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Описание

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Алзепил таб. п/о плен., 5 мг, 28 шт.

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5.0
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Дозировка: 5 мг

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Количество штук в упаковке, шт.: 28

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Коротко о товаре

Артикул Маркета
4453164640
Тип препарата
Назначение
Действующее вещество
Возраст
от 18 лет
Инструкция
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Дозы, превышающие 10 мг/сутки в клинических исследованиях, не изучались.\u003Cbr\u003EЛечение следует начинать и проводить под наблюдением врача, имеющего опыт в диагностике и лечении деменции Альцгеймеровского типа. Диагноз должен быть основан на принятых рекомендациях, например, DSM IV, МКБ 10.\u003Cbr\u003EЛечение донепезилом можно начинать только при наличии лиц, ухаживающих за пациентом, способных регулярно следить за приемом препарата. Поддерживающую терапию можно продолжать до тех пор, пока сохраняется терапевтически эффект, который следует регулярно оценивать. При отсутствии терапевтического эффекта следует рассмотреть возможность отмены лечения.\u003Cbr\u003EПосле отмены препарата может наблюдаться постепенное снижение благоприятного эффекта лечения.\u003Cbr\u003EНарушение функции почек и печени\u003Cbr\u003EПациенты с нарушением функции почек не нуждаются в изменении схемы лечения, т.к. это состояние не влияет на клиренс донепезила.\u003Cbr\u003EВ связи с возможным увеличением экспозиции при легком или умеренном нарушении функции печени повышение дозы следует выполнять с учетом индивидуальной переносимости. Отсутствуют данные о применении препарата у пациентов с тяжелым нарушением функции печени.\u003Cbr\u003EДети и подростки\u003Cbr\u003EПрепарат Алзепил не предназначен для лечения детей и подростков."},{"name":"Побочные действия","value":"Самыми частыми нежелательными явлениями являются диарея, мышечные судороги, утомляемость, тошнота, рвота и бессонница. Сообщалось также о головокружении, головной боли, болевых ощущениях, несчастных случаях и простудах. В большинстве случаев эти явления проходят и не требуют прекращения введения препарата.\u003Cbr\u003EОпределение частоты побочных реакций: очень часто (≥1/10), часто (≥1/100, \u003C1/10), нечасто (≥1/1000, ≤1/100), редко (≥1/10 000, ≤1/1000), очень редко (≤1/10 000), частота неизвестна (невозможно оценить по имеющимся данным).\u003Cbr\u003EПсихические нарушения: часто - галлюцинации**, возбуждение **, агрессивное поведение**, ненормальные сновидения, кошмарные сновидения**.\u003Cbr\u003EСо стороны нервной системы: очень часто - головная боль; часто - обмороки*, головокружение, бессонница; нечасто - судорожные припадки*; редко - экстрапирамидные симптомы; очень редко - ЗНС.\u003Cbr\u003EСо стороны сердечно-сосудистой системы: нечасто - брадикардия; редко - синоатриальная блокада, AV-блокада.\u003Cbr\u003EСо стороны пищеварительной системы: очень часто - диарея, тошнота; часто - рвота, диспепсия, анорексия; нечасто - кровотечение из ЖКТ, язвы желудка и двенадцатиперстной кишки; редко - нарушение функции печени, в т.ч. гепатит***.\u003Cbr\u003EСо стороны кожи и подкожных тканей: часто - сыпь, кожный зуд.\u003Cbr\u003EСо стороны костно-мышечной системы: часто - мышечные спазмы; очень редко - рабдомиолиз****.\u003Cbr\u003EСо стороны мочевыделительной системы: часто - недержание мочи.\u003Cbr\u003EСо стороны лабораторных и инструментальных исследований: нечасто - незначительное повышение активности мышечной изоформы КФК в сыворотке крови.\u003Cbr\u003EПрочие: часто - насморк, утомляемость, боль, несчастный случай."},{"name":"Фармакологическое действие","value":"Механизм действия и фармакодинамический эффект\u003Cbr\u003EДонепезил - селективный и обратимый ингибитор ацетилхолинэстеразы, которая являете основным преобладающим типом холинэстеразы в головном мозге. In vitro донепези ингибирует этот фермент более чем в 1000 раз сильнее, чем бутирилхолинэстеразу - фермени который находится в основном вне центральной нервной системы.\u003Cbr\u003EОднократный прием 5 мг или 10 мг в равновесном состоянии сопровождается угнетение активности холинэстеразы (оценивается на модели мембран эритроцитов) на 63,6 и 77,39 соответственно. Способность донепезила гидрохлорида угнетать активность холинэстераз эритроцитов коррелирует с изменениями результатов по шкале ADAS-cog, которая являете чувствительным инструментом для оценки изменений когнитивной функции. Способность донепезила гидрохлорида изменять течение сопутствующих неврологических изменений не исследована. Таким образом, нельзя считать, что донепезил влияет на прогрессирование заболевания.\u003Cbr\u003EЭффективность донепезила была исследована в четырех плацебо-контролируемых испытаниях, двух шестимесячных и двух одногодичных.\u003Cbr\u003EВ шестимесячном клиническом испытании анализ был выполнен с применением трех критерием эффективности после завершения введения донепезила. Применяли шкалу ADAS-Cog (показатель когнитивной функции); шкалу впечатлений клинициста об изменениях на основе интервью и данных, полученных от лиц, ухаживающих за пациентом (показатель общего уровня функции); подшкалу ежедневной активности клинической шкалы оценки деменции (показатель способности пациента участвовать в жизни общества, выполнять домашние дела, любимые дела, обслуживать себя).\u003Cbr\u003EПациенты, достигшие указанных ниже критериев, считались ответившими на лечение.\u003Cbr\u003EОтвет = улучшение по шкале ADAS-Cog не менее чем на 4 пункта, отсутствие ухудшения по шкале CIBIC, отсутствие ухудшения по подшкале ежедневной активности клинической шкалы оценю деменции."},{"name":"Фармакологическая группа","value":"средства лечения деменции"},{"name":"Форма выпуска","value":"таблетки"},{"name":"Способ применения/введения","value":"пероральный","transition":{"type":"catalog","params":{"categorySlug":"sredstva-dlia-nervnoi-sistemy","categoryId":"15756525","navnodeId":"72478","glfilters":["35947170:36763744"]}}},{"name":"Минимальный возраст применения","value":"от 18 лет"},{"name":"Условия хранения","value":"При температуре не выше 30 °С.\u003Cbr\u003EХранить в недоступном для детей месте."},{"name":"Передозировка","value":"По существующим оценкам, медиана летальной дозы донепезила гидрохлорида после однократного приема внутрь у мышей и крыс равна соответственно 45 мг/кг и 32 мг/кг, что примерно в 225 и 160 раз выше максимальной рекомендованной для человека дозы 10 мг/кг в сутки. У животных наблюдались дозозависимые признаки стимуляции холинергической системы, к числу которых относились снижение спонтанной подвижности, положение тела ничком, пошатывающаяся походка, слезотечение, клонические судороги, угнетение дыхания, слюнотечение, миоз, фасцикуляции и снижение температуры поверхности тела.\u003Cbr\u003EПередозировка ингибиторов холинэстеразы может привести к холинергическому кризу, характеризующемуся сильной тошнотой, рвотой, слюнотечением, потоотделением, брадикардией, гипотензией, угнетением дыхания, коллапсом и судорогами. Может усилиться мышечная слабость, что может привести к смерти при поражении дыхательных мышц.\u003Cbr\u003EЛечение: как и в любом случае передозировки, следует назначать общее поддерживающее лечение. Третичные антихолинергические препараты, например, атропин, могут применяться в качестве антидотов при передозировке препарата Алзепил. Рекомендуется внутривенное введение атропина\u003Cbr\u003Eсульфата в возрастающих дозах до достижения эффекта: сначала вводят 1-2 мг/кг в/в, после чего дополнительные дозы в зависимости от клинического ответа. Атипичные реакции артериального давления и частоты сердечных сокращений были зарегистрированы при введении других холиномиметиков совместно с четвертичными антихолинергическими препаратами, например, гликопирролатом. Неизвестно, возможно ли выведение донепезила гидрохлорида и/или его метаболитов при помощи диализа (гемодиализа, перитонеального диализа или гемофильтрации)."},{"name":"Применение при беременности и кормлении грудью","value":"Опыта применения препарата во время беременности и в период лактации нет. Неизвестно, выделяется ли препарат с грудным молоком. Поэтому применение во время беременности противопоказано, в случае необходимости приема препарата в период лактации, необходимо решить вопрос о прекращении грудного вскармливания."