Inosine pranobex
Inosin pranobex: 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. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Inosine pranobex
ATX code: J05AX05
Active ingredient: Inosine pranobex (Inosine pranobex)
Manufacturer: NPO PharmVILAR LLC (Russia); LLC "OZON" (Russia)
Description and photo update: 2020-23-07
Inosine pranobex is an immunostimulating drug.
Release form and composition
The drug is produced in the form of tablets: white or almost white, biconvex, oblong with rounded ends or round (depending on the manufacturer), with a dividing line, there may be a weak specific odor (depending on the manufacturer - 5, 10, 20, 25 or 30 pcs. In a blister strip; 10, 20, 30, 40, 50 or 100 pcs. In a PET / polypropylene can; in a cardboard box 1, 2, 3, 4, 5, 10 packs or 1 can and instructions for use of Inosine pranobex).
1 tablet contains:
- active substance: inosine pranobex - 500 mg;
- additional components (depending on the manufacturer): corn or potato starch, povidone K-17 or povidone K-25, magnesium stearate, mannitol.
Pharmacological properties
Pharmacodynamics
Inosine pranobex is an immunostimulating agent with antiviral activity. The active substance belongs to synthetic purine derivatives and is a complex containing inosine and a salt of 4-acetamidobenzoic acid with N, N-dimethylamino-2-propanol in a molar ratio of 1 ÷ 3. The effect of this complex is due to the presence of inosine, the second component enhances its availability for lymphocytes. The agent normalizes lymphocyte functions under conditions of immunosuppression, stimulates the processes of blastogenesis in the monocyte population, induces the expression of membrane receptors on the surface of T-helpers, prevents a decrease in the activity of lymphocytic cells associated with the effect of glucocorticosteroids (GCS), and ensures the normal inclusion of thymidine in them.
Inosine pranobex promotes the activation of T-lymphocytes and natural killer cells of the function of T-suppressors of T-helpers. It potentiates the production of interferon-gamma (IFN-γ), immunoglobulin G (IgG), interleukins (IL) -1 and -2, suppresses the production of anti-inflammatory cytokines - IL-4 and IL-10, enhances the chemotaxis of monocytes, macrophages, neutrophilic granulocytes.
The immunostimulating agent demonstrates in vivo activity against cytomegalovirus (CMV), polioviruses, human enterocytopathogenic virus (ECHO virus) as well as viruses that cause the following diseases: measles, herpes simplex, human T-cell lymphoma (type III), influenza A and B, encephalomyocarditis and equine encephalitis.
The antiviral effect of Inosine pranobex is due to the suppression of viral ribonucleic acid (RNA) and the enzyme dihydropteroate synthetase, which is involved in the replication of a number of viruses. By potentiating the synthesis of messenger RNA (mRNA) of lymphocytes inhibited by viruses, the active substance leads to a decrease in the production of viral RNA and the translation of virus proteins, as well as to an increase in the production of INF-α and IFN-γ by lymphocytes, which have antiviral properties. The tool helps to reduce the clinical manifestations of viral diseases, accelerate convalescence, and increase the body's resistance.
When used in combination, the drug increases the effect of INF-α, zidovudine and acyclovir.
Pharmacokinetics
After oral administration, Inosine pranobex is well absorbed from the gastrointestinal tract (GIT). In blood plasma, the maximum concentration of the immunostimulating substance is recorded after 1–2 hours.
Inosine pranobex undergoes intensive metabolism and is eliminated by the kidneys. Biotransformation of the drug corresponds to that of endogenous purine nucleotides and proceeds with the formation of uric acid. Salt of 4-acetamidobenzoic acid (4-acetamidobenzoate) is metabolized to o-acetylglucuronide, and N, N-dimethylamino-2-propanol - to N-oxide. The accumulation of the agent in the body is not detected.
The half-life (T 1/2) for N, N-dimethylamino-2-propanol is 3.5 hours, for 4-acetamidobenzoate - 50 minutes. The drug and its metabolites are excreted from the body within 24–48 hours by the kidneys.
Indications for use
- acute respiratory viral infections (ARVI), including influenza;
- infections caused by the herpes simplex virus type 1–4: herpetic keratitis, genital and labial herpes, chickenpox, shingles, infectious mononucleosis caused by the Epstein-Barr virus;
- severe measles;
- CMV;
- subacute sclerosing panencephalitis (PSPE);
- papillomavirus infection (PVI): papillomas of the larynx, vocal cords (fibrous type), genital PVI in women and men, warts;
- molluscum contagiosum.
Contraindications
Absolute:
- arrhythmias;
- chronic renal failure;
- urolithiasis disease;
- gout;
- pregnancy and lactation;
- age up to 3 years (body weight up to 15–20 kg);
- hypersensitivity to any substance that is part of the drug.
Relative (Inosine pranobex 500 mg tablets should be used with caution): acute hepatic failure; simultaneous administration with diuretics, zidovudine, xanthine oxidase inhibitors.
Inosine pranobex, instructions for use: method and dosage
Inosine pranobex tablets are intended for oral administration. They need to be taken 3 or 4 times a day, after meals, with a small amount of water, with equal intervals between doses - 6 or 8 hours.
Children over 3 years old, adolescents and adults should use Inosine pranobex at a daily dose of 50 mg / kg, based on the required number of tablets.
In case of severe infectious diseases, at the discretion of the doctor, it is allowed to increase the daily dose to 100 mg / kg, divided into 4-6 doses, while for adults the maximum daily dose should not be higher than 3000-4000 mg, for children - 50 mg / kg.
