{"id":55417,"date":"2024-02-06T23:57:42","date_gmt":"2024-02-06T23:57:42","guid":{"rendered":"https:\/\/medsname.com\/amantrel\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"amantrel","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/amantrel\/","title":{"rendered":"Amantrel"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Amantrel<\/strong> je peror\u00e1ln\u00ed amantadin<\/strong> (100 mg) tobolka s jedine\u010dn\u00fdm dvoj\u00edm mechanismem \u00fa\u010dinku: jednak uvol\u0148uje dopamin<\/strong> z presynaptick\u00fdch z\u00e1sob a blokuje NMDA glutam\u00e1tov\u00e9 receptory<\/strong>. U Parkinsonovy choroby m\u00e1 dva odli\u0161n\u00e9 \u00fa\u010dely: (1) m\u00edrn\u00fd symptomatick\u00fd p\u0159\u00ednos v \u010dasn\u00e9m st\u00e1diu onemocn\u011bn\u00ed (zejm\u00e9na u t\u0159esu a rigidity) a (2) jeden z m\u00e1la \u00fa\u010dinn\u00fdch l\u00e9k\u016f pro levodopou indukovan\u00e9 dyskineze<\/strong> v pokro\u010dil\u00e9m st\u00e1diu onemocn\u011bn\u00ed. \u010cast\u00e9, \u010dasto d\u00e1vkov\u00e1n\u00edm limitovan\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky: otoky kotn\u00edk\u016f, livedo reticularis (mramorovan\u00fd modrofialov\u00fd vzor na k\u016f\u017ei), zmatenost, halucinace (zejm\u00e9na u star\u0161\u00edch pacient\u016f), nespavost. Amantadin byl historicky tak\u00e9 pou\u017e\u00edv\u00e1n k prevenci a l\u00e9\u010db\u011b ch\u0159ipky A \u2014 toto pou\u017eit\u00ed bylo opu\u0161t\u011bno kv\u016fli rezistenci.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Co je Amantrel?<\/h2>\n

Amantrel je peror\u00e1ln\u00ed tobolka obsahuj\u00edc\u00ed amantadin 100 mg<\/strong>. Amantadin byl p\u016fvodn\u011b schv\u00e1len v 60. letech 20. stolet\u00ed jako l\u00e9k proti ch\u0159ipce; jeho \u00fa\u010dinek u Parkinsonovy choroby byl objeven n\u00e1hodou, kdy\u017e se u pacienta s Parkinsonovou chorobou l\u00e9\u010den\u00e9ho na ch\u0159ipku ne\u010dekan\u011b zlep\u0161il stav. P\u016fvodn\u00ed zna\u010dka je Symmetrel<\/strong>. Amantrel je vyr\u00e1b\u011bn ve v\u00fdrobn\u00edm za\u0159\u00edzen\u00ed certifikovan\u00e9m WHO-GMP a je bioekvivalentn\u00ed v d\u00e1vce 100 mg.<\/p>\n

Jak Amantrel (Amantadin) funguje?<\/h2>\n

Amantadin je mezi l\u00e9ky na Parkinsonovu chorobu unik\u00e1tn\u00ed t\u00edm, \u017ee m\u00e1 dva dopl\u0148kov\u00e9 mechanismy<\/strong>:<\/p>\n

    \n
  1. Dopaminergn\u00ed zes\u00edlen\u00ed.<\/strong> Zvy\u0161uje presynaptick\u00e9 uvol\u0148ov\u00e1n\u00ed dopaminu, blokuje zp\u011btn\u00e9 vychyt\u00e1v\u00e1n\u00ed dopaminu a m\u016f\u017ee m\u00edrn\u011b stimulovat dopaminov\u00e9 receptory. To vytv\u00e1\u0159\u00ed p\u0159\u00edm\u00fd antiparkinsonick\u00fd \u00fa\u010dinek, zejm\u00e9na na rigiditu a tremor.<\/li>\n
  2. Antagonismus NMDA receptor\u016f.<\/strong> Amantadin je nekompetitivn\u00ed blok\u00e1tor N-methyl-D-aspart\u00e1tov\u00fdch (NMDA) glutam\u00e1tov\u00fdch receptor\u016f. Nadm\u011brn\u00e1 aktivita striat\u00e1ln\u00edch NMDA receptor\u016f zp\u016fsobuje levodopou indukovan\u00e9 dyskineze<\/em> \u2014 mimovoln\u00e9 kroutiv\u00e9 pohyby, kter\u00e9 se objevuj\u00ed po letech l\u00e9\u010dby levodopou. T\u00edm, \u017ee amantadin tlum\u00ed tento glutam\u00e1tov\u00fd sign\u00e1l, sni\u017euje dyskineze bez<\/em> bez sn\u00ed\u017een\u00ed \u00fa\u010dinku levodopy. Toto je jeho nejv\u00fdrazn\u011bj\u0161\u00ed role.<\/li>\n<\/ol>\n

