Omnopon
Omnopon: 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: Omnopon
ATX code: N02AX, N02AA51
Active ingredient: codeine (codeine) + morphine (morphine) + narcotine (noscapine) [narcotinum (noscapine)] + papaverine hydrochloride (papaverini hydrochloridum) + tebaine (tebaine)
Manufacturer: Moscow Endocrine Plant FSUE (Russia)
Description and photo updated: 28.08.
Omnopon is a narcotic opioid drug with analgesic action.
Release form and composition
Solution for subcutaneous (s / c) administration 1% or 2%: clear liquid, light yellow or colorless (in 1 ml ampoules, 5 ampoules in blister packs, in a cardboard box 1 or 2 packages and instructions for use Omnopon) …
Active ingredients in 1 ml of a 1% / 2% solution:
- Morphine hydrochloride - 5.75 / 11.5 mg;
- Narcotine - 2.7 / 5.4 mg;
- Codeine - 0.72 / 1.44 mg;
- Papaverine hydrochloride - 0.36 / 0.72 mg;
- Tebain - 0.05 / 0.1 mg.
Auxiliary components: disodium edetate (disodium salt of ethylenediaminetetraacetic acid), glycerol (glycerin), 1M hydrochloric acid solution, water for injection.
Pharmacological properties
Pharmacodynamics
Omnopon is a combined drug. It has a moderate hypnotic and central antitussive effect, causes euphoria, constriction of the pupil (associated with activation of the center of the oculomotor nerve).
Other effects of Omnopon:
- an increase in the threshold of pain sensitivity;
- an increase in the tone of the center of the vagus nerve;
- inhibition of conditioned reflexes;
- oppression of the respiratory center;
- excitation of the center of vomiting;
- inhibition of the secretory activity of the glands of the gastrointestinal tract;
- weakening of intestinal motility.
As a result of using the drug, the basal metabolism and body temperature are slightly reduced, the release of antidiuretic hormone is stimulated. The analgesic effect with subcutaneous administration of Omnopon develops in 10-15 minutes, its duration is 3-5 hours.
The main pharmacological effects of Omnopon are due to its constituent morphine, which is an agonist of predominantly μ-opioid receptors. The substance activates the endogenous antinociceptive system, which contributes to the disruption of the interneuronal transmission of pain impulses at different levels of the central nervous system, and also, acting on the higher parts of the brain, changes the emotional color of pain.
Morphine has a euphorizing and moderate hypnotic effect, inhibits conditioned reflexes, increases the threshold of pain sensitivity to stimuli of various modalities, and increases the tone of the vagus nerve center.
Other effects of morphine:
- stimulation of the chemoreceptors of the starting zone of the vomiting center, as a result, the development of nausea and vomiting is possible;
- constriction of the pupil (associated with activation of the center of the oculomotor nerve);
- oppression of the respiratory and vomiting centers;
- an increase in the tone of the bronchi and smooth muscle sphincters of internal organs (biliary tract, intestines, bladder);
- weakening of intestinal peristalsis;
- increased contractile activity of the myometrium;
- inhibition of the secretory activity of the glands of the gastrointestinal tract;
- stimulating the release of antidiuretic hormone;
- a slight decrease in basal metabolism and body temperature;
- strengthening the effect on the central nervous system of drugs for general anesthesia, drugs with hypnotics, sedative action, blockers of H 1 -histamine receptors with a central component of action, antidepressants, anxiolytic and antipsychotic drugs;
- expansion of peripheral blood vessels and the release of histamine, resulting in a decrease in blood pressure, redness of the skin and white of the eyes, increased sweating.
Codeine is a natural narcotic analgesic belonging to the group of opioid receptor agonists. Its analgesic activity is associated with the excitation of opioid receptors in different parts of the central nervous system and peripheral tissues, which leads to a change in the emotional perception of pain and stimulation of the antinociceptive system.
