Antiarrhythmic drug Riboxin - principles of action and instructions for use. Riboxin solution Riboxin in ampoules orally

Riboxin is a drug that regulates metabolic processes and has an antihypoxic and antiarrhythmic effect.

Release form and composition

• Film-coated tablets: round, biconvex, yellow; tablet core - white or almost white (in a blister pack of 10 pcs., in a cardboard pack 1-5 or 10 packs; in a blister pack 25 pcs., in a cardboard pack 1-5 or 10 packs; 50 pcs each . in a polymer jar, 1 jar in a cardboard pack; 50 pieces in a dark glass jar, 1 jar in a cardboard pack);
• Film-coated tablets: biconvex, from yellow-orange to light yellow in color, when cut, two layers are visible (in a blister pack of 10 pcs., in a cardboard pack 1, 2, 3, 4 or 5 packs);
• Solution for intravenous (i.v.) administration: colorless or slightly colored transparent liquid (5 and 10 ml each in glass ampoules of neutral color: 10 ampoules in a cardboard pack; 5 or 10 pcs. in a blister pack, 1 or 1 in a cardboard pack 2 packs);
• Capsules: No. 1, gelatin, solid structure, red, inside the capsules there is white powder (10 pcs in a blister pack, 5 packs in a cardboard box).

1 film-coated tablet contains:

• Active ingredient: inosine (riboxin) – 0.2 g;
• Auxiliary components: lactose monohydrate, microcrystalline cellulose, copovidone, calcium stearate;
• Shell composition: Opadry II (series 85) (macrogol-3350, partially hydrolyzed polyvinyl alcohol, titanium dioxide (E171), aluminum varnish based on sunset yellow dye (E110), aluminum varnish based on indigo carmine (E132), aluminum varnish based on quinoline yellow dye (E104), talc).

1 film-coated tablet contains:

• Auxiliary components: sugar, potato starch, titanium dioxide, water-soluble methylcellulose, Tween-80, tropeolin O, stearic acid.

1 ml of solution for intravenous administration contains:

• Active ingredient: inosine – 0.02 g;
• Auxiliary components: hexamethylenetetramine (methenamine), 1M sodium hydroxide solution, water for injection.

1 capsule contains:

• Active ingredient: inosine – 0.2 g;
• Auxiliary components: potato starch, calcium stearate;
• Shell composition: pharmaceutical gelatin, methyl parahydroxybenzoate, glycerol, propyl parahydroxybenzoate, titanium dioxide, Charming Red dye (E129), sodium lauryl sulfate, purified water.

Pharmacological properties

Pharmacodynamics

Riboxin is a drug that regulates metabolic processes. It belongs to the category of purine derivatives (nucleosides) and is a precursor to adenosine triphosphate (ATP). Riboxin is characterized by antiarrhythmic, metabolic and antihypoxic effects. It normalizes the energy balance of the myocardium, stabilizes coronary circulation, and eliminates the consequences of renal intraoperative ischemia.

This substance is directly involved in glucose metabolism and activates metabolism in the absence of ATP and under hypoxic conditions. Riboxin accelerates the metabolism of pyruvic acid, which helps normalize the process of tissue respiration, and also ensures the activation of xanthine dehydrogenase. The drug stimulates the production of nucleotides and increases the activity of certain enzymes of the Krebs cycle. Riboxin penetrates cells, improving energy metabolism and having a positive effect on metabolic processes in the myocardium: the compound increases the strength of heart contractions and ensures more complete relaxation of the myocardium in diastole. As a result, the stroke volume of blood increases. Riboxin inhibits platelet aggregation and improves tissue regeneration (mainly the gastrointestinal mucosa and myocardium).

Pharmacokinetics

Riboxin is well absorbed from the gastrointestinal tract and metabolized in the liver, forming glucuronic acid, which is subsequently subject to oxidation. The compound is excreted in small quantities through the kidneys.

Indications for use

According to the instructions, Riboxin is used as part of complex therapy:

• The period after myocardial infarction;
• Cardiac ischemia;
• Heart rhythm disturbances due to the use of cardiac glycosides;
• Myocardial dystrophy;
• Liver diseases: fatty degeneration, hepatitis, cirrhosis;
• Urocoproporphyria.

