Kalimin 60 N is a cholinesterase inhibitor that has a cholinomimetic effect, improves neuromuscular transmission and secretion of exocrine glands, increases GI motility, increases the tone of the bladder and bronchi, causes bradycardia, weak miosis and accommodation spasm. No central action.
Release form and composition
Kalimin is available in the form of tablets (100 each in dark glass bottles, 1 bottle in a carton box).
The active ingredient of the drug is pyridostigmine bromide (60 mg / 1 tab.).
Auxiliary components: purified water, corn starch, microcrystalline cellulose, glutamic acid hydrochloride, colloidal silicon dioxide, polyvidone K25, magnesium stearate.
Indications for use
Kalimin 60 N is intended for the treatment of myasthenia (myasthenia gravis).
Contraindications
- Bronchial asthma;
- Chronic obstructive bronchitis;
- Myotonia;
- Spastic states of the digestive tract;
- Mechanical intestinal obstruction;
- Obstruction of the urinary and biliary tract;
- Shock in the postoperative period;
- Iritis;
- Pregnancy;
- Lactation;
- Age up to 18 years;
- The previous use of depolarizing muscle relaxants (suxamethonia or decamethonia);
- Hypersensitivity to the drug.
The following diseases and conditions require caution in the use of Kalimin and constant patient monitoring:
- Renal / hepatic impairment;
- Acute myocardial infarction;
- Heart failure in the decompensation stage;
- Hypotension;
- Bradycardia;
- Diabetes;
- Gallstone and urolithiasis without obstruction;
- Stomach ulcer;
- States after operations on the gastrointestinal tract;
- Parkinsonism;
- Hyperthyroidism.
Dosing and Administration
Kalimin 60 N is taken orally with water.
The dose is determined individually for each patient, taking into account the severity of the course of the disease and the response to treatment.
Approximate doses:
- With the initial symptoms of the disease - 1 / 2-1 tablet 1 or 2 times a day;
- With the progression of the disease - 1-3 tablets 2-4 times a day.
The maximum allowable daily intake for adults is 12 tablets.
A dose reduction is required in patients with kidney disease.
Side effects
Possible side effects of the drug: allergic reactions, cramping abdominal pain (due to increased intestinal motility), nausea, vomiting, diarrhea, increased secretion of bronchial glands, increased sweating, tears and drooling, spasms of skeletal muscles, muscle tremor, muscle weakness, frequent urges on urination, accommodation disorder.
When you receive Kalimin in high doses, there is a risk of developing bradycardia and lowering blood pressure.
In rare cases, rash appears on the skin.
Overdose symptoms: skin hyperemia, blurred vision, miosis, severe weakness, dizziness, increased secretion of sweat, lacrimal and salivary glands, nausea, vomiting, intestinal colic, involuntary defecation and / or urination, increasing or severe muscle weakness, bronchospasm, pulmonary excretion, and / or urination; lowering blood pressure, bradycardia, collapse, paralysis of the respiratory muscles, paradoxical tachycardia. Possible cardiac arrest.
First aid for overdose involves washing the stomach, taking activated charcoal and / or other enterosorbents. The specific antidote of pyridostigmine bromide is atropine - it is slowly injected intravenously in a dose of 1-2 mg. Taking into account the pulse rate, if necessary, after 2-4 hours, make a repeated injection in the same dose. Patients need to control water and electrolyte balance. Heart and respiratory monitoring is required. In case of pulmonary insufficiency or cardiac arrest, appropriate resuscitation measures are taken.
special instructions
During the treatment with Kalimino:
- It is strictly forbidden to consume alcoholic beverages;
- It is recommended to be careful when driving a car and performing potentially dangerous activities that require increased attention and speed of psychomotor reactions.
In the case of skipping the next dose to take a double dose should not be.
Drug interaction
Atropine is a specific antidote of pyridostigmine bromide - it weakens its m-cholinomimetic action (bradycardia and hypersecretion), but does not reduce the effect of the drug on skeletal muscle.
Kalimin is not compatible with ethanol.
Pyridostigmine bromide enhances the action of barbiturates, morphine and its derivatives, depolarizing muscle relaxants.
Anti-Parkinsonian and antiepileptic drugs, tricyclic antidepressants, local anesthetics, ganglioblokatory, m-anticholinergic blockers, as well as procainamide and quinidine reduce the effectiveness of the drug.
Terms and conditions of storage
Keep out of reach of children at temperature up to 25 ºС.
Shelf life - 3 years, after opening the bottle - 6 months.