Panangin 50 pcs. film-coated tablets

Composition of Panangin

The tablets contain active substances: magnesium aspartate (280 mg) and potassium aspartate (316 mg).
Additional substances: silicon dioxide, corn and potato starch, talc, povidone, magnesium stearate. The shell consists of talc, macrogol 6000, titanium dioxide, methacrylic acid copolymer. The concentrate for Panangin IV solution includes magnesium aspartate (40 mg) and potassium aspartate (45.2 mg), as well as water for injection.

Panangin tablet film x50

PANANGIN

Representative office: GEDEON RICHTER OJSC ATX code: A12CX Registration certificate holder: GEDEON RICHTER, Plc. potassium aspartate &, magnesium aspartate

Release form, composition and packaging Tablets, film-coated, white or almost white, round, biconvex, with a slightly shiny and uneven surface, almost odorless. 1 tab. potassium aspartate hemihydrate 166.3 mg, which corresponds to the content of potassium aspartate 158 mg, magnesium aspartate tetrahydrate 175 mg, which corresponds to the content of magnesium aspartate 140 mg Excipients: colloidal silicon dioxide, povidone, magnesium stearate, talc, corn starch, potato starch.

Film shell composition: macrogol 6000, titanium dioxide (E171), methacrylic acid copolymer (E 100%), talc. 50 - polypropylene bottles (1) - cardboard packs.

The solution for intravenous administration is colorless or slightly greenish, transparent, without visible mechanical inclusions. 1 ml 1 amp. potassium aspartate 45.2 mg 452 mg, which corresponds to the K+ content 10.33 mg 103.3 mg magnesium aspartate 40 mg 400 mg, which corresponds to the Mg2+ content 3.37 mg 33.7 mg Excipients: water d/i. 10 ml - colorless glass ampoules (5) - contour plastic packaging (1) - cardboard packs.

Clinical and pharmacological group: A drug that replenishes the deficiency of potassium and magnesium in the body Registration Nos.: • tablets, film-coated, 158 mg + 140 mg: 50 - P N013093/02, 08/13/07. Validity period of reg. beat is not limited. VED. DLO. • solution for intravenous administration 452 mg + 400 mg/10 ml: amp. 5 - P N013093/01, 08/26/10. Active. VED. DLO. ——————————————————————————— Description of the drug PANANGIN is based on the officially approved instructions for use of the drug PANANGIN for specialists and approved by the manufacturer for the 2013 edition of the year. ——————————————————————————— Pharmacological action | Pharmacokinetics | Indications | Dosage regimen | Side effect | Contraindications | Pregnancy and lactation | Special instructions | Overdose | Drug interactions | Terms of release from pharmacies | Storage conditions and expiration dates ——————————————————————————— Pharmacological action A drug that affects metabolic processes. Source of potassium and magnesium ions.

Potassium and magnesium are intracellular cations that play a major role in the functioning of many enzymes, the interaction of macromolecules and intracellular structures, and in the mechanism of muscle contractility. The intra- and extracellular ratio of potassium, magnesium, calcium and sodium ions affects myocardial contractility. A low level of potassium and/or magnesium ions in the internal environment can have a proarrhythmogenic effect, predisposing to the development of arterial hypertension, atherosclerosis of the coronary arteries and the occurrence of metabolic changes in the myocardium.

One of the most important physiological functions of potassium is maintaining the membrane potential of neurons, myocytes and other excitable structures of myocardial tissue. An imbalance between the intra- and extracellular potassium content leads to a decrease in myocardial contractility, the occurrence of arrhythmia, tachycardia and increased toxicity of cardiac glycosides.

Magnesium is a cofactor in more than 300 enzymatic reactions in energy metabolism and the synthesis of proteins and nucleic acids. Magnesium reduces contractile tension and heart rate, leading to a decrease in myocardial oxygen demand. Magnesium has an anti-ischemic effect on myocardial tissue. Decreased contractility of smooth muscle myocytes in the walls of arterioles, incl. coronary, leads to vasodilation and increased coronary blood flow.

The combination of potassium and magnesium ions in one preparation is justified by the fact that potassium deficiency in the body is often accompanied by magnesium deficiency and requires simultaneous correction of the content of both ions in the body. With simultaneous correction of the levels of these electrolytes, an additive effect is observed, in addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting their positive inotropic effect.

Pharmacokinetics Absorption When taken orally, absorption of the drug is high. Excretion Excreted in urine. Data on the pharmacokinetics of the drug in the form of a solution for intravenous administration are not provided.

Indications for use of the drug PANANGIN - as part of complex therapy for heart failure, myocardial infarction, cardiac arrhythmias (mainly ventricular arrhythmias), - to improve the tolerability of cardiac glycosides, - replenishment of potassium and magnesium deficiency when their content in the diet is reduced (for tablets).

Dosage regimen For oral administration Prescribe 1-2 tablets 3 Maximum daily dose - 3 tablets 3 The drug should be taken after meals, because the acidic environment of the stomach contents reduces its effectiveness.

The duration of therapy and the need for repeated courses are determined by the doctor individually.