In addition, a solution for intravenous administration is prescribed during surgery on an isolated kidney for pharmacological protection when the blood circulation is turned off.

Contraindications

• Age up to 18 years;
• Gout;
• Hyperuricemia;
• The period of pregnancy and breastfeeding;
• Individual intolerance to the components of the drug.

In addition, the use of film-coated tablets is contraindicated in patients with lactase deficiency, lactose intolerance, or glucose-galactose malabsorption.

Instructions for use of Riboxin: method and dosage

Film-coated tablets and film-coated tablets

Riboxin tablets are taken orally before meals.

Recommended dosage regimen: at the beginning of therapy - 0.2 g 3-4 times a day, after 2-3 days of treatment (if the drug is adequately tolerated) the patient is transferred to taking 0.4 g 3 times a day. To achieve a therapeutic effect, a gradual increase in the dose is possible, but not more than 2.4 g per day. Course duration is 30-90 days.

For the treatment of urocoproporphyria, 0.2 g is prescribed 4 times a day for 30-90 days.

Solution for intravenous administration

Riboxin solution is administered slowly intravenously in a stream or drip. The infusion rate should not exceed 40-60 drops per minute.

To prepare an infusion solution, it is necessary to mix the drug solution with 250 ml of 0.9% sodium chloride solution or 5% glucose solution.

Recommended dosage for intravenous drip administration: initial dose – 0.2 g (10 ml) 1 time per day. If there is a good response to the drug, the dose can be increased to 0.4 g (20 ml) 1-2 times a day. The course of treatment is 10-15 days.

Dosing regimen for jet administration:

• Acute cardiac arrhythmias: single administration in a dose of 0.2-0.4 g (10-20 ml of solution);
• Pharmacological protection of the kidneys: a single administration 5-15 minutes before turning off the blood circulation - 1.2 g (60 ml), then immediately after restoration of the hepatic artery - 0.8 g (40 ml).

Capsules

Capsules are intended to be taken orally before meals.

Recommended dosage: initial dose – 1 pc. 3-4 times a day, with adequate tolerability of the drug for 2-3 days of therapy to achieve the desired effect, the dose can be increased to 2 pcs. 3 times a day (1.2 g). The daily dose should not exceed 12 pcs. (2.4 g).

For urocoproporphyria, the patient is prescribed 1 pc. 4 times a day.

Duration of treatment is 30-90 days.

Side effects

• Allergic reactions: possible – skin hyperemia, skin itching;
• Other: rarely - increased levels of uric acid in the blood; during long-term therapy - exacerbation of gout.

In addition, the use of Riboxin capsules and tablets can cause an allergic reaction in the form of urticaria.

Overdose

When Riboxin is administered in high doses, the patient may experience increased individual sensitivity reactions to the drug. In this case, the drug is discontinued and desensitizing therapy is prescribed. Sometimes there is an increase in the concentration of uric acid in the blood, causing an exacerbation of the condition in patients with gout and requiring discontinuation of Riboxin.

special instructions

It is not recommended to prescribe Riboxin for emergency assistance in case of cardiac dysfunction.

If skin hyperemia occurs, immediate discontinuation of the drug is required.

The use of the drug should be accompanied by regular monitoring of the level of uric acid concentration in urine and blood.

Does not affect the patient's ability to drive vehicles and machinery.

Drug interactions

The action of inosine as part of complex therapy increases the effectiveness of antianginal, antiarrhythmic, and inotropic drugs.

Concomitant use of immunosuppressants (including antithymocyte immunoglobulin, gamma-D-glutamyl-D-tryptophan, cyclosporine) reduces the effectiveness of inosine.

No other clinically significant interactions with Riboxin have been established.

Analogs

Analogues of Riboxin are: Inosie-F, Inosine, Inosine-Eskom, Riboxin Bufus, Riboxin-Vial, Riboxin-LekT, Riboxin-Ferein, Ribonosine.

Terms and conditions of storage

Keep out of the reach of children and protected from light at temperatures up to 25 °C; protect tablets and capsules from moisture.

Shelf life: tablets and solution – 3 years, capsules – 2 years.

Active ingredient:inosine;

1 ml of solution contains inosine 20 mg;

excipients: hexamethylenetetramine, 1 M sodium hydroxide solution, water for injection.

