Cerucal tabs 10mg #50

Cerucal is a drug that normalizes gastric and intestinal motility, and also stops vomiting. Cerucal is used to stop vomiting of any genesis in children and adults, to expand the lower part of the stomach in the area of ​​its connection with the duodenum in pyloric stenosis, to eliminate heartburn and epigastric discomfort, in the complex therapy of reflux esophagitis, as well as in intestinal and stomach atony. In addition, Cerucal can be used to prepare a person for gastroesophagoscopy and intubation, since it relaxes the muscles of the esophagus and stomach, facilitating diagnostic manipulation.

International name, release forms and composition

Currently, the drug is available in two dosage forms:
1. Tablets for oral administration;
2. Solution for intravenous and intramuscular administration.
The international non-proprietary name (INN) of the drug is Metoclopramide. INN is the official, common name of an active ingredient in a medicinal product. Since the active substance in Cerucal is metoclopramide, the INN of the drug is metoclopramide, respectively.
 As an active substance, both dosage forms of the drug include metoclopramide in various dosages. So, one tablet contains 10 mg of metoclopramide, and in solution its concentration is 5 mg per 1 ml. Since the solution is poured into hermetically sealed 2 ml ampoules, one ampoule contains 10 mg of metoclopramide. Thus, a solution from one ampoule and a Cerucal tablet contain the same amount of active substance. This ratio can be used to recalculate the number of tablets required for taking into ampoules and vice versa.
Cerucal tablets contain the following substances as auxiliary components:
    Potato starch;
    Lactose;
    Gelatin;
    Silica;
    Magnesium stearate.
Cerucal solution contains the following as auxiliary substances:
    Sodium sulfite;
    Disodium edetate;
    Sodium chloride;
    Distilled sterile water for injection.
Cerucal tablets are white, have a round flat shape and a risk on one side, and are available in cartons of 50 pieces. The solution is a clear, colorless liquid and is available in 2 ml glass ampoules, packed in cardboard boxes of 10 pieces. Ampoules with a solution are made of transparent glass, on which three stripes are applied - blue in the lower part, green - in the upper part, and white - in the area of ​​transition of the bottle to the narrow sealed part. On some ampoules, instead of a white strip, a notch and a dot above it may be applied.

Therapeutic action

Cerucal has an antiemetic and antiemetic effect by suppressing these reflexes at the level of the central nervous system. All other therapeutic effects of the drug are derived from these basic ones.
The action of the drug is carried out due to its penetration into the bloodstream and the brain, and by blocking dopamine and serotonin receptors in all organs and tissues. As a result of blocking receptors in the brain, its special area, called the vomiting center, ceases to function, as a result of which irritants from the digestive and respiratory tract are not processed, and the gag reflex does not occur. Thus, vomiting is stopped. And since the vomiting center of the brain is also responsible for hiccups, vomiting and hiccups are suppressed at the same time.
In addition to stopping vomiting and hiccups, the drug effectively eliminates persistent and excruciating nausea caused by various reasons, with the exception of motion sickness.
In addition, due to the effect on dopamine and serotonin receptors in the organs of the digestive tract, the drug has the following therapeutic effects:
Reduces the motor and contractile activity of the esophagus, which helps to expand its lumen and facilitate the passage of a food lump through it;
    Increases the tone of the esophageal sphincter, which separates it from the stomach. As a result, the number of gastroesophageal refluxes is prevented and reduced;
    Accelerates the transition of the food lump from the stomach to the duodenum, eliminating the feeling of heaviness and discomfort;
    Accelerates the movement of the food bolus through the intestines, stimulating its peristalsis and not provoking diarrhea;
    Normalizes the release of bile in response to food intake in the intestines;
    Reduces spasm of the sphincter of Oddi, which is located at the junction of the bile duct and duodenum. Due to this, bile regularly leaves the gallbladder and enters the duodenum without lingering in the duct;
    It normalizes the contractile activity of the gallbladder, eliminating its dyskinesia.
Cerucal does not change the level of secretion of gastric juice, pancreatic enzymes and bile.
The therapeutic effect of the drug develops one hour after oral administration, 10-15 minutes after intramuscular injection and a few minutes after intravenous administration. The duration of action is determined by the method of administration of the drug and is 30 minutes for intravenous injection, 1.5 - 2 hours for intramuscular injection and 6 hours for a tablet taken orally.

