Antique Rapid
Antiqua Rapid: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. Use in the elderly
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Antique Rapid
ATX code: H01BA02
Active ingredient: desmopressin (Desmopressin)
Manufacturer: Pharmstandard-UfaVITA OJSC (Russia)
Description and photo update: 2020-14-05
Prices in pharmacies: from 1180 rubles.
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Antiqua Rapid is an antidiuretic.
Release form and composition
The drug is produced in the form of tablets dispersed in the oral cavity: round, biconvex, almost white or white (30 or 100 pcs. In polyethylene bottles, 10 pcs. In blisters, in a cardboard box instructions for use of Antiqua Rapid and 1 bottle, or 1, 3 or 10 blisters).
Composition of 1 tablet:
- active substance: desmopressin - 60 or 120 μg (in the form of desmopressin acetate - 67.5 μg or 135 μg);
- auxiliary components: mannitol, sodium stearyl fumarate, croscarmellose sodium.
Pharmacological properties
Pharmacodynamics
The active ingredient of Antiqua Rapid - desmopressin, is a structural analogue of the natural hormone arginine-vasopressin, obtained by altering the structure of the vasopressin molecule. Due to this, desmopressin, in contrast to vasopressin, has a less pronounced effect on the smooth muscles of blood vessels and internal organs and, as a result, does not cause the development of spastic side effects.
Compared with vasopressin, desmopressin has a longer effect and does not increase blood pressure. Under the influence of Antiqua Rapid, the permeability of the epithelium of the distal tubules of the nephron for water increases, and its reabsorption also increases. In central diabetes insipidus, the drug reduces the volume of excreted urine, increases its osmolarity and reduces the osmolarity of blood plasma. As a result, the frequency of urination decreases, and nocturnal polyuria decreases.
Pharmacokinetics
When desmopressin is used sublingually, its bioavailability is about 0.25%. The maximum plasma concentration (C max) is reached after 0.5–2 hours, this indicator is directly proportional to the dose taken: after taking a dose of 200, 400 and 800 μg, C max is 14, 30 and 65 pg / ml, respectively.
The drug does not have the ability to penetrate the blood-brain barrier.
It is excreted from the body by the kidneys, the half-life is 2.8 hours.
Indications for use
- primary nocturnal enuresis in children from 5 years of age and adults;
- central diabetes insipidus;
- polyuria and polydipsia after surgery in the area of the Turkish saddle or surgery to remove the pituitary gland;
- nocturia due to nocturnal polyuria.
Contraindications
Absolute:
- syndrome of inadequate production of antidiuretic hormone;
- habitual or psychogenic polydipsia (the volume of urination - 40 ml / kg during the day);
- moderate to severe renal failure [creatinine clearance (CC) <50 ml / min];
- hyponatremia (present or history);
- chronic heart failure (including suspicion of it) and other diseases requiring diuretic drugs;
- polydipsia against the background of chronic alcoholism;
- age from 65 years in the treatment of nocturia;
- children under 5 years of age.
Relative (Antiqua Rapid should be used with caution):
- age from 65 years in the treatment of diabetes insipidus;
- period of pregnancy;
- cystic fibrosis;
- arterial hypertension;
- cardiac ischemia;
- the presence of risk factors for the development of thrombosis;
- fibrosis of the bladder;
- chronic renal failure (CC> 50 ml / min);
- violation of water and electrolyte balance;
- conditions that predispose to increased intracranial pressure.
Antiqua Rapid, instructions for use: method and dosage
Antiqua Rapid tablets must be kept in the mouth until they are completely dissolved. Do not take the tablets with wet hands, otherwise they will begin to dissolve. You do not need to wash them down with water or any drinks. Eating slightly reduces the absorption and effectiveness of the drug, so it is recommended to take it some time after eating.
The dose of the drug for each patient is selected individually. Dispersible tablet Antiqua Rapid 60 mcg corresponds to 100 mcg of conventional tablets for oral administration, Antiqua Rapid 120 mcg - 200 mcg of conventional tablets for oral administration.
Central diabetes insipidus and polyuria / polydipsia
After hypophysectomy or operations in the area of the Turkish saddle, with the development of diabetes insipidus of central genesis and polyuria / polydipsia, the doctor selects the initial dose for therapy depending on the osmolarity and urine volume. Treatment is carried out under the control of water and electrolyte balance and the duration of sleep. Usually, at the beginning of treatment, 60 mcg is prescribed 3 times a day. Depending on the therapeutic effect, the dose of Antiqua Rapid is adjusted if necessary.
