KARDIKET 20 mg. 20 tablets

What is Kardiket retard 20 and what is it used?
Kardiket retard is a medicine that acts on violations of blood flow in the coronary vessels of the heart.


Indications:

Kardiket retard 20 apply:
• Prolonged treatment of impaired blood flow in the coronary vessels (coronary heart disease)
• Prevention of attacks of angina (heart pain due to disorders of blood flow in the coronary vessels of the heart)
• After myocardial infarction, prevention and long term treatment of attacks of angina pectoris
• Treatment of chronic heart failure in combination with cardiac glycosides, ACE inhibitors and / or diuretics
• Treatment of the increased pressure in the pulmonary circulation (pulmonary hypertension)


2. Before you use Kardiket retard 20

2.1. Kardiket retard 20 should not be taken in the event of:
• Hypersensitivity to the active substance, isosorbide dinitrate, other nitro compounds or any of the excipients of Kardiket retard 20;
• Acute circulatory failure (shock, circulatory collapse);
• If you suffer from hypertrophic obstructive cardiomyopathy (heart muscle disease with narrowing of the interior chambers of the heart), constrictive pericarditis (inflammation of the tapering core-bag) or cardiac tamponade (tamponade of core-bag);
• Shock due to heart failure (cardiogenic shock), unless they are provided with the necessary measures high filling pressures of the heart (left ventricular end diastolic pressure)
• Very low blood pressure (hypotension: systolic blood pressure less than 90 mmHg);
During treatment with Kardiket retard 20, the patient should not take the medicines for erectile dysfunction, whose pharmacologically active ingredient is a phosphodiesterase type 5 inhibitor, NR sildenafil, vardenafil or tadalafil, because it is associated with a significant reduction in blood pressure, which can lead to severe consequences (NR sudden loss of consciousness, myocardial infarction)

2.2. The use of Kardiket retard 20 requires special care:
• In the case of low pressures of the filling, NR as a result of acute myocardial infarction or reduced left ventricular function (left ventricular failure). Reduction of systolic blood pressure below 90 mm Hg should be avoided.
• Aortic and / or mitral stenosis (narrowing of the aortic or mitral valve);
• Tendency to gravitational disturbances in the regulation of blood circulation;
• Diseases that occur with increased intracranial pressure (so far only in high intravenous doses of glyceryl trinitrate / chemically similar substance / observed further increase intracranial pressure).
This product contains lactose. Please ask your doctor before taking Kardiket 20 retard if you are intolerant to other sugars.
Kardiket® 20 retard is not suitable for the treatment of pain with sudden onset of angina pectoris (eg acute attack of angina pectoris).

Pregnancy
During pregnancy, particularly due caution Kardiket retard 20 should be taken only under an express medical indication because there is insufficient experience with the use of this product in pregnant women Experimental animal studies gave no evidence of fetal harm.

Breastfeeding
Due to extreme caution, and during lactation Kardiket retard 20 should be taken only under an express medical indication because it is uncertain whether produkg drug is excreted in human milk. When Kardiket retard is used during breastfeeding infant should be monitored for adverse reactions.

Ability to drive and operate machines
This product can even complied with instructions for use so the opportunity to change the response of the patient to limit its ability to operate a motor vehicle to operate machines or to work in unsafe conditions. This applies to a greater extent at the start of treatment, when increasing the dose, or changing medication, as well as the concomitant use of alcohol.


2.3. Interactions with other drugs or other interactions:
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, even if they are without a prescription. Hiotenzivniyat effect can be enhanced by:
• Other vasodilators
• Hypotensive drugs (napr.beta blockers, diuretics, calcium antagonists, ACE inhibitors)
• Medicinal products for psychiatric disorders such as depression, or neuroleptics
• Drink
• Medicinal products for the treatment of erectile dysfunction, whose active ingredient is a phosphodiesterase inhibitor type 5 NR sildenafil, vardenafil or tadalafil (see section 2.1) When used together with dihydroergotamine (DHE), 20 Kardiket retard may lead to increased levels of DHE and thus increase the hypotensive effect of the latter.


3. How to use Kardiket retard 20?

Always follow the instructions of your doctor when taking Kardiket® retard 20. Please ask again your doctor or pharmacist if you are not sure.

3.1. Method and duration of administration
Take the prolonged-release tablets without chewing, with a sufficient amount of water (eg. A glass of water).

3.2. In case you do not otherwise prescribed, the usual dose;
• Normal daily (24 hours hours): one prolonged-release tablet twice daily (ekvivaletno of isosorbide dinitrate 20 mg twice a day)
• Maximum daily dose (24 hours): one prolonged-release tablet three times a day (ekvivaletno of isosorbide dinitrate 20 mg three times a day)
Treatment should be initiated at a low dose and gradually and it can be increased according nuzhdite.Lekuvashtiyat doctor determine the duration of therapy.
Please consult your doctor if you think that the effect of Kardiket retard is too strong or too weak.


Note:
Since Kardiket retard tablets 20 consist of several related substances, overall isosorbide dinitrate-release may be excreted in exceptional cases.


Z.Z.Kogato you take larger quantities Kardiket retard 20 what should you do?
If overdose is suspected of large quantities Kardiket retard 20, call your doctor immediately. Depending on the extent of overdose may experience the following symptoms: a significant drop in blood pressure (hypotension), a reflex increase in heart rate, feeling of weakness, vertigo and dizziness, flushing, nausea, vomiting and diarrhea.

3.4. When you forget to take a dose of 20 retard Kardiket
Do not take a double dose to make up for a missed dose. Continue treatment in the prescribed manner.

3.5. Implications if discontinue Kardiket retard 20
Treatment success is doubtful.


4. What are possible side effects?
Like all medicines, Kardiket retard 20 could have side effects.
The following specifications of the frequency of side effects was used in the leaves of the undesirable effects:

Very common: More than 1/10 patients treated Common: Less than 1/10, but more than 1/100 patients treated
Uncommon: Less than 1/100 but morethan 1/1000 patients treated
Rare: Less than 1/1000, but more than 1/10 000 treated patients
Very rare: Less than one in 10,000 patients treated, including individual cases
At the start of treatment often can appear headache (ie. "Nitrate headache"), which - as we know from experience - most commonly resolves after several days for further acceptance of the product. In some cases, at an initial use, but also by increasing the dose can be observed drop in blood pressure and / or circulatory disorders in the change of position (orthostatic hypotension), which may be accompanied by a reflex increase in the pulse rate, dizziness and feeling of dizziness and weakness.

Uncommonly may occur:
• nausea, vomiting, barzopreminavashti redness of the skin and allergic skin reactions.
• greater reduction in blood pressure accompanied by amplification of heart pain (angina symptoms).
• states of collapse, in some cases with heart rhythm disturbances, delayed pulse rate (bradycardia heart rhythm disturbance), and sudden loss of consciousness (syncope).


Very rare
• Serious inflammatory skin diseases (exfoliative dermatitis / Stevens-Johnson
• Angioedema (tissue swelling)


Other observations: • Due to the relatively redistribution of blood flow to hipoventiliranite alveolar regions of the lung, upon acceptance of 20 Kardiket retard may occur temporarily reducing the oxygen content in the arterial blood (hypoxemia), which may result in insufficient supply of the myocardium with oxygen in patients suffering from disorders of the blood flow of coronary artery (coronary artery disease)
• Reduction of efficiency and reduction of the effect of the use of other products containing nitrates. To prevent the reduction or lack of effect, prolonged high doses should be avoided
• If any of the above mentioned side effects occur, please inform your doctor who will assess their burden and necessary measures predpreme
• Do not take Kardiket 20 retard if you experience signs of svrahchuvstvitelnostMolya tell your doctor or pharmacist if you notice any side effects not listed in this leaflet.


5. What conditions are necessary for storage Kardiket retard 20?
Keep medicines out of reach of children.
Do not use medicines expiry date stated on the blister and carton.