Vasokardin
Vasokardin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Vasocardin
ATX code: C07AB02
Active ingredient: metoprolol (metoprolol)
Manufacturer: Zentiva as (Slovak Republic)
Description and photo update: 2019-26-08
Vasokardin is a drug with antihypertensive, antiarrhythmic and antianginal action, used for arterial hypertension and some other cardiac disorders.
Release form and composition
Vazokardin is produced in the form of tablets (flat, round, from white to white with a creamy shade, with a risk and a chamfer on one side, slight marbling is possible), 10 pieces in blisters, 2 or 5 blisters in cardboard boxes.
The composition of 1 tablet contains 50 mg or 100 mg of the active substance - metoprolol tartrate.
Auxiliary components that make up Vasocardin: povidone K25, lactose monohydrate, colloidal silicon dioxide, corn starch, microcrystalline cellulose, calcium stearate, methylated silicon dioxide, sodium carboxymethyl starch.
Pharmacological properties
Pharmacodynamics
The active substance of Vasocardin is metoprolol, an antihypertensive and antianginal agent from the group of selective beta 1 -adrenoreceptor blockers.
Metoprolol reduces the activity of plasma renin and blocks the activity of catecholamines at the level of beta-adrenergic receptors. Reduces myocardial oxygen demand, lengthens the refractory phase, reduces diastolic (after a few weeks of therapy) and systolic (with arterial hypertension) blood pressure. Decreases the heart rate, suppresses the automatism of the sinus node, slows down atrioventricular conduction, lowers cardiac selection, excitability and myocardial contractility.
The drug is effective in arterial hypertension and long-term therapy of angina pectoris.
Pharmacokinetics
After taking Vazocardin inside, metoprolol is well absorbed (95%) from the gastrointestinal tract. The maximum concentration in blood plasma reaches within 1.5–2 hours. It is characterized by the effect of the first passage through the liver.
With a single dose, the bioavailability of metoprolol is approximately 50%, with repeated administration - 70%.
Communication with plasma proteins - 10%. The volume of distribution is 5.5 l / kg.
Biotransformed in the liver with the formation of pharmacologically inactive metabolites. It is excreted mainly by the kidneys in the form of metabolites; about 5% of metoprolol is excreted unchanged. The half-life (T ½) is approximately 3.5 hours.
Penetrates into breast milk.
In severe hepatic impairment, the pharmacokinetic parameters of metoprolol may change, which may require dose adjustment.
In patients with impaired renal function and elderly patients, significant changes in the pharmacokinetics of metoprolol are not observed.
Indications for use
According to the instructions, Vasokardin is prescribed for:
- Arterial hypertension (in monotherapy or simultaneously with other antihypertensive drugs);
- Ischemic heart disease: myocardial infarction (complex therapy, secondary prevention), prevention of angina attacks;
- Functional disorders of cardiac activity, accompanied by tachycardia;
- Hyperthyroidism (as part of complex therapy);
- Violation of the rhythm of the heart (ventricular extrasystole, supraventricular tachycardia);
- Prevention of migraine attacks.
Contraindications
The use of Vasokardin is contraindicated in:
- Cardiogenic shock;
- Sinoatrial blockade;
- AV blockade II-III degree (without an artificial pacemaker);
- Sick sinus syndrome;
- Prinzmetal's angina;
- Severe peripheral circulatory disorders;
- Chronic heart failure in the stage of decompensation;
- Sinus bradycardia (with a heart rate (HR) less than 50 beats per minute);
- Acute myocardial infarction (heart rate less than 45 beats per minute, PQ interval more than 0.25 seconds, systolic blood pressure less than 100 mm Hg);
- Arterial hypotension (if used for secondary prevention of myocardial infarction - systolic blood pressure less than 100 mm Hg, heart rate less than 45 beats per minute);
- Hereditary diseases - lactase deficiency, lactose intolerance or glucose-galactose malabsorption (due to lactose that is part of Vasocardin);
- Pheochromocytoma (without the simultaneous use of alpha-blockers);
- Hypersensitivity to metoprolol, other components of the drug and other beta-blockers.
