Today, many specialists prescribe Isoket vasodilator spray to patients for prophylactic purposes or, if necessary, to stop an angina attack.
This drug has an extensive list of different indications for use. It is successfully used in the treatment of cardiovascular pathologies, including for the treatment of acute conditions.
Pharmacology
The active substance of this angina medicine has pronounced vasodilating and vasodilating properties. Isosorbide dinitrate stimulates the formation of nitric oxide in the body and reduces the needs of the heart muscle for oxygen and energy, thereby reducing the load on the myocardium. It effectively reduces pressure in the pulmonary circulation, weakens blood flow to the right atrium, reduces the tension of the walls of the heart ventricles, lowering diastolic pressure and improving systolic function in them. The drug does not affect the heart rate and expands the cerebral vessels well. It can also enlarge the vessels in the dura and the brain itself, causing pain in the head.
The drug affects the redistribution of coronary blood flow in areas where blood circulation is reduced. With IHD (coronary heart disease) and angina pectoris, due to the action of the drug, patients have the opportunity to increase the allowable physical activity.
Spray "Izoket" is quickly absorbed over the entire area of the oral mucosa, so the effect of its use occurs after 30 seconds and lasts up to 120 minutes. Due to its speed of action, it is often prescribed to patients for the relief of acute acute conditions.
Issue form
The drug is a clear, colorless solution with an alcoholic odor. It comes in two varieties:
- Spray "Izoket" sublingual and dosed. With one click on the dispenser, one dose of it is released in the form of tiny drops, which consists of 1.25 mg of the active ingredient - isosorbide dinitrate, as well as auxiliary elements: ethanol and macrogol 400. The aerosol does not contain freon, therefore it belongs to drugs that are harmless for the environment. Produced in transparent bottles of 15 ml, packed in a box with a dispenser and instructions. The glass bottle, designed for 300 clicks (doses), allows you to monitor the amount of the drug and buy a replacement in a timely manner.
- Solution in the form of a concentrate for infusion. 1 ml of this drug contains 1 mg of the active element isosorbide dinitrate and additional substances: sodium chloride, sodium hydroxide, water. In one ampoule - 10 ml of solution for infusion. Issued incardboard packs of 10 pieces each.
Indications for use
Spray "Izoket" is prescribed by specialists for angina attacks of all forms and as a preventive measure to avoid them. It is also recommended for post-infarction conditions, myocardial infarction in the acute stage, increased tolerance for UTIs and therapy for coronary artery spasm. Aerosol "Izoket" is successfully used as a medicine for heart failure in the left ventricle.
According to the instructions, the infusion concentrate is prescribed for patients with the following pathologies of the cardiovascular system:
- unstable angina occurring in a pre-infarction state or preceding myocardial infarction;
- vasospastic angina;
- acute myocardial infarction caused by left ventricular failure of the heart;
- spasm of coronary vessels during surgical interventions;
- heart failure of all kinds;
- acute left ventricular heart failure;
- pulmonary edema.
How to use aerosol
The drug in the form of a spray is sprayed into the patient's mouth, due to this it quickly enters the bloodstream. Each injection ensures that one dose of the drug enters the inside. Instructions for use indicate various ways to use the medication, depending on the symptoms.
In order to stop an angina attack, before the upcoming physical or emotional stress that can becomecausing an exacerbation, breath is held, and the patient receives 1 to 3 doses with an interval of 30 seconds between injections. Increasing the dosage without the supervision of a specialist is prohibited.
In case of suspected exacerbation of heart failure or acute myocardial infarction, the patient receives from 1 to 3 doses of the drug under strict control of both heart rate and blood pressure. If there is no improvement, then the procedure is repeated after five minutes at the discretion of the doctor. In the next ten minutes, the condition should stabilize. Otherwise, you can repeat the manipulation again under the supervision of a doctor.
Before the treatment procedure for the relief of coronary spasm (in the case of diagnostic or therapeutic catheterization), the patient is prescribed 1-2 injections. If necessary, the dosage can be repeated, but subject to control of blood circulation parameters.
Special recommendations for the use of the spray
In cases where a new aerosol is used for the first time, or more than 24 hours have passed since the last dose, it is recommended to direct the first pressure into the air, as it may not contain the required dosage. To obtain a dose in accordance with the instructions, the nebulizer is pressed continuously to the end and then released. During use, the spray bottle must be kept with the dispenser up and in a vertical position.
Be careful not to splash into eyes. During the entire period of treatment, constant monitoring is necessary.blood pressure (BP) and ECG. The value of blood pressure should not be less than 100 mm Hg. Art. Abrupt withdrawal of the drug is prohibited by the instructions, so the prescribed doses are reduced gradually. Alcoholic drinks are contraindicated when taking Isoket aerosol.
Reviews of experts indicate that a high dosage of the drug, its frequent appointment or systematic use can lead to the development of tolerance in the patient. This feature also develops when using other drugs containing nitrates. In such situations, doctors recommend canceling the use of the drug for 2-3 days, and after a course of regular therapy that lasted 3-6 weeks, pause for 3-5 days, and temporarily replace it with other drugs of a similar effect. In most cases, after a break or discontinuation of therapy, the sensitivity of the patient is quickly restored. The components of the drug are excreted in the form of metabolites by the kidneys almost in full.
Dosage and application of solution
According to the instructions in the instructions, the drug "Izoket" (solution for infusion) is used intravenously. The dosage is prescribed by the attending physician individually, taking into account the hemodynamic and clinical parameters of the patient. Therapy should be started with low doses and slowly increased to the required amount. The dosage recommended by the instruction is 2-7 mg / h, respectively, the average dose is about 7.5 mg / h. In cases of special need, the volume can be increased to 10 mg/h.
