Mesaton - instructions for use, reviews, analogs and forms of release (injections in ampoules for injections, eye drops 2.5% and 10% in the nose) drugs for the treatment of shock conditions, iridocyclitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Mesatone. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Mesatone in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Mesaton in the presence of existing structural analogues. Use for the treatment of shock conditions, iridocyclitis and red eye syndrome in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Mesatone - alpha1-adrenostimulant, which has little effect on the beta-adrenoreceptors of the heart; is not catecholamine (contains only one hydroxyl group in the aromatic nucleus). It causes a narrowing of arterioles and an increase in blood pressure (with a possible reflex bradycardia). Compared with norepinephrine and epinephrine, it lowers blood pressure less sharply, but it acts longer (it is less susceptible to the action of catechol-O-methyltransferase); does not cause an increase in the minute volume of blood.

The action begins immediately after the introduction and lasts for 5-20 minutes (after intravenous administration), 50 minutes (with subcutaneous injection), 1-2 hours (after intramuscular injection).

Composition

Phenylephrine hydrochloride + excipients.

Pharmacokinetics

Metabolized in the liver and GIT (without the participation of catechol-O-methyltransferase). It is excreted by the kidneys in the form of metabolites.

Indications

Parenteral:

• arterial hypotension;
• shock conditions (including traumatic, toxic);
• vascular insufficiency (including against the background of an overdose of vasodilators);
• as a vasoconstrictor for local anesthesia.

Intranasally (in the nose):

• vasomotor and allergic rhinitis.

Intraocular (in the eye):

• iridocyclitis (to prevent the occurrence of posterior synechia and to reduce exudation in the iris);
• dilated pupil in ophthalmoscopy and other diagnostic procedures necessary to monitor the state of the posterior segment of the eye;
• carrying out a provocative test in patients with a narrow anterior chamber angle profile and suspected closure angle glaucoma;
• differential diagnosis of superficial and deep injection of the eyeball;
• in ophthalmic surgery with preoperative preparation to dilate the pupil (10% solution);
• carrying out laser interventions on the fundus and in vitreoretinal surgery;
• treatment of glaucomycyclic crises;
• treatment of red eye syndrome (2.5% solution) (to reduce hyperemia and irritation of the membranes of the eye).

Forms of release

Solution for injections and in the nose (injections in ampoules).

Eye drops 2.5% and 10% (under the trademark Irifrin).

Other dosage forms, be it pills or ointment, do not exist.

Instructions for use and dosage

Ampoules

Intravenously slowly, with the collapse - 0,1-0,3-0,5 ml of 1% solution, diluting in 20 ml of 5% Dextrose solution or 0.9% solution of sodium chloride.If necessary, repeat the introduction.

Intravenously drip (in the form of a dropper) - 1 ml of a 1% solution in 250-500 ml of a 5% solution of dextrose.

Subcutaneously or intramuscularly, adults - 0,3-1 ml of 1% solution 2-3 times a day; children older than 15 years with arterial hypotension during spinal anesthesia - 0.5-1 mg / kg.

To narrow the vessels of the mucous membranes and reduce the inflammatory phenomena, they are lubricated or buried (the concentration of the solution is 0.125%, 0.25%, 0.5%, 1%).

With local anesthesia, add 0.3-0.5 ml of a 1% solution to 10 ml of an anesthetic solution.

Higher doses for adults: subcutaneously and intramuscularly: single dose - 10 mg, daily - 50 mg; intravenously: single - 5 g, daily - 25 mg.

Eye Drops

When conducting ophthalmoscopy, single instillations of 2.5% solution are used. As a rule, to create mydriasis, it is enough to inject 1 drop of 2.5% into the conjunctival sac. The maximal mydriasis is reached after 15-30 minutes and remains at a sufficient level for 1-3 hours. If it is necessary to maintain mydriasis for a long time in 1 hour, a repeated instillation is possible.

In adults and children over 12 years with insufficient dilatation of the pupil, as well as in patients with rigid iris (pronounced pigmentation), a 10% solution in the same dosage can be used for diagnostic dilatation of the pupil.

With iridocyclites 2.5 or 10% solution is used to prevent the development and rupture of the already formed rear synechiae; to reduce exudation in the anterior chamber of the eye. For this purpose, one drop of the drug is buried in the conjunctival sac of the diseased eye (eye) 2-3 times a day.

