Imdur
Imdur
Imdur (Isosorbide-5-Mononitrate)Pharmacological action
Antianginal preparation of the prolonged action. Reduces a preload (at the expense of expansion of peripheric veins) and an afterload (at the expense of depression of peripheric vascular resistance) by a myocardium and reduces requirement of a myocardium for oxygen. Enlarges a coronary blood flow, promotes its redistribution in area with the lowered blood supply. At preparation application tolerance rising to an exercise stress at patients from an ischemic heart disease, a stenocardia becomes perceptible. Reduces pressure in a small circle of a circulation.
Indications
- Preventive maintenance of attacks of a stenocardia;
- Secondary preventive maintenance of a myocardial infarction (carrying out of regenerative treatment at a remaining stenocardia);
- A pulmonary hypertensia (as a part of the combined therapy);
- A chronic heart failure (as a part of the combined therapy).
Dosage regimen
Dose establish individually.
The average dose of an Imdur preparation makes 50 mg of 1 times a day.
At long application of a preparation probably development of tolerance in this connection recommend to do after 3-6 weeks of regular reception of a preparation a break for 3-5 days, Imdur replacing other antianginal preparations.
Imdur tablets accept after meal, not chewing and washing down with a liquid small amount.
Side effect
From cardiovascular system: as a rule, disappears in some days of treatment and does not demand preparation cancellation. At the first application of a preparation or at dose rising are possible an arterial hypotension (including orthostatic), accompanied by a reflex tachycardia, block, giddiness, delicacy. At the expressed falling of a BP probably intensifying of symptoms of a stenocardia and-or the expressed bradycardia.
From the alimentary system: seldom - a nausea, vomiting.
Dermatological reactions: seldom - an erythema; on occasion - an exfoliative dermatitis.
The other: allergic reactions.
Imdur Contraindications
- An acute myocardial infarction with an arterial hypotension;
- A left ventricular failure with the lowered pressure of filling of a left ventricle;
- A shock, a vascular collapse;
- The expressed arterial hypotension (a systolic BP less than 90 mm hg);
- A hypertrophic subaortic stenosis;
- A chronic cardial compression;
- A cardiac tamponade;
- A hypersensibility to Sodium nitritums.
Pregnancy and lactemia
Application Efoksa Long at pregnancy and in a lactemia is possible only in that case when the prospective advantage for mother exceeds potential risk for a foetus or the child.
Imdur Special indicatings
Imdur does not apply to cupping of attacks of a stenocardia.
The preparation should be accepted with care at an aortal and-or mitral stenosis, at predilection to an arterial hypotension, at patients with disturbances of a cerebral circulation, at rising of intracranial pressure (including in the anamnesis), at patients with the expressed disturbances of function of kidneys.
At long application of a Imdur preparation probably development of tolerance to Isosorbidum to Monosodium nitritum. It is necessary to consider possibility of occurrence of two-dimensional tolerance to other Sodium nitritums. For prevention of weakening of action of a preparation it is necessary to avoid its constant application in high doses.
To cancel a preparation follows gradually because of possibility of development of a withdrawal.
At reception of a Imdur preparation probably occurrence of a time anoxemia at the expense of relative redistribution of a blood flow in hypoventilated alveolar zones. At patients from an ischemic heart disease it can lead to a time hypoxia of a myocardium.
In preparation application it is necessary to exclude the alcohol use.
Influence on ability to driving of motor transport and to management of mechanisms
Against application of a preparation do not recommend to be engaged in potentially dangerous kinds of activity demanding special attention and speed of psychomotor reactions.
Imdur Overdosage
Symptoms: a Crocq's disease (as a result of a methemoglobinemia), the delicacy, the speeded up and superficial breath, a hyperthermia, the expressed long arterial hypotension, a strong headache, frequent pulse of very weak filling.
Treatment: spend symptomatic therapy.
Medicinal interaction
At simultaneous Imdur application with antihypertensive preparations, beta adrenoblockers, blockers of calcium channels, neuroleptics, and also ethanol probably intensifying of hypotensive action.
Conditions and periods of storage
The preparation should be stored in a dry place. Not to apply a preparation after a period of validity specified on packing.
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