DRUGS & SUPPLEMENTS
When are you taking this medicine?
Sunzepan 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.
Sunzepan has rapid absorption. Cmax in plasma observed after 90 min. Plasma protein binding is 98%. Sunzepan crosses the placental barrier into the cerebrospinal fluid; excreted in breast milk; metabolized in the liver; excreted by the kidneys - 70%.
Sunzepan prescribed for oral, IV, IM, rectal use. The daily dose of Sunzepan ranges from 0.5 mg to 60 mg. Single dose, frequency and duration of use are set individually.
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.
Myasthenia gravis, severe chronic hypercapnia. Specifying a history of alcohol or drug dependence. Hypersensitivity to Sunzepan and other benzodiazepines.
Sunzepan should not be used in the I trimester of pregnancy, except in cases of extreme necessity. Sunzepan 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 Sunzepan in newborn infants, since they have not yet fully formed enzyme system involved in the metabolism of Sunzepan.
Sunzepan with caution used in patients with cardiac and respiratory failure, organic changes in the brain, with angle-closure glaucoma and predisposition to it, in myasthenia.
There are needed special care when using Sunzepan (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 Sunzepan 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 Sunzepan 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.
Sunzepan can cause slowing of psychomotor responses that should be considered for patients involved in potentially danger activities.
When used Sunzepan 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 Sunzepan 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 Sunzepan. 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 Sunzepan elimination from the body.
Drugs that cause induction of liver enzymes, including antiepileptic drugs (carbamazepine, phenytoin) may accelerate the elimination of Sunzepan.
When this medicine used with caffeine decreases sedative and possibly anxiolytic action of Sunzepan.
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 Sunzepan and its metabolite desmethyldiazepam; with risperidone - described the cases of NMS.
Co-administration with rifampicin increased excretion of Sunzepan is due to a significant increase in its metabolism under the influence of rifampicin.
Theophylline at low doses changes a sedative effect of Sunzepan.
In rare cases Sunzepan inhibits the metabolism and increases the effect of phenytoin. Phenobarbital and phenytoin may accelerate the metabolism of Sunzepan.
Fluvoxamine increases plasma concentrations and side effects of Sunzepan.
Cimetidine, omeprazole, disulfiram may increase the intensity and duration of action of Sunzepan.
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.
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.
Depending on the reaction of the Sunzepan after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Sunzepan 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 Sunzepan 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