Izoket - instruction , application reviews


1. active substance

2. Product form

3. Composition

4. Indications

5. Contraindications

6. dosage and Administration

7. Side effects

8. Cautions

9. Conditions and terms

Izoket - antianginal, antihypertensive medication.

active substance

isosorbide dinitrate (Isosorbide dinitrate).

Product form

Izoket issued in the form of a concentrate for the preparation of the infusion solution and metered spray.

concentrate is sold in glass ampules (10 ml of the drug), placed on 10 pcs in cardboard packaging.Spray

realized in glass vials with a metering device (15 mL (300 doses)) placed in the cartons by one piece.



1 amp.

1 ml

isosorbide dinitrate

10 mg

1 mg

Excipients: sodium hydroxide solution 2M, sodium chloride, water for injection,1M hydrochloric acid (to pH 5.0-7.0).


1 dose (42.25 mg)

isosorbide dinitrate

1.25 mg

Excipients: Ethanol 100%, macrogol 400.

Indications Indications for Izoketa are the following diseases:

  • for cutaneous application: treatment and prevention of angina attacks.
  • For oral administration, sublingual: replacement therapy after myocardial infarction, the prevention and relief of angina attacks, treatment of heart failure, chronic course (as part of combination therapy), some forms of pulmonary heart disease, pulmonary hypertension (in a combination therapy).
  • for intravenous administration: pulmonary edema, unstable angina, myocardial infarction in the acute stage (including complicated by acute left ventricular failure).
  • for inhalation use: prevention and relief of angina attacks, treatment and prevention of coronary artery spasm in the case of a heart catheter, as well as a means of emergency aid in myocardial infarction in the acute stage, and left ventricular failure (acute stage) in the prehospital phase.

Contraindications Contraindications to the appointment of Medicine are:

  • Cardiogenic shock (in the event that there is no possibility to carry out the correction of left ventricular end-diastolic pressure by intra-aortic counterpulsation or positive inotropic medications with exposure).
  • vascular insufficiency in the acute stage (vascular collapse).
  • Closure form of glaucoma.
  • Hyperthyroidism.
  • Severe hypotension (diastolic blood pressure - less than 60 mm Hg SBP below 90 mmHg..).
  • The lack of glucose-6-phosphate dehydrogenase.
  • adolescence to 18 years (safety and efficacy of using the drug have not been established).
  • Increased individual sensitivity to the auxiliary components of the preparation (including nitrate compounds).

Izoket appointed with extreme caution when: cardiac tamponade, and constrictive (squeezes) pericarditis, mitral and / or aortic stenosis, hypertrophic obstructive cardiomyopathy, tendency to orthostatic reactions (sudden drop in blood pressure when changing body position), old age, disease,accompanied by increased intracranial pressure (including traumatic brain injury and hemorrhagic stroke), and severe renal and hepatic failure (there is a risk of methemoglobinemia).

Dosage and Administration

Spray .The drug in the dosage form suitable for spraying onto the oral mucosa.

Do not inhale the solution.Take a deep breath and hold your breath for a few seconds.Hold the bottle close to his mouth and pressing the dispenser, inject the solution into the oral cavity (with the premium you feel a slight burning tongue).Now close your mouth and breathe for 30 seconds through the nose.Use this information if your doctor did not give other recommendations.If these guidelines are not followed, Izoket may not have the desired effect.

In order to attack the relief of angina or prior to the intended emotional or exercise stress, which can trigger an attack, you need to inject the drug into the mouth 1-3 times with the interval between injections in 30 seconds against the backdrop of breath-holding.

cupping a single dose of 3 injections can be increased only at the urgent doctor's recommendation.

In heart failure, and myocardial infarction in the acute stage of the application Izoketa start with 1-3 injections under careful control heart rate and blood pressure.In the absence of the expected therapeutic effect for 5 minutes allowed repeat injection (under the strict supervision of the attending physician).If within 10 minutes of improvement does not occur, can be repeated use of the drug by controlling blood pressure.

concentrate .

Intravenously .The solution is administered as an intravenous infusion via automatic infusion systems.This should be done in a hospital setting under the scrutiny of indicators of the cardiovascular system.Depending on the severity and type of disease, in addition to the usual diagnosis (control heart rate, blood pressure, urine output, symptoms), appoint an invasive procedure to determine the hemodynamic parameters.

For intravenous administration system used the following materials: polytetrafluoroethylene, polypropylene and polyethylene.Infusion materials made of polyurethane or PVC, by adsorption cause loss of active material that it is necessary to replenish the dose increased.

dose of the drug should be chosen individually for each patient.Therapy should start with low doses, gradually increasing to the desired.

Izoketa The recommended initial dose is 2-7 mg / hour.In some cases, the dose can be increased to 10 mg / hr.

For heart failure patients increasing doses are typically required (in some cases up to 50 mg / hour).Optimal average dose of approximately 7.5 mg / hr.

Preparation of solution:

  • solution at a concentration of 200 micrograms / ml (0.02%) - 100 ml of 0.1% solution of (. 10 ml ampoules at 10) should be diluted to 500 ml.
  • solution at a concentration of 100 micrograms / ml (0.01%) - 50 ml 0.1% solution of (. 5 amp, 10 mL) should be diluted to 500 ml.

Oral .The recommended single dose ingestion of 10-120 mg.The optimal frequency of reception 1-5 times a day (depending on the evidence).

Sublingual .The maximum single dose is 5-10 mg, and the frequency of dosing depends on the patient's response to therapy and on the evidence.

cutaneous .The initial dose is 1, the drug is recommended to use at night before going to sleep, and if necessary and in the morning.Duration of therapy in each case is determined individually for each patient.

Side effects

Application Izoketa can cause the following adverse reactions:

  • central and peripheral nervous system : blurred vision, drowsiness, stiffness, reduced ability to rapid motor and mental reactions (especially at the beginning of treatment);rare - collapse and cerebral ischemia.
  • Cardiovascular system: tachycardia, headache, hypotension, dizziness, feeling of heat, transient facial flushing;in some cases - a paradoxical reaction (increasing angina attacks).
  • Digestive system: nausea, vomiting, dry mouth, burning sensation appearance of language.
  • Allergic manifestations : skin rashes.
  • Other : in some cases - exfoliative dermatitis, the development of tolerance (including cross to the other nitrates).

Overdose symptoms: palpitations, headache, fainting, dizziness, collapse, visual disturbances, seizures, hyperthermia, skin flushing, nausea, vomiting, excessive sweating, diarrhea, bradycardia, paralysis, methemoglobinemia (dyspnea, cyanosis), increased intracranialpressure, coma.


Spray .For the first use and in the case where after the last application Izoketa (in spray form), it took more than 24 hours is required for pressing the first spray dispenser to direct the air, as they can not contain the full dosage.To ensure the perfect effect of the drug need to click on the nebulizer continuously until the end, and then let go again.When using a spray bottle must be held in an upright position upward spray.Try to avoid contact with eyes solution.

solution contains alcohol (85%).During the period of drug therapy is recommended to exclude the use of ethanol.It is also desirable to avoid abrupt withdrawal Izoketa.It is better to gradually reduce the dose of the drug.

During treatment needed to control heart rate and blood pressure.

must be remembered that high doses and frequent administration may trigger the development of tolerance.If this happens, removal of the drug is needed for 24-48 hours.Also, after 3-6 weeks of regular use, you can do a short break (3-5 days), replacing this time spray other antianginal drugs.

particularly careful medical supervision is needed in myocardial infarction (acute stage) with reduced ventricular filling pressure.

Store spray at room temperature, and from time to time, check the sprayer operation.This is particularly important when a long period of its application.On the label of the bottle spray, bottom, applied arrow.Once the liquid level in the vessel reaches the upper edge of the arrow, it is recommended to change to a new vial.Further the use of such a vial is also possible, as long as the tip of the suction tube with gentle tilting container is immersed in liquid.

can not simultaneously designate Izoket and phosphodiesterase inhibitors, because in this case there is a risk of increasing the hypotensive effect of the drug.

concentrate .With extreme caution in patients with impaired cerebral circulation, with mitral and / or aortic stenosis, in patients who have a tendency to orthostatic hypotension in elderly patients.During the therapy, especially in the case of a gradual increase in the dose required to control heart rate and blood pressure.

concentrate solution contains no preservatives, sterile.0.1% solution should be opened immediately before use, under aseptic conditions.

For both dosage forms .Features of the individual patient's response to Izoket may impair the ability to work with complex mechanisms and control of vehicles.This effect is intensified at the beginning of therapy, at higher doses, and changing the drug, as well as in combination with taking alcoholic drinks.

Terms and Conditions of storage

Store at temperatures not exceeding 25 ° C.Keep away from children.Shelf life - 5 years.


Product description posted on this page is a supplement and a simplified version of the official version of the annotations to the drug.The information is provided for informational purposes only and is not a guide to self-medication.Before using the product you should consult with a specialist and to get acquainted with the instructions approved by the manufacturer.

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