"Galantamine" and analogues of the drug belong to the group of anticholinesterase drugs. As a result of their intake, the transmission of cholinergic impulses is improved, the action of endogenous acetylcholine is prolonged. In the article we will talk about these medicines and the opinions of patients.
Release form, composition
The drug is available in three forms - tablets, capsules and injection.
Round white tablets of a flat shape contain the active substance - galantamine, and there are various dosages of the active substance - 4 mg, 8 mg and 12 mg. Auxiliary components are:
- copovidone (collidone or plasdon);
- Ca hydrophosphate dihydrate;
- croscarmellose Na;
- Mg stearic acid;
- microcrystalline cellulose;
- colloidal Si dioxide (aerosil).
Analogues of "Galantamine" have a similar composition and a similar effect.
The shell covering the core of the active component consists of hypromellose, Ti dioxide, macrogol (polyethylene glycol), and a dye-based aluminum varnish.
The drug goes on sale for ten, fifteen, thirty or sixty tablets in a pack.
Capsules are light pink or white containers containing white granules inside. As additional components are:
- sucrose;
- ethyl cellulose;
- corn starch;
- diethyl phthalate;
- hypromellose;
- red or yellow iron oxide;
- macrogol;
- titanium dioxide.
Capsules are enclosed in blisters of seven pieces, of which one, two, four, eight or twelve pieces can be in one box. Instructions for taking the drug are attached.
The solution for injection is a colorless transparent liquid. One milliliter may contain 1 mg or 5 mg of galantamine hydrobromide (active ingredient), as well as water for injection and sodium chloride as auxiliary components. The liquid is poured into ampoules of 1 ml and laid in five pieces per cell package, which go on sale two in a box.
Store the product at temperatures up to 25 ° C in a dry, inaccessible to children, dark place.
When application is indicated
The use of "Galantamine" and analogues is indicated for such diseases:
- myopathy
- muscle dystrophy;
- sciatica and other disorders in the musculoskeletal system;
- neuritis, accompanied by memory lapses;
- cerebral palsy;
- polio;
- dementia
- moderate to mild Alzheimer's disease.
In addition, a solution for injection is used in the treatment of:
- pathologies of the spinal cord and brain;
- neurological disorders, including idiopathic paresis of the facial nerve;
- enuresis;
- digestive system;
- atony of the bladder;
- Guillain-Barré syndrome;
- intoxication in case of poisoning with anticholinergic drugs or morphine.
Also, this drug is used when iontophoresis is performed for pathologies of the peripheral nervous system or the diagnosis of diseases of the digestive tract.
The healing properties of drugs
According to the instructions for use, "Galantamine" and analogues act on a wide range of diseases. Drugs are dispensed to consumers strictly on prescription.
As a result of taking "Galantomina" and similar drugs:
- cholinergic transmission improves;
- the effect of endogenous acetylcholine is prolonged;
- intramuscular nerve transmission is activated;
- the activity of the endocrine glands is enhanced;
- antagonism to curariform substances is shown, which have a non-depolarizing effect;
- muscle tone improves.
There is also evidence that after taking the drugs, intraocular pressure decreases, but a spasm of accommodation may occur and myosis develop. The active substance galantamine penetrates the cells of the brain, as a result of which nerve excitation is significantly increased.
Pharmacokinetics of drugs
As stated in the instructions, "Galantamine" and analogues are characterized by fast and complete absorption into the gastrointestinal tract immediately after ingestion. This is evidenced by the high absolute bioavailability indicator, which reaches 90%.
Concentration in the therapeutic norm is reached already after half an hour from the moment of taking the medications due to good absorption. The maximum plasma content, subject to the adoption of 8 mg of the active substance, is observed after an hour and a half and equals 1.2 mg / ml. The half-life of the substance reaches 5 hours. After taking medications with galantomine many times, the equilibrium concentration value is established.
The active substance can slightly bind to proteins in the blood, easily passing through the blood-brain barrier.
