Tenoric, pills 100/25, 28pcs

Composition

1 tablet contains:

Active ingredients:

atenolol 100 mg;

chlortalidone 25 mg.

Auxiliary substances:

corn starch,

lactose,

polyvinylpyrrolidone,

sodium lauryl sulfate,

talc,

isopropanol,

colloidal silicon dioxide,

magnesium stearate.

Composition of the film shell:

isopropanol, methylene chloride, hypromellose, talc, titanium dioxide, petrolatum oil, macrogol.

Pharmacological action

Tenorik is a combined antihypertensive drug that has a long-lasting antihypertensive effect. The effect is due to the action of two components: a beta-1-adrenoblocker (atenolol) and a diuretic (chlortalidone).

Atenolol is a cardioselective beta-1-adrenoblocker. Selectivity decreases with increasing dose. Atenol has no internal sympathomimetic and membrane-stabilizing effects. Like other beta-blockers, it has a negative inotropic effect, reduces heart rate.

Chlortalidone is a non-thiazide sulfonamide diuretic, increases the release of sodium and chlorine. Increases the release of potassium, magnesium, and bicarbonate.

The mechanism of antihypertensive action is probably related to sodium excretion. The combination of atenolol with diuretics is more effective than the use of each of the components separately.

Action of the drug Tenorik persists for 24 hours after a single oral dose in a daily dose.

Indications

Arterial hypertension.

Contraindications

• cardiac arrhythmias
• heart failure
• renal dysfunction
• pheochromocytoma
• hypersensitivity to the components of the drug Tenorik.

Side effects

Hyperuricemia, hypokalemia, impaired glucose tolerance, bradycardia, heart block, orthostatic hypotension, heart failure, cold extremities, intermittent claudication, Raynaud’s syndrome, confusion, mood swings, hallucinations, insomnia, nightmares, dry eyes, dyspeptic disorders and visual disorders, leukopenia, thrombocytopenia, purpura, alopecia, psoriasis, paresthesia, bronchospasm.

Interaction

Concomitant use of Tenorik with dihydropyridine derivatives (nifedipine) may increase the risk of hypotension, and patients with latent heart failure may show signs of circulatory disorders.

Cardiac glycosides in combination with beta-blockers can increase the time of AV conduction.

Beta-blockers can exacerbate rebound hypertension, which can occur after clonidine withdrawal. If both medications are prescribed, the beta-blocker should be discontinued several days before clonidine is discontinued. If it is necessary to replace clonidine with a beta-blocker, the latter should be prescribed several days after discontinuation of clonidine therapy.

Caution should be exercised when prescribing a beta-blocker in combination with Class I antiarrhythmics (disopyramide), as the cardiodepressive effect may be cumulative.

Concomitant use of sympathomimetic agents, for example, epinephrine( epinephrine), norepinephrine (norepinephrine) can neutralize the effect of beta-blockers and lead to a significant increase in blood pressure.

Salicylates and NSAIDs (ibuprofen, Indometacin), estrogens can reduce the hypotensive effect of beta-blockers, and when using salicylates in a high dose, the toxic effect of salicylates on the central nervous system may increase.

Lithium-containing medications should not be used with diuretics, as they may reduce the renal clearance of lithium.

The use of beta-blockers together with general anesthesia may lead to an increased risk of hypotension and the summation of the negative inotropic effect of both drugs (an anesthetic with minimal negative inotropic effect should be used). It is also possible to enhance the effect of curare-like muscle relaxants. When using Tenorik with MAO inhibitors, blood pressure may increase (this combination should be avoided).

When Tenorik is co-administered with ACE inhibitors (captopril, enalapril) at the beginning of therapy, a sharp increase in the antihypertensive effect may occur.

With the combined use of Tenorik with corticosteroids, amphotericin B, furosemide, it is possible to increase the excretion of potassium.

When combined with Tenorik, the effect of insulin and oral hypoglycemic agents may decrease (blood glucose levels should be monitored).

Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators, and other antihypertensive agents may enhance the antihypertensive effect of Tenorik.

The use of beta-blockers in combination with calcium channel blockers that have a negative inotropic effect, such as verapamil, diltiazem, can lead to an increase in this effect, especially in patients with reduced myocardial contractility and/or impaired sinoatrial or AV conduction, which can cause severe hypotension, severe bradycardia and heart failure (a calcium channel blocker should not be used intravenously for 48 hours after beta-blocker withdrawal).

With the simultaneous appointment of Tenorik with reserpine, clonidine, guanfacine, severe bradycardia may occur.

How to take, course of use and dosage

The dosage regimen is given in terms of atenolol.

The average dose of Tenorik for adults is 100 mg; the initial dose is 50 mg 1 time/day.

As a rule, the use of the drug in a dose corresponding to 100 mg of atenolol gives a good clinical effect. A subsequent increase in the dose either does not lead to a further decrease in blood pressure, or reduces it very slightly. If necessary, an additional antihypertensive agent may be prescribed.

In the elderly, the drug should be prescribed in lower doses.

Overdose

Symptoms: severe bradycardia, hypotension, acute heart failure, bronchospasm, convulsions, increased drowsiness.

Treatment: careful monitoring of the patient’s condition, if necessary – hospitalization in the ICU, gastric lavage, the use of activated charcoal and laxatives; with hypotension and shock-the introduction of plasma or plasma substitutes; with bronchospasm-the use of bronchodilators, with significant diuresis-the introduction of fluids and electrolytes. It is possible to perform hemodialysis or hemoperfusion.

Special instructions

Caused by the beta-blocker atenolol, which is part of Tenorik

Caution should be used in patients with grade I AV blockade.

It should be borne in mind that the use of the drug may mask the phenomena of thyrotoxicosis and hypoglycemia.

If the drug develops bradycardia (heart rate up to 50 beats/min) with clinical symptoms, the dose should be reduced or the drug should be discontinued.

Tenorik should not be abruptly discontinued in patients with CHD.

Smokers may experience a decrease in the therapeutic effect of the drug.

Special attention should be paid in cases where surgical intervention with general anesthesia is required. The drug should be discontinued 48 hours before surgery, and the drug with the minimum possible negative inotropic effect should be chosen as an anesthetic.

While taking the drug, it is possible to increase sensitivity to allergens and develop severe anaphylactic reactions, and therefore patients receiving desensitizing therapy should take the drug with great caution. Such patients may not respond to the average dose of epinephrine (epinephrine) used to treat allergic reactions. Caution should be used in patients with bronchial obstructive syndrome, and in case of deterioration of bronchial conduction, beta-adrenomimetics should be used.

When using atenolol, it is possible to reduce the production of tear fluid, which is important for patients using contact lenses.

Caused by the diuretic chlorthalidone, which is part of Tenorik

Hypokalemia may occur during the use of the drug. Serum potassium levels should be monitored, especially in patients receiving cardiac glycosides for the treatment of heart failure, in patients with an unbalanced diet (low in potassium), or in patients with complaints of gastrointestinal disorders. The development of hypokalemia in patients receiving cardiac glycosides may lead to arrhythmia.

The drug is used with caution in patients with impaired renal function.

Against the background of the use of the drug, a violation of glucose tolerance may occur. Caution should be exercised when prescribing the drug to patients with a predisposition to diabetes mellitus.

Against the background of the use of the drug, hyperuricemia may develop, usually insignificant, but in some cases it may be necessary to use agents that promote the excretion of uric acid.

Use in pediatrics

The efficacy and safety of Tenorik in children and adolescents under 18 years of age have not been established, so do not prescribe the drug to patients of this age group.

Influence on the ability to drive motor vehicles and manage mechanisms

The use of Tenorics, as a rule, does not affect the ability to drive vehicles and manage mechanisms. However, the possibility of driving a vehicle should be decided after evaluating the individual tolerability of the drug.

Form of production

Tablets

Storage conditions

In a dark place, at a temperature not exceeding 25 °C.

Active ingredient

Atenolol, Chlortalidone

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Purpose

For adults as directed by your doctor

Indications

Hypertension