For intravenous administration The drug is prescribed intravenously as a drip, as a slow infusion. Single dose - 1-2 ampoules, if necessary, repeated administration after 4-6 hours is possible. To prepare a solution for IV infusion, the contents of 1-2 ampoules. dissolve in 50-100 ml of 5% glucose solution.

Side effects When taken orally From the central nervous system and peripheral nervous system: possible paresthesia (caused by hyperkalemia), hyporeflexia, convulsions (caused by hypermagnesemia). From the cardiovascular system: possible AV blockade, paradoxical reaction (increased number of extrasystoles), decreased blood pressure, redness of the facial skin (due to hypermagnesemia). From the digestive system: possible nausea, vomiting, diarrhea (including those caused by hyperkalemia), a feeling of discomfort or burning in the pancreas (in patients with anacid gastritis or cholecystitis). From the respiratory system: possible - respiratory depression (due to hypermagnesemia). Other: feeling of heat (due to hypermagnesemia).

With intravenous administration With rapid intravenous administration, symptoms of hyperkalemia and/or hypermagnesemia may develop.

Contraindications to the use of the drug PANANGIN

For oral and intravenous administration - acute and chronic renal failure, - oliguria, anuria, - Addison's disease, - AV block II and III degrees, - cardiogenic shock (BP <.90 mm Hg), - hyperkalemia , - hypermagnesemia, - hypersensitivity to the components of the drug.

For oral administration - myasthenia gravis, - AV block of the first degree, - hemolysis, - amino acid metabolism disorder, - acute metabolic acidosis, - dehydration.

The drug should be used orally with caution during pregnancy (especially in the first trimester) and during lactation (breastfeeding), intravenously - with AV blockade of the first degree.

Use of the drug PANANGIN during pregnancy and breastfeeding There is no data on the negative effects of the drug in the form of a solution for intravenous administration during pregnancy and lactation (breastfeeding). The drug should be used orally with caution during pregnancy (especially in the first trimester) and during lactation (breastfeeding).

Use for renal dysfunction Acute and chronic renal failure, oliguria, anuria.

Special instructions The drug should be prescribed with caution to patients with an increased risk of developing hyperkalemia. In this case, it is necessary to regularly monitor the level of potassium ions in the blood plasma. Before taking the drug, the patient should consult a doctor. With rapid intravenous administration of the drug, skin hyperemia may develop.

Effect on the ability to drive vehicles and operate machinery The drug does not affect the ability to drive a car or engage in activities that require increased concentration and speed of psychomotor reactions.

Overdose Symptoms: with intravenous administration - hyperkalemia, hypermagnesemia, with oral administration - impaired cardiac conduction (especially if there is pathology of the cardiac conduction system at the time of drug administration). Treatment: discontinuation of the drug, symptomatic therapy (iv administration of 100 mg/min calcium chloride solution), if necessary, hemodialysis and peritoneal dialysis.

Drug interactions When used simultaneously with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, ACE inhibitors, NSAIDs, the risk of developing hyperkalemia up to the appearance of arrhythmia and asystole increases. The use of potassium supplements together with corticosteroids eliminates the hypokalemia they cause. Under the influence of potassium, a decrease in the undesirable effects of cardiac glycosides is observed.

The drug enhances the negative dromo- and bathmotropic effects of antiarrhythmic drugs. Due to the presence of potassium ions in the drug, when Panangin is used with ACE inhibitors, beta-blockers, cyclosporine, potassium-sparing diuretics, heparin, NSAIDs, the development of hyperkalemia is possible (monitoring the level of potassium in the blood plasma is necessary), with anticholinergic drugs - a more pronounced decrease in intestinal motility , with cardiac glycosides - reducing their effect.

Magnesium preparations reduce the effectiveness of neomycin, polymyxin B, tetracycline and streptomycin.

Anesthetics enhance the inhibitory effect of magnesium on the central nervous system. When used with atracurium, dexamethonium, suxamethonium, neuromuscular blockade may be enhanced; with calcitriol, an increase in the level of magnesium in the blood plasma is observed; with calcium preparations, a decrease in the effect of magnesium ions is observed.

When Panangin is used simultaneously with potassium-sparing diuretics and ACE inhibitors, the risk of developing hyperkalemia increases (the level of potassium in plasma should be monitored).

Conditions for dispensing from pharmacies The drug in the form of a solution for intravenous administration is available with a prescription. Panangin in tablet form is approved for use as an over-the-counter product.

Conditions and periods of storage The drug should be stored at a temperature of 15° to 30°C, out of the reach of children. The shelf life for tablets is 5 years, for solution for intravenous administration - 3 years.

pharmachologic effect

What is the medicine for? It is a source of potassium and magnesium. The drug helps restore electrolyte balance, regulates metabolic reactions and processes, and has a pronounced antiarrhythmic effect.