To a small extent (up to 10%), metabolism occurs in the liver through demethylation. Up to 74% of the drug is excreted in the urine in the form of metabolites (galantaminone and epigalantamine) and partially unchanged.
About 100 ml / min of metabolites pass through the kidneys, the rest is excreted through the intestines.
The plasma concentration of the active substance can increase in people with Alzheimer's disease, as well as in severe and moderate pathologies of the kidneys and liver.
Instructions for use tablet form
Reception of "Galantamine" and analogues of the drug in tablets is carried out during meals with a sufficient amount of liquid.
For adults, a daily dose of 8-32 mg is prescribed according to the following dosage regimen:
- with myasthenia gravis - three times a day;
- in Alzheimer's disease - twice a day, starting with 4 mg of the concentration of the active substance and ending in four weeks 16 mg (one tablet of 8 mg in the evening and in the morning);
- with other pathologies, the doctor prescribes the dose and frequency of administration individually.
In case of impaired functioning of the kidneys and liver, they begin with a dose of 4 mg once a day in the morning for a week. Then increase the frequency of administration: the same dosage - twice a day for four weeks. It is forbidden to exceed the daily norm in excess of 12 mg.
If during therapy the medication is stopped for any reason, then resume it again with the lowest dose with a gradual increase. The total duration of the course is usually from four to five weeks.
According to the instructions for use, "Galantamine" and analogues of the drug are used for children, from the age of nine, for the treatment of cerebral palsy and polio (tablets):
- 9-11 years - the dose per day is 4-12 mg for two to three doses;
- 12-15 years - the dose per day is 4-16 mg in two to four doses.
Galantamine capsules are taken orally twice a day - with meals in the morning and evening. The initial dosage is recommended by specialists - 8 mg (4 mg twice a day) for four weeks, then the patient should consume a maintenance dose (8 mg twice a day) within a month. The maximum permitted amount of the drug is 24 mg per day, which are prescribed by the doctor after evaluating the clinical course of the disease.
In the event of a break in therapy, which lasted several days, they begin to take the initial dose again, and then gradually increase it to the previous values. In moderate or mild forms of liver pathology, the basic dosage should be no more than 4 mg once a day in the morning for seven days. This is followed by a gradual increase to 4 mg twice daily with a monthly course. In this case, the daily maximum dose can not be set above 16 mg.
Instructions for the use of injections
The amount of solution for injection depends on the age of the patient and is determined by the attending physician. For use in adults, the maximum single dose is 10 mg, daily - 20 mg. In children aged one year - 0.25 mg once, at sixteen years - 10 mg once a day.
Subcutaneous and intravenous administration is applied up to two times a day as usual and up to three at higher dosages. Treatment should begin with a minimum amount and continue with a gradual increase to the desired volume.
The injection course lasts one and a half months, then a break of the same duration and a new cycle, if prescribed by the treatment regimen. In total, the doctor can prescribe three courses of injections.
Precautions and contraindications
According to the instructions for use of "Galantamine" and analogues, therapy with these drugs is not allowed for the following diseases:
- obstructive pulmonary disease;
- pathological disorders in the liver and kidneys;
- atrioventricular block;
- bowel obstruction;
- epilepsy;
- hypertension;
- arterial hypertension;
- diseases of the digestive system and operations on its organs;
- hyperkinetic syndrome;
- bronchial asthma;
- surgery on the prostate or urinary tract;
- diseases of the cardiovascular system (angina pectoris, bradycardia);
- hypersensitivity (allergic reaction) to the components of the drug;
- pregnancy and lactation;
- children's age up to nine years.
With great care, "Galantamine" and analogues (photos of drugs are presented in the article) are used:
- with moderate and mild pathologies of the kidneys and liver;
- with existing ulcers of the digestive tract or the risks of their occurrence;
- during general anesthesia;
- with sick sinus syndrome;
- in the presence of supraventricular conduction disturbances.
Injection solution is not used for the treatment of children under the age of one year.
Drinking alcohol is strictly prohibited during the treatment period.
