Calmirex
Kalmirex: 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. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Calmirex
ATX code: M03BX04
Active ingredient: lidocaine + tolperisone (lidocaine + tolperisone)
Producer: PharmFirma SOTEX, CJSC (Russia)
Description and photo updated: 20.11.2018
Prices in pharmacies: from 195 rubles.
Buy
Calmirex is a combined preparation with membrane stabilizing, local anesthetic, muscle relaxant action.
Release form and composition
The dosage form of Kalmyrex is a solution for intravenous and intramuscular administration: transparent, colorless or somewhat greenish, has a specific odor (in a cardboard box 1 or 2 blisters of 5 dark glass ampoules, 1 ml each).
Active substances in 1 ml (1 ampoule):
- tolperisone hydrochloride - 100 mg;
- lidocaine hydrochloride - 2.5 mg.
Excipients: methyl parahydroxybenzoate - 0.6 mg; concentrated hydrochloric acid - up to pH 3-4.5; diethylene glycol monoethyl ether - 0.3 ml; water for injection - up to 1 ml.
Pharmacological properties
Pharmacodynamics
Tolperisone hydrochloride is a centrally acting muscle relaxant. It has a local anesthetic and membrane stabilizing effect, helps to inhibit the conduction of nerve impulses in the primary afferent fibers and motor neurons. As a result, spinal monosynaptic and polysynaptic reflexes are blocked. There is a possibility that the substance mediates the blocking of the release of mediators due to inhibition of the entry of calcium ions into synapses.
Tolperisone hydrochloride inhibits the conduction of excitation in the brain stem along the reticulospinal pathway. Regardless of the effect on the central nervous system, peripheral blood flow increases, which can be provided by the weak antispasmodic and antiadrenergic properties of the substance.
Lidocaine hydrochloride has a local anesthetic effect. Systemic effects are not observed when the dosing regimen is observed.
Pharmacokinetics
Tolperisone hydrochloride
The substance is extensively metabolized in the kidneys and liver. Almost in full (> 99%) is excreted in the form of metabolites in the urine. The pharmacological activity of metabolites has not been studied.
T 1/2 (half-life) after intravenous administration is approximately 90 minutes.
Lidocaine hydrochloride
Complete absorption of the substance occurs (its rate is determined by the site of administration and dose). The time to reach C max (maximum concentration of the substance) in blood plasma after intramuscular administration is in the range from 30 to 45 minutes. Plasma protein binding is within 50–80%.
Rapid distribution in organs and tissues is observed. Penetrates through the blood-brain and placental barriers, as well as into breast milk (40% of the concentration in the mother's plasma).
Metabolism occurs in the liver (by 90–95%) with the participation of microsomal enzymes (due to dealkylation of the amino group and breaks of the amide bond with the subsequent formation of metabolites with activity). It is excreted by the kidneys (unchanged - up to 10%) and with bile (part of the dose is reabsorbed in the gastrointestinal tract).
Indications for use
- spasm and hypertonicity of the striated muscles associated with organic diseases of the central nervous and musculoskeletal systems (including encephalomyelitis, lesions of the pyramidal pathways, multiple sclerosis, myelopathy, stroke, spondyloarthrosis, spondylosis, arthrosis of large joints, lumbar / cervical syndrome);
- recovery period after orthopedic / trauma surgery.
In combination with other drugs, Kalmirex is prescribed in the following cases:
- obliterating vascular diseases (diffuse scleroderma, Raynaud's disease, thromboangiitis obliterans and / or atherosclerosis, diabetic angiopathy);
- diseases, the development of which is associated with disorders of vascular innervation (intermittent angioneurotic dysbasia, acrocyanosis).
Contraindications
Absolute:
- severe myasthenia gravis;
- age up to 18 years;
- pregnancy and lactation;
- individual intolerance to the components of the drug.
Relative (Calmirex is prescribed under medical supervision without adjusting the dosage regimen):
- renal failure;
- liver failure.
Instructions for the use of Kalmirex: method and dosage
Calmirex is used daily.
Recommended dosage regimen:
- intramuscularly: 2 times a day, 100 mg;
- intravenously: 1 time per day, 100 mg.
