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Cartan 1 g/10 ml No. 10 solution for oral administration bottle.

Instructions for medical use of the drug CARTAN Trade name Cartan International nonproprietary name Levocarnitine Dosage form Oral solution, 1 g/10 ml Composition 1 ml of the drug contains the active substance - levocarnitine 100 mg, excipients: sorbitol solution 70%, methylparaben E-218 (methylhydroxybenzoate), sodium saccharin, sodium citrate dihydrate (equivalent to sodium citrate anhydrous), orange flavor, hydrochloric acid and/or sodium hydroxide, water for injection Description A clear, colorless or light yellow solution with an orange odor. Pharmacotherapeutic group Other drugs for the treatment of gastrointestinal diseases and metabolic disorders. Amino acids and their derivatives. ATC code A16AA01 Pharmacological properties Pharmacokinetics When taken orally, it is well absorbed from the gastrointestinal tract (80%). Swipe. is achieved after 3 hours, the therapeutic concentration is maintained for 9 hours. From the blood plasma it penetrates into the liver, myocardium, and skeletal muscles. Excreted by the kidneys, mainly in the form of acyl esters. Pharmacodynamics L-carnitine is a natural substance related to B vitamins. It participates in metabolic processes as a carrier of fatty acids through cell membranes from the cytoplasm to the mitochondria, where they undergo the process of beta-oxidation with the formation of a large amount of metabolic energy in the form of ATP. With a lack of carnitine in the body, lipids are deposited in muscle tissue (skeletal muscles, myocardium), which disrupts their contractile activity. Normalizes protein and fat metabolism, increased basal metabolism in hyperthyroidism, being a partial antagonist of thyroxine, restores the alkaline reserve of the blood, inhibits the formation of keto acids and anaerobic glycolysis, reduces the degree of lactic acidosis, and also increases physical activity and increases exercise tolerance, while promoting economical consumption of glycogen and an increase in its reserves in the liver and muscles. Cartan has an anabolic effect, stimulates the secretion of gastric juice, slows down the breakdown of protein and carbohydrate molecules. Reduces excess body weight and reduces fat content in muscles. It has a neurotrophic effect, inhibits the development of apoptosis, limits the affected area and restores the structure of nervous tissue. Indications for use - consequences of birth trauma and asphyxia of newborns - malnutrition and hypotension of newborns - respiratory distress syndrome in newborns - nursing of premature newborns on parenteral nutrition and children undergoing hemodialysis - underweight in children and adolescents under 16 years of age - primary or secondary carnitine deficiency in adults, children and newborns - secondary carnitine deficiency in patients receiving long-term hemodialysis and having the following symptoms: severe persistent muscle spasms, skeletal muscle weakness, myopathies, loss of muscle mass, symptoms of hypotension, anemia that does not respond to treatment or requiring large doses of erythropoietin, cardiomyopathy - myocardial metabolic disorders due to ischemic heart disease (stable angina, acute myocardial infarction, post-infarction cardiosclerosis) - chronic heart failure - acute and chronic cerebrovascular accident (stroke, encephalopathy of various origins) - physical exhaustion, intense physical activity in athletes (as an anabolic and adaptogen) Method of administration and dose Used orally. Before use, dilute in 100 ml of chilled boiled water. Treatment must be carried out under monitoring the level of free and acyl L-carnitine in plasma and urine to determine an adequate dosage. The concentration of carnitine in plasma is 35 to 60 μmol/l. The ratio of acyl and free L-carnitine in plasma is normal 0.35. The daily dose depends on age and body weight: Up to 2 years – 150 mg/kg body weight 2 – 6 years – 100 mg/kg body weight 6 – 12 years – 75 mg/kg body weight of the child. Children over 12 years of age and adults - 2 - 3 years. In case of primary or secondary carnitine deficiency, the dosage depends on the congenital abnormalities in metabolism and the severity during the treatment period. In most cases, the recommended oral dose is 100 to 200 mg/kg/day, divided into 2 to 4 divided doses. If clinical and biochemical parameters do not improve, the dose may be increased on a short-term basis. High doses up to 400 mg/kg/day are necessary for acute metabolic decompensation. For secondary carnitine deficiency in patients with end-stage chronic renal failure, maintenance therapy is prescribed 1 g per day orally. Side effects - pain in the epigastric region, dyspeptic symptoms - nausea, vomiting - muscle weakness Contraindications - hypersensitivity to the components of the drug Drug interactions Before taking the drug, you should inform your doctor about taking other drugs. Glucocorticoids increase carnitine levels in many tissues (except the liver). Excessive doses of choline inhibit the synthesis and activity of carnitine. Carnitine can be combined with various anabolic agents; with drugs that have antioxidant and/or antihypoxic activity. Special instructions It is recommended to monitor therapy by measuring the level of free and acyl L-carnitine in plasma and urine to determine an adequate dosage. L-carnitine is not addictive, as it is a natural solution for the human body. Administration of L-carnitine to diabetic patients receiving insulin or oral hypoglycemic treatment may cause hypoglycemia. Plasma glucose levels in such patients should be continuously monitored to adjust hypoglycemic treatment. Long-term oral administration of high doses of L-carnitine in patients with severe renal impairment may cause increased concentrations of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are usually excreted in the urine. In this case, urine, breath and sweat have an unpleasant odor. Pregnancy and lactation Prescribed during pregnancy or lactation only if absolutely necessary, if the benefit to the mother outweighs the potential risk to the sex or the child. Peculiarities of the drug's influence on the ability to drive a vehicle or operate potentially dangerous mechanisms. No effect. Overdose There are no data on toxicity in case of overdose of L-carnitine. Tolerability of the drug is monitored during the first week of use and after each increase in the dose taken. Symptoms: high doses of the drug cause diarrhea. Treatment: reducing the dose of the drug and replacement therapy. Release form and packaging 10 ml of the drug in polypropylene ampoules. 5 ampoules are placed in thermoplastic blister packs, sealed with aluminum foil. 2 contour packages together with instructions for medical use in the state and Russian languages are placed in a cardboard box. Storage conditions Store at a temperature not exceeding 25 ° C, in a place protected from light. Keep out of the reach of children! Shelf life: 4 years Do not use the drug after the expiration date indicated on the package. Conditions for dispensing from pharmacies By prescription Manufacturer DEMO SA Pharmaceutical Industry, 21 Km National Road Athens-Lamia, 14568 Athens. Greece, tel.: + 30 210 8161802 fax: + 30 210 8161802 Owner of the registration certificate DEMO SA Pharmaceutical Industry, Greece, Address of the organization that accepts claims from consumers on the quality of products (products) in the territory of the Republic of Kazakhstan KFK Medservice Plus LLP RK, Almaty, st. Mametova, 54 tel.

