"Midokalm": instructions for use, analogues, reviews

In the article, we consider the instructions for use for the drug "Midokalm".

It is a medication of a group of muscle relaxants with a central effect.

The manufacturer produces the drug in two pharmacological forms - in the form of a solution for injection and in the form of coated tablets.

"Midokalm" in the form of a solution is packaged in 2 ml ampoules. The solution is a sterile clear liquid with a specific odor. The ampoule contains a solution ready for administration; no additional dilution is required. Each cardboard box holds 5 ampoules.

In tablets, the drug can be in two dosages - 50 mg and 150 mg. Instructions for use with Midokalm indicate that the tablets are white, convex on both sides, covered with a glossy film overlay. On one side of the tablet there is a notch indicating the dosage of the active substance. In a cardboard box there are 3 blisters with 10 tablets each.

Structure

According to the instructions to Midokalm, the main active component in the composition of the medication is the tolperisone hydrochloride compound. Its amount in the preparation depends on the pharmacological form.

Lidocaine, which potentiates the action of tolperisone, as well as purified water, methyl parahydroxybenzoate, diethylene glycol monoethyl ether, are used as auxiliary components in the manufacture of a solution for injections.

As additional ingredients in the composition of the tablets are: lactose monohydrate, corn starch, citric acid monohydrate, microcrystalline cellulose, talc, stearic acid, colloidal silicon dioxide. The film membrane of the tablet consists of hypromellose, macrogol 6000, lactose monohydrate, titanium dioxide, colloidal silicon dioxide.

Pharmacological effects

As indicated by the instruction, "Midokalm" in its pharmacological properties belongs to the group of muscle relaxants with a central mechanism of action. Tolperisone as part of the drug is able to quickly penetrate into the nerve tissues of the body, accumulate in certain parts of the spinal cord and brain.

Due to these properties, when using the drug, the following pharmacological effects are observed:

1. The transmission of nerve impulses from the spinal cord to the muscles is slowed down.
2. Downward impulses from the brain are delayed.
3. The excitability of cells of the nervous tissue is reduced.
4. There is a rapid relaxation of skeletal muscles throughout the body, muscle spasm is eliminated.
5. The compression of nerve fibers and their endings with the muscles involved in the spasm is eliminated.
6. A local anesthetic effect arises, since in its structure tolperisone is similar to lidocaine.

Tolperisone is actively absorbed in the intestines. When consuming large amounts of fatty foods, the bioavailability of the substance increases significantly. The active substance "Midokalma" and its metabolites are excreted mainly by the kidneys.

Indications for use

In accordance with the instructions for use with Midokalm, the indications for use of the drug vary depending on its pharmacological form. So, a medication in the form of tablets of any dosage is recommended for use in the following cases:

1. In order to treat pathologies that arose against the background of spasm of blood vessels by the muscle layer in the organs of vision, as well as in patients suffering from diabetes mellitus.
2. For the treatment of Parkinson's disease. In this case, "Midokalm" should be used as one of the elements of complex therapy.
3. To eliminate muscle hypertonicity that occurs against the background of cerebral palsy. Allowed use in childhood.
4. In order to eliminate muscle spasm arising from a stroke.
5. For symptomatic and complex treatment of muscle spasms arising from pathologies such as neuralgia, radiculitis, VVD, spinal hernia, back pain, osteochondrosis of the lumbar spine. It can be used to stop diseases of the nervous system of an infectious-inflammatory nature, as well as headaches provoked by cramping in the upper shoulder girdle. So it is said in the instructions for use for tablets "Midokalm".

The drug in the form of a solution for injection is recommended for use:

1. With obliterating vascular pathologies, in particular in the organs of vision in patients with diabetes mellitus.
2. With inflammatory and dystrophic diseases of the muscles and joints, for example, with arthrosis.
3. With muscle cramps arising from a stroke.
4. With muscle spasms that occur against various pathologies.
5. In order to restore the functionality of the musculoskeletal system after surgery.

The treatment regimen, as well as the duration of treatment, should be selected individually taking into account the severity of the pathology by the attending neurologist. The instruction to "Midokalm" is very detailed.

Contraindications

Experts do not recommend the use of medication during therapy in the following cases:

1. If the patient has hypersensitivity to any of the components of the drug.
2. With myasthenia gravis.
3. Injections should not be given to children under 12 years of age.
4. Tablets are prohibited for children under 3 years of age.
5. Women in the first trimester of pregnancy.
6. During lactation.

