Dicinone

Dicynone (etamzilat) is a drug used to reduce bleeding and improve the blood clotting process. It belongs to the group of hemostatic (hemostatic agents) and antihemorrhagic drugs.

Dicynone has several mechanisms of action:

1. Stimulation of platelet adhesion and aggregation: This drug promotes the activation of platelets, which speeds up the process of blood clot formation and helps stop bleeding.
2. Increased secretion of endogenous blood coagulation factors: Dicynone can stimulate the release of coagulation factors from the vascular wall, which promotes rapid blood coagulation.

Dicynone is used to treat various types of bleeding, including nosebleeds, gum bleeding, uterine bleeding, and other bleeding. It can also be used in the postoperative period to speed up wound healing and prevent postoperative bleeding.

This medication is usually available as a tablet or solution for intravenous or intramuscular administration. Dosage and administration schedule may vary depending on the specific clinical situation and the doctor's recommendations.

Indications Dicinone

1. Nosebleeds: Dicynone can be used to quickly stop nosebleeds (epistaxis).
2. Bleeding gums: The drug can be used to treat bleeding gums caused by various reasons, such as gingivitis (inflammation of the gums) or periodontitis (inflammation of the tissues surrounding the teeth).
3. Uterine bleeding: Dicynone can be used to reduce bleeding associated with various gynecological problems, such as menstrual irregularities or bleeding after childbirth or abortion.
4. Surgical and postoperative bleeding: The drug can be used to prevent or treat bleeding after surgery.
5. Upper respiratory tract bleeding: Dicynone can be used in case of bleeding from the upper respiratory tract, such as bleeding from the throat or trachea.
6. Hemorrhagic diathesis: The drug may be recommended for patients with blood clotting disorders or hemorrhagic diathesis to speed up the blood clotting process.

Release form

1. Tablets: Dicynone can be produced in the form of tablets for oral administration. Tablets can have different dosages depending on the specific medical purpose.
2. Injection solution: This medication can also be presented as an injection solution. Injection solution is usually used to quickly introduce a drug into the body in case of an urgent need.
3. Oral solution: Dicynone can also be supplied as an oral solution.

Pharmacodynamics

1. Stimulation of thromboplastin synthesis: Etamsylate stimulates thromboplastin synthesis, which increases the formation of thromboplastins in vascular endothelial cells. Thromboplastin is an important blood clotting factor that promotes thrombus formation during bleeding.
2. Improving microcirculation: Etamsylate improves microcirculation in capillaries, which promotes better tissue perfusion and accelerates blood clotting processes.
3. Reducing capillary permeability: Etamsylate also affects capillary endothelial cells, reducing their permeability. This helps prevent effusion and edema in tissues.
4. Anti-inflammatory action: In some cases, etamsylate also exhibits anti-inflammatory action, reducing inflammation in the vascular wall.
5. Improving blood rheology: Etamsylate helps improve blood rheology, which can help prevent blood clots and reduce blood viscosity.

Pharmacokinetics

1. Absorption: Etamsylate is generally well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are usually reached 1-2 hours after administration.
2. Distribution: Etamsylate is rapidly distributed in the tissues and organs of the body. It has a high affinity for the vascular endothelium, which contributes to its hemostatic effect.
3. Metabolism: Etamsylate is metabolized in the liver to form several metabolites. However, the nature and main metabolic pathways of this drug are not fully understood.
4. Elimination: The half-life of etamsylate in the body is about 2-4 hours. Most of the dose is excreted through the kidneys as metabolites and unmetabolized drug.

Dosing and administration

1. Directions for use:

   • Dicynone is usually taken orally, i.e. through the mouth.
   • The tablets are usually taken whole with plenty of water.
   • The oral solution can also be used, in which case the dosage is measured using the included dropper or measuring cup.
   • To achieve maximum effect, it is recommended to take the drug during meals.

2. Dosage:

   • The dosage of Dicynone may vary depending on the type and severity of bleeding, as well as the individual characteristics of the patient.
   • The usual starting dosage for adults is 250-500 mg 3-4 times daily.
   • For children, the dosage is determined by the doctor depending on their age and weight.

Use Dicinone during pregnancy

The use of Dicynone during pregnancy should be very careful and controlled, as data on its effects on pregnant women and the fetus are limited. However, there are studies indicating its potential benefits in certain clinical situations:

1. Etamsylate as a prophylactic agent: In one study, etamsylate was used during labor to prevent cerebral hemorrhage in premature infants. The results showed a significant reduction in the incidence of cerebral hemorrhage among the infants given etamsylate (Györe et al., 1990).
2. Effect on prostaglandin synthesis: Studies show that etamsylate may inhibit prostaglandin synthesis in the myometrium of pregnant women, which could potentially affect uterine contractility and the labor process (Kovács & Falkay, 1981).

These data suggest that etamsylate may be useful in certain situations during pregnancy, but its use should be closely monitored by health professionals. Before starting to use etamsylate during pregnancy, it is important to have a thorough discussion with your doctor, considering all possible risks and benefits.

Contraindications

1. Hypersensitivity to etamsylate: People with known hypersensitivity to etamsylate or any of the components of the drug should avoid its use.
2. Thrombosis, thrombophlebitis or hypercoagulability: Dicynone is contraindicated in the presence of thrombosis (formation of a blood clot in a blood vessel), thrombophlebitis (inflammation of the vein wall with formation of a blood clot) or hypercoagulability (increased tendency to form blood clots).
3. Hemorrhagic disorders: The use of Dicynone may be undesirable in patients with hemorrhagic disorders or thrombocytopenia (decreased number of platelets in the blood).
4. Pregnancy and breastfeeding: The use of Dicynone during pregnancy and breastfeeding should be discussed with a doctor, since data on its safety during these periods is limited.
5. Childhood: The use of Dicynone in children requires special caution and should be carried out under the supervision of a physician.
6. Use with other medications: Before using Dicynone in combination with other medications, you should consult your doctor to ensure there are no potential interactions.

Side effects Dicinone

1. Systemic reactions:

   • Rarely, allergic reactions such as hives, itching, rash or swelling may occur.
   • Anaphylactic shock may develop in extremely rare cases.

2. Digestive system:

   • Stomach upset, nausea, vomiting, diarrhea, or a general feeling of discomfort in the abdomen may occur.
   • Some patients may experience heartburn or discomfort in the epigastric region.

3. Central nervous system:

   • In rare cases, headache, dizziness or fatigue may occur.

4. Cardiovascular system:

   • Increased blood pressure (hypertension) may occur.
   • In rare cases, cardiac arrhythmias may occur.

5. Skin reactions:

   • Some patients may experience dry skin or skin irritation.

6. Other reactions:

   • Changes in the blood may occur, such as a mild decrease in platelet count or other bleeding disorders.
   • Rarely, hypersensitivity to light or photodermatitis may occur.

Overdose

1. Systemic allergic reactions: Allergic reactions such as skin rash, itching, or angioedema may occur.
2. Gastrointestinal Disorders: Gastrointestinal disturbances such as nausea, vomiting, abdominal pain and diarrhea may occur.
3. Hypercoagulability: Due to the drug that improves blood clotting, there may be an increased risk of thrombosis and clot formation.
4. Hemostasis disorders: Bleeding may occur from various sources due to changes in the blood clotting system.

Interactions with other drugs

1. Medicines affecting blood clotting: Dicynone is an agent that improves blood clotting, so its effect may be enhanced when used simultaneously with other drugs such as aspirin, heparin, warfarin or other anticoagulants. This may increase the risk of bleeding.
2. Drugs affecting the circulatory system: Dicynone may enhance the effects of some drugs affecting the cardiovascular system, such as adrenaline or digitalis, which may lead to an increase in heart rate or changes in blood pressure.
3. Drugs that affect kidney function: Since Dicynone is partially excreted through the kidneys, drugs that affect kidney function may alter its concentration in the body. This may include diuretics or other drugs that may affect the kidneys' filtration rate.
4. Drugs affecting the gastrointestinal tract: Dicynone may affect the gastrointestinal tract, so its effectiveness may be reduced when taken simultaneously with drugs that accelerate intestinal movement, such as metoclopramide or macrogol.

Storage conditions

1. Temperature: The product should be stored at room temperature, usually between 15°C and 30°C.
2. Humidity: Store Dicynone in a dry place to avoid damage.
3. Packaging: Before use, make sure that the packaging of the drug is intact. If the packaging is damaged or expired, the drug should be disposed of in accordance with local rules and regulations.
4. Child safety: Keep Dicynone out of the reach of children to prevent accidental use.
5. Other recommendations: Observe hygiene rules when working with the drug.