Treatment of cardiac arrhythmias is a complex medical problem that has not been fully resolved even today. There are many antiarrhythmic drugs, but they all have many contraindications and side effects, which can be much more dangerous for the patient than the disease. There are whole groups of drugs designed to stop life-threatening arrhythmias, but their use for a long time is not recommended due to the increase in complications resulting from taking medications. Accordingly, patients require a reliable, effective, but relatively safe drug or its equivalent.
Kordaron is an effective antiarrhythmic drug
According to various studies, "Kordaron" is the most effective drug among other similar drugs, has a proven ability to reduce mortality in people with cardiac pathology. It has been successfully used to treat almost all cardiac arrhythmias. Among physicians, it is considered the standard among class III antiarrhythmic drugs. In addition to antiarrhythmic, it has an antianginal effect, as it was first created as a drug for the treatmentcoronary heart disease.
It has not only the action characteristic of class III antiarrhythmics, that is, the blockade of potassium channels, but also the action characteristic of class I drugs - blockade of sodium channels, class IV - blockade of calcium channels. Among other things, the drug gives alpha- and beta-adrenergic blocking, coronary dilating effect.
Indications for use
The active substance of the drug is amiodarone. Trade name - "Kordaron". Analogues are produced under other names, but contain the same active substance. Amiodarone is available as an intravenous solution and tablets.
The solution is used when it is necessary to stop attacks of ventricular and supraventricular tachycardia, atrial fibrillation, including seizures. Tablets are used to prevent ventricular and atrial fibrillation and paroxysmal tachycardia.
Operation principle
Suppressing the process of intracellular transport of potassium ions, the drug lengthens the third phase of the action potential of heart muscle cells. At the same time, the transmission of an electrical impulse in the fibers of the atrioventricular node is also suppressed. Because of this, the pulse slows down. As a result of partial blocking of the influence of the sympathetic nervous system, the heart rate slows down.
Amiodarone is metabolized in the liver and excreted primarily in the urine. The maximum content of the active substance is observed 3-7 hours after taking the tablet. A persistent therapeutic effect does not appearless than a week after starting treatment.
Analogues of "Kordaron"
In many cases, patients for a number of reasons prefer not the original drug, but its analogues, generics. Since "Kordaron" is just a trade name for amiodarone, those suffering from arrhythmias are often interested in whether there are analogues of the drug "Kordaron".
As for amiodarone, the question of its analogues is of particular relevance, because it is one of the most popular cardiological drugs in the world, which is widely used. Such drugs, as mentioned above, have a large number of side effects, often worsening he alth. Therefore, both the doctor and the patient are interested in choosing a drug with maximum efficiency and minimal risk to he alth and life. If you are looking for analogues equivalent to Kordaron, the medical reviews in this case should be of decisive importance to you, although, of course, patient reviews are also important, since they can tell about the sensations during the reception and about the speed of improvement. At the same time, treatment with both "Kordaron" and any of its analogues should be accompanied by medical supervision and monitoring of the state of he alth, including with the help of ECG.
An important role is played by the composition of the drug. For example, iodine, which is part of amiodarone, is contraindicated in a number of diseases. It can also distort the results of some studies. Therefore, it is not surprising that many people suffering from arrhythmia are looking for an analogue of Kordaron without iodine.like Dronedaron. Of course, you can replace any drugs only after consulting a doctor. So, many Russian experts do not recommend choosing Dronedarone without the need, since it is a weaker analogue of Kordaron. In Europe, however, it is already fairly common.
When choosing a drug or analogue, it is necessary to compare their composition. As a general rule, analogues and generics are not compared with each other - only with the original. Say, if you need an analogue of Cordarone in ampoules, then benzyl alcohol should be present in the composition of a similar injection solution, as in the original Cordarone.
