"Panangin": side effects, description, instructions, contraindications, composition, storage. What helps "Panangin"

"Panangin" in ampoules is a drug that can affect the metabolism in tissues and contains magnesium and potassium. The drug is recommended for patients in the treatment of pathologies in the cardiovascular system, accompanied by impaired metabolism in the myocardium. The drug is contraindicated in childhood, during pregnancy, in patients suffering from hypermagnesemia (high levels of magnesium in the blood) and hyperkalemia (high levels of potassium in the blood).

In the article, we will consider the instructions for use for Panangin and the reviews of cardiologists.

Pharmacological forms

The manufacturer "Panangin" is produced in two pharmacological forms: tablets intended for oral administration, and a solution that can be administered intravenously as a stream or drip. Tableted "Panangin" has a biconvex rounded shape, has a former color and a shiny surface. The drug is packaged in 50 tablets in polypropylene bottles.

"Panangin" in ampoules is intended for intravenous administration, it is a clear, colorless, sterile liquid without any impurities. It is packaged in 10 ml ampoules, which are packed in 5 pieces in a cardboard box. Before jet intravenous administration, the contents of the ampoule should be diluted with 50 ml of glucose (5%). If drip administration is intended, then the drug should be diluted with saline in an amount of 200 ml.

Composition, description

The main active ingredients of the drug are potassium aspartate and magnesium aspartate. Each tablet contains 158 and 140 mg of substances, respectively. Each ampoule of "Panangin" contains 452 mg and 400 mg of substances, respectively. Potassium and magnesium ions are important intracellular cations. Along with sodium and calcium, they take part in the activity of various enzymes that regulate tissue metabolic processes, including those in myocardial tissues. The active components of the drug have a positive effect on the process of oxygen absorption, nutrients on the ability of the heart to contract.

As additional components in the composition of the tablets, potato starch, corn starch, magnesium stearate, povidone, silicon dioxide were used. The auxiliary substance in the composition of the solution is injection water. The additional ingredients contained in the preparation are necessary to improve the absorption of active ingredients, to create the most convenient pharmacological form.

Pharmacological group

"Panangin" in ampoules is included in a group of drugs with a predominant effect on tissue metabolism. In its own way pharmacological group it refers to mineral substances containing potassium and magnesium. The drug is able to influence the metabolic processes in myocardial tissues, prevent the death of cardiomyocytes, the development of hypoxic phenomena. Against the background of the use of "Panangin", the contractility of the heart and the activity of the heart and vascular system as a whole are normalized.

What is the effect of "Panangin"?

Pharmacodynamics, pharmacokinetics

Magnesium and potassium ions are important cations that affect the function of enzymes that can regulate tissue metabolism. Aspartate, which is an endogenous substance that forms strong chemical compounds with various elements, transports cations through the membranes into the cell. in a cage active substances the drug is in the form of complex compounds. Their function depends on the concentration of calcium and sodium in the intercellular and cellular space. Cations are able to regulate the process of assimilation of nutrients and oxygen by the myocardium, as well as myocardial contractility. Deficiency of potassium and magnesium in the body can cause pathological changes in the cardiovascular system, for example, arterial hypertension, arrhythmia, sclerosis of the myocardium, coronary arteries.

The pharmacokinetics of Panangin has not been studied by the manufacturer. It is reliably known that the absorption of active components in the gastrointestinal tract is quite high. If the drug is administered intravenously, then the accumulation of substances occurs in the myocardium, while developing the maximum therapeutic effect. Potassium and magnesium aspartate is excreted from the body mainly through the kidneys.

So, what is Panangin for?

Indications for use

  1. Substitution therapy for deficiency of magnesium and potassium ions of various nature.
  2. Chronic form of heart failure.
  3. Conditions after a heart attack.
  4. Cardiac ischemia due to circulatory failure in the coronary arteries.
  5. Ventricular extrasystole.
  6. Atrial fibrillation type arrhythmia.
  7. Cardiac arrhythmias caused by intoxication with glycosides, which are part of the digitalis group.
  8. Heart rhythm disturbances that develop against the background of changes in electrolyte balance, associated primarily with hypokalemia (lack of potassium ions in the blood).

When conducting long-term therapy using Panangin, it is important to periodically monitor the concentration of potassium and magnesium ions in the blood.

It is contraindicated in pediatric patients.

During pregnancy, the use of the drug is allowed if there are individual indications starting from the second trimester. The use of the drug in the first trimester can lead to toxic poisoning of the fetus.

