17-08-2016
17-08-2016
18-08-2016
۱۹۸٦ – (ﺕﺍﺭﺿﺣﺗــﺳﻣ) ﺔﻟﺩﺎﻳﺻﻟﺍ ﺔﻣﻅﻧﺃ ﺏﺟﻭﻣﺑ ﻙﻠﻬﺗــﺳﻣﻠﻟ ﺔﻳﺑﻁ ﺓﺭـ ـﺷﻧ ﻂﻘﻓ ﺐﻴﺒﻁ ﺔﻔﺻﻭ ﺐﺟﻮﻤﺑ ءﺍﻭﺪﻟﺍ ﻕ
ﻮﺴ
٥۰۰ ﺏﻳﺗﻭﻣﻳﺭ ۲٥۰ ﺏﻳﺗﻭﻣﻳﺭ ﺔﻳﻠﻁﻣ ﺹﺍﺭﻗﺃ :ﺔﻟﺎ
ّ
ﻌﻔﻟﺍ ﺓﺩﺎﻤﻟﺍ
.(St. John's wort)
ﻡﻮﻜﻳﺮݒﻴﻬﻟﺍ ﺕﺎﺒﻧ ﻦﻣ ﺔﻓﺎﺟ ﺓﺭﺎﺼﻋ ﻎﻠﻣ ۲٥۰ :ﻰﻠﻋ ﻱﻮﺘﺤﻳ ۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ ﻦﻣ ﺹﺮﻗ ﻞﻛ
.(St. John's wort)
ﻡﻮﻜﻳﺮݒﻴﻬﻟﺍ ﺕﺎﺒﻧ ﻦﻣ ﺔﻓﺎﺟ ﺓﺭﺎﺼﻋ ﻎﻠﻣ ٥۰۰ :ﻰﻠﻋ ﻱﻮﺘﺤﻳ ٥۰۰ ﺐﻴﺗﻮﻤﻳﺭ ﻦﻣ ﺹﺮﻗ ﻞﻛ .ﻉﺍﺮﺘﺧﺍ ﺓءﺍﺮﺒﺑ ﺔﻴﻤﺤﻤﻟﺍ ﺎﻬﻋﻮﻧ ﻦﻣ ﺓﺪﻳﺮﻓ ﺔﻘﻳﺮﻄﺑ ,
Ze117
ﻰﻋﺪﺗ ﻲﺘﻟﺍﻭ ,ﺔﺻﺎﺨﻟﺍ ﺓﺭﺎﺼﻌﻟﺍ ﺝﺍﺮﺨﺘﺳﺍ ﻢﺘﻳ
ﻦﻴﺳﺮﭙﻳﺎﻫ ﻎﻠﻣ ۰.٥ ,
ﺕﺎﺒﻛﺮﻤﻟﺍ ﺔﻴﻘﺒﻟ ﺔﻓﺎﺿﻹﺎﺑ
ﻰﻠﻋ ۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ ﺹﺮﻗ ﻲﻓ ﺓﺭﺎﺼﻌﻟﺍ ﻱﻮﺘﺤﺗ .ﻦﻴﺳﺮﭙﻳﺎﻫ ﻎﻠﻣ ۱ ,
ﺕﺎﺒﻛﺮﻤﻟﺍ ﺔﻴﻘﺒﻟ ﺔﻓﺎﺿﻹﺎﺑ
ﻰﻠﻋ ٥۰۰ ﺐﻴﺗﻮﻤﻳﺭ ﺹﺮﻗ ﻲﻓ ﺓﺭﺎﺼﻌﻟﺍ ﻱﻮﺘﺤﺗ .ﻦﻳﺭﻮﻓﺮﭙﻳﺎﻬﻟﺍ ﻦﻣ ﺓﺮﻴﻐﺻ ﺔﻴﻤﻛ ﻰﻠﻋ ﻱﻮﺘﺤﺗ ﺪﻗ ﺓﺭﺎﺼﻌﻟﺍ .۲ ﺪﻨﺒﻟﺍ ﻲﻓ 'ءﺍﻭﺪﻟﺍ ﺕﺎﺒﻛﺮﻣ ﻦﻣ ءﺰﺟ ﻦﻋ ﺔﻤﻬﻣ ﺕﺎﻣﻮﻠﻌﻣ' ﺎ
ﻀﻳﺃ ﺮﻈﻧﺃ .٦ ﺪﻨﺒﻟﺍ ﺮﻈﻧﺃ ﺔﻟﺎ
ﻌﻔﻟﺍ ﺮﻴﻏ ﺩﺍﻮﻤﻟﺍ ﺔﻤﺋﺎﻘﻟ
ءﺍﻭﺪﻟﺍ ﻞﻤﻌﺘﺴﺗ ﻥﺃ ﻞﺒﻗ ﺎﻬﺘﻳﺎﻬﻧ ﻰﺘﺣ ﻥﺎﻌﻣﺈﺑ ﺓﺮﺸﻨﻟﺍ ﺃﺮﻗﺇ ﺐـ ـﻴﺒﻄﻟﺍ ﻰــﻟﺇ ﻪــﺟﻮﺗ ,ﺔــﻴﻓﺎﺿﺇ ﺔﻠﺌــﺳﺃ ﻚــﻳﺪﻟ ﺖـ ـﻧﺎﻛ ﺍﺫﺇ .ءﺍﻭﺪـ ـﻟﺍ ﻦـ ـﻋ ﺔـ ـﺼ
ﺨﻠﻣ ﺕﺎـ ـﻣﻮﻠﻌﻣ ﻰـ ـﻠﻋ ﺓﺮــﺸﻨﻟﺍ ﻩﺬـ ـﻫ ﻱﻮـ ـﺘﺤﺗ .ﻲﻟﺪﻴﺼﻟﺍ ﻭﺃ ﻚــﻟ ﺍﺪــﺑ ﺍﺫﺇ ﻰــﺘﺣ ﻢــﻬﻟ ﺭﺮــﻀﻟﺍ ﺐﺒــﺴﻳ ﺪــﻗ ﻮــﻬﻓ .ﻦــﻳﺮﺧﺁ ﻰــﻟﺇ ﻪــﻄﻌﺗ ﻻ .ﻚــﻠﺟﺃ ﻦــﻣ ﺝﻼــﻌﻠﻟ ﻒــﺻﻭ ءﺍﻭﺪــﻟﺍ ﺍﺬــﻫ .ﻞﺛﺎﻤﻣ ﻲﺤﺼﻟﺍ ﻢﻬﻌﺿﻭ ﻥﺃ ؟ءﺍﻭﺪﻟﺍ ﺺﺼﺨ
ُ
ﻣ ﺽﺮﻏ ﻱﻷ .۱ ﻭﺃ ﺔﺣﺍﺭ ﻡﺪﻋ ,ﺮﺗﻮﺗ ﺕﻻﺎﺣ ,ﻖﻠﻘﺑ ﺏﻮﺤﺼﻤﻟﺍ ,ﻂﺳﻮﺘﻤﻟﺍ ﻰﺘﺣ ﻒﻴﻔﺨﻟﺍ ﺏﺎﺌﺘﻛﻻﺍ ﺽﺍﺮﻋﺃ ﻦﻣ ﺐﻴﺗﻮﻤﻳﺭ ﻒﻔﺨﻳ .ﻪﻠﻛ ﻞﻴﻠﻟﺍ ﺩﺍﺪﺘﻣﺍ ﻰﻠﻋ ﻡﻮﻨﻟﺍ ﻲﻓ ﺔﺑﻮﻌﺻ ﻭﺃ ﻡﻮﻨﻟﺍ ﻲﻓ ﺕﺎﺑﻮﻌﺻ ,ﺔﺒﻠﻘﺘﻣ ﺕﺎﺟﺍﺰﻣ ,ﺔﻴﻧﺪﺘﻣ ﺕﺎﺟﺍﺰﻣ ,ﺔﻴﺒﺼﻋ
:ﺔ
ّ
ﻴﺟﻼﻌﻟﺍ ﺔﻠﻴﺼﻔﻟﺍ .ﻲﺗﺎﺒﻧ ﺭﺪﺼﻣ ﻦﻣ ﻲﻌﻴﺒﻁ ﺏﺎﺌﺘﻛﺍ ﺩﺎﻀﻣ
Patient Leaflet According to the Pharmacists' Regulations
(Preparations) - 1986
This medicine is sold with a doctor's prescription only
REMOTIV 250 REMOTIV 500
Film-coated Tablets
Active ingredient:
Each tablet of Remotiv 250 contains: 250 mg dry extract of the plant Hypericum
(St. John’s Wort).
Each tablet of Remotiv 500 contains: 500 mg dry extract of the plant Hypericum
(St. John’s Wort).
The special extract, called Ze117, is produced via a unique, patented extraction
process. The extract in a tablet of Remotiv 250 contains (among other ingredients)
0.5 mg of hypericin.
The extract in a tablet of Remotiv 500 contains (among other ingredients) 1 mg of hypericin.
The extract may contain a minuscule amount of hyperforin.
For a list of inactive ingredients, please see section 6. Also see 'Important
information about some of the medicine's ingredients' in section 2.
Read this entire leaflet carefully before using this medicine.
This leaflet contains concise information about the medicine. If you have any
further questions, please refer to your doctor or pharmacist.
This medicine has been prescribed for you. Do not pass it on to others. It may
harm them, even if it seems to you that their medical condition is similar to yours.
1. What is the medicine intended for?
Remotiv alleviates symptoms of mild to moderate depression, accompanied by
anxiety,
states
tension,
restlessness
irritability,
dejected
mood,
mood
changes, difficulty in falling asleep or difficulty sleeping through the night.
Therapeutic group:
Natural anti-depressant from a plant source.
2. Before you take the medicine
Do not use this medicine if:
Do not use if you are sensitive (allergic) to the active ingredient or to any of
the other ingredients of this medicine (for a list of inactive ingredients, please
see section 6).
Do not use this medicine if you are taking immunosuppressant medicines
(e.g.
cyclosporine,
tacrolimus,
sirolimus),
medicines
against
virus/AIDS (e.g. nevirapine, indinavir), anticoagulants of the coumarin group
(e.g. warfarin), chemotherapy medicines (e.g. irinotecan, imatinib).
Do not use this medicine if you suffer or have suffered in the past from light
sensitivity, including sun light.
Do not use in children under 6 years of age.
Special warnings regarding the use of this medicine:
Do not use this medicine for a prolonged period without consulting your doctor.
If you are about to undergo a photodynamic diagnostic procedure or therapy
(based on light), or if you are about to undergo surgery, inform the attending
doctor and/or anaesthesiologist that you are taking this medicine.
During treatment with Remotiv, your skin and eyes should be protected from
sun exposure. Rarely, especially in people with fair skin, side effects of the
eyes or skin (e.g. redness similar to sunburn) may appear after taking
Remotiv and exposure to the sun. In this case – stop the treatment and
avoid sun exposure (or other UV radiation) for approximately two weeks.
During the treatment avoid visiting a solarium or tanning salons.
ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺍ ﻞﺒﻗ .۲ :ﺍﺫﺇ ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺍ ﺯﻮﺠﻳ ﻻ ﺕﺎــﺒﻛﺮﻤﻟﺍ ﻦــﻣ ﺪــﺣﺍﻭ ﻱﻷ ﻭﺃ ﺔــﻟﺎﻌﻔﻟﺍ ﺓ
ﺩﺎــﻤﻠﻟ (ﺔﻴــﺳﺎﺴﺣ ﻚــﻳﺪﻟ) ﺎــ
ﺳﺎﺴﺣ ﺖــﻨﻛ ﺍﺫﺇ ﻝﺎﻤﻌﺘــﺳﻻﺍ ﺯﻮــﺠﻳ ﻻ
.(٦ ﺪﻨﺑ ﺮﻈﻧﺃ ,ﺔﻟﺎ
ﻌﻔﻟﺍ ﺮﻴﻏ ﺕﺎﺒﻛﺮﻤﻟﺍ ﺔﻤﺋﺎﻘﻟ) ﺮﻀﺤﺘﺴﻤﻟﺍ ﺎﻬﻴﻠﻋ ﻱﻮﺘﺤﻳ ﻲﺘﻟﺍ ﻯﺮﺧﻷﺍ ,ﻦﻳﺭﻭﭙﺴﻮﻠﻜﻴــﺳ ﻞــﺜﻣ) ﺔــﻋﺎﻨﻤﻟﺍ ﺯﺎــﻬﺟ ﻂــﻴﺒﺜﺘﻟ ﺔــﻳﻭﺩﺃ ﻝﻭﺎــﻨﺘﺗ ﺖــﻨﻛ ﺍﺫﺇ ءﺍﻭﺪــﻟﺍ ﻝﺎﻤﻌﺘــﺳﺍ ﺯﻮــﺠﻳ ﻻ
ﺓﺩﺎﻀﻣ ﺔﻳﻭﺩﺃ ,(ﺮﻴﭬﺎﻨﻳﺪﻨﻳﺇ ,ﻥﻴﭙﺍﺭﻴﭭﻨ ﻞﺜﻣ) ﺯﺪﻳﻹﺍ
-ﺱﻭﺮﻴﻓ ﺪﺿ ﺔﻳﻭﺩﺃ ,(ﺱﻮﻤﻴﻟﻭﺮﻴـ ـﺳ ,ﺱﻮﻤﻴﻟﻭﺮﻜﺗ .(ﺐﻴﻨﻴﺘﻤﻳﺇ ,ﻥﺎﻜﺗﻮﻨﻳﺮﻳﺇ) ﻲ
ﺋﺎﻴ
ﻤﻴ
ﻜﻟﺍ ﺝﻼﻌﻟﺍ ﺔﻳﻭﺩﺃ ,(ﻦﻳﺮ
ﻓﺍﺭﻭ ﻞﺜﻣ) ﻦﻳﺭﺎﻣﻮﻜﻟﺍ ﺔﻠﻴﺼﻓ ﻦﻣ ﺮﺜﺨﺘﻠﻟ .ﺲﻤﺸﻟﺍ ءﻮﺿ ﻚﻟﺫ ﻲﻓ ﺎﻤﺑ ,ءﻮﻀﻠﻟ ﺔﻴﺳﺎﺴﺣ ﻦﻣ ﻲﺿﺎﻤﻟﺍ ﻲﻓ ﺖﻴﻧﺎﻋ ﻭﺃ ﻲﻧﺎﻌﺗ ﺖﻨﻛ ﺍﺫﺇ ﻝﺎﻤﻌﺘﺳﻻﺍ ﺯﻮﺠﻳ ﻻ
.٦ ﻦﺳ ﻥﻭﺩ ﻝﺎﻔﻁﻷﺍ ﻯﺪﻟ ﻝﺎﻤﻌﺘﺳﻻﺍ ﺯﻮﺠﻳ ﻻ
:ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺎﺑ ﺔﻘﻠﻌﺘﻣ ﺔﺻﺎﺧ ﺕﺍﺮﻳﺬﺤﺗ .ﺐﻴﺒﻄﻟﺍ ﺓﺭﺎﺸﺘﺳﺍ ﻥﻭﺩ ﺔﻠﺻﺍﻮﺘﻣ ﺓﺮﺘﻔﻟ ءﺍﻭﺪﻟﺍ ﺍﺬﻫ ﻝﺎﻤﻌﺘﺳﺍ ﺯﻮﺠﻳ ﻻ
ءﺍﺮﺟﺇ ﻚﺷﻭ ﻰﻠﻋ ﺖﻨﻛ ﺍﺫﺇ ﻭﺃ (ءﻮﻀﻟﺎﺑ
ﻮﻘﺘﻣ) ﻲﻣﺎﻨﻳﺩﻮﺗﻮﻓ ﺝﻼﻋ ﻭﺃ ﺺﻴﺨﺸﺗ ءﺍﺮﺟﺇ ﻚﺷﻭ ﻰﻠﻋ ﺖﻨﻛ ﺍﺫﺇ
.ءﺍﻭﺪﻟﺍ ﺍﺬﻫ ﻝﻭﺎﻨﺘﺗ ﻚﻧﺄﺑ ﺭﺪﺨﻤﻟﺍ ﻭﺃ/ﻭ ﺞﻟﺎﻌﻤﻟﺍ ﺐﻴﺒﻄﻟﺍ ﻍﻼﺑﺇ ﺐﺠﻳ ,ﺔﻴﺣﺍﺮﺟ ﺔ
ﻴﻠﻤﻋ ﻯﺪﻟ ﺔﺻﺎﺧ ,ﺓﺭﺩﺎﻧ ﺕﺎﻗﻭﺃ ﻲﻓ .ﺲﻤﺸﻠﻟ ﺽﺮﻌﺘﻟﺍ ﻦﻣ ﻦﻴﻨﻴﻌﻟﺍﻭ ﺓﺮﺸﺒﻟﺍ ﺔﻳﺎﻗﻭ ﺐﺠﻳ ,ﺐﻴﺗﻮﻤﻳﺮﺑ ﺝﻼﻌﻟﺍ ﻝﻼﺧ
ﻝﺎﺜﻤﻟﺍ ﻞﻴﺒﺳ ﻰﻠﻋ) ﺓﺮﺸﺒﻟﺍ ﻭﺃ ﻦﻴﻨﻴﻌﻟﺍ ﻲﻓ ﺔﻴﺒﻧﺎﺟ ﺽﺍﺮﻋﺃ ﺮﻬﻈﺗ ﻥﺃ ﻦﻜﻤﻳ ,ﺔﺤﺗﺎﻔﻟﺍ ﺓﺮﺸﺒﻟﺍ ﻱﻭﺫ ﺹﺎﺨﺷﻷﺍ ﺝﻼﻌﻟﺍ ﻑﺎﻘﻳﺇ ﺐﺠﻳ – ﺔﻟﺎﺤﻟﺍ ﻩﺬﻫ ﻲﻓ .ﺲﻤﺸﻠﻟ ﺽﺮﻌﺘﻟﺍﻭ ﺐﻴﺗﻮﻤﻳﺭ ﻝﻭﺎﻨﺗ ﺪﻌﺑ (
ﻲﺴﻤﺷ ﻕﺮﺣ ﻪﺒﺸﻳ ﺭﺍﺮﻤﺣﺍ .ﻦﻴﻋﻮﺒﺳﺃ ﺏﺭﺎﻘﻳ ﺎﻣ (ﻯﺮﺧﺃ
ﺔﻌﺷﻷ ﻭﺃ) ﺲﻤﺸﻠﻟ ﺽﺮﻌﺘﻟﺍ ﻱﺩﺎﻔﺗﻭ .ﺲﻤﺸﺘﻟﺍ ﺕﺎﻧﻮﻟﺎﺻ ﻭﺃ ﺔ
ﻤﻟﺍ ﺓﺭﺎﻳﺯ ﻦﻋ ﻉﺎﻨﺘﻣﻻﺍ ﺐﺠﻳ ﺝﻼﻌﻟﺍ ﻝﻼﺧ
.ءﺍﻭﺪﻟﺍ ﻝﻭﺎﻨﺗ ﻞﺒﻗ ﻚﻟﺍﺬﺑ ﺐﻴﺒﻄﻟﺍ ﻍﻼﺑﺃ ﻚﻴﻠﻋ ,ﻦﻴﻌﻣ ءﺍﻭﺩ ﻭﺃ ﻦﻴﻌﻣ ﻡﺎﻌﻄﻟ ﺔ
ﻴﺳﺎﺴﺣ ﻚﻳﺪﻟ ﻥﺎﻛ ﺍﺫﺇ
.ﻝﻮﺒﻟﺍ ﺯﺎﻬﺟ/ﻰﻠﻜﻟﺍ ,ﺪﺒﻜﻟﺍ ﺔﻔﻴﻅﻭ ﻲﻓ ﻞﻠﺧ ﻦﻣ ﻲﺿﺎﻤﻟﺍ ﻲﻓ ﺖﻴﻧﺎﻋ ﻭﺃ ﻲﻧﺎﻌﺗ ﺖﻨﻛ ﺍﺫﺇ
:
ﺐﻴﺒﻄﻟﺍ ﻝﺄﺳﺇ ﺐﻴﺗﻮﻤﻳﺮﺑ ﺝﻼﻌﻟﺍ ﻞﺒﻗ ﺕﺎﻓﺎﺿﺇﻭ ﺐﻴﺒﻁ ﺔﻔﺻﻭ ﻥﻭﺪﺑ ﺔﻳﻭﺩﺃ ﻚﻟﺫ ﻲﻓ ﺎﻤﺑ ,ﻯﺮﺧﺃ ﺔﻳﻭﺩﺃ ﺓﺮﻴﺧﻷﺍ ﺔﻧﻭﻵﺍ ﻲﻓ ﺖﻟﻭﺎﻨﺗ ﻭﺃ ﻝﻭﺎﻨﺘﺗ ﺖﻨﻛ ﺍﺫﺇ ﺖﻨﻛ ﺍﺫﺇ ﻲﻟﺪﻴﺼﻟﺍ ﻭﺃ ﺐﻴﺒﻄﻟﺍ ﻡﻼﻋﺇ ﺐﺠﻳ ﺹﻮﺼﺨﻟﺍ ﻪﺟﻭ ﻰﻠﻋ .ﻚﻟﺬﺑ ﻲﻟﺪﻴﺼﻟﺍ ﻭﺃ ﺞﻟﺎﻌﻤﻟﺍ ﺐﻴﺒﻄﻟﺍ ﺮﺒﺧﺃ ,ﺔ
ّ
ﻳﺬﻐﺗ ﺍﺫﺇ ﺎﻤﻴﻓ ﺍ
ﺪﻛﺄﺘﻣ ﻦﻜﺗ ﻢﻟ ﺍﺫﺇ ﺔﻳﻭﺩﻷﺍ ﻲﻓ ﺔﻟﺎﻌﻔﻟﺍ ﺩﺍﻮﻤﻟﺍ ﻰﻟﺇ ﺮﻴﺸﺗ ﻩﺎﻧﺩﺃ ﺔﻤﺋﺎﻘﻟﺍ ﻥﺄﺑ ﺓﺭﺎﺷﻻﺍ ﺭﺪﺠﺗ) ﺔﻴﻟﺎﺘﻟﺍ ﺔﻳﻭﺩﻷﺍ ﻰﻘﻠﺘﺗ :(ﻲﻟﺪﻴﺼﻟﺍ ﻭﺃ ﺐﻴﺒﻄﻟﺍ ﻊﻣ ﺭﻭﺎﺸﺗ ءﺎﺟﺮﻟﺍ ﺔﻳﻭﺩﻷﺍ ﻩﺬﻫ ﺪﺣﺃ ﻞﻤﻌﺘﺴﺗ ﺖﻨﻛ
SSRIs
ﺔﻴﺋﺎﻘﺘﻧﻹﺍ
ﻦﻴﻨﻴﺗﻭﺮﻴﺴﻟﺍ
ﻉﺎﺟﺮﺘﺳﺍ
ﺕﺎﻄﺒﺜﻣ
ﺔﻠﻴﺼﻓ
ﻦﻣ
ﺔﻳﻭﺩﺃﻭ
ﻥﻭﺮﻴﻔﺳﻮﺑ
ﻞﺜﻣ
ﺏﺎﺌﺘﻛﻻﺍ
ﺪﺿ
ﺔﻳﻭﺩﺃ
ﻢﺣﺮﻟﺍ
ﻞﺧﺍﺩ
ﺕﺍﺰﻴﻬﺟ
ﺔﻳﺪﻠﺟ
ﺕﺎﻘﺼﻟ
ﻞﻤﺤﻟﺍ
ﻊﻨﻣ
ﺏﻮﺒﺣ
ﻞﺜﻣ
ﺔﻴﻧﻮﻣﺮﻫ
ﻞﻤﺣ
ﻊﻨﻣ
ﻞﺋﺎﺳﻭ
ﻥﻭﺩﺎﺜﻴﻣ
ﻡﻮﻨﻠﻟ
ﺔﺋﺪﻬﺘﻠﻟ
ﺎﻬﻨﻣ
ﺭﻮﻣﺃ
ﺓﺪﻌﻟ
ﻞﻤﻌﺘﺴﺗ
ﻲﺘﻟﺍﻭ
ﻦﻴﺒﻳﺯﺎﻳﺩﻭﺰﻨ
ﺒﻟﺍ
ﺔﻠﻴﺼﻓ
ﻦﻣ
ﺔﻳﻭﺩﺃ
ﻦﻴﺗﺎﺘﺘﺴﺍﭭﺭﻮﺗﺃ
ﻦﻴﺗﺎﺘﺘﺳﺎﭭﻤﻴﺴ
ﻞﺜﻣ
ﻦﻴﺗﺎﺘﺴﻟﺍ
ﺔﻠﻴﺼﻓ
ﻦﻣ
ﻝﻭﺮﺘﺴﻟﻮﻜﻟﺍ
ﺾﻔﺨﻟ
ﺔﻳﻭﺩﺃ
ﺔﻘﻴﻘﺸﻟﺍ
ﺝﻼﻌﻟ
ﺔﻳﻭﺩﺃ
ﻞﺜﻣ
ﻝﻮ
ﻤﻟﺍ
ﻲﻨﻴﻧﻮﺗﻭﺮﻴﺳ
ﺔﻠﻴﺼﻓ
ﻦﻣ
ﺔﻳﻭﺩﺃ
ﻉﺮﺼﻟﺍ
ﺝﻼﻌﻟ
ﺔﻳﻭﺩﺃ
ﻦﻴﺴﻛﻮﺠﻳﺩ
ﺔﻳﺪﻴﺋﻭﺮﻴﺘﺳ
ﺕﺎﻧﻮﻣﺮﻫ
ﻞﺜﻣ
ﻦﻳﺭﺎﻣﻮﻜﻟﺍ
ﺔﻠﻴﺼﻓ
ﻦﻣ
ﻡﺪﻟﺍ
ﻂﻠﺠﺘﻟ
ﺩﺎﻀﻣ
ﺔﻳﻭﺩﺃ
ﺔﻴﺗﻵﺍ
ﺔﻳﻭﺩﻷﺍ
ﻝﻭﺎﻨﺘﺗ
ﺖﻨﻛ
ﺍﺫﺇ
ﺐﻴﺗﻮﻤﻳﺭ
ﻝﻭﺎﻨﺗ
ﺯﻮﺠﻳ
ﺱﻭﺮﻴﻓ
ﺪﺿ
ﺔﻳﻭﺩﺃ
ﺱﻮﻤﻴﻟﻭﺮﻴﺳ
ﺱﻮﻤﻴﻟﻭﺮﻜ
ﻦﻳﺭﻮﭙﺳﻮﻠﻜﻴﺳ
ﻞﺜﻣ
ﺔﻋﺎﻨﻤﻟﺍ
ﺯﺎﻬﺟ
ﺖﺒﻜﻟ
ﺔﻳﻭﺩﺃ
ﻦﻳﺭﺎﻓﺭﺍﻭ .'ﺍﺫﺇ ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺍ ﺯﻮﺠﻳ ﻻ' ﺪﻨﺑ ﺮﻈﻧﺃ -(ﺐﻴﻨﻴﺘﻤﻳﺇ ,ﻥﺎﻜﺗﻮﻨﻳﺮﻳﺇ ﻞﺜﻣ) ﻲ
ﺋﺎﻴ
ﻤﻴ
ﻜﻟﺍ ﺝﻼﻌﻟﺍ ﺔﻳﻭﺩﺃ
ﺯﺪﻳﻹﺍ
/HIV -
ﻝﺍ .ﺎﻫﺪﻌﺑ ﻭﺃ ﺔﺒﺟﻮﻟﺍ ﻊﻣ ءﺍﻭﺪﻟﺍ ﻝﻭﺎﻨﺗ ﺬ
ﺒﺤ
ﻡﺎﻌﻄﻟﺍﻭ ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺍ ﻝﻮـ ـﺧﺪﻟﺍ ﻦــﻴﻟﻭﺎﺤﺗ ,
ﻼــﻣﺎﺣ ﺖـ ـﻨﻛ ﺍﺫﺇ .ﻉﺎـ ـﺿﺭﻹﺍﻭ ﻞــﻤﺤﻟﺍ ﺖـ ـﻗﻭ ءﺍﻭﺪــﻟﺍ ﻝﺎﻤﻌﺘـ ـﺳﺎﺑ ﻰـ ـﺻﻮﻳ ﻻ :ﻉﺎــﺿﺭﻹﺍﻭ ﻞـ ـﻤﺤﻟﺍ .ﺐﻴﺒﻄﻟﺍ ﺓﺭﺎﺸﺘﺳﺍ ﺐﺠﻳ ,ﺔﻌﺿﺮﻣ ﻭﺃ ﻞﻤﺤﻟﺍ ﻲﻓ ﺭﺍﻭﺪﻟﺎﺑ ﺮﻌﺸﺗ ﺖﻨﻛ ﺍﺫﺇ .ﺭﺍﻭﺩ ﻞﺜﻣ ﺔﻴﺒﻧﺎﺟ ﺽﺍﺮﻋﺃ ﺐﺒﺴﻳ ﺪﻗ ءﺍﻭﺪﻟﺍ ﺍﺬﻫ ﻝﺎﻤﻌﺘﺳﺍ
:ﺕﻻﻵﺍ ﻝﺎﻤﻌﺘﺳﺍﻭ ﺔﻗﺎﻴﺴﻟﺍ ﺕﻻﺁ ﻞﻴﻐﺸﺗ ,ﺔﺒﻛﺮﻤﻟﺍ ﺔﻗﺎﻴﺳ ﺪﻨﻋ ﺭﺬﺤﻟﺍ ﻲﺧﻮﺗ ﻚﻴﻠﻋ - ﺕﻻﻵﺍ ﻞﻴﻐﺸﺗ ﻭﺃ ﺔﻗﺎﻴﺴﻟﺍ ﻰﻠﻋ ﺮﺛﺆﺗ ﺪﻗ ﻲﺘﻟﺍ ﺽﺍﺮﻋﺄﺑ ﻭﺃ .ﺔﻈﻘﻴﻟﺍ ﺐﻠﻄﺘﺗ ﻲﺘﻟﺍ ﺔﻴﻟﺎﻌﻓ ﻞﻜﺑﻭ ﺓﺮﻄﺧ
ﺓﺩﺎﻋ ﺺﺼﺨﻣ ﺮﻴﻏ ءﺍﻭﺪﻟﺍ ﺍﺬﻫ .٦ ﻦﺳ ﻥﻭﺩ ﻝﺎﻔﻁﻷﺍ ﻯﺪﻟ ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺍ ﺯﻮﺠﻳ ﻻ :ﻝﺎﻔﻁﻷﺍ ﻯﺪﻟ ﻝﺎﻤﻌﺘﺳﻻﺍ .۱۲ﻦﺳ ﻥﻭﺩ ﻝﺎﻔﻁﻸﻟ ﻚﻳﺪﻟ ﺖﻧﺎﻛ ﺍﺫﺇ .ﺯﻮﺘﻛﻻ ﻰﻠﻋ ۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ ﺹﺍﺮﻗﺃ ﻱﻮﺘﺤﺗ :ءﺍﻭﺪﻟﺍ ﺕﺎﺒﻛﺮﻣ ﻦﻣ ءﺰﺟ ﻦﻋ ﺔﻤﻬﻣ ﺕﺎﻣﻮﻠﻌﻣ .(٦ ﺪﻨﺑ ﺮﻈﻧﺃ) ءﺍﻭﺪﻟﺍ ﺍﺬﻫ ﻝﻭﺎﻨﺗ ﻞﺒﻗ ﺐﻴﺒﻄﻟﺍ ﻍﻼﺑﺇ ﺐﺠﻴﻓ ﺯﻮﺘﻛﻼﻟ ﺔ
ﻴﺳﺎﺴﺣ ؟ءﺍﻭﺪﻟﺍ ﻞﻤﻌﺘﺴﺗ ﻒﻴﻛ .۳
.ﺍ
ﺪﻛﺄﺘﻣ ﻦﻜﺗ ﻢﻟ ﺍﺫﺇ ﻲﻟﺪﻴﺼﻟﺍ ﻭﺃ ﺐﻴﺒﻄﻟﺍ ﻦﻣ ﺪﻛﺄﺘﻟﺍ ﻚﻴﻠﻋ .ﺐﻴﺒﻄﻟﺍ ﺕﺎﻤﻴﻠﻌﺘﻟ ﺎ
ﻘﻓﻭ ﻝﺎﻤﻌﺘﺳﻻﺍ ﺎ
ﻤﺋﺍﺩ ﺐﺠﻳ .ﻂﻘﻓ ﺐﻴﺒﻄﻟﺍ ﻞﺒﻗ ﻦﻣ ﻥﺍﺩﺪﺤ
ﻳ ﺝﻼﻌﻟﺍ ﺔﻘﻳﺮﻁﻭ ﺔﻋﺮﺠﻟﺍ :ﺐﻴﺒﻄﻟﺍ ﻦﻣ ﻯﺮﺧﺃ ﺕﺎﻤﻴﻠﻌﺗ ﺩﻮﺟﻭ ﻡﺪﻋ ﻝﺎﺣ ﻲﻓ ﺔﻋﺮﺠﻟﺍ .(ءﺎﺴﻤﻟﺍ ﻲﻓﻭ ﺡﺎﺒﺼﻟﺍ ﻲﻓ) ﻡﻮﻴﻟﺍ ﻲﻓ ﻦﻴﺗﺮﻣ ﺪﺣﺍﻭ ﺹﺮﻗ :۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ .(ءﺎﺴﻤﻟﺍ ﻲﻓ ﻭﺃ ﺡﺎﺒﺼﻟﺍ ﻲﻓ) ﻡﻮﻴﻟﺍ ﻲﻓ ﺓﺮﻣ ﺪﺣﺍﻭ ﺹﺮﻗ :٥۰۰ ﺐﻴﺗﻮﻤﻳﺭ
ﺎﻬﺑ ﻰﺻﻮﻤﻟﺍ ﺔﻋﺮﺠﻟﺍ ﺯﻭﺎﺠﺗ ﺯﻮﺠﻳ ﻻ .ﺞﻟﺎﻌﻤﻟﺍ ﺐﻴﺒﻄﻟﺍ ﻩﺩﺪﺣ ﺎﻤﻟ ﺎ
ﻘﻓﻭ ﺓﺩﺪﺤﻣ ﺕﺎﻗﻭﺄﺑ ءﺍﻭﺪﻟﺍ ﺍﺬﻫ ﻝﺎﻤﻌﺘﺳﺍ ﺐﺠﻳ
If you are sensitive to any type of food or medicine, inform your doctor
before t
aking this medicine.
Before the treatment with Remotiv tell your doctor:
If you suffer or have
suffered in the past from impaired function of the liver, kidneys/urinary system.
If you are taking or have recently taken any other medicines, including
non-prescription medicines and nutrition supplements, please tell your
doctor or pharmacist. Especially inform your doctor or pharmacist if you are
taking the following medicines (it should be noted that the following list mentions
the active ingredients of the medicines. If you are unsure whether you are using
one of these medicines, please consult with your doctor or pharmacist):
