PC-Merz
PK-Merz: 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: PK-Merz
ATX code: N04BB01
Active ingredient: amantadine (amantadine)
Manufacturer: Merz Pharma GmbH & Co. KGaA (Germany)
Description and photo update: 2018-21-11
Prices in pharmacies: from 233 rubles.
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PK-Merz is an antiparkinsonian drug.
Release form and composition
Dosage forms PK-Merz:
- film-coated tablets: round, biconvex, orange, with a notch on one side (10 tablets in a blister, 3 blisters in a cardboard box);
- solution for infusion: clear, colorless liquid (500 ml in a bottle, in a cardboard box 1 or 2 bottles).
Composition of 1 film-coated tablet:
- active substance: amantadine sulfate - 100 mg;
- auxiliary components: lactose monohydrate, microcrystalline cellulose, potato starch, gelatin, povidone, croscarmellose sodium, talc, colloidal silicon dioxide, magnesium stearate;
- film shell: talc, butyl methacrylate copolymer, titanium dioxide, magnesium stearate, sunset yellow dye.
Composition of 500 ml solution (1 bottle):
- active substance: amantadine sulfate - 200 mg;
- auxiliary components: sodium chloride, water for injection.
Pharmacological properties
Pharmacodynamics
Amantadine stimulates the release of dopamine from neuronal stores, and also increases the sensitivity of dopaminergic receptors to it. Due to this, even with a decrease in the formation of dopamine, conditions are created for the normalization of neurophysiological processes in the basal ganglia. In addition, amantadine has an inhibitory effect on the generation of impulses in motor neurons of the central nervous system (CNS). At therapeutic concentrations, it slows down the production of acetylcholine, providing an anticholinergic effect.
Pharmacokinetics
When taken orally, the maximum concentration of the substance in the plasma is reached after 2-8 hours, with an infusion of 200 mg - after 3 hours. Stable plasma concentration when taking the drug at a dose of 200 mg per day occurs on days 4-7. The half-life is 10-30 hours. Communication with plasma proteins - 67%. Amantadine crosses the blood-brain barrier. It is excreted mainly by the kidneys unchanged (90% of a single dose) and in small quantities - by the intestines. Dialysis is ineffective.
Indications for use
Film-coated tablets
- Parkinson's disease and parkinsonism of various etiologies;
- pain and residual symptoms after stereotaxic surgery.
Solution for infusion
- severe and life-threatening cases of parkinsonism (akinetic crises);
- temporary interruption of oral therapy;
- loss of consciousness in traumatic brain injury (TBI);
- slowing down the recovery from anesthesia;
- neuralgia with shingles.
Contraindications
Absolute:
- severe congestive heart failure (class IV on the New York Heart Association scale);
- cardiomyopathy;
- myocarditis;
- atrioventricular block II and III degree;
- bradycardia (heart rate ˂ 55 beats / min);
- lengthening of the QT interval by more than 420 ms;
- ventricular arrhythmia (including ventricular flutter);
- low levels of potassium and magnesium in the blood;
- joint administration with drugs that prolong the QT interval;
- glaucoma;
- prostate adenoma;
- psychomotor agitation;
- psychosis (including a history);
- epilepsy;
- thyrotoxicosis;
- lactase deficiency, hereditary galactose deficiency, glucose-galactose malabsorption, phenylketonuria, sucrose-isomaltase deficiency, hereditary fructose deficiency;
- liver diseases (chronic and acute);
- severe renal failure (creatinine clearance ˂ 10 ml / min);
- pregnancy and lactation;
- age up to 18 years;
- increased sensitivity to any component of the drug.
Relative contraindications:
- hyperplasia of the prostate;
- narrow-angle glaucoma;
- renal failure;
- agitation;
- delirium;
- depression of the central nervous system;
- exogenous psychosis (including a history);
- reception as part of combination therapy with memantine, triamterene / hydrochlorothiazide.
Instructions for use of PC-Merz: method and dosage
Film-coated tablets
PC-Merz is taken after meals, preferably in the morning. The first three days take 1 tablet per day, then - 2 tablets per day. In the future, if necessary, the dose can be increased by 1 tablet per week. In combination therapy, the dose is prescribed individually. The maximum dose is 600 mg per day.
The last tablet PC-Merz is recommended to be taken in the afternoon, no later than 16:00.
Solution for infusion
PK-Merz is injected intravenously 1-2 times a day (if necessary, 3 times a day), 500 ml. The duration of the infusion is 3 hours. The average duration of treatment with this form of the drug is 1 week, then it is recommended to switch to PK-Merz tablets.
