- Characteristics of the drug
- Basic instructions
- Price of funds
- Video about the drug Pradaxa
Pradaxa is a medicine, which prevents the formation of blood clots by affecting the proteins circulating in the blood. This drug and its cheaper analogs slow down the appearance of fibrin filaments, woven into a dense network and, together with captured platelets, forming clots - closing defects of blood vessels.
The drug slows down the growth of blood clots that have already arisen, enhances the effect on intravital blood clots in the lumen of a blood vessel or in the heart cavity of endogenous fibrinolytic enzymes.
Characteristics of the drug
The main active component of the Pradaxa preparation, which is produced in the form of oblong capsules with an opaque white body and the same opaque the lid is dabigatran etexilate mesylate - a yellowish powder, easily soluble in methanol, slightly soluble in monohydric alcohol and poorly soluble in isopropanol.
As for the excipients, among them in the composition of the tablets are present:
- gum arabic (or glycoprotein) - natural polysaccharide colloid from Senegalese acacia;
- tartaric or dioxysuccinic acid, characterized by a pronounced sour taste;
- hydroxypropyl methylcellulose;
- dimethicone is a synthetic silicone capable of reducing gas formation in the intestine and covering the walls of the alimentary canal with a protective film;
- pharmaceutical talc, which does not dissolve in liquids and forms a precipitate when combined with acids.
For the manufacture of the shell of each capsule, the manufacturer (German pharmaceutical company Boehringer Ingelheim, founded in 1885) uses purified water, linear sulfate polysaccharides derived from red algae, potassium chloride, hypromellose and titanium dioxide (food additive E171).
Today, on the shelves of pharmacies, you can find Pradaxa containing 75 mg, 110 mg and 150 mg of dabigatran etexilate. One carton contains from 1 to 6 opaque blisters, which are small pockets or holes made of thermoplastic resin (plastic), with ten tablets in everyone.
Pradaxa, cheaper analogs of which will be discussed later, is prescribed to patients in the process of treating dysfunctions of the musculoskeletal system. This is done in order to prevent acute blockage (embolism) of blood vessels by a thrombus that has come off from the place of its formation (on the wall of the heart, vessel) and entered the circulating blood.
In the absence of proper treatment, the blood flow in the vessel stops, tissue ischemia occurs in the basin of the occluded vessel, which leads to cerebral infarction.
Other indications for the use of Pradax are the prevention of stroke and the minimization of cardiovascular mortality in patients with supraventricular tachyarrhythmias with chaotic electrical activity of the atria with a pulse frequency of 350-700 V minute.
Often, doctors prescribe this medication for people with pulmonary embolism (PE). The disease is characterized by blockage of the pulmonary artery or its branches with blood clots, which form more often in the large veins of the lower extremities or pelvis (embolism).
The regimen of admission, depending on the history of diseases, is as follows:
- prevention of acute disturbance of the blood supply to the brain, characterized by the sudden appearance of focal or cerebral neurological symptoms, which persists for more than 24 hours or leads to the death of the patient in a shorter period of time due to cerebrovascular pathology (stroke) - 1 tablet in the morning and in the evening;
- deep vein thrombosis of the lower extremities, pulmonary embolism and prevention of deaths provoked by these diagnoses - too 1 capsule twice a day, but only after five days of treatment with a parenteral anticoagulant (sodium heparin, calcium nadroparin).
Patients who are 75-80 years old should be treated with Pradaxa under the strict supervision of doctors. The same applies to people with esophageal disease, accompanied by inflammation of the esophageal lining, gastritis, an increased risk of bleeding, and moderate renal failure.
Patients who are being treated with an antianginal and antiarrhythmic drug from the group slow calcium channel blockers (Verapamil), it is recommended to reduce the daily dose from 300 mg up to 220 mg.
Pradaxa, analogues of which can be bought at a cheaper cost in almost any pharmacy, is strictly forbidden to take in hemorrhagic hemostasiopathies - extensive a group of hereditary or acquired pathologies of the hemostasis system, in which there is an increased tendency to intense bleeding, hemorrhages of various localizations.
