"Allapinin": instructions for use. Analogues, reviews and contra-indications "Allapinina"

Tablets "Allapinin" refer to the first class of antiarrhythmic drugs. The drug is able to block sodium channels in the membranes of cardiomyocytes. It provokes retardation of intraventricular and atrioventricular conduction, shortens the functional and effective refractory periods in the atria, the bundle of the Hyis, the AV node and the Purkinje fibers. The tool has absolutely no effect on the duration of the QT-interval, the frequency of contractions. With the initial absence of manifestations of cardiac insufficiency, the drug "Allapinin" (the instruction for use contains such information) does not affect the contractility of the myocardium. Does not affect the conductivity of the atrioventricular node in the anterograde direction. The drug does not have a negative hypotensive effect. In practice, its inotropic influence is not noted. When taking medication, the automatism in the sinus node is not inhibited. Has spasmolytic, local anesthetic, as well as anticholinergic action in a moderate, not having clinical significance, degree. Has a minor coronary, sedative properties. The effect of oral intake is noted after forty or sixty minutes. The maximum activity reaches 80 minutes later. Duration of therapeutic action - from 8 hours.

Pharmacokinetics in general cases

Bioavailability of about 40%. The drug is metabolized in the liver and is able to penetrate the BBB. Drug withdrawal occurs in the urine. With violations of kidneys, the excretion period increases by 2-3 times.

What are the means of "Allapinin" indications for use?

The drug is prescribed for ventricular and supraventricular extrasystole and tachycardia paroxysmal type (without lesions in the heart of an organic nature and with WPW syndrome), trembling and atrial paroxysms.

Dosing regimen

The drug "Allapinin" instructions for use recommends in dosage - 25 mg once every 8 hours. In the absence of a pronounced therapeutic result, medication is taken every 6 hours. In a number of cases, a single dose may be doubled (up to 50 mg). The time interval is 6-8 hours.

A maximum of 300 mg is allowed per day. The duration of therapy and the appropriateness of adjusting the regimen are determined by a specialist. The medicine is drunk after a meal. Grind or break this tool is not allowed.

"Allapinin" medication: side effects

At observance of prescriptions of the doctor the preparation is transferred by patients of different age well enough. However, there is a possibility of development of undesirable consequences on the basis of therapy with the drug "Allapinin". Side effects can have different degrees of severity. The agent can provoke disorders in the activity of the peripheral and central nervous systems. In particular, there are dizziness, diplopia, ataxia. Among the negative consequences of the effect of the medication on the cardiovascular system, experts note possible violations in the intraventricular and atrioventricular conduction, the development of sinus tachycardia (with prolonged admission). Undesirable manifestations include arrhythmogenic action, prolongation of the QP-interval, expansion of the QRS complex and other changes in the ECG pattern. On the basis of therapy with the drug "Allapinin" (instructions for use warns about this) there is hyperemia of the skin, pain in the head or a feeling of heaviness. Some patients experience an allergic reaction (rash or skin irritation). Contains information about the undesirable effects of the drug "Allapinin" instructions for use. The experts' comments on the tolerability of the remedy are generally positive. However, given the severity of some of the negative consequences, the drug is taken under close medical supervision.
If complications occur and the condition worsens, you should immediately visit a specialist. In this case, the doctor can choose the same drugs instead of the "Allapinin".

When is the medication not prescribed?

Contraindications include cardiogenic shock, atrioventricular blockade in the third and second degree (in the absence of an artificial pacemaker driver). It is not allowed to drink medicine for arterial hypertension in a difficult period (with a systolic pressure less than 90 mm / Hg), hypertrophy in the myocardium of the left ventricle of a pronounced character. Prohibited medication for postinfarction cardiosclerosis. The drug is not recommended for blockade in the right leg of the bundle of the Hisnia (when combined with disorders in the branch on the left side), chronic failure of the cardiac function of the moderate and severe course. Contraindicated drug up to 18 years (due to the fact that the safety and efficacy of the drug have not been established), intolerance to fructose. Do not take medicine for people with a syndrome of impaired absorption of galactose / glucose, pregnancy, with isomaltase / sucrose deficiency. The drug is not recommended for hypersensitivity to components. If it is necessary to carry out therapy for a nursing patient, it is required to stop lactation.

When is the dose adjustment required?

