Promedol - instructions for use, analogs, testimonials and release forms (injections in ampoules for injections in 1% and 2% solution, tablets of 25 mg) medications for pain treatment, at birth for analgesia and stimulation in adults, children and during pregnancy

In this article, you can read the instructions for using the drug Promedol. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Promedol 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 Promedol in the presence of existing structural analogues. Use for the treatment of pain, during labor for pain and stimulation in adults, children, as well as during pregnancy and lactation.

Promedol - refers to agonists of opioid receptors (mainly mu-receptors). Activates the endogenous antinociceptive system and thus disrupts the interneuronal transmission of pain impulses at various levels of the central nervous system, and also changes the emotional color of the pain, affecting the higher parts of the brain. According to its pharmacological properties, trimeperidine is close to morphine: it increases the threshold of pain sensitivity with pain stimuli of different modalities, inhibits conditioned reflexes, and has a moderate hypnotic effect. Unlike morphine, it lessens the respiratory center to a lesser degree and causes nausea and vomiting less often. Has moderate spasmolytic and uterotonic effect. Promotes the opening of the cervix during labor, increases the tone and contractile activity of the myometrium.

With parenteral administration analgesic effect develops in 10-20 minutes, reaches a maximum after 40 minutes and lasts 2-4 hours.

Composition

Trimeperidine + auxiliary substances.

Pharmacokinetics

Connection with plasma proteins - 40%. Metabolized by hydrolysis with the formation of meperidine and normeperidic acids followed by conjugation.In small amounts it is excreted by the kidneys unchanged

Indications

• pain of moderate to severe intensity (unstable angina, myocardial infarction, dissecting aortic aneurysm, thrombosis, renal artery thrombosis, arterial limb or pulmonary embolism, acute pericarditis, air embolism, pulmonary infarction, acute pleurisy, spontaneous pneumothorax, gastric ulcer and 12- ulcer, perforation of the esophagus, chronic pancreatitis, paranephritis, acute dysuria, paraphimosis, priapism, acute prostatitis, acute glaucoma attack, causalgia, acute neuritis, sciatica t, acute vesicles, thalamic syndrome, burns, cancer, trauma, disc protrusion; foreign body bladder, rectum, urethra);
• in combination with atropine and antispasmodics for pain caused by spasm of smooth muscles of internal organs (liver, kidney, intestinal colic);
• acute left ventricular failure, pulmonary edema, cardiogenic shock;
• preoperative, operating and postoperative periods;
• childbirth (anesthesia and stimulation);
• Neuroleptanalgesia (in combination with neuroleptics).

Forms of release

Solution for injection 1% and 2% (injections in ampoules for injection).

Tablets 25 mg.

Instructions for use and dosage

Subcutaneously, intramuscularly or intravenously (only s / s and / m for the drug in syringe tubes).

Adults: from 0.01 g to 0.04 g (from 1 ml of a 1% solution to 2 ml of a 2% solution). During anesthesia with fractional doses, the drug is administered iv in 0.003-0.01 g.

Children from two years: 0.003-0.01 g, depending on the age.

For premedication, before the anesthesia is injected under the skin or in / m 0.02-0.03 g together with atropine (0.0005 g) for 30-45 minutes before the operation.

Analgesia of childbirth: subcutaneously or intramuscularly at a dose of 0.02-0.04 g when the opening of the pharynx is 3-4 cm and with a satisfactory condition of the fetus. The last dose of the drug is administered for 30-60 minutes before the delivery in order to avoid a drug depression of the fetus and the newborn.

Higher doses for adults: single dose - 0.04 g, daily - 0.16 g.

