Aminazine: instructions for use, indications, price, side effects and reviews

Compound

Contains the active substance chlorpromazine hydrochloride .
The dragee contains 50 or 100 mg of this substance. Auxiliary elements: sunflower oil, talc, gelatin, sucrose, wax, starch syrup, titanium dioxide, iron oxide.

The solution contains 25 mg of chlorpromazine per 1 ml.

Tablets contain 25, 50 or 100 mg of active substance in the form of hydrochloride. Auxiliary elements are: magnesium stearate, cellulose, copovidone, starch, lactose monohydrate, croscarmellose sodium.

Pharmacodynamics and pharmacokinetics

The active component is a phenothiazine derivative. The drug has antiemetic, sedative, antipsychotic, weak hypothermic, vasodilating, local irritant, and moderate anticholinergic effects.

The antipsychotic effect is achieved by blockade of dopamine D2 receptors in the mesocortical and mesolimbic systems. The antipsychotic effect is manifested in the elimination of delusions, hallucinations and other productive symptoms of psychosis.

Aminazine helps relieve various types of psychomotor agitation, reduces the severity of psychotic fear and aggressiveness. The sedative effect is achieved by blocking the adrenergic receptors of the reticular pharmacy, located in the brain stem.

The drug inhibits conditioned reflex activity (especially motor-defensive receptors), reduces the spontaneity of motor activity, reduces sensitivity to exogenous and endogenous stimuli while maintaining consciousness, and relaxes skeletal muscles. Prescribing large dosages causes drowsiness.

Blockade of dopamine D2 receptors in the vomiting center in the trigger zone , as well as blockade of the vagus nerve in the gastrointestinal tract provide an antiemetic effect. Aminazine has a weak effect on m-cholinergic receptors, a pronounced effect is observed on alpha-adrenergic receptors.

The medication is able to completely eliminate the effects caused by epinephrine . The hypothermic effect is provided by blockade of dopamine receptors located in the hypothalamus. The medication increases heart rate, lowers blood pressure, has a pronounced cataleptogenic effect , a weak antihistamine effect, and reduces the permeability of capillary walls. When dopamine receptors are blocked, the production of prolactin by the pituitary gland increases. With intramuscular administration, the sedative effect develops after 15 minutes, with oral administration - after 2 hours. Tolerance to the hypotensive and sedative effects develops after 1 week.

When taken orally, the antipsychotic effect is observed on days 4-7. The most pronounced therapeutic effect lasts from 6 weeks to six months.

The action of aminazine and the effects it causes

Antipsychotic

. Reduces or completely eliminates hallucinations and delusions, especially in endogenous diseases.

Sedative

. Relieves overexcitation (psychomotor agitation), reduces the severity of affect (fear, anger, melancholy), stops aggressiveness.

Antiemetic

. Regardless of the cause of vomiting (poisoning, inflammation of the gastrointestinal tract, psychosomatic reactions, gestosis, etc.), it has an effect that reduces gag reflexes. Also relieves (or reduces) hiccups.

Hypotensive

. Reduces blood pressure, as a result of which tachycardia (increased heart rate) often develops.

Other actions: extrapyramidal (muscle tone changes), hypothermic (body temperature decreases), antipruritic (itching decreases), antiallergic, anticonvulsant, hypnotic, analgesic.

Indications for use of Aminazin

In psychiatric practice, the drug is used in the treatment of psychomotor agitation in patients with schizophrenia . The drug is prescribed for chronic psychosis, hypomanic agitation, acute delusional states, psychopathy, insomnia, anxiety, mental illnesses accompanied by agitation, anxiety, fear, for which tablets are often used.

Also, indications for the use of Aminazin are: alcoholic psychosis , persistent hiccups , “indomitable” vomiting, nausea. For persistent pain, the drug enhances the effect of analgesic medications.

The medicine is prescribed for diseases accompanied by increased muscle tone: tetanus (combination therapy with barbiturates), after suffering cerebrovascular accidents.

Previously, Aminazine was used as part of “lytic” mixtures (for artificial hypothermia ).

In anesthesiology, medication is prescribed to potentiate general anesthesia and for premedication .

