Ryth
Generic Name
ryth-300-mg-tablet
Manufacturer
PharmaCorp Bangladesh Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ryth 300 mg tablet | ৳ 14.08 | ৳ 84.48 |
Description
Overview of the medicine
Ryth 300 mg Tablet is an antiarrhythmic medication used to treat and prevent various types of irregular heartbeats (arrhythmias). It works by restoring normal heart rhythm and maintaining a regular heart rate. It is particularly effective for life-threatening ventricular arrhythmias and certain supraventricular arrhythmias.
Uses & Indications
Dosage
Adults
Oral loading dose: 600-800 mg/day for 1-3 weeks. Maintenance dose: 100-400 mg/day, taken once daily or in divided doses. Individualized based on response and tolerability.
Elderly
Similar to adult dosage, but start with lower doses and monitor closely due to potential for increased sensitivity and co-morbidities.
Renal_impairment
No significant dosage adjustment is generally required in patients with renal impairment, as renal excretion is minimal.
How to Take
Take the tablet orally, preferably with meals to minimize gastrointestinal upset. Swallow whole with a glass of water. Do not crush or chew.
Mechanism of Action
Ryth (assumed Amiodarone) primarily works by blocking potassium channels in the heart muscle, prolonging the cardiac action potential and the refractory period. It also has effects on sodium and calcium channels, and possesses some alpha- and beta-adrenergic blocking properties. This multifocal action helps to stabilize heart rhythm.
Pharmacokinetics
Onset
Oral onset of action can be slow, ranging from a few days to several weeks.
Excretion
Primarily excreted via biliary and fecal routes. Renal excretion is minimal.
Half life
Very long elimination half-life, typically 25-110 days for parent drug and 60-160 days for active metabolite.
Absorption
Slow and variable oral absorption (bioavailability 35-65%). Peak plasma concentrations occur 3-7 hours after administration.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4, to its active metabolite N-desethylamiodarone (DEA).
Side Effects
Contraindications
- Known hypersensitivity to Amiodarone or iodine
- Severe sinus node dysfunction (sick sinus syndrome) without a pacemaker
- Second or third-degree AV block without a pacemaker
- Cardiogenic shock
- Hypotension and bradycardia in patients with decompensated heart failure
- Thyroid dysfunction (unless treated)
Drug Interactions
Digoxin
Increases digoxin levels, leading to toxicity. Requires digoxin dose reduction and monitoring.
Warfarin
Potentiates anticoagulant effect, significantly increasing INR. Requires dose reduction of warfarin and close monitoring.
Statins (e.g., Simvastatin)
Increased risk of myopathy/rhabdomyolysis due to CYP3A4 inhibition.
CYP3A4 inducers (e.g., Rifampin, Phenytoin)
May decrease amiodarone levels.
Beta-blockers/Calcium channel blockers (non-dihydropyridine)
Increased risk of bradycardia, AV block, and hypotension.
CYP3A4 inhibitors (e.g., Grapefruit juice, Protease inhibitors)
May increase amiodarone levels.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, heart block, hypotension, and liver injury. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered. Continuous monitoring of cardiac function and blood pressure is essential. Amiodarone is not dialyzable.
Pregnancy & Lactation
Pregnancy Category D: Ryth (Amiodarone) can cause fetal harm when administered to a pregnant woman. It is contraindicated in pregnancy unless the benefits outweigh the risks. Lactation: Excreted into breast milk. Should not be used during breastfeeding due to potential for serious adverse reactions in the infant.
Side Effects
Contraindications
- Known hypersensitivity to Amiodarone or iodine
- Severe sinus node dysfunction (sick sinus syndrome) without a pacemaker
- Second or third-degree AV block without a pacemaker
- Cardiogenic shock
- Hypotension and bradycardia in patients with decompensated heart failure
- Thyroid dysfunction (unless treated)
Drug Interactions
Digoxin
Increases digoxin levels, leading to toxicity. Requires digoxin dose reduction and monitoring.
Warfarin
Potentiates anticoagulant effect, significantly increasing INR. Requires dose reduction of warfarin and close monitoring.
Statins (e.g., Simvastatin)
Increased risk of myopathy/rhabdomyolysis due to CYP3A4 inhibition.
CYP3A4 inducers (e.g., Rifampin, Phenytoin)
May decrease amiodarone levels.
Beta-blockers/Calcium channel blockers (non-dihydropyridine)
Increased risk of bradycardia, AV block, and hypotension.
CYP3A4 inhibitors (e.g., Grapefruit juice, Protease inhibitors)
May increase amiodarone levels.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe bradycardia, heart block, hypotension, and liver injury. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered. Continuous monitoring of cardiac function and blood pressure is essential. Amiodarone is not dialyzable.
Pregnancy & Lactation
Pregnancy Category D: Ryth (Amiodarone) can cause fetal harm when administered to a pregnant woman. It is contraindicated in pregnancy unless the benefits outweigh the risks. Lactation: Excreted into breast milk. Should not be used during breastfeeding due to potential for serious adverse reactions in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ryth (Amiodarone) has been extensively studied in numerous clinical trials demonstrating its efficacy in various arrhythmias, including the SAFE-T and ATHENA trials. Ongoing post-marketing surveillance continues to monitor its long-term safety profile.
Lab Monitoring
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) before and every 6 months during treatment
- Thyroid function tests (TSH, free T3, free T4) before and every 6 months during treatment
- Serum electrolytes (potassium, magnesium) periodically
- ECG before and periodically during treatment
- Chest X-ray before and annually during treatment to monitor for pulmonary toxicity
Doctor Notes
- Counsel patients thoroughly on potential severe side effects, particularly pulmonary and hepatic toxicity, and the importance of monitoring.
- Monitor for drug interactions, especially with warfarin, digoxin, and statins, and adjust concomitant drug dosages as needed.
- Consider alternative antiarrhythmics in patients with pre-existing lung, liver, or thyroid disease.
Patient Guidelines
- Take Ryth exactly as prescribed by your doctor.
- Avoid prolonged sun exposure and use sunscreen, even on cloudy days, due to photosensitivity.
- Report any new or worsening symptoms, especially shortness of breath, cough, fatigue, jaundice, or vision changes, to your doctor immediately.
- Do not stop taking this medicine suddenly without consulting your doctor, as it may worsen your heart condition.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Ryth may cause dizziness, blurred vision, or tremor. If you experience these side effects, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, as advised by your doctor.
- Limit or avoid alcohol consumption, as it can worsen arrhythmias and liver function.
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Global Brand Names
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