Instructions for use ANAPRILIN-ZDOROVYE

The medicine Anaprilin does a good job of restoring heart rhythm and lowering blood pressure. However, the use of this drug due to the high risk of side effects is not always possible, so sometimes it is more advisable to use analogues that have a safer effect on the body.

Composition of Anaprilin and its mechanism of action

The active component of Anaprilin is propranolol. The drug belongs to the group of β-receptor blockers. Available in a single dosage form - in the form of tablets containing 10 or 40 mg of the active substance.

Main properties of the medicine:

• hypotensive;
• antiarrhythmic;
• antianginal, that is, reducing the risk of heart attacks.

The pronounced hypotensive effect of the drug is explained by a sharp decrease in the blood supply to the vessels per minute. At the same time, sympathetic stimulation of peripheral blood vessels occurs and the activity of the renin-angiotensin complex is blocked.

Anaprilin blocks a number of nerve endings located in cardiomyocytes, the conduction system of the heart, renal and lipid tissue. As a result of this mechanism of action, the following changes occur:

• heart rate drops;
• the contractile activity and excitability of the myocardium decreases, as a result of which the muscle relaxation time lengthens;
• myocardial oxygen demand decreases.

Blood pressure decreases after taking the first dose of Anaprilin, but finally stabilizes after 1-2 weeks of constant use of the medication. The medicine reduces the severity of dilation of the great vessels, which helps prevent the occurrence of cluster headaches caused by vascular pathologies.

With the use of Anaprilin, tremor of the lower and upper extremities is stopped, so the medicine does a good job of eliminating the symptoms of withdrawal syndrome.

Anaprilin appeared on the pharmacological market more than 50 years ago. The successful practice of its use confirms the high effectiveness of the medicine.

But Anaprilin analogues without side effects have now been developed. But not all of them can have the effects that are characteristic of the original medicine.

Indications for prescribing the medication

Anaprilin in the treatment of hypertension is mainly used at a fairly young age - up to 40-45 years. For older adults, this medication may be contraindicated due to chronic medical conditions.

Among the main indications for prescribing the described medication:

• arrhythmia, manifested in atrial fibrillation and tachysystolic form;
• tachycardia - supraventricular, sinus;
• angina pectoris - unstable and tense;

• initial stages of hypertension;
• cardiopsychoneurosis;
• intoxication with cardiac glycosides.

As an auxiliary drug, Anaprilin is used for thyrotoxicosis, essential tremor, and migraine. The medicine eliminates anxiety well, which, together with its hypotensive and antiarrhythmic properties, helps to cope with a panic attack.

Anaprilin can be used to relieve hangover syndrome. Under the influence of the drug after intoxication with alcoholic beverages, the heartbeat quickens, trembling in the hands goes away, and the headache disappears.

It is forbidden to use Anaprilin while drinking alcohol-containing drinks, since the combination of propranolol with ethanol leads to severe adverse reactions

.
Anaprilin stimulates not only the nerve endings in the heart muscle. The beta blocker also affects the myometrium, the muscular layer of the uterus.

In obstetrics, this mechanism of action of the drug is used after childbirth when it is necessary to stimulate uterine contractility.

Pharmacodynamics and pharmacokinetics

The main active ingredient is propranolol . Anaprilin is a non-selective adrenergic blocker, reduces the sympathetic effect on beta-adrenergic receptors of the heart, reduces the frequency and strength of heart contractions, reduces the contractile function of the myocardium, regulates cardiac output downwards, blocks the positive inotropic and chronotropic effect of catecholamines, reduces the heart's need for oxygen, reduces arterial pressure. The mechanism of action of the drug is aimed at increasing bronchial tone through blockade of beta2-adrenergic receptors. Anaprilin increases the contractility of the uterus, reduces the risk of bleeding during childbirth, the postpartum and postoperative periods.

When taken orally, the drug is quickly absorbed and excreted from the body. The maximum peak content of the active substance in the blood plasma is recorded after 1 -1.5 hours. The drug penetrates the fetoplacental barrier.