Antidepressants (e.g. buspirone and medicines of the selective serotonin
reuptake inhibitors group - SSRIs).
Hormonal contraceptives (e.g. birth control pills, transdermal patches,
intrauterine devices).
Medicines of the benzodiazepine group (used, among other things, for
sedation and/or for sleep), methadone.
Medicines for reducing cholesterol of the statin group (e.g. simvastatin,
atorvastatin).
Medicines of the serotoninergic group (e.g. medicines for the treatment of migraines).
Medicines for the treatment of epilepsy.
Steroidal hormones, digoxin.
Do not take Remotiv if you are taking the following medicines: anticoagulants of
coumarin
group
(e.g.
warfarin),
immunosuppressant
medicines
(e.g.
cyclosporine, tacrolimus, sirolimus) medicines against the HIV virus/AIDS,
chemotherapy medicines (e.g. irinotecan, imatinib) - See section "Do not use
this medicine if".
Use of this medicine and food:
It is recommended to take this medicine with
a meal or after it.
Pregnancy and breastfeeding:
The use of this medicine is not recommended
during pregnancy and breastfeeding. If you are pregnant, trying to get pregnant or
breastfeeding, consult your doctor.
Driving and use of machinery:
The use of this medicine may cause side
effects such as dizziness. If you experience dizziness or other effects that may
affect driving or operating machinery- caution should be taken while driving a
vehicle, operating dangerous machinery and any other activity that requires alertness.
Use in children:
Do not use this medicine in children under 6 years of age. This
medicine is usually not intended for children under 12 years of age.
Important information about some of the medicine's ingredients:
Remotiv 250 tablets contain lactose. If you are sensitive to lactose, inform your
doctor before taking this medicine (see section 6).
3. How to use this medicine?
Always use according to the doctor's instructions. Check with your doctor or
pharmacist if you are not sure.
The dosage and the manner of treatment will be determined by the doctor only.
Recommended dosage unless otherwise instructed by your doctor:
Remotiv 250: one tablet twice daily (in the morning and in the evening).
Remotiv 500: one tablet once daily (in the morning or in the evening).
Do not exceed the recommended dose.
The medicine should be used at set intervals, as determined by the attending doctor.
The effect of the medicine is expected to begin within 14 days.
Do not chew or crush the tablet! Do not halve the tablet since there is no scored line.
Swallow the tablet with a little water. The medicine should preferably be taken with
a meal or after it.
If you have accidentally taken a higher dosage:
if you have taken an
overdose
child
accidentally
swallowed
medicine,
proceed
immediately to a hospital emergency room and bring the package of the
medicine with you.
Continue with the treatment as recommended by your doctor. Even if your
medical condition improves, do not stop the treatment with this medicine without
consulting your doctor.
Do not take medicines in the dark! Check the label and the dose each time you
take a medicine. Wear glasses if you need them.
If you have any further questions regarding the use of this medicine, consult your
doctor or pharmacist.
4. Side effects:
Like any medicine, the use of Remotiv may cause side effects in some users. If
these side effects persist or if they are bothersome or get worse, consult your
doctor. Do not be alarmed while reading the list of side effects, you may not suffer
from any of them.
Stop the treatment and refer to your doctor immediately upon the appearance
skin
redness,
sensitivity
eyes
skin
(e.g.
sunburn),
photosensitivity (rare). Also see 'Special warnings regarding the use of this medicine'.
Additional side effects:
Common side effects (appear in 1-10 users out of 100): digestive system
problems (e.g. abdominal pain), headache, sweating, weakness.
Uncommon side effects (appear in less than 1 out of 100 users): dizziness.
Side effects with an unknown frequency: mania, restlessness, rash, dry mouth.
In any case you experience side effects that are not mentioned in this leaflet, or if
there is a change in your general feeling, consult your doctor immediately!
5. How to store the medicine?
Avoid poisoning! This medicine, and any other medicine, must be stored in a safe
place out of the reach of children and/or infants, to avoid poisoning. Do not induce
vomiting unless explicitly instructed to do so by a doctor.
Do not use the medicine after the expiry date (exp. date) stated on the
package. The expiry date refers to the last day of that month.
Storage conditions: Store in the original package below 25°C.