Papaverine is an antispasmodic agent. It has a hypotensive effect, lowers tone and helps to relax the smooth muscles of blood vessels and internal organs. Due to the content of papaverine, Omnopon causes spasms of smooth muscles of internal organs to a lesser extent than morphine.
Tebain, in comparison with other active substances, is included in the smallest amount. In terms of chemical structure, the substance is similar to codeine and morphine and potentiates their action. Tebain has an analgesic effect by affecting the opioid receptors in the central nervous system. According to its pharmacological properties, the substance differs from codeine and morphine in that it acts as an exciting, not depressing, on the nervous system. In small doses, it has a weak hypnotic effect.
Narcotine (noscapine) is a hypnotic poppy alkaloid derived from benzylisoquinoline. An agonist of predominantly σ-opioid receptors, has an antitussive effect, and practically does not have analgesic properties. It has an antispasmodic effect on smooth muscles, and a potentiating effect on the antispasmodic activity of papaverine.
Pharmacokinetics
- morphine: V d (volume of distribution) - 4 l / kg. The substance binds to blood plasma proteins at a level of 30–35%. Morphine is excreted from the body in the form of glucuronide metabolites (up to 80%) or through the kidneys unchanged; a small part of the substance is excreted in the bile and excreted in the feces. Passes through the placental barrier and is excreted in breast milk;
- codeine: undergoes biotransformation in the liver, while 10% of the dose received is converted to morphine by demethylation. It is excreted by the kidneys: as codeine - from 5 to 15%, as morphine and its metabolites - 10%. It binds to plasma proteins slightly;
- papaverine: undergoes biotransformation in the liver. Excretion is carried out by the kidneys, mainly in the form of metabolites. Binds to plasma proteins;
- thebaine: pharmacokinetic similar to codeine. Its main metabolite is oripavine;
- narcotine (noscapine): after injection into the body from the blood quickly passes into the tissues. 6 hours after entering the body, it is excreted unchanged in the urine, after a specified period of time - in the form of conjugates. Decay products are found in urine for a long time (up to 1 month).
Indications for use
Omnopon is used for severe pain syndrome of various origins, chronic or acute: trauma, post-traumatic pain, myocardial infarction, malignant neoplasms, preparation for surgery, postoperative period, and other similar conditions.
In combination with atropine-like drugs or myotropic antispasmodics, Omnopon is used to relieve pain in renal, hepatic, intestinal colic.
Contraindications
Absolute:
- Bronchial asthma;
- Chronic pulmonary heart failure;
- Heart arythmy;
- Simultaneous use with MAO (monoamine oxidase) inhibitors and for 2 weeks after their withdrawal;
- Conditions / diseases accompanied by severe depression of the central nervous system (central nervous system) or respiratory depression;
- Head trauma;
- Increased intracranial pressure;
- Conditions after surgery on the biliary tract;
- Acute diseases of the abdominal organs requiring surgical intervention prior to diagnosis;
- Paralytic ileus;
- Epilepsy and other convulsive conditions;
- Children under 2 years old;
- Hypersensitivity to Omnopon components.
Relative (the drug is used with caution, due to the increased likelihood of complications): old age, general exhaustion, liver and kidney disease, insufficiency of the adrenal cortex, history of opioid dependence.
During pregnancy, childbirth and lactation (breastfeeding) Omnopon is approved for use solely for health reasons, since the risk of drug dependence in the child is high.
Omnopon, instructions for use: method and dosage
Omnopon solution in ampoules is intended for subcutaneous administration.
The dose is selected individually and depends on the patient's condition and the severity of the pain syndrome.
The recommended dose for adults is 10-20 mg (1 ml of 1% or 2% solution); if necessary, repeated administration of the drug is allowed after 4-5 hours. The maximum single dose is 30 mg (1.5 ml of a 2% solution or 3 ml of a 1% solution). The maximum daily dose is 100 mg (5 ml of a 2% solution or 10 ml of a 1% solution).
Omnopon is administered to children, depending on the required degree of anesthesia, general condition and age, at a dose of 1 mg (2-3 years) to 7.5 mg (12-14 years).
