Hypothiazid pills 25mg №20×1

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Hypothiazid tab 25mg in a blister pack No. 20×1
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Tablets are white or almost white, round, flat, engraved with “H” on one side and a notch on the other. The main active substance Hydrochlorothiazide Release form Tablets are white or almost white, round, flat, engraved with “H” on one side and a risk on the other. 1 tab. Active substance: hydrochlorothiazide 25 mg; – “- 100 mg; Excipients: magnesium stearate, talc, gelatin, corn starch, lactose monohydrate. 20 pcs. – blisters (1) – cardboard packs. Dosage 25 mg in blister. in pack No. 20×1 Special indications With prolonged course treatment, clinical symptoms of fluid and electrolyte imbalance should be carefully monitored, primarily in high-risk patients: patients with diseases of the cardiovascular system, impaired liver function, with severe vomiting or signs of fluid and electrolyte imbalance (in including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pain or cramps, muscle weakness, hypotension, oliguria, tachycardia, gastrointestinal complaints). h. fruits, vegetables), especially with loss of potassium due to increased diuresis, prolonged therapy with diuretics, or simultaneous treatment with glycosides first ointment or corticosteroid drugs, avoids hypokalemia. An increase in the excretion of magnesium in the urine with the use of thiazides can lead to hypomagnesemia. With reduced renal function, control of creatinine clearance is necessary. In patients with impaired renal function, the drug can cause azotemia and the development of cumulative effects. If impaired renal function is evident, discontinuation of the drug should be considered upon the onset of oliguria. In patients with impaired liver function or progressive liver disease, thiazides should be used with caution, since a slight change in fluid and electrolyte balance, as well as serum ammonium levels, can cause hepatic coma. Thiazides are able to increase the concentration of bilirubin in the blood serum. In severe cerebral and coronary sclerosis, the use of the drug requires special care. Treatment with thiazide drugs may impair glucose tolerance. During a long course of treatment in overt and latent diabetes mellitus, systematic monitoring of carbohydrate metabolism is necessary due to the potential need to change the dose of hypoglycemic drugs. Enhanced monitoring of the condition of patients with impaired uric acid metabolism is required. In rare cases, with prolonged therapy, a pathological change in the parathyroid glands was observed, accompanied by hypercalcemia and hypophosphatemia. Thiazides are able to reduce the amount of iodine that binds to serum proteins without showing signs of thyroid dysfunction. The possibility of gastrointestinal complaints in patients with lactose intolerance should be considered, since Hypothiazid® 25 mg tablets contain 63 mg of lactose, Hypothiazid® 100 mg – 39 mg of lactose. Influence on the ability to drive vehicles and control mechanisms At the initial stage of the drug (the duration of this period is determined individually), it is forbidden to drive a car and perform work that requires increased attention. Pharmacological action Diuretic. The primary mechanism of action of thiazide diuretics is to increase diuresis by inhibiting the reabsorption of sodium and chloride ions in the initial part of the renal tubules. This leads to increased excretion of sodium and chloride and hence water. It also increases the excretion of other electrolytes, namely potassium and magnesium. At maximum therapeutic doses, the diuretic / natriuretic effect of all thiazides is approximately the same. Natriuresis and diuresis occur within 2 hours and reach a maximum level after about 4 hours. Thiazides also reduce carbonic anhydrase activity by increasing the excretion of bicarbonate ions, but this effect is usually weak and does not affect urine pH. Hydrochlorothiazide also has antihypertensive properties. Thiazide diuretics do not affect normal blood pressure. Pharmacokinetics Absorption and distribution Hydrochlorothiazide is incomplete, but rather rapidly absorbed from the gastrointestinal tract. This effect persists for 6-12 hours. After oral administration at a dose of 100 mg, Cmax in plasma is reached after 1.5-2.5 hours. At the maximum diuretic activity (approximately 4 hours after ingestion), the concentration of hydrochlorothiazide in blood plasma is 2 μg / ml . Plasma protein binding is 40%. Hydrochlorothiazide crosses the placental barrier and is excreted in breast milk. Withdrawal The primary route of excretion is by the kidneys (filtration and secretion) in unchanged form. T1 / 2 for patients with normal renal function is 6.4 hours. Pharmacokinetics in special clinical cases T1 / 2 for patients with moderate renal insufficiency is 11.5 hours. T1 / 2 for patients with CC<30 ml / min is 20.7 hours. hypertension (both for monotherapy and in combination with other antihypertensive drugs); edematous syndrome of various origins (chronic heart failure, nephrotic syndrome, premenstrual tension syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, treatment with corticosteroids); control of polyuria, mainly in nephrogenic diabetes insipidus; prevention of stone formation in the urinary tract in predisposed patients (reduction of hypercalciuria). Route of administration and doses The dose should be selected individually. With constant medical supervision, the minimum effective dose is established. The drug should be taken orally after meals. Adults In arterial hypertension, the initial dose is 25-50 mg / day once, as monotherapy or in combination with other antihypertensive agents. For some patients, an initial dose of 12.5 mg is sufficient (both in the form of monotherapy and in combination). It is necessary to use the minimum effective dose, not exceeding 100 mg / day. When combining Hypothiazide with other antihypertensive drugs, it may be necessary to reduce the dose of another drug to prevent an excessive decrease in blood pressure. The hypotensive effect is manifested within 3-4 days, but it may take 3-4 weeks to achieve the optimal effect. After the end of therapy, the hypotensive effect persists for 1 week. With edematous syndrome of various origins, the initial dose is 25-100 mg / day once or 1 time in 2 days. Depending on the clinical response, the dose may be reduced to 25-50 mg / day once or 1 time in 2 days. In some severe cases, at the beginning of treatment, it may be necessary to increase the dose of the drug to 200 mg / day. With premenstrual tension syndrome, the drug is prescribed at a dose of 25 mg / day and is used from the onset of symptoms to the onset of menstruation. In nephrogenic diabetes insipidus, the usual daily dose of the drug is 50-150 mg (in divided doses). Due to the increased loss of potassium and magnesium ions during treatment (serum potassium levels may be <3.0 mmol/l), it becomes necessary to replace potassium and magnesium. Children Doses should be adjusted based on the child's body weight. Usual pediatric daily doses: 1-2 mg / kg of body weight or 30-60 mg / m2 of body surface 1 time / day. The daily dose in children aged 3 to 12 years is 37.5-100 mg. Use during pregnancy and lactation The use of the drug in the first trimester of pregnancy is contraindicated. In the II and III third trimesters of pregnancy, the use of the drug is possible only if the intended benefit to the mother outweighs the potential risk to the fetus. Hydrochlorothiazide crosses the placental barrier. There is a danger of fetal or neonatal jaundice, thrombocytopenia and other consequences. The drug is excreted in breast milk. If necessary, the use of the drug during lactation should decide on the termination of breastfeeding. Precautions The drug should be used with caution in case of hypokalemia, hyponatremia, hypercalcemia, ischemic heart disease, cirrhosis of the liver, gout, lactose intolerance, the use of cardiac glycosides, as well as in elderly patients. Interaction with other drugs Simultaneous use of hypothiazide with lithium salts should be avoided, as the renal clearance of lithium decreases and its toxicity increases. With the simultaneous use of Hypothiazide with antihypertensive drugs, their action is potentiated and it may be necessary to adjust the dose. With the simultaneous use of Hypothiazide with cardiac glycosides, hypokalemia and hypomagnesemia, associated with the action of thiazide diuretics, can increase the toxicity of digitalis. With the simultaneous use of hypothiazide with amiodarone, the risk of arrhythmias associated with hypokalemia increases. With the simultaneous use of Hypothiazide with oral hypoglycemic agents, the effectiveness of the latter decreases and hyperglycemia may develop. With the simultaneous use of Hypothiazide with corticosteroid drugs, calcitonin, the degree of potassium excretion increases. With the simultaneous use of Hypothiazide with NSAIDs, the diuretic and hypotensive effect of thiazides is weakened. With the simultaneous use of Hypothiazid with non-depolarizing muscle relaxants, the effect of the latter may be enhanced. With the simultaneous use of Hypothiazide with amantadine, a decrease in the clearance of amantadine is possible, which leads to an increase in the concentration of the latter in plasma and increases the risk of toxicity. With the simultaneous use of hypothiazide with cholestyramine, the absorption of hydrochlorothiazide decreases. With simultaneous use with ethanol, barbiturates and opioid analgesics, the orthostatic hypotensive effect of thiazide diuretics increases. Thiazides should be discontinued before testing for parathyroid function. Contraindications Anuria; severe renal failure (CC <30 ml / min); severe liver failure; difficult-to-control diabetes mellitus; Addison's disease; refractory hypokalemia, hyponatremia, hypercalcemia; children's age up to 3 years (for solid dosage form); hypersensitivity to the components of the drug; hypersensitivity to sulfonamide derivatives. With caution, the drug should be used for hypokalemia, hyponatremia, hypercalcemia, coronary artery disease, cirrhosis, gout, lactose intolerance, the use of cardiac glycosides, as well as in elderly patients. Composition Active substance: hydrochlorothiazide 100 mg; Excipients: magnesium stearate, talc, gelatin, corn starch, lactose monohydrate. OverdoseSymptoms: due to acute loss of fluid and electrolytes with an overdose of the drug, tachycardia, decreased blood pressure, shock, weakness, confusion, dizziness, spasms of the calf muscles, paresthesia, impaired consciousness, fatigue, nausea, vomiting, thirst, polyuria, oliguria or anuria (due to hemoconcentration), hypokalemia, hyponatremia, hypochloremia, alkalosis, increased levels of urea nitrogen in the blood (especially in patients with renal insufficiency). Treatment: artificial vomiting, gastric lavage, the use of activated charcoal. With a decrease in blood pressure or a state of shock, the BCC and electrolytes (including potassium, sodium) should be replaced. The state of water and electrolyte balance (especially the level of potassium in the serum) and kidney function should be monitored until normal values are established. There is no specific antidote. Side effects From the side of metabolism: hypokalemia, hypomagnesemia, hypercalcemia, hyponatremia (including confusion, convulsions, lethargy, slowing of the thinking process, fatigue, excitability, muscle cramps), hypochloremic alkalosis (including dry mouth, thirst, irregular heart rhythm, mood or mental changes, muscle cramps and pain, nausea, vomiting, unusual tiredness or weakness). Hypochloremic alkalosis can cause hepatic encephalopathy or hepatic coma. Hyperglycemia (decrease in glucose tolerance can provoke a manifestation of previously latent diabetes mellitus), glucosuria, hyperuricemia (with the development of a gout attack). When using the drug in high doses, it is possible to increase the levels of lipids in the blood serum. From the digestive system: cholecystitis, pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia. From the side of the cardiovascular system: arrhythmia, orthostatic hypotension, vasculitis. From the urinary system: impaired renal function, interstitial nephritis. From the side of the central nervous system and peripheral nervous system: dizziness, temporarily blurred vision, headache, paresthesia. From the hemopoietic system: very rarely - leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia. Allergic reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (including pneumonitis, non-cardiogenic pulmonary edema), photosensitivity, anaphylactic reactions up to shock. Others: reduced potency. Storage conditions The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25 ° C. Buy Hypothiazid tablets 25mg No. 20x1