In dermatological practice, the drug is used for itchy dermatoses . The drug is prescribed for the treatment of acute “intermittent” porphyria .

Aminazine

Aminazine weakens the vasoconstrictor effect of ephedrine.

May mask some manifestations of ototoxicity (tinnitus, dizziness) of ototoxic drugs, especially antibiotics.

Reduces the antiparkinsonian effect of levodopa (due to the blockade of dopamine receptors), as well as the effects of amphetamines, clonidine and guanethidine.

Strengthens the anticholinergic effects of other drugs, while its own antipsychotic effect may decrease.

With the simultaneous use of Aminazine with prochlorperazine, which is related in chemical structure, an overdose and prolonged loss of consciousness may occur. Compatible with other antipsychotic drugs, anxiolytics and antidepressants.

Long-term combination with analgesics and antipyretics is undesirable (possible development of hyperthermia).

When used simultaneously with other drugs that have a depressant effect on the central nervous system (general anesthesia, anticonvulsants, narcotic analgesics, ethanol and drugs containing it, barbiturates and other hypnotics, anxiolytics, (tranquilizers) and others), increased and prolongation of the depressive effect, as well as respiratory depression. Prescription together with tricyclic antidepressants, maprotiline or monoamine oxidase inhibitors increases the risk of developing neuroleptic malignant syndrome.

With drugs for the treatment of thyrotoxicosis, the risk of developing agranulocytosis increases.

With other drugs that cause extrapyramidal reactions, Aminazine increases the frequency and severity of extrapyramidal disorders.

With antihypertensive drugs, it increases the severity of the decrease in blood pressure in orthostasis.

Antacids, antiparkinsonian drugs, lithium preparations can interfere with the absorption of Aminazine.

Hepatotoxic drugs when used together with Aminazine increase the risk of developing toxic effects on the liver.

During treatment with Aminazine, the administration of epinephrine should be avoided (due to the possibility of distortion of the effect of epinephrine and a further decrease in blood pressure).

Drugs that inhibit bone marrow hematopoiesis increase the risk of myelosuppression.

Contraindications

Aminazine is not used in comatose states of any etiology, with severe depression of the functions of the nervous system, with severe pathology of the cardiovascular system, with intolerance to the active substance, with progressive diseases of the spinal cord and brain of a systemic nature, with breastfeeding, with ulcerative lesions of the digestive tract .

Due to the risk of developing hepatotoxic reactions, Aminazine is prescribed with caution for alcoholism. For breast cancer, pathological changes in the blood, prostatic hyperplasia , angle-closure glaucoma, Parkinson's disease, myxedema, epilepsy, vomiting, cachexia, Reye's syndrome, and elderly patients, the drug is prescribed with caution.

Aminazine, 25 mg, film-coated tablets, 10 pcs.

During treatment, it is necessary to regularly monitor blood pressure, pulse, liver and kidney function. It is also necessary to monitor the blood picture (at first weekly, and then every 3-4 months); if during therapy the number of leukocytes decreases to 3.0-3.5x109/l, and the number of neutrophils decreases to 1.5-2.0x109/l, these indicators should be monitored 2 times a week; if leukocytosis and granulocytopenia occur, treatment should be interrupted.

Each patient should be informed that if they have a fever, sore throat or other manifestations of infectious diseases, they should immediately notify their doctor. In the event of hyperthermia, which may be one of the symptoms of neuroleptic malignant syndrome (pallor, hyperthermia, autonomic dysfunction, changes in consciousness, muscle rigidity), the drug Aminazine should be discontinued immediately. Early manifestations preceding the onset of hyperthermia may include side effects such as increased sweating and instability of blood pressure (BP). Although the etiology of the dependence of such side effects on antipsychotics is most often unknown, there are a number of risk factors: individual predisposition, dehydration, organic brain damage. Neuroleptic malignant syndrome can occur at any time during treatment with antipsychotic drugs and can be fatal.

If signs and symptoms of tardive dyskinesia occur, consider reducing the dose or discontinuing all antipsychotic medications. Tardive dyskinesia sometimes occurs after discontinuation of the antipsychotic and disappears with repeated use or increased dosage. Prescription of antiparkinsonian and anticholinergic drugs in the development of tardive dyskinesia is contraindicated (the condition may worsen).

