In the article, we consider the instructions for use with Alprostan.
It is a modern drug for the treatment of vascular diseases and valvular heart apparatus. It acts as a substitute for natural prostaglandin, has a wide spectrum of effects, exhibits angioprotective, vasodilating and anti-aggregation property. The drug "Alprostan" is produced in the form of ampoules, which are intended for the preparation of solutions for drip intravenous administration. This medication is used in the complex treatment of acquired and congenital pathologies of arterioles, arteries, and cavernous vessels.
About the medicine
As the instructions to Alprostan indicate, the active substance of the drug improves microcirculation along with peripheral blood flow, it relaxes the vascular walls. The process of inhibition of platelet aggregation makes it possible to use the agent in question for the treatment of atherosclerosis. The drug is used among newborns suffering from heart defects.
The drug "Alprostan" is able to keep the arterial duct open, which makes it possible to postpone surgery if necessary. Also, this medicine is used for atresia of the valves and pulmonary trunk. An additional effectiveness of the drug lies in the stimulating effect on the smooth muscle cells of the uterus and stomach. The tool affects the increase in the elasticity of red blood cells and contributes to fibrinolytic blood activity. Next, we consider the main indications.
Indications for use
In accordance with the instructions "Alprostan" is used in the presence of the following pathologies of blood vessels and heart:
- Against the background of trophic diseases in violation of arterial blood supply.
- In case of obliterating diseases of arteries of high degree.
- With vascular lesions due to prolonged vibration exposure.
- Against the background of severe intermittent claudication in the absence of the possibility of surgical treatment.
- In case of atherosclerosis of blood vessels.
- Against the background of vascular pathologies that are associated with diabetes.
- With Buerger's disease and Raynaud's syndrome.
- In the case of the development of autoimmune diseases, for example, with vasculitis, scleroderma.
- Against the background of the occurrence of mitral and tricuspid atresia.
- To temporarily support the opening of the arterial ducts with congenital heart disease.
Instruction manual
The drug is administered intravenously drip. In order to prepare a therapeutic solution, the contents of one ampoule are diluted in 9.8 milliliters of five percent glucose. And then from 100 to 500 milliliters of isotonic solution is added. With obliterating artery disease, the daily dosage is from 50 to 200 micrograms of the substance, the medicine is administered once, and twice in severe cases.
The effectiveness of treatment is evaluated after a two-week course, against the background of a positive result, therapy is continued for another two weeks. The total duration is one month. For newborns, the drug is administered directly through the large veins into the lumen of the ductus arteriosus. The drug is administered at a rate of 0.05 micrograms per minute per kilogram of mass. As for the maximum speed, it is 0.1 micrograms per minute. Upon reaching the desired effect, a maintenance dosage of 0.02 is left.
In patients with severe chronic arterial pathologies, the effect may appear after the entire course of complex therapy, of which Alprostan is a part. During drug administration, it is necessary to monitor the hemodynamic index along with the state of the coagulation system, heart rate, and basic acid balance. The substance is metabolized very quickly, excreted mainly through the kidneys, and the rest through the intestines.
Composition and format of release: ampoules
Alprostan is available in ampoules. Its active ingredient is a substance called alprostadil.
Interaction with other medicines
According to the instructions "Alprostan" is not recommended to combine with other drugs. The medication can potentiate the effect of vasodilating, antihypertensive, antianginal drug components. When used with drugs that are designed to suppress blood clotting, the chance of bleeding may increase.
Similar results are observed with simultaneous use with such medicines as Cefotetan, Cefamandol and thrombolytic agents. An undesirable combination with Norepinephrine and Epinephrine, as the effect of vasodilation decreases.
Side effects
According to the instructions for use with Alprostan, with the intravenous method of drug administration, phlebitis (inflammatory changes in the venous walls) may develop in the injection area. In most situations, this will not require discontinuation of treatment, as the symptoms go away without therapy after a few hours. An allergic reaction in the form of urticaria and itching may also occur.
The blood system can respond by lowering or increasing the number of white blood cells. Respiratory organs sometimes respond with dyspnea and pulmonary edema. As for the digestive system, it may cause discomfort in the upper abdomen along with nausea, an increase in the concentration of the liver enzyme in the blood.
On the part of the genitourinary apparatus, a decrease in renal functions and the appearance of red blood cells in the urine are sometimes observed. In addition, patients may experience pain in the joints and the development of hyperostosis. In newborn patients, an increase in temperature can be observed, apnea is not excluded along with redness of the skin, slowing of the heart rhythm and diarrhea.
Overdose
What else does the instruction for use with Alprostan in ampoules tell us? Symptoms of an overdose are an excessive decrease in pressure in combination with reddening of the skin, general malaise, and a decrease in heart rate. If such a clinical picture occurs, it is recommended to stop the drug administration, to carry out symptomatic treatment, and for newborn patients, mechanical ventilation may be required.
Contraindications
The drug in question is not recommended for use in a number of the following cases:
- Against the background of hypersensitivity to the main ingredient.
- With suppressed respiratory function.
- In the case of respiratory distress syndrome.
- With spontaneous persistent open arterial duct in the newborn.
- In case of pregnancy.
Terms, price and shelf life
It is necessary to use the described medication for two years, store it in a dry place at a temperature of one to five degrees. The finished solution is suitable only for one day. The average cost of a medicine is five and a half thousand rubles per ten ampoules.
Analogs
Analogues of Alprostan are not described in the instructions for use.
The drug has several direct substitutes that contain the same active substance. We are talking about Vazaprostan (its average price is eight and a half thousand rubles) and a Belgian drug called Kaverdzhekt. The latter will cost consumers eight thousand rubles.
Reviews about "Alprostan"
It is worth noting that there are a lot of good reviews about this medicine on the Internet. Patients showed a significant improvement in condition after a course of treatment. It is reported that patients observe a very good effect in the treatment of obliterating vascular pathologies of the lower extremities, the clinical manifestation of the disease is markedly reduced, and the distance of painless walking increases.
The high effectiveness of this drug is also described by patients with diabetes who suffer from various vascular lesions. Patients noted a decrease in the severity of trophic changes in the legs, along with the normalization of the biochemical index of blood.
The drug "Vazaprostan"
The analog of "Alprostan" "Vazaprostan" is a prostaglandin drug. It improves peripheral blood circulation and microcirculation. This medicine decreases the tone of post-capillary sphincters, arterioles and total peripheral vascular resistance without changing pressure, increases the intensity of coronary blood flow along with the ejection fraction of the left ventricle.
Among other things, rheological blood properties are improved by lowering the adhesion and aggregation of platelets, reducing the aggregation and deformability of red blood cells. When using this medication, fibrinolytic activity stabilizes and blood viscosity decreases. Like Alprostan, Vazaprostan should be used in the following cases:
- Therapy of chronic heart failure at the stage of decompensation.
- In acute myocardial infarction and in post-infarction periods for six months.
- In the case of severe cardiac arrhythmias.
- In acute circulatory failure (against the background of shock, vascular collapse).
- In the case of severe hypotension (with systolic pressure less than ninety millimeters of mercury).
- Against the background of severe violations of the liver.
- With peptic ulcer of the stomach and intestines.
- In case of hypersensitivity to the drug.
This drug is administered intramuscularly. To obtain the medicine, 20 micrograms (the contents of one ampoule) must be dissolved in 50 milliliters of a physiological preparation. As part of the infusion, 25 milliliters of the finished solution is administered within sixty-one hundred and twenty minutes using a special device. If necessary (especially with necrosis), the dosage can be increased to 50 milliliters (20 micrograms).
Means "Alprostan Zentiva"
"Alprostan Zentiva" is a synthetic analogue of natural prostaglandin. It is a vasodilator, angioprotective drug. It acts in a complex way, improves microcirculation along with peripheral circulation, and at the level of arterioles causes vasodilation.
The medication presented improves the rheological property of blood, increases the elasticity of red blood cells, has an effect on hemocoagulation, decreases the adhesion and aggregation of platelets. The described medication has fibrinolytic effects. It can have an anti-atherogenic effect and slow down the activation of neutrophils along with excessive proliferation of vascular wall cells.
The drug decreases the overall vascular peripheral resistance along with blood pressure, the frequency of contractions increases reflexively, which leads to an increase in cardiac output. Smooth muscles of the intestines, uterus and bladder are stimulated, and in addition, the secretion of gastric juice is suppressed by this tool.
Indications and contraindications for medication
In accordance with the instructions for use with Alprostan Zentiva, the indications for use of this drug are as follows:
- If necessary, temporary support for the functioning of the arterial ducts until corrective operations for congenital heart defects among newborns.
- In the case of atresia of the pulmonary arteries, stenosis or coarctation of the aorta.
- Against the background of atresia of the left heart.
- When the aortic arch is interrupted with the occurrence of valve stenosis.
- With the development of chronic obliterating diseases of the arteries.
Contraindications include:
- The presence of hypersensitivity to the main ingredient of the drug or to any excipients of the drug.
- Against the background of pregnancy and during periods of breastfeeding.
- With myocardial infarction suffered during the last five to seven months.
- In the case of a patient with subacute myocardial infarction, along with a severe stable form of angina pectoris.
- Against the background of chronic heart failure in the stage of decompensation.
- With serious violations in the heart rhythm.
- When severe bronchial obstructive syndrome occurs with manifestations of respiratory failure.
- In case of pulmonary edema.
- Against the background of infiltrative changes in the lungs, confirmed by x-ray or clinical examination.
- With severe chronic dysfunction of the liver or acute failure of this organ.
- In case of simultaneous use with anticoagulant and vasodilating agents.
Guidance on the use of this medicine
It is required to prepare a solution immediately before the infusion with the mandatory observance of all aseptic conditions. The solution is recommended to be used immediately after preparation. True, it is allowed to temporarily store the prepared medicine for no more than twenty-four hours at a temperature of two to eight degrees.
Direct interaction of the concentrate with any plastic surfaces should be avoided. In this regard, it is recommended to introduce the concentrate into the finished solution of sodium chloride or glucose in order to avoid contact with the walls of the container. One ampoule of Alprostan Zentiva is diluted in 9.8 milliliters of a 0.9 percent solution of sodium chloride or in five percent glucose, thus, a concentration of 100 micrograms of the active component in 10 milliliters of the drug is obtained.
So, we examined the drug Alprostan, as well as its analogues in the form of Alprostan Zentiva and Vazaprostan. Thus, the drug "Alprostan" is a vasodilator with angioprotective and anti-aggregation properties. The drug acts as a synthetic substitute for prostaglandins, and it is used for chronic pathologies of the arterial bed and as part of the complex therapy of congenital heart defects. The drug is administered drip intravenously, under the supervision of specialists. The advantage of this medicine is that it is well tolerated by patients.
We reviewed the instructions for use with Alprostan in ampoules.