DRUGS & SUPPLEMENTS
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Pralam is an anxiolytic drug, a derivative of triazolo-benzodiazepine. This medication has anxiolytic, sedative, hypnotic, anticonvulsant, central muscle relaxant effect. The mechanism of action is to enhance the inhibitory effect of endogenous GABA in the CNS by increasing the sensitivity of the GABA-receptor mediator as a result of stimulation of benzodiazepine receptors located in the allosteric center of postsynaptic GABA-receptor activating ascending reticular formation of brain stem neurons and the lateral horns of the spinal cord; reduces the excitability of the subcortical brain structures (the limbic system, thalamus, hypothalamus), inhibits the polysynaptic spinal reflexes.
Pronounced anxiolytic activity (reduction of emotional tension, easing anxiety, fear, anxiety) is combined with moderate soporific effect; it shortens the period of sleep, increases sleep duration and reduces the number of nighttime awakenings. The mechanism of hypnotic action is inhibition of cell reticular formation of the brain.
After oral administration Pralam is rapidly and completely absorbed from the gastrointestinal tract. Cmax plasma levels achieved within 1-2 hours. Binding to plasma proteins is 80%. This drud metabolized in the liver. T1/2 is an average of 12-15 hours. Pralam and its metabolites are mainly excreted by kidneys.
Individual. It is recommended to use the minimum effective dose of Pralam Aurobindo. The dose is corrected in the treatment process depending on the achieved effect and tolerability. If necessary, increase the dose should be increased gradually, first in the evening and then in the daytime reception.
The initial dose of Pralam is 250-500 mcg 3 times / day, if necessary, it gradually increases to 4.5 mg / day.
For elderly or debilitated patients the initial dose is 250 mcg 2-3 / day, maintenance doses - 500-750 mcg / day, if necessary, taking into account the tolerance dose can be increased.
Cancellation or reduction of the dose of Pralam should be done gradually by reducing the daily dose of no more than 500 mcg every 3 days; sometimes can needed even more slowly cancelling.
CNS: at the beginning of treatment drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, unsteady gait, slowing of mental and motor responses; rare - headache, euphoria, depression, tremors, memory loss, impaired coordination of movements, depressed mood, confusion, extrapyramidal dystonic reactions (involuntary movements, including for eyes), weakness, myasthenia gravis, dysarthria; in some cases - paradoxical reactions (aggressive flare, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasms, hallucinations, agitation, irritability, anxiety, insomnia).
Digestive system: possible dry mouth or excessive salivation, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea, abnormal liver function, elevated liver transaminases and alkaline phosphatase, jaundice.
Hematopoietic system: possible leukopenia, neutropenia, agranulocytosis (chills, pyrexia, sore throat, extreme tiredness or weakness), anemia, thrombocytopenia.
Urinary tract: possible urinary incontinence, urinary retention, renal failure, decreased or increased libido, dysmenorrhea.
Endocrine system: possible change in body weight, disturbances in libido, menstrual irregularities.
Cardiovascular system: possible decrease in blood pressure, tachycardia.
Allergic reactions: possible skin rash, itching.
Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute alcohol poisoning (with the weakening of the vital functions), narcotic analgesics, hypnotics and psychotropic drugs, chronic obstructive airways disease with incipient respiratory failure, acute respiratory failure, severe depression (suicidal tendencies may occur), pregnancy (especially the I trimester), lactation, childhood and adolescence to 18 years, increased sensitivity to benzodiazepines.
Pralam has a toxic effect on the fetus and increases the risk of birth defects when used in the I trimester of pregnancy. The constant use during pregnancy can cause physical dependence with the development of withdrawal syndrome in the newborn. Reception at therapeutic doses in the later stages of pregnancy can cause neonatal CNS depression. Using of Pralam immediately before birth or during labor can cause neonatal respiratory depression, decreased muscle tone, hypotension, hypothermia and a weak act of sucking.
It is possible to excretion of the benzodiazepines in breast milk that can cause drowsiness in the newborn and hinder feeding.
In experimental studies have been shown that Pralam and its metabolites are excreted in breast milk.
Keep in mind that anxiety or conditions related to everyday stress usually does not require treatment with anxiolytics.
If you experience paradoxical reactions then stop taking the drug. During the period of treatment is unacceptable to use of alcoholic drinks. With caution use Pralam for drivers of vehicles and people whose profession is associated with increased concentration.
The simultaneous use of Pralam with psychotropic, anticonvulsant medications and ethanol is observed enhancement inhibitory action Pralam on the CNS.
The simultaneous use with blockers of histamine H2-receptor reduce the clearance of Pralam and increase the inhibitory effect of Pralam on the CNS; macrolide antibiotics reduce the clearance of Pralam.
The simultaneous use with hormonal oral contraceptives increased T1/2 of Pralam.
Simultaneous administration of Pralam with dextropropoxyphene observed a more pronounced CNS depression than in combination with other benzodiazepines, as may increase the concentration of Pralam in blood plasma.
Simultaneous treatment with digoxin increases the risk of intoxication by cardiac glycosides.
Pralam increases the concentration of imipramine in plasma.
Simultaneous administration with itraconazole, ketoconazole increases the effects of Pralam.
Simultaneous administration with paroxetine may increases the effects of Pralam due to the inhibition of its metabolism.
Fluvoxamine increases the concentration of Pralam in plasma and risk of its side effects.
Simultaneous administration of Pralam with fluoxetine may increase the concentration of Pralam in plasma by decreasing its metabolism and clearance under the influence of fluoxetine which is accompanied by psychomotor disorders.
It can not be exclude the possibility of strengthening effect of Pralam for simultaneous administration with erythromycin.
Symptoms: Varying degrees of CNS oppression (from sleepiness to coma) - drowsiness, confusion; in more severe cases (especially in patients receiving other drugs depressing the central nervous system or alcohol) - ataxia, decreased reflexes, hypotension, coma.
Treatment: induction of vomiting, gastric lavage, symptomatic therapy, monitor vital signs. In severe hypotension prescribed an injection of norepinephrine. Specific antidote is benzodiazepine receptor antagonist flumazenil (administration only in a hospital).
Depending on the reaction of the Pralam after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Pralam 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 Pralam 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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The information was verified by Dr. Rachana Salvi, MD Pharmacology