Nemozole suspension 100/5ml vial 20ml

Mechanism of action

Nemozole - antihelminthic (anthelmintic) drug of a broad spectrum of activity; benzimidazole carbamate derivative. Albendazole is similar in structure to mebendazole.
The main mechanism of action of Nemozole (albendazole) is associated with selective suppression of the polymerization of beta-tubulin, which leads to the destruction of cytoplasmic microtubules of intestinal cells of helminths.
Nemozole (albendazole) changes the course of biochemical processes: it inhibits glucose utilization and inhibits ATP synthesis, blocks the movement of secretory granules and other organelles in the muscle cells of worms, causing their death.
Nemozole is especially effective against larval forms of cestodes - Echinococcus granulosus and Taenia solium, nematodes - Strongyloides stercolatis.
Nemozole is effective both in mono- and polyinvasions.

Pharmacokinetics:
When Nemozole is taken orally, albendazole is poorly absorbed from the gastrointestinal tract; it is not detected in plasma in unchanged form, since quickly converted in the liver to the primary metabolite - albendazole sulfoxide, which also has anthelmintic activity. Bioavailability of Nemozole is low. Intake of fatty foods increases the absorption and Cmax of albendazole 5 times. The time to Cmax of albendazole sulfoxide is 2-5 hours.Associated with plasma proteins by 70%. Almost completely distributed throughout the body; found in urine, bile, liver, in the wall of the cyst and cystic fluid, cerebrospinal fluid. It penetrates the wall and fluids of helminth cysts. Albendazole sulfoxide is metabolized to albendazole sulfone (secondary metabolite) and other oxidized products. T1 / 2 albendazole sulfoxide - 8-12 hours. Excreted in the bile through the intestine as an active metabolite of albendazole sulfoxide, only a small amount is excreted in the urine. Clearance does not change in patients with impaired renal function. With liver damage, bioavailability increases, while Cmax of albendazole sulfoxide increases by 2 times, and T1 / 2 is extended. Albendazole is an inducer of microsomal enzymes of the cytochrome P-450 (IA) system; speeds up the metabolism of many drugs.

Indications and usage

Nemozole is used for helminthic invasions, incl. nematodoses:

• neurocysticercosis caused by the larval form of pork tapeworm (Taenia solium);
• echinococcosis of the liver, lungs, peritoneum, caused by the larval form of canine tapeworm (Echinococcus granulosus); as an aid in the surgical treatment of ehonococcosis cysts;
• ascariasis;
• trichocephalosis;
• hookworm;
• enterobiosis;
• necatoriasis;
• strongyloidiasis (stratiloidosis);
• opisthorchiasis;
• microsporidiosis;
• toxocarosis;
• giardiasis;
• mixed helminthiasis.

Nemosol prescribed inside, during a meal or after a meal, the pills are not chewed, washed down with water. The use of laxatives and a special diet are not required.It is recommended that simultaneous treatment of all family members.
The dose of Nemozole is set individually, depending on the type of helminth and body weight of the patient.

The use of Nemozole in children under 2 years:
Cysticercosis of the brain (neurocysticercosis): 15 mg / kg / day for 8 days; repeat if necessary.
Ankilostomidosis, enterobiosis, ascariasis: 200 mg once, if necessary, repeated after 3 weeks.
Strongiloidosis and cestodosis: 200 mg 1 time per day for 3 days, if necessary, repeat after 3 weeks.

The use of Nemozole in children over 2 years old and adults:
Neurocysticercosis and echinococcosis: patients with a body weight of 60 kg or more Nemozole is prescribed 400 mg 2 times / day, with a body weight less than 60 kg, the dose is determined at the rate of 15 mg / kg / day, divided into 2 doses; the maximum daily dose is 800 mg; treatment with neurocysticercosis - 8-30 days; with echinococcosis - 3 cycles of 28 days each with a 14-day interval between cycles.
Ascariasis, trichocephalosis, enterobiosis and ankilostomidosis: 400 mg once, if necessary, repeat after 3 weeks.
Strongyloidiasis and cestodosis: 400 mg once a day for 3 days, if necessary, repeat after 3 weeks.
Lambliosis: 400 mg 1 time per day for 3 days or at the rate of 10-15 mg / kg 1 time per day for 5-7 days.
Toxocarosis: for adults and children over 14 years old with a body weight of more than 60 kg Nemozole is used in a single dose of 400 mg; weighing less than 60 kg - 200 mg, children under the age of 14 set the dose at the rate of 10 mg / kg; the frequency of reception is 2 times / day, the duration of therapy is 7-14 days.

Overdosage

Treatment: gastric lavage, Activated carbon.If necessary, conduct symptomatic therapy.

Contraindications

• hypersensitivity to Nemozole (including other benzimidazole derivatives);
• pregnancy, lactation;
• lesion of the retina.

Nemozole used with caution

• oppression of bone marrow hematopoiesis;
• liver failure, liver cirrhosis (liver function should be regularly monitored before and during treatment).

Pregnancy and breastfeeding

In experimental studies on animals, teratogenicity of albendazole was shown.
Nemozole is contraindicated for use during pregnancy. Before the appointment Nemozole should ensure that no pregnancy in women of childbearing age. Women of childbearing age during the treatment period Nemozole recommended non-hormonal methods of contraception.
It is not known whether albendazole and its active metabolite in breast milk is excreted. If necessary, the appointment of Nemozole during lactation should decide on the termination of breastfeeding.

Adverse reactions

On the part of the digestive system: abdominal pain, nausea, vomiting, increased activity of liver transaminases.
From the nervous system: headache, dizziness, meningeal symptoms.
On the part of the blood-forming organs: inhibition of bone marrow hematopoiesis - leukopenia, granulocytopenia, agranulocytosis, thrombocytopenia, pancytopenia.
On the part of the urinary system: impaired renal function, acute renal failure.
Allergic reactions: skin rash, itching.
Other: hyperthermia (fever), high blood pressure, reversible alopecia.

Special notes

Nemozole is prescribed with caution to patients with oppression of bone marrow hematopoiesis, liver failure, liver cirrhosis, and retinal pathology.
Blood tests should be performed at the beginning of each 28-day cycle and every 2 weeks during the period of Nemozole therapy. It is necessary to discontinue therapy in the development of leukopenia. It is possible to continue the treatment with Nemozole, if the decrease in the total content of leukocytes and neurotrophil leukocytes is moderate and does not progress.
Patients receiving high doses of Nemozole should be carefully monitored, with constant monitoring of the state of the liver functions.
In case of neurocysticercosis with damage to the eyes, before starting treatment with Nemozole, a study of the retina of the eye is necessary (the risk of aggravating its pathology).
Patients with neurocystic cystic disease should receive appropriate steroid therapy (GCS) and anticonvulsant drugs. Oral or intravenous corticosteroids are used to prevent a hypertensive seizure during the first week of anti-cystic therapy.

Drug interactions

Dexamethasone, praziquantel and cimetidine increase the concentration of albendazole in the blood.
An increase in the concentration of albendazole in the bile and in the contents of an echinococcal cyst was detected with simultaneous use with cimetidine, which may increase the effectiveness of treatment of echinococcosis.

Storage conditions

List B. Store in a dry, protected from light, out of reach of children, at a temperature below 25 ° C.
Shelf life 3 years.
Conditions of sale from pharmacies - on prescription.