Pharmacological action Elmiron 100 mg:
Elmiron 100 mg The product contains the active ingredient – sodium salt of pentosan polisulfat possessing fibrinolytic action. The mechanism of drug action based on its ability to enhance endogenous fibrinolytic potential, due to the influence on the mechanism of fibrinolysis and AT III-independent effects of anticoagulants. Pentosan polisulfat SP 54 prevents the development of thrombosis, blood clots lyses already formed, and promotes the release of lipoprotein lipase, thereby reducing the overall level of lipids, triglycerides and cholesterol. Using the drug indicated a shift in the direction of lipoprotein fractions of high density lipoproteins and decreased risk of atherosclerosis.
Pentosan polisulfat sodium reduces blood viscosity, by reducing adhesion and increasing the elasticity of red blood cells.
After parenteral (subcutaneous or intramuscular) administration the bioavailability of the drug reaches 100%.
Distribution, metabolism and elimination of the drug are similar to those of heparin, however, pentosan polisulfat sodium is absorbed in the gastrointestinal tract that allows the use of this drug is in pill form.
Peak concentrations of the active substance in plasma was within 1-4 hours after administration. The half-life of the drug reaches about 25 hours.
Drug derived primarily by the kidneys as unchanged and as metabolites. A small part of drug output intestine.
Indications Elmiron 100 mg:
Dosage form is used to treat patients who suffer acute and chronic diseases – thrombotic, embolic lesions, atherosclerotic disease.
In addition, the drug used as prophylaxis for people who are in risk of developing thromboembolic and thrombotic complications of varying severity.
Contraindications for use Elmiron 100 mg:
High individual sensitivity to the individual components of the active substance or aids, general hypersensitivity of the organism to the dosage form.
The active substance in the form of pills covered with a sweet wrapper contains some lactose and should not be used for the treatment of patients with systemic allergic to lactose.
The substance is not used for the treatment of patients with concomitant allergic thrombocytopenia in the second type, particularly that caused by the use of pentocana polisulfata sodium salt of heparin or in any form, even in history.
This drug is also contraindicated in patients suffering from lesions of kidney function or liver disease, have severe pancreatic disease, endocarditis, hemophilia, a bleeding tendency of different etiologies and also contraindicated in people with gastrointestinal bleeding. It is strictly forbidden to use the drug in the recently adjourned hemorrhage in the brain.
The active substance should not be used during pregnancy, pregnancy with a direct threat to abortion, if the patient has a tendency to recurrent abortion, and in case of suspicion of a possible placental previa.
The drug is contraindicated in severely in case of possible surgical operations on the brain and spinal cord, if necessary, spinal anesthesia, if you have the slightest suspicion of neoplasm with the risk of hemorrhagic syndrome, are also prohibited from carrying out any treatment for eye operations.
The active substance should not be administered to children aged less than 18 years due to the complete absence of clinically proven safety data and the overall efficiency pentocana polisulfata sodium in patients with this age group. The drug was shown with great caution in patients with thrombocytopenia. The drug is in pill form in the supplements contain sucrose, which is why it should be with caution to patients who suffer from diabetes.
Side effects Elmiron 100 mg:
Pentosan polisulfat SP54, in general, fairly well tolerated.
When taking high doses pentosana polisulfata meet occasional bouts of nausea and vomiting. In some cases, after the injections reached the local hemorrhagic reactions. Sometimes the symptoms observed in allergic skin at injection site – in case of skin rash, hives and itching.
Rarely serious bleeding can occur and, as in the treatment of heparin in the case of certain diseases – can occur reversible alopecia.
In the event of complications may reduce the number of platelets (thrombocytopenia on the first type) with the values of measurements occurring after treatment with pentosanom polisulfatom P 54 between 100,000 and 150,000 109 / l.
Complications of these, in general, are quite rare and quite quickly, so treatment can be continued.
Very rarely allergic caused a rapid decrease in platelet count (thrombocytopenia in the second type) is clearly observed values with less than 100.000 109 / l.
At the same time figures fall to no less than 50% of its original value. In patients without hypersensitivity against heparin and / or active substance of the dosage form decrease in platelet count begins, usually after 6-14 days after starting treatment. In patients with a high sensitivity to these substances – usually occur within several hours after the administration or reception.
This severe adverse reactions may be linked to a number of other negative effects – arterial and venous thrombosis / embolism, increased coagulation (consumption coagulopathy), the partial extinction of the skin tissue (skin necrosis), bleeding in the stool (melena), and hemorrhage in injection site.
