Nausea and vomiting are a rather unpleasant symptom of many diseases. It can appear even in healthy people with overeating or food poisoning. Most often, it is best to get rid of this condition, eliminating its cause. But sometimes you just need to eliminate nausea or prevent the appearance of vomiting. For this, antiemetic agents are used, for example, Tserukal. Side effects from taking this drug appear mainly with prolonged use or in the presence of contraindications.
Description of the drug "Cerucal"
This medicine refers to antiemetics. The active substance of the drug is metoclopramide hydrochloride. It enhances the motility of the digestive tract, improving digestion and accelerating the release of the stomach. A strong antiemetic effect is based on the ability of metoclopramide to block dopamine receptors in the stomach, sending impulses to the brain. This substance also affects the medulla oblongata, which is responsible for the vomiting reflex. Thanks to this complex action, nausea and vomiting are stopped.
The drug "Cerucal" is available in tablets and ampoules for injection. Tablets contain 10 mg of active ingredient. They begin to act in about an hour. The use of Cerucal ampoules is more appropriate in emergency cases when it is necessary to quickly stop indomitable vomiting. With intramuscular administration, its effect occurs after 15 minutes, and with intravenous administration almost immediately. Replace "Cerucal" can be completely similar drugs, also based on metoclopramide. This, in fact, is Metoclopramide, as well as Perinor, Raglan, or Metamol.
Mechanism of action
The drug "Cerucal" accelerates the movement of food through the digestive tract by improving its motility. It does not affect the acidity of the gastric juice, the enzyme production process. But this tool has a complex effect. It affects not only the receptors of the stomach, but also the autonomic nervous system. As a result of this, “Tserukal” has the following effect:
- slows down the motility of the esophagus;
- improves tone of the lower esophageal sphincter;
- accelerates intestinal motility;
- contributes to the production of bile and its free entry into the duodenum;
- normalizes the work of the bile ducts;
- eliminates hiccups and burping;
- accelerates bowel movement.
Indications for use
Despite the presence of many side effects, Cerucal is widely used in medicine. It is prescribed not only for nausea and vomiting. The complex effect of the drug contributes to the fact that it can be used for a variety of pathologies:
- with hiccups, belching;
- atony of the stomach;
- after surgery on the stomach;
- reflux disease or heartburn;
- with nausea due to food poisoning;
- irritable bowel syndrome;
- diabetic paresis of the stomach;
- to relieve severe nausea during chemotherapy.
In addition, often before the examination of the stomach and intestines with the use of sounding, "Cerucal" is also used. Side effects with such a single dose are rare, but the drug will help the patient easier to transfer the procedure. But it is not advisable to use this remedy for motion sickness, as well as for nausea caused by stress. "Cerucal" does not affect the vestibular apparatus and the psyche of the patient, therefore, does not help in these cases.
What contraindications may be
Despite the effectiveness of the drug and its complex effect on the body, it is not always used in such cases. Most importantly, caution should be given to children. Until the age of 14, it is not recommended to use tablets, only injections. And up to 2 years, the drug is not prescribed at all. Contraindications "Cerucal" during pregnancy is associated with the fact that it quickly penetrates the bloodstream and through the placental barrier. This can negatively affect the baby. He can be prescribed only from the second trimester of pregnancy for health reasons. You can not use the drug during breastfeeding, because it easily penetrates into breast milk.
In addition, there are other contraindications to the use of Cerucal:
- individual intolerance to metoclopramide;
- pyloric stenosis;
- bowel obstruction;
- the presence of bleeding from the digestive tract;
- perforation of an ulcer or perforation of some part of the gastrointestinal tract;
- epilepsy or frequent bouts of seizures;
- hormone-dependent tumors.
With caution and only as directed by a doctor, you can use this drug with high or low blood pressure, liver failure, bronchial asthma, as well as people over 65 years of age. In such cases, side effects of Cerucal are more often manifested. The drug is excreted by the kidneys, so if their functions are impaired, it can only be used in a reduced dosage.
Possible side effects
When taken correctly, the drug is well tolerated by most patients if it is taken only to relieve acute symptoms of nausea or vomiting. Negative reactions to the drug "Cerucal" occur with an overdose or the presence of contraindications. Most often, such side effects appear:
- headaches;
- fluctuations in blood pressure;
- cramps
- noise in ears;
- heart palpitations;
- swelling
- diarrhea or constipation;
- allergic reactions.
