Arrhythmia is a type of heartbeat that is different from normal sinus rhythm. With arrhythmia in a person, one or several disorders in the work of the heart are observed. Pathology can manifest itself both in an increase in the frequency and strength of heart contractions (tachycardia), and, conversely, in their decrease (bradycardia). Interruptions in the work of the heart muscle also occur in a he althy person. However, in most cases, arrhythmia occurs in combination with other cardiac diseases. Such a condition is risky in that the excitability of the tissues of the heart - the myocardium - increases, which can subsequently lead to heart failure if the disease is not treated.
To normalize the heart rate, there are special drugs, one of which is Sotahexal. Analogues of the drug are also widely used in medical practice. Such drugs belong to the group of drugs with antiarrhythmic action, and beta-blockers. When ingested, they block beta-adrenergic receptors, which are located in smooth muscles, heart muscle and other tissues, and are responsible for the body's response to action.stress. The general cardio effect consists in a decrease in the frequency and intensity of heart contractions, a decrease in cardiac conduction. As a systemic effect, there is also a decrease in blood pressure on the walls of the coronary vessels.
Composition of the drug
Sotalol is the worldwide accepted international name for Sotahexal. Analogues composition may have a different, but similar antiarrhythmic effect. Sotahexal contains sotalol hydrochloride as the main active ingredient. In addition, it includes a small number of auxiliary components. Among them are cellulose, lactose monohydrate, corn starch, magnesium stearate and other binders.
The shelf life of tablets or solution for injection is 5 years.
"Sotahexal", analogues and release form
One tablet of this drug contains 40, 80 or 160 mg of the active ingredient. It is produced mainly in the form of white round tablets, on the one hand slightly convex and with the abbreviation SOT squeezed out. On the back, the tablet is divided in half with the help of a risk for ease of dosage. Everything is packed in blisters of 10 pieces and cardboard packs. Each pack can contain from 1 to 10 blisters (from 10 to 100 tablets in total).
Also, "Sotahexal" is available in the form of a solution for intravenous injection. Each ampoule contains 4 ml of medicine. 1 ml of solution contains 10 mg of pure basic substance. The drug must be stored in a dark and dark place protected from sunlight.dry place where children have limited access.
Analogues with the active ingredient sotalol hydrochloride are made in tablets:
- Sotalex (160 mg each).
- "Soritmik" (0.16 g each).
- Sotalol Canon (80 and 160 mg each).
- "Darob" (80 and 160 mg each).
- "Tenzol" (80 and 160 mg each).
Pharmacological action
"Sotahexal", analogues and synonyms of the drug have a pronounced antiarrhythmic effect. This is achieved due to their ability to block β-adrenergic receptors and inhibit potassium channels. The drugs increase the duration of impulses and reflex periods of the atria, as well as the ventricles. Increase the tone of the smooth muscles of the bronchi and the muscular layer of the walls of blood vessels. Reduce myocardial contractility.
Sotalol hydrochloride has a whole range of properties. It has a negative chronotropic, dromotropic, bathmotropic and inotropic effect of the German drug Sotahexal. Analogues, the composition of which is identical, may have a different trade name. They are also able to reduce the heart rate and their strength. Due to this, the need for myocardial oxygen consumption is significantly reduced. And as a result, the load on the heart is reduced.
Drug absorption and excretion
Absorption of the drug is fast. Its bioavailability is 90%, and absorption is about 80%. Within 2.5–4 hours after ingestion, the maximum concentration of the active substance is reached in the blood plasma. BUTafter intravenous administration, the effect appears after 5-10 minutes. Absorption occurs 20% better and faster if taken on an empty stomach. Due to the fact that the solubility of the substance in fats is very low, sotalol hydrochloride should not be taken simultaneously with dairy products and animal fats.
Without binding to blood proteins, the drug is distributed in tissues and peripheral organs evenly over 3-4 days of regular intake. At the same time, a positive effect is achieved in hypertension. In the cerebrospinal fluid concentration of the drug is not more than 20%. Action after injection lasts up to 2 hours. Up to 12 hours, the effect persists after oral administration of Sotahexal tablets. Analogues of the drug, which contain sotalol hydrochloride, are also not metabolized and are excreted by the kidneys with urine (up to 90%) and with feces after an average of 10–20 hours.
That is why patients with impaired functioning of the kidneys and urinary system are shown taking the medicine at a lower dosage. Older people often experience age-related deterioration in kidney function. This contributes to the fact that the substance is excreted at a slower rate and can accumulate in the body. Therefore, this group of patients is prescribed the drug with caution, and its dosage is determined individually.
The drug contributes to the normalization of oxygen metabolism in tissues, eliminates increased nervous excitability, anxiety, stress and other factors that affect the frequency and intensity of heart contractions.
"Sotahexal": instructions forapplication
Analogues of the drug and the remedy with the original name are used for symptomatic cardiac arrhythmias, for the treatment of ventricular extrasystole. But the effect is different in patients with similar diagnoses. Therefore, it should be prescribed by a doctor after a thorough examination and strictly according to indications.
Rarely, the remedy is used to treat patients who have had psoriasis or have diabetes mellitus with impaired carbohydrate metabolism. With caution, it is prescribed to people who have a history of allergies, the remedy "Sotahexal". Its analogues are also able to suppress the body's sensitivity to allergic stimuli. Gently the medicine is used in the treatment of persons with heart failure, prone to frequent depression. Patients who have had a myocardial infarction are at risk of exacerbating arrhythmias while taking Sotahexal.
Dosage and treatment period
Depending on the severity of the disease, the duration of therapy with Sotahexal is also determined. Instructions for use (analogues may have other instructions for taking) contains the following recommendations:
- the tablet is swallowed whole, without chewing and washed down with plenty of water;
- taken 1-2 hours before meals;
- The drug is taken 2-3 times a day.
At the beginning of treatment, the daily dose should not exceed 80 mg (1 tablet) for hypertension and tachycardia. However, in the absence of the desired therapeutic effect, the dose is increased. Gradually fromat intervals of 2-3 days, it is adjusted to 240-320 mg per day, but only in a hospital setting. The most effective is a gradual increase in dosage of 80 mg per week.
The maximum dose can be 6 tablets per day of Sotahexal medication. Analogues, the dosage of which can also be increased if the doctor considers it necessary, are prescribed individually. Even if there is a threat to life, the total amount of the active substance should not exceed more than 480 mg per day.
If the patient has functional disorders of the kidneys, then the treatment regimen is selected depending on the value of creatinine clearance. When it is increased (up to 30 mg / min), the dose is usually reduced by two to four times.
Intravenous injections are made twice a day, dividing the ampoule into two injections of 2 ml. The solution is injected slowly over 5-7 minutes. During treatment, it is mandatory to control blood pressure, pulse, kidney and urinary system function, and serum creatinine clearance.
Indications
The drug is prescribed for the treatment of such diseases:
- ventricular tachycardia;
- Wolf-Parkinson-White syndrome;
- cardiomyopathy;
- ventricular extrasystoles;
- mitral valve prolapse;
- paroxysmal atrial fibrillation;
- arterial hypertension (high blood pressure);
- prevention and treatment of myocardial infarction (in some cases).
In case of severe impairment of kidney function, the doctor must constantly monitor the concentration of the activesubstances in the blood serum and adjust the dose of the drug "Sotahexal". Analogues indications for admission are similar. But, despite this, it is strictly forbidden to independently replace one drug with another. Cancellation of treatment should not occur immediately, but gradually. Abrupt discontinuation may lead to clinical deterioration.
Contraindications
Any antiarrhythmic agent cannot always be prescribed to a patient, including Sotahexal. Contraindication analogues are the same, they cannot be used in the presence of the following conditions:
- hypersensitivity or individual intolerance to the main substance or auxiliary components;
- weak sinus angle;
- marked decrease in heart rate (bradycardia);
- chronic obstructive pulmonary disease;
- severe asthma;
- kidney failure;
- acute myocardial infarction;
- acute or chronic heart failure;
- cardiogenic shock;
- long QT syndrome;
- childhood;
- allergy, allergic rhinitis;
- pregnancy and breastfeeding;
- low blood pressure (arterial hypotension);
- general anesthesia;
- gangrene;
- pathology of peripheral vessels;
- development of Pirouette type tachycardia (the condition is diagnosed more often in women than in men).
Sufficient application experience duringthere is no drug pregnancy. Only for vital indications is Sotahexal prescribed. Analogues in the first trimester also pose a threat to the life of the fetus, and their use can lead to termination of pregnancy. There are still no reliable research data on taking the drug in pregnant women.
In the last months, therapy is canceled gradually 2-4 days before the expected birth, if the woman took it throughout the entire period of pregnancy. This is done so that the newborn does not develop respiratory depression, bradycardia or arterial hypotension due to Sotahexal.
Analogues based on sotalol hydrochloride should be discontinued if a young mother is breastfeeding, as the substance has the ability to penetrate into breast milk and reach high concentrations there. If, according to indications, treatment must be continued, then it is better to stop breastfeeding, replacing milk with adaptive mixtures appropriate for the age of the child.
Side effects and overdose
May have adverse effects on the cardiovascular, endocrine, genitourinary, respiratory, digestive and central nervous systems long-term use of Sotahexal. Analogues cause similar side effects. The patient may experience:
- shortness of breath, increased angina attacks, symptoms of heart failure, heart pain, angiospasm, Raynaud's syndrome;
- nausea, vomiting, diarrhea, stomach pain, increasedgas, bloating, difficult bowel movements, dry mouth;
- anxiety, anxiety, panic states, hallucinations, impaired coordination of movements, hearing, mood swings, tremors, fatigue, headache, dizziness, lack of sleep or, conversely, increased drowsiness, disturbing dreams, depression;
- conjunctivitis, keratoconjunctivitis or dry eye syndrome (especially in contact lens wearers), corneal inflammation, loss of taste and smell, eye pain, photophobia, visual acuity, hearing loss;
- hypoglycemia (in people with diabetes);
- bronchial spasms, laryngitis, tracheitis;
- urticaria, dermatoses, skin itching, redness, psoriasis, Quincke's edema, increased sweating;
- in men, a decrease in potency, pain during ejaculation, in women - a decrease in libido and menstrual irregularities;
- fever, muscle weakness, cramps, bluish extremities.
Overdose may cause:
- depression of cardiac functions;
- shortness of breath;
- asystole, fainting, weakness, dizziness;
- cyanosis of extremities;
- muscle cramps;
- bradycardia to cardiac arrest;
- cardiovascular shock;
- bronchospasm;
- tachycardia.
Despite such severe overdose symptoms, death is rare. In case of drug poisoning, it is first necessary to stop taking the drug."Sotahexal". Analogues and generics of sotalol hydrochloride are effectively excreted from the gastrointestinal tract after taking absorbent drugs. In case of overdose, symptomatic therapy is indicated. In case of serious poisoning, it is necessary to wash the stomach and induce vomiting, maintaining the functions of internal organs that are important for life. Excess doses are completely eliminated by hemodialysis. A metabolic decrease in blood sugar can be observed in those patients who are on a strict diet or starve.
Analogues and generics "Sotahexal"
Sotalol hydrochloride is contained in a preparation produced in Switzerland and Germany, with the trade name Sotahexal. Its analogues are also represented by other drugs with a different composition, which, in addition to the antiarrhythmic effect, relieve muscle spasms, reduce pressure and improve atrial function. These include:
- "Anaprilin", "Inderal", "Obzidan", "Pranolol" (active ingredient - propranolol) are used to treat ischemia, arrhythmia and hypertension.
- "Pumpan" - a homeopathic remedy based on herbal ingredients.
- "Magnerot" contains magnesium orotate dihydrate, used to treat atherosclerosis, lipid metabolism disorders.
- Corvitol (metoprolol tartrate) is effective for migraines.
- "Nebilet" (nebivolol hydrochloride) is prescribed for hypertension, coronary disease.
- Kudesan (drops) - a biological supplement based on coenzymes Q10 for the prevention and treatment of arrhythmias.
- "Etacizine"(ethacizine) is used for tachycardia;
- "Aritmil", "Amiodarone" (amiodarone hydrochloride) are used for cardiac arrest, tachycardia, atrial arrhythmia.
- "Propanorm" (propafenone hydrochloride) is used for ventricular and supraventricular extrasystoles.
- "Neo-Gilurithmal" (primalium bitartrate) is prescribed for ventricular arrhythmia, tachycardia.
- "Korgard" (nadolol) is taken for the treatment of angina pectoris, migraine.
Sotalol Canon and Tenzol are produced in Russia with the same active ingredient as Sotahexal. Analogues in Moldova, Ukraine and neighboring countries are easier to find in pharmacies than the original medicine. The cost of drugs depends on the country and the manufacturer. Domestic drugs, as a rule, have a price much lower than foreign ones.
Reviews
There is a significant reduction in the frequency of seizures with atrial fibrillation, if you take Sotahexal constantly. Patient reviews are not as positive. Not always drugs from different manufacturers act similarly, even if they have the same composition. Many fear that unscrupulous manufacturers indicate a higher concentration of the active substance in one tablet than it actually is. Because of this, the treatment may not bring the expected results. Reviews about Sotahexal, on the contrary, are more positive. It is effectively used as part of the complex treatment of diseases of the heart and blood vessels at different stages.
In most cases there is a gradual improvementthe general condition of patients under the condition of complex treatment. The drug is indispensable both for the relief of attacks and for prevention. Judging by the reviews of patients diagnosed with "paroxysmal arrhythmia", the drug helps to keep the heart rate normal (provided that it is taken constantly as maintenance therapy). However, patients note that they would not dare to increase the dose on their own without the advice of a doctor due to the risk of serious side effects.
Some reviews are not very positive effect on the reputation of the drug. It is believed that it is advertised and will not be able to cure anemia, microbial arrhythmias, hypokalemia and hypomagnesemia. It is noted that sotalol hydrochloride of foreign brands is difficult to find in domestic pharmacies. People who are accustomed to constantly using the tool experience difficulties in acquiring it. Therefore, before starting therapy, you should make sure that it will be possible to continue it for a long time.
What can not be combined with the reception of "Sotahexal"
For the period of treatment, it is advisable for patients to stop driving a car, riding a bicycle, or a motorcycle. Also dangerous are all activities that require increased attention, psychomotor concentration and concentration. When taking additional drugs to reduce pressure, there is a possibility of hypotension. It is forbidden to combine Sotahexal with the following drugs:
- insulin, since its blood levels are already rising;
- ions and calcium antagonists;
- funds for general orinhalation anesthesia;
- MAO inhibitors;
- iodine-containing substances;
- diuretics;
- ergot alkaloids;
- tetracyclic antidepressants.
The drug is not prescribed simultaneously with class I and class III antiarrhythmic drugs. It is also contraindicated to take narcotic drugs, sedatives and antihistamines, neuroleptics, coumarins, relaxants. They further contribute to the oppression of the central nervous system. Simultaneous anesthesia leads to an increase in blood pressure and inhibits myocardial tissue. It is forbidden to do skin tests to determine the types of allergens. This increases the risk of anaphylactic shock, angioedema and asphyxia.
The drug "Sotahexal" is released in pharmacies by prescription. Self-treatment of arrhythmias with this remedy can cause serious adverse reactions. Therefore, before taking medicine, you should definitely consult a doctor.
