Perinorm - instructions for use, reviews, analogs and formulations (tablets 10 mg, solution or suspension 30 ml and 100 ml, injections in ampoules for injection 2 ml) drugs for the treatment of nausea, vomiting, hiccups in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Perinorm. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Perinorm in their practice are presented. 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 Perinorm with available structural analogues.Use to treat nausea, vomiting, hiccups in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Perinorm - Antiemetic, helps reduce nausea, hiccups; stimulates the peristalsis of the gastrointestinal tract (GIT). Antiemetic effect is due to blockade of dopamine D2 receptors and an increase in the threshold of chemoreceptors of the trigger zone, is a blocker of serotonin receptors. It is believed that Metoclopramide (the active ingredient of Perinorm) inhibits the relaxation of the smooth muscle of the stomach caused by dopamine, thereby enhancing the cholinergic reactions of the smooth muscles of the gastrointestinal tract. Promotes the acceleration of gastric emptying by preventing the relaxation of the body of the stomach and increasing the activity of the antrum of the stomach and upper parts of the small intestine. Reduces the reflux of the contents in the esophagus by increasing the pressure of the sphincter of the esophagus at rest and increases the clearance of acid from the esophagus due to an increase in the amplitude of its peristaltic contractions. Metoclopramide stimulates the secretion of prolactin and causes a transient increase in the level of circulating aldosterone,which can be accompanied by a short-term fluid retention.

Composition

Metoclopramide hydrochloride + excipients.

Pharmacokinetics

After oral administration, it is rapidly absorbed from the digestive tract. Binding to plasma proteins is about 30%. Biotransformatsya in the liver. It is excreted mainly by the kidneys both in unchanged form and in the form of metabolites. The half-life is between 4 and 6 hours.

Indications

• vomiting;
• nausea;
• hiccough;
• atony and hypotension of the stomach and intestines (including postoperative);
• biliary dyskinesia;
• reflux esophagitis;
• flatulence;
• in the complex therapy of exacerbations of peptic ulcer of the stomach and duodenum;
• acceleration of peristalsis during X-ray contrast studies of the gastrointestinal tract.

Forms of release

Tablets 10 mg.

Injections in ampoules for injection 2 ml.

Solution for oral administration of 30 ml and 100 ml.

Instructions for use and dosing regimen

Adults inside - 5-10 mg 3-4 times a day. When vomiting, severe nausea, metoclopramide is administered intramuscularly or intravenously at a dose of 10 mg. Intranasal - 10-20 mg per nostril 2-3 times a day.

Maximum doses: one-time with oral administration - 20 mg; daily - 60 mg (for all modes of administration).

The average single dose for children over 6 years is 5 mg 1-3 times a day orally or parenterally. For children under 6 years of age, the daily dose for parenteral administration is 0.5-1 mg per kilogram, the frequency of reception is 1-3 times a day.

Side effect

• constipation, diarrhea;
• dry mouth;
• fatigue;
• drowsiness;
• dizziness;
• headache;
• depression;
• akathisia (pathological need to walk, restlessness);
• spasm of facial musculature;
• hyperkinetic (pathological sudden involuntary movements in one, or a whole group of muscles, by an erroneous command of the brain);
• spasmodic torticollis;
• agranulocytosis (a decrease in the level of leukocytes due to granulocytes and monocytes, which increases the susceptibility of the organism to bacterial and fungal infections);
• galactorrhea (excretion of milk or colostrum, not related to feeding);
• gynecomastia (enlargement of mammary glands or glands in men);
• violation of the menstrual cycle;
• skin rash.

Contraindications

• bleeding from the digestive tract;
• mechanical intestinal obstruction;
• perforation of the stomach or intestines;
• pheochromocytoma;
• extrapyramidal disorders;
• epilepsy;
• prolactin-dependent tumors;
• glaucoma;
• pregnancy, lactation;
• simultaneous use of anticholinergic drugs;
• increased sensitivity to metoclopramide.

Application in pregnancy and lactation

Perinorm is contraindicated in pregnancy.

When used during lactation (breastfeeding), it should be borne in mind that metoclopramide penetrates into breast milk. In experimental studies, no adverse effect of metoclopramide on the fetus has been established.

Use in children

With extreme caution, Perinorm should be used in children, especially young children, because they have a significantly higher risk of developing a dyskinetic syndrome.