Antiparkinsonian drugs - trihexyphenidyl and others - are used as correctors for extrapyramidal disorders, the occurrence of which is possible with the use of the drug Aminazin®.

Aminazine®, depending on the dose, may increase the prolongation of the QT interval, which increases the risk of ventricular arrhythmias, including the “pirouette” type. Bradycardia, hypokalemia, and congenital or acquired long QT period also increase. Therefore, before starting treatment, you must ensure that:

- bradycardia below 55 beats per minute;

- hypokalemia;

- congenital prolongation of the QT interval.

Except in emergency situations, it is recommended to perform an ECG during the preliminary examination of patients requiring treatment with an antipsychotic.

In randomized clinical trials in elderly patients with dementia, atypical antipsychotic drugs (AEDs) were found to have an increased risk of stroke compared with placebo. The mechanism for this increased risk is not known. An increased risk with other antipsychotics or in other age groups cannot be excluded. Aminazine should be used with caution in patients with risk factors for stroke, in elderly patients with dementia, since the risk of mortality increases in elderly patients with psychoses associated with dementia and receiving antipsychotic drugs. Placebo-controlled studies, which were conducted primarily in patients taking atypical antipsychotic drugs, showed a 1.6- to 1.7-fold increased risk of mortality compared with placebo. At the end of treatment, lasting an average of 10 weeks, the risk of mortality was 4.5% in the chlorpromazine group, compared with 2.6% in the placebo group. Although the causes of death in clinical studies with atypical antipsychotics varied, the majority of these deaths were the result of cardiovascular problems (eg, heart failure, sudden death) or infections (eg, pneumonia).

There is a risk of venous thromboembolism (VTE) during treatment with antipsychotics. In patients receiving antipsychotic drugs, especially those with acquired risk factors for VTE, preventive measures should be taken and any potential risk factor for VTE should be assessed before and during treatment with Aminazine®.

Except in exceptional circumstances, Aminazine® should not be used in Parkinson's disease.

The occurrence of intestinal obstruction, which can be detected by bloating and abdominal pain, requires emergency care.

Predisposing factors for the development of arrhythmia when taking Aminazin® are: hypokalemia (including when using diuretics that cause hypokalemia), bradycardia (including those caused by drugs), an existing (congenital or acquired) increase in the duration of the QT interval. The simultaneous administration of chlorpromazine with dopaminergic non-antiparkinsonian drugs (cabergoline, quinagolide) is not recommended due to the mutual antagonism of dopamine agonists and antipsychotics. Concomitant use with other antipsychotics that can cause irritation (amisulpride, cyamemazine, droperidol, fluphenazine, propericiazine, haloperidol, levomepromazine, pimozide, pipamperone, pipothiazine, sertindole, sulpiride, sultopride, tiapride) is not recommended. Concomitant use with antiparasitic drugs (halofantrine, lumefantrine, pentamidine) is not recommended. Also, simultaneous use with antifungal agents from the azole group is not recommended (increased risk of arrhythmia). If it is impossible to avoid the co-administration of the above combinations, it is recommended to carry out regular ECG monitoring with monitoring of the duration of the QT interval. When using non-potassium-sparing diuretics, correction of hypokalemia and ECG monitoring are necessary before starting chlorpromazine therapy.

Monitoring during treatment with Aminazine should be intensified:

- in patients with epilepsy and a history of seizures, due to the possibility of lowering the seizure threshold. The occurrence of seizures requires cessation of treatment.

- in elderly patients with:

a) high susceptibility and effect of orthostatic hypotension (increased risk of excessive sedation and hypotensive effects),

b) chronic constipation (risk of paralytic intestinal obstruction),

c) possible prostate hypertrophy;

- in patients with cardiovascular diseases taking quinidine, due to a possible increase in the hypotensive effect;

- in case of liver failure and/or severe renal failure, due to the risk of accumulation.

For long-term treatment, regular ophthalmological monitoring is recommended.

It should be taken into account that the use of phenothiazine derivatives can lead to hyperglycemia or impaired glucose tolerance, development or exacerbation of diabetes mellitus, hypercholesterolemia, fecal impaction, severe intestinal obstruction and megacolon.