The average effective daily dose can range from 120 to 720 mcg. The optimal maintenance dose is 60 or 120 mcg 3 times a day.
In case of symptoms of hyponatremia and / or fluid retention in the body, Antiqua Rapid is canceled or its dose adjusted.
Primary nocturnal enuresis
At the beginning of treatment, a dose of 120 mcg of Antiqua Rapid is recommended, it should be taken before bedtime. If the severity of the therapeutic effect is not enough, the dose can be increased to 240 mcg. For the period of treatment, patients should limit fluid intake in the evening.
In case of symptoms of hyponatremia and / or fluid retention in the body, Antiqua Rapid is canceled or its dose adjusted.
The duration of therapy is 3 months. Within 1 week after discontinuation of the drug, careful monitoring of the patient's condition is required; if necessary, the doctor can extend the course of treatment.
Nocturia
At the beginning of therapy, a dose of Antiqua Rapid 60 mcg is recommended, it should be taken before bedtime. If the severity of the therapeutic effect is not enough, after a week, the dose is first increased to 120 μg, if necessary, after another week it is increased to 240 μg. For the period of treatment, patients should limit fluid intake in the afternoon.
If, after adjusting the dose within 4 weeks of taking Antiqua Rapid, there is no adequate therapeutic effect, further use of the drug is inappropriate.
During the treatment period, fluid intake should be limited.
Side effects
If during the period of taking Antiqua Rapid you do not limit the use of water and drinks, fluid retention in the body and the development of hyponatremia are possible. These conditions may not manifest themselves in any way, but may be accompanied by the following symptoms: headache, dizziness, abdominal pain, nausea, vomiting, weight gain. In severe cases, there is a likelihood of seizures, accompanied by impaired consciousness, up to prolonged loss of consciousness, in the most serious cases, brain edema and coma are possible. The risk of complications is highest in children and the elderly (over 65), the severity of symptoms also depends on their general health.
In adults with nocturia, hyponatremia usually occurs at the beginning of therapy and during the dose escalation period. It is reversible. Due to fluid retention, the development of arterial hypertension is possible, with concomitant ischemic heart disease - angina pectoris.
The frequency of the side effects described below is classified as follows: very often - ≥ 1/10, often - from ≥ 1/100 to <1/10, infrequently - from ≥ 1/1000 to <1/100, rarely - from ≥ 1/10 000 to <1/1000, very rarely - <1/10000, unknown frequency - to date, there are no data on the prevalence of reactions.
Side effects observed in adults:
- on the part of the heart and blood vessels: often - arterial hypertension; infrequently - palpitations, orthostatic hypotension;
- from the nervous system: very often - headache; often - dizziness; infrequently - paresthesia, drowsiness; unspecified frequency - asthenia, convulsions, coma;
- from the side of the psyche: infrequently - insomnia; rarely - confusion of consciousness;
- from the gastrointestinal tract: often - abdominal pain, nausea, diarrhea, vomiting, constipation; infrequently - bloating, flatulence, dyspeptic disorders;
- on the part of the kidneys and urinary tract: often - impaired urination, impaired bladder function;
- from the side of metabolism and nutrition: often - hyponatremia; unspecified frequency (in patients with diabetes insipidus) - hypernatremia, dehydration;
- from the respiratory system: infrequently - shortness of breath;
- from the musculoskeletal and connective tissue: infrequently - myalgia, muscle spasms;
- on the part of the organ of vision and hearing: infrequently - decreased visual acuity, vertigo;
- from the immune system: unknown frequency - anaphylactic reactions;
- from the skin and subcutaneous tissues: infrequently - itching, rash, urticaria, increased sweating; rarely - allergic dermatitis;
- laboratory data: infrequently - hypokalemia, increased activity of liver enzymes;
- others: often - increased fatigue, peripheral edema; infrequently - weight gain, chest discomfort or pain, flu-like syndrome.
