{"id":56808,"date":"2024-02-27T17:08:42","date_gmt":"2024-02-27T17:08:42","guid":{"rendered":"https:\/\/medsname.com\/spectra\/"},"modified":"2026-04-30T10:24:34","modified_gmt":"2026-04-30T10:24:34","slug":"spectra","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/spectra\/","title":{"rendered":"Spectra"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fff8d6;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">\u26a1 R\u0103spuns rapid<\/h3>\n<p style=\"margin-bottom:0;\">Spectra (Doxepin 10 \/ 25 mg) este un antidepresiv triciclic. Cea mai modern\u0103 utilizare este la doze mici pentru insomnie cronic\u0103 (3\u20136 mg) sau doze complete de antidepresiv (75\u2013300 mg) pentru depresie sedativ\u0103\/anxiolitic\u0103.<\/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>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Spectra la MedsBase este furnizat direct de la un produc\u0103tor certificat WHO-GMP \u00een ambalaj simplu \u0219i discret. Fiecare comand\u0103 este acoperit\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Politica noastr\u0103 de Reexpediere Garantat\u0103<\/a> \u2014 perioad\u0103 de livrare de 20 de zile lucr\u0103toare sau retrimitem f\u0103r\u0103 costuri suplimentare \u2014 \u0219i se calific\u0103 pentru <a href=\"https:\/\/medsbase.com\/ro\/loyalty-points\/\">programul nostru de loialitate pentru clien\u021bi<\/a>. Livr\u0103rile sunt disponibile \u00een majoritatea destina\u021biilor la nivel mondial.<\/p>\n<h2>Ce este Spectra \u0219i cum func\u021bioneaz\u0103<\/h2>\n<p>Spectra este un comprimat care con\u021bine Doxepin, furnizat de Cipla. Doze disponibile: <strong>10 \/ 25 mg<\/strong>.<\/p>\n<p>Doxepina este neobi\u0219nuit\u0103 printre ATC-uri prin faptul c\u0103 <strong>utilizarea sa modern\u0103 primar\u0103 este \u00een doze mici (3\u20136 mg) pentru insomnie cronic\u0103<\/strong> \u2014 ac\u021biunea sa profund\u0103 antihistaminic\u0103 H1 este cea mai puternic\u0103 dintre toate triciclicele \u0219i produce beneficii de men\u021binere a somnului f\u0103r\u0103 profilul adictiv al benzodiazepinelor sau Z-drugs. La doze complete antidepresive (75\u2013300 mg), func\u021bioneaz\u0103 ca un ATC clasic mixt serotonin\u0103-noradrenalin\u0103 cu propriet\u0103\u021bi sedative, anxiolitice \u0219i analgezice.<\/p>\n<p>Antidepresivele triciclice blocheaz\u0103 recaptarea serotoninei \u0219i noradrenalinei la nivelul transportorilor presinaptici, similar cu SSRI-urile \u0219i SNRI-urile. Dezavantajul lor de tolerabilitate provine din <strong>blocarea receptorilor off-target<\/strong>: muscarinic (efecte secundare anticolinergice), histaminergici H1 (sedare, cre\u0219tere \u00een greutate) \u0219i \u03b11-adrenergici (hipotensiune ortostatic\u0103). De asemenea, blocheaz\u0103 canalele rapide de sodiu \u00een \u021besutul cardiac \u2014 baza at\u00e2t pentru ac\u021biunea lor analgezic\u0103, c\u00e2t \u0219i pentru toxicitatea cardiac\u0103 \u00een caz de supradoz\u0103.<\/p>\n<p>Indica\u021bia de 3\u20136 mg pentru insomnie este singura gam\u0103 de doze de TCA care nu necesit\u0103 consult ECG \u0219i consiliere anticolinergic\u0103 pentru clasa TCA \u2014 la aceste doze, expunerea sistemic\u0103 este neglijabil\u0103.