Domrid SR (domperidone maleatee) tablets with prolonged release 30 mg. №10

Description

Domrid SR №10 Storage
active substance: domperidone maleate;

1 tablet contains domperidone maleate in terms of domperidone 30 mg;

Domrid SR №10 Excipients: lactose monohydrate, povidone, quinoline yellow (E 104), croscarmellose sodium, magnesium stearate, colloidal anhydrous silica, hydroxypropylmethylcellulose, talc.

Domrid SR №10 Dosage form
Prolonged-release tablets.

Main physical and chemical properties: white-yellow two-layer, round flat tablets with beveled edges and the “K” logo on the yellow layer of the tablet.

Pharmacotherapeutic group
Stimulators of peristalsis. ATX code A03F A03.

Pharmacological properties

Pharmacodynamics.

Domperidone is a dopamine antagonist with antiemetic properties. Domperidone slightly crosses the blood-brain barrier. Domperidone is very rarely accompanied by extrapyramidal side effects, especially in adults, but domperidone stimulates the secretion of prolactin from the pituitary gland. Its anti-inflammatory effect may be due to a combination of peripheral (gastrokinetic) action and antagonism to dopamine receptors in the trigger zone of chemoreceptors, which is outside the blood-brain barrier in the posterior region (area postrema).

Animal studies, as well as low brain concentrations, indicate a predominantly peripheral effect of domperidone on dopamine receptors.

Studies in humans have shown that domperidone, when administered orally, increases the pressure in the lower esophagus, improves antroduodenal motility and accelerates gastric emptying. Domperidone does not affect gastric secretion.

Pharmacokinetics.

Absorption.

Domperidone is rapidly absorbed after oral administration on an empty stomach, the maximum concentration in blood plasma is reached after about 60 minutes. The low absolute bioavailability of oral domperidone (approximately 15%) is due to extensive first-pass metabolism in the intestinal wall and liver. Although the bioavailability of domperidone increases in healthy people when taken after a meal, patients with gastrointestinal complaints should take domperidone 15-30 minutes before a meal. Reduced gastric acidity reduces the absorption of domperidone. When the drug is taken orally after a meal, the maximum absorption is somewhat slowed down and the area under the curve (AUC) is slightly increased.

Distribution.

When taken orally, domperidone does not accumulate and does not induce its own metabolism; the maximum level in blood plasma after 90 minutes (21 ng / ml) after two weeks of oral administration of 30 mg per day was almost the same as after the first dose (18 ng / ml). Domperidone is 91-93% bound to plasma proteins. Studies of the distribution of domperidone in animals using a radiolabeled drug have shown significant tissue distribution but low concentrations in the brain. In animals, small amounts of the drug penetrate the placenta.

Metabolism.

Domperidone is rapidly and extensively metabolized in the liver by hydroxylation and N-dealkylation.

Breeding.

Excretion in urine and faeces is 31% and 66% of the oral dose, respectively. Excretion of the drug in unchanged form is a small percentage (10% with feces and about 1% – with urine). The plasma half-life after a single dose is 7-9 hours in healthy volunteers, but prolonged in patients with severe renal insufficiency.

Indication
To relieve symptoms of nausea and vomiting.

Contraindication
Domrid® SR is contraindicated:

patients with established hypersensitivity to the drug or to excipients;
patients with prolactin-secretory pituitary tumor (prolactinoma);
patients with severe or moderate hepatic and / or renal impairment (see section “Special warnings and precautions for use”);
patients with known prolongation of cardiac conduction intervals, in particular QTc, patients with significant electrolyte imbalance or with background heart disease, such as congestive heart failure (see section “Features”);
patients with hepatic insufficiency;
if stimulation of motor function of the stomach can be dangerous, for example, in gastrointestinal bleeding, mechanical obstruction or perforation;
contraindicated concomitant use of ketoconazole, erythromycin or other potent CYP3A4 inhibitors;
Contraindicated concomitant use of drugs that prolong the QT interval, such as fluconazole, erythromycin, itraconazole, oral ketoconazole, posaconazole, ritonavir, saquinavir, telaprevir, voriconazole, clarithromycin, amiodarone, especially dilutomycin. drugs and other types of interactions “).