Bleeding is a condition that can threaten a person’s life. To eliminate them created hemostatic drugs. The list of these medicines includes Dicinon. This is a prescription drug that can not be used at its discretion. Let's get acquainted with the instructions and side effects of Dicinon.
Dosage Forms and Composition
In pharmacies "Ditsinon" is offered in 2 dosage forms:
- in the form of a solution for administration to muscles and veins;
- in the form of tablets for internal use.
Both dosage forms are manufactured on the basis of etamsylate. This is the active substance in Dicinone, which has a hemostatic effect. In the human body, etamzilate leads to normal capillary permeability, has a stimulating effect on the formation of platelets, helps to stop bleeding, and reduce bleeding.
Also, the composition of "Ditsinona" contains auxiliary components. The solution includes sodium disulfite, sodium bicarbonate, water for injection. Excipients in tablets are corn starch, lactose, anhydrous citric acid, povidone and magnesium stearate.
Before using the medicine, it is necessary to take into account its composition, because the side effects of Dicinon arise due to its components. A patient who knows that he has hypersensitivity to any of the above substances should tell his doctor.
Pharmacodynamics and pharmacokinetics
Ethamsilate, which is the active ingredient in Dicinone, not only affects capillaries and platelet formation. It reduces the synthesis of prostaglandins. Because of them, by the way, platelet disaggregation occurs in the body, the lumen of blood vessels and the permeability of capillaries increase.
The active component of the drug has almost no effect on the composition of peripheral blood, its lipoproteins and proteins. The erythrocyte sedimentation rate can only decrease. Ethamzilate also does not cause blood vessel constriction.
Pharmacokinetics depends on the dosage form. When the solution is administered intravenously, the hemostatic effect of the drug begins to appear after about 5 minutes. The maximum effect occurs 1-2 hours after the introduction of the solution and lasts from 4 to 6 hours. Then the effect gradually weakens during the day. With the introduction of the drug into the muscle, the hemostatic effect begins after 30-60 minutes. After taking the tablet dosage form, it takes time for the medicine to dissolve in the stomach, penetrate through the mucous membrane into the bloodstream and spread throughout the body.
The active substance "Ditsinona" is slightly metabolized in the body. A large proportion of the drug (approximately 80% of the applied dose) is excreted unchanged by the kidneys. And here the question arises: does Dicinon provoke side effects in those people who have impaired liver and kidney function? It is impossible to give an unambiguous answer here, since there are no results of relevant studies.
Indications and contraindications
Some indications are common for solution and tablets:
- operations (tablets are used before and after them);
- hematuria - the presence of blood in the urine (deviation from the norm);
- metrorrhagia - the appearance of uterine bleeding that is not associated with menstruation;
- menorrhagia in women using intrauterine contraceptives, primary menorrhagia - menstrual dysfunction, manifested by heavy and prolonged bleeding;
- bleeding gums;
- nosebleeds.
Tablets can also be prescribed for vomiting of blood, a black semi-liquid stool, which in medicine is called melena. Additional indications for the introduction of the solution are intracranial hemorrhages that occur in newborns and premature babies, diabetic microangiopathy.
In order not to encounter the side effect of "Dicinon", you need to use the drug not only if there are indications, but also in the absence of contraindications. Common contraindications for tablets and solution are acute porphyria, hemoblastosis in children, thrombosis, thromboembolism, hypersensitivity to the components. In addition, the solution is prohibited for use in bronchial asthma (with confirmed sensitivity to sodium sulfite). Additional contraindications for tablets are lactose intolerance, lack of lactase, impaired glucose / galactose absorption.
Doses for adults
For the solution, the optimal daily dose is set in the range of 10–20 mg per 1 kg of body weight. This volume of medicine is usually divided into 3-4 doses. For some situations, specific doses have been established. For example, 1 hour before prophylactic operations, doctors administer to their patients 250-500 mg of the drug (1-2 ampoules) either intravenously or intramuscularly. During surgery, the dose is repeated. The route of administration is intravenous. After surgery, patients are again administered 250–500 mg of the drug every 4–6 hours. Stop using the solution after the risk of bleeding has disappeared.