},{"name":"Влияние на способность управлять транспортом и механизмами","value":"Донепезил в незначительной или средней мере влияет на способность управления автотранспортом и работы с механизмами. Деменция Альцгеймеровского типа сама может сопровождаться нарушением способности управления автомобилем и использования техники. Вопрос о способности пациента с деменцией Альцгеймеровского типа во время приема донепезила управлять автомобилем или пользоваться сложной техникой должен решить врач после оценки индивидуальной реакции пациента на лечение."},{"name":"Особые указания","value":"Эффективность донепезила не установлена у пациентов с тяжелой альцгеймеровской деменцией, другими видами деменции или нарушением памяти (например, при возрастном снижении когнитивной функции).\u003Cbr\u003EАлзепил является ингибитором холинэстеразы, в связи с чем он может усилить сукцинилхолиновую релаксацию мышц во время наркоза.\u003Cbr\u003EСердечно-сосудистые нарушения\u003Cbr\u003EИнгибиторы холинэстеразы, в связи с их фармакологическим действием, могут оказывать ваготонические эффекты на частоту сердечного ритма (например, вызывать брадикардию). Возможность такого действия следует особенно учитывать при слабости синусового узла или других нарушений суправентрикулярного проведения в сердце, например, при синоатриальной или атриовентрикулярной блокаде.\u003Cbr\u003EСообщалось об обмороках и судорожных припадках. При обследовании таких пациентов следует учитывать возможность сердечной блокады или длинных пауз в синусовом ритме.\u003Cbr\u003EНарушения функции желудочно-кишечного тракта\u003Cbr\u003EПациенты с повышенным риском развития язв, например, имеющие в анамнезе язвенную болезнь или получающие сопутствующее лечение нестероидными противовоспалительными средствами (НПВС) нуждаются в наблюдении для выявления симптомов язвообразования. Однако клинические испытания донепезила, в сравнении с плацебо, не выявили повышения частоты пептических язв или желудочно-кишечных кровотечений.\u003Cbr\u003EМочеполовая система\u003Cbr\u003EХолиномиметики могут вызвать нарушение оттока мочи из мочевого пузыря, однако такие эффекты не наблюдались в клинических испытаниях донепезила.\u003Cbr\u003EНеврологические состояния\u003Cbr\u003EСчитается, что холиномиметики обладают некоторой склонностью к провоцированию генерализованных судорожных припадков. Однако судорожная активность может быть также проявлением болезни Альцгеймера.\u003Cbr\u003EХолиномиметики могут усиливать или вызывать экстрапирамидные симптомы.\u003Cbr\u003EЗлокачественный нейролептический синдром\u003Cbr\u003EЗлокачественный нейролептический синдром - потенциально опасное для жизни расстройство, которое характеризуется гипертермией (лихорадкой), мышечной ригидностью, расстройствами вегетативной нервной системы, измененным сознанием, повышенными уровнями сывороточной креатининфосфокиназы. Дополнительные симптомы могут включать миоглобинурию (рабдомиолиз) и острую почечную недостаточность.\u003Cbr\u003EСуществуют очень редкие сообщения о развитии злокачественного нейролептического синдрома, связанного с применением донепезила, особенно у пациентов, также получающих сопутствующую терапию антипсихотическими лекарственными средствами.\u003Cbr\u003EЕсли у пациента развились признаки и симптомы злокачественного нейролептического синдрома или присутствует необъяснимая высокая температура без дополнительных клинических проявлений, лечение следует прекратить.\u003Cbr\u003EНарушения функции легких\u003Cbr\u003EИнгибиторы холинэстеразы, в связи с их фармакологическим действием, следует назначать с осторожностью больным, имеющим в анамнезе астму или обструктивную болезнь легких.\u003Cbr\u003EСледует избегать одновременного введения препарата Алзепил и других ингибиторов ацетилхолинэстеразы, а также агонистов или антагонистов холинергической системы.\u003Cbr\u003EТяжелое нарушение функции печени\u003Cbr\u003EОтсутствуют данные о применении препарата у пациентов с тяжелым нарушением функции печени.\u003Cbr\u003EСмертность в клинических исследованиях сосудистой деменции\u003Cbr\u003EБыли проведены три клинических испытания продолжительностью 6 месяцев с участием пациентов, соответствующих критериям NINDS-AIREN возможной или вероятной сосудистой деменции (СД). Критерии NTNDS-AIREN разработаны для выявления пациентов, у которых деменция может быть связана только с сосудистыми причинами, и исключения пациентов с болезнью Альцгеймера.\u003Cbr\u003EВ первом исследовании частота случаев смерти была 2/198 (1%) в группе, получающей 5 мг донепезила гидрохлорида, 5/206 (2,4%) в группе, получающей 10 мг донепезила гидрохлорида, и 7/199 (3,5%) в группе плацебо. Во втором исследовании частота случаев смерти была 4/208 (1,9%) в группе, получающей 5 мг донепезила гидрохлорида, 3/215 (1,4%) в группе, получающей 10 мг донепезила гидрохлорида, и 1/193 (0,5%) в группе плацебо. В третьем исследовании частота случаев смерти была 11/648 (1,7%) в группе, получающей 5 мг донепезила гидрохлорида, и 0/326 (0%) в группе плацебо. Частота случаев смерти во всех группах, получающих донепезила гидрохлорид, в трех исследованиях СД (1,7%) была численно выше, чем в группе плацебо (1,1), однако это различие не было статистически достоверным. Большинство случаев смерти пациентов, принимающих донепезила гидрохлорид или плацебо, наступала в результате различных сосудистых нарушений, которые являются ожидаемыми в данной популяции пожилых лиц с сопутствующими поражениями сосудов. Анализ всех серьезных несмертельных и смертельных сосудистых нарушений не выявил различия в частоте их появления в группах, получающих донепезила гидрохлорид и плацебо.\u003Cbr\u003EВ объединенных материалах исследований болезни Альцгеймера (n=4146), а также тех же исследований болезни Альцгеймера с добавлением исследований сосудистой деменции (общее число пациентов 6888) показатели смертности в группах плацебо численно превосходят такие же показатели в группах, получавших донепезила гидрохлорид."},{"name":"Взаимодействие","value":"Донепезил и/или продукты его метаболизма не подавляют метаболизм теофиллина, варфарина, циметидина, дигоксина. Одновременный прием дигоксина или циметидина, не влияет на метаболизм донепезила.\u003Cbr\u003EИсследования in vitro показали, что в метаболизме донепезила применяют участие изоферменты цитохрома Р450 - 3А4 и в меньшей степени - 2D6. Кетоконазол и хинидин, являющиеся ингибиторами CYP3A4 и 2D6 соответственно, подавляют метаболизм донепезила. Следовательно, эти и другие ингибиторы CYP3A4, такие как итраконазол и эритромицин, и ингибиторы CYP2D6, такие как флуоксетин могут ингибировать метаболизм донепезила.\u003Cbr\u003EУ здоровых добровольцев кетоконазол повышал средние концентрации донепезила примерно на 30%.\u003Cbr\u003EИндукторы ферментов, такие как рифампицин, фенитоин, карбамазепин и этанол могут вызвать снижение уровней донепезила. Поскольку степень такого ингибирующего или индуцирующего действия неизвестна, применять подобные средства в сочетании с донепезилом следует с осторожностью.\u003Cbr\u003EДонепезил оказывает влияние на действие препаратов, обладающих антихолинергической активностью. Кроме того, при одновременном применении, донепезил может усиливать действие сукцинилхолина, других миорелаксантов или агонистов холинергических рецепторов и бета-адреноблокаторов, оказывающих влияние на проводимость сердца."},{"name":"Регистрационный номер","value":"ЛП-000228"},{"name":"Дата государственной регистрации","value":"10.01.2018"},{"name":"Владелец регистрационного удостоверения","value":"Egis Pharmaceuticals","transition":{"type":"catalog","params":{"categorySlug":"sredstva-dlia-nervnoi-sistemy","categoryId":"15756525","navnodeId":"72478","glfilters":["34324371:35649313","7893318:16002706"]}}},{"name":"Изготовитель","value":"Egis"},{"name":"Фасовщик","value":"Egis"},{"name":"Страна бренда","value":"Венгрия"},{"name":"Страна-производитель","value":"Венгрия"},{"name":"Название препарата","value":"Алзепил","transition":{"type":"catalog","params":{"categorySlug":"sredstva-dlia-nervnoi-sistemy","categoryId":"15756525","navnodeId":"72478","glfilters":["17796364:18020928"]}}},{"name":"Срок годности","value":"60 мес."}]}},"fullSpecsGrouped":{"9857788681522619291":{"groups":[{"name":"Общие характеристики","items":[{"name":"Тип препарата","value":"лекарственный препарат"},{"name":"Рецептурный препарат","value":"да"},{"name":"Органы и системы","value":"нервная система"},{"name":"Назначение","value":"болезнь Альцгеймера"},{"name":"Показания к применению","value":"Симптоматическое лечение деменции Альцгеймеровского типа легкой и средней степени."},{"name":"Противопоказания","value":"Гиперчувствительность к действующему веществу, производным пиперидина и любому из вспомогательных веществ.