Cilazapril
When ATH:
C09AA08
Characteristic.
The white crystalline powder, poorly soluble in water.
Pharmacological action.
Gipotenzivnoe, vazodilatirtee, kardioprotektivnoe, natriuretic.
Application.
Arterial hypertension (incl. renovascular), congestive heart failure (in a combination therapy with digitalis drugs and / or diuretics).
Contraindications.
Hypersensitivity (incl. to other ACE inhibitors), angioedema in history, pregnancy, lactation.
Restrictions apply.
Aortalnыy stenosis, childhood (Safety and efficacy have not determined).
Pregnancy and breast-feeding.
Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.
Side effects.
Cardio-vascular system and blood (hematopoiesis, hemostasis): hypotension, decrease in hemoglobin levels, hematocrit and / or leukocytes.
From the digestive tract: dyspepsia, nausea, pancreatitis (isolated cases).
From the nervous system and sensory organs: headache, dizziness, slackness.
With the genitourinary system: reduction in kidney function.
Other: cough, rash, angioedema (It requires the removal of PM), rarely — increased creatinine and urea nitrogen (primarily, patients with renal artery stenosis or renal insufficiency, and in patients with normal renal function, incl. against the backdrop of the simultaneous reception of diuretics).
Cooperation.
Potentiates the hypoglycemic effect of oral antidiabetic drugs. Co-administration of potassium-sparing diuretics can cause hyperkalemia (especially in patients with renal insufficiency). Antihypertensive effect of weakening the NSAID.
Overdose.
Symptoms: possible development of hypotension.
Treatment: introduce measures to increase BCC. Partially removed from the body during hemodialysis.
Dosing and Administration.
Inside, regardless of the meal, single, at the same time of the day.
When hypertension the initial dose of 1-1, 25 mg 1 once a day, supporting-2.5-5 mg/day.
If renovascular hypertension the initial dose 0,5 mg / day one.
In chronic heart failure the initial dose - 0,5 mg (under close medical supervision) with a gradual increase, depending on tolerability and effectiveness of the drug and the patient before the lowest maintenance dose is 1 mg/day and continue to support 1-2, 5 mg/day. The maximum daily dose - 5 mg 1 once a day.
If the kidney function, in patients with chronic heart failure and related renal impairment dosage regimen depends on creatinine clearance: When creatinine clearance greater 40 ml / min - 1 mg 1 once a day (the maximum dose - 5 mg / day), 10-40 ml/min — 0,5 mg 1 once a day (the maximum dose - 2,5 mg / day), less 10 mL/min-0.25-0.5 mg 1 or 2 times a week, depending on the dynamics of blood pressure.
In cirrhosis of the liver in a dose of 0.25-0.5 mg 1 once a day. Older patients initial dose 0.5-1.25 mg/day.
Precautions.
Treatment is carried out under regular medical supervision. In the event of severe hypotension the patient should be given a horizontal position, and if necessary to take measures to increase BCC. After payment BCC treatment can be continued. In the case of conservation hypotension should reduce the dose or cancel the drug. Patients, receiving diuretics, to reduce the risk of symptomatic hypotension diuretic should be discontinued for 2-3 days prior to treatment. During treatment avoid hemodialysis through high capacity membranes from poliakrilonitritmetallilsulfata (eg, АN69), gemofilytratsii or LDL apheresis, tk. may develop anaphylaxis, anaphylactoid reactions and life-threatening shock. Patients, undergoing desensitization with wasp or bee venom during treatment with ACE inhibitors may experience an anaphylactic reaction (therapy should be discontinued prior to desensitization). Caution is advised to carry out surgery with anesthetic drugs, have hypotensive action.
