Table of contents:
- Release form and composition
- Indications for use
- Method of administration and dosage
- Side effects
- special instructions
- Drug interactions
- Terms and conditions of storage
- Terms of dispensing from pharmacies
- Cordaron: prices in online pharmacies
Video: Kordaron - Instructions For Use, Indications, Doses, Analogues
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 172 rub.
Cordaron is an antiarrhythmic drug.
Release form and composition
- Divisible tablets: from white with a creamy shade to white, round in shape with a chamfer on two sides, bevel from the edges to the fracture line on one side and engraving: above the dividing line - a symbol in the form of a heart, under the line - the number 200 (10 pcs. in blisters, in a carton box 3 blisters);
- Solution for intravenous (intravenous) administration: transparent light yellow liquid (3 ml in ampoules, 6 pcs in a box).
Active ingredient - amiodarone hydrochloride:
- 1 tablet - 200 mg;
- 1 ml of solution - 50 mg.
- Tablets: corn starch, lactose monohydrate, magnesium stearate, anhydrous colloidal silicon dioxide, povidone K90F;
- Solution: benzyl alcohol, polysorbate 80, water for injection.
Indications for use
The use of Cordaron in tablet form is indicated for the prevention of relapses:
- Supraventricular paroxysmal tachycardia: attacks of recurrent persistent supraventricular paroxysmal tachycardia, fixed in patients with organic heart disease; attacks of recurrent persistent supraventricular paroxysmal tachycardia, fixed in patients without organic heart disease (with ineffectiveness of other classes of antiarrhythmic drugs or contraindications to their use); attacks of recurrent persistent supraventricular paroxysmal tachycardia, fixed in patients with Wolff-Parkinson-White syndrome;
- Ventricular arrhythmias that pose a threat to the patient's life, including ventricular tachycardia and ventricular fibrillation (with inpatient treatment with careful cardiac monitoring);
- Atrial fibrillation (atrial fibrillation) and atrial flutter.
In addition, tablets are prescribed for the treatment of patients with arrhythmias associated with impaired left ventricular function and / or ischemic heart disease (IHD).
The tablets are taken to prevent sudden arrhythmic death in patients who have recently had myocardial infarction, who have clinical manifestations of chronic heart failure or more than 10 ventricular extrasystoles in 1 hour and a reduced left ventricular ejection fraction (less than 40%).
The use of the drug in the form of a solution is indicated for the relief of attacks of ventricular paroxysmal tachycardia, supraventricular paroxysmal tachycardia with a high frequency of ventricular contractions (especially with Wolff-Parkinson-White syndrome), persistent and paroxysmal forms of atrial fibrillation (atrial fibrillation) and atrial flutter.
Also, Cordaron injections are used for cardiac resuscitation in case of cardiac arrest, against the background of ventricular fibrillation, resistant to defibrillation.
Contraindications to the use of tablets and solution:
- Age under 18;
- Atrioventricular (AV) block of II and III degree, two- and three-beam blockade in patients without a pacemaker;
- Syndrome of weakness of the sinus node (sinus blockade, sinus bradycardia), except in cases of correction by an artificial pacemaker (pacemaker);
- Simultaneous use with drugs that lengthen the QT interval and cause the development of paroxysmal tachycardia, including ventricular "pirouette" tachycardia: class IA antiarrhythmic drugs (hydroquinidine, quinidine, procainamide, disopyramide) and class III (bretilium tosylate, ibutilide, sothalolidelide); other drugs with no antiarrhythmic action: vincamine, bepridil, phenothiazines (fluphenazine, cyamemazine, chlorpromazine, levomepromazine, trifluoperazine, thioridazine), benzamides (sultopride, amisulpride, sulpride, veraliprid, tiaprid, serprofenosol) cisapride, tricyclic antidepressants, azoles, macrolide antibiotics (including spiramycin, erythromycin when administered intravenously), antimalarial drugs (chloroquine, halofantrine, quinine, mefloquine), difemanil methyl sulfate,pentamidine for parenteral administration only, mizolastine, fluoroquinolones, astemizole and terfenadine;
- Hypomagnesemia, hypokalemia;
- Prolongation of the QT interval, including congenital;
- The period of pregnancy and breastfeeding;
- Dysfunction of the thyroid gland (hyperthyroidism, hypothyroidism);
- Hypersensitivity to the components of the drug and to iodine.
Care should be taken to prescribe Cordaron to patients with AV block I degree, arterial hypotension, severe chronic (III – IV functional class according to NYHA classification) or decompensated heart failure, hepatic failure, bronchial asthma, severe respiratory failure and elderly patients.
Tablets should not be taken for interstitial lung disease.
Additional contraindications to the use of the solution:
- Severe arterial hypotension, cardiogenic shock, collapse;
- Intraventricular conduction disorders (two- and three-beam blockade) in the absence of a permanent pacemaker;
- Heart failure, arterial hypotension, cardiomyopathy or severe respiratory failure - for intravenous jet injection.
