"Grandaxin" has been known all over the world for a very long time and has established itself as an effective drug for the treatment of neurosis, vegetative and anxiety manifestations of other diseases. According to the prescription or not, "Grandaxin" is dispensed in pharmacies, it will become clear if you understand its properties, indications, contraindications and side effects.
Active ingredient
"Grandaxin" is a drug with the active ingredient tofisopam, which is obtained by improving the diazepam molecule. As you know, Diazepam is a benzodiazepine tranquilizer, which is a serious controlled drug, so the answer to the question of whether a prescription for Grandaxin is needed will be positive. But unlike its older brother, thanks to the chemical modifications carried out, Grandaxin is not addictive and does not cause serious side effects. Therefore, you will need a regular white prescription for Grandaxin, whichcan be prescribed not only by a psychiatrist and psychotherapist.
The properties of tofisopam are:
- Anti-anxiety effect, that is, relieving nervous tension, stopping fear, inner trembling and anxiety.
- The vegetostabilizing effect is due to the balancing of the work of the parasympathetic and sympathetic divisions of the autonomic nervous system, which helps to correct disorders in the form of tachycardia, blood pressure drops, sweating, stool disorders, nausea, abdominal pain, urination disorders of functional origin.
- Moderate stimulating activity helps fight apathy, weakness, asthenia, depression, lack of energy.
Indications for prescription
The drug is prescribed for the following pathologies:
- Neurotic disorders accompanied by anxiety, anxiety, asthenia (anxiety-phobic disorders, neurasthenia, anxiety depression, panic attacks).
- Somatoform autonomic disorders (somatoform autonomic dysfunction, somatoform pain disorder, hypochondriacal disorder).
- Adjustment disorders accompanied by anxiety and low mood.
- In gynecological practice for the relief of premenstrual syndrome and menopausal manifestations (increased blood pressure, sweating, tachycardia, hot flashes, irritability).
- In neurological practice to eliminate tension headaches, dizziness,syncope associated with anxiety disorders, relief of manifestations of radiculopathy and osteochondrosis.
- In cardiology practice to get rid of tachycardia, hypertension and arrhythmias of a functional nature that occur when the nervous system is unbalanced.
- In narcology to alleviate the withdrawal of alcohol and other psychoactive substances.
Thus, a specialist of any profile can write out a prescription for Grandaxin, depending on the indications for use.
Dosing regimen
The drug is taken orally, regardless of food. The dose depends on the disease and is selected by the doctor individually. On average, 1-2 tablets of 50 mg are prescribed from one to three times a day. You can take a maximum of 6 tablets of tofisopam per day, which is 300 mg. Perhaps the situational use of the drug 1-2 tablets.
To write out "Grandaxin" by prescription or not, only the doctor decides, but according to the rules, the pharmacy must require a form with a seal.
Contraindications
What can be the reason for refusing to take the drug:
- Severe motor overexcitation, aggressive behavior, severe depression.
- Decompensated cardiopulmonary failure.
- Sleep apnea.
- Pregnancy in the first trimester (12 weeks).
- Breastfeeding.
- Conditions in which lactose is not tolerated, which is present in the tablet as an auxiliarycomponent.
- Individual intolerance to benzodiazepines or tofisopam.
- Co-administration with cyclosporine, sirolimus, tacrolimus.
If at least one of the above diseases or conditions is present, the drug is not approved. "Grandaxin" by prescription or in a hospital is prescribed after a thorough questioning of the patient.
Side effects
The drug is well tolerated, but in rare cases the following undesirable effects were noted, which appeared more often when using large doses of the medicinal substance:
- Headache, increased irritability, sleep disturbance, motor agitation, mental confusion, seizures in epileptics.
- Disturbed appetite, flatulence, constipation, nausea, dry mouth, jaundice.
- Painful sensations in the muscles associated with their tension.
- Allergic urticaria, itchy skin, scarlet fever-like rash.
- Respiratory depression.
If side effects occur, seek medical attention immediately.
Use in pregnancy
The drug should not be used in pregnant women in the first trimester, as it may harm the developing child. After 12 weeks, "Grandaxin" can be prescribed only when the benefits of taking it for the mother will significantly outweigh the risk to the fetus.
The active ingredient passes into breast milk, so duringduring lactation, you should refrain from taking the drug.
Special Instructions
"Grandaxin" is prescribed with caution in patients with the following diseases:
- Diseases of the pulmonary sphere (chronic respiratory distress syndrome in the stage of decompensation, acute respiratory failure).
