Atacand Plus

Description overdue on 12/13/2014

Latin name: Atacand Plus
ATC code: C09DA06
Active substance: Candesartan + Hydrochlorothiazide (Hydrochlorothiazide + Candesartan)
Manufacturer: ASTRAZENECA AB (Sweden)

Photos of the drug

Composition
Product form
Pharmacological action
Pharmacodynamics and pharmacokinetics
Indications
Contraindications
Side effects
Instructions for use Atacand Plus (method and dosage)
Overdose
Cooperation
Terms of sale
Storage conditions
Shelf life
Cautions
Analogs
Babies
With alcohol
During pregnancy (and lactation)
Reviews
Price, where to buy

Atacand Plus

Composition

One tablet means Atacand Plus contains 12.5 mg hydrochlorothiazide and 16 mg cilexetil candesartan .

Excipients: giproloza, carmellose calcium, magnesium stearate, lactose monohydrate, starch, Yellow dye iron oxide, macrogol , Red dye iron oxide .

Product form

Atacand Plus is an oval, biconvex tablets pink serif with both edges and drawing «A / CS» from one side.

Pharmacological action

Blocks the receptors angiotensin the first type has diuretic and pressure reducing action.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Atacand Plus - a combination antihypertensive drug. Angiotensin the second type is important in the pathogenesis heart failure, arterial hypertension and other diseases of the circulatory system. The main effects angiotensin the second type are vasoconstriction, stimulation of synthesis aldosterone Correction water and electrolyte status and activation of cell growth. The effects associated with the interaction angiotensin second type receptors angiotensin type 1.

Candesartan - selective antagonist Angiotensin 2 receptors, does not inhibit angiotensin-converting enzyme (first type converts angiotensin I to angiotensin a second type, which inactivates bradykinin ), Does not cause accumulation bradykinin and Substance P . Dose-dependent increase in angiotensin first type renin angiotensin and lowering the second type content aldosterone blood occurs as a result of suppression type receptors Angiotensin AT1 the second type.

Candesartan does not interact with other receptors, other than those mentioned above, and suppresses ion channels .

Hydrochlorothiazide - A diuretic from the group thiazides Inhibits active reabsorption Sodium ion in the distal tubule and stimulates secretion chlorine ions, sodium and water. Withdrawal Magnesium and Potassium buds stimulated dose-dependent manner, and calcium reabsorbed to a greater extent than before.

It reduces the volume of extracellular fluid and plasma suppresses the intensity of the transport of blood through the heart, lowers blood pressure. After long-term treatment effect is due to the increase arterioles .

Candesartan and hydrochlorothiazide have summed hypotensive effect. In individuals with hypertension drug causes prolonged pressure reduction without increasing the contractile activity of the heart. Orthostatic hypotension in the early stages of treatment is not observed after the treatment of hypertension is not amplified.

After a single administration of the drug hypotensive the effect is detected after 2 hours. Use of the drug once a day gently and effectively lowers blood pressure for 24 hours. Prolonged treatment sure the pressure drop occurs within four weeks.
Efficacy has not depending on age or gender.

Pharmacokinetics

Candesartan cilexetil . A prodrug for internal administration. During absorption from the gut candesartan cilexetil While undergoing ester hydrolysis Quickly transformed into active substance is firmly bound to the receptor type AT1 - candesartan . The absolute bioavailability reaches 14%. Food intake has no effect on pharmacokinetics.

Maximum concentration in the blood occurs four hours after ingestion of the drug. Cooperation candesartan to plasma proteins up to 99%. Pharmacokinetic parameters did not depend on the gender of the patient.

Excreted in the urine and bile in their original form, in a very small extent undergoes changes in the liver. The half-life candesartan close to 9 hours. Accumulation of the drug in the body are not revealed.

Hydrochlorothiazide . Rapidly absorbed from the intestine. Bioavailability is 70%. Together with the food intake increases the level of absorption by 15%. The interaction with plasma proteins is 60%. Do not metabolized and excreted through the kidneys. The half-life - 8 hours. 70% of the dose is excreted by the kidneys within two days.

Indications

Hypertension If the patient is recommended complex therapy.

Contraindications

Anury .
Liver damage or cholestasia .
Renal disease.
Refractory hypercalcemia and hypokalemia .
Podagra .
Gestation .
Lactation .
Age less than 18 years.
Hypersensitivity derivatives sulfonamides .
Hypersensitivity to the drug.

With careful use of Atacand Plus in severe forms Heart Failure chronic type, bipolar renal artery stenosis , Hemodynamically significant narrowing aortic or mitral valve, cerebrovascular disease, ischemic heart disease, hypertrophic obstructive cardiomyopathy, liver cirrhosis , Decreased blood volume, primary hyperaldosteronism, lactose intolerance, renal failure, hyponatremia , Surgery, kidney transplantation and diabetes .

