The highest dosage of phenazepam. Real experience of using Phenazepam: reviews, clinical studies, instructions

Release form: Solid dosage forms. Pills.

General characteristics. Compound:

Active substance: bromod(phenazepam) 1 mg; 500 mcg; 2.5 mg

Excipients: lactose (milk sugar), potato starch, povidone (kollidon 25), calcium stearate, talc.

Pharmacological properties:

Anxiolytic (tranquilizer), benzodiazepine derivative. It has a pronounced anxiolytic, hypnotic, sedative, as well as anticonvulsant and central muscle relaxant effect.
It has a depressant effect on the central nervous system, occurring primarily in the thalamus, hypothalamus and limbic system. Enhances the inhibitory effect of gamma-aminobutyric acid (GABA), which is one of the main mediators of pre- and postsynaptic inhibition of transmission nerve impulses in the central nervous system.
The mechanism of action of phenazepam is determined by stimulation of benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chlorionophore-receptor complex, leading to activation of GABA receptors, which, in turn, causes a decrease in the excitability of subcortical structures of the brain and inhibition of polysynaptic spinal reflexes.

Pharmacokinetics. Suction. When taken orally, the drug is well absorbed from the gastrointestinal tract. Cmax of phenazepam in the blood is from 1 to 2 hours.

Metabolism. Metabolized in the liver.

Excretion. T1/2 ranges from 6 to 18 hours. The drug is excreted mainly in the urine.

Indications for use:

- neurotic, neurosis-like, psychopathic, psychopath-like and other conditions accompanied by anxiety, fear, increased irritability, tension, emotional lability;
- reactive psychoses;
— hypochondriacal-senestopathic syndrome (including resistant to the action of other tranquilizers);
— autonomic dysfunctions;
- sleep disorders;
- prevention of states of fear and emotional stress;
- temporal and myoclonic;
- And ;
— ;
- vegetative lability.

Important! Get to know the treatment

Directions for use and dosage:

The drug should be taken orally. A single dose of Phenazepam is usually 0.5-1 mg.
Average daily dose Phenazepam is 1.5 - 5 mg, divided into 2-3 doses: usually 0.5-1 mg in the morning and afternoon, at night - up to 2.5 mg. The maximum daily dose of Phenazepam is 10 mg.
For sleep disorders, the drug should be used in a dose of 0.25-0.5 mg 20-30 minutes before bedtime.
For neurotic, psychopathic, neurosis-like and psychopath-like conditions, the initial dose of the drug is 0.5-1 mg 2-3 After 2-4 days, taking into account the effectiveness and tolerability of the drug, the dose can be increased to 4-6 mg/
With severe agitation, fear, anxiety, treatment begins with a dose of 3 mg/day, quickly increasing the dose until therapeutic effect.
For epilepsy, the dose is 2-10 mg/day
At alcohol withdrawal Phenazepam is prescribed at a dose of 2.5-5 mg/day
For diseases with increased muscle tone, the drug is prescribed at a dose of 2-3 mg 1-2
To avoid the development of drug dependence when course treatment The duration of use of Phenazepam is 2 weeks. In some cases, the duration of treatment can be increased to 2 months. When discontinuing npenapata, the dose is reduced gradually.

Features of application:

Special caution is required when prescribing Phenazepam for severe depression, since the drug can be used to realize suicidal intentions.

For renal/ liver failure And long-term treatment control over the picture is necessary peripheral blood and liver enzyme levels.

The frequency and nature of side effects depend on individual sensitivity, dose and duration of treatment. When reducing doses or stopping the use of Phenazepam side effects disappear.

Like other benzodiazepines, Phenazepam has the ability to cause drug addiction at long-term use V large doses ah (> 4 mg/).

If you suddenly stop using the drug, withdrawal syndrome may occur (especially when using the drug for more than 8-12 weeks).

Phenazepam enhances the effect of alcohol, so drinking alcohol during treatment with the drug is not recommended.

Use in pediatrics
Children, especially young children, are very sensitive to the CNS depressant effects of benzodiazepines.

Impact on the ability to drive vehicles and operate machinery
Phenazepam is contraindicated for use by transport drivers and other persons performing work requiring quick and accurate reactions.

Side effects:

From the central nervous system and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, fatigue, impaired concentration, disorientation, slowed mental and motor reactions, confusion; rarely - memory loss, impaired coordination of movements (especially when used in high doses), decreased mood, dystonic extrapyramidal reactions, asthenia, ; very rarely - paradoxical reactions (aggressive outbursts, fear, suicidal tendencies, muscle spasm, sleep disturbance).

