pharmachologic effect
The active component inhibits pseudocholinesterase and acetylcholinesterase . It exhibits a cholinomimetic effect through a direct mechanism, which is ensured by reversible inhibition of cholinesterase and enhancement and prolongation of the action of the endogenous form of acetylcholine .
An improvement in impulse transmission along the neuromuscular pathway, increased intestinal peristalsis and general tone of the gastrointestinal tract, a slowdown in sinus rhythm, increased tone of the bronchi and bladder, and increased secretion of the exocrine glands were recorded.
Storage conditions, price and analogues
It is recommended to store tablets at a temperature not exceeding +25 degrees. Under such conditions, the medicine is suitable for use for 3 years. After opening the bottle, the tablets can be used for six months.
— pharmaceutical companies Klocke Pharma Service Gmbh (Germany) and Teva (Israel). This medicine is strictly a prescription medication. It belongs to list A (potent drug). The price of the drug in pharmacy chains ranges from 750 to 850 rubles.
This medicine is currently very difficult to find in pharmacy chains. Therefore, patients are often interested in analogues. The instructions for “Kalimina 60 N” indicate that the active component of the medicine is pyridostigmine bromide. The same substance is contained in the drug "Kalimin Forte". However, it is only available in the form of an injection solution. The medicine Mestinon has a similar composition; it is produced in the form of dragees. Unfortunately, these drugs are almost impossible to find in Russian pharmacies.
It is possible to order “Kalimin 60 N” and “Kalimin Forte” from Germany through special Internet sites, but their cost is very high - from 5,000 to 8,000 rubles.
You can select analogues based on their therapeutic effect. These include the following medications:
- "Neuromidin."
- "Ipigrix."
- "Axamon."
- "Prozerin."
These products contain other active ingredients, but are also cholinesterase inhibitors. They are used in the treatment of myasthenia gravis. The price of Neuromidin is about 1000 rubles, and Ipigrix and Aksamon are about 500 rubles. The cheapest drug is Prozerin, its cost is 50-60 rubles. However, this is a fairly old drug and has many side effects.
Indications for use of Kalimin
Main indications:
- intestinal atony after surgery;
- myasthenic syndrome;
- pathology of bladder emptying after delivery, gynecological surgical interventions;
- Myasthenia gravis;
- atonic constipation .
Additional indications for use
The drug can be used to reverse the effects caused by curare-like non-depolarizing medications.
A drug
For neuromuscular diseases, doctors prescribe the drug “Kalimin 60 N”. The instructions state that this remedy is effective in the treatment of myasthenic disorders and atony of internal organs.
The medicine helps normalize the transmission of neuromuscular impulses, tones the muscles of the bladder, and improves peristalsis in the digestive organs.
In this case, the drug does not affect the central nervous system.
Composition and effect of the medicine
The active component of the drug is pyridostigmine bromide. The medication is available in the form of tablets that contain 60 mg of the drug.
Pyridostigmine bromide is a substance that inhibits the activity of the enzyme cholinesterase.
This leads to increased action of the neurotransmitter acetylcholine, which is responsible for transmitting signals between nerve cells and muscles.
Pyridostigmine bromide also has a general cholinomimetic effect on the body. Under the influence of the drug, a person’s heartbeat slows down, the tone of the muscles of internal organs increases, the activity of the exocrine glands increases, the drug causes a slight constriction of the pupils and a spasm of accommodation.
Undesirable effects
The instructions and reviews of “Kalimina 60 N” indicate that side effects are possible after consuming the tablets. This is due to the cholinomimetic effect of the drug on the body.
The medicine can cause a sharp decrease in blood pressure and heart rate. Due to the effect of pyridostigmine bromide on muscle tone, spasms of skeletal muscles, abdominal pain due to increased peristalsis, diarrhea, and frequent urination are possible.