<\/p>\n<h2>Indica\u021bii \u0219i dozaj<\/h2>\n<table>\n<thead>\n<tr>\n<th>Indica\u021bie<\/th>\n<th>Doza ini\u021bial\u0103<\/th>\n<th>\u021aint\u0103<\/th>\n<th>Maxim<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Depresie major\u0103 \/ anxietate<\/td>\n<td>25\u201375 mg HS<\/td>\n<td>75\u2013300 mg\/zi<\/td>\n<td>300 mg<\/td>\n<\/tr>\n<tr>\n<td>Insomnie cronic\u0103 (doz\u0103 mic\u0103)<\/td>\n<td>3 mg HS<\/td>\n<td>3\u20136 mg HS<\/td>\n<td>6 mg<\/td>\n<\/tr>\n<tr>\n<td>Urtcarie cronic\u0103 \/ prurit<\/td>\n<td>10 mg TID<\/td>\n<td>10\u201325 mg TID<\/td>\n<td>\u00een func\u021bie de tolerabilitate<\/td>\n<\/tr>\n<tr>\n<td>Pacien\u021bi v\u00e2rstnici<\/td>\n<td>10 mg HS<\/td>\n<td>30\u201375 mg\/zi<\/td>\n<td>150 mg<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Considera\u021bii importante de siguran\u021b\u0103<\/h2>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Risc cardiac \u0219i toxicitate la supradoz\u0103<\/strong><\/p>\n<p style=\"margin-bottom:0;\">TCA prelungesc QRS \u0219i QT, iar supradozarea este <strong>amenin\u021b\u0103toare la via\u021b\u0103<\/strong> \u2014 istoric, cea mai frecvent\u0103 cauz\u0103 a deceselor prin antidepresive. ECG de baz\u0103 \u00eenainte de ini\u021biere la pacien\u021bii cu boli cardiace cunoscute, sub terapie care prelunge\u0219te QT sau la v\u00e2rstnici. Nu \u00eencepe\u021bi dup\u0103 infarct miocardic recent, anomalie de conducere, insuficien\u021b\u0103 cardiac\u0103 necompensat\u0103 sau QT lung congenital. Limita\u021bi cantit\u0103\u021bile dispuse la pacien\u021bii cu risc de suicid \u2014 raportul terapeutic-toxic este \u00eengust.<\/p>\n<\/div>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>\u00cenc\u0103rc\u0103tur\u0103 anticolinergic\u0103<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Gur\u0103 uscat\u0103, constipa\u021bie, vedere \u00eence\u021bo\u0219at\u0103, dificultate la urinare, \u00eencetinire cognitiv\u0103 \u2014 universale la doze terapeutice. Evita\u021bi la glaucom cu unghi \u00eengust, HBP cu reten\u021bie semnificativ\u0103 \u0219i demen\u021b\u0103. Combina\u021bi cu gum\u0103 de mestecat \/ pastile f\u0103r\u0103 zah\u0103r, fibre + lichide \u0219i emoliente fecale.<\/p>\n<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<strong>Avertisment cutie neagr\u0103 privind riscul de suicid (sub 25 de ani)<\/strong><\/p>\n<p style=\"margin-bottom:0;\">Toate antidepresivele poart\u0103 un avertisment FDA \u00een cadou negru pentru cre\u0219terea g\u00e2ndurilor suicidare la pacien\u021bii sub 25 de ani \u2014 relevant mai ales pentru clomipramin\u0103 \u00een TOC la adolescen\u021bi.<\/p>\n<\/div>\n<h2>Efecte secundare frecvente<\/h2>\n<ul>\n<li><strong>Anticolinergic:<\/strong> gur\u0103 uscat\u0103, constipa\u021bie, vedere \u00eence\u021bo\u0219at\u0103, dificultate la urinare.<\/li>\n<li><strong>Sedare:<\/strong> \u00een special doxepin\u0103 \u0219i clomipramin\u0103; administrarea la ora de culcare ajut\u0103.<\/li>\n<li><strong>Cardiovascular:<\/strong> hipotensiune ortostatic\u0103 (blocare \u03b11), tahicardie, prelungire a intervalelor de conducere.