Hydrohlorotyazyd, Hynapryl | Akkuzid tablets are covered. 25 mg + 20 mg 30 pcs.

Latin name

ACCUZIDE

Release form

Coated tablets.

Packing

30 pcs

Pharmacological action

Akkuzid - a combined antihypertensive drug, which includes an ACE inhibitor hinapril and a thiazide diuretic hydrochlorothiazide in three different proportions. Hinapril is an ACE inhibitor. ACE catalyzes the formation of angiotensin II, which has a vasoconstrictor effect and controls vascular tone, including due to stimulation of the secretion of aldosterone by the adrenal cortex. Quinapril inhibits circulating and tissue ACE and causes a decrease in vasopressor activity and aldosterone secretion. Elimination of the negative effect of angiotensin II on renin secretion by the feedback mechanism leads to an increase in plasma renin activity. At the same time, a decrease in blood pressure is accompanied by a decrease in OPSS and renal vascular resistance, while changes in heart rate, cardiac output, renal blood flow, glomerular filtration rate and filtration fraction are insignificant or absent. In addition, quinapril slightly reduces the loss of potassium caused by hydrochlorothiazide, which, due to its diuretic effect, also increases the activity of blood plasma renin, the secretion of aldosterone, reduces serum potassium levels and increases its excretion in the urine.

Hydrochlorothiazide is a diuretic that has a direct effect on the kidneys, increasing the excretion of sodium, chloride, water, as well as potassium and bicarbonate ions, and decreasing the excretion of calcium ions. Although the mechanism of the antihypertensive effect of diuretics has not been fully studied, with their long-term use, a decrease in OPSS is observed, probably associated with a change in the exchange of sodium ions. Thus, the use of a combination of quinapril and hydrochlorothiazide leads to a more pronounced decrease in blood pressure than therapy with each drug separately.

Indications

Arterial hypertension (in patients who are shown combination therapy with quinapril and a diuretic).

Contraindications

- history of angioneurotic edema as a result of previous treatment with ACE inhibitors

- children and adolescents under 18 years of age (efficacy and safety of the drug have not been established)

- anuria

- hypersensitivity to the components of the drug

.

- pregnancy and lactation.

Special instructions

Accuzide may cause symptomatic arterial hypotension, but not more often than with monotherapy with both components of the drug. Symptomatic hypotension is rare in quinapril treatment of patients with uncomplicated arterial hypertension, however, it can develop as a result of treatment with ACE inhibitors in patients with reduced BCC, for example, after treatment with diuretics, following a diet with a limited sodium intake or during hemodialysis. In case of symptomatic hypotension, the patient should be given a horizontal position and, if necessary, give him an IV infusion using a 0.9% sodium chloride solution. Transient arterial hypotension is not a contraindication to the further use of the drug, however, in such cases it is advisable to reduce its dose. In patients with chronic heart failure, with or without renal failure, therapy with an ACE inhibitor for hypertension can lead to an excessive decrease in blood pressure, which may be accompanied by oliguria, azotemia, and, in rare cases, acute renal failure and even death. Treatment of such patients with Accuside should begin under close medical supervision and supervision during the first 2 weeks and with an increase in the dose of the drug. In rare cases, therapy with ACE inhibitors may be accompanied by the development of agranulocytosis and suppression of bone marrow hematopoiesis in patients with uncomplicated arterial hypertension, but more often in patients with impaired renal function, especially with connective tissue diseases. In these cases, the number of leukocytes in the blood should be monitored. Thiazide diuretics sometimes cause exacerbation of SLE.

Composition

1 tablet contains quinapril (in the form of hydrochloride) 20 mg, hydrochlorothiazide 25 mg.

Dosage and administration

Inside 1 time per day, regardless of food intake. For patients not receiving diuretics (regardless of whether monotherapy with quinapril was previously performed or not), the recommended initial dose is 1 tablet. Accuzide (20 mg + 12.5 mg) once a day. Subsequently, if necessary, the dose can be increased to 2 tablets. Akkuzid drug (20 mg + 12.5 mg) 1 time per day or up to the maximum recommended daily dose of Akkuzid drug (20 mg + 25 mg) 1 time per day.

Side effects

The most common side effects (> 1%) when taking any combination of quinapril and hydrochlorothiazide were headache (6.7%), dizziness (4.8%), cough (3.2%), which usually was unproductive, persistent and went away after cessation of therapy, increased fatigue (2.9%).

In general, side effects were mild and transient, independent of age, gender, race, and duration of therapy.

Overdose

There is no information on an overdose of Accusid in the treatment of humans. The main clinical manifestations of hydrochlorothiazide mototherapy are symptoms associated with loss of electrolytes (hypokalemia, hypochloremia, hyponatremia), and dehydration due to the stimulation of diuresis. With concomitant use of digitalis, hypokalemia may increase cardiac arrhythmia.

There is no information on the specific treatment for quinapril / hydrochlorothiazide overdose. The effectiveness of hemodialysis and peritoneal dialysis is negligible. Treatment is symptomatic.

Storage Conditions

The product should be stored out of the reach of children at a temperature not exceeding 25 РC.

Shelf life

3 years.

Deystvuyushtee substance

Gidrohlorotiazid, Quinapril

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