Lizitar-LF

General characteristics. Structure:

Active ingredient: 5 mg, 10 mg or 20 mg of lisinopril.

Excipients: mannitol, starch corn, talc, magnesium stearate, hydrophosphate calcium dihydrate.

Cardiological drug with pronounced vasodilating and hypotensive action.

Pharmacological properties:

Pharmacodynamics. APF inhibitor, reduces formation of II angiotensin of angiotensin I. Decrease in content of angiotensin II leads to direct reduction of allocation of Aldosteronum. Reduces degradation of bradikinin and increases synthesis of prostaglandins. Reduces the general peripheric vascular resistance, the arterial pressure (AP), preloading, pressure in pulmonary capillaries, causes increase in minute volume of blood and increases tolerance of a myocardium to loadings at patients with chronic heart failure. Expands arteries more than veins. At prolonged use the hypertrophy of a myocardium and walls of arteries of resistive type decreases. Improves blood supply of an ischemic myocardium. APF inhibitors extend life expectancy at patients with chronic heart failure, slow down progressing of dysfunction of a left ventricle at the patients who had a myocardial infarction without clinical displays of heart failure. The anti-hypertensive effect begins approximately in 6 hours and remains within 24 hours.

Duration of effect depends also on the accepted dose. The beginning of action - in 1 hour. The maximum effect is defined in 6-7 hours. At arterial hypertension the effect is noted in the first days after an initiation of treatment, stable action develops in 1-2 months. The expressed withdrawal was not observed.

In addition to decrease in the ABP lisinopril reduces an albuminuria. At patients with a hyperglycemia contributes to normalization of function of the damaged glomerular endothelium. Lisinopril does not influence concentration of glucose in blood at patients with a diabetes mellitus and does not lead to increase of cases of a hypoglycemia.

Pharmacokinetics. Meal does not influence lisinopril absorption. Absorption - 30%. Bioavailability - 29%. Almost does not contact proteins of a blood plasma, contacts only APF. In not changed look gets to system blood circulation. Time of achievement of the maximum concentration in blood - the 6th hour. In a dose of 10 mg/day the maximum concentration - 32-38 ng/ml. To metabolism it is practically not exposed, removed by kidneys in an invariable look. The fraction connected with APF is removed slowly. An elimination half-life - 12,6 hour. Permeability through a blood-brain and placental barrier low.

Indications to use:

Arterial hypertension (in the form of monotherapy or in a combination with other anti-hypertensive means

Chronic heart failure (as a part of a combination therapy for treatment of the patients accepting drugs of a foxglove and/or diuretics).

Acute myocardial infarction (in the first 24 hours with stable indicators of a hemodynamics for maintenance of these indicators and prevention of dysfunction of the left heart camera and heart failure).

Diabetic nephropathy (decrease in an albuminuria at insulin-dependent patients with the normal ABP and non-insulin-dependent patients with arterial hypertension).

Route of administration and doses:

At essential hypertensia Lizitar-LF appoint in an initial dose 10 mg a day. The maintenance dose makes 20 mg a day. The maximum daily dose – 40 mg. For full development of effect the 2-4 weeks course of treatment drug can be required (it should be considered at increase in a dose). If use Lizitara-LF in the maximum dose does not cause sufficient therapeutic effect, then perhaps additional purpose of other anti-hypertensive drug.

At renovascular hypertensia or other states about the system renin-angiotensin-aldosteronovoy raised by function Lizitar-LF appoint in an initial dose 2,5-5 mg a day. The maintenance dose is established depending on the ABP.

At patients with a renal failure and the patients who are on a hemodialysis, the initial dose is established depending on the level of clearance of creatinine. The maintenance dose is defined depending on the ABP (under control of function of kidneys, level of potassium and sodium in a blood plasma).

At heart failure use Lizitara-LF along with diuretics and/or cardiac glycosides is possible. Whenever possible the dose of diuretic should be reduced prior to administration of drug. The initial dose makes 2,5 mg a day, further it is gradually increased to 5-10 mg a day. The maximum daily dose – 20 mg.

It is necessary to accept drug 1 time a day in the morning, to or after food, preferably at the same time.

Features of use:

Drug is contraindicated to use during pregnancy. In need of appointment in the period of a lactation breastfeeding should be stopped.