- Liver diseases (cirrhosis, severe hepatitis, liver tumors). In this case, an increase in adverse reactions to the medication is possible.
- Persons with renal insufficiency should reduce the dose by half, because the active substance is excreted by the kidneys.
- Diseases of the nervous system (epilepsy of various origins, organic pathologies of the brain, including severe atherosclerotic lesions of the brain vessels).
- Angle-closure glaucoma due to risk of increased intraocular pressure.
- Elderly people should adjust the dosage by half.
- In psychosis accompanied by motor reactions, obsessive-compulsive disorders and phobias in the acute stage, as well as in the depressive phase, treatment with Grandaxin alone will not bring the desired effect, but can only aggravate the situation. Therefore, it is necessary to combine it with more pathogenic agents.
Driving vehicles and working at height while using tofisopam is not forbidden, as the drug does not have a sedative and inhibitory effect on the central nervous system.
Drug Interactions
"Grandaxin" is prohibited for joint use with tacrolimus, cyclosporine, sirolimus, as these medicinal substances undergo chemical transformations using the same enzyme, which can lead to a significant increase in their blood levels.
Drugs that affect brain cells, changing the functioning of the central nervous system (anesthetics, anesthetics, painkillers, antidepressants, sedatives, blockers of histamine H1-receptors, sleeping pills medicines, antipsychotics) can increase their effect, which can lead to an increase in adverse reactions.
Accelerating the transformation of the active ingredient under the influence of inducers of enzymatic liver activity (ethyl alcohol, barbiturates, drugs for epilepsy) causes an increase in their amount in the blood plasma, which weakens the therapeutic effect of the drug. Therefore, it is forbidden to use drops with phenobarbital ("Corvalol"), alcohol during the treatment of "Grandaxin" is prohibited.
Medications that kill fungal infection, containing itraconazole and ketoconazole as the main substance, slow down the metabolic reactions of tofisopam, which causes its accumulation in plasma and increases the risk of side effects.
Intensification of the effect of the drug is possible under the influence of certain drugs for pressure (clonidine, calcium channel blockers).
To a small extent, without clinical manifestations, beta-blockers can reduce the conversion of the drug in the body.
When taken together with "Digoxin", its amount in the bloodmay increase, which should be considered in patients with cardiac pathology.
"Warfarin", taken for blood thinning, can interact with "Grandaxin", so you should carefully monitor the coagulation parameters of patients.
Antacids that reduce stomach acid may interfere with normal absorption of the drug.
"Omeprazole" and "Cimetidine", used in gastroenterological practice, reduce the metabolic transformations of "Grandaxin", which may affect the occurrence of negative effects.
Combined oral contraceptives reduce the metabolism of the drug, which should be taken into account when choosing a dose.
"Grandaxin": prescription or not?
According to the law, 70% of drugs registered in the Russian Federation must be dispensed on a prescription form. The drug is a derivative of a benzodiazepine. Therefore, Grandaxin should not be dispensed without a prescription. This is also indicated in the instructions for the drug. For non-prescription dispensing, the pharmacy faces a fine. In addition, the prescription for the drug with the active ingredient tofisopam must remain in the pharmacy and is subject to accounting in order to control the number of packages sold.
It is possible to purchase "Grandaxin" without prescriptions in a pharmacy via the Internet, but when delivering goods to their homes, patients may also require a prescription form. These rules are written on the site when placing an order.
Sample prescription for Grandaxin
According to the order of the Ministry of He alth of the Russian Federation No. 403n (2017-11-07) “On approval of the rules for dispensing drugs”, the issuance of medicines from pharmacies has changed somewhat and the list of prescription substances has expanded. For the drug "Grandaxin", a prescription in Latin should be written out only by a doctor in the form No. 107-1 / y. Any activity is illegal. The form must contain the patient's surname and initials, his age, the surname and initials of the doctor, the date of discharge, the type (adult or child), the number of tablets, the method and mode of administration, the validity of the prescription, the personal seal and signature of the doctor, as well as the seal of the institution where the specialist works.
Reviews
According to the statistics on the responses of patients to the drug Grandaxin, from 80 to 90% of people who took this medicine are positive about it.
Doctors of various speci alties are happy to prescribe the drug because of its high efficiency, wide range of indications and good tolerance of the active substance.
Studying the reviews of patients, it should be noted that it is quite easy to buy "Grandaxin" without prescriptions in Moscow. This also applies to a large number of other drugs that must be dispensed by prescription. Such violations lead to unreasonable and uncontrolled use of drugs, which leads to an increase in the number of poisonings, side effects and overdoses.
