Amiodaronum

Амиодарон Drug photo

The description is actual on 24.01.2015

  • Latin name: Amiodaron
  • ATH code: C01BD01
  • Active ingredient: Amiodaronum (Amiodarone)
  • Producer: Balkanpharma-Dupnitza (Bulgaria), Northern star, Organic chemistry, Bioky closed joint stock company, AVVA-RUS, Obolensky FP (Russia)

Structure

One tablet of Amiodaronum contains 200 mg of Amiodaronum of a hydrochloride and such excipients as: lactose, corn starch, alginic acid, low-molecular povidone and magnesium stearate.

Release form

Amiodaronum is issued in tablets in blisters on 10 pieces or in bank from light-protective glass on 30 pieces. Drug is packed into cardboard packs which can contain 30 or 60 tablets.

Solution for intravenous administration (the recipe in Latin): Rp.: Sol. 300 mg Amiodaroni diluitur Dextrosum 5%-20 ml.

Pharmacological action

Possesses antiarrhytmic, koronarovazodilatiruyushchy and anti-anginal action.

Pharmacodynamics and pharmacokinetics

Amiodaronum — active agent which is capable to facilitate cardiac performance, significantly without changing cordial emission and contractility of a cardiac muscle of a myocardium. At the same time, drug increases a coronary blood flow due to decrease in resistance in heart arteries, and also reduces ChSS and the ABP thanks to peripheral vazodilatiruyushchy effect. It significantly reduces consumption level a myocardium of oxygen and at the same time raises power stocks of a myocardium by means of increase in content of creatine phosphate and a glycogen.

Indications to use of Amiodaronum

It is applied to treatment, and also prevention of paroxysmal disturbances of a rhythm:

  • ventricular arrhythmias which threaten life, and also at patients with Shagas's myocarditis;
  • ventricular tachycardia;
  • prevention of fibrillation of ventricles, among other — after carrying out actions of cardioversion;
  • blinking paroxysm;
  • atrial flutter;
  • ekstrasistoliya atrial or ventricular;
  • the arrhythmias arising against chronic heart or coronary failure;
  • parasystole;
  • stenocardia.

The indication to use of Amiodaronum are also supraventricular arrhythmias in cases of inefficiency or impossibility of use of other therapy that is usually connected with WPW syndrome.

Contraindications

  • sinus bradycardia;
  • syndrome of a loose sinus knot;
  • sinuatrial or AV blockade of the 2nd and 3rd degree (without use of a pacemaker);
  • cardiogenic shock;
  • collapse;
  • hypopotassemia;
  • arterial hypotension;
  • hypothyroidism (insufficient release of hormones of a thyroid gland);
  • thyrotoxicosis;
  • intersticial pulmonary diseases;
  • reception of MAO inhibitors;
  • period of pregnancy and lactation;
  • hypersensitivity to components of Amiodaronum or to iodine;
  • with care should apply children and teenagers till 18 flyings.

Side effects

Use of tablets of Amiodaronum can cause the following side effects of rather certain bodies and systems:

  • Cardiovascular system: a sinus bradycardia (refractory to m-holinoblokatoram), AV blockade, thrombophlebitis, a vasculitis, at prolonged use — progressing of HSN, ventricular arrhythmia like "pirouette ", strengthening of the existing arrhythmia or its emergence, at parenteral use — decrease in the ABP.
  • Endocrine system: hypo — or a hyper thyroidism develops.
  • Respiratory system: prolonged use can lead to developing of cough, asthma, intersticial pneumonia or an alveolitis, and also pneumosclerosis, pleurisy. At parenteral use the bronchospasm, an apnoea, especially at people with severe forms of respiratory insufficiency is possible.
  • Alimentary system: most often there is nausea, vomiting, a lock or diarrhea, a meteorism, weight in epigastriums, appetite goes down, flavoring feelings become dull, is more rare — increase of activity of transaminases of a liver, in case of prolonged use — toxic hepatitis, a cholestasia, icteric coloring of covers, and also cirrhosis.
  • Central and peripheral nervous system: headaches, an adynamy, dizziness, depressions, paresthesias, auditory hallucinations are possible. In case of prolonged use — a peripheral neuropathy, extrapyramidal manifestations, a tremor, disturbance of memory, a dream, an ataxy, an optic neuritis. At parenteral use intracranial hypertensia can develop.
  • Sense bodys: a uveitis (an inflammation of a choroid of an eye of various localization), adjournment of a glycolipoproteid lipofuscin in an eye cornea epithelium that can be shown at bright light in the form of disturbances: complaints to the shining points or a so-called "veil before eyes", besides, micropeeling of a retina is possible.
  • Bodies of a hemopoiesis: thrombocytopenia, hemolitic or aplastic anemia.
  • Integuments: rash, defeat in a type of exfoliative dermatitis, a photosensitization, an alopecia, seldom arose manifestations in the form of gray-blue coloring of integuments.
  • Others: the epididymite and decrease in a potentiality, a myopathy, at parenteral use is possible heat and the increased sweating.

Use of drug for patients of advanced age considerably increases risk of development of severe forms of bradycardia.

Tablets Amiodaronum, application instruction (Way and dosage)

The pill Amiodaronum should be taken inside, to food, with a necessary amount of water for a proglatyvaniye. The application instruction of Amiodaronum assumes the individual mode of dosing which has to be established and adjusted by the attending physician.

