Monochinkve - peripheral vazodilatator; drug with antianginal and vasodilating action.
Release form and composition
Monochinkve is produced in the form of tablets: round, white in color, with a risk on one side (15 pieces in a blister, in a cardboard bundle 1 blister).
Active ingredient - isosorbid-5-mononitrate: 40 mg in 1 tablet.
Auxiliary components: corn starch, lactose monohydrate, microcrystalline cellulose, talc, magnesium stearate.
Indications for use
- Treatment of chronic heart failure (Monochinkwe is used as one of the drugs of complex therapy);
- Prevention of angina attacks in patients with coronary heart disease, including after myocardial infarction.
- The simultaneous use of phosphodiesterase inhibitors, incl. vardenafil, sildenafil, tadalafil;
- Severe anemia;
- Toxic pulmonary edema;
- Severe arterial hypotension (systolic blood pressure less than 90 mm Hg, diastolic - less than 60 mm Hg);
- Acute myocardial infarction, accompanied by severe arterial hypotension;
- Acute circulatory disorders (such as shock and vascular collapse);
- Cardiogenic shock in the event that it is not possible to provide a sufficiently high terminal diastolic blood pressure in the left ventricle due to the use of intra-aortic counterpulsation or the administration of drugs with a positive inotropic effect;
- Hereditary intolerance to galactose, malabsorption syndrome of glucose and galactose, or lactase deficiency;
- Age up to 18 years;
- Hypersensitivity to the components of the drug or other nitrates.
Relative (special care must be taken because of the risk of complications):
- Left ventricular failure, low filling pressure in acute myocardial infarction (to prevent a decrease in systolic blood pressure below 90 mm Hg);
- The tendency to orthostatic disorders of vascular regulation;
- Mitral and / or aortic stenosis;
- Diseases accompanied by increased intracranial pressure;
- Constrictive pericarditis, hypertrophic obstructive cardiomyopathy, pericardial tamponade;
- Hemorrhagic stroke;
- Recently suffered a traumatic brain injury.
- Liver failure;
- Severe renal failure;
Dosing and Administration
To accept inside after meal, swallowing tablets entirely and washing down with enough water.
The doctor determines individual doses and duration of treatment with the drug individually. A starting dose of 20 mg (1/2 tablet) 2 times / day is considered expedient, with a gradual increase to a therapeutic dose of 40 mg, 2-3 times / day (with 7-8 hour intervals).
The maximum allowable daily intake for an adult is 120 mg.
When using Monochinkve in therapeutic doses, any significant side effects are usually not observed.
- Very often (in more than 10% of cases): “nitrate” headache (usually disappears within a few days;
- Often (more than 1%, but less than 10% of patients): decrease in blood pressure and / or development of orthostatic hypotension (after the first dose or increase in dose), which may be accompanied by weakness, dizziness, tachycardia;
- Rarely (in more than 0.1%, but less often than in 1% of cases): nausea, slight burning sensation of the tongue, vomiting, dry mouth, skin allergic reactions, facial flushing, marked reduction in blood pressure, aggravation of stenocardia, collaptoid conditions (sometimes with fainting and bradyarrhythmia);
- Selected case (less often than in 0.01% of patients): exfoliative dermatitis.
The following side effects may be noted on the part of the nervous system: blurred vision, drowsiness, stiffness, reduced speed of motor and mental reactions, especially at the beginning of treatment.
Monochinkwe is not intended for the relief of acute strokes and treatment of acute myocardial infarction.
Treatment with the drug should be carried out under the control of heart rate and blood pressure.
At the beginning of taking the drug, “nitrate” headaches very often occur, they can be largely prevented if at the beginning of treatment ½ tablet is taken 2 times a day, in the morning and evening.
It should take into account the likelihood of tolerance to Monochinkve or cross-tolerance to other nitrites, which is manifested by a decrease in the effectiveness of the therapy. To prevent risks, it is not recommended to take Monochinkve in high doses for a long time.
It is not recommended to abruptly cancel the drug - the dose should be reduced gradually.
In patients with blood circulation lability, already at the first dose of the drug, symptoms of acute circulatory failure may develop.
During the period of therapy should refrain from the use of alcoholic beverages, it is not recommended to engage in potentially hazardous activities and drive vehicles.
Possible interaction reactions when using monochinkwe with other drugs:
- Other vasodilators, antihypertensive drugs, angiotensin-converting enzyme inhibitors, beta-blockers, diuretics, slow calcium channel blockers (including nifedipine, verapamil), neuroleptics, tricyclic antidepressants, phosphodiesterase inhibitors (vadenaafil), and non-active diaphragms, tropyclic antidepressant inhibitors, phosphodiesterase inhibitors (vadenafil), and anti-depressants, tropychotic esters (vadenaphiline) , amiodarone, ethanol: increased antihypertensive effect of isosorbide mononitrate;
- Barbiturates: an acceleration of metabolism and a decrease in the concentration of isosorbide mononitrate in the blood plasma;
- Vasopressors: decrease in their effectiveness;
- Alpha-adrenergic blockers (for example, dihydroergotamine), beta-adrenostimulyatory: a decrease in anti-anginal effect (which leads to tachycardia and excessive lowering of blood pressure);
- M-holinoblokatory (atropine): the risk of increased intraocular pressure;
- Adsorbent, enveloping and astringent drugs: a decrease in the absorption of isosorbide mononitrate from the gastrointestinal tract;
- Norepinephrine (norepinephrine): reduced therapeutic effect.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° С out of the reach of children, protected from light.
Shelf life - 5 years.