Tiapridum
Tiapridal is available in tablet form and contains tiapride as the active substance.
Tiapride is an atypical neuroleptic with anxiolytic and sedative effects. Additionally, it has a beneficial effect on the level of alertness in elderly patients.
Tiapridal is used for the short-term treatment of agitation and aggression in elderly patients.
The patient should contact their doctor immediately:
˗ in case of fever and/or muscle stiffness during treatment with Tiapridal, especially if taken in combination with other psychiatric medicines;
˗ if the patient has or has had problems with alcohol (see section: Tiapridal with food, drink, and alcohol).
At the start of treatment, the doctor may order an ECG and blood electrolyte tests (especially potassium levels). Taking tiapride may cause changes in the ECG and increase the risk of serious ventricular arrhythmias, such as torsades de pointes. This risk is higher when there is also bradycardia (heart rate below 55 beats per minute), decreased potassium levels in the blood, and in cases of congenital or acquired QT interval prolongation in the ECG (during concurrent use of medicines that cause QT interval prolongation). Therefore, the patient should inform their doctor about all recently taken medicines.
In patients with Parkinson's disease, the medicine can only be used if absolutely necessary.
Tiapride is excreted from the body by the kidneys, and in patients with renal failure, the dose of the medicine will be reduced by the doctor depending on the assessment of kidney function (creatinine clearance).
In case of liver failure, dose reduction is not necessary.
Tiapride should be used with caution in patients with stroke risk factors and in patients with risk factors for venous thromboembolism.
Elderly patients with dementia-related psychosis treated with antipsychotic medicines are at an increased risk of death.
Tiapride may lower the seizure threshold; patients with epilepsy should be under medical supervision during treatment with this medicine.
In elderly patients, tiapride, like other neuroleptics, should be used with special caution due to the risk of consciousness disorders and coma.
There is insufficient data on the use of tiapride in children.
Cases of leukopenia, neutropenia, and agranulocytosis have been observed after the use of antipsychotic medicines, including Tiapridal. Unexplained infections or fever may be a sign of abnormal blood counts, and blood tests should be performed immediately.
The medicine should be taken directly before a meal.
During treatment with tiapride, the patient should avoid drinking alcohol and taking medicines containing alcohol.
Consuming alcohol during treatment with Tiapridal may also cause electrolyte balance disorders (mineral imbalance in the blood) and may cause QT interval prolongation (heart rhythm disorders) (see "Warnings and precautions").
If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor or pharmacist before taking this medicine.
Pregnancy
Taking Tiapridal is not recommended for pregnant women and women of childbearing age who do not use effective contraception.
If a patient took Tiapridal during the last three months of pregnancy, their child may experience hyperactivity, increased muscle tone, tremors, drowsiness, breathing difficulties, or feeding disorders. If any of these symptoms occur in the child, the patient should contact their doctor.
Breastfeeding
Tiapridal should not be taken while breastfeeding. If a patient is taking Tiapridal, they should discuss alternative breastfeeding options with their doctor.
Fertility
Tiapridal may lead to amenorrhea or anovulation and may reduce fertility in humans.
Tiapridal may cause excessive sedation, which may affect the ability to drive vehicles and operate machines while taking the medicine.
The patient should tell their doctor about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take.
Concomitant use of tiapride and levodopa is contraindicated.
Concomitant use of tiapride and medicines that may cause torsades de pointes(serious heart rhythm disorders) or QT interval prolongation in the ECG is not recommended. These medicines include:
˗ medicines that cause bradycardia (heart rate below 55 beats per minute): diltiazem and verapamil, clonidine, guanfacine, digitalis glycosides;
˗ medicines that decrease potassium levels: diuretics, laxatives, amphotericin B administered intravenously, glucocorticoids, tetracosactide;
˗ class Ia antiarrhythmic medicines, such as quinidine, disopyramide;
˗ class III antiarrhythmic medicines, such as amiodarone, sotalol;
˗ other medicines, such as pimozide, sulpiride, haloperidol, thioridazine, methadone, tricyclic antidepressants, lithium, bepridil, cisapride (a medicine that stimulates gastrointestinal motility), intravenous erythromycin, intravenous vincamine (a medicine used for cerebral circulation disorders), halofantrine, pentamidine, sparfloxacin.
The doctor should consider the possibility of concomitant use of tiapride and medicines that suppress the central nervous system, such as: opioid derivatives (painkillers and antitussives); most antihistamines (H1 receptor antagonists), barbiturates, benzodiazepines, and other anxiolytic medicines, clonidine and its derivatives.
The dosage may vary and should be adjusted for each patient.
This medicine should always be taken as directed by the doctor. In case of doubts, the patient should consult their doctor.
The initial dose is 100 mg per day. If necessary, the dose can be gradually increased to a maximum of 300 mg per day.
The treatment duration should not exceed 28 days.
If the patient feels that the effect of Tiapridal is too strong or too weak, they should consult their doctor.
There is limited data on tiapride overdose. Cases of death have been reported after tiapride overdose, mainly in combination with other antipsychotic medicines. The most common symptoms after overdose include: dizziness, excessive sedation, coma, decreased blood pressure, and extrapyramidal symptoms (muscle stiffness, reduced facial expressions, slowed movements, restlessness, involuntary muscle contractions, and involuntary movements).
In case of severe overdose, the possibility of poisoning with other medicines should always be considered.
