Esperal - instructions for use, reviews, analogs and forms of release (tablets 500 mg, including for sewing) drugs to treat alcohol and eliminate cravings for alcohol in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Esperal. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Espera 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 Esperal in the presence of existing structural analogues. Use to treat alcoholism and eliminate cravings for alcohol in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Esperal - a drug for the treatment of alcoholism.The action of Disulfiram (the active substance of the drug Esperal) is based on the blockade of acetaldehyde genase, which is involved in the metabolism of ethanol (alcohol). This leads to an increase in the concentration of the metabolite of ethanol - acetaldehyde, which causes negative sensations (including flushing to the face, nausea, vomiting, tachycardia, lowering blood pressure), which make it extremely unpleasant to drink alcohol after taking the drug. This leads to a conditioned reflex aversion to the taste and smell of alcoholic beverages.

The maximum therapeutic effect is achieved 12 hours after taking the drug inside and can last for 10-14 days after discontinuation of treatment.

Composition

Disulfiram + auxiliary substances.

Pharmacokinetics

After oral administration, absorption of disulfiram from the gastrointestinal tract is from 70 to 90%. It is rapidly metabolized, recovering to dithiocarbamate, which itself is excreted as a glucuron-conjugate or converted to diethylamine and carbon sulphide, some of which (4-53%) is excreted through the lungs.

Indications

• treatment and prevention of recurrences of chronic alcoholism;
• as a detoxification agent for chronic nickel poisoning.

Forms of release

Tablets 500 mg.

Other forms of the drug, such as injections in injectable ampoules, gel, drops, suspension or spray do not exist at the time of drug description in the reference book.

Instructions for use and dosing regimen

Before starting treatment, the patient should be carefully examined and warned about the consequences and complications.

The drug is administered orally 500 mg once a day in the morning during meals on an individual basis, gradually reducing the dose to 250 mg (1/2 tablet) or 125 mg (1/4 tablet) per day. Depending on the patient's response to treatment, the dose can be increased or decreased.

After 7-10 days, a Teturam alcohol test is performed: 20-30 ml 40% ethanol (vodka) after taking the drug at a dose of 500 mg; with a weak reaction, the dose of alcohol is increased by 10-20 ml (the maximum dose of vodka is 100-120 ml). The sample is repeated after 1-2 days in the hospital and 3-5 days after an outpatient treatment, with the correction of the doses of alcohol and / or the drug, if necessary. In the future, the drug can be used in a maintenance dose of 150-200 mg per day for 1-3 years.

Side effect

• metallic taste in the mouth;
• unpleasant odor in patients with colostomy (associated with carbon sulphide);
• hepatitis, sometimes found in patients with nickel eczema, not suffering from alcoholism;
• polyneuritis of the lower extremities;
• optic neuritis;
• decreased memory;
• confusion of consciousness;
• asthenia;
• headache;
• skin allergic reactions;
• psychoses resembling alcoholic;
• gastritis;
• thrombosis of the vessels of the brain.

When taking doses of alcohol in excess of 50-80 ml (in terms of 40% ethanol) against the background of taking the drug, severe violations of the cardiovascular and respiratory systems, swelling, convulsions develop. In this case, urgently carry out detoxification therapy, inject analeptics, perform symptomatic treatment.

Contraindications

Absolute:

• severe hepatic impairment;
• diabetes;
• epilepsy and convulsive syndrome of any genesis;
• mental illness;
• pregnancy;
• lactation period;
• hypersensitivity to the components of the drug.

Relative:

• kidney failure;
• hypothyroidism.

Application in pregnancy and lactation

The drug is contraindicated for use in pregnancy and lactation (breastfeeding).

special instructions

During the treatment period, alcohol and drugs containing ethanol should be avoided.

Used for the treatment of chronic alcoholism by the method of implantation of tablets (as they say in the common people - coding or stitching of the torpedo) in hard to reach places for extraction by the patient.

Drug Interactions

Combinations are contraindicated

With the simultaneous administration of the drug Esperal and ethanol (alcohol), a reaction of intolerance develops (blood tides, erythema, vomiting, tachycardia).

Combinations are not recommended

With simultaneous application with Isoniazid - impaired behavior and coordination.

With the simultaneous use of 5-nitroimidazole derivatives (metronidazole, ornidazole, secnidazole, tinidazole), delirious disorders develop, confusion of consciousness.

With simultaneous application with phenytoin, a significant and rapid increase in the concentration of phenytoin in the blood plasma is observed with the development of toxic symptoms (due to the inhibition of the metabolism of phenytoin). If combinations can not be avoided, clinical monitoring and control of plasma phenytoin concentrations during and after disulfiram should be performed.

Combinations that require caution

When used simultaneously with Warfarin (and other oral anticoagulants), its effect increases and the risk of bleeding increases (due to the inhibition of the metabolism of warfarin in the liver). With this combination, more frequent prothrombin control in the blood and correction of the dose of anticoagulants within 8 days after disulfiram cancellation is recommended.

Disulfiram inhibits theophylline metabolism. Therefore, a decrease in the dose of theophylline, depending on the clinical symptoms and its concentration in the plasma, is required.

Disulfiram is able to enhance the sedative effect of benzodiazepines due to inhibition of their oxidative metabolism (especially chlordiazepoxide and diazepam). Doses of benzodiazepines should be adjusted in accordance with clinical manifestations.

Tricyclic antidepressants enhance the reaction of alcohol intolerance, if patients treated with disulfiram, take alcohol.

Analogues of the drug Esperal

Structural analogs for the active substance:

• Antabus;
• Disulfiram;
• Lidevin;
• Teturam.

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