In most cases, people with heartinsufficiency require higher doses of the drug. The introduction of the drug should take place in a hospital under the supervision of a specialist and using automatic infusion systems. The whole procedure is accompanied by monitoring of blood circulation indicators (blood pressure and heart rate).
Solution for intravenous administration is prepared under sterile conditions immediately before the procedure. The drug is stored no more than 24 hours. Cooking Methods:
- for 0.01% concentration (100mcg/mL) – 500mL of 0.1% drug can be made into 500mL ready for administration;
- for 0.02% concentration (200mcg/mL) - 100mL of 0.1% drug can be made into 500mL of drug ready for administration.
Contraindications and precautions
The drug is not prescribed for patients with hypersensitivity to nitrate compounds, as well as other elements of the Isoket aerosol. The use is also prohibited if the patient has such diseases:
- severe hypotension, in which the systolic pressure falls below 90 mmHg;
- vascular insufficiency in the acute stage, such as shock or vascular collapse;
- pericarditis and pericardial tamponade;
- with cardiogenic shock in cases where there is no other way to correct the pressure in the left heart ventricle;
- hypertrophic cardiomyopathy;
- Angle-closure glaucoma.
In addition, the drug is not prescribed to persons under eighteen years of age. Instructions for use recommends the use of the drug with extreme caution and under constant supervision in such cases:
- myocardial infarction with an acute form of the course in the presence of a reduced filling pressure of the left heart ventricle;
- increased intracranial pressure;
- mitral and/or aortic stenosis;
- detection in a patient of the likelihood of an orthostatic disorder in the regulation of blood circulation;
- kidney or liver failure.
Pregnancy and lactation
Scientists in the development of the drug were conducted animal studies. The experiment on the subjects showed that there is no damaging effect on the fetus.
However, during pregnancy and lactation, the appointment of an aerosol is recommended only in situations where the intended benefit to the woman will significantly outweigh the potential risk to the fetus or infant. Treatment in these cases should be carried out under the strict supervision of specialists who monitor blood circulation indicators (blood pressure and heart rate), as well as the general condition of the patient.
Interaction with other medicines
The combined use of vasodilators and the drug "Izoket" (spray) is prohibited. Their use in combination may cause an increase in the hypotensive effect. The same consequence entails the simultaneoustaking Isoket aerosol and such medicines: antihypertensive drugs, calcium channel blockers, Quinidine or Novocainamide, antipsychotics, phosphodiesterase-5 inhibitors.
Possible increased antianginal effect when used in conjunction with drugs such as Amiodarone, Propranolol, Nifedipine, Verapamil, and other calcium slow channel blockers.
Increased intracranial pressure in a patient may occur during combination therapy with atropine and other m-anticholinergics.
Excessive decrease in blood pressure, leading to coronary perfusion, appears under the influence of alpha-blockers and sympathomimetics.
Side effects and reviews
The instructions describe a lot of side effects that can be caused by the drug "Izoket" (spray). Reviews of some patients taking this medication indicate the appearance of headaches, which are called "nitrate" in medicine. As a rule, after 2-3 days the problem disappears on its own and does not require correction. Quite rarely, a medication can cause symptoms such as nausea, redness of the skin, vomiting and dry mouth.
Some patients who received the drug for the first time complain of general weakness, dizziness, low blood pressure and a feeling of lethargy. It is caused by slight disturbances in the functioning of the cardiovascular system. They occur during initial use or when the recommended dosage is exceeded.
However, according toreviews, patients noticed the effectiveness of the drug. And when taken in accordance with the prescriptions of a specialist, side effects do not occur so often. The exception is a headache in the first days of use, which accompanies most cases, but usually disappears in a few days.
Exceeding the maximum volume
Overdose of this medication can cause a number of serious side effects: syncope, collapse, high intracranial pressure, hyperthermia, convulsions, visual disturbances, increased sweating, methemoglobinemia, bradycardia, paralysis, and coma. That is why it is important not to self-medicate the heart, but to take the drug strictly according to the instructions of a specialist!
With the described symptoms, drug withdrawal and therapy aimed at stabilizing the patient's condition are required.
Analogues
Medication "Kardiket" (CHWARZ PHARMA, Germany) is one of the common generics (analogues) of the drug "Izoket" (spray). The price of this substitute depends on the concentration of the active ingredient and the number of pills in the package.
For example, a drug in tablets of 20 mg "Kardiket retard" (20 pieces per pack) costs from 62 to 72 rubles, and the same drug, only with a dosage of 40 mg tablets and a quantity of 50 pieces, has a cost 210-220 rubles.
The group of medicines "Nitrosorbid", produced by several Russian companies and having different forms of release, is also a substitute for the drug "Izoket". Analogues of this group have the following names: Nitrosorbide-Rusfar, Nitrosorbide, NitrosorbideN. S., Nitrosorbide-UVI.
Cost
In Russian pharmacies, you will have to pay from 365 to 470 rubles for one dosed drug Isoket (spray). The price is formed depending on the location of the outlet and its status. On sites selling medicines, it can be purchased at a lower cost than in a regular pharmacy near the house. But when ordering via the Internet, you will have to pay about 200 rubles for delivery or get the product for free at the pickup point, which is not always geographically convenient.
Also, in any pharmacy you can buy a package (10 ampoules) of a concentrated solution for infusion "Izoket". The price for it fluctuates between 906-980 rubles.
General information
The drug is produced by the German company YUSB Pharma GmbH. Its shelf life is five years. The condition of sale is the presence of a doctor's prescription. With a long break in use, it is recommended to check the performance of the atomizer. An arrow is drawn on the aerosol label at the bottom. When the liquid reaches its level, a new drug should be purchased, since the use of an existing vial is possible only if it is slightly tilted, at which the suction tube is immersed in the liquid.
