The heart, as you know, is our main organ, but it often fails. In order to restore its normal functioning, a variety of drugs are used. One of them is Amiodarone. Analogues are much more expensive, as they are produced abroad and are not always effective.
Composition of the drug and release form
The drug "Amiodarone", reviews of which are very different, contains in one tablet 200 mg of the active ingredient - amiodarone hydrochloride. The drug is also produced in the form of a solution, where 3 ml accounts for 5% of the active substance.
Auxiliary components in one tablet are: potato starch, crystalline microcellulose, milk sugar, m altodextrin, primellose, polyvinylpyrrolidone, magnesium stearate.
The tablets are coated with a white glaze with a slight, barely perceptible creamy tint. They have a flat-cylindrical shape, as well as a chamfer and a risk. Therefore, if necessary, they can easily be divided into two equal parts.
For Saledrug in cardboard boxes, where there is one or two blisters with ten tablets. The medicine is also available in glass, polymer and plastic bottles, which have 30 or 100 tablets.
Pharmacological mechanism of drug action
Antiarrhythmic and antianginal property is characterized by "Amiodarone", analogues in some cases can replace it. Its antiarrhythmic effect is based on a decrease in the currents of potassium ions when exposed to cell membranes - cardiomyocytes. Causes a decrease in the sinus node, which forms bradycardia.
The use of the drug "Amiodarone" (tablets) allows you to increase the refractory segment of the conduction mechanism of the heart. It inhibits conduction along secondary pathways in patients with severe Wolff-Parkinson-White syndrome. In turn, the antianginal effect of the drug is based on a decrease in myocardial oxygen consumption and a decrease in its effect on arterial muscles. It contains iodine, which, when consumed, changes the quantitative content of thyroid hormones, as a result of which the degree of their effect on the myocardium is reduced.
"Amiodarone" has a cumulative effect, and a pronounced effect from its use occurs only after a week of regular use of the drug, and the maximum is achieved after two to three weeks.
About 40% of the drunk dose of the drug is absorbed inside, Cmax in plasma appears after 3-7 hours. The effect can persist for several weeks. Metabolic processes take place mainly in the liver, wherethe active element deethylamiodarone is formed, which is the main metabolite. Excreted with excreted bile and urine, T1 / 2 - after a single dose of the drug 3, 2–20, 7 hours, with prolonged therapy - after 53 ± 24 days.
Drug "Amiodarone": indications for use
The drug is prescribed for the prevention and treatment of arrhythmia, which can be life-threatening, as well as for ventricular arrhythmias, in ventricular flutter with unstable dynamics, the drug "Amiodarone" is also used.
Indications for use allow the use of the drug when:
- atrial flutter;
- supraventricular arrhythmias;
- Wolf-Parkinson-White syndrome;
- appearance of tachycardia;
- ventricular fibrillation;
- arrhythmias due to heart and coronary insufficiency;
- chronic coronary heart disease;
- myocardial infarction.
"Amiodarone": instructions for use
Pills are intended to be taken by mouth 15 minutes after a meal.
During ventricular arrhythmia, the dose recommended by the doctor is 800-1200 mg per day. It should be divided into 3-4 doses. The course of treatment in this case lasts about 5-10 days and can be extended to ensure a more stable condition of the patient, and the rate can be reduced to 600-800 mg per day. It's intensetreatment, which later progresses to prophylactic, with a lower dose of the drug content.
The therapeutic maintenance period is 7-14 days, during this time the drug is taken at 200-400 mg. This amount of medication is prescribed to stabilize the patient's condition in the post-rehabilitation period.
Often, the drug "Amiodarone" is prescribed when the patient is in the hospital, and the doctor can control his intake. This allows you to minimize side effects and individually adjust the dose of the drug.
In case of angina pectoris, the drug is taken twice a day, 200 mg. After two weeks, the dosage is reduced to once a day. The maximum single dose should not exceed 400 mg, and the daily dose should not exceed 1200 mg.
When prescribing such drugs to children, it should be borne in mind that pills affect a child much faster than an adult. Therefore, the dosage is calculated based on the weight of the child. So, for one kilogram of weight should be 10 mg of the drug. This dose should be maintained for ten days of the therapeutic period or until the patient's condition improves completely. In the future, this standard is reduced to a proportion: 5 mg per kilogram of the child's live weight. The prophylactic and maintenance dose is taken on the basis of 2.4 mg of Amiodarone per kilogram of body weight.
Indications for the drug are prescribed to use a solution based on the active ingredient amiodaronehydrochloride for acute cardiac arrhythmias. In this case, the drug is administered intravenously, injected into the body slowly with a dropper. To do this, in 250 ml of a 5% glucose solution for 1 or 2 hours, the drug is slowly injected at the rate of 5 mg per kilogram of live weight. At this time, the patient's condition is monitored using an ECG and measurements of blood pressure readings.
Side effects
Many people in our country are prescribed Amidaron. Analogs can not always replace it. But, despite the positive effect of the drug on the human body, side effects were also identified.
Negative symptoms appear mainly due to an overdose of the drug. These are disorders in the work of the cardiovascular system, such as bradycardia, malfunctions of the sinus node, heart block, and impaired coordination of movement. Also on the part of the respiratory organs, diffuse interstitial pulmonary fibrosis, interstitial pneumonia, Hamman-Rich syndrome, chest pain, pulmonary fibrosis, tachypnea, bronchopulmonary spasms were noticed. Liver failure was observed when taking the drug "Amidarone". The pills have rarely caused jaundice, hepatitis, and sometimes cirrhosis of the liver.
