The largest dosage of phenazepam. Real experience with Phenazepam: reviews, clinical studies, instructions

Release form: Solid dosage forms. Pills.

General characteristics. Compound:

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

Excipients: lactose (milk sugar), potato starch, povidone (collidon 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 action.
It has a depressing effect on the central nervous system, which is realized mainly 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 CNS.
The mechanism of action of phenazepam is determined by stimulation of the benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chlorionophore-receptor complex, leading to the activation of GABA receptors, which, in turn, causes a decrease in the excitability of the 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 - from 1 to 2 hours.

Metabolism. Metabolized in the liver.

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

Indications for use:

- neurotic, neurosis-like, psychopathic, psychopathic 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);
— vegetative dysfunctions;
- sleep disorders;
- prevention of states of fear and emotional tension;
- temporal and myoclonic;
- And ;
— ;
- vegetative lability.

Important! Get to know the treatment

Dosage and administration:

The drug should be taken orally. A single dose of Phenazepam is usually 0.5-1 mg.
Medium daily dose Phenazepam is 1.5 - 5 mg, it is 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 at a dose of 0.25-0.5 mg 20-30 minutes before bedtime.
In case of neurotic, psychopathic, neurosis-like and psychopathic conditions, the initial dose of the drug is 0.5-1 mg 2-3 days later, taking into account the effectiveness and tolerability of the drug, the dose can be increased to 4-6 mg / day.
With severe agitation, fear, anxiety, treatment begins with a dose of 3 mg / day, rapidly increasing the dose until you get therapeutic effect.
In epilepsy, the dose is 2-10 mg /
At alcohol withdrawal Phenazepam is prescribed at a dose of 2.5-5 mg /
In diseases with increased muscle tone, the drug is prescribed 2-3 mg 1-2
To avoid the development of drug dependence course treatment the duration of the use of Phenazepam is 2 weeks. In some cases, the duration of treatment can be increased up to 2 months. When canceling npenapat, the dose is reduced gradually.

Application Features:

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

With renal / liver failure And long-term treatment painting needs to be controlled peripheral blood and liver enzymes.

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 /).

With a sudden discontinuation of the drug, a withdrawal syndrome may occur (especially when using the drug for more than 8-12 weeks).

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

Pediatric use
Children, especially young children, are very sensitive to the CNS depressant effects of benzodiazepines.

Influence on the ability to drive vehicles and control mechanisms
Phenazepam is contraindicated for use by drivers of vehicles and other persons performing work that requires quick and accurate reactions.

Side effects:

From the CNS and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, fatigue, impaired concentration, disorientation, slowing down of 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, strax, suicidal tendencies, muscle spasm, sleep disturbance).

From the side digestive system: dry mouth or salivation, loss of appetite, or, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.

From the side reproductive system: decrease or increase in libido,; effect on the fetus - teratogenicity (especially the first trimester), CNS depression, respiratory failure, suppression of the sucking reflex in newborns.

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

Interaction with other drugs:

At simultaneous application Phenazepam with other drugs that cause CNS depression (including hypnotics, anticonvulsants, neuroleptics), one should take into account the mutual enhancement of their action.
With the simultaneous use of Phenazepam with levodopa in patients with parkinsonism, the effectiveness of the latter is reduced.
With the simultaneous use of Phenazepam with zidovudine, the toxicity of the latter may increase.
With the simultaneous use of Phenazepam with inhibitors of microsomal oxidation, the risk of developing toxic effects Phenazepam.
With the simultaneous use of Phenazepam with inducers of microsomal liver enzymes, the effectiveness of Phenazepam decreases.
With the simultaneous use of Phenazepam with imipramine, the concentration of the latter in the blood serum increases.
With the simultaneous use of Phenazepam with antihypertensive drugs may increase the severity of antihypertensive action.
With the simultaneous use of Phenazepam with clozapine, respiratory depression may increase.

Contraindications:

- coma;
- shock;
- myasthenia gravis;
— (acute attack or predisposition)
- severe COPD (possibly increased respiratory failure);
— ;
- pregnancy (especially the first trimester);
- period breastfeeding;
- children's and adolescence up to 18 years (safety and efficacy not determined);
— hypersensitivity to benzodiazepines.

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

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

The use of the drug immediately before childbirth or during childbirth can cause respiratory depression in the newborn, a decrease in muscle tone, hypotension, hypothermia, weakening of the act of sucking ("sluggish baby" syndrome).

Application for violations of liver function
The drug should be used with caution when.

Application for violations of kidney function
The drug should be used with caution when kidney failure.

Use in elderly patients
It is necessary to use the drug with caution in elderly and debilitated patients.