From the outside digestive system: dry mouth or drooling, decreased appetite, or increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the outside reproductive system: decreased or increased libido; effect on the fetus - teratogenicity (especially the first trimester), central nervous system depression, respiratory failure, suppression of the sucking reflex in newborns.

Other: addiction, drug dependence, decreased blood pressure; rarely - visual impairment (diplopia), weight loss, ; at sharp decline dose or discontinuation of use - withdrawal syndrome.

Interaction with other drugs:

At simultaneous use Phenazepam with other drugs that cause depression of the central nervous system (including hypnotics, anticonvulsants, antipsychotics), the mutual enhancement of their action should be taken into account.
When phenazepam is used simultaneously with levodopa in patients with parkinsonism, the effectiveness of the latter is reduced.
With simultaneous use of Phenazepam with zidovudine, the toxicity of the latter may increase.
With simultaneous use of Phenazepam with inhibitors of microsomal oxidation, the risk of developing toxic effects Phenazepam.
With simultaneous use of Phenazepam with inducers of microsomal liver enzymes, the effectiveness of Phenazepam is reduced.
With simultaneous use of Phenazepam with imipramine, the concentration of the latter in the blood serum increases.
When using phenazepam simultaneously with antihypertensive drugs the severity of the antihypertensive effect may be enhanced.
When phenazepam is used concomitantly with clozapine, respiratory depression may increase.

Contraindications:

- coma;
- shock;
- myasthenia;
— (acute attack or predisposition);
- severe COPD (possible increased respiratory failure);
— ;
— pregnancy (especially the first trimester);
- period breastfeeding;
- children's and adolescence up to 18 years of age (safety and effectiveness have not been determined);
— increased sensitivity to benzodiazepines.

The drug should be used with caution in case of hepatic and/or cerebral and spinal ataxia, hyperkinesis, and a tendency to abuse psychotropic drugs, organic diseases brain (paradoxical reactions are possible), depression, in elderly patients.

Use of the drug PHENAZEPAM® during pregnancy and breastfeeding
During pregnancy, Phenazepam is used only for health reasons. The drug has toxic effect on the fetus and increases the risk of developing birth defects when used in the first trimester of pregnancy. The use of therapeutic doses over late dates pregnancy can cause depression of the central nervous system of the newborn. Permanent use Phenazepam during pregnancy can cause withdrawal syndrome in the newborn.

Use of the drug immediately before or during childbirth may cause respiratory depression in the newborn, decreased muscle tone, hypotension, hypothermia, weakening of the act of sucking ("flaccid baby" syndrome).

Use for liver dysfunction
The drug should be used with caution.

Use for renal impairment
The drug should be used with caution when renal failure.

Use in elderly patients
The drug should be used with caution in elderly and debilitated patients.

Use in children
Contraindication: children and adolescents under 18 years of age (safety and effectiveness have not been determined).

Overdose:

Symptoms: with moderate overdose - increased therapeutic action and side effects; with a significant overdose - pronounced depression of consciousness, cardiac and respiratory activity.

Treatment: vital monitoring important functions body, maintaining respiratory and cardiovascular activity, symptomatic therapy. Strychnine nitrate (injections of 1 ml of 0.1% solution 2-3) is recommended as an antagonist of the muscle relaxant effect of Phenazepam. Flumazenil (Anexat) can be used as a specific antagonist: 0.2 mg IV (if necessary, the dose can be increased to 1 mg) in a 5% glucose solution (dextrose) or 0.9% sodium chloride solution.

Storage conditions:

List B. The drug should be stored out of the reach of children, in a dry place, protected from light at a temperature not exceeding 25 °C.

Vacation conditions:

By prescription

Package:

10 pcs. - contour cell packaging (5) - cardboard packs.
25 pcs. - contour cell packaging (2) - cardboard packs.
50 pcs. - polymer jars (1) - cardboard packs.

Name:

Phenazepam (Phenazepaitium)

Pharmacological
action:

Phenazepam is highly active tranquilizer(a drug that has a calming effect on the central nervous system). The strength of the tranquilising and anxiolytic (anti-anxiety) action is superior to other tranquilizers; also has a pronounced anticonvulsant, muscle relaxant (muscle relaxant) and hypnotic effect. When used together with sleeping pills and drugs there is a mutual strengthening of the influence on the central nervous system.

Indications for
application:

Phenazepam prescribed for:
- various neurotic,
- neurosis-like,
- psychopathic and psychopath-like states,
- accompanied by anxiety,
- fear,
- increased irritability,
- emotional lability (instability).
The drug is effective with obsession, phobia (fear), hypochondriacal syndromes(depressed state caused by fear for one’s health), including those resistant (resistant) to the action of other tranquilizers, is also indicated for psychogenic psychoses, panic reactions, etc., as it relieves anxiety and fear. Phenazepam's sedative (calming effect on the central nervous system) and mainly anti-anxiety effect is not inferior to some neuroleptics (medicines that have an inhibitory effect on the central nervous system and in usual doses does not cause a hypnotic effect).
Phenazepam is also used to relieve alcohol withdrawal (a condition that occurs as a result of a sudden cessation of alcohol intake). In addition, it is prescribed as an anticonvulsant and hypnotic. The strength of the hypnotic effect is close to eunoctin.
Can also be used in preparation for surgical operations.

Directions for use:

IM or IV(stream or drip).

For rapid relief of fear, anxiety, psychomotor agitation, as well as in vegetative paroxysms and psychotic states: IM or IV, initial dose for adults - 0.5–1 mg (0.5–1 ml of 0.1% solution ), the average daily dose is 3–5 mg (3–5 ml of 0.1% solution), in severe cases – up to 7–9 mg (7–9 ml of 0.1% solution). The duration of use of the drug is determined by the doctor.

For serial epileptic seizures the drug is administered intramuscularly or intravenously, starting with a dose of 0.5 mg (0.5 ml of a 0.1% solution), the average daily dose is 1–3 mg (1–3 ml of a 0.1% solution).

For the treatment of alcohol withdrawal syndrome Phenazepam® is prescribed IM or IV at a dose of 0.5 mg, 1 time per day (0.5–1 ml of 0.1% solution).

IN neurological practice for diseases with increased muscle tone, the drug is prescribed intramuscularly at 0.5 mg 1–2 times a day (0.5–1 ml of 0.1% solution).

Premedication: IV slowly 3-4 ml of 0.1% solution.

Maximum daily dose- 10 mg. The course of treatment for parenteral administration is up to 3–4 weeks. When discontinuing the drug, the dose is reduced gradually.

After achieving a stable therapeutic effect, it is advisable to switch to oral administration dosage forms drug.

Side effects:

Possible side effects are the same as for Elenium and Seduxen. It should be taken into account that due to high activity phenazepam more often may be observed ataxia (impaired coordination of movements), drowsiness, muscle weakness, dizziness.

Sometimes- ataxia, itchy skin, rash, nausea, constipation, disorder menstrual cycle, decreased libido, muscle weakness. If side effects develop, phenazepam is discontinued.

Contraindications:

Impaired liver and kidney function, myasthenia gravis, pregnancy.

Interaction with
other medicinal
by other means:

Phenazepam should not be used concomitantly with MAO inhibitors, phenothiazine derivatives and barbiturates.

Pregnancy:

The drug is contraindicated during pregnancy.

Phenazepam - medicinal product group of benzodiazepines. Suppresses the activity of the central nervous system, specifically affecting brain structures such as the thalamus and hypothalamus, as well as the limbic system.

Together with gamma-aminobutyric acid(GABA) enhances pre- and postsynaptic inhibition of the transmission of nerve impulses. Activation of GABA receptors consists of stimulation by phenazepam of the GABA-benzodiazepine-chlorionophore prescription complex of benzodiazepine receptors.

As a result, the sensitivity of GABA receptors to this mediator increases, thereby enhancing the inhibitory effect of GABA on the central nervous system. At the psychological level, the patient experiences a decrease in emotional stress, restlessness, anxiety, and glimpses of positive attitude, depression and obsessive fears go away.

The central muscle relaxant effect is due to inhibition of polysynaptic spinal afferent inhibitory pathways (to a lesser extent, monosynaptic ones). Direct braking is also possible motor nerves and muscle function.

Phenazepam is a highly active tranquilizer, has anxiolytic, anticonvulsant, central muscle relaxant and sedative effect. The tranquilizing and anti-anxiety effect is superior in strength to the analogues of Phenazepam. The drug also has an anticonvulsant and hypnotic effect. It has virtually no effect on affective, hallucinatory and acute delusional disorders.

When taken orally, the drug is well absorbed from the gastrointestinal tract. Cmax of phenazepam in the blood is from 1 to 2 hours. Metabolized in the liver. T1/2 is from 6 to 18 hours. The drug is excreted mainly in the urine.

