In the article, we will consider the indications for Nitrosorbide. It is used for the prevention and treatment of heart failure, myocardial infarction and angina pectoris in adult patients.
The use of this drug is allowed, which is its undoubted advantage during pregnancy, but only from the second trimester and under the supervision of a doctor.
Features
According to the instructions for use, "Nitrosorbide" is a medication that can expand small arteries and veins, affect vascular smooth muscles. Against the background of its intake, preload and afterload are reduced, which, in turn, reduces the oxygen demand of the heart muscle. An increase in the lumen of the peripheral vessels contributes to the normalization of blood circulation in the myocardium and its area undergoing ischemia.
In addition, in the pulmonary circulation decreases pressure. As a result, patients with coronary artery disease have an increased ability to carry physical loads. Moreover, in patients with heart failure, the load on the myocardium is significantly reduced.
Nitrosorbide is part of a group of pharmacological preparations that promote the production of nitric oxide in the smooth muscle layer of blood vessels, as well as the activation of a specific enzyme that relaxes the veins, but does not affect the state of arteries.
Structure
The main active ingredient that is part of Nitrosorbide is isosorbide dinitrate. As additional components in the manufacture of the medicine are used: crospovidone, calcium stearate, lactose, sucrose.
Pharmacological forms
The manufacturer produces the drug in several pharmacological forms. Among them:
- Tableted Nitrosorbide, the dosage of which can be 10 mg and 20 mg.
- Ointment.
- Spray for sublingual use.
- Films intended for gluing to gums.
- Sustained-release capsules.
- The concentrate used to make the infusion solution.
As indicated by the instructions for use with Nitrosorbide, storage of any form of the drug should not exceed 2 years. The product should be in a dark place, and the temperature range should be 8-15 degrees Celsius.
The average cost of a tabletted drug in Russian drugstores is about 25 rubles. Other pharmacological forms are quite rare, therefore their cost must be clarified by pharmacists.
Pharmacological effects
In accordance with the instructions for use, Nitrosorbide is capable of exerting a vasodilating, coronary dilating, vasodilating, antianginal effect. Under its influence, the oxygen demand of the myocardium and the load on the vascular walls are reduced. In addition, there is a redistribution of blood flow in the area where blood supply is reduced. The medication is effective if the patient has high blood pressure in the pulmonary circulation. What is the mechanism of action of Nitrosorbide?
Under the influence of a drug:
- The flow of blood to the area where blood circulation is lowered increases. In this regard, patients suffering from coronary heart disease and angina pectoris increase their ability to tolerate physical activity.
- There is an expansion of blood vessels located in the brain.
- The symptoms of pulmonary edema regress.
- The final volume of the left ventricle decreases, as well as the systolic tension in its walls, as a result of which the oxygen demand of the myocardium decreases.
- The production of nitric oxide is stimulated, which can stimulate the activation of guanylate cyclase inside the cell, which increases the amount of guanidine monophosphoric acid relaxing on the smooth muscle layers of blood vessels.
After taking the Nitrosorbide tablets, the active components enter the liver tissue. The highest concentration is observed after an hour. If the drug is used buccally, then its absorption occurs instantly, and it penetrates into the blood plasma within 5 minutes.
Isosorbide dinitrate is metabolized in the tissues of the liver and intestines. As a result, two metabolites are formed: isosorbide-2-mononitrate, isosorbide-5-mononitrate. Their elimination is carried out by the kidneys and intestines.
Indications for use
As indicated by the instructions for use, "Nitrosorbide" is indicated for use in the following cases:
- The external form of the drug is used as a prophylactic, which reduces the number of angina attacks that occur periodically.
- Intravenous administration is indicated for acute myocardial infarction, which is complicated by left ventricular failure, unstable angina, pulmonary edema.
- Oral, sublingual and buccal primrose is indicated for the prevention and relief of angina attacks, during the recovery phase after myocardial infarction, in some forms of pulmonary hypertension, chronic heart failure, and some forms of pulmonary heart.
- Inhalation is recommended for the prevention and treatment of angina attacks, spasm of the coronary arteries (if a cardiac catheter is installed), myocardial infarction, and left ventricular failure in acute periods.
Indications for Nitrosorbide should be strictly observed.
Using
The method of use and dosage of the drug depends on its pharmacological form and indications:
- Tableted Nitrosorbide is recommended to be taken one hour before a meal, or 2 hours after that. Use the drug four times or five times a day in an amount of 10-20 mg. If there are no marked improvements on the fifth day of therapy, experts recommend increasing the daily dosage to 120 mg. If the patient is prescribed complex therapy of heart failure, triple or quadruple use of Nitrosorbide tablets in the initial dosage is indicated.
