Atasart-H 16mg/12.5mg Getz medicine for hypertension (4 blisters x 7 tablets)

Dosage form Box of 4 blisters x 7 tablets
Specifications Candesartan, hydrochlorothiazide
Ingredient High blood pressure

Ingredient

Composition informationContent
Candesartan16mg
Hydrochlorothiazide12.5mg

Uses

Indications

Atasart-H medicine is indicated for high blood pressure treatment. The drug in combination with the determined dosage is not indicated for the beginning of treatment.

Pharmacokology

Candesartan Cilexetil

Candesartan prevents vascular shrinkage and aldosteron effects of Angiotensin II by inhibiting Angiotensin II cohesion into the ATI receptor of multiple tissues such as blood vessel muscles and adrenal glands. Therefore, its impact depends on the synthesis of angiotensin II. The impact of the Renin - Angiotensin closing system with enzyme inhibitors, Angiotensin II biosynthetic inhibitors from Angiotensin I, widely used in the treatment of high blood pressure.

The enzyme inhibitor also inhibits Bradykinin, a reaction thanks to the catalyst of metabolic enzymes. Because Candesartan does not inhibit the conversion (Kininase II), it does not affect the response of Bradykinin. Candesartan does not cohesive as well as blockade other hormone receptors or important ion channels in the cardiovascular air conditioner.

hydrochlorothiazide

Hydrochlorothiazide is a thiazide diuretics, which affects the mechanism of electrolyte recovery in the renal tubules, directly increasing the excretion of sodium and chloride in the same amount.

Indirectly, the diuretic effect of hydrochlorothiazide reduces the volume of plasma, leading to increased plasma renin activity, increase aldosterone secretion, increase urine potassium and reduce serum potassium. Renin-Lostosterone bridge is regulated by Angiotensin II, so the combination with an Angiotensin II receptor antagonist tends to reverse the loss of potassium in combination with diuretic.

pharmacokinetic

absorption

Candesartan Cilexetil

The absolute bioavailability of Candesartan is about 15%. After oral medication, plasma concentration is achieved after 3 to 4 hours. Fat -rich foods do not affect the bioavailability of Candesartan.

hydrochlorothiazide

Hydrochlorothiazide is not completely absorbed but quite fast through the digestive tract. Plasma peak concentration reaches 60 to 120 minutes. The level of absorption increases when used with food.

distribution

Candesartan Cilexetil

After using single dose, restoring, pharmacokinetics of linear cantesartan with a dose of up to 32mg of Candesartan Cilexetil. Candesartan and its inactive metabolites are not accumulated in the body when repeating the dose once a day. The distribution volume of Candesartan is 0.13L/kg. The cohesion rate of Candesartan with high plasma proteins (> 99%), the drug does not penetrate the red blood cells. Protein cohesion does not change when Candesartan levels in plasma are higher than the recommended dose.

hydrochlorothiazide

Hydrochlorothiazide prioritizes cohesion to red blood cells. Drugs through placenta and distribution into milk.

transformation

Candesartan Culilil

Candesartan Cilexetil has a biological and completely biological available by ester hydrolysis in the process of absorption from the stomach-intestine, selecting AT1 on Angiotensin II receptor antagonist. Candesartan metabolizes a small part of the liver through the 0-Dethyl path turned into an inactive metabolic substance.

hydrochlorothiazide

Hydrochlorothiazide is not metabolized but quickly excreted through the kidneys.

Elimination

Candesartan Cilexetil

After taking Candesartan oral, about 26% of the dose is excreted in the form of unchanged urine. The total clearance of the plasma of Candesartan is 0.37ml/min/kg, with glomerular clearance of 0.19ml/minute/kg. The sale time of Candesartan is about 9 hours.

hydrochlorothiazide

hydrochlorothiazide excreted in the form of unchanged urine, about 50% of the dose for the first 12 hours and 70% after 4 days. About 11-25% of the dose found in feces. Hydrochlorothiazide waste time is 5 -15 hours.

Before taking Atasart-H 16mg/12.5mg Getz medicine for hypertension (4 blisters x 7 tablets)

How to use

Take the tablet with a glass of water. Can be taken with food or not.

Dosage

The starting dose is 1 tablet/day can be used with or not with food.

To minimize the side effects due to the dose, only start using Atasart-H combination therapy when the single-treatment therapy does not achieve the desired effect.

Determine the dose

A patient who does not control blood pressure at the dose of hydrochlorothiazide 25mg x 1 time/day can be more positive with coordination Candesartan cilexetil/hydrochlorothiazide, a patient who controls the blood pressure with the dose of hydrochlorothiazide 25mg x 1 time/day, but there is signs of reduced hypotension, it is possible Culiletil/Hydrochlorothiazide, which will help control blood pressure similar to hydrochlorothiazide and help potassium more stable.

Patients with renal failure

Candesartan cilexetil/hydrochlorothiazide treatment mode can be applied when creatinine clearance> 30ml/min.

Patients with liver failure

Candesartan Culleil hydrochlorothiazide treatment can be applied to patients with mild liver failure. In patients with liver failure, the medium level needs to be considered for the use of Candesartan Cilexetil with a low starting dose like 8mg. If it is necessary to use the lower dose of Candesartan Culilil, it is not advisable to start treatment with Candesartan Cilexetil/Hydrochlorothiazide.

Dosage can be adjusted by age and symptoms.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? In the case of overdose (using up to 672mg of Candesartan Cilexetil), the patient's recovery has no important effect.

The main manifestations caused by hydrochlorothiazide overdose are dehydration and provincial electrolytes. It is also possible to observe symptoms such as dizziness, hypotension, thirst, tachycardia, ventricular arrhythmia, drowsiness.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Atasart-H medicine, you may experience unwanted effects.

