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With the ability to selectively block the “slow” calcium channels, increases the elasticity of the artery walls and reduces the total peripheral vascular resistance. It helps to androlic side effects reviews reduce hypertrophy of the left ventricle of the heart. It did not affect carbohydrate metabolism (including patients with concomitant diabetes). Reduces the sensitivity of the vascular wall to norepinephrine and angiotensin II of, stimulates the synthesis of protaglandina , reduces the production of free and stable oxygen radicals. The hypotensive effect develops at the end of the first week, it lasts for 24 hours on a background of a single dose.

After intake of rapidly and completely absorbed from the gastrointestinal tract; bioavailability – high . Food intake slows down the absorption rate, but does not affect the amount of the absorbed compound.Maximum plasma concentration – 2.1 hours after oral administration. Repeated receptions fluctuations in drug concentration in blood plasma in the interval between receptions of two anadrol reviews doses reduced. The equilibrium concentration is set at 7 days of regular admission. The half-life – 18 hours, connection with blood plasma proteins. Associated also with elastin smooth muscles of the vascular wall. It has a high volume of distribution, passes through the blood-tissue barriers (including placental) passes into breast milk. It is metabolized in the liver. The kidneys remove 60-80% as metabolites (unchanged output of about 5%).through the intestine – 20%. In patients with renal insufficiency The pharmacokinetics does not change. Not accumulates.

Indications
Hypertension.

Contraindications:
Hypersensitivity to the drug and other sulfonamide derivatives, anuria, severe hypokalaemia liver (including with encephalopathy) and / or renal failure, pregnancy, lactation, age 18 years (effectiveness and safety have been established); concomitant use of drugs anadrol reviews prolonging the QT interval.
Be wary appoint diabetes in decompensation stage, hyperuricemia (especially accompanied by gout and urate nephrolithiasis).

Dosage and administration
The tablets are taken orally without chewing. The daily dose – 1 tablet (2.5 mg) a day (morning). If after 4-8 weeks of treatment is not achieved the desired therapeutic effect, the dose of the drug is not recommended to increase (increase in the risk of side effects without increasing the antihypertensive effect). Instead, the drug regimen is recommended to include another antihypertensive drug, which is not a diuretic. In cases where treatment is needed starting drugs remains Ionic dose of 2.5 mg once a day in the morning.

Side effect On the part of the gastrointestinal tract: nausea / anorexia, dry mouth, gastralgia, vomiting, diarrhea, constipation. From the nervous system: fatigue, nervousness, headache, dizziness, drowsiness, vertigo, insomnia, depression, rarely – fatigue, weakness, malaise, muscle spasm, tension, irritability, anxiety. From the senses : conjunctivitis, blurred vision. respiratory system: cough, pharyngitis, sinusitis, rarely – rhinitis. With the cardiovascular system: orthostatic hypotension, changes in the electrocardiogram (hypokalemia), arrhythmia, palpitations. From the urinary system: frequent infections, nocturia, polyuria. Allergic reactions: rash, urticaria, pruritus, hemorrhagic vasculitis. Laboratory tests – hyperuricemia, hyperglycemia, hypokalemia, hyposalemia, hyponatremia, hypercalciuria, increased blood urea nitrogen plasma hypercreatininemia, glycosuria. Others – flu-like symptoms, chest pain, back pain, infection, decreased potency, decreased libido, runny nose, sweating, weight loss, tingling in the extremities, pancreatitis, exacerbation systemic lupus erythematosus.

Overdosing
Symptoms: nausea, vomiting, weakness, impaired function of the gastrointestinal tract, water and electrolyte disturbance, in some cases – an excessive fall in blood pressure, respiratory depression. Patients with cirrhosis may develop hepatic coma. Treatment: gastric lavage, correction fluid and electrolyte balance, symptomatic therapy. No specific antidote.

