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Clomipramine canine
| ANAFRANIL (Clomipramine)
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The composition and the form of the drug anafranil
Anafranil synthetic drug. Active ingredient – clomipramine hydrochloride.
Are produced the anafranil: clomipramine for dogs
1) coated tablets (1 tablet in 10 or 25 mg of clomipramine hydrochloride) – 10 pcs. Packing;
2) retard tablets divisible (in 1 retard tablets – 75 mg of clomipramine hydrochloride) – 30 pcs. Packing;
3) injection in ampoules (in 1 ampoule – 25 mg of active substance) – 5 pcs. In the package.
Medicinal properties
Anafranil has antidepressant, alpha-adrenoliticheskoe, anticholinergic, antihistamine and antiserotoninergicheskoe action. -Factor for a depressive syndrome, including psychomotor retardation, depressed mood and anxiety.
Indications for use
- Depressive states of different etiology, occurring at different symptoms (endogenous, reactive, neurotic, organic, masked, involutional forms of depression, depression in patients with schizophrenia and psychopathy, depressive symptoms, occurring in old age, taking a dog off clomipramine, depression, chronic pain syndrome caused by chronic physical or disease, reactive depressive mood disorders, neurotic or psychopathic nature);
- Obsessive-compulsive syndromes;
- Chronic pain syndrome.
For oral administration:
- Phobias and panic disorder (seizures);
- Cataplexy, accompanying narcolepsy;
- Nocturnal enuresis (aged 5 years and subject to the exclusion of organic causes of disease).
For solution for injection:
- Phobias.
Terms of use
Anafranil is used only on prescription. Doses and route of administration anafranila picked individually, taking into account the patient’s condition. In depression, obsessive-compulsive syndrome, phobias at the beginning of the treatment prescribed for 1 film-coated tablet, 25 mg 2-3 times daily or 1 tablet retard 75 mg 1 time a day (preferably in the evening). Then, during the first week of treatment dose anafranila gradually increase, such as 25 mg every few days (depending on tolerability) until the daily dose is 4-6 tablets of 25 mg or 2 retard tablets, 75 mg. In severe cases, the daily dose can be increased to the maximum – 250 mg. After you’ve achieved a clear-cut improvement, maintenance dose is selected anafranila – 2-4 tablets of 25 mg or 1 tablet retard 75 mg. Panic disorder, clomipramine + veterinary agoraphobia treated with 1 tablet of 10 mg per day, possibly in combination with the drug from the group of benzodiazepines. Then, depending on the tolerability anafranila increase the dose to achieve the desired effect. Then gradually abolish anafranil from the group of benzodiazepines. Required in these cases, the daily dose anafranila ranged from 25 to 100 mg, if necessary, it can be increased to 150 mg. It is recommended not to stop treatment within 6 months, slowly reducing the maintenance dose of the drug. When cataplexy accompanying narcolepsy anafranila daily dose is 25-75 mg. In chronic pain syndromes dose picked individually – from. 10 to 150 mg per day – in the light receiving concomitant analgesic drugs and the possibility of reducing their use. Elderly patients treated with 1 tablet anafranila to 10 mg per day. Then, gradually, in approximately 10 days, the daily dose increases up to 30-50 mg and maintain it at that level until the end of treatment. At night enuresis anafranila initial dose for children aged 5-8 years is 2-3 tablets, 10 mg, 9-12 years – 1-2 tablets of 25 mg over 12 years – 1-3 tablets of 25mg. Application anafranila in higher doses is shown in cases where there is no clinical effect after the first week of treatment. Typically, the daily dose anafranila appointed at once after dinner, but if incontinent noted in the early hours of the night, some of the previously prescribed dose in 16 hours. After achieving the desired effect of treatment continues for 1-3 months, gradually reducing the dose. Experience with anafranila in children under 5 years of absence. Retard tablets should be swallowed whole, not chewed. Intramuscular use of injections anafranila begin with the introduction of 25-50 mg (1-2 ampoules), then increase the daily dose of 25 mg until a daily dose of 100-150 mg (4-6 ampoules). After improving the number of injections gradually reduce and replace them with supportive therapy tablets. Intravenous infusions begin with drip of 50-75 mg (2-3 ampoules) 1 times a day. To prepare the infusion solution using 250-500 ml isotonic sodium chloride or glucose solution, duration of infusion – 1,5-3 hours. During the infusion should be carefully monitored by the patient to quickly identify possible side effects. Particular attention is paid to control blood pressure in order to avoid orthostatic hypotension. After achieving improvements infusion continued for 3-5 days, then to maintain and secure the effect of moving to a reception inside anafranila: 2 tablets of 25 mg equivalent to 1 ampoule of 25 mg. For the gradual transition from intravenous to favor receiving the drug in tablets can first convert the patient navnutrimyshechnoe introduction. Children anafranila injections are not recommended.