All these contraindications should not be taken into account when carrying out cardiac resuscitation in case of cardiac arrest against the background of ventricular fibrillation resistant to cardioversion.
The use of amiodarone in pregnant women is possible with ventricular arrhythmias that threaten the life of the mother, if the expected clinical effect outweighs the potential risk and danger to the fetus.
Method of administration and dosage
- Tablets: orally, before meals with a little water. The dosage is prescribed by the doctor based on clinical indications and the patient's condition. The loading dose in a hospital is increased, starting with a daily dose of 0.6-0.8 g (up to 1.2 g) divided into several doses, until a total dose of 10 g is reached after 5-8 days of administration; outpatient saturation up to 10 g is performed for 10-14 days at a daily dose of 0.6-0.8 g. The maintenance dose should be the minimum effective, selected individually, and may range from 0.1 to 0.4 g per day. The average therapeutic single dose is 0.2 g, the daily dose is 0.4 g. The maximum single dose is 0.4 g, the daily dose is 1.2 g. Tablets can be taken every other day or with a break 2 days a week;
- Solution for injection: intended for intravenous administration to achieve a rapid antiarrhythmic effect or when it is impossible to take the drug inside. In addition to special emergency clinical situations, the solution should be used only in intensive care of a hospital under constant monitoring of blood pressure and an electrocardiogram (ECG). Do not mix the solution with other agents, inject into the same line of the infusion system, or use undiluted. For dilution, only 5% dextrose (glucose) solution should be used, the concentration of the resulting solution should be no less than when diluting 6 ml of the drug in 500 ml of 5% dextrose (glucose). The introduction should always be made through a central venous catheter, introduction through peripheral veins is allowed for cardiac resuscitation with ventricular fibrillation,resistant to cardioversion, in the absence of central venous access. In severe cardiac arrhythmias, if it is impossible to take the drug orally, intravenous drip through a central venous catheter is recommended in the usual loading dose at the rate of 0.005 g per 1 kg of patient weight in 250 ml of 5% dextrose (glucose) solution. It should be administered within 20-120 minutes, preferably using an electronic pump. It can be injected 2-3 times within 24 hours, the correction of the injection rate depends on the clinical effect. The maintenance daily dose of amiodarone is usually prescribed in the amount of 0.6-0.8 g, an increase to 1.2 g in 250 ml of 5% dextrose (glucose) solution is allowed. Within 2-3 days of intravenous administration, you should gradually switch to taking the drug inside. Intravenous jet injection during cardiac resuscitation in case of cardiac arrest against the background of ventricular fibrillation resistant to cardioversion is recommended at a dose of 0.3 g of the drug diluted in 20 ml of 5% dextrose (glucose) solution. In the absence of a clinical effect, additional administration of 0.15 g of amiodarone is possible.
The use of Cordaron can cause side effects common to each of the forms:
- From the respiratory system: very rarely - bronchospasm and / or apnea against the background of severe respiratory failure, especially bronchial asthma; acute respiratory distress syndrome (sometimes immediately after surgery, sometimes fatal);
- From the side of the cardiovascular system: often - moderate (dose-dependent) bradycardia; very rarely - severe bradycardia or stopping of the sinus node (in exceptional cases), more often in patients with sinus node dysfunction and elderly patients;
- From the nervous system: very rarely - headache, benign intracranial hypertension.
The use of tablets can cause the following side effects:
- From the side of the cardiovascular system: infrequently - AV block of various degrees, sinoatrial block (conduction disturbance), the emergence of new or worsening of existing arrhythmias; frequency unknown - progression of chronic heart failure (against the background of long-term therapy);
- On the part of the respiratory system: often - cases of development of alveolar or interstitial pneumonitis, obliterating bronchiolitis with pneumonia (sometimes fatal), pleurisy, pulmonary fibrosis, severe shortness of breath or dry cough with symptoms of deterioration of the general condition (increased fatigue, weight loss, increased body temperature) or without; frequency unknown - pulmonary hemorrhage;
- On the part of the digestive system: very often - nausea, vomiting, decreased appetite, decreased taste or loss of taste, a feeling of heaviness in the epigastrium (especially at the beginning of use, after lowering the dose passes), isolated abrupt disruption of the activity of liver enzymes in the blood serum; often - jaundice, acute liver damage, liver failure (sometimes fatal); very rarely - chronic liver diseases such as cirrhosis, pseudo-alcoholic hepatitis (sometimes fatal);
- On the part of the sense organs: very often - transient visual impairment (blurred contours in bright light) caused by the deposition of complex lipids in the corneal epithelium; very rarely - optic neuritis or optic neuropathy;
- On the part of the skin: very often - photosensitivity; often - transient skin pigmentation (with prolonged therapy); very rarely - erythema, skin rash, alopecia, exfoliative dermatitis (the connection with the drug has not been confirmed);
- From the nervous system: often - extrapyramidal symptoms (tremor), sleep disturbances, nightmares; rarely - myopathy and / or peripheral neuropathies (sensorimotor, mixed, motor); very rarely - cerebellar ataxia;
- Endocrine disorders: often - hypothyroidism (with a high level of thyroid-stimulating hormone (TSH) in the blood serum, it is necessary to cancel the drug), hyperthyroidism; very rarely - syndrome of impaired secretion of antidiuretic hormone;
- Others: very rarely - epididymitis, vasculitis, impotence (the connection with amiodarone has not been confirmed), hemolytic anemia, thrombocytopenia, aplastic anemia.
The use of Cordaron in the form of a solution causes undesirable effects:
- From the side of the cardiovascular system: often - a moderate and transient decrease in blood pressure (BP); very rarely - proarrhythmogenic effect, progression of heart failure, rush of blood to the skin of the face (with intravenous jet injection);
- Immune system disorders: very rarely - anaphylactic shock; frequency unknown - angioedema;
- From the respiratory system: very rarely - shortness of breath, cough, interstitial pneumonitis;
- On the part of the skin: very rarely - increased sweating, a feeling of heat;
- From the digestive system: very often - nausea; very rarely - an increase or decrease in the activity of liver enzymes in the blood (isolated), acute liver damage (sometimes fatal);
- Reactions at the injection site: often - pain, edema, induration, erythema, necrosis, infiltration, transudation, inflammation, phlebitis (including superficial), thrombophlebitis, cellulitis, pigmentation, infection.
The drug should only be taken as directed by a doctor!
Side effects of Cordaron are dose-dependent, therefore, treatment should be carried out with the minimum effective doses.
During the period of use of the drug, patients should avoid exposure to direct sunlight.
The appointment of the drug should be made taking into account the data of the ECG and blood tests to determine the potassium content. Correction of hypokalemia should be completed before starting treatment. Treatment should be accompanied by regular monitoring of ECG (1 time in 3 months) and liver function indicators.
Patients with and without thyroid diseases, before starting therapy with amiodarone, during treatment and for several months after discontinuation of the drug, should undergo laboratory and clinical examination of the thyroid gland.
In case of suspicion of functional disorders, it is necessary to determine the level of TSH in the blood serum.
The iodine content in the preparation does not affect the reliability of determining the level of TSH, hormones T 3 and T 4 in the blood plasma, but it can distort the results of radioisotope studies of the thyroid gland.
During the period of use of the drug, patients should undergo an X-ray examination of the lungs and pulmonary functional tests every 6 months.
During long-term therapy of patients with a pacemaker or an implanted defibrillator, it is necessary to regularly monitor their correct functioning.
With the appearance of AV block of the first degree, it is necessary to strengthen supervision. In case of development of sinoatrial blockade, AV-blockade of II and III degree or double-beam intraventricular block, treatment should be discontinued.
An ophthalmological examination should be carried out with an examination of the fundus with a decrease in acuity and the appearance of blurred vision. Patients with optic neuritis or neuropathy that develop while taking amiodarone, further use of the drug should be canceled.
Before the operation, it is necessary to inform the anesthesiologist about the drug intake.
Long-term therapy with Cordaron may increase the hemodynamic risk associated with anesthesia.
In addition, in rare cases, patients may experience acute respiratory distress syndrome immediately after surgery, which requires careful monitoring with mechanical ventilation.
IV jet administration should be carried out for at least 3 minutes, repeated administration is possible only 15 minutes after the first.
Against the background of the introduction of the drug, the development of interstitial pneumonitis is possible, therefore, in the event of severe shortness of breath or dry cough, with or without deterioration of the general condition (increased fatigue, fever), the patient should undergo a chest x-ray. If the x-ray picture is disturbed, the drug must be canceled, since the disease can develop pulmonary fibrosis.
It is possible to develop severe acute liver damage with the development of liver failure (sometimes fatal) during the first days of injection, it is necessary to regularly monitor liver function during therapy.
Simultaneous use with verapamil, diltiazem and beta-blockers, except for esmolol and sotalol, is possible only for the prevention of life-threatening ventricular arrhythmias and restoration of cardiac activity after cardiac arrest caused by ventricular fibrillation resistant to cardioversion.
During the period of therapy, patients are advised to refrain from driving vehicles and mechanisms.
Only the attending physician can determine the possibility of concomitant therapy, taking into account the condition and clinical indications of the patient.
Analogues of Cordaron are: Amiocordin, Amiodarone, Amiodarone-SZ, Vero-Amiodarone, Cardiodarone, Ritmorest, Arrhythmil, Rotaritmil.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 30 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Cordaron: prices in online pharmacies
Cordaron tablets 200mg 30 pcs.
Cordaron 200 mg tablets 30 pcs.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!