Side effects
- Depression, euphoria, hallucinations, dizziness, agitation, drowsiness;
- Constipation, nausea, less often vomiting (in order to reduce the side effect on the intestines, it is recommended to take laxatives);
- Spasms of the sphincter of the bladder, urinary disorders;
- Muscle weakness;
- Exacerbation of brain diseases due to increased intracranial pressure;
- Spasms of the biliary tract;
- Moderate respiratory depression;
- Hypersensitivity reactions.
As a result of the injection, peripheral blood vessels expand with the release of histamine, which can cause bronchospasm, hypotension, skin redness, increased sweating, reddening of the albumin of the eyes.
In the case of repeated use of the solution for 1-2 weeks, and sometimes 2-3 days, addiction may develop with a weakening of the anesthetic effect and opioid drug dependence. 1-2 days after the cessation of injections, signs of withdrawal syndrome may appear: headache, yawning, mydriasis, muscle contractions, hyperthermia, vomiting, diarrhea, sweating, tachycardia, hypertension, and other vegetative symptoms. This condition requires therapy in an inpatient specialized department.
Overdose
The main symptoms: hypothermia, coma / stupor state, lowering blood pressure, respiratory depression. An overdose is characterized by a pronounced constriction of the pupils (in the case of significant hypoxia, their expansion may be noted).
Therapy: maintaining adequate pulmonary ventilation.
A specific opioid antagonist is injected intravenously - 0.4–2 mg of naloxone (in order to quickly restore breathing). If there is no effect, naloxone is re-injected after 2-3 minutes. For children, the starting dose of Omnopon is 0.01 mg / kg. The short duration of action of naloxone must be taken into account, and the likelihood of withdrawal symptoms when naloxone is administered to opioid-dependent patients must also be taken into account (its dose must be increased gradually).
special instructions
Omnopon is addictive, physically and mentally opioid drug dependence.
Influence on the ability to drive vehicles and complex mechanisms
In the course of treatment, it is required to refrain from potentially hazardous activities that require speed of psychomotor reactions and increased concentration of attention, including from driving.
Application during pregnancy and lactation
Omnopon during pregnancy / lactation can only be used for health reasons.
Pediatric use
For patients under 2 years of age, the drug is not prescribed.
With impaired renal function
With renal failure, Omnopon is used with caution.
For violations of liver function
In liver failure, Omnopon is used with caution.
Use in the elderly
In elderly patients, therapy should be carried out under medical supervision.
Drug interactions
Omnopon suppresses the activity of the respiratory center and increases the depressing effect on the central nervous system against the background of the use of drugs for anesthesia, antidepressants, antipsychotics and anxiolytics, as well as sedatives, hypnotics and antihistamines of central action. If the use of Omnopon in such combinations is necessary, reduced doses should be taken and therapy should be carried out under close medical supervision.
Narcotic analgesics from the group of partial agonists (tramadol, buprenorphine) and antagonist agonists (butorphanol, nalbuphine) of opioid receptors should not be used concurrently with Omnopon due to the increased likelihood of weakening analgesia and the possibility of provoking withdrawal syndrome.
Opioid agonists (promedol, fentanyl), when used in therapeutic doses simultaneously with Omnopon, give a total analgesic effect, their side undesirable reactions are also cumulative.
Analogs
Omnopon analogs are: Morphine, Pantopon, Trimeperidin, Fentanyl, Sufentanil.
Terms and conditions of storage
Store in a dark place, out of reach of children, at temperatures up to 15 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Released strictly according to the recipe.
Reviews about Omnopon
Reviews of Omnopon relate mainly to the description of side effects. Most often, after using the drug in the postoperative period, there is the development of nausea and repeated vomiting, which does not bring relief.
Omnopon price in pharmacies
The price of Omnopon in ampoules is unknown, since the drug is not available in pharmacies (included in the list of drugs subject to control in the Russian Federation).
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!