Side effects
In applying anafranila possible:
- Drowsiness; clomipramine for dogs
- General weakness;
- Anxiety;
- Increased appetite;
- Dizziness
- Tremor;
- Headache;
- Myoclonus;
- Confusion;
- Disorientation;
- Hallucinations (especially in elderly patients and patients with Parkinson’s disease);
- Anxiety;
- Excitation;
- Manic state;
- Elated state;
- Aggressiveness;
- Memory impairment;
- Depersonalization;
- Strengthening of depression;
- Violation of concentration;
- Insomnia;
- Nightmares;
- Yawn.
Sometimes:
- Delirium;
- Violation of speech;
- Paresthesia;
- Muscle weakness;
- Increased tone of the mouse.
Rare
- Activation of the symptoms of psychosis, seizures;
- Ataxia,
In some cases:
- Changes in the electroencephalogram; hyperpyrexia;
- Dry mouth;
- Sweating;
- Constipation;
- Disturbance of accommodation;
- Blurred vision;
- Violation of urination;
- Tides;
- Mydriasis;
- Glaucoma;
- Sinus tachycardia;
- Heartbeat;
- Orthostatic hypotension;
- Arrhythmia;
- Increased blood pressure;
- Violation of intracardiac conduction;
- Nausea;
- Vomiting
- Abdominal discomfort;
- Diarrhea;
- Anorexia;
- Raising the level of transaminases in blood;
- Hepatitis with jaundice or without it;
- Allergic skin reaction (rash, urticaria);
- Photosensitivity;
- Itching;
- Edema (local or general);
- Hair loss;
- Local reaction to intravenous (thrombophlebitis, lymphangitis, burning sensation, allergic skin reactions);
- Increase of body weight;
- Violation of libido and potency;
- Galactorrhea;
- Breast enlargement;
- Syndrome of inappropriate secretion of antidiuretic hormone;
- Allergic alveolitis (pneumonitis) with or without eosinophilia;
- Systemic anaphylactic, anaphylactoid reactions, including arterial hypotension;
- Leukopenia;
- Agranulocytosis;
- Eosinophilia;
- Thrombocytopenia;
- Purple;
- Sometimes a violation of taste;
- Noise in my ears.
After the sudden cancellation or rapid reduction of the dose sometimes arise:
- Nausea;
- Vomiting
- Diarrhea;
- Insomnia;
- Headache;
- Irritability, anxiety.
These effects are usually mild and cease during the continuation of treatment or after dose reduction anafranila. In the case of serious side effects in the nervous system or mental status of the application anafranila to cancel.
Contraindications
- Hypersensitivity to clomipramine and other components of the drug;
- Cross-sensitivity to tricyclic antidepressants in the group dibenzazepina;
- Simultaneous use of MAO inhibitors, as well as the period of less than 14 days before and after their use;
- The simultaneous application of selective inhibitors of MAO type A reversible actions (such as moclobemide);
- Recent myocardial infarction.
