Accuzide 20, 20mg/12.5mg 30 tablets — Made in Germany — Free Delivery
(Accuzide 20)
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Description Accuzide 20, 20mg/12.5mg 30 tablets — Made in Germany — Free Delivery
Product description
Tablets "Accuzide® 20" are used in essential hypertension, when it is impossible to provide adequate control of hypertension with quinapril alone.
Compound
One tablet contains (active ingredients) 21.664 mg of quinapril hydrochloride, equivalent to 20 mg of quinapril, and 12.5 mg of hydrochlorothiazide.
Excipients: lactose, monohydrate; magnesium carbonate; povidone K 25; crospovidone; magnesium stearate; Opadry pink OY-S-6937 (hypromellose, hydroxypropyl cellulose, titanium dioxide (E 171), macrogol 400, iron oxide red (E172), iron oxide yellow (E172)), candelilla wax.
Contraindications
hypersensitivity to the active substances or other components of the preparation, thiazides or sulfonamides (possible cross-reactions should be taken into account);
- a history of congenital / idiopathic angioedema, including those associated with previous therapy with ACE inhibitors (angiotensin-converting enzyme);
- combination with sacubitril / valsartan (due to an increased risk of developing angioedema);
- severe renal impairment (serum creatinine greater than 1.8 mg/dl or creatinine clearance less than 30 ml/minute);
- dialysis procedures;
- bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney;
- after kidney transplant;
- anuria;
- hemodynamically significant stenosis of the aortic or mitral valve or hypertrophic cardiomyopathy;
- decompensated heart failure;
- primary hyperaldosteronism;
- severe liver dysfunction (precoma / coma) or primary liver disease;
- clinically significant electrolyte imbalance (hypercalcemia, hypokalemia, hyponatremia);
- children's age (due to insufficient application experience);
- pregnancy;
- lactation.
Life-threatening hypersensitivity reactions have been observed during low-density lipoprotein apheresis (in severe hypercholesterolemia) with dextran sulfate and concomitant use of an ACE inhibitor.
Sometimes life-threatening hypersensitivity reactions (eg, low blood pressure, shortness of breath, vomiting, allergic skin reactions) may occur during treatment to reduce or eliminate the tendency to develop allergic reactions (desensitizing therapy) to insect toxins (such as bee or wasp stings) , and concomitant use of an ACE inhibitor. If low-density lipoprotein (LDL) apheresis or desensitization therapy for insect toxins is required, the preparation should be temporarily replaced with other antihypertensive preparations.
Dialysis or hemofiltration using high flow polyacrylonitrile membranes (e.g. "AN69") is contraindicated during therapy with Accuzid® 20, since during dialysis or hemofiltration there is a risk of developing hypersensitivity reactions (anaphylactic reactions), including life-threatening shock . If hemodialysis is necessary, the preparation should be changed to a preparation that is not an ACE inhibitor, or alternative dialysis membranes should be used.
The simultaneous use of the preparation "Accuzide® 20" and medicines containing aliskiren is contraindicated in patients with diabetes mellitus or impaired renal function (glomerular filtration rate (GFR) < 60 ml / min / 1.73 m2).
Mode of application
For oral use.
"Accuzide® 20" can be used regardless of the meal. All the indicated daily amount of the preparation must be taken in the morning (once) with plenty of liquid.
The strip on the tablet serves only to break it in order to facilitate swallowing, and not to divide it into equal parts.
The duration of use is determined by the doctor.
In general, the treatment of hypertension should be started with small doses of one active substance, and then gradually increase the dose.
Combination therapy with the preparation "Accuzide® 20" is recommended to start only after titrating the doses of individual components (quinapril and hydrochlorothiazide). In the presence of clinical indications, the possibility of an immediate transition from monotherapy to combination therapy should be considered.