If there is a need to use the medication in the lactation period, it is recommended to temporarily suspend feeding and transfer the child to artificial mixtures.

Contraindications for use

Before starting the use of "Panangin" in injections, it is important to consult a doctor and take into account existing contraindications, among which:

  1. Violations of the conduction of impulses in the AV node.
  2. Severe forms of hepatic, renal failure.
  3. cardiogenic shock,
  4. Addison's disease.
  5. metabolic acidosis.
  6. hemolytic anemia.
  7. Dehydration of the body against the background of extensive burns, overheating, diarrhea, repeated vomiting.
  8. Impaired amino acid metabolism.
  9. Hypermagnesemia (increased concentration of magnesium in the blood), hyperkalemia (increased concentration of potassium).
  10. Individual susceptibility to any of the components that make up the medicinal product.

Let us consider in more detail the dosages of "Panangin".

Medication use

The tablet preparation is recommended to be used three times a day in an amount of up to 2 tablets. If the patient has severe forms of the disease, it is permissible to increase the single dosage to 3 tablets. Maintenance therapy involves the use of the drug for 3 weeks three times a day, 1 tablet. The drug should be taken after eating, as gastric juice has a destructive effect on active ingredients drug. The tablets should be swallowed whole with a sufficient amount of liquid.

Before jet intravenous administration, the ampoule is diluted in 50 ml of glucose (5%). Before installing a dropper with Panangin, the drug is diluted with 200 ml of saline. The introduction should be done slowly. The duration of the therapeutic course is determined by the doctor, taking into account the severity of the pathological phenomenon.

In the treatment of pregnant women, Panangin is prescribed according to standard schemes, taking into account the risk to the child and the therapeutic need for the mother. In the lactation period, the drug is contraindicated.

Negative impacts

Against the background of the use of Panangin, the following negative effects may develop: dizziness, abdominal pain, nausea. As a rule, side effects are rare, and their clinical manifestations disappear without any treatment within a few days.

What is the compatibility of "Panangin"?

Interaction with other drugs

The parallel use of the drug with potassium-sparing diuretics and ACE inhibitors can provoke the development of hyperkalemia, which increases the likelihood of severe arrhythmias and subsequent cardiac arrest.

Rapid intravenous administration of the drug causes dizziness, nausea, redness of the face. To prevent these conditions, it is recommended to administer the medication at a slow pace.

It is important to exercise caution when prescribing the drug to patients suffering from extensive tissue damage, extensive burns, myasthenia gravis, since the risk of hyperkalemia is significant.

Is the action of "Panangin" always safe?

Overdose

In case of an overdose, the patient develops symptoms of hypermagnesemia and hyperkalemia: arrhythmia develops, sensitivity in the limbs is disturbed, diarrhea occurs, repeated vomiting, facial flushing, lethargy, hypotension, convulsions, respiratory depression, there is a possibility of cardiac arrest.

If signs of intoxication occur, you should immediately stop taking the drug, wash the patient's stomach, ensure the intake of enterosorbents, prescribe peritoneal dialysis and hemodialysis.

Analogues of "Panangin"

If necessary, the medication can be replaced with one of the following drugs:

  1. "Asparkam-L". It is a domestic analogue of Panangin, produced in injectable form. Prohibited for use by minors, pregnant women, in the lactation period.
  2. "Potassium Magnesium". It is a dietary supplement that is not allowed to be taken during the lactation period, during pregnancy, under the age of 14 years.
  3. "Potassium and magnesium aspartate". It is a drug of German origin. Produced in the form of a solution. Contraindications for its use are childhood, lactation period, pregnancy.
  4. "Asparkam". It is a complete analogue of "Panangin". Pharmacological form of "Asparkam" - tablets. It is allowed to use with caution in the lactation period and during pregnancy.

"Asparkam" or "Panangin"?

It should be noted that "Asparkam" is a complete analogue of "Panangin", time-tested. Moreover, the cost of Asparkam is much lower than that of Panangin.

However, the main requirement for the drug is its effectiveness. Patients note that this figure is higher in Panangin.

Despite this, the doctor should determine which drug should be taken - "Asparkam" or "Panangin".

Price

The average cost of "Panangin" is 145 rubles per pack of solution, 140 rubles per pack of tablets. It depends on the region.

