Panangin: instructions for use, dosage,analogues, contraindications

Update: October 2018

Panangin is a popular combination preparation containing
trace elements magnesium and potassium in active and easily digestible form.
Traditionally prescribed to strengthen the heart muscle,
normalization of metabolic processes and prevention of premature
myocardial wear. Regular, course use of medication
interferes with the development of hypertension, ischemic heart disease, arrhythmias, atherosclerosis and
the development of metabolic disorders in the heart muscle.

Pharmacological group: Drugs that fill
magnesium and potassium deficiency.

Состав, физико-химические свойства, цена

Panangin is available in 2 forms: tablets for oral administration and
solution for injection through a vein.

Panangin tablets (50 pcs.): 115-130 rubles Panangin solution (5 ampoules), 140-150 rubles

Round biconvex tablets that are coated with white or
milky-white film coating, almost odorless.
The surface of the tablets is slightly uneven and shiny.

On 50 tablets in polypropylene bottles which are packed into
cardboard packs.

Colorless or greenish solution, transparent.

On 10 ml in one ampoule made of transparent glass. By
5 ampoules in one plastic pallet.

Basic substances (1 tablet and 1 ampoule
respectively):
  • 166.3 mg of potassium asparaginate hemihydrate;
  • 175 mg of magnesium aspartic tetrahydrate.
  • 452 mg of potassium asparaginate hemihydrate;
  • 400 mg of magnesium aspartic tetrahydrate.
Excipients:
  • 2 mg of colloidal silicon dioxide; панангин таблетки
  • 3.3 mg povidone;
  • 4 mg of magnesium stearate;
  • 10 mg of talc;
  • 86.1 mg of corn starch;
  • 3.3 mg of potato starch.

In the composition of the shell: titanium dioxide, macrogol 6000, talc,
methacrylic acid copolymer.

  • панангин ампулыwater for injection up to a volume of 10
    ml.

pharmachologic effect

Panangin influences myocardial metabolism and is
source of magnesium and potassium ions (see all potassium and magnesium preparations in
tablets).

These trace elements are intracellular cations and
play a leading role in the functioning of a number of enzymes, provide
the connection between the intracellular structures of the heart muscle and
macromolecules, as well as involved in the process of muscle
contractility. Normal heart contractile function is possible with
the physiological extra-and intracellular ratio of magnesium ions,
sodium, potassium and calcium.

Endogenous aspartate works as a conductor of ions. High
cell affinity possible due to its small dissociation
salts, provides the penetration of ions in the form of complex
compounds inside the cell wall. Magnesium and Potassium Aspartate
positive effect on metabolism in the myocardium. Disadvantage
these ions is a predisposing factor in the development
atherosclerosis of the arteries of the heart, hypertension and
metabolic disorders.

  • Potassium performs one of the most important physiological functions –
    participates in the maintenance of the membrane potential of muscle and nerve
    cells and other structures of the myocardium, with excitability. With
    imbalance of intracellular and extracellular potassium
    decreases in the contractile function of the myocardium occurs
    arrhythmia, tachycardia, and also increases the toxicity of the heart
    glycosides taken in therapeutic doses.
  • Magnesium is a cofactor of about three hundred enzymatic reactions,
    among which are synthesis of nucleic acids, proteins and energy
    metabolism. The trace element improves muscle contractility and
    normalizes heart rate, reducing the need for heart
    in oxygen. Magnesium also eliminates ischemia of the heart muscle.

Byчему эффективен прием комплексного препарата, нежели
trace elements separately? The fact is that almost always
potassium deficiency is accompanied by a magnesium deficiency, therefore
it is more rational to carry out a comprehensive correction of the microelement
failure. Simultaneous elimination of the pathological
lack of potassium and magnesium leads to an additive effect
(the effectiveness of the joint action is equal to the sum of the effects of
each item separately). Another positive joint
action – reducing the toxicity of cardiac glycosides without
the oppression of their inotropic effect.

Pharmacokinetics

The oral form is characterized by a high degree of absorption.
Excreted in the urine. Information on the pharmacokinetics of the solution in
instructions for use Panangina missing.

Byказания к применению

Pills

  • Supplementing the lack of magnesium and potassium with a slight
    keeping them in the diet. Withменение препарата с этой целью
    is a factor in the prevention of cardiovascular diseases and
    development of complications of existing pathologies of the cardiovascular system.

Solution

  • Comprehensive treatment of heart failure,
    rhythm disorders (more ventricular arrhythmias and conditions
    against the background of excess doses of cardiac glycosides), acute myocardial infarction
    myocardium.
  • Improving the tolerability of heart drugs
    glycosides.

