1 ampoule (5 ml) of solution for injection contains l-carnitine 1 g
1 ml of solution for injection contains l-carnitine 200 mg
other ingredients:diluted hydrochloric acid, water for injections.The
Solution for injection.
basic physico-chemical properties: transparent colorless liquid.The
amino Acids and their derivatives. Levocarnitine.
ATX a16a A01 Code.The
l-carnitine is present as a natural component in animal tissues, microorganisms and plants. In humans, physiological needs for carnitine are replenished by the consumption of foods containing carnitine (primarily meat products), and by endogenous synthesis in the liver with trimethyllysine. Only the L-isomer is biologically active. L-carnitine plays an important role in fat metabolism and in the metabolism of ketone bodies. l-carnitine is required for transporting long chain fatty acids into the mitochondria for further beta-oxidation. Releasing coenzyme-a from complex thioethers, l-carnitine also enhances carbohydrate oxidation in the tricarboxylic acid cycle of Krebs, stimulates the activity of key enzyme of glycolysis - pyruvate dehydrogenase and in skeletal muscle oxidation of branched chain amino acids. Thus, the l-carnitine directly or indirectly involved in most energy processes, its presence is necessary for oxidation of fatty acids, amino acids, carbohydrates and ketone bodies.
the Largest concentration is determined by the l-carnitine in muscle, myocardium and liver. L-carnitine plays an important role in cardiac metabolism, since fatty acid oxidation is dependent on a sufficient quantity of this substance. Experimental studies have shown that under certain conditions, such as stress, acute ischemia, myocarditis, etc., it is possible to reduce the level of levocarnitine in myocardial tissue. Many animal studies have confirmed the positive impact of the l-carnitine in induced cardiac disorders, such as acute and chronic ischemia, decompensation of heart failure as a result of myocarditis, drug-induced cardiotoxicity (taxanes, adriamycin, etc.).
Levocarnitine is absorbed by the cells of the small intestine mucosa and enters the blood stream relatively slowly; probably, the absorption is associated with the active transluminal mechanism. Suction after intake is limited (<10%) and volatile.
absorbed levocarnitine is transported to various organs through the bloodstream; it is believed that the transport system of red blood cells is involved in the transport process.
l-carnitine is excreted mainly in the urine. The withdrawal rate is directly proportional to the concentration of carnitine in the blood.
l-carnitine is practically not metabolized in the body.
Primary and secondary carnitine insufficiency in adults and children, including Newborns and infants.
Secondary carnitine insufficiency in patients undergoing hemodialysis.
Secondary carnitine insufficiency should be suspected in patients who undergo hemodialysis in the following cases:The
hypersensitivity to the components of the drug.The
Simultaneous use of glucocorticoids leads to the accumulation of levocarnitine in the tissues of the body (except the liver). Other anabolic agents enhance the effect of the drug.
l-carnitine improves glucose metabolism, therefore, the use Meticorten patients with diabetes mellitus receiving treatment with antidiabetic drugs can cause hypoglycemia. The level of glucose in the blood plasma in such cases should be regularly monitored for timely correction therapy.
use during pregnancy or lactation.
Teratogenic effects in preclinical studies of the drug have not been identified. When applying the most studied dose of 600 mg/kg of body weight in animals, there was a statistically insignificant increase in the frequency of post-implantation fetal death in the early stages of pregnancy. The significance of these results is unknown to humans.
Considering the consequences of the failure carnitine for pregnant women, termination of treatment with Metkatinon mother seems a greater risk than the theoretical risk to the fetus in case of continued treatment.
Levocarnitine is a common component of human breast milk.
Ability to influence the reaction rate when driving motor transport or operating other mechanisms.
the Drug is administered intravenously slowly for 2-3 minutes.
use in congenital metabolic disorders.
during therapy it is advisable to monitor the level of carnitine and acyl carnitine in both blood plasma and urine.
the required dose depends on the specifics of congenital metabolic disorders and the severity of manifestations of the disease.
in case of acute decompensation, the recommended dose may be up to 100 mg/kg per day in 3-4 injections. If necessary, you can apply higher doses, although this may increase the side effects, in particular diarrhea.
Secondary carnitine deficiency in hemodialysis patients.
Before starting therapy with Metkatinon it is advisable to check the level of carnitine in the blood plasma.
Secondary carnitine deficiency is diagnosed when the ratio of acyl carnitine to free carnitine in blood plasma is greater than 0.4 and/or when the concentration of free carnitine is less than 20 µmol/L.
a Dose of 2 g should be administered intravenously jet at the end of each dialysis session. The overall response should be assessed by monitoring the levels of acyl carnitine and free carnitine in the blood plasma and the patient's condition. Normalization of carnitine content in muscle tissue and cardiomyocytes occurs approximately 3 months after reaching the normal concentration of carnitine in blood plasma. If the introduction of carnitine to stop his level will start to decrease again. The need for re-saturating the course of treatment is determined by quantifying carnitine in blood plasma at regular intervals and after the patient.
Hemodialysis - supportive therapy.
after saturating the course of levocarnitine used maintenance dose - 1 g of the drug per day orally. On the day of dialysis Meticorten applied intravenously at a dose of 1 g immediately after the completion of the next session.
the Drug is used for children from the first day of life, including premature.
reports of toxicity to l-carnitine overdose was not. High doses can cause diarrhea. Levocarnitine is easily removed from blood plasma by dialysis.
Treatment:take measures to remove the drug from the digestive tract when administered, perform symptomatic and supportive therapy. There were no reported cases of overdose that threatened lives.
Moderate gastrointestinal disorders were observed with a long reception of oral levocarnitine, including fleeting nausea and vomiting, abdominal pain and diarrhea. Dose reduction often reduces or eliminates gastrointestinal symptoms. It is necessary to carefully monitor tolerance during the first week of administration and after any increase in the dose. Intravenous application Meticorten generally well tolerated.The
Store at a temperature not exceeding 25 ° C out of reach of children.The
do not mix with other drugs.The
5 ml in a glass ampoule of brown color 5 ampoules in a contour cell package; 1 or 2 contour packages in a cardboard box.The
According to the recipe.The
Mear ILAC San. A. Sh./Mefar Ilac San. AS
Ramazanoglu MAh. Ansar JUD. № 20 34906 jacket-Besiktas/Istanbul, Turkey/Ramazanoglu Mah. Ensar Cad. No. 34906 20 Kurtkoy - Pendik/Istanbul, Turkey.The
WORLD Medicine ILAC SAN. VE TJ. A. S., Turkey/Istanbul, Turkey ILАС SAN. VE TIC. AS, Turkey.
Mezim Forte 10000 tablets No. 20 is a medicinal product, the effect of which is to fill the deficiency of enzymes of the pancreas. Pancreatin powder improves the digestive process, the proper assimilation of nutrients from food. Included in the trypsin and lipase have sufficient enzyme activity to suppress activated pancreatic secretion glands while providing an analgesic effect.
zantac used for effective prevention and therapy in the following cases:
Pathological changes in the external secretory functionality of the pancreas. The
Mezim Forte 10000 is prescribed in the rate of 1-2 tablets for better absorption of hard-to-digest or fatty foods. In disorders of the digestive process recommended dose means increased to 4 tablets at each meal.
the Use of drugs is strictly limited for kids up to 3 years. Children under 12 years of age and older treatment regimen is prescribed exclusively by the therapist, taking into account the weight of the child.