Side effects observed in children:
- from the side of the vessels: rarely - arterial hypertension;
- from the nervous system: often - headache; rarely - drowsiness; unspecified frequency - impaired attention, convulsions, psychomotor hyperactivity;
- on the part of the psyche: infrequently - emotional lability, aggression; rarely - sudden mood swings, nightmares, anxiety; unspecified frequency - emotional disorders, hallucinations, behavior change, insomnia, depression;
- from the immune system: unknown frequency - anaphylactic reactions;
- from the gastrointestinal tract: infrequently - stomach pain, nausea, diarrhea, vomiting;
- on the part of the kidneys and urinary tract: infrequently - impaired urination, impaired bladder function;
- on the part of the skin and subcutaneous tissues: unknown frequency - skin rash, urticaria, increased sweating, allergic dermatitis;
- from the side of metabolism: unknown frequency - hyponatremia;
- others: infrequently - a feeling of fatigue, peripheral edema; rarely - nervousness; unspecified frequency - epistaxis.
Overdose
An overdose of desmopressin is possible if the dose is too high, or if you drink too much fluids with the drug or shortly after taking it.
Possible symptoms: nausea, headache, fluid retention in the body and, as a result, weight gain, in severe cases - overhydration, convulsions, confusion or loss of consciousness.
Depending on the severity of the condition, reduce the dose of Antiqua Rapid, increase the intervals between doses, or cancel the drug. If there is a suspicion of cerebral edema, the patient should be urgently admitted to the intensive care unit. Emergency intensive care is required for seizures.
Desmopressin has no specific antidote. To enhance diuresis, it is possible to prescribe diuretics (for example, furosemide), treatment should be carried out under the control of the level of electrolytes in the blood.
special instructions
Prior to initiating therapy, the patient should be screened for bladder dysfunction or urethral obstruction. In acute urinary incontinence, nocturia, dysuria, urinary tract infections, polydipsia, suspected bladder or prostate swelling, decompensated diabetes mellitus, Antiqua Rapid can be prescribed only after their treatment.
Patients with nocturia and primary nocturnal diuresis during treatment with the drug must necessarily limit fluid intake: within 1 hour before taking Antiqua Rapid and for 8 hours after. If this rule is ignored, fluid retention in the body and the development of hyponatremia are possible. The safety of desmopressin in the long-term treatment of nocturnal enuresis has not been studied. In case of vomiting or diarrhea, the drug should be discontinued until water balance is restored. When prescribing Antiqua Rapid, the doctor should make sure that the patient (or the parent of the child) understands the importance of limiting fluid intake.
Special fluid restriction to avoid the development of hyponatremia is required with the simultaneous use of non-steroidal anti-inflammatory drugs or drugs that can cause a syndrome of inadequate production of antidiuretic hormone (tricyclic antidepressants, selective serotonin reuptake inhibitors, carbamazepine, chlorpropamide, chlorpromazine).
In case of fever, nausea, vomiting, headache or systemic infectious diseases, Antiqua Rapid should be canceled. Resume treatment is allowed only after the normalization of the water and electrolyte balance.
During treatment, it is necessary to monitor changes in body weight.
The risk of developing seizures against the background of hyponatremia is minimized if the drug is taken at the recommended initial dose and other drugs that can increase the secretion of antidiuretic hormone are excluded.
For patients with nocturia, to diagnose nocturnal polyuria within 2 days before starting to take Antiqua Rapid, it is necessary to assess the volume and frequency of urination. Nocturnal polyuria is said when the increase in urine production at night exceeds the capacity of the bladder or ⅓ part of the daily urine volume.
There are known cases of seizures and cerebral edema in healthy children and adolescents who received desmopressin for the treatment of nocturnal enuresis. Taking into account the available information, doctors conclude that the risk of seizures and cerebral edema is highest in the first week of therapy.
Hyponatremia most often occurs in elderly patients (over 65 years of age) with diabetes insipidus, polyuria 2.8–3 L / day, and initially low plasma sodium concentration. Antiqua Rapid in this category of patients should be used with extreme caution. Before starting therapy, 3 days after starting it and at each dose increase, it is necessary to check the plasma sodium concentration, as well as carefully monitor the patient's condition.
In case of insufficient function of the thyroid gland or adrenal cortex, it is possible to start taking Antiqua Rapid only after treatment of these conditions.
