Nitrocore - instructions for use, dose, side effects, contraindications

Peripheral vasodilator with predominant effect on venous vessels. The effect of nitroglycerin is mainly due to a decrease in myocardial oxygen demand due to a reduction in preload (peripheral veins and a decrease in the flow of blood to the right atrium) and postnagruzki (a decrease in the total peripheral vascular resistance).

Has a central inhibitory effect on the sympathetic tone of blood vessels, inhibits the vascular component of the formation of pain syndrome. It causes the expansion of meningeal vessels, which explains the headache when it is used. When using the drug under the tongue, the attack of stenocardia usually stops after 1.5 minutes, the hemodynamic and antianginal effect persists from 30 to 60 minutes.

Pharmacokinetics:

Quickly and completely absorbed from the surface of the mucous membranes. When taking the drug under the tongue in a dose of 0.5 mg nitroglycerine immediately enters the systemic circulation, bioavailability is 100%. The maximum concentration in the blood plasma is reached after 5 minutes. The preparation has a large volume of distribution. The connection with plasma proteins is 60%.

Indications:

Kupirovanie and short-term prophylaxis of attacks of a stenocardia.

Contraindications:

Hypersensitivity to nitrates, shock, collapse, age under 18 years (efficacy and safety not established for age less than 18 years), lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome and phenylketonuria.

Carefully:

With caution (comparing risk and benefit): simultaneous administration of inhibitors of phosphodiesterase 5 (sildenafil, tadalafil, vardenafil, etc.), craniocerebral hypertension,cardiac tamponade, uncontrolled hypovolemia, in patients with heart failure at normal or low pressure in the pulmonary artery, arterial hypotension (systolic blood pressure less than 90 mm Hg. v.), zakratougolnaya form of glaucoma with high intraocular pressure, severe anemia, hyperthyroidism, chronic edema lung, subarachnoid hemorrhage, head trauma recently transferred, hemorrhagic stroke, conditions accompanied by reduction of the filling pressure of the left ventricle (acute myocardial infarction Isolated mitral stenosis, constrictive pericarditis), idiopathic hypertrophic subaortic stenosis, cerebrovascular disease, severe renal and / or hepatic insufficiency (risk of methemoglobinemia).

Pregnancy and lactation:Application during pregnancy and during breast-feeding is possible only for vital indications.

Dosing and Administration:

Nitrocor® is recommended for use as directed by a physician.

Nitrocor® should be taken immediately with the first signs of an attack of angina pectoris:

1 Nitrokora® tablet is placed under the tongue and held until complete dissolution, without swallowing.The usual dose of the drug is 1 tablet under the tongue.

If the attack of angina is not stopped within 5 minutes, one more Nitrocor® tablet should be taken.

In the absence of therapeutic effect after taking 2 tablets, you must call a doctor.

With frequent attacks of angina pectoris, it is advisable to use prolonged drugs of the nitroglycerin series.

Side effects:

From the central nervous system: blurred vision, "nitrate" headache (especially at the beginning of the course of treatment, with the continuation of therapy decreases), dizziness and a sense of weakness, anxiety, psychotic reactions, inhibition, disorientation.

From the side of the cardiovascular system: lowering blood pressure; tachycardia, rarely (especially with an overdose) - orthostatic collapse, cyanosis, reddening of the facial skin.

From the gastrointestinal tract: dry mouth, nausea, vomiting, abdominal pain.

Allergic reactions, hypothermia are possible.

Overdose:

Symptoms: decrease in blood pressure (below 90 mm Hg) with orthostatic dysregulation, severe dizziness, headache, fainting, shortness of breath, severe weakness, palpitations, fever, seizures, asthenia, drowsiness.At application of high doses (more than 20 mkg / kg) - a collapse, cyanosis, methemoglobinemia, dyspnea and tachypnea.

When symptoms of an overdose occur, immediately put the patient, raise his legs and call a doctor immediately.

Interaction:

The hypotensive effect of the drug may be excessive in the case of uncontrolled simultaneous administration of vasodilators, antihypertensive agents, angiotensin converting enzyme (ACE) inhibitors, phosphodiesterase inhibitors, slow calcium channel blockers, tricyclic antidepressants, alcohol, diuretics, beta adrenoblockers, monoamine oxidase inhibitors (MAO), procainamide.

The appointment with dihydroergotamine can lead to an increase in its content in the blood and an increase in blood pressure (due to an increase in the bioavailability of dihydroergotamine).

The simultaneous appointment Nitrokora® and heparin reduces the effectiveness of the latter (after discontinuation of the drug may significantly decrease blood clotting, which may require reduction of heparin dosage).

Special instructions:

Against the background of taking Nitrocor® tablets, it is possible to significantly reduce blood pressure and the appearance of dizziness during a sharp transition tovertical position from the "sitting" or "lying" position; at the use of alcohol, performance of physical exercises and hot weather. To Nitrocor®, as well as to other organic nitrates, with frequent use, addiction may occur, requiring an increase in dosage.

If blurred vision or dry mouth persists or is severe, treatment should be discontinued.

Severity of headache with Nitrocor® may be reduced by lowering its dose and / or concurrent administration of Validol.

Effect on the ability to drive transp. cf. and fur:

When driving vehicles and managing mechanisms that require increased attention, it should be borne in mind that taking Nitrocor® can lead to a reduction in motor and mental reactions.

Form release / dosage:

Tablets are sublingual, 0.5 mg.

Packaging:

For 40 tablets in a glass or polymer tube with a polyethylene plug.

One test tube together with the instruction for use is placed in a pack of cardboard.

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C, away from fire.

Keep out of the reach of children.

Shelf life:

2 years.

The drug should not be used after the expiration date.

Terms of leave from pharmacies:Without recipe

Registration number:LS-001302

Date of registration:23.07.2010 / 23.05.2013

Expiration Date:Unlimited

The owner of the registration certificate:PHARMSTANDART-FORESTRY, OJSC PHARMSTANDART-FORESTRY, OJSC Russia

Manufacturer: & nbsp

PHARMSTANDART-FORESTRY, OJSC Russia

Information update date: & nbsp03.12.2016

Illustrated instructions

Instructions

Nitrocor® (Nitrocor®)