Amiodarone tablet user manual
Amiodarone tablets are referred to as antiarrhythmic drugs. They are used to treat various types of arrhythmia - violation of the frequency and rhythm of contractions of the heart.
Form of issue and composition
Amiodarone is available as a dosage form - a tablet. They have a rounded shape, a flat surface, in the middle there is a dividing risk. Color of tablets is white, light cream color is allowed. The main active substance of the drug is amiodarone hydrochloride, its concentration in 1 tablet is 200 mg (0.2 g). Also contain auxiliary substances, which include:
- Potato starch - 8.4 mg.
- Ludipress (lactose monohydrate, povidone K30, crospovidone) - 204.2 mg.
- Magnesium stearate 4.2 mg.
- Silica colloidal - 4.2 mg.
Tablets are packaged in blisters for 10 pieces. One cardboard pack contains 3 blisters (30 tablets). Usually such quantity of tablets suffices for 1 month of their application.
The active substance of amiodarone hydrochloride tablets is an antiarrhythmic drug. The main therapeutic effect of this drug is the normalization and the frequency of cardiac contractions due to such influences on the sinus node (generates nerve impulses for contractions) and the conducting system:
- Lengthens the active potential of cardiac muscle cells (cardiomyocytes).
- Increases the effective refractory period of the atria, ventricles and elements of the conduction system of the heart (atrioventricular node, bundles of Guiss, fibers Purkinje).
- It blocks the sodium channels of nerve cells that are part of the conduction system of the heart.
- It inhibits the slow depolarization of sinus node cells, which set the rhythm frequency, thereby reducing the frequency of cardiac contractions.
Amiodarone also has an antianginal effect (slightly dilates coronary vessels), decreases the sensitivity of beta receptors (the effect of beta-blocker drugs), increases the energy reserves of cardiomyocytes. Amiodarone hydrochloride has a chemical structure similar to that of thyroid hormones, so when ingested, it depresses their production, thereby reducing the stimulating effect on the heart.
After ingestion, the active substance of Amiodarone tablets is absorbed from the intestine into the blood, the therapeutic concentration in it is reached after 40 minutes, the maximum concentration is 4-7 hours after administration. Amiodarone hydrochloride accumulates better (cumulation) in tissues with increased blood circulation and a high content of fat cells (adipose tissue, myocardium), where its concentration is significantly higher than in blood. This feature of the drug distribution in the body requires initial application in high doses with the subsequent transition to a maintenance dosage. It penetrates the blood-brain barrier, through the placenta into the developing fetus during pregnancy and into breast milk during lactation. Amiodarone hydrochloride is metabolized in the liver, the intermediate products of its disintegration also have antiarrhythmic activity. Mostly they are excreted with bile (up to 85%).
Indications for use
The use of Amiodarone tablets is indicated in the pathology of the heart, accompanied by a violation of the rhythm and frequency of its contractions, which include:
- Supraventricular arrhythmias are rhythm disturbances caused by changes in pulse generation in the atria and sinus node.
- Ventricular arrhythmias are severe disorders of the rhythm, in which excess nerve impulses are generated in the cardiac conduction system in the ventricles (ventricular tachycardia , ventricular fibrillation).
- Arrhythmias that develop against a background of ischemic disease (insufficient blood supply) of the heart, chronic heart failure.
- Extrasystolia - the formation of additional extraordinary cardiac contractions that have a ventricular or atrial origin.
- Arrhythmia of the heart, developing against the backdrop of myocarditis.
- Angina pectoris or unstable angina of the heart.
The presence of indications for the use of amiodarone tablets is determined by a cardiologist or therapist on the basis of clinical symptoms and ECG results (cardiac electrocardiography).
Contraindications for use
Use of tablets Amiodarone is contraindicated in the presence of such pathological or physiological conditions of the body:
- Individual intolerance to amiodarone hydrochloride or other auxiliary components of the drug.
- Syndrome of weakness of the sinus node, which reduces its functional activity and the ability to generate nerve impulses - sinus bradycardia (decrease in the frequency of contractions of the heart), sinoatrial blockade.
- Atrioventricular blockade of II and III degree characterized by impaired conduction of nerve impulse through the atrioventricular node of the conduction system of the heart.
- Blockade of the legs of the bundle Guiss, intracardiac local blockade of the nerve impulse in the Purkinje fibers.
- Arterial hypertension and collapse (significant, threatening decrease in systemic arterial pressure).
- Cardiogenic shock.
- Insufficient amount in the blood of some ions - hypokalemia, hypocalcemia.
- Thyrotoxicosis (a significant increase in thyroid hormones) and hypothyroidism (insufficient functional activity of the thyroid gland).
- Pregnancy on any terms and breastfeeding.
Determination of the possible presence of contraindications should be carried out before the use of Amiodarone tablets.
Dosage and Administration
Scheme and duration of therapy with pills Amiodarone is prescribed by the doctor individually, depending on the underlying pathology and degree of severity of heart rhythm disturbances. Tablets are taken as a whole, after eating, washed down with a sufficient amount of water. The average dosage is 200 mg (1 tablet) 2-3 times a day. After a certain time (usually within a week), the daily dose of the drug is reduced - 1 tablet 1-2 times a day. After every 5 days of taking the drug, a two-day break is done. It is also possible to use a regimen that includes daily taking of tablets for 3 weeks followed by a break of 7 days.
Reception of tablets Amiodarone can cause certain side effects from various systems and organs, they include:
- The sense organs are uveitis (inflammation of the choroid of the eye), deposition of lipofuscin in the cornea.
- The heart - the development of bradycardia (a significant reduction in the frequency of cardiac contractions), atrioventricular blockade (impairment of impulse through the atrioventricular node).
- Respiratory organs - dyspnea, cough, bronchospasm (narrowing of the lumen of the bronchi), pleurisy (reactive inflammation of the pleura).
- Nervous system - memory impairment, insomnia, depression, general weakness, auditory hallucinations and headache.
- Endocrine system - a change in the functional activity of the thyroid gland with the development of thyrotoxicosis or hypothyroidism.
- Organs of the digestive system - nausea, vomiting, decreased appetite, bloating (flatulence), dulling sensation when eating, diarrhea, abdominal pain of a spastic nature.
- Allergic reactions - rash on the skin, itching, exfoliative dermatitis, Quincke's edema , hives . In severe cases, the development of anaphylactic shock (multiple organ failure with a marked decrease in systemic blood pressure).
If any side effects develop, depending on their severity, the dose of the drug is reduced or discontinued.
When the dose is exceeded and amiodarone hydrochloride accumulates in the body, first of all, violations from the functional activity and rhythm of the heart develop: sinus bradycardia, blockade of the atrioventricular node, ventricular tachycardia. Also, there may be signs of side effects in other organs and systems. Since there is no specific detoxification with an increase in the concentration of amiodarone hydrochloride in the body, symptomatic therapy is aimed at reducing the symptoms of overdose.
Reception of the drug is possible only after the appointment of a doctor who determines the regimen of treatment and dosage based on the data of the clinical study and ECG. It is also necessary to take into account such specific instructions:
- You can not combine the use of Amiodarone tablets with other antiarrhythmic drugs, as this will lead to an increase in its effects and the development of disturbances in the functional activity of the heart. Also, a combination with antimalarials, antibiotics of the macrolide group, fluoroquinolones is excluded.
- With increased caution and with the constant ECG control of the heart, Amiodarone tablets are prescribed when used together with beta-blockers, laxatives and diuretics, which remove potassium ions from the body (potassium not storing diuretics-furosemide), anticoagulants (warfarin), certain antibiotics (Rifampicin) and antiviral agents (especially drugs that inhibit reverse transcriptase of viruses).
- Before starting the drug, it is recommended to conduct a study of the functional activity of the thyroid gland and the level of its hormones in the blood.
- With prolonged use, ECG monitoring of the heart, determination of the level of thyroid hormones and hepatic enzymes in the blood are mandatory.
- In the case of coughing and shortness of breath, radiologic examination of the thoracic organs is performed to differentiate the inflammatory pathology of the respiratory organs.
- During the reception of Amiodarone tablets, it is necessary to abandon the activity associated with increased concentration of attention and requiring a high rate of psychomotor reactions.
In pharmacies, the drug is dispensed only on prescription.
Terms and conditions of storage
Amiodarone tablets should be stored in a dark, dry place inaccessible from children at a temperature of no more than +25 ° C. Shelf life - 3 years.
Analogues of Amiodarone
Analogues of Amiodarone tablets are preparations of Cordarone, Rhythmorest, Cardiodarone, Amiocordin, Vero-Amiodarone.
Price for Amiodarone
Amiodarone tablets 200 mg, 30 pcs. - from 74 rubles.