Indications for use

What does Phenazepam help with? The drug is prescribed for the following diseases or states:

• Psychopathic-like, psychopathic, neurosis-like, neurotic and other conditions that are accompanied by emotional lability, tension, increased irritability, fear, anxiety;
• Vegetative lability;
• Reactive psychoses;
• Muscle stiffness;
• Hypochondriacal-senestopathic syndrome;
• Tics and hyperkinesis;
• Autonomic dysfunctions;
• Myoclinic and temporal lobe epilepsy;
• Sleep disorders;
• Prevention of emotional stress and fear.

Recommended as a means to overcome fear and emotional stress in extreme situations. In schizophrenia, with high sensitivity to antipsychotic medications. Used for resistance to various tranquilizers.

Instructions for use of Phenazepam and dosage

Phenazepam injections intramuscularly or intravenously (stream or drip): for rapid relief of fear, anxiety, psychomotor agitation, as well as for vegetative paroxysms and psychotic states, initial dose – 0.5-1 mg (0.5-1 ml of 0.1% solution) , the average daily dose is 3-5 mg, in severe cases - up to 7-9 mg.

Orally: for sleep disorders – 0.25-0.5 mg 20-30 minutes before bedtime.

For the treatment of psychopathic, neurosis-like and psychopath-like conditions, the initial dose is 0.5-1 mg 2-3 times a day. After 2-4 days, taking into account the effectiveness and tolerability, the dose of Phenazepam can be increased to 4-6 mg/day.

In neurological practice, for diseases with increased muscle tone, the drug is prescribed intramuscularly at 0.5 mg 1 or 2 times a day.

In case of severe agitation, fear, anxiety, treatment begins with a dose of 3 mg/day, quickly increasing the dose until a therapeutic effect is obtained.

For epilepsy, Phenazepam is administered by injection IM or IV, starting with a dose of 0.5 mg.

For the treatment of alcohol withdrawal - orally, 2-5 mg/day or intramuscularly, 0.5 mg 1-2 times a day, for vegetative paroxysms - intramuscularly, 0.5-1 mg.

The average daily dose is 1.5-5 mg, divided into 2-3 doses, usually 0.5-1 mg in the morning and afternoon and up to 2.5 mg at night. In neurological practice, for diseases with muscle hypertonicity, 2-3 mg is prescribed 1 or 2 times a day.

The maximum daily dose is 10 mg. To avoid the development of drug dependence during a course of treatment, the duration of use of Phenazepam is 2 weeks (in some cases, the duration of treatment can be increased to 2 months).

Phenazepam in tablet form is prescribed for oral administration, in inpatient conditions daily dosage the drug is up to 4 mg, for therapy convulsive conditions for epilepsy, the dose is increased to 9 mg. At outpatient treatment up to 0.5 mg of the drug is prescribed once a day.

In order to relieve alcohol withdrawal, the patient is prescribed 5 mg of medication per day. For the treatment of sleep disorders - 1 mg half an hour before rest. The maximum daily dose should not exceed 10 mg.

In cases of severe agitation, fear, and anxiety, treatment begins with a dose of 3 mg/day, quickly increasing the dose until a therapeutic effect is obtained.

• When discontinued, the dose is reduced gradually. During the course of treatment, alcohol consumption is prohibited!

Contraindications

The use of Phenazepam is contraindicated in the following cases:

• Coma;
• Myasthenia;
• COPD (possible increased respiratory failure);
• Severe form of depression;
• Angle-closure glaucoma;
• Analgesic poisoning or acute alcohol poisoning;
• Acute respiratory failure;
• I trimester of pregnancy;
• Children under 18 years of age;
• During lactation;
• Intolerance to benzodiazepines.

Prescribe with caution when:

• Liver and/or renal failure, cerebral and spinal ataxia, history of drug dependence;
• Tendency to abuse psychoactive drugs;
• Organic brain diseases, psychosis (paradoxical reactions are possible), hypoproteinemia;
• Sleep apnea (known or suspected);
• Elderly patients.

Side effects

At the beginning of treatment, especially in elderly patients, the following may develop:

• drowsiness, feeling tired, dizziness, impaired concentration, ataxia, disorientation, slowed mental and motor reactions, confusion;
• rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements (especially when used in high doses), decreased mood, dystonic extrapyramidal reactions, asthenia, myasthenia, dysarthria;
• very rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidality, muscle spasms, hallucinations, anxiety, sleep disturbance).

