Pharmacodynamics and pharmacokinetics
The main active ingredient is propranolol . Anaprilin is a non-selective adrenergic blocker, reduces the sympathetic effect on beta-adrenergic receptors of the heart, reduces the frequency and strength of heart contractions, reduces the contractile function of the myocardium, regulates cardiac output downwards, blocks the positive inotropic and chronotropic effect of catecholamines, reduces the heart's need for oxygen, reduces arterial pressure. The mechanism of action of the drug is aimed at increasing bronchial tone through blockade of beta2-adrenergic receptors. Anaprilin increases the contractility of the uterus, reduces the risk of bleeding during childbirth, the postpartum and postoperative periods.
When taken orally, the drug is quickly absorbed and excreted from the body. The maximum peak content of the active substance in the blood plasma is recorded after 1 -1.5 hours. The drug penetrates the fetoplacental barrier.
Mechanism of action of Anaprilin
Propranolol reduces the frequency and increases the strength of myocardial contractions. The product works systemically: at the same time it reduces the need for oxygen in the muscular system and improves its tone. As a result, contraction of the walls of the uterus, bronchi, and gastrointestinal tract increases. Anaprilin causes a persistent decrease in systolic and diastolic pressure, prevents the development of a hypertensive crisis, and alleviates the condition during angina attacks. The effectiveness of the medicine is equally high in any position of the patient’s body. The drug reduces the risk of sudden myocardial infarction and allows you to reduce the intake of nitroglycerin. With regular use, Anaprilin helps improve physical performance.
Indications for use of Anaprilin tablets
What does the drug help with?
Indications for the use of Anaprilin are: arterial hypertension , sinus tachycardia , angina pectoris, supraventricular tachycardia, unstable angina, atrial fibrillation (tachysystolic form), prevention of migraine attacks, sympathoadrenal crises, NCD. For arterial hypertension, the drug is effective in the initial stages of the disease, and therefore is used more often in young people (under 40 years of age). A decrease in systolic pressure is accompanied by a decrease in heart rate, a decrease in cardiac output and stroke volume. For coronary heart disease, taking the drug reduces the number of angina and increases resistance to physical activity. Particularly effective for concomitant arterial hypertension and arrhythmias.
Anaprilin
Beta blockers should not be used in patients with untreated chronic heart failure until the condition has been stabilized.
Before using the drug, patients with heart failure (early stages) must use cardiac glycosides and/or diuretics.
Monitoring of patients taking the drug should include monitoring heart rate and blood pressure (daily at the beginning of treatment, then once every 3-4 months), recording an electrocardiogram.
In elderly patients, it is recommended to monitor renal function (once every 4-5 months).
In case of increasing bradycardia (less than 60 beats/min), arterial hypotension (systolic blood pressure less than 100 mm Hg), atrioventricular block, bronchospasm, ventricular arrhythmias, severe liver and/or kidney dysfunction in elderly patients, it is necessary reduce the dose of the drug or stop treatment.
The drug should be used with caution in patients with first degree atrioventricular block.
The patient should be trained in the method of calculating heart rate and instructed about the need for medical consultation if the heart rate is less than 60 beats/min.
It is recommended to discontinue therapy if depression caused by taking beta-blockers develops.
Patients who use contact lenses should take into account that during treatment with beta-blockers, there may be a decrease in the production of tear fluid.
Treatment of coronary heart disease and persistent arterial hypertension should be long-term - taking the drug is possible for several years.
Discontinuation of treatment is carried out gradually, under the supervision of a physician: abrupt withdrawal can dramatically increase myocardial ischemia, anginal syndrome, and worsen exercise tolerance. Cancellation is carried out gradually, reducing the dose by 25% every 3-4 days for 2 weeks or more.
When deciding on the use of the drug Anaprilin in patients with psoriasis, one should carefully weigh the expected benefits and the possible risk of exacerbation of psoriasis.
In thyrotoxicosis, propranolol may mask certain clinical signs of thyroid hyperfunction (for example, tachycardia). Abrupt withdrawal in patients with hyperthyroidism is contraindicated as it can worsen symptoms.
Isolated reports of myasthenia gravis have been reported during propranolol therapy. If muscle weakness occurs, consult a doctor. In patients with diabetes mellitus, the drug is used under the control of blood glucose concentration (once every 4-5 months). Use with caution simultaneously with hypoglycemic agents, since hypoglycemia may develop during prolonged breaks in food intake, as well as during insulin therapy. Moreover, its symptoms such as tachycardia or tremor will be masked due to the action of the drug. The patient should be instructed that the main symptom of hypoglycemia during treatment with the drug is increased sweating. There is also a risk of hyperglycemia when taking oral hypoglycemic agents.
When taking clonidine concomitantly, it can be discontinued only a few days after propranolol is discontinued.
For pheochromocytoma, it is used only in combination with alpha-blockers. Do not use simultaneously with antipsychotic drugs (neuroleptics) and tranquilizers.
Beta blockers may increase sensitivity to allergens and the severity of anaphylactic reactions. Propranolol may cause severe reactions to a number of allergens when administered to patients with a history of severe anaphylactic reactions to these allergens. These patients may not respond to the usual doses of epinephrine (adrenaline) used to treat anaphylactic shock.
Drugs that reduce catecholamine reserves (for example, reserpine) may enhance the effect of beta-blockers, so patients taking combinations of drugs should be under constant medical supervision to detect arterial hypotension and bradycardia.
During treatment with propranolol, intravenous administration of verapamil and diltiazem should be avoided.
Use with caution in combination with psychotropic drugs, for example, MAO inhibitors, when used for a course of more than 2 weeks.
A few days before general anesthesia with chloroform or ether, it is necessary to stop taking the drug (increased risk of depression of myocardial function and the development of arterial hypotension). It is necessary to warn the anesthesiologist that the patient is taking propranolol.
In smokers, the effectiveness of beta-blockers is lower.
The drug should be discontinued before testing the content of catecholamines, normetanephrine and vanillinmandelic acid in the blood and urine; antinuclear antibody titers.
Therapy with the drug should be suspended if there is a respiratory infection of the lower respiratory tract accompanied by difficulty breathing. The use of beta2-agonists and inhaled glucocorticosteroids is allowed. Resumption of use of the drug is possible only after the patient has completely recovered. In case of repeated infection, as well as in the case of isolated bronchospasm, the use of the drug should be stopped completely.
It is not recommended to drink alcohol during treatment (a sharp decrease in blood pressure is possible). Beta-blockers should be used with caution in patients with peripheral circulatory disorders, as these symptoms may worsen.
Avoid using natural licorice during treatment; Protein-rich foods can increase bioavailability.
Propranolol may give a positive result in a doping test.
Contraindications
Anaprilin is not prescribed for arterial hypotension , intolerance to components, heart failure, atrioventricular block, sinus bradycardia , sinoatrial block , diabetes mellitus, acute myocardial infarction, bronchial asthma, obliterating vascular diseases, metabolic acidosis , tendency to bronchospasm, vasomotor rhinitis , during pregnancy, breast nom breastfeeding
Side effects
Bradycardia , atrioventricular block, bronchiolospasm, the development of Raynaud's syndrome , heart failure, vomiting, muscle weakness , epigastric pain, vomiting, diarrhea , itching , depression , hypoglycemia - of diabetes are noted. diabetes , visual impairment, decreased potency.
Side effects of Anaprilin
If the recommendations are followed, the drug is well tolerated. In some cases it is possible:
- dizziness, tinnitus;
- physical weakness;
- asthenia;
- increased drowsiness;
- decreased concentration;
- dyspepsia: loss of appetite, nausea;
- bowel dysfunction: diarrhea, constipation;
- bronchopulmonary spasm, cough;
- dyspnea;
- dry eye syndrome, decreased visual acuity.
The likelihood of side effects increases with smoking.
Anaprilin tablets, instructions for use (Method and dosage)
The initial dosage of the drug for arterial hypertension is 40 mg, twice a day. No more than 320 mg per day.
For heart rhythm disturbances, angina pectoris: 20 mg three times a day with a gradual increase in dose to 120 mg in 2-3 doses.
How to take for migraine prevention and essential tremor? First, 20 mg of the drug is prescribed 2-3 times a day, then the dose can be increased to 160 mg.
According to the instructions for use of Anaprilin for pathology of the renal system, dosage adjustment is not required.
Dosage forms of the drug
The medication is intended for oral administration and parenteral administration. Anaprilin is produced:
- In the form of white tablets: with a concentration of 10 and 40 mg of the active substance. Auxiliary and formative components of pills: talc, hypromellose, starch, MCC, silicon dioxide, calcium stearate. The packaging of the drug contains from 10 to 10 pieces, packaged in blisters.
- In the form of a water-based injection solution. A transparent liquid with a concentration of 0.1% is packaged in glass ampoules of 1 and 5 ml, packed in cardboard packs of 10 or 100 pcs. The drug with 25% of the active substance is available in a dosage of 1 ml. One package contains 10 ampoules.
The active ingredient of Anaprilin is propranolol hydrochloride. This compound has a pronounced hypotensive effect, dilates blood vessels, and prevents heart rhythm disturbances. Included in drugs for the treatment of angina attacks and other cardiac pathologies.
Interaction
Anaprilin mutually enhances the negative effects of diltiazem and verpamil on the myocardium, inhibits the elimination of lidocaine, and prolongs the duration of action of non-polarizing muscle relaxants . The hypotensive effect is weakened when taken simultaneously with glucocorticosteroids , estrogens, and NSAIDs. The hypotensive effect is enhanced by the use of nitrates. Antacids and heparin reduce the concentration of the drug in the blood, phenothiazines and cimetidine increase it. Concomitant use with MAO inhibitors . Anaprilin increases the concentration of theophylline in plasma and slows down its metabolism.
Compatibility of Anaprilin with other medications and alcohol
The active ingredient of the drug prolongs and enhances the effect of muscle relaxants. With simultaneous treatment, a reduction in the dosage of the latter is required. When combined with lidocaine and aminophylline, it slows down their elimination.
Anaprilin requires careful use in diabetes, as it increases the risk of hypoglycemia when using insulin and other hypoglycemic agents. The drug must be discontinued during a medical examination using X-ray contrast agents. Their combined administration with Anaprilin greatly increases the likelihood of acute allergic reactions, including anaphylactic shock.
In combination with alcohol, Anaprilin can provoke a sharp development of hypotension, hypoxia, even vascular collapse. The danger of intoxication remains both in a state of intoxication and in a hangover. When drinking large doses of alcohol along with medication, there is a risk of delirium, acute respiratory failure, and coma.
special instructions
Taking the drug together with tranquilizers and antipsychotics . During long-term treatment with Anaprilin, it is recommended to simultaneously take cardiac glycosides . Discontinuation of the drug should be carried out gradually to prevent the development of acute myocardial ischemia or bronchospasm. For arrhythmias, the beta-blocker Anaprilin helps normalize sinus rhythm, transition atrial fibrillation from tachysystolic to bradysystolic and reduce subjective interruptions in the heart. Possible inhibition of reaction and attention, which must be taken into account when prescribing the drug to drivers, operators and people of similar professions.
Recipe in Latin: Rp.: Anaprilini 0.01 D. td N 20 in tabul. S.
Who is Anaprilin contraindicated for?
The medication is prohibited for use in the first 4 days after myocardial infarction. Other contraindications:
- allergic conjunctivitis;
- bronchial asthma;
- bradycardia with a decrease in heart rate to 60 beats per minute.
Anaprilin reduces the speed of psychomotor reactions. For this reason, treatment with the drug is incompatible with driving vehicles and performing work that requires intense attention.
Anaprilin price, where to buy
The price of Anaprilin tablets is 10 rubles per pack of 30 pieces of 40 mg.
You can buy a package of 50 pieces of 10 mg for 20 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
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