Tradename: Kuraltil ® 25.
International UnPatented Name (MNN): Dipyridamol.
Chemical name: 2,2,2,2,2 - ((4.8 - di (piperidine - 1 -il) pyrimidine (5,4 - d) pyrimidine - 2.6 - dyire) dinitilo) tetraethanol
Dosage form:
Dragee.Structure:
In one dragee contains:Core:
Active substance: Dipyridamol 25 mg
Auxiliary substances: Corn starch, monohydrate lactose, gelatin, magnesium stearate, talc.
Shell: sucrose, calcium carbonate, magnesium carbonate, talc, macrogol 6000, glucose syrup, titanium dioxide, polyvidone K25, carnab wax, chinoline yellow dye (E 104).
Description: Dragee from yellow to greenish yellow, with smooth surfaces, have a homogeneous look.
Pharmacotherapeutic Group:
Vasodilator.ATH code: V01As07.
Pharmachologic effect: Kuranyl ® has a thoring effect on platelet aggregation, improves microcirculation. It has a vasodilatory action.
As a pyrimidine derivative, Kuranyl ® is an inducer of interferon and has a modulating effect on the functional activity of the interferon system, increases the reduced products of interferon alpha (A) and gamma (y) in vitro blood leukocytes. Kuranyl ® increases nonspecific antiviral resistance to viral infections,
Pharmacokinetics: The maximum concentration of dipyridamol in plasma is achieved within 1 hour after intake. Dipyridamol is almost completely associated with blood proteins. The accumulation of dipyridamol occurs in the heart and in red blood cells. Dipyridamol is metabolized in the liver by binding with glucuronic acid. The half-life is 20 - 30 minutes. Displays with bile in the form of a monoglucronide.
Indications for use
Contraindications
Method of application and dose
If the doctor is not appointed differently, the following dosing modes are recommended:To reduce the aggregation of platelets, it is recommended to use KARRATIL ® at a dose of 75 - 225 mg / day in several techniques. In severe cases, the dose can be increased to 600 mg / day.
For the prevention of influenza and other ARVI, especially during the epidemic, take according to the following scheme: 50 mg / per day (2 dragey 25 mg) 1 time in 7 days within 4-5 weeks.
For the prevention of relapses, in frequently ill with respiratory viral infections of patients, Kuranyl ® (25 mg dragee) is recommended to be taken according to the scheme:
100 mg / per day (2 times 50 mg with an interval at 2 o'clock) 1 time per week for 8-10 weeks, Kuraltil ® It is recommended to take an empty stomach, without sampling the drag, drinking a small amount of fluid. Side effects. When using therapeutic doses, side effects are usually not expressed and are transitional. It is possible to occur vomiting, diarrhea, epigastric pains, as well as symptoms such as weakness, dizziness, nausea, headache, arthritis, myalgia, rhinitis. Usually, these side effects are disappearing with a longer use of KARANTIL ®. As a result of the potential vasculating action of Kuranyl ® in high doses, it may cause arterial hypotension, a feeling of "tides" and tachycardia, especially in persons taking other vasodilators, coronary condemning syndrome (with doses of more than 225 mg per day).
Possible reactions of hypersensitivity by type of rash or urticaria. In very rare cases there was an increased bleeding during or after surgery.
When the side effects appear, you must consult a doctor! Interaction with other drugs (other interaction)
Xanthine derivatives (coffee, tea) can weaken the vasodilatory effect of dipyridamole.
The use of dipyridamol simultaneously with anticoagulants (heparin, thrombolytics) or acetylsalicylic acid increases the risk of developing hemorrhagic complications, which must be considered when sharing. Dipyridamol can enhance the effect of hypotensive drugs. Dipyridamol can weaken the anticholinergic properties of cholinesterase inhibitors.
