Description
Release form
Film-coated retard tablets.
Packing
30 pcs.
Pharmacological action
Selective class III calcium channel blocker, benzothiazepine derivative.
Diltiazem Lannacher is antianginal, hypotensive and antiarrhythmic effect. Reduces myocardial contractility, slows down AV conduction, reduces heart rate, reduces myocardial oxygen demand, expands coronary arteries, increases coronary blood flow. Diltiazem reduces the smooth muscle tone of peripheral arteries and OPSS.
Reduces intracellular calcium ions in cardiomyocytes and smooth muscle cells of blood vessels, reduces heart rate, may have a slight negative inotropic effect, increases coronary, cerebral and renal blood flow. In concentrations at which there is no negative inotropic effect, Diltiazem Lannacher causes relaxation of the smooth muscles of the coronary vessels and dilatation of both large and small arteries.
The antianginal effect is due to an improvement in the blood supply to the myocardium and a decrease in its oxygen demand as a result of a decrease in OPSS, systemic blood pressure (afterload), a decrease in myocardial tone, and an increase in the time of diastolic relaxation of the left ventricle.
Contraindications
Severe bradycardia, AV block II and III degree (except for patients with a pacemaker), CVS, cardiogenic shock, atrial fibrillation with WPW and Launa-Ganoga-Levin syndrome, pulmonary myocardial infarction, hypotension, congestive symptoms chronic heart failure II B-III stage, acute heart failure, hemodynamically significant aortic stenosis, impaired liver and kidney function, pregnancy, lactation, hypersensitivity to benzothiazepine derivatives.
Special instructions
Diltiazem Lannacher is used with caution in case of AV blockade of I degree, disturbances of intraventricular conduction, in patients prone to arterial hypotension, chronic heart failure, myocardial infarction with left ventricular failure, ventricular tachycardia with enlargement of the liver with enlargement of the liver insufficiency, in elderly patients, in children (the effectiveness and safety of use have not been investigated).
Composition
1 tablet contains the active substance diltiazem 0.09 g (90 mg),
as well as excipients:
lactose monohydrate,
poly (ethyl acrylate, methyl acrylate),
Eudrajol meth30ryl NE30D lots + Eudrazhit L100-55,
poly (ethyl acrylate, methyl methacrylate, trimetilammoniyametilmetakrilata chloride),
Eudrazhit RS PM,
hydroxypropylmethyl cellulose,
magnesium stearate,
polyethylene glycol,
titanium dioxide,
talc,
antifoaming agent SE2.
Dosage and Administration
Tablets should be taken before meals, without chewing and drinking a small amount of liquid.
The dosage regimen is set individually. Usually prescribed in a daily dose of 180-360 mg, divided into 2 doses.
When switching to long-term maintenance therapy, the dose can be reduced to 180 mg once a day, in the morning.
Side effects
From the nervous system and sensory organs: headache, dizziness, fainting, fatigue, asthenia, sleep disturbances, drowsiness, anxiety, extrapyramidal (parkinsonism) disorders (ataxia, masked face, shuffling gait, stiffness of the hands or feet, trembling of the hands and fingers, difficulty swallowing), depression when used in high doses – paresthesia, tremor, visual impairment (transient loss of vision).
From the cardiovascular system: asymptomatic decrease in blood pressure rarely – angina pectoris, arrhythmia (including flutter and ventricular fibrillation), bradycardia (less than 50 beats / min) or tachycardia, AV block II-III art. up to asystole, the development or worsening of heart failure when used in high doses and with iv administration – angina pectoris, bradycardia, AV block, marked decrease in blood pressure, worsening of chronic heart failure.
From the digestive system: dry mouth, increased appetite, nausea, vomiting, constipation or diarrhea, increased activity of hepatic transaminases, gingival hyperplasia (bleeding, soreness, swelling).
From the hemopoietic system: rarely – thrombocytopenia, agranulocytosis.
Drug interactions
Potentially dangerous are combinations with beta-blockers, quinidine and other antiarrhythmic drugs of class Ia, cardiac glycosides (excessive bradycardia, slower AV conduction, decreased myocardial contractility).
Procainamide, quinidine, and other drugs that cause a prolongation of the QT interval increase the risk of a significant prolongation of it. May increase the bioavailability of propranolol. Means for inhalation anesthesia (hydrocarbon derivatives), thiazide diuretics, and other drugs that lower blood pressure increase the hypotensive effect of diltiazem.
Cimetidine increases the concentration of diltiazem in the blood phenobarbital, diazepam, rifampicin – reduce. Increases the concentration in the blood of cyclosporine, carbamazepine, theophylline, quinidine, valproic acid and digoxin (dose reduction may be required).
Possible simultaneous administration of nitrates (including prolonged form). Enhances cardiodepressive effect of general anesthetics. Li + drugs can enhance the neurotoxic effects of diltiazem (nausea, vomiting, diarrhea, ataxia, trembling and / or tinnitus). Indomethacin (and other NSAIDs), corticosteroids and estrogens, as well as sympathomimetic drugs reduce the hypotensive effect.
Overdose of
Symptoms:
bradycardia, atrioventricular conduction disturbances, arterial hypotension.
Treatment:
depending on the severity of an overdose.
It is necessary to rinse the stomach, prescribe activated charcoal, symptomatic further treatment.
If necessary, it is recommended to prescribe atropine, isoproterenol, dopamine or dobutamine, and also, in case of severe conduction disturbances, the use of pacing is possible.
Storage conditions
Keep out of the reach and sight of children at temperatures not exceeding 25 ° C.
Expiration
3 years.
Active ingredient
Diltiazem
Terms leave through pharmacies
In retseptu
Dosage form
tablet prolong.
G.L. Pharma GmbH, Austria
