Instruction for use: Hyperici perforati herbae extract

Latin name: Extractum herbae Hyperici perforati (Genus. Extracti herbae Hyperici perforati)

Pharmacological group of the substance of Hyperici perforati herbae extract

Antidepressants

Sedatives

Model clinical-pharmacological article 1

Characteristic. Obtained from the plant is St. John's wort (Hypericum perforatum).

Pharmacotherapy. The drug of plant origin, has antidepressant anxiolytic and sedative effect. Favorably affects the functional state of the central and autonomic nervous system. It is assumed that the drug is able to inhibit the activity of mainly MAO A-type and to some extent - MAO B-type. Bioflavonoids bind to benzodiazepine receptors and have a sedative effect. The drug improves mood, increases mental and physical performance, normalizes sleep. The antidepressant effect is due to the ability to inhibit the reuptake of serotonin, norepinephrine and dopamine.

Pharmacokinetics. Cmax hypericin (the main active substance) after taking 300-900 mg is 7.2-16.6 ng / ml. Css when taken 300 mg 3 times a day is achieved by 7 days, the average value of Css is 8.8 ng / ml. The volume of distribution is 19.7 liters. The total clearance is 0.55 ml / min. T1 / 2 - 37 h.

Indications. Asthenia, depression (including hypochondriac depression, manic-depressive states with suicidal tendencies), feelings of anxiety, anxiety, agitation in skin diseases, pain, trauma and burns.

Contraindications. Hypersensitivity, depression (severe course); simultaneous administration with MAO inhibitors, cyclosporin, indinavir, etc. protease inhibitors, photodermatitis (including in the anamnesis), children's age (up to 12 years), pregnancy, lactation.

Dosing. Inside.

Nonstrustin: 1 capsule 1-2 times a day or 1 ml of solution for ingestion 3 times a day (undiluted or with a small amount of water during meals) for 6-8 weeks.

Hypericum: 1-2 tablets 3 times a day for at least 3 weeks; it is possible to increase the duration of treatment to 3 months (no more).

Gelarium Hypericum: 1 tablet 3 times a day for at least 4 weeks.

Deprim: 1 tablet 3 times a day for 4-6 weeks.

Deprim forte: 1 capsule 1-2 times a day for 4-6 weeks.

Take with food, without chewing, with a small amount of liquid.

Side effect. Allergic reactions: skin itching, skin rash, eczema, skin pigmentation, photosensitivity (more often in HIV-infected patients), increases sensitization to animal wool.

From the side of the central nervous system: anxiety, excessive fatigue, headache.

From the digestive system: nausea, abdominal pain (including in the epigastric region), dry mouth, flatulence, diarrhea or constipation, anorexia.

From the side of the reproductive system: it has a mutagenic effect on spermatozoa and ovules.

On the part of the organs of hematopoiesis: iron deficiency anemia.

Overdose. In the case of chronic intoxication, UV radiation should be avoided for 1-2 weeks.

Interaction. Can suppress the metabolism of LS (inhibitor of microsomal oxidation).

Reduces the effectiveness of indirect anticoagulants (fenprokumona, warfarin), amitriptyline, nortriptyline.

Increases the antidepressant effect of MAO inhibitors, while increasing the risk of developing hypertensive crises (not taken simultaneously with antidepressants (MAO inhibitors), the interval between admission should be at least 14 days.

When combined with fluoxetine, paroxetine, sertraline, fluvoxamine or citalopram, it increases the hemolytic reactions and the course of the "serotonin syndrome" (increased sweating, tremor, dizziness, nausea, vomiting, headache, epigastric pain, anxiety, anxiety, confusion, confusion, feelings of anxiety and irritability).

The drug is able to enhance the photosensitizing effect of other drugs: tetracyclines, sulfonamides, thiazide diuretics, quinolones, piroxicam, etc.

Lengthens sleep caused by drugs for general anesthesia and narcotic analgesics, but shortens sleep caused by barbiturates.

Reduces the hypotensive effect of reserpine.

Reduces the concentration of cyclosporine in the blood.

St. John's wort reduces the concentration in the blood and the effectiveness of indinavir therapy.

With simultaneous use with ethinyl estradiol and desogestrel, the risk of bleeding "breakthrough" increases.

Increases the metabolic rate of theophylline.

Reducing the concentration in the blood of digoxin, reduces its effectiveness.

Special instructions. During the treatment period, care must be taken when driving vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions. During the treatment it is necessary to refrain from using ethanol-containing beverages and for 1-2 weeks, to avoid UV radiation (including solarium, UV lamps, prolonged exposure to sunlight).

In connection with the presence of sorbitol in the solution for each use of the drug in the body receives about 121 mg of sorbitol.