Nakom tabs #100

Instruction for Nakom

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Composition

In 1 tablet contains active substances: levodopa in an amount of 250 mg and carbidopa at a rate of 25 mg. The drug also contains additional substances: starch, microcrystalline cellulose, magnesium stearate and colorant.

Form of issue

Nakom is available in tablet form.

pharmachologic effect

Antiparkinsonian means.

Pharmacodynamics and pharmacokinetics

The main components: levodopa (is a precursor of dopamine), carbidopa (is an inhibitor of decarboxylase aromatic amino acids).
The antiparkinsonian effect of levodopa is based on the transformation of the main substance in the central nervous system into dopamine, which makes it possible to fill the lack of dopamine in the nervous system. Nak removes tremors, stiffness, drooling, hypokinesia, dysphagia.
Dopamine, formed in peripheral tissues, does not participate in the implementation of the antiparkinsonian effect of levodopa, it responds to the severity of the side effects of the drug.
Carbidopa is an inhibitor of peripherally located dopa-decarboxylase. Carbidopa reduces the production of dopamine in peripheral tissues, which leads to an increase in the amount of levodopa that enters the central nervous system. The optimal combinations of levodopa and carbidopa are 4: 1, 10: 1.
Nakom starts to act in a day, the full therapeutic effect is achieved within a week.

Indications for use

Nakom appointed in the syndrome of Parkinsonism, Parkinson's disease, with Parkinson's syndrome, caused by intoxication with toxic substances, methane, carbon monoxide, against cerebrovascular diseases.

Contraindications

Nakom does not apply to psychoneurosis, severe form of psychosis, with closed angle glaucoma, intolerance to levodopa, carbidopa, breastfeeding, skin diseases of unknown etiology, melanoma, gestation.
With pathology of the pulmonary system, with erosive and ulcerative lesions of the digestive tract, with epileptic seizures, bronchial asthma, myocardial infarction with rhythm disturbances, with severe liver pathology, renal system, with decompensated forms of endocrine diseases, with diabetes mellitus, NAC CHF is used with caution.

Side effects

At the beginning of therapy, dyspeptic disorders, vomiting, nausea, epigastric pain, ulcerogenic effects, dysphagia are possible. Orthostatic hypotension, rhythm disturbances are rarely noted.
Against the background of long-term treatment, hyperkinesis, spontaneous movements, dyskinesia are noted. Rarely recorded depression, increased excitability, insomnia, mental disorders, thrombocytopenia, hemolytic anemia, leukopenia, constipation, tachycardia, weight gain.
Nakom, instructions for use (Method and dosage)
According to the instructions for use, the drug is taken 2-3 times a day for ¼ tablet inside. Gradually, the dose is increased every 3 days by ¼ tablets until the optimal effect is achieved.
Average therapeutic dosage is 1-2 tablets per day.
It is inadmissible to take more than 1.5 g of levodopa, 150 mg of carbidopa, which corresponds to 6 tablets.

Overdose

Overdose become more severe side effects.
Attention should be paid to the occurrence of arrhythmia, in the case of which, a special antiarrhythmic therapy is performed.

Interaction

Violation of the heart rhythm is observed with the simultaneous use of dithilin, beta-adrenostimulants, medicines for inhalation anesthesia.
Tricyclic antidepressants reduce the bioavailability of one of the active components - levodopa.
Clozepine, diazepam, m-holinoblokatory, clonidine, phenytoin, neuroleptics, thioxanthene, diphenylbutylpiperidine, phenothiazine, reserpine, papaverine, pyridoxine reduce the antiparkinsonian effect of the drug.
Hallucinations and dyskinesias are noted with the appointment of lithium preparations.
Methyldopa aggravates the side effect.
MAO inhibitors lead to impaired blood circulation, which is associated with the accumulation of norepinephrine and dopamine under the influence of levodopa, an increase in blood pressure.
When taking tubocurarine, there is a marked drop in blood pressure.

Storage conditions

In a dark, dry, sheltered from children place at a temperature of no more than 25 degrees Celsius.
Shelf life - not more than three years.

special instructions

It is unacceptable to abruptly cancel the drug Nakom because of the risk of developing a symptom complex that is similar to a malignant, neuroleptic syndrome: increased serum CK, abnormalities in the psyche, increased body temperature, muscle rigidity.
Patients who take antipsychotic medications or abruptly discontinue treatment need special supervision. The drug is not used to eliminate extrapyramidal reactions associated with taking medications.
Nakom therapy requires monitoring of peripheral blood, assessing the patient's mental health. When eating high protein foods, there may be a violation of absorption of the drug. Patients with glaucoma require monitoring of intraocular pressure.
Tablets should be taken with food, washed down with water if necessary, not chewed. Long-term treatment requires evaluation of the cardiovascular system, kidneys, hematopoiesis, liver. Nakom take on the scheme before the planned operation, as well as immediately after it.
The drug affects the management of motor vehicles, reduces the speed of psychomotor reactions.

Reviews about Nakom

Has positive reviews in the treatment of parkinsonism. Side effects usually appear weakly. There are opinions that over time the medicine may stop helping.