Interferon ointment 10g

[RU] An ointment containing recombinant a-2-interferon and CIP (complex immunoglobulin preparation) is a mixture of the above-mentioned fat-based drugs.

Complex immunoglobulin preparation - dry for enteral use, is a lyophilized protein solution containing immunoglobulins of the classes IgG, IgM, IgA, isolated from human blood plasma, tested for the absence of antibodies to HIV, hepatitis C virus and surface antigen of the hepatitis B virus. If the preparations contain normal human immunoglobulin content of IgM and IgA is less than 3%, then in CIP it is increased to 15-25%, which makes it possible to use it topically for inflammatory processes of the skin and mucous membranes, since immunoglobulins of the IgM class, due to the presence of a secretory component, are more resistant to the effects of proteolytic agents enzymes in the secretions of the mucous membranes, on the cells of which they are fixed. It has been proven that the complex immunoglobulin preparation contains specific antibodies against herpes viruses, chlamydia, staphylococcus and other pathogenic microorganisms.

Human recombinant d-2-interfron is a protein synthesized by the Pscudomonas putida strain,

The gene for human leukocyte α-2-interferon, which is identical to leukocyte d-2b-interferon, is built into its genetic apparatus. Recombinant a-2-interferon inhibits the intracellular stages of development of viruses, chlamydia, rickettsia, cytomegaloviruses, bacteria, has immunocorrective and antitumor properties, stimulates antibacterial, antiviral, antiprotozoal immunity. The combined effect of these drugs causes a powerful antimicrobial effect - both intracellular and extracellular due to direct impact on microorganisms and stimulation of immune systems. In addition, due to a significant increase in the protein content in the preparation, greater stability of interferons is ensured in the presence of aggressive factors in the secretions of the mucous membranes and discharge in the lesions of the skin and mucous membranes.

Indications for use:

flu;
acute respiratory diseases, contact with a patient with acute respiratory viral infection;
herpes simplex of the skin and mucous membranes;
herpes zoster (shingles);
genital warts and papillomas^ chlamydia;
urogenital mycoplasmosis;
vaginal dysbiosis, vulvovaginitis, cervicitis;
atonic dermatitis;
eczema of bacterial-viral etiology;
long-term non-healing wounds, fistulas, trophic skin ulcers;
anal fissures.

Mode of application

An ointment containing CIP and recombinant interferon-γ-2 is applied in a thin layer to the lesions. For influenza, acute respiratory diseases, herpes, it is used 2-3 times a day for 5-7 days, for other diseases 1-2 times a day for 7-14 days.

If there is heavy discharge from the nasal cavity during acute respiratory diseases, before applying the ointment, it is advisable to use drugs such as naphthyzine, sanorin, galazolin.

Before applying the ointment, mucus should be removed from the walls of the vagina and cervix with a tampon

For abundant, overgrown genital warts and papillomas, the ointment can be used in combination with cryodestruction, electrocoagulation and chemotherapy. Moreover, it can be used both before and after destructive manipulations, which prevents the contamination of surrounding healthy tissues with viruses.

For trophic and long-term non-healing wounds, the ointment is applied along their periphery in a thin layer with light rubbing. For eczema and atonic dermatitis, the ointment is applied to the entire affected surface.

It is possible to use the ointment in combination with antibiotics and other chemotherapeutic drugs

A product that has the smell of rancid oil is not suitable for use.

Contraindications for use

Individual intolerance to the drug.

Release form

An ointment containing a complex immunobiological preparation and recombinant interferon is produced in tubes and jars of 5, 10 and 30 g.

10 g contain 500,000 IU of a-interferon.

Storage

List B Store at a temperature from +4 to +10°C in a place protected from light

Best before date

The shelf life of an ointment containing CIP and recombinant γ-2-interferon is 1 year.

The shelf life of the ointment containing KIP and recombinant γ-2-interferon is 1 year. The shelf life of the ointment containing KIP and recombinant γ-2-interferon is 1 year.

Dosage form

Oral solution, 1 g/10 ml

Compound

1 ml of the drug contains

active substance - levocarnitine 100 mg,

excipients: sorbitol solution 70%, methylparaben E-218 (methylhydroxybenzoate), sodium saccharin, sodium citrate dihydrate (equivalent to anhydrous sodium citrate), orange flavor, hydrochloric acid and/or sodium hydroxide, water for injection

Description

A clear, colorless or light yellow solution with an orange odor.

Pharmacological properties

Pharmacokinetics

When taken orally, it is well absorbed from the gastrointestinal tract (80%). Swipe. is achieved after 3 hours, the therapeutic concentration is maintained for 9 hours. From the blood plasma it penetrates into the liver, myocardium, and skeletal muscles. Excreted by the kidneys, mainly in the form of acyl esters.

Pharmacodynamics

L-carnitine is a natural substance related to B vitamins. It participates in metabolic processes as a carrier of fatty acids through cell membranes from the cytoplasm to the mitochondria, where they undergo the process of beta-oxidation with the formation of a large amount of metabolic energy in the form of ATP. With a lack of carnitine in the body, lipids are deposited in muscle tissue (skeletal muscles, myocardium), which disrupts their contractile activity. Normalizes protein and fat metabolism, increased basal metabolism in hyperthyroidism, being a partial antagonist of thyroxine, restores the alkaline reserve of the blood, inhibits the formation of keto acids and anaerobic glycolysis, reduces the degree of lactic acidosis, and also increases physical activity and increases exercise tolerance, while promoting economical consumption of glycogen and an increase in its reserves in the liver and muscles.

Cartan has an anabolic effect, stimulates the secretion of gastric juice, slows down the breakdown of protein and carbohydrate molecules. Reduces excess body weight and reduces fat content in muscles. Has a neurotrophic effect, inhibits the development of apoptosis, limits the affected area and restores the structure of nervous tissue

Indications for use

consequences of birth trauma and asphyxia of newborns
malnutrition and hypotension of newborns
respiratory distress syndrome in newborns
nursing of premature newborns on parenteral nutrition and children undergoing hemodialysis
underweight in children and adolescents under 16 years of age
primary or secondary carnitine deficiency in adults, children and newborns
secondary carnitine deficiency in patients receiving long-term hemodialysis and having the following symptoms: severe persistent muscle spasms, skeletal muscle weakness, myopathy, loss of muscle mass, symptoms of hypotension, anemia that does not respond to treatment or requires large doses of erythropoietin, cardiomyopathy
disorders of myocardial metabolism due to ischemic heart disease (stable angina, acute myocardial infarction, post-infarction cardiosclerosis)
chronic heart failure
acute and chronic cerebrovascular accident (stroke, encephalopathy of various origins)
physical exhaustion, intense physical activity in athletes (as an anabolic and adaptogen)

Directions for use and doses

Used internally. Before use, dilute in 100 ml of chilled boiled water.

