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Neuleptil - instructions for use, analogs, reviews and release forms (solution or drops for ingestion, capsules or tablets 10 mg) of the drug for the treatment of schizophrenia, epilepsy, aggressiveness in adults, children and pregnancy. Composition

Neuleptil - instructions for use, analogs, reviews and release forms (solution or drops for ingestion, capsules or tablets 10 mg) of the drug for the treatment of schizophrenia, epilepsy, aggressiveness in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Neulethyl. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Neuleptil 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 Neuleptil with existing structural analogues.Use for the treatment of schizophrenia, epilepsy, behavioral disorders with aggressiveness in adults, children, as well as in pregnancy and lactation. Composition of the preparation.

 

Neulethyl - a neuroleptic from piperidine derivatives of phenothiazine. Has moderate antipsychotic and sedative effect without stimulating component. Has adrenolytic, spasmolytic, parasympatolytic, antiemetic, hypothermic action. Potentiates the activity of narcotic and non-narcotic analgesics, hypnotics.

 

Has a distinctive sedative effect, reduces aggressiveness, excitability, disinhibition. Has a hypnotic effect.

 

In connection with the selective normalizing influence on behavior, Neuleptil was called the "behavior corrector".

 

Composition

 

Periciazin + auxiliary substances.

 

Pharmacokinetics

 

Well absorbed from the digestive tract. After oral administration, the concentration in the plasma is lower than with intramuscular injection (the effect of the first passage through the liver) and varies widely. The connection with plasma proteins is 90%. Intensively penetrates into the tissue, as it easily passes through the histohematological barriers, including the blood-brain barrier. Penetrates into breast milk.Metabolized in the liver by hydroxylation and conjugation, has the effect of "first passage" through the liver, undergoes hepatic recirculation. Elimination of metabolic products is more prolonged. It is excreted by the kidneys, with bile and calves.

 

Indications

  • acute psychotic disorders;
  • chronic psychotic disorders such as schizophrenia;
  • chronic non-schizophrenic delusional disorders: paranoid delusional disorders, chronic hallucinatory psychoses (for the treatment and prevention of relapses);
  • anxiety;
  • psychomotor agitation;
  • aggressive or dangerous impulsive behavior (as an additional drug for short-term treatment of these conditions).

 

Forms of release

 

Solution for ingestion 4 g (sometimes mistakenly called drops).

 

Capsules 10 mg (sometimes mistakenly called pills).

 

Instructions for use and dosage

 

The dosage regimen varies considerably depending on the indications and age of the patient. The average daily dose should be given in 2 or 3 admission, with an emphasis on the evening hours.

 

In adults, the average daily dose can range from 30 mg to 100 mg.In some cases it is permissible to increase the daily dose to 200 mg.

 

In children older than 3 years, the average daily dose is from 0.1 mg to 0.5 mg per kg of body weight.

 

Side effect

 

Neuleptil is usually well tolerated, however, in some cases, the following undesirable reactions may occur, the severity of which varies depending on the pharmacological properties of the antipsychotic.

 

Small initial doses:

  • orthostatic hypotension;
  • disorders of the autonomic nervous system: anticholinergic effects, such as dry mouth, constipation, accommodation paresis, urinary retention;
  • sedation or drowsiness, which are more pronounced at the beginning of treatment;
  • apathy;
  • anxiety;
  • mood changes;
  • state of depression.

 

Higher doses:

  • early dyskinesia (spasmodic torticollis, oculomotor crises, trismus, etc.);
  • tardive dyskinesia, observed with prolonged treatment;
  • extrapyramidal disorders (akinesia, sometimes combined with muscle hypertonia and partially eliminated in the appointment of anticholinergic antiparkinsonic drugs, hyperkinesia-hypertonus, motor agitation, akathisia);
  • impotence;
  • frigidity;
  • hyperprolactinemia: amenorrhea, galactorrhea, gynecomastia;
  • increase in body weight;
  • thermoregulation disorders;
  • hyperglycemia;
  • decreased glucose tolerance;
  • allergic skin reactions;
  • photosensitization;
  • agranulocytosis (regular blood test is recommended), leukopenia;
  • decreased tone of the eyeballs;
  • brownish deposits in the anterior chamber of the eye due to accumulation of the drug, usually not affecting the vision
  • positive serological test for antinuclear antibodies without clinical manifestations of lupus erythematosus;
  • the possibility of development of cholestatic jaundice;
  • neuroleptic malignant syndrome (in the case of unexplained fever, stop antipsychotic therapy, as it may be one of the symptoms neuroleptic malignant syndrome, neuroleptic described in the application, the clinical manifestations which are pallor, hyperthermia and dysfunction of the autonomic nervous system);
  • cases of sudden death, possibly caused by the reasons for cardiac nature, as well as cases of unexplained sudden death.

 

Contraindications

  • angle-closure glaucoma;
  • retention of urine on the background of diseases of the prostate;
  • Parkinson's disease;
  • agranulocytosis, porphyria in the anamnesis;
  • concomitant therapy with levodopa;
  • hypersensitivity to pericyazin.

 

Application in pregnancy and lactation

 

Pregnancy

 

Experimental studies in animals did not reveal a teratogenic effect of the drug. Studies of the teratogenic effect of pericyazine in humans have not been conducted. As with other phenothiazine derivatives, the findings of various epidemiological prospective studies on the possible risk of developing fetal malformations are contradictory. There is no evidence of the effect of the appointment of Neuleptil during pregnancy on the development of the fetal brain.

 

In rare cases, the following disorders were reported in neonates whose mothers received long-term treatment with large doses of Neuleptil:

  • gastrointestinal disorders (bloating, etc.) associated with the atropine-like effect of phenothiazines;
  • extrapyramidal disorders.

 

Thus, the risk of teratogenic action of the drug, if any, is negligible.It is advisable to limit the duration of the drug during pregnancy.

 

If possible, at the end of pregnancy, it is desirable to reduce the dose of Neuleptil and the antiparkinsonian drugs that correct them, which can potentiate the atropine-like effect of neuroleptics. The neonates should monitor the state of the nervous system and the function of the gastrointestinal tract.

 

Lactation

 

Due to the lack of data on the penetration of the drug into breast milk, it is not recommended to breast-feed while taking the drug.

 

Use in children

 

In children older than 3 years, the average daily dose is from 0.1 mg to 0.5 mg per kg of body weight.

 

Application in elderly patients

 

With caution, the drug should be used in elderly patients (possibly the development of excessive sedative and hypotensive effects).

 

special instructions

 

In case of fever or infection, a general blood test should be performed, as there have been reports of the potential for agranulocytosis.

 

It is not recommended to take alcohol during treatment.

 

For patients with epilepsy, due to the ability of the drug to lower the threshold of excitability of the cerebral cortex,Clinical and, if possible, electroencephalographic observation should be carried out.

 

Neuroleptics of the phenothiazine series may contribute to the prolongation of the QT interval, which increases the risk of serious ventricular arrhythmias such as torsade de point, which are potentially dangerous (sudden death).

 

The prolongation of the QT interval is particularly enhanced with bradycardia, hypokalemia and congenital or acquired (as a result of taking medication) QT interval prolongation. Before the appointment of therapy with neuroleptics as an absolutely necessary factor of treatment, and if the clinical picture allows, to avoid the possible emergence of risk factors, it is necessary to conduct medical and laboratory studies.

 

The drug is released by prescription.

 

Care should be taken with pericyazine:

  • in elderly patients, due to their high predisposition to the development of sedation and orthostatic hypotension;
  • in patients with severe cardiovascular pathology, due to hemodynamic disorders and changes in the ECG;
  • in patients with hepatic and / or renal insufficiency, due to the risk of overdose.

 

Impact on the ability to drive vehicles or other mechanisms

 

It is necessary to inform patients, especially those who are drivers of vehicles or persons working with other mechanisms, about the possibility of their drowsiness due to taking the drug, especially at the beginning of treatment.

 

Drug Interactions

 

Combinations of drugs, the use of which is contraindicated

 

Levodopa: the presence of a mutual antagonism between levodopa and neuleptil has been established. Do not treat extrapyramidal disorders with levodopa against the background of treatment with neuleptil (decrease or loss of neuroleptic activity).

 

If it is necessary to appoint a neuleptil to patients suffering from Parkinsonism and taking levodopa, it is illogical to continue taking levodopa, as it increases mental disorders and can not affect receptors blocked by neuroleptics.

 

Inadequate combinations of drugs

 

Alcohol: increased sedative effect did not improve: decreased response, which can be dangerous for persons driving vehicles and using mechanisms.Avoid the use of alcoholic beverages and preparations containing alcohol.

 

Guanethidine and similar drugs: a decrease in the antihypertensive activity of guanethidine, due to a decrease in the penetration of guanethidine into the fibers of the sympathetic nerves, to which the action of the drug is associated. Use other antihypertensives.

 

Sultopride: increased risk of developing ventricular arrhythmias, in particular ventricular fibrillation.