6. Additional information
In addition to the active ingredient, the tablets also contain the following
inactive ingredients:
Each tablet of Remotiv 250 contains:
Microcrystalline
cellulose,
lactose
monohydrate,
macrogol
6000,
magnesium stearate, macrogol 400, macrogol 20000, propylene glycol,
hypromellose, iron oxide red (E172), titanium dioxide (E171).
Each tablet of Remotiv 250 contains approximately 120 mg of lactose.
Each tablet of Remotiv 500 contains:
Microcrystalline
cellulose,
croscarmellose
sodium,
macrogol
6000,
magnesium stearate, colloidal anhydrous silica, macrogol 20000, stearic
acid, hypromellose, iron oxide red (E172), titanium dioxide (E171).
What does the medicine look like and what does the package contain?
Remotiv 250: round pink colored tablets. 60 tablets in blisters.
Remotiv 500: elongated pink colored tablets. 30 tablets in blisters.
Registration holder: Rafa Laboratories Ltd., P.O.Box 405, Jerusalem 9100301
Manufacturer:
Max Zeller Söhne AG, Switzerland.
Medicine registration number in the National Medicine Registry of the
Ministry of Health:
Remotiv 250: 130 71 30720 Remotiv 500: 141 28 31607
This leaflet was checked and approved by the Ministry of Health in April 2014.
Remotiv 250+500 PIL PB0514-02
194511 511007MZ
.ﺎ
ﻣﻮﻳ ۱٤ ﻝﻼﺧ ءﺍﻭﺪﻟﺍ ﺮﻴﺛﺄﺗ ﺃﺪﺒﻳ ﻥﺃ ﻊﻗﻮﺘﻤﻟﺍ ﻦﻣ .ﺮﻄﺷ ﻂﺧ ﺩﻮﺟﻭ ﻡﺪﻌﻟ ﻚﻟﺫﻭ ﺹﺮﻘﻟﺍ ﺮﻄﺷ ﺯﻮﺠﻳ ﻻ !ﺹﺮﻘﻟﺍ ﻖﺤﺳ ﻭﺃ ﻎﻀﻣ ﺯﻮﺠﻳ ﻻ .ﺎﻫﺪﻌﺑ ﻭﺃ ﺔﺒﺟﻮﻟﺍ ﻊﻣ ءﺍﻭﺪﻟﺍ ﻝﻭﺎﻨﺗ ﺬ
ﺒﺤ
ﻳ .ءﺎﻤﻟﺍ ﻦﻣ ﻞﻴﻠﻘﻟﺍ ﻊﻣ ﺹﺮﻘﻟﺍ ﻊﻠﺑ ﺐﺠﻳ ﻦﻋ ءﺍﻭﺪـ ـﻟﺍ ﻦﻣ ﻞﻔﻁ ﻊـ ـﻠﺑ ﺍﺫﺇ ﻭﺃ ﺔـ ـﻋﺮﺠﻟﺍ ﻝﻭﺎـ ـﻨﺗ ﻲـ ـﻓ ﺖــﻁﺮﻓﺃ ﺍﺫﺇ :ﺮــﺒﻛﺃ ﺔــﻋﺮﺟ ﺄــﻄﺨﻟﺍ ﻖــﻳﺮﻁ ﻦــﻋ ﺖــﻟﻭﺎﻨﺗ ﺍﺫﺇ .ﻚﻌﻣ ءﺍﻭﺪﻟﺍ ﺓﻮﺒﻋ ﺎ
ﺒﺤﻄﺼﻣ ﻰﻔﺸﺘﺴﻤﻟﺍ ﻲﻓ ﺉﺭﺍﻮﻄﻟﺍ ﺔﻓﺮﻏ ﻰﻟﺇ ﺍ
ﺭﻮﻓ ﻪﺟﻮﺗ ,ﺄﻄﺨﻟﺍ ﻖﻳﺮﻁ ﺯﻮـ ـﺠﻳ ﻻ ,ﻲـ ـﺤﺼﻟﺍ ﻚـ ـﻌﺿﻭ ﻰـ ـﻠﻋ ﻦــﺴﺴﺤﺗ ﺃﺮـ ـﻁ ﻮـ ـﻟ ﻰـ ـﺘﺣ .ﺐــﻴﺒﻄﻟﺍ ﻰــﺻﻭﺃ ﺎـ ـﻤﻛ ﺝﻼــﻌﻟﺍ ﻰــﻠﻋ ﺔــﻣﻭﺍﺪﻤﻟﺍ ﺐـ ـﺠﻳ .ﺐﻴﺒﻄﻟﺍ ﺓﺭﺎﺸﺘﺳﺍ ﻥﻭﺩ ءﺍﻭﺪﻟﺎﺑ ﺝﻼﻌﻟﺍ ﻑﺎﻘﻳﺇ ﻊﺿ .ءﺍﻭﺩ ﺎــﻬﻴﻓ ﻝﻭﺎﻨﺘﺗ ﺓﺮــﻣ ﻞﻛ ﻲﻓ ﺔﻴﺋﺍﻭﺪﻟﺍ ﺔــﻋﺮﺠﻟﺍﻭ ﻖـ ـﺼﻠﻤﻟﺍ ﻦﻣ ﻖـ ـﻘﺤﺗ !ﻡﻼـ ـﻈﻟﺍ ﻲــﻓ ﺔــﻳﻭﺩﻷﺍ ﻝﻭﺎـ ـﻨﺗ ﺯﻮـ ـﺠﻳ ﻻ .ﺎﻬﻴﻟﺇ ﺔﺟﺎﺤﺑ ﺖﻨﻛ ﺍﺫﺇ ﺔﻴﺒﻄﻟﺍ ﺕﺍﺭﺎﻈﻨﻟﺍ
ﻲﻟﺪﻴﺼﻟﺍ ﻭﺃ ﺐﻴﺒﻄﻟﺍ ﺮﺸﺘﺳﺇ ,ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺍ ﻝﻮﺣ ﺔﻴﻓﺎﺿﺇ ﺔﻠﺌﺳﺃ ﻚﻳﺪﻟ ﺖﻧﺎﻛ ﺍﺫﺇ
ﺔ
ّ
ﻴﺒﻧﺎﺠﻟﺍ ﺽﺍﺮﻋﻷﺍ .٤ ﺽﺍﺮﻋﻷﺍ ﺾﻘﻨﺗ ﻢﻟ ﺍﺫﺇ .ﻦﻴﻣﺪﺨﺘﺴﻤﻟﺍ ﻦﻣ ءﺰﺟ ﻯﺪﻟ ﺔﻴﺒﻧﺎﺟ ﺽﺍﺮﻋﺃ ﺐﻴﺗﻮﻤﻳﺭ ﻝﺎﻤﻌﺘﺳﺍ ﺐﺒﺴﻳ ﺪﻗ ,ءﺍﻭﺩ
ﻱﺃ ﻞﻜﻛ ﺽﺍﺮﻋﻷﺍ ﺔﻤﺋﺎﻗ ﺓءﺍﺮﻗ ﻦﻣ ﻉﺰﻔﺗ ﻻ .ﺐﻴﺒﻄﻟﺍ ﺓﺭﺎﺸﺘﺳﺍ ﺐﺠﻳ ,ﺔﻤﻴﺧﻭ ﺢﺒﺼﺗ ﻭﺃ ﺔﻘﻳﺎﻀﻤﻟﺍ ﺐﺒﺴﺗ ﺎﻬﻧﺃ ﻭﺃ ﺔ
ﻴﺒﻧﺎﺠﻟﺍ .ﺎﻬﻨﻣ ﺓﺪﺣﺍﻭ ﻱﺄﺑ ﺏﺎﺼﺗ ﻻ ﻥﺃ ﻦﻜﻤﻤﻟﺍ ﻦﻣ .ﺔ
ﻴﺒﻧﺎﺠﻟﺍ ﺲﻤﺸﻠﻟ ﺓﺮﺸﺒﻟﺍﻭ ﻦﻴﻨﻴﻌﻟﺍ ﺔ
ﻴﺳﺎﺴﺣ - ﺓﺮﺸﺒﻟﺍ ﻲﻓ ﺭﺍﺮﻤﺣﺍ ﺭﻮﻬﻅ ﺪﻨﻋ
ﺍ
ً
ﺭﻮﻓ ﺐﻴﺒﻄﻟﺍ ﻰﻟﺇ ﻪﺟﻮﺘﻟﺍﻭ ﺝﻼﻌﻟﺍ ﻑﺎﻘﻳﺇ ﺐﺠﻳ .'ءﺍﻭﺪﻟﺍ ﻝﺎﻤﻌﺘﺳﺎﺑ ﺔﻘﻠﻌﺘﻣ ﺔﺻﺎﺧ ﺕﺍﺮﻳﺬﺤﺗ ' ﺎ
ﻀﻳﺃ ﺮﻈﻧﺃ .(
ﺭﺩﺎﻧ)
photosensitivity
,(ﻲ
ﺷ ﻕ
ﺣ ﻞﺜﻣ) :ﺔﻴﻓﺎﺿﺇ ﺔﻴﺒﻧﺎﺟ ﺽﺍﺮﻋﺃ ﻢﻟﺃ ﻞﺜﻣ) ﻲﻤﻀﻬﻟﺍ ﺯﺎﻬﺠﻟﺍ ﻲﻓ ﻞﻛﺎﺸﻣ
:
.ﻒﻌﺿ ,ﻕﺮﻌﺗ ,ﻉﺍﺪﺻ ,(ﻦﻄﺑ .ﺭﺍﻭﺩ
.ﻢﻔﻟﺎﺑ ﻑﺎﻔﺟ ,ﻱﺪﻠﺟ ﺢﻔﻁ ,ﻞﻤﻠﻤﺗ ,ﺱﻮﻫ ﻚﻴﻠﻋ ,ﻡﺎﻌﻟﺍ ﻙﺭﻮﻌﺷ ﻰﻠﻋ ﺮﻴﻴﻐﺗ ﻱﺃ ﺍﺮﻁ ﺍﺫﺇ ﻭﺃ ,ﺓﺮﺸﻨﻟﺍ ﻩﺬﻫ ﻲﻓ ﺮﻛﺬﺗ ﻢﻟ ﺔﻴﺒﻧﺎﺟ ﺽﺍﺮﻋﺄﺑ ﻪﺑ ﺮﻌﺸﺗ ﻝﺎﺣ ﻞﻛ ﻲﻓ
ﻻﺎﺣ ﺐﻴﺒﻄﻟﺍ ﺓﺭﺎﺸﺘﺳﺍ ؟ءﺍﻭﺪﻟﺍ ﻦﻳﺰﺨﺗ ﺔ
ّ
ﻴﻔﻴﻛ . ٥ ,ﻊﺿﺭﻟﺍ ﻭﺃ/ﻭ ﻝﺎﻔﻁﻷﺍ ﻱﺩﻳﺃ ﻝﻭﺎﻧﺗﻣ ﻥﻋ ﺍ
ﺩﻳﻌﺑ ﻕﻠﻐﻣ ﻥﺎﻛﻣ ﻲﻓ ﺭﺧﺁ ءﺍﻭﺩ ﻝﻛﻛ ءﺍﻭﺩﻟﺍ ﺍﺫﻫ ﻅﻔﺣ ﺏﺟﻳ !ﻡﻣﺳﺗﻟﺍ ﺏﻧﺟﺗ .ﺏﻳﺑﻁﻟﺍ ﻥﻣ ﺔﺣﻳﺭﺻ ﺕﺎﻣﻳﻠﻌﺗ ﻥﻭﺩ ﺅﻳﻘﺗﻟﺍ ﺏﺑﺳﺗ ﻻ .ﻡﻣﺳﺗﻟﺍ ﻊﻧﻣﺗ ﻙﻟﺫﺑﻭ ءﺎﻬﺗﻧﺍ ﺦﻳﺭﺎﺗ .ﺓﻭﺑﻌﻟﺍ ﻰﻠﻋ ﺭﻬﻅﻳ ﻱﺫﻟﺍ (exp. date) ﺔﻳﺣﻼﺻﻟﺍ ءﺎﻬﺗﻧﺍ ﺦﻳﺭﺎﺗ ﺩﻌﺑ ءﺍﻭﺩﻟﺍ ﻝﺎﻣﻌﺗﺳﺍ ﺯﻭﺟﻳ ﻻ
.ﺭﻬﺷﻟﺍ ﺱﻔﻧ ﻥﻣ ﺭﻳﺧﻷﺍ ﻡﻭﻳﻟﺍ ﻰﻟﺇ ﻊﺟﺭﻳ ﺔﻳﺣﻼﺻﻟﺍ .ﺔﻳﻭﺋﻣ ﺔﺟﺭﺩ ۲٥ ﺕﺣﺗ ﺔ
ﻳﻠﺻﻷﺍ ﺓﻭﺑﻌﻟﺍ ﻲﻓ ﻥﻳﺯﺧﺗﻟﺍ ﺏﺟﻳ :ﻥﻳﺯﺧﺗﻟﺍ ﻑﻭﺭﻅ
ﺔﻴﻓﺎﺿﺇ ﺕﺎﻣﻮﻠﻌﻣ
٦
:ﺔﻴﻟﺎﺘﻟﺍ ﺔﻟﺎﻌﻔﻟﺍ ﺮﻴﻏ ﺩﺍﻮﻤﻟﺍ ﻰﻠﻋ ﺎ
ً
ﻀﻳﺃ ﻱﻮﺘﺤﺗ ﺹﺍﺮﻗﻷﺍ ,ﺔﻟﺎﻌﻔﻟﺍ ﺓﺩﺎﻤﻟﺍ ﻰﻟﺇ ﺔﻓﺎﺿﺇ :ﻰﻠﻋ ﻱﻮﺘﺤﻳ ۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ ﻦﻣ ﺹﺮﻗ ﻞﻛ
Microcrystalline
cellulose,
lactose
monohydrate,
macrogol
6000,
magnesium stearate, macrogol 400, macrogol 20000, propylene glycol,
hypromellose, iron oxide red (E172), titanium dioxide (E171).
