Mydocalm - Ingredients, uses, doses and precautions when using

Posted by Pharmacist Quang Anh Nguyet - Pharmacist in charge of pharmacy - Faculty of Pharmacy - Vinmec Central Park International General Hospital

Mydocalm is a centrally acting muscle relaxant. The drug is prescribed by doctors to treat spasticity and muscle spasms. To ensure effective treatment, patients need to follow the instructions of the consulting pharmacist.

The drug mydocalm has the ingredient Tolperison, there are 2 types of strength: mydocalm 50mg and mydocalm 150mg. So what is mydocalm? Mydocalm is a centrally acting muscle relaxant, but the exact mechanism is unknown.
Accordingly, by stabilizing the membrane and local anesthetic, tolperison inhibits conduction in primary nerve fibers and motor neurons, thereby inhibiting polysynaptic and monosynaptic reflexes. On the other hand, a second mechanism is to inhibit synaptic Ca2+ influx, which is thought to inhibit neurotransmitter release. In the brain stem, tolperison inhibits the reticular–spinal reflex. In various animal models, this preparation was able to reduce increased muscle tone and spasticity after brain loss.
In addition, tolperison in mydocalm improves peripheral circulation. Circulation-improving effects are independent of those seen in the central nervous system. This effect may be related to the mild antispasmodic and anti-adrenergic effects of tolperison.
2. Indications and contraindications to taking mydocalm medicine Mydocalm is prescribed by doctors to treat spasticity and muscle spasms. In addition, mydocalm is contraindicated in the following subjects:
Hypersensitivity to tolperison or substances with chemical structure similar to eperison, excipients. Mechanical weakness. Children under 3 months of age (the manufacturer recommends not using mydocalm for children under 18 years of age). 3. Dosage and administration of mydocalm Patients should take mydocalm during or after meals with 1 glass of water. Specific dosage for each subject is as follows:
3.1. Adults For adults, the dose of mydocalm is from 50-150 mg x 3 times per day. Accordingly, the patient should take the drug during or after a meal with 1 glass of water.
3.2. Children The manufacturer recommends that mydocalm not be used in children under 18 years of age because safety and efficacy have not been established. The use, if any, in this population is subject to the physician's prescription when weighing the benefits/risks.
Children 3 months - 6 years old: oral dose of 5 mg/kg body weight/day, divided into 3 times. Children 6-14 years old: daily dose is 2-4 mg/kg body weight, divided into 3 times.

3.3. Special populations It is necessary to adjust the dosage of mydocalm in patients with moderate hepatic/renal impairment and closely monitor liver/kidney disease. Mydocalm is not recommended for people with severe liver/kidney impairment.
4. Possible undesirable effects when using Mydocalm Undesirable effects when using tolperison are mainly manifestations on the skin, subcutaneous tissue, systemic disorders, neurological disorders and digestive disorders . Specifically:
Hypersensitivity reactions: pruritus, erythema, exanthema, most reactions are not serious and are reversible. Very rarely, life-threatening hypersensitivity reactions such as angioedema, anaphylaxis, dyspnoea. Muscle weakness, fatigue, headache, dizziness, mild hypotension, nausea, abdominal discomfort (uncommon, usually disappears with dose reduction). Increased sweating (rare). Confusion (rare). Patients need to inform the doctor about the unwanted effects encountered when using mydocalm.
5. Can Mydocalm be used in pregnant and lactating women? In animal tests, tolperison did not cause teratogenicity. In humans, due to the lack of relevant clinical data, mydocalm should not be used during pregnancy (especially during the first trimester) unless the potential benefit to the mother outweighs the potential risk. for the unborn baby. It is not known whether mydocalm is excreted in human milk, therefore tolperisone should not be used during lactation.
6. Other notes when taking mydocalm The data on Mydocalm overdose are rare because the drug has a wide therapeutic range. Irritation has been observed following treatment in children with an oral dose of 600 mg. In acute preclinical toxicity studies, high doses of mydocalm may cause ataxia, tonic-clonic seizures, dyspnea, and respiratory paralysis. Mydocalm has no specific antidote. If an overdose occurs, the patient should receive supportive and symptomatic treatment.

7. People who are close to being careful when using mydocalm The following people need to be careful when using mydocalm:
People with a history of allergies to other drugs Patients with liver and kidney failure. People who are driving and operating machines: The drug does not affect the ability to drive and use machines, however if you experience dizziness, lightheadedness, loss of concentration, seizures, blurred vision, or muscle weakness When taking tolperison, patients should consult a doctor. Mydocalm is a centrally acting muscle relaxant. The drug is prescribed by doctors to treat spasticity and muscle spasms. To ensure effective treatment, patients need to follow the instructions of the consulting pharmacist. In case of abnormal symptoms, you should immediately notify your doctor or go to a medical center for examination.

References
Manufacturer's manual. Vinmec's handbook on drug use.