通用中文 | 琥珀酸普芦卡必利片 | 通用外文 | Prucalopride |
品牌中文 | 力洛 | 品牌外文 | Resolor |
其他名称 | 普卡必利片 | ||
公司 | 强生(Johnson) | 产地 | 意大利(Italy) |
含量 | 1mg | 包装 | 28片/盒 |
剂型给药 | 储存 | 室温 | |
适用范围 | 便秘 |
通用中文 | 琥珀酸普芦卡必利片 |
通用外文 | Prucalopride |
品牌中文 | 力洛 |
品牌外文 | Resolor |
其他名称 | 普卡必利片 |
公司 | 强生(Johnson) |
产地 | 意大利(Italy) |
含量 | 1mg |
包装 | 28片/盒 |
剂型给药 | |
储存 | 室温 |
适用范围 | 便秘 |
通用名称:琥珀酸普芦卡必利片
商品名称:琥珀酸普芦卡必利片(力洛)
英文名称:Prucalopride Succinate Tablets
【主要成份】 琥珀酸普芦卡必利。
【成份】
化学名:4-氨基-5-氯-2,3-二氢-N-[1-(3-甲氧基丙基)-4-哌啶基]-7-苯并呋喃甲酰胺丁二酸盐
分子式:C18H26ClN3O3·C4H6O4
分子量:485.96
【性状】 本品为薄膜衣片,除去包以后显白色或类白色。
【适应症/功能主治】用于治疗成年女性患者中通过轻泻剂难以充分缓解的慢性便秘症状。
【规格型号】2mg*7s
【用法用量】 用法:口服。可在一天中任何时间服用,餐前餐后均可。成人:每日1次,每次2mg。 老年患者(>65岁):起始剂量为每日1次,每次1 mg,如有需要,可增加至每日1次,每次2mg。 儿童及青少年:不建议儿童及小于18岁的青少年使用本品。 肾功能障碍患者:严重肾功能障碍患者(GFR<30 mL/min/1.73 m2)的剂量为每日1次,每次1mg。轻到中度肾功能障碍患者无需调整剂量。 肝功能障碍患者:严重肝功能障碍患者(Child-PughC级)的剂量为每日1次,每次1mg。轻到中度肝功能障碍患者无需调整剂量。 考虑到本品促动力的特有作用机制,其每日剂量超过2mg时,可能不会增加疗效。 如本品治疗4周后无效,应该对患者进行重新评估,并重新考虑继续治疗是否有益。 本品在长达3个月的双盲安慰剂对照研究中证明具有良好疗效。若延长疗程,应定期评估患者是否获益。
【不良反应】 1.营养及代谢疾病:少见食欲减退。 2.神经系统疾病:很常见头痛;常见头晕;少见震颤。 3.心血管疾病:少见心悸。 4.胃肠道疾病:很常见恶心、腹泻、腹痛;常见呕吐、消化不良、直肠出血、胃肠胀气、肠鸣音异常。 5.肾脏及泌尿系统疾病:常见尿频。 6.全身及给药部位情况:常见疲劳;少见发热、全身乏力。详见内包装说明书。
【禁忌】 1、对本品活性成分或任何辅料过敏的患者。 2、肾功能障碍需要透析的患者。 3、由于肠壁结构性或功能性异常引起的肠穿孔或梗阻、闭塞性肠梗阻、严重肠道炎性疾病,如克罗恩氏病、溃疡性结肠炎和中毒性巨结肠/巨直肠的患者。 4、近期接受过肠部手术的患者。
【注意事项】 1、使用本品治疗之前,需要彻底了解患者病史及检查情况,以排除继发性原因导致的便秘,并确定患者在至少6个月时间内使用轻泻剂而无法达到充分缓解。 2、虽然轻泻剂在关键性临床试验中被用作临时急救缓解性用药,但尚未评估本品联合轻泻剂的安全性和有效性。 3、本品的有效性和安全性仅在慢性功能性便秘治疗中得到证明。尚未评估本品用于存在继发原因的便秘患者中的有效性和安全性,包括内分泌疾病、代谢性疾病和神经性疾病引起的便秘,因此不建议这些患者使用本品。尚未证实本品对药物相关性便秘的有效性和安全性,其中包括由于阿片类药物导致的继发原因的便秘,因此不建议此类患者使用本品。 4、肾脏排泄是本品清除的主要途径。建议严重肾功能障碍患者的给药剂量降为1 mg。 5、未对本品在患有严重及临床不稳定的伴随疾病的患者(如肝脏、心血管或肺脏疾病、神经或精神疾病、癌症或AIDS及其他内分泌疾病)进行研究。6、当向这些患者处方本品时,应该谨慎。应特别慎用于有心律失常或缺血性心血管病病史的患者。 7、如果患者用药期间出现心悸,应予以适当处理。 8、使用本品时,如发生严重腹泻,口服避孕药的效果可能会降低,建议采取其它避孕方法,以预防可能发生的口服避孕失败。 9、肝功能障碍不太可能对本品的代谢及暴露量产生有临床意义的影响。尚无轻、中或重度肝功能障碍患者的临床数据,因此建议严重肝功能障碍患者的给药剂量降为1 mg。 10、片剂中含乳糖一水合物。患有半乳糖不耐受、Lapp乳糖酶缺乏或葡萄糖-半乳糖吸收不良等罕见遗传性疾病的患者,不得服用本品。 11、正在服用已知可引起QTc延长的药物治疗的患者应慎用本品。 12、尚未进行本品对驾驶及操控机器能力影响的研究。使用本品,特别是在用药第1天,可引起头晕和疲乏,可能对驾驶及操控机器产生影响。
【儿童用药】目前该方面的临床数据较少,因此不建议儿童及小于18岁的青少年使用本品。
【老年患者用药】大于65岁的老年患者起始剂量为1mg,如有需要,可增加至2mg。
【孕妇及哺乳期妇女用药】 1、妊娠期间使用本品的临床经验有限。尽管在临床研究中发现有自然流产的病例,但由于同时存在其它危险因素,尚不能确定本品与自然流产之间的相关性。动物研究中,未发现本品对妊娠、胚胎/胎儿发育、分娩及出生后发育有直接或间接的有害影响。不建议在妊娠期间使用本品。育龄女性在使用本品期间应采用有效的避孕方法。 2、普芦卡必利会在母乳中分泌。预计在治疗剂量下服用本品时,母乳喂养对新生儿/婴儿没有影响。但由于缺乏人体数据,不建议在哺乳期间使用本品。 3、动物研究显示本品对男性或女性生育力没有影响。
【药物相互作用】针对健康受试者的研究显示,本品对华法林、地高辛、乙醇及帕罗西汀的药代动力学没有临床意义的影响。
【药物过量】在一项针对健康志愿者的研究中,当以每日1次20 mg(推荐治疗剂量的10倍)的本品进行治疗时,对本品仍具有良好的耐受性。药物过量可能会导致由药品已知药效作用放大所致的症状,包括头痛、恶心和腹泻。本品药物过量时,无特异的治疗方法。如果发生药物过量,必要时患者应该接受对症治疗,或使用支持性的医疗措施。如有需要,可治疗由腹泻或呕吐引起的液体大量流失而导致的电解质紊乱。详见内包装说明书。
【药理毒理】普芦卡必利是一种二氢苯并呋喃甲酰胺类化合物,为选择性、高亲和力的五羟色胺(5-HT4)受体激动剂,具有促肠动力活性。体内外研究结果显示,普芦卡必利克通过5-HT4受体激活作用来增强胃肠道中蠕动反射盒推进运动模式。详见内包装说明书。
【药代动力学】尚不明确。
【贮藏】密封。
【包装】2mg*7s/盒。
【有效期】24 月
【批准文号】H20140058
【生产企业】美国(shire) 西尔
Resolor
Active Substance: prucalopride succinate
Common Name: prucalopride
ATC Code: A06AX05
Marketing Authorisation Holder: Shire Pharmaceuticals Ireland Ltd
Active Substance: prucalopride succinate
Status: Authorised
Authorisation Date: 2009-10-15
Therapeutic Area: Constipation
Pharmacotherapeutic Group: Other drugs for constipation
Therapeutic Indication
Resolor is indicated for symptomatic treatment of chronic constipation in adults in whom laxatives fail to provide adequate relief.
What is Resolor?
Resolor is a medicine that contains the active substance prucalopride. It is available as tablets (1 and 2 mg).
What is Resolor used for?
Resolor is used to treat symptoms of chronic (long-term) constipation in adults for whom laxatives (medicines that trigger bowel movements) do not work well enough.