According to doctors, analogues in Russia that are not inferior in properties to Kordaron are represented by a fairly large number of drugs, including: Rhythmiodarone, Sedacoron, Amiocordin, Cardiodaron, Ritmorest, "Opacorden", "Amiodarone" from various manufacturers ("Amiodarone-Akri", "Vero-Amiodarone" and many others). All of them have the same active ingredient, but may have different excipients. Many of them are noticeably cheaper than the original. In most cases, this factor depends on the manufacturer. For example, "Amiodarone", which is called the same as the main substance contained in the drug "Cordarone". The analogue is Russian, and its price is almost three times lower, although the form of release and indications for the appointment are the same.
Amiodoron is the best analogue in Russia. It is practically indistinguishable from "Kordaron" both by the principle of action and by the method of application, it has the samehigh efficiency in stopping arrhythmia attacks and preventing their occurrence. Patient reviews about him are mostly positive. Many of them note that Russian-made Amiodoron helps quickly and without severe side effects.
Method of using the drug in ampoules
As mentioned above, the injection solution is indicated for quick relief of the problem. In other cases, Kordaron tablets are used. Analogues work in the same way. Solutions are administered intravenously through a catheter for 20-120 minutes or by stream for at least 3 minutes at a dosage of 5 mg per 1 kg of body weight.
Method of application of the tableted "Kordaron"
The pill is taken in two steps.
First stage, or loading phase: 600-800 mg once a day, increased to 10 g.
Second stage, or maintenance phase: 100-400 mg of the drug (the duration is determined by the doctor). The maximum dose is 1200 mg per day.
Overdose of the drug is quite dangerous. In order to prevent it, the patient is advised to know exactly how the instructions for use recommend taking the Cordaron preparation. Analogues, including the popular analogue in Russia "Amiadarone", for the most part give the same overdose symptoms.
There is severe bradycardia, even to the point of cardiac arrest. If it is caused by a tablet form, it is necessary to wash the stomach and take enterosorbents. Other symptomatic treatment is also carried out, the electrolyte balance is corrected. Installed if necessarypacemaker.
Information on intravenous overdose is incomplete. Rare cases of sinus bradycardia, tachycardia, and cardiac arrest have been described. Treatment is similar to that prescribed for an overdose caused by pills. Amiodarone and its metabolites are not removed by hemodialysis.
Side effects
Like any effective remedy with a powerful action, "Kordaron", "Amiodarone" and other analogues provoke a number of side effects. They cause bradycardia, up to cardiac arrest, lowering blood pressure, have a negative effect on the liver, as a result of which they have a rather impressive list of contraindications.
Of the less severe, but nevertheless unpleasant side effects, one can note headache and dizziness, pleurisy, cough, the patient may complain of weakness, decreased visual acuity. Possible allergic reactions. The same problems can be obtained by taking any analogue. Cordarone and other amiodarone tablets for this reason are sold in pharmacies only by prescription. The solution for injection is used only in a hospital setting.
However, if precautions are taken when choosing the maximum dose, side effects are mild or may not appear at all. As noted in the reviews of Cordarone and Amiodarone, patients taking these drugs, the side effects are usually weak, the dose adjustment of the drug is easily eliminated.
Contraindications
Since amiodarone is a pretty strong drug,not surprisingly, it can not only help improve the condition of a number of cardiac problems, but at the same time has a devastating effect on other organs or worsens the condition in some concomitant diseases. To avoid risk, therapy with this drug is not recommended in some cases.
There is a whole range of conditions in which it is forbidden to take "Kordaron", "Amiodarone" and other analogues in tablets. First of all, these are some pathological cardiac conditions - sinus bradycardia, severe atrioventricular block, arterial hypotension, prolongation of the QT interval on the cardiogram. It should not be used if the patient has low levels of magnesium and potassium in the body.
Contraindications include pathologies of the thyroid gland, as well as pregnancy and breastfeeding - the reason is iodine, which contains the drug "Kordaron". An analogue that does not contain it can only be taken on the recommendation of a doctor.
Patients in old age are advised to take both "Kordaron" and "Amiodarone" and other analogues with caution. Patients under 18 years of age are not prescribed these medicines.
It is not recommended to prescribe this remedy to those who suffer from bronchial asthma, respiratory failure, and severe heart failure. Severe pathologies of the liver and kidneys are also a reason to refuse treatment with this method.
Undoubtedly, you should not take medicine if there is an individual intolerance to the components of the drug "Kordaron". Analogues in Russia and another European country havethe same composition, therefore, in this case, it is unlikely that it will be possible to replace one remedy with another.
As for injections, they should not be given to babies under 3 years old, for children over 3 years old, the dose should not exceed 5 mg / kg. Do not mix the drug in the same syringe with other drugs. In general, contraindications to the solution are similar to contraindications to tablets. These are sinus bradycardia, sick sinus syndrome and severe conduction disturbances, as well as sinoatrial heart block and paroxysmal ventricular tachycardia. In particular, such phenomena are possible when taking amiodarone in combination with a number of other drugs.
It is possible to prescribe injections during pregnancy only in exceptional cases; during lactation, this method of treatment is completely excluded. It is impossible to carry out therapy using the Cordarone solution for thyroid dysfunctions, allergic reactions to iodine or amiodarone.
Interaction with other drugs
"Kordaron" can be combined with other drugs. So, its antianginal effect is enhanced in combination with long-acting nitrate preparations. It can be used in conjunction with anticoagulants, diuretics, cardiotonic drugs, do not interact and, accordingly, do not weaken or enhance the effect of each other "Kordaron" and some antipsychotics, analgesics, hypnotics and sedatives. Almost any analog reacts to these drugs in the same way.
"Kordaron" can not be used simultaneously with MAO inhibitors and beta-blockers (only inexceptional cases).
Precautions in the treatment of Cordarone and Amiodarone
While taking these drugs, it is necessary to monitor the state of the body before the start of treatment, during and after it.
ECG is recommended before and during tablet therapy. The action of the drug causes changes in the electrocardiogram, in particular, the lengthening of the interval Q-T and Q-Tc. Based on the results of the examination, the doctor can adjust the dosage and determine the effectiveness of the treatment.
Treatment is stopped if atrioventricular block II and III degree, sinoatrial, bifascicular intraventricular block develops.
Since one of the components of the drug is iodine, regular monitoring of thyroid function is necessary. Before treatment, it is required to determine the level of hormones T3, T4 and TSH. Please note that while taking Kordaron, the results of a radioisotope study of the thyroid gland may be unreliable. Iodine does not affect hormone level data.
Also an important factor is the determination of serum potassium levels before and during treatment.
When administering Kordaron intravenously, only infusions are recommended, not syringe injections. Otherwise, the development of hemodynamic disorders is possible - arterial hypotension, acute cardiovascular insufficiency. It is possible to administer the drug with a syringe only in exceptional emergency situations and in the absence of other possibilities. In this case, the dose is 5 mg/kg administered over three minutes,repeatedly - not earlier than 15 minutes after the first administration of the drug. The procedure can only be performed in cardio intensive care units under ECG control. "Kordaron" is forbidden to be mixed in a syringe with other drugs. If long-term treatment is ahead, it is required to switch to infusions. Any intravenous injections of amiodarone are carried out in hospitals.
If the patient is going to be under general anesthesia, the anesthesiologist should be made aware that the drug is being taken.
To avoid side effects, patients should follow the dosage prescribed by their doctor.
During treatment, patients should avoid sunlight and, if necessary, use protection against it (including special creams).
Be sure to consult your doctor if for some reason you plan to take not Cordaron, but its analogue. "Kordaron" and drugs similar to it, like any other cardiac drugs, can be extremely dangerous if taken uncontrolled. Only a doctor can determine which medication is best for you and select a safe but effective dosage.
