Ixelles

Ixel is an effective antidepressant.

[1]

Indications of the ixela

It is indicated for the treatment of depression of varying severity.

[2], [3]

Release form

Available in capsules. One package contains 56 capsules.

[4]

Pharmacodynamics

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

Due to the high selectivity of drugs, treatment of depression with its use makes it possible to obtain a qualitative effect against a background of high safety. The use of capsules promotes the alignment of the depressed state, normalizes the emotional background, and at the same time accelerates cognitive activity.

Pharmacokinetics

After taking the medicine inside, the active substance is quickly absorbed from the digestive tract, the level of its bioavailability reaches up to 85% (this value does not depend on the consumption of food). The highest index of milnacipran reaches after 2 hours after the use of the capsule.

About 13% of the component is synthesized with protein (inside the serum). An insignificant part of the drug is converted by conjugation together with hyaluronic acid, and the major part (about 90%) is excreted unchanged through the kidneys. With long-term use, the drug will be excreted from the tissues about 2-3 days after the drug is withdrawn.

A small part of milnacipran is found inside the mother's milk. The substance can pass through the BBB.

[5]

Dosing and administration

Capsules are for internal use. It is recommended to take them with food. During the treatment period it is important to observe the regularity of use, not missing the dose. The duration of the therapeutic course and dosage sizes are prescribed by the treating doctor.

Typically, the daily dosage is twice 50 mg. The size of the dose can vary according to the patient's condition. The maximum for the day is not more than 250 mg, and the daily average is 100 mg. Often, the course of therapy is quite long (for several months).

For people with impaired renal activity, dosage adjustment is required (taking into account the level of filtration in the kidneys).

If necessary, perform local anesthesia (with the help of epinephrine or norepinephrine), the dosage of these pain relievers should not exceed 0.1 mg for 10 minutes, as well as 0.3 mg for 1 hour.

[7], [8], [9], [10]

Use of the ixela during pregnancy

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

Contraindications

Among the unconditional contraindications of drugs:

• high sensitivity relative to milnacipran, and with it the remaining elements of the drug;
• treatment with MAO type B inhibitors (also within 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 completion of Ixel;
• treatment with sumatriptan;
• the drug is not used in children under 15 years of age.

Among the contingent contraindications:

• treatment with the help of adrenaline or noradrenaline, and besides this clonidine and its derivatives;
• obstruction of urinary ducts of different origin;
• BPH.

Care must be taken when prescribing to people with the following conditions:

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

You can not drink alcohol during the period of Ixelles treatment. Also, during the treatment course, you must refrain from driving the car.

Side effects of the ixela

In the treatment of Ixelles, the following side effects may appear in patients:

• CNS: the appearance of tremors or dizziness, feelings of anxiety;
• Gastrointestinal tract: dryness of oral mucosa, disorders of stool (mainly constipation), nausea, increased activity of ALT or AST indicators, and besides this vomiting;
• others: increased sweating, problems with urination or palpitations, the appearance of hot flashes, the development of serotonin intoxication.

Negative manifestations due to the use of capsules are often observed during the first 2 weeks of drug use, with most of them disappearing on their own, without specific treatment or drug withdrawal.

At the initial stage of the therapeutic course, a feeling of anxiety can worsen in patients with depression.

[6]

Overdose

Due to a random excess of the drug, vomiting occurs, and in addition sweating is increased and there are disorders of the stool. If the dosage is continued to increase (single use of 800-1000 mg), in addition to the above manifestations, there are problems with breathing and tachycardia. As a result of the use of 1900-2800 mg of the drug once (also in combination with other psychotropic drugs (such as benzodiazepine)) drowsiness and consciousness disorders may develop, and hypercapnia may also begin.

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

There is no information on a specific antidote.

Interactions with other drugs

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

The combination of Ixel and adrenaline with norepinephrine can trigger frustration in the rhythm of the heartbeat, and in addition hypertensive crisis.

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

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

[11], [12], [13], [14], [15]

Storage conditions

The medicine must be kept in a place that is inaccessible to children. To store it does not require a special temperature regime.

[16], [17]

Shelf life

Ixel is usable for 3 years from the date of its release.

[18]