"Propafenone" (instructions, analogues and reviews are presented in the article) - antiarrhythmic medication. Available in the form of tablets for oral use and a solution for intravenous administration. What instructions for use and analogues does "Propafenone" have? We will clarify further. The active substance of the drug is propafenone hydrochloride.
Additional substances are:
- sodium dodecyl sulfate;
- lactose monohydrate;
- polyvinylpyrrolidone;
- carboxymethyl cellulose sodium salt;
- cellulose;
- a salt of magnesium and stearic acid;
- talc.
Pharmacological actions
"Propafenone" is an antiarrhythmic drug that has a membrane-stabilizing property aimed at eliminating heart rhythm disturbances. In addition, the medication has the effect of a sodium channel blocker, and also has a local anesthetic and weakly expressed adrenergic blocking effect. What indications, reviews and analogues does "Propafenone" have?
When using the drug in tablets, the maximum content of the active substance in the blood occurs after three and a half hours. After the start of treatment, an equilibrium concentration is reached after four days.
Indications
"Propafenone" and analogues are prescribed for the following conditions and diseases:
- Ventricular arrhythmias (violation of the frequency, rhythm, sequence of the spread of excitation and contraction of the myocardium).
- Atrial ventricular tachycardia.
A solution for intravenous administration is recommended for use:
- With supraventricular and ventricular extrasystoles (this is a common heart rhythm disorder that develops under the influence of premature impulses coming from the wall of the left or right ventricle).
- Paroxysmal cardiac arrhythmias.
- Wolff-Parkinson-White Syndrome (a clinical electrocardiographic syndrome characterized by ventricular overstimulation along additional atrioventricular routes and the development of paroxysmal tachyarrhythmias).
- Atrial fibrillation and flutter (this is one of supraventricular tachycardia).
- Atrial ventricular tachycardia (one of the types of malfunction in the heart rhythm that appears as a result of severe damage to the heart muscle).
- Monomorphic sustained ventricular tachycardia (a violation of the heart rhythm, which appears almost always as a result of a serious damage to the heart muscle).
Contraindications
"Propafenone" and analogues are prohibited for use in the following conditions:
- Violations of atrial conduction.
- Cardiogenic shock (extreme left ventricular failure, characterized by a sharp decrease in myocardial contractility).
- Arterial hypotension with systolic blood pressure (lowering blood pressure by more than twenty percent of the initial values).
- Severe violations of the water-electrolyte balance.
- Syndrome of bradycardia-tachycardia.
- Myasthenia gravis (an autoimmune neuromuscular disease characterized by pathologically rapid fatigability of striated muscles).
- Under the age of eighteen.
- Lactation
- Increased sensitivity to the components of the drug.
How to take the drug?
According to the instructions for use, "Propafenone" is taken orally after a meal, swallowed whole and washed down with water. The dosage and frequency of administration are determined by a medical specialist based on clinical indications and adjusts it as necessary.
The use of the medication must begin after the preliminary cancellation of all previously taken antiarrhythmic drugs, since there is a risk of its proarrhythmic effect.
Recommended dosage of tablets for people weighing from seventy kilograms and above:
- The initial dose is four hundred and fifty milligrams once a day. Therapy should be started in a hospital under the control of blood pressure, electrocardiography and assessment of the latitude of the ventricular complex.
- To achieve the best pharmacological action, a gradual increase in dosage to three hundred milligrams twice a day is indicated. The maximum daily dosage is 900 mg.
It is necessary to start drug therapy in patients weighing up to seventy kilograms and people of retirement age with a lower dosage with its gradual increase only after eight days of treatment. In case of impaired liver function, a single dosage of the drug should be no more than twenty to thirty percent of the usual.
The solution for intravenous administration is applied by jet or drip infusion. With the drip, the drug can be mixed with a five percent solution of glucose or fructose. It is not recommended to mix with a 0.9% solution of sodium chloride.
The doctor sets and adjusts the dosage regimen individually. Therapy must be started in the hospital, after the preliminary cancellation of all previously used antiarrhythmic drugs. The recommended dosage for intravenous administration for patients weighing more than seventy kilograms is 560 milligrams per day. With a body weight of up to seventy kilograms and in people in retirement age, therapy should be started with a lower dosage with a gradual increase in it.
The patient is injected intravenously with a dosage of 0.5–1 milligrams per kilogram of body weight, if necessary, repeat the procedure in two hours after the same dosage. For the treatment of patients with severe arrhythmias, the use of Propaphenone drip is indicated.
Adverse reactions
According to the instructions for use, it is known that if the drug is used improperly, the following diseases can be observed:
- Angina pectoris (a clinical disease characterized by discomfort behind the sternum).
- Severe bradycardia (decrease in heart rate).
- Supraventricular tachyarrhythmias (a condition that is characterized by a sudden onset of a heart palpitations and the same sudden end of it, while there is no violation of the heart rhythm).
- Atrioventricular dissociation (a condition in which the atria and ventricles do not work in synchronous mode, but contract, regardless of the activity of each other).
- Ventricular tachyarrhythmias (heart rhythm disturbance, the root cause of which is localized at the level of the ventricles of the heart).
- Sinoatrial blockade (a pathological condition that is accompanied by a violation of the natural heart rhythm).
- Marked drop in blood pressure.
- Chest pain.
- Orthostatic and postural hypotension (excessive decrease in blood pressure at the time when a person is in an upright position).
- Thrombocytopenia (a condition characterized by a decrease in the number of platelets below the standard, which is accompanied by increased bleeding and problems with stopping bleeding).
- Leukopenia (a decrease in the number of white blood cells in the blood).
- Granulocytopenia (a decrease in the number of granulocytes such as white blood cells that are responsible for a number of immune functions).
- Agranulocytosis (a pathological condition in which there is a decrease in the level of leukocytes due to granulocytes and monocytes).
- Decrease in appetite.
- Cholestasis (a disease manifested in the form of stagnation in the liver tissue of bile components with a concomitant decrease in its entry into the duodenum).
- Anemia (a group of clinical and hematological syndromes, the common moment for which is a decrease in hemoglobin in the blood, more often with a simultaneous decrease in red blood cells).
- Allergic manifestations.
- Anxiety.
- Anxiety.
What other negative reactions can the drug cause?
In addition, the medication can also provoke the following side effects:
- Migraine (a disease for which episodic or constant strong and painful headache attacks in one half of the head are a characteristic sign).
- Dizziness.
- Nightmares in dreams.
- Extrapyramidal symptoms (a complex of neurological complications manifested by motor disorders associated with the use of antipsychotic drugs).
- Paresthesia (one of the types of sensitivity disorder, characterized by spontaneously arising sensations of burning, tingling, crawling ants).
- Tremor (fast, rhythmic movements of the limbs or trunk, caused by muscle contractions and associated with a temporary delay in corrective afferent signals).
- Vertigo (this symptom, known as dizziness, is characteristic of ear pathology or less commonly brain damage).
- Vomiting.
- Abdominal pain.
- Intestinal obstruction (a disease characterized by a partial or complete violation of the passage of food through the esophagus and due to a mechanical obstruction).
Next, consider the analogues and synonyms of "Propafenone".
"Propanorm"
The drug represents a therapeutic group of antiarrhythmic drugs. It is used in various pathological processes of the cardiovascular system, which is accompanied by a malfunction in the rhythm of heart contractions.
According to the instructions for the analogue of "Propafenone" it is known that the main active substance belongs to antiarrhythmic drugs. After taking the pill, the orally active component of the drug is almost completely absorbed from the intestine into the blood. The active substance spreads throughout all body tissues and after sixty minutes begins to have a pharmacological effect.
With extreme caution, the medication is used for muscle weakness, chronic obstructive pulmonary disease, moderate course of chronic heart failure, cardiomyopathy, arterial hypotension, in patients over the age of seventy years.
Before using the drug, the doctor must make sure that there are no restrictions. "Propanorm" is an analogue of "Propaphenone" in Russia.
"Rhythmorm"
This is another trade name for the analogue of "Propaphenone". The drug is considered an antiarrhythmic drug. The active substance "Rhythmorm" - propafenone - has a membrane-stabilizing effect. The tablets are taken orally, swallowed whole and washed down with water. Dosage is selected individually.
Therapy must be started in a hospital setting. First you need to stop taking all antiarrhythmic drugs. During treatment, electrocardiogram and blood pressure should be monitored.
For adult patients weighing 70 kg or more, the medication is prescribed in an initial dosage of one hundred and fifty milligrams three times a day. In the future, with interruptions of at least three to four days, it is possible to increase the concentration to 300 milligrams twice a day, and, if necessary, to 900 milligrams per day. For patients weighing less than seventy kilograms, the drug is prescribed in a lower dosage. An increase in the concentration of the active substance begins not earlier than after four days of treatment.
In people of retirement age, therapy is carried out strictly under the supervision of a medical specialist. An increase in the dosage of the drug begins not earlier than after eight days of therapy.
"Graveyard"
A synonym and analogue of "Propaphenone" is "Propastad". It is recommended to begin treatment with this drug in a hospital, having previously canceled all antiarrhythmic drugs. Use orally, at an initial dosage of 150 milligrams every eight hours, with a subsequent increase.
In rare situations, an increase in daily dosage is possible, subject to strict cardiological control. "Propastad" is taken after a meal, without chewing, washed down with water.
Children are given the drug in an average daily dosage of ten to twenty milligrams per kilogram of weight in three to four doses.
Reviews
According to the instructions, the medication is used for diseases of the cardiovascular system. Responses about the drug are usually only positive. Most patients write that its use effectively alleviated a serious condition, and taking the medicine helped restore health and get rid of discomfort.
The drug "Propafenone" has established itself as the safest and most popular representative of antiarrhythmic drugs. It has a strong antiarrhythmic effect in the treatment of supraventricular tachycardic arrhythmias, instant absorption in the gastrointestinal tract and rapid elimination from the body.
In addition, low cost and high efficiency allow the drug to compete confidently among analogues. The only minor drawback of the drug is the mandatory monitoring of the state of the heart at the time of course treatment.