NEOPEPTINE CAPSULE

Indications

• Hypertension
• Benign prostatic hyperplasia
• Urinary retention related to prostate enlargement

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines in the paediatric population.

Adults: Refer to the BNF for specific dosing recommendations based on individual clinical scenarios.

Mechanism of action

Alpha acts by selectively blocking alpha-1 adrenergic receptors, which are responsible for mediating vasoconstriction in blood vessels. By inhibiting these receptors, alpha promotes vasodilation, leading to a decrease in peripheral vascular resistance and subsequently lowering blood pressure. Additionally, this action can help alleviate urinary symptoms associated with an enlarged prostate.

Pharmacodynamics

The pharmacodynamics of alpha involve its competitive antagonism at alpha-1 adrenergic receptors, resulting in decreased vasoconstriction and increased blood flow. This mechanism is beneficial in conditions characterized by high blood pressure and urinary retention due to prostatic enlargement. The onset of action typically occurs within hours, with peak effects observed within a few days of consistent dosing.

Pharmacokinetics

Alpha is absorbed well from the gastrointestinal tract, with peak plasma concentrations achieved within 1-3 hours post-administration. The drug undergoes hepatic metabolism, primarily via cytochrome P450 enzymes, resulting in active and inactive metabolites. The elimination half-life varies, but it generally is around 6-12 hours, allowing for once-daily dosing in many cases. Renal excretion is a significant route for its metabolites, necessitating caution in patients with renal impairment.

Interactions

• maois, irreversible + alpha blockers: Severe (increases effects)
• ribociclib + alpha blockers: Severe (increases exposure)
• cobicistat + alpha blockers: Moderate (increases exposure)
• idelalisib + alpha blockers: Moderate (increases exposure)
• dronedarone + alpha blockers: Unknown (increases exposure)
• antifungals, azoles + alpha blockers: Unknown (increases exposure)
• crizotinib + alpha blockers: Unknown (increases exposure)
• imatinib + alpha blockers: Unknown (increases exposure)
• letermovir + alpha blockers: Unknown (increases exposure)
• clarithromycin + alpha blockers: Unknown (increases exposure)

Indications

• Dyspepsia
• Flatulence
• Bloating
• Indigestion
• Enzyme supplementation in pancreatic insufficiency

Dosage

Children: Refer to the specific product guidelines or BNF for appropriate dosing information.

Adults: Refer to the specific product guidelines or BNF for appropriate dosing information.

Mechanism of action

Amylase works by hydrolyzing starch into sugars, facilitating carbohydrate digestion. Papain is a proteolytic enzyme that breaks down proteins into smaller peptides and amino acids, enhancing protein digestion. Simethicone functions by decreasing surface tension of gas bubbles, allowing for their easier expulsion from the gastrointestinal tract, thereby reducing bloating and discomfort.

Pharmacodynamics

The combination of digestive enzymes and simethicone promotes efficient digestion and reduces symptoms of flatulence. The efficacy of amylase and papain in breaking down food substances can lead to improved nutrient absorption, while simethicone's anti-foaming properties provide symptomatic relief from gas-related discomfort.

Pharmacokinetics

Amylase and papain are typically absorbed in the gastrointestinal tract where they exert their effects. Simethicone is not absorbed systemically and acts locally within the gastrointestinal tract. The onset of action for simethicone is generally rapid, providing quick relief from gas discomfort, while the digestive enzymes may take longer to exert their effects depending on food intake.

Adverse effects

• Nausea
• Diarrhea
• Abdominal discomfort
• Allergic reactions

Precautions

• Use with caution in patients with gastrointestinal obstruction.
• Assess for potential allergic reactions in patients with known sensitivities.

Pregnancy

There is limited data on the safety of amylase, papain, and simethicone during pregnancy. Consult a healthcare professional before use.

Breast-feeding

It is unknown whether these components are excreted in human milk. Consult a healthcare professional before use.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Tablets
• Chewable tablets
• Suspensions