СОСТАВ И ФОРМА ВЫПУСКА
капли оральные флакон с капельницей 20 мл, в коробке, № 1
Экстракт семян конского каштана | 4,725 г/100 г |
Тиамина гидрохлорид | 0,5 г/100 г |
№ UA/0217/01/01 от 01.10.2018 Без рецепта C
ДИАГНОЗЫ
ФАРМАКОЛОГИЧЕСКИЕ СВОЙСТВА
механизм действия эсцина, содержащегося в семенах конского каштана, обусловлен стабилизацией лизосомальных мембран, торможением высвобождения аутолитических клеточных ферментов, в результате чего снижается распад мукополисахаридов и улучшаются трофические процессы в стенках венозных сосудов и окружающей соединительной ткани. Препарат Эскузан капли уменьшает патологически повышенную сосудисто-тканевую проницаемость, предотвращая транскапиллярную фильтрацию низкомолекулярных белков, электролитов и воды в межклеточное пространство, повышает тонус венозной стенки, устраняет венозный застой (особенно в нижних конечностях), уменьшает периферические отеки, уменьшает чувство тяжести в ногах, усталость, напряжение, зуд, боль. При пероральном применении эсцин быстро абсорбируется, преимущественно из двенадцатиперстной кишки. Подлежит выраженному эффекту первого прохождения через печень. В тканевой жидкости и плазме крови эсцин связывается с белками (примерно 84%) и ХС. Метаболизируется в печени. Выводится из организма с мочой и желчью в виде метаболитов.
Тиамина гидрохлорид в организме превращается в активный тиаминдифосфат, участвует в углеводном и энергетическом обмене, является коферментом многих ферментных реакций.
ПОКАЗАНИЯ
хроническая венозная недостаточность: отеки; судороги икроножных мышц; зуд, а также боль и чувство тяжести в ногах; варикозное расширение вен. Посттромботический синдром. Трофические изменения вен нижних конечностей, например язвы голени. Геморрой. Профилактика и лечение посттравматических и послеоперационных отеков и гематом.
ПРИМЕНЕНИЕ
рекомендуется принимать по 12–15 капель 3 раза в сутки перед едой, с небольшим количеством жидкости. Курс лечения составляет от 2 нед до 2–3 мес.
В связи с возможным наличием осадка растительного происхождения перед применением препарат рекомендуется взбалтывать.
ПРОТИВОПОКАЗАНИЯ
повышенная чувствительность к компонентам препарата. Почечная недостаточность, аллергические заболевания.
ПОБОЧНЫЕ ЭФФЕКТЫ
со стороны сердечно-сосудистой системы: тахикардия, ускоренное сердцебиение, артериальная гипотензия.
Со стороны нервной системы: головная боль, головокружение.
Со стороны пищеварительного тракта: диспептические явления, боль в эпигастральной области, тошнота, диарея, рвота.
Со стороны иммунной системы: реакции повышенной чувствительности, в том числе крапивница, сыпь, зуд, ощущение жара, ангионевротический отек, шок.
В случае применения препарата в высоких дозах возможны нефротоксические реакции, тромбоз.
ОСОБЫЕ УКАЗАНИЯ
в случае возникновения в ногах необычных симптомов (отек, изменение цвета кожи, ощущение напряженности или жара) или боли следует прекратить применение препарата и обратиться к врачу , так как это может свидетельствовать о серьезных медицинских осложнениях (тромбоз вен ног). Следует обязательно соблюдать неинвазивные методы лечения, назначенные врачом (наложение компрессов, ношение поддерживающих эластичных чулок, обливание холодной водой).
Препарат содержит небольшое количество этанола (менее 100 мг/дозу).
Препарат содержит лактозу. Если установлена непереносимость некоторых сахаров, то перед применением препарата необходима консультация врача.
При применении препарата следует контролировать функцию почек.
Применение тиамина в высоких дозах может искажать результаты при определении теофиллина в плазме крови спектрофотометрическим методом и уробилиногена с помощью реагента Эрлиха.
Применение в период беременности или кормления грудью. Препарат не рекомендуется применять в период беременности и кормления грудью из-за недостаточности данных о безопасности его применения у этой категории пациентов.
Способность влиять на скорость реакции при управлении транспортными средствами или работе с другими механизмами. Не влияет.
Дети . Не применять у детей.
ВЗАИМОДЕЙСТВИЯ
препарат может усилить действие антитромботических средств. Антибиотики цефалоспоринового ряда повышают концентрацию свободного эсцина в крови и риск развития побочных эффектов. Следует избегать одновременного применения препарата с аминогликозидными антибиотиками в связи с усилением токсического действия аминогликозидов на почки.
