Panangin - instructions for use, reviews, analogs and release forms (tablets, ampoule solution) of the drug for the treatment of potassium and magnesium deficiency, heart failure in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Panangin. Comments of visitors of the site - consumers of this medicine, as well as opinions of doctors of specialists on using Panangin in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Panangin in the presence of existing structural analogs. Use to treat potassium and magnesium deficiency, heart failure and myocardial infarction in adults, children,as well as during pregnancy and lactation.

Panangin - a drug that affects metabolic processes. The source of potassium and magnesium ions.

Potassium and magnesium are intracellular cations that play a major role in the functioning of many enzymes, the interaction of macromolecules and intracellular structures, and in the mechanism of muscle contractility. The intra- and extracellular ratio of potassium, magnesium, calcium and sodium ions has an effect on myocardial contractility. Low levels of potassium and / or magnesium ions in the internal environment can exert a pro-rhythmogenic effect, predispose to the development of arterial hypertension, coronary artery atherosclerosis, and metabolic changes in the myocardium.

One of the most important physiological functions of potassium is the maintenance of the membrane potential of neurons, myocytes and other excitable structures of myocardial tissue. Violation of the balance between intra- and extracellular potassium content leads to a decrease in myocardial contractility, arrhythmia, tachycardia, and increased cardiac glycoside toxicity.

Magnesium is a cofactor of more than 300 enzymatic reactions of energy metabolism and synthesis of proteins and nucleic acids.Magnesium reduces the stress of contraction and heart rate, leading to a decrease in myocardial oxygen demand. Magnesium has an anti-ischemic effect on the tissue of the myocardium. Reduction of myocardial contractility of smooth muscles of arteriolar walls, incl. coronary, leads to vasodilation and increased coronary blood flow.

The combination of potassium and magnesium ions in one preparation is justified by the fact that potassium deficiency in the body is often accompanied by a deficiency of magnesium and requires simultaneous correction of the content in the body of both ions. With simultaneous correction of the levels of these electrolytes, an additive effect is observed, in addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting their positive inotropic effect.

Pharmacokinetics

When ingested, the absorption of the drug is high. It is excreted in the urine.

Data on the pharmacokinetics of the drug in the form of a solution for intravenous administration are not provided.

Indications

• in the complex therapy of heart failure, myocardial infarction, cardiac arrhythmias (mainly ventricular arrhythmias);
• to improve the tolerability of cardiac glycosides;
• replenishment of potassium and magnesium deficiency with a decrease in their content in the diet (for tablets).

Forms of release

Film-coated tablets.

Solution for intravenous administration (in ampoules for injection).

Instructions for use and dosage

For oral administration

Assign 1-2 tablets 3 times a day. The maximum daily dose is 3 tablets 3 times a day.

The drug should be used after a meal, tk. The acidic environment of the contents of the stomach reduces its effectiveness.

The duration of therapy and the need for repeated courses the doctor determines individually.

For intravenous administration

The drug is administered intravenously drip (in a dropper), in the form of a slow infusion. Single dose - 1-2 ampoules, if necessary, repeated administration after 4-6 hours.

To prepare a solution for intravenous infusion, the contents of 1-2 amp. dissolved in 50-100 ml of a 5% solution of glucose.

Side effect

• paresthesia (due to hyperkalemia);
• hyporeflexion;
• convulsions (caused by hypermagnesemia);
• AV blockade;
• a paradoxical reaction (an increase in the number of extrasystoles);
• a decrease in blood pressure;
• redness of the facial skin (caused by hypermagnesemia);
• nausea, vomiting;
• Diarrhea (including caused by hyperkalemia);
• a feeling of discomfort or burning in the pancreas (in patients with an anatomic gastritis or cholecystitis);
• respiratory depression (due to hypermagnesemia);
• feeling of heat (caused by hypermagnesemia);
• with rapid on / in the introduction of possible symptoms of hyperkalemia and / or hypermagnesemia.

Contraindications

For oral and intravenous administration

• acute and chronic renal failure;
• oliguria, anuria;
• Addison's disease;
• AV-blockade of 2 and 3 degrees;
• cardiogenic shock (BP <90 mmHg);
• hyperkalemia;
• hypermagnesia;
• hypersensitivity to the components of the drug.

For oral administration

• severe myasthenia gravis;
• AV-blockade of 1 degree;
• hemolysis;
• impaired metabolism of amino acids;
• Acute metabolic acidosis;
• dehydration of the body.

Application in pregnancy and lactation

Data on the negative effect of the drug in the form of a solution for intravenous administration during pregnancy and lactation (breastfeeding) are absent.

With caution should be used inside the drug during pregnancy (especially in the first trimester) and during lactation (breastfeeding).

special instructions

Caution is necessary to prescribe the drug to patients with an increased risk of hyperkalemia.In this case, it is necessary to regularly monitor the level of potassium ions in the blood plasma.

Before taking the drug, the patient should consult a doctor.

With rapid intravenous administration of the drug may develop skin hyperemia.

Impact on the ability to drive vehicles and manage mechanisms

The drug does not affect the ability to drive and engage in activities that require increased concentration and speed of psychomotor reactions.

Drug Interactions

When used simultaneously with potassium-sparing diuretics (triamterene, spironolactone), beta adrenoblockers, cyclosporine, heparin, ACE inhibitors, NSAIDs, the risk of developing hyperkalemia increases up to the appearance of arrhythmia and asystole. The use of potassium preparations together with GCS eliminates the hypokalemia caused by them. Under the influence of potassium, there is a decrease in the undesirable effects of cardiac glycosides.

The drug enhances the negative dromo- and batmotropic effect of antiarrhythmic drugs.

Due to the presence of potassium ions in the formulation of Panangin with ACE inhibitors, beta-adrenoblockers, cyclosporin, potassium-sparing diuretics, heparin,NSAIDs may develop hyperkalemia (potassium levels need to be monitored in the blood plasma); with anticholinergics - a more pronounced decrease in intestinal peristalsis; with cardiac glycosides - a decrease in their action.

Magnesium preparations reduce the effectiveness of neomycin, polymyxin B, Tetracycline and streptomycin.

Anesthetics increase the inhibitory effect of magnesium on the central nervous system. When used with atracurium, dexamethonium, suxamethonium, neuromuscular blockade may increase; with calcitriol - an increase in the level of magnesium in the blood plasma; with calcium preparations, a decrease in the action of magnesium ions is observed.

With the simultaneous use of Panangin with potassium-sparing diuretics and ACE inhibitors, the risk of hyperkalemia increases (the level of potassium in the plasma should be monitored).

Analogues of the drug Panangin

Structural analogs for the active substance:

• Asparks;
• Asparks-L;
• Asparks-UBF;
• Asparks-Farmak;
• Potassium and magnesium asparaginate Berlin-Chemie;
• Pamaton.

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