Phenazepam: instructions for use

Phenazepam - a tranquilizer, which has a pronounced anti-anxiety, anticonvulsant, muscle relaxant effect, soothes the central nervous system. It is used for various neurotic and psychopathic conditions, to suppress feelings of fear, anxiety, can be prescribed for withdrawal symptoms.

The drug is able to cause a strong addiction, and after continued uninterrupted use in humans develops a strong dependence, the consequence of which are serious disorders of the nervous system. If at the initial stages of drug use a person is drowsy and positively dyed emotions, then with the continuous use of phenazepam positive emotions are replaced by negative emotions.

Self-treatment with phenazepam, excess dosages prescribed by the doctor, an increase in the duration of the treatment course leads to unpredictable, severe and irreversible consequences.

Clinical and pharmacological group

Tranquilizer.

Terms of sale from pharmacies

For Saleby prescription.

Price

How much does phenazepam cost in pharmacies? The average price is at the level of110 rubles.

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Can I buy without a prescription?

Phenazepam is a so-called small tranquilizer, a drug that depresses many processes at the level of the central nervous system. It has a wide range of effects, but it can also cause numerous side effects. In general, it can be said that the reaction to certain doses of the drug in all people is to some extent individual. Since the drug in case of an overdose is potentially life threatening, its sale is strictly according to medical prescriptions. So the state provides, in part, the security of the population.

Benzodiazepines (including phenazepam) are sold strictly by prescription for the following reasons:

the drug has many contraindications, and the patient himself can not always recognize them;
if improperly taken, the drug may cause an overdose;
overdose of the drug is dangerous by stopping breathing and palpitations;
Phenazepam is sometimes used by patients with drug dependence to facilitate "withdrawal";
Phenazepam may cause habituation with prolonged use.

Thus, officially in most countries, phenazepam can not be purchased without a doctor's prescription. It is also forbidden to transport it across the state border without an appropriate certificate. Theoretically, private individuals can purchase the drug, but its application in this case will involve very serious risks.

Composition and form of release

Phenazepam is available in the following forms:

tablets of 0.5 mg, 1 mg or 2.5 mg: flat-cylindrical, white, equipped with a facet (0.5 and 2.5 mg) or with a chamfer and chamfer (1 mg). The drug is packaged in blisters (10 or 25 tablets) or polymer cans (50 tablets each) and packs of cardboard (2 or 5 blisters or 1 bank in a pack);
solution for intramuscular and intravenous administration: weakly colored or colorless. The drug is packaged in glass ampoules of 1 ml and blisters (5 ampoules each). Ampoules are packed in cardboard boxes (10 ampoules each) or cardboard packs (2 blisters each).

The composition of 1 tablet includes:

active ingredient: phenazepam - 0.5, 1 or 2.5 mg;
auxiliary substances: talc, calcium stearate, povidone, lactose, potato starch.

The composition of 1 ml of the solution includes:

active ingredient: phenazepam - 1 mg;
auxiliary substances: sodium hydroxide solution , M, polyvinylpyrrolidone low molecular weight medical, tween-80, sodium pyrosulfite, glycerol distilled, water d / u.

Pharmacological effect

The main active ingredient is phenazepam. It is a benzodiazepine derivative that manifests a tranquilizing, hypnotic and anticonvulsant effect. He has a fairly high activity, and the strength of the tranquilizing and anxiolytic action is superior to other drugs of this group. Effects of taking phenazepam:

Anticonvulsant.
Muscle-relaxing.
Hypnotic.
Protivotrevozhny (tranquilizing).
Sedative.

The main effect is tranquilizing, which means eliminating the patient's feelings of anxiety, fear and anxiety. Phenazepam helps to reduce emotional tension. After the course of treatment in patients disappear obsessive thoughts, increased suspiciousness, a negative attitude toward what is happening. Phenazepam does not have a positive effect on the symptoms caused by psychotic pathologies (hallucinations, delirium).

The soothing effect is expressed, mainly, in the reduction of psychomotor excitability, and the sleeping pills - in the relief of sleep, the increase in its duration and the increase in quality. The mechanism of action of phenazepam is the effect on certain receptors that are located in the brain and spinal cord, therefore all effects have a central genesis.

Indications for use

What helps? Phenazepam is effective in the following cases:

with reactive psychoses;
when cupping alcohol abstinence;
for the treatment of hypochondriacelo-senestatic syndrome;
for the elimination of autonomic dysfunctions and sleep disorders;
for the prevention of conditions of emotional stress, anxiety and fear;
for the treatment of autonomic lability, rigidity of muscles, tics and hyperkinesis;
as an anticonvulsant for the treatment of patients with myoclonic and temporal epilepsy;
with neurotic, psychopathic and other conditions, accompanied by increased irritability, anxiety, tension, fear and emotional lability.

How much does phenazepam work?

The time of action of phenazepam averages 3-6 hours, but some of its effects may persist a little longer. The time of onset depends on the mode of administration of the drug. When administered orally (in tablets), this is about 15 - 20 minutes, with intramuscular injection - faster, and with intravenous - even faster.

Contraindications

The drug should not be taken under the following conditions:

poisoning with hypnotic drugs with impaired vital functions;
depression with manifestations of suicidal tendencies;
disturbances of respiratory function;
the presence of hypersensitivity to the components of the drug;
shock;
comatose and shock conditions;
closed angle glaucoma - predisposition or during an acute course;
acute drug and alcohol poisoning;
pregnancy, breast feeding.

Due to the fact that the effectiveness and safety of therapy with the use of Phenazepam for children and adolescents under 18 years is not defined, the remedy is not used for treatment.

Apply strictly under the supervision of a doctor, adjusting the dosage under such conditions:

apnea;
spinal or cerebral ataxia;
drug dependence;
organic disruption of the brain;
psychosis;
renal or hepatic insufficiency.

Elderly patients should be used with caution.

Intended use for pregnancy and lactation

Phenazepam may be given to pregnant women only for vital indications. The active substance has a negative effect on the fetus, increases the likelihood of developing congenital malformations, depresses the development of the central nervous system of the unborn child. It is the children that are most sensitive to the ability of benzodiazepines to suppress CNS functions.

With prolonged treatment of a pregnant with phenazepam, a newborn can experience withdrawal symptoms. It is also dangerous to use immediately before childbirth, as the drug can provoke respiratory depression, decrease muscle tone, hypothermia and weakening of sucking movements.

Dosage and route of administration

As indicated in the instructions for use of the tablet, phenazepam is taken orally, without chewing, with enough water. The dose of the drug is determined by the doctor, depending on the indications and characteristics of the patient's body.

Inside with sleep disorders - 250-500 mcg for 20-30 minutes before sleep. For treatment of neurotic, psychopathic, neurosis-like and psychopathic-like 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 starts with a dose of 3 mg / day, rapidly increasing the dose to obtain a therapeutic effect. In the treatment of epilepsy - 2-10 mg / day.

For the treatment of alcohol withdrawal - inside, 2-5 mg / day or in / m, 500 mcg 1-2 times / day, with vegetative paroxysms - in / 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 in the afternoon and up to 2.5 mg at night. In neurological practice, for diseases with muscular hypertension, 2-3 mg 1-2 times / day are prescribed. The maximum daily dose is 10 mg.

To avoid the development of drug dependencewith course treatment, the duration of the use of phenazepam 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.

The withdrawal syndrome

Phenazepam refers to drugs that can cause addiction. In patients with developed dependence on phenazepam after its withdrawal, characteristic symptoms may appear. Usually they are united into two concepts - the syndrome "ricochet" and withdrawal syndrome. Each of them has its own development mechanism. It should be noted that with the proper administration of phenazepam in the vast majority of patients, none of these syndromes develops.

"Ricochet" syndrome refers to the aggravation of the symptoms of the underlying pathology, from which the patient was treated with phenazepam. Thus, the manifestations of this syndrome will be to some extent opposite to the action of the drug. The patient may have insomnia, irritability, tremor (trembling in the limbs), emotional excitement. All this is the result of excitation of the nervous system, which has been suppressed for a long time by the use of phenazepam.

The withdrawal syndrome is in some ways similar to the "rebound" syndrome, and many manifestations are the same in them. However, in the case of withdrawal syndrome, symptoms may be more diverse. This condition is somewhat similar to the "breaking" of drug addicts, although there are practically no such serious conditions in the case of the withdrawal of phenazepam.

The withdrawal syndrome may include the following symptoms and manifestations:

propensity to suicide;
severe depression;
increased heart rate;
nervous excitement;
severe headaches;
convulsions;
unstable blood pressure;
stool disorders.

All these symptoms can occur with a sharp withdrawal of the drug, especially if it was taken in large doses or for a long time. The duration of the syndrome of "rebound" or withdrawal syndrome may be different. Usually the symptoms go away in a week or so. However, cases are described where some manifestations persisted for more than a month.

To prevent such a deterioration of the condition, phenazepam is canceled gradually, slightly reducing the dose every day. Of course, with a one-time admission (for example, once a month to fight insomnia) such a prolonged cancellation is not required, since addiction does not have time to develop.

Adverse Reactions

During the reception of Feazepam tablets in patients with increased individual sensitivity, some side effects may develop:

Allergic reactions - skin itching, rashes, hives;
From the hematopoietic system - a decrease in the level of leukocytes, neurophiles, hemoglobin, platelets;
On the part of the reproductive system - a decrease in sexual desire;
From the nervous system - a constant sense of fatigue, drowsiness, lethargy, dizziness, decreased concentration, ataxia, oppression of consciousness, disorientation in space, confusion consciousness, headaches, limb tremor, memory impairment, coordination of movements, myasthenia gravis, attacks of aggression, suicidal thoughts, unreasonable fear and anxiety;
On the part of the digestive system - dry mouth, stomach pain, heartburn, nausea, vomiting, lack of appetite, liver disease, inflammation of the pancreas, increased activity of liver transmissions;
From the cardiovascular system - tachycardia, dyspnea, a decrease or a rapid increase in blood pressure, attacks of panic attacks.

If one or more side effects occur, the patient should consult a doctor for advice, perhaps the drug will have to be canceled or the dose reduced.

Overdose

In case of an overdose, confusion, decreased reflexes, drowsiness and even coma may occur. Patients can complain of shortness of breath, tremor, bradycardia. Inhibitory effects on the central nervous system can lead to an attempted suicide in the patient. At the first signs are shown gastric lavage, sorbent intake, symptomatic therapy, especially aimed at maintaining the function of breathing.

special instructions

In the course of treatment, patients are strictly prohibited from drinking ethanol.

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

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

In renal and / or hepatic insufficiency and long-term treatment, it is necessary to monitor the picture of peripheral blood and the activity of hepatic enzymes.

Like other benzodiazepines, it has the ability to induce drug dependence in long-term admission in large doses (more than 4 mg / day). With a sudden discontinuation of reception may be a withdrawal syndrome (including depression, irritability, insomnia, increased sweating), especially with prolonged admission (more than 8-12 weeks). When patients develop such unusual reactions as increased aggressiveness, acute excitations, feelings of fear, thoughts about suicide, hallucinations, increased muscle cramps, difficulty falling asleep, superficial sleep, treatment should be discontinued.

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

In case of overdose, severe drowsiness, prolonged confusion, decreased reflexes, prolonged dysarthria, nystagmus, tremor, bradycardia, shortness of breath or shortness of breath, lowering of blood pressure, coma. Recommended gastric lavage, the reception of activated charcoal; symptomatic therapy (maintenance of respiration and blood pressure), administration of flumazenil (in hospital settings); hemodialysis is ineffective.

Compatibility with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

Increases the concentration of imipramine in the blood serum.
Phenazepam may increase the toxicity of zidovudine.
With simultaneous use of phenazepam reduces the effectiveness of levodopa in patients with Parkinsonism.
Inhibitors of microsomal oxidation increase the risk of toxic effects. Inducers of microsomal liver enzymes reduce efficacy.
There is a mutual enhancement of the effect with simultaneous use of antipsychotic, antiepileptic or hypnotics, as well as central muscle relaxants, narcotic analgesics, ethanol.
With simultaneous use with antihypertensive agents, it is possible to increase antihypertensive action. Against the background of simultaneous administration of clozapine, an increase in respiratory depression is possible.

Reviews

We offer you to read reviews of people who used Phenazepam:

Olga. There was somehow my mom's emotional breakdown, and if it were not for Fenazepam, I do not even know how we would stand it, it's hard for even the people around to live with a man who has a nervous breakdown. My mother could not sleep properly, she was worried all the time, and we all worried about her.
Vladislav. I'm almost 45 years old. Recently, problems have started, I often woke up in the morning and could not go back to sleep. After consultation, the neurologist began taking Phenazepam 0.5 mg each. for half an hour before bedtime for 2 weeks. Now I finish the course, I sleep well
Lida. I'm a very nervous person. I'm literally experiencing every occasion! I can even burst into tears for a trifle. At work all this is just annoying already. The doctor advised me of phenazepam. I became much calmer! It works very well! As soon as I feel that I will break, I drink it right away. So far, I have not found a drug better than this. Finally, I began to respond moderately to difficult situations for me !!

Analogues

Analogues of the drug are such drugs:

Gidazepam;
Fanazepam;
Grandaxin;
Diazepam;
Relanium;
Relium;
Sibazon.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Keep the tablets out of the reach of children, at room temperature. The shelf life of the drug is indicated on the packaging and is 4 years from the date of manufacture.