Tiapride is only slightly removed from the body by hemodialysis. Therefore, hemodialysis is not recommended for removing the medicine from the body.
There is no specific antidote for tiapride. Treatment consists of supportive care for basic life functions and close monitoring of heart function until the patient's condition improves.
In case of overdose, the patient should immediately consult their doctor or pharmacist.
If a dose is missed, the patient should take it as soon as possible, unless it is close to the time for the next dose. The patient should not take two doses at the same time or in a short period. In case of doubts, the patient should consult their doctor.
Like all medicines, Tiapridal can cause side effects, although not everybody gets them.
Common (in 1 to 10 patients out of 100):
˗ dizziness, headaches;
˗ Parkinson's disease-like symptoms: tremors, increased muscle tone, hypokinesia (reduced mobility), and salivation. These symptoms usually disappear after administration of anti-Parkinson's disease medicines (e.g., biperiden);
˗ drowsiness, insomnia, agitation, reduced sensitivity to stimuli (apathy);
˗ weakness, fatigue;
˗ hyperprolactinemia (increased prolactin levels in the blood). This symptom disappears after the medicine is discontinued. Hyperprolactinemia can cause other disorders, such as breast swelling and pain, milk secretion, menstrual disorders in women (painful menstruation, amenorrhea), gynecomastia (breast enlargement in men), orgasm disorders, and erectile dysfunction.
Uncommon (in 1 to 10 patients out of 1,000):
˗ early dyskinesia, dystonia (spasm, spastic torticollis, oculogyric crises), and akathisia (excessive psychomotor activity, restlessness, anxiety). These symptoms usually disappear after administration of anti-Parkinson's disease medicines (e.g., biperiden);
˗ weight gain;
˗ disorientation, hallucinations;
˗ fainting, seizures;
˗ decreased blood pressure, usually when standing up;
˗ deep vein thrombosis;
˗ constipation;
˗ rash (including redness or nodular/papular rash);
˗ amenorrhea, orgasm disorders.
Rare (in 1 to 10 patients out of 10,000):
˗ acute dyskinesia. This symptom usually disappears after administration of anti-Parkinson's disease medicines;
˗ decreased white blood cell count (leukopenia, neutropenia, and agranulocytosis);
˗ decreased sodium levels in the blood (hyponatremia), a condition called "syndrome of inappropriate antidiuretic hormone secretion" (SIADH);
˗ late dyskinesia (characterized by rhythmic, involuntary movements of the tongue and/or facial muscles) after prolonged use of the medicine for more than 3 months, similar to other antipsychotic medicines. If these movement disorders occur, the patient should immediately inform their doctor, who will decide on the necessary actions. Anti-Parkinson's disease medicines should not be taken. In this case, administration of anti-Parkinson's disease medicines is ineffective and may even worsen the symptoms;
˗ malignant neuroleptic syndrome (see also section 2 "Warnings and precautions"), which is a potentially life-threatening complication;
˗ loss of consciousness;
˗ QT interval prolongation, ventricular arrhythmias, such as torsades de pointes, ventricular tachycardia, which can lead to ventricular fibrillation or cardiac arrest and sudden death (see also section 2 "Warnings and precautions");
˗ pulmonary embolism [blood clots in the veins, especially in the legs (with swelling, pain, and redness of the legs), which can move through the bloodstream to the lungs, causing chest pain and breathing difficulties], sometimes resulting in death;
In case of any of the above symptoms, the patient should immediately consult their doctor (see section 2 "Important information before taking Tiapridal");
˗ aspiration pneumonia caused by food particles or vomit entering the lungs;
˗ respiratory disorders, such as dyspnea, breathing difficulties, shallow breathing, especially when used with other medicines that have a depressive effect on the central nervous system;
˗ intestinal obstruction;
˗ increased liver enzyme activity;
˗ urticaria;
˗ increased creatine kinase activity in the blood, muscle weakness, and/or muscle pain;
˗ breast swelling and pain, milk secretion, gynecomastia, erectile dysfunction.
Additionally, the following side effects have been reported:
Frequency not known (frequency cannot be estimated from the available data):
˗ withdrawal symptoms in newborns;
˗ falls.
If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor or pharmacist. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products, Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
Reporting side effects can help gather more information on the safety of the medicine.
The medicine should be stored out of sight and reach of children.
Do not use the medicine after the expiration date stated on the packaging. The expiration date refers to the last day of the specified month.
There are no special precautions for storage.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.
˗ The active substance of the medicine is 100 mg tiapride (in the form of 111.10 mg tiapride hydrochloride).
˗ The medicine also contains the following excipients: mannitol, microcrystalline cellulose, povidone, colloidal anhydrous silica, magnesium stearate.
Tiapridal tablets are round, smooth, white to almost white, with beveled edges, with a cross on one side and the inscription "T100" on the other side.
The packaging contains 20 or 50 tablets.
For more detailed information, the patient should contact the marketing authorization holder or the parallel importer.
neuraxpharm Arzneimittel GmbH
Elisabeth-Selbert-Straße 23
40764 Langenfeld, Germany
Delpharm Dijon
6, boulevard de l’Europe
21800 Quetigny
France
InPharm Sp. z o.o.
ul. Strumykowa 28/11
03-138 Warsaw
InPharm Sp. z o.o. Services sp. k.
ul. Chełmżyńska 249
04-458 Warsaw
Marketing authorization number in Romania, the country of export:7570/2015/01
Parallel import authorization number:326/17
[Information about the trademark]
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