Obzidan - description of the drug, instructions for use, reviews

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Manufacturers: Isis Pharmaceuticals Inc.

Active ingredients

• Propranolol

Disease class

• Some infectious and parasitic diseases
• Thyrotoxicosis (hyperthyroidism)
• Migraine without aura [simple migraine]
• Autonomic nervous system disorders
• Essential [primary] hypertension
• Secondary hypertension
• Renovascular hypertension
• Angina [angina pectoris]
• Unstable angina
• Chronic ischemic heart disease
• Obstructive hypertrophic cardiomyopathy
• Heart rhythm disorder, unspecified
• Pain in the heart area
• Tremor, unspecified
• Cardiac glycosides and drugs with similar effects

Clinical and pharmacological group

• Not indicated. See instructions

Pharmacological action

• Antianginal
• Antiarrhythmic
• Hypotensive

Pharmacological group

• Beta blockers

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Non-selective beta-blocker with moderate antihypertensive, antianginal and antiarrhythmic effects. Indiscriminately blocks beta-adrenergic receptors , weakens catecholamine- biosynthesis of cAMP from ATP , after which it reduces the intracellular supply of calcium ions, has a negative dromotropic , bathmotropic , chronotropic and inotropic effect (reduces heartbeat, inhibits conductivity and excitability, reduces the ability of the myocardium to contract).

On the first day of using the drug, peripheral vascular resistance increases (as a result of an increase in the activity of alpha-adrenergic receptors and blocking of beta-2-adrenergic receptors in muscle vessels), but after two days its value returns to its original value, and with long-term administration it decreases.

The antihypertensive effect is associated with a decrease in cardiac output, a weakening of sympathetic stimulation of the vessels of peripheral organs, inhibition of the renin-angiotensin system , a decrease in the sensitivity of aortic arch pressure receptors and an effect on the nervous system. This antihypertensive effect is completely stabilized by the end of the second week of the course of administration of the drug.

The antianginal effect is caused by a decrease in the heart's oxygen demand (due to negative inotropic and chronotropic effects). A decrease in heart rate leads to prolongation of diastole and increased myocardial perfusion. As a result of increased diastolic pressure in the left side of the heart and increased stretching of the ventricular muscles, the need for oxygen and nutrients may increase, especially in patients suffering from heart failure .

The antiarrhythmic effect manifests itself as a result of blocking arrhythmogenic factors (excessive activity of the sympathetic system, tachycardia , increased levels of cAMP in tissues, arterial hypertension ), reducing the speed of spontaneous excitation of ectopic and sinus pacemakers and inhibition of AV conduction . Suppression of impulse conduction is recorded primarily in the forward direction and, to a lesser extent, in the reverse direction through the AV node and along additional pathways. Due to a decrease in the heart's oxygen demand, the severity of cardiac ischemia is weakened, and post-infarction mortality may decrease due to the antiarrhythmic effect .

The ability to prevent the occurrence of headaches of vascular etiology is caused by a decrease in the severity of enlargement of the cerebral arteries due to blocking of beta-adrenergic receptors of platelet adhesion and lipolysis caused by catecholamines adhesiveness , inhibition of activation of blood coagulation factors during the release of adrenaline , stimulation of oxygen transport into tissues and weakening of renin .

The decrease in the severity of tremor with the use of propranolol is due to the blocking of beta-2 adrenergic receptors.

The drug enhances the ability of the uterus to contract. Stimulates the tone of the bronchial walls.

Pharmacokinetics

After internal administration, up to 90% of the product is quickly absorbed. The maximum concentration in the blood occurs after an hour and a half. Bioavailability after a single dose reaches 40%, with long-term use it increases. The value of bioavailability depends on the nature of the meal and the intensity of liver perfusion.

The drug is highly lipophilic and accumulates in the kidneys, brain, lungs and heart. Penetrates through histohematic barriers and is excreted in breast milk. Reaction with blood proteins is 90-95%.

