Tavor® expidet®
introduction
Tavor® expidet® is a prescription drug that is used briefly for anxiety disorders, nervousness and sleep disorders.
It contains the active ingredient lorazepam, which belongs to the group of benzodiazepines. Benzodiazepines all have a calming (sedative) and anxiolytic (anxiolytic) effect.
The drug Tavor® expidet® consists of small platelets that are placed directly under the tongue and then dissolve. This way they get into the blood faster and can develop their effect quickly.
Generally speaking, the drug only relieves symptoms, but it can Do not cure the cause of the disease, so that for anxiety or sleep disorders, which often indicate mental or physical illness, additional therapies such as psychotherapy are recommended.
Another important area of application for Tavor® expidet® is epileptic seizureswhich are caused by excessive or uncontrolled excitation of the activating nerve tracts and thus can be dampened by the increased inhibition
Because the active ingredient is lorazepam makes you dependent, the drug should can only be taken for a short time (approx. 4 weeks). In order to avoid withdrawal symptoms when the drug is discontinued, Tavor® expidet® is gradually reduced in the dose until it is finally discontinued.
Difference between Tavor® and Tavor® expidet®
The biggest difference between Tavor® and Tavor® expidet® lies in the different types of application. Tavor® is a tablet that should be swallowed whole with plenty of liquid. Lorazepam is absorbed into the blood via the gastric and intestinal mucosa. Therefore, when taking the tablet, a slower onset of action is to be expected, which is on average between 10 to 40 minutes.
Read more about the topic here: Tavor®
In contrast, Tavor® expidet® is an orodispersible tablet. It is placed in the mouth as a plate and melts there directly. If necessary, you can drink some liquid to swallow. The platelets can be taken with or without meals. As a result, lorazepam largely passes through the oral mucosa into the blood and in most cases shows an effect after just a few minutes.
The advantage of Tavor® expidet® is that it can be used primarily for people with swallowing difficulties, for children, or in emergencies. Doctors or rescue personnel can simply place the plate in the patient's cheek or under the tongue. The patient does not have to concentrate on swallowing and it is ensured that the correct dose of the substance is absorbed.
Indications
Tavor® expidet® is used in the short term for the symptomatic treatment of states of anxiety, excitement and tension, such as those in depressions or Psychosis (e.g. schizophrenia) occurrence.
It can also be used to treat temporarily sleep disorders (Difficulty falling asleep and staying asleep), which are triggered by fear, restlessness or worry, are used.
Furthermore, Tavor® is expidet® before operations or diagnostic interventions to relieve the patient of fear of the intervention. Tavor® expidet® is also found as Emergency medication at the Status epilepticus (acute, long-lasting epileptic seizure) Application.
epilepsy
Tavor® expidet® becomes not the drug of first choice to Long-term treatment for epilepsy recommended as it quickly becomes addicting.
For this, drugs such as Valproate (in generalized epilepsy) or Lamotrigine (in focal epilepsy) administered.
Tavor® expidet® is mainly used when a Series of epileptic seizures with long pauses occurs between seizures - a so-called seizure series. It is sometimes administered by laypeople as an emergency medication for so-called status epilepticus - a complication of epilepsy.
Of the Status epilepticus can express itself in different ways: On the one hand, it can lead to a seizure that lasts longer than 5 minutes. On the other hand, seizures can occur repeatedly without the affected person having reached a normal state between the attacks. Tavor® expidet® is intended to break through the status epilepticus in order to life-threatening consequences how Prevent brain edema or cardiovascular arrest.
Here, however, have other drugsthat are trickled into the nose, for example, better proven, as it can sometimes take up to 40 minutes for an effective amount of Tavor® expidet® to pass into the blood.
Read more about the topic here: Medicines for epilepsy
effect
The active ingredient contained in Tavor® expidet® is called Lorazepam.
Like all active ingredients from the group of Benzodiazepines also binds lorazepam to specific receptors in the brain.
These specific receptors are called GABA-A receptors and are so-called ligand-controlled ion channels. Usually the endogenous transmitter GABA (Gamma-aminobutyric acid). GABA inhibits nerve cells in the brain by binding the receptors to the Excitation of cells degrades.
Lorazepam can how GABA bind to GABA-A receptors and thereby mimicking the GABA effect. When Lorazepam (or GABA) binds to the receptors, the ion channel opens and negatively charged chloride ions flow into the cell. This makes the potential in the cell more negative and the nerve cell can no longer be excited for a certain period of time.
This inhibiting effect the receptors solves ultimately the Fear, tension- or Convulsive states, because the nerve cell can no longer transmit impulses.
Read more about the topic here: Benzodiazepines
How quickly does Tavor® expidet® work?
After dissolving in the mouth, the Tavor® expidet® platelets are excessively supplied with blood Oral mucosa added and thus reach the body's circulation via the blood. In some patients, the onset of action is therefore faster than with a tablet that is completely absorbed through the stomach and intestinal mucosa.
However, the onset of action varies greatly among patients. Sometimes the effect of Tavor® expidet® is already effective after a few minutes a. However, it can also happen that a sufficiently effective amount of Tavor® expidet® could not be absorbed through the oral mucosa. Then the onset of action, as the rest has to be absorbed through the intestinal mucosa, up to 40 minutes be. The time the drug is absorbed through the gastrointestinal mucosa also depends on when the patient ate the last meal.
Since until The effect takes about 30 minutes, If Tavor® expidet® is used as a sleep aid, it should be taken 30 minutes before going to bed.
It should be noted that, depending on the duration of sleep (7 to 8 hours are provided), the effect can last until the next morning and so, for example, to persistent fatigue and slowed responsiveness can come.
What do you do if Tavor® expidet® doesn't work?
