Post-infarction angina: mechanisms of development, clinical features, treatment, and prognosis - Bobrov V. O. 2009

Drug Dossier

CARDIOMAGNYL®

General characteristics: white, Heart-shaped, film-coated tablets containing 75 mg, or white, oval, film-coated tablets with a score line on one side containing 150 mg.

Composition: 1 tablet contains 75 mg (150 mg) of acetylsalicylic acid and 15.2 mg (30.39 mg) of magnesium hydroxide; excipients: maize starch, microcrystalline Cellulose, magnesium stearate, potato starch, hypromellose 15, talc, polyethylene glycol.

Pharmacodynamics. Through Acetylation, acetylsalicylic acid irreversibly inhibits the enzyme cyclooxygenase and selectively suppresses the synthesis of thromboxane A2, which exhibits aggregating properties. In higher doses, acetylsalicylic acid has analgesic and antipyretic effects. Magnesium hydroxide protects the gastrointestinal mucosa from the direct irritating effects of acetylsalicylic acid.

Indications for use. Prevention of conditions associated with increased platelet aggregation: thrombosis, embolism, myocardial infarction, unstable angina, migraine, ischemic stroke, cerebrovascular disorders, and vascular surgery (postoperative period) following coronary artery bypass grafting or percutaneous transluminal coronary angioplasty.

Administration and dosage. Tablets should be swallowed whole, with Water if necessary. If desired, the tablet can be broken in half, chewed, or crushed beforehand. Tablets should be taken immediately after a meal: 150 mg daily on the first day, followed by a maintenance dose of 75 mg daily taken in a single dose. The duration of Treatment is determined by the physician on an individual basis, depending on the indications and severity of the condition.

Side effects. Allergic reactions, headache, nausea, vomiting, diarrhea, and rarely — gastrointestinal erosion, ulcers, and gastrointestinal bleeding.

Contraindications. Recent gastrointestinal bleeding or Cerebral Hemorrhage, thrombocytopenia or bleeding tendencies, hemophilia, hemorrhagic diathesis, hypoprothrombinemia, asthma or allergies, erosive and ulcerative gastrointestinal lesions (acute phase), renal impairment, Pregnancy (first and third trimesters), Lactation, erythrocyte glucose-6-phosphate dehydrogenase deficiency, and pediatric age.

Special precautions. Long-term use requires monitoring of Blood Hemoglobin levels. The drug should be prescribed with caution to patients with a history of gastric and duodenal ulcers, hepatic or renal impairment, and Heart Failure. The drug should not be used during pregnancy and breastfeeding. Cardiomagnyl has been shown to have no effect on The ability to drive or operate machinery.

Drug interactions. Rarely, in high doses, the drug enhances the effects of oral anticoagulants and inhibits the uricosuric effect of probenecid and oral hypoglycemic agents. Cardiomagnyl potentiates the effects of methotrexate, chlorpropamide, antiplatelet agents, and fibrinolytics, while attenuating the effects of spironolactone, certain Diuretics, and antihypertensive agents. Antacids and cholestyramine reduce the absorption of the drug.

Dispensing status. Over-the-counter — 30 tablets. Prescription-only — 100 tablets.

Manufacturer. Nycomed Danmark ApS, Denmark.

Address. Langebjerg 1, DK - 4000 Roskilde, Denmark.

Registration certificate: NqUA/2370/01/01 dated 10.12.2004, NqUA/2370/01/02 dated 26.01.2005.

CONCOR®

General characteristics: film-coated tablets.

Composition: 1 tablet contains 5 mg or 10 mg of bisoprolol fumarate; excipients: anhydrous colloidal silicon dioxide, magnesium stearate, crospovidone, microcrystalline cellulose, maize starch, anhydrous calcium hydrogen phosphate.

Pharmacodynamics. A selective beta-1 adrenergic receptor blocker. When used in therapeutic doses, it lacks intrinsic sympathomimetic activity and clinically significant membrane-stabilizing properties. It exhibits antianginal effects: it reduces myocardial oxygen demand by lowering heart rate and Cardiac Output, as well as reducing blood pressure, while increasing myocardial oxygen supply by decreasing end-diastolic pressure and prolonging diastole.

Pharmacotherapeutic group. Selective beta-blocking agents. ATC code C07A B07.

Indications for use. Arterial Hypertension, ischemic heart disease (angina pectoris), chronic heart failure.

Administration and dosage. The recommended dose is 5 mg (one 5 mg tablet) daily. For stage II arterial hypertension (diastolic blood pressure up to 105 mmHg), treatment may be initiated with a dose of 2.5 mg (one 2.5 mg tablet) daily. If necessary, the daily dose may be increased to 10 mg (one 10 mg tablet) daily. Dose increases are permitted only in specific cases.