Note. Since an excessive decrease in blood pressure is possible when the treatment regimen is changed from quinapril monotherapy to combination therapy with Accuzide® 20, including in patients with salt and / or fluid deficiency (for example, in case of vomiting, diarrhea, treatment with diuretics), severe arterial hypertension, patients should be monitored for at least 6 hours.
The usual dose for patients in whom combination therapy is indicated is one tablet of Accuzid® 20 (corresponding to quinapril 20 mg and hydrochlorothiazide 12.5 mg) in the morning. The maximum daily dose should not exceed one tablet of Accuzide® 20.
Application features
Drivers
Treatment of hypertension with this preparation requires regular medical supervision. Since some patients may experience adverse reactions such as drowsiness and dizziness, their ability to drive a car or other machinery may be impaired, especially at the beginning of treatment, when increasing the dose, when switching to another therapy, or when drinking alcohol.
Overdose
There are no specific data on overdose and treatment of overdose with the quinapril/hydrochlorothiazide combination.
Symptoms of overdose or intoxication
Depending on the degree of overdose, the following symptoms are possible: persistent diuresis, electrolyte imbalance, severe hypotension, consciousness disorders (with possible progression to coma), convulsions, paresis, cardiac arrhythmia, bradycardia, shock, renal failure, paralytic ileus.
Treatment of intoxication
The following immediate measures are recommended in the event of life-threatening angioedema involving the tongue, glottis and/or larynx: immediate subcutaneous injection of 0.3-0.5 mg epinephrine (e.g. 0.3-0.5 ml of a 1:1000 solution) or slow administration of 0.1 mg epinephrine (follow dilution instructions) under conditions of ECG and blood pressure monitoring and further systemic administration of glucocorticoids. In addition, the introduction of antihistamines and H2 receptor antagonists is recommended. In addition to the administration of epinephrine, a C1 inactivator can be administered in case of a known deficiency.
Therapeutic measures in case of overdose or intoxication depend on the method of application, time after application, type and severity of symptoms. In addition to general measures to eliminate the preparation "Accuzide® 20" (including gastric lavage, taking adsorbents and sodium sulfate within 30 minutes after taking the preparation"Accuzide® 20"), vital parameters should be checked and adjusted in intensive care . Quinapril and hydrochlorothiazide are not quantitatively excreted by dialysis.
If hypotension occurs, it is first necessary to restore the water-salt balance. If the reaction is insufficient, it is necessary to additionally inject catecholamines intravenously. Angiotensin II may also be considered.
In the case of sustained bradycardia, pacemaker therapy may be considered.
It is necessary to carefully monitor the indicators of water-electrolyte and acid-base balance, blood sugar levels, as well as substances that are excreted in the urine. In case of hypokalemia, potassium supplements should be used.
Side effects
During treatment with quinapril / hydrochlorothiazide, the following adverse reactions were observed very often (≥ 1/10) and often (from ≥ 1/100 to < 1/10).
Infections and invasions: often - viral infections, bronchitis, infections of the upper respiratory tract, pharyngitis, rhinitis.
On the part of the psyche: often - insomnia (partly due to a violation of the water and electrolyte balance).
Neurological disorders: often - dizziness, headache, drowsiness, apathy.
On the part of the organs of hearing and balance: often - vertigo.
From the side of the heart: very often - ECG changes and cardiac arrhythmia (caused by hypokalemia when taking hydrochlorothiazide); often - angina pectoris, tachycardia, palpitations.
From the side of the vessels: often - vasodilatation.
On the part of the respiratory system, chest organs and mediastinum: often - dry, irritating cough, cough.
From the gastrointestinal tract: often - vomiting, diarrhea, digestive disorders, discomfort in the upper abdomen, abdominal pain, nausea.
From the musculoskeletal system and connective tissue: often - back pain, muscle pain.
From the side of the kidneys and urinary tract: often - impaired renal function may occur or increase.
Storage conditions
Store in the original packaging at a temperature not exceeding 25°C, out of the reach of children.
Shelf life - 3 years.
Tags: Accuzide
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