Other ingredients: glycerin, water for injection.
Preparations. Injection.
Pharmacotherapeutic group:  antidepressant. Nonselective inhibitors of reverse neuronal capture.
Pharmacological properties:
Pharmacodynamics. It is believed that the therapeutic effect of anafranil ( clomipramin) at the expense of its ability to inhibit reverse neuronal capture of noradrenaline (ON) and serotonin (5-HT), and most important is feedback inhibition of serotonin capture. Clomipramine addition, typical wide range of other pharmacological actions: alfa1-adrenolitychna, Anticholinergic, antihistamine and antyserotoninerhichna (block 5-HT receptor).
Anafranil (Clomipramine) effect on depressive as a whole includes its typical manifestations such as psychomotor inhibited, depressed mood and clomipramine (anafranil) canine anxiety. The clinical effect is usually marked by 2 – 3 weeks of treatment. Clomipramine also has specific effects in obsesyvno-compulsive disorder drug treatments for clomipramine (anafranil) induced anorgasmia, which differs from its antidepressive effect. Action clomipramine in chronic pain syndromes caused by or resulting from somatic diseases associated with facilitated transmission of nerve impulses, mediated serotonin and norepinephrine.
Anafranil (Clomipramine) pharmacokinetics:
Absorption. After intramuscular introduction clomipramine is absorbed completely. When repeated intramuscular or intravenous drug in doses 50 – 150 mg per day equilibrium concentration is achieved at the 2 nd week of treatment. The value of equilibrium concentration of clomipramine ranges from 15 to 447 ng / ml.
Distribution. Link clomipramine of plasma proteins reached 97.6%. Apparent volume of distribution is approximately 12 – 17 l / kg body weight. Concentration in the cerebrospinal fluid is about 2% from its level in plasma. Clomipramine penetrates into milk, where it appears in concentrations close to the concentrations in blood plasma. The main route of metabolism clomipramine is demethylation with the formation of the active metabolite. Clomipramine also by 2 positions and N-desmetylklomipramin can continue with the formation.
Pharmacokinetics in separate clomipramine (anafranil) treatment iv groups of patients: In elderly patients, regardless of the dose clomipramine, because of lower metabolic intensity clomipramine its concentration in plasma higher than in young patients. Influence of disorders of the liver and kidney function on the pharmacokinetics clomipramine not yet studied.
Indications for anafranil (clomipramine )use.
Depression different etiology that Events History Historic figures with different symptoms:
endogenous, reactive, neurotic, organic, disguised, involyutsiyni form of depression;
Depression in patients with schizophrenia and psychopathy;
depressive syndromes that occur side effects of canine clomipramine (anafranil) in old age, depression, chronic pain syndrome caused or chronic somatic diseases, depression violation mood reactive, neurotic or psychopathic nature. Obsessive -compulsive syndromes: phobia, chronic pain syndrome, cataplexy.
Anafranil dosage and administration. The dose of the drug pick up individually, taking into account the condition of the patient. Tactics of treatment is to achieve an optimal effect on the background of the use of smaller doses, as well as careful of their increasing clomipramine(anafranil) use in dogs inducing dog to dog aggression, especially for elderly patients and adolescents who are more sensitive to Anafranilu than patients of intermediate age groups.
Intramuscular injection: Begin treatment with the introduction of 25 – 50 mg (contents of 1 – 2 ampoules), then increase the daily dose of 25 mg (1 vial) to achieve a daily dose of 100 – 150 mg (4 – 6 ampoules). After that, when marked improvement dosing for clomipramine(anafranil) for dogs, gradually reduce the number of injections, replacing their maintenance therapy, oral dosage forms.
Intravenous infusion. Treatment begins with intravenous drip 50 – 75 mg (contents of 2 – 3 vials) 1 per day. To prepare the infusion solution using 250 – 500 ml isotonic sodium chloride or glucose solution, the duration of infusion of 1.5 – 3 o’clock canine clomipramine(anafranil) side effects. During infusion it is necessary to closely monitor the patient for timely detection of possible adverse reactions. Particular attention should be given to control blood pressure, as can develop canting hypotension.
If unable to reach a clear improvement of patient reducing canine clomipramine(anafranil) treatment through infusion should continue for another 3 – 5 days. Then, for the achieved effect of moving to the drug internally, 2 tablets of 25 mg equivalent Anafranil 1 ampoule containing 25 mg. In order to gradually shift from infusion therapy to supportive oral drugs are also beginning to transfer the patient to intramuscular introduction.
