Amiokordin

Amiokordin – the antiarrhytmic drug of a class III possessing anti-anginal action.

Form of release and structure

Amiokordin is issued in the following forms:

• Tablets: biconvex, round, white or white with a cream shade, on one party is available risk (on 10 pieces in blister strip packagings, in a cardboard pack of 3, 6 or 50 packagings; for hospitals – on 100 packagings in a cardboard box);
• Solution for intravenous administration: transparent, slightly yellowish, visible mechanical inclusions are absent (on 3 ml in ampoules, on 5 ampoules in blisters, in a cardboard pack 1 blister; for hospitals – on 20 blisters in a cardboard box).

Structure of 1 tablet:

• Active ingredient: Amiodaronum a hydrochloride – 200 mg;
• Auxiliary components: povidone, magnesium stearate, lactoses monohydrate, silicon dioxide colloid anhydrous, starch corn.

Structure of 1 ml of solution:

• Active ingredient: Amiodaronum a hydrochloride – 50 mg;
• Auxiliary components: polysorbate 80, benzyl alcohol, water for injections.

Indications to use

• Ventricular arrhythmias, life-threatening (including ventricular tachycardia);
• Supraventricular arrhythmias (a thicket at impossibility or inefficiency of other treatment), including a paroxysm of trembling and atrial fibrillation;
• Arrhythmias against the background of chronic heart failure or coronary insufficiency;
• Ventricular arrhythmias at patients with Shagas's myocarditis;
• Ventricular and atrial premature ventricular contraction;
• Prevention of attacks of stenocardia;
• Stopping of a parasystole;
• Prevention of fibrillation of ventricles.

Contraindications

Absolute:

• Sinuatrial blockade;
• Cardiogenic shock;
• Collapse;
• Sinus bradycardia;
• Arterial hypotension;
• Sick sinus syndrome;
• Intersticial pulmonary diseases;
• Heavy respiratory insufficiency;
• AV blockade of the II-III degree (provided that the pacemaker is not used);
• Thyrotoxicosis;
• Hypopotassemia;
• Hypothyroidism;
• Period of pregnancy and breastfeeding;
• Simultaneous use of monoamine oxidase inhibitors;
• Hypersensitivity to iodine and/or any of drug components.

Relative (Amiokordin apply with care):

• Liver failure;
• Chronic heart failure;
• Advanced age;
• Bronchial asthma;
• Children's and teenage age up to 18 years (there are no data on efficiency of drug and its safety during use for children).

Route of administration and dosage

Tablets
Pill Amiokordin is taken inside, in time or after food. They should be swallowed entirely, washing down with water. To adult patients drug appoint 200 mg in an initial single dose. An initial daily dose – 600-800 mg, maximum daily – 1200 mg. Frequency rate of use – 2-3 times a day. Therapy duration – 8-15 days.

The maintenance dose of Amiokordin makes 100-400 mg a day in 1-2 receptions. The drug minimal effective dose is recommended. It can be accepted every other day in a double dose.

To patients 75 years drug are more senior appoint in minimal effective doses (both initial, and supporting).

Solution for intravenous administration
Solution Amiokordin is intended for injections only for use in the conditions of a hospital when oral administration of drug is impossible or achievement of antiarrhytmic effect is required urgently. For intravenous jet or drop administration the single dose makes 5 mg on body weight kg, daily – to 15 mg on body weight kg (but no more than 1200 mg).

To patients 75 years drug are more senior appoint in minimal effective doses (both initial, and supporting).

Side effects

• Alimentary system: a loss of appetite, an abdominal pain, vomiting and nausea, heavy feeling in epigastric area, loss or obtusion of taste, diarrhea or locks, a meteorism; seldom – increase in activity of transaminases of a liver; at prolonged treatment – a cholestasia, cirrhosis, toxic hepatitis, jaundice;
• Respiratory system: at prolonged treatment – short wind, pleurisy, cough, a pneumosclerosis, an alveolitis or intersticial pneumonia; at intravenous administration – an apnoea, a bronchospasm (at patients with heavy respiratory insufficiency);
• Cardiovascular system: AV blockade, bradycardia; at prolonged treatment – emergence or strengthening of the available arrhythmia, ventricular arrhythmia on the pirouette type, progressing of chronic heart failure; at intravenous administration – lowering of arterial pressure;
• System of a hemopoiesis: aplastic and hemolitic anemia, thrombocytopenia;
• Central and peripheral nervous system: depression, paresthesias, weakness, auditory hallucinations, dizziness and headache, fatigue; at prolonged treatment – an ataxy, disturbance of memory and a dream, a tremor, an optic neuritis, a peripheral neuropathy, extrapyramidal frustration; at intravenous administration – increase in intracranial pressure;
• Sense bodys: retina microamotio, adjournment of a pigment of lipofuscin in an eye cornea epithelium, a uveitis;
• Endocrine system: hyper - or a hypothyroidism;
• Dermatological reactions: exfoliative dermatitis, baldness, photosensitivity, skin rash; seldom – coloring of integuments in gray-blue color;
• Local reactions (at intravenous administration): thrombophlebitis;
• Other reactions: vasculitis, myopathy, seed plant appendage inflammation, decrease in a potentiality; at intravenous administration – the strengthened sweating, heat.

Special instructions

Before therapy by drug Amiokordin, and also at long therapy it is necessary to control function of a thyroid gland and to carry out X-ray of lungs, in case of need – to correct electrolytic disturbances. During treatment it is necessary to visit the oculist regularly.

Intravenous administration is carried out under constant control of heart rate, arterial pressure and an ECG.

During treatment patients have to avoid direct exposure to sunlight.

At drug withdrawal there can be recurrence of disturbances of a cordial rhythm.

Amiokordin can influence test results on the iodconcentrating function of a thyroid gland.

Medicinal interaction

Amiokordin it is not necessary to apply at the same time with the following medicines: other antiarrhytmic means, Vincaminum, blockers of calcium channels, corticosteroids, сультоприд, beta adrenoblockers, purgatives, Amphotericinum In intravenously, erythromycin intravenously, pentamidine intravenously and diuretics.

Astemizol, tricyclic antidepressants, терфенадин and fenotiazina exponentiate lengthening of an interval of QT and probability of development of ventricular arrhythmia.

Cimetidinum slows down metabolism of Amiodaronum.

Drug strengthens effects of digoxin, cyclosporine, warfarin and Phenytoinum.

Terms and storage conditions

To store in the dark place at a temperature no more than 25 °C. To protect from children.

Period of validity: tablets – 5 years, solution for injections – 2 years.