Kardiket - instructions for use, reviews, analogs and formulations (tablets 20 mg, 40 mg and 60 mg retard, capsules 120 mg) drugs for the treatment and prevention of angina attacks, myocardial infarction in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Kardicket. The reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Cardicets 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 Kardiket in the presence of existing structural analogues.Use for the treatment and prevention of angina attacks, myocardial infarction in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Kardicket - antianginal drug, organic nitrate.

Isosorbide dinitrate (the active substance of the drug Kardiket) causes relaxation of the smooth-muscular wall of the vessels, thus inducing vasodilation. Isosorbide dinitrate acts as a peripheral vasodilator, affecting both arteries and veins. These effects contribute to the deposition of venous blood and a decrease in venous return to the heart, reducing the end-diastolic pressure and volume of the left ventricle (reduce preload).

The drug is characterized by a combination of rapid onset of effect with duration of action.

Advantages of the drug are determined by the fact that the active substance contained in tablets and capsules of prolonged action, quickly enters the bloodstream. As a result, the drug provides a rapid onset of the effect in the treatment of angina and permanently retains its protective effect.

The beginning of the drug is observed after 15-30 minutes.

Composition

Isosorbide dinitrate + excipients.

Pharmacokinetics

Capsules after ingestion dissolve in the stomach for several minutes. The contents of the active substance granules are released gradually over several hours. After ingestion of isosorbide, dinitrate is rapidly absorbed. Binding to blood plasma proteins - 30%. Metabolised in the liver with the formation of active metabolites - isosorbide-5-mononitrate (T1 / 2 is 4-6 h) and isosorbide-2-mononitrate (T1 / 2 - 1.5-2 h). It is excreted in urine (almost completely in the form of metabolites).

Indications

• long-term treatment of IHD: prevention of angina attacks;
• chronic heart failure (in combination therapy with cardiac glycosides, ACE inhibitors and / or diuretics);
• secondary prevention of myocardial infarction and treatment with persistent angina pectoris (as part of combination therapy) for prolonged-release tablets.

Forms of release

Tablets of prolonged action of 20 mg, 40 mg and 60 mg retard.

Capsules of prolonged action 120 mg.

Instructions for use and dosage

Tablets of prolonged action of 20 mg appoint 1 tablet 2 times a day.With increasing requirements for the drug, the dose can be increased to 1 tablet 3 times a day.

Tablets of prolonged action of 40 mg at the beginning of treatment appoint 1 tablet once a day or 1/2 tablet 2 times a day. If the therapeutic effect is insufficient, the dose can be increased to 1 tablet 2 times a day. The second tablet should be taken no later than 8 hours after the first.

Tablets of prolonged action of 60 mg at the beginning of treatment appoint 1 tablet once a day. If necessary, the dose can be increased to 1 tablet 2 times a day. The second tablet should be taken no later than 8 hours after the first.

The drug in the form of prolonged-action capsules is prescribed 120 mg once a day.

Treatment should be started with the lowest doses and slowly increase the dose to the maximum effective dose. The decision on the duration of treatment is made by the doctor. The drug is intended for long-term use, and without consulting a physician, it should not be abruptly discontinued.

The drug is taken inside regardless of food intake, without chewing and squeezed with a small amount of liquid. In order to divide the tablet in half, it should be placed on a hard surface with a line of fracture upwards and press with your thumb on the tablet. It can easily be divided into two halves.

Side effect

• headache ("nitrate" headache), which, as a rule, disappears in a few days with further use of the drug;
• a pronounced decrease in blood pressure, especially when the patient gets out of bed, which can be accompanied by tachycardia (paradoxical bradycardia is possible), inhibition, as well as dizziness and a sense of weakness;
• paradoxical intensification of angina attacks;
• collapoid states, sometimes with bradycardia and sudden loss of consciousness (syncope);
• nausea, vomiting;
• dry mouth;
• eructation;
• abdominal pain;
• stiffness;
• drowsiness;
• blurred vision;
• decreased ability to rapid mental and motor reactions (especially at the beginning of treatment);
• ischemia of the brain;
• skin rash;
• development of tolerance (including cross-over to other nitrates);
• exfoliative dermatitis;
• hyperemia of the facial skin.

