Panangin Forte tabs 316mg + 280mg #60

Instruction for Panangin Forte

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Panangin Forte is a preparation of potassium and magnesium.

Form of release and composition

Dosage form - coated tablets: oval, biconvex, with a slightly glossy surface, white or almost white, almost odorless, engraved with "A83" on one side; on a cross-section almost white or white (15 pieces in a blister, in a cardboard box of 2, 4 or 6 blisters).
Composition of Panangin Forte (1 tablet):
    active ingredients: potassium asparaginate (in the form of hemihydrate) - 316 mg, magnesium asparaginate (in the form of tetrahydrate) - 280 mg;
    auxiliary components: colloidal silicon dioxide, magnesium stearate, potato starch, talc, K30 povidone, corn starch;
    shell: macrogol 6000, butyl methacrylate copolymer, talc, titanium dioxide (color index: C.I. 77891, E 171).

Pharmacodynamics

Potassium (K +) and magnesium (Mg ++) cations are the most important intracellular positively charged ions that play a key role in the functioning of numerous enzymes, the formation of bonds between intracellular structures and macromolecules, as well as in the mechanism of muscle contractility. The extra- and intracellular ratio of magnesium, potassium, sodium and calcium ions affects myocardial contractility.
Endogenous asparaginate acts as a conductor of ions, having a high affinity for cells. Due to the slight dissociation of its salts, ions penetrate into the cell in the form of complex compounds. Potassium asparaginate and magnesium asparaginate improve myocardial metabolism. Accordingly, a lack of potassium and magnesium predisposes to the development of metabolic changes in the myocardium, arrhythmias, atherosclerosis of the coronary arteries, and arterial hypertension.

Pharmacokinetics

Potassium asparaginate and magnesium asparaginate, which are part of the drug, are intensively absorbed in the intestine, mainly in the small intestine. Excreted by the kidneys.

Indications for use

According to the instructions, the drug is designed to eliminate the deficiency of magnesium and potassium in the body. It is used as part of complex therapy in such cases:
    various manifestations of coronary heart disease, including acute myocardial infarction;
    cardiac arrhythmias, in particular arrhythmias due to an overdose of cardiac glycosides;
    chronic heart failure.

Contraindications

    hypermagnesemia;
    hyperkalemia;
    acute and chronic renal failure;
    a state of dehydration;
    acute metabolic acidosis;
    violation of amino acid metabolism;
    hemolysis;
    severe myasthenia gravis;
    shock, including cardiogenic (blood pressure less than 90 mm Hg);
    atrioventricular block I – III degree;
    Addison's disease;
    age under 18;
    hypersensitivity to any component of the drug.
Panangin Forte should be used with caution during pregnancy (especially for the first trimester) and breastfeeding.

Instructions for the use of Panangin Forte: method and dosage

The drug is indicated for oral administration. The tablets should be swallowed whole, without chewing, and washed down with plenty of drinking water. It is recommended to take the drug after a meal, since its effectiveness decreases with the acidic environment of the stomach.
Adults need to take 1 tablet 3 times a day.
The duration of therapy is set individually.

Side effects

During the period of taking the drug, in certain cases, the following undesirable reactions were noted:
    diarrhea, nausea, vomiting, burning or discomfort in the epigastric region (in patients with cholecystitis and anacid gastritis);
    paradoxical reaction (increase in the number of extrasystoles), atrioventricular block;
    hypermagnesemia (thirst, hyporeflexia, facial flushing, respiratory depression, decreased blood pressure, convulsions);
    hyperkalemia (diarrhea, nausea, vomiting, paresthesia).

Overdose

If the recommended dose of Panangin Forte is significantly exceeded, the likelihood of developing hypermagnesemia and hyperkalemia increases.
Symptoms of hypermagnesemia:
    nausea, vomiting;
    lowering blood pressure;
    decrease in neuromuscular excitability;
    lethargy.
With a sharp increase in the content of magnesium ions in the blood, suppression of deep tendon reflexes, respiratory paralysis, and coma are possible.
Hyperkalemia symptoms:
    confusion of consciousness;
    increased fatigue;
    paresthesia;
    myasthenia gravis;
    cardiac arrhythmias (arrhythmia, atrioventricular block, bradycardia, cardiac arrest).
Overdose treatment is symptomatic; calcium chloride (100 mg / min) is injected intravenously. If necessary, hemodialysis is performed.

Special instructions

Patients with diseases accompanied by hyperkalemia should be under special supervision. It is necessary to regularly monitor the level of potassium in the blood plasma.

Influence on the ability to drive vehicles and complex mechanisms

Special studies have not been carried out, however, taking into account the pharmacokinetic parameters of Panangin Forte, a negative effect of the drug on the ability to control complex mechanisms and vehicles, as well as to perform other work requiring increased attention, speed of mental and physical reactions, is not expected.

Application during pregnancy and lactation

During pregnancy, especially in the first trimester, the drug should be used with caution and if the expected benefit to the expectant mother outweighs the possible risks to the fetus.
The active substances of Panangin Forte penetrate into breast milk, therefore, lactating women should stop breastfeeding for the period of treatment.

Childhood use

Due to the lack of an evidence base on the safety of using Panangin Forte under the age of 18, this category of patients is not prescribed the drug.

With impaired renal function

Acute and chronic renal failure is a contraindication to taking Panangin Forte.

Drug interactions

The risk of developing hyperkalemia (up to arrhythmia and asystole) increases with the combined use of non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, heparin, cyclosporine, beta-blockers, potassium-sparing diuretics (for example, spironolactone, triamterene).
Panangin Forte enhances the negative batmo- and dromotropic effect of antiarrhythmic drugs.
With the simultaneous use of suxamethonium, decamethonium, succinyl chloride, atracuronium, neuromuscular blockade may increase.
Calcium supplements reduce the effectiveness of magnesium.
Calcitriol increases plasma magnesium levels.
Anesthetics increase the inhibitory effect of magnesium on the central nervous system.
Magnesium reduces the severity of the action of tetracycline, streptomycin, polymyxin B and neomycin.
Potassium reduces the unwanted effects of cardiac glycosides.
Glucocorticosteroids eliminate potassium-induced hypokalemia.
Coating and astringent preparations reduce the absorption of Panangin Forte in the gastrointestinal tract, therefore, 3-hour intervals should be observed between their doses.

Terms and conditions of storage

Store for no more than 2 years out of the reach of children with an ambient temperature of up to 30 ° C.

Reviews

According to reviews, Panangin Forte is a relatively inexpensive and effective remedy that helps to normalize heart function, including heart rate and blood pressure.
Some of the disadvantages include the impossibility of using the drug by patients with kidney disease, as well as the large size of the tablets and, as a result, the inconvenience of taking them.

Terms of sell

You don't need a doctor's prescription to buy Panangin Forte.