Clopixol
Klopiksol: 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: Clopixol
ATX code: N05AF05
Active ingredient: zuclopenthixol (zuclopenthixol)
Manufacturer: Lundbeck H. A / S (Denmark)
Description and photo update: 2019-14-08
Prices in pharmacies: from 174 rubles.
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Clopixol is a drug that has sedative, antipsychotic and neuroleptic effects.
Release form and composition
Clopixol is available in the form of film-coated tablets: biconvex, round, pale pink (2 mg each), pinkish brown (10 mg each) or red-brown (25 mg each); in cross section - white (in plastic containers of 50 or 100 pcs., 1 container in a cardboard box).
The composition of 1 tablet includes:
- Active ingredient: zuclopenthixol - 2, 10 or 25 mg (in the form of zuclopenthixol dihydrochloride - 2.364, 11.82 or 29.55 mg, respectively);
- Auxiliary components (2/10/25 mg, respectively): hydrogenated castor oil - 0.48 / 0.72 / 0.96 mg, potato starch - 22.2 / 29.2 / 31.6 mg, lactose monohydrate - 17, 4 / 21.6 / 22 mg, glycerol 85% - 1.2 / 1.8 / 2.4 mg, microcrystalline cellulose - 9 / 13.5 / 18 mg, copovidone - 3 / 4.5 / 6 mg, talc - 4.2 / 6.3 / 8.4 mg, magnesium stearate - 0.42 / 0.63 / 0.84 mg;
- Sheath (2/10/25 mg, respectively): hypromellose 5 - 1.37 / 2.05 / 2.74 mg, macrogol 6000 - 0.274 / 0.411 / 0.548 mg, E172 (red iron oxide) - 0.011 / 0.205 / 0.822 mg, E171 (titanium dioxide) - 0.445 / 0.479 / 0.091 mg.
Pharmacological properties
Pharmacodynamics
Clopixol is an antipsychotic drug (neuroleptic) of the thioxanthene group.
It has an antipsychotic effect by blocking dopamine receptors and, possibly, 5-hydroxytryptamine (5-HT) receptors.
Zuclopenthixol in vitro has a high affinity for dopamine receptors D 2 and D 1, as well as serotonin receptors 5-HT 2 and alpha 1 -adrenergic receptors, but does not have an affinity for muscarinic cholinergic receptors. Clopixol has a weak affinity for histamine H 1 receptors and does not exhibit alpha 2 -adrenergic blocking activity. In vivo, affinity for D 2 receptors prevails over affinity for D 1 receptors.
Like most antipsychotics, taking zuclopenthixol increases serum prolactin levels.
Zuclopenthixol is indicated for the treatment of chronic and acute psychoses, as well as for the treatment of mentally retarded patients characterized by hyperactivity and aggressive behavior. This substance significantly weakens or completely eliminates the main symptoms of schizophrenia (hallucinations, thought disorders, delusions), and also has a pronounced effect on accompanying symptoms (suspicion, hostility, aggressiveness, agitation).
Zuclopenthixol is characterized by a dose-dependent transient sedative effect. At the beginning of therapy, a rapid sedative effect is provided, which is considered an advantage in cases of treatment of acute psychoses. Tolerance to the nonspecific sedative effect of the drug develops rapidly. The specific inhibitory effect is especially beneficial when treating patients with agitation, hostility, aggressiveness or anxiety.
Pharmacokinetics
When taken orally, the bioavailability of zuclopenthixol is approximately 44%. The time to reach the maximum serum concentration is about 4 hours.
The apparent volume of distribution is about 20 l / kg. Approximately 98-99% of the substance binds to blood plasma proteins.
Zuclopenthixol penetrates the placental barrier insignificantly, excreted in breast milk in small quantities. The half-life of the active substance is 20 hours. Zuclopenthixol metabolites are not neuroleptically active and are excreted mainly in the feces, as well as in some amount in the urine.
In patients with mild to moderate severity of schizophrenia, with maintenance therapy, it is recommended to maintain a minimum (that is, measured immediately before administration) content of the drug in serum from 2.8 to 12 ng / ml.
Indications for use
- Schizophrenia (chronic and acute) and other psychotic disorders, especially those accompanied by hallucinations, impaired thinking and paranoid delusions;
- Hostility, aggressiveness, states of increased anxiety, agitation;
- Manic-depressive psychosis in the manic phase;
- Mental retardation, proceeding with agitation, psychomotor agitation and other behavioral disorders;
- Senile dementia, proceeding with behavioral disturbances, disorientation, paranoid ideas, confusion.
Contraindications
Absolute:
- Coma;
- Acute intoxication with barbiturates, alcohol and opioid analgesics.
Relative (Klopiksol is prescribed with caution):
- Chronic hepatitis;
- Heart disease (including arrhythmias);
- Convulsive syndrome;
- Hypersensitivity to drug components.
According to the instructions, Clopixol is not recommended for pregnant and lactating women.
Instructions for the use of Klopiksol: method and dosage
Clopixol tablets are taken orally.
The doctor prescribes the dosage regimen individually, depending on the patient's condition, the daily dose can be divided into several doses.
At the beginning of therapy, it is recommended to take Klopixol in low doses. Depending on the response to treatment, it can be rapidly increased until an optimal clinical response is achieved.
