Cancetro Plus Shinpoong Deawoo treatment drugs for hypertension (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Hydrochlorothiazid, candesartan cilexetil
Ingredient DP Shinpoong Daewoo Company Limited

Ingredient

Thành phần cho 1 viên

Composition information	Content
Hydrochlorothiazid	12.5mg
Candesartan Culilil	16mg

Uses

Indications

cancetil plus 16mg/12.5mg used in the treatment of hypertension (do not recommend the combination form for initial treatment).

Pharmacokic

Candesartan Ciulinei is an ARB (Angiotensin II receptor blockers). Candesartan CilexETIL is pre -pharmaceutical, has very little pharmacological effects until hydrogenated during the absorption process in the gastrointestinal tract and forming Candesartan, active substance. Cilexetil salt formula increases the bioavailability of Candesartan. ARBs the physiological impact locks of Angiotensin II, including the effects of vascular contractions and excretion of Aldosterone, by selectively inhibiting the cohesion of Angiotensin II into the AT1 receptor in many tissues, including blood vessel smooth and adrenal glands. When comparison, the enzyme inhibitors of Angiotensin (ACE, Kinase II) have the effect of locking the shift of angiotensin I into angiotensin II; However, the formation of Angiotensin II is not completely inhibited because vascular CO hormones can be formed through other enzymes without being subject to the inhibition of ACEI. The ARBS does not inhibit ACE, does not affect the response of Bradykinin and P; Should not cause side effects related to Acei (such as dry cough), but may have to sacrifice the effect of protecting the kidneys and/or cardiovascular.

hydrochlorothiazid is a thiazid diuretic, increasing the secretion of sodium chloride and water attached to the mechanism of inhibiting the reabsorption of sodium and chloride ions in the distance. HCTZ has the effect of lowering blood pressure, which is probably due to a decrease in plasma volume and extracellular fluids related to sodium dollar cards. Thiazids have a moderate diuretic effect, because about 90% of sodium ions have been reabsorbed before reaching the distance (the main position of the drug). The hypotension effect of HCTZ is shown slowly after 1 - 12 weeks, while the diuretic effect occurs quickly and can be seen right after a few hours. HCTZ increases the effects of other antihypertensive drugs.

Dynamic pharmacokinetics

After drinking, the bioavailability of Candesartan Cilexeter is approximately 14%. CMAX peak concentration is reached after about 3-4 hours. Candesartan's bioavailability is not affected by food. Candesartan binds over 99% of plasma proteins. The drug is excreted mainly in the form of unchanged and urine. Half life is approximately 9 hours. There is no accumulation of drugs when repeating the dose.

After drinking, HCTZ is quickly absorbed. The absorption level is approximately 65 - 75% of the dose. HCTZ accumulated in red blood cells, through the placenta and excreted through the kidneys (mainly in the form of non -metabolic). Half life is about 9.5 - 13 hours (may last longer when renal failure and need to reduce the dose). The diuretic effect appears after 2 hours of taking the drug, reaching a maximum after 4-6 hours and lasts for approximately 12 hours. Hypotension effects appear later (after 2 weeks) and often achieved optimal at 12.5 mg.

Before taking Cancetro Plus Shinpoong Deawoo treatment drugs for hypertension (3 blisters x 10 tablets)

How to use

cancetil plus 16mg/12.5mg oral.

Take the same or not with food, can combine other antihypertensive drugs. To minimize the side effects related to the dose, it is advisable to only combine the drug if it does not achieve the desired effect when single treatment. It is possible to combine the drug instead of adjusting the dose of each ingredient.

Dosage

The recommended starting dose is 1 tablet/day in people who do not impair the volume of fluid. Can increase the dose to a maximum of 2 tablets/day.

Hydrochlorothiazid (HCTZ) is effective at 12.5 - 50 mg x 1 time/day.

Should adjust the clinical effect. Maximum hypotension effect, corresponding to any dose, can be achieved after 4 weeks of using that dose.

It is not recommended to use drugs when the clearine clearance (CLCR) is below 30 ml/min.

Average liver failure: It is not recommended to use the drug to start treatment because it is impossible to achieve the appropriate starting dose of Candesartan of 8 mg.

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 do

do when overdose? For HCTZ, the common symptom is to reduce electrolytes (potassium lowering, chloride lowering, sodium lowering) and dehydration due to excessive diuretic. If used with digitalis, the lower potassium can cause arrhythmia.

When dealing with overdose, it is advisable to consider the possibility of overdose of many drugs, drug interactions and pharmacological changes in patients. If the hypotension occurs symptoms, it is advisable to apply supportive treatment. Candesartan is not eliminated when dialysis. The level of elimination of HCTZ when dialysis has not been determined.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 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

General: fatigue, chest pain, peripheral edema, weakness, back pain, influenza symptoms; dizziness, dizziness, paresthesia, reducing sensation; Depression, insomnia, anxiety.

Digestive: Nausea, abdominal pain, diarrhea, indigestion, gastritis - intestines, vomiting; Pancreatitis, jaundice, salivary gland inflammation, cramps, constipation, stomach stimulation, anorexia; Abnormal liver function, increased transaminase, hepatitis.

Respiratory: bronchitis, sinusitis, sore throat, cough, rhinitis, shortness of breath.

musculoskeletal joints: joint pain, muscle pain, joint damage, arthritis, cramps in the legs, scoundreled nerve pain, muscle pepper (rare); Mechanical spasm.

Metabolism: hyperuricemia, hyperglycemia, potassium and sodium, bun and creatin phosphokinase.

Urinary tract infection, urinary tract, blood, cystitis.

Cardiovascular: tachycardia, broken chest drum, ventricular extra, slow heartbeat, angina, myocardial infarction and angioedema; Abnormal ECG.

Skin: eczema, sweat, itching, dermatitis, rash, urticaria; Diverse erythematosus, Stevens-Johnson syndrome, flaking dermatitis, poisoned epidermal necrosis, hair loss.

Blood: Nosebleeds, neutropenia, leukopenia, grain leukemia; Anemia, leukopenia, hemolytic anemia, thrombocytopenia.

immune: infection, viral infection.

Hypersensitivity: Anaphylaxis, vasculitis, respiratory failure (including pneumonia, pulmonary edema), light sensitivity, urticaria, hemorrhage.Other: conjunctivitis; tinnitus; fade through the eyes, seeing yellow; helpless.

Warnings

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

Contraindicated

cancetil plus 16mg/12.5mg contraindicated in the following cases:

Hypersensitivity to candesartan, hydrochlorothiazid, other sulfonamid derivatives or any ingredients of the drug. Remove the road.

Caution when using

may occur symptomatic hypotension, especially when the fluid volume is reduced and/or salt due to prolonged diuretic, diet that limits salt, dialysis, diarrhea or vomiting. At that time, it is necessary to temporarily reduce the dose or restore the fluid volume. It is necessary to restore the reduction of fluid volume and/or salt before treatment.

In people with heart failure, the drug can cause excessive hypotension, leading to urinary disruption, blood nitrogen, acute renal failure and death (but rare). Should start treatment under close supervision, especially in the first 2 weeks and when increasing the dose.

Monitor periodic renal function during treatment. People with renal function depend partly on the operation of the Renin - Angiotensin (RAS) system (RAS) (Kidney artery stenosis, chronic kidney disease, severe heart failure, impaired fluid impairment) may be at risk of urinary tract, progressive blood nitrogen or acute renal failure. Consider continuing or stopping drugs in people with significant kidney failures.

Candesartan can cause hyperkalemia. HCTZ can cause potassium and blood sodium. Should monitor serum electricity periodically. Avoid shared, as much as possible, with potassium supplements or potassium -containing salts.

