From - Mick longum

General characteristics. Structure:

Active ingredient: 20 mg, 40 mg, 60 mg of isosorbide of dinitrate.

Excipients: lactose monohydrate, corn starch, cellulose microcrystallic, polyacrylate dispersion, кросповидон, povidone, silicon dioxide colloid anhydrous, magnesium stearate, sodium lauryl sulfate.

The cover contains hydroxypropyl cellulose or a gidroksipropilmetiltsellyuloza, titanium dioxide (E171), talc.

Medicine is organic nitrate, concerns to group of peripheral vazodilatator. It is applied in cardiology.

Pharmacological properties:

Pharmacodynamics. Peripheral vazodilatator. Anti-anginal drug. Like all organic nitrates, isosorbide dinitrate works as the donor of nitrogen oxide. Nitrogen oxide causes relaxation of a smooth muscle wall of vessels, inducing, thus, a vazodilatation. Isosorbide dinitrate works as the peripheral vazodilatator exerting impact both on arteries, and on veins.

Action From - Mick longum is connected with decrease in need of a myocardium for oxygen due to reduction of preload of heart (expansions of peripheral veins and reduction of inflow of blood to the right auricle) and afterloads (reduction of OPSS), and also with direct coronarodilator effect. Promotes redistribution of a coronary blood-groove in sites with reduced blood supply. At heart failure medicine promotes unloading of a myocardium due to reduction of preloading. Action on an artery, and at the highest doses – on arterioles, leads to decrease in system vascular resistance (afterload).

Influence both on preloading, and on an afterload leads to consumption reduction by oxygen heart.

Besides, isosorbide dinitrate causes redistribution of a blood-groove to subendocardial departments of heart in the conditions of atherosclerotic defeat. The last effect, perhaps, is explained by the selection dilatation of big coronary vessels. The dilatation of collateral arteries caused by nitrates can improve perfusion of a myocardium at a stenosis of vessels.

From - Mick longum is characterized by a combination of bystry approach of effect to action duration.

Indications to use:

- prevention and long-term treatment of stenocardia.

Route of administration and doses:

The dosage and duration of treatment is defined by the doctor. Treatment, as a rule, begins with the smallest dose which gradually raises to necessary level. Is accepted inside entirely irrespective of meal, it is washed down with a small amount of water.

From - Mick longum is intended for prolonged use! Independently it is impossible to stop reception!

From - Mick longum 20 mgprinimatsya on 1 tablet 2-3 times a day. It is necessary to accept the second/following dose not earlier than in 6-8 hours after reception of the first dose.

From - Mick longum 40 mgprinimatsya on 1 tablet once a day. At the increased need for nitrodrugs it is possible to increase a day dose to 1 tablet 2 times a day. About 18 hours are recommended to accept the last day dose.

From - Mick longum of 60 mg is accepted on 1 tablet once a day. At the increased need for nitrodrugs it is possible to increase a day dose to 1 tablet 2 times a day. It is necessary to accept the second dose not earlier than in 6-8 hours after reception of the first dose.

If you forgot to accept the next dose From in time - Mick longum: take a pill during the following reception. Do not accept a double dose in case of the admission.

Features of use:

It is applied with extra care and under control of the doctor in the following cases:

- low the ABP (for example, at an acute myocardial infarction, the broken function of a left ventricle);
- orthostatic dysfunctions;
- anemia;
- renal (hepatic) failure;
- advanced age;
- surgical interventions;
- the closed glaucoma;
- the craniocereberal injury, a hemorrhagic stroke and other diseases which are followed by the increased intracranial pressure.

From - Mick Long should not be used for stopping of attacks of stenocardia.

It is impossible to interrupt treatment From - Mick longum for the purpose of reception of inhibitors of phosphodiesterase 5 of type (sildenafit, tadalafit, vardenafit, etc.) - development of an attack of stenocardia is possible.

Prolonged use of medicine can cause passing decrease in level of oxygen in blood that can lead to air hunger of a cardiac muscle at patients with coronary heart disease.

Contains lactose. Patients with such rare inherited disorders as intolerance of fructose or a galactose, a lactose intolerance, disturbance of absorption of glucose galactose or sucrose-isomaltose, should not accept this drug.

Uses From - Mick longum at pregnancy and in the period of a lactation: At pregnancy and in the period of a lactation use is possible only in cases when the estimated advantage for mother exceeds possible risk for a fruit or the child.
 
Influence From - Mick longum on ability to driving of motor transport and control of mechanisms: During treatment it is necessary to refrain from driving of motor transport and occupation potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reaction.
 
Use From - Mick longum at children: efficiency and safety are not established.

Side effects:

Disturbances from a nervous system: very often - the headache, gradually decreases at the subsequent administration of drug; often – dizziness, drowsiness, weakness.

Disturbances from cardiovascular system: often – increase of pulse, decrease in the ABP in a standing position, including orthostatic reactions; infrequently - strengthening of symptoms of stenocardia, decrease in the ABP, a collapse with an urezheniye of pulse and a syncopal state.

Disturbances from digestive tract: infrequently – nausea, vomiting, dryness in a mouth, heartburn.

Disturbances from skin and hypodermic cellulose: infrequently - allergic reactions, rash, a dermahemia of the person, a Quincke's edema, Stephens-Johnson's syndrome, exfoliative dermatitis.

The general disturbance: very often – weakness.

Others: for organic nitrates the cases of development of the expressed decrease in the ABP which are followed by nausea, vomiting, the concern, pallor increased by sweating were noted. Tolerance development is possible (including cross to other nitrates), for prevention of it it is necessary to avoid continuous reception of high doses of medicine.

Interaction with other medicines:

Vasodilators, blockers of slow calcium channels, beta adrenoblockers, tricyclic antidepressants, новокаинамид, quinidine, ethanol: strengthening of hypotensive action at a concomitant use is possible.

Inhibitors of phosphodiesterase of type 5 (sildenafit, vardenafit, tadalafit): strengthening гипотензивнго actions, development of life-threatening cardiovascular complications. The concomitant use is contraindicated.

Digidroergotamin: concentration of dihydroergotamine in blood it uvlichivatsya, action amplifies.

Sympathomimetic means (adrenaline, ephedrine, noradrenaline, Naphthyzinum, phenylephine hydrochloride), alpha adrenoblockers: decrease in analgetic action From - Mick longum is possible.

Acetylsalicylic acid: combined use promotes improvement of coronary circulation.

M-holinoblokatory (atropine): the probability of increase in intraocular pressure increases.

The adsorbents knitting and enveloping means: absorption From - Mick longum from digestive tract decreases.

Sapropterin (tetrahydrobiopterine, BH4): influences nitrogen metabolism, it is applied with care at joint appointment including and with other nitrogen-containing medicines (nitroglycerine, isosorbide mononitrate, etc.).

Ethanol: strengthening of hypotensive action, development of life-threatening cardiovascular complications. It is impossible to accept together with alcohol!

Contraindications:

- an acute myocardial infarction with the expressed lowering of arterial pressure (ABP);
- acute vascular insufficiency (shock, vascular collapse);
- the expressed decrease in the ABP (systolic pressure is lower than 90 mm hg);
- aortal and/or mitral stenosis;
- tendency to disturbances of regulation of blood circulation because of the low ABP;
- hypertrophic subaortic stenosis;
- chronic cardial compression;
- cardiac tamponade;
- the diseases which are followed by increase in intracranial pressure;
- toxic fluid lungs;
- closed-angle glaucoma;
- heavy hypovolemia;
- heavy anemia;
- children up to 18 years;
- a concomitant use with inhibitors of phosphodiesterase of type 5 (sildenafit, vardenafit, tadalafit);
- hypersensitivity to nitrates or excipients.

Overdose:

If quantity of pill in day which you took exceed that quantity which was recommended by your doctor, or your child swallowed tablets, immediately see a doctor or call the Ambulance!

The overdose most likely will cause decrease in the ABP of ≤90 mm of mercury., pallor, the strengthened sweating, weak filling of pulse, the speeded-up pulse, dizziness, a headache, weakness, nausea, vomiting, diarrhea. Cyanosis of integuments, breath disturbance, feeling of alarm, a loss of consciousness and a cardiac standstill is possible.

To stop reception of medicine! As first aid to lay the patient on a back so that the head was hung, and legs are raised. Control of the ABP, ChSS. The gastric lavage is recommended.

Storage conditions:

To store 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. Not to accept medicine after a period of validity.

Issue conditions:

According to the recipe

Packaging:

50 or 60 tablets in bank of polymeric. One bank together with a leaf insert in secondary packaging from a cardboard bandbox.