Platiphylline: instructions for use, indications for use, price and reviews

Pharmacodynamics and pharmacokinetics

Platyphylline is an international name (INN) that has been adopted for use in the UK (BAN). Platyphylline is a pyrrolizidine alkaloid found in plants of the genus Senécio. The active substance of the drug is used in the form of hydrotartrate , a prescription in Latin for the substance Platyphyllini hydrotartratis, which is capable of inhibiting the cholinergic system , which transmits excitation from the parasympathetic nerves to the executive organs, thereby exerting a calming effect on the vasomotor center, and blocks the H-cholinergic receptors of the autonomic ganglia .

The drug has an anticholinergic dose-dependent effect , that is, smaller doses inhibit the secretion of the salivary and bronchial glands, sweating, eye accommodation, causing dilation of the pupils, an increase in heart rate, while large doses reduce the contractile activity of the digestive tract, including the biliary tract and gallbladder, In addition, it affects the urinary tract and inhibits gastric secretion.

As for pharmacokinetics, Platiphylline can easily pass through histohematic barriers , including the blood-brain, cellular and synaptic membranes. The correct dosage and intervals of administration do not cause accumulation of the drug, however, the administration of large doses causes its accumulation in the tissues of the central nervous system in significant concentrations. Metabolized in the liver and eliminated in the kidneys and intestines.

Description of the drug PLATYPHYLLINE

M-cholinergic receptor blocker. Compared to atropine, it has a less pronounced effect on peripheral m-cholinergic receptors (the effect on smooth muscle cells of the gastrointestinal tract and circular muscle of the iris is 5-10 times weaker than atropine). By blocking m-cholinergic receptors, it disrupts the transmission of nerve impulses from postganglionic cholinergic nerves to the effector organs and tissues innervated by them (heart, smooth muscle organs, exocrine glands); also suppresses n-cholinergic receptors (much weaker). The anticholinergic effect is more pronounced against the background of increased tone of the parasympathetic part of the autonomic nervous system or the action of m-anticholinergic stimulants.

To a lesser extent than atropine, it causes tachycardia, especially when used in high doses. By reducing the influence of n.vagus, it improves cardiac conductivity, increases myocardial excitability, and increases cardiac output. It has a direct myotropic antispasmodic effect and causes dilation of small blood vessels in the skin. In high doses, it inhibits the vasomotor center and blocks the sympathetic ganglia, as a result of which the blood vessels dilate and blood pressure decreases (mainly with intravenous administration). Weaker than atropine, it inhibits the secretion of endocrine glands; causes a marked decrease in smooth muscle tone, amplitude and frequency of peristaltic contractions of the stomach, duodenum, small and large intestine, a moderate decrease in gallbladder tone (in persons with hyperkinesia of the biliary tract); with hypokinesia, the tone of the gallbladder increases to normal. Causes relaxation of the smooth muscles of the uterus, bladder and urinary tract; Providing an antispasmodic effect, it eliminates pain. Relaxes the smooth muscles of the bronchi caused by increased tone of the n.vagus or cholinergic stimulants, increases the volume of breathing, inhibits the secretion of the bronchial glands; reduces sphincter tone.

When instilled into the conjunctival sac of the eye and parenterally administered, it causes pupil dilation due to relaxation of the orbicularis muscle of the iris. At the same time, intraocular pressure increases and paralysis of accommodation occurs (relaxation of the ciliary muscle of the ciliary body). Compared to atropine, the effect on accommodation is less pronounced and shorter. Stimulates the brain and respiratory center, and to a greater extent the spinal cord (in high doses, convulsions and depression of the central nervous system, vasomotor and respiratory centers are possible). Penetrates through the BBB.

Indications for use of Platiphylline

Used for:

spasms of smooth muscles of internal organs ( pylorospasm , intestinal, renal or biliary colic );
for stomach and duodenal ;
cholecystitis or cholelithiasis ;
for acute or other chronic types of pancreatitis;
for bronchial asthma or laryngospasms ;
for arterial hypertension , angina pectoris , spasms of cerebral arteries and angiotrophoneurosis as part of combination therapy.

For diagnostic purposes, Platiphylline is used to dilate the pupil , in examining the fundus , in determining the true refraction of the eye, acute inflammatory diseases of the eyes, inflammation of the iris , keratitis and other eye injuries.

Platyphyllin

Pregnancy; lactation period;

diseases of the cardiovascular system, in which an increase in the number of heart contractions may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary heart disease, mitral stenosis, arterial hypertension, acute bleeding; thyrotoxicosis (possibly increased tachycardia); increased body temperature (may further increase due to suppression of the activity of the sweat glands); reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); diseases of the gastrointestinal tract accompanied by obstruction: achalasia and pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents); intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic intestinal obstruction (possible development of obstruction); diseases with increased intraocular pressure: closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; therapy adjustment may be required), age over 40 years (risk of undiagnosed glaucoma ); nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic ileus; in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); dry mouth (long-term further increase in the severity of xerostomia); liver failure (decreased metabolism) and renal failure (risk of side effects due to decreased excretion); chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); autonomic (autonomic) neuropathy (urinary retention and paralysis of accommodation may increase), prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy) ; gestosis (possibly increased arterial hypertension); brain damage in children (central nervous system effects may be enhanced); Down's disease (possibly unusually dilated pupils and increased heart rate); central paralysis in children (reaction to anticholinergic drugs may be more pronounced).

