Dilasid
Dilasidom: 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. In case of impaired renal function
- 11. For violations of liver function
- 12. Use in the elderly
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Dilasidom
ATX code: C01DX12
Active ingredient: Molsidomin (Molsidomine)
Producer: WARSAW PHARMACEUTICAL WORK POLFA SA (Poland)
Description and photo update: 18.10.2018
Dilasidom is a vasodilating agent.
Release form and composition
Dilasidom is available in the form of tablets: flat, round, beveled, with a risk on only one side, single dark inclusions on the surface of the tablet are possible; 2 mg - heterogeneous light orange color, 4 mg - heterogeneous pink color (30 tablets in aluminum PVC blisters, one blister in a cardboard box).
Composition of 1 tablet:
- active substance: molsidomin - 2/4 mg;
- excipients: sucrose, lactose, magnesium stearate, povidone K-25, potato starch; aluminum varnish based on dye sunny sunset yellow (E110) - for tablets with a dosage of 2 mg, aluminum varnish based on a dye crimson (Ponso 4R) (E124) - for tablets with a dosage of 4 mg.
Pharmacological properties
Pharmacodynamics
Molsidomin is a sydnone imine derivative. The active metabolite of molsidomin is linsidomin (SIN 1A) - a compound that reduces the tone of smooth muscles of the vascular walls and has an antiplatelet effect. The increase in vein volume promotes relaxation of smooth muscles, in this regard, the capacity of the vascular bed increases and venous return decreases, due to which the filling pressure of both ventricles decreases. As a result, the load on the heart decreases, the hemodynamic conditions in the coronary circulation improve. The expansion of the large coronary arteries provokes a decrease in the total peripheral vascular resistance, the load on the heart decreases and the tension of the myocardial wall decreases, which contributes to a decrease in myocardial oxygen demand. Also,Molsidomin reduces the spasm of the coronary arteries and enlarges the large branches of these arteries. The antiaggregatory effect of molsidomine has a clinical role in the treatment of ischemic heart disease. In comparison with nitrates, molsidomin does not cause tachycardia. Molsidomin begins to act presumably 20 minutes after ingestion, the maximum result is achieved in 30-60 minutes, the duration of action is from 4 to 6 hours.
Pharmacokinetics
Absorption from the gastrointestinal tract is about 90%, bioavailability is about 65%, the connection with plasma proteins reaches 11%. Molsidomin is biotransformed in the liver by an enzymatic way to an active metabolite - sydnone imine 1 (SIN-1), which is then non-enzymically converted to N-morpholino-N-aminoacetonitrile (SIN 1 A) - linsidomine. The excretion of molsidomine or its metabolites in breast milk is unknown. Molsidomin is excreted through the kidneys (90–95%, including 2% unchanged), as well as through the intestines (3–4%). The total ground clearance reaches 40–80 l / h, and the SIN-1 is 170 l / h.
The half-life is 1.6 hours, but in the presence of severe hepatic insufficiency it increases (for example, in liver cirrhosis it is about 13.1 hours). The half-life of the linsidomine metabolite varies from 1 to 2 hours, and, as in the case of molsidomine, increases in severe hepatic insufficiency (up to about 7.5 hours). The medicinal product does not accumulate biologically active substances in the body.
Indications for use
- chronic heart failure (as part of complex therapy with diuretics, cardiac glycosides);
- prevention of angina attacks.
Contraindications
- collapse, shock;
- acute stage of myocardial infarction;
- low filling pressure of the left ventricle;
- lowering central venous pressure;
- severe arterial hypotension (systolic blood pressure less than 100 mm Hg. Art.);
- pregnancy;
- lactation period;
- high sensitivity to drug components;
- simultaneous use of phosphodiesterase type 5 (PDE 5) inhibitors - vardenafil, sildenafil, tadalafil - taking into account the high risk of arterial hypotension;
- age up to 18 years.
Instructions for use of Dilasidom: method and dosage
Dilasid should be taken orally (by mouth), at regular intervals, with plenty of water. The drug is used regardless of food intake.
For the prevention of angina attacks, 2–4 mg is most often used 1–2 times a day. If necessary, the dose can be increased to 12-16 mg per day (1 tablet 4 mg 3-4 times).
Side effects
- cardiovascular system: marked decrease in blood pressure (rarely collapse), orthostatic hypotension;
- nervous system: (mainly at the beginning of treatment) - headache, dizziness, slowing down of the speed of motor and mental reactions;
- digestion: nausea;
- allergic reactions: skin rash, itching, facial redness, bronchospasm; very rarely - anaphylactic shock.
Overdose
According to the instructions, overdose with Dilasidom can cause the following symptoms:
- Strong headache;
- a marked decrease in blood pressure;
- tachycardia.
If no more than an hour has passed since the moment of taking a large dose of the drug, it is necessary to wash the stomach, and also start symptomatic treatment.
special instructions
The first dose should be administered under blood pressure control.
For relief of angina attacks, Dilasid is not used.
For patients with a high risk of developing a hypotensive reaction, the dose of the drug is selected individually.
In case of myocardial infarction in its acute stage, Dilasid can be used only after the blood circulation parameters have stabilized.
The drug should not be taken by patients with a rare form of congenital galactose intolerance, glucose-galactose malabsorption syndrome or Lapp lactase deficiency, taking into account the lactose content.
With glaucoma (mainly closed-angle), patients with cerebrovascular accident, increased intracranial pressure, renal and / or hepatic insufficiency, with a tendency to arterial hypotension, elderly patients, after acute myocardial infarction, should take Dilasid with caution.
During the period of treatment, it is recommended to exclude alcohol (ethanol) intake.
Influence on the ability to drive vehicles and complex mechanisms
During therapy (especially at the beginning of treatment), it is required to refrain from driving and other potentially dangerous activities that require a high concentration of attention and speed of psychomotor reactions.
Application during pregnancy and lactation
The use of molsidomine in pregnant women, mainly in the first trimester, and during breastfeeding is contraindicated.
If it is necessary to use the drug during lactation, it is necessary to suspend breastfeeding.
With impaired renal function
The concentration of molsidomine in blood plasma in renal failure does not change. Combination with antianginal agents is allowed.
For violations of liver function
Adjustment of the dose of Dilasidom may be required in case of impaired liver function, only with a pronounced decrease in it (an increase in the bromsulfalein test in the range from 20 to 50%), since the half-life of the concentration of molsidomine in the blood plasma increases.
Use in the elderly
In elderly people, with renal or hepatic insufficiency, and with low blood pressure, lower doses are recommended.
Drug interactions
- peripheral vasodilators, slow calcium channel blockers, antihypertensive drugs and ethanol: increased antihypertensive effect;
- acetylsalicylic acid: increased antiplatelet activity;
- phosphodiesterase 5 (PDE 5) inhibitors, such as vardenafil, sildenafil, tadalafil: a high risk of developing arterial hypotension, combined use is contraindicated.
Analogs
Dilasidom's analogues are Korvaton and Sidnopharm.
Terms and conditions of storage
Store in a dry place, out of reach of light and children, at a temperature of 15-25 ° С.
Shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Dilasidom
There are few reviews about Dilasidom, indicating the effectiveness of the drug. Those taking the drug experienced headache, nausea, manifestation of diarrhea (isolated cases).
The price of Dilasidom in pharmacies
There is no reliable data on the price of Dilasidom.
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!
