Neurologic Drugs : Parkinsonism
OPKME1 “PK-Merz tablet” 100 mg/tab
適應症：帕金森氏病、預防及治療Ａ型流行性感冒症狀。
Usual dose:
Parkinsonism:
Adult: monotherapy, 100 mg bid, may titrate up to 400 mg/day in divided doses.
Influenza due to Influenza virus, type A, human:
Adult: 100 mg bid or 200 mg qd, started within 24-48 h after onset and continued 24-48 h after disappearance of signs and symptoms.
Pediatric
(1-9 yrs): 4.4-8.8 mg/kg/day bid, started within 24-48 h after onset and continued 24-48 h after disappearance of signs and symptoms; max. 150 mg/day.
(10-12 yrs): 100 mg bid, started within 24-48 h after onset and continued 24-48 h after disappearance of signs and symptoms; max. 200 mg/day.
Dose adjustment:
Renal impairment:
|
CrCl (ml/min) |
Dosage regimen |
|
30-50 |
200 mg on Day 1 then 100 mg/day. |
|
15-29 |
200 mg on Day 1 then 100 mg qod |
|
< 15 |
200 mg q7d |
Geriatric (> 65 yrs): 100mg qd.
Adverse effect:
Common: orthostatic hypotension, peripheral edema, constipation, diarrhea, loss of appetite, nausea, xerostomia, ataxia, confusion, dizziness, headache, insomnia, somnolence, agitation, anxiety, depression, dream disorder, fatigue, feeling nervous, hallucinations, irritability.
Serious: cardiac arrest, cardiac dysrhythmia, congestive heart failure, hypotension, tachycardia, agranulocytosis, leukopenia, neutropenia, immune hypersensitivity reaction, neuroleptic malignant syndrome, suicidal intent, acute respiratory failure, pulmonary edema
健保使用規範：(91/11/1、93/2/1、95/9/1、96/9/1、97/7/1、100/6/1、101/6/1)
1.如病人開始出現功能障礙，在使用levodopa之前或同時，得使用一種dopamine agonist，如amantadine，或是levodopa併用 COMT抑制劑（entacapone：如Comtan film-coated tab.）。
2.若已同時使用上述藥物且達高劑量，仍無法達到滿意的 “on” state，或出現運動併發症（如異動症或肌強直），需合併使用多類藥物治療時，應於病歷上詳細記載理由。