Ziprex: instructions for use."Ziprexa": reviews, counterparts and contraindications
The human nervous system is the command post of the whole organism. In the presence of problems, it is possible to observe deviations in development, both in the physical, and in the emotional and mental. Currently, there is a huge number of drugs that can work wonders and help cope with many ailments. One of them is Ziprex. In the article, instructions for use will be considered for this medication."Ziprex" - a drug that is often prescribed for abnormalities in the nervous system.
Pharmacological properties of the preparation
This drug belongs to the group of neuroleptics with a wide range of effects on many receptor systems. Numerous studies have been conducted in which it has been found that olanzapine, the active substance of this drug, has antagonism with serotonin, dopamine and cholinergic receptors.
It has also been established that olanzapine reduces the excitability of mesolimbic dopaminergic neurons and has little effect on the striatal neural pathways that participate in the regulation of motor functions.
The active substance of the drug increases the anti-anxiety effect during the anxiolytic test.
The medicine of Ziprex is available in two forms:
- in the form of tablets coated with a film membrane.
- Lyophilizate for solution for injection.
Olanzapine is the main active ingredient in the preparation. The auxiliary components in the tablets are:
- Magnesium stearate.
- Monohydrate of lactose.
The film coating of tablets includes white dye, blue food ink, carnauba wax and hypromellose.
The lyophilisate for the injection solution includes, in addition to the main active ingredient, lactose monohydrate and tartaric acid.
In what form should I prescribe a drug for the treatment of a patient, should only the doctor decide.
Indications for use of the drug
The preparation Ziprexa has extensive indications for use, most often it is prescribed under the following conditions:
- Schizophrenia in acute form.
- Nervous disorders, accompanied by delirium, hallucinations, a disorder of thinking.
- Severe hostility and suspicion for nervous disorders.
- Emotional or social isolation.
- Affective symptoms on the background of developed schizophrenia.
- As a preventive tool for the recurrence of schizophrenia.
Do not prescribe yourself a drug without consulting a specialist, such treatment is fraught with serious consequences.
Scheme of treatment with
What does the instruction for use say about this? Ziprexa is prescribed at the beginning of schizophrenia therapy in a minimal dosage. At first, it will be enough to take 10 mg of medication once a day. On the effectiveness of treatment, food intake has no effect.
The therapeutic dosage of the drug can vary from 5 to 20 mg, but it is set individually for each patient, taking into account his condition. After all the studies, if the patient tolerates the drug well, you can increase the dose, but only under the supervision of the doctor.
In the presence of persecution mania, Ziprex tablets are prescribed in the amount of 15 mg once a day. During the therapy, it is necessary to monitor the patient's condition and, if necessary, adjust the dosage.
If a patient suffers from hepatic or renal insufficiency, he is prescribed a 5 mg Ziprex preparation, if the condition is normal and the remedy is well tolerated, then gradually the dosage can be increased.
The drug is often given to patients in the form of injections. Before you take an injection, you need to dilute the lyophilizate correctly. To do this, the contents of the vial should be dissolved in 2 ml of water for injection. The prepared solution should be clear and have a yellow color.
How to take?"Ziprex", as already mentioned, is appointed only by a specialist. Therefore, the treatment regimen, if therapy is carried out at home, should be discussed with the doctor.
When preparing the solution for injection, remember:
- "Ziprexu" can only be dissolved in sterile water.
- This drug and "Diazepam" can not be mixed in the same syringe.
- The combination of Ziprex and Haloperidol leads to a weakening of the first drug.
If the doctor prescribes Ziprex, the dosage will depend on the diagnosis. For example, in schizophrenia, the initial dose is 10 mg once daily. The drug should be administered only intramuscularly. If the patient's condition so requires, then a second injection of the drug can be done, but not earlier than two hours after the first injection.
Elderly patients and in the presence of some chronic diseases the drug is prescribed in a dosage of 2.5-5 mg.
Given that the introduction of Ziprex is capable of provoking a drop in blood pressure, it is better to be in a supine position during the injection, especially if drowsiness and dizziness occur after the injection. To lay it is necessary until the doctor after survey does not fix absence of depression of arterial pressure and a bradycardia.
It is also worth recalling that the cancellation of "Ziprex" should be carried out gradually, since the drug has a withdrawal syndrome. It is necessary to discuss this issue with your doctor.
With prolonged therapy of Zipreksoy, after a while, injections are replaced with tablets in a dosage of 5 to 20 mg per day. The doctor will explain in detail how long the Ziprex preparation should be taken. What the remedy treats and what the therapy scheme is, we have considered, but we should not forget about the undesirable consequences.
Side effects of the drug
Almost all drugs for the treatment of diseases of the nervous system belong to the group that is not recommended to be taken without consulting a doctor. This is no exception for Ziprexa, as this drug has a fairly extensive list of side effects:
- The nervous system can respond with headache and dizziness, general weakness and insomnia, amnesia and various phobias. Tremor and muscle rigidity are also possible. Often there is noise in the ears, deafness, pain in the eyes, a violation of taste.
