Dicinon (solution for injection): instructions for use. Reviews for dicynone during menstruation and how to take the drug Drug dicynone instructions

The drug Dicinon is an effective remedy for combating bleeding of various origins. In addition to the hemostatic effect, the agent helps to strengthen the vascular walls, reduces their permeability, restores microcirculation, and also affects blood clotting.

Description and release form

Dicinon is a modern hemostatic drug used in many areas of medicine from surgery to gynecology. It is included in the group of hemostatic drugs that activate the synthesis of thromboplastins. The tool also has antihemorrhagic and angioprotective effects. Dicinon reduces the permeability of small vessels - capillaries, increases their resistance to negative factors, and normalizes microcirculation.

Also, the drug has a vasoconstrictive effect by activating the production of prostacyclins. This additionally has a positive effect on stopping bleeding. Despite such a powerful hemostatic effect, Dicinon does not lead to the synthesis of blood clots and does not affect the overall systemic blood coagulation. During drug therapy, blood pressure remains within the normal range.

Manufacturers of Dicinon offer two forms of release of the drug: tablets, ampoules. The tablet form for adults contains 250 mg of the active ingredient - etamsylate. A children's dosage is also presented - 50 mg. Tablets are packaged in blister strips for No. 100 in one cardboard box. The solution for injection is offered in the pharmacy network in ampoules of 1 or 2 ml. 20 or 50 glass ampoules are placed in one box.

The therapeutic effect of the use of the drug, on average, occurs after 2-3 hours, if the treatment is carried out in a tablet form. When injected into the muscle, the action occurs much faster, on average, after 1-1.5 hours. The time of exposure to the body is 4-6 hours, then the activity of the substance decreases and finally disappears after 24 hours. With course therapy, the therapeutic effect is observed for about a week.

The mechanism of action of Dicinon

When the drug begins to act, the process of formation of platelets is activated, which are separated from the tissues of the bone marrow. Platelet adhesion increases significantly, which leads to stabilization of the capillary walls and a decrease in their permeability. In addition, Dicinon inhibits the synthesis of prostaglandins, which stimulate the processes of platelet disaggregation.

It is this property of the drug that negatively affects the intensity of bleeding and their duration. Thanks to clinical studies, it became known that etamsylate does not affect blood components in the periphery and has nothing to do with proteins and lipoproteins. Dicinon prevents the destruction of capillaries, stimulates the synthesis of mucopolysaccharides with a large mass. Thanks to this, the vessels become stronger, stronger. Sometimes, during therapy, a decrease in the rate of erythrocytes is noted.

Against the background of the use of Dicinon, there is no risk of blood clots.

Below are the methods of dosing the drug Dicinon, indications for use and other subtleties of using the drug. Before use, you must also familiarize yourself with other features of the drug.

Who needs Dicynon?

The drug is prescribed as a therapeutic and prophylactic agent. The medicine is necessary for those patients who are diagnosed with external or internal bleeding. Dicynon helps against diseases and conditions such as:

Dicinon is prescribed to prevent cerebral hemorrhages in newborns, premature babies. It is allowed for frequent and excessive bleeding of the gums.

Contraindications to the use of Dicinon

It is strictly forbidden to take the described drug to patients with identified tumor formations of the hematopoietic system. Do not use the drug in patients with lymphoblastic and myeloid leukemia, osteosarcoma, in the acute stage of porphyria. The use of Dicinon for bleeding that has developed as a result of treatment with drugs from the group of anticoagulants is not shown. In this case, the appointment of specific antidotes will be required.

It is also not recommended to carry out drug therapy in case of hypersensitivity to at least one of the components. Especially often there are reactions to components such as sodium disulfite or lactose. Patients diagnosed with glucose-lactose deficiency should not take Dicinon.

If the patient has a predisposition to thromboembolism, thrombosis, and increased blood clotting is also detected, then the drug is also not recommended. Contraindications are deviations in the functioning of the renal and hepatic systems.

Methods of application, dosing

The tablet form of the drug is taken simultaneously with or after meals. Tablets need to be taken with a sufficient amount of liquid, it is better if it is plain water. The dosage in all cases should be selected by the attending physician, depending on the weight, age of the patient, and the severity of the pathology. The maximum single dose is not more than 3 tablets.

To prevent possible bleeding after surgery, it is recommended to drink 1-2 tablets every 6 hours until complete stabilization. With pulmonary, uterine and intestinal blood loss, 2 tablets per day for 4-9 days are sufficient. If it is necessary to extend the course, the dose must be reduced.

With heavy menstruation, patients are recommended to take Dicinon 5 days before menstruation and stop on the 5th day of the cycle. To consolidate the result, women need to drink the drug in the same way in the next two female cycles. In childhood, the dose does not exceed 10-15 mg per kilogram of the child's weight, divided into 3-4 parts.

If you deviate from the instructions and exceed the dosage, serious complications may develop.

The minimum dose of intramuscular injections of Dicinon is 0.5-1 ampoule. In acute cases, it is possible to increase the dosage to 1.5 ampoules. To prevent blood loss before surgical procedures, 250-500 mg of Dicinon is prescribed. The drug is administered intravenously or intramuscularly for an hour of the proposed operation.

In neonatology, the dose should not exceed 10 mg per kilogram of the baby's weight. Therapy begins from the first hours after birth. The agent is administered at intervals of 6 hours for 4 days. Until the total dose reaches 200 mg/kg. When mixing the drug with saline, it requires immediate administration.

Side effects from the use of the drug

The correct use of Dicinon is a guarantee of the absence of negative phenomena, however, some patients complain. During the period of therapy, heaviness in the epigastric region, heartburn, nausea may occur. Sometimes there are headaches, flushing of the face, dizziness, asthenic conditions.

At the injection site, hyperemia, slight itching, small rashes may appear. Anaphylactic shock, Quincke's edema, deterioration in bronchial asthma were very rarely diagnosed.

Negative effects irrevocably disappear after discontinuation of the drug. No specific treatment is required.

Special instructions, use during pregnancy and lactation

Despite the fact that during the period of treatment with Dicinon, the process of thrombosis is excluded, caution is required when prescribing this drug to patients with previously diagnosed thrombosis and thromboembolism. In the event of hemorrhagic conditions associated with excessive use of anticoagulants, the use of specific antidotes, as well as symptomatic therapy, is required. If a patient has defects in blood clotting, then treatment with the drug is possible, but should be combined with the introduction of special agents that eliminate the described violations.

Clinical information on the use of Dicinon during pregnancy is currently not available. Its use is possible only after assessing the likely risks to the mother and fetus. Data on the release of the drug with breast milk are also not available. Therefore, when prescribing a remedy during this period, it is required to resolve the issue of abolishing breastfeeding.

Interaction with other tools

Dicinone is pharmaceutically incompatible with substances other than sodium chloride. Therefore, mixing it with other medicines in the same syringe is prohibited. Sometimes combined use with aminocaproic acid or sodium menadione bisulfite is possible. The introduction of Dicynon one hour before the use of dextrans minimizes their antiplatelet effect. With subsequent administration, there is no hemostatic effect.

Storage conditions and how to buy at a pharmacy

In pharmacies, the drug Dicinon can only be purchased with a pre-written medical prescription. Store it at room temperature in a place protected from children and ultraviolet radiation. Do not apply after 5 years from the date of issue.

Dicinon's analogs

There are some pathologies and conditions when the appointment of the described drug is impossible. In such cases, you will need to choose a tool similar in action. Today, pharmacy chains can offer a range of medicines that can cope with many types of bleeding. The most popular analogues of Dicinon are:

Herbal preparations are often prescribed to stop bleeding. Horse sorrel and horsetail tinctures effectively cope with such pathologies. During menstrual bleeding, you can take nettle extract, infusion of Siberian cedar shells, shoots of thuja western.

One of the most important positive properties of the described medication is the speed of action. In addition, the relatively safe composition and the minimum number of side effects can be attributed to the pluses. A positive result from the application occurs in a short time.

1. Pharmacological action

The drug has an effect on the cardiovascular system, provides protection against hemorrhages of a different nature. The list of its effects includes the normalization of the state of the vascular wall and an increase in the rate of formation of the primary thrombus. Dicinon begins to act 15 minutes after injection and 2 hours after taking in the form of tablets. Duration of action - up to 8 hours. There is a preservation of the therapeutic effect within a week after the course of treatment.

