What are the efficacy, functions and side effects of Cibenzoline?

Efficacy and effect

It is a group i anti-arrhythmic drug that exhibits anti-arrhythmic effects by inhibiting sodium ion channels and inhibiting the maximum depolarization rate of action potentials. Cibenzoline is subdivided into group Ia, binds to Na+ channels at a moderate dissociation rate, and prolongs the action potential duration.

Cibendazoline is also used as a Group I antiarrhythmic drug. Especially at high concentrations, it also has an inhibitory effect on calcium ion channels, which is a Group IV antiarrhythmic effect.

Side effects

1. Heart disease: prolongation of PQ interval, prolongation of QRS interval, prolongation of QTc interval, atrioventricular block, and palpitations.

2. Urinary system diseases: urinary disorders such as anuria and dysuria.

3. Eye diseases: vision adjustment disorders, including photoopia, foggy vision, etc.

4. Allergic reaction: rash, erythema, itching.

5. Mental illness: headache, dizziness, drowsiness, dizziness, and tremor.

6. Digestive system diseases: loss of appetite, constipation, vomiting, stomatitis, thirst, nausea, abdominal pain.

7. Systemic diseases: feeling of weakness, fatigue, cold sweat, chest pressure, shortness of breath.

Some side effects treatment measures

1. Headache: Pay attention to rest. When a headache occurs, you can rest in bed. You can use a wet towel to apply cold compresses to your forehead, which will help relieve the headache. You can also take analgesic drugs, such as ibuprofen.

2. Dizziness: Avoid frequent changes in body position, ensure adequate rest time, and avoid heavy physical labor.

3. Rash or itching: Keep the rash or itching area clean and hygienic, avoid using irritating toiletries, and wear loose, comfortable cotton clothing to reduce friction on the affected area.

4. Nausea or vomiting: Eat a light diet and avoid contact with or eating pungent smells or foods to avoid aggravating nausea and vomiting. If necessary, you can temporarily stop eating and drinking.

Research

Research Background

Cabendazoline is a Class Ia antiarrhythmic drug that can be used to reduce the left ventricular pressure gradient (LVPG) in patients with hypertrophic obstructive cardiomyopathy (HOCM), but the chronic effects of cibendazoline on LVPG and left ventricular remodeling are unknown.

Research Methods

This study included a total of 41 HOCM patients and compared the echocardiogram, electrocardiogram and brain natriuretic peptide (BNP) data collected before and after cibendazoline treatment.

Research results

The average follow-up time was 74.2±47.1 months, LVPG decreased from 104.8±62.6 mmHg to 27.6±30.5 mmHg, and left ventricular end-diastolic diameter increased from 42.8±5.8 mm to 46.2±5.4 mm, but there were no significant changes in left ventricular end-systolic diameter and left ventricular systolic fraction. The size of the left atrium decreased from 40.0±4.7 mm to 36.2±5.1 mm.

The E wave velocity/A wave velocity ratio increases, the early diastolic ring velocity (Ea) increases, and the E/Ea ratio decreases. The interventricular septal wall thickness, left ventricular posterior wall thickness and negative T wave depth were reduced. Heart rate corrected QT interval shortening. Plasma BNP levels decreased from 418.8±423.7 pg/ml to 213.7±154.1 pg/ml.

Research conclusion

Long-term use of cibendazolin in the treatment of patients with HOCM can weaken LVPG, improve left ventricular diastolic dysfunction, and induce regression of left ventricular hypertrophy without causing serious complications.

Overdosage

1. Symptoms

The main manifestations are electrocardiogram changes, especially significant prolongation of QRS and cardiac depression symptoms such as cardiogenic shock. There is also kidney failure. Very high blood concentrations of cibendazoline can easily cause hypoglycemia and may occasionally cause myasthenia.

2. Disposal

Perform electrocardiogram, respiration, blood pressure monitoring and general maintenance treatment. Since cibendazoline is hardly removed during dialysis, dialysis is ineffective as a treatment method for poisoning, and prompt vomiting and gastric lavage are required. Treatment of overdose is a continuous infusion of sodium lactate along with potassium as needed.

For symptoms of cardiac depression, dopamine, dobutamine, isoephrine, etc. are given as needed. If there is blockage, install a pacemaker. In addition, for electrocardiogram abnormalities that are ineffective with drugs, we will handle them as needed, such as installing a pacemaker or giving an electric shock. Give glucose immediately if hypoglycemia occurs.

References:

Hamada M, Ikeda S, Ohshima K, Nakamura M, Kubota N, Ogimoto A, Shigematsu Y. Impact of chronic use of cibenzoline on left ventricular pressure gradient and left ventricular remodeling in patients with hypertrophic obstructive cardiomyopathy. J Cardiol. 2016 Mar;67(3):279-86. doi: 10.1016/j.jjcc.2015.05.014. PMID: 26116980.

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