The heart, as you know, is our main organ, but it often fails. In order to restore its normal functioning, a variety of drugs are used. One of them is Amiodarone. Analogs are much more expensive, as they are produced abroad and are not always effective.
The composition of the drug and the form of release
The drug "Amiodarone", reviews of which are very different, contains in one tablet 200 mg of the active component - amiodarone hydrochloride. The drug is also produced in the form of a solution, where 3% of the active substance is 3 ml.
Auxiliary components in the composition of one tablet are: potato starch, crystalline microcellulose, milk sugar, maltodextrin, primellose, polyvinylpyrrolidone, magnesium stearate.
The tablets are coated with a white glaze with a light, subtle cream shade. They have a cylindrical shape, as well as a chamfer and a risk. Therefore, if necessary, they can easily be divided into two equal parts.
The drug is sold in cardboard boxes, where there is one or two blisters with ten tablets. The medicine is also available in glass, polymer and plastic bottles, which have 30 or 100 tablets.
Pharmacological mechanism of action of the drug
The antiarrhythmic and antianginal property is characterized by Amiodarone, analogues in some cases can replace it. Its antiarrhythmic effect is based on a decrease in potassium ion currents when exposed to cell membranes - cardiomyocytes. Causes a decrease in the sinus node, which forms bradycardia.
The use of Amiodarone (tablets) allows to increase the refractory segment of the cardiac conduction mechanism. Inhibits conduction along minor pathways in patients with severe Wolf-Parkinson-White syndrome. In turn, the antianginal effect of the drug is based on a decrease in oxygen consumption by the myocardium and a decrease in its effect on arterial muscles. It contains iodine, which, when consumed, changes the quantitative content of thyroid hormones, as a result of which the degree of their effect on the myocardium decreases.
Amiodarone has a cumulative effect, and a pronounced effect from its use occurs only after a week of regular use of the drug, and the maximum is achieved after two to three weeks.
About 40% of the drunk dose of the drug is absorbed inside, Cmax in the plasma appears after 3ā7 hours. The effect can persist for several weeks. Metabolism processes occur mainly in the liver, where the active element desethylamiodarone is formed, which is the main metabolite. It is excreted with excreted bile and urine, T1 / 2 - after a single dose of the drug 3.2ā20.7 hours, with prolonged therapy - after 53 Ā± 24 days.
The medicine "Amiodarone": indications for use
The drug is prescribed for the prevention and treatment of arrhythmias, which can mortally threaten a personās life, as well as with ventricular arrhythmias, and in the case of ventricular flutter with unstable dynamics, the drug Amiodarone is also used.
Indications for use allow the use of the drug for:
- atrial flutter;
- supraventricular arrhythmia;
- Wolf-Parkinson-White syndrome;
- the occurrence of tachycardia;
- ventricular fibrillation;
- arrhythmias resulting from heart and coronary insufficiency;
- chronic form of coronary heart disease;
- myocardial infarction.
Amiodarone: instructions for use
The tablets are intended for oral administration 15 minutes after a meal.
During a ventricular arrhythmia, the dose recommended by a doctor is 800-1200 mg per day. It should be divided into 3-4 doses. The course of treatment in this case lasts about 5-10 days and to ensure a more stable condition of the patient can be extended, and the norm can be reduced to 600-800 mg per day. This is an intensive treatment, which then proceeds to prophylactic, with a lower dose of the drug.
The therapeutic support period is 7-14 days, at which time the drug is taken 200-400 mg. Such a volume of medication is prescribed to stabilize the patient in the post-rehabilitation period.
Often, the medicine āAmiodaroneā is prescribed when the patient is in the hospital, and his doctor can control his intake. This allows you to minimize side effects and individually adjust the dose of the drug.
In case of angina pectoris, the drug is consumed 200 mg twice a day. After two weeks, the dosage is reduced to once a day. The maximum dose of a single dose should not exceed 400 mg, and the daily dose is 1200 mg.
When prescribing such drugs, children should keep in mind that tablets affect a child much faster than an adult. Therefore, the dosage is calculated based on the weight of the child. So, per kilogram of weight should be 10 mg of the drug. This dose should be maintained for ten days of the therapeutic period or until the patient's condition improves completely. In the future, this norm is reduced to a proportion of: 5 mg per kilogram of live weight of the child. The prophylactic and maintenance dose is taken on the basis of one kilogram of weight 2.4 mg of the drug "Amiodarone".
Indications for the drug are prescribed to use a solution based on the active substance amiodarone hydrochloride in acute cardiac arrhythmias. In this case, the drug is administered intravenously, injected slowly into the body with a dropper. To do this, in 250 ml of a 5% glucose solution for 1 or 2 hours, the drug is slowly administered at a rate of 5 mg per kilogram of live weight. At this time, the patient's condition is monitored using an ECG and blood pressure readings.
Side effects
To many people in our country prescribe the drug "Amidaron". Analogs cannot always replace it. But, despite the positive effect of the drug on the human body, side effects were identified.
Negative symptoms are manifested mainly due to an overdose of the drug. These are disorders in the cardiovascular system, such as bradycardia, malfunction of the sinus node, heart block, impaired coordination of movement. Also, from the respiratory organs, diffuse interstitial pulmonary fibrosis, interstitial pneumonia, Hamman-Rich syndrome, sternum pain, pulmonary fibrosis, tachypnea, bronchopulmonary spasms were seen. Hepatic insufficiency was observed when taking the drug "Amidaron". Tablets in rare cases caused jaundice, hepatitis, and sometimes cirrhosis.
Failure to comply with the dosage can cause a significant imbalance of thyroid hormones, distyroidism, as well as hypothyroidism and a set of extra pounds. An overdose can lead to disruption of the visual apparatus, causing accumulation of lipids in the cornea in the pupil. Severe skin pigmentation, photosensitivity, urticaria, or erythema were also observed. Slight rashes, alopecia, and dermatitis were noticed on the face. Side effects also affected reproductive function in men. In these cases, orchitis, impotence, and also epididymitis occurred. Thrombocytopenia, renal failure, Quincke's edema, or vasculitis were rare enough.
Contraindications
Amiodarone (reviews about it are not always positive) is selected strictly individually. There are people to whom this drug did not help or they did not notice any changes in their state of health, others began to suffocate after using it, felt a rapid heartbeat. According to them, with prolonged use, he is able to disrupt the endocrine system, increase hormones. Therefore, before taking this medication, you need to not only carefully read the instructions, but also pay attention to the indications, side effects and contraindications.
So, the medicine is not prescribed if there is atrioventricular blockade of 2-3 degrees, with cardiogenic shock, thyrotoxicosis. The drug "Amiodarone" is not used with high sensitivity to its active substance and iodine. Serious cardiac conduction disturbances and bradycardia attacks with syncope are prohibited. Do not use the medicine during pregnancy and lactation. With lactation, during treatment with the drug, breastfeeding should be stopped.
Special recommendations
The therapeutic treatment with Amiodarone should be carefully monitored by the physician. Instructions for use of the tablet are recommended to be used after an X-ray examination of the liver, lungs and electrocardiogram. Similar control should be carried out in the future if the patient continues to take the medicine.
The severity of side effects often depends on the dose that the patient consumes. You should try to use the drug as little as possible and in minimal quantities. Often causes a failure of the heart rhythm cancellation of the drug Amiodarone.
Instructions for use - reviews say that, despite the side effects, this drug saved more than one life, - claims that the pharmacological effect of the drug persists for another two weeks after its cancellation.
The tablets contain iodine, which contributes to the accumulation of radioactive iodine in the thyroid gland. Therefore, at the beginning of therapeutic treatment, in the process and at the end, you need to constantly take tests for the number of thyroid hormones.
During therapeutic treatment, it is necessary to avoid prolonged exposure to the sun, do not take open sun baths. The drug should be prescribed with extreme caution to the elderly, with general anesthesia or during a course of oxygen treatment. With caution, it should be used by drivers of vehicles and persons whose profession is associated with a special concentration of attention.
In cases of overdose, aggravation of side effects can be observed, as well as hypotension, arrhythmia. Bradycardia or malfunction in AV conduction may occur. Too much can lead to liver dysfunction.
In this case, immediate gastric lavage is recommended, activated charcoal is prescribed, saline laxative solutions are recommended. With bradycardia, atropine is injected, beta-adrenoreceptor agonists are used, pacemaking is performed.
Relationship with other medicines
With caution, the drug should be used simultaneously with other drugs, especially if they are from the same antiarrhythmic group. You should not combine his administration with Erythromycin, Pentamidine and Vincamine. There is a risk of developing polymorphic ventricular tachycardia in combination with Sultoprid. It is not recommended to combine taking BKK and beta-blockers with Amphotericin B and laxative drugs, diuretics. Use caution with the drug in combination with corticosteroids, antidepressants, Astemizole, Terfenadine. It can significantly enhance the effect of such drugs as: "Warfarin", "Phenytoin", "Cyclosporin" or "Digoxin". When used simultaneously with "Cimetidine" it slows down the metabolic process in the body.
Shelf life and storage standards
The drug "Amiodarone", the action of which is aimed at eliminating tachycardia, ventricular fibrillation, tachyarrhythmia and reducing atrial flutter, belongs to the category of drugs of group "B". The shelf life of the drug does not exceed three years. Tablets should be stored in a dark, cool place inaccessible to children.
It is necessary to strictly monitor the use of Amiodarone. Only a doctor prescribes a prescription for its use. In this case, self-medication should be completely excluded.
Drug Analogs
If the drug "Amiodarone" does not come up, analogues can be found in any pharmacy. Among them, one can distinguish such drugs as: āAmiodarone Belupoā and āAmiodarone Aldaronā, āAngoronā and āAtlansilā, also āCordaronā or āCordinilā can replace this medicine. Similar to Amiodarone in its effect on the human body, Medacoron and Palpitin. In some cases, the drug is replaced by Sedacoron and Sandoz.
These drugs either contain the same active substance, or are similar in their antiarrhythmic effect to the drug Amiodarone. Analogs are often issued abroad and are several times more expensive.
Patient Reviews
Many patients note stabilization of their condition after taking Amiodarone. Instructions for use - analogues to the drug are often selected based on the individual characteristics of the body - promises the normalization of heart rate, pressure. With short-term administration and in small doses, as a rule, there are no problems, and the drug has an effective effect.
After taking the medicine for a long time, some of the patients experienced shortness of breath, palpitations, nervousness and depression, sudden mood swings and an increase in thyroid hormones, upset gastrointestinal tract, and in some cases nausea and vomiting occurred.
Many people use it in the treatment of angina pectoris, and note that it is no worse than imported analogues. Some men are afraid to take the drug, as it is in them that it can cause a number of oncological diseases. It is believed that the drug should be taken only in a condition that threatens a personās life, in all other situations he should look for an alternative. In addition, tablets can adversely affect the reproductive function of men, which also must be considered when taking them.
And yet, for many, the drug āAmiodaroneā turned out to be a panacea, thanks to which the disease receded, and the person remained alive. Not the fact that analogues would be just as effective. Therefore, in the treatment of heart disease, you should not discount this medicine, especially if it is recommended by a doctor.