Pharmacodynamics. Riboxin is an anabolic drug that has antihypoxic and antiarrhythmic effects. It is a precursor of ATP, is directly involved in glucose metabolism and promotes the activation of metabolism in conditions 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 metabolism in the myocardium, in particular, it increases the energy balance of cells, stimulates the synthesis of nucleotides, and increases the activity of a number of Krebs cycle enzymes. The drug normalizes the contractile activity of the myocardium and promotes complete relaxation of the myocardium in diastole due to the ability to bind calcium ions that penetrated the cells during their excitation, and activates tissue regeneration (especially the myocardium and the mucous membrane of the digestive canal).

Pharmacokinetics. When administered intravenously, Riboxin is quickly distributed in tissues, metabolized in the liver, where it is completely utilized in the biochemical reactions of the body. Excreted mainly in urine.

Pharmaceutical characteristics.

Basic physical and chemical properties: transparent, colorless liquid.

Incompatibility. The drug should not be mixed with other drugs in the same syringe or in the same infusion system. Use only recommended solvents.

Directions for use and dosage:

Features of application:

Side effects:

Interaction with other drugs:

Contraindications:

Overdose:

Storage conditions:

Shelf life: 3 years. In a place protected from light at a temperature not exceeding 25 ° C. Keep out of the reach of children.

Vacation conditions:

On prescription

Package:

5 ml or 10 ml per ampoule; 10 ampoules per box. 5 ml or 10 ml per ampoule; 5 ampoules in a blister; 2 blisters per pack.

"Riboxin" is a medical product from the category of drugs that affect metabolic reactions in the human body by increasing working cellular energy. Acts on metabolic, antiarrhythmic, antihypoxic and coronary dilation processes. The medication is highly active against cardiac structures, therefore it is often prescribed in cardiology for the treatment of various heart pathologies. You can find out more information about Riboxin injections from the instructions for use.

The main ingredient of Riboxin is inosine - 20 mg per milliliter. The ampoule also contains excipients and water.

Release form

The medicine is produced in the form of a solution for intravenous injection. A 2% solution of "Riboxin" for injection is produced in ampoules of 10 ml. Riboxin ampoules include 20 mg of inosine per milliliter. The solution is injected into a vein. The drug is not used intramuscularly.

Dosing

"Riboxin" is infused intravenously through a dropper or by the jet method. The initial daily dose is 200 mg once daily. The dose is then adjusted to 400 mg once or twice daily. The duration of therapy is determined by the attending physician, usually two weeks.

For acute cardiac pathologies, sudden arrhythmias, acute failure of the heart muscle, one-time use of the drug by jet method of 200 - 400 milligrams is possible.

The effect of "Riboxin" on the body

“Riboxin” is the formation of purine, a nucleoside that includes hypoxanthine associated with a residual amount of ribofuranose. Precedes ATP - adenosine triphosphate. The main active component of the drug, inosine, triggers metabolic processes in the body in a state of oxygen deficiency and is directly involved in the biological reaction of glucose formation. "Riboxin" is a medicine that controls the biochemical reactions of converting useful substances into energy.

The drug exhibits particular activity against myocardial cells and liver. Produces antihypoxic and antiarrhythmic effects. Replenishes the deficiency of cellular tissue oxygen. Increases the energy and power of the myocardium, accelerates the movement of blood through the coronary vessels, intensifies cardiac work, and participates in the process of diastolic relaxation of the heart muscle. As a result, the volume of blood pushed out by the heart increases, and a normal heart rhythm is established. Thanks to Riboxin, the heart recovers after myocardial infarction. The medication triggers the metabolism of pyruvic acid, which normalizes respiration in tissues even with ATP deficiency.

"Riboxin" intensifies the saturation of the heart with oxygenated blood, normalizes the movement of blood through the kidneys after surgical interventions. Stimulates the action of xanthine dehydrogenase, which catalyzes oxidative reactions, and forms uric acid with the participation of hypoxanthine. Reduces the formation of blood clots. Prevents the occurrence of heart failure syndrome.

Accelerates the process of cell regeneration inside the stomach after erosions and ulcers, and also improves the condition of the liver in any pathology.

Pharmakinetics

"Riboxin" is completely absorbed by the stomach. The liver metabolizes it with the production of glucuronic acid and its further oxidation reaction. A small part is excreted through the kidneys.

What is the drug used for?