<\/li>\n<li><strong>Metabolic:<\/strong> cre\u0219tere \u00een greutate (5\u201310 kg pe parcursul a 12 luni la mul\u021bi pacien\u021bi), cre\u0219tere a apetitului.<\/li>\n<li><strong>Sexual:<\/strong> libido sc\u0103zut, ejaculare \u00eent\u00e2rziat\u0103 (uneori utilizat\u0103 clinic pentru ejaculare prematur\u0103), dificult\u0103\u021bi de erec\u021bie.<\/li>\n<li><strong>Interrup\u021bie tratament:<\/strong> reducere progresiv\u0103 pe 4 s\u0103pt\u0103m\u00e2ni; \u00eentreruperea brusc\u0103 provoac\u0103 simptome asem\u0103n\u0103toare gripei, tulbur\u0103ri digestive \u0219i tulbur\u0103ri de somn.<\/li>\n<\/ul>\n<h2>Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>MAOI<\/strong> \u2014 contraindica\u021bie absolut\u0103. Perioad\u0103 de eliminare de 14 zile \u00een ambele direc\u021bii.<\/li>\n<li><strong>SSRI \/ SNRI<\/strong> \u2014 risc serotoninergic aditiv; inhibarea CYP2D6 de fluoxetin\u0103 \u0219i paroxetin\u0103 cre\u0219te nivelul TCA.<\/li>\n<li><strong>Medicamente care prelungesc intervalul QT<\/strong> (azole, macrolide, amiodaron\u0103, sotalol, metadon\u0103, ondansetron, antipsihotice) \u2014 risc aditiv.<\/li>\n<li><strong>Alte anticolinergice<\/strong> (oxibutinin\u0103, benztropin\u0103, antihistaminice, clozapin\u0103, olanzapin\u0103) \u2014 \u00eenc\u0103rcare aditiv\u0103 la adul\u021bii \u00een v\u00e2rst\u0103.<\/li>\n<li><strong>Depresante ale SNC<\/strong> \u2014 sedare aditiv\u0103.<\/li>\n<li><strong>Tramadol, bupropion, fluoroquinolone<\/strong> \u2014 sc\u0103dere a pragului convulsiv; risc aditiv de convulsii.<\/li>\n<\/ul>\n<h2>Sarcina, al\u0103ptare, pediatric<\/h2>\n<p>TCA sunt aprobate de FDA \u00een sarcin\u0103 <strong>categoria C<\/strong>. Expunerea \u00een sarcin\u0103 t\u00e2rzie poate produce sindrom de sevraj anticolinergic neonatal. Lacta\u021bie: TCA trec \u00een lapte matern \u00een cantit\u0103\u021bi mici; nortriptilina \u0219i imipramina sunt cele mai studiate. Pediatric: imipramina este autorizat\u0103 de la v\u00e2rsta de 6 ani (enurez\u0103) \u0219i clomipramina de la 10 ani (TOC); doxepina la adolescen\u021bi doar cu consult specializat.<\/p>\n<h2>Depozitare<\/h2>\n<p>P\u0103stra\u021bi la 15\u201330 \u00b0C, departe de lumina direct\u0103 a soarelui, \u00een ambalajul original. \u021aine\u021bi departe de copii \u2014 ingestia pediatric\u0103 de TCA este o urgen\u021b\u0103 medical\u0103.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3>C\u00e2t dureaz\u0103 p\u00e2n\u0103 \u00eencepe s\u0103 ac\u021bioneze Spectra?<\/h3>\n<p>TCA-urile arat\u0103 de obicei beneficii \u00een 2\u20134 s\u0103pt\u0103m\u00e2ni. \u00cembun\u0103t\u0103\u021birile somnului \u0219i ale anxiet\u0103\u021bii apar adesea \u00een s\u0103pt\u0103m\u00e2na 1; efectul antidepresiv se dezvolt\u0103 \u00een 4\u20136 s\u0103pt\u0103m\u00e2ni. <\/p>\n<h3>De ce administrare la ora de culcare?<\/h3>\n<p>Doxepina, clomipramina \u0219i imipramina au toate efect sedativ. Administrarea la ora de culcare transform\u0103 seda\u021bia \u00eentr-un beneficiu (somn) \u00een loc de un efect secundar negativ (somnolen\u021b\u0103 diurn\u0103). De asemenea, reduce hipotensiunea ortostatic\u0103 prin somnul \u00een perioada de v\u00e2rf.