Sirdalud - international name. Sirdalud: warehouse, authorities, indications and contraindications, dosage, side effects. Dosage and important nuances of therapy

Drugs that counteract tizanidine (Tizanidine, ATC code M03BX02):

Parts of the release form (more than 100 propositions in Moscow pharmacies)
Name	Vipusu form	Packaging, pcs.	Kraina virobnik	Price in Moscow, r	Proposition in Moscow
	tablets 2mg	30	Nimechchina and Turechchina, Novartis	190 (mid 224) -258	753↗
Sirdalud - original.	tablets 4mg	30	Nimechchina and Turechchina, Novartis	162 (average 328) -381	783↗
Sirdalud MR (Sirdalud MR) - original	capsules with enhanced strength 6 mg	30	Spain, Novartis	442-(middle 547) -633/td>	430↗
Tisalud	tablets 2mg	30	Russia, Veropharm	96- (mid 128) -149	132↗
Tisalud	tablets 4mg	30	Russia, Veropharm	143 - (mid 179) -223	123↗
Form a release that is rarely published (less than 100 products in Moscow pharmacies)
Tisanil	tablets 2mg	30	India, Simpex	140 (mid 165) -198	75↘
Tisanil	tablets 4mg	30	India, Simpex	170 (mid 245) -298	45↘
Tisanil	tablets 6mg	30	India, Simpex	327	1↘

Sirdalud MR (original Tizanidine with variations that are modified) - official instructions from stagnation. The drug is a prescription, the information is intended only for health care providers!

Clinical and pharmacological group:

Central muscle relaxant

Pharmacological action

Central muscle relaxant. The main point of congestion of this substance is located in the spinal cord. By stimulating presynaptic 2-receptors, tizanidine suppresses the excitatory amino acids that stimulate N-methyl-D-aspartate-sensitive receptors (NMDA receptors). As a result of this loss, at the level of intermediate neurons of the spinal cord, polysynaptic transmission of awakening is suppressed. Since this mechanism itself is responsible for the excessive tone of the meat, then when it is strangled, the muscle tone decreases. In addition to muscle relaxant effects, tizanidine also has a central analgesic effect.

Sirdalud MR is effective for chronic spasticity of spinal and cerebral origin. Spasticity and clonic vessels are changing, as a result of which the support for passive arms decreases and the burden of active arms increases.

Pharmacokinetics

Vsmotuvannya

When taken internally, tizanidine may be absorbed more readily. The average Cmax value is reached over a period of 8.5 years and becomes approximately half the Cmax value when taking Sirdalud tablets in a similar supplementary dose, divided into 3 doses, at which the total exposure (AUC) remains unchanged whine.

Rozpodil

Trivalent formulation of tizanidine in a medicinal capsule form with modified formulations provides a “modified” pharmacokinetic profile that ensures maintenance of a stable therapeutic concentration of tizanidine in plasma for 24 years.

Plasma protein binding becomes 30%.

Metabolism

Tizanidine is extensively metabolized in the liver. In vitro, it has been shown that tizanidine is extensively metabolized by the CYP1A2 isoenzyme. Metabolites are inactive.

Vivedennya

Tizanidine is excreted mainly as a metabolite (approximately 70% of the dose); The portion of unchanged speech accounts for only about 2.7%.

Pharmacokinetics in specific clinical situations

The effect does not affect the pharmacokinetic parameters of tizanidine.

Indications before administration of the drug Sirdalud® MR

spasticity of skeletal muscles in neurological illnesses (for example, with multiple sclerosis, chronic myelopathy, degenerative illnesses of the spinal cord, in cases of impaired cerebral blood flow and infantile cerebral palsy (patients over 18 years of age)).

Dosing mode

The drug is administered internally. The dosing mode must be set individually.

The maximum dosage is 6 mg (1 capsule). If necessary, the additional dose can be increased in increments (in increments) by 6 mg (1 capsule) at intervals of 3-7 days. Clinical evidence shows that for most patients the optimal dose is 12 mg per dose (2 capsules); In isolated cases, the dose may need to be increased to 24 mg.

Treatment of patients with narcotic deficiency (CC< 25 мл/мин) рекомендуется начинать с приема препарата Сирдалуд® в дозе 2 мг 1 раз в сутки. Повышение дозы проводят малыми "шагами", с учетом переносимости и эффективности. Если необходимо получить более выраженный эффект, рекомендуется сначала увеличить дозу, назначаемую 1 раз в сутки, после чего увеличивают кратность назначения.

Side activities

Unnecessary reactions of distribution are consistent with the frequency of guilt. To assess the frequency of development of unexpected reactions, the following criteria are used: very often (>10%); often (in >1% to<10%); иногда (от >0.1% up<1%); редко (от >0.01% up<0.1%); очень редко (<0.01%, включая отдельные сообщения). В одной группе по частоте возникновения нежелательные реакции ранжированы по степени значимости.

On the side of the nervous system: often – drowsiness, weakness, confusion; rarely – hallucinations, insomnia, sleep disturbance.

On the side of the cardiovascular system: often – bradycardia, decreased arterial pressure; in several episodes, there is a decrease in arterial pressure right up to collapse and loss of fluidity.

On the side of the herbal system: often – dry mouth; rarely – boredom, scolial-intestinal disorders, increased activity of liver transaminases; very rarely - hepatitis, liver failure.

On the side of the cystic-muscular system: rarely - muscular weakness.

Others: often – increased fatigue.

When taken in small doses recommended for the relief of painful muscle spasms, drowsiness, increased fatigue, confusion, dry mouth, decreased arterial pressure, boredom, glandular-intestinal disorders, active dilation hundred liver transaminases. Compare the reactions described above in proportion to their manifestations and past ones.

At the bail, the bilsh of leap doses, recommended for the likivanni spastic, the Vishchevani Victory reaction is vinica often і bilsh virazhezhezhey, the prote rido Buyut Nastilki, the Likuvannya Shchob was reached. In addition, the following symptoms may occur: decreased arterial pressure, bradycardia, muscle weakness, insomnia, sleep disturbance, hallucinations, hepatitis.

SIRDALUD® MR is contraindicated before administration of the drug

manifestations of impaired liver function;
immediate treatment with strong inhibitors of CYP1A2 isoenzymes (including fluvoxamine or ciprofloxacin);
sensitivity to tizanidine or any other component of the drug is increased.

Treatment with the drug SIRDALUD® MP for vaginosis and breastfeeding

No controlled studies have been carried out on tizanidine in pregnant women, so it should not be observed in case of vaginosis, due to symptoms of seizures, if the potency outweighs the possible risk.

Tizanidine is excreted in breast milk in small amounts. Tim is no less, for women who are breastfeeding children, the drug should not be stagnant.

Stagnation with impaired liver function

Contraindications for cases of impaired liver function.

Stagnation in case of impaired function of the nirok

Use caution when using Sirdalud MR in patients with nitric deficiency.

Congestion in elderly patients

Suspension in children up to 12 years of age

special inserts

Episodes of hepatic dysfunction associated with tizanidine have been reported with a stable dose of up to 12 mg, and the episodes have rarely resolved. In connection with this, it is recommended to monitor liver function tests once a month for the first 4 months of treatment in those patients who are prescribed tizanidine at an additional dose of 12 mg or more, and Also in these episodes, if clinical signs are observed, damage can be allowed to liver functions, such as unreasonable boredom, anorexia, seem to be the same. In times when the same ALT and AST in the serum are stable

Episodes of hepatic dysfunction associated with tizanidine have been reported with a stable dose of up to 12 mg, and the episodes have rarely resolved. In connection with this, it is recommended to monitor liver function tests once a month for the first 4 months of treatment in those patients who are prescribed tizanidine at an additional dose of 12 mg or more, and Also in these episodes, if clinical signs are observed, damage can be allowed to liver functions, such as unreasonable boredom, anorexia, seem to be the same. When the equal ALT and AST in a serum patient consistently exceed the ULN by 3 times or more, the stagnation of Sirdalud MR will follow.

Do not take Sirdalud MR too suddenly; reduce the dose of the drug step by step.

With a sharp dose of Sirdalud MR after heavy treatment and/or taking high doses of the drug (as well as after one-hour treatment with antihypertensive drugs), the development of tachycardia and hypertension was observed swelling of the arterial pressure, in extreme cases it can lead to acute destruction of cerebral hemorrhage.

Be careful with stagnant Sirdalud MR in patients with nitric deficiency. In case of stagnation of Sirdalud MR in patients with nitric deficiency (creatinine clearance less than 25 ml/xv), correction of the dosing regimen is necessary.