Since in high doses (100 mg/day) chlorpromazine can cause an increase in blood glucose levels by reducing insulin secretion, in patients with diabetes mellitus it is necessary to adjust insulin doses before and after completion of therapy. If necessary, the dose of the antipsychotic should also be adjusted in patients taking sulfonylureas.

Chlorpromazine should not be used as monotherapy if depression predominates.

Aminazine® should be used with caution in case of hypersensitivity to other phenothiazine drugs or severe respiratory diseases.

Due to the risk of photosensitivity, ultraviolet irradiation should be avoided.

Aminazine® can worsen the course or promote the manifestation of latent myasthenia gravis, as well as cause myasthenic syndrome.

To avoid the development of withdrawal syndrome, it is necessary to stop treatment with Aminazin® gradually.

The mutual antagonism of levodopa and antipsychotics must be taken into account. Dopamine may cause or worsen psychotic disorders. To treat patients suffering from parkinsonism, it is necessary to use minimal effective doses of both drugs. If it is necessary to treat patients with parkinsonism treated with dopamine with antipsychotics, the dose of the latter should be reduced gradually to a minimum (abrupt withdrawal of dopamine may increase the risk of developing “neuroleptic malignant syndrome”).

In patients with pheochromacetoma taking Aminazine®, false positive results of catecholamine levels in the blood may be observed.

During therapy, it is necessary to stop drinking alcohol, since chlorpromazine enhances the inhibitory effect of alcohol on the central nervous system.

Impact on the ability to drive vehicles and operate machinery:

During the treatment period, it is necessary to refrain from engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Side effects of Aminazine

Let's look at the side effects of Aminazine. At the first stages of therapy, dry mouth, increased drowsiness , accommodation paresis, constipation, dizziness, appetite disturbances, tachycardia, a severe form of orthostatic hypotension, decreased potency, urinary retention, sleep disorders, allergic reactions , frigidity , drop in blood pressure are noted.

Long-term therapy with chlorpromazine causes neuroleptic depression , cramps of the tongue, neck muscles, floor of the mouth, extrapyramidal disorders , akathisia, akineto-rigid phenomena, delayed reaction to stimuli, mental changes, amenorrhea , hypercoagulation, inhibition of bone marrow hematopoiesis, cardiac arrhythmias, cholestatic jaundice, gynecomastia, hyperplolactinemia , galactorrhea, skin pigmentation, oliguria, diarrhea, vomiting, neuroleptic malignant syndrome. When administered intramuscularly, infiltrates may form; with intravenous infusion - phlebitis .

Aminazine, 10 pcs., 2 ml, 25 mg/ml, solution for intravenous and intramuscular administration

Aminazine weakens the vasoconstrictor effect of ephedrine.

May mask some manifestations of ototoxicity (tinnitus, dizziness) of ototoxic drugs, especially antibiotics.

Reduces the antiparkinsonian effect of levodopa (due to the blockade of dopamine receptors), as well as the effects of amphetamines, clonidine and guanethidine. Strengthens the anticholinergic effects of other drugs, while its own antipsychotic effect may decrease.

Long-term combination with analgesics and antipyretics is undesirable (possible development of hyperthermia).

When used simultaneously with other drugs that have a depressant effect on the central nervous system (general anesthesia, anticonvulsants, narcotic analgesics, ethanol and drugs containing it, barbiturates and other hypnotics, anxiolytic drugs (tranquilizers) and others), it is possible to enhance and prolongation of the depressive effect, as well as respiratory depression. Prescription together with tricyclic antidepressants, maprotiline or monoamine oxidase inhibitors increases the risk of developing neuroleptic malignant syndrome.

With drugs for the treatment of thyrotoxicosis, the risk of developing agranulocytosis increases.

With other drugs that cause extrapyramidal reactions, Aminazine increases the frequency and severity of extrapyramidal disorders.

With antihypertensive drugs, it increases the severity of the decrease in blood pressure in orthostasis.

Antacids, antiparkinsonian drugs, lithium preparations can interfere with the absorption of Aminazine.

