Rexetin

width = Rexetin is a medicament of the group of antidepressants.

Used to treat depression, obsessive, anxious and panic disorders, and social anxiety disorders. The drug can be combined with antihypertensive, antidiabetic and other medicines prescribed to the patient for vital indications.

Rexetin does not cause the pharmacological dependence inherent in the drugs of the benzodiazepine series and barbiturates.

Clinical and pharmacological group

Antidepressant.

Terms of sale from pharmacies

It is possible to buy under the prescription of the doctor.

Price

How much does Rexsetin cost in pharmacies? The average price is at the level of800 rubles.

Composition and form of release

Rexetin is produced in the form of tablets coated with a film membrane: biconvex, round, almost white or white, with a risk on one side; on the other side engraving "X20" - for a dose of 20 mg, "X30" - for a dose of 30 mg 10 pieces. in blisters; 3 blisters in a pack of cardboard).

The composition of 1 tablet includes:

Active ingredient: paroxetine hydrochloride hemihydrate - 2, 6 or 3, 4 mg (corresponds to the content of paroxetine - 20 or 30 mg);
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Auxiliary components: magnesium stearate, sodium carboxymethyl starch, calcium hydrophosphate dihydrate, hypromellose;
Sheath: titanium dioxide, polysorbate 80, macrogol 6000, macrogol 400, hypromellose.

pharmachologic effect

Rexetin, as noted earlier, is a powerful antidepressant. It acts on the central nervous system. CNS), suppressing the neuronal seizure of serotonin (a hormone of joy). Practically does not affect norepinephrine (a substance secreted by the brain, a provoking sense of rage, courage, etc.) and dopamine (a hormone predecessor of adrenaline, a desire to do something). Also, in addition to the central nervous system, affects the substance-psychostimulants in the human body.

Any drug has some stages of being in the human body, namely:

Metabolism. Due to the inactive metabolites of the liver, it is split and later removed from the body, having worked its resources.
Spread. Approximately 95% of paroxetine binds to blood plasma protein cells, thus distributing the drug throughout the body and affecting the necessary substances. Stably the debugged action comes in 1-2 weeks after the beginning of therapy, in the future it does not change.
Suction. Getting into the human gastrointestinal tract, Rexetin excels in the body. The ingestion of food or liquid does not affect the process.
Excretion. The drug is active for up to 3 days, but usually 24-30 hours. About 65% of paroxetine leaves the body with urine (2-4% of which in the same form as entered the body, 58-62% - as metabolites). The rest is excreted through the intestine, of which less than one percent is in unchanged form.

An increase in the concentration of paroxetine in the blood occurs if there are abnormalities in the functioning of the kidneys or the liver, as well as in the elderly. This should be paid attention when using the drug.

Indications for use

From what appoint? Rexetin is used for the treatment of neuropsychic disorders, including:

Treatment and prevention of relapses in obsessive-compulsive disorders;
Neuropsychiatric disorders accompanied by panic attacks and agoraphobia;
Depression of various origins, including depression, which are accompanied by a constant sense of anxiety;
The drug is also used to treat patients suffering from the syndrome of social phobia;
Post-traumatic mental disorders associated with severe stress, which occurs during a catastrophe and life-threatening situations.

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Contraindications

Rexetin is contraindicated to take:

In the period of breastfeeding;
In pregnancy;
In combination with MAO inhibitors and within 2 weeks after discontinuation of treatment;
Patients younger than 18 years of age (there is no reliable data on the safety and efficacy of the drug in pediatric practice);
When hypersensitivity to the components of tablets.

Rexetin should not be administered with thioridazine, as paroxetine increases its plasma concentration and, therefore, toxicity. Even the appointment of only thioridazine can lead to an extension of the QT interval on the ECG and the development of severe ventricular arrhythmia (eg, pirouette ventricular tachycardia). In a number of cases, such conditions cause a sudden death of the patient.

Care should be taken when prescribing Rexetin to elderly people, with hepatic or chronic renal disease deficiency, prostatic hyperplasia, functional cardiovascular system infertility, glaucoma (since paroxetine causes mydriasis).

With caution use Rexetin and for the treatment of patients in whose anamnesis there are indications of epilepsy. Studies have shown that approximately,% of patients use paroxetine causes the development of epileptiform seizures. If a similar disorder occurs during treatment, the course should be discontinued.

Intended use for pregnancy and lactation

The drug Rexetin during pregnancy is used only for absolute life indications, since the use of a medicinal product can significantly affect the intrauterine development the fetus.

For example, in the first trimester, the risk of developing a congenital anomaly of the cardiovascular system increases catastrophically (especially atrioventricular septal defects are common). And in the treatment of expectant mothers in the last trimester, premature birth and other prenatal complications are possible child (respiratory distress, extensive cyanosis, epilepsy, hyperreflexia, lethargy, arterial hypotension).

If it is necessary to conduct a course of conservative treatment with Rexetin during lactation, then the treating doctor should decide on the termination of breastfeeding, since the active components of the drug are contraindicated for use in childhood, and in breast milk, a small amount paroxetine.

Dosage and route of administration

As indicated in the instructions for use of the tablet Rexetin should be taken 1 time / day, preferably in the morning, while eating, without chewing. As with other antidepressants, depending on the clinical condition of the patient after 2-3 weeks of therapy, the dose of the drug can be changed.

In panic disorders, the recommended therapeutic dose is 40 mg / day. Therapy should be started with a small (10 mg / day) dose, with a weekly increase of 10 mg per week to achieve the desired effect. The maximum daily dose should not exceed 60 mg. The recommended low initial dose of the drug is due to the possibility of a temporary increase in the intensity of the symptoms of the disease at the beginning of therapy.
In obsessive-compulsive disorders (obsessive-compulsive disorder), the initial dose is 20 mg / day. The dose may be increased by 10 mg until a therapeutic response is obtained. The maximum daily dose is usually 40 mg, but should not exceed 60 mg.
With depression, the recommended daily dose is 20 mg. The effect in most cases develops gradually. In some patients, an increase in the dose of the drug is possible. The daily dose can be increased by 10 mg per week until the therapeutic effect is achieved; the maximum daily dose is 50 mg / day.
With social phobia therapy can be started with a dose of 20 mg / day. If after a two-week course of treatment there is no significant improvement in the patient's condition, the dose of the drug can be increased weekly by 10 mg until the desired effect is achieved. The maximum daily dose should not exceed 50 mg. For maintenance therapy, the drug is used at a dose of 20 mg / day.
In post-traumatic stress disorders, the recommended therapeutic dose is 20 mg / day. Depending on the patient's response to therapy, the daily dose can be increased by 10 mg, the maximum daily dose is 50 mg.
With a generalized anxiety disorder, the recommended therapeutic dose is 20 mg / day. Depending on the patient's response to therapy, the daily dose can be increased gradually by 10 mg per week; the maximum daily dose is 50 mg.

Depending on the clinical condition of the patientTo prevent the possibility of relapses, it is necessary to carry out maintenance therapy. The course of maintenance therapy after the disappearance of symptoms of depression can be 4-6 months, and with obsessional and panic disorders and more. As with other psychotropic drugs, the drug should be abruptly discontinued.

Weakened patients and the elderlythe concentration of paroxetine in the blood serum can grow faster than usual, so the recommended initial dose is 10 mg / day. This dose can be increased by 10 mg weekly depending on the patient's condition. The maximum dose should not exceed 40 mg / day.

Childrendue to lack of clinical experience the drug is not shown.

In renal (KK <30 ml / min) or liver failurethe concentration of paroxetine in the blood plasma increases, so the recommended daily dose of the drug in these cases is 20 mg. This dose can be increased depending on the patient's condition, but it is necessary to strive to maintain the dose at the lowest possible level.

Side effect

Side effects of the drug are most pronounced at the beginning of therapy, however, during treatment, their intensity and frequency of occurrence decrease.

Patients may develop such side effects:

Allergic reactions: skin itching, rash, urticaria, edema of the face and limbs, bronchospasm, Quincke's edema;
From the skin: skin hyperemia, hematoma;
On the part of the genitourinary system: violations of ejaculation, decreased libido, difficulty urinating;
On the part of the gastrointestinal tract: nausea, vomiting, stool disorders (both constipation and diarrhea are possible), increased activity of hepatic enzymes, decreased appetite, impaired liver function;
From the cardiovascular system: heart rhythm disturbances, changes in blood pressure (both hypertension and hypotension are possible), changes in the electrocardiogram, vasodilation, fainting;
From the side of the peripheral and central nervous system: headache, dizziness, violation of the regime sleep and wakefulness, drowsiness, trembling of limbs, increased fatigue, irritability, paresthesia. Very rarely possible extrapyramidal conditions, orofacial dystonia, convulsions. Dry mouth, increased sweating, impaired visual system;
Other side effects: electrolyte imbalance, in particular hyponatremia, increased synthesis of antidiuretic hormone. Myopathy, myalgia, hyper- or hypoglycemia, galactorrhea, influenza-like symptoms, thrombocytopenia.

With a drastic withdrawal of the drugpatients had disturbances in sleep and wakefulness, tremor, nausea, vomiting, paresthesia, dizziness, confusion.

To avoid these side effects, it is necessary to cancel the drug gradually.

Overdose

Usually, treatment with Rexetin is well tolerated by patients, since it has rather wide limits of safe use, however, at a single dose of more than 2000 mg or in a complex with medicines that contain Paroxetine, the toxicity of the main active ingredient and the development of acute poisoning are possible with the following symptoms:

dilated pupils;
state of excitement or drowsiness;
headaches or dizziness;
nausea, vomiting;
intense trembling of the limbs;
soupness in the mouth;
redness of the upper half of the body, especially the skin of the face.

There is no specific antidote for overdosing of Rexetin, therefore only symptomatic treatment of manifestations of increased concentration of a pharmacological preparation is used. It is necessary to carefully monitor life functions, to ensure free airway patency. It is recommended to wash the stomach as soon as possible and receive enterosorbents. The addition of oxygen therapy with Rexetin overdose showed itself well.

special instructions

Before you start using the drug, read the special instructions:

There is insufficient experience of simultaneous use of electroconvulsive therapy and paroxetine.
In connection with the predisposition to suicidal attempts in patients with depression and patients with drug abuse during the period of abstinence, this category of patients requires close monitoring in process of treatment.
In many cases, hyponatremia has been noted, especially in elderly patients who receive diuretics. After the withdrawal of paroxetine, the level of sodium in the blood is normalized.
In some cases, against the background of paroxetine treatment, increased bleeding occurred (mainly ecchymosis and purpura).
Against the background of paroxetine, hyperglycemic conditions were rarely noted.
Contraindicated taking paroxetine simultaneously with MAO inhibitors and within 14 days after their withdrawal. In the future, paroxetine should be used with extreme caution, starting a course of treatment with small doses and gradually increasing dosages until the desired therapeutic effect is achieved. After the end of paroxetine therapy for 14 days, treatment with MAO inhibitors should not be started.
If the patient was previously manic, during the reception of paroxetine, the possibility of relapse (as with other antidepressants) should be considered.

Interaction with other drugs

Effect of paroxetine on drugs / substances with simultaneous application:

Theophylline: can increase its concentration in the blood;
Protsiklidin: increases its concentration in the blood plasma, and therefore with the appearance of anticholinergic side effects, a decrease in the dose of procyclidine is required;
Tricyclic antidepressants: can inhibit their metabolism (by inhibiting the isoenzyme CYP2D6), which is why it is necessary to reduce their dose and take care when using this combination;
Isozyme CYP2D6: inhibits its activity, and therefore requires special care while using paroxetine with drugs, the metabolism of which occurs through this isoenzyme, including some antidepressants (fluoxetine, desipramine, imipramine, amitriptyline, nortriptyline), phenothiazines (thioridazine), antiarrhythmic drugs of class 1 C (enkainide, flecainide, propafenone) or with drugs blocking its action (codeine, cimetidine, quinidine).

Influence of drugs / substances on paroxetine with simultaneous application:

Cimetidine: increases its level in blood plasma at the stage of equilibrium (since cimetidine inhibits some isoenzymes of cytochrome P450);
Phenobarbital: reduces its concentration in blood plasma and shortens T1 / 2 (as phenobarbital increases the activity of some cytochrome P450 isoenzymes);
Phenytoin: reduces its concentration in the blood plasma (it is also possible to increase the frequency of side effects of both drugs);
Drugs that enhance or inhibit the activity of liver enzyme systems: can affect its metabolism and pharmacokinetics. When combined with inhibitors of liver metabolic enzymes, the lowest effective dose of paroxetine should be used; from inducers of hepatic enzymes - a change in its initial dose is not required; further dosages are changed depending on the clinical effect.

With the simultaneous use of paroxetine in combination with tryptophan, dizziness, increased sweating, nausea and headache were observed (it is recommended to avoid their overlapping).

Due to the use of Rexetin with sumatriptan, coordination disorders, hyperreflexia, general weakness are possible (medical control is required).

Pharmacodynamic interaction is assumed between paroxetine and warfarin (with unchanged prothrombin time there is increased bleeding), in connection with which such a combination should be used with caution.

As with other serotonin reuptake inhibitors, undesirable interaction was observed between paroxetine and MAO inhibitors in animal experiments.

Paroxetine should be used with caution in combination with digoxin (due to lack of sufficient clinical experience).

Rexetin does not enhance the action of ethanol, however, due to the effect of paroxetine on the enzyme system of the liver, it is necessary to exclude the use of alcoholic drinks during its administration.

Since paroxetine binds to a large extent to blood plasma proteins, when it is used simultaneously with drugs, which also bind to plasma proteins, it is possible to increase the side effects (against the background of increased concentrations of paroxetine in the plasma blood).

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Suicidal / Suicidal Thinking

Depression is associated with an increased risk of suicidal thoughts, autoaggression and suicide. This risk persists until a remission occurs. Because the improvement may not occur within the first few weeks or more from the start of treatment, patients should be carefully monitored until such an improvement occurs. The current clinical experience indicates that when treating with antidepressants, the risk of suicide may increase in the early stages of recovery.

Other psychiatric conditions in which Rexetin is administered may also be associated with an increased risk of suicidal behavior. In addition, these conditions can be associated with a major depressive disorder. The same precautions as for the treatment of patients with major depressive disorder should be observed when it comes to treating patients with other psychiatric disorders. Patients with an anamnesis of suicidal behavior or thoughts, or demonstrating a significant degree of suicidal thinking before treatment, are at greater risk of suicidal thoughts or suicide attempts, and should be carefully observed during treatment. Such patients aged 18-29 years have an increased risk of suicide, so treatment with the drug should be carefully monitored.

Patients (and those who provide assistance to patients) should be prepared for the need for monitoring in emergency situations - the appearance of suicidal intentions / behaviors or thoughts about autoaggression, in order to seek medical help immediately if these symptoms are present.

Reviews

We offer you to familiarize yourself with the opinions of people who used the drug Reksetin:

Katerina. Everyone has everything individually. Because, I can only say for myself. I had panic disorder and depression. Sleep and appetite have disappeared. I felt terribly. The doctor prescribed reksitin. I started with a quarter of a tablet. Then I increased the dose. Has helped. But not at once. The first effect was felt a week later. After 2-3 I felt almost perfectly. Appetite, sleep, mood. No panic. They say that many people complain of nausea and dizziness. Or something else. But I did not have anything like that. But! The sexual desire disappeared. Has made a break in 3 days - it has returned. Again began to drink reksitin - was gone. Now I throw again reksitin. But it seems to me that I left early. Again anxious. And trembling... Hardly it can be canceled. This is an untreated disease, which reektin silenced. I do not know what to do. Whether again to accept, whether not. I decide how I feel.
Marina. My feelings about this drug-they just saved me these pills! After the operation, I was allergic to the medicine and the body began to give out every day a panic attack on the remembered stress. It was bad so I thought everything. Two months she tried to cope on her own, but when she was already very ill decided on an antidepressant. Just could not believe that the body can react to stress. The tablets were taken immediately after the first dose. I took a week in half. Half a tablet for 4 months. Have appointed a floor of year to drink but has thrown before 3 operation. I was afraid of withdrawal syndrome!!! The first three days are visible while the medicine in the body was kept all fine. And then 3 days it was decent. So I wanted to have a tablet. The doctor said bear it. And suffered another day 4. Then as it is released thank God now all the rules. So try everything individually.

Analogues

The composition and effect of the same effect for tablets Rexetin are preparations Paxil, Adepress, Paroxetine, Plizil, Sirestill.

Before buying an analogue, consult your doctor.

Impact on the ability to drive vehicles

Controlled studies have not revealed a negative effect of paroxetine on the psychomotor or cognitive function. Despite this, at the beginning of the course of therapy, for an individually defined period, you can not drive a car or work in an environment of increased danger requiring quick reaction.

The degree of restriction is determined individually.