Standard scheme of dosing:

  • Load (in a different way saturating) the initial dose for hospitalization which is divided into several receptions makes 600–800 mg a day, and the most admissible daily dose — to 1200 mg. It is necessary to consider that the total dose has to be 10 g, usually it is reached in 5–8 days.
  • For out-patient treatment appoint an initial dose within 600–800 mg a day which is divided into several receptions, reaching also total dose no more than 10 g, however in 10–14 days.
  • For continuation of a course of treatment Amiodaronum it is enough to accept 100–400 mg a day. Attention! The minimum effective maintenance dose is used.
  • To avoid drug cumulation, it is necessary to take a pill or every other day, or with a break in 2 days once a week.
  • The average single dose having therapeutic effect makes 200 mg.
  • Average daily dose — 400 mg.
  • The most admissible dose – no more than 400 mg for 1 time, no more than 1200 mg for 1 knocks.
  • For children a dose — usually within 2,5-10 mg a day.

Overdose

The one-time considerable dose can cause:

As treatment appoint a gastric lavage, absorbent carbon, symptomatic actions, at development of bradycardia Atropine, β1-адреномиметики, in extreme cases — cardiostimulation.

The specific antidote does not exist, the hemodialysis is inefficient.

Interaction

At simultaneous use of this drug with the following means there can be various reactions:

  • Antiarrhytmic means of a class 1A and Disopyramidum, Prokainamid, Quinidine increase a cordial interval of QT and increase risk of development of ventricular tachycardia "pirouette".
  • The purgatives causing a hypopotassemia, and also diuretics, corticosteroids including in/in Amphotericinum, Tetrakozaktid, tsizaprid, in a combination with Amiodaronum increase risk of development of arrhythmia of ventricles of heart.
  • Means of the general anesthesia, oxygenotherapy — risk of development of bradycardia, disturbances of conductivity of heart, arterial hypotension, reduction of shock V heart.
  • Tricyclic antidepressants, fenotiazina, Astemizol and Terfenadin also cause lengthening of an interval of QT and risk of development of ventricular arrhythmia (most often the pirouette type).
  • Warfarin, Fenprokumon, Atsenokumarol strengthen anticoagulating effect and increase risk of development of bleedings.
  • Vincaminum, Sultoprid, Erythromycin in/in, Pentamidine in/in and in oil increase risk of development of ventricular arrhythmias, including like "a pirouette ".
  • Dextromethorphan — increase of plasma concentration owing to reduction of speed of a metabolism in a liver, and also removal from an organism that is caused by inhibition of activity of an isoenzyme of Tsitokhrom of CYP2D6.
  • Digoxin – essential increase in its plasma concentration, its clearance connected with decrease that raises a possibility of development of digitalis intoxication.
  • Diltiazem, Verapamil — strengthening of a negative inotropic effect, development of bradycardia, conductivity disturbance, and also AV blockade.
  • Indinavir, Ritonavir, Nelfinavir, Sakvinavir, Cimetidinum – increase of concentration of active agent — Amiodaronum in plasma is possible. Colestyraminum, Phenytoinum – opposite action.
  • Amiodaronum can increase concentration of Lidocaine in a blood plasma, and also cause spasms, perhaps, owing to suppression of a metabolism of Lidocaine.
  • Lithium carbonate — development of a hypothyroidism.
  • Propranolol, Metoprolol, Sotalol — arterial hypotension, an asystolia, bradycardia, fibrillation of ventricles.
  • Trazodonum — is described a case of developing of arrhythmia "pirouette".
  • Cyclophosphamide in high doses — pulmonary toxicity.

Terms of sale

Drug is released according to the recipe.

Storage conditions

In the dry dark place, at a temperature no more than 30 ° Celsius. It is necessary to limit access to children to drug.

Period of validity

No more than three years.

Synonyms

Belupo's Amiodaronum, Amiodaronum Aldaron, Angoronum, Atlansil, Kordaron, Cordinil, Medakoron, Sandoz, Sedakoron.

Analogs of Amiodaronum

Coincidence on the ATH code of the 4th level:

Analogs of Amiodaronum relatives on structure or effect can be chosen depending on portability, the scheme of therapy and reception in a complex of other drugs, and also from individual preferences of the doctor or patient (the price, the manufacturing country and other):

Zdravzona

  • Amiodaronum Acre of 200 mg No. 30 tabletkiakrikhin HFK of joint stock company
  • Amiodaronum of 200 mg No. 30 tablet/Biokom/Biok of closed joint stock company
  • Amiodaronum Sandoz of 200 mg No. 60 tabletkisalyutas Farm Gmbh
  • Amiodaronum Sandoz of 200 mg No. 100 tabletkisalyutas Farm Gmbh
  • Amiodaron-SZ 200 mg No. 60 tabletkiseverny star of closed joint stock company
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Apteka24

  • Amiodaron-LH No. 30lekhim-Kharkiv tablets 0.2g (Ukraine, Kharkiv)

Paniapteka

  • Amiodaron-LH tab. 0.2g No. 30
Section: Cardiological Cardiovascular
in more detail

Education: Graduated from the Nikolaev national university of V. A. Sukhomlinsky, gained the diploma of the specialist with honors as "An embryologist, a cytologist, a histologist". Also, the human physiology and animals, the teacher of biology" graduated from a magistracy majoring in ". The course on discipline "Pharmacology" is with honors passable.

Experience: Worked as the senior laboratory assistant of department of Physiology and biochemistry of the Nikolaev national university of V. A. Sukhomlinsky in 2010 - 2011.

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