Due to the increased activity of acetylcholine in patients, the activity of the sweat glands increases, and increased lacrimation and salivation are observed. Vision may deteriorate due to spasm of accommodation. Allergy sufferers experience skin rashes.
How to use the pills
At the initial signs of myasthenia gravis, 1/2-1 tablet of the drug is prescribed 1-2 times a day. If the disease progresses, then the single dose is increased to 1-3 tablets, the frequency of administration is 2-4 times a day.
However, this dosage is approximate. For myasthenia gravis, the required amount of the drug is selected individually for each patient.
Patients with kidney disease should be prescribed lower doses, since the drug is excreted primarily in the urine.
When treating atony of the gastrointestinal tract and bladder, it is recommended to take 1 tablet every 4 hours.
Interaction with other medications
“Atropine” reduces the cholinomimetic effect of the drug: reduction in heart rate, increased activity of the exocrine glands. However, when these medications are used together, the effect of “Kalimin 60 N” on the muscles is not weakened.
Avoid simultaneous use of the drug with tricyclic antidepressants, medications for epilepsy and Parkinson's disease, local anesthesia, acetylcholine antagonists, ganglion blockers, and medications for arrhythmia. This weakens the therapeutic effect of “Kalimin 60 N”.
It must also be remembered that pyridostigmine bromide enhances the effect of muscle relaxants, hypnotics and narcotic analgesics.
Storage conditions, price and analogues
It is recommended to store tablets at a temperature not exceeding +25 degrees. Under such conditions, the medicine is suitable for use for 3 years. After opening the bottle, the tablets can be used for six months.
Manufacturers of “Kalimina 60 N” are pharmaceutical companies Klocke Pharma Service Gmbh (Germany) and Teva (Israel). This medicine is strictly a prescription medication. It belongs to list A (potent drug). The price of the drug in pharmacy chains ranges from 750 to 850 rubles.
This medicine is currently very difficult to find in pharmacy chains. Therefore, patients are often interested in analogues. The instructions for “Kalimina 60 N” indicate that the active component of the medicine is pyridostigmine bromide.
Unfortunately, these drugs are almost impossible to find in Russian pharmacies.
It is possible to order “Kalimin 60 N” and “Kalimin Forte” from Germany through special Internet sites, but their cost is very high - from 5,000 to 8,000 rubles.
You can select analogues based on their therapeutic effect. These include the following medications:
- "Neuromidin".
- “Ipigrix.”
- “Axamon.”
- “Prozerin.”
These products contain other active ingredients, but are also cholinesterase inhibitors. They are used in the treatment of myasthenia gravis. The price of Neuromidin is about 1000 rubles, and Ipigrix and Aksamon are about 500 rubles. The cheapest drug is “Prozerin”, its cost is 50-60 rubles. However, this is a fairly old drug and has many side effects.
Reviews about the medicine
You can hear a lot of positive reviews about “Kalimina 60 N”. Patients with myasthenia gravis write that this drug literally put them back on their feet. They managed to achieve remission of the disease, the weakness and fatigue of the muscles gradually disappeared.
Judging by the reviews, the drug helps well with the bulbar form of myasthenia gravis, when a person has impaired swallowing function. After the course of treatment, the patients regained the ability to eat normally. Patients note that it has become easier for them to move, stay on their feet, and do work.
There is practically no mention of side effects of the drug in reviews. Apparently, undesirable effects occur quite rarely. Only in the first days of therapy did some patients experience low blood pressure. Moreover, the medicine is not addictive, has no withdrawal syndrome and can be taken for a long time.
The disadvantages of the drug include its incompatibility with many other medications. This is not always convenient if the patient is undergoing complex therapy using many medications.
Many patients consider this drug the best remedy for myasthenia gravis. In their opinion, it is more effective and has fewer side effects than other cholinesterase inhibitors. People regret that this medicine has recently become very difficult to find in pharmacies.