Recommended dosing regimen (daily dose):
- Acute attacks of schizophrenia and other acute psychotic disorders, severe agitation and mania: 10-50 mg;
- Psychotic disorders with moderate and severe course: 20 mg, with an interval of 2-3 days, the dose may be increased by 10-20 mg to 75 mg per day;
- Psychotic conditions in the chronic course of schizophrenia and other chronic psychoses: 20-40 mg;
- Agitation in patients with oligophrenia: 6-20 mg, if necessary, the dose may be increased to 25-40 mg;
- Senile disorders, accompanied by confusion and agitation: 2-6 mg, if necessary, it is possible to increase the dose to 10-20 mg (the drug is preferable to take in the evening).
Side effects
- Cardiovascular system: possible tachycardia, orthostatic dizziness; rarely, orthostatic hypotension;
- Central and peripheral nervous system: at the initial stage of therapy, extrapyramidal symptoms may occur (as a rule, they are corrected by lowering the dose and / or prescribing antiparkinsonian drugs, however, it is not recommended to regularly use the latter for prophylactic purposes), drowsiness, and the development of accommodation disorders is also possible; very rarely, with long-term therapy, some patients develop tardive dyskinesia (antiparkinsonian drugs do not eliminate the symptoms of this condition, a dose reduction is recommended or, if possible, discontinuation of therapy);
- Urinary system: urinary retention;
- Digestive system: constipation, dry mouth; rarely - transient minor changes in liver function tests.
Overdose
In case of an overdose of the drug, drowsiness, seizures, movement disorders, the development of shock, hyperthermia / hypothermia, coma may occur.
In cases of overdose against the background of simultaneous administration of drugs that affect cardiac activity, changes in the electrocardiogram, prolongation of the QT interval, the development of polymorphic pirouette ventricular tachycardia, ventricular arrhythmias, and cardiac arrest were recorded.
Symptomatic and supportive treatment is indicated. Measures should be taken to maintain the activity of the cardiovascular and respiratory systems. Due to the possible decrease in blood pressure, the use of epinephrine (epinephrine) is not recommended. Movement disorders can be stopped with biperiden, convulsions with diazepam.
special instructions
With prolonged therapy, periodically, it is necessary to carry out careful clinical monitoring of the patient's condition to reduce the maintenance dose.
It should be borne in mind that when using Clopixol, in rare cases, neuroleptic malignant syndrome (NMS) with a fatal outcome can develop. The main symptoms of NMS include: muscle rigidity, hyperthermia and impaired consciousness in combination with dysfunction of the autonomic nervous system (tachycardia, labile blood pressure, increased sweating). With the development of these symptoms, it is necessary to urgently cancel therapy and prescribe symptomatic and supportive treatment.
When using Klopiksol, especially at the beginning of therapy, before determining an individual response to the treatment, care must be taken when driving and performing potentially hazardous types of work.
Application during pregnancy and lactation
During pregnancy, the drug should be used with caution and only in cases where the perceived risk to the fetus is lower than the potential benefit to the mother.
There is evidence that in the case of the mother taking antipsychotics at the end of pregnancy or during childbirth, the newborns may show signs of intoxication (lethargy, excessive excitability, tremor). Along with this, such children had a low indicator on the Apgar scale.
In case of clinical need, breastfeeding is allowed during treatment with Clopixol. In this case, it is recommended to monitor the condition of the newborn, especially during the first 4 weeks after birth.
Pediatric use
It is necessary to use Klopixol tablets with caution for the treatment of patients under the age of 18 years.
With impaired renal function
With reduced renal function, dose adjustment of Clopixol is not required.
For violations of liver function
In hepatic impairment, the drug should be used with caution. Patients with impaired liver function are advised to prescribe a half dose of Clopixol with monitoring of serum zuclopentixol levels.
Use in the elderly
When treating elderly patients, the drug should be prescribed in the lowest possible dose range (2–6 mg and higher).
Drug interactions
With the simultaneous use of Clopixol with some drugs, the following effects may occur:
- Ethanol, barbiturates and other drugs that have a depressing effect on the central nervous system: increased sedation;
- Guanethidine and drugs with a similar effect: blocking their hypotensive effect (the combination is not recommended);
- Metoclopramide, piperazine: increased risk of developing extrapyramidal symptoms;
- Levodopa and other adrenergic drugs: decreased effectiveness.
The pharmaceutical incompatibility of Clopixol has not been established.
Analogs
Analogues of Klopiksol are: Klopiksol depot, Klopiksol-akufaz.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 25 ° C.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Klopiksol
Reviews of Klopiksol are mostly positive. According to patients, the drug is effective, however, before starting the administration, when adjusting the dose and in the event of side effects, it is imperative to consult a doctor.
The price of Klopiksol in pharmacies
The approximate price of Klopixol is: 50 tablets 2 mg - 220 rubles, 50 tablets 10 mg - 280 rubles.
Klopiksol: prices in online pharmacies
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Drug name Price Pharmacy |
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Clopixol 10 mg film-coated tablets 50 pcs. 174 r Buy |
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Clopixol 2 mg film-coated tablets 50 pcs. 229 r Buy |
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Clopixol Depot 200 mg / ml solution for intramuscular administration (oil) 1 ml 1 pc. 230 RUB Buy |
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Reviews Klopiksol Depot 230 RUB Buy |
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Clopixol Depot 200 mg / ml solution for intramuscular administration (oil) 1 ml 10 pcs. RUB 2779 Buy |
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!
