{"id":61045,"date":"2024-02-28T07:22:29","date_gmt":"2024-02-28T07:22:29","guid":{"rendered":"https:\/\/medsname.com\/encorate\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"encorate","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/encorate\/","title":{"rendered":"Encorate"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Encorate?<\/h3>\n<p style=\"margin:0;\"><strong>Encorate<\/strong> je <strong>200 mg tablety natrium valpro\u00e1tu\/kyseliny valproov\u00e9 s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm<\/strong> od Sun Pharma \u2014 antiepileptikum \/ stabiliz\u00e1tor n\u00e1lady \/ preventivn\u00ed l\u00e9k na migr\u00e9nu. V prevenci migr\u00e9ny se pou\u017e\u00edv\u00e1 v d\u00e1vce <strong>250 mg dvakr\u00e1t denn\u011b, s postupn\u00fdm zv\u00fd\u0161en\u00edm na 500\u20131 500 mg\/den v rozd\u011blen\u00fdch d\u00e1vk\u00e1ch<\/strong> jako l\u00e9k t\u0159et\u00ed nebo \u010dtvrt\u00e9 volby po propranololu, topiram\u00e1tu a amitriptylinu. <strong>Absolutn\u00ed kontraindikace v t\u011bhotenstv\u00ed a u \u017een v reproduk\u010dn\u00edm v\u011bku bez programu prevence t\u011bhotenstv\u00ed<\/strong> \u2014 valpro\u00e1t zp\u016fsobuje 10% riziko z\u00e1va\u017en\u00fdch vrozen\u00fdch vad (defekty neur\u00e1ln\u00ed trubice, kraniofaci\u00e1ln\u00ed, srde\u010dn\u00ed, kon\u010detinov\u00e9, urogenit\u00e1ln\u00ed) a 30-40% riziko neurov\u00fdvojov\u00fdch poruch (sn\u00ed\u017een\u00ed IQ o 7-10 bod\u016f, poruchy autistick\u00e9ho spektra). EMA a MHRA vydaly od roku 2014 postupn\u011b p\u0159\u00edsn\u011bj\u0161\u00ed omezen\u00ed p\u0159edepisov\u00e1n\u00ed. Dal\u0161\u00ed v\u00fdznamn\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: hepatotoxicita (idiosynkratick\u00e1; z\u00e1va\u017en\u00e1, vz\u00e1cn\u011b fat\u00e1ln\u00ed), pankreatitida, trombocytopenie, hyperamonemie, p\u0159\u00edr\u016fstek hmotnosti, vypad\u00e1v\u00e1n\u00ed vlas\u016f, tremor a syndrom polycystick\u00fdch ovari\u00ed u \u017een.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co 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 <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<h2 class=\"wp-block-heading\">Co je Encorate?<\/h2>\n<p>Encorate jsou tablety s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm obsahuj\u00edc\u00ed <strong>natrium valpro\u00e1t\/kyselinu valproovou 200 mg<\/strong> od spole\u010dnosti Sun Pharma, dod\u00e1van\u00e1 v balen\u00edch po 30-180 tablet\u00e1ch. Valpro\u00e1t je rozv\u011btven\u00e1 mastn\u00e1 kyselina s kr\u00e1tk\u00fdm \u0159et\u011bzcem, p\u016fvodn\u011b pou\u017e\u00edvan\u00e1 jako rozpou\u0161t\u011bdlo ve farmaceutick\u00e9 chemii, pozd\u011bji n\u00e1hodn\u011b objeven\u00e1 pro sv\u00e9 antiepileptick\u00e9 \u00fa\u010dinky. Od 70. let 20. stolet\u00ed je l\u00e9kem prvn\u00ed volby u generalizovan\u00e9 a parci\u00e1ln\u00ed epilepsie a v roce 1996 se stal t\u0159et\u00edm l\u00e9kem schv\u00e1len\u00fdm FDA USA pro profylaxi migr\u00e9ny (po propranololu a timololu).