Panangin Forte - instructions for use, dose, side effects, contraindications

Active substances: potassium asparaginate 316.00 mg (in the form of potassium asparaginate hemihydrate 332.60 mg), magnesium aspartate 280.00 mg (in the form of magnesium aspartate tetrahydrate 350.00 mg);

Excipients: starch corn 172.20 mg, talc 20.00 mg, magnesium stearate 8.00 mg, potato starch 6.60 mg, povidone KZO 6.60 mg, silicon dioxide colloid 4,00 mg;

Casing of the tablet: talc 7.30 mg, butyl methacrylate copolymer 6.00 mg, titanium dioxide (color index: C.I. 77891, E171) 5.30 mg, macrogol-6000 1.40 mg.

Description:

Oval, biconvex tablets covered with a film shell, white or almost white, with a slightly glossy surface, engraved "A83" on one side, almost odorless. On a cross-section of white or almost white color.

Pharmacotherapeutic group:Potassium and magnesium preparation

ATX: & nbsp

A.12.C.X Preparations of other minerals

Pharmacodynamics:

The most important intracellular potassium cations (K⁺) and magnesium (Mg⁺⁺) play a key role in the functioning of numerous enzymes, in the formation of bonds between macromolecules and intracellular structures and in the mechanism of muscle contractility. The intra- and extracellular ratio of potassium, calcium, sodium and magnesium ions has an effect on myocardial contractility. Endogenous asparaginate acts as an ion conductor: it has a high affinity for cells, due to the insignificant dissociation of its salts, the ions enter the cell in the form of complex compounds. Magnesium aspartate and potassium asparaginate improve myocardial metabolism. The lack of magnesium / potassium predisposes to the development of arterial hypertension, coronary artery atherosclerosis, arrhythmias and metabolic changes in the myocardium.

Each tablet of Panangin® Forte contains 280 mg of magnesium asparaginate and 316 mg of potassium asparaginate, which is 2 times higher than the active ingredient in Panangin®, tablets coated with a film coat. The daily dose of Panangin® Forte: 1 tablet 3 times a day, corresponds to a daily dose of Panangin®: 2 tablets 3 times a day.Taking a single dose of Panangin® Forte as a single pill makes the treatment more convenient for the patient.

Pharmacokinetics:

Potassium and magnesium asparaginates are intensively absorbed in the intestine, mainly in the small intestine. They are excreted by the kidneys.

Indications:

To eliminate the deficiency of potassium and magnesium in the combination therapy for various manifestations of coronary heart disease (including acute myocardial infarction); chronic heart failure; heart rhythm disturbances (including arrhythmias caused by an overdose of cardiac glycosides).

Contraindications:

Hypersensitivity to any of the constituent components of the drug, acute and chronic renal failure, hyperkalemia, hypermagnesia, Addison's disease, atrioventricular blockade I-III degree, shock (including cardiogenic) (blood pressure less than 90 mm Hg), impaired metabolism of amino acids, severe myasthenia gravis, hemolysis, acute metabolic acidosis, dehydration status, age under 18 years (efficacy and safety not established).

Carefully:

Pregnancy (especially in the first trimester of pregnancy) and the period of breastfeeding.

Pregnancy and lactation:

The application is possible if the potential benefit to the mother exceeds the possible risk to the fetus.

Potassium and magnesium aspartate penetrate into breast milk. If you need to take the drug during breastfeeding, breastfeeding should be discontinued.

Dosing and Administration:

Before use, consult a physician.

Inside, not liquid and squeezed with enough water.

Panangin® Forte should be taken after meals, because The acidic environment of the stomach reduces its effectiveness.

Recommended daily dose: 1 tablet 3 times a day.

The maximum daily dose: 1 tablet 3 times a day.

Side effects:

Nausea, vomiting, diarrhea, unpleasant sensations or burning sensation in the epigastric region (in patients with an anatomic gastritis or cholecystitis), atrioventricular blockade, a paradoxical reaction (an increase in the number of extrasystoles), hyperkalemia (nausea, vomiting, diarrhea, paresthesia), hypermagnia (redness of the face , thirst, lowering blood pressure, hyporeflexia, respiratory depression, convulsions).

If any of these side effects become serious, or if you notice any side reactions not listed in this manual, you should consult your doctor.

Overdose:

There is a growing risk of symptoms of hyperkalemia and hypermagnesemia.

Symptoms of hyperkalemia: increased fatigue, myasthenia gravis, paresthesia,

confusion, violation of the heart rhythm (bradycardia, atrioventricular blockade, arrhythmias, cardiac arrest).

Symptoms of hypermagnesemia: decreased neuromuscular excitability, nausea, vomiting, lethargy, lowering of blood pressure.

With a sharp increase in the content of magnesium ions in the blood: depression of deep tendon reflexes, respiratory paralysis, coma.

Treatment: symptomatic therapy - intravenous calcium chloride at a dose of 100 mg / min, if necessary - hemodialysis.

Interaction:

Pharmacodynamic interaction

When combined with potassium-sparing diuretics (triamterene, spironolactone), beta-adrenoblockers, cyclosporine, heparin, angiotensin converting enzyme (ACE) inhibitors, non-steroidal anti-inflammatory drugs increase the risk of hyperkalemia up to the development of arrhythmia and asystole. Simultaneous use of potassium preparations with glucocorticosteroids eliminates hypokalemia caused by the latter.Potassium reduces the undesirable effects of cardiac glycosides. Panangin® Forte intensifies the negative dromo- and batmonotropic effect of antiarrhythmic drugs. Magnesium reduces the effects of neomycin, polymyxin B, tetracycline and streptomycin. Anesthetics increase the oppressive effect of magnesium preparations on the central nervous system; when used simultaneously with atrakuronium, decamethonium, succinyl chloride and suxamethonium, neuromuscular blockade may be enhanced. Calcitriol increases the content of magnesium in blood plasma, calcium preparations reduce the effects of drugs magnesium.

Pharmacokinetic interaction

Drugs that have an astringent and enveloping effect reduce the absorption of magnesium asparaginate and potassium asparaginate in the gastrointestinal tract, so it is necessary to observe a three-hour interval between ingestion of the drug Panangin® Forte with the above medicines.

Special instructions:

Particular attention is required by patients with diseases accompanied by hyperkalemia: regular monitoring of the potassium content in the blood plasma is necessary.

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

Studies have not been conducted.It is not expected to influence the ability to drive vehicles and work with mechanisms that require increased concentration and speed of psychomotor reactions.

Form release / dosage:

Film-coated tablets, 316 mg + 280 mg.

Packaging:

For 15 tablets in a blister of PVC / PVDC and aluminum foil. For 2, 4, 6 blisters together with instructions for use are placed in a cardboard box.

Storage conditions:

At a temperature of no higher than 30 ° C.

Keep out of the reach of children!

Shelf life:

2 years.

Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:Without recipe

Registration number:LP-002814

Date of registration:13.01.2015

The owner of the registration certificate:GEDEON RICHTER, OJSC GEDEON RICHTER, OJSC Hungary

Manufacturer: & nbsp

GEDEON RICHTER, Plc. Hungary

GEDEON RICHTER POLAND, Co. Ltd. Poland

Representation: & nbspGEDEON RICHTER OJSC GEDEON RICHTER OJSC Hungary

Information update date: & nbsp13.01.2015

Illustrated instructions

Instructions

Panangin® Forte (Panangin® Forte)