1. According to the instructions for use, Riboxin injections are used mainly for cardiovascular pathologies: metabolic disorders in the structures of the heart muscle, ischemia, cardiac defects of any etiology, conditions after myocardial infarction, arrhythmias (especially with glycoside lesions), myocarditis, after intense physical stress, infections or due to endocrine disorders. For ischemia, the medicine begins to be used at any period of the disease, regardless of the stage.
2. In case of fatty liver transformation, which also occurs due to taking medications or alcohol. For toxic damage to hepatocytes, hepatitis, cirrhosis.
3. As a preventive measure against a decrease in the level of leukocytes in the blood when exposed to radioactive substances.
4. During kidney operations as a means of medicinal protection in the process of stopping blood circulation.
5. With uroporphyria, there is a failure of metabolic biological reactions.
6. For glaucoma in combination with basic treatment.
7. The drug is indicated during radiation therapy sessions, which helps to improve the procedures and eliminate side effects.
8. Prescribed for severe physical stress as a means of increasing the body's endurance. Used by athletes during intense training.
9. For male infertility.
10. In cosmetology.

Contraindications

• hypersensitivity to inosine;
• gout;
• hyperuricemia;
• age up to 3 years;
• fructose intolerance and glucose malabsorption syndrome or sucrose deficiency;
• renal failure;
• diabetes;
• complex kidney diseases.

Side effects

Allergic responses: itchy skin rash, redness of the skin, angioedema. The occurrence of an allergy requires discontinuation of the medication.

Increased uric acid density and relapse of gout with long-term use (occurs infrequently). It is necessary to stop therapy with Riboxin and prescribe appropriate treatment to relieve inflammation in the joints.

Pregnancy and lactation period

No studies have been conducted to confirm the safety of the drug for pregnant and lactating women. Therefore, it is forbidden to use Riboxin during pregnancy. Although some doctors note the positive effect of the medication on metabolic reactions in the woman and fetus and prescribe it. In this case, the decision must be made by the doctor, taking into account the potential risks to the child. It is recommended to stop breastfeeding during medication injections.

What to pay attention to

During therapy with Riboxin, you need to keep the amount of uric acid in the urine and blood under control.

For patients undergoing chemotherapy, the medicine is prescribed with caution under strict medical supervision, as it can sharply worsen the general condition of such patients.

The drug is safe for drivers when driving vehicles and devices that require particularly strong concentration.

Overdose situations

"Riboxin" is used strictly according to medical prescriptions. In situations where the dosage is exceeded, allergic symptoms, itching of the skin, increased heart rate, and cardiac heaviness may appear. Typically, such manifestations are not scary and disappear after a decrease in inosine in the blood. Medical studies do not contain information describing cases of drug overdose.

Compatibility with other drugs

The effectiveness of Riboxin decreases when used together with immunosuppressants - drugs that suppress the immune system.

The drug combines well with cardiac metabolites; their combined use prevents the development of arrhythmic reactions and enhances the inotropic effect.

The medication increases the anabolism of steroid and non-steroidal drugs when used together.

The drug reduces the bronchodilator effect of theophylline and the psychoactivating effect of caffeine.

In injections, the medicine does not combine with alkaloids; their combination leads to the formation of insoluble substances.

Vitamin B6, when taken together with inosine, deactivates both substances.

The injection solution should not be combined with any medications in the same syringe, as such use may cause undesirable results.

Pros and cons of the drug

A positive consequence of the use of the drug is the optimization of metabolism in the myocardium. The medicinal characteristics of inosine are expressed in multiplying the energy of the muscle cells of the heart, accelerating the production of nucleotides, which is expressed in the activation of regenerative formations in the tissue structures of the heart.

A negative effect of Riboxin is considered to be a change in the physiological order of metabolic processes. Many researchers have a negative attitude towards any interference in the metabolic processes of the body, especially through substances coming from outside. However, the ratio of possible benefits and harm should be taken into account. In the presence of various pathologies and disruptions in the activity of the heart muscle, the benefit of the medication is higher than the potential harm.

Riboxin and sports

"Riboxin" is known not only to doctors, but also to athletes as an energy supplement for bodybuilders. It is especially often used by bodybuilders who build muscle. The drug does not harm the body; it is used by supporters of non-steroidal and anti-doping sports.