<\/p>\n<p>Formulace s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm vy\u017eaduje d\u00e1vkov\u00e1n\u00ed dvakr\u00e1t a\u017e t\u0159ikr\u00e1t denn\u011b. Pro pacienty, kte\u0159\u00ed preferuj\u00ed jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed, zva\u017ete <a href=\"https:\/\/medsbase.com\/cs\/encorate-chrono\/\">Encorate Chrono (s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm)<\/a>.<\/p>\n<h2 class=\"wp-block-heading\">Jak valpro\u00e1t p\u0159edch\u00e1z\u00ed migr\u00e9n\u011b<\/h2>\n<p>Valpro\u00e1t p\u016fsob\u00ed prost\u0159ednictv\u00edm v\u00edce mechanism\u016f relevantn\u00edch pro migr\u00e9nu:<\/p>\n<ul>\n<li><strong>GABAergn\u00ed potenciace<\/strong> \u2014 zvy\u0161uje synt\u00e9zu GABA a sni\u017euje jej\u00ed degradaci, \u010d\u00edm\u017e zesiluje inhibi\u010dn\u00ed tonus v nucleus caudalis trigemini a k\u016f\u0159e<\/li>\n<li><strong>Potla\u010den\u00ed kortik\u00e1ln\u00ed deprese \u0161\u00ed\u0159\u00edc\u00ed se<\/strong> \u2014 patologick\u00e1 vlna, kter\u00e1 je z\u00e1kladem migr\u00e9nov\u00e9 aury<\/li>\n<li><strong>Blok\u00e1da nap\u011b\u0165ov\u011b \u0159\u00edzen\u00fdch sod\u00edkov\u00fdch kan\u00e1l\u016f<\/strong> \u2014 sni\u017euje neuron\u00e1ln\u00ed hyperexcitabilitu<\/li>\n<li><strong>Inhibice NMDA-glutam\u00e1tov\u00e9 transmise<\/strong><\/li>\n<\/ul>\n<p>V studi\u00edch prevence migr\u00e9ny (Jensen 1994, Mathew 1995, Klapper 1997) valpro\u00e1t v d\u00e1vce 500-1 500 mg\/den sn\u00ed\u017eil m\u011bs\u00ed\u010dn\u00ed frekvenci migr\u00e9n p\u0159ibli\u017en\u011b o 50 % u zhruba poloviny l\u00e9\u010den\u00fdch pacient\u016f.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Profylaxe migr\u00e9ny u dosp\u011bl\u00fdch<\/strong> \u2014 schv\u00e1leno FDA 1996<\/li>\n<li><strong>10\u201315 mg\/kg\/den ve 2 d\u00e1vk\u00e1ch<\/strong> \u2014 absence, myoklonick\u00e9, tonicko-klonick\u00e9 z\u00e1chvaty (l\u00e9k prvn\u00ed volby)<\/li>\n<li><strong>Fok\u00e1ln\u00ed epilepsie<\/strong> (parci\u00e1ln\u00ed z\u00e1chvaty) \u2014 alternativa k karbamazepinu<\/li>\n<li><strong>Bipol\u00e1rn\u00ed porucha<\/strong> \u2014 akutn\u00ed m\u00e1nie a udr\u017eovac\u00ed l\u00e9\u010dba<\/li>\n<li><strong>Status epilepticus<\/strong> (intraven\u00f3zn\u00ed forma)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Encorate pro prevenci migr\u00e9ny<\/h2>\n<p>Valpro\u00e1t se <strong>postupn\u011b zvy\u0161uje<\/strong> b\u011bhem 2-4 t\u00fddn\u016f, aby se minimalizovala nevolnost:<\/p>\n<ul>\n<li><strong>T\u00fdden 1:<\/strong> 250 mg dvakr\u00e1t denn\u011b s j\u00eddlem<\/li>\n<li><strong>T\u00fdden 2:<\/strong> 250 mg r\u00e1no + 500 mg ve\u010der<\/li>\n<li><strong>3. t\u00fdden a d\u00e1le:<\/strong> 500 mg dvakr\u00e1t denn\u011b (c\u00edlov\u00e1 d\u00e1vka; upravit v rozmez\u00ed 500\u20131 500 mg\/den)<\/li>\n<li><strong>Vyhodno\u0165te \u00fa\u010dinek za 8-12 t\u00fddn\u016f.<\/strong> Veden\u00ed den\u00edku migr\u00e9n pro kvantifikaci zm\u011bn.