Side effects of "phenazepam" and contraindications. The drug "Phenazepam": overdose, side effects, as well as a number of other characteristics. What to do if you have taken a large dose of Phenazepam

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The drug "Phenazepam" belongs to an extensive group of tranquilizers of a number of benzodiazepines. It is used to relieve anxiety in patients with neurological and mental illness. The tool helps to relieve tension, pathological arousal, eliminate problems with sleep. Due to the nature of the action, the product is not only very effective, but also quite dangerous. Doctors try to prescribe "Phenazepam" as rarely as possible because of its side effects, a lot of contraindications, and the likelihood of developing drug dependence. An overdose of a drug or its combination with alcohol can lead to death.

Contraindications

"Phenazepam" is a prescription drug that is forbidden to be taken without the permission of a doctor. Before starting therapy, you need to make sure that the patient has no contraindications. Ignoring the prohibitions threatens with serious negative consequences up to disruption of the internal organs, disability, death.

From "Phenazepam" will have to refrain from such conditions:

coma - the medication will aggravate CNS depression. This will complicate the diagnosis of the victim, reduce the effectiveness of therapeutic measures;
state of shock - with it there is a drop in blood pressure to critical levels. "Phenazepam" is able to enhance the severity of the phenomenon, lead to clinical death;
children's age - the effect of the drug on the body of patients under 18 years of age has not been studied. Theoretically, such actions threaten with inhibition of brain functions, overdose, serious side effects due to the instability of the central nervous system;
muscle weakness - under the influence of a tranquilizer, it will increase, which can lead to a malfunction of the internal organs;
poisoning with medicines, drugs or alcohol - increased CNS depression threatens to stop breathing;

respiratory diseases - pathologies that are accompanied by respiratory failure, with the participation of the composition "Phenazepam" can lead to asphyxia;
deep depression, suicidal tendencies - the drug enhances the severity of these manifestations.

The drug used in the third trimester threatens to inhibit the work of the vital parts of the central nervous system. A baby born against such a background will have problems with breathing, reflexes, and feeding. During lactation, the drug is also prohibited due to the high likelihood of the active ingredient entering breast milk.

Possible side effects of Phenazepam

Taking a tranquilizer can cause an allergic reaction in people with hypersensitivity of the body. If one of the forms of the product is intolerant, it is better to refrain from trying to use the second. The immune response to "Phenazepam" can manifest itself in the form of nausea, vomiting, skin rash, edema, drop in blood pressure, anaphylactic shock.

Side effects of the drug against the background of certain diseases:

stroke - with depressed consciousness, the medication can aggravate the picture;
hepatitis - if the organ damage is accompanied by kidney failure, the active substances of the drug will begin to accumulate in the blood and tissues. This threatens the development of an overdose, even if therapeutic doses are observed;
diabetes mellitus - lactose, which is part of Phenazepam tablets, can cause a slight increase in blood sugar levels;
bradycardia - a tranquilizer makes the pulse even less frequent, which can lead to disturbances in the work of the heart and blood vessels;
tachycardia - if the phenomenon is caused by profuse blood loss or dehydration, taking the medicine threatens with a drop in blood pressure, fainting, death.

In cases where the medicine is dangerous to the body, the doctor tries to find an adequate replacement for it. Sometimes treatment is still carried out, but requires dose adjustments and monitoring by medical personnel.

Side effects of "Phenazepam"

The use of a drug that depresses the central nervous system is often accompanied by the appearance of discomfort and anxiety in the patient.

However, side effects are not always limited to neurological symptoms. They can affect different organs and systems, have a weak or strong severity.

The most common side effects of "Phenazepam":

neurological - muscle weakness, lethargy, decreased reaction rate, daytime sleepiness, impaired concentration. Some patients have severe headaches, dizziness. There are cases of problems with memory, speech, mood swings. Very rarely, taking a tranquilizer leads to an increase in the symptoms against which it is directed;
on the part of the reproductive system - a decrease in sexual desire in both sexes, problems with erection in men;
cardiovascular - a slight decrease in blood pressure. In the case of hypotension, this consequence can be dangerous. The product is not recommended for use in patients with upper blood pressure below 90 mm Hg. Art. and dehydration;
on the part of the excretory organs - urinary retention or incontinence;
dyspeptic - destruction of liver cells, increased activity of liver enzymes.