.ﺯﻮﺘﻛﻻ ﻎﻠﻣ ۱۲۰ ﺏﺭﺎﻘﻳ ﺎﻣ ﻰﻠﻋ ﻱﻮﺘﺤﻳ
۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ ﻦﻣ ﺹﺮﻗ ﻞﻛ : ﻰﻠﻋ ﻱﻮﺘﺤﻳ
٥۰۰
ﺏﻳﺗﻭﻣﻳﺭ ﻦﻣ ﺹﺮﻗ ﻞﻛ
Microcrystalline
cellulose,
croscarmellose
sodium,
macrogol
6000,
magnesium stearate, colloidal anhydrous silica, macrogol 20000, stearic
acid, hypromellose, iron oxide red (E172), titanium dioxide (E171).
؟ﺓ
ّ
ﻮﺒﻌﻟﺍ ﻯﻮﺘﺤﻣ ﻮﻫ ﺎﻣﻭ ءﺍﻭﺪﻟﺍ ﻭﺪﺒﻳ ﻒﻴﻛ .ﺕﺎﺤﻳﻮﻟ ﺓﻮﺒﻌﺑ ﺹﺮﻗ ٦۰ .ﻱﺩﺭﻭ ﻥﻮﻠﺑ ﺓﺮﻳﺪﺘﺴﻣ ﺹﺍﺮﻗﺃ :۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ .ﺕﺎﺤﻳﻮﻟ ﺓﻮﺒﻌﺑ ﺹﺮﻗ ۳۰ .ﻱﺩﺭﻭ ﻥﻮﻠﺑ ﺔﻟﻭﺎﻄﻣ ﺹﺍﺮﻗﺃ :٥۰۰ ﺐﻴﺗﻮﻤﻳﺭ ۹۱۰۰۳۰۱ ﺱﺪﻘﻟﺍ ,٤۰٥ .ﺏ.ﺹ ﺽ.ﻡ ﺎﻓﺍﺭ ﺕﺍﺮﺒﺘﺨﻣ :ﻞﻴﺠﺴﺘﻟﺍ ﺐﺣﺎﺻ .ﺍﺮﺴﻳﻮﺳ ,
ﻪﻴﻧﻮﺳ ﺮﻴﻠﻳﺯ ﺲﻛﺎﻣ :ﺞﺘﻨﻤﻟﺍ
:ﺔﺤﺼﻟﺍ ﺓﺭﺍﺯﻭ ﻲﻓ ﻲﻣﻮﻜﺤﻟﺍ ﺔﻳﻭﺩﻷﺍ ﻞﺠﺳ ﻲﻓ ءﺍﻭﺪﻟﺍ ﻞﻴﺠﺴﺗ ﻢﻗﺭ
۱٤۱ ۲۸۳۱٦۰۷
٥۰۰ ﺐﻴﺗﻮﻤﻳﺭ
۱۳۰
۳۰۷۲۰ : ۲٥۰ ﺐﻴﺗﻮﻤﻳﺭ .۲۰۱٤ ﻥﺎﺴﻴﻧ ﻲﻓ ﺔﺤﺼﻟﺍ ﺓﺭﺍﺯﻭ ﻞﺒﻗ ﻦﻣ ﺎﻬﻴﻠﻋ ﺔﻗﺩﺎﺼﻤﻟﺍ
ﻢﺗﻭ ﺓﺮﺸﻨﻟﺍ ﻩﺬﻫ ﺖﺼﺤ
.ﻦﻴﺴﻨﺠﻟﺍ ﻼﻜﻟ ﺺﺼﺨ
ﻣ ءﺍﻭﺪﻟﺍ ﻦﻜﻟ .ﺮﻛﺬﻤﻟﺍ ﺔﻐﻴﺼﺑ ﺓﺮﺸﻨﻟﺍ ﻩﺬﻫ ﺔﻏﺎﻴﺻ ﺖﻤﺗ ,ﺓءﺍﺮﻘﻟﺍ ﻞﻴﻬﺴﺗﻭ ﻂﻴﺴﺒﺘﻠﻟ (۱۰۰ ﻥﻳﺑ ﻥﻣ ﻥﻳﻣﺩﺧﺗﺳﻣ ۱۰-۱ ﻯﺩﻟ ﺭﻬﻅﺗ) ﺔﻌﺋﺎﺷ
ﺔﻴﺒﻧﺎﺟ
ﺽﺍﺮﻋﺃ :(ﻡﺩﺧﺗﺳﻣ ۱۰۰ ﻥﻳﺑ ﻥﻣ۱ ﻥﻣ ﻝﻗﺃ ﻯﺩﻟ ﺭﻬﻅﺗ) ﺔﻌﺋﺎﺷ
ﺮﻴﻏ
ﺔﻴﺒﻧﺎﺟ
ﺽﺍﺮﻋﺃ :ﻑﻭﺮﻌﻣ
ﺮﻴﻏ
ﺎﻬﻋﻮﻴﺷ
ﺽﺍﺮﻋﺃ
Remotiv-DL-March 2015-02
Product Information
Remotiv 250
Remotiv 500
Film-coated tablets
Composition
Active substance of Remotiv 250 mg: St. John's wort (Hypericum perforatum), dry
extract. One film-coated tablet contains 250mg of the standardized dry extract (Ze 117),
standardized to 0.5mg total hypericin. The unique patented extraction process (extraction
solvent: ethanol 50% w/w; drug-extract ratio: 4-7:1) guarantees a consistently high-
quality product, which has a very low hyperforin content (see below “Drug interactions”).
Active substance of Remotiv 500mg: St. John's wort (Hypericum perforatum), dry
extract. One film-coated tablet contains 500mg of the standardized dry extract (Ze 117),
standardized to 1mg total hypericin. The unique patented extraction process (extraction
solvent: ethanol 50% w/w; drug-extract ratio: 4-7:1) guarantees a consistently high-
quality product, which has a very low hyperforin content (see below “Drug interactions”).
Inactive ingredients Remotiv 250mg: microcrystalline cellulose, lactose monohydrate,
hypromellose, macrogol 6000, titanium dioxide, magnesium stearate, macrogol 400,
propylene glycol, macrogol 20000, iron oxide red.
Inactive ingredients Remotiv 500mg: microcrystalline cellulose, croscarmellose sodium,
macrogol 6000, magnesium stearate, silica colloidal anhydrous, stearic acid,
hypromellose, titanium dioxide, macrogol 20000, iron oxide red.
Pharmacodynamic actions
ATC-Code: N05CM
Herbal sedative
St John’s wort may modulate brain levels of neurotransmitters but the precise mechanism
of action of St John’s wort is not known. The extract Ze 117 contains many ingredients
which may be responsible for the pharmacological action of Remotiv. Animal studies
suggest that the therapeutic effect of Remotiv is based on the inhibition of the reuptake of
norepinephrine and serotonin into the presynaptic neurons, as well as a down-regulation
of central beta-adrenergic receptors. Medical literature has described other possible
mechanisms of action for St. John’s wort.
Pharmacokinetic properties
St. John's wort contains a number of phytochemical components, but hypericin is
considered to be one of the main biological constituents. Hypericin can be used as a
marker in order to determine the pharmacokinetics of the extract.
In male volunteers administered a Remotiv dose of 250mg and 500mg, peak plasma
levels of hypericin were 0.67 mcg/l and 1.3mcg/l, respectively, at t
values of 7.1 hours
and 7.0 hours, respectively. The measured half-life values of hypericin were 21.4 hours
and 24.6 hours, respectively. Following multiple bid dosing with 250 mg, mean hypericin
plasma concentrations were 2.6 mcg/l. Steady state was achieved within 14 days without
undue accumulation.
Clinical Trials
Remotiv has been shown to be as effective as fluoxetine and imipramine for the treatment
of mild to moderate depression in short-term controlled clinical trials. Remotiv was
associated with fewer adverse events in these trials. An open, 12-month study in 141
patients established the long-term safety of Remotiv. Remotiv maintained symptom
improvement relative to baseline over this period. However, because there was no
comparator arm, this study did not establish the long-term efficacy of the product.
Indications
For the treatment of symptoms of mild to moderate depression including dejected mood,
mood lability, anxiety, inner restlessness, states of tension, and difficulty in falling asleep
and sleeping through the night which is associated with these conditions.
Treatment is
recommended for up to 24 weeks.
Contraindications
Known hypersensitivity to products based on St. John's wort or to one of the
excipients contained in Remotiv.
Known photohypersensitivity.
Remotiv must not be taken concomitantly with the following medicinal products:
- certain immunosuppressants (e.g. cyclosporine, tacrolimus or sirolimus)
- anti-retroviral HIV-drugs from the group of non-nucleoside reverse transcriptase
inhibitors (e.g. nevirapine) and proteinase inhibitors (e.g. indinavir)
- certain cytostatics (e.g. imatinib, irinotecan)
- oral anti-coagulants of the coumarin type
(see Drug Interactions).
Children under 6 years of age, since there is no data available for this patient
group.
Special warnings and precautions for use
Although extracts of St. John's wort have been used for many years without
evidence of an adverse effect on the liver or kidney, there are no controlled clinical
studies available in patients with impaired hepatic or renal function. Therefore, in
such patients Remotiv should be used with caution and under medical supervision.
In patients concurrently taking other drugs, especially drugs with a narrow
therapeutic window, extracts of St. John’s wort should be taken only after careful
consideration due to the possibility of potential drug interactions (see Drug
Interactions). Plasma levels and/or the effect of the interactive drug should be
monitored closely at the beginning of Remotiv therapy, when any change in
dosage occurs and after Remotiv therapy is discontinued.
Very rarely and especially in fair-skinned persons, unwanted reactions of the skin
(sunburn- like redness) or eyes may occur after ingestion of St. John’s wort preparations
and subsequent exposure to sun light. If such symptoms occur, the treatment must be
discontinued. During treatment with Remotiv, the skin and eyes should therefore be
protected from extensive sun exposure.
It has been demonstrated that Remotiv does not affect driving ability or ability to
use machinery safely. However, in isolated patients the underlying mood disorder
or the medicine’s side effects may adversely affect the patient’s ability to drive or
use machinery and these patients should be cautioned.
Pregnancy and Lactation
Reproduction studies in animals have indicated no risks to the fetus. However, scientific
evidence documenting the safe use of Remotiv during pregnancy and lactation in humans
is not available. Therefore, the use of Remotiv in pregnant and nursing women should be
avoided.
Use in Pediatrics
This product is not intended for use in children (<12 years).
Use in Elderly
There is usually no need to adjust the dosage in elderly patients.
Drug Interactions
Current data indicates that St. John's wort preparations may induce hepatic cytochrome
P450 enzymes, specifically CYP3A4, and transport proteins, specifically P-glycoprotein.
This can result in drug interactions. Specifically, starting therapy with a St. John's wort
preparation can lead to a reduction in plasma levels of a concomitant medicine, and,
conversely, stopping therapy with a St. John's wort preparation can lead to an increase in
plasma levels of a concomitant medicine
In case of an accidental intake of St. John’s wort preparations together with interactively
acting substances, the St. John’s wort preparation should, generally, be discontinued
gradually.
Hyperforin (one of the constituents in St John’s wort) has been demonstrated to be
responsible for many of the observed drug interactions. Therefore, due to its low
hyperforin content, Remotiv may have less potential for drug interactions than other St.
John’s wort preparations.
Immunosuppressants (Cyclosporin and Tacrolimus and Sirolimus)
Patients with a suppressed immune system from cyclosporine, tacrolimus or sirolimus must
not be treated with St. John’s wort at the same time. St. John’s wort leads to a rapid and
marked decrease in plasma levels and loss of the immunosuppressive effect with potentially
severe consequences (transplant rejection).
Anti-retroviral HIV-drugs from the group of non-nucleoside reverse transcriptase
inhibitors (e.g. nevirapine) and proteinase inhibitors (e.g. indinavir)
When treated with non-nucleoside reverse transcriptase inhibitors (e.g. nevirapine) and
proteinase inhibitors (e.g. indinavir), the intake of St. John’s wort preparations is contra-
indicated since St. John's wort can lead to a decrease in plasma levels.
Cytostatics (Irinotecan/Imatinib)
During treatment with irinotecan and imatinib, Remotiv is contraindicated. Interactions
with other chemotherapy agents metabolized by CYP enzymes or P-glycoprotein are
possible and should be avoided.
