Amiodaron tabs 200mg #30

User manual for Amiodaron

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Composition

One Amiodaron tablet contains 200 mg of Amiodaron hydrochloride and such auxiliary substances as lactose, corn starch, alginic acid, low molecular weight povidone and magnesium stearate.

Form of issue

Amiodaron is available in tablets in blister packs of 10 or in a bank of light-protective glass of 30 pieces. The drug is packed in cardboard packs, which can hold 30 or 60 tablets.
Solution for intravenous administration (recipe in Latin): Rp .: Sol. 300 mg Amiodaroni diluitur Dextrosum 5% - 20 ml.

pharmachologic effect

It has antiarrhythmic, coronavodizodilating and antianginal action.

Pharmacodynamics and pharmacokinetics

Amiodaron is an active substance that can facilitate the work of the heart, without significantly altering the cardiac output and contractility of the cardiac muscle of the myocardium. At the same time, the drug increases coronary blood flow by decreasing resistance in the arteries of the heart, and also reduces heart rate and blood pressure due to peripheral vasodilating effect. This significantly reduces the level of oxygen consumption in myocardium and at the same time increases the energy reserves of the myocardium by increasing the content of creatine phosphate and glycogen.

Indications for use Amiodaron

It is used for treatment, as well as prevention of paroxysmal rhythm disturbances:
    ventricular arrhythmias that threaten life, as well as in patients with Chagas myocarditis;
    ventricular tachycardia;
    prevention of ventricular fibrillation, among other things - after cardioversion;
    flicker paroxysm;
    atrial flutter;
    extrasystole atrial or ventricular;
    arrhythmias that occur against a background of chronic cardiac or coronary insufficiency;
    parasystole;
    angina pectoris.
Indications for the use of Amiodaron are also supraventricular arrhythmias in cases of ineffectiveness or impossibility of using other therapy, which is usually associated with WPW syndrome.

Contraindications

    sinus bradycardia;
    weak sinus node syndrome;
    sinoatrial or AV block of the 2nd and 3rd degree (without the use of a pacemaker);
    cardiogenic shock;
    collapse;
    hypokalemia;
    arterial hypotension;
    hypothyroidism (insufficient allocation of thyroid hormones);
    thyrotoxicosis;
    interstitial lung diseases;
    administration of MAO inhibitors;
    period of pregnancy and lactation;
    hypersensitivity to the components of Amiodaron or to iodine;
    with caution should be used for children and adolescents under 18 years.

Side effects

You should know side effects of the drug before you buy Amiodaron online.
The use of Amiodaron tablets may cause the following side effects with respect to certain organs and systems:
    Cardiovascular system: sinus bradycardia (refractory to m-holinoblokatoram), AV-blockade, thrombophlebitis, vasculitis, with prolonged use - progression of CHF, ventricular arrhythmia of the type "pirouette", strengthening of the existing arrhythmia or its occurrence, with parenteral application - a decrease in blood pressure .
    Endocrine system: hypo- or hyperthyroidism develops.
    Respiratory system: prolonged use may lead to coughing, shortness of breath, interstitial pneumonia or alveolitis, as well as pulmonary fibrosis, pleurisy. When parenteral use is possible bronchospasm, apnea, especially in people with severe respiratory failure.
    Digestive system: most often there is nausea, vomiting, constipation or diarrhea, flatulence, heaviness in epigastrium, appetite is reduced, taste sensations are dulled, less often - increased activity of liver transaminases, in case of prolonged use - toxic hepatitis, cholestasis, icteric colouration, and cirrhosis of the liver.
    Central and peripheral nervous system: headaches, asthenia, dizziness, depression, paresthesia, auditory hallucinations are possible. In case of long-term use - peripheral neuropathy, extrapyramidal manifestations, tremor, memory impairment, sleep, ataxia, optic neuritis. In parenteral application, intracranial hypertension may develop.
    Organs of the senses: uveitis (inflammation of the choroid of the eye of different localization), the deposition of glycolipoprotein-lipofuscin in the epithelium of the cornea of ​​the eye, which can manifest itself in bright light in the form of disturbances: complaints of luminous points or the so-called "veil before the eyes," and possibly micro-detachment retina.
    Organs of hematopoiesis: thrombocytopenia, hemolytic or aplastic anemia.
    Skin: rash, lesions in the form of exfoliative dermatitis, photosensitization, alopecia, there were rarely manifestations in the form of gray-blue staining of the skin.
    Other: epididymitis and decreased potency, myopathy, with parenteral use, fever and increased sweating are possible.
The use of the drug in elderly patients significantly increases the risk of developing severe forms of bradycardia.

