Pain sensations that appear due to tension of the veins lead to the fact that the heart is not fully supplied with oxygen. In medicine, this condition is called angina pectoris. Most often, older people suffer from such an ailment. However, due to improper daily routine, nutrition and bad habits, pathology can affect young people. In order to prevent an attack and to prevent the disease, doctors recommend the use of Pectrol tablets. Instructions for use of the drug explain how to prevent an ailment with its help, what negative reactions can be and which analogue is better to choose.
What is Pectrol?
The drug has an antianginal effect, affecting mainly large venous vessels. It is recognized as one of the most effective peripheral vasodilators. Pectrol has the ability to expand the coronary vessels and quickly reduce the load on the heart. Also, the drug helps to expand the vessels of the brain, and in patients with coronary heart disease it helps to increase exercise tolerance. The main direction of using the drug "Pectrol" according to the instructions is the prevention of chronic heart failure and angina pectoris.
Structure
Each tablet of the drug contains respectively 40 or 60 mg of the main substance, which is isosorbide mononitrate. Also, it contains such auxiliary ingredients as:
- purified stearic acid;
- talc;
- carnauba wax;
- titanium dioxide;
- hypromellose;
- silicon dioxide;
- iron oxide yellow oxide (code 172).
You should carefully read the instructions for Pectrol 60 mg, as in some cases an allergy to any of the additional components may occur.
Pharmacological properties
A medicine such as Pectrol tablets is a modern peripheral vasodilator that affects venous vessels. It has the following pharmacodynamics: isosorbide mononitrate, which is the main active ingredient, provokes the appearance of a nitric oxide compound inside endothelial vascular cells. After the reaction has passed, intracellular guanylate cyclase is activated. Due to this process, the amount of cyclic guanosine monophosphate, which is the mediator of vasodilation, becomes significantly larger.
Complete relaxation of the smooth muscles of the blood vessels occurs, due to which the venous outflow to the heart becomes smaller. Consequently, the load on the heart muscle is reduced. This property helps reduce the heart's need for oxygen.
Nitrates have a dilating effect on arteries and arterioles, so there is resistance to ejection and relief after exercise. The coronary arteries expand, and the flow of blood into the area of the right atrium becomes smaller. The pressure inside the pulmonary circulation decreases, pulmonary edema passes.
The main substance helps to redistribute blood circulation through the vessels of the myocardium in those areas where blood circulation is significantly reduced. Patients with a diagnosis of coronary heart disease and angina pectoris are much easier to tolerate various physical activities after treatment with this drug. Negative actions such as headache, dizziness, and visual impairment may occur due to the fact that the drug helps to dilate the vessels of the brain and the dura mater.
In addition, the properties of Pectrol are known to reduce the synthesis of thromboxane in platelets and inhibit the aggregation of these blood bodies. Often, after prolonged treatment, addiction can develop. Almost all drugs from the nitrite group have this effect. After a break is made in treatment, sensitivity to medicines will quickly recover. The main antianginal properties of Pectrol is achieved within 35-40 minutes after the first dose. If the dosage is selected correctly, then the action will last no less than 8-10 hours.
Pharmacokinetics
The drug has the ability to be absorbed completely from the digestive system. The bioavailability of isosorbide mononitrate is about 100%. This is because the effect of the "first passage" through the liver is absent. "Pectrol" is evenly distributed over all body systems. Up to 5% of the active component binds to plasma proteins. The medication can be metabolized by denitrification and conjugation with glucuronic acid. Harmful metabolites are rapidly excreted through the kidneys. The rate of renal clearance is 115 mm / min with an average elimination half-life of 4.5-10 hours. If the patient has hepatic or renal failure, then the time and method of excretion remain the same.
Release form
The drug "Pectrol" is sold in the form of biconvex round tablets with a film membrane. The color is white or slightly yellowish, slight blotches are allowed. On one side of the tablets is engraved "IM40".
Indications for use
As a result of the examination, the doctor can identify serious problems with the cardiovascular system and prescribe a course of Pectrol. Indications for use relate to diseases of the heart and vascular system. The medication has shown its effectiveness in the field of prevention and therapy for the following diseases:
- angina pectoris after a heart attack;
- pulmonary hypertension;
- chronic heart failure;
- angina attacks in patients with coronary artery disease.
It should be noted that when diagnosing chronic heart failure, Pectrol, according to the indications for use, should be used as a combination therapy with other drugs. The medication also helps well so that there are no attacks of vasospastic angina pectoris.
Contraindications
What are the contraindications for Pectrol? Instructions for use explains that it is forbidden to use the drug in the presence of the following diseases:
- toxic pulmonary edema;
- vascular collapse;
- arterial hypotension and hypovolemia;
- acute heart failure;
- shock state;
- cardiac tamponade;
- any painful conditions associated with increased pressure inside the cranium;
- left ventricular failure with low diastolic blood pressure.
In addition, Pectrol is forbidden to use for treatment if an individual intolerance to one of its components has been identified. This applies to both main and auxiliary components. The drug is also not used in children under 18 years of age, during pregnancy and breastfeeding due to the high risk of negative effects on the nervous system of children. With great care, repeatedly assessing any risks, doctors prescribe the drug to patients over the age of 50 years. A relative contraindication is the presence of a history of the following diseases:
- mitral stenosis;
- constrictive pericarditis;
- severe anemia;
- thyrotoxicosis and other thyroid diseases;
- aortic stenosis;
- hypertrophic cardiomyopathy;
- hepatic or renal failure.
These suggestions are associated with a risk of impaired vascular regulation, therefore it is recommended to choose more sparing medications for treatment. But in some cases, when there is no alternative to Pectrol, the doctor may decide to use small dosages that will be safe for the patient.
Overdose
If the patient inattentively studies the instructions for use of Pectrol and chooses the wrong dose or frequency of administration, an overdose of the drug may occur. In this case, the patient has symptoms such as:
- drowsiness;
- redness of the skin of the face;
- bradycardia;
- diarrhea;
- temperature rise;
- vomiting
- loss of consciousness;
- visual impairment.
These and other symptoms often arise due to a sharp increase in intracranial pressure. If the patient feels ill after taking Pectrol, he should immediately contact a medical institution for help. In especially severe cases, negative reactions such as paralysis and coma are observed. At home, before the arrival of an ambulance, you should do a gastric lavage and drink 1-2 g of ascorbic acid. In case of complicated arterial hypotension, the patient should administer “Phenylephrine” intravenously.
Instructions for use
The patient should begin the course of treatment after the appointment of a medical professional. The duration and frequency of admission is determined individually and directly depends on the specific disease and age of the patient. Pectrol tablets according to the instructions for use are taken orally a few minutes after a meal. One should be swallowed and washed down with a glass of water. Start taking the drug in the early morning. The recommended dose of Pectrol is 40 mg according to the instructions for use. In cases where patients are concerned about nighttime attacks of angina pectoris, it is preferable to use pills shortly before bedtime.
If after taking the medicine, the patient does not feel the desired effect, then starting from 3-5 days the therapeutic dose can be increased to 60 mg per day or twice a day, but 40 mg each.
When a chronic heart failure is diagnosed, then treatment in a hospital is indicated under the supervision of a medical professional. Therapy is carried out until, with the help of dosage selection, the desired effect is achieved. If further maintenance treatment is necessary, the optimal dose is 40-60 mg per day or 40 mg twice a day. When applying "Pectrol" twice, the interval between doses should be at least 8 hours.
special instructions
The instructions for use of Pectrol indicate the features of use. This section helps prevent unwanted effects of the drug. You need to carefully study the special instructions before starting a course of treatment:
- "Pectrol" is not used to stop angina attacks.
- During treatment, it is forbidden to engage in any activities that are potentially dangerous and require an increased psychomotor reaction. For example, drive a car.
- It is recommended to refrain from use by patients with increased intracranial pressure.
- After completing the course of therapy, the dosage of the drug substance should be reduced gradually, in order to avoid a sharp increase in blood pressure.
Patients taking Pectrol and isosorbide dinitrate at the same time should monitor their motor-mental reactions. Perhaps they will be significantly reduced during this period.
Drug interaction
This section helps to understand which medicines Pectrol cannot be used with. The list of drugs that can not be taken simultaneously with tablets includes:
- Stimulants of male potency.
- Derivatives of barbituric acid, which have a depressing effect on the nervous system of the patient.
- Astringents and enveloping agents, due to the fact that the absorption of isosorbide mononitrate may be reduced.
- Anticholinergic drugs that affect impaired attention and memory. This effect is observed in elderly patients.
- Vasodilators, tricyclic antidepressants, calcium channel blockers, PDE inhibitors. They can enhance the hypotensive property.
- Any medicine containing ethanol.
- "Dihydroergotamine", due to increased action and a significant excess of the concentration of the active substance.
- "Sildenafil", as there is a threat of severe arterial hypotension or myocardial infarction.
- Amiodarone, acetylsalicylic acid, propranolol, because there is an increase in antianginal properties.
- If you use "Pectrol" with m-anticholinergic drugs, there is a risk of developing increased intraocular pressure.
Analogs
We have reviewed the instructions for the use of Pectrol. Analogues of the drug are of interest to many. Patients should take into account that these medicines also have side effects and contraindications, therefore a doctor’s consultation is required. Replace "Pectrol" can only be prescribed by a doctor. The list of generics includes:
- "Isomonate";
- Monizol
- Cardix Mono
- "Monochinkwe";
- Monizid
- Olikard;
- "Monosan";
- Sorbimon;
- Mono Mack
- Pentacard.
If a patient with angina pectoris has problems with the swallowing reflex, a special Isoket spray is prescribed, which is based on the same active substance. This is the only alternative drug that is a different dosage form. They should irrigate the oral cavity. The medicine should be used carefully, given the individual action.
Reviews
Many patients suffering from angina pectoris prefer to get the opinion of other people. We have reviewed the instructions for the use of Pectrol. Reviews about the drug will help to better imagine its effectiveness. In most cases, when the drug was used correctly and taking into account the recommendations of the doctor, patient reviews are only positive.
There are negative opinions when patients began to drink medicine on the advice of friends. Then people were faced with unpleasant side effects. This is evidenced by numerous reviews.
We disassembled the instructions for the Pectrol tablets. Reviews and analogues were also presented.