Kardiket: instructions for use, contraindications, reviews, prices, analogies

Cardiquet, being a nitrate of organic origin, belongs in pharmacology to a group of antianginal agents and vasodilators. This material will be devoted to the study of instructions for use and indications for the drug Kardiket, its analogs, prices, reviews about it.

Features of the drug

Cardiabetes has the property to lower the need of the heart muscle in oxygen and activates its intake to the cells of the myocardium. At the same time, its ability to relax the walls of the vessels causes vasodilation - a decrease in the tone of the veins and arteries with the expansion of their lumen for unimpeded blood flow.

Composition

The main active ingredient is dinitrate isoborodide.

• Auxiliary components for tablets: polyvinyl acetate, lactose monohydrate, talc, potato starch, magnesium stearate.
• For capsules: lactose, shellac, sugar beads, polycellulose.

Medicinal forms

Round white tablets with a long curative effect. On one side is a flat section with IR indication above the risk and figures "20, 40 or 60" below the risks that denote the amount of isobiode dinitrate in milligrams. The other side is convex, with the designation of the manufacturing company SCHWARZ PHARMA.

In the cardboard package, place 2 or 4 blisters with cells for 10 tablets. Hard gelatin capsules with long-lasting therapeutic effect of dark beige color, filled with white and yellowish granules, which do not have a smell. Two blisters are placed in the package, 10 tablets in each.

Pharmacological action

Cardiсk operates in a complex and long-term, giving a quick healing effect and preserving its activity for a long time. Active substance actively enters the bloodstream, providing a quick( 20 - 30 minutes) therapeutic result, which is permanently fixed in the treatment of angina pectoris.

Farmakodinamika

Dinitrate isosorbide affects arteries and veins, which contributes to the deposition - the accumulation of blood in the veins and a decrease in the volume of venous blood returning to the myocardium. This reduces the load on the left ventricle and lowers blood pressure.

Decrease in the load and filling of the ventricle reduces the need for oxygen in the heart muscle, causes the opening of unworked cardiac vessels, improves the flow of oxygen to the sites with vessel ischemia( reduced blood supply caused by constriction or clogging of the artery).

Pharmacokinetics

Capsules, getting into the stomach, dissolve in 8 to 12 minutes, but isosorbide dinitrate is released from the capsule granules gradually. Dissolution of tablets occurs faster, but the action of the prolonged form is as long.

The active component of the drug is actively absorbed into the bloodstream. Bioavailability of Kardiket( the indicator of the amount and speed with which the unchanged part of the drug enters the bloodstream) is 22%.The greatest content in the blood plasma is found in the range from 15 minutes to 2 hours. The half-life of isosorbide dinitrate is approximately 12 hours.

The active component undergoes metabolic treatment with hepatic enzymes with the synthesis of active metabolites( intermediates having pharmacological properties) - isosorbide-5-mononitrate and isosorbide-2-mononitrate.

Next, consider the indications for the use of Kardiket tablets.

Indications

The card is designated for long courses:

• for long-term therapy of coronary heart disease;
• for the prevention of exacerbations of angina pectoris;
• for chronic myocardial insufficiency;
• to prevent recurrence of myocardial infarction;
• infarction therapy in the presence of angina pectoris.

During the gestation and feeding of an infant with human milk, the use of Cardiket is allowed in extreme cases - after analysis and evaluation of the ratio of the threat to the health of the baby and the possible benefits for the mother. A long-term regimen is used for the drug, therefore, to avoid negative reactions, a sharp cessation of treatment is not allowed.

Instructions for use of the medicine The cardioc is reviewed below.

Instructions for Use

Tablets are a continuous product.

• At the beginning of treatment take 20 mg twice a day or 40 mg - once.
• In the absence of a curative result, an increase in the dose to 60-120 mg( in 3 divided doses) is permitted.
• If tablets of 60, 80 mg are used, the interval between doses is not less than 8 hours.
• Capsules take one piece( 120 mg) once a day.

At the beginning of therapy, minimal dosages are applied, giving an effect, gradually increasing the daily amount to the maximum expressed result. The duration of the course of therapy is prescribed only by a doctor.