An anti-aggregative effect is enhanced when taking cefalosporins antibiotics (cefamandol, cefoperazone, cefithetan). Antacids reduce the maximum concentration due to reduction of absorption. Conditions of vacation According to the doctor's prescription. Release form. 100 dragee in a bottle of transparent glass with a polyethylene cork. One bottle in a cardboard pack along with instructions for use. Storage conditions. List B. in light-protected place, at a temperature not higher than +25 ° C! Keep out of the reach of children! Shelf life. 5 years. The date of the expiration date of the drug is indicated on the folding cardboard box and on the primary packaging.
After the expiration of this period, the drug is impossible! The name of the manufacturer and address: Berlin-Chemie AG / Menarini Group
Glienicker WEG 125 D-12489
Berlin Germany Berlin-Hemi AG / Menarini Groups
Glinicker Vegg 125 D-12489
Berlin, Germany Address for complaints:
115162, Moscow, ul. Shabolovka, house 31, p. B.
Pharmacodynamics. KARANYTH - antiagregative tool inhibits the inverse penetration of adenosine into intracellular space, thereby increasing its concentration in blood plasma and anti-aggregation effect on platelets and red blood cells. In addition, the Kuraltil increases the anti-aggregative activity of Prostaglandin E1 and in high doses inhibits PDE in platelets, as a result of which the CAMF accumulates and the release of thromboxane A2 is hampered, which leads to the braking of platelet aggregation and increase their life. Thanks to the adenosine mechanism, the drug also expands the coronary artery, increases coronary blood flow and stimulates the formation of collaterals.
Pharmacokinetics. After oral administration, it is quickly absorbed into the gastrointestinal tract, mainly in the stomach and partially in the small intestine. Absorption largely depends on the level of pH of the gastric juice, therefore bioavailability has significant individual oscillations and is 43 ± 13%. About 98% binds to blood plasma proteins and accumulates in heart and red blood cells. Cmax in blood plasma is noted approximately 60 minutes after oral administration. Dipyridamol is metabolized in the liver by binding with glucuronic acid. T1 / 2 is 20-30 minutes. The removal of the drug occurs mainly with biliary and feces in the form of a monocluucronide.
Indications for the use of the drug Kuraltil
Stable angina, chronic heart failure, prevention and treatment of myocardial infarction, prevention and treatment of violations of cerebral blood circulation on ischemic type, chronic brainwater failure, discirculatory encephalopathy, vascular failure, prevention of arterial and venous thrombus and thromboembolic complications (in combination with acetylsalicylic acid or With anticoagulants), the prevention of thromboembolism after the prosthetics of the heart valves, the prevention of placental insufficiency, intersecting chromotype, as part of complex therapy in the microcirculation disorders of various genesis.
Application of drug Kuraltil
Therapy should be started with a gradual increase in dose. The duration of treatment and the dose is established individually depending on the testimony and tolerance. Kuraltil can be used to carry out a long course of treatment. Drying is not chewing, drinking liquid, on an empty stomach or 1 hour before meals.
Adults and children over the age of 12: 75-225 mg of dipyridamol per day (3-9 dragee) in several techniques. With a light course of the disease or, with an improvement in the state, 25-50 mg 3 times a day can be received. In case of severe dose of dose, up to 600 mg of dipyridamol per day can be elevated. To prevent thromboembolism in patients using anticoagulants or acetylsalicylic acid simultaneously, the drug is prescribed 75 mg 3-6 times a day.
Contraindications for the use of drug Kuraltil
Increased sensitivity to dipyridamol, diffuse stenosis atherosclerosis of coronary arteries, subaportal stenosis, unstable angina, acute myocardial infarction, heart failure in the decompensation stage, arterial hypotension of severe, collapse, heart rate disorders, renal insufficiency of severe, diseases with increased risk of bleeding development ( Poor disease of the stomach and duodenal intestine, hemorrhagic diathesis).
