Antidepressant: Coaxil (Tianeptine)
Active ingredient: TianeptineSynonyms: Tianeptine, Servier.
The drug belongs to the group of tricyclic antidepressants. Coaxil increases the reuptake of serotonin by the neurons of the cortex of the prepared brain and the hippocampus. Increases the spontaneous activity of pyramidal cells and increases the rate of their recovery after functional suppression.
It activates the pyramidal cells of the cerebral cortex, as well as accelerates the process of recovery of these cells in case of functional damage.
The action of the drug can not be characterized only as a sedative or as a stimulant, it occupies a middle position between these two, seemingly quite opposite effects.
Admission of coaxil helps to improve somatic status: reduces abdominal pain, nausea, dizziness, headaches, increased heart rate, heat, muscle pain.
The drug has a positive effect on the character of patients with chronic alcoholism, which for a long time refrains from drinking alcohol.
Coaxil does not reduce memory, does not worsen sleep, does not reduce concentration, does not affect the cardiovascular system, and the drug is not addictive.
Pharmacokinetics: 94% of the dose of the drug binds to plasma proteins. After taking the tablet, tianeptine is completely and quickly removed from the gastrointestinal tract. The active substance is evenly distributed throughout the body, and its cleavage occurs in the liver. From the body the drug is excreted by the kidneys, the elimination time is 2.5, and in the elderly 3.5 hours. 8% of the drug is excreted unchanged, the rest is recycled.
In patients with renal insufficiency, patients older than 70 years, patients who are treated for various chronic diseases, the time for removing coaxil from the body is increased by 1 hour. Pharmacokinetics does not depend on the state of hepatocytes (with hepatic insufficiency and cirrhosis of the liver).
Indications for use: Coaxil is assigned to patients in a depressed state.
Usage: Take the drug 1 tablet (12.5 mg) in the morning, afternoon and evening before eating. The same dose is prescribed for patients with cirrhosis of alcoholic etiology. Patients with renal insufficiency and patients older than 70 years should take 2 tablets a day (25 mg per day).
Side effects: When taking coaxil, the following side effects may occur: abdominal and stomach pain, dry mouth, decreased appetite, vomiting, nausea, bloating, constipation, insomnia, drowsiness, nightmares, headache, dizziness, fainting, weakness , a feeling of heat and trembling of the whole body or of individual limbs. Also, pain in the chest, rapid heartbeat, irregular heartbeat rhythm, unpleasant sensations during breathing, sensations of "lump in the throat", back pain and muscle pain may appear. However, the described side effects are extremely rare and pass very quickly.
Contraindications: Do not use this medication for children and adolescents under 15 years and patients with intolerance to the components of the drug.
Pregnancy: During pregnancy, it is highly undesirable to take this medication, since the safety of its administration is not confirmed. Since antidepressants are excreted in breast milk, breastfeeding should be interrupted for a while.
Interaction with other drugs: Coaxil should not be used concomitantly with other psychotropic drugs, in particular monoamine oxidase inhibitors. With their joint appointment, there is a high risk of a crisis or sudden increase in blood pressure, fever, seizures, and the likelihood of a fatal outcome. These medicines should not be taken together.
Overdose: In case of an overdose, it is necessary to stop taking a coaxil and monitor the work of the heart, lungs, kidneys, and metabolism in the body. If necessary, rinse the stomach and conduct kidney and general metabolism.
Form release: Coaxil is produced in the form of white coated tablets, in a package of 30 pcs.
Storage conditions: Coaxil is stored at a temperature not exceeding 30 ° in a place inaccessible to children. Shelf life - 3 years, after its expiration, the drug can not be used.
Structure: The composition of the preparation includes:
- active substance - tianeptine sodium 12.5 mg
- auxiliary substances: corn starch, magnesium stearate, talc, white beeswax, sucrose, mannitol, anhydrous colloidal silicon dioxide, baking soda, sodium carboxymethylcellulose, titanium dioxide, ethyl cellulose ether, glycerol-80, polysorbate-80 (Tween 80) and Povidone.
Additionally: At the beginning of treatment with coaxil, patients should be under the constant supervision of doctors, since with depressive states there is the possibility of suicide attempts.
If a patient taking coaxil needs to undergo an operation under general anesthesia, an anesthesiologist-resuscitator should be warned about taking this medication. Treatment should be stopped 24 hours or 2 days before surgery. In emergency cases, the operation can be carried out without canceling the coaxil, but under the vigilant supervision of doctors. It is not recommended to stop the treatment abruptly, it is better if the patient gradually reduces the dosage and within a week or two will completely abandon the drug.
When replacing monoamine oxidase (MAO) inhibitors with a coaxil preparation, a break of 2 weeks is necessary. When replacing the drug coaxil for MAO inhibitors, the break is reduced to 24 hours.
In some cases, attention may be reduced, so patients are advised to give up risk-related activities that require concentration and quick response.