Sometimes there is a need to change the scheme of taking the "Allapinin". Instruction, expert reviews contain information that a decrease in the amount of the drug or an increase in the interval between doses can be recommended for atrioventricular blockade in the first degree, disorders in intraventricular conduction, bradycardia. Caution is observed in closed-angle glaucoma, circulatory disorders (peripheral) of a serious nature, hypertrophy in the tissues of the prostate. The correction of the circuit is necessary on the basis of changes in electrolyte metabolism, conductivity in Purkinje fibers, blockade in one of the legs in the bundle of His. Caution is also needed when taking other anti-arrhythmic drugs simultaneously with the medicine "Allapinin". The opinions of many specialists are very categorical on the issue of changing the dosage in the absence of effect.

additional information

Before the beginning of therapy, the disorders in the water-electrolyte balance are eliminated, and during the medication intake it is necessary to ensure constant and careful control over it. The threshold of heart stimulation can increase in persons who have had a heart attack (acute), with heart failure or having an artificial pacemaker. In case of dizziness, diplopia, headaches, it is recommended to reduce the dosage. When sinus tachycardia appears on the ground of prolonged medication, if necessary, beta-blockers are prescribed. These drugs are recommended in low doses. On the basis of therapy, care must be taken when practicing potentially dangerous activities, when increased attention and rapid concentration or reaction is required.

Overdose

Due to the fact that the medicine has a small breadth of therapeutic activity, severe intoxication can develop quite easily. Especially the risk of poisoning is high when taking other antiarrhythmic medications. In case of overdose, the PR- and QT-intervals are extended, the amplitude of the T-wave is enlarged, and the QRS-complex is enlarged. Against the backdrop of intoxication, there is an asystole, a bradycardia, a decrease in contractility in the myocardium. The patient also has a sinotric block, a decrease in pressure of a pronounced nature, a digestive system disorder. Intoxication is accompanied by paroxysms of ventricular polymorphic tachycardia, blurred vision, dizziness, headache. If an overdose occurs, symptomatic therapy is indicated. Treatment of ventricular tachycardia is carried out using antiarrhythmic drugs of category I A and I C. The expansion of the QRS complex, arterial hypotension and bradycardia are eliminated by sodium bicarbonate.

Interaction with other medicines

When administered simultaneously with inducers of microsomal hepatic enzymes, the effectiveness of the drug "Allapinin" is reduced. This increases the risk of toxic effects. When taking antiarrhythmic drugs of other classes, the probability of developing arrhythmogenic influence increases. The agent also enhances the activity of nondepolarizing muscle relaxants.

What is an effective drug with a similar mechanism of action?

"Allaritmin" contains the same active substance as the drug "Allapinin" - lappakonitina hydrobromide. The drug belongs to the first class of antiarrhythmic drugs. The medicine "Allaritmin" is available in tablet form and as a solution for insertion into the muscle or vein. When oral intake of the drug takes about an hour. After 4-5 hours, the efficiency reaches a maximum. The duration of the action is 8 hours or more. With the introduction of a vein, the effect of the medicine comes faster - after 15-20 minutes. In contrast to the drug "Allapinin", the drug "Allaritmin" is recommended to drink 3 times a day for 25 mg. Take medicine before meals. It is desirable to crush tablets. In the case of lack of efficiency, dosage and frequency of admission may be increased. Intravenous administration is slow, for 5 minutes. The dosage is set according to the weight of the patient. It is recommended for 0,3-0,4 mg / kg. In some cases (especially severe), the drug is given again after 6 hours. The muscle is prescribed at 0.4 mg / kg at intervals of 6 hours. It should be noted that intravenous administration is not recommended at home. The drug "Allaritmin" has the same restrictions on use as the drug "Allapinin". The treatment is carried out under stationary conditions with constant monitoring of the doctor and ECG monitoring. This is especially important in the therapy of patients with the first degree of atrioventricular block, heart failure of the chronic course of decompensated type.

Conclusion

The "Allapinin" drug, the use of which must be strictly controlled, like other antiarrhythmic drugs, belongs to the category of potent medicines. If there is no therapeutic effect, when taking the dosage prescribed by a specialist, do not increase it on your own. This is due to the fact that there is a risk of intoxication with subsequent complications. Before appointing a medication, the doctor should inform the patient of possible side effects and contraindications. In turn, the patient tells about the presence of intolerance, including in anamnesis, to any funds, as well as about the drugs that he takes in addition. Before taking medication should study the annotation.