Tonemide
Generic Name
Toneram 20 mg tablet
Manufacturer
Global Pharma Solutions
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tonemide 20 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Tonemide 20 mg Tablet is a benzodiazepine derivative primarily used for the short-term treatment of anxiety disorders, insomnia, and muscle spasms. It acts on the central nervous system to produce a calming effect.
Uses & Indications
Dosage
Adults
Anxiety: 10-20 mg orally, 2-3 times daily. Insomnia: 20 mg orally at bedtime. Muscle spasms: 20 mg orally, 2-3 times daily.
Elderly
Initiate with a lower dose, e.g., 5-10 mg orally, 2-3 times daily, to minimize side effects and reduce risk of over-sedation.
Renal_impairment
Use with caution. Dosage adjustments may be necessary, starting with lower doses.
How to Take
Take the tablet orally with water, with or without food. Do not chew or crush the tablet. Follow your doctor's instructions carefully.
Mechanism of Action
Tonemide enhances the effect of gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain. This results in decreased neuronal excitability and thus exerts anxiolytic, sedative, hypnotic, anticonvulsant, and muscle relaxant properties.
Pharmacokinetics
Onset
30-60 minutes for sedative effects.
Excretion
Excreted mainly through the kidneys as conjugated metabolites.
Half life
Approximately 10-20 hours, varies with individual metabolism.
Absorption
Well absorbed from the gastrointestinal tract, peak plasma concentrations typically achieved within 1-2 hours.
Metabolism
Primarily metabolized in the liver via oxidative pathways (e.g., CYP3A4, CYP2C19) into active and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to toneram or any benzodiazepine
- Severe respiratory insufficiency
- Sleep apnea syndrome
- Severe hepatic impairment
- Myasthenia gravis
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Alcohol and other CNS depressants
Additive CNS depressant effects.
CYP3A4 inducers (e.g., rifampin, carbamazepine)
May decrease toneram plasma concentrations.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase toneram plasma concentrations.
Storage
Store in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children. Store below 30°C.
Overdose
Symptoms of overdose include drowsiness, confusion, impaired coordination, slurred speech, and coma. In severe cases, respiratory depression, hypotension, and shock may occur. Treatment is supportive; maintaining a patent airway, monitoring vital signs, and intravenous fluids. Flumazenil may be considered in specific cases as an antidote, but caution is advised due to risk of withdrawal seizures.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Not recommended during pregnancy, especially during the first trimester and near term due to risk of neonatal withdrawal syndrome. Avoid during lactation as it passes into breast milk and may cause sedation in the infant.
Side Effects
Contraindications
- Hypersensitivity to toneram or any benzodiazepine
- Severe respiratory insufficiency
- Sleep apnea syndrome
- Severe hepatic impairment
- Myasthenia gravis
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Alcohol and other CNS depressants
Additive CNS depressant effects.
CYP3A4 inducers (e.g., rifampin, carbamazepine)
May decrease toneram plasma concentrations.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase toneram plasma concentrations.
Storage
Store in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children. Store below 30°C.
Overdose
Symptoms of overdose include drowsiness, confusion, impaired coordination, slurred speech, and coma. In severe cases, respiratory depression, hypotension, and shock may occur. Treatment is supportive; maintaining a patent airway, monitoring vital signs, and intravenous fluids. Flumazenil may be considered in specific cases as an antidote, but caution is advised due to risk of withdrawal seizures.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Not recommended during pregnancy, especially during the first trimester and near term due to risk of neonatal withdrawal syndrome. Avoid during lactation as it passes into breast milk and may cause sedation in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory authorities (e.g., DGDA, FDA)
Patent Status
Patent expired
Clinical Trials
Clinical trials have demonstrated Tonemide's efficacy and safety in the short-term treatment of anxiety and related conditions. Further trials are ongoing to evaluate its long-term effects and potential new indications.
Lab Monitoring
- Routine lab monitoring is not typically required for short-term use. For long-term therapy or in patients with hepatic/renal impairment, periodic monitoring of liver function tests and renal function tests may be advisable.
Doctor Notes
- Prescribe for the shortest effective duration, usually 2-4 weeks for anxiety or insomnia.
- Counsel patients on the risks of dependence, withdrawal, and concomitant use with opioids/alcohol.
- Gradual tapering of the dose is essential to prevent withdrawal symptoms when discontinuing treatment.
- Assess for history of substance abuse before initiating therapy.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor, as it can lead to withdrawal symptoms.
- Avoid alcohol and other CNS depressants while on this medication.
- This medicine may cause drowsiness or dizziness; avoid driving or operating heavy machinery until you know how it affects you.
- Use for the shortest possible duration to manage symptoms effectively.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine can cause drowsiness, dizziness, and impaired concentration. Do not drive, operate machinery, or engage in activities requiring mental alertness until you know how this medication affects you.
Lifestyle Advice
- Practice stress reduction techniques (e.g., meditation, deep breathing).
- Maintain a regular sleep schedule and create a relaxing bedtime routine.
- Engage in regular physical activity.
- Avoid excessive caffeine intake, especially in the evening.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.