Nitrosorbide, tablets 10 mg 60 pcs

Peripheral vasodilator with predominant effect on the venous vessels. Antianginal agent. The mechanism of action is associated with the release of the active substance nitric oxide in the vascular smooth muscle.

Nitric oxide causes activation of guanylate cyclase and increases the level of cGMP, which ultimately leads to relaxation of smooth muscles. Under the influence of isosorbide dinitrate, arterioles and precapillary sphincters relax less than large arteries and veins. This is partly due to reflex reactions, as well as less intense formation of nitric oxide from the active substance molecules in the walls of the arterioles.

The action of isosorbide dinitrate is mainly due to the reduction of myocardial oxygen demand by reducing preload (dilation of peripheral veins and reduction of blood flow to the right atrium) and postload (reduction of PPS), as well as the direct coronary dilatation action. It promotes redistribution of coronary blood flow in the area with reduced blood supply.

Enhances exercise tolerance in patients with CHD, angina pectoris. In heart failure helps to unload the myocardium by reducing the preload. It decreases pressure in the small circle of the circulation.

Indications

For oral, sublingual, buccal administration: control and prevention of angina attacks, rehabilitation treatment after myocardial infarction. Chronic heart failure (as part of combination therapy), some forms of pulmonary hypertension, pulmonary heart failure (as part of combination therapy).

For oral injection: cure and prevention of angina attacks; as first aid in acute myocardial infarction and acute left ventricular failure in the pre-hospital phase. Prevention and treatment of coronary artery spasm when using a cardiac catheter.

For IV administration: acute myocardial infarction, including one complicated by acute left ventricular failure; unstable angina pectoris; pulmonary edema.

For topical application: prophylaxis of angina attacks.

Active ingredient

Interaction

In concomitant use with adsorbents, astringents and coating agents, absorption of isosorbide dinitrate is reduced.

Concomitant use of antihypertensive agents, peripheral vasodilators, calcium channel blockers, beta-adrenoblockers, antipsychotics (neuroleptics), tricyclic antidepressants, FDE inhibitors, ethanol may increase the hypotensive effect.

When used concomitantly with anticholinergic agents, memory and attention disorders are possible in elderly patients.

Concomitant use with sympathomimetic agents may decrease the antianginal effect of isosorbide dinitrate.

Concomitant use with dihydroergotamine may increase the concentration and potency of dihydroergotamine.

Concomitant use with norepinephrine decreases the therapeutic effect of norepinephrine.

Concomitant use with sildenafil causes the risk of severe arterial hypotension and myocardial infarction.

Directions for use

When administered orally, the single dose is 10-120 mg, the frequency of administration is 1-5 times a day, depending on the indication and the dosage form used.

In sublingual or buccal administration, the single dose is 5-10 mg; the frequency of administration depends on the indication and the patient’s response to treatment.

Injection into the oral cavity uses 1-3 doses at intervals of about 30 seconds against a background of breath-holding. In acute myocardial infarction and acute heart failure, the initial dose is 1-3 injections. If there is no improvement after 5 min, the injection can be repeated, provided that BP and HR are constantly monitored. To prevent coronary spasm in case of catheterization, 1-2 doses should be administered immediately before the procedure.

In case of IV administration, the dosing regimen depends on the clinical situation and the dosage form used.

For topical use, the starting dose is 1 g at night, before bedtime and, if necessary, in the morning.

The duration of treatment is determined on a case by case basis.

Special Instructions

With caution is used in patients with cerebral circulatory disorders, with aortic and/or mitral stenosis; in patients prone to orthostatic hypotension; in elderly patients. During the treatment period, especially if the dose is gradually increased, BP and HR should be monitored.

Do not drink alcohol during treatment.

Isosorbide dinitrate Effect on driving and operating machinery

During treatment, it is not recommended to drive vehicles and engage in other potentially hazardous activities because regular use impairs the ability to concentrate and the speed of psychomotor reactions.

Contraindications

Side effects

Cardiovascular system disorders: dizziness, headache, tachycardia, transient facial hyperemia, fever, arterial hypotension; in some cases – exacerbation of angina attacks (paradoxical reaction).

Digestive system disorders: nausea, vomiting, mild burning sensation of the tongue, dry mouth.

CNS and peripheral nervous system disorders: drowsiness, blurred vision; rarely – brain ischemia and collapse.

Allergic reactions: skin rash.

Pregnancy use

Similarities