{"id":56096,"date":"2024-02-07T05:53:10","date_gmt":"2024-02-07T05:53:10","guid":{"rendered":"https:\/\/medsname.com\/lariago\/"},"modified":"2026-04-30T10:24:41","modified_gmt":"2026-04-30T10:24:41","slug":"lariago","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/lariago\/","title":{"rendered":"Lariago"},"content":{"rendered":"

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

Lariago<\/strong> obsahuje chloroquine fosf\u00e1t 250 mg z\u00e1kladn\u00ed ekvivalent<\/strong> (Ipca Laboratories). Pou\u017e\u00edv\u00e1 se k l\u00e9\u010db\u011b mal\u00e1rie citliv\u00e9 na chloroquine<\/strong> zp\u016fsoben\u00e9 P. falciparum<\/em>, P. vivax<\/em>, P. ovale<\/em>, a P. malariae<\/em>, a tak\u00e9 se pou\u017e\u00edv\u00e1 k prevenci a l\u00e9\u010db\u011b mimost\u0159evn\u00ed amebi\u00e1zy<\/strong>. V\u011bt\u0161ina modern\u00edch endemick\u00fdch oblast\u00ed m\u00e1 roz\u0161\u00ed\u0159enou rezistenci na chlorochin<\/strong> (subsaharsk\u00e1 Afrika, Indie, jihov\u00fdchodn\u00ed Asie, povod\u00ed Amazonky) \u2014 chlorochin NEN\u00cd vhodnou profylax\u00ed pro tyto destinace. D\u00e1vka pro akutn\u00ed l\u00e9\u010dbu: 1 g \u00favodn\u00ed d\u00e1vka \u2192 500 mg po 6 \/ 24 \/ 48 h. Profylaxe (pouze v oblastech citliv\u00fdch na chlorochin): 500 mg jednou t\u00fddn\u011b za\u010d\u00ednaj\u00edc\u00ed 1\u20132 t\u00fddny p\u0159ed cestou, pokra\u010duj\u00edc\u00ed po dobu 4 t\u00fddn\u016f po n\u00e1vratu. U\u017e\u00edvejte s j\u00eddlem. Povinn\u00e9 vstupn\u00ed + ka\u017edoro\u010dn\u00ed oftalmologick\u00e9 vy\u0161et\u0159en\u00ed po 5 letech kontinu\u00e1ln\u00edho u\u017e\u00edv\u00e1n\u00ed.<\/strong><\/p>\n<\/div>\n

\ud83c\udfed V\u00fdrobce certifikovan\u00fd WHO-GMP<\/strong>  \u00b7  \ud83d\udce6 Diskr\u00e9tn\u00ed balen\u00ed<\/strong>  \u00b7  \ud83c\udf0d Doprava do cel\u00e9ho sv\u011bta<\/strong>  \u00b7  \u2b50 1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a><\/strong><\/div>\n

\ud83d\udee1\ufe0f Ka\u017ed\u00e1 objedn\u00e1vka je kryta 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, za\u0161leme zdarma n\u00e1hradn\u00ed z\u00e1silku prost\u0159ednictv\u00edm kur\u00fdrn\u00ed slu\u017eby EMS nebo ITPS.<\/p>\n

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

Lariago je dod\u00e1v\u00e1no od v\u00fdrobce certifikovan\u00e9ho WHO-GMP a expedov\u00e1no po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm balen\u00ed. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a> a podporov\u00e1na na\u0161\u00ed 1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>. . Celosv\u011btov\u00e1 doprava bez p\u0159edpisov\u00e9 dokumentace.<\/p>\n

O p\u0159\u00edpravku Lariago<\/h2>\n

Lariago je tableta chlorochinfosf\u00e1tu 250 mg vyr\u00e1b\u011bn\u00e1 spole\u010dnost\u00ed Ipca Laboratories za podm\u00ednek certifikovan\u00fdch WHO-GMP. Chlorochin je 4-aminochinolinov\u00e9 antimalarikum \u2014 poprv\u00e9 syntetizovan\u00e9 v roce 1934 a z\u00e1kladn\u00ed k\u00e1men l\u00e9\u010dby mal\u00e1rie po v\u011bt\u0161inu druh\u00e9 poloviny 20. stolet\u00ed, ne\u017e se v 60. letech objevila rezistence u P. falciparum. Z\u016fst\u00e1v\u00e1 \u00fa\u010dinn\u00fd v n\u011bkolika zb\u00fdvaj\u00edc\u00edch oblastech citliv\u00fdch na chlorochin a je na seznamu z\u00e1kladn\u00edch l\u00e9k\u016f WHO.<\/p>\n

