Оликард® ретард

General characteristics. Structure:

Active agent: isosorbide-5 mononitrate of 40 mg
Excipients: ethyl cellulose — 14,2 mg; corn starch — 51,6 mg; sucrose — 206,4 mg; talc — 7,8 mg 
Cover: gelatin — 60,76 mg; titanium dioxide — 1,24 mg.
 
Active agent: isosorbide-5 mononitrate of 60 mg
Excipients: ethyl cellulose — 21,3 mg; corn starch — 65,4 mg; sucrose — 261,7 mg; talc — 11,6 mg
Cover: gelatin — 75,46 mg; titanium dioxide — 1,54 mg.

Pharmacological properties:

Pharmacodynamics. Nitrate. A peripheral vazodilatator with preferential influence on venous vessels.

Stimulates formation of nitrogen oxide (the endothelial running-down factor) in an endothelium of vessels causing activation of intracellular guanylate cyclase and, as a result, increase in tsGMF (a vazodilatation mediator). Possesses coronarodilator action. Increases tolerance to an exercise stress at ischemic heart disease patients, stenocardia.

Reduces the need of a myocardium for oxygen due to decrease before - and afterloads (reduces the final diastolic volume of a left ventricle and reduces the systolic tension of its walls). Reduces inflow of blood to the right auricle, promotes redistribution of a coronary blood-groove in the area with reduced blood circulation.

Expands vessels of a brain, a firm meninx that can be followed by a headache.
The possibility of development of cross tolerance to other nitrates is not excluded. After a break in use sensitivity to it is quickly recovered.

Pharmacokinetics. Absorption is high, bioavailability — 90–100%. Time of achievement of Cmax — 8 h. Linkng with proteins of a blood plasma — less than 4%. Almost it is completely metabolized in a liver, the formed metabolites are inactive. Almost only 2% — in not changed look are completely removed by kidneys in the form of metabolites. T1/2 — 4–5 h.

Indications to use:

- prevention of attacks of stenocardia at ischemic heart disease patients;
- treatment of chronic heart failure (as a part of a combination therapy).

Route of administration and doses:

Inside, without chewing and washing down with enough liquid.

Оликард® 40 ретард

On 40 mg (1 капс.) 1 time a day. If necessary it is possible to increase a dose to 80 mg (2 капс.) in 2 receptions. For maintenance of therapeutic effect it is necessary to accept drug the second time no later than in 6 h after the first reception.

Treatment begin 40 mg with a dose, slowly increasing it to necessary level.

Duration of treatment is defined by the doctor.

Оликард® 60 ретард

On 60 mg (1 капс.) 1 time a day.

Duration of treatment is defined by the doctor.

Features of use:

With care appoint at an idiopathic hypertrophic subaortal stenosis, chronic cardial compression and a cardiac tamponade, low values of perfused pressure, including at an acute myocardial infarction or insufficiency of a left ventricle, an aortal and/or mitral stenosis, orthostatic hypotension, diseases which are followed by increase in intracranial pressure, heavy anemia, the closed-angle glaucoma expressed to a renal and liver failure.

There are no data on administration of drug at children's age.

In an initiation of treatment decline in the ability to bystry reactions is possible, during treatment it is necessary to abstain from occupations potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions.
It is not necessary to accept continuously drug in high doses in order to avoid decrease in therapeutic action.

Olikard 40 ретард and Olikard 60 ретард are not intended for stopping of a bad attack of stenocardia, an acute myocardial infarction.

Side effects:

From cardiovascular system: a "nitrate" headache, the expressed decrease in the ABP and/or orthostatic arterial hypotension which can be followed by reflex increase ChSS, dizziness and feeling of weakness; sometimes, in rare instances, the expressed decrease in the ABP can be followed by strengthening of symptoms of stenocardia; passing dermahemia of the person and neck. Conditions of a collapse, bradycardia were seldom observed.

From skin: allergic skin reactions, exfoliative dermatitis.

From a GIT: nausea, vomiting.

Interaction with other medicines:

Increases concentration of dihydroergotamine in a blood plasma. Reduces effect of vazopressor. Barbiturates accelerate metabolism and reduce concentration of isosorbide-5-mononitrate in a blood plasma. At combined use with hypotonic means, vazodilatator, neuroleptics, tricyclic antidepressants, procaineamide, ethanol, quinidine, beta adrenoblockers, blockers of slow calcium channels, dihydroergotamine, sildenafily strengthening of hypotensive effect is possible.

At a combination with Amiodaronum, propranolol, blockers of slow calcium channels (verapamil, nifedipine, etc.) strengthening of anti-anginal effect is possible.

Under the influence of adrenostimulyator and alpha adrenoblockers, including dihydroergotamine (cause excessive decrease in the ABP and, as a result, coronary perfusion) decrease in anti-anginal effect is possible.

At the combined use with m-holinoblokatorami (atropine, etc.) the probability of increase in intraocular pressure increases.

The adsorbents knitting and enveloping means reduce mononitrate isosorbide absorption in a GIT.

Contraindications:

- hypersensitivity to drug components (including to other nitro compounds);
- acute circulatory unefficiency (shock, vascular collapse);
- acute myocardial infarction;
- cardiogenic shock if by means of intraaortalny counterpulsation or by means of the HP possessing positive inotropic action it is not possible to provide rather high end diastolic pressure in a left ventricle;
- the expressed arterial hypotension and a hypovolemia (the GARDEN is lower than 90 mm of mercury.);
- concomitant use of a sildenafil;
- age up to 18 years (efficiency is not established).

Use at pregnancy and feeding by a breast
Use at pregnancy and during breastfeeding is possible by comparison of advantage for mother and potential risk for a fruit and the child.

Overdose:

Symptoms: the expressed decrease in the ABP, a collapse, reflex tachycardia, a headache, weakness, dizziness, a dermahemia, nausea, vomiting and diarrhea. Large numbers nitrite ion can cause a methemoglobinemia, cyanosis, short wind and a tachypnea.

At very high doses of drug intracranial pressure with cerebral symptoms can increase. At chronic overdose the increased methemoglobin level comes to light.

Treatment: gastric lavage. At the expressed decrease in the ABP and/or shock it is necessary to carry out plasma substituting therapy; in exceptional cases it is possible to enter into infusionally Norepinephrinum and/or a dopamine.

Use of Epinephrinum (adrenaline) and related to it connections contraindicated.

At a methemoglobinemia: ascorbic acid — 1 g in/in, 1% solution a chloride metiltioniniya (methylene blue) — 1–2 mg/kg (to 50 ml) in/in, an oxygenotherapy, a hemodialysis, hemotransfusion.

Storage conditions:

At a temperature not above 25 °C.
To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

In the blister of 10 pieces; in a pack of cardboard 2, 5 or 10 blisters.