Indications for use

Cerucal tablets have a narrower range of indications for use in comparison with a solution. Therefore, tablets are usually used at home on the recommendation of a doctor, and the solution is used in a medical institution to achieve certain therapeutic effects.
Indications for the use of tablets and Cerucal solution are the following conditions and diseases:
    Vomiting of any origin;
    Nausea of ​​any origin;
    Hiccups of any origin;
    Atony and hypotension of the stomach and intestines;
    Diabetic gastroparesis (complete absence of stomach contractions);
    Symptoms of digestive disorders (belching, heartburn, flatulence, etc.) with irritable stomach syndrome, reflux esophagitis, pyloric stenosis and biliary dyskinesia;
    As part of the complex therapy of gastric ulcer and duodenal ulcer, cholelithiasis and gastritis.

What to prefer - pills or injections?

Cerucal tablets and injections are used to achieve the same therapeutic effects associated with the need to stop vomiting and accelerate the movement of food through the stomach and intestines.
Tablets are preferred in cases where a relatively long-term therapeutic effect is required, since their effect lasts for 5.5 to 6 hours. As a rule, this is a complex therapy of various chronic diseases of the digestive tract, in which the movement of the food lump through the intestines and stomach is disrupted, as a result of which symptoms of dyspepsia develop (heartburn, flatulence, heaviness in the stomach, etc.). Usually, Cerucal is used in the complex therapy of reflux esophagitis, gastritis, gastric ulcer and duodenal ulcer, pyloric stenosis and biliary dyskinesia, in which food stagnates in the stomach and intestines, causing unpleasant symptoms.
For vomiting, hiccups and nausea, the choice between pills and injections is made based on the person's ability to ingest the drug. In other words, if a person can swallow a pill and do not vomit within 15 - 20 minutes after that, then this particular form of the drug should be chosen. And only if it is impossible to take Cerucal in tablets to stop vomiting, hiccups and nausea, injections should be used. However, at the first opportunity, Cerucal's injections should be replaced with tablets.
With diabetic gastroparesis, it is optimal to inject the drug intramuscularly in the morning after breakfast, and take it in tablets during the rest of the day.
For diagnostic manipulations, such as probing the duodenum, X-ray of the small intestine and stomach, intravenous or intramuscular administration of Cerucal solution should be used, since in this case its action occurs quickly and lasts a short period of time (no more than 2 hours), which is very convenient ... With the injection of Cerucal, the stomach and intestines are freed from the food lump, the introduction of the probe and contrast medium is facilitated, which provides optimal conditions for high-quality diagnosis. Moreover, these effects do not last long and, thus, do not cause anxiety to the person after the completion of the procedure.
For children over 14 years old, you can adhere to the recommendations described above for choosing the dosage form of the drug. Children aged 2-14 years should use the drug exclusively in the form of injections, since the solution allows you to accurately dose the drug.

Tablets - instructions for use

The tablets should be taken orally half an hour before meals, swallowing whole, without chewing, not biting or crushing in other ways, but with a little water (100-200 ml).
Between taking the tablets, approximately the same intervals should be maintained, lasting at least 6 hours, since this is how long the effect of the drug lasts. It is recommended to take pills every 5-6 hours during the daytime, and take a longer break during the night's sleep.
For various diseases of the gastrointestinal tract, accompanied by a violation of the passage of food (reflux esophagitis, gastritis, peptic ulcer, biliary dyskinesia, pyloric stenosis, etc.), adults take the drug in the same dosage - 1 tablet 3 to 4 times a day ... Children aged 14 - 18 years with the same diseases of the digestive tract should take Cerucal 1/2 - 1 tablet 2 - 3 times a day. The duration of therapy is from 4 to 6 weeks to six months, depending on the rate of cure of the underlying disease. Reception of Cerucal is usually stopped after completion of the course of treatment for the disease.
To stop vomiting, hiccups and nausea, it is recommended to take one tablet at a time. If it does not work within an hour, then you can take another Cerucal pill. The third pill can only be taken after six hours.
If nausea, vomiting and hiccups are not one-time, but constant, accompanying any diseases or conditions, then the drug is taken for a long time according to the same scheme as in the complex treatment of gastrointestinal pathologies. That is, adults over 18 years old take 1 tablet 3 - 4 times a day, and children from 14 to 18 years old - 1/2 - 1 tablet 2 - 3 times a day. In this case, taking the drug continues until the condition normalizes and the painful symptoms disappear.
The maximum permissible single dosage of the drug for adults is 20 mg (2 tablets), and the daily dose is 60 mg (6 tablets). For adolescents, the maximum allowable dosage is half as much, that is, a single dose is 10 mg (1 tablet), and a daily dose is 30 mg (3 tablets).

