testosterone cypionate dosage
Carbamazepine, the active ingredient of the drug testosterone cypionate dosagel is dibenzoazepinovym derivatives. Along with antiepileptic, the drug has also neurotropic and psychotropic effects. The mechanism of action of carbamazepine to date only partially explained.
Carbamazepine stabilizes overexcited neurons membranes, suppresses the serial bits of neurons and synaptic transmission reduces the excitation pulses. Probably, the main mechanism of action of carbamazepine is to prevent the re-emergence in depolarized neurons of the sodium action potentials by blocking the “action.” – Dependent and voltage-gated sodium channels when used as monotherapy in patients with epilepsy (especially in children and adolescents), it was noted psychotropic effect of the drug, which included a positive effect on symptoms of anxiety and depression, as well as reducing irritability and aggressiveness. With regard to the effect of the drug on cognitive and psychomotor functions are no definitive data: some studies have shown a double or a negative effect, which is dependent on the dose, other studies have found a positive effect of the drug in relation to attention and memory. As a neurotropic agent drug is effective in a number of neurological diseases.
For example, in idiopathic and secondary trigeminal neuralgia it prevents the appearance of paroxysmal pain attacks. When alcohol withdrawal syndrome drug increases the seizure threshold, which in this state is usually reduced, and reduces the severity of the clinical manifestations of the syndrome, such as irritability, tremors, disturbances gait. in patients with diabetes insipidus drug reduces urine output and thirst. as a psychotropic drug the drug is effective in affective disorders, namely, the treatment of acute manic states in the maintenance treatment of bipolar affective (manic-depressive) disorder (both as a monotherapy and in combination with antipsychotic agents, antidepressant drugs, or lithium) at attacks schizoaffective psychosis, seizures with manic, where it is used in combination with neuroleptics as well as in manic-depressive psychosis rapid cycling. The ability of the drug to suppress manic symptoms may be due to inhibition of metabolism of dopamine and norepinephrine.
Pharmacokinetics Absorption After oral carbamazepine absorbed almost completely, while taking the tablet form the absorption is relatively slow. After a single mean maximum plasma concentration is achieved after 12 hours. After oral syrup Tegretol average value testosterone cypionate dosageis achieved in 2 hours . After a single oral pill unchanged active substance is approximately . Do not observed clinically significant differences in the amount of intake of the active substance after application of various dosage forms for oral Tegretol. When using any drug form Tegretol meal does not significantly affect the rate and extent of absorption of the drug. The equilibrium concentration of carbamazepine in plasma are achieved within 1-2 weeks. The time achieve individual and depends on the degree of auto-induction of liver enzyme systems carbamazepine geteroinduktsii other simultaneously used drugs and the patient’s condition before treatment, the dose and duration of treatment.
There are substantial individual differences of the equilibrium concentration values within the therapeutic range: the majority of patients, these values range fromtestosterone cypionate dosage. the distribution and binding to plasma protein binding of carbamazepine to plasma proteins is 70-80 %. The concentration of unchanged carbamazepine in cerebrospinal fluid and saliva proportional to the fraction of active substances not bound to plasma proteins (20-30%). The concentration of carbamazepine in breast milk is 25-60% of its level in the blood plasma. Carbamazepine crosses the placental barrier. Given the complete absorption of carbamazepine, the apparent volume of distribution is 0.8-1.9 L / kg. Testosterone cypionate dosage is metabolized in the liver. The main route of biotransformation is epoxidation, thereby forming the main metabolites: 10,11 transdiolovoe derivative and its conjugate with glucuronic acid.
The conversion of carbamazepine-10,11 epoxide, carbamazepine-10,11-tranedyol occurs in humans using microsomal enzyme epoxide hydrolase. The content of carbamazepine-10,11 epoxide (active metabolite) is about 30% of the plasma level of carbamazepine. The basic isoenzyme providing Carbamazepine biotransformation . As a result of metabolic reactions also formed a small amount of another metabolite -. 9-hydroxy-methyl-10-karbamoilakridana Another important way carbamazepine metabolism – formation by the enzyme different monogidroksilirovannyh derivatives.Elimination half-life of unchanged carbamazepine after single oral administration is on average about 36 hours, and after the re-admission of the drug – an average of 16-24 hours, depending on the duration of treatment (due to auto-induction of the monooxygenase system of the liver). it is shown that in patients taking other medications at the same time inducing liver enzymes ( eg, phenytoin, phenobarbital), carbamazepine half-life is on average 9-10 hours. When administered carbamazepine-10,11-epokeyda average period of its half-life is approximately 6 hours. After a single oral administration of 400 mg carbamazepine 72% of the dose is excreted in the the urine and 28% in the feces. About 2% of the dose excreted in the urine as unchanged carbamazepine, about 1% – in the form of the pharmacologically active 10,11-epoxide metabolite. After a single oral administration of 30% carbamazepine excreted in the urine as a final epoxidation product.
In children, testosterone cypionate dosage due to the more rapid elimination of carbamazepine, may require higher doses of the drug per kilogram of body weight, compared with adults . there is no evidence that would indicate that the pharmacokinetics of carbamazepine altered in elderly patients (compared with adults younger). on the pharmacokinetics of carbamazepine data in patients with impaired renal or hepatic function has not yet been available.