Sotageksal, analogues and reviews about them

Arrhythmia is a type of heartbeat that is different from normal sinus rhythm. At an arrhythmia at the person one or at once some disturbances in work of heart is observed. Pathology can manifest itself both in increasing the frequency and strength of cardiac contractions (tachycardia), and, conversely, in reducing them (bradycardia). Interruptions to the work of the heart muscle are also in a healthy person. However, in most cases, arrhythmia occurs in conjunction with other cardiac diseases. This condition is risky because the excitability of the heart tissue - the myocardium - increases, which can lead subsequently to heart failure if the disease is not treated.

To normalize the heart rhythm, there are special preparations, one of which is Sotagexal. Analogs of the drug are also widely used in medical practice. Such drugs belong to the group of drugs that have antiarrhythmic action, and beta-blockers. When ingested, they block beta-adrenergic receptors, which are found in smooth muscles, heart muscle and other tissues, and are responsible for the body's response to stress. The general cardio effect is a decrease in the frequency and intensity of heartbeats, a decrease in cardiac conduction. As a systemic effect, there is also a decrease in arterial pressure on the walls of the coronary vessels.

Structure of the preparation

Sotalol is the internationally accepted international name for the drug Sotagexal. Analogues the composition may have a different, but similar antiarrhythmic effect. As the main active substance, "Sotagexal" contains sotalol hydrochloride. In addition, it includes a small number of auxiliary components. Among them - cellulose, lactose monohydrate, corn starch, magnesium stearate and other binders.

Shelf life of tablets or solution for injection is 5 years.

Sotageksal, analogs and form of release

In one tablet of this preparation contains 40, 80 or 160 mg of the active substance. It is produced mainly in the form of white round tablets, on the one hand a little convex and with the extruded abbreviation SOT. On the back, the tablet is divided in half with the help of risks for convenient dosage. All is packed in blisters of 10 pieces and cardboard packs. Each pack can contain from 1 to 10 blisters (in total from 10 to 100 pieces of tablets).

Also, Sotagexal is available in the form of a solution for intravenous injection. Each ampoule contains 4 ml of the drug. In 1 ml of solution is 10 mg of pure basic substance. The drug should be stored in a dark and dry place protected from sunlight, in which children are restricted.

Analogues with the active substance sotalol hydrochloride are made in tablets:

• "Sotalex" (160 mg each).
• "Soritmik" (for 0.16 g).
• "Sotalol Canon" (80 and 160 mg each).
• "Darub" (80 and 160 mg each).
• "Tenzol" (80 and 160 mg each).

pharmachologic effect

"Sotagexal", analogs and synonyms of the drug have a pronounced antiarrhythmic effect. This is due to their ability to block β-adrenergic receptors and inhibit potassium channels. The drugs increase the duration of pulses and reflex periods of the atria, as well as the ventricles. Increase the tone of the smooth muscles of the bronchi and the muscular layer of the walls of the vessels. Reduce the contractility of the myocardium.

Sotalol hydrochloride has a whole complex of properties. Has a negative chronotropic, dromotropic, butmotropic and inotropic effect of the German drug "Sotageksal." Analogues, whose composition is identical, may have another trade name. They are also able to reduce the heart rate and their strength. Due to this, the need for oxygen consumption in myocardium is significantly reduced. And as a result, the load on the heart decreases.

Absorption and excretion of medicine

Absorption of the drug occurs quickly. Its bioavailability is 90%, and absorption is about 80%. Within 2.5-4 hours after administration, the maximum concentration of the active substance is reached in the blood plasma. And after intravenous administration, the effect manifests itself after 5-10 minutes. Absorption occurs 20% better and faster if you take the medicine on an empty stomach. Due to the fact that the solubility of the substance in fats is very low, sotalol hydrochloride can not be taken simultaneously with dairy products and fats of animal origin.

Without binding to blood proteins, the drug is distributed in tissues and peripheral organs in regular intervals for 3-4 days of regular intake. At the same time, a positive effect is achieved with hypertension. In cerebrospinal fluid the concentration of the drug is not more than 20%. The effect after injection lasts up to 2 hours. Up to 12 hours, the effect remains after oral administration of the Sotagexal tablets. Analogues of the drug, which contain sotalol hydrochloride, are also not metabolized and are excreted by the kidneys with urine (up to 90%) and with feces on average in 10-20 hours.

This is why patients with impaired renal and urinary system performance are shown taking the drug at a lower dosage. Older people often suffer from age-related impairment of kidney function. This contributes to the fact that the substance is excreted at a lower rate and can accumulate in the body. Therefore, this drug is prescribed with caution, and its dosage is determined individually.

The medicine helps to normalize oxygen metabolism in tissues, eliminates the increased nervous excitability, anxiety, stress and other factors affecting the frequency and intensity of heart contractions.

Sotageksal: instructions for use

Analogues of the drug and a remedy with the original name are used for symptomatic heart rhythm disorders, for the treatment of ventricular extrasystole. But the effect is different in patients with similar diagnoses. Therefore, appoint a doctor after a thorough examination and strictly according to the indications.

Rarely the agent is used to treat patients who have had squamous psoriasis or have diabetes mellitus with a violation of carbohydrate metabolism. With caution, it is prescribed to people who have an allergy in the anamnesis, Sotagexal. His analogues are also able to suppress the sensitivity of the body to allergic stimuli. Accurately, the drug is used to treat people with heart failure, prone to frequent depressions. Patients who underwent myocardial infarction risk to aggravate arrhythmia during Sotagexal administration.

Dosage and treatment period

Depending on the severity of the disease, the duration of therapy with Sotagexal is determined. Instructions for use (analogues may have other instructions for receiving) contains the following recommendations:

• The tablet is swallowed whole, without chewing and washing with a lot of water;
• Reception is carried out 1-2 hours before meals;
• The drug is taken 2-3 times a day.

At the beginning of treatment, the daily dose should not exceed 80 mg (1 tablet) for hypertension and tachycardia. However, in the absence of the desired therapeutic effect, the dose is increased. Gradually, with an interval of 2-3 days, it is adjusted to 240-320 mg per day, but only in a hospital. The most effective is a phased increase in dosage by 80 mg per week.

The maximum dose can be 6 tablets per day of Sotagexal. Analogs, the dosage of which can also be increased, if the doctor thinks fit, are assigned individually. Even if there is a threat to life, the total amount of active substance should not exceed 480 mg per day.

If a patient has functional renal impairment, the treatment regimen is selected depending on the amount of creatinine clearance. When it increases (up to 30 mg / min), the dose is usually reduced by two to four times.

Intravenous injections are done twice a day, dividing the ampoule into two injections of 2 ml each. The solution is injected slowly for 5-7 minutes. During treatment, it is mandatory to monitor blood pressure, pulse, kidney and urinary system, and creatinine clearance in the blood serum.

Indications

The agent is prescribed for the therapy of such diseases:

• Ventricular tachycardia;
• Wolff-Parkinson-White syndrome;
• Cardiomyopathy;
• Extrasystole of the ventricles;
• mitral valve prolapse;
• Atrial fibrillation paroxysmal atrial fibrillation;
• Arterial hypertension (high blood pressure);
• Prevention and therapy of myocardial infarction (in some cases).

In case of serious violations of kidney functions, the doctor must constantly monitor the concentration of the active substance in the blood serum and adjust the dosage of the drug "Sotagexal". Analogues of the indications for admission are similar. But, despite this, it is strictly forbidden to replace one drug with another. Cancellation of treatment should not take place immediately, but gradually. A sharp discontinuation may lead to a worsening of the clinical condition.

Contraindications

Any antiarrhythmic drug can not always be prescribed to a patient, including Sotagexal. Analogues contraindications have the same, they can not be used in the presence of the following states:

• Hypersensitivity or individual intolerance to the main substance or ancillary components;
• Weakness of sinus angle;
• Marked decrease in heart rate (bradycardia);
• Chronic obstructive processes in the lungs;
• Severe form of bronchial asthma;
• Kidney failure;
• Acute myocardial infarction;
• Acute or chronic heart failure;
• Cardiogenic shock;
• Syndrome of elongated QT interval ;
• childhood;
• Allergy, allergic rhinitis;
• Pregnancy and breastfeeding;
• Low blood pressure (arterial hypotension);
• General anesthesia;
• gangrene;
• Peripheral vascular pathology;
• Development of the type of tachycardia "Pirouette" (the condition is diagnosed more often in women than in men).

There is no sufficient experience of use during pregnancy. Only for vital indications is assigned "Sotageksal". Analogues in the first trimester also pose a threat to the life of the fetus, and their administration can lead to an abortion. There are still no reliable research data on the taking of the drug in women bearing babies.

In the last months, therapy is canceled gradually 2-4 days before the expected delivery, if the woman took it throughout the period of pregnancy. This is done so that the newborn does not experience respiratory depression, bradycardia or arterial hypotension due to Sotagexal.

Analogues based on sotalol hydrochloride should be discontinued if the young mother is breastfeeding, since the substance has the ability to penetrate into breast milk and reach high concentrations there. If, according to the indications, the treatment needs to be continued, then it is better to stop breastfeeding by replacing the milk with adaptive mixtures appropriate to the child's age.

Side effect and overdose

May have undesirable effects from the cardiovascular, endocrine, urogenital, respiratory, digestive and central nervous system long-term use of the drug "Sotageksal." Analogues side effects cause similar. The patient can observe:

• Shortness of breath, increased attacks of angina pectoris, symptoms of heart failure, heart pain, angiospasm, Raynaud's syndrome ;
• Nausea, vomiting, diarrhea, stomach pain, increased gas emission, bloating, difficulty bowel movement, dry mouth mucous membranes;
• Anxiety, anxiety, panic conditions, hallucinations, impaired coordination of movements, hearing, sudden mood changes, tremors, fatigue, headache, dizziness, lack of sleep or, conversely, increased drowsiness, anxious dreams, depression;
• Conjunctivitis, keratoconjunctivitis or dry eye syndrome (especially in patients who constantly wear contact lenses), inflammation of the cornea, decreased taste and smell, eye pain, photophobia, visual acuity, hearing loss;
• Hypoglycemia (in people with diabetes mellitus);
• Spasms of the bronchi, laryngitis, tracheitis;
• Urticaria, dermatoses, skin itching, redness, psoriasis, Quincke's edema, increased sweating;
• Men have decreased potency, soreness with ejaculations, in women - decreased libido and menstrual cycle disorder;
• Fever, weakness in the muscles, cramps, cyanosis of the extremities.

In case of an overdose, you may experience:

• Oppression of cardiac functions;
• labored breathing;
• Asystole, fainting, weakness, dizziness;
• Cyanosis of the extremities;
• Muscle cramps;
• Bradycardia until cardiac arrest;
• Cardiovascular shock;
• Bronchospasm;
• tachycardia.

Despite such serious symptoms of an overdose, lethal outcome is rare. When the drug is poisoned, it is first necessary to stop taking the Sotagexal medication. Analogues and generics of sotalol hydrochloride are effectively removed from the gastrointestinal tract after taking absorbent drugs. In case of an overdose, symptomatic therapy is indicated. Serious poisoning requires washing the stomach and causing vomiting, maintaining vital functions of internal organs. Excess doses are completely eliminated by hemodialysis. Metabolic decrease in blood sugar can be observed in those patients who adhere to a strict diet or fast.

