Amphetamine and analogues can reduce the sedative effect of opioids. Loxapine and periciazine can increase the sedative effect of opioids. Concomitant use of flibanserin and opioids may increase the risk of CNS depression. Opioids can increase the plasma concentrations of desmopressin and sertraline. The patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this respect, it is strongly recommended to inform patients and their caregivers to be aware of these symptoms (see section 4.5).

Elimination is reduced and delayed in renal impairment - avoid or reduce dose. See Sections 4.3 and 4.4. Treatment should be initiated and supervised by a specialist, i.e. oncologist or gastroenterologist. Use under medical supervision. From the first days of life until the end of 4 weeks of age: the contents of one capsule added to each serving of food. From 5 to 6 weeks of age: the contents of two capsules added to each serving of food. Over 16 weeks of age: add three capsules each serving of food. The capsule is not suitable for human consumption. Do not exceed recommended servings for consumption during the day. Dropizol should not be used in children and adolescents aged below 18 years for safety reasons, see section 5.1. Peak serum concentrations of morphine, the main alkaloid of the opium extract, are achieved within 2 to 4 hours after oral administration.

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Vì vậy, bổ sung enzyme lactase sẽ đem lại nhiều lợi ích trong việc cải thiện các tình trạng dưới đây: 1.1. Kém hoặc không dung nạp Lactose Dropizol drops should be used with caution in the following conditions / for the following patients Delicol. Жените, които са бременни или планират да забременеят, трябва да се консултират предварително с лекаря си. Delicol – взаимодействия There is limited amount of data from the use of opium in pregnant women. Studies in animals have shown reproductive toxicity (see section 5.3). These effects of are mediated by opioid receptors. The receptors are widely distributed in the central nervous system. Receptors are also present to a lesser extent, in vas deferens, knee joints, the gastrointestinal tract, and in the heart and the immune system.

The posology should be individualized to use the lowest effective dose for the shortest duration of time taking into account the patient's general condition, the patient's age, weight, and medical history (see sections 4.3 and 4.4). Delicol, както всяко друго лекарство, може да предизвика нежелани реакции. Все пак трябва да се помни, че те няма да се появят на всеки и че обикновено ползите от употребата на препарата надвишават възможните рискове, свързани със страничните ефекти. Avoid use in older adults with a history of falls or fractures as ataxia, impaired psychomotor function, syncope, and additional falls may occur. If use is necessary, consider reducing use of other CNS-active agents that increase risk of falls and fractures and implement other strategies to reduce risk of falls. Concomitant use of Dropizol and sedative medicines such as benzodiazepines or related drugs may result in sedation, respiratory depression, coma and death. Dropizol is not recommended during pregnancy unless the benefits clearly outweigh the risks to both mother and child.

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Because of these risks, concomitant prescribing with these sedative medicines should be reserved for patients for whom alternative treatment options are not possible. If a decision is made to prescribe Dropizol concomitantly with sedative medicines, the lowest effective dose should be used, and the duration of treatment should be as short as possible. The μ-opioid receptor agonists inhibit gastric emptying, increases pyloric muscle tone, induce pyloric and duodenojejunal phasic pressure activity, disturb the migrating myoelectric complex, delay transit time through the small and large intestine and elevate the resting anal sphincter pressure. In addition to this, opioids attenuate the intestinal secretion of electrolytes and water and thereby facilitate the net absorption of fluid. In addiction to this, the μ, κ and δ-opioid receptors contribute to opioid-inhibition of muscle activity in the intestine. The result of all these effects is constipation. Opium alkaloids are extensively metabolized to glucuronide conjugates (3-glucuronide (M3G) and 6-glucuronide (M6G)) that undergo an enterohepatic cycle. 6-glucuronide is a metabolite of morphine about 50 times more active than the parent substance. Anti-diarrheals inhibiting peristalsis should be used with caution in patients with infection or inflammatory bowel diseases due to the increased risk of absorption of toxins, and of developing toxic megacolon and intestinal perforation. Due to the risk of paralytic ileus, Dropizol is not recommended before a surgical operation or within 24 hours after operation. If paralytic ileus is suspected during the use of Dropizol, the treatment must be stopped immediately. Opium is excreted in human milk, where it reaches higher concentrations than in maternal plasma. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Dropizol therapy taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman. If Dropizol is used during breastfeeding, infants should be closely monitored for symptoms of respiratory depression and sedation.

Administer at reduced doses and with the utmost caution to patients who are also being treated with other narcotic agents, sedatives, and tricyclic antidepressants and MAO-inhibitors (see also section 4.2). Rifampicin induces CYP 3A4 in the liver thus increasing the metabolism of morphine, codeine and methadone. The effect of these opioids is thereby decreased or counteracted. Adjustment of dose may be needed in the elderly, patients with thyroid insufficiency, and patients with mild to moderate renal or hepatic impairment (see also section 4.2 and 4.3). Concomitant administration of other antidiarrheal or antiperistaltic drugs, anticholinergics, antihypertensives

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Due to the ethanol content, Dropizol should not be used concomitantly with disulfiram or metronidazole. Both of these drugs can cause disulfiram-like reactions (flushing, rapid breathing, tachycardia).