Isoket spray 1.25mg/dose 15ml 300doses

Isoket user manual

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Composition

One dose of Isoket Spray (42.25 mg) contains 1.25 mg of isosorbide dinitrate. One bottle contains 300 doses.
Additional substances: ethanol, macrogol.
1 ml Isoket in the form of a concentrate for the preparation of a solution for injection contains 1 mg of isosorbide dinitrate.
Additional substances: water, sodium chloride, sodium hydroxide solution, hydrochloric acid.

Form of issue

Spray Isoket is a clear solution without color, with the smell of alcohol. 300 doses or 15 ml of such a solution in a shaded glass vial with a dispenser, one such bottle in a paper package.
Isoket concentrate is produced by 10 ml in an ampoule, ten such ampoules in a paper bundle.

pharmachologic effect

The drug has antianginal and hypotensive effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

INN (international non-proprietary name) of the drug - Isosorbide dinitrate.
Isoket - peripheral vasodilator, affecting the venous vessels. Activates the synthesis of nitric oxide (a relaxing endothelial factor) in the walls of the vessels, which stimulates intracellular guanylate cyclase, which leads to an increase in cGMP (a vasodilator mediator). Reduces the need of the heart in oxygen because of the reduction in preload.
Has a coronary expansive effect - reduces the volume of blood arriving at the right atrium, lowers the pressure in the pulmonary circulation, causes a regression of symptoms with pulmonary edema. Redistributes cardiac blood flow to tissues with reduced blood circulation. Lowers the sensitivity to physical activity in people with coronary heart disease. Expands the cerebral vessels, which can provoke a headache.
The drug may develop cross-tolerance, but after stopping the reception, the sensitivity to Isoket is restored. After spraying the spray on the mucous membrane of the mouth, the effect manifests itself after 30 seconds and lasts up to two hours.

Pharmacokinetics

Isoket Spray. The degree of adsorption is high. Bioavailability is 60%. Binding to blood proteins - 31%. Half-life is one hour.
Isoket concentrate after ingestion from the intestine. The maximum concentration in the blood comes in one hour. With buccal use, the maximum concentration occurs within 5-6 minutes.
Metabolised in the liver to isosorbide 5-mononitrate and isosorbide 2-mononitrate. The half-life period depends on the dosage form used and may be up to 4 hours. It is excreted in urine and feces.

Indications for use

    Acute myocardial infarction.
    Kupirovanie or prophylaxis of stenocardia attacks.
    Condition after myocardial infarction.

Contraindications

    Allergy to the components of the drug.
    Arterial hypotension.
    Acute form of vascular insufficiency.
    Lack of glucose-6-phosphate dehydrogenase.
    Cardiogenic shock.
    Closed-angle glaucoma.
    Hyperthyroidism.
    Age is less than 18 years.
Use with caution in obstructive hypertrophic cardiomyopathy; cardiac tamponade; mitral or aortic stenosis; orthostatic reactions; diseases complicated by increased intracranial pressure; renal or hepatic insufficiency; in old age.

Side effects

Before you buy Isoket you should know side effects of the drug.
At the first use or increase of dosage it is possible to develop orthostatic hypotension, decrease of pressure, which can be complicated by pulse increase, inhibition, dizziness and weakness.
At the beginning of therapy sometimes develop headaches, feelings of dry mouth and burning tongue.
Rarely, nausea, vomiting, hyperemia of the face, fever, allergic reactions, complication of the course of angina pectoris.
Even more rarely there is a collapse, fainting, exfoliative dermatitis, the development of addiction.

Instructions for use Isoket (Method and dosage)

Instructions for the use of the spray Isoket recommends spraying it on the mucous membrane of the mouth. Ampoules with Isoket concentrate are allowed to be applied buccally, sublingually, intravenously.
Do not inhale the Isoket Spray, it should be sprayed into the mouth.
To treat or prevent an attack of angina pectoris, it is necessary to inject the aerosol into the oral cavity up to 3 times with an interval of half a minute, holding the breath after each procedure.
In acute infarction and acute course of heart failure, treatment begins with 1-3 similar procedures, controlling pressure and cardiac activity. If there are no changes after 5 minutes, it is possible to repeat the injection under medical supervision.
Isoket concentrate for the preparation of an infusion solution. Single dose can fluctuate within 10-120 mg, the frequency of reception is from 1 to 5 times a day.
With buccal or sublingual method, a single dose is 5-10 mg, the multiplicity depends on the patient's readings and sensitivity to Isoket.
When administered intravenously, the dosage of the drug depends on the clinical picture and dosage form.
For dermal application, the initial dose is 1 gram at bedtime, and if necessary in the morning.
The duration of therapy is determined individually.

Overdose

Symptoms: fainting, dizziness, palpitations, visual disturbances, hyperthermia, hyperemia, convulsions, sweating, diarrhea, vomiting, methemoglobinemia, bradycardia, paralysis, coma.
Therapy: with methemoglobinemia, intravenously 1-2 mg / kg of 1% methylene blue solution is recommended. Symptomatic therapy.

Interaction

When using Isoket:
    with vasodilators, antipsychotic, calcium channel blockers, antihypertensive agents, β-adrenoblockers, novocainamide, quinidine, tricyclic antidepressants, hypotensive effect may be enhanced;
    with propranolol, amiodarone, calcium channel blockers (Nifedipine, Verapamil) may increase the antianginal effect;
    with sympathomimetics and α-adrenoblockers, a decrease in the antianginal effect is possible;
    with m-holinoblokatorami increases the likelihood of increased intracranial pressure.

Storage conditions

Store at temperatures up to 25 ° C, protect from children.
Shelf life - five years.

special instructions

It is not recommended to discontinue therapy with the drug.
In some cases, individual reactions to the Isoket can lead to a disruption in the ability to drive.

Children

Age under 18 years is a contraindication for the use of the drug.

With alcohol

During treatment with Isoket it is recommended to exclude the use of alcohol-containing substances.

During pregnancy (and lactation)

It is possible to use only with a strict indication with the permission of the attending physician.

Reviews

Isoket's comments on the spray positively characterize the drug, some doctors recommend that they always have it with patients with angina pectoris. However, there are frequent reports of individual resistance.