Hepatotoxic drugs when used together with Aminazine increase the risk of developing toxic effects on the liver.

During treatment with Aminazine, the administration of epinephrine should be avoided (due to the possibility of distorting the effect of epinephrine and further reducing blood pressure). Drugs that inhibit bone marrow hematopoiesis increase the risk of myelosuppression.

Instructions for use of Aminazin (Method and dosage)

The drug is taken orally, administered intramuscularly, intravenously.

Aminazine tablets, instructions for use

The initial daily dosage in psychiatric practice is 25-100 mg (for 1-4 doses). Gradually, the amount of the drug is increased every 3-4 days by 25-50 mg until the desired effect is achieved. In case of anxiety before surgical interventions, the medication is prescribed 2-3 hours before surgery. The maximum one-time intake is 300 mg, per day - 1.5 g.

Solution

A 2.5% solution is administered intravenously and intramuscularly.

The initial dose is 25-50 mg. Before intramuscular administration, the drug solution is diluted in 2-5 ml of procaine (0.25-0.5%), or in a 0.9% sodium chloride solution. Aminazine is administered deeply intramuscularly. Before surgical interventions in cases of anxiety, patients are administered the drug intramuscularly at the rate of 0.55 mg per 1 kg of weight 2 hours before the intended surgical treatment. For tetanus, 0.55 mg/kg is administered intramuscularly every 8 hours, the infusion rate is 1 mg/2 minutes.

Maximum one-time intramuscular injection is 150 mg, per day - 1 g.

The maximum one-time intravenous dose is 100 mg, per day - 250 mg.

In pediatric practice, only special, pediatric forms of the drug are used.

Aminazin dragee

With the simultaneous use of drugs that have a depressant effect on the central nervous system, ethanol, ethanol-containing drugs, it is possible to increase the depressant effect on the central nervous system, as well as respiratory depression.

With the simultaneous use of tricyclic antidepressants, maprotiline, MAO inhibitors, the risk of developing NMS may increase.

When used simultaneously with anticonvulsants, the threshold for convulsive readiness may be reduced; with drugs for the treatment of hyperthyroidism - increased risk of developing agranulocytosis; with drugs that cause extrapyramidal reactions - an increase in the frequency and severity of extrapyramidal disorders is possible; with drugs that cause arterial hypotension - an additive effect on blood pressure is possible, which leads to severe arterial hypotension and increased orthostatic hypotension.

When used concomitantly with amphetamines, antagonistic interactions are possible; with anticholinergic drugs - increased anticholinergic effect; with anticholinesterase drugs - muscle weakness, worsening myasthenia gravis.

When used simultaneously with antacids containing aluminum and magnesium hydroxide, the concentration of chlorpromazine in the blood plasma decreases due to impaired absorption from the gastrointestinal tract.

When used concomitantly, barbiturates enhance the metabolism of chlorpromazine, inducing microsomal liver enzymes and thereby reducing its concentration in the blood plasma.

With the simultaneous use of hormonal contraceptives for oral administration, a case of increased concentrations of chlorpromazine in the blood plasma has been described.

When used simultaneously with epinephrine, it is possible to “pervert” the pressor effect of epinephrine, as a result of which only stimulation of β-adrenergic receptors occurs and severe hypotension and tachycardia occur.

When used simultaneously with amitriptyline, the risk of developing tardive dyskinesia increases. Cases of the development of paralytic ileus have been described.

When used concomitantly, chlorpromazine may reduce or even completely inhibit the antihypertensive effects of guanethidine, although some patients may experience the hypotensive effects of chlorpromazine.

When used simultaneously with diazoxide, severe hyperglycemia is possible; with doxepin - potentiation of hyperpyrexia; with zolpidem - the sedative effect is significantly enhanced; with zopiclone - increased sedative effect is possible; with imipramine - the concentration of imipramine in the blood plasma increases.

When used concomitantly, chlorpromazine suppresses the effects of levodopa due to blockade of dopamine receptors in the central nervous system. Extrapyramidal symptoms may increase.

When used simultaneously with lithium carbonate, severe extrapyramidal symptoms and neurotoxic effects are possible; with morphine - myoclonus may develop.

