Pharmacological properties
Pharmacodynamics. Riboxin is an anabolic drug, has antihypoxic and antiarrhythmic effects. It is a precursor of ATP, takes a direct part in glucose metabolism and promotes the activation of metabolism in conditions of hypoxia and in the absence of ATP. The drug activates the metabolism of pyruvic acid to ensure the normal process of tissue respiration and promotes the activation of xanthine dehydrogenase. Riboxin has a positive effect on the metabolism in the myocardium, in particular, increases the energy balance of cells, stimulates the synthesis of nucleotides, increases the activity of a number of enzymes of the Krebs cycle. The drug normalizes the contractile activity of the myocardium and promotes a more complete relaxation of the myocardium in diastole due to the ability to bind calcium ions that penetrate the cells during their excitation, activates tissue regeneration (especially the myocardium and the mucous membrane of the digestive tract).
Pharmacokinetics. Riboxin is well absorbed in the digestive tract. When administered intravenously, Riboxin is rapidly distributed in tissues, metabolized in the liver, where it is completely utilized in biochemical reactions of the body. It is excreted mainly with urine, to a lesser extent with feces and bile.
Indication
Complex treatment of coronary heart disease (condition after myocardial infarction, angina pectoris), heart rhythm disturbances, intoxication with cardiac glycoside drugs, treatment of cardiomyopathies of various genesis, myocardial dystrophy (against heavy physical exertion, infectious and endocrine genesis), myocarditis, liver diseases (hepatitis, cirrhosis, fatty liver dystrophy), uroproporphyria; prevention of leukopenia during irradiation. to improve visual functions in open-angle glaucoma with normalized intraocular pressure.
Application
Tablets: take orally before meals, without chewing, with sufficient water. The daily dose is determined individually and is for adults 600-2400 mg (3-12 tablets). For adults in the first days of treatment, the daily dose is 600-800 mg (1 tablet 3-4 times a day). If the drug is well tolerated, the dose is increased within 2-3 days from 1200 mg (2 tablets 3 times a day) to 2400 mg.
The duration of the treatment course is from 4 weeks to 1.5-3 months.
For uroproporphyria, the daily dose is 800 mg (1 tablet 4 times a day), the duration of the treatment course is 1-3 months.
Solution for injection. The drug should be administered to adults intravenously by jet or drip (slowly) at a rate of 40-60 drops per minute.
For intravenous drip administration, the drug is diluted in 5% glucose solution or 0.9% sodium chloride solution (up to 250 ml). At the beginning of treatment, 200 mg (10 ml of 2% solution) is administered once a day, later, with good tolerability, the dose can be increased to 400 mg (20 ml of 2% solution) 1-2 times a day. The course of treatment is determined individually, on average it is 10-15 days.
Jet injection is possible for acute heart rhythm disturbances in a single dose of 200-400 mg (10-20 ml of 2% solution).
Contraindication
Hypersensitivity to the drug. gout, hyperuricemia. Restrictions on taking the drug - renal failure.
Side effects
Immune system, skin and subcutaneous tissue disorders: allergic/anaphylactic reactions including rash, itching, redness of the skin, urticaria, anaphylactic shock.
Cardiovascular system: tachycardia, arterial hypotension, which may be accompanied by headache, dizziness, nausea, vomiting, increased sweating.
From the side of metabolism: hyperuricemia, exacerbation of gout (with prolonged use of high doses).
General disorders: general weakness, changes at the injection site (including hyperemia, itching).
Special instructions
Inosine should not be used for the urgent correction of cardiac disorders.
If itching and skin hyperemia occur, treatment with the drug should be discontinued.
During treatment, it is necessary to monitor the concentration of urea in the blood and urine. A limitation for the use of the drug is renal failure. In renal failure, the drug should be prescribed only when, in the opinion of the doctor, the expected effect exceeds the possible risk of use.
Riboxin tablets contain lactose. Patients with rare hereditary conditions of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Pregnancy and breastfeeding. Studies of efficacy and safety in this group of patients have not been conducted, therefore it should not be used during pregnancy and breastfeeding.
Children: Should not be used in children due to lack of safety data.
The ability to influence the reaction rate when driving vehicles or working with other mechanisms. The drug does not have a negative effect on the ability to drive vehicles and work with complex mechanisms.
Interactions
When using the drug simultaneously with other medications, it is possible:
with heparin: enhanced effects of heparin, increased duration of its action;
with cardiac glycosides: prevention of arrhythmias, enhancement of positive inotropic effect.
When used simultaneously with β-adrenergic blockers, the effect of Riboxin does not decrease.
Simultaneous use with nitroglycerin, nifedipine, furosemide, spironolactone is possible.
Incompatibility: The drug should not be mixed with other drugs in the same syringe or infusion system.
Use only recommended solvents (see Method of application).
Overdose
Possible increase in symptoms of adverse reactions.
Treatment: Drug withdrawal, symptomatic therapy.
Storage conditions
In the original packaging at a temperature not exceeding 25 °C.
