Accuzid pills 12.5mg+20mg, 30pcs

Composition

1 tablet sodezhit quinapril (in the form of hydrochloride) 20 mg,

hydrochlorothiazide 12.5 mg

Pharmacological action

Accuzide is a combined antihypertensive drug that includes the ACE inhibitor quinapril and the thiazide diuretic hydrochlorothiazide in three different ratios. Quinapril is an ACE inhibitor. ACE catalyzes the formation of angiotensin II, which has a vasoconstrictive effect and controls vascular tone, including by stimulating 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 action, also increases the activity of plasma renin, aldosterone secretion, 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 reducing the excretion of calcium ions. Although the mechanism of antihypertensive action of diuretics is not fully understood, long-term use of diuretics shows a decrease in OPSS, probably due to changes 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.

Pharmacological action

Accuzide has an antihypertensive effect.

Indications

Indications for the use of Accuzid arterial hypertension in patients requiring combination therapy with quinapril and a diuretic.

Use during pregnancy and lactation

It is contraindicated in pregnancy and children under 18 years of age.

Contraindications

• angioedema in the anamnesis as a result of previous therapy 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;
• hypersensitivity to sulfonamide derivatives.
• pregnancy and lactation.

Side effects

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

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

Interaction

The use of tetracycline together with quinapril reduces the absorption of tetracycline by approximately 28-37%. This is due to the presence of magnesium carbonate as a filler in the preparation. It should be borne in mind the possibility of such an interaction with the simultaneous use of quinapril/hydrochlorothiazide with tetracycline or with other drugs that react with magnesium. Lithium is not usually prescribed with diuretics. Diuretics reduce its renal clearance and increase the risk of toxic effects. Increased serum lithium concentrations and symptoms of lithium poisoning as a consequence of sodium loss under the action of quinapril / hydrochlorothiazide were detected in patients taking lithium and ACE inhibitors simultaneously. When using quinapril / hydrochlorothiazide, the risk of lithium intoxication may increase. Concomitant use of these drugs should be carried out with caution; frequent monitoring of serum lithium levels is recommended. Concomitant use of a diuretic may increase the risk of lithium toxicity.

No clinically relevant pharmacokinetic interactions were observed when quinapril was administered with propranolol, hydrochlorothiazide, digoxin, or cimetidine. The anticoagulant effect of a single dose of warfarin (estimated by prothrombin time) did not change significantly with simultaneous use of quinapril 2 times a day.

Alcohol, barbiturates or drugs — orthostatic hypotension may occur; antidiabetic agents (oral hypoglycemic agents and insulin) — it may be necessary to increase the dose of antidiabetic agents; other antihypertensive agents — an additive effect or potentiation of the effect; corticosteroids, adrenocorticotropic hormone — increased electrolyte loss, especially hypokalemia; pressor amines (for example, norepinephrine) — there may be a slight decrease in the response to the use of these drugs; non — depolarizing muscle relaxants (for example, tubocurarin) — may increase the response to the use of muscle relaxants; NSAIDs-in some patients, the use of NSAIDs may reduce the diuretic, natriuretic and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.

Therefore, when quinapril / hydrochlorothiazide is co-administered with NSAIDs, patients should be closely monitored for the desired effect of Accuzide; drugs that increase serum potassium levels-quinapril may reduce aldosterone levels, which in turn may cause potassium retention. Therefore, the concomitant use of quinapril and potassium preparations or preparations containing potassium salts should be cautious, with appropriate monitoring of serum potassium concentrations; anion exchange resins-absorption of hydrochlorothiazide is impaired by anion exchange resins such as colestyramine and colestipol. Simultaneous use of anion exchange resin binds hydrochlorothiazide and reduces its absorption from the digestive tract by up to 85 and 43%, respectively.

How to take, course of use and dosage

Inside 1 time a day, regardless of food intake.

For patients who do not receive diuretics (regardless of whether quinapril monotherapy was previously performed or not), the recommended initial dose is 1 tablet of Accuzide (20 mg +12.5 mg) once a day.

Subsequently, if necessary, the dose can be increased to 2 tablets of the drug Akkuzid (20 mg + 12.5 mg) 1 time per day or to the maximum recommended daily dose of the drug Akkuzid – (20 mg + 25 mg) 1 time per day.

Overdose

There is no information about overdose of Accuzide in the treatment of people.

The main clinical manifestations of motor therapy with hydrochlorothiazide are symptoms associated with loss of electrolytes (hypokalemia, hypochloremia, hyponatremia), and dehydration due to stimulation of diuresis.

With concomitant use of digitalis preparations, hypokalemia may increase cardiac arrhythmia.

There is no information on the specific treatment of quinapril/hydrochlorothiazide overdose.

The effectiveness of hemodialysis and peritoneal dialysis is insignificant.

Treatment is symptomatic.

Special instructions

Accuzide can cause symptomatic hypotension, but not more often than with monotherapy with both components of the drug.

Symptomatic hypotension is rare in patients with uncomplicated arterial hypertension treated with quinapril, but it can develop as a result of ACE inhibitor therapy in patients with reduced BCC, for example, after treatment with diuretics, while following a diet with limited sodium intake, or during hemodialysis. In case of symptomatic hypotension, the patient should be placed in a horizontal position and, if necessary, given an intravenous infusion using 0.9% sodium chloride solution.

Transient arterial hypotension is not a contraindication to further use of the drug, but in such cases it is advisable to reduce its dose. In patients with chronic heart failure, combined with or without renal insufficiency, ACE inhibitor therapy for arterial hypertension can lead to an excessive decrease in blood pressure, which can be accompanied by oliguria, azotemia and, in rare cases, acute renal failure and even death. Treatment of such patients with Accuzide should be initiated under close medical supervision and supervision during the first 2 weeks and with an increase in the dose of the drug.

In rare cases, ACE inhibitor therapy may be associated with 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 connective tissue diseases. In these cases, the number of white blood cells in the blood should be monitored. Thiazide diuretics sometimes cause an exacerbation of SLE.

Form of production

Akkuzid – coated tablets.

Storage conditions

At a temperature not exceeding 25 °C

Shelf life

3 years

Active ingredient

Hydrochlorothiazide, Quinapril

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Purpose

For adults as directed by your doctor

Indications

Hypertension