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Всегда каждую зиму пьём аквадетрим.в жидком виде лучше усваивается 👍всем рекомендую
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По сравнению с витамином D2 характеризуется на 25% более высокой активностью.\u003Cbr\u003EВитамин D связывается со специфическим рецептором витамина D (VDR), который регулирует экспрессию многих генов, включая гены ионного канала TRPV6 (обеспечивает абсорбцию кальция в кишечнике), CALB1 (кальбиндин; обеспечивает транспорт кальция в кровеносное русло), BGLAP (остеокальцин; обеспечивает минерализацию костной ткани и гомеостаз кальция), SPP1 (остеопонтин; регулирует миграцию остеокластов), REN (ренин; обеспечивает регуляцию артериального давления, являясь ключевым элементов ренин-ангиотензин-альдостероновой системы регуляции), IGFBP (связывающий белок инсулинподобного фактора роста; усиливает действие инсулинподобного фактора роста), FGF23 и FGFR23 (фактор роста фибробластов 23; регулируют уровни кальция, фосфат-аниона, процессы клеточного деления фибробластов), TGFB1 (трансформирующий фактор роста бета-1; регулирует процессы клеточного деления и дифференцировки остеоцитов, хондроцитов, фибробластов и кератиноцитов), LRP2 (ЛПНП-рецептор-связанный белок 2; является посредником эндоцитоза липопротеинов низкой плотности), INSR (рецептор инсулина; обеспечивает эффекты инсулина на любые типы клеток).\u003Cbr\u003EВитамин D3 является активным антирахитическим фактором. Самой важной функцией витамина D3 является регулирование метаболизма кальция и фосфатов, что способствует правильной минерализации и росту скелета.\u003Cbr\u003EКолекальциферол играет существенную роль в абсорбции кальция и фосфатов в кишечнике, в транспорте минеральных солей и в процессе кальцификации костей, регулирует также выведение кальция и фосфатов почками.\u003Cbr\u003EКонцентрация ионов кальция в крови обуславливает поддержание тонуса мышц скелетной мускулатуры, функцию миокарда, способствует проведению нервного возбуждения, регулирует процесс свертывания крови.\u003Cbr\u003EНедостаток витамина D в пище, нарушение его всасывания, дефицит кальция, а также недостаточное пребывание на солнце в период быстрого роста ребенка приводит к рахиту, у взрослых - к остеомаляции, у беременных могут возникнуть симптомы тетании, нарушение процессов обызвествления костей новорожденных.\u003Cbr\u003EПовышенная потребность в витамине D возникает у женщин в период менопаузы, поскольку у них часто развивается остеопороз в связи с гормональными нарушениями.\u003Cbr\u003EВитамин D обладает рядом т.н. внескелетных эффектов.\u003Cbr\u003EВитамин D участвует в функционировании иммунной системы путем модуляции уровней цитокинов и регулирует деление лимфоцитов Т-хелперов и дифференцировку В-лимфоцитов. В ряде исследований отмечено снижение заболеваемости инфекциями дыхательных путей на фоне приема витамина D.\u003Cbr\u003EПоказано, что витамин D является важным звеном гомеостаза иммунной системы: предотвращает аутоиммунные заболевания (сахарный диабет 1 типа, рассеянный склероз, ревматоидный артрит, воспалительные болезни кишечника и др.)\u003Cbr\u003EВитамин D обладает антипролиферативным и продифференцирующим эффектами, которые обуславливают онкопротективное действие витамина D. Отмечено, что частота некоторых опухолей (рак молочной железы, рак толстого кишечника) повышается на фоне низкого уровня витамина D в крови.\u003Cbr\u003EВитамин D участвует в регуляции углеводного и жирового метаболизма путем влияния на синтез IRS1 (субстрат рецептора инсулина 1; участвует во внутриклеточных путях проведения сигнала рецептора инсулина), IGF (инсулинподобный фактор роста; регулирует баланс жировой и мышечной ткани), PPAR-δ (активированный рецептор пролифераторов пероксисом, тип δ; способствует переработке избыточного холестерина).\u003Cbr\u003EПо данным эпидемиологических исследований дефицит витамина D ассоциирован с риском метаболических нарушений (метаболический синдром и сахарный диабет 2 типа).\u003Cbr\u003EРецепторы и метаболизирующие ферменты витамина D экспрессируются в артериальных сосудах, сердце и практически всех клетках и тканях, имеющих отношение к патогенезу сердечно-сосудистых заболеваний. На животных моделях показаны антиатеросклеротическое действие, супрессия ренина и предупреждение повреждения миокарда и др. Низкие уровни витамина D у человека связаны с неблагоприятными факторами риска сердечно-сосудистой патологии, такими как сахарный диабет, дислипидемия, артериальная гипертензия, и ассоциированы с риском сердечно-сосудистых катастроф в т.