Тиосемикарбазон и 5-флуороурацил, а также одновременная инфузия р-ров, содержащих сульфиты, ингибируют активность тиамина.
ПЕРЕДОЗИРОВКА
не сообщалось о случаях передозировки препарата. Возможно усиление побочных эффектов. Симптомы отравления, наблюдаемые после приема большого количества экстракта плодов конского каштана: ощущение беспокойства, сильно выраженная диарея, рвота, мидриаз, сонливость, бред, возможен летальный исход в результате дыхательного паралича через 24–48 ч.
Лечение: симптоматическое. Если было принято большое количество экстракта плодов конского каштана и отсутствует рвота, рекомендуется промывание желудка (например 0,02% р-ром перманганата калия), прием активированного угля.
Цена на Эскузан
Форма выпуска: кап. орал. фл.-капельн. 20мл
Дозировка: 47,25 мг
Производитель: ФАРМА ВЕРНИГЕРОДЕ ГМБХ
Состав и форма выпуска:
Раствор для приема внутрь по 20мл во флаконе-капельнице темного стекла, по 1 флакону в картонной упаковке.
1г раствора для приема внутрь содержит:
- Экстракт каштана конского сухой (в пересчете на эсцин) – 10мг;
- Тиамина хлорид – 5мг;
- Вспомогательные вещества: в том числе спирта этилового 31%.
Таблетки, покрытые оболочкой, по 20 мг действующего вещества по 20; 50 или 100 таблеток в упаковке.
1 таблетка препарата содержит:
- Экстракт каштана конского сухой (в пересчете на эсцин) – 20мг;
- Вспомогательные вещества.
Фармакологическое действие:
Эскузан – препарат содержащий экстракт плодов каштана конского и тиамин (витамин В1). Обладает антиоксидантным, противоотечным, антиэкссудативным, капилляропротекторным и венотонизирующим действием.
Основным действующим веществом экстракта конского каштана является эсцин, относящийся к группе тритерпеновых гликозидов. Он оказывает венотонизирующее и капилляропротекторное свойства за счёт стимуляции выработки гормонов корой надпочечников и увеличения в сосудистой стенке количества простагландинов F-2. эсцин способствует нормализации сократительной деятельности гладких мышц сосудистой стенки, за счет чего снижается ломкость сосудов, улучшается метаболизм в тканях, нормализуется состояние капилляров. Капилляропротекторные свойства эсцина проявляются также за счет его способности угнетать активность лизосомных ферментов, таким образом, блокируется расщепление мукополисахаридов (в частности протеогликана) в стенках сосудов. Препарат стимулирует высвобождение медиатора норадреналина в синаптическую щель, улучшает проводимость импульсов в сосудистой стенке. Уменьшает проявления венозного застоя, что положительно сказывается на состоянии просвета сосудов и венозных клапанах.
Противоотечное действие препарат оказывает за счет способности эсцина уменьшать проницаемость плазмолимфатического барьера, снижать лимфоток (при этом повышая сухой остаток лимфы). Прием препарата существенно понижает выход электролитов, низкомолекулярных соединений и воды в межклеточное пространство. Усиление синтеза и повышение высвобождения простагландинов оказывает некоторое антиэкссудативное действие.
Препарат оказывает также противовоспалительное действие, так как снижает проницаемость сосудистой стенки и уменьшает миграцию лейкоцитов, кроме того, стероловые соединения которые содержатся в экстракте конского каштана, способствуют снижению интенсивности проявления воспалительных реакций.
Эсцин обладает антиагрегационной активностью и при регулярном приеме способствует значительному снижению частоты образования тромбов и атеросклеротических бляшек на стенках сосудов.
Антиоксидантное действие проявляется за счет входящего в состав тиамина, который предотвращает перекисное окисление липидов. Кроме того кверцетин, являющийся компонентом экстракта каштана конского, способен инактивировать активную форму кислорода и гидроксильные группы снижая их разрушительный эффект на клеточные мембраны. Кверцетин также способен ингибировать липоксигеназу, тормозить синтез ликотриена В4, и уменьшать приток гранулоцитов к поврежденным сосудистым стенкам, что способствует улучшению состояния эндотелия сосудов и мышц сосудистой стенки.
Препарат хорошо всасывается из желудочно-кишечного тракта после перорального приема. Связывание с белками плазмы достигает 85%. Метаболизируется преимущественно в печени, выводится с желчью. Небольшой процент препарата выводится почками в неизмененном виде.
