Lerivon
Lerivon: 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: Lerivon
ATX code: N06AX03
Active ingredient: mianserin (mianserin)
Manufacturer: Organon (Netherlands)
Description and photo update: 2019-20-08
Lerivon is an antidepressant with sedative and anxiolytic effects.
Release form and composition
Lerivon's dosage form - film-coated tablets: oval, convex on both sides, white, on one side there is a dividing risk, above which there are two extruded codes "ST", under the line - the number "7", on the opposite side of the tablet - the inscription "ORGANON" (10 pcs. in a blister strip, 2 packs in a cardboard box; 20 pcs. in a blister strip, 1 package in a cardboard box).
Active ingredient: mianserin hydrochloride, 1 tablet - 30 mg.
Additional components: magnesium stearate, anhydrous colloidal silicon dioxide, methylcellulose, potato starch, calcium hydrogen phosphate, titanium dioxide (E 171), macrogol, hypromellose.
Pharmacological properties
Pharmacodynamics
Mianserin belongs to the group of piperazino-azepine compounds that are not chemically related to TCAs (tricyclic antidepressants).
The mechanism of action is based on the enhancement of noradrenergic transmission by mianserin in the brain, which is provided by a blockade of interaction with serotonin receptors in the central nervous system. Lerivon's activity towards histamine H 1 -receptors and antagonism towards α 1 -adrenergic receptors are responsible for its sedative properties. The drug also has an anxiolytic effect, which is important in the treatment of patients with anxiety and sleep disorders associated with depressive disorders.
Lerivon is well tolerated by elderly patients, as well as against the background of diseases of the cardiovascular system. In therapeutically effective doses, the drug practically does not affect the cardiovascular system and, in fact, does not have anticholinergic activity.
Compared to TCAs, fewer cardiotoxic effects are observed with overdose. Lerivon is not an antagonist of antihypertensive and sympathomimetic drugs.
Pharmacokinetics
After oral administration, mianserin is rapidly and well absorbed. The maximum plasma concentration of the substance is reached in 3 hours. Bioavailability is approximately 20%.
Plasma protein binding of mianserin is approximately 95%. Equilibrium plasma levels are reached after 6 days.
The half-life is in the range from 21 to 61 hours, so Lerivon can be taken once a day.
Mianserin undergoes intensive metabolism and is excreted after 7-9 days in feces and urine. The main pathways of biotransformation are demethylation and oxidation, after which conjugates are formed.
Indications for use
According to the instructions, Lerivon is a drug for the treatment of depression of various etiologies.
Contraindications
Absolute:
- Liver disease with severe dysfunction;
- Mania;
- Age under 18;
- Hypersensitivity to Lerivon's components.
Relative:
- Renal / hepatic impairment;
- Diabetes;
- Hypertrophy of the prostate;
- Closed-angle glaucoma;
- Chronic heart failure.
According to the results of animal experiments and limited human data, mianserin has no intrauterine or neonatal harm, and is excreted in breast milk in very small quantities. Nevertheless, the possibility of using Lerivon during pregnancy and lactation should be assessed individually, taking into account the expected benefits and possible risks.
Instructions for use of Lerivon: method and dosage
Lerivon tablets should be taken orally, swallowed whole and, if necessary, with plenty of water.
Doses are set individually depending on the clinical situation. The initial dose is 30 mg per day (1 tablet). If the effect is insufficient, the dose is increased every few days until the optimal clinical response is achieved. The average effective daily dose for adults is 60-90 mg (2-3 tablets). Older adults may need a lower dose.
Due to the beneficial effect of Lerivon on sleep, the daily dose is preferably taken in 1 dose before bedtime, but if necessary, it can be divided into several doses.
Treatment with the prescribed dose should lead to a positive clinical response in 2-4 weeks, otherwise the dose should be increased. If after another 2-4 weeks there is no effect, Lerivon should be canceled.
The duration of antidepressant therapy is 4-6 months after the onset of clinical improvement.
Side effects
Depressed patients develop a range of symptoms that may be directly related to the disease (such as dry mouth, persistent constipation, and accommodation problems). For this reason, in some cases it is difficult to determine which of the developed side effects are a consequence of the use of Lerivon, and which are diseases.
