The period of pregnancy is characterized by the limitation of a wide range of medications due to the sensitivity of the female body to the drugs taken. In gynecological practice, the prescription of drugs is carried out with an assessment of the possible risks and benefits for the mother and child. "Curantil" is one of the medicines used to treat pathologies of pregnant women. The medication is used to improve the rheological properties of blood, microcirculation in the placental tissue and normalize hemodynamics in the uterine vessels.
For what and why is "Curantil" used during pregnancy?
"Curantil" is a representative of the class of antiplatelet agents - drugs that prevent platelets from sticking together and the formation of blood clots.
The mechanism of action and the main therapeutic effects of "Curantil" are presented in the table:
| Pharmacodynamic effects | Clinical significance |
|---|---|
| Increased synthesis of prostaglandin-1 |
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| Suppression of phosphodiesterase activity in platelets (accumulation of cAMP inside the cell) |
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| Normalization of the ratio of the concentrations of prostacyclin and thromboxane A2 |
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| Increased synthesis of nitric oxide (NO) |
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| Stimulation of cAMP formation by adenosine | Replenishment of the body's energy reserves |
Additional properties of "Kurantila":
- stimulation of angiogenesis and erythropoiesis (synthesis of new vessels and erythrocytes);
- increased density of the walls of the arteries in the placenta;
- improving the elasticity of the erythrocyte membrane (allows you to penetrate through the lumen of thin capillaries);
- stimulation of the secretion of interferon (a means of nonspecific immunity against viral infection);
- prevention of dystrophic changes in the placenta.
Placental insufficiency (FPI) is one of the main problems in obstetrics and perinatology, which leads to malnutrition, chronic hypoxia and intrauterine fetal death.
The mechanism of development of pathology is associated with a violation of the trophic, hormone-synthesizing and metabolic function of the placenta. Lack of blood circulation between the organisms of the mother and the child is the reason that the fetus dies (freezes) or stops development.
Pathogenetic links of FPN:
- lack of prostacyclins and nitric oxide leads to severe vasospasm;
- foci of placental ischemia develop due to impaired blood flow in spasmodic arteries;
- poikilocytosis and anemia (an insufficient amount of hemoglobin and an altered form of red blood cells) reduce the delivery of oxygen to the tissues of the placenta and the baby.
Chronic hypoxia, intrauterine growth retardation (IUGR), placental and amnion dysfunction (oligohydramnios), preeclampsia are pathological conditions in obstetrics caused by hemodynamic disturbances.
"Curantil" is a blood thinner, improves gas exchange between the mother and fetus, restores damaged erythrocyte cell walls. The spectrum of therapeutic effects determines the widespread use of the drug in obstetric and gynecological practice.
Instructions for use
Curantil is a medication prescribed by cardiologists, therapists, vascular surgeons and obstetricians.
Indications for use of the drug during pregnancy:
- mild preeclampsia;
- chronic fetal hypoxia;
- lack of water;
- prevention of hyperaggregation in patients with prosthetic valves, atrial fibrillation;
- FPN;
- ZVUR;
- premature maturation of the placenta;
- peripheral vascular disease in pregnant women with a risk of thromboembolic complications;
- frequent respiratory viral infections during pregnancy;
- prevention of miscarriage in patients at risk (when planning).
"Curantil" has no embryotoxic effect, therefore it is considered a safe remedy in any trimester of pregnancy.
The bioavailability of the drug is 35-65%. "Curantil" is rapidly absorbed in the stomach, binding to albumin by 95%. Peak concentration is reached 1 hour after oral administration.
The drug is transformed by the liver cells with the participation of glucuronic acid into an inactive substance (monoglucuronide) and is excreted into the intestinal lumen with bile.
Restrictions on taking the drug are due to the risk of bleeding, hemodynamic destabilization and metabolic disorders. Contraindications to the use of "Curantil":
- intolerance to the components of the drug;
- acute forms of coronary heart disease (myocardial infarction, unstable angina pectoris);
- subvalvular aortic stenosis;
- decompensated circulatory failure;
- arterial hypotension (low blood pressure);
- rhythm disturbances (ventricular tachycardia, high-grade extrasystoles);
- genetic and acquired hemorrhagic diathesis (hemophilia, Schönlein-Henoch vasculitis);
- ulcerative lesions of the digestive tract (Crohn's disease, nonspecific colitis);
- renal and hepatic impairment;
- bronchial asthma.