Side Effects of the drug Kuraltil
Usually weavigrate and transient:
from cardiovascular system: Headache and dizziness of vascular genesis, arterial hypotension, hyperemia of the skin with a feeling of heat, tachycardia, especially when using vasodilators, sometimes - an exacerbation of IBS, unstable angina or myocardial infarction may develop;
from the gearbox: nausea, vomiting, diarrhea, dyspeptic disorders;
from the hepatobiliary system: There are reports that dipyridamol is part of the gallbladder stones;
from the side of the skin and subcutaneous fiber: skin rash and urticaria;
from the immune system: bronchospasm and swelling of quinqua are possible;
from the blood system and lymphatic system: It is very rare - an increase in bleeding during or after surgical interventions, in some cases - thrombocytopenia.
from the musculoskeletal system: Malgy;
general violations: Total weakness.
Special guidelines for the use of the drug
With lactase deficiency, galactosemia and impaired glucose / galactose absorption, the drug should not be applied.
Use during pregnancy and lactation. The use of Kurantyl is possible only after estimating the possible risk and expected benefit.
Application in children. The use of dipyridamol in children under the age of 12 years is not recommended, since there is no sufficient clinical experience.
The ability to influence the reaction rate when driven by vehicles or working with mechanisms. It is possible to reduce blood pressure, and the insufficient insufficiency of the blood supply to the brain may affect the ability to control vehicles and work with potentially hazardous mechanisms.
The interactions of the drug Kuraltil
Ksanthina derivatives (caffeine, theophylline) can weaken or completely neutralize the effect of the drug, so they cannot be assigned simultaneously. During treatment, KARANTIL should refrain from frequent use of strong coffee or tea. Under the influence of the drug may increase the effect of hypotensive agents, as well as decrease by the antiholinergic activity of the distigmine. Kuraltil can enhance the effect of anticoagulants and acetylsalicylic acid, so if they are simultaneously use, it is necessary to take into account the possible increase in the risk of intolerance to these funds.
Overdose of the drug Kuraltil, Symptoms and Treatment
Symptoms: GENERAL VASODULATION, accompanied by hypotension, tachycardia, feeling of heat in the body, hyperemia of the skin of the face, weakness and dizziness.
Treatment: It is necessary to rinse the stomach or cause vomiting; Activities are carried out to reduce suction, adsorbents and other symptomatic therapy are prescribed. The vasodilating effect of dipyridamol can be stopped in / in the introduction of aminoophylline (50-100 mg for 1 min). Nitroglycerin sublingual is used to relieve the attack of angina.
Conditions for the storage of the drug
In a dark place at a temperature not higher than 25 ° C.
List of pharmacies where you can buy Kuraltil:
- St. Petersburg
"Kuraltil" is a drug that is widely used in cardiological, obstetric and therapeutic practice. The remedy has a combined effect, which allows it to be used to treat pathologies and complications of various genes.
The most often "Kuraltil" is prescribed to pregnant women in the manifestations of the second and third degree toxicosis, as well as violations in the formation or functioning of the placenta.
Pharmacological effect of the drug
"Kuraltil" has a pronounced therapeutic effect, starting from 3-4 days of use. Therapeutic effect is achieved thanks to the pharmacological properties of the drug, among which:
- expansion of blood vessels, improved blood circulation;
- reducing platelet aggregation;
- improving the activity of human interferon;
- strengthening resistance against viruses;
- immunomodulatory action.
When is it assigned?
Kuraltil is rarely used as the main component of therapy - most often the drug is in the combined diagram of the treatment of diseases of various genesis. Diagnoses and pathologies in which it is advisable to appoint the drug, indicated in the official instruction.
In cardiology:
- violation of blood circulation processes of the brain;
- encephalopathy (the defeat of certain parts of the brain) of the discirculatory type;
- vessel thrombosis and arteries (treatment and prevention);
- prosthetics of heart valves (rehabilitation period after surgery for the prevention of thromboembolism).
In obstetrics / gynecology:
- placental insufficiency;
- other placenta pathology, accompanied by circulatory disorders;
- hypoxia arising from the lack of oxygen molecules due to impaired blood microcirculation in the placenta vessels.
