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Azaphen (Pipofezinum, Pipofezine, Azafen) - Tricyclic antidepressants. Reverse blocking presynaptic neuronal uptake of monoamines membranes increases their content in the synaptic cleft leading to relief of the symptoms of depression. Timolepticheskoe effect of the drug combined with sedative activity, and anxiolytic effect. Unlike tricyclic antidepressants anticholinergic properties has no effect on MAO activity, has no cardiotoxicity.
Precautions should be prescribed the drug in patients with chronic heart failure, myocardial infarction, in ischemic heart disease, condition after acute stroke, infectious diseases, diabetes, childhood (not enough data about the use of security).
After the transfer to the MAO inhibitor therapy on Azaphen should be an interval of 2 weeks.
A periodic monitoring of liver and kidney functions.
During treatment, prohibited the use of alcohol.
Effects on ability to drive vehicles and management mechanisms
During treatment, patients should refrain from activities potentially hazardous activities that require increased attention and psychomotor speed reactions, for example, driving a vehicle.
The starting dose for adults is 25-50 mg in 2 divided doses (morning and afternoon). With good tolerance dose gradually increased to 150-200 mg / day (3-4 hours, final reception bedtime), in some cases - to 400 mg / day. The optimal daily dose - 150-200 mg, the maximum daily dose - 400-500 mg. When the desired effect of moving to maintenance doses - 25-75 mg / day. Treatments - up to 1 year (at least 1-1.5 months).
After establishing the optimal daily dose Azaphen using 25 mg tablets, administered Azafen MB (modified-release tablets) 150 mg 1 time (morning) or 2 times (morning and evening) based on efficacy and tolerance.
In an application Azaphen potentiate the effects of ethanol and other CNS depressants, antihistamines iantikoagulyantov.
Reduces the effectiveness of anticonvulsant therapy.
In the in vitro study showed that pipofezine not an inhibitor or inducer isozymes CYP1A2, CYP2C9, CYP2C19, CYP2D6, and of CYP3A4, so it is unlikely Azafen drug interaction with drugs that are substrates of these isoenzymes. Fluvoxamine, propafenone, mexiletine, ciprofloxacin, as inhibitors of CYP1A2, pipofezine can increase the concentration in plasma.
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