Description overdue on 01.12.2014
- Latin name: Isoket
- ATC code: C01DA08
- Active substance: Isosorbide dinitrate (Isosorbide dinitrate)
- Manufacturer: JENAHEXAL PHARMA (Germany)
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions for use Izoketa (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Babies
- With alcohol
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
One dose of the spray Izoket (42.25 mg) contains 1.25 mg isosorbide dinitrate . One vial contains 300 doses.
Additional material: ethanol, Macrogol 400 .
1 ml Izoketa as a concentrate for the manufacture of an injectable solution containing 1 mg isosorbide dinitrate .
Additional ingredients: water, sodium chloride, sodium hydroxide, hydrochloric acid .
Product form
Spray Izoket a clear solution without color, with the smell of alcohol. Doses of 300 or 15 ml of the solution darkened glass vial with the dispenser, one such vial in a paper wrapping.
Concentrate Izoket produced in 10 ml ampoule of ten vials in the paper bundle.
Pharmacological action
The drug has antianginal and hypotensive action.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
INN (international non-proprietary name) of the drug - isosorbide dinitrate .
Izoket - peripheral vasodilator Means, which influence on the venous vessels. It activates the synthesis nitric oxide ( relaxing endothelial factor ) In the walls of blood vessels, stimulating intracellular guanylate cyclase That increases cGMP (vasodilatory mediator). It lowers the heart's need for oxygen due to the reduction in preload.
It has koronarorasshiryayuschee effect - reduces the amount of blood coming to the right atrium, lowers blood pressure in the pulmonary circulation, causing regression of the symptoms of pulmonary edema. Redistributes blood flow to the heart tissue with reduced blood circulation. It reduces sensitivity to physical activity in individuals with coronary heart disease . Extends cerebral vessels, that the can provoke headache.
On the drug can develop cross-tolerance, but after discontinuation of the sensitivity Izoketu restored. After spraying, the spray to the mucous membrane of the mouth effect appears after 30 seconds and lasts up to two hours.
Pharmacokinetics
Spray Izoket. The degree of adsorption - high. Bioavailability - 60%. Binding to blood proteins - 31%. The half - one hour.
Concentrate Izoketa after oral absorption from the gut. Maximum concentration in the blood occurs within one hour. When using buccal maximum concentration occurs within 5-6 minutes.
It is metabolized in the liver to isosorbide mononitrate 5 and isosorbide mononitrate-2 . The half-life depends upon the dosage form and may be up to 4 hours. Return with urine and feces.
Indications
- Acute myocardial infarction .
- Relief or prevention stenokardicheskie attacks .
- Condition after myocardial infarction .
Contraindications
- Allergies the drug components.
- Hypotension .
- The acute form of vascular insufficiency .
- Lack glucose-6-phosphate dehydrogenase .
- Cardiogenic shock .
- Angle-closure glaucoma .
- Hyperthyroidism .
- Age less than 18 years.
Be wary of obstructive hypertrophic cardiomyopathy ; cardiac tamponade; mitral or aortic stenosis; orthostatic reactions ; diseases, complicated by increased intracranial pressure; kidney or hepatic insufficiency ; in old age.
Side effects
When you first use or higher doses may develop orthostatic hypotension , Reducing the pressure that may be complicated by an increase in heart rate, confusion, dizziness and weakness.
At the beginning of therapy, sometimes develop headaches, dryness of the mouth and tongue burning.
Rarely appear nausea, vomiting, flushing of the face, fever . allergic reactions , Complicated course angina .
More rarely observed collapse . fainting . exfoliative dermatitis The development of addiction.
Instructions for use Izoketa (method and dosage)
Instructions for use Spray Izoket recommends spraying it on the oral mucosa. The vials were allowed to concentrate Izoketa apply buccal, sublingual, i.v. .
Spray Izoket smoking inhale, it should be sprayed in the oral cavity.
For the treatment or prevention of attack angina , You need to inject a spray into the mouth up to 3 times with an interval of half a minute, holding the breath after each procedure.
With acute myocardial and acute course Heart Failure treatment begins with 1-3 such procedures, controlling blood pressure and heart activity. When absence of changes through 5 minutes possibly repetition Injection under medical supervision.
Concentrate Izoketa for preparation of infusion solution. A single dose can vary between 10-120 mg, the multiplicity of reception from 1 to 5 times a day.
With buccal or sublingual the method of a single dose is 5-10 mg, the multiplicity depends on the evidence and the patient's sensitivity to Izoket.
With Intravenous introduction of dosing of of the drug depends on the clinical paintings and the dosage form.
With nakozhnom of the initial dose of 1 gram at bedtime and, if necessary, and in the morning.
The duration of therapy is determined individually.
Overdose
Symptoms: fainting, dizziness, palpitations, visual disturbances, hyperthermia . congestion, cramps . Sweating . diarrhea . vomiting . methemoglobinemia, bradycardia . paralysis . coma .
Therapy: the methemoglobinemia recommended intravenously administering 1-2 mg / kg of 1% solution methylene blue . Symptomatic therapy.
Cooperation
When using Izoketa:
- from vasodilators, antipsychotics, calcium channel blockers, antihypertensive agents, β-blockers . novokainamidom . quinidine . tricyclic antidepressants may increase the hypotensive action;
- from propranolol . amiodarone . blokatorami calcium channel ( Nifedipine . Verapamil ) Can be amplified antianginal effect;
- from simpatomimetikami and α-blockers may reduce the antianginal effect;
- from Mr. holinoblokatorami It increases the likelihood of increased intracranial pressure.
Terms of sale
Selling is done in the presence of a prescription.
Storage conditions
Store at temperatures up to 25 ° C, keep away from children.
Shelf life
Five years.
Cautions
Not recommended to abruptly stop therapy drug.
In some cases, individual reactions to Izoket can lead to disruption of the ability to control the car.
Analogs
Ernits
Kardiket
Fort sustaka
Nitrosorbid
Nitroglycerine
The most common analogs Izoketa - Izodinit and Kardiket, Retard .
Babies
The age of 18 is a contraindication for the use of the drug.
With alcohol
During treatment Izoketom recommended to exclude the use of alcohol-containing substances.
During pregnancy (and lactation)
It can be used only on strict conditions with the approval of the treating physician.
Reviews
Reviews on Spray Izoket positively characterize the drug, some doctors recommend to constantly keep it to yourself for patients with angina pectoris. Often, however, and the reports of individual resistance.
Price Izoketa where to buy
Price spray Izoket in Russia is 365-325 rubles, and the Ukraine 155-185 hryvnia. Izoket infusion stands in Russia and Ukraine 971-1026 rubles 350-400 hryvnia, respectively.
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