Spray "Izoket": instruction manual, reviews, description, analogs, price

Today, many specialists prescribe to patients a vasodilating spray "Izoket" with a prophylactic purpose or when it is necessary to stop an attack of angina pectoris. This drug has an extensive list of different indications for use. It is successfully used in the therapy of cardiovascular pathologies, including for the control of acute conditions.

Pharmacology

The active substance of this medicine for angina pectoris is characterized by pronounced vasodilating and vasodilating properties. Isosorbide dinitrate stimulates the formation of nitric oxide in the body and reduces the needs of the heart muscle in oxygen and energy, thereby reducing the burden on the myocardium. It effectively reduces pressure in a small circle of blood circulation, weakens the blood flow to the right atrium, reduces the stress of the walls of the cardiac ventricles, decreasing diastolic pressure and improving the systolic function in them. The drug has no effect on the frequency of cardiac contractions and extends well the cerebral vessels. It can also increase the vessels of the dura mater and the brain itself, thereby causing pain in the head. The drug affects the redistribution of coronary blood flow in the area where blood circulation is reduced. With IHD (ischemic heart disease) and angina due to the drug in patients, it becomes possible to increase the permissible physical loads.

The spray "Izoket" is quickly absorbed over the entire area of the oral mucosa, therefore the effect of its application comes after 30 seconds and lasts up to 120 minutes. Due to its speed, it is often prescribed to patients for relief of acute acute conditions.

Form of issue

The drug is a clear solution that is colorless and has an alcoholic odor. It comes in two varieties:

1. Spray "Izoket" is sublingual and dosed. With one push on the dispenser, one dose is released in the form of tiny drops, which consists of 1.25 mg of the active ingredient isosorbide dinitrate, as well as auxiliary elements: ethanol and macrogol 400. The aerosol is not contained in Freon, so it refers to drugs that are harmless For the environment. Produced in transparent bottles of 15 ml, packed in a box with a dispenser and instruction. Glass bottle, designed for 300 clicks (doses), allows you to monitor the amount of the drug and promptly purchase a replacement.
2. Solution in the form of a concentrate, intended for infusion. In 1 ml of this drug contains 1 mg of the active isosorbide dinitrate element and additional substances: sodium chloride, sodium hydroxide, water. In one ampoule - 10 ml of solution for infusion. Produced in cardboard packs of 10 pieces in each.

Indications for use

The "Isoket" spray is prescribed by specialists for stenocardic attacks of all forms and as a preventive measure for their avoidance. It is also recommended for postinfarction conditions, myocardial infarction in the acute stage, increased tolerance for IC and treatment of spasm of the coronary arteries. Aerosol "Izoket" is successfully used as a medicine for heart failure in the area of the left ventricle. According to the instructions, concentrate for infusion is prescribed for patients with such cardiovascular pathologies:

• Unstable angina arising in the pre-infarction state or a previous myocardial infarction;
• Vasospastic angina pectoris;
• Myocardial infarction in acute form, caused by left ventricular failure of the heart;
• Spasm of coronary vessels during surgical interventions;
• Heart failure of all kinds;
• Acute left ventricular heart failure;
• pulmonary edema.

Methods of aerosol application

The drug in the form of a spray is sprayed into the oral cavity of the patient, due to this, it quickly enters the bloodstream. Each injection provides ingestion of one dose of the drug. Instructions for use indicate different ways of using the medication depending on the symptomatology.

In order to stop angina pectoris, before the forthcoming physical or emotional load, which can cause an exacerbation, the breath is delayed, and the patient receives from 1 to 3 doses with an interval of 30 seconds between injections. Increase in dosage without specialist supervision is prohibited.

In case of suspicion of exacerbation of heart failure or myocardial infarction with acute course, the patient receives from 1 to 3 doses of the drug under strict control of both heart rate and blood pressure. If the improvement does not occur, then the procedure is repeated after five minutes by the doctor's decision. In the next ten minutes, the condition should stabilize. Otherwise, you can repeat the manipulation again under the supervision of a doctor.