Taking the drug is also prohibited for the following diseases:
- end-stage chronic renal failure, which threatens the patient's life and requires replacement of lost renal function;
- the presence of an artificial heart valve - a prosthesis that provides the required direction of blood flow due to intermittent overlap of the mouths of venous and arterial vessels;
- aneurysm or protrusion of the artery wall due to its thinning or stretching; expansion of the vessel lumen by more than 2 times;
- varicose veins of the esophagus, which is the result of disturbances in blood flow in the portal vein and the gastroesophageal plexus by an excessive amount of flowing blood, which seeks outflow from the heart;
- hypersensitivity to the active ingredients that make up the capsules.
If the daily dose of Pradax is exceeded, the patient may complain of bleeding from the anus, urticaria, vomiting, and nausea. A common side effect is a decrease in the mass of red blood cells, or red blood cells, in the human body; the presence of blood in the urine in excess of the values that constitute the physiological norm.
People with increased risk of bleeding, such as age over 75, history of gastrointestinal bleeding (especially not associated with a reversible cause), stroke history of non-cardioembolic nature, chronic liver or kidney disease, other acute and chronic diseases, it is necessary to take Pradax tablets with maximum caution.
Before undergoing a medical procedure involving penetration through the body's natural external barriers (skin, mucous membranes) or before surgery, the medication should be stopped one day before operations.
With regard to drug interactions, dabigatran etexilate mesylate can be taken in complex therapy with a class III synthetic antiarrhythmic drug for oral administration Dronedarone.
At the terminal half-life, the renal clearance rate is an indicator of the cleansing of biological fluids or tissues organism from a substance in the process of its biotransformation, redistribution in the body, as well as excretion from the body, Dronedarone does not affect.
Pradaxa, analogs of which are cheaper, are presented below, with complex therapy with Verapamil, a phenylalkylamine derivative and a blocker of "slow" calcium channels (BMCC), is able to increase the pharmacokinetic parameter characterizing the total concentration of the drug in the blood plasma during the entire time observation.
But from the simultaneous administration of dabigatran etexilate with a membrane efflux transporter protein with a wide spectrum endogenous and exogenous substrates, it is advisable to abstain, since this leads to a decrease in the effect of a direct inhibitor thrombin.
Replacing an original drug with its equivalent or generic is a fairly common situation faced by pharmacists selling drugs. People ask to find a substitute because the necessary medication is not available at the pharmacy, or in order to save money.
All generics of Pradax, which will be listed below, have been tested for toxicity and bioequivalence, which is determined in a multi-stage biopharmaceutical classification system. It is also worth noting that these analogs are nosological, that is, having a different composition, but similar in indication, and allowing to solve the main problem. Doctors use their help when prescribing therapy in the absence of first-line drugs.
The main similarity of this drug, the main active component of which is acetylsalicylic acid (75 mg), and also stearic acid, microcrystalline cellulose and enterosorbent colloidal silicon dioxide, is effective in the primary prevention of heart attacks in patients angina pectoris.
This is a clinical syndrome characterized by a feeling of discomfort behind the sternum, appears suddenly during physical exertion or emotional overstrain, after eating, usually spreads to the left shoulder, neck, lower jaw, between the shoulder blades, left subscapularis and lasts no more than 10-15 min.
Lospirin is an excellent prophylactic agent for acute ischemic cerebrovascular accident. It is damage to the brain as a result of the formation of a blood clot or cholesterol plaque in a vessel.
During pregnancy, it is strictly forbidden to take Lospirin, if the need for medication has arisen during lactation, then breastfeeding stops without fail. For children aged 4-12 years, the medication is contraindicated, since there is a risk of developing acute liver failure and rapidly progressive encephalopathy.
Pradaxa, cheaper analogs of which are sold in every pharmacy, can be replaced with an indirect anticoagulant and a coumarin derivative - Warfarin.
It is prescribed with the following diagnoses in the patient's history:
- postoperative thrombosis, provoked by the fact that after the operation a person does not move, the muscle-venous pump stops work, respectively, venous blood flow slows down, and clots form in the valves under the influence of thromboplastin blood;
- repeated myocardial infarction;
- vascular embolism is a pathological condition in which particles of a different nature circulate to the blood circulation system (normally they should be absent in the bloodstream);
- atrial fibrillation;
- replacing the affected heart valve with an artificially created product or prosthesis.