HCTZ can cause a specific reaction, resulting in an acute transparent myopia and an increased glaucoma of acute angle. Symptoms include sudden or eye pain reduction, often occurs when the drug is first started, within a few hours or weeks. If the above symptoms occur, HCTZ should be stopped as soon as possible.

Hypersensitivity reactions with HCTZ may occur, especially in people with a history of allergies or bronchial asthma.

HCTZ may change glucose tolerance, increasing cholesterol and blood triglycerides. The drug may increase blood uric acid due to reduced clearance, which can cause serious increase in uric acid and gout in sensitive people.

Thiazids reduce calcium secretion in the kidneys and can cause a slight increase in blood calcium. Avoid using drugs in patients with blood calcium.

Thiazid can activate or exacerbate the system erythema.

The effect of the drug on driving and operating machinery

has not been conducted. However, dizziness can occur.

Use drugs for women during pregnancy and lactation

do not recommend using Candesartan and HCTZ in the first 3 months of pregnancy. Contraindicated use of Candesartan in the middle of the 3 months and the end of pregnancy. When detecting pregnancy, the drug should be stopped immediately, and use other alternative therapy if possible.

HCTZ excrete small amounts into breast milk. It is not recommended to use HCTZ and Candesartan when breastfeeding. Consider stopping the drug or stop breastfeeding and the importance of the drug for the mother.

Drug interaction

Interacting with Candesartan Culilil and HCTZ

Non-steroid anti-inflammatory drugs, including COX-2 selective inhibitors: can reduce the effect of lowering blood pressure and reducing recovery kidney function (including acute renal failure), especially in the elderly, reducing fluid volume or kidney function damage.

Lithi: Increasing the risk of toxicity of lithium toxicity (HCTZ can reduce the clearance of lithium and Candesartan can increase lithium concentration in serum).

Other antihypertensive drugs: Causing the combined effect.

Interaction with Candesartan Culilil

Angiotensin receptor blockers, Angiotensin (ACEI), Aliskiren inhibitors: Increases the risk of hypotension, hyperkalemia, renal function (including acute renal failure). Closely monitor blood pressure, kidney and electrolyte function when combining drugs that affect RAS.

Can be coordinated with beta blockers, diuretic, digitalis or coordination of these drugs. It is not recommended to coordinate with ACEI, potassium -saving dtered (such as Spironolacton) and should only be coordinated after careful evaluation of benefits and risks.

Potassium -saving diocesia, potassium supplements, potassium -containing salt, other drugs (such as heparin): can increase blood potassium.

Aliskiren: Do not coordinate in diabetes, avoid shared use in people with renal failure (GFR

Interaction with hydrochlorothiazid

alcohol, barbiturat, narcotic: can cause posture lowering.

Oral and insulin diabetes treatment: The dose of these drugs should be reduced.

Cholestyramine and Colestipol plastic: can reduce the absorption of HCTZ. HCTZ should be taken at least 4 hours in advance or after 4-6 hours of using the above plastic.

corticosteroid, ACTH: increases decrease in electrolytes (hypotension).

glycosidtim: Thiazid lower potassium or blood magnesium, easily causing arrhythmia due to digitalis.

Amines that cause hypertension (such as noradrenalin): reduce the effects of these amines.

TuboCurarin: Increases the effects of these drugs.

Gout medicine: Need to adjust these drugs.

Calcium salt: HCTZ can increase blood calcium due to excretion decrease.

Carbamazepin: Increasing risk of symptomatic sodium sodium.

Other: Beta, diazoxid blockers (hyperglycemia); Antilinergic drugs such as atropine, beeriden (can increase the bioavailability of thiazid due to reducing intestinal motility and stomach empty speed); Amantadin (thiazide increases the risk of side effects of amantadin); Cyclophosphamide, methotrexate (reduces the elimination of these drugs through the kidneys and increases the inhibition of the marrow).

Storage

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

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