Lisoretic, 20mg+12.5mg pills, 28pcs

Composition

Active ingredients:  

lisinopril 20 mg;

hydrochlorothiazide 12.5 mg;

Auxiliary substances:

calcium hydrophosphate, mannitol.

corn

starch,

polyslatinated starch, red

iron oxide dye, yellow iron oxide dye,

magnesium stearate,

purified water

Pharmacological action

Lisoretic has an antihypertensive, diuretic effect.

Pharmacodynamics

A Lisoretic is a combination of an angiotensin converting enzyme inhibitor (lisinopril) and a diuretic (hydrochlorothiazide). It has antihypertensive and diuretic effects.

Lisinopril. ACE inhibitor, reduces the formation of angiotensin II from angeotensin I. A decrease in the content of angeotensin II leads to a direct decrease in the release of aldosieron. Reduces bradykinin degradation and increases prostaglandin synthesis. Reduces total peripheral vascular resistance, blood pressure (BP), preload, pulmonary capillary pressure, causes an increase in minute blood volume and increased exercise tolerance in patients with heart failure.

Dilates the arteries to a greater extent than the veins. Some of the effects are explained by the effect on the tissue retin-angiotensin systems. With prolonged use, hypertrophy of the myocardium and arterial walls of the resistive type decreases. Improves blood supply to the ischemic myocardium. ACE inhibitors prolong life expectancy in patients with chronic heart failure, slow the progression of left ventricular dysfunction in patients who have suffered a myocardial infarction without clinical manifestations of heart failure. The action starts in 1 hour, the maximum effect is determined in 6-7 hours, and the duration is 24 hours. With arterial hypertension, the effect is noted in the first days after the start of treatment, a stable effect develops after 1-2 months.

Hydrochlorothiazide. Thiazide diuretic, the diuretic effect of which is associated with a violation of the reabsorption of sodium, chlorine, potassium, magnesium, and water ions in the distal nephron; delays the excretion of calcium and uric acid ions. It has antihypertensive properties; hypotensive effect develops due to the expansion of arterioles. It has almost no effect on normal blood pressure. The diuretic effect occurs in 1-2 hours, reaches a maximum in 4 hours and lasts 6-12 hours.

The antihypertensive effect occurs in 3-4 days, but it may take 3-4 weeks to achieve the optimal therapeutic effect. Lisinopril and hydrochlorothiazide, if used simultaneously, have an additive antihypertensive effect.

Indications

Arterial hypertension (in patients who are indicated for combination therapy).

Use during pregnancy and lactation

The use of Lisoretic during pregnancy is contraindicated. If pregnancy is established, the drug should be discontinued as soon as possible.

Taking inhibitors in the second and third trimester of pregnancy has an adverse effect on the fetus (there may be a pronounced decrease in blood pressure, renal failure, hyperkalemia, cranial hypoplasia, intrauterine death). There are no data on the negative effects of Lisoretic on the fetus when used during the first trimester.

Newborns and children who have been exposed to intrauterine ACE inhibitors are recommended to be monitored for timely detection of a pronounced decrease in blood pressure, oliguria, and hyperkalemia. For the period of treatment with the drug, it is necessary to cancel breastfeeding.

Contraindications

• Hypersensitivity to Lazaretto, other ACE inhibitors and derivatives of sulfonamides;
• anuria;
• severe renal insufficiency (Cl creatinine < 30 ml/min);
• angioedema (including in the anamnesis in the application of ACE inhibitors);
• hemodialysis using a high-flow membranes;
• hypercalcemia;
• hyponatremia;
• porphyria;
• precoma;
• hepatic coma;
• severe forms of diabetes;
• age to 18 years (efficacy and safety not established).

Side effects

From the cardiovascular system:  marked decrease in blood pressure, chest pain, rarely-orthostatic hypotension, tachycardia, bradycardia, the appearance of symptoms of heart failure, violation of atrioventricular conduction, myocardial infarction.

From the digestive tract:  nausea, vomiting, abdominal pain, dry mouth, diarrhea, dyspepsia, anorexia, taste changes, pancreatitis, hepatitis (hepatocellular and cholestatic), jaundice.

Nervous system disorders:  mood lability, impaired concentration, paresthension, increased fatigue, drowsiness, convulsive twitching of the muscles of the limbs and lips, rarely-asthenic syndrome, confusion.

From the respiratory system-dyspnoea, bronchospasm, apnea.

From the skin – urticaria, sweating, hair loss, photosensitization.

Allergic reactions:  angioedema of the face, limbs, lips, tongue, epiglottis and / or larynx, skin rashes, pruritus, fever, vasculitis, positive results for antinuclear antibodies, increased ESR, eosinophilia.

From the side of hematopoietic organs:  leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anemia (decreased hemoglobin, hematocrit, erythrocytopenia). From the genitourinary system – uremia, oliguria/anuria, impaired renal function, acute renal failure, decreased potency.

Laboratory parameters:  hyperkalemia and / or hypokalemia, hyponatremia, hypomagnesemia, hypochloremia, hyperuricemia, hyperglycemia, increased urea and creatinine levels, rarely – increased activity of “hepatic” transaminases, hyperbilibinemia, hypercholesterolemia, hypertriglyceridemia, decreased glucose tolerance.

Other services:  dry cough, arthralgia/arthritis, myalgia, impaired fetal kidney development, exacerbation of gout.

Interaction

When used simultaneously:  with potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium preparations, salt substitutes containing potassium – the risk of hyperkalemia increases, especially in patients with impaired renal function;with vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, ethanol – increased hypotensive effect;with nonsteroidal anti – inflammatory drugs (Indometacin, etc. ), estrogens – reduced blood pressure. antihypertensive effect of lisinopril;with lithium preparations – slowing the excretion of lithium from the body (increased cardiotoxic and neurotoxic effects of lithium);with antacids and colestramine-reduced absorption in the gastrointestinal tract. Increases the neurotoxicity of salicylates, weakens the effect of oral hypoglycemic agents, norepinephrine, epinephrine and anti-gouty agents, enhances the effects (including side effects) of cardiac glycosides, the effect of peripheral muscle relaxants, reduces the excretion of quinidine. Reduces the effect of oral contraceptives.

How to take, course of use and dosage

Take orally, once a day.

Arteraial hypertension on 1 tablet of Lisoretic 10 mg) 12.5 mg 1 time a day. If necessary, the dose can be increased to Lisoretic 20 mg +12.5 mg per day.

Doses for renal insufficiency in patients with creatinine clearance greater than 30 and less than 80 ml / min, the drug can be used only after titrating the dose of individual components of the drug. The recommended initial dose of lisinopril for uncomplicated renal failure is 5-10 mg.

Previous diuretic therapy: Symptomatic hypotension may occur after the initial dose of the drug. Such cases are more common in patients who have had fluid and electrolyte loss due to previous diuretic treatment. Therefore, you should stop taking diuretics 2-3 days before starting treatment with Lisoretic

Overdose

Symptoms:  marked decrease in blood pressure.

Treatment:  induce vomiting and / or gastric lavage, symptomatic therapy aimed at correcting dehydration and disorders of the water-salt balance. In case of arterial hypotension, enter an isotonic solution. Control of urea, creatinine and electrolytes in the blood serum, as well as diuresis.

Special instructions

Most often, a marked decrease in blood pressure occurs with a decrease in BCC caused by diuretic therapy, a decrease in the amount of salt in food, dialysis, diarrhea or vomiting. Patients with chronic heart failure with or without concomitant renal failure may develop symptomatic hypotension. It is more often detected in patients with severe forms of heart failure, as a result of the use of high doses of diuretics, hyponatremia or impaired renal function. In such patients, treatment should be started under the strict supervision of a doctor. Such rules should be followed when prescribing to patients with CHD, cerebrovascular insufficiency, in which a sharp decrease in blood pressure can lead to myocardial infarction or stroke.

Influence on the ability to drive motor vehicles and manage mechanisms:

During treatment, patients should refrain from driving vehicles and engaging in potentially dangerous activities that require increased concentration and speed of psychomotor reactions, as dizziness is possible, especially at the beginning of the course of treatment.

Composition

Tablet Form of production

Storage conditions

Store in a dry place, protected from light, at a temperature not exceeding 25 °C

Shelf life

2 years

Active ingredient

Lisinopril, Hydrochlorothiazide

Conditions of release from pharmacies

By prescription

Dosage form

Tablets