Trandolapril

When ATH:
C09AA10

Characteristic.

Colorless crystal, soluble in chloroform, dichloromethane and methanol.

Pharmacological action.
Gipotenzivnoe, vazodilatirtee, kardioprotektivnoe, natriuretic.

Application.

Arterial hypertension (mono- and combination therapy), heart failure (auxiliary treatment).

Contraindications.

Hypersensitivity, a history of angioneurotic edema using ACE inhibitors, pregnancy, lactation.

Restrictions apply.

Assessment of the risk-benefit ratio is necessary in the presence of an autoimmune disease (systemic lupus erythematosus, scleroderma, etc.. systemic collagen); disorders of cerebral or coronary circulation; severe heart failure;, aortic and mitral stenosis; hypertrophic cardiomyopathy; diabetes; dehydration; giponatriemii; carrying out dialysis treatments; bilateral renal artery stenosis or stenosis of the artery to a solitary kidney; the presence of the transplanted kidney; violation of the liver and kidneys; детском возрасте (Safety and efficacy have not determined).

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): a sharp drop in blood pressure (особенно у пациентов с нарушением водно-солевого обмена, diuretics in the treatment of), chest pain, heartbeat, Beards- or tachycardia, arrhythmia, angina, myocardial infarction, понижение уровня гемоглобина, gematokrita, lejko- и/или нейтропения, agranulocytosis, thrombocytopenia, anemia (в отдельных случаях — гемолитическая), eozinofilija.

From the nervous system and sensory organs: dizziness, headache, fainting, depression, нарушение сна и/или равновесия, cerebral stroke, paraesthesia, loss of taste, blurred vision, convulsions.

From the digestive tract: glossitis, dry mouth, dyspepsia, vomiting, diarrhea or constipation, abdominal pain, abnormal liver function (cholestatic jaundice, fulminant hepatic necrosis with fatal), hepatitis, pancreatitis, ileus.

For the skin: allergic skin reactions, псориатические изменения кожи, rash, буллезный пемфигус, photosensitivity, alopecia.

With the genitourinary system: impairment of renal function (acute renal failure, proteinuria), swelling, the weakening of the libido, impotence.

From the respiratory system: dry cough, dyspnoea, bronchospasm, bronchitis, sinusitis, rhinitis, infections of the upper and lower respiratory tract.

On the part of the musculoskeletal system: myalgia, arthralgia, arthritis, convulsions.

Other: the development of infections, angioedema, hyperkalemia, giponatriemiya, уратемия, гиперпротеинемия, increase in serum creatinine, билирубина и печеночных ферментов в сыворотке крови.

Cooperation.

Effect increase (additive effect) others. antihypertensives, including beta-blockers, incl. при значительном системном всасывании из офтальмологических лекарственных форм, diuretics, alcohol; weaken - estrogens, NSAIDs, sympathomimetic, funds, aktiviruyushtie renin-angiotensin-alydosteronovuyu sistemu. Potassium-sparing diuretics (spironolactone, amilorid, triamterene et al.), cyclosporine, kalievыe supplements, заменители соли и др. kalisodergaszczye funds - increase the risk of hyperkalemia. Mielodepressanty increase the likelihood of a lethal neutropenia and / or agranulocytosis; аллопуринол и прокаинамид — нейтропении. Antacids increase the absorption. Потенцирует угнетающее действие алкоголя на ЦНС, reduces symptoms of hypokalemia and hyperaldosteronism, caused by diuretics, increases the toxic effect (increases the concentration) lithium.

Overdose.

Symptoms: severe hypotension, angioedema.

Treatment: dose reduction or complete removal of the drug; gastric lavage, Transfer the patient to a horizontal position, introduce measures to increase BCC (a physiological solution, transfusions, etc.. blood liquids), simptomaticheskaya therapy: epinephrine (n / a or I /), antihistamines, gidrokortizon (I /).

Dosing and Administration.

Inside, regardless of the meal, по 2–4 мг/сут в 1–2 приема, при необходимости увеличение доз следует проводить не ранее чем через 2–4 нед. Пациентам группы риска — в начальной дозе 1 mg / day, при нарушении функций печени начинают с 0,5 mg in the morning, but not more 2 mg per day, на фоне гемодиализа — в начальной дозе 0,5 mg in the morning.

Precautions.

Treatment is carried out under regular medical supervision. Для уменьшения риска симптоматической гипотензии за 1 нед до начала лечения следует отменить проводимую гипотензивную терапию, incl. назначение диуретиков (или значительно уменьшить дозу последних) and adjust the water and electrolyte balance. During therapy necessary to control blood pressure, the peripheral blood (before its beginning, first 3-6 months of therapy and thereafter at periodic intervals to 1 year, especially in patients with an increased risk of neutropenia), protein level, Plasma potassium, BUN, creatinine, renal function, body weight, diet. With the development of cholestatic jaundice and progression of fulminant hepatic necrosis treatment should be discontinued. Care should be taken during surgical interventions (including dental), especially when used general anesthetics, hypotensive effect. Avoid hemodialysis through high capacity membranes poliakrilonitritmetallilsulfata (например АN69), gemofilytratsii or LDL apheresis (may develop anaphylaxis or anaphylactoid reactions). Hyposensitization therapy may increase the risk of anaphylactic reactions. At the time of treatment is recommended the use of alcohol. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention.