Ixel

Ixel is an effective antidepressant.

Indications Ixela

Indicated for the treatment of depression of varying severity.

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Release form

Available in capsules. One package contains 56 capsules.

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Pharmacodynamics

The drug is a selective neurotransmitter reuptake blocker (of serotonin and norepinephrine). It contains the active ingredient milnacipran, which has no affinity for histamine receptors (H1), M-cholinergic receptors, α-adrenergic receptors, and along with this, benzodiazepine receptors with opium and D1-, as well as D2-dopaminergic receptors.

Due to the high selectivity of the drug, the treatment of depression using it allows for a high-quality effect against the background of high safety. The use of capsules helps to level out the state altered by depression, normalizes the emotional background, and at the same time accelerates cognitive activity.

Pharmacokinetics

After oral administration of the drug, the active substance is quickly absorbed from the gastrointestinal tract, its bioavailability level reaches 85% (this value does not depend on food intake). Milnacipran reaches its highest level 2 hours after taking the capsule.

About 13% of the component is synthesized with protein (inside the serum). A small part of the drug is converted during conjugation together with hyaluronic acid, and the main part (about 90%) is excreted unchanged through the kidneys. With prolonged use, the drug will be excreted from the tissues for about 2-3 days after the drug is discontinued.

A small amount of milnacipran is found in breast milk. The substance can cross the blood-brain barrier.

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Dosing and administration

The capsules are intended for internal use. It is recommended to take them with food. During the treatment period, it is important to maintain regular use, without missing doses. The duration of the therapeutic course and the dosage sizes are prescribed by the attending physician.

As a rule, the daily dosage is twice 50 mg. The dose size may vary depending on the patient's condition. The maximum per day is no more than 250 mg, and the average daily figure is 100 mg. The course of therapy is often quite long (over several months).

For people with impaired renal function, dosage adjustments of the drug are required (taking into account the level of filtration in the kidneys).

If it is necessary to perform local anesthesia (using adrenaline or noradrenaline), the dosage of these painkillers should not exceed 0.1 mg for 10 minutes, and 0.3 mg for 1 hour.

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Use Ixela during pregnancy

The period of pregnancy or lactation is a conditional contraindication to the use of capsules. Only a doctor can prescribe the drug after performing diagnostic procedures, as well as assessing the prognosis of benefit/risk.

Contraindications

Among the absolute contraindications of the drug:

• high sensitivity to milnacipran, and along with it to other components of the drug;
• treatment with MAO type B inhibitors (also for 14 days after the end of the therapeutic course with these drugs). In addition, MAO inhibitors are allowed to be prescribed at least 7 days after the end of the use of Ixel;
• treatment with sumatriptan;
• The medicine is not used in children under 15 years of age.

Among the conditional contraindications:

• treatment with adrenaline or noradrenaline, and also clonidine and its derivatives;
• obstruction of the urinary tract of various origins;
• prostate adenoma.

Caution is required when prescribing to people with the following conditions:

• if there is a history of seizures;
• cardiomyopathy;
• high blood pressure.

You must not drink alcohol during treatment with Ixel. You must also refrain from driving a car during the treatment course.

Side effects Ixela

When treated with Ixel, patients may experience the following side effects:

• CNS: the appearance of tremors or dizziness, feelings of anxiety;
• Gastrointestinal tract: dry mouth, bowel disorders (mainly constipation), nausea, increased activity of ALT or AST indicators, and also vomiting;
• others: increased sweating, problems with urination or heartbeat, hot flashes, development of serotonin intoxication.

Negative effects from taking capsules are often observed during the first 2 weeks of using the drug, and most of them disappear on their own, without specific treatment or discontinuing the drug.

At the initial stage of the therapeutic course, patients with depression may experience increased feelings of anxiety.

Overdose

As a result of an accidental overdose of the drug, vomiting occurs, and in addition, sweating increases and bowel disorders are observed. If the dosage continues to be increased (single use of 800-1000 mg), in addition to the above symptoms, breathing problems and tachycardia appear. As a result of using 1900-2800 mg of the drug once (also in combination with other psychotropic drugs (such as benzodiazepine)) drowsiness and disturbances of consciousness may develop, and hypercapnia may begin.

To eliminate signs of overdose, it is necessary to reduce the absorption of the active component of the drug - among the required measures are gastric lavage and the use of absorbents. In addition, symptomatic treatment is required. The patient must be placed under medical supervision for at least 24 hours.

There is no information on a specific antidote.

Interactions with other drugs

There is a risk of serotonin intoxication in case of combined use of the drug with lithium drugs, MAO inhibitors, and sumatriptan.

The combined use of Ixel and adrenaline with noradrenaline can provoke disturbances in the heart rhythm, as well as a hypertensive crisis.

The concomitant use of milnacipran and digoxin (especially its parenteral form) increases the risk of developing hemodynamic disorders.

Taking Ixel with clonidine reduces the hypotensive effect of the latter (as well as its derivatives).

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Storage conditions

The medicine should be kept in a place inaccessible to children. No special temperature conditions are required for its storage.

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Shelf life

Ixel is suitable for use within 3 years from the date of its release.