ч. инсультов.\u003Cbr\u003EВ исследованиях на экспериментальных моделях болезни Альцгеймера показано, что витамин D3 снижал накопление амилоида в мозге и улучшал когнитивную функцию. В неитервенционных исследованиях у человека показано, что частота развития деменции и болезни Альцгеймера увеличивается на фоне низкого уровня витамина D и низкого диетарного потребления витамина D. Отмечалось ухудшение когнитивной функции и заболеваемости болезнью Альцгеймера при низких уровнях витамина D."},{"description":"","filters":[{"id":50921473,"name":"Состав"}],"isMainProperty":false,"name":"Состав","value":"1 мл препарата содержат: действующее вещество: колекальциферол (витамин D3) 15 000 МЕ\u003Cbr\u003Eвспомогательные вещества: макрогола глицерилрицинолеат, сахaроза, натрия гидрофосфата додекагидрат, лимонная кислота моногидрат, ароматизатор анисовый, бензиловый спирт, вода очищенная."},{"description":"","filters":[{"id":50921347,"name":"Взаимодействие"}],"isMainProperty":false,"name":"Взаимодействие","value":"Противоэпилептические средства, рифампицин, колестирамин снижают реабсорбцию витамина D3.\u003Cbr\u003EПрименение одновременно с тиазидными диуретиками повышает риск проявления гиперкальциемии.\u003Cbr\u003EОдновременное применение с сердечными гликозидами может усиливать их токсическое действие (повышается риск проявления нарушений ритма сердца)."},{"description":"","filters":[{"id":50921465,"name":"Показания к применению"}],"isMainProperty":false,"name":"Показания к применению","value":"Профилактика и лечение дефицита витамина D.\u003Cbr\u003EПрофилактика и лечение рахита, рахитоподобных заболеваний, гипокальциемической тетании, остеомаляции и заболеваний костей на метаболической основе (таких как, гипопаратиреоз и псевдогипопаратиреоз).\u003Cbr\u003EПри комплексном лечении остеопороза, в том числе постменопаузального."},{"description":"","filters":[{"id":50925451,"name":"Противопоказания"}],"isMainProperty":false,"name":"Противопоказания","value":"Повышенная чувствительность к компонентам препарата, особенно к бензиловому спирту. Гипервитаминоз D, повышенная концентрация кальция в крови (гиперкальциемия), повышенное выделение кальция с мочой (гиперкальциурия), мочекаменная болезнь (образование кальциевых оксалатных камней), саркоидоз, острые и хронические заболевания печени и почек, почечная недостаточность, активная форма туберкулеза легких."},{"description":"","filters":[{"id":50921469,"name":"Способ применения и дозы"}],"isMainProperty":false,"name":"Способ применения и дозы","value":"Перорально.\u003Cbr\u003EПрепарат принимать в ложечке жидкости.\u003Cbr\u003E1 капля содержит около 500 МЕ витамина D3.\u003Cbr\u003EЕсли врач не назначил иначе, препарат используется в следующих дозировках:\u003Cbr\u003EПрофилактические дозы: доношенные новорожденные с 4-х недель жизни до 2-3 лет при правильном уходе и достаточном пребывании на свежем воздухе: 500 МЕ (1 капля) в сутки; недоношенные дети с 4-х недель жизни, близнецы, младенцы, находящиеся в плохих жизненных условиях: 1000 - 1500 МЕ (2 - 3 капли) в сутки.\u003Cbr\u003EВ летнее время года можно ограничить дозу до 500 МЕ (1 капля) в сутки.\u003Cbr\u003Eу взрослых здоровых лиц без нарушений всасывания: 500 МЕ (1 капля) в день.\u003Cbr\u003Eу взрослых пациентов при синдроме мальабсорбции: 3000-5000 МЕ (6-10 капель) в день.\u003Cbr\u003Eбеременные женщины: ежедневная доза 500 МЕ (1 капля) витамина D3 на время всего периода беременности, либо прием 1000 МЕ (2 капли) в сутки, начиная с 28 недели беременности.\u003Cbr\u003Eв постменопаузальном периоде 500 – 1000 МЕ (1 - 2 капли) в сутки.\u003Cbr\u003EТерапевтические дозы: при рахите: ежедневно 1000 – 5000 МЕ (2 - 10 капель), в зависимости от степени тяжести рахита (I, II, или III) и варианта протекания, на протяжении 4 - 6 недель, под тщательным контролем за клиническим состоянием и исследованием биохимических показателей (кальция, фосфора, щелочной фосфатазы) крови и мочи. Начинать следует с 1000 МЕ в течение 3 - 5 дней. Затем, при хорошей переносимости, дозу повышают до индивидуальной лечебной дозы (чаще всего 3000 МЕ). Доза 5000 МЕ назначается только при выраженных костных изменениях.\u003Cbr\u003EПо мере необходимости после одной недели перерыва, можно повторить курс лечения.\u003Cbr\u003EЛечение проводится до получения четкого лечебного эффекта, с последующим переходом на профилактическую дозу 500 - 1500 МЕ в сутки.