Co-Trupril 20mg/12.5mg Getz drug treatment for mild and medium hypertension (2 blisters x 14 tablets)

Dosage form Box of 2 blisters x 14 tablets
Specifications Lisinopril, hydrochlorothiazide
Ingredient Getz Pharm (PVT)., Ltd - India

Ingredient

Composition information	Content
Lisinopril	20mg
Hydrochlorothiazide	12.5mg

Uses

Indications

co-trupril (lisinopril/hydrochlorothiazide) are indicated for mild and medium hypertension treatment in untrainwooded patients with single-treatment therapy.

Pharmacokic

Hydrochlorothiazide is a diuretics, increasing lenin activity in plasma, increasing aldosterone secretion and reducing potassium in plasma. Using Lisinopril inhibits the renin-analiotensinaldosterone system and tends to reverse the loss of potassium due to diuretics. Simultaneous use of Lisinopril and Hydrochlorothiazide does not have little effect on the bioavailability of each drug. The tablet combined with 2 components is equivalent to biological equivalent as simultaneously using 2 individual ingredients.

Mechanism of impact

lisinopril

Lisinopril's blood pressure lowering mechanism is mainly inhibiting the Rennin-Anotensin-Aldosterone system. Lisinopril hypotension even in hypertension patients with low rennin.

hydrochlorothiazide

The mechanism of treating hypertension of thiazide is not known. Thiazide usually does not affect normal blood pressure. Hydrochlorothiazide is a diuretics and treatment of hypertension. Thiazide affects the mechanism of reabsorption of electrolytes in the renal tubules, directly increasing the excretion of sodium and chloride in the same number. The diuretic activity of hydrochlorothiazide indirectly reduces plasma volume, increases the activity of lenin in plasma, increases aldosterone secretion, increases potassium discharge through urine, and decreased serum potassium. Renin-Lostosterone system is controlled by Angiotensin II, so combined with an Angiotensin II receptor antagonist tend to reverse potassium loss due to diuretics.

pharmacokinetic

lisinopril

absorption

Lisinopril absorbs slowly and not completely orally use. The average absorption of Lisinopril is approximately 25%, with a variation between patients about 6 - 60%.

Distribution

The peak concentration of plasma is reached after 7 hours. Lisinopril has been reported not to bind to plasma proteins.

Metabolism

The drug is excreted in the form of unchanged urine.

Elimination

Effective semi -canceling time due to the accumulation of drugs is 12 hours in people with normal kidney function.

hydrochlorothiazide

absorption

Hydrochlorothiazide absorbs quite quickly through the gastrointestinal tract.

Distribution

Biological use is about 65% to 70%, hydrochlorothiazide passes through the placenta and distributed into milk.

Metabolism

The drug is excreted in the form of unchanged urine.

Elimination

Semi -cancellation time in plasma has been recorded as a change from 5 to 15 hours and has priority to bond with red blood cells.

Before taking Co-Trupril 20mg/12.5mg Getz drug treatment for mild and medium hypertension (2 blisters x 14 tablets)

How to use

Take oral use.

Dosage

The usual dose of Co-Trupril is 1 tablet 1 time/day, should be taken at the same time a day. If the treatment effect is not as expected in 2-4 weeks at this dose, it may increase to 2 capsules x 1 time/day.

Case of renal failure

can use CO-Trupril for patients with creatinine clearance above 30 and less than 80ml/minute but only after evaluating the content of drugs in the blood.

Patients who have been treated with diuretics before: stop taking diuretics 2-3 days before starting treatment with co -trupril (lisinopril/ hydrochlorothiazide). If not, it is possible to start using the Lisinopril monotherapy at a dose of 2.5mg.

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? Need symptomatic treatment and support. Treatment should be discontinued with Co-Trupril (Lisinopril + Hydrochlorothiazide) drugs and closely monitor patients.

