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Teopek - instructions for use, reviews, analogs and forms of release (tablets prolonged action of 100 mg, 200 mg and 300 mg) drugs for the treatment of bronchial asthma, obstructive bronchitis in adults, children and pregnancy. Composition

Teopek - instructions for use, reviews, analogs and forms of release (tablets prolonged action of 100 mg, 200 mg and 300 mg) drugs for the treatment of bronchial asthma, obstructive bronchitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Theopack. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Teopek 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 Teopek in the presence of existing structural analogs. Use for the treatment of bronchial asthma, obstructive bronchitis, COPD in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

 

Theopack - phosphodiesterase inhibitor, methylxanthine. Increases accumulation in the tissues of cAMP, blocks adenosine (purine) receptors; reduces the flow of calcium ions through the channels of cell membranes, reduces the contractile activity of smooth muscles. Relaxes the muscles of the bronchi, blood vessels (mainly the vessels of the brain, skin and kidneys); has a peripheral vasodilating effect, increases renal blood flow, has a moderate diuretic effect. Stabilizes the membrane of mast cells, inhibits the release of mediators of allergic reactions. Increases mucociliary clearance, stimulates contraction of the diaphragm, improves the function of the respiratory and intercostal muscles, stimulates the respiratory center. Normalizing the respiratory function, promotes the saturation of blood with oxygen and a decrease in the concentration of carbon dioxide; stimulates the centers of respiration. Strengthens lung ventilation in hypokalemia.

 

Has a stimulating effect on the activity of the heart, increases the strength of heartbeats and heart rate, increases coronary blood flow and the need for myocardium in oxygen. Reduces the tone of blood vessels (mainly vessels of the brain, skin and kidneys).Reduces pulmonary vascular resistance, lowers pressure in a small circle of blood circulation.

 

Increases renal blood flow, has a moderate diuretic effect. Expands extrahepatic biliary tract. It inhibits platelet aggregation (suppresses the platelet activation factor and PgE2alpha), increases the resistance of erythrocytes to deformation (improves the rheological properties of the blood), reduces thrombus formation and normalizes microcirculation.

 

Composition

 

Theophylline + auxiliary substances.

 

Pharmacokinetics

 

When ingested Teopek quickly and completely absorbed from the digestive tract. The presence of food in the stomach can affect the speed (but not the degree) of absorption of theophylline, as well as its clearance. When using the dosage form of the usual duration of action, Cmax in the plasma is achieved after 1-2 hours. After intramuscular injection, the absorption is slow and incomplete. The binding to plasma proteins is approximately 40%; In newborns, as well as in adults with diseases, binding decreases. Theophylline is metabolized in the liver with the participation of several cytochrome P450 isoenzymes, the most important of which is CYP1A2.In the process of metabolism, 1,3-dimethylurea, 1-methylmercury and 3-methylxanthine are formed. These metabolites are excreted in the urine. In unchanged form, adults are 10%. In newborns, a significant proportion is excreted in the form of Caffeine (due to the immaturity of the ways of its further metabolism), in unchanged form - 50%.

 

Significant individual differences in the rate of hepatic metabolism of theophylline are the cause of pronounced variability in the values ​​of clearance, concentration in the plasma. The liver metabolism is affected by factors such as age, addiction to tobacco smoking, diet, diseases, concomitant drug therapy.

 

Clearance decreases with heart failure, violations of liver function, chronic alcoholism, pulmonary edema, with COPD.

 

Indications

  • bronchoobstructive syndrome of various genesis;
  • bronchial asthma (the drug of choice for asthma physical stress and as an additional remedy for other forms of bronchial asthma);
  • COPD (chronic obstructive bronchitis, emphysema);
  • pulmonary hypertension, pulmonary heart;
  • edematous syndrome of renal genesis (as part of combination therapy);
  • night apnea.

 

Forms of release

 

Tablets of prolonged action of 100 mg, 200 mg and 300 mg (prolong or retard).

 

Instructions for use and dosing regimen

 

Install individually. The initial dose is an average of 400 mg per day. With good tolerability, the dose can be increased approximately 25% from the initial dose every 2-3 days until the optimal therapeutic effect is achieved.

 

The maximum doses that can be used without monitoring the concentration of theophylline in the blood plasma: children aged 3-9 years - 24 mg / kg per day, 9-12 years - 20 mg / kg per day, 12-16 years - 18 mg / kg per day; patients aged 16 years and older - 13 mg / kg per day or 900 mg per day.

 

If the symptoms of toxic effects appear in the indicated doses or if there is a need for a further increase in the dose (due to an insufficient therapeutic effect), it is recommended to monitor the concentration of theophylline in the blood plasma. The optimal therapeutic concentrations of theophylline are 10-20 μg / ml. At lower concentrations, the therapeutic effect is weak, at large - there is no significant increase in therapeutic effect, while the risk of side effects increases significantly. The frequency of reception depends on the dosage form.