In most cases, the appearance of these problems becomes an indication for discontinuation of therapy. The negative reaction of the body to "Phenazepam" does not go away with time, it intensifies with continued treatment. After the withdrawal of the product, the disturbed functions of the body are restored within a few days and rarely require symptomatic intervention.

Is it possible to take "Phenazepam" in old age

With age, the intensity of the work of the body's defenses and its filters decreases. This is manifested in the increased action of "Phenazepam", its pronounced inhibitory effect on brain function. The result is consequences in the form of lethargy, weakness, apathy in aged patients. To reduce potential risks, a thorough examination of the patient is carried out before starting therapy, and the standard therapeutic dose is reduced by 20-30%. In general, doctors try not to prescribe a tranquilizer to people over 65 years of age. One of the side effects of the drug at this age is senile dementia and it is impossible to calculate the probability.

What is dangerous expired tranquilizer "Phenazepam"

The shelf life of the drug in the form of a solution is 2 years, tablets - 3 years. Direct exposure to sunlight and high temperatures significantly reduces these indicators, increasing the danger of the product. The use of an expired medication, at best, will not give the desired therapeutic effect. Still similar experiments threaten drug poisoning and intoxication, the appearance of side effects, severe allergies.

Side effects of "Phenazepam" with an overdose

Even a slight excess of the therapeutic dose of a tranquilizer can lead to negative consequences. If the intake of the product is combined with the consumption of alcohol, such risks increase many times over. Sometimes one tablet of the drug in combination with strong alcohol is enough to provoke deep sleep and vomiting, leading to asphyxia with vomit.

An overdose of the drug can be manifested by the following symptoms:

lethargy, drowsiness, slow reactions;
muscle weakness;
confusion;
problems with speech, coordination;
slow heart rate;
tremor of the limbs;
a decrease or a sharp drop in blood pressure;
the inability to take full breaths and exhalations due to a decrease in the tone of smooth muscles;
coma with a high probability of subsequent death.

It is difficult to calculate the lethal dosage of the drug. The formula is officially recognized - 0.5 mg of the active ingredient per 1 kg of adult weight, 0.25 mg - per 1 kg of child weight. These are conditional data, since much depends on the age of the victim, his general condition, the presence of alcohol in the blood, and the dosage form of the composition. There are cases when, after 500 mg of Phenazepam, the patient could be saved.

Addiction

With prolonged use of the drug, its active substance and metabolites accumulate in body tissues, causing addiction to the drug. The subsequent abrupt refusal of the product leads to the development of a withdrawal syndrome. It manifests itself in the form of insomnia, tremor, irritability, anxiety, increased psychomotor activity. Usually the phenomenon is the result of 2-4 weeks of taking the remedy. When using large doses, dependence can develop within a week. To prevent such effects of "Phenazepam" it is necessary to use the medicine strictly according to the scheme selected by the doctor. Cancellation of the drug is carried out within 3-5 days, gradually reducing its daily dose.

Treatment with such powerful tranquilizers as Phenazepam is often accompanied by side effects. For this reason, doctors are trying to use the product less and less, replacing it with safer modern analogues. Consumers are still attracted by the low cost of the drug, so they often insist on it themselves, risking their health. The situation is complicated by the ability to purchase medication through online pharmacies without presenting a prescription. Such experiments often end in serious negative consequences.

"Phenazepam" is prescribed for neurotic, psychopathic, neurosis-like and psycho-like conditions. It is also used for senesto-hypochondriac disorders, reactive psychoses, insomnia, epileptic seizures. Sometimes it is recommended as a means to overcome emotional stress and fear in extreme situations. The drug is used to treat muscle rigidity, athetosis, hyperkinesis, tic, autonomic.

