Form and composition
A transparent solution of yellow-green color with a brownish tint is packaged in dark glass bottles (volume 25-50 ml), which are sold in cardboard packaging with enclosed instructions for use. A plastic dispenser is inserted into the neck of the bottle.
Active ingredients:
- nitroglycerin in the form of an alcohol solution;
- validol in liquid form (a solution of levomenthol in menthyl isovalerate);
- alcohol tincture of valerian;
- alcohol tincture of lily of the valley.
The taste of the medicine is tart, with a pronounced mint flavor, slightly bitter, the aroma is with a characteristic note of valerian and menthol. The main component is organic nitrate and nitrite with prolonged action.
Composition of the medicinal product
Only a doctor can prescribe medication after tests have been completed to confirm the diagnosis.
Valerian officinalis
This medicine is produced in the form of drops used for internal use. Their contents include:
- Nitroglycerin solution
- Validol or menthol
- Tinctures of lily of the valley, belladonna, valerian
In the pharmacy chain, the medicine is dispensed in bottles made of dark glass. The volume of one is 25 ml. Buying the drug will not put a big dent in your wallet; its price in different regions of Russia ranges from 50 to 70 rubles.
It is important to know! There is a similar medicine on the pharmaceutical market - Carniland drops (sublingual). However, the content of the main components of the product is reduced by 2 times.
Indications and contraindications for use
The drug is prescribed for mild attacks of angina pectoris, for cardioneurosis, to eliminate spasms of smooth muscles.
Votchal drops are introduced into a therapeutic course during the treatment of angina pectoris to relieve pain in the chest area not associated with damage to the coronary vessels.
Contraindications for use:
- age under 18 years;
- pregnancy and lactation;
- myocardial infarction;
- stroke;
- severe hypotension;
- increased intracranial pressure;
- aortic stenosis and collapse;
- toxic pulmonary edema;
- severe anemia;
- hyperthyroidism;
- glaucoma or increased intraocular pressure, regardless of what causes it.
The drug should not be taken by patients who suffer from alcoholism or have undergone treatment. The medicine contains ethyl alcohol. Even a single dose can lead to relapse. Despite the natural ingredients in the composition, the use of drops can cause an allergic reaction. Symptoms of intolerance are similar to side effects.
Read more How to use Hilo-chest eye drops
Votchal drops consist of an alcohol solution of nitroglycerin, validol or menthol, tinctures of lily of the valley, belladonna and valerian. Used as an antianginal, sedative and antispasmodic.
The effectiveness of Votchal drops in relieving attacks of angina, including vasospastic, is largely due to the mutual potentiation of the action of nitroglycerin and menthol. The tolerability of Votchal drops is better than short-acting nitrates: when preparing them, nitroglycerin and menthol are usually mixed in a ratio of 1: 9. The presence of menthol or validol in Votchal drops can reduce the likelihood of headaches induced by nitroglycerin.
Along with the relief of angina attacks, thanks to the moderate sedative effect, Votchal drops are successfully used for cardialgia of various origins, including in patients with somatized depression, vegetative-vascular dystonia, and mitral valve prolapse. It is possible to prescribe Votchal drops for pain caused by spasms of smooth muscles.
Prescribe Votchal drops 10-20 drops 3-4 times a day. They can be applied to sugar or under the tongue; It is recommended to shake the bottle before use.
Adverse effects that may develop when using Votchal drops include headache, arterial hypotension, including orthostatic, nausea, vomiting, as well as dryness and allergic reactions. Votchal drops are contraindicated for hemorrhagic cerebral stroke and hemorrhages in the meninges, acute myocardial infarction with ST segment elevation, aortic stenosis, arterial hypotension and glaucoma.
When recommending Votchal drops, the patient should be warned against using them too often during the day, since this may result in the formation of tolerance to nitroglycerin. During the period of taking the drops, the patient must completely stop drinking alcohol. It is also necessary to keep in mind that Votchal drops, even with established high efficiency in relieving chest pain, are not a full-fledged alternative to standard therapeutic regimens used for stable angina and including (3-blockers, calcium antagonists, as well as antiplatelet drugs and statins.
The history of the development of this drug is associated with the name of the outstanding domestic physician Boris Evgenievich Votchal (1895-1971). B.E. Votchal was born into the family of a corresponding member of the Academy of Sciences of the Ukrainian SSR, Professor E.F. Votchala, one of the founders of plant physiology.
While studying in the 3rd year of the Faculty of Medicine at Kyiv University, B.E. Votchal was drafted into the Armed Forces of Southern Russia. After the defeat of the White Army in Crimea, he was under the threat of reprisals, and therefore completed his studies in Hamburg. In 1922-1924. B.E. Votchal studied in clinical residency at the department of Professor F.G. Yanovsky, in the second half of the 1920s he interned in clinics in Germany, including under the leadership of G. Schotmuller.
Since 1929 B.E. Votchal worked in Moscow under the leadership of RA Luria.DD. Pletneva, M.P. Konchalovsky. During the Great Patriotic War, he served as chief therapist of the 59th Army and the Volkhov Front. In 1945, he became deputy head of the department of military field therapy of the Central
Institute for Advanced Medical Studies (the head of the department is Major General of the Medical Service, Academician of the USSR Academy of Medical Sciences M.S. Vovsi), in 1952 he headed the 2nd Department of Therapy of the same institute. Scientific interests of B.E. Votchala were concentrated in the field of clinical physiology of blood circulation, including the theory of the so-called. peripheral heart, mechanisms for the implementation of the act of breathing and the development of bronchial obstruction. B.E. Votchal developed the design of the first domestic plethysmograph and pneumotachograph. Representatives of the scientific school B.E. Votchala continue to work fruitfully in our country and abroad.
