How much can you inject cerucal with severe vomiting. The drug 'Cerukal' for children: description, contraindications and possible side effects. Cerucal side effects

Cerucal is a group of drugs that act on the central nervous system and motility of the gastrointestinal tract. The medication is prescribed to stop vomiting and nausea in children and adults. The drug in liquid form is used intramuscularly and intravenously.

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Properties

The basis of the drug is metoclopramide. This substance blocks receptors that are associated with the work of the intestines and stomach. They transmit impulses to the part of the brain responsible for the gag reflex. Under the influence of this component, signals are inhibited, and unpleasant manifestations recede.

Important! Vomiting caused by problems of a vestibular and psychogenic nature is not eliminated with this medicine.

Cerucal also works and on gastrointestinal function. Increases the tone of the smooth muscles of the stomach, accelerating the process of food entering the intestines.

At the same time, the protection of the esophagus from the return of food from the stomach is stimulated. This prevents belching and heartburn.

Under the influence of the drug, intestinal motility improves, and it is quickly released from processed food.

After how many minutes Cerucal will act on the body, it depends on the method of administration.

After intramuscular injection, the effect is felt after 10-15 minutes, with intravenous injection, the effect becomes noticeable after 1-3 minutes. The drug is excreted by the kidneys during the day. In lactating women, the components of the drug easily pass into breast milk.

Indications and contraindications

Cerucal in ampoules is prescribed adults and children as an auxiliary drug in the treatment of various diseases. Indications for taking it:

nausea and vomiting, as symptoms of any disease;
prevention of nausea and vomiting after surgery and chemotherapy;
paresis of the stomach in diabetes mellitus;
disturbed activity of the digestive tract;
flatulence;
poor tone of the walls of the stomach;
hiccups, belching, heartburn caused by disruption of the digestive tract;
diagnostics of the esophagus, stomach, intestines (introduced before the procedure to prevent the gag reflex and improve peristalsis).

It is prescribed for nausea and vomiting in combination with other drugs.

When examining the stomach or intestines by X-ray, injections of the active substance are necessary to speed up the passage of the food bolus and facilitate the research process. For the same purposes, the drug is used for probing.

A group of medicines based on metoclopramide has a number of contraindications. These include:

high sensitivity to the constituent components;
age up to 2 years;
intestinal and stomach bleeding;
glaucoma;
epilepsy;
intestinal obstruction;
perforation of the gastrointestinal tract;
a tumor that provokes an excess of adrenaline or norepinephrine;
peritonitis;
lactation period and first trimester of pregnancy;
Parkinson's disease;
impaired function of the pylorus of the stomach;
kidney failure;
liver disease;
bronchial asthma.

Cerucal prescribe with caution elderly patients, people with neurological problems and those who suffer from impaired cardiac conduction.

In the process of taking drugs that depress the central nervous system, injections should be abandoned. They enhance the absorption of antibiotics, and this should be taken into account if complex treatment is necessary.

Important! Cerucal, combined with alcohol, can lead to unwanted and dangerous side effects.

In the first three months of pregnancy, the medication should not be taken. In the second and third trimester, the medication should be strictly controlled by the doctor. In recent months, there is a risk of developing extrapyramidal symptoms in the fetus.

Cerucal is prescribed with caution at a late gestation period and only for health reasons of a pregnant woman.

Since metoclopramide readily passes into breast milk, during lactation it is contraindicated. In the case when the reception is necessary, you should stop breastfeeding.

Those whose professional activities require increased attention, concentration and quick reactions should stop taking the drug or temporarily not work. It is also better to refrain from driving a car, as the drug affects psychomotor.

Overdose and side effects

Instructions for use are attached to Cerucal, and it is worth doing injections only after reading it. The dosage is determined by the doctor, but the patient should not forget to be careful and check the prescribed prescription with the manufacturer's recommendations.

Cerucal, an overdose of which dangerous to health and life, can adversely affect the functioning of many organs. The following symptoms signal the excess of the permissible dose:

drowsiness;
dizziness and confusion;
convulsions;
palpitations;
a decrease or increase in blood pressure;
hallucinations;
abdominal pain;
labored breathing;
severe irritability;
poor orientation in space.

If the drug was taken at the dosage indicated by the doctor, but the above symptoms appear, you should immediately contact a specialist and stop taking the medicine.

In most cases, side effects go away after 1-2 days. But, if intoxication is complex, treatment is required. He is being held depending on symptoms strictly under medical supervision.

Cerucal causes side effects and subject to all the rules of admission. It all depends on the individual characteristics of an individual organism. Complications usually arise from:

central nervous system;
heart and blood vessels;
endocrine system;
immune system.

Problems from the central nervous system are manifested by a depressive state, an inexplicable feeling of fear, uncontrolled contraction of the muscles of the neck, face and limbs.

Crashes in work of the cardiovascular system expressed in tachycardia, bradycardia and agranulocytosis.

Violation of the functions of the endocrine system leads to an imbalance of the hormone estrogen, gynecomastia and failure of the menstrual cycle.

From the gastrointestinal tract, manifestations of diarrhea, constipation, dryness in the oral cavity are possible. Sometimes taking medication leads to a violation of taste buds.

With a strong immune response possible skin rashes in the form of urticaria, accompanied by itching and burning.