\u003Cbr\u003EДетский возраст до 18 лет (ввиду отсутствия клинических данных)"},{"name":"Состав","value":"На 1 таблетку:\u003Cbr\u003EДействующее вещество: донепезила гидрохлорид 5,00/10,00 мг, в форме донепезила гидрохлорида моногидрата 5,21/10,42 мг.\u003Cbr\u003EВспомогательные вещества: целлюлоза микрокристаллическая 96,00/192,00 мг, гидроксипропилцеллюлоза с низкой степенью замещения (L-HPC В1) 24,00/48,00 мг, магния стеарат 1,00/2,00 мг, пленочная оболочка Опадрай Y-1-7000 белый (гипромеллоза 1,875 мг (62,50 %)/ 3,750 мг (62,50 %), титана диоксид 0,9375 мг (31,25%)/ 1,875 мг (31,25 %), макрогол 400 0,1875 мг (6,25 %)/0,375 мг (6,25 %)) 3,00/6,00 мг."},{"name":"Действующее вещество","value":"Донепезил"},{"name":"Способ применения и дозы","value":"Внутрь.\u003Cbr\u003EПрепарат рекомендуется принимать вечером перед сном.\u003Cbr\u003EВзрослые/пожилые пациенты\u003Cbr\u003EЛечение начинают с приема 5 мг один раз в день и продолжают в течение не менее 4 недель, чтобы достичь равновесных концентраций донепезила и оценить ранний клинический эффект терапии.\u003Cbr\u003EЧерез 1 месяц дозу препарата Алзепил можно повысить до 10 мг один раз в день, что является максимальной рекомендуемой суточной дозой. Дозы, превышающие 10 мг/сутки в клинических исследованиях, не изучались.\u003Cbr\u003EЛечение следует начинать и проводить под наблюдением врача, имеющего опыт в диагностике и лечении деменции Альцгеймеровского типа. Диагноз должен быть основан на принятых рекомендациях, например, DSM IV, МКБ 10.\u003Cbr\u003EЛечение донепезилом можно начинать только при наличии лиц, ухаживающих за пациентом, способных регулярно следить за приемом препарата. Поддерживающую терапию можно продолжать до тех пор, пока сохраняется терапевтически эффект, который следует регулярно оценивать. При отсутствии терапевтического эффекта следует рассмотреть возможность отмены лечения.\u003Cbr\u003EПосле отмены препарата может наблюдаться постепенное снижение благоприятного эффекта лечения.\u003Cbr\u003EНарушение функции почек и печени\u003Cbr\u003EПациенты с нарушением функции почек не нуждаются в изменении схемы лечения, т.к. это состояние не влияет на клиренс донепезила.\u003Cbr\u003EВ связи с возможным увеличением экспозиции при легком или умеренном нарушении функции печени повышение дозы следует выполнять с учетом индивидуальной переносимости. Отсутствуют данные о применении препарата у пациентов с тяжелым нарушением функции печени.\u003Cbr\u003EДети и подростки\u003Cbr\u003EПрепарат Алзепил не предназначен для лечения детей и подростков."},{"name":"Побочные действия","value":"Самыми частыми нежелательными явлениями являются диарея, мышечные судороги, утомляемость, тошнота, рвота и бессонница. Сообщалось также о головокружении, головной боли, болевых ощущениях, несчастных случаях и простудах. В большинстве случаев эти явления проходят и не требуют прекращения введения препарата.\u003Cbr\u003EОпределение частоты побочных реакций: очень часто (≥1/10), часто (≥1/100, \u003C1/10), нечасто (≥1/1000, ≤1/100), редко (≥1/10 000, ≤1/1000), очень редко (≤1/10 000), частота неизвестна (невозможно оценить по имеющимся данным).\u003Cbr\u003EПсихические нарушения: часто - галлюцинации**, возбуждение **, агрессивное поведение**, ненормальные сновидения, кошмарные сновидения**.\u003Cbr\u003EСо стороны нервной системы: очень часто - головная боль; часто - обмороки*, головокружение, бессонница; нечасто - судорожные припадки*; редко - экстрапирамидные симптомы; очень редко - ЗНС.\u003Cbr\u003EСо стороны сердечно-сосудистой системы: нечасто - брадикардия; редко - синоатриальная блокада, AV-блокада.\u003Cbr\u003EСо стороны пищеварительной системы: очень часто - диарея, тошнота; часто - рвота, диспепсия, анорексия; нечасто - кровотечение из ЖКТ, язвы желудка и двенадцатиперстной кишки; редко - нарушение функции печени, в т.ч. гепатит***.\u003Cbr\u003EСо стороны кожи и подкожных тканей: часто - сыпь, кожный зуд.\u003Cbr\u003EСо стороны костно-мышечной системы: часто - мышечные спазмы; очень редко - рабдомиолиз****.\u003Cbr\u003EСо стороны мочевыделительной системы: часто - недержание мочи.\u003Cbr\u003EСо стороны лабораторных и инструментальных исследований: нечасто - незначительное повышение активности мышечной изоформы КФК в сыворотке крови.\u003Cbr\u003EПрочие: часто - насморк, утомляемость, боль, несчастный случай."},{"name":"Фармакологическое действие","value":"Механизм действия и фармакодинамический эффект\u003Cbr\u003EДонепезил - селективный и обратимый ингибитор ацетилхолинэстеразы, которая являете основным преобладающим типом холинэстеразы в головном мозге. In vitro донепези ингибирует этот фермент более чем в 1000 раз сильнее, чем бутирилхолинэстеразу - фермени который находится в основном вне центральной нервной системы.\u003Cbr\u003EОднократный прием 5 мг или 10 мг в равновесном состоянии сопровождается угнетение активности холинэстеразы (оценивается на модели мембран эритроцитов) на 63,6 и 77,39 соответственно. Способность донепезила гидрохлорида угнетать активность холинэстераз эритроцитов коррелирует с изменениями результатов по шкале ADAS-cog, которая являете чувствительным инструментом для оценки изменений когнитивной функции. Способность донепезила гидрохлорида изменять течение сопутствующих неврологических изменений не исследована. Таким образом, нельзя считать, что донепезил влияет на прогрессирование заболевания.\u003Cbr\u003EЭффективность донепезила была исследована в четырех плацебо-контролируемых испытаниях, двух шестимесячных и двух одногодичных.\u003Cbr\u003EВ шестимесячном клиническом испытании анализ был выполнен с применением трех критерием эффективности после завершения введения донепезила. Применяли шкалу ADAS-Cog (показатель когнитивной функции); шкалу впечатлений клинициста об изменениях на основе интервью и данных, полученных от лиц, ухаживающих за пациентом (показатель общего уровня функции); подшкалу ежедневной активности клинической шкалы оценки деменции (показатель способности пациента участвовать в жизни общества, выполнять домашние дела, любимые дела, обслуживать себя).\u003Cbr\u003EПациенты, достигшие указанных ниже критериев, считались ответившими на лечение.\u003Cbr\u003EОтвет = улучшение по шкале ADAS-Cog не менее чем на 4 пункта, отсутствие ухудшения по шкале CIBIC, отсутствие ухудшения по подшкале ежедневной активности клинической шкалы оценю деменции."},{"name":"Фармакологическая группа","value":"средства лечения деменции"},{"name":"Форма выпуска","value":"таблетки"},{"name":"Способ применения/введения","value":"пероральный"},{"name":"Минимальный возраст применения","value":"от 18 лет"}]},{"name":"Дополнительно","items":[{"name":"Условия хранения","value":"При температуре не выше 30 °С.\u003Cbr\u003EХранить в недоступном для детей месте."},{"name":"Передозировка","value":"По существующим оценкам, медиана летальной дозы донепезила гидрохлорида после однократного приема внутрь у мышей и крыс равна соответственно 45 мг/кг и 32 мг/кг, что примерно в 225 и 160 раз выше максимальной рекомендованной для человека дозы 10 мг/кг в сутки. У животных наблюдались дозозависимые признаки стимуляции холинергической системы, к числу которых относились снижение спонтанной подвижности, положение тела ничком, пошатывающаяся походка, слезотечение, клонические судороги, угнетение дыхания, слюнотечение, миоз, фасцикуляции и снижение температуры поверхности тела.\u003Cbr\u003EПередозировка ингибиторов холинэстеразы может привести к холинергическому кризу, характеризующемуся сильной тошнотой, рвотой, слюнотечением, потоотделением, брадикардией, гипотензией, угнетением дыхания, коллапсом и судорогами. Может усилиться мышечная слабость, что может привести к смерти при поражении дыхательных мышц.\u003Cbr\u003EЛечение: как и в любом случае передозировки, следует назначать общее поддерживающее лечение. Третичные антихолинергические препараты, например, атропин, могут применяться в качестве антидотов при передозировке препарата Алзепил. Рекомендуется внутривенное введение атропина\u003Cbr\u003Eсульфата в возрастающих дозах до достижения эффекта: сначала вводят 1-2 мг/кг в/в, после чего дополнительные дозы в зависимости от клинического ответа. Атипичные реакции артериального давления и частоты сердечных сокращений были зарегистрированы при введении других холиномиметиков совместно с четвертичными антихолинергическими препаратами, например, гликопирролатом. Неизвестно, возможно ли выведение донепезила гидрохлорида и/или его метаболитов при помощи диализа (гемодиализа, перитонеального диализа или гемофильтрации)."