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Ixel (Milnacipranum, Milnaciprane) - activating antidepressant action. It inhibits the reuptake of norepinephrine and serotonin. It has affinity for nicotinic acetylcholine receptor m, a1-adrenergic receptors, histamine H1 receptors, and dopamine, benzodiazepine and opioid receptors.
With care prescribe a drug to patients with a history of seizures, hypertensive cardiomyopathy.
Ixel can be administered no earlier than 14 days after discontinuation of MAO inhibitors. Also from the time of withdrawal of the drug Ixel before the MAO inhibitor therapy should be at least 7 days.
To reduce the severity of side effects gradual increase recommended dose.
When conducting on background therapy with a local anesthetic Ixel preparations containing epinephrine or norepinephrine, anesthetic dose should not exceed 0.1 mg per 10 minutes, and 0.3 mg for 1 h.
During treatment Ixelles should not drink alcohol.
Effects on ability to drive and management mechanisms
During the period of the drug should refrain from activities potentially hazardous activities that require increased attention and rapid psychomotor reactions.
CNS: anxiety, dizziness; rarely - a tremor.
From the digestive system: rarely - dry mouth, nausea, vomiting, constipation; in rare cases - moderate increase in transaminases.
Other: rarely - palpitations, increased sweating, flushing, difficulty urinating; in rare cases - serotonergic syndrome.
Side effects are rare, especially during the first 2 weeks of treatment, usually self-cropped as regression of depressive symptoms and do not require discontinuation of therapy.
With simultaneous use of Ixelles with MAO inhibitors, sumatriptan, lithium therapy there is a risk of serotonin syndrome.
Concomitant use of Ixelles with adrenaline and noradrenaline can provoke the development of hypertensive crisis and cardiac arrhythmias.
When concomitantly with digoxin (especially with parenteral administration) there is a risk of potentiation of haemodynamic disorders.
In an application Ixel inhibit the hypotensive effect of clonidine and its derivatives.
The average daily dose is 100 mg; the drug should be taken in 2 divided doses in the morning. Depending on the severity of symptoms the dose can be increased to 250 mg.
The drug is preferably taken with meals.
The duration of therapy is determined individually.
In patients with renal failure to reduce the dose depending on the creatinine clearance values.
Symptoms: Accidental increasing doses - nausea, vomiting, sweating, and constipation. Before the drug at a dose exceeding 800-1000 mg - vomiting, shortness of breath, tachycardia. Upon receiving excessively high dose (1900-2800 mg milnacipran) in combination with other psychotropic drugs (mostly benzodiazepines) the symptoms described above are added drowsiness, hypercapnia, disturbances of consciousness.
Treatment: gastric lavage, symptomatic therapy. Recommended medical surveillance of the patient for at least a day. No specific antidote.
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