Isoptin SR 240 tabs 240mg #30

Instruction for Isoptin SR 240

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Composition

One tablet of Isoptin SR 240 contains 240 mg of verapamil hydrochloride.
Additional substances: povidone K30, microcrystalline cellulose, sodium alginate, magnesium stearate, water.
Coating composition: aluminum varnish, hypromellose, macrogol 6000, macrogol 400, talc, titanium dioxide, glycolic wax.

Form of issue

Light green tablets long-lasting, oblong form, on both sides of the transverse notches, on one edge are engraved two symbols in the form of a triangle.

pharmachologic effect

Antiarrhythmic, antianginal and antihypertensive action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Refers to a group of calcium channel blockers. Suppresses the transmembrane transfer of calcium ions to vascular cells and smooth myocardial myocytes. Has antiarrhythmic, antianginal and antihypertensive action.
The antihypertensive effect of the drug is due to the weakening of peripheral vascular resistance without a reflex increase in heart rate. The pressure starts to decrease already on the first day of therapy and this action is preserved with prolonged therapy. Isoptin SR 240 is used to treat all types of arterial hypertension: in combination with other antihypertensive agents (diuretics and ACE inhibitors) has a vasodilating, negative inotropic and chronotropic action; in the form of monotherapy of compensated arterial hypertension.
Antianginal action is associated with the effect on hemodynamics and myocardium (lowers the tone of arteries of the peripheral type, the resistance of the walls of blood vessels). The inhibition of the transfer of calcium ions into the cell causes a decrease in the transformation of the energy of ATP into mechanical work and the weakening of myocardial contractility.
The drug also has a strong antiarrhythmic effect, mainly with supraventricular arrhythmia. It stops the nerve impulse in the AV node, restoring the normal sinus rhythm. The normal incidence of myocardial contractions does not change or decreases only slightly.

Pharmacokinetics

Absorbed quickly and completely (90-92%) in the small intestine. The average bioavailability is 22% in healthy individuals, in patients with cardiac pathology it can reach 35%.
Binding to blood proteins by 90%. The drug is able to penetrate the placenta and stand out with breast milk. Metabolized almost completely in the liver. The main metabolite is noravapamil is active, the rest metabolites are inactive.
The elimination half-life is 4-6 hours after administration once. Excreted mainly with urine. Up to 16% is evacuated with feces.

Indications for use

Indications for use Isoptin SR 240:
    angina pectoris tension;
    arterial hypertension;
    angina caused by vasospasm;
    Atrial fibrillation in the background of tachyarrhythmias (except WPW syndrome);
    supraventricular paroxysmal tachycardia.

Contraindications

Contraindications of an absolute nature:
    complicated myocardial infarction (hypotension, bradycardia, left ventricular failure);
    sinoatrial blockade;
    bradycardia-tachycardia syndrome;
    cardiogenic shock;
    AV-blockade of the second or third degree.
Contraindications of a relative nature:
    arterial hypotension;
    AV-blockade of the first degree;
    bradycardia;
    atrial fibrillation with WPW syndrome;
    heart failure.

Side effects

    Reactions from the circulation: arrhythmia, AV-blockade, tachycardia, palpitations, arterial hypotension, increased signs of heart failure.
    Reactions of nervous activity: dizziness, tremor, headache, fatigue, drowsiness, nervousness, paresthesia.
    Reactions from the digestive side: constipation, vomiting, nausea, intestinal obstruction, abdominal pain, increased levels of hepatic enzymes, reversible gingival hyperplasia.
    Reactions from the musculoskeletal system: pain in the muscles and joints.
    Allergic reactions: exanthema, Quincke's edema, hives, Stevens-Johnson syndrome.
    Reactions from the hormonal sphere: increased prolactin levels, galactorrhea, reversible gynecomastia, impotence.
    Other reactions: erythromelalgia, edema, hot flashes.

