Moexipril

When ATH:
C09AA13

Characteristic.

The fine powder of white or almost white, soluble in distilled water at room temperature.

Pharmacological action.
Gipotenzivnoe, vazodilatirtee, kardioprotektivnoe, natriuretic.

Application.

Arterial hypertension.

Contraindications.

Hypersensitivity, gipotenziya, pregnancy, lactation, childhood (Safety and efficacy have not determined).

Restrictions apply.

Assessment of the risk-benefit ratio in the following cases: angioedema (incl. history), severe autoimmune disease (systemic lupus erythematosus, scleroderma, and other systemic collagen), bone marrow depression (leukopenia, thrombocytopenia), cerebral or coronary (CHD) circulatory, severe heart failure, aortic, mitral stenosis or other obstructive changes, impede the outflow of blood from the heart, bilateral renal artery stenosis or stenosis of the artery to a solitary kidney, diabetes, severe renal failure or hyperkalemia (more 5,5 mmol / l), hyponatremia or restriction of sodium in the diet, carrying out dialysis treatments, general anesthesia and surgical procedures, dehydration, cough, the transplanted kidney, advanced age.

Pregnancy and breast-feeding.

Contraindicated in pregnancy.

Category actions result in FDA - C (I trimester). (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

Category actions result in FDA - D (II and III trimesters).

At the time of treatment should stop breastfeeding.

Side effects.

Cardio-vascular system and blood (hematopoiesis, hemostasis): gipotenziya, heartbeat, chest pain, angina, myocardial infarction, heart rhythm disturbances, gemoliticheskaya anemia, Lake / neutropenia, agranulocytosis.

From the nervous system and sensory organs: dizziness (4,3%), headache, syncope, cerebrovascular disorders, mood disorders and / or sleep, of view.

From the digestive tract: loss of appetite, dry mouth, taste disturbance, nausea, dyspepsia, vomiting, abdominal pain, diarrhea (3,1%), constipation, pancreatitis, abnormal liver function (jaundice, fulminant hepatic necrosis with fatal), changes in the level of transaminases.

Allergic reactions: rash (1,6%), hives, angioedema (person, lips, fingers, throat, larynx), photosensitivity.

With the genitourinary system: swelling, proteinuria, acute (asymptomatic) renal failure.

From the respiratory system: cough (6,1%), pharyngitis (1,8%) and etc. respiratory diseases of the upper respiratory tract, rhinitis, sinusitis, bronchospasm, dyspnoea.

Other: pain-myalgia (1,3%), arthralgia, etc., gynecomastia, increasing the concentration of bilirubin, alkaline phosphatase, antinuklearnyh antibody titer, creatinine, urea, Uric acid, hyperkalemia, giponatriemiya.

Cooperation.

Effect increase (additive effect) others. antihypertensives, including beta-blockers, incl. systemic absorption of ophthalmic formulations, diuretics, alcohol; weaken - estrogens, NSAIDs, sympathomimetic, funds, aktiviruyushtie renin-angiotensin-alydosteronovuyu sistemu. Potassium-sparing diuretics (spironolactone, amilorid, triamterene et al.), cyclosporine, kalisodergaszczye supplements and drugs, salt substitutes, increase the risk of hyperkalemia. Mielodepressanty increase the likelihood of a lethal neutropenia and / or agranulocytosis.

Potentiates the hypoglycemic effect of oral antidiabetic drugs, and the inhibitory effect of alcohol on the central nervous system; reduces symptoms of hypokalemia and hyperaldosteronism, caused by diuretics; increases the toxic effect (increases the concentration) lithium. Antacids increase the absorption. The probability of occurrence of dry cough reduces Intalum (inhalation).

Overdose.

Symptoms: gipotenziya.

Treatment: dose reduction or complete removal of the drug; gastric lavage, Transfer the patient to a horizontal position, introduce measures to increase BCC (isotonic sodium chloride solution, transfusions, etc.. blood liquids), simptomaticheskaya therapy: epinephrine (n / a or I /), antihistamines, gidrokortizon (I /). Monitoring of serum creatinine and potassium in the plasma. As a specific antidote recommend angiotensin II.

Dosing and Administration.

Inside, for 1 hour before meals, at an initial dose 7,5 mg / day, with a gradual increase in dose to 30 mg / day in 1-2 reception. While therapy dioretikami and in patients with Cl creatinine less than 40 mL/min/1.73 m² starting dose is 3,75 mg (under the control of blood pressure).

Precautions.

Treatment is carried out under regular medical supervision. When the previous diuretic therapy, to reduce the risk of symptomatic hypotension diuretic should be discontinued for 2-3 days prior to treatment (or significantly reduce the dose) and adjust the water and electrolyte balance. During therapy, blood pressure monitoring is necessary, continuous monitoring of peripheral blood (before treatment, first 3-6 months of treatment, and thereafter at periodic intervals to 1 year, especially in patients with an increased risk of neutropenia), protein levels, Plasma potassium, BUN, creatinine, renal function, body weight, diet. With the development of hyponatremia and dehydration correction dosing regimen (dose reduction). Dose-related neutropenia develops over 3 months after initiation of therapy, a frequency, depending on the degree of renal dysfunction, especially in scleroderma and systemic lupus erythematosus. При уменьшении числа нейтрофилов до 1·10⁹/l, cholestatic jaundice development and progression of fulminant hepatic necrosis treatment should be discontinued. Maculopapular or urticaria (less often) rash occurs during the first 4 weeks of treatment, disappears with decreasing doses of medication or cancellation, introduction of antihistamines. Care should be taken during surgical interventions (including dental), especially when used general anesthetics, hypotensive effect. Avoid hemodialysis through high capacity membranes poliakrilonitritmetallilsulfata (eg, АN69), gemofilytratsii or LDL apheresis (may develop anaphylaxis or anaphylactoid reactions). Giposensibilizatsionnaya therapy may increase the risk of anaphylactic reactions. It is recommended that the use of alcohol at the time of treatment. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention.

Cautions.

When you miss a dose do not receive follow-doubles.

Cooperation