Be careful with stagnant Sirdalud MR in summer patients. Evidence of the use of Sirdalud MR in elderly patients. Based on pharmacokinetic data, it can be assumed that in some cases, nitric clearance in these patients may be significantly reduced.

Wikipedia in Pediatrics

Evidence of drug use in children and adults. Therefore, the use of Sirdalud MR in this category of patients is not recommended.

Ferrying to the building to the center by vehicles and controlling the mechanisms

If drowsiness develops, confusion or a decrease in arterial pressure during therapy with Sirdalud MR should be avoided from types of work that elicit a high concentration of respect and a fluid reaction, for example, car bath transport or robots with mechanisms.

Overdose

Please be informed about an overdose of Sirdalud MR, including a fall, if a dose of 400 mg is taken.

Symptoms: boredom, vomiting, decreased arterial pressure, prolonged QTc interval, confusion, drowsiness, miosis, restlessness, impaired breathing, coma.

To remove the drug from the body, it is recommended to rinse the vulgaris with rich acid and identify the active vugilla. Forcing diuresis may also speed up the elimination of tizanidine. It is necessary to carry out symptomatic therapy.

Medical mutualism

When administered concomitantly with Sirdalud MR with inhibitors of the CYP1A2 isoenzyme, the concentration of tizanidine in plasma may be increased.

Co-administration of tizanidine with fluvoxamine or ciprofloxacin, inhibitors of cytochrome P450 isoenzyme 1A2, results in a 33-fold or up to 10-fold increase in the AUC of tizanidine. The result of consumed stagnation can be a clinically significant decrease in arterial pressure, which can lead to drowsiness, weakness, and impaired psychomotor reactions (in some cases, even to collapse and loss of speed). Simultaneous administration of tizanidine with fluvoxamine or ciprofloxacin is contraindicated.

It is not recommended to combine tizanidine with other inhibitors of the CYP1A2 isoenzyme - antiarrhythmic drugs (amiodarone, mexiletine, propafenone), cimetidine, fluoroquinolones (enoxacin, pefloxacin, ciprofloxacin, norfloxacin, nor floxacin, idinom.

With increased concentrations of tizanidine in plasma, the QTc interval may be prolonged, which is typical for drug overdose.

At the same time, Sirdalud MR is associated with antihypertensive drugs, including diuretics, which can cause a decrease in arterial pressure (in some cases, even to the point of collapse and loss of fluid speed) and bradycardia.

Ethanol or sedatives may cause sedation for Sirdalud MR; immediate use of other sedatives and/or alcohol is not recommended.

Umovi dispensers from pharmacies

The drug is available with a prescription.

Understand the term saving

List B. Keep the drug out of the reach of children at a temperature not exceeding 30°C. The term of attribution is 3 rocks.

Indication for stagnation. Sirdalud at a dose of 2 and 4 mg:

Spasticity of skeletal muscles caused by neurological diseases (multiple sclerosis, chronic myelopathy, stroke, degenerative diseases of the spinal cord). Painful spasm of skeletal muscles, swelling of the spine (cervical and transverse syndromes) or occurs after surgery (herniation of the intervertebral disc or osteoarthritis of the spine).

Dosing regimen for Sirdalud 2 and 4 mg tablets

To relieve painful spasms of skeletal muscles, take 2-4 mg 3 times per dose; In severe seizures, it is recommended to take 2-4 mg at night. For spastic pain associated with neurological illnesses, the daily dose should be 6 mg per 3 doses. Increase the dose incrementally by 2-4 mg for every 3-7 days. The optimal therapeutic effect can be achieved at a dose of 12-24 mg per dose, divided into 3-4 doses. Do not overdo the 36 mg dose

Today, sickness of the joints, osteochondrosis is even more widespread, and not only young people suffer from the disease, but also young people.

For effective treatment of the disease, the drug Sirdalud, which is a central infusion muscle relaxant, can be prescribed. You can take the medication if you have spasms of the meat system.

The tablets have a distinct antispasmodic effect and are often associated with the symptoms of many diseases of the warehouses.

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Depending on the release form, 1 tablet can contain 2 mg or 4 mg of the main active component tizanidine. These varieties, however, may be worth the price. Crimea, vikoryism and additional speeches.

Vipusu form

Among the different types of the drug there are no ampoules for injection or other forms. The single configuration of the release consists of tablets, they have a round shape, with a white tint. Consume orally. Packaging – blisters of 10 tablets per skin. Packaging contains 3 blisters and instructions before use.

Pharmacological action

The drug Sirdalud is directly injected onto the spinal cord. This leads to the suppression of the processes of impulse transmission in synapses, thereby increasing the process of awakening and expansion.

Since an increase in the muscle tone of the fibers often provokes the presence of neurotransmitters in the transmission of impulses in the synapses of the spinal cord, then the use of Sirdalud is important in reducing the hypertonicity of the transverse muscles.

It is worth mentioning that the medication also has an analgesic effect, although it is insignificant. This fact allows us to effectively use it to enhance the patient’s status as a way of eliminating symptoms that are sensitive to illness during spinal genesis.

Sirdalud tablets are prescribed for cases of short-lived shortening of the flesh, severe cerebral genesis and spasticity of a chronic nature. The cream is actively prescribed for herniation of the ridge, swelling of the courts.

Based on the basic and additional components, the medication is effective for alleviating the symptoms of illness:

are pinned by the courts, splinters of the face - a relaxant of skeletal muscles;
there is a suffocation of meaty rigidity;
The support of the rukhs is going to decline.

Tizanidine, which is the active component, is absorbed quickly from the intestines. The blood reaches its maximum concentration after 60 minutes. When passing first through the liver, at least 30% of the active substance is metabolized. These active components do not exhibit any activity associated with pharmacology. After the first dose, you may experience insomnia or even more sleep.

This is explained by the fact that the body adapts to the components that have penetrated into it. In general, the drug does not require any administration. Instructions are given an hour in advance for 2-4 year olds. Metabolites are excreted from the section. In cases where the patient suffers from nitric deficiency, tizanidine may be used for accumulation.

Pharmacodynamics and pharmacokinetics

Tizanidine, when administered before tablets, stimulates presynaptic alpha2 receptors. It is important to take into account the fluidity of the lips during the prescribed complex therapy with the medicinal products of Sirdalud.

There is a suppression of the active amino acids, which in turn stimulates the receptors to N-methyl-D-aspartate. As a result, polysynaptic transmissions of activation are preferentially applied to the neurons of the spinal cord.

Then, the muscle tone begins to decline, and an analgesic effect appears. The drug Sirdalud may be indicated until later if acute spasm of the muscles develops, which is also effective in seizures, since spasticity of cerebral and spinal origin is chronic.

The active arms become more active, the support for the passive arms is reduced, and the courts change. Any side effect of the given drug depends on the concentration of the drug in the blood plasma. You cannot drink alcohol while taking Sirdalud. Contraindications for vaginosis.

Due to pharmacokinetics, the drug has high absorption, so that Cmax reaches the blood level within a year. Close to 35% – bioavailability. Regardless of the fact that if the hedgehogs have survived, the pharmacokinetics remain unchanged.

The active component of binding with plasma proteins is 30%. A rapid metabolism is observed, 95% in the liver, which is excreted in two phases. The doctor usually assumes that Sirdalud suffers from nitric deficiency, and the plasma Cmax increases by 1.5-2 times.

What is Sirdalud prescribed for: indications, contraindications and side effects

According to the annotation, Sirdalud is assigned to the patient in the following cases:

Bekhterev's illness.
Intercostal neuralgia.
Myelopathy.
Red sclerosis.
Central paralysis.
Spasms of the muscles.
Spasticity of skeletal muscles.
Diseases of the spinal cord.
Severe pain in the head.

Showing before stagnation

According to the evidence, why Sirdalud is prescribed, the medicine has a beneficial effect on relaxing the muscles and will soon go away. The main feature of the drug is the effective relaxation of the spinal cord, there is no negative effect or suppression of the central nervous system and the autonomic nervous system. In addition to its main prescriptions, the drug Sirdalud may be prescribed in a different way.

These can be included:

grow up during the period after surgery on the intervertebral hernia;
renewal after spinal injuries due to injuries of the great tendons;
myelopathy of pronounced chronic nature;
strokes in the meninges and tissues of the ischemic, hemorrhagic type;
spastic diaphragm;
importance of spine disease.

The drug is used for the treatment of epiglobular and spinal pathologies; Serdalud tablets are prescribed at the required dose to be taken (2 mg or 4 mg):

with pathology of the ceremonial plan, such as ligaments weakening due to impaired blood flow in the intervertebral joints and discs;
for arthrosis;
for arthritis;
for pathologies of spinal structures, etc.

Contraindicated

This is a contraindication; Sirdalud is usually prescribed either with special caution or not prescribed at all.

