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Procoralan 5mg is one of the leading drugs in the treatment of sinus tachycardia. It is effective in treating symptoms of stable chronic angina in people with coronary artery disease and normal sinus rhythm.
1. What is Procoralan 5mg?
Procoralan 5mg brand-name drug includes ivabradin (as hydrochloride) as an ingredient. Procoralan 5mg is a film coated tablet containing 5mg Ivabradine (5,390mg Ivabradine hydrochloride equivalent).
1.1. Indications Procoralan 5mg drug has the generic name Ivabradine. This medication is indicated for the treatment of chronic stable angina pectoris in adults with coronary artery disease with normal sinus rhythm and a heart rate greater than 70 beats/min.
In adults with intolerance or contraindications to beta-blockers. Or in combination with beta-blockers in patients not adequately controlled with optimal doses of beta-blockers. In addition, Procoralan 5mg is also indicated in the treatment of NYHA class II to IV chronic heart failure with systolic dysfunction.
1.2. Pharmacokinetics of the drug About absorption:
Procoralan 5mg drug has the ability to be absorbed into the body quickly and almost completely after oral administration with peak plasma concentrations reaching about 1 hour after taking the drug, if Take medicine on an empty stomach.
The absolute bioavailability of the film-coated tablet is approximately 40%, due to first-pass metabolism in the intestines and liver. Food can delay drug absorption by about 1 hour and increase plasma drug concentrations by 20-30%. It is recommended that Procoralan 5mg be taken with meals to help reduce individual variability in drug concentrations.
Thuốc procoralan 5mg được dùng trong điều trị bệnh lý đau thắt ngực ổn định mạn tính
About distribution:
Procoralan 5mg is approximately 70% bound to plasma proteins and has a steady-state volume of distribution of approximately 100 liters in human subjects.
Regarding the rate of metabolism:
Procoralan 5mg is extensively metabolised in the liver and intestine, by oxidation via cytochrome P450 3A4 (CYP3A4). The major active metabolite is the N-reduced Methyl derivative (S 18982) with a concentration of about 40% of the parent drug ivabradine. Metabolism via this active metabolite is via the CYP3A4 receptor.
Elimination:
Procoralan 5mg is eliminated with a major half-life of 2 hours (70-75% of AUC) in plasma, and an effective half-life of 11 hours.
Overall clearance is about 400ml/min and renal clearance is 70ml/min. Elimination capacity of metabolites in feces and urine in similar amounts. Approximately 4% of an oral dose is excreted in the urine almost intact.
2. Dosage of procoralan 5mg
2.1. How to take Procoralan 5mg is taken orally in the morning and evening with meals.
2.2. Dosage Adults: Symptomatic treatment of chronic stable angina
Initiation or dose adjustment is recommended during cardiac monitoring as well as ECG monitoring or outpatient monitoring. within 24 hours.
The starting dose of ivabradine should not exceed 5 mg twice daily in persons under 75 years of age. After three to four weeks of treatment, if symptoms persist, if the initial dose is well tolerated, and if resting heart rate is above 60 beats/min, a further dose increase should be made in patients receiving 2.5 mg twice daily. times daily or 5 mg twice daily. The maintenance dose should not exceed 7.5 mg twice a day.
If there is no improvement in angina within 3 months after initiation of treatment, treatment with Procoralan 5mg should be discontinued.
If during treatment, the heart rate drops continuously below 50 beats/min at rest or the patient has symptoms related to bradycardia such as dizziness, fatigue or low blood pressure, the therapeutic dose should be adjusted. reduced, possibly to 2.5 mg twice daily (half a 5 mg tablet twice daily). After reducing the therapeutic dose, it is necessary to monitor the heart rate daily. Discontinue treatment if heart rate remains below 50 beats/min or there are signs of bradycardia that persists even after dose reduction.
For the treatment of chronic heart failure
Treatment should be started only in people with stable heart failure conditions. Generally, the recommended starting dose of ivabradine is 5 mg twice daily.
If during treatment, the resting heart rate drops continuously below 50 beats / min or you develop symptoms related to bradycardia, the dose should be reduced to a lower dose in patients are using 7.5mg twice daily or 5mg twice daily.
If the heart rate rises steadily above 60 beats/min at rest, those taking doses of 2.5 mg or 5 mg i.e. 1 tablet twice daily may be titrated to a higher therapeutic dose.
Procoralan 5mg treatment must be discontinued in case the heart rate is maintained below 50 beats/min or signs of bradycardia persist.
Người bệnh nên dùng Procoralan 5mg theo đúng chỉ định
3. Undesirable effects of procoralan 5mg
Undesirable effects when treated with Procoralan 5mg commonly include: bradycardia, headache, dizziness, blurred vision, visual disturbances.
Rare adverse effects such as: supraventricular extrasystoles, palpitations, vomiting, nausea, constipation, diarrhea, dizziness, dyspnea, muscle withdrawal.
The above side effects of the drug are not all undesirable effects that can be experienced. As a result, you may also experience other side effects from the drug. If you have any questions about side effects, please inform and consult your treating doctor.
4. People who need to be careful when using procoralan 5mg
Elderly:
In the elderly 75 years of age and older, a lower therapeutic dose (2.5 mg twice daily equivalent to Procoralan 5 mg twice daily tablet) should be considered before increasing the therapeutic dose. if necessary. Patients with renal impairment:
No dose adjustment is required in patients with renal impairment and creatinine clearance above 15mL/min. There are no data available in patients with renal failure with creatinine clearance less than 15 mL/min. Ivabradine should therefore be used with caution in this regard. Hepatic impairment:
No dose adjustment is required in patients with mild hepatic impairment. Procoralan 5mg should be used with caution in patients with moderate hepatic impairment. Contraindicated to use Procoralan 5mg for people with severe liver failure, because it has not been studied in this subject. Children:
Efficacy and safety of Procoralan 5mg in the treatment of chronic heart failure in children under 18 years of age have not been established.
5. Be careful when using procoralan 5mg
Before using Procoralan 5mg, you should note the following cases:
Hypersensitivity or sensitivity to drug components. Resting heart rate less than 60 beats/min before treatment. Cardiogenic shock, arrhythmia, bradycardia. Acute myocardial infarction Blood pressure is too low (less than 90/50 mmHg). Sudden and unstable chest pain. Severe heart failure. Severe liver failure. Women who are pregnant or breastfeeding. Contraindicated in combination with the following drugs: itraconazole, ketoconazole, erythromycin, HIV-protease inhibitors such as ritonavir, nelfinavir, nefazodone. Note: The dosage mentioned above is for reference only. The specific dose depends on the individual condition and the progression of the disease. For the right therapeutic dose, you need to consult your treating doctor or medical professional.
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