Деменция альцгеймеровского типа, сосудистая деменция, смешанная деменция всех степеней тяжести.
Противопоказания
Индивидуальная повышенная чувствительность к препарату, выраженные нарушения функции почек, беременность, грудное вскармливание, дети до 18 лет (в связи с недостаточностью данных). С осторожностью назначают больным тиреотоксикозом, эпилепсией, судорогами (в том числе в анамнезе), при инфаркте миокарда, сердечной недостаточности.
Действующее вещество: Мемантин (Memantin)Концентрация действующего вещества (мг): 20
Фармакологические свойства
Производное адамантана. Являясь неконкурентным атггагонистом N-метил-D-acnapraт(NMDA)-рецепторов, оказывает модулирующее действие на глутаматергаческую систему. Регулирует ионный транспорт, блокирует кальциевые каналы, нормализует мембранный потенциал, улучшает процесс передачи нервного импульса. Улучшает когнитивные процессы, повышает повседневную активность.
Показания к применению
Деменция альцгеймеровского типа, сосудистая деменция, смешанная деменция всех степеней тяжести.
Противопоказания
Индивидуальная повышенная чувствительность к препарату, выраженные нарушения функции почек, беременность, грудное вскармливание, дети до 18 лет (в связи с недостаточностью данных). С осторожностью назначают больным тиреотоксикозом, эпилепсией, судорогами (в том числе в анамнезе), при инфаркте миокарда, сердечной недостаточности.
Применение при беременности и в период грудного вскармливания
Запрещено применение препарата при беременности и в период лактации.
Способ применения и дозы
Взрослым при деменции назначают в течение 1-й недели терапии в дозе 5 мг/сутки, в течение 2-й недели - в дозе 10 мг/сутки. В течение 3-й недели - в дозе 15–20 мг/сутки. При необходимости возможно дальнейшее еженедельное повышение дозы на 10 мг до достижения суточной дозы 30 мг. Оптимальная доза достигается постепенно, при увеличении дозы каждую неделю.
Побочное действие
Гиперчувствительность к компонентам препарата, грибковые инфекции, сонливость, спутанность сознания, галлюцинации, психотические реакции, повышение ад, венозный тромбоз/тромбоэмболия, сердечная недостаточность, отдышка, запор, тошнота, рвота, панкреатит, головокружение, нарушение походки, судороги.
У пациентов с болезнью Альцгеймера на стадии умеренной и тяжелой деменции обычно нарушена способность к вождению автотранспорта и управлению сложными механизмами. Кроме того, мемантин может вызывать изменение скорости реакции, поэтому пациентам необходимо воздержаться от управления автотранспортом или работы со сложными механизмами. С осторожностью назначают больным тиреотоксикозом, эпилепсией, судорогами (в т.ч. в анамнезе), одновременное применение антагонистов NMDA-рецепторов (амантадин, кетамин, декстрометорфан), наличие факторов, повышающих рН мочи (резкая смена диеты, например, переход на вегетарианство, обильный прием щелочных желудочных буферов), тяжелые инфекции мочевыводящих путей, инфаркт миокарда (в анамнезе), сердечная недостаточность III-IV функциональный класс (по классификации NYHA), неконтролируемая артериальная гипертензия, почечная недостаточность, печеночная недостаточность.
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