Advocate

Advocard is a combined antianginal (anti-ischemic) drug from the group of cardiovascular drugs.

Indications Advocate

Indications for the use of this drug are:

• ischemic heart disease;
• all types of angina (combination therapy and relief of attacks);
• cardiosclerosis, including after myocardial infarction;
• myocardiopathy (myocarditis, myocardial dystrophy);
• cardiac arrhythmia.

[ 1 ], [ 2 ]

Release form

Release form: tablets of 0.01 and 0.03 g, 10 tablets per blister.

Pharmacodynamics

The anti-ischemic, antioxidant and cell membrane stabilizing effects of the drug Advokard are provided by the active substances included in its composition: magladen (adenosine-5-triphosphate gluconate-magnesium (II) trisodium salt), molsidomine and folic acid (vitamin B9).

Magladen contains adenosine triphosphate (ATP), magnesium and sodium salts and affects the ATP-activated (purine) receptors of chemodependent potassium channels. As a result, their activation and inhibition of potassium ions entering the cells occurs, due to which processes develop that help protect the myocardium from damage associated with an imbalance in the supply and need of the myocardium for oxygen, i.e. its ischemization.

Magnesium cations suppress lipid peroxidation of cell membranes, support ATP synthesis and intercellular interactions. Molsidomine - N-ethoxycarbonyl-3-(4-morpholinyl)sydnonimine (part of the drugs Molsidomine, Corvaton, Sydnopharm, Morial, Motazomine) - when entering the body, it forms an active metabolite linsidomine (SIN 1A), which promotes the release of nitric oxide, due to which large coronary vessels expand, the tone of smooth muscles of their walls decreases, platelet aggregation decreases (i.e., the risk of blood clots decreases).

Once in the body, folic acid (vitamin B9) is absorbed from the gastrointestinal tract and reduced to tetrahydrofolic acid, which reduces the level of the sulfur-containing amino acid homocysteine, the increased content of which in the blood plasma leads to the development of cardiovascular diseases and strokes.

[ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ]

Pharmacokinetics

The pharmacokinetics of the drug, according to the official instructions, have not been studied. However, it is known that almost 90% of molsidomine after oral administration is absorbed from the gastrointestinal tract, more than 10% of the substance binds to plasma proteins, and its bioavailability is approximately 65%. Molsidomine is metabolized in the liver, and metabolites are excreted through the kidneys (with urine) and intestines (with feces).

Folic acid is transformed in the liver and tissues and excreted in urine and bile.

[ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ]

Dosing and administration

Method of application of Advokard – sublingually (under the tongue), until the tablet is completely dissolved, regardless of food intake. Dissolution of the tablet is allowed – for faster achievement of the therapeutic effect.

The dosage is determined by the doctor; the recommended doses are 10-90 mg Advocard 3-4 times a day. The maximum daily dose is 400-600 mg. The standard duration of taking the drug is 3-4 weeks.

[ 23 ], [ 24 ]

Use Advocate during pregnancy

The use of Advocard during pregnancy and by lactating women is contraindicated due to the lack of verified data regarding its safety for the fetus and infant.

Contraindications

Contraindications for taking Advocard are: individual hypersensitivity to the active and auxiliary substances of the drug, arterial hypotension, severe forms of bronchial asthma, cardiogenic shock, hemorrhagic stroke, traumatic brain injury, closed-angle glaucoma, children under 14 years of age.

[ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ]

Side effects Advocate

As a rule, the drug is well tolerated, but side effects are possible in the form of headache, drop in blood pressure, tachycardia, general weakness, bronchospasm, nausea, and a bitter taste in the mouth.

[ 22 ]

Overdose

Overdose of Advocard causes headache and dizziness, treatment for overdose is symptomatic.

Interactions with other drugs

Advocard increases the hypotensive effect of drugs (especially those containing nitrates) to reduce blood pressure, vasodilators (dipyridamole, curantil, parsedyl, etc.), adrenergic blockers (phentolamine, peroxan, anaprilin, etc.).

Advocard reduces the therapeutic effect of xanthinol nicotinate, aminophylline, etc. used to improve cerebral and general circulation.

When Advokard is used simultaneously with acetylsalicylic acid, its antiplatelet effect is enhanced. Folic acid reduces the effect of drugs for the treatment of epilepsy.

[ 25 ], [ 26 ]

Storage conditions

The drug should be stored in a dry place, protected from sunlight, at a storage temperature not exceeding +25°C.

Shelf life

The shelf life of the drug is 3 years.