Combined medication. It has a diuretic and hypotensive effect. Contains equipoise cycle – a thiazide diuretic, diuretic effect which is associated with impaired reabsorption of sodium, chlorine, potassium, magnesium, water in the distal nephron: delays the excretion of calcium, uric acid. It has antihypertensive properties;hypotensive action develops due to the expansion of the arterioles. It has no effect on normal blood pressure. The diuretic effect of equipoise cycle occurs within 1-2 hours, reaches a peak after 4 hours and lasts 6-12 hours. The antihypertensive effect occurs within 3-4 days, but in order to achieve optimal therapeutic effect may require 3-4 weeks. Triamterene – potassium-sparing diuretic, reduces the permeability of cell membranes of distal tubules to sodium ions and increases their excretion in the urine without increasing the excretion of potassium ions. The secretion of potassium ions in the distal tubule decreases. In combination with equipoise cycle triamterene can reduce hypokalemia caused by thiazide diuretics and enhance the diuretic effect of equipoise cycle. Diuretic action triamterena after ingestion observed after 15-20 minutes. The maximum effect – in 2-3 hours, duration -12 hours.
The pharmacokinetics of equipoise cycle is absorbed from the gastrointestinal tract is incomplete (60-80% of an oral dose), but pretty quickly.Communication with plasma proteins – 40%, the apparent distribution volume – 4.3 l / kg. equipoise cycle Maximum concentration in blood plasma of 2 ug / ml. The half-life – about 3-4 hours. equipoise cycle is not subject to significant metabolism. The primary way its elimination is renal excretion (filtration and secretion) unchanged drug. equipoise cycle crosses the placental barrier. Triamterene quickly, but not completely (30-70%) of the dose absorbed from the gastrointestinal tract. Moderate (67%) bound to plasma proteins. Maximum plasma concentration is achieved after 2-4 h. Bio transformed in the liver to form both active and inactive metabolites. The half-life of the drug normally is 1.5-2 h (anuria -10 h), metabolites -. 12 hours main route of elimination triamterena bile and feces, the secondary – the kidneys.
- edematous syndrome of different genesis (chronic heart failure, nephrotic syndrome, cirrhosis);
- arterial hypertension.
Hypersensitivity to the drug (including to sulfonamides), chronic renal failure, anuria, acute glomerulonephritis, severe hepatic insufficiency, precoma, hepatic coma, hyperkalemia, lactation, age 18 years (effectiveness and safety have been established), I trimester of pregnancy.
with care – diabetes, gout, patients with impaired liver and / or kidney disease, folic acid deficiency (in patients with cirrhosis of the liver).
Dosage and administration.
Inside, not liquid, squeezed small amounts of water after eating. When edema initial dose is determined by the severity of violations of water-electrolyte metabolism and is usually 1 tablet 2 times a day after meals, then the dose may be increased to a maximum daily (3 tablets a day): 2 tablets after breakfast and 1 tablet after lunch. If compensation of swelling switching to maintenance therapy 1-2 tablets after 1 -2 days.
When hypertension – an initial dose of 1 tablet per day (in the morning, after breakfast), then gradually increase the dose. The maximum daily dose – 4 tablets. In patients with impaired renal function (creatinine clearance -. 30-50 ml / min) the maximum daily dose -1 tablet.
Fatigue, muscle weakness, cramps, palpitations, marked reduction of blood pressure, rarely thrombosis, embolism, increased urea, nephrolithiasis, dry mouth, thirst, pain or discomfort in the epigastric region, nausea, vomiting, abdominal pain, spastic nature , constipation, diarrhea, jaundice, hemorrhagic pancreatitis, acute cholecystitis, an increase of myopia, hyponatremia, hypomagnesemia, hyposalemia, hypo- or hyperkalemia, hypercalcemia, hyperuricemia, gout exacerbation, hypertriglyceridemia, impaired glucose tolerance, hyperglycemia, sometimes anemia, allergic reactions: redness skin, itching, hives.
Overdose. Symptoms : marked reduction of blood pressure. Treatment : symptomatic.
Interaction with other drugs.
Drugs extensively bind to proteins of blood (indirect anticoagulants, clofibrate, non-steroidal anti-inflammatory drugs) increase the diuretic effect of the drug.
The hypotensive effect reinforce vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, ethanol.
Apo-triazido enhances neurotoxicity equipoise cycle salicylates, reduces the effect of oral hypoglycemic drugs, norepinephrine, epinephrine and protivopodagricakih funds, it enhances the effects (including spin), cardiac glycosides, cardiotoxic and neyrotokeicheskoe action lithium curariform effects of muscle relaxants, reduces excretion of quinidine. At the same time taking methyldopa increased risk of hemolysis.Cholestyramine reduces absorption of Apo-triazido.
Hlorpropamid while admission to Apo-triazido may cause severe hypokalemia.
In combination with non-steroidal anti-inflammatory drugs may develop acute renal failure.
Prolonged use of Apo-triazido necessary to monitor blood levels of potassium ions, sodium, chloride, urea, creatinine, glucose, uric acid, peripheral blood (suspected folate deficiency).
At the start of treatment to avoid potentially hazardous activities that require increased attention and psychomotor speed reactions (due to lower blood pressure – slowing of psychomotor reactions). Do not take two doses at the same time, if the drug has been omitted.
Release form for filling and hospitals : In 1000 tablets in bottles of high density polyethylene (HDPE) white paper sealed with laminate floors, plastic screw cap. In the case of packing of the Russian enterprises : 50 tablets in bottles LDPE. Tablets on top put the swab of cotton wool Medical absorbent or polymer shock absorbers. 1 bottle with equipoise cycle instruction on the medical application in a cardboard box. 10 tablets in blisters of PVC foil and aluminum foil; 5 contour cell packages with instruction on the medical application in a cardboard box. online anabolic steroids pharmacy
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