Transformed in the liver by glucuronidation. Then it enters the intestine with bile, where it is deglucuronidated and reabsorbed.

The half-life is four hours. Excreted in the urine in the form of metabolites (99%). Not evacuated during hemodialysis .

Oral tablets Obsidan

Instructions for medical use of the drug

Description of pharmacological action

Blocks beta-adrenergic receptors, weakens the effect of sympathetic impulses on the heart and reduces the frequency and strength of heart contractions, cardiac output and myocardial oxygen demand.

Indications for use

Angina pectoris, progressive angina pectoris, silent myocardial ischemia, arterial hypertension, arrhythmias, hypertrophic cardiomyopathy, neurocirculatory dystonia, digitalis intoxication, thyrotoxicosis, migraine, essential familial tremor.

Release form

tablets 40 mg; blister 20 cardboard pack 3;

Pharmacodynamics

Blocks beta1 and beta2 adrenergic receptors and has a membrane-stabilizing effect. Inhibits the automatism of the sinoatrial node, suppresses the occurrence of ectopic foci in the atria, AV junction, and ventricles (to a lesser extent). Reduces the speed of excitation in the AV junction along the Kent bundle, mainly in the anterograde direction. Reduces heart rate, reduces the strength of heart contractions and myocardial oxygen demand. Reduces cardiac output, renin secretion, blood pressure, renal blood flow and glomerular filtration rate. Suppresses the response of the aortic arch baroreceptors to a decrease in blood pressure. After taking a single dose, the hypotensive effect continues for 20–24 hours. A single dose of prolonged forms is equivalent to taking several doses of propranolol hydrochloride. Hypotension stabilizes by the end of the 2nd week of treatment. With long-term use, it reduces venous return and has a cardioprotective effect (reliably reduces the risk of recurrent myocardial infarction and sudden death by 20–50%). In patients with moderate arterial hypertension, it reduces the likelihood of developing coronary artery disease and cerebral strokes. In case of coronary artery disease, it reduces the frequency of attacks, increases exercise tolerance, and reduces the need for nitroglycerin. It is most effective in young patients (up to 40 years old) with a hyperdynamic type of blood circulation and with increased renin levels. Increases bronchial tone and uterine contractility (reduces bleeding during childbirth and in the postoperative period), enhances the secretory and motor activity of the gastrointestinal tract. Inhibits platelet aggregation and activates fibrinolysis. Inhibits lipolysis in adipose tissue, preventing an increase in the level of free fatty acids (while the concentration of triglycerides in plasma and the atherogenicity coefficient increase. Suppresses glycogenolysis, the secretion of glucagon and insulin, the conversion of thyroxine to triiodothyronine. Lowers intraocular pressure, reduces the secretion of aqueous humor. Long-term administration (18 months) in rats and mice doses up to 150 mg/kg/day did not reveal carcinogenic properties and adverse effects on fertility.At a dose of 150 mg/kg/day, 10 times higher than the MRDC, it had an embryotoxic effect (increased incidence of fetal resorption).

Pharmacokinetics

When taken orally, it is quickly and almost completely absorbed from the gastrointestinal tract (90%). Bioavailability is 30–40% (the “first pass” effect), depends on the nature of the food and the intensity of hepatic blood flow and increases with prolonged use (metabolites are formed that inhibit liver enzymes). Cmax in plasma is observed after 1–1.5 hours or 6 hours (for the prolonged form). Binds to plasma proteins by 90–95%; T1/2 is 2–5 hours (10 hours for the prolonged form). Volume of distribution: 3–5 l/kg. It accumulates in the lung tissue, brain, kidneys, heart, passes through the placental barrier, and penetrates into breast milk. Subject to glucuronidation in the liver (99%). It is excreted with bile into the intestine, deglucuronidated and reabsorbed (T1/2 during a course of administration can be extended to 12 hours). Excreted by the kidneys in the form of metabolites.

