Atehexal compositum

Release form, composition and packing

Coated tablets 1 tab.
Atenolol 100 mg
chlorthalidone 25 mg

Clinico-pharmacological group

Antihypertensive medication.

Pharmacological action

Combined antihypertensive medication. Provides long-hypertensive effects, including providing morning protection. Prevent another heart attack and strokes. Effect is due to the action of two components - a beta-blocker (atenolol) and a diuretic (chlorthalidone).

Atenolol

Hydrophilic cardioselective beta1-blocker. Has no intrinsic sympathomimetic activity, has no membrane stabilizing activity.

The main pharmacological actions - antiadrenergicheskoe, antianginal, antiarrhythmic, antihypertensive, cardioprotective.

Decreases heart rate (negative chronotropic effect), slows AV-conduction (negative dromotropic effect), reduces the excitability of the myocardium (negative bathmotropic action), reduces myocardial contractility (negative inotropic effect), lowers blood pressure by these mechanisms, as well as by suppressing the secretion renin reduces the pressure in the portal vein system by reducing the hepatic and mesenteric blood flow.

Chlorthalidone

Netiazidny sulphanylamide diuretic drug is long-acting (48-72 h after a single oral administration).

Chlorthalidone violates the reabsorption of sodium, chlorine, and equivalent amounts of water in the distal tubules of the nephron, increases excretion of potassium, magnesium, bicarbonate, delays excretion of uric acid and calcium ions, decreases the sensitivity of the vascular wall to vasoconstrictor influences.

Refers to the diuretic-average performance and is characterized by extremely low toxicity.

The main therapeutic effect - a diuretic and antihypertensive.

Indications for use of the drug
essential hypertension (prophylaxis and treatment).

Combined medication Atehexal compositum designate when individual therapy is an active substance in order to normalize blood pressure is insufficient, or for more convenient use of drugs, doses that were selected during separate therapy.

Dosing regimen

Therapy begins, usually with a low dose (50 mg atenolol and 12.5 mg chlorthalidone). If necessary, and depending on the patient, the dose may be increased to receive 1 tablet containing 100 mg of atenolol and chlorthalidone 25 mg 1 time /

In patients with impaired renal function, dose should be reduced.

Atehexal compositum should be taken before breakfast, without chewing and drinking plenty of fluids.

Abolition of the drug after prolonged treatment should be carried out, if possible, gradually.

Side effect

Atehexal compositum generally well tolerated. In rare cases there may be a manifestation of the following side effects:
Cardio-vascular system: bradycardia, heart failure, cold extremities. Perhaps the appearance of AV-blockade, increased manifestations of intermittent claudication syndrome, the occurrence of Raynaud's syndrome.
CNS: dizziness, insomnia, fatigue.
From the digestive system: diarrhea disorders.
From the hemopoietic system: in rare cases - thrombocytopenia, leukopenia.

Dermatological reactions: skin rash, exacerbation of psoriasis.
From the water and electrolyte balance: hyponatraemia (associated with chlorthalidone), hypokalemia.
With the respiratory system: patients with bronchial asthma, or have a history of references to bronchospasm, bronchospasm may occur.

Other: hyperuricemia, impaired glucose tolerance, reduced potency (with prolonged use).

Contraindications to the use of the drug
congestive heart failure;
Chronic heart failure;
sick sinus syndrome;
marked bradycardia;
AV-block grade II and III;
severe hypotension;
disorders of peripheral circulation;
concomitant use of MAO inhibitors (except for receiving MAO inhibitors type B);
bronchial asthma and severe forms of chronic obstructive bronchitis;
hypokalemia;
hyponatremia;
hypercalcemia;
gout;
Infancy;
Hypersensitivity to any component of the drug.

Pregnancy and lactation

Application Atehexal compositum during pregnancy and lactation is contraindicated.

Use in renal impairment

In patients with impaired renal function, dose should be reduced.

Cautions

Prescribed with care in violation of the expressed liver and kidney function (glomerular filtration rate below 30 ml / min and / or creatinine clearance above 1.8 mg/100 ml), labile type 1 diabetes, the presence of patients gormonprodutsiruyuschey adrenal tumors; during the therapy of digitalis glycosides, GCS or laxatives, AV-blockade of I degree.

Patients with a family history of psoriasis, administration of drugs containing beta-adrenergic blockers, is possible only through careful weighing of risk-benefit.

Blockers, beta-blockers may increase sensitivity to allergens and cause an anaphylactic reaction in connection with this, patients on desensitizing therapy should take the drug with great caution.

On the background of treatment with the regular control of potassium levels in the blood, particularly in elderly patients, patients receiving cardiac glycosides in patients with dysfunction of the gastrointestinal tract.

Effect on ability to drive vehicles and operate machinery

In connection with the possibility of development of individual reactions to the drug can disrupt the ability to adequately participate in road traffic, or when servicing machines that require quick response. Such an effect enhanced by simultaneous intake of alcohol.

Overdose

Symptoms: nausea, vomiting, loss of appetite, tremors, anxiety, palpitations, headache, chest pain.

Treatment: the development of severe bradycardia should be put in / to 1-2 mg of atropine if necessary - 10 mg of glucagon in the form of I / O bolus. In the absence or ineffectiveness of glucagon, possibly intravenous dobutamine (2.5 micrograms / min / kg body weight) or 10-25 mg isoprenaline / drip at a rate not exceeding 5 mcg / min.

Drug Interactions

Insulin and oral antidiabetic agents: effect of the latter may increase. Symptoms of hypoglycemia - tachycardia and tremor. Should regularly monitor blood glucose levels.

Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators, and other antihypertensive drugs and alcohol: probably increased antihypertensive effect.

ACE inhibitors (captopril, enalapril): early treatment may sharp intensification of antihypertensive effect Atehexal compositum.

Calcium channel blockers such as nifedipine: possible increased antihypertensive effect.

Antiarrhythmic drugs: cardiodepressive stacking.

Calcium channel blockers such as verapamil or diltiazem, other antiarrhythmic drugs (disopyramide): possibly a sharp increase in antihypertensive effect, the development of bradycardia and other cardiac arrhythmias. Should be avoided in the intravenous administration of these funds while taking the drug Atehexal compositum.

Cardiac glycosides, reserpine, alpha-methyldopa, guanfacine and clonidine: the emergence of zavozmozhnogo potassium deficiency and / or magnesium in connection with the admission Atehexal compositum, can increase the sensitivity of the heart muscle to cardiac glycosides, and thus increase the frequency of their side effects. Abrupt cancellation of clonidine may increase blood pressure, so stop taking clonidine should be done gradually and only a few days after receiving cancellation Atehexal compositum.

Noradrenaline, adrenaline: is it possible a significant increase in blood pressure.

MAO inhibitors: may increase blood pressure.