Kalimin 60n tablets 60mg, No. 100

Myasthenia gravis and myasthenic syndrome, postoperative intestinal atony, atonic constipation, disorders of urinary bladder emptying after gynecological operations and childbirth.

Elimination of the effect of non-depolarizing curariform drugs.

When taken orally - 60-180 mg 2-4 times / day, if necessary, the dose is increased.

Tablets are white, biconvex, oblong, with a risk on one side, the presence of roughness is possible.

1 tab. pyridostigmine bromide 60 mg

Excipients: microcrystalline cellulose - 336 mg, corn starch - 120 mg, polyvidone K25 - 60 mg, colloidal silicon dioxide - 63 mg, purified water - 16 mg, magnesium stearate - 3 mg, glutamic acid hydrochloride - 2 mg.

• Mechanical obstruction of the intestine or urinary tract,

• bronchial asthma,

• hypersensitivity to pyridostigmine bromide.

pharmachologic effect

Acetylcholinesterase and pseudocholinesterase inhibitor. It has an indirect cholinomimetic effect due to reversible inhibition of cholinesterase and potentiation of the action of endogenous acetylcholine. Improves neuromuscular transmission, enhances the tone and peristalsis of the gastrointestinal tract, increases the tone of the bladder, bronchi, secretion of exocrine glands. Causes bradycardia.

Pharmacokinetics

After oral administration, it is poorly absorbed from the gastrointestinal tract. Unlike neostigmine and physostigmine, it is not hydrolyzed by cholinesterase. It is excreted in the urine.

Side effect

From the side of the cardiovascular system: bradycardia.

From the digestive system: nausea, vomiting, diarrhea, stomach cramps, increased salivation.

From the side of the central nervous system: muscle twitching, muscle lethargy, miosis.

From the respiratory system: an increase in the tone and secretion of the bronchi.

Allergic reactions: skin rash.

Application during pregnancy and lactation

Application during pregnancy and lactation is possible only on strict indications.

Application for violations of liver function

Particular care should be taken when used in patients with previous liver diseases.

Application for impaired renal function

Particular care should be taken when used in patients with kidney disease.

special instructions

In patients with gastric ulcer, hyperthyroidism, heart failure in the decompensation phase and myocardial infarction, pyridostigmine bromide is used only after careful comparison of the risk of side effects and the expected beneficial effect. Particular care should be taken when used in patients with bradycardia, diabetes mellitus, kidney disease, parkinsonism, past liver disease, as well as after surgery on the gastrointestinal tract.

It is recommended to choose the time of taking pyridostigmine bromide so that its maximum effect coincides with the patient's physical activity cycle. It should be remembered that the absence of the expected response to treatment may be the result of an overdose.

Influence on the ability to drive vehicles and use mechanisms

When using pyridostigmine bromide, you should avoid driving a car and other activities that require high concentration of attention, rapid psychomotor reactions.

Drug interactions

Pyridostigmine bromide is an antagonist of non-depolarizing muscle relaxants and enhances the effect of depolarizing muscle relaxants.

M-anticholinergics, ganglion blockers, quinidine, novocainamide, local anesthetics, tricyclic antidepressants, antiepileptic and antiparkinsonian drugs reduce the effect of pyridostigmine bromide.

Atropine is able to neutralize the m-cholinergic effect of pyridostigmine (but not its effect on skeletal muscle).

Pyridostigmine bromide can enhance the action of morphine derivatives and barbiturates.