Mexiprim solution for injection 50mg / ml, 5ml No. 5

• Acute disorders of cerebral circulation (as part of complex therapy);

• traumatic brain injury, the consequences of traumatic brain injury;

• encephalopathy;

• vegetative dystonia syndrome;

• mild cognitive disorders of atherosclerotic genesis;

• anxiety disorders in neurotic and neurosis-like states;

• acute myocardial infarction (from the first day as part of complex therapy);

• primary open-angle glaucoma of various stages, as part of complex therapy;

• relief of withdrawal symptoms in alcoholism with a predominance of neurosis-like and vegetative-vascular disorders;

• acute intoxication with antipsychotic drugs;

• acute purulent-inflammatory processes of the abdominal cavity (acute necrotizing pancreatitis, peritonitis) as part of complex therapy.

MexiprimЃ is prescribed intramuscularly or intravenously (jet or drip). When administered by infusion, the drug should be diluted in 0.9% sodium chloride solution. It is injected slowly over 5-7 minutes, drip - at a rate of 40-60 drops per minute.
The dosage regimen is selected individually. The maximum daily dose should not exceed 1200 mg.
Acute disorders of cerebral circulation (as part of complex therapy): in the first 10-14 days intravenous drip of 200-500 mg 2-4 times a day, then - intramuscularly 200-250 mg 2-3 times a day for 2 weeks.
Traumatic brain injury, the consequences of traumatic brain injury: within 10-15 days intravenous drip of 200-500 mg 2-4 times a day.
Dyscirculatory encephalopathy in the phase of decompensation: intravenous stream or drip in a dose of 200-500 mg 1-2 times a day for 14 days; then - intramuscularly at 100-250 mg per day for the next 2 weeks.
Course prevention of discirculatory encephalopathy: intramuscularly at a dose of 200-250 mg 2 times a day for 10-14 days.
Syndrome of vegetative dystonia, neurotic and neurosis-like states: intramuscularly, 50-400 mg per day for 14 days.
Mild cognitive impairment of atherosclerotic genesis (in elderly patients), anxiety disorders: intramuscularly at a dose of 100-300 mg per day for 14-30 days.
Acute myocardial infarction (from the first day as part of complex therapy): intravenously or intramuscularly for 14 days; the drug is used against the background of standard therapy for myocardial infarction, including nitrates, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, thrombolytics, anticoagulant and antiplatelet agents, as well as symptomatic agents when indicated.
In the first 5 days, to achieve the maximum effect, the drug is administered intravenously, in the next 9 days the drug can be administered intramuscularly.
Intravenous administration is carried out by drop infusion, slowly (to avoid side effects) for 30-90 minutes (in 100-150 ml of 0.9% sodium chloride solution or 5% dextrose (glucose) solution). If necessary, a slow (lasting at least 5 minutes) intravenous jet injection of the drug is possible.
The drug is administered (intravenously or intramuscularly) 3 times a day every 8 hours. The daily dose is 6-9 mg / kg of body weight, a single dose is 2-3 mg / kg of body weight. The maximum daily dose should not exceed 800 mg, single dose - 250 mg.
Primary open-angle glaucoma of various stages (as part of complex therapy): intramuscularly, 100-300 mg per day; 1-3 times a day for 14 days.
Withdrawal alcohol syndrome: intramuscular or intravenous drip in a dose of 200-500 mg 2-3 times a day for 5-7 days.
Acute intoxication with antipsychotic drugs: intravenously at a dose of 200-500 mg per day for 7-14 days.
Acute purulent-inflammatory processes of the abdominal cavity (acute necrotizing pancreatitis, peritonitis): as part of complex therapy, the drug is prescribed on the first day both in the preoperative and postoperative periods. The doses administered depend on the form and severity of the disease, the prevalence of the process, and the options for the clinical course. The drug should be withdrawn gradually only after a stable positive clinical and laboratory effect.
In acute edematous (interstitial) pancreatitis, the drug is prescribed 200-500 mg 3 times a day, intravenously (in 0.9% sodium chloride solution) and intramuscularly.
Mild severity of necrotizing pancreatitis - 100-200 mg 3 times a day, intravenously drip (in 0.9% sodium chloride solution) and intramuscularly. Average severity - 200 mg 3 times a day, intravenous drip (in 0.9% sodium chloride solution). Severe course - at a dosage of 800 mg on the first day, with a two-fold administration regimen; then 200-500 mg 2 times a day with a gradual decrease in the daily dose. Extremely severe course - at an initial dosage of 800 mg per day until persistent relief of the manifestations of pancreatogenic shock, after stabilization of the state, 300-500 mg 2 times a day intravenously (in 0.9% sodium chloride solution) with a gradual decrease in the daily dose.

Composition for 1 ml:

Ethylmethylhydroxypyridine succinate - 50 mg

Water for injection - up to 1 ml

• Increased individual sensitivity to the drug.

• Acute hepatic and / or renal failure.

• Due to the lack of data on efficacy and safety - children's age, pregnancy, breastfeeding.

Pharmacodynamics:
Antioxidant drug, 3-hydroxypyridine derivative; has antihypoxic, membrane-protective, nootropic, anticonvulsant, stress-protective, anxiolytic effect. The drug increases the body's resistance to the effects of the main damaging factors, to oxygen-dependent pathological conditions (shock, hypoxia and ischemia, cerebrovascular accident, alcohol intoxication and antipsychotic drugs (neuroleptics)).
The mechanism of action of ethylmethylhydroxypyridine succinate is due to its antioxidant, antihypoxant and membrane protective effect. The drug reduces the manifestations of oxidative stress, inhibits lipid peroxidation, increases the activity of superoxide dismutase, increases the lipid-protein ratio, improves the structure and function of the cell membrane. The drug modulates the activity of membrane-bound enzymes (calcium-independent phosphodiesterase, adenylate cyclase, acetylcholinesterase), receptor complexes (benzodiazepine, gamma-aminobutyric acid (GABA), acetylcholine), which enhances their ability to bind to ligand-functional neu- synaptic transmission. The drug increases the content of dopamine in the brain.It causes an increase in the compensatory activation of aerobic glycolysis and a decrease in the degree of inhibition of oxidative processes in the Krebs cycle under conditions of hypoxia with an increase in the content of adenosine triphosphate (ATP) and creatine phosphate, activation of the energy-synthesizing functions of mitochondria, and stabilization of cell membranes.
Ethylmethylhydroxypyridine succinate normalizes metabolic processes in the ischemic myocardium and improves its functional state, reduces the zone of necrosis, restores and improves the electrical activity and contractility of the myocardium, and also increases coronary blood flow in the ischemic zone, reduces the consequences of reperfusion syndrome in acute coronary insufficiency. In conditions of coronary insufficiency, it increases collateral blood supply to the ischemic myocardium, contributes to the preservation of the integrity of cardiomyocytes and the maintenance of their functional activity. Effectively restores myocardial contractility in reversible cardiac dysfunction. Increases the antianginal activity of nitro drugs.
Improves metabolism and blood supply to brain tissues, improves microcirculation and rheological properties of blood, reduces platelet aggregation. It stabilizes the membrane structures of blood cells (erythrocytes and platelets). It has a hypolipidemic effect, reduces the content of total cholesterol and low density lipoproteins.
Promotes the preservation of retinal ganglion cells and optic nerve fibers in progressive neuropathy, the causes of which are chronic ischemia and hypoxia. Improves the functional activity of the retina and optic nerve, increasing visual acuity.
The drug reduces enzymatic toxemia and endogenous intoxication in acute pancreatitis.

Pharmacokinetics:
Absorption: When a dose of 400-500 mg is administered, the maximum plasma concentration is reached after 0.45-0.5 hours and is 3.5-4.0 ?g / ml.
Distribution: After intramuscular injection of ethylmethylhydroxypyridine, succinate is determined in blood plasma within 4 hours. It is rapidly distributed in organs and tissues. The average retention time of the drug in the body is 0.7-1.3 hours.
Metabolism: Metabolized in the liver by glucuronidation. 5 metabolites have been identified: 3-hydroxypyridine phosphate - formed in the liver and, with the participation of alkaline phosphatase, decomposes into phosphoric acid and 3-hydroxypyridine; The 2nd metabolite is pharmacologically active, is formed in large quantities and is found in the urine for 1-2 days. After administration, the third is excreted in large quantities by the kidneys; 4th and 5th - glucuron conjugates.
Excretion: It is excreted from the body by the kidneys mainly in glucuron-conjugated form and in small amounts - unchanged.

Side effect:
Immune system disorders: very rarely anaphylactic shock, angioedema, urticaria.
Mental disorders: very rarely, drowsiness.
Disturbances from the nervous system: very rarely headache, dizziness (may be associated with an excessively high rate of administration and is short-lived).
Vascular disorders: very rarely, a decrease in blood pressure (BP), an increase in blood pressure (may be associated with an excessively high rate of administration and is short-lived).
Disturbances from the respiratory system, chest and mediastinal organs: very rarely, dry cough, sore throat, chest discomfort, difficulty breathing (may be associated with an excessively high rate of administration and is short-lived).
Gastrointestinal disturbances: very rarely, dry mouth, nausea, an unpleasant odor, metallic taste in the mouth.
Violations of the skin and subcutaneous tissues: very rarely itching, rash, hyperemia. General disturbances and reactions at the injection site: very rarely a feeling of warmth.

Special instructions:
Under the influence of ethylmethylhydroxypyridine succinate, the effect of tranquilizing, anticonvulsants is enhanced, which may require adjusting the dose of the corresponding drugs.
The drug is not prescribed for children under 18 years of age due to insufficient knowledge of the drug's action.

Interaction with other medicinal products:
Enhances the effect of benzodiazepine anxiolytics, anticonvulsants (carbamazepine), antiparkinsonian drugs (levodopa).
Reduces the toxic effects of ethyl alcohol.