Cytisine is an agonist of the cholinoreceptors in the vegetative ganglia and belongs to the group of the gangliostimulating drugs. Tabex excites the nicotine-sensitive cholinoreceptors of the postsynaptic membranes in the vegetative ganglia, chromaffin cells in the molecular part of the suprarenal gland and sinocarotid reflexogenic zone, which results in excitation of the respiratory center, predominantly through the reflexes, simulation of adrenaline release by the medullar part of the suprarenal glands and a rise in the blood pressure. After its absorption in the gastrointestinal tract, cytisine plays the part of a nicotine-substitute substance which decreases the period of interaction between nicotine and the corresponding receptors. This in turn leads to a gradual decrease and interruption of the smokers' psychic and physical nicotine dependence.
To be Used for
Tabex is a drug of choice of treatment of chronic nicotinism. It is particularly appropriate for treatment of risk groups of smokers with health problems on the part of the cardiovascular and respiratory systems, as well as smokers professionally subjected to tension and stress that are predisposed to seek a "false comfort" in nicotine or other drugs causing dependence.
Dosage and Administration
The drug is administered perorally according to the following schedule:
First 3 days: 1 tablet 6 times daily (every 2 hours) with a parallel reduction of the number of cigarettes smoked. If the result is unsatisfactory, the treatment is discontinued and a new therapy can be resumed after 2-3 months. In case of good effect, the treatment should continue according to the following schedule::
from the 4th to 12th day - 1 tablet every 2,5 hours (5 tablets daily);
from the 13th to 16th day - 1 tablet every 3 hours (4 tablets daily;)
from the 21st to 25th day - 1-2 tablets daily.
Complete discontinuation of smoking must occur by the 5th day of treatment.
Advanced atherosclerosis, some forms of schizophrenia, pheochromocytome, conditions connected with severe impairment of the cardiovascular system and malignant hypertension.
Pregnancy and lactation
The intraovular application of Cytisine substance to hen embryos induced no embriotoxic and teratogenic effect within the limits of the single therapeutic doses. Higher doses of the drug lead to embryotoxic action. On the base of the experimental data obtained, Tabex is recommended (with Cytisine as the basic component) not to be taken by pregnant women, due to the potential risk of embryotoxic action in case of uncontrolled administration. The drug should not be administered during breast feeding.
The high doses may provoke nausea, vomiting, dizziness, tachycardia and muscle weakness. These effects pass quickly after the dose is decreased.
Symptoms of nicotine intoxication are observed in Tabex overdose. The toxic effects are manifested in nausea, vomiting, pupil dilation, tachycardia, general weakness, clonic convulsions, paralysis of respiration. The communications of overdose with the drug are scarce. Lavage of the stomach, monitoring of respiration, arterial pressure and heart rate are initiated as in all cases of overdose. Infusion, reanimation is undertaken with saline and glucose solutions, anticonvulsants, cardiotonics, analeptics, etc. symptomatic agents.
The drug should be administered carefully to patients with exacerbated peptic ulcer. After completing the treatment course, the patients should refrain from smoking even one cigarette, in order to obtain a lasting effect.
The analeptic effect of cytisine decreases during combined therapy with antituberculosis drugs (PASA, streptomycin, etc.).