Anticoagulants of the coumarin type (e.g. warfarin acenocoumarol, phenprocoumon)
Patients taking oral anticoagulants must not be treated with St. John’s wort, since it
influences their coagulation inhibiting effect (and increases the risk of
thromboembolism).
Antidepressives and other serotonergic substances (such as buspirone, amitriptyline,
nortriptyline, citalopram, escitalopram, fluoxetine, paroxetine, sertraline, and others)
Simultaneous use of St John’s wort and other anti-depressants such as selective serotonin
re-uptake inhibitors (SSRIs) may lead to excessive serotonin stimulation and possible
toxicity (serotonin syndrome) with autonomic dysfunction (such as perspiration,
tachycardia, diarrhoea, fever), mental alterations (such as agitation, disorientation), and
motor alterations (such as tremor, myoclonias). Concomitant use is not generally
recommended and a sufficient washout period in-between Remotiv and other anti-
depressants should be allowed in order to avoid serotonin syndrome. Similar precautions
should be exercised for other serotonergic drugs such as buspirone.
Selective serotonin 5-
HT1 agonists used to treat migraine may theoretically also cause serotonin syndrome in
concomitant use.
Should the prescriber nevertheless decide to concomitantly prescribe Remotiv with an
SSRI/SNRI or other serotonergic drug after a careful individual risk/benefit assessment,
caution should be exercised and the patient should be closely monitored.
Methadone
Other preparations of St. John’s wort (not Remotiv) have been documented to cause a
significant reduction in the plasma levels of methadone.
Digoxin
Prescribers should be aware that St. John’s wort preparations may interact with digoxin.
Apparently due to Remotiv’s low hyperforin content, there is no evidence for a
pharmacokinetic interaction between Remotiv and digoxin. A pharmacokinetic study
showed that Remotiv (250 mg bid) had no effect on serum levels of digoxin. Drug
interaction studies cannot predict with 100% certainty the response of an individual
patient.
Hormonal Contraceptives
St. John’s wort can lead to reduced efficacy of hormonal contraceptives (e.g. oral
products, injected depot preparations, sub cutaneous implants, transdermal, intrauterine,
and vaginally applied products with hormone release). Several cases of interim bleeding
with so-called low-dose micro pills (ethinylestradiol content 30 μg or lower) were
reported internationally. Even individual cases of undesired pregnancies with hormonal
contraceptives and concomitant intake of St. John’s wort were reported.
Apparently due to Remotiv’s low hyperforin content, there is no evidence for a
pharmacokinetic interaction between Remotiv and oral contraceptives. A
pharmacokinetic study with a combined low-dose oral contraceptive
(Lovelle=Mercilon=Feminet) showed that Remotiv (250 mg bid) did not affect the serum
levels of the estrogenic or progesterone components of the oral contraceptive, and did not
lead to spotting. Drug interaction studies cannot predict with 100% certainty the response
of an individual patient.
Benzodiazepines
Other preparations of St. John’s wort (not Remotiv) have been documented to cause a
significant reduction in the plasma levels of benzodiazepines that are metabolized via
CYP3A4 such as alprazolam and midazolam.
St. John’s wort should only be given with
caution together with benzodiazepines
Anticonvulsants
There is also a theoretical possibility of an interaction between St. John's wort and
antiepileptics such as carbamazepine, phenobarbital and phenytoin. Stopping St. John's
wort abruptly may result in increased and possibly toxic, concentrations of the interacting
drug.
Steroid hormones
It cannot be excluded that St. John’s wort preparations also influence the metabolisms of
orally or intravenously applied steroid hormones. St. John’s wort should only be given with
caution together with steroid hormones.
Statins
Other preparations of St. John’s wort (not Remotiv) have been documented to cause a
significant reduction in the plasma levels or effects of simvastatin and atorvastatin, but
not pravastatin.
Agents used for photodiagnostic procedures or for phototherapy
There is a possibility that concurrent use of Remotiv with agents used for photodiagnostic
procedures or for phototherapy, eg porfimer, could lead to an increased risk of
photosensitivity.
General
Surgeons/anesthesiologists should discuss with patients scheduled for surgery the need to
initiate changes in dosing and administration of Remotiv during the peri-operative period.
Remotiv must be discontinued at least 5 days before any surgery and started again only
after consultation of a physician
The amount of active ingredient may vary widely between different preparations
containing St John’s wort. Switching from Remotiv to an alternative St. John’s wort
preparation may therefore alter the degree of enzyme induction of other drugs taken
concurrently.
Adverse effects
The most common adverse effects are gastrointestinal disturbances (4-6%), followed by
headache, sweating, and asthenia (1-2%). Dizziness (<1%) and restlessness may also
occasionally occur.
If redness of the skin appears, therapy should be discontinued and the cutaneous
symptoms should be followed-up.
As for other anti-depressants, isolated cases of mania associated with the use of St. John’s
wort have been reported.
Dosage and Administration
One tablet of Remotiv 250 mg morning and evening.
One tablet of Remotiv 500 mg morning or evening. The tablets should be
swallowed, without chewing, with a little liquid, preferably during or after a
meal. Remotiv 500 mg tablet is not easily split.
The product should be taken for at least 14 days, since onset of action may
be deferred until then. A minimum length of therapy of 4-6 weeks is
recommended. The treatment period is recommended for up to 24 weeks.
Remotiv may be prescribed for longer periods following the physician’s
assessment of the benefit-safety profile in long-term use.
Overdose
No acute or chronic toxic manifestations have been reported in humans but those side
effects listed above could manifest with greater intensity. In addition, photosensitivity is
also possible. In this case skin and eye exposure to sun or other UV irradiation (e.g. as
found in solariums or tanning salons) should be avoided for about 1-2 weeks.
Presentation
Remotiv 250: Film coated tablets: 20, 60
Remotiv 500: Film coated tablets: 10, 30
Store below 25
C in the original package.
Manufacturer
Max Zeller Sohne AG, Romanshorn, Switzerland
Registration Holder
Rafa Laboratories Ltd., P.O. Box 405, Jerusalem 9100301
Registration numbers:
Remotiv 250:
130 71 30720
Remotiv 500:
141 28 31607
The format of this leaflet has been determined by the Ministry of Health and its content has been checked
and approved by it in March 2015.
)תוחיטב עדימ( הרמחה לע העדוה )תוחיטב עדימ( הרמחה לע העדוה :ל חולשל(
(
alonim.urgent@moh.health.gov.il
:ךיראת
26
יאמב
2013
:תילגנאב רישכת םש
REMOTIV 250, REMOTIV 500 Tablets
:םושיר רפסמ
130-71-30720
,
141-28-31607
:םושירה לעב םש מ"עב אפר תודבעמ :עבצב םינמוסמ ןולעב םייונישה בוהצ ,הפסוה= קורי ,הקיחמ= לוחכ .םוקמ יוניש= אפורל ןולעב אפורל ןולעב
(
לירפאב תואירבה דרשמ רושיאל חלשנ
2012
ןולעב קרפ יחכונ טסקט שדח טסקט
INDICATIONS
For the treatment of symptoms of mild
to moderate depression including
dejected mood, mood lability, anxiety,
inner restlessness, states of tension,
and difficulty in falling asleep and
sleeping through the night which is
associated with these conditions.
Treatment is recommended for up to
12 weeks
For the treatment of symptoms of mild to moderate
depression including dejected mood, mood lability,
anxiety, inner restlessness, states of tension, and
difficulty in falling asleep and sleeping through the
night which is associated with these conditions. A
minimum length of therapy of 4-6 weeks is
recommended. Treatment is recommended for up to
12 weeks. Longer treatment duration should only take
place after the prescriber has performed an individual
risk/benefit analysis for the patient
CONTRA-
INDICATIONS
Known hypersensitivity to products
based on St. John's wort or to one of
the excipients contained in Remotiv.
Known photohypersensitivity.
Concurrent use of
immunosuppressants )systemic),
medicines for HIV and
chemotherapeutic drugs )see Drug
Interactions),
Known hypersensitivity to products based on St. John's
wort or to one of the excipients contained in Remotiv.
Known photohypersensitivity.
Remotiv must not be taken concomitantly with the
following medicinal products:
- certain immunosuppressants )e.g. cyclosporine,
tacrolimus or sirolimus)
- anti-retroviral HIV-drugs from the group of non-
nucleoside reverse transcriptase inhibitors )e.g.
nevirapine) and proteinase inhibitors )e.g. indinavir)
- certain cytostatics )e.g. imatinib, irinotecan)
- oral anti-coagulants of the coumarin type
)see Drug Interactions).
Concurrent use of immunosuppressants )systemic),
medicines for HIV and chemotherapeutic drugs )see
Drug Interactions).
SPECIAL
WARNINGS AND
PRECAUTIONS
FOR USE
Although extracts of St. John's wort
have been used for many years
without evidence of an adverse effect
on the liver or kidney, there are no
controlled clinical studies available in
patients with impaired hepatic or renal
function. Therefore, in such patients
Remotiv should be used with caution
and under medical supervision.
In patients concurrently taking other
drugs, especially drugs with a narrow
therapeutic window, extracts of St.
John’s wort should be taken only after
careful consideration due to the
possibility of potential drug interactions
)see Drug Interactions). Plasma levels
and/or the effect of the interactive drug
should be monitored closely at the
beginning of Remotiv therapy, when
any change in dosage occurs and after
Remotiv therapy is discontinued.
Very rarely, and mainly in fair-skinned
individuals, skin reactions such as
redness resembling sunburn may
occur after the ingestion of high doses
of St. John's wort preparations
Although extracts of St. John's wort have been
used for many years without evidence of an
adverse effect on the liver or kidney, there are
no controlled clinical studies available in
patients with impaired hepatic or renal function.
Therefore, in such patients Remotiv should be
used with caution and under medical
supervision.
In patients concurrently taking other drugs,
especially drugs with a narrow therapeutic
window, extracts of St. John’s wort should be
taken only after careful consideration due to the
possibility of potential drug interactions )see
Drug Interactions). Plasma levels and/or the
effect of the interactive drug should be
monitored closely at the beginning of Remotiv
therapy, when any change in dosage occurs
and after Remotiv therapy is discontinued.
Very rarely, and mainly in fair-skinned
individuals, skin reactions such as redness
resembling sunburn may occur after the
ingestion of high doses of St. John's wort
preparations following exposure to sunlight. If
such symptoms appear, the treatment should
be stopped.
Very rarely and especially in fair-skinned persons,
following exposure to sunlight. If such
symptoms appear, the treatment
should be stopped.
It has been demonstrated that Remotiv
does not affect driving ability or ability
to use machinery safely. However, in
isolated patients the underlying mood
disorder or the medicine’s side effects
may adversely affect the patient’s
ability to drive or use machinery and
these patients should be cautioned.
unwanted reactions of the skin )sunburn- like redness)
or eyes may occur after ingestion of St. John’s wort
preparations and subsequent exposure to sun light. If
such symptoms occur, the treatment must be
discontinued. During treatment with Remotiv, the skin
and eyes should therefore be protected from extensive
sun exposure
It has been demonstrated that Remotiv does not affect
driving ability or ability to use machinery safely.
However, in isolated patients the underlying mood
disorder or the medicine’s side effects may adversely
affect the patient’s ability to drive or use machinery and
these patients should be cautioned.
DRUG
INTERACTIONS
Current data indicates that St. John's
wort preparations may induce hepatic
cytochrome P450 enzymes,
specifically CYP3A4, and transport
proteins, specifically P-glycoprotein.
This can result in drug interactions.
Specifically, starting therapy with a St.
John's wort preparation can lead to a
reduction in plasma levels of a
concomitant medicine, and,
conversely, stopping therapy with a St.
John's wort preparation can lead to an
increase in plasma levels of a
concomitant medicine.
Hyperforin )one of the constituents in
St John’s wort) has been
demonstrated to be responsible for
many of the observed drug
interactions. Therefore, due to its low
hyperforin content, Remotiv may have
less potential for drug interactions than
other St. John’s wort preparations.
Cyclosporin and Tacrolimus and
Sirolimus)
Published reports have shown that
transplant patients taking preparations
of St. John's wort can develop sub-
therapeutic levels of cyclosporin.
Although not reported specifically with
Remotiv, concurrent use of cyclosporin
and Remotiv should be avoided.
Remotiv should also be avoided with
systemic tacrolimus and sirolimus.
Indinavir and Nevirapine
Although not reported specifically with
Remotiv, other preparations of St
John’s wort have been documented to
cause a significant reduction in the
plasma levels of indinavir. Concurrent
use of Remotiv and indinavir or other
protease inhibitors should be avoided.
Remotiv should also be avoided with
nevirapine and other non-nucleoside
reverse transcriptase inhibitors.
Irinotecan/Imatinib
Although not reported specifically with
Current data indicates that St. John's wort preparations
may induce hepatic cytochrome P450 enzymes,
specifically CYP3A4, and transport proteins,
specifically P-glycoprotein. This can result in drug
interactions. Specifically, starting therapy with a St.
John's wort preparation can lead to a reduction in
plasma levels of a concomitant medicine, and,
conversely, stopping therapy with a St. John's wort
preparation can lead to an increase in plasma levels of
a concomitant medicine.
In case of an accidental intake of St. John’s wort
preparations together with interactively acting
substances, the St. John’s wort preparation should,
generally, be discontinued gradually.