Also, Vasokardin is not prescribed:
- Simultaneously with MAO inhibitors, intravenous administration of calcium channel blockers such as verapamil;
- Pregnant and breastfeeding women;
- Patients under the age of 18 years (the safety and efficacy of using Vasocardin for this age group have not been established).
Vasokardin should be used with caution in elderly patients, as well as in patients with:
- Metabolic acidosis;
- Diabetes mellitus;
- Depression (including a history);
- Impaired renal function (CC less than 40 ml per minute);
- Liver dysfunction;
- AV blockade of the 1st degree;
- Myasthenia gravis;
- Chronic obstructive pulmonary disease (emphysema, chronic obstructive bronchitis);
- Psoriasis;
- Thyrotoxicosis;
- History of allergic reactions (possibly a decrease in the therapeutic response to epinephrine, aggravation of arterial hypertension and increased sensitivity to allergens);
- Obliterating diseases of peripheral vessels (Raynaud's syndrome, intermittent claudication);
- Bronchial asthma.
Instructions for the use of Vasokardin: method and dosage
Vasokardin tablets are taken orally with a small amount of water, during or immediately after a meal. If necessary, the tablets can be divided in half and swallowed without chewing.
For arterial hypertension, the drug is prescribed in a daily dosage of 50-100 mg with a frequency of administration 1-2 times a day (morning and evening). If the effect is insufficient, you can gradually increase the daily dose to 100-200 mg and / or additionally take other antihypertensive drugs. The maximum daily dosage of Vasokardin is 200 mg.
With hyperthyroidism, the daily dose is 150-200 mg per day in 3-4 doses.
For arrhythmias, angina pectoris, for the prevention of migraine attacks, the daily dose is 100-200 mg in 2 divided doses (morning and evening).
With the secondary prevention of myocardial infarction, the daily dose is 200 mg in 2 divided doses (morning and evening).
With functional disorders of cardiac activity accompanied by tachycardia, the daily dose is 100 mg in 2 divided doses (morning and evening).
Elderly patients, patients with functional impairment of the kidneys (CC less than 40 ml per minute), as well as, if necessary, hemodialysis, the dosage is not adjusted.
With pronounced violations of liver function, depending on the clinical condition, the dosage of Vasocardin should be reduced.
Side effects
Side effects when using Vasocardin depend on the individual sensitivity of the patient. As a rule, they are mild and disappear after drug withdrawal.
From the side of the central nervous system: weakness, increased fatigue, drowsiness, confusion, headache, convulsions, slowing down of the speed of motor and mental reactions, paresthesia in the extremities (in patients with Raynaud's syndrome and intermittent claudication), anxiety, depression, depression, decreased concentration attention, anxiety, increased nervous irritability, insomnia, "nightmares", amnesia, hallucinations, short-term memory impairment, muscle weakness.
From the side of the cardiovascular system: a pronounced decrease in blood pressure, arrhythmias, sinus bradycardia, palpitations, orthostatic hypotension (dizziness, sometimes loss of consciousness), cardiogenic shock in patients with myocardial infarction, AV block of the 1st degree, decreased myocardial contractility, manifestation of angiospasm (increased impairment of peripheral circulation, cooling of the lower extremities, Raynaud's syndrome, gangrene), temporary worsening of symptoms of chronic heart failure (swelling of the lower legs and / or feet, shortness of breath), impaired myocardial conduction.
From the hematopoietic system: agranulocytosis, thrombocytopenia (unusual hemorrhages and bleeding), leukopenia.
From the senses: soreness and dryness of the eyes, decreased vision, tinnitus, decreased secretion of lacrimal fluid, conjunctivitis.
On the part of the respiratory system: rhinitis, nasal congestion, shortness of breath, difficulty in exhaling (bronchospasm when administered in high dosages - loss of selectivity and / or in predisposed patients).
