The drug is based on the blockade of acetaldehyde dehydrogenase, which is involved in the metabolism of ethanol. This leads to increasing the concentration of ethyl alcohol metabolite – acetaldehyde causing negative sensations (flushing, nausea, vomiting, tachycardia, decrease in blood pressure (BP) and the like), which make it extremely unpleasant alcohol Lidevina after administration. This buy testosterone suspension leads to a conditioned reflex aversion to the taste and smell of alcoholic beverages. The maximum therapeutic effect is reached within 12 hours after receiving peroralyyugo and may continue for 10-14 days after cessation of treatment. Combination dnsul-Piram with vitamins. The combination of the disulfiram with vitamin B3 and B4 provides a pronounced clinical effect on the reception of even small doses of alcohol, has minimal side effects, reduces the toxicity of disulfiram, provides for prevention of alcoholic polyneuropathy and hypovitaminosis. PharmacokineticsAfter oral absorption of disulfiram from the gastrointestinal tract (GIT) is from 70 to 90%. It is rapidly metabolized, recovering to dithio-carbamate, which he presented as a glucuronyl conjugate or transformed into diethyl-lamin and carbon sulfide, part of which (4-53%) is output from the light.
Treatment and prevention of relapse of chronic alcoholism.
Contraindications Absolute: diseases of the cardiovascular system in the stage of decompensation, hearing (auditory nerve neuritis) and the eye (glaucoma, optic neuritis); asthma, emphysema; pulmonary tuberculosis, severe hepatic impairment, disease-forming organs, diabetes, hyperthyroidism, epilepsy and convulsions of any origin, mental illness, exacerbation of peptic ulcer disease, kidney disease, malignant tumor, polyneuritis any etiology, pregnancy, increased individual sensitivity to the drug. Relative: cardiovascular diseases in the stage of compensation, advanced age (over 60), peptic ulcer and 12 duodenal ulcer in remission, residual effects after cerebrovascular accident, previously transferred teturamnye (precipitates a) psychoses.
Lidevin should be taken with caution in patients with renal insufficiency and hypothyroidism, especially when the risk of a possible combination with alcohol.
Dosage and administration
Treatment is prescribed after careful obsledovashr patient and warning of the consequences and complications. The drug is taken orally by 125-500 mg 2 times a day on an individual scheme (dose calculation being based on disulfiram). After 7-10 days carried disulfiramalkogolnuyu sample (20-30 ml of 40% after administration regia 500 mg) is increased to 10-20 ml (maximum dose of 100 120 ml of vodka) with a weak dose of alcohol of reaction. The sample is repeated every 1-2 days in the hospital and after 3-5 days, outpatient correction doses of alcohol and / or the need for the drug. Further it is possible to use a maintenance dose of 125-200 mg per day for 1-3 years.
Side effects due to the properties of disulfiram:
- Metallic taste in the mouth.
- Unpleasant smell in patients with colostomy (associated with carbon sulfide).
- Rare cases of hepatitis, sometimes found in patients with eczema of nickel, not suffering from alcoholism.
- Polyneuropathy of the lower limbs, optic neuritis.
- Memory loss, confusion, fatigue.
- Skin allergic buy testosterone suspension reactions.
Related to the combination of disulfiram-ethanol:
- Cases of respiratory failure; cardiovascular collapse, cardiac arrhythmias, angina pectoris, myocardial infarction sometimes, and neurological disorders; swelling of the brain.
Complications of chronic administration: rarely psychosis, resembling alcoholic; hepatitis, gastritis; in patients suffering from cardiovascular diseases is possible thrombosis of the brain vessels, so the complaints of paresthesia should stop the drug immediately limbs and face; exacerbation of polyneuritis.
When receiving doses of alcohol of more than 50-80 ml of vodka while taking Lead Evin develop severe disorders of the cardiovascular and respiratory systems, edema, convulsions. In this case urgently carried out detoxication therapy, administered analeptics, symptomatic treatment.
combination with ethanol can cause depression of consciousness up to coma, cardiovascular collapse, neurological complications. Treatment is symptomatic.
Interaction with other medicinal products is contraindicated in combination:
- Alcohol. hypersensitive reaction (flushing, erythema, vomiting, tachycardia).
Avoid taking alcoholic drinks and medicines containing alcohol. Undesirable combinations:
- Isoniazid. Violations of conduct and co-ordination.
- Nitro-5-imidazole (metronndazol, ordinazol, seknidazol, tinidazole). Delirious disorder, confusion.
- Phenytoin. A significant and rapid rise in the level of phenytoin plasma with toxic symptoms (suppression of its metabolism).
If the combination can not be avoided, it is necessary to conduct the clinical observation and monitoring of drug concentrations in plasma during and after treatment Lidevinom. Combinations requiring caution:
- Warfarin (and other oral anticoagulants). The increased effect of oral anticoagulants and risk of bleeding (decrease warfarin collapse of the liver). It is recommended more frequent buy testosterone suspension monitoring of warfarin concentration and dose adjustment of anticoagulants within 8 days after the cancellation Lidevina.
Theophylline. Lidevin inhibits the metabolism of theophylline. As a result, the theophylline dose should be adjusted (reduced dose), depending on the clinical symptoms and the drug concentration in plasma.
- Benzodiazepines. Disulfiram may potentiate the sedative effects of benzodiazepines by inhibiting their oxidative metabolism (especially chlordiazepoxide and diazepam). Benzodiazepine dosage should be adjusted according to the clinical manifestations.
- Tricyclic antidepressants. Perhaps strengthening the reaction of alcohol intolerance (especially if patients on a background of reception Lidevina take alcoholic drinks).