Koraksan

Кораксан Drug photo

The description is actual on 17.06.2014

  • Latin name: Coraxan
  • ATH code: C01EB17
  • Active ingredient: Ivabradin (Ivabradine)
  • Producer: "Servye Indastri's laboratories", France

Structure

The quantity of excipients practically does not differ in different forms of production of drug, that is the dosage of excipients corresponds to tablets both with 5, and from 7.5 mg of an ivabradin:

  • monohydrate of lactose – 62 mg;
  • corn starch – 20 mg;
  • maltodextrin – 10 mg;
  • magnesium stearate – 0.5 mg;
  • anhydrous, colloid silicon dioxide – 0.2 mg.

The cover of each tablet of Koraksan consists from:

  • gipromelloza – 1.5 mg;
  • titanium dioxide (E 171) – 0.26 mg;
  • macrogoal of 6000 - 0.09 mg;
  • magnesium stearate – 0.087 mg;
  • yellow dye of iron oxide (E 172) – 0.015 mg;
  • red dye of iron oxide (E 172) – 0.00485 mg.

Release form

It is possible to find drug in two variations:

  • The oval, biconvex tablets covered with a salmoncolored film with marks on two parties (on one "-", and on another figure "5"). A dosage of active agent – 5 mg.
  • Triangular tablets with a salmoncolored film and an engraving on the different parties: on one "-" on another "7.5" that means 7.5 mg of the main operating component.

Pharmacological action

Medicine Koraksan is an anti-anginal means, that is pharmacological drug which prevents development of stenocardia (the disease in Latin sounds, as "angina pectoralis", from here and the name of pharmaceutical group).

The action mechanism directly depends on biologically active component – an ivabradin. Substance is a specific selective blocker of If-channels of a sinuatrial node (the link of the carrying-out system of heart initiating excitement). Thus ivabradin promotes stabilization of spontaneous depolarization in the period of a diastole and normalizes heart rate.

Thanks to clinical trials the main pharmacological advantage of Koraksan in comparison with other anti-anginal drugs was noted. Reduction of heart rate is a dozozavisimy factor at conservative therapy by this medicine. That is at continuous increase in a daily dose up to 40 mg/day, the therapeutic effectiveness takes a plateau form that considerably reduces a possibility of decrease in a rhythm to 40 beats per minute (pathological bradycardia).

Positive line of drug is lack of impact on contractility of a myocardium (the negative inotropic effect is not exponentiated). Also Koraksan does not influence on:

  • processes of repolarization of ventricles;
  • endocardiac conductivity of a myocardium;
  • atrioventricular pause of excitement;
  • the corrected QT intervals on the electrocardiogram.

In a human body exists channels which on chemical structure are similar If. These educations are in a conjunctiva of an eye and Ih-channels are called. They take part in change of visual perception of a retina in response to bright light incentives. Being in a system blood-groove ivabradin can reach eyes and influence these educations. In that case, the photopsia phenomenon (tranzitorny distortions a svetovospriyatiya a human eye in a limited field of vision) in response to trigger factors will be observed, for example, at fast change of brightness of surrounding light.

Pharmacodynamics and pharmacokinetics

Drug is recommended to be accepted along with food upotrebleniyemprodukt as the food increases concentration in plasma of a system blood-groove from 20 to 30 percent that is shown in the form of fuller effect of medicine. That is thanks to more long absorption (the food increases a time interval for 1 hour), efficiency drug increases considerably.

Getting to a system blood stream, 70 percent of an ivabradin contact proteins of plasma by which are delivered to a sinoarterialny node of the carrying-out system of heart. Drug mainly in a liver and intestines under the influence of tsitokhrom is metabolized.

Medicinal substance is evacuated by kidneys from an organism. The elimination half-life of drug makes 2 hours, however an effective elimination half-life (a time interval when efficiency of effect of biologically active component is equal to a half of initial) – 11 hours. The renal clearance of an ivabradin – 70 ml/min., at the same time the general clearance remains at the level of 400 ml/min.

