Efoksa refers to groups of peripheral vasodilators and antianginal drugs.
Pharmacological action Efoksa
Efoksa is an organic nitrate, the therapeutic effect of the reception which is distributed primarily on the venous vessels. Effect of the drug is directed to the stimulation of nitric oxide in the endothelium of blood vessels. In turn, nitric oxide contributes to the activation of intracellular guanylate cyclase, thereby increasing cGMP.
Efoksa able to reduce preload and afterload on the myocardium, thereby reducing its need for oxygen. Also, the drug has the ability to provide koronarorasshiryayuschee action.
Use Efoksa leads to a decrease in blood flow to the right atrium, resulting in marked regression of symptoms of pulmonary edema and reduced the pressure in the pulmonary circulation. Furthermore, the use Efoksa positive effect on the course of coronary blood flow distribution in the areas with reduced blood circulation.
During the reception Efoksa there is an increase in exercise tolerance in patients with angina and coronary artery disease, vasodilation hard shell GM (may cause pain reactions).
For drug tolerance develops, but after its cancellation or interruption of treatment sensitivity Efoksa soon restored.
Antianginal effect of admission comes after 35-40 minutes after application Efoksa, its duration is from 8 to 10 hours.
Efoksa comes in tablet form, flat and round. Color pills - white, one side is beveled and notch for a break. Over notch discernible engraved "E" under the notch - engraved "20".
One pack contains 10 tablets, packaged in blisters, which in a carton box packed 5 pieces.
According to the instructions Efoksa drug is given to prevent strokes in patients with ischemic heart disease (including patients with prior myocardial infarction), and chronic heart failure, as part of combination therapy.
Efoksa not recommended for use in the following cases:
- In acute circulatory disorders (including vascular collapse and shock);
- In cardiogenic shock in the event that the correction of the left ventricular diastolic pressure using intraaortic counterpulsation or by the introduction of agents affecting inotropic action causes difficulties;
- In severe arterial hypotension (systolic pressure if less than 90 mm. Hg. Art., And diastolic - less than 60 mm. Hg. V.), Hypovolemia;
- In simultaneous reception with phosphodiesterase inhibitors (including sildenafil, tadalafil, vardenafil) because they contribute to strengthening the hypotensive effect of receiving Efoksa;
- Myocardial infarction in the acute form, accompanied by arterial hypotension;
- When severe anemia;
- When hereditary galactose intolerance, lactase deficiency, the syndrome of malabsorption of glucose and galactose;
- During the period of lactation;
- When toxic pulmonary edema;
- If the patient's age less than 18 years;
- with hypersensitivity to any component of the composition Efoksa in particular to organic nitrates.
In some cases, allowed to use the drug, but requires careful medical supervision during the course of treatment. Such conditions include:
- Constrictive pericarditis;
- Hypertrophic obstructive cardiomyopathy;
- Pericardial tamponade;
- The mitral and / or aortic stenosis;
- Myocardial infarction in acute form and other conditions that reduce the pressure in the left ventricle;
- The tendency to hypotension;
- Glaucoma, since there is a risk of increased intraocular pressure;
- Heart failure is accompanied by a low-pressure filling of the left ventricle;
- Diseases accompanied by increased intracranial pressure, including hemorrhagic stroke and head injury recently transferred;
- Renal and / or hepatic impairment;
- Severe anemia.
Instructions for use Efoksa
Tablets Efoksa administered orally, after meals. Chew the medication should not be, you need to drink plenty of water.
Dosage reception Efoksa and duration of treatment and repeated courses of doctor sets, focusing on the patient and the severity of the disease.
Instructions to Efoksa recommended to use the drug to start with small doses: 10 mg of the drug twice a day. Subsequently increasing the dose until a therapeutic recommended: from 20 to 40 mg divided into 1-2 daily administration. If necessary, the daily dose may be increased to 60 mg. Maximum daily dosage Efoksa should not exceed 80 mg.
Side effects Efoksa
Instruction Efoksa warns of the possibility of adverse reactions during treatment with the drug. Among them are noted:
- The headache that occurs at the beginning of the application Efoksa. In most cases, it passes over time. Also recorded dizziness, feeling of fever, facial flushing, tachycardia, decreased blood pressure, confusion, increased heart rate, feeling of weakness, orthostatic collapse, increasing angina attacks, kollaptoidnye state, fainting;
- Vomiting, nausea, dry mouth, sensation of slight burning tongue;
- Blurred vision, drowsiness, stiffness, decrease in the rate of mental and motor responses;
- Skin rash;
- Exfoliative dermatitis;
- The development of tolerance.
Use Efoksa in doses exceeding recommended by the doctor, can lead to overdose, the symptoms of which are presented below:
- Increased heartbeat;
- The decrease in blood pressure, accompanied by orthostatic dysregulation;
- The collapse;
Recommended treatment is a gastric lavage, introduction of the liquid. In some cases the possible input of dopamine and / or norepinephrine in the form of infusion. Enter epinephrine prohibited.
Efoksa antidotes are:
- Vitamin C in the form of its sodium salt. 1g / in;
- Methylene blue. Introduced to 50 ml of a 1% solution of i / v infusion;
- Toluidine blue. First, administered from 2 to 4 mg per 1 kg of body weight / in. Possible re-introduction of one hour in the minimum dosage;
- Hemodialysis, oxygen therapy, exchange transfusion.
Treatment Efoksa not compatible with alcohol.
During use of the drug should be discarded from driving and performing other activities requiring rapid psychomotor reactions.
Abrupt withdrawal Efoksa unacceptable. The dosage should be reduced gradually.
The development of the symptoms of intolerance is the reason for the complete failure of the drug.
Efoksa kept not more than 5 years at a temperature not exceeding the mark of 25 ° C.