In children, most often against the background of taking the drug, dyspeptic disorders appear. And in adults, the side effects of Cerucal are often manifested in disruption of the central nervous system. It can be drowsiness, dizziness, anxiety, depression. Therefore, with prolonged use, it is better not to drive and do not operate complex mechanisms. Sometimes gynecomastia also occurs in men, and women suffer from menstrual irregularities.
Consequences of an overdose
If you do not follow the instructions and take the drug in large doses, the risk of side effects increases. In this case, damage to the cardiovascular system, psyche usually occurs, and the work of muscles is disrupted. Convulsions appear, blood pressure rises, the rhythm of the heart is disturbed. Bradycardia may also develop, and pressure decreases. In this case, drowsiness, weakness, anxiety, even confusion appear. If the dose is exceeded, older people may develop parkinsonism. And children often have tics, cramps, muscle hypertonicity in such cases. Usually, overdose symptoms go away after a day, but you still need medical help. In severe cases, gastric lavage is necessary. But usually symptomatic therapy is enough.
Instructions for use of the drug "Cerucal"
Usually, the drug is prescribed 1 tablet three times a day. You need to take it half an hour before eating, drinking plenty of water. If there is an urgent need, you can take 2 tablets, but not more, as this will increase the risk of side effects. You can also take the drug 4 times, but so that the daily dose does not exceed 60 mg. The duration of treatment is set individually. To relieve nausea and vomiting during food poisoning, you can take "Cerucal" for several days. But usually the duration of treatment of various pathologies is a month. And in some cases, for example, with constant nausea from chemotherapy, you need to take it for at least six months.
The solution "Cerucal" is administered intramuscularly or intravenously. The dosage is the same: 1 ampoule (2 ml) containing 10 mg of the active substance. Injections are done three times a day. With intravenous injection, the solution is administered very slowly, with rapid administration, the risk of severe side effects increases. Before diagnostic tests, they take 1-2 injections before the procedure. Cerucal is also used when taking cytostatics to prevent the appearance of a gag reflex. In this case, it is administered through a dropper up to 1 mg per 1 kg of patient weight per hour, diluted in a glucose solution. The procedure is performed 2 hours before taking cytostatics.
"Cerucal": instructions for use for children
The drug is prescribed with caution for children and adolescents, especially in the presence of renal failure. Assign "Tserukal" only after 3 years. It is advisable to take it under the supervision of a doctor, since at this age, intramuscular or intravenous administration is indicated. Side effects of Cerucal in children are more pronounced. They often have a violation of the intestines, motor disorders, cramps. Therefore, it is necessary to accurately calculate the dosage.
Adolescents after 14 years of age are given 0.5-1 tablets, no more than 2-3 times a day. Children from 3 to 14 years of age are prescribed injections. The drug is administered in a dose of 0.1-0.5 mg per 1 kg of the child's weight per day.
Drug interaction
There are several drugs with which it is not recommended to take Cerucal. This is especially true for drugs related to serotonin reuptake inhibitors. When used together with Cerucal, the development of serotonin syndrome is possible. "Paracetamol" together with this drug can lead to toxic damage to the liver, and antipsychotics - to convulsions and motor disorders. "Cerucal" is also incompatible with alkaline solutions for droppers and sedatives.
In addition, Cerucal may affect the absorption rate and effectiveness of certain drugs. It impairs the absorption of B vitamins, tricyclic antidepressants, antihistamines, Levodopa, Digoxin and Cimetidine. And the absorption of certain antibiotics, on the contrary, speeds up, which can increase the risk of side effects.
Features of the use of different forms of release
It is impossible to unequivocally answer which is better - tablets or injections. Tablets are recommended for use in chronic pathologies, disruption of the gastrointestinal tract. And with severe vomiting, they will be ineffective, since they will not have time to act. Therefore, in this case, it is better to use injections. They are also used when it is necessary to remove the gag reflex as soon as possible. True, the effect of the drug in the form of injections is much less than from tablets. But in general, the choice of the form of release of the drug is carried out by the doctor, depending on the condition of the patient. Contraindications and side effects of Cerucal are also taken into account. For example, children under 14 years old are better to use it in the form of injections, because it is easier to calculate the dosage.
The drug "Cerucal": reviews
Side effects with the correct use of this tool are rare. Therefore, doctors often prescribed “Cerucal” for various disorders of the gastrointestinal tract. Judging by the feedback from patients, this drug relieves nausea and removes vomiting. It is effective in violation of the motility of the digestive tract, reduces severity and bloating. Many patients with chronic gastritis or pancreatitis always keep Tserukal at home to take as needed.