From the digestive system: taste changes, increased activity of liver enzymes, hepatitis, dry mouth, vomiting, nausea, abdominal pain, diarrhea, constipation, liver dysfunction, hyperbilirubinemia.
From the musculoskeletal system: arthralgia, back pain;
From the endocrine system: hypoglycemia, in patients with type 1 diabetes mellitus - hyperglycemia (rarely).
Allergic reactions: rash, pruritus, urticaria.
Dermatological reactions: psoriasis-like skin reactions, exanthema, exacerbation of the course of psoriasis, increased sweating, skin hyperemia, photodermatosis, reversible alopecia.
Influence on the fetus: development of intrauterine growth retardation, bradycardia, hypoglycemia is possible.
Others: sexual dysfunction, decreased libido and / or potency, slight increase in body weight.
Overdose
In case of an overdose of Vasokardin, the first signs appear 20-120 minutes after taking the drug. Overdose is usually expressed by symptoms such as arrhythmia, dizziness, severe sinus bradycardia, nausea, cyanosis, vomiting, marked decrease in blood pressure, bronchospasm, ventricular premature beats, fainting. In acute overdose, cardiogenic shock may develop, loss of consciousness, coma, AV blockade (up to the development of cardiac arrest and complete transverse blockade), hyperkalemia, cardialgia, convulsions, hypoglycemia, respiratory arrest.
For the treatment of an overdose, gastric lavage, the use of adsorbing drugs, symptomatic therapy are indicated. With a pronounced decrease in blood pressure, the patient needs to take the Trendelenburg position. With an excessive decrease in pressure, the development of heart failure and bradycardia, beta-adrenostimulants are injected intravenously (with an interval of 2-5 minutes) until the desired effect or 0.5-2 mg of atropine sulfate is achieved. If there is no effect, administration of dobutamine, dopamine or norepinephrine (norepinephrine) is indicated Hemodialysis is not effective.
special instructions
When using Vasokardin, the patient should be trained in the method of calculating heart rate and instructed to consult a doctor with a heart rate of less than 50 beats per minute.
Monitoring patients taking the drug includes regular monitoring of heart rate, blood pressure, blood glucose concentration in diabetes mellitus. For patients with diabetes mellitus, dosage adjustment of insulin or oral hypoglycemic agents may be required. Vasocardine can mask hypoglycemia-induced tachycardia.
In smoking patients, the effectiveness of the drug is lower.
When taking a dose of more than 200 mg per day, cardioselectivity decreases.
In chronic heart failure, Vasocardin can be taken only after reaching the stage of compensation.
Cancellation of Vasokardin is carried out gradually, reducing the dosage within 10 days. With a sudden cessation of therapy, a withdrawal syndrome may occur (increased blood pressure, increased angina attacks).
With angina pectoris, the selected dosage of the drug should provide a resting heart rate within 55-60 beats per minute, with a load - up to 110 beats per minute.
Patients using contact lenses should take into account that during treatment, there may be a decrease in tear fluid production.
The drug may mask some of the symptoms of hyperthyroidism (eg, tachycardia). Abrupt withdrawal of Vasocardin in patients with thyrotoxicosis is contraindicated (due to a possible increase in symptoms).
In chronic obstructive bronchitis, chronic obstructive pulmonary disease, bronchial asthma, emphysema, the drug should be taken in the minimum effective dosage and only if other antihypertensive drugs are ineffective or poorly tolerated.
It is necessary to carry out special monitoring of the condition of patients with depressive disorders. With the development of depression associated with taking Vasocardin, therapy is recommended to be discontinued.
In elderly patients, it is recommended to regularly monitor liver function. In the case of the development of increasing bradycardia (less than 50 beats per minute), a pronounced decrease in blood pressure (systolic pressure below 100 mm Hg), bronchospasm, AV blockade, severe liver dysfunction, ventricular arrhythmias, a correction of the dosage regimen or withdrawal of Vasocardin is required.
Patients with severe renal insufficiency (CC less than 40 ml per minute) are recommended to monitor renal function.
