In the article, we consider the instructions for use and reviews for the Amiodarone preparation.
This remedy is a rather old drug, it was created fifty years ago. This drug has passed the test of time and clinical trials in laboratories. Despite the danger of various side effects, experts highly appreciate this remedy for its very high efficiency. We’ll find out what analogues he has and what people write about him in their reviews.
Instructions for use with Amiodarone are very detailed.
Features of the drug
The presented remedy among antiarrhythmic medicines has established itself as one of the best. The use of this drug should be prescribed with caution, given the many adverse reactions that it can cause. For a long time, cardiologists considered this medicine to be the “last resort”.
A number of studies have found that this drug not only has the characteristic of the most effective medication, but it is the safest compared to drugs of this direction. Observations, as well as the study of statistical information, revealed that the use of Amiodarone leads to a decrease in the mortality rate, including sudden deaths.
Arrhythmogenic effect while taking this medication was seen in one percent of patients, which is the minimum number compared to other drugs. Amiodarone is appointed by specialists if there is appropriate evidence. This remedy is prescribed to patients even if they have organic lesions of the heart.
The composition of the drug
According to the instructions for use with Amiodarone, the main active ingredient is amiodarone hydrochloride. Each tablet contains 200 milligrams of this substance. Additional substances are sodium carboxymethyl starch along with povidone, lactose monohydrate, silicon dioxide, magnesium stearate, corn starch and microcrystalline cellulose.
What else does the instructions for use with Amiodarone tell us?
Dosage Forms
This drug is available in the form of round tablets. They have a cylindrical shape. The color of the tablets is white. Each package contains three blisters. There are ten tablets in one blister. The average cost per package is one hundred and thirty rubles.
Also on sale is a solution of Amiodarone. Instructions for use indicate that it is a clear liquid with a yellowish or greenish tint.
Each ampoule (3 ml of solution) contains: active substance: amiodarone hydrochloride - 150 mg; excipients: sodium acetate trihydrate, glacial acetic acid, polysorbate 80, benzyl alcohol, water for injection.
Now let's talk about the mechanism of action of the drug.
Pharmacological action of the drug
In accordance with the instructions for use, Amiodarone may have the following effects on the body:
- The antianginal effect is to remove the prerequisites for ischemia.
- The antiarrhythmic effect involves the normalization of the state against the background of cardiac arrhythmias.
Pharmacodynamics of the drug
According to the instructions for use with Amiodarone, the action of this drug is aimed at reducing the oxygen demand of the heart muscles. This effect occurs due to the blocking of channels that allow ions to pass through. Against this background, potassium is skipped to a greater extent. Channels that are associated with the passage of calcium ions are typically blocked to a lesser extent. As a result of such changes in the operation of the channels, the conductivity slows down.
This tool has a relaxing effect on the smooth muscles of blood vessels. Thus, the effect of the drug increases the lumen of the coronary vessels, which significantly reduces the resistance in them.
Instructions for use with Amiodarone 200 mg confirms this.
Pharmacokinetics of the drug
During treatment, only half of the accepted dosage of the drug is absorbed in the body. Ninety-six percent of a bioavailable substance is directly involved in plasma proteins. The active ingredient accumulates in organs such as the spleen, liver and lungs. In addition, the main component is able to be deposited in the tissues of the fat layer. This drug is excreted mainly through bile. Now we find out in what cases doctors prescribe this drug to their patients.
Indications for use of the drug
According to the instructions for use, the drug "Amiodarone" is prescribed for the following conditions:
- The presence of atrial flutter and atrial fibrillation.
- The development of ventricular arrhythmia, which can endanger the patient’s life.
- Patients diagnosed with Parkinson's syndrome, in which attacks of supraventricular tachycardia are recorded.
- The presence of supraventricular arrhythmias. The presented drug is prescribed even in situations where other similar drugs can not be taken or they are not able to help, as well as if there are organic lesions of the heart.
During the period of gestation and feeding, this drug is not prescribed. Next, consider the instructions for use with Amiodarone.
Analogs will be presented below.
Instructions for use
The dosage of taking the medicine presented is determined once by the doctor. On average, the following standards are generally accepted:
- A single maximum dosage is 400 milligrams.