Contraindications

Basic

Cardiabetes requires careful analysis of contraindications. These include:

• myocardial infarction in the presence of a marked drop in blood pressure;
• aortic stenosis, mitral( narrowing of the aortic lumen when the valves of the heart valves coalesce, which interferes with normal blood flow);
• markedly reduced blood pressure( upper - below 90 mm Hg);
• acute vascular dysfunction( disturbance of blood circulation in veins and arteries due to disruption of their patency), which can acquire extreme forms in the form of shock and vascular collapse);
• brain injury;
• hypovolemia( decrease in the amount of blood in the vessels, which leads to damage to the internal organs);
• closed-angle glaucoma( eyeball disease when fluid outflow occurs) with high intraocular pressure;
• hemorrhagic stroke( arising from rupture of the vessel and cerebral hemorrhage);
• age group is under 18 years of age( effectiveness, safety of medication has not been investigated);
• joint administration of phosphodiesterase inhibitors, which include Tadalafil, Sildenafil, Vardenafil, which increase the likelihood of a significant drop in blood pressure;
• is an allergy to nitrates.

Relative

Relative contraindications:

• myocardial tamponade( accumulation of fluid between the pericardium - the membrane of the heart - and the myocardium, leading to its squeezing and impossibility of contractions);
• constrictive pericarditis( inflammation of the pericardium and thickening of its inner layer, compressing the heart and not allowing it to fully shrink);
• pulmonary edema;
• hypertrophic cardiomyopathy( thickening of the wall of the interventricular septum of the myocardium with violation of the release of blood);
• severe anemia;
• cerebral hemorrhage.

Particular attention to

Continuous medical supervision is required during cardiac treatment in conditions such as:

• , a disorder of cerebral and coronary blood circulation provoked by low blood pressure;
• disease with a risk of increasing intracranial and intraocular pressure;
• serious liver pathology, failure of kidney function;
• hyperthyroidism;
• enhanced motility of the gastrointestinal system;
• Malabsorption syndrome( a violation of the mechanism of absorption of certain substances in the intestinal mucosa).

Side effects of

Negative reactions of the body to Cardiket do not develop often, and, basically - at the initial stage. The following manifestations are noted:

• the so-called "nitrate headache", which passes through 3 to 6 days;
• at unreasonable intake of a high initial dose, when the patient rises from the bed, manifest -
  • a sharp decrease in blood pressure;
  • sudden heartbeat attack;
  • bradycardia( abnormally delayed heart contraction);
  • dizziness, weakness in the muscles, apathy, impaired orientation;
• with a decrease in blood pressure may manifest:
  • increased intensity of angina pectoris;
  • collapsoid states with bradycardia and syncope( sudden loss of consciousness) - extremely rare;
• dryness of the oral mucosa, eructation, nausea, stomach and intestinal pain, vomiting;
• at the beginning of treatment - apathy, increased drowsiness, inhibition, cloudiness of vision, rarely - violation of blood circulation in the vessels of the brain;
• development of the syndrome of tolerance - a decrease in the therapeutic effect and a positive reaction to the active substance( including other nitrates), exfoliative dermatitis( skin inflammation, redness, flaking, itching and exudate).

Special instructions

1. Cardiope is not used to stop an attack of angina pectoris. To this end, nitrates of quick action are additionally used.
2. To prevent more frequent use of the Cardicat, do not allow the cessation of treatment in severe form.
3. Throughout therapy, continuous monitoring of blood pressure and myocardial contraction rates is required.
4. development of temporary hypoxemia( a drop in the amount of oxygen in the blood below the norm) in patients with pulmonary pathologies, in patients with ischemic heart disease hypoxemia can cause transient myocardial ischemia( acute short-term circulatory disturbance).
5. In detecting a heart attack, myocardial insufficiency, the drug is prescribed only with continuous monitoring of the patient's condition.
6. To relieve the headache helps to reduce the dose and simultaneous reception of funds with menthol( validol).
7. To prevent a sharp drop in blood pressure, the dosage is calculated taking into account contraindications for a particular patient.
8. During therapy, dizziness occurs with a sharp rise, muscular load, the use of ethanol.
9. There are rare cases of paradoxical enhancement of signs of angina at low pressure, a heart attack and sudden death.
10. With long treatment, frequent admission of large doses of CardiKet without intervals, there is an addiction to the drug and other nitrates, which forces unreasonably increase the dose.
11. To prevent a decrease in the effectiveness of the drug due to tolerance and addiction to the drug, high doses are not recommended for a long time. The optimal scheme is the daily reception of the Cardicet with a night interval of 10 to 12 hours. This scheme of treatment for patients is preferable to continuous therapy.
12. The impact on the ability to drive vehicles and manage mechanisms depends on the individual reaction of the body to the Cardicoot, however, it is recommended to exclude hazardous activities requiring quick response and concentration.
13. In case of severe blurred vision and dryness of the oral mucosa, the treatment is stopped.
14. In case of disruption of the liver and kidneys, the Cardiqet is prescribed with extreme caution, subject to constant monitoring.

Overdose of

Exceeding the dose of any nitrate and cardiac, in particular, is dangerous for the following pathological conditions:

• sudden significant decrease in blood pressure, loss of consciousness, collapse;
• severe headache caused by sudden expansion of cerebral vessels, dizziness;
• sensation of strong heart tremors, pulsation in the temples;
• visual disorders;
• fever, redness of the face;
• dyspeptic phenomena in the form of diarrhea, nausea, vomiting;
• methemoglobinemia( blue skin, anoxia - acute oxygen deficiency in tissues);
• hyperpnoea( decrease in the level of carbon dioxide in the blood to dangerously low values ​​with possible loss of consciousness);
• dyspnea( heart rhythm disorder, shortness of breath, tightness in the chest, shortness of breath);
• bradycardia( a decrease in the incidence of myocardial contractions below the normal values ​​of 55 beats / min);
• perspiration, profuse sweat;
• increased intracranial pressure with oppression of consciousness;
• paralysis, coma.

First measures in case of overdose: repeated gastric lavage;when developing methaemoglobinemia - intramuscularly apply methylene blue( 1% solution), based on the amount of 1 - 2 mg per 1 kg of the weight of the patient. Treatment with adrenaline and analogs is ineffective.

Drug Interactions

The mutual influence of CardiKet and other drugs may be negative in the following cases:

1. The effect of reducing pressure is too strong if the drug is simultaneously taking:
   • with other means that dilate the blood vessels or lower blood pressure;
   • with beta-blockers, phosphodiesterase 5 inhibitors for the treatment of erectile dysfunction, calcium channel blockers, often used in the therapy of sexual disorders;
   • with antidepressants, vardenafil, neuroleptics, quinidine, dihydroergotamine, novocainamide and alcohol( ethanol);
2. Combination of cardiac with m-holinoblokatorami( atropine) increases the risk of increased intraocular pressure.
3. Adsorptive agents( coal, Polysorb, Polypefan), covering the gastric mucosa( omeprazole), slow the rate of absorption of isosubrid dinitrate.
4. The anti-anginal effect of the Cardiket is reduced with simultaneous reception with sympathomimetic agents, alpha-blockers.

But in the therapy of angina, IHD, prevention of heart attacks, the combination of:

1. Cardiabetes with antiarrhythmics( amiodarone, anaprilin, nifedipine, atenolol, propranolol, verapamil), as well as Panangin and Riboxin has a positive effect.
2. The combination of aspirin and cardiac, leading to increased blood flow in the coronary vessels.

Reviews

Most of the patients' reviews of Cardiac are positive. There is clear support for a drug taken for the purpose of coronary artery enlargement, less severe and frequent development of angina attacks. Patients better tolerate exacerbations of coronary heart disease and a very rare secondary development of myocardial infarction.

Negative treatment of a drug is more often associated with its undesirable manifestations. Frequent complaints about the painful state of a headache, similar to the "hangover syndrome."However, using combined means to relieve pain and spasms( Spazmolgon, Spazgan, No-shpa - especially, injectively) significantly alleviates the condition, especially since it usually lasts no longer than 7-10 days.

Observations on the condition of patients undergoing cardiectomy show that the adverse side effects manifest themselves in the following cases:

• unnecessarily exceeding the dose, especially at the beginning of the treatment;
• for prolonged use without recommended night intervals of 10 to 12 hours;
• ignoring the contraindications and special instructions when using Cardiac.

Analogues and Substitutes for the Cardiac

The advantage of Cardiket is that unlike many similar medicines, it expands the large vessels of the heart, supplying it with oxygen without the so-called "stealing syndrome".This phenomenon occurs when the vasodilator is able to expand only small healthy heart vessels instead of expanding large, poorly passable blood vessels and distribute blood not to affected tissues, but to healthy parts of the heart muscle.

This significantly worsens the patient's condition. Cardiac acts quite differently, increasing blood flow in ischemic( difficult to pass, compressed) vessels and capillaries. Common to synonyms Cardiqet is an active ingredient - isosorbide dinitrate and medicinal properties.

• Isoket( 300 doses of 1.25 mg) in the form of a dosed aerosol, used sublingually( Kolep Si Si El Lauphaym GmbH, Germany) - 422 rubles.
• Isocet 0,1% in ampoules 10 ml for intramuscular injections( Shvarc Farma Produkcions GmbH, Germany) - 948 - 1055 rub.
• Nitrosorbide( Russia) from 21 to 38 rubles.
• Dinisorb in various forms: capsules, concentrate for infusions, gum films, sublingual aerosol, tablets, from 639 to 855 rub.

Analog: Monochinkwe( Berlin-Chemie, Germany), active component of isosorbide mononitrate - 285 rub.