The drug Panangin is an important source of electrolytes (magnesium, potassium ions) for the activity of the main organ. In addition, it expresses the impact on metabolic processes. A remedy is produced, both in tablets, and you can find panangin in ampoules, the instructions for use of which prescribe for which diseases the medication is indicated, how it is used.

One of the forms of release is a solution for internal use; it is also an injection ampoules.

The medicine contains components that are important to the body. These are substances such as potassium and magnesium. With a lack of these substances in the body, a large number of problems arise in the activity of the heart.

In the substance potassium, the main purpose is to maintain the membrane capacity of myocytes, neurons, and tissue structures of the myocardium. When the balance between the extracellular and intracellular presence of potassium is disturbed, a decrease in contractions of the heart muscle occurs, and then arrhythmia and tachycardia occur.

The substance magnesium belongs to the main in most of the farm effects, the most active metabolism, the integrity of nucleic acids. It affects the activity of the main organ, favoring a decrease in the tension of contractions, reduces the frequency of contractions of the function of the main organ and the need for myocardial oxygen. Thanks to the magnesium substance, a pronounced anti-ischemic effect on the myocardium occurs.

Together, these 2 components present in the solution reduce the toxicity of cardiac glycosides without affecting their inotropic activity.

In addition, the combination of components indicates that a lack of one of them leads to a deficiency of the other and leads to the manifestation of the following diseases.

  1. Hypertension.
  2. Atherosclerosis.
  3. Arrhythmia.

The solution for intravenous injection has a colorless tint or a slightly greenish, transparent color.

The composition of the solution:

  • potassium asparanginate - hemihydrate;
  • magnesium aspartate - tetrahydrate.

The other ingredient is water.

Indications for use

The medicine in the form of a solution is shown:

  • as a complex cure for heart failure, heart attack acute form, when it changes heart rate(ventricular arrhythmia, arrhythmias provoked by an overdose of glycosides) which are determined by electrolyte changes;
  • with hypokalemia, when the level of potassium in the circulatory system;
  • with rhythm changes that are associated with digitalis drug intoxication;
  • with paroxysms of atrial fibrillation;
  • to improve the tolerance of cardiac glycosides;
  • make up for the lack of magnesium and potassium, if their intake is reduced in food.

Panangin also treats coronary inferiority, which indicates a discrepancy between the cardiac need for oxygen and its intake.

How is the solution used?

Panangin is prescribed into the vein, a slow introduction of the solution is required, 20 drops per minute are dripped. If necessary, the drug can be administered again after 6 hours.

To prepare a medicine for an intravenous dropper, take 1 ampoule and dilute them with 5% glucose (50-100 ml).

The drug can be used for combined treatment.

Use of the solution during childbearing and breastfeeding

There is no information on the negative impact of the drug in the form of a solution for intravenous infusion during childbearing and breastfeeding.

Use for changes in kidney function

With acute and chronic form renal insufficiency, oliguria, anuria.

Important Information

It is necessary to prescribe panangin with extreme caution to patients with an increased risk of hyperkalemia. In this case, you will need to constantly monitor the level of potassium ions in the blood.

Before using the medicine, the patient should consult a doctor.

If you quickly inject the drug into the vein, hyperemia of the skin may develop.

Panangin does not affect the ability to drive vehicles, and to do work that requires concentrated concentration and an instant psychomotor reflex.

Panangin contraindication

The drug is not administered in the following diseases and conditions of the patient:

  • renal inferiority in acute and chronic form;
  • hyperkalemia;
  • hypermagnesemia;
  • Addison's disease;
  • cardiogenic shock;
  • dehydration;
  • severe myasthenia gravis;
  • inferiority of the adrenal cortex;
  • minors;
  • lactation period;
  • during breastfeeding;
  • high sensitivity to the components present in the composition.

With extreme caution, the solution is administered in case of:

  • with changes in the functioning of the liver;
  • metabolic acidosis;
  • threat of puffiness;
  • changes in the functioning of the kidneys, when it is not possible to regularly monitor the content of magnesium in the blood;
  • hypophosphatemia;
  • urolithic diathesis, which is associated with a change in the metabolism of magnesium, calcium, ammonium phosphate.


Side effects of panangin

When the solution is abruptly administered, signs of hyperkalemia may develop.

  1. The patient gets tired quickly.
  2. Myasthenia.
  3. Paresthesia.
  4. Confused consciousness.
  5. The rhythm of the heart is disturbed (tachycardia, bradycardia).

If the patient complains of dizziness, reduce the dose.