Side effects
Possible adverse reactions (> 10% - very common;> 1% and 0.1% and 0.01% and <0.1% - rarely; <0.01% - very rare):
- cardiovascular system: infrequently - arterial hypotension; rarely - palpitations, angina pectoris, tachycardia; very rarely - hot flushes, bradycardia;
- musculoskeletal system: infrequently - myalgia, muscle weakness, pain in the limbs; rarely - discomfort in the limbs; very rarely - osteopenia;
- nervous system: infrequently - dizziness, headache, drowsiness; rarely - convulsions, lethargy, sensitivity disorders, tremors, loss of sensitivity, attention deficit disorder;
- digestive system: infrequently - diarrhea, gastrointestinal discomfort, dyspepsia, dry mouth, nausea; rarely - vomiting, liver dysfunction, constipation, epigastric pain, flatulence;
- hematopoietic system: very rarely - lymphadenopathy, anemia;
- immune system: rarely - anaphylactic reactions, hypersensitivity reactions; very rarely - anaphylactic shock;
- respiratory system: rarely - nosebleeds, shortness of breath, rapid breathing;
- urinary system: rarely - proteinuria, enuresis;
- metabolism and nutrition: infrequently - anorexia; very rarely - polydipsia;
- psyche: infrequently - sleep disorders, insomnia; rarely - depression, loss of activity;
- sense organs: rarely - disturbances in visual perception, vertigo, ringing in the ears;
- skin and subcutaneous tissues: rarely - skin rash, sweating, allergic dermatitis, pruritus, urticaria;
- instrumental / laboratory data: rarely - a violation of liver function tests, a decrease in blood pressure, an increase in the concentration of bilirubin and the number of leukocytes, a decrease in the number of platelets; very rarely - an increase in creatinine levels;
- violations at the injection site and general disorders: often - redness of the injection site; infrequently - malaise, asthenia, fatigue; rarely - a feeling of heat / intoxication, thirst, irritability; very rarely - a feeling of discomfort in the chest.
Overdose
The main symptoms are: respiratory arrest, ataxia, clonic / tonic convulsions, dyspnea.
There is no specific antidote. Symptomatic / supportive therapy is indicated.
special instructions
Influence on the ability to drive vehicles and complex mechanisms
Patients during the period of application of Kalmyrex when driving vehicles should be careful.
Application during pregnancy and lactation
According to the instructions, Calmirex is contraindicated during pregnancy / lactation.
Pediatric use
For patients under 18 years of age, the drug is not prescribed.
With impaired renal function
Calmirex for renal failure should be used under medical supervision.
For violations of liver function
Calmirex for liver failure should be used under medical supervision.
Drug interactions
Calmirex does not cause sedation, therefore, its combined use with hypnotics and sedatives, as well as ethanol-containing drugs, is possible.
Calmirex enhances the effect of non-steroidal anti-inflammatory drugs, and therefore, with combined use, a decrease in their dose may be required.
Analogs
The analogue of Kalmirex is Midocalm-Richter.
Terms and conditions of storage
Store in a dark place at a temperature of 8-15 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Calmirex
Reviews of Calmirex are few. During use, it is necessary to take into account contraindications and possible side reactions.
Price for Calmirex in pharmacies
The approximate price for Kalmyrex (5 or 10 ampoules per pack) is 298–405 rubles. or 606-739 rubles.
Kalmirex: prices in online pharmacies
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Drug name Price Pharmacy |
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Calmirex 2.5 mg / ml + 100 mg / ml solution for intravenous and intramuscular administration 1 ml 5 pcs. 195 RUB Buy |
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Calmirex tabs 50 mg tablets 30 pcs. 214 r Buy |
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Calmirex tabs 150 mg tablets 30 pcs. 239 r Buy |
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Calmirex tabc tablets p.o. 150mg 30 pcs. 288 r Buy |
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Calmirex solution for intravenous and intramuscular injection. 2.5mg / ml + 100mg / ml 1ml 5 pcs. 349 r Buy |
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Calmirex 2.5 mg / ml + 100 mg / ml solution for intravenous and intramuscular administration of 1 ml 10 pcs. 425 RUB Buy |
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Calmirex solution for intravenous and intramuscular injection. 2.5mg / ml + 100mg / ml 1ml 10 pcs. 645 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!
