Spazmeks - instructions for use, analogs, reviews and release forms (tablets 5 mg, 15 mg and 30 mg) of the drug for the treatment of enuresis, urinary incontinence and cystitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Spazmex. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of spasmox 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 Spazmeksa in the presence of existing structural analogs. Use for treatment of enuresis, urinary incontinence and cystitis in adults, children, as well as during pregnancy and lactation.Composition of the preparation.

Spazmex - a drug that reduces the tone of the smooth muscles of the urinary tract. Trospium chloride (active ingredient of Spasmox) is a quaternary ammonium base, m-holinoblokator. It is a competitive antagonist of acetylcholine on the receptors of postsynaptic membranes of smooth muscles. Has a high affinity for m1- and m3-cholinergic receptors. Reduces the increased activity of detrusor of the bladder. Has spasmolytic and some ganglioblokiruyuschee effect. Does not have central effects.

Composition

Trospium chloride + excipients.

Pharmacokinetics

After taking the drug inside Cmax is achieved in 4-6 hours The concentration of trospium chloride with a single intake of 20-60 mg is proportional to the dose. Binding to plasma proteins is 50-80%. Do not cumulate. During the hydrolysis of ester bonds, a metabolite - spiroalcohol is formed. It is excreted in the urine, most of it in unchanged form, about 10% in the form of a spiroalcohol-metabolite, formed during the hydrolysis of ester bonds.

Indications

• hyperactivity of the urinary bladder, accompanied by urinary incontinence,imperative urge to urinate and increase the frequency of urination (with idiopathic hyperactivity detrusor non-hormonal and inorganic etiology);
• mixed forms of urinary incontinence;
• spastic neurogenic disorders of the bladder function (with neurogenic hyperactivity (hyperreflexia) detrusor against multiple sclerosis, spinal injuries, congenital and acquired spinal cord diseases, strokes, parkinsonism);
• detrusor-sphincter-dissynergy against intermittent catheterism;
• pollakiuria, nocturia;
• night and daytime enuresis;
• in the complex therapy of cystitis, accompanied by imperative symptoms.

Forms of release

Tablets 5 mg, 15 mg and 30 mg.

Instructions for use and dosage

The drug is prescribed inside adults and children over 14 years. Dosing regimen and duration of treatment are set individually depending on the clinical picture and the severity of the disease.

Tablets should be taken before meals, without chewing, with enough water.

Tablets 5 mg: appoint 2-3 tablets 3 times a day (30-45 mg) with an interval of 8 hours; at a daily dose of 45 mg is acceptable to take 30 mg in the morning and 15 mg in the evening.

Tablets, film-coated, 15 mg: 1 tablet 3 times a day with an interval of 8 hours; daily dose of 45 mg.

Film-coated tablets, 30 mg: appoint 1/2 tablet 3 times daily or 1 tablet in the morning and 1/2 tablet in the evening; daily dose of 45 mg.

In patients with renal insufficiency (CC 10-30 ml / min / 1.73 m2) the daily dose of the drug should not exceed 15 mg.

The average duration of treatment is 2-3 months. If a longer treatment is required, the doctor continues to review the issue of continuing treatment every 3-6 months.

Side effect

• tachycardia;
• pain behind the sternum;
• fainting;
• tachyarrhythmia;
• hypertensive crisis;
• dry mouth;
• dyspepsia;
• constipation, diarrhea;
• nausea;
• stomach ache;
• bloating;
• gastritis;
• slight or moderate increase in transaminase activity;
• dyspnea;
• confusion of consciousness;
• hallucinations;
• acute necrosis of skeletal muscles;
• violation of accommodation;
• violation of emptying the bladder;
• retention of urine;
• skin rash;
• anaphylactic reactions;
• Stevens-Johnson syndrome.

Contraindications

• angle-closure glaucoma;
• tachyarrhythmia;
• myasthenia gravis;
• retention of urine;
• slowing the evacuation of food from the stomach and the conditions predisposing to their development;
• renal failure requiring dialysis (CC less than 10 ml / min / 1.73 m2);
• children and adolescents up to 14 years;
• intolerance to galactose, deficiency of lactase, glucose-galactose malabsorption;
• hypersensitivity to the components of the drug.

