Indopres

General characteristics. Structure:

International and chemical names: индапамид; (RS) - 4-hloro-3-sulfamoil-N-(2-methyl-2,3-dihydro-1H-indole-1-silt) benzamide; main physical and chemical properties: tablets, coated white color, with a biconvex surface. On cross section two layers of different structure are visible; structure: 1 tablet contains 2,5 mg of an indapamid; excipients: lactose monohydrate, sodium lauryl sulfate, calcium stearate, film covering 39G28601 of Oradgu II White.

Pharmacological properties:

Pharmacodynamics. Sulfanamide diuretic, derivative indolon (contains an indole ring in structure of a molecule), with anti-hypertensive activity. Advantage of hypotensive or diuretic effect is shown depending on a drug dose. In a dose of 2,5 mg/days индапамид causes the expressed prolonged anti-hypertensive effect and weak diuretic effect. Increase in a daily dose does not influence anti-hypertensive action while the diuretic effect increases. The vascular mechanism of effect of drug is explained with reduction of reduction of a vascular wall in response to increase in catecholamines thanks to the braking influence on transmembrane current of ions of Sa2 + and stimulation of synthesis of prostagalandin of E2. Diuretic action is connected with blockade of a reabsorption of ions of sodium, chlorine and water in proximal and distal tubules, and also in the field of the ascending department of a Henle's loop. Indapamid has an exclusive pharmacological profile: without getting through GEB, drug does not cause the central effects, anti-hypertensive action does not change and well remains at a renal failure, индапамид does not exert negative impact on metabolism of lipids and carbohydrate metabolism; the pharmacokinetics of drug allows administration of drug once a day. Influence of an indapamid is shown only with initially increased arterial pressure. Achievement of the maximum therapeutic effect is noted at long systematic administration of drug.

Pharmacokinetics. Indapamid is quickly soaked up in a food path. The maximum concentration of drug in plasma is reached in 1,5-2 hours after reception. The elimination half-life makes 14-18 hours. Extent of linkng with blood proteins makes 70-80%. The maximum hypotensive effect develops in 12 hours after a single dose. Drug does not get through GEB. It is evenly distributed in all bodies and fabrics, except TsNS. In unstriated muscles of a vascular wall contacts elastin. Biotransformation of an indapamid is carried out in a liver. With urine it is removed

Indications to use:

Arterial hypertension, heart failure (in a combination with other drugs).

Route of administration and doses:

Indopres appoint in a dose 2,5 mg (1 tablet) of 1 times a day (morning), to food. At insufficient manifestation of anti-hypertensive effect in 2 weeks of treatment it is necessary to increase a dose of drug to 5 mg (2 tablets) a day, also once. In higher doses anti-hypertensive action significantly does not increase, and the diuretic effect increases. The maximum dose - 10 mg (4 tablets) a day in 2 receptions, in the first half of day. Drug can be used for monotherapy or in a combination with other anti-hypertensive drugs. Duration of treatment is defined by course of a disease and efficiency of therapy.

Features of use:

During treatment control of level of potassium and uric acid at patients with a hypopotassemia and gout is necessary. Safety and good tolerance of Indopres allows to apply it to people of old age, a sick diabetes mellitus easy and moderately severe, at a chronic renal failure and lipidemias. At a combination with other anti-hypertensive means the dose of drug has to be lowered. At use of drug control of laboratory indicators is necessary: potassium level in blood, sodium, uric acid, glucose. Against the background of long therapy by Indopres activity of a renin increases.
Data on safety of use of drug during pregnancy are absent. Indopres's use for athletes can affect a positive doping test.
Due to decrease in the ABP drug can influence ability to manage vehicles and to work with potentially dangerous mechanisms.

Side effects:

Indopres is usually well had. At long use or at reception in high doses the hypopotassemia, a hyponatremia, orthostatic hypotension can develop; in isolated cases – a hypercalcemia, a miyelosupressiya, a leukopenia, thrombocytopenia, an aggravation of a system lupus erythematosus, a hyperuricemia. Allergic reactions in the form of skin rashes, an itch are possible. Nausea, locks, dryness in a mouth, dizziness, paresthesias are sometimes noted. At reduction of a dose these phenomena quickly pass.

Interaction with other medicines:

Indopres do not appoint together with lithium salts, astemizoly, terfenadiny, erythromycin, bepridily, Metforminum, some anti-arrhythmic means (sotaloly, Amiodaronum), iodinated contrast agents. Simultaneous use of drug with cardiac glycosides and corticosteroids for system use increases risk of emergence of a hypopotassemia. The drug combination with APF inhibitors increases risk of development of the expressed hypotension or renal failure in patients of risk group (organism dehydration, a hyponatremia, a disease of kidneys).

Contraindications:

The acute disorders of cerebral circulation (including recently postponed) expressed an abnormal liver function and kidneys, a dekompensirovanny diabetes mellitus, hypersensitivity to drug or to derivatives of streptocides, pregnancy, a lactation, children's age.

Overdose:

In high, not therapeutic doses (40 mg), drug caused considerable diuretic effect without intoxication phenomena. Symptoms of acute poisoning with Indopres are caused by disturbance of water and electrolytic balance and are clinically shown by nausea, vomiting, hypotension, spasms, dizziness, a polyuria or an oliguria.
Treatment: gastric lavage, administration of absorbent carbon, rehydration therapy and correction of electrolytic disturbances.

Storage conditions:

To store in the unavailable to children, protected from light place at a temperature not above 25 °C.

Period of validity – 3 years.

Issue conditions:

According to the recipe

Packaging:

On 10 tablets in blister strip packagings; on 3 packagings in a pack.