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Pharmacological properties

Riabal selectively blocks the peripheral m-cholinergic receptors of the mucous membrane of the digestive tract, bile and urinary tract and uterus. the riabal does not penetrate the GEB.

Selectively blocking M-cholinergic receptors, Riabal makes them insensitive to acetylcholine, which is formed at the ends of postganglionic parasympathetic nerves. The consequence of this is a decrease in the tone of the smooth muscles of the esophagus, intestines, gall bladder, bile ducts, urinary tract and uterus, as well as a decrease in the secretion of hydrochloric acid, pepsin, and exocrine pancreatic activity. With prolonged use, Riabal does not adversely affect the function of the liver, kidneys, hematopoietic tissue.

Pharmacokinetics The drug is poorly absorbed in the digestive tract. Blood plasma clearance and renal clearance are 12.5 and 5.80 ml / min / kg body weight, respectively. T½ is 2.13 hours. It is excreted in feces and urine.

Indications

Pain caused by cramping and hyperperistalsis of the digestive tract: with gastritis, gastric and duodenal ulcers, enteritis, colitis, after gastrectomy.

Pain associated with spasms and biliary dyskinesia: with cholecystitis, gallstone disease.

Pancreatitis pain.

Pain with spasms of the urinary tract: with calculi in the urinary tract, tenesmus of the bladder, cystitis, pyelitis.

Assign before endoscopy of the stomach and gastrointestinal radiography.

Assign with vomiting.

Assign with dysmenorrhea.

Application

Tablets. riabal tablets are administered orally. children aged 6-12 years - 15-30 mg 2-3 times a day.

Children over the age of 12 years and adults - 30-60 mg 3 times a day.

In acute acute pain, adults can be prescribed 90 mg per 1 dose. If it is necessary to use prinfinium bromide at a dose of 15 mg, the drug is prescribed in the appropriate dose or in the form of a syrup.

Syrup. Children under the age of 3 months - 1 ml every 6–8 hours; 3–6 months - 1–2 ml every 6–8 hours; 6-12 months - 2 ml every 6-8 hours; 1-2 years - 5 ml every 6-8 hours; 2-6 years - 5-10 ml every 6-8 hours.

The doctor determines the duration of the course of treatment individually.

Contraindications

Riabal is contraindicated in patients with the following diseases:

  • glaucoma: symptoms may worsen due to increased intraocular pressure;
  • urinary disorders caused by prostatic hypertrophy: symptoms may be aggravated because they are caused by relaxation of the detrusor and contraction of the muscles of the sphincter of the bladder; acute urinary retention;
  • serious heart disease: symptoms may worsen as the heart rate accelerates;
  • paralytic intestinal obstruction: symptoms may worsen as gastrointestinal motility slows down;
  • hypersensitivity to affinity bromide or any component of the drug.

Side effects

On the part of the immune system: allergic reactions, including skin rashes, itching, hyperemia, urticaria, angioedema.

From the digestive tract: nausea, vomiting, constipation, dry mouth.

From the urinary system: urinary retention.

From the side of the organ of vision: violation of accommodation, blurred vision.

From the nervous system: headache, dizziness, weakness, tremor.

From the cardiovascular system: hot flashes, tachycardia, increased blood pressure, palpitations.

The listed adverse reactions disappear when the dose is reduced or after drug withdrawal.

special instructions

It is believed that anticholinergics can lead to increased intraocular pressure.

In patients with prostatic hypertrophy, anticholinergics can cause a decrease in the maximum pressure in the bladder and an increase in the maximum volume of the bladder, which sometimes leads to increased dysuria.

Prifinia bromide should be used with caution in patients with hyperthyroidism, since they usually have a rapid heartbeat or tachycardia, and therefore the symptoms may intensify.

Riabal should be used with caution in patients with congestive heart failure, as the heart rate can be accelerated, so the symptoms may intensify.

The drug should be used with caution in patients with ulcerative colitis, since the development of toxic megacolon is possible.

Prefinium bromide should be used with caution in patients sensitive to high ambient temperatures, since sweat glands and body thermoregulation are suppressed; hyperthermia may occur.

In connection with the anticholinergic effect of the drug, prinfinium bromide should be used with caution in elderly patients, as symptoms such as impaired accommodation, dry mouth or urination (see ADVERSE EFFECTS) may occur.

Use with caution in chronic lung diseases, especially in young children and debilitated patients, as well as in brain damage in children, with Downs disease, central paralysis in children.

As excipients, the preparation contains sucrose and non-crystallizing sorbitol solution (E420). If you are intolerant of certain sugars, you should consult your doctor before taking this medication.

Riabal Syrup contains the dye E110, which can cause allergic reactions.

Use during pregnancy and lactation. Pregnancy: the safety of prinfinium bromide for pregnant women has not been proven.

The use of the drug during pregnancy and lactation is possible only when the expected benefit to the mother outweighs the potential risk to the fetus / baby.

Children. The drug in the form of a syrup is used in children under the age of 6 years; in the form of tablets - in children over the age of 6 years.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. Riabal can cause visual impairment, which should be warned for patients who engage in potentially hazardous activities that require alertness, such as driving vehicles or working with other mechanisms.

Interactions

Priffia bromide must be used with caution while taking the following medicines (table).

Medicines Signs, Symptoms, and Treatment The mechanism and risk factors
Tricyclic antidepressants (imipramine; amitriptyline).

Phenothiazines (chlorpromazine).

Antihistamines (diphenylhydramine)

In connection with the anticholinergic effect, the development of adverse reactions (impaired accommodation of eyesight, dry mouth, impaired urination) is possible Since prinfinium bromide and these drugs have an anticholinergic effect, their effect may be further enhanced
MAO inhibitors In connection with the anticholinergic effect, the development of adverse reactions (impaired accommodation of eyesight, dry mouth, impaired urination) is possible As the drug metabolism slows down, the anticholinergic effect may be enhanced

The cholinolytic effect of the drug can be potentiated with the simultaneous use of antihistamines, tricyclic antidepressants, antipsychotics of the phenothiazine derivative group, disopyramide.

Enhances the effect of narcotic analgesics, antidepressants, antipsychotic drugs, antipsychotics, antiparkinsonian and M-anticholinergic drugs.

Overdose

In case of an overdose, the stomach must be emptied by aspiration and washing.it is necessary to apply a laxative saline solution to improve peristalsis. physostigmine salicylate (1–2 mg) must be administered IM, IV or SC to control the effect of anticholinergics on the central nervous system and peripheral nervous system.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C.

Tags: Riabal