 

Side effect

  • dizziness;
  • headache;
  • insomnia;
  • excitation;
  • anxiety;
  • irritability;
  • tremor;
  • palpitation;
  • tachycardia (including fetus with admission in the 3rd trimester);
  • arrhythmias;
  • a decrease in blood pressure;
  • cardialgia;
  • increased frequency of angina attacks;
  • gastralgia;
  • nausea, vomiting;
  • gastroesophageal reflux;
  • heartburn;
  • exacerbation of peptic ulcer;
  • diarrhea;
  • decreased appetite (with prolonged admission);
  • skin rash;
  • itching;
  • fever;
  • chest pain;
  • tachypnea;
  • sensation of tides to the face;
  • albuminuria (protein in the urine);
  • hematuria (blood in the urine);
  • hypoglycemia;
  • increased diuresis;
  • increased sweating.

 

Side effects decrease with decreasing dose.

 

Contraindications

  • epilepsy;
  • peptic ulcer of the stomach and duodenum in the phase of exacerbation;
  • gastritis with high acidity;
  • recent bleeding from the gastrointestinal tract;
  • severe arterial hyper- or hypotension;
  • severe tachyarrhythmias;
  • hemorrhagic stroke;
  • hemorrhage in the retina of the eye;
  • children's age (up to 3 years, for prolonged oral forms - up to 12 years);
  • hypersensitivity to theophylline and other xanthine derivatives (caffeine, pentoxifylline, theobromine).

 

Application in pregnancy and lactation

 

Theophylline penetrates through the placental barrier, excreted in breast milk.

 

In pregnancy, Teopec is used only if the intended benefit to the mother exceeds the possible risk to the fetus.

 

If it is necessary to use during lactation, it should be borne in mind that theophylline is excreted in breast milk.

 

Use in children

 

Contraindicated in children under the age of 12 years for prolonged oral forms.

 

Application in elderly patients

 

Use with caution in elderly patients.

 

special instructions

 

Use with caution in severe coronary insufficiency (acute phase of myocardial infarction, angina pectoris), widespread atherosclerosis of vessels, hypertrophic obstructive cardiomyopathy, ventricular extrasystole, chronic heart failure, increased convulsive readiness, with hepatic and / or renal insufficiency, peptic ulcer of stomach and duodenum in anamnesis), with uncontrolled hypothyroidism (the possibility of cumulation) or thyrotoxicosis, prolonged hyperthermia, gastroesophageal reflux, prostatic hypertrophy, during pregnancy, during lactation, in elderly patients,in children (especially for oral forms).

 

The intensity of the action of Teopek can decrease in smokers.

 

In severe diseases of the cardiovascular system, liver, viral infections, as well as in elderly patients, the dose of theophylline should be reduced.

 

Drug Interactions

 

With the simultaneous use of macrolides with antibiotics, allopurinol, cimetidine, oral contraceptives, isoprenaline, lincomycin, the clearance of theophylline decreases.

 

With the simultaneous use of beta-adrenoblockers, especially non-selective, can cause bronchoconstriction, which reduces the bronchodilating effect of theophylline. Possible decrease in the effectiveness of beta-blockers.

 

Theopack is not used simultaneously with other xanthine derivatives.

 

With the simultaneous use of beta2-adrenoreceptor stimulants, caffeine, furosemide, the effect of theophylline is enhanced.

 

With simultaneous use with aminoglutethimide, the effectiveness of Teopek may be reduced due to an increase in its excretion from the body.

 

With simultaneous use with acyclovir, an increase in the concentration of theophylline in the blood plasma and an increase in adverse reactions are possible.

 

With simultaneous use with verapamil, diltiazem, nifedipine, felodipine, the concentration of theophylline in the blood plasma is usually slightly or moderately altered in the absence of changes in bronchodilator action. The cases of increasing the concentration of theophylline in the blood plasma and enhancing its side effect in patients simultaneously receiving Verapamil or Nifedipine are described.

 

With the simultaneous use of disulfiram, the concentration of theophylline in the blood plasma increases and toxic reactions develop.

 

With the simultaneous use of lithium salts, it is possible to reduce their effectiveness.

 

With simultaneous use with propranolol, the clearance of theophylline decreases.

 

With simultaneous application with phenytoin, the concentrations of theophylline and phenytoin in the blood plasma decrease and their therapeutic effectiveness decreases.

 

With simultaneous use with phenobarbital, rifampicin, isoniazid, carbamazepine, sulfinpyrazone, the intensity of theophylline may decrease due to an increase in its clearance.

 

With simultaneous use with enoxacin or other fluoroquinolones, a significant increase in the concentration of theophylline in the blood plasma is possible.

 

Analogues of the drug Teopek

 

Structural analogs for the active substance:

  • Afonilum;
  • Wentax;
  • Diffumal 24;
  • Retafil;
  • Spofillin retard;
  • Theostat;
  • Theotard;
  • Theophylline;
  • Eufilong.

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Reviews (2):
Visitors
asolt 15
I accept teopek, he helps me, twice a day for 200 mg. How long does the drug take? I've been taking a month. Is it possible to continue reception?
Administrators
admin
asolt 15, Teopek can be taken for a long time, up to 3 months. In occasion of cancellation of a preparation it is better to address to the attending physician who appointed or nominated to you the given medicine.

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