Other side effects:

• leukopenia, neutropenia, agranulocytosis;
• anemia, thrombocytopenia;
• dry mouth or drooling, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea;
• impaired liver function, increased activity of liver transaminases and alkaline phosphatase, jaundice;
• urinary incontinence, urinary retention, renal dysfunction;
• decreased or increased libido, dysmenorrhea;
• effect on the fetus - teratogenicity (especially the first trimester), central nervous system depression, respiratory failure, suppression of the sucking reflex in newborns whose mothers used the drug during pregnancy;
• skin rash, itching;
• addiction, drug dependence, decreased blood pressure;
• phlebitis or venous thrombosis(hyperemia, swelling or pain at the injection site).

Overdose

In case of an overdose of Phenazepam, it is possible that all side effects, as well as failure of breathing and heart rhythm.

The antidote is strychnine nitrate or flumazenil. Treatment is symptomatic.

Pregnancy and lactation

Phenazepam is contraindicated for use at any stage of pregnancy and during breastfeeding.

Drug interactions

• Simultaneous use with Levodopa drugs leads to a decrease in therapeutic effect the latter;
• Concomitant use with Imipramine leads to an increase in the plasma concentration of the latter;
• Concomitant use with Zidovudine leads to increased toxicity of the latter;
• Concomitant use with antiepileptic drugs, sleeping pills, narcotic substances, drugs containing ethanol or alcoholic drinks, leads to a sharp increase in the therapeutic effect of the latter;
• When used simultaneously with Clozapine, there is an increase in side effects associated with respiratory depression.

Phenazepam analogues, list of drugs

If necessary, you can replace Phenazepam with similar drugs, list:

1. Tranquesipam
2. Fesipam
3. Phenazepam-Ros
4. Phenorelaxan
5. Elzepam

When choosing analogues, it is important to understand that instructions for use of Phenazepam, price and reviews of the drugs similar action do not apply. It is important to consult a doctor and not change the drug yourself.

The average price in pharmacies is 497-520 rubles.

Store in a place protected from light and out of reach of children at a temperature not exceeding +25°C. Shelf life – 3 years.

Analogs

These are medicines belonging to the same pharmaceutical group that contain different active substances(INN), differ from each other in name, but are used to treat the same diseases.

• - Tablets 500 mg
• - Substance-powder
• - Concentrate for the preparation of solution for infusion
• - Nasal drops
• - Tablets 250 mg

Indications for use of the drug Phenazepam

Neurotic, neurosis-like, psychopathic and psychopath-like and other conditions (irritability, anxiety, nervous tension, emotional lability), reactive psychoses and senesto-hypochondriacal disorders (including those resistant to the action of other anxiolytic drugs (tranquilizers), obsession, insomnia, withdrawal syndrome(alcoholism, substance abuse), status epilepticus, epileptic seizures (of various etiologies), temporal and myoclonic epilepsy.

IN extreme conditions- as a means of facilitating overcoming feelings of fear and emotional stress.

As antipsychotic- schizophrenia with hypersensitivity to antipsychotic drugs(including febrile form).

In neurological practice - muscle rigidity, athetosis, hyperkinesis, tic, autonomic lability (sympathoadrenal and mixed paroxysms).

In anesthesiology - premedication (as a component of induction anesthesia).

Release form of the drug Phenazepam

tablets 0.5 mg; contour packaging 10, cardboard pack 5;
tablets 0.5 mg; contour packaging 25, cardboard pack 2;
tablets 0.5 mg; polymer jar (jar) 50, cardboard pack 1;
tablets 1 mg; contour packaging 10, cardboard pack 5;
tablets 1 mg; contour packaging 25, cardboard pack 2;
tablets 1 mg; polymer jar (jar) 50, cardboard pack 1;
tablets 2.5 mg; contour packaging 10, cardboard pack 5;
tablets 2.5 mg; contour packaging 25, cardboard pack 2;
tablets 2.5 mg; polymer jar (jar) 50, cardboard pack 1;

Compound
Tablets 1 tablet.
bromod0.5 mg, 1 mg, 2.5 mg
(in terms of 100% substance)
excipients: lactose (milk sugar); potato starch; povidone (Kollidon 25); calcium stearate; talc
in blister packs 10 or 25 pcs.; in a cardboard pack of 2 (25 pcs.) or 5 (10 pcs.) packages; or in polymer cans of 50 pcs., in a cardboard pack 1 can.