If signs of hypermagnesemia occur, the following may occur:

  • neuromuscular excitability will decrease;
  • there will be reflexes to vomiting;
  • vomit;
  • lethargy;
  • blood pressure will decrease.

Phlebitis may also develop, the amount of extrasysitol will increase. With a rapid increase in the presence of magnesium ions in the circulatory system, the following occurs:

  • suppression of tendon reflexes;
  • paralysis of the respiratory system;
  • a person has a coma.

For treatment, the drug is canceled, symptomatic therapy is carried out, calcium chloride is injected into the vein. When necessary, carry out the procedure of hemodialysis, peritoneal dialysis.


Conjugation of Panangin with other drugs

If used simultaneously with potassium-sparing diuretics - triamterene, spironolactone, as well as beta-andrenoblockers, cyclosporine, heparin, inhibitors, ACE, NVPS, there is an increase in the risk of hyperkalemia, arrhythmia, asystole may occur.

When taking potassium along with GCS, hypokalemia goes away. Under the influence of potassium, one can notice a decrease in the unjustified effects of cardiac glycosides. Panangin is also able to enhance the negative dromo and bathmotropic effect of antiarrhythmic drugs.

Since potassium ions are present in the preparation, when using the product together:

  • with ACE inhibitors;
  • beta - andrenoblockers;
  • cyclosporine;
  • heparin;
  • NSAIDs;
  • hyperkalemia may develop, up to the occurrence of extrasystole.

Magnesium medicines reduce the effect of:

  • neomycin;
  • polymyxin;
  • tetracycline;
  • streptomycin.

Calcium supplements can reduce the effects of magnesium medications. Thanks to anesthetics, the inhibitory effect of magnesium on the nervous system becomes stronger.

Using Panangin with atracurium, dexamethonium, suxamethonium, an increase in the neuromuscular environment can be observed. If taken with calcitriol, the magnesium level in the circulatory system will increase.

Medicines that have an astringent and enveloping effect can reduce the absorption of the drug in the gastrointestinal tract. It is required to adhere to a 3-hour interval between the use of the medicine with the means listed above.

The drug for internal use is compatible with a solution of cardiac glycosides, which help to improve their tolerance, reduce the unpleasant effects of cardiac glycosides.

In order to purchase panangin in the form of a solution, you will need a prescription from a doctor.

Registration number: P N013093/02

Tradename: Panangin ®

Dosage form : film-coated tablets.

Composition:

Active ingredients:
Magnesium aspartate 140.0 mg
(in the form of magnesium aspartate 4 H 2 O - 175.00 mg) and potassium aspartate 158.0 mg
(in the form of potassium aspartate 1/2 H 2 O - 166.30 mg).
Excipients:
Silicon dioxide, colloidal - 2.00 mg, povidone K30 - 3.30 mg, magnesium stearate - 4.00 mg, talc - 10.00 mg, corn starch - 86.10 mg, potato starch - 3.30 mg in the core tablets.
Shell composition:
Macrogol 6000 - 1.40 mg, titanium dioxide Color. ind. 77891, E171 - 5.30 mg, butyl methacrylate, dimethylaminoethyl methacrylate and methyl methacrylate copolymer - 6.00 mg, talc - 7.30 mg.

Description

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

Pharmacological group: potassium and magnesium preparation.

ATX code: A12CX

Pharmacological properties

Pharmacodynamics: the most important intracellular cations K + and 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, calcium, sodium and magnesium ions affects myocardial contractility. Endogenous aspartate acts as an ion conductor: 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. Magnesium/potassium deficiency predisposes to the development of hypertension, atherosclerosis of the coronary arteries, arrhythmias and metabolic changes in the myocardium.
Pharmacokinetics: Absorption is high. Excreted by the kidneys.

Indications for use

As additional funds during treatment chronic diseases heart (heart failure, condition after myocardial infarction), cardiac arrhythmias (primarily ventricular arrhythmias), in the treatment of digitalis; replacement therapy with a lack of magnesium / potassium in food.

Contraindications

Hypersensitivity to any of the constituent components of the drug, acute and chronic kidney failure, hyperkalemia, hypermagnesemia, Addison's disease, atrioventricular block I-III degree, cardiogenic shock (blood pressure less than 90 mm Hg), amino acid metabolism disorder, myasthenia gravis, hemolysis, acute metabolic acidosis, dehydration.