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

Overdose:

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

Treatment: vital control important functions body, maintaining respiratory and cardiovascular activity, symptomatic therapy. As antagonists of the muscle relaxant action of Phenazepam, strychnine nitrate is recommended (injections of 1 ml of a 0.1% solution 2-3). As a specific antagonist, flumazenil (anexat) can be used: i.v. 0.2 mg (if necessary, the dose can be increased to 1 mg) in 5% glucose (dextrose) solution or 0.9% sodium chloride solution.

Storage conditions:

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

Leave conditions:

On prescription

Package:

10 pieces. - cellular contour packings (5) - packs of cardboard.
25 pcs. - cellular contour packings (2) - packs of cardboard.
50 pcs. - polymer cans (1) - packs of cardboard.

Name:

Phenazepam (Phenazepaitium)

Pharmacological
action:

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

Indications for
application:

Phenazepam prescribed for:
- various neurotic,
- neurosis-like,
- psychopathic and psychopathic states,
- accompanied by anxiety
- fear,
- increased irritability
- emotional lability (instability).
The drug is effective with obsession, phobia (fear), hypochondriacal syndromes(depressed state due to fear for one's health), including resistant (resistant) to the action of other tranquilizers, is also indicated for psychogenic psychosis, panic reactions, etc., as it relieves anxiety and fear. Phenazepam is not inferior to some neuroleptics (drugs that have an inhibitory effect on the central nervous system and in usual doses non-hypnotic effect).
Phenazepam is also used for the relief (removal) of 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. By the strength of the hypnotic action, it approaches eunoctin.
It can also be used in preparation for surgery.

Mode of application:

V / m or / in(jet or drip).

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

With 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 intramuscularly or intravenously at a dose of 0.5 mg, 1 time per day (0.5–1 ml of a 0.1% solution).

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

Premedication: in / in slowly 3-4 ml of a 0.1% solution.

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

After achieving a stable therapeutic effect, it is advisable to switch to taking oral 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, pruritus, rash, nausea, constipation, impaired menstrual cycle, decreased libido, muscle weakness. If side effects develop, phenazepam is discontinued.

Contraindications:

Impaired liver and kidney function, myasthenia gravis, pregnancy.

Interaction
other medicinal
by other means:

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

Pregnancy:

The drug is contraindicated during pregnancy.

Phenazepam - medicinal product benzodiazepine groups. It suppresses the activity of the central nervous system, pointwise affecting such brain structures as the thalamus and hypothalamus, as well as the limbic system.

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

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 has a decrease in emotional stress, anxiety, anxiety, glimpses positive attitude, depression and obsessive fears go away.

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

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

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

Indications for use

What helps Phenazepam? The drug is prescribed for the following diseases or states:

• Psychopathic, 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;
• Vegetative 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. With schizophrenia, high sensitivity to antipsychotic medications. It is used for resistance to various tranquilizers.

Instructions for use Phenazepam and dosage

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

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

For the treatment of psychopathic, neurosis-like and psychopathic 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, in diseases with increased muscle tone, the drug is prescribed intramuscularly at 0.5 mg 1 or 2 times / day.

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

In epilepsy, Phenazepam is administered by injection intramuscularly or intravenously, starting with a dose of 0.5 mg.

For the treatment of alcohol withdrawal - inside, 2-5 mg / day or / m, 0.5 mg 1-2 times a day, with vegetative paroxysms - / m, 0.5-1 mg.

The average daily dose is 1.5-5 mg, it is 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, in diseases with muscle hypertonicity, 2-3 mg are prescribed 1 or 2 times a day.

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

Phenazepam in the form of tablets is prescribed for oral administration, in stationary conditions daily dosage the drug is up to 4 mg, for therapy convulsive conditions with 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.

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

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

Contraindications

The appointment of Phenazepam is contraindicated in the following cases:

• Coma;
• myasthenia;
• COPD (possibly increased respiratory failure);
• severe form of depression;
• Angle-closure glaucoma;
• Poisoning with analgesics or acute alcohol poisoning;
• Acute respiratory failure;
• I trimester of pregnancy;
• Children under 18;
• With lactation;
• Intolerance to benzodiazepines.

Be wary appoint when:

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

Side effects

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

• drowsiness, fatigue, dizziness, impaired concentration, ataxia, disorientation, slowing down of 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 gravis, dysarthria;
• very rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, anxiety, sleep disturbance).

Other side effects:

• leukopenia, neutropenia, agranulocytosis;
• anemia, thrombocytopenia;
• dry mouth or drooling, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea;
• abnormal liver function, increased activity of hepatic transaminases and alkaline phosphatase, jaundice;
• urinary incontinence, urinary retention, impaired renal function;
• decreased or increased libido, dysmenorrhea;
• effect on the fetus - teratogenicity (especially the first trimester), CNS depression, respiratory failure, suppression of the sucking reflex in newborns whose mothers used the drug during pregnancy;
• skin rash, itching;
• addiction, drug dependence, lowering 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 to increase all side effects, as well as failure of breathing and heart rate.

