Panangin Forte, 316 mg+280 mg 60 pcs

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

Pharmacodynamics
Essential 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 asparaginate acts as a conductor of ions: it has a high affinity for cells, due to the insignificant dissociation of its salts, ions in the form of complex compounds penetrate the cell. Magnesium asparaginate and potassium asparaginate improve myocardial metabolism.
Magnesium / potassium deficiency predisposes to the development of arterial hypertension, coronary atherosclerosis, arrhythmias and metabolic changes in myocardium.
Each tablet of Panangin® Forte preparation contains 280 mg of magnesium aspartate and 316 mg of potassium aspartate that is twice more content of active substances in Panangin®, film-coated tablets. The daily dose of Panangin® Forte: 1 tablet 3 times a day corresponds to the daily dose of Panangin®: 2 tablets 3 times a day. Taking a single dose of Panangin® Forte as a single tablet makes the treatment more convenient for the patient.

Pharmacokinetics
Potassium and magnesium asparginates are intensively absorbed in intestine, mainly in small intestine. It is excreted by the kidneys.

Indications

Tachycardia, Heart FailureTo eliminate potassium and magnesium deficiency in combination therapy for various manifestations of coronary heart disease (including acute myocardial infarction); chronic heart failure; heart rhythm disorders (including arrhythmias caused by overdose of cardiac glycosides)

Active ingredient

Potassium and magnesium asparaginate

Composition

Pill kernel

Active ingredients: potassium asparaginate 316.00 mg (in the form of potassium asparaginate hemihydrate 332.60 mg), magnesium asparaginate 280.00 mg (in the form of magnesium asparaginate tetrahydrate 350.00 mg);

Additives: corn starch, talc, magnesium stearate, potato starch, povidone K30, colloidal silica;

Pill coating: talc, butyl methacrylate copolymer, titanium dioxide (color index: C.I. 77891, E171), macrogol-6000.

How to take, the dosage

Before use it is necessary to consult with a physician.

In the mouth, without chewing and with plenty of water.

Panangin® Forte should be taken after eating, because the acidic environment of the stomach reduces its effectiveness.

Recommended daily dose: 1 tablet 3 times a day.

Maximum daily dose: 1 tablet 3 times a day.

Interaction

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

Pharmacokinetic interaction
. Medicines 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® Forte and the above medicines should be observed.

Special Instructions

Patients with diseases accompanied by hyperkalemia require special attention: regular monitoring of plasma potassium content is necessary.

Impact on the ability to drive vehicles and mechanisms

Studies have not been conducted. No effect is expected on the ability to drive vehicles and work with mechanisms that require high concentration and speed of psychomotor reactions
.

Synopsis

Oval, biconvex film-coated tablets, white or almost white, with a slightly glossy surface, engraved “A83” on one side, almost odorless. On the cross section white or almost white color.

Contraindications

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

With caution
Pregnancy (especially in the first trimester of pregnancy) and breast-feeding period

Side effects

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

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

Use 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