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Selective beta2-adrenergic, reduces the tone and contractile activity of the myometrium. Reduces the frequency and intensity of contractions of the uterus, inhibits spontaneous, as well as oxytocin-induced labor pains. During labor normalizes excessively strong or irregular contractions.
Under the action of the drug, premature contractions in most cases cease, which makes it possible to prolong the pregnancy to the normal term of labor.
Due to its beta2-selectivity of the drug has a slight effect on the heart and blood flow of the pregnant woman and the fetus.
- Inhibition of labor contractions during labor during acute intrauterine asphyxia, with uterus immobilization before a cesarean section, before fetal rotation from the transverse position, with umbilical cord prolapse, with complicated labor activity.
- Emergency measure for preterm birth before the delivery of the pregnant woman to the hospital.
- Inhibition of premature labor contractions in the presence of a flattened cervix and / or disclosure of the uterine cavity.
- Prevention of preterm labor in case of intensified or accelerated contractions without smoothing the cervix or opening the uterus.
- Immobilization of the uterus before, during and after cervical cerclage.
1 ml of solution contains:
Active substances: hexoprenaline sulfate - 5 mcg.
Excipients: sodium pyrosulphite, disodium edetate dihydrate, sodium chloride, 2N sulfuric acid (to maintain the pH level), water d / and.
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Dosage and Administration
The contents of the ampoule must be led iv slowly over 5–10 min using automatically dosing infusomats or using conventional infusion systems — after dilution with isotonic sodium chloride to 10 ml. The dose of the drug should be selected individually.
In acute tocolysis: the drug is prescribed in a dose of 10 μg (1 amp. 2 ml each). Further, if necessary, treatment can be continued using infusions.
With massive tocolysis: administration of the drug begins with 10 μg (1 amp. 2 ml each), followed by infusion of Gynipral with a speed of 0.3 μg / min. As an alternative treatment, it is possible to use only infusions of the drug at a speed of 0.3 mcg / min without prior bolus administration of the drug.
With prolonged tocolysis: the drug is prescribed as a long-term drip infusion at a rate of 0.075 mcg / min.
If there is no resumption of contractions within 48 hours, treatment with Gynipral pills of 500 μg should be continued.
From the side of the central nervous system and peripheral nervous system: headache, dizziness, anxiety, light tremor of fingers.
Since the cardiovascular system: maternal tachycardia (fetal heart rate in most cases remains unchanged), hypotension (mainly diastolic); rarely - rhythm disturbances (ventricular premature beats), cardialgia (disappear quickly after drug withdrawal).
From the digestive system: rarely - nausea, vomiting, depression of intestinal motility, intestinal obstruction (it is recommended to monitor the regularity of the stool), a temporary increase in transaminase levels.
Allergic reactions: difficulty in breathing, bronchospasm, impairment of consciousness down to coma, anaphylactic shock (in patients with bronchial asthma or patients with hypersensitivity to sulfites).
From the laboratory indicators: hypokalemia, hypocalcemia at the beginning of therapy, increased plasma glucose levels.
Other: increased sweating, oliguria, edema (especially in patients with kidney disease). Side effects in newborns: hypoglycemia, acidosis.
- Mitral valve disease and aortic stenosis.
- Arterial hypertension.
- Severe liver and kidney disease.
- Closed angle glaucoma.
- Uterine bleeding, premature detachment of the placenta.
- Intrauterine infections.
- I trimester of pregnancy.
- Lactation (breastfeeding).
- Hypersensitivity to the drug components (especially in patients with bronchial asthma and history of hypersensitivity to sulfites).
When combined with beta-blockers, Gynipral®'s effect is weakened or neutralized.
When combined with methylxanthines (including with theophylline), the effectiveness of Gynipral increases.
The combined use of Gynipral with GCS reduces the intensity of glycogen accumulation in the liver.
When combined, Gynipral weakens the effect of oral hypoglycemic drugs.
When combined, Gynipral®a with other drugs with sympathomimetic activity (cardiovascular and bronchodilator drugs) may increase the effect of drugs on the cardiovascular system and the appearance of symptoms of overdose.