Carefully:

• diseases of the cardiovascular system, in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, IHD, mitral stenosis, hypertension, acute bleeding;
• thyrotoxicosis (tachycardia may be worse);
• increased body temperature (may still increase due to suppression of activity of sweat glands);
• reflux-esophagitis, hernia of the esophagus of the diaphragm, combined with reflux-esophagitis (reduction of esophageal and gastric motility and relaxation of the lower esophageal sphincter can contribute to slowing down gastric emptying and strengthening gastro-esophageal reflux through a sphincter with impaired function);
• Gastrointestinal diseases, accompanied by obstruction: achalasia and stenosis of the pylorus (there may be a decrease in motor and tone, leading to obstruction and retention of stomach contents);
• atony of the intestine in elderly patients or weakened patients (possible the development of obstruction), paralytic ileus (possible the development of obstruction);
• diseases with increased intraocular pressure: open-angle glaucoma (mydriatic effect may cause some increase in intraocular pressure, correction of therapy may be required), age over 40 (risk of undiagnosed glaucoma);
• ulcerative colitis (a drug in a high dose can inhibit the intestinal peristalsis, increasing the probability of paralytic intestinal obstruction, and possibly the manifestation or aggravation of such a serious complication as a toxic megacolon);
• dry mouth (prolonged use may cause further intensification of xerostomia);
• Kidney failure (risk of side effects due to reduced excretion);
• chronic lung diseases, especially in children and weakened patients (a decrease in bronchial secretion can lead to a thickening of the secret and the formation of congestion in the bronchi);
• myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine);
• autonomic neuropathy (urinary retention and paralysis of accommodation may be exacerbated), prostatic hyperplasia without obstruction of the urinary tract, urinary retention or predisposition to it, or diseases accompanied by
• obstruction of the urinary tract (including the neck of the bladder due to prostatic hypertrophy);
• gestosis (hypertension is possible);
• brain diseases in children (effects from the central nervous system may be intensified);
• Down's disease (possibly an unusual dilated pupil and increased heart rate);
• central paralysis in children (reaction to anticholinergic drugs may be most pronounced);
• liver failure.

Application in pregnancy and lactation

The use of Spasmaks during pregnancy and lactation is possible only if the intended benefit to the mother exceeds the potential risk to the fetus and newborn.

Use in children

Contraindicated in children and adolescents under 14 years (adequate and strictly controlled studies of the use of trospium chloride in children have not been performed).

Application in elderly patients

With caution should prescribe the drug in elderly patients.

special instructions

Taking Spazmeks in case of a violation of the internal sphincter function of the urethra or detrusor of the bladder should be accompanied by its complete release by catheterization.

In vegetative disorders of the bladder, the cause of dysfunction should be determined before the treatment, organic causes of pollakiuria, nocturia and incontinence, such as heart failure, polydipsia, the possibility of urinary tract infection and bladder cancer, are excluded. they require the appointment of etiotropic therapy.

Impact on the ability to drive vehicles and manage mechanisms

At the beginning of treatment, with an increase in the dose of the drug, the replacement of the drug, as well as in the interaction with alcohol, visual impairment is possible, which should be taken into account when driving vehicles and working with moving mechanisms.

Drug Interactions

With simultaneous application Spasmox enhances the m-cholinoblocking effect of amantadine, tricyclic antidepressants,quinidine and disopyramide, antihistamines, as well as a positive chronotropic effect of beta-adrenomimetics.

Spasmox weakens the effect of prokinetics (metoclopramide and cisapride). It affects the motor and secretory functions of the gastrointestinal tract, changing the absorption of concomitantly used drugs.

With the simultaneous administration of drugs containing substances such as guar, colestyramine and colestipol, a decrease in the absorption of trospium chloride is possible.

There was no interaction between trospium chloride and isoenzymes of the cytochrome P450 system (CYP1A2, 2A6, 2C9, 2C19, 2D6, 2E1, 3A4), since trospium chloride is metabolized only in small amounts, and hydrolysis of esters is the main pathway of its metabolism.

Analogs of the drug Spazmeks

Structural analogs for the active substance:

• Spasmodic-lithium.

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

• Adenostop;
• Adiuretin;
• Amizole;
• Amirol;
• Anaphranil;
• Brusniver;
• Vesicar;
• Gopantam;
• Gutron;
• Detruzitol;
• Driptan;
• Clominal;
• Librax;
• Mininin;
• Novitropane;
• Oxybutynin;
• Pantogam;
• Pantogam is an asset;
• Pantokaltsin;
• Pyramids;
• Piracetam;
• Raveron;
• Rolitan;
• Triptysole;
• Urotol;
• Cystrin;
• Enablex;
• Estrokad.

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