Parkopan
Parkopan: 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: Parkopan
ATX code: N04AA01
Active ingredient: trihexyphenidyl (Trihexyphenidyl)
Manufacturer: JSC "Tatkhimfarmpreparaty" (Russia)
Description and photo update: 2019-13-11
Parkopan is an antiparkinsonian drug that inhibits cholinergic transmission in the central nervous system (CNS).
Release form and composition
The drug is available in the form of tablets: white, round, flat-cylindrical, with a chamfer and a dividing line (in blisters: 10 pcs., 5 packs in a cardboard box; 25 pcs., 2 packs in a cardboard box and instructions for use of Parkopan).
1 tablet contains:
- active substance: trihexyphenidyl (trihexyphenidyl hydrochloride) - 2 mg;
- auxiliary components: potato starch, sucrose, calcium stearate.
Pharmacological properties
Pharmacodynamics
Parkopan is a potent antiparkinsonian drug. The mechanism of action of the drug is due to the properties of its active substance, trihexyphenidil, to have a blocking effect on m- and n-cholinergic receptors. The central n-anticholinergic action is aimed at reducing or eliminating movement disorders that are associated with extrapyramidal disorders. In parkinsonism, it reduces tremor, affects rigidity and bradykinesia. Stimulation of the central nervous system is accompanied by depression. Peripheral m-anticholinergic action is more aimed at reducing the secretion of the salivary and bronchial glands. By reducing salivation, it slightly affects perspiration and skin greasiness.
Possessing antispasmodic activity, trihexyphenidil has a direct inhibitory effect on the parasympathetic nervous system and muscle relaxant effect on smooth muscles. Slightly affects the secretion of the pancreas and bile.
Pharmacokinetics
After oral administration, trihexyphenidil is rapidly absorbed from the gastrointestinal tract (gastrointestinal tract), the clinical effect occurs after 1 hour.
Easily crosses the blood-brain barrier, there is no information about penetration through the placenta and into breast milk.
The half-life is 6 to 10 hours.
It is quickly excreted from the body, mainly unchanged.
With prolonged use, it does not cumulate.
Indications for use
- parkinsonism treatment;
- prevention and control of drug-induced extrapyramidal symptoms (not including tardive dyskinesia).
Contraindications
Absolute:
- mechanical stenosis of the gastrointestinal tract;
- megacolon;
- retention of urine;
- hyperplasia of the prostate (with residual urine);
- angle-closure glaucoma;
- tachyarrhythmia;
- tardive dyskinesia;
- acute poisoning with psychotropic drugs (including opioids), alcohol or drugs;
- fructose intolerance, sucrase or isomaltase deficiency, glucose-galactose malabsorption;
- period of pregnancy;
- breast-feeding;
- childhood;
- hypersensitivity to drug components.
With caution, Parkopan tablets should be used to treat patients with arterial hypertension, heart disease, tachycardia, acute myocardial infarction, prostatic hyperplasia, psychotic and manic disorders, dementia syndrome, glaucoma, myasthenia gravis, obstructive gastrointestinal diseases, uncompensated kidney or liver pathologies, obstruction urinary tract, patients in old age.
Parkopan, instructions for use: method and dosage
The drug is intended for use exclusively in adult patients!
Parkopan tablets are taken orally, regardless of food, with a sufficient amount of liquid (150-200 ml).
For treatment, it is necessary to use the minimum effective dose, starting with the lowest dose, then it is selected individually.
If the patient had hypersalivation before the start of treatment, then the tablets should be taken after meals. If dryness of the oral mucosa occurs during treatment, the drug is prescribed before eating, provided that the patient does not develop nausea.
Recommended dosage:
- Parkinson's syndrome: the initial dose is 1 mg once a day. With an interval of 3-5 days, the dose is increased by 1-2 mg, depending on the patient's response. In most cases, the maintenance dose for optimal clinical benefit is 6 to 10 mg per day. For some patients, including Parkopan-resistant patients with post-encephalic parkinsonism, a daily dose of 12–15 mg or more may be required;
- drug-induced extrapyramidal disorders: depending on the severity of symptoms - 5-10 mg per day, for some patients it is sufficient to take 1 mg of trihexyphenidil per day.