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 lactation.

drug interaction

• Simultaneous use with Levodopa preparations leads to a decrease therapeutic effect the latter;
• Simultaneous use with Imipramine leads to an increase in the plasma concentration of the latter;
• Simultaneous use with Zidovudine leads to an increase in the toxicity of the latter;
• Simultaneous use with antiepileptic drugs, sleeping pills, drugs, preparations containing ethanol or alcoholic drinks, leads to a sharp increase in the therapeutic effect of the latter;
• With simultaneous use 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 preparations, list:

1. Tranquezipam
2. Fezipam
3. Phenazepam-Ros
4. Phenorelaxan
5. Elzepam

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

The average price in pharmacies is 497-520 rubles.

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

Analogues

These are drugs belonging to the same pharmaceutical group, which 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 solution for infusion
• - Nasal drops
• - Tablets 250 mg

Indications for the use of the drug Phenazepam

Neurotic, neurosis-like, psychopathic and psychopathic and other states (irritability, anxiety, nervous tension, emotional lability), reactive psychoses and senesto-hypochondriac disorders (including those resistant to the action of other anxiolytic drugs (tranquilizers), obsession, insomnia, withdrawal syndrome(alcoholism, substance abuse), status epilepticus, epileptic seizures (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 introductory anesthesia).

Release form of the drug Phenazepam

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

Compound
Tablets 1 tab.
bromd0.5 mg, 1 mg, 2.5 mg
(in terms of 100% substance)
Excipients: lactose (milk sugar); potato starch; povidone (Kollidon 25); calcium stearate; talc
in a blister pack 10 or 25 pcs.; in a cardboard pack 2 (25 pcs.) or 5 (10 pcs.) packs; or in polymer cans of 50 pcs., in a cardboard pack 1 can.

Pharmacodynamics of the drug Phenazepam

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

Enhances 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 intercalary neurons lateral horns spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

The anxiolytic effect is due to the effect on the amygdala complex of the limbic system and is manifested in a decrease in emotional stress, weakening anxiety, fear, anxiety.

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

On productive symptoms of psychotic origin (acute delusional, hallucinatory, affective disorders) has practically no effect, a decrease in affective tension, 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 spread of the convulsive impulse, but the excited state of the focus is not removed. The central muscle relaxant effect is due to the 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 Phenazepam

After oral administration, it is well absorbed from the gastrointestinal tract, Tmax - 1-2 hours. It is 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, the use is possible only for health reasons. It has a toxic effect on the fetus and increases the development of congenital malformations when used in the first trimester of pregnancy. Admission to therapeutic doses in later pregnancy may cause CNS depression in the newborn. Chronic use during pregnancy may result in physical addiction with the development of withdrawal syndrome in the newborn. Children, especially in younger age are very sensitive to the CNS depressant action of benzodiazepines.

Use immediately before or during labor may cause respiratory depression, reduced muscle tone, hypotension, hypothermia, and poor suckling (sluggish baby syndrome) in the newborn.

Contraindications to the use of the drug Phenazepam

Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute poisoning alcohol (with a weakening of vital functions), narcotic analgesics and hypnotics, severe COPD (respiratory failure may increase), acute respiratory failure, severe depression (suicidal tendencies may occur); I trimester of pregnancy, lactation, children and adolescents under 18 years of age (safety and efficacy 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, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, gait instability, mental and motor reactions slowdown, confusion; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements (especially at high doses), mood depression, dystonic extrapyramidal reactions (uncontrolled movements, including the eyes), asthenia, myasthenia gravis, dysarthria, epileptic seizures (in patients with epilepsy); extremely rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia).

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

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

From the side genitourinary system: urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.

Allergic reactions: skin rash, itching.

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

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

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

Dosage and administration of Phenazepam

inside. The average daily dose is 1.5–5 mg, it is 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 psychopathic 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 can be increased to 4-6 mg / day.

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

In 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.

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

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

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

Like other benzodiazepines, it has the ability to cause drug dependence with long-term use in high doses (more than 4 mg / day). With a sudden cessation of administration, a “withdrawal” syndrome 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, an acute state of arousal, a feeling of fear, suicidal thoughts, hallucinations, increased muscle cramps, difficulty falling asleep, superficial sleep- treatment should be stopped.

Influence on the ability to drive vehicles and control mechanisms. During the period of treatment, care must be taken when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration of attention 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 shortness of breath, decreased blood pressure, coma.

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

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

Interactions of the drug Phenazepam with other drugs

With simultaneous use reduces the effectiveness of levodopa in patients with parkinsonism.

May increase zidovudine toxicity.

