Numencial

Rating: 5 - 1 review(s)
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Numencial uses

Numencial consists of Diazepam, Sulpiride.

Diazepam:


Pharmacological action

Numencial is a benzodiazepine derivative tranquilizer. It provides anxiolytic, sedative, anticonvulsant, central muscle relaxant effect. The mechanism of action is associated with increased inhibitory effect of GABA in the CNS. Muscle relaxant effect is also due to the inhibition of spinal reflexes. This medication may cause anticholinergic effects.

Pharmacokinetics

Numencial (Diazepam) has rapid absorption. Cmax in plasma observed after 90 min. Plasma protein binding is 98%. Numencial (Diazepam) crosses the placental barrier into the cerebrospinal fluid; excreted in breast milk; metabolized in the liver; excreted by the kidneys - 70%.

Why is Numencial prescribed?

  • neuroses, borderline states with symptoms of stress, restlessness, anxiety, fear
  • sleep disturbance, motor stimulation of various etiologies in neurology and psychiatry, withdrawal syndrome in chronic alcoholism
  • spastic conditions associated with lesions of the brain or spinal cord, and myositis, bursitis, arthritis, accompanied by a voltage of skeletal muscle
  • status epilepticus
  • premedication before anesthesia as a component of combined anesthesia
  • relief labor, premature birth, abruptio placenta, tetanus

    Dosage and administration

    Numencial prescribed for oral, IV, IM, rectal use. The daily dose of Numencial (Diazepam) ranges from 0.5 mg to 60 mg. Single dose, frequency and duration of use are set individually.

    Numencial (Diazepam) side effects, adverse reactions

    CNS: drowsiness, dizziness, muscle weakness; rare - confusion, depression, blurred vision, diplopia, dysarthria, headache, tremor, ataxia; in single cases - a paradoxical response: excitement, anxiety, sleep disturbances, hallucinations. After IV injection is sometimes seen a hiccup. With prolonged use may develop drug dependence, memory impairment.

    Digestive system: rarely - constipation, nausea, dry mouth, excessive salivation; in single cases - raising the level of transaminases and alkaline phosphatase in blood plasma, jaundice.

    Endocrine system: rarely - increased or decreased libido.

    Urinary system: rare - incontinence.

    Cardiovascular system: when administered parenteral may be some fall in blood pressure.

    Respiratory system: when administered parenteral in single cases - respiratory disorders.

    Allergic reactions: rarely - a skin rash.

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    Contraindications

    Myasthenia gravis, severe chronic hypercapnia. Specifying a history of alcohol or drug dependence. Hypersensitivity to Numencial (Diazepam) and other benzodiazepines.

    Numencial (Diazepam) using during pregnancy and breastfeeding

    Numencial (Diazepam) should not be used in the I trimester of pregnancy, except in cases of extreme necessity. Numencial (Diazepam) taking during pregnancy may significantly change fetal heart rate.

    When used in obstetrics doses recommended to facilitate childbirth, newborns (most preterm) it is possible temporary muscular hypotonia, hypothermia, respiratory failure.

    When taken regularly during lactation breastfeeding should be discontinued.

    Should avoid the use of Numencial (Diazepam) in newborn infants, since they have not yet fully formed enzyme system involved in the metabolism of Numencial (Diazepam).

    Special instructions

    Numencial with caution used in patients with cardiac and respiratory failure, organic changes in the brain (in such cases are advised to avoid parenteral administration of Numencial (Diazepam)), with angle-closure glaucoma and predisposition to it, in myasthenia.

    There are needed special care when using Numencial (Diazepam) (especially at the beginning of treatment) for patients receiving long-term antihypertensive medications of central action, beta-blockers, anticoagulants, cardiac glycosides.

    If you cancel the therapy dose should be reduced gradually. With the sudden cancellation of Numencial (Diazepam) after prolonged use may concern, excitement, tremors, convulsions. This medicine should be abolished in the development of paradoxical reactions (acute agitation, anxiety, sleep disturbances and hallucinations).

