Duzopharm

Duzofarm (active ingredient: naftidrofuryl) is a drug that belongs to vasodilators and is used to improve peripheral circulation. Naftidrofuryl improves blood supply to tissues and organs, which is especially important in diseases associated with impaired peripheral circulation.

Naftidrofuryl improves metabolism and energy supply of cells, dilates peripheral vessels, which leads to improved microcirculation and increased blood flow in tissues. It also has antiplatelet properties, which helps prevent the formation of blood clots.

Indications Duzopharma

1. Peripheral vascular diseases:

   • Obliterating endarteritis
   • Obliterating atherosclerosis
   • Raynaud's disease

2. Cerebrovascular diseases:

   • Chronic cerebrovascular disorders
   • Post-stroke conditions
   • Dementia of vascular origin

3. Syndromes associated with peripheral circulation disorders:

   • Intermittent claudication
   • Night leg pain
   • Trophic ulcers of the lower extremities

Release form

1. Capsules:
   • Dosage: 100 mg, 200 mg or 400 mg of naftidrofuryl in one capsule.
   • Packaging: blisters of 10 or 15 capsules per package, may contain from 30 to 120 capsules depending on the manufacturer and specific packaging.

Pharmacodynamics

1. Vasodilation:

   • Naftidrofuryl dilates peripheral vessels, which improves tissue blood supply. This action is due to the inhibition of phosphodiesterase and an increase in the content of cyclic adenosine monophosphate (cAMP) in vascular smooth muscle cells, which leads to their relaxation.

2. Improving tissue metabolism:

   • The drug enhances metabolic processes in tissues, especially in conditions of hypoxia (lack of oxygen). This is achieved by improving aerobic metabolism and increasing the energy level in cells.

3. Antiplatelet action:

   • Naftidrofuryl has the ability to reduce platelet aggregation, which reduces the risk of thrombus formation. This is especially important for patients with peripheral vascular diseases, where the risk of thrombus formation is increased.

4. Antioxidant action:

   • Naftidrofuryl has an antioxidant effect, reducing the amount of free radicals in tissues, which helps reduce cell damage and improve their functions.

5. Improving microcirculation:

   • The drug improves microcirculation by reducing blood viscosity and improving the deformability of red blood cells. This improves blood flow in the capillaries and increases the supply of oxygen and nutrients to tissues.

Clinical effects:

• Reduction in intermittent claudication symptoms: Patients with peripheral arterial disease report improved ability to walk long distances without pain.
• Reducing symptoms of chronic cerebrovascular diseases: Patients with vascular dementia and other chronic cerebrovascular disorders may experience improvements in cognitive function and overall well-being.

Pharmacokinetics

1. Suction:

   • Naftidrofuryl is rapidly and almost completely absorbed from the gastrointestinal tract after oral administration. Maximum plasma concentrations are reached within 1-2 hours after administration.

2. Distribution:

   • The drug is well distributed in the body tissues. The connection with plasma proteins is about 80-90%, which indicates a high degree of binding to blood proteins.
   • Naftidrofuryl penetrates the blood-brain barrier, which facilitates its use in the treatment of cerebrovascular diseases.

3. Metabolism:

   • Naftidrofuryl is extensively metabolized in the liver to form several metabolites. The main metabolic pathway involves hydrolysis of the ester bond to form naftidrofuryl acid and other metabolites.

4. Withdrawal:

   • Excretion of naftidrofuryl and its metabolites occurs primarily through the kidneys. About 60-70% of the administered dose is excreted in the urine, and only a small amount in the feces.
   • The half-life is approximately 3-5 hours, which allows the drug to be taken several times a day to maintain therapeutic concentrations.

5. Pharmacokinetic features in special patient groups:

   • In patients with impaired liver and kidney function, changes in the pharmacokinetics of naftidrofuryl may be observed, which requires dose adjustment and more careful monitoring.
   • In elderly patients, metabolism and elimination of the drug may be slower, which may also require dosage adjustment.

Features of application:

• Taking the drug with food may slow down absorption, but does not reduce the overall bioavailability of naftidrofuryl.
• It is necessary to follow the recommended dosage and regimen prescribed by the doctor to ensure the optimal therapeutic effect and minimize the risk of side effects.

Dosing and administration

Recommended dosages:

Adults:

• Standard dose: 100 mg (1 capsule) 3 times a day.
• For more severe conditions: The dose may be increased to 200 mg (2 capsules) 3 times daily, depending on the severity of the disease and the individual patient's response.

Directions for use:

1. Oral administration:

   • The capsules should be taken orally with a sufficient amount of water (at least half a glass).
   • It is best to take the capsules with food to reduce the risk of gastrointestinal irritation.

2. Duration of treatment:

   • The duration of treatment is determined by the doctor individually depending on the nature of the disease, the clinical picture and the patient's response to therapy.
   • In most cases, the course of treatment lasts from several weeks to several months.

Special instructions:

• Patients with renal insufficiency:

  • In patients with impaired renal function, dosage adjustment may be necessary. The physician will assess the need for dosage adjustment based on creatinine clearance and the patient's general condition.

• Elderly patients:

  • Elderly patients may have slower metabolism and elimination of the drug, requiring careful monitoring and possibly dose adjustment.

• Missed dose:

  • If you miss a capsule, take it as soon as possible. If it is almost time for your next dose, do not double the dose, just continue taking it as usual.

• Discontinuation of treatment:

  • The drug should be discontinued gradually and under the supervision of a physician to avoid a sharp deterioration in the condition.

Use Duzopharma during pregnancy

1. Lack of sufficient data:

   • There is currently insufficient clinical data on the safety of naftidrofuryl in pregnant women. Animal studies may not accurately predict human responses, so the risks remain uncertain.

2. Prescription only for strict indications:

   • The use of naftidrofuryl during pregnancy is possible only in cases where the potential benefit to the mother significantly exceeds the possible risk to the fetus. The decision to prescribe the drug is made by the doctor, carefully assessing all possible risks and benefits.

3. Use in the first trimester:

   • During the first trimester of pregnancy, when the formation of the main organs and systems of the fetus occurs, the use of naftidrofuryl should be avoided due to the potential risk of teratogenic effects.

4. Status monitoring:

   • If the drug is prescribed to a pregnant woman, careful monitoring of the mother and fetus is required. The doctor may recommend regular examinations and monitoring of indicators for the timely detection of possible side effects.

Alternative measures:

• If you have conditions that involve peripheral or cerebrovascular circulation, your doctor may consider alternative treatments that have been proven safe during pregnancy.
• Non-pharmacological approaches such as physical therapy and lifestyle changes may also be considered as alternative or complementary measures.

Lactation:

• There is insufficient information on the excretion of naftidrofuryl in breast milk. If it is necessary to use the drug during lactation, it is necessary to consider stopping breastfeeding for the duration of treatment to avoid potential risk to the infant.

Contraindications

1. Hypersensitivity:

   • Hypersensitivity to naftidrofuryl or any of the excipients of the drug.

2. Severe liver dysfunction:

   • The drug is metabolized in the liver, therefore, in case of severe liver dysfunction, the use of naftidrofuryl is contraindicated.

3. Severe renal impairment:

   • Since naftidrofuryl and its metabolites are excreted by the kidneys, the drug is contraindicated in cases of severe renal impairment.

4. Acute myocardial infarction:

   • The drug is not recommended for use in the acute period of myocardial infarction.

5. Bradycardia:

   • The drug may affect heart rhythm, so its use is contraindicated in cases of severe bradycardia (slow heart rate).

6. Severe forms of arterial hypotension:

   • The drug may lower blood pressure, which is dangerous if severe hypotension already exists.

7. Pregnancy and lactation period:

   • As already mentioned, the use of naftidrofuryl during pregnancy and breastfeeding is contraindicated due to lack of safety data.

8. Childhood:

   • The drug is contraindicated in children under 18 years of age, as safety and efficacy for this group of patients have not been established.

Special warnings:

• Cardiovascular diseases: In the presence of cardiovascular diseases, caution and careful monitoring of the patient's condition is required.
• Epilepsy: The drug may affect the central nervous system, so it should be used with caution in patients with epilepsy.
• Possible interactions with other drugs: Possible drug interactions should be considered, especially with drugs that affect heart rhythm and blood pressure.

Side effects Duzopharma

Common side effects:

1. From the gastrointestinal tract:

   • Nausea
   • Vomit
   • Diarrhea
   • Abdominal pain

2. From the nervous system:

   • Headache
   • Dizziness
   • Insomnia
   • Agitation or irritability

3. From the cardiovascular system:

   • Tachycardia (rapid heartbeat)
   • Arterial hypotension (low blood pressure)
   • Bradycardia (slow heartbeat)
   • Worsening of angina symptoms (rare)

4. Allergic reactions:

   • Rash
   • Itching
   • Hives
   • Angioedema (very rare)

5. From the skin:

   • Redness of the skin
   • Rash
   • Sweating

6. From the respiratory system:

   • Dyspnea
   • Bronchospasm (rare)

Less common side effects:

1. From the liver side:

   • Increased liver enzyme levels
   • Hepatitis (very rare)

2. From the hematopoietic system:

   • Anemia
   • Leukopenia (decrease in the number of white blood cells)
   • Thrombocytopenia (decreased platelet count)

3. Mental disorders:

   • Depression
   • Anxiety

Overdose

1. From the gastrointestinal tract:

   • Nausea
   • Vomit
   • Diarrhea

2. From the cardiovascular system:

   • Decreased blood pressure (hypotension)
   • Rapid heartbeat (tachycardia)
   • Heart rhythm disorders (arrhythmias)

3. From the central nervous system:

   • Dizziness
   • Headache
   • Excitation or, conversely, depression of the central nervous system

4. Allergic reactions:

   • Skin rash
   • Itching
   • In rare cases, angioedema

Interactions with other drugs

Drug interactions:

1. Anticoagulants and antiplatelet agents:

   • Concomitant use with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin) may increase the risk of bleeding. It is necessary to monitor blood coagulation parameters and adjust drug doses.

2. Antihypertensive drugs:

   • Naftidrofuryl may potentiate the action of antihypertensive drugs, which may lead to excessive reduction in blood pressure. Monitoring of blood pressure and, if necessary, adjustment of antihypertensive drug doses are required.

3. Cardiac glycosides:

   • Concomitant use with cardiac glycosides (eg, digoxin) may increase the risk of arrhythmia. Monitoring of cardiac activity is recommended.

4. Drugs affecting the central nervous system:

   • Naftidrofuryl may interact with drugs that affect the central nervous system, such as sedatives and antipsychotics, enhancing or changing their effects.

5. Cytochrome P450:

   • Naftidrofuryl is metabolized in the liver with the participation of the cytochrome P450 system. Drugs that inhibit or induce this system (eg, rifampicin, ketoconazole) may alter the metabolism of naftidrofuryl, requiring dose adjustment.

Interactions with food and alcohol:

1. Food:

   • Food intake may slow the absorption of naftidrofuryl, but does not affect its overall bioavailability. It is recommended to take the drug with food to reduce the risk of gastrointestinal irritation.

2. Alcohol:

   • Concomitant use of alcohol and naftidrofuryl may increase sedative effects and adverse effects on the gastrointestinal tract. It is recommended to avoid alcohol consumption during treatment.