The maximum single dose is 10 mg, the daily dose is 20 mg. The doctor determines the duration of the course of treatment individually. If you stop taking Parkopan abruptly, there is a risk of a sudden exacerbation of the symptoms of the disease and worsening of the patient's condition. In this regard, the cancellation of therapy should be carried out by gradually reducing the daily dose over 7-14 days.
Treatment of patients over the age of 65 should be carried out with the use of the minimum doses of trihexyphenidil - 1–2 mg, accompanied by the control of mental state and cognitive functions.
If Parkopan is included in a combination therapy that includes other drugs for the treatment of parkinsonism, a reduction in the dose of trihexyphenidil is required.
When combined with levodopa, it is necessary to reduce the dosage of both drugs, the daily dose of trihexyphenidil is usually 3–6 mg, divided into two doses.
Side effects
- from the side of the central nervous system: irritability, increased fatigue, headache, dizziness, increased nervous irritability, psychomotor agitation, euphoria, agitation, hallucinations, delirium, decreased ability to concentrate, psychosis; at high doses or hypersensitivity, the appearance of disturbances in consciousness and memory, anxiety, insomnia, deterioration of the clinical parameters of myasthenia gravis, involuntary movements in the form of dyskinesias (more often when used simultaneously with levodopa);
- from the digestive system: nausea, vomiting;
- disorders caused by anticholinergic activity: dryness of the oral mucosa, paresis of accommodation, tachycardia, bradycardia, increased intraocular pressure, visual impairment, mydriasis, decreased sweating, difficulty urinating, urinary retention, constipation;
- allergic reactions: skin rash, photophobia;
- others: skin flushing, decreased muscle tone, purulent mumps, drug dependence.
Overdose
The first manifestations of intoxication include the following symptoms: flushing of the face, redness and dryness of the skin, dryness of the mucous membranes (including the oral cavity), rash (face and upper body), nausea, vomiting, fever, rapid breathing, impaired swallowing, tachycardia, high blood pressure (BP), dilated pupils. Symptoms of an overdose of Parkopan from the central nervous system are unreasonable euphoria, atactic gait, pronounced visual hallucinations against the background of a delirious state. Severe overdose causes cardiovascular and respiratory failure, coma, death.
Treatment: there is no specific antidote, therefore, the use of all possible methods is shown to reduce the absorption of the drug (including immediate gastric lavage, artificial vomiting), the use of cold compresses, and drinking plenty of fluids. For the treatment of complications from the heart, sodium lactate or sodium bicarbonate is prescribed, for seizure relief - diazepam, symptoms of delirium - physostigmine.
The use of hemodialysis and hemoperfusion is effective only during the first hours after poisoning.
special instructions
With long-term use of Parkopan, as well as the treatment of patients with hypertension, impaired heart, liver or kidney function, careful regular monitoring of their condition is required.
Due to the fact that taking trihexyphenidil can potentiate the development of early glaucoma, it is recommended to accompany treatment with periodic monitoring of intraocular pressure.
The use of trihexyphenidil is associated with a clinical worsening of myasthenia gravis, therefore, if possible, the appointment of Parkopan to patients with this pathology should be avoided.
With extreme caution, the drug should be used in elderly patients; in rare cases, psychiatric manifestations such as confusion, delirium, hallucinations, and impairment of memory and thinking may occur.
It is required to discontinue treatment with Parkopan if the patient has the appearance of nausea or vomiting caused by taking the drug, mental disorders in the form of changes in mood, agitation or increased irritability. The risk of developing these adverse events is increased with the use of high doses of trihexyphenidil in elderly patients or with a history of atherosclerosis or idiosyncrasy to other drugs.
The drug must not be abused in order to obtain a euphoric or hallucinogenic effect.
If, while taking Parkopan, the patient feels dry mouth, it is advisable to take the tablets before meals.
With long-term treatment, the severity of side effects due to anticholinergic action decreases.