In general (family) therapy:
- viral infections (flu, ORVI, etc.);
- decrease in immunity;
- rehabilitation period after surgery (as an immunomodulator).
How to use?
Tablets and Dragee "Kurantil" should be swallowed entirely. Wash the liquid without caffeine and sugar. The dosage of the drug is selected by the attending physician, taking into account the tolerance, the established diagnosis and related chronic diseases.
Note! For maximum efficiency, the drug should be taken on an empty stomach.
Contraindications
The list of restrictions for the destination "KARANTIL" is quite impressive, therefore, the independent use of this drug is strictly prohibited. The use of "KARANTIL" is contraindicated with the following diagnoses / conditions:
- heart failure in the decompensation stage (dysfunction);
- collapse;
- heart rate violation;
- myocardial infarction (acute stage);
- aggravation of the ulcer of the stomach / duodenum;
- hemorrhagic diathesis;
- atherosclerosis of the coronary arteries;
- subiutal aortic stenosis;
- elevated or reduced pressure;
- angina (in the absence of stability).
Also, the drug is not prescribed to children under 12 years and patients with heavy forms of renal and liver failure.
Overdose cases have not been recorded so far.
Application during pregnancy
"Kuraltil" is one of the frequently appointed drugs during pregnancy. It discharges a watching gynecologist or an obstetrician to normalize the state of the fetus in various violations in the functioning of the child's place (placenta). The placenta consists of a huge number of small blood vessels and capillaries, for which nutrients transportation takes place. Vitamins and oxygen to the fruit.
When malfunctions occur in the circulatory system, the fetus lacks the useful elements and oxygen molecules, which can affect its growth and development. The selection drug to normalize the work of the placenta is the "Kuraltil" (as the most safe and effective drug).
Remember that you can not appoint a drug yourself.
Application with lactation
The use of "KARANTIL" is not contraindicated when breastfeeding with the permission of the attending physicianwho estimated the ratio of possible risks and health benefits.
Side effects
The tolerability of the drug is usually very good, but the side effects were still diagnosed. Most often, patients complain about digestive disorders, epigastric pain, heart disease and skin reactions.
It manifests itself with the following signs:
- nausea;
- diarrhea;
- headaches (perhaps dizziness);
- malgy;
- facial redness;
- heartbearance;
- allergies (in the form of skin manifestations).
Important! When prescribing, patients with unstable pressure should take into account the hypotensive effect "KARANTIL".
Composition and form of release
The main component of the drug with an angioprotective and immunomodulatory action is dipyridamol. Depending on the main component content, the drug is produced in three dosage forms:
- dragee containing 25 mg of dipyridamole (100 pieces in a pack);
- shell tablets containing 25 mg of dipyridamole (120 pieces in a pack);
- pills in the shell containing 75 mg of dipyridamole (40 pieces in a pack).
Pharmacokinetics
The main part of the dipyridamole is absorbed from the stomach (the minimum amount is absorbed from the colors). "Kuraltil" is perfectly associated with plasma proteins (by 98%), metabolized in the liver. The maximum concentration reaches 60 minutes after the reception, accumulating mainly in red blood cells and the heart muscle.
special instructions
At the time of treatment, "KARANTIL" should be excluded from the diet, any drinks containing caffeine (tea, cocoa, coffee, etc.) should be excluded, since they significantly reduce the effectiveness of the therapy.
Registration Certificate Owner:
Berlin-Pharma CJSC
Produced:
Berlin-Chemie AG / Menarini Group
ATX code for Kuraltil
B01AC07 (Dipyridamole)
Analogs of the drug in ATX codes:
Before using the drug, Kuraltil you should consult with your doctor. This application instruction is intended exclusively for familiarization. For more information, please contact the manufacturer's annotation.
Clinical and Pharmacological Group
01.065 (Antiagregant. Vasodilator of myotropic action)
Release form, composition and packaging
Kuraltil® 25.