Potassium takes an active part in synaptic transmission, in the conduction of nerve impulses along fibers, in muscle contractions, and supports the normal functioning of the heart. When potassium metabolism is disturbed, the excitability of muscle tissue and nerves changes. Active ion transport maintains a high potassium gradient across the plasma membrane. Small dosages of potassium contribute to the expansion of the coronary arteries, and in large dosages the microelement narrows their lumen. Potassium has a moderate diuretic effect, negative bathmotropic and chronotropic effects.

Magnesium is a cofactor in three hundred enzyme reactions. Magnesium is an essential element during processes and reactions that provide energy intake and expenditure. Magnesium is part of the pentose phosphate structure of DNA, takes part in the process of cell division and growth, the structure of heredity, and RNA synthesis; is a natural BMCA, prevents the release of free fatty acids and catecholamines during stress, and promotes the penetration of potassium ions into the cell. The drug has a stimulating effect on intercellular phosphate synthesis.

Panangin 50 pcs. film-coated tablets

pharmachologic effect

Panangin is a drug that affects metabolic processes in the human body.
The drug is a source of magnesium and potassium ions. Potassium and magnesium are intracellular cations that play a major role in the proper functioning of most enzymes. These cations interact with macromolecules and intracellular structures, and also take part in the processes of muscle contraction in the body.

The contractile property of the myocardium depends on the intracellular and extracellular ratio of ions of such substances. Like calcium, magnesium, potassium and sodium. A low content of potassium and magnesium ions in the body can provoke a proarrhythmogenic effect, which will lead to the development of an increase in blood pressure in the vessels, atherosclerosis and the appearance of metabolic changes in the myocardium.

The most important physiological property of potassium is considered to maintain the stability of the membrane potential of neurons and other structures in myocardial tissue. If there is a violation of the relationship between the intracellular and extracellular presence of potassium, this can lead to a decrease in the ability of the myocardium to contract, to the occurrence of disturbances in the heartbeat rhythm, tachycardia, as well as to an increase in the level of toxicity in cardiac glycosides.

Magnesium is a substance necessary for the body to carry out more than three hundred enzymatic interactions of energy metabolism and synthesis in proteins and nucleic acids. Magnesium can reduce the tension that occurs as a result of contraction and heart rate. This leads to a decrease in myocardial oxygen demand. In addition, magnesium can be used to prevent ischemic effects on myocardial tissue.

The simultaneous combination of magnesium and potassium ions in the drug Panangin is based on the fact that potassium deficiency in the body is almost always accompanied by magnesium deficiency and vice versa. In such cases, simultaneous correction of the presence of these ions in the body is necessary. During correction of the levels of these electrolytes, an additive effect can be observed. In addition, magnesium and potassium reduce the toxicity of cardiac glycosides without affecting their effect on the force of heart contractions.

When the medicine is taken orally, it is characterized by high absorption. The drug is excreted in the urine.

Composition and release form Panangin 50 pcs. film-coated tablets

Tablets - 1 tablet.

• Active ingredients: potassium aspartate hemihydrate - 166.3 mg, which corresponds to the content of potassium aspartate - 158 mg; magnesium aspartate tetrahydrate - 175 mg, which corresponds to the content of magnesium aspartate - 140 mg;
• Excipients: colloidal silicon dioxide - 2 mg, povidone K30 - 3.3 mg, magnesium stearate - 4 mg, talc - 10 mg, corn starch - 86.1 mg, potato starch - 3.3 mg;
• Shell composition: macrogol 6000 - 1.4 mg, titanium dioxide Color ind. 77891, E171 - 5.3 mg, butyl methacrylate, dimethylaminoethyl methacrylate and methacrylate copolymer [1:2:1] - 6 mg, talc - 7.3 mg.

Description of the dosage form

White or almost white film-coated tablets, round, biconvex, with a slightly shiny and uneven surface, almost odorless.

Directions for use and doses

Before use, the patient should consult a doctor.

Prescribe 1-2 tablets orally. 3 times/day. The maximum daily dose is 3 tablets. 3 times/day.

The drug should be used after meals, because the acidic environment of the stomach contents reduces its effectiveness.

The duration of taking the drug and the need for repeated courses is determined by the doctor.

Pharmacodynamics

The most important intracellular cations potassium and magnesium play a key role in the functioning of many 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, magnesium, calcium and sodium ions affects myocardial contractility. Endogenous aspartate 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. Potassium and magnesium aspartate improves myocardial metabolism. A lack of potassium and/or magnesium ions predisposes to the development of arterial hypertension, atherosclerosis of the coronary arteries and the occurrence of metabolic changes in the myocardium.

Pharmacokinetics

When taken orally, absorption of the drug is high. Excreted by the kidneys.

Indications for use Panangin 50 pcs. film-coated tablets

As an additional remedy:

• in the treatment of chronic heart diseases (heart failure, condition after myocardial infarction);
• for heart rhythm disturbances (primarily ventricular arrhythmias);
• during treatment with cardiac glycosides.

Replacement therapy for lack of magnesium/potassium in food.

Contraindications

• hypersensitivity to the components of the drug;
• acute and chronic renal failure;
• hyperkalemia;
• hypermagnesemia;
• Addison's disease;
• AV blockade I-III degree;
• cardiogenic shock (BP
• violation of amino acid metabolism;
• myasthenia gravis;
• hemolysis;
• acute metabolic acidosis;
• dehydration of the body.