Influence on the ability to drive vehicles and complex mechanisms
Until now, it has not been established whether Antiqua Rapid is able to influence the speed of reactions and concentration of attention. However, the drug is known to cause dizziness and headache in some patients. These symptoms can affect the ability to drive vehicles and perform types of work that require quick psychomotor reactions and increased concentration. In this regard, during the period of therapy, patients engaged in such activities are advised to be careful.
Application during pregnancy and lactation
According to limited data, desmopressin, used during pregnancy for diabetes insipidus, does not adversely affect the health of the woman, fetus and newborn, as well as the course of pregnancy. In animal studies, no direct or indirect effects on the course of pregnancy and childbirth, intrauterine and postnatal development have been revealed. However, Antiqua Rapid should be prescribed to pregnant women after a careful assessment of the expected benefits and possible risks. Treatment should be carried out with caution, under regular monitoring of blood pressure.
In the course of studies of women who received intranasal desmopressin at a dose of 300 μg, it was found that with breast milk such a small amount of the drug enters the child's body that it is not able to affect his diuresis.
Pediatric use
Antiqua Rapid is contraindicated in children under 5 years of age. Children from 5 years old can be prescribed for the treatment of nocturnal primary enuresis. Treatment is carried out with caution, carefully monitoring the child's health.
With impaired renal function
Antiqua Rapid is contraindicated in severe and moderate renal failure (CC <50 ml / min).
The drug is used with caution in chronic renal failure (CC> 50 ml / min).
Use in the elderly
Antiqua Rapid is contraindicated in people over 65 with nocturia. It is used with caution to treat diabetes insipidus.
Before the start of therapy, 3 days after its start, at each dose increase and, if possible, periodically during treatment, the plasma sodium content should be monitored.
Drug interactions
- loperamide and possibly other drugs that reduce the tone and motility of intestinal smooth muscles: approximately 3 times increase the plasma concentration of desmopressin, which increases the risk of side effects, especially fluid retention and hyponatremia;
- glibenclamide, lithium preparations: reduce the antidiuretic effect of Antiqua Rapid;
- non-steroidal anti-inflammatory drugs: fluid retention and hyponatremia may develop;
- oxytocin: the antidiuretic effect of desmopressin increases, uterine perfusion decreases;
- clofibrate and drugs that can cause a syndrome of inappropriate antidiuretic hormone secretion, including selective serotonin reuptake inhibitors, tricyclic antidepressants, carbamazepine, chlorpropamide, chlorpromazine: enhance the antidiuretic effect of Antiqua Rapid;
- drugs metabolized in the liver: drug interaction is unlikely, since in vitro desmopressin does not significantly affect hepatic metabolism. In vivo studies have not been performed.
Analogs
Analogues of Antikva Rapid are Desmopressin, Minirin, Minirin Melt, Nativa, Nurem, Presyneks.
Terms and conditions of storage
Store in a dark place, out of the reach of children, at a temperature not exceeding 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Antiqua Rapid
To date, on specialized sites and forums, there are few reviews about Antique Rapid. They are mostly from patients who have been using the drug to treat bedwetting. Enuresis is a serious and rather delicate problem, which is not publicly discussed, but both adult patients and parents of children taking the drug respond positively about its antidiuretic effect. The effect is visible already from the beginning of admission, and at the end of the course, the situation with incontinence improves significantly.
Experts conducted an open-label, randomized, multicenter, crossover study involving 221 patients aged 5 to 15 years, lasting 3 weeks. We compared the effectiveness of standard and orodispersible tablets, the active ingredient of which is desmopressin. It was found that with similar efficacy (reducing the number of "wet" nights per week to an average of 1.88) and comparable adverse reactions, most children preferred to take Antique Rapid, tablets that dissolve in the oral cavity.
Price for Antiqua Rapid in pharmacies
The price of Antiqua Rapid in the form of dispersible tablets at a dosage of 60 mcg is from 1385 rubles. per pack of 30 pcs., at a dosage of 120 mcg - from 2340 rubles. per pack of 30 pcs.
Antiqua Rapid: prices in online pharmacies
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Drug name Price Pharmacy |
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Antiqua Rapid 60 μg oral dispersible tablets 30 pcs. 1180 RUB Buy |
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Antiqua Rapid tablets dispersion 60mkg 30 pcs. 1266 RUB Buy |
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Antiqua Rapid 120 mcg oral dispersible tablets 30 pcs. 1790 RUB Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