Attention! A certified medicinal product must be accompanied by instructions for use, which must be read before using the drug.

The risk of side effects is high in teenagers, the elderly, and those with chronic illnesses. When combining the drug with alcohol, serious problems from the central nervous system can occur.

Can it be used to treat children

Doctors prescribe Cerucal to children with severe nausea caused by various problems of the digestive organs or due to illness.

Injections are used in emergency cases when vomiting does not stop.

Cerucal injections for adolescents and children with vomiting are done at a dosage calculated for each kilogram.

Dosage is determined strict physician.

The maximum daily dose of medicine for children is set by weight:

with a body weight of 10 to 20 kg - 0.3-0.5 ml;
with a mass of 20 to 30 kg - 0.5-1 ml;
with a mass of 30 to 40 kg - 1-1.5 ml.

You can do 3-4 injections of the drug per day. The calculation is made from the ratio of 0.1 mg per 1 kg of weight.

Important! FROM the morning dose for children from 3 to 14 years old should not exceed 0.5 mg per 1 kilogram of weight. Children are administered cerucal intramuscularly and slowly.

One ampoule contains 2 ml. medicines. 1 ml contains 5 mg of metoclopramide. To determine a single dose, calculate the daily rate and divide it by 3-4 times. For example, if the weight of the child is 30 kg, then at one time you need to take 3 mg of the active substance, which is about 0.7 ml of the solution.

Cerucal from severe nausea is prescribed only by a pediatrician, after the cause of the disease has been established. For children who vomit, it helps stop water loss and prevent dehydration. But you should always remember about the possibility of side effects and not self-medicate. While taking Cerucal, an overdose can have dangerous consequences; it should not be used by children under 2 years of age.

Cerucal for adults

For adults, the drug is administered intravenously or intramuscularly. From the chosen method depends on how long the substance will act. When the drug enters the vein, the effect is noticeable faster, but lasts less than with intramuscular injection.

The daily rate is determined by the attending physician, depending from the total course of treatment. Recommended doses:

prevention of vomiting and nausea after operations - 2 ml (1 ampoule) 3-4 times a day;
in complex treatment after a course of chemotherapy - 2 ml (1 ampoule) 3-4 times a day;
before the diagnosis of the gastrointestinal tract (X-ray, probing) - 2-4 ml (1-2 ampoules) 10 minutes before the start of the examination.

The daily dose should not exceed 0.5 mg per 1 kilogram of body weight. It is necessary to use the drug in liquid form as little as possible, switching to rectal or oral administration.

Cerucal from vomiting during therapy with cytostatics injected through a drip. There are two main ways:

Short-term. The infusion is calculated for 15 minutes. The solution is administered in a ratio of 2 mg per 1 kg of the patient's weight. The first dropper is placed 30 minutes before taking the cytostatic, then time intervals follow - 1.5 hours, 3.5 hours, 5.5 hours, 8.5 hours.
Long. The drug begins to drip 2 hours before the use of the cytostatic drug. Dose - 0.5 or 1 mg per 1 kg of body weight per hour. Then it is reduced to 0.25 mg per 1 kg and administered within 24 hours after taking the cytostatic.

Release form

Tablets and solution for injections.

Pharmacological action of Cerucal

This drug is able to suppress the emetic effect, as well as normalize the tone of the digestive tract. The composition of the drug includes metoclopramide, which has a therapeutic effect on the human body. The drug is able to block (selectively) serotonin and dopamine receptors, suppressing the impulses of the brain (brain) chemoreceptors, while preventing increased sensitivity of visceral nerve cells responsible for advancing to the medulla oblongata (in which the vomiting reflex is located) impulses from the duodenum and pylorus, such thus preventing the appearance of a gag reflex. The drug Cerucal - a complete instruction is the best reference for patients.

As a result of the conduction of nerve impulses, as well as the effect of the action of the (parasympathetic) division of the autonomic nervous system, the motility of the gastrointestinal tract, especially the upper ones, returns to normal. The action of the substance methaclopramide allows you to increase the tone of the muscles (smooth) of the digestive tract, while significantly reducing the time of movement of the mass of the contents of the stomach into the intestines, especially into the duodenum, while improving its peristalsis.

This drug allows you to prevent the appearance of reflux processes (pyloric and esophageal), as well as gastrostasis. The drug normalizes the separation of bile, reduces all symptoms associated with biliary dyskinesia, suppresses the manifestation of jaundice associated with disorders in the gallbladder (most often with bile stasis). The sphincter of Oddi is freed from spasms with a normal general tone thanks to this remedy. The beneficial effect of the drug is known - the suppression of gag reflexes, but in some cases its use may not be entirely effective, in particular if vomiting was caused by psychogenic factors and disorders of the vestibular apparatus.

Cerucal is prescribed both orally and in the form of injections at the discretion of the doctor, which of these methods of treatment is most useful and productive in a particular situation. During oral administration of the drug, it is fully excreted through the gastrointestinal tract with almost no residue. In plasma, the substance that is part of the drug can reach the highest concentration within half an hour or an hour from the moment of administration. At the same time, the medicinal property reaches development in about 30 minutes, its preservation is observed within 12 hours from the moment of administration. The substance is excreted from the body after an average of 5 hours. Its excellent penetration through the biobarrier, including the hematoplacental and blood-brain barriers, has been noted. The fact of penetration of the substance into breast milk was also revealed, which requires a special approach during breastfeeding. If the drug is administered intravenously, its activity is fixed after two minutes, if intramuscularly - after 12 minutes on average.

