Lorvas SR

General characteristics. Structure:

Active ingredient: 1,5 mg of an indapamid.

Excipients: gidroksipropilmetiltsellyuloza of K4M, lactose monohydrate, K-30 povidone, magnesium stearate, silicon dioxide colloid, covering A TRC.

Pharmacological properties:

Pharmacodynamics. Anti-hypertensive (diuretic) means it is similar to thiazide diuretics. Indapamid causes decrease in a tone of unstriated muscles of arteries (due to change of transmembrane transfer of calcium ions, reduction of hypersensitivity of vessels to noradrenaline and angiotensin) that leads to decrease in the general peripheric vascular resistance. Indapamid stimulates synthesis of E2 and І2 prostaglandins which have vasodilating and hypotensive effects. Has the moderate diuretic effect connected with blocking of a reabsorption of ions of sodium, chlorine, water and to a lesser extent potassium ions and magnesium. Drug does not break metabolism of lipids and does not exert a negative impact on carbohydrate metabolism, does not influence the general level of cholesterol, triglycerides, reduces the level of phosphates in blood. The therapeutic effect occurs in 7 - 8 days, the maximum action – in 4 weeks.

Pharmacokinetics. The dosage form provides gradual uniform release of fraction of an indapamid in digestive tract where it is quickly and completely soaked up. The maximum concentration in blood is reached approximately in 1 - 2 h after intake of a single dose of 1,5 mg. At repeated administration of drug of fluctuation of concentration of an indapamid in a blood plasma in an interval between reception of the next doses decreases.

Meal slows down absorption speed, but does not reduce it. Bioavailability makes 93%. Linkng with proteins of plasma about 79%, can be occluded by erythrocytes. The equilibrium state is established in 7 days of regular reception. Gets through gistogematichesky barriers (including placental) and into breast milk. Is exposed to biotransformation in a liver and it is removed in the form of inactive metabolites, generally by kidneys – 70% and through intestines – 22%. The elimination half-life makes 14 - 24 h.

Pharmacokinetic parameters do not change at patients with a renal failure. At elderly patients drug cumulation is not observed.

Indications to use:

Arterial hypertension.

Route of administration and doses:

Appoint the adult better in the morning on 1 tablet (1,5 mg), without crushing, without chewing and washing down with ½ glass of water of 1 times a day. The maximum daily dose – 1 tablet (1,5 mg). Increase in a dose of drug strengthens diuretic action.

Features of use:

Before an initiation of treatment it is necessary to conduct laboratory examination, especially in the presence of the states which are followed by disturbance of water and electrolytic balance.

With extra care appoint drug sick with abnormal liver functions and kidneys. In the course of treatment by drug periodic control of electrolytes in blood serum, in connection with possibility of a hypopotassemia and disturbance of water and electrolytic balance is necessary. That is applied Lorvas SR, periodic control of uric acid is necessary for patients with a hyperuricemia and gout.

Displays of latent diabetes, and also change of need for insulin are possible.

Decrease in level K (£3,4 mmol) promotes development of arrhythmias, increases toxicity of cardiac glycosides therefore it is necessary to define and adjust potassium level, especially patients have risk groups with a hyponutrient, with cirrhosis, with heart failure, to patients who take a lot of medicine. During use of drug positive takes when carrying out a drug test are possible.

In case of need carrying out surgical intervention it is necessary to warn the anesthesiologist about treatment Lorvasy WEDNESDAY.

Drug does not break psychomotor reactions, however care is necessary during the work with motor transport and potentially dangerous mechanisms, in the presence of fluctuations of arterial pressure.

Side effects:

The hepatotoxic action – is rare. In isolated cases – a hypercalcemia, hematologic disturbances (thrombocytopenia, a leukopenia, an agranulocytosis, hemolitic anemia).

From digestive tract: nausea, vomiting, a lock, dryness in a mouth, occasionally – pancreatitis. Patients with a liver failure have an encephalopathy.

From the central nervous system: dizziness, adynamy, paresthesias, headache.

Aggravation of symptoms of a lupus erythematosus.

Allergic reactions (rash, itch, urticaria). Disturbance of salt balance (a hyponatremia, dryness in a mouth, thirst, increased fatigue, weakness), a hypochloraemia (alkalosis), a hypopotassemia (arrhythmias, a heart consciousness, changes of mood, a spasm, muscle pain, nausea, vomiting). Disturbance of salt balance – a dozozavisima, increase in level of uric acid and glucose in plasma.

Seldom – anorexia, diarrhea, a headache, orthostatic hypotension (as a result of diuretic effect of drug), sleep disorders, dyspepsias.

Interaction with other medicines:

Amiodaronum other antiarrhytmic means – at a concomitant use – risk of the aritmogenny action connected with a hypoxia.

Anticoagulants (derivatives of coumarin, indandion) – at appointment together with indapamidy decrease in anticoagulating action of the specified means is possible.

Cardiac glycosides (foxglove drugs) – the risk of intoxications glycosides increases.

Potentiation of action of other anti-hypertensive means.

Lithium – development of intoxication is possible, the concomitant use with _ndapam_dy is not recommended.

Sympathomimetic means – easing of efficiency of the last at purpose of an indapamid.

Yodokontrastny means – risk of development of a renal failure.

Drugs астенизол, bepridit, erythromycin, терфенадин, Vincaminum, галофантрин, сультоприд which promote lengthening of an interval of QT, together with indapam_dy promote developing of vitally dangerous ventricular arrhythmias.

Amphotericinum, a glitch - and mineralokortikoida, purgatives can strengthen risk of development of a hypopotassemia.

APF inhibitors under control of the ABP - the risk of sharp decrease in the ABP, especially after the first dose is possible.

Cyclosporine – risk of development of acidosis.

System non-steroidal anti-inflammatory drugs, estrogen – decrease in efficiency of an indapamid.

Tricyclic antidepressants – strengthening of hypotensive action.

Calcium salts – a hypercalcemia.

Contraindications:

Hypersensitivity to drug or its components, and also to other drugs of group of sulphamides. The Dekompensirovanny form of a diabetes mellitus, disturbance of cerebral circulation, the hyper aldosteronism expressed an abnormal liver function and kidneys, a hypopotassemia. Pregnancy and lactation. Children's age.

Overdose:

Symptoms: nausea, vomiting, weakness, hypopotassemia, hyponatremia, disturbance of gastrointestinal functions, disturbance of water and electrolytic balance. At acute intoxication: hypotension, respiratory depression, dizziness, drowsiness, a polyuria, an oliguria to anury degree.

Treatment: there is no specific antidote. It is necessary to cause vomiting, to wash out a stomach and to carefully adjust water and electrolytic balance.

Storage conditions:

To store in the unavailable to children, protected from light place at a temperature not above 25 °C. A period of validity – 2 years.

Issue conditions:

According to the recipe

Packaging:

On 10 tablets in a strip, on 3 strips in cardboard packaging (No. 10 * 3).