Coronary heart disease: prevention of attacks of stable and unstable angina (especially in elderly patients and with individual intolerance to nitrates). As part of the combined treatment of chronic heart failure.
active substance: molsidomin;
1 tablet contains molsidomine 2 mg;
auxiliary substances: lactose monohydrate, mannitol (E 421), wheat starch, microcrystalline cellulose, hypromellose, anhydrous colloidal silicon dioxide, magnesium stearate, peppermint oil, sunset yellow FCF (E 110).
Dosage form. Pills.
Molsidomin has a venodilating, antiplatelet, analgesic and long-term antianginal effect. Venodilating activity is due to the release after a series of metabolic transformations of nitric oxide (NO), which stimulates soluble guanylate cyclase; therefore, molsidomin is considered as a NO donor. The accumulation of cyclic guanosine monophosphate (cGMP) causes relaxation of the smooth muscle cells of the vascular wall (mostly veins). A decrease in preload even without affecting myocardial contractility leads to the restoration of the ratio between oxygen demand and oxygen intake, disturbed in patients with coronary insufficiency. Expands large epicardial coronary arteries affected by atherosclerosis, but capable of dilatation, improves peripheral circulation.
Increases exercise tolerance, reduces manifestations of angiospasm. Suppresses the early phase of platelet aggregation, reduces the synthesis and release of serotonin, thromboxane and other proaggregants.
Reduces the preload on the myocardium in patients with chronic heart failure, reduces pressure in the pulmonary artery, reduces left ventricular filling and myocardial wall tension, stroke volume of the heart. The action begins 20 minutes after ingestion, reaches a maximum in 0.5-1 hour and lasts for 6 hours. In contrast to nitrate therapy, the development of tolerance with a decrease in effectiveness during long-term therapy with molsidomine is usually not observed.
Ischemic heart disease: prevention of attacks of stable and unstable angina pectoris (especially in elderly patients and with individual intolerance to nitrates).
As part of the combined treatment of chronic heart failure.
Hypersensitivity to the active or to any of the excipients, glaucoma (especially angle-closure), acute anginal attack, acute myocardial infarction, acute circulatory failure, including shock (including cardiogenic), vascular collapse, severe arterial hypotension (systolic pressure less than 100 mm Hg), simultaneous use of phosphodiesterase 5 (PDE 5) inhibitors (sildenafil, vardenafil, tadalafil) due to a high risk of arterial hypotension; toxic pulmonary edema, lowering of central venous pressure; the simultaneous administration of nitric oxide donors in any form and soluble guanylate cyclase stimulants (eg riociguat) is contraindicated due to the risk of hypotension.
Method of administration and dosage
The drug should be taken orally during or after a meal with plenty of liquid.
For the prevention of angina attacks, appoint 1-2 mg (½-1 tablet) 4-6 times a day on the first and second days of therapy, after which the dose should be increased to 2-4 mg 2-3 times a day if necessary.
The dosage regimen is individual and depends on the type and stage of the disease, the severity of clinical symptoms. The daily dose is usually 2-4 mg (1-2 tablets), divided into 2 equal doses. Sometimes the dose can be increased to 6-8 mg (3-4 tablets), which should be divided into 3-4 doses.
The maximum daily dose is 12 mg.
The duration of treatment depends on the course of the disease and is determined by the doctor.
The use of the drug for children is contraindicated.
Symptoms: bradycardia, weakness, drowsiness, severe headache, dizziness and arterial hypotension, tachycardia, accompanied by nausea and vomiting; in severe cases, collapse.
Treatment: measures are taken to rapidly remove the drug from the body (gastric lavage, forced diuresis), symptomatic therapy.
There is no evidence of the effectiveness of dialysis in overdose.
- From the nervous system: headache (usually minor, disappears with further treatment), dizziness, increased fatigue, slow speed of psychomotor and motor reactions (mostly at the beginning of treatment), weakness.
- From the gastrointestinal tract: nausea, loss of appetite, diarrhea, vomiting.
- From the side of the cardiovascular system: thrombocytopenia, circulatory failure, a marked decrease in blood pressure, orthostatic hypotension, rarely before the development of collapse or shock, tachycardia, redness of the facial skin. In such cases, a dose reduction or drug withdrawal may be required.
- From the immune system: hypersensitivity reactions, including allergic reactions, itching, rashes, bronchospasm, asthma, anaphylactic shock.
- Skin and subcutaneous tissue disorders: urticaria.
Keep out of the reach of children.
Store in its original packaging at a temperature not exceeding 25 ° C.