Coraxan is referred to as a means of normalizing the heart rate. It also makes it possible to prevent numerous negative consequences with concomitant diseases. So.let's take a closer look at the instructions for use, the indications and contraindications of Corascan, its analogs, reviews about it and the prices of the medicine in pharmacies.
Features of the preparation
Carefully select a dose for elderly patients, as well as additionally monitor their condition during the period of therapy. Strictly it is contraindicated to use the product in conjunction with such medications as:
- antidepressants of pronounced effect;
- tablets that affect hepatic cytochrome;
- funds used for anesthesia;
- sedative normotimics;
- antibiotics from the macrolide category;
- HIV protease inhibitors.
The medicament contains lactose, which means that some categories of patients should not use it.
Composition
The main substance in the drug is ivabradine. Regardless of the different forms of release, the amount of auxiliary components does not change:
- silica,
- corn starch,
- lactose monohydrate,
- magnesium stearate,
- maltodextrin.
Dosage forms
Tablets in a film shell, 14 pcs. Each.in the blister pack. The active substance is contained in an amount of 5 and 7.5 mg.
One package has 1, 2 or 4 blisters. The cost of the medium in the middle range is about 1000 rubles.
Pharmacological action
Antianginal, anti-ischemic.
Farmakodinamika
The mechanism of action of Koraxan is associated with a specific as well as selective inhibition of If channels of the sinus node. These channels regulate the heart rate and control depolarization at the sinus node. For the period of impulses, the basic substance of the tablets does not affect, including the conductive, intracardiac, intraventricular and atrioventricular pathways.
For prevention and treatment of cardiovascular diseases, our readers advise the drug "NORMALIFE".This is a natural remedy that affects the cause of the disease, completely preventing the risk of getting a heart attack or stroke. NORMALIFE has no contraindications and begins to act within a few hours after its use. The effectiveness and safety of the drug has been repeatedly proven by clinical studies and long-term therapeutic experience.
The opinion of doctors. .. & gt; & gt;
Does not medicate influence neither on repolarization of ventricles nor on contractility. Signs of tolerance after long treatment are absent, and a favorable therapeutic effect persists for about 4-5 months.
Pharmacokinetics
It is recommended to take a pill at the time of food intake, which helps improve digestion and increases its concentration by an additional 10%. Due to digestion of food, the absorption time increases, but this has a beneficial effect on the medicinal effect, allowing better efficacy of the drug. Bioavailability - 40%.
About 70% of the ivabradine that enters the systemic circulation is bound to the plasma protein. Under the influence of cytochromes, metabolism occurs in the intestine and liver. Excretion from the body is carried out by the kidneys. The half-life is different and the first signs appear after 2 hours, but the maximum reaches only after 11 hours.
About what Korachsan is needed for, its indications for use are discussed below.
Indications
- The drug is necessary for the therapy of angina pectoris in patients whose disease is combined with a normal sinus rhythm. It is required if the beta-blockers are poorly tolerated, or when they are combined with them if angina pectoris is unstable.
- For chronic insufficiency and coronary artery disease, Coraxan is required in order to reduce the likelihood of complications, including fatal outcomes.
Completely contraindicated in pregnancy, because it is not known how Koraksan is able to influence the fetus. Teratogenic and embryotoxic effects were noted in the studies, but the mechanism of influence has not been fully studied. That is why the drug is banned for the treatment of children and during lactation.
The instruction on the use of Korascan tablets is offered below.
Instructions for Use
The dose to be taken is divided into 2 divided doses and consumed together with the food intake.
- Heart failure of a chronic type. The initial dose is only 10 mg per day, which must be divided into receptions at different times of the day. After about 2 weeks, it is possible to increase the dosage to 7.5 mg at a time. This is necessary with a low effect. With a serious decrease in heart rate or the appearance of signs of bradycardia, a dose reduction will be required. The number of heart beats should be in the range of 50-60 beats per minute. If the indicators are higher or lower, the dose is adjusted accordingly, raising or lowering it.
- Stenocardia is stable. During the month, 10 mg of medication per day are treated, and after this time, the daily amount of Coraxan can be increased to 15 mg. With a bradycardia, as in the previous case, you may need to reduce the dosage, and if after some time its signs have not passed, then the medication is replaced with another suitable means.
- Impaired renal function. Patients require a standard dose of 10 mg( twice daily for 5 mg).In the future, it is adjusted individually, depending on the clinical manifestations. When the creatinine clearance is less than 15 ml / minute, then Coraxan is used with caution.
