Far pills 10 mg + 4 mg 30 pcs
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Active ingredients
Amlodipine + Perindopril
Release form
Pills
Composition
Amlodipine besylate 13.87 mg, which corresponds to the content of amlodipine 10 mg perindopril erbumin and semi-finished granules 21 mg, which corresponds to the content of perindopril erbumin 4 mg adjuvants: microcrystalline cellulose - 181.91 mg, starch, pregelatinized - 42 mg, sodium starch glycol, and glyarium glycol, and glyarium glucose, and glycol glycerium, 42 mg, sodium glucose; 760 mcg, colloidal silicon dioxide, anhydrous - 860 mcg, magnesium stearate - 2.8 mg.
Indications
- arterial hypertension and / or ischemic heart disease: stable exertional angina in patients who require perindopril and amlodipine.
Contraindications
Perindopril-angioedema (Quincke edema) in history (including in the presence of other ACE inhibitors), hereditary / idiopathic angioedema, age up to 18 years (efficacy and safety not established), hypersensitivity to perindopril or other ACE inhibitors.Amlodipine- severe arterial hypotension (systolic blood pressure less than 90 mm Hg); - shock, including cardiogenic shock; - obstruction of the left ventricular output tract (eg, severe aortic stenosis); - unstable angina (with the exception of walls Princetal Prinzmetal); - age up to 18 years (efficacy and safety not established); - hemodynamically unstable heart failure after acute myocardial infarction; - hypersensitivity to amlodipine or other dihydropyridine derivatives. Far-renal failure (KK less than 60 ml / min); - age up to 18 years (efficacy and safety have not been established); - hypersensitivity to the components of the drug. With caution: liver failure; chronic heart failure; aortic and / or mitral stenosis; hypertrophic obstructive cardiomyopathy; bilateral stenosis of the renal arteries, stenosis of the artery of the only functioning kidney; renal failure (CC less than 60 ml / min); systemic connective tissue diseases (including systemic lupus erythematosus, scleroderma); therapy with immunosuppressants, allopurinol, procainamide (risk of developing neutropenia, agranulocytosis); reduced bcc (diuretic intake, diet with limited salt, vomiting,diarrhea); atherosclerosis; cerebrovascular diseases; renovascular hypertension; diabetes; use of dantrolene, estramustine, potassium-sparing diuretics, potassium preparations, potassium-containing food salt substitutes and lithium preparations; hyperkalemia; surgery / general anesthesia; hemodialysis using high-flow polyacrylonitrile membranes (risk of developing anaphylactoid reactions); LDAP apheresis with dextran sulfate; simultaneous desensitization therapy with allergens (for example, hymenoptera poison); condition after kidney transplantation (lack of clinical data); elderly age; use in patients of the Negroid race.
Precautionary measures
During treatment, psoriasis may worsen. During pheochromocytoma, propranolol can only be used after taking an alpha blocker. After a long course of treatment, propranolol should be discontinued gradually, under the supervision of a physician. during anesthesia, you must stop taking propranolol or find a remedy for anesthesia with minimal negative inotropic effects. The impact on the ability to drive vehicles and control mechanisms of patients whose activities require increased attention, the question of the use of propranolol on an outpatient basis should be addressed only after evaluating the individual response of the patient.
Dosage and administration
The drug is taken orally, 1 tab. 1 time / day, preferably in the morning before a meal. The dose of the Dalnev drug is selected after a previous titration of the doses of the individual components of the drug: perindopril and amlodipine in patients with arterial hypertension and stable angina. doses of individual components: (amlodipine 5 mg + perindopril 4 mg) or (amlodipine 10 mg + perindopril 4 mg) or (amlodipine 5 mg + perindopril 8 mg) or (amlodipine 10 mg + perindopril 8 mg). Maximum with weft dose: amlodipine 10 mg + perindopril 8 mg. The drug Dalnev can be prescribed to patients with CC more than 60 ml / min. The drug Far is contraindicated for use in patients with QA less than 60 ml / min.Such patients are recommended individual selection of doses of perindopril and amlodipine. Changes in the concentration of amlodipine in the blood plasma do not correlate with the severity of renal failure. Care must be taken when using the drug Dalnev in patients with hepatic insufficiency, because there are no recommendations for the doses of the drug in such patients. When using the drug Dalnev in elderly patients, dose adjustment is not required. Dalnev should not be prescribed to children and adolescents under the age of 18, as there are no data on the efficacy and safety of perindopril and amlodipine in these groups of patients both in monotherapy and as part of combination therapy.
Side effects
Classification of the incidence of side effects (WHO): very often (≥1 / 10); often (≥1 / 100 to less than 1/10); infrequently (from ≥1 / 1000 to less than 1/100); rarely (from ≥1 / 10,000 to less than 1/1000); very rarely (less than 1/10 000), the frequency is unknown (cannot be estimated based on the available data). In each group, undesirable effects are presented in order of decreasing severity. From the hematopoietic system: very rarely - leukopenia / neutropenia, agranulocytosis, pancytopenia, thrombocytopenia, hemolytic anemia in patients with congenital deficiency of glucose-6-phosphate dehydrogenase, a decrease in the concentration of hemoglobin and hematocrit. On the immune system side: infrequently - urticaria. Metabolic disorders: infrequently - weight gain eating, decrease in body weight; very rarely - hyperglycemia, the frequency is unknown - hypoglycemia. From the nervous system: often - drowsiness, dizziness, headache, paresthesia, vertigo; infrequently - insomnia, mood lability, sleep disturbance, tremor, hypoesthesia; very rarely - peripheral neuropathy, confusion of consciousness. From the sensory organs: often - visual disturbances, tinnitus. From the cardiovascular system: often - a sensation of heartbeat, flushing to the skin of the face, marked decrease in blood pressure; infrequently - fainting; rarely - pain behind the sternum; very rarely - angina, myocardial infarction, possibly due to an excessive decrease in blood pressure in patients from the high-risk group, arrhythmias (including bradycardia, ventricular tachycardia and atrial fibrillation), stroke, possiblydue to an excessive decrease in blood pressure in patients from a high-risk group, vasculitis. On the part of the respiratory system: often - shortness of breath, cough; infrequently - rhinitis, bronchospasm; very rarely - eosinophilic pneumonia. From the digestive system: often - abdominal pain, nausea, vomiting, dyspepsia, diarrhea, constipation; infrequently - dryness of the oral mucosa, a violation of taste perception, a change in the rhythm of defecation; very rarely - pancreatitis, gingival hyperplasia, gastritis, hepatitis, cholestatic jaundice, cytolytic or cholestatic hepatitis. On the skin side: often - pruritus, skin rash; infrequently - angioedema of the face, extremities, lips, mucous membranes, tongue, vocal folds and / or larynx, alopecia, hemorrhagic rash, photosensitization, increased sweating; very rarely - angioedema, erythema multiforme, Stevens-Johnson syndrome. On the part of the musculoskeletal system: often - muscle spasms; infrequently - arthralgia, myalgia, back pain. From the urinary system: infrequently - urination disturbance, nocturia, frequent urination, renal failure; very rarely - acute renal failure. From the reproductive system: infrequently - impotence, gynecomastia. Others: often - peripheral edema, asthenia, fatigue; infrequently - chest pain, malaise. Laboratory values: rarely - increased bilirubin concentration; very rarely - increased activity of ACT, ALT (most often in combination with cholestasis); frequency unknown - increase in the concentration of urea and creatinine in the serum. Additional data on amlodipine: isolated cases of extrapyramidal syndrome have been reported with the use of slow calcium channel blockers.