Nitrosorbide - instructions for use, analogs, reviews and release forms (10 mg and 20 mg tablets) for the treatment and prevention of angina pectoris, myocardial infarction, heart failure in adults, children and pregnancy

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

Nitrosorbide - a peripheral vasodilator with a predominant effect on venous vessels. Antianginal remedy. The mechanism of action is associated with the release of the active substance of nitric oxide in the smooth muscles of the vessels. Nitric oxide causes the activation of guanylate cyclase and increases the level of cGMP, which ultimately leads to a relaxation of smooth muscles. Under the influence of isosorbide dinitrate (active ingredient of Nitrosorbide), arterioles and precapillary sphincters relax less than large arteries and veins. This is partly due to reflex reactions, as well as less intense formation of nitric oxide from the molecules of the active substance in the arteriolar walls.

The effect of isosorbide dinitrate is mainly associated with a decrease in the demand for myocardium in oxygen due to a reduction in preload (the expansion of peripheral veins and a decrease in the flow of blood to the right atrium) and postnagruzki (reduction in OPSS), as well as with a direct coronary dilatory action.Promotes redistribution of coronary blood flow in the area with reduced blood supply.

Increases tolerance to physical activity in patients with IHD, angina pectoris. With heart failure helps discharge the myocardium by reducing preload. Reduces pressure in a small circle of blood circulation.

Composition

Isosorbide dinitrate + excipients.

Pharmacokinetics

When ingested after absorption from the gastrointestinal tract, Nitrosorbide undergoes the effect of "first passage" through the liver. With buccal application, isosorbide dinitrate is rapidly absorbed. Metabolized with the formation of an active metabolite of isosorbide-5-mononitrate, as well as isosorbide-2-mononitrate. It is excreted by the kidneys and through the intestines.

Indications

For oral administration, sublingually, buccally:

• cupping and prevention of angina attacks;
• Restorative treatment after myocardial infarction;
• chronic heart failure (as part of combination therapy);
• some forms of pulmonary hypertension, pulmonary heart (as part of combination therapy).

For inhalation use:

• cupping and prevention of angina attacks;
• as an emergency aid for acute myocardial infarction and acute left ventricular failure at the prehospital stage;
• prevention and treatment of coronary artery spasm when using a cardiac catheter.

For intravenous administration:

• acute myocardial infarction, incl. complicated by acute left ventricular failure;
• unstable angina;
• pulmonary edema.

For dermal application:

• prevention of angina attacks.

Forms of release

Tablets 10 mg and 20 mg.

Instructions for use and dosage

When administered orally, a single dose is 10-120 mg, the frequency of taking 1-5 times a day, depending on the indications and the dosage form used.

With sublingual or buccal administration, a single dose of 5-10 mg, the frequency of reception depends on the indications and the patient's response to treatment.

When inhaled, 1-3 doses are injected into the oral cavity at intervals of about 30 seconds against the background of a delay in breathing. In acute myocardial infarction and acute heart failure, the initial dose is 1-3 inhalations. If no improvement occurs after 5 minutes, inhalations can be repeated under the condition of constant monitoring of blood pressure and heart rate.To prevent coronary spasm in the case of catheterization, 1-2 doses should be applied immediately before the procedure.

When administered intravenously, the dosing regimen depends on the clinical situation and the dosage form used.

For dermal application, the initial dose is 1 g at bedtime, before bed, and if necessary in the morning.

Duration of treatment is determined in each case individually.

Side effect

• dizziness;
• headache;
• tachycardia;
• transient hyperemia of the face;
• sensation of heat;
• arterial hypotension;
• increased attacks of angina (paradoxical reaction);
• nausea, vomiting;
• the appearance of a slight burning sensation of the tongue;
• dry mouth;
• drowsiness;
• blurred vision;
• ischemia of the brain;
• collapse;
• skin rash.

Contraindications

• severe arterial hypotension (systolic blood pressure less than 100 mm Hg, diastolic blood pressure less than 60 mm Hg);
• collapse;
• shock;
• acute myocardial infarction with severe arterial hypotension;
• hypertrophic obstructive cardiomyopathy;
• constrictive pericarditis;
• cardiac tamponade;
• toxic pulmonary edema;
• Conditions, accompanied by increased intracranial pressure (incl.hemorrhagic stroke, craniocerebral injury);
• angle-closure glaucoma;
• simultaneous reception sildenafila (inhibitor PDE);
• hypersensitivity to nitrates.

Application in pregnancy and lactation

The use of nitrosorbide during pregnancy and lactation (breastfeeding) is possible only if the intended benefit to the mother exceeds the potential risk to the fetus or child.

Application in elderly patients

Use with caution in elderly patients.

Use in children

There is no data on the use of this age group.

special instructions

Use with caution in patients with impaired cerebral circulation, with aortic and / or mitral stenosis; in patients prone to orthostatic hypotension; in elderly patients. During the treatment, especially in the case of a gradual increase in the dose, control of blood pressure and heart rate is necessary.

During the treatment period, do not drink alcohol.

Impact on the ability to drive vehicles and manage mechanisms

During the period of treatment, it is not recommended to drive vehicles and engage in other potentially hazardous activities,with regular use of isosorbide dinitrate reduces the ability to concentrate and the speed of psychomotor reactions.

Drug Interactions

At simultaneous application with adsorbents, astringents and enveloping agents absorption of Nitrosorbide decreases.

With the simultaneous use of antihypertensive agents, peripheral vasodilators, calcium channel blockers, beta-blockers, antipsychotics (antipsychotics), tricyclic antidepressants, PDE inhibitors, ethanol (alcohol), the hypotensive effect may increase.

With simultaneous use with anticholinergic drugs, memory and attention disorders in elderly patients are possible.

With simultaneous use with sympathomimetic agents, it is possible to reduce the antianginal effect of Nitrosorbide.

With simultaneous application with dihydroergotamine, an increase in the concentration and increase in the action of dihydroergotamine is possible.

With the simultaneous use of norepinephrine, the therapeutic effect of norepinephrine is reduced.

With simultaneous use with Sildenafil there is a risk of severe arterial hypotension and myocardial infarction.

Analogues of the drug Nitrosorbide

Structural analogs for the active substance:

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

Analogues for the pharmacological group (nitrates and nitrate-like agents):

• Amyl nitrite;
• Gluconite;
• Deposits 10;
• Dilaside;
• Dinisorb;
• Isacardin;
• Isoket;
• Isolong;
• Isosorbide dinitrate;
• Isosorbide mononitrate;
• Cardiac;
• Cardix;
• Carneland;
• Corvaton;
• Mono Mack;
• Monolong;
• Mononite;
• Monosan;
• Monochinkwe;
• Monochinkwe retard;
• Nitradisk;
• Nitroglycerine;
• Nitrolong;
• Nitromint;
• Nitroung forte;
• Nitrogen;
• Nitrosorbid Rusfar;
• Nitrospray;
• Nitrosprint;
• Olicard;
• Pentacard;
• Perlingant;
• Sidnofarm;
• Sorbimon;
• Sustak mite;
• Sustak forte;
• Sustonite;
• Trinitrolong;
• Erinit;
• Efoks;
• Efoks long.

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