},{"name":"Применение при беременности и кормлении грудью","value":"Опыта применения препарата во время беременности и в период лактации нет. Неизвестно, выделяется ли препарат с грудным молоком. Поэтому применение во время беременности противопоказано, в случае необходимости приема препарата в период лактации, необходимо решить вопрос о прекращении грудного вскармливания."},{"name":"Влияние на способность управлять транспортом и механизмами","value":"Донепезил в незначительной или средней мере влияет на способность управления автотранспортом и работы с механизмами. Деменция Альцгеймеровского типа сама может сопровождаться нарушением способности управления автомобилем и использования техники. Вопрос о способности пациента с деменцией Альцгеймеровского типа во время приема донепезила управлять автомобилем или пользоваться сложной техникой должен решить врач после оценки индивидуальной реакции пациента на лечение."},{"name":"Особые указания","value":"Эффективность донепезила не установлена у пациентов с тяжелой альцгеймеровской деменцией, другими видами деменции или нарушением памяти (например, при возрастном снижении когнитивной функции).\u003Cbr\u003EАлзепил является ингибитором холинэстеразы, в связи с чем он может усилить сукцинилхолиновую релаксацию мышц во время наркоза.\u003Cbr\u003EСердечно-сосудистые нарушения\u003Cbr\u003EИнгибиторы холинэстеразы, в связи с их фармакологическим действием, могут оказывать ваготонические эффекты на частоту сердечного ритма (например, вызывать брадикардию). Возможность такого действия следует особенно учитывать при слабости синусового узла или других нарушений суправентрикулярного проведения в сердце, например, при синоатриальной или атриовентрикулярной блокаде.\u003Cbr\u003EСообщалось об обмороках и судорожных припадках. При обследовании таких пациентов следует учитывать возможность сердечной блокады или длинных пауз в синусовом ритме.\u003Cbr\u003EНарушения функции желудочно-кишечного тракта\u003Cbr\u003EПациенты с повышенным риском развития язв, например, имеющие в анамнезе язвенную болезнь или получающие сопутствующее лечение нестероидными противовоспалительными средствами (НПВС) нуждаются в наблюдении для выявления симптомов язвообразования. Однако клинические испытания донепезила, в сравнении с плацебо, не выявили повышения частоты пептических язв или желудочно-кишечных кровотечений.\u003Cbr\u003EМочеполовая система\u003Cbr\u003EХолиномиметики могут вызвать нарушение оттока мочи из мочевого пузыря, однако такие эффекты не наблюдались в клинических испытаниях донепезила.\u003Cbr\u003EНеврологические состояния\u003Cbr\u003EСчитается, что холиномиметики обладают некоторой склонностью к провоцированию генерализованных судорожных припадков. Однако судорожная активность может быть также проявлением болезни Альцгеймера.\u003Cbr\u003EХолиномиметики могут усиливать или вызывать экстрапирамидные симптомы.\u003Cbr\u003EЗлокачественный нейролептический синдром\u003Cbr\u003EЗлокачественный нейролептический синдром - потенциально опасное для жизни расстройство, которое характеризуется гипертермией (лихорадкой), мышечной ригидностью, расстройствами вегетативной нервной системы, измененным сознанием, повышенными уровнями сывороточной креатининфосфокиназы. Дополнительные симптомы могут включать миоглобинурию (рабдомиолиз) и острую почечную недостаточность.\u003Cbr\u003EСуществуют очень редкие сообщения о развитии злокачественного нейролептического синдрома, связанного с применением донепезила, особенно у пациентов, также получающих сопутствующую терапию антипсихотическими лекарственными средствами.\u003Cbr\u003EЕсли у пациента развились признаки и симптомы злокачественного нейролептического синдрома или присутствует необъяснимая высокая температура без дополнительных клинических проявлений, лечение следует прекратить.\u003Cbr\u003EНарушения функции легких\u003Cbr\u003EИнгибиторы холинэстеразы, в связи с их фармакологическим действием, следует назначать с осторожностью больным, имеющим в анамнезе астму или обструктивную болезнь легких.\u003Cbr\u003EСледует избегать одновременного введения препарата Алзепил и других ингибиторов ацетилхолинэстеразы, а также агонистов или антагонистов холинергической системы.\u003Cbr\u003EТяжелое нарушение функции печени\u003Cbr\u003EОтсутствуют данные о применении препарата у пациентов с тяжелым нарушением функции печени.\u003Cbr\u003EСмертность в клинических исследованиях сосудистой деменции\u003Cbr\u003EБыли проведены три клинических испытания продолжительностью 6 месяцев с участием пациентов, соответствующих критериям NINDS-AIREN возможной или вероятной сосудистой деменции (СД). Критерии NTNDS-AIREN разработаны для выявления пациентов, у которых деменция может быть связана только с сосудистыми причинами, и исключения пациентов с болезнью Альцгеймера.\u003Cbr\u003EВ первом исследовании частота случаев смерти была 2/198 (1%) в группе, получающей 5 мг донепезила гидрохлорида, 5/206 (2,4%) в группе, получающей 10 мг донепезила гидрохлорида, и 7/199 (3,5%) в группе плацебо. Во втором исследовании частота случаев смерти была 4/208 (1,9%) в группе, получающей 5 мг донепезила гидрохлорида, 3/215 (1,4%) в группе, получающей 10 мг донепезила гидрохлорида, и 1/193 (0,5%) в группе плацебо. В третьем исследовании частота случаев смерти была 11/648 (1,7%) в группе, получающей 5 мг донепезила гидрохлорида, и 0/326 (0%) в группе плацебо. Частота случаев смерти во всех группах, получающих донепезила гидрохлорид, в трех исследованиях СД (1,7%) была численно выше, чем в группе плацебо (1,1), однако это различие не было статистически достоверным. Большинство случаев смерти пациентов, принимающих донепезила гидрохлорид или плацебо, наступала в результате различных сосудистых нарушений, которые являются ожидаемыми в данной популяции пожилых лиц с сопутствующими поражениями сосудов. Анализ всех серьезных несмертельных и смертельных сосудистых нарушений не выявил различия в частоте их появления в группах, получающих донепезила гидрохлорид и плацебо.\u003Cbr\u003EВ объединенных материалах исследований болезни Альцгеймера (n=4146), а также тех же исследований болезни Альцгеймера с добавлением исследований сосудистой деменции (общее число пациентов 6888) показатели смертности в группах плацебо численно превосходят такие же показатели в группах, получавших донепезила гидрохлорид."},{"name":"Взаимодействие","value":"Донепезил и/или продукты его метаболизма не подавляют метаболизм теофиллина, варфарина, циметидина, дигоксина. Одновременный прием дигоксина или циметидина, не влияет на метаболизм донепезила.\u003Cbr\u003EИсследования in vitro показали, что в метаболизме донепезила применяют участие изоферменты цитохрома Р450 - 3А4 и в меньшей степени - 2D6. Кетоконазол и хинидин, являющиеся ингибиторами CYP3A4 и 2D6 соответственно, подавляют метаболизм донепезила. Следовательно, эти и другие ингибиторы CYP3A4, такие как итраконазол и эритромицин, и ингибиторы CYP2D6, такие как флуоксетин могут ингибировать метаболизм донепезила.\u003Cbr\u003EУ здоровых добровольцев кетоконазол повышал средние концентрации донепезила примерно на 30%.\u003Cbr\u003EИндукторы ферментов, такие как рифампицин, фенитоин, карбамазепин и этанол могут вызвать снижение уровней донепезила. Поскольку степень такого ингибирующего или индуцирующего действия неизвестна, применять подобные средства в сочетании с донепезилом следует с осторожностью.\u003Cbr\u003EДонепезил оказывает влияние на действие препаратов, обладающих антихолинергической активностью. Кроме того, при одновременном применении, донепезил может усиливать действие сукцинилхолина, других миорелаксантов или агонистов холинергических рецепторов и бета-адреноблокаторов, оказывающих влияние на проводимость сердца."},{"name":"Регистрационный номер","value":"ЛП-000228"},{"name":"Дата государственной регистрации","value":"10.01.2018"},{"name":"Владелец регистрационного удостоверения","value":"Egis Pharmaceuticals"},{"name":"Изготовитель","value":"Egis"},{"name":"Фасовщик","value":"Egis"},{"name":"Страна бренда","value":"Венгрия"},{"name":"Страна-производитель","value":"Венгрия"},{"name":"Название препарата","value":"Алзепил"},{"name":"Срок годности","value":"60 мес."}]}],"transitionId":"tr_7912417817049195954"}}}}
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    на основе 3 оценки
    Цена 1 819 ₽
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  • Стимулотон таб. п/о плен., 50 мг, 30 шт.
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    Стимулотон таб. п/о плен., 50 мг, 30 шт.