 

Combinations of medicines requiring caution when used

 

Antacids (salts, oxides and hydroxides of magnesium, aluminum and calcium): decreased absorption of nuleptil in the gastrointestinal tract. If possible, the interval between taking antacids and nuleptil should be at least two hours.

 

Combinations of drugs, in the application of which there is interaction, which should be taken into account

 

Hypotensive drugs (all): increased hypotensive effect and the risk of development of orthostatic hypotension (cumulative effect). For guanethidine, see the section "Inappropriate combinations of drugs."

 

Other drugs that depress the nervous system are derivatives of morphine.Most blockers of histamine H1 receptors with sedative action, barbiturates, benzodiazepines, anxiolytics, which are not derivatives of benzodiazepines, clopidines and preparations containing it: an increase in the CNS inhibitory effect may be of significant significance, in particular when driving vehicles and using other mechanisms.

 

Atropine and other holinoblokatory, antidepressants, derivatives of imipramine, antiparkinsonic drugs with anticholinergic action; disopyramide - the possibility of cumulation of undesirable effects associated with anticholinergic action, such as urinary retention, constipation, dry mouth, and the like.

 

Strengthens the effects of anxiolytics, analgesics, anesthetics, hypnotics, ethanol, as well as side effects of hepato- and nephrotoxic drugs. When combined with tricyclic antidepressants, maprotiline, MAO inhibitors, lengthening and strengthening of sedative and anticholinergic effects may be possible, with thiazide diuretics - increased hyponatremia, with Li + - decreased absorption in the gastrointestinal tract, increased elimination rate of Li +, increased manifestation of extrapyramidal disorders,early signs of Li + intoxication (nausea and vomiting) may be masked by the antiemetic effect of phenothiazines. When combined with beta-adrenoblockers contribute to an increase in the hypotensive effect, there is a risk of developing irreversible retinopathy, arrhythmias and tardive dyskinesia. The appointment of alpha and beta adrenostimulators (epinephrine) and sympathomimetics (ephedrine) can lead to a paradoxical decrease in blood pressure. Amitriptyline, amantadine, antihistamines and other drugs with anticholinergic effect increase anticholinergic activity.

 

Antithyroid drugs increase the risk of agranulocytosis. Reduces the effect of funds that reduce appetite (with the exception of fenfluramine). Reduces the effectiveness of the emetic action of apomorphine. strengthens its inhibitory effect on the central nervous system. Increases the concentration in the plasma of prolactin and prevents the action of bromocriptine.

 

Analogues of the drug Neuleptil

 

Structural analogs for the active substance:

  • Periciazin.

 

Analogues on the curative effect (means for the treatment of schizophrenia):

  • Abilifay;
  • Azaleptin;
  • Amitriptyline;
  • Betamax;
  • Haloperidol;
  • Demanol;
  • Diazepam;
  • Zalast;
  • Zeldox;
  • Zilaxera;
  • Ziprex;
  • Invega;
  • Quentiaks;
  • Ketilept;
  • Klozasten;
  • Lakvel;
  • Lorazepam;
  • Mazeptil;
  • Peaceful;
  • Moditen;
  • Nantarid;
  • Olanzapine;
  • Pantogam;
  • Pantogam;
  • Pantokaltsin;
  • Parnasan;
  • Piportil;
  • Prolinate;
  • Prosulfin;
  • Ridonex;
  • Rileptid;
  • Ridonal;
  • Risperidone;
  • Rispolept;
  • Rispolux;
  • Senorm;
  • The servicer;
  • The Serdolect;
  • Seroquel;
  • Seroquel Prolong;
  • Sibazon;
  • Sidnokarb;
  • Solian;
  • Sonapaks;
  • Speridan;
  • Sulpiride;
  • Tizerzin;
  • Thiodasin;
  • Torendo;
  • Triftazine;
  • Truksal;
  • Phenotropil;
  • Chloroproticsen;
  • Eglek;
  • Eglonyl;
  • Etaperazine.

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Reviews (1):
Guests
Anton
Features - less frequently than other antipsychotics of the first generation, causes extrapyramidal disorders due to a higher affinity for 5-HT2 and 5-HT6 and a powerful,more powerful than other, holinoliticheskogo effect, which, however, gives its own pobochki - constipation, paresis of accommodation, the risk of paralytic obstruction of the intestine, cognitive impairment. Therefore, with nonpsychotic disorders is not recommended, and for psychotic drugs are better, even among the first generation. There is no particular tropism in relation to behavioral disorders. Like other antipsychotics, this is a banal "chemical straitjacket." No differences. Moreover, it has long been known that the impulsive aggressiveness of antipsychotics can even exacerbate (neuroleptic dysphoria is mixed here).

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