MicardisPlus 80mg/12.5 28 tablets — Made in Greece — Free Delivery

Mikardis Plus is an antihypertensive preparation. It is a combination of telmisartan (an angiotensin II receptor antagonist) and hydrochlorothiazide (a thiazide diuretic). The simultaneous use of these components leads to a greater antihypertensive effect than the use of each of them separately. Taking MikardisPlus® 1 time / leads to a significant gradual decrease in blood pressure.

Telmisartan is a specific angiotensin II receptor antagonist. It has a high affinity for the AT1 subtype of angiotensin II receptors, through which the action of angiotensin II is realized. Telmisartan displaces angiotensin II from binding to the receptor, without having an agonist effect on this receptor. Telmisartan binds only to the AT1 angiotensin II receptor subtype. The bond is long lasting. Telmisartan has no affinity for other receptors (including AT2 receptors) of angiotensin. The functional significance of these receptors, as well as the effect of their possible excessive stimulation with angiotensin II, the concentration of which increases with the appointment of telmisartan, have not been studied. Telmisartan leads to a decrease in the level of aldosterone in the blood. Telmisartan does not block blood renin and ion channels, does not block ACE, does not inactivate bradykinin.

In patients with arterial hypertension, telmisartan reduces systolic and diastolic blood pressure without affecting heart rate.

Telmisartan 80 mg completely blocks the hypertensive effect of angiotensin II. Its action lasts more than 24 hours, including the last 4 hours before taking the next dose. The onset of the hypotensive effect is noted within 3 hours after the first telmisartan administration. In the case of abrupt withdrawal of telmisartan, blood pressure gradually returns to the initial level without the development of a "withdrawal" syndrome.

Hydrochlorothiazide is a thiazide diuretic. Thiazide diuretics affect the reabsorption of electrolytes in the renal tubules, directly increasing the excretion of sodium and chloride (in approximately equivalent amounts). The diuretic effect of hydrochlorothiazide leads to a decrease in the BCC, an increase in plasma renin activity, an increase in the secretion of aldosterone and is accompanied by an increase in the content of potassium and bicarbonates in the urine, as well as hypokalemia. With the simultaneous administration of telmisartan, there is a tendency to stop the loss of potassium caused by these diuretics, presumably due to the blockade of the RAAS.

Long-term use of hydrochlorothiazide reduces the risk of developing complications of cardiovascular diseases and mortality from them.

After taking hydrochlorothiazide, diuresis increases after 2 hours, and the maximum effect is observed after about 4 hours. The diuretic effect of the preparation lasts for about 6-12 hours.

The maximum antihypertensive effect of MikardisPlus® is usually achieved 4 weeks after the start of treatment.

The combined use of hydrochlorothiazide and telmisartan does not affect the pharmacokinetics of each of the components of the preparation.

Telmisartan

When taken orally, Cmax of telmisartan is achieved within 0.5-1.5 hours after application. The absolute bioavailability of telmisartan at doses from 40 to 160 mg was 42% and 58%, respectively. When taken simultaneously with food, the bioavailability of telmisartan slightly decreases with a decrease in the AUC value by 6% at a dose of 40 mg and about 19% at a dose of 160 mg. After 3 hours after ingestion, the concentration in the blood plasma levels off, regardless of whether the preparation was taken with food or on an empty stomach. The pharmacokinetics of telmisartan when administered orally is nonlinear at doses of 20-160 mg with a more than proportional increase in plasma concentrations (Cmax and AUC) with increasing doses.