\u003Cbr\u003Eпри лечении рахитоподобных заболеваний: 20 000 – 30 000 МЕ в сутки (40 – 60 капель) в зависимости от возраста, массы и тяжести заболевания, под контролем биохимических показателей крови и анализа мочи. Курс лечения 4 – 6 недель. Лечение проводится под контролем врача.\u003Cbr\u003Eпри комплексном лечении постменопаузального остеопороза: 500 – 1000 МЕ (1 - 2 капли) в сутки.\u003Cbr\u003EДозировка, как правило, назначается с учетом количества витамина D, поступающего с пищей."},{"description":"","filters":[{"id":50921474,"name":"Применение при беременности"}],"isMainProperty":false,"name":"Применение при беременности","value":"В период беременности не следует применять витамин D3 в высоких дозах из-за возможности проявления тератогенного действия в случае передозировки.\u003Cbr\u003EС осторожностью следует назначать витамин D3 у женщин, кормящих ребенка грудью – препарат, принимаемый в высоких дозах матерью, может вызвать симптомы передозировки у ребенка."},{"description":"","filters":[{"id":50921464,"name":"Побочные действия"}],"isMainProperty":false,"name":"Побочные действия","value":"Повышенная чувствительность к компонентам препарата, гипервитаминоз D (симптомы гипервитаминоза: потеря аппетита, тошнота, рвота; головные, мышечные и суставные боли; запоры; сухость в полости рта; полиурия; слабость; нарушение психики, в том числе депрессия; потеря массы тела; нарушение сна; повышение температуры; в моче появляется белок, лейкоциты, гиалиновые цилиндры; повышение уровня кальция в крови и его выделение с мочой; возможен кальциноз почек, кровеносных сосудов, легких).\u003Cbr\u003EПри появлении признаков гипервитаминоза D необходимо отменить препарат, ограничить поступление кальция, назначить витамины А, С и В."},{"description":"","filters":[{"id":50921468,"name":"Передозировка"}],"isMainProperty":false,"name":"Передозировка","value":"Симптомы передозировки: снижение аппетита, тошнота, рвота, запоры, беспокойство, жажда, полиурия, понос, кишечная колика. Частыми симптомами являются головная боль, мышечные и суставные боли, нарушения психики, в том числе депрессия, ступор, атаксия и прогрессирующая потеря массы тела. Развивается нарушение функции почек с альбинурией, эритроцитурией и полиурией, повышенной потерей калия, гипостенурией, никтурией и повышение артериального давления.\u003Cbr\u003EВ тяжелых случаях может возникнуть помутнение роговицы, реже отек сосочка зрительного нерва, воспаление радужной оболочки вплоть до развития катаракты.\u003Cbr\u003EМогут образоваться камни в почках, происходит процесс кальцификации мягких тканей, в том числе кровеносных сосудов, сердца, легких и кожи.\u003Cbr\u003EРедко развивается холестатическая желтуха.\u003Cbr\u003EЛечение\u003Cbr\u003EПрервать применение препарата. Обратиться к врачу. Принимать большое количество жидкости. При необходимости может потребоваться госпитализация."},{"description":"","filters":[{"id":50921467,"name":"Условия хранения"}],"isMainProperty":false,"name":"Условия хранения","value":"Хранить при температуре не выше 25 °С, в оригинальной упаковке.\u003Cbr\u003EХранить в местах, недоступных для детей."},{"description":"","filters":[{"id":50921466,"name":"Особые указания"}],"isMainProperty":false,"name":"Особые указания","value":"Избегать передозировки.\u003Cbr\u003EИндивидуальное обеспечение определенной потребности должно учитывать все возможные источники этого витамина.\u003Cbr\u003EСлишком высокие дозы витамина D3, применяемые продолжительно или ударные дозы, могут быть причиной хронического гипервитаминоза D3.\u003Cbr\u003EОпределение суточной потребности ребенка в витамине D и способа его применения должны устанавливаться врачом индивидуально и каждый раз подвергаться коррекции во время периодических обследований, особенно в первые месяцы жизни.\u003Cbr\u003EПри достижении адекватного уровня концентрации витамина D в крови (\u003E30 нг/мл 25(ОН)D) у взрослых возможно продолжение поддерживающей терапии препаратом Аквадетрим в дозе 1500 – 2000 МЕ (3-4 капли) в сутки.\u003Cbr\u003EНе применять одновременно с витамином D3 высоких доз кальция.\u003Cbr\u003EВо время лечения необходим периодический контроль концентрации фосфатов в крови и моче.\u003Cbr\u003EПри длительном приеме колекальциферола необходимо регулярно определять уровень кальция в сыворотке крови и моче, а также оценивать функцию почек путем измерения сывороточного уровня креатинина. При необходимости, следует корректировать дозу колекальциферола в зависимости от уровня кальция в сыворотке крови."