Omnadren 250 jelfa receptors modulate . Omnadren 250 jelfa sphingosine kinase is metabolized to the active metabolite Omnadren 250 jelfafosfata.At nanomolar concentrations Omnadren 250 jelfafosfat binds to receptors SlP-1, 3, and 4 on the surface of lymphocytes and types rapidly penetrates into the central nervous system (CNS) through the blood-brain barrier, binding to receptors SlP-1, 3, and 5 on the surface of neuronal types. Binding to SlP-lymphocyte receptors, blocks the ability of lymphocytes Omnadren 250 jelfafosfat leave the lymph nodes, which leads to a redistribution of lymphocytes in the body. Thus there is no reduction of the total number of lymphocytes in the body.
Redistribution of lymphocytes leads to a decrease lymphocytic infiltration of the central nervous system, reduce the severity of inflammation and the degree of nerve tissue damage.However, about 15-20% of T lymphocytes which are effector memory cells and plays an important role in peripheral immune surveillance, do not pass through lymphoid organs and are not affected by Omnadren 250 jelfa.
Within a few days after stopping the drug in the blood marked increase in the number of lymphocytes. Normalization of the number of lymphocytes occurs in 1-2 months following cessation of treatment.Constant reception Omnadren 250 jelfa results in a slight decrease in neutrophil count to approximately 80% from baseline. Monocytes are not affected by Omnadren 250 jelfa.
When applied in patients with relapsing-remitting multiple sclerosis (average score on a scale of disability, EDSS, 2.0) Omnadren 250 jelfa 0.5 mg reduced the frequency of clinical exacerbations of the disease by 54%. Before the drug was observed in 70% of stable remission for 2 years (compared to 45.6% in the placebo group). Omnadren 250 jelfa significantly reduced the risk of disability progression. In applying the drug significantly increased the time before the 3-month and 6-month period of confirmed disability progression (assessed as an increase on the EDSS scale assessment from baseline) compared to placebo. The results of magnetic resonance imaging (MRI) of patients with relapsing-remitting multiple sclerosis brain during treatment with Omnadren 250 jelfa confirm a significant reduction in disease activity flow (intensity of the inflammatory process in the central nervous system, the size and number of foci of demyelination).
pharmacologically active metabolite is (S) -enantiomer Omnadren 250 jelfafosfata.
When taken orally absorbed? 85% of the dose. Omnadren 250 jelfa absorption is slow (the time to reach maximum plasma concentration, t max 12-16 hours).
The absolute oral bioavailability is 93%. Equilibrium concentration in the blood plasma is reached within 1-2 months of regular treatment (1 per day). The equilibrium concentration of Omnadren 250 jelfa is about 10 times higher than the concentration after the first dose. After multiple dose 0.5 mg 1 time per day and the concentration of Omnadren 250 jelfa Omnadren 250 jelfafosfata increased, probably proportional to dose.
Food does not affect the maximum concentration (C max ) and exposure (AUC is the area under the curve “concentration-time”) or Omnadren 250 jelfa Omnadren 250 jelfafosfata.
Omnadren 250 jelfa considerably distributed in erythrocytes (Omnadren 250 jelfa blood cells fraction 86%). Omnadren 250 jelfafosfat has less ability to penetrate the blood cells (blood cells fraction <17%). Omnadren 250 jelfa and Omnadren 250 jelfafosfat highly bound to plasma protein (> 99%). Contact Omnadren 250 jelfa and Omnadren 250 jelfafosfata to plasma proteins is not changed in patients with impaired renal or hepatic function.
Omnadren 250 jelfa largely distributed in the body tissues (volume of distribution of about 1200 ± 260 L). Omnadren 250 jelfa penetrates into the brain, which was shown in a clinical study in healthy volunteers. In a study in 13 volunteers remitting multiple sclerosis who have received the drug at equilibrium Gielen ® in a dose of 0.5 mg, the amount Omnadren 250 jelfa (or Omnadren 250 jelfafosfata) appeared in the semen of 10,000 times lower than the initial dose (0.5 mg).
In humans Omnadren 250 jelfa biotransformation occurs due to a reversible phosphorylation stereoselective pharmacologically active (S) -enantiomer Omnadren 250 jelfafosfata and oxidative biotransformation due mainly CYP4F2 isoenzyme and possibly other isoenzymes CYP4F, with subsequent degradation of fatty acids is similar to the inactive metabolite, and the formation of pharmacologically inactive non-polar analogs Omnadren 250 jelfatseramida.
After a single oral administration in plasma were detected (within about 1 month) unmodified Omnadren 250 jelfa (23.3%), Omnadren 250 jelfafosfat (10.3%), inactive metabolites (M3 – acidic carboxyl metabolite (8.3%), conjugates of metabolites in ceramide M29 (8.9%) and MLO (7.3%)).
Plasma clearance of Omnadren 250 jelfa 6.3 ± 2.3 L / h, the average apparent half-life (T1 / 2) – 6-9 days. Reduced concentrations and Omnadren 250 jelfa Omnadren 250 jelfafosfata plasma occurs in the terminal stage in parallel, which leads to a similar half-life.
After oral administration, about 81% of the dose excreted in the urine as inactive metabolites. Unchanged Omnadren 250 jelfafosfat Omnadren 250 jelfa and not excreted in the urine, but are the main compounds in the stool (the amount of each <2.5% of the dose). Within 1 month displayed about 89% of the drug dose.
Pharmacokinetics in special cases
Gender and ethnicity have no effect on the pharmacokinetics of Omnadren 250 jelfa and Omnadren 250 jelfafosfata.
Severe renal dysfunction leads to an increase in C max and AUC Omnadren 250 jelfa at 32% and 34%, 25% and 14% -Omnadren 250 jelfafosfata.
Use of the drug in patients with mild, moderate and severe hepatic impairment (> 9 points on the Child-Pugh classification) leads to an increase in Omnadren 250 jelfa AUC by 12%, 44% and 103%, respectively. In patients with mild hepatic impairment the half-life remains unchanged, with moderate to severe impairment -uvelichivaetsya at 49-50%. In patients with hepatic impairment, severe (class C Child-Pugh classification) the C max Omnadren 250 jelfafosfata decreased by 22%, a AUC increased by 38%. In patients with hepatic impairment, mild to moderate severity function Omnadren 250 jelfafosfata pharmacokinetics has not been evaluated. Elimination mechanism Omnadren 250 jelfa and population pharmacokinetic study results suggest that the correct dose of the drug in elderly patients is not required. However, clinical experience with Omnadren 250 jelfa in patients aged over 65 years is limited. alphapol