CO-Diovan

Combined preparation, having hypotensive activity, consisting of angiotensin II receptor blockers and thiazide diuretic. Valsartan – peripheral vasodilator, hypotensive and diuretic effect. Specific blocker of AT1 angiotensin II receptor, It does not inhibit ACE; no effect on total cholesterol, TG, glucose and uric acid, It does not interact and does not block the receptors, etc.. hormones or ion channels, relevant to the regulation of functions CCC. There is a decrease in blood pressure, not accompanied by a change in heart rate. Gidroxlorotiazid – thiazide diuretic medium strength. It reduces the reabsorption of Na at the level of the cortical segment of the loop of Henle, without affecting its portion, takes place in the kidney medulla, that defines weaker diuretic effect compared with furosemide. Blocks carbonic anhydrase in the proximal convoluted tubules, increases the urinary excretion of K (in the distal tubule Na is exchanged for K ), bicarbonates and phosphates. Virtually no impact on CBS (Na or displayed together with Cl-, or with sodium, so when alkalosis increases the excretion of sodium, with acidosis – Cl-). Increases excretion of Mg2 ; delays in the body ions Ca2 and urate. The diuretic effect develops in 1-2 no, reaches through 4 no, continues 10-12 no. Action is reduced with a decrease in glomerular filtration rate and stops when it is less than the value of 30 ml / min. It lowers blood pressure by reducing the BCC, the reactivity of the vascular wall, reduce the pressor effect of vasoconstrictor drugs (epinephrine, norepinephrine) and strengthen the depressive effect on ganglia. The maximum antihypertensive effect was observed in the first 2-4 weeks of treatment.

Arterial hypertension (the ineffectiveness of monotherapy with valsartan).

Hypersensitivity; biliary cirrhosis, bile duct obstruction; anurija, CRF (CC less than 30 ml / min); giponatriemiya, kaliopenia, hypercalcemia, hyperuricemia with clinical manifestations, refractory to adequate therapy; renal artery stenosis (single or double); SLE; pregnancy, lactation.

Dizziness, feeling tired, diarrhea, abdominal pain, nausea, cough, rhinitis, pharyngitis, viral infections, decrease in hematocrit, hyperkalemia, giperkreatininemiя, arthralgia, chest pain, allergic reactions, angioedema, itch, serum sickness, vasculitis, each eruption, impairment of renal function. Potentiality: valsartan – swelling, insomnia, asthenia, decreased libido (less 1%); gidroxlorotiazid – disorder of water and electrolyte balance; often: hives, decreased appetite, nausea, vomiting, orthostatic hypotension, reduced potency; rarely: photosensitivity, constipation or diarrhea, abdominal discomfort, intrahepatic cholestasis, jaundice, Arrhythmia, headache, depression, paresthesia, visual impairment, thrombocytopenia, sometimes with purpura; rarely: nekrotiziruyushtiy vasculitis, toxic epidermal necrolysis (Lyell's syndrome), skin reactions, resembling SLE, exacerbation of cutaneous manifestations of SLE, pancreatitis, leukopenia, agranulocytosis, bone marrow depression, gemoliticheskaya anemia, pneumonitis, swelling legkih.Peredozirovka. Symptoms: decrease in blood pressure. Treatment: gastric lavage, I / 0.9% NaCl solution. Hemodialysis is effective in respect of hydrochlorothiazide.

Inside, by 1 tablet 1 once a day, daily (80 mg valsartan and 12.5 mg of hydrochlorothiazide, for those patients, which showed a further decrease in blood pressure, – 160/12.5 mg respectively).

Before treatment, shall adjust the content of Na in the blood and / or bcc. Requires regular monitoring of plasma K , Glucose, Uric acid, fats and creatinine. In case of pregnancy during treatment with the drug should be discontinued. During the period of treatment must be careful when driving and other lesson. potentially hazardous activities, require high concentration and speed of psychomotor reactions.

Enhances neurotoxicity salicylates, side effects of cardiac glycosides, cardiotoxic and neurotoxic effects of drugs Li , the effectiveness of muscle relaxants curariform. It reduces the excretion of quinidine, reduces the effect of oral hypoglycemic drugs, norepinephrine, epinephrine and arthrifuge drugs. It increases the frequency of allergic reactions to allopurinol; reduces renal excretion of cytotoxic drugs (cyclophosphamide, methotrexate) and leads to increased their myelosuppressive action. PM, rapidly bind to blood proteins (indirect anticoagulants, clofibrate, NSAIDs), enhance the diuretic effect. Increase the hypotensive effect of vasodilators, beta-blockers, barbiturates, fenotiazinы, tricyclic antidepressants, ethanol. At the same time taking methyldopa may develop hemolysis; cholestyramine reduces the absorption of.