Pharmacodynamics of the drug Phenazepam

Anxiolytic drug (tranquilizer) of the benzodiazepine series. It has anxiolytic, sedative-hypnotic, anticonvulsant and central muscle relaxant effects.

Strengthens the inhibitory effect of GABA on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brain stem and interneurons lateral horns spinal cord; reduces the excitability of subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

The anxiolytic effect is due to the influence on the amygdala complex of the limbic system and manifests itself in a decrease in emotional stress, easing anxiety, fear, and restlessness.

The sedative effect is due to the influence on the reticular formation of the brain stem and nonspecific nuclei of the thalamus and is manifested by a decrease in symptoms of neurotic origin (anxiety, fear).

For productive symptoms of psychotic origin (acute delusional, hallucinatory, affective disorders) has virtually no effect, a decrease in affective tension and delusional disorders is rarely observed.

The hypnotic effect is associated with inhibition of the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

The anticonvulsant effect is realized by enhancing presynaptic inhibition, suppresses the propagation of the convulsive impulse, but does not relieve the excited state of the focus. The central muscle relaxant effect is due to inhibition of polysynaptic spinal afferent inhibitory pathways (to a lesser extent, monosynaptic ones). Direct inhibition of motor nerves and muscle function is also possible.

Pharmacokinetics of the drug Phenazepam

After oral administration, it is well absorbed from the gastrointestinal tract, Tmax is 1-2 hours. Metabolized in the liver. T1/2 - 6-10-18 hours. Excreted mainly by the kidneys in the form of metabolites.

Use of the drug Phenazepam during pregnancy

During pregnancy, use is possible only for health reasons. It has a toxic effect on the fetus and increases the development of birth defects when used in the first trimester of pregnancy. Admission to therapeutic doses in later stages of pregnancy can cause depression of the central nervous system in the newborn. Chronic use during pregnancy may lead to physical dependence with the development of withdrawal syndrome in the newborn. Children, especially in younger age, are very sensitive to the CNS depressant effects of benzodiazepines.

Use immediately before or during childbirth may cause respiratory depression in the newborn, decreased muscle tone, hypotension, hypothermia and weak sucking ("floppy baby" syndrome).

Contraindications to the use of the drug Phenazepam

Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute poisoning alcohol (with weakening of vital functions), narcotic analgesics and hypnotics, severe COPD (possible increased respiratory failure), acute respiratory failure, severe depression (suicidal tendencies may occur); I trimester of pregnancy, lactation period, childhood and adolescence up to 18 years (safety and effectiveness have not been determined), hypersensitivity (including to other benzodiazepines).

Side effects of the drug Phenazepam

From the side of the central nervous system and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, feeling of fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, unsteady gait, slowed mental and motor reactions, confusion; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements (especially at high doses), depressed mood, dystonic extrapyramidal reactions (uncontrolled movements, including the eye), asthenia, myasthenia gravis, dysarthria, epileptic seizures (in patients with epilepsy); extremely rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidal tendencies, muscle spasms, hallucinations, agitation, irritability, anxiety, insomnia).

From the hematopoietic organs: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.

From the digestive system: dry mouth or drooling, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea; liver dysfunction, increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the outside genitourinary system: urinary incontinence, urinary retention, renal dysfunction, decreased or increased libido, dysmenorrhea.

Allergic reactions: skin rash, itching.

Local reactions: phlebitis or venous thrombosis (redness, swelling or pain at the injection site).

Other: addiction, drug dependence; decrease in blood pressure; rarely - visual impairment (diplopia), weight loss, tachycardia.

With a sharp reduction in dose or discontinuation of use - withdrawal syndrome (irritability, nervousness, sleep disturbances, dysphoria, smooth muscle spasm internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor, perception disorders, incl. hyperacusis, paresthesia, photophobia; tachycardia, convulsions, rarely - acute psychosis).

Method of administration and dosage of the drug Phenazepam

Inside. The average daily dose is 1.5–5 mg, divided into 2–3 doses, usually 0.5–1 mg in the morning and afternoon and up to 2.5 mg at night.

The maximum daily dose is 10 mg.

For sleep disorders - 0.5 mg 20–30 minutes before bedtime.

For the treatment of neurotic, psychopathic, neurosis-like and psychopath-like conditions, the initial dose is 0.5–1 mg 2–3 times a day. After 2–4 days, taking into account effectiveness and tolerability, the dose can be increased to 4–6 mg/day.

In cases of severe agitation, fear, and anxiety, treatment begins with a dose of 3 mg/day, quickly increasing the dose until a therapeutic effect is obtained.

For the treatment of epilepsy - 2–10 mg/day.

For the treatment of alcohol withdrawal - 2–5 mg/day.

In neurological practice for diseases with muscle hypertonicity - 2–3 mg 1–2 times a day.

To avoid the development of drug dependence, during a course of treatment the duration of use of phenazepam is 2 weeks (in some cases, the duration of treatment can be increased to 2 months). When discontinuing the drug, the dose is reduced gradually.

Special instructions
In case of renal/liver failure and long-term treatment, it is necessary to monitor the peripheral blood picture and the activity of liver enzymes.

In patients who have not previously taken psychoactive drugs, a therapeutic response to the use of Phenazepam® in lower doses is observed, compared to patients who have taken antidepressants, anxiolytics, or those suffering from alcoholism.

Like other benzodiazepines, it has the ability to cause drug dependence when taken long-term in large doses (more than 4 mg/day). If you suddenly stop taking it, withdrawal symptoms may occur (including depression, irritability, insomnia, increased sweating), especially with long-term use (more than 8–12 weeks). If patients experience such unusual reactions as increased aggressiveness, acute state of agitation, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficulty falling asleep, light sleep- treatment should be stopped.

Influence on the ability to drive vehicles and operate machinery. During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration and speed of psychomotor reactions.

Overdose of Phenazepam

Symptoms: severe depression of consciousness, cardiac and respiratory activity, severe drowsiness, prolonged confusion, decreased reflexes, prolonged dysarthria, nystagmus, tremor, bradycardia, shortness of breath or difficulty breathing, decreased blood pressure, coma.

Treatment: symptomatic therapy, gastric lavage, prescription activated carbon, control over the vital functions of the body, maintaining respiratory and cardiovascular activity. Hemodialysis is ineffective.

Specific antagonist: flumazenil (in a hospital setting) - 0.2 mg intravenously (if necessary - up to 1 mg) in a 5% glucose solution or 0.9% sodium chloride solution.

Interactions of the drug Phenazepam with other drugs

When used simultaneously, it reduces the effectiveness of levodopa in patients with parkinsonism.

May increase the toxicity of zidovudine.

There is a mutual enhancement of the effect with the simultaneous use of antipsychotic, antiepileptic or sleeping pills, and also central muscle relaxants, narcotic analgesics, ethanol.

Inhibitors of microsomal oxidation increase the risk of developing toxic effects of Phenazepam®. Inducers of microsomal liver enzymes reduce its effectiveness. Increases the concentration of imipramine in the blood serum.

When used simultaneously with antihypertensive drugs, the antihypertensive effect may be enhanced. Increased respiratory depression may occur during concomitant administration of clozapine.

Overdose

Special instructions when taking Phenazepam

Use with caution in case of liver and/or renal failure, cerebral and spinal ataxia, history of drug dependence, tendency to abuse psychoactive drugs, hyperkinesis, organic diseases of the brain, psychosis (paradoxical reactions are possible), hypoproteinemia, sleep apnea(established or suspected), in elderly patients.

In case of renal and/or liver failure and long-term treatment, it is necessary to monitor the peripheral blood picture and the activity of liver enzymes.

Patients who have not previously taken psychoactive drugs exhibit a therapeutic response to the use of phenazepam in lower doses compared to patients taking antidepressants, anxiolytics, or alcoholism.

Like other benzodiazepines, it has the ability to cause drug dependence when taken long-term in large doses (more than 4 mg/day). If you suddenly stop taking it, withdrawal symptoms may occur (including depression, irritability, insomnia, increased sweating), especially with long-term use (more than 8-12 weeks). If patients experience unusual reactions such as increased aggressiveness, acute conditions agitation, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficulty falling asleep, shallow sleep, treatment should be discontinued.

During treatment, patients are strictly prohibited from consuming ethanol.

The effectiveness and safety of the drug in patients under 18 years of age have not been established.

In case of overdose, severe drowsiness, prolonged confusion, decreased reflexes, prolonged dysarthria, nystagmus, tremor, bradycardia, shortness of breath or difficulty breathing, decreased blood pressure, and coma are possible. Gastric lavage and activated charcoal are recommended; symptomatic therapy (maintaining breathing and blood pressure), administration of flumazenil (in a hospital setting); hemodialysis is ineffective.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Storage conditions for the drug Phenazepam

List B: In a dry place, protected from light, at a temperature not exceeding 25 °C.

