Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Peripheral vasodilator with predominant effect on venous vessels, antianginal agent. It causes a decrease in the need for myocardium in oxygen due to a decrease in preload (the expansion of peripheral veins and a decrease in the flow of blood to the right atrium) and postnagruzki (a decrease in OPSS), and also has a direct coronary expansive effect. Promotes the redistribution of coronary blood flow in the area with reduced blood supply. Increases exercise tolerance in patients with IHD, angina pectoris. With heart failure helps discharge the myocardium by reducing preload. Reduces pressure in a small circle of blood circulation.
PHARMACOKINETICS
After intake of isosorbide-5-mononitrate quickly and completely absorbed from the digestive tract. Bioavailability is 90-100%. The concentration in the plasma is directly proportional to the dose.
Isosorbide-5-mononitrate is almost completely biotransformed in the liver with the formation of inactive metabolites.
It is excreted by the kidneys mainly in the form of metabolites, 2% - in unchanged form. T 1/2 is 4-5 hours.
INDICATIONS
Preventing attacks of angina pectoris. Chronic heart failure (as part of combination therapy), some forms of pulmonary hypertension and pulmonary heart (as part of combination therapy).
DOSING MODE
Install individually. A single dose of 10-100 mg, depending on the dosage form used. The frequency of admission and duration of treatment depends on the indications and effectiveness of the therapy.
SIDE EFFECT
From the side of the cardiovascular system: at the beginning of treatment - "nitrate" headache (usually disappears in a few days while continuing treatment); possible arterial hypotension, dizziness, tachycardia, weakness; rarely with severe arterial hypotension - increased symptoms of angina (paradoxical effect of nitrates); in some cases - collapse, bradyarrhythmia, syncope.
From the digestive system: rarely - nausea, vomiting.
Dermatological reactions: transient redness of the skin; in some cases - exfoliative dermatitis.
Allergic reactions: cutaneous manifestations.
Other: in some cases, a decrease in the speed of psychomotor reactions.
CONTRAINDICATIONS
Acute circulatory disorders (shock, vascular collapse); cardiogenic shock in cases where high end-diastolic pressure in the left ventricle is not achieved by using intra-aortic counterpulsation or by administering drugs that have a positive inotropic effect; severe arterial hypotension (systolic blood pressure less than 90 mm Hg, diastolic blood pressure less than 60 mm Hg); simultaneous reception sildenafila (inhibitor PDE); hypersensitivity to nitrates.
PREGNANCY AND LACTATION
Application in pregnancy and lactation (breastfeeding) is possible in cases where the expected benefit of therapy for the mother exceeds the potential risk to the fetus or child.
SPECIAL INSTRUCTIONS
Do not use to stop angina attacks. Use with caution with increased intracranial pressure.
Impact on the ability to drive vehicles and manage mechanisms
During the period of treatment, it is not recommended to drive vehicles and engage in other potentially dangerous activities requiring rapid psychomotor reactions.
DRUG INTERACTION
At simultaneous application with adsorbents, astringents and enveloping agents absorption of isosorbide mononitrate decreases.
With simultaneous use with anticholinergic drugs, memory and attention disorders may occur in elderly patients.
With the simultaneous use of vasodilators, calcium channel blockers, tricyclic antidepressants, ethanol, hypotensive effect may increase.
With simultaneous use with antihypertensive drugs, beta-adrenoblockers, neuroleptics, PDE inhibitors, the hypotensive effect may increase.
With simultaneous application with dihydroergotamine, an increase in the concentration and increase in the action of dihydroergotamine is possible.
With the simultaneous use of norepinephrine, the therapeutic effect of norepinephrine decreases.
With simultaneous use with sildenafil there is a risk of severe arterial hypotension and myocardial infarction.
