Melipramin (imipramine) coated tablets 25 mg. №50 vial

Description

Melipramin composition
active substance: imipramine;
1 film-coated tablet contains 25 mg of imipramine hydrochloride;
Excipients: magnesium stearate, crospovidone, talc, povidone, lactose monohydrate, hypromellose, iron oxides (E 172), dimethicone.

Dosage form
Film-coated tablets.

Pharmacological properties
The mechanism of action of imipramine is not fully understood. Imipramine, a derivative of dibenzoazepine, is a tricyclic antidepressant. Inhibits the reuptake at the synapses of norepinephrine and serotonin, neurons released during stimulation, thereby facilitating noradrenergic and serotonergic transmission. Imipramine also has an inhibitory effect on muscarinic and H1-histamine receptors, providing anticholinergic and moderate sedative effect. The antidepressant effect of the drug is manifested gradually: the optimal therapeutic effect is usually achieved after 2-4 (sometimes 6-8) weeks of therapy.

Indications
It is prescribed for the treatment of various types of depression. It is also effective for the treatment of behavioral disorders, cocaine withdrawal syndrome, alcoholic depression, migraines, panic conditions, chronic pain, including headaches. Narcolepsy, narcolepsy associated with catalepsy, postherpetic neuralgia, diabetic neuropathy, bulimia nervosa, urinary incontinence (enuresis) are amenable to Melipramine treatment.
The drug Melipramin is an effective antidepressant, antidiuretic, anxiolytic, alpha-blocker, analgesic, has an anticholinergic effect, a sedative effect.
It is able to slow down the conduction of the heart ventricles, as a result – to stop the progression of arrhythmia. Melipramin treatment restores the balance of adrenergic and serotonergic, the improper functioning of which affects the development of depression. Has antiulcer effect, relieving pain in patients suffering from this disease.
Melipramin is able to stop the state of lethargy, help to raise health, mood, normalize sleep patterns, and the digestion process. In the initial stage of treatment, the patient may experience a slight sedative effect. The antidepressant effect becomes noticeable after 2-3 weeks from the start of treatment.

Contraindications
It is contraindicated to prescribe in case of allergy to active substances, during therapy with monoxidase inhibitors, acute alcoholic, drug, narcotic poisoning, inhibition of the functions of the central nervous system. Not recommended (or should be used with great caution) in chronic alcoholism, vascular pathologies (strokes). It is also undesirable to use if the patient is diagnosed with bronchial asthma, neuroblastoma, renal and hepatic insufficiency, diseases in the field of cardiology, including myocardial infarction, as well as thyrotoxicosis, prostatic hyperplasia with anuria, schizophrenia, epilepsy, pheochromocytoma.

Children
The drug can be used in children over 6 years of age as a temporary adjunct therapy for nocturnal enuresis, provided that the organic cause of this disorder is excluded.

Application during pregnancy and lactation
Forbidden.

Method of application and dosage
The daily dose and dosing regimen should be set individually, taking into account the nature and severity of the disease. As with other antidepressants, it takes 2 to 4 weeks (in some cases 6-8 weeks) to achieve the desired therapeutic effect. The drug should be started with small doses, gradually increasing them to achieve the minimum effective and maintenance dose.
Dose titration should be performed with extreme caution in the elderly and children.

Depression:

• Outpatients aged 18-60 years
  The usual starting dose for such patients is 25 mg 1-3 times a day, gradually increasing to 150-200 mg / day by the end of the first week of treatment. The usual maintenance dose is 50-100 mg / day.
• Patients aged 18-60 years in hospital
  For inpatients (especially in severe cases), the initial dose is 75 mg / day with a gradual increase of 25 mg per day to 200 mg / day or (in exceptional cases) to 300 mg / day.
• Patients over 60 years of age
  For these patients, treatment should be started at the lowest dose. Then the initial dose should be gradually increased, bringing it to 50-75 mg / day. It is desirable to reach the optimal dose within 10 days and maintain it until the end of therapy.

Children
The drug can be used only in children over 6 years of age and only as a temporary adjunctive therapy for nocturnal diuresis, provided that the organic cause of this disorder.
Recommended doses:

• children aged 6-8 years (body weight 20-25 kg): 25 mg / day;
• children aged 9–12 years (body weight 25–35 kg): 25–50 mg / day;
• children over 12 years of age (body weight more than 35 kg): 50–75 mg / day.

The use of doses higher than recommended can be justified only in cases where after the 1st week of therapy with a lower dose of the drug a satisfactory response to treatment has not been achieved.
For children, the daily dose of the drug in any case should not exceed 2.5 mg / kg body weight.
It is recommended to use the minimum dose of the specified range. It is desirable to take a daily dose of the drug once, after meals, at bedtime. If nocturnal enuresis is observed at the beginning of the night, it is recommended to take the daily dose in two doses – in the afternoon and at bedtime.
The duration of treatment in children should not exceed 3 months.
Depending on the achieved therapeutic effect, the maintenance dose may be reduced. Withdrawal of the drug should be carried out by gradually reducing the dose.

Overdose
Overdose symptoms can be both agitation and lethargy of the central nervous system – from lethargy, drowsiness, up to coma, or tachycardia, excitement, hyperreflexia, up to respiratory arrest, shock. Treatment is symptomatic.

Side effects
When taking Melipramin, side effects such as blurred vision, nightmares, insomnia, drowsiness, delirium, mydriasis, psychosis, manic syndrome, aggression, difficulty urinating, hypohidrosis, asthenia, ataxia, diarrhea, arrhythmia, dysarthria, hypo- and hyperglycemia, heartburn, glaucoma, leukopenia, hepatitis, other side effects.

Storage conditions and periods
Storage conditions and periods depend on the form of the drug. Tablets (pills) can be stored for up to 3 years at an ambient temperature of + 20 ° C.