Use during pregnancy

Possibly if the expected effect of therapy exceeds the potential risk to the fetus. Breastfeeding should be stopped during treatment.

Contraindications for use

Hypersensitivity, AV block II-III degree, severe bradycardia, hypotension, obstructive airway diseases; relative contraindications - diabetes mellitus in the sub- and decompensation stage, psoriasis in the acute stage.

Side effects

Weakness, dizziness, headache, paresthesia, cold extremities, dyspeptic disorders, conjunctivitis, skin rashes, itching.

Directions for use and doses

For hypertension - 40 mg 2 times a day. If necessary, the dose can be increased over 2–4 weeks to 80–160 mg 2 times a day. For angina, migraine, essential tremor - 20 mg 2-3 times a day. The dose can be increased over 1 week to 40 mg 4 times a day or up to 80 mg 2-3 times a day. The maximum daily dose is 240 mg for migraine and 480 mg for angina. For arrhythmia, hypertrophic cardiomyopathy, thyrotoxicosis - 10-40 mg 3-4 times a day (up to 240 mg/day).

Overdose

Symptoms: dizziness, bradycardia, arrhythmia, heart failure, hypotension, collapse, difficulty breathing, acrocyanosis, convulsions. Treatment: gastric lavage and administration of adsorbents, symptomatic therapy: atropine, beta-adrenergic agonists (isoprenaline, isadrin), sedatives (diazepam, lorazepam), cardiotonic (dobutamine, dopamine, epinephrine) drugs, vasopressors, glucagon, etc.; transvenous stimulation is possible. Hemodialysis is ineffective.

Interactions with other drugs

Barbiturates and nicotine increase the effect, cimetidine weakens it; enhances the negative inotropic effect of calcium antagonists, the negative dromotropic effect of cardiac glycosides, the hypotensive effect of antihypertensive drugs, and the antiarrhythmic effect of lidocaine. Increases the likelihood of developing hypoglycemia due to insulin.

Precautions for use

Treatment should be carried out with regular medical supervision. With long-term use, the possibility of additional administration of cardiac glycosides should be considered. Reduces compensatory cardiovascular reactions in response to the use of general anesthetics. A few days before anesthesia, it is necessary to stop taking it or choose an anesthetic with the least negative inotropic effect. IV administration is not recommended for children. Elderly patients have an increased risk of CNS side effects. If liver function is impaired, dose reduction and observation during the first 4 days of therapy are recommended. May mask the symptoms of hypoglycemia (tachycardia) in patients with diabetes mellitus taking insulin and other hypoglycemic drugs. It is possible that the severity of the hypersensitivity reaction may increase and the absence of effect from usual doses of epinephrine against the background of a burdened allergic history. During treatment, it is recommended to avoid drinking alcoholic beverages. Use with caution while working for vehicle drivers and people whose profession involves increased concentration. Stop treatment gradually over about 2 weeks.

Special instructions for use

During treatment, test results may change during laboratory tests (increased levels of urea, transaminases, phosphatases, LDH).

Storage conditions

List B.: In a place protected from light, at a temperature of 15–25 °C.

Best before date

60 months

ATX classification:

C Cardiovascular system

C07 Beta blockers

C07A Beta blockers

C07AA Non-selective beta-blockers

C07AA05 Propranolol

Indications for use of Obzidan

The drug has the following indications for use:

• atrial fibrillation;
• angina pectoris of an unstable nature (excluding Prinzmetal angina );
• angina pectoris ;
• tachycardia of various etiologies;
• ventricular and supraventricular extrasystole ;
• arterial hypertension;
• prevention of myocardial infarction ;
• essential tremor;
• migraine (prevention of attacks);
• as a symptomatic treatment of thyrotoxicosis or thyrotoxic crisis (if intolerance to thyreostatic drugs is present);
• sympathoadrenal crises complicated by diencephalic syndrome.

