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Описание

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Мемантин таб. п/о плен., 10 мг, 90 шт.

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У продавца: 
нет • На Маркете: 4.6
(43)
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Дозировка: 10 мг

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Количество штук в упаковке, шт.: 90

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Коротко о товаре

Артикул Маркета
545380438
Тип препарата
Назначение
Действующее вещество
Возраст
от 18 лет
Инструкция
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Терапию следует начинать только в том случае, если есть ухаживающее лицо, которое будет регулярно следить за приемом лекарственного препарата пациентом. Диагноз должен выставляться в соответствии с текущими рекомендациями.\u003Cbr\u003EНеобходимо регулярно оценивать достаточность дозы и переносимость мемантина, предпочтительно в течение трех месяцев после начала терапии. Далее клиническую пользу препарата и переносимость его пациентом необходимо оценивать в соответствии с текущими рекомендациями. Поддерживающую терапию следует продолжать, пока имеется терапевтическая польза и наблюдается удовлетворительная переносимость препарата. При исчезновении терапевтического эффекта или непереносимости препарата лечение отменяют.\u003Cbr\u003EВзрослые\u003Cbr\u003EПодбор дозы\u003Cbr\u003EМаксимальная суточная доза составляет 20 мг. Для снижения риска нежелательных реакций поддерживающая доза достигается подбором по 5 мг в неделю в течение первых трех недель по следующей схеме:\u003Cbr\u003EНеделя 1 (дни 1-7):\u003Cbr\u003EРекомендуемая доза - 5 мг ( 1/2 таблетки с дозировкой 10 мг) в сутки в течение 7 дней.\u003Cbr\u003EНеделя 2 (дни 8-14):\u003Cbr\u003EРекомендуемая доза - 10 мг (1 таблетка с дозировкой 10 мг) в сутки в течение 7 дней.\u003Cbr\u003EНеделя 3 (дни 15-21):\u003Cbr\u003EРекомендуемая доза - 15 мг (1 1/2 таблетки с дозировкой 10 мг) в сутки в течение 7 дней.\u003Cbr\u003EНачиная с 4 недели:\u003Cbr\u003EРекомендуемая доза - 20 мг в сутки.\u003Cbr\u003EПоддерживающая доза\u003Cbr\u003EРекомендуемая поддерживающая доза - 20 мг в сутки.\u003Cbr\u003EПациенты пожилого возраста\u003Cbr\u003EНа основании клинических данных рекомендуемая доза для пациентов старше 65 лет составляет 20 мг в сутки в соответствии с вышеописанным.\u003Cbr\u003EПациенты с нарушением функции почек\u003Cbr\u003EУ пациентов с легкими нарушениями функции почек (клиренс креатинина 50-80 мл/мин) изменение дозы не требуется. У пациентов с нарушением функции почек средней степени (клиренс креатинина 30-49 мл/мин) доза составляет 10 мг/сут. Если она хорошо переносится в течение, по меньшей мере, 7 дней, ее можно повысить до 20 мг/сут согласно стандартной схеме. У пациентов с тяжелым нарушением функции почек (клиренс креатинина 5-29 мл/мин) доза составляет 10 мг/сут.\u003Cbr\u003EПациенты с нарушением функции печени\u003Cbr\u003EУ пациентов с легким или средней степени нарушением функции печени (классы А и В по классификации Чайлд-Пью) изменение дозы не требуется. Данные по применению мемантина у пациентов с тяжелым нарушением функции печени отсутствуют. Не рекомендуется назначать мемантин пациентам с тяжелым нарушением функции печени.\u003Cbr\u003EДети и подростки\u003Cbr\u003EВследствие отсутствия данных об эффективности и безопасности мемантин не рекомендован детям младше 18 лет.\u003Cbr\u003EСпособ применения\u003Cbr\u003EМемантин принимают 1 раз в сутки, предпочтительно в одно и то же время каждый день. Таблетки, покрытые пленочной оболочкой, допускается принимать независимо от приема пищи."},{"name":"Побочные действия","value":"Резюме профиля безопасности\u003Cbr\u003EВ клинических исследованиях деменции легкой и средней степени, включавших 1784 пациента, получивших мемантин, и 1595 пациентов, получивших плацебо, общая частота нежелательных реакций при применении мемантина не отличалась от таковой для плацебо; тяжесть нежелательных реакций, как правило, колебалась от легкой до средней степени.\u003Cbr\u003EНаиболее частными нежелательными реакциями с более частой, чем группе плацебо частотой возникновения, были головокружение (6,3 и 5,6% соответственно), головная боль (5,2 и 3,9%), запор (4,6 и 2,6%), сонливость (3,4 и 2,2%) и артериальная гипертензия (4,1 и 2,8%). Представленный ниже перечень нежелательных реакций включает опыт клинических исследований и пострегистрационные данные. В каждой частотной группе нежелательные реакции перечислены в порядке снижения степени их серьезности.\u003Cbr\u003EНежелательные явления, представленные ниже, распределены по системно-органным классам и частоте встречаемости. Частота встречаемости определяется следующим образом: очень часто (≥1/10), часто (≥1/100 и \u003C1/10), нечасто (≥1/1000 и \u003C1/100), редко (≥1/10 000 и \u003C1/1000), очень редко (\u003C1/10 000, включая отдельные случаи), неизвестно (не может быть оценена по данным, имеющимся в наличии).\u003Cbr\u003EИнфекции и инвазии: нечасто - грибковые инфекции.\u003Cbr\u003EСо стороны иммунной системы: часто - гиперчувствительность к препарату.\u003Cbr\u003EПсихические расстройства: часто - сонливость; нечасто - спутанность сознания, галлюцинации1; частота неизвестна - психотические реакции2.\u003Cbr\u003EСо стороны нервной системы: часто - головокружение, нарушение равновесия; нечасто - нарушение походки; очень редко - судороги.\u003Cbr\u003EСо стороны сердца: нечасто - сердечная недостаточность.\u003Cbr\u003EСо стороны сосудов: часто - повышение артериального давления; нечасто - венозный тромбоз/тромбоэмболия.\u003Cbr\u003EСо стороны дыхательной системы, органов грудной клетки и средостения: часто - одышка.\u003Cbr\u003EСо стороны желудочно-кишечного тракта: часто - запор; нечасто - рвота; частота неизвестна - панкреатит2.