Compound
- One tablet of Tizercin contains 25 mg of levomepromazine. Additional substances: sodium starch glycolate, magnesium stearate, potato starch, microcrystalline cellulose, povidone, lactose. Shell composition: magnesium stearate, titanium dioxide, dimethicone , hypromellose.
- One milliliter of Tizercin solution contains 25 mg of levomepromazine. Additional substances: sodium chloride, monothioglycerol, anhydrous citric acid, water.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Phenothiazine-type neuroleptic . It has antipsychotic, antiemetic, sedative, hypothermic, antihistamine, analgesic, and anticholinergic effects. Reduces blood pressure.
The antipsychotic effect is caused by blockade of D2-dopamine receptors in the mesocortical and mesolimbic systems of the brain.
The sedative effect is caused by the blockade of adrenaline receptors in the reticular formation of the brain; hypothermic – blockade of hypothalamic dopamine receptors ; antiemetic - blockade of D2-dopamine receptors of the vomiting center. Extrapyramidal side effects are less pronounced with levomepromazine than with “classical” antipsychotics.
Increases the pain threshold. Due to its ability to enhance the effect of analgesics , anesthesia drugs and antihistamines, Tizercin can be used for additional therapy for pain. The greatest analgesic effect is achieved within 40 minutes after intramuscular administration and lasts four hours.
Pharmacokinetics
After oral administration, the highest concentration is recorded in the blood after an average of 2 hours, and after intramuscular administration - after 60 minutes.
Actively penetrates through any histohematic barriers and is distributed in various organs and tissues. It is rapidly transformed in the liver, undergoing demethylation with the formation of final glucuronide and sulfate conjugates, which are evacuated in the urine. N-desmethylomono-methotrimeprazine is the only metabolite with pharmacological activity; other metabolites are inactive.
The half-life is approximately 20-25 hours. A small part of the dose taken (up to 1%) is excreted in its original form in urine and feces.
Pharmacological properties of the drug Tizercin
Tizercin is a phenothiazine neuroleptic that has antipsychotic, analgesic and moderate antiemetic effects. It relieves psychomotor agitation, has a sedative effect, exhibits antidepressant, adrenergic blocking, moderate anticholinergic and antihistamine activity. Causes hypotension. The maximum concentration in blood plasma is achieved 30–90 minutes after intramuscular administration. The metabolite formed as a result of demethylation has pharmacological activity, others are inactive. The half-life is 15–78 hours. Eliminated in urine and feces.
Indications for use
- Psychomotor agitation in psychosis, bipolar disorders, mental retardation, schizophrenia, epilepsy.
- Other mental disorders complicated by anxiety, agitation , phobias, panic, persistent insomnia .
- The need to enhance the effects of analgesics , drugs for general anesthesia , H1-histamine receptor inhibitors.
- Pain syndrome (inflammation of the facial nerve, trigeminal neuralgia , herpes zoster ).
Contraindications
- overdose of drugs that have a suppressive effect on the nervous system ( general anesthetics , alcohol, sleeping pills );
- concomitant use of antihypertensive drugs;
- angle-closure glaucoma;
- Parkinson's disease;
- multiple sclerosis;
- hemiplegia;
- myasthenia gravis;
- urinary retention;
- chronic cardiac failure in the stage of decompensation;
- severe liver or kidney failure ;
- suppression of bone marrow hematopoiesis;
- severe arterial hypotension;
- lactation;
- porphyria;
- hypersensitivity to the components of the drug or other phenothiazines;
- age less than 12 years.
The drug is used with caution in case of epilepsy , in old age, in persons with a history of cardiac diseases.
Side effects
- Circulatory phenomena: orthostatic hypotension , decreased blood pressure, Adams-Stokes syndrome , increased QT interval, tachycardia . When using phenothiazine antipsychotics, cases of sudden death are known.
- Hematopoietic phenomena: agranulocytosis, pancytopenia, leukopenia, thrombocytopenia, eosinophilia.
- Nervous phenomena: dizziness, drowsiness, fatigue, visual hallucinations, confusion, increased intracranial pressure, catatonia , slurred speech, extrapyramidal symptoms , disorientation, epileptic seizures .
- Metabolic phenomena: changes in the menstrual cycle, galactorrhea , weight loss, mastalgia . The development of pituitary adenomas in a number of patients using phenothiazine derivatives , but more research is needed to prove a cause-and-effect relationship.
- Phenomena from the genitourinary system: discoloration of urine, difficulty urinating, impaired uterine contractions.
- Digestive symptoms: abdominal discomfort, dry mouth, vomiting, nausea, constipation , liver damage.
- Skin phenomena: hyperpigmentation, erythema, photosensitivity.
- Visual effects: pigmentary retinopathy.
- Allergic reactions: peripheral edema , laryngeal edema, bronchospasm, urticaria, anaphylactoid reactions, exfoliative dermatitis.
- Other phenomena: hyperthermia , pain and swelling in the injection area.
Side effects of the drug Tizercin
The most common side effect is postural hypotension. In this case, loss of consciousness, dizziness, drowsiness or increased fatigue may occur. In addition, side effects such as dry mouth, tachycardia, constipation and/or difficulty urinating may be noted. Cases of impotence, frigidity, and cessation of menstrual bleeding have been reported. In some cases, the composition of the blood changed and neurological symptoms occurred (extrapyramidal disorders with a predominance of akinetic-hypotonic syndrome, for example, inability to stand still, tremor, are possible). Allergic reactions and photosensitivity reactions can also sometimes develop.
Instructions for use of Tizercin (Method and dosage)
The instructions for use of Tizercin allow the drug to be administered orally, starting from 25-50 mg per day, divided into several doses. The dose is increased by 25-50 mg daily until the condition improves. In patients who are insensitive to other antipsychotics , the daily dose is allowed to be increased by 50-75 mg per day. Average doses are 200-300 mg per day. After improvement and stabilization of the condition, the dose should be reduced to maintenance (determined individually).
For patients with neurotic disorders in outpatient practice, the drug is prescribed at a dose of 12.5-50 mg per day.
Parenteral use
This delivery route is used when it is not possible to take the drug orally. The daily dose is usually 75-100 mg and is divided into 2-3 injections, which are carried out in bed rest and under the control of blood pressure and pulse. If necessary, the daily dose is increased to 200-250 mg.
The solution can be administered deeply intramuscularly or intravenously. For intravenous drip infusion, 50-100 mg of the drug must be diluted in 250 ml of saline or 5% glucose solution and slowly administered through a dropper.
Tisercin (Levomepromazine)
Clinical and pharmacological group
Antipsychotic drug (neuroleptic)
Contraindications
- - simultaneous use of antihypertensive drugs;
- - overdose of drugs that have a depressant effect on the central nervous system (alcohol, general anesthetics, sleeping pills);
- - angle-closure glaucoma;
- - urinary retention;
- - Parkinson's disease;
- - multiple sclerosis;
- - myasthenia;
- - hemiplegia;
- — chronic heart failure in the stage of decompensation;
- - severe renal failure;
- - severe liver failure;
- - severe arterial hypotension;
- - inhibition of bone marrow hematopoiesis (granulocytopenia);
- - porphyria;
- - lactation;
- - children under 12 years of age;
- - hypersensitivity to levomepromazine and other phenothiazines.
Use with caution in epilepsy, in patients with a history of cardiovascular diseases, especially in old age (cardiac muscle conduction disorders, arrhythmias, congenital long QT interval syndrome).
Dosage
It is prescribed orally, starting with a dose of 25-50 mg/day in several doses (the maximum part of the daily dose should be prescribed before bedtime), increasing it daily by 25-50 mg until the patient’s condition improves. In patients resistant to other antipsychotics, the daily dose can be increased more quickly, increasing it by 50-75 mg/day. Average daily doses are 200-300 mg.
After the patient’s condition improves, the dose should be reduced to a maintenance dose, the amount of which is determined individually.
In outpatient practice, patients with neurotic disorders are prescribed the drug in a daily dose of 12.5-50 mg (1/2-2 tablets).
The drug is administered parenterally when it is not possible to take it orally. The daily dose is 75-100 mg, divided into 2-3 injections, in bed rest under the control of blood pressure and pulse. If necessary, the daily dose is increased to 200-250 mg.
Injected intramuscularly (deeply) or intravenously.
For administration as an intravenous drip infusion, Tizercin (50-100 mg) should be diluted in 250 ml of 0.9% sodium chloride solution or 5% dextrose (glucose) solution and administered slowly through a dropper.
There is insufficient clinical experience on the parenteral use of the drug in children under 12 years of age. If there are strict indications, doses of 0.35-3 mg/kg body weight/day are recommended for children over 12 years of age.
Side effects
From the cardiovascular system: decreased blood pressure, orthostatic hypotension (with accompanying weakness, dizziness and loss of consciousness), Adams-Stokes syndrome, tachycardia, prolongation of the QT interval (arrhythmogenic effect, ari). Cases of sudden death (possibly caused by cardiac causes) have been reported when taking phenothiazine antipsychotics.
From the hematopoietic system: pancytopenia, agranulocytosis, leukopenia, eosinophilia, thrombocytopenia.
From the central nervous system: drowsiness, dizziness, increased fatigue, confusion, slurred speech, visual hallucinations, catatonia, disorientation, extrapyramidal symptoms with a predominance of akinetic-hypotonic syndrome (dyskinesia, dystonia, parkinsonism, opisthotonus, hyperreflexia), epileptic seizures, increased intracranial pressure, ZNS.
Metabolism: weight loss, galactorrhea, menstrual irregularities, mastalgia. Pituitary adenomas have been reported in some patients receiving phenothiazine derivatives, but further research is needed to establish a causal relationship between the use of these drugs and tumor development.
From the reproductive and urinary system: difficulty urinating, discoloration of urine, impaired contractions of the uterine muscles.
From the digestive system: dry mouth, discomfort in the abdomen, nausea, vomiting, constipation, liver damage (jaundice, cholestasis).
From the skin: photosensitivity, erythema, hyperpigmentation.
From the organ of vision: deposits in the lens and cornea, pigmentary retinopathy.
Allergic reactions: laryngeal edema, peripheral edema, anaphylactoid reactions, bronchospasm, urticaria, exfoliative dermatitis.
Other: hyperthermia (may be the first sign of NMS), pain and swelling at the injection sites.
Overdose
Symptoms: decreased blood pressure, hyperthermia, conduction disturbances in the heart muscle (prolongation of the QT interval, ventricular tachycardia of the “pirouette” type, AV block), depression of consciousness of varying severity (up to coma), extrapyramidal symptoms, sedation, epileptic seizures, NMS .
Treatment: it is recommended to monitor the acid-base balance, fluid and electrolyte balance, kidney function, urine volume, liver enzyme activity, ECG readings, and in patients with NMS, additionally serum CPK levels and body temperature. Symptomatic treatment should be carried out based on the results of the assessment of the above parameters. In case of a decrease in blood pressure, intravenous fluid administration, Trendelenburg position, and the use of dopamine and/or norepinephrine are indicated. Due to the proarrhythmogenic effect of levomepromazine, it is necessary to provide conditions for resuscitation, and when administering dopamine and/or norepinephrine, an ECG must be performed. In case of an overdose of antipsychotics, the use of adrenaline is not recommended. The use of lidocaine and, if possible, long-acting arrhythmic drugs should also be avoided. To eliminate seizures, use diazepam or, for recurrent seizures, phenytoin. If rhabdomyolysis occurs, mannitol is prescribed. There is no specific antidote. Forced urination, hemodialysis and hemoperfusion are ineffective.
It is not recommended to induce vomiting, since intermittent epileptic convulsions and dystonic reactions of the head and neck muscles can lead to vomit entering the respiratory tract. Gastric lavage, along with monitoring vital signs, is indicated even 12 hours after taking the drug, since its natural elimination is slow due to the m-anticholinergic effect of levomepromazine. An additional reduction in drug absorption is achieved by using activated carbon and laxatives.
Drug interactions
Concomitant use of levomepromazine and the following drugs should be avoided:
- antihypertensive drugs due to the risk of a pronounced decrease in blood pressure;
- MAO inhibitors, because it is possible to increase the duration of action of levomepromazine and increase the severity of its side effects.
Caution should be exercised when used concomitantly with the following drugs
Drugs with m-anticholinergic activity (tricyclic antidepressants; histamine H1 receptor blockers; some antiparkinsonian drugs; atropine, scopolamine, suxamethonium) enhance the m-anticholinergic effect of levmepromazine (paralytic intestinal obstruction, urinary retention, glaucoma). When used concomitantly with scopolamine, extrapyramidal side effects were observed.
CNS depressants (opioid analgesics, general anesthesia, anxiolytics, sedatives and hypnotics, tranquilizers, tricyclic antidepressants) enhance the inhibitory effect of levomepromazine on the central nervous system.
CNS stimulants (eg, amphetamine derivatives): levomepromazine reduces their psychostimulant effect.
Levodopa: Levomepromazine reduces the effect of levodopa.
Oral hypoglycemic agents: when used simultaneously with levomepromazine, their effectiveness decreases, which requires dose adjustment.
Drugs that prolong the QT interval (some antiarrhythmic drugs, macrolide antibiotics, some azole antifungals, cisapride, some antidepressants, some antihistamines, and potassium-lowering diuretics) increase the risk of QT prolongation and therefore increase risk of arrhythmia.
Drugs that cause photosensitivity, when used simultaneously with levomepromazine, increase the likelihood of photosensitivity.
Ethanol enhances central nervous system inhibition and increases the likelihood of extrapyramidal side effects when used simultaneously with levomepromazine.
Antacids reduce absorption in the gastrointestinal tract (levomepromazine should be prescribed 1 hour before or 4 hours after taking antacids).
Drugs that inhibit bone marrow hematopoiesis increase the risk of myelosuppression.
Dilevalol, like levomepromazine, inhibits metabolism, which leads to a mutual enhancement of the effect of both drugs. If they are used simultaneously, it may be necessary to reduce the dosage of one or both drugs. A similar interaction with other beta-blockers is possible.
Levomepromazine and its non-hydroxylated metabolites are potent inhibitors of CYP2D6. Concomitant use of levomepromazine with drugs primarily metabolized by CYP2D6 may result in increased concentrations of these drugs, which may increase the adverse effects of these drugs.
special instructions
The use of the drug should be discontinued if allergic reactions occur.
Concomitant use with CNS depressants, MAO inhibitors and m-anticholinergics requires special caution.
The drug should be prescribed with extreme caution to patients with impaired liver and/or kidney function.
Elderly patients are predisposed to orthostatic hypotension, as well as the m-anticholinergic and sedative effects of phenothiazines. In addition, they are particularly prone to extrapyramidal side effects. Therefore, treatment of these patients should be started with low doses and gradually increased.
In older people with dementia who were treated with antipsychotics, there was a small increase in the risk of mortality. There are insufficient data to determine the exact magnitude of the risk, and the reason for this increased risk is unknown. Tizercin should not be used to treat behavioral disorders associated with dementia. To avoid the development of orthostatic hypotension, the patient should lie down for half an hour after the first dose. If dizziness occurs after administration of the drug, you should remain in bed after each dose until the dizziness disappears.
In cases of parenteral administration of the drug Tizercin, the injection sites should, if necessary, be alternated, since the drug can cause local irritation and tissue damage.
It is also necessary to be careful when prescribing the drug to patients (especially the elderly) with a history of cardiovascular diseases, patients with congestive heart failure, conduction disorders, arrhythmia, and congenital long QT interval syndrome. Before starting treatment with Tizercin, an ECG should be performed to exclude any cardiovascular disorder that may contraindicate the use of the drug.
There are reports of QT prolongation, arrhythmia and, very rarely, arrhythmias with phenothiazine therapy.
If hyperthermia occurs during antipsychotic therapy, the possibility of NMS should be excluded. This potentially life-threatening syndrome is characterized by the following symptoms: muscle rigidity, hyperthermia, confusion, dysfunction of the autonomic nervous system (unstable blood pressure, tachycardia, arrhythmia, increased sweating), catatonia, increased CPK activity, myoglobinuria (rhabdomyolysis) and acute renal failure. If they occur, as well as if hyperthermia of unknown etiology occurs during treatment without other clinical symptoms of NMS, the use of Tizercin should be stopped immediately.
After sudden withdrawal of a drug used in high doses or for a long time, the following may occur: nausea, vomiting, headache, tremor, increased sweating, tachycardia, insomnia and anxiety, as well as the development of tolerance to the sedative effect of phenothiazine derivatives and cross-tolerance to various antipsychotics. For this reason, drug withdrawal should always be done gradually.
Many antipsychotics, incl. levomepromazine may lower the seizure threshold and cause epileptiform EEG changes. For this reason, when titrating the dose of Tizercin, all patients with epilepsy must ensure careful clinical observation and EEG monitoring.
The development of cholestatic jaundice depends on the individual sensitivity of the patient and completely disappears after stopping the use of the drug. Therefore, during long-term treatment, regular monitoring of liver function is required.
Agranulocytosis and leukopenia have been reported in some patients receiving phenothiazines. Despite the rarity of such cases, during long-term therapy with levomepromazine it is necessary to regularly monitor the leukocyte count. During treatment and until the drug stops working (within 4-5 days after discontinuation of the drug), alcohol consumption is prohibited.
Before and during treatment, it is recommended to regularly monitor the following indicators: blood pressure, liver function (especially in patients with liver disease), leukocyte count, ECG (for cardiovascular diseases and in elderly patients), potassium concentration in the blood serum. Periodic monitoring of the level of electrolytes in the blood and its correction is necessary (especially when planning long-term therapy).
Impact on the ability to drive vehicles and operate machinery
At the beginning of treatment (for a period the duration of which depends on the patient’s response), driving a car and performing work associated with an increased risk of accidents is prohibited. Subsequently, the severity of the ban is determined individually for each patient.
Pregnancy and lactation
The drug should not be used during pregnancy, unless the expected benefit of therapy for the mother outweighs the potential risk to the fetus.
Adequate and strictly controlled clinical studies on the safety of Tizercin during lactation have not been conducted. Levomepromazine is excreted in breast milk. Given these facts, the use of the drug during breastfeeding is contraindicated. If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided.
Use in childhood
Contraindication: children under 12 years of age.
For impaired renal function
The drug should be prescribed with extreme caution to patients with renal failure due to the risk of drug accumulation.
The drug is contraindicated in severe renal failure.
For liver dysfunction
The drug should be prescribed with extreme caution to patients with liver failure due to the risk of drug accumulation.
The drug is contraindicated in severe liver failure.
Use in old age
Use with caution in patients with a history of cardiovascular diseases, especially in old age (conduction disorders of the heart muscle,
Conditions for dispensing from pharmacies
The drug is available with a prescription.
Storage conditions and periods
The drug belongs to list No. 1 of potent substances of the Standing Committee for Drug Control of the Ministry of Health of the Russian Federation.
The drug in the form of film-coated tablets should be stored out of the reach of children at a temperature of 15° to 25°C. Shelf life: 5 years.
The drug in the form of a solution for infusion and injection should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life: 2 years.
Release form, composition and packaging
White film-coated tablets, round, slightly biconvex, odorless.
1 tab.
levomepromazine hydromaleate 33.8 mg,
which corresponds to the content of levomepromazine 25 mg
Excipients: magnesium stearate - 1 mg, sodium starch glycolate - 2 mg, povidone - 8 mg, microcrystalline cellulose - 10 mg, potato starch - 15.2 mg, lactose - 40 mg.
Shell composition: titanium dioxide - 0.758 mg, hypromellose - 2.632 mg, dimethicone - 0.355 mg, magnesium stearate - 0.255 mg.
50 pcs. — brown glass bottles with a PE cap, with first opening control and an accordion shock absorber (1) — cardboard packs.
The solution for infusion and intramuscular administration is colorless or slightly colored, transparent, with a characteristic odor.
1 ml
levomepromazine 25 mg
Excipients: anhydrous citric acid - 9 mg, monothioglycerol - 7.5 mg, sodium chloride - 6 mg, water for injection - up to 1 ml.
1 ml - ampoules made of colorless glass type I (5), with red and blue code rings and with a break point - contour cell packaging (2) - cardboard packs.
Overdose
Signs of overdose: decreased blood pressure, conduction disturbances, hyperthermia , depression of consciousness up to coma , sedation, extrapyramidal symptoms, epileptic seizures.
Treatment of overdose: control and correction of fluid balance, electrolytes and acid-base balance, kidney function, diuresis liver enzyme concentrations . Symptomatic treatment is carried out based on an assessment of the results of the above indicators. When pressure decreases, intravenous fluid administration, Trendelenburg position, and administration of Dopamine or Norepinephrine . It is recommended to provide conditions for resuscitation due to the proarrhythmogenic effect of levomepromazine.
In case of overdose of antipsychotics , it is not recommended to use Adrenaline, Lidocaine and arrhythmic drugs . To treat seizures, Diazepam or Phenytoin (for recurrent seizures ). rhabdomyolysis develops, Mannitol is administered . selective antidote .
It is not recommended to induce artificial vomiting, since epileptic convulsions and dystonic movements of the muscles of the head or neck can lead to the penetration of vomit into the respiratory tract.
Gastric lavage is performed with monitoring of vital signs. Additional suppression of drug absorption is achieved by using enterosorbents and laxatives.
Interaction
Antihypertensive drugs and MAO inhibitors should not be used simultaneously with Levomepromazine
Caution is recommended when used concomitantly with the following drugs (due to possible increased side effects):
- m-anticholinergic drugs (H1-histamine receptor inhibitors, tricyclic antidepressants);
- a number of antiparkinsonian drugs;
- Scopolamine, Atropine, Suxamethonium;
- drugs that suppress the nervous system (general anesthesia, opioid analgesics, sedatives and hypnotics, anxiolytics, tricyclic antidepressants, tranquilizers );
- drugs that stimulate the nervous system ( amphetamine derivatives and other drugs);
- Levodopa;
- hypoglycemic oral agents;
- drugs that increase the QT interval ;
- drugs that cause photosensitivity ;
- ethanol;
- antacids;
- drugs that suppress bone marrow hematopoiesis;
- Dilevalol (dosage reduction of both drugs may be required).
Levomepromazine and its non-hydroxylated derivatives are potent CYP2D6 . Concomitant use with drugs metabolized by CYP2D6 leads to increased concentrations and increased undesirable effects.
Contraindications to the use of the drug Tizercin
Tizercin tablets and solution should not be used:
- if you are allergic to phenothiazine or any ingredients included in the drug;
- during pregnancy (or planning it) or breastfeeding;
- with severe liver disease, changes in blood counts, circulatory failure;
- in case of a sudden decrease in blood pressure;
- when treated with an antidepressant belonging to MAO inhibitors;
- when treated with drugs to lower blood pressure (especially guanethidine and ACE inhibitor).
The drug should not be administered to children and persons who are unconscious, intoxicated or under the influence of drugs..
special instructions
It is recommended to stop using the drug if hypersensitivity reactions develop.
Combined use with MAO inhibitors , drugs that depress the nervous system, and m-anticholinergic blockers requires extreme caution.
Tizercin should be prescribed with caution to patients with liver or kidney damage.
Elderly people are predisposed to the development of orthostatic hypotension , as well as to the sedative and m-anticholinergic effects of phenothiazines . They are more likely to experience extrapyramidal side effects .
In cases of parenteral use of the drug, the injection sites should be alternated, since local irritation and tissue changes may occur.
Caution must be exercised when using the drug in patients (especially the elderly) suffering from cardiac diseases, patients with congestive heart failure , arrhythmia QT syndrome
hyperthermia occurs during treatment with antipsychotics , it is necessary to exclude the possibility of neuroleptic malignant syndrome , which poses a threat to life and is characterized by the following symptoms: confusion, hyperthermia, muscle rigidity , disruption of the autonomic system, increased activity creatine phosphokinase, catatonia, myoglobinuria and acute renal failure . If such symptoms or hyperthermia of unknown origin occur, use of the drug should be stopped immediately.
After abrupt withdrawal of a drug used for a long time or in large doses, vomiting, nausea, tremor , headache , increased sweating, insomnia, tachycardia , anxiety, tolerance to the sedative effect of phenothiazine derivatives and cross-tolerance to other antipsychotic drugs . For these reasons, Tizercin should always be discontinued gradually.
The development of cholestatic jaundice depends on the individual characteristics of the patient. This symptom completely disappears after stopping use of the drug, so long-term treatment requires constant monitoring of liver parameters.
Before and during treatment, it is necessary to regularly monitor the following indicators: liver function, leukocyte count, blood pressure , ECG (for cardiac diseases and in elderly patients), potassium in the blood. It is also necessary to periodically monitor the ratio of plasma electrolytes and correct it.
During the initial period of treatment, operating mobile mechanisms is strictly prohibited. The duration of the ban is determined in each case individually.
Special instructions for the use of the drug Tizercin
If the patient has already taken MAO inhibitors, then before starting treatment with Tizercin it is necessary to take a break of at least 14 days, during which time not to take any medication. Before and during treatment, the composition of peripheral blood and the functional state of the liver, kidneys, heart, and in elderly patients, blood pressure should be regularly monitored. During treatment, drinking alcoholic beverages is prohibited. In weakened and elderly patients, it is recommended to reduce the dose. At the beginning of treatment, patients taking the drug should refrain from potentially hazardous activities that require increased attention and quick reaction. In the future, these restrictions depend on the individual response to the drug.
Reviews of Tizercin
Reviews indicate that the drug has a powerful sedative effect in case of sleep disorders and severe agitation against the background of autism, schizophrenia and other mental pathologies.
There are frequent cases of individual insensitivity to the product. Side effects are rarely reported by patients. In outpatient practice, the use of Tizercin is limited due to the difficulty of selecting doses and monitoring the patient.
Tizercin price, where to buy
The price of a package of the drug in tablets in Russia starts from 245 rubles, and in Ukraine the price of tablets approaches 114 hryvnia.
- Online pharmacies in UkraineUkraine
Pharmacy24
- Tizercin 25 mg 1 ml No. 10 injection solution ZAT FZ EGIS/VAT Pharmaceutical plant EGIS, Ugorshchina/Ugorshchina
109 UAH.order - Tizercin 25 mg No. 50 tablets ZAT FZ EGIS/VAT Pharmaceutical plant EGIS, Ugorshchina/Ugorshchina
95 UAH order
Interactions of the drug Tizercin
MAO inhibitors increase the risk of extrapyramidal disorders during treatment with Tizercin due to decreased inactivation of the drug in the liver. The simultaneous administration of Tizercin and drugs that depress the central nervous system leads to an increase in the central depressive effect. Tizercin blocks dopaminergic receptors and therefore has an antagonistic effect when used simultaneously with levodopa. Under the influence of Tizercin, the antiparkinsonian effect of levodopa is sharply reduced. With the simultaneous use of Tizercin and antihypertensive drugs, the risk of orthostatic hypotension increases.