Carefully

Pregnancy (especially in the first trimester) and during lactation.

Dosage and administration

Before use, you should consult with your doctor.
Inside, the drug should be used after meals, because. the acidic environment of the stomach reduces its effectiveness.
Plain daily dose: 1-2 tablets. 3 times a day. Maximum daily dose: 3 tablets 3 times a day.
The duration of the drug and the need for repeated courses is determined by the doctor.

Side effect

Nausea, vomiting, diarrhea, discomfort or burning in the pancreas (in patients with anacid gastritis or cholecystitis), atrioventricular blockade, a paradoxical reaction (an increase in the number of extrasystoles), hyperkalemia (nausea, vomiting, diarrhea, paresthesia), hypermagnesemia (flushing of the face, feeling of thirst, decreased blood pressure, hyporeflexia, respiratory depression, convulsions).

Overdose

Symptoms: conduction disturbance (especially with previous pathology of the conduction system of the heart).
Treatment: intravenous administration of calcium chloride; if necessary - hemodialysis and peritoneal dialysis.

Interaction with other drugs

Pharmacodynamic: combined use with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, angiotensin-converting enzyme (ACE) inhibitors, non-steroidal anti-inflammatory drugs increases the risk of developing hyperkalemia up to the development of arrhythmia and asystole. The use of potassium preparations in conjunction with glucocorticosteroids eliminates the hypokalemia caused by the latter. Decreases under the influence of potassium unwanted effects cardiac glycosides. Enhances the negative dromo- and batmotropic effect of antiarrhythmic medicines. Magnesium reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin. Anesthetics increase the inhibitory effect of magnesium preparations on the central nervous system; with simultaneous use with atracuronium, decamethonium, succinyl chloride and suxamethonium, an increase in neuromuscular blockade is possible; calcitriol increases the content of magnesium in the blood plasma, calcium preparations reduce the effect of magnesium preparations.
Pharmacokinetic: astringents and enveloping agents reduce the absorption of the drug in the gastrointestinal tract and it is necessary to observe a three-hour interval between ingestion of Panangin ® with the listed agents.

special instructions

Patients with diseases accompanied by hyperkalemia require special attention: regular monitoring of the ionogram is necessary.

Influence on the ability to drive a car and perform work associated with an increased risk of injury: does not affect the ability to drive a car and engage in activities that require increased concentration and speed of psychomotor reactions.

Release form

Film-coated tablets.
50 tablets in a polypropylene bottle. 1 bottle in a cardboard box with instructions for use.

Storage conditions

At a temperature of 15-30 °C. Keep out of the reach of children.

Best before date

5 years.
Do not use the drug after the expiration date.

Terms of dispensing from pharmacies

Without recipe.

Manufacturer:

OJSC "Gedeon Richter"
1103 Budapest, st. Dömröi, 19-21, Hungary
JSC "GEDEON RICHTER - RUS"

In the case of packaging and packaging of the drug, JSC "GEDEON RICHTER - RUS" additionally indicate:
Packaged/Packed at JSC "GEDEON RICHTER - RUS"
140342 Russia, Moscow region, Egoryevsky district, Shuvoe settlement, st. Lesnaya, 40

Consumer complaints should be directed to:
Moscow Representative Office of JSC "Gedeon Richter"
119049 Moscow, 4th Dobryninsky lane, house 8.

Panangin is a complex preparation for replenishing the deficiency of potassium and magnesium in the body. The active ingredients are potassium and magnesium aspartate.

The drug is a source of magnesium and potassium and affects the metabolic processes in the body. Potassium and magnesium are directly involved in the functioning of various enzymes, involved in the interaction of macromolecules and intracellular structures, as well as in the mechanism of muscle contractility.

These microelements are especially necessary for the correct contractile work of the myocardium. With a prolonged deficiency of magnesium and potassium ions, the body may develop arterial hypertension, atherosclerosis of the coronary arteries, and metabolic changes in the myocardium may also occur.

One of the most significant physiological function of potassium is to maintain membrane potential neurons and various excitable structures of myocardial tissue. A prolonged lack of potassium in the body leads to an increase in the toxicity of cardiac glycosides and the occurrence of arrhythmia and tachycardia.

No less valuable for the body is magnesium, which is a cofactor in about 300 enzymatic metabolic reactions of energy metabolism and the production of nucleic acids and proteins. Due to magnesium, the heart rate and myocardial muscle tension partially decrease, and magnesium also produces an anti-ischemic effect on myocardial tissue.

