Indapamide retard hemofarm pills 1,5 mg N30
Condition: New product
1000 Items
Rating:
Be the first to write a review!
More info
Active ingredients
Indapamide
Release form
Pills
Composition
Active ingredient: Indapamide (Indapamide) Concentration of the active substance (mg): 1.5
Pharmacological effect
Antihypertensive agent (diuretic, vasodilator). Pharmacologically similar to thiazide diuretics (impaired reabsorption of sodium ions in the cortical segment of the loop of Henle). Increases urinary excretion of sodium, chlorine and, to a lesser extent, potassium and magnesium ions. Possessing the ability to selectively block slow calcium channels, it increases the elasticity of artery walls and reduces total peripheral vascular resistance. Helps to reduce left ventricular hypertrophy. Does not affect plasma lipids (triglycerides, low density lipoproteins, high density lipoproteins); does not affect carbohydrate metabolism (including in patients with diabetes mellitus). Reduces the sensitivity of the vascular wall to noradrenaline and angiotensin II, stimulates the synthesis of prostaglandin E2, reduces the production of free and stable oxygen radicals. The antihypertensive effect develops by the end of the first week, persists for 24 hours against a single dose.
Pharmacokinetics
After ingestion is rapidly and completely absorbed from the gastrointestinal tract; bioavailability - high (93%). Meal somewhat slows down the rate of absorption, but does not affect the amount of absorbed substance. Cmax in plasma - 12 hours after ingestion. With repeated administration, fluctuations in the concentration of the drug in the blood plasma in the interval between administration of two doses are reduced. Equilibrium concentration is established after 7 days of regular intake. T1 / 2 - 18 h, the bond with plasma proteins is 79%. Also associated with elastin smooth muscle of the vascular wall. It has high Vd, passes through histohematogenous barriers (including placental), penetrates into breast milk. It is metabolized in the liver. 60-80% are excreted by the kidneys as metabolites (about 5% are excreted unchanged), through the intestine - 20%. In patients with renal insufficiency, pharmacokinetics do not change. Does not accumulate.
Indications
Primary hypercholesterolemia, mixed hyperlipidemia (including in patients with insulin-dependent diabetes mellitus), heterozygous and homozygous familial hypercholesterolemia (as a supplement to the diet).
Contraindications
Hypersensitivity to indapamide, other sulfonamide derivatives or other components of the drug, decompensation of renal function (anuria) and / or liver (includingwith encephalopathy), hypokalemia, simultaneous administration of drugs that extend the QT interval, pregnancy, lactation, age up to 18 years (efficacy and safety have not been established).
Use during pregnancy and lactation
Patients taking cardiac glycosides, laxatives, against the background of hyper aldosteronism, as well as in elderly people show regular monitoring of the content of potassium and creatinine ions. Against the background of administration of indapamide, the concentration of potassium, sodium, magnesium ions in the blood plasma should be monitored (electrolyte ions can develop violations), pH, glucose, uric acid and residual nitrogen concentrations. The most careful control is shown in patients with cirrhosis (especially with edema or ascites) - the risk of developing metabolic whom alkalosis, which increases the manifestations of hepatic encephalopathy), coronary heart disease, heart failure, as well as in the elderly. The increased risk group also includes patients with an increased QT interval on the ECG (congenital or developed on the background of any pathological process). The first measurement of the concentration of potassium in the blood should be carried out within 1 week of treatment. Hypercalcemia in the presence of indapamide may be due to previously undiagnosed hyperparathyroidism. In patients with diabetes mellitus It is extremely important to control blood glucose levels, especially in the presence of hypokalemia. Significant dehydration can lead to the development of acute renal failure (reduced glomerular filtration). Patients need to compensate for water loss and at the beginning of treatment carefully monitor kidney function. -control. Patients with arterial hypertension and hyponatremia (due to the intake of diuretics) need 3 days before the start of angiotensin-preservative intake To stop taking diuretics (if necessary, diuretics can be resumed a little later), or they are prescribed initial low doses of ACE inhibitors. Influence on the ability to drive vehicles and control mechanisms In some cases, individual reactions are possible associated with changes in blood pressure, especially but at the beginning of treatment and with the addition of another antihypertensive agent.As a result, the ability to drive and work with mechanisms requiring increased attention may be reduced.
