RITMONORM table. 150 mg. 50 tablets
Symptomatic and requiring treatment tachycardiac supraventricular cardiac arrhythmias such. AU-nodal tachycardia, supraventricular tachycardia in WPW-syndrome or paroxysmal atrial mazhdene.Tezhkostepenni symptomatic ventricular tachycardia cardiac arrhythmias
RITMONORM table. 150 mg. 50 tablets
Active substance: 1 filmtabletka contains 150 mg of propafenone hydrochloride. Method deystvieRytmonorm 150 mg is an antiarrhythmic agent with local anesthetic, mainly action and membrane stabilizing effect on myocardial kletka.Rytmonorm ® 150 mg prevents the formation and implementation of excitement in the atrium and cameras. This is due to its pronounced effect on heart rhythm disorders of various origins.
Symptomatic and requiring treatment tachycardiac supraventricular cardiac arrhythmias such. AU-nodal tachycardia, supraventricular tachycardia in WPW-syndrome or paroxysmal atrial mazhdene.Tezhkostepenni symptomatic ventricular tachycardia cardiac arrhythmias, if in the judgment of the physician are life-threatening.
Contraindications are diseases or circumstances that should not be used certain drugs or used only after careful consideration by the doctor, because they are generally expected benefit is favorable relative to possible injury. For the doctor to carefully check for contraindications, he must be aware of your previous illnesses, comorbidities other concurrent treatments, and your living conditions and habits. Contraindicated s may occur or become known after initiation of therapy with this medication. In such cases had to inform your doctor.
Propafenone should not be used in:
expressed heart failure, cardio-circulatory shock, unless caused by a heart rhythm disorder, illness in heart rate,
during the first 3 months after myocardial infarction or cardiac function limited '(relevant left ventricular ejection volume <35%) than in patients with life-threatening ventricular arrhythmias of the heart
available high-grade sino-atrial, atrioventricular and vatrekamerni violations in the conduct of excitement heart syndrome sick sinus (tahini-beards syndrome), hypotension (low blood morbid significant pressure) expressed electrolyte balance disorders (eg, disorders of potassium metabolism ), severe obstructive (caused by blockage), lung disease, myasthenia gravis, known hypersensitivity to the active substance propafenone.
Use during pregnancy and lactation
During pregnancy, especially during the first three months, and during lactation, propafenone should be taken only by explicit medical indication.
Drugs can have with your main actions and side effects. Side effects that have been observed at the time of treatment with propafenone, but that does not necessarily occur in any patient mentioned below. Sometimes, especially at high initial dosage may occur gastrointestinal disorders such as loss of appetite, nausea, vomiting tendency, feeling of fullness, constipation, dry mouth, and taste orchiv, fading ears, sensory disorders, vision and dizziness. In elderly patients with limited myocardial function from time to time may occur donarushena regulation of blood circulation with a tendency to lower blood pressure, which is caused by the body upright or prolonged standing. It may come and proarrhythmic effects in the form of change or enhance cardiac arrhythmias. These proarrhythmic effects have also severely delayed or heart rhythm disorder or conduct of the excitement or increase in heart rate. May worsen heart failure.
Rarely can lead to fatigue, headaches, mental disorders such as fear, confusion, anxiety, nightmares and sleep disturbances as well as disturbances in the course of involuntary movements, allergic skin reactions (redness, itching, exanthema or urticaria), and seizure of bronchi in patients with increased susceptibility to bronhospazam.V some cases, high doses of propafenone, decreases in potency and number of seminal cells.
These events resolved after discontinuation of therapy. Because treatment with propafenone may be vital, it should not be interrupted without medical advice for these side effects.
Interaction with other drugs
The effects of some drugs can be influenced by the concomitant use of other agents. Therefore, consult your doctor if you consistently drink, have recently used or want to use other medication while drug discussions here. Your doctor will tell you that under these circumstances there is mutual intolerance between the two medications or need to take some special measures, eg. defining a new dose when using this drug.
Concurrent use of drugs with local anesthetic-action (eg pacemaker insertion, surgical or dental procedures), as well as other drugs that cause the heart rate and / or the pumping ability of the heart (eg betaretseptorni blockers , tricyclic antidepressants) should be given the opportunity to enhance the active action. Moreover described further increases in plasma concentrations, respectively. propranolol levels in the blood, metoprolol, desipramine, digoxin, and cyclosporin. In one case, an additional grant of propafenone was observed doubling of theophylline plasma concentrations. If an overdose of relevant phenomena to determine plasma concentrations and, if necessary to reduce the dosage of prescribed medication. Increases in plasma concentrations of propafenone are described with the concomitant use of cimetidine, respectively. quinidine. Concurrent use of propafenone with phenobarbital, respectively. rifampicin may lead to reduced plasma concentrations propafenonovata even subtherapeutic levels. It is the interaction of propafenone with oral anticoagulants (increase of the effect of anticoagulants). In these patients, careful monitoring of coagulation.
Precautions for use
This may mezikament at normal dosage alter the ability to respond to such an extent as to affect significantly on driving or operating machinery. This applies more prominently in concomitant use with alcohol.
When propafenone therapy can change senzing pacing-and-threshold pacemaker. function of the pacemaker should be checked and if necessary re-programmed.
Establishing individual maintenance dose should be done under medical supervision with frequent monitoring of ECG and blood pressure (initial phase of dosage adjustment). When extending the QRS-interval (over 20%) or frequency-dependent QT-interval, the dose should be reduced or temporarily discontinued therapy to normalize electrocardiogram. In limited hepatic and / or renal function, therapeutic doses may lead to accumulation. Under control of ECG and plasma and these patients may be included treatment with propafenone. Unless otherwise specified, the phase of adjustment and maintenance dose is recognized daily dose of 450 to 600 mg, which corresponds to 3-4 filmtabletki in 2-3 single doses spread evenly throughout the day. Sometimes increasing the daily dose of 900 mg, respectively 6 filmtabletki evenly distributed throughout the day in 3 single doses.
In certain exceptional cases this dose may be exceeded under strict cardiac kontrol.Dannite apply to patients with a body weight of about 70 kg. In patients with lower weight daily doses should be reduced accordingly.
Propafenone should be dosed very carefully in the initial phase step for the elderly or severely damaged heart muscle. The increase in dose should be done only during the 3-4 day interval.
Initiation of therapy with antiarrhythmic drugs for ventricular arrhythmias requires careful medical supervision and should be done only in case of emergency treatment equipment and the ability to monitor control. During therapy, in regular intervals, should be performed check-ups (eg in one month - standard ECG, respectively. 3 months - Holter ECG and ECG under load). With the deterioration of certain parameters, eg. prolongation of the QRS-interval, respectively. QT-interval of more than 25% or PQ-interval of more than 50%, respectively. prolongation of the QT interval greater than 500 msec or an increase in the number or severity of arrhythmias, therapy should be re-verified.
Patients with significant left ventricular function limit (<35%), respectively. structural myocardial diseases, should be dosed very carefully step. In these cases we recommend a therapeutic dose increase required to be undertaken only when they are already established pharmacokinetic steady-state relations, usually after about 5-8 days. Thus reducing (risk of potential proarrhythmic effects in the initial phase of therapy in these patients.
Method and duration of administration
filmtabletkite should be taken and suspended unchewed with some liquid after meals because of the bitter taste and anesthetic effect of surface active agent. The duration of treatment is determined by the doctor.
Drug should not be used after the expiry date indications. Drugs to be kept out of reach of children.
Start, peak and duration of drug action
After a rapid onset of drug action (after 30 minutes) Rytmonorm 150 mg reaches its maximum effect after 2-3