- From the cardiovascular system, tachycardia, lowering of blood pressure, changes in ECG, cyanosis are possible. Analyzes can show neutropenia, eosinophilia, leukocytosis, thrombocytopenia. In severe cases, cardiac arrest is possible.
- There is a risk of developing rhinitis, pharyngitis, laryngitis, increased cough. Asthma can become aggravated, the risk of apnea is high. Attacks of increased appetite or bulimia, thirst and dryness in the oral cavity.
- Nausea and vomiting.
- Exacerbation of gastritis and gastroenteritis. Disturbance of stool and flatulence.
- Metabolic disorders may manifest as a change in body weight, the development of diabetes, diabetic coma.
- Urinary incontinence, cystitis, uterine fibrosis, amenorrhea and the development of urinary tract infections are also an undesirable manifestation of drug administration.
- Instruction for use( Ziprex, as we see, a drug that can cause many unwanted side effects) warns that it is possible to develop arthritis, bursitis, cramps in the calf muscles and bone pain.
- Skin can react with the appearance of excessive dryness, dermatitis, ulcerous lesions.
- Urticaria often occurs.
- Other symptoms include fever, chills, flu-like condition.
From all of the above it can be concluded that "Ziprexa" side effects are serious enough, so you can take the drug only on the advice of a doctor.
Symptoms of an overdose of
If the patient does not follow the doctor's advice on the dosage of the drug, there is a risk of an overdose that is manifested by the following symptoms:
- Tachycardia. Excessive excitability and aggressiveness.
- Speech disorder.
- Impaired consciousness.
- Neuroleptic Syndrome.
- Depression of respiratory function.
- Blood pressure jumps.
- In severe cases, cardiac arrest and respiratory depression.
At the first signs of an overdose, it is necessary to rinse the stomach, take activated charcoal. Symptomatic treatment is carried out in accordance with clinical manifestations, constant monitoring of the function of vital organs is carried out.
Contraindications to the use of the drug
To avoid undesirable manifestations after taking Ziprex, you should carefully study the list of contraindications. These include:
- Increased sensitivity to the components of the drug.
- Depression of the nervous system.
- To whom.
- Age under 18 years old.
- With great care, it is necessary to prescribe the drug Ziprexa in the following diseases and conditions:
- Renal and hepatic insufficiency.
- Hyperplasia of the prostate.
- Paralytic intestinal obstruction.
- Breastfeeding period.
If the patient has at least one of the listed diseases or conditions, then you should definitely inform the doctor about it.
Taking the drug during pregnancy and breastfeeding
If a woman is taking Ziprexa and there is a pregnancy, you should inform your doctor about it. This drug in the period of bearing a child is only worth taking in cases when the benefit to the mother significantly exceeds the potential risk for the developing baby.
"Ziprexa" is an antipsychotic that is able to penetrate into breast milk, so during therapy with the drug it is not necessary to continue feeding the baby, it is better to switch to artificial feeding.
Special recommendations during therapy
Psychiatrists often choose the Ziprex product, the price of which, unfortunately, is quite high. So, one package of tablets( 5 mg, 28 pcs.) Will cost 2500 rubles, and one bottle for injections - at 239 rubles.
Almost all drugs in this group are capable of provoking neuroleptic syndrome, and Ziprex is no exception. During treatment with the drug, you need to be careful, and if there is an unstable pulse or tachycardia, an arrhythmia or sweating, your body temperature rises, then it is worthwhile to tell the doctor about it.
Clinical manifestations of malignant neuroleptic syndrome require that the drug be immediately withdrawn.
Clinical studies have been conducted, during which it was found that long-term therapy Zipreksoy was rarely accompanied by dyskinesia, which would require medication. But do not forget that there is a risk of late development of this condition.
If symptoms of dyskinesia are detected, it is necessary to correct the dose of the drug in the direction of its decrease.
In the presence of the diagnosis of "liver failure" the drug should be taken with extreme caution, especially with increasing activity of AST and ALT.If the indicators reach a critical level, then it is necessary to reduce the dosage of Ziprex.
This medication should be taken carefully if a history of the patient has epileptic seizures or is regularly exposed to factors that lower the threshold of convulsive readiness.
If patient tests show a reduced number of white blood cells or neutrophils, Ziprexa should be administered under the supervision of a doctor and with periodic monitoring of blood counts. So the instruction on application testifies. Ziprex also requires special care during treatment with it, if:
- There are signs of oppression or toxic damage to the bone marrow.
- Presence of concomitant diseases that inhibit bone marrow function.
- If a patient has a history of radiotherapy or chemotherapy.
- The presence of hypereosinophilia.
