Периферический вазодилататор, антиангинальный препарат из гр... Инструкция
Показания к применению
Профилактика приступов стенокардии.
Противопоказания
Острый инфаркт миокарда, протекающий с артериальной гипотензией. - Выраженная артериальная гипотензия (систолическое АД ниже 100 мм рт.ст.). - Коллапс. - Кардиогенный шок. - Низкое давление наполнения левого желудочка. - Токсический отек легких. - Одновременный прием сильденафила. - Беременность. - Период лактации. - Детский и подростковый возраст до 18 лет (эффективность и безопасность не установлены). - Повышенная чувствительность к препарату. С осторожностью назначают препарат в следующих случаях: - Перенесенный геморрагический инсульт. - Повышенное внутричерепное давление. - Склонность к артериальной гипотензии. - Лица пожилого возраста. - Пациенты с глаукомой (особенно закрытоугольной). - При нарушениях мозгового кровообращения.
Действующее вещество: Молсидомин (Molsidomine)Концентрация действующего вещества (мг): 2
Фармакологические свойства
Периферический вазодилататор, антиангинальный препарат из группы сиднониминов. расширяет периферические венозные сосуды, оказывает антиагрегантное, анальгезирующее и антиангинальное действие. венодилатирующая активность обусловлена выделением после ряда метаболических превращений оксида азота (nо), стимулирующего растворимую гуанилатциклазу, в связи с этим молсидомин рассматривается как донатор nо. в результате этого происходит накопление цгмф, который способствует расслаблению гладких мышц стенки сосудов (в большей степени - вен). снижение преднагрузки даже без прямого влияния на сократимость миокарда приводит к восстановлению нарушенного при ибс соотношения между потребностью миокарда в кислороде и его поступлением (на 26% уменьшается потребность в кислороде). препарат снимает спазм коронарных артерий, улучшает коллатеральное кровообращение.увеличивает переносимость нагрузок, уменьшает число приступов стенокардии при физической нагрузке. подавляет раннюю фазу агрегации тромбоцитов, снижает выделение и синтез серотонина, тромбоксана и других проагрегантов.у больных с хронической сердечной недостаточностью, снижая преднагрузку, способствует уменьшению размеров камер сердца. снижает давление в легочной артерии, уменьшает наполнение левого желудочка и напряжение стенки миокарда, ударный объем крови.действие начинается через 20 мин после приема внутрь, достигает максимума через 0.5-1 ч и длится до 6 ч. развитие толерантности со снижением эффективности во время длительной терапии нехарактерно (в отличие от нитратов).
Показания к применению
Профилактика приступов стенокардии.
Противопоказания
Острый инфаркт миокарда, протекающий с артериальной гипотензией. - Выраженная артериальная гипотензия (систолическое АД ниже 100 мм рт.ст.). - Коллапс. - Кардиогенный шок. - Низкое давление наполнения левого желудочка. - Токсический отек легких. - Одновременный прием сильденафила. - Беременность. - Период лактации. - Детский и подростковый возраст до 18 лет (эффективность и безопасность не установлены). - Повышенная чувствительность к препарату. С осторожностью назначают препарат в следующих случаях: - Перенесенный геморрагический инсульт. - Повышенное внутричерепное давление. - Склонность к артериальной гипотензии. - Лица пожилого возраста. - Пациенты с глаукомой (особенно закрытоугольной). - При нарушениях мозгового кровообращения.
Применение при беременности и в период грудного вскармливания
Применение Сиднофарма противопоказано при беременности. При необходимости назначения препарата в период лактации следует отказаться от грудного вскармливания.
Способ применения и дозы
Режим дозирования и продолжительность терапии устанавливают индивидуально. Препарат принимают внутрь независимо от приема пищи. Таблетки проглатывают целиком, не разжевывая и запивая достаточным количеством жидкости. Препарат назначают в начальной дозе 1-2 мг (0.5-1 таб.) 2 раза/сут. При недостаточной выраженности терапевтического эффекта кратность назначения увеличивают до 3 раз/сут. Максимальная суточная доза - 6 мг.
Побочное действие
Со стороны сердечно-сосудистой системы: часто - снижение АД, коллапс (при исходно повышенном АД выраженность его снижения больше, чем при исходно нормальном или пониженном АД); покраснение кожи лица, тахикардия. Со стороны ЦНС: головная боль (обычно незначительная, исчезает в процессе дальнейшего лечения), замедление скорости психомоторных реакций (в большей степени в начале лечения), головокружение. Со стороны пищеварительной системы: тошнота, потеря аппетита, диарея. Аллергические реакции: кожная сыпь, зуд, бронхоспазм; редко - анафилактический шок.
Передозировка
Симптомы: сильная головная боль, выраженное снижение АД, тахикардия. Лечение: при необходимости проводят симптоматическую терапию.
Особые указания
Препарат не применяют для купирования приступа стенокардии. С осторожностью и под контролем АД назначают первую дозу препарата, т.к. возможны интенсивные головные боли и чрезмерное снижение АД с потерей сознания. Пожилым больным с нарушениями функции печени и почек и артериальной гипотензией требуется коррекция дозы. Во время лечения следует избегать приема алкоголя. Влияние на способность к вождению автотранспорта и управление механизмамиВ период лечения (особенно в начале терапии) необходимо воздерживаться от вождения автотранспорта и занятий потенциально опасными видами деятельности, требующими повышенного внимания и быстроты психомоторных реакций.
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