The dosage regimen of Warfarin should be determined by the doctor based on the patient's blood coagulation parameters, his reactions to therapy and a number of simple syndromes, which together are characterized by a delineated clinical painting.
The composition of tablets, coated with a thin shell, formed after the drying of the film-forming substance solution applied to the surface of the capsule, contains magnesium salt and acetylsalicylic acid. The role of auxiliary substances is performed by a carbohydrate polymer obtained from corn kernels (corn starch), magnesium stearate, microcrystalline cellulose and potato starch.
A mixture of all these organic compounds has an analgesic, anti-inflammatory, antipyretic and antiplatelet effect, which is aimed at blocking receptors on the surface platelets.
In addition to chronic and acute ischemic heart disease, unstable angina pectoris and acute necrosis of the area of the heart muscle due to prolonged circulatory disorders in the myocardium, which most often develops in the left ventricle, Magnikor is recommended for prescribing to patients with diabetes mellitus, a violation of the lipid composition of the blood, which is accompanied by an increase in its concentration cholesterol.
If a daily dose of 150 mg is exceeded in acute / chronic form of the disease, due to a mismatch between the oxygen demand of the heart muscle and its delivery, leading to impaired heart function (IHD), or a maintenance dose of 75 mg per day, people can face a number of side effects effects.
These include anemia, febrile neutropenia, autonomic dystonia syndrome, decreased white blood cell counts, and heartburn. On the part of the gastrointestinal system, diarrhea, inflammatory disease of the mucous membrane of the colon, erosion of the upper gastrointestinal tract are not excluded.
Pradax, the cheaper analogs of which are presented in the article, can be replaced with Fraxiparine - low molecular weight heparin obtained from standard heparin by depolymerization in special conditions. A distinctive feature of this generic is the dosage form, since it is produced in the form of a transparent or slightly opalescent solution for parenteral administration. Included with the medicine are single-dose glass syringes in the amount of 2 pieces.
Fraxiparin, the main active ingredient of which is calcium nadroparin, is effective in preventive purposes for surgical and orthopedic interventions that increase the risk of developing thromboembolic complications. It is prescribed for proximal deep vein thrombosis in the lower legs, thighs and pelvis, with unstable angina pectoris and myocardial infarction without pathological Q wave.
Prevention of thromboembolic complications during surgery requires the introduction of the recommended dose Fraxiparine, which is 0.3 ml a couple of hours before the operation, after which it will be necessary to do one injection a day. Treatment of unstable angina pectoris and myocardial infarction without a Q wave involves the administration of an anticoagulant twice a day with a time interval of at least 12 hours.
The drug, the active substance of which is cilostazol, reversibly inhibits the aggregation of small (2-9 microns) nuclear-free flat colorless shaped elements blood, formed from megakaryocytes, minimizes the formation of arterial thrombi and proliferation of smooth muscle cells, causes the expansion of blood vessels.
Pletal is prescribed for the treatment of acute occlusion of the vessels of the extremities, which occurs as a result of injuries (if the artery is pinched) or due to the fact that the lumen is blocked by a thrombus / embolus. Vascular atherosclerosis can contribute to the development of occlusion, during which the separated fragments of athermatous plaques lead to blood coagulation and the formation of a thrombus.
It is necessary to take Pletal strictly on an empty stomach, 100 mg twice a day. The treatment course should be from 2 weeks to 25 days, but the first improvements can be noted as early as 5 days.
Price of funds
The cost of generic drugs may differ depending on the origin and quality of raw materials, excipients, dosage form, packaging, country of origin. The price also depends on the degree of "promotion" of the drug (the more often its name flashes on television advertisements or on the internet, the more likely it is that a less popular drug substitute can be purchased cheaper). The cost of all the analogs of Pradax considered in the article is presented in the table below.
|Pradaxa||from 3 173 rub. (60 capsules) up to 9,777 rubles. (180 capsules)|
|Lospirin||from 80 rubles.|
Pradaxa is a highly effective anticoagulant drug and a direct thrombin inhibitor. In the absence of a medication on the shelf of a pharmacy, it can be replaced with one of the cheaper analogues indicated in the article.
Video about the drug Pradaxa
Comparison of Pradax, Xarelto, Eliquis: