The benefits and harms of Panangin. Instructions for use, indications, price, reviews and analogues

Composition of Panangin

The tablets contain active substances: magnesium aspartate (280 mg) and potassium aspartate (316 mg).
Additional substances: silicon dioxide, corn and potato starch, talc, povidone, magnesium stearate. The shell consists of talc, macrogol 6000, titanium dioxide, methacrylic acid copolymer. The concentrate for Panangin IV solution includes magnesium aspartate (40 mg) and potassium aspartate (45.2 mg), as well as water for injection.

pharmachologic effect

What is the medicine for? It is a source of potassium and magnesium. The drug helps restore electrolyte balance, regulates metabolic reactions and processes, and has a pronounced antiarrhythmic effect.

Potassium takes an active part in synaptic transmission, in the conduction of nerve impulses along fibers, in muscle contractions, and supports the normal functioning of the heart. When potassium metabolism is disturbed, the excitability of muscle tissue and nerves changes. Active ion transport maintains a high potassium gradient across the plasma membrane. Small dosages of potassium contribute to the expansion of the coronary arteries, and in large dosages the microelement narrows their lumen. Potassium has a moderate diuretic effect, negative bathmotropic and chronotropic effects.

Magnesium is a cofactor in three hundred enzyme reactions. Magnesium is an essential element during processes and reactions that provide energy intake and expenditure. Magnesium is part of the pentose phosphate structure of DNA, takes part in the process of cell division and growth, the structure of heredity, and RNA synthesis; is a natural BMCA, prevents the release of free fatty acids and catecholamines during stress, and promotes the penetration of potassium ions into the cell. The drug has a stimulating effect on intercellular phosphate synthesis.

Overdose

It is not recommended to exceed the prescribed dose. An overdose of the drug is possible, manifested by the following symptoms:

excessive levels of potassium and magnesium ions in the blood;
muscle hypotonicity;
problems with the functioning of the heart, even to the point of cardiac arrest;
arrhythmia;
changes on the electrodiogram.

If such signs appear, you should immediately inject a solution of dextrose and sodium chloride intravenously. Depending on the patient's condition, peritoneal dialysis may be required.

Indications for use of Panangin

Indications for the use of Panangin are as follows; the drug is prescribed:

for hypomagnesemia , hypokalemia ;
when taking laxatives and diuretics, glucocorticosteroids;
for diarrhea, persistent vomiting, taking saluretics;
for myocardial infarction, heart failure , digitalis intoxication, ventricular extrasystole , atrial extrasystole , supraventricular tachycardia , paroxysmal tachycardia .

Example of a recipe in Latin: Rp.: Dragee “Panangin” N. 20

Combination with other medications

The drug may enhance the negative effects of antiarrhythmic drugs. Panagin helps to cope with the lack of potassium ions in the blood, which is associated with prolonged use of diuretic medications. Non-steroidal anti-inflammatory drugs, heparin, cyclosporine, increase the likelihood of hyperkalemia. When using general anesthetics, the inhibitory effect of the drug on the central nervous system increases.

Increased neuromuscular blockade can occur under the influence of decamethonium, suxamethonium and atracuronium. The use of astringents and coating agents reduces the absorption of trace elements in the stomach.

The drug improves the tolerability of antiarrhythmic and cardiotonic drugs.

Contraindications for Panangin

The drug is not used for:

intolerance to fructose, sorbitol ;
impaired amino acid metabolism;
chronic pathology of the renal system;
hemolysis;
exicosis;
dehydration;
arterial hypotension;
myasthenia gravis;
atrioventricular block;
hypermagnesemia;
hyperkalemia;
metabolic acidosis;
Addison's disease.

Panangin is used with caution during pregnancy.

special instructions

The drug should be prescribed with caution to patients with an increased risk of developing hyperkalemia. In this case, it is necessary to regularly monitor the level of potassium ions in the blood plasma.

Before taking the drug, the patient should consult a doctor.

With rapid intravenous administration of the drug, skin hyperemia may develop.

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive a car or engage in activities that require increased concentration and speed of psychomotor reactions.

Side effects

Side effects are the following:

ulceration of the mucous wall of the digestive tract;
epigastric pain;
diarrhea;
bleeding from the digestive system;
drop in blood pressure;
bradycardia;
paradoxical reaction in the form of an increase in the number of extrasystoles;
dry mouth, nausea, flatulence ;
hyporeflexia;
itchy skin;
dyspnea;
thrombosis;
phlebitis;
paresthesia;
dizziness;
increased sweating;
asthenia;
myasthenia gravis.

With rapid intravenous infusion, hypermagnesemia and hyperkalemia .

Instructions for use of Panangin (Method and dosage)

Panangin tablets, instructions for use

How to take the medicine? The drug is taken orally three times a day, 2 tablets. Maintenance and preventive therapy: 1 tablet three times a day, course for 3-4 weeks. In some situations, a repetition of the course of therapy is required.

Instructions for intravenous use

Panangin solution is injected intravenously, slowly. The drug is administered at a rate of 20-30 drops per minute, 1-2 times a day, 300 ml. Dosing of the drug Panangin during pregnancy is carried out according to the standard regimen of medication use.

Children can take the medicine from birth.

How to take Panangin for prevention?

If you ask the question of the benefits and harms of Panangin, you should realize that this is a drug that has its own side effects, so you should not use it for prevention. Firstly, in this way you accustom the body to a high content of magnesium and potassium, and secondly, you can provoke an overabundance of these substances, which in turn can cause a lot of negative reactions.

How to use

Pills

The medicine in tablet form is intended for oral administration. You can take 2 tablets three times a day. For maintenance purposes, you can take 1 tablet three times a day. The treatment course is 20-25 days.

In special cases, an additional therapeutic course may be required.

Intravenous administration

Panangin in the form of a solution should be administered intravenously slowly, drip-wise. The rate of administration of the drug should not be more than 25 drops per minute. This procedure can be carried out no more than 2 times a day. No more than 300 ml can be administered at a time. The dosage of the medicine for pregnant women does not require adjustment and is carried out according to the standard scheme.

For prevention purposes

Patients are often interested in questions regarding the benefits and harms of a drug. It is worth understanding that Panangin can cause many negative reactions, so you should not use it for preventive purposes. This is explained by the fact that taking medications will cause the body to become accustomed to a certain content of microelements or may lead to an excess of these microelements in the human body, which will entail many negative consequences.

Interaction

Panangin is able to enhance the negative bathmotropic, dromotropic effects of antiarrhythmic drugs.

The medication eliminates hypokalemia, which develops against the background of long-term use of diuretics, glucocorticosteroids, and MCS.

NSAIDs, ACE inhibitors, Heparin , potassium-sparing diuretics, Cyclosporine , beta-blockers - increase the risk of developing hyperkalemia.

When using general anesthetics, the inhibitory effect of Panangin on the nervous system increases.

Succinyl chloride, decamethonium, atracuronium, suxamethonium enhance neuromuscular blockade.

The use of enveloping and astringent medications reduces the absorption of potassium and magnesium in the digestive tract.

In combination with insulin , dextrose as part of a polarizing mixture, the heart rate is normalized in case of an overdose of cardiac glycosides, in case of ectopic arrhythmias, myocardial infarction .

Panangin improves the tolerability of cardiac glycosides and is pharmaceutically compatible with their solutions.

Panangin 50 pcs. film-coated tablets

pharmachologic effect

Panangin is a drug that affects metabolic processes in the human body.
The drug is a source of magnesium and potassium ions. Potassium and magnesium are intracellular cations that play a major role in the proper functioning of most enzymes. These cations interact with macromolecules and intracellular structures, and also take part in the processes of muscle contraction in the body.

The contractile property of the myocardium depends on the intracellular and extracellular ratio of ions of such substances. Like calcium, magnesium, potassium and sodium. A low content of potassium and magnesium ions in the body can provoke a proarrhythmogenic effect, which will lead to the development of an increase in blood pressure in the vessels, atherosclerosis and the appearance of metabolic changes in the myocardium.