With simultaneous use of nortriptyline in patients with schizophrenia, a worsening of the clinical condition may occur, despite increased levels of chlorpromazine in the blood plasma. Cases of the development of paralytic ileus have been described.

With simultaneous use with piperazine, a case of seizures has been described; with propranolol - increased plasma concentrations of propranolol and chlorpromazine; with trazodone - arterial hypotension is possible; with trihexyphenidyl - there are reports of the development of paralytic ileus; with trifluoperazine - cases of severe hyperpyrexia have been described; with phenytoin - an increase or decrease in the concentration of phenytoin in the blood plasma is possible.

When used simultaneously with fluoxetine, the risk of developing extrapyramidal symptoms increases; with chloroquine, sulfadoxine/pyrimethamine, the concentration of chlorpromazine in the blood plasma increases with the risk of developing the toxic effect of chlorpromazine.

With simultaneous use of cisapride, the QT interval on the ECG is additively prolonged.

When used simultaneously with cimetidine, a decrease in the concentration of chlorpromazine in the blood plasma is possible. There is also evidence to suggest an increase in the concentration of chlorpromazine in the blood plasma.

With simultaneous use of ephedrine, the vasoconstrictor effect of ephedrine may be weakened.

Overdose

An overdose is manifested by blurred visual perception, hyperreflexia or areflexia . Cardiotoxic effects in the form of shock, drop in blood pressure, development of heart failure , arrhythmia, cardiac arrest, ventricular fibrillation, and changes in the QRS complex on the electrocardiogram are also noted

Neurotoxic effects include coma, stupor, drowsiness, disorientation , convulsions, confusion, agitation, respiratory depression, pulmonary edema, vomiting, muscle rigidity, hypothermia, or hyperpyrexia .

The administration of enterosorbents and gastric lavage are required. When arrhythmia develops, phenytoin is administered intravenously; when heart failure develops, the use of cardiac glycosides . When blood pressure drops, vasopressors ( phenylephrine , norepinephrine) are given intravenously. Diazepam is indicated for the development of seizures. Diphenhydramine and diphenyltropine are effective for parkinsonism For five days, control over the functioning of the cardiovascular system and respiratory system is required, and consultation with a psychotherapist is required. Dialysis has not proven effective.

Trazyn

From the nervous system: drowsiness, dizziness, insomnia (at the beginning of treatment), with long-term use in high doses (0.5-1.5 g / day) - akathisia, dystonic extrapyramidal reactions (spasms of the muscles of the face, neck and back, tic-like movements or twitching, twisting movements of the body, inability to move the eyes, weakness in the arms and legs), parkinsonism (difficulty speaking and swallowing, loss of balance control, mask-like face, shuffling gait, stiffness of the arms and legs, tremors of the hands and fingers), tardive dyskinesia (smacking and wrinkling lips, puffing out of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, uncontrolled movements of the arms and legs), neuroleptic malignant syndrome (convulsions, difficulty or rapid breathing, rapid or irregular pulse, pyrexia, unstable blood pressure, increased sweating, loss of control urination, pronounced muscle rigidity, unusually pale skin, excessive fatigue and weakness), phenomena of mental indifference, delayed reaction to external irritations and other mental changes, in isolated cases - convulsions (antiparkinsonian drugs are used as correctors - tropacin, cyclodol, etc. ; dyskinesias are relieved by subcutaneous injection of 2 ml of a 20% solution of caffeine-sodium benzoate and 1 ml of a 0.1% solution of atropine).

From the genitourinary system: urinary retention, decreased potency, frigidity (at the beginning of treatment), decreased libido, ejaculation disorders, priapism, oliguria.

From the endocrine system: hypo- or hyperglycemia, glycosuria, hyperprolactinemia, galactorrhea, swelling or pain in the mammary glands, gynecomastia, amenorrhea, dysmenorrhea, weight gain.

From the digestive system: loss of appetite, dry mouth, constipation (at the beginning of treatment), bulimia or anorexia, nausea, vomiting, diarrhea, gastralgia, cholestatic jaundice, hepatitis, intestinal paresis.

From the senses: visual impairment - accommodation paresis (at the beginning of treatment), retinopathy, clouding of the lens and cornea, blurred visual perception.

From the hematopoietic organs: inhibition of bone marrow hematopoiesis (thrombocytopenia, leukopenia, agranulocytosis (4-10 weeks of treatment), pancytopenia, eosinophilia), hemolytic anemia.

Laboratory indicators: false-positive tests for pregnancy and phenylketonuria.

From the cardiovascular system: tachycardia, decreased blood pressure (including orthostatic hypotension) especially in elderly patients and those suffering from alcoholism (at the beginning of treatment), heart rhythm disturbances, prolongation of the QT interval, decrease or inversion of the T wave, increased frequency of angina attacks ( against the background of increased physical activity).

Allergic reactions: skin rash, urticaria, exfoliative dermatitis, angioedema.

Other: staining of the skin and conjunctiva, photosensitivity, discoloration of the sclera and cornea, decreased tolerance to high temperatures (up to the development of heat stroke - hot dry skin, loss of the ability to sweat, confusion), myasthenia gravis.

Local reactions: with intramuscular administration, infiltrates may occur; if liquid forms come into contact with the skin, contact dermatitis may occur. Overdose. Symptoms: neuroleptic malignant syndrome, collapse, hypothermia, coma, toxic hepatitis.

Treatment: symptomatic: for collapse, Niketamide, caffeine, phenylephrine are administered. Neurological complications usually decrease with dose reduction, as well as with the administration of cyclodol; When neuroleptic depression develops, antidepressants and psychostimulants are used. Dialysis is ineffective.

Interaction

Aminazine may weaken the vasoconstrictor effect of the drug Ephedrine . Some manifestations of ototoxicity (severe dizziness, tinnitus) when taking ototoxic medications may be masked during treatment with chlorpromazine.

The drug reduces the severity of the antiparkinsonian effect of levodopa (as a result of blockade of dopamine receptors). A similar effect is observed when taking clonidine , amphetamine, and guanethidine.

The medication enhances the anticholinergic effect of other drugs, but at the same time there is a decrease in its own antipsychotic effect. The medication is compatible with antidepressants , antipsychotics, and anxiolytics. Long-term use of antipyretics and analgesics is not recommended due to the risk of hyperthermia .

The risk of developing neuroleptic malignant syndrome increases significantly when combined with tricyclic antidepressants, MAO inhibitors, and manprotiline.

Lithium preparations, antiparkinsonian drugs, antacid medications interfere with the absorption of chlorpromazine.

Instructions for use AMINAZIN

With the simultaneous use of Aminazin® with other drugs that have a depressant effect on the central nervous system (general anesthesia, narcotic analgesics, ethanol (alcohol) and drugs containing it, barbiturates, tranquilizers, etc.), increased depression of the central nervous system, as well as respiratory depression, is possible; prolonged combination with analgesics and antipyretics is undesirable - the development of hyperthermia is possible; with tricyclic antidepressants, maprotiline or MAO inhibitors - increased risk of developing neuroleptic malignant syndrome; with anticonvulsants - the seizure threshold may be lowered; with drugs for the treatment of hyperthyroidism - the risk of developing agranulocytosis increases; with other drugs that cause extrapyramidal reactions - an increase in the frequency and severity of extrapyramidal disorders is possible; with antihypertensive drugs - severe orthostatic hypotension is possible; with ephedrine - the vasoconstrictor effect of ephedrine may be weakened.

When treating with Aminazine®, the administration of epinephrine (adrenaline) should be avoided, as the effect of epinephrine may be distorted, which can lead to a drop in blood pressure. The antiparkinsonian effect of levodopa is reduced due to blocking of dopamine receptors. Aminazine® can suppress the effect of amphetamines, clonidine, guanethidine.

Aminazine® enhances the anticholinergic effects of other drugs, while the antipsychotic effect of the antipsychotic may decrease.

When Aminazine® is used simultaneously with prochlorperazine, which is related in chemical structure, prolonged loss of consciousness may occur.

Antacids, antiparkinsonian drugs and lithium salts can reduce the absorption of chlorpromazine; in addition, combination with lithium drugs increases the risk of extrapyramidal complications.