Contraindications

• acute myocardial infarction with severe arterial hypotension;
• acute vascular insufficiency (shock, vascular collapse);
• severe arterial hypotension (systolic pressure less than 90 mm Hg);
• closed angle glaucoma with high intraocular pressure;
• craniocerebral trauma;
• severe aortic and / or mitral stenosis;
• hypovolemia;
• hemorrhagic stroke;
• children and adolescents under 18 years of age (efficacy and safety of use not established);
• simultaneous administration of phosphodiesterase type 5 inhibitors (such as sildenafil, vardenafil or tadalafil), as they potentiate the hypotensive effect of nitrates;
• hypersensitivity to nitrates.

Relative contraindications:

• cardiac tamponade;
• hypertrophic obstructive cardiomyopathy (there may be an increase in angina attacks);
• severe anemia;
• constrictive pericarditis;
• cerebral hemorrhage;
• toxic pulmonary edema.

Application in pregnancy and lactation

During pregnancy and lactation, cardiac use is possible only if the intended benefit to the mother exceeds the possible risk to the fetus and / or the child.

Use in children

Contraindicated in children and adolescents under the age of 18 years (efficacy and safety of use not established).

special instructions

Cardiac is not used to stop angina attacks.

In the period of treatment, control of blood pressure and heart rate is necessary.

With constant continuous treatment with Cardicet in high doses, the development of tolerance is possible, as well as the appearance of cross tolerance to other drugs of the nitrate group. To prevent a decrease in the effectiveness of the drug, its use in high doses should be avoided.

When Cardistet is taken in patients with primary lung diseases, temporary hypoxemia may occur due to the relative redistribution of blood flow to the hypoventilation alveolar zones. In patients with IHD, this can lead to transient myocardial ischemia.

In case of acute myocardial infarction or acute heart failure, the drug should be used only under condition of careful clinical observation of the patient.

To prevent the increase in angina attacks, sharp abolition should be avoided.

Against the background of cardiac treatment in the event of an attack of angina pectoris for its arresting it is necessary to additionally apply high-speed nitrates.

To prevent undesirable BP reduction, you should individually select the dose of the drug.

Against the backdrop of treatment, it is possible to lower blood pressure and the appearance of dizziness during a sharp transition to a vertical positionfrom the position of "lying" or "sitting", with the use of ethanol (alcohol), physical exercises and hot weather, as well as increased angina with a sharp decrease in blood pressure, ischemia until myocardial infarction and sudden death (paradoxical "nitrate reactions").

The severity of the headache on the background of cardiac therapy can be reduced by reducing its dose and / or concurrent intake of menthol-containing drugs (validol).

With frequent use without intervals free from use, habituation that requires a dose increase may develop.

In order to prevent the occurrence of tolerance, it is recommended to observe a daily, preferably nocturnal, "no-nite interval" for 8-12 hours. In most patients, such therapy is more effective than continuous treatment.

If on the background of taking the drug blurred vision or dry mouth is retained or expressed strongly, treatment should be discontinued.

During the treatment with the drug should be excluded from drinking alcohol.

Impact on the ability to drive vehicles and manage mechanisms

During cardiac therapy, it is necessary to refrain from driving vehicles and practicing potentially dangerous speciesactivities that require increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

It is possible to intensify the hypotensive effect of Cardiket while taking with other vasodilators (vasodilators), antihypertensive drugs, beta-blockers, slow calcium channel blockers, phosphodiesterase 5 inhibitors used to treat erectile dysfunction, neuroleptics and tricyclic antidepressants, novocainamide, quinidine, and ethanol.

The simultaneous use of Cardiqet with dihydroergotamine may lead to an increase in the concentration of dihydroergotamine in the blood and, thus, enhance its hypotensive effect.

With the simultaneous use of sympathomimetic agents, alpha-blockers, it is possible to reduce the antianginal effect of the Cardicet drug.

The combination of Amiodarone and other medications such as propranolol, slow calcium channel blockers (verapamil, nifedipine) and Cardiqet is rational for the treatment of IHD.

The combined use of Acetylsalicylic acid and Cardicet improves coronary circulation.

With the combined use of Cardiket with m-holinoblokatorami (atropine) the probability of increasing intraocular pressure increases.

Adsorbents, astringents and enveloping agents reduce the absorption of Cardiac in the digestive tract.

Analogues of the drug Kardiket

Structural analogs for the active substance:

• Aerosonite;
• Dinisorb;
• Isacardin;
• From MacArthard;
• Is Mac Spray;
• Isoket;
• Isolong;
• Isosorbide dinitrate;
• Cardix;
• Nitrosorbide;
• TD spray Iso Mack.

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