Amiodaron tablets, instructions for use (Method and dosage)

Tablets Amiodaron should be taken orally, before meals, with the necessary amount of water to swallow. Instructions for use Amiodaron suggests an individual dosing regimen, which should be installed and adjusted by the attending physician.
Standard dosing schedule:
    Loading (in a different way saturating) the initial dose for inpatient treatment, which is divided into several receptions, is 600-800 mg per day, and the maximum allowable daily dose is up to 1200 mg. It should be taken into account that the total dose should be 10 g, usually it is achieved in 5-8 days.
    For outpatient treatment, an initial dose of 600-800 mg per day is prescribed, which is divided into several doses, and also reaches a total dose of not more than 10 g, but for 10-14 days.
    To continue the course of treatment with Amiodaron, it is enough to take 100-400 mg per day. Attention! The minimum effective maintenance dose is used.
    To avoid cumulation of the drug, you must take the pill every other day, or with a break in 2 days 1 time a week.
    The average single dose, which has a therapeutic effect, is 200 mg.
    The average daily dose is 400 mg.
    The maximum allowable dose is not more than 400 mg per time, not more than 1200 mg per 1 knock.
    For children, the dose is usually in the range of 2.5-10 mg per day.

Overdose

A single significant dose may cause:
    lowering blood pressure;
    bradycardia or arrhythmia;
    violation of the normal functioning of the liver;
    atrioventricular blockade.
As a treatment prescribed gastric lavage, activated charcoal, symptomatic measures, with the development of bradycardia - Atropine, β1-adrenomimetics, in extreme cases - pacing.
There is no specific antidote, hemodialysis is ineffective.

Interaction

With the simultaneous use of this drug with the following agents, various reactions may occur:
    Antiarrhythmics of Class 1A and Dysopyramide, Procainamide, Quinidine increase the cardiac interval of QT and increase the risk of developing ventricular tachycardia "pirouette".
    Laxative agents that cause hypokalemia, as well as diuretics, corticosteroids, incl. in / in Amphotericin, tetracosactide, cisapride, in combination with Amiodaron increase the risk of arrhythmia of the ventricles of the heart.
    Means of general anesthesia, oxygen therapy - the risk of bradycardia, conduction disorders of the heart, arterial hypotension, reduction of the shock V heart.
    Tricyclic antidepressants, phenothiazines, astemizole and terfenadine also cause prolongation of the QT interval and risk of ventricular arrhythmia (most often of the pirouette type).
    Warfarin, Fenprokumon, Atsenokumarol increase the anticoagulant effect and increase the risk of bleeding.
    Vincomamine, Sultopride, Erythromycin IV, Pentamidine IV and I / m increase the risk of ventricular arrhythmias, including pirouettes.
    Dextromethorphan is an increase in plasma concentration due to a decrease in the metabolic rate in the liver, as well as removal from the body, which is caused by inhibition of the cytochrome CYP2D6 isoenzyme activity.
    Digoxin - a significant increase in its plasma concentration, associated with a decrease in its clearance, which increases the possibility of digitalis intoxication.
    Diltiazem, Verapamil - intensification of negative inotropic effect, development of bradycardia, conduction disturbance, and AV blockade.
    Indinavir, Ritonavir, Nelfinavir, Saquinavir, Cimetidine - an increase in the concentration of the active substance - Amiodaron in plasma is possible. Kolestyramin, Phenytoin - the opposite action.
    Amiodaron may increase the concentration of lidocaine in the blood plasma, and cause seizures, possibly due to the suppression of the metabolism of lidocaine.
    Lithium carbonate - the development of hypothyroidism.
    Propranolol, Metoprolol, Sotalol - arterial hypotension, asystole, bradycardia, ventricular fibrillation.
    Trazodone - a case of occurrence of an arrhythmia "pirouette" is described.
    Cyclophosphamide in high doses - pulmonary toxicity.

Storage conditions

In a dry dark place, at a temperature of no more than 30 ° Celsius. It is necessary to limit access to the drug for children.
Shelf life not more than three years.

Reviews about Amiodaron

The reviews on the drug are mostly positive, many note the effectiveness in stabilizing the heart rate and blood pressure, but there is a fairly large list of side effects and reactions when interacting with other drugs, therefore, this antiarrhythmic drug can only be used as directed by the doctor.