Amiodarone tablets instructions for use
Amiodarone tablets are anti-arrhythmic drugs. They are used to treat various types of arrhythmias - violation of the frequency and rhythm of heart contractions.
Release form and composition
Amiodarone is available in dosage form - tablets. They have a rounded shape, a flat surface, in the middle there is a separation risk. The color of the tablets is white; a light cream color is allowed. The main active ingredient of the drug is amiodarone hydrochloride, its concentration in 1 tablet is 200 mg (0.2 g). Also contains excipients, which include:
- Potato starch - 8.4 mg.
- Ludipress (lactose monohydrate, povidone K30, crospovidone) - 204.2 mg.
- Magnesium stearate - 4.2 mg.
- Colloidal silicon dioxide - 4.2 mg.
The tablets are packaged in blisters of 10 pieces. One cardboard pack contains 3 blisters (30 tablets). Typically, such a number of tablets is enough for 1 month of their use.
The active ingredient of amiodarone hydrochloride tablets is an anti-arrhythmic drug. The main therapeutic effect of this drug is the normalization and frequency of contractions of the heart due to such effects on the sinus node (generates nerve impulses for contractions) and the conducting system:
- Extends the active action potential of the heart muscle cells (cardiomyocytes).
- Increases the effective refractory period of the atria, ventricles and elements of the cardiac conduction system (atrioventricular node, Giss bundles, Purkinje fibers).
- Blocks the sodium channels of nerve cells that make up the cardiac conduction system.
- It slows down the depolarization of the sinus node cells, which determine the frequency of the rhythm, thereby reducing the heart rate.
Amiodarone also has an antianginal effect (slightly expands the coronary vessels), reduces the sensitivity of beta receptors (the effect of beta-blocker drugs), increases the energy reserves of cardiomyocytes. Amiodarone hydrochloride chemical structure is similar to the thyroid hormones, so when ingested, it inhibits their products, thereby reducing the exciting effect on the heart.
After ingestion, the active ingredient of the tablets Amiodarone is absorbed from the intestine into the blood, the therapeutic concentration in it is reached after 40 minutes, the maximum concentration - 4-7 hours after ingestion. 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 much higher than in the blood. This feature of the distribution of the drug in the body requires initial use in high doses, followed by a switch to a maintenance dosage. Penetrates through the blood-brain barrier, through the placenta into the body of a developing fetus during pregnancy and into breast milk during lactation. Amiodarone hydrochloride is metabolized in the liver, the intermediate decay products also have anti-arrhythmic activity. To a greater extent they are excreted in the 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 the generation of impulses in the atria and the sinus node.
- Ventricular arrhythmias are severe rhythm disturbances in which excess nerve impulses are generated in the cardiac conduction system in the ventricles (ventricular tachycardia , ventricular fibrillation).
- Arrhythmias developing on the background of coronary heart disease (insufficient blood supply) of the heart, chronic heart failure.
- Extrasystole - the formation of additional extraordinary contractions of the heart, which are of ventricular or atrial origin.
- Arrhythmia of the heart, developing on the background of myocarditis.
- Angina or unstable angina of the heart.
The presence of indications for the use of amiodarone tablets is determined by the cardiologist or therapist on the basis of clinical symptoms and ECG results (electrocardiographic examination of the heart).
The use of Amiodarone tablets is contraindicated in the case of the presence of such pathological or physiological conditions of the body:
- Individual intolerance to amiodarone hydrochloride or other auxiliary components of the drug.
- The syndrome of weakness of the sinus node, in which its functional activity and the ability to generate nerve impulses are reduced - sinus bradycardia (reduction of the heart rate), sinoatrial block.
- Atrioventricular block II and III degree, characterized by a violation of the nerve impulses through the atrioventricular node of the cardiac conduction system.
- The blockade of the legs of the Guiss bundle, intracardiac local blockade of the nerve impulses in Purkinje fibers.
- Arterial hypertension and collapse (significant, threatening reduction in systemic arterial pressure).
- Cardiogenic shock.
- Insufficient amount of certain ions in the blood - hypokalemia, hypocalcemia.
- Thyrotoxicosis (a significant increase in thyroid hormones) and hypothyroidism (insufficient functional activity of the thyroid gland).
- Pregnancy at any time and breastfeeding.
Determination of the possible presence of contraindications should be carried out before the use of Amiodarone tablets.
Dosing and Administration
The scheme and duration of therapy using Amiodarone tablets is determined by the doctor individually, depending on the underlying pathology and the degree of cardiac rhythm disturbances. Tablets are taken whole, after meals, washed down with enough 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 is a two-day break. A regimen of administration is also possible, including daily pills for 3 weeks followed by a break of 7 days.
Taking Amiodarone tablets can cause certain side effects from various systems and organs, including:
- Sense organs - uveitis (inflammation of the choroid), lipofuscin deposition in the cornea.
- Heart - the development of bradycardia (a significant reduction in the frequency of contractions of the heart), atrioventricular block (impaired impulse through the atrioventricular node).
- Respiratory organs - shortness of breath, 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, loss of appetite, abdominal distention (flatulence), dulling of taste when eating, diarrhea, abdominal pain of a spastic nature.
- Allergic reactions - skin rash, itching, exfoliative dermatitis, angioedema , urticaria . In severe cases, the development of anaphylactic shock (multiple organ failure with a marked reduction in systemic arterial pressure).
In the event of the development of any side effects, depending on their severity, the dose of the drug is reduced or discontinued.
When the dose is exceeded and the accumulation of amiodarone hydrochloride in the body primarily develops disorders of the functional activity and heart rhythm - sinus bradycardia, atrioventricular node block, ventricular tachycardia. There may also 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 severity of symptoms of overdose.
The drug can only be taken after prescribing by a doctor, who determines the treatment regimen and dosage on the basis of data from a clinical study and an ECG. It is also necessary to take into account such special instructions:
- It is impossible to combine the use of Amiodarone tablets with other antiarrhythmic drugs, since this will lead to an increase in its effects and the development of disturbances in the functional activity of the heart. The combination with antimalarial drugs, macrolide antibiotics, fluoroquinolones is also excluded.
- With increased caution and continuous ECG monitoring of the heart, Amiodarone tablets are prescribed when used together with beta-blockers, laxatives and diuretics, which remove potassium ions from the body (potassium does not save diuretics - furosemide), anticoagulants (warfarin), some antibiotics (rifampicin) and antiviral drugs (especially drugs that inhibit reverse transcriptase of viruses).
- Before starting to use the drug, it is recommended to study the functional activity of the thyroid gland and the level of its hormones in the blood.
- With prolonged use, ECG monitoring of the heart is required, as well as determination of the level of thyroid hormones and liver enzymes in the blood.
- In the case of cough and shortness of breath, an x-ray examination of the chest organs is performed to differentiate the inflammatory pathology of the respiratory organs.
- While taking Amiodarone tablets, it is necessary to abandon activities involving increased concentration of attention and requiring a high rate of psychomotor reactions.
In pharmacies, the drug is released only by prescription.
Terms and conditions of storage
Amiodarone tablets should be stored in a dark, dry, out of reach of children at a temperature not higher than + 25 ° C. Shelf life - 3 years.
Analogs of Amiodarone
Analogues of Amiodarone tablets are drugs Kordaron, Ritmorest, Cardiodarone, Amiokordin, Vero-Amiodarone.
Amiodarone tablets 200 mg, 30 pcs. - from 74 rubles.