tamoxifen

Drops chlorpromazine prescribed inside , without chewing, drinking plenty of water.
The initial daily dose for oral tamoxifen administration of 25-100 mg / day, 1-4 times a day, then, subject to tolerability, the dose is gradually increased to 25-50 mg every 3-4 days, until the desired therapeutic effect. In the case of the low efficiency of moderate doses of chlorpromazine, a dose increase to 700-1000 mg / day, in some cases, extremely resistant without somatic contraindications dose can be increased up to 1200-1500 mg / day. In the treatment with high doses, the daily dose is divided into 4 parts (the latter – before going to bed). Duration of treatment with high doses should not exceed 1-1.5 months, in the absence of the effect it is advisable to go to the treatment of other drugs.
Higher doses of chlorpromazine for adults inside: single 0.3 g daily 1.5 g chlorpromazine Children appoint depending on age: more than 3 years and older into 550 ug / kg (0.55 mg / kg) or 15 mg per 1 m of the body surface, if necessary every 6-8 hours children 3 years – 5 years (body weight 23 kg. ) should not be given more than 40 mg per day; children 5-12 years of age (body weight 23 to 46 kg) should not be administered more than 75 mg per day.
For use in pediatric dosage forms appropriate to use for children.
Impaired and elderly patients, depending on the age, prescribed to 0.3 g / day.

Side effects :
At the beginning of treatment tamoxifen may experience drowsiness, dizziness, dry mouth, anorexia, constipation, paresis of accommodation, moderately severe orthostatic hypotension, tachycardia, insomnia, urinary retention, reduced potency, frigidity, allergic reactions of the skin and mucous membranes ( photosensitivity), angioneurotic edema of the face and extremities); at least – a sharp decrease in blood pressure.With prolonged use of high doses (0.5-1.5 g / day) – extrapyramidal disorders (dyskinesias – paroxysmally arising convulsions neck muscles, tongue, floor of the mouth, akinetorigidnye effects, akathisia, hyperkinesia, tremor and autonomic disorders), psychic phenomena indifference, a belated reaction to external stimuli, neuroleptic depression and others. mental changes, cholestatic jaundice, cardiac arrhythmias, lymph and leukopenia, anemia, agranulocytosis, hypercoagulation, amenorrhea, galactorrhea, hyperprolactinemia, gynecomastia, nausea, vomiting, diarrhea, oliguria, skin pigmentation, blurred lens and cornea; in rare cases – seizures (as correctors used antiparkinsonian agents – tropatsin, trihexyphenidyl, etc .; dyskinesia tamoxifen cropped s / c administration of 2 ml of a 20% solution of caffeine sodium benzoate and 1 ml of 0.1% solution of atropine), neuroleptic malignant syndrome.

Overdose (intoxication) drug
Symptoms: areflexia and hyperreflexia, blurred vision, cardiotoxic effects (arrhythmia, heart failure, decreased blood pressure, shock, tachycardia, changes , ventricular fibrillation, cardiac arrest), neurotoxic effects, including agitation, confusion, convulsions, disorientation, lethargy, stupor or coma; dilated pupils, dry mouth, hyperpyrexia or hypothermia, muscle rigidity, vomiting, pulmonary edema and respiratory depression. Treatment: gastric lavage, the appointment of activated charcoal (to avoid the induction of vomiting as impaired consciousness, and dystonic reactions from the muscles tamoxifen of the neck and the head, caused by an overdose may lead to aspiration of vomit). Symptomatic treatment: arrhythmia – in / phenytoin 9-11 mg / kg, in heart failure – cardiac glycosides, with marked decrease in blood pressure – in / in a liquid or vasopressor agents such as norepinephrine, phenylephrine (avoid the use of alpha and beta -adrenomimetikov such as epinephrine as possible paradoxical decrease in blood pressure by blocking the alpha-adrenoceptor chlorpromazine), in convulsions – diazepam (barbiturates avoided due to possible subsequent depression  and respiratory depression), parkinsonism – difeniltropin, diphenhydramine. CCC Control functions for at least 5 days, the central nervous system, respiration, body temperature measurement, consulting psychiatrist. Dialysis is ineffective.