Vazokardin

Vazokardin – the drug with anti-hypertensive, antiarrhytmic and anti-anginal action applied at arterial hypertension and some other disturbances of cordial activity.

Form of release and structure

Vazokardin produce in the form of tablets (flat, round, from color, white to white with a creamy shade, with risky and a facet on one of the parties, the easy mramornost is possible), 10 pieces in blisters, on 2 or 5 blisters in cardboard packs.

50 mg or 100 mg of active agent – a metoprolol of tartrate are a part of 1 tablet.

The auxiliary components which are a part of drug: K25 povidone, monohydrate of lactose, silicon dioxide colloid, corn starch, microcrystallic cellulose, calcium stearate, silicon dioxide metilirovanny, sodium carboxymethylstarch.

Indications to use

Vazokardin appoint at:

• Arterial hypertension (in monotherapy or along with other anti-hypertensive drugs);
• Coronary heart disease: myocardial infarction (complex therapy, secondary prevention), prevention of attacks of stenocardia;
• The functional disturbances of cordial activity which are followed by tachycardia;
• Hyperthyroidism (as a part of complex therapy);
• Disturbance of a heart rhythm (ventricular premature ventricular contraction, supraventricular tachycardia);
• To prevention of attacks of migraine.

Contraindications

Vazokardin's use is contraindicated at:

• Cardiogenic shock;
• To sinuatrial blockade;
• To AV blockade of the II-III degree (without artificial pacemaker);
• Sick sinus syndrome;
• Printsmetal's stenocardias;
• The expressed disturbances of peripheric circulation;
• Chronic heart failure in a decompensation stage;
• Sinus bradycardia (at the heart rate (HR) less than 50 beats per minute);
• Acute myocardial infarction (ChSS is less than 45 beats per minute, PQ interval more than 0,25 seconds, systolic arterial pressure is less than 100 mm hg);
• Arterial hypotension (in case of use at secondary prevention of a myocardial infarction – systolic arterial pressure is less than 100 mm hg, ChSS is less than 45 beats per minute);
• Hereditary diseases – deficit of lactase, a lactose intolerance or glyukozo-galaktozny malabsorption (because of the lactose which is a part of drug);
• To pheochromocytoma (without simultaneous use of alpha adrenoblockers);
• Hypersensitivity to a metoprolol, other components of drug and other beta adrenoblockers.

Also Vazokardin do not appoint:

• Along with MAO inhibitors, intravenous administration of blockers of calcium channels like verapamil;
• To the feeding women;
• To patients aged up to 18 years (safety and efficiency of use of drug for this age group are not established).

Drug should be used with care to patients of advanced age, and also patients at:

• Metabolic acidosis;
• Diabetes mellitus;
• Depressions (including in the anamnesis);
• Renal failure (KK less than 40 ml a minute);
• Abnormal liver function;
• To AV blockade of the I degree;
• Myasthenias;
• Chronic obstructive pulmonary disease (emphysema of lungs, chronic obstructive bronchitis);
• Psoriasis;
• Thyrotoxicosis;
• Allergic reactions in the anamnesis (decrease in the therapeutic answer to adrenaline, weighting of arterial hypertension and strengthening of sensitivity to allergens is possible);
• Obliterating diseases of peripheral vessels (Reynaud's syndrome, the alternating lameness);
• To bronchial asthma.

Route of administration and dosage

Vazokardin accept inside, washing down with a small amount of water, in time or right after food. In need of a tablet it is possible to halve and swallow without chewing.

At arterial hypertension drug 1-2 times a day appoint in a daily dosage 50-100 mg with frequency rate of reception (in the morning and in the evening). At insufficient effect it is possible to raise gradually a daily dose to 100-200 mg and/or in addition to accept other anti-hypertensive means. The maximum daily dosage of drug – 200 mg.

At a hyperthyroidism, a daily dose - 150-200 mg a day in 3-4 receptions.

At arrhythmias, stenocardia, for prevention of attacks of migraine, a daily dose - 100-200 mg in 2 receptions (in the morning and in the evening).

At secondary prevention of a myocardial infarction, a daily dose - 200 mg in 2 receptions (in the morning and in the evening).

At the functional disturbances of cordial activity which are followed by tachycardia, a daily dose - 100 mg in 2 receptions (in the morning and in the evening).

To patients of advanced age, patients with functional disturbances of kidneys (KK is less than 40 ml in a minute), and also in need of carrying out a hemodialysis the dosage is not adjusted.

At the expressed abnormal liver functions depending on a clinical state the dosage of drug should be lowered.

Side effects

Side effects at Vazokardin's use depend on individual sensitivity of the patient. As a rule, they are poorly expressed and pass after drug withdrawal.

From the central nervous system: weakness, increased fatigue, drowsiness, confusion of consciousness, a headache, spasms, delay of speed of motor and mental reactions, paresthesias in extremities (at patients with Reynaud's syndrome and the alternating lameness), alarm, depression, a depression, decrease in concentration of attention, concern, the increased nervous irritability, sleeplessness, "dreadful" dreams, amnesia, hallucinations, short-term disturbance of memory, muscular weakness.

From cardiovascular system: the expressed lowering of arterial pressure, arrhythmias, a sinus bradycardia, heartbeat, orthostatic hypotension (dizziness, sometimes a loss of consciousness), cardiogenic shock at patients with a myocardial infarction, AV blockade of the I degree, decrease in sokratitelny ability of a myocardium, manifestation of a vasomotor spasm (strengthening of disturbance of peripheric circulation, a cold snap of the lower extremities, Reynaud's syndrome, gangrene), temporary aggravation of symptoms of chronic heart failure (puffiness of the lower part of shins and/or feet, an asthma), disturbance of conductivity of a myocardium.

From system of a hemopoiesis: agranulocytosis, thrombocytopenia (unusual hemorrhages and bleedings), leukopenia.

From sense bodys: morbidity and xerophthalmus, decrease in sight, sonitus, decrease in secretion of the lacrimal liquid, conjunctivitis.

From respiratory system: rhinitis, a nose congestion, an asthma, difficulty of an exhalation (a bronchospasm at appointment in high dosages – loss of selectivity and/or at predisposed patients).

From the alimentary system: taste change, increase in activity of liver enzymes, hepatitis, dryness in a mouth, vomiting, nausea, abdominal pain, diarrhea, lock, abnormal liver function, hyperbilirubinemia.

From a musculoskeletal system: arthralgia, dorsodynia;

From endocrine system: a hypoglycemia, at patients with a diabetes mellitus of 1 type – a hyperglycemia (seldom).

Allergic reactions: rash, skin itch, small tortoiseshell.

Dermatological reactions: psoriazopodobny skin reactions, dieback, aggravation of a course of psoriasis, sweating strengthening, dermahemia, photodermatosis, reversible alopecia.

Influence on a fruit: development of a pre-natal growth inhibition, bradycardia, a hypoglycemia is possible.

Others: sexual dysfunction, decrease in a libido and/or potentiality, insignificant increase in body weight.

At Vazokardin's overdose the first signs are shown in 20-120 minutes after administration of drug. The overdose is usually expressed by such symptoms as arrhythmia, dizziness, the expressed sinus bradycardia, nausea, cyanosis, vomiting, the expressed lowering of arterial pressure, a bronchospasm, ventricular premature ventricular contraction, a syncope. At acute overdose development of cardiogenic shock, a loss of consciousness, a coma, AV blockade (is possible up to development of a cardiac standstill and total cross block), a hyperpotassemia, a cardialgia, spasms, a hypoglycemia, an apnoea.

For treatment of overdose the gastric lavage, use of the adsorbing drugs, symptomatic therapy is shown. At the expressed lowering of arterial pressure the patient needs to adopt the provision of Trendelenburga. At excessive pressure decrease, development of heart failure and bradycardia intravenously enter (at an interval of 2-5 minutes) beta адреностимуляторы before achievement of desirable effect or 0,5-2 mg of Atropini sulfas. In the absence of effect introduction of Dobutaminum, dopamine or Norepinephrinum (noradrenaline) is shown. The hemodialysis is not effective.

Special instructions

At Vazokardin's use the patient should be trained in a technique of calculation of ChSS and to instruct about need of the address to the doctor at ChSS less than 50 beats per minute.

Control of the patients accepting drug includes regular observation of ChSS, arterial pressure, concentration of glucose in blood at a diabetes mellitus. For patients with a diabetes mellitus correction of a dosage of insulin or the hypoglycemic means accepted inside can be required. Drug can mask the tachycardia caused by a hypoglycemia.

At the smoking patients efficiency of drug is lower.

At reception of a dose more than 200 mg a day decrease cardioselectivity.

At chronic heart failure drug can be accepted only after achievement of a stage of compensation.

Vazokardin's cancellation is carried out gradually, reducing a dosage within 10 days. At the sharp termination of therapy there can be a withdrawal (increase in arterial pressure, strengthening of attacks of stenocardia).

At an angina of exertion the picked-up dosage of drug has to provide ChSS at rest within 55-60 beats per minute, at loading – to 110 beats per minute.

The patients using contact lenses need to consider that during treatment decrease in products of the lacrimal liquid is possible.

Drug can mask some symptoms of a hyperthyroidism (for example, tachycardia). Sharp cancellation of Vazokardin at patients with a thyrotoxicosis is contraindicated (because of possible strengthening of symptomatology).

At chronic obstructive bronchitis, a chronic obstructive pulmonary disease, bronchial asthma, emphysema drug should be accepted in minimum effective dosage and only at inefficiency of other antihypertensives or their bad portability.

It is necessary to carry out special control of a condition of patients with depressive frustration. At development of the depression connected with administration of drug, therapy is recommended to be stopped.

At elderly patients it is recommended to exercise control of function of a liver regularly. In case of development of the accruing bradycardia (less than 50 beats per minute), the expressed lowering of arterial pressure (systolic pressure is lower than 100 mm hg), a bronchospasm, AV blockade, heavy abnormal liver functions, ventricular arrhythmias correction of the mode of dosing or Vazokardin's cancellation is required.

Patients with a heavy renal failure (KK less than 40 ml a minute) are recommended to control functions of kidneys.

During treatment it is necessary to avoid excess insolation as drug can cause allergic reaction to the sun.

At the beginning of Vazokardin's use patients can test fatigue and dizziness owing to what it is recommended to be careful when driving the car and when performing potentially dangerous types of the works demanding from patients of speed of psychomotor reactions and the increased concentration of attention.

Analogs

Vazokardin's analogs on active agent are: Betalok, Vazokardin Retard, Betalok of ZOK, Metokard Retard, Corvitolum 100, Corvitolum 50, Metozok, Emzok, Metokard, Metokor Adifarm, Metolol, Metoprolol, Metoprolol Zentiva, Serdol, Metoprolol Organika, Metoprolol-OBL, Metoprolol-Acre, Metoprolol-ratiofarm, Egilok, Egilok Retard, Egilok S.

Terms and storage conditions

To store in the protected from light, dry place at a temperature of 15-21 °C. To protect from children.

Period of validity – 2 years.