Spirapril

When ATH:
C09AA11

Pharmacological action.
Gipotenzivnoe, vazodilatirtee, kardioprotektivnoe, natriuretic.

Application.

Arterial hypertension, heart failure.

Contraindications.

Hypersensitivity, hypotension, severe renal insufficiency, Cl creatinine less than 10 ml / min, severe hyperkalemia, pregnancy, lactation.

Restrictions apply.

Assessment of risk / benefit ratio in the following cases: angioedema in history, severe autoimmune diseases, aortalnыy or stenosis mytralnыy, gipertroficheskaya cardiomyopathy (violations of hemodynamics) 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, the transplanted kidney, chronic obstructive pulmonary disease, hyperuricemia, hyperkalemia, hyponatremia or restriction of sodium in the diet, general anesthesia and surgical procedures, dehydration, 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): decrease in blood pressure, orthostatic hypotension, arrhythmia, leukopenia, thrombocytopenia, anemia.

From the digestive tract: nausea, decreased appetite, xerostomia, changes in taste, dyspepsia, plaque on the tonsils and tongue.

From the nervous system and sensory organs: fatigue, dizziness, headache; при использовании в высоких дозах — нарушение сна.

Allergic reactions: angioedema, skin rash and itching.

Other: dry cough, disfonija, muscle twitching lips and limbs, hyperkalemia, hyperuricemia.

Cooperation.

Effects strengthen antihypertensives (additive effect), incl. beta-blockers with significant systemic absorption in ophthalmic forms, diuretics, alcohol, weaken - estrogens, NSAIDs (the latest simultaneously increase the risk of renal dysfunction), sodium chloride, sympathomimetic. Potentiates the hypoglycemic effect of oral antidiabetic drugs; reduces secondary hyperaldosteronism and hypokalemia, caused by diuretics; It improves concentration and toxic effects of lithium. Potassium-sparing diuretics, cyclosporine, kalievыe supplements, salt substitutes, milk with a low salt content increase the risk of hyperkalemia. Funds, suppress bone marrow function, increase the risk of neutropenia and / or fatal agranulocytosis. Dampening effect of alcohol on the central nervous system. Antacids cholestyramine and slow absorption from the gastrointestinal tract.

Overdose.

Symptoms: marked reduction in blood pressure, bradycardia, cardiovascular shock, electrolyte imbalance, renal failure.

Treatment: dose reduction or withdrawal of the drug; gastric lavage, applying the adsorbing substance and sodium sulfate in the first 30 minutes after administration, giving patients a horizontal position, introduce measures to increase the volume of circulating blood (a physiological solution, transfusion of other blood liquids), simptomaticheskaya therapy: administration of epinephrine (n / a or I /), hydrocortisone (I /).

Dosing and Administration.

Inside, regardless of the meal, liquid squeezed small amounts of liquid, single (morning). Dose picked individually depending on the dynamics of blood pressure. Adults, the initial dose - 3 mg 1 once a day, if necessary - up 6 мг/сут до достижения желаемого эффекта. If the kidney function dosing regimen is dependent on the values ​​of Cl creatinine: при Cl 30–60 мл/мин назначают средние терапевтические дозы, при Cl 10–30 мл/мин — 3 mg.

Precautions.

Treatment is carried out under regular medical supervision. For 1 weeks prior to treatment prior antihypertensive therapy should be discontinued. To reduce the risk of symptomatic hypotension should be canceled a few days before the start of treatment or dose is much lower, correct water and electrolyte balance. During treatment requires monitoring of blood pressure, control of peripheral blood picture (before treatment, first 3-6 months of treatment, and thereafter at periodic intervals during 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 patient dehydration or hyponatremia necessary correction mode (decreasing doses). During treatment, it is recommended the use of alcohol and use of adequate contraceptive measures. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention. When receiving the pass subsequent dose does not double.

Cooperation