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Active ingredients
Pentaerythritol tetranitrate
Release form
Pills
Composition
Pentaerythritol tetranitrate 10 mg
Pharmacological effect
Peripheral vasodilator with a predominant effect on the venous vessels, antianginal agent. The action is associated with a decrease in preload (dilation of peripheral veins and a decrease in blood flow to the right atrium) and afterload (reduction of OPS), as well as with a direct coronary dilating effect. It promotes the redistribution of coronary blood flow in the area with reduced blood supply. In patients with coronary artery disease, angina increases tolerance to physical activity. In heart failure, it helps to relieve the myocardium by reducing preload. Reduces pressure in the pulmonary circulation. Compared with nitroglycerin, the action develops more slowly, but is characterized by a longer duration.
Pharmacokinetics
When ingestion of pentaerythritol tetranitrate is slowly absorbed from the gastrointestinal tract.
Indications
IHD, angina (prevention of seizures, including in the post-infarction period); heart failure (as part of complex therapy).
Contraindications
Hypersensitivity, severe hypotension (systolic blood pressure below 90 mm Hg., Diastolic blood pressure below 60 mm Hg), collapse, shock, acute myocardial infarction, flowing with hypotension, hemorrhagic stroke, skull, cerebrospinal trauma, cerebral infarction, flowing with hypotension, hemorrhagic stroke, skull, cerebral infarction, lesions, and cerebral infarction. glaucoma, severe liver failure (risk of developing methemoglobinemia), severe renal failure, severe anemia, hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, severe aortic stenosis primary and / or mitral valve, hyperthyroidism, primary pulmonary hypertension (hyperemia of insufficiently ventilated alveolar zones can lead to hypoxia), chronic heart failure with a low filling pressure of the left ventricle, simultaneous administration of phosphodiesterase-5 inhibitors (including sildenafil, vardenafil, tadalafil), intolerance to lactose and sucrose, deficiency of sucrase-isomaltase, lactase or glucose-galactose malabsorption, hypersensitivity to the drug and its components, other organic nitra am,age up to 18 years (efficacy and safety not established) .; With caution; Applied with a tendency to hypotension in the elderly, dehydrated patients; with a tendency to orthostatic hypotension in history.
Use during pregnancy and lactation
Use with caution during pregnancy and lactation.
Dosage and administration
Dose set individually. Inside - 20 mg 3-4 times / day, if necessary, the dose can be increased to 40 mg 4 times / day or taken 80 mg 2 times / day.
Side effects
On the part of the digestive system: dyspeptic symptoms .; From the side of the central nervous system: feeling tired, anxious; rarely - headache, dizziness .; Since the cardiovascular system: rarely - orthostatic hypotension .; Other: excessive sweating, skin allergic reactions.
Overdose
The use of the drug in large doses may develop tolerance .; Symptoms: orthostatic hypotension, the feeling of compression of the head, throbbing headache, severe sweating, skin cold covered clammy or hyperemic, palpitations, bradycardia, impaired conduction (block), labored respiration, Kussmaul breathing, bloody diarrhea, vomiting, dizziness, confusion, syncopal conditions, coma, fever, paralysis, visual disturbances .; Treatment: gastric lavage, giving a horizontal position with raised legs, with severe arterial hypotension and / or in patients in a state of shock - introduction of fluid in / to the drip injection of infusion solutions, monitoring the level of methemoglobin in the blood, with its increase - the appointment of ascorbic acid dose 1 g orally, methylthioninium chloride (methylene blue) in / in up to 50 ml of 1% solution, toluidine blue - 2-4 mg / kg body weight in / in quickly, if necessary, again in a dose of 2 mg / kg with an interval of 1 h , oxygen therapy, hemodialysis, o blood transfusion.
Interaction with other drugs
If you are taking this drug with other drugs at the same time, talk with your doctor. Under the influence of dihydroergotamine may decrease antianginal effect of erinitis. The combination of these funds is considered irrational .; It is possible to enhance the hypotensive action when used simultaneously with vasodilators and antihypertensives (beta-blockers, calcium channel blockers, etc.), neuroleptics, tricyclic antidepressants, monoamine oxidase inhibitors, procainamide, ethanol,phosphodiesterase inhibitors-5 .; The combination with anaprilin is rational, since the antianginal effect is enhanced.
special instructions
Due to the slow development of the effect of pentaerythritol, tetranitrate is not used for the relief of strokes .; With caution used for violations of cerebral circulation (especially with hemorrhagic stroke), with a tendency to hypotension, in the elderly .; With prolonged use may decrease therapeutic effect (due to the development of tolerance). When using the drug 1 time / day in combination with other antianginal drugs, the risk of tolerance is less. Alcohol is contraindicated during treatment.