},{"description":"","filters":[{"id":32849454,"name":"Страна бренда"}],"isMainProperty":false,"name":"Страна бренда","value":"Польша"},{"description":"","filters":[{"id":16064056,"name":"Страна производства"}],"isMainProperty":false,"name":"Страна производства","value":"Польша"},{"description":"","filters":[{"id":34362170,"name":"Владелец регистрационного удостоверения"}],"isMainProperty":false,"name":"Владелец регистрационного 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препарат","value":"да"},{"description":"","filters":[{"id":34045610,"name":"Органы и системы"}],"isMainProperty":false,"name":"Органы и системы","value":"пищеварительная система"},{"description":"","filters":[{"id":36476390,"name":"Назначение"}],"isMainProperty":false,"name":"Назначение","value":"алиментарное ожирение, избыточная масса тела"},{"description":"","filters":[{"id":15768013,"name":"Показания к применению"}],"isMainProperty":false,"name":"Показания к применению","value":"показан для снижения массы тела при следующих состояниях:\u003Cbr\u003E- алиментарное ожирение с индексом массы тела (ИМТ) 30 кг/м2 и более;\u003Cbr\u003E- алиментарное ожирение с индексом массы тела 27 км/м2 и более в сочетании с сахарным диабетом 2 типа и дислипидемией."},{"description":"","filters":[{"id":15768002,"name":"Противопоказания"}],"isMainProperty":false,"name":"Противопоказания","value":"установленная повышенная чувствительность к сибутрамину или к другим компонентам препарата;\u003Cbr\u003E- наличие органических причин ожирения (например, гипотиреоз);\u003Cbr\u003E- серьезные нарушения питания - нервная анорексия или нервная булимия;\u003Cbr\u003E- психические заболевания;\u003Cbr\u003E- синдром Жиль де ля Туретта (генерализованные тики);\u003Cbr\u003E- одновременный прием ингибиторов МАО (например, фентермина, фенфлурамина, дексфенфлурамина, этиламфетамина, эфедрина) или применение в течение 2-х недель до приема препарата Голдлайн ПЛЮС и 2-х недель после окончания его приема других препаратов, действующих на центральную нервную систему, ингибирующих обратный захват серотонина (например, антидепрессантов, нейролептиков); снотворных препаратов, содержащих триптофан, а также других препаратов центрального действия для снижения массы тела или для лечения психических расстройств;\u003Cbr\u003E- сердечно-сосудистые заболевания (в анамнезе или в настоящее время): ишемическая болезнь сердца (инфаркт миокарда (ИМ), стенокардия); хроническая сердечная недостаточность в стадии декомпенсации, окклюзирующие заболевания периферических артерий, тахикардия, аритмия, цереброваскулярные заболевания (инсульт, транзиторные нарушения мозгового кровообращения);\u003Cbr\u003E- неконтролируемая артериальная гипертензия (артериальное давление (АД) выше 145/90 мм рт.ст.) (см. также раздел \"Особые указания\");\u003Cbr\u003E- закрытоугольная глаукома;\u003Cbr\u003E- тиреотоксикоз;\u003Cbr\u003E- тяжелые нарушения функции печени и/или почек;\u003Cbr\u003E- доброкачественная гиперплазия предстательной железы;\u003Cbr\u003E- феохромоцитома;\u003Cbr\u003E- установленная фармакологическая, наркотическая или алкогольная зависимость;\u003Cbr\u003E- беременность и период грудного вскармливания;\u003Cbr\u003E- возраст до 18 лет и старше 65 лет."},{"description":"","filters":[{"id":15768292,"name":"Состав"}],"isMainProperty":false,"name":"Состав","value":"Состав на 1 капсулу для дозировки 10 мг + 158,5 мг:\u003Cbr\u003EАктивные вещества:\u003Cbr\u003EСибутрамина гидрохлорида моногидрат - 10,0 мг, целлюлоза микрокристаллическая - 158,5 мг.\u003Cbr\u003EВспомогательные вещества:\u003Cbr\u003EКальция стеарат - 1,5 мг.\u003Cbr\u003EСостав оболочки капсулы:\u003Cbr\u003EКрышечка: краситель азорубин (Е122) - 0,0570%; индигокармин (Е132) - 0,3079%; натрия лаурилсульфат - 0,0800%; титана диоксид - 1,0000%; желатин - до 100%.\u003Cbr\u003EКорпус: краситель солнечный закат желтый (Е110) - 0,0027%; краситель желтый хинолиновый (Е104) - 0,9193%; натрия лаурилсульфат - 0,0800%; титана диоксид - 2,0000%; желатин - до 100%.\u003Cbr\u003EСостав на 1 капсулу для дозировки 15 мг + 153,5 мг:\u003Cbr\u003EАктивные вещества:\u003Cbr\u003EСибутрамина гидрохлорида моногидрат - 15,0 мг, целлюлоза микрокристаллическая - 153,5 мг.\u003Cbr\u003EВспомогательные вещества:\u003Cbr\u003EКальция стеарат - 1,5 мг.\u003Cbr\u003EСостав оболочки капсулы:\u003Cbr\u003EКрышечка: краситель азорубин (Е122) - 0,0570%; индигокармин (Е132) - 0,3079%; натрия лаурилсульфат - 0,0800%; титана диоксид - 1,0000%; желатин - до 100%.\u003Cbr\u003EКорпус: натрия лаурилсульфат - 0,0800%; титана диоксид - 2,0000%; желатин - до 100%."},{"description":"","filters":[{"id":27144131,"name":"Действующее вещество"}],"isMainProperty":false,"name":"Действующее вещество","value":"Сибутрамин+[Микрокристаллическая целлюлоза]"},{"description":"","filters":[{"id":15768000,"name":"Способ применения и дозы"}],"isMainProperty":false,"name":"Способ применения и дозы","value":"Голдлайн ПЛЮС принимают внутрь 1 раз в сутки. Дозу устанавливают индивидуально, в зависимости от переносимости и клинической эффективности.\u003Cbr\u003EРекомендуемая начальная доза сибутрамина 10 мг/сутки. Капсулы следует принимать утром, не разжевывая и запивая достаточным количеством жидкости (стакан воды). Препарат можно принимать как натощак, так и сочетать с приемом пищи.\u003Cbr\u003EЕсли в течение 4-х недель от начала лечения не достигнуто снижение массы тела менее 2 кг, то доза сибутрамина увеличивается до 15 мг/сутки.\u003Cbr\u003EЛечение препаратом Голдлайн ПЛЮС не должно продолжаться более 3-х месяцев у пациентов, которые недостаточно хорошо реагируют на терапию, т.е. которым в течение 3-х месяцев лечения не удается достичь снижения массы тела на 5% от исходного показателя.\u003Cbr\u003EЛечение не следует продолжать, если при дальнейшей терапии, после достигнутого снижения массы тела, пациент вновь прибавляет в массе тела 3 кг и более.\u003Cbr\u003EДлительность лечения не должна превышать 1 год, поскольку в отношении более продолжительного периода приема сибутрамина данные об эффективности и безопасности отсутствуют.\u003Cbr\u003EЛечение препаратом Голдлайн ПЛЮС должно осуществляться в комплексе с диетой и физическими упражнениями под контролем врача, имеющего практический опыт лечения ожирения."},{"description":"","filters":[{"id":15767998,"name":"Побочные действия"}],"isMainProperty":false,"name":"Побочные действия","value":"Чаще всего побочные эффекты возникают в начале лечения (в первые 4 недели). Их выраженность и частота с течением времени ослабевают. Побочные эффекты носят, в целом, нетяжелый и обратимый характер. Побочные эффекты, в зависимости от воздействия на органы и системы органов, представлены в следующем порядке: очень часто (\u003E 10 %), часто (≥ 1%, но ≤ 10%).\u003Cbr\u003EНарушения со стороны нервной системы: очень частыми побочными эффектами являются сухость во рту и бессонница, часто отмечаются головная боль, головокружение, беспокойство, парестезии, а также изменение вкуса.\u003Cbr\u003EНарушения со стороны сердца: часто встречаются тахикардия, ощущение сердцебиения. Наблюдается умеренное увеличение пульса на 3-7 ударов в минуту. В отдельных случаях не исключается более выраженное повышение частоты сердечных сокращений. Клинически значимые изменения пульса регистрируются преимущественно в начале лечения (в первые 4-8 недель).\u003Cbr\u003EНарушения со стороны сосудов: часто встречаются повышение артериального давления, вазодилатация. Наблюдается умеренный подъем артериального давления в покое на 1-3 мм рт. ст. В отдельных случаях не исключаются более выраженные повышения артериального давления. Клинически значимые изменения артериального давления регистрируются преимущественно в начале лечения (в первые 4-8 недель).\u003Cbr\u003EНарушения со стороны желудочно-кишечного тракта: очень часто наблюдаются потеря аппетита и запор, часто тошнота и обострение геморроя. При склонности к запорам в первые дни необходим контроль за эвакуаторной функцией кишечника. При возникновении запора прием прекращают и принимают слабительное.\u003Cbr\u003EНарушения со стороны кожи и подкожных тканей: часто отмечается повышенное потоотделение.\u003Cbr\u003EВ единичных случаях при лечении сибутрамином описаны следующие нежелательные клинически значимые явления: дисменорея, отеки, гриппоподобный синдром, зуд кожи, боль в спине, боль в животе, парадоксальное повышение аппетита, жажда, ринит, депрессия, сонливость, эмоциональная лабильность, тревожность, раздражительность, нервозность, острый интерстициальный нефрит, кровотечения, пурпура Шенлейн-Геноха (кровоизлияния в кожу), судороги, тромбоцитопения, транзиторное повышение активности \"печеночных\" ферментов в крови.\u003Cbr\u003EПрименение препарата Голдлайн® ПЛЮС у пациентов с повышенным артериальным давлением: смотри раздел \"Противопоказания\" и \"Особые указания\".