<\/li>\n<li><strong>Terapeutick\u00e9 hladiny v plazm\u011b<\/strong> jsou 50-100 \u03bcg\/mL pro kontrolu z\u00e1chvat\u016f; u migr\u00e9ny se hladiny rutinn\u011b nem\u011b\u0159\u00ed \u2014 d\u00e1vkov\u00e1n\u00ed podle klinick\u00e9 odpov\u011bdi.<\/li>\n<\/ul>\n<p><strong>Monitorov\u00e1n\u00ed:<\/strong><\/p>\n<ul>\n<li>V\u00fdchoz\u00ed vy\u0161et\u0159en\u00ed: jatern\u00ed testy (AST, ALT, bilirubin), krevn\u00ed obraz (po\u010det trombocyt\u016f), amyl\u00e1za, t\u011bhotensk\u00fd test (u \u017een v reproduk\u010dn\u00edm v\u011bku), hladina amoniaku (v\u00fdchoz\u00ed)<\/li>\n<li>1., 3., 6. m\u011bs\u00edc, pot\u00e9 ka\u017ed\u00fdch 6 m\u011bs\u00edc\u016f: jatern\u00ed testy, krevn\u00ed obraz<\/li>\n<li>Kontrola amoniaku p\u0159i zmatenosti nebo nov\u00fdch kognitivn\u00edch p\u0159\u00edznac\u00edch<\/li>\n<\/ul>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> postupn\u00e9 vysazov\u00e1n\u00ed b\u011bhem 2-4 t\u00fddn\u016f. U pacient\u016f se sou\u010dasnou epilepsi\u00ed nikdy nevysazujte valpro\u00e1t bez konzultace s neurologem (riziko z\u00e1chvat\u016f).<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:18px 0;border-radius:4px;\">\n<strong>\u26a0\ufe0f VAROV\u00c1N\u00cd T\u011aHOTN\u00ddM.<\/strong> Valpro\u00e1t pat\u0159\u00ed mezi nejv\u00edce teratogenn\u00ed l\u00e9ky b\u011b\u017en\u011b pou\u017e\u00edvan\u00e9 v klinick\u00e9 praxi. Expozice v prvn\u00edm trimestru s sebou nese <strong>~10% riziko z\u00e1va\u017en\u00fdch vrozen\u00fdch vad<\/strong> (defekty neur\u00e1ln\u00ed trubice, srde\u010dn\u00ed vady, roz\u0161t\u011bp rtu\/patra, defekty kon\u010detin, urogenit\u00e1ln\u00ed abnormality) a <strong>30-40% riziko neurov\u00fdvojov\u00fdch poruch<\/strong> (sn\u00ed\u017een\u00ed d\u011btsk\u00e9ho IQ o 7-10 bod\u016f, 5\u00d7 vy\u0161\u0161\u00ed riziko poruch autistick\u00e9ho spektra). <strong>Valpro\u00e1t se NESM\u00cd pou\u017e\u00edvat v t\u011bhotenstv\u00ed ani u \u017een v reproduk\u010dn\u00edm v\u011bku, pokud selhaly jin\u00e9 mo\u017enosti l\u00e9\u010dby a nen\u00ed zaveden form\u00e1ln\u00ed program prevence t\u011bhotenstv\u00ed.<\/strong> Pro prevenci migr\u00e9ny p\u0159ejd\u011bte p\u0159ed pl\u00e1novan\u00fdm t\u011bhotenstv\u00edm na <a href=\"https:\/\/medsbase.com\/cs\/inderal\/\">propranolol<\/a>, amitriptylin nebo antagonistu CGRP.\n<\/div>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>Velmi \u010dast\u00e9 (&gt;10 %):<\/strong> nevolnost, dyspepsie, ospalost, t\u0159es, p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze, \u0159\u00eddnut\u00ed vlas\u016f \/ vypad\u00e1v\u00e1n\u00ed vlas\u016f, alopecie (obvykle p\u0159echodn\u00e9; vlasy dor\u016fstaj\u00ed po sn\u00ed\u017een\u00ed d\u00e1vky nebo vysazen\u00ed).<\/p>\n<p><strong>B\u011b\u017en\u00e9 (1-10 %):<\/strong> ataxie, z\u00e1vrat\u011b, bolesti hlavy, p\u0159echodn\u00e9 zv\u00fd\u0161en\u00ed jatern\u00edch test\u016f, trombocytopenie (obvykle m\u00edrn\u00e1 a z\u00e1visl\u00e1 na d\u00e1vce), amenorea nebo nepravideln\u00e1 menstruace, syndrom polycystick\u00fdch ovari\u00ed (u mlad\u0161\u00edch \u017een), sn\u00ed\u017een\u00e9 libido, perifern\u00ed otoky.