Cardioarginine-zdorovya

INSTRUCTIONS FOR MEDICAL USE OF THE MEDICINAL PRODUCT CARDIOARGININ-ZDOROVYE

Composition:

Active substances: arginine aspartate, diarginine succinate, magnesium aspartate, potassium aspartate;

7.5 ml of the preparation contains arginine aspartate 1700 mg, diarginine succinate 1400 mg, magnesium aspartate 175 mg, potassium aspartate 175 mg;

Excipients: sodium saccharin; methylparaben (E 218); propylparaben (E 216); "Strawberry" flavor containing propylene glycol, flavoring substances (natural and nature-identical); purified water.

Pharmaceutical form. Syrup.

Main physicochemical properties: clear, colorless or slightly yellowish liquid with a fruity odor.

Pharmacotherapeutic group. Agents acting on the cardiovascular system. Various combined cardiovascular preparations. ATC code C01EX.

Pharmacological properties.

Pharmacodynamics. A cardio- and endothelioprotective metabolic agent with antihypertensive and adaptogenic properties. The drug reduces myocardial ischemia, improves coronary circulation, normalizes the functional state of the endothelium of coronary and peripheral vessels, and has anti-hypoxic, membrane-stabilizing, antioxidant, and free radical-scavenging properties. In arterial hypertension, it promotes normalization of arterial pressure and reduces total peripheral vascular resistance. The antihypertensive effect of the drug is achieved due to the ability of arginine, as a nitric oxide donor, to enhance endothelium-dependent vasodilation, as well as the capacity of this amino acid to regulate arterial pressure and maintain osmolarity of body fluids and blood volume by participating in the synthesis of the peptidergic hormone arginine-vasopressin. The metabolic cardioprotective action of the drug is due to the ability of arginine, aspartate, and succinate to activate energy supply processes in cardiac muscle, restore cellular energy potential, normalize acid-base balance and intermediate metabolism, as well as protein metabolism in the myocardium, and stimulate the synthesis of amino acids, amino sugars, and nucleotides.

Aspartate acts as an intracellular carrier of K+ and Mg2+ ions. Due to potassium and magnesium aspartate, electrolyte imbalance in the body is corrected and coronary circulation is improved. Mg2+ ions activate Na+-K+-ATPase, thereby decreasing intracellular Na+ concentration and increasing K+ influx into the cell. The reduction in intracellular Na+ concentration leads to inhibition of Na+/Ca2+ ion exchange in vascular smooth muscle, resulting in their relaxation. K+ ions stimulate the synthesis of ATP, glycogen, proteins, and acetylcholine.

The drug exhibits adaptogenic and antiprotective effects through substrate-induced stimulation of cellular metabolism. Arginine, aspartate, and succinate activate enzymatic processes in the Krebs cycle, stimulate cellular utilization of fatty acids and glucose during physical exertion, exert a positive effect on aerobic cellular energy production, and reduce lactic acidosis.

Pharmacokinetics. Not studied.

Clinical characteristics.

Indications.

In complex therapy of chronic heart failure, ischemic heart disease (stable angina caused by vascular dysfunction or spasm, painless myocardial ischemia), arterial hypertension, and in the early rehabilitation period after myocardial infarction.

Contraindications.

• Hypersensitivity to any component of the drug;
• Hyperkalemia;
• Acute and chronic renal failure;
• Addison's disease;
• Atrioventricular block;
• Cardiogenic shock (with systolic arterial pressure < 90 mm Hg).

Interaction with other medicinal products and other forms of interaction.

When using arginine aspartate, it should be considered that concomitant use of aminophylline with arginine may be accompanied by increased insulin levels in the blood; spironolactone with arginine – by increased potassium levels in the blood.

The drug improves tolerance of cardiac glycosides and enhances the effect of medicinal agents stimulating trophic processes in the myocardium; prevents development of hypokalemia caused by diuretics, corticosteroids, and cardiac glycosides. When used simultaneously with potassium-sparing diuretics and angiotensin-converting enzyme (ACE) inhibitors, the risk of hyperkalemia increases (plasma potassium levels must be monitored).

The drug reduces sensitivity to cardiac glycosides.

Special precautions for use.

Use with caution in patients with myasthenia gravis; in conditions that may lead to hyperkalemia, such as acute dehydration, extensive tissue damage, particularly in severe burns. In these patient groups, regular monitoring of serum electrolyte levels is recommended.

The presence of methylparaben (E 218) and propylparaben (E 216) in the formulation may cause allergic reactions (possibly delayed).

Use during pregnancy or breastfeeding.

The safety of using the drug during pregnancy or breastfeeding has not been established.

Breastfeeding should be discontinued for the duration of treatment with this drug.

Ability to affect reaction speed when driving or operating machinery.

Does not affect.

Dosage and Administration.

For oral use in adults.

For cardiovascular diseases and during rehabilitation period: 1–2 doses of syrup (7.5 mL) per day. Treatment duration: 10–20 days.

Maximum daily dose – 15 mL.

May be used in patients with diabetes mellitus.

The package contains a measuring cup.

Children. The efficacy and safety of the medicinal product in pediatric patients have not been established.

Overdose.

Symptoms of hyperkalemia: general weakness, paresthesia, bradycardia, paralysis. Extremely high plasma potassium concentration may lead to death due to suppression of cardiac function, arrhythmia, or cardiac arrest.

Symptoms of hypermagnesemia: nausea, vomiting, drowsiness, hypotension, bradycardia, weakness, slurred speech, double vision. With very high magnesium concentration in plasma, hyporeflexia, neuromuscular blockade, respiratory depression, and cardiac arrest may develop.

Symptoms: arterial hypotension, hyperkalemia, hypermagnesemia, stomach pain, metallic taste in mouth, muscle weakness, paresthesia, muscle stiffness; electrocardiogram shows increased T-wave amplitude, decreased P-wave amplitude, and widened QRS complex.

Treatment: symptomatic therapy aimed at supporting vital functions, parenteral administration of calcium preparations.

Adverse reactions.

Gastrointestinal tract: a feeling of mild discomfort in the stomach and intestine, nausea, vomiting, diarrhea, abdominal pain, formation of ulcers and gastrointestinal bleeding, flatulence, dyspeptic symptoms, thirst immediately after administration, which disappear spontaneously.

Cardiovascular system: decreased arterial pressure, disturbances in intraventricular conduction, tachycardia.

Nervous system: general weakness, muscular weakness, hyporeflexia, disorientation, dizziness, paresthesia, sensation of warmth, facial hyperemia, respiratory depression, convulsions, increased sweating.

Skin: possible allergic reactions including pruritus, rash, urticaria, skin hyperemia.

Other: myasthenia, asthenia, phlebitis, venous thrombosis, dyspnea.

Shelf life. 2 years.

Storage conditions. Store in original packaging at a temperature not exceeding 25 °C. Do not refrigerate. Keep out of reach of children.

Packaging. 50 ml or 100 ml in a bottle with a measuring cup in a box.

Availability. Over-the-counter.

Manufacturer. LIMITED LIABILITY COMPANY "CORPORATION "ZDOROV'YA".

Manufacturer's address and location of business activity.
Ukraine, 61013, Kharkiv region, city of Kharkiv, Shevchenka Street, building 22.