Influence on the ability to drive vehicles and complex mechanisms
During the period of treatment with Parkopan, patients need to be especially careful when engaging in potentially hazardous activities, the implementation of which requires an increased concentration of attention and a high speed of psychomotor reactions, including driving and complex mechanisms.
Application during pregnancy and lactation
The use of Parkopan is contraindicated during pregnancy and lactation.
If necessary, the appointment of the drug during lactation, breastfeeding should be discontinued.
Pediatric use
The appointment of Parkopan is contraindicated for the treatment of patients in childhood.
With impaired renal function
The appointment of Parkopan is contraindicated in case of urinary retention, prostatic hyperplasia (with the presence of residual urine).
It is recommended to use the drug with caution for the treatment of patients with uncompensated kidney pathologies, obstruction of the urinary tract, and prostatic hyperplasia.
For violations of liver function
It is recommended to use Parkopan with caution to treat patients with uncompensated liver pathologies.
Use in the elderly
It is recommended to use Parkopan with caution for the treatment of elderly patients.
Patients over the age of 65 years should be prescribed a minimum dose of trihexyphenidil - 1–2 mg and accompany treatment with control of mental state and cognitive functions.
Drug interactions
- drugs that have a depressing effect on the central nervous system: the combination of trihexyphenidil with these agents increases the inhibitory effects on the central nervous system;
- parasympathomimetics (pilocarpine, neostigmine, carbachol): the listed drugs are antagonists of trihexyphenidil and contribute to an increase in antimuscarinic side effects, therefore, their combination should not be allowed;
- monoamine oxidase (MAO) inhibitors, anticholinergics or drugs with anticholinergic activity: against the background of concomitant therapy with the listed drugs, the anticholinergic effect of trihexyphenidil increases, and there is a risk of developing gastrointestinal disorders, fever, hyperthermia or heatstroke;
- metoclopramide, domperidone: trihexyphenidil weakens the clinical effect of domperidone and metoclopramide;
- antihistamines: a combination with these drugs can cause unwanted reactions due to an increase in the anticholinergic effect;
- quinidine: combined reception with Parkopan enhances the anticholinergic effect on cardiac activity and inhibition of atrioventricular conduction;
- nitrate preparations for sublingual use: due to dry mouth caused by taking trihexyphenidil, the effect of these drugs is reduced;
- nefopam, antimuscarinic drugs: an increase in the frequency and severity of anticholinergic side effects (including dry mouth, drowsiness, constipation) is possible;
- tricyclic antidepressants (imipramine, amitriptyline, trimipramine), blockers of H 1 -histamine receptors (diphenhydramine, promethazine, clemastine), amantadine, phenothiazine derivatives (chlorpromazine, alimemazine): these drugs can enhance the action of trihexyphene;
- chlorpromazine: when combined with trihexyphenidil, the metabolism of chlorpromazine increases, which may cause a decrease in its plasma concentration;
- ketoconazole: absorption of an orally administered drug may decrease;
- reserpine: the combination with reserpine helps to reduce the antiparkinsonian effect of trihexyphenidil and enhance parkinsonism;
- other antiparkinsonian drugs (for example, levodopa): when combined, dyskinesia may increase (especially at the beginning of therapy), therefore, a significant reduction in the dose of trihexyphenidil is required; when taken in combination with levodopa, the latter reduces its absorption and C max (maximum concentration) in blood plasma;
- tranquilizers: in combination with trihexyphenidil, they increase dyskinesia;
- barbiturates, opiates, cannabinoids, ethanol: these agents may have additive effects with trihexyphenidyl.
Analogs
Parkopan's analogs are Trihexyphenidil, Trihexyphenidyl Organic, Trihexyphenidyl-Pharmstandard, Cyclodol, etc.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C in a dark place, observing the rules provided for the preservation of potent substances.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Parkopan
Reviews about Parkopan are currently not available.
Price for Parkopan in pharmacies
Due to the lack of the drug in the pharmacy chain, the price for Parkopan has not been set.
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!
