{"id":59996,"date":"2024-02-28T06:28:05","date_gmt":"2024-02-28T06:28:05","guid":{"rendered":"https:\/\/medsname.com\/metopar\/"},"modified":"2026-04-30T10:23:52","modified_gmt":"2026-04-30T10:23:52","slug":"metopar","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/metopar\/","title":{"rendered":"Metopar"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Metopar?<\/h3>\n

Metopar<\/strong> je fixn\u00ed kombinace paracetamol 500 mg + metoclopramid 5 mg<\/strong> ur\u010deno pro akutn\u00ed z\u00e1chvaty migr\u00e9ny s nevolnost\u00ed<\/strong>. Paracetamol poskytuje jednoduchou analgezii; metoklopramid urychluje vyprazd\u0148ov\u00e1n\u00ed \u017ealudku (kter\u00e9 je b\u011bhem migr\u00e9ny ochrnut\u00e9, co\u017e jinak sni\u017euje vst\u0159eb\u00e1v\u00e1n\u00ed jak\u00e9hokoli peror\u00e1ln\u00edho analgetika) a p\u016fsob\u00ed centr\u00e1ln\u011b jako antiemetikum s D2 antagonistick\u00fdm \u00fa\u010dinkem. Vyrobeno spole\u010dnost\u00ed Macleods podle standard\u016f WHO-GMP. N\u00e1stup \u00fa\u010dinku za 30\u201360 minut; obvykl\u00e1 d\u00e1vka 1\u20132 tablety ka\u017ed\u00fdch 4\u20136 hodin, max. 4 tablety\/den.<\/p>\n<\/div>\n

Pro\u010d objedn\u00e1vat z MedsBase:<\/strong> \u2714 v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong> \u2714 Diskr\u00e9tn\u00ed balen\u00ed \u2714 Celosv\u011btov\u00e1 doprava \u2714 Ov\u011b\u0159en\u00e9 recenze z\u00e1kazn\u00edk\u016f (1 400+ z\u00e1kazn\u00edk\u016f)<\/a><\/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

\u26a0\ufe0f Varov\u00e1n\u00ed ohledn\u011b d\u00e9lky u\u017e\u00edv\u00e1n\u00ed metoklopramidu a EPS.<\/strong> Metoklopramid je omezen na 5 dn\u00ed FDA \/ 12 t\u00fddn\u016f EMA<\/strong> kv\u016fli riziku tardivn\u00ed dyskineze \u2013 trval\u00e9 poruchy mimovoln\u00edch pohyb\u016f. FDA black-box varov\u00e1n\u00ed<\/strong> plat\u00ed pro tardivn\u00ed dyskinezi p\u0159i dlouhodob\u00e9m nebo vysokod\u00e1vkov\u00e9m u\u017e\u00edv\u00e1n\u00ed. Vyvarujte se u Parkinsonovy choroby (D2 antagonismus zhor\u0161uje motorick\u00e9 p\u0159\u00edznaky). Akutn\u00ed dystonick\u00e9 reakce (okulogyrick\u00e1 krize, tortikolis) jsou nej\u010dast\u011bj\u0161\u00ed u mlad\u00fdch \u017een p\u0159i IV\/IM pod\u00e1n\u00ed a mohou se objevit i po jedn\u00e9 peror\u00e1ln\u00ed d\u00e1vce \u2013 l\u00e9\u010dit IV procyklidinem nebo difenhydraminem. Vyvarujte se u epilepsie, GI obstrukce, perforace nebo krv\u00e1cen\u00ed. Riziko p\u0159ed\u00e1vkov\u00e1n\u00ed paracetamolem:<\/strong> nep\u0159ekra\u010dujte celkov\u011b 4 g\/den paracetamolu ze v\u0161ech zdroj\u016f (v kombinaci s t\u00edmto produktem, jin\u00fdm paracetamolem a kombinovan\u00fdmi p\u0159\u00edpravky proti nachlazen\u00ed\/ch\u0159ipce).<\/div>\n

Pro\u010d kombinovat paracetamol s metoklopramidem p\u0159i migr\u00e9n\u011b?<\/h2>\n

B\u011bhem akutn\u00edho z\u00e1chvatu migr\u00e9ny se \u017ealude\u010dn\u00ed motilita zpomaluje nebo zastavuje (\u017ealude\u010dn\u00ed st\u00e1za). To znamen\u00e1, \u017ee peror\u00e1ln\u00ed analgetika se vst\u0159eb\u00e1vaj\u00ed pomalu a ne\u00fapln\u011b \u2013 co\u017e vysv\u011btluje, pro\u010d n\u011bkte\u0159\u00ed pacienti \u0159\u00edkaj\u00ed \u201cparacetamol na mou migr\u00e9nu nezab\u00edr\u00e1\u201d. P\u0159id\u00e1n\u00ed metoklopramidu m\u00e1 t\u0159i \u00fa\u010dinky:<\/p>\n