Side effects (often - in more than 1% of patients, infrequently - in 0.1-1% of cases, rarely - in less than 1% of patients):
- Blood and lymphatic system: rarely - agranulocytosis or granulocytopenia;
- Metabolism and nutrition: often - weight gain;
- Mental disorders: rarely - hypomania;
- Nervous system: often - sedation (occurs at the beginning of therapy and decreases with continued treatment); rarely - hyperkinesis (including restless legs syndrome), seizures, neuroleptic malignant syndrome;
- Cardiovascular system: infrequently - hypotension; rarely - bradycardia (usually occurs after the initial dose);
- Hepatobiliary system: often - increased activity of liver enzymes; rarely, jaundice;
- Musculoskeletal system: infrequently - arthralgia;
- Skin and subcutaneous tissues: infrequently - exanthema;
- Others: often - edema.
With an abrupt end of the course of treatment with Lerivon, in rare cases, a withdrawal syndrome occurs.
Overdose
Acute overdose usually manifests itself as an increase in the duration of sedation. In rare cases, the development of cardiac arrhythmias, seizures, severe hypotension and respiratory depression is noted.
There is no specific antidote. Therapy consists of gastric lavage in combination with supportive and symptomatic treatment for vital signs.
special instructions
Lerivon is not used to treat children and adolescents under the age of 18 due to the fact that, according to clinical studies, this age group is more prone to suicidal behavior (suicidal thoughts and attempts) and hostility (mainly aggressiveness, anger and supportive behavior). In addition, there are no data on the long-term safety of use in children and adolescents regarding maturation, growth, behavioral and cognitive development. If the doctor nevertheless decides to prescribe the drug, the patient should be under special control during treatment.
It should be borne in mind that depression is always associated with an increased risk of suicidal thoughts and actions, which persists until significant remission occurs. For this reason, during the first few weeks, until there is a significant clinical improvement in the condition, patients should be constantly monitored.
Young people are at greater risk of suicidal intentions, as well as patients with a history of suicidal gestures, who showed a high degree of suicidal imagination before starting treatment. Therefore, these categories of patients should be closely monitored during treatment. The patients themselves and the people who care for them should be warned to control the sudden appearance of suicidal thoughts, and in the event of such symptoms, seek urgent medical attention.
During treatment with Lerivon, cases of bone marrow suppression are known, manifested by agranulocytosis or granulocytopenia. Most often, these reactions occur after 4-6 weeks of therapy, are usually reversible (when the drug is discontinued), are observed in all age groups, but are more often observed in elderly patients. In case of fever, stomatitis, pharyngitis or other signs of infection, it is necessary to stop treatment and check the expanded blood count.
Like all antidepressants, Lerivon can cause hypomania in susceptible people with bipolar depressive illness. In this case, the drug should be canceled.
Patients with heart disease, diabetes mellitus, renal or hepatic insufficiency should be closely monitored during the treatment period. The same applies to patients with symptoms of prostatic hypertrophy or angle-closure glaucoma.
If jaundice or convulsions occur during treatment, Lerivon must be canceled.
Influence on the ability to drive vehicles and complex mechanisms
Lerivon can have a negative effect on psychomotor activity, therefore, during the period of therapy, it is recommended to refrain from performing activities with potentially dangerous consequences, including driving a car.
Application during pregnancy and lactation
Lerivon can be used during pregnancy / lactation only after the doctor has assessed the ratio of the expected benefit to the possible risk.
Pediatric use
Lerivon therapy is contraindicated in patients under 18 years of age.
With impaired renal function
In case of renal failure, the use of the drug requires caution.
For violations of liver function
- liver disease with severe impairment of its function: Lerivon therapy is contraindicated;
- liver failure: the use of the drug requires caution.
Use in the elderly
The dosage regimen in elderly patients is determined by the doctor individually.
Drug interactions
Lerivon is contraindicated to use simultaneously with monoamine oxidase inhibitors and within 2 weeks after their cancellation.
The drug can disrupt the metabolism of coumarin derivatives (including warfarin), therefore, if necessary, their simultaneous use, the patient should be under constant control.
Lerivon does not interact with guanethidine, clonidine, betanidine, methyldopa and propranolol (including in combination with hydralazine). However, it is recommended that blood pressure be monitored in patients receiving antihypertensive drugs.
Mianserin hydrochloride can enhance the inhibitory effect of ethanol on the central nervous system, therefore, during treatment, one should refrain from drinking alcoholic beverages.
Analogs
Lerivon's analogues are: Miansan, Mianserin.
Terms and conditions of storage
Keep out of reach of children, protected from light and moisture. Adhere to a temperature regime of 2-30 ºС.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Lerivon
Reviews about Lerivon are different. Some users were satisfied with its action, in other cases they report the absence of the expected effect and the development of pronounced side reactions, due to which the therapy had to be canceled. The cost of the drug is estimated to be high.
Price for Lerivon in pharmacies
The approximate price for Lerivon (20 tablets) is 1000–1167 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!
