How to use Cibenzoline, its efficacy and side effects?

Cibenzoline is a new class IA antiarrhythmic drug. Clinical trials have proven that Cibenzoline can inhibit ventricular arrhythmias. After patients with frequent premature ventricular contractions take the drug multiple times, the elimination half-life is 7.6-22.3 (average 12.3) hours. Cibenzoline can be administered orally or intravenously.

About Cibenzoline

It is an imidazoline derivative with anti-arrhythmic properties. It is rapidly absorbed after oral administration and its bioavailability is close to 100%.

Cibenzoline is an effective antiarrhythmic drug with good pharmacokinetic characteristics and can be used together with other Class I drugs in patients who need to treat high-risk arrhythmias.

How to use Cibenzoline

Cibenzoline is a Class I antiarrhythmic drug with limited Class III and Class IV activity that can be administered orally or intravenously.

Although age and renal function must be considered when determining dosage, an elimination half-life of approximately 8 to 12 hours allows twice daily dosing. Cibenzoline has some activity against ventricular and supraventricular arrhythmias, including drug-refractory ventricular tachycardia or ventricular arrhythmias after recent acute myocardial infarction, although results are less promising in patients with sustained ventricular tachycardia.

In comparative trials, Cibenzoline has been shown to be similar to or better than many other Class I antiarrhythmic drugs and is at least well tolerated and has a more convenient dosing regimen.

Oral dosage of Cibenzoline

The recommended dosage of Cibenzoline is 300mg. If the treatment effect is not good, the dosage can be increased to 450mg, which should be administered orally three times a day.

Effects and effects of Cibenzoline

Cibenzoline can inhibit left ventricular contraction and increase systemic vascular resistance.

Cibenzoline has been shown to reduce the maximum rise rate of depolarization and increase the duration of action potentials in isolated cardiac fibers. Voltage clamp studies showed a reduction in both fast and slow sodium currents.

The following clinical electrophysiological effects have been observed: increases in QRS duration, AH and HV intervals, and effective ventricular refractory period. The compound has been shown to be effective in preventing atrial arrhythmias, inhibiting recurrent intranodal tachycardia and tachycardia associated with Wolff-Parkinson-White syndrome, and treating ventricular arrhythmias (especially premature contractions and non-sustained ventricular tachycardia) with few side effects.

Side effects

Cibenzoline can cause dizziness and tremor, nausea, fatigue, vomiting and diarrhea, blurred vision and hypoglycemia, right bundle branch block, and new arrhythmias or aggravation of existing arrhythmias.

Measures for dealing with side effects

1. Dizziness: When an attack of vertigo occurs, the patient should rest in place immediately and look for something to rely on to avoid falling. Keep your mind calm and avoid causing tension, panic and other negative emotions. Do not shake your head during an attack of vertigo. Use a cold towel to apply ice to your forehead.

2. Hypoglycemia: When hypoglycemia occurs, patients can relieve it by eating sugary foods such as biscuits and candies. Discontinue Cibenzoline promptly if necessary.

3. Diarrhea: Patients with diarrhea should keep their abdomen warm and avoid eating cold foods such as ice cream and cold drinks. They can also receive antidiarrheal treatment under the guidance of a doctor.

4. Blurred vision: Patients with blurred vision should pay attention to medication, reduce the time of using electronic products, and go to the ophthalmology department of the hospital in time when necessary.

5. New arrhythmia or aggravation of existing arrhythmia: If the patient experiences such a situation, the drug dose can be reduced or discontinued under the evaluation of the doctor, and anti-arrhythmic treatment can be performed at the same time.

Effectiveness of Cibenzoline in the treatment of hypertrophic cardiomyopathy

Objective: This study aims to elucidate the long-term effects of Cibenzoline treatment on cardiovascular complications and prognosis in patients with hypertrophic obstructive cardiomyopathy (HOCM).

Methods and results: 88 patients with HOCM received cibendazoline (group A), and 41 patients did not receive treatment (group B). Changes in left ventricular remodeling, incidence of cardiovascular complications, and death were examined. The average follow-up period was 15.8±5.6 years in group A and 17.8±7.2 years in group b. In Group A, left ventricular pressure gradient (LVPG) decreased immediately after treatment and remained decreased throughout the study.

As the left ventricular function worsened, LVPG gradually decreased in group B. Reverse left ventricular remodeling was confirmed in group A, and left ventricular remodeling progressed in group b. The incidence rates of various cardiovascular complications in group A were <10%. Only one patient developed left ventricular heart failure (LVHF).

The incidence of LVHF and atrial fibrillation in group B was higher than that in group A. The mortality rate was 20.5% in group A and 90.2% in group B. The most common causes of death were sudden cardiac death (SCD) in group A (38.9%) and LVHF in group b (67.6%). There was no significant difference in the incidence of SCD between the two groups. The cumulative cardiac survival rate of group A was higher than that of group B.

Conclusion: Cibenzoline treatment significantly reduced all cardiovascular complications and deaths caused by LVHF and may be a promising treatment for patients with HOCM.

Effectiveness of Cibenzoline in the treatment of arrhythmia

33 patients with ventricular tachyarrhythmia received programmed electrical stimulation to evaluate arrhythmia to guide antiarrhythmic treatment. To compare the new antiarrhythmic drug Cibenzoline with procainamide in patients with ventricular tachycardia.

During electrophysiological testing, Cibenzoline was administered intravenously, initially at 1.0 mg/kg and then increased in 1 mg/kg increments to a maximum of 3.0 mg/kg. The results were compared with procainamide, which was also administered intravenously at 1000 mg followed by 1500 mg.

Cibenzoline prevented induction of ventricular tachycardia in 16 of 33 patients. The PR interval increased by 13%, the QRS time by 26%, and the QTc interval by 7%. Mean arterial blood pressure fell by 9%. Procainamide prevented the induction of ventricular tachycardia in 21 of 31 patients tested. The PR interval increased by 11%, the QRS time by 27%, and the QTc interval by 8%.

Thirteen patients took Cibenzoline orally for chronic treatment. After an average follow-up of 8.8 months, long-term oral Cibenzoline treatment reduced ventricular ectopy from 666 beats/hour to 190 beats/hour. According to Holter monitoring records, ventricular tachycardia events dropped from 6 to 0.6. Cibenzoline treatment was discontinued in 5 of 13 patients due to breakthrough arrhythmia (non-sustained ventricular tachycardia and recurrence of symptoms on Holter monitoring).

In selected patients, Cibenzoline may be an effective antiarrhythmic agent.

Summary

Cibenzoline is effective in treating arrhythmia and hypertrophic cardiomyopathy. Patients can choose oral or intravenous treatment under the guidance of a doctor.