Application in elderly patients

When using Perinorm in elderly patients, it should be borne in mind that with prolonged use of metoclopramide in high or medium doses, the most common side effect is extrapyramidal disorders, especially parkinsonism and tardive dyskinesia.

special instructions

With caution apply in patients with bronchial asthma, arterial hypertension, impaired liver or kidney function, with Parkinson's disease.

Metoclopramide in some cases can be effective in vomiting caused by the use of cytotoxic drugs.

Against the background of the use of Perinorm, there may be distortions in the laboratory parameters of liver function and the determination of the concentration of aldosterone and prolactin in the blood plasma.

Impact on the ability to drive vehicles and manage mechanisms

During the treatment period, potentially dangerous activities requiring increased attention, rapid psychomotor reactions should be avoided.

Drug Interactions

With simultaneous use with anticholinergic agents, mutual weakening of effects is possible.

When used simultaneously with neuroleptics (especially the phenothiazine series and butyrofenone derivatives), the risk of extrapyramidal reactions increases.

With simultaneous use, absorption of acetylsalicylic acid, paracetamol, ethanol (alcohol) is enhanced.

Perinorm with intravenous administration increases the absorption rate of Diazepam and increases its maximum concentration in blood plasma.

When used simultaneously with the slowly dissolving dosage form of digoxin, it is possible to reduce the serum Digoxin concentration by one third.With simultaneous use with digoxin in liquid dosage form or in the form of a rapidly dissolving drug, no interaction was observed.

With simultaneous application with zopiclone, Zopiclone absorption is accelerated; with cabergoline - possibly reducing the effectiveness of cabergoline; with Ketoprofen - the bioavailability of ketoprofen decreases.

Due to the antagonism of dopamine receptors, metoclopramide can reduce the antiparkinsonian action of levodopa, while increasing the bioavailability of levodopa due to the acceleration of its evacuation from the stomach under the influence of metoclopramide. The results of the interaction are ambiguous.

With simultaneous application with mexiletine, the absorption of mexiletine is accelerated; with mefloquine - increases the rate of absorption of mefloquine and its concentration in the blood plasma, while reducing its side effects.

When used simultaneously with morphine, the absorption of morphine is accelerated when ingested and its sedative effect is enhanced.

At simultaneous application with nitrofurantoin absorption of nitrofurantoin decreases.

When metoclopramide is used immediately before administration of propofol or thiopental, their induction doses may need to be reduced.

In patients receiving metoclopramide, the effects of suxamethonium chloride are enhanced and prolonged.

With simultaneous application with tolterodine, the effectiveness of metoclopramide decreases; with fluvoxamine - the case of development of extrapyramidal disorders has been described; with Fluoxetine - there is a risk of developing extrapyramidal disorders; with cyclosporine - increases the absorption of cyclosporine and increases its concentration in the blood plasma.

Analogues of the drug Perinorm

Structural analogs for the active substance:

• Apo-Metoclop;
• Metamol;
• Metoclopramide;
• Raglan;
• Ceruglan;
• Cried.

Analogues for the pharmacological group (antiemetics):

• Avioplant;
• Avomit;
• Bimaral;
• Bonin;
• Validol;
• Vero-Ondansetron;
• Granisetron;
• Domegan;
• Domet;
• Domperidone;
• Domiridon;
• Domstal;
• Zofran;
• Citril;
• Kormenthal;
• Lazaran;
• Latran;
• Motigect;
• Motilac;
• Motilium;
• The monotonous;
• Motion;
• Navoban;
• Notirol;
• Ondwell;
• Ondansetron;
• Ondantor;
• Onitsit;
• Sturgeon;
• Passion;
• Rondaset;
• Stronon;
• Ciel;
• Torekan;
• Trifluoperazine;
• Triftazine;
• Tropindol;
• Emend;
• Emeset;
• Emetron;
• Etaperazine.

Recall of a gastroenterologist

Perinorm - an effective drug for the treatment of such symptoms of digestive disorders, such as nausea, vomiting, hiccough. Often I prescribe this medicine for meteorism, dyskinesia of biliary tract, patients with atony and hypotonia of the gastrointestinal tract. Perinorm well improves peristalsis, I use it in the complex treatment of gastric and duodenal ulcers. The list of contraindications and adverse events in this drug is relatively small, which allows it to be used to treat a wide range of patients.

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