Aritmil (amiodarone hydrochloride) tablets 0.2 №20

active ingredient : amiodarone hydrochloride;

1 tablet contains 200 mg of amiodarone hydrochloride (in terms of dry 100% substance);

excipients : corn starch, microcrystalline cellulose, calcium stearate, povidone, lactose monohydrate.

Pills.

Basic physical and chemical properties: tablets are round, white or almost white in color, with a flat surface with bevelled edges and a risk.

cardiac drugs. Class III antiarrhythmic drugs. ATX code С01B D01.

Class III antiarrhythmic drug. The antiarrhythmic effect is due to an increase in the III phase of the action potential, mainly due to the blockade of potassium channels in the membranes of cardiomyocytes, as well as calcium channels, slowing down the conduction through the AV node and reducing the automatism of the sinus node. To a small extent, blocks open and inactivated sodium channels and slows down the fast input sodium flow. The drug non-competitively blocks alpha- and beta-adrenergic receptors in the main myocardium, which also slows down sinoatrial, atrial and AV conduction without affecting intraventricular conduction. Amiodarone increases the refractory period and reduces myocardial excitability. Slows down the conduction of excitation and lengthens the refractory period of additional atrioventricular pathways. The antianginal effect of amiodarone is due to a decrease in myocardial oxygen consumption due to a decrease in heart rate and a decrease in total peripheral vascular resistance. Amiodarone does not cause a significant negative inotropic effect.

Amiodarone has a large volume of distribution. In the first days of the appointment, the drug accumulates in almost all tissues, especially in fatty inclusions, the liver, spleen, and lungs. After a few days, amiodarone is excreted from the body.

A stable concentration is achieved within 1 to several months, depending on the individual characteristics of the patient. Amiodarone is excreted in bile and feces. Renal excretion is negligible. The half-life is 20-100 days. After stopping treatment with amiodarone, its elimination from the body continues for several months. Amiodarone contains iodine, therefore, during metabolism in the liver, iodine is split off and excreted in the urine in the form of salts. The main part of amiodarone and its metabolites are excreted through the intestines for more than 30 days. After discontinuation of the drug, its effective action continues for several days or even weeks.

Relapse prevention:

• ventricular tachycardia, which poses a threat to the life of the patient: treatment must be started in a hospital with constant monitoring of the patient’s condition;
• symptomatic ventricular tachycardia (documented), which leads to disability;
• supraventricular tachycardia (documented), which requires treatment, and in cases where other drugs have no therapeutic effect or are contraindicated;
• ventricular fibrillation.

Treatment of supraventricular tachycardia: slowing down or reducing fibrillation, or atrial flutter.

Ischemic heart disease and / or dysfunction of the left ventricle.

• Hypersensitivity to iodine and / or amiodarone, to other components of Aritmil (amiodarone hydrochloride);
• sinus bradycardia (< 50-55 beats / min), sinoatrial blockade, sick sinus syndrome in the absence of an artificial pacemaker (danger of stopping the sinus node);
• severe conduction disturbances (AV block II and III degree, bifascicular or trifascicular block) in the absence of an artificial pacemaker;
• dysfunction of the thyroid gland (hypothyroidism, hyperthyroidism). Before starting treatment, thyroid function should be checked in all patients;
• simultaneous use with drugs that can cause polymorphic ventricular tachycardia of the “torsade de pointes” type:
• class IA antiarrhythmic drugs (quinidine, hydroquinidine, disopyramide);
• class III antiarrhythmic drugs (sotalol, dofetilide, ibutilide);
• other drugs such as arsenic compounds, bepridil, cisapride, difemanil, dolasetron (IV), domperidone, dronedarone, prucalopride, erythromycin (IV), mizolastine, moxifloxacin, levofloxacin, mequitazine, citalopram, escitalopram, spiramycin (IV), vincamine (IV) ), toremifene, some antipsychotics;
• telaprevir
• cobicistat.