{"id":54915,"date":"2023-09-20T10:06:40","date_gmt":"2023-09-20T10:06:40","guid":{"rendered":"https:\/\/medsname.com\/alzil\/"},"modified":"2026-04-30T16:30:23","modified_gmt":"2026-04-30T16:30:23","slug":"alzil","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/alzil\/","title":{"rendered":"Alzil"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Alzil<\/strong> \u2014 donepezil 5\/10 mg (Intas Pharma). Reverzibiln\u00ed centr\u00e1ln\u011b p\u016fsob\u00edc\u00ed inhibitor acetylcholinester\u00e1zy pro m\u00edrnou, st\u0159edn\u011b t\u011b\u017ekou a t\u011b\u017ekou Alzheimerovu chorobu a demenci u Parkinsonovy choroby. M\u00edrn\u00e9 zlep\u0161en\u00ed kognitivn\u00edch funkc\u00ed a aktivit denn\u00edho \u017eivota; nezpomaluje progresi onemocn\u011bn\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Alzil je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, fakturov\u00e1n p\u0159es regulovan\u00e9ho platebn\u00edho procesora (na v\u00fdpisu z karty se objev\u00ed regulovan\u00fd platebn\u00ed procesor \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je kryta na\u0161\u00ed 20-pracovn\u00ed-denn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Stanovte si realistick\u00e1 o\u010dek\u00e1v\u00e1n\u00ed<\/strong><br \/>Donepezil zp\u016fsobuje m\u00edrn\u00e9, kr\u00e1tkodob\u00e9 zlep\u0161en\u00ed kognice (obvykle o 2-4 body na ADAS-cog \u0161k\u00e1le) a m\u016f\u017ee odd\u00e1lit um\u00edst\u011bn\u00ed do pe\u010dovatelsk\u00e9ho za\u0159\u00edzen\u00ed. NEzpomaluje v\u0161ak z\u00e1kladn\u00ed neurodegenerativn\u00ed proces. Efekt dosahuje plat\u00f3 a p\u0159\u00ednosy mohou vymizet b\u011bhem 6-24 m\u011bs\u00edc\u016f. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby proberte realistick\u00e9 c\u00edle s rodinou.<\/div>\n<h2>D\u00e1vkov\u00e1n\u00ed<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">Indikace<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">D\u00e1vka<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">M\u00edrn\u00e1 a\u017e st\u0159edn\u011b t\u011b\u017ek\u00e1 Alzheimerova choroba<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">5 mg p\u0159ed span\u00edm po dobu 4 t\u00fddn\u016f \u2192 10 mg p\u0159ed span\u00edm<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">T\u011b\u017ek\u00e1 Alzheimerova choroba<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">10 mg\/den; n\u011bkte\u0159\u00ed l\u00e9ka\u0159i titruj\u00ed na 23 mg\/den (kde je dostupn\u00e9)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Parkinsonova demence \/ DLB<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">5-10 mg\/den p\u0159ed span\u00edm<\/td>\n<\/tr>\n<\/table>\n<p>U\u017e\u00edvejte ve\u010der s j\u00eddlem nebo bez n\u011bj. Formulace 23 mg mus\u00ed b\u00fdt spolknuta cel\u00e1; tablety 5\/10 mg lze v p\u0159\u00edpad\u011b pot\u0159eby rozdrtit.<\/p>\n<h2>Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li><strong>Cholinergn\u00ed GI \u00fa\u010dinky (nej\u010dast\u011bj\u0161\u00ed, z\u00e1visl\u00e9 na d\u00e1vce):<\/strong> nevolnost, zvracen\u00ed, pr\u016fjem, nechutenstv\u00ed, \u00fabytek hmotnosti<\/li>\n<li><strong>CNS:<\/strong> nespavost (p\u0159i p\u0159etrv\u00e1v\u00e1n\u00ed zkuste pod\u00e1v\u00e1n\u00ed r\u00e1no), \u017eiv\u00e9 sny, z\u00e1vrat\u011b, \u00fanava<\/li>\n<li><strong>Kardi\u00e1ln\u00ed:<\/strong> bradykardie, synkopa, AV blok \u2013 opatrnost u syndromu nemocn\u00e9ho sinu nebo p\u0159edexistuj\u00edc\u00edch poruch veden\u00ed; vyvarujte se kombinace s ne-DHP blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f nebo betablok\u00e1tory bez monitorov\u00e1n\u00ed<\/li>\n<li><strong>Dal\u0161\u00ed:<\/strong> mo\u010dov\u00e1 inkontinence (vz\u00e1cn\u00e9), sn\u00ed\u017een\u00ed prahu pro z\u00e1chvaty, zv\u00fd\u0161en\u00e9 riziko GI krv\u00e1cen\u00ed p\u0159i kombinaci s NSAID<\/li>\n<\/ul>\n<h2>Interakce l\u00e9k\u016f<\/h2>\n<ul>\n<li><strong>Siln\u00e1 anticholinergika:<\/strong> oxybutynin, hyoscin, TCA, antihistaminika prvn\u00ed generace \u2013 p\u0159\u00edmo antagonizuj\u00ed donepezil; pokud mo\u017eno se kombinaci vyhn\u011bte<\/li>\n<li><strong>Bradykardizuj\u00edc\u00ed l\u00e9ky:<\/strong> betablok\u00e1tory, ne-DHP blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f (verapamil\/diltiazem), digoxin \u2013 zv\u00fd\u0161en\u00e9 riziko bradykardie\/AV bloku; monitorujte<\/li>\n<li><strong>NSAID:<\/strong> zv\u00fd\u0161en\u00e9 riziko GI krv\u00e1cen\u00ed<\/li>\n<li><strong>Inhibitory CYP2D6 + CYP3A4:<\/strong> ketokonazol, paroxetin, fluoxetin \u2013 m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed hladin donepezilu; obvykle klinicky nev\u00fdznamn\u00e9<\/li>\n<li><strong>Sukcinylcholin (anestezie):<\/strong> prodlou\u017een\u00fd neuromuskul\u00e1rn\u00ed blok \u2014 informujte anesteziologa o u\u017e\u00edv\u00e1n\u00ed donepezilu p\u0159ed jak\u00fdmkoliv chirurgick\u00fdm z\u00e1krokem<\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Jak rychle uvid\u00edm zlep\u0161en\u00ed?<\/h3>\n<p>Kognitivn\u00ed a behavior\u00e1ln\u00ed benefity, pokud se objev\u00ed, jsou obvykle m\u00edrn\u00e9 a projevuj\u00ed se b\u011bhem 6-12 t\u00fddn\u016f. N\u011bkte\u0159\u00ed pacienti nevykazuj\u00ed m\u011b\u0159iteln\u00e9 zlep\u0161en\u00ed; to je o\u010dek\u00e1van\u00e9 a neznamen\u00e1 selh\u00e1n\u00ed l\u00e9\u010dby.<\/p>\n<h3>Kdy by m\u011bl b\u00fdt vysazen?<\/h3>\n<p>P\u0159eru\u0161te l\u00e9\u010dbu, pokud nedojde k vn\u00edman\u00e9mu zlep\u0161en\u00ed po 3-6 m\u011bs\u00edc\u00edch u maxim\u00e1ln\u00ed tolerovan\u00e9 d\u00e1vky, nebo pokud vedlej\u0161\u00ed \u00fa\u010dinky (zejm\u00e9na \u00fabytek hmotnosti) p\u0159eva\u017euj\u00ed nad benefity. N\u011bkte\u0159\u00ed klinici pokra\u010duj\u00ed i v pokro\u010dil\u00e9m stadiu onemocn\u011bn\u00ed \u2014 d\u016fkazy jsou nejednozna\u010dn\u00e9.<\/p>\n<h3>Lze kombinovat s memantinem?<\/h3>\n<p>Ano \u2014 kombinovan\u00e1 terapie (donepezil + memantin) je schv\u00e1lena a b\u011b\u017en\u011b pou\u017e\u00edv\u00e1na u st\u0159edn\u011b t\u011b\u017ek\u00e9ho a\u017e t\u011b\u017ek\u00e9ho onemocn\u011bn\u00ed. Memantin p\u016fsob\u00ed na glutam\u00e1tov\u00e9 (NMDA) receptory, donepezil na acetylcholin \u2014 r\u016fzn\u00e9 mechanismy, aditivn\u00ed \u00fa\u010dinek, \u017e\u00e1dn\u00e9 v\u00fdznamn\u00e9 l\u00e9kov\u00e9 interakce.<\/p>\n<h3>Nespavost?<\/h3>\n<p>Donepezil m\u016f\u017ee zp\u016fsobovat \u017eiv\u00e9 sny a nespavost. Pokud p\u0159etrv\u00e1vaj\u00ed, p\u0159ejd\u011bte na rann\u00ed pod\u00e1v\u00e1n\u00ed.<\/p>\n<h3>Zpomal\u00ed Alzheimerovu chorobu?<\/h3>\n<p>Ne. Jde o symptomatickou l\u00e9\u010dbu. Podkladov\u00e1 neurodegenerace pokra\u010duje. Nov\u011bj\u0161\u00ed chorobu modifikuj\u00edc\u00ed l\u00e1tky (lekanemab, donanemab) sice redukuj\u00ed amyloidn\u00ed plaky, ale jde o samostatn\u00e9, drah\u00e9, infuzn\u00ed terapie s vlastn\u00edmi riziky.<\/p>\n<h3>A co bradykardie?<\/h3>\n<p>P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby prove\u010fte v\u00fdchoz\u00ed EKG, pokud m\u00e1te zn\u00e1m\u00e9 poruchy srde\u010dn\u00edho p\u0159evodu, u\u017e\u00edv\u00e1te betablok\u00e1tory nebo trp\u00edte nevysv\u011btlitelnou synkopou. Donepezil zvy\u0161uje vagotonii a vz\u00e1cn\u011b m\u016f\u017ee zp\u016fsobit AV blok.<\/p>\n<h3>M\u016f\u017ee m\u016fj partner p\u0159estat u\u017e\u00edvat anticholinergn\u00ed l\u00e9ky na hyperaktivn\u00ed mo\u010dov\u00fd m\u011bch\u00fd\u0159?<\/h3>\n<p>Pokud v\u00e1\u0161 bl\u00edzk\u00fd u\u017e\u00edv\u00e1 donepezil na Alzheimerovu chorobu, anticholinergn\u00ed l\u00e9ky na hyperaktivn\u00ed m\u011bch\u00fd\u0159 (oxybutynin, tolterodin) p\u0159\u00edmo p\u016fsob\u00ed proti \u00fa\u010dinku donepezilu A NEZ\u00c1VISLE zhor\u0161uj\u00ed kognici. Mirabegron (beta-3 agonista) je preferov\u00e1n u pacient\u016f s demenc\u00ed.<\/p>\n<h3>Co kdy\u017e vynech\u00e1te d\u00e1vku?<\/h3>\n<p>Vynechejte vynechanou d\u00e1vku a pokra\u010dujte v obvykl\u00e9m sch\u00e9matu. Ned\u00e1vejte dvojn\u00e1sobnou d\u00e1vku. Pokud bylo vynech\u00e1no v\u00edce d\u00e1vek (v\u00edce ne\u017e n\u011bkolik dn\u00ed), za\u010dn\u011bte znovu s ni\u017e\u0161\u00ed d\u00e1vkou 5 mg, abyste p\u0159ede\u0161li gastrointestin\u00e1ln\u00edm ne\u017e\u00e1douc\u00edm \u00fa\u010dink\u016fm.<\/p>\n<h3>M\u016f\u017eu p\u00edt alkohol?<\/h3>\n<p>M\u00edrn\u00e1 konzumace alkoholu je p\u0159ijateln\u00e1. Nadm\u011brn\u00e9 pit\u00ed alkoholu zhor\u0161uje kognitivn\u00ed \u00fabytek nez\u00e1visle na donepezilu a m\u011blo by b\u00fdt odrazov\u00e1no.<\/p>\n<h3>Operace a anestezie?<\/h3>\n<p>Informujte anesteziologa o u\u017e\u00edv\u00e1n\u00ed donepezilu \u2014 prodlu\u017euje \u00fa\u010dinek sukcinylcholinu a dal\u0161\u00edch neuromuskul\u00e1rn\u00edch blok\u00e1tor\u016f. N\u011bkte\u0159\u00ed chirurgov\u00e9 preferuj\u00ed vysazen\u00ed donepezilu 24-48 hodin p\u0159ed pl\u00e1novan\u00fdm z\u00e1krokem; to v\u0161ak d\u011blejte pouze na doporu\u010den\u00ed specialisty.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed l\u00e9ky na Alzheimerovu chorobu a demenci<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/nemdaa\/\">Nemdaa<\/a> \u2014 memantin 5\/10 mg \u2014 NMDA antagonista pro st\u0159edn\u011b t\u011b\u017ek\u00e9 a\u017e t\u011b\u017ek\u00e9 onemocn\u011bn\u00ed<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donamem\/\">Donamem<\/a> \u2014 fixn\u00ed kombinace donepezilu a memantinu<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/alzil\/\">Alzil<\/a> \u2014 donepezil 5\/10 mg \u2014 alternativn\u00ed zna\u010dka<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donecept\/\">Donecept<\/a> \u2014 donepezil 5\/10 mg \u2014 zna\u010dka Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donep\/\">Donep<\/a> \u2014 donepezil 5\/10 mg \u2014 zna\u010dka Alkem<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informaci a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho odborn\u00edka. Proberte jak\u00e9koli nov\u00e9 l\u00e9ky se sv\u00fdm l\u00e9ka\u0159em nebo l\u00e9k\u00e1rn\u00edkem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Alzil (Donepezil 5\/10 mg) \u2014 Intas Pharma, inhibitor cholinester\u00e1zy pro m\u00edrnou, st\u0159edn\u011b t\u011b\u017ekou a t\u011b\u017ekou Alzheimerovu chorobu a demenci u Parkinsonovy choroby. Jednou denn\u011b p\u0159ed span\u00edm. M\u00edrn\u00fd symptomatick\u00fd p\u0159\u00ednos.<\/p>","protected":false},"featured_media":54916,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3772,3141,3223],"product_tag":[3848,3849],"class_list":{"0":"post-54915","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-alzheimers-treatment","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_tag-alzil","10":"product_tag-donepezil","12":"first","13":"outofstock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/54915","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=54915"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/54916"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=54915"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=54915"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=54915"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=54915"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}