Contraindications and possible side effects

The list of pathologies for which the medication is prohibited for use is extensive. The main contraindications to taking the medicine are:

• hypersensitivity to the main and auxiliary components;
• bradycardia - a decrease in the number of heartbeats to 55 or less;
• hypotension;
• acute myocardial infarction;

• bronchial asthma;
• vasomotor rhinitis;
• metabolic acidosis;
• Raynaud's disease;
• cardiogenic shock.

Anaprilin should not be taken by pregnant women, as propranolol increases the activity of the uterus, which can threaten miscarriage. It is also prohibited for breastfeeding women to use it - the components of the medicine can adversely affect the growth and physical development of the child.

For children, Anaprilin is most often prescribed for the complex treatment of thyrotoxicosis. Dosages for a child are selected based on his age, body weight, severity of pathology, and concomitant diseases. For the treatment of other pathologies in childhood, Anaprilin is usually not used until the age of 18.

The most likely adverse reactions to the medication:

• bronchospasm;
• a pronounced decrease in the number of heart contractions;
• weakness of the heart muscle;
• stomach pain;

• vomit;
• bowel disorders;
• depressive states;
• increased fatigue.

Possible overstimulation of the nervous system, allergic skin rashes, sexual dysfunction in men, increased glucose levels in patients with insulin-dependent diabetes, and blurred vision.

If severe adverse reactions are detected, you should stop taking the medication and replace it with analogues of Anaprilin of the new generation.

Instructions for use ANAPRILIN-ZDOROVYE

In patients with diabetes mellitus, caution should be exercised when prescribing propranolol and hypoglycemic agents simultaneously, as propranolol may prolong the hypoglycemic response to insulin and change heart rate.

Class I antiarrhythmic drugs and amiodarone may potentiate the effect of propranolol on atrial conduction time and cause a negative inotropic effect. Propranolol is used with extreme caution in patients receiving concomitant treatment with cardiodepressants (chloroform, ether or related anesthetics), antiarrhythmic drugs (quinidine, lidocaine, procainamide), which may potentiate the depressive effects of propranolol.

Digitalis glycosides, when used concomitantly with beta-blockers, may increase atrioventricular conduction time.

Antihypertensive drugs potentiate the antihypertensive effect of propranolol.

The simultaneous use of propranolol with calcium channel blockers with negative inotropic action (veralamil, diltiazem) may lead to increased negative inotropic action in patients with impaired cardiac function and/or impairment of sinoatrial or atrioventricular conduction, leading to the development of severe hypotension. bradycardia and heart failure. A β-blocker or calcium channel blocker should not be administered intravenously within 48 hours after stopping the other. Concomitant use of dihydropyridine calcium channel blockers (eg, nifedipine) may increase the risk of hypotension and cause heart failure in patients with latent hypotension. The hypotensive effect of propranolol is enhanced when combined with diuretics (hydrochlorothiazide).

Concomitant use of epinephrine, isoproterenol and dobutamine may reduce or block the effects of propranolol. Caution should be exercised when administering drugs containing epinephrine parenterally to patients using propranolol. as this may lead to vasoconstriction, hypertension and bradycardia. Caution should also be exercised when used with drugs such as isoprenaline and norepinephrine.

Propranolol may exacerbate the "withdrawal" hypertension caused by clonidine withdrawal. If these two drugs are used concomitantly, the β-blocker should be discontinued several days before stopping clonidine. When replacing clonidine with a β-blocker, use of the latter should begin several days after stopping clonidine. Reserpine, when used simultaneously with propranolol, can reduce the activity of the sympathetic nervous system, which leads to hypotension, bradycardia, dizziness, fainting, and orthostatic hypotension.

The use of propranolol during a lidocaine infusion may increase lidocaine plasma concentrations by approximately 30%. Patients who have already used propranolol have a greater tendency to have higher lidocaine blood concentrations than those who have not used propranolol.

When using propranolol concomitantly with ergotamine, dihydroergotamine or related drugs, caution should be exercised due to the possibility of vasospastic reactions.

When used concomitantly, prostaglandin synthesis inhibitors (eg, ibuprofen and indomethacin) may reduce the hypotensive effect of propranolol.

The administration of propranolol, like other beta-blockers, together with an anesthetic may result in attenuation of reflex tachycardia and increase the risk of hypotension. The anesthesiologist should be informed about the patient's use of propranolol and the drug with the least negative inotropic effect should be selected as an anesthetic agent.