Linearity of pharmacokinetic activity of Koraksan is observed in the range of concentration of active ingredient from 0.5 to 24 mg.

Indications to use

  • Stable stenocardia (at intolerance or to absolute contraindications to pharmacological drugs of group of beta adrenoblockers);
  • chronic heart failure (if the sinoatrial rate, and heart rate remains at the level of 70 beats per minute);
  • symptomatic therapy of stenocardia (sanatsionny measures for reduction of needs of a cardiac muscle for oxygen);
  • coronary heart disease (in complex therapy and courses of prevention for normalization of a rhythm and frequency of reductions of a myocardium).

Contraindications

Koraksan's use in the scheme of conservative treatment of anginal attacks is not recommended if is available:

  • individual hypersensitivity or intolerance of the operating drug components;
  • bradycardia is lower than 60 beats per minute;
  • acute myocardial infarction;
  • cardiogenic shock;
  • renal or liver failure;
  • arterial hypotension (systolic the ABP is lower than 90 mm of mercury, and diastolic – it is lower than 50 mm of mercury);
  • total block of a sinuatrial node;
  • artificial pacemaker of non-adaptive character (with a constant impulsation);
  • children's age till 18 flyings (clinical physicians have no information on use of drug in this time interval of an ontogeny of the person).

Also there is a number of situations when it is necessary to accept Koraksan in therapeutic departments under strict control of medical personnel, in order to avoid development of an adverse effect and unexpected reactions:

  • inborn syndrome of lengthening of QT;
  • recently had ischemic stroke of a brain;
  • pigmental degeneration of a retina of an eye;
  • atrioventricular block of the second degree;
  • simultaneous use of drugs which block the slow potassium pumps extending QT interval is inhibited or action of tsitokhrom of a digestive tract oppresses.

Side effects

Clinical trials confirm that undesirable reactions of a human body to pharmacological drug are a dozozavisimy phenomenon. So at the increased concentration of the operating drug in the central and peripheral blood-groove can be observed:

Application instruction of Koraksan (Way and dosage)

Medicine should be used during meal, so the effectiveness ratio of the operating component increases several times. The daily dose can be divided into two times: in the morning at breakfast and evening – at supper. The average amount of drug makes 2 tablets (with concentration of an ivabradin – 5 mg) in day, however depending on therapeutic effect a dosage can increase. In that case, in 3-4 weeks of a conservative course of treatment the scheme of reception changes on 2 tablets with concentration of biologically active component – 7.5 mg.

The application instruction of Koraksan also considers side effects and contraindications to reception of medicinal substance. First of all, if after development of symptoms of bradycardia (constant fatigue, dizziness, lowering of arterial pressure to pathological figures) lower dosage does not promote development of therapeutic effect, the course of treatment this pharmaceutical drug is immediately stopped.

It is necessary to be extremely careful in sanitation of elderly patients. Treatment of an age category is more senior than 75 years carry out in a special way – the starting dosage makes a half of a tablet (in terms of the mass rest – about 2.5 mg of Ivabradin) and increases daily amount of drug to 5 mg only at signs of stable and high-quality conservative therapy.

Overdose

In case of overdose pharmacological drug observes the persistent, not stopped in the usual ways bradycardia. In systemically blood-groove it is necessary to apply to elimination of a condition of the increased concentration of medicine effector antagonists of Koraksan – beta-adrenergic agonists. First of all, the selection drugs interacting only with a cardiac muscle are used, however in urgentny states it is possible to apply also non-selective substances. At an urgent need overdose it is possible to treat in the surgical way – to insert a temporary artificial pacemaker of cordial reductions.

Interaction

During a conservative course of treatment Koraksan it is necessary to avoid inclusion in the scheme of reception of medicines which extend the QT segment on the electrocardiogram as Ivabradin, the main operating component of tablets, can cause additional increase in a segment and an urezheniye of heart rate. At absolute measures of use of such drugs as Quinidine, Amiodaronum, Sotalol, Erythromycin, Pimozidum, it is worth carrying out the round-the-clock monitoring of indicators of the electrocardiogram in special therapeutic departments.

With care it is possible to apply nekaliysberegayushchy diuretics (the group consists of tiazid and "loopback" diuretics) as the hypopotassemia (result of combined action of Koraksan and the pharmacological drugs increasing diuresis) can lead to heavy arrhythmias that in a complex with bradycardia or a syndrome of the extended QT directly threatens undesirable with side effects of treatment of the patient and even a lethal outcome. Therefore to force a mocheproduktion or urination it is recommended under careful supervision of the qualified medical personnel.

Unambiguously contraindicated simultaneous use of Koraksan and following list of medicines:

  • pharmacological drugs which influence hepatic cytochrome;
  • antifungal means from group of azoles (for example, ketokonazol or itrakonazol);
  • the antibiotics relating to macroleads (klaritromitsin, erythromycin, telitromitsin) or groups of rifampicin;
  • inhibitors of protease of a human immunodeficiency virus;
  • strong antidepressants (especially nefazodon);
  • sedative normotimik (the St. John's Wort which is made a hole);
  • some medicines for an anesthesia (in particular barbiturates).

Interesting feature of the main active ingredient, ivabradin, increase of concentration in a system blood-groove depending on the drunk grapefruit juice is. This natural drink is capable to increase relative amount of active component twice that unambiguously demands rational correction of a diet during a therapeutic course of administration of drug.

Terms of sale

Koraksan in pharmaceutical booths is released only according to the receptor form.

Storage conditions

It is necessary to preserve medicine Koraksan in the warm, dry place unavailable to children of younger age.

Period of validity

3 years.

Special instructions

Koraksan is applied to stabilization of a sinoatrial rate and prevention of stenocardia, however activity of pharmacological drug aims at zero if to use it against tachycardia, fibrillation of auricles or trembling of ventricles. In the listed situations ivabradin as the basic biologically active component of drug, will not render therapeutic effect, even on the contrary, substance can worsen a condition of the patient at heart failure of such genesis.

Koraksan's inclusion in a course of conservative treatment is not recommended if there is a need of complex pharmacological therapy as the safety profile can korrigirovatsya (the risk of side effects or undesirable reactions increases) owing to indirect interaction of components. You should not use drug together with blockers of calcium channels or derivatives of a dihydropyridinic row which urezhat heart rate. In particular, Verapamil, Diltiazem or Amlodipin change a profile of safety of the carried-out treatment considerably therefore it is necessary to avoid their concomitant use with Koraksan.

Koraksan's analogs

Koraksan's analogs are provided only by active ingredient in pure form, that is it is possible to knead drug in conservative treatment only Ivabradin or a hydrochloride of active component. Therefore the price of analogs not strongly differs from the market value of Koraksan and makes about 900-1000 rubles in the territory. In Ukraine Ivabradin's distribution did not gain wide popularity therefore not to find it in pharmaceutical booths.

Zdravzona

  • Koraksan 7,5mg No. 56 tabletkiservier
  • Koraksan of 5 mg No. 56 tabletkiservier

Drugstore of IFC

  • Koraksan tbl p/pl/o 5 mg No. 56, Ooorossiya's Servier/Serdiks
  • Koraksan tbl p / about 7.5mg No. 56 **, Ooorossiya's Servier/Serdiks
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Apteka24

  • Koraksan of a tablet coated 5 mg No. 56servye (France)
  • Koraksan of a tablet coated 7.5mg No. 56servye (France)

Paniapteka

  • Koraksan of the tab. p / about 5 mg No. 56servye
  • Koraksan of the tab. p / about 5 mg No. 56servye

BIOSPHERE

  • Koraksan of 7,5 mg No. 56 tabl.p.o.servier (France)
  • Koraksan of 5 mg No. 56 tabl.p.o.servier (France)
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Section: Cardiological
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Education: Kharkiv national medical university

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use Koraksan surely consult with the attending physician.