The medicine can only be obtained with a prescription.
How is Resolor used?
The recommended dose of Resolor is 2 mg taken once a day. Patients aged over 65 years should start with a 1 mg dose once a day, and this can be increased to 2 mg once a day if needed.
How does Resolor work?
The active substance in Resolor, prucalopride, is a ‘5-HT4 receptor agonist’. This means that it works like a substance in the body called 5-hydroxytryptamine (5-HT, also known as serotonin) and attaches to receptors for 5-HT in the gut called ‘5-HT4 receptors’.
When 5-HT binds to these receptors, it normally stimulates movement in the gut. In the same way, when prucalopride attaches to and stimulates these receptors, it increases this movement and allows the bowels to empty faster.
How has Resolor been studied?
Resolor (2 or 4 mg once a day) was compared with placebo (a dummy treatment) in three main studies involving 1,999 patients with chronic constipation, 88% of whom were women. The patients had not responded well enough to previous treatment with laxatives.
Resolor 2 mg once a day was also compared with placebo in another main study involving 374 men with chronic constipation.
The main measure of effectiveness in the studies was the number of patients who completely emptied their bowels at least three times a week over a 12 week period without the help of laxatives.
What benefit has Resolor shown during the studies?
Resolor was more effective than placebo at treating chronic constipation. Over the 12-week period, 24% (151 out of 640) of patients who received Resolor 2 mg completely emptied their bowels at least three times a week, compared with 11% (73 out of 645) of patients who received placebo. The result from patients who received Resolor at the higher dose of 4 mg was similar to those who took the 2 mg dose.
In the study of men with chronic constipation, 38% of patients treated with Resolor 2 mg (67 out of 177) completely emptied their bowels at least three times a week, compared with 18% of those given placebo (32 out of 181).
What is the risk associated with Resolor?
The most common side effects with Resolor (seen in more than 1 patient in 10) are headache, nausea (feeling sick), diarrhoea and abdominal (tummy) pain. For the full list of all side effects reported with Resolor, see the package leaflet.
Resolor must not be used in patients with kidney problems requiring dialysis (a blood clearance technique). It must also not be used in patients with intestinal perforation or obstruction, severe inflammatory conditions of the intestines such as Crohn’s disease, ulcerative colitis (inflammation of the large intestine causing ulceration and bleeding) and toxic megacolon and megarectum (very serious complications of colitis). For the full list of restrictions, see the package leaflet.
Why has Resolor been approved?
The CHMP decided that Resolor’s benefits are greater than its risks and recommended that it be given marketing authorisation.
What measures are being taken to ensure the safe and effective use of Resolor?
A risk-management plan has been developed to ensure that Resolor is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Resolor, including the appropriate precautions to be followed by healthcare professionals and patients.
Other information about Resolor
The European Commission granted a marketing authorisation valid throughout the European Union for Resolor on 15 October 2009.
For more information about treatment with Resolor, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.