Propranolol, tricyclic antidepressants and MAO inhibitors mutually potentiate each other's hypotensive effects. With the simultaneous use of propranolol with haloperidol, the development of hypotension and heart failure is possible, with chlorpromazine - an increase in the concentrations of both drugs in the blood plasma, resulting in an increase in the antipsychotic effect of chlorpromazine and the antihypertensive effect of propranolol. Propranolol increases blood concentrations of imipramine.

The simultaneous administration of propranolol with drugs that are metabolized with the participation of cytochrome P450 isoenzymes CYPD6, CYP2C19, CYP1A2 may lead to changes in the effectiveness and tolerability of propranolol. The metabolism of propranolol in the liver increases with a decrease in its level in the blood when used simultaneously with inducers of these enzymes - barbiturates, rifampicin, phenytoin, ethanol; decreases with increasing levels of propranolol in the blood when used simultaneously with enzyme inhibitors - amiodarone, cimetidine, serotonin reuptake inhibitors (fluoxetine, naroxetine, fluvoxamine), quinidine, ritonavir, imipramine. ciprofloxacin, isoniazid, theophylline, zolmitriptan. No interaction of propranolol with ranitidine and lansoprazole has been established.

Allergens used for immunotherapy or allergen extracts for skin testing, when used concomitantly with propranolol, increase the risk of severe systemic allergic reactions or anaphylaxis. Iodine-containing radiocontrast agents, when administered intravenously during propranolol therapy, increase the risk of developing anaphylactic reactions.

Signs of overdose

When using the medication, you must fully comply with all recommendations regarding dose selection and frequency of use. If the instructions are not followed, you may unintentionally exceed the number of tablets. This leads to an overdose of the drug, which manifests itself:

• increased excitement or, conversely, slowing down the speed of reactions;
• dizziness;
• apathy;
• severe headaches;
• panic - increased anxiety, the appearance of a feeling of approaching death;

• deterioration of orientation in space and time;
• blueness of the skin;
• failure of breathing;
• a sharp drop in blood pressure;
• convulsions;
• bradycardia and arrhythmia.

If the above signs appear, you need to rinse your stomach, drink a saline laxative, and 1-2 hours after that, one of the enterosorbents. Further treatment depends on the symptoms of overdose. In case of clinical death, resuscitation measures are carried out. The risk of death from an overdose increases if Anaprilin is taken simultaneously with alcoholic beverages.

Is there a lethal dose of Anaprilin?

A lethal outcome when using “Anaprilin” develops with the simultaneous use of 2 grams of the drug. Death occurs due to impaired blood supply in the arteries of the brain, inhibition of the vasomotor and respiratory centers. Patients die from circulatory and respiratory arrest within 2-3 hours.

Emergency assistance when the first signs of an overdose appear includes:

• rinse the stomach (stimulating vomiting is strictly prohibited);
• take enterosorbents (“White Coal”, “Smecta”);
• upon arrival of the ambulance - connection to intravenous detoxification therapy;
• antidote (antidote): Orciprenaline sulfate (“Ac”);
• glucagon intravenously at a dose of 2-5 mg (bolus), maintenance dose - 1 mg/hour;
• atropine sulfate intravenously 1 mg;
• if you have a dosing syringe: “Isadrin” 1-5 mg/hour or “Dopamine” 5-8 mcg/min.

Patients with signs of acute poisoning with Anaprilin are hospitalized in the intensive care unit.

Dosages of Anaprilin

Anaprilin tablets are taken approximately 30 minutes before meals. They are recommended to be swallowed without chewing and washed down with 100-150 ml of water. To speed up the therapeutic effect, you can put a dissolving tablet under the tongue. But this method of using the medication in most cases leads to temporary numbness of the oral cavity.

The daily dosage depends on the pathology for which Anaprilin is used:

• in the treatment of tachycardia, arrhythmic conditions, thyrotoxicosis, 30 to 160 mg of the drug is required per day;

• during the recovery period after a heart attack, to eliminate tremor, 40 to 160 mg is needed;
• in the treatment of angina pectoris, 80-320 mg of Anaprilin is usually prescribed per day;
• patients with migraines and overexcitement need from 80 to 160 mg per day.

