Yumeks - the preparation of
the group of anti-money inhibitors of monoamine oxidase type B. The active ingredient - selegiline. Involved in the metabolism of dopamine, other catecholamines. The drug shall inhibition of serotonin reuptake in the presynaptic dopamine receptors, increasing its concentration in both extrapyramidal nuclei and other parts of the brain.
Yumeks able to potentiate, prolong the effect of levodopa treatment in the case of Parkinson's disease.
Yumeks not used for the treatment of patients with extrapyramidal symptoms, is not accompanied by a deficit of dopamine (Huntington's disease, essential tremor).
When taken orally Yumeks quite intensively and rapidly absorbed. The maximum concentration is reached after 0, 5-2 hours. It binds to plasma proteins in an amount of 94%. Yumeks rapidly metabolized in the body. Major metabolites - L-amphetamine, L-methamphetamine, N-dizmetilselegilin. And the active substance and metabolites are able to penetrate the blood-brain barrier. The metabolites are excreted in the urine (about 73%), and through the intestines (about 15%).
According to the instructions Yumeksu, a drug indicated for the treatment of Parkinson's disease, symptomatic parkinsonism.
As monotherapy Yumeks can be used in the early stages of Parkinson's disease to delay application of levodopa (with a peripheral decarboxylase inhibitor purpose or not) can also be used together with levodopa (with or without PID).
The instructions to Yumeksu contain the following contraindications:
- Hypersensitivity to selegiline;
- Extrapyramidal pathology not related to dopamine deficiency (Huntington's disease, essential tremor);
- Pregnancy, lactation.
With extreme caution should be used when a Yumeks pathology:
- Peptic ulcer, duodenum;
- Labile blood pressure;
- Severe angina;
- Tardive dyskinesia;
- Krupnorazmashisty tremor;
- Prostatic hyperplasia;
- Angle-closure glaucoma.
In combination with levodopa Yumeks can not appoint:
- Open-angle glaucoma;
- Kidney, liver failure;
- CNS depression;
- Bronchial asthma;
- Myocardial infarction.
According to the instructions, Yumeks administered orally at a dose of 5-10 mg (monotherapy, and together with levodopa). Take once in the morning can be Yumeks. At a daily dose of 10 mg dose may be divided into two stages. When concomitant administration Yumeksa with levodopa, the dose of levodopa can be reduced by about 30%.
The drug Yumeks monotherapy is well tolerated.
The instructions to Yumeksu describes the following side effects:
- Allergic reaction: shortness of breath, rash, photosensitivity, bronchospasm;
- on the part of the intestine: dry mouth, nausea, constipation, diarrhea, loss of appetite, dysphagia;
- From the CCC: orthostatic hypotension, rarely - increased blood pressure, arrhythmias;
- CNS: mood changes, insomnia, vertigo, psychosis, dyskinesia;
- Other: elevated liver enzymes, urinary retention, nocturia, headache, double vision, impaired visual acuity, increased sweating, hair loss, hypoglycemia.
Since Yumeks able to potentiate the clinical effects of levodopa, the side effects of levodopa (hyperkinesia, agitation, abnormal movements, confusion, postural hypotension, arrhythmias, hallucinations) in combination therapy
Interaction with other drugs Yumeksa
Contraindicated combination Yumeksa with the following medications:
- Sympathomimetics: Risk of high blood pressure;
- Pethidine: non-selective MAO inhibitors and pethidine are incompatible. The mechanism of this interaction is unknown, but the use of Yumeksa, pethidine or other opioid analgesic is absolutely contraindicated;
- Serotonin reuptake inhibitors: Yumeks drug should not be taken with fluoxetine because of the risk of developing hypertension, agitation, convulsions, ataxia, hallucinations, manic psychosis. Fluoxetine should not be taken two weeks after the cancellation Yumeksa. Because of the long half-life of fluoxetine after its cancellation, and before applying Yumeksa must pass more than 5 weeks;
- Tricyclic antidepressants: describes the phenomenon of severe CNS toxicity (tremor, dizziness, seizures) accompanied by hypotension, hypertension, profuse sweating in patients who received this combination;
Not recommended Yumeks combined with MAO inhibitors (risk of severe hypotension).
Yumeks enhances the clinical effects of levodopa, CNS depressants, ethanol increases the incidence of side effects of amantadine.
Interaction with food
When monotherapy Yumeksom (unlike conventional treatment MAO inhibitors) to adhere to a special diet should not be. However, in combination therapy with inhibitors of MAO or MAO-A to avoid foods containing large amounts of tyramine: yeast products of ripe cheese.
In connection with the property of potentiating the effects of the drug levodopa, and enhance its side effects, requires constant monitoring of the patient. Involuntary movements, agitation arising from the admission of this combination of drugs were decreased dosage of levodopa. Do not exceed the maximum daily dosage Yumeksa (10 mg), as this drug loses its selectivity, which increases the likelihood of developing hypertension.
Studies revealing Yumeksa influence on the ability to drive vehicles, were not carried out. However, it should avoid potentially hazardous activities that require attention, speed, motor, mental reactions.
Application Yumeksa during pregnancy
The drug Yumeks contraindicated in pregnancy, lactation.
Due to the high clinical efficacy Yumeksa reviews about this preparation positive. Yumeks well established in the treatment of Parkinson's disease, and symptomatic parkinsonism.
Registered Yumeksa following analogues: cognitive, Segan, Nair, selegiline, Eldepril, Stillin.