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Cardiket (Nitrates) are used to treat the symptoms of angina (chest pain).
50 tablets 20mg
Pharmacological action:
Kartiket has anti-anginal activity. It consists of isosorbide dinitrate (organic nitrate). Increase peripheral arteries and veins. When this deposit is observed in the peripheral blood vasculature, thereby reducing the venous return to the heart, reduced end-diastolic pressure, decreased left ventricular filling volume. For internal use dissolves within a few minutes in the stomach. The release of active substance from the pellets is observed for a prolonged time. The effect occurs quickly and lasts for a long time. Rapidly absorbed, becomes effective within 15 minutes. Maximum concentration in the blood after 15 minutes (maintained for 1-2 hours). Bioavailability is 22%, blood proteins bind 30% of the drug. In hepatocytes transformed to isosorbide-2-mononitrate and isosorbide-5-mononitrate. The half-life of metabolites - 4-6 and 1.5-2 hours, respectively. Is eliminated by the kidneys as metabolites.
Indications for use:
• therapy of coronary heart disease for a long time, the prevention of angina attacks;
• prevention infaktov infarction (secondary) - used long-acting dosage forms kardiket;
• as part of a comprehensive treatment of chronic heart failure (diuretics, cardiac glycosides, and angiotensin-converting factor).
How to use:
Therapy begins with the most minimal doses. Should be carried out slowly increase the dose to the most effective. The duration of therapy is determined individually by your doctor. Designed exclusively for prolonged use, so you can not abruptly stop using kardiket without consulting a physician.
Kardiket administered orally, with a little water, regardless of the meal. Do not chew. When you need to divide in half tablet is placed on a hard surface so that the fault line was on top and press down on the line with your finger.
Tablets 20 mg prolonged appoint 1 piece 2 times a day. If necessary dosage can be increased - 1 tablet 3 times daily.
Prolonged tablets 40 mg is first applied on one tablet / day (or half a tablet a day, 2 times). If necessary, increase the dose to 1 tablet 2 times a day with an interval of at least 8 hours.
Tablets 60 mg prolonged administered as initial therapy: 1 tablet / day. If necessary, increase to 2 tablets / day at intervals of at least 8 hours.
Sustained-release capsules are used for the 120 mg / day.
Side effects:
Cardiovascular system: nitrate headaches (at the beginning of therapy) - usually disappear after a few days of taking the drug; hypotension, palpitations, orthostatic collapse, confusion, feeling of weakness, paradoxical bradycardia, loss of consciousness against the background of deceleration heartbeat (syncope), paradoxical angina.
Central nervous system: drowsiness, blurred vision, stiffness, ischemic, slowing the rate of psycho-motor response.
Gastrointestinal tract: vomiting, nausea, dry mouth, epigastric pain, belching.
Allergic reactions: urticaria.
Other: exfoliative dermatitis, the development of tolerance to kardiket or other nitrate drugs, redness of the skin.
Contraindications:
absolute:
Pregnancy:
Pregnant and nursing mothers kardiket appointed only if the expected positive effects for women prevail over potential risk to the fetus (baby).
Interaction with other drugs:
At a joint appointment with other vasodilators, means to lower blood pressure, slow calcium channel blockers, antipsychotics, tricyclic antidepressants, ethanol, quinidine, blockers, inhibitors of the enzyme phosphodiesterase type 5, novokainamidom, drugs to treat impotence kardiket hypotensive effect is potentiated.
In combination with dihydroergotamine hypotensive effect is enhanced by increasing the latter to its concentration in the blood. Reduced antianginal effect kardiket may occur when combined with sympathomimetics and alpha-blockers.
The most efficient in the treatment of coronary heart disease is a combination of co-administration kardiket with nifedipine, propranolol, amiodarone.
Simultaneous treatment with acetylsalicylic acid improves blood circulation in coronary vessels.
Increased intraocular pressure is possible with a combination kardiket with atropine or other M-holinoblokatorami.
Kardiket absorption from the stomach to reduce the enveloping and binding agents.
overdose:
In case of overdose kardiket there is a strong decrease in blood pressure, loss of consciousness, collapse, dizziness, headache, redness of the skin, visual disturbances, nausea, vomiting, diarrhea, palpitations, cyanosis of the skin and mucous membranes and anoxia (due metgemoglobinoobrazovaniya), slowing of the heartbeat, paralysis coma; hyper, dyspnea; perspiration, brain hypotension. When symptoms of overdose you must enter into a vein 1% solution of methylene blue at the rate of 1-2 mg / kg body weight (with methemoglobinemia). Symptomatic therapy is ineffective epinephrine.
Product:
Sustained-release tablets 20 mg (white, round, flat, one side, and of risk chamfer on one side engraved letters «IR» and the numeral "20" engraved on the other side «SCHWARZ PHARMA»).
On prolonged action tablets 40 mg instead of "20" engraved "40" on the sustained-release tablets 60 instead of the "20" engraved "60". Other characteristics of the tablets are the same.
Po120 mg capsule - gelatin, hard, light brown, capsules containing granules of white or white-yellow practically odorless or with a slight odor.
The tablets are packed in depot stripes package in a carton box 20 or 50 tablets. Capsules - 10 pieces in blisters, carton box.
Storage conditions:
Keep out of the reach of children, dry and at a temperature not exceeding 25 ° C. Shelf life kardiket - 5 years. List B.
Ingredients:
Long-acting tablets kardiket:
Active ingredient: isosorbide dinitrate.
Auxiliary components: magnesium stearate, talc, potato starch, lactose monohydrate, polyvinyl acetate.
Sustained-release capsules:
Active ingredient: isosorbide dinitrate.
Auxiliary components: sugar spheres, lactose, talc, poly-0-ethylcellulose, shellat.
In addition:
A tendency to hypotension, increased intracranial pressure, renal and / or hepatic insufficiency, increased peristalsis of the gastrointestinal tract, hypothyroidism, malabsorption, the elderly should be used with caution under constant medical supervision.
Do not use for relief of angina attacks. The drug should be avoided in high doses - with the possible development of tolerance to both kardiket and other nitrates (cross-tolerance).
When administered to patients with lung diseases (primary) may develop transient hypoxemia as a result of redistribution of blood in less ventilated lung areas. If the patient says coronary heart disease - it can cause myocardial ischemia transient in nature.
In acute cardiovascular disease and / or myocardial infarction in the acute phase requires careful medical supervision for patients who take kardiket.
Do not abruptly cancel the drug because of the risk of increased frequency of angina attacks.
If a patient develops angina while taking kardiket - must also enter the number of fast-acting nitrates. Titration is carried out individually depending on the blood pressure.
By paradoxical nitrate reactions include reaction of lowering blood pressure, orthostatic hypotension, decreased blood pressure after drinking alcohol (ethanol) during exercise in hot weather. It is possible exacerbations of angina until the development of myocardial infarction or sudden death.
In severe headache while taking kardiket must assign mentolsoderzhaschie drugs (validol) and / or reduce the dose kardiket.
At the very frequent use may develop addiction, it requires doge increase in dosage. For the prevention of such a state must follow the mode of reception kardiket: required daily medication-free interval (usually at night for 9-12 hours). This is more efficient than a continuous therapy without kardiket intervals.
Treatment is canceled if the intake of kardiket there is a pronounced dry mouth and blurred vision, which are expressed strongly enough.
At the time of treatment kardiket absolutely can not drink alcohol and ethanol-containing drugs. The period of treatment is not recommended to drive vehicles engaged in the production, which requires intense concentration and attention to speed psihodvigatelnyh reactions.
