The treatment of heart rhythm disturbances is a complex medical problem that is not solved until the end even today. There are many antiarrhythmic drugs, but all of them have many contraindications and side effects, which can be a much more dangerous disease for the patient. There are whole groups of drugs designed to stop life-threatening arrhythmias, but their use for a long time is not recommended because of the increase in complications arising from taking medications. Accordingly, patients require a reliable, effective, but relatively safe drug or its analogue.
Cordaron is an effective antiarrhythmic medicine
According to various studies, "Cordaron" is the most effective drug from other similar drugs, has a proven ability to reduce mortality in people with cardiac pathology. It has been successfully used to treat almost all cardiac arrhythmias. Among doctors, it is considered the standard among class III antiarrhythmic drugs. In addition to antiarrhythmic, it has an antianginal effect, as it was primarily created as a drug for the treatment of coronary heart disease.
It has not only an action characteristic of class III antiarrhythmics, that is, a blockade of potassium channels, but also an action characteristic of class I drugs - a blockade of sodium channels, class IV blockade of calcium channels. In addition, the drug gives an alpha and beta adrenergic blocking, coronary expansion effect.
Indications for use
The active substance of the drug is amiodarone. The trade name is Cordaron. Analogs are released under other names, but contain the same active substance. Amiodarone is available in the form of a solution for intravenous administration and tablets.
The solution is used when it is necessary to stop attacks of ventricular and supraventricular tachycardia, atrial fibrillation, including attacks. Tablets are used to prevent ventricular and atrial fibrillation and paroxysmal tachycardia.
Operating principle
Suppressing the process of intracellular transport of potassium ions, the drug lengthens the third phase of the action potential of the heart muscle cells. At the same time, the transmission of an electrical impulse in the fibers of the atrioventricular node is also suppressed. Because of this, the pulse slows down. Partial blocking of the sympathetic nervous system slows down the heart rate.
Amiodarone is metabolized in the liver, excreted mainly in the urine. The maximum content of the active substance is observed 3-7 hours after taking the pill. Persistent therapeutic effect is manifested no earlier than a week after the start of treatment.
Analogs of Cordaron
In many cases, patients for several reasons prefer not the original drug, but its analogues, generics. Since Kordaron is just the trade name for amiodarone, those with arrhythmias are often interested in whether there are analogues of the Kordaron medicine.
As for amiodarone, the question of its analogues is of particular relevance, because it is one of the most popular cardiological preparations in the world, which is widely used. Such drugs, as mentioned above, have a large number of side effects, often worsening health status. Therefore, both the doctor and the patient are interested in choosing a drug with maximum effectiveness and minimal risk to health and life. If you are looking for analogues equivalent to the Cordaron preparation, the reviews of doctors in this case should be of decisive importance to you, although, undoubtedly, the reviews of patients are also important, since they can tell you about the sensations during administration and the speed of improvement. In this case, treatment by both Cordaron and any of its analogues should be accompanied by medical supervision and monitoring of the state of health, including with the help of an ECG.
An important role is played by the composition of the drug. For example, iodine, which is part of amiodarone, is contraindicated in a number of diseases. It may also distort the results of some studies. Therefore, it is not surprising that many people with arrhythmias are looking for an analogue of Cordarone without iodine like Dronedaron. Of course, you can replace any drugs only after consulting a doctor. So, many Russian experts do not recommend unnecessarily choosing Dronedaron, since this is a weaker analogue of Cordaron. In Europe, however, it is already quite common.
When choosing a drug or analogue, it is necessary to compare their composition. As a general rule, analogues and generics are not compared with each other - only with the original. Say, if you need an analogue of “Cordarone” in ampoules, then benzyl alcohol should be present in the composition of a similar injection solution, as in the original “Cordarone”.