Before using the drug, you should consult a specialist and exclude each of these contraindications.

Using

According to the instructions for use of "Midokalm" in the form of an injection solution, it is strictly prohibited in the treatment of children under 12 years of age.

The solution is administered intramuscularly or intravenously, the dosage should be used as follows:

1. Intramuscularly, 200 mg of the drug is administered twice a day (100 mg each).
2. Intravenously, 100 mg of the drug should be administered very slowly once a day.

This is confirmed by the instructions for use for injections "Midokalm".

Despite the fact that the drug is compatible with many drugs, it is forbidden to mix it in the same syringe with other injection solutions.

The duration of drug treatment should be selected by the physician based on the patient’s health status and research data.

What does the instruction for Medokalm tablets tell us?

In tablet form, it can be taken only 10 minutes after the end of a meal, including oily. It should be washed down with water in the amount of one glass. Compliance with such simple rules of admission will increase the bioavailability of the active component and its therapeutic efficacy.

Patients in whom the kidneys and liver function normally are allowed to take 150 mg at a time.

The instructions for Midokalm tablets indicate that the daily dosage prescribed by the doctor must be divided into three doses. This will achieve uniform concentrations of tolperisone in the blood. Maximum per day - 450 mg. The duration of the course of therapy is selected individually taking into account the severity of the disease and susceptibility to the drug.

In the presence of moderate degrees of liver and kidney damage, Midokalm should be prescribed with caution, and the condition of the body should be monitored by a specialist.

In severe forms of impaired liver and kidney function, experts do not recommend taking Midokalm.

Overdose

According to the instructions for Midokalm, tolperisone is characterized by a broad therapeutic index, that is, a range of doses, when used which do not cause signs of intoxication and overdose. It has been clinically established that an overdose does not occur if up to 600 mg in tablet form are taken per day. At the same time, there is no negative effect on the body. Despite this, it is important to adhere to therapeutic dosages established by a specialist during therapy.

This rule must be observed when prescribing Midokalma injections. The instruction reports that, due to the properties of tolperisone and the rare occurrence of overdoses, the symptoms are not well understood. It is believed that most often with irrational use of the drug, signs of intoxication are manifested, such as:

1. Attacks of nausea ending in vomiting.
2. Severe incontinence of feces and urine as a result of extremely strong relaxation of the sphincter muscles.
3. Respiratory depression. It develops only in severe cases of overdose, is extremely rare.
4. Difficulty swallowing and breathing.
5. Ataxia.
6. Excessive muscle weakness.
7. Convulsive conditions.

If any of the described symptoms of an overdose occurs, the intake of Midokalm should be stopped and symptomatic therapy should be prescribed to the patient. Antidotes that inactivate tolperisone in the body currently do not exist.

Side effects

Instructions for use with "Midokalm" must be strictly observed. Negative reactions of the body to taking the drug develop very rarely, however, they do occur. All the side effects that develop during therapy are conventionally divided into three groups - extremely rarely, rarely, rarely developing.

According to the instructions for use and reviews of "Midokalm" in injections or tablets, among the infrequently developing negative effects of the drug should be highlighted:

1. Pain in the muscles and limbs.
2. Weak abdominal pains that do not have a clear localization.
3. Diarrhea
4. Dry mucous membranes in the mouth.
5. Pressure reduction in blood vessels.
6. Fatigue, excessive drowsiness.
7. Muscle weakness.
8. Pain in the head.
9. Insomnia and other sleep disorders.
10. Weight loss.

Among the rare negative effects:

1. Irritability.
2. Great thirst.
3. Hot flashes.
4. Discomfort and a feeling of weakness in the limbs.
5. Vomiting
6. Constipation
7. Shortness of breath, shortness of breath.
8. Swelling and redness of the skin.
9. Marked decrease in blood pressure, tachycardia.
10. Noise in ears.
11. Decreased visual acuity.
12. Pronounced drowsiness.
13. Paresthesia.
14. Convulsive conditions.
15. Impaired attention.
16. The state of depression.
17. Decreased activity.
18. Allergic reactions to the substances that make up the drug.

Extremely rare side effects are:

1. Osteopenia (increased fragility of bones, a decrease in their density).
2. Discomfort in the sternum.
3. Bradycardia
4. Impaired speech and consciousness.
5. Increased appetite.
6. Inflammatory conditions of the lymph nodes.
7. Anemia.

