Gizaar

Gizaar – the combined anti-hypertensive drug.

Form of release and structure

Dosage form – tablets, coated: an oval form, with dividing risky on one party and marking "717" – on another, yellow color (on 7 or 14 pieces in blisters, in a cardboard box 1 or 2 blisters).

The maintenance of the operating components in 1 tablet:

• Lozartan of potassium – 50 mg;
• Hydrochlorothiazide – 12,5 mg.

Excipients: starch prezhelatinizirovanny 1500, lactose water (spray dried), magnesium stearate, cellulose microcrystallic (Avicel PH102).

Structure of a cover: a gidroksipropilmetiltsellyuloza (6 cps), hydroxypropyl cellulose (about less than 0,3% of silicon), Brazilian wax palm wax, an aluminum varnish quinolinic yellow (E104), titanium dioxide (E171).

Indications to use

• Arterial hypertension (at patients with indications of a combination therapy);
• Reduction of risk of cardiovascular pathologies and mortality at a hypertrophy of a left ventricle and arterial hypertension.

Contraindications

• Age up to 18 years;
• Heavy abnormal liver functions;
• Heavy renal failures (clearance of creatinine (CC) less than 30 ml/min.);
• Anury;
• Syndrome of glyukozo-galaktozny malabsorption, lactose intolerance, deficit of lactase;
• Period of pregnancy and breastfeeding;
• Hypersensitivity to derivatives of sulfonamides and/or components of drug.

With care Gizaar the patient with a renal failure (KK of 30-50 ml/min.), a stenosis of an artery of the only kidney, a bilateral stenosis of renal arteries, disturbances of water and electrolytic balance of blood (including caused by vomiting or diarrhea (a hyponatremia, a gipokhloremichesky alkalosis, a hypomagnesiemia, a hypopotassemia)), gout, a hypercalcemia, a hyperuricemia, a diabetes mellitus, bronchial asthma and the burdened allergological anamnesis, a hypovolemia (including against the background of reception of high doses of diuretics), general diseases of connecting fabric is recommended to appoint (including a system lupus erythematosus); at a concomitant use of non-steroidal anti-inflammatory drugs, including inhibitors of cyclooxygenase (TsOG)-2.

Route of administration and dosage

Gizaar accept inside, irrespective of meal.

The recommended dosing: on 1 tablet of 1 times a day; in the absence of therapeutic effect after three weeks of treatment it is possible to raise a dose to 2 tablets of 1 times a day.

The maximum daily dose of drug – 2 tablets.

For elderly patients selection of an initial dose is not required.

Side effects

At clinical trials undesirable reactions in the form of weakness, dizzinesses, fatigues were most often noted.

Post-marketing experience of use of drug defined additional side effects:

• Alimentary system: seldom – diarrhea, hepatitis;
• Immunopathological and allergic reactions: anaphylactic reactions, hypostasis of a throat and glottis with development of obstruction of respiratory tracts or other symptoms of a Quincke's disease, including a face edema, lips, language and/or a throat; seldom – a vasculitis (Shenleyn-Genokh's purpura);
• Dermatological reactions: the small tortoiseshell raised photo and a photosensitivity;
• Respiratory system: perhaps – cough;
• Laboratory indicators: seldom – an insignificant hyperpotassemia (does not demand drug withdrawal), passing increase in activity of alaninaminotranspherase.

Special instructions

Gizaar's appointment in a combination with other anti-hypertensive drugs is shown.

Impact of medicines on a renin-angiotenzinovuyu system can increase the content of creatinine and urea in blood at patients with a bilateral renal artery stenosis or a stenosis of an artery of the only kidney.

Existence of a lozartan suppresses function a renin-angiotenzinovoy of system and can cause changes of function of kidneys, a renal failure. Changes have reversible character and after drug withdrawal disappear.

Against the background of administration of drug at patients symptomatic arterial hypotension can develop.

Treatment should be accompanied with regular control of water and electrolytic balance that will allow to reveal timely clinical signs of a hyponatremia, dehydration, a gipokhloremichesky alkalosis, a hypopotassemia, a hypomagnesiemia. It is necessary to check the level of electrolytes of blood serum at vomiting or intercurrent diarrhea.

Gizaar can break tolerance to glucose therefore dose adjustment of insulin and other hypoglycemic means can be necessary for some patients.

Tiazida can cause slight and incidental increase of concentration of calcium in blood serum and reduce removal of calcium with urine. The expressed hypercalcemia can testify to the hidden hyperparathyreosis.

As influence of tiazid on metabolism of calcium can distort indicators of researches of function of epithelial bodies, before a research reception of thiazide diuretic should be cancelled.

Against the background of therapy by thiazide diuretics the content of triglycerides and cholesterol in blood can increase, to develop hypersensitivity reaction, to progress or become aggravated a system lupus erythematosus.

The combined composition of drug allows to reduce expressiveness of a hyperuricemia and/or risk of development of gout as лозартан reduces the level of uric acid.

Medicinal interaction

The drug combination to kaliysberegayushchy diuretics, including Spironolactonum, Triamterenum, amiloride, salts of potassium or kaliysoderzhashchy additives can promote increase in level of potassium concentration in blood serum.

The therapeutic effect of drug can reduce a combination to non-steroidal anti-inflammatory drugs.

Simultaneous use with ethanol, barbiturates, opioid analgetics can increase risk of emergence of orthostatic arterial hypotension.

At a combination to other anti-hypertensive means there is the additive effect.

Absorption of a hydrochlorothiazide breaks presence of anion exchange pitches. At a concomitant use of Colestyraminum or a kolestipol absorption of a hydrochlorothiazide significantly decreases.

Gizaar's use with adrenocorticotropin, corticosteroids leads to strong decrease in level of electrolytes, a hypopotassemia.

Drug strengthens effect of tubocurarine and other muscle relaxants of not depolarizing action type.

The combination to lithium drugs as it leads to decrease in renal clearance of lithium is not recommended, increases risk of development of its toxic action.

Terms and storage conditions

To store in the place, unavailable to children, at a temperature of 15-30 °C.

Period of validity – 3 years.