Sotageksal - instructions for use, analogs, reviews and release forms (tablets 80 mg and 160 mg) drugs for the treatment of heart rhythm disorders (tachycardia, extrasystole) in adults, children and in pregnancy
In this article, you can read the instructions for using the drug Sotageksal. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Sotagexal in their practice. 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 Sotagexal in the presence of existing structural analogs. Use for the treatment of cardiac arrhythmias (tachycardia, extrasystole) in adults, children, as well as during pregnancy and lactation.
Sotageksal - beta1-, beta2-adrenoblocker. Sotalol (active ingredient of the drug Sotagexal) is a non-selective blocker of beta1-, beta2-adrenoreceptors, which does not have its own sympathomimetic and membrane-stabilizing activity. Like other beta-blockers, sotalol inhibits the secretion of renin, and this effect has a pronounced character both at rest and during exercise. Beta-adrenoblokiruyuschee effect of the drug causes a decrease in heart rate (negative chronotropic action) and a limited decrease in the force of the heartbeats (negative inotropic effect). These heart function changes reduce myocardial oxygen demand and heart burden volume.
Antiarrhythmic properties of Sotagexal are associated with both blockade of beta-adrenoreceptors and prolongation of the potential of the action of the myocardium. The main effect of sotalol is to increase the duration of effective refractory periods in the atrial, ventricular and additional ways of carrying out the pulse.
Composition
Sotalol hydrochloride + excipients.
Pharmacokinetics
Bioavailability when ingestion is almost complete (more than 90%). Absorption of the drug is reduced by approximately 20% when eating compared to fasting. Distribution occurs in the plasma, as well as in peripheral organs and tissues. Sotalol does not bind to blood plasma proteins. Poorly penetrates the blood-brain barrier (BBB), and its concentration in the cerebrospinal fluid is only 10% of the concentration in the blood plasma. Not exposed to metabolism. The main way to remove from the body is the secretion through the kidneys. From 80 to 90% of the administered dose is excreted unchanged in the urine, and the rest with feces.
Patients with impaired renal function should be given smaller doses of the drug.
With age, the pharmacokinetics changes insignificantly, although renal dysfunction in elderly patients reduces the rate of excretion, which leads to increased accumulation of the drug in the body.
Indications
Symptomatic and chronic heart rhythm disturbances:
- ventricular tachycardia, incl. supraventricular tachycardia with Wolff-Parkinson-White syndrome;
- ventricular extrasystole;
- paroxysmal form of atrial fibrillation.
Forms of release
Tablets of 80 mg and 160 mg.
Instructions for use and dosing regimen
The drug is taken orally for 1-2 hours before eating, without chewing, squeezed with enough liquid.
Simultaneous intake of food (especially milk and dairy products) reduces the absorption of the drug.
The dose of the drug is selected individually, depending on the severity of the disease and the patient's response to treatment.
The initial dose is 80 mg per day. If the therapeutic effect is insufficient, the dose can be gradually increased to 240-320 mg per day, divided into 2-3 doses. In most patients, the therapeutic effect is achieved at a total daily dose of 160-320 mg divided into 2 doses.
In life-threatening severe arrhythmias, a dose increase of up to 480 mg, divided into 2 or 3 separate doses, is possible. However, such doses can be prescribed only in cases where the potential benefit outweighs the risk of side effects, especially pro-arrhythmogenic action.
The duration of therapy is determined by the attending physician.
In the event that the patient forgot to take a pill on time, the next time you should not take an additional amount of the drug, you only need to take the prescribed amount of Sotagexal.
Side effect
- bradycardia;
- dyspnea;
- retrosternal pain;
- palpitation;
- AV blockade;
- increased symptoms of heart failure;
- palpitation;
- edema;
- fainting;
- arrhythmogenic action;
- a decrease in blood pressure;
- increased attacks of angina pectoris;
- nausea, vomiting;
- diarrhea;
- constipation;
- dry mouth;
- abdominal pain;
- flatulence;
- headache;
- dizziness;
- increased fatigue;
- state of depression;
- sense of anxiety;
- mood changes;
- tremor;
- asthenia;
- sleep disorders (drowsiness or insomnia);
- depression;
- paresthesia in the limbs;
- visual impairment;
- inflammation of the cornea and conjunctiva (should be considered when wearing contact lenses);
- reduction of lacrimation;
- hearing impairment, taste sensations;
- hypoglycemia (most likely in patients with diabetes mellitus, or with strict adherence to diets);
- bronchospasm (especially when pulmonary ventilation is impaired);
- decreased potency;
- skin rash, itching, redness;
- psoriasis dermatosis;
- alopecia;
- hives;
- coldness of limbs;
- muscle weakness;
- convulsions;
- fever.
Contraindications
- chronic heart failure 2B-3 stage;
- cardiogenic shock;
- AV blockade of 2 or 3 degrees;
- sinoatrial blockade;
- syndrome of weakness of the sinus node;
- pronounced bradycardia (heart rate less than 50 beats per minute);
- congenital or acquired syndrome of an elongated QT interval;
- arterial hypotension (systolic blood pressure less than 90 mm Hg);
- obliterating vascular diseases;
- bronchial asthma or COPD;
- metabolic acidosis;
- pheochromocytoma without simultaneous administration of alpha-blockers;
- acute myocardial infarction;
- renal failure (CC less than 10 ml / min);
- general anesthesia, which causes suppression of myocardial function (for example, cyclopropane or trichlorethylene);
- tachycardia of the "pirouette" type;
- severe allergic rhinitis;
- simultaneous administration of MAO inhibitors;
- lactation period;
- age under 18 years (effectiveness and safety not established);
- hypersensitivity to sotalol, sulfonamides and other components of the drug.
Application in pregnancy and lactation
Sotagexal intake during pregnancy, especially in the first 3 months, is possible only for vital signs and with a careful correlation of all risk factors.
In the case of pregnancy therapy,the drug should be withdrawn 48-72 hours before the expected delivery due to the possibility of developing bradycardia, arterial hypotension, hypokalemia and respiratory depression in newborns.
Sotalol penetrates into breast milk and reaches effective concentrations there. If it is necessary to prescribe the drug during the period of breastfeeding, breastfeeding should be discontinued.
Application in elderly patients
With caution appoint the drug to elderly patients.
Use in children
The drug is contraindicated in children and adolescents under the age of 18 years.
special instructions
Caution should be exercised when administering Sotagexal to patients:
- at a diabetes in the anamnesis with the expressed fluctuations of level of a glucose in a blood, and also at observance of strict diets;
- with pheochromocytoma (simultaneous administration of alpha-blockers is necessary);
- if there is a history or family history of psoriasis;
- if the kidney function is impaired;
- the elderly.
Treatment with the drug is carried out under the control of heart rate, blood pressure, ECG. With a marked decrease in blood pressure or a decrease in heart rate, the daily dose should be reduced.
Patients with impaired renal function require a correction of the dosing regimen.
The withdrawal of Sotagexal should be performed under the supervision of the attending physician and gradually (especially after a long reception).
Sotagexal should not be used in patients with hypokalemia or hypomagnesemia before correction of existing disorders. These conditions can increase the degree of prolongation of the QT interval and increase the likelihood of arrhythmia of the "pirouette" type. It is necessary to control the electrolyte balance and acid-base state in patients with severe or prolonged diarrhea and in patients receiving medicines that cause a decrease in magnesium and / or potassium in the body.
In thyrotoxicosis, sotalol may mask certain clinical signs of thyrotoxicosis (eg, tachycardia). Sharp abolition in patients with thyrotoxicosis is contraindicated, since it can strengthen the symptoms of the disease.
When prescribing beta-blockers, patients receiving hypoglycemic agents should be careful, because during prolonged interruptions in eating, hypoglycemia may develop, and symptoms such as tachycardia or tremor can be masked by the action of the drug.
Drug Interactions
With the simultaneous administration of slow calcium channel blockers such as Verapamil and diltiazem, it is possible to decrease the blood pressure as a result of worsening contractility. Avoid intravenous administration of these drugs against the background of the use of sotalol (except for cases of emergency medicine).
The combined use of antiarrhythmic agents of class 1A (especially quinidine type: disopyramide, quinidine, procainamide) or class 3 (eg, amiodarone) can cause a pronounced prolongation of the QT interval. Drugs that increase the duration of the QT interval should be used with caution with drugs that extend the QT interval, such as Class 1 antiarrhythmics, phenothiazines, tricyclic antidepressants, terfenadine and astemizole, and some quinolone antibiotics.
With the simultaneous administration of Nifedipine and other 1,4-dihydropyridine derivatives, a decrease in blood pressure is possible.
The simultaneous administration of norepinephrine or MAO inhibitors, as well as the abrupt withdrawal of clonidine, can cause hypertension. In this case, the abolition of clonidine should be carried out gradually and only a few days after the end of Sotagexal.
Tricyclic antidepressants, barbiturates, phenothiazines, opioid and antihypertensives, diuretics and vasodilators can cause a sharp decrease in blood pressure.
The use of funds for inhalation anesthesia, incl. tubokurarina on the background of taking Sotagexal increases the risk of oppression of myocardial function and the development of arterial hypotension.
With the simultaneous use of Sotagexal with reserpine, clonidine, alpha-methyldopa, guanfacin and cardiac glycosides, it is possible to develop a pronounced bradycardia and slowing down the excitation in the heart.
Beta-adrenoblockers can potentiate the hypertension of withdrawal, after stopping the use of clonidine, so beta-blockers should be canceled gradually, a few days before the gradual cessation of the use of clonidine.
The appointment of insulin or other oral hypoglycemic agents, especially when exercising, can lead to increased hypoglycemia and the manifestation of its symptoms (excessive sweating, rapid pulse, tremor). Diabetes requires correction of insulin doses and / or hypoglycemic drugs.
Potassium-withdrawing diuretics (eg, furosemide, hydrochlorothiazide) can trigger the occurrence of arrhythmia caused by hypokalemia.
When used simultaneously with Sotagexal may require the use of higher doses of beta-adrenomimetics, such as salbutamol, terbutaline and isoprenaline.
Analogues of the drug Sotageksal
Structural analogs for the active substance:
- Darub;
- Sotaleks;
- Sotalol Canon;
- Sotalol hydrochloride.
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