Many people suffer from heart and vascular diseases. Moreover, with age, the risk of such pathological conditions increases significantly. To reduce the likelihood of serious processes in the body, doctors recommend the use of special tools. Among them, calcium channel blockers are especially popular. They belong to a heterogeneous group of drugs. Their mechanism of action is associated with the ability to inhibit the penetration of Ca ions from the intercellular space into the cells of blood vessels and the heart. Reducing the concentration of these elements, the medication has a vasodilating effect.
The most effective drug with these properties is Finoptin. Instructions for use, composition, analogs, indications for the use of the drug and its side effects are described below.
Form, composition
What form is typical for Finoptin? The instruction for use states that it can be purchased in the form of an injection solution and tablets.
The active ingredient of this tool is verapamil hydrochloride. Also, the composition of the drug includes various auxiliary compounds (depending on the form of release).
pharmachologic effect
What features are inherent in the drug Finoptin? Instructions for use, reviews claim that this is a first-class calcium channel blocker (selective). It is a derivative of diphenylalkylamine, and also exhibits antianginal, antihypertensive and antiarrhythmic effects.
The antianginal effect of this drug is associated with its ability to affect the myocardium and peripheral hemodynamics. In other words, this drug reduces the tone of the arteries. In addition, it reduces the transformation of ATP energy, which is contained in macroergic bonds, into mechanical work and helps to reduce myocardial contractility.
It should be noted that the use of this medication significantly reduces the myocardial need for O2, and also has a negative chrono-, inotropic and vasodilating effect.
Drug properties
Due to its composition, the medication Finoptin, the analogues of which are listed below, suppresses the automatism of the sinus node, reduces AV conductivity and increases the period of refractoriness.
Increasing the time of diastolic relaxation of the ventricle (left), this drug significantly reduces the tone of the walls of the myocardium, that is, it is an auxiliary tool designed to treat obstructive hypertrophic cardiomyopathy.
It should also be noted that the drug in question exhibits antiarrhythmic properties in supraventricular arrhythmias.
Kinetics of the drug
The drug "Finoptin", the instruction of which is described below, is absorbed from the gastrointestinal tract (about 90% of the dose taken). Its connection with proteins is 90%.
The drug undergoes metabolism during the passage of the (first) through the liver. In this case, a derivative such as norverapamil is formed, which has less hypotensive activity than unchanged verapamil.
The half-life of the drug when taking a single dosage is 3-8 hours. With the use of repeated doses of the drug, this indicator changes (5-12 hours).
The drug is excreted through the intestines and kidneys.
Indications
In what cases is Finoptin prescribed? Instructions for use (tablets and injection solution have the same ostentatious) states that this remedy can be used for supraventricular tachycardia (including paroxysmal, Laun-Ganong-Levin syndrome and WPW syndrome), angina pectoris (voltage stable without angiospasm, stable vasospastic), sinus tachycardia, atrial flutter, atrial tachyarrhythmia, atrial extrasystole, hypertensive crisis (for intravenous administration), arterial hypertension, primary hypertension in the small circle in circulation, hypertrophic obstructive cardiomyopathy.
Contraindications
When should you not prescribe Finoptin? Instructions for use (injections and tablets have the same contraindications) indicate that this drug is prohibited for use in severe arterial hypotension, sinoatrial blockade and SSSU (except for patients with a pacemaker), AV blockade of the third and second degree, Laun's syndrome -Ganong-Levine and WPW-syndrome in combination with atrial fibrillation or flutter (except for sick people with a pacemaker), pregnancy, hypersensitivity to verapamil, breastfeeding.
The drug "Finoptin": instructions for use
The dosage of this drug is calculated by the doctor individually.
For adult patients, tablets are administered orally at an initial dose of 40-80 mg three times a day. For dosage forms with prolonged action, a single dosage should be increased, and the frequency of administration should be reduced.
For children aged 6-14 years, this medication is recommended to be taken in an amount of 80-360 mg per day, and up to 6 years old - at a dose of 40-60 mg per day. The frequency of taking this medicine is four times a day.
If necessary, then the drug in question can be administered intravenously jet (slowly). In this case, the ECG, blood pressure and heart rate of the patient should be monitored.
A single dosage of the solution for adults is 5-10 mg. If there is no therapeutic effect, then after 20 minutes the drug can be re-administered (in the same dose).
A single dosage of the injection form of the drug for children 6-14 years old is 2.5-3.5 mg, for babies 1-5 years old - 2-3 mg, and for a child up to one year old - 0.75-2 mg.
For patients with severe hepatic impairment, the daily dose should not exceed 120 mg.
The maximum oral dosage per day is 480 mg.
