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Numed medicine is made in the form of capsules, with the main ingredient being Sulpiride. The drug is used in the short-term treatment of adult anxiety, severe behavioral disorders,...
1. What is Numed?
What is the use of Numed? The main ingredient of Numed is Sulpiride 200mg. Sulpiride belongs to the group of benzamides, which resemble neuroleptics in some of the brain's dopamine receptor antagonist properties. One of the properties of Sulpiride is its dual activity, which includes antidepressant and neuroleptic properties. The drug is remarkably effective for people with schizophrenia characterized by a lack of social contact. After a few days of taking the drug, the patient's mood improved, then the schizophrenic symptoms gradually disappeared.
Indications for the use of Numed:
Treatment of acute and chronic schizophrenia. Contraindications to using Numed:
Patients with hypersensitivity to Sulpiride or other components of the drug; Patients with pheochromocytoma, acute porphyria; Patients with prolactin-dependent tumors such as breast or pituitary tumors; In combination with levodopa or antiparkinsonian drugs (including ropinirol).
2. Instructions on how to use Numed
Usage: Orally.
Dosage:
Dosage in adults:
Usual starting dose: 400 - 800mg/day, take 1-2 tablets/time x 2 times/day (morning and early afternoon); Positive symptoms of schizophrenia: The minimum starting dose is 400mg/time x 2 times/day. May increase to a maximum dose of 1200m/time x 2 times/day if necessary; Negative symptoms of schizophrenia: Initial dose is 400mg/time x 2 times/day. Reducing the dose to 200mg/time x 2 times/day will normally increase the warning effect of the Sulpiride component; Combined positive and negative symptoms: 400-600mg/time x 2 times/day. Dosage in other subjects:
Children: There is no clinical experience in children under 14 years of age; Elderly: Use the same dose range as adults. In patients with evidence of renal impairment, the dose should be reduced; Patients with renal impairment: The dose should be reduced or the interval between doses of Numed increased depending on creatinine clearance. If Clcr (creatinine clearance 30 - 60ml/min, use 2⁄3 of the usual dose; Clcr 10 - 30ml/min, use 1/2 the usual dose; Clcr less than 10ml/min, use 1 dose of 1 ⁄3 usual doses Or the interval between doses can be increased by 1.5 - 2 - 3 times compared with normal people. In case of moderate and severe renal impairment, Sulpiride may not be used if possible. Overdosage: There is not much experience in the management of Sulpiride overdose. Single dose range of toxicity is 1 - 16g but no deaths at 16g doses have been reported. There have been reports of deaths mainly due to overdose. Combining Sulpiride with other psychotropic drugs Some symptoms of poisoning due to overdose include: Restlessness, confusion, extrapyramidal symptoms, agitation, coma, hypotension,...
How to handle is hemodialysis (partial elimination of Sulpiride) At the same time, appropriate support, monitoring of the heart and vital functions should be made until the patient recovers.If severe extrapyramidal symptoms occur, the patient should be treated. patients taking anticholinergic drugs. In addition, overdose can be treated with an alkaline osmotic diuretic and anti-parkinsonian drugs if necessary. In comatose patients, appropriate care should be taken, with cardiac monitoring until the patient recovers.
Missed dose: When forgetting to take a dose of Numed, the patient should take it as soon as possible. If it is almost time for your next dose, skip the missed dose and take your next dose at the pre-scheduled time.
3. Numed . side effects
When using Numed, patients may experience some side effects such as:
Common: Hyperprolactinemia, insomnia, drowsiness or sedation, extrapyramidal disorders (usually reversible with anti-parkinsonian drugs). ), tremor, Parkinson's syndrome, restlessness, increased liver enzymes, maculopapular skin rash, breast tenderness, increased lactation, weight gain; Uncommon: Leukopenia, dystonia, hypertonia, dyskinesia, orthostatic hypotension, increased salivation, amenorrhea, breast enlargement, abnormal orgasm, dysfunction Erectile; Rare: Eye rotation, ventricular arrhythmia, ventricular tachycardia, ventricular fibrillation; Frequency not known: Agranulocytosis, neutropenia, urticaria, dyspnoea, anaphylactoid reactions, hypotension and anaphylaxis, confusion, neuroleptic malignant syndrome, dyskinesia delayed, decreased motor function, convulsions, QT prolongation on electrocardiogram, sudden death, cardiac arrest, torsades de pointes, pulmonary embolism, venous thrombosis, hypertension, deep vein thrombosis, jaw stiffness, torticollis, neonatal withdrawal syndrome, extrapyramidal symptoms, gynecomastia in men. When experiencing side effects of Numed, patients should stop taking the drug and immediately notify the doctor or go to the nearest hospital for quick and timely treatment.