According to doctors, the analogues in the properties of the drug “Kordaron” analogues in Russia are represented by a rather large number of drugs, which include: “Rhythmiodaron”, “Sedacoron”, “Amiocordin”, “Cardiodaron”, “Rhythmorest”, “Opacordin”, Amiodarone from various manufacturers (Amiodarone-Acre, Vero-Amiodarone and many others). All of them have the same active substance, but can have different excipients. Many of them are noticeably cheaper than the original. In most cases, this factor depends on the manufacturer. For example, “Amiodarone”, which is called the same as the main substance contained in the drug “Cordaron”. The analogue is Russian, and its price is almost three times lower, although the form of release and indications for use coincide.
Amiodoron is the best analogue in Russia. It is practically indistinguishable from Cordaron in terms of both the principle of action and the method of application, it has the same high effectiveness in stopping arrhythmias and preventing their occurrence. Patient reviews about him are mostly positive. Many of them note that Russian-made Amiodoron helps quickly and without a heavy side effect.
Method of use of the drug in ampoules
As stated above, the injection is indicated for quick relief of the problem. In other cases, Cordaron tablets are used. Analogs act in the same way. The solutions are administered intravenously through a catheter for 20-120 minutes or jet for at least 3 minutes at a dosage of 5 mg per 1 kg of body weight.
The use of tableted "Cordarone"
The drug in tablets is taken in two stages.
The first stage, or loading phase: 600-800 mg once a day with an increase of up to 10 g.
The second stage, or the supporting phase: 100-400 mg of the drug (the duration is determined by the doctor). The maximum dose is 1200 mg per day.
An overdose of the drug is quite dangerous. In order to prevent it, the patient is advised to know exactly how the Cordaron drug is recommended for use. Analogs, including the popular analogue in Russia, Amiadaron, for the most part give the same symptoms of an overdose.
Strong bradycardia is noted, even up to cardiac arrest. If it is caused by the tablet form, it is necessary to rinse the stomach and take enterosorbents. Other symptomatic treatment is also carried out, the electrolyte balance is adjusted. If necessary, a pacemaker is installed.
Information about an overdose of intravenous information is incomplete. Rare cases of sinus bradycardia, tachycardia, cardiac arrest are described. Treatment is similar to that prescribed for an overdose caused by tablets. With hemodialysis, amiodarone and its metabolites are not removed.
Side effects
Like any effective product with a powerful effect, “Cordaron”, “Amiodarone” and other analogues provoke a number of side effects. They cause bradycardia, up to cardiac arrest, a decrease in blood pressure, have a negative effect on the liver, as a result of which they have a rather impressive list of contraindications.
Of the less severe, but nevertheless unpleasant side effects, headache and dizziness, pleurisy, coughing can be noted, the patient may complain of weakness, decreased visual acuity. Allergic reactions may occur. The same problems can be obtained by taking any analogue. For this reason, Cordaron and other amiodarone preparations in tablets are sold in pharmacies only by prescription. The solution for injection is used only in a hospital setting.
However, subject to precautions when choosing the maximum dose, side effects are not pronounced or may not appear at all. As noted in the reviews of “Cordarone” and “Amiodarone”, patients taking these drugs, the side effect is usually weak, dose adjustment of the drug is easily eliminated.
Contraindications
Since amiodarone is a fairly powerful drug, it is not surprising that it can not only improve the condition with a number of cardiac problems, but also has a destructive effect on other organs or worsens the condition with some concomitant diseases. To avoid risk, it is not recommended therapy with this drug in some cases.
There is a whole range of conditions in which it is forbidden to take "Cordaron", "Amiodarone" and other analogs in tablets. First of all, these are some pathological heart conditions - sinus bradycardia, severe atrioventricular block, arterial hypotension, lengthening of the QT interval on the cardiogram. It can not be used if the patient's body has a reduced content of magnesium and potassium.
Contraindications include thyroid pathology, as well as pregnancy and the period of breastfeeding - the reason is in iodine, which contains the drug "Cordaron". An analogue that does not contain it can be taken only on the recommendation of a doctor.
