Fosinopril pills 20mg 30pcs

Composition

Fosinopril 20 mg

Pharmacological action

Pharmacogroup:

ACE inhibitor.

Pharmaceutical action:  

ACE inhibitor, has antihypertensive, vasodilating, diuretic and potassium-sparing effects. Reduces the formation of angiotensin II from angiotensin I, which leads to a decrease in OPSS and systemic blood pressure.

Inhibits the synthesis of aldosterone, inhibits tissue ACE.

The hypotensive effect is also due to the suppression of bradykinin metabolism, which has a pronounced vasodilating effect. A decrease in blood pressure is not accompanied by changes in BCC, cerebral and renal blood flow, blood supply to internal organs, skeletal muscles, skin, and myocardial reflex activity.

With hypertension and LV hypertrophy, treatment leads to a decrease in its mass and thickness of the septum wall. Long-term treatment does not lead to metabolic disorders.

After oral use, the antihypertensive effect develops within 1 hour, reaches a maximum in 3-6 hours and persists for 24 hours.

:  

Absorption – 36% (regardless of food intake). In the mucous membrane of the gastrointestinal tract and liver, it is hydrolyzed to form fosinoprilate. TCmax – 3 h, T1 / 2-11.5 h.

Binding to plasma proteins is 95%, has a relatively small volume of distribution and is sorbed to a small extent by cellular components.

It does not penetrate the BBB. It is excreted in the bile and urine.

Indications

Arterial hypertension, CHF.

Contraindications

Hypersensitivity to fosinopril, pregnancy, lactation.

With caution. Angioedema in the anamnesis during ACE inhibitor therapy, hereditary or idiopathic angioedema, aortic stenosis, cerebro – and cardiovascular diseases (including cerebral circulatory failure, CHD, coronary insufficiency), severe autoimmune systemic connective tissue diseases (including SLE, scleroderma), bone marrow hematopoiesis suppression, diabetes mellitus, hyperkalemia, bilateral renal artery stenosis, single kidney artery stenosis, post-kidney transplant condition, liver failure, Na+ restricted diet, conditions associated with reduced BCC (including diarrhea, vomiting), elderly age, age up to 18 years (safety and efficacy have not been studied).

Side effects

From the cardiovascular system: decreased blood pressure, orthostatic collapse, tachycardia, palpitations, arrhythmias, angina pectoris, myocardial infarction.

From the urinary system: development or strengthening of CRF, proteinuria.

From the nervous system: stroke, cerebral ischemia, dizziness, headache, weakness; when used in high doses – insomnia, anxiety, depression, confusion, vestibular disorders, paresthesia.

From the sensory organs: hearing and vision disorders, tinnitus.

From the digestive system: nausea, intestinal obstruction, pancreatitis, hepatitis, cholestatic jaundice, abdominal pain, vomiting, dyspepsia, constipation, decreased appetite, stomatitis, glossitis.

Respiratory system disorders: dry cough, pulmonary infiltrates, bronchospasm, shortness of breath, rhinorrhea, pharyngitis, dysphonia.

Allergic, toxic-allergic and immunopathological reactions, including angioedema of the small intestine (very rare).

Laboratory parameters: hypercreatininemia, increased urea concentration, increased activity of “hepatic” transaminases, hyperbilirubinemia, hyperkalemia, hyponatremia; decreased Hb and hematocrit, neutropenia, leukopenia, eosinophilia, increased ESR.

Hypoglycaemia has been reported in patients with diabetes mellitus who have taken insulin and oral hypoglycaemic drugs.

Teratogenic, fetotoxic effect-impaired fetal kidney development, decreased fetal and newborn blood pressure, impaired renal function, hyperkalemia, cranial hypoplasia, oligohydramnion, limb contracture, cranial deformity, lung hypoplasia.

Interaction

Increases the hypoglycemic effect of sulfonylurea derivatives, insulin, the risk of leukopenia when used simultaneously with allopurinol, cytostatic drugs, immunosuppressants, procainamide.

When taken simultaneously with Li+ preparations, an increase in its concentration in the blood is noted. Antihypertensive drugs, diuretics, narcotic analgesics, and drugs for general anesthesia enhance the hypotensive effect. NSAIDs, table salt weaken the effect.

K+ drugs, potassium-sparing diuretics (amiloride, spironolactone, triamterene) increase the risk of hyperkalemia. NSAIDs, including selective COX-2 inhibitors and estrogens (retain fluid) may reduce the severity of the hypotensive effect. With the simultaneous use of ACE inhibitors and gold preparations (sodium aurothiomalate), a symptom complex is described, including facial hyperemia, nausea, vomiting, and a decrease in blood pressure.

Insulin and oral hypoglycemic drugs – the risk of hypokalemia.

How to take, course of use and dosage

Inside,10 mg / day,1 time a day; if necessary, the dose can be increased to 40 mg.

The dose should be selected in accordance with the dynamics of blood pressure.

Overdose

Symptoms: decreased blood pressure, bradycardia, shock, impaired water-electrolyte balance, acute renal failure, stupor. Treatment: place the patient in a “lying” position with raised legs.

In mild cases of overdose-gastric lavage, use of adsorbents and sodium sulfate within 30 minutes after ingestion. With a decrease in blood pressure-intravenous use of catecholamines, angiotensin II; with bradycardia – the use of a pacemaker.

It is not excreted during hemodialysis.

Special instructions

Patients with malignant arterial hypertension or concomitant decompensated CHF should start treatment in a hospital setting.

Before starting therapy with ACE inhibitors and during treatment, the total number of white blood cells is calculated and the leukocyte formula is determined (1 time a month in the first 3-6 months of treatment and at periodic intervals of up to 1 year in patients with an increased risk of neutropenia: with impaired renal function, systemic connective tissue diseases, in those receiving high doses), as well as at the first signs of infection.

Before and during treatment, it is necessary to monitor blood pressure, kidney function, plasma K+, Hb and creatinine concentrations, urea, electrolyte concentrations, and the activity of “liver” enzymes in the blood.

Based on the results of epidemiological studies, it is assumed that simultaneous use of ACE inhibitors and insulin, as well as oral hypoglycemic drugs, can lead to the development of hypoglycemia. The greatest risk of development is observed during the first weeks of combination therapy, as well as in patients with impaired renal function. In patients with diabetes mellitus, careful glycemic control is required, especially during the first month of ACE inhibitor therapy. Caution should be exercised when prescribing to patients on a low-salt or salt-free diet (increased risk of hypotension).

Safety and efficacy in pediatric practice: newborns who have been exposed to intrauterine ACE inhibitors should be closely monitored for hypotension, oliguria, and hyperkalemia.

Newborns and children are at risk of oliguria and neurological disorders, possibly due to reduced renal and cerebral blood flow due to a decrease in blood pressure caused by ACE inhibitors; lower initial doses and careful monitoring are recommended. Caution should be exercised when driving vehicles or performing other work that requires increased attention, as dizziness may occur, especially after the initial dose of an ACE inhibitor in patients taking diuretic drugs.

Caution should be exercised when exercising or in hot weather because of the risk of dehydration and reduced blood pressure due to reduced fluid volume.

Before surgery (including dentistry), the surgeon/anesthesiologist should be warned about the use of ACE inhibitors. When using ACE inhibitors in the II-III trimesters of pregnancy, oligohydroamnion, fetal and newborn hypotension, oliguria and fatal outcomes are possible.

Active ingredient

Fosinopril

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Purpose

For adults as directed by your doctor

Indications

Heart Failure, Hypertension