Coaxil
Coaxil: 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. Drug interactions
- 11. Analogs
- 12. Terms and conditions of storage
- 13. Terms of dispensing from pharmacies
- 14. Reviews
- 15. Price in pharmacies
Latin name: Coaxil
ATX code: N06AX14
Active ingredient: tianeptine (tianeptine)
Producer: Les Laboratoires Servier (France)
Description and photo update: 2019-13-08
Coaxil is an antidepressant.
Release form and composition
Dosage form - tablets: oval, coated white (in blisters of 30 pcs., 1 blister in a cardboard box with a first opening control).
The active ingredient of Coaxil is sodium tianeptine: in 1 tablet - 12.5 mg.
Auxiliary components: mannitol, talc, magnesium stearate, corn starch.
Shell composition: white beeswax, sodium carmellose, glyceryl monooleate, titanium dioxide, sodium bicarbonate, polysorbate 80, ethylcellulose, colloidal anhydrous silicon dioxide, talc, sucrose, povidone.
Pharmacological properties
Pharmacodynamics
Tianeptine belongs to antidepressants belonging to the group of tricyclic derivatives. Experiments carried out on laboratory animals have shown that this substance stimulates the spontaneous activity of pyramidal cells localized in the hippocampus and increases the rate of their regeneration after functional inhibition. Tianeptine activates the reuptake of serotonin by neurons in the hippocampus and cerebral cortex. The nature of the clinical effect of the drug on mood disorders indicates its intermediate position in the bipolar classification between stimulating and sedative antidepressants.
In patients taking tianeptine, the severity of somatic symptoms (especially from the gastrointestinal tract) decreases, for example, nausea, fever, heart palpitations, muscle pain and epigastric pain caused by mood disorders and anxiety. Tianeptine does not affect the cholinergic system (it is not characterized by cholinergic action), the ability to concentrate and sleep.
Pharmacokinetics
Tianeptine is rapidly and almost completely absorbed from the gastrointestinal tract and has a high rate of distribution throughout the body. It is characterized by a high degree of protein binding (approximately 94%).
The active component of Coaxil is actively involved in metabolic processes in the liver, including oxidation and N-demethylation. The half-life of tianeptine is about 2.5 hours. The drug is excreted in the urine, and about 8% is excreted unchanged, and the main part is excreted in the form of metabolites.
In elderly patients and those suffering from renal failure, the half-life is increased by 1 hour. It has been proven that the pharmacokinetic parameters of tianeptine in patients with chronic alcoholism, including diagnosed liver cirrhosis, do not change significantly.
Indications for use
According to the instructions, Coaxil is used to treat depressive conditions.
Contraindications
Absolute:
- Glucose-galactose malabsorption, sucrase-isomaltase deficiency and fructose intolerance;
- Age under 18;
- Simultaneous use of non-selective monoamine oxidase (MAO) inhibitors, as well as a period of 2 weeks after their withdrawal;
- Hypersensitivity to drug components.
Coaxil should be used with caution when treating patients with a history of drug and alcohol dependence.
Instructions for the use of Coaxil: method and dosage
Tablets must be taken orally 1 pc. before meals 3 times a day (morning, afternoon and evening).
For elderly people, the frequency of application of Coaxil is reduced by up to 2 times.
Side effects
The incidence of side effects:
- Often - ≥1 / 100, but <1/10;
- Uncommon - ≥1 / 1000, but <1/100;
- Rarely - ≥1 / 10,000, but <1/1000;
- Frequency unknown - data from post-registration experience of use.
Possible unwanted effects of Coaxil:
- Hepatobiliary system: frequency unknown - increased activity of liver enzymes, hepatitis (in extremely rare cases - in severe form);
- Digestive system: often - pain in the epigastrium and abdomen, dry mouth, constipation, nausea, vomiting, flatulence;
- Cardiovascular system: often - rush of blood to the skin of the face, chest pain, extrasystole, tachycardia;
- Respiratory system: often - shortness of breath;
- Mental disorders: often - "nightmares"; rarely with drug abuse - drug dependence (especially in patients under 50 years of age with a history of alcohol / drug dependence); the frequency is unknown - suicidal thoughts and behavior (including soon after the cancellation of Coaxil), hallucinations, confusion;
- Central nervous system: often - headache, dizziness, tremors, drowsiness or insomnia, fainting (lipotimia); frequency unknown - dyskinesia, extrapyramidal disorders;
- Connective tissue and musculoskeletal system: often - pain in the lumbar region, myalgia;
- Metabolic disorders and diseases that have arisen against this background: often - anorexia; frequency unknown - hyponatremia;
- Skin: infrequently - erythematous or maculopapular rash, pruritus, urticaria; frequency unknown - acne; extremely rare - bullous dermatitis;
- Others: often - a feeling of a lump in the throat, asthenia.