Pregnancy and lactation
Avoid anafranila during pregnancy, except in cases where the expected effect of treatment of the mother clearly outweighs the potential risk to the fetus. Anafranil should be phased out no less than 7 weeks before the expected birth. In the period of lactation should either stop breastfeeding or to phase out the drug.
Interaction anafranila with alcohol
Anafranil with special care given to a patient in the presence of factors predisposing to the emergence of a convulsive syndrome in the period of non-alcohol. Drinking alcohol during treatment anafranilom could also affect the deterioration of the ability to drive vehicles and management mechanisms.
Cautions
With caution anafranil used in patients with epilepsy, the presence of other predisposing factors, the emergence of a convulsive syndrome (brain damage of any cause, while the use of neuroleptics or withdrawal of drugs with anticonvulsant properties). With extreme caution should be prescribed anafranil patients with cardiovascular disease, patients with a history of which there are data on increased intraocular pressure, closed-angle glaucoma or coal urinary retention (eg, due to diseases of the prostate gland); patients with severe liver disease, with tumors of the medulla adrenal gland (pheochromocytoma, neuroblastoma – increases risk of hypertensive crisis), with chronic constipation (possibly the development of paralytic ileus in elderly patients or patients who are forced to comply with bed rest). Patients with panic attacks in the early treatment of increased anxiety (most pronounced in the first days of treatment and usually subsides within 2 weeks).
When injected anafranila possible isolated cases of anaphylactic shock, in patients with orthostatic hypotension and lability of the vascular system, there may be a sharp decline in blood pressure. Observe caution in patients with hyperthyroidism or patients receiving thyroid hormone drugs. Please continue to study the composition of peripheral blood and attention to symptoms such as fever and sore throat. Depression, is characteristic of the risk of suicidal acts, which may persist until significant remission achievement. Prior to the general or local anesthesia should alert the anesthesiologist that the patient takes anafranil. With long-term treatment may develop tooth decay, decreased tearing, and the relative increase in the number of mucus in the tear fluid, which can cause damage to the corneal epithelium in patients using contact lenses. In the treatment may appear blurred vision, drowsiness and other violations of the CNS, which may affect activities requiring attention and quickness of psychomotor reactions. Avoid abrupt cancellation anafranila. You should not assign anafranil for at least 2 weeks after discontinuation of MAO inhibitors (there is a risk of severe symptoms and conditions, as hypertensive crisis, hyperpyrexia, myoclonus, generalized convulsions, delirium and coma). The same rules should be followed in the case of MAO inhibitor is given after previous treatment anafranilom. The initial dose anafranila or MAO inhibitors should be low, they should be increased gradually. Anafranil may be appointed not earlier than 24 hours after discontinuation of MAO inhibitors type A reversible actions (such as moclobemide). If such a drug is given after the abolition anafranila, the break must be at least 2 weeks. Anafranil may exacerbate the effects on the cardiovascular system (epinephrine, norepinephrine, isoprenaline, ephedrine and phenylephrine, including those of local anesthetics), as well as the effect of ethanol and other means of having a depressing effect on the central nervous system (barbiturates, benzodiazepines, or the means to anesthesia), anticholinergic activity of a number of funds (phenothiazines, antiparkinsonian drugs, atropine, biperiden, antihistamines) in the organs of vision, central nervous system, bowel and bladder.
The joint application anafranila with selective serotonin reuptake inhibitors may increase the effects on the serotonin system. The combined use of neuroleptics may increase the level of tricyclic antidepressants in the blood plasma, lowering the threshold of convulsive readiness and promote the development of seizures. Combination with thioridazine may lead to severe arrhythmias. Concomitant use of cimetidine, methylphenidate, estrogen leads to increased concentrations of tricyclic antidepressants in plasma, so their use is recommended to lower the dose of antidepressants. Solution for injection is incompatible with a solution of Voltaren (diclofenac sodium) for injection.
Storage
Anafranila tablets, coated to protect from the effects of moisture, storage pill retard the special conditions not required; injection to protect from the effects of light. Keep out of reach of children. Expiration date indicated on the package.