In a study of patients with a diagnosis of pathological gambling nalmefene was used in doses up to 90 mg / day for 16 weeks. In a study of patients with interstitial cystitis nalmefene 20 patients received a dose of 108 mg / day for more than 2 years. It reported the case of a single dose of nalmefene at a dose of 450 mg, which was not accompanied by a change in blood pressure, heart rate, respiratory rate and body temperature. In such cases, the safety profile of nalmefene was consistent with that described above in the section “Side effects”, but anavar vs winstrol the experience of observation is limited. Treatment In case of overdose symptomatic therapy is recommended, and monitoring of the patient.
Interaction with other drugs
Studies of interaction with other medicinal products in vivo has not been carried out.
According to the study data in vitro there is no evidence to suggest the presence of a clinically significant interaction between the nalmefene or its metabolites and drugs, is metabolized with the participation of the majority isoenzymes and membrane transporters . Concomitant use with drugs that are potent inhibitors of isoenzyme (for example, diclofenac, fluconazole, medroxyprogesterone acetate, meclofenamic acid) can significantly increase the exposure of nalmefene. Rare use of these drugs simultaneously with nalmefene can hardly cause clinically significant consequences. At the same time, in case of prolonged simultaneous use of potent inhibitors of isoenzyme anavar vs winstrol, we can not exclude the potential to raise the exposure of nalmefene (see. Section “Special instructions and precautions”). Accordingly, the simultaneous application of inductors (e.g., dexamethasone, phenobarbital, rifampin, omeprazole) can potentially lead to a decrease in the concentration of nalmefene in plasma below the therapeutic level.
In the case of nalmefene simultaneously with opioid agonists (e.g., some antitussive, cough, antidiarrheals and opioid analgesics) may experience a decrease in their therapeutic effect (see. section “Special instructions and precautions”).
there is no clinically significant pharmacokinetic interaction between the nalmefene and alcohol.
After application of nalmefene may experience a slight deterioration of cognitive and psychomotor functions. However, the result of the simultaneous reception of nalmefene and alcohol does not exceed the sum of the effects of each agent used alone.
Concomitant use of alcohol and Selinkro does not prevent the development of alcohol intoxication.
Special instructions (warnings)
Selinkro is not intended anavar vs winstrol to achieve immediate abstinence from alcohol. Reducing alcohol consumption is the intermediate target on the way to a complete abstinence. The use of opioids in an emergency situation when a patient receiving Selinkro need to opioids, the dose of the latter, as required to achieve the desired effect, can exceed the standard. Thus it is necessary to closely monitor symptoms of respiratory depression resulting from opioid administration, and other adverse reactions. If a patient to assist in emergency situations need to opioids and their dose should be selected individually. In the event that requires the use of very high doses of opioids, should be carefully monitored for the patient’s condition. Selinkro to temporarily cancel 1 week prior to the intended use of opioids, such as during routine surgery. The doctor assigns Selinkro, should advise the patient to inform health care providers about time of the last dose, in cases when it becomes necessary to use opioids. care must be taken when the medicinal preparations containing opioids (e.g., antitussive drugs and opioid analgesics) are used in patients already receiving therapy Selinkro. Nalmefene is contraindicated in patients taking currently opioid analgesics. Concomitant diseases Mental disorders during clinical trials reported adverse reactions on the part of the psyche (see. “side effects” section). If the patient has disorders of the psyche, not associated with the beginning of the application Selinkro and / or they are not temporary, the doctor should consider alternative causes of these symptoms and to assess the need for continued therapy with Selinkro.