\u003Cbr\u003EВ ходе постмаркетинговых исследований были описаны дополнительные побочные реакции, перечисленные ниже по системам органов:\u003Cbr\u003EНарушения со стороны сердца: мерцательная аритмия.\u003Cbr\u003EНарушения со стороны иммунной системы: реакции гиперчувствительности (от умеренных высыпаний на коже и крапивницы до ангионевротического отека (отека Квинке) и анафилаксии).\u003Cbr\u003EНарушения психики: психоз, состояния суицидально направленного мышления, суицид и мания. При возникновении подобных состояний препарат необходимо отменить.\u003Cbr\u003EНарушения со стороны нервной системы: судороги, кратковременные нарушения памяти.\u003Cbr\u003EНарушения со стороны органа зрения: затуманивание зрения (\"пелена перед глазами\").\u003Cbr\u003EНарушения со стороны желудочно-кишечного тракта: диарея, рвота.\u003Cbr\u003EНарушения со стороны кожи и подкожных тканей: алопеция.\u003Cbr\u003EНарушения со стороны почек и мочевыводящих путей: задержка мочи.\u003Cbr\u003EНарушения со стороны половых органов и молочной железы: нарушение эякуляции/оргазма, импотенция, нарушение менструального цикла, маточные кровотечения."},{"description":"","filters":[{"id":15768001,"name":"Фармакологическое действие"}],"isMainProperty":false,"name":"Фармакологическое действие","value":"Голдлайн ПЛЮС - комбинированный препарат, действие которого обусловлено входящими в его состав компонентами.\u003Cbr\u003EСибутрамин является пролекарством и проявляет свое действие in vivo за счет метаболитов (первичных и вторичных аминов), ингибирующих обратный захват моноаминов (серотонина, норадреналина, дофамина). Увеличение содержания в синапсах нейротрансмиттеров повышает активность центральных 5НТ-серотониновых и адренергических рецепторов, что способствует увеличению чувства насыщения и снижению потребности в пище, а также увеличению термопродукции. Опосредованно активируя бета3-адренорецепторы, сибутрамин воздействует на бурую жировую ткань. Снижение массы тела сопровождается увеличением концентрации в плазме крови липопротеинов высокой плотности (ЛПВП) и понижением количества триглицеридов, общего холестерина, липопротеинов низкой плотности (ЛПНП) и мочевой кислоты. Сибутрамин и его метаболиты не влияют на высвобождение моноаминов, не ингибируют моноаминоксидазу (МАО); обладают низким сродством к большому числу нейромедиаторных рецепторов, включая серотониновые (5-HT1, 5-HT1А, 5-HT1В, 5-НТ2С), адренергические (бета1, бета2, бета3, альфа1, альфа2), дофаминовые (D1, D2), мускариновые, гистаминовые (H1), бензодиазепиновые и глутаматные (NMDA) рецепторы.\u003Cbr\u003EЦеллюлоза микрокристаллическая является энтеросорбентом, обладает сорбционными свойствами и неспецифическим дезинтоксикационным действием. Связывает и выводит из организма различные микроорганизмы, продукты их жизнедеятельности, токсины экзогенной и эндогенной природы, аллергены, ксенобиотики, а также избыток некоторых продуктов обмена веществ и метаболитов, ответственных за развитие эндогенного токсикоза."},{"description":"","filters":[{"id":34045110,"name":"Фармакологическая группа"}],"isMainProperty":false,"name":"Фармакологическая группа","value":"ожирения средство лечения"},{"description":"","filters":[{"id":27141511,"name":"Форма выпуска для карточки"}],"isMainProperty":false,"name":"Форма выпуска","value":"капсулы"},{"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":"В защищенном от света месте, при температуре не выше 25 °С.\u003Cbr\u003EХранить в недоступном для детей месте."},{"description":"","filters":[{"id":15768014,"name":"Передозировка"}],"isMainProperty":false,"name":"Передозировка","value":"Имеются крайне ограниченные данные по поводу передозировки сибутрамина. Наиболее часто встречающиеся неблагоприятные реакции, связанные с передозировкой: тахикардия, повышение артериального давления, головная боль, головокружение. Следует известить своего лечащего врача в случае предполагаемой передозировки. При передозировке необходимо немедленно прекратить применение препарата.\u003Cbr\u003EСпециального лечения и специфических антидотов не существует. Необходимо выполнять общие мероприятия: обеспечить свободное дыхание, наблюдать за состоянием сердечно-сосудистой системы, а также при необходимости осуществить поддерживающую симптоматическую терапию.\u003Cbr\u003EСвоевременное применение активированного угля, а также промывание желудка может уменьшить поступление сибутрамина в организм.\u003Cbr\u003EПациентам с повышенным артериальным давлением и тахикардией можно назначить бета-адреноблокаторы.