There is a mutual enhancement of the effect with the simultaneous use of antipsychotic, antiepileptic or sleeping pills, and 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.

With simultaneous use with antihypertensive agents, it is possible to increase the antihypertensive effect. Against the background of the simultaneous appointment of clozapine, it is possible to increase respiratory depression.

Overdose

Special instructions for taking Phenazepam

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

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

In patients who have not previously taken psychoactive drugs, there is a therapeutic response to the use of phenazepam at lower doses, compared with patients taking antidepressants, anxiolytics or suffering from alcoholism.

Like other benzodiazepines, it has the ability to cause drug dependence with long-term use in high doses (more than 4 mg / day). With a sudden cessation of administration, a withdrawal syndrome may occur (including depression, irritability, insomnia, increased sweating), especially with prolonged use (more than 8-12 weeks). If patients experience unusual reactions such as increased aggressiveness, acute conditions agitation, fear, suicidal thoughts, hallucinations, increased muscle cramps, difficulty falling asleep, superficial sleep, treatment should be discontinued.

In the process of treatment, patients are strictly prohibited from using ethanol.

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

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

Influence on the ability to drive vehicles and control mechanisms

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

Storage conditions of the drug Phenazepam

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

Shelf life of the drug Phenazepam

Phenazepam belongs to the ATX classification:

N Nervous system

N05 Psycholeptics

In our article, the drug "Phenazepam" will be considered, its indications and contraindications for use are briefly given, and cases of overdose are described in detail. this medicine and the answer to the question of what to do if it happened.

What is the drug "Phenazepam"?

The medical preparation belongs to the group of tranquilizers, that is, drugs that have a pronounced sedative effect. Also, the agent in question is able to effectively relieve symptoms such as increased anxiety, fears, anxiety. Main active ingredient the drug "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 soldered in blisters of 10 pieces. The package itself contains, as a rule, 50 tablets.

Indications for the use of the drug "Phenazepam"

Pay attention to the cases in which this is usually prescribed medicine. Here are some indications for its appointment:

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

In general, the range of application of this drug is quite wide, it is used both for the treatment of schizophrenia and reactive psychoses, and as an introductory 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 can not 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 the use of this medical device may be drowsiness, distraction, fatigue And general weakness. From the gastrointestinal tract - constipation or, conversely, diarrhea, vomiting, nausea, various violations appetite. They may also appear skin rashes caused by an allergy to the drug: itching, urticaria, various rashes and reddening of the integument.

The drug "Phenazepam": dosage for different categories of patients

The dosage of this medicine depends on which disease or condition is diagnosed in the patient. So, adult dose at the beginning of 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 on exactly how much to take the drug should be taken by the doctor. When taking the drug "Phenazepam" dose per day should not exceed 10 mg. At the same time, for sleep disorders, insomnia, usually prescribed from 250 to 500 mg, that is, half or a quarter of the tablet half an hour before bedtime. With epilepsy - 2-10 mg per day, with alcohol or drug withdrawal syndrome - 2-5 mg per day. At the same time, keep in mind that this drug is not sold freely in a pharmacy, it can only be purchased with a doctor's prescription.

The drug "Phenazepam": overdose. What to do if it happened?

Please note that taking large doses this drug can cause impaired coordination, trembling of the hands, impaired vision and speech, slow breathing and heartbeat. Two recent symptom are especially dangerous, therefore the drug "Phenazepam", an overdose of which can also cause coma, in no case should you take more than 10 mg per day. If it happened that a one-time was taken a large number of of this medicine, the person immediately needs to call ambulance either immediately go to the nearest hospital, and go or go there not on your own, but accompanied by someone. Usually in medical institutions to weaken the effect of this drug, drugs based on the substance strychnine are used. They are injected intramuscularly 2-3 times a day. Also, the patient is prescribed drugs that stimulate the functioning of the lungs and heart. For some time, the patient should be observed by a doctor. Please note that alcohol greatly affects the effect of 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 inhibitory effect of the drug, and also makes it more likely to have toxic and other side effects from taking it. Therefore, be careful, when treating with Phenazepam, alcohol is contraindicated during the entire course of the drug.

Conclusions and conclusion

In general, the drug in question is very known medicine, it has been used to treat patients for more than a dozen years. It is quite efficient and correct dosage does not cause any special side effects, except for drowsiness. But it is impossible to say at what exact number of single doses pronounced unwanted effects from Phenazepam. An overdose is also possible within the recommended 10 mg if you took the drug along with alcohol. Also, its effect depends on the age, health status and weight of the patient. Therefore, in no case should you take this medicine without the advice of a doctor, and also strictly follow his instructions. Physicians usually count single dose depending on the patient's complaints, as well as many other factors. Self-medication in this case can be life-threatening.