During the experimental studies, Zipreksoy therapy was rarely accompanied by anticholinergic undesirable effects, but the experience of using this drug in patients with concomitant diseases is small, so treatment should be carried out cautiously and only under medical supervision, if necessary.
Intestinal obstruction and closed glaucoma are also grounds for careful therapy with Ziprex. The action of the drug on the central nervous system requires caution, if a combination with other drugs of similar effect is necessary.
The drug does not combine with alcohol, so during therapy it is not necessary to drink alcoholic beverages.
Given that during the treatment of "Zipreksoy" drowsiness is possible, for this period it is better to refrain from driving vehicles, as well as from performing work that requires excessive concentration.
How to combine Ziprexa with other drugs
Metabolism of the main active substance of the drug can undergo changes under the influence of inhibitors or inducers of cytochrome P450 isoenzymes that show activity against CYP1A2.Clearance "Ziprex" significantly increases in patients who have such a bad habit, like smoking, and also take the drug "Carbamazepine".
Clinical studies have proved that if there is a single dose of Ziprexa against the background of therapy with Warfarin, Teofillinum, Diazepam, Imipramine, then a decrease in the metabolism of the latter was not observed.
Simultaneous reception of the drug with alcoholic beverages is fraught with increased sedative properties of the drug, which can lead to a weakening of concentration.
Joint reception with Ziprexa Fluoxetine leads to an increase in the maximum allowable concentration of the active substance olanzapine. But in all patients this factor can have different severity, therefore dosage is adjusted strictly individually.
If Ziprexa is prescribed intramuscularly with benzodiazepines, it is recommended that a thorough examination of the patient's clinical condition regarding the inhibition of the respiratory system and heart muscle is recommended. Clinical studies of such a combination of drugs have not been conducted, so if possible, it should be avoided.
Administration of the drug is fraught with the development of bradycardia or lowering blood pressure, so this therapy should be carried out very carefully in patients who have problems in the cardiovascular system, there were fainting and sudden pressure drops.
It should also be noted that the use of activated charcoal or antacid preparations significantly reduces the absorption of Ziprex in the intestinal tract, which can adversely affect the effectiveness of treatment.
Precautions during Ziprexoy therapy
If there are factors that help slow the metabolism of olanzapine, then dosage should be reduced. These factors include:
- Female gender.
- Having a bad habit, such as smoking.
- Aged age.
Despite the fact that Ziprexa is often prescribed, such therapy requires special attention to patients who have or have had suicidal tendencies.
During the therapy should monitor the activity of hepatic transaminases, this primarily applies to patients with impaired liver function.
Patients whose professional activities are associated with the management of vehicles or performing work that requires special attention and concentration, the drug is prescribed with caution. If possible, it is replaced with another medicine.
If signs of a malignant neuroleptic syndrome appear in the form of increased body temperature, tachycardia, muscle tension, then stop taking the drug.
As against the background of therapy of motor anxiety "Zipreksoy" there may be restlessness, constant aspiration to move, it should be reduced a little and prescribe antiparkinsonics.
Analogues of the preparation
"Ziprexa" analogs have two groups:
- Synonyms, that is having the same active substance. This group includes the following drugs: Zalasta, Olanzapine, Parnasan, Olanex, Normiton.
- The second group includes drugs that have a similar pharmacological effect on the human body, for example: Azaleptin, Victorel, Ketilept, Kutipin, Lakvel, Nantarid, Saffris and others.
If the doctor has prescribed Ziprex as a therapy, the analogs should not be rushed to pick up, because you can not get the desired therapeutic effect. Only a doctor can help in resolving this issue. The desire to replace the drug with an analogue is justified, because the price of Ziprex is high enough, but its effectiveness is still worth the money.
At present, almost every patient, before going to the pharmacy for a doctor's prescription medicine, is sure to ask the opinion of those who have already been treated."Zipreksa" reviews often have positive. Patients who underwent therapy with this drug noted its high efficacy. Even after the main course of treatment, most patients note that in maintenance doses the medicine does not allow the disease to return and there are almost no relapses. It is well fought with this drug with depression, from which after the course of therapy there is no trace, and there is a desire to live on.
It should also be noted that, despite the fact that Ziprexa reviews are good, many patients report undesirable effects. Especially often, as a result of such therapy, excess weight appears, the metabolism is disturbed, some note restlessness and a desire to constantly do something.
Quite often, patients also complain about too high a cost of the drug, which does not allow it to be taken by some segments of the population.
Currently, from a single disease in the arsenal of physicians there is a large number of drugs, but only after a complete examination the doctor can choose one of them. That's why you should not prescribe therapy yourself, the same medicine can have a different effect on patients. Everything depends on the characteristics of the body, the general condition and the course of the disease. First of all it concerns preparations for the treatment of diseases of the nervous system. Take care of yourself and be well!