Compound
Active ingredient: sodium meglumine succinate – 15.00 g.
Excipients: sodium chloride – 6.00 g, potassium chloride – 0.30 g, magnesium chloride hexahydrate (in terms of anhydrous) – 0.12 g, sodium hydroxide – 1.788 g, succinic acid – to pH from 6.0 to 7.0, water for injection – up to 1.0 l.
Ionic composition per 1 l:
- sodium 147 mmol - potassium 4.02 mmol - magnesium 1.26 mmol - chlorides 109 mmol - succinates 46.0 mmol - meglumine 44.7 mmol
Theoretical osmolarity 353 mOsm/l
Description: transparent colorless liquid.
Pharmacotherapeutic group: solutions affecting water and electrolyte balance. ATX code: В05ВВ
Analogs
Level 4 ATC code matches:
Calcium Chloride
Calcium chloride
Magnesium sulfate
Sodium chloride
Rheosorbilact
Reamberin
Analogs of the drug, according to the ATX code up to the fourth digit, are solutions: Calcium Chloride and Sodium Chloride , Xylate , Glyxil , Magnesium Sulfate , Laktoxyl , Soda-Buffer , Reamberin , etc.
Pharmacological properties
Pharmacodynamics
REAMBERIN® has an antihypoxic and antioxidant effect, having a positive effect on aerobic processes in the cell, reducing the production of free radicals and restoring the energy potential of cells.
The drug activates the enzymatic processes of the Krebs cycle and promotes the utilization of fatty acids and glucose by cells, normalizes the acid-base balance and gas composition of the blood. Has a moderate diuretic effect. Pharmacokinetics
When administered intravenously, the drug is quickly utilized and does not accumulate in the body.
Pharmacokinetics
Suction
Since the drug is administered intravenously, its bioavailability is 100%.
Distribution
Potassium and chlorine ions are included in the general pool of the body. Potassium concentration and the acid-base state of blood plasma are closely related. Alkalosis is often accompanied by hypokalemia, and acidosis is often accompanied by hyperkalemia. Plasma potassium concentrations within the normal range during acidosis indicate potassium deficiency. The intracellular potassium concentration is about 140-150 mmol/l. The potassium concentration in the blood plasma is within the normal range from 3.5 to 5 mmol/l.
Biotransformation
Not applicable.
Removal
Potassium is mainly excreted by the kidneys with urine (about 90%), about 10% is excreted from the body through the gastrointestinal tract. Even in conditions of potassium deficiency, 10-50 mmol of potassium per day is excreted by the kidneys.
Contraindications
Individual intolerance, condition after traumatic brain injury, accompanied by cerebral edema, acute renal failure, chronic kidney disease (stage 5, glomerular filtration rate less than 15 ml/min), pregnancy, breastfeeding period.
With caution
In case of alkalosis, renal failure.
Use during pregnancy and breastfeeding The use of REAMBERIN® during pregnancy and breastfeeding is contraindicated due to the lack of clinical studies in these groups of patients.
Interaction
Increases the negative bathmotropic and dromotropic effectiveness of antiarrhythmic drugs .
When used in parallel with cardiac glycosides, it improves their tolerability.
The combined use of Cyclosporine , Heparin , beta-blockers, potassium-sparing diuretics, ACE inhibitors, NSAIDs may increase the possibility of hyperkalemia .
Directions for use and doses
Adults: administered intravenously at a rate of 1–4.5 ml/min (up to 90 drops per minute). The average daily dose is 10 ml/kg. The course of therapy is up to 11 days.
Children: administered intravenously at a rate of 6–10 ml/kg per day at a rate of 3–4 ml/min. The course of therapy is up to 11 days.
Use in elderly patients. No studies have been conducted in elderly patients. In this regard, the use of the drug should be started with a slower rate of administration: 20–40 drops (1–2 ml) per minute.
Use in patients with renal failure. No studies have been conducted in patients with renal failure. In this regard, it is recommended to exercise caution when using the drug in such patients.
Use for alkalosis. If decompensated alkalosis is detected, the use of the drug should be discontinued until the acid-base state of the blood normalizes.
Potassium chloride 4%/10 ml No. 10 solution d/in.amp.