\u003Cbr\u003EЭффективность форсированного диуреза или гемодиализа не установлена."},{"description":"","filters":[{"id":15768015,"name":"Применение при беременности и кормлении грудью"}],"isMainProperty":false,"name":"Применение при беременности и кормлении грудью","value":"Поскольку до настоящего времени не имеется достаточно большого количества исследований в отношении безопасности воздействия сибутрамина на плод, данный препарат противопоказан в период беременности. Женщины, находящиеся в репродуктивном возрасте, во время приема препарата Голдлайн ПЛЮС должны пользоваться контрацептивными средствами.\u003Cbr\u003EПротивопоказано принимать препарат Голдлайн ПЛЮС во время грудного вскармливания."},{"description":"","filters":[{"id":17360993,"name":"Влияние на способность управлять транспортом и механизмами"}],"isMainProperty":false,"name":"Влияние на способность управлять транспортом и механизмами","value":"Прием препарата Голдлайн ПЛЮС может ограничить способность к управлению транспортными средствами и механизмами. В период применения препарата Голдлайн ПЛЮС необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."},{"description":"","filters":[{"id":15771167,"name":"Особые указания"}],"isMainProperty":false,"name":"Особые указания","value":"С осторожностью: При следующих состояниях: аритмии в анамнезе, хронической недостаточности кровообращения, заболеваниях коронарных артерий (в т.ч. в анамнезе), кроме ишемической болезни сердца (ИМ, стенокардии); глаукоме, кроме закрытоугольной глаукомы, холелитиазе, артериальной гипертензии (контролируемой и в анамнезе), неврологических нарушениях, включая задержку умственного развития и судороги (в т.ч. в анамнезе), эпилепсии, нарушении функции печени и/или почек легкой и средней степени тяжести, моторных и вербальных тиках в анамнезе, склонности к кровотечению, нарушению свертываемости крови, приеме препаратов, влияющих на гемостаз или функцию тромбоцитов.\u003Cbr\u003EГолдлайн ПЛЮС следует применять только в тех случаях, когда все немедикаментозные мероприятия по снижению массы тела малоэффективны - если снижение массы тела в течение 3-х месяцев составило менее 5 кг.\u003Cbr\u003EЛечение препаратом Голдлайн ПЛЮС должно осуществляться в рамках комплексной терапии по снижению массы тела под контролем врача, имеющего практический опыт лечения ожирения. Комплексная терапия включает в себя как изменение диеты и образа жизни, так и увеличение физической активности. Важным компонентом терапии является создание предпосылок к стойкому изменению пищевого поведения и образа жизни, которые необходимы для сохранения достигнутого снижения массы тела и после отмены медикаментозной терапии. Пациентам необходимо в рамках терапии препаратом Голдлайн ПЛЮС изменить свой жизненный уклад и привычки таким образом, чтобы после завершения лечения обеспечить сохранение достигнутого уменьшения массы тела. Пациенты должны четкое представлять себе, что несоблюдение этих требований приведет к повторному увеличению массы тела и повторным обращением к лечащему врачу.\u003Cbr\u003EУ пациентов, принимающих Голдлайн ПЛЮС, необходимо регулярно измерять артериальное давление и частоту сердечных сокращений. В первые 3 месяца лечения эти параметры следует контролировать каждые 2 недели, а затем ежемесячно. Если во время двух визитов подряд выявляется увеличение частоты сердечных сокращений в покое ≥ 10 ударов в минуту или систолического/диастолического давления ≥ 10 мм рт. ст., необходимо прекратить лечение.\u003Cbr\u003EУ пациентов с артериальной гипертензией, у которых на фоне гипотензивной терапии артериальное давление выше 145/90 мм рт. ст., этот контроль должен проводиться особенно тщательно и при необходимости через более короткие интервалы.\u003Cbr\u003EУ пациентов, у которых артериальное давление дважды при повторном изменении превышало уровень 145/90 мм рт. ст., лечение препаратом Голдлайн ПЛЮС должно быть отменено (см. раздел \"Побочное действие\").\u003Cbr\u003EУ пациентов с синдромом апноэ во сне необходимо особенно тщательно контролировать артериальное давление.\u003Cbr\u003EОсобого внимания требует одновременное назначение препаратов, увеличивающих интервал QT. К этим препаратам относятся H1-гистаминоблокаторы (астемизол, терфенадин); антиаритмические препараты, увеличивающие интервал QT (амиодарон, хинидин, флекаинид, мексилетин, пропафенон, соталол); стимулятор моторики желудочно-кишечного тракта цизаприд; пимозид, сертиндол и трициклические антидепрессанты. Это касается и состояний, которые способны приводить к увеличению интервала QT, таких как гипокалиемия и гипомагниемия (см. также раздел \"Взаимодействие с другими лекарственными средствами\").\u003Cbr\u003EИнтервал между приемом ингибиторов МАО (в т.ч. фуразолидона, прокарбазина, селегилина) и препаратом Голдлайн ПЛЮС должен составлять не менее 2-х недель.\u003Cbr\u003EХотя не установлена связь между приемом сибутрамина и развитием первичной легочной гипертензии, однако, учитывая общеизвестный риск препаратов данной группы, при регулярном медицинском контроле необходимо особое внимание обращать на такие симптомы, как прогрессирующее диспноэ (нарушение дыхания), боль в грудной клетке и отеки на ногах.\u003Cbr\u003EПри пропуске дозы препарата Голдлайн ПЛЮС не следует принимать в следующий прием двойную дозу препарата, рекомендовано продолжать дальнейший прием препарата по предписанной схеме.\u003Cbr\u003EДлительность приема препарата Голдлайн ПЛЮС не должна превышать 1 год.\u003Cbr\u003EПри совместном приеме сибутрамина и других ингибиторов обратного захвата серотонина существует повышенный риск развития кровотечений. У пациентов, предрасположенных к кровотечениям, а также принимающих препараты, влияющие на гемостаз или функцию тромбоцитов, сибутрамин следует применять с осторожностью.\u003Cbr\u003EХотя клинические данные о привыкании к сибутрамину отсутствуют, следует выяснить, не было ли в анамнезе пациента случаев лекарственной зависимости, и обратить внимание на возможные признаки злоупотребления лекарственными препаратами."},{"description":"","filters":[{"id":15768012,"name":"Взаимодействие"}],"isMainProperty":false,"name":"Взаимодействие","value":"Ингибиторы микросомального окисления, в т.ч. ингибиторы изофермента CYP3A4 (кетоконазол, эритромицин, циклоспорин и др.) повышают в плазме крови концентрации метаболитов сибутрамина с повышением частоты сердечных сокращений и клинически несущественным увеличением интервала QT.\u003Cbr\u003EРифампицин, антибиотики из группы макролидов, фенитоин, карбамазепин, фенобарбитал и дексаметазон могут ускорять метаболизм сибутрамина.\u003Cbr\u003EОдновременное применение нескольких препаратов, повышающих содержание серотонина в плазме крови, может привести к развитию серьезного взаимодействия. Так называемый серотониновый синдром может развиться в редких случаях при одновременном применении сибутрамина с селективными ингибиторами обратного захвата серотонина (препаратами для лечения депрессии), с некоторыми препаратами для лечения мигрени (суматриптан, дигидроэрготамин), с сильнодействующими анальгетиками (пентазоцин, петидин, фентанил) или противокашлевыми препаратами (декстрометорфан).\u003Cbr\u003EСибутрамин не влияет на действие пероральных контрацептивных средств.\u003Cbr\u003EПри одновременном приеме сибутрамина и алкоголя не было отмечено усиления негативного действия алкоголя. Однако алкоголь абсолютно не сочетается с рекомендуемыми при приеме сибутрамина диетическими мероприятиями.\u003Cbr\u003EПри одновременном применении с сибутрамином других препаратов, влияющих на гемостаз или функцию тромбоцитов, увеличивается риск развития кровотечений.\u003Cbr\u003EЛекарственное взаимодействие при одновременном применении сибутрамина с препаратами, повышающими артериальное давление и частоту сердечных сокращений, в настоящее время недостаточно полно изучено. Эта группа препаратов включает деконгестанты, противокашлевые, противопростудные и противоаллергические препараты, в состав которых входят эфедрин или псевдоэфедрин. Поэтому в случаях одновременного приема этих препаратов с сибутрамином следует соблюдать осторожность.\u003Cbr\u003EСовместное применение сибутрамина с препаратами для снижения массы тела, действующими на центральную нервную систему, или препаратами для лечения психических расстройств противопоказано."},{"description":"","filters":[{"id":50164710,"name":"Источник"}],"isMainProperty":false,"name":"Источник","value":"\u003Ca href=\"https://www.vidal.ru\" target=\"_blank\"\u003EСправочник лекарственных препаратов Видаль<\u002Fa\u003E"},{"description":"","filters":[{"id":16435314,"name":"Регистрационный номер"}],"isMainProperty":false,"name":"Регистрационный номер","value":"ЛП-003382"},{"description":"","filters":[{"id":16435315,"name":"Дата государственной регистрации"}],"isMainProperty":false,"name":"Дата государственной регистрации","value":"29.12.2020"},{"description":"","filters":[{"id":34324371,"name":"Тип 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