Sydnopharm, tablets 2 mg 30 pcs

Pharmacodynamics

Sydnopharm has venodilator, antiaggregant, analgesic and antianginal action. Venodilator activity is due to the release of nitric oxide (N0), stimulating soluble guanylate cyclase, after a series of metabolic transformations, in this regard, molcidamine is considered as a “donator” of N0. Accumulation of cGMP causes relaxation of smooth muscle cells of the vascular wall (mostly veins).

The reduction of preload, even without direct effect on myocardial contractility, leads to restoration of the disturbed in patients with coronary insufficiency correlation between oxygen demand and oxygen supply (oxygen demand decreases by 26%).

May widen the sections of the coronary arteries capable of vasodilation, improves collateral circulation.Increases exercise tolerance, reduces the number of angina attacks that occur during exercise. Suppresses the early phase of platelet aggregation, reduces the release and synthesis of serotonin, thromboxane and other proaggregants.

In patients with chronic heart failure, by reducing the preload, it helps to reduce the size of the heart chambers. It reduces the pressure in the pulmonary artery, decreases left ventricular filling and myocardial wall tension, blood stroke volume. The action begins 20 minutes after oral administration, reaches a maximum in 0.5-1 hour and lasts up to 6 hours. Unlike nitrates, the development of tolerance with a decrease in efficacy during long-term therapy is uncharacteristic.

Pharmacokinetics

After oral administration, Sydnopharm is almost completely absorbed from the gastrointestinal tract. Bioavailability is 60-70%. Maximum concentration is reached (4.4 mcg/ml) -1 hour. When taken orally after a meal, absorption, although slower, is not reduced (maximum plasma concentration is reached 30-60 minutes later than when taken on an empty stomach).

The minimum effective concentration of molcidomine in blood plasma is 3-5 ng/ml. It is practically not bound to plasma proteins. It is metabolized in liver with formation of pharmacologically active compound SIN-1, (3-morpholino-sidnonimine), from which very unstable substance SIN-la (N-morpholino-N-aminosinonitrile) is formed, which releases NO with formation of pharmacologically inactive compound SIN-lc. Other metabolites are also formed during metabolism.

It is excreted by the kidneys by 90% (as metabolites), 9% – through the intestine. The elimination half-life is 0.85-2.35 hours. It does not cumulate (including in patients with renal insufficiency). In severe hepatic insufficiency (increase of bromsulfalein test up to 20-50%) retardation of excretion and increase of its concentration in blood plasma were noted.

Indications

Preventing angina attacks.

Active ingredient

Composition

1 tablet contains:

the active ingredient:

Molcidomine 2.00 mg.

Auxiliary substances:

lactose,

wheat starch,

mannitol,

colloidal silicon dioxide,

magnesium stearate,

/p>

hydroxypropyl methylcellulose,

mint oil,

“Sunset yellow” dye,

microcrystalline cellulose.

How to take, the dosage

Overly, regardless of meals. Sidnopharm tablets are swallowed whole, without chewing and with plenty of liquid.

Start taking the drug in small doses – ½ to 1 tablet 2 times a day.

If the therapeutic effect is not enough the number of times a day is increased up to 3 times a day.

The maximum daily dose is 6 mg.

The dosage and duration of treatment are determined individually.

Interaction

In concomitant administration of Sidnopharm with other vasodilators, antihypertensive drugs and ethanol the severity of the hypotensive effect is increased.

Acetylsalicylic acid increases antiaggregant activity.

Special Instructions

Do not use Sidnopharm to stop angina attacks!

The first dose of the drug is administered with caution (and under BP control), intense headaches and excessive BP reduction with loss of consciousness are possible.

Elderly patients with hepatic or renal impairment and arterial hypotension require dose adjustment.

Ethanol administration should be avoided during treatment.

If it is necessary to prescribe the drug during lactation, breastfeeding should be discontinued.

At the time of treatment (especially at the beginning) it is necessary to refrain from driving and engaging in potentially hazardous activities requiring increased concentration and quick psychomotor reactions.

Contraindications

Side effects

Overdose

Symptoms: severe headaches, marked BP decrease, tachycardia.

Treatment: symptomatic.

Pregnancy use

The use of Sidnopharm is contraindicated in pregnancy.

If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.