Source: https://fb.ru/article/367089/preparat-kalimin-n-instruktsiya-po-primeneniyu-analogi-otzyivyi
Kalimin, instructions for use (Method and dosage)
Parenteral route (intravenous, subcutaneous, intramuscular): 5 mg up to 5 times a day.
When taken per os: 2-4 times a day, 60-180 g. It is possible to increase the dosage as needed.
The tablets are intended for internal use. The maximum daily dose is 720 mg, which corresponds to 12 tablets. With the progression of the underlying pathology, 60-180 mg (respectively 1-3 tablets) 2-4 times a day are prescribed. At initial manifestations of the disease, 30-60 mg (respectively 1/2-1 tablet) is prescribed 1-2 times a day.
Instructions for use of Kalimin for muscle relaxation
To stop muscle relaxation, 5 mg of pyridostigmine bromide is administered intravenously. A combination with Atropine at a dose of 500 mcg is effective. It is possible to distribute the dose into 2 injections.
For Myasthenia gravis, dosing is carried out according to an individual scheme, taking into account the patient’s general response to previous therapy, the severity and severity of the underlying disease and concomitant pathology. The doses presented in the instructions should be taken as indicative.
In case of pathology of the renal system, dose selection is required taking into account individual characteristics, since pyridostigmine bromide is excreted mainly through the renal system in its original form.
Composition and effect of the medicine
The active component of the drug is pyridostigmine bromide. The medication is available in the form of tablets that contain 60 mg of the drug.
Pyridostigmine bromide is a substance that inhibits the activity of the enzyme cholinesterase. This leads to increased action of the neurotransmitter acetylcholine, which is responsible for transmitting signals between nerve cells and muscles. For this reason, the instructions for use of “Kalimina 60 N” recommend the use of tablets for the treatment of myasthenia gravis. This disease is characterized by impaired transmission of neuromuscular impulses.
Pyridostigmine bromide also has a general cholinomimetic effect on the body. Under the influence of the drug, a person’s heartbeat slows down, the tone of the muscles of internal organs increases, the activity of the exocrine glands increases, the drug causes a slight constriction of the pupils and a spasm of accommodation.
Overdose
Redness of the skin, increased lacrimation and salivation, increased sweating , constriction of the pupils, dizziness, impaired visual perception, intestinal colic , weakness , involuntary defecation and urination, swelling of the lung tissue, hypotension (collapse possible), reflex tachycardia, cardiac arrest, nausea, bronchospasm are recorded. , cholinergic crisis , paralysis of muscle tissue.
The administration of enterosorbing medications ( Polysorb, Activated Carbon, Smecta ) and gastric lavage are effective.
Atropine sulfate (1-2 mg intravenously) is used as an antidote Depending on the heart rate, a second dose of the antidote can be administered after 2-4 hours.
Indications
According to the instructions for “Kalimina 60 N”, the main indication for prescribing the medicine is myasthenia gravis. The drug is also used in neurology for the treatment of other syndromes in which muscle weakness and fatigue is observed due to impaired neuromuscular transmission.
In addition, Kalimin 60 N tablets are used in the treatment of atony of the intestinal and bladder muscles with delayed bowel movements and urination.
Interaction
The active substance exhibits an antagonistic effect against non-depolarizing types of muscle relaxants. The opposite effect is observed in relation to depolarizing muscle relaxants.
Quinidine , m-anticholinergic drugs, tricyclic antidepressants, local anesthetics, ganglion blockers, antiparkinsonian drugs, antiepileptic drugs inhibit the activity of pyridostigmine bromide.
Atropine neutralizes the m-cholinergic effect of pyridostigmine, but has no effect on skeletal muscle. The active substance stimulates the effects of barbiturates and medications that contain morphine derivatives.
Interaction with other medications
"Atropine" reduces the cholinomimetic effect of the drug: reduction in heart rate, increased activity of the exocrine glands. However, when these medications are used together, the effect of “Kalimin 60 N” on the muscles is not weakened.
