Cordarone for atrial fibrillation - what is important for the patient to know

A good remedy for ari. The medicine is used to treat one of the most common problems of the cardiovascular system, which is called cardiac arrhythmia. In addition to counteracting arrhythmia, the new drug has an anesthetic effect and can also be used to block sodium channels. It is important to remember that medication used without a prescription, like most others, can be harmful. Due to adverse reactions of the body and contraindications to the use of the medicine, it is recommended to use it only after consulting a doctor.

Release form and composition

The drug is presented in the form of biconvex round white tablets. The main active ingredient is propafenone hydrochloride. Microcrystalline granulated cellulose, sodium lauryl sulfate, titanium dioxide, magnesium stearate, and copovidone are used as excipients. The drug goes on sale in cardboard packaging.

The drug "Propanorm" belongs to the group of arrhythmic drugs. Reviews from cardiologists show that the main active component blocks fast sodium channels. The local anesthetic effect provided by the drug practically corresponds to the activity of procaine. The effect of propafenone begins within an hour after taking the tablets orally. The maximum effect is achieved after 3 hours. The effect of the drug lasts for 12 hours.

Indications

In most cases, the medication is prescribed for the manifestation of ventricular and supraventricular extrasystoles. To avoid the development of the disease, tablets can also be prescribed for the purpose of prevention. The drug is also indicated for the treatment of such abnormalities as paroxysmal deviations of heart rate, ventricular-atrial tachycardia, monomorphic ventricular tachycardia.

Patients who have impaired liver function should be prescribed Propane tablets with caution. Analogs should also be taken after prior consultation with a doctor. In most cases, the medicine can be prescribed in a reduced dosage (20-30% of the usual dose). Patients with excessive body weight, as well as patients over 70 years of age, undergo treatment strictly under the supervision of a doctor. The first dose of tablets is monitored by ECG.

Propanorm can be prescribed to pregnant women if the expected benefit to the mother outweighs the potential harm to the baby. The decision on dosage is made by the cardiologist in accordance with the individual characteristics of the patient’s body.

Treatment of arrhythmia

There are two strategies in the treatment of patients with atrial fibrillation:

1. restoration of sinus rhythm using antiarrhythmic drugs or electrical cardioversion followed by prevention of relapse
2. control of heart rate in combination with anticoagulant or antiplatelet therapy for persistent AF

The rate control strategy for atrial fibrillation also involves anticoagulation. According to ACC/AHA/ESC guidelines (2006), antithrombotic therapy for atrial fibrillation involves taking aspirin or warfarin. To select therapy, risk factors (mild, moderate or high risk) are important:

The results of the multicenter studies RACE and AFFIRM did not reveal significant differences in the prognosis of patients when comparing rhythm control strategies and heart rate control in atrial fibrillation. However, most doctors strive to restore and maintain sinus rhythm in recurrent AF. The main reason for choosing this treatment strategy is a significant reduction in the risk of thromboembolic complications, as well as the prevention of electrophysiological and structural remodeling of the atria.

According to international recommendations (ACC/AHA/ESC, 2006), the following forms of MA are distinguished:

1. new: paroxysmal or persistent atrial fibrillation
2. recurrent: paroxysmal or persistent atrial fibrillation
3. constant

Contraindications

You should not take Propanorm tablets without a doctor’s recommendation. Reviews from cardiologists show that the medicine has many contraindications. Under no circumstances should the medication be taken for abnormalities such as arterial hypotension, severe heart failure, bradycardia, myocardial infarction, or cardiogenic shock. Before starting treatment, the patient must undergo a complete examination of the body. This will help avoid unpleasant consequences during therapy.

There are age restrictions. Propanorm tablets cannot be prescribed to minor patients. Reviews from cardiologists show that for children there is a separate group of medications that have a mild effect on the cardiovascular system.

special instructions

Propanorm tablets are in most cases prescribed to patients in a hospital setting. This is due to the fact that during the treatment process it is periodically necessary to monitor heart function using an ECG. This is especially important at the beginning of therapy. Great attention is paid to elderly patients whose weight exceeds 80 kg. Do not forget that propafenone has an arrhythmogenic effect. In this regard, the patient’s well-being at the initial stage of treatment may worsen.

Patients with insufficient liver function should start taking the drug after prior consultation with a doctor. In such patients, the bioavailability of propafenone may increase by 70%. In this regard, side effects often develop. The dosage for patients with liver abnormalities is reduced. In addition, laboratory parameters are regularly monitored.

During the period of therapy with Propanorm, it is advisable to refrain from driving a car or any other vehicles. Patients may experience attention disturbance or dizziness.

PROPANORM

Name:

Pavel Rud
Review:
I am 37 years old, in the past I led an unhealthy lifestyle, irritable, explosive in nature, 5 years ago extrasystoles appeared, Holter revealed 500 extrasystoles per day and sinoatrial block of the second degree of the first type, they prescribed treatment with metabolic agents - potassium, magnesium, Mildronate and as the main one - Sotalex, from which I already began to lose consciousness on the 3rd day, the condition was terrible, terrible pauses with failures were added to the interruptions, it seemed to me that I was going to die, by this time I had already been discharged from the hospital, a cardio-arrhythmologist at there is no need to go to Yekaterinburg, the therapist could not help with anything other than metabolism, which kept me more or less normal, I was done with alcohol and nicotine, as a cognitive person began to study his illness, drank various herbs, but something was missing, there were interruptions , I didn’t go to the doctors anymore - I remembered the situation with Sotalex, more and more often I had terrible thoughts about the pacemaker, 5 years passed, one friend who had bypass surgery convinced me of the need to go to the regional hospital in Yekaterinburg, before the trip the Holter showed 2700 extrasystoles + blockade , the arrhythmologist, a young energetic girl, quickly looked at everything and prescribed Propanorm 150 mg 2 times a day, in general, after a week I no longer heard any interruptions, my well-being was like in my school years, after eating there was silence in my chest, and before I ate, the interruption began. malfunction, I’ve been taking it since September, now in March I’m going back for a re-examination, the Holter showed only 36 extrasystoles and a complete absence of blockade, I don’t know where it went but I’m just happy, the quality of life is 100 percent, I forgot to say since January I’ve already been taking 1 tablet per day day, I’m not a doctor, but I noticed in my experience that bee pollen gives good energy to the heart. Here’s a story, I wish everyone not to drag out 5 years like I did - what a fool I was, but to immediately go to a specialist, in general, good luck and health to everyone

Name:

SERGEY KOROBOV
Review:
I read the reviews, everything is the same, I’m on the third day of treatment, today I managed to stop the attack. I hope to extend my working capacity for several years

Name:

SERGEY KOROBOV
Review:
I take one tablet for 40 days, resulting in just one headache attack and it’s not very strong, but after eating I feel interruptions, as well as after a slight exertion.

Name:

Anastasia Parfenova
Review:
I am 37 years old, in the past I led an unhealthy lifestyle, irritable, explosive in nature, extrasystoles appeared 5 years ago, Holter revealed 500 extrasystoles per day and second-degree sinoatrial block of the first type, prescribed treatment with metabolic agents - potassium, magnesium, Mildronate and as the main one - Sotalex, from which I already began to lose consciousness on the 3rd day, the condition was terrible, terrible pauses with failures were added to the interruptions, it seemed to me that I was going to die, by this time I had already been discharged from the hospital, a cardio-arrhythmologist at there is no need to go to Yekaterinburg, the therapist could not help with anything other than metabolism, which kept me more or less normal, I was done with alcohol and nicotine, as a cognitive person began to study his illness, drank various herbs, but something was missing, there were interruptions , I didn’t go to the doctors anymore - I remembered the situation with Sotalex, more and more often I had terrible thoughts about the pacemaker, 5 years passed, one friend who had bypass surgery convinced me of the need to go to the regional hospital in Yekaterinburg, before the trip the Holter showed 2700 extrasystoles + blockade , the arrhythmologist, a young energetic girl, quickly looked at everything and prescribed Propanorm 150 mg 2 times a day, in general, after a week I no longer heard any interruptions, my well-being was like in my school years, after eating there was silence in my chest, and before I ate, the interruption began. malfunction, I’ve been taking it since September, now in March I’m going back for a re-examination, the Holter showed only 36 extrasystoles and a complete absence of blockade, I don’t know where it went but I’m just happy, the quality of life is 100 percent, I forgot to say since January I’ve already been taking 1 tablet per day day, I’m not a doctor, but I noticed in my experience that bee pollen gives good energy to the heart. Here’s a story, I wish everyone not to drag out 5 years like I did - what a fool I was, but to immediately go to a specialist, in general, good luck and health to everyone

Name:

0.
Review:
I have been taking Propanorm for a month now. Prescribed after coronary angiography and RFA. My health has improved. There are no attacks of ventricular flutter or flicker. I just started feeling nauseous. Is the drug discontinued if a side effect occurs, in my case nausea?

Name:

Larisa Noskova
Review:
About ten years ago, arrhythmia appeared. I suffered terribly from seizures. Panic attacks occurred against the background of arrhythmias. I brought myself to this point. that she was afraid to leave the house alone. Three times I was in the arrhythmology department at the regional hospital, they selected various drugs until they found Propanorm. I started taking it and returned to a completely normal life. I took it continuously for seven years. I actually forgot what seizures and arrhythmia are. Well, that’s it... I thought that everything was back to normal and stopped taking it. How I regret this now!!!! Probably six months passed and my rhythm broke down again and the torment began again. I am currently taking Sotahexal. The rhythm seems to be holding, but there is no such effect as from the ancestral norm. Now I’m thinking that I need to switch to proponorm. So if this drug works for you and you feel good, don’t stop drinking and don’t look for anything better. This is far from the worst drug for arrhythmias.

Name:

Svetlana Kazanina
Review:
I have 27,000 parasystoles and extrasystoles. Generally a madhouse. I feel every interruption. This is the second day I’ve been taking Propanorm, I hope it will help me too......

Name:

Nikolai Goncharov
Review:
I am 37 years old, in the past I led an unhealthy lifestyle, irritable, explosive in nature, extrasystoles appeared 5 years ago, Holter revealed 500 extrasystoles per day and second-degree sinoatrial block of the first type, prescribed treatment with metabolic agents - potassium, magnesium, Mildronate and as the main one - Sotalex, from which I already began to lose consciousness on the 3rd day, the condition was terrible, terrible pauses with failures were added to the interruptions, it seemed to me that I was going to die, by this time I had already been discharged from the hospital, a cardio-arrhythmologist at there is no need to go to Yekaterinburg, the therapist could not help with anything other than metabolism, which kept me more or less normal, I was done with alcohol and nicotine, as a cognitive person began to study his illness, drank various herbs, but something was missing, there were interruptions , I didn’t go to the doctors anymore - I remembered the situation with Sotalex, more and more often I had terrible thoughts about the pacemaker, 5 years passed, one friend who had bypass surgery convinced me of the need to go to the regional hospital in Yekaterinburg, before the trip the Holter showed 2700 extrasystoles + blockade , the arrhythmologist, a young energetic girl, quickly looked at everything and prescribed Propanorm 150 mg 2 times a day, in general, after a week I no longer heard any interruptions, my well-being was like in my school years, after eating there was silence in my chest, and before I ate, the interruption began. malfunction, I’ve been taking it since September, now in March I’m going back for a re-examination, the Holter showed only 36 extrasystoles and a complete absence of blockade, I don’t know where it went but I’m just happy, the quality of life is 100 percent, I forgot to say since January I’ve already been taking 1 tablet per day day, I’m not a doctor, but I noticed in my experience that bee pollen gives good energy to the heart. Here’s a story, I wish everyone not to drag out 5 years like I did - what a fool I was, but to immediately go to a specialist, in general, good luck and health to everyone

Name:

Lyudmila Stukalova
Review:
I am 37 years old, in the past I led an unhealthy lifestyle, irritable, explosive in nature, 5 years ago extrasystoles appeared, Holter revealed 500 extrasystoles per day and second-degree sinoatrial block of the first type, prescribed treatment with metabolic agents - potassium, magnesium, Mildronate and as the main one - Sotalex, from which I already began to lose consciousness on the 3rd day, the condition was terrible, terrible pauses with failures were added to the interruptions, it seemed to me that I was going to die, by this time I had already been discharged from the hospital, a cardio-arrhythmologist at there is no need to go to Yekaterinburg, the therapist could not help with anything other than metabolism, which kept me more or less normal, I was done with alcohol and nicotine, as a cognitive person began to study his illness, drank various herbs, but something was missing, there were interruptions , I didn’t go to the doctors anymore - I remembered the situation with Sotalex, more and more often I had terrible thoughts about the pacemaker, 5 years passed, one friend who had bypass surgery convinced me of the need to go to the regional hospital in Yekaterinburg, before the trip the Holter showed 2700 extrasystoles + blockade , the arrhythmologist, a young energetic girl, quickly looked at everything and prescribed Propanorm 150 mg 2 times a day, in general, after a week I no longer heard any interruptions, my well-being was like in my school years, after eating there was silence in my chest, and before I ate, the interruption began. malfunction, I’ve been taking it since September, now in March I’m going back for a re-examination, the Holter showed only 36 extrasystoles and a complete absence of blockade, I don’t know where it went but I’m just happy, the quality of life is 100 percent, I forgot to say since January I’ve already been taking 1 tablet per day day, I’m not a doctor, but I noticed in my experience that bee pollen gives good energy to the heart. Here’s a story, I wish everyone not to drag out 5 years like I did - what a fool I was, but to immediately go to a specialist, in general, good luck and health to everyone

Name:

Olga Alexander
Review:
I take one tablet for 40 days, as a result there is only one attack of headache and it is not very strong, but after eating I feel interruptions, as well as after a slight exertion.

Name:

Dyachenko Natalia
Review:
still recommends something.

Name:

Nastenka
Review:
Hello! Are there those who drink it for years, constantly? How are you? I have paroxysmal supraventricular tachycardia and wpw syndrome

Name:

Elena R
Review:
Hello Nastya, I have been taking this drug for three years in the morning and evening, 1 t. At the same time, an RFA operation was performed, but it was unsuccessful. Extrasystole has not gone away. In addition to propanorm, I take 0.25 mg Concor in the morning. My blood pressure is rather low - 100/60. Now they are suggesting to switch to maxomidin, but I very much doubt it. On May 29 I will go to see a cardiologist for a consultation on this issue. Reduces paroxysms. But everything is individual. And after eating it really gets worse, because the load on the heart increases.

Name:

Galina Khalikova (Galaktionova)
Review:
Hello Nastya, I have been taking this drug for three years, morning and evening, 1 t. At the same time, an RFA operation was performed, but it was unsuccessful. Extrasystole has not gone away. In addition to propanorm, I take 0.25 mg Concor in the morning. My blood pressure is rather low - 100/60. Now they are suggesting to switch to maxomidin, but I very much doubt it. On May 29 I will go to see a cardiologist for a consultation on this issue. Reduces paroxysms. But everything is individual. And after eating it really gets worse, because the load on the heart increases.

Name:

Elena Roslik
Review:
My name is Galina, after RFA I felt very good. However, the surgeons managed to get to the beam only the second time. Everything was fine until I started treating the spine with VTES (intra tissue electrical stimulation), I went to an arrhythmologist, he prescribed me allapinin, I’ve been drinking it for quite a long time, it helps, but the other day I had a severe allergy, I think it’s allapinin. Without a doctor’s prescription, I started drinking propanorm, I feel better, but my blood pressure has become lower and my pulse is below 60

Name:

Galina Khalikova (Galaktionova)
Review:
Monitor your pulse, it should not be lower than 55 beats per minute.

Name:

Natalya Kolesnikova
Review:
What can you take with chronic hepotension? All drugs for hypertensive patients. And flickering also happens at low pressure. Pulse 150-170 blood pressure - close to 0 and what to do?

Name:

Evgeniy Mataev
Review:
Everyone’s body is different, and reactions to any drug can be completely different. Propanorm is the only drug that copes quite effectively with my periodic flicker due to atrial fibrillation. With long-term therapy in the second year in the spring, for the first time, there was no disruption of the rhythm. According to the effects described in the accompanying document, it does not affect driving in any way. The effect of indirect anticoagulants does not enhance - no adjustments in warfarin doses are required from the age of 16 with constant monitoring of the INR. Does not cause any dryness or dizziness. I didn’t hear anything intelligible about this from “cardiologists-arrhythmologists”. Or they live somewhere in parallel worlds.

Name:

Inna Sotnikova
Review:
Everyone’s body is different, including reactions to any drug that can be completely different. Propanorm is the only drug that copes quite effectively with my periodic flicker due to atrial fibrillation. With long-term therapy in the second year in the spring, for the first time, there was no disruption of the rhythm. According to the effects described in the accompanying document, it does not affect driving in any way. The effect of indirect anticoagulants does not enhance - no adjustments in warfarin doses are required from the age of 16 with constant monitoring of the INR. Does not cause any dryness or dizziness. I didn’t hear anything intelligible about this from “cardiologists-arrhythmologists”. Or they live somewhere in parallel worlds.

Name:

Evgeniy Mataev
Review:
The instructions say that you need to start taking it in a hospital. And they gave me an appointment at home. Afraid!

Dosage

The course of treatment is established by the cardiologist individually for each patient in accordance with the clinical manifestations of a particular disease. The bioavailability of the drug increases if taken after meals. The tablets are swallowed whole with a small amount of liquid. The initial dosage may be 150 mg every 8 hours (three times a day). The daily intake should not exceed 450 mg. Gradually the dose is increased. You should not take Propanorm tablets on your own. Reviews from patients note that only a qualified specialist can determine the required dosage. The maximum daily dose in the middle of the course of treatment can reach 900 mg (divided into three doses).

For elderly patients whose weight exceeds 70 kg, the dosage is reduced. They can take no more than 100 mg at a time. In this case, the daily norm is 300 mg. During treatment, patients periodically undergo heart rhythm monitoring using an ECG machine.

Patients with severe liver dysfunction may be prescribed a dosage that is only 30% of the standard dose. If positive dynamics are observed, the daily norm may be slightly reduced. Treatment takes place in a hospital setting.

Arrhythmia treatment tactics

Indications for restoration of sinus rhythm at the prehospital stage:

• Duration of MA < 48 hours.
• Duration of AF > 48 hours in combination with hemodynamic disturbances, myocardial ischemia and heart rate > 250 per minute

The following circumstances also support rhythm restoration:

• Symptoms of CHF or weakness increase in the absence of sinus rhythm
• Hypertrophy or severe dysfunction of the LV
• LA size less than 50 mm
• Duration of MA less than 1 year
• Young age of the patient
• Presence of paroxysmal arrhythmia
• Contraindications for long-term anticoagulant therapy

Indications for hospitalization

1. Newly diagnosed atrial fibrillation.
2. Paroxysmal form in case of ineffectiveness of antiarrhythmic drugs.
3. Paroxysmal form, accompanied by hemodynamic disorders or myocardial ischemia, which was managed with the help of antiarrhythmic drugs or with the help of electrical cardioversion.
4. Complications of antiarrhythmic therapy, side effects from the use of drugs.
5. Frequently recurrent paroxysms of AF (for the selection of antiarrhythmic therapy).
6. A permanent form of arrhythmia against the background of high tachycardia and increasing heart failure (for correction of antiarrhythmic therapy).

Overdose

As soon as the patient only twice exceeds the norm recommended by the doctor, he will feel the symptoms of intoxication. Therefore, strictly on the recommendation of a specialist, you should use Propanorm tablets. Reviews from doctors show that dizziness and nausea appear first. In addition, the patient may feel dry mouth, and his blood pressure decreases.

Overdose treatment can only take place in a hospital setting. First of all, gastric lavage is performed. In the future, symptomatic therapy gives good results. The patient is administered Dobutamine and Diazepam. In the most difficult cases, ventilation of the lungs is performed, as well as indirect cardiac massage.

Side effects

Unpleasant symptoms can also be observed if the patient takes the drug in the dosage recommended by the doctor. It is worth studying the full information about the medication before you start taking Propanorm tablets. Instructions for use, reviews - all this can be obtained from your doctor. Most often, side effects occur in the digestive system at the beginning of the course. The patient may feel nausea or loss of appetite. In rare cases, diarrhea occurs. All these symptoms are reversible and do not require any treatment.

Side effects from the central nervous system may include dizziness, pain in the temples, confusion, and sleep disturbances. At the beginning of treatment, the patient may feel excessively tired. All this is not a reason. Reviews from cardiologists show that any side effects disappear within a week after the start of therapy.

Pay attention to allergic reactions. The patient may notice rashes on the back and arms. Swelling of the limbs and face should alert you. The most dangerous is Quincke's edema. As soon as the patient notices that the neck area is swelling, he should immediately call an ambulance.

Complications of atrial fibrillation

In any form of AF, doctors are primarily afraid of thromboembolic vascular accidents - ischemic strokes and heart attacks. The second most common serious complication of atrial fibrillation and flutter is dilated cardiomyopathy and subsequent heart failure. In rare cases, MA can provoke life-threatening cardiac dysfunction, including cardiac arrest.

Thromboembolic complications.

With atrial fibrillation, the atria contract extremely inefficiently: in fact, they fibrillate or “quiver”, accordingly, the blood stagnates in them. With such hemodynamics, blood clots form in the cavities, which, with the blood flow, enter the left ventricle, from there into the aorta, and then through the arteries into smaller vessels. Blockage of the artery supplying an area of ​​the organ causes a heart attack. Most often (due to anatomical features), emboli “fly” into the carotid arteries, and from there into the vessels of the brain, causing thromboembolic ischemic strokes. According to recent data, every fifth patient with ischemic stroke has atrial arrhythmia. This is why it is critical for patients with AF to take medications that prevent blood clots from forming.

Chronic heart failure.

Against the backdrop of ineffective heart function during AF, it is constantly overloaded. The effect of overload is expressed especially clearly in cases of the tachyform of atrial fibrillation. As a result of constant excessive load and pathological hemodynamics, the chambers of the heart are stretched; dilated cardiomyopathy occurs, leading to circulatory failure.

Drug interactions

Before use, you must carefully study the instructions for the drug "Propanorm". Analogues are also used after all necessary information has been clarified. The fact is that antiarrhythmic drugs are not compatible with all medications. Under no circumstances should tablets be used together with lidocaine. This ratio enhances the cardiodepressive effect.

Propanorm tablets are not taken together with the drug Varvarin. By blocking metabolism, the effect of the latter medication is significantly enhanced. It is also not recommended to use antiarrhythmic drugs in parallel with local anesthetics. The risk of damage to the central nervous system increases.

Do not take the drug “Propanorm” together with drugs that inhibit cerebral hematopoiesis. Instructions for use (tablets) state that such a combination can lead to the development of myelosuppression.

Analogs

What to do if you couldn’t find Propanorm tablets at the pharmacy? A cardiologist can suggest analogues that have good reviews. The drug "Propafenone" is popular. This is an antiarrhythmic drug that can be prescribed for diseases such as supraventricular tachycardia, WPW syndrome, etc. The medication is not prescribed to minor patients, or to women during pregnancy.

"Ritmonorm" is another antiarrhythmic drug that is well reviewed by cardiologists. It is most often used in hospital settings. You will not be able to purchase the medication without a prescription.

Why did Cordarone disappear from pharmacies?

How has Cordarone harmed modern medicine, and why is it not available in pharmacies? This is a question many patients have been asking since the beginning of 2020. It’s clear that the first thing that came to the minds of those who bought it was that the drug was of poor quality or dangerous to health. This is not so, the manufacturer still guarantees the high quality of its product and produces it in accordance with all standards.

The answer to the question of where Cordarone disappeared from pharmacies is much more banal: the medicine simply ran out of warehouses, and Sanofi is convinced that in the near future, the drug will return to the shelves. In the meantime, the French are convincingly asking patients who are in dire need of the action of this drug to temporarily choose some alternative medicine.