Dosage and administration
Tablets are taken orally in a dose of 1.5 mg once a day (in the morning). In case of insufficient expression of the hypotensive effect, after 2 weeks of treatment, the dose is increased to 5-7.5 mg / day. Maximum dose: 10 mg / day in 2 divided doses (in the morning).
Side effects
Saluretics, cardiac glycosides, gluco- and mineralocorticoid drugs, tetrakozaktid, amphotericin B (w / w), laxatives increase the risk of hypokalemia. If taken simultaneously with cardiac glycosides, the likelihood of digitalis intoxication increases; with calcium preparations - hypercalcemia; with metformin - aggravation of lactic acidosis is possible. Increases the concentration of lithium ions in the blood plasma (decreased excretion with urine), lithium has a nephrotoxic effect. ) and class III (amiodarone, Bretiliya tosylate, sotalol) can lead to the development of pirouette arrhythmias ”(torsades de pointes). NSAID, GCS, tetracosactide, sympathomimetics reduce the hypotensive effect, baclofen - increases. diuretics may be effective in a certain category of patients, however, this does not completely exclude the possibility of the development of hypo- or hyperkalemia, especially in patients with diabetes mellitus and renal insufficiency. ACE inhibitors increase the risk of arterial hypotension and / or acute renal failure stenosis of the renal artery). Increases the risk of developing renal dysfunction when using iodine-containing contrast media in high doses (dehydration of the body). Before applied Patients need to recover fluid loss with iodine-containing contrast agents. Imipramine (tricyclic) anti-depressants and neuroleptics increase the hypotensive effect and increase the risk of orthostatic hypotension. Cyclosporine increases the risk of hypercreatininemia. result of a decrease in circulating blood volume and an increase in their production by the liver (it may be necessary to dose correction). Increases the blockade of neuromuscular transmission, which develops under the action of non-depolarizing muscle relaxants.
Overdose
On the part of the gastrointestinal tract: nausea / anorexia, dry mouth, gastralgia, vomiting, diarrhea, constipation. Of the nervous system: asthenia, nervousness, headache, dizziness, drowsiness, vertigo, insomnia, depression; rarely - increased fatigue, general weakness, malaise, muscle spasm, tension, irritability, anxiety. From the senses: conjunctivitis, blurred vision. On the part of the respiratory system: cough, pharyngitis, sinusitis, rarely - rhinitis. Since the cardiovascular system: orthostatic hypotension, changes in the electrocardiogram (hypokalemia), arrhythmia, palpitations. On the part of the urinary system: frequent infections, nocturia, polyuria. Allergic reactions: rash, urticaria, pruritus, hemorrhagic vasculitis. Laboratory indicators: hyperuricemia, hyperglycemia, hypokalemia, hypochloremia, hyponatremia, hypercalcemia, increased urea nitrogen in the blood plasma, hypercreatininemia, glucosuria. Others: flu-like syndrome, chest pain, back pain, infections, reduced potency, decreased libido, rhinorrhea, sweating, weight loss, tingling of limbs, pancreatitis, exacerbation of systemic lupus erythematosus.
Interaction with other drugs
Precautionary measures
special instructions
Symptoms: nausea, vomiting, weakness, dysfunction of the gastrointestinal tract, water and electrolyte disturbances, in some cases - an excessive reduction in blood pressure, respiratory depression. Hepatic coma may develop in patients with cirrhosis. Treatment: gastric lavage, correction of water and electrolyte balance, symptomatic therapy. There is no specific antidote.