KAPOZID

Active material: Captopril, Gidroxlorotiazid
When ATH: C09BA01
CCF: Antihypertensive drugs
ICD-10 codes (testimony): I10
When CSF: 01.09.16.03
Manufacturer: QUIBB AUSTRALIA Pty. Ltd. (Australia)

PHARMACEUTICAL FORM, COMPOSITION AND PACKAGING

Pills white or white with Valium a color shade, Oval, lenticular, scored on one side and embossed inscription “SQUIBB” and the numbers “50/25” on the other side, having a beveled edge, a sulfide-odor; Slight marbling.

Excipients: microcrystalline cellulose, pregelatinized corn starch, stearic acid, lactose, magnesium stearate.

14 PC. – packings Valium planimetric (2) – packs cardboard.

Pharmacological action

Combined preparation, hypotensive and diuretic effect.

Captopril - an ACE inhibitor. Reduces the formation of angiotensin II from angiotensin I, reduces the release of aldosterone. It lowers blood pressure, PR, afterload, preload. It expands the artery to a greater extent, than veins. Enhances coronary and renal blood flow. Prolonged use reduces the severity of myocardial hypertrophy and arterial walls resistive type; It improves blood flow to the ischemic myocardium; reduces platelet aggregation.

Gidroxlorotiazid – thiazide diuretic medium potency, It reduces the reabsorption of sodium ions at the level of the cortical segment of the loop of Henle. No effect on acid-base status. It lowers blood pressure by changing the reactivity of the vascular wall, reduce the pressor effect vasoconstrictors (epinephrine, norepinephrine) and strengthen the depressive effect on the autonomic ganglia (less, by reducing the BCC). It enhances the hypotensive effect of captopril.

Pharmacokinetics

The data on the pharmacokinetics Kapozid^® not provided.

Testimony

- Arterial hypertension.

Dosage regimen

The drug is prescribed inside of 1 tab. 1 time / day.

Tablets should be taken 1 hour before meals.

Side effect

Cardio-vascular system: “tides” of blood to the skin of the face, feeling the heat, dizziness, headache, tachycardia, palpitations, swelling of lower legs, severe hypotension (incl. orthostatic) with symptoms of dizziness, weakness; rarely – fainting; with a sharp or prolonged marked decrease in blood pressure – transient ischemic attack, stroke, myocardial infarction, Raynaud's syndrome.

From the water-electrolyte metabolism: dry mouth, thirst; rarely – reduction in the formation of tear fluid.

The respiratory system: bronchospasm, dry cough; rarely – respiratory insufficiency, sinusitis, rhinitis, laringit.

Allergic reactions: angioneurotic edema of extremities, person, lips, mucosas, larynx, throat and / or tongue, allergic reactions (until the development of pulmonary edema); rarely – hives.

Dermatological reactions: skin rash (rash), erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome). These skin changes may be accompanied by a rise in temperature, pain in muscles and joints, development of vasculitis. In some cases, – psoriasiform skin changes, photosensitivity, alopecia, onycholysis.

From the digestive system: nausea, vomiting, constipation or diarrhea, epigastric discomfort, stomach ache, decreased appetite, Acute cholecystitis (in cholelithiasis), pancreatolysis, hepatitis, cholestatic jaundice, increase in liver transaminases, giperʙiliruʙinemija; prolonged use – giperplaziya right, taste disturbances.

From the central and peripheral nervous system: headache, feeling tired; rarely – oppression, drowsiness, weakness, depression, sleep disorders, convulsions, ataxia, dizziness, noise in ears, visual impairment, tremor, paresthesia.

From the hematopoietic system: anemia (including aplastic and haemolytic forms), decrease in hematocrit, thrombocytopenia, leukopenia, neutropenia, until the development of pancytopenia and agranulocytosis (especially against the backdrop of the simultaneous reception of allopurinol, prokaynamyda, immunosuppressants), eozinofilija, increasing titer of antinuclear antibodies.

From the urinary system: proteinuria, polyuria, oligurija, glycosuria, thamuria; rarely (especially in patients with renal insufficiency) – increase in serum concentrations of urea, creatinine and potassium ions (the risk of hyperkalemia is also increased in patients with diabetes), and hyponatremia; prolonged use – impairment of renal function, jade.

Metabolism: gipermagniemiya, hyperlipidemia, giperglikemiâ, hyperuricemia (up to the worsening of gout).

Other: impotence, the progression of myopia.

Contraindications

- Angioedema (a history in patients receiving ACE inhibitors);

- Aortic stenosis;

- Mytralnыy stenosis;

- Gipertroficheskaya obstruktivnaya cardiomyopathy;

- Bilateral renal artery stenosis or stenosis of the artery to a solitary kidney;

- Condition after kidney transplantation;

- Congestive heart failure;

- Cardiogenic shock;

- Hypotension;

- Tachycardia;

- Severe liver (prekomatosnoe state, pechenochnaya coma);

- Expressed by the human kidney (serum creatinine > 1.8 mg / dL or KK<30 ml / min, anurija);

- Primary hyperaldosteronism;

- Pregnancy;

- Lactation (breast-feeding);

- Up to 18 years;

- Hypersensitivity to the drug, thiazide diuretics, sulfonamide derivatives (possible cross allergic reactions).

FROM caution should appoint Kapozid at moderate renal impairment (serum creatinine < 1.8 mg / dL or KK 30-60 ml / min), when proteinuria (more 1 g / day), hypokalemia (medication not korrektiruyushteysya), giponatriemii, gipovolemii, hypercalcemia, podagre, collagenosis and other autoimmune diseases (incl. SLE, scleroderma, periarteritis nodosa), in elderly patients (senior 65 years), while the appointment of the SCS, cytostatics, immunosuppressants, allopurinola, prokaynamyda, lithium preparations.

Pregnancy and lactation

The drug is contraindicated during pregnancy and lactation.

Cautions

Early treatment Kapozidom^® there may be an excessive reduction of blood pressure, especially in patients with heart failure, severe hypertension (incl. renogenic) and / or renal insufficiency.

Before treatment Kapozidom^® It is necessary to adjust the water-salt balance (reduce the dose of diuretics or appointed earlier, in some cases, cancel them completely).

Before treatment is necessary to monitor renal function.

During the reception Kapozida^® should be regular monitoring of plasma potassium and calcium (especially while receiving cardiac glycosides, GCS, laxatives, as well as in elderly patients), Glucose, Uric acid, lipids (cholesterol and triglycerides), urea and creatinine, liver transaminases.

Particularly careful control of blood pressure levels, and laboratory parameters is necessary for patients with renal insufficiency, hypertensive severe (incl. renal genesis), in elderly patients (senior 65 years), in patients with impaired water and electrolyte balance and decompensated congestive heart failure, as well as the simultaneous use of allopurinol, lithium salts, procainamide and immunosuppressants.

When the fever, swollen lymph nodes and / or signs of laryngitis, and / or pharyngitis should immediately analyze the peripheral blood.

Appointment Kapozida^® amid dialysis using dialysis membranes of certain high permittivity (eg, polyacrylonitrile membranes-metalilsulfonatnyh) It increases the risk of anaphylactic reactions.

Effects on ability to drive vehicles and management mechanisms

During treatment, you should be careful when driving and occupation of other potentially hazardous activities, requiring concentration and speed of psychomotor reactions.

Overdose

Perhaps the increased severity of side effects.

Treatment: symptomatic therapy.

Drug Interactions

Kapozid^® increases the concentration of digoxin in blood plasma 15-20%, increases the bioavailability of propranolol.

The risk of immunosuppressive effect is increased by the combined use with procainamide, as well as preparations, block tubular secretion (reduction in the number of white blood cells and granulocytes).

Increases neurotoxicity salicylates, effects of non-depolarizing muscle relaxants competitive type of action, ethanol.

It reduces the excretion of quinidine, effects of oral hypoglycemic drugs, norepinephrine, epinephrine and protivopodagricakih drugs.

Strengthens side effects of cardiac glycosides, particularly with concomitant administration with drugs, that increase the excretion of potassium and magnesium and / or calcium ions retard (such as diuretics, adrenocortical hormones, laxatives, Amphotericin B, karʙenoksolon, penicillin G , salicilaty).

Cimetidine, slowing down the metabolism in the liver captopril, increases its concentration in plasma.

Indomethacin, and other NSAIDs, including COX, and salt may reduce the antihypertensive effect of the drug, and reduce the absorption of hydrochlorothiazide.

Hydrochlorothiazide may increase the effects of drugs for the initiation of anesthesia and anesthetics, used in surgery (eg, tubocurarine chloride and gallamine triethiodide).

Combination with nitratami, thiazide diuretics, verapamil, Beta-blockers and other antihypertensives, MAO inhibitors, ganglioblokatorami, and tricyclic antidepressants, hypnotics and ethanol increases the severity of the hypotensive effect.

When concomitant administration with lithium may be a slowing of excretion of lithium ions (strengthening of the damaging effect on the heart and central nervous system).

Drugs, intense binding proteins, enhance the diuretic effect.

You may need a dose adjustment of oral anticoagulants, probenecid and sulfinpirazona, as hydrochlorothiazide may inhibit their action.

Diazoksid increases hyperglycemic, hyperuricemic and antihypertensive effect while the use of hydrochlorothiazide. It is necessary to check the level of glucose in the blood and the concentration of uric acid.

Higher doses may be necessary in connection with the, hydrochlorothiazide which has hyperuricemic action.

At the same time taking methyldopa may develop erythrocyte hemolysis.

Cholestyramine and colestipol hydrochloride may delay or reduce the absorption of hydrochlorothiazide.

Potassium salts, potassium-sparing diuretics (triamterene, amiloride and spironolactone) Heparin and contribute to the development of hyperkalemia.

Methenamine may reduce the effect of hydrochlorothiazide due to increased alkaline urine.

Conditions of supply of pharmacies

The drug is released under the prescription.

Conditions and terms

List B. The drug should be stored in a dry, inaccessible to children at temperature not exceeding 25 ° C. Shelf life - 3 year.