SUSTONIT

Active material: Nitroglycerin
When ATH: C01DA02
CCF: Peripheral vasodilators. Antianginal drug
When CSF: 01.06.01.01.03
Manufacturer: WARSAW PHARMACEUTICAL WORK POLFA S.A. (Poland)

PHARMACEUTICAL FORM, COMPOSITION AND PACKAGING

Excipients: gipromelloza, lactose, colloidal silicon dioxide, stearic acid, cochineal red lacquer.

10 PC. – packings Valium planimetric (3) – packs cardboard.

Pharmacological action

Peripheral vasodilator with a primary effect on the venous vessels. Antianginal drug.
The mechanism of action of the drug is probably associated with the endothelial derived relaxing factor (FRPE), in chemical structure is nitrogen oxide. FRPE stimulates the production of c-GMP, which relaxes the smooth muscles of blood vessels. Atherosclerotic coronary vessels have a pronounced tendency to vasoconstriction, due to deficiency of endogenous FRPE due to the destruction of the endothelium.
For the action of nitrates requires free SH groups in the cytosol. Deficiency of these groups, appearing with regular use of nitrates, It is the cause tachyphylaxis, which takes place during the second appearance of a sufficient number of sulfhydryl groups in the cytosol. Therefore, you should take breaks in therapy Sustonitom.
The drug reduces the preload on the heart by veins, which leads to a decrease in end-diastolic volume of the left ventricle and systolic ventricular wall stress. Sustonit also reduce afterload on the heart due to the expansion of arterioles and reduce systemic vascular resistance. Due to these effects, the drug reduces myocardial oxygen demand and reduces energy costs infarction. It provides direct expansionary effect on the coronary arteries. The drug reduces the pressure in the pulmonary circulation.
Thanks to the particular dosage form, release of nitroglycerin occurs gradually, its concentration in blood plasma for a few hours remains at, sufficient to reduce the frequency of angina attacks and increase exercise tolerance.

Testimony

- Prevention of angina attacks, improving exercise tolerance in patients with coronary artery disease;
- Heart failure (incl. left ventricular).

Dosage regimen

Establish individually, depending on the condition of the patient and efficacy.
The drug is not intended for the relief of angina attacks.
The average daily dose is 6.5-13 mg / day. The drug is recommended for use 2 times / day with an interval between doses 8 no (eg, in 8 a.m. and 16 no) for the prevention of tachyphylaxis.
A longer break should occur in a small period of physical activity and the time of day, which usually do not occur angina (or are rare).
The tablets should be swallowed whole, not raskusyvaya and grinding.

Side effect

Cardio-vascular system: dilation of blood vessels in the skin, flushing of the face, orthostatic hypotension (at the beginning of treatment, They tend to disappear or decrease in therapy); sometimes - tachycardia.
CNS: headache, dizziness, weakness, anxiety.
From the digestive system: nausea.
Other: pale mucous membranes.

Contraindications

- Severe anemia;
- Traumatic brain injury;
- The cerebral circulation on hemorrhagic type;
- Arterial hypertension;
- Increased intraocular pressure;
- Hyperthyroidism;
- Gipertroficheskaya cardiomyopathy;
- Right ventricular infarction;
- Cardiogenic shock;
- Gipovolemiя;
- Hypersensitivity to nitrates.

Pregnancy and lactation

Application Sustonita during pregnancy and lactation (breast-feeding) is admissible only if absolutely indicated and under medical supervision.

Cautions

With careful use of the drug in the early post-infarction period, in patients with narrow-angle glaucoma.
Patients, receiving Sustonit, Avoid alcohol (because of the possible increase the hypotensive effect of nitroglycerin).

Overdose

Symptoms: znachitelynaya vasodilation, drop in blood pressure. If a large overdose – serious hemodynamic disorder, loss of consciousness. Considering the slow release of the active drug substance from, occurrence of severe symptoms at unintentional overdose is unlikely.
Treatment: artificial vomiting, gastric lavage. In mild cases it is sufficient to give the patient a horizontal position with raised legs. In more severe cases - in / in a liquid, possible use of a vasoconstrictor (but their effectiveness has not been confirmed unequivocally). As the use of vasoconstrictors, and in / IV fluids requires special care in diseases of the cardiovascular system or kidneys.

Drug Interactions

When using Sustonita combined with beta-blockers or calcium channel blockers may be a significant drop in blood pressure.
When combined with other peripheral Sustonita vazodilatatormi may increase or decrease their effect.
With simultaneous use of tricyclic antidepressants and Sustonita (phenothiazine derivatives) possible significant drop in blood pressure.

Conditions and terms

The drug should be stored in a dark and inaccessible to children at temperature not exceeding 25 ° C. Shelf life – 3 year; Do not use beyond the expiration date, on the package.
Conditions of supply of pharmacies
The drug is released under the prescription.