Side effects

Side effects candesartan cilexetil :

from the hematopoietic system - neutropenia, leukopenia, agranulocytosis ;
on the part of the digestive system - nausea , Liver disease, elevated levels liver enzymes, hepatitis ;
on the part of the musculoskeletal system - arthralgia, lumbalgia, myalgia ;
the nervous system - headache . dizziness ;
on the part of the genitourinary system - kidney disease;
by metabolism - hyponatremia, hyperkalemia ;
allergic reactions - hives . rash . angioedema . itch .

Side effects hydrochlorothiazide :

from the hematopoietic system - neutropenia, leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia, bone marrow depression ;
the nervous system - dizziness , Headache, depression . sleep disturbance . paresthesia ;
from the sensory organs - blurred image;
on the part of the circulatory system - orthostatic hypotension, necrotizing vasculitis, arrhythmia, cutaneous vasculitis ;
From the respiratory system - shortness of breath;
on the part of the digestive system - pancreatitis . diarrhea . constipation . cholestatic jaundice ;
on the part of the musculoskeletal system - myalgia ;
genitourinary - glycosuria , Kidney disease, nephritis ;
from the metabolism - hyperuricemia, hyperglycemia, hypokalemia, hyponatremia, hypertriglyceridemia, hypercholesterolemia, increased levels creatinine ;
allergic reactions - anaphylactic reactions . rash . hives . eritematozopodobnye skin reaction.

Instructions for use Atacand Plus (method and dosage)

The drug should be taken once a day 1 tablet. It is advisable to make a titration candesartan before starting therapy Atacand Plus. Confident hypotensive effect develops within 4 weeks after initiation of therapy.

For persons at risk of developing hypotension recommended titration candesartan (monotherapy Atacand) starting at 4 mg dose.

Older people make a correction dose is not required.

Overdose

Symptoms: The main symptoms of overdose candesartan - Expressed pressure decrease and dizziness . The main symptoms of overdose hydrochlorothiazide - Severe loss of water and electrolytes. There may be symptoms such as dizziness, pressure reduction, ventricular arrhythmia, tachycardia , Muscle cramps.

Treatment: symptomatic, stabilization of the patient's condition. Recommended prone position with raised legs. If necessary to increase blood volume, intravenous isotonic solution sodium chloride . Hemodialysis is not effective.

Cooperation

Hydrochlorothiazide, digoxin, warfarin, glibenclamide, oral contraceptives, nifedipine and E nalapril It does not reveal the interactions of the components of Atacand Plus.

Use Atacand Plus with other antihypertensive agents It enhances the hypotensive effect. Effects T idrohlorotiazida Which cause loss of potassium may potentiate other means of stimulating hypokalemia and potassium loss ( diuretics, amphotericin, laxatives, penicillin G sodium, Carbenoxolone, derivatives salicylic acid ).

Potassium-sparing diuretics . kalisodergaszczye salt substitutes, potassium supplements and other agents that increase the levels of potassium in the blood at a joint reception with Atacand Plus give rise hyperkalemia .

Simultaneous therapy preparations lithium It causes a reversible increase in the concentration of lithium in the blood and the development of specific toxic reactions.

Absorption T idrohlorotiazida weakened the application K olestipola and K olestiramina .

Thiazide diuretics cause an increase in the content Calcium Blood reinforce hyperglycemic the effect of beta-blockers and The D iazoksida Increases sensitivity to glucose slows down cytostatics ( C iklofosfamid . Methotrexate ) And activate them mielopodavlyayuschee action .

Effects non-depolarizing muscle relaxants hydrochlorothiazide worse.

Anticholinergic agents ( B iperidin, Atropine ) Increase the bioavailability of the diuretics group thiazides due to the weakening of intestinal motility.

Hydrochlorothiazide able to weaken the action vasoconstrictor amines ( epinephrine ) And increase the likelihood of Acute renal failure .

Terms of sale

The drug can be purchased only by doctor's prescription.

Storage conditions

Store at temperatures up to 30 degrees. Keep away from children.

Shelf life

Three years.

Cautions

Occurrence allergic reactions to Hydrochlorothiazide most often in patients asthma . hypersensitivity reactions history; but it is possible the emergence of such symptoms in other patients.

When using thiazide diuretics there were cases of signs congestive seborrhea .

The product contains in its composition lactose , So it is forbidden to take patients with low tolerance lactose lack lactase or violation of assimilation Glucose or lactose .

Care must be taken during treatment with Atacand Plus while driving.