If Tavor® expidet® does not work for the supportive treatment of anxiety or nervousness in psychoses or depression, for the general treatment of anxiety (e.g. before an operation) or sleep disorders, it should be communicated to the doctor.
This can increase initial dose or a another drug as a substitute prescribe.
With a status epilepticus should definitely be one Called an emergency doctor become. Lorazepam can either be injected directly into the vein, which means that the drug arrives more quickly in the bloodstream and ultimately in the brain.
If this does not break through the attack either, the doctor can other means (Phenytoin or narcotics like Propofol, thiopental or Midazolam), which are also given directly into the vein.
Side effects
Like any other drug, Tavor® expidet® can have side effects, mostly due to a too high starting dose to be triggered.
Often it comes to Muscle weakness and languor. Because lorazepam affects the central nervous system, too high a dose can cause a strong sedation (Reassurance), fatigue and Drowsiness come. Also, it often leads to States of confusion, Dizziness, Unsteadiness and Movement and coordination disorders.
Furthermore, Tavor® expidet® can do that decrease sexual desire and can in rare cases too impotence to lead. Occasionally, nausea occurs while taking Tavor® expidet®. It can too constipation, Jaundice (Jaundice) and to Increase in liver enzymes to lead.
When patients on the drug or its components oversensitive or allergic react, it can too Skin reactions With Rashes and itching and in the worst case to one anaphylactic shock come with cardiovascular failure and respiratory failure.
Read more about the topic here: Rash from allergy
Since Tavor® expidet® a high potential for dependence owns, it can become too after weaning Withdrawal symptoms such as sleep disorders, renewed states of fear and tension and inner restlessness. Therefore, the drug should definitely be gradually reduced in dose before final discontinuation.
interaction
When using Tavor® expidet® you have to pay particular attention Interactions with other drugs, the central depressant work, be respected.
These include, among others Antidepressants, beta blockers, opiates and Neuroleptics.
The effects of lorazepam and other central depressant drugs may increase if taken at the same time.
It should also be used while taking Tavor® expidet® refrained from consuming alcohol as this combination also increases brain power and reduces it.
Some drugs like for example Probenecid (Drug used to treat gout) may make Lorazepam more effective. Probenecid also causes lorazepam to be excreted by the kidneys less. This can extend the effect of Tavor® expidet®.
When taking Lorazepam and Clozapine (Neuroleptic, which is used to treat psychoses), in addition to increased central damping, increased salivation and impaired movement coordination can also occur.
dosage
Which dosage of the drug is chosen should be different for each patient individually roofed become. A risk-benefit assessment should be made, especially in patients with certain underlying diseases. In general, because of the high potential for dependencythat lorazepam always in the lowest effective dose is prescribed.
The starting dose (initial dose) is usually 1 mg Tavor® expidet® 2-3 times a day in case of anxiety. At older people must be a lower dose to get voted. Therefore you usually start with one here 50% lower dose of 0.5 mg lorazepam 2-3 times a day. If the starting dose does not work well, it can be increased slowly.
If short-term sleep disorders should be treated, a single daily intake is sufficient from about 0.5 - 2.5 mg lorazepam (depending on the doctor's advice) half an hour before going to bed.
Overdose
When taking a dose above that used Daily dose of 0.2mg - 2.5 mg of the active ingredient lorazepam, it may too serious undesirable side effects come.
The first signs of an overdose are Tiredness, lightheadedness and confusion. The affected patient shows a decrease in alertness and the ability to react and can become more and more sleepy. This can go as far as unconsciousness or to Hallucinations to lead. A very dangerous side effect that occurs especially with an overdose is the Release of muscle tension. Since the activating nerve tracts are blocked further and further, the muscles can even relax. This is particularly problematic with regard to the respiratory muscles. So it can become one fatal respiratory failure come. As Antidote give the active ingredient in case of poisoning with lorazepam Flumazenil. This blocks the inhibitory neurons that have been activated too strongly and thus enables normal stimulation of the respiratory muscles.
Only in acute emergencies can the attending physician administer a single dose of up to 7.5 mg (with extreme caution). This should always be done with the utmost caution and the patient should then remain or be admitted to the hospital to monitor possible side effects
Is the Tavor® expidet® divisible?
The Tavor® expidet® platelets are not divisiblei.e. that a Tavor® 1.0 mg expidet® cannot be prescribed if the dose to be taken is actually 0.5 mg lorazepam. This is because when the desired dose not guaranteed and there can be either more or less lorazepam in each half. Since you want to dose this drug exactly in order to achieve the desired effect, the platelet should not be divided.
Tavor® expidet® in combination with alcohol
The combination of Tavor® expidet® and alcohol is very dangerous. Alcohol, like the active ingredient lorazepam, has a central depressant effect even without combination with medication. This means that high consumption leads to unconsciousness here too. If you consume alcohol and Tavor® expidet® at the same time, the effect of the drug may change in an unexpected way. The mutual reinforcement can thus become a uncontrolled anesthesia, lead, with the greatest danger here too fatal respiratory failure is.
In addition, the patient has an increased risk of vomiting due to the alcohol. Due to the reduced consciousness, this can result in a unnoticed swallowing or choking on vomit come, which in turn can be fatal. For this reason, the simultaneous ingestion of both substances should be avoided and in the event of poisoning the doctor should be informed.
price
The basic price for the prescription-only Tavor® expidet® tablets varies, depending on the size of the pack and how many milligrams of lorazepam are contained in each tablet, roughly between 17 and 20 € for 50 tiles.
At Cash patients is the Co-paymentdepending on whether the patient is exempt from co-payment or not, to the medication at most 5 €. Private patients first have to go to the pharmacy total drug price pay and get that money then from the health insurance companyr.