When used in conjunction with ftorotan and beta-adrenostimulyatorim side effects Gynipral®a from the cardiovascular system.
Gynipral is incompatible with ergot alkaloids, MAO inhibitors, tricyclic antidepressants, as well as with drugs containing calcium and vitamin D, dihydrotachisterol and mineralocorticoids.
Sulfite is a highly active component, so you should refrain from mixing Gynipral with other solutions, except for isotonic sodium chloride solution and 5% dextrose (glucose) solution.
Pregnancy and Lactation
The drug is contraindicated for use in the first trimester of pregnancy and lactation (breastfeeding). In the II and III trimesters of pregnancy, the drug is used as indicated.
During the period of Gynipral application, it is recommended to carry out thorough monitoring of the cardiovascular system (HR, BP) functions of the mother and fetus. It is recommended to register an ECG before and during treatment.
Patients with hypersensitivity to sympathomimetics should be prescribed Gynipral in small doses, selected individually, under the constant supervision of a physician.
With a significant increase in the mother's heart rate (more than 130 beats / min) or / and with a marked decrease in blood pressure, the dose of the drug should be reduced.
When there is difficulty breathing, pain in the heart, signs of heart failure, use of Gynipral should be stopped immediately.
The use of Gynipral®a can cause an increase in glucose in the blood plasma (especially in the initial period of treatment), therefore, should be monitored indicators of carbohydrate metabolism in mothers with diabetes. If childbirth occurs immediately after a course of treatment with Gynipral, it is necessary to consider the possibility of hypoglycemia and acidosis in newborns due to transplacental penetration of lactic and ketonic acids.
When applying Gynipral, diuresis is reduced, so you should closely monitor the symptoms associated with fluid retention in the body.
In some cases, the simultaneous use of GCS during Gynipral infusion can cause pulmonary edema. Therefore, with infusion therapy, constant careful clinical monitoring of patients is necessary. This is especially important in the combined treatment of corticosteroids in patients with kidney disease. Strict limitation of excess fluid intake is required. The risk of possible development of pulmonary edema requires limiting the amount of infusion to the extent possible, as well as the use of dilution solutions that do not contain electrolytes. It is necessary to limit salt intake with food.
It is recommended to monitor the regularity of the activity of the intestine during the period of use of the drug.
Before the start of tocolytic therapy, it is necessary to take potassium preparations, since with hypokalemia, the effect of sympathomimetics on the myocardium is enhanced.
The simultaneous use of funds for general anesthesia (halothane) and sympathomimetics can lead to cardiac arrhythmias. Reception of Gynipral should be stopped before using halothane.
With prolonged tocolytic therapy, it is necessary to monitor the state of the placental complex, to ensure that there is no placental abruption. Clinical symptoms of premature placental abruption can be smoothed against the background of tocolytic therapy. When the rupture of the membranes of the cervix and disclosure of the cervix more than 2-3 cm, the effectiveness of tocolytic therapy is low.
Symptoms of concomitant dystrophic myotonia may increase during tocolytic therapy with beta-adrenergic mimetics. In such cases, the use of drugs diphenylhydantoin (phenytoin) is recommended.
When using the drug in the form of pills with tea or coffee may increase the side effects of Gynipral.
Symptoms: severe tachycardia in the mother, arrhythmia, finger tremor, headaches, increased sweating, anxiety, cardialgia, decreased blood pressure, shortness of breath.
Treatment: the use of Gynipral antagonists - non-selective beta-blockers, which completely neutralize the effect of the drug.
- Brand name: Gynipral®
- Active ingredient: Hexoprenaline
- Dosage form: Drops for oral administration homeopathic in the form of a clear liquid from slightly pale yellow to light yellow in color, with the smell of ethanol.
- Manufacturer: Heel
- Country of Origin: Germany
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- Effects of hexoprenaline on the lecithin/sphingomyelin ratio and pressure-volume relationships in fetal rabbits
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