Моночинкве® ретард

General characteristics. Structure:

Active agent: 50 mg of isosorbide-5-mononitrate.

excipients: sucrose, starch corn, ethyl cellulose, stearin to - that, talc, red dye 4 R (Е 124), quinoline yellow (Е 104), titanium dioxide, gelatin.

Pharmacological properties:

Active agent of the drug Monochinkve® ретард - isosorbide-5-mononitrate has vasodilating and anti-anginal effect. Operates on molecular level due to formation of nitrogen oxide (NO) and a cyclic guanozinmonofosfat (tsGMF), reduction of concentration of calcium in cells of unstriated muscles. Reduces preloading (due to expansion of peripheral veins) and an afterload (owing to decrease in the general peripheric vascular resistance), reduces the need of a myocardium for oxygen, expands coronary arteries and improves a coronary blood stream, promotes its redistribution to ischemic areas, reduces the final diastolic volume of a left ventricle and reduces the systolic tension of its walls. Increases tolerance to an exercise stress of patients with an ischemic heart disease, reduces pressure in a small circle of blood circulation.

The special compounding of Monochinkve® ретард with the slowed-down release of active agent guarantees that after a single daily dose, concentration in blood provides therapeutic action for 24 hours. This medicine is especially recommended for long therapy of coronary heart diseases.

Pharmacokinetics. Drug is quickly and completely soaked up in intestines after intake. Bioavailability at intake makes from 90 to 100%. Has no effect of "the first passing through a liver". Level of concentration of drug in a blood plasma is approximately identical at a peroral and parenteral way of introduction. The maximum concentration is reached in a blood plasma in 1 - 1,5 hour after reception. An elimination half-life about 5 hours that is about 8 times higher, than at dinitrate isosorbide. Isosorbide-5-mononitrat it is removed through kidneys only in the form of metabolites. About 2% are removed in an invariable look.

Indications to use:

• Prevention and long-term therapy of stenocardia of the III-IV functional class.
• Recovery treatment after a myocardial infarction.
• Treatment of chronic heart failure (as a part of a combination therapy).

Route of administration and doses:

In the absence of other instructions appoint on 1 Monochinkve® capsule ретард once a day in the morning after food, without chewing and washing down with a small amount of liquid. The dose can korregirovatsya by the attending physician according to a condition of the patient.

Features of use:

In case of arterial hypertension drug has to be accepted only under medical control.

Drug is not used for stopping of attacks of stenocardia.

Drug is used independently or in a combination with beta adrenoblockers, blockers of calcium channels, APF inhibitors, cardiac glycosides or diuretics.

At administration of drug decline in the ability to quick response in this connection, the control of vehicles and occupation is not recommended by other potentially dangerous types of activity is possible.

Side effects:

In the recommended dosage reliable side effects are not described. However, as well as at reception of other nitrates are possible: a "nitrate" headache in an initiation of treatment. At therapy continuation it usually decreases in several days.

After the first reception or after increase in a dose of drug there can be a lowering of arterial pressure and/or development of orthostatic hypotension that can be followed by tachycardia, dizziness, and also the general weakness.

Very seldom nausea, vomiting, face reddening and skin allergic reactions can be noted.

Interaction with other medicines:

At use with other vazodilatator, anti-hypertensive drugs, beta adrenoblockers, blockers of calcium channels, antipsychotic drugs, tricyclic antidepressants, with phosphodiesterase inhibitor sildenafily, and also with alcohol potentiation of anti-hypertensive effect of the drug Monochinkve® ретард is possible.

Contraindications:

• hypersensitivity to isosorbides (mono - to dinitrate, and other organic nitrates);
• acute disorders of blood circulation (shock, vascular collapse), hemorrhagic stroke;
• acute stage of a myocardial infarction;
• sildenafit a concomitant use of inhibitor of phosphodiesterase as sildenafit exponentiates hypotensive effect of nitrates;
• the expressed arterial hypotension (systolic arterial pressure less than 90 mm hg, diastolic arterial pressure less than 60 mm hg);
• states after a craniocereberal injury;
• children's age up to 18 years;
• closed-angle glaucoma;
• deficit glyukozo-6-fosfatdegidrogenazy.

Use at pregnancy and a lactation

During pregnancy drug can be appointed only in urgent cases when the advantage for mother exceeds potential risk for a fruit. If there is a need to accept drug in the period of a lactation, then breastfeeding needs to be stopped.

Overdose:

About cases of overdose it was not reported. However at emergence of symptoms of overdose the standard measures are recommended: to cause vomiting and to wash out a stomach. It is necessary to control: whether the patient at the same time took any else medicine, to watch hypodynamic indicators.

Storage conditions:

In the place protected from light at a temperature not above 25 °C. To store in the place, unavailable to children!

Period of validity 3 years. Expiration date of a period of validity of drug is given on a folding cardboard box and on the blister.

After the expiration of this term drug cannot be used.

Issue conditions:

According to the recipe

Packaging:

Capsules ретард on 50 mg.

One cardboard box contains 2 blisters (everyone on 15 capsules) together with the application instruction (No. 30).