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** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Obzidan, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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Contraindications

• sinoatrial block;
• AV block of the second and third degree;
• sinus bradycardia;
• uncontrolled heart failure of the chronic type, stage 2B-3;
• arterial hypotension;
• acute heart failure
• myocardial infarction (with systolic pressure up to 100 mm Hg);
• pulmonary edema;
• cardiogenic shock;
• sick sinus syndrome;
• cardiomegaly (without heart failure);
• Prinzmetal's angina;
• vasomotor rhinitis;
• occlusive diseases of peripheral vessels (including complicated);
• metabolic acidosis;
• diabetes;
• bronchial asthma;
• chronic obstructive pulmonary disease
• spastic colitis;
• pheochromocytoma (without combined use of alpha-blockers );
• simultaneous use with antipsychotics , MAO inhibitors and anxiolytics ;
• lactation period;
• sensitization to the drug.

Take the drug with caution in case of renal or hepatic failure , first degree AV blockade myasthenia gravis, hyperthyroidism, chronic heart failure stage 1-2A, psoriasis , pheochromocytoma, allergic reactions in the past, pregnancy, Raynaud's syndrome , in old age, persons in under 18 years of age.

Side effects

• Reactions from the circulatory system: AV block, sinus bradycardia, heart failure , myocardial conduction disorders, decreased pressure, arrhythmias, hypotension, thoracalgia , spasm of the arteries of peripheral organs.
• Reactions from the digestive system: constipation, nausea, diarrhea , vomiting, epigastric pain, liver dysfunction.
• Reactions from the nervous system: nightmares, headache , asthenic syndrome, insomnia, lethargy, agitation, paresthesia, depression, fatigue, dizziness , weakness, drowsiness, confusion, hallucinations, tremor.
• Reactions from the respiratory system: nasal congestion, rhinitis, bronchospasm , shortness of breath, laryngospasm.
• Metabolic reactions: hypoglycemia or hyperglycemia.
• Reactions from the senses: decreased visual acuity, dry mucous eyes, keratoconjunctivitis.
• Reactions from the genitourinary system: decreased libido and potency.
• Dermatological reactions: exacerbation of psoriasis, exanthema, alopecia, hyperemia, psoriasis-like reactions.
• Reactions from the hormonal system: decreased functioning of the thyroid gland.
• Allergic reactions: rash , itching .
• From the laboratory test indicators: leukopenia, agranulocytosis, thrombocytopenia , activation of liver transaminases and increased bilirubin .
• Other: weakness, arthralgia, lumbodynia, withdrawal syndrome.

Obzidan

Name: Obzidan Pharmacological action: The drug Obzidan affects two types of adrenergic receptors and is a non-selective adrenergic blocker. The active ingredient is propranolol. It causes the antianginal, hypotensive, antiarrhythmic effect of the drug. Due to its effect on beta-adrenergic receptors, it provokes inhibition of the synthesis of cAMP from adenosine triphosphoric acid. This indirectly causes a decrease in the intracellular calcium content due to a decrease in its penetration through the membrane.

The drug has negative inotropic, dromotropic, bathmotropic and chronotropic effects. The effect on peripheral vascular resistance is observed only in the first 2 days of use. The hypotensive effect is due to a decrease in myocardial minute volume, a decrease in the influence of the adrenal system on peripheral vessels, and a decrease in the hyperactivity of the renin-angiotensin system. The drug reduces the sensitivity of aortic baroreceptors. Stabilization of the antihypertensive effect is observed by the third week of the course. Obzidan reduces myocardial oxygen demand, lengthens diastole, and improves myocardial perfusion. In case of CHF, the drug may have the opposite effect due to its effect on diastolic pressure and increased stretching of the myocardial fibers of the ventricles.

Obzidan eliminates factors that provoke arrhythmia (increased influence of the sympathetic system, tachycardia, increased cAMP content, hypertension). Propranolol reduces the rate of spontaneous excitation of pacemakers, slows down atrioventricular conduction by inhibiting the conduction of impulses in the antegrade and retrograde directions. During therapy, the manifestations of ischemia are reduced and post-infarction mortality is reduced by preventing the spontaneous development of arrhythmias. Propranolol reduces the dilation of cerebral arteries, reduces pathological platelet aggregation caused by the influence of catecholamines and their effect on the blood coagulation system. Obzidan helps eliminate ischemia and reduces the secretion of renin. Elimination of tremor manifestations is observed due to the blocking effect on beta-adrenergic receptors. The drug has atherogenic, uterotonic, bronchospastic effects.

Indications for use: Obzidan is prescribed for: - angina pectoris; - migraine prevention; - arterial hypertension; - unstable angina; - supraventricular extrasystole; - supraventricular tachyarrhythmia; - essential tremor; - ventricular extrasystole; - tachycardia due to hyperthyroidism; - thyrotoxicosis; — atrial fibrillation; - thyrotoxic crisis in the presence of hypersensitivity to thyreostatic drugs; - sympathoadrenal crises; - prevention of myocardial infarction in conditions of increased systolic pressure above normal.

Directions for use: Daily dosage of Obzidan – 80-160 mg. The tablets are taken orally. Chewing is not allowed. The tablets should be taken with 100 ml of clean water. Dosage regimens: 40 mg/2 times; 40 mg/3 times; 80 mg/2 times. In rare cases, it is permissible to increase the daily dosage to 0.32 g of propranolol.

Side effects: Taking Obzidan may be accompanied by: - ​​alopecia; - heart failure; - laryngospasm; - thrombocytopenia; — depressive states; - sinus bradycardia; - urticaria; - dry mouth; - tremor; - increased activity of liver transaminases; - leukopenia; - skin rash; - chest pain; - headache; - nausea; - bronchospasm; - confusion; - atrioventricular block; - tachycardia; - insomnia; - liver dysfunction; - arrhythmia; - psoriasis-like reactions; — fatigue; - decreased libido; - hallucinations; - epigastric pain; - hypotension; - nasal congestion; - nightmares; - spasms of peripheral vessels; - orthostatic hypotension; - diarrhea; - agranulocytosis; — keratoconjunctivitis; - asthenia; - paresthesias; - decreased potency; - shortness of breath; - rhinitis; - increased bilirubin levels; - changes in taste perception; - slowing down the reaction; - exanthema; - exacerbation of psoriasis; - drowsiness; - dry eyes; - anaphylaxis; - short-term anesthesia; - cold feet and hands; — hypoglycemia in insulin-dependent diabetes; - decreased visual acuity; - hyperhidrosis; — hyperglycemia in non-insulin-dependent diabetes; - skin hyperemia; - hypothyroidism.

Contraindications: Obzidan is not prescribed for: - acute heart failure; - sinoatrial blockade; - arterial hypotension; - sinus bradycardia; - spastic colitis; — sick sinus angle syndrome; - diabetes mellitus; - pheochromocytoma; - bronchial asthma; — atrioventricular block II, III degree; — chronic heart failure (CHF) stage IIB-III (uncontrolled); - acute myocardial infarction; - vasomotor rhinitis; - lactation; - cardiogenic shock; - pulmonary edema; - tendency to bronchospasm; - Prinzmetal's angina; - metabolic acidosis; - cardiomegaly; - hypersensitivity to propranolol, tablet components; - COPD; — diseases of peripheral vessels with occlusion; - taking antipsychotic drugs; - taking anxiolytics.

Obzidan is prescribed with caution for: - myasthenia gravis; - renal failure; — atrioventricular block of the first degree; - liver failure; - psoriasis; — CHF stages I-IIA; - hyperthyroidism; - Raynaud's syndrome; - pregnancy; - history of allergies.

Elderly and children under 18 years of age are prescribed only after assessing the benefit/possible risk ratio.

Pregnancy: Obzidan can cause fetal hypoglycemia, intrauterine growth retardation, and fetal bradycardia. The decision on the possibility of use is made jointly by the cardiologist, gynecologist, obstetrician and the patient. Obzidan is discontinued 3 days before birth.

Interaction with other drugs:

Overdose: Exceeding the therapeutic dose of Obzidan may be accompanied by: - ​​bradycardia; - fainting conditions; - dizziness of varying degrees; — collapse; - decrease in pressure; - arrhythmia; - difficulty breathing; - cyanosis of fingers, palms, nails; - convulsions.

If you have recently taken a large number of tablets, gastric lavage and the use of adsorbents are indicated. In case of disturbances in the functioning of the heart, hospitalization with the provision of qualified assistance is necessary. If there is a violation of AV conduction, the administration of adrenaline, atropine is indicated; in case of extrasystole, lidocaine is indicated. If the pressure drops, the patient is placed on a bed with the head of the bed slightly lowered. For bronchospasm, beta-agonists are used.

Release form: Obzidan is produced in tablets of one dosage - 0.04 g. Packaging - 20 tablets × 3 blisters (60 tablets) / package.

Storage conditions: Storage temperature of Obzidan tablets is 15-25 degrees Celsius. The drug is suitable for use for 5 years.

Synonyms: Propranolol, Inderal PD, Apo-propranolol, Betake, Anaprilin, Inderal, Propra-ratiopharm, Novo-Pranol, Prolol, Propranobene, Propranolol Nycomed, Propranolol hydrochloride, Propranolol Farmkhim.

Composition: 1 tablet Obzidan contains propranolol hydrochloride 0.04 g. Auxiliary components: lactose, starch, talc, sodium KMC type A, gelatin, magnesium stearate, aerosil.

Additionally: At the beginning of therapy with Obzidan, you should constantly monitor blood pressure, heart rate, and do an ECG. In the elderly, monitoring of kidney condition once a quarter is necessary. When prescribed to patients with diabetes, blood sugar control is necessary. Increasing bradycardia, significant hypotension, atrioventricular block, and other severe side effects are a reason to reduce doses or discontinue the drug. When wearing lenses, a state of discomfort may occur due to dry eyes as a result of the drug. The use of special liquids, which are an analogue of tear fluid, is indicated.

In the early stages of heart failure, cardiac glycosides and diuretics should be used before prescribing the drug. Therapy with Obzidan can be long-term and continuous. Cancellation is not carried out abruptly (within 3 weeks) to exclude withdrawal syndrome from the myocardium. The drug affects the detection of the following substances in biological fluids: normetanephrine, catecholamines, vinyl amidic acid, as well as titers of antinuclear antibodies. Obzidan reduces the speed of psychomotor reactions, affects attention and concentration. It is not recommended to drive a car or engage in activities that are potentially hazardous to health.

Attention! The description of the drug " Obzidan " on this page is a simplified and expanded version of the official instructions for use. Before purchasing or using the drug, you should consult your doctor and read the instructions approved by the manufacturer. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Obzidan, instructions for use (Method and dosage)

Instructions for use Obzidan recommends taking the tablets without chewing them before meals and washing them down with a small volume of liquid when swallowed.

For angina pectoris and rhythm disturbances, the initial daily dose is 60 mg per day in three divided doses, then increase the dose to 80-120 mg per day in 2-3 divided doses. The highest daily dose is 240 mg.

For arterial hypertension , take 40 mg twice a day. If the indicated dose is not enough, it is increased to 120 mg per day in three divided doses or up to 160 mg per day in four divided doses. The highest daily dose is 320 mg.

To prevent migraine and essential tremor, the drug is prescribed at an initial dose of 120 mg per day in three divided doses.

To prevent recurrence of myocardial infarction, treatment begins between the first and fourth weeks after a heart attack . Obzidan is prescribed at 120 mg per day in three divided doses for three days, and then continues at 80 mg per day in two divided doses. The highest daily dose is 180-240 mg in three doses.

For symptomatic treatment of hyperthyroidism, take 40 mg three to four times a day.

Obzidan 40mg N60

Indications for use of the drug OBZIDAN®

- arterial hypertension;

- angina pectoris;

- unstable angina (with the exception of Prinzmetal's angina);

— sinus tachycardia (including with hyperthyroidism);

- supraventricular tachycardia;

- atrial fibrillation;

- supraventricular and ventricular extrasystole;

- prevention of myocardial infarction (systolic blood pressure above 100 mm Hg);

- essential tremor;

— migraine (prevention of attacks);

- as a symptomatic treatment of thyrotoxicosis and thyrotoxic crisis (in case of intolerance to thyreostatic drugs);

- sympatho-adrenal crises against the background of diencephalic syndrome.

Dosage regimen

The tablets should be taken orally, before meals, without chewing and with a small amount of liquid.

For arterial hypertension, prescribe 40 mg 2 times a day. If the hypotensive effect is insufficient, the daily dose is increased to 120 mg (40 mg 3 times/day) or to 160 mg (80 mg 2 times/day). The maximum daily dose is 320 mg.

For angina pectoris and heart rhythm disturbances, the initial daily dose is 60 mg (20 mg 3 times a day), then the daily dose is increased to 80-120 mg, dividing it into 2-3 doses. The maximum daily dose is 240 mg.

For the prevention of migraine, as well as for essential tremor, the drug is prescribed in an initial dose of 120 mg (40 mg 3 times a day).

To prevent recurrent myocardial infarction, therapy with Obzidan should be started between the 5th and 21st days after myocardial infarction. The drug is prescribed at a dose of 120 mg (40 mg 3 times)/day. for 2-3 days, and then continue taking the drug 80 mg 2 times a day. If necessary, Obzidan can be prescribed at a daily dose of 180-240 mg in 2-3 doses.

For hyperthyroidism (symptomatic therapy), Obzidan is prescribed 40 mg 3-4 times a day.

If renal function is impaired, it is necessary to reduce the initial dose or increase the interval between doses of the drug.

If liver function is impaired, it is necessary to reduce the dose of the drug.

Side effect

From the cardiovascular system: sinus bradycardia, AV block, heart failure, palpitations, myocardial conduction disturbances, arrhythmias, decreased blood pressure, orthostatic hypotension, chest pain, spasm of peripheral arteries, cold extremities.

From the digestive system: dry mouth, nausea, vomiting, diarrhea, constipation, pain in the epigastric region, impaired liver function, change in taste.

From the central nervous system and peripheral nervous system: rarely - headache, insomnia, nightmares, asthenic syndrome, decreased ability for rapid mental and motor reactions, agitation, depression, paresthesia, increased fatigue, weakness, dizziness, drowsiness, confusion or short-term loss memory, hallucinations, tremor.

From the respiratory system: rhinitis, nasal congestion, shortness of breath, bronchospasm, laryngospasm.

Metabolism: hypoglycemia (in patients with type 1 diabetes mellitus), hyperglycemia (in patients with type 2 diabetes mellitus).

From the senses: dryness of the mucous membrane of the eyes (decreased secretion of tear fluid), impaired visual acuity, keratoconjunctivitis.

From the reproductive system: decreased libido, decreased potency.

Dermatological reactions: alopecia, exacerbation of psoriasis, increased sweating, skin hyperemia, exanthema, psoriasis-like skin reactions.

From the endocrine system: decreased thyroid function.

Allergic reactions: skin rash, itching.

Laboratory indicators: agranulocytosis, leukopenia, thrombocytopenia; increased activity of liver transaminases and bilirubin levels.

Other: muscle weakness, back or joint pain, chest pain, withdrawal syndrome.

Contraindications to the use of the drug OBZIDAN®

- AV block of II and III degrees;

- sinoatrial block;

- sinus bradycardia;

— arterial hypotension (systolic blood pressure below 90 mm Hg);

— uncontrolled chronic heart failure stage IIB-III;

- acute heart failure;

— acute myocardial infarction (systolic blood pressure below 100 mm Hg);

- cardiogenic shock;

- pulmonary edema;

— sick sinus syndrome;

- Prinzmetal's angina;

- cardiomegaly (without signs of heart failure);

- vasomotor rhinitis;

- occlusive diseases of peripheral vessels (complicated by gangrene, symptoms of intermittent claudication or pain at rest);

- diabetes;

- metabolic acidosis (including diabetic ketoacidosis);

- bronchial asthma;

- tendency to bronchospastic reactions;

— chronic obstructive pulmonary disease (including history);

- pheochromocytoma (without simultaneous use of alpha-blockers);

- spastic colitis;

- simultaneous use with antipsychotics and anxiolytics (chlorpromazine, trioxazine, etc.);

- simultaneous use with MAO inhibitors;

- lactation period (breastfeeding);

- hypersensitivity to the drug.

The drug should be prescribed with caution in case of AV blockade of the first degree, liver and/or renal failure, hyperthyroidism, myasthenia gravis, chronic heart failure stages I-IIA, pheochromocytoma, psoriasis, a history of allergic reactions, Raynaud's syndrome, during pregnancy, elderly patients, children and adolescents under 18 years of age (efficacy and safety have not been established).

Use of the drug OBZIDAN® during pregnancy and breastfeeding

The use of Obzidan during pregnancy is possible only when the expected benefit to the mother outweighs the potential risk to the fetus. If it is necessary to use it during this period, careful monitoring of the condition of the fetus should be carried out, because Taking Obzidan during pregnancy can cause intrauterine growth retardation, hypoglycemia and bradycardia in the fetus. Obzidan should be discontinued 48-74 hours before birth.

The use of Obzidan is contraindicated during lactation. If it is necessary to use it during this period, breastfeeding should be stopped.

Use for liver dysfunction

If liver function is impaired, it is necessary to reduce the dose of the drug.

Use for renal impairment

If renal function is impaired, it is necessary to reduce the initial dose or increase the interval between doses of the drug.

Storage conditions and periods

List B. The drug should be stored in a place protected from light, out of reach of children at a temperature of 15° to 25°C. Shelf life: 5 years.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Overdose

Signs: fainting, convulsions, bradycardia , decreased blood pressure , arrhythmia , shortness of breath , cyanosis of the fingers or palms, cardiac arrest (with intravenous injection).

Treatment: perform gastric lavage, take activated charcoal ; for AV conduction - administer intravenously up to 2 mg of Epinephrine , Atropine ; for ventricular extrasystole, administer L idocaine ; for arterial hypotension plasma-substituting solutions are administered intravenously ; for convulsions , diazepam is administered intravenously; for bronchospasm - beta-agonists .

Interaction

When the drug is used together with MAO inhibitors an excessive hypotensive effect , so this combination is prohibited; The interval between taking these medications should be more than 14 days.

When used together with R eserpine, Nifedipine, diuretics, ethanol, hydralazine and other antihypertensive drugs, the hypotensive effect of the drug is enhanced.

The hypotensive effect of Obzidan is weakened by glucocorticosteroids, non-steroidal anti-inflammatory drugs, and estrogens .

When used together, Obzidan enhances the effect of uterotonic and thyreostatic drugs and weakens the effect of antihistamines .

Cardiac glycosides, Guanfacine, Reserpine, Methyldopa, and antiarrhythmic drugs increase the risk of or intensify the manifestations of AV block, bradycardia, and heart failure.

Obzidan's analogs

Level 4 ATC code matches:
Sotalol Canon

SotaHEXAL

Propranolol

Sotalex

Anaprilin

The most common analogues of Obzidan: Adrenoblock, Anaprilin, Vero-Anaprilin, Inderal, Inderal LA, Propranobene, Propranolol, Propranolol Nycomed.