Izoptin cf. Table 240 n / an film prolong. 240mg 30 pieces

$9.19

Izoptin cf. Table 240 n / an film prolong. 240mg 30 pieces

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Description

Composition
Active substance:
1 tablet contains: 240 mg of verapamil hydrochloride.
The active substance is embedded in a hydrocolloid matrix of alginate, a natural polysaccharide. The rate of release is determined by diffusion and surface erosion. Upon contact with the liquid contents of the intestine surface of the tablet swells to form a gel-like diffusion layer. Specifically included surface defects cause uniform erosion of the gel, and therefore provide diffusion characteristics with almost constant. The combination of these two mechanisms allows controlling the release of the active substance with almost zero order kinetics over a period of about seven hours.
Excipients:
Microcrystalline cellulose, sodium alginate, Povidone (30 K = constant), magnesium stearate, purified water, hypromellose, macrogol 400, macrogol 6000, talc, titanium dioxide, quinoline yellow, indigotine, mountain wax glycol.
Description:
Light green kapsulovidnoy form tablets, film-coated. Tablets from both sides have transverse risks. On one side of the two characters specified “//”.
Product form:
Izoptin CP 240
By 10,15 or 20 tablets in a blister made of PVC / PVDC / AL foil.
1, 2, 3, 5 or 10 blisters together with instructions for use in a cardboard package.
Contraindications
absolute
Cardiogenic shock; complicated by acute myocardial infarction (bradycardia, hypotension yrazhennaya, left ventricular failure); atrioventricular block second or third degree; sick sinus syndrome (bradycardia-tachycardia syndrome), sinoatrial block.
relative
First degree heart block, bradycardia (Effect on the ability to control the vehicle and operate machinery
Treatment of hypertension drug Isoptinum requires regular medical supervision. Depending on the individual response to treatment of the patient the ability to drive a car or operate machinery may be impaired. This is particularly important in the initial period of treatment, when there is a transfer from one drug to another, and when taking it in combination with alcohol.
Dosage
240 mg
Indications
Arterial hypertension, chronic stable angina (angina classical); angina caused by vascular spasm (Prinzmetal angina, variant).
Paroxysmal supraventricular tachycardia; flicker / atrial flutter, accompanied tachyarrhythmia (except Wolff-Parkinson-White syndrome (WPW) syndrome cm. Contra).
Interaction with other drugs
in vitro studies suggest that verapamil hydrochloride is metabolized by the action of isozymes CYP3A4, CYP1A2, CYP2C8, CYP2C9 and CYP2C18 cytochrome P450. Clinically significant interaction was observed while applying CYP3A4 inhibitors which induced an increase in plasma levels of verapamil, while inducers of CYP3A4 reduces its concentration in plasma. Accordingly, while the use of such means should be considered to interact *.
* Detailed information is provided in the instructions for use.
Overdose
Symptoms of poisoning from an overdose of the drug Isoptinum depends on the adoption of the preparation, the time of the events of detoxification and of myocardial contractility, depending on age. Fatal cases have been reported as a result of an overdose.
Dominated by the following symptoms:
Blood pressure drop (in some cases to levels that can not be measured); shock, loss of consciousness; atrioventricular block first and second degree, often as Wenckebach periods with or without slip rate; complete atrioventricular block with complete atrioventricular dissociation, slips rhythm, cardiac arrest; sinus bradycardia, sinus arrest.
Therapeutic activities should be performed depending on the duration and route of administration of the drug Isoptin and the nature and severity of symptoms of poisoning.
In the case of an overdose of large quantities of sustained-release tablets, coated tablets (i.e. drug Isoptin CP 240) must be kept in mind that the active substance is released and absorbed in the intestine within 48 hours after ingestion of the drug. Depending on the time of taking the drug inside the individual conglomerates residues swollen tablets that act as active depot, probably will be located throughout the digestive tract.
General measures:
If there is no motility of the stomach and intestines (peristalsis signs on auscultation), it is advisable to carry out gastric lavage even 12 hours after ingestion of the drug. If there is a suspected drug overdose Isoptinum CP 240 is shown holding the relevant activities aimed at elimination of the drug, for example, induce vomiting, wash out the stomach and small intestine in combination with endoscopy, rinse the intestines, take laxatives, emetics.
Conventional emergency resuscitation include chest compressions, artificial respiration and cardiac electrical stimulation.
Special events:
Exception effects associated with inhibition of cardiac function, hypotension and bradycardia.
Calcium is a specific antidote: inputting 10-30 mL of 10% solution of calcium gluconate as an intravenous injection (2.25 – 4.5 mmol), if necessary repeatedly or administered as a slow drip infusion (for example 5 mmole / hour).
May require the following activities:
In the case of atrioventricular block second or third degree, sinus bradycardia, cardiac arrest: atropine, isoprenaline, orsiprenalin or stimulation of the heart. In case of hypotension: Dopamine, dobutamine, norepinephrine.
In the case of stable signs of myocardial insufficiency: dopamine, dobutamine, additional calcium injections as needed.
pharmachologic effect
Pharmacological group:
A calcium channel blocker.
Pharmacological properties:
Verapamil inhibits the transmembrane current of calcium ions into smooth muscle cells. Antianginal effect is due to a direct action on the myocardium and the effect on peripheral hemodynamics (lowers peripheral arterial tone, total peripheral resistance). Incoming blockade of calcium ions into the cell leads to a reduction in transformation energy bonds contained in ATP energy into mechanical work and to reduce myocardial contractility.
The antihypertensive efficacy of the drug due Isoptin decrease peripheral vascular resistance without increasing the heart rate as a reflex response. Blood pressure begins to fall directly on the first day of treatment; This effect persists during long-term therapy. Isoptin drug used to treat all types of arterial hypertension: monotherapy for mild to moderate hypertension, in combination with other antihypertensive drugs, especially diuretics and in accordance with the latest observations, ACE inhibitors with more severe hypertension. It has vasodilating, hypotensive, negative foreign-and chronotropic effect. Isoptin drug has a marked antiarrhythmic effect, particularly in supraventricular arrhythmias. It delays the pulse conducting in the atrioventricular node. The resulting restored sinus rhythm and / or ventricular rate is normalized, depending on the type of arrhythmia. Normal heart rate is unchanged or slightly reduced.
Pharmacokinetics:
Verapamil Isoptin active ingredient of the drug, is rapidly and almost completely absorbed in the small intestine. The extent of absorption is 90-92%. The half-life ranges from three to seven hours after a single oral administration of the drug. When multiple dose verapamil half-life may be increased by almost half compared to a single dose. Verapamil is metabolised almost completely. The main metabolite are norverapamil having pharmacological activity, the other metabolites are largely inactive.
Verapamil and its metabolites are excreted primarily through the kidneys; Only 3-4% is excreted in unaltered form. Within 24 hours, 50% of the administered dose of the drug is excreted in the urine within 48 hours and 55-60% within five days -70%. Up to 16% is excreted in the feces. Recent results indicate that there are no differences in the pharmacokinetics of verapamil in patients with normal renal function and patients with end-stage renal failure.
Coronary heart disease and hypertension is not a correlation between the therapeutic effect and the concentration of drug in blood plasma; there is only a certain relationship between the plasma level of the drug and influence on the interval PR. Upon receiving the long-acting formulations of verapamil concentration curve in plasma expands and becomes more shallow than when administered dosage forms with a normal release.
Since blood plasma protein binds about 90% of the formulation.
bioavailability:
Hour Following oral verapamil undergoes considerable first pass metabolism, which occurs almost exclusively in the liver. The mean absolute bioavailability in healthy volunteers after a single reception of the drug is 22%. Recent studies in patients with atrial arrhythmia or angina showed that the average levels of bioavailability is 35% and 24% after a single dose of reception inside and intravenous dosing respectively.
When multiple dose bioavailability increases almost doubled compared to a single dose. This effect is probably due to partial saturation systems hepatic enzyme and / or transitory increase in blood flow in the liver after a single dose of verapamil. Patients with hepatic impairment compared to individuals with normal liver function bioavailability of verapamil was much higher, and there was a delay removing the drug.
Pregnancy and breast-feeding
During pregnancy (especially in the first trimester) and during breast-feeding should analyze the potential benefits from taking Isoptin drug on a possible risk for the mother and child. During lactation the drug should be abolished.
Verapamil crosses the placental barrier; concentrations found in umbilical venous plasma were 20-92% in the plasma concentration of the mother.
Excretion in breast milk:
Verapamil is excreted in breast milk, but at therapeutic doses, the concentration is so low that the clinical effects in infants is unlikely.
Conditions of supply of pharmacies
By prescription.
side effects
Sometimes when receiving verapamil in high doses or in the presence of any cardiovascular disorders can be observed: arrhythmia amid bradycardia (sinus bradycardia, sinoatrial block, atrioventricular block, the first, second or third degree or bradyarrhythmia with atrial fibrillation), an arterial hypotension, palpitations, tachycardia, development or increased symptoms of heart failure called awns.
It reported fairly frequent occurrence of constipation while taking the drug inside; in rare cases may develop nausea, vomiting, ileus, pain or abdominal discomfort, dizziness or drowsiness, fatigue, increased nervousness / tremor, edema of the lower leg, rodonalgia or paresthesia.
In rare cases, can occur dizziness, headache and flushing. In very rare cases, it may be observed myalgia and arthralgia. Rarely reported allergic reactions (rash, hives, urticaria, angioneurotic edema, Stevens-Johnson syndrome). Also described reversible increase levels “liver” transaminases and / or alkaline phosphatase, increased prolactin levels.
In rare cases, elderly patients developed gynecomastia during long-term therapy, which in all cases was completely reversible after discontinuation of the drug. Reported cases of galactorrhea and impotence.
In extremely rare cases during long-term treatment may develop hyperplasia of the gums, which is fully reversible after discontinuation of the drug.
Storage conditions
Store at a temperature not higher than 25 ° C. Tablets CP 240 Isoptin preparation of prolonged action, coated, should be stored in the blister pack until use.
The drug should be stored out of the reach of children.
Dosing and Administration
Prolonged action tablets, coated tablets, Isoptin preparation CP 240 should be swallowed whole with water, preferably during meals or immediately after meals.
The time of application is not limited.
Dose verapamil, the active substance in various dosage forms Isoptin formulation should be applied depending on the clinical picture of the disease; years of clinical experience has shown that the average dose for all indications of 240-360 mg per day.
Prolonged treatment should not exceed 480 mg daily dose; It may be a temporary increase of the dose above that level.
In patients with impaired liver function is enhanced effect of verapamil and becomes longer as a result of sustained drug metabolism, depending on the severity of liver dysfunction. In such cases the dose should be installed with special care and therapy should be initiated with lower doses (i.e. patients with liver cirrhosis originally prescribed 1 tablet, coated preparation Isoptin 40 mg two-three times a day.) *
* Detailed information is provided in the instructions for use.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist

Additional information

Weight0.100 kg
Manufacturer

Abbott

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