2010/09/17

Akripamide

Composition, structure and packing

Coated tablets are round, biconvex, white or white with kremovatym or grayish tint. Class roughness.

1 tab. indapamide 2.5 mg.

Excipients: lactose (milk sugar), potato starch, low molecular weight polyvinylpyrrolidone Medical (povidone), sodium dodecyl sulphate (sodium lauryl sulfate), talc, magnesium stearate. The composition of the shell: hydroxypropylmethylcellulose (gipromelloza), polyethylene glycol (macrogol), glycerol, titanium dioxide, talc.

Clinico-pharmacological group: diuretics.

Antihypertensives.

Pharmacological action

Antihypertensives. Tiazidopodobny diuretic, a derivative of sulfonamides.

Causes moderate saluretichesky and diuretic effect associated with inhibition of reabsorption of sodium, chlorine, hydrogen, and to a lesser extent, of potassium ions in the proximal tubules and in the cortical segment of the loop of Henle.

Has antihypertensive effect. Lowers the tone of smooth muscles of the arteries, reduces TPVR. Reducing TPVR due to several mechanisms: reduced sensitivity of the vascular wall to noradrenaline and angiotensin II; increase in the synthesis of prostaglandins with vasodilating activity, inhibition of entry of calcium ions in smooth muscle elements of the vascular wall.

Antihypertensive effect of the drug is only if the initially elevated blood pressure usually develops by the end of the first week and reaches a maximum after 3 months of systematic reception.

Statement
hypertension.

Dosage regimen

In a monotherapy Akripamid appoint 2.5 mg (1 tab.) / D in the morning.

The maximum daily dose should not exceed 2.5 mg. As part of combination therapy Akripamid appointed in the same daily dose - 2.5 mg in the morning once. Tablets are taken without chewing.

Side effect
From the laboratory parameters: hypokalemia, chloropenia, hyponatremia, hypercalcemia, increase in blood levels of uric acid, glucose, urea nitrogen and creatinine blood.
From the CNS: asthenia, headache, dizziness, lethargy, drowsiness, insomnia, weakness, apathy.
On the part of the digestive system: nausea, anorexia, dry mouth, stomachalgia, diarrhea, constipation.
Since the cardiovascular system: orthostatic hypotension, tachycardia, ECG changes (nonspecific changes segment ST-T, U-wave).

Dermatological reactions: rash, itching, photosensitivity with bullous elements, erythroderma, purpura.

Contraindications
diabetes at the stage of decompensation;
gout;
anuria;
hypokalemia;
pronounced renal dysfunction;
acute ischemic stroke;
Hypersensitivity to any component of a drug or other derivatives of sulfonamides.

Pregnancy and lactation

The drug is not recommended during pregnancy, including for removal of physiological edema. It should be borne in mind that diuretics can cause placental ischemia and lead to a breach of fetal development. Due to the fact that indapamide is excreted in breast milk is not recommended the appointment of the drug during breastfeeding. If you need to conduct therapy, breast-feeding should be discontinued.

Application for violations of liver function

Precautions should be prescribed Akripamid patients with liver disease, because against the possible development of hypokalemia drug may cause metabolic alkalosis, enhances the manifestation of hepatic encephalopathy.

Application for violations of renal function

Contraindications vyrazhnnyh violations of kidney function. With caution and under close supervision should be prescribed to patients with impaired renal function (as the elimination of indapamide from the body is carried out mainly by the kidneys). With increasing azotemia and oliguria occur during treatment receiving the drug should be discontinued.

Cautions

With caution and under close supervision should be prescribed to patients with impaired renal function (as the elimination of indapamide from the body is carried out mainly by the kidneys). With increasing azotemia and oliguria occur during treatment receiving the drug should be discontinued.

Precautions should be prescribed Akripamid patients with liver disease, because against the possible development of hypokalemia drug may cause metabolic alkalosis, enhances the manifestation of hepatic encephalopathy.

In applying Akripamida it may hyperuricaemia. Required control over the level of uric acid in the blood, especially in patients with a history of gout.

During the reception Akripamida may develop hypokalemia. It should monitor the level of potassium in the blood and when necessary, appoint agents of potassium, especially in patients receiving cardiac glycosides. The risk of hypokalemia increases with concomitant steroid therapy, receiving ACTH and insufficient intake of electrolytes in the body.

During the reception Akripamida must also conduct monitoring of electrolyte blood serum, the residual nitrogen of blood and the blood glucose level. Signs of electrolyte imbalance are: dryness of mouth, thirst, weakness, apathy, drowsiness, constant fatigue, muscle pain or cramps, muscle weakness, hypotension, oliguria, nausea, vomiting, and tachycardia and ECG changes.

Against the background of the drug may develop orthostatic hypotension, which may result in admission of alcohol, barbiturates, opioid analgesics and the simultaneous intake of other antihypertensive drugs. It is known that sulfonamide derivatives may exacerbate the course of systemic lupus erythematosus, which should be considered when applying Akripamida.

Rarely in the treatment of skin may appear Akripamidom adverse reactions. In most cases they are completely within 14 days after drug discontinuation. Although Akripamid has minimal effect on glucose metabolism in patients with insulin-dependent diabetes mellitus can be marked increase in the required insulin dose, and in patients with latent diabetes mellitus may experience hyperglycemia and glycosuria.

Use in Pediatrics

Due to the lack of sufficient clinical data is not recommended to use in children and adolescents under 18 years.

Overdose

Posts of overdose were reported.

Symptoms: on the basis of pharmacological activity can be assumed that an overdose will lead to excessive diuresis with electrolyte derangement. In patients with cirrhosis of the liver overdosing can lead to hepatic coma.

Treatment: No specific antidote.

Treatment should be symptomatic and supportive. It should stop taking the drug, to induce vomiting or make gastral lavage, correction of dehydration, electrolyte disturbances, hypotension, hepatic coma.

Drug Interactions

When applied simultaneously with Akripamida astemizolom, erythromycin (IV), pentaminidinom, sultopridom, terfenadinom, antiarrhythmics class I (quinidine, gidrohinidin, dizopiramid), amiodarone, bretiliumom, sotalol increases the likelihood of cardiac arrhythmias such as "pirouette".

With simultaneous application Akripamida with NSAIDs for systemic use may reduce antihypertensive action of indapamide.

With the simultaneous use of drugs, which can cause hypokalemia (including those with amphotericin B, gluco-and mineralocorticoid, tetrakozaktidom, laxatives, cardiac glycosides) increased risk of developing hypokalaemia. Tricyclic antidepressants, antipsychotic agent in the simultaneous use of antihypertensive effect Akripamida reinforce and increase the risk of orthostatic hypotension.

When the joint application Akripamida with cyclosporine may increase creatinine in blood plasma at a constant concentration of circulating cyclosporine. With simultaneous application Akripamida with ACE inhibitors increases the risk of arterial hypotension and / or renal insufficiency. When using iodine contrast agents at high doses on a background of reception Akripamida increased risk of renal failure.

Antihypertensive drugs other groups reinforce the influence of Akripamida on BP.

With simultaneous application Akripamida with drugs lithium may increase the concentration of lithium in blood plasma.

Terms and Conditions of storage

The drug should be stored in a dry place protected from light, away from children at or above 25 ° C. Shelf life - 2 years.