The drug has the following: it is not prescribed for severe depression, shock, myasthenia gravis, angle-closure glaucoma, analgesic poisoning or acute alcohol poisoning, acute respiratory failure, in the first trimester, and adolescents under 18 years of age, during lactation, with intolerance to benzodiazepines.

Caution should be given to "Phenazepam" in patients with renal or hepatic insufficiency, in the elderly, in patients prone to substance abuse, with existing organic brain damage. With long-term treatment with doses of "Phenazepam" can cause dependence. During therapy, the use of ethanol is strictly prohibited.

"Phenazepam" affects the concentration of attention, so special care is needed when driving vehicles for patients taking this drug.

Side effects of "Phenazepam"

"Phenazepam" has the following side effects on the body: in the first days of admission (especially in the elderly) - drowsiness, fatigue, confusion, ataxia, dizziness, decreased concentration, slow reactions, disorientation. In some cases, depression, headache, incoordination, tremor, memory impairment, uncontrolled movements, asthenia, myasthenia gravis, fear, aggressive outbursts, psychomotor agitation, muscle spasms, irritability, hallucinations, agitation, anxiety, insomnia appear.

With a sharp discontinuation of the drug or a decrease in dose, patients develop a withdrawal syndrome.

Perhaps the appearance of heartburn, diarrhea, vomiting, stool disorders, allergic reactions, lowering blood pressure, tachycardia, visual impairment. In case of an overdose, there is a decrease in reflexes, tremor, drowsiness, shortness of breath or shortness of breath, a decrease in blood pressure, coma. For treatment prescribed

Instructions for use:

pharmachologic effect

Phenazepam is a highly active tranquilizer that has anxiolytic, anticonvulsant, central muscle relaxant and sedative effects. The tranquilizing and anti-anxiety effect is superior in strength to Phenazepam's analogues. Also, the drug has an anticonvulsant and hypnotic effect. The anxiolytic effect of the drug is expressed in a decrease in emotional stress, weakening fear, anxiety and anxiety.

According to the received reviews, Phenazepam has practically no effect on affective, hallucinatory and acute delusional disorders.

Dosage of Phenazepam and instructions for use

Intramuscularly and intravenously: for the rapid relief of psychomotor agitation, anxiety, fear, as well as in psychotic states and vegetative paroxysms, the initial dose is up to 1 mg, the average dose per day is 3-5 mg, the maximum is 7-9 mg.

Oral: for sleep disorders, 250 to 500 micrograms, 20 to 30 minutes before bedtime. In the treatment of psychopathic, neurotic, psycho-like and neurosis-like conditions, the first dose is up to 1 mg, 2-3 times a day. The dosage can be increased after 2-4 days, in the presence of a positive effect, up to 4-6 mg per day. With severe fear, agitation, anxiety, the first dose is 3 mg per day, with a rapid increase until a therapeutic effect is achieved. In the treatment of epilepsy, 2-10 mg per day. In the treatment of diseases with muscle hypertonicity, 2-3 mg of the drug is taken 1-2 times a day. The maximum dose is 10 mg / day.

In order to avoid acquiring dependence on Phenazepam, the instructions recommend that the course of therapy should not last more than two weeks. In exceptional cases, it is possible to increase the duration of the course up to 2 months. Dosage reduction should be gradual.

Indications for the use of Phenazepam

Phenazepam is indicated for neurotic, neurosis-like, psychopathic and psycho-like conditions. With reactive psychoses, senesto-hypochondriac disorders, insomnia, alcoholism, substance abuse, status epilepticus, epileptic seizures.

For the treatment of muscle rigidity, hyperkinesis, athetosis, tics, autonomic lability.

Contraindications to the use of Phenazepam

coma;
myasthenia gravis;
severe form of depression;
angle-closure glaucoma;
analgesic poisoning or acute alcohol poisoning;
acute respiratory failure;
I trimester of pregnancy;
children under 18;
with lactation;
intolerance to benzodiazepines.

special instructions

Caution is required when using Phenazepam in patients with hepatic or renal insufficiency, persons prone to substance abuse, with organic brain damage, and elderly patients.

