Topral - instructions for use, reviews, analogs and forms of release (tablets 400 mg, injections in ampoules for injection in solution) drugs for the treatment of schizophrenia, psychosis and delusional disorders in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Topral. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Topral 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 Topral in the presence of existing structural analogues.Use for the treatment of schizophrenia, psychosis and delusional disorders in adults, children, as well as in pregnancy and lactation. Composition and interaction of the drug with alcohol.

Topral - antipsychotic agent (neuroleptic) from the group of substituted benzamides. Has moderate antipsychotic, as well as antidepressant action in combination with an activating action. The mechanism of antipsychotic action is associated with selective blockade of central dopamine D2 receptors. Sedation is poorly expressed, alpha-adrenoblocking activity is low, practically does not cause antimuscarinic effects. Rarely causes extrapyramidal disorders, so it refers to atypical neuroleptics.

Composition

Sultopride + excipients.

Pharmacokinetics

After oral administration in a dose of 400 mg, the maximum concentration of sulphopida in blood plasma is reached after 2 hours. After a single intramuscular injection at a dose of 200 mg - after 25 minutes, with repeated administration of the same dose - after 1 hour. Bioavailability of sultopride after oral administration is 80-90%. There is a linear relationship between the dose value and the concentration of the active substance in the plasma.The distribution of sultopride occurs rapidly (within 2 hours) and evenly. Sultopride freely penetrates the blood-brain barrier (GEB), the placental barrier, excreted in breast milk. Do not cumulate in the tissues of the body. It is exposed to insignificant metabolism: 77-90% is excreted unchanged in urine, 4% - in the form of an inactive metabolite, 5-10% is excreted through the intestine.

Indications

• acute manic syndrome;
• acute stage of schizophrenia with excitation;
• state of excitement in alcoholism;
• chronic psychoses with behavioral disorders;
• aggressiveness;
• instability of behavior in patients with mental illness.

Forms of release

Tablets 400 mg.

Solution for intramuscular injection of 200 mg in 2 ml (injections in ampoules for injection).

Instructions for use and dosing regimen

For oral administration, the daily dose of Topral is 0.4-1.6 g (1-4 tablets), divided into 3-4 doses at intervals of at least 6 hours. When the condition is improved, the dose is reduced to 0.4-0.6 g per day.

For relief of acute attacks - intramuscularly at a dose of 0.4-1.2 g per day (2-6 ampoules). Stimulation of excitation - intramuscularly 0.4-0.8 g per day.The maintenance dose is 0.4-0.6 g per day. The maximum daily dose for intramuscular injection of adults is 1.6 g.

Side effect

• retardation, drowsiness;
• early dyskinesia (spasmodic torticollis, spasms of masticatory and oculomotor muscles);
• extrapyramidal syndrome (changes in motor activity as a result of violations of muscle tone);
• disorders of the heart rhythm (including arrhythmia of the "pirouette" type);
• bradycardia (decrease in heart rate);
• Orthostatic hypotension (a violation of the ability of the body to maintain a normal level of blood pressure in the vertical position);
• amenorrhea (absence of menstruation during several menstrual cycles);
• galactorrhea (excretion of milk from the mammary glands without lactation);
• hyperprolactinemia (increasing the level of the hormone prolactin in the blood);
• gynecomastia (enlargement of the breast with hypertrophy of glands and adipose tissue);
• impotence, frigidity;
• increase in body weight.

Contraindications

• bradycardia;
• pheochromocytoma (tumor of adrenal medulla);
• hypokalemia (low level of potassium in the blood);
• lactation (breastfeeding);
• simultaneous administration of clonidine, beta-adrenoblockers, cardiac glycosides, antiarrhythmic drugs 1 and 3 classes, tricyclic antidepressants;
• hypersensitivity to sultopride.

Application in pregnancy and lactation

If Topral is needed during pregnancy (especially in the 3rd trimester), the dose and duration of treatment should be reduced, followed by monitoring the condition of the newborn. The drug is contraindicated in lactation.

Use in children

Do not administer the drug to children and adolescents.

Application in elderly patients

In elderly patients, the risk of developing sedative and hypotensive effects is increased.

special instructions

They are used with caution in patients with epilepsy (due to a possible reduction in the convulsive threshold), Parkinsonism.

In severe cardiovascular diseases, the likelihood of developing arterial hypotension and cardiac arrhythmias increases.

During the treatment with Topral, do not use ethanol (alcohol).

Impact on the ability to drive vehicles and manage mechanisms

During the treatment period, one should refrain from engaging in potentially dangerous activities requiring increased attention and speed of psychomotor reactions.

Drug Interactions

With the simultaneous use of drugs that have a depressant effect on the central nervous system (CNS), including opioid analgesics, central antitussives, antihistamines, barbiturates, benzodiazepines, other tranquilizers, and ethanol (alcohol), it is possible to increase the inhibitory effect on the central nervous system and mutual enhancement of effects.

With simultaneous use with phenothiazine derivatives, the risk of heart rhythm disturbances increases; with tricyclic antidepressants - it is possible to develop slow dyskinesia; with antihypertensive drugs - it is possible to strengthen the hypotensive effect and the development of orthostatic hypotension.

With simultaneous use with clonidine, beta-blockers, cardiac glycosides, antiarrhythmic drugs of 1 and 3 classes, it is possible to increase manifestations of side effects (bradycardia, arterial hypotension, arrhythmia).

With simultaneous application with levodopa, the effects are mutually weakened.

Analogues of the drug Topral

Structural analogs for the active substance:

• Barnetil.

Analogues of the drug Topral by pharmacological group (antipsychotics):

• Abilifay;
• Azaleptin;
• Aminazine;
• Ariprizol;
• Barnetil;
• Betamax;
• Vero-Sulpiride;
• Victor;
• Haloper;
• Hedonin;
• Droperidol;
• Zalast;
• Zilaxera;
• Ziprasidone;
• Invega;
• Quentiaks;
• Quetitex;
• Ketiap;
• Clopixol;
• Lakvel;
• Leptinorm;
• Limipranil;
• Mazeptil;
• Melleril;
• Peaceful;
• Moditen;
• Nantarid;
• He did not;
• Normiton;
• Olanex;
• Olanzapine;
• Parnasan;
• Pericyzine;
• Piportil;
• Prolinate;
• Propazine;
• Prosulfin;
• It is resilient;
• Risperidone;
• Rispolept;
• Rispolux;
• Risset;
• Saffris;
• Senorm;
• The servicer;
• The Serdolect;
• Seroquel;
• Sonapaks;
• Speridan;
• Sulpiride;
• Terialgen;
• Tizerzin;
• Thioril;
• Tyson;
• Torendo;
• Triftazine;
• Truksal;
• Fluphenazine;
• Fluanexol;
• Chlorpromazine hydrochloride;
• Chloroproticsen;
• Eglek;
• Eglonyl;
• Escap;
• Etaperazine.

Doctor's comment

The medicinal preparation Topral has established itself as a good tool for the treatment of patients with chronic alcoholism, who have episodes of agitation, aggressiveness and instability of behavior.Already in the first week of treatment, behavior becomes more stable, aggressiveness is suppressed, and excitement attacks rarely occur. Later the patients become calm and balanced. The patients are transferred to therapy with Topral well. Only a few of them complain of drowsiness and lethargy. A couple of times in my practice there were violations of the heart rhythm (bradycardia).

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