Analogs and generics "Sotageksala"

Sotalol hydrochloride is contained in a preparation manufactured in Switzerland and Germany, with the trade name "Sotagexal". Its analogs are represented by other drugs with a different composition, which, in addition to antiarrhythmic effect, relieve muscle spasms, reduce blood pressure and improve atrial function. These include:

• Anaprilin, Inderal, Obzidan, Pranolol (propranolol) are used to treat ischemia, arrhythmia and hypertension.
• "Pumpan" is a homeopathic remedy based on plant components.
• "Magnerot" contains magnesium orotate dihydrate, is used to treat atherosclerosis, in cases of lipid metabolism disorders.
• "Corvitol" (metoprolol tartrate) is effective in migraines.
• "Nebilet" (nebivolol hydrochloride) is prescribed for hypertension, ischemic disease.
• "Kudesan" (drops) is a biological supplement based on coenzymes Q10 for the prevention and treatment of arrhythmia.
• "Etatsizin" (etatsizin) is used for tachycardia;
• "Aritmil", "Amiodarone" (amiodarone hydrochloride) are used for cardiac arrest, tachycardia, arrhythmia of the atria.
• Propanorm (propafenone hydrochloride) is used for ventricular and supraventricular extrasystoles.
• "Neo-Giluritmal" (primalia bitartrate) is prescribed for ventricular arrhythmia, tachycardia.
• "Korgard" (nadolol) is taken for the treatment of angina pectoris, migraine.

In Russia, Sotalol Canon and Tenzol are produced with the same active substance as Sotagexal. Analogues in Moldova, Ukraine and the near abroad can be found in pharmacies easier than the original medicine. The cost of drugs depends on the country and the manufacturer. Domestic drugs, as a rule, have a much lower price than foreign medicines.

Reviews

There is a significant reduction in the frequency of attacks with atrial fibrillation, if you take Sotagexal constantly. Analogues patients' reviews are not so positive. Not always drugs of different manufacturers act in a similar way, even if they have the same composition. Many fear that unscrupulous producers indicate a large concentration of active substance in a single tablet than there is in fact. Because of this, treatment may not yield the expected results. Reviews on "Sotagexal", on the contrary, are more positive. It is effectively used in the complex treatment of heart and vascular diseases at different stages.

In most cases, there is a gradual improvement in the overall condition of patients on the condition of complex treatment. The drug is indispensable both for relief of seizures and for prevention. Judging by the opinions of patients diagnosed with "paroxysmal arrhythmia", the drug helps to keep the heart rate in norm (provided it is taken continuously as maintenance therapy). However, patients note that they would not have dared to raise the dose independently without the doctor's recommendations because of the risk of serious side effects.

Some reviews do not have a very positive effect on the reputation of the drug. It is believed that it is advertised and can not cure anemia, microbial rhythm disturbances, hypokalemia and hypomagnesemia. It is noted that sotalol hydrochloride of foreign brands is difficult to find in domestic pharmacies. People who are accustomed to constantly use the product, have difficulty in acquiring it. Therefore, before starting therapy, you should make sure that it will be possible to continue for a long time.

With what it is impossible to combine the reception of Sotahexal

For the period of treatment, it is desirable for patients to refuse driving a car, riding a bicycle, or riding a motorcycle. Also dangerous are all activities that require increased attention, psychomotor concentration and concentration. When taking additional funds to reduce blood pressure there is a possibility of hypotension. It is forbidden to combine Sotagexal with such medicines:

• Insulin, because its blood content is already increasing;
• Ions and calcium antagonists;
• Means for general or inhalational anesthesia;
• MAO inhibitors;
• Iodine-containing substances;
• Diuretics;
• Alkaloids of ergot;
• Tetracyclic antidepressants.

The medicine is not prescribed simultaneously with antiarrhythmic drugs of I and III class. Also contraindicated is the use of narcotic drugs, sedatives and antihistamines, neuroleptics, coumarins, relaxants. They further contribute to the suppression of the central nervous system. Simultaneous anesthesia leads to an increase in blood pressure and depresses myocardial tissue. It is forbidden to do skin tests to determine the types of allergens. This increases the risk of anaphylactic shock, angioedema and asphyxia.

The drug "Sotageksal" is released in pharmacies according to the prescription of a doctor. Self-treatment of arrhythmia with this remedy can cause serious adverse reactions. Therefore, before taking the medicine, you should always consult a doctor.