Captopril Pharmland tablets 25mg №10×5

Name Captopril Pharmland tabl. colloidal anhydrous, sodium starch glycolate. It belongs to the group of drugs that affect the renin-angiotensin system. Angiotensin-converting enzyme (ACE) inhibitors. Expands peripheral vessels, which facilitates the work of the heart and lowers blood pressure (BP). Normalization and control of blood pressure avoids such consequences of arterial hypertension as myocardial infarction and stroke. The main active ingredient Captopril Release form tablets Dosage 25 mg Indications for use Hypertension: the drug is indicated for the treatment of arterial hypertension. Heart failure: the drug is indicated for the treatment of chronic heart failure with a decrease in left ventricular systolic function. May be used in combination with diuretics and, if necessary, digitalis preparations and beta-blockers. Myocardial infarction: Short-term (4 weeks) use: the drug is used for clinically stable patients during the first 24 hours after a heart attack. Long-term prevention of symptomatic heart failure: Used in clinically stable patients with asymptomatic left ventricular dysfunction. Type I diabetic nephropathy: the drug is indicated for the treatment of diabetic nephropathy in insulin-dependent diabetes mellitus. Dosage and administration The drug is taken before meals. If captopril is taken under the tongue, its absorption is faster than when taken orally. The dosage regimen is set individually, taking into account the characteristics of the patient and the reaction from the side of blood pressure. The recommended maximum daily dose is 150 mg. Captopril Pharmland tablets are not divided into smaller doses, the line on the tablet serves to facilitate the administration of the drug. If it is necessary to prescribe captopril at a lower dosage, it is recommended to use other drugs. Arterial hypertension: the recommended initial dose is 25-50 mg per day in two divided doses. If necessary, the dose is increased gradually, with an interval of at least 2 weeks, up to 100-150 mg per day in two divided doses to achieve the desired level of blood pressure. Captopril is used alone or in combination with other drugs, most often with thiazide diuretics, in which case a single daily dose is sufficient. In patients with renovascular hypertension, hypovolemia, heart failure, the recommended single dose is 6.25 mg or 12.5 mg. Treatment begins under medical supervision. Gradually, with an interval of at least 2 weeks, the dose can be increased to 50 mg per day in one or two doses, and if necessary, up to 100 mg per day in one or two doses. Heart failure: Captopril should be started under medical supervision. The initial dose is 6.25-12.5 mg two to three times a day. The maintenance dose (75-150 mg per day) depends on the response to treatment, condition and tolerability. The maximum recommended daily dose is 150 mg in divided doses. The dose is increased gradually, at intervals of at least 2 weeks, to evaluate the response to treatment. Myocardial infarction: short-term treatment: treatment with captopril can be started in a hospital after the doctor has assessed the stability of the patient’s condition. First, captopril is taken at a dose of 6.25 mg, then after 2 hours – 12.5 mg and after 12 hours – 25 mg. From the next day, in the absence of adverse reactions, take 100 mg per day in two divided doses for 4 weeks. After 4 weeks of treatment, the patient’s condition is reassessed and a decision is made to continue further treatment. long-term treatment: if treatment with captopril is not started within the first 24 hours after an acute myocardial infarction, it is assumed that treatment of clinically stable patients will be started between 3 and 16 days after the infarction. Treatment should be started in a hospital with close monitoring of blood pressure until a dose of 75 mg is reached. The initial dose should be low, especially in normal or low blood pressure. Treatment begins with a dose of 6.25 mg, then 12.5 mg per day for 2 days, and then 25 mg 3 times a day, in the absence of adverse hemodynamic reactions. The recommended dose for long-term treatment is 75-150 mg per day in two to three divided doses. In the event of symptomatic hypotension, the dose of diuretics and/or vasodilators used concomitantly is reduced in order to achieve a stable dose of captopril. If necessary, the treatment regimen is adjusted depending on the response to treatment. The drug is used in conjunction with other drugs for the treatment of myocardial infarction, in particular thrombolytic agents, beta-blockers and acetylsalicylic acid. Type I diabetic nephropathy: Patients with type 1 diabetic nephropathy are recommended captopril at a dose of 75-100 mg per day in divided doses. Impaired renal function: since captopril is excreted mainly through the kidneys, in patients with renal insufficiency, the dose is reduced, and the interval between doses is increased. The level of potassium and creatinine in the blood is monitored: creatinine level> 40 ml / min / 1.73 m3 – initial daily dose of 25-50 mg – maximum daily dose of 150 mg; 21-40 ml / min / 1.73 m3 – initial daily dose 25 mg – maximum daily dose 100 mg; 10-20 ml / min / 1.73 m3 – initial daily dose 12.5 mg – maximum daily dose 75 mg; <10 ml/min/1.73 m3 - initial daily dose 6.25 mg - maximum daily dose 37.5 mg. If concomitant diuretic therapy is required, loop diuretics (eg, furosemide) are preferred. Thiazide diuretics should be avoided. Elderly Patients: Elderly patients are advised to start treatment with the lowest dose (6.25 mg twice daily) because there may be decreased renal function or other complications. Children and adolescents: The efficacy and safety of captopril in children and adolescents under 18 years of age have not been studied. Captopril should only be given to children under the supervision of a physician, provided that other antihypertensive drugs have not been effective. Use during pregnancy and lactation Captopril is contraindicated in the second and third trimesters of pregnancy (toxic effect on the fetus) and during breastfeeding. Captopril is not recommended during the first trimester of pregnancy. If pregnancy is planned or confirmed, captopril is canceled and switched to alternative treatment. Precautions Hypotension: Rarely observed in patients with uncomplicated hypotension. Symptomatic hypotension is more typical of hypertensive patients with reduced blood volume and/or reduced blood sodium as a result of intensive diuretic therapy, low salt intake, diarrhea, vomiting, or hemodialysis. Decreased blood volume and sodium must be corrected before using captopril, and low starting doses are preferred. It should be remembered that, as with all cases of the use of drugs that reduce blood pressure, the reduction of elevated blood pressure in patients with cardiovascular or cerebrovascular diseases is associated with an increased risk of myocardial infarction or stroke. With the development of hypotension, the patient should be brought to a horizontal position. Intravenous saline may be required to replenish blood volume in a hospital setting. Renovascular hypertension: The initial dose of captopril is determined according to creatinine clearance. Angioedema: in the treatment of patients with ACE inhibitors, especially in the first weeks of admission, Quincke's edema (swelling of the face, tongue, pharynx, larynx) may develop. In rare cases, it occurs after prolonged use of ACE inhibitors. In this case, the reception should be stopped immediately. Seek immediate medical attention or call an ambulance! Treatment must be carried out in a hospital! The condition is life-threatening! Cough: often seen with ACE inhibitors. The cough is unproductive, disappears when the drug is stopped. Liver failure: This rare complication of ACE inhibitors has been observed in association with jaundice and progressive fulminant hepatic necrosis. The mechanism of development of the syndrome is unknown. With the development of jaundice and a significant increase in the activity of liver enzymes, stop taking ACE inhibitors! Hyperkalemia: when taking ACE inhibitors, an increase in serum potassium is possible, which often develops in patients with renal insufficiency, diabetes mellitus, when using potassium-sparing diuretics and other drugs that increase potassium (for example, heparin). Recommended control of potassium in the blood. Aortic and mitral stenosis/obstructive cardiomyopathy: ACE inhibitors are taken with caution. Neutropenia/Agranuloitosis: Rare cases of decreased blood cell count and hemoglobin have been reported with ACE inhibitors, including captopril. The risk of these reactions is increased in patients with collagenosis, vascular disease, immunosuppressive therapy, treatment with allopurinol or procainamide, or a combination of these factors with impaired renal function. In these cases, captopril is taken with caution. These patients may develop serious infections. It is recommended to control the number of leukocytes before starting treatment, and then every 2 weeks during the first 3 months of therapy, periodically thereafter. Tell your doctor about any signs of infection (sore throat, fever)! If the number of neutrophils in the blood is less than 1000 ml3, captopril is canceled. In most patients, the neutrophil count quickly returns to normal when captopril is discontinued. Proteinuria: Protein in the urine may occur in patients with renal insufficiency or when taking high doses of captopril (>150 mg/day). In most cases, proteinuria decreases or disappears after 6 months, regardless of the use of captopril. Anaphylactoid reactions during desensitization: In rare cases, life-threatening anaphylactic reactions have been noted in patients undergoing desensitization while taking captopril. In this regard, care should be taken when conducting desensitization. Recommended temporary cancellation of captopril during the period of desensitization. Anaphylactic reactions in patients undergoing hemodialysis: Anaphylactic reactions have been reported in patients taking ACE inhibitors while undergoing hemodialysis using high-flow membranes (eg, AN 69). These patients should be offered to change their dialysis membranes to another type of membrane or use a different class of antihypertensive agent. Risk of hypokalemia: with the simultaneous use of an ACE inhibitor and a thiazide diuretic, hypokalemia may develop. Potassium levels should be monitored regularly. Laboratory researches: the false positive reaction of urine to acetone is possible. Surgery/Anesthesia: With major surgery, blood pressure may decrease with the use of anesthetics. Correction of the circulating blood volume is recommended. Patients with diabetes: in the first months of taking ACE inhibitors, patients with diabetes need careful monitoring of blood sugar levels. Double blockade of the renin-angiotensin-aldosterone system (RAAS): increases the risk of hypotension, hyperkalemia and renal dysfunction compared with monotherapy. Dual RAAS blockade with ACE inhibitors, ARB II, or Aliskiren cannot be recommended for any patient, especially those with diabetic nephropathy. In some cases, when the combined use of an ACE inhibitor and ARB II is absolutely indicated, careful observation by a specialist and mandatory monitoring of renal function, water electrolyte balance, and blood