For neuromuscular diseases, doctors prescribe the drug "Kalimin 60 N". The instruction reports that this tool is effective in the treatment of myasthenic disorders and atony of internal organs. The medicine helps to normalize the transmission of neuromuscular impulses, tones the muscles of the bladder, improves peristalsis in the digestive organs. In this case, the drug does not affect the central nervous system.
Composition and effect of the drug
The active ingredient of the drug is pyridostigmine bromide. The medication is available in the form of tablets that contain 60 mg of the drug.
Pyridostigmine bromide refers to substances that inhibit the activity of the cholinesterase enzyme. This leads to increased action of the neurotransmitter acetylcholine, which is responsible for the transmission of signals between nerve cells and muscles. For this reason, the instructions for use "Kalimin 60 N" recommends the use of tablets for the treatment of myasthenia gravis. This disease is characterized by impaired transmission of neuromuscular impulses.
Pyridostigmine bromide also has a general cholinomimetic effect on the body. Under the influence of the drug, a person’s heart rate slows down, the tone of the muscles of the internal organs increases, the activity of the endocrine glands increases, the medicine causes a slight constriction of the pupils and an accommodation spasm.
Indications
According to the instructions of Kalimin 60 N, the main indication for prescribing medication is myasthenia gravis. The drug is also used in neurology for the treatment of other syndromes in which muscle weakness and fatigue due to impaired neuromuscular transmission are observed.
In addition, Kalimin 60 N tablets are used in the treatment of atony of the muscles of the intestines and bladder with delayed bowel movements and urination.
Contraindications
This drug has a powerful cholinomimetic effect and refers to potent drugs. Take this tool is not shown to all patients. The instruction "Kalimin 60 N" warns that the drug has many contraindications.
These pills are not applicable for the treatment of children, they can be taken from the age of 18 years. This remedy is strictly contraindicated for pregnant women. Pyridostigmine bromide does not cause defects or abnormalities in the fetus, but has a toxic effect on the embryo. An anticholinergic can cause premature birth. It is not recommended to take "Kalimin 60 N" during lactation, as the active ingredient penetrates into milk. If the use of the drug is necessary, then breastfeeding is interrupted.
Also, the drug is contraindicated in the following pathologies:
- obstructive diseases of the bronchi, urinary and biliary tract;
- spasms of the stomach, esophagus and intestines;
- intestinal obstruction;
- bronchial asthma;
- allergies to the active component of the tablets;
- shock conditions after operations;
- inflammation of the iris;
- neurological pathologies with muscle spasms;
- after the introduction of muscle relaxants.
Caution when prescribing the drug is necessary for the following diseases:
- low blood pressure;
- stomach ulcer;
- bradycardia;
- renal and liver failure;
- cardiological pathologies (myocardial infarction, heart failure);
- after surgery on the digestive tract;
- Parkinson's disease;
- urolithiasis and cholelithiasis.
If the patient has such ailments, it is necessary to prescribe a lower dosage of the drug.
Unwanted effects
Instructions and reviews on "Kalimin 60 N" indicate that after taking the tablets, side effects are possible. This is due to the cholinomimetic effect of the drug on the body.
The medicine can cause a sharp decrease in blood pressure and heart rate. Due to the effect of pyridostigmine bromide on muscle tone, skeletal muscle spasms, abdominal pain due to increased peristalsis, diarrhea, and frequent urination are likely.
Due to the increased activity of acetylcholine in patients, the activity of sweat glands is enhanced, increased lacrimation and salivation are observed. Vision may be impaired due to accommodation spasm. Allergy sufferers have skin rashes.
Overdose
The instruction "Kalimin 60 N" warns about the inadmissibility of exceeding the recommended dosage. Otherwise, serious poisoning is possible. With an overdose of tablets, severe symptoms are observed:
- a sharp increase in the work of sweat, salivary and lacrimal glands;
- involuntary bowel movements and urination;
- visual impairment;
- bradycardia up to cardiac arrest;
- sharp weakness;
- respiratory paralysis;
- drop in blood pressure, collapse;
- nausea, vomiting;
- severe abdominal pain;
- pulmonary edema.
Treatment of intoxication is carried out using intravenous injection of atropine solution. This drug is an antidote for poisoning with cholinomimetics. It is also necessary to rinse the stomach of the patient and give activated charcoal. With cardiac arrest and respiratory paralysis, resuscitation is required.