Very rarely, qualitative changes in the blood can be observed, such as an increase in the number of leukocytes, a decrease in the number of platelets, an increase in bilirubin in the blood, an increase in the concentration of creatinine, and a violation of the indicators of renal enzymes.

Subject to the recommended dosage, as well as the duration of the course of therapy, side effects develop extremely rarely. In general, the drug is well tolerated by patients.

Interaction with other medicines

As indicated by the instructions for use with Midokalm, the use of medications metabolized in the liver in parallel with tolperisone may increase the effectiveness of the latter. Therefore, you should not combine taking the drug with the following substances and medicines:

1. With non-steroidal anti-inflammatory drugs, including meloxicam, nimesulide, niflumic acid.
2. With central muscle relaxants, analogues of Midokalma.
3. With beta-blockers, that is, with drugs that are based on substances such as nebivolol, metoprolol, atenolol.
4. With psychotropic medicines based on dextromethorphan, desipramine, atomoxetine, venlafaxine, thioridazim.
5. With products intended for general anesthesia.
6. With peripheral muscle relaxants, which include detrutizol, tolterodine.
7. With clonidine.

If there is a need for parallel therapy involving these substances, it is important to correctly calculate the dosage when it is reduced in order to exclude the occurrence of negative reactions and not harm the patient's condition.

During lactation and during pregnancy

Tolperisone does not have teratogenic and toxic effects on the fetus. Nevertheless, his appointment during pregnancy should be done with caution, and in the first trimester of his admission should be completely abandoned.

An insignificant amount of tolperisone is excreted in breast milk, in connection with which it is forbidden to prescribe Midokalm to lactating women. Otherwise, the negative effect of the substance on the development of the child is not ruled out. If there is an urgent need to use this drug, a woman should first stop breastfeeding.

Joint reception with alcoholic drinks

What else can you learn from the instructions for use with Midokalm? With the parallel use of tolperisone and alcohol, the risk of negative effects, as well as symptoms of an overdose, increases. Due to the fact that ethanol and tolperisone are metabolized in the liver, the load on this organ increases, and the effectiveness of the drug is significantly reduced. In this regard, experts recommend eliminating the use of alcohol during drug therapy - such a combination can be hazardous to health.

We reviewed the drug "Midokalm" instructions for use.

Analogs

Generics (analogues in composition) are drugs such as Tolperil, Midostad Combi, Miaxil.

Midokalm differs from the indicated medications solely in price and in the company producing it. There are no differences in safety and pharmacological properties.

Analogs that differ in composition but have a similar therapeutic effect include: “Tizanidine”, “Tizalud”, “Sirdalud”, “Muskomed”, “Myoflex”, “Miorix”, “Baclofen”.

Each of these drugs can be replaced with Midokalm, since they are all its analogues and synonyms. However, the replacement of the drug should be carried out by a doctor.

Detailed instructions for analogues of "Midokalma" are enclosed in each pack of the drug.

Cost

The cost of the drug depends on the region of implementation, as well as its pharmacological form.

"Midokalm" in the form of a solution intended for injection will cost an average of 550 rubles for a package containing 5 ampoules.

In tablet form, a drug with a dosage of tolperisone 50 mg costs about 350 rubles per pack containing 30 tablets.

In tablet form, the medication will cost an average of 550 rubles for 30 tablets with a dosage of 150 mg. The instructions for Midokalm do not contain such information.

Reviews

On the Internet you can find a large number of positive (for the most part) and neutral reviews left by patients who underwent therapy using Midokalm. Patients note the high effectiveness of the drug in the fight against osteochondrosis and other pathological conditions of the musculoskeletal system. It is reported that even a short course of drug injections allows you to achieve the desired therapeutic effect.

"Midokalm" as an element of complex treatment is highly effective in the treatment of multiple sclerosis, cerebral palsy, chronic prostatitis, diseases of the internal organs, accompanied by spastic syndrome.

Another advantage of Midokalm is separately noted - when the recommendations on the dosage of the drug are followed, side effects rarely develop while taking it. An undoubted advantage is the possibility of using the medication by pregnant women.

There are also negative reviews that indicate the development of such undesirable effects as tachycardia, shortness of breath, tremor, clouding of consciousness, gastrointestinal upset, jumps in blood pressure. Experts suggest that these patients had gastrointestinal diseases before starting treatment. Therefore, the use of the drug must necessarily be agreed with a specialist who can exclude the presence of contraindications.

We reviewed the instructions for use with "Midokalm" 150 and 50 mg, as well as with the drug in ampoules.