With caution: pregnancy (especially in the first trimester) and during lactation.

Application Panangin 50 pcs. film-coated tablets during pregnancy and breastfeeding

The drug should be used with caution during pregnancy (especially in the first trimester) and during lactation (breastfeeding).

special instructions

Use for renal impairment

Acute and chronic renal failure, oliguria, anuria.

Particular attention is required for patients with diseases accompanied by hyperkalemia: regular monitoring of the potassium ionogram in the blood plasma is necessary.

Overdose

Symptoms: cardiac conduction disturbances (especially with previous pathology of the cardiac conduction system).

Treatment: intravenous administration of calcium chloride, if necessary, hemodialysis and peritoneal dialysis.

Side effects Panangin 50 pcs. film-coated tablets

From the cardiovascular system: AV blockade, paradoxical reaction (increased number of extrasystoles) are possible.

From the digestive system: possible nausea, vomiting, diarrhea, discomfort or burning sensation in the pancreas (in patients with anacid gastritis or cholecystitis).

From the side of water and electrolyte balance: possible hyperkalemia (nausea, vomiting, diarrhea, paresthesia), hypermagnesemia (redness of the face, thirst, decreased blood pressure, hyporeflexia, respiratory depression, convulsions).

Drug interactions

When used simultaneously with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, ACE inhibitors, NSAIDs, the risk of developing hyperkalemia up to the appearance of arrhythmia and asystole increases.

The use of potassium supplements together with corticosteroids eliminates the hypokalemia they cause.

Under the influence of potassium, a decrease in the undesirable effects of cardiac glycosides is observed.

Strengthens the negative dromo- and bathmotropic effect of antiarrhythmic drugs.

Magnesium preparations reduce the effectiveness of neomycin, polymyxin B, tetracycline and streptomycin.

Anesthetics enhance the inhibitory effect of magnesium on the central nervous system.

When used simultaneously with atracurium, dexamethonium, succinyl chloride and suxamethonium, neuromuscular blockade may be enhanced; with calcitriol - increasing the level of magnesium in the blood plasma.

Calcium supplements reduce the effect of magnesium supplements.

Pharmacokinetic interaction

Astringents and enveloping agents reduce the absorption of the drug in the gastrointestinal tract. It is necessary to observe a 3-hour interval between oral administration of the drug Panangin® with the listed means.

Indications for use of Panangin

Indications for the use of Panangin are as follows; the drug is prescribed:

• for hypomagnesemia , hypokalemia ;
• when taking laxatives and diuretics, glucocorticosteroids;
• for diarrhea, persistent vomiting, taking saluretics;
• for myocardial infarction, heart failure , digitalis intoxication, ventricular extrasystole , atrial extrasystole , supraventricular tachycardia , paroxysmal tachycardia .

Example of a recipe in Latin: Rp.: Dragee “Panangin” N. 20

Panangin

The drug Panangin from the Hungarian pharmaceutical belongs to the group of drugs that correct deficiency conditions that develop as a result of a lack of potassium and magnesium ions in the body. Panangin is used mainly in cardiological practice (as a means of complex treatment of heart failure, myocardial infarction and some arrhythmias). The drug contains two components: potassium and magnesium aspartates. The role of these intracellular cations in the body is difficult to exaggerate: they participate in the functioning of a number of enzymes, are actively involved in the formation of connections between intracellular structures and macromolecules, and are one of the tools that ensure muscle contractility. Thus, the contractility of the heart muscle is largely determined by the ratio of potassium and magnesium ions, as well as calcium and sodium in the cells and in the intercellular space. Potassium and magnesium in panangin are contained in the form of aspartate. Endogenous aspartate functions as an ion carrier: it easily binds to cells, and due to the strength of the connection with ions, it penetrates into the cell without losing its valuable “burden”. Potassium and magnesium aspartate stimulate metabolic processes in the myocardium. The lack of these ions is fraught with the development of such cardiovascular pathologies as arterial hypertension, coronary atherosclerosis, not to mention guaranteed metabolic changes in the myocardium. If we talk about potassium, its main function is to maintain the resting membrane potential of nerve and muscle cells at a constant level. An imbalance between intracellular and extracellular potassium levels impairs myocardial contractility, causes cardiac arrhythmias, causes tachycardia, and potentiates the side effects of cardiac glycosides. The presence of magnesium is strictly necessary to ensure the occurrence of more than 300 enzymatic reactions, including energy metabolism and protein biosynthesis.

In addition, magnesium is a “guarantor” of normal heart function: it improves contractility and regulates heart rate, thereby reducing the myocardium’s need for oxygen. Among other extremely useful “options” of magnesium is an increase in coronary blood flow (which is a consequence of the dilation of arterioles), and, consequently, an anti-ischemic (antianginal) effect on myocardial tissue. The combination of potassium and magnesium ions in one preparation is due to the fact that potassium deficiency very often goes side by side with magnesium deficiency, resulting in the need for simultaneous correction of these two deficiency conditions.

Panangin is one of the most famous and, in a good sense, “promoted” potassium and magnesium preparations. Clinical studies have shown that the use of this drug increases the effectiveness of therapy for heart failure and reperfusion arrhythmias (ventricular extrasystoles and tachycardia, ventricular fibrillation). The same reperfusion processes increase the area of ​​ischemic damage to the myocardium. As a result of multicenter trials of panangin, its effectiveness in preventing ischemia and reducing mortality in patients with acute coronary syndrome was confirmed. The role of panangin is also great in maintaining normal electrolyte balance while taking diuretics,

Panangin can be found in pharmacies in two dosage forms: tablets and solution for intravenous administration. It is recommended to take the tablets after meals, because... an aggressively acidic stomach environment will negatively affect the effectiveness of the drug. The duration of the medication course (as well as the need to repeat it) is determined by the doctor in each specific case. In conclusion, we should recall the need to regularly monitor the level of potassium ions in the blood when taking Panangin in patients with an increased risk of developing hyperkalemia.

Contraindications for Panangin

The drug is not used for:

• intolerance to fructose, sorbitol ;
• impaired amino acid metabolism;
• chronic pathology of the renal system;
• hemolysis;
• exicosis;
• dehydration;
• arterial hypotension;
• myasthenia gravis;
• atrioventricular block;
• hypermagnesemia;
• hyperkalemia;
• metabolic acidosis;
• Addison's disease.

Panangin is used with caution during pregnancy.

Is it possible to combine Panangin and Riboxin?

It is necessary to combine medications with caution, having first consulted with your doctor. Riboxin, in addition to increasing cell metabolism and improving the absorption of drugs and other elements into the heart tissue, also enhances myocardial contraction. Taking them together can have a beneficial effect - potassium and magnesium best penetrate the fibers of the heart muscle. On the other hand, this may require adjustment of the dosage of Panangin to ensure that the required amounts of potassium and magnesium are not exceeded, in order to eliminate hyperkalemia.

Side effects

Side effects are the following:

• ulceration of the mucous wall of the digestive tract;
• epigastric pain;
• diarrhea;
• bleeding from the digestive system;
• drop in blood pressure;
• bradycardia;
• paradoxical reaction in the form of an increase in the number of extrasystoles;
• dry mouth, nausea, flatulence ;
• hyporeflexia;
• itchy skin;
• dyspnea;
• thrombosis;
• phlebitis;
• paresthesia;
• dizziness;
• increased sweating;
• asthenia;
• myasthenia gravis.

With rapid intravenous infusion, hypermagnesemia and hyperkalemia .

First meeting

The leaflet tells everything about the tablets. Instructions for use of "Panangin" contain information about the composition, dosage, contraindications, and side effects. The main active ingredients of the tablets are magnesium and calcium.

Potassium is “cement” for the human body

This is the most important component that enables normal functioning. Thanks to potassium, the following points are supported:

• coagulability of red liquid - blood;
• proper functioning of the endocrine gland;
• integrity of teeth, strength of enamel;
• intact, healthy nails – brittleness, splitting, diseases of the corneas signal health problems;
• calm nervous system - microelement deficiency can be immediately determined in people who can flare up due to any little thing; Constant hysterics and tears in women also indicate a lack of this component. Insomnia also indicates this;
• the work of the heart and its muscles directly depends on an important chemical element.

The bulk “lives” in the bones and skeleton. Weak components of the foundation lead to the formation of fractures and cracks. In children, potassium deficiency affects growth and mental retardation. The element interacts closely with neurons, so its absence immediately affects the functioning of almost all organs. The heart, bones, blood, and brain are primarily affected. The following symptoms will help you know about an impending problem:

1. Constant pain in the head, migraines, loss of consciousness, dizziness, the effect of “flying eyes”.
2. The skin becomes covered with a network of cracks, bleeds, and the wounds do not heal well.
3. Nails and teeth deteriorate greatly.
4. Baldness begins, hair comes out in strands.
5. The onset of osteoporosis.
6. Night cramps in legs, calves.
7. Constant lethargy, fatigue.

The second component is magnesium.

While children know about the first element, almost nothing is known about its brother, but it is this element that forms the skeleton, helps the heart beat, calms hormonal changes, and forms the reproductive system. It is inextricably linked with potassium: the elements practically duplicate each other, but the absence of any of them has an extremely negative impact on health. A lack of magnesium is immediately visible. The signs are:

• Dental diseases.
• Baldness.
• Nervous tic of the eyes, twitching of the fingers.
• The vestibular system is disturbed, frequent fainting.
• The general negative state is mental depression, depression.

The symptoms are almost identical, since the elements work in pairs. Pregnant women and young children are particularly affected by deficiency. Expectant mothers give almost everything to the unborn baby, the result being exhaustion and vitamin deficiency. Preschoolers are growing by leaps and bounds. Lack of potassium and magnesium will sharply stop growth and limit mental capabilities. More detailed instructions for Panangin are available here.