Side effect

• increased blood pressure;
• palpitation;
• ventricular fibrillation of the heart;
• arrhythmia;
• bradycardia;
• cardialgia;
• dizziness;
• feeling of fear;
• insomnia;
• anxiety;
• weakness;
• headache;
• tremor;
• paresthesia;
• convulsions;
• cerebral hemorrhage;
• pallor of the facial skin;
• skin ischemia at the injection site;
• in isolated cases necrosis and the formation of a scab during tissue ingestion or subcutaneous injection are possible;
• allergic reactions.

Contraindications

• hypersensitivity to the drug;
• hypertrophic obstructive cardiomyopathy;
• pheochromocytoma;
• ventricular fibrillation.

Application in pregnancy and lactation

Adequate and strictly controlled studies in humans and animals on the effect of the drug Mesatone on pregnant women have not been conducted, there is no data on the allocation of the drug to breast milk,based on which during pregnancy and during breastfeeding, the drug can be used with caution, only under strict indications and under the supervision of a doctor, assessing the ratio of benefit and risk.

Use in children

Use with caution in children under 18 years of age (efficacy and safety not established).

Application in elderly patients

Use with caution in elderly patients.

special instructions

During the treatment period, ECG, blood pressure, minute blood volume, blood circulation in the extremities and at the injection site should be monitored.

In patients with arterial hypertension in the case of drug-induced collapse, it is sufficient to maintain systolic blood pressure at a level below the usual 30-40 mm Hg.

Before or during the therapy of shock conditions, correction of hypovolemia, hypoxia, acidosis and hypercapnia is mandatory.

A sharp increase in blood pressure, pronounced bradycardia or tachycardia, persistent cardiac arrhythmias require discontinuation of treatment.

To prevent recurrence of blood pressure after discontinuation of the drug, the dose should be reduced gradually, especially after a prolonged infusion.

Infusion is resumed if the systolic blood pressure drops to 70-80 mm Hg.

It should be borne in mind that the use of vasoconstrictors during childbirth to correct arterial hypotension or as an additive to local anesthetics against the background of stimulant generic activities (vasopressin, ergotamine, ergometrine, and metergergometrin) may result in a persistent increase in arterial pressure in the postpartum period.

With age, the number of adrenoreceptors sensitive to phenylephrine decreases. Inhibitors of monoamine oxidase, increasing the pressor effect of sympathomimetics, can cause the occurrence of headaches, arrhythmias, vomiting, hypertensive crisis, so when patients take monoamine oxidase inhibitors in the preceding 2-3 weeks, the dose of sympathomimetics should be reduced.

Impact on the ability to drive vehicles and manage mechanisms

During therapy, you should not engage in hazardous activities that require rapid motor and mental reactions (including driving).

Drug Interactions

Mesaton reduces the antihypertensive effect of diuretics and antihypertensive drugs (methyldopa, mekamilamin, guanadrel, guanethidine).

Phenothiazines, alpha-adrenoblockers (phentolamine), Furosemide and other diuretics reduce the hypertensive effect of Mesatone.

Inhibitors of monoamine oxidase (furazolidone, procarbazine, selegiline), oxytocin, ergot alkaloids, tricyclic antidepressants, methylphenidate, adrenostimulants enhance the pressor effect and arrhythmogenicity of phenylephrine.

Beta-adrenoblockers reduce cardio-stimulating activity, against the background of reserpine - arterial hypertension is possible (as a result of depletion of catecholamine stores in adrenergic endings, sensitivity to adrenomimetics increases).

Inhalational anesthetics (chloroform, enflurane, halothane, isoflurane, methoxyflurane) increase the risk of severe atrial and ventricular arrhythmia, as sharply increase the sensitivity of the myocardium to sympathomimetics.

Ergometrin, ergotamine, methylergometrine, oxytocin, doxapram increase the severity of the vasoconstrictor effect.

Reduces the antianginal effect of nitrates, which, in turn, can reduce the pressor effect of sympathomimetics and the risk of arterial hypotension (simultaneous use is possible depending on the achievement of the necessary therapeutic effect).

Thyroid hormones increase (mutually) the effect and the associated risk of coronary insufficiency (especially in coronary atherosclerosis).

Analogues of the drug Mezaton

Structural analogs for the active substance:

• Visophrine;
• Irifrin;
• Nazol Baby;
• Nazole Kids;
• Neosinephrine PIC;
• Relief;
• Phenylephrine hydrochloride.

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