These include:

Porushennaya roboti nirok.
Personal intolerance of components.
Combination of tizanidine and fluvoxamine.
Contraindications for children and pregnant women, as well as during breastfeeding.

Side activities

During the period of taking the medication in low concentration for therapeutic treatment in cases of illness associated with blood vessels and shortness of breath, side effects practically do not develop or the stench is indirectly expressed.

Rarely, fatigue, disruption of the scutum and herbal system, and increased activity of liver transaminases may develop. The most common manifestations are drowsiness, dry mouth, fatigue, hypotension, and confusion.

When the drug is administered at higher doses to reduce spasticity, negative swelling is more pronounced and develops much more often.

However, this phenomenon is not marked by the use of tablets. Most often, patients may develop arterial hypotension and bradycardia. Among the rare manifestations you may see hallucinations, problems with sleep, insomnia and weakness in the muscles. Very rarely, a form of hepatitis can develop (in 0.01% of cases).

Sirdalud: instructions from stagnation, overdose and interaction with other drugs

The drug is prescribed in case of illness. The instructions for taking the medication direct the administration of the medicine to the doctor's instructions.

Instructions for stagnation (method of dosing) for the ingredients:

Neurological pathology that led to spasm of the wrist muscles. The initial dosage is a 2 mg triche tablet for 24 years. After a few days, the dosage increases to 3-6 mg. Dose selection depends on the variety of symptoms and the body’s response to the medication. The shortest dose per dose is 12-24 mg. If you take more than 36 mg per day, you may experience side effects.
For elderly people. In this situation, dosage adjustments occur. Observatory and ulcer control of medical practitioners at the time of administration of the drug. Most often, the dose of tablets is reduced because in older people, the nitric clearance increases, and the fluidity of nitric excretion is much lower than in young people. If the dose is high, it can cause accumulation of metabolites in the blood.
For nitric deficiency. The drug is taken instead of 2 mg of active ingredient 3 times a day. Obviously, before changing the clinical picture, the stability of the dosing components is adjusted.

The tablets are taken internally, washed down with plain water. The daily dosage is 2 mg of triche per dose, so that the body is acclimated to the components of the drug, which will help eliminate side effects.

Tablets with dosages of 2 and 4 mg can be divided into 2 parts. A special procedure is necessary in case of serious damage to the oven. Most often, it appears to be due to the recognition that the Sirdalud instruction allows for the replacement of the face in cases of moderate manifestations of damage to the functioning of the organ.

The dosage of the medication begins with the lowest dose, and after dosing it is advanced until the optimal combination of treatment effectiveness and tolerability is achieved.

Where else to stagnate

Faces swell widely due to other ailments.

So, the drug Sirdalud has instructions to talk about those who can take the medication in such conditions:

after a stroke to neutralize the judicial manifestations of pain;
with spinal cord injury and craniocerebral injury;
for the relief of pain syndrome in muscles;
for back pain (radiculopathy), neck pain, headache;
if necessary, get rid of the symptoms that arise after the supernatural attack on the skeleton and flesh;
after injuries, surgeries on the spine, etc.

Overdose

In case of overdosing with medication, it was installed.

This time the following symptoms of excess fluid in the body appear:

The pressure is incredibly low.
Vomit is such a tedious thing.
Drowsiness, confusion.
Drawing camp.
Difficulty in breathing.
Coma (only during heavy travel).

After taking a very high dose of the drug, you need to rinse the tube for 60 minutes and take sorbents. This is a necessary forcing diuresis, which helps to eliminate excess drug and remove it from the body. Then symptomatic treatment is carried out.

When taking the drug, it is not possible to consume chicken, alcohol, drugs or sedatives. If these recommendations are ignored, there may be side effects that could result in human death.

Liki Sirdalud: avoid selling, saving and special items

There are some nuances to taking when taking a medication. So, the faces of Sirdalud can be completely changed from the dosage until the vikoristan is completely squeezed. You can avoid or change the risk of developing AT movement, tachycardia.

It is most important for those who are sick, as the drug is used in very high cases.

Mind the sale

Liki Sirdalud in tablets is sold in pharmacies, including with a prescription.

Umovi sberіgannya

Store Sirdalud in a cool place, out of reach of children, at a temperature that does not exceed 25 degrees.

Term of attribution

The term of affiliation can be found on the packaging of the drug no more than 3 years after the date of its manufacture. Particular cases. The drug has a special requirement for lactose, so it is not possible to prescribe the drug Sirdalud to patients with severe malabsorption or congenital intolerance to the component.

In addition, if the patient has a history of liver disease, before prescribing the medication, an obligatory examination is performed by a doctor to identify possible risks. During therapeutic visits, vicoric acid tablets Sirdalud may exhibit drowsiness and slight diarrhea, therefore, transport, mechanisms and activity are associated with a serious reaction.

The drug Sirdalud: how it is prescribed for children and vaginal patients, as well as its analogues, prices and treatments

Almost the skin can be treated with its analogues, the drug Sirdalud does not become a culprit. Before you replace it with cheaper options, you need to consult a facist to determine the extent of the replacement.

Analogues

The following tablets are similar in their infusion and storage:

Tizalud;
Tizanidine-TEVA;
Tyzanil.

For children

For gestation and lactation

Due to the impossibility of conducting controlled investigations under the hour, fetal wine treatment is contraindicated during this period. The culprit may be a little less bitter, which will overwhelm the rizik.

For pregnant mothers, the drug Sirdalud in tablets is also not recommended for use, since there is no evidence of the loss of milk components in mother’s milk.

The site provides preliminary information for information purposes only. Diagnosis and treatment of illness must be carried out under the supervision of a doctor. All medications may be contraindicated. Consultation with a medical professional!

About the drug

Likarsky zasib Sirdalud affects the tone of skeletal muscles, exhibits a mild analgesic effect. The drug belongs to the group of muscle relaxants. The active component of the drug is rechovina tizanidine.

Vikoristannya Sphere

Spastic disorders of spinal and cerebral origin, in acute and chronic forms. The drug reduces the manifestations of spasms and clonic diseases.

Pharmacological action

Rechovina is active when taken orally and is absorbed quickly and almost completely. The maximum plasma concentration of tizanidine is determined one year after taking the drug. Get out at once from the section.

When taken by hedgehogs immediately with tablets, the drug does not affect the pharmacokinetic processes and absorption.

Showing before stagnation

1. Spasticity of skeletal muscles, associated with neurological disorders:

degenerative disorders of the spinal cord,
damage to the blood supply to the brain,

2. Functional diseases of the spinal joint.

3. Post-operative period – renewal after surgical procedures, for example, after surgery to relieve intervertebral hernia.

Instructions for packing tablets

1. Spasm of skeletal muscles caused by neurological pathology.
Dosage in such cases is selected based on the reaction to the drug and the severity of symptoms.

Pochatkov dozuvannya – 2 mg trichy per day.
After a few days The dosage can be increased by 3 - 6 mg.
Optimal dosing - Type 12 to 24 mg.
Dosage: 36 mg per dose threatens the development of side effects.

2. Dosage for elderly patients.
Dosage for people with frail age is adjusted. Such patients may be under the constant supervision of medical personnel. Most often, dosages are reduced, because in older people, nitric clearance increases ( The liquidity of nitric excretion of various substances from the blood). Excessive dosing can cause accumulation of metabolites in the blood, development of overdose, and the appearance of adverse reactions.

3. Nirkova lack of availability.
For nitric deficiency, the average dosage is 2 mg trice per day. It is important to determine the further clinical picture and tolerability of the drug, adjust dosage and frequency of administration.

Side activities

When taking therapeutically prescribed dosages of Sirdalud, side effects practically do not develop at all.

The edges are rarely sharpened:

damaged etching.

What appears more often:

hypotension,
weakness,

If movement is detected, dose the drug ( for relieving severe spasms), side effects may appear more often, but this does not lead to the need to change the drug.
In such episodes, the following side effects are often experienced:

hypotension and bradycardia;
rarely - insomnia, weakness, sleep disturbance;
Very rarely - acute hepatitis.

Contraindicated

Severe impairment of liver and liver functions.
Overreaction to tizanidine.
Combination of tizanidine and fluvoxamine.

When you are pregnant

Investigations were carried out on animals, which did not demonstrate evidence of a teratogenic effect of the drug on the fetus. However, no controlled studies of the drug were carried out in pregnant women. Therefore, it is still recommended not to take Sirdalud during pregnancy.

The drug consumes milk in the breast, so for women who are pregnant, the drug is also not recommended for use.

For osteochondrosis

Back pain, which is a factor in reducing the quality of life, results from pathologies of the spine. One of the main causes of back pain is osteochondrosis, which causes degenerative-dystrophic changes in the spine.