The daily amount of the drug is divided into 3-4 doses. It is advisable to maintain equal intervals between doses.

Dose selection is carried out individually in each case. Treatment should begin with a minimum number of tablets, recording all changes in well-being. If the chosen dose is sufficient to stabilize blood pressure and heart function, then it is worth stopping at it.

People with hypertension during therapy with Anaprilin need to constantly measure their blood pressure. If it decreases significantly, you need to reduce the dose of the medicine.

Treatment lasts on average from three weeks to 2 months. With prolonged use, addiction to Anaprilin may develop, which accordingly reduces its effectiveness.

The drug is withdrawn gradually. Abruptly stopping the use of the pills can lead to a heart attack.

Anaprilin price, where to buy

The price of Anaprilin tablets is 10 rubles per pack of 30 pieces of 40 mg.

You can buy a package of 50 pieces of 10 mg for 20 rubles.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

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Interaction of the drug with other pharmaceuticals

Anaprilin in combination with a number of other drugs can cause perverse reactions. This can manifest itself as a decrease in blood pressure, severe bradycardia, the development of atrioventricular block, and bronchospasm.

Manufacturers of the drug recommend caution if, at the time of its use, patients are forced to take medications such as:

• Adrenalin;

• Salbutamol;
• Lidocaine;
• Verapamil;
• Phenobarbital and its analogues;
• Rifampicin.

When used simultaneously with hypoglycemic oral agents, masking of the main symptoms of hypoglycemia is possible.

Contraindications

Anaprilin is not prescribed for arterial hypotension , intolerance to components, heart failure, atrioventricular block, sinus bradycardia , sinoatrial block , diabetes mellitus, acute myocardial infarction, bronchial asthma, obliterating vascular diseases, metabolic acidosis , tendency to bronchospasm, vasomotor rhinitis , during pregnancy, breast nom breastfeeding

Is Anaprilin discontinued or not?

Many people who have been using Anaprilin for several years note that the drug disappeared from most pharmacy shelves at the end of 2022. Some believe that the inexpensive Anaprilin was discontinued due to the fact that it is more profitable for pharmaceutical companies to produce and sell more expensive medications with a similar composition and mechanism of action.

A number of pharmaceutical companies do not comment on the lack of cheap medicine in pharmacies. Others claim that Anaprilin will be available for sale at the same price after its re-registration. The uninterrupted supply of the medicine to the market is planned for the fall of 2022.

Structural analogues of Anaprilin

Substitutes for a medicine available to the majority of the population may also contain propranolol or substances with a similar pharmaceutical effect. The first are called structural analogues, their names are synonyms for Anaprilin. Basically, they are no different, and therefore have the same indications, contraindications for use and similar features of use. The only difference may be the cost of the product.

Table of structural analogues

Such drugs as Atobene and Propamin are also considered structural substitutes. However, they are not available in Russian pharmacies.

Anaprilin or Concor - which is better for tachycardia

Manufacturer: Takeda Pharmacytilax, Germany
Release form: tablets

Active ingredient: bisoprolol hemifumarate

Concor is an analogue of Anaprilin tablets, which is a selective beta1-blocker, without its own symptomatic activity.

Concor is recommended to be taken for high blood pressure, ischemia, and heart failure, regardless of type. Before starting the course, it is necessary to take into account contraindications and drug interactions. You should not take the analogue during pregnancy and breastfeeding.

As for the reviews, they are positive, since if all recommendations and dosage are followed, a positive effect is observed.

Analogues by mechanism of action

New generation drugs are considered modern substitutes for Anaprilin. They can be either imported or domestically produced. Some of them help better with arterial hypertension, others effectively and without side effects normalize the heart rhythm. Therefore, select them taking into account the course of the disease in a particular person.

The safety of new drugs is mainly due to the fact that they contain substances that selectively block beta receptors. Thus, such drugs can only affect certain organs, which is not typical for Anaprilin.

