The indication to application. Different forms of an arterial hypertensia. 20 tablets
Pharmacological action:
Captopres (Kaptopres) - complex antihypertensive drug. The preparation consists of two active components - captopril and hydrochlorothiazide. The drug has a pronounced antihypertensive and diuretic activity. The mechanism of action and therapeutic effects of the drug due to the pharmacological properties of the active ingredients in its composition:
Captopril - medicated group of angiotensin converting enzyme. The drug helps reduce blood pressure, reduces the total peripheral vascular resistance and preload on the myocardium, increases cardiac output and exercise tolerance. The mechanism of drug action based on its ability to inhibit the angiotensin-converting enzyme is inhibited whereby the conversion of angiotensin I to angiotensin II, which has a strong vasoconstrictor action.
Hydrochlorothiazide - a thiazide diuretic, increases the excretion of fluids and sodium ions, potassium and chlorine. Enhances the antihypertensive effect of captopril.
After oral administration, the active drug components are well absorbed from the gastrointestinal tract. The peak concentration in the blood plasma captopril observed 60 minutes after oral administration of hydrochlorothiazide after 1-2.5 hours. About 30% of captopril bound to plasma proteins. The active components are derived mainly from the urine as unchanged or as metabolites. The half-life of captopril is 45-120 minutes, hydrochlorothiazide - 5,5-15 hours.
Hydrochlorothiazide penetrates the blood-placenta barrier, excreted in breast milk.
Indications for use:
The drug is used for the treatment of patients suffering from various forms of hypertension.
How to use:
The drug is taken orally. Tablet is recommended to swallow whole without chewing or crushing, drinking plenty of water. If necessary, the tablet can be divided. Taking the drug is independent of food intake. The duration of treatment and the dose determined by the attending physician for each patient individually. Doses are calculated based on captopril.
Adults with normal renal function is usually prescribed drug in an initial dose of 25 mg 2 times a day (half a tablet formulation Kaptopres 12.5). Further, in case of need to increase the dose of captopril 50mg 2 times per day (one tablet preparation Kaptopres 12.5). If the antihypertensive effect is insufficient, it should pass away on the drug Kaptopres not change the dose of captopril.
The maximum daily dose is 100 mg of captopril.
The maximum daily dose is 50 mg of hydrochlorothiazide.
Adults with impaired renal function and creatinine clearance 30 to 80 mL / min of drug administered in an initial dose of 25 mg 1 time a day (half a tablet formulation Kaptopres 12.5). In the case of the drug 1 time per day is recommended to take a pill in the morning.
While taking the drug Kaptopres recommended to monitor the level of potassium, creatinine and urea in the blood plasma and peripheral blood picture.
Side effects:
In applying the drug Kaptopres patients experienced the development of such side effects:
On the part of the gastrointestinal tract and liver: loss of appetite, nausea, vomiting, epigastric pain, violation of the chair, dryness of mucous membranes in the mouth, stomatitis, peptic ulcer, jaundice, hepatitis, hyperbilirubinemia.
Cardio-vascular system and the hematopoietic system: tachycardia, angina, hypotension, Raynaud's syndrome, flushing or pallor, cardiogenic shock, neutropenia, agranulocytosis, thrombocytopenia, pancytopenia, hemolytic or aplastic anemia.
Of the central and peripheral nervous system: a violation of sleep and wakefulness, headache, dizziness, emotional lability, confusion, blurred vision and taste, tinnitus, paresthesia, stroke.
The respiratory system: cough, respiratory failure, bronchospasm, allergic rhinitis.
From the urinary system: renal failure, polyuria, oliguria, nephrotic syndrome.
Allergic reactions: skin rash, itching, hives, angioedema syndrome Stivnsa-Johnson syndrome, photosensitivity, erythema.
From the laboratory parameters: raising the calcium level, BUN, creatinine and bilirubin in blood plasma, reduction of sodium levels in the blood and glucose, decreased hemoglobin, leucocytes, platelets and hematocrit proteinuria.