    After I.M. injection of Numencial (Diazepam) may increase the activity of CK in the blood plasma (which should be considered in the differential diagnosis of myocardial infarction).

    Avoid IA injection.

    Avoid alcohol during the period of treatment.

    Numencial (Diazepam) can cause slowing of psychomotor responses that should be considered for patients involved in potentially danger activities.

    Numencial (Diazepam) drug interactions

    When used Numencial (Diazepam) with drugs providing a depressing effect on the CNS (including with antipsychotics, sedatives, hypnotics, opioid analgesics, drugs for anesthesia), enhanced inhibitory effect on the central nervous system, the respiratory center, pronounced arterial hypotension.

    When used Numencial (Diazepam) with the tricyclic antidepressants (including amitriptyline) may be increasing of the CNS depressant effect, increasing concentrations of antidepressants and increased cholinergic action.

    Patients receiving long-term antihypertensive medications central action, beta-blockers, anticoagulants, cardiac glycosides, the extent and mechanisms of drug interactions are unpredictable.

    Simultaneous administration with muscle relaxants the action of muscle relaxants increases, also increases the risk of apnea.

    Co-administration with oral contraceptives may increase the effects of Numencial (Diazepam). The risk of breakthrough bleeding increases.

    Simultaneous administration with bupivacaine may increase the concentration of bupivacaine in blood plasma; with diclofenac - may increase dizziness; with isoniazid - a decrease of Numencial (Diazepam) elimination from the body.

    Drugs that cause induction of liver enzymes, including antiepileptic drugs (carbamazepine, phenytoin) may accelerate the elimination of Numencial (Diazepam).

    When this medicine used with caffeine decreases sedative and possibly anxiolytic action of Numencial (Diazepam).

    Simultaneous administration with with clozapine may be expressed as hypotension, respiratory depression, loss of consciousness; with levodopa - may suppress antiparkinsonian action; with lithium carbonate - described a case of coma, with metoprolol - possible decreased visual acuity, impairment of psychomotor reactions.

    Simultaneous administration with paracetamol may decrease excretion of Numencial (Diazepam) and its metabolite desmethyldiazepam; with risperidone - described the cases of NMS.

    Co-administration with rifampicin increased excretion of Numencial (Diazepam) is due to a significant increase in its metabolism under the influence of rifampicin.

    Theophylline at low doses changes a sedative effect of Numencial (Diazepam).

    In rare cases Numencial (Diazepam) inhibits the metabolism and increases the effect of phenytoin. Phenobarbital and phenytoin may accelerate the metabolism of Numencial (Diazepam).

    Fluvoxamine increases plasma concentrations and side effects of Numencial (Diazepam).

    Cimetidine, omeprazole, disulfiram may increase the intensity and duration of action of Numencial (Diazepam).

    Alcohol and alcohol containing drugs enhanced inhibitory effect on the central nervous system (mainly on the respiratory center) but can also occur syndrome of pathological intoxication.

    Numencial in case of emergency / overdose

    Symptoms: CNS depression of varying severity (from lethargy to coma): severe drowsiness, lethargy, weakness, decreased muscle tone, ataxia, prolonged confusion, depression of reflexes, coma; perhaps hypotension, respiratory depression.

    Treatment: induction of vomiting and the appointment of activated charcoal (if the patient is conscious), gastric lavage through a tube (if patient is unconscious), symptomatic therapy, monitor vital functions, liquids' intravenous injection (to increase urine output), if necessary - artificial ventilation. With the development of excitation barbiturates should not be used. In hospital conditions used a benzodiazepine receptor antagonist flumazenil as specific antidote. Hemodialysis is ineffective.

  • Sulpiride:


    A dopamine D2-receptor antagonist. It has been used therapeutically as an antidepressant, antipsychotic, and as a digestive aid. (From Merck Index, 11th ed)

    Indication: Numencial (Sulpiride) is indicated for the treatment of schizophrenia.