    Рейтинг товара: 4.7 из 5
    на основе 21 оценка
    Цена 246 ₽
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  • Кетилепт таб. п/о плен., 100 мг, 60 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-w702mfwszoe/toggleWishlist":{"skuId":"453475035","productId":1404748652,"offerId":"YD_X5g65C4pL9zwMhSJwiA","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhYI7IbrnQUQ2/Wd2AEYkt3QByDt2cEH","sign":"M53mnjEE7yLNNFPhI7dpESC75jU7f7YSEa+JoFAYNqc="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-w702mfwszoe/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Кетилепт таб. п/о плен., 100 мг, 60 шт.

    Рейтинг товара: 4.1 из 5
    на основе 8 оценок
    Цена 1 096 ₽
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  • Акатинол Мемантин таб. п/о плен., 10 мг, 30 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-abc3xoaag7f/toggleWishlist":{"skuId":"226179103","productId":1404748429,"offerId":"0P0NKP_1Zn9m4zkdTThnkA","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhUIjYXrnQUQn/DsaxjO5dUHIO3ZwQc=","sign":"pG/bTEyNEWK9emjizB3IhRGhyKXC0YAsiEWMtwSZM8U="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-abc3xoaag7f/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Акатинол Мемантин таб. п/о плен., 10 мг, 30 шт.