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Price in pharmacies

Information about the price of Panangin in pharmacies in Russia is taken from the data of online pharmacies and may differ slightly from the price in your region.

You can buy the drug in pharmacies in Moscow at a price: Panangin tablets 50 pieces - from 144 to 167 rubles, Panangin injection solution 10ml 5 ampoules - from 149 to 171 rubles.

Conditions for dispensing from pharmacies - tablets without a prescription, prescription solution.

Keep out of the reach of children at a temperature of +15…+30 °С. The shelf life of tablets is 5 years, the solution for intravenous administration is 3 years.

The list of analogues is presented below.

What is Panangin for?

The drug Panangin is prescribed in the following cases:

  • violation of the heart rhythm;
  • chronic heart disease;
  • condition after myocardial infarction;
  • replacement therapy for potassium / magnesium deficiency;
  • treatment with cardiac glycosides.

Panangin is also used in the treatment of coronary insufficiency (a discrepancy between the heart's need for oxygen and its delivery). There is evidence of a decrease under the influence of the drug of hypoxic disorders of myocardial metabolism associated with deterioration coronary circulation and hypokalemia caused by the use of diuretics that increase the excretion of sodium and chlorine.

Instructions for use Panangin, doses and rules

Tablets are taken orally after meals with clean water.

The standard dosage according to the instructions for use is 1-2 Panangin tablets 3 times a day. In severe cases, it is permissible to take 3 tablets 3 times a day for a course of no more than 3 weeks, then switch to the standard dosage.

The duration of the course of treatment is determined by the doctor individually.

Panangin injections

Solution (ampoules) Panangin is administered intravenously at a rate of 20 drops per minute. Before administration, dilute the contents of 1 ampoule (10 ml) in 20-30 ml of isotonic sodium chloride solution or 5% glucose solution.

If necessary, you can add a solution of strophanthin or other cardiac glycosides in combination therapy.

The introduction of the solution can be repeated after 4-6 hours.

Important information

With fast intravenous administration solution for injection may develop hyperkalemia and hypermagnesemia.

Use during pregnancy and lactation

With special care it is prescribed to pregnant and lactating women. In the first trimester, taking the drug is prohibited, then only as directed and under the supervision of a doctor.

Application features

Before using the drug, read the sections of the instructions for use on contraindications, possible side effects and other important information.

Side effects of Panangin

Instructions for use warns of the possibility of development side effects drug Panangin:

  • Digestive system - nausea, occasional vomiting, development of a feeling of discomfort or burning in the upper abdomen (pit of the stomach).
  • Cardiovascular system - a paradoxical reaction of the heart, accompanied by the development of arrhythmia, atrioventricular blockade.
  • Metabolism and water-salt metabolism - hyperkalemia (increased levels of potassium ions in the blood), which is accompanied by nausea, vomiting, skin paresthesia (impaired sensitivity), heart rhythm disturbances, muscle cramps, confusion and hypermagnesemia (increased levels of magnesium ions in the blood) with the development of vomiting, lethargy (severe drowsiness up to coma), a decrease in systemic blood pressure.

With the rapid intravenous administration of the solution for injection, hyperkalemia and hypermagnesemia may develop. In the event of side effects, the administration or administration of the drug is stopped.

Contraindications

It is contraindicated to use Panangin tablets in the following diseases or conditions:

  • hypersensitivity to any of the constituent components of the drug;
  • acute and chronic renal failure;
  • hyperkalemia;
  • hypermagnesemia;
  • Addison's disease;
  • AV block I–III degree;
  • cardiogenic shock (BP<90 мм рт. ст.);
  • violation of amino acid metabolism;
  • severe myasthenia gravis;
  • hemolysis;
  • acute metabolic acidosis;
  • dehydration.

Carefully:

  • pregnancy (especially the first trimester);
  • lactation period.

The solution for parenteral administration should not be used in case of insufficiency of the adrenal cortex, hypersensitivity to the components of the solution, pregnancy at any stage of the course and lactation (breastfeeding), as well as for children under the age of 18 years.

With caution, Panangin solution is used for atrioventricular blockade of the 1st degree, severe violations of the functional activity of the liver, kidneys, metabolic acidosis.

Overdose

With many years of use of the drug, cases of overdose were not recorded. Theoretically, overdose may develop signs of hyperkalemia (nausea, vomiting, weakness, muscle paralysis, diarrhea, paresthesia) and hypermagnesemia (facial redness, thirst, lowering blood pressure, hyporeflexia, neuromuscular blockade, respiratory depression, convulsions, weakness, paralysis, arrhythmias).