The recommended duration of treatment, depending on the nature of the disease:
- acute viral lesions: a course of 5-14 days, after relieving symptoms, you should continue to take Inosine pranobex for 1-2 days or more, taking into account the indications;
- chronic recurrent diseases: courses of 5-10 days with 8 days interruptions; maintenance therapy in children and adults can last no more than 30 days, the daily dose in this case can be reduced to 500-1000 mg.
Recommended doses of Inosine pranobex, frequency of administration and courses of therapy, depending on the indications:
- PVI: adults 3 times / day, 1000 mg, children 3-4 doses in a daily dose of 50 mg / kg, a course of 14-28 days in monotherapy;
- herpes infection: for adults and children - a course of 5-10 days before the symptoms are relieved, in the asymptomatic period in order to reduce the number of relapses in adults, the duration of maintenance treatment is 30 days, at a dose of 500 mg 2 times / day;
- dysplasia of the cervix associated with human papillomavirus: adults 3 times / day, 1000 mg for 10 days, then 2-3 courses are prescribed with a break of 10-14 days;
- recurrent genital warts: adults 3 times / day, 1000 mg, children at a daily dose of 50 mg / kg, divided into 3-4 doses, as a monotherapy drug or in combination with surgical treatment for 14-28 days, then three times a course.
Side effects
- hepatobiliary system: often - a transient increase in the blood plasma of the activity of transaminases, alkaline phosphatase;
- Gastrointestinal tract: often - loss of appetite, epigastric pain, nausea, vomiting; infrequently - constipation or diarrhea;
- nervous system: often - fatigue, headache, feeling unwell, dizziness; infrequently - insomnia / drowsiness, nervousness;
- kidneys and urinary tract: infrequently - polyuria;
- allergic reactions: infrequently - urticaria, maculopapular rash, angioedema;
- skin and subcutaneous fat: often - rash, itching;
- laboratory and instrumental data: often - an increase in the level of urea nitrogen in the blood;
- general disorders: often - joint pain, exacerbation of gout.
Overdose
If an overdose of inosine is suspected, pranobex is prescribed for gastric lavage and symptomatic treatment.
special instructions
Before starting the course of therapy, it is necessary to consult a specialist.
As well as other antiviral drugs, Inosine pranobex demonstrates the best therapeutic effect when treatment was started immediately after the development of the first symptoms of a viral lesion (preferably on the first day).
2 weeks after the start of the course, as well as monthly against the background of prolonged use of the drug, it is recommended to monitor the content of uric acid in urine and blood serum. With a pronounced increase in concentration, combined use with drugs that reduce its content is possible.
It is required to control the serum level of uric acid in the blood also with concomitant administration of drugs that increase its concentration or impair renal function.
If long-term therapy with inosine pranobex is necessary, it is advisable to monitor the functional state of the kidneys and liver at least once a month.
Influence on the ability to drive vehicles and complex mechanisms
The effect of inosine pranobex on the ability to drive vehicles and control other complex equipment has not been studied. However, patients performing potentially hazardous work, including driving, need to take into account that the drug can provoke the development of dizziness or drowsiness.
Application during pregnancy and lactation
Treatment with the drug is contraindicated for pregnant and lactating women, since the safety of its use in this category of patients has not been established.
Pediatric use
Inosine pranobex tablets are contraindicated in children under 3 years of age with a body weight of less than 15–20 kg.
With impaired renal function
Chronic renal failure is an absolute contraindication for the use of Inosine pranobex.
Patients with functional impairment of the kidneys should be treated with mandatory monitoring every 14 days of the level of uric acid in serum and urine, as well as regular monitoring (every month) of the level of transaminases and creatinine.
For violations of liver function
Inosine pranobex metabolism occurs in the liver, so the drug must be taken with caution in the presence of acute liver failure. During long-term therapy, the activity of liver enzymes and creatinine levels should be monitored every 4 weeks.
Use in the elderly
Elderly patients do not need to change the dose of Inosine pranobex. At the same time, it should be borne in mind that in patients of this age group, an increase in the content of uric acid in urine and blood serum is more often observed, compared with middle-aged patients.
Drug interactions
- loop diuretics (ethacrynic acid, furosemide, torasemide), xanthine oxidase inhibitors (allopurinol): the risk of an increase in the plasma concentration of uric acid in the blood is aggravated; these combinations require caution;
- zidovudine: there is an increase in the content of this substance in the blood plasma and an increase in its T 1/2, in connection with which a change in the dose of zidovudine may be required;
- immunosuppressants: weaken the immunostimulating effect of Inosine pranobex.
Analogs
Inosin pranobex analogs are Groprinosin, Isoprinosin, Groprinosin-Richter, Normomed, etc.
Terms and conditions of storage
Store out of the reach of children at a temperature not exceeding 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Inosine pranobex
Currently, there are no reviews on Inosine pranobex from patients and specialists on specialized sites, on the basis of which it would be possible to objectively assess the therapeutic effect and disadvantages of this drug.
Price for Inosine pranobex in pharmacies
The reliable price for Inosine pranobex 500 mg is unknown, since the drug is currently not available in the pharmacy network.
The cost of a complete analogue for the active substance, the drug Groprinosin, in the form of tablets (in a dose of 500 mg), can be: for 30 pcs. in the package - 670-830 rubles; for 50 pcs. in the package - 1100-1350 rubles.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
