Moxonidine Canon
Moxonidin Canon: 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: Moxonidine Kanon
ATX code: C02AC05
Active ingredient: moxonidine (Moxonidine)
Producer: CJSC "Kanonfarma production" (Russia)
Description and photo update: 2019-08-07
Prices in pharmacies: from 103 rubles.
Buy
Moxonidine Canon is a centrally acting antihypertensive drug.
Release form and composition
The drug is available in the form of film-coated tablets: round, biconvex, slight surface roughness is allowed, at a dose of 0.2 mg and 0.4 mg - pink, at a dose of 0.3 mg - dark pink, the core of the tablet is almost white colors (in blisters: 7 pcs., in a cardboard bundle 2, 4, 6 or 8 packages; 10 pcs., in a cardboard bundle 1, 2, 3, 4 or 6 packages; 28 pcs., in a cardboard pack 1 or 2 packs, 30 pcs., in a cardboard pack 1, 2, 3 or 4. Each pack also contains instructions for the use of Moxonidine Canon).
1 tablet contains:
- active substance: moxonidine - 0.2; 0.3 or 0.4 mg;
- auxiliary components: hyprolose (hydroxypropyl cellulose), mannitol, croscarmellose sodium, magnesium stearate, microcrystalline cellulose;
- composition of the film shell: Opadray II pink - titanium dioxide, polyvinyl alcohol, sunset yellow dye, crimson dye (Ponso 4R), indigo carmine dye, macrogol (polyethylene glycol), talc.
Pharmacological properties
Pharmacodynamics
Moxonidine Canon is a centrally acting antihypertensive drug. Its active ingredient, moxonidine, is a selective agonist of imidazoline receptors localized in the ventrolateral part of the medulla oblongata, which are involved in the tonic and reflex regulation of the sympathetic nervous system. Agonist of pre- and postsynaptic alpha 2 -adrenergic receptors.
The mechanism of action of Moxonidine Canon is due to the ability of moxonidine, with a single and long-term use, to reduce the effect of the sympathetic system on peripheral vessels, to reduce peripheral vascular resistance, systolic and diastolic blood pressure (BP), without significantly changing cardiac output and heart rate (HR).
Against the background of drug treatment for a long period, the capillary blood supply of the myocardium is normalized, the hypertrophy of the left ventricular myocardium decreases, the signs of microarteriopathy and myocardial fibrosis are leveled. Moxonidine helps to reduce the activity of renin, norepinephrine and epinephrine, angiotensin II at rest and during exercise, plasma aldosterone, and during exercise - atrial natriuretic peptide.
Moxonidine's low affinity for alpha 2 -adrenergic receptors reduces the risk of dry mouth and sedation.
The resistance of tissues to insulin decreases, there is no effect of Moxonidine Canon on the processes of glucose and lipid metabolism.
Pharmacokinetics
After oral administration, moxonidine is almost completely (90%) absorbed from the gastrointestinal tract. Simultaneous food intake does not affect the degree of absorption. The bioavailability of the substance is 88%. The maximum concentration (C max) in plasma is reached after 0.5–3 hours and is 1–3 ng / ml.
Plasma protein binding - 7.2%.
V d (volume of distribution) - 1.4-3 l / kg.
Moxonidine crosses the blood-brain barrier and is excreted in breast milk. Long-term use does not cause cumulation.
The main metabolite is dehydrated moxonidine, the pharmacodynamic activity of which corresponds to 10% of the activity of moxonidine.
T 1/2 (half-life) of moxonidine is 2.5 hours, its metabolites - 5 hours.
More than 90% of the substance is excreted through the kidneys within 24 hours, of which 78% is unchanged, 13% is in the form of dehydrated moxonidine, 8% is in the form of other metabolites. Less than 1% of the dose is excreted through the intestines. During hemodialysis, a small part of the drug is removed.
With arterial hypertension, there are no changes in the pharmacokinetics of moxonidine.
In elderly patients, clinically insignificant changes in the pharmacokinetics of moxonidine occur, which are associated with a decrease in the intensity of its metabolism and / or a higher bioavailability.
The excretion of the active substance is largely correlated with creatinine clearance (CC), therefore, in case of impaired renal function, the dose should be selected individually. It is important to take into account that with an average degree of renal failure (CC 30-60 ml / min) C ss (equilibrium concentration) of moxonidine in blood plasma is approximately 2 times, and the final T 1/2 is 1.5 times higher than with normal renal function (CC more than 90 ml / min). In severe renal failure (CC less than 30 ml / min) C ss and final T 1/2 is 3 times higher than with CC more than 90 ml / min. In end-stage renal failure (CC less than 10 ml / min) and in patients on hemodialysis, the C ss of the drug in the blood plasma is 6 times and the final T1/2 is 4 times higher than in patients with normal renal function.
Indications for use
Moxonidine Canon is recommended for the treatment of patients with arterial hypertension.
Contraindications
Absolute:
- acute and chronic heart failure III – IV functional class according to NYHA classification (New York Heart Association);
- severe heart rhythm disturbances;
- sinoatrial and atrioventricular (AV) blockade II-III degree;
- sick sinus syndrome (SSS);
- severe bradycardia (heart rate less than 50 beats per minute);
- chronic renal failure (CC less than 30 ml / min, creatinine level more than 160 μmol / l);
- hemodialysis;
- severe liver failure with a Child-Pugh score of more than 9 points;
- concomitant therapy with tricyclic antidepressants;
- a history of angioedema;
- breast-feeding;
- age under 18 and over 75;
- hypersensitivity to the components of the drug.
With caution, Moxonidine Canon should be prescribed for severe Parkinson's disease, epilepsy, depression, Raynaud's disease, intermittent claudication, glaucoma, degree I AV block, chronic heart failure (NYHA functional class I – II), unstable angina pectoris, severe coronary artery disease heart, after myocardial infarction, with severe coronary artery disease, chronic renal failure (CC 30-60 ml / min), liver dysfunction, severe cerebrovascular pathologies, during pregnancy.
Moxonidin Canon, instructions for use: method and dosage
Moxonidine Canon tablets are taken orally, preferably in the morning before or after breakfast, with a sufficient amount of liquid.
Recommended dosage regimen: for adult patients, the initial daily dose is 0.2 mg per dose. In the absence of a sufficient therapeutic effect after 21 days of therapy, the daily dose can be increased to 0.4 mg and taken once or 0.2 mg in the morning and evening.
The maximum allowable dose of Moxonidine Canon is: single - 0.4 mg; daily - 0.6 mg (it should be divided into 2 doses - in the morning and evening).
Elderly patients with normal renal function do not need to adjust the dosage regimen.
In patients with renal insufficiency with CC 30-60 ml / min and patients on hemodialysis, a single dose should not exceed 0.2 mg. Maximum per day is allowed to take 0.4 mg of moxonidine.
Side effects
- mental disorders: often - decreased concentration of attention; infrequently - anxiety, nervousness, depression;
- from the central and peripheral nervous system: often - drowsiness, increased fatigue, dizziness, headache; infrequently - insomnia, fainting, paresthesia;
- on the part of the cardiovascular system (CVS): often - symptoms of vasodilation; infrequently - lowering blood pressure, orthostatic hypotension, peripheral circulation disorders, Raynaud's syndrome;
- from the digestive system: often - dry mouth, dyspeptic disorders, constipation; infrequently - nausea, anorexia; extremely rare - cholestasis, hepatitis;
- on the part of the musculoskeletal system: often - a feeling of back pain; infrequently - neck pain;
- from the urinary system: infrequently - urinary incontinence, urinary retention;
- on the part of the genitals and mammary gland: infrequently - gynecomastia, impotence, decreased libido;
- on the part of the visual system: infrequently - itching or burning sensation in the eyes against the background of dryness of the mucous membrane of the eyes;
- on the part of the auditory analyzer: infrequently - ringing in the ears;
- dermatological reactions: infrequently - itchy skin, rash, edema of different localization; extremely rare - angioedema;
- others: often - asthenia; infrequently - pain in the parotid glands, weakness in the legs, fainting.
Overdose
- symptoms: excessive decrease in blood pressure, bradycardia, sedation, dry mouth, general weakness, headache, drowsiness, dizziness, increased fatigue, stomach pain, vomiting. In addition, there is a risk of tachycardia, a paradoxical increase in blood pressure, and the development of hyperglycemia;
- treatment: a specific antidote has not been established. Shows immediate gastric lavage or artificial vomiting, intake of activated charcoal and laxatives. Appointment of symptomatic therapy. With an excessive decrease in blood pressure to restore the volume of circulating blood, it is necessary to prescribe the introduction of a liquid, dopamine. For the relief of bradycardia, the administration of atropine is indicated. In order to reduce or eliminate transient arterial hypertension - the use of alpha-adrenergic receptor antagonists.
special instructions
Treatment must be accompanied by regular monitoring of blood pressure, heart rate and electrocardiogram (ECG).
Patients who are simultaneously using beta-blockers and Moxonidine Canon should be aware that if it is necessary to cancel two drugs at once, the beta-blocker should be stopped first and only after a few days - moxonidine. Cancellation of therapy with an antihypertensive drug should be carried out, reducing the daily dose gradually.
The appointment of Moxonidine Canon in combination with thiazide diuretics, blockers of slow calcium channels, inhibitors of angiotensin-converting enzyme (ACE) is shown.
Influence on the ability to drive vehicles and complex mechanisms
During the period of treatment with Moxonidine Canon, due to the possible occurrence of drowsiness and dizziness, patients should be careful when performing potentially hazardous activities, including driving or working with complex mechanisms.
Application during pregnancy and lactation
There is no information on the negative effect of Moxonidine Canon on the course of pregnancy. However, the drug can be prescribed during gestation only in cases where the expected therapeutic effect for the mother outweighs the potential threat to the fetus.
The use of Moxonidine Canon is contraindicated when breastfeeding. If there is a need to prescribe moxonidine during lactation, you should stop breastfeeding.
Pediatric use
The efficacy and safety of using Moxonidine Canon under the age of 18 have not been established, therefore, the use of the drug in pediatrics for the treatment of children and adolescents is contraindicated.
With impaired renal function
- chronic renal failure with CC less than 30 ml / min: it is contraindicated to prescribe Moxonidine Canon;
- chronic renal failure with CC 30-60 ml / min: patients should be careful; for this category of patients and those on hemodialysis, a single dose should be no more than 0.2 mg, the maximum daily dose should be 0.4 mg.
For violations of liver function
It is contraindicated to use Moxonidine Canon in severe hepatic insufficiency with a Child-Pugh score of more than 9 points.
It is recommended to use the drug with caution to treat patients with impaired liver function.
Use in the elderly
It is contraindicated to take Moxonidine Canon for patients over the age of 75 years.
With normal renal function, no dosage adjustment is required for elderly patients.
Drug interactions
With simultaneous use with Moxonidine Canon:
- antihypertensive drugs: concomitant therapy with thiazide diuretics, slow calcium channel blockers and other antihypertensive drugs / substances causes an additive effect;
- hydrochlorothiazide, glibenclamide (glyburide), digoxin, moclobemide: these drugs do not cause pharmacokinetic interactions;
- tricyclic antidepressants: it is possible to reduce the antihypertensive effect when combined with these drugs;
- lorazepam: in patients taking lorazepam, there is a moderate increase in impaired cognitive ability;
- benzodiazepine derivatives: it is possible to enhance the sedative effect of benzodiazepine derivatives;
- anxiolytics, barbiturates, ethanol: their inhibitory effect on the central nervous system is enhanced;
- beta-blockers: there is an increase in bradycardia, the severity of the negative dromotropic and inotropic action of beta-blockers.
Analogs
Analogs of Moxonidin Canon are Moxonidin, Moxonidin-SZ, Tenzotran, Moxarel, Physiotens, Moxonitex and others.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C, protected from moisture and light.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Moxonidine Canon
Reviews of Moxonidine Canon are predominantly positive. Patients report that regular intake of tablets once a day provides the necessary lowering of blood pressure, retains the effect until the next dose of the drug, and ensures a comfortable and active lifestyle. Among antihypertensive drugs, it is characterized as effective and available for long-term use.
Price for Moxonidine Canon in pharmacies
The price of Moxonidin Canon for a package containing 14 tablets in a dose of 0.2 mg can be approximately 111 rubles, 28 tablets - 144 rubles; the cost of packaging tablets 28 pcs. at a dose of 0.4 mg - from 241 rubles.
Moxonidine Canon: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Moxonidin Canon 0.2 mg film-coated tablets 14 pcs. RUB 103 Buy |
|
Moxonidin Canon 0.2 mg film-coated tablets 28 pcs. 108 RUB Buy |
|
Moxonidine Canon tablets p.o. 0.2mg 28 pcs. 117 RUB Buy |
|
Moxonidine Canon tablets p.o. 0.4mg 14 pcs. 139 RUB Buy |
|
Moxonidine Canon 0.4 mg film-coated tablets 14 pcs. 139 RUB Buy |
|
Moxonidin Canon 0.4 mg film-coated tablets 28 pcs. 171 r Buy |
|
Moxonidine Canon tablets p.o. 0.4mg 28 pcs. RUB 180 Buy |
|
Moxonidin Canon tablets p.p. 0.2mg 60pcs RUB 200 Buy |
|
Moxonidine Canon 0.2 mg film-coated tablets 60 pcs. RUB 200 Buy |
|
Moxonidin Canon 0.4 mg film-coated tablets 60 pcs. 313 r Buy |
|
Moxonidin Canon tablets p.p. 0.4mg 60pcs 316 RUB Buy |
| See all offers from pharmacies |
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!
