"Cardiket": analogues, instructions for use. Kardiket - instructions, use, indications, contraindications, action, side effects, analogues, composition, dosage Different composition, may coincide in indication and method of application

International name

Group affiliation

Dosage form

pharmachologic effect

Peripheral vasodilator with a predominant effect on venous vessels. Stimulates the formation of "first pass" nitric oxide (endothelial relaxing factor) in the vascular endothelium, causing the activation of intracellular guanylate cyclase, resulting in an increase in cGMP (mediator of vasodilation). Reduces myocardial oxygen demand by reducing preload and afterload (reduces end-diastolic LV volume and reduces systolic tension of its walls). It has a coronary dilating effect.

Reduces blood flow to the right atrium, helps to reduce pressure in the "small" circle of blood circulation and regression of symptoms in pulmonary edema. Promotes the redistribution of coronary blood flow in areas with reduced blood circulation. Increases exercise tolerance in patients with coronary artery disease, angina pectoris.

Expands the vessels of the brain, which may be accompanied by a headache.

As with other nitrates, cross-tolerance develops. After cancellation (break in treatment), sensitivity to it is quickly restored.

The onset of action after sublingual administration or chewing is 2-5 minutes, after ingestion of capsules and tablets - 15-40 minutes, prolonged forms - 30 minutes. The duration of action is 1-2 hours, 4-6 and 12 hours, respectively.

After spraying on the oral mucosa, the effect appears after 30 seconds and lasts 15-120 minutes.

Indications

Angina pectoris (stopping and prevention, including unstable angina), acute myocardial infarction (including complicated by acute left ventricular failure), condition after myocardial infarction.

Spasm of the coronary arteries (prevention and treatment when using a cardiac catheter).

CHF, pulmonary edema, hypertension in the "small" circle of blood circulation, "pulmonary" heart (as part of combination therapy).

Spasm of peripheral arteries (obliterating endarteritis, angiospastic retinitis).

Contraindications

Hypersensitivity.

For intravenous administration (except in special circumstances) - hemorrhagic stroke, TBI (increases intracranial pressure), intracranial hypertension, cardiac tamponade, constrictive pericarditis, hypovolemia (must be corrected before using nitroglycerin - risk of a pronounced decrease in blood pressure). C with caution. For all forms (comparing risk and benefit) - hemorrhagic stroke, recent TBI, acute myocardial infarction (risk of lowering blood pressure and tachycardia, which can increase ischemia), glaucoma (risk of increased intraocular pressure), severe anemia, thyrotoxicosis, arterial hypotension with low systolic blood pressure (may aggravate the condition by causing paradoxical bradycardia and angina attacks), HOCM (possibly more frequent angina attacks), severe chronic renal failure, liver failure (risk of methemoglobinemia), pregnancy, lactation, childhood (safety has not been established).

For oral dosage forms - increased gastrointestinal motility, malabsorption syndrome.

Side effects

From the side of the cardiovascular system: headache, dizziness, flushing of the skin of the face, feeling of heat, tachycardia, lowering blood pressure. In rare cases, a paradoxical increase in angina attacks and collapse.

On the part of the digestive system: nausea, vomiting, there may be a slight burning sensation of the tongue, dry mouth.

From the nervous system: stiffness, drowsiness, blurred vision, decreased ability to quick mental and motor reactions (especially at the beginning of treatment). In rare cases, cerebral ischemia.

Allergic reactions: skin rash.

Local reactions: burning, itching, skin hyperemia at the site of application.

Other: development of tolerance (including cross to other nitrates), exfoliative dermatitis.

Application and dosage

Sublingually, orally, parenterally, topically, externally.

Sublingual. Spray: 1-3 doses (1.25-3.75 mg) are injected into the oral cavity with an interval of about 30 seconds against the backdrop of holding the breath. If after 5 minutes there is no improvement, inhalation is repeated (subject to constant monitoring of blood pressure and heart rate). For the prevention of coronary spasm in the case of catheterization, 1-2 doses should be applied immediately before the procedure.

Tablets: 2.5-5 mg, if necessary - every 2-3 hours. To stop an attack of angina pectoris - sublingually (to speed up the action, it is advisable to chew the tablet).

inside. 10-20 mg 4-5 times a day 1 hour before or 2 hours after meals, without chewing, with a glass of water. With insufficient severity of the effect from 3-5 days of treatment, the dose is increased to 60-120 mg / day. The multiplicity of the appointment depends on the duration of action and is for tablets of medium duration of action (tablets containing 5, 10 and 20 mg) 3-4 times; for retard tablets 20 mg - 2-3 times; for retard tablets 40 and 60 mg - 2 times; for retard tablets 120 mg - 1 time per day. As part of complex therapy for CHF, 10-20 mg 3-4 times a day are used.

Parenterally. In / in drip, 0.1 mg / ml at an initial rate of 3-4 drops / min or 0.2 mg / ml at a rate of 1-2 drops / min. The rate of administration can be increased every 5 minutes by 2-3 drops, depending on the patient's response (subject to monitoring blood pressure, heart rate, ECG and diuresis). The maximum injection rate is 33 drops / min (for a solution with a concentration of isosorbide dinitrate 0.1 mg / ml) and 17 drops / min (for a solution with a concentration of 0.2 mg / ml).

Buccal. Plates (20-40 mg) are glued to the gingival mucosa on the anterior surface of the upper jaw at the level of the incisors or small molars, each time alternating sides, 1-3 times a day.

TTS: wipe the skin area with ethanol or water; the protective coating is removed from the system, applied with the sticky side to the skin and pressed to ensure contact of the entire surface with the skin. The selected area of ​​the skin should be hairless and not subjected to intense mechanical stress (inner surface of the forearm, side or front surface of the chest, skin of the back). The next system is glued to another (preferably symmetrical) area of ​​the skin. The dose is proportional to the area and is 0.5-1 mg/sq.cm. To select an individual dose, the system can be cut into pieces of any size. The duration of a single application is 12-24 hours. The course of treatment is 2 weeks. Abrupt withdrawal should be avoided.

Spray for skin application: spray 1-2 doses from a distance of 20 cm and rub it with your fingertips. After the spray dries, the skin can be covered with clothing. After 20 minutes, skin areas can be washed.

Ointment: initial dose - 1 g of ointment 1-2 times a day; applied to the chest area, the inner surface of the forearms or abdomen; the minimum area of ​​application surface is 20 sq.cm.

special instructions

During treatment, especially in the case of a gradual increase in dose, it is necessary to control blood pressure and heart rate.

For the relief of angina attacks, in acute myocardial infarction (including complicated by acute left ventricular failure), pulmonary edema, unstable angina pectoris, spasm of the coronary arteries (prevention and treatment using a cardiac catheter), sublingual or intravenous administration is used.

If necessary, use against the background of arterial hypotension should be administered simultaneously with drugs that have a positive inotropic effect, or use circulatory support.

Frequent administration and high doses may cause the development of tolerance; in this case, it is recommended to cancel for 24-48 hours or after 3-6 weeks of regular use, take a break for 3-5 days, replacing isosorbide dinitrate with other antianginal drugs for this time.

During the period of taking isosorbide dinitrate, the use of ethanol should be excluded.

For pregnant and lactating women, the drug is prescribed only according to strict indications, under the constant supervision of a physician.

Ineffective in HF caused by cardiac tamponade and toxic pulmonary edema.

Abrupt discontinuation of the drug should be avoided, the dose should be reduced gradually.

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Interaction

Pharmacodynamic: under the influence of beta-adrenergic stimulants, alpha-blockers (prazosin, dihydroergotamine, etc.), it is possible to reduce the severity of the antianginal effect of isosorbide dinitrate (tachycardia and excessive decrease in blood pressure).

With a combination of amiodarone, propranolol, BMCC (verapamil, nifedipine, etc.), ASA and isosorbide dinitrate, an increase in the antianginal effect is possible.

With the combined use of isosorbide dinitrate with antihypertensive drugs, vasodilators, antipsychotic drugs (neuroleptics), tricyclic antidepressants, procainamide, ethanol, quinidine, beta-blockers, BMCC, ethanol, dihydroergotamine and sildenafil, an increase in the hypotensive effect is possible.

With a combined appointment with m-anticholinergics (atropine, etc.), the likelihood of an increase in intraocular pressure increases.

Pharmacokinetic: adsorbents, astringents and enveloping drugs reduce the absorption of isosorbide dinitrate in the gastrointestinal tract.

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Heart disease is getting younger every year. More and more people, starting from the age of twenty, complain of heaviness, burning in the region of the heart. Cardiologists say that coronary disease is getting younger due to the lifestyle of a modern person. Fatty foods, bad habits and low mobility are the main causes of ischemia.

In order to alleviate an attack of angina pectoris, nitrate preparations are prescribed. Long-acting forms are in great demand, which reduce the number of "eaten" tablets, and the effect of the drug lasts throughout the day. One of these is "Cardiket retard"

Features of the drug

The action of "Kardiket" is based on the expansion of the lumen of the blood vessels, which in turn contributes to the deposition of blood. This effect reduces the load on the heart muscle and reduces myocardial oxygen demand.

Oxygen supplied with the blood not only enriches the heart muscle, but also enters those tissues that have not received enough of it for a long time. The load on the heart during the period of activity decreases, the pain associated with a lack of oxygen disappears.

Having a prolonged form, "Kardiket" allows you to use from one to three tablets in the acute period. This is due to the intensity of the loads and the form of angina pectoris in the patient.

There are dosages of 20, 40, 60 milligrams. The peculiarity of this form is that it begins to "work" in a certain part of the gastrointestinal tract, gradually releasing the active substance.

How are they received?

It is worth remembering that nitrate preparations cannot be used alone. Their dosage and number of doses are adjusted by the attending physician.

The maximum daily dosage is one hundred and twenty milligrams. Taking such an amount of "Kardiket" is possible with an increased need for nitrates contained in the preparations.

• 20 mg - 1 tablet twice a day;
• 40 mg - 1 tablet per day (may be increased if necessary);
• 60 mg - 1 tablet per day (may be increased if necessary);

Six to eight hours should elapse before taking the next tablet.

What to replace?

The cost of this drug is quite high, but if necessary, you can use synonyms and analogues of "Kardiket". All of them are derivatives of nitrates, but in different forms of release (tablets, aerosol, injection) and dosage.

The simplest and most affordable of the analogues of "Kardiket" is the drug "Nitrosorbit". Its dosage is 10 mg, which significantly affects the number of doses. On average, the patient can take three to four tablets per day, which is a standard daily dose of 40 mg. With high physical exertion, the dose can be increased, but not more than 120 mg per day.

Tablets are taken before meals with a glass of water.

"Iso-mic" is a spray for sublingual use. It can be used both to prevent and to relieve angina attacks in adults. One application accounts for one to three sprays with a difference of thirty seconds.

For this you need:

• shake the can;
• put it horizontally;
• inhale deeply;
• hold the breath;
• and close your mouth while breathing through your nose for the next thirty seconds.

In case of myocardial infarction or acute heart failure, relief of an attack begins with one spray, increasing to three. If the patient's condition does not improve in the next five minutes, another application is allowed.

If the effect is not visible in the next ten minutes, you can use "Izo-mic" again, but at the same time carefully monitoring blood pressure. If the systolic pressure is below 90 units, the drug is canceled.

If desired, and on the advice of a doctor, you can easily pick up "Kardiketa retard" analogues that are more affordable.

Contraindications and side effects

With an overdose of nitrate preparations, reactions such as severe dizziness, nausea, loss of vision clarity, a sharp decrease in blood pressure, sensations of heat, reddening of the face, and rapid heartbeat are possible.

To avoid this, you should carefully study the instructions for use of "Kardiket". Analogues have a similar way of using. After all, there is a list of diseases during which nitrate preparations are strictly prohibited. The main reason: a sharp drop in blood pressure.

"Cardiket" with analogues is contraindicated in:

• traumatic brain injury;
• acute myocardial infarction with low blood pressure;
• increased intracranial pressure;
• shock, collapse;
• severe hypotension;
• sensitivity to the components of the drug.

Patients using "Kardiket" and its analogues, should take a break in use after three weeks of use for twenty-four hours. In addition, it must be remembered that the doctor is engaged in the selection of the dosage. A properly used drug with an individually adjusted dosage is only beneficial. And even if you did not have enough funds to purchase the drug "Cardiket retard", cheaper analogues can easily replace it.

In this article, you can read the instructions for using the drug cardiket. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Kardiket in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Kardiket's analogs in the presence of the available structural analogs. Use for the treatment and prevention of angina attacks, myocardial infarction in adults, children, as well as during pregnancy and lactation. The composition of the drug.

cardiket- antianginal drug, organic nitrate.

Isosorbide dinitrate (the active substance of the drug Kardiket) causes relaxation of the smooth muscle wall of blood vessels, thus inducing vasodilation. Isosorbide dinitrate acts as a peripheral vasodilator, affecting both arteries and veins. These effects contribute to the deposition of venous blood and reduce venous return to the heart, reducing end-diastolic pressure and left ventricular volume (reduce preload).

The drug is characterized by a combination of rapid onset of effect with duration of action.

The advantages of the drug are determined by the fact that the active substance contained in tablets and capsules of prolonged action quickly enters the bloodstream. As a result, the drug provides a rapid onset of effect in the treatment of angina pectoris and retains its protective effect for a long time.

The onset of action of the drug is noted after 15-30 minutes.

Compound

Isosorbide dinitrate + excipients.

Pharmacokinetics

Capsules after oral administration dissolve in the stomach within a few minutes. The contents of the granules with the active substance are released gradually over several hours. After oral administration of isosorbide, dinitrate is rapidly absorbed. Binding to plasma proteins - 30%. It is metabolized in the liver with the formation of active metabolites - isosorbide-5-mononitrate (T1 / 2 is 4-6 hours) and isosorbide-2-mononitrate (T1 / 2 - 1.5-2 hours). It is excreted in the urine (almost completely in the form of metabolites).

Indications

• long-term treatment of coronary artery disease: prevention of angina attacks;
• chronic heart failure (as part of combination therapy with cardiac glycosides, ACE inhibitors and / or diuretics);
• secondary prevention of myocardial infarction and treatment of persistent angina pectoris (as part of combination therapy) for prolonged-release tablets.

Release form

Long-acting tablets 20 mg, 40 mg and 60 mg retard.

Long-acting capsules 120 mg.

Instructions for use and dosage

Long-acting tablets 20 mg are prescribed 1 tablet 2 times a day. With an increase in the need for the drug, the dose can be increased to 1 tablet 3 times a day.

Prolonged-release tablets 40 mg at the beginning of treatment are prescribed 1 tablet 1 time per day or 1/2 tablet 2 times a day. If the therapeutic effect is insufficient, the dose can be increased to 1 tablet 2 times a day. The second tablet should be taken no later than 8 hours after the first.

Prolonged-release tablets 60 mg at the beginning of treatment are prescribed 1 tablet 1 time per day. If necessary, the dose can be increased to 1 tablet 2 times a day. The second tablet should be taken no later than 8 hours after the first.

The drug in the form of prolonged-release capsules is prescribed 120 mg 1 time per day.

Treatment should begin with the lowest dose and slowly increase the dose to the maximum effective dose. The decision on the duration of treatment is made by the doctor. The drug is intended for long-term use, and without consulting a doctor, you should not abruptly stop taking it.

The drug is taken orally, regardless of the meal, without chewing and drinking a small amount of liquid. In order to split a tablet in half, it must be placed on a hard surface with a fault line up and press the tablet with your thumb. It easily splits into two halves.

Side effect

• headache ("nitrate" headache), which, as a rule, disappears after a few days with further use of the drug;
• a pronounced decrease in blood pressure, especially when the patient gets out of bed, which may be accompanied by tachycardia (paradoxical bradycardia is also possible), lethargy, as well as dizziness and a feeling of weakness;
• paradoxical increase in angina attacks;
• collaptoid states, sometimes with bradycardia and sudden loss of consciousness (syncope);
• nausea, vomiting;
• dry mouth;
• belching;
• abdominal pain;
• stiffness;
• drowsiness;
• blurred vision;
• decreased ability to quick mental and motor reactions (especially at the beginning of treatment);
• cerebral ischemia;
• skin rash;
• development of tolerance (including cross to other nitrates);
• exfoliative dermatitis;
• hyperemia of the skin.

Contraindications

• acute myocardial infarction with severe arterial hypotension;
• acute vascular insufficiency (shock, vascular collapse);
• severe arterial hypotension (systolic pressure less than 90 mm Hg);
• angle-closure glaucoma with high intraocular pressure;
• traumatic brain injury;
• severe aortic and / or mitral stenosis;
• hypovolemia;
• hemorrhagic stroke;
• children and adolescents under 18 years of age (efficacy and safety of use have not been established);
• concomitant use of phosphodiesterase type 5 inhibitors (such as sildenafil, vardenafil or tadalafil), as they potentiate the hypotensive effect of nitrates;
• hypersensitivity to nitrates.

Relative contraindications:

• cardiac tamponade;
• hypertrophic obstructive cardiomyopathy (may increase angina attacks);
• severe anemia;
• constrictive pericarditis;
• hemorrhage in the brain;
• toxic pulmonary edema.

Use during pregnancy and lactation

During pregnancy and lactation, the use of Kardiket is possible only if the intended benefit to the mother outweighs the possible risk to the fetus and / or child.

Use in children

Contraindicated in children and adolescents under the age of 18 (efficacy and safety of use have not been established).

special instructions

Kardiket is not used to stop angina attacks.

During treatment, control of blood pressure and heart rate is necessary.

With constant continuous treatment using Kardiket in high doses, tolerance may develop, as well as the appearance of cross-tolerance to other drugs of the nitrate group. To prevent a decrease in the effectiveness of the drug, its constant use in high doses should be avoided.

When taking Cardiket in patients with primary pulmonary diseases, temporary hypoxemia may occur due to the relative redistribution of blood flow to hypoventilated alveolar zones. In patients with CAD, this can lead to transient myocardial ischemia.

In acute myocardial infarction or acute heart failure, the drug should be used only under the condition of careful clinical monitoring of the patient.

To prevent an increase in angina attacks, abrupt withdrawal should be avoided.

Against the background of treatment with Kardiket, in the event of an attack of angina pectoris, fast-acting nitrates should be additionally used to stop it.

To prevent an undesirable decrease in blood pressure, the dose of the drug should be individually selected.

Against the background of treatment, a decrease in blood pressure and the appearance of dizziness are possible with a sharp transition to a vertical position from a “lying” or “sitting” position, with the use of ethanol (alcohol), exercise and hot weather, as well as increased angina pectoris with a sharp decrease in blood pressure, ischemia up to to myocardial infarction and sudden death (paradoxical "nitrate reactions").

The severity of headache during therapy with Kardiket can be reduced by reducing its dose and / or concomitantly taking menthol-containing drugs (validol).

With frequent use without application-free intervals, addiction may develop, requiring an increase in dose.

In order to prevent the occurrence of tolerance, it is recommended to observe a daily, preferably nightly "nitrate-free interval" for 8-12 hours. In most patients, this therapy is more effective than continuous treatment.

If, while taking the drug, blurred vision or dry mouth persist or are severe, treatment should be discontinued.

During the period of treatment with the drug, alcohol should be excluded.

Influence on the ability to drive vehicles and control mechanisms

During the period of therapy with Kardiket, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

drug interaction

It is possible to increase the hypotensive effect of Kardiket while taking it with other vasodilators (vasodilators), antihypertensive drugs, beta-blockers, slow calcium channel blockers, phosphodiesterase 5 inhibitors used to treat erectile dysfunction, neuroleptics and tricyclic antidepressants, novocainamide, quinidine, as well as ethanol.

The simultaneous use of Kardiket with dihydroergotamine can lead to an increase in the concentration of dihydroergotamine in the blood and, thus, enhance its hypotensive effect.

With the simultaneous use of sympathomimetic drugs, alpha-blockers, it is possible to reduce the antianginal effect of the drug Kardiket.

The combination of amiodarone and other drugs such as propranolol, slow calcium channel blockers (verapamil, nifedipine) and Kardiket is rational for the treatment of coronary artery disease.

The combined use of acetylsalicylic acid and Kardiket improves coronary circulation.

With the combined use of Kardiket with m-anticholinergics (atropine), the likelihood of an increase in intraocular pressure increases.

Adsorbents, astringents and enveloping agents reduce the absorption of Kardiket in the gastrointestinal tract.

Analogues of the drug Kardiket

Structural analogues for the active substance:

• Aerosonite;
• Dinisorb;
• Isacardine;
• ISO Mac retard;
• Iso Mac spray;
• Isoket;
• Isolong;
• Isosorbide dinitrate;
• Cardix;
• Nitrosorbide;
• TD spray Iso Mac.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

This page contains a list of all Kardiket analogues by composition and indications for use. A list of cheap analogues, and you can also compare prices in pharmacies.

• The cheapest analogue of Cardicket:
• The most popular analogue of Kardiket:
• ATH classification: Isosorbide dinitrate

Cheap analogues of Cardicket

When calculating the cost cheap analogues of Cardicket the minimum price was taken into account, which was found in the price lists provided by pharmacies

Popular analogues of Kardiket

The list of drug analogues based on the statistics of the most requested drugs

All analogues of Kardiket

Analogues in composition and indications for use

The above list of analogues of drugs, which indicates Substitutes for Cardicket, is the most suitable, since they have the same composition of active ingredients and match the indications for use

Analogues by indication and method of application

Different composition, may coincide in indication and method of application

To compile a list of cheap analogues of expensive drugs, we use the prices provided by more than 10,000 pharmacies throughout Russia. The database of drugs and their analogues is updated daily, so the information provided on our website is always up-to-date as of the current day. If you have not found the analogue you are interested in, please use the search above and select the medicine you are interested in from the list. On the page of each of them you will find all possible options for analogues of the desired medicine, as well as prices and addresses of pharmacies in which it is available.

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Cardicket price

Cardicket instruction

Dosage form

Prolonged action tablets.

Compound

Active substance: isosorbide dinitrate 40 mg;

Excipients: lactose monohydrate; talc; magnesium stearate; polyvinyl acetate; potato starch

Clinical pharmacology

Kardiket is a vasodilator.

Pharmacodynamics

Isosorbide dinitrate causes relaxation of the smooth muscle wall of blood vessels, thus inducing vasodilation. Isosorbide dinitrate acts as a peripheral vasodilator, affecting both arteries and veins. These effects contribute to the deposition of venous blood and a decrease in venous return to the heart, reducing the final diastolic blood pressure and the volume of the left ventricle (reduce preload).

Long-acting cardiket is characterized by a combination of a rapid onset of effect with a duration of action.

The advantages of the drug are determined by the fact that the active substance contained in the Kardiket tablet ® prolonged action, rapidly enters the bloodstream. As a result, the drug provides a rapid onset of effect in the treatment of angina pectoris and retains its protective effect for a long time.

Pharmacokinetics

When taken orally, isosorbide dinitrate is rapidly absorbed. Bioavailability when taken orally - 22% (effect of "first pass" through the liver). Beginning of action - after 15-30 minutes, C max substances in the blood plasma is reached after 15 minutes - 1-2 hours. As a result of the passage through the liver of isosorbide, dinitrate is metabolized to form isosorbide-2-mononitrate and isosorbide-5-mononitrate, which have T 1/2 1.5-2 and 4-6 hours, respectively. Both metabolites are pharmacologically active. It is excreted by the kidneys (almost completely in the form of metabolites). Plasma protein binding - 30%.

Indications

• attacks of all forms of angina pectoris
• prevention of angina pectoris
• acute myocardial infarction
• chronic heart failure.

Dosage

The dose is selected individually, since it depends on the stage of the disease and the individual need for nitrates. Tablets 40 mg - 1 tab. 2 times/day The drug should be taken after meals, without chewing and with a small amount of liquid. When prescribing more than 1 tablet / day, the interval between doses should be at least 8 hours (to ensure the full effect of the drug).

Contraindications

• acute phase of myocardial infarction
• pronounced decrease in blood pressure
• hypersensitivity to the drug Kardiket

Special Instructions

Kardiket retard should not be prescribed to relieve an attack of angina pectoris.

Severe headache that occurs at the beginning of therapy, in most cases, significantly decreases or completely disappears with continued use of the drug.

Alcohol should be avoided during treatment with Kardiket.

Influence on the ability to drive vehicles and control mechanisms

The question of the possibility of engaging in potentially hazardous activities should be decided only after assessing the patient's individual response to the drug.

Interaction

With the simultaneous use of Kardiket retard with antihypertensive drugs, cyclic antidepressants, MAO inhibitors, its hypotensive effect may be enhanced.

With the simultaneous use of Kardiket retard potentiates the action of dihydroergotamine and ethanol.

Side effects

From the side of the cardiovascular system: at the beginning of treatment - a severe headache (due to dilatation of the venous bed of the cerebral vessels); possibly - tachycardia, orthostatic hypotension.

From the side of the central nervous system: drowsiness.

From the gastrointestinal tract:in some cases - nausea, vomiting.

Dermatological reactions: in some cases - erythematous rashes.

Overdose

Symptoms:headache, palpitations, dizziness, arterial hypotension, nausea, vomiting.

Treatment:symptomatic.

Best before date

5 years.

Storage conditions

The drug should be stored at a temperature not exceeding 25°C.

In cardiovascular diseases, in particular, in violation of the oxygen supply to myocardial cells, drugs with vasodilatory and antianginal effects are often prescribed. They are aimed at maintaining the normal functioning of the heart in conditions of ischemia.

Among such drugs, Cardiket should be noted - a prescription drug with a prolonged action and a very fast effect. Due to its active action and low price, it is very popular with cardiologists.

Kardiket is a drug that is used for the treatment of only a few indications, but has a large number of limitations, so it is necessary to carefully study the annotation before use.

medicinal group

Kardiket is based on organic nitrate, therefore it belongs to the group of nitrates and nitrate-like drugs. Also, according to its action, it can be attributed to angtianginal and vasodilating drugs, but the manufacturer indicates the ATC code - C01DA08 (nitrates). Kardiket is the trade name of the drug, and the international non-proprietary name is Isosorbide dinitrate, similar to the name of the active substance.

The drug is used strictly in cardiology practice and only by prescription, as its use should be carried out with extreme caution. Kardiket is prescribed for the treatment of cardiovascular diseases, as the only drug, as well as as part of complex therapy, since it goes well with many heart drugs.

Forms of release and cost

Kardiket is available in the form of long-acting tablets in various dosages and with different packaging. The estimated cost of different forms of the drug is presented in the table (Table 1).

Table 1 - Cost

A sublingual spray with Isosorbide dinitrate is also available, but under a different trade name - Izacardin.

Compound

The active substance of Kardiket is isosorbide dinitrate, which belongs to organic nitrates. Each tablet contains 20, 40 or 60 mg of this substance, which determines the dosage of the drug.

Additionally, excipients are included in the tablets: 20 mg tablets contain lactose monohydrate, magnesium stearate, talc, polyvinyl acetate, and 40 and 60 mg tablets, in addition to these components, also contain starch.

Pharma properties

Kardiket dissolves very quickly when ingested, but the therapeutic effect lasts a long time, since the tablets have a prolonged action. The rapidly developing action promotes the release of NO2 in the smooth muscles located in the vessels. As a result, a process is launched that causes relaxation and expansion of blood vessels: coronary, pulmonary and located in the brain.

The drug reduces the load on the heart, reduces the need for oxygen in the heart muscle and redistributes blood flow in the coronary vessels, redirecting it to areas with reduced nutrition.

Kardiket reduces pressure in the vessels of the pulmonary circulation, increases the resistance of the myocardium to heavy loads in patients with angina pectoris and ischemic disease. The drug does not affect the contraction of the myocardium, but is able to slightly increase the heart rate.

After taking the drug, the maximum concentration in the blood is reached after 1-2 hours. Passing through the liver, isosorbide dinitrate breaks down into two metabolites, which are excreted along with urine, while the half-life is 12 hours.

Indications and contraindications

Kardiket has very few indications for use and is most often used in ischemic conditions and diseases associated with vascular spasms, leading to disruption of the heart.

In what cases is it appropriate to take:

It is very important that the drug is prescribed only by a doctor, as it has too many absolute and relative contraindications. Kardiket is completely forbidden to receive in the following cases:

Relative contraindications include:

• cerebral hemorrhages;
• severe anemia;
• cardiac tamponade;
• toxic pulmonary edema;
• advanced stage of pericarditis;
• obstructive hypertrophic cardiomyopathy.

Special care is required in the following cases:

Also, caution is necessary for elderly patients - they are prescribed the drug in minimal doses and, with good tolerance, gradually increase the dosage. Women during pregnancy and lactation, the drug is rarely prescribed and only under strict indications.

Instructions for use

Taking Kardiket does not depend on whether the stomach is full or not, which is very convenient, since you do not need to adjust to meals. Tablets should not be chewed and preferably taken whole, but if it is necessary to split the tablet, then it must be cut with a knife along the fault line.

Initially, the minimum dosage is prescribed, which is gradually increased to the maximum, causing a positive therapeutic result.

Cancellation of the drug should also be gradual, so as not to provoke a sharp deterioration in the condition.

Dosages

Tablets with a dosage of 20 mg should initially be taken 2 times a day, one at a time, with a small amount of liquid. If necessary, appoint a three-time dose of one tablet.

Kardiket with a dosage of 40 mg is initially prescribed with caution - 2 times a day for half a tablet or a single dose of 1 tablet per day. If the therapeutic effect is insufficient, then the dose is increased to 1 tablet 2 times a day.

The drug with a dosage of 60 mg is initially prescribed 1 tablet per day. In severe cases, a double daily dose of the drug, 1 tablet, may be prescribed. If you need to take pills more than once a day, then to achieve the effect, it is necessary that the break be no more than 8 hours.

Duration of treatment

The duration of therapy, increase in dosage and withdrawal of the drug is determined by the doctor based on the results of the examination and questioning of the patient.

Kardiket is intended for long-term therapy, which the attending physician should warn about so that the patient does not cancel the drug on his own, since abrupt cancellation can lead to serious consequences. It should be remembered that taking the drug should be accompanied by regular measurement of blood pressure and the determination of cardiac contractility.

Some patients may become addicted to long-term treatment, but this does not mean that you need to increase the dosage yourself, as overdose symptoms may develop.

Given that the drug is taken for more than one month, it is important to ensure that tolerance does not develop to it. If the patient felt a decrease in the effectiveness of the remedy, you need to take a break for one or two days, and then resume taking it.

If this does not help, then you should consult a doctor to prescribe a medicine with a similar effect, but with a different active ingredient. To prevent the development of tolerance to the drug with prolonged use, a break should be taken every three to six weeks for three to four days.

At what pressure is prescribed

Kardiket is not a drug used to treat hypertension, but due to the peculiarity of the mechanism of action, it is used in patients with heart disease, accompanied by an increase in blood pressure.

The drug can reduce pressure due to the following properties:

Kardiket only temporarily reduces blood pressure and does not affect the causes of its increase. Basically, it is prescribed only for coronary diseases, persistent angina and pulmonary hypertension, in order to reduce pressure and support the work of the heart.

Very rarely, the drug is prescribed as a means to reduce pressure without concomitant heart disease. Such an appointment is necessary when the patient has a risk of developing cardiac pathologies or other means do not have the necessary effect.

Before taking Kardiket with elevated blood pressure, it is necessary to conduct a thorough examination and identify the causes of hypertension. It is imperative to monitor hemodynamics in order to select the most appropriate dosage of the drug. If it is necessary to use Kardiket in elderly patients, it is necessary to reduce the dosage due to the high risk of side effects.

Kardiket cannot be used simultaneously with IFD type 5, since there is a possibility of a sharp and critical decrease in pressure, up to hypotonic collapse. It is also forbidden to take with drugs that expand the vascular lumen. The intake of alcohol with Kardiket is strictly prohibited, since alcoholic beverages significantly enhance the effect of the active substance.

It is undesirable to use Kardiket with a tendency to hypotension, and with an upper pressure below 90 mm. Hg the use is possible in minimal dosages, only according to strict indications and under the supervision of the attending physician.

Possible side effects and compatibility

Kardiket may cause some side effects:

Analogues

Kardiket is a replaceable drug, depending on the situation, it can be replaced by structural analogues or other drugs with a similar effect.

Structural

The most popular structural analogue is, whose name is similar to the active substance. It is produced in the same dosages, its price is slightly less, but differs slightly (from 70 rubles).

Other structural analogues:

If we compare these drugs, then Kardiket is much more convenient to take - no more than 2-3 times a day, while Nitrosorbide is taken up to 5 times a day. Other drugs in tablets are much more expensive, so you can choose Kardiket, since their action is no different.

Solutions for intravenous administration are used only in a hospital setting, for the relief of acute conditions. To stop angina attacks, it is more convenient to take a spray, since it acts almost instantly and does not need to be washed down, which also eliminates the risk of overdose.

Other drugs with a similar effect

Kardiket is often alternated or replaced with other drugs with a similar effect. The most popular analogues:

It is possible to replace Kardiket with other drugs only at the discretion of the attending physician. Even structural analogues should be agreed with the attending physician, as they are available in various dosages and forms.

Reviews of doctors

The experience of specialists shows that Kardiket and its analogues are undoubtedly useful for the prevention of angina pectoris and myocardial infarction. The drug is often prescribed in monotherapy, which allows you to reduce the number of other pills taken. But it can also be used in combination with other drugs, the main thing is that the doctor chooses the right dosage.