Dragee from yellow to greenish yellow, with smooth surfaces, homogeneous on appearance.
Auxiliary substances: corn starch, monohydrate lactose, gelatin, magnesium stearate, talc.
Composition of the shell of dragee: sucrose, calcium carbonate, magnesium carbonate, talc, 6000, dextrose syrup, titanium dioxide, polyvidone K25, carnab wax, chinoline yellow dye (E104).
100 pieces. - Flakes of colorless glass (1) - packs cardboard.
Kuraltil® N 25.
Auxiliary substances: lactose monohydrate, starch corn, gelatin, sodium carboxymethyl starch type A, silicon colloidal dioxide, magnesium stearate, hypimon, talc, titanium dioxide (E171), macrogol 6000, chinoline yellow (E104), Sixtone Emulsion.
120 pcs. - Flakes of colorless glass (1) - packs cardboard.
Kuraltil® N 75.
Tablets covered with yellow shell, round, flat-cylindrical.
Auxiliary substances: monohydrate lactose, corn starch, gelatin, carboxymethyl starchy sodium (type A), silicon colloidal dioxide, magnesium stearate, hypimon, talc, titanium dioxide (E171), macrogol 6000, chinoline emulsion (E104), Emulsion Symethylene.
10 pieces. - blisters (5) - packs cardboard.20 pcs. - Blister (2) - Cardboard packs. 20 pcs. - blisters (3) - packs cardboard.20 pcs. - Blister (5) - Cardboard packs.
pharmachologic effect
Vasodilator of myotropic action. It has a thoring effect on platelet aggregation, improves microcirculation.
Dipyridamol expands the arterioles in the system of coronary blood flow, when taking high doses - and in other parts of the circulatory system. However, in contrast to organic nitrates and calcium antagonists, the expansion of larger coronary vessels does not occur.
The vasodilator is due to two different inhibiting mechanisms: suppression of adenosine capture and inhibition of phosphodiesterase.
In vivo adenosine is detected at a concentration of approximately 0.15-0.20 μmol. This level is maintained due to the dynamic equilibrium between the emission and reverse capture. Dipyridamol slows down adenosine capture by endothelium cells, erythrocytes and platelets. After the administration of dipyridamol, an increase in the concentration in the blood of adenosine and the strengthening of due vasodilation was found. In higher doses, the aggregation of platelets caused by adenosine occurs, and the tendency to thrombosis decreases.
The decay of the CAMF and CGMF, overwhelming platelet aggregation, occurs in platelets under the action of the corresponding phosphodiesterase. In high concentrations, dipyridamol is oppressed by both phosphodiesterases, in therapeutic concentrations in the blood - only CGMF phosphodiesterase. As a result of the stimulation of the corresponding cyclas, the power of the CAMF synthesis increases.
As a pyrimidine derivative, dipyridamol is an interferon inducer and has a modulating effect on the functional activity of the interferon system, increases the reduced products of interferon alpha and gamma in vitro blood leukocytes. The drug increases nonspecific resistance to viral infections.
Pharmacokinetics
Suction and distribution
After one-time intake, at a dose of 150 mg of Cmax, dipyridamole in the plasma is an average of 2.66 μg / l and is achieved within 1 hour after reception.
Dipyridamol is almost completely associated with plasma proteins. Dipyridamol accumulates in the heart and in red blood cells.
Metabolism and elimination
Dipyridamol is metabolized in the liver by binding with glucuronic acid. T1 / 2 is 20-30 minutes. Displays with bile in the form of a monoglucronide.
Kuraltil: Dosage
The dose of the drug is selected depending on the severity of the disease and the patient's individual reaction.
For the prevention and treatment of violations of cerebral circulation, as well as for prevention, 75 mg 3-6 times / day are prescribed. The maximum daily dose is 450 mg.
To reduce the aggregation of platelets, the KARARTILE is prescribed at a dose of 75-225 mg / day in several techniques. In severe cases, the dose can be increased to 600 mg / day.
