Nitrosorbidum

Nitrosorbidum – anti-anginal drug from group of organic nitrates.

Form of release and structure

Is issued in tablets (on 20 pieces in packagings planimetric cell, in a box cardboard 2 packagings; on 50 pieces in cases polyethylene).

Contains in 1 tablet:

• Active agent: isosorbide dinitrate – 10 mg;
• Excipients, including lactose and sucrose.

Indications to use

Nitrosorbidum is intended for treatment of coronary heart disease, including:

• Prevention and stopping of attacks of stenocardia;
• Complex recovery therapy of the patients who had a myocardial infarction.

Also drug is used as a part of a combination therapy of pulmonary hypertensia and chronic heart failure.

Contraindications

Absolute:

• Glucose galactose malabsorption, lactose intolerance;
• Craniocereberal injuries;
• Acute myocardial infarction with a toxic fluid lungs and arterial hypotension;
• Anemia;
• Hemorrhagic stroke;
• Closed-angle glaucoma;
• Systolic arterial pressure is less than 100 ml hg;
• Chronic cardial compression;
• Hypertrophic cardiomyopathy;
• Cardiac tamponade;
• Collapse;
• Shock;
• Disturbances of cerebral blood circulation;
• Tendency to orthostatic hypotension;
• Lactation (or feeding should be interrupted);
• Children's age;
• Hypersensitivity to drug.

Relative (it is necessary to be careful because of risk of development of complications):

• Mitral and/or aortal stenosis;
• Advanced age;
• Pregnancy (in this case drug can be appointed only after careful assessment of the expected advantage and possible risks).

Route of administration and dosage

The pill Nitrosorbidum can be taken orally, bukkalno (for a cheek) or it is sublingual (under language). In case of oral administration of a tablet it is necessary to swallow entirely, washing down with enough water, at bukkalny and sublingual use – to hold in a mouth before full dissolution.

The doctor defines doses and duration of treatment individually depending on a clinical situation.

The recommended doses:

• Prevention of stenocardia, and also the recovery period after a myocardial infarction: on 1 tablet orally 3-4 times a day in 30 minutes prior to food. If necessary the single dose is increased to 2-3 tablets. The most admissible daily dose makes 180 mg of isosorbide of dinitrate (18 tablets). If regular use of Nitrosorbidum is undesirable, it is appointed on 1 tablet in 30-40 minutes prior to the forthcoming loading;
• Chronic heart failure: on 1-2 tablets orally 3-4 times a day;
• Pulmonary hypertensia: on 2 tablets of 5-6 times a day before food with equal intervals;
• Stopping of an attack of stenocardia: 1 tablet bukkalno or sublingual. To accelerate approach of therapeutic effect, the tablet can be chewed, and then to hold in a mouth before full dissolution.

Side effects

Nitrosorbidum is generally transferred well. The following side effects are in rare instances noted:

• Alimentary system: dryness of a mucous membrane of an oral cavity, nausea, vomiting, at bukkalny and sublingual use – burning and a pricking of language;
• Allergic reactions: rash on skin, urticaria, an itch;
• Central and peripheral nervous system: disturbance of the mode of a dream wakefulness, increased fatigue, dizziness, a vision disorder, brain ischemia, a nitrate headache (it is most brightly expressed in an initiation of treatment, disappears at drug use continuation);
• Cardiovascular system: arterial hypotension (including orthostatic hypotension), rushes of blood to the person, tachycardia, feeling of heat, the paradoxical nitrate reaction which is shown strengthening of attacks of stenocardia and also a considerable lowering of arterial pressure, up to a collapse.

Special instructions

For use of Nitrosorbidum it is recommended to refuse management of the vehicle and performance of potentially dangerous types of works.

In case of reduction of intervals between receptions, and also at prolonged use of drug, especially in high doses, there is a risk of development of tolerance to Nitrosorbidum.

During treatment, especially during increase in a dose, careful control of heart rate and indicators of arterial pressure is necessary.

Medicinal interaction

It is contraindicated to apply Nitrosorbidum along with sildenafily (Viagra) in connection with risk of development of heavy arterial hypotension and myocardial infarction.

Ethanol, peripheral vazodilatator, anti-hypertensive means, blockers of calcium channels, tricyclic antidepressants, neuroleptics, FED inhibitors, beta adrenoblockers strengthen hypotensive effect of isosorbide of dinitrate.

Sympathomimetics reduce anti-anginal action of Nitrosorbidum.

The adsorbents enveloping and astringents reduce dinitrate isosorbide absorption in digestive tract.

Nitrosorbidum increases plasma concentration and therapeutic effect of dihydroergotamine.

Terms and storage conditions

To store in the dry place protected from direct sunshine unavailable to children. To observe temperature condition 8-15 ºС.

Period of validity – 2 years.