In this case the inhibitory effect of this drug on blood clotting can be reduced (tolerance of heparin). Patients who are found mentioned allergic reaction to pentosan polisulfat SP54 immediately stop taking the drug
Later, in their treatment can not be taken pentosan polisulfat SP54 and any medication containing heparin, which is required to notify the card.
Because of the above-mentioned possibility of nonspecific side effects and allergic reactions, therapy should take place under strict laboratory control.
In the event of thrombocytopenia, or low molecular weight high-spend heparin samples. In case of overdose, pentocana polisulfata sodium salt, can be neutralized with protamine sulfate preparation (forty-ME protamine sulfate neutralizes introduced subcutaneously one mg pentosana polisulfata sodium salt).
Interactions with other medication Elmiron 100 mg:
While receiving heparin with another clotting substance mutually inhibitory increased inhibitory effect on blood clotting.
Guidelines for dosage form and terms of use Elmiron 100 mg:
The form of application, dosage and treatment strategy guided by the appearance, severity and phase of the disease. While not shown in the following way prescribed dosage for adults:
Before treatment the drug should carry out research in prothrombin index, in order to eliminate the possibility of hemorrhagic diathesis. Control the overall picture of blood should be carried out every three days during the first five weeks of treatment.
The active substance in the form of solution for injection:
The drug is intended for intramuscular and subcutaneous administration. Intramuscularly injected it deep into the tissue of any muscle during the puncture of a subcutaneous injection is carried out perpendicular to the skin surface in a raised two fingers to tuck the abdomen, most often in the area of the side or front wall of the peritoneum.
When the need arose medication can be administered intravenously, the drip method, previously dissolved in a vial sufficient solution for injection. As the tool for breeding drug can be used 0.9% sodium chloride solution or 5% dextrose. Total duration of treatment regimens and dosage is determined by the attending physician, and individually in each case.
Typically, adult patients in acute severe conditions assigned to a hundred mg (one ml) intramuscularly twice daily at regular time intervals. With symptoms of acute embolism, as well as in other critical situations is usually given a hundred mg of the drug intramuscularly every eight hours on the first day of treatment. After knocking over the state and improve the situation daily dose reduced to one hundred mg. The total duration of therapy with this drug should not exceed twelve hours.
Adults, if necessary, may appoint three hundred mg of the drug dissolved in the required quantity of infusion solution, the first and second day of treatment. From the third to sixth day is usually assigned to two hundred mg of the drug, which was also dissolved in the required amount of solution for infusion. The total duration of continuous drip into a vein for a given drug can not exceed the daily time period. In severe cases of urgency may be single injection of one hundred mg of the drug as an initial-stage loading dose.
Adults with chronic conditions can assign one hundred mg of the drug under the scheme three times a week. After four weeks of the time interval between intravenous injection increases, while oral administration of the drug – controlled by the total dosage and frequency of administration.
In order to prevent occurrence of thrombosis in the operations and other interventions abdominal active agent may be appointed at a dose of fifty mg injection is carried out by following type scheme:
The first dose is injected two hours before surgery.
A second dose is usually administered on the day of surgery, following a strict time period not less than six hours after the first injection.
Later transferred to the circuit one hundred mg once per day.
Patients at risk for thrombosis permit the introduction of the drug at a dosage of fifty mg every seven – eight hours during the first three days.
Injecting maintenance should be carried out before the motor mode, but not less than a week, it is also possible transition to an oral form.
Tablets covered with a sweet wrapper:
Medication taken orally, a pill to swallow whole show, not crushing or chewing, it should drink plenty of water. The tablets should preferably be taken two hours before receiving a meal. Duration of the course of treatment and dosage prescribed by your doctor on an individual basis.
Adult patients is usually given four tablets of the drug three times a day for eight weeks. The maximum therapeutic response continued for three weeks of continuous dosage, if necessary, the dosage can be increased.
A few weeks after starting treatment (assuming positive clinical dynamics) drug dosage can be reduced to three tablets three times a day.
The course of treatment is determined by the physician and may continue, if necessary, up to one year.
In the case of subcutaneous or intramuscular administration, the blood picture and analyzes the general should be monitored before treatment, between the third and fifth day after the start of treatment, twice a week for three weeks after starting treatment and at the end of therapy.