For the prevention of influenza and ARVI, especially during epidemics, the N25 chief and the chief 25 is prescribed 50 mg (2 tabs. Or 2 of the dragee) / day in 1 reception. The drug is accepted 1 time per week for 4-5 weeks.
For the prevention of ORVI recurrences, the patients with respiratory viral infections are often prevented by N25 patients and kuraltil 25 permits 100 mg / day (2 tabs. Or 2 times / day with an interval between receptions in 2 h). The drug is accepted 1 time per week for 8-10 weeks.
Tablets should be taken on an empty stomach, not blunting and not schoing, drinking with a small amount of fluid. The duration of the course of treatment is determined by the doctor.
Overdose
Symptoms: decreased blood pressure, angina, tachycardia, feeling of tides, weakness and dizziness.
Treatment: artificial vomiting, stomach wash, appointing activated carbon. The vesseloring effect of the drug can be stopped slow (50-100 mg / min) in / in the introduction of aminoophylline. In the event of the preservation of the symptoms of angina, the appointment of nitroglycerin is sublingual.
Medicinal interaction
With the simultaneous use of KARANTIL with anticoagulants or acetylsalicylic acid, the antithrombotic effect of the latter and, accordingly, the risk of developing hemorrhagic complications is enhanced.
With the simultaneous use of the chief enhances the effect of antihypertensive preparations.
When co-use, the kuraltil can weaken the anticholinergic effects of cholinesterase inhibitors.
With the simultaneous use of xanthin derivatives weakened by the vessels of the KARANTIL.
Pregnancy and lactation
It is possible to use the drug during pregnancy by testimony.
The use of the drug during lactation is possible only if the expected benefits of treatment exceeds the possible risk.
Kuraltil: Side effects
From the side of the cardiovascular system: heartbeat, tachycardia (especially with the simultaneous use of other vasodilators), bradycardia, blood tides to face, hyperemia of the skin of the face, coronary condemnation syndrome (when using the drug at a dose of more than 225 mg / day), decreased blood pressure.
From the digestive system: nausea, vomiting, diarrhea, pain in the epigastric area. Usually these side effects disappear with a longer use of the drug.
From the blood coagulation system: thrombocytopenia, change in the functional properties of platelets, bleeding; In isolated cases - increased bleeding during or after surgery.
From the CNS side: dizziness, noise in the head, headache.
Allergic reactions: skin rash, urticaria.
Others: Weakness, Feeling of Ear, Arthritis, Malgy, Rhinitis.
When using the drug in therapeutic doses, side effects are usually slightly expressed and carried out with a conventional nature.
Terms and Storage Terms
List B. The drug should be stored in a seat protected, inaccessible to children at a temperature not higher than 30 ° C. The shelf life of Karrantil N 25 and KARANTIL N 75 - 3 years, KARANTIL 25 - 5 years.
Indications
- treatment and prevention of violations of cerebral circulation on ischemic type;
- encephalopathy;
- primary and secondary prevention of IBS,
- especially in the intolerance of acetylsalicylic acid;
- prevention of arterial and venous thrombosis and the treatment of their complications;
- prevention of thromboembolism after surgery for the prosthetics of the heart valves;
- prevention of placental insufficiency with complicated pregnancy;
- disorders of microcirculation of any type (as part of comprehensive therapy);
- prevention and treatment of influenza,
- ARVI (as an interferon and immunomodulator inductor) - for receiving the drug at a dose of 25 mg.
Contraindications
- acute myocardial infarction;
- unstable angina;
- common stenosis atherosclerosis of the coronary arteries;
- subiutal aortic stenosis;
- heart failure in the decompensation stage;
- arterial hypotension;
- collapse;
- severe arterial hypertension;
- heavy heart rate disorders;
- chronic obstructive lung diseases;
- chronic renal failure;
- liver failure;
- hemorrhagic diathesis;
- diseases with increased risk of bleeding development (including
- ulcerative disease of the stomach and duodenum);
- increased sensitivity to the components of the drug.
special instructions
With simultaneous use of tea or coffee (containing xanthine derivatives), the vessels of the extraction of the KARANTIL can decrease.