Side effect

• constipation;
• nausea, vomiting;
• dry mouth;
• anorexia;
• spasm of biliary tract;
• paralytic intestinal obstruction and toxic megacolon;
• jaundice;
• dizziness;
• headache;
• blurred vision;
• tremor;
• convulsions;
• weakness;
• drowsiness;
• confusion of consciousness;
• euphoria;
• nightmares or unusual dreams;
• hallucinations;
• depression;
• paradoxical stimulation;
• anxiety;
• tinnitus;
• slowing the speed of psychomotor reactions;
• depression of the respiratory center;
• decrease or increase in blood pressure;
• arrhythmia;
• decreased diuresis;
• retention of urine;
• bronchospasm;
• laryngospasm;
• angioedema;
• skin rash;
• itching;
• swelling of the face;
• hyperemia, edema, "burning" at the injection site;
• increased sweating;
• addiction, drug dependence.

Contraindications

• hypersensitivity;
• conditions accompanied by respiratory depression;
• simultaneous treatment with MAO inhibitors and within 3 weeks after their cancellation;
• children's age up to 2 years.

Application in pregnancy and lactation

Use with caution in pregnancy, during lactation.

Application in elderly patients

Use with caution in old age.

Use in children

Contraindicated in childhood up to 2 years. Use with caution in children older than 2 years.

special instructions

During the treatment period it is necessary to refrain from driving motor vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.Do not use alcohol (alcohol).

It is released by prescription. The rate of release of the drug for one prescription is 0.25 g.

Overdose

Symptoms: miosis, depression of consciousness (up to coma), increased severity of side effects.

Treatment: maintenance of adequate pulmonary ventilation, symptomatic therapy. Intravenous injection of a specific opioid naloxone antagonist at a dose of 0.4-2 mg quickly restores breathing. If there is no effect after 2-3 min, the administration of naloxone is repeated. The initial dose of naloxone for children is 0.01 mg / kg.

Drug Interactions

Strengthens the inhibition of the central nervous system and respiration caused by the use of other narcotic analgesics, sedatives, hypnotics, antipsychotics (antipsychotics), anxiolytics, drugs for general anesthesia, ethanol (alcohol), muscle relaxants. Against the background of the systematic use of barbiturates, especially phenobarbital, a decrease in analgesic effect is possible.

Strengthens the hypotensive effect of drugs that reduce blood pressure (including ganglioblocators, diuretics).

Medicines with anticholinergic activity and antidiarrhoeal drugs (incl.loperamide) increase the risk of constipation (up to intestinal obstruction) and urinary retention.

Strengthens the effect of anticoagulants (should monitor prothrombin plasma).

Buprenorphine (including the previous therapy) reduces the effectiveness of promedol. When used simultaneously with MAO inhibitors, it is possible to develop severe reactions due to overexcitation or inhibition of the central nervous system with the emergence of hyper- or hypotensive crises.

Naloxone restores breathing, eliminates analgesia and reduces central nervous system depression caused by taking Promedol. It can accelerate the appearance of symptoms of "withdrawal syndrome" against the background of drug dependence.

Naltrexone accelerates the appearance of withdrawal symptoms on the background of drug dependence (symptoms may appear as early as 5 minutes after drug administration, continue for 48 hours, are resistant and difficult to resolve); reduces the effects of promedol; does not affect the symptoms caused by the histamine reaction.

Reduces the effect of metoclopramide.

Analogues of the drug Promedol

Structural analogues of the active ingredient, Promedol, do not.

Analogues for the pharmacological group (opioid narcotic analgesics):

• Bupranal;
• Buprenorphine hydrochloride;
• DGC Continus;
• Dipidolor;
• Dolphorin;
• Durogesic;
• Durogezik Matrix;
• Codeine phosphate hemihydrate;
• Codeine phosphate hemihydrate;
• Lunaldin;
• M. Eslong;
• Morphine;
• MST Continuum;
• Nopan;
• Nurofen Plus;
• Omnopon;
• Prosidol;
• Sedalgin Neo;
• Schenan;
• Thebaine;
• Transtec;
• Ultiva;
• Fendivia;
• Fentadol;
• Fentanyl.

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