The list of analogues similar in therapeutic effect to Anaprilin includes:

• Bisoprolol
  . The drug contains bisoprolol fumarate. The drug is endowed with complete similarity to the original, has a hypotensive and antiarrhythmic effect, and helps prevent attacks of arrhythmia. Produced in Israel, Russia, Ukraine. Dosage form: film-coated tablets. Cost - from 50 rubles per package.

• Metoprolol
  . The active ingredient is metoprolol tartrate. Produced in Russia, Bulgaria, Germany, Slovakia. Refers to blood pressure lowering and antiarrhythmic drugs. The cost of tablets starts from 20 rubles.

• Nebivolol
  . Contains nebivolol. Used in the treatment of angina pectoris and arterial hypertension. Produced in Germany, the price is on average 150 rubles.

• Serdol
  . Complete structural analogue of Metoprol. The manufacturing company is located in Romania.

• Sotahexal
  . The main component is sotalol. Belongs to the group of antiarrhythmic drugs. It has an extensive list of contraindications. The drug is produced by a German company. The cost of a package of 20 tablets starts from 120 rubles.

• Kapoten
  . The Russian medicine is based on captopril. The drug is intended only to lower blood pressure. The cost is about 100 rubles.

A replacement for Anaprilin should be selected taking into account the characteristics of the drug’s effect on the body.

What it is?

Anaprilin has been one of the most popular non-selective beta-blockers for over 50 years; it lowers blood pressure and reduces pain. The drug itself, like anaprilin substitutes, has a good therapeutic effect and is affordable.

The medicine has a negative ionotropic effect, normalizes the heartbeat, inhibits conductivity and excitability, as well as the tendency of the myocardium to contract.

Taking the drug is recommended for different patients in case of hypertension, tachycardia, to prevent myocardial infarction, with panic attacks and unstable emotional states, it reduces pain of vascular etiology and calms tremors of the extremities.

Due to the specific nature of the drug’s action and possible side effects, it is strictly recommended to use the medicine only as directed and under the supervision of a physician.

Rules for selecting analogues

Anaprilin is a well-known medicine in Russia. Thousands of people constantly or periodically resort to his help, and this applies not only to the elderly, but also to young patients with chronic diseases. Therefore, in the absence of an original medicine, certain difficulties arise in selecting a suitable pharmaceutical product.

It must be taken into account that not all analogues are able to simultaneously reduce blood pressure and relieve arrhythmia.

To avoid purchasing an ineffective medication, you must first carefully study the instructions.

When choosing a medication, several criteria should be taken into account:

• The medicine should not contain components that can lead to a sharp deterioration in health. This is especially true for patients with a predisposition to drug allergies.
• It is advisable to select the analogue that has the smallest list of contraindications. It is imperative to pay attention to the risk of developing adverse reactions;
• You should not purchase drugs that are at the experimental production stage. Their full effect on the body has not been sufficiently studied, so when using them it is difficult to predict the risk of unwanted effects.
• Medicines in solutions intended for injection act faster. However, they are more often used in acute conditions and are not suitable for a long course.

• Daily doses of Anaprilin analogues, frequency of use and course duration may differ significantly from the nuances of using the original. The development of a therapeutic effect may also depend on when the medication is administered - before or after meals.

It is best to purchase previously unused drugs with the smallest number of capsules or tablets in the package. This will save money if an adverse reaction occurs to the drug.

conclusions

"Anaprilin" is a non-selective blocker of beta-aderenergic receptors, which is often used in cardiology to treat arterial hypertension of various origins, improve the well-being of patients with coronary heart disease and neurological disorders. A wide range of effects requires dose adjustment with monitoring of the functional state of the body and drug interactions with other pathogenetic drugs. The presence of high-quality and safer substitutes on the pharmaceutical market allows the doctor to choose the most optimal treatment for each patient.

What to choose for treatment - Anaprilin or analogues

Anaprilin attracts many, first of all, with its low cost and optimal effectiveness. Analogue drugs should be selected if adverse reactions to Anaprilin have previously occurred. In such situations, medications that do not contain propranolol are more suitable for replacement.

Blood pressure-lowering analogues with the least likelihood of adverse reactions are best used if only hypertension is a concern. Anaprilin substitutes may be required if the original is used for too long, as long-term use can lead to addiction.