The most important physiological property of potassium is considered to maintain the stability of the membrane potential of neurons and other structures in myocardial tissue. If there is a violation of the relationship between the intracellular and extracellular presence of potassium, this can lead to a decrease in the ability of the myocardium to contract, to the occurrence of disturbances in the heartbeat rhythm, tachycardia, as well as to an increase in the level of toxicity in cardiac glycosides.

Magnesium is a substance necessary for the body to carry out more than three hundred enzymatic interactions of energy metabolism and synthesis in proteins and nucleic acids. Magnesium can reduce the tension that occurs as a result of contraction and heart rate. This leads to a decrease in myocardial oxygen demand. In addition, magnesium can be used to prevent ischemic effects on myocardial tissue.

The simultaneous combination of magnesium and potassium ions in the drug Panangin is based on the fact that potassium deficiency in the body is almost always accompanied by magnesium deficiency and vice versa. In such cases, simultaneous correction of the presence of these ions in the body is necessary. During correction of the levels of these electrolytes, an additive effect can be observed. In addition, magnesium and potassium reduce the toxicity of cardiac glycosides without affecting their effect on the force of heart contractions.

When the medicine is taken orally, it is characterized by high absorption. The drug is excreted in the urine.

Composition and release form Panangin 50 pcs. film-coated tablets

Tablets - 1 tablet.

Active ingredients: potassium aspartate hemihydrate - 166.3 mg, which corresponds to the content of potassium aspartate - 158 mg; magnesium aspartate tetrahydrate - 175 mg, which corresponds to the content of magnesium aspartate - 140 mg;
Excipients: colloidal silicon dioxide - 2 mg, povidone K30 - 3.3 mg, magnesium stearate - 4 mg, talc - 10 mg, corn starch - 86.1 mg, potato starch - 3.3 mg;
Shell composition: macrogol 6000 - 1.4 mg, titanium dioxide Color ind. 77891, E171 - 5.3 mg, butyl methacrylate, dimethylaminoethyl methacrylate and methacrylate copolymer [1:2:1] - 6 mg, talc - 7.3 mg.

Description of the dosage form

White or almost white film-coated tablets, round, biconvex, with a slightly shiny and uneven surface, almost odorless.

Directions for use and doses

Before use, the patient should consult a doctor.

Prescribe 1-2 tablets orally. 3 times/day. The maximum daily dose is 3 tablets. 3 times/day.

The drug should be used after meals, because the acidic environment of the stomach contents reduces its effectiveness.

The duration of taking the drug and the need for repeated courses is determined by the doctor.

Pharmacodynamics

The most important intracellular cations potassium and magnesium play a key role in the functioning of many enzymes, in the formation of bonds between macromolecules and intracellular structures and in the mechanism of muscle contractility. The intra- and extracellular ratio of potassium, magnesium, calcium and sodium ions affects myocardial contractility. Endogenous aspartate acts as a conductor of ions: it has a high affinity for cells, due to the slight dissociation of its salts, ions in the form of complex compounds penetrate into the cell. Potassium and magnesium aspartate improves myocardial metabolism. A lack of potassium and/or magnesium ions predisposes to the development of arterial hypertension, atherosclerosis of the coronary arteries and the occurrence of metabolic changes in the myocardium.

Pharmacokinetics

When taken orally, absorption of the drug is high. Excreted by the kidneys.

Indications for use Panangin 50 pcs. film-coated tablets

As an additional remedy:

in the treatment of chronic heart diseases (heart failure, condition after myocardial infarction);
for heart rhythm disturbances (primarily ventricular arrhythmias);
during treatment with cardiac glycosides.

Replacement therapy for lack of magnesium/potassium in food.

Contraindications

hypersensitivity to the components of the drug;
acute and chronic renal failure;
hyperkalemia;
hypermagnesemia;
Addison's disease;
AV blockade I-III degree;
cardiogenic shock (BP
violation of amino acid metabolism;
myasthenia gravis;
hemolysis;
acute metabolic acidosis;
dehydration of the body.

With caution: pregnancy (especially in the first trimester) and during lactation.

Application Panangin 50 pcs. film-coated tablets during pregnancy and breastfeeding

The drug should be used with caution during pregnancy (especially in the first trimester) and during lactation (breastfeeding).

special instructions

Use for renal impairment

Acute and chronic renal failure, oliguria, anuria.