    Рейтинг товара: 4.8 из 5
    на основе 30 оценок
    Цена 1 727 ₽
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  • Нооджерон таб. п/о плен., 10 мг, 60 шт.
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    Нооджерон таб. п/о плен., 10 мг, 60 шт.

    Рейтинг товара: 5 из 5
    на основе 1 оценка
    Цена 2 636 ₽
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  • Грандаксин таб., 50 мг, 60 шт.
    –15 %
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-1dao4bgqqwb/toggleWishlist":{"skuId":"227814185","productId":1404748508,"offerId":"4MErYaZHTc2eq2LTeuxmrA","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhUI3IXrnQUQqdbQbBiS3dAHIO3ZwQc=","sign":"5DkVPNHFNdU1NY/dO0QPaPTIi7f109HhEQBicrX3TP8="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-1dao4bgqqwb/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Грандаксин таб., 50 мг, 60 шт.

    Рейтинг товара: 4.7 из 5
    на основе 17 оценок
    Цена 1 082 ₽ вместо 1 266
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  • Бринтелликс таб. п/о плен., 10 мг, 28 шт.
    –19 %
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    Бринтелликс таб. п/о плен., 10 мг, 28 шт.

    Рейтинг товара: 4.4 из 5
    на основе 14 оценок
    Цена 2 414 ₽ вместо 2 993
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  • Миореол таб. п/о плен., 10 мг+20 мг, 28 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-6xgbposatua/toggleWishlist":{"skuId":"101786649875","productId":1759636686,"offerId":"qBPqh3pG_BW9gJ_nLacdCQ","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhcIztmHxwYQk4rUl/sCGP7UhxEg7dnBBw==","sign":"5GQSICmavsKv/dlzxFabeLNwHAbuOVDIu3msOGxbcVQ="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-6xgbposatua/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Миореол таб. п/о плен., 10 мг+20 мг, 28 шт.

    Рейтинг товара: 5 из 5
    на основе 2 оценки
    Цена 4 199 ₽
    {"widgets":{"@light/AddToCartButtonSnippet":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-6xgbposatua/addToCartButton":{"offerId":"qBPqh3pG_BW9gJ_nLacdCQ","skuId":"101786649875","pendingCartItem":{"productId":1759636686,"offerId":"qBPqh3pG_BW9gJ_nLacdCQ","showPlaceId":"OTNDnItfwRMjN9MRHuEMMrn9eyP1rIL2ENcG6LNpSTMkHB768gh9kYFEv_texePFhrmf-nSHjuMVkSAWp9sCJLAQ1JkyVnP7MZwskd2ginR6F2eqbAe9QT_mWNqEXDTTBvXFOQx6KjQaD_zkro4aJRXT1l4V4hBlCnjp0oXk20mDzVj9keeZNBql3WKNSA4a-tCHu8kMKuzpkvmWcn5PjA,,","feeShow":"OTNDnItfwRMjN9MRHuEMMrn9eyP1rIL2ENcG6LNpSTMkHB768gh9kYFEv_texePFhrmf-nSHjuMVkSAWp9sCJLAQ1JkyVnP7MZwskd2ginR6F2eqbAe9QT_mWNqEXDTTBvXFOQx6KjQaD_zkro4aJRXT1l4V4hBlCnjp0oXk20mDzVj9keeZNBql3WKNSA4a-tCHu8kMKuzpkvmWcn5PjA,,","skuId":"101786649875","shopId":55106433,"price":{"applicablePriceDiscounts":[],"value":"4199","currency":"RUR"},"hid":"15756525","name":"Миореол таб. п/о плен., 10 мг+20 мг, 28 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  • Реагила капс., 4.5 мг, 28 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-lf33pmfc50o/toggleWishlist":{"skuId":"101828814316","productId":1733918190,"offerId":"DcWma08lqz_ipy6pZB0Plw","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhcI7vvlugYQ7Mvhq/sCGP7Vtggg7dnBBw==","sign":"KD1BsR8tL18/wXlUT70PEihuLXBP1DzD7JwtxfNGIe4="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-lf33pmfc50o/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Реагила капс., 4.5 мг, 28 шт.

    Рейтинг товара: 3.8 из 5
    на основе 4 оценки
    Цена 4 010 ₽
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  • Реквип Модутаб таб. пролонг. действ. п/о плен., 4 мг, 28 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-dokh5p6jei/toggleWishlist":{"skuId":"187385917","productId":1404748467,"offerId":"4gysDIhF2t68DQld6ymmfQ","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhUIs4XrnQUQvZCtWRjHxp4IIO3ZwQc=","sign":"yD+WPiYfLLRB4hlAaFssGGbIKm2y0Aku1GuKDwRh3cY="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-dokh5p6jei/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Реквип Модутаб таб. пролонг. действ. п/о плен., 4 мг, 28 шт.

    Рейтинг товара: 5 из 5
    на основе 4 оценки
    Цена 3 269 ₽
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  • Зелдокс капс., 60 мг, 30 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-qwehl402t3r/toggleWishlist":{"skuId":"228045384","productId":1404748509,"offerId":"Zam3PBJAt6o_rgUM3iWB9Q","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EjEKL0NvbXBldGl0aXZlQW5hbG9nc19NYXJrZXRNb2RlbENhcmRfRnJvbnRTbmlwcGV0MhUI3YXrnQUQyOTebBi7k4wGIO3ZwQc=","sign":"X6Zm/jf9S02r8wGYrIDkhpVHFjklSjrmC9HDYtQMd94="},"waitWishlistCollections":false,"place":{"page":"product","widget":"scrollbox"}}}},"meta":{"/content/page/fancyPage/kkmCarousel/kkmCarousel/content/content/slot-qwehl402t3r/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Зелдокс капс., 60 мг, 30 шт.

    Рейтинг товара: 5 из 5
    на основе 2 оценки
    Цена 6 052 ₽
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Инструкция

Показания к применению

Симптоматическое лечение деменции Альцгеймеровского типа легкой и средней степени.

Противопоказания

Гиперчувствительность к действующему веществу, производным пиперидина и любому из вспомогательных веществ.
Детский возраст до 18 лет (ввиду отсутствия клинических данных)

Способ применения и дозы

Внутрь.
Препарат рекомендуется принимать вечером перед сном.
Взрослые/пожилые пациенты
Лечение начинают с приема 5 мг один раз в день и продолжают в течение не менее 4 недель, чтобы достичь равновесных концентраций донепезила и оценить ранний клинический эффект терапии.
Через 1 месяц дозу препарата Алзепил можно повысить до 10 мг один раз в день, что является максимальной рекомендуемой суточной дозой. Дозы, превышающие 10 мг/сутки в клинических исследованиях, не изучались.
Лечение следует начинать и проводить под наблюдением врача, имеющего опыт в диагностике и лечении деменции Альцгеймеровского типа. Диагноз должен быть основан на принятых рекомендациях, например, DSM IV, МКБ 10.
Лечение донепезилом можно начинать только при наличии лиц, ухаживающих за пациентом, способных регулярно следить за приемом препарата. Поддерживающую терапию можно продолжать до тех пор, пока сохраняется терапевтически эффект, который следует регулярно оценивать. При отсутствии терапевтического эффекта следует рассмотреть возможность отмены лечения.
После отмены препарата может наблюдаться постепенное снижение благоприятного эффекта лечения.
Нарушение функции почек и печени
Пациенты с нарушением функции почек не нуждаются в изменении схемы лечения, т.к. это состояние не влияет на клиренс донепезила.
В связи с возможным увеличением экспозиции при легком или умеренном нарушении функции печени повышение дозы следует выполнять с учетом индивидуальной переносимости. Отсутствуют данные о применении препарата у пациентов с тяжелым нарушением функции печени.
Дети и подростки
Препарат Алзепил не предназначен для лечения детей и подростков.
Полная инструкция
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Алзепил таб. п/о плен.
Алзепил таб. п/о плен., 5 мг, 28 шт.
5.0
(5)
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Задать вопрос
Инструкция

2 609 ₽

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5.0
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У продавца:5 оценок·2 отзыва
У всех продавцов:58 оценок·12 отзывов
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user avatar
2 недели назад • Анна Харитонова • Куплен на Маркете
Достоинства: таблетки оригинал, постоянно покупаю для родственника. нет никаких нареканий.
Недостатки: нет, всё хорошего качества
Комментарий: таблетки рекомендую к покупке
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9 месяцев назад • татьяна амелина • Куплен на Маркете
Достоинства: Эффективное средство, лучшая цена
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Рекомендуем

  • Vitamin D3, 10000 МЕ, 120 шт.
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    Vitamin D3, 10000 МЕ, 120 шт.

    Цена 1 190 ₽ вместо 2 455
  • Дементис таб. п/о плен., 5 мг, 28 шт.
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    Дементис таб. п/о плен., 5 мг, 28 шт.

    Цена 1 819 ₽
  • Стимулотон таб. п/о плен., 50 мг, 30 шт.
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    Стимулотон таб. п/о плен., 50 мг, 30 шт.

    Цена 246 ₽
  • ЛимфоТранзит концентрат напитка фл., 100 мл
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    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1780857920_3/content/content/toggleWishlist":{"skuId":"663078029","productId":1780857920,"offerId":"sfF41jLd_lfJnq7MPes0zw","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EhoKGHJlbWl4X2Rlc2t0b3BfbW9kZWxfY2FyZDIWCMD4ltEGEI2Jl7wCGNW7oQYg19zBBw==","sign":"HOuUjvlRjfJwhSCGyaHp2CFDiNrwxXhxwT9eyNNE9nA="},"waitWishlistCollections":false,"place":{"page":"product","widget":"feed"}}}},"meta":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1780857920_3/content/content/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    ЛимфоТранзит концентрат напитка фл., 100 мл

    Цена 332 ₽ вместо 390
  • Кетилепт таб. п/о плен., 100 мг, 60 шт.
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    Кетилепт таб. п/о плен., 100 мг, 60 шт.

    Цена 1 096 ₽
  • Табекс таб. п/о плен., 1.5 мг, 100 шт.
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    Табекс таб. п/о плен., 1.5 мг, 100 шт.

    Цена 1 510 ₽ вместо 1 525
  • БиоГая Пробиотик капли детск. фл., 5 мл, 1 уп.
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    БиоГая Пробиотик капли детск. фл., 5 мл, 1 уп.

    Цена 2 025 ₽ вместо 3 500
  • Акатинол Мемантин таб. п/о плен., 10 мг, 30 шт.
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    Акатинол Мемантин таб. п/о плен., 10 мг, 30 шт.

    Цена 1 727 ₽
  • Реклама
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    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  • Нооджерон таб. п/о плен., 10 мг, 60 шт.
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    Нооджерон таб. п/о плен., 10 мг, 60 шт.

    Цена 2 636 ₽
  • Грандаксин таб., 50 мг, 60 шт.
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    Грандаксин таб., 50 мг, 60 шт.

    Цена 1 082 ₽ вместо 1 266
  • Флексотрон Соло импл. вязкоэластич. стер. для в/суст. ин., 22 мг/мл, 2 мл, 1 шт.
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    Флексотрон Соло импл. вязкоэластич. стер. для в/суст. ин., 22 мг/мл, 2 мл, 1 шт.

    Цена 15 939 ₽ вместо 16 100
  • Эвалар чай Турбослим Очищение ф/п, 2 г, 20 шт.
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    Эвалар чай Турбослим Очищение ф/п, 2 г, 20 шт.

    Цена 351 ₽ вместо 418
  • Бринтелликс таб. п/о плен., 10 мг, 28 шт.
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    Бринтелликс таб. п/о плен., 10 мг, 28 шт.

    Цена 2 414 ₽ вместо 2 993
  • Хронотрон имплантат инъекц. гель для в/суст. введ., 20 мг/мл, 2 мл, 1 шт.
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    Хронотрон имплантат инъекц. гель для в/суст. введ., 20 мг/мл, 2 мл, 1 шт.