2. indications for use

• Stopping pulmonary and intestinal bleeding;
• Stop capillary bleeding;
• Stopping parenchymal bleeding;
• Prevention of bleeding during surgical interventions on the eyes, ENT organs, organs of the female reproductive system and extraction of teeth;
• Diseases of the circulatory system;
• progressive form.

3. How to use

• In preparation for surgery for prevention purposes: 0.25 - 0.5 g (intravenously or intramuscularly) about an hour before surgery or 2-3 tablets of Dicinon for 3 hours;
• In the postoperative period for prevention or in the event of bleeding: 0.5-0.75 g intravenously or intramuscularly or 1.5-2 g in the form of tablets. The dose should be evenly distributed throughout the day;
• In the event of an emergency: at the same time (intravenously or intramuscularly) pour in 0.25 - 0.5 g of the drug, then continue the introduction of the drug every couple of hours at a dosage of 0.25 g;
• With damage to the retina during the course of diabetes, a course of treatment is prescribed: 0.25-0.5 g of the drug in the form of tablets 3 times a day, dividing the courses for 2-3 months;
• In the treatment of uterine bleeding, course treatment is also prescribed: 5-14 days, 1.5 g of Dicinon per day, evenly distributing the dose;
• When patients have a history of thrombosis, embolism, thrombophlebitis and similar disorders of the circulatory system, the drug is used with the utmost care.

4. Side effects

• Decreased blood pressure;
• Violation of the sensitivity of the lower extremities;
• Headache and dizziness;
• Violation of the digestive system (heartburn, feeling of heaviness, nausea);
• Redness of the skin and other manifestations of skin allergic reactions.

5. Contraindications

• Blood clotting disorders;
• Overdose of anticoagulants.

6. During pregnancy and lactation

The drug is contraindicated for pregnant women and nursing mothers.

7. Interaction with other drugs

Incompatible while being in the same syringe with other drugs.

8. Overdose

Such cases have not been observed in practice.

9. Release form

Tablets, 250 mg - 100 pcs. Solution for intravenous and intramuscular administration, 250 mg / 2 ml - amp. 50 pcs.

10. Storage conditions

11. Composition

1 tablet:

• etamsylate - 250 mg;
• Excipients: anhydrous citric acid, corn starch, povidone K25, magnesium stearate, lactose.

1 ampoule of solution:

• etamzilat - 125 or 250 mg;
• Excipients: sodium disulfite, water for injection, sodium bicarbonate (used in some cases to correct pH).

12. Terms of dispensing from pharmacies

Dicynon for uterine bleeding

Persistent uterine bleeding can indicate serious gynecological diseases, as well as hormonal disruptions. Instructions for use Dicinon says that the drug has a hemostatic effect, so it is used for uterine bleeding.

The first aid for severe uterine bleeding is complete rest and the use of hemostatic agents. The full effect of the drug Dicinon occurs after 1-2 hours and its therapeutic effect continues for another 6 hours.

The drug can be used in the form of tablets and injections. With uterine bleeding, take tablets of 250-500 mg up to 3 times a day. Intravenous administration is used to stop severe uterine bleeding, the effect in this case occurs after 5-15 minutes.

How to take Dicinon with heavy periods

Abundant and prolonged periods can cause anemia and other problems, so the doctor in such cases prescribes hemostatic drugs such as Dicinon. A hemostatic drug in some cases is taken in courses.

There may be several treatment options:

• With the preventive purpose of heavy bleeding, the drug begins to be drunk from the third day from the onset of menstruation. Take 250 mg up to 3-4 times a day. After such a reception with subsequent menstrual bleeding, the amount of discharge becomes much less;
• With heavy bleeding, the drug begins to be taken on the 5th day from the onset of menstruation and continues to be drunk for another 10 days. In some cases, such a course may be prescribed for another 2 menstruation;
• With prolonged menstrual bleeding for more than 7 days, the doctor prescribes the drug at a dosage of 250 mg / 1 time per day. Reception continues until the cessation of menstrual bleeding, but can not be more than 10 days.

What is better for bleeding Tranexam or Dicinon

The instructions for Dicinon and Tranexam indicate that both drugs are hemostatic agents, but which one is more effective?

Dicinon normalizes blood clotting by strengthening the vascular wall and reducing its permeability. And also the drug promotes the release of platelets.

Tranexam has a slightly different mechanism of action. The drug has a direct effect on the process of blood clotting. The tranexamic acid included in it inhibits the activation of plasminogen and converts it into plasmin.

It's believed that Tranexam is more effective, because it quickly copes with bleeding. At the same time, it is worth remembering that Tranexam and Dicinon have a number of contraindications and side effects, so only a doctor can determine which drug is better.

How many days can I take Dicynon

The duration of taking Dicinon depends on the type and severity of bleeding. For example, with heavy menstrual bleeding, the drug in the form of tablets at a dosage of 250-500 mg is taken for no more than 10 days. If you continue taking the drug, the woman's condition may worsen significantly.

During inpatient treatment Dicynon is usually prescribed by doctors in the form of injections at a dosage of 2 ml with a course of treatment up to 14 days.

In no case should you take the drug on your own without a doctor's prescription, because it has a number of contraindications and side effects. Only a doctor can determine the exact dosage and duration of Dicinon treatment.

Dicinon compatibility with alcohol

The consequences of combining alcoholic beverages with Dicinon can be the most terrible. The fact is that alcoholic beverages themselves can increase blood viscosity, because under the influence of alcohol, erythrocytes stick together.

If Dicynon, which has a hemostatic effect, is added to this effect, then blood viscosity will increase even faster and stronger. In addition, alcoholic beverages significantly increase the risk of side effects from taking medications.

Therefore, the joint intake of alcoholic beverages with Dicinon is strictly prohibited.

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* Instructions for medical use for the drug Dicinon published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, IT IS NECESSARY TO CONSULT WITH A SPECIALIST

Women are often concerned about uterine bleeding, which have different causes. In the arsenal of doctors there are a large number of tools that help to cope with this pathology. Dicinone is one of the most popular, effective and inexpensive drugs.

Why does uterine bleeding occur?

The discharge of blood from the female genital organs, not programmed by nature, is an abnormal condition and requires treatment. There are many causes of uterine bleeding. Therefore, a classification of the main factors affecting the body of women that can cause bleeding from the uterus has been created.

Conventionally, there are 2 main categories of reasons:

1. Pathologies arising on the basis of diseases and conditions that do not affect the reproductive system:
   • infections:
     • sepsis;
     • dysentery;
   • blood diseases:
     • vasculitis;
     • hemophilia;
   • metabolic disease;
   • pathologies in the work of the cardiovascular system;
   • cirrhosis of the liver.
2. Diseases, pathologies and conditions related to the reproductive system:
   • tumors (benign and malignant) of the uterus and/or ovaries;
   • ruptures of cysts and/or ovaries;
   • genital infections;
   • inflammatory processes of the uterus:
     • endometritis;
     • cervicitis;
     • erosion;
   • menopause;
   • pathology during pregnancy;
   • puberty.

Most often, vaginal / uterine bleeding occurs in menopause, when a woman's body is very susceptible to the influence of negative external factors.

Uterine bleeding is divided into dysfunctional and breakthrough. Any manifestation of the outflow of blood from the uterus requires emergency measures aimed at stopping the bleeding and identifying (with subsequent elimination / treatment) the true causes of this condition.

Dicynon for uterine bleeding: effectiveness and expediency

The primary pre-medical measures to stop uterine bleeding to prevent large blood loss are to ensure complete rest and the use of hemostatic agents (only if absolutely necessary).

Among the drugs that can reduce the abundance of blood secretions, Dicinon is the most popular. It can be found in any pharmacy chain.

Dicinon is a scientific and pharmaceutical development of the well-known company LEK (Slovenia). The drug is based on the active ingredient etamsylate, which has the following properties:

• angioprotective;
• hemostatic;
• stimulating.

Etamsylate in the basis of Dicinon promotes the formation of platelets, their aggregation and activity. The drug helps in the formation of thromboplastin, which as a result reduces bleeding. Dicinon prevents the destruction of blood vessels, and also helps to reduce fragility, normalizing their permeability in various pathological processes. There is an improvement in blood microcirculation without thrombosis.