Instructions for use of Panangin (Method and dosage)

Panangin tablets, instructions for use

How to take the medicine? The drug is taken orally three times a day, 2 tablets. Maintenance and preventive therapy: 1 tablet three times a day, course for 3-4 weeks. In some situations, a repetition of the course of therapy is required.

Instructions for intravenous use

Panangin solution is injected intravenously, slowly. The drug is administered at a rate of 20-30 drops per minute, 1-2 times a day, 300 ml. Dosing of the drug Panangin during pregnancy is carried out according to the standard regimen of medication use.

Children can take the medicine from birth.

How to take Panangin for prevention?

If you ask the question of the benefits and harms of Panangin, you should realize that this is a drug that has its own side effects, so you should not use it for prevention. Firstly, in this way you accustom the body to a high content of magnesium and potassium, and secondly, you can provoke an overabundance of these substances, which in turn can cause a lot of negative reactions.

Panangin 10 ml No. 5 solution d/in.amp.

Instructions for medical use of the drug

Tradename

Panangin®

International nonproprietary name

No

Dosage form

Concentrate for solution for infusion, 10 ml

Compound

One ampoule contains active ingredients: magnesium aspartate 400.00 mg (as magnesium aspartate tetrahydrate 499.80 mg), potassium aspartate 452.00 mg (as potassium aspartate hemihydrate 475.73 mg), excipients: potassium hydroxide, 10% solution , water for injections.

Description

Transparent, colorless or slightly greenish solution.

Pharmacotherapeutic group

Mineral supplements. Other minerals. ATX code A12СХ

Pharmacological properties

Pharmacokinetics

Potassium and magnesium ions, as important intracellular cations, are involved in the work of a number of enzymes, in the process of binding macromolecules with subcellular elements and in the mechanism of muscle contraction at the molecular level. The ratio of extra- and intracellular concentrations of potassium, calcium, sodium and magnesium ions affects myocardial contractility. Aspartate as an endogenous substance is a carrier of potassium and magnesium ions; has a pronounced affinity for cells, its salts undergo dissociation only to a small extent. As a result, ions penetrate into the intracellular space in the form of complex compounds. Magnesium and potassium aspartate improve myocardial metabolism. Insufficient potassium and magnesium content in the body increases the risk of developing arterial hypertension, atherosclerotic lesions of the coronary vessels, heart rhythm disturbances, and myocardial pathology.

Indications for use

• for additional therapy for chronic heart diseases (for heart failure, in the post-fracture period)
• heart rhythm disturbances, mainly ventricular arrhythmias
• in combination with digitalis preparations

Directions for use and doses

The drug is intended for intravenous administration only. For this purpose, use the contents of 1-2 ampoules in a 5% glucose solution and administer it as an intravenous infusion slowly, drip-wise. If necessary, the dose can be repeated after 4-6 hours. The duration of therapy is determined individually.

The drug is suitable for combination therapy.

The maximum single dose is 2 ampoules (20 ml) of Panangin®; if necessary, re-administration is possible after 4-6 hours.

The maximum daily dose is 4 ampoules (40 ml) of Panangin®.

Use in pediatrics

There are no data on the safety and effectiveness of the drug in children and adolescents under 18 years of age.

Side effects

• the appearance of symptoms of hyperkalemia/hypermagnesemia with rapid administration of the drug (for a description of symptoms, see the section “Overdose”)

Contraindications

• acute and chronic renal failure
• Addison's disease
• III degree atrioventricular block, cardiogenic shock (BP < 90 mm Hg)
• severe hyperkalemia
• hypersensitivity to the components of the drug

Drug interactions

When Panangin® is used simultaneously with potassium-sparing diuretics and/or ACE inhibitors, hyperkalemia may develop.

special instructions

Rapid administration of the drug may cause facial flushing. Caution should be exercised when prescribing the drug to patients with diseases accompanied by hyperkalemia. In this category of patients, it is recommended to regularly examine the concentrations of electrolytes in the blood serum.

Pregnancy and lactation

It is possible to use the drug Panangin® during pregnancy and lactation according to indications.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

When using the drug, care must be taken when driving vehicles or other potentially dangerous mechanisms.

Overdose

With long-term use of the drug, cases of overdose have not been recorded.

Symptoms of hyperkalemia: fatigue, muscle weakness, paresthesia, confusion, cardiac dysfunction (bradycardia, atrioventricular block, arrhythmia, cardiac arrest).

Symptoms of hypermagnesemia: decreased neuromuscular excitability, nausea, vomiting, drowsiness, decreased blood pressure. With a sharp increase in the concentration of magnesium ion in the blood: inhibition of deep tendon reflexes, respiratory paralysis, coma.

Treatment: discontinuation of the drug, symptomatic therapy (intravenous administration of calcium chloride solution at a dose of 100 mg/min, hemodialysis if necessary).

Release form and packaging

10 ml of the drug in colorless glass ampoules with a breaking point.

5 ampoules are placed in a plastic blister pack.

1 blister pack together with instructions for medical use in the state and Russian languages ​​are placed in a cardboard box.