    Numencial (Sulpiride) is a substituted benzamide derivative and a selective dopamine D2 antagonist with antipsychotic and antidepressant activity. Other benzamide derivatives include metoclopramide, tiapride, and sultopride.

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    Numencial pharmaceutical active ingredients containing related brand and generic drugs:

    Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


    Numencial available forms, composition, doses:

    Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
    Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
    Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


    Numencial destination | category:

    Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
    Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


    Numencial Anatomical Therapeutic Chemical codes:

    A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


    Numencial pharmaceutical companies:

    Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
    Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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    References

    1. Dailymed."DIAZEPAM INJECTION, SOLUTION [HOSPIRA, INC.]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
    2. Dailymed."DIAZEPAM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
    3. "sulpiride". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).

    Frequently asked Questions

    Can i drive or operate heavy machine after consuming Numencial?

    Depending on the reaction of the Numencial after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Numencial not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

    Is Numencial addictive or habit forming?

    Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

    Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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    Review

    sdrugs.com conducted a study on Numencial, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Numencial consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

    Visitor reports

    One visitor reported useful

    How is the drug Numencial useful in reducing or relieving the symptoms? How useful is it?
    According to the survey conducted by the website sdrugs.com, there are variable results and below are the percentages of the users that say the medicine is useful to them and that say it is not helping them much. It is not ideal to continue taking the medication if you feel it is not helping you much. Contact your healthcare provider to check if there is a need to change the medicine or if there is a need to re-evaluate your condition. The usefulness of the medicine may vary from patient to patient, depending on the other diseases he is suffering from and slightly depends on the brand name.
    Visitors%
    Useful1
    100.0%

    Visitor reported side effects

    No survey data has been collected yet

    Visitor reported price estimates

    No survey data has been collected yet

    Three visitors reported frequency of use

    How often in a day do you take the medicine?
    Are you taking the Numencial drug as prescribed by the doctor?

    Few medications can be taken Once in a day more than prescribed when the doctor's advice mentions the medicine can be taken according to frequency or severity of symptoms. Most times, be very careful and clear about the number of times you are taking the medication. The report of sdrugs.com website users about the frequency of taking the drug Numencial is mentioned below.
    Visitors%
    Once in a day3
    100.0%

    Fifteen visitors reported doses

    What is the dose of Numencial drug you are taking?
    According to the survey conducted among sdrugs.com website users, the maximum number of people are using the following dose 11-50mg. Few medications come in only one or two doses. Few are specific for adult dose and child dose. The dose of the medicine given to the patient depends on the severity of the symptom/disease. There can be dose adjustments made by the doctor, based on the progression of the disease. Follow-up is important.
    Visitors%
    11-50mg9
    60.0%
    1-5mg4
    26.7%
    201-500mg1
    6.7%
    51-100mg1
    6.7%

    Four visitors reported time for results

    What is the time duration Numencial drug must be taken for it to be effective or for it to reduce the symptoms?
    Most chronic conditions need at least some time so the dose and the drug action gets adjusted to the body to get the desired effect. The stastistics say sdrugs.com website users needed 1 week to notice the result from using Numencial drug. The time needed to show improvement in health condition after using the medicine Numencial need not be same for all the users. It varies based on other factors.
    Visitors%
    1 week1
    25.0%
    2 days1
    25.0%
    3 days1
    25.0%
    > 3 month1
    25.0%

    One visitor reported administration

    The drugs are administered in various routes, like oral or injection form. They are administered before food or after food. How are you taking Numencial drug, before food or after food?
    Click here to find out how other users of our website are taking it. For any doubts or queries on how and when the medicine is administered, contact your health care provider immediately.
    Visitors%
    Empty stomach1
    100.0%

    Four visitors reported age

    Visitors%
    > 602
    50.0%
    30-451
    25.0%
    16-291
    25.0%

    Visitor reviews


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    The information was verified by Dr. Rachana Salvi, MD Pharmacology

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