Cerucal indications

The drug is prescribed for therapeutic purposes in violation of the digestive organs, in particular their motor activity, as well as in irritable bowel syndrome, with intestinal stenosis (functional), heartburn. In addition, such a drug is prescribed during the complex treatment of disorders of the kidneys, liver, migraines, skull injuries with concussion, nausea, vomiting after taking various kinds of drugs. Cerucal is prescribed for diabetics, the indications are quite consistent with the elimination of the symptoms of intestinal paresis. It is also prescribed before diagnostic methods regarding the study of the gastrointestinal tract, most often for x-ray studies of the small intestine and stomach.

Cerucal application

This drug is prescribed both in tablets and in the form of injections. Cerucal solution is administered intramuscularly or slowly intravenously. Adults and adolescents from fourteen years of age are prescribed intravenous infusion or intramuscular injection three or four times a day, 2 ml, the dose of the drug per day is an average of 25 mg (metoclopramide in its pure form), the dose at a time is not more than 10 mg.

Intravenous drip for fifteen minutes, the drug is administered at the rate of 2 mg / kg half an hour before the use of cytostatics, then one and a half hours, three and a half, 5.5 and 8.5 hours after the cytostatic substance was administered.

Dosing of the drug is possible according to another scheme. Intravenously, the drug is administered in an amount of 0.5 mg/kg or 1 mg/kg over 60 minutes two hours before the administration of the cytostatic, after which a dose of 0.25 mg/kg or 0.5 mg/kg is administered over 60 minutes over a period of 24 hours after the administration of the cytostatic. If cytostatic drugs are prescribed, cerucal should be taken for the entire period of their appointment. Within fifteen minutes, cerucal is administered intravenously, diluted in 50 ml of an infusion solution, it is permissible to dilute cerucal in a glucose solution (5%) or isotonic Na Cl solution. It is important to remember that it is unacceptable to mix the cerucal solution with alkaline solutions (infusion). In many cases, the drug Cerucal will be quite useful, while the use should be observed with due regard for precautions.

Cerucal during pregnancy

Pregnancy is a complex physiological process that requires special care regarding the use of drugs, as this can be fraught with negative consequences and lead to damage to the vital organs of the fetus or provoke an abortion.

In the first trimester of pregnancy, it is not recommended to take Cerucal, as well as during breastfeeding, since the substance in its composition is able to penetrate the milk and through the placental barrier, thereby affecting the body of an infant or a developing fetus. The attending physician, as a rule, prescribes cerucal during pregnancy during the first trimester, other alternative methods of treatment and replaces cerucal with other therapeutic agents that do not adversely affect the fetus.

During pregnancy in the third and second trimesters, cerucal can be prescribed only in exceptional cases, when this kind of therapy exceeds possible negative reactions to the body. At the same time, one should not exceed the dose of medicine recommended by specialists, take Cerucal, strictly adhering to the prescription, at a certain time. It is important to know that self-medication, especially during pregnancy, is strictly prohibited due to possible undesirable consequences for both the pregnant woman and the developing fetus.

Cerucal for children

Adolescents over the age of fourteen can take cerucal at the doses recommended for adults. At the same time, do not exceed the indicated doses and take the drug without consulting a doctor. Children under the age of three are not recommended to take cerucal, since the action of the substance included in its composition can adversely affect the health of the child. With caution, you can prescribe medicine to children from three years. Children from three to fourteen years of age take the medicine at a dose of 0.1 mg per kilogram of total body weight, the largest daily dose is half a milligram per kilogram of body weight. A medicine is prescribed in cases where it is necessary to eliminate the state of nausea and suppress the gag reflex. Also, if vomiting is caused by the use of cytostatics, this remedy will be the most effective and will give a positive result very quickly.

Cerucal for children older than three years is recommended both in tablets and in injections. The doses recommended by the doctor should not be exceeded, because in this way the opposite effect can be achieved instead of accelerating the positive effect. Children should take the medicine orally half an hour after meals. Usually the course of treatment is a month or a half, but in some cases it is increased to six months.

Cerucal tablets

Cerucal in the form of tablets (50 pieces in one package) is prescribed for both adults and children over the age of three. Children from three years of age should be prescribed the drug at the rate of 0.1 mg per kilogram of weight. Children fourteen years of age and older take the recommended adult dose of 10 mg three or four times a day (as recommended by a doctor). Special precautions must be taken by people suffering from kidney disease, in particular, a disorder of the functions of these organs. In this case, the dose of the drug is set individually for each case. If possible, the drug is replaced by another, but if it is necessary to use metoclopramide for the best effect due to the severity of the state of the body due to dysfunction of the gastrointestinal tract and manifestations of gallbladder dyskinesia, the drug is prescribed with caution. On average, the course of treatment is from 4 to 6 weeks.

Cerucal - tablets should be taken half an hour before meals with water. It is important to remember that alcoholic beverages are incompatible with most drugs and can lead to severe complications, and therefore alcohol should be discontinued during the course of treatment. Do not take the tablets with tea or milk, as the therapeutic effect may be significantly reduced. If the doctor has prescribed activated charcoal, it should also not be consumed less than an hour (one and a half) after taking cerucal, and you should not take cerucal less than an hour after taking activated charcoal.

