Pharmacodynamics and pharmacokinetics
Azafen is a tricyclic antidepressant and belongs to a group of drugs that indiscriminately inhibit (suppress) the neuronal uptake of monoamines . The antidepressant effectiveness of the active ingredient of the drug, pipofezin, is manifested due to its ability to non-selectively inhibit the neuronal reuptake of norepinephrine and serotonin , which leads to an increase in their levels in the central nervous system. In the drug Azafen, thymoleptic (improving mental state and mood) activity is combined with sedative (calming) effects and anxiolytic (anti-anxiety) effect.
Pipofezin has virtually no m-anticholinergic effects and does not affect the activity of the enzyme monoamine oxidase (MAO). Also, this drug is not characterized by cardiotoxic effects.
Oral administration of pipofezin leads to rapid and complete absorption from the gastrointestinal tract. The bioavailability of the drug is approximately 80%. Binding to plasma proteins occurs by 90%. With a single oral dose of 25 mg, the Cmax of pipofezin after 60-120 minutes is 24.5 ng/ml.
Metabolic transformations take place in the liver with the help of the CYP1A2 isoenzyme and the release of inactive metabolic products.
Pipofezin from the bloodstream quite quickly, T1/2 of the drug is 4.3 hours. Excretion is carried out primarily by the kidneys.
Medicine "Azafen": instructions for use
Reviews from patients claim that the tablets help eliminate anxiety and do not cause lethargy or drowsiness. According to them, the use of this drug does not have a negative impact on a person’s daily life.
The medicine is taken orally only. The norm for each patient is selected individually. The initial standard dosage for adults is 25-50 mg. This amount of medication should be divided into two doses, in the morning and lunchtime.
If the patient tolerates the drug well, then the initial dose is increased to 150-200 mg per day. This amount of the drug is divided into three or four doses. The last dose of medication should be taken immediately before bedtime. As needed, your doctor may recommend dosages up to 400 mg per day.
The most optimal daily dose is 150-200 mg, the maximum allowed amount of the drug is 400-500 mg per day. After achieving the desired result, the dose is gradually reduced to a maintenance daily value of 25-75 mg.
The therapeutic course of the drug "Azafen" (reviews from patients who have taken this medicine indicate the occurrence of negative reactions in the body that occur with short-term use of the medication) should last at least a month and can last up to one year. To avoid side effects, you should not take the pills without a doctor's prescription. It is also not recommended to exceed the dosage recommended by the doctor.
Contraindications
Therapy with Azafen is absolutely contraindicated in the following cases:
- severe liver and/or kidney pathologies;
- breastfeeding;
- concurrent use of MAO inhibitors ;
- personal hypersensitivity to pipofezin or other auxiliary ingredients of tablets;
- pregnancy.
Patients suffering from:
- chronic heart failure;
- infectious diseases;
- myocardial infarction;
- diabetes mellitus;
- coronary heart disease;
- cerebrovascular accidents (including post-stroke conditions).
Also, pediatric patients require a particularly careful approach to prescribing Azafen.
Directions for use and dosage
According to the instructions for use, treatment with Azafen involves a long course of treatment from several weeks to a year. At the beginning of drug therapy, the drug is prescribed at a dose of 25-50 mg (1-2 tablets) per day. Then gradually increase to 150-200 mg. In acute conditions of mental disorders, the dose of the medication is 400 mg. It is recommended to take tablets 1-3 times a day. regardless of food intake. After completing the main course of treatment, the patient is prescribed maintenance dosages (25-50 mg) for some time.
The duration of treatment and dosage are prescribed by the attending physician depending on the condition, age of the patient, the presence of concomitant pathologies, and the need to simultaneously take medications of other groups. If side effects develop, you should immediately consult a doctor to adjust the prescribed therapy, replace the pharmacological drug or supporting, stabilizing agents.
Side effects of Azafen
Some patients experienced side effects while using Azafen, such as headaches , nausea , dizziness and vomiting . Also, if the patient is sensitive to the active or auxiliary ingredients of the tablets, allergic reactions .
Side effects
Azafen, unlike other tricyclic antidepressants, has virtually no effect on the autonomic nervous system. This explains the fact that the drug rarely causes side effects and is the least dangerous. Sometimes nausea, dizziness and vomiting are possible, which quickly disappear when the dosage of the drug is reduced.
At the beginning of therapy, drowsiness, fatigue, decreased attention, trembling hands, increased heart rate, and decreased libido are possible. The listed symptoms, as a rule, disappear on their own with continued treatment in therapeutic doses.
Azafen, instructions for use (Method and dosage)
Instructions for use of Azafen involve a course of prescription of the drug tablets for up to 1 year (the minimum therapeutic course is 1-1.5 months).
As a rule, Azafen is initially prescribed in a daily dose of 25-50 mg (1-2 tablets) taken twice a day (morning and afternoon). In case of good tolerability of the drug and adequate response of the patient to the treatment, a gradual increase in the daily dosage is practiced to 150-200 mg (6-8 tablets), sometimes up to 400 mg (16 tablets), with its 3-4-fold dose in 24 hours (last dose taken before bedtime). The optimal therapeutic dosage is considered to be a daily dose of 150-200 mg (6-8 tablets). It is permissible to take 500 mg (20 tablets) of the drug within a maximum of 24 hours. After achieving the desired positive effect of therapy, the patient is transferred to maintenance dosages varying in the range of 25-75 mg (1-3 tablets) per day.
Instructions for use
Azafen is always taken after meals in dosages prescribed by the doctor. The dose of the drug is titrated gradually. First, 25 mg of the drug per day is prescribed in one dose. Then increase to 50 mg in two doses, one tablet each. Gradually the dose is increased by 25 mg, reaching an average therapeutic dose of 150-300 mg. For convenience, after reaching the therapeutic dose, it is recommended to switch to Azafen MB, the dosage of which is 150 mg. Take it one tablet once or twice a day.
As a rule, the desired effect can be achieved no earlier than 4 weeks from the start of treatment.
You can continue taking the drug for up to one year. When stopping treatment, the dose of the drug is reduced gradually, otherwise withdrawal syndrome may develop.
During the course of treatment, it is not recommended to drive vehicles, drink alcohol, or independently prescribe or discontinue other medications. Addiction to the drug practically does not develop.
Interaction
While taking Azafen, there is a decrease in the effectiveness of concurrent anticonvulsant therapy .
The combined use of pipofezin with anticoagulants , antihistamines , ethanol-containing and other central nervous system depressants potentiates their effectiveness and, as a result, toxicity .
Co-administration of ciprofloxacin , fluvoxamine , mexiletine , propafenone and other drugs that inhibit the CYP1A2 isoenzyme may cause an increase in the plasma concentration of pipofezin .
special instructions
depressive state itself is associated with a risk of suicidal tendencies , and therefore, during the treatment of such mental disorders patients should be monitored for early detection of changes in their behavioral sphere and the prevention of possible suicide attempts .
between courses of therapy using MAO inhibitors and Azafen.
At all stages of the therapeutic course, it is necessary to periodically check the functionality of the liver / kidneys .
While taking Azafen tablets, it is better for the patient to refrain from performing potentially life-threatening activities, including driving.
Analogs
Level 4 ATC code matches:
Pipofezin
Bethol
Incazan
Melitor
Miaser
Velafax
Mirtazonal
Venlaxor
Remeron
Venlafaxine
Lerivon
Mirtazapine
Cymbalta
Velaxin
Coaxil
Pyrazidol
Deprim
Gelarium Hypericum
Negrustin
Trittico
Analogues of Azafen are represented by medicinal drugs with a similar main effect:
- Alventa;
- Velaxin;
- Bethol;
- Venlaxor;
- Mirzaten;
- Deprim;
- Mirtazonal;
- Coaxil;
- Pyrazidol;
- Noxibel;
- Remeron;
- Trittico;
- Neuroplant;
- Ephevelon;
- Tetrindole , etc.
Reviews about Azafen
In the process of discussing the effectiveness and relative safety of using this antidepressant , positive reviews about Azafen are much more common than negative statements about it. Most patients who took this drug at one time managed to overcome their own depression , cope with feelings of anxiety and apathy , and significantly improve their mood and general mental state. Mentions of Azafen's side effects are quite rare and are mainly related to personal sensitivity to its ingredients.
However, it is worth recalling that the personal prescription and use of any antidepressant medications is unacceptable and can lead to serious negative consequences. Treatment of a person’s mental sphere, with individual selection of a medicinal drug and its dosage regimen, should be carried out exclusively by a psychotherapist with experience in conducting such therapy.
The choice is yours
What should you use first to get out of a panic attack? As clinical practice shows, the best remedy is breathing exercises. Meditation techniques, mantras (for those who are proficient), yoga (for advanced patients) and any distraction techniques (positive thoughts, relaxing music, visualization, rituals) will also be useful.
If panic episodes recur over and over again, you should consult a psychotherapist who practices non-drug treatments.
Today, psychotherapy has a huge arsenal of help. This includes art therapy, Gestalt, directive methods (behavioral and cognitive behavioral therapy), existential analysis, and psychodrama. Systemic constellations according to Bert Helinger are in demand and effective, during which you can make your panic a self-sufficient interlocutor and partner, playing a destructive role only at first glance, but in reality – warning and encouraging you to change your life for the better.
Azafen price, where to buy
The average price of Azafen fluctuates around 200 rubles for 50 tablets and 650 rubles for 250 tablets.
- Online pharmacies in RussiaRussia
ZdravCity
- Azafen tablets 25 mg 50 pcs. Hemofarm LLC
198 rub. order