List of analogues Panangin

If necessary, replace the drug, there are two options - choosing another drug with the same active ingredient or a drug with a similar effect, but with a different active substance.

Analogues Panangin, list of drugs:

  1. Aspangin,
  2. Pamaton.

ATX code matches:

  • Asparkam,
  • Potassium and magnesium asparaginate,
  • Pamaton.

When choosing a replacement, it is important to understand that the price, instructions for use and reviews for Panangin do not apply to analogues. Before replacing, you must obtain the approval of the attending physician and do not replace the drug yourself.

Panangin and Asparkam what is the difference?

Panangin is the original drug, Asparkam is its generic. It is generally accepted that generics are worse in terms of the degree of purification of raw materials and, accordingly, cheaper than their originals.

Both drugs are identical in chemical composition, but differ in dosage form. Panangin is available in coated dragees, and Asparkam is in the form of tablets. With colitis, stomach ulcers and duodenal ulcers, it is better to take Panangin, it is more gentle for the stomach.

Special Information for Healthcare Professionals

Interactions

The risk of hyperkalemia increases with the simultaneous use of the drug with beta-blockers, potassium-sparing diuretics (spironolactone, triamterene), cyclosporine, ACE inhibitors, heparin and NSAIDs.

The negative batmo- and dromotropic effect of antiarrhythmic drugs is increasing.

The use of Panangin together with GCS reduces hypokalemia caused by these substances.

It is possible to increase the neuromuscular blockade when using Panangin with atracurium, suxamethonium, dexamethonium.

Calcium preparations reduce the effect of magnesium ions, and anesthetics increase the inhibitory effect of magnesium on the central nervous system.

special instructions

Astringents and enveloping preparations reduce the absorption of Panangin in the gastrointestinal tract.

The drug Panangin is a source of electrolytes important for the work of the heart: magnesium and potassium ions. In addition, the drug affects the metabolic processes.

Pharmacodynamics and pharmacokinetics of the drug

The composition of Panangin medicines includes two vital components - potassium and magnesium. Why their deficiency in the body causes a lot of problems in the work of the heart? Let's consider in more detail.

  • Potassium. An important function of this element is that it maintains the membrane potential of myocytes, neurons and myocardial tissue structures. The disturbed balance between extracellular and intracellular potassium content can lead to a decrease in heart contractions, which, in turn, provokes arrhythmia, tachycardia.
  • Magnesium. An important cofactor for most enzymatic reactions, in particular, energy metabolism and nucleic acid synthesis. It has an important effect on the work of the heart: it reduces the tension of contractions, as well as the frequency of the rhythm of the heart, helping to reduce the need for myocardial tissue in oxygen. Magnesium has a pronounced anti-ischemic effect on myocardial tissue.

The "potassium + magnesium" tandem in Panangin reduces the toxicity of cardiac glycosides and does not affect their inotropic effect.

In addition, the combination of potassium and magnesium is based on the fact that a deficiency of one substance is often accompanied by a deficiency of another, which develops diseases such as hypertension, atherosclerosis of the coronary arteries, and arrhythmias.

Therefore, simultaneous correction of the content of both elements is required.

Indications for use

The range of possible use of the medicine Panangin is very wide, let us consider in more detail in what situation and for what health problems it helps:

  • the drug is actively used for cardiac arrhythmias, which are mainly due to electrolyte disorders (or, more simply, ionic composition disorders) - a lack of potassium in the blood,
  • the drug is used for cardiac arrhythmias, which are caused by intoxication with digitalis medicinal plants,
  • Panangin is effective in violation of the atrial rhythm (paroxysms of their flicker),
  • use the medicine for early violations of the rhythm of the heart ventricles (ventricular extrasystole),
  • prescribe a remedy for the treatment of coronary insufficiency (which in the language of medicine means a discrepancy between the need for oxygen in the heart and the volume of its supply),
  • Panangin is used to reduce hypoxic disorders of myocardial metabolism (lack of oxygen supply to the heart tissues or a violation of its absorption),
  • with a decrease in potassium in the blood, which is caused by the use of saluretic drugs (for example, diuretics, which increase the excretion of chlorine and sodium),
  • as replacement therapy for potassium or magnesium deficiency in foods.

