Panangin, 158 mg+140 mg 100 pcs

Pharmacotherapeutic group:potassium and magnesium drug.
ATX code: A12CX

Pharmacodynamics:Critical intracellular potassium (K+) and magnesium (Mg++) cations play key roles in the function of numerous enzymes, in the formation of bonds between macromolecules and intracellular structures, and in the mechanism of muscle contractility. The intra- and extracellular ratios of potassium, calcium, sodium, and magnesium ions influence myocardial contractility. Endogenous aspartate acts as a conductor of ions: it has a high affinity for cells; due to slight dissociation of its salts, ions in the form of complex compounds penetrate the cell. Magnesium and potassium aspartates improve myocardial metabolism. Magnesium/potassium deficiency predisposes to the development of arterial hypertension, coronary artery atherosclerosis, arrhythmias and metabolic changes in the myocardium. Taking magnesium and potassium aspartates helps to compensate for the lack of these electrolytes in food.

Pharmacokinetics:

Magnesium
The total magnesium reserve in a 70 kg person averages 24 g (1000 mmol); more than 60% of magnesium is in bone tissue and about 40% in skeletal muscle and other tissues. About 1% of the body’s total magnesium supply is in extracellular fluid, primarily serum. In healthy adults, serum magnesium content is in the range of 0.7-1.10 mmol/l.
Magnesium is absorbed from the gastrointestinal tract by active transport. The main regulator of magnesium balance in the body is the kidneys. 3-5%
of ionized magnesium is excreted by the kidneys.
Increased urine volume (for example, during therapy with loop diuretics) leads to increased excretion of ionized magnesium. If absorption of magnesium in the small intestine is reduced, subsequent hypomagnesemia results in decreased excretion (< 0.5 mmol/day).

Kalium
The total potassium reserve in a 70 kg body weight is on average 140 g (3570 mmol). The total potassium reserve is somewhat lower in women than in men and decreases slightly with age. 2% of the body’s total potassium supply is outside the cells, and the remaining 98% is inside the cells. Potassium is absorbed in the gastrointestinal tract.
Optimal intake of potassium with food is 3-4 g (75-100 mmol) per day. The main route of potassium excretion is through the kidneys (about 90% of potassium is excreted daily by the kidneys). The remaining 10% is excreted through the gastrointestinal tract. Thus, the kidneys are responsible for the long-term homeostasis of potassium, as well as for the content of potassium in the blood plasma. In the short term, blood potassium content is also regulated by the flow of potassium between the intracellular and extracellular space.

Indications

To eliminate potassium and magnesium deficiency in combination therapy for various manifestations of coronary heart disease (including acute myocardial infarction); chronic heart failure; cardiac arrhythmias (including arrhythmias caused by overdose of cardiac glycosides).

Active ingredient

Potassium and magnesium asparaginate

Composition

Active ingredients:
Magnesium asparaginate 140.0 mg (in the form of magnesium asparaginate-4 H₂O – 175.00 mg)
Potassium asparaginate 158.0 mg (in the form of potassium asparaginate-1/2 H₂O – 166.30 mg).

Excipients:
Silicon dioxide, colloidal – 2.00 mg, povidone K30 – 3.30 mg, magnesium stearate – 4.00 mg, talc – 10.00 mg, corn starch – 86.10 mg, potato starch – 3.30 mg in the core of the tablets.

Shell composition:
Macrogol 6000 – 1.40 mg, titanium dioxide Color. 77891, E171 – 5.30 mg, butyl methacrylate, dimethylaminoethyl methacrylate and methyl methacrylate copolymer [1:2:1] – 6.00 mg, talc – 7.30 mg.

How to take, the dosage

Consult a physician before use.
Inside, without chewing and with plenty of water. The drug should be used after meals, because the acidic environment of the stomach reduces its effectiveness.

Normal daily dose: 1-2 tablets 3 times a day. Maximum daily dose: 2 tablets 3 times a day.

