The instruction for medical use of medicine Inosine the Trade name of the drug Inosine International Unlicensed Name Inosine Dosage Form Solution for intravenous administration of 20 mg/ml contains Structure of 1 ml of solution: Active agent: Inosine (inosine) – 20 mg Excipients: methenamin (hexamethylenetetramine), solution of sodium of hydroxide of 1 M, water for injections. The description the Transparent colourless or poorly painted liquid. Pharmacotherapeutic group Drugs for treatment of heart diseases. Other cardiotonic drugs. The ATX C01EB code the Pharmacological Pharmacodynamics Inosine properties belongs to the anabolic nonsteroid substances stimulating metabolic processes. Derivative purine, the predecessor of adenosine triphosphate (ATP), has anti-hypoxemic, metabolic and antiarrhytmic effect. Increases power balance of a myocardium, improves coronary circulation, renders pharmacological protection of the kidneys subjected to ischemia during operation. Is directly involved in exchange of glucose and promotes activization of exchange in the conditions of a hypoxia and in the absence of ATP. Activates metabolism of pyruvic acid for ensuring normal process of tissue respiration and also activation is promoted by xanthine-dehydrogenase. Stimulates synthesis of nucleotides, enhances activity of some enzymes of a tricarbonic acid cycle. The pharmacokinetics Is metabolized in a liver with formation of glucuronic acid and the subsequent its oxidation. In insignificant quantity it is allocated with urine. Indications Complex therapy of coronary heart disease, the disturbances of a heart rhythm caused by use of cardiac glycosides after the postponed myocardial infarction, against the background of a myocardial dystrophy after the postponed infectious diseases. Liver diseases (hepatitis, cirrhosis, fat dystrophy). The route of administration and doses Enter intravenously struyno (slowly) or by drop infusion (40-60 drops a minute). Treatment begin with introduction 200 mg (10 ml of 2% of solution) once a day, then, at good tolerance, the dose is increased to 400 mg (20 ml of 2% of solution) by 1-2 times a day. Duration of treatment is 10-15 days. In acute disorders of a heart rhythm perhaps jet introduction in a single dose of 200-400 mg (10-20 ml of 2% of solution). For pharmacological protection of the kidneys subjected to ischemia, inosine is entered intravenously struyno in a single dose of 1.2 g (60 ml of 2% of solution) in 5-15 min. prior to crossclamping of a renal artery, and then by 0.8 more g (40 ml of 2% of solution) immediately after blood circulation restoration. For intravenous drop administration of 2% of solution drug is dissolved in 5% solution of glucose or isotonic solution of sodium of chloride (to 250 ml). Side effects – arterial hypotension, tachycardia, the general weakness – allergic/anaphylactic reactions, including rash, an itching, a dermahemia, urticaria, an acute anaphylaxis – the lipodystrophy In rare instances at treatment can occur increase in level of uric acid in blood, at long treatment – exacerbation of gout. Contraindications Hypersensitivity to drug, gout, a hyperuricemia, pregnancy, the lactation period, children’s age up to 18 years (the efficiency and safety are not established), a renal failure. Medicinal interactions At use as a part of complex therapy Inosine promotes increase in efficiency of antiarrhytmic, anti-anginal and inotropic medicines. At simultaneous use of Inosine with beta blockers Riboksin’s effect does not decrease. In combination with cardiac glycosides, drug can prevent developing of arrhythmias and strengthen inotropic action. At simultaneous use with immunodepressants the efficiency decreases. Clinically significant interaction of Inosine with medicines of other groups is not described. Inosine should not be mixed in one syringe with other medicines in order to avoid chemical incompatibility of drugs. Special instructions In a renal failure the use of medicine is possible only when, according to the doctor, the expected positive effect exceeds possible risk at use. During treatment it is regularly necessary to control the level of uric acid in blood. With care appoint drug in renal failures. At appearance of an itching and dermahemia, drug should be cancelled. Pregnancy and the period of a lactation At pregnancy and in the period of a lactation inosine is appointed taking into account a ratio advantage/risk of Feature of influence of medicine on ability to run the vehicle or potentially dangerous mechanisms It is necessary to be careful at control of motor transport and potentially dangerous types of activity demanding the increased concentration of attention. Overdose Symptoms – are possible allergic reactions. Treatment is symptomatic, in hard cases it is necessary to see a doctor. A form of release and packing Solution for intravenous administration of 20 mg/ml in ampoules of neutral glass on 5 ml. On 10 ampoules together with the instruction for use and a knife for opening of ampoules or the scarificator ampoule place in a box of cardboard. When using ampoules with notches, rings and points the scarificator or a knife ampoule do not put. Storage conditions In the place protected from light at a temperature from 15 to 25 wasps. To store out of children’s reach. Period of storage 3 years. Not to use after an expiration date. Prescription status According to the prescription. JSC DALKHIMFARM producer, 680001, Russian Federation, Khabarovsk Krai, Khabarovsk, Tashkentskaya St., 22, ph. / fax (4212) 53-91-86. Owner of the registration certificate of JSC DALKHIMFARM, 680001, Russian Federation, Khabarovsk Krai, Khabarovsk, Tashkentskaya St., 22, ph. / fax (4212) 53-91-86. The address of the organization accepting claims from consumers on quality of drug in the territory of the Republic of Kazakhstan: MedLayn Pharmaceutics LLP Republic of Kazakhstan, 050054, Almaty, Suyunbaya Avenue, 162 A, ph. 8 (727) 225 00 37 Address of the organization responsible for post-registration observation of safety of medicine: MedLayn Pharmaceutics LLP Republic of Kazakhstan, 050054, Almaty, Suyunbaya Avenue, 162 A, ph. 8 (727) 225 00 37.