Cerucal injections

Cerucal is produced in liquid form for injection, each ampoule contains 2 ml of solution, there are only ten ampoules in a carton.

If necessary, the metoclopramide contained in this preparation is administered intravenously with extreme caution, slowly or intramuscularly. Children under the age of fourteen are not given intravenous infusion. The doctor, at his discretion, prescribes injections, cerucal can be useful in any form. From the age of fourteen, adolescents and adult patients can receive a dose of the drug intravenously up to four times a day for certain diseases, the dose of the drug is 2 ml, the daily dose does not exceed 25 mg, a single dose is up to 10 mg. By drip, the drug is administered over 15 minutes (2 mg per kilogram of body weight), usually such treatment is prescribed while taking cytotoxic drugs, while respecting the generally accepted appropriate scheme for administering the substance.

Cerucal side effects

During the use of the drug, side effects from some organ systems are possible, in particular: the nervous system, cardiovascular, hematopoietic, digestive and endocrine, as well as allergic reactions of the body. The following symptoms are observed:

headache, fatigue, dizziness, tinnitus, depression, fear, neuroleptic syndrome;
hypertension, hypotension, agranulocytosis, tachycardia;
dry mouth, change in taste, constipation, loose stools;
estrogenic hormonal disorders, menstrual disorders, gynecomastia;
urticaria, pruritus.

Adolescents and the elderly are more likely than young and middle-aged adults to experience side effects, especially if there is kidney disease. With any manifestation of side effects, you should immediately seek advice and help from your doctor.

Contraindications for the use of Cerucal

Despite a considerable number of useful properties, metoclopramide, which is part of cerucal, has a number of contraindications, which is associated with the effect of the substance on weakened organs that are subject to a pathological process. Among the contraindications:

pheochromocytoma;
individual intolerance to metoclopramide;
intestinal obstruction;
sulfite intolerance;
bronchial asthma;
intestinal perforation, bleeding from the gastrointestinal tract;
prolactin-dependent tumors;
convulsions, epilepsy.

If a patient has impaired renal function, the drug should be prescribed with extreme caution and, if possible, replaced with another analogue that is less dangerous in this case.

Interaction of cerucal with other drugs

During the use of cerucal with other drugs, a change in the rate of their absorption is observed, since the active substance, metoclopramide, helps to reduce the excretion of cimetidine, digoxin, but increases the absorption of ethanol, paracetamol and antibiotic. There was a decrease in the effectiveness of metoclopramide during simultaneous use with anticholinergics.

In no case should you take Cerucal with alcoholic beverages, as well as antipsychotics and sedatives. The breakdown of vitamin B1 is greatly accelerated under the influence of metoclopramide, while sympathomimetics, tricyclic antidepressants and MAO inhibitors change their activity under its influence. During an overdose of the drug, side effects such as convulsions, hyperkinesis, irritability, drowsiness, an increase or decrease in blood pressure are possible.

Cerucal storage conditions

The medicine must be stored at a temperature of 15 - 30 degrees Celsius in a dry place protected from light. The shelf life is five years. Ready solution for infusion is stored up to a day at a temperature of 18-22 degrees Celsius.

Cerucal price

The cost of the drug varies in the range of 90 rubles - 267 rubles. For a medicine such as cerucal, the price is quite acceptable.

Cerucal - reviews

The doctor prescribed cerucal for vomiting and nausea, he is very pleased with the effect, which came very quickly. I recommend.
A month ago, I became interested in the drug Cerucal, I re-read the reviews on the site. I suffer from gallbladder dyskinesia, after taking the medicine I feel much better. I continue treatment.
I have problems with the gastrointestinal tract, after taking Cerucal, the relief is significant. The doctor did not recommend it to his wife, as she has problems with the kidneys.
My child is taking Cerucal as prescribed by the pediatrician. Satisfied with the result.

Similar instructions:

Adults often take Cerucal for vomiting or severe nausea. Such a drug is in demand both for functional disorders and in the treatment of various diseases of the digestive system, for example, with gastritis. This medicine is also used in children, but it has some limitations in use, therefore, without a doctor's prescription, it is impossible to give such a drug to a child.

Release form

"Cerukal" is made in two forms. The first is a solution for injections, which is sold in colorless glass ampoules of 2 ml. One package includes 10 ampoules, and the solution itself is colorless and completely transparent.

The second form is tablets. This "Cerukal" is sold in glass bottles of 50 tablets. They have a smooth flat surface, round shape and white coloration, and there is a line on one side. In the form of capsules, suspensions, suppositories, drops, chewable tablets or syrup, this drug is not produced.

Compound

The main component of both forms of Cerucal is represented by metoclopramide. It is contained in the drug in the form of hydrochloride monohydrate. If we take into account the content of the active form, then the dosage of the active substance in one tablet is 10 mg, and in one ml of the solution - 5 mg, that is, one ampoule also contains 10 mg.

Among the auxiliary ingredients of the injection form, one can see sodium chloride and disodium edetate. The solution also contains water for injection and sodium sulfite. The inactive components of Cerucal in tablets are magnesium stearate and gelatin. These substances are supplemented with milk sugar, silicon dioxide and potato starch.