Instructions for medical use of the drug Potassium chloride Trade name Potassium chloride International nonproprietary name no Dosage form Solution for intravenous administration 40 mg/ml, 10 ml Composition 1 ml of the drug contains the active substance - potassium chloride 40 mg, excipients: dextrose monohydrate, hydrochloric acid 1 M solution – up to pH 3.0-4.0, water for injection. Description Transparent colorless to light yellow liquid Pharmacotherapeutic group Plasma replacement and perfusion solutions. Additives to solutions for intravenous administration. Electrolyte solutions. Potassium chloride ATC code B05XA01 Pharmacological properties Pharmacokinetics Potassium chloride is completely absorbed. In patients with normal potassium levels, approximately 90% of the administered potassium is excreted in the urine. Pharmacodynamics Potassium is the main intracellular ion. The drug normalizes water-electrolyte balance in the body and replenishes potassium deficiency. Activates many cytoplasmic enzymes, regulates intracellular osmotic pressure, protein synthesis, amino acid transport, conduction of nerve impulses, improves skeletal muscle contraction in muscular dystrophy, myasthenia gravis. Potassium ions cause a decrease in heart rate, reduce contractile activity, reduce conductivity, automaticity and excitability of the myocardium. In small doses, K+ dilates the coronary vessels, in large doses it narrows. Potassium helps to increase the content of acetylcholine and stimulate the sympathetic part of the central nervous system. Has a moderate diuretic effect. Increasing potassium levels reduces the risk of developing toxic effects of cardiac glycosides on the heart. Stimulates the adrenal glands and increases their release of epinephrine. Indications for use - treatment and prevention of hypokalemia arising from diabetes mellitus, prolonged diarrhea, vomiting, with the use of certain diuretics (thiazide, thiazide-like, loop), therapy with glucocorticosteroids, cardiac glycosides, antihypertensive drugs - treatment and prevention of digitalis intoxication - arrhythmias of various origins (associated with electrolyte disturbances and absolute or relative hypokalemia) - prevention of arrhythmia in patients with myocardial infarction (in the acute period). Method of administration and dosage: Administer intravenously by stream or drip. 1 ampoule (10 ml) 40 mg/ml potassium chloride solution contains 0.4 g of potassium chloride. 50 ml of a 40 mg/ml solution of potassium chloride (2.0 g of potassium chloride) is diluted with water for injection 10 times (up to 500 ml) to obtain an isotonic solution (the concentration of the resulting solution is 4 mg/ml) and administered intravenously, drip (20- 30 drops per minute). For drip intravenous administration, you can prepare a solution at the rate of up to 2.5 g of potassium chloride (up to 62.5 ml of potassium chloride solution 40 mg/ml) in 500 ml of 0.9% sodium chloride solution or 5% dextrose solution (the concentration of the resulting potassium solution chloride 5 mg/ml). Side effects - nausea, vomiting, diarrhea, flatulence, abdominal pain, ulceration of the gastrointestinal mucosa, gastrointestinal bleeding, perforation and intestinal obstruction - paresthesia, muscle weakness, confusion - decreased blood pressure, arrhythmias, slowdown of atrioventricular conduction until complete AV blockade, cardiac arrest (in case of overdose) - hyperkalemia, allergic reactions. Contraindications - hypersensitivity to the components of the drug - acute and chronic renal failure - complete atrioventricular block - adrenal insufficiency - concomitant therapy with potassium-sparing diuretics - hyperkalemia - metabolic disorders (acidosis, hypovolemia with hyponatremia) - erosive and ulcerative diseases of the gastrointestinal tract - childhood and adolescence up to 18 years of age (efficacy and safety have not been established) - pregnancy and lactation. Drug interactions Pharmaceutically compatible with solutions of cardiac glycosides (improves their tolerability). Strengthens the negative dromo- and bathmotropic effect of antiarrhythmic drugs. As part of a polarizing mixture (in combination with dextrose and insulin), it helps to normalize heart rhythm during myocardial infarction, ectopic arrhythmias and overdose of cardiac glycosides. Beta-blockers, cyclosporine, heparin, potassium-sparing diuretics, potassium supplements, ACE inhibitors, non-steroidal anti-inflammatory drugs increase the risk of developing hyperkalemia. Enhances the effect of quinidine, a side effect of disopyramide. Special instructions Use with caution in case of atrioventricular block I-II degree. During the treatment period, it is necessary to monitor the content of potassium ions in the blood serum, ECG; when treating hypokalemia, monitoring of the acid-base state is necessary. It should be borne in mind that hypokalemia, leading to death, can develop quickly and be asymptomatic. The safety and effectiveness of potassium chloride in children has not been established. Pregnancy and lactation Due to insufficient experience of use, it is not prescribed to pregnant women. If it is necessary to use it during lactation, the issue of stopping breastfeeding should be decided. Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms Considering the possible side effects, care must be taken when driving a vehicle and performing work that requires precise coordination of movements. Overdose Symptoms: hyperkalemia (increased concentration of potassium ions in the blood serum from 5.5 to 6.5 mEq/l), which manifests itself in the form of: muscle hypotonia, paresthesia in the extremities, slowing of atrioventricular conduction, arrhythmia, cardiac arrest. Early changes in the electrocardiogram are a tall T wave with a pointed apex and a narrow base, most pronounced in chest leads V2-V4. With moderate hyperkalemia (concentration of potassium ions in the blood serum 6.5-8.0 meq/l), electrocardiographic signs are: decreased P wave amplitude, lengthened PQ interval, widened QRS complex, decreased R wave amplitude, ventricular extrasystole. More severe symptoms of hyperkalemia - muscle paralysis and cardiac arrest (changes in the electrocardiogram - slow or accelerated idioventricular rhythm, ventricular fibrillation, asystole) develop when the concentration of potassium ions in the blood serum is 9-14 mEq/l. Treatment: orally or intravenously - sodium chloride solution; IV - 300-500 ml of dextrose solution with 10-20 units of insulin per 1000 ml; if necessary, hemodialysis and peritoneal dialysis. Release form and packaging 10 ml in neutral glass ampoules. 10 ampoules in a cardboard box. Each box contains instructions for medical use in the state and Russian languages, a knife for opening ampoules or an ampoule scarifier. When packaging ampoules with a break ring or break point, do not insert a knife for opening ampoules or an ampoule scarifier. Storage conditions Store at temperatures between 15 °C and 25 °C. Keep out of the reach of children! Shelf life 4 years Do not use after the expiration date indicated on the package Conditions for dispensing from pharmacies By prescription 630028, Russia, Novosibirsk, st. Dekabristov, 275 tel., fax Registration certificate holder Novosibkhimpharm OJSC, Russia Address of the organization receiving claims on the territory of the Republic of Kazakhstan from consumers regarding the quality of products (goods) Valenta Asia LLP, Almaty, Abay Ave., corner st. . Radostovtsa, 151/115, business office No. 1102 Tel./fax, E-mail
Side effect
According to the World Health Organization, adverse effects are classified according to their frequency as follows:
– very frequent (≥ 1/10); – common (from ≥ 1/100 to – infrequent (from ≥ 1/1000 to – rare (from ≥ 1/10000 to – very rare ( – frequency unknown (cannot be determined based on available data).
If the drug is administered quickly, undesirable effects are possible.
General disorders and disorders at the injection site: very rarely - hyperthermia, chills, sweating, weakness, pain at the injection site, edema, hyperemia, phlebitis. Immune system disorders: very rarely - allergic reactions, angioedema, anaphylactic shock. Disorders of the skin and subcutaneous tissues: very rarely - allergic rash, urticaria, itching. Disorders of the respiratory system, chest and mediastinal organs: very rarely - shortness of breath, dry cough. Cardiac disorders: very rarely - tachycardia, palpitations, shortness of breath, pain in the heart, chest pain. Vascular disorders: very rarely - arterial hypotension/hypertension, short-term reactions in the form of a burning sensation and redness of the upper body. Gastrointestinal disorders: very rarely - nausea, vomiting, metallic taste in the mouth, abdominal pain, diarrhea. Nervous system disorders: very rarely - dizziness, headache, convulsions, tremor, paresthesia, agitation, anxiety. To avoid unwanted effects, it is recommended to adhere to the dosage regimen and rate of administration of the drug. If adverse reactions occur, it is recommended to reduce the rate of drug administration. If any of the undesirable effects indicated in the instructions get worse or you notice any other undesirable effects not listed in the instructions, tell your doctor.
Price of Potassium Chloride, where to buy
In Russian pharmacies you can buy Potassium Chloride 30 mg/ml: 100 ml – 40-45 rubles; 200 ml – 50-55 rubles.
You can buy Potassium Chloride 150 mg/ml: 100 ml – 45-50 rubles; 200 ml – 55-65 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Potassium chloride bufus conc.
ready r-ra d/inf. 40 mg/ml amp. 10ml No. 10AO Update PFK 124 rub. order
Pharmacy Dialogue
- Potassium chloride (amp. 4% 10ml No. 10)Grotex LLC
92 rub. order
- Potassium chloride (amp. 4% 10ml No. 10)Update of PFC JSC
132 RUR order
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Pharmacy24
- Potassium chloride 7.5% 10 ml solution TOV "Yuriya-Pharm", Ukraine
22 UAH. order - Potassium chloride 7.5% 20 ml TOV Yuria-Pharm, Ukraine
40 UAH order
- Potassium chloride 4% 50 ml solution ZAT"Infusion", Ukraine
25 UAH order
PaniPharmacy
- Potassium chloride infusion Potassium chloride solution for inf. 4% 50 ml Ukraine, Infusion JSC
21 UAH order
- Potassium chloride infusion Potassium chloride conc. d/r-ra d/inf.7.5% 10ml Ukraine, Yuria-Pharm LLC
22 UAH order
- Potassium chloride infusion Potassium chloride conc. d/r-ra d/inf.7.5% 20ml Ukraine, Yuria-Pharm LLC
34 UAH order
- Potassium chloride infusion Potassium chloride solution for inf. 4% 100ml Ukraine, Infusion JSC
36 UAH order
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special instructions
Due to the activation of aerobic processes in the body by the drug, a decrease in the concentration of glucose in the blood and the appearance of an alkaline reaction in urine are possible. In patients with diabetes mellitus and patients with reduced glucose tolerance, periodic monitoring of blood glucose concentrations is required. If the color of the solution changes or there is a precipitate, the use of the drug is unacceptable.
Effect on the ability to drive vehicles and machinery It is not recommended to drive vehicles or operate machinery during a course of treatment with REAMBERIN®.
Why is saline solution prescribed?
Saline solution is administered intravenously in the form of infusions when indicated:
- Severe and critical dehydration of the body, disturbance of water-salt balance.
- Reduced plasma volume with large blood losses, dyspepsia, severe burns, diabetic coma.
- Carrying out surgical procedures, postoperative period.
- Intoxication of the body due to infections and poisonings of various origins.
- Epigastric, ileocecal, pulmonary bleeding.
- Digestive pathologies: nausea, vomiting, diarrhea, chronic and acute constipation.
- Lack of Na and Cl in the body.
When introducing droppers of saline solution with additional components, the list of indications expands.
Release form
Solution for infusion 1.5%. 200 ml in glass bottles with a capacity of 250 ml or 400 ml in glass bottles with a capacity of 450 or 500 ml, sealed with rubber stoppers, crimped with aluminum or combined aluminum and plastic caps. Each bottle, along with instructions for medical use, is placed in a cardboard pack, on which a tamper evident label can be applied.
250 or 500 ml in containers made of multilayer polyolefin film. 5 or 10 containers of 250 or 500 ml, together with instructions for medical use, are placed in a corrugated cardboard box (prescription). 32 containers of 250 ml or 20 containers of 500 ml, together with instructions for medical use, are placed in a group container in a corrugated cardboard box (for hospitals). The number of instructions for medical use is equal to the number of primary packaging in a group container.
Overdose
In case of overdose hyperkalemia , characterized by the following symptoms: muscle hypotonicity , paresthesia of the extremities, arrhythmia , inhibition of atrioventricular conduction, cardiac arrest . The first manifestations of hyperkalemia usually occur when the serum potassium is more than 6 mEq/L (loss of the U wave, if it was present on previous cardiograms; highlighting of the T wave; prolongation of the QT interval; decrease in the ST segment; increase in the QRS complex. Serious symptoms of hyperkalemia ( muscle paralysis and cardiac arrest ) are formed at a plasma content of 9-10 meq/l.
To relieve this condition, intravenous administration of 0.9% sodium chloride and 300-500 ml of 5% dextrose containing insulin (10-20 units/liter) is prescribed. If necessary, peritoneal dialysis and hemodialysis .