Storage conditions

Store at temperatures between 15°C and 30°C. Keep out of the reach of children!

Shelf life

3 years. Do not use after expiration date.

Conditions for dispensing from pharmacies

On prescription.

Interaction

Panangin is able to enhance the negative bathmotropic, dromotropic effects of antiarrhythmic drugs.

The medication eliminates hypokalemia, which develops against the background of long-term use of diuretics, glucocorticosteroids, and MCS.

NSAIDs, ACE inhibitors, Heparin , potassium-sparing diuretics, Cyclosporine , beta-blockers - increase the risk of developing hyperkalemia.

When using general anesthetics, the inhibitory effect of Panangin on the nervous system increases.

Succinyl chloride, decamethonium, atracuronium, suxamethonium enhance neuromuscular blockade.

The use of enveloping and astringent medications reduces the absorption of potassium and magnesium in the digestive tract.

In combination with insulin , dextrose as part of a polarizing mixture, the heart rate is normalized in case of an overdose of cardiac glycosides, in case of ectopic arrhythmias, myocardial infarction .

Panangin improves the tolerability of cardiac glycosides and is pharmaceutically compatible with their solutions.

Instructions

INSTRUCTIONS FOR MEDICAL USE

PANANGIN®

Trade name of the drug : PANANGIN®

Dosage form : film-coated tablets

Compound:

Each film-coated tablet contains:

active ingredients: potassium aspartate 158 mg (in the form of 166.30 mg potassium aspartate hemihydrate) and magnesium aspartate 140 mg (in the form of 175.0 mg magnesium aspartate tetrahydrate);

Excipients:

core: colloidal anhydrous silicon dioxide, potato starch, povidone, magnesium stearate, talc, corn starch;

film shell: macrogol 6000, titanium dioxide (E 171), eudragit E 100, talc.

Description: White or almost white, film-coated tablets, disc-shaped, with a biconvex, slightly glossy and slightly uneven surface, almost odorless.

Pharmacotherapeutic group: Mineral supplements. Other mineral preparations.

ATX code: A12СХ

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 (K+), calcium (Ca++), sodium (Na+) and magnesium (Mg++) ions affects myocardial contractility. Endogenous aspartate (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 and potassium aspartates 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.

Pharmacokinetics

Magnesium:

The total supply of magnesium in the body of a person weighing 70 kg is on average 24 g (1000 mmol); more than 60% of magnesium comes from bone tissue and about 40% from skeletal muscle and other tissues. About 1% of the total magnesium reserve in the body is found in the extracellular fluid, mainly in the blood serum. In healthy adults, serum magnesium levels range from 0.7 to 1.10 mmol/l.

The recommended dietary intake of magnesium for men is 350 mg per day, for women - 280 mg per day. The need for magnesium increases during pregnancy and breastfeeding.

Magnesium is absorbed from the gastrointestinal tract by active transport. The main regulator of magnesium balance in the body is the kidneys. 3–5% of ionized magnesium is excreted by the kidneys.

An increase in urine volume (for example, during therapy with highly effective loop diuretics) leads to an increase in the excretion of ionized magnesium. If absorption of magnesium in the small intestine is reduced, subsequent hypomagnesemia leads to a decrease in its excretion (<0.5 mmol/day).

Potassium:

The total potassium reserve in the body of a person weighing 70 kg is on average 140 g (3570 mmol). The total potassium reserve is slightly less in women than in men and decreases slightly with age. 2% of the total potassium reserve in the body is located outside the cells, and the remaining 98% is inside the cells.

The optimal intake of potassium with food is 3–4 g (75–100 mmol) per day. The main route of potassium excretion is renal (about 90% of potassium is excreted by the kidneys daily). The remaining 10% is excreted through the gastrointestinal tract. Thus, the kidneys are responsible for long-term potassium homeostasis as well as serum potassium levels. In the short term, blood potassium levels are also regulated by the flow of potassium between the intracellular and extracellular spaces.

Indications for use

• As an additional source of magnesium and potassium.
• As part of combination therapy for chronic heart diseases (chronic heart failure, condition after myocardial infarction), cardiac arrhythmias (mainly ventricular arrhythmias) as prescribed by the attending physician.
• Addition to therapy with cardiac glycosides as prescribed by the attending physician.

Directions for use and doses

Doses

Adults

Usual daily dose: 1-2 tablets 3 times a day. The daily dose can be increased to 3 tablets 3 times a day.

Children and teenagers

There are no data on the safety and effectiveness of Panangin in children and adolescents.

Mode of application

For oral administration.

The drug should be taken after meals, as the acidic environment of the stomach may reduce its effectiveness.

Side effects

Gastrointestinal disorders:

When using high doses of the drug, increased bowel movements may occur.

Reports of suspected adverse reactions

After registration of a medicinal product, it is important to provide information about cases of suspected adverse reactions. This allows for continuous monitoring of the benefit-risk ratio of the drug. Health care professionals are asked to report any suspected adverse reactions using the national reporting system.

