{"id":55973,"date":"2024-02-07T05:47:52","date_gmt":"2024-02-07T05:47:52","guid":{"rendered":"https:\/\/medsname.com\/tegrital\/"},"modified":"2026-05-01T10:49:13","modified_gmt":"2026-05-01T10:49:13","slug":"tegrital","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/tegrital\/","title":{"rendered":"Tegrital 100 mg \u017ev\u00fdkac\u00ed tablety (karbamazepin) \u2014 trigemin\u00e1ln\u00ed neuralgie a z\u00e1chvaty"},"content":{"rendered":"
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Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Tegrital 100 mg \u017ev\u00fdkac\u00ed tablety<\/strong> obsahuje karbamazepin<\/strong>, antikonvulzivum blokuj\u00edc\u00ed sod\u00edkov\u00e9 kan\u00e1ly, kter\u00e9 je prvn\u00ed volbou pro trigemin\u00e1ln\u00ed neuralgii od roku 1962<\/strong> a st\u00e1le z\u016fst\u00e1v\u00e1 z\u00e1kladn\u00edm l\u00e9kem p\u0159i parci\u00e1ln\u00edch z\u00e1chvatech a stabilizaci n\u00e1lady u bipol\u00e1rn\u00ed poruchy. \u017dv\u00fdkac\u00ed forma je vhodn\u00e1 pro d\u011bti, pacienty s pot\u00ed\u017eemi p\u0159i polyk\u00e1n\u00ed a dosp\u011bl\u00e9, kte\u0159\u00ed preferuj\u00ed nepolyk\u00e1n\u00ed cel\u00fdch tablet. L\u00e9\u010dba za\u010d\u00edn\u00e1 n\u00edzkou d\u00e1vkou (100 mg jednou a\u017e dvakr\u00e1t denn\u011b) a pomalu se zvy\u0161uje, proto\u017ee karbamazepin indukuje vlastn\u00ed metabolismus b\u011bhem 2\u20134 t\u00fddn\u016f. Pacienti asijsk\u00e9ho p\u016fvodu by m\u011bli b\u00fdt p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby testov\u00e1ni na HLA-B*1502<\/strong> \u2014 tento alel zna\u010d\u00ed vysok\u00e9 riziko Stevens-Johnsonova syndromu.<\/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 Tegrital?<\/h2>\n

Tegrital je indick\u00fd generick\u00fd ekvivalent karbamazepin<\/strong>, dostupn\u00fd jako 100 mg \u017ev\u00fdkac\u00ed tableta. Karbamazepin je tricyklick\u00e1 slou\u010denina strukturn\u011b p\u0159\u00edbuzn\u00e1 imipraminu, ale farmakologicky klasifikovan\u00e1 jako antiepileptikum. \u017dv\u00fdkac\u00ed forma m\u016f\u017ee b\u00fdt \u017ev\u00fdk\u00e1na, rozlomena nebo polknuta cel\u00e1 s vodou \u2014 vhodn\u00e9 pro d\u011bti a pacienty s dysfagi\u00ed.<\/p>\n

Jak karbamazepin p\u016fsob\u00ed<\/h2>\n

Karbamazepin se v\u00e1\u017ee na nap\u011b\u0165ov\u011b \u0159\u00edzen\u00e9 sod\u00edkov\u00e9 kan\u00e1ly<\/strong> v jejich inaktivovan\u00e9m stavu, \u010d\u00edm\u017e zabra\u0148uje n\u00e1vratu kan\u00e1lu do klidov\u00e9ho stavu a blokuje opakovan\u00e9 vysokofrekven\u010dn\u00ed neuron\u00e1ln\u00ed v\u00fdboje, zat\u00edmco norm\u00e1ln\u00ed fyziologick\u00e9 signalizov\u00e1n\u00ed z\u016fst\u00e1v\u00e1 zachov\u00e1no. Tento mechanismus vysv\u011btluje jeho \u00fa\u010dinnost u:<\/p>\n

    \n
  • Fok\u00e1ln\u00ed (parci\u00e1ln\u00ed) z\u00e1chvaty<\/strong> \u2014 trval\u00e9 potla\u010den\u00ed epileptogenn\u00edch v\u00fdboj\u016f<\/li>\n
  • Neuralgie trojklann\u00e9ho nervu<\/strong> \u2014 blokuje paroxysm\u00e1ln\u00ed nervov\u00e9 v\u00fdboje v ganglionu trigeminu<\/li>\n
  • Stabilizace n\u00e1lady<\/strong> \u2014 sni\u017euje neuron\u00e1ln\u00ed excitabilitu a limbickou hyperaktivitu<\/li>\n<\/ul>\n

    Indikace<\/h2>\n
      \n
    • Neuralgie trojklann\u00e9ho nervu<\/strong> \u2014 prvn\u00ed volba dle doporu\u010den\u00ed NICE, EFNS a AAN<\/li>\n
    • Parci\u00e1ln\u00ed z\u00e1chvaty<\/strong> s nebo bez sekund\u00e1rn\u00ed generalizace<\/li>\n
    • Generalizovan\u00e9 tonicko-klonick\u00e9 z\u00e1chvaty<\/strong> \u2014 druh\u00e1 volba<\/li>\n
    • Bipol\u00e1rn\u00ed porucha<\/strong> \u2014 stabiliz\u00e1tor n\u00e1lady, zejm\u00e9na u sm\u00ed\u0161en\u00fdch a rychle se st\u0159\u00eddaj\u00edc\u00edch epizod<\/li>\n
    • Glosofarynge\u00e1ln\u00ed neuralgie<\/strong> \u2014 analogick\u00e9 pou\u017eit\u00ed jako u trigemin\u00e1ln\u00ed neuralgie<\/li>\n
    • Diabetick\u00e1 neuropatie<\/strong> \u2014 druh\u00e1 volba p\u0159i selh\u00e1n\u00ed nebo kontraindikaci gabapentinoid\u016f<\/li>\n
    • Odvyk\u00e1n\u00ed alkoholu<\/strong> \u2014 vybran\u00e9 p\u0159\u00edpady pod odborn\u00fdm dohledem<\/li>\n<\/ul>\n

      D\u00e1vkov\u00e1n\u00ed a pod\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n\n\n
      Indikace<\/th>\nPo\u010d\u00e1te\u010dn\u00ed d\u00e1vka<\/th>\nTitrace<\/th>\nUdr\u017eovac\u00ed d\u00e1vka<\/th>\n<\/tr>\n<\/thead>\n
      Neuralgie trojklann\u00e9ho nervu<\/td>\n100 mg jednou nebo dvakr\u00e1t denn\u011b<\/td>\n+100\u2013200 mg ka\u017ed\u00e9 2 dny<\/td>\n200\u2013400 mg t\u0159ikr\u00e1t denn\u011b<\/td>\n<\/tr>\n
      Parci\u00e1ln\u00ed z\u00e1chvaty (dosp\u011bl\u00ed)<\/td>\n100\u2013200 mg jednou nebo dvakr\u00e1t denn\u011b<\/td>\n+100\u2013200 mg t\u00fddn\u011b<\/td>\n800\u20131200 mg\/den ve 2\u20134 d\u00e1vk\u00e1ch<\/td>\n<\/tr>\n
      Bipol\u00e1rn\u00ed porucha<\/td>\n200 mg dvakr\u00e1t denn\u011b<\/td>\n+200 mg ka\u017ed\u00e9 3\u20134 dny<\/td>\n400\u20131600 mg\/den<\/td>\n<\/tr>\n
      D\u011bti (epilepsie)<\/td>\n10\u201320 mg\/kg\/den<\/td>\nOdborn\u00e9 doporu\u010den\u00ed<\/td>\n15\u201330 mg\/kg\/den v rozd\u011blen\u00fdch d\u00e1vk\u00e1ch<\/td>\n<\/tr>\n
      Star\u0161\u00ed pacienti<\/td>\n100 mg dvakr\u00e1t denn\u011b<\/td>\nOpatrn\u00e9 titrov\u00e1n\u00ed<\/td>\nSpodn\u00ed hranice typick\u00e9ho rozmez\u00ed pro dosp\u011bl\u00e9<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
      Testov\u00e1n\u00ed HLA-B*1502 p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby<\/strong> Pacienti \u010d\u00ednsk\u00e9, thajsk\u00e9, malajsk\u00e9, vietnamsk\u00e9, filip\u00ednsk\u00e9, indon\u00e9sk\u00e9 a jihoindick\u00e9 populace maj\u00ed v\u00fdrazn\u011b vy\u0161\u0161\u00ed v\u00fdskyt alely HLA-B*1502 \u2013 kter\u00e1 je siln\u011b asociov\u00e1na se Stevens-Johnsonov\u00fdm syndromem a toxickou epiderm\u00e1ln\u00ed nekrol\u00fdzou p\u0159i u\u017e\u00edv\u00e1n\u00ed karbamazepinu. U t\u011bchto populac\u00ed prove\u010fte test p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby a v p\u0159\u00edpad\u011b pozitivity zvolte alternativn\u00ed l\u00e9\u010divo. HLA-A*3101 je podobn\u00fd, ale m\u00e9n\u011b rizikov\u00fd marker u evropsk\u00e9 a japonsk\u00e9 populace.<\/div>\n
      Terapeutick\u00e9 monitorov\u00e1n\u00ed hladin l\u00e9\u010div<\/strong> Dosa\u017een\u00ed stabiln\u00ed plazmatick\u00e9 hladiny 4\u201312 mg\/l (17\u201351 \u00b5mol\/l). Karbamazepin je siln\u00fd autoinduktor \u2014 va\u0161e denn\u00ed pot\u0159eba m\u016f\u017ee vzr\u016fst b\u011bhem prvn\u00edch 2\u20134 t\u00fddn\u016f l\u00e9\u010dby, jak doch\u00e1z\u00ed k indukci jatern\u00edho CYP3A4. Hladiny by m\u011bly b\u00fdt kontrolov\u00e1ny 5\u20137 dn\u00ed po ka\u017ed\u00e9 zm\u011bn\u011b d\u00e1vkov\u00e1n\u00ed.<\/div>\n

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