Side effects
The drug "Finoptin" can provoke the appearance of the following adverse reactions:
- weight gain, bradycardia, agranulocytosis, aggravation or development of heart failure, hyperprolactinemia, tachycardia, transient loss of vision, peripheral edema;
- marked decrease in blood pressure, gynecomastia, galactorrhea, arthritis, angina pectoris, arrhythmia, pulmonary edema, third-degree AV block, asystole, thrombocytopenia asymptomatic, collapse;
- nausea, stiffness of the arms or legs, gingival hyperplasia, fainting, fatigue, increased appetite, anxiety, increased liver transaminase activity;
- skin rash, dizziness, constipation or diarrhea, headache, depression, lethargy, extrapyramidal disorders, asthenia, skin hyperemia, drowsiness, erythema multiforme exudative, skin itching.
Drug interaction
Is it possible to combine Finoptin with other medicines? The instruction for use states that the combination of this agent with antihypertensive drugs mutually enhances their antihypertensive effect.
With intravenous administration of verapamil to people who have recently received a dose of beta-blockers, there is a high risk of hypotension (arterial) and asystole.
With the combined use of Finoptin with beta-blockers, drugs for inhalation anesthesia and antiarrhythmic drugs, the risk of developing heart failure, bradycardia, severe arterial hypotension and AV blockade increases.
With simultaneous administration with Amiodarone, bradycardia, negative inotropic effect, AV block and conduction disturbance are enhanced.
Due to the fact that verapamil inhibits the CYP3A4 isoenzyme involved in the metabolism of simvastatin, lovastatin and atorvastatin, some manifestations of the interaction are possible, which are due to an increase in the concentration of statins in the blood. There are also cases of rhabdomyolysis.
When combined with nitrates, the antianginal properties of Finoptin are enhanced.
With the simultaneous administration of acetylsalicylic acid, the bleeding time increases due to the antiplatelet additive effect.
Can I take "Disopyramide" in conjunction with the drug "Finoptin"? Instructions for use report that such a combination can lead to severe arterial hypotension and collapse, especially in people with decompensated heart failure or cardiomyopathy.
With the simultaneous use of tablets and a solution with Imipramin, its concentration in the blood increases, resulting in the risk of undesirable changes on the ECG. It should also be noted that verapamil increases the bioavailability of Imipramine, reducing its clearance.
When combining the drug with "Carbamazepine", the effect of the latter is enhanced, and the risk of side effects from the central nervous system is also increased.
While taking the drug with "Clonidine" there are cases of cardiac arrest in people with arterial hypertension.
When combining a drug with lithium carbonate, the manifestations of drug interactions are unpredictable and ambiguous. There are cases of the development of neurotoxicity, severe bradycardia, increased effects of lithium and a decrease in its concentration in the blood.
How does Rifampicin affect Finoptin? The instruction states that such a combination induces the activity of liver enzymes, accelerating the metabolism of verapamil. Ultimately, this leads to a decrease in the clinical effectiveness of the drug in question.
Special recommendations
What should I know before using Finoptin (40 mg)? The instruction reports that this agent is used with caution in case of first-degree AV block, severe stenosis of the aortic orifice, bradycardia, myocardial infarction with left ventricular failure, chronic heart failure, moderate or mild arterial hypotension, liver or kidney failure. Also, this medication is carefully recommended for elderly people and minor children.
In case of acute need, it is allowed to carry out combined therapy of arterial hypertension and angina pectoris with verapamil and beta-blockers. But it is necessary to avoid intravenous administration of the latter.
After taking this drug, the patient may develop such individual reactions as drowsiness and dizziness, which can affect a person's ability to perform dangerous types of work.
Lactation and pregnancy
Is it possible for future mothers to prescribe the drug Finoptin? Instructions for use during pregnancy say that this tool adversely affects the development of the fetus. It also passes into breast milk. Therefore, in such conditions, this drug is strictly contraindicated.
Medication Finoptin: analogues and cost
The price of this tool may be different. As a rule, it depends on the form of release of the drug, its quantity or volume. The average cost of Finoptin is 100-170 rubles.
If the drug in question is contraindicated for you, then it can be replaced with one of the following drugs: Verapamil, Verogalid, Verapamil-OBL, Kaveril, Verapamil Sofarma, Verapamil-LekT, Verapamil-Fereyn, “Verapamil-ratiopharm”, “Isoptin”, “Verapamil-Eskom”, “Vero-Verapamil”, “Verapamil hydrochloride”, “Lecoptin”.
Reviews of doctors and consumers
Experts say that tablets and Finoptin solution are effective and inexpensive means that are designed to restore blood pressure, as well as improve well-being in other diseases of the heart and blood vessels.
As for the patients, most of them are quite satisfied with the results of treatment with this remedy. Taking tablets or intravenous infusion of the solution helps to quickly eliminate the symptoms of arterial hypertension and other signs of diseases of the cardiovascular system.
It should also be noted that negative messages are also found about this medicine. They talk about a large number of adverse reactions that occur immediately after using the medication. Also, many consumers complain about many contraindications.