Children and adolescents. Kids parenteral administration of the drug is not recommended.
Side effects. Including adverse effects associated with the use of oral dosage forms. Adverse events that occur, is usually slight and transient, disappearing in the course of continued treatment or after dose reduction buy Anafranil online. They are not always associated with the level of active drug substances in blood plasma or its dose. Some clomipramine(anafranil) side effects in dogs unwanted, such as general weakness, sleep disorders, nervousness, anxiety, constipation, dry mouth; it is often difficult to distinguish from the manifestations of depression. In case of adverse reactions from the nervous system or mental status Anafranil should be canceled. The elderly are particularly vulnerable to changes of the nervous, cardiovascular systems, psychological field, as well as anticholinergic action Anafranil. Metabolism and withdrawal of medications in this age increases the concentration of drugs in blood plasma, even with high therapeutic doses. From the psychological sphere: very often – drowsiness, general weakness, anxiety, increased appetite, often – confusion, disorientation, hallucinations (especially in elderly patients and in patients with Parkinson’s disease), anxiety, agitation, sleep disturbance, maniacal state, aggression, side effects of drug (anafranil)clomipramine hcl, memory disturbance, increasing depression, a violation attention, insomnia, nightmares night, yawn, sometimes – activating psychosis symptoms.
From the neurological field: very often – dizziness, tremor, headache, mioklonus; often – Delirium, violation of the language, paresthesia, muscle weakness, increased muscle tone, sometimes – convulsions, ataxia, rarely – changes in electroencephalogra.
PRECAUTIONS: Reported sporadic cases of anaphylactic shock associated with intravenous drug.
When expressed depression increases the risk of suicidal acts, which can save up to achieve significant remission. In many patients clomipramine (anafranil) dogs with panic attacks at the beginning of treatment Anafranil increases anxiety. Such a paradoxical increase of anxiety dog + appetite+ clomipramine (anafranil) is most pronounced in the first days of therapy and usually calms down within 2 weeks. In patients with schizophrenia receiving tricyclic clomipramine (anafranil) dosing for dogs antidepressants, sometimes marked activation of psychosis. It is known that in patients with cyclic affective disorders taking tricyclic antidepressants, during the depressive phase may develop manic or states. In such cases you may need to lower clomipramine(anafranil) + pacing + panting the dose Anafranil or cancel and appointed new antipsychotic drug. After these states, if there is evidence, Anafranil treatment in low doses can resume. In patients predisposed to mental disorders, and patients older tricyclic antidepressants can provoke the development of drug psychoses, mainly at night. After taking a dog off clomipramine (anafranil) discontinuation of the medicinal product listed disorders disappear within a few days. With particular caution should appoint Anafranil to patients with cardiovascular diseases, primarily from cardiovascular insufficiency, conduction clomipramine(anafranil) for dogs disturbances (such as atrioventricular block, and – third degree), or arrhythmia. In such cases, as in elderly patients should regularly monitor the performance features of the cardiovascular system and ECG. Possible risk of QT interval at higher therapeutic doses or therapeutic concentrations, as well as in the case of joint appointment with selective serotonin inhibitors reverses admiration or inhibitors of reverse admiration serotonin-norepinephrine. Therefore, the simultaneous appointment of drugs that may cause the accumulation clomipramine, should be avoided. You also need to avoid clomipramine (anafranil) + veterinary the simultaneous appointment of drugs that can prolong the interval QTs. The basis of these phenomena is hypokalemia. Therefore, before the appointment Anafranil need to assess the level of potassium in serum. Before therapy Anafranil recommended measuring blood pressure, as in patients with hypotension or canting of the lability of the vascular system may sharp decrease in blood pressure.
Because of the risk of toxicity must adhere to the recommended doses. Serotonin syndrome with factors such as agitation, attacks anafranil and orap drug interaction, delirium and coma may occur when used in conjunction with (Anafranil) clomipramine drugs such as selective serotonin inhibitors reverse admiration, inhibitors reverse admiration serotonin-norepinephrine antidepressant drugs or lithium . For fluoxetine flush period is 2 – 3 weeks, which anafranil success stories recommend stand before and after fluoxetine treatment.