Like analogues, Phenazepam can cause drug dependence during long-term therapy with high doses. During treatment with Phenazepam, the use of ethanol is strictly prohibited. There are no reviews on the treatment of persons under 18 years of age with Phenazepam, the effectiveness and safety of the drug has not been established. Phenazepam has an effect on concentration, so special care is required when driving vehicles for people receiving Phenazepam treatment.

Overdose of Phenazepam

Symptoms of an overdose of Phenazepam: decreased reflexes, drowsiness, tremor, nystagmus, prolonged dysarthria, shortness of breath or shortness of breath, bradycardia, coma, lowering blood pressure.

Interaction of Phenazepam with other drugs

According to reviews, Phenazepam reduces the effectiveness of levodopa in patients with Parkinson's disease. Phenazepam increases the toxicity of zidovudine.

A mutual enhancement of the effect was noted when combined with antipsychotic, antiepileptic and hypnotic drugs, as well as with central muscle relaxants, narcotic analgesics and ethanol.

When combined with antihypertensive agents, it is possible to enhance their action. With the simultaneous use of clozapine, respiratory depression is possible.

Pregnancy and lactation

The use of Phenazepam by pregnant women is permissible only for vital signs. The drug has a toxic effect on the fetus, increasing the risk of congenital malformations, when used in the 1st trimester of pregnancy. The use of Phenazepam at a later date causes depression of the central nervous system in the newborn. Regular use during pregnancy may develop addiction and withdrawal symptoms in the newborn.

The use of Phenazepam during childbirth, or immediately before them, may be the cause of the newborn: respiratory depression, hypothermia and hypotension.

Side effects of Phenazepam

From the side of the central and peripheral nervous system: in the first days of admission (especially in elderly patients) - a feeling of fatigue, confusion, drowsiness, dizziness, ataxia, decreased concentration, disorientation, slow reactions; rarely - depression, euphoria, headache, tremor, impaired coordination, memory impairment, uncontrolled movements, asthenia, dysarthria, myasthenia gravis, epileptic seizures (in patients with epilepsy); extremely rarely - aggressive outbursts, fear, psychomotor agitation, suicidal tendencies, muscle spasms, hallucinations, irritability, agitation, insomnia, anxiety.

From the circulatory system: leukopenia, agranulocytosis, neutropenia, thrombocytopenia, anemia.

From the digestive system: heartburn, vomiting, diarrhea or constipation.

Allergic reactions in the form of itching or skin rash are possible.

Other possible reactions: like its analogues, Phenazepam causes drug dependence, lowering blood pressure; rarely - visual impairment, tachycardia. With a sharp cancellation or dose reduction - the appearance of a withdrawal syndrome.

Name:

Phenazepam (Phenazepaitium)

Pharmacological
action:

Phenazepam is highly active tranquilizer(an agent that has a calming effect on the central nervous system). The strength of the tranquilizing and anxiolytic (anti-anxiety) action surpasses other tranquilizers; It also has a pronounced anticonvulsant, muscle relaxant (muscle relaxing) and hypnotic effect. When used together with sleeping pills and narcotic drugs, there is a mutual strengthening of the effect on the central nervous system.

Indications for
application:

Phenazepam prescribed for:
- various neurotic,
- neurosis-like,
- psychopathic and psychopathic states,
- accompanied by anxiety
- fear,
- increased irritability
- emotional lability (instability).
The drug is effective with obsession, phobia (fear), hypochondriacal syndromes (a depressed state caused by fear for one's health), including those resistant (resistant) to the action of other tranquilizers, it is also indicated for psychogenic psychoses, panic reactions, etc., as it relieves anxiety and fear. Phenazepam in terms of sedative (calming effect on the central nervous system) and mainly anti-anxiety effect is not inferior to some antipsychotics (drugs that have an inhibitory effect on the central nervous system and do not cause a hypnotic effect in normal doses).
Phenazepam is also used for the relief (removal) of alcohol withdrawal (a condition that occurs as a result of a sudden cessation of alcohol intake). In addition, it is prescribed as an anticonvulsant and hypnotic. By the strength of the hypnotic action, it approaches eunoctin.
It can also be used in preparation for surgery.

