Isoptin
Isoptin (Verapamil)Pharmacological action
Selective blocker of calcium channels. Renders hypotensive, antianginal, antiarrhytmic action. Isoptin SR 240 suppresses function sin knot, slows down AV conductivity and extends the effective refractory period, causes negative inotropic effect. Dilates arterial vessels (including coronary), enlarges a renal blood flow. Hypotensive action of Isoptin SR 240 is based on ability of a preparation to reduce peripheric resistance of vessels without reflex augmentation of the CARDIAC CONTRACTIONS RATE. BP depression occurs already in the first days of reception of a preparation. The effect remains and at long therapy.
Isoptin SR 240 does not render significant influence on a BP normal amount.
The preparation has long therapeutic an effect at reception of 1 times/days Thanks to the medicinal form constant level of verapamil in plasma and long action is provided.
Indications
- A soft and moderate arterial hypertensia (in the form of monotherapy);
- A serious arterial hypertensia (as a part of the combined therapy with other hypotensive preparations: diuretics).
Dosage regimen
The dose of Isoptin SR 240 should be selected individually, depending on disease severity level.
Average dose at an arterial hypertensia - 240 mg of 1 times/sut in the morning. In need of slow depression of a BP the recommended initial dose makes 120 mg of 1 times/sut in the morning.
Dose rising should be spent after 2 weeks of reception of a preparation. A dose enlarge to 480 mg/sut (on 1 tablet. In the morning and in the evening, with an interval nearby 12 h between receptions).
At long therapy the daily dose should not exceed 480 mg. Dose excess probably only for very short time under the careful medical control.
Tablets 240 are necessary for accepting Isoptin SR not chewing, washing down with a liquid small amount, it is preferable before food intake or right after meal.
Side effect
From cardiovascular system: sometimes - a sinus bradycardia, AV blockade, an arterial hypotension, a congestive heart failure.
From nervous system: seldom - giddiness, block, a headache, feeling of weariness, nervousness, paresthesias.
From the party GASTROINTESTINAL TRACT: sometimes - constipations, a nausea.
The other: seldom - occurrence of pains in muscles and joints.
Contraindications
- A cardiogenic shock;
- An acute phase of the complicated myocardial infarction (with the phenomena of the bradycardia expressed to an arterial hypotension, a left ventricular failure);
- AV blockade II and III degrees;
Pregnancy and lactemia
Isoptin SR 240 should be prescribed in pregnancy (especially in I trimester) only under strict indications and under the careful medical control.
In need of appointment in a lactemia it is possible to continue thoracal feeding under condition of preparation reception at once after feeding and for 4 h to the following and at the medical control over a condition of the child.
Special indicatings
With care prescribe a preparation to patients with a heart failure (in this case it is necessary to compensate preliminary a condition of the patient). At simultaneous application with digoxin it is necessary to supervise carefully a condition of the patient and concentration of digoxin in a blood plasma.
It is necessary to be careful at appointment of Isoptin SR to 240 patients with AV blockade of I degree (in connection with transition possibility in full blockade), at an arterial hypotension (a systolic BP below 90 mm hg), the patient with a torsade de pointes of auricles in a combination to a syndrome of premature excitation of ventricles (including with syndrome WPW), the patient with the expressed disturbances of function of a liver (it is possible, is required the dose decline), to patients of advanced age (because of possible depression of volume of distribution and the general clearance of verapamil).
Overdosage
Symptoms: BP falling, serious disturbances of conductivity, a cardiogenic shock.
Treatment: the gastric lavage is recommended in all cases when has passed less than 12 h from the moment of preparation reception, and in later terms at the lowered motility GASTROINTESTINAL TRACT (absence of intestinal hums at stomach auscultation
Medicinal interaction
At simultaneous application of Isoptin SR 240 with carbamazepine and lithium salts probably development of toxic lesions of nervous system.
Simultaneous appointment of Isoptin SR 240 with rifampicin or phenobarbital leads to reduction of its efficiency.
Appointment of Isoptin SR 240 together with Cimetidinum leads to intensifying of action of Isoptin SR 240.
Isoptin SR 240 can strengthen action of other antihypertensive agents.
Conditions and periods of storage
The preparation should be stored at temperature not above 25 C.
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