Dibenzimil

Dibenzamil is a peripheral vasodilator.

Indications Dibenzimil

It is used in pheochromocytoma: to control increasing blood pressure during the preoperative period, during surgery, and in addition in individuals with inoperable lesions.

Release form

The therapeutic agent is released in the form of an infusion liquid, in ampoules with a capacity of 1 ml. There are 5 such ampoules inside the pack.

Pharmacodynamics

The drug acts as a non-selective adrenergic blocker, exerts its effect through α-adrenergic receptors, possessing a prolonged vasodilatory effect of a peripheral nature. After an intravenous injection, "chemical sympathectomy" develops.

It has a vasodilating effect, due to which there is an increase in blood circulation inside the epidermal vessels, mucous membranes and organs located inside the peritoneum, which causes a significant decrease in blood pressure values. Does not affect the activity of the parasympathetic NS.

Pharmacokinetics

After the use of one intravenous dose (1 mg/kg), the Cmax value is reached after 60 minutes; it is maintained for a 2-3-day period. After an intravenous injection, the half-life of the drug is 24 hours.

Metabolic processes of Dibenzimil are carried out inside the liver. The substance accumulates inside the body. In case of daily use of the medicine, its therapeutic effect lasts for another 7 days after the last dose is administered.

The duration of the effect of phenoxybenzamine is determined by the rate of binding of new α-adrenergic receptors within the body after their irreversible blockade caused by the use of phenoxybenzamine has occurred.

Dosing and administration

At the preoperative stage, as well as during operations in people with pheochromocytoma, the medication is administered intravenously via a drip in a dose of 1 mg/kg per day, for at least 2 hours. The medication must first be diluted in 0.9% NaCl (0.2 l).

Therapy with dissolved phenoxybenzamine should be continued until adequate blood pressure is achieved.

Subsequent treatment requires the administration of Dibenzimil tablets, in a 10 mg dose, 2 times a day, with a gradual increase in dosage until the desired result is achieved. The maximum permissible daily dose is 1-2 mg/kg (this dosage should be divided into 2-3 uses).

If the drug needs to be used for a long time to eliminate negative symptoms (tachycardia), β-blockers should be used.

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Use Dibenzimil during pregnancy

No relevant animal studies have been performed, which is why Dibenzimil is prescribed to pregnant women only in situations where the potential benefit to the woman is more likely to outweigh the risk of complications to the fetus.

If there is a need to use the medication during lactation, breastfeeding should be discontinued, because there is no information on whether phenoxybenzamine is excreted in breast milk.

Contraindications

Contraindicated for use in cases of severe intolerance to therapeutic elements, and also if there is a risk of decreased blood pressure.

Side effects Dibenzimil

There is evidence that in animals after prolonged use of phenoxybenzamine (longer than 52 weeks) the likelihood of developing malignant neoplasms increases.

Among the lesions of the nervous system, nausea, miosis, dizziness, tachycardia, orthostatic collapse, swelling of the nasal mucosa and suppression of ejaculation are noted. Dryness of the mucous membranes, erosions in the gastrointestinal tract, a feeling of increased fatigue or drowsiness are observed less often.

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Overdose

Poisoning can provoke the development of tachycardia, allergic symptoms, dizziness, orthostatic collapse, vomiting and a feeling of weakness.

In case of development of signs of intoxication it is necessary to stop using the drug. Standard procedures will be ineffective. Adrenaline should not be used, because blocking of α-adrenoreceptors occurs for a long time, due to which manifestations of "cancelled adrenaline effect" may occur in the form of subsequent decrease in blood pressure.

The patient should also be laid horizontally with his legs raised. In case of mild overdoses, this measure will be sufficient to normalize hemodynamics. Since the effect of the drug is prolonged, the victim should remain in this position for about 24 hours. The use of bandages in the peritoneum and limbs reduces the period of discomfort.

In severe stages of the disorder, levarterenol bitartrate should be administered intravenously in a dose that is sufficient to stabilize blood pressure values.

Interactions with other drugs

Dibenzimil interacts with medications that stimulate α- and β-adrenergic receptors (this includes adrenaline), reducing tachycardia and the antihypertensive effect.

The drug blocks the development of hypothermia that occurs due to the use of reserpine.

The medication enhances the effect of alcoholic beverages, and therefore it is prohibited to take them during treatment with Dibenzimil.

Combination with antihypertensive drugs may potentiate antihypertensive activity.

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Storage conditions

Dibenzimil should be stored in a place closed to small children. Temperature marks - no more than 25°C.

Shelf life

Dibenzimil can be used within a 24-month period from the date of release of the pharmaceutical product.

Application for children

The drug cannot be prescribed in pediatrics.

Analogues

Analogues of the drug are the medications Papazol, Galidor with Dibazol, as well as Vinebral and Duzofarm.