Instructions for Use Isoptin SR 240 (Method and Dosage)

Instructions for use Isoptin SR 240 indicates that the average dose of the drug is 240-360 mg per day. When prolonged treatment is not recommended to exceed the dose of 480 mg per day. Tablets should be taken during or immediately after meals in full, washed down with water.
With arterial hypertension prescribe 240 mg of the drug once a day in the morning. If a slow decrease in pressure is necessary, then treatment is recommended starting at 120 mg once a day in the morning.
With ischemic heart disease (angina pectoris, angina Prinzmetal) the drug is prescribed for 120-240 mg twice a day (morning and evening).
With supraventricular paroxysmal tachycardia or atrial fibrillation with tachyarrhythmia, the drug is prescribed 120-240 mg twice daily.
If the liver is broken, the drug should be treated with a low dose of 40 mg twice a day.
The duration of treatment with the drug is not limited.

Overdose

Symptoms of drug overdose depend on the dose taken, the timing of detoxification and the ability of the myocardium to contract. There are reports of fatal cases of overdose.
Symptoms: pressure drop, shock, AV blockade, loss of consciousness, slipping rhythm, sinus bradycardia, cardiac arrest.
Treatment: gastric lavage, taking emetic and laxatives. If necessary, perform artificial respiration, closed heart massage and electrostimulation of the heart.
Selective antidote is calcium: inject up to 30 ml of a solution of 10% calcium gluconate intravenously.
In the case of AV blockade, sinus bradycardia is injected with Isoprenaline, Atropine, Orciprenaline.
In the case of arterial hypotension, Dobutamine, Dopamine, and Norepinephrine are prescribed.
With myocardial insufficiency, Dopamine and Dobutamine are prescribed.

Interaction

Before you buy Isoptin SR 240 you should know the drug interaction.
With the joint application of the drug with beta-blockers and antiarrhythmic agents, the effects on the circulatory system are mutually stimulated (AV blockade, palpitation, strengthening of hypotension).
The drug enhances the antihypertensive effects of other antihypertensive drugs.
When combined with Terazozinom and Prazozin observed additive hypotensive effect.
Ritonavir and other antiviral drugs suppress the metabolism of verapamil, which leads to an increase in its content in the blood.
When combined with quinidine, hypotension develops; and in persons with obstructive hypertrophic cardiomyopathy, pulmonary edema may occur.
With simultaneous use with carbamazepine, an increase in the level of the latter in the blood and an increase in its neurotoxicity develop.
With simultaneous use with lithium drugs, their neurotoxicity is enhanced.
The hypotensive effect of the drug may be weakened when used simultaneously with Rifampicin and Sulfinpyrazone.
When combined with muscle relaxants, their effect may be enhanced.
When combined with acetylsalicylic acid, an increase in bleeding time is possible.
With simultaneous use with ethanol, its content in plasma rises.
Joint use with simvastatin or lovastatin may cause an increase in the concentrations of the latter in the blood.
Patients taking verapamil, therapy with HMG-CoA reductase inhibitors are advised to start with low doses, which are further increased. If it is necessary to take verapamil, people who are already using HMG-CoA reductase inhibitors are advised to revise and lower their dosages. Similar tactics are recommended to adhere to and with a combined appointment with Atorvastatin.

Storage conditions

Store in original packaging at temperatures up to 24 degrees. Keep away from children
Shelf life - three years.

special instructions

Individual reactions to the drug are possible which lead to a decrease in the ability to control mobile mechanisms.

Children

There are no studies that confirm the harmlessness of the drug in children, therefore it is recommended to avoid the appointment of verapamil in this category of persons.

In pregnancy and lactation

In pregnancy, this drug is prescribed only for strict indications, lactation is not prescribed at all.

Reviews about Isoptin SR 240

Feedback about the evidence that the drug is actively used in the most common cardiac pathology, where he has proven himself well. Patients report that Isoptin significantly improved their quality of life.