Proposal measures include vomiting or gastric lavage, and improving dehydration, electrolyte imbalance and hypotension due to drug use.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Co-Trupril, you may experience unwanted effects (ADR).

lisinopril/hydrochlorothiazide is often well tolerated. Side effects are usually mild and transient and in most cases where it is not necessary to stop treatment.

Common

Neurological: dizziness, headache, fatigue.

Respiratory: dry cough. Cardiovascular: Hypotension includes hypotension.

Other: hemoglobin mitigation and concentrated blood volume.

Occurs less

Digestive: diarrhea, nausea, vomiting.

DA: rash.

Other: dry mouth, room, brushing chest, heavy chest, cramps, fatigue, paresthesia, weakness and helplessness. Hyperglycemia, hyperuricemia, increased or decreased potassium.

Rare

Pancreatitis, grain leukemia, increased liver enzymes or serum bilirubin.

Testing

Infold with urea, blood nitrogen, serum creatinine has been recorded in patients with no signs of renal failure before.

Bone marrow inhibition, manifestation of anemia or thrombocytopenia and leukopenia has been recorded.

Hypersensitivity/nerve edema

Neurosus on the face, limbs, lips, tongue and/or larynx have been reported but very little.

In some very rare cases, the gastrointestinal angioedema reports. A complex symptom has been reported to include one or more of the following symptoms: fever, vasculitis, muscle pain, joint pain/arthritis, positive ana, ESR increases, acidic leukemia, general leukemia, rash, light sensitivity or other skin manifestations.

There may also be other side effects caused by each active ingredient.

Notice the doctor's side effects when taking the drug.

Warnings

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

Contraindicated

Contraindicated in patients with hypersensitivity to the ingredients of the drug and in patients with a history of nerve edema related to previous treatment with angiotensin enamel inhibitors, patients with genetic or spontaneous angioedema.

Patients with hypersensitivity to other sulfonamide derivatives.

Lisinopril/hydrochlorothiazide contraindicated in patients with auria.

Contraindicated for pregnant women, must immediately stop the drug if suspected of being pregnant.

Precautions when using

Hypotension and electrolyte/epidemic imbalance:

Similar to other therapies for hypertension, blood pressure symptoms may occur in some patients when using lisinopril/ hydrochlorothiazide.

These patients should be regularly tested for serum electrolytes at appropriate times.

For patients at high risk of hypotension, they should be closely monitored at the beginning of treatment and when adjusting the dose.

Consider carefully when using drugs for patients with ischemia in the heart or have brain vascular disease because excessive hypotension will cause myocardial infarction or brain vasoconstriction.

Patients with kidney function:

Not suitable for using thiazide to treat diuretics in patients with renal impairment and drugs that are not effective when creatinine clearance is 30ml/minute or lower (for example, in case of medium and severe renal failure).

should start treatment at low doses and under tight medical supervision and careful dosage.

Should monitor kidney function in the first weeks of treatment with co-trupril.

Patients with liver disease: Be cautious when taking Thiazide for patients with liver function or liver disease progressing because of the minor change of fluid balance and electrolyte can cause liver coma.

Impact on metabolism and endocrine.

Thiazide can reduce the secretion of calcium urinary and can increase calcium in mild plasma and batches. Thiazide should be discontinued before conducting parathyroid function tests.

Increasing cholesterol and triglycerides may be related to thiazide diuretic therapy.

The use of thiazide may increase the concentration of blood uric acid or cause leprosy disease in some patients. However, Lisinopril may increase urinary uric acid and thus reduces toxicity caused by increased uric acidic acid by hydrochlorothiazide.

The ability to drive and operate machinery

Similar to other drugs to treat hypertension, combining lisinopril + hydrochlorothiazide can have light to medium impact to driving and operating machinery.

Pregnancy

Contraindicated for pregnant women

Must stop the drug immediately if suspected of being pregnant.

Breastfeeding period

Hydrