Nadecin 10mg prevention and treatment of angina, congestive heart failure (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Isosorbidi Dinitras

Ingredient

Composition information	Content
Isosorbidi Dinitras	10mg

Uses

indications

Nadecin 10mg drug is indicated in the following cases:

Prevent and treat angina.

Treatment of congestive heart failure (in combination with other drugs).

Into the body, nitrates are converted into oxyde nitric (NO) root thanks to Glutathion - S -Reductase and Cysteine; NO combined with the thiol group into nitrosothiol (R - sno), this substance activates Ganylat Cyclase to convert guanosin triphosphate (GTP) into guanosin 3'-5 'monophosphate ring (GMPC).

GMPC makes myosin in vascular fibers not activity, unable to combine with Actin, so they dilate.

Pharmacology

Nitrates act primarily on the vein system, with high doses that relax the artery system and coronary artery. Venous relaxation causes blood stagnation in the peripheral and in viscera, reducing the amount of blood in the heart (reducing the burden), the result is to reduce the pressure in the heart chambers.

Stretching the arteries leads to peripheral resistance (reduced post -burden), resulting in reducing blood pressure, especially systolic blood pressure, although not much but can cause sympathetic reflexes that make the circuit slightly fast and increase myocardial muscle contraction. The nitrates also have the effect of inhibiting platelets.

In the failure, reducing the burden, reducing the burden will reduce the attack and oxygen consumption of the heart muscle, supply and demand for the balanced heart muscle will quickly cut angina. The drug also relaxes coronary artery, losing vascular spasms, and long -term use also has the effect of redistributing blood benefits for the inner heart and developing the circulatory system.

In heart failure, nitrate due to reducing the amount of blood in the heart should improve the burden, reduce the right ventricular pressure and the pressure of the pulmonary circulation, thus reducing the signs of blood stasis, with the appropriate doses, the drug reduces the burden, creates better conditions for the heart disease, increases the volume of systolic and cardiac supply.

Use long -term nitirat, prone to the phenomenon of "escape" to gradually lose the effect of the drug. It is explained that may be due to lack of reserve - SH, due to the lack of glutathion - S -reducase enzymes needed to metabolize nitrates, due to increased intravascular volume, activation of vasoconstriction that responds to the vasodilation effect of the drug. So in the day, it is recommended to arrange for a while of at least 8 hours without drugs.

Pharmacokinetics

absorption

Isosorbid Dinitrate (ISDN) is used in oral form, faster absorption when sucking under the tongue or chewing.

Distribution

The drug is combined with plasma protein up to 28 ± 12%.

Metabolism

The drug is metabolized a lot when passing the liver for the first time. Two main metabolites are active, isosorbid - 2 mononitrate (2 -an) with short -effect time and isosorbid - 5 Mononitrate (5 - ISMN) has a longer -effect time.

Elimination

Eliminate mainly through urine. Half life eliminates plasma of ISDN is 50 ± 20 minutes, of 2 - ISMN about 2 hours, of 5 - ISMN about 5 hours.

Before taking Nadecin 10mg prevention and treatment of angina, congestive heart failure (3 blisters x 10 tablets)

How to use

Nadecin 10mg tablets for oral tablets.

Time of effects of the drug depends on how to take the drug:

Take: Start working after 15 - 45 minutes, maximum effect after 45-10 minutes, lasting 2 - 6 hours. Slow liberation tablets can last up to 24 hours.

Dosage

adults

Angina

Take the dose of 30 - 120 mg daily, the dose is divided as required by each individual. Dosage should be gradually increased to minimize the possibility of nitrate headaches.

Treatment for congestive heart failure

Dosage for severe congestive heart failure is 40 - 160 mg daily, the dose is divided as required by each individual. The best optimal dosage is determined by continuous hemodynamic monitoring. The use of Isosorbide Dinitrate tablets in severe congestion heart failure should be considered as a therapy combined with conventional treatments (such as using heart glycoside, diuretics).

Maximum daily dose should not exceed 240 mg.

Other objects

Elderly

There is no special instructions, but need to be cautious, especially for people who are sensitive to drugs that cause hypotension.

Children

Safety and effectiveness of drugs for children has not been determined.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

The most common when overdose is hypotension, headache such as a hammer, tachycardia, blushing. When the dose is too high, methemoglobin can occur.

How to handle

Treatment of hypotension is needed for patients in a lying position to raise their legs, can be injected with epidemics, treatment of purple blue by methemoglobin blood by methylene intravenous intravenous injection at a dose of 1 - 2 mg/kg body weight. Gastric lavage immediately if used by oral medication.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Nadecin 10mg, you may experience unwanted effects (ADR).

The first days of treatment often have headaches (25% of users), due to the vasodilation effect of the drug. This symptom is out after a week.

Common, ADR

Cardiovascular: Peripheral vasodilation makes the skin flushing, especially in the chest and face, the vasodiles in the eye are easy to increase the secretion and increase glaucoma, relax the vascular vessels in the brain that can increase the intracranial pressure and cause headaches.

Lower blood pressure, dizziness, dizziness occurs when taking drugs for patients with low blood pressure, the elderly.

Uncommon, 1/1000

Skin exterior: There may be rash, flaking dermatitis, digestive disorders.

Rare, ADR

Blood: With a higher dose than the treatment dose, there may be a blood methemoglobin due to Fe2+ oxygen of the hemorrhage to the Fe3+ hematoma to make the blood from transporting oxygen.

Digestive: nausea.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Nadecin 10mg drug is contraindicated in the following cases:

Low blood pressure, cardiovascular collapse.

severe anemia.

Increased intracranial pressure, glaucom.

Right myocardial infarction.

Aortic valve stenosis, congested heart disease.

Contragging pericarditis.

allergies to organic nitrates.

Be cautious when used

When taking the drug, the dose should be increased slowly to avoid the risk of lowering blood pressure and headache in some patients who should sit or lie after the drug.

When using high doses, do not reduce the drug suddenly.

Because there is not enough information about the effects of the drug on pregnant women and whether the drug can be through breast milk, should not use the drug for women who are breastfeeding.

The ability to drive and operate machinery

Due to the side effects of the drug that causes hypotension with standing posture with symptoms such as dizziness, patients should be careful when driving or operating machinery if they have these symptoms.

Pregnancy

There has been no report on the drug of the drug with pregnant women.

The period of breastfeeding

It is unknown whether the drug is excreted in milk or not. ISOSORBID DINITRAT should not be used for breastfeeding people.

Medicinal interaction

Nitrate -containing preparations when used with alcohol will increase vasodilation effect and cause serious vertical posture.

When taking the drug with DisopyID phosphate anti -saliva effect of Disopyramid hindering the dissolution of the ISOSorbid Dinitrat lozenges.

Storage

Store under 30 ° C, in the original packaging.

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.