Use in pediatrics
Impact on the ability to driving vehicles and control mechanisms
Care should be taken when driving vehicles and management of mechanisms, since the ability to concentrate the attention and speed of psychomotor reactions may deteriorate as a result of the decline of blood pressure on the background of Kurantyl intake.
Application in violation of the kidney function
Contraindicated in chronic renal failure
Application in violation of the liver function
Contraindicated in hepatic insufficiency
Description of the dosage form Solution for injections
Pharmacological effect solution for injections
Expands the coronary vessels (predominantly arteriole) and causes a significant increase in the volumetric speed of blood flow. Increases the oxygen content in the venous blood of the coronary sine and its absorption of myocardium. Promotes the development of collateral coronary blood circulation, reduced OPS, improves microcirculation, has an angioprotective effect. These effects are due to increased activity of endogenous adenosine by reducing its seizure of tissues and destruction (adenosine affects the smooth muscles of vessels and prevents the release of norepinephrine).It is an antagonist of the endogenous agregant ADP, inhibits FDE, while the release of aggregation activators - thrombooxane, ADP, serotonin, etc. is reduced, increases the synthesis of prostacyclin PGI2 endothelium of vascular tissue, which prevents platelet aggregation. Reduces platelets adhesiveness, prevents the formation of blood clots in vessels and reduce blood flow in ischemia. The antiagregant effect occurs at a plasma concentration of 0.1 μg / ml. As an antiagregative drug, it is often used in combination with ASK. Dose-dependent lengthens the pathologically shortened timbanity lifetime.
Expanding the coronary artery, especially unchanged, causes the phenomenon of the break. It is an inducer of interferon, a modulating effect has a modulating effect on the functional activity of the interferon system, increases the reduced products of interferon alpha and gamma in vitro blood leukocytes. Increases nonspecific antiviral resistance to viral infections.
Dipyridamol stress-echocrine in the diagnosis of IBS in patients with angiographically unchanged coronary arteries is characterized by high sensitivity in combination with high specificity (respectively 91 and 83%); The sensitivity of this test is higher with a multi-propelled lesion in patients with well-developed collaterals and in patients with reduced regional myocardial perfusion.
The venous outflow normalizes, reduces the incidence of deep veins in the postoperative period. Improves the microcirculation in the mesh shell of the eye, kidney gloms. Reduces the tone of the brain vessels, effective with dynamic violations of the cerebral circulation. According to an angiographic study, the combination of ASK with dipyridamol slows down the progression of atherosclerosis.
In obstetric practice, placental blood flow processes, warns the dystrophic changes in the placenta (in the threat of preeclampsia), eliminates the hypoxia of the fetus tissues and contributes to the accumulation of glycogen in them.
Pharmacokinetics solution for injections
When taking inside it is quickly absorbed in the stomach (most) and the small intestine. Bioavailability - 37-66%. TCMAX plasma - 40-60 min. Communication with plasma proteins - 80-95%. Quickly penetrates the fabric. Accumulates in large numbers in the heart and red blood cells. T1 / 2 - 20-30 minutes in the first phase, in the second phase - about 10 hours. Metabolized in the liver with the formation of a monoglucronide, which is excreted with bile (20% of the drug is included in the enterogeptic circulation). Cumulation is possible (mainly in patients with impaired liver function).With caution solution for injections
Lactation period, children's age (up to 12 years old - lack of sufficient experience).Dosing mode The injection solution
For the prevention of thrombosis as monotherapy and in combination with oral anticoagulants or with ASK - inward (on an empty stomach or 1 hour before meals), 75 mg 3-6 times a day; The daily dose is 300-450 mg, if necessary - 600 mg.For the prevention of thromboembolic syndrome, the wall thrombing and the aortocortonary shunts - on the first day of 50 mg, together with ASK, then 100 mg, the multiplicity of reception - 4 times a day (canceled 7 days after the operation, provided that the ASK is continued in the dose of 325 mg / SUT) or 100 mg 4 times a day for 2 days before operation and 100 mg 1 hour after surgery (if necessary in combination with warfarin).
With coronary insufficiency - inward, 25-50 mg 3 times a day; In severe cases, at the beginning of treatment - 75 mg 3 times a day, then the dose is reduced; Daily dose - 150-200 mg.
For the treatment of chronic binding diseases of the lower limbs - 75 mg 3 times a day; Course of treatment 2-3 months (it is advisable to combine with small doses of ASK). Parenterally - in the absence of conditions for administration inside, in / m or V / in slowly, 5-10 mg, the infusion rate should not exceed 200 μg / min. Daily dose - 150-200 mg. For children, daily dose - 5-10 mg / kg.
For diagnostic purposes - 300-400 mg directly during stress echoca or 45 minutes before the injection of the radiopharmaceutical preparation.
Contraindications solution for injections
Hypersensitivity, acute myocardial infarction, common coronary arterial sclerosing atherosclerosis, unstable angina, GOPP, decompensated HSN, arterial hypotension, severe arterial hypertension, heavy arrhythmias, hemorrhagic diathesis, ulcerative illness of the stomach and 12-rosewind (tendency to bleeding), COPD, CPN , liver failure.Indication to the use of a solution for injections
Thrombosis and thromboembolism (prevention of arterial and venous thromboms, incl. After the testing of the valves of the heart valves), the prevention of occlusion of stents and the aortocamonary shunts (in combination with ASC); HSN; myocardial infarction; Prevention of myocardial hypertrophy.Treatment and prevention of violations of cerebral circulation on ischemic type; encephalopathy.
Prevention of placental insufficiency with complicated pregnancy.
Disorders of microcirculation of any genesis (as part of comprehensive therapy), chronic binding diseases of the vascular of the lower extremities, especially in the presence of risk factors (arterial hypertension, smoking).
Treatment and prevention of influenza and ARVI.
Treatment and prevention of DVS-syndrome in children with infectious toxicosis and sepsis, three-component treatment of glomerulonephritis (complex therapy), platelet reduction syndrome in children.
Conducting Dipyridamol-Tallium-201 perfusion scintigraphy with exercise, dimiridamola stress echoc.
Side effect solution for injections
From the side of the CSS: heartbeat, tachycardia, bradycardia, "rings" of blood to face, coronary condemnation syndrome (when using doses of more than 225 mg / day), decreased blood pressure (especially with fast / in administration).From the digestive system: nausea, vomiting, diarrhea, epigastric pain.
From the blood and hemostasis system: thrombocytopenia, changes in the functional properties of platelets, bleeding, elevated bleeding.
Others: weakness, dizziness, feeling of the ear, noise in the head, headache, hyperemia of the face of the face, arthritis, myalgia, rhinitis, allergic reactions.
Special instructions for injection injections
To reduce dyspepsic phenomena, taken with milk. In the treatment, the use of natural coffee and tea, weakening the effect of dipyridamole should be avoided.In the syndrome of coronary breakdown to improve the intracardiac blood flow, the administration of aminoophylline is shown.
Interaction solution for injections
An antiagregative effect is enhanced when taking indirect anticoagulants, ASCs, antibiotics of penicillin row, cephalosporins, tetracyclines, chloramphenicol, nicotinic acid.Ksanthina derivatives containing caffeine, weaken antithrombotic effect.
The action of cholinesterase inhibitors weakens.
Beta-lactam antibiotics, tetracycles and chloramphenicol reinforce action.
Antacids reduce the maximum concentration due to reduction of absorption.
Heparin, indirect anticoagulants, thrombolytics increase the risk of developing hemorrhagic complications.
Loading ...