Показания к применению:
Препарат используют для лечения хронической венозной недостаточности различной этиологии у взрослых, в том числе назначают при таких проявления заболевания как:
- Отек нижних конечностей;
- Судороги мышц нижних конечностей (в частности икроножных мышц);
- Боль и ощущение тяжести в ногах, кожный зуд, вызванный венозными нарушениями;
- Расширенные вены, гематомы и сосудистые "звездочки";
- Посттромбофлебитический синдром;
- Трофические изменения, в том числе язвы конечностей;
- Послеоперационные и посттравматические отеки и воспаления мягких тканей (в том числе отек мозга, вывихи, ушибы, разрывы и растяжения связок, гематомы различного происхождения).
Препарат также рекомендован к использованию при геморрое.
Препарат также может быть использован в комплексной терапии для лечения и профилактики атеросклероза, инсультов и трофических изменений мягких тканей в качестве средства, улучшающего тканевый метаболизм и обладающего ангиопротекторными свойствами.
Способ применения:
Раствор для приема внутрь принимают обычно по 12-15 капель 3 раза в день перед приемом пищи. Капли необходимо запивать, либо растворять в небольшом количестве воды. Перед приемом препарата флакон с раствором необходимо взболтать.
Таблетки принимают обычно после приема пищи по 1 таблетке 3 раза в день. При необходимости доза препарата может быть увеличена вдвое.
Курс лечения в среднем составляет 3 месяца, но может быть увеличен лечащим врачом.
Побочные действия:
При приеме препарата может наблюдаться раздражение слизистой оболочки желудочно-кишечного тракта, диспептические явления.
Очень редко возможно развитие таких побочных эффектов как: тошнота, чувство жара, аллергические реакции (в том числе зуд, крапивница, кожная сыпь, ангионевротический отек, в единичных случаях – анафилактический шок).
Противопоказания:
Повышенная индивидуальная чувствительность к компонентам препарата, срок беременности до 14 недель (I триместр), период лактации, почечная недостаточность.
В связи с отсутствием соответствующих клинических исследований не рекомендуется назначение Эскузана пациентам в возрасте до 12 лет.
Беременность:
Прием препарата по назначению врача возможен во втором и третьем триместре беременности. Не рекомендуется назначение препарата в форме капель (так как они содержат 31% спирта этилового). В период лактации при необходимости приема препарата Эскузан нужно решить вопрос о прекращении грудного вскармливания.
Взаимодействие с другими лекарственными средствами:
Одновременный прием препарата Эскузан с антикоагулянтами может усиливать действие последних.
Передозировка:
На данный момент отсутствует информация относительно случаев передозировки препарата Эскузан.
При передозировке препарата в форме капель возможны симптомы алкогольного опьянения.
Условия хранения:
Хранить в сухом, защищенном от света месте при температуре 15-25 градусов Цельсия.
- Срок годности препарата Эскузан в форме раствора для перорального приема – 3 года.
- Срок годности препарата Эскузан в форме таблеток, покрытых оболочкой, — 4 года.
Обратите внимание!
Это описание препарата Эскузан есть упрощенная авторская версия сайта apteka911, созданная на основании инструкции/ий по применению. Перед приобретением или использованием препарата вы должны проконсультироваться с врачом и ознакомиться с оригинальной инструкцией производителя (прилагается к каждой упаковке препарата).
Информация о препарате предоставлена исключительно с ознакомительной целью и не должна быть использована как руководство к самолечению. Только врач может принять решение о назначении препарата, а также определить дозы и способы его применения.
Условия отпуска | Без рецепта |
Производитель | ЭСПАРМА ГМБХ |
Форма выпуска | упаковка |
ЗАТВЕРДЖЕНО
ІНСТРУКЦІЯ
для медичного застосування препарату
ЕСКУЗАН КРАПЛІ
(AESCUSAN DROPS)
Склад лікарського засобу:
діючі речовини: 100 г розчину містять 4,725 г сухого екстракту з насіння кінського каштану (Hippocastani extractum siccum normatum) (5-7:1) (екстрагент етанол 60 % (об/об)) 0,5 г тіаміну гідрохлориду;
допоміжні речовини: етанол 96 %, вода очищена, лактози моногідрат, кремнію діоксид колоїдний.
Лікарська форма. Краплі оральні.
Прозора або ледь каламутна рідина від жовтого до червонувато-коричневого кольору з характерним запахом. У процесі зберігання можливе утворення осаду.