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  1. Obnovuje \u017ealude\u010dn\u00ed motilitu<\/strong> \u2013 paracetamol se nyn\u00ed vst\u0159eb\u00e1v\u00e1 norm\u00e1ln\u00ed rychlost\u00ed a dosahuje terapeutick\u00fdch plazmatick\u00fdch hladin.<\/li>\n
  2. L\u00e9\u010d\u00ed nevolnost\/zvracen\u00ed<\/strong> p\u0159\u00edmo prost\u0159ednictv\u00edm D2 antagonismu v chemorecep\u010dn\u00ed spou\u0161t\u011bc\u00ed z\u00f3n\u011b.<\/li>\n
  3. P\u0159\u00edm\u00fd protimigren\u00f3zn\u00ed \u00fa\u010dinek<\/strong> \u2014 samotn\u00fd metoklopramid prok\u00e1zal sn\u00ed\u017een\u00ed bolesti p\u0159i migr\u00e9n\u011b v intraven\u00f3zn\u00edch studi\u00edch (mechanismus nen\u00ed pln\u011b objasn\u011bn, pravd\u011bpodobn\u011b jde o D2 antagonismus v trigeminocervik\u00e1ln\u00edm komplexu).<\/li>\n<\/ol>\n

    Tato kombinace je pevn\u011b zakotvena v britsk\u00fdch a evropsk\u00fdch migren\u00f3zn\u00edch doporu\u010den\u00edch jako l\u00e9\u010dba prvn\u00ed volby p\u0159ed nasazen\u00edm triptan\u016f u st\u0159edn\u011b t\u011b\u017ek\u00fdch z\u00e1chvat\u016f.<\/p>\n

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

    Metopar je dod\u00e1v\u00e1n z v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong>. Ka\u017ed\u00e1 objedn\u00e1vka je diskr\u00e9tn\u011b zas\u00edl\u00e1na po cel\u00e9m sv\u011bt\u011b a je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a> \u2014 pokud nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, provedeme op\u011btovn\u00e9 dod\u00e1n\u00ed bez dal\u0161\u00edch n\u00e1klad\u016f. Metopar kombinuje nejpou\u017e\u00edvan\u011bj\u0161\u00ed analgetikum s nejpou\u017e\u00edvan\u011bj\u0161\u00edm prokinetick\u00fdm antiemetikem v jedn\u00e9 tablet\u011b, kter\u00e1 je kalibrov\u00e1na k p\u0159ekon\u00e1n\u00ed migr\u00e9nou indukovan\u00e9 gastrick\u00e9 st\u00e1zy \u2014 klinicko-farmakologick\u00e9ho probl\u00e9mu, kter\u00fd samotn\u00fd paracetamol nedok\u00e1\u017ee \u0159e\u0161it.<\/p>\n

    Mechanismus \u00fa\u010dinku<\/h2>\n

    Paracetamol (acetaminofen)<\/strong> p\u016fsob\u00ed p\u0159edev\u0161\u00edm centr\u00e1ln\u00ed inhibic\u00ed synt\u00e9zy prostaglandin\u016f (pravd\u011bpodobn\u011b prost\u0159ednictv\u00edm COX-3 v CNS nebo peroxid-dependentn\u00ed inhibice COX-1\/COX-2) a aktivac\u00ed sestupn\u00e9 serotoninergn\u00ed dr\u00e1hy moduluj\u00edc\u00ed bolest. Je slab\u0161\u00edm analgetikem ne\u017e NSAID, ale na rozd\u00edl od nich nevykazuje gastrointestin\u00e1ln\u00ed\/ren\u00e1ln\u00ed\/kardiovaskul\u00e1rn\u00ed toxicitu a je bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed.<\/p>\n

    Metoklopramid<\/strong> je antagonista dopaminov\u00fdch D2 receptor\u016f, kter\u00fd pronik\u00e1 hematoencefalickou bari\u00e9rou (na rozd\u00edl od domperidonu). P\u016fsob\u00ed centr\u00e1ln\u011b v chemorecep\u010dn\u00ed spou\u0161t\u011bc\u00ed z\u00f3n\u011b (antiemetick\u00fd \u00fa\u010dinek) a nigrostriat\u00e1ln\u00edm syst\u00e9mu (co\u017e p\u0159in\u00e1\u0161\u00ed riziko EPS), perifern\u011b pak na D2 receptory ve st\u011bn\u011b tr\u00e1vic\u00edho traktu, kde urychluje vyprazd\u0148ov\u00e1n\u00ed \u017ealudku a zpev\u0148uje doln\u00ed j\u00edcnov\u00fd sv\u011bra\u010d. D\u00e1vka 5 mg v jedn\u00e9 tablet\u011b t\u00e9to kombinace je v\u00fdrazn\u011b ni\u017e\u0161\u00ed ne\u017e standardn\u00ed antiemetick\u00e1 d\u00e1vka 10 mg \u2014 jedna kombinovan\u00e1 tableta obsahuje n\u00edzkou d\u00e1vku metoklopramidu, co\u017e umo\u017e\u0148uje u\u017e\u00edvat 1\u20132 tablety na d\u00e1vku bez p\u0159ekro\u010den\u00ed denn\u00edch limit\u016f.<\/p>\n

    Indikace<\/h2>\n