RYTMONORM 150 mg. 50 tablets

Indications
Symptomatic and requiring treatment tachycardiac supraventricular cardiac arrhythmias such. AU- nodal tachycardia, supraventricular tachycardia in WPW-syndrome or paroxysmal atrial mazhdene.Tezhkostepenni symptomatic ventricular tachycardia heart rhythm disorders, if prescribed by the physician are life-threatening.
 
 
Contraindications
Contraindications are diseases or circumstances in which not to use certain drugs or used only after careful consideration by the doctor, because they generally expected benefits compare favorably against possible injury. To enable a doctor to make a careful check contraindications, he must be informed about your previous illnesses, concomitant diseases, concurrent other treatments, and your living conditions and habits. Contraindicated s may occur or become known only after the start of therapy with this medication. In such cases we should tell your doctor.
 
 
Propafenone should not be used in:
overt cardiac failure, cardio-circulatory shock, unless caused by heart rhythm disorder, disease slow heart rhythm
during the first 3 months after myocardial infarction or in restricted cardiac function '(left ventricular ejection volume <35%) than in patients with life-threatening ventricular arrhythmias of the heart,
available high-sino-atrial, atrioventricular and vatrekamerni violations in the conduct of excitement heart syndrome sick sinus (tachycardia bradycardia syndrome), hypotension (significant disease low blood pressure), expressed disorders in electrolyte balance (eg. metabolic disorders of potassium ), severe obstructive (caused by blockage) lung disease, myasthenia gravis, known hypersensitivity to the active substance propafenone.
 
 
Use during pregnancy and lactation
During pregnancy, especially during the first trimester and during lactation, propafenone should be taken only at the express medical indication.
 
 
Adverse effects
Drugs can have with your basic actions and side effects. Side effects that have been observed at the time of treatment with propafenone, but which does not necessarily occur in every patient are mentioned hereinafter. Sometimes, especially at a high initial dosage may occur gastrointestinal disorders such as loss of appetite, nausea, tendency to vomiting, feeling of fullness, constipation, dry mouth, and orchiv taste fading ears, sensory disorders, vision and dizziness. In elderly patients with impaired myocardial function occasionally can lead donarushena regulation of blood circulation with a tendency to lower blood pressure, which is caused by an upright body position or prolonged standing. Can lead to proarrhythmic effects in the form of change or enhance cardiac arrhythmias. These proarrhythmic effects also manifest as strong or slow heart beat or a breach in the conduct of excitement or heart rate. Possible worsening of heart failure.
Rarely can lead to fatigue, headaches, mental disorders such as anxiety and confusion, anxiety, nightmares and sleep disturbances and disorders in the course of involuntary movements, allergic skin reactions (redness, itching, exanthema or urticaria), and seizure of bronchi in patients with increased susceptibility to bronhospazam.V some cases after high dose of propafenone was observed a decrease in libido and number of seminal cells.
These effects disappear after cessation of treatment. Because treatment with propafenone may be vital, it should not be interrupted without medical advice in these adverse effects.
 
Interaction with other drugs
The effect of some medicines may be affected by concomitant use of other means. Therefore, consult your doctor if you use constantly, have recently used or want to consume another medicine simultaneously 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 for use of this drug.
For concomitant use 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. Betaretseptorni blockers , tricyclic antidepressants) should be given the possibility to enhance the therapeutic effect. Further described further increases in plasma concentrations, respectively. the level of propranolol in the blood, metoprolol, desipramine, cyclosporine and digoxin. In one case, the additional administration of propafenone was observed a doubling of the plasma concentration of theophylline. In the event of relevant phenomena of overdose should determine the plasma concentrations and, if necessary, to reduce the dose of prescribed medication. Increased plasma concentrations of propafenone have been reported with concomitant use of cimetidine, respectively. quinidine. When concomitant administration 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 (amplification of the effects of anticoagulants). In these patients, it is recommended careful monitoring of coagulation.
 
Precautions for use
This mezikament may in normal dosage to change the possibility to react to such an extent that significantly affect driving or operating machinery. This applies in an enhanced degree in concomitant use with alcohol.
 
Warning:
Therapy with propafenone may change peysing- and senzing- threshold of pacemakers. pacemaker function should be checked and if necessary re-programmed.
 
 
Dosage
Establishment of individual maintenance dose should be done under medical supervision with frequent monitoring of ECG and blood pressure (initial phase of adjustment of the dose). In an extension of the QRS-interval (over 20%) or frequency-dependent QT-interval, the dose should be reduced or temporarily discontinued therapy to normalize the electrocardiogram. Under reduced liver and / or renal function, therapeutic doses can lead to accumulation. Under the control of ECG and plasma concentration and these patients may be included therapy with propafenone. If not otherwise specified, the phase of adjustment and maintenance dose is recognized daily dose of 450-600 mg, which corresponds to a 3-4 coated tablets in 2-3 single doses spread evenly throughout the day. It is sometimes necessary increase in the daily dose of 900 mg of 6 coated tablets, evenly distributed over the day in 3 individual doses.
In exceptional cases, this daily dose may be exceeded under strict cardiology kontrol.Dannite apply to patients with a body weight of about 70 kg. In patients with lower weight daily doses should therefore be reduced.
Propafenone should be dosed with caution, in the initial phase step in elderly or severely damaged heart muscle. Rising dose should be only in the 3-4 day interval.
Initiation of therapy with antiarrhythmic agents in ventricular arrhythmias requires careful medical supervision and should only be done with the facilities for emergency treatment and opportunity for monitor control. During therapy, at regular intervals, must be carried out check-ups (eg. In one month - standard ECG, respectively. In three months - Holter ECG and ECG under load). Deterioration in certain parameters, eg. extension of QRS- interval, respectively. QT- interval by more than 25% or PQ- interval by more than 50%, respectively. QT prolongation more than 500 milliseconds or increase the number or severity of the arrhythmia, the therapy should be verified again.
In patients with significant left ventricular function restriction (<35%), respectively. structural myocardial diseases, should be dosed with caution, step. In these cases the recommended therapeutic dose escalation is necessary to take only when they are already established pharmacokinetic steady-state relations; usually after about 5-8 days. Thus is reduced (the risk of possible proarrhythmic effects in the initial phase of therapy in these patients.
 
 
Method and duration of administration
coated tablets should be swallowed unchewed and suspended with liquid after a meal due to the bitter taste and the superficial anesthetic activity of the active substance. The duration of therapy is determined by the doctor.
 
 
Recommendations
The drug should not be used after the expiry of the expiration date. Drugs to be stored out of the reach of children.
 
Home, and a maximum duration of drug action
After a rapid onset of drug action (after about 30 min.) Rytmonorm  150 mg reaches its maximum effect after 2-3 hours. The action lasts more than 8 hours.