<\/p>\n<p><strong>Vz\u00e1cn\u00e9, ale z\u00e1va\u017en\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Hepatotoxicita<\/strong> \u2014 idiosynkratick\u00e1; obvykle v prvn\u00edch 6 m\u011bs\u00edc\u00edch; vy\u0161\u0161\u00ed riziko u d\u011bt\u00ed mlad\u0161\u00edch 2 let, u pacient\u016f s mitochondri\u00e1ln\u00edmi poruchami (mutace POLG jsou absolutn\u00ed kontraindikac\u00ed) a p\u0159i polyterapii. Projevuje se nevolnost\u00ed, zvracen\u00edm, \u00fanavou, \u017eloutenkou. Vy\u017eaduje urgentn\u00ed vy\u0161et\u0159en\u00ed jatern\u00edch test\u016f + vysazen\u00ed.<\/li>\n<li><strong>Pankreatitida<\/strong> \u2014 vz\u00e1cn\u00e9, ale potenci\u00e1ln\u011b fat\u00e1ln\u00ed; projevuje se bolest\u00ed b\u0159icha, nevolnost\u00ed, zvracen\u00edm, zv\u00fd\u0161enou hladinou lip\u00e1zy<\/li>\n<li><strong>Hyperamonemick\u00e1 encefalopatie<\/strong> \u2014 m\u016f\u017ee se vyskytnout i p\u0159i norm\u00e1ln\u00edch jatern\u00edch testech; projevuje se zmatenost\u00ed, letargi\u00ed, nov\u00fdmi kognitivn\u00edmi p\u0159\u00edznaky<\/li>\n<li><strong>Trombocytopenie, leukopenie<\/strong> \u2014 z\u00e1visl\u00e9 na d\u00e1vce; z\u00e1va\u017en\u00e9 formy jsou vz\u00e1cn\u00e9<\/li>\n<li><strong>Stevens-Johnson\u016fv syndrom \/ TEN<\/strong> \u2014 vz\u00e1cn\u00e9; okam\u017eit\u011b vysadit a vyhledat urgentn\u00ed p\u00e9\u010di<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed (absolutn\u00ed kontraindikace)<\/strong> a \u017eeny v reproduk\u010dn\u00edm v\u011bku bez programu prevence t\u011bhotenstv\u00ed<\/li>\n<li><strong>Zn\u00e1m\u00e1 nebo podez\u0159en\u00ed na mitochondri\u00e1ln\u00ed poruchu POLG<\/strong> (a d\u011bti mlad\u0161\u00ed 2 let, u kter\u00fdch nelze vylou\u010dit POLG) \u2014 riziko fat\u00e1ln\u00ed hepatotoxicity<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed nebo rodinn\u00e1 anamn\u00e9za t\u011b\u017ek\u00e9 jatern\u00ed dysfunkce<\/li>\n<li>Akutn\u00ed porfyrie<\/li>\n<li>Pankreatitida (osobn\u00ed anamn\u00e9za)<\/li>\n<li>Poruchy mo\u010dovinov\u00e9ho cyklu<\/li>\n<li>P\u0159ecitliv\u011blost na valpro\u00e1t<\/li>\n<\/ul>\n<p><strong>Kojen\u00ed:<\/strong> valpro\u00e1t p\u0159ech\u00e1z\u00ed do ml\u00e9ka v mal\u00e9m mno\u017estv\u00ed (pom\u011br ml\u00e9ko\/plazma ~0,02). Obecn\u011b pova\u017eov\u00e1no za p\u0159ijateln\u00e9 b\u011bhem kojen\u00ed, pokud je l\u00e9k nezbytn\u00fd; sledujte u kojence neobvyklou letargii nebo \u0161patn\u00e9 p\u0159\u00edjmy potravy.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Lamotrigin<\/strong> \u2014 valpro\u00e1t zdvojn\u00e1sobuje hladiny lamotriginu; d\u00e1vkov\u00e1n\u00ed lamotriginu na polovinu obvykl\u00e9 po\u010d\u00e1te\u010dn\u00ed d\u00e1vky<\/li>\n<li><strong>Karbapenemov\u00e1 antibiotika<\/strong> (meropenem, imipenem, ertapenem) \u2014 dramaticky sni\u017euj\u00ed hladinu valpro\u00e1tu \u2014 riziko z\u00e1chvat\u016f u epilepsie; kombinaci se vyhn\u011bte<\/li>\n<li><strong>Warfarin<\/strong> \u2014 