делаются внутримышечно и внутривенно, при этом вводится не более 2 мл двухпроцентного раствора.
  • Доза для детей. Малышам в возрасте от 1 до 12 месяцев можно давать не больше 6,25 мг, до 6 лет – 8,33 мг, от 7 до 14 – 12,5 мг. Принимать 3 раза в сутки. Маленьким детям лучше давать таблетку растертой до порошкового состояния.

Фармакологические эффекты

Хлоропирамин является блокатором Н1 -рецепторов. По химическому строению относится к производным этилендиамина. Хлоропирамин селективно ингибирует гистаминовые Н1 -рецепторы и уменьшает проницаемость капилляров. Предупреждает развитие и облегчает течение аллергических реакций.

Оказывает седативное и выраженное противозудное действие. Обладает умеренной периферической антихолинергической и спазмолитической активностью и противорвотным действием.

Противопоказания

Многочисленные отзывы о Хлоропирамине предупреждают о наличии ряда противопоказаний, при которых прием препарата крайне не рекомендован. Их список представлен ниже:

  • обострение язвенной болезни желудка;
  • острые приступы бронхиальной астмы;
  • сочетание приема препарата с ингибиторами МАО;
  • гиперплазия предстательной железы;
  • беременность и период лактации;
  • дети возрастом менее 1 месяца;
  • гиперчувствительность к компонентам препарата, в частности, к производным этилендиамина (в том числе к хлоропирамину).

Побочные явления

  • сонливость, нарушение координации движений, головокружение, замедление психомоторных реакций, снижение концентрации внимания;
  • сухость во рту, горле, носу;
  • тошнота, диарея, потеря аппетита или его повышение, гастралгия;
  • снижение артериального давления, аритмии и тахикардия.

Аналоги лекарства Хлоропирамин

Для лечения назначают аналоги:

К группе антигистаминных препаратов относят аналоги:

  1. Авиамарин;
  2. Аллегра;
  3. Аллергодил;
  4. Аллергоферон;
  5. Аллертек;
  6. Астемизол;
  7. Гисманал;
  8. Гистаглобин;
  9. Гисталонг;
  10. Гистафен;
  11. Дезал;
  12. Дезлоратадин;
  13. Диазолин;
  14. Димедрол;
  15. Доксиламина сукцинат;
  16. Донормил;
  17. Зиртек;
  18. Зодак;
  19. Кестин;
  20. Кларитин;
  21. Клемастин;
  22. Ксизал;
  23. Левоцетиризин;
  24. Ломилан;
  25. Лоратадин;
  26. Мебгидролин;
  27. Налориус;
  28. Парлазин;
  29. Пипольфен;
  30. Реактин;
  31. Сиресп;
  32. Супрастин;
  33. Супрастинекс;
  34. Тавегил;
  35. Телфаст;
  36. Фексофенадин;
  37. Фенирамина малеат;
  38. Фенистил;
  39. Фенспирид;
  40. Цетиризин;
  41. Цетрин;
  42. Эзлор;
  43. Эреспал;
  44. Эриспирус;
  45. Эриус;
  46. Эролин.

Лекарственное взаимодействие

Аналоги и сам препарат усиливают эффективность снотворных, м-холиноблокаторов, местных анестетиков, опиоидных анальгетиков, седативных лекарственных средств, транквилизаторов и средств для общей анестезии.

Ингибиторы МАО и трициклические антидепрессанты повышают угнетающее и м-холиноблокирующее действие Хлоропирамина на ЦНС, а фенамин и кофеин, наоборот, уменьшают его.

Лечение препаратом на фоне употребления этанола повышает риск тяжелого угнетения ЦНС.

Особые условия

Запрещено принимать препарат одновременно с алкоголем. Из-за возможности усиления симптомов рефлюкс-эзофагита, лекарственное средство не рекомендуется использовать перед сном.

Длительное применение Хлоропирамина может вызвать нарушения гемопоэза, выражающиеся в беспричинном повышении температуры, бледности кожных покровов, ларингите, появлении гематом, трудно останавливаемом и необычном кровотечении, язвах на слизистой оболочке рта. При наличии этих симптомов существует необходимость незамедлительного обращения к врачу.

Аналоги, как и сам препарат, иногда дают искаженную картину в случае постановки аллергологических проб. Чтобы избежать этого, инструкция к Хлоропирамиду рекомендует прекратить прием препарата за несколько дней до предполагаемого теста.

Сочетанный прием ототоксичных средств и Хлоропирамина маскирует проявления ототоксичности.

Применение лекарственного средства может негативно сказаться на концентрации внимания. Поэтому на время терапии препаратом следует воздержаться от видов деятельности, требующих этого качества.

Цена и условия отпуска

Средняя цена Хлоропирамин, таблетки стоят в Москве около 125 рублей, ампулы – 110 рублей. Отпускается по рецепту.

Хранят Хлоропирамин в затемненном месте при температуре, не превышающей 25 градусов Цельсия. Место хранения не должно быть доступным для детей. Срок годности – 4 года.

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