Mapa rezistence \u2014 p\u0159e\u010dt\u011bte si p\u0159ed n\u00e1kupem.<\/strong> Chlorochin ji\u017e nen\u00ed \u00fa\u010dinn\u00fd proti P. falciparum v subsaharsk\u00e9 Africe, Indii, jihov\u00fdchodn\u00ed Asii (Thajsko, Kambod\u017ea, Vietnam, Myanmar, Laos), povod\u00ed Amazonky (Braz\u00edlie, Peru, Kolumbie, Venezuela, Bol\u00edvie, Guyana), Papua-Nov\u00e1 Guinea, \u0160alamounovy ostrovy<\/strong>, a v\u011bt\u0161inu dal\u0161\u00edch tropick\u00fdch destinac\u00ed. Pro tyto oblasti pou\u017eijte meflochin, doxycyklin nebo atovaquon-proguanil. Chlorochin z\u016fst\u00e1v\u00e1 \u00fa\u010dinn\u00fd v n\u011bkolika zb\u00fdvaj\u00edc\u00edch oblastech citliv\u00fdch na chlorochin: Mexiko (oblasti z\u00e1padn\u011b a severn\u011b od Panamsk\u00e9ho pr\u016fplavu), \u010d\u00e1sti St\u0159edn\u00ed Ameriky (Belize, vyso\u010diny Guatemaly, Honduras, Nikaragua, Panama z\u00e1padn\u011b od pr\u016fplavu), Hispaniola (Haiti, Dominik\u00e1nsk\u00e1 republika), velk\u00e1 \u010d\u00e1st Bl\u00edzk\u00e9ho v\u00fdchodu<\/strong>, a vybran\u00e9 destinace v Tichomo\u0159\u00ed. P\u0159ed cestou si ov\u011b\u0159te aktu\u00e1ln\u00ed vzorec rezistence na CDC Yellow Book<\/a> .<\/div>\n

Jak chlorochin funguje<\/h2>\n

Malarick\u00fd parazit tr\u00e1v\u00ed hostitelsk\u00fd hemoglobin uvnit\u0159 kysel\u00e9ho potravinov\u00e9ho vakuolu, uvol\u0148uje voln\u00fd hem (pro parazita toxick\u00fd). Norm\u00e1ln\u011b parazit polymeruje hem na inertn\u00ed hemozoin (malarick\u00fd pigment). Chlorochin se hromad\u00ed v potravinov\u00e9m vakuolu, proto\u017ee jeho slab\u011b z\u00e1sadit\u00e1 povaha ho zachycuje v kysel\u00fdch odd\u00edlech, kde se v\u00e1\u017ee na voln\u00fd hem a br\u00e1n\u00ed polymeraci. Toxick\u00fd voln\u00fd hem se hromad\u00ed a zab\u00edj\u00ed parazita. Rezistence na chlorochin vznik\u00e1 mutacemi PfCRT (P. falciparum chloroquine-resistance transporter), kter\u00e9 pumpuj\u00ed chlorochin zp\u011bt z potravinov\u00e9ho vakuolu.<\/p>\n

Polo\u010das rozpadu je 1\u20132 m\u011bs\u00edce \u2014 chlorochin se hromad\u00ed v tk\u00e1n\u00edch a uvol\u0148uje se pomalu. Proto se profylaxe d\u00e1vkuje t\u00fddn\u011b a pokra\u010duje se 4 t\u00fddny po expozici.<\/p>\n

Indikace a d\u00e1vkov\u00e1n\u00ed<\/h2>\n
\n\n\n\n\n\n\n\n\n\n
Indikace<\/th>\nD\u00e1vkov\u00e1n\u00ed (v mg b\u00e1ze)<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
Chlorochin-citliv\u00e1 mal\u00e1rie \u2014 akutn\u00ed l\u00e9\u010dba, dosp\u011bl\u00ed<\/td>\n1 000 mg b\u00e1ze jako \u00favodn\u00ed d\u00e1vka \u2192 500 mg b\u00e1ze v 6., 24. a 48. hodin\u011b (celkem 2 500 mg b\u00e1ze za 48 hodin)<\/td>\nP\u0159idat primachin pro radik\u00e1ln\u00ed l\u00e9\u010dbu P. vivax \/ P. ovale (po testu G6PD).<\/td>\n<\/tr>\n
Profylaxe mal\u00e1rie citliv\u00e9 na chlorochin, dosp\u011bl\u00ed<\/td>\n500 mg b\u00e1ze jednou t\u00fddn\u011b<\/td>\nZa\u010dn\u011bte 1\u20132 t\u00fddny p\u0159ed cestou; pokra\u010dujte t\u00fddn\u011b b\u011bhem expozice; pokra\u010dujte 4 t\u00fddny po n\u00e1vratu.<\/td>\n<\/tr>\n
D\u011btsk\u00e1 l\u00e9\u010dba<\/td>\n10 mg\/kg b\u00e1ze \u00favodn\u00ed d\u00e1vka \u2192 5 mg\/kg v 6., 24., 48. hodin\u011b<\/td>\nStejn\u00e9 celkov\u00e9 mno\u017estv\u00ed za 48 hodin. Tablety lze rozdrtit a sm\u00edchat s j\u00eddlem.<\/td>\n<\/tr>\n
D\u011btsk\u00e1 profylaxe<\/td>\n5 mg\/kg b\u00e1ze jednou t\u00fddn\u011b (max. 500 mg)<\/td>\nStejn\u00fd \u010dasov\u00fd rozvrh zah\u00e1jen\u00ed\/pokra\u010dov\u00e1n\u00ed\/ukon\u010den\u00ed jako u dosp\u011bl\u00fdch.<\/td>\n<\/tr>\n
Mimost\u0159evn\u00ed am\u00e9b\u00f3za (am\u00e9bov\u00fd jatern\u00ed absces)<\/td>\n1 g\/den po 2 dny, pot\u00e9 500 mg\/den po 2\u20133 t\u00fddny<\/td>\nDopln\u011bk k metronidazolu.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
P\u0159epo\u010det s\u00edly.<\/strong> Chlorochinfosf\u00e1t 250 mg soli = ~150 mg chlorochinov\u00e9 b\u00e1ze. \u00dadaje 1 g \/ 500 mg \/ 250 mg b\u00e1ze v\u00fd\u0161e odkazuj\u00ed na chlorochinovou b\u00e1zi; vyn\u00e1sobte ~1,66 pro p\u0159evod na s\u00edlu soli uvedenou na \u0161t\u00edtku tablety. Mnoho klinik\u016f preferuje uva\u017eovat v b\u00e1zi, ale tablety se prod\u00e1vaj\u00ed podle s\u00edly soli \u2014 p\u0159i v\u00fdpo\u010dtu d\u00e1vek pe\u010dliv\u011b kontrolujte.<\/div>\n
Varov\u00e1n\u00ed p\u0159ed retin\u00e1ln\u00ed toxicitou (\u010derven\u00fd r\u00e1me\u010dek).<\/strong> Stejn\u011b jako hydroxychlorochin se i chlorochin p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed kumuluje v pigmentov\u00e9m epitelu s\u00edtnice. Riziko makulopatie typu \"b\u00fd\u010d\u00ed oko\" je VY\u0160\u0160\u00cd u chlorochinu ne\u017e u hydroxychlorochinu<\/strong>. Dlouhodob\u00ed u\u017eivatel\u00e9 (autoimunitn\u00ed onemocn\u011bn\u00ed, profylaxe > 5 let) vy\u017eaduj\u00ed vstupn\u00ed oftalmologick\u00e9 vy\u0161et\u0159en\u00ed + ka\u017edoro\u010dn\u00ed screening od 5. roku s pou\u017eit\u00edm spektr\u00e1ln\u00ed dom\u00e9ny OCT, automatizovan\u00e9ho zorn\u00e9ho pole 10-2 a autofluorescence fundu. Kr\u00e1tkodob\u00e9 l\u00e9\u010debn\u00e9 k\u00fary (n\u011bkolik dn\u00ed) nep\u0159edstavuj\u00ed v\u00fdznamn\u00e9 riziko pro s\u00edtnici.<\/div>\n
Pozn\u00e1mka k G6PD.<\/strong> Chlorochin m\u00e1 mnohem ni\u017e\u0161\u00ed riziko hemol\u00fdzy ne\u017e primachin, ale v p\u0159\u00edpad\u011b t\u011b\u017ek\u00e9ho deficitu G6PD existuj\u00ed kazuistiky. P\u0159i pod\u00e1v\u00e1n\u00ed chlorochinu po del\u0161\u00ed dobu pacientovi s prok\u00e1zan\u00fdm deficitem G6PD monitorujte mo\u017en\u00e9 zn\u00e1mky hemol\u00fdzy.<\/div>\n

Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n