<\/p>\n<h3>Este Spectra sigur pentru persoanele \u00een v\u00e2rst\u0103?<\/h3>\n<p>ATC-urile sunt pe lista Beers Criteria a medicamentelor poten\u021bial inadecvate pentru adul\u021bii \u00een v\u00e2rst\u0103 din cauza \u00eenc\u0103rc\u0103turii anticholinergice, a hipotensiunii ortostatice \u0219i a riscului cardiac. Nu sunt absolut contraindicate, dar sunt \u00een general de a doua linie \u2014 ISRS\/ISRSN sunt preferate, cu excep\u021bia cazurilor \u00een care un beneficiu specific (de ex. durere, somn) dep\u0103\u0219e\u0219te riscurile.<\/p>\n<h3>Pot consuma alcool \u00een timp ce iau Spectra?<\/h3>\n<p>Alcoolul amplific\u0103 efectele sedative \u0219i ortostatice ale ATC-urilor. Limita\u021bi-v\u0103 la consum ocazional \u0219i moderat; evita\u021bi complet consumul excesiv. Combina\u021bia nu este de obicei periculoas\u0103 \u00een modera\u021bie, dar se simte mai r\u0103u dec\u00e2t fiecare substan\u021b\u0103 luat\u0103 separat.<\/p>\n<h3>Care este riscul de supradoz\u0103?<\/h3>\n<p>ATC-urile sunt printre cele mai letale clase de medicamente \u00een caz de supradoz\u0103 \u2014 <strong>colaps al conduc\u021biei cardiace, convulsii \u0219i com\u0103<\/strong> poate ap\u0103rea la multipli relativ mici ai dozei terapeutice. Limita\u021bi cantit\u0103\u021bile dispuse la pacien\u021bii cu risc de suicid. Dac\u0103 se suspecteaz\u0103 supradozare, prezenta\u021bi-v\u0103 imediat la urgen\u021be \u2014 bicarbonatul de sodiu este antidotul pentru toxicitatea cardiac\u0103, dar momentul administr\u0103rii conteaz\u0103.<\/p>\n<h3>Spectra \u00eemi afecteaz\u0103 capacitatea de a conduce?<\/h3>\n<p>Sedarea \u0219i afectarea timpului de reac\u021bie sunt frecvente \u00een primele 1\u20132 s\u0103pt\u0103m\u00e2ni. Evita\u021bi condusul p\u00e2n\u0103 c\u00e2nd se cunoa\u0219te tolerabilitatea la stadiul stabil. Unii pacien\u021bi tolereaz\u0103 doze complete pe termen nedefinit f\u0103r\u0103 afectarea condusului; al\u021bii r\u0103m\u00e2n prea seda\u021bi chiar \u0219i la doze mici.<\/p>\n<h3>Poate fi Spectra combinat cu un SSRI?<\/h3>\n<p>\u00cen general, nu \u2014 combina\u021bia cre\u0219te riscul de sindrom serotoninergic \u0219i nivelurile serice de TCA (\u00een special cu fluoxetina \u0219i paroxetina). Combina\u021bia este uneori utilizat\u0103 \u00een TOC refractar sau depresie sub supraveghere specializat\u0103 cu monitorizare terapeutic\u0103 a medicamentului (TDM), niciodat\u0103 empiric.<\/p>\n<h3>Cum trebuie redus\u0103 treptat doza de Spectra?<\/h3>\n<p>Reduce\u021bi cu aproximativ 25\u201350% din doz\u0103 la fiecare 2 s\u0103pt\u0103m\u00e2ni. Sindromul de sevraj (denumit uneori \u201cgrip\u0103 TCA\u201d) produce stare de indispozi\u021bie, tulbur\u0103ri gastrointestinale \u0219i tulbur\u0103ri de somn \u2014 gestionabile cu reduc\u021bii mai lente ale dozei. Consulta\u021bi medicul prescriptor \u00eenainte de \u00eentrerupere.<\/p>\n<h3>Spectra provoac\u0103 cre\u0219tere \u00een greutate?