Before the therapeutic procedure of arresting coronary spasm (in the case of diagnostic or therapeutic catheterization), the patient is prescribed 1-2 injections. If the need arises, the dosage can be repeated, but under the condition of monitoring the circulatory indices.

Special recommendations on the use of a spray

In cases where a new aerosol is used for the first time, or after more than 24 hours after the last intake, it is recommended that the first pressure be directed into the air, since it may not contain the required dosage. To receive a dose according to the instructions, the nebulizer is pressed continuously until the end and then released. During use, the spray bottle must be placed upside down and in a vertical position. Care should be taken not to spill into the eyes. During the entire treatment period, constant monitoring of blood pressure (BP) and ECG is necessary. The value of blood pressure should not be less than 100 mm Hg. Art. Abrupt drug cancellation is forbidden by the instruction, therefore the prescribed doses decrease gradually. Alcoholic beverages are contraindicated when taking an aerosol "Izoket".

Experts' reviews indicate that a high dosage of a drug, its frequent use or systematic application can lead to the development of tolerance in the patient. This feature develops with the use of other drugs that have nitrates in the composition. In such situations, doctors recommend that the use of the drug be canceled for 2-3 days, and after a course of regular therapy lasting 3-6 weeks, pause for 3-5 days, and replace it temporarily with other drugs of a similar effect. In most cases, after a break or cancellation of therapy, the patient's sensitivity is restored fairly quickly. The components of the drug are excreted in the form of metabolites by the kidneys almost in full.

Dosage and use of the solution

According to the prescriptions in the manual, the drug "Izoket" (solution for infusion) is used intravenously. The dosage is prescribed by the treating vrach individually, taking into account the hemodynamic and clinical parameters of the patient. Therapy should start with low doses and, slowly increasing, bring to the required amount. The recommended dosage is 2-7 mg / h, respectively, the average dose is about 7.5 mg / h. In cases of special need, the volume may be increased to 10 mg / h.

In most cases, people with heart failure need increased doses of the drug. The drug should be administered under in-patient treatment under the supervision of a specialist and using automatic infusion systems. The entire procedure is accompanied by monitoring of blood circulation (blood pressure and heart rate).

The solution for intravenous administration is prepared under sterile conditions immediately before the procedure. The drug is stored no more than 24 hours. Ways of preparation:

• For a concentration of 0.01% (100 μg / ml), 500 ml of the preparation ready for administration can be prepared from 50 ml of 0.1% medicament;
• For a concentration of 0.02% (200 μg / ml), 500 ml of a medicament ready for administration can be prepared from 100 ml of 0.1% medicament.

Contraindications and precautions

The drug is not prescribed for hypersensitivity of the patient to nitrate compounds, as well as other elements of the aerosol "Izoket". The use is also prohibited if the patient has such diseases:

• Pronounced hypotension, at which the systolic pressure drops below 90 mm Hg;
• Vascular insufficiency in the acute stage, for example, with shock or vascular collapse;
• Pericarditis and pericardial tamponade;
• With cardiogenic shock in cases where it is not possible to correct in another way the pressure in the left heart ventricle;
• Hypertrophic cardiomyopathy;
• Angle-closure glaucoma.

In addition, the drug is not prescribed to persons under the age of eighteen. Instruction for use recommends the use of the drug with extreme caution and with constant supervision in such cases:

• Myocardial infarction with an acute form of flow in the presence of a patient with a low filling pressure of the left cardiac ventricle;
• Increased intracranial pressure;
• Mitral and / or aortic stenosis;
• Detection of a patient's probability of occurrence of an orthostatic disorder in the regulation of blood circulation;
• Renal or hepatic insufficiency.

Pregnancy and lactation

Scientists in the development of the drug were carried out animal studies. Experiment on the subjects showed that the damaging effect on the fetus is not performed. However, during pregnancy and during the lactation period, the appointment of an aerosol is recommended only in those situations where the intended use for a woman will significantly exceed the potential risk to the fetus or infant. Treatment in these cases should be conducted under the strict supervision of specialists who monitor blood circulation (blood pressure and heart rate), as well as the general condition of the patient.