Avoid simultaneous use of the drug with tricyclic antidepressants, medications for epilepsy and Parkinson's disease, local anesthesia, acetylcholine antagonists, ganglion blockers, and medications for arrhythmia. This weakens the therapeutic effect of Kalimina 60 N.
It must also be remembered that pyridostigmine bromide enhances the effect of muscle relaxants, hypnotics and narcotic analgesics.
special instructions
In case of ulcerative pathology of the digestive system , in case of heart failure (stage of decompensation), hyperfunction of the thyroid gland, after myocardial infarction the medication is used with caution, after a thorough assessment of the consequences of using pyridostigmine bromide.
With extreme caution, Kalimin is prescribed to patients with parkinsonism , pathology of the renal system, diabetes mellitus , bradycardia, diseases of the hepatic system and after surgical interventions on the digestive tract.
The appointment time is selected individually, trying to take into account physical activity cycles as much as possible. It happens that the lack of effect is due to an overdose of the medication.
The drug can affect the ability and ability to perform complex activities and drive vehicles.
Contraindications
This drug has a powerful cholinomimetic effect and is a potent drug. Not all patients are advised to take this medication. The instructions for “Kalimina 60 N” warn that the drug has many contraindications.
These tablets are not suitable for treating children; they can be taken from the age of 18 years. This remedy is strictly contraindicated for pregnant women. Pyridostigmine bromide does not cause defects or anomalies in the fetus, but has a toxic effect on the embryo. Cholinomimetic may cause premature labor. It is not recommended to take “Kalimin 60 N” during lactation, since the active ingredient penetrates into milk. If the use of the drug is necessary, then breastfeeding is interrupted.
The drug is also contraindicated in the following pathologies:
- obstructive diseases of the bronchi, urinary and biliary tracts;
- spasms of the stomach, esophagus and intestines;
- intestinal obstruction;
- bronchial asthma;
- allergies to the active ingredient of the tablets;
- shock states after operations;
- inflammation of the iris;
- neurological pathologies with muscle spasms;
- after administration of muscle relaxants.
Caution when prescribing the drug is necessary for the following diseases:
- low blood pressure;
- stomach ulcer;
- bradycardia;
- renal and liver failure;
- cardiac pathologies (myocardial infarction, heart failure);
- after surgery on the gastrointestinal tract;
- Parkinson's disease;
- urolithiasis and cholelithiasis.
If the patient has such ailments, it is necessary to prescribe a lower dosage of the medicine.
Reviews about Kalymin
Reviews from doctors about the medication are positive, the drug is often prescribed and has proven effective in the treatment of all diseases declared by the manufacturer. Patients indicate severe tolerance to the drug, which may be due to taking large doses. The difficulty lies in selecting an individual treatment regimen for each patient individually.
Among the frequently occurring negative reactions, patients note skin rashes, acne, and acne .
Undesirable effects
The instructions and reviews of “Kalimina 60 N” indicate that side effects are possible after consuming the tablets. This is due to the cholinomimetic effect of the drug on the body.
The medicine can cause a sharp decrease in blood pressure and heart rate. Due to the effect of pyridostigmine bromide on muscle tone, spasms of skeletal muscles, abdominal pain due to increased peristalsis, diarrhea, and frequent urination are possible.
Due to the increased activity of acetylcholine in patients, the activity of the sweat glands increases, and increased lacrimation and salivation are observed. Vision may deteriorate due to spasm of accommodation. Allergy sufferers experience skin rashes.
Release form and composition
Dosage form - tablets: oblong, biconvex, with a separating line on one side, white in color, roughness is allowed (100 pieces in dark glass bottles, 1 bottle in a cardboard pack).
The active ingredient is pyridostigmine bromide, 60 mg in 1 tablet.
Auxiliary components: corn starch, microcrystalline cellulose, polyvidone K25, magnesium stearate, colloidal silicon dioxide, glutamic acid hydrochloride, purified water.
