Indication: coronary heart disease: prevention of angina (intolerance or insufficient effectiveness of nitrates); chronic heart failure (as part of combination therapy).
active substance: molsidomine;
1 tablet of 4 mg (mg) contains molsidomine 4 mg (mg);
excipients: lactose monohydrate; saccharose; potato starch; cochineal red A (E 124); povidone K-25; magnesium stearate.
Molsidomine is a derivative of sydnoimin. The active metabolite of molsidomine, linsidomine (SIN 1A), is a combination that reduces vascular smooth muscle tone and has an antianginal effect. Relaxation of smooth muscles increases the volume of veins and the volume of the vascular bed, which leads to a decrease in venous return, thereby reducing the filling pressure of both ventricles. This reduces the load on the heart and improves hemodynamic conditions in the coronary circulation. Dilation of arterial vessels leads to a decrease in peripheral resistance, which reduces the load on the heart, reduces myocardial tension, and as a consequence, reduces myocardial oxygen demand. In addition, molsidomine reduces the spasm of the coronary arteries and dilates their large branches. The antiplatelet effect of molsidomine is of clinical importance in the treatment of coronary heart disease. Unlike nitrates, molsidomine does not cause tachyphylaxis.
- coronary heart disease: prevention of angina (intolerance or insufficient effectiveness of nitrates);
- chronic heart failure (as part of combination therapy).
- hypersensitivity to any component of the drug;
- glaucoma, especially angle-closure;
- acute stage of myocardial infarction, especially with a decrease in blood pressure;
- cardiogenic shock;
- arterial hypotension;
- concomitant use of molsidomine and sildenafil;
Concomitant administration of nitric oxide donors in any form and soluble guanylate cyclase stimulants (eg, riociguat) is contraindicated due to the risk of hypotension.
Do not use the drug in children.
Use during pregnancy or breastfeeding
Animal studies have shown no teratogenic effects of the drug. However, due to the lack of convincing data on the safety of the drug, the use of Molsicor in the treatment of pregnant women is contraindicated.
During breastfeeding, the drug is contraindicated.
Method of application and dosage
The dosage and frequency of Molsicor are set individually for each patient depending on the severity and phase of disease activity.
In case of spontaneous angina attacks, it is better to take the last dose of molsidomine at bedtime.
The dose of Molsicor should be increased gradually to prevent side effects such as persistent headache in some patients.
The drug can be used regardless of food intake.
Usually prescribe 1-2 mg of the drug 3-4 times a day (3-8 mg of molsidomine per day).
If necessary, the dose can be increased to 4 mg 3-4 times a day (12-16 mg of molsidomine per day).
Symptoms of overdose are severe headache, hypotension, tachycardia. If the dose is significantly higher than the usual single dose and no more than one hour has elapsed, gastric lavage should be performed. If necessary, symptomatic treatment should be performed.
Treatment: forced diuresis. There are no data on the effectiveness of dialysis in overdose.
The following side effects are observed:
- From the cardiovascular system – lower blood pressure, orthostatic hypotension, collapse.
- From the central nervous system – a headache that occurs from the beginning of treatment and disappears with continued treatment; dizziness, fatigue, general weakness.
- From the gastrointestinal tract – anorexia, nausea, vomiting.
- On the skin – redness of the face; allergic reactions, including skin rashes.
- From the respiratory system – bronchospasm.
Store in the original package at a temperature not exceeding 25 ° C in a place protected from light and out of reach of children.