How to take pills
At the initial signs of myasthenia gravis, 1 / 2-1 tablet of the drug is prescribed 1-2 times a day. If the disease progresses, then a single dose is increased to 1-3 tablets, the frequency of administration - 2-4 times a day.
However, this dosage is indicative. With myasthenia gravis, the required amount of the drug is selected individually for each patient.
Patients with kidney disease should be given lower doses, since the drug is excreted mainly in the urine.
In the treatment of atony of the gastrointestinal tract and bladder, it is recommended to take 1 tablet every 4 hours.
special instructions
The instruction "Kalimin 60 N" warns that during therapy it is necessary to completely eliminate the use of alcohol. Cholinomimetics are incompatible with ethyl alcohol. Alcohol can dramatically increase the effect of the drug and increase the risk of unwanted effects.
If the patient accidentally missed taking the drug "Kalimin 60 N", then the next time you should not take a double dose.
The medicine may affect the speed of the reaction and weaken the attention. In addition, the drug affects the muscles and eyesight. Therefore, during therapy should refrain from driving a car. Avoid work that requires quick response and increased attention.
Interaction with other medicines
"Atropine" reduces the cholinomimetic effect of the drug: reducing the heart rate, increased activity of the endocrine glands. However, when these medications are used together, the effect of Kalimin 60 N on muscles does not weaken.
Avoid simultaneous administration of the drug with tricyclic antidepressants, drugs for epilepsy and Parkinson's disease, local anesthetics, acetylcholine antagonists, ganglion blockers, and arrhythmia medications. This weakens the therapeutic effect of Kalimin 60 N.
It should also be remembered that pyridostigmine bromide enhances the effect of muscle relaxants, sleeping pills and narcotic analgesics.
Storage conditions, price and analogues
Tablets are recommended to be stored at a temperature not exceeding +25 degrees. Under such conditions, the medicine is suitable for use for 3 years. After opening the bottle, tablets can be used within six months.
Manufacturers of Kalimin 60 N are pharmaceutical companies Klocke Pharma Service Gmbh (Germany) and Teva (Israel). This medicine is a strictly prescription drug. It belongs to list A (potent agent). The price of the drug in pharmacy chains is from 750 to 850 rubles.
This medicine is currently very difficult to find in pharmacy chains. Therefore, patients are often interested in analogues. The instruction "Kalimin 60 N" says that the active ingredient in the drug is pyridostigmine bromide. The same substance is contained in the preparation "Kalimin Forte". However, it is available only in the form of a solution for injection. The medicine "Mestinon" has a similar composition, it is produced in the form of dragees. Unfortunately, these drugs are almost impossible to find in Russian pharmacies.
It is possible to order "Kalimin 60 N" and "Kalimin Forte" from Germany through special Internet sites, but their cost is very high - from 5000 to 8000 rubles.
You can choose analogues for the therapeutic effect. These include the following medications:
- "Neuromidine."
- Ipigrix.
- "Axamon."
- Proserin.
These agents contain other active ingredients, but are also cholinesterase inhibitors. They are used in the treatment of myasthenia gravis. The price of Neuromidin is about 1000 rubles, and Ipigriks and Axamon are about 500 rubles. The cheapest drug is Prozerin, its cost is 50-60 rubles. However, this is already a rather old drug and it has many side effects.
Drug Reviews
You can hear a large number of positive reviews about the "Kalimin 60 N". Patients with myasthenia write that this drug literally put them on their feet. They managed to achieve a remission of the disease, and the weakness and fatigue of the muscles gradually disappeared.
Judging by the reviews, the drug helps well with the bulbar form of myasthenia gravis, when a person’s swallowing function is impaired. After a course of treatment, patients gained the ability to eat normally. Patients note that it has become easier for them to make movements, to be on their feet, to do work.
The side effects of the drug in the reviews are almost not mentioned. Apparently, unwanted effects are quite rare. Only in the early days of therapy, some patients experienced low blood pressure. In this case, the medicine is not addictive, has no withdrawal syndrome and can be taken for a long time.
The disadvantages of the drug include its incompatibility with many other medicines. This is not always convenient if the patient is undergoing complex therapy using many drugs.
Many patients consider this drug the best remedy for myasthenia gravis. In their opinion, it is more effective and has fewer side effects than other cholinesterase inhibitors. People regret that this medicine has recently become very difficult to find in pharmacies.