Эфокс

Эфокс treats groups of peripheral vazodilatator and anti-anginal drugs.

Pharmacological action of Efoks

Эфокс represents organic nitrate, the therapeutic effect of which reception extends preferential to venous vessels. Effect of drug is directed to stimulation of formation of nitrogen oxide in endothelia of vessels. In turn, nitrogen oxide promotes activation of intracellular guanylate cyclase thanks to what tsGMF increases.

Эфокс it is capable to reduce preload and an afterload of a myocardium thanks to what its oxygen requirement decreases. Also drug has ability to have coronarodilator effect.

Efoks's use leads to decrease in inflow of blood to the right auricle owing to what regression of a number of symptoms at pulmonary hypostasis is noted and pressure in a small circle of blood circulation decreases. Besides, Efoks's use positively affects process of distribution of a coronary blood-groove in areas with the lowered blood circulation.

During Efoks's reception increase in tolerance to an exercise stress at patients with stenocardia and an ischemic heart disease, vasodilatation of a firm cover of hypermarket is noted (emergence of pain reactions is possible).

To drug tolerance develops, however after its cancellation or at a break in treatment sensitivity to Efoks is shortly recovered.

The anti-anginal effect of reception occurs 35-40 minutes later after Efoks's use, duration makes it from 8 to 10 h.

Release form

Эфокс is issued in the form of tablets, flat and round. Color of tablets – white, on the one hand is a facet and a notch for a break. Over a notch the engraving "Е", under a notch – an engraving "20" is distinguishable.

One pack contains 10 tablets packaged in blisters which in one cardboard pack 5 pieces are packed.

Indications to Efoks's use

According to the instruction to Efoks drug is appointed for prevention of attacks of stenocardia at patients with an ischemic heart disease (including patients with the postponed myocardial infarction), and also at chronic heart failure, as an element of a combination therapy.

Contraindications to Efoks's use

Эфокс it is not recommended for use in the following cases:

• At acute disorders of blood circulation (including a vascular collapse and state of shock);
• At cardiogenic shock if correction of diastolic pressure of a left ventricle by means of intra aortal counterpulsation or by means of introduction of the means influencing inotropic action causes difficulties;
• At the expressed arterial hypotension (if systolic pressure less than 90 mm Hg, and diastolic – less than 60 mm Hg), at a hypovolemia;
• At a concomitant use with phosphodiesterase inhibitors (including sildenafit, tadalafit, vardenafit) since they promote strengthening of hypotensive effect of Efoks's reception;
• At the myocardial infarction in an acute form which is followed by arterial hypotension;
• At anemia in a severe form;
• At hereditary intolerance of a galactose, deficit of lactase, at a sprue of a galactose and glucose;
• During feeding by a breast;
• At a toxic fluid lungs;
• If age of the patient less than 18 years;
• at hypersensitivity to any of components of list of Efoks, in particular, to organic nitrates.

In some cases drug is admissible to use, however careful medical control is required during all course of treatment. Treat such states:

• Chronic cardial compression;
• Hypertrophic subaortic stenosis;
• Pericardium tamponade;
• Mitral and/or aortal stenosis;
• Myocardial infarction in an acute form and other states promoting pressure decrease in a left ventricle;
• Tendency to arterial hypotension;
• Glaucoma since there is a risk of increase in intraocular pressure;
• The heart failure which is followed by the low pressure of filling of a left ventricle;
• The diseases which are followed by the increased intracranial pressure including a hemorrhagic stroke and recently postponed head injuries;
• Renal and / or liver failure;
• Severe form of anemia.

The instruction to Efoks's use

Tablets of Efoks are applied orally, after meal. It is not necessary to chew medicine, it is necessary to wash down with enough water.

The dosage of reception of Efoks, and also duration of treatment and repeated courses are established by the doctor, being guided by a condition of the patient and disease severity.

It is recommended to begin with the instruction to Efoks use of drug with small doses: on 10 mg of medicine twice a day. The dose is recommended to be increased afterwards to therapeutic: to break from 20 to 40 mg into 1-2 receptions a day. If necessary the daily dose can be increased to 60 mg. The maximum dosage of Efoks in days should not exceed 80 mg.

Side effects of Efoks

The instruction to Efoks warns about possibility of side reactions during treatment by drug. Among them are noted:

• The headache arising at the beginning of Efoks's use. Most often, it passes over time. Also dizzinesses, feeling of heat, a dermahemia of the person, tachycardia, decrease in the ABP, block, increase in ChSS, feeling of weakness, an orthostatic collapse, strengthening of attacks of stenocardia, kollaptoidny states, faints are noted;
• Vomiting, nausea, dryness in an oral cavity, feeling of easy burning of language;
• Sight illegibility, drowsiness, constraint, reduction of speed of mental and motor reactions;
• Skin rash;
• Exfoliative dermatitis;
• Tolerance development.

Overdose by Efoks

Efoks's use in the doses exceeding recommended by the doctor is capable to lead to overdose which symptoms are given below:

• The increased heartbeat;
• Weakness;
• The decrease in the ABP which is followed by orthostatic dysregulation;
• Dizziness;
• Headache;
• Block;
• Nausea;
• Diarrhea;
• Collapse;
• Spasms;
• Perspiration;
• Диспноэ;
• Paralysis;
• Coma.

Treatment in the form of a gastric lavage, liquid input is recommended. Input of a dopamine and/or noradrenaline in the form of infusions is in certain cases possible. It is forbidden to enter Epinephrinum.

Efoks's antidotes are:

• Vitamin C in the form of sodium salt. On 1 g in/in;
• Methylene blue. About 50 ml of 1% of solution in a look in/in infusions are entered;
• Toluidine blue. At first enter from 2 to 4 mg on 1 kg of body weight in / century. Repeated introductions later in the minimum dosage are possible an hour;
• Hemodialysis, oxygenotherapy, exchange hemotransfusion.

Special instructions

Treatment by Efoks is incompatible with alcohol intake.

During use of drug it is necessary to refuse control of vehicles and performance of other types of activity, demanding bystry psychomotor reactions.

Sharp cancellation of Efoks is inadmissible. The dosage should be reduced gradually.

Development of symptoms of intolerance is the cause for full refusal of administration of drug.

Storage conditions

Эфокс no more than 5 years are stored at a temperature which is not exceeding a mark of 25 °C.