Curantyl n Coated Tablets 75mg N40
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Active ingredients
Dipyridamole
Release form
Pills
Composition
1 tablet contains: Active substances: dipyridamole 75 mg. Adjuvants: starch-corn - 33.75 mg, lactose -12.5 mg monohydrate, carboxymethyl starch sodium (type A) - 3.75 mg, gelatin - 2.5 mg, anhydrous colloidal silicon dioxide - 1.25 mg, magnesium stearate - 1.25 mg. The composition of the film coating: hypromellose - 0.9 mg, talc - 0.4 mg, macrogol 6000 - 0.12 mg, titanium dioxide (E171) - 0.1 mg , the quinoline yellow dye (E104) - 0.01 mg, simethicone emulsion - 0.002 mg.
Pharmacological effect
Vasodilator myotropic action. It has a inhibitory effect on platelet aggregation, improves microcirculation. Dipyridamole expands arterioles in the coronary blood flow system, when taken in high doses - and in other parts of the circulatory system. However, unlike organic nitrates and calcium antagonists, the expansion of larger coronary vessels does not occur. The vasodilator action of dipyridamole is due to two different mechanisms of inhibition: suppression of adenosine uptake and inhibition of phosphodiesterase. In vivo, adenosine is found at a concentration of approximately 0.15-0.20 mcmol. This level is maintained due to the dynamic equilibrium between overshoot and reverse capture. Dipyridamole inhibits the capture of adenosine by endothelial cells, red blood cells and platelets. After the administration of dipyridamole, an increase in the concentration of adenosine in the blood and an increase in adenosine-induced vasodilation are detected. At higher doses, inhibition of platelet aggregation caused by adenosine occurs, and the tendency to thrombosis is reduced. The decline of cAMP and cGMP, which suppress platelet aggregation, occurs in platelets under the action of the corresponding phosphodiesterase. In high concentrations, dipyridamole inhibits both phosphodiesterase, in therapeutic concentrations in the blood - only cGMP-phosphodiesterase. As a result of stimulation of the corresponding cyclases, the power of cAMP synthesis increases. As a pyrimidine derivative, dipyridamole is an interferon inducer and has a modulating effect on the functional activity of the interferon system, increases the decreased production of interferon alpha and gamma leukocytes in vitro.The drug increases nonspecific resistance to viral infections.
Pharmacokinetics
Absorption and distribution After a single oral dose of 150 mg Cmax of dipyridamole in plasma averages 2.66 mcg / l and is reached within 1 hour after administration. Dipyridamole is almost completely bound to plasma proteins. Dipyridamole builds up in the heart and in red blood cells. Metabolism and excretion Dipyridamole is metabolized in the liver by binding to glucuronic acid. T1 / 2 is 20-30 minutes. It is displayed with bile in the form of a monoglucuronide.
Indications
- Treatment and prevention of cerebral circulatory disorders of the ischemic type; - dyscirculatory encephalopathy; - primary and secondary prevention of coronary artery disease, especially with intolerance to acetylsalicylic acid; - prevention of arterial and venous thrombosis and treatment of their complications; - prevention of thromboembolism after the prosthetic heart valve prevention of placental insufficiency in complicated pregnancies; - disorders of microcirculation of any type (as part of complex therapy); prevention and treatment of influenza A, acute respiratory viral infections (as an interferon inducer and immunomodulator) - to receive the drug in a dose of 25 mg.
Contraindications
- Hypersensitivity to the components of the drug; - Acute myocardial infarction; - Unstable stenocardia; - Common stenotic atherosclerosis of the coronary arteries; - Subaortic aortic stenosis; - Heart failure in the decompensation stage; heart rhythm; - chronic obstructive pulmonary disease; - chronic renal failure; - liver failure; - hemorrhagic diathesis; - diseases with an increased risk of developing ichthyroid bleeding (including gastric ulcer and duodenal ulcer).
Precautionary measures
Curantil is not recommended to appoint children under the age of 12 years due to the lack of sufficient clinical experience of its use.
Use during pregnancy and lactation
It is possible to use the drug during pregnancy according to indications. The use of the drug during lactation is possible only if the expected benefit from the treatment outweighs the possible risk.
Dosage and administration
The dose of the drug is selected depending on the severity of the disease and the individual reaction of the patient. 75 mg 3 times a day is recommended for IHD. If necessary, the daily dose may be increased under the supervision of a physician. For the prevention and treatment of disorders of cerebral circulation, as well as for prevention, 75 mg is prescribed 3-6 times / day. The maximum daily dose is 450 mg. To reduce platelet aggregation, Curantil is prescribed at a dose of 75-225 mg / day in several doses. In severe cases, the dose may be increased to 600 mg / day. For the prevention of influenza and ARVI, especially during epidemics, Curantil is N25 and Curantil 25 are prescribed 50 mg each (2 pills or 2 pills) / day in 1 administration. The drug is taken 1 time per week for 4-5 weeks. To prevent recurrence of acute respiratory viral infections in patients who frequently have respiratory viral infections, Curantil N25 and Curantil 25 are prescribed 100 mg / day (2 pills or pills 2 times / day with an interval of 2 h) The drug is taken 1 time per week for 8-10 weeks. Tablets should be taken on an empty stomach, without breaking and not cracking, with a small amount of liquid. The duration of the course of treatment is determined by the doctor.
Side effects
On the part of the cardiovascular system: palpitations, tachycardia (especially when other vasodilators are used simultaneously), bradycardia, flushing to the face, flushing of the skin, coronary robbery syndrome (when using the drug in a dose of more than 225 mg / day), reducing AD. Systems: nausea, vomiting, diarrhea, epigastric pain. Usually, these side effects disappear with longer use of the drug. From the blood coagulation system: thrombocytopenia, change in the functional properties of platelets, bleeding; in rare cases - increased bleeding during or post-surgical intervention. On the CNS side: dizziness, noise in the head, headache. Allergic reactions: skin rash, urticaria. Others: weakness, feeling of ear congestion, arthritis, myalgia, rhinitis. When using the drug In therapeutic doses, side effects are usually mild and transient.
Overdose
Symptoms: decreased blood pressure, angina pectoris, tachycardia, tidal sensation, weakness and dizziness. Treatment: artificial vomiting, gastric lavage, the appointment of activated charcoal. The vasoconstrictor effect of the drug can be stopped by a slow (50-100 mg / min) i.v. administration of aminophylline.If the symptoms of stenocardia persist, the appointment of nitroglycerin sublingually.
Interaction with other drugs
With simultaneous use of Curantila with anticoagulants or acetylsalicylic acid, the antithrombotic effect of the latter increases and, accordingly, the risk of developing hemorrhagic complications. With simultaneous use, Curantil enhances the effect of antihypertensive drugs.
special instructions
If tea or coffee is consumed simultaneously (contain xanthine derivatives), the Courantila vasodilator effect may decrease. and the speed of psychomotor reactions.