With care appoint Lizitar-LF at the diseases which are followed by liquid loss (the increased sweating, diarrhea, vomiting) and at the previous therapy diuretics since the risk of development of arterial hypotension increases. Therefore after reception of the first dose medical control within several hours is shown.

With care appoint drug to patients of advanced age

Prior to treatment whenever possible it is necessary to normalize the level of sodium and/or to compensate the lost volume of liquid and to carefully control development of anti-hypertensive action.

In case of a renal artery stenosis (in particular at a bilateral stenosis or a stenosis of an artery of the only kidney), disturbances of water and electrolytic balance use of drug can lead to renal failures, development of an acute renal failure which is, as a rule, reversible after drug withdrawal

At extensive surgical interventions or at use of the opioid analgetics causing arterial hypotension, Lizitar-LF blocks the formation of angiotensin II occurring after compensatory release of a renin. The hypotension caused by this mechanism is eliminated with compensation of the lost liquid

At development of arterial hypotension the patient should give horizontal position with the raised legs, if necessary carry out infusion of normal saline solution

During treatment by drug it is necessary to control a pattern of peripheral blood.

At development of a Quincke's disease carrying out adequate emergency treatment (administration of adrenaline, GKS, antihistaminic drugs) is necessary.
At use of drug in the conditions of dialysis about polyacryle - a nitrile membrane development of an acute anaphylaxis therefore it is recommended or to use other membranes is possible, or to appoint other anti-hypertensive drugs.

Influence on ability to driving of motor transport and to control of mechanisms. the issue of a possibility of occupations should be resolved by potentially dangerous types of activity only after assessment of individual reaction of the patient to drug.

Side effects:

From TsNS: dizziness, headache (5-6%).

From the alimentary system: diarrhea, nausea, vomiting.

From respiratory system: dry cough (3%).

From cardiovascular system: orthostatic hypotension, pains behind a breast (1-3%).

From system of a hemopoiesis: an agranulocytosis, decrease in hemoglobin and a hematocrit (especially at long reception); in an isolated case – increase in SOE.

From laboratory indicators: a hyperpotassemia, increase in level of creatinine, an urea nitrogen (especially at patients with diseases of kidneys, a diabetes mellitus, renovascular hypertensia).

Allergic reactions: skin rash, Quincke's disease.

Others: feeling of weakness; in an isolated case – an arthralgia.

Interaction with other medicines:

At simultaneous use Lizitara-LF with kaliysberegayushchy diuretics (Spironolactonum, Triamterenum, amiloride), the drugs of potassium or substitutes of edible salt containing potassium raises risk of development of a hyperpotassemia (especially at patients with renal failures). Therefore these combinations are appointed with care, under control of level of potassium in plasma and function of kidneys.

At simultaneous use Lizitara-LF with diuretics, anti-hypertensive drugs is marked out the additive anti-hypertensive effect.

At simultaneous use with NPVS (especially with indometacin) Lizitara-LF is marked out reduction of anti-hypertensive action

At simultaneous use Lizitar-LF strengthens effect of ethanol.

At simultaneous use Lizitara-LF with lithium drugs removal of lithium from an organism can decrease (therefore it is regularly necessary to control lithium level in plasma).

At simultaneous use with diuretics Lizitar-LF reduces removal of potassium from an organism.

Contraindications:

- a Quincke's disease in the anamnesis against the background of treatment by other APF inhibitors;
- pregnancy;
- lactation (breastfeeding);
- children's age;
- hypersensitivity to lisinopril and other APF inhibitors

Overdose:

Symptoms: arterial hypotension.

Treatment: recovery of introduction and electrolytic balance. If necessary carry out symptomatic therapy. Lisinopril is removed from an organism at a hemodialysis.

Storage conditions:

In the place protected from moisture and light at a temperature not above 25 °C. To store in the place, unavailable to children. Period of validity 2 years.

Issue conditions:

Without recipe

Packaging:

10 tablets a dosage of 20 mg, 15 tablets a dosage of 10 mg, 20 tablets a dosage of 5 mg in a blister strip packaging. On two or three blister strip packagings on 10 tablets together with the application instruction in a pack; on one or two blister strip packagings on 15 or 20 tablets together with the application instruction in a pack.