B.E. Votchal is rightfully considered the founder of domestic clinical pharmacology. His well-known monograph “Essays on Clinical Pharmacology” remains relevant today: it insists on the need for careful consideration of the pharmacokinetics and pharmacodynamics of drugs when prescribing them to a particular patient, and special attention is also paid to the substantiation of approaches to the rational choice of drugs. B.E. Votchal masterfully extrapolated the achievements of pharmacology and related biomedical disciplines into real clinical practice: an example of this is his development of a mixture of drugs, currently known as Votchal drops, which made it possible to achieve a significant increase in patient adherence to nitroglycerin treatment.
B.E. Votchal combined the talent of a researcher with the skill of a clinician, enjoyed unquestioned authority among his colleagues and the respect of patients. Among his patients were A.A. Akhmatova and Academician of the USSR Academy of Sciences L.D. Landau.
Side effects and overdose
During treatment, the following may appear: dizziness, arrhythmia, nausea, dry mouth. The following were noted: disturbance of consciousness, orthostatic collapse, development of arrhythmia, bradycardia, Quincke's edema.
Most often, side effects develop due to overdose or abuse of the drug. Additional signs: increase or decrease in temperature, convulsions, increased intracranial pressure - up to stroke and coma, apnea, increased sweating.
In case of overdose, you must call an ambulance. While she is driving, the victim needs to be helped at home. If a little time has passed after consumption, it is advisable to rinse the stomach and induce vomiting. If blood pressure drops, the patient is placed on his back, raising his legs above his head, turning it slightly on his side so that the patient does not choke on vomit and mucus.
If the deterioration increases gradually, within 24 hours after administration, then it is too late to rinse the stomach. Help can only be provided in a hospital setting. Can be used: sympathomimetics, plasma expanders. Oxygen pillows are used for additional oxygen supply. For methemoglobinemia (low oxygen levels in the blood), methylene blue is administered. Body functions are supported with symptomatic treatment.
special instructions
Uncontrolled use is addictive, and in the future leads to tolerance to nitrates, which is why you will have to constantly increase the dose or increase the frequency of use. To avoid this effect, ACE inhibitors and calcium antagonists are simultaneously prescribed, and diuretics are added to the therapeutic course. Another method is to adjust the frequency of administration; the drug is taken not 3-4, but 5-6 times a day, without increasing the daily dosage.
Immediately after resorption of Votchal drops, dizziness may appear, which goes away after 15-30 minutes.
If there is a short-term deterioration, drug withdrawal or dosage adjustment is not required. But at this time, sudden movements should be avoided. Before getting up from a lying position, first take an intermediate position - sit down and calm down. It is advisable to wait until blood pressure normalizes.
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During treatment you should avoid alcohol. The drug contains ethyl alcohol; increasing the dose may provoke the development of overdose symptoms. In mild cases this is a decrease in blood pressure, in severe cases it is bradycardia, coma, stroke.
Drug interactions
Do not combine with pharmacological agents that contain menthol and nitroglycerin - for example, with cough lozenges or tablets, cardiac glycosides. Do not take during treatment with Sapropterin - the likelihood of developing arterial hypotension increases.
During pregnancy and lactation
Votchal drops are not prescribed to women carrying a child or during breastfeeding. The medicine contains ethyl alcohol. During these “special” periods, analogues of the original drug are used.
Impact on coordination
Votchal drops slow down nerve impulse conduction, lower blood pressure, and slow down reactions. Therefore, they cannot be used by persons whose professional activities require increased attention, for example, vehicles.
Instructions for use
The drops should be used internally. The required dosage should only be prescribed by a doctor. It depends on a number of factors: the severity of the pathological process, the individual characteristics of the body, etc.
If you look at the annotation, it states that an adult should take 10, 15 and 20 drops once 3 to 4 times a day.
Before taking the medicine, it is recommended to shake the bottle well. For convenience, drops can be poured onto a small piece of sugar and placed under the tongue.
Votchal drops should be used only as prescribed by a doctor, under his strict supervision and for a short time. If you do not adhere to the last rule, nitrates will accumulate in the body. As a result, the body will develop tolerance to the components of the drug. To prevent this from happening, the doctor prescribes the simultaneous use of diuretics, angiotensin-converting enzyme inhibitors, and calcium blockers.
Analogs
Most often, it is recommended to purchase drops as a substitute for the original drug.
Carniland, an antianginal agent with a similar composition (the concentration of all components is 2 times lower). Price - from 60 rub. for 25 ml, from 90 rub. - for 50 ml.
They have a similar effect:
- Coraxan, the active constituent of ivabradine, is used to treat stable angina. Package price - from 1137 rubles.
- Preductal OV in capsules, with the active substance - trimetazidine dihydrochloride. Introduced into a therapeutic course for ischemic disease to relieve angina pectoris, price from 707 rubles.
- Ranexa tablets with ranolazine for the treatment of angina pectoris, price from 2900 rubles.
- Lily of the valley-valerian drops are prescribed for neurocircular dystonia, cardioneurosis, for a symptomatic reduction in blood pressure against the background of stress or emotional instability. Price - up to 50 rubles. This drug is used in pediatric practice.
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In some cases, doctors, instead of Votchal drops, recommend simultaneously taking Nitroglycerin with menthol to enhance the effect and improve the tolerability of the antianginal component. The ratio of organic nitrite and menthol is 1:9.