pressure are necessary. This applies to the use of candesartan or valsartan in combination with ACE inhibitors in patients with chronic heart failure. Race: The hypotensive effect of captopril is less pronounced in dark-skinned patients due to the high prevalence of hypertension with low renin activity. Interaction with other drugs When prescribing Captopril Pharmland, be sure to inform your doctor about taking any of the following medicines. Perhaps, when they are taken together, a dose adjustment or additional examinations will be necessary. Non-steroidal anti-inflammatory drugs (indomethacin, ibuprofen, etc.): an increase in serum potassium levels with a decrease in kidney function is possible. In patients with impaired renal function, the elderly or dehydrated, acute renal failure may develop. Long-term use of anti-inflammatory drugs may reduce the ability of ACE inhibitors to reduce blood pressure. Medicines for gout (allopurinol), immunosuppressive drugs (azathioprine, cyclophosphamide, etc.): increased risk of a decrease in the number of white blood cells in the blood. Potassium preparations, salt-substituting solutions with potassium, other drugs that increase the level of potassium in the blood (spironolactone, amiloride, etc.): ACE inhibitors reduce potassium loss, serum potassium increases significantly. Monitoring of potassium levels is recommended. Diuretics: risk of hypotension. BP control recommended. Medicines for the treatment of diabetes: their ability to lower sugar levels is enhanced, regular monitoring of blood glucose levels is recommended. Medicines that dilate blood vessels (minoxidil, clonidine, etc.): risk of hypotension. BP control recommended. Medicines for the treatment of psychiatric problems, including depression (lithium preparations, amitriptyline, etc.): may increase the hypotensive effect. BP control recommended. Co-administration with lithium preparations is not recommended. Other drugs that reduce blood pressure (alpha- and beta-blockers – prazosin, urapidil, propanolol, atenolol, bisoprolol, carvedilol, etc.; calcium channel blockers – amlodipine, nifedipine): risk of developing orthostatic hypotension. BP control recommended. Medicines for the treatment of acute myocardial infarction or used in the post-infarction period: used simultaneously with acetylsalicylic acid (in cardiological doses), thrombolytics, beta-blockers and / or nitrates. Contraindications hypersensitivity to captopril, excipients or other ACE inhibitors; angioedema in the past (including those associated with therapy with ACE inhibitors); hereditary or idiopathic angioedema; second and third trimester of pregnancy; lactation period; concomitantly with aliskiren in the presence of diabetes mellitus or moderate / severe renal insufficiency (GFR <60 ml / min / 1.73 m2). Composition Each Captopril Pharmland tablet contains the active substance - captopril 25 mg or 50 mg and excipients: corn starch, microcrystalline cellulose, povidone K-30, purified talc, magnesium stearate, anhydrous colloidal silicon dioxide, sodium starch glycolate. It belongs to the group of drugs that affect the renin-angiotensin system. Angiotensin-converting enzyme (ACE) inhibitors. Overdose If the number of tablets per day that you have taken exceeds the amount recommended by your doctor, or your child has swallowed the tablets, immediately consult a doctor or call an ambulance! An overdose is likely to cause a pronounced significant decrease in blood pressure, heart rate, stupor, impaired renal function, and changes in blood biochemical parameters. Stop taking the medicine! As a first aid, lay the patient on his back so that the head is lowered and the legs are raised. Control of blood pressure, heart rate. Gastric lavage, activated charcoal and sodium sulfate are recommended for 30 minutes after taking the tablets. Side effects Like all medicines, Captopril Pharmland can cause side effects with varying frequency, regardless of whether it has been used before. Common (1 in 100 to 1 in 10 cases): dizziness, itching, rash, hair loss, change in taste, shortness of breath, dry mouth, sleep disturbance, loose stools or constipation, dry cough, stomach upset, abdominal pain. Infrequently (1/1000 - 1/100 cases): arrhythmias, low blood pressure, poor circulation of the arms and legs, fatigue, deterioration in general condition, pallor, swelling of the eyes and lips. Rarely (1/10000 - 1/1000 cases): loss of appetite, drowsiness, headache, numbness, paresthesia, oral ulcers, impaired renal function, change in the frequency of urination. Very rare (less than 1 in 10,000 cases): abnormal liver function, elevated liver enzymes, confusion, depression, syncope, cerebrovascular accident, blurred vision, heart attack, chest infection, pancreatitis, nasal discharge, swelling of the tongue, sexual dysfunction, Stevens-Jones syndrome, liver damage, jaundice, stomach ulcers, muscle and joint pain, shortness of breath, difficulty breathing, rash or skin reactions, swelling of the mammary glands in men, fever, skin sensitivity to light, changes in blood biochemical parameters (potassium, sugar, etc.). If you experience any of the following side effects, stop taking the medicine and immediately consult a doctor or call an ambulance: swelling of the hands, face, lips, tongue; difficulty breathing; sudden appearance of rashes, lesions, redness, peeling of the skin; sore throat; severe dizziness or weakness; acute pain in the abdomen; irregular or rapid heartbeat; yellowness of the skin or eyes. Storage conditionsKeep in a place protected from light at a temperature not exceeding 25°C. Keep out of the reach of children. Buy Captopril Farmland tablets 25mg №10x5