Effox Long Tablets 50mg N30
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Active ingredients
Isosorbide mononitrate
Release form
Pills
Composition
Isosorbide mononitrate 50 mg. Auxiliary substances: pellets (sugar balls containing sucrose (sucrose), corn starch), lactose monohydrate, magnesium hydrosilicate, ethylcellulose, polyethylcellulose, polyethylene glycol (macrogol), hyprolose. The composition of the lid of the capsule: titanium dioxide (E171), iron oxide red (E172), iron oxide black (E172), gelatin. The composition of the body of the capsule: titanium dioxide (E171), iron oxide red (E172), gelatin.
Pharmacological effect
Peripheral vasodilator with a predominant effect on the venous vessels. Stimulates the formation of nitric oxide (endothelial relaxing factor) in the vascular endothelium, which causes the activation of intracellular guanylate cyclase, resulting in an increase in cGMP (vasodilation mediator). Reduces the oxygen demand of the myocardium by reducing preload and afterload (reduces the end-diastolic volume of the left ventricle and reduces the systolic tension of its walls). It has a coronary expanding action. Reduces blood flow to the right atrium, helps reduce pressure in the pulmonary circulation and regression of symptoms in pulmonary edema. Promotes redistribution of coronary blood flow in the area with reduced blood circulation. Increases tolerance to exercise in patients with coronary artery disease, angina. Expands the vessels of the brain, dura mater, which may be accompanied by headache. Like other nitrates, cross-tolerance develops. After cancellation (interruption of treatment), sensitivity to it is quickly restored. Antianginal effect occurs within 30-45 minutes after ingestion and lasts up to 8-10 hours
Pharmacokinetics
Absorption: When ingestion, the absorption of isosorbide mononitrate is high, the bioavailability is 100%. The time to reach Cmax is 8 hours. Distribution: Binding to plasma proteins is less than 4%. Metabolism: Isosorbide mononitrate is almost completely metabolized in the liver to form pharmacologically inactive metabolites. Withdrawal: T1 / 2 is about 4-5 hours. It is excreted by the kidneys almost exclusively as metabolites, 2% - unchanged.
Indications
- prevention of strokes and subsequent treatment of angina after myocardial infarction - pulmonary hypertension (as part of combination therapy) - treatment of chronic heart failure (as part of combination therapy with cardiac glycosides, diuretics, ACE inhibitors).
Contraindications
- acute circulatory disorders (shock, vascular collapse) - cardiogenic shock, if correction of the end diastolic pressure of the left ventricle is impossible using intra-aortic counterpulsation or by administering agents that have a positive inotropic effect — severe arterial hypotension (systolic BP <90 mm Hg). and diastolic blood pressure <60 mmHg) - simultaneous administration of phosphodiesterase inhibitors, incl. Sildenafil, vardenafil, tadalafil, because they potentiate the hypotensive effect of the drug — acute myocardial infarction with severe arterial hypotension — traumatic brain injury, cerebral hemorrhage — anemia (severe form), hereditary intolerance to galactose, lactase deficiency, or malampormalization intolerance, or malampormalization intolerance, or malampormalization intolerance, maltogravity intolerance, malactase intolerance, malactori intolerance, malacto-intolerance syndrome, lactase and malampormalization intolerance, maltoxicity syndrome, malaine tosis, anemia (galactose intolerance, lactase deficiency, or malampormalization intolerance; pulmonary edema — children and adolescents under 18 years of age (efficacy and safety not established) - hypersensitivity to the drug, organic nitrates. It is recommended to use the drug for: - hypertrophic obstructive cardiomyopathy - constrictive pericarditis - tamponade pericardium - reduced filling pressure of the left ventricle, for example, in acute myocardial infarction (risk of reducing blood pressure and tachycardia, which can increase ischemia), reducing the function of the left ventricle (left ventricular failure) Systolic BP <90 mmHg — aortic and / or mitral stenosis — susceptibility to arterial hypotension (orthostatic disturbances in the regulation of blood circulation) —Head failure with low left ventricular filling pressure — glaucoma (risk of increased intraocular pressure) should not be tolerated. an increase in intracranial pressure (previously, an increase in pressure was noted only with IV injection of high doses of nitroglycerin), incl. in hemorrhagic stroke, a recent head injury — severe renal failure — liver failure (risk of developing methemoglobinemia).
Dosage and administration
Assign orally at a dose of 50 mg 1 time / day. The duration of treatment and repeated courses - as recommended by the doctor.The drug is taken after meals, without chewing and squeezing a small amount of liquid.