Side effects of phenazepam. Safe dose of phenazepam

What kind of drug is phenazepam?

International name and mechanism of action of phenazepam

The mechanism of the therapeutic effect of phenazepam is due to its effect on neuronal activity ( nerve cells ) brain. When the drug interacts with specific receptors ( so-called regulatory centers) it inhibits certain neurons, inhibits the processes of transmission of nerve impulses through them, thereby inhibiting their activity. As a result of this, the severity of all processes in the human brain slows down, which determines the manifestation of the clinical effects of the drug.

Phenazepam has:

• Anxiolytic ( anti-anxiety) action. The drug inhibits the activity of the part of the brain responsible for the occurrence of emotions, thereby eliminating feelings of anxiety, fear and emotional distress.
• Calming effect. By eliminating feelings of anxiety and fear, the drug stabilizes emotional condition the patient, as a result of which he becomes calmer and less susceptible to various external influences.
• Hypnotic effect. Inhibition of brain activity also helps facilitate the process of falling asleep and reduces the frequency of night awakenings, especially along with anti-anxiety and sedative effects.
• Muscle relaxant ( relaxing muscles) action. Phenazepam inhibits the activity of nerve cells responsible for maintaining muscle tone, resulting in muscle human body partially relax.
• Anticonvulsant effect. Cramps are uncontrolled, extremely painful contractions of the muscles of the human body. They can occur when various diseases, for example, in epilepsy. The mechanism of occurrence of seizures is due to the appearance of a pathological focus of excitation in those brain cells that are responsible for muscle contractions. Phenazepam blocks the excitation of nerve cells in this area, thereby interrupting seizure activity and reducing the risk of developing seizures in the future.

How long does it take for phenazepam to start working, how long does it last and how long is it eliminated from the body?

At the same time, it is worth noting that the duration of action of a single dose of the drug is from 6 to 12 hours, regardless of the route of administration. After a specified period of time, the active substance is neutralized ( mainly in the liver) and excreted from the body ( mainly through the kidneys with urine), as a result of which its concentration in the blood decreases, and the effects caused by it disappear. It is important to note that traces of phenazepam may remain in the patient’s blood and tissues for 4–6 or more days after a single use of the medication, but no clinical effects or adverse reactions will be observed.

Phenazepam is a tranquilizer or antidepressant ( drug prescribed for depression)?

Composition, release forms and analogues of phenazepam

Composition of phenazepam tablets ( 0.5 mg, 1 mg, 2.5 mg)

• lactose ( milk sugar, which gives the tablet a sweetish taste);
• potato starch;
• calcium stearate;
• talc.

Ampoules with phenazepam solution for intravenous or intramuscular injection ( injections)

Analogues and substitutes of phenazepam ( diazepam, relanium, sibazon, clonazepam, nozepam, phenobarbital, atarax)

If necessary, phenazepam can be replaced by:

• Diazepam ( relanium, sibazon). This drug has almost the same healing effects, as phenazepam ( that is, anti-anxiety, sedative, hypnotic, anticonvulsant).
• Alprazolam. A drug from the same group that has a moderate sedative and hypnotic effect.
• Clonazepam. This drug is used primarily to treat seizures, but also has other therapeutic effects ( weak sedative and hypnotic effect).
• Nozepam. Has a moderate hypnotic and sedative effect.
• Phenobarbital. The drug has a pronounced hypnotic and anticonvulsant effect.
• Atarax. The drug has an anti-anxiety and sedative effect.

Trade names of phenazepam ( elzepam, fenzitate, phenorelaxan, fesipam)

Phenazepam is an active component of such drugs as:

• elzepam;
• fenzitate;
• phenorelaxan;
• fesipam;
• fesanef;
• tranquesipam.

Instructions for use of phenazepam

Should Phenazepam be taken before or after meals?

Should phenazepam be placed under the tongue and dissolved or swallowed and washed down?

Dosage and indications for use of phenazepam ( panic attacks and anxiety disorders, seizures, neuroses, psychoses, alcohol withdrawal syndrome, epilepsy, schizophrenia, VSD)

Contraindications to the use of phenazepam

Phenazepam is contraindicated:

• In a coma. The drug can cause depression of the central nervous system and make it difficult to diagnose the underlying disease that caused the development of coma.
• In shock. This pathology characterized by a pronounced drop in blood pressure. Phenazepam may worsen this phenomenon.

• For myasthenia gravis. This pathology is characterized by severe muscle weakness, which may intensify after taking phenazepam.
• In case of severe intoxication with alcohol or drugs. IN in this case the drug can lead to excessive depression of the central nervous system and respiratory failure.
• For lung diseases. Pathologies such as chronic bronchitis or bronchial asthma may be accompanied by the development of respiratory failure ( a condition in which a person begins to lack oxygen). The use of phenazepam may cause drowsiness and respiratory depression, which will worsen symptoms respiratory failure.
• For depression with suicidal tendencies. The drug may worsen depression.

Allergy to phenazepam

Is it possible to take phenazepam during pregnancy and lactation ( breastfeeding)?

The use of phenazepam during pregnancy may be complicated by:

• Congenital developmental anomalies. This complication occurs if a woman takes the drug in the first trimester of pregnancy, when the formation and formation of internal organs fetus
• Depression of the central nervous system of the fetus. This phenomenon it is most dangerous in the third trimester of pregnancy and before childbirth, since after birth such a child will not be able to breathe and breastfeed normally due to severe muscle weakness, lethargy, and drowsiness.
• Development of physical dependence. In this case, after birth, the child may develop withdrawal syndrome, characterized by insomnia, increased nervous excitability, tearfulness, and so on.

Can phenazepam be given to children and adolescents?

Can older people take phenazepam?

Is it possible to take phenazepam while driving ( when driving a car)?

After once dose taken drug ( in the form of a tablet or solution) you can get behind the wheel no earlier than 24 hours later ( when most of the medication is eliminated from the body). If the patient took phenazepam for a long time ( 7 – 10 days or more), he is not recommended to drive for at least 3 to 4 days after taking the last dose of the medication. This is due to the fact that when long-term use the active substance can accumulate in the tissues of the body, as a result of which its inhibitory effect on the central nervous system will manifest itself within several days after stopping use.

How soon can you take phenazepam after alcohol ( with a hangover)?

At the same time, it is worth noting that using the drug after taking small doses of alcohol will not have a significant effect. negative influence on the body's systems and will not lead to the development of complications, although the effectiveness of the medication may be reduced. This is due to the fact that in low concentrations ethyl alcohol ( active ingredient all alcoholic drinks) stimulates the central nervous system, thereby exerting the opposite effect of phenazepam.

Is it possible to drink coffee after phenazepam?

Can I take phenazepam during the day?

Phenazepam for various diseases and pathologies ( after a stroke, with hepatitis, diabetes, with low pulse, tachycardia)

Phenazepam should be used with caution:

• For stroke ( cerebrovascular accident). This pathology may be accompanied by increased neuropsychic agitation, to eliminate which phenazepam can be used. At the same time, with other forms of stroke, deep depression of consciousness may be observed, in which this medication is contraindicated ( due to the risk of excessive depression of the central nervous system and the development of respiratory failure).
• For hepatitis. With this disease it is noted inflammatory lesion liver cells. Although phenazepam is neutralized in the liver, uncomplicated hepatitis will not affect the effectiveness and duration of action of the drug in any way, since healthy cells organs will neutralize the drug quickly enough. At the same time, if severe liver failure develops, it is not recommended to use this drug, as this can lead to the accumulation of the active substance in the blood ( due to insufficiently fast neutralization) and to the development of overdose.
• For diabetes mellitus. With this pathology, the processes of glucose use are disrupted ( Sahara) cells of the body. Phenazepam itself has no effect on the course of diabetes mellitus, however, lactose included in the tablet form of the drug ( milk sugar) may cause a slight increase in blood glucose levels.
• With low heart rate. This condition May be normal occurrence (for example, in athletes) or develop with various diseases of the heart, brain and other body systems. Taking phenazepam with a low pulse is not recommended, since the drug ( especially in large doses) may contribute to a decrease in heart rate and the development of related complications.
• With tachycardia ( increase in heart rate, heart rate). This condition can develop in response to stress, emotional experience, as well as diseases of the central nervous system ( for psychoses, neuroses, panic attacks and so on). In this case, the use of phenazepam will help stabilize the patient’s emotional state and normalize heart rate. At the same time, it is worth noting that tachycardia can be a sign of blood loss or dehydration. In this case, taking phenazepam is prohibited, as this can cause a significant drop in blood pressure, loss of consciousness, or even death.

Is it possible to take phenazepam for fever?

Side effects and harmful effects of phenazepam

Effect on the brain and psyche ( weakness, drowsiness, lethargy, dizziness, development of dementia)

• drowsiness;
• muscle weakness;
• retardation of consciousness;
• impaired ability to concentrate;
• slow reactions;
• violation of memory processes;
• dizziness;
• headaches;
• dysarthria ( speech process disorder);
• decreased mood ( rarely).

Extremely rarely, when taking the drug, there may be an increase in feelings of anxiety, fear, nervous excitability. In this case, it is recommended to consult a doctor to select more effective treatment.

Effect on potency, erection, libido and conception

Effect on the heart ( Does phenazepam increase or decrease blood pressure?)

Effect on the liver and kidneys

It is also worth noting that the drug can have a damaging effect on the functions of the kidneys and urinary system, which may manifest itself as urinary retention or incontinence. This is why the drug is also not recommended for use by people suffering from chronic renal failure.

Addiction and dependence on phenazepam

Habituation and dependence can develop after 1 week of continuous use of the medication, but more often develops after 2 to 4 weeks. To avoid these reactions, you should take the drug only for prescribed by a doctor time. If addiction does develop, the drug should be discontinued gradually, reducing the daily dose over several days in a row, which will avoid withdrawal symptoms.

Does phenazepam cause hallucinations?

Consequences of an overdose of phenazepam ( Is it possible to die from phenazepam and what is the lethal, lethal dose for a person?)

An overdose of phenazepam can manifest itself:

• severe drowsiness;
• inhibition of reactions;
• speech disorders;
• decreased heart rate;
• a pronounced drop in blood pressure;
• coma ( brain damage);
• tremor ( muscle tremors);
• difficulty breathing ( due to weakness of the respiratory muscles).

Antidote for phenazepam poisoning

Flumazenil is administered intravenously and only in the presence of a doctor. The initial dose is 0.2 – 0.3 mg, but if necessary, the drug can be re-prescribed ( until the maximum daily dose of 2 mg is reached).

Is phenazepam detected during blood or urine tests?

The drug can be detected in the patient’s blood within 4–6 days after a single dose, but the concentration of the active substance will be insignificant ( which will be confirmed during the study). For example, a concentration of phenazepam that does not exceed 20 micrograms/liter will not have any effect on the patient’s condition and will not lead to the development of adverse reactions.

Identification of phenazepam and its metabolites ( by-products) in urine is also possible, which makes it possible to determine by urine analysis whether a person has used this drug during the last 4 - 7 days.

Is phenazepam a drug and does a drug test show it?

What to do if a child takes phenazepam?

If the child took several tablets at once, and also if the child is too small ( under 6 years old), it is recommended to urgently call ambulance. Without waiting for the doctors to arrive, you should begin to lavage the child’s stomach, which will reduce the amount of the drug absorbed through the mucous membrane of the gastrointestinal tract into the systemic bloodstream. For this you can use weak saline solutions (1 tablespoon of salt per liter of warm boiled water). The child should be given 1 to 3 glasses of this solution to drink, and then induce vomiting ( touching the root of the tongue with your fingertips). This procedure can be repeated 2–3 times.

If the doctor who comes to the call reveals any side effects, and also if the dose of the drug taken by the child is too high, the baby may be hospitalized for further observation and specific treatment with flumazenil ( antidote, antidote). If the doctor is convinced that there is no significant intoxication with phenazepam, he can leave the child at home, but he must inform the parents about possible late complications (drowsiness, lethargy, muscle weakness, breathing problems and others), when they appear, they should immediately call an ambulance.

Consultation with a medical specialist on the drug phenazepam

Price ( price) phenazepam in pharmacies in various cities of Russia

Price of phenazepam in various cities of Russia

Which doctor writes a prescription for phenazepam, and how long is it valid?

When writing a prescription for phenazepam, the doctor must indicate in it the form in which the drug is prescribed ( in ampoules or tablets), in what dosage, and in what quantity ( that is, how many ampoules or tablets can be sold to the patient). The shelf life of this recipe is 30 days. If during this time the patient does not purchase the prescribed drug, he ( recipe) will lose its legal force, and to purchase phenazepam the patient will have to go to the doctor for a new prescription.

Is it possible to buy phenazepam without a prescription or doctor's prescription?

Shelf life and storage conditions of phenazepam at home

After purchase, the drug should be stored in a dry, protected from sunlight place, since direct sunlight can destroy the active substance ( especially in the case of a solution). Also, the drug should be stored out of the reach of children, which will prevent them from accidentally using the medication.

Is it possible to drink or inject expired phenazepam?

The drug "Phenazepam" is a tranquilizer from the group of benzdiazepine derivatives. It has anticonvulsant, muscle relaxant, anxiolytic and hypnotic effects. The mechanism of functioning of this medication is based on reducing the excitability of certain brain centers and inhibiting their interaction with the cerebral cortex. Its maximum concentration is reached several hours after consumption. The half-life of Phenazepam varies between 6 – 10 hours. It is metabolized in the liver and excreted through the kidneys.

Main active substance This medication is an anxiolytic substance -zepine. Thanks to its presence in medicine Phenazepam relieves tension in the smooth muscles of internal organs, has a calming effect on the human body, having an inhibitory effect on the central nervous system. As a result, impulses begin to be transmitted more slowly, brain stem receptors are activated, and neurons become less sensitive.

Due to the fact that this drug is one of the strongest tranquilizers, it should never be taken independently without medical supervision!

The dose of this medication depends on your disease and is determined individually by your doctor.

• For sleep disorders, it is recommended to take 0.5 of the drug half an hour before bedtime.
• To treat epilepsy, doctors advise drinking 2–10 mg of the drug per day.
• For fear and anxiety, treatment begins with a daily dosage of 3 mg with a further gradual increase.
• In order to cure psychopathic conditions, doctors recommend taking the medicine in a dose of 0.5 - 1 mg several times a day. After 2–4 days, the dosage can be increased to 4–6 mg per day.
• During treatment alcohol withdrawal you need to take 2–5 mg per day.

It is important to know that the maximum permissible daily dosage the medication is 10 mg. In order to avoid drug dependence on Phenazepam, the duration of treatment should not exceed two weeks. This drug should be discontinued gradually.

What are Phenazepam tablets prescribed for?

This medication is prescribed in such cases as:

• psychopathic and neurotic conditions;
• reactive psychosis;
• prevention of emotional instability and fear;
• sleep disorder and autonomic dysfunctions;
• myoclonic and temporal lobe epilepsy;
• tics and hyperkinesis;
• muscle stiffness, etc.

Contraindications to the use of Phenazepam include the following:

• to whom;
• myasthenia gravis;
• angle-closure glaucoma;
• hypersensitivity to medicinal components;
• acute respiratory failure;
• the first trimester of pregnancy and the entire period of lactation;
• childhood;
• liver and kidney failure;
• tendency to take alcoholic beverages and psychotropic drugs;
• organic diseases of the brain.

If you notice at least one of the above phenomena, stop using this medication and consult a doctor!

Remember that you should not combine this drug with the use of other medications to avoid unpredictable reactions. Doctors recommend being extremely careful with drugs that suppress the functioning of the central nervous system and informing them about all medications you take!

Phenazepam is a highly active tranquilizer, has anxiolytic, anticonvulsant, central muscle relaxant and sedative effects.

The tranquilizing and anti-anxiety effect is superior in strength to the analogues of Phenazepam. The drug also has an anticonvulsant and hypnotic effect. The anxiolytic effect of the drug is expressed in a decrease emotional stress, reducing fear, anxiety and worry.

In this article we will look at why doctors prescribe the drug Phenazepam, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Phenazepam, leave your feedback in the comments.

Composition and release form

Clinical and pharmacological group: tranquilizer (anxiolytic). "Phenazepam" is produced in the form of tablets and solution for injection.

• One tablet contains 2.5 mg, 1 mg or 0.5 mg of phenazepam (active ingredient).

One package contains fifty tablets. The drug solution is available in glass ampoules, each with a volume of 1 ml. A pack may contain 100, 50 or 10 glass ampoules of different concentrations: with a three percent or 0.1% solution.

What is Phenazepam used for?

Most often, the medication is used as a tranquilizer - it eliminates convulsive activity, tremors, hyperkinesis, etc. The drug interacts with benzodiazepine receptors of the GABAergic complex, as a result of which the inhibitory effect of GABA increases, the activity of neurons decreases and the descending effect on the departments spinal cord.

Most often, the remedy helps with the following conditions:

1. Various neurosis-like conditions combined with anxiety or fears;
2. As a sleeping pill;
3. Conditions requiring immediate relief from feelings of obsessive fear;
4. A sedative for persistent depression of mood;
5. Phobias of various origins and varying gravity;
6. An aid in preparing patients for surgery;
7. Suppressing withdrawal syndrome in patients suffering from alcohol dependence;
8. Convulsions varying degrees heaviness;
9. Treatment of epileptic seizures;
10. Panic reactions associated with nervous excitement.

pharmachologic effect

Anxiolytic (tranquilizer), benzodiazepine derivative. It has a pronounced anxiolytic, hypnotic, sedative, as well as anticonvulsant and central muscle relaxant effect.

The mechanism of action of phenazepam is determined by stimulation of benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chlorionophore-receptor complex, leading to activation of GABA receptors, which, in turn, causes a decrease in excitability subcortical structures brain and inhibition of polysynaptic spinal reflexes.

It has a depressant effect on the central nervous system, occurring primarily in the thalamus, hypothalamus and limbic system. Enhances the inhibitory effect of gamma-aminobutyric acid (GABA), which is one of the main mediators of pre- and postsynaptic inhibition of the transmission of nerve impulses in the central nervous system.

Instructions for use

The drug should be taken orally. A single dose of Phenazepam is usually 0.5-1 mg. Average daily dose Phenazepam is 1.5 - 5 mg, divided into 2-3 doses: usually 0.5-1 mg in the morning and afternoon, at night - up to 2.5 mg. The maximum daily dose of Phenazepam is 10 mg.

1. For alcohol withdrawal, Phenazepam is prescribed at a dose of 2.5-5 mg/day.
2. In case of severe agitation, fear, anxiety, treatment begins with a dose of 3 mg/day, quickly increasing the dose until a therapeutic effect is obtained.
3. For sleep disorders, the drug should be used in a dose of 0.25-0.5 mg 20-30 minutes before bedtime.
4. For epilepsy, the dose is 2-10 mg/day.
5. For diseases with increased muscle tone, the drug is prescribed 2-3 mg 1-2 times a day.
6. For neurotic, psychopathic, neurosis-like and psychopath-like conditions, the initial dose of the drug is 0.5-1 mg 2-3 times a day. After 2-4 days, taking into account the effectiveness and tolerability of the drug, the dose can be increased to 4-6 mg/day.

To avoid the development of drug dependence when course treatment The duration of use of Phenazepam is 2 weeks. IN in some cases the duration of treatment can be increased to 2 months. When discontinuing npenapata, the dose is reduced gradually.

Contraindications

Like any medicine, Phenazepam has a number of contraindications. You should strictly follow them and not take pills or injections, otherwise there is a high probability of causing great harm to the body.

The drug should not be used in the following cases:

1. Severe poisoning with alcoholic beverages, in which there is an immediate danger to life.
2. Poisoning with sleeping pills, sedatives, drugs.
3. Chronic obstructive pulmonary disease.
4. Severe depression accompanied by suicidal tendencies.
5. Acute respiratory failure.
6. Hypersensitivity to the components of the drug.
7. Minority (the safety of the drug for children has not been tested).
8. Pregnancy (especially the first trimester);
9. Breastfeeding period;
10. With hepatic and renal failure Phenazepam should be taken with extreme caution.

Side effects

A large list of contraindications indicates the presence of an even larger list of side effects:

1. Severe fatigue and lethargy, constant drowsiness;
2. Clouding of consciousness and reason;
3. Frequent tachycardia;
4. Irritation skin, available severe itching and rash;
5. Drug dependence;
6. Inhibition of human reaction;
7. A sharp decrease in blood pressure;
8. Significant weight loss;
9. Lack of concentration;
10. Loss of a person in space;
11. Double vision is recorded;
12. Causeless euphoria;
13. Tremor of the limbs;
14. Functional impairment digestive tract, constipation and diarrhea are most often observed;
15. In addition, the following may occur:
16. Impaired pronunciation caused by damage to the central nervous system;
17. Forgetfulness, memory lapses;
18. Strong and frequent pain in the head;
19. The person is in a bad mood;
20. Frequent dizziness;
21. Gagging, nausea, painful vomiting;
22. Anemia;
23. Dry mucous membranes;
24. Decreased libido;
25. Appetite decreases;
26. Heartburn appears.

Overdose

Using the drug, the patient may receive an overdose of Phenazepam. Symptoms of an overdose of Phenazepam are as follows: decreased reflexes, severe drowsiness, tremor, nystagmus, prolonged dysarthria. Shortness of breath or difficulty breathing, bradycardia may occur. Sometimes an overdose of Phenazepam can cause a coma and a decrease in blood pressure in the patient.

In case of an overdose of Phenazepam, it is necessary to use activated charcoal, perform gastric lavage, and administer flumazenil (this is done in a hospital). In any case, in case of an overdose of the drug, you should urgently call a doctor.

Pregnancy and lactation

During pregnancy, Phenazepam is used only for health reasons. The drug has toxic effect on the fetus and increases the risk of developing birth defects when used in the first trimester of pregnancy.

The use of therapeutic doses in later stages of pregnancy may cause depression of the central nervous system of the newborn. Permanent use Phenazepam during pregnancy can cause withdrawal syndrome in the newborn.

Use of the drug immediately before or during childbirth can cause respiratory depression in the newborn, decreased muscle tone, hypotension, hypothermia, and weakened sucking (“floppy baby” syndrome).

Interaction with other drugs and alcohol

The drug Phenazepam ІС enhances the effect of narcotic, sleeping pills, anticonvulsants, and ethyl alcohol. Phenazepam should not be taken together with monoamine oxidase inhibitors, barbiturates and phenothiazine derivatives, due to mutually enhancing effects.

It is forbidden to take alcoholic beverages during treatment with Phenazepam ІС, as the drug enhances the effect of alcohol

Withdrawal syndrome. addictive

Like other benzodiazepines, it has the ability to cause drug dependence when long-term use in large doses (more than 4 mg/day). If you suddenly stop taking it, you may experience withdrawal syndrome (depression, irritability, insomnia, increased sweating, etc.), especially with long-term use (more than 8-12 weeks).

If patients experience unusual reactions such as increased aggressiveness, acute conditions agitation, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficulty falling asleep, shallow sleep, treatment should be discontinued.

Phenazepam analogs

Analogs of Phenazepam based on the active substance are Fezanef, Fesipam, Elzepam, Phenorelaxan, Tranquesipam. When replacing Phenazepam it medicinal analogues consultation with a doctor is required.

Prices

The average price of Phenazepam in pharmacies (Moscow) is 90 rubles.

Storage conditions

Phenazepam is included in list B. It is recommended to store it in a dry place, protected from sun rays and out of the reach of children at a temperature of no more than 25°C.

Shelf life: the drug can be used within 36 months from the date of manufacture.

Analogs

These are medicines belonging to the same pharmaceutical group that contain different active substances(INN), differ in name, but are used to treat the same diseases.

• - Tablets 500 mg
• - Substance-powder
• - Concentrate for the preparation of solution for infusion
• - Nasal drops
• - Tablets 250 mg

Indications for use of the drug Phenazepam

Neurotic, neurosis-like, psychopathic and psychopath-like and other conditions (irritability, anxiety, nervous tension, emotional lability), reactive psychoses and senesto-hypochondriacal disorders (including those resistant to the action of other anxiolytic drugs (tranquilizers), obsession, insomnia, withdrawal syndrome(alcoholism, substance abuse), status epilepticus, epileptic seizures (of various etiologies), temporal and myoclonic epilepsy.

IN extreme conditions- as a means of facilitating overcoming feelings of fear and emotional stress.

As an antipsychotic - schizophrenia with hypersensitivity to antipsychotic drugs (including febrile form).

IN neurological practice- muscle rigidity, athetosis, hyperkinesis, tic, autonomic lability (sympathoadrenal and mixed paroxysms).

In anesthesiology - premedication (as a component of induction anesthesia).

Release form of the drug Phenazepam

tablets 0.5 mg; contour packaging 10, cardboard pack 5;
tablets 0.5 mg; contour packaging 25, cardboard pack 2;
tablets 0.5 mg; polymer jar (jar) 50, cardboard pack 1;
tablets 1 mg; contour packaging 10, cardboard pack 5;
tablets 1 mg; contour packaging 25, cardboard pack 2;
tablets 1 mg; polymer jar (jar) 50, cardboard pack 1;
tablets 2.5 mg; contour packaging 10, cardboard pack 5;
tablets 2.5 mg; contour packaging 25, cardboard pack 2;
tablets 2.5 mg; polymer jar (jar) 50, cardboard pack 1;

Compound
Tablets 1 tablet.
bromod0.5 mg, 1 mg, 2.5 mg
(in terms of 100% substance)
Excipients: lactose (milk sugar); potato starch; povidone (Kollidon 25); calcium stearate; talc
in blister packs 10 or 25 pcs.; in a cardboard pack of 2 (25 pcs.) or 5 (10 pcs.) packages; or in polymer cans of 50 pcs., in a cardboard pack 1 can.

Pharmacodynamics of the drug Phenazepam

Anxiolytic drug (tranquilizer) of the benzodiazepine series. It has anxiolytic, sedative-hypnotic, anticonvulsant and central muscle relaxant effects.

Strengthens the inhibitory effect of GABA on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation brain stem and interneurons of the lateral horns of the spinal cord; reduces the excitability of subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

The anxiolytic effect is due to the influence on the amygdala complex of the limbic system and manifests itself in a decrease in emotional stress, easing anxiety, fear, and restlessness.

The sedative effect is due to the influence on the reticular formation of the brain stem and nonspecific nuclei of the thalamus and is manifested by a decrease in symptoms of neurotic origin (anxiety, fear).

For productive symptoms of psychotic origin (acute delusional, hallucinatory, affective disorders) has virtually no effect, a decrease in affective tension and delusional disorders is rarely observed.

The hypnotic effect is associated with inhibition of the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

The anticonvulsant effect is realized by enhancing presynaptic inhibition, suppresses the propagation of the convulsive impulse, but does not relieve the excited state of the focus. The central muscle relaxant effect is due to inhibition of polysynaptic spinal afferent inhibitory pathways (to a lesser extent, monosynaptic ones). Direct inhibition of motor nerves and muscle function is also possible.

Pharmacokinetics of the drug Phenazepam

After oral administration, it is well absorbed from the gastrointestinal tract, Tmax is 1-2 hours. Metabolized in the liver. T1/2 - 6-10-18 hours. Excreted mainly by the kidneys in the form of metabolites.

Use of the drug Phenazepam during pregnancy

During pregnancy, use is possible only for health reasons. It has a toxic effect on the fetus and increases the development of birth defects when used in the first trimester of pregnancy. When taken in therapeutic doses later in pregnancy, it may cause CNS depression in the newborn. Chronic use during pregnancy can lead to physical dependence with the development of withdrawal syndrome in the newborn. Children, especially young children, are very sensitive to the CNS depressant effects of benzodiazepines.

Use immediately before or during childbirth may cause respiratory depression in the newborn, decreased muscle tone, hypotension, hypothermia and weak sucking ("floppy baby" syndrome).

Contraindications to the use of the drug Phenazepam

Coma, shock, myasthenia gravis, angle-closure glaucoma ( acute attack or predisposition) acute poisoning alcohol (with weakening of vital functions), narcotic analgesics and hypnotics, severe COPD (possible increased respiratory failure), acute respiratory failure, severe depression (suicidal tendencies may occur); I trimester of pregnancy, lactation period, childhood and adolescence up to 18 years of age (safety and effectiveness have not been determined), increased sensitivity(including other benzodiazepines).

Side effects of the drug Phenazepam

From the side of the central nervous system and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, feeling of fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, unsteady gait, slowed mental and motor reactions, confusion; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements (especially at high doses), depressed mood, dystonic extrapyramidal reactions (uncontrolled movements, including the eye), asthenia, myasthenia gravis, dysarthria, epileptic seizures (in patients with epilepsy); extremely rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia).

From the hematopoietic organs: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.

From the outside digestive system: dry mouth or drooling, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea; liver dysfunction, increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the outside genitourinary system: urinary incontinence, urinary retention, renal dysfunction, decreased or increased libido, dysmenorrhea.

Allergic reactions: skin rash, itching.

Local reactions: phlebitis or venous thrombosis(redness, swelling or pain at the injection site).

Other: addiction, drug addiction; decrease in blood pressure; rarely - visual impairment (diplopia), weight loss, tachycardia.

If the dose is sharply reduced or taken is stopped, withdrawal syndrome occurs (irritability, nervousness, sleep disturbances, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor, perception disorders, incl. hyperacusis, paresthesia, photophobia; tachycardia, convulsions, rarely - acute psychosis).

Method of administration and dosage of the drug Phenazepam

Inside. The average daily dose is 1.5–5 mg, divided into 2–3 doses, usually 0.5–1 mg in the morning and afternoon and up to 2.5 mg at night.

The maximum daily dose is 10 mg.

For sleep disorders - 0.5 mg 20–30 minutes before bedtime.

For the treatment of neurotic, psychopathic, neurosis-like and psychopath-like conditions, the initial dose is 0.5–1 mg 2–3 times a day. After 2–4 days, taking into account effectiveness and tolerability, the dose can be increased to 4–6 mg/day.

In case of severe agitation, fear, anxiety, treatment begins with a dose of 3 mg/day, quickly increasing the dose until a therapeutic effect is obtained.

For the treatment of epilepsy - 2–10 mg/day.

For the treatment of alcohol withdrawal - 2–5 mg/day.

In neurological practice for diseases with muscle hypertonicity - 2–3 mg 1–2 times a day.

To avoid the development of drug dependence, during a course of treatment the duration of use of phenazepam is 2 weeks (in some cases, the duration of treatment can be increased to 2 months). When discontinuing the drug, the dose is reduced gradually.

special instructions
For renal/ liver failure And long-term treatment it is necessary to control the picture peripheral blood and liver enzyme activity.

In patients who have not previously taken psychoactive drugs, a therapeutic response to the use of Phenazepam® in lower doses is observed, compared to patients who have taken antidepressants, anxiolytics, or those suffering from alcoholism.

Like other benzodiazepines, it has the ability to cause drug dependence when taken long-term in large doses (more than 4 mg/day). If you suddenly stop taking it, withdrawal syndrome may occur (including depression, irritability, insomnia, increased sweating), especially with long-term use (more than 8-12 weeks). If patients experience such unusual reactions as increased aggressiveness, acute state of agitation, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficulty falling asleep, shallow sleep, treatment should be stopped.

Influence on the ability to drive vehicles and operate machinery. During the treatment period, care must be taken when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration and speed of psychomotor reactions.

Overdose of Phenazepam

Symptoms: severe depression of consciousness, cardiac and respiratory activity, severe drowsiness, prolonged confusion, decreased reflexes, prolonged dysarthria, nystagmus, tremor, bradycardia, shortness of breath or difficulty breathing, decreased blood pressure, coma.

Treatment: symptomatic therapy, gastric lavage, appointment activated carbon, monitoring the vital functions of the body, maintaining respiratory and cardiovascular activity. Hemodialysis is ineffective.

Specific antagonist: flumazenil (in a hospital setting) - 0.2 mg intravenously (if necessary - up to 1 mg) in a 5% glucose solution or 0.9% sodium chloride solution.

Interactions of the drug Phenazepam with other drugs

At simultaneous use reduces the effectiveness of levodopa in patients with parkinsonism.

May increase the toxicity of zidovudine.

There is a mutual enhancement of the effect with the simultaneous use of antipsychotic, antiepileptic or sleeping pills, as well as central muscle relaxants, narcotic analgesics, ethanol.

Inhibitors of microsomal oxidation increase the risk of developing toxic effects of Phenazepam®. Inducers of microsomal liver enzymes reduce its effectiveness. Increases the concentration of imipramine in the blood serum.

When used simultaneously with antihypertensive drugs, the antihypertensive effect may be enhanced. Increased respiratory depression may occur during concomitant administration of clozapine.

Overdose

Special instructions when taking Phenazepam

Use with caution in case of liver and/or renal failure, cerebral and spinal ataxia, a history of drug dependence, a tendency to abuse psychoactive substances. medicines, hyperkinesis, organic diseases brain, psychosis (paradoxical reactions are possible), hypoproteinemia, sleep apnea(established or suspected), in elderly patients.

In case of renal and/or liver failure and long-term treatment, it is necessary to monitor the peripheral blood picture and the activity of liver enzymes.

Patients who have not previously taken psychoactive drugs exhibit a therapeutic response to the use of phenazepam in lower doses compared to patients taking antidepressants, anxiolytics, or alcoholism.

Like other benzodiazepines, it has the ability to cause drug dependence when taken long-term in large doses (more than 4 mg/day). If you suddenly stop taking it, withdrawal symptoms may occur (including depression, irritability, insomnia, increased sweating), especially with long-term use (more than 8-12 weeks). If patients experience unusual reactions such as increased aggressiveness, acute states of agitation, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficulty falling asleep, shallow sleep, treatment should be discontinued.

During treatment, patients are strictly prohibited from consuming ethanol.

The effectiveness and safety of the drug in patients under 18 years of age have not been established.

In case of overdose, severe drowsiness, prolonged confusion, decreased reflexes, prolonged dysarthria, nystagmus, tremor, bradycardia, shortness of breath or difficulty breathing, decreased blood pressure, and coma are possible. Gastric lavage and activated charcoal are recommended; symptomatic therapy (maintaining breathing and blood pressure), administration of flumazenil (in a hospital setting); hemodialysis is ineffective.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Storage conditions for the drug Phenazepam

List B: In a dry place, protected from light, at a temperature not exceeding 25 °C.

Shelf life of the drug Phenazepam

The drug Phenazepam belongs to the ATX classification:

N Nervous system

N05 Psycholeptics

Release form: Solid dosage forms. Pills.

General characteristics. Compound:

Pharmacological properties:

Indications for use:

Important! Get to know the treatment

Directions for use and dosage:

Features of application:

Side effects:

Interaction with other drugs:

Contraindications:

Overdose:

Storage conditions:

List B. The drug should be stored out of the reach of children, in a dry place, protected from light at a temperature not exceeding 25 °C.

Vacation conditions:

On prescription

Package:

10 pieces. - contour cell packaging (5) - cardboard packs.
25 pcs. - contour cell packaging (2) - cardboard packs.
50 pcs. - polymer jars (1) - cardboard packs.