Назва і місцезнаходження виробника.
Фарма Вернігероде ГмбХ/
Pharma Wernigerode GmbH.
Дорнбергсвег 35, Д-38855 Вернігероде, Німеччина/
Dornbergsweg 35, D-38855 Wernigerode, Germany.
Фармакотерапевтична група.
Капіляростабілізуючі засоби. Код АТС С05С Х.
Ангіопротекторний, капіляростабілізуючий, протинабряковий, протизапальний засіб. Механізм дії есцину зумовлений стабілізацією лізосомальних мембран, гальмуванням вивільнення аутолітичних клітинних ферментів, унаслідок чого знижується розпад мукополісахаридів і поліпшуються трофічні процеси у стінках венозних судин і навколишній сполучній тканині. Препарат зменшує патологічно підвищену судинно-тканинну проникність, запобігаючи транскапілярній фільтрації низькомолекулярних білків, електролітів і води у міжклітинний простір, підвищує тонус венозної стінки, усуває венозний застій (особливо у нижніх кінцівках), зменшує периферичні набряки, зменшує відчуття важкості у ногах, втому, напруження, свербіж, біль. При пероральному прийомі есцин швидко абсорбується, переважно з дванадцятипалої кишки. Підлягає вираженому ефекту «першого проходження» через печінку. У тканинній рідині і плазмі крові есцин зв’язується з білками (приблизно 84 %) і холестерином. Метаболізується у печінці. Виводиться з організму із сечею та жовчю у вигляді метаболітів.
Тіаміну гідрохлорид в організмі перетворюється на активний тіаміндифосфат, бере участь у вуглеводному та енергетичному обміні, є коферментом багатьох ферментних реакцій.
Показання для застосування.
Хронічна венозна недостатність:
— судоми литкових м’язів;
— свербіж, а також біль і відчуття важкості у ногах;
— варикозне розширення вен.
Трофічні зміни вен нижніх кінцівок, наприклад, виразки гомілки.
Профілактика і лікування посттравматичних та післяопераційних набряків і гематом.
Протипоказання.
Підвищена чутливість до компонентів препарату. Ниркова недостатність, алергічні захворювання.
Належні заходи безпеки при застосуванні.
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Слід обов’язково дотримуватись неінвазивних методів лікування, що призначені лікарем (накладання компресів, носіння підтримуючих еластичних панчіх, обливання холодною водою).
При застосуванні препарату слід контролювати функцію нирок.
Особливі застереження.
Застосування тіаміну у високих дозах може спотворювати результати при визначенні теофіліну в сироватці крові спектрофотометричним методом та уробіліногену за допомогою реагента Ерліха.
Застосування у період вагітності або годування груддю.
Препарат не рекомендується застосовувати у період вагітності або годування груддю через недостатність даних щодо безпеки його застосування цій категорії пацієнтів.
Здатність впливати на швидкість реакції при керуванні автотранспортом або роботі з іншими механізмами.
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Рекомендується приймати по 12-15 крапель 3 рази на добу перед їдою, з невеликою кількістю рідини. Курс лікування становить від 2 тижнів до 2-3 місяців.
У зв’язку з можливою наявністю осаду рослинного походження перед вживанням препарат рекомендується збовтувати.
Передозування.
Не повідомлялося про випадки передозування препаратом. Можливе посилення побічних проявів. Симптоми отруєння, що спостерігаються після прийому великої кількості екстракту плодів кінського каштану: відчуття стурбованості, сильна діарея, блювання, мідріаз, сонливість, марення, можливий летальний наслідок у результаті дихального паралічу через 24-48 годин.
Лікування: симптоматичне. Якщо була прийнята велика кількість екстракту плодів кінського каштану і відсутнє блювання, рекомендується промивання шлунка (наприклад, 0,02 % розчином перманганату калію), прийом активованого вугілля.
Побічні ефекти.
З боку серцево-судинної системи: тахікардія, прискорене серцебиття, артеріальна гіпотензія.
З боку нервової системи: головний біль, запаморочення.
З боку травного тракту: диспепсичні явища, біль в епігастральній ділянці, нудота, діарея, блювання.
З боку імунної системи: реакції підвищеної чутливості, у тому числі кропив’янка, висипання, свербіж, відчуття жару, ангіоневротичний набряк, шок.
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Взаємодія з іншими лікарськими засобами та інші види взаємодій.
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Умови зберігання.
Зберігати у недоступному для дітей місці при температурі 8-25 °С. Не заморожувати.
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