Overdose
The clinical experience of overdose (the maximum dose taken was 2250 mg once) made it possible to determine the following consequences of Coaxil: dry mouth, drowsiness, blurred consciousness, seizures and respiratory failure (mainly when tianeptine is combined with alcoholic beverages).
In this case, it is recommended to cancel the drug and carefully monitor the patient's condition. If threatening symptoms appear, gastric lavage should be performed (if Coaxil was taken no earlier than 2 hours before the patient was admitted to the hospital) or the patient should be given activated charcoal (if the drug was taken earlier than the time indicated above). It also monitors homeostasis indicators, renal function, and the functions of the respiratory and cardiovascular systems. If necessary, symptomatic therapy is prescribed (for example, correction of renal dysfunction and metabolic disorders, as well as artificial ventilation). No specific antidotes for tianeptine have been identified at the moment.
special instructions
In depressive states, the likelihood of suicidal thoughts and behavior, attempts at self-harm is high. This risk persists until apparent remission occurs. For this reason, all patients undergoing treatment should be under close medical supervision until the condition improves significantly (this may take several weeks). According to clinical experience, the risk of suicide may increase in the early stages of remission.
Patients with a history of events associated with suicide, as well as patients who had suicidal intentions before starting treatment, should be under especially close medical supervision for the entire period of therapy.
A meta-analysis of clinical trials of antidepressant drug use in patients with mental disorders suggests that the risk of suicidal behavior is increased in young people under the age of 25.
All patients who are prescribed Coaxil should be informed of the need to immediately consult a doctor in case of deterioration, unusual behavior, or the appearance of suicidal thoughts.
If it is necessary to carry out a surgical intervention using general anesthesia, the drug should be canceled 24-48 hours before. In the case of emergency surgery, the operation should be carried out under the strict control of the patient's condition.
Like any other psychotropic drugs, Coaxil should not be canceled abruptly, the dose should be reduced gradually over 7-14 days.
It is forbidden to independently exceed the dose prescribed by the doctor. Patients with a history of alcohol / drug dependence should be under special supervision to avoid dose increases.
In some cases, Coaxil affects the speed of reactions and the ability to concentrate, so care should be taken when driving and performing potentially hazardous activities.
Application during pregnancy and lactation
It is not recommended to take Coaxil during pregnancy. During this period, it is desirable to maintain mental balance. If this requires drug treatment, it is allowed to start or continue the previously started therapy (monotherapy remains preferable).
The results of studies on the use of Coaxil in laboratory animals look quite encouraging, but the experience of using the drug in humans remains insufficient. If vital indications require the initiation or continuation of treatment with Coaxil during pregnancy, the pharmacological characteristics of the drug must be taken into account when monitoring the condition of the newborn.
Since tricyclic antidepressants are found in breast milk, breastfeeding during therapy is contraindicated. Clinical data describing the effects of tianeptine on fertility in humans are lacking to date.
Drug interactions
With the simultaneous use of MAO inhibitors, a sharp increase in blood pressure, convulsions, collapse, hyperthermia and death are possible. Therefore, Coaxil can be taken no earlier than 2 weeks after their cancellation.
Simultaneous administration of mianserin is undesirable, because in the course of the experiments, an antagonistic effect was established.
It is recommended to refrain from consuming ethanol during treatment.
Analogs
Coaxil analogs are: Lotosonic, Azafen, Amitriptyline.
Terms and conditions of storage
Store at a temperature not exceeding 30 ° C out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Released only for hospitals.
Reviews about Coaxil
Almost all reviews of Coaxil left by narcologists are positive. It is actively used in the treatment of depressive conditions. Patient opinions are contradictory. Some note that during treatment they experienced a surge of energy and a state of "creative flight". Others say they suffered from drowsiness and apathy while taking the drug. Some reviews mention that an exacerbation of gastroenterological diseases was observed as a side effect, which is due to the stimulating effect of Coaxil.
Price for Coaxil in pharmacies
At the moment, the price of Coaxil is unknown, since the drug is not available for sale.
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!