<\/h3>\n<p>Da \u2014 majoritatea TCA-urilor provoac\u0103 o cre\u0219tere semnificativ\u0103 a greut\u0103\u021bii \u00een 6\u201312 luni, adesea 5\u201310 kg. Doxepina \u0219i amitriptilina sunt cele mai problematice; nortriptilina mai pu\u021bin. Dac\u0103 aceasta este o preocupare major\u0103, men\u021biona\u021bi-o \u00eenainte de ini\u021biere \u2014 un SSRI\/SNRI poate fi o op\u021biune mai bun\u0103.<\/p>\n<h3>Poate fi Spectra utilizat pentru dureri cronice?<\/h3>\n<p>Da \u2014 TCA-urile (\u00een special amitriptilina, nortriptilina \u0219i imipramina) la doze mici (10\u201375 mg) sunt de prim\u0103 inten\u021bie pentru neuropatia diabetic\u0103 periferic\u0103, nevralgia post-herpetic\u0103 \u0219i cefaleea cronic\u0103 de tip tensional. Blocarea canalelor de sodiu este mecanismul dominant. Efectul analgezic este independent de efectul antidepresiv \u0219i apare mai devreme (1\u20132 s\u0103pt\u0103m\u00e2ni).<\/p>\n<h2>Alte Medicamente pentru S\u0103n\u0103tatea Mintal\u0103<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/spectra\/\">Spectra (Doxepin TCA)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/doxin\/\">Doxin (Doxepin TCA)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/antidep\/\">Antidep (Imipramine TCA)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/flunil\/\">Flunil (Fluoxetine SSRI)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/duvanta\/\">Duvanta (Duloxetine SNRI)<\/a><\/li>\n<\/ul>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;font-size:0.9em;\">\n<strong>Not\u0103 medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop educa\u021bional \u0219i nu \u00eenlocuie\u0219te sfatul medical personalizat. Farmacoterapia pentru s\u0103n\u0103tatea mintal\u0103 ar trebui ini\u021biat\u0103, monitorizat\u0103 \u0219i ajustat\u0103 de c\u0103tre un clinician calificat. Dac\u0103 tu sau cineva cunoscut se afl\u0103 \u00eentr-o criz\u0103 suicidal\u0103, contacteaz\u0103 imediat serviciile de urgen\u021b\u0103 locale sau sun\u0103 la linia de preven\u021bie a suicidului din \u021bara ta (SUA\/Canada: 988; UK: Samaritans 116 123; list\u0103 interna\u021bional\u0103: <a href=\"https:\/\/findahelpline.com\/\" rel=\"nofollow noopener\" target=\"_blank\">findahelpline.com<\/a>).\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Spectra (Doxepin 10\/25 mg) \u2014 TCA cu cea mai puternic\u0103 sedare H1 pentru depresie, anxietate, urticarie cronic\u0103. Doza de 3\u20136 mg HS utilizat\u0103 pentru insomnie cronic\u0103.<\/p>","protected":false},"featured_media":56809,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3342,3906],"product_tag":[4174,4176],"class_list":{"0":"post-56808","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-general-health","8":"product_cat-mental-health-and-psychiatric-medications","9":"product_tag-doxepine","10":"product_tag-spectra","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/56808","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=56808"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/56809"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=56808"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=56808"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=56808"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=56808"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}