Side reactions have been reported when using Candesartan Cilexetil/Hydrochlorothiazide is usually mild, transient and rarely required to stop treatment.

Normal reaction: back pain, dizziness, symptoms like colds, headaches, upper respiratory tract infections.

Less occurs: abdominal pain, change of urine volume, increased sweating, abnormal thirst, to be tired, digestive disorders, erratic temperament.

Rarely occurs: Prolonged throat, cough, fever, abnormal fatigue, bleeding or abnormal bruises on the skin, skin and pale eyes, dark urine, chest pain, non -regulating heartbeat, joint pain.

Notice the doctor the side effects encountered when taking the drug.

Instructions on how to handle

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Atasart-H Contrain to the following cases:

  • Patients with hypersensitivity to any ingredients of the drug.
  • Patients with indigestion or hypersensitivity to other derivatives of sulfonamide.

    • Simultaneously used with other anti -blood pressure drugs such as dofetilide.

  • Patients with severe renal failure.

    • Precautions when used

    Low blood pressure in patients with salt loss and reduced fluid volume.

    Patients with renin - angiotensin system, such as salt loss patients and fluid volume (for example, patients who have been treated with diuretics) may occur symptoms of lowering blood pressure. These symptoms should be resolved before taking Candesartan Cilexetil Hydrochlorothiazide, or treated under close supervision.

    Candesartan Cilexetil

    Renal failure: Because of the inhibition of the reninangiotensin - aldosterone system of the drug, it is necessary to anticipate changes in renal function on individuals treated with Candesartan Culilil. Be careful when taking the drug in treatment. In studies of enzyme inhibitors transferred in patients with kidney stenosis on the one side or on both sides, there is a report on increased plasma or bun -bun creatinine. Candesartan Culilil has not been used for a long time in patients with kidney stenosis on one side or both sides, but similar symptoms may occur.

    hydrochlorothiazide

    Patients with liver failure: Caution should be used carefully in thiazide diuretics in patients with liver or liver disease 1 progressive because of the minor change of water and electrolytes can cause liver coma.

    Patients with renal impairment: Caution should be used for thiazide diuretics in patients with severe renal failure. In patients with kidney disease, Thiazide can cause hyperur with hyperemia. The accumulated effect of the drug can develop in patients with renal function.

    Hypersensitivity reactions: Hypersensitivity reactions to hydrochlorothiazide can occur in patients with or without a history of allergies or asthma, but more likely to occur for patients with these history.The report shows that hydrochlorothiazide can worsen or activate systemic lupus erythematosus.

    Should regularly check the serum electrolyte to detect electrolyte imbalance.

    Thiazide drugs can reduce calcium secretion. Thiazide can also increase slightly and not continuously serum calcium concentration, no signs of knowledgeable calcium metabolic disorders. Significant hypercalcemia may be a hidden sign of the parathyroid gland syndrome, and stop using Thiazide before conducting parathyroid function tests.

    Use for children: The effect and safety of the drug in children are not known.

    Powering and operating machinery

    Candesartan Cilexetil Hydrochlorothiazide hardly affects the ability to drive and operate machinery, but it should be noted that dizziness or fatigue may occur during hypertension treatment.

    Pregnancy

    When used in pregnant women in the middle of the middle and late pregnancy, the drug can act directly on the renin-angiotensin system so it can cause damage and death for the fetus. Therefore, when you know pregnant, you must stop taking the drug as soon as possible.

    Breastfeeding period

    hydrochlorothiazide excreted into breast milk, but it is not known whether Candesartan Cilexetil will excrete in milk. Because strong side effects on children's emulsion, it is advisable to calculate whether to stop taking the drug or stop breastfeeding depending on the importance of the drug for the mother.

    Drug interaction

    Candesartan Cilexetil

    Candesartan culexetil is negligible by the Cytochrom P450 enzyme system and at the dose of treatment without the P450 fermentation effect, so there is no interaction with the inhibited or metabolic drugs by these enzymes.

    There is no significant interaction reported in the studies of Candesartan Culexetil with other drugs such as Glyburide, Nifedipine, Digoxin, Warfarin, Hydrochlorothiazide and oral contraceptives in healthy volunteers.

    Because of the enzyme inhibitor and Angiotensin receptor blockers, including Candesartan Culilil, can increase the concentration of potassium in the blood. Hence should be cautious when using candesartan

    cilexETIL with other drugs may increase blood potassium concentration such as spironolactone and potassium supplements.

    There is an increase in plasma lithium concentration during the time of using lithium with Candesartan Culilil, so be careful to monitor plasma lithium concentration when using these two drugs simultaneously.

    hydrochlorothiazide

    Used with the following drugs can cause drug interaction with hydrochlorothiazide:

  • Alcohol, barbiturate or narcotic: can cause vertical hypotension.
  • Diabetes (oral or insulin medications): The dose of diabetes should be adjusted.
  • cholestyramine and Colestipol Resim: Single dose of cholestyramine or colestipol resin will be associated with hydrochlorothiazide and reduce the absorption of gastrointestinal drugs to 85% and 43%.
  • corticosteroid, ATCH: causing intense electrolyte imbalance, especially hypokalemia.
    • pressor amine (norepinephrine): can reduce response to pressors amine but do not need to quit medication,
  • Tubocurarine: may increase the response of muscle relaxants.

    • lithium: hydrochlorothiazide can reduce lithium clearance in the kidney so it can cause the risk of lithium poisoning.

    NSAID: When using Candesartan Cilexetil Hydrochlorothiazide with nonsteroidal anti -inflammatory drugs, patients should be closely monitored to determine whether to achieve the desired diuretic effect.

    Storage

    Leave a cool place, avoid light, temperatures below 30⁰C.

    To be out of reach of children.

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