To relieve pain in osteochondrosis associated with increased tone of the muscles, take the muscle relaxant Sirdalud, 2 - 4 mg once per day. The mechanism of action of the drug is significantly different from the mechanism of action of muscle relaxants. The drug is stagnated if other methods that reduce the tone of the muscles do not have the desired effect. The great advantage of the drug lies in the fact that when the meat tone is reduced, it does not affect the meat strength.

For children

The use of Sirdalud in children is not recommended, since clinical studies of the safety of drug administration in this age group have not been conducted.

Sirdalud and Mydocalm

Mydocalm Having appeared on the pharmaceutical market earlier, Nizh Sirdalud. There are different drugs and analogues, but there may be different words that work. The action of Mydocalma is better than that of Vivchena. As a muscle relaxant, it has a wider range of effects. Natomist Sirdalud in therapeutic dosages shows fewer side effects.

Liki and alcohol

The use of the drug in non-drinkers with alcohol consumption. Alcohol will enhance the sedative and narcotic effects of Sirdalud.

Interaction

1. You cannot take Fluvoxamine.

2. Great care is required when combining Sirdalud with:

Mexiletine,
Amiodarone,
propafenone,
Pefloxacin,
Norfloxacin,
Enoxacin,
Ticlopidine,
Rofecoxib,
with oral hormonal contraceptives.

3. In combination with diuretics and/or antihypertensive agents, the drug may cause bradycardia and cause arterial hypotension.

Overdose

The phenomena of drug overdose have become more frequent in clinical practice.

Symptoms of overdose:

ruined dikhannya,
drowsiness,
arterial hypotension,
restless,
miosis,

During the hour of treatment, overdose in an effective way and force diuresis.

Form of release - walking

Tablets of 2 and 4 mg, the blister contains 30 tablets.

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The drug's speech is active- Tizanidine.

Additional speeches:

microcrystalline cellulose,
stearic acid,
anhydrous lactose,
hydroxide silicon dioxide.

Additional information

In clinical practice, episodes of impaired liver function associated with taking the drug have been described. Therefore, before bath time, it is recommended to periodically monitor liver symptoms. If, during the course of therapy, symptoms such as loss of appetite and unreasonable boredom appear, then monitoring of liver symptoms is carried out more often, since these signs may indicate a decrease in liver function.

If the patient becomes drowsy while taking the drug, it means that he should avoid driving in vehicles.

The drug Sirdalud should be administered before muscle relaxants in the central system. The injection directly transmits the nerve signal in the meat tissue. The active drug is tizanidine - a skeletal muscle relaxant, the main zone of action is the spinal cord. For this reason, this speech is also effective in treating the increased tone of the meat masses, which is manifested by spasms of skeletal muscles, swelling. Vicor is also recommended to reduce the pain threshold in certain pathologies. Sirdalud has a slight analgesic effect.

Tizanidine will be absorbed immediately.

Zmist [Show]

Release form and warehouse

Sirdalud is vibrated in tablet form. The dragees have a bluish color. The rolls are flat, round, with beveled ends, with a mark (2 mg tablets with code - OZ) or intersected with marks (4 mg tablets with code - RL). The balls are placed in blisters of 10 pieces. There are three blisters in one paper box.

The drug is included in the warehouse

Tizanidine is active (present in the form of tizanidine hydrochloride).

Additional warehouses:

Lactose monohydrate;
Stearic acid;
Cellulose is microcrystalline;
Silicon dioxide without water instead.

Diya

The active compound tizanidine is a central muscle relaxant that affects skeletal muscles. Speech also gives a stimulating influx to alpha 2 receptors in the spinal cord and changes the presence of restless amino acids. The overall effect of the drug on the body involves polysynaptic transmission of the nerve signal and makes it possible to reduce the tension of the muscles.

Sirdalud has the power to relieve pain. The mechanism of infusion of thiazidine makes it possible to use the drug to alleviate chronic and acute spasmodic ulcers of the musculoskeletal system. Patients who took Sirdalud may experience an increase in the amplitude of active impulses. The result after taking it depends on the concentration of thiazidine in the blood.

The active component of the drug after oral administration over a short period of time is absorbed in the organs of the intestinal tract. The maximum concentration in the blood is recorded one year after the test. The level of biological availability of the active component reaches 34%, and the level associated with serum albumin is approximately 30%.

The drug is metabolized by the liver. The main part of the face undergoes such biotransformations, and most of the passive components are deprived of the body by sechovye viz. Continuing to follow the closest ones - 3 years.

Showcase for vikoristan

Sirdalud is successfully used for spasticity of skeletal muscles caused by neurological diseases. Sirdalud tablets are successfully used to treat osteochondrosis of the cervical, thoracic or transverse parts. Taking the drug for certain pathologies causes relaxation of the muscles, a change in the pain syndrome, and allows you to improve sensitivity in case of pinched nerve endings.

The medication is used for:

Red sclerosis;
Chronic myelopathy;
Degenerative pathologies of the spinal cord.

Sirdalud is also victorious for:

Meat spasms and tension of the nerve cores, which are accompanied by severe pain, which is associated with diseases of the ridge;
Spasms of meat mas;
stan after surgical handing on the spinal column;
Interspinal hernias (in complex therapy);
Osteoarthrosis of the hip joint (with complex therapy);
Treating the legacy of ischemic and hemorrhagic stroke.

Contraindicated

Sensitivity or intolerance to thiazidine or other ingredients of medicinal products;
lactase deficiency of a recessionary nature;
There is a functional deficiency of the liver.

Patients of minor age are also not allowed to receive medical treatment.

Side effects

After vikorstan Sirdalud there is a negative impact on the side of the body, it is rare to get enough. The main side effects are a decrease in blood flow and a decrease in heart rate sooner.

Possible signs:

Sleeplessness;
Confused;
Shvidka in case of minor changes;
Destruction of the grass system;
You notice that your mouth is dry;
Weakness of meat products;
Hallucinations;
Damage to the liver by toxins.

Special inserts

The drug Sirdalud should be administered with care to people of advanced age (after 65 years of age), the elderly and patients with liver diseases.
It is not recommended to take a course of treatment abruptly in order to reduce the development of asthenia and damage to cerebral blood flow;
During the treatment period, from the inclusions to the warehouse of Sirdalud, the alcohol activity of the brain is reduced.

A dose change is possible when taking 300 milligrams per dose.

The overdose station is knocked down:

Damage to the grass tract;
Pronounced hypotension;
Miosis;
Loss of respiratory function and the appearance of a comatose state.

With this type of outbreak, the use of enterosorbents, symptomatic therapy, and forced diuresis.

Interactions with other drugs

Sirdalud should not vikorist in full with:

Cimetidine;
Rofecoxib;
oral anti-seizure drugs;
Fluoroquinolones (Pefloxacin, Unoxacin, Norfloxacin).

The use of such drugs in combination with Sydalud may cause an increase in plasma saturation of tizanidine, which causes a prolonged QTc interval.

The medication should be taken with care and administered simultaneously with medications to suppress the QT interval (Azithromycin, Cisapride).

With one-hour treatment with hypotensive agents, a decrease in blood pressure and bradycardia is very pronounced. When combined with rifampicin, the concentration of tizanidine in plasma is reduced by half, which changes the therapeutic effect of Sirdalud.

A day's worth of smoked cigarettes changes the bioavailability of tizanidine by 30%, which means that a larger dosage of the drug is required for a given clinical course.

Antihistamines, drugs and sedatives may enhance the sedative effects of tizanidine. Other agonists of alpha 2 - adrenergic receptors, when combined with Sirdalud, negatively enhance the hypotensive effect.

Instructions for Wikoristan

Sirdalud tablets are indicated for internal use. The dosage is chosen by the doctor who is recovering from the disease.

Start with the next dose – 2 mg 3 times throughout the day. This dose changes the rice. Because of the need, take an additional dose in the form of one tablet (2 mg or 4 mg, at the doctor’s discretion). Since the medication causes drowsiness, it is recommended to take an additional dose in the evening, close to bedtime.

In case of spasticity of the skeletal muscles, as a result of an ailment of a neurological nature, start with 6 mg (maximum). There are three receptions per day. Increase the dose by 2–4 mg over time.
The greatest therapeutic effect is observed at a dose of 12 – 24 mg per 4 doses at equal intervals of an hour.

The maximum daily dose is 36 mg.

In case of nitric deficiency, the norm may not exceed 2 mg 1 time per day. Increase the dose incrementally depending on the tolerability and effectiveness of the drug.

Since it is necessary to obtain the desired result, initially increase the rate of one-time use, and then increase the frequency of the dose.

The use of Sirdalud for pregnant women and breastfeeding mothers is not recommended.

Miorelaxants are contraindicated in patients aged up to 17 years.

The therapeutic cycle is set by a specialist, which means it does not exceed 10 days.

The drug must be stored dry and protected from natural light, at a temperature of 25 degrees.

You are allowed to become victorious for 5 years from the day of vibrating.

Price

The cost of the Sirdalud walks amounts to approximately 360 rubles.

Analogues

Replacement drugs for Sirdalud, the active component of tizanidine, are:

Tyzanil;
Tizalud;
Mydocalm;
Tizandine - Teva;
Sirdalud MP.

The choice of analogue is necessary to wait with the doctor, as the drug may be contraindicated.

Vidguki koristuvachiv

You can deprive yourself of your information about the drug Sirdalud; other users will benefit from:

Irina

For three years now I have been suffering from pain, the cause of which is osteochondrosis. Shoulder pain, wrist pain, neck pain. I used ointments, pain pills, traditional medicine recipes, but didn’t notice any special changes. I didn’t want to go to the doctor’s office. Returning to the doctor, he said that you can take a lot of treatment at home. After completing the previous analyses, having taken into account the comprehensive treatment, we entered the warehouse of Sirdalud. My pain is unstable, which is associated with the menopause. The doctor recommended that the drug be started at a minimal dose in order to check the body’s reaction to the drug. Everything went fine, there were no side effects, and the pain went away. Vikoristova Sirdalud periodically gets sick during the holidays. It helps!

Volodymyr

My son has cerebral palsy. The illness is transformed into poisonous devastation. Having worked fleetingly, we were afraid of problems with the cuttings and the process of receiving hedgehogs.

Treatment was organized including massage sessions, special complexes, and normalization of meat tone was included in the therapeutic course of Sirdalud. The faces sank into the relaxed spasm of the meat masses. It has become easier for synova to take care of the pain center. There was a hope that I would like to ease his condition. Step by step, the sadness of the hands rose. Taking Sirdalud resulted in improved effectiveness of the treatment course. Garniy zasib!

Pharmacology

Central muscle relaxant. The main point of congestion of this substance is located in the spinal cord. By stimulating presynaptic α2 receptors in the spinal cord, tizanidine inhibits the release of amino acids that stimulate receptors for N-methyl-D-aspartate (NMDA receptors). As a result of this loss, at the level of intermediate neurons of the spinal cord, polysynaptic transmission of awakening is suppressed. Since this mechanism itself is responsible for the excessive tone of the meat, then when it is strangled, the muscle tone decreases. In addition to muscle relaxant effects, tizanidine also has a moderate central analgesic effect.

Sirdalud® is effective both for acute painful flesh spasms and for chronic spasticity of spinal and cerebral origin. Spasticity and clonic vessels are changing, as a result of which the support for passive arms decreases and the burden of active arms increases.

The muscle relaxant effect (measured on the Ashworth scale and on the additional “pendulum” test) and side reactions (decrease in heart rate and AT) of the drug Sirdalud lie in the concentration of the drug in the blood plasma.

Pharmacokinetics

Vsmotuvannya

Tizanidine will soak up quickly and immediately. Cmax in plasma is reached approximately 1 year after taking the drug. Through expression of metabolism during the “first pass” through the liver, the average bioavailability value becomes approximately 34%.

The concentration of tizanidine became 12.3 ng/ml and 15.6 ng/ml after a single or multiple dose of tizanidine at a dose of 4 mg, daily.

One-hour administration of hedgehogs does not affect the pharmacokinetics of tizanidine. Although the Cmax value increases by 1/3, if you take the tablet after a hedgehog, it is important that this is not clinically significant. There is no Suttivogo influx on the wind-up (AUC). Tizanidine exhibits linear pharmacokinetics in the dose range of 1 mg to 20 mg.

Rozpodil

Plasma protein binding becomes 30%.

Metabolism

Tizanidine is significantly (about 95%) metabolized in the liver. In vitro, it has been shown that tizanidine is extensively metabolized by isoenzyme 1A2 of the cytochrome P450 system. Metabolites are inactive.

Vivedennya

The average T1/2 value of tizanidine in the systemic circulation takes 2-4 years. The drug is excreted primarily in doses (approximately 70% of the dose) in the form of metabolites; Some of the unchanged speech accounts for about 4.5%.

Pharmacokinetics in specific clinical situations

In patients with nitric deficiency (creatinine clearance ≤ 25 ml/min), the average Cmax of the drug in plasma is 2 times higher than in healthy volunteers, and the terminal T1/2 reaches 14 years, which leads to increased (approximately 6 times iv) systemic bioavailability tizanidine (reported for AUC)/

No specific studies were carried out on patients with impaired liver function.

Tizanidine is extensively metabolized in the liver by cytochrome CYP1A2, and therefore, impaired liver function can lead to increased systemic dosing of the drug.

Data on pharmacokinetics in patients with cancer over 65 years of age.

This does not affect the pharmacokinetic properties of tizanidine.

Ethnicity and race did not influence the pharmacokinetics of tizanidine.

Vipusu form

Shoes in a white to off-white color, round, flat, with beveled edges, on one side there is a printed rhizik and the code “OZ”.

Additional ingredients: anhydrous silica dioxide – 0.3 mg, stearic acid – 3 mg, microcrystalline cellulose – 74.412 mg, lactose monohydrate – 80 mg.

10 pieces. - blisters (3) - cardboard packs.

Dozuvannya

Sirdalud® has a narrow therapeutic index and high variability in the concentration of tizanidine in the blood plasma of patients, which requires careful dose selection.

An initial dose of 2 mg 3 times per dose is designed to minimize the risk of adverse reactions. The dose should be carefully selected to suit the individual needs of the patient.

The drug is administered internally. Select the dosing mode individually.

For painful flesh spasms, prescribe 2 mg or 4 mg 3 times per dose. In severe episodes, you can take an additional dose of 2 mg or 4 mg (importantly before bedtime to prevent drowsiness).

Tablets 2 mg and 4 mg can be divided into two equal parts.

In case of spasticity of skeletal muscles, caused by neurological illnesses, the daily dose should not exceed 6 mg, divided into 3 doses. The dose should be increased incrementally, by 2-4 mg, at intervals of 3-4 to 7 days. Achieve the optimal therapeutic effect by taking a dose of 12 to 24 mg, divided into 3 or 4 doses at equal intervals of an hour. Do not exceed the dose of 36 mg per dose.

Evidence of use of the drug Sirdalud in patients aged 65 years and older. It is recommended to begin therapy at a minimal dose with incremental increases until an optimal balance of tolerability and effectiveness of therapy is achieved.

Treatment of patients with nitric deficiency (creatinine clearance less than 25 ml/min) is recommended to start with a dose of 2 mg 1 time per dose. Dose adjustments should be made in small increments to improve tolerability and effectiveness. If it is necessary to eliminate more pronounced effects, it is recommended to initially increase the dose, which is prescribed 1 time per dose, after which increase the frequency of administration.

Administration of the drug Sirdalud in patients with severely impaired liver function is contraindicated. In patients with severely impaired liver function, the drug should be stagnated with caution; It is recommended to begin therapy with a minimal dose, with incremental advancements until optimal tolerability and effectiveness of therapy are achieved.

Perevannya likuvannya

When initiating therapy with the drug Sirdalud to reduce the risk of developing rebound arterial pressure and tachycardia, the dose should be reduced until the drug is completely replaced, especially in patients with and wean off high doses of the drug over three hours.

Overdose

Please be informed about an overdose of the drug Sirdalud, including a fall, if a dose of 400 mg is taken. In all cases, dressing went smoothly.

Symptoms: boredom, vomiting, decreased arterial pressure, prolonged QTc interval, confusion, drowsiness, miosis, restlessness, impaired breathing, coma.

For the drug to be introduced into the body, it is recommended to use a high-grade value of the active vugilla. Forcing diuresis will also speed up the administration of the drug Sirdalud®. It is necessary to carry out symptomatic treatment.

Interaction

When administered with the drug Sirdalud simultaneously with inhibitors of cytochrome CYP1A2, the concentration of tizanidine in the blood plasma may be increased. In some cases, elevated tizanidine plasma concentrations can lead to symptoms of drug overdose, incl. prolongation of the QTc interval.

Co-administration of the drug Sirdalud with CYP1A2 inducers may lead to a decrease in the concentration of tizanidine in plasma. Decreases in plasma levels of tizanidine may result in a decrease in the therapeutic effect of Sirdalud.

Contraindications for the combination of the drug Sirdalud

Co-administration of tizanidine with fluvoxamine or ciprofloxacin, which are inhibitors of cytochrome CYP1A2, is contraindicated.

When administered with the drug Sirdalud with fluvoxamine or ciprofloxacin, the AUC of tizanidine is significantly increased by 33-fold and 10-fold. The result of exhausted stagnation may result in a clinically significant decrease in AT, which is accompanied by drowsiness, confusion, and decreased fluidity of psychomotor reactions (in some cases, even to the point of collapse and loss of fluidity).

It is not recommended to co-administer tizanidine with other CYP1A2 inhibitors - antiarrhythmic drugs (amiodarone, mexiletine, propafenone), cimetidine, certain fluoroquinolones (enoxacin, pefloxacin, norfloxacin), rofecoxib, rofecoxib.

Combinations of the drug Sirdalud®, which require continued precautions

It is necessary to be careful when taking Sirdalud with drugs that prolong the QT interval (for example, cisapride, amitriptyline, azithromycin).

Antihypertensive drugs

At the same time, the use of the drug Sirdalud with antihypertensive drugs, including sechoginal drugs, may result in a decrease in arterial pressure (in some cases, even to the point of collapse and loss of fluid speed) and bradycardia.

With acute administration of the drug Sirdalud after concomitant administration of antihypertensive drugs, the development of tachycardia and an increase in arterial pressure is observed, which in some cases can lead to acute damage to the cerebral circulation Igu.

Rifampicin

One-hour administration of Sirdalud and rifampicin results in up to a 50% reduction in plasma tizanidine concentrations. As a result, the therapeutic effect of the drug Sirdalud may decrease, which may result in clinical significance for certain patients. In the event of unfavorable treatment with rifampicin and tizanidine, careful selection of the tizanidine dose (increased) is recommended if this is inconvenient.

Systemic bioavailability of the drug Sirdalud in chickens (more than 10 cigarettes per day) is reduced by approximately 30%. Trival therapy with the drug Sirdalud® Kurts can be administered at higher doses, at lower therapeutic levels.

Alcohol

During the hour of treatment with Sirdalud, avoid drinking alcohol, because You can promote the smooth development of unwanted symptoms (for example, decreased arterial pressure and blood pressure). Sirdalud can improve the effect of ethanol on the central nervous system.

Other medicinal uses

Sedatives, narcotics (benzodiazepine, baclofen) and other drugs such as antihistamines may also cause the sedative effect of tizanidine.

The use of Sirdalud is unique from other α2-adrenergic receptor agonists (for example, clonidine) due to the potential enhancement of the hypotensive effect.

Side activities

Adverse reactions are similar to frequency: very common (≥1/10); often (≥1/100,

stock

As per release form, 1 tablet of Sirdalud contains 4 mg or 2 mg. tizanidine. Also in the warehouse there are additional words:

MCC;
lactose monohydrate ;
stearic acid;
silicon dioxide anhydrous monthly .

Vipusu form

The package contains 30 tablets of 2 and 4 mg, the blister itself contains 10 tablets, and the package contains 3 blisters.

2 mg rolls: white, flat, round, line on one side, code “OZ” on the other.

4 mg tablets: white, flat, round, with “RL” written on one side and lines on the other side that intersect.

Pharmacological action

A central muscle relaxant.

Pharmacodynamics and pharmacokinetics

Tizanidine is a skeletal muscle relaxant, mainly affecting the spinal cord. This drug changes the movement tone of the skeletal muscles, relieves spasms, and increases the strength of the muscles in a short time. Sirdalud is effective for chronic spasticity of cerebral and spinal origin and for acute muscle spasms. The cream has a slight analgesic effect.

Tizanidine should be soaked up quickly and almost completely. The highest level of drug concentration in plasma can be observed approximately one year after administration. Speech is to be played by nirks.

Indication for stagnation.

What are the Sirdalud walks like? Indications before drying are as follows:

ulcer spasm, which is associated with diseases of the ridge (one can see them crossforkі cervical syndrome), or who appeared after the surgeon was handed over;
spasticity of skeletal muscles upon development neurological diseases (multiple sclerosis, myelopathy is chronic, infantile cerebral palsy, degenerative diseases of the spinal cord).

Contraindicated

These drugs have a number of common contraindications:

individual intolerance to the component present in the drug;
significant impairment of liver function;
Children and children under 18 years of age.

With special care, it is necessary to take the drug for patients over 65 years of age, as well as for patients with impaired function of the brain.

Side activities

The side effects of Sirdalud include:

confused, drowsiness, ruined sleep, sleeplessness;
bradycardia, ;
rozladi shlunka, tediousness, dry mouth;
increased fatigue, meaty weakness;
increased activity liver transaminases.

As a result of the sharp rise in acceptance of Sirdalud, after the three-year period of rejoicing, the celebration may develop tachycardia, pressure, which can lead to damage to the blood flow to the brain, so the dose of the drug should be gradually reduced, right up to the next day.

As a result of clinical investigations, the following unexpected manifestations were revealed, the frequency of manifestations was not detected:

confusion of information, hallucinations, vertigo;
blurred vision;
Pechenkov's deficiency, hepatitis;
urinary syndrome, asthenia.

Instructions for pouring Sirdalud (Method of dosing)

The drugs are taken internally, the dose is determined based on the individual characteristics of the human body. To minimize the risk of side effects, start with the next dose – 1 tablet (2 mg) or one tablet (4 mg) 3 times per dose.

At severe flesh spasm tablets of 2 or 4 mg are prescribed 3 times per dose. In particularly severe episodes, you can take an additional dose of 2 mg or 4 mg before bedtime.

When developing spasticity of skeletal muscles If you may suffer from neurological illnesses, the daily dose is 6 mg per dose, taken in 3 doses. It is necessary to increase the dose incrementally by 2-4 mg, at an interval of 3 to 7 days. The optimal effect is achieved by taking 12-24 mg per day, 3-4 times a day. Do not take more than 36 mg per dose.

Patients with the damaged function of the nirok It is necessary to start a course of treatment with a dose of 2 mg per dose at a time. Increase the dose incrementally, in small increments, to determine the effectiveness and tolerability of the medications.

Instructions for administration of the drug Sirdalud MR

The drug is available in capsules containing 6 mg. tizanidine. The daily dose of Sirdalud is 1 capsule per day. The dose can be increased incrementally by 6 mg at intervals of 3 to 7 days. For most patients, the optimal dose is 12 mg per dose. In single episodes, the dose can be increased to 24 mg (4 capsules) per day.

Injections of this drug can be considered as a medicine.

Overdose

Overdosing with Sirdalud Tinazidine can be done as follows:

decreased arterial pressure;
vomit, tediousness;
drowsiness, confused, restlessness, miosis;
coma, ruined dikhannya.

Likuvannya: great acceptance active vugillі forcing diuresis speed up the elimination of the drug from the body. After removal, carry out symptomatic treatment.

Interaction

Simultaneous rebirth of faces from inhibitors of cytochrome CYP1A2 lead to an increase in the level of tizanidine in plasma, which, in its turn, lead to the appearance of symptoms of overdose. One-time commemoration of Sirdalud with inducers of CYP1A2 lead to a decrease in the level of tizanidine, which causes a decrease in the therapeutic potency of the drug.

It is contraindicated to sterilize Sirdalud at the same time fluvoxamine, ciprofloxacin. The result of one-hour stagnation may be a significant decrease in arterial pressure, which is accompanied by confusion and drowsiness, and in other cases, loss of speed.

It is not recommended to take drugs containing antiarrhythmic drugs (such as Propaphenone, mexiletine, amiodarone), some fluoroquinolones ( norfloxacin, enoxacin, perfloxacin), cimetidine, ticlopidine, oral contraceptives, rofecoxib.

Caution should be taken when taking Sirdalud with these drugs as they may affect the QT interval ( amitriptyline, cisapride, azithromycin ta in.).

Zastosuvannya to Sirdalurd at once rifampicin instead of tizanidine, it reduces plasma levels, apparently changing the clinical effect of drug administration.

Treatment with the drug Kurtsiv may require a larger dose. When exposed to alcohol, splinters of alcohol can cause a negative effect of alcohol on the central nervous system. The sedative effect of Sirdalud can be caused by narcotics, sedatives and antihistamines.

Mind the sale

Liki is allowed to obtain a prescription.

Umovi sberіgannya

Store at a temperature not exceeding 25 °C, out of the reach of children.

Term of attribution

The term of attribution consists of 3 terms.

special inserts

The drug is not recommended for use by patients who suffer from galactose intolerance, as well as those suffering in severe forms lack of lactase or else glucose /galactose malabsorption , due to the presence of lactose in the warehouse.

Some of the side effects of the drug are drowsiness, it is highly recommended to avoid using a car or any work related to mechanisms or machines.

Analogs of Sirdalud

Search for the ATX code of the 4th level:

Analogue of Sirdalud in form, release and warehouse Tizalud. Also in stock is an analogue of Mydocalm, which is produced in both melt-coated tablets and as injections.

Price for analogues of Sirdalud: Tisalud costs 55 to 72 UAH; Mydocalm, stored in the release form – from 67 to 98 UAH.

Mydocalm chi Sirdalud: which is better?

Sirdalud is an important daily drug, which is in a medicinal form, which allows you to take it once a day, whereas Mydocalm is more used by doctors, and has a wider range of indications before stagnation. The side effects of both drugs are similar.

Dyucha rechovina

Tizanidine

Release form, warehouse and packaging

Pigulki in white to slightly white color, round, flat, with beveled edges, on one side there is a rhizik and the code "OZ".

Additional ingredients: silicon dioxide – 0.3 mg, stearic acid – 3 mg, microcrystalline cellulose – 74.412 mg, lactose – 80 mg.

Pigulki in a white to slightly white color, round, flat, with beveled edges, on one side there are ribs that intersect, on the other - the code "RL".

Additional ingredients: silicon dioxide – 0.4 mg, stearic acid – 4 mg, microcrystalline cellulose – 101.024 mg, lactose – 110 mg.

10 pieces. - blisters (3) - cardboard packs.

Pharmacological action

Tizanidine is a central muscle relaxant. The main point of congestion of this substance is located in the spinal cord. Stimulating presynaptic α 2 receptors, tizanidine inhibits the release of restless amino acids, which stimulate receptors for N-methyl-D-aspartate (NMDA receptors). As a result of this loss, at the level of intermediate neurons of the spinal cord, polysynaptic transmission of awakening is suppressed. Since this mechanism itself is responsible for the excessive tone of the meat, then when it is strangled, the muscle tone decreases. In addition to muscle relaxant effects, tizanidine also has a moderate central analgesic effect.

Sirdalud is effective both for acute painful flesh spasms and for chronic spasticity of spinal and cerebral origin. Spasticity and clonic vessels are changing, as a result of which the support for passive arms decreases and the burden of active arms increases.

The muscle relaxant effect (measured on the Ashworth scale and on the additional “pendulum” test) and adverse reactions (decrease in heart rate and AT) of the drug Sirdalud lie depending on the concentration of the drug in the blood.

Pharmacokinetics

Vsmotuvannya

The tizanidine max is 12.3 ng/ml and 15.6 ng/ml after a single or multiple dose of tizanidine at a dose of 4 mg daily.

Immediate administration does not affect the pharmacokinetics of tizanidine (at 4 mg in the form of tablets or 12 mg in the form of capsules with modified formulations).

Immediate administration of hedgehogs does not affect the pharmacokinetics of tizanidine (when the drug is in the form of 4 mg tablets). Regardless of the fact that the Cmax value increases by 1/3 after eating, it is not clinically significant. There is no Suttivogo influx on the wind-up (AUC). Tizanidine in the dose range from 1 mg to 20 mg is characterized by linear pharmacokinetics.

Rozpodil

The average V d at an equal level with internal administration becomes 2.6 l/kg. Plasma protein binding becomes 30%.

Metabolism

Tizanidine is significantly (about 95%) metabolized in the liver. In vitro, tizanidine is extensively metabolized by the CYP1A2 isoenzyme. Metabolites are inactive.

Vivedennya

The average T1/2 of tizanidine from the systemic circulation takes 2-4 years. It is important to administer drugs (approximately 70% of the dose) in the form of metabolites; The portion of unchanged speech accounts for about 4.5%.

Pharmacokinetics in specific clinical situations

U patients with impaired nirofunction(CC≤ 25 ml/x) Cmax of tizanidine in blood plasma is 2 times higher, lower in healthy volunteers, end T 1/2 is 14 years old, which leads to increased (approximately 6 times) systemic bioavailability of tizanidine ( virtual AUC) .

Specific investigations patients with impaired liver function was not carried out. Tizanidine fragments are extensively metabolized in the liver by the CYP1A2 isoenzyme; impaired liver function can lead to increased systemic drug exposure.

Data from pharmacokinetics patients over 65 years of age exchange.

Pidloga does not interfere with the pharmacokinetic power of tizanidine.

Floating in ethnicity and race There was no effect on the pharmacokinetics of tizanidine.

Showing

Painful ulcer spasm:

connections with static and functional diseases of the ridge (cervical and transverse syndromes);
after surgical procedures (for example, herniation of the intervertebral disc or osteoarthritis of the hip joint).

Spasticity of skeletal muscles in neurological illnesses, incl.

with multiple sclerosis, chronic myelopathy, degenerative diseases of the spinal cord;
with inheritance, damage to cerebral blood circulation;
with inheritances of infantile cerebral palsy (patients over 18 years of age).

Contraindicated

increased sensitivity to tizanidine or any other component of the drug;
severe impairment of liver function;
immediate treatment with strong inhibitors of the CYP1A2 isoenzyme, such as fluvoxamine or;
It is not recommended to use it in patients with rare congestive illnesses, such as lactase deficiency, lactose intolerance, glucose-galactose malabsorption, because The medicinal form eliminates lactose.
patients up to 18 years of age (there is evidence of drug use in this category of patients).

Z care It is recommended to use the drug in patients over 65 years of age, patients with impaired liver function, patients with impaired liver function of moderate severity; simultaneously with drugs that prolong the QT interval (for example, cisapride, azithromycin).

Dozuvannya

Sirdalud has a narrow therapeutic index and high variability in the concentration of tizanidine in the blood plasma of patients, which requires careful dose selection.

The dose and dosing regimen should be selected individually according to the patient’s needs. Taking the drug at an initial dose of 2 mg 3 times per dose reduces the risk of side effects.

The drug is taken internally. Tablets 2 mg and 4 mg can be divided into two equal parts.

At sick flesh spasm Sirdalud is usually available at a dose of 2 mg or 4 mg 3 times per dose. In severe episodes, you can take an additional dose of 2 mg or 4 mg (importantly before bedtime to prevent drowsiness).

At spasticity of skeletal muscles caused by neurological illnesses The cobalt dose should not exceed 6 mg, divided into 3 doses. The dose should be increased incrementally, by 2-4 mg, at intervals of 3-4 to 7 days. As a rule, the optimal therapeutic effect is achieved with an additional dose of 12 to 24 mg, divided into 3 or 4 doses at equal intervals of an hour. Do not exceed the dose of 36 mg per dose.

Confirmation of drug use with Sirdalud patients aged 65 years and older

Likuvannya patients with nitric deficiency (creatinine clearance less than 25 ml/min) It is recommended to start with a dose of 2 mg 1 time per dose. Dose adjustments should be made in small increments to improve tolerability and effectiveness. If it is necessary to achieve a more pronounced effect, it is recommended to initially increase the dose so that it is infused once per dose, after which the infusion multiplicity is increased.

patients with severely impaired liver function contraindicated. U patients with impaired mid-stage liver function The drug should be congealed with caution; It is recommended to begin therapy with a minimal dose, with incremental advancements until optimal tolerability and effectiveness of therapy are achieved. Recommendations for monitoring liver function indicators are provided in the section “Peculiarities of insertion”.

Perevannya likuvannya

When initiating therapy with Sirdalud, in order to reduce the risk of rebound hypertension and tachycardia, the dose should be reduced until the drug is completely replaced, especially in patients who have take high doses of the drug over three hours.

Side activities

When taking the drug in small doses recommended for the relief of painful muscle spasms, drowsiness, increased fatigue, confusion, dry mouth, decreased arterial pressure, boredom, intestinal disorders, looseness were observed. on the activity of liver transaminases. Calculate the side reactions described above depending on the duration and duration.

When taken at higher doses recommended for the treatment of spasticity, excessive adverse reactions (ARs) occur more often and are more severe, and it is rarely important that treatment is needed. Mine to the drug. In addition, the following symptoms may occur: bradycardia, muscle weakness, insomnia, sleep disturbance, hallucinations, hepatitis.

HP are grouped according to the MedDRA classification of organs and organ systems, and within the skin group they are re-arranged in order of decreasing frequency of occurrence. The highest frequency category of HP is even more common (≥1/10); often (≥1/100,<1/10); нечасто (≥1/1000, <1/100); редко (≥1/10 000, <1/1000); очень редко (<1/10 000), включая отдельные сообщения.

On the side of the nervous system: very often - drowsiness, confusion.

On the side of the psyche: often - sleeplessness, sleep disturbance.

On the side of the cardiovascular system: often - a decrease in AT (in frequent episodes, even to the point of collapse and loss of confidence); infrequently – bradycardia.

On the side of the grass system: very often - gastrointestinal disorders, dry mouth; often - tediousness.

On the side of the cysto-muscular system: very often - fleshy weakness.

Zagalni discord: very often - increased fatigue.

Laboratory displays: often – increased activity of liver transaminases.

With acute administration of the drug Sirdalud after heavy treatment and/or taking high doses of the drug (as well as after one-hour ingestion with antihypertensive drugs), the development of tachycardia and arterial thysoma are observed. ku, now in the next few episodes, give a dose of the drug Sirdalud until acute destruction of cerebral blood circulation lower incrementally until you take the drug again.

In addition to information about ADR based on data from clinical practice

Splinters in the post-life period of knowledge about HP are in voluntary order with a population of unknown size, it is impossible to reliably estimate the frequency of their occurrence ( frequency unknown).

On the side of the immune system: hypersensitivity reactions, including anaphylactic reactions, angioedema and urticaria.

On the side of the psyche: hallucinations, confusion of information.

On the side of the nervous system: confused.

On the side of the organ of the eye: dimming the dawn.

On the side of the liver and the yellow paths: hepatitis, liver failure.

On the side of the skin and under the skin fabrics: scalding on the skin, erythema, itching of the skin, dermatitis.

Zagalni discord: asthenia, urinary syndrome.

If any side effects occur, or the patient notes that any other side effects are not indicated in the instructions, it is the responsibility of the patient to inform the doctor.

Overdose

Please be informed about an overdose of the drug Sirdalud, including a fall, if a dose of 400 mg is taken. In all cases, dressing went smoothly.

Symptoms: fatigue, vomiting, decreased arterial pressure, prolonged QT interval, confusion, drowsiness, miosis, restlessness, depressed breathing, coma.

Likuvannya: To remove tizanidine from the body, it is recommended to take a large dose of active vugill. Forcing diuresis can also speed up the administration of the drug Sirdalud. It is necessary to carry out symptomatic treatment.

Medical mutualism

With one-hour administration of Sirdalud with inhibitors of cytochrome CYP1A2, the concentration of tizanidine in the blood plasma may increase. In some cases, elevated tizanidine plasma concentrations can lead to symptoms of drug overdose, incl. prolongation of the QT interval c.

Acute administration of Sirdalud with CYP1A2 inducers may result in a decrease in tizanidine plasma concentrations. Decreases in plasma levels of tizanidine may cause a change in the therapeutic effect of Sirdalud.

Contraindications for the combination of the drug Sirdalud

Co-administration of tizanidine with fluvoxamine or ciprofloxacin, which are inhibitors of cytochrome CYP1A2, is contraindicated.

When administered with the drug Sirdalud with fluvoxamine or ciprofloxacin, a 33-fold and 10-fold increase in the AUC of tizanidine is observed. The result of exhausted stagnation may result in a clinically significant decrease in AT, which is accompanied by drowsiness, confusion, and decreased fluidity of psychomotor reactions (in some cases, even to the point of collapse and loss of fluidity).

It is not recommended to use tizanidine together with other inhibitors of the CYP1A2 isoenzyme - antiarrhythmic drugs (mexiletine, propafenone), cimetidine, some fluoroquinolones (enoxacin, pefloxacin, norfloxacin), rofekitsin, r ofecicin, rofecidine.

Combinations of the drug Sirdalud that require continued precautions

It is necessary to be careful when sirdalud is heavily administered with drugs that prolong the QT interval (for example, cisapride, amitriptyline, azithromycin).

Antihypertensive drugs

Rifampicin

One-hour administration of the drug Sirdalud and rifampicin results in up to a 50% decrease in the concentration of tizanidine in blood plasma. As a result, the therapeutic effect of the drug Sirdalud may decrease, which may result in clinical significance for certain patients. In the event of unfavorable treatment with rifampicin and tizanidine, careful selection of the tizanidine dose (increased) is recommended if this is inconvenient.

Other medicinal uses

Sedatives, narcotics (benzodiazepine, baclofen) and other drugs such as antihistamines may also cause the sedative effect of tizanidine.

The use of Sirdalud is unique from other α 2 -adrenergic receptor agonists (for example, clonidine) due to the potential enhancement of the hypotensive effect.

Chicken

Systemic bioavailability of the drug Sirdalud in people who smoke (more than 10 cigarettes per day) is reduced by approximately 30%. Trival therapy with the drug Sirdalud for humans, which may require more than high doses, is less than moderately therapeutic.

Alcohol

During the hour of treatment with Sirdalud, avoid alcohol, because You can promote the smooth development of unwanted symptoms (for example, decreased arterial pressure and blood pressure). Sirdalud can improve the effect of ethanol on the central nervous system.

special inserts

Arterial hypotension may occur due to stagnation with Syrdalud, as well as as a result of drug interactions with CYP1A2 inhibitors and/or. A decrease in blood pressure can lead to loss of speed and collapse.

Episodes of hepatic dysfunction associated with tizanidine have been reported with a stable dose of up to 12 mg, and the episodes have rarely resolved. In connection with this, it is recommended to monitor liver function tests once a month for the first 4 months of treatment in those patients who are prescribed tizanidine at an additional dose of 12 mg or more, and Also in these episodes, if clinical signs are observed, damage can be allowed to liver functions, such as undiagnosed boredom, anorexia, it seems. In times when the activity of ALT and AST in a serum patient consistently exceeds the ULN by 3 times or more, treatment with the drug Sirdalud should be followed.

Floating to the building to the center using transport means and mechanisms

Patients who experience drowsiness due to drug ingestion should be advised to avoid activities that require a high concentration of attention and a quick reaction, for example, cervical transport. ami or robots with machines and mechanisms.

Vaginism and lactation

In studies of animals, no evidence of teratogenicity was revealed. When administered at doses of 10 and 30 mg/kg/product, an increase in the term of gestation was observed in animals, and episodes of prenatal and postnatal fetal loss were recorded, as well as a delay in fetal development. When the prescribed doses were administered, females showed signs of muscle relaxation and sedation. Based on the body surface, the prescribed doses exceeded the maximum recommended dose for humans (0.72 mg/kg/dose) in 2.2 and 6.7 times.

In studies of animals, tizanidine was found in small amounts in the milk of lactating females. Sirdalud should not stagnate during lactation (breastfeeding), because There is no data on the penetration of tizanidine into breast milk in humans.

Contraception. In order to preserve reproductive potential, patients should be informed about the adverse infusion of the drug into the fetus that is developing, manifestations in follow-up studies in animals. Before taking the drug, and also for a period of 1 year after taking the drug, patients should use reliable methods of contraception to preserve their reproductive potential (with the correct and trivial choice of which frequency will become important sti become<1%).

Vagism test. Before administering the drug Sirdalud to patients, in order to preserve reproductive potential, it is recommended to cancel the result of the vaginosis test.

Influx on fertility. In the animals studied, there was no adverse effect on fertility in human or female animals when treated with tizanidine at a dose of 10 mg/kg/day. Changes in fertility were observed in human subjects who took tizanidine at a dose exceeding 30 mg/kg/dose, and in female subjects - at a dose exceeding 10 mg/kg/dose. Based on the body surface, the prescribed doses exceeded the maximum recommended dose for humans (0.72 mg/kg/dose) in 2.2 and 6.7 times. When the prescribed doses were administered to the mother's side, behavioral effects and clinical signs were observed, which included pronounced sedation, changes in body weight and ataxia.

Zastosuvannya at the child’s place

Evidence of drug use in patients with cancer up to 18 days of age. Administration of the drug Sirdalud to this category of patients is not recommended.

If the function of the nirok is impaired

Likuvannya patients with nirkov deficiency (CC less than 25 ml/xv) It is recommended to start with a dose of 2 mg 1 time per dose. Dose adjustments should be made in small increments to improve tolerability and effectiveness. If it is necessary to eliminate more pronounced effects, it is recommended to initially increase the dose, which is administered once per dose, and then increase the frequency of administration.

In case of impaired liver function

Treatment with the drug Sirdalud patients with severely impaired liver function contraindicated. U patients with severely impaired liver function the drug must be taken into account with caution; It is recommended to begin therapy with a minimal dose, with incremental advancements until optimal tolerability and effectiveness of therapy are achieved.

Zastosuvannya at the Summer Palace

Dosvid zastosuvannya Sіrdaludu patients in 65 years і older boundaries. It is recommended to begin therapy at a minimal dose with incremental increases until an optimal balance of tolerability and effectiveness of therapy is achieved.

Umovi dispensers from pharmacies

The drug is available with a prescription.

Understand the term saving

Keep the drug out of the reach of children at a temperature not exceeding 25°C. The term of attribution is 5 rocks.