Shelf life of the drug Phenazepam

The drug Phenazepam belongs to the ATX classification:

N Nervous system

N05 Psycholeptics

Our article will review the drug “Phenazepam”, briefly describe its indications and contraindications for use, and also describe in detail cases of overdose of this medicine and the answer is given to the question of what to do if this happens.

What is the drug “Phenazepam”?

Given medical drug belong to the group of tranquilizers, that is, drugs that have a pronounced sedative effect. Also, the remedy in question can effectively relieve symptoms such as increased anxiety, fears, worries. Main active component medicine “Phenazepam” is, in fact, the substance phenazepam, also each tablet of the named drug contains auxiliary components: lactose, corn starch, magnesium stearate and silicon dioxide. The drug is available in the form of white tablets, each 1 mg. They are sealed in blisters of 10 pieces. The package itself contains, as a rule, 50 tablets.

Indications for use of the drug “Phenazepam”

Please note in what cases this is usually prescribed medicine. Here are some indications for its use:

• increased anxiety and irritability, unreasonable fears;
• obsessive states;
• insomnia;
• withdrawal syndrome (withdrawal syndrome) in alcoholism and drug addiction;
• psychoses.

In general, the range of use of this medicine is quite wide; it is used both for the treatment of schizophrenia and reactive psychoses, and as an induction of anesthesia before surgery.

The drug “Phenazepam”: contraindications for use, side effects

The drug has an extensive list of contraindications for use. So, it is not used if the patient has following states or diseases:

• hypersensitivity to individual components, present in the composition of the drug;
• it cannot be used to treat pregnant and lactating women;
• persons under 18 years of age;
• it is not used to treat severe depression;
• as well as myasthenia gravis, coma, shock, closed glaucoma.

Side effects from using this medical product There may be drowsiness, absent-mindedness, increased fatigue And general weakness. From the gastrointestinal tract - constipation or, conversely, diarrhea, vomiting, nausea, various disorders appetite. May also appear skin rashes caused by an allergy to the drug: itching, urticaria, various rashes and redness of the integument.

The drug “Phenazepam”: dosage for different categories of patients

The dosage of this medicine depends on the specific disease or condition diagnosed in the patient. So, adult dose at the beginning of taking the drug is 0.5-1 mg two or three times a day. The average daily dose for adults is 3-5 mg. The final decision about the exact quantities to take the drug must be made by the doctor. When taking Phenazepam, the dose per day should not exceed 10 mg. Moreover, for sleep disorders and insomnia, 250 to 500 mg is usually prescribed, that is, half or a quarter of a tablet half an hour before bedtime. For epilepsy - 2-10 mg per day, for alcohol or drug withdrawal syndrome - 2-5 mg per day. Please keep in mind that this drug is not sold freely in pharmacies; it can only be purchased with a doctor’s prescription.

The drug “Phenazepam”: overdose. What to do if it happens?

Please note that taking large doses this drug may cause loss of coordination, hand tremors, blurred vision and speech, slow breathing and heart rate. Two last symptom are especially dangerous, therefore the drug “Phenazepam”, an overdose of which can also cause coma, should in no case be taken more than 10 mg per day. If it happened that it was accepted once large number of this medicine, the person must immediately call ambulance or immediately go to the nearest hospital, and go or go there not alone, but accompanied by someone. Usually in medical institutions To weaken the effect of this medicine, drugs based on the substance strychnine are used. They are injected intramuscularly 2-3 times a day. The patient is also prescribed medications that stimulate the functioning of the lungs and heart. The patient should be observed by a doctor for some time. Please note that alcohol greatly affects the effect of the drug “Phenazepam”; an overdose in such cases can occur, even if you have taken the recommended dose of the drug. The thing is that ethanol enhances the suppressive effect of the drug, and also makes toxic and other side effects from taking it more likely. Therefore, be careful; when treating with Phenazepam, alcohol is contraindicated throughout the entire course of use of the drug.

Conclusions and Conclusion

In general, the drug in question is very famous medicine, it has been used to treat patients for decades. It is quite effective and correct dosage does not cause any special side effects, except drowsiness. But it is impossible to say at what exact quantity of a single dose pronounced unwanted effects from the drug “Phenazepam”. An overdose is possible within the recommended 10 mg if you take the drug with alcohol. Also, its effect depends on the age, health and weight of the patient. Therefore, do not take this medicine under any circumstances without a doctor’s recommendation, and strictly follow its instructions. Doctors usually calculate single dose depending on the patient's complaints, as well as many other factors. Self-medication in this case can be life-threatening.