Excessive sun exposure should be avoided during treatment, as the drug can cause an allergic reaction to the sun.
Influence on the ability to drive vehicles and complex mechanisms
At the beginning of the use of Vasokardin, patients may experience fatigue and dizziness, as a result of which it is recommended to be careful when driving a car and when performing potentially hazardous types of work that require patients to have quick psychomotor reactions and increased concentration of attention.
Application during pregnancy and lactation
Metoprolol is contraindicated during pregnancy.
Women of reproductive age should exclude pregnancy before starting taking Vasocardin, and during treatment, use reliable contraception.
If therapy is necessary during lactation, breastfeeding should be discontinued.
Pediatric use
Vasocardin is not used in pediatrics (in children and adolescents under 18 years of age).
With impaired renal function
In case of impaired renal function, the drug should be used with caution, under medical supervision.
For violations of liver function
In case of impaired liver function, the drug should be used with caution, under medical supervision, since the dose of Vasocardin may need to be adjusted.
Use in the elderly
Elderly patients do not usually need to adjust the dosage regimen of Vasocardin, but such patients are advised to take the drug with caution.
Drug interactions
- MAO (monoamine oxidase) inhibitors: a significant increase in the hypotensive effect is possible (contraindicated combination; at least 2 weeks should elapse between taking the drugs);
- phenothiazines, barbiturates, tricyclic antidepressants, vasodilators, diuretics, nitroglycerin and other drugs with an antihypertensive effect: the risk of arterial hypotension increases;
- lercanidipine: the bioavailability of metoprolol is significantly reduced (dose adjustment of Vasocardine is required);
- adrenaline: its effectiveness decreases;
- nifedipine, verapamil and other calcium antagonists: the risk of severe arterial hypotension, bradycardia and heart failure increases (the use of drugs in combination is allowed only for intensive therapy);
- clonidine, alpha-methyldopa, guanfacine, reserpine, cardiac glycosides: possibly a decrease in heart rate, slowing of intracardiac conduction;
- cimetidine, opioid analgesics: the effects of metoprolol are potentiated;
- rifampicin, indomethacin: the effect of metoprolol decreases;
- lidocaine: its excretion from the body slows down;
- peripheral muscle relaxants: the neuromuscular blockade caused by them increases;
- ethanol: it is possible to increase the severity of the depression of the central nervous system;
- sympathomimetic drugs: the risk of developing arterial hypertension increases;
- hypoglycemic drugs: their effect is enhanced.
Analogs
The analogues of Vasokardin in terms of active substance are: Betaloc, Vasocardin Retard, Betaloc ZOK, Metocard Retard, Corvitol 100, Corvitol 50, Metozok, Emzok, Metocard, Metocor Adipharm, Metolol, Metoprolol, Metoprolol Zentivrol, Serdol-OB -Acri, Metoprolol-ratiopharm, Egilok, Egilok Retard, Egilok S.
Terms and conditions of storage
Store in a dark, dry place at a temperature of 15-21 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Vasokardin
Reviews about Vasokardin are usually found on various thematic sites dedicated to diseases of the cardiovascular system. Most often, patients write about intolerance to this drug, which in many manifests itself as urticaria, skin irritation, and swelling. There are also references to breathing problems and severe headaches. However, doctors note that the most common cause of side effects is inaccurate adherence to the doctor's recommendations.
The price of Vasokardin in pharmacies
Approximate prices for Vasokardin are 64-73 rubles. for 50 tablets of 50 mg, 113-120 rubles. per pack of 50 tablets of 100 mg. However, it is quite difficult to purchase the drug, since it is often not available on the market.
The cost of popular analogues of Vasocardin: Metoprolol - 18–38 rubles. for 30 tablets of 50 mg, Egilok - 120-155 rubles. for 60 tablets of 50 mg, 140-200 rubles. for 60 tablets of 100 mg, Betalok - 398-490 rubles. for 100 tablets of 100 mg.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
