Sirdalud - instructions for use, reviews, analogs and formulations (2 mg and 4 mg tablets, 6 mg capsules) medications for the treatment of muscle spasms in various diseases in adults, children and pregnancy
In this article, you can read the instructions for using the drug Sirdalud. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Sirdalud 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 Sirdalud in the presence of existing structural analogues. Use to treat muscle spasm in various diseases in adults, children, as well as during pregnancy and lactation.Joint reception of alcohol and medicine.
Sirdalud - Muscle relaxant of central action. Reduces the increased tone of skeletal muscles, relieves their spasm; reduces the resistance of muscles with passive movements, increases the force of arbitrary contractions. The muscle-relaxing effect of tizanidine (the active substance of the preparation of Sirdalud) is probably due to the suppression of spinal polysynaptic reflexes, which is associated with a decrease in the release of excitatory amino acids from presynaptic terminals of spinal interneurons, as well as stimulation of alpha2-adrenergic receptors. Tizanidine does not affect the transmission of excitation in the neuromuscular synapses.
Pharmacokinetics
When taken orally, Syrdalud is absorbed almost completely. Long-term release of tizanidine from the dosage form of the modified-release MP capsule results in a "relaxed" pharmacokinetic profile, which maintains a stable therapeutic concentration of tizanidine in the blood plasma for 24 hours. Tizanidine is rapidly and largely metabolized in the liver. Tizanidine is excretedmainly kidneys (approximately 70% of the dose) in the form of metabolites; the share of unchanged substance accounts for only about 2.7%.
Sex does not affect the pharmacokinetic parameters of tizanidine.
Indications
- the spastic condition of skeletal muscles caused by neurological diseases (multiple sclerosis, chronic myelopathy, stroke, degenerative diseases of the spinal cord);
- consequences of cerebral circulation and cerebral palsy (patients over 18 years of age);
- painful spasm of skeletal muscles, caused by spinal cord injury (cervical and lumbar syndrome) or arising after surgery (for herniation of the intervertebral disc or arthrosis of the hip).
Forms of release
Tablets 2 mg and 4 mg.
Capsules with modified release MP 6 mg.
Instructions for use and dosing regimen
Pills
To stop the painful spasm of skeletal muscles, apply 2-4 mg 3 times a day; in severe cases it is recommended to take 2-4 mg for the night. With spasmodic conditions of muscles caused by neurological diseases, the initial dose is 6 mg per day in 3 divided doses. The dose is gradually increased by 2-4 mg per day every 3-7 days.The optimal therapeutic effect is usually achieved at a dose of 12-24 mg per day, divided into 3-4 doses. Do not exceed the dose of 36 mg per day.
Capsules
The drug is prescribed inside. The dosage regimen should be set individually.
The initial daily dose is 6 mg (1 capsule). If necessary, the daily dose can be gradually ("steps") increased - by 6 mg (1 capsule) at intervals of 3-7 days. Clinical experience shows that for most patients the optimal dose is 12 mg per day (2 capsules); In rare cases, an increase in the daily dose to 24 mg may be required.
Treatment of patients with renal insufficiency (CK <25 ml / min) is recommended to start with taking Sirdalud in a dose of 2 mg 1 time per day. Increase the dose in small "steps", taking into account the portability and effectiveness. If it is necessary to obtain a more pronounced effect, it is recommended first to increase the dose prescribed once a day, after which increase the multiplicity of the appointment.
Side effect
- drowsiness;
- weakness;
- dizziness;
- hallucinations;
- insomnia;
- sleep disorders;
- bradycardia;
- a decrease in blood pressure;
- a marked decrease in blood pressure until collapse and loss of consciousness;
- dry mouth;
- nausea;
- gastrointestinal disorders;
- muscle weakness;
- increased fatigue.
Contraindications
- severe liver dysfunction;
- simultaneous application with strong inhibitors of CYP1A2 isoenzymes (including fluvoxamine or ciprofloxacin);
- hypersensitivity to tizanidine or to any other component of the drug.
Application in pregnancy and lactation
Since controlled trials of tizanidine in pregnant women have not been performed, it should not be used in pregnancy, unless the potential benefit exceeds the potential risk.
Sirdalud excreted in breast milk in small amounts. Nevertheless, women who breastfeed children should not use the drug.
Use in children
The use of Sirdalud in children is not recommended. the experience of using the drug in children is limited.
special instructions
Reported cases of violations of liver function associated with tizanidine, but with a daily dose of up to 12 mg, these cases were rare. In this regard, it is recommended to monitor functional liver function tests once a month in the first 4 months of treatment in those patients,which is prescribed tizanidine at a daily dose of 12 mg and above, and also in those cases when there are clinical signs suggesting a violation of liver function, such as unexplained nausea, anorexia, a feeling of fatigue. In the case when the levels of ALT and AST in the serum persistently exceed the VGN by 3 times or more, the use of Sirdalud should be discontinued.
Do not abruptly cancel Sirdalud, the dose of the drug is reduced gradually.
With the sharp cancellation of Sirdalud after prolonged treatment and / or taking high doses of the drug (and also after simultaneous use with antihypertensive medications), development of tachycardia and an increase in blood pressure were noted, which in some cases can lead to acute impairment of cerebral circulation.
Care should be taken when using Sirdalud in patients with renal insufficiency. When using Sirdalud in patients with renal insufficiency (KC less than 25 ml / min), correction of the dosing regimen is necessary.
Care should be taken when using Sirdalud in elderly patients. The experience of using Sirdalud in elderly patients is limited.Based on pharmacokinetic data, it can be assumed that in some cases, renal clearance in these patients can be significantly reduced.
Impact on the ability to drive vehicles and manage mechanisms
With the development of drowsiness, dizziness or lowering blood pressure on the background of Sirdalud therapy, one should refrain from types of work requiring high concentration of attention and quick reaction, for example, driving or working with machinery.
Drug Interactions
When using Sirdalud together with inhibitors of the isoenzyme CYP1A2, an increase in the concentration of tizanidine in the blood plasma is possible.
The simultaneous use of tizanidine with fluvoxamine or ciprofloxacin, inhibitors of the 1A2 cytochrome P450 isoenzyme results in a 33-fold or 10-fold increase in the aUC of tizanidine. The result of a combined application may be a clinically significant and prolonged decrease in blood pressure, leading to drowsiness, weakness, inhibited psychomotor reactions (in some cases, up to collapse and loss of consciousness). The simultaneous use of tizanidine with fluvoxamine or Ciprofloxacin is contraindicated.
It is not recommended simultaneous administration of Sirdalud with other inhibitors of the isoenzyme CYP1A2 - antiarrhythmic drugs (amiodarone, mexiletine, propafenone), cimetidine, fluoroquinolones (enoxacin, pefloxacin, ciprofloxacin, norfloxacin), rofecoxib, oral contraceptives, ticlopidine.
Simultaneous appointment of Sirdalud with antihypertensive drugs, including diuretics, can sometimes cause a decrease in blood pressure (in some cases, up to collapse and loss of consciousness) and bradycardia.
Ethanol (alcohol) or sedatives can enhance the sedative effect of Sirdaluda, therefore, concomitant use with other sedatives and / or alcohol is not recommended.
Analogues of the drug Sirdalud
Structural analogs for the active substance:
- Sirdalud MR;
- Tisaloud;
- Tizanidine hydrochloride;
- Tizanil.
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