CERUCAL 10 mg. 50 tablets
CERUCAL 10 mg. 50 tablets
Cerucal medicine that stimulates motility (ability to move spontaneously) of the stomach and intestines and act to prevent nausea and vomiting.
Symptomatic treatment of:
motility disorders (ability to movement) in the upper part of the gastrointestinal tract;
nausea and vomiting of various origins;
diabetic gastroparesis (stomach muscle weakness in diabetes).
In what cases should not take Cerucal
Cerucal should not be taken if:
- Known hypersensitivity to the drug metoclopramide or any of the excipients of the medicinal product;
- Certain hormone dependent tumors (tumors prolaktinzavisimi);
- Tumors of the adrenal medulla (pheochromocytoma);
- Mechanical intestinal obstruction;
- Intestinal perforation;
- Bleeding in the gastrointestinal area;
- Patients with extrapyramidal movement disorders;
- Children (see "What should be considered in children?")
In what cases only after consulting your doctor may take Cerucal?
In patients with impaired hepatic function (liver failure) and in patients with impaired renal function due to
difficult radiation dose should be adjusted according to functional impairment (see "Dosage, route and duration of administration").
Special precautions for use
What special measures should be considered?
In patients with impaired renal function and in patients with liver function disorders, the dosage should be adjusted according to functional impairment (see also "Dosage, route and duration of administration").
Particular caution is advised in epileptic patients and in patients with porphyria.
In adolescents and in patients with severely impaired renal function (renal failure), due to the limited broadcast of metoclopramide should be very careful about the side effects and if these occur, the administration of the medicinal product should be discontinued immediately (see also and "Undesirable effects").
What other drugs affect the action of Cerucal or are affected by it?
Cerucal can affect the absorption (absorption from the gastrointestinal tract) of the other drugs, such as the absorption of digoxin and cimetidine may be weakened, while the absorption of levodopa, bromocriptine, pergolide, aspirin, acetaminophen, various antibiotics (tetracycline shown for and pivampicillin), lithium and alcohol can be accelerated, respectively. increased. With concomitant Cerucal and lithium may increase plasma levels of lithium.
Anticholinergic drugs may weaken the effect of Cerucal.
Concomitant administration of Cerucal neuroleptics (eg phenothiazines, thioxanthen derivatives, butyrophenones) may increase the tendency to extrapyramidal disorders (eg. Seizures in the head, neck and shoulders).
The effect of succinylcholine may be extended by metoclopramide.
Please note that these data may relate to previously used drugs.
What you should consider during pregnancy?
Until contrary scientific evidence, metoclopramide should not be used in the first three months of pregnancy and during lactation. During the second and third trimester of pregnancy, metoclopramide should be administered only under strict medical prescription.
What should be considered in children?
In infants and young children up to 2 years is shown taking metoclopramide containing compounds.
Due to the high content of the active substance, the appointment of Cerucal tablets to children aged between 2 and 14 years is not recommended.
What you should consider when participating in traffic and operating machinery and working without reliable support?
Cerucal can, even if compliance with prescribed use, to the extent that the reactivity changes that impair the ability to actively participate in traffic or maintenance of machines. Unexpected and sudden situations possible, you can no longer fast enough to react and targeted. This is especially true when interacting with alcohol or sedating drugs (ie. Sedatives).
Dosage, route and duration of administration
The following data are valid if your doctor prescribes otherwise for taking Cerucal. Please adhere to the recommendations for use, otherwise Cerucal can not match for her properly.
In how much and how often you should take Cerucal
In the event that otherwise prescribed treatment adults take 1 tablet Cerucal 3 to 4 times per day (corresponding to 10 mg of metoclopramide are three to four times daily), and children over 14 years - ½ to 1 tablet 2 to 3 times per day (corresponding to 5 to 10 mg metoclopramide 2 to 3 times a day).
In children aged between 2 and 14 years, the dose is 0,1 mg. metoclopramide / kg body weight. For this purpose available form (eg. Injection), which can be dosed more accurately.
When renal FUNCTION dose should be adapted to functional disorders.
Should be given the following parameters in adults:
Creatinine clearance up to 10 ml / min .: 1 tablet once daily (equivalent to 10 mg metoclopramide).
Creatinine clearance between 11 and 60 ml / min .: 1 tablet once daily (equivalent to 10 mg metoclopramide) and ½ tablet once a day (corresponding to 5 mg metoclopramide).
In patients with severely impaired hepatic function (liver failure) and dropsy of the abdominal cavity (ascites), the dose should be reduced by half due to a prolonged half-life.
How, when and how long you should take Cerucal
The tablets are taken chewed along with liquid before a meal.
The duration of treatment with Cerucal determined by the physician. Are usually sufficient for 4-6 weeks. Treatment for longer than 6 months is possible in exceptional cases.
Prolonged treatment with Cerucal increased risk of movement disorders (see "Undesirable effects").
Overdose and other errors in use
What you should consider if you take Cerucal in too much (overdose or intentional overdose by mistake)?
Symptoms of overdose Cerucal are drowsiness (somnolence), confusion, irritability, anxiety, respectively. increase anxiety, seizures, extrapyramidal movement disorders, cardiovascular function with a slow heart rate (bradycardia) and increase, respectively. drop in blood pressure.
In some cases the reported occurrence of methemoglobinemia (reduced ability to transport oxygen due to chemical changes in red blood cells).
In suspected overdose Cerucal immediately seek the assistance of a doctor!
Treatment is geared to the symptoms of an overdose and to the picture of the disease.
Can therefore take the following measures:
Extrapyramidal symptoms disappeared after the slow intravenous administration of biperiden. At high doses, the elimination of metoclopramide from the gastrointestinal tract, can be taken gastric lavage or give medical charcoal and sodium sulphate.
Monitoring of vital signs (vital functions) until the symptoms disappear.
What you should consider if you take Cerucal in very small quantities or have forgotten a single dose?
In the next dose, do not take more tablets than prescribed single dose and continue treatment as prescribed dosage regimen.
What you should consider if you interrupt or stop treatment in advance?
If you stop or advance stop taking medicine may wholly or partially lost the effect of treatment, respectively. again deteriorated picture of your disease. Prior to willfully treatment interruption or discontinuation of prior drug - eg. based on the occurrence of adverse drug reactions - seek the advice of your doctor! Following the occurrence of side effects can actually have immediate discontinuation of the drug (see "Special precautions for use" and "Adverse Reactions").
What side effects may occur when taking Cerucal and what countermeasures to be taken in these cases?
During the administration of metoclopramide may occur diarrhea, fatigue, headache, dizziness, anxiety and restlessness.
Rarely may develop a skin rash.
More rarely occurred in depression while taking metoclopramide.
In isolated cases, mainly in children settled dyskinetic syndrome (spontaneous seizure movements, especially in the head, neck and shoulders). This side effect occurs for example as: vertical or horizontal paresis of eye or lens distortion of the head and neck, over-stretching of the spine, shoulder flexion spasms, rarely lingering spasms of the legs. Antidote: Biperiden intravenously.
In rare cases in adults after prolonged treatment with metoclopramide reported occurrence of parkinsonism (with typical symptoms: tremor, rigidity, akinesia) and tardive dyskinesia (movement disorders).
In some rare cases, though, the use of metoclopramide has been observed neuroleptic malignant syndrome (characterized by symptoms: fever, muscle rigidity, altered consciousness and variable blood pressure). In these cases must immediately be brought to a doctor! Recommended following urgent measures: discontinuation of Cerucal, cold compresses, dantrolene and / or bromocriptine and consistent watering.
Long-term use can cause an increase in prolactin, gynecomastia (breast development in men), galactorrhea (spontaneous leakage of milk from the mammary glands), or menstrual disorders. In these cases, treatment should be discontinued.
In adolescents and in patients with severe renal impairment (severe renal insufficiency), showing limited elimination of metoclopramide, the occurrence of adverse events should be carefully monitored and their occurrence immediately stop taking the drug.