Long-term use of the drug, exceeding the therapeutic dose is accompanied by the development of side effects. The most common groups of adverse reactions from taking "Curantil" are presented in the table.
| Pathogenesis | Clinical manifestations |
|---|---|
| Lowering blood pressure |
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| Allergic reactions |
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| Antiplatelet action |
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In case of an overdose, a sharp drop in pressure, pain in the region of the heart, tachycardia, a feeling of warmth throughout the body, general weakness and dizziness develops.
Algorithm of actions in case of poisoning with "Curantil":
- gastric lavage (at home - try to induce vomiting);
- reception of sorbents ("Activated carbon", "Sorbeks");
- call an ambulance.
In a hospital setting, means are used to increase vascular tone, correct the volume of circulating fluid and the number of platelets.
How to drink correctly: doses and rules of admission?
"Curantil" is a drug that requires dynamic control of its use. Basic recommendations for taking the drug:
- the tablets must be swallowed (without chewing) and washed down with plenty of liquid;
- an hour before the appointment, it is recommended to drink a glass of clean water - to prevent stealing syndrome;
- drinking coffee or strong tea while taking "Curantil" reduces the effectiveness of the drug;
- regular use of the product at the same time of day (agreed with the doctor).
The dosage of "Curantil" during pregnancy for the treatment of various pathologies is presented in the table.
| Disease | Reception mode |
|---|---|
| Placental insufficiency | 25-50 mg 3 times a day one hour before meals |
| ZVUR | 25 mg 3 times a day |
| Preeclampsia | 50 mg 3 times a day |
| Recurrent viral infections | 100 mg once a week. The duration of the course is 2 months. |
For pregnant women with signs of thrombophilia (increased coagulation), blood flow disorders of an infectious genesis, an increase in the daily dose to 450-600 mg is allowed, or a combination of "Curantil" with other anticoagulant (antiplatelet) agents.
Efficiency and safety control is carried out using:
- coagulograms (laboratory analysis of blood clotting);
- fetal condition: assessment of perturbations, cardiotocography (CTG), biophysical profile (BPP);
- dopplerometry of blood flow in placental vessels.
How long to use and how long to start?
The drug "Curantil" has a cumulative effect, so the average duration of the course is at least 28 days from the moment of diagnosis.
Treatment regimen for pathologies of pregnancy:
- FPN - 8 weeks, followed by a break (1 month) to assess the effectiveness and condition of the fetus.
- Preeclampsia - 2 weeks -2 months. The duration of the course is determined by the severity of the pathology, gestational age and individual sensitivity to the drug.
- ZVUR - courses for 2-4 weeks with BPP control every 7-10 days.
Analogues of the drug: what can replace "Curantil"?
The original drug is produced by the German pharmaceutical company Berlin-Chemie. The average cost of a pack of 100 tablets is 500-800 rubles. In Russia, generics are in great demand - cheaper products with a similar chemical composition.
Analogues of "Kurantila":
- "Dipyridamole" at a dosage of 25 and 75 mg (Russia);
- Drysetin-Sanovel 75 mg (Turkey);
- "Parsedil";
- "Persantin" (Spain) - ampoules for intravenous administration;
- Sanomil-Sanovel (Turkey).
Pregnant women are forbidden to independently replace the drug with a generic one without first consulting a gynecologist.
Conclusions
Protocols of complex therapy of obstetric pathologies recommend "Curantil" during pregnancy to normalize placental blood flow. The drug allows you to influence the initial links of the blood coagulation system, improves hemodynamics between the body of the mother and the child. The agent penetrates the hematoplacental barrier without embryotoxic effect on the fetus. Self-medication with Curantil during pregnancy is strictly prohibited due to the risk of undesirable consequences for the mother and child (for example, a drop in systemic pressure or massive bleeding). Before using "Curantil", you must read the instructions.