Mode of application:

V / m or / in(jet or drip).

For quick relief of fear, anxiety, psychomotor agitation, as well as for vegetative paroxysms and psychotic states: intramuscularly or intravenously, the initial dose for adults is 0.5–1 mg (0.5–1 ml of a 0.1% solution ), the average daily dose is 3–5 mg (3–5 ml of a 0.1% solution), in severe cases, up to 7–9 mg (7–9 ml of a 0.1% solution). The duration of the drug is determined by the doctor.

With serial epileptic seizures the drug is administered intramuscularly or intravenously, starting with a dose of 0.5 mg (0.5 ml of a 0.1% solution), the average daily dose is 1–3 mg (1–3 ml of a 0.1% solution).

For the treatment of alcohol withdrawal syndrome Phenazepam® is prescribed intramuscularly or intravenously at a dose of 0.5 mg, 1 time per day (0.5–1 ml of a 0.1% solution).

In neurological practice in diseases with increased muscle tone, the drug is prescribed intramuscularly at 0.5 mg 1-2 times a day (0.5-1 ml of a 0.1% solution).

Premedication: in / in slowly 3-4 ml of a 0.1% solution.

Maximum daily dose- 10 mg. The course of treatment with parenteral administration is up to 3-4 weeks. When the drug is discontinued, the dose is reduced gradually.

After achieving a stable therapeutic effect, it is advisable to switch to oral dosage forms of the drug.

Side effects:

Possible side effects are the same as for Elenium and Seduxen. It should be borne in mind that due to the high activity of phenazepam, more often may be observed ataxia (impaired coordination of movements), drowsiness, muscle weakness, dizziness.

Sometimes- ataxia, pruritus, rash, nausea, constipation, menstrual disorders, decreased libido, muscle weakness. If side effects develop, phenazepam is discontinued.

Contraindications:

Impaired liver and kidney function, myasthenia gravis, pregnancy.

Interaction
other medicinal
by other means:

Phenazepam should not be used simultaneously with MAO inhibitors, phenothiazine derivatives and barbiturates.

Pregnancy:

The drug is contraindicated during pregnancy.

Analogues

These are medicines belonging to the same pharmaceutical group, which contain different active substances (INN), differ from each other in name, but are used to treat the same diseases.

- Tablets 500 mg
- Substance-powder
- Concentrate for solution for infusion
- Nasal drops
- Tablets 250 mg

Indications for the use of the drug Phenazepam

Neurotic, neurosis-like, psychopathic and psychopathic and other conditions (irritability, anxiety, nervous tension, emotional lability), reactive psychoses and senesto-hypochondriac disorders (including those resistant to the action of other anxiolytic drugs (tranquilizers), obsession, insomnia, withdrawal syndrome (alcoholism, substance abuse), status epilepticus, epileptic seizures (of various etiologies), temporal and myoclonic epilepsy.

In extreme conditions - as a means of facilitating overcoming feelings of fear and emotional stress.

As an antipsychotic agent - schizophrenia with hypersensitivity to antipsychotic drugs (including febrile form).

In neurological practice - muscle rigidity, athetosis, hyperkinesis, tic, autonomic lability (sympathoadrenal and mixed paroxysms).

In anesthesiology - premedication (as a component of introductory anesthesia).

Release form of the drug Phenazepam

substance-powder; plastic bag (bag) 1 kg, wrapping paper 1;
substance-powder; plastic bag (bag) 2 kg, wrapping paper 1;
substance-powder; jar (jar) of dark glass 0.5 kg;

Pharmacodynamics of the drug Phenazepam

Anxiolytic agent (tranquilizer) of the benzodiazepine series. It has an anxiolytic, sedative-hypnotic, anticonvulsant and central muscle relaxant effect.

