Talliton

The beta-adrenergic receptor blocker, the drug Talliton, contains the active substance carvedilol, a drug that has a direct effect on the functioning of the cardiovascular system.

Indications Talliton

The drug Talliton is usually prescribed:

• for essential hypertension (as an independent medication or in combination with diuretics);
• in chronic heart failure, in combination with diuretic medications, cardiac glycosides (Digoxin), or with ACE inhibitors;
• with stable angina.

Release form

Talliton is a tablet form of a medication based on carvedilol, which may contain 6.25 mg, 12.5 mg, or 25 mg of the active ingredient.

The tablets are flattened, have a dosing notch and the inscription E341, E342 or E343, depending on the dosage of the drug.

The tablets are packed in dark glass bottles, 20 or 30 pieces each. Each bottle has a protection on the plastic cap, which prevents accidental opening of the package.

It is possible to produce blister plates, 14 tablets each. A cardboard box contains 1-2 plates and annotation for the use of the medicine.

Names of analogues of the drug Talliton

In accordance with the active ingredient, the pharmaceutical industry produces a number of drugs with similar effects that can be used as a replacement for Talliton tablets (upon recommendation of the attending physician):

• Atram is a Czech drug;
• Dilator is a drug produced by a Canadian manufacturer;
• Carvedigamma (Cardiostat) is a medicine produced in Germany;
• Carvedilol (Orion, Sandoz, Grindeks, Zentiva, KVZ, Lugal) – similar drugs from different pharmaceutical companies;
• Carvetrend is a medicinal product of a joint Polish-Israeli venture;
• Karvid (Karvidex, Cardivax, Cardilol, Cardoz) – Indian drugs;
• Carvium - Romanian tablets;
• Corvazan is a domestic drug (KMP);
• Coriol is a drug produced in Slovenia;
• Protecard is an Israeli medicine;
• Medocardil is a tablet preparation produced in Cyprus.

[ 1 ]

Pharmacodynamics

Talliton is a β-blocker drug with a vasodilatory effect, which also has secondary antioxidant properties.

The vasodilator effect of the drug is manifested in a decrease in the peripheral resistance of the vascular walls, and the property of a β-adrenoblocker is in the suppression of the renin-angiotensin-aldosterone system. The active ingredient of the drug deactivates renin in the blood serum. For this reason, edema occurs extremely rarely during treatment with this drug.

Inotropic, chronotropic, dromotropic and bathmotropic properties of Talliton are known. The drug inhibits the conduction function of the atrioventricular node and has membrane-stabilizing properties.

Talliton properties may manifest themselves in the following clinical signs:

• slowing of heart contractions against the background of unchanged renal perfusion function;
• no changes in peripheral blood flow;
• development of a rapid hypotensive effect (within 2-3 hours after a single dose of the drug);
• elimination of ischemia and pain in the heart area;
• reducing the load on the heart muscle;
• improvement of hemodynamic processes, functional capacity of the left ventricle;
• in case of acute heart failure, the final systolic and final diastolic volumes decrease;
• the resistance of vascular walls (peripheral and pulmonary vessels) decreases;
• In case of left ventricular dysfunction, dilation of blood vessels (mainly arteries) occurs.

When using the drug Talliton in complex treatment, the mortality rate decreases, the disease becomes controllable, and the patient’s general well-being improves.

[ 2 ]

Pharmacokinetics

After oral administration, Talliton is well absorbed by the digestive system. Metabolism begins with the initial passage through the liver, and its bioavailability can be about 25%. The maximum level of the drug in the blood serum is observed 60 minutes after oral administration of the tablet.

The kinetic properties of Talliton are considered linear, that is, the total amount of the drug in the bloodstream directly depends on the amount consumed. The presence of food masses in the stomach does not affect the quality of the drug's bioavailability, but can delay the onset of the period of maximum concentration in the bloodstream.

The active ingredient of Talliton is considered a lipophilic substance, its binding to plasma proteins is about 98%. The values of the probable volume of distribution are determined to be about 2 l/kg. This value may be increased in severe liver diseases.

Metabolic processes occur in the liver, with the formation of glucuronides. The resulting metabolites have less pronounced vasodilatory properties, but their antioxidant activity is significantly higher.

The mean half-life is 6 to 10 hours and plasma clearance is approximately 590 ml/min.

The active component of Talliton is excreted mainly with bile. Metabolic products, as well as the main component of the drug, are able to cross the placenta and are found in breast milk.

Hemodialysis is not effective against the active ingredient of the drug.

[ 3 ]

Dosing and administration

Talliton tablets are taken orally, without crushing or chewing, with water or other liquid.

• For the treatment of essential hypertension, Talliton is prescribed in the amount of 12.5 mg per day in one dose, for a minimum of 2 days.

If the effect obtained is insufficient, then on the 14th day of treatment the dosage is increased to 50 mg (25 mg in the morning and the same at night).

The maximum daily dose of the drug is 50 mg, and a single dose is 25 mg.

• For the treatment of chronic stable angina, Talliton is prescribed at 12.5 mg in the morning and at night. After two days, switch to a maintenance dose: 25 mg in the morning and the same amount at night.

If ineffective, switch to taking 50 mg of the drug twice a day.

• For the treatment of chronic heart failure, the dosage is selected for each patient individually. It is recommended to start treatment with 3.125 mg twice a day for 2 weeks. If necessary, the dosage is increased by two times or more, depending on the doctor's decision.

During therapy with Talliton, it is necessary to monitor the well-being of patients, since an increase in the amount of the drug taken may worsen the course of heart failure. Fluid accumulation in tissues, decreased blood pressure, apathy are possible. In case of edema, diuretics are additionally prescribed.

[ 6 ]

Use Talliton during pregnancy

Talliton is not recommended for use by pregnant and lactating patients, since studies conducted to date have demonstrated insufficient information on the safety of this drug. If the question arises about the use of Talliton during the lactation period, it is better to refuse breastfeeding for the duration of treatment.

Contraindications

Talliton should not be prescribed in the following pathological conditions:

• if there is a high probability of allergy to the drug;
• in decompensated heart failure;
• in arrhythmia associated with sinoatrial or atrioventricular block, or with weakened sinus node syndrome;
• with significant bradycardia (heart rate less than 50 beats/min);
• with low blood pressure (below 85 mm Hg);
• patients in a state of cardiogenic shock;
• with diagnosed asthma;
• in case of liver dysfunction;
• during pregnancy and breastfeeding;
• patients in a state of metabolic acidosis;
• patients under 18 years of age.

In the following situations, taking Talliton is possible, but only under constant monitoring of the patient's condition:

• in chronic pulmonary obstruction;
• with variant angina;
• in diabetes mellitus;
• patients with hypoglycemia, thyrotoxic goiter;
• in pheochromocytoma;
• patients with peripheral vascular occlusion;
• in atrioventricular block;
• patients with unstable angina;
• for psoriasis;
• in case of renal dysfunction;
• patients in a depressive state;
• for myasthenia;
• with combined use of alpha-blockers and alpha-adrenergic agonists.

[ 4 ], [ 5 ]

Side effects Talliton

Standard doses of Talliton rarely cause side effects, but sometimes they may still occur. The following side effects may occur:

• headaches, dizziness, worsening mood, insomnia, impaired sensitivity of the extremities;
• a sharp drop in blood pressure, a slowdown in heart rate, paroxysmal angina, cold extremities, and increasing cardiac failure;
• difficulty breathing, bronchospasm, feeling of nasal congestion;
• thirst, diarrhea, nausea, epigastric pain;
• allergies, skin rashes;
• conjunctivitis, urinary disorders, false "cold".

In addition, the condition of patients with diabetes may worsen.

Overdose

Taking an excessive dose of the drug Talliton may result in a sharp drop in blood pressure, a slowing of the heart rate, signs of heart failure, cardiogenic shock, and even cardiac arrest.

To eliminate signs of overdose, gastric lavage is performed, laxatives and emetics are prescribed.

Antidote - Orciprenaline or Isoprenaline 0.5-1 mg as an intravenous injection. It is also possible to administer Glucagon in an amount of 1 to 5 mg (maximum - 10 g).

In case of a significant decrease in blood pressure, fluids and adrenaline (drip) are administered parenterally in an amount of 5-10 mcg.

When the heart rate slows down, atropine is used in a dosage of 0.5 to 2 mg. To stimulate cardiac function, Glucagon is prescribed in an amount of 1 to 10 mg as an intravenous injection, followed by intravenous infusion (2 to 5 mg per hour).

In case of excessive dilation of peripheral vessels, norepinephrine is used in an amount of 5-10 mcg (with drip infusion - 5 mcg per minute).

In case of bronchospasm, Aminophylline is prescribed in the form of an intravenous injection.

In case of convulsive syndrome, Diazepam or Clonazepam is administered.

Interactions with other drugs

The following combinations of Talliton and other specific medications require a special approach:

• combination with drugs that affect the accumulation of catecholamines in the body (Reserpine, MAO inhibitor drugs) - can lead to bradycardia and decreased blood pressure;
• combination with Verapamil or Diltiazem, as well as antiarrhythmic drugs - may lead to cardiac failure and hypotension;
• combination with adrenomimetic drugs – may cause arrhythmia, increased blood pressure;
• combined use with Clonidine - may lower blood pressure and slow the heart rate;
• concomitant administration of Digoxin may inhibit atrioventricular conduction;
• combination with hypoglycemic agents and insulin – may hide signs of hypoglycemia;
• combination with antihypertensive drugs – may lead to a sharp drop in blood pressure;
• combined use of anesthetic agents – can lower blood pressure, has an inotropic effect;
• simultaneous administration of drugs that affect the central nervous system can unpredictably enhance each other's effects;
• combination with NSAIDs – may reduce the hypotensive effect of Talliton;
• combination with Ergotamine, which constricts blood vessels;
• Concomitant treatment with xanthines reduces the beta-blocking effect.

In addition, combinations of Talliton with Rifampicin, sleeping pills, Cimetidine, Digoxin, and Cyclosporine are undesirable.

[ 7 ]

Storage conditions

Talliton is stored at room temperature, at temperatures from +15°C to +25°C, in a dark and dry place. Children should not be allowed near places where medicines are stored.

Shelf life

Talliton is preserved:

• in bottles – up to 5 years;
• in blister plates – up to 3 years.

Do not use Talliton if its expiration date has passed.