Duration of drug administration and necessity of repeated courses is determined by the physician.

Application in children and adolescents
No data on safety and efficacy of Panangin® administration in children and adolescents are available.

Interaction

Pharmacodynamic interaction: combined use with potassium-saving diuretics (triamterene, spironolactone), beta-adrenoblockers, cyclosporine, heparin, angiotensin-converting enzyme inhibitors (ACE), nonsteroidal anti-inflammatory drugs increases the risk of hyperkalemia up to arrhythmia and asystole. Concomitant use of potassium preparations with glucocorticosteroids eliminates hypokalemia caused by the latter. Potassium decreases undesirable effects of cardiac glycosides. Panangin® enhances negative dromo- and batmotropic effects of antiarrhythmic drugs.
Magnesium reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin.
Anesthetics increase suppressive effect of magnesium preparations on CNS; simultaneous use with atracuronium, decamethonium, succinyl chloride and
suxamethonium may increase neuromuscular blockade; calcitriol increases magnesium content in blood plasma, calcium preparations reduce the effect of magnesium preparations.

Pharmacokinetic interaction: Drugs with astringent and coating action decrease magnesium asparaginate and potassium asparaginate absorption in gastrointestinal tract, therefore a three-hour interval between oral administration of Panangin® and the above mentioned drugs should be observed.

Special Instructions

Patients with diseases accompanied by hyperkalemia require special attention: regular monitoring of plasma potassium content is necessary.
Each film-coated tablet of Panangin® contains 36.2 mg of potassium. This should be considered in patients with impaired renal function or in patients receiving potassium preparations or potassium-containing food supplements.

Impact on driving and operating ability

Studies have not been conducted. No effect is expected on the ability to drive vehicles and engage in activities requiring increased concentration and rapid psychomotor reactions.

Synopsis

Round biconvex film-coated tablets, white or almost white, with a slightly shiny and uneven surface, almost odorless.

Contraindications

High sensitivity to any of the drug components, acute and chronic renal failure, hyperkalemia, hypermagnesemia, Addison’s disease, grade I-III atrioventricular block, cardiogenic shock (blood pressure less than 90 mm Hg., amino acid metabolism disorders, severe myasthenia gravis, hemolysis, acute metabolic acidosis, dehydration, age under 18 years (efficacy and safety have not been established).

Cautions

Pregnancy (especially in the first trimester) and during lactation.

Side effects

Nausea, vomiting, diarrhea, discomfort or burning in the epigastrium (in patients with anacidic gastritis or cholecystitis), atrioventricular blockade, paradoxical reaction (increased number of extrasystoles), hyperkalemia (nausea, vomiting, diarrhea, paresthesias), hypermagnesemia (redness of face, thirst, decrease of blood pressure, hyporeflexia, respiratory depression, seizures) are possible.

If any of these adverse reactions become serious, or if you notice the appearance of adverse reactions not listed in this instruction, you should consult a physician.

Overdose

Risk of hyperkalemia and hypermagnesemia symptoms increases.

Symptoms of hyperkalemia: fatigue, myasthenia, paresthesias, confusion, heart rhythm disorders (bradycardia, atrioventricular block, arrhythmias, cardiac arrest).

Symptoms of hypermagnesemia: reduction of neuromuscular excitability, nausea, vomiting, lethargy, decreased blood pressure.

With a sharp increase in blood magnesium ions: suppression of deep tendon reflexes, respiratory paralysis, coma.

Treatment: symptomatic therapy – intravenous calcium chloride administration at a dose of 100 mg/min, if necessary – hemodialysis.

Pregnancy use

Application is possible if the potential benefit to the mother exceeds the possible risk to the fetus.
Potassium and magnesium asparaginate penetrate into the breast milk. If it is necessary to take the drug while breastfeeding, breastfeeding should be stopped.

Similarities

Panangin, Asparkam, Potassium and Magnesium Asparaginate, Panangin Forte