Description overdue on 08/24/2014
- Latin name: MicardisPlus
- ATC code: C09DA07
- Active substance: Telmisartan + Hydrochlorothiazide (Hydrochlorothiazide + Telmisartan)
- Manufacturer: BOEHRINGER INGELHEIM INTERNATIONAL (Germany)
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions on Mikardis Plus
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Babies
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
One tablet Micardis Plus contains 40 or 80 mg telmisartan and 12.5 mg hydrochlorothiazide .
Excipients: sodium hydroxide, meglumine, povidone, sorbitol, magnesium stearate, lactose monohydrate, iron oxide red, microcrystalline cellulose, sodium carboxymethyl starch, corn starch.
Product form
The drug Micardis Plus is biconvex, oval tablets, double-layer on the cut, on a white surface engraved "H4" and the logo of the manufacturer.
Pharmacological action
Has combined hypotensive action .
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Mikardis Plus - a combination telmisartan (receptor blocker angiotensin the second type) and hydrochlorothiazide ( diuretic thiazide-type). The combined use of these components is stronger antihypertensive effect Than using them individually. The drug 1 per day results in significant gradual reduction of pressure.
Telmisartan - Selective receptor blocker angiotensin the second type. It has a high affinity for angiotensin II subtype AT1- . He replaces Angiotensin II from the receptor. The binding is long-lasting. Telmisartan It does not block other receptors (including AT2-type receptors) angiotensin . Telmisartan It reduces synthesis aldosterone .
In individuals with hypertension 80 mg telmisartan day completely suppresses effects angiotensin II . Onset of action occurs within three hours after consumption of the drug inside. The action persists for days. Permanent antihypertensive effect It recorded a month after the regular use telmisartan .
Hydrochlorothiazide It is diuretic thiazide-type. It affects the reabsorption of electrolytes in the renal tubules, directly increasing excretion of sodium and chloride. This causes a decrease in blood volume, an increase in activity Renin , An increase in the synthesis of aldosterone .
After applying hydrochlorothiazide diuresis increased after two hours, but the maximum effect is achieved after four hours and maintained for 6-12 hours.
Pharmacokinetics
Telmisartan. Rapidly absorbed from the digestive tract. The maximum concentration telmisartan It occurs within hours. Bioavailability is 50%.
Responding to blood proteins - more than 99.5%. It is metabolized by reacting with glucuronic acid . Derivative telmisartan pharmacologically inactive.
Half-life is about 20 hours. Excreted in the feces in its original form, and kidney - to 2%.
Pharmacokinetics telmisartan in elderly persons are not different from the younger patients. Selection of doses required.
Hydrochlorothiazide. After oral administration hydrochlorothiazide maximum concentration reached in 1-2 hours. Bioavailability is 60%.
Responding to plasma proteins - 64%. Do not metabolized and excreted by the kidneys unchanged.
Indications
Hypertension (if monotherapy telmisartan or hydrochlorothiazide ineffective).
Contraindications
The product has the following contraindications:
- violation of patency of the biliary tract;
- severe disorders of the liver or kidneys;
- refractory g iperkaltsiemiya, hypokalemia ;
- intolerance fructose ;
- deficit Lactase and intolerance galactose or lactose ;
- age less than 18 years;
- lactation ;
- pregnancy ;
- allergy to the drug.
Carefully:
- stenosis both renal arteries, severe kidney damage;
- disorders of liver or progressive liver disease;
- hyperkalemia;
- hypovolemia after treatment diuretics And after limiting salt intake, or vomiting diarrhea ;
- congestive heart failure Functional class III-IV;
- mitral stenosis and aortic valve ;
- condition after kidney transplantation;
- obstructive cardiomyopathy ;
- primary aldosteronism ;
- diabetes ;
- gout .
Side effects
- From the respiratory system: dyspnea, respiratory distress syndrome .
- From the circulatory system: tachycardia . Arrhythmia . bradycardia , A strong decrease in pressure.
- From the nervous system: syncope, paresthesia , Dizziness, insomnia , Anxiety, depression , Anxiety, headache.
- From the digestive system: bloating, diarrhea, dry mucous membranes of the mouth, abdominal pain, constipation, gastritis, hypercholesterolemia, hyperglycemia, pancreatitis, jaundice, dyspepsia.
- Skin: sweating.
- From the musculoskeletal system: muscle cramps, arthralgia . myalgia . arthrosis , chest pain.
- From hemopoiesis system: leucopenia, eosinophilia, anemia, neutropenia, thrombocytopenia, thrombocytopenia.
- From the urogenital: renal failure, nephritis, glycosuria.
- On the part of the eye: blurred vision, glaucoma, xanthopsia, acute myopia .
- Infections: sepsis , Respiratory tract infections ( pharyngitis, bronchitis, sinusitis ), Inflammation of the salivary glands.
- Metabolic disorders: increasing creatinine, liver enzymes, creatine, uric acid in blood, hypertriglyceridemia, hyperkalemia, hypokalemia, hypoglycemia, hyponatremia, reduction Hemoglobin .
- Allergic reactions : Itching, angioedema , Rash, erythema . anaphylactic reactions . eczema, systemic vasculitis, necrotizing vasculitis .
Instructions on Mikardis Plus
Instructions for use are recommended to take the drug into one tablet once a day, regardless of the meal.
Mikardis Plus can be used by patients who have drug Mikardis or hydrochlorothiazide It causes no pressure drop.
In patients with severe Arterial hypertension the maximum dose telmisartan is 160 mg per day.
Overdose
Cases of overdose have not been described.
Possible signs of overdose telmisartan : Strong pressure reduction, tachycardia, bradycardia.
Possible signs of overdose hydrochlorothiazide : Violations of water-salt balance of the blood, hypovolemia, arrhythmia.
Treatment: symptomatic.
Cooperation
When used together, telmisartan from:
- other antihypertensive drugs - may increase strength antihypertensive action ;
- preparations lithium - Possible temporary elevation of lithium in blood;
- NSAIDs - May cause Acute renal failure in patients with reduced circulating blood volume;
- digoxin - May increase the concentration Digoxin levels by 20%.
In an application hydrochlorothiazide from:
- barbiturates, ethanol or opioid painkillers - may develop orthostatic hypotension ;
- metformin - Possible development lactic acidosis ;
- hypoglycemic agents and insulin - Require dose adjustment hypoglycemic agents ;
- kolestiraminom and colestipol - Possible inhibition of absorption hydrochlorothiazide ;
- non-depolarizing mioreklaksantami - May enhance their effect;
- cardiac glycosides - Possible development hypokalemia or hypomagnesemia ;
- arthrifuge - May increase the content Uric acid in blood.
- calcium supplementation - May increase the concentration Calcium in the blood due to inhibition of its release by the kidneys.
- amantadine - May increase the risk of adverse effects amantadine ;
- Mr. holinoblokatorami ( atropine . biperidenom ) - May weaken the intestinal motility, increased bioavailability thiazide diuretics ;
- NSAIDs - May weaken diuretic and antihypertensive action .
Terms of sale
It sold strictly on prescription.
Storage conditions
Keep away from children. Store at temperatures up to 25 degrees.
Shelf life
Three years.
Cautions
Patients with coronary heart disease application of any pressure lowering agents, in case of strong pressure reduction may lead to the development of myocardial infarction or brain.
Mikardis Plus has a weaker therapeutic effect in individuals blacks.
When driving vehicles should be aware of the possibility of dizziness and drowsiness of the drug field.
Analogs Mikardis Plus
Atacand Plus
Co-Diovan
Vasari H
Valz H
Lorista N / ND
Known analogues of the drug: Atacand Plus . Valzap Plus . Valsacor . Gizaar Forte . Co-Diovan . Teveten Plus and others.
Babies
It prohibited the use of funds from persons under 18 years of age.
During pregnancy (and lactation)
State or lactation pregnancy a contraindication to treatment.
Reviews Mikardis Plus
Reviews show more pronounced therapeutic effect compared with just Mikardisom Especially when the latter ineffective.
Price Mikardis Plus
In Ukraine, the price of the drug at a dose of 80 mg / 12 mg 5 №28 on average 450 hryvnia, in Russia such a package will cost 855-1000 rubles.
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