Particular attention is required for patients with diseases accompanied by hyperkalemia: regular monitoring of the potassium ionogram in the blood plasma is necessary.

Overdose

Symptoms: cardiac conduction disturbances (especially with previous pathology of the cardiac conduction system).

Treatment: intravenous administration of calcium chloride, if necessary, hemodialysis and peritoneal dialysis.

Side effects Panangin 50 pcs. film-coated tablets

From the cardiovascular system: AV blockade, paradoxical reaction (increased number of extrasystoles) are possible.

From the digestive system: possible nausea, vomiting, diarrhea, discomfort or burning sensation in the pancreas (in patients with anacid gastritis or cholecystitis).

From the side of water and electrolyte balance: possible hyperkalemia (nausea, vomiting, diarrhea, paresthesia), hypermagnesemia (redness of the face, thirst, decreased blood pressure, hyporeflexia, respiratory depression, convulsions).

Drug interactions

When used simultaneously with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, ACE inhibitors, NSAIDs, the risk of developing hyperkalemia up to the appearance of arrhythmia and asystole increases.

The use of potassium supplements together with corticosteroids eliminates the hypokalemia they cause.

Under the influence of potassium, a decrease in the undesirable effects of cardiac glycosides is observed.

Strengthens the negative dromo- and bathmotropic effect of antiarrhythmic drugs.

Magnesium preparations reduce the effectiveness of neomycin, polymyxin B, tetracycline and streptomycin.

Anesthetics enhance the inhibitory effect of magnesium on the central nervous system.

When used simultaneously with atracurium, dexamethonium, succinyl chloride and suxamethonium, neuromuscular blockade may be enhanced; with calcitriol - increasing the level of magnesium in the blood plasma.

Calcium supplements reduce the effect of magnesium supplements.

Pharmacokinetic interaction

Astringents and enveloping agents reduce the absorption of the drug in the gastrointestinal tract. It is necessary to observe a 3-hour interval between oral administration of the drug Panangin® with the listed means.

Panangina price, where to buy

The price of Panangin in tablets is about 150 rubles per package No. 50, the price in ampoules is about 160 rubles.

The price of Panangin in Ukraine is 110 and 140 UAH. for tablets and solution, respectively.

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

ZdravCity

Panangin Forte tablets p.p.o.
316mg+280mg 60pcs JSC Gedeon Richter RUB 342 order
Panangin tab. p/o captivity. 158 mg + 140 mg No. 100 JSC "Gedeon Richter-RUS" RU
RUB 285 order
Panangin tab. p/o captivity. 50 pcs JSC "Gedeon Richter-RUS" RU
RUB 159 order
Panangin conc. ready solution d/inf 45.2 mg mg/ml + 0.04 g/ml 10 ml 5 pcs CJSC PharmFirma Sotex
155 rub. order

Pharmacy Dialogue

Panangin (tab.p.pl/rev. No. 50)Gedeon-Richter/Gedeon-Richter-RUS ZAO
172 RUR order
Panangin forte (tab.pl/vol. 316mg+280mg No. 60)Gedeon-Richter
RUR 358 order
Panangin (concentrated solution 10ml No. 5) Gedeon-Richter
RUB 163 order
Panangin (tab.p.pl.vol. 158 mg + 140 mg No. 50) Gedeon-Richter/Gedeon Richter-RUS JSC
162 RUR order
Panangin (tab.p.pl.vol. 158 mg + 140 mg No. 100) Gedeon-Richter/Gedeon Richter-RUS JSC
RUB 304 order

Pharmacy24

Panangin N50 tablets VAT "Gedeon Richter", Ugorshchina
110 UAH. order
Panangin 10 ml No. 5 concentrate for the preparation of solution for infusion VAT "Gedeon Richter", Ugorshchina
142 UAH order

PaniPharmacy

Panangin solution d/in. 10ml No. 5 Hungary, Gedeon Richter
142 UAH order
Panangin tablet p/captivity about. No. 50 Hungary, Gedeon Richter
115 UAH order