Arifam 1.5mg/5mg 30 tablets — Made in France — Free Delivery
(Arifam )
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Description Arifam 1.5mg/5mg 30 tablets — Made in France — Free Delivery
Pharmachologic Effect
Antihypertensive combination preparation (calcium channel blocker + diuretic).
Amlodipine is a calcium ion influx inhibitor, a dihydropyridine derivative (slow calcium channel blocker or calcium ion antagonist) that inhibits the transmembrane influx of calcium ions into cardiomyocytes and vascular smooth muscle cells. The mechanism of the antihypertensive action of amlodipine is due to a direct relaxing effect on vascular smooth muscle.
Indapamide is a sulfonamide derivative with an indole ring, belonging to the pharmacological group of thiazide-like diuretics. Acts by decreasing sodium reabsorption in the cortical segment of the nephron loop. Indapamide increases the excretion of sodium and chloride in the urine and, to a lesser extent, the excretion of potassium and magnesium, thereby increasing urine output and exerting an antihypertensive effect.
Indication for use
Arterial hypertension in patients requiring therapy with amlodipine and indapamide.
Methods of administration and dosage
Inside, 1 tablet 1 time / day, preferably in the morning. The tablet must be swallowed without chewing and drinking water.
Contraindications
- severe renal failure (CC <30 ml / min);
- severe hepatic impairment or hepatic encephalopathy;
- hypokalemia;
- severe hypotension;
- shock (including cardiogenic shock);
- obstruction of the left ventricular outflow tract (eg, high-grade aortic stenosis);
- heart failure after acute myocardial infarction with unstable hemodynamics;
- galactose intolerance, lactase deficiency or glucose-galactose malabsorption (since the preparation contains lactose);
- lactation period;
- children under 18 years of age;
- hypersensitivity to active substances, other sulfonamides, dihydropyridine derivatives or any of the excipients.
Special instructions
If liver function is impaired, thiazide-like diuretics can cause hepatic encephalopathy, especially in the case of electrolyte imbalance. Due to the presence of indapamide in the development of this phenomenon, the use of the preparation Arifam should be discontinued immediately.
Cases of photosensitivity reactions are described when taking thiazide and thiazide-like diuretics (see the section "Side effects"). If a photosensitivity reaction occurs during treatment, it is recommended to discontinue treatment. If reappointment of a diuretic is deemed necessary, it is recommended to protect exposed parts of the body from exposure to the sun or artificial ultraviolet rays.
The safety and efficacy of amlodipine in hypertensive crisis have not been established.
Due to the presence of indapamide, it is necessary to control the blood glucose level in patients with diabetes mellitus, especially in the presence of hypokalemia.
Patients with heart failure should be treated with caution. In a long-term, placebo-controlled study in patients with severe heart failure (NYHA Class III and IV), the incidence of pulmonary edema was higher in the amlodipine group than in the placebo group.
Calcium channel blockers, incl. amlodipine should be used with caution in patients with congestive heart failure as they may increase the risk of cardiovascular events and death.
Thiazide and thiazide-like diuretics are fully effective only in case of normal or slightly impaired renal function (plasma creatinine level is below 25 mg / l, i.e. 220 μmol / l in adult patients). In elderly patients, normal plasma creatinine levels should be calculated based on age, body weight and gender.
At the beginning of treatment, patients may experience a decrease in GFR due to hypovolemia, which, in turn, is caused by the loss of water and sodium ions while taking diuretic preparations. This can lead to an increase in the concentration of urea and creatinine in the blood plasma. This transient functional renal failure is not clinically significant in normal renal function, but may exacerbate pre-existing renal failure.
In patients with renal insufficiency, amlodipine can be used in usual doses. Changes in the concentration of amlodipine in blood plasma do not correlate with the degree of renal dysfunction. Amlodipine is not eliminated from the body through dialysis.
The effects of the combined preparation Arifam in renal impairment have not been studied. In case of impaired renal function, the dose of the preparation should be selected taking into account the content of individual components.
Due to the presence of indapamide in patients with hyperuricemia, the risk of developing gout attacks may increase.
Arifam® has a small or moderate effect on the ability to drive vehicles and work with mechanisms.
Amlodipine has little or moderate effect on the ability to drive vehicles and work with mechanisms. If patients receiving amlodipine experience dizziness, headache, fatigue, or nausea, the ability to respond may be impaired. Caution is advised, especially at the beginning of treatment.
Indapamide does not affect alertness, but in some cases, various reactions associated with a decrease in blood pressure may occur, especially at the beginning of treatment or when another antihypertensive preparation is added. As a result, the ability to drive vehicles and work with mechanisms may be impaired.
Storage conditions
The preparation should be stored out of the reach of children at a temperature not exceeding 30 ° C.
Tags: Arifam
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