valpro\u00e1t vyt\u011bs\u0148uje warfarin z albuminu; sledujte INR<\/li>\n<li><strong>Kyselina acetylsalicylov\u00e1<\/strong> \u2014 vyt\u011bs\u0148uje valpro\u00e1t z albuminu; zvy\u0161uje koncentraci voln\u00e9ho valpro\u00e1tu<\/li>\n<li><strong>Fenytoin, karbamazepin<\/strong> \u2014 sni\u017euj\u00ed hladinu valpro\u00e1tu indukc\u00ed CYP<\/li>\n<li><strong>Jin\u00e1 CNS depresiva<\/strong> (benzodiazepiny, alkohol, opioidy) \u2014 aditivn\u00ed sedace<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte p\u0159i teplot\u011b do 25\u00b0C v p\u016fvodn\u00edm blistru. Chra\u0148te p\u0159ed vlhkost\u00ed. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Za jak dlouho za\u010dne Encorate p\u0159edch\u00e1zet migr\u00e9n\u00e1m?<\/h3>\n<p>Pro pln\u00fd \u00fa\u010dinek je pot\u0159eba 8\u201312 t\u00fddn\u016f v c\u00edlov\u00e9 d\u00e1vce. Vedejte si den\u00edk migr\u00e9n, zaznamen\u00e1vejte po\u010det dn\u00ed s migr\u00e9nou m\u011bs\u00ed\u010dn\u011b na za\u010d\u00e1tku a v 12. t\u00fddnu. Klinicky v\u00fdznamn\u00e1 odpov\u011b\u010f je 50% sn\u00ed\u017een\u00ed po\u010dtu dn\u00ed s migr\u00e9nou za m\u011bs\u00edc.<\/p>\n<h3 class=\"wp-block-heading\">Je Encorate bezpe\u010dn\u00fd, pokud pl\u00e1nuji t\u011bhotenstv\u00ed?<\/h3>\n<p><strong>Ne.<\/strong> Valpro\u00e1t je jedn\u00edm z nejv\u00edce teratogenn\u00edch l\u00e9k\u016f v klinick\u00e9 praxi (~10% riziko malformac\u00ed, 30\u201340% riziko neurov\u00fdvojov\u00fdch poruch). \u017deny v reproduk\u010dn\u00edm v\u011bku by m\u011bly b\u00fdt p\u0159evedeny na bezpe\u010dn\u011bj\u0161\u00ed profylaktikum (<a href=\"https:\/\/medsbase.com\/cs\/inderal\/\">propranolol<\/a> je preferov\u00e1n v t\u011bhotenstv\u00ed) p\u0159ed po\u010det\u00edm. Obvykle se doporu\u010duje 3m\u011bs\u00ed\u010dn\u00ed vyplavovac\u00ed obdob\u00ed p\u0159ed pokusem o po\u010det\u00ed. Valpro\u00e1t by nem\u011bl b\u00fdt pou\u017e\u00edv\u00e1n u \u017een pl\u00e1nuj\u00edc\u00edch nebo schopn\u00fdch ot\u011bhotn\u011bt bez form\u00e1ln\u00edho programu prevence t\u011bhotenstv\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se forma s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm li\u0161\u00ed od Encorate Chrono?<\/h3>\n<p>Stejn\u00e1 molekula (valpro\u00e1t sodn\u00fd\/kyselina valproov\u00e1), ale odli\u0161n\u00fd profil uvol\u0148ov\u00e1n\u00ed. Encorate IR m\u00e1 okam\u017eit\u00e9 uvol\u0148ov\u00e1n\u00ed, vy\u017eaduje d\u00e1vkov\u00e1n\u00ed 2\u20133\u00d7 denn\u011b a m\u00e1 m\u00edrn\u011b vy\u0161\u0161\u00ed vrcholov\u00e9 plazmatick\u00e9 hladiny (v\u011bt\u0161\u00ed nevolnost a t\u0159es p\u0159i vrcholu). <a href=\"https:\/\/medsbase.com\/cs\/encorate-chrono\/\">Encorate Chrono (s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm)<\/a> Umo\u017e\u0148uje jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed s lep\u0161\u00ed sn\u00e1\u0161enlivost\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Zp\u016fsob\u00ed Encorate p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze?<\/h3>\n<p>Ano \u2014 p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze je jedn\u00edm z nej\u010dast\u011bj\u0161\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f (pr\u016fm\u011brn\u011b 3-5 kg za 6-12 m\u011bs\u00edc\u016f, u n\u011bkter\u00fdch v\u00edce). Mechanismus zahrnuje zv\u00fd\u0161enou chu\u0165 k j\u00eddlu a mo\u017en\u00e1 zm\u011bn\u011bn\u00fd metabolismus gluk\u00f3zy. Pokud je p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze probl\u00e9m, zva\u017ete p\u0159echod na <a href=\"https:\/\/medsbase.com\/cs\/topicon\/\">topiram\u00e1t<\/a> (kter\u00fd zp\u016fsobuje \u00fabytek hmotnosti) nebo <a href=\"https:\/\/medsbase.com\/cs\/inderal\/\">propranolol<\/a> (neutr\u00e1ln\u00ed v\u016f\u010di hmotnosti).<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d pot\u0159ebuji p\u0159i u\u017e\u00edv\u00e1n\u00ed Encorate krevn\u00ed testy?<\/h3>\n<p>Valpro\u00e1t m\u016f\u017ee zp\u016fsobit hepatotoxicitu, pankreatitidu, trombocytopenii a hyperamon\u00e9mii. V\u00fdchoz\u00ed + pravideln\u00e9 testy jatern\u00edch funkc\u00ed, kompletn\u00ed krevn\u00ed obraz a klinick\u00e9 sledov\u00e1n\u00ed odhal\u00ed probl\u00e9my v\u010das. Terapeutick\u00e9 monitorov\u00e1n\u00ed hladin l\u00e9\u010diva (hladiny 50-100 \u03bcg\/mL) nen\u00ed rutinn\u011b nutn\u00e9 pro prevenci migr\u00e9ny \u2014 d\u00e1vkov\u00e1n\u00ed se \u0159\u00edd\u00ed klinickou odpov\u011bd\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed Encorate?<\/h3>\n<p>Vyhn\u011bte se pravideln\u00e9mu nebo nadm\u011brn\u00e9mu u\u017e\u00edv\u00e1n\u00ed alkoholu. Alkohol zesiluje sedativn\u00ed \u00fa\u010dinky valpro\u00e1tu a zvy\u0161uje z\u00e1t\u011b\u017e jater. P\u0159\u00edle\u017eitostn\u00e9 mal\u00e9 mno\u017estv\u00ed nen\u00ed absolutn\u011b kontraindikov\u00e1no, ale pravideln\u00e9 pit\u00ed zvy\u0161uje riziko hepatotoxicity. Alkohol je tak\u00e9 \u010dast\u00fdm spou\u0161t\u011b\u010dem migr\u00e9ny; sn\u00ed\u017een\u00ed p\u0159\u00edjmu \u010dasto zlep\u0161uje migr\u00e9nu nez\u00e1visle na valpro\u00e1tu.<\/p>\n<h3 class=\"wp-block-heading\">Mohu Encorate n\u00e1hle vysadit?<\/h3>\n<p>Ne \u2014 postupn\u011b vysazujte b\u011bhem 2\u20134 t\u00fddn\u016f. N\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat rebound migr\u00e9nu a u pacient\u016f se sklonem k z\u00e1chvat\u016fm m\u016f\u017ee zp\u016fsobit z\u00e1chvat.<\/p>\n<h3 class=\"wp-block-heading\">Kde lze koupit Encorate online?<\/h3>\n<p>Encorate (valpro\u00e1t sodn\u00fd 200 mg tablety s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm, balen\u00ed po 30\u2013180 tablet\u00e1ch) m\u016f\u017eete zakoupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed l\u00e9\u010dba migr\u00e9ny na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zolmist-nasal-spray\/\">Zolmist nosn\u00ed sprej \u2014 Zolmitriptan 5 mg (rychlej\u0161\u00ed n\u00e1stup \u00fa\u010dinku)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zolitas-ods\/\">Zolitas ODS \u2014 Zolmitriptan 2,5\/5 mg orodispergovateln\u00e9 