Raunatin-Zdorovye, the tab. on 2 mg No. 10/on 2 of mg No. 20/on 2 of mg No. 10х5

General characteristics. Structure:

International name: Rauwolfia alkaloids; main physical and chemical properties: tablets, coated, light green color, with a biconvex surface. On a surface of tablets the mramornost and impregnations is allowed. On cross section three layers are visible; structure: 1 tablet contains Raunatinum in terms of 100% the content of alkaloids – 2 mg; excipients: granulated sugar, starch potato or corn, glucose, calcium stearate, stearic acid, a liquid paraffin, magnesium a carbonate, titanium dioxide, povidone, sikovit Green Z2755, talc, silicon dioxide colloid, beeswax.

Pharmacological properties:

Pharmacodynamics. Drug contains the sum of alkaloids from roots of Rauwolfia snake (Rauwolfia serpentina Benth.) or bark of roots of Rauwolfia of emetic (Rauwolfia vomitoria Afz) of family of kurtovy (Apocynaceae). Alkaloids are presented by Reserpinum, serpentine, Ajmalinum, etc. The general content of alkaloids – not less than 90%.
Raunatinum has the hypotensive effect caused by decrease in content of biogenic monoamines (noradrenaline, dopamine, serotonin) in the central nervous system (kortiko-hypothalamic structures, especially back part of a hypothalamus). Breaking processes of deposition of a mediator in vesicles of a presynaptic membrane of peripheral adrenergic nerve terminations, a vascular wall, a medulla of adrenal glands, drug blocks adrenergic transfer what to lead to a gradual lowering of arterial pressure. The hypotensive effect of drug develops more gradually, than at Reserpinum, but on expressiveness significantly does not concede to Reserpinum. Feature of drug is strengthening of glomerular filtering in kidneys that leads to increase in renal blood circulation.
Drug has also antiarrhytmic action and the calming influence on the central nervous system. Sedative effect of drug is expressed to a lesser extent, than at Reserpinum.
The therapeutic effect of drug develops gradually by 10–14 day after the beginning of its use and remains for 2–3 months.
In some cases Raunatinum is transferred better than Reserpinum.

Pharmacokinetics. Alkaloids of drug are well soaked up from digestive tract; the maximum concentration in blood is observed in 1–3 hour after reception. Linkng with blood proteins – 40–50%. An elimination half-life – 50–170 hour; metabolizing – in intestines and a liver, removal, mainly, with a stake, and also with urine.

Indications to use:

Arterial hypertension of easy and average degree.

Route of administration and doses:

Arterial hypertension леРаунатин appoint the adult inside after food.
In the 1st day the initial dose usually makes 1 tablet for the night, for the 2nd day – on 1 tablet 2 times a day; for the 3rd day – on 1 tablet 3 times a day, then bring the general dose to 4–6 tablets a day. After achievement of steady therapeutic effect (as a rule, in 10–14 days) the drug dose is gradually reduced to 1–2 tablets a day. A course of treatment – 3–4 weeks, but in some cases according to indications accept drug is long in a maintenance dose (1 tablet a day) .gky and average degree.

Features of use:

Treatment by drug has to be carried out under observation of the doctor. At patients with stenocardia strengthening of pain in heart is possible.
Before planned operative measures administration of drug should be stopped some days before operation. In case of need premedication atropine is necessary for an immediate surgery under the general anesthesia at the patients accepting Raunatinum.
It is not necessary to use drug before a countershock session.
Data on use of drug for children are absent.

Pregnancy and lactation. Use of drug during pregnancy and feeding by a breast contraindicated since alkaloid Reserpinum gets through a placenta and into breast milk. In need of use of drug during a lactation feeding by a breast should be stopped.

Influence on a possibility of control of vehicles and mechanisms. Drug can break ability of the patient to bystry reactions, especially in an initiation of treatment owing to what during a course of treatment drug patients should avoid potentially dangerous types of activity requiring special attention and speed of psychomotor reactions.

Side effects:

Drug is usually well transferred. Nausea, vomiting, diarrhea, an abdominal pain, drowsiness, skin rashes, an itch, dryness of mucous membranes, a rhinedema, perspiration, the general weakness, a depression, bradycardia are sometimes possible. At patients with stenocardia strengthening of pains in heart is possible. By-effects pass at reduction of a dose or after short-term (1–3 days) a break in administration of drug.
At prolonged use in high doses the abnormal liver function, emergence of dreadful dreams, development of symptoms of parkinsonism, increase of attacks of stenocardia is possible.

Interaction with other medicines:

Anti-hypertensive action of Raunatinum amplifies at use with other anti-hypertensive means (thiazide diuretics, b-adrenoblockers, APF inhibitors, antagonists of calcium ions, etc.). Strengthens the oppressing action on the central nervous system of alcohol, barbiturates, antidepressants. Can strengthen toxic effect of cardiac glycosides and quinidine. Reduces efficiency of protivoparkinsonichesky means and sympathomimetics.

Contraindications:

The increased individual sensitivity to Rauwolfia alkaloids, arterial hypotension, heart failure, organic lesions of heart, bradycardia, aortal defects, the expressed cerebral atherosclerosis, a depression, epilepsy, parkinsonism, a peptic ulcer of a stomach and duodenum in aggravation stages, a nephrosclerosis, bronchial asthma, pregnancy, a lactation.

Overdose:

Symptoms: perspiration, the general weakness and the expressed hypotension. In hard cases after the short period of euphoria drowsiness, a depression, a hypodynamia, the phenomena of the expressed parkinsonism, a loss of consciousness, a coma develops. Treatment: gastric lavage, reception of absorbent carbon. The artificial diuresis is shown. At the expressed lowering of arterial pressure, at a collapse of the patient to lay with the raised legs; if necessary intravenous administration of a reopoliglyukin or phenylephine hydrochloride with addition of Angiotensinamidum or 2% of solution of noradrenaline of hydrotartrate is shown. Adrenomimetichesky means are appointed carefully because of risk of edematization of lungs. Subcutaneously enter 10% solution caffeine-sodium benzoate. Existence of sharp respiratory depression or its delay demand suction of slime from respiratory tracts, an intubation and carrying out artificial ventilation of the lungs, an oxygenotherapy.
There are no specific antidotes at poisoning with Raunatinum and other drugs of Rauwolfia.

Storage conditions:

To store in the place protected from light at a temperature from 8 °C to 25 °C. To store in the place, unavailable to children.
Period of validity – 3 years.

Issue conditions:

According to the recipe

Packaging:

Tablets, coated, No. 10, No. 20 in a blister strip packaging,
No. 10х5, No. 20 in a blister strip packaging in a pack.