- The average therapeutic dosage is 200 milligrams.
- The maximum daily dosage is 1200 milligrams.
That is what the instructions for use say.
Amiodarone tablets by adults should be taken before meals, washed down with plain water.
Contraindications
This medication is not used in a number of the following cases:
- The presence of thyroid dysfunction.
- The presence of hypersensitivity to the components of the drug, especially iodine.
- The development of sinus bradycardia.
- The appearance of conduction disturbances of a pronounced nature.
- The development of sinus failure syndrome.
- The appearance of cardiogenic shock.
We will tell about what side effects are associated with administration, below.
Side effects
As indicated by instructions for use with Amiodarone 200 mg, blood vessels and the heart can respond with moderate bradycardia, sinoatrial and atrioventricular blockade of various degrees and proarrhythmogenic effect. Very rarely, in the framework of adverse reactions, severe bradycardia is observed along with a stop of the sinus node, ventricular tachycardia, and in addition, the progression of the symptoms of chronic heart failure. Typically, such adverse reactions develop as a result of prolonged use of the drug.
The digestive system during treatment with Amiodarone is often accompanied by nausea, vomiting, loss of appetite, dulling or loss of taste and a metallic taste in the mouth. In parallel, patients have a feeling of heaviness in the epigastric region, and in addition, there is an increased activity of hepatic transaminases. Often there is acute toxic hepatitis, jaundice and the development of liver failure.
The respiratory system can respond with interstitial or alveolar pneumonitis, obliterating bronchiolitis with pneumonia, pleurisy, or pulmonary fibrosis. It is extremely rare for patients with severe respiratory failure to have bronchospasm or respiratory syndrome. Pulmonary bleeding is not ruled out.
The organs of vision can be affected due to microscopic deposits in the corneal epithelium, which are composed of complex lipids and lipofuscin. At the same time, patients complain of the occurrence of a colored halo and the fuzziness of objects against a background of bright lighting. Very rarely observed optic neuritis.
The work of metabolism may be accompanied by hypothyroidism and a syndrome of impaired secretion of antidiuretic hormones. Grayish pigmentation may occur on the skin, which disappears immediately after stopping treatment with the drug. At times, erythema occurs in patients along with a skin rash, exfoliative dermatitis, and alopecia. Urticaria is also possible.
The same side effects provoke the drug in ampoules.
The nervous system can respond with tremors and other extrapyramidal disorders, sleep disturbances, peripheral myopathy, cerebellar ataxia, benign intracranial hypertension, and headaches.
Among other side effects in people taking Amiodarone, there are reactions in the form of angioedema, the formation of granulomas, vasculitis, epididymitis, impotence, thrombocytopenia, hemolytic and aplastic anemia.
In case of side effects, it is required to immediately cancel treatment with this drug and consult a doctor. In the event that any of the adverse reactions mentioned in the instructions are aggravated or a person notices any other effects that are not indicated in the instructions for use with Amiodarone in ampoules, the doctor should be informed.
Drug overdose
Symptoms of an overdose are bradycardia along with ventricular tachycardia and exacerbation of the manifestations of existing heart failure. Also, impaired liver function or cardiac arrest is not excluded.
Overdose treatment involves gastric lavage, and in addition, the use of activated charcoal. Symptomatic therapy will also be required. Against the background of the occurrence of bradycardia, treatment with beta-adrenostimulants will be needed, Atropine or the establishment of a pacemaker will also help. In the case of tachycardia, the patient will need the introduction of a magnesium salt along with pacemaker. This is confirmed by the instructions for use with Amiodarone tablets.
Interaction with other medicines
A combination with beta-adrenoblockers is considered a recommended combination, since there is a risk of severe bradycardia. In the case of the simultaneous use of laxatives, which stimulate intestinal motility, there may be a risk of ventricular tachycardia.
Caution is required with the simultaneous use of Amiodarone with diuretics that cause hypokalemia. In case of combination with Esmolol, suppression of the compensatory reaction of the nervous system is possible. When combined with Phenytoin, the risk of neurological impairment is likely. The drug "Orlistat" can lower the concentration of "Amiodarone" with its active metabolites.
The drug "Cimetidine", as well as grapefruit juice, can slow down the metabolism of "Amiodarone" and increase its plasma concentration. Inhaled medications intended for general anesthesia cause a risk of bradycardia, acute respiratory syndrome, low blood pressure, impaired conduction and cardiac output. Rifampicin reduces the concentration of Amiodarone in the blood plasma. With simultaneous use with Amiodarone, the concentration of Dabigatran in the blood plasma increases.
Now consider what recommendations should be followed in the case of the appointment of tablets and injections of Amiodarone according to the instructions for use.
special instructions
This medicine, as you already know, can cause many side effects. Specialists note that most often this occurs with prolonged use of the drug. An uncomfortable condition occurs according to statistics in half of the patients who take this drug. Against this background, negative manifestations of adverse reactions force doctors to cancel taking the drug in twenty-five percent of patients. Particular attention in this case should be given to the state of vision. With regard to the intake of these tablets, the experts make the following recommendations:
- On the eve of the treatment course, it is necessary to examine the patient, which must include an electrocardiogram.
- In order to avoid possible negative effects from the use of this drug, patients should be prescribed a minimum dosage of a substance that can give a therapeutic effect.
- Patients taking Amiodarone are advised to avoid activities that require particular accuracy and increased attention. And, in addition, it is necessary to abandon classes that are associated with danger, for example, driving a car.
- In the event that the patient has shortness of breath with coughing, it is necessary to check the condition of the lungs. If there are symptoms of lung damage, an x-ray of the chest should be taken. Such a study is preferably carried out once every six months.
- In order to avoid the effect of photosensitization, direct sunlight must be avoided. In the event that you still have to be in an open area, protective measures should be used.
- During treatment with this drug, patients are shown regular examination of the ocular cornea. Observation of such a patient by an ophthalmologist will provide information on whether it is possible to continue the course of therapy with Amiodarone.
- This medication contains iodine in its composition. Therefore, the question of whether it is possible to use the drug for a particular patient, and whether the treatment course does harm the state of the thyroid gland, is decided by the endocrinologist.
We reviewed the instructions for use.
Analogues of Amiodarone
This drug has several analogues. The most popular of these are drugs such as Amiocordin, along with Rhythmiodaron, Cardiodaron, Sedacoron, Cordaron, Vero-Amiodaron, and Opacordan. Also often prescribed:
- Myacardin.
- Novocainamide.
- "Propanorm."
- "Etatsizin."
Next, we find out what people write in their reviews about the treatment with this drug.
Reviews
Reading reviews about this drug, very often you can find complaints about certain adverse reactions against the background of its use. For example, many users report that they felt an unpleasant stitching feeling in the heart during the course of treatment. True, it is said that some side effects can often be endured, and the discomfort from taking the drug disappears over time.
In the reviews there are many comments that people leave about their elderly parents. For example, they write that they are grateful to Amiodaron for the fact that this drug effectively relieves old people of atrial fibrillation. It is noted that the medicine is able to help even with strong pressure surges, against which arrhythmia is still not observed. But for some people, this medication did not help at all from arrhythmia, but in addition caused chronic heart failure.
Patients like the pills to be easy to take. It is noted that they are not at all bitter and are easily swallowed.
Before taking, of course, you should read the instructions for use with Amiodarone 200 mg.
Otherwise, the reviews mainly relate to complaints of adverse reactions. And although in some cases people manage to endure them or wait until they pass on their own, but in some situations, undesirable effects persist for a very long time. For example, some often experience very vivid and unpleasant remembered dreams against the background of treatment with this drug. In addition, adverse reactions such as the occurrence of periodic liver pain and nausea are very often reported.
In the reviews, some also complain about the fact that the instructions for using this medicine are written in very small print, which, of course, is inconvenient especially for older people, for whom this drug is prescribed most often.
It should be emphasized that, despite the age and proven effectiveness of this medicine, there are a lot of negative reviews about it on the Internet. Some write that after the first intake of this drug in older people, vomiting with bile opens, which lasts for the first day. It is reported that while the elderly are not able to eat, they become lethargic and completely indifferent to everything.
In addition, people are scared by the fact that the risk of getting a thyroid disease while taking this drug is very high. A lot of other side effects, up to a possible fatal outcome, are alarming patients.
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Cardiologist reviews
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