Interaction with other medicines

The joint use of vasodilators and the drug "Izoket" (spray) is forbidden. Applying them in combination can cause an increase in the hypotensive effect. The same consequence entails the simultaneous administration of Isoket aerosol and such medications: antihypertensive agents, calcium channel blockers, quinidine or Novokainamide, neuroleptics, phosphodiesterase-5 inhibitors.

It is possible to enhance the antianginal effect when used in combination with such drugs as Amiodarone, Propranolol, Nifedipine, Verapamil, and with other calcium delayed channel blockers.

Increased intracranial pressure in the patient may occur with combined therapy with atropine and other m-holinoblokatorami.

Excessive reduction in blood pressure, leading to coronary perfusion, appears under the influence of alpha-adrenoblockers and sympathomimetics.

Side effects and reviews

The manual describes a lot of side effects that can be caused by the drug "Isoket" (spray). Reviews of some patients taking this medication indicate the appearance of headaches, which in medicine are called "nitrate". As a rule, after 2-3 days the problem disappears on its own and does not require correction. Quite often, a drug can cause such things as nausea, redness of the skin, vomiting and dry mouth. Some patients who received medication for the first time complain of general weakness, dizziness, lower blood pressure and a sense of inhibition. This is caused by small disturbances in the functioning of the cardiovascular system. They occur during initial use or when the recommended dosage is exceeded.

However, according to reviews, patients noticed the effectiveness of the drug. And when taken in accordance with the prescription of a specialist, side effects do not occur so often. The exception is the headache in the first days of use, which accompanies most cases, but usually takes a few days.

Exceeding the maximum volume

Overdose of this medication can cause a number of serious abnormalities: fainting, collapse, high intracranial pressure, hyperthermia, convulsions, visual function disorders, increased sweating, methemoglobinemia, bradycardia, paralysis and coma. That is why it is important not to engage in self-medication of the heart, but take the drug strictly according to the instructions of a specialist!

With the described symptoms, it is necessary to cancel the drug and conduct therapy aimed at stabilizing the patient's condition.

Analogues

The drug "Kardiket" (CHWARZ PHARMA, Germany) - one of the most common generics (analogues) of the drug "Isoket" (spray). The price of this substitute depends on the concentration of the active substance and the number of pills in the package.

For example, the drug in 20 mg tablets "Kardiket retard" (20 pieces per pack) costs from 62 to 72 rubles, and the same drug, only with a dosage of 40 mg tablets and a quantity of 50 pieces, has a cost of 210-220 rubles.

The group of medicines "Nitrosorbid", produced by several Russian companies and having different forms of release, is also a substitute for the drug "Izoket". Analogues of this group have the following names: Nitrosorbid-Rusfar, Nitrosorbid, Nitrosorbid NS, Nitrosorbid-UVI.

Cost

In Russian pharmacies will have to pay from 365 to 470 rubles for a dosed drug "Izoket" (spray). The price is formed depending on the location of the outlet and its status. On the sites that sell medicines, it can be purchased at a lower cost than in a regular pharmacy near the house. But when ordering through the Internet, you will have to pay about 200 rubles for delivery or receive the product for free at the point of self-transportation, which is not always geographically conveniently located.

Also in any pharmacy you can buy a package (10 ampoules) of concentrated solution for infusion "Izoket". The price for it varies between 906-980 rubles.

General information

The drug was produced by the German company "USB Farma GmbH". Its shelf life is five years. The condition of sale is the prescription of a doctor. If the pump is not used for a long time, it is recommended to check the sprayer for proper operation. An arrow is drawn on the aerosol label from the bottom. When the liquid reaches its level, a new preparation should be purchased, since the use of an already available vial is possible only with a slight inclination, at which the suction tube is immersed in the liquid.