Enhances the inhibitory effect of GABA on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brain stem and intercalary neurons of the lateral horns of the spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

The anxiolytic effect is due to the effect on the amygdala complex of the limbic system and manifests itself in a decrease in emotional stress, weakening anxiety, fear, anxiety.

The sedative effect is due to the effect on the reticular formation of the brain stem and nonspecific nuclei of the thalamus and is manifested by a decrease in the symptoms of neurotic origin (anxiety, fear).

It practically does not affect the productive symptoms of psychotic genesis (acute delusional, hallucinatory, affective disorders), rarely there is a decrease in affective tension, delusional disorders.

The hypnotic effect is associated with inhibition of the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

The anticonvulsant effect is realized by enhancing presynaptic inhibition, suppresses the spread of the convulsive impulse, but the excited state of the focus is not removed. The central muscle relaxant effect is due to the inhibition of polysynaptic spinal afferent inhibitory pathways (to a lesser extent, monosynaptic ones). Direct inhibition of motor nerves and muscle function is also possible.

Pharmacokinetics of Phenazepam

After oral administration, it is well absorbed from the gastrointestinal tract, Tmax - 1-2 hours. It is metabolized in the liver. T1 / 2 - 6-10-18 hours. Excreted mainly by the kidneys in the form of metabolites.

Use of the drug Phenazepam during pregnancy

During pregnancy, the use is possible only for health reasons. It has a toxic effect on the fetus and increases the development of congenital malformations when used in the first trimester of pregnancy. Admission at therapeutic doses in later pregnancy may cause CNS depression in the newborn. Chronic use during pregnancy can lead to physical dependence with the development of withdrawal syndrome in the newborn. Children, especially at a younger age, are very sensitive to the CNS depressant effects of benzodiazepines.

Use immediately before or during labor may cause respiratory depression, decreased muscle tone, hypotension, hypothermia, and poor suckling (sluggish baby syndrome) in the newborn.

Contraindications to the use of the drug Phenazepam

Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute alcohol poisoning (with weakening of vital functions), narcotic analgesics and sleeping pills, severe COPD (respiratory failure may worsen), acute respiratory failure, severe depression (may manifest suicidal tendencies) I trimester of pregnancy, lactation period, children and adolescents under 18 years of age (safety and efficacy have not been determined), hypersensitivity (including to other benzodiazepines).

Side effects of the drug Phenazepam

From the side of the central nervous system and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, gait instability, mental and motor reactions slowdown, confusion; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements (especially at high doses), mood depression, dystonic extrapyramidal reactions (uncontrolled movements, including the eyes), asthenia, myasthenia gravis, dysarthria, epileptic seizures (in patients with epilepsy); extremely rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia).

On the part of the hematopoietic organs: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.

From the digestive system: dry mouth or salivation, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea; abnormal liver function, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.

From the genitourinary system: urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.

Allergic reactions: skin rash, itching.

Local reactions: phlebitis or venous thrombosis (redness, swelling or pain at the injection site).

Others: addiction, drug dependence; decrease in blood pressure; rarely - visual impairment (diplopia), weight loss, tachycardia.

With a sharp decrease in the dose or discontinuation of the intake, a withdrawal syndrome (irritability, nervousness, sleep disturbances, dysphoria, spasm of the smooth muscles of the internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor, perception disorders, incl. hyperacusis, paresthesia, photophobia; tachycardia, convulsions, rarely - acute psychosis).

Dosage and administration of Phenazepam

In / m or / in (jet or drip): for the rapid relief of fear, anxiety, psychomotor agitation, as well as autonomic paroxysms and psychotic conditions, the initial dose is 0.5-1 mg, the average daily dose is 3-5 mg, in severe cases - up to 7-9 mg.