tablety<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/maxtan\/\">Maxtan \u2014 Rizatriptan 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/rizatop\/\">Rizatop \u2014 Rizatriptan 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/rizact\/\">Rizact \u2014 Rizatriptan (Cipla)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/sumitop\/\">Sumitop \u2014 Sumatriptan 25\/50\/100 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/anti-migraine\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky proti migr\u00e9n\u011b<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje odbornou l\u00e9ka\u0159skou pomoc. P\u0159ed zah\u00e1jen\u00edm, zm\u011bnou nebo ukon\u010den\u00edm jak\u00e9hokoli l\u00e9\u010den\u00ed migr\u00e9ny se v\u017edy pora\u010fte se sv\u00fdm l\u00e9ka\u0159em.<\/div>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>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<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/modin-2-5\/\">Modin 2.5<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/glyxambi-empagliflozin\/\">Glyxambi (Empagliflozin)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/leetrexate\/\">Leetrexate<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">Ramcor<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/baclof-liquid\/\">Baclof Liquid (peror\u00e1ln\u00ed roztok baklofenu 5 mg\/5 ml) \u2014 \u00faleva od spasticity<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Encorate jsou tablety natrium valpro\u00e1tu 200 mg s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm od Sun Pharma \u2014 antiepileptikum\/stabiliz\u00e1tor n\u00e1lady\/profylaxe migr\u00e9ny. Pro prevenci migr\u00e9ny: 250 mg dvakr\u00e1t denn\u011b s postupn\u00fdm zv\u00fd\u0161en\u00edm na 500\u20131 500 mg\/den v rozd\u011blen\u00fdch d\u00e1vk\u00e1ch. VAROV\u00c1N\u00cd: T\u011bhotensk\u00e1 kategorie D \u2014 valpro\u00e1t zp\u016fsobuje p\u0159ibli\u017en\u011b 10% riziko z\u00e1va\u017en\u00fdch vrozen\u00fdch vad a 30\u201340% riziko neurov\u00fdvojov\u00fdch poruch. \u017deny v reproduk\u010dn\u00edm v\u011bku vy\u017eaduj\u00ed form\u00e1ln\u00ed program prevence t\u011bhotenstv\u00ed.<\/p>","protected":false},"featured_media":61046,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3553,3141,3223],"product_tag":[4968,4677],"class_list":{"0":"post-61045","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-migraine","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_tag-encorate","10":"product_tag-sodium-valproate","12":"first","13":"instock","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\/61045","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=61045"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/61046"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=61045"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=61045"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=61045"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=61045"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}