\u003Cbr\u003EСо стороны печени и желчевыводящих путей: часто - повышение функциональных проб печени; частота неизвестна - гепатит.\u003Cbr\u003EОбщие расстройства и расстройства в месте введения: часто - головная боль; нечасто - утомляемость.\u003Cbr\u003E1 Галлюцинации наблюдались преимущественно у пациентов с тяжелой степенью болезни Альцгеймера.\u003Cbr\u003E2 В пострегистрационном периоде получены отдельные сообщения.\u003Cbr\u003EПри болезни Альцгеймера могут возникать депрессия, суицидальные мысли и попытки. В рамках пострегистрационного применения такие явления возникали у пациентов, принимавших мемантин."},{"name":"Фармакологическое действие","value":"Появляется все больше доказательств того, что нарушение работы глутаматергической нейротрансмиссии, в частности М-метил-D-аспартат-рецепторов (NMDA-рецепторах) способствует как возникновению симптомов, так и прогрессированию нейродегенеративной деменции.\u003Cbr\u003EМемантин является потенциалзависимым неконкурентным блокатором NMDA-рецепторов с умеренным аффинитетом к ним. Он модулирует действие патологически повышенного тонического содержания глутамата, который может приводить к нейрональной дисфункции."},{"name":"Фармакологическая группа","value":"средства лечения деменции"},{"name":"Форма выпуска","value":"таблетки, покрытые пленочной оболочкой"},{"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 25 °С.\u003Cbr\u003EХранить в недоступном для детей месте."},{"name":"Передозировка","value":"По результатам клинических исследований и пострегистрационного наблюдения получены лишь ограниченные данные по передозировке.\u003Cbr\u003EСимптомы\u003Cbr\u003EОтносительно большая передозировка (200 мг и 105 мг/день в течение 3 дней соответственно) проявлялась только утомляемостью, слабостью и (или) диареей, либо симптомы отсутствовали. У пациентов с передозировкой \u003C140 мг либо с неизвестной дозой наблюдались симптомы со стороны центральной нервной системы (спутанность сознания, гиперсомния, сонливость, вестибулярное головокружение, ажитация, агрессия, галлюцинации, нарушение походки) и (или) желудочно-кишечного тракта (рвота и диарея).\u003Cbr\u003EВ наиболее тяжелом случае - приеме 2000 мг мемантина - летальный исход не возникал, однако он сопровождался нарушениями со стороны центральной нервной системы: кома в течение 10 дней с последующей диплопией и ажитацией. Пациенту были назначены симптоматическое лечение и плазмаферез. Наступило выздоровление без стойких неблагоприятных последствий.\u003Cbr\u003EВ другом зарегистрированном случае пациент также выжил и выздоровел. После приема 400 мг мемантина внутрь у него отмечались следующие нарушения со стороны центральной нервной системы: беспокойство, психоз, зрительные галлюцинации, склонность к судорожным реакциям, сонливость, ступор и потеря сознания.\u003Cbr\u003EЛечение\u003Cbr\u003EВ случае передозировки проводят симптоматическое лечение. Специфического антидота от интоксикации или передозировки нет. Следует воспользоваться стандартными клиническими процедурами для удаления действующего вещества, например, активированный уголь (нарушает возможную кишечно-печеночную рециркуляцию), закисление мочи, форсированный диурез.\u003Cbr\u003EПри наличии признаков и симптомов общей гиперстимуляции центральной нервной системы следует проводить тщательное симптоматическое лечение."},{"name":"Применение при беременности и кормлении грудью","value":"Беременность\u003Cbr\u003EКлинические данные, полученные у беременных, отсутствуют. Результаты исследований на животных показывают, что при концентрациях, эквивалентных терапевтическим или несколько более высоких, возможно замедление внутриутробного роста плода. Потенциальный риск для человека неизвестен. Мемантин не следует применять при беременности в отсутствии явной необходимости.\u003Cbr\u003EГрудное вскармливание\u003Cbr\u003EДанные о проникновении мемантина в грудное молоко отсутствуют, однако, принимая во внимание липофильность вещества, этого нельзя исключить. Женщинам, принимающим мемантин, следует отказаться от грудного вскармливания.\u003Cbr\u003EФертильность\u003Cbr\u003EВ доклинических исследованиях мужской и женской фертильности нежелательное влияние мемантина не выявлено."},{"name":"Влияние на способность управлять транспортом и механизмами","value":"У пациентов с болезнью Альцгеймера на стадии умеренной и тяжелой деменции обычно нарушена способность к вождению автотранспорта и управлению сложными механизмами. Кроме того, мемантин может вызывать изменение скорости реакции, поэтому пациентам необходимо воздержаться от вождения автотранспорта и работы со сложными механизмами."},{"name":"Особые указания","value":"Необходимо соблюдать осторожность при применении у пациентов с эпилепсией, судорогами в анамнезе или у пациентов с предрасположенностью к эпилепсии.\u003Cbr\u003EСледует избегать одновременного применения препарата с другими блокаторами NMDA-рецепторов, включая амантадин, кетамин и декстрометорфан. Эти соединения действуют на ту же рецепторную систему, что и мемантин, вследствие чего нежелательные реакции (преимущественно со стороны центральной нервной системы) могут более частыми или выраженными (см. также раздел \"Взаимодействие с другими лекарственными препаратами\").\u003Cbr\u003EНекоторые факторы, которые могут повышать pH мочи (см. раздел \"Фармакокинетика\"), требуют тщательного наблюдения за пациентом. К подобным факторам относятся: резкие изменения в диете, например, переход от мясной диеты к вегетарианской, или чрезмерное потребление щелочных желудочных буферов. Также к повышению pH мочи могут привести почечный тубулярный ацидоз (ПТА) или тяжелые инфекции мочевыводящих путей, вызванные Proteus spp.\u003Cbr\u003EИз большинства клинических исследований исключались пациенты с инфарктом миокарда в анамнезе, декомпенсированной хронической сердечной недостаточностью (III-IV функциональный класс по NYНA) или неконтролируемой артериальной гипертензией. Данные по таким пациентам ограничены, поэтому они требуют тщательного наблюдения врача."},{"name":"Взаимодействие","value":"В силу фармакологических эффектов и механизма действия мемантина могут возникать следующие взаимодействия:\u003Cbr\u003E- Механизм действия предполагает, что при одновременном применении с антагонистами NMDA-рецепторов, к которым относится мемантин, может усиливаться действие леводопы, агонистов дофаминовых рецепторов и м-холиноблокаторов. При одновременном применении мемантина с барбитуратами и нейролептиками действие последних может снижаться. Одновременное применение мемантина и противосудорожных средств, дантролена или баклофена может изменить их действие, поэтому может потребоваться коррекция дозы последних.\u003Cbr\u003E- Вследствие риска фармакотоксического психоза следует избегать одновременного применения мемантина с амантадином. Данные препараты являются химически родственными антагонистами NMDA-рецепторов. Данный риск также характерен кетамину и декстрометорфану (см. раздел \"Особые указания\"). Описан случай риска подобного взаимодействия между мемантином и фенитоином.\u003Cbr\u003E- Прочие активные вещества, такие как циметидин, ранитидин, прокаинамид, хинидин, хинин и никотин, которые используют ту же почечную катионную транспортную систему, как и амантадин, вероятно, могут взаимодействовать с мемантином, приводя к потенциальному риску увеличения содержания этих веществ в плазме крови.\u003Cbr\u003E- Существует возможность снижения концентрации гидрохлоротиазида в сыворотке крови при одновременном применении его с мемантином или любой комбинации, содержащей гидрохлоротиазид.\u003Cbr\u003E- В пострегистрационных исследованиях были описаны отдельные случаи повышения международного нормализованного отношения (МНО) у пациентов, одновременно принимавших варфарин и мемантин. Несмотря на отсутствие причинно-следственной связи, рекомендуется тщательное наблюдение за протромбиновым временем или МНО у пациентов, одновременно принимающих непрямые антикоагулянты.\u003Cbr\u003EВ фармакокинетических исследованиях однократный прием мемантина здоровыми добровольцами не приводил к фармакокинетическому взаимодействию с глибенкламидом/метформином или донепезилом.\u003Cbr\u003EКлинические исследования у здоровых добровольцев не выявили влияния мемантина на фармакокинетику галантамина.\u003Cbr\u003EМемантин не ингибирует изоферменты CYP1А2, 2А6, 2С9, 2D6, 2Е1, 3А, флавинсодержашую монооксигеназу, эпоксидгидролазу, или сульфатирование in vitro."},{"name":"Регистрационный номер","value":"ЛП-004105"},{"name":"Дата государственной регистрации","value":"26.01.2017"},{"name":"Владелец регистрационного удостоверения","value":"Атолл","transition":{"type":"catalog","params":{"categorySlug":"sredstva-dlia-nervnoi-sistemy","categoryId":"15756525","navnodeId":"72478","glfilters":["34324371:35649313","7893318:17601668"]}}},{"name":"Изготовитель","value":"ОЗОН"},{"name":"Фасовщик","value":"ОЗОН"},{"name":"Страна бренда","value":"Россия"},{"name":"Страна-производитель","value":"Россия"},{"name":"Название препарата","value":"Мемантин","transition":{"type":"catalog","params":{"categorySlug":"sredstva-dlia-nervnoi-sistemy","categoryId":"15756525","navnodeId":"72478","glfilters":["17796364:18020949"]}}},{"name":"Срок годности","value":"847 дн."}]}},"fullSpecsGrouped":{"17270504406807516816":{"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":"Лечение болезни Альцгеймера от средней до тяжелой степени."},{"name":"Противопоказания","value":"Гиперчувствительность к любому из компонентов, входящих в состав препарата;\u003Cbr\u003E- тяжелая печеночная недостаточность (класс С по классификации Чайлд-Пью);\u003Cbr\u003E- беременность, период грудного вскармливания;\u003Cbr\u003E- детский возраст до 18 лет (эффективность и безопасность не установлены).\u003Cbr\u003E- непереносимость галактозы, дефицит лактазы, лактазная недостаточность."},{"name":"Состав","value":"Дозировка 10,0 мг\u003Cbr\u003EДействующее вещество: мемантина гидрохлорид - 10,0 мг.\u003Cbr\u003EВспомогательные вещества: лактозы моногидрат (сахар молочный) - 64,5 мг, целлюлоза микрокристаллическая - 14,0 мг, кроскармеллоза натрия - 4,0 мг, повидон-К25 - 3,0 мг, кремния диоксид коллоидный - 0,5 мг, магния стеарат - 1,0 мг.\u003Cbr\u003EСостав оболочки: гипромеллоза - 1,7 мг, макрогол-4000 - 0,4 мг, титана диоксид - 0,9 мг.\u003Cbr\u003EДозировка 20,0 мг\u003Cbr\u003EДействующее вещество: мемантина гидрохлорид - 20,0 мг.\u003Cbr\u003EВспомогательные вещества: лактозы моногидрат (сахар молочный) - 129,0 мг, целлюлоза микрокристаллическая - 28,0 мг, кроскармеллоза натрия - 8,0 мг, повидон-К25 - 6,0 мг, кремния диоксид коллоидный - 1,0 мг, магния стеарат-2,0 мг.\u003Cbr\u003EСостав оболочки: гипромеллоза - 3,4 мг, макрогол-4000 - 0,8 мг, титана диоксид - 1,8 мг."},{"name":"Действующее вещество","value":"Мемантин"},{"name":"Способ применения и дозы","value":"Режим дозирования\u003Cbr\u003EЛечение должно проводиться под наблюдением врача, имеющего опыт в вопросах диагностики и лечения деменции альцгеймеровского типа. Терапию следует начинать только в том случае, если есть ухаживающее лицо, которое будет регулярно следить за приемом лекарственного препарата пациентом. Диагноз должен выставляться в соответствии с текущими рекомендациями.\u003Cbr\u003EНеобходимо регулярно оценивать достаточность дозы и переносимость мемантина, предпочтительно в течение трех месяцев после начала терапии. Далее клиническую пользу препарата и переносимость его пациентом необходимо оценивать в соответствии с текущими рекомендациями. Поддерживающую терапию следует продолжать, пока имеется терапевтическая польза и наблюдается удовлетворительная переносимость препарата. При исчезновении терапевтического эффекта или непереносимости препарата лечение отменяют.\u003Cbr\u003EВзрослые\u003Cbr\u003EПодбор дозы\u003Cbr\u003EМаксимальная суточная доза составляет 20 мг. Для снижения риска нежелательных реакций поддерживающая доза достигается подбором по 5 мг в неделю в течение первых трех недель по следующей схеме:\u003Cbr\u003EНеделя 1 (дни 1-7):\u003Cbr\u003EРекомендуемая доза - 5 мг ( 1/2 таблетки с дозировкой 10 мг) в сутки в течение 7 дней.\u003Cbr\u003EНеделя 2 (дни 8-14):\u003Cbr\u003EРекомендуемая доза - 10 мг (1 таблетка с дозировкой 10 мг) в сутки в течение 7 дней.\u003Cbr\u003EНеделя 3 (дни 15-21):\u003Cbr\u003EРекомендуемая доза - 15 мг (1 1/2 таблетки с дозировкой 10 мг) в сутки в течение 7 дней.\u003Cbr\u003EНачиная с 4 недели:\u003Cbr\u003EРекомендуемая доза - 20 мг в сутки.\u003Cbr\u003EПоддерживающая доза\u003Cbr\u003EРекомендуемая поддерживающая доза - 20 мг в сутки.\u003Cbr\u003EПациенты пожилого возраста\u003Cbr\u003EНа основании клинических данных рекомендуемая доза для пациентов старше 65 лет составляет 20 мг в сутки в соответствии с вышеописанным.\u003Cbr\u003EПациенты с нарушением функции почек\u003Cbr\u003EУ пациентов с легкими нарушениями функции почек (клиренс креатинина 50-80 мл/мин) изменение дозы не требуется. У пациентов с нарушением функции почек средней степени (клиренс креатинина 30-49 мл/мин) доза составляет 10 мг/сут. Если она хорошо переносится в течение, по меньшей мере, 7 дней, ее можно повысить до 20 мг/сут согласно стандартной схеме. У пациентов с тяжелым нарушением функции почек (клиренс креатинина 5-29 мл/мин) доза составляет 10 мг/сут.\u003Cbr\u003EПациенты с нарушением функции печени\u003Cbr\u003EУ пациентов с легким или средней степени нарушением функции печени (классы А и В по классификации Чайлд-Пью) изменение дозы не требуется. Данные по применению мемантина у пациентов с тяжелым нарушением функции печени отсутствуют. Не рекомендуется назначать мемантин пациентам с тяжелым нарушением функции печени.\u003Cbr\u003EДети и подростки\u003Cbr\u003EВследствие отсутствия данных об эффективности и безопасности мемантин не рекомендован детям младше 18 лет.\u003Cbr\u003EСпособ применения\u003Cbr\u003EМемантин принимают 1 раз в сутки, предпочтительно в одно и то же время каждый день. Таблетки, покрытые пленочной оболочкой, допускается принимать независимо от приема пищи."},{"name":"Побочные действия","value":"Резюме профиля безопасности\u003Cbr\u003EВ клинических исследованиях деменции легкой и средней степени, включавших 1784 пациента, получивших мемантин, и 1595 пациентов, получивших плацебо, общая частота нежелательных реакций при применении мемантина не отличалась от таковой для плацебо; тяжесть нежелательных реакций, как правило, колебалась от легкой до средней степени.\u003Cbr\u003EНаиболее частными нежелательными реакциями с более частой, чем группе плацебо частотой возникновения, были головокружение (6,3 и 5,6% соответственно), головная боль (5,2 и 3,9%), запор (4,6 и 2,6%), сонливость (3,4 и 2,2%) и артериальная гипертензия (4,1 и 2,8%). Представленный ниже перечень нежелательных реакций включает опыт клинических исследований и пострегистрационные данные. В каждой частотной группе нежелательные реакции перечислены в порядке снижения степени их серьезности.\u003Cbr\u003EНежелательные явления, представленные ниже, распределены по системно-органным классам и частоте встречаемости. Частота встречаемости определяется следующим образом: очень часто (≥1/10), часто (≥1/100 и \u003C1/10), нечасто (≥1/1000 и \u003C1/100), редко (≥1/10 000 и \u003C1/1000), очень редко (\u003C1/10 000, включая отдельные случаи), неизвестно (не может быть оценена по данным, имеющимся в наличии).\u003Cbr\u003EИнфекции и инвазии: нечасто - грибковые инфекции.\u003Cbr\u003EСо стороны иммунной системы: часто - гиперчувствительность к препарату.\u003Cbr\u003EПсихические расстройства: часто - сонливость; нечасто - спутанность сознания, галлюцинации1; частота неизвестна - психотические реакции2.\u003Cbr\u003EСо стороны нервной системы: часто - головокружение, нарушение равновесия; нечасто - нарушение походки; очень редко - судороги.\u003Cbr\u003EСо стороны сердца: нечасто - сердечная недостаточность.\u003Cbr\u003EСо стороны сосудов: часто - повышение артериального давления; нечасто - венозный тромбоз/тромбоэмболия.\u003Cbr\u003EСо стороны дыхательной системы, органов грудной клетки и средостения: часто - одышка.\u003Cbr\u003EСо стороны желудочно-кишечного тракта: часто - запор; нечасто - рвота; частота неизвестна - панкреатит2.\u003Cbr\u003EСо стороны печени и желчевыводящих путей: часто - повышение функциональных проб печени; частота неизвестна - гепатит.\u003Cbr\u003EОбщие расстройства и расстройства в месте введения: часто - головная боль; нечасто - утомляемость.\u003Cbr\u003E1 Галлюцинации наблюдались преимущественно у пациентов с тяжелой степенью болезни Альцгеймера.\u003Cbr\u003E2 В пострегистрационном периоде получены отдельные сообщения.\u003Cbr\u003EПри болезни Альцгеймера могут возникать депрессия, суицидальные мысли и попытки. В рамках пострегистрационного применения такие явления возникали у пациентов, принимавших мемантин."},{"name":"Фармакологическое действие","value":"Появляется все больше доказательств того, что нарушение работы глутаматергической нейротрансмиссии, в частности М-метил-D-аспартат-рецепторов (NMDA-рецепторах) способствует как возникновению симптомов, так и прогрессированию нейродегенеративной деменции.\u003Cbr\u003EМемантин является потенциалзависимым неконкурентным блокатором NMDA-рецепторов с умеренным аффинитетом к ним. Он модулирует действие патологически повышенного тонического содержания глутамата, который может приводить к нейрональной дисфункции."},{"name":"Фармакологическая группа","value":"средства лечения деменции"},{"name":"Форма выпуска","value":"таблетки, покрытые пленочной оболочкой"},{"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 25 °С.\u003Cbr\u003EХранить в недоступном для детей месте."},{"name":"Передозировка","value":"По результатам клинических исследований и пострегистрационного наблюдения получены лишь ограниченные данные по передозировке.\u003Cbr\u003EСимптомы\u003Cbr\u003EОтносительно большая передозировка (200 мг и 105 мг/день в течение 3 дней соответственно) проявлялась только утомляемостью, слабостью и (или) диареей, либо симптомы отсутствовали. У пациентов с передозировкой \u003C140 мг либо с неизвестной дозой наблюдались симптомы со стороны центральной нервной системы (спутанность сознания, гиперсомния, сонливость, вестибулярное головокружение, ажитация, агрессия, галлюцинации, нарушение походки) и (или) желудочно-кишечного тракта (рвота и диарея).\u003Cbr\u003EВ наиболее тяжелом случае - приеме 2000 мг мемантина - летальный исход не возникал, однако он сопровождался нарушениями со стороны центральной нервной системы: кома в течение 10 дней с последующей диплопией и ажитацией. Пациенту были назначены симптоматическое лечение и плазмаферез. Наступило выздоровление без стойких неблагоприятных последствий.\u003Cbr\u003EВ другом зарегистрированном случае пациент также выжил и выздоровел. После приема 400 мг мемантина внутрь у него отмечались следующие нарушения со стороны центральной нервной системы: беспокойство, психоз, зрительные галлюцинации, склонность к судорожным реакциям, сонливость, ступор и потеря сознания.\u003Cbr\u003EЛечение\u003Cbr\u003EВ случае передозировки проводят симптоматическое лечение. Специфического антидота от интоксикации или передозировки нет. Следует воспользоваться стандартными клиническими процедурами для удаления действующего вещества, например, активированный уголь (нарушает возможную кишечно-печеночную рециркуляцию), закисление мочи, форсированный диурез.\u003Cbr\u003EПри наличии признаков и симптомов общей гиперстимуляции центральной нервной системы следует проводить тщательное симптоматическое лечение."},{"name":"Применение при беременности и кормлении грудью","value":"Беременность\u003Cbr\u003EКлинические данные, полученные у беременных, отсутствуют. Результаты исследований на животных показывают, что при концентрациях, эквивалентных терапевтическим или несколько более высоких, возможно замедление внутриутробного роста плода. Потенциальный риск для человека неизвестен. Мемантин не следует применять при беременности в отсутствии явной необходимости.\u003Cbr\u003EГрудное вскармливание\u003Cbr\u003EДанные о проникновении мемантина в грудное молоко отсутствуют, однако, принимая во внимание липофильность вещества, этого нельзя исключить. Женщинам, принимающим мемантин, следует отказаться от грудного вскармливания.\u003Cbr\u003EФертильность\u003Cbr\u003EВ доклинических исследованиях мужской и женской фертильности нежелательное влияние мемантина не выявлено."},{"name":"Влияние на способность управлять транспортом и механизмами","value":"У пациентов с болезнью Альцгеймера на стадии умеренной и тяжелой деменции обычно нарушена способность к вождению автотранспорта и управлению сложными механизмами. Кроме того, мемантин может вызывать изменение скорости реакции, поэтому пациентам необходимо воздержаться от вождения автотранспорта и работы со сложными механизмами."},{"name":"Особые указания","value":"Необходимо соблюдать осторожность при применении у пациентов с эпилепсией, судорогами в анамнезе или у пациентов с предрасположенностью к эпилепсии.\u003Cbr\u003EСледует избегать одновременного применения препарата с другими блокаторами NMDA-рецепторов, включая амантадин, кетамин и декстрометорфан. Эти соединения действуют на ту же рецепторную систему, что и мемантин, вследствие чего нежелательные реакции (преимущественно со стороны центральной нервной системы) могут более частыми или выраженными (см. также раздел \"Взаимодействие с другими лекарственными препаратами\").\u003Cbr\u003EНекоторые факторы, которые могут повышать pH мочи (см. раздел \"Фармакокинетика\"), требуют тщательного наблюдения за пациентом. К подобным факторам относятся: резкие изменения в диете, например, переход от мясной диеты к вегетарианской, или чрезмерное потребление щелочных желудочных буферов. Также к повышению pH мочи могут привести почечный тубулярный ацидоз (ПТА) или тяжелые инфекции мочевыводящих путей, вызванные Proteus spp.\u003Cbr\u003EИз большинства клинических исследований исключались пациенты с инфарктом миокарда в анамнезе, декомпенсированной хронической сердечной недостаточностью (III-IV функциональный класс по NYНA) или неконтролируемой артериальной гипертензией. Данные по таким пациентам ограничены, поэтому они требуют тщательного наблюдения врача."},{"name":"Взаимодействие","value":"В силу фармакологических эффектов и механизма действия мемантина могут возникать следующие взаимодействия:\u003Cbr\u003E- Механизм действия предполагает, что при одновременном применении с антагонистами NMDA-рецепторов, к которым относится мемантин, может усиливаться действие леводопы, агонистов дофаминовых рецепторов и м-холиноблокаторов. При одновременном применении мемантина с барбитуратами и нейролептиками действие последних может снижаться. Одновременное применение мемантина и противосудорожных средств, дантролена или баклофена может изменить их действие, поэтому может потребоваться коррекция дозы последних.\u003Cbr\u003E- Вследствие риска фармакотоксического психоза следует избегать одновременного применения мемантина с амантадином. Данные препараты являются химически родственными антагонистами NMDA-рецепторов. Данный риск также характерен кетамину и декстрометорфану (см. раздел \"Особые указания\"). Описан случай риска подобного взаимодействия между мемантином и фенитоином.\u003Cbr\u003E- Прочие активные вещества, такие как циметидин, ранитидин, прокаинамид, хинидин, хинин и никотин, которые используют ту же почечную катионную транспортную систему, как и амантадин, вероятно, могут взаимодействовать с мемантином, приводя к потенциальному риску увеличения содержания этих веществ в плазме крови.\u003Cbr\u003E- Существует возможность снижения концентрации гидрохлоротиазида в сыворотке крови при одновременном применении его с мемантином или любой комбинации, содержащей гидрохлоротиазид.\u003Cbr\u003E- В пострегистрационных исследованиях были описаны отдельные случаи повышения международного нормализованного отношения (МНО) у пациентов, одновременно принимавших варфарин и мемантин. Несмотря на отсутствие причинно-следственной связи, рекомендуется тщательное наблюдение за протромбиновым временем или МНО у пациентов, одновременно принимающих непрямые антикоагулянты.\u003Cbr\u003EВ фармакокинетических исследованиях однократный прием мемантина здоровыми добровольцами не приводил к фармакокинетическому взаимодействию с глибенкламидом/метформином или донепезилом.\u003Cbr\u003EКлинические исследования у здоровых добровольцев не выявили влияния мемантина на фармакокинетику галантамина.\u003Cbr\u003EМемантин не ингибирует изоферменты CYP1А2, 2А6, 2С9, 2D6, 2Е1, 3А, флавинсодержашую монооксигеназу, эпоксидгидролазу, или сульфатирование in vitro."},{"name":"Регистрационный номер","value":"ЛП-004105"},{"name":"Дата государственной регистрации","value":"26.01.2017"},{"name":"Владелец регистрационного удостоверения","value":"Атолл"},{"name":"Изготовитель","value":"ОЗОН"},{"name":"Фасовщик","value":"ОЗОН"},{"name":"Страна бренда","value":"Россия"},{"name":"Страна-производитель","value":"Россия"},{"name":"Название препарата","value":"Мемантин"},{"name":"Срок годности","value":"847 дн."}]}],"transitionId":"tr_8700143010930713014"}}}}
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В рамках пострегистрационного применения такие явления возникали у пациентов, принимавших мемантин."},{"description":"","filters":[{"id":15768001,"name":"Фармакологическое действие"}],"isMainProperty":false,"name":"Фармакологическое действие","value":"Появляется все больше доказательств того, что нарушение работы глутаматергической нейротрансмиссии, в частности М-метил-D-аспартат-рецепторов (NMDA-рецепторах) способствует как возникновению симптомов, так и прогрессированию нейродегенеративной деменции.\u003Cbr\u003EМемантин является потенциалзависимым неконкурентным блокатором NMDA-рецепторов с умеренным аффинитетом к ним. Он модулирует действие патологически повышенного тонического содержания глутамата, который может приводить к нейрональной дисфункции."},{"description":"","filters":[{"id":34045110,"name":"Фармакологическая группа"}],"isMainProperty":false,"name":"Фармакологическая группа","value":"средства лечения деменции"},{"description":"","filters":[{"id":27141511,"name":"Форма выпуска для карточки"}],"isMainProperty":false,"name":"Форма выпуска","value":"таблетки, покрытые пленочной оболочкой"},{"description":"","filters":[{"id":35947170,"name":"Способ применения/введения"}],"isMainProperty":false,"name":"Способ применения/введения","value":"пероральный"},{"description":"","filters":[{"id":23679511,"name":"Минимальный возраст применения"},{"id":16082123,"name":"С рождения"}],"isMainProperty":false,"name":"Минимальный возраст применения","value":"от 18 лет"}]},{"name":"Дополнительно","specs":[{"description":"","filters":[{"id":15767999,"name":"Условия хранения"}],"isMainProperty":false,"name":"Условия хранения","value":"При температуре не выше 25 °С.\u003Cbr\u003EХранить в недоступном для детей месте."},{"description":"","filters":[{"id":15768014,"name":"Передозировка"}],"isMainProperty":false,"name":"Передозировка","value":"По результатам клинических исследований и пострегистрационного наблюдения получены лишь ограниченные данные по передозировке.\u003Cbr\u003EСимптомы\u003Cbr\u003EОтносительно большая передозировка (200 мг и 105 мг/день в течение 3 дней соответственно) проявлялась только утомляемостью, слабостью и (или) диареей, либо симптомы отсутствовали. У пациентов с передозировкой \u003C140 мг либо с неизвестной дозой наблюдались симптомы со стороны центральной нервной системы (спутанность сознания, гиперсомния, сонливость, вестибулярное головокружение, ажитация, агрессия, галлюцинации, нарушение походки) и (или) желудочно-кишечного тракта (рвота и диарея).\u003Cbr\u003EВ наиболее тяжелом случае - приеме 2000 мг мемантина - летальный исход не возникал, однако он сопровождался нарушениями со стороны центральной нервной системы: кома в течение 10 дней с последующей диплопией и ажитацией. Пациенту были назначены симптоматическое лечение и плазмаферез. Наступило выздоровление без стойких неблагоприятных последствий.\u003Cbr\u003EВ другом зарегистрированном случае пациент также выжил и выздоровел. После приема 400 мг мемантина внутрь у него отмечались следующие нарушения со стороны центральной нервной системы: беспокойство, психоз, зрительные галлюцинации, склонность к судорожным реакциям, сонливость, ступор и потеря сознания.\u003Cbr\u003EЛечение\u003Cbr\u003EВ случае передозировки проводят симптоматическое лечение. Специфического антидота от интоксикации или передозировки нет. Следует воспользоваться стандартными клиническими процедурами для удаления действующего вещества, например, активированный уголь (нарушает возможную кишечно-печеночную рециркуляцию), закисление мочи, форсированный диурез.\u003Cbr\u003EПри наличии признаков и симптомов общей гиперстимуляции центральной нервной системы следует проводить тщательное симптоматическое лечение."},{"description":"","filters":[{"id":15768015,"name":"Применение при беременности и кормлении грудью"}],"isMainProperty":false,"name":"Применение при беременности и кормлении грудью","value":"Беременность\u003Cbr\u003EКлинические данные, полученные у беременных, отсутствуют. Результаты исследований на животных показывают, что при концентрациях, эквивалентных терапевтическим или несколько более высоких, возможно замедление внутриутробного роста плода. Потенциальный риск для человека неизвестен. Мемантин не следует применять при беременности в отсутствии явной необходимости.\u003Cbr\u003EГрудное вскармливание\u003Cbr\u003EДанные о проникновении мемантина в грудное молоко отсутствуют, однако, принимая во внимание липофильность вещества, этого нельзя исключить. Женщинам, принимающим мемантин, следует отказаться от грудного вскармливания.\u003Cbr\u003EФертильность\u003Cbr\u003EВ доклинических исследованиях мужской и женской фертильности нежелательное влияние мемантина не выявлено."},{"description":"","filters":[{"id":17360993,"name":"Влияние на способность управлять транспортом и механизмами"}],"isMainProperty":false,"name":"Влияние на способность управлять транспортом и механизмами","value":"У пациентов с болезнью Альцгеймера на стадии умеренной и тяжелой деменции обычно нарушена способность к вождению автотранспорта и управлению сложными механизмами. Кроме того, мемантин может вызывать изменение скорости реакции, поэтому пациентам необходимо воздержаться от вождения автотранспорта и работы со сложными механизмами."},{"description":"","filters":[{"id":15771167,"name":"Особые указания"}],"isMainProperty":false,"name":"Особые указания","value":"Необходимо соблюдать осторожность при применении у пациентов с эпилепсией, судорогами в анамнезе или у пациентов с предрасположенностью к эпилепсии.\u003Cbr\u003EСледует избегать одновременного применения препарата с другими блокаторами NMDA-рецепторов, включая амантадин, кетамин и декстрометорфан. Эти соединения действуют на ту же рецепторную систему, что и мемантин, вследствие чего нежелательные реакции (преимущественно со стороны центральной нервной системы) могут более частыми или выраженными (см. также раздел \"Взаимодействие с другими лекарственными препаратами\").\u003Cbr\u003EНекоторые факторы, которые могут повышать pH мочи (см. раздел \"Фармакокинетика\"), требуют тщательного наблюдения за пациентом. К подобным факторам относятся: резкие изменения в диете, например, переход от мясной диеты к вегетарианской, или чрезмерное потребление щелочных желудочных буферов. Также к повышению pH мочи могут привести почечный тубулярный ацидоз (ПТА) или тяжелые инфекции мочевыводящих путей, вызванные Proteus spp.\u003Cbr\u003EИз большинства клинических исследований исключались пациенты с инфарктом миокарда в анамнезе, декомпенсированной хронической сердечной недостаточностью (III-IV функциональный класс по NYНA) или неконтролируемой артериальной гипертензией. Данные по таким пациентам ограничены, поэтому они требуют тщательного наблюдения врача."},{"description":"","filters":[{"id":15768012,"name":"Взаимодействие"}],"isMainProperty":false,"name":"Взаимодействие","value":"В силу фармакологических эффектов и механизма действия мемантина могут возникать следующие взаимодействия:\u003Cbr\u003E- Механизм действия предполагает, что при одновременном применении с антагонистами NMDA-рецепторов, к которым относится мемантин, может усиливаться действие леводопы, агонистов дофаминовых рецепторов и м-холиноблокаторов. При одновременном применении мемантина с барбитуратами и нейролептиками действие последних может снижаться. Одновременное применение мемантина и противосудорожных средств, дантролена или баклофена может изменить их действие, поэтому может потребоваться коррекция дозы последних.\u003Cbr\u003E- Вследствие риска фармакотоксического психоза следует избегать одновременного применения мемантина с амантадином. Данные препараты являются химически родственными антагонистами NMDA-рецепторов. Данный риск также характерен кетамину и декстрометорфану (см. раздел \"Особые указания\"). Описан случай риска подобного взаимодействия между мемантином и фенитоином.\u003Cbr\u003E- Прочие активные вещества, такие как циметидин, ранитидин, прокаинамид, хинидин, хинин и никотин, которые используют ту же почечную катионную транспортную систему, как и амантадин, вероятно, могут взаимодействовать с мемантином, приводя к потенциальному риску увеличения содержания этих веществ в плазме крови.\u003Cbr\u003E- Существует возможность снижения концентрации гидрохлоротиазида в сыворотке крови при одновременном применении его с мемантином или любой комбинации, содержащей гидрохлоротиазид.\u003Cbr\u003E- В пострегистрационных исследованиях были описаны отдельные случаи повышения международного нормализованного отношения (МНО) у пациентов, одновременно принимавших варфарин и мемантин. Несмотря на отсутствие причинно-следственной связи, рекомендуется тщательное наблюдение за протромбиновым временем или МНО у пациентов, одновременно принимающих непрямые антикоагулянты.\u003Cbr\u003EВ фармакокинетических исследованиях однократный прием мемантина здоровыми добровольцами не приводил к фармакокинетическому взаимодействию с глибенкламидом/метформином или донепезилом.\u003Cbr\u003EКлинические исследования у здоровых добровольцев не выявили влияния мемантина на фармакокинетику галантамина.\u003Cbr\u003EМемантин не ингибирует изоферменты CYP1А2, 2А6, 2С9, 2D6, 2Е1, 3А, флавинсодержашую монооксигеназу, эпоксидгидролазу, или сульфатирование in vitro."},{"description":"","filters":[{"id":16435314,"name":"Регистрационный номер"}],"isMainProperty":false,"name":"Регистрационный номер","value":"ЛП-004105"},{"description":"","filters":[{"id":16435315,"name":"Дата государственной регистрации"}],"isMainProperty":false,"name":"Дата государственной 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Ещё может подойти

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Инструкция

Показания к применению

Лечение болезни Альцгеймера от средней до тяжелой степени.

Противопоказания

Гиперчувствительность к любому из компонентов, входящих в состав препарата;
- тяжелая печеночная недостаточность (класс С по классификации Чайлд-Пью);
- беременность, период грудного вскармливания;
- детский возраст до 18 лет (эффективность и безопасность не установлены).
- непереносимость галактозы, дефицит лактазы, лактазная недостаточность.

Способ применения и дозы

Режим дозирования
Лечение должно проводиться под наблюдением врача, имеющего опыт в вопросах диагностики и лечения деменции альцгеймеровского типа. Терапию следует начинать только в том случае, если есть ухаживающее лицо, которое будет регулярно следить за приемом лекарственного препарата пациентом. Диагноз должен выставляться в соответствии с текущими рекомендациями.
Необходимо регулярно оценивать достаточность дозы и переносимость мемантина, предпочтительно в течение трех месяцев после начала терапии. Далее клиническую пользу препарата и переносимость его пациентом необходимо оценивать в соответствии с текущими рекомендациями. Поддерживающую терапию следует продолжать, пока имеется терапевтическая польза и наблюдается удовлетворительная переносимость препарата. При исчезновении терапевтического эффекта или непереносимости препарата лечение отменяют.
Взрослые
Подбор дозы
Максимальная суточная доза составляет 20 мг. Для снижения риска нежелательных реакций поддерживающая доза достигается подбором по 5 мг в неделю в течение первых трех недель по следующей схеме:
Неделя 1 (дни 1-7):
Рекомендуемая доза - 5 мг ( 1/2 таблетки с дозировкой 10 мг) в сутки в течение 7 дней.
Неделя 2 (дни 8-14):
Рекомендуемая доза - 10 мг (1 таблетка с дозировкой 10 мг) в сутки в течение 7 дней.
Неделя 3 (дни 15-21):
Рекомендуемая доза - 15 мг (1 1/2 таблетки с дозировкой 10 мг) в сутки в течение 7 дней.
Начиная с 4 недели:
Рекомендуемая доза - 20 мг в сутки.
Поддерживающая доза
Рекомендуемая поддерживающая доза - 20 мг в сутки.
Пациенты пожилого возраста
На основании клинических данных рекомендуемая доза для пациентов старше 65 лет составляет 20 мг в сутки в соответствии с вышеописанным.
Пациенты с нарушением функции почек
У пациентов с легкими нарушениями функции почек (клиренс креатинина 50-80 мл/мин) изменение дозы не требуется. У пациентов с нарушением функции почек средней степени (клиренс креатинина 30-49 мл/мин) доза составляет 10 мг/сут. Если она хорошо переносится в течение, по меньшей мере, 7 дней, ее можно повысить до 20 мг/сут согласно стандартной схеме. У пациентов с тяжелым нарушением функции почек (клиренс креатинина 5-29 мл/мин) доза составляет 10 мг/сут.
Пациенты с нарушением функции печени
У пациентов с легким или средней степени нарушением функции печени (классы А и В по классификации Чайлд-Пью) изменение дозы не требуется. Данные по применению мемантина у пациентов с тяжелым нарушением функции печени отсутствуют. Не рекомендуется назначать мемантин пациентам с тяжелым нарушением функции печени.
Дети и подростки
Вследствие отсутствия данных об эффективности и безопасности мемантин не рекомендован детям младше 18 лет.
Способ применения
Мемантин принимают 1 раз в сутки, предпочтительно в одно и то же время каждый день. Таблетки, покрытые пленочной оболочкой, допускается принимать независимо от приема пищи.
Полная инструкция
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Мемантин таб. п/о плен.
Мемантин таб. п/о плен., 10 мг, 90 шт.
У продавца: 
нет • На Маркете: 4.6
(43)
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1 вопрос
Инструкция

1 673 ₽

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

    Цена 494 ₽ вместо 544
  • Таблетница на 7 дней/контейнер для таблеток и витаминов на 7 дней, Immunit
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    Таблетница на 7 дней/контейнер для таблеток и витаминов на 7 дней, Immunit

    Цена 143 ₽ вместо 189
  • 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 ₽
  • Таблетница на 7 дней 3 приема черная
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    Таблетница на 7 дней 3 приема черная

    Цена 733 ₽ вместо 1 000
  • Таблетница из 14 секций на семь дней Утро-вечер
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    Таблетница из 14 секций на семь дней Утро-вечер

    Цена 167 ₽ вместо 200
  • VETTA / Таблетница-органайзер для таблеток аптечка для лекарств карманная в дорогу с разделителем на 14 секций, на неделю 7 дней, утро вечер
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    VETTA / Таблетница-органайзер для таблеток аптечка для лекарств карманная в дорогу с разделителем на 14 секций, на неделю 7 дней, утро вечер

    Цена 331 ₽ вместо 950
  • Таблетница органайзер на неделю утро / день / вечер; Органайзер для таблеток на 7 дней; Карманная аптечка
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    Таблетница органайзер на неделю утро / день / вечер; Органайзер для таблеток на 7 дней; Карманная аптечка

    Цена 781 ₽ вместо 1 890
  • Реклама
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  • Контейнер для хранения/таблетница/кейс для таблеток
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    Контейнер для хранения/таблетница/кейс для таблеток

    Цена 365 ₽ вместо 699
  • Таблетница компактная /органайзер аптечка/ контейнер для таблеток БАД Panda_Home (синего цвета)
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    Таблетница компактная /органайзер аптечка/ контейнер для таблеток БАД Panda_Home (синего цвета)

    Цена 245 ₽ вместо 263
  • Таблетница на 7 дней / органайзер / бокс / контейнер на неделю для хранения таблеток и лекарств 1 прием Компактный, Daswerk
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    Таблетница на 7 дней / органайзер / бокс / контейнер на неделю для хранения таблеток и лекарств 1 прием Компактный, Daswerk

    Цена 147 ₽ вместо 428
  • Мемантин-Вертекс таб. п/о плен., 10 мг, 30 шт.
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    Мемантин-Вертекс таб. п/о плен., 10 мг, 30 шт.

    Цена 670 ₽
  • Мемантин-Риxтер таб. п/о плен., 10 мг, 30 шт.
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    Мемантин-Риxтер таб. п/о плен., 10 мг, 30 шт.

    Цена 471 ₽ вместо 521
  • Мемантин таб. п/о плен., 10 мг, 30 шт.
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    Мемантин таб. п/о плен., 10 мг, 30 шт.

    Цена 928 ₽
  • Таблетница пенал - органайзер ABORNS на неделю 7 ячеек 7 дней
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    Таблетница пенал - органайзер ABORNS на неделю 7 ячеек 7 дней

    Цена 176 ₽ вместо 400
  • Меманталь таб. п/о плен., 10 мг, 90 шт.
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    Меманталь таб. п/о плен., 10 мг, 90 шт.

    Цена 1 545 ₽
  • Таблетница пенал - органайзер ABORNS на неделю 7 ячеек 7 дней
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    Таблетница пенал - органайзер ABORNS на неделю 7 ячеек 7 дней

    Цена 176 ₽ вместо 350
  • Таблетница пилюля С делителем
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    Таблетница пилюля С делителем

    Цена 461 ₽ вместо 665
  • Таблетница «Ряд», английские буквы, 7 секций, 13 см х 3,5 см х 2,5 см, цвет белый
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    Таблетница «Ряд», английские буквы, 7 секций, 13 см х 3,5 см х 2,5 см, цвет белый

    Цена 252 ₽ вместо 304
  • Таблетница «Ряд», английские буквы, 7 секций, 13 см х 3,5 см х 2,5 см, цвет белый
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    Таблетница «Ряд», английские буквы, 7 секций, 13 см х 3,5 см х 2,5 см, цвет белый

    Цена 439 ₽ вместо 554
  • Реклама
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  • Оланзапин таб. п/о плен., 5 мг, 28 шт.
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    Оланзапин таб. п/о плен., 5 мг, 28 шт.

    Цена 444 ₽
  • Контейнер-органайзер для лекарств DASWERK таблетница 7 дней/1 прием компактный
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