Dosage for various diseases

Cerucal tablets for all indicated conditions are used in the following identical dosages:
    Children 14 - 18 years old - 1/2 - 1 tablet, 2 - 3 times a day;
    Adults over 18 years old - 1 tablet 3 - 4 times a day.
The maximum allowable single dosage of the drug is 20 mg (2 tablets) for adults and 10 mg for adolescents, and the daily dose is 60 mg (6 tablets) for adults and 30 mg for adolescents.
The solution of the drug is also used for indicated diseases and conditions in the same dosages:
    Children over 14 years old and adults - 1 ampoule 1 - 3 times a day;
    Children 2 - 14 years old - calculated individually according to the ratio of 0.1 - 0.5 mg per 1 kg of body weight.
In case of liver pathology, accompanied by ascites, the usual dosage is divided in half. In renal pathology, the dosage of the drug is prescribed on the basis of creatinine clearance, determined by the Reberg test. If the creatinine clearance is less than 10 ml / min, then Cerucal can be taken only 1 tablet or 1 ampoule once a day. With a creatinine clearance of 11 to 60 ml / min, Cerucal is allowed to take 15 mg per day, divided into two doses - in the morning 10 mg (1 whole tablet or 1 ampoule) and in the evening 5 mg (half a tablet or 1 ml of solution). When creatinine clearance is more than 60 ml / min, Cerucal should be taken in usual dosages according to age.

Special instructions

During the entire period of therapy with the drug, alcohol should be avoided.
Adolescents, the elderly over 65, and people with kidney disease, liver disease, bronchial asthma and hypertension have a higher risk of side effects. If any appear, then the drug must be canceled.
While taking the drug, the concentrations of bilirubin, protein, AST, ALT and prolactin in the blood plasma may change. These changes are reversible and do not require discontinuation of the drug.
It is not recommended to use the drug for epilepsy, glaucoma and extrapyramidal disorders, since the course of the disease may worsen.

Impact on the ability to control mechanisms

Cerucal can reduce the rate of reactions, therefore, during therapy, it is necessary to refrain from potentially hazardous activities associated with the need to control mechanisms.

Compatibility with other medicines

Anticholinergics (Atropine, Scopolamine, Promethazine, Diphenhydramine, etc.) weaken the effect of the drug. And Cerucal weakens the effect of Levodopa, Pergolin and H2-histamine blockers (Ranitidine, Famotidine, etc.).
Cerucal slows down the absorption of Digoxin and Cimetidine into the bloodstream from the intestines, but accelerates that for antibiotics (Tetracycline, Ampicillin, etc.), Paracetamol, Aspirin, Levodopa, lithium and alcohol preparations.
When taken simultaneously, the drug leads to an increase in the concentration of lithium and bromocriptine in the blood. In addition, the drug enhances the effects of alcohol and sedatives, and lengthens the effect of succinylcholine. Cerucal also changes the effects of tricyclic antidepressants (Amitriptyline, etc.), monoamine oxidase inhibitors (Iproniazide, Selegilin, etc.) and sympathomimetics (Adrenaline, Oxymetazoline, Xylometazoline, etc.).
When taken with neuroleptics (Aminazine, Phenothiazine, etc.), the likelihood of extrapyramidal disorders increases.
Cerucal causes inactivation of vitamin B1, so they should not be used at the same time.

Overdose

An overdose is manifested by the following symptoms:
    Drowsiness;
    Confusion of consciousness;
    Irritability;
    Anxiety;
    Seizures;
    Extrapyramidal disorders;
    Bradycardia;
    Increased blood pressure.
In case of a mild overdose, all symptoms go away on their own within 24 hours after discontinuation of the drug without any treatment. In case of more severe poisoning, it is necessary to flush the stomach, give the person sodium sulfate and carry out symptomatic treatment aimed at relieving painful manifestations. In this case, extrapyramidal disorders are usually eliminated with Bipereden, and anxiety is removed with Diazepam.

For children

General Provisions

Cerucal is a drug that is often used to stop vomiting in children, including those under 2 years old, although this is prohibited. Despite the contraindication to the use of Cerucal in tablets for children under 14 years of age, it is actively used to stop vomiting. Since children, as a rule, do not suffer from other diseases of the gastrointestinal tract, the only purpose of using Cerucal is to stop vomiting.
Year after year, women share with each other information about how they gave their children the drug for vomiting, advising them not to pay attention to the prohibition on use specified in the instructions, since according to their observations nothing bad happened to the child. Of course, women want to help each other by sharing life experiences and their own observations, but in this case they are not entirely correct.
The fact is that vomiting in a child under 2 years old is a signal to call an ambulance. And for a child over 2 years old, to stop vomiting, you need to give the drug not in tablets, but buy a solution and inject it intramuscularly. Such use of the drug will be correct and safe, since the solution allows you to accurately dose Cerucal, minimizing the risk of overdose.

