Korglikon is a cardiac glycoside of plant origin that has a direct vasoconstrictor, positive inotropic, negative chronotropic and negative dromotropic effect.
Release form and composition
Korglikon is produced in the form of a solution for intravenous (IV) administration - 1 ml each in ampoules, 10 ampoules in a cardboard box; 10 ampoules in blisters, 1 pack in carton packs.
The active ingredient of the drug - Korglikon (glycoside leaves of lily of the valley in May). In 1 ml of its solution contains 0.6 mg.
Indications for use
- Tachysystolic form of flutter and atrial fibrillation of paroxysmal and chronic course (especially in combination with chronic heart failure);
- Comprehensive treatment of chronic heart failure II-IV functional class (in the presence of clinical manifestations).
Contraindications
Korglikon is strictly contra-indicated in the following cases:
- Atrioventricular (AV) blockade of the II degree;
- Intermittent total blockade;
- Glycosidic intoxication;
- Wolff-Parkinson-White syndrome;
- Pregnancy and breastfeeding;
- Hypersensitivity to the drug.
With extreme caution, after a thorough assessment of the expected benefits and possible risks, Korglikon can be prescribed in the presence of the following diseases / conditions:
- Unstable Angina;
- Acute myocardial infarction;
- Arteriovenous shunt;
- Cardiac asthma in patients with mitral stenosis (in the absence of a tachysystolic form of atrial fibrillation);
- Hypertrophic subaortic stenosis;
- Sick sinus syndrome without a pacemaker;
- Severe dilatation of the cavities of the heart;
- Isolated mitral stenosis with a rare heart rate;
- Atrioventricular block I degree;
- Pulmonary heart;
- Hypoxia;
- Probability of unstable conduction along the atrioventricular node;
- Extrasystole;
- Heart failure with impaired diastolic function (cardiac tamponade, restrictive cardiomyopathy, constrictive pericarditis, cardiac amyloidosis);
- Indications in the history of the attacks of Morgagni-Edems-Stokes;
- Myocarditis;
- Renal hepatic impairment;
- Hypothyroidism;
- Electrolyte disorders (hypercalcemia, hypomagnesemia, hyponatremia, hypokalemia);
- Alkalosis;
- Obesity;
- Elderly age.
Dosing and Administration
Korglikon is intended for intravenous injection. It is administered slowly over 5-6 minutes 1-2 times a day, after diluting 10-20 ml of 20% or 40% dextrose solution.
Recommended single doses:
- Adults - 0.5-1 ml;
- Children 6-12 years old - 0.5-0.75 ml;
- Children 2-5 years old - 0.2-0.5 ml.
With the frequency of injections 2 times a day, the interval between injections should be 8-10 hours.
Maximum doses for adults: single - 1 ml, daily - 2 ml.
Side effects
Side effects caused by Korglikon are associated with overdose or hypersensitivity to cardiac glycosides.
Possible adverse effects:
- Cardiovascular system: arrhythmia and AV block;
- Digestive system: anorexia;
- Hematopoietic organs: nosebleeds, thrombocytopenia and thrombocytopenic purpura;
- Central nervous system and sensory organs: sleep disturbance, confusion, headache, reduced visual acuity, drowsiness, dizziness, delirious psychosis;
- Other: allergic reactions.
special instructions
Hypernatremia, hypercalcemia, hypomagnesemia, hypokalemia, hypothyroidism, pulmonary heart, severe dilatation of the cardiac cavities, myocarditis, obesity, old age - factors that increase the likelihood of intoxication.
In patients with mitral stenosis, cardiac glycoside may be prescribed in the presence of atrial tachyarrhythmia or in the joining of right ventricular failure.
As one of the methods to control the level of digitalization in patients receiving cardiac glycosides, their plasma concentration monitoring is used.
With WPW syndrome (Wolf-Parkinson-White syndrome), Korglikon reduces AV conduction, thereby facilitating the conduction of impulses to bypass the AV node through additional paths, which causes the development of paroxysmal tachycardia.
Drug interaction
Possible undesirable reactions of interaction with korglykon:
- Adrenomimetic agents (epinephrine hydrochloride, norepinephrine hydrotartrate, ephedrine hydrochloride), xanthine derivatives (caffeine, theophylline) - the occurrence of cardiac arrhythmias;
- Aminazine and other phenothiazine derivatives - reduction of the effect of Korgikon;
- Anticholinesterase drugs - increased bradycardia (eliminated by the introduction of atropine sulfate);
- Glucocorticosteroids (GCS) - an increase in the undesirable effects of Korglikon, due to the development of hypokalemia as a result of the use of GCS;
- Diuretics, corticotropin preparations - enhancing the action of cardiac glycoside;
- Potassium preparations - reducing the side effects of cardiac glycoside;
- Ergocalciferol - increased action of korglikon, due to the development of hypercalcemia as a result of the use of ergocalciferol;
- Narcotic analgesics - the development of hypotension;
- Paracetamol - a decrease in the release of corglycon by the kidneys;
- Ethylenediaminetetraacetic acid disodium salt - reducing the toxicity and effectiveness of cardiac glycoside.
Patients undergoing treatment with Korglikon should not be given sodium adenosine triphosphate or calcium supplements.
Terms and conditions of storage
To store at a temperature of 8-15 ºС in the place, inaccessible for children and light.
Shelf life - 2 years.