Contraindications

The drug is not indicated for all patients, there are diseases in which the use of this medicine is contraindicated:

  • hyperkalemia (content in excess of the established norm of potassium in the blood),
  • hypermagnesemia (magnesium content in excess of the established norm in the blood),
  • cardiogenic shock,
  • severe form of myasthenia gravis,
  • violation of amino acid metabolism,
  • acute form of metabolic acidosis,
  • hemolysis, dehydration,
  • insufficient function of the adrenal cortex,
  • hypersensitivity to the components of the drug,
  • lack of water in the body (dehydration).

Use with caution:

  • in the 1st trimester of pregnancy,
  • with sensitive and severe disorders of the liver,
  • with a possible risk of varying degrees of edema,
  • with hypophosphatemia,
  • with metabolic acidosis
  • with urolithic diathesis, which is associated with a violation of calcium, magnesium metabolism.

Mode of application

Panangin is prescribed using the following dosage:

  • the classic norm according to the instructions is 1-2 tablets per day,
  • severe cases (intolerance to the digitalis preparation, impaired coronary circulation) - 3 times a day for 3 tablets, and after 5-7 days the dose is reduced to 1 tablet 2 times a day.

The tablet is taken after a meal.

To relieve (stop) attacks of arrhythmia, the drug solution is administered slowly intravenously, for this the contents of the ampoule must be diluted with an isotonic solution of glucose or sodium chloride.

Overdose and elimination of symptoms

Cases of overdose with Panangin have not been registered to date. However, there is a possibility of symptoms of hypermagnesemia and hyperkalemia, that is, an oversaturation of potassium and magnesium preparations in the blood.

Symptoms of hyperkalemia:

  • myasthenia,
  • fast and prolonged fatigue,
  • paresthesia,
  • disorders in the work of the heart (arrhythmia, bradycardia, rarely - cardiac arrest),
  • confusion.

Symptoms of hypermagnesemia:

  • vomiting (urges),
  • Sopor,
  • decrease in blood pressure,
  • respiratory paralysis, coma,
  • with a sharp increase in the concentration of magnesium in the blood, deep tendon reflexes can be inhibited.

Treatment of an overdose of Panangin consists in the abolition of the drug or in the elimination of symptoms by administering calcium chloride intravenously. In severe cases, hemodialysis is prescribed.

Interaction with other drugs

In the case of taking other medications, the patient must notify his doctor about this in order to establish the possibility of joint treatment with Panangin. Consider the interaction of this drug with others.

  1. The drug is able to significantly inhibit the absorption of tetracycline and iron salts, as well as sodium fluoride. It is recommended to keep at least 3 hours between taking these medications.
  2. Simultaneous use of ACE inhibitors or potassium-sparing diuretics (Triamteren, Spironolactone) increases the risk of developing hyperkalemia, therefore, potassium in the blood plasma should be monitored.
  3. Under the influence of potassium contained in Panangin, the side effects of cardiac glycosides are reduced.
  4. Anesthetizing drugs increase the inhibition of magnesium drugs of the central nervous system.
  5. Parallel administration of Panangin and drugs Atracuronium, Decamethonium, Succinyl chloride, Suxamethonium can provoke an increase in neuromuscular blockade.
  6. The drug Calcitriol increases the amount of magnesium in the blood.

Price

The price of the drug in question varies within the following limits:

  • in Russia - from 128 to 139 rubles,
  • in Ukraine - from 38 to 43 hryvnias.

Analogues

Asparkam. The most popular analogue of Panangin is Asparkam. This is a time-tested medicine - it has been produced for several decades.

This drug is of domestic production, its composition is completely similar to the composition of Panangin, while the price of Asparkam is several times less.

The main indicator of these drugs is their effectiveness, and the reviews of patients who used both drugs indicate the high effectiveness of Panangin.

The difference between Panangin and Asparkam is that Panangin is available in dragee, and Asparkam is in tablets.

The dragee is covered with a protective shell, therefore, with colitis, enterocolitis, stomach diseases, ulcers, it is better to take Panangin to protect against the active active substance.

The main difference between these drugs is that Panangin is the original, and Asparkam is an analogue, so its effect is somewhat weaker.

Aspangin. This medicine is a complete analogue of Panangin in composition, indications, contraindications and side effects. It is produced in the form of dragees, solutions for injections and for intramuscular administration, however, the effectiveness of the use is somewhat weaker and less pronounced than from the use of Panangin.