VAP 20
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from RUB 3001
Buy
VAP 20 - synthetic analogue of prostaglandin E 1; vasodilating agent.
Release form and composition
Dosage form - concentrate for preparation of solution for infusion: colorless transparent liquid with a characteristic smell of ethanol (1 ml each in dark glass ampoules with a break ring, 5 or 10 ampoules in a cardboard box with a special ampoule holder).
Active ingredient: alprostadil (prostaglandin E 1), in 1 ampoule - 20 μg.
Excipient: ethanol.
Indications for use
VAP 20 is used for the treatment of chronic obliterating arterial diseases of III and IV stages in accordance with the Fontaine classification.
Contraindications
- exacerbation of ischemic heart disease, severe heart rhythm disturbances, chronic heart failure, stroke or myocardial infarction in the last 6 months;
- pulmonary edema, chronic obstructive and infiltrative lung diseases;
- diseases accompanied by an increased risk of bleeding (for example, peptic ulcer of the stomach or duodenal ulcer, extensive trauma);
- a history of dysfunction and severe liver disease;
- general contraindications for infusion therapy, such as overhydration, cerebral or pulmonary edema, renal dysfunction (oliguria), decompensated heart failure;
- children up to age 18;
- period of pregnancy and lactation;
- simultaneous use of anticoagulants or vasodilators;
- hypersensitivity to any component of the drug.
Carefully:
- arterial hypotension;
- cardiovascular failure in patients on hemodialysis;
- diabetes;
- diabetic angiopathy.
Method of administration and dosage
VAP 20 is intended for intravenous administration.
The solution is prepared immediately before administration: 1-2 ampoules of the concentrate are dissolved in a solution of sodium chloride 0.9% or a solution of dextrose 5% to a volume of 100-250 ml.
50-250 ml of ready-made infusion solution is injected over 2 hours at a rate of 0.4-2 ml / minute. The frequency of infusions is 1 time per day, in severe cases of the disease - 2 times a day.
The course of treatment is on average 14 days, with a positive effect from the initial therapy, the use of the drug can be continued for another 7-14 days. The maximum duration of treatment is 4 weeks.
If after 2 weeks there is no improvement in the condition, further use of VAP 20 is impractical.
In case of impaired renal function (the concentration of creatinine in the blood serum exceeds 1.5 mg / dl), the initial dose is 20 mcg, after 2-3 days, if necessary, it is increased to 40-60 mcg. In renal and heart failure, the volume of injected fluid should not exceed 50-100 ml per day. The duration of therapy is 4 weeks.
Side effects
- on the part of the cardiovascular system: cardiac arrhythmias, chest pain, decreased blood pressure, atrioventricular block;
- on the part of the musculoskeletal system: with long-term continuous administration from 4 weeks - reversible hyperostosis of long bones;
- from the central nervous system: excessive fatigue, impaired sensitivity of the skin and mucous membranes, headache, feeling of malaise, dizziness, convulsive syndrome;
- from the digestive system: dyspeptic symptoms (diarrhea, nausea, vomiting), a feeling of discomfort in the epigastric region;
- laboratory parameters: increased activity of transaminases, increased titer of C-reactive protein, leukopenia, leukocytosis;
- rarely: confusion, psychosis, fever, chills, joint pain, arthralgia, anuria, renal failure, bradypnea, convulsions of central origin, pulmonary edema, acute left ventricular failure;
- allergic reactions: skin rashes, itching;
- others: hyperthermia, increased sweating, swelling of the limb, into the vein of which the infusion is carried out;
- local reactions: impaired sensitivity, erythema, edema, pain, phlebitis (proximal to the intravenous injection site).
Side effects disappear after lowering the dose or stopping the infusion.
If the dosage is exceeded, the following reactions are possible: lowering blood pressure, increased heart rate, vasovagal reactions, accompanied by symptoms such as increased sweating, pallor of the skin, nausea, vomiting, possibly myocardial ischemia and symptoms of heart failure. Redness, swelling, and pain may also occur at the infusion site. In these cases, it is necessary to reduce the dose of the drug or stop the administration. With a pronounced decrease in blood pressure, the patient should take a lying position and raise his legs.
special instructions
VAP 20 should only be used by a doctor who has experience in the treatment of angiological diseases, who is familiar with modern methods of continuous monitoring of the cardiovascular system and who has the appropriate equipment for this.
In chronic obliterating diseases of the arteries of the lower extremities, treatment with VAP 20 is a necessary component of complex therapy. The clinical effect may appear with some delay after the end of the course and is long-term.
During the period of treatment, it is necessary to monitor blood pressure (BP) and heart rate (HR), blood biochemical parameters, as well as indicators of the blood coagulation system (in case of disorders of the blood coagulation system or the simultaneous use of drugs that affect the coagulation system).
Patients with renal failure and ischemic heart disease should be in the hospital under the supervision of the attending physician during therapy and within 24 hours after its completion. To prevent the development of hyperhydration, the volume of daily injected fluid in such patients, if possible, should not exceed 50-100 ml. Dynamic monitoring of their condition is required: control of blood pressure and heart rate, if necessary, control of fluid balance and body weight, measurement of central venous pressure or echocardiography.
Phlebitis (proximal to the injection site) is usually not a reason to discontinue treatment. The signs of inflammation usually disappear within a few hours after stopping the infusion or changing the injection site. In this case, no specific therapy is required. Central vein catheterization can reduce the incidence of this side effect.
A solution prepared more than 24 hours ago is unusable.
VAP 20 can affect the speed of reactions and the ability to concentrate, especially at the beginning of treatment, when the dose is increased, the drug is discontinued, and also in the case of the simultaneous use of alcohol.
Drug interactions
Alprostadil can enhance the effect of vasodilators, antianginal and antihypertensive drugs.
With the simultaneous use of drugs that prevent blood clotting (anticoagulants or antiplatelet agents), thrombolytics, cefoperazone, cefotetan, cefamandol, the risk of bleeding increases.
Adrenomimetics (epinephrine and norepinephrine) reduce the vasodilating effect of the drug.
It is important to consider that the described drug interactions are possible even if the listed drugs were used shortly before the start of therapy with alprostadil.
Analogs
Analogs of VAP 20 are: Alprostan Zentiva, Vasostenon, VAP 500, Prostin BP.
Terms and conditions of storage
Store out of the reach of children, protected from light, at a temperature of 2-8 ° C (in the refrigerator).
The shelf life is 3 years.
The prepared solution retains its properties for 24 hours if stored in a dark place at a temperature of 2-8 ° C (in the refrigerator).
Terms of dispensing from pharmacies
Dispensed by prescription.
VAP 20: prices in online pharmacies
|
Drug name Price Pharmacy |
|
VAP 20 20 μg / ml concentrate for preparation of solution for infusion 1 ml 5 pcs. RUB 3001 Buy |
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VAP 20 20 μg / ml concentrate for preparation of solution for infusion 1 ml 10 pcs. RUB 5968 Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