Operating principle

Cerucal has a specific effect on dopamine receptors in the brain, which are concentrated in the vomiting center. After absorption into the bloodstream and passing through the blood-brain barrier, this medicine is able to block them, as well as reduce the sensitivity of the nerves responsible for conducting nerve impulses from receptors in the digestive tract to the brain. Thanks to such effects, the drug helps to stop vomiting, eliminate nausea or hiccups.

By acting on the parasympathetic part of the nervous system and the hypothalamus, taking the medication also affects the motor activity and the state of the muscles of the gastric walls, including the digestive sphincters in the upper gastrointestinal tract. The result of this influence will be an increase in the tone of the stomach and 12-colon, the acceleration of the movement of food from the stomach into the small intestine. The drug prevents the reflux of food masses into the esophagus or stomach, but the drug does not provoke diarrhea.

Cerucal also has an effect on the biliary tract. The use of such a drug helps to normalize the secretion of bile, since under its influence the sphincter of Oddi relaxes, and gallbladder dyskinesia is eliminated.

The effect of the taken Cerucal tablet begins to develop after about one hour, and the effect of the drug administered intramuscularly appears after 10-15 minutes. If the patient was injected with a solution into a vein, its effect appears after 1-2 minutes. The method of application also affects the duration of the therapeutic effect of the drug. After an intravenous injection, Cerucal acts for about 30 minutes, after an intramuscular injection - about 2 hours, and after taking a tablet form - about 6 hours.

Indications

"Cerukal" is most often used for vomiting or nausea, provoked by various factors. For example, such a medicine is used:

with liver diseases;
with traumatic brain injury;
when taking cytostatics, antibiotics or other drugs;
with violations in the diet;
with radiation therapy;
with renal failure.

In addition, Cerucal is in demand:

with a decrease in the tone of the walls of the stomach and intestines (hypotension or atony), for example, after surgery;
with reflux disease;
with functional spasm of the pyloric muscles;
with biliary dyskinesia;
with paresis of the stomach, which arose in a patient with diabetes mellitus;
with peptic ulcer or gastritis (the drug is included in the treatment complex).

The medication in the form of injections is also used when examining the digestive system, for example, with an X-ray contrast study or duodenal sounding. With such procedures, Cerucal accelerates the movement of food and enhances peristalsis, and also relaxes the muscles of the digestive tract, which facilitates manipulation and helps to obtain more accurate results.

At what age is it prescribed?

In the form of injections, "Cerukal" can be used in children over 2 years old, since the liquid form allows you to accurately dose the active substance of the drug. In this case, for children aged two to 14 years, injections are used only as directed by a doctor, and if any side effects occur, the medication is immediately canceled. Most often, such injections are used as an emergency remedy that helps to stop vomiting, hiccups or nausea of various origins.

The tablet preparation is not used in the treatment of patients under 14 years of age. This is associated not only with the solid form (problems with swallowing), but also with a greater risk of overdose.

If vomiting or severe nausea occurs in a child under 2 years old, it is forbidden to give him Cerucal. In such a situation, the right solution would be to call an ambulance.

Contraindications

The drug should not be used in children with hypersensitivity to metoclopramide or another component of the selected form of Cerucal. It is also contraindicated:

with such serious pathologies of the gastrointestinal tract as bleeding from the stomach wall, intestinal perforation or intestinal obstruction;
with pheochromocytoma (the drug can cause a hypertensive crisis) or prolactin-dependent tumors (the drug stimulates the synthesis of prolactin);
with extrapyramidal movement disorders and epilepsy.

If a small patient has high blood pressure, diagnosed with bronchial asthma or impaired liver function, the drug should be used only under the supervision of a physician. Caution also requires the appointment of "Cerukal" for children with hypersensitivity to procaine. If the child has kidney disease, then, depending on the degree of violation of their function, the dosage of the drug is reduced. If vomiting is provoked by problems with the vestibular apparatus, Cerucal is not prescribed due to its inefficiency.

Side effects

Treatment with "Cerukal" can affect the child's nervous system, for example, cause a feeling of fear, depression, tinnitus, facial muscle twitches, dizziness and other disorders. At very high doses, parkinsonism and various extrapyramidal disorders may develop.

Sometimes the medication provokes diarrhea, dry mouth, or constipation. Occasionally, when using Cerucal, blood pressure indicators change or agranulocytosis develops.

The appearance of any side symptoms should be the reason for contacting a doctor who will decide on the further use of the drug or select a suitable analogue.

Instructions for use

The drug in tablets should be taken before meals (about half an hour) and washed down with water in a volume of 100-200 ml. It is not recommended to crack the medicine or grind it in any other way. "Cerukal" in injections can be administered in two ways:

Intramuscularly. With this method, the injection is performed in a place where muscle tissue is well developed (shoulder, thigh, buttock). In addition, the injection site is periodically changed to prevent local adverse reactions.
Into a vein Usually this way the drug is administered by jet, but the injection should be performed slowly. Droppers are also sometimes prescribed for 15 minutes. To do this, the desired dose of "Cerukal" is dissolved in 50 ml of a 5% glucose solution or a 0.9% sodium chloride solution.