- When using Nitrosorbide sublingually, up to 3 injections into the oral cavity should be carried out with delayed breathing. The interval between injections should be about half a minute. If there are no improvements, repeat the injection after 5 minutes. If the patient has an acute attack of angina pectoris, you must first chew, and then swallow up to 5 mg of the drug, that is, half the tablet.
- When using Nitrosorbide buccally, the plate of the preparation must be glued onto the upper jaw from the outside, into the incisor area. Gluing of plates is carried out up to three times a day. It is necessary to alternate the gluing sides.
- In case of lateral use, administration at the initial stage should be carried out at a rate of up to 4 drops per minute (if a dosage of 0.1 mg is used) and up to 2 drops per minute (if a dosage of 0.2 mg is used). After every five minutes, the speed should be increased by a couple of drops. The maximum allowable rate of administration is 17 drops per minute (at a dosage of 0.2 mg) and 33 drops per minute (at a dosage of 0.1 mg).
- When using an external spray, it is necessary to spray onto the skin in the region of the heart from a distance of 20 cm, and then rub the drug with light movements. You should not carry out more than two sprays in one application, and also wash the specified area for 20 minutes.
- TTS. Before installing the system, the skin area must be cleaned of the hairline and wiped with alcohol. Remove the protective coating from the system and press its sticky side to the prepared skin area. It is recommended to use a dosage of 0.5-1 mg per square cm. One application is designed for 12-24 hours. If necessary, then cutting the system into several parts is allowed. Therapy is carried out for two weeks, it is important to prevent a sharp withdrawal of the medication.
- The ointment form of Nitrosorbide is used for application to the inside of the forearms, stomach, chest area. Use once or twice a day. It is recommended to use up to 1 mg, while the maximum area of the skin on which the ointment is applied should not exceed 20 cm 2 .
Contraindications
The main contraindication to the use of Nitrosorbide, like any other medication, is the presence of individual susceptibility to any of the components that make up its composition, as well as to any nitrates. In addition, Nitrosorbide should not be used in the following situations:
- In childhood and adolescence.
- With a deficient content of glucose-6-phosphate dehydrogenase.
- In the first trimester of pregnancy.
- With lactation.
- With hyperthyroidism.
- If recently suffered a head injury, hemorrhagic stroke.
- With primary pulmonary hypertension.
- With hypertrophic obstructive cardiomyopathy.
- With cardiogenic shock.
- With anemia.
- With vascular collapse.
- With stenosis of the aortic or mitral valves.
- With heart failure, accompanied by low pressure when filling the left ventricle.
- In acute myocardial infarction.
- With pulmonary edema of a toxic nature.
- With a patient noted arterial pressure, the level of which is below 100 mm. Hg. Art., that is, with arterial hypotension.
- With impaired blood circulation in the brain.
- With angle-closure glaucoma.
- With high intracranial pressure.
With special caution, the use of Nitrosorbide is allowed if the patient has a disease that can increase intracranial pressure, mitral or aortic stenosis, orthostatic hypotension, cardiac tamponade, subaortic stenosis, pericarditis.
Compatibility "Nitrosorbide" with alcohol and other medicines
With the simultaneous use of nitrosorbide with clonidine, procainamide, alcohol and other substances, a sharp decrease in blood pressure is possible, up to orthostatic collapse (its early symptoms are dizziness, weakness, etc.). So such combinations should be excluded.
Side effects of Nitrosorbide
The following negative effects may develop with the use of the drug:
- Cerebral ischemia.
- Slight burning of the tongue.
- Headache.
- Feeling of heat.
- Strengthening angina attacks.
- Dry mouth.
- Blurred vision.
- Drowsiness.
- Arterial hypotension.
- Tachycardia.
- Nausea, vomiting.
- Collapse.
- Dizziness.
With the development of these adverse reactions should visit a doctor.
Below we consider analogues and substitutes for Nitrosorbide.
Analogs
The most popular analogues of this drug are: Efox Long, Erinit, Sustonit, Sustak Mite, Sidnofarm, Pentakard, Nitrosprint, Nitrosorbid Rusfar, Nitrong forte, Nitrolong , "Nitroglycerin", "Monochinkwe Retard", "Monosan", "Mononite", "Mono Mac", "Karniland", "Cardicet", "Isosorbide dinitrate", "Isoket", "Diniboros", "Deposit 10". The doctor should pick them up.
Reviews
Patients who have used Nitrosorbide respond extremely positively. Its effectiveness as a vasodilator and antianginal agent is separately noted. An undoubted advantage is the low cost of the medication, it is available to every patient. However, taking the medicine should only be prescribed by a specialist. Subject to all recommendations, the risk of developing negative effects is minimized.
We reviewed the instructions for the drug "Nitrosorbide", from which the medicine helps and how to use it.