A hemostatic light effect is noticeable already 15-30 minutes after taking the drug, and the highest peak of effectiveness is observed after 1-2 hours. The effect of the drug lasts no more than six hours, and then weakens over the next day.

The drug is available in two forms: a solution for intramuscular or intravenous internal administration and tablets. In pre-medical practice, a tablet preparation is used. In other cases, the use of this medication requires a special prescription from a doctor in a hospital setting.

The most effective method of use is the intravenous administration of Dicinon.

Composition and description of the drug Dicinon

As already mentioned, the main active ingredient in any form of release of the drug is etamsylate. As part of tablets and injections, its amount is 250 mg.

The remaining components of the tablet Dicinon are auxiliary:

• corn starch;
• lactose;
• lemon acid;
• magnesium stearate;
• povidone K25.

Tablets are biconvex, white, with a break line. Packed in a blister of 10 units.

The solution for intramuscular and intravenous administration in its composition (except for the active substance) has the following additional components:

• sodium disulfide;
• sodium bicarbonate (for pH adjustment);
• distilled water.

The drug is a colorless liquid, in 2 ml ampoules of neutral transparent glass with special marks for proper opening. The break point is marked with colored paint. Ampoules are packed in special blisters of 5 or 10 pieces.

When the drug is prescribed

Any bleeding can serve as an indication for the use of Dicinon. However, most often this drug is used in pathological conditions, when there is a danger of large blood loss. These can be the following types of uterine bleeding:

• dysfunctional, when the ovaries fail;
• profuse, not accompanied by pain and caused by abortion, infections, fibroids;
• breakthrough, with hormonal imbalance or against the background of an injury;
• hypotonic, with minimal uterine tone, usually after abortion or childbirth.

Use during pregnancy

However, during pregnancy, if bleeding occurs from the genital organs, you should refrain from using Dicinon on your own, since only a doctor can correctly assess the situation and decide on the advisability of taking this drug.

The use of the drug during the period of bearing a baby is possible only when the potential benefit to the woman outweighs the possible risks to the unborn child. If it is necessary to use the drug during lactation, breastfeeding must be stopped.

Use in childhood

It is possible to use the remedy in the treatment of uterine bleeding in children only in accordance with the doses prescribed by the doctor. In such cases, they must be strictly adjusted for the age and weight of the patient.

Contraindications and application features

There are a number of contraindications to the use of this medication. You can not use Dicinon in the following diseases and conditions:

• thrombosis;
• thromboembolism;
• in children under the age of 12;
• acute porphyria;
• hemorrhages and bleeding caused by an excess dose of anticoagulants;
• increased susceptibility of the body to the components of the drug.

Special conditions

The drug should be used with extreme caution for the treatment of patients suffering from congenital lactose intolerance, the Lapp lactose deficiency. It should be borne in mind that the daily dose of milk sugar consumption should not exceed 5 g (1 tablet of the drug contains almost 60 mg of lactose).

You can not simultaneously use the drug and solutions of sodium bicarbonate and sodium lactate.

When using the medicine in injections, it must not be mixed with other drugs in the same syringe! It is forbidden to use Dicinon when a color shade appears in the solution!

Side effects

During therapy, side effects are possible, which disappear after discontinuation of the drug.

1. From the side of the central and peripheral nervous systems, there may be:
   • headache;
   • dizziness;
   • numbness of the lower extremities.
2. From the gastrointestinal tract:
   • nausea;
   • heartburn;
   • heaviness in the stomach;
   • flatulence.
3. Allergy.
4. Decreased blood pressure.
5. Redness of the skin of the face.

Mode of application

The use of the drug without prescription is possible only as an "ambulance" in anticipation of qualified treatment. In this case, a single intake of Dicinon should not exceed 2 tablets (for adults).

In the future, the drug is prescribed by the attending physician, if its use is considered appropriate. The duration of therapy depends on the effectiveness.

How to replace the medicine

Dicinon has a number of analogues, which are often used in the treatment of uterine bleeding. These are hemostatic drugs that can be used to stop the flow of blood from the uterus.

More about one of the analogues of dicynone - tranexam:

Analogues of the drug - table

Photo gallery of analogues

Aminocaproic acid - quick stop of uterine bleeding Quickly stops bleeding Immunin

A drug to prevent and stop bleeding. Influences the first stage of the mechanism of hemostasis (interaction between endothelium and platelets). Dicinone increases platelet adhesiveness, normalizes the strength of capillary walls (reducing their permeability), inhibits the biosynthesis of prostaglandins, which cause platelet disaggregation, vasodilation and increased capillary permeability.
When administered orally, the drug is almost completely absorbed in the gastrointestinal tract, reaching peak serum concentrations 4 hours after ingestion. Approximately 72% of the dose taken is excreted in the urine unchanged within 24 hours.
After intravenous administration of the drug, the hemostatic effect is noted after 5-15 minutes, the maximum therapeutic effect is achieved within 1 hour. The effectiveness of the drug begins to decrease after 4-6 hours. 10 min and is 50 mcg / ml. Approximately 72% of the administered dose is excreted within 24 hours in the urine unchanged. Etamzilat gets through a placental barrier and gets into breast milk.

Indications for use of the drug Dicinon

Tablets, injection solution:

• prevention and treatment of bleeding during and after surgical operations in otolaryngology, gynecology, obstetrics, urology, dentistry, ophthalmology, plastic surgery;
• prevention and treatment of capillary bleeding of various etiologies and localizations: hematuria, metrorrhagia, primary menorrhagia in women with intrauterine contraceptives, epistaxis, bleeding with gingivitis.

Solution for injection:

• in neonatology (the drug is prescribed as an angioprotector until the microcirculation is normalized).

The use of the drug Dicinon

Tablets
The daily dose is: 1-2 tablets 3-4 times a day. In severe cases, the dose is 3 tablets 3-4 times a day. For menorrhagia, 3-4 tablets per day are prescribed, starting 5 days before the expected onset of menstruation and until the 5th day of the next menstrual cycle.
After surgery, 1-2 tablets are used every 6 hours until the risk of bleeding disappears.
Solution for injections
It is applied in / in (slowly) or in / m. The optimal dose for adults is 10-20 mg / kg of etamsylate and is administered in 3-4 doses. In most cases, the daily dose is 1-2 ampoules 3-4 times a day.
Before surgery, 1-2 ampoules are administered intravenously or intramuscularly. During operation enter in/in 1-2 ampoules; administration at the same dose can be repeated. After surgery, 1-2 ampoules are administered every 6 hours until the risk of bleeding disappears.
In neonatology, Dicinon is administered intramuscularly or intravenously at doses of 12.5 mg/kg (0.1 ml = 12.5 mg). Treatment should be initiated within the first 2 hours after birth and administered every 6 hours for 4 days up to a total dose of 200 mg/kg.
Dicynon can be applied topically (skin graft, tooth extraction) using a sterile gauze pad moistened with the drug.

Contraindications to the use of the drug Dicinon

Hypersensitivity to the components of the drug, acute porphyria, hemoblastosis in children. Increased blood clotting.

Side effects of Dicinon

Tablets: rarely - nausea, epigastric pain, dizziness, skin rash.
Solution for injection: headache, dizziness, flushing of the face, transient skin reactions, nausea, epigastric pain, paresthesia of the lower extremities. Sometimes - a decrease in systolic pressure after intravenous administration of the drug. These side effects are mild and transient.

Special instructions for the use of the drug Dicinon

Other causes of bleeding must be ruled out before starting treatment.
Use the drug with caution in patients with a history of thrombosis and thromboembolism. The drug is ineffective in reducing the number of platelets.
During pregnancy and breastfeeding. The safety of the drug has not been established. Dicynon is allowed to be taken only if the potential benefit to the mother outweighs the potential risk to the fetus. When using the drug, breastfeeding should be discontinued.
Influence on the ability to drive vehicles and mechanisms. Does not affect.
Tablets should be taken with meals or after meals.
It is forbidden to use the drug in case of discoloration of the solution.

Interactions of the drug Dicinon

solution for injections not compatible with sodium bicarbonate solution and sodium lactate powder. The contents of the ampoule should not be mixed with other drugs in the same syringe. If Dicinon is mixed with physiological solution, it must be used immediately.
Tablets: interactions with other drugs have not been established.

Overdose of the drug Dicinon, symptoms and treatment

No data.

Storage conditions of the drug Dicinon

Store in a dry, dark place at temperatures up to 25°C.

List of pharmacies where you can buy Dicinon:

• St. Petersburg

The drug dicynone (INN - etamzilat) from the Slovenian pharmaceutical company "Lek" refers to hemostatic (hemostatic) drugs and is used for capillary bleeding of various origins. It stimulates the synthesis of glycosaminoglycans of large molecular weight in the walls of blood vessels, increases the stability of blood vessels, regulates the permeability of their walls against the background of various pathological processes, and improves blood circulation in the capillary bed. The hemostatic effect of dicynone is associated with its ability to stimulate the synthesis of thromboplastin, the most important factor in the blood coagulation system, in the focus of capillary injury. The drug activates the formation of tissue thromboplastin (blood clotting factor III), normalizes adhesion (the ability to adhere to the vascular wall) of platelets. Dicinone does not affect prothrombin time (blood clotting time), does not cause an increase in blood clotting and does not contribute to thrombosis. After intravenous administration, the effect of the drug develops after 5-15 minutes, reaching its peak after 1 hour and continuing for another 4-5 hours.

Dicinon is available in two dosage forms: tablets and solution for intravenous and intramuscular administration (used only in hospitals).

The optimal daily dose of oral dicynone is determined at the rate of 10-20 mg per 1 kg of body weight and is divided into 3-4 doses during the day. As a rule, a single dose is 250-500 mg, the largest is 750 mg. With heavy menstruation, dicynone is prescribed at 750-1000 mg per day from the fifth day from the expected onset of menstruation until the fifth day of the next menstrual cycle. After surgical interventions, the drug is indicated at a dose of 250-500 mg with a frequency of 1 time in 6 hours until all the prerequisites for the development of bleeding disappear. The daily dose of dicynone for children also depends on body weight and is calculated on the basis of 10-15 mg per 1 kg of body weight for the same 3-4 doses. The optimal daily dose of injectable dicynone is similar to that of tablets: 10-20 mg per 1 kg of body weight with a frequency of administration 3-4 times a day for both intravenous and intramuscular administration (in the first case, the drug is administered slowly). With the introduction of dicynone in a mixture with saline, the injection is made immediately.

Before using dicynone as a hemostatic agent, it is necessary to accurately establish the cause of the bleeding. If the injection solution has acquired color, then it can no longer be used and must be disposed of.

Pharmacology

hemostatic drug. The drug increases the formation of mucopolysaccharides of large molecular weight in the walls of capillaries and increases the stability of capillaries, normalizes their permeability during pathological processes, and improves microcirculation. It has a hemostatic effect, which is due to the activation of the formation of thromboplastin at the site of damage to small vessels. The drug stimulates the formation of blood coagulation factor III, normalizes platelet adhesion. The drug does not affect prothrombin time, does not have hypercoagulable properties and does not contribute to the formation of blood clots.

After intravenous administration, the drug begins to act after 5-15 minutes; the maximum effect is observed after 1 hour, the duration of action is 4-6 hours.

Pharmacokinetics

Suction and distribution

After intravenous administration of the drug at a dose of 500 mg, Cmax is reached after 10 minutes and is 50 μg / ml.

After oral administration, the drug is rapidly and almost completely absorbed. After taking the drug at a dose of 50 mg, Cmax is reached after 4 hours and is 15 μg / ml.

Etamzilat crosses the placental barrier and is excreted in breast milk.

breeding

About 72% of the administered dose is excreted by the kidneys during the first 24 hours unchanged.

After intravenous administration, T 1/2 is about 2 hours, after oral administration, T 1/2 is about 8 hours.

Release form

Tablets are white or almost white, round, biconvex.

Excipients: anhydrous citric acid, corn starch, povidone K25, magnesium stearate, lactose.

10 pieces. - blisters (10) - packs of cardboard.

Dosage

Tablets

The optimal daily dose for adults is 10-20 mg / kg of body weight, divided into 3-4 doses. In most cases, a single dose is 250-500 mg 3-4 times / day. In exceptional cases, a single dose may be increased to 750 mg 3-4 times / day.

With menorrhagia, 750-1000 mg / day is prescribed, starting from the 5th day of the expected menstruation until the 5th day of the next menstrual cycle.

In the postoperative period, the drug is prescribed in a single dose of 250-500 mg every 6 hours until the risk of bleeding disappears.

Children are prescribed in a daily dose of 10-15 mg / kg in 3-4 doses.

Solution for intramuscular and intravenous injections

The optimal daily dose for adults is 10-20 mg/kg divided into 3-4 IM or IV (slow) injections.

Adults during surgical interventions are prophylactically administered intravenously or intramuscularly 250-500 mg 1 hour before surgery. During the operation, 250-500 mg is administered intravenously, the administration of this dose can be repeated again. After surgery, 250-500 mg is administered every 6 hours until the risk of bleeding disappears.

For children, the daily dose is 10-15 mg / kg of body weight, divided into 3-4 injections.

In neonatology: Dicinone is administered intramuscularly or intravenously (slowly) at a dose of 12.5 mg/kg (0.1 ml = 12.5 mg). Treatment should begin within the first 2 hours after birth.

If Dicinon is mixed with saline, then it should be administered immediately.

Overdose

Interaction

Administration at a dose of 10 mg/kg of body weight 1 hour before the administration of dextrans prevents their antiaggregant effect. The introduction of Dicinon after the introduction of dextrans does not have a hemostatic effect.

Perhaps a combination with aminocaproic acid and menadione sodium bisulfite.

Pharmaceutical interaction

Pharmaceutically incompatible (in one syringe) with other drugs.

Incompatible with sodium bicarbonate injection and sodium lactate solution.

Side effects

From the side of the central nervous system and peripheral nervous system: headache, dizziness, paresthesia of the lower extremities.

From the digestive system: nausea, heartburn, heaviness in the epigastric region.

Other: allergic reactions, hyperemia of the skin of the face, decrease in systolic blood pressure.

Indications

Prevention and treatment of capillary bleeding of various etiologies:

• during and after surgical operations on all well-vascularized tissues in otorhinolaryngology, gynecology, obstetrics, urology, dentistry, ophthalmology and plastic surgery;
• hematuria, metrorrhagia, primary menorrhagia, menorrhagia in women with intrauterine contraceptives, epistaxis, bleeding gums;
• diabetic microangiopathy (hemorrhagic diabetic retinopathy, repeated retinal hemorrhages, hemophthalmos);
• intracranial hemorrhages in newborns and premature babies.

Contraindications

• acute porphyria;
• hemoblastosis in children (lymphoblastic and myeloblastic leukemia, osteosarcoma);
• thrombosis;
• thromboembolism;
• hypersensitivity to the components of the drug and sodium sulfite;
• hypersensitivity to sodium sulfite (solution for intravenous and intramuscular administration).

With caution, the drug should be prescribed for thrombosis, a history of thromboembolism, bleeding against the background of an overdose of anticoagulants.

Application features

Use during pregnancy and lactation

Application during pregnancy is possible only in cases where the potential benefit of therapy for the mother outweighs the possible risk to the fetus.

If necessary, the appointment of the drug during lactation should decide on the termination of breastfeeding.

Use in children

special instructions

Other causes of bleeding should be ruled out before starting treatment.

1 tablet of Dicinon contains 60.5 mg of lactose (the maximum daily dose of lactose should not exceed 5 g). Do not prescribe the drug to patients with congenital glucose intolerance, lapp lactase deficiency (lactase deficiency in some peoples of the North) or glucose-galactose malabsorption syndrome.

If the solution for intramuscular and intravenous administration becomes stained, it should not be used.

The solution for i / m and / in the introduction is intended only for use in hospitals and clinics.

Solution for intramuscular and intravenous injection can be applied topically: a sterile swab or gauze is soaked in solution and applied to the wound (for example, skin graft, tooth extraction).

Influence on the ability to drive vehicles and control mechanisms

No special precautions required.