- Violation of the function of the liver. If hepatic insufficiency is of low severity, then it is acceptable to use the usual dosage regimen of Koraxan. In other cases, the medication is administered individually.
Contraindications
- Arterial hypotension of severe type,
- cardiogenic shock,
- angina unstable,
- bradycardia( before therapy),
- sinoatrial blockade,
- atrioventricular blockade,
- lactose intolerance,
- acute myocardial infarction,
- severe form of renal failure,
- pacemaker,
- weakness of the sinus node.
Side effects of
Most of the mechanism for the occurrence of side effects is directly associated with dosage. Its excess increases, respectively, and the risk of their occurrence.
- Sense organs: fuzzy vision and photopsy( change of light perception).Most often appears at the initial stage of treatment. However, in the subsequent it is possible and repetition of episodes of a photopsy, but already expressed to a lesser extent. It appears as a sudden change of intensity in the visual field of illumination. With prolonged therapy in most patients this phenomenon occurs. Only in rare cases( up to 1%) the photopsy served as a reason for replacing Coraxan with another drug.
- Cardiovascular system: rarely has supraventricular extrasystole or a feeling of heartbeat. Relatively often there is a bradycardia. As with the use of such a group of drugs, there is a risk of atrial fibrillation, angina pectoris, ischemia, ventricular tachycardia. It is worth noting that the probability of these side effects is rather small.
- Digestive system: diarrhea, nausea, constipation.
- Skin: erythema, pruritus, angioedema edema, rash, urticaria.
- CNS: dizziness( sometimes a consequence of bradycardia and does not occur on its own), headaches at the beginning of the treatment phase, muscle spasm, vertigo, fainting, shortness of breath.
- Laboratory indicators: a small chance of increasing creatinine in the blood, eosinophilia, hyperuricemia.
Just as a person can experience malaise, asthenia, fatigue faster. In many cases, these manifestations provoke a bradycardia.
Overdose
The overdose status manifests itself as a prolonged and vivid episode of bradycardia. Treatment is carried out permanently, the therapy itself is symptomatic.
If in addition to bradycardia hemodynamic disorders occur, then in addition to symptomatic treatment, beta-blockers are also used. The driver of the rhythm is set for individual need.
Special instructions
- When hypotension arterial care is required, because there is insufficient evidence of the clinical effect of the drug on the body in the presence of this disease. If hypotension is severe, it is better to stop using Coraxan. In the nearest period after the stroke, it is also better to stop using the medication.
- If the drug is used in complex treatment to achieve an antianginal effect, it is important to take into account that the combination of Coraxan with a means of reducing heart rate is undesirable.
- The medication has little efficacy for the therapy or prevention of arrhythmias, and with tachyarrhythmias, there is a decrease in the action of the main substance. Use of the medication is not recommended for a number of other cardiac arrhythmias, including those associated with sinus node disorders or atrial fibrillation.
- During the treatment period, monitoring of the condition is required, which is necessary for early detection of the depressing effect on the heart muscle. If there are clinical indicators indicating an aggravation of the course of the underlying disease or the development of additional cardiac pathologies, dosage adjustment is carried out and subsequently the ECG examination will necessarily be included in the surveillance measures.
- The period of application of the medicinal product is limited and more than the prescribed course( 6 months) can not be consumed without interruption. Koraksan is able to have a negative effect on the retina of the eye, which is not associated with toxic effects. If visual disturbances, not described in the category of side effects, appear, immediate consultation of the doctor is required regarding dose adjustment or replacement of the drug. If a person has pigmentary degeneration, the retina is used with caution.
Due to the pronounced action of Coraxan, all medicines that are selected for complex therapy should be selected by a professional.
Reviews of doctors and patients about Koraksan
Not every patient is satisfied with the cost of the drug, however, the effectiveness of the drug is very high, and it is used even in severe tachycardia. It is noted that the drug was developed not so long ago. He is one of the few medications that can lower the pulse, but without affecting blood pressure.
In most cases, reviews remain positive throughout the course of treatment. The most negative impressions associated with the effect of the drug are observed after a conservative sanation. In such cases, side effects usually affect the organs of vision.
As for the opinion of doctors, it is favorable, since many side effects can be quenched by symptomatic treatment, and Coraxan's effect is irreplaceable for special groups of patients.
Analogues
The same action as Coraxan has only the main component of this drug, i.e., either ivabradine hydrochloride, or it, but in its pure form.
There are also Vivaroxan and Bravadin preparations with the same component. Their cost differs little, therefore there is no need to replace this medication.