If you have one of the listed diseases, be sure to consult your doctor before taking the drug.

Side effects

Dry mouth and thirst , difficulty urinating or urinary retention, paresis of accommodation (ciliary muscle of the eye), central nervous system excitement, dizziness , dilated pupils, headaches , convulsions , photophobia , acute psychosis , from the cardiovascular system - tachycardia . pulmonary atelectasis may occur .

The likelihood of adverse reactions increases with high doses of Platiphylline.

Platyphyllin hydrotartrate

Diseases of the cardiovascular system in which an increase in heart rate (HR) may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary heart disease, mitral stenosis, arterial hypertension, acute bleeding.

Thyrotoxicosis (possibly increased tachycardia).

Increased body temperature (may further increase due to suppression of the activity of the sebaceous glands).

Reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function).

Diseases of the gastrointestinal tract accompanied by obstruction: achalasia and pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents).

Intestinal atony in elderly or debilitated patients and paralytic intestinal obstruction (possible development of obstruction).

Diseases with increased intraocular pressure: closed-angle glaucoma (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack), open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; therapy adjustment may be required), age over 40 years (risk of undiagnosed glaucoma).

Nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic ileus; a complication such as megacolon may occur or worsen).

Dry mouth (long-term use may cause further worsening of xerostomia).

Liver failure (decreased metabolism), renal failure (risk of side effects due to decreased excretion).

Chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi).

Myasthenia gravis (condition may worsen due to acetylcholine inhibition).

Autonomic (autonomic) neuropathy (urinary retention and paralysis of accommodation may increase), prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy).

Preeclampsia (possibly increased arterial hypertension).

Brain damage in children (central nervous system effects may be enhanced).

Down's disease (possibly unusual pupil dilation and increased heart rate).

Central paralysis in children (response to anticholinergics may be more pronounced)

Pregnancy, lactation period.

Instructions for use of Platiphylline (Method and dosage)

It must be used parenterally (subcutaneously, intramuscularly), rectally, and in ophthalmology - topically.

Platiphylline injections, instructions for use

Use 2–4 mg 3 times a day. The maximum permissible single dose is no more than 10 mg, while the daily dose is 30 mg. The dose is determined depending on the indications, route of administration and age of the patient.

For pancreatitis is prescribed subcutaneously 1-2 ml over 12 hours during periods of intense pain to reduce spasm of the smooth muscles of the pancreas.

Platyfillin tablets, instructions for use

Take 1 tablet orally 2 or 3 times a day.

Overdose

Paralytic intestinal obstruction , urinary retention, paralysis of accommodation, increased eye pressure, dry mucous membranes of the mouth, nose and throat, which can cause difficulty swallowing, mydriasis until the iris disappears completely, tremor , convulsions , hyperthermia , excitation of the central nervous system with subsequent depression of it, as well as respiratory and vasomotor centers.

As a treatment forced diuresis , cholistenase inhibitors such as Physostigmine , Galantamine or Proserin , which can ease intestinal paresis and reduce tachycardia.

In cases of moderate agitation and weak convulsions, it is best to administer Magnesium sulfate , but in severe cases - sodium hydroxybutyrate , oxygen therapy and artificial ventilation.

If tachycardia threatens the patient’s life, then quinidine sulfate and Propranolol .

Platyfillin

Use during pregnancy and breastfeeding

There are no data on the safety of platiphylline during pregnancy and lactation (breastfeeding).

Use for liver dysfunction

Use with caution in case of liver failure.

Use for renal impairment

Use with caution in case of renal failure (risk of side effects due to decreased excretion).

Use in children

Use with caution for chronic lung diseases in young children (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); brain damage in children (CNS effects may be enhanced); Down's disease (possibly unusual pupil dilation and increased heart rate), cerebral palsy (reaction to anticholinergic drugs may be more pronounced).

special instructions

Use with caution in patients with diseases of the cardiovascular system, in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary artery disease, mitral stenosis, arterial hypertension, acute bleeding;
with thyrotoxicosis (possible increased tachycardia); elevated temperature (may further increase due to suppression of the activity of the sweat glands); with reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); for gastrointestinal diseases accompanied by obstruction - achalasia of the esophagus, pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents), intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic ileus; with an increase in intraocular pressure - closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; adjustment of therapy may be required); with nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic intestinal obstruction, in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); with dry mouth (long-term use may cause further increase in the severity of xerostomia); with liver failure (decreased metabolism) and renal failure (risk of side effects due to decreased excretion); for chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); with myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy); with gestosis (possibly increased arterial hypertension); brain damage in children (CNS effects may be enhanced); Down's disease (possibly unusual pupil dilation and increased heart rate), cerebral palsy (reaction to anticholinergic drugs may be more pronounced). Impact on the ability to drive vehicles and operate machinery

It is necessary to refrain from potentially hazardous activities that require increased attention and speed of psychomotor reactions.