Riboxin is a component of the protein biosynthesis reaction that helps build muscle. Thanks to the drug, the athlete’s performance, endurance and strength increase and training becomes easier.

Instructions

on medical use of the drug

Riboxin

Tradename

Riboxin

International nonproprietary name

Dosage form

Solution for intravenous administration 20 mg/ml, 10 ml

Compound

1 ml of the drug contains:

active substance: Riboxin (inosine) - 20 mg;

Excipients: hexamethylenetetramine (methenamine), sodium hydroxide solution, water for injection.

Description

Transparent colorless or slightly colored liquid.

Pharmacotherapeutic group

Drugs for the treatment of heart diseases.

Other cardiotonic drugs.

ATX code:C01 E.B.

Pharmacological properties

Pharmacokinetics

Metabolized in the liver with the formation of glucuronic acid and its subsequent oxidation. A small amount is excreted through the kidneys.

Pharmacodynamics

Has antihypoxic and antiarrhythmic effects. Increases the energy balance of the myocardium, improves coronary circulation, and prevents the consequences of intraoperative renal ischemia. It is directly involved in glucose metabolism and promotes the activation of metabolism under hypoxic conditions and in the absence of ATP.

Activates the metabolism of pyruvic acid, which is necessary to ensure the normal process of tissue respiration, and also promotes the activation of xanthine dehydrogenase. Stimulates the synthesis of nucleotides, enhances the activity of some Krebs cycle enzymes. Penetrating into cells, it has a positive effect on metabolic processes in the myocardium - it increases the strength of heart contractions and promotes more complete relaxation of the myocardium in diastole, resulting in an increase in stroke volume. The mechanism of antiarrhythmic action is not completely clear.

Reduces platelet aggregation, activates tissue regeneration (especially the myocardium and the mucous membrane of the gastrointestinal tract).

Indications for use

In complex treatment:

Previous myocardial infarction,

Coronary heart disease,

Heart rhythm disturbances caused by the use of cardiac glycosides, as well as against the background of myocardial dystrophy after infectious diseases;

Liver diseases (hepatitis, cirrhosis, fatty degeneration), urocoproporphyria. Surgeries on an isolated kidney (as a means of pharmacological protection when turning off blood circulation).

Directions for use and doses

The drug is administered intravenously in a slow stream or drip (40-60 drops per minute). Treatment begins with the administration of 200 mg (10 ml of a 20 mg/ml solution) 1 time per day, then, if well tolerated, the dose is increased to 400 mg (20 ml of a 20 mg/ml solution) 1-2 times a day. Duration of treatment is 10-15 days.

Injection of the drug is possible for acute cardiac arrhythmias in a single dose of 200-400 mg (10-20 ml of a 20 mg/ml solution).

For pharmacological protection of kidneys subjected to ischemia, Riboxin is administered intravenously as a bolus in a single dose of 1.2 g (60 ml of a 20 mg/ml solution) 5-15 minutes before clamping the renal artery, and then another 0.8 g (40 ml of a 20 mg/ml solution) mg/ml) immediately after restoration of blood circulation.

When administered drip into a vein, a 20 mg/ml solution of the drug is diluted in a 5% dextrose (glucose) solution or isotonic sodium chloride solution (up to 250 ml).

Side effects

Allergic reactions:

Itchy skin

Skin hyperemia (the drug should be discontinued).

Increased concentration of uric acid in the blood

Tachycardia.

Contraindications:

Hypersensitivity to the drug

Gout

Hyperuricemia

Pregnancy

Lactation period

Age up to 18 years (efficacy and safety have not been established).

Carefully

Kidney failure.

Drug interactions

Immunosuppressants reduce the effectiveness of Riboxin.

When used together with cardiac glycosides, the drug can prevent the occurrence of arrhythmias and enhance the positive inotropic effect.

special instructions

Riboxin is not used for emergency correction of cardiac dysfunction. If itching and hyperemia of the skin occurs, treatment should be discontinued.

During long-term treatment, it is advisable to monitor the concentration of uric acid in the blood and urine.

Pregnancy and lactation

Use during pregnancy is contraindicated. If it is necessary to use the drug during lactation, breastfeeding should be stopped during treatment.

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

Considering the side effects of the drug, during the treatment period you should refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Overdose

Currently, no cases of overdose have been reported.