Isoket
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. Conditions for dispensing pharmacies
Prices in online pharmacies:
from 685 rub.
Buy
Isoket is an antianginal drug, a peripheral vasodilator.
Release form and composition
Dosage forms:
- Concentrate for the preparation of solution for infusion (10 ml in ampoules, in cardboard boxes of 10 ampoules);
- Dosed spray: colorless transparent liquid, smell of alcohol (15 ml, or 300 doses, in dark glass vials with a dosing device, in a cardboard box 1 bottle).
The active substance is isosorbide dinitrate:
- 1 ml of concentrate - 1 mg;
- 1 dose (1 injection) spray - 1.25 mg.
Auxiliary components:
- Concentrate: sodium chloride, hydrochloric acid 1M (up to pH 5.0-7.0), sodium hydroxide solution 2M, water for injection;
- Spray: ethanol 100%, macrogol 400.
Indications for use
Isoket's application is shown:
- Concentrate for the preparation of a solution for infusions: in case of heart failure of various etiologies, acute myocardial infarction with left ventricular failure, unstable angina pectoris, acute left ventricular failure;
- Spray: for the prevention and relief of angina attacks, in acute myocardial infarction (including those complicated by acute left ventricular failure), during the rehabilitation period after myocardial infarction.
Contraindications
- Acute vascular insufficiency (vascular collapse);
- Severe arterial hypotension (systolic blood pressure (BP) below 90 mm Hg (Hg), diastolic blood pressure below 60 mm Hg);
- Cardiogenic shock;
- Hypersensitivity to drug components.
With caution, under the supervision of the attending physician, Isoket should be used: in acute myocardial infarction with reduced ventricular filling pressure, mitral and / or aortic stenosis (systolic blood pressure should not be allowed to drop below 90 mm Hg), tendency to orthostatic reactions; in diseases accompanied by an increase in intracranial pressure, including hemorrhagic stroke and traumatic brain injury.
During pregnancy and breastfeeding, the drug is prescribed only if absolutely necessary, if the expected therapeutic effect for the mother significantly outweighs the potential risk to the fetus or child.
In addition, a contraindication to the use of the concentrate is:
- Hypertrophic obstructive cardiomyopathy;
- Cardiac tamponade;
- Constrictive pericarditis;
- Primary pulmonary disease (risk of hypoxemia);
- Cardiac ischemia;
- Traumatic brain injury, hemorrhagic stroke and other conditions occurring with increased intracranial pressure;
- Toxic pulmonary edema.
Additional contraindications for the use of Isoket in the form of a spray:
- Closed-angle glaucoma;
- Deficiency of glucose-6-phosphate dehydrogenase;
- Hyperthyroidism;
- Simultaneous reception with phosphodiesterase inhibitors (it is possible to increase the hypotensive effect of the drug);
- Age under 18.
Care should be taken to prescribe a spray for cardiac tamponade, constrictive pericarditis, hypertrophic obstructive cardiomyopathy, liver failure (the risk of methemoglobinemia increases), severe renal failure, and elderly patients.
Method of administration and dosage
- Concentrate for the preparation of solution for infusion: intended for intravenous infusion administration using automatic systems. Systems for intravenous administration of the drug should be used from polyethylene, polypropylene and polytetrafluoroethylene, systems from other materials cause a loss of the active substance. The procedure is carried out in stationary conditions, under constant monitoring of the indicators of the cardiovascular system. Based on clinical indications and the patient's condition, the doctor prescribes the drug, starting with a low dose and gradually increasing it, bringing it to therapeutically effective. Ampoules with concentrate should be opened immediately before use, observing the conditions of asepsis. For infusions, a solution is used at a concentration of 100 μg / ml (it is necessary to dilute 50 ml of the drug 0.1% to 500 ml) or in 200 μg / ml (100 ml of drug 0 is required,Dilute 1% to 500 ml). The initial dose is 2-7 mg per hour, if necessary, an increase to 10 mg per hour is allowed. Patients with heart failure are usually prescribed higher doses, up to 50 mg per hour. The infusion rate depends on the concentration of the solution and is determined according to a special table on the basis that 20 drops correspond to 1 ml of solution. Taking into account the clinical picture, electrocardiogram (ECG) indicators and hemodynamics, the course of treatment can last 3 or more days;Taking into account the clinical picture, electrocardiogram (ECG) indicators and hemodynamics, the course of treatment can last 3 or more days;Taking into account the clinical picture, electrocardiogram (ECG) indicators and hemodynamics, the course of treatment can last 3 or more days;
- Spray: the bottle should be held upright. Before the first use and in the case when more than 1 day has passed since the last use, the first spray should be directed into the air. The application of the spray is made by injecting it into the oral cavity, for this you need to bring the sprayer to your mouth, take a deep breath and, holding your breath (you cannot inhale the aerosol), press the dosing device. After injection, the mouth should be closed, a slight burning sensation of the tongue is allowed, and breathe for 30 seconds through the nose, then repeat the procedure. Single dose - 3 injections. Dosage is prescribed by the doctor based on the patient's clinical indications. Application for acute heart failure and acute myocardial infarction is performed under the control of blood pressure and heart rate. Treatment begins with 1 dose,if necessary, with an interval of 5-10 minutes, the patient can take two more doses of the spray under the supervision of the attending physician. For relief and prevention of angina attacks, 1-3 injections are recommended. A single dose (3 injections) for relief of seizures can only be increased by a doctor.
Side effects
- From the side of the cardiovascular system: perhaps - orthostatic hypotension and / or a decrease in blood pressure (with the first use or an increase in the dose of the drug), the condition may be accompanied by lethargy, a reflex increase in the pulse rate, feeling of weakness, dizziness; at the beginning of therapy, a headache may appear, which is temporary and disappears during the first days of use; rarely - increased symptoms of angina pectoris against the background of a pronounced decrease in blood pressure; very rarely - collaptoid state, sometimes with syncope and bradycardia;
- From the digestive system: rarely - nausea and vomiting;
- Others: allergic reactions of dermatological etiology, redness of the skin of the face; very rarely - exfoliative dermatitis.
In addition, the use of the spray can cause side effects:
- From the digestive system: possibly - dry mouth, a feeling of a slight burning sensation of the tongue;
- From the nervous system: drowsiness, stiffness, visual impairment (blurred), decreased psychomotor reactions (more often at the beginning of treatment); rarely - cerebral ischemia.
special instructions
With intravenous administration, the pulse, blood pressure (systolic at least 100 mm Hg), the volume of urine excreted (catheterization of the bladder) should be monitored, and the ECG should be monitored.
It is not recommended to use the concentrate if it crystallizes.
The use of the spray must be accompanied by monitoring blood pressure and heart rate.
It is recommended to withdraw the drug gradually.
With frequent administration and use of high doses, the patient may develop tolerance to the drug, in case of a decrease in the effect of Isoket, it should be canceled for 24–48 hours. It is recommended to alternate regular intake for 3-6 weeks with a 3-5-day break, temporarily taking other antianginal drugs.
The spray contains up to 85% ethanol. During the period of treatment, alcohol consumption should be excluded.
Avoid contact with eyes.
The spray does not contain Freon, therefore it is safe for the environment.
During the period of using the drug, especially at the beginning of treatment, when changing the drug or increasing the dose, you should temporarily abstain or take special care when driving vehicles and mechanisms.
Drug interactions
It is possible to increase the hypotensive activity of the drug when combined with other peripheral vasodilators, beta-blockers, antihypertensive drugs, phosphodiesterase inhibitors, calcium channel blockers, tricyclic antidepressants, neuroleptics, novocainamide, ethanol, quinidine.
An increase in the antianginal effect of the drug can occur while taking slow calcium channel blockers (verapamil, nifedipine), amiodarone, propranolol.
A decrease in the severity of antianginal action is possible when combined with alpha-blockers (dihydroergotamine), sympathomimetics.
With the simultaneous use of Isoket with m-anticholinergics (atropine), the risk of increased intracranial pressure increases.
Analogs
Isoket's analogs are: Izakardin, Dinisorb, Izodinite.
Terms and conditions of storage
Store at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Isoket: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Isoket 1 mg / ml concentrate for preparation of solution for infusion 10 ml 10 pcs. RUB 685 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!