    Цена 9 356 ₽ вместо 9 450
  • Миореол таб. п/о плен., 10 мг+20 мг, 28 шт.
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    Миореол таб. п/о плен., 10 мг+20 мг, 28 шт.

    Цена 4 199 ₽
  • Реагила капс., 4.5 мг, 28 шт.
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    Реагила капс., 4.5 мг, 28 шт.

    Цена 4 010 ₽
  • Реквип Модутаб таб. пролонг. действ. п/о плен., 4 мг, 28 шт.
    {"widgets":{"@marketfront/SnippetConstructor/Gallery":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1404748467_17/content/content/gallery":{"title":"Реквип Модутаб таб. пролонг. действ. п/о плен., 4 мг, 28 шт.","images":[{"src":"https://avatars.mds.yandex.net/get-mpic/1382936/img_id1981207158843182947.jpeg/orig","srcSet":"https://avatars.mds.yandex.net/get-mpic/1382936/img_id1981207158843182947.jpeg/120x160 120w, https://avatars.mds.yandex.net/get-mpic/1382936/img_id1981207158843182947.jpeg/180x240 180w, https://avatars.mds.yandex.net/get-mpic/1382936/img_id1981207158843182947.jpeg/240x320 240w, https://avatars.mds.yandex.net/get-mpic/1382936/img_id1981207158843182947.jpeg/300x400 300w, https://avatars.mds.yandex.net/get-mpic/1382936/img_id1981207158843182947.jpeg/600x800 600w","sizes":"(max-width: 1456px) 15vw, 217px"},{"src":"https://avatars.mds.yandex.net/get-mpic/6259567/img_id6564938807125497434.jpeg/orig","srcSet":"https://avatars.mds.yandex.net/get-mpic/6259567/img_id6564938807125497434.jpeg/120x160 120w, https://avatars.mds.yandex.net/get-mpic/6259567/img_id6564938807125497434.jpeg/180x240 180w, https://avatars.mds.yandex.net/get-mpic/6259567/img_id6564938807125497434.jpeg/240x320 240w, https://avatars.mds.yandex.net/get-mpic/6259567/img_id6564938807125497434.jpeg/300x400 300w, https://avatars.mds.yandex.net/get-mpic/6259567/img_id6564938807125497434.jpeg/600x800 600w","sizes":"(max-width: 1456px) 15vw, 217px"},{"src":"https://avatars.mds.yandex.net/get-mpic/4956986/img_id2892635399817862110.png/orig","srcSet":"https://avatars.mds.yandex.net/get-mpic/4956986/img_id2892635399817862110.png/120x160 120w, https://avatars.mds.yandex.net/get-mpic/4956986/img_id2892635399817862110.png/180x240 180w, https://avatars.mds.yandex.net/get-mpic/4956986/img_id2892635399817862110.png/240x320 240w, https://avatars.mds.yandex.net/get-mpic/4956986/img_id2892635399817862110.png/300x400 300w, https://avatars.mds.yandex.net/get-mpic/4956986/img_id2892635399817862110.png/600x800 600w","sizes":"(max-width: 1456px) 15vw, 217px"}],"firstImageLazyLoading":false,"baobabClientData":{"realTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EhoKGHJlbWl4X2Rlc2t0b3BfbW9kZWxfY2FyZDIVCLOF650FEL2QrVkYx8aeCCDt2cEH","sign":"tAS54DlKYKLn3Do2rTSZ2oS+c0d20sImPZ1r53Mf5cc="},"target":"model_card"},"isNoPicturePadding":true}}},"meta":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1404748467_17/content/content/gallery":{"name":"@marketfront/SnippetConstructor/Gallery"}}}
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    Реквип Модутаб таб. пролонг. действ. п/о плен., 4 мг, 28 шт.

    Цена 3 269 ₽
  • Пастилки California Gold Nutrition Vitamin D3 gummies со вкусом фруктов и ягод, 280 г, 90 шт.
    {"widgets":{"@marketfront/SnippetConstructor/Gallery":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1780868129_18/content/content/gallery":{"title":"Пастилки California Gold Nutrition Vitamin D3 gummies со вкусом фруктов и ягод, 280 г, 90 шт.","images":[{"src":"https://avatars.mds.yandex.net/get-mpic/5221216/img_id7471792949168823942.jpeg/orig","srcSet":"https://avatars.mds.yandex.net/get-mpic/5221216/img_id7471792949168823942.jpeg/120x160 120w, https://avatars.mds.yandex.net/get-mpic/5221216/img_id7471792949168823942.jpeg/180x240 180w, https://avatars.mds.yandex.net/get-mpic/5221216/img_id7471792949168823942.jpeg/240x320 240w, https://avatars.mds.yandex.net/get-mpic/5221216/img_id7471792949168823942.jpeg/300x400 300w, https://avatars.mds.yandex.net/get-mpic/5221216/img_id7471792949168823942.jpeg/600x800 600w","sizes":"(max-width: 1456px) 15vw, 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    Пастилки California Gold Nutrition Vitamin D3 gummies со вкусом фруктов и ягод, 280 г, 90 шт.

    Цена 421 ₽ вместо 425
  • Эвалар Чай Эвалар БИО при повышенном содержании мочевой кислоты, 20 фильтр-пакетов
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    Эвалар Чай Эвалар БИО при повышенном содержании мочевой кислоты, 20 фильтр-пакетов

    Цена 194 ₽ вместо 224
  • Эндокринол капс., 0.275 г, 30 шт.
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    Эндокринол капс., 0.275 г, 30 шт.

    Цена 414 ₽ вместо 460
  • Реклама
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  • Зелдокс капс., 60 мг, 30 шт.
    {"widgets":{"@marketfront/SnippetConstructor/ToggleWishlist":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1404748509_22/content/content/toggleWishlist":{"skuId":"228045384","productId":1404748509,"offerId":"Zam3PBJAt6o_rgUM3iWB9Q","size":24,"color":"#BDBDBC","wishlistLink":"/my/wishlist","baobabRealTimeEventPayload":{"version":"EPV_BRT_V1","payload":"CgoQo+L7saKNqNg2EhoKGHJlbWl4X2Rlc2t0b3BfbW9kZWxfY2FyZDIVCN2F650FEMjk3mwYu5OMBiDt2cEH","sign":"M155AcwnCtnFiADELd3/0uIGd9Z2mst+sC0oG52A1rw="},"waitWishlistCollections":false,"place":{"page":"product","widget":"feed"}}}},"meta":{"/content/page/fancyPage/recommendationRoll/content/lazyGenerator/initialContent/recomLayoutItem_21#1:1404748509_22/content/content/toggleWishlist":{"name":"@marketfront/SnippetConstructor/ToggleWishlist"}}}

    Зелдокс капс., 60 мг, 30 шт.

    Цена 6 052 ₽
  • Детралекс таб. п/о плен., 500 мг, 60 шт.
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    Детралекс таб. п/о плен., 500 мг, 60 шт.

    Цена 1 889 ₽ вместо 1 908
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