Application of Cardiket and its available analogues

Pharmacodynamics and pharmacokinetics

The active substance leads to relaxation of the smooth muscle walls of blood vessels , thus dilating peripheral veins and arteries and producing a vasodilating effect . Diastolic pressure decreases, the return of venous blood into the ventricle decreases, as does its volumetric filling.

After taking the tablet, its effect occurs quickly (within 15 minutes). Bioavailability – 22%, degree of protein binding – 30%. The main metabolites formed in the liver: isosorbide-2-mononitrate , isosorbitol-5-mononitrate , they are excreted through the kidneys. It is completely eliminated within a day.

Contraindications

• drug allergy;
• vascular collapse and shock ;
• severely low blood pressure;
• diseases and conditions accompanied by increased intracranial or intraocular pressure ( glaucoma );
• acute myocardial infarction and hemorrhagic stroke ;
• stenosis;
• head injuries;
• decrease in circulating blood volume;
• combination with phosphodiesterase type 5 inhibitors ( tadalafil, sildenafil, vardenafil ).

The use of the drug is not recommended, or should be under the supervision of a physician.

• in children under 18 years of age;
• with cardiac tamponade;
• pronounced anemia ;
• toxic pulmonary edema;
• hypertrophic obstructive cardiomyopathy ;
• with constrictive pericarditis ;
• chronically low blood pressure ;
• hyperthyroidism;
• severe kidney and liver diseases.

Instructions for use of the drug Cardiket

The active ingredient of the drug is isosorbide dinitrate.
A sufficient number of medicines based on nitrates have been developed on the domestic market. Internationally, isosorbide dinitrate is known as Cardiquet Vidal. Regardless of the manufacturer, the recommendations in the instructions for the drug are the same. The advantage of a big name is, perhaps, a more advanced manufacturing technology, but the active substance remains the same.

Indications for use: what does it help with?

This medicine is prescribed in the following cases:

• to prevent the occurrence of angina attacks (as basic therapy for coronary heart disease);
• for chronic failure of the pumping function of the heart (as one of the additional elements in complex therapy);
• after myocardial infarction (to prevent repeated necrosis of the heart muscle, this is called secondary prevention).

In general, indications for the use of Cardiket are limited to conditions in which it is necessary to reduce the risk of coronary vasoconstriction to prevent myocardial hypoxia.

Methods of use and dosage of the medicine

The manufacturer produces the medication in the form of tablets for internal use. They differ in different concentrations of the active substance. The use of tableted Cardiket should follow the following scheme:

Extended-release capsules are available, each containing 120 mg of isosorbide dinitrate. They are prescribed once a day.

Prescription of the drug begins with minimal doses. This is due to the development of the body’s addiction to the action of nitrates, when the previously helping amount of the active substance ceases to have the desired effect. To overcome this phenomenon, it is necessary to increase the dose taken by the patient, which leads to an increase in the likelihood of adverse reactions.

The individual sensitivity of the patient’s body also plays a certain role (it all depends on the degree of activity of enzyme systems and the rate of biochemical reactions).

Since this drug is prescribed starting with minimal doses (and then increasing immediately may be required), the manufacturer has provided the ability to easily divide the tablet into two equal parts.

To do this you need:

• find a transverse stripe on one side of the tablet;
• place the dosage form on a flat and hard surface, with the dividing line facing up;
• Press the strip on top with the pad of your thumb.

It is recommended to swallow Cardiket without chewing, washing it down with clean water at a comfortable temperature. Can be used regardless of meals.

Possible side effects and symptoms of overdose

If you use the medicine more often than recommended by the instructions for use of Cardiket, you can provoke the appearance of certain symptoms:

• arterial hypotension (due to the prolonged vasodilatory effect of isosorbide dinitrate, systolic pressure may drop below 90 mm Hg);
• tachycardia (as an attempt by the body to compensate for a decrease in blood pressure);

• 
  asthenia (includes weakness, pale skin and mucous membranes, dizziness);

• nausea;
• diarrhea;
• shortness of breath;
• skin redness;
• visual impairment;
• headache (due to vasodilation, intracranial pressure increases, which leads to unpleasant sensations).

When taking large doses of the drug, the pressure inside the skull increases so much that symptoms of irritation of the meninges and damage to the gray matter become possible.

Cardiket can slow down a person's reaction, which can negatively affect driving skills and lead to a traffic accident. This feature of this medication is especially pronounced in the presence of alcohol in the blood.

Side effects are similar to those of an overdose. However, the unpleasant manifestations described above occur only when the dose specified in the instructions is exceeded. But the side effect manifests itself even if all standards are observed, depending on the characteristics of the body of each individual patient.

The intensity of headaches that arise as a side effect of nitrates gradually decreases with long-term use of Cardiket.

Contraindications for use

This medication should not be prescribed if the patient has absolute contraindications:

• increased individual sensitivity to isosorbide dinitrate, other nitrate compounds, or any of the excipients used for the production of the drug;
• acute myocardial necrosis (infarction), which is accompanied by low blood pressure;
• obstructive hypertrophic cardiomyopathy;
• acute increase in the volume of the vascular bed (collaptoid, shock conditions);
• dry cardiac tamponade or hemopericardium;
• constrictive pericarditis.

It is permissible to use Cardiket under close medical supervision in the following conditions (relative contraindications):

• impaired left ventricular function;
• hemodynamically significant stenosis of the heart valves;
• orthostatic disorders (jumps in blood pressure when moving from a horizontal to a vertical position and vice versa);
• anemia;
• insufficiency of liver enzyme systems;
• impaired excretory function of the kidneys;
• elderly patients;
• glaucoma (closed-angle type);
• fresh traumatic brain injury;
• hemorrhagic stroke.

Clinical studies on the use of Cardiket during pregnancy and lactation have not been conducted, and therefore in these conditions, taking this medicine is allowed only if there is an urgent need, under the supervision of the attending physician.

Interaction

Combine with caution with vasodilators, calcium channel blockers, tricyclic antidepressants, alcohol, adrenergic blockers, antihypertensives, antipsychotics, quinidine, procainamide, dihydroergotamine, tadalafil, sildenafil and vardenafil .

When used with sympathomimetics and alpha-blockers , the antianginal effect of the drug is reduced. The effectiveness of the drug is directly affected by drugs that coat the stomach, as they reduce the rate of penetration of the active substance into the systemic bloodstream from the stomach.

Atropine and other M-anticholinergic drugs may increase the risk of increased intraocular pressure.

Cardiket can and even should be combined with Nifedipine , Panangin , amiodarone , Riboxin and propranolol .

Analogs of Cardiket that are available on the Russian market

Long-acting nitrates are a fairly popular group of drugs, so finding analogues and cheaper substitutes for Cardiket will not be a problem.

On the Russian pharmaceutical market you can find the following analogues (medicines in which the active ingredient is also isosorbide dinitrate):

• 
  Dinisorb;

• Nitrosorbide;
• Isacardine;
• Iso Mac Retard;
• Iso Mac spray;
• Nitrosorbide-Rusfar;
• Cardix;
• Aerosonite;
• Nisopercuten;
• Isoket;
• Isolong;
• Monosan (Czech production).

Kardiket's analogs

Level 4 ATC code matches:
Nitrospray

Nitroglycerine

Efox

Monosan

Nitromint

Pectrol

Isoket

Erinite

Sustak Forte

Nitrosorbide

The closest ones: dikor long, nitrosorbide, isodinite, isoket, iso-mic .

Other analogues of Cardiket: mononitrosid, nitro, nitrogranulong, nitro-mic, Nitrospray, erinit, monocontin od, monosan, nitroglycerin, nitrocontin, nitromint, olicard retard, efox long .

conclusions

Cardiket belongs to the group of long-acting nitrates. It is prescribed to improve blood supply to the myocardium during angina pectoris, after a heart attack and for some other conditions.

The main side effect is headache. In routine use, hypotension caused by the drug is dangerous, especially in the elderly. The medication can only be taken if it is prescribed by a cardiologist.

There are many domestic names and imported analogues of Cardiket. The abundance of nitrate-based products indicates their effectiveness and demand.

Kardiketa price, where to buy

The cost of 20 tablets of 20 mg is approximately 65 rubles. The price of Cardiket 20 mg for 50 tablets is about 137 rubles.

You can buy Cardiket Retard 40 mg for 104 rubles - 20 pieces, 209 rubles - 50 pieces.

For 60 mg of the drug you will have to pay 143 rubles for 20 pieces, 363 rubles for 50 pieces.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Cardiket tablets prolonged action 20 mg 50 pcs. Eisika Pharmaceuticals GmbH
  108 rub. order
• Cardiket tablets prolonged action 40 mg 20 pcs. USB Pharma SA/Eisika Pharmaceuticals GmbH

  88 rub. order

• Cardiket tablets prolonged action 40 mg 50 pcs. Eisika Pharmaceuticals GmbH

  RUB 171 order

• Cardiket tablets prolonged action 20 mg 20 pcs. Eisika Pharmaceuticals GmbH

  58 RUR order

Pharmacy Dialogue

• Cardiket-retard (tab. 40 mg No. 20)UCB/Aesica

  81 RUR order

• Cardiket-retard (tab. 40 mg No. 20)UCB Pharma GmbH/NextPharma

  86 rub. order

• Cardiket-retard (tab. 20 mg No. 50)UCB/Aesica

  115 rub. order

• Cardiket (tab.prolon.effective.20mg No. 50)Alvogen/Eisika Pharmaceuticals

  116 RUR order

• Cardiket-retard (tab. 20 mg No. 20)UCB/Aesica

  57 RUR order

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Pharmacy24

• Cardiket retard 40 mg No. 50 tablets Eysika Pharmaceuticals GmbH, Nimechchina
  116 UAH.order
• Cardiket retard 20 mg No. 50 tablets Eysika Pharmaceuticals GmbH, Nimechchina

  80 UAH order

PaniPharmacy

• Cardiket retard tablets Cardiket retard tablets. 20mg No. 50 Germany, Aesica Pharmaceuticals

  90 UAH order

• Cardiket retard tablets Cardiket retard tablets. 40 mg No. 50 Germany, Aesica Pharmaceuticals

  128 UAH order

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