A different way of using the solution is established for the diagnosis of diabetic microangiopathy. In the presence of such a disease, “Dicinon” is administered retrobulbarly or subconjunctivally. The established dose is half an ampoule.
Solid dosage form is prescribed:
- 1 hour before surgery - 1 or 2 tablets;
- after surgery - 1 or 2 tablets every 4-6 hours;
- to stop any bleeding - 2 tablets every 8-12 hours with a little water or with food.
Use in childhood
The solution and tablets "Ditsinona" can be used in childhood if indicated. The recommended dosage is a 50% reduced dose for adults. It is important to consider that tablets are contraindicated in children under 3 years of age. From the age of 12, adolescents weighing more than 40 kg can be prescribed tablets in the same doses as adults.
The solution is allowed to prescribe to newborn babies. Specifically for this category of patients, the recommended dose is 10 mg per 1 kg of weight. Therapy begins within the first 2 hours after birth. Then the administration of the drug is repeated every 6 hours. The duration of treatment is 4 days.
Use for menstrual irregularities
It has already been noted above that a hemostatic drug can be used for menorrhagia. For women with this problem, “Dicinon” has a positive effect. It reduces the duration of menstruation, i.e., normalizes menstrual function. Also, the drug eliminates metrorrhagia - bleeding that can be taken for menstruation, but in fact they are not.
In the treatment of metro- and menorrhagia, any dosage form of Dicinon can be used. The solution is administered either intravenously or intramuscularly. A single dose is 250 mg. It is administered every 6–8 hours. The course of treatment is 5-10 days. Therapy with tablets is carried out for the same period of time. They need to drink 2 pieces three times a day to normalize the menstrual cycle. "Ditsinon" side effects associated with menstruation, does not cause if used correctly.
What is important for pregnant and lactating women to know
No specialist will say what consequences, side effects, "Dicinon" during pregnancy can cause. There is no clinical evidence confirming the safety of the drug. But it is worth considering that various bleeding is a manifestation of dangerous complications and conditions. They require emergency treatment. For this reason, Dicinon may be prescribed. The manufacturer allows the use of this hemostatic agent in cases where the expected benefit exceeds the potential risk.
Also, studies have not been conducted on the penetration of the active substance into breast milk. With lactating women who have indications for the use of "Dicinon", the issue of stopping breastfeeding for the period of treatment is necessarily resolved.
Side effects
The use of the drug in the form of a solution does not always bring a positive result. Often there are side effects in Dicinon in children and adults. A list of the most common adverse effects includes:
- severity in the epigastric region;
- nausea
- skin rash;
- headache;
- fatigue.
Side effects from Dicinon, such as hyperemia of the skin of the face, dizziness, thrombocytopenia, neutropenia, agranulocytosis, arthralgia, fever, paresthesia of the lower extremities, allergic reactions, are slightly less common. Particular attention should be paid to the last undesirable effect. Allergic reactions can provoke not only the active substance of the drug, but also auxiliary components. For example, sodium sulfite can cause nausea, diarrhea, asthma attacks, anaphylactic shock, manifested by generalized itching, shortness of breath, hypoxia, seizures. With side effects, “Dicinon” is canceled.
There is another undesirable consequence. With parenteral administration of the drug, blood pressure can significantly decrease. This must be considered when treating patients with hypotension.
Reviews about "Dicinone", side effects
Experts speak positively about Ditsinon. In their opinion, the drug has several advantages. Firstly, it is available in 2 dosage forms. In some cases, it is more correct to use the solution, and in others, tablets. Secondly, “Dicinon” is available in every pharmacy and is affordable. Thirdly, it effectively copes with various types of bleeding. Doctors also warn that it is possible to use this medicine only as prescribed by a specialist.
Patients also praise the drug very often. In their reviews, they talk about successful treatment. Some with the help of "Ditsinona" restore normal menstrual function, others stop nosebleeds, others without collision with any problems are restored in the postoperative period.
Negative opinions in people are formed, as a rule, for the reason that the drug did not suit them. Patients in reviews of side effects of Dicinon complain, for example, of a rash or abdominal pain. No one talks about the severe deterioration in well-being, since when the drug is discontinued, all side effects quickly disappear.