Interaction with other drugs
Saluretics, cardiac glycosides, gluco-and mineralocorticoid, tetrakozaktid, amphotericin B (w / w), laxatives increase the risk of hypokalemia. When concomitantly with cardiac glycosides increases the likelihood of digitalis intoxication; with drugs Ca2 + – hypercalcemia; metformin -. possible worsening of lactic acidosis
increases the concentration of Li + ions anadrol reviews in the blood plasma (reduced excretion of urine), lithium has nephrotoxic effects.
astemizole, erythromycin, a / c, pentamidine, sultopride, terfenadine, vincamine, antiarrhythmics of class Ia (quinidine, disopyramide ) and class III (amiodarone bretilium, sotalol) can lead to the development of arrhythmia type “torsades de pointes”. Nonsteroidal anti-inflammatory drugs, glucocorticosteroid agents tetrakozaktid, sympathomimetic reduce the hypotensive effect of baclofen – intensifies. The combination with potassium-sparing diuretics may be effective in a certain category of patients, however, this is not completely exclude the possibility of the development of hypo- or hyperkalemia, especially in patients with diabetes and renal failure.
Angiotensin converting enzyme inhibitors increase the risk of hypotension and / or acute renal failure ( especially when existing renal artery stenosis).
Increases the risk of renal dysfunction when using iodine-containing contrast agents in high doses (dehydration). Before the use of contrast iodine-containing substances the patient is necessary to restore the loss of fluids.
Imipraminovye (tricyclic) antidepressants and antipsychotic drugs increase the hypotensive effect and increase the risk of orthostatic hypotension.
Cyclosporin increases the risk of hypercreatininemia.
Reduces the effect of indirect anticoagulants (coumarin derivatives or indandiona) due to increased concentration of clotting factors by reducing the volume of circulating blood and to increase their production by the liver (may require dose adjustment).
Enhances the blockade of neuromuscular transmission, developing under the influence of non-depolarizing muscle relaxants.

Cautions
Patients taking cardiac glycosides, laxatives, amid Gypea raldosteronizma, as well as in the elderly shows a content control. K + and creatinine.
While taking Ionica – should systematically monitor the concentration of K +, Na +, Mg2 + in the plasma (may develop electrolyte disturbances), pH, concentration of glucose, uric acid and residual nitrogen.
The most careful control shown in patients with liver cirrhosis (especially developed, with edema or ascites – the risk of metabolic alkalosis, increase the expression of hepatic encephalopathy), coronary heart disease, heart failure, as well as in the elderly. The group of high risk include patients with an increased QT interval on the electrocardiogram (congenital or develop on the background of a pathological process).
The first measurement of the concentration of K + in the blood should be held during the first week of starting treatment.
Hypercalcemia in patients receiving indapamide may be the result of previously undiagnosed hyperparathyroidism.
in patients with diabetes is extremely important to control blood glucose levels, especially in the presence of hypokalemia.
Significant dehydration can lead to acute renal failure (reduced glomerular filratsii). Patients need to compensate anadrol reviews for the loss of water and at the beginning of treatment carefully monitor renal function.
Ionic may give a positive result during the doping control. Patients with hypertension and hyponatremia (due to diuretics) must be 3 days before the beginning of the prima ingibitovov ACE stop taking diuretics (if necessary diuretic may be resumed later), either initially assign low doses of angiotensin converting enzyme inhibitors.
Sulfonamide derivative can exacerbate during system lupus erythematosus (must be borne in mind when assigning Ionica). The efficacy and safety in children has not been established.

Form release
tablets are coated; 10 or 30 tablets in blisters. On 1 blisters of 30 tablets or 3 blisters of 10 tablets along with instructions for use are placed in packs of cardboard.

Storage conditions
List B. In dry, dark place at a temperature no higher than 25 ° C. Keep out of the reach of children.

Shelf life
2 years.
Do not use beyond the expiration anadrol reviews date printed on the package.

Conditions of supply at the pharmacy
with a prescription.

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