The permissible dosage of Cerucal for children who are not yet fourteen years old is calculated by body weight. Usually, a medicine in a solution is prescribed for children at the rate of 0.1 mg / kg. Injections are made 1 to 4 times a day, and the maximum dosage can be 0.5 mg / kg. For example, the weight of a child is 20 kg, then at one time he needs 2 mg of metoclopramide (0.1x20), which corresponds to 0.4 ml of the solution, and it is permissible for such a patient to administer 10 mg of the drug (0.5x20) per day, that is one ampoule.

Dosages of Cerucal for a teenager over 14 years of age will be slightly higher, but they differ from adult doses. If injections are used, then 10 mg of the active substance is administered to such a patient at a time, which corresponds to 1 ampoule. Such injections are made from one to three times a day.

When prescribing a solid form in adolescence, a single dosage can be either half a tablet (it is carefully divided according to risk) or a whole tablet. The frequency of administration, unlike adults, is no more than 3 times a day. The maximum single dosage for a teenager 14-18 years old is 10 mg (one tablet or one ampoule), and the daily dose is 30 mg (three tablets or 6 ml of solution).

How long to use Cerucal in a child should be determined by the doctor. Sometimes the treatment lasts only a few days until the condition improves, and for some pathologies, the duration of use can be 4-6 weeks or several months (up to six months).

If the drug is prescribed before the study of the upper digestive tract, then it is used once - 10 minutes before the procedure. A child 2-13 years old is given a slow intravenous injection (the solution is administered within one to two minutes) at a dose of 0.1 mg / kg, and a teenager over 14 years old is slowly injected into a vein 10 or 20 mg of the active substance - a solution of one or two ampoules .

Overdose

A very large dose of Cerucal can lead to drowsiness, irritability, confusion, motor and other disorders of the nervous system. In addition, exceeding the dosage can affect the heart rate (cause bradycardia) and blood pressure (it may increase or decrease). If the poisoning is mild, then after the abolition of Cerucal, all the symptoms disappear on their own within 24 hours.

Compatibility with other drugs

"Cerucal" in solution should not be mixed with infusion preparations that have an alkaline environment. Under the influence of Cerucal, the effect of anticholinesterase drugs decreases, and the absorption of cimetidine, paracetamol, some antibiotics, digoxin, levodopa and lithium preparations increases. When combined with drugs that depress the central nervous system, their effect on the brain will be stronger.

If you assign "Cerukal" together with antipsychotics, the risk of extrapyramidal disorders will increase. In the treatment of "Cerukal" the effectiveness of antihistamines may decrease. If such a medicine is used with hepatotoxic medicines, the likelihood of liver damage increases. With simultaneous use with vitamin B1, a rapid breakdown of thiamine is observed.

Terms of sale

To buy any of the forms of "Cerukal" in a pharmacy, you need to present a prescription from a doctor, so consultation with a gastroenterologist, pediatrician or other doctor is required. The average price of one pack of injection solution is 220-230 rubles, and one bottle of tablets - 120 rubles.

Storage conditions

Keep ampoules with a solution or a jar of tablets at home in a place hidden from direct sunlight at temperatures up to +30 degrees. The drug should be stored so that small children cannot get it.

The shelf life of both the injectable form of "Cerukal" and the tablets is 5 years. If it has expired (it is important to check the date on the box), the use of the drug is unacceptable. The solution from the opened ampoule should be used within 15-30 minutes. You can not store it until the next injection.

Active substance

Metoclopramide hydrochloride (metoclopramide)

Release form, composition and packaging

Solution for intravenous and intramuscular administration transparent, colorless.

Excipients: sodium sulfite, disodium edetate (disodium ethylenediaminetetraacetate), water for injection.

2 ml - colorless glass ampoules (5) - blister packs (2) - cardboard packs.

pharmachologic effect

A specific blocker of dopamine receptors, weakens the sensitivity of the visceral nerves that transmit impulses from the pylorus and duodenum 12 to the vomiting center. Through the hypothalamus and parasympathetic nervous system, it has a regulating and coordinating effect on the tone and motor activity of the upper gastrointestinal tract (including the tone of the lower digestive sphincter at rest). Increases the tone of the stomach and intestines, accelerates gastric emptying, reduces hyperacid stasis, prevents pyloric and esophageal reflux, stimulates intestinal motility.

Pharmacokinetics

V d is 2.2 - 3.4 l / kg.

Metabolized in the liver. The half-life is from 3 to 5 hours, in chronic renal failure - 14 hours. It is excreted by the kidneys during the first 24 hours unchanged and as metabolites (about 80% and a single dose). It easily crosses the blood-brain barrier and is excreted in breast milk.

Indications

- vomiting and nausea of various origins;

- atony and hypotension of the stomach and intestines (in particular, postoperative);

- biliary dyskinesia, reflux esophagitis, functional pyloric stenosis;

- to enhance peristalsis during radiopaque studies of the gastrointestinal tract;

- paresis of the stomach in diabetes mellitus;

- as a means of facilitating duodenal sounding (to accelerate the emptying of the stomach and the promotion of food through the small intestine).

Contraindications

- hypersensitivity to metoclopramide;

- pheochromocytoma (possible hypertensive crisis, due to the release of catecholamines);

- intestinal obstruction, intestinal perforation and gastrointestinal bleeding;

- prolactin-dependent tumor;

- epilepsy and extrapyramidal movement disorders, first trimester of pregnancy and lactation, age up to 2 years.

Carefully: with arterial hypertension, impaired liver function, hypersensitivity to procaine and procainamide, children aged 2 to 14 years

During the 2nd and 3rd trimester of pregnancy, the drug is prescribed only for health reasons.

In patients with reduced renal function, the drug is prescribed in reduced doses.

Dosage

In / m or slowly in / in.

Adults and teenagers over 14 years of age: 1 ampoule (10 mg metoclopramide) 3-4 times a day.

Children from 3 to 14 years old: The therapeutic dose is 0.1 mg metoclopramide/kg body weight, the maximum daily dose is 0.5 mg metoclopramide/kg body weight.

In case of impaired renal function, the dose of the drug is selected according to the severity of renal dysfunction.

Prevention and treatment of nausea and vomiting caused by the use of cytostatics:

Scheme 1.

Short-term drip infusion (within 15 minutes) at a dose of 2 mg / kg half an hour before the start of treatment with a cytostatic agent, and then 1.5 hours, 3.5 hours, 5.5 hours and 8.5 hours after the use of cytostatics.

Scheme 2.

Long-term drip infusion at a dose of 1.0 or 0.5 mc / kg per hour, starting 2 hours before the use of a cytostatic agent, then at a dose of 0.5 or 0.25 mg / kg per hour for the next 24 hours after the use of a cytostatic agent.

Drop infusion is carried out for a short time within 15 minutes after preliminary dilution of the dose in 50 ml of infusion solution.

Cerucal injection solution can be diluted with isotonic sodium chloride solution or 5% glucose solution.

Cerucal is used during the entire period of treatment with cytostatic agents.

Side effects

From the nervous system: sometimes there may be a feeling of fatigue, headaches, dizziness, fear, anxiety, depression, drowsiness, tinnitus; in some cases, mainly in children, dyskinetic syndrome (involuntary tic-like twitching of the muscles of the face, neck or shoulders) may develop. Perhaps the appearance of extrapyramidal disorders: spasm of the facial muscles, trismus, rhythmic protrusion of the tongue, bulbar type of speech, spasm of extraocular muscles (including oculogiric crisis), spastic torticollis, opisthotonus, muscle hypertonicity. Parkinsonism (tremor, muscle twitching, limited mobility, the risk of development in children and adolescents increases when the dose is exceeded 0.5 mg / kg / day) and tardive dyskinesia (in elderly patients with chronic renal failure). In isolated cases, a severe neuroleptic syndrome may develop.

With long-term treatment with cerucal in elderly patients, symptoms of parkinsonism (tremor, muscle twitching, limited mobility) and tardive dyskinesia may develop.

From the hematopoietic system: agranulocytosis.

From the side of the cardiovascular system: supraventricular tachycardia, hypotension, hypertension.

From the gastrointestinal tract: constipation, diarrhea, dry mouth.

From the endocrine system: with prolonged use of the drug, gynecomastia (enlargement of the mammary glands in men), galactorrhea (spontaneous flow of milk from the mammary glands) or menstrual irregularities may occur; with the development of these phenomena cancel.

Overdose

Symptoms: drowsiness, confusion, irritability, anxiety, convulsions, extrapyramidal movement disorders, dysfunction of the cardiovascular system with bradycardia and arterial hypo- or hypertension. In mild forms of poisoning, symptoms disappear 24 hours after drug withdrawal. Depending on the severity of the symptoms, it is recommended to establish monitoring of the patient's vital functions. Fatal cases of poisoning due to overdose have not yet been identified.

Treatment: symptomatic. Extrapyramidal disorders are eliminated by the slow administration of biperiden (adult doses - 2.5 - 5 mg; manufacturer's recommendations should be followed). Perhaps the use of diazepam.

drug interaction

Incompatible with infusion solutions having an alkaline environment.

Decreased action of anticholinesterase agents.

Enhances the absorption of antibiotics (, ampicillin), paracetamol, levodopa, lithium and alcohol.

Reduces the absorption of digoxin and cimetidine.

Enhances the effect of alcohol and drugs that depress the central nervous system.

Antipsychotic drugs should not be administered concomitantly with metoclopramide in order to avoid a possible increase in extrapyramidal disorders.

May interfere with the action of tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and symptomatic agents.

Reduces the effectiveness of therapy with H 2 -histamine blockers.

Increased risk of hepatotoxicity when combined with hepatotoxic agents.

Reduces the effectiveness of pergolide, levodopa.

Increases bioavailability, which may require control of its concentration.

Increases the concentration of bromocriptine.

With the simultaneous appointment of cerucal with thiamine (Vitamin B1), the latter quickly disintegrates.

special instructions

During the period of treatment, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

During treatment, patients are prohibited from drinking alcohol.

In adolescents and in patients with severely impaired renal function, the possible development of side effects is monitored, if they occur, the drug is canceled.

Not effective for vomiting of vestibular origin.

Against the background of the use of metoclopramide, distortions in the data of laboratory parameters of liver function and the determination of the concentration of aldosterone and prolactin are possible.

Pregnancy and lactation

It is contraindicated to use in the first trimester of pregnancy and lactation.

In the II and III trimesters of pregnancy, the drug is prescribed only for health reasons.

Application in childhood

Do not administer to children under 2 years of age.

Be wary appoint children aged 2 to 14 years. In adolescents, the possible development of side effects is monitored, if they occur, the drug is canceled.