Patients in old age are advised to take with care both Cordaron and Amiodaron and other analogues. For patients under 18 years of age, these medicines are not prescribed.
It is not recommended to prescribe this remedy to those who suffer from bronchial asthma, respiratory failure, and have severe heart failure. Severe pathologies of the liver and kidneys are also an excuse to refuse treatment with this method.
Undoubtedly, you should not take the medicine if there is an individual intolerance to the components of the drug Cordaron. Analogs in Russia and another European country have the same composition, so in this case it is unlikely that it will be possible to replace one remedy with another.
As for injections, they should not be given to babies up to 3 years old, for children older than 3 years the dose should not exceed 5 mg / kg. Do not mix the drug in the same syringe with other medicines. In general, contraindications to the solution are similar to contraindications to tablets. These are sinus bradycardia, sinus node weakness syndrome and severe conduction disturbances, also sinoatrial heart block and paroxysmal ventricular tachycardia. In particular, such phenomena are possible when taking amiodarone in combination with a number of other drugs.
Injections during pregnancy can be prescribed only in exceptional cases, with lactation this method of treatment is completely excluded. You can not carry out therapy using a solution of "Cordarone" with thyroid gland dysfunctions, allergic reactions to iodine or amiodarone.
Interaction with other drugs
Cordaron can be combined with other drugs. So, its antianginal effect is enhanced in combination with prolonged action nitrate preparations. It can be used in conjunction with anticoagulants, diuretics, cardiotonic drugs, do not interact and, accordingly, do not weaken and do not enhance the effect of each other "Cordaron" and some antipsychotics, analgesics, sleeping pills and sedatives. Almost any analogue responds to these drugs in the same way.
"Cordaron" can not be used simultaneously with MAO inhibitors and beta-blockers (only in exceptional cases).
Precautions in the treatment of "Cordarone" and "Amiodarone"
While taking these funds, it is necessary to monitor the state of the body before treatment, during and after it.
Before and during therapy with a tablet form, an ECG is recommended. The action of the drug causes changes in the electrocardiogram, in particular, lengthening the interval Q-T and Q-Tc. Based on the results of the examination, the doctor can adjust the dosage and determine the effectiveness of the treatment.
Treatment stops if atrioventricular block II and III degree, sinoatrial, two-beam intraventricular block develop.
Since iodine is one of the components of the drug, regular monitoring of thyroid function is necessary. Before treatment, it is required to determine the levels of hormones T3, T4 and TSH. Please note that while taking Cordaron, the results of a radioisotope study of the thyroid gland may be unreliable. Iodine does not affect the level of hormones.
Another important factor is the determination of serum potassium levels before and during treatment.
With the introduction of "Cordarone" intravenously, only infusions are recommended, and not syringe injection. Otherwise, the development of hemodynamic disorders - arterial hypotension, acute cardiovascular failure. It is possible to administer the drug with a syringe only in exceptional emergency situations and in the absence of other possibilities. In this case, the dose is 5 mg / kg and is administered within three minutes, repeatedly - not earlier than 15 minutes after the first injection of the drug. The procedure can only be carried out in cardioreanimation units under the supervision of an ECG. "Cordaron" is forbidden to mix in a syringe with other drugs. If there is a long-term treatment, it is necessary to switch to infusion. Any intravenous injection of amiodarone is carried out in hospitals.
If the patient is undergoing general anesthesia, the anesthesiologist should be informed that this drug is being taken.
To avoid side effects, patients should observe the dosage prescribed by the doctor.
During treatment, patients should avoid sunlight and, if necessary, use protection from it (including special creams).
Be sure to consult your doctor if for some reason you plan to take not "Cordaron", but its analogue. Kordaron and drugs similar to it, like any other cardiological medicines, can be extremely dangerous if taken uncontrolled. Only a doctor can determine which medication will be the best in your case and select a safe but effective dosage.