Depratal - antidepressant, is used for treatment of big depressive disorder, diabetic peripheral neuropatichesky pain, a generalized anxiety disorder.

Structure

• active ingredient: duloksetina hydrochloride;
• 1 tablet kishechnorastvorimy supports a duloksetin a hydrochloride that is equivalent a duloksetina of 30 mg;
• excipients: the pressed sugar, corn starch, magnesium stearate;
• structure of a cover: copolymer of methacrylic acid-ethyl acrylate (1: 1), dispersion of 30% triethyl citrate; talc of the titan dioxide (E 171) emulsion of a simetikon.

Route of administration

In big depressive disorder. Initial the maintenance dose of 60 mg of 1 times a day irrespective of meal is also recommended.

In a generalized anxiety disorder the recommended initial dose makes 30 mg of 1 times a day irrespective of meal. Patients with insufficient effect of treatment need to increase a dose to 60 mg a day that is a usual maintenance dose at most of patients. At patients with the accompanying big depressive disorder the initial and maintenance dose is recommended makes 60 mg of 1 times a day (see. Also recommendations about a dosage are higher).

At diabetic peripheral neuropatichesky pain. The recommended initial dose makes 60 mg of 1 times a day irrespective of meal. Some patients can recommend increase in the dose to the maximum 120 mg a day divided into 2 receptions. Given dosing it was estimated in terms of safety in clinical trials. Concentration of plasma of a duloksetin shows big individual variability. So, some patients who react to a dose of 60 mg insufficiently can receive a high dose.

within 2 months.

Feature of use

Use during pregnancy or feeding by a breast

Pregnancy

Adequate controlled researches with the assistance of pregnant women were not conducted therefore it is not recommended to use medicament during pregnancy.

Duloksetin is poorly brought by

in breast milk. The dose for the child at the rate of 1 mg on 1 kg of body weight is established makes about 0.14% of a maternal dose. Safety of use of a duloksetin is unknown to children therefore feeding by a breast during reception of a duloksetin is not recommended.

Fertility

In researches on animals duloksetin did not affect male fertility, and effects at women appeared only in doses, caused toxicity for mother.

Children

use Drug in pediatric practice.

Ability to influence speed of response at control of motor transport or other mechanisms

Research of influence of a duloksetin on speed of response at control of motor transport or other mechanisms was not carried out. Use of a duloksetin can be connected with a sedation and dizziness. During treatment the patients can feel sedative reaction or dizziness. At emergence of it it is necessary to abstain from potentially dangerous types of activity requiring special attention and speed of psychomotor reactions.

Overdose

Symptoms. Overdose cases at use of a duloksetin of 5400 mg as monotherapy or in a combination with other medicines are recorded. Several lethal cases are recorded first of all at mixed to overdose, but there were also lethal cases after use of a duloksetin separately in a dose about 1000 mg. Signs and symptoms of overdose (duloksetin separately or with other medicines) included drowsiness, a coma, a serotoninovy syndrome, spasms, vomiting and tachycardia in combinations. Overdose symptoms (mainly at inclusion in combinations with other drugs) included drowsiness, a coma, a serotoninovy syndrome, epileptic seizures, vomiting and tachycardia.

, at emergence of a serotoninovy syndrome the specific treatment (cyproheptadine and/or control of temperature) is necessary. It is necessary to check passability of airways. Monitoring of warm activity and control of key indicators of activity together with the appropriate symptomatic and supporting measures is recommended. Gastric lavage can be appropriate if it is carried out right after administration of medicament or with the symptomatic purpose. Activated carbon reduces medicament absorption. Duloksetin has the large volume of distribution in an organism in this connection an artificial diuresis, hemoperfusion and exchange perfusion will be hardly useful.

Contraindication

Contraindication for use of medicament is the hypersensitivity to a duloksetin or to any excipients of drug.

together with the MAO (MAO) non-selective irreversible inhibitors.

patient with unstable hypertensia as it can provoke hypertensive crisis.

patient with an end-stage of a renal failure (clearance of creatinine <30 ml/min.).

with liver diseases, it can lead to a liver failure.

in a combination with fluvoksaminy, ciprofloxacin or enoksatsiny (strong CYP1A2 inhibitors) because of increase in concentration of a duloksetin in blood plasma.

to Store

at a temperature not above 25 °C in original packing.

to Store

out of children's reach.