Other: pain in the muscles and joints, chest pain, fever, muscle spasms, impotence, gynecomastia, alopecia.
Contraindications:
Individual hypersensitivity to the drug, the drug group of angiotensin-converting enzyme inhibitors and sulfonamide derivatives.
The drug is contraindicated in patients with severe renal impairment (creatinine clearance less than 30 ml / min or plasma creatinine concentration more than 1,8mg / 100ml), stenosis of the artery to a solitary kidney or bilateral renal artery stenosis, as well as in patients after kidney transplantation.
The drug is not prescribed to patients with obstructive disorders in which impaired blood flow from the left ventricle (including aortic stenosis), primary hyperaldosteronism, reduced levels of potassium and sodium in the blood plasma, hypovolemia, gout and hypercalcemia.
In addition, the drug is contraindicated in severe liver disease, women during pregnancy and lactation and children under the age of 18 years.
The drug should be used with caution in patients with impaired immunity, creatinine clearance 30 to 60 ml / min, the high content of protein in the urine (more than 1 g per day), as well as patients receiving procainamide.
Care should be taken when administering the drug to patients suffering from heart failure, renal failure, diabetes, high blood pressure and renal arteries in elderly patients. In the appointment of these categories of patients should regularly monitor blood pressure, renal function and electrolyte levels in the blood plasma.
Patients taking diuretic drugs should stop taking diuretics for at least 3 days prior to the start of therapy with Kaptopres.
It should be used with caution to patients whose work is connected with the management of potentially dangerous machinery and driving.
Pregnancy:
The drug is contraindicated in women during pregnancy and lactation.
Interaction with other drugs:
The combined application diazoxide, monoamine oxidase inhibitors, diuretic drugs, vasodilators, ganglionic blockers and increase the hypotensive effect of the drug.
Potassium supplements and potassium-sparing diuretics with concomitant use of drugs Kaptopres increase the plasma concentrations of potassium and increase the risk of hyperkalemia.
There is a decrease efficacy Kaptopres the combined use with non-steroidal anti-inflammatory drugs and methenamine.
With the simultaneous use of the drug with lithium marked increase in plasma concentrations of lithium.
The combined application of the drug with ethyl alcohol, barbiturates, and narcotic drugs increases the risk of orthostatic hypotension.
When combined with the use of the drug amphotericin B, corticosteroids and adrenocorticotropic hormone may develop electrolyte metabolism disorders.
The drug can increase the calcium concentration in blood plasma.
Kaptropres the combined use enhances the toxic effects of cardiac glycosides.
The combined application with the drug Kaptopres may require dosage adjustment probenecid, sulfinpyrazone oral anticoagulants, antidiabetic drugs and medicines for the treatment of gout.
Cholestyramine and colestipol in combined therapy reduce the absorption of hydrochlorothiazide.
Should stop taking the drug Kaptopres at least one week prior to elective surgery.
Overdose:
In the application of excessive doses of the drug in patients noted the development of arterial hypotension, tachycardia, headache, nausea, vomiting, defecation disorders, anorexia, neutropenia. With further increase of the dose indicated the development of symptoms of poisoning hydrochlorothiazide, in particular violation of water-salt balance, the development of coma, which is a consequence of the effect of the drug on the central nervous system.
If overdose is a removal of the drug, gastric lavage, enterosorbents. If necessary, symptomatic therapy. In case of severe poisoning hydrochlorothiazide requires hospitalization of the patient, hemodialysis, and measures aimed at restoring and maintaining water and electrolyte balance and function of the cardiovascular system. Furthermore, measures may be required to maintain the function of the respiratory system, central nervous system and kidney.
Product:
Tablets 10 pieces in blister, 1 or 2 blisters in carton.
Storage conditions:
The drug should be stored in a dry place away from direct sunlight at temperatures between 15 and 30 degrees Celsius.
Shelf life - 3 years.
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