    M\u00e1 tak\u00e9 slabou anticholinergn\u00ed aktivitu, kter\u00e1 p\u0159isp\u00edv\u00e1 jak k \u00falev\u011b od p\u0159\u00edznak\u016f, tak ke kognitivn\u00edm vedlej\u0161\u00edm \u00fa\u010dink\u016fm u star\u0161\u00edch pacient\u016f.<\/p>\n

    Pro koho je Amantrel ur\u010den?<\/h2>\n
      \n
    • Ran\u00e9 st\u00e1dium Parkinsonovy choroby<\/strong> \u2014 jako monoterapie nebo dopln\u011bk k inhibitoru MAO-B nebo dopaminov\u00e9mu agonistovi, poskytuje m\u00edrnou \u00falevu od p\u0159\u00edznak\u016f a oddaluje zaveden\u00ed levodopy.<\/li>\n
    • Pokro\u010dil\u00e9 st\u00e1dium Parkinsonovy choroby s dyskinezemi vyvolan\u00fdmi levodopou<\/strong> \u2014 toto je nejsiln\u011bj\u0161\u00ed indikace pro amantadin s podlo\u017een\u00fdmi d\u016fkazy. P\u0159id\u00e1n\u00ed 100\u2013300 mg\/denn\u011b sni\u017euje dyskineze p\u0159ibli\u017en\u011b o 50 % u mnoha pacient\u016f.<\/li>\n
    • L\u00e9ky indukovan\u00e9 extrapyramidov\u00e9 p\u0159\u00edznaky<\/strong> \u2014 u antipsychotik; n\u011bkdy pou\u017e\u00edv\u00e1no jako alternativa k anticholinergik\u016fm, zejm\u00e9na u star\u0161\u00edch pacient\u016f, kde anticholinergika zhor\u0161uj\u00ed kognitivn\u00ed funkce.<\/li>\n
    • \u00danava spojen\u00e1 s roztrou\u0161enou skler\u00f3zou<\/strong> \u2014 mimo schv\u00e1len\u00e9 indikace, omezen\u00e9 d\u016fkazy.<\/li>\n
    • Ch\u0159ipka typu A<\/strong> \u2014 ji\u017e se nedoporu\u010duje<\/em>: prakticky v\u0161echny cirkuluj\u00edc\u00ed kmeny ch\u0159ipky A jsou od poloviny 2000. let rezistentn\u00ed na amantadin.<\/li>\n<\/ul>\n

      D\u00e1vkov\u00e1n\u00ed a pod\u00e1v\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n\n
      Indikace<\/th>\nPo\u010d\u00e1te\u010dn\u00ed d\u00e1vka<\/th>\nObvykl\u00e1 udr\u017eovac\u00ed d\u00e1vka<\/th>\n<\/tr>\n<\/thead>\n
      Parkinsonova choroba (\u010dasn\u00e1 monoterapie)<\/strong><\/td>\n100 mg jednou denn\u011b po dobu 1 t\u00fddne<\/td>\n100 mg dvakr\u00e1t denn\u011b; max. 300 mg\/den<\/td>\n<\/tr>\n
      Levodopou indukovan\u00e9 dyskineze<\/strong><\/td>\n100 mg dvakr\u00e1t denn\u011b<\/td>\n100 mg 2\u20133kr\u00e1t denn\u011b; a\u017e 400 mg\/den u vybran\u00fdch pacient\u016f<\/td>\n<\/tr>\n
      L\u00e9ky indukovan\u00fd parkinsonismus<\/strong><\/td>\n100 mg dvakr\u00e1t denn\u011b<\/td>\n100\u2013300 mg\/den<\/td>\n<\/tr>\n
      Ren\u00e1ln\u00ed insuficience (CrCl < 50 ml\/min)<\/strong><\/td>\nSn\u00ed\u017eit o 50 %<\/td>\nCrCl 15\u201330: 100 mg ka\u017ed\u00e9 2\u20133 dny; hemodial\u00fdza: 100 mg\/t\u00fdden<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

      \u010cas pod\u00e1n\u00ed m\u00e1 v\u00fdznam.<\/strong> Vyhn\u011bte se ve\u010dern\u00edm d\u00e1vk\u00e1m \u2014 amantadin m\u00e1 stimula\u010dn\u00ed \u00fa\u010dinky a \u010dasto zp\u016fsobuje nespavost a \u017eiv\u00e9 sny. U\u017e\u00edvejte r\u00e1no a odpoledne, s j\u00eddlem nebo bez j\u00eddla.<\/p>\n

      \u26a0 D\u00e1vkov\u00e1n\u00ed p\u0159i ren\u00e1ln\u00ed insuficienci \u2014 nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dina toxicity amantadinu<\/strong> Amantadin se vylu\u010duje t\u00e9m\u011b\u0159 v\u00fdhradn\u011b v nezm\u011bn\u011bn\u00e9 form\u011b ledvinami. P\u0159i ren\u00e1ln\u00ed insuficienci hladiny v plazmu rychle stoupaj\u00ed a n\u00e1sleduje toxicita (zmatenost, halucinace, agitovanost, myoklonus, z\u00e1chvaty, zhor\u0161en\u00ed livedo reticularis). V\u017edy zkontrolujte clearance kreatininu p\u0159ed d\u00e1vkov\u00e1n\u00edm u star\u0161\u00edch pacient\u016f. Sni\u017ete nebo vysa\u010fte d\u00e1vku, pokud se zhor\u0161\u00ed funkce ledvin.<\/div>\n

      B\u011b\u017en\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n

      \u010cast\u00e9:<\/strong> nespavost, \u017eiv\u00e9 sny, nevolnost, z\u00e1vrat\u011b, sucho v \u00fastech, z\u00e1cpa, perifern\u00ed ed\u00e9m (otoky kotn\u00edk\u016f), livedo reticularis<\/em> (fialov\u011b skvrnit\u00e1 vyr\u00e1\u017eka na nohou \u2014 ne\u0161kodn\u00e1, ale kosmeticky znepokojiv\u00e1).<\/p>\n

      M\u00e9n\u011b \u010dast\u00e9:<\/strong> rozmazan\u00e9 vid\u011bn\u00ed, retence mo\u010di, postur\u00e1ln\u00ed hypotenze, agitace, deprese.<\/p>\n

      Z\u00e1va\u017en\u011bj\u0161\u00ed (p\u0159edev\u0161\u00edm u star\u0161\u00edch osob nebo p\u0159i ren\u00e1ln\u00edm posti\u017een\u00ed):<\/strong> zmatenost, vizu\u00e1ln\u00ed halucinace, paranoia, sebevra\u017eedn\u00e9 my\u0161lenky, z\u00e1chvaty, neuroleptick\u00fd malign\u00ed syndrom p\u0159i n\u00e1hl\u00e9m vysazen\u00ed.<\/p>\n

      Livedo reticularis<\/strong> je typick\u00fd vedlej\u0161\u00ed \u00fa\u010dinek \u2014 krajkovit\u00fd, fialovo-\u010derven\u00fd mramorovan\u00fd vzor na doln\u00edch kon\u010detin\u00e1ch a pa\u017e\u00edch. Je ne\u0161kodn\u00fd a pln\u011b vymiz\u00ed b\u011bhem t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f po vysazen\u00ed l\u00e9ku. Mnoho pacient\u016f m\u016f\u017ee amantadin d\u00e1le u\u017e\u00edvat i p\u0159es jeho v\u00fdskyt.<\/p>\n

      Interakce s l\u00e9\u010divy<\/h2>\n