Treatment must be carried out under monitoring the level of free and acyl L-carnitine in plasma and urine to determine an adequate dosage. The concentration of carnitine in plasma is 35 to 60 μmol/l. The ratio of acyl and free L-carnitine in plasma is normal 0.35.

The daily dose depends on age and body weight:

Up to 2 years – 150 mg/kg body weight

2 – 6 years – 100 mg/kg body weight

6 – 12 years – 75 mg/kg child’s body weight.

Children over 12 years old and adults - 2 - 3 years old.

In case of primary or secondary carnitine deficiency, the dosage depends on the congenital abnormalities in metabolism and the severity during the treatment period. In most cases, the recommended oral dose is 100 to 200 mg/kg/day, divided into 2 to 4 divided doses. If clinical and biochemical parameters do not improve, the dose may be increased on a short-term basis. High doses up to 400 mg/kg/day are necessary for acute metabolic decompensation.

For secondary carnitine deficiency in patients with end-stage chronic renal failure, maintenance therapy is prescribed 1 g per day orally.

Side effects

pain in the epigastric region, dyspeptic symptoms
nausea, vomiting
muscle weakness

Contraindications

- hypersensitivity to the components of the drug

Drug interactions

Before taking the drug, you should inform your doctor about taking other drugs.

Glucocorticoids increase carnitine levels in many tissues (except the liver). Excessive doses of choline inhibit the synthesis and activity of carnitine. Carnitine can be combined with various anabolic agents; with drugs that have antioxidant and/or antihypoxic activity.

special instructions

It is recommended to monitor therapy by measuring the level of free and acyl L-carnitine in plasma and urine to determine adequate dosage.

L-carnitine is not addictive, as it is a natural solution for the human body. Administration of L-carnitine to diabetic patients receiving insulin or oral hypoglycemic treatment may cause hypoglycemia. Plasma glucose levels in such patients should be continuously monitored to adjust hypoglycemic treatment.

Long-term oral administration of high doses of L-carnitine in patients with severe renal impairment may cause increased concentrations of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are usually excreted in the urine. In this case, urine, breath and sweat have an unpleasant odor.

Pregnancy and lactation

Prescribed during pregnancy or breastfeeding only if absolutely necessary, if the benefit to the mother outweighs the potential risk to the sex or child.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

Does not affect.

Overdose

There are no data on toxicity in case of overdose of L-carnitine. Tolerability of the drug is monitored during the first week of use and after each increase in the dose taken.

Symptoms: high doses of the drug cause diarrhea.

Treatment: reducing the dose of the drug and replacement therapy.

Release form and packaging

10 ml of the drug in polypropylene ampoules.

5 ampoules are placed in thermoplastic blister packs, sealed with aluminum foil.

2 contour packages together with instructions for medical use in the state and Russian languages are placed in a cardboard box.

Storage conditions

Store at a temperature not exceeding 25 °C, in a place protected from light.

Keep out of the reach of children!

Shelf life

4 years

Do not use the drug after the expiration date indicated on the package.

Vacation conditions

from pharmacies

According to the recipe
Attention! The description of the drug on this page is simplified. Before purchasing and using the drug, consult your doctor or pharmacist, and also read the instructions approved by the manufacturer. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. ATTENTION! This section is provided for informational purposes only and is not a catalog or price list of our company. To obtain information about the availability of drugs, call + 99871 202 0999 Pharmacy Network Helpline 999.

Telmisartan

Pregnancy

ARA II should not be prescribed during pregnancy. If continuation of ARB II therapy is not considered necessary, women planning pregnancy should switch to alternative antihypertensive drugs that have an established safety profile for use during pregnancy. If pregnancy is diagnosed, treatment with ARA II should be stopped immediately and, if necessary, alternative therapy should be started (see sections “Contraindications” and “Use during pregnancy and breastfeeding”).

Liver dysfunction

Telmisartan should not be used in patients with cholestasis, biliary obstruction or severe liver dysfunction (Child-Pugh class C), since telmisartan is excreted primarily in the bile. In such patients, a slower elimination of the drug from the body is expected. Telmisartan should be used with caution in patients with mild to moderate hepatic impairment (Child-Pugh class A and B).

Renovascular hypertension

When using drugs that affect the RAAS, patients with bilateral renal artery stenosis or stenosis of a single functioning kidney have an increased risk of developing severe arterial hypotension and renal failure.

Renal dysfunction, condition after kidney transplantation

When using Telmisartan in patients with renal failure, it is recommended to monitor serum potassium levels and plasma creatinine concentrations. There is no experience with the use of telmisartan in patients who have recently undergone kidney transplantation.