Chlorpromazine may mask some manifestations of ototoxicity (tinnitus, dizziness) of drugs that have ototoxic effects (for example, antibiotics with ototoxic effects).

Other hepatotoxic drugs increase the risk of developing hepatotoxicity. Drugs that inhibit bone marrow hematopoiesis increase the risk of myelosuppression. Aminazine® is not recommended for use with drugs that can cause Torsadesde Pointes type arrhythmia:

class Ia antiarrhythmic drugs (eg quinidine, hydroquinidine, disopyramide);
class III antiarrhythmic drugs (eg, amiodarone, sotalol);
some antipsychotic drugs (eg, thioridazine, levomepromazine, trifluoperazine, sulpiride, tiapride, pimozide, haloperidol, droperidol);
other agents (eg, bepridil, cisapride, erythromycin IV, halofantrine, ketanserin, mizolastine, pentamidine, sparfloxacin, terfenadine, vincamine IV, moxifloxacin, spiramycin IV).

Hypokalemia (as a result of taking diuretics, laxatives, glucocorticoids, tetracosactide, IV administration of amphotericin), bradycardia (as a result of taking class Ia and III antiarrhythmic drugs, beta blockers, some calcium channel blockers, digitalis drugs, pilocarpine, anticholinesterase drugs) , congenital or acquired prolongation of the QT interval predisposes to the development of arrhythmias such as Torsades de Pointes.

When using Aminazine in high doses (more than 100 mg/day), an increase in blood glucose levels may occur as a result of a decrease in insulin release. It is necessary to adjust the dose of insulin and other hypoglycemic agents during treatment with antipsychotics and after stopping their use.

When taken simultaneously with beta blockers (bisoprolol, carvedilol, metoprolol, nebivolol), the risk of developing ventricular arrhythmia, including arrhythmia of the Torsades de Pointes type, increases. In addition, the risk of developing arterial hypotension, including orthostatic, increases. Clinical observation and ECG monitoring are necessary. The risk of orthostatic hypotension is also increased when taking Aminazine® simultaneously with antihypertensive drugs and nitrates.

Taking antacids and activated charcoal reduces the intestinal absorption of phenothiazine neuroleptics. It is necessary to maintain an interval of at least 2 hours between taking these medications.

special instructions

Therapy with the drug requires control over the pulse, blood pressure, and the functioning of the hepatic and renal systems. To prevent a sharp drop in blood pressure after intravenous and intramuscular injections, the patient is placed on the couch for 1.5-2 hours.

Due to the fact that the drug can cause photosensitivity , it is recommended to avoid ultraviolet rays and radiation. Ethanol intake is not allowed during therapy. It is necessary to completely eliminate the possibility of chlorpromazine getting on mucous membranes and skin.

The drug affects driving.

Described on Wikipedia as Chlorpromazine.

INN: Chlorpromazine.

Recipe in Latin:

Rp.: Sol. Aminazini 2.5% 1.0 D. td N 10 in amp. S.

Aminazine recipe in Latin

Rp.: Sol. Chiorpromazini 2.5% - 2.0 Dtd No. 10 in amp. S. 2.0 intramuscularly 2 times a day. Rp.: Tab. Chiorpromazini 0.05 Dtd No. 50 S. 1 tablet 3 times a day.

The main difference between chlorpromazine and other antipsychotics is its strong and quickly onset sedative (calming) effect. Therefore, in practice, it is widely used only as an “ambulance” remedy for psychosis, nervous breakdowns, aggression, etc.

Due to its side effects, it is used extremely rarely for permanent or long-term use (only in cases where other means are not effective).

Like any medicine, aminazine should be used only after examination by a doctor and determination of indications and contraindications.

Reviews about Aminazine

The drug has a very powerful effect, helping to eliminate signs of psychomotor agitation. However, reviews of Aminazine are very different.

Some people maintain that the drug is very effective for schizophrenia, Alzheimer's disease, epilepsy, psychosis, and relieves stress and anxiety. Others consider the drug sometimes even simply terrible; they say that it provokes epileptic seizures, hand tremors, a state of increased drowsiness, and various personality disorders.

In any case, this medication should only be used under the supervision of a physician.

Description of the drug AMINAZIN