Interaction with other means
There are the following restrictions on the use of medicines of this group with other drugs:
- Galantamine and analogues (synonyms) are strictly forbidden to be taken simultaneously with other cholinomimetics.
- You can not use simultaneously with medicines that slow down the heart.
- "Cimetidine" increases the bioavailability of galantamine.
- Antibiotics of the aminoglycoside group reduce the therapeutic effect of drugs.
- Isoenzymes of the cytochrome system in symbiosis with galantamine can cause vomiting and nausea.
- "Erythromycin", "Zidovudine", "Ketoconazole" reduce the absorption of the active substance.
- "Galantamine" and analogues enhance the effect of sedatives and ethanol.
- Aminoglyzolides lower the effectiveness of the described drugs.
- Concomitant use with paroxetine and ketaconazole increases the concentration of galantamine by thirty percent.
Side effects and overdose
According to reviews and instructions for the use of "Galantamine" and analogues, the following side symptoms may appear during the treatment period:
- From the side of the heart and blood vessels: swelling, jumps in blood pressure, tachycardia, the occurrence of orthostatic collapse and atrial fibrillation, bradycardia, ischemia, myocardial infarction.
- From the digestive tract: vomiting, nausea, abdominal pain, diarrhea and flatulence, dyspepsia and gastritis, hepatitis, lack of appetite.
- From the muscular and musculoskeletal system: weakness, cramping.
- From the urinary tract: renal colic, enuresis, hematuria, infection, lack of urination.
- From the nervous system and sensory organs: hallucinations, tremors, cramps, lethargy and fatigue, taste changes, depression and apathy, dizziness, paranoid behavior.
- Other: painful symptoms in the sternum, fever, bronchospasm, hypokalemia, dehydration, nosebleeds, excessive sweating, tinnitus, visual impairment.
When side effects appear, treatment is discontinued.
Reviews on the use of "Galantamine" and analogues suggest that the following symptoms occur with an overdose of these drugs:
- oppressed consciousness right up to falling into a coma;
- manifestation of convulsive syndrome;
- pronounced side effects;
- increased secretory secretions of the tracheal mucosa in combination with bronchospasm and muscle weakness can cause lethal airway blockage.
In the event of the occurrence of such symptoms or conditions, urgent therapy is necessary, which consists of the following steps:
- Rinse your stomach with a mild solution (light pink) of potassium permanganate or just a large amount of warm boiled water.
- Use symptomatic treatment.
- At the initial stage, intravenously administer 0.5-1 mg of atropine as an antidote, further therapy with this drug is carried out depending on the patient's condition and the effectiveness of the measures taken.
Analogues of "Galantamine" and reviews
Like many medicines, this drug has analogues, the intake of which must be agreed with the attending physician.
You can replace the medicine with the following medicines, which almost completely coincide with it in composition and action:
- "Nivalin" - tablets and solution for injection (base - galantamine);
- "Reminyl" - capsules with the active component galantamine.
A similar effect is also exerted by:
- "Physostigmine" - injection solution with the same active substance;
- "Kalimin" - tablets (base - pyridostigmine);
- "Proserin" - ampoules and tablets with neostigmine;
- "Neuromidine" - tablets and solution for injections based on ipidacrine;
- "Exelon" - capsules with rivastigmine;
- "Alzepil", "Arisept" - tablets in a film shell based on donepezil;
- "Neuromidine" - an injection solution with the active ingredient ipidacrine.
According to reviews, the instructions for “Galantamine” and its analogues adequately reflect the information about the drugs, which greatly facilitates the process of taking them.
According to experts, these drugs are actively used in clinical practice and are quite effective. Especially often, drugs are prescribed for the treatment of Alzheimer's disease. High drug efficacy is important because a significant number of elderly people suffer from this disease. But in some cases, treatment with Galantamine and its analogues does not lead to the desired improvements.
Negative reviews of relatives of patients can be found quite often. They share information that sometimes long-term therapy does not improve memory in the elderly, in some cases, drugs cause additional dysfunctions.
There are also many positive reviews that confirm that the use of drugs of this group helps to significantly slow down the processes of personality destruction.