Mismatching the dosage can cause a significant imbalance of thyroid hormones, dysthyroidism, as well as hypothyroidism and weight gain. An overdose can lead to disruption of the visual apparatus, causing the accumulation of lipids near the cornea in the pupil area. There was also a pronouncedskin pigmentation, photosensitivity, urticaria or erythema. Minor rashes, alopecia, dermatitis were noticed on the face. Side effects also affected the reproductive function in men. In these cases, orchitis, impotence, and also epididymitis occurred. Rarely, thrombocytopenia, renal failure, angioedema, or vasculitis have been reported.
Contraindications for use
"Amiodarone" (reviews about it are not always positive) is selected strictly individually. There are people for whom this drug did not help or they did not notice any changes in their state of he alth at all, others began to choke after its use, felt a rapid heartbeat. According to them, with prolonged use, it can disrupt the endocrine system, increase hormones. Therefore, before taking this drug, you should not only carefully read the instructions, but also pay attention to the indications, side effects and contraindications.
So, the medicine is not prescribed if there is an atrioventricular blockade of 2-3 degrees, with cardiogenic shock, thyrotoxicosis. The drug "Amiodarone" is not used in case of high sensitivity to its active substance and iodine. The prohibition is serious violations of cardiac conduction and attacks of bradycardia with syncope. Do not use the medicine during pregnancy and lactation. When lactating, during the period of drug treatment, breastfeeding should be stopped.
Special Recommendations
Therapeutic treatment with Amiodarone should be carefully monitored by a doctor. Instructions forThe use of the tablet is recommended to be used after an X-ray study of the liver, lungs and an electrocardiogram. Similar monitoring should continue if the patient continues to take the medication.
The severity of side effects often directly depends on the dose that the patient consumes. You should try to use the drug as little as possible and in minimal quantities. Often causes a failure of the heart rhythm to cancel the drug "Amiodarone".
Instructions for use - reviews say that, despite the side effects, this drug has saved more than one life - claims that the pharmacological effect of the drug persists for another two weeks after its withdrawal.
Pills contain iodine, which contributes to the accumulation of radioactive iodine levels in the thyroid gland. Therefore, at the beginning of therapeutic treatment, in the process and at the end, it is necessary to constantly take tests for the amount of thyroid hormones.
During therapeutic treatment it is necessary to avoid prolonged exposure to the sun, do not take open sunbathing. The drug should be administered with extreme caution to the elderly, under general anesthesia or during the course of oxygen treatment. It should be used with caution by drivers of vehicles and persons whose profession is associated with a special concentration of attention.
In cases of overdose, there may be an aggravation of side effects, as well as hypotension, arrhythmia. Bradycardia or AV conduction failure may occur. Excess can lead toliver dysfunction.
In this case, immediate gastric lavage is recommended, activated charcoal is prescribed, saline laxative solutions are recommended. For bradycardia, atropine injections are used, beta-adrenergic agonists are used, and pacing is performed.
Interaction with other drugs
With caution, the drug should be used simultaneously with other drugs, especially if they are from the same antiarrhythmic group. You should not combine his reception with Erythromycin, Pentamidine and Vincamine. There is a risk of developing polymorphic ventricular tachycardia in combination with Sultopride. It is not recommended to combine the intake of CCBs and beta-blockers with Amphotericin B and drugs that cause a laxative effect, diuretics. Use the drug with caution in combination with corticosteroids, antidepressants, Astemizol, Terfenadine. It can significantly enhance the effect of such drugs as: "Warfarin", "Phenytoin", "Cyclosporine" or "Digoxin". When used simultaneously with Cimetidine, it slows down the metabolic process in the body.
Shelf life and storage rates
The drug "Amiodarone", whose action is aimed at eliminating tachycardia, ventricular fibrillation, tachyarrhythmia and reducing atrial flutter, belongs to the category of drugs of group "B". The shelf life of the drug does not exceed three years. Tablets should be stored in a dark, cool place out of the reach of children.
It is necessary to strictly control the use of the drug "Amiodarone". recipe for ituse is prescribed only by a doctor. In this case, self-treatment should be completely excluded.
Drug analogues
If suddenly the drug "Amiodarone" does not fit, analogues can be found in any pharmacy. Among them, one can single out such drugs as: "Amiodarone Belupo" and "Amiodarone Aldaron", "Angoron" and "Atlansil", "Kordaron" or "Kordinil" can also replace this medicine. Similar to "Amiodarone" in their effect on the human body "Medakoron" and "Palpitin". In some cases, the drug is replaced by Sedacoron and Sandoz.
These drugs either contain the same active ingredient or are similar in their antiarrhythmic action to Amiodarone. Analogues are often produced abroad and cost several times more.
Patient testimonials
Many patients note the stabilization of their condition after taking the drug "Amiodarone". Instructions for use - analogues of the drug are often selected based on the individual characteristics of the body - it promises the normalization of heart rate and pressure. With short-term use and in small doses, as a rule, there are no problems, and the drug has an effective effect.
After prolonged use of the medicine, some patients developed shortness of breath, palpitations, nervousness and depression, mood swings and an increase in thyroid hormones, gastrointestinal upset, and in some cases nausea andvomiting.
Many people use it in the treatment of angina pectoris, and note that it is no worse than imported counterparts. Some men are afraid to take the drug, since it is in them that it can cause a number of oncological diseases. There is an opinion that the drug should be taken only in a condition that threatens a person's life, in all other situations he should look for an alternative. In addition, pills can adversely affect the reproductive function of a man, which must also be taken into account when taking them.
And yet for many, the drug "Amiodarone" turned out to be a panacea, thanks to which the disease receded, and the person remained alive. Not the fact that analogues would be as effective. Therefore, in the treatment of heart disease, you should not discount this medicine, especially if it is recommended by a doctor.