For impaired renal function

In patients with reduced renal function, the drug is prescribed in reduced doses. In patients with severely impaired renal function, the possible development of side effects is monitored, if they occur, the drug is canceled.

For impaired liver function

Use this drug with caution in case of impaired liver function.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

List B.

The drug should be stored in a place protected from light, at a temperature not exceeding 30°C.

Keep out of the reach of children.

Shelf life 5 years. Do not use after the expiration date.

Instructions for use:

Cerucal is an antiemetic drug that blocks dopamine receptors, presented in two dosage forms:

Tablets are round, flat, white, with bevelled edges. 1 tablet contains 10.54 mg metoclopramide hydrochloride monohydrate (active substance) and auxiliary components (potato starch, lactose monohydrate, magnesium stearate, gelatin, precipitated silicon dioxide);
Solution for intramuscular and intravenous administration. 1 ampoule of the drug contains 10 mg of metoclopramide hydrochloride - the active ingredient - and excipients: sodium chloride, sodium sulfite, disodium EDTA, water for injection.

Pharmacological action of Cerucal

According to the instructions for Cerucal, the drug has an antiemetic effect, normalizing the functioning of the digestive tract. Metoclopramide, the main active ingredient of the drug, selectively blocks serotonin and dopamine receptors, preventing the passage of impulses through the brain receptors and reducing the sensitivity of the nerve cells responsible for transmitting impulses from the duodenum to the vomiting center located in the medulla oblongata. Due to the effect the drug has on the work of the autonomic nervous system, Cerucal restores the motility of the upper gastrointestinal tract. Under the influence of Cerucal, the tone of the smooth muscles of the intestinal and stomach walls returns to normal, as a result of which the time for the evacuation of digested food into the duodenum decreases, and the peristalsis of the small intestine improves. In addition, Cerucal contributes to the normal separation of bile, reducing the symptoms of gallbladder dyskinesia and preventing the appearance of cholestatic jaundice. According to the instructions for Cerucal, the active substance of the drug has a direct effect on the sphincter of Oddi, reducing the manifestations of its spasm.

Despite the antiemetic effect of the drug, Cerucal, according to patients, is not able to have a therapeutic effect on vomiting of a vestibular and psychogenic nature.

After oral administration, Cerucal is almost completely absorbed from the gastrointestinal tract, reaching the maximum concentration of metoclopramide in the blood within an hour. The main therapeutic effect of the drug lasts for 12 hours. The metabolism of Cerucal occurs in the liver. The drug is excreted in the urine: unchanged, as well as in the form of metabolites.

After intramuscular or intravenous administration, the therapeutic effect of Cerucal reaches its maximum after 10-15 minutes and 1-3 minutes, respectively.

Indications for use Cerucal

Indications for Cerucal are conditions associated with a violation of the activity of the digestive tract, which include: heartburn, irritable bowel syndrome, functional pyloric stenosis. The effectiveness of the drug also extends to nausea and vomiting of various origins (caused by taking medications, disorders of the liver and kidneys, migraine, traumatic brain injury), paresis of the stomach, which developed due to diabetes mellitus. In addition, Cerucal is used as a means of reducing vomiting during diagnostic studies of the gastrointestinal tract (in particular, duodenal sounding).

Contraindications

Pheochromocytoma;
Intestinal obstruction;
Bleeding from the gastrointestinal tract;
Perforations of the gastrointestinal tract;
The presence of a prolactin-dependent tumor;
Epilepsy and convulsive seizures.

The drug is not prescribed in the presence of hypersensitivity to metoclopramide and sodium sulfite, especially in patients suffering from bronchial asthma and other allergic diseases. Cerucal is not intended for use by pregnant women in the first trimester of pregnancy, as well as by children under 3 years of age. In the second and third trimesters of pregnancy, the use of the drug is possible only in case of vital indications. According to indications, Cerucal is taken with caution by patients with arterial hypertension, bronchial asthma, people suffering from impaired liver function, hypersensitivity to procainamide and procaine.

Side effects of Cerucal

According to reviews of Cerucal, the use of the drug can provoke the following side effects:

From the side of the central nervous system: dizziness, tinnitus, headache, fatigue, fear, depression, anxiety;
From the side of the cardiovascular system: tachycardia, agranulocytosis, changes in blood pressure;
From the gastrointestinal tract: dry mouth, impaired stool, change in taste sensations;
On the part of the endocrine system, unwanted symptoms may manifest as a change in the amount of estrogen, accompanied by menstrual irregularities and gynecomastia;
Allergic reactions: urticaria, pruritus.

In case of an overdose of the drug, irritability, confusion, convulsions, hyperkinesis, bradycardia, extrapyramidal movement disorders, an increase or decrease in blood pressure are possible. According to reviews of Cerucal, the symptoms of mild poisoning disappear 24 hours after the drug is discontinued. For more severe disorders, symptomatic treatment is recommended.

Interaction of Cerucal with drugs

Metoclopramide, when used simultaneously with other drugs, reduces the absorption of cimetidine and digoxin and accelerates the absorption of antibiotics, ethanol and paracetamol. The effectiveness of Cerucal when taken simultaneously with anticholinergics is reduced. The introduction of an injection solution of the drug contributes to a more rapid breakdown of vitamin B1 - thiamine.

This instruction to Cerucal is presented for informational purposes only. Before using the medicine, consult a doctor.