Contraindications

• Hypersensitivity to the active substances or to any of the excipients of the drug.
• Acute and chronic renal failure.
• Addison's disease.
• Third degree atrioventricular block.
• Cardiogenic shock (blood pressure less than 90 mm Hg).

Drug interactions

No drug interaction studies have been conducted with Panangin. According to scientific literature, potassium and magnesium may interact with certain medications. When used together with potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, cyclosporine, heparin and non-steroidal anti-inflammatory drugs, the risk of developing hyperkalemia increases.

Tetracyclines used orally, iron salts and sodium fluoride reduce the absorption of the drug from the gastrointestinal tract. The break between taking the above drugs and Panangin should be at least 3 hours.

special instructions

Special warnings and precautions

Patients with diseases accompanied by hyperkalemia require special attention: regular monitoring of electrolyte levels in the blood serum is necessary.

Each film-coated tablet of Panangin contains 36.2 mg of potassium. This should be taken into account in patients with impaired renal function or in patients receiving potassium supplements or potassium-containing dietary supplements.

Use during pregnancy and breastfeeding

To date, no harmful effects have been reported when using the drug in this category of patients.

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive vehicles and other machinery.

Overdose

To date, there have been no reports of cases of overdose with Panangin, even when taking high doses. Given the ability of the kidneys to excrete large amounts of potassium, increasing the dose of the drug can lead to hyperkalemia only against the background of acute and obvious disturbances in potassium excretion.

Magnesium has a wide therapeutic window, and in the absence of renal failure, serious side effects are extremely rare.

According to the literature, oral magnesium supplementation may cause mild side effects such as diarrhea. High doses of Panangin may cause increased stool frequency due to its magnesium content.

When administered intravenously, symptoms of hyperkalemia/hypermagnesemia may develop if administered rapidly.

Symptoms of hyperkalemia: general weakness, paresthesia, bradycardia, paralysis, arrhythmia.

Symptoms of hypermagnesemia: nausea, vomiting, lethargy, decreased blood pressure, bradycardia, weakness, hyporeflexia.

In case of overdose, you should stop taking the drug and carry out symptomatic therapy (intravenous administration of calcium chloride, if necessary, hemodialysis).

Release form

50 film-coated tablets in polypropylene bottles with a sealable cap equipped with a harmonic-shaped polyethylene gasket. The bottle is placed in a cardboard box with attached instructions for medical use.

Storage conditions

Store at a temperature not exceeding 25°C.

Keep out of the reach of children.

Best before date

5 years.

Do not use after the expiration date stated on the package.

Conditions for dispensing from pharmacies

Over the counter.

Manufacturer's name and address

JSC "Gedeon Richter"

1103 Budapest, st. Dymroyi 19-21, Hungary

Name and address of the organization accepting claims (proposals ) regarding the quality of medicines in the territory of the Republic of Uzbekistan

Representative office of JSC Gedeon Richter

100015, Tashkent, st. Nukus, 71, 5th floor

Tel.: (99878) 1479042

E-mail

Panangina price, where to buy

The price of Panangin in tablets is about 150 rubles per package No. 50, the price in ampoules is about 160 rubles.

The price of Panangin in Ukraine is 110 and 140 UAH. for tablets and solution, respectively.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Panangin Forte tablets p.p.o.
  316mg+280mg 60 pcs. JSC Gedeon Richter RUB 307 order
• Panangin tab. p/o captivity. 158 mg + 140 mg No. 100 JSC "Gedeon Richter-RUS" RU

  RUB 307 order

• Panangin tab. p/o captivity. No. 50 JSC "Gedeon Richter-RUS" RU

  RUB 143 order

• Panangin conc. ready solution d/inf 45.2 mg mg/ml + 0.04 g/ml 10 ml 5 pcs CJSC PharmFirma Sotex

  RUB 156 order

• Panangin conc.d/inf. 10ml n5JSC Gedeon Richter

  155 rub. order

Pharmacy Dialogue

• Panangin (concentrated solution 10ml No. 5) Gedeon-Richter

  145 rub. order

• Panangin (tab.p.pl.vol. 158 mg + 140 mg No. 50) Gedeon-Richter/Gedeon Richter-RUS JSC

  RUB 171 order

• Panangin (tab.p.pl.vol. 158 mg + 140 mg No. 100) Gedeon-Richter/Gedeon Richter-RUS JSC

  RUB 317 order

• Panangin forte (tab.pl/vol. 316mg+280mg No. 60)Gedeon-Richter

  RUB 322 order

• Panangin (amp. 10ml No. 5) Gedeon-Richter

  RUB 161 order

show more

Pharmacy24

• Panangin N50 tablets VAT "Gedeon Richter", Ugorshchina
  110 UAH. order
• Panangin 10 ml No. 5 concentrate for the preparation of solution for infusion VAT "Gedeon Richter", Ugorshchina

  142 UAH order

PaniPharmacy

• Panangin solution d/in. 10ml No. 5 Hungary, Gedeon Richter

  142 UAH order

• Panangin tablet p/captivity about. No. 50 Hungary, Gedeon Richter

  115 UAH order

show more