Симбалта Капсулы, коробка, 14 шт, 30 мг, для приема внутрь

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Дулоксетин обладает центральным механизмом подавления болевого синдрома, что в первую очередь проявляется повышением порога болевой чувствительности при болевом синдроме невропатической этиологии."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Депрессия, генерализованное тревожное расстройство, болевая форма периферической диабетической невропатии, хронический болевой синдром костно-мышечной системы."}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Некомпенсированная закрытоугольная глаукома; заболевания печени, сопровождающиеся печеночной недостаточностью; почечная недостаточность тяжелой степени (KK <30 мл/мин); неконтролируемая артериальная гипертензия; одновременное применение с ингибиторами МАО, одновременный прием мощных ингибиторов изофермента CYP1A2 (флувоксамина, ципрофлоксацина, эноксацина); повышенная чувствительность к дулоксетину."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение дулоксетина при беременности возможно только в случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода. "}},{"type":"paragraph","data":{"text":"При необходимости применения дулоксетина в период лактации следует решить вопрос о прекращении грудного вскармливания (из-за отсутствия опыта применения)."}},{"type":"paragraph","data":{"text":"Пациентки должны быть предупреждены, что в случае наступления или планирования беременности в период применения дулоксетина им необходимо сообщить об этом своему лечащему врачу."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Рекомендуемая начальная доза составляет 60 мг 1 раз/сут."}},{"type":"paragraph","data":{"text":"При необходимости можно увеличить суточную дозу с 60 мг до максимальной дозы 120 мг/сут в 2 приема."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны ЦНС:\u003c/i\u003e часто - головокружение (кроме вертиго), нарушения сна (сонливость или бессонница), головная боль (головная боль отмечалась реже, чем на фоне приема плацебо); иногда - тремор, слабость, нечеткость зрения, летаргия, тревога, зевота; очень редко - глаукома, мидриаз, нарушения зрения, возбуждение, дезориентация."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны пищеварительной системы:\u003c/i\u003e часто - сухость во рту, тошнота, запор; иногда - диарея, рвота, снижение аппетита, изменение вкуса, нарушения показателей функции печени; очень редко - гепатит, желтуха, повышение активности ЩФ, АЛТ, АСТ и уровня билирубина; отрыжка, гастроэнтерит, стоматит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны костно-мышечной системы:\u003c/i\u003e иногда - мышечная напряженность и/или подергивания; очень редко - бруксизм."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы:\u003c/i\u003e иногда - сердцебиение; очень редко - ортостатическая гипотензия, синкопе (особенно в начале терапии), тахикардия, повышение АД, похолодание конечностей."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны половой системы:\u003c/i\u003e иногда - аноргазмия, снижение либидо, задержка и нарушение эякуляции, эректильная дисфункция."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны мочевыделительной системы:\u003c/i\u003e иногда - затрудненное мочеиспусканние; очень редко - никтурия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e иногда - снижение массы тела, повышенное потоотделение, приливы, ночная потливость; очень редко - анафилактические реакции, жажда, гипонатриемия, озноб, ангионевротический отек, сыпь, синдром Стивенса-Джонсона, крапивница, плохое самочувствие, чувство жара и/или холода, повышение массы тела, дегидратация, фотосенсибилизация. При отмене часто отмечались головокружение, тошнота, головная боль. У пациентов с болевой формой диабетической невропатии может наблюдаться незначительное увеличение глюкозы в крови натощак."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"С осторожностью применяют при обострении маниакального/гипоманиакального состояния, эпилептических припадках, мидриазе, нарушении функции печени или почек, у пациентов со склонностью к суицидальным попыткам."}},{"type":"paragraph","data":{"text":"При назначении ингибиторов обратного захвата серотонина в комбинации с ингибиторами МАО отмечались случаи серьезных реакций, иногда с летальным исходом (гипертермия, ригидность, миоклонус, различные нарушения с возможными резкими колебаниями показателей жизненно важных функций организма и изменения психического статуса, включая выраженное возбуждение с переходом в делирий и кому). Такие реакции возможны также в случаях, когда ингибитор обратного захвата серотонина был отменен незадолго до назначения ингибиторов МАО (возможно развитие симптомов, в т.ч. характерных для злокачественного нейролептического синдрома)."}},{"type":"paragraph","data":{"text":"Эффекты комбинированного применения дулоксетина и ингибиторов МАО не оценивались ни у людей, ни у животных. Применение дулоксетина одновременно с ингибиторами МАО или в период до 14 дней после их отмены не рекомендуется, т.к. дулоксетин является ингибитором обратного захвата серотонина, и норэпинефрина (норадреналина). Ингибиторы МАО не следует назначать в течение как минимум 5 дней после отмены дулоксетина."}},{"type":"paragraph","data":{"text":"С осторожностью применять у пациентов с маниакальными эпизодами в анамнезе, а также с эпилептическими припадками в анамнезе."}},{"type":"paragraph","data":{"text":"Депрессивные состояния сопровождаются высоким риском развития суицидального поведения. Вследствие этого пациенты с диагнозом депрессии, принимающие дулоксетин, должны информировать врача о любых беспокоящих мыслях и чувствах."}},{"type":"paragraph","data":{"text":"На фоне применения дулоксетина возможно развитие мидриаза, следует проявлять осторожность при назначении дулоксетина пациентам с повышенным внутриглазным давлением или у лиц с риском развития острой закрытоугольной глаукомы."}},{"type":"paragraph","data":{"text":"У пациентов с артериальной гипертензией и/или иными заболеваниями сердечно-сосудистой системы рекомендуется контролировать АД."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВлияние на способность к управлению транспортными средствами и механизмами\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Пациенты, принимающие дулоксетин, должны соблюдать осторожность при занятии потенциально опасными видами деятельности (из-за возможного возникновения сонливости)."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Капсулы."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре 15–30 °C"}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"3 года"}}]}],"source":{"title":"ЗдравСити","url":"https://zdravcity.ru"}},"description_toggle":false,"short_description":"Антидепрессант, ингибитор обратного захвата серотонина и норэпинефрина (норадреналина). 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