4. Notes when using Numed
Some notes patients need to remember before and while using Numed:
A small number of patients have increased motor agitation. During the aggressive, agitated or agitated phase of the disease, low doses of sulpiride may worsen symptoms. Caution should be exercised in the presence of hypomania; Extrapyramidal reactions (mainly sedation and restlessness) have occurred in a small number of patients. If necessary, reduce the dose or use anti-Parkinson drugs; There have been some cases of using Numed with neuroleptic malignant syndrome (potentially fatal complication) characterized by manifestations of hyperthermia, altered consciousness, muscle stiffness, autonomic dysfunction, elevated CPK levels,... All antipsychotic drugs (including Sulpiride) should be discontinued when the above symptoms occur or the patient has a high fever of unknown cause; Elderly patients are prone to postural hypotension, extrapyramidal effects and sedation caused by sulpiride. Therefore, caution should be exercised when using Numed for this group of subjects; Sulpiride can be used together with sedation in patients with aggressive, agitated, impulsive behavior; Abrupt discontinuation of Numed may cause nausea, vomiting, sweating and insomnia, recurrence of psychiatric symptoms, and involuntary movement disorders (sitting or lying restless). , dyskinesia, dystonia). Therefore, the drug should be discontinued gradually; Elderly people with dementia treated with Numed have an increased risk of death. Therefore, do not use Sulpiride to treat behavioral disorders related to dementia; Use of Sulpiride can cause venous thromboembolism. Therefore, risk factors for VTE should be identified prior to sulpiride therapy and appropriate precautions taken; Sulpiride may increase prolactin levels, so caution and close monitoring should be exercised when treating with Numed in patients with a history or family history of breast cancer; The effectiveness and safety of Sulpiride in children has not been fully studied, so caution should be exercised when giving it to children; Sulpiride may be used, but caution should be exercised in neuroleptic treatment in patients with Parkinson's disease; Caution is advised when prescribing Numed to patients with unstable epilepsy, closely monitoring patients with a history of epilepsy during treatment with Sulpiride. The dose of anticonvulsants should not be changed in patients requiring sulpiride and receiving anticonvulsant therapy; Sulpiride has anticholinergic effects and should be used with caution in patients with a history of glaucoma, urinary retention, intestinal obstruction, congenital gastrointestinal stenosis or prostatic hyperplasia. The drug is eliminated mainly by the kidneys, so it is necessary to adjust the dose in small steps, reduce the dose in patients with renal impairment; Sulpiride prolongs the QT interval, which may pose a risk of serious ventricular arrhythmias such as torsades de pointes. Before using Sulpiride, patients should be monitored for risk factors for arrhythmias (bradycardia below 55 beats/min, electrolyte imbalance - especially hypokalemia), congenital prolongation of the QT interval. , are taking a drug that can cause bradycardia, hypokalemia, prolongation of the QTc interval, or decreased intracardiac conduction). Sulpiride should be used with caution in patients with the above factors and in those with cardiovascular disorders (which may lead to QT prolongation). Concomitant treatment of Sulpiride with other neuroleptics should be avoided; Sulpiride should be used with caution in patients at risk of stroke, because of the increased risk of cerebrovascular accident; There have been cases of using Sulpiride causing leukopenia, neutropenia, agranulocytosis. Unexplained bacterial infections or fever are signs of a hematopoietic disorder, requiring immediate hematologic testing. Sulpiride should be used with caution in hypertensive patients, especially the elderly. Patients should be monitored for appropriate health; Numed medicine contains lactose, so people with galactose intolerance, glucose - galactose malabsorption or lactase lactase deficiency should not take the drug; Sulpiride can cause drowsiness, reduce alertness, so caution should be exercised when using the drug in people working at height, driving, operating machinery,...; Sulpiride is not recommended during pregnancy and lactation.
5. Numed drug interactions
Some drug interactions of Numed include:
Contraindicated to use the combination of Sulpiride with Levodopa, anti-parkinsonian drugs (including ropinirol) because of their antagonistic effects; The combination of Sulpiride and: Alcohol is not recommended because alcohol increases the sedative effect of Sulpiride; Drugs that can cause torsades de pointes, prolong the QT interval such as: Drugs that slow the heart rate (beta blockers, calcium channel blockers that slow the heart rate such as diltiazem, verapamil, clonidine; digitalis); drugs that cause electrolyte imbalance, especially those that cause hypokalemia (stimulant laxatives, hypokalemic diuretics, glucocorticoids, tetracosactide, amphotericin B IV); class 1a antiarrhythmic drugs (quinidine, disopyramide); class III antiarrhythmic drugs (amiodarone, sotalol); other drugs (pimozide, haloperidol, methadone, lithium, cisapride, thioridazine, IV erythromycin, antidepressant imipramine, halofantrin, pentamidine); Caution should be exercised when using Sulpiride in combination with: Antihypertensives because of the enhanced hypotensive effect and the risk of orthostatic hypotension; CNS depressants: Analgesics, hypnotics, tranquilizers, hypnotic H1 antihistamines, benzodiazepines, other neuroleptics, clonidine and derivatives; Antacids or sucralfate because they reduce the absorption of Sulpiride if used concurrently. Therefore, Sulpiride should be taken 2 hours before taking these drugs; Lithium because Lithium increases the risk of extrapyramidal side effects, if taken concomitantly with Sulpiride. At the first sign of neurotoxicity, both drugs should be discontinued. When using Numed, the patient should strictly follow the instructions of the doctor. Compliance with the indications will ensure that the drug promotes the best therapeutic effect, avoiding the risk of dangerous side effects.
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