Cerucal for nausea

Cerucal effectively relieves attacks of nausea and vomiting, provoked by any reason other than motion sickness. If the attacks are one-off, then the drug should be taken only as needed, 1 - 2 tablets with a glass of water, regardless of food. If the tablets cannot be swallowed, or they cause vomiting, then 1 ampoule of Cerucal should be administered intramuscularly. Injections can be made 1 ampoule 1 - 3 times a day.
 If nausea or vomiting is constant and associated with any diseases, then the drug should be taken for a long time, 1 tablet 3-4 times a day, 30 minutes before meals. In this case, the use of Cerucal injections is not recommended. The duration of use can be from 4 weeks to six months, and in each case is determined by the doctor.
To stop nausea, you should not use Cerucal injections. To stop vomiting, the drug is administered intravenously or intramuscularly only if taking pills for some reason is impossible. However, as soon as possible, you should replace injections with taking pills.

Side effects

Cerucal solution and tablets can provoke the same side effects from various organs and systems:
1. Nervous system:
    Feeling tired;
    Headache;
    Dizziness;
    Feeling of fear;
    Anxiety;
    Depression;
    Drowsiness;
    Noise in ears;
    Teak-like twitching of the muscles of the face, neck and shoulders (it develops very rarely, mainly in children);
    Extrapyramidal disorders (mask-like face, trismus, spastic torticollis, muscle hypertonia, speech impairment, involuntary movements of the tongue, lips and neck, etc.);
    Parkinson-like disorders (tremors, muscle twitching, limited mobility), as a rule, develop in elderly patients with prolonged use of the drug;
    Neuroleptic syndrome (fever, muscle spasm and altered consciousness).
2. Blood system: Agranulocytosis (absence of neutrophils, basophils and eosinophils in the blood).
3. Cardiovascular system:
    Tachycardia (palpitations);
    Increase or decrease in pressure;
    Extrasystole.
4. Digestive tract:
    Constipation;
    Diarrhea;
    Dry mouth.
5. Endocrine system:
    Gynecomastia;
    Galactorrhea;
    Menstrual irregularities.
6. Allergic reactions:
    Rash and itching of the skin;
    Hives;
    A bronchial asthma attack;
    Dyspnea.
Usually the drug is well tolerated, and side effects are very rare. However, with the development of side effects from the endocrine and cardiovascular systems, as well as neuroleptic and parkinsonian syndromes or extrapyramidal disorders, the drug is canceled.

Contraindications for use

Tablets and solution have the following identical contraindications for use:
    Increased individual sensitivity to drug components;
    Intolerance to lactose or galactose;
    Syndrome of malabsorption of lactose or galactose;
    Glucosemia or galactosemia;
    Glaucoma;
    Pheochromocytoma;
    Hypotension or hypertension;
    Prolactin-dependent tumors (pituitary adenoma);
    Intestinal obstruction;
    Gastrointestinal bleeding;
    Pyloric stenosis;
    Perforation of the wall of the stomach or intestines;
    Epilepsy;
    Parkinson's disease;
    Extrapyramidal disorders;
    Dyskinesia against the background of the use of neuroleptics;
    I trimester of pregnancy;
    Breastfeeding period;
    Age under 14 for tablets and under 2 for solution.

Reviews

In almost all cases, the drug was used to relieve vomiting and nausea caused by various reasons. Most of the reviews about the drug (from 85% to 95%) are positive, due to the relatively quick and excellent clinical effect of the drug. People note that the drug quickly relieves vomiting or nausea and normalizes the condition, making it possible to start taking other drugs or drinking to treat the disease.
Separately, it should be noted that a large number of positive reviews about the drug concern its use for severe vomiting in children. So, mothers note that with severe vomiting, one injection of the solution was enough for it to stop, and the child could drink water, electrolyte solutions and take other necessary medications.
However, the reviews also note that the drug is quite serious, and therefore requires careful use and strict adherence to dosages, but at the same time it is an excellent "first aid" for severe vomiting.
There are few negative reviews about Cerucal and they are due to the development of severe side effects that forced a person to stop taking the drug.

Terms of sell

You can buy Cerucal without a prescription.