Hyperforin )one of the constituents in St John’s wort)
has been demonstrated to be responsible for many of
the observed drug interactions. Therefore, due to its
low hyperforin content, Remotiv may have less
potential for drug interactions than other St. John’s
wort preparations.
Immunosuppressants (Cyclosporin and Tacrolimus
and Sirolimus)
Published reports have shown that transplant patients
taking preparations of St. John's wort can develop sub-
therapeutic levels of cyclosporin. Although not reported
specifically with Remotiv, concurrent use of cyclosporin
and Remotiv should be avoided.
Remotiv should also be avoided with systemic
tacrolimus and sirolimus.
Patients with a suppressed immune system from
cyclosporine, tacrolimus or sirolimus must not be
treated with St. John’s wort at the same time. St.
John’s wort leads to a rapid and marked decrease in
plasma levels and loss of the immunosuppressive
effect with potentially severe consequences )transplant
rejection)
Anti-retroviral HIV-drugs from the group of non-
nucleoside reverse transcriptase inhibitors (e.g.
nevirapine) and proteinase inhibitors (e.g.
indinavir) Indinavir and Nevirapine
Although not reported specifically with Remotiv, other
preparations of St John’s wort have been documented
to cause a significant reduction in the plasma levels of
indinavir. Concurrent use of Remotiv and indinavir or
other protease inhibitors should be avoided. Remotiv
should also be avoided with nevirapine and other non-
nucleoside reverse transcriptase inhibitors.
Remotiv, other preparations of St
John’s wort have been documented to
cause a significant reduction in the
plasma levels of irinotecan and
imatinib. Concurrent use of Remotiv
and irinotecan or imatinib should be
avoided. Interactions with other
chemotherapy agents metabolized by
CYP enzymes or P-glycoprotein are
possible and should be avoided.
Coumarin derivative anticoagulants
Exercise caution during the
concomitant administration of Remotiv
with coumarin derivative
anticoagulants )eg warfarin), since
Remotiv may lead to a reduced
anticoagulant effect and a decrease in
the INR. During concurrent therapy,
the Quick value or the INR value
should be closely checked, especially
at the start of therapy and again after
discontinuation of treatment with
Remotiv.
Selective serotonin re-uptake
inhibitors
Simultaneous use of St John’s wort
and other anti-depressants such as
selective serotonin re-uptake inhibitors
may lead to excessive serotonin
stimulation and possible toxicity
)serotonin syndrome) Concomitant use
is not recommended and a sufficient
washout period in-between Remotiv
and other anti-depressants should be
allowed in order to avoid serotonin
syndrome. Similar precautions should
be exercised for other serotonergic
drugs such as buspirone. Selective
serotonin 5-HT1 agonists used to treat
migraine may theoretically also cause
serotonin syndrome in concomitant
use. however no such interaction has
ever been reported between these
drugs and St John’s wort preparations.
Methadone
Other preparations of St. John’s wort
)not Remotiv) have been documented
to cause a significant reduction in the
plasma levels of methadone. Although
such an interaction with Remotiv is not
likely )due to Remotiv's low hyperforin
content), such a drug interaction study
has not been performed.
Digoxin
Prescribers should be aware that St.
John’s wort preparations may interact
with digoxin. Apparently due to
Remotiv’s low hyperforin content, there
When treated with non-nucleoside reverse
transcriptase inhibitors )e.g. nevirapine) and proteinase
inhibitors )e.g. indinavir), the intake of St. John’s wort
preparations is contra-indicated since St. John's wort
can lead to a decrease in plasma levels.
Cytostatics (Irinotecan/Imatinib)
Although not reported specifically with Remotiv, other
preparations of St John’s wort have been documented
to cause a significant reduction in the plasma levels of
irinotecan and imatinib. Concurrent use of Remotiv
and irinotecan or imatinib should be avoided. During
treatment with irinotecan and imatinib, Remotiv is
contraindicated. Interactions with other chemotherapy
agents metabolized by CYP enzymes or P-glycoprotein
are possible and should be avoided.
Coumarin derivative anticoagulants Anticoagulants
of the coumarin type (e.g. warfarin acenocoumarol,
phenprocoumon)
Exercise caution during the concomitant administration
of Remotiv with coumarin derivative anticoagulants )eg
warfarin), since Remotiv may lead to a reduced
anticoagulant effect and a decrease in the INR. During
concurrent therapy, the Quick value or the INR value
should be closely checked, especially at the start of
therapy and again after discontinuation of treatment
with Remotiv.
Patients taking oral anticoagulants must not be treated
with St. John’s wort, since it influences their
coagulation inhibiting effect )and increases the risk of
thromboembolism).
Antidepressives and other serotonergic
substances (such as buspirone, amitriptyline,
nortriptyline, citalopram, escitalopram, fluoxetine,
paroxetine, sertraline, and others)Selective
serotonin re-uptake inhibitors
Simultaneous use of St John’s wort and other anti-
depressants such as selective serotonin re-uptake
inhibitors )SSRIs) may lead to excessive serotonin
stimulation and possible toxicity )serotonin syndrome)
with autonomic dysfunction )such as perspiration,
tachycardia, diarrhoea, fever), mental alterations )such
as agitation, disorientation), and motor alterations
)such as tremor, myoclonias). Concomitant use is not
generally recommended and a sufficient washout
period in-between Remotiv and other anti-depressants
should be allowed in order to avoid serotonin
syndrome. Similar precautions should be exercised for
other serotonergic drugs such as buspirone. Selective
serotonin 5-HT1 agonists used to treat migraine may
theoretically also cause serotonin syndrome in
concomitant use. however no such interaction has ever
been reported between these drugs and St John’s wort
preparations.
Should the prescriber nevertheless decide to
concomitantly prescribe Remotiv with an SSRI/SNRI or
other serotonergic drug after a careful individual
risk/benefit assessment, caution should be exercised
and the patient should be closely monitored.
is no evidence for a pharmacokinetic
interaction between Remotiv and
digoxin. A pharmacokinetic study
showed that Remotiv )250 mg bid) had
no effect on serum levels of digoxin.
Drug interaction studies cannot predict
with 100% certainty the response of an
individual patient.
Oral Contraceptives
Prescribers should be aware that St.
John’s wort preparations may interact
with hormonal contraceptives,
including oral contraceptives. In
Switzerland there have been reports of
irregular vaginal bleeding and
unintended pregnancy in women
concurrently taking preparations
containing St John’s wort )not
Remotiv) and oral contraceptives with
low estrogen content )<30 ug
ethinylestradiol).
Apparently due to Remotiv’s low
hyperforin content, there is no
evidence for a pharmacokinetic
interaction between Remotiv and oral
contraceptives. A pharmacokinetic
study with a combined low-dose oral
contraceptive
)Lovelle=Mercilon=Feminet) showed
that Remotiv )250 mg bid) did not
affect the serum levels of the
estrogenic or progesterone
components of the oral contraceptive,
and did not lead to spotting. Drug
interaction studies cannot predict with
100% certainty the response of an
individual patient.
Benzodiazepines
Other preparations of St. John’s wort
)not Remotiv) have been documented
to cause a significant reduction in the
plasma levels of benzodiazepines that
are metabolized via CYP3A4 such as
alprazolam and midazolam. Although
such an interaction with Remotiv is not
likely )due to Remotiv's low hyperforin
content), such a drug interaction study
has not been performed.
Anticonvulsants
There is also a theoretical possibility of
an interaction between hypericum and
antiepileptics such as carbamazepine,
phenobarbital and phenytoin. Stopping
hypericum may result in increased and
possibly toxic, concentrations of the
interacting drug. However due to the
low concentration of hyperforin in
Remotiv such an interaction is unlikely;
moreover, there have been no reports
Methadone
Other preparations of St. John’s wort )not Remotiv)
have been documented to cause a significant reduction
in the plasma levels of methadone. Although such an
interaction with Remotiv is not likely )due to Remotiv's
low hyperforin content), such a drug interaction study
has not been performed.
Digoxin
Prescribers should be aware that St. John’s wort
preparations may interact with digoxin. Apparently due
to Remotiv’s low hyperforin content, there is no
evidence for a pharmacokinetic interaction between
Remotiv and digoxin. A pharmacokinetic study showed
that Remotiv )250 mg bid) had no effect on serum
levels of digoxin. Drug interaction studies cannot
predict with 100% certainty the response of an
individual patient.
Oral Hormonal Contraceptives
Prescribers should be aware that St. John’s wort
preparations may interact with hormonal
contraceptives, including oral contraceptives. In
Switzerland there have been reports of irregular
vaginal bleeding and unintended pregnancy in women
concurrently taking preparations containing St John’s
wort )not Remotiv) and oral contraceptives with low
estrogen content )<30 ug ethinylestradiol).
St. John’s wort can lead to reduced efficacy of
hormonal contraceptives )e.g. oral products, injected
depot preparations, sub cutaneous implants,
transdermal, intrauterine, and vaginally applied
products with hormone release). Several cases of
interim bleeding with so-called low-dose micro pills
)ethinylestradiol content 30 μg or lower) were reported
internationally. Even individual cases of undesired
pregnancies with hormonal contraceptives and
concomitant intake of St. John’s wort were reported.
Apparently due to Remotiv’s low hyperforin content,
there is no evidence for a pharmacokinetic interaction
between Remotiv and oral contraceptives. A
pharmacokinetic study with a combined low-dose oral
contraceptive )Lovelle=Mercilon=Feminet) showed that
Remotiv )250 mg bid) did not affect the serum levels of
the estrogenic or progesterone components of the oral
contraceptive, and did not lead to spotting. Drug
interaction studies cannot predict with 100% certainty
the response of an individual patient.
Benzodiazepines
Other preparations of St. John’s wort )not Remotiv)
have been documented to cause a significant reduction
in the plasma levels of benzodiazepines that are
metabolized via CYP3A4 such as alprazolam and
midazolam. St. John’s wort should only be given with
caution together with benzodiazepines. Although such
an interaction with Remotiv is not likely )due to
Remotiv's low hyperforin content), such a drug
interaction study has not been performed.
of an interaction between these drugs
and St John’s wort preparations.
Theophylline
Decreased plasma concentrations of
theophylline have been reported in one
case report in concurrent use with
preparations containing St John’s wort.
Some in vitro studies have shown that
St John’s wort induces CYP1A2, which
is responsible for the metabolism of
theophylline; however, other studies
have shown that there is no effect.
Statins
Other preparations of St. John’s wort
)not Remotiv) have been documented
to cause a significant reduction in the
plasma levels or effects of simvastatin
and atorvastatin, but not pravastatin.
Although such an interaction with
Remotiv is not likely )due to Remotiv's
low hyperforin content), such a drug
interaction study has not been
performed.
Agents used for photodiagnostic
procedures or for phototherapy
There is a possibility that concurrent
use of Remotiv with agents used for
photodiagnostic procedures or for
phototherapy, eg porfimer, could lead
to an increased risk of photosensitivity.
General
Surgeons/anesthesiologists should
discuss with patients scheduled for
surgery the need to initiate changes in
dosing and administration of Remotiv
during the peri-operative period.
The amount of active ingredient may
vary widely between different
preparations containing St John’s wort.
Switching from Remotiv to an
alternative St. John’s wort preparation
may therefore alter the degree of
enzyme induction of other drugs taken
concurrently
Anticonvulsants
There is also a theoretical possibility of an interaction
between St. John's wort hypericum and antiepileptics
such as carbamazepine, phenobarbital and phenytoin.
Stopping St. John's wort hypericum abruptly may result
in increased and possibly toxic, concentrations of the
interacting drug. However due to the low
concentration of hyperforin in Remotiv such an
interaction is unlikely; moreover, there have been
no reports of an interaction between these drugs
and St John’s wort preparations.
Steroid hormones
It cannot be excluded that St. John’s wort preparations
also influence the metabolisms of orally or
intravenously applied steroid hormones. St. John’s
wort should only be given with caution together with
steroid hormones
Theophylline
Decreased plasma concentrations of theophylline have
been reported in one case report in concurrent use
with preparations containing St John’s wort. Some in
vitro studies have shown that St John’s wort induces
CYP1A2, which is responsible for the metabolism of
theophylline; however, other studies have shown that
there is no effect.
Statins
Other preparations of St. John’s wort )not Remotiv)
have been documented to cause a significant reduction
in the plasma levels or effects of simvastatin and
atorvastatin, but not pravastatin. Although such an
interaction with Remotiv is not likely )due to Remotiv's
low hyperforin content), such a drug interaction study
has not been performed.
Agents used for photodiagnostic procedures or for
phototherapy
There is a possibility that concurrent use of Remotiv
with agents used for photodiagnostic procedures or for
phototherapy, eg porfimer, could lead to an increased
risk of photosensitivity.
General
Surgeons/anesthesiologists should discuss with
patients scheduled for surgery the need to initiate
changes in dosing and administration of Remotiv
during the peri-operative period.
Remotiv must be discontinued at least 5 days before
any surgery and started again only after consultation of
a physician.
The amount of active ingredient may vary widely
between different preparations containing St John’s
wort. Switching from Remotiv to an alternative St.