Interaction

Indications for the use of Platiphylline should take into account the presence of diseases that require regular use of other medications. When used simultaneously with the following substances, reactions may occur:

Haloperidol - Antipsychotic effect may be reduced in patients with schizophrenia .
Proserin - Platiphylline is its antagonist.
Phenobarbital , sodium etaminal , magnesium sulfate - increase the duration of the hypnotic effect.
Other m-anticholinergic agents and drugs with m-anticholinergic activity (for example, Amantadine , Phenothiazine , tricyclic antidepressants, some antihistamines) – increase the likelihood of adverse reactions.
Morphine - enhances the inhibitory effect of Platyphylline on the cardiovascular system.
MAO inhibitors have a positive chronotropic (increased heart rate) and bathmotropic effect (increased cardiac excitability).
Cardiac glycosides have a positive bathmotropic effect.
Analgesics , sedatives and anxiolytics can enhance the effect of Platiphylline for pain resulting from spasm of smooth muscles.
Antihypertensive/sedatives enhance the effect of Platiphylline in vascular spasms.

Platyphyllinum

Use with caution in case of renal failure (risk of side effects due to decreased excretion). Use with caution in case of liver failure.

Use with caution in patients with diseases of the cardiovascular system, in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary artery disease, mitral stenosis, arterial hypertension, acute bleeding; with thyrotoxicosis (possible increased tachycardia); elevated temperature (may further increase due to suppression of the activity of the sweat glands); with reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); for gastrointestinal diseases accompanied by obstruction - achalasia of the esophagus, pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents), intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic ileus; with an increase in intraocular pressure - closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; adjustment of therapy may be required); with nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic intestinal obstruction, in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); with dry mouth (long-term use may cause further increase in the severity of xerostomia); with myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy); with gestosis (possibly increased arterial hypertension).

For children

It is recommended to use with caution if children have chronic lung diseases , since a decrease in bronchial secretion can cause thickening of secretions and the formation of plugs in the bronchi.

Children with brain damage are at risk (the drug can enhance the effects of the disease); in addition, it is not recommended to take the drug for children with Down syndrome (there is a possibility of unusual dilation of the pupils and increased heart rate), cerebral palsy (a more pronounced reaction to the anticholinergic effect). It is not recommended to give Platiphylline injections to children under 15 years of age.

Platyphylline hydrotartrate, 2 mg/ml, solution for subcutaneous administration, 1 ml, 10 pcs.

Increased individual sensitivity, pregnancy, lactation.

Carefully

Hyperthyroidism (possibly increased tachycardia).

Increased body temperature (may further increase due to suppression of the activity of the sebaceous glands).

Reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function).

Diseases of the gastrointestinal tract accompanied by obstruction: achalasia and pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents).

Intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic intestinal obstruction.

Diseases with increased intraocular pressure: closed-angle glaucoma (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack), open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; adjustment of therapy may be required), age over 40 years (the risk of manifestation is not diagnosed glaucoma).

Nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic ileus; in addition, the manifestation or exacerbation of a complication such as toxic megacolon is possible).

Dryness of the oral mucosa (long-term use may cause a further increase in the severity of xerostomia).

Liver failure (decreased metabolism) and renal failure (risk of side effects due to decreased excretion).

Chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi).

Myasthenia gravis (condition may worsen due to acetylcholine inhibition).

Autonomic (autonomic) neuropathy (urinary retention and paralysis of accommodation may increase), prostatic hyperplasia without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hyperplasia) .

Preeclampsia (possibly increased arterial hypertension).

Brain damage in children (central nervous system effects may be enhanced).

Down syndrome (possibly unusually dilated pupils and increased heart rate).

Central paralysis in children (the reaction to anticholinergic drugs may be most pronounced).

Analogs

Level 4 ATC code matches:
Disflatil

Aprofen

Mint tablets

Spasmol

Kuplaton

Espumisan

Espumisan Baby

Espumisan L

Espumisan 40

No-Shpa

Drotaverine Hydrochloride

Bobotik

Dill water

Pepsan-R

Sub Simplex

Spasmomen

Meverin

Metacin

Niaspam

Sparex

Meteospasmil;
Vinboron;
Infacol.

Platiphylline price, where to buy

The price of ampoules (for 10 pieces in a box) averages 50 rubles, the price of Platyfillin tablets with papaverine is slightly higher - 140-180 rubles. (the package contains 10 tablets).

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

Pharmacy Dialogue

Platifillina h/t (amp. 0.2% 1 ml No. 10) DHF OJSC
82 rub. order
Platyphylline with papaverine (Table No. 10) Vifitech CJSC
RUB 137 order
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80 rub. order

Pharmacy24

Platyfillin 0.2% 1 ml No. 10 solution
50 UAH. order

PaniPharmacy

Platifillin ampoule Platifillin g/t solution d/in. 0.2% amp. 1ml No. 10 Ukraine, Health LLC
47 UAH order
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55 UAH order