Side effects
- nervous system, sensory organs and psyche: often (more than 1/100, but less than 1/10) - motor and mental agitation, dizziness, sleep disorder, paranoid exogenous psychosis, accompanied by visual hallucinations (in elderly patients with a predisposition), decreased severity vision; very rarely (less than 1/10 000, including individual reports) - epileptic seizures (usually after taking a dose exceeding the recommended), temporary loss of vision, peripheral neuropathy, myoclonus;
- cardiovascular system: often - marbled skin syndrome in combination with edema of the lower leg and ankles; very rarely - heart failure (development or aggravation), arrhythmia, tachycardia, ventricular fibrillation, prolongation of the QT interval, orthostatic hypotension;
- gastrointestinal tract: often - nausea, dry mouth, loss of appetite, dyspepsia;
- other: often - urinary retention with prostate adenoma; very rarely - allergic skin reactions, dermatosis, photosensitivity, leukopenia, thrombocytopenia, polyuria, nocturia, edema of the cornea of the eye (which disappears when the drug is discontinued).
Overdose
Symptoms of an overdose of PK-Merz: increased excitability, nausea, vomiting, ataxia, decreased visual acuity, lethargy, dysarthria, depression, epileptic seizures, arrhythmia.
Treatment recommendations: gastric lavage, activated charcoal intake, symptomatic therapy (sedatives, anticonvulsants, antiarrhythmic drugs).
special instructions
Patients with diseases of the cardiovascular system during the period of PK-Merz therapy should be closely monitored.
In order to avoid worsening symptoms, it is not recommended to stop taking the drug abruptly.
During treatment, you should refrain from drinking alcohol.
Influence on the ability to drive vehicles and complex mechanisms
During the period of taking PK-Merz, care must be taken when driving vehicles and other complex mechanisms that require the speed of psychomotor reactions.
Application during pregnancy and lactation
According to the instructions, PK-Merz is contraindicated in pregnancy.
If necessary, its use during lactation, breastfeeding should be discontinued.
Pediatric use
PK-Merz is contraindicated for use in pediatrics.
With impaired renal function
The recommended dosage of PK-Merz in case of impaired renal function [Glomerular Filtration Rate (GFR) / dosage / dosage interval]:
- 80-60 ml per minute / 100 mg / 12 hours;
- 60-50 ml per minute / 100 and 200 mg alternately / every other day;
- 50-30 ml per minute / 100 mg / day;
- 30–20 ml per minute / 200 mg / 2 times a week;
- 20-10 ml per minute / 100 mg / 3 times a week;
- ˂ 10 ml per minute / 100 and 200 mg / weekly and every other week.
For violations of liver function
PK-Merz is contraindicated in liver dysfunction.
Use in the elderly
Elderly patients with agitation, confusion, preddelirium and delirium need lower doses of the drug.
Drug interactions
It is contraindicated to take PK-Merz in combination with amantadine and drugs that prolong the QT interval (for example, quinidine, disopyramide, procainamide, amiodarone, thioridazine, amitriptyline, astemizole, erythromycin, clarithromycin, sparfloxacin, halofantazole, and others).
Possible interactions:
- diuretics containing triamterene and hydrochlorothiazide: risk of increased plasma amantadine concentration;
- antiparkinsonian drugs (levodopa, bromocriptine, memantine, trihexyphenidil): due to the risk of psychotic reactions, a dose reduction of one or both drugs may be required;
- memantine, sympathomimetics, anticholinergics, psychostimulants and other drugs that stimulate the central nervous system, ethanol: the risk of increased unwanted effects.
Analogs
The analogs of PK-Merz are Midantan, Neomidantan.
Terms and conditions of storage
Store in a dry place, away from light, at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about PC-Merz
Reviews of PC-Merz are mostly positive. Patients note its ease of use, fast action and relative safety. Among the cons, as a rule, they talk about the side effects of the drug.
Price for PC-Merz in pharmacies
Estimated prices for PC-Merz:
- film-coated tablets (30 pcs in a package) - 270 rubles;
- solution for infusion (in the package 2 bottles of 500 ml) - 1410 rubles.
PK-Merz: prices in online pharmacies
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Drug name Price Pharmacy |
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PK-Merz 100 mg film-coated tablets 30 pcs. 233 r Buy |
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PK-Merz tablets p.o. 100mg 30 pcs. 272 r Buy |
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PK-Merz 200 mg / 500 ml solution for infusion 500 ml 2 pcs. 758 RUB Buy |
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PK-Merz solution for inf. 0.4mg / ml 500ml 2 pcs. 1383 RUB 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!
