Proserinum is a synthetic anticholinesterase drug with powerful effects. It is used to treat a variety of pathological conditions, including paralysis, disorders of motor activity as a result of head injury, open-angle glaucoma, atony of the bladder, atony of the digestive tract, neuritis, myasthenia gravis. Do not prescribe medication to patients suffering from prostate adenoma, atherosclerosis, asthma, thyrotoxicosis, angina pectoris, peritonitis, coronary heart disease, epilepsy, bradycardia, arrhythmias, gastrointestinal ulcers.
Pharmacological forms
According to the instructions for use, Prozerin is available in tablet and injection form. Tablets are packed in packs with contour cells of 10 pieces. Each cardboard box holds two cell packs.
Injection "Proserin" is packaged in glass ampoules, each of which contains 1 ml of the drug.
Structure
The active ingredient in Prozerin tablets is neostigmine methyl sulfate. As additional substances are used: calcium stearate, potato starch.
As a part of Prozerin, in ampoules is 0.5 mg of neostigmine as an active substance, as well as injection water as an auxiliary component.
Indications for use
As indicated by the instructions for use, Prozerin is prescribed for patients who have the following pathological conditions:
- Disorders of neuromuscular transmission resulting from the use of non-depolarizing muscle relaxants.
- Weakened labor.
- Atrophic changes in the optic nerve, neuritis.
- Atony of the bladder.
- Atony of the intestine or gastrointestinal tract in general.
- Open angle glaucoma.
- The recovery period after suffering encephalitis, meningitis, polio.
- Movement disorders resulting from head injury.
- Paralysis.
- Myasthenia gravis
The list of indications of Proserinum is quite extensive.
Also, experts practice the use of the drug for the treatment of similar conditions in pediatric patients.
Contraindications
It is unacceptable to assign Prozerin to patients who have the following conditions or pathological abnormalities:
- Individual hypersensitivity to neostigmine methyl sulfate or any auxiliary component of a medicinal product.
- Intoxication in children with respiratory and infectious diseases.
- The acute form of the course of infectious diseases.
- Obstruction of the digestive tract or urinary tract of a mechanical nature.
- Peritonitis.
- Thyrotoxicosis.
- Peptic ulcer in the duodenum and stomach.
- Severe form of atherosclerosis.
- Angina pectoris and coronary heart disease.
- Bronchial asthma.
- Vagotomy.
- Bradycardia, arrhythmia.
- Epilepsy.
- Hyperkinesis
Negative impact
In accordance with the instructions for use with Prozerin, against the background of the use of injectable and tablet forms of the drug, some negative effects may develop, including:
- Arthralgia.
- Increased sweating.
- Increased urination.
- Dyspnea.
- Strengthening the secretory function of the bronchial glands.
- Increased tone of the bronchi.
- Respiratory depression.
- Anaphylactic manifestations.
- Hyperemia of the dermis on the face.
- Skin rash.
- Decrease in blood pressure.
- Nonspecific ECG changes.
- Nodal rhythm.
- AV block.
- Arrhythmia.
- Bradycardia
- Tachycardia.
- Twitching of the muscles of the skeleton.
- Dysarthria
- Impaired consciousness.
- Cramps.
- Drowsiness.
- Myosis.
- Weakness.
- Visual impairment.
- Headaches.
- Dizziness.
- Strengthening peristalsis.
- Nausea.
- Flatulence.
- Vomiting
- Hypersalivation.
- Diarrhea.
If this negative symptom occurs, the patient should consult a specialist. Probably, a dosage reduction or complete discontinuation of the drug will be required, followed by its replacement with a similar medication.
Using
According to the instructions for use, Prozerin tablets are used orally, it should be taken 30 minutes before meals. Most of the entire daily dosage is recommended to be taken before noon.
Adult patients should take 15 mg of the drug twice or three times a day. The total daily dosage of Prozerin tablets can reach 50 mg.
Therapy most often takes about 30 days. In the treatment of myasthenia gravis, the course should be selected individually. If necessary, the therapeutic course can be repeated, but not earlier than a month after completion of the previous one.
When treating children under 10 years old, the daily dosage is calculated according to the formula 1 mg for one year of life. The resulting dose is divided into several doses. Children from 10 years per day should take no more than 10 mg.
The lactation period and pregnancy are complete contraindications to the use of Proserinum. With a weak labor activity, the doctor may consider the purpose of the drug appropriate. In this case, a woman should take 3 mg of the substance every 40 minutes.
"Proserine" in ampoules can be used for subcutaneous or intravenous administration. So, when administered subcutaneously, a single dose of 0.002 grams should be used. The daily dosage is 0.006 mg.
In order to stop the effect of muscle relaxant drugs, Prozerin should be administered intravenously. Previously, the patient is given an injection of atropine sulfate, wait for the pulse to increase, and then 1.5 milligrams of the drug are administered. If the effect is insufficient, the introduction of a repeated dose is allowed. Within half an hour, no more than 6 mg of the drug solution can be used.
Prozerina solution is also used in ophthalmic practice. It is necessary up to 4 times a day to administer the drug in the conjunctival sac in an amount of up to 2 drops.
Overdose
When an overdose of the drug develops, symptoms associated with overexcitation of cholinergic receptors develop. Also, patients have a decrease in blood pressure, twitching of the muscles of the tongue and skeleton, general weakness, frequent urination, diarrhea, bronchospasm, nausea, bradycardia, miosis, hypersalivation.
If there are signs of an overdose, the dose of Prozerin should be reduced or canceled at all. If necessary, metacin, atropine or other anticholinergic agents are administered to the patient.
Interaction with other medicines
It is important to take into account that neostigmine methyl sulfate is an antagonist of non-depolarizing muscle relaxants, therefore, parallel administration activates the effect of depolarizing muscle relaxants.
When combined with antiparkinsonian drugs, antiepileptic drugs, tricyclic antidepressants, local anesthetics, quinidine, novocainamide, m-anticholinergics, ganglion blockers, the effectiveness of neostigmine methyl sulfate decreases.
Special instructions for use
Caution should be exercised when prescribing any pharmacological form of Prozerin to patients with Addison's syndrome.
If the drug is administered parenterally and in significant doses, the patient should first enter atropine.
In cases where therapy is accompanied by the development of myasthenic or cholinergic crises, the patient is shown to conduct a thorough differential diagnosis, since the signs of these conditions are similar.
Experts recommend that during therapy, refuse to perform work related to driving or complex mechanisms.
Analogues of Prozerina
If necessary, Prozerin can be replaced with a drug whose active components and therapeutic effect are similar. However, it is important to understand that each analogue of Prozerin has its own set of specific contraindications and is able to provoke the development of negative reactions. That is why the replacement of the drug should be agreed with a specialist.
The most popular analogues of Prozerin are: Oxazil, Ubretide, Deoxypeganine hydrochloride, Amiridin, Armin, Neostigmine Methyl Sulfate, Neuromidin, Axamon, Kalimin.
Cost
The average cost of an injectable Prozerin is 60 rubles, for a tablet - 55 rubles. The price may depend on the manufacturer and region of distribution of the drug.
Reviews about Proserin
Quite often, patients who used the drug report that the drug provokes the development of negative reactions. Quite often they develop: a strong heartbeat, numbness of the tongue, salivation, dryness in the oral cavity.
Reviews about Prozerin from patients suffering from myasthenia gravis are rather controversial, but most of them allow us to conclude that the drug should be used exclusively as directed by a specialist.