Inside: for sleep disorders - 250-500 mcg 20-30 minutes before bedtime. For the treatment of neurotic, psychopathic, neurosis-like and psychopathic conditions, the initial dose is 0.5-1 mg 2-3 times a day. After 2-4 days, taking into account the effectiveness and tolerability, the dose can be increased to 4-6 mg / day. With severe agitation, fear, anxiety, treatment begins with a dose of 3 mg / day, quickly increasing the dose until a therapeutic effect is obtained. In the treatment of epilepsy - 2-10 mg / day.

For the treatment of alcohol withdrawal - inside, 2-5 mg / day or / m, 500 mcg 1-2 times / day, with vegetative paroxysms - / m, 0.5-1 mg. The average daily dose is 1.5-5 mg, it is divided into 2-3 doses, usually 0.5-1 mg in the morning and afternoon and up to 2.5 mg at night. In neurological practice, in diseases with muscle hypertonicity, 2-3 mg are prescribed 1-2 times / day. The maximum daily dose is 10 mg.

In order to avoid the development of drug dependence during course treatment, the duration of phenazepam use is 2 weeks (in some cases, the duration of treatment can be increased to 2 months). With the abolition of phenazepam, the dose is reduced gradually.

Interactions of the drug Phenazepam with other drugs

With the simultaneous use of phenazepam reduces the effectiveness of levodopa in patients with parkinsonism.

Phenazepam may increase the toxicity of zidovudine.

There is a mutual enhancement of the effect with the simultaneous use of antipsychotic, antiepileptic or hypnotic drugs, as well as central muscle relaxants, narcotic analgesics, ethanol.

Inhibitors of microsomal oxidation increase the risk of developing toxic effects. Inducers of microsomal liver enzymes reduce the effectiveness.

Increases the concentration of imipramine in the blood serum.

With simultaneous use with antihypertensive agents, it is possible to increase the antihypertensive effect. Against the background of the simultaneous appointment of clozapine, it is possible to increase respiratory depression.

Precautions while taking Phenazepam

Mesocarb can be used as a corrector that removes or reduces some side effects. Use with caution in organic cerebral insufficiency. Cancellation should be carried out gradually, by reducing the dose, to reduce the risk of withdrawal syndrome.

It should not be used during work by drivers of vehicles and people whose profession is associated with increased concentration of attention. At the time of treatment, you should stop taking alcohol.

Special instructions for taking Phenazepam

Use with caution in hepatic and / or renal failure, cerebral and spinal ataxia, a history of drug dependence, a tendency to abuse psychoactive drugs, hyperkinesis, organic brain diseases, psychosis (paradoxical reactions are possible), hypoproteinemia, sleep apnea (established or suspected ) in elderly patients.

With renal and / or liver failure and long-term treatment, it is necessary to monitor the picture of peripheral blood and the activity of liver enzymes.

In patients who have not previously taken psychoactive drugs, there is a therapeutic response to the use of phenazepam at lower doses, compared with patients taking antidepressants, anxiolytics or suffering from alcoholism.

Like other benzodiazepines, it has the ability to cause drug dependence with long-term use in high doses (more than 4 mg / day). With a sudden cessation of administration, a withdrawal syndrome may occur (including depression, irritability, insomnia, increased sweating), especially with prolonged use (more than 8-12 weeks). If patients experience such unusual reactions as increased aggressiveness, acute states of arousal, fear, suicidal thoughts, hallucinations, increased muscle cramps, difficulty falling asleep, superficial sleep, treatment should be discontinued.

In the process of treatment, patients are strictly prohibited from using ethanol.

The efficacy and safety of the drug in patients under 18 years of age has not been established.

In case of an overdose, severe drowsiness, prolonged confusion, decreased reflexes, prolonged dysarthria, nystagmus, tremor, bradycardia, shortness of breath or shortness of breath, decreased blood pressure, coma are possible. Gastric lavage, activated charcoal are recommended; symptomatic therapy (maintenance of breathing and blood pressure), the introduction of flumazenil (in a hospital setting); hemodialysis is ineffective.

Influence on the ability to drive vehicles and control mechanisms

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.