Isoket, concentrate 1 mg/ml 10 ml 10 pcs

Isoket – hypotensive, antianginal.

Pharmacodynamics

Peripheral vasodilator with predominant effect on the venous vessels. Stimulates the formation of nitric oxide (endothelial relaxing factor) in the vascular endothelium, causing activation of intracellular guanylate cyclase, the consequence of which is an increase of cGMP (mediator of vasodilation). Reduces myocardial oxygen demand by reducing preload (reduces left ventricular end-diastolic volume and reduces systolic stress on its walls). It has coronary dilator effect.

Limits blood flow to the right atrium, helps decrease the pressure in the small circle of the blood circulation and regresses symptoms of pulmonary edema.

Promotes redistribution of coronary blood flow to areas with decreased blood flow. Increases tolerance to physical activity in patients with coronary heart disease, angina pectoris. It dilates the vessels of the brain, dura mater, which may be accompanied by headache.

As with other nitrates, cross-tolerance develops. After withdrawal (interruption of treatment), sensitivity to it quickly recovers. After spraying on the oral mucosa, the effect is evident in 30 seconds and lasts 15-120 minutes.

Indications

Active ingredient

Composition

Active ingredient:

Isosorbide dinitrate 10 mg.

How to take, the dosage

The dose of Isoket should be selected individually. Treatment should be started with low doses, gradually increasing to the necessary.
The initial dose is 2-7 mg/h. In individual cases, the dose may be increased to 10 mg/h.

For patients with heart failure, higher doses are usually required, up to 50 mg/h in some cases. The average dose is 7.5 mg/h.

The solution is administered as an IV infusion using automated infusion systems under hospital conditions with constant monitoring of cardiovascular parameters. Depending on the type and severity of the disease, in addition to the usual examination (symptoms, control of BP, heart rate, diuresis), invasive procedures are performed to determine hemodynamic parameters.

The solution concentrate is sterile and contains no preservatives. The 0.1% solution should be opened under aseptic conditions immediately prior to use.

Interaction

In concomitant use of Isoket with other vasodilators (vasodilators), hypotensive drugs, beta-adrenoblockers, calcium channel blockers, phosphodiesterase type 5 inhibitors used for treatment of erectile dysfunction (for example, sildenafil), neuroleptics, tricyclic antidepressants, and ethanol may increase the hypotensive effect./p>

In concomitant use of Isoket with dihydroergotamine an increase in dihydroergotamine concentration in blood may be noted, which leads to an increase in its hypotensive effect.

Special Instructions

When using Isoket, cardiovascular system parameters should be monitored: BP control (systolic BP not lower than 100 mmHg), ECG monitoring, HR, urinary volume (bladder catheterization).

As the 0.1% solution of Isocet is an oversaturated solution, crystallization of the substance may be observed. Although under normal conditions this does not affect the activity of the drug, it is not recommended to use the solution in case of crystallization.

Contraindications

Side effects

Cardiovascular system disorders: at the first use or when increasing the dose of the drug a decrease in BP and/or orthostatic hypotension may occur, which may be accompanied by a reflex increase in heart rate, lethargy as well as dizziness and a feeling of weakness. Headache (“nitrate” headache) may appear at the beginning of treatment, which usually disappears after a few days with further use of the drug. In rare cases with a pronounced decrease of BP, an increase in symptoms of angina pectoris may be observed.

In isolated cases, collaptoid states, sometimes with bradycardia and syncope (seizures with impaired consciousness, dizziness associated with cerebral circulation disorders due to heart rhythm disturbances, primarily caused by significant palpitations) have been observed.

Digestive system disorders: rarely – nausea, vomiting.

Others: skin redness, allergic skin reactions; in some cases – exfoliative dermatitis.

Similarities