The maximum daily dose is 20 mg.

For patients with mild to moderate hepatic or renal impairment, dose adjustment is generally not required. For patients with severe renal impairment (creatinine clearance less than 20 mL/min) and patients with severe hepatic impairment, the daily dose should not exceed 10 mg of Concor. The dosage is selected individually.

The tablets should be taken in the morning without chewing, regardless of food intake, with a small amount of liquid. Treatment is long-term. The duration of therapy depends on The Nature and course of the disease. Treatment must not be discontinued abruptly; the course should be completed gradually with a slow reduction in dosage.

Side effects — see the package leaflet.

Contraindications. Decompensated heart failure; cardiogenic Shock; second- and third-degree atrioventricular block; sick sinus syndrome; severe sinoatrial block; symptomatic bradycardia (heart rate less than 50 beats per minute); symptomatic arterial hypotension (systolic blood pressure below 90 mmHg); Bronchial Asthma; late stages of peripheral Circulatory Disorders, Raynaud's disease; untreated pheochromocytoma; metabolic acidosis; pregnancy and breastfeeding; hypersensitivity to the Components of the drug; childhood and adolescence.

Special precautions for use and interaction with other medicinal products - see the package leaflet.

Prescription status. Prescription-only.

Manufacturer. Merck KGaA, Germany. Represented in Ukraine by Nycomed Austria GmbH, Austria. Address: Frankfurter Straße 250, 64293 Darmstadt, Germany.

Registration Certificate No. UA/3322/01/02 and No. UA/3322/01/03 dated 30.05.2008.

CONCOR COR®

General characteristics: almost white, heart-shaped, biconvex film-coated tablets with a score on both sides.

Composition: 1 tablet contains 2.5 mg of bisoprolol fumarate; excipients: colloidal anhydrous silica, magnesium stearate, crospovidone, microcrystalline cellulose, maize starch, anhydrous calcium hydrogen phosphate, dimeticone 100, macrogol 400, titanium dioxide (E 171), hypromellose.

Pharmacodynamics. When used in therapeutic doses, it exhibits no intrinsic sympathomimetic activity and no clinically significant membrane-stabilizing properties. It exerts an antianginal effect: it reduces myocardial oxygen demand by lowering heart rate, cardiac output, and blood pressure, while increasing myocardial oxygen supply. In chronic heart failure, the drug suppresses The activity of the sympathoadrenal and renin-angiotensin-aldosterone systems. A single dose provides effects lasting for 24 hours.

Pharmacotherapeutic group. Selective beta-1-adrenoceptor blocking agents. ATC code C07AB07.

Indications. Chronic heart failure.

Administration and dosage. For oral administration. The tablets should be swallowed whole without chewing, with a sufficient amount of water. It is recommended to take the drug in the morning, either on an empty Stomach or with breakfast. The starting dose is 1.25 mg once daily for the first week. During the 2nd week of treatment, the dose is increased to 2.5 mg daily, and during the 3rd week, to 3.75 mg daily. From the 4th to the 8th week of treatment, the dose is 5 mg (2 tablets), which is then increased to 7.5 mg (from the 8th to the 12th week). After the 12th week of treatment, the maximum daily dose of 10 mg bisoprolol fumarate is administered. Dosage titration is guided by the patient's heart rate (HR), blood pressure (BP), and general clinical condition. Following the initial 1.25 mg dose, patients with chronic heart failure should be monitored for 4 hours (BP, heart rate, conduction disturbances, worsening of heart failure symptoms).

Treatment must not be discontinued abruptly; the course should be completed gradually with a slow dose reduction. The duration of treatment is long-term and determined by the physician.

Undesirable effects - see the package leaflet.

Contraindications. Hypersensitivity to the components of the drug; shock; second- and third-degree atrioventricular block; sick sinus syndrome; severe sinoatrial block; bradycardia (heart rate less than 50 beats per minute); arterial hypotension (systolic blood pressure below 90 mmHg); decompensated heart failure; bronchial asthma and other obstructive airway diseases; severe peripheral circulatory disorders; concomitant use of MAO inhibitors (except MAO-B inhibitors); psoriasis (including a family history); pheochromocytoma; pregnancy; lactation (breastfeeding); childhood and adolescence.

Special precautions for use and interaction with other medicinal products - see the package leaflet.

Prescription status. Prescription-only.

Manufacturer. Merck KGaA, Germany. Represented in Ukraine by Nycomed Austria GmbH, Austria. Address: Frankfurter Straße 250, 64293 Darmstadt, Germany.

Registration Certificate No. UA/3322/01/01 dated 24.06.2005.