Contraindications

Pills Solution
Byчечная недостаточность в остром и хроническом течении
Hyperkalemia and Hypermagnesemia
Addison’s Gd
Cardiogenic shock (BP) less than 90 mm Hg)
Severe myasthenia
Dehydration
Byвышенная чувствительность к составляющим препарата
Hemolysis Adrenal insufficiency
AV block I-III degree AV block II-III degree
Metabolic acute acidosis Age up to 18 years
Amino acid metabolism disorders Lactation and pregnancy
Carefully
Gestation period (especially 1 trimester) and lactation.
  • AV block I degree;
  • Severe disruption of the liver;
  • Metabolic acidosis;
  • Disturbance of bundle function and the inability to control the level
    serum magnesium;
  • Hypophosphatemia;
  • Urolithiasis diathesis on the background of metabolic disorders of magnesium, calcium and
    ammonium phosphate.

Dosage

Pills

Withнимают по 1-2 табл. three times a day, but not more than 3 tablets per
one reception, after a meal, because the stomach togas content reduces
the effectiveness of the drug.

Duration of use and the need for repeated
Applications are determined individually.

Injections

Withменяют внутривенно, капельно, в виде медленного инфузионного
administration (~ 20 drops in 1 minute): a preparation from 1-2 ampoules is dissolved
in 50-100 ml of glucose or dextrose 5%. maybe
combined treatment with panagin with other drugs with a / in
introduction.

Byвторное введение – не ранее чем через 4-6 ч после первой
droppers.

Byбочные эффекты

With внутреннем применении возможны следующие побочные
effects:

  • on the CVS side: paradoxical reactions, AV blockade;
  • on the part of the digestive system: vomiting, nausea, diarrhea,
    epigastric discomfort in patients with cholecystitis or antacid
    gastritis;
  • water-electrolyte changes: hyperkalemia, which
    manifested by diarrhea, vomiting, nausea, confusion and
    paresthesias; hypermagnesium, which is characterized by redness
    facial skin, thirst, falling blood pressure, convulsions, respiratory depression.

With быстром инфузионном введении могут развиться симптомы
hyperkalemia or hypermagnesemia, described above. May also
develop phlebitis, AV blockade and paradoxical reactions.

Overdose

To date, such cases have not been described, but with
exceeding the recommended doses may develop symptoms of hyperkalemia.
or hypermagnesemia. With передозировки таблеток возможно нарушение
conduction of the heart.

Drug interactions

  • In combination with ACE inhibitors, potassium-sparing diuretics,
    cyclosporine, beta-blockers, NSAIDs, heparin increases
    risk of developing hyperkalemia.
  • In combination with glucocorticosteroids, hypokalemia is eliminated,
    which is a side effect of hormone therapy.
  • In combination with cardiac glycosides decreases their
    toxicity.
  • With приеме совместно с антиаритмическим препаратвми усиливается
    their negative dromo-and bathmotropic action.
  • Reduced effects of neomycin, tetracycline, polymyxin B and
    streptomycin.
  • Calcium reduces the effect of magnesium in the composition of Panangin.
  • With применении с анестетиками усиливается угнетающее
    effects of magnesium on the central nervous system.
  • Atracurium, Dexametonium and Suxametonium can cause
    increased neuromuscular blockade.
  • Calcitroiol increases plasma levels of magnesium.
  • Knitting and enveloping drugs reduce absorption
    Panangina from the digestive tract.

Cardiology reviews

Physicians specializing in the treatment of diseases of the CAS,
have a positive attitude towards Panangin and regularly appoint him with
therapeutic and prophylactic purposes. By наблюдениям врачей,
regular intake of two “heart” elements reduces viscosity
blood, normalizes heart rhythm, improves contractility
myocardium, slows the growth of atherosclerotic plaques.

Moreover, there are official statistics that
an increase in potassium intake of 391 mg per day leads to a decrease in
risk of ischemic complications by 40%. results
pathoanatomical studies of potassium and magnesium in
cardiac muscle of patients who died from acute ischemia of the heart
(heart attack) indicates a low content of these elements (in
1.5-2 times lower than normal).

All this confirms the propriety of prophylactic use.
Panangina or similar drugs, especially in people with
or risk of cardiovascular disease and elderly patients.

Panangin Forte difference from Panangin

Both drugs are manufactured by GEDEON RICHTER / GEDEON RICHTER
LTD have the same indications for use and are intended for
oral administration. Papangin Forte is twice as big
the content of trace elements per 1 tablet. This allows you to reduce
the number of pills taken at a time up to 1 pc, i.e. more
convenient form for use.

Analogs

Asparkam, Aspangin, Asparkad, Pamaton, Panangin Forte.

Aspark Panangin Forte Aspark Авексима
     
50 tab. 44-58 rubles 60 tab. 315-357 rub. 56 tab. 95-120 rubles

Автор: врач-гигиенист, эпидемиолог

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