John’s wort preparation may therefore alter the degree
of enzyme induction of other drugs taken concurrently.
ADVERSE
EFFECTS
The most common adverse effects are
gastrointestinal disturbances, followed
by headache, sweating, and asthenia .
Dizziness and restlessness may also
The most common adverse effects are gastrointestinal
disturbances )4-6%), followed by headache, sweating,
and asthenia )1-2%). Dizziness )<1%) and
restlessness may also occasionally occur.
occasionally occur.
If redness of the skin appears, therapy
should be discontinued and the
cutaneous symptoms should be
followed-up.
As for other anti-depressants, isolated
cases of mania associated with the
use of St. John’s wort have been
reported.
If redness of the skin appears, therapy should be
discontinued and the cutaneous symptoms should be
followed-up.
As for other anti-depressants, isolated cases of mania
associated with the use of St. John’s wort have been
reported.
DOSAGE AND
ADMINISTRATION
Remotiv 250 mg 1 film-coated
tablet morning and evening.
Remotiv 500 mg 1 film-coated
tablet morning or evening. The
tablets should be swallowed
whole, without chewing, with a little
liquid, preferably during or after a
meal.
The product should be taken for
at least 14 days, since onset of
action may be deferred until then.
A minimum length of therapy of 4-6
weeks is recommended. The
treatment period is up to 12 weeks.
Remotiv may be prescribed for
more than 12 weeks according to
the physician’s assessment of the
benefit-safety profile in long-term
use.
One tablet of Remotiv 250 mg 1 film-coated
tablet morning and evening.
One tablet of Remotiv 500 mg 1 film-coated
tablet morning or evening. The tablets should
be swallowed whole, without chewing, with a
little liquid, preferably during or after a meal.
Remotiv 500 mg tablet is not easily split.
The product should be taken for at least 14
days, since onset of action may be deferred
until then. A minimum length of therapy of 4-6
weeks is recommended. The treatment period
is up to 12 weeks.
Remotiv may be prescribed for more than 12
weeks followingaccording to the physician’s
assessment of the benefit-safety profile in
long-term use.
OVERDOSE
No acute or chronic toxic
manifestations have been reported in
humans but those side effects listed
above could manifest with greater
intensity. In addition, photosensitivity is
also possible. In such a case,
exposure to daylight and other sources
of UV radiation )eg tanning salons)
should be avoided for 1–2 weeks.
No acute or chronic toxic manifestations have been
reported in humans but those side effects listed above
could manifest with greater intensity. In addition,
photosensitivity is also possible. In such a case,
exposure to daylight and other sources of UV radiation
)eg tanning salons) should be avoided for 1 –2 weeks.
In this case skin and eye exposure to sun or other UV
irradiation )e.g. as found in solariums or tanning
salons) should be avoided for about 1-2 weeks.
PRESENTATION
Store below 25
Remotiv 250: Film coated tablets:20,60
Remotiv 500: Film coated tablets:10,30
Protect the film-coated tablets from
light, heat and moisture.
Remotiv 250: Film coated tablets: 20, 60
Remotiv 500: Film coated tablets: 10, 30
Store below 25
C in the original package.
Protect the film-coated tablets from light, heat and
moisture.
עב עב ןכרצל ןול ןכרצל ןול רבמצדב תואירבה דרשמ רושיאל חלשנ(
2012
ןולעב קרפ יחכונ טסקט שדח טסקט יתמ
ןיא שמתשהל ?רישכתב תושיגר העודי םא רישכתב שמתשהל ןיא .ויביכרממ דחאל לטונ ךניה םא רישכתב שמתשהל ןיא ןוסיחה תכרעמ יוכידל תופורת
תופורת ב לופיטל
סדייא
תופורת וא תויפרתומיכ
רתי תושיגר לש הבוגת תחתיפ רבעב םא .תרחא הפורת תליטנמ האצותכ שמשל דחאל תושיגר העודי םא רישכתב שמתשהל ןיא .ויביכרממ תופורת לטונ ךניה םא רישכתב שמתשהל ןיא ןוסיחה תכרעמ יוכידל
,ןירופסולקיצ ןוגכ) )סומילוריס ,סומילורקט
תופורת ףיגנ דגנ
ב לופיטל
סדייא
)ריוונידניא ,ןיפריוונ ןוגכ)
ןוגכ) םינירמוקה תחפשממ השירק תודגונ תופורת )ןירפרוו תויפרתומיכ תופורת וא
ןוגכ) ,ןאקטוניריא ביניטמיא
הבוגת תחתיפ רבעב םא רישכתב שמתשהל ןיא שמשל רתי תושיגר לש
הפורת תליטנמ האצותכ .תרחא עיפשת ךיא לע הפורתה שומישה
הפורתב
וז
לולע
םורגל
תועפותל
יאוול
ןוגכ םא .תרוחרחס
התא
שח
תרוחרחסב
וא
תועפותב תולולעה
עיפשהל
לע
הגיהנה
וא
תלעפה
תונוכמ
םוי םויה ייח ?ךלש ךילע
טוקנל
תוריהז
הגיהנב
תלעפהב ,בכרב תונוכמ
תונכוסמ
לכבו
תוליעפ
תבייחמה
.תונרע תורהזא הפוקתל וז הפורתב שמתשהל ןיא .אפורב ץעוויהל ילבמ תכשוממ הפורתל וא והשלכ ןוזמל שיגר ךניה םא ינפל אפורל ךכ-לע עידוהל ךילע ,יהשלכ .הפורתה תליטנ לופיט וא ןוחבא רובעל דמוע ךניה םא ךניה םא וא ,)רוא תועצמאב) ימנידוטופ אפורל עידוהל שי ,חותינ רובעל דמוע ת/לטונ ךניהש םידרמל וא/ו לפטמה .וז הפורת ביטומר תוילבט
םא .זוטקל תוליכמ אפורה תא עדיל שי זוטקלל שיגר ךניה .וז הפורת תליטנ ינפל ילבמ תכשוממ הפוקתל וז הפורתב שמתשהל ןיא .אפורב ץעוויהל ,יהשלכ הפורתל וא והשלכ ןוזמל שיגר ךניה םא .הפורתה תליטנ ינפל אפורל ךכ-לע עידוהל ךילע ימנידוטופ לופיט וא ןוחבא רובעל דמוע ךניה םא ,חותינ רובעל דמוע ךניה םא וא ,)רוא תועצמאב) ךניהש םידרמל וא/ו לפטמה אפורל עידוהל שי .וז הפורת ת/לטונ רועה לע ןגהל שי ,ביטומרב לופיטה ךלהמב דחוימב ,תורידנ םיתיעל .שמשל הפישחמ םייניעהו יאוול תועפות ונכתי ,ריהב רוע ילעב םישנאב )שמש תיווכל המודה םדוא) רועב וא םייניעב -הז הרקמב .שמשל הפישחו ביטומר תליטנ רחאל שמשל הפישחמ ענמיהלו לופיטה תא קיספהל שי .םייעובשכ ביטומר תוילבט
שיגר ךניה םא .זוטקל תוליכמ .וז הפורת תליטנ ינפל אפורה תא עדיל שי זוטקלל ןיב תובוגת תויתפורת ללוכ תופסונ תופורת לטונ ךניה םא יפסותו םשרמ אלל תורכמנה תופורת לופיט התע הז תרמג םא וא הנוזת תרחא הפורתב
אפורל חוודל ךילע יא וא םינוכיס עונמל ידכ לפטמה
תוליעי דחוימב ,תויתפורת-ןיב תובוגתמ םיעבונה תולולג :תואבה תוצובקהמ תופורת יבגל ןוירה תעינמל
ןיסקוגיד
תא לטונ ךניה םא ביטומר לוטיל ןיא םד תשירק דגנ תופורת :תואבה תופורתה ןוגכ) ןואכיד דגנ תופורת ,)ןירפרוו ןוגכ) -ה תחפשממ תופורת
SSRI
,ןירופסולקיצ ,) ,סומילוריס ,)ףרגורפ) סומילורקט -ל תופורת ,ביניטמיא ,ןאקטוניריא
תויפרתומיכ תופורת וא/ו סדייא
תופורת ללוכ תופסונ תופורת לטונ ךניה םא תרמג םא וא הנוזת יפסותו םשרמ אלל תורכמנה תרחא הפורתב לופיט התע הז
אפורל חוודל ךילע יא וא םינוכיס עונמל ידכ לפטמה
םיעבונה תוליעי תופורת יבגל דחוימב ,תויתפורת-ןיב תובוגתמ :תואבה תוצובקהמ ןוגכ) ןואכיד דגנ תופורת ו ןוריפסוב מ תופורת לש םינררב םיבכעמ תצובק ןינוטורס לש תרזוח הגיפס
SSRIs
העינמ יעצמא ןוגכ) םיילאנומרוה
ןוירה תעינמל תולולג
תוקבדמ םיימחר-ךות םינקתה ,תוירוע
ןיסקוגיד ,
תופורת ראשה ןיב תושמשמה) םיניפזאידוזנבה תחפשממ תדרוהל תופורת ,ןודתמ ,)הניש ,העגרהל ,ןיטטסבמיס ןוגכ) םיניטטסה תחפשממ לורטסלוכ ,היספליפאב לופיטל תופורת ,)ןיטטסברוטא תחפשממ הנרגימב לופיטל תופורת .םידיאורטס םינומרוה ,םיגרנינוטורסה תופורתה תא לטונ ךניה םא ביטומר לוטיל ןיא םד תשירק דגנ תופורת :תואבה תחפשממ םינירמוקה ,)ןירפרוו ןוגכ) ןוגכ) ןואכיד דגנ תופורת -ה תחפשממ תופורת
SSRI
,ןירופסולקיצ סומילורקט )ףרגורפ) ,סומילוריס , ,ןאקטוניריא ביניטמיא -ל תופורת ,
תופורת וא/ו סדייא / תויפרתומיכ ,ןוגכ) ביניטמיא ,ןאקטוניריא
האר ףיעס
רישכתב שמתשהל ןיא יתמ
יאוול תועפות ןמזב ,הפורתה לש היוצרה תוליעפל ףסונב יאוול תועפות עיפוהל תולולע הב שומישה ,העזה ,שאר באכ ,ןטב באכ ,החירפ :ןוגכ השלוח
.הפב שבוי ,תרוחרחס ןהש וא תופלוח ןניא יאוולה תועפות םא .אפורה םע ץעייתהל שי ,תודירטמ ןמזב ,הפורתה לש היוצרה תוליעפל ףסונב :ןוגכ יאוול תועפות עיפוהל תולולע הב שומישה השלוח ,העזה ,שאר באכ ,ןטב באכ ,החירפ
טקש-יא
.הפב שבוי ,תרוחרחס ,תודירטמ ןהש וא תופלוח ןניא יאוולה תועפות םא .אפורה םע ץעייתהל שי תועפות תובייחמה תוסחייתה תדחוימ עיפוהב
photosensitivity
תושיגר
רועה )שמש תיווכ ומכ) שמשל
קספה :)רידנ) !דימ אפורל הנפו לופיטה תא
יאוול תועפות שיגרמ ךניה ובש הרקמ לכב יוניש לח םא וא ,הז ןולעב וניוצ אלש םע ץעייתהל ךילע ,תיללכה ךתשגרהב !דימ אפורה עיפוהב ,רועב םדוא תושיגר םייניעה שמשל רועהו )שמש תיווכ ומכ)
photosensitivity
תושיגר
רועה שמשל )שמש תיווכ ומכ)
תא קספה :)רידנ) !דימ אפורל הנפו לופיטה
.)תורהזא םג האר) אלש יאוול תועפות שיגרמ ךניה ובש הרקמ לכב ,תיללכה ךתשגרהב יוניש לח םא וא ,הז ןולעב וניוצ !דימ אפורה םע ץעייתהל ךילע ןונימ .דבלב אפורה תוארוה יפל ןונימ .תצלמומה הנמה לע רובעל ןיא .דבלב אפורה תוארוה יפל ןונימ .תצלמומה הנמה לע רובעל ןיא
ליגמ שומישל תרשואמ וז הפורת
.הלעמו ללכ ךרדב תדעוימ הניא וז הפורת ליגל תחתמ םידלילו תוקוניתל
הפורתה תעפשה תליחתש תופצל שי ךות לחת
.םוי םיבוצק םינמזב וז הפורתב שמתשהל שי .לפטמה אפורה י"ע עבקנש יפכ :אפורהמ תרחא הארוה רדעהב ןונימ ביטומר
םויב םיימעפ תחא הילבט : .)ברעו רקוב) ביטומר
םויב םעפ תחא הילבט : .)ברעב וא רקובב) ליגמ שומישל תרשואמ וז הפורת
.הלעמו תוקוניתל ללכ ךרדב תדעוימ הניא וז הפורת ליגל תחתמ םידלילו
ש תופצל שי תליחת
ךות לחת הפורתה תעפשה
.םוי יפכ םיבוצק םינמזב וז הפורתב שמתשהל שי .לפטמה אפורה י"ע עבקנש :אפורהמ תרחא הארוה רדעהב ןונימ ביטומר
רקוב) םויב םיימעפ תחא הילבט : .)ברעו ביטומר
וא רקובב) םויב םעפ תחא הילבט : .)ברעב