Xelx is an antidepressant without sedation. The drug is in the form of capsules for oral administration. Hard gelatin tablets, the contents of the capsules are milky powder, packaged in blisters for fourteen pieces, in total there are two or four of them in a package. What instructions for use and reviews does Xel have?
The main active microelement is milnacipran hydrochloride, in one capsule it contains twenty-five or fifty milligrams. Additional substances are:
- carmellose calcium salt;
- disubstituted calcium phosphate;
- polyvinylpyrrolidone;
- a salt of magnesium and stearic acid;
- fumed silica;
- talc.
The shell includes:
- hydrolyzed collagen protein;
- iron hydroxide;
- titanium dioxide;
- iron oxide yellow.
Pharmacological actions
The main active substance belongs to the pharmacotherapeutic group of third-generation antidepressants intended for the treatment of anxiety disorders and depression. Milnacipran hydrochloride absolutely does not affect the conductivity or relaxation of the heart.
Also, the main component does not change the higher brain functions and has a mild sedative effect. Milnacipran is particularly effective in treating people with sleep problems caused by depression.
In such a situation, the total duration of dreams increases, the period of falling asleep is minimized, the interval increases until the onset of the fast phase of sleep, the number of night awakenings decreases. The effectiveness of the drug is comparable to the positive effect of tricyclic sedatives.
When taken orally, the active substance is well absorbed. Its bioavailability reaches eighty-five percent and is not determined by features and nutrition.
The maximum content of milnacipran in the blood is recorded approximately two hours after oral administration. When using Ixel once in a dosage of fifty milligrams, the maximum concentration of an active trace element in the blood is approximately one hundred and twenty nanograms per milliliter.
When using the drug in dosages that do not exceed two hundred milligrams, a dose-dependent increase in the maximum mark is observed. After repeated courses, the equilibrium concentration is achieved within two to three days, and it is seventy to ninety percent higher than when using a single dose.
The differences in the measured value between individuals remain low. The active trace element binds to blood proteins in small quantities (about thirteen percent). The volume of distribution is five liters per kilogram with a total clearance of about forty liters per hour. Non-renal and renal measures of plasma volume, which is purified from the drug substance per unit time, coincide.
What other positive properties does Xel have?
Milnacipran is not involved in metabolic processes. No active metabolic product was detected; the component combines with glucuronic acid. The elimination half-life of the main Ixela trace element is approximately eight hours.
Milnacipran is excreted in urine (approximately ninety percent of the dosage taken) as a result of the transport of substances from the blood into the lumen of the tubules. After the end of therapy, the active substance is completely eliminated from the body within two to three days after cessation of treatment. Improper liver function does not provoke significant changes in the performance of the active substance.
The rate of excretion of the active component decreases in proportion to the degree of kidney damage in people with renal failure. In persons of retirement age, the pharmacokinetic parameters of milnacipran do not change much. But when choosing a dosage, it is important to consider the physiological changes in the functioning of the kidneys in elderly patients.
According to information obtained from preclinical studies, with the constant use of Ixel, the liver is primarily affected. Negative effects were observed with the use of high doses, approximately ten times higher than prescribed, and were reversible.
Preclinical studies obtained during the examination of reproductive toxicity, genotoxicity and the usual toxicity of milnacipran do not confirm the presence of risks to human health. Milnacipran hydrochloride has no carcinogenic or mutagenic effects.
Indications and contraindications to the medication
The use of the drug "Xel" is recommended in the treatment of depression of varying severity. The drug has certain prohibitions, for example:
- Joint use with Sumatriptan, as well as non-selective and selective type B monoamine oxidase inhibitors
- Age to fifteen years.
- A pathological condition in which there is a violation of the outflow of urine.
- Period of pregnancy.
- Lactation (the process of formation, accumulation and periodic elimination of milk in a woman).
- Excessive susceptibility to trace elements of the drug.
In what cases should you be careful when taking the drug?
It is necessary to be especially careful when using Ixel to people suffering from the following conditions and diseases:
- Angle-closure glaucoma (a defect that develops due to increased intraocular pressure).
- Epilepsy (a chronic neurological disease that manifests itself in a predisposition of the body to a sharp appearance of convulsive attacks).
- Renal failure.
- Arterial hypertension (persistent increase in blood pressure from one hundred and forty to ninety millimeters of mercury and higher).
- Cardiomyopathy (damage to the heart muscle that is not associated with inflammatory, tumor, ischemic etiology, the manifestations of which are cardiomegaly, as well as heart failure and arrhythmias).
Instructions for use "Iksela"
Tablets must be taken orally in the morning, preferably during breakfast. The dosage and duration of treatment is determined by the attending doctor based on the individual severity of the symptoms.
The recommended average daily dosage of Ixel is one hundred milligrams, you need to divide it into two uses. To achieve a stable pharmacological effect in severe cases of the disease, it is allowed to increase the content of the active substance, but not more than two hundred and fifty milligrams per day. Patients suffering from renal failure, the daily dosage must be reduced.
Side effects
In their reviews, patients who took the drug "Xel" tell about a number of negative effects with improper use and dosage, for example:
- Dizziness.
- Sense of anxiety.
- Migraine (a neurological disease, the most common and characteristic symptom of which is episodic or regular severe and painful headache in one half of the head).
- Tremor (sharp, rhythmic movements of the legs, arms, or trunk that are triggered by muscle cramps).
According to reviews, "Xel" causes a side effect from the stomach and intestines:
- Dry mouth.
- Intestinal obstruction (obstructed or insufficient emptying).
- Vomiting.
- Increased sweating.
- Skin rashes.
Symptoms of an overdose of the drug
In case of Ixel poisoning, constipation, excessive sweating, nausea, and vomiting are considered the first signs of this condition. The use of a drug in a dosage of more than a thousand milligrams provokes the appearance of tachycardia and breathing problems.
According to reviews of Ixel, an antidepressant when used in extremely high concentrations (two thousand eight hundred milligrams) in conjunction with other psychotropic drugs causes impaired consciousness, hypercapnia (high levels of carbon dioxide in the blood, poisoning caused by carbon dioxide).
Poisoning of milnacipran hydrochloride does not lead to manifestations of cardiological toxicity. In this case, it is necessary to rinse the stomach, use activated charcoal and consult a medical specialist who will prescribe a comprehensive treatment. There is no definite antidote to Ixelos. In this case, the general condition of the patient should be monitored throughout the day.
Features of Ixel
Due to a slight increase in heart rate during the use of the drug for patients with cardiomyopathy, arterial hypertension, it is important to take the medication with extreme caution.
The occurrence of negative phenomena, as a rule, is extremely rare and does not require discontinuation of the drug. Reactions appear during the first fourteen days of therapy, have a low severity and pass away on their own as the signs of depressive disorder decrease.
To reduce the severity and number of adverse reactions, it is recommended that the dosage be increased gradually during treatment.
Advice
You can use the medication after you stop taking monoamine oxidase inhibitors no earlier than two weeks later, and the use of MAO inhibitors must be started seven days after the drug is discontinued. It is forbidden to drink alcohol during treatment.
Doctors in their reviews of Ixel indicate that when using the drug it is necessary to refrain from driving and complicated mechanisms throughout the course.
Can I use Xel during pregnancy?
Since there is no information on the safety and effectiveness of the use of the active substance in women in an interesting position, Ixel is not recommended to be used during pregnancy.
The active trace element passes into breast milk, so the drug should not be taken during lactation. In case of malfunctioning of the kidneys, the medication should not be prescribed with concomitant obstruction of the genitourinary system. Patients with renal failure should use the drug with caution. In this case, a dosage reduction may be required, which is associated with an increase in the half-life of milnacipran.
According to the instructions for use and patient reviews about Ixel, it is known that patients with cirrhosis of the liver (a pathological process in the liver that is considered to be the result of impaired microcirculation in the system of hepatic vessels and bile ducts) are prescribed with extreme caution.
Drug interaction
When combined with Norepinephrine and Adrenaline, arterial hypertension and arrhythmia can occur. If local anesthesia is necessary when using a sedative, the dosage should not be higher than 0.1 milligrams in ten minutes or 0.3 milligrams in one hour.
You can not prescribe the drug together with Digoxin, as this can provoke the appearance of arterial hypertension and tachycardia.
It is not recommended to use the drug with "Clonidine" and other similar compounds due to a decrease in their hypotensive effect.
Analogues of the drug
There is no information on substitutes for Ixel.
Keep the drug at a temperature of up to thirty degrees. Keep out of the reach of children. Shelf life is thirty-six months. The medicine is dispensed strictly according to the doctor’s prescription, as indicated in the instructions.
Reviews about "Iksel"
Patients who take this medicine leave positive feedback. They confirm that the drug helps with prolonged depressive disorders and panic attacks. As a result, interest in life reappears, anxiety and a feeling of weakness disappear, side effects are almost not observed.
It must be consumed for a long time (from six months or longer), gradually reducing dosage. But some patients in their reviews about the drug "Xel" talk about the high cost of the drug and the need to buy it on order. And also in rare situations, poor drug efficacy and allergy manifestations are noted. The price of Ixel varies from 1200 to 3000 rubles, depending on the region and the pharmacy chain.