RYTMONORM 70mg. 20 ml. 5 ampoules

Active substance: Propafenon hydrochloride
Injection antiarrhythmic

20 ml contains 70 mg of propafenone hydrochloride.
Other ingredients: 1,076 g of glucose monohydrate recovery isotonicity of the blood, water for injectable solutions.
 
 
indications
Symptomatic and requiring treatment tahikarni supraventricular cardiac arrhythmias such. AV-nodal tachycardia, supraventricular tachycardias in the WPW-syndrome or paroxysmal atrial fibrillation.
Tezhkostepenni symptomatic ventricular tachycardia cardiac arrhythmias, if in the judgment of the physician are life-threatening.
 
 
Contraindications
In order to enable the physician to make a careful examination of contraindications, it must be aware of your previous illness, concomitant diseases, concurrent other therapies, as well as for your specific living conditions and habits. Contraindications may occur or become known after initiation of therapy with this medication. In such cases we should tell your doctor.
Propafenone should not be used in: sarechna weakness, cardiovascular shock, unless caused by a heart rhythm disorder) disease in heart rate during the first 3 months after myocardial infarction or in restricted cardiac function (left ventricular volume ejection <35%) than in patients with life-threatening ventricular arrhythmias of the heart, available high-sino-atrial, atrioventricular and vatrekamerni violations in carrying on the excitement of the heart syndrome sick sinus, hypotension, manifest electrolyte balance disorders (eg. disorders in the metabolism of potassium), severe obstructive (caused by obstruction) lung disease, myasthenia gravis, known hypersensitivity to active substance propafenone.
 
Use during pregnancy and lactation
During pregnancy, especially during the first trimester and during lactation, propafenone should be taken only by explicit medical indication.
 
 
Undesirable effects
Drugs can have with your main actions and so on. Called. Adverse reactions. Reactions that were observed in the time of treatment with propafenone, but are not necessarily manifest in any patient, are mentioned below. Sometimes, especially at a high initial dose may occur gastrointestinal symptoms, such as loss of appetite, nausea, vomiting, binge, feeling of fullness, constipation, dry mouth, as well as a bitter taste and numbness in the mouth, and and sensory disturbances, visual disturbances and dizziness.
In elderly patients with reduced myocardial function from time to time, may lead to impaired regulation of blood circulation with a tendency to decrease in blood pressure, which is caused by a standing body or by prolonged standing. Can lead to proarrhythmic effects in the form of change or strengthening of heart rhythm disorders that can lead to severe damage to sarechnata activity.
These proarrhythmic effects also manifest as very slow heart rhythm as an offense conduct of excitement or heart rate (eg. New onset of ventricular tahikarii).
Rarely can lead to fatigue, headaches, mental disorders such as anxiety and confusion, anxiety, nightmares and sleep disorders as well as disorders in the course of involuntary movements, allergic skin reactions such as redness, itching, exanthema or urticaria, bronchospasm in susceptible patients.
In rare cases may occur retention of bile secretion as an expression of Hyperergic-allergic reaction and / or in violation chernorobnata function.
In some cases, after a high dose of propafenone is no decrease in the potency and the number of seed cells.
 
These events resolved after discontinuation of therapy. Because therapy with propafenone may be vital, it should not be interrupted pore these side effects without medical advice.
 
Effects on ability to drive and use machines
This drug may in the normal dosage change ability to respond to such an extent as to significantly affect the ability to drive and use machines. This applies more prominently in concomitant use with alcohol.
Warning: If therapy with propafenone may change peysing- and senzing- threshold of pacemakers. function of the pacemaker should be checked and re-programmed neobhoimost.
 
Interaction with other drugs
Action of certain drugs may be affected by the concomitant use of other agents. Therefore, check with your doctor if you use a permanent, rather than drink or want to drink another drug concomitantly with drug debate here. Your doctor will tell you that in these circumstances there is incompatibility between the two drugs or need to take some special measures, eg. determining a new dose when using this meikament.
The simultaneous administration of drugs with local anesthetic activity, (eg. In the pacemaker, surgical or dental procedures), as well as other drugs, which cause slowing of heart rate and / or the pumping ability of the heart (eg. Beta receptor blockers, tricyclic antidepressants), must is meant the ability to enhance the therapeutic effect.
Further described further increases in plasma concentrations, respectively. levels of propranolol in the blood, metoprolol, desipramine, cyclosporine and digoxin. In the event of the relevant phenomena of overdose should be determined plasma concentrations and, if necessary to reduce the dosage of prescribed medication. Increased plasma concentrations of propafenone are described with the concomitant use of cimetidine, respectively. quinidine.
Concurrent use of propafenone with phenobarbital, respectively. rifampicin can lead to a reduction in plasma concentration propafenonovata even to subtherapeutic levels. Possible interaction of propafenone with oral anticoagulants (increase the effects of anticoagulants). In these patients, it is recommended that careful monitoring of coagulation.
 
 
dosage
Establishment of individual maintenance dose should be in cardiac monitoring with frequent monitoring of ECG and blood pressure (initial phase of the specification of the dose).
Under reduced liver and / or renal function, therapeutic doses can lead to accumulation.
Under control of ECG and plasma concentration and these patients may be included treatment with propafenone.
 
Unless otherwise specified:
A single dose of 1 mg / kg body weight intravenously (with an average body weight of 70 kg corresponds to 20 ml). Often can be achieved an effect even at 0.5 mg / kg body weight (equivalent to 10 ml). If necessary, a single dose may be increased to 2 mg / kg of body weight (with an average body weight of 70 kg corresponds to 40 ml).
For short-term infusion (1-3 hours) propafenone is appointed at a dose of 0.5-1 mg / min. in 5% solution of glucose and levulose.
For long term infusion typically is sufficient daily dose of 560 mg (corresponding to 160 ml).
Initiation of therapy with antiarrhythmic agents for ventricular arrhythmias kariologichno requires careful monitoring and should be done only with the facilities for emergency treatment and the ability to monitor control. During therapy, at regular intervals of time, needs to be conducted checkups (eg. Over 1 month - standard ECG, respectively. Every 3 months - Holter ECG and EKG optionally under load). In the deterioration of the individual parameters, eg. QRS- extending the range, respectively. QT- interval by more than 25% or PQ-interval by more than 50%, respectively. QT prolongation to more than 500 milisekuni or increase the number or severity of the rhythm disorders, the treatment has to be verified again. Patients with significant left ventricular function limitation (LVEF <35%), respectively. structural disorders of the myocardium should be dosed with special care. In these cases we recommend a therapeutic need will increase the dose to be taken only when they are already established pharmacokinetic "steady-state" relations. Thus reducing the risk of potential proarrhythmic effects in the initial phase of therapy in these patients.
 

Method and duration of administration
Intravenous to application should be done slowly, a distance of 3-5 minutes.
The therapy begins with careful patient monitoring and control of ECG and blood
pressure, optionally with a low dose.
The distance between the two applications, as a rule should not be less than 90-120 min.
Upon extension of the QRS-range (above 20%) or a frequency-dependent QT-interval,
injection should be discontinued immediately. In the long-term infusion is needed especially
careful monitoring of ECG and blood circulation, possibly plasma concentration.
To avoid mixing with a physiological solution of sodium chloride, b.p. can be prepared
temperaturestable and concentration dependent precipitation.
 
 
Expiration date
Drug should not be used after the expiry of the names date.
Store at 15 ° C.
Drug store out of reach of children.
 
 
Mode of action
Rytmonorm  is an antiarrhythmic agent with local anesthetic, mainly action and membrane stabilizing effect on myocardial cell.
Rytmonorm  prevents the formation and implementation of excitement in predsarieto and cameras. This is due to its pronounced effect on arrhythmias of different genesis.
 
Home, and maximum duration of drug action
The action occurs even at a time respectively. shortly after the end of the application reaches its peak a few minutes after application and lasts until 4:00.
 
Pack
Original package with 5 ampoules of 20 ml.