Decrease in BCC

In patients with a decrease in blood volume (hypovolemia) and/or hyponatremia due to intensive diuretic therapy, restriction of salt intake, diarrhea or vomiting, symptomatic arterial hypotension may develop, especially after taking the first dose of the drug. Before starting therapy with Telmisartan, it is necessary to correct disturbances in water and electrolyte balance.

Double blockade of the RAAS

There is evidence that the simultaneous use of ACE inhibitors, ARB II or aliskiren increases the risk of arterial hypotension, hyperkalemia and decreased renal function (including acute renal failure). Therefore, double blockade of the RAAS through the combined use of ACE inhibitors, ARB II or aliskiren is not recommended.

If therapy with dual blockade of the RAAS is considered absolutely necessary, it should be carried out only under the supervision of a specialist and with careful monitoring of renal function, electrolyte levels and blood pressure.

ACE inhibitors and ARB II should not be used simultaneously in patients with diabetic nephropathy.

Other conditions associated with stimulation of the RAAS

In patients whose vascular tone and renal function depend primarily on the activity of the RAAS (for example, patients with severe chronic heart failure or primary kidney disease, including renal artery stenosis), therapy with drugs that affect this system, for example, telmisartan , has been associated with acute hypotension, hyperazotemia, oliguria, or, in rare cases, acute renal failure (see section "Side effects").

Primary hyperaldosteronism

Patients with primary aldosteronism generally do not respond to antihypertensive drugs that act by inhibiting the RAAS. Therefore, the use of telmisartan is not recommended.

Stenosis of the aortic and/or mitral valve, HOCM

Caution should be exercised when using telmisartan (as well as other vasodilators) in patients with aortic and/or mitral stenosis, or with HOCM.

Patients with diabetes mellitus receiving insulin or oral hypoglycemic agents

In patients with diabetes mellitus and additional cardiovascular risk, such as coronary artery disease (CHD), the risk of fatal myocardial infarction and sudden cardiovascular death may be increased when taking blood pressure-lowering drugs such as ARBAs or ACE inhibitors. In patients with diabetes mellitus, CAD may be asymptomatic and therefore may not be diagnosed. Before starting the use of Telmisartan in patients with diabetes mellitus, appropriate diagnostic tests, including exercise testing, should be performed to identify and treat coronary artery disease.

When using telmisartan, hypoglycemia may develop in such patients. It is recommended to regularly monitor the concentration of glucose in the blood and, if necessary, correct hypoglycemic agents.

Hyperkalemia

The use of drugs that affect the RAAS can lead to the development of hyperkalemia.

In elderly patients, patients with renal failure, patients with diabetes mellitus, patients concomitantly taking other drugs that increase potassium levels, and/or patients with underlying medical conditions, hyperkalemia can be fatal.

When considering the simultaneous use of such drugs, the benefit-risk ratio should be assessed.

The main risk factors for the development of hyperkalemia are:

diabetes mellitus, impaired renal function, age over 70 years;
simultaneous use of drugs that affect the RAAS and/or cause an increase in potassium levels in the blood serum. Drugs that may cause hyperkalemia include potassium-containing salt substitutes, potassium-sparing diuretics (spironolactone, eplerenone, amiloride, triamterene), ACE inhibitors, ARB II, NSAIDs including selective cyclooxygenase type 2 [COX-2] inhibitors, heparin , immunosuppressive drugs (cyclosporine and tacrolimus), as well as co-trimoxazole (sulfamethoxazole + trimethoprim);
associated conditions, such as dehydration, acute heart failure in the decompensation stage, metabolic acidosis, impaired renal function, sudden progression of kidney disease (for example, infectious diseases), conditions accompanied by tissue necrosis (acute limb ischemia, rhabdomyolysis, extensive trauma).

Patients at high risk of developing hyperkalemia should undergo careful monitoring of serum potassium levels (see section "Interaction with other drugs").

Ethnic characteristics

ACE inhibitors and AR II inhibitors (including telmisartan) may have a less pronounced antihypertensive effect in black patients. This may be due to a decrease in renin activity during arterial hypertension in such patients compared to representatives of other races.

Other

As with any antihypertensive drug, an excessive decrease in blood pressure in patients with coronary artery disease or ischemic cardiomyopathy can lead to myocardial infarction or stroke.

Excipients

Lactose monohydrate and sorbitol

The drug Telmisartan contains lactose monohydrate and sorbitol (E420). Patients with rare hereditary galactose or fructose intolerance, lactase deficiency or glucose-galactose malabsorption should not take this drug.

Sodium

1 film-coated tablet of Telmisartan contains less than 1 mmol of sodium (23 mg), i.e., practically no sodium.