Panangin Forte tablets p / o, No. 60

To eliminate the deficiency of potassium and magnesium as part of combination therapy for various manifestations of coronary heart disease (including acute myocardial infarction); chronic heart failure; cardiac arrhythmias (including arrhythmias caused by an overdose of cardiac glycosides).

Before using it is necessary to consult a doctor.
Inside, without chewing and drinking plenty of water.
PananginЃ Forte should be taken after meals, because the acidic environment of the stomach reduces its effectiveness.
Recommended daily dose: 1 tablet 3 times a day.
Maximum daily dose: 1 tablet 3 times a day.

Tablet core
Active ingredients:potassium asparaginate 316.00 mg (in the form of potassium asparaginate hemihydrate 332.60 mg), magnesium asparaginate 280.00 mg (in the form of magnesium asparaginate tetrahydrate 350.00 mg);
Excipients:corn starch 172.20 mg, talc 20.00 mg, magnesium stearate 8.00 mg, potato starch 6.60 mg, povidone K30 6.60 mg, colloidal silicon dioxide 4.00 mg;
Tablet shell : talc 7.30 mg, butyl methacrylate copolymer 6.00 mg, titanium dioxide (color index: CI 77891, E171) 5.30 mg, macrogol-6000 1.40 mg.

Hypersensitivity to any of the constituent components of the drug, acute and chronic renal failure, hyperkalemia, hypermagnesemia, Addison's disease, atrioventricular block I-III degree, shock (including cardiogenic) (blood pressure less than 90 mm Hg), metabolic disorder amino acids, severe myasthenia gravis, hemolysis, acute metabolic acidosis, dehydration, age up to 18 years (efficacy and safety have not been established).

Carefully

Pregnancy (especially in the first trimester of pregnancy) and the period of breastfeeding.

Trade name : PananginЃ Forte

International or group name : Potassium asparaginate + magnesium asparaginate.

Dosage form : film-coated tablets.

Composition for one tablet:

Tablet core
Active ingredients:potassium asparaginate 316.00 mg (in the form of potassium asparaginate hemihydrate 332.60 mg), magnesium asparaginate 280.00 mg (in the form of magnesium asparaginate tetrahydrate 350.00 mg);
Excipients:corn starch 172.20 mg, talc 20.00 mg, magnesium stearate 8.00 mg, potato starch 6.60 mg, povidone K30 6.60 mg, colloidal silicon dioxide 4.00 mg;
Tablet shell : talc 7.30 mg, butyl methacrylate copolymer 6.00 mg, titanium dioxide (color index: CI 77891, E171) 5.30 mg, macrogol-6000 1.40 mg.

Description

Oval, biconvex film-coated tablets, white or almost white, with a slightly glossy surface, engraved with 'A83' on one side, almost odorless. The cross section is white or almost white.

Pharmacotherapeutic group : potassium and magnesium drug.

ATX code : ј12—’

Pharmacological properties

Pharmacodynamics
The most important intracellular cations of potassium (K +) and magnesium (Mg ++) play a key role in the functioning of numerous 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, calcium, sodium and magnesium ions affects myocardial contractility. Endogenous asparaginate 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. Magnesium asparaginate and potassium asparaginate improve myocardial metabolism.
Lack of magnesium / potassium predisposes to the development of arterial hypertension, atherosclerosis of the coronary arteries, arrhythmias and metabolic changes in the myocardium.
Each tablet of PananginЃ Forte contains 280 mg of magnesium asparaginate and 316 mg of potassium asparaginate, which is 2 times higher than the content of active substances in PananginЃ, film-coated tablets. The daily dose of PananginЃ Forte: 1 tablet 3 times a day, corresponds to the daily dose of PananginЃ: 2 tablets 3 times a day. Taking a single dose of PananginЃ Forte in the form of one tablet makes the treatment more convenient for the patient.

Pharmacokinetics
Potassium and magnesium asparaginates are intensively absorbed in the intestine, mainly in the small intestine. Excreted by the kidneys.

Indications for use

To eliminate the deficiency of potassium and magnesium as part of combination therapy for various manifestations of coronary heart disease (including acute myocardial infarction); chronic heart failure; cardiac arrhythmias (including arrhythmias caused by an overdose of cardiac glycosides).

Contraindications

Hypersensitivity to any of the constituent components of the drug, acute and chronic renal failure, hyperkalemia, hypermagnesemia, Addison's disease, atrioventricular block I-III degree, shock (including cardiogenic) (blood pressure less than 90 mm Hg), metabolic disorder amino acids, severe myasthenia gravis, hemolysis, acute metabolic acidosis, dehydration, age up to 18 years (efficacy and safety have not been established).

Carefully

Pregnancy (especially in the first trimester of pregnancy) and the period of breastfeeding.

Application during pregnancy and during breastfeeding

Application is possible if the potential benefit to the mother outweighs the potential risk to the fetus.
Potassium and magnesium asparaginate pass into breast milk. If necessary, taking the drug during breastfeeding, breastfeeding should be discontinued.

Method of administration and dosage

Before using it is necessary to consult a doctor.
Inside, without chewing and drinking plenty of water.
PananginЃ Forte should be taken after meals, because the acidic environment of the stomach reduces its effectiveness.
Recommended daily dose: 1 tablet 3 times a day.
Maximum daily dose: 1 tablet 3 times a day.

Side effect

Possible nausea, vomiting, diarrhea, discomfort or burning sensation in the epigastric region (in patients with anacid gastritis or cholecystitis), atrioventricular block, paradoxical reaction (an increase in the number of extrasystoles), hyperkalemia (nausea, vomiting, diarrhea, paresthesia) (redness of the face) , feeling of thirst, lowering blood pressure, hyporeflexia, respiratory depression, convulsions).

If any of the listed adverse reactions become serious, or you notice the appearance of adverse reactions not listed in this leaflet, you should consult your doctor.

Overdose

The risk of symptoms of hyperkalemia and hypermagnesemia increases.
Symptoms of hyperkalemia: increased fatigue, myasthenia gravis, paresthesias, confusion, heart rhythm disturbances (bradycardia, atrioventricular block, arrhythmias, cardiac arrest).
Symptoms of hypermagnesemia: decreased neuromuscular excitability, nausea, vomiting, lethargy, decreased blood pressure.
With a sharp increase in the content of magnesium ions in the blood: suppression of deep tendon reflexes, respiratory paralysis, coma.
Treatment: symptomatic therapy - intravenous administration of calcium chloride at a dose of 100 mg / min, if necessary - hemodialysis.

Interaction with other medicinal products

Pharmacodynamic interaction
When used together with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs, the risk of hyperkalemia up to the development of arrhythmia and asystole increases. The simultaneous use of potassium preparations with glucocorticosteroids eliminates the hypokalemia caused by the latter. Potassium reduces the unwanted effects of cardiac glycosides. PananginЃ Forte enhances the negative dromo- and batmotropic effect of antiarrhythmic drugs. Magnesium reduces the effects of neomycin, polymyxin B, tetracycline, and streptomycin. Anesthetics increase the inhibitory effect of magnesium preparations on the central nervous system; with simultaneous use with atracuronium, decametonium,succinyl chloride and suxamethonium may increase the neuromuscular blockade. Calcitriol increases the level of magnesium in the blood plasma, calcium preparations reduce the effects of magnesium preparations.

Pharmacokinetic interaction
Drugs with an astringent and enveloping effect reduce the absorption of magnesium asparaginate and potassium asparaginate in the gastrointestinal tract, therefore it is necessary to observe a three-hour interval between taking PananginЃ Forte with the above drugs.

special instructions

Patients with diseases accompanied by hyperkalemia require special attention: regular monitoring of the potassium content in the blood plasma is necessary.

Influence on the ability to drive vehicles and mechanisms

No studies have been conducted. It is not expected to affect the ability to drive vehicles and work with mechanisms that require increased concentration of attention and speed of psychomotor reactions.

Release form

Film-coated tablets, 316 mg + 280 mg.
15 tablets in a PVC / PVDC blister and aluminum foil. 2, 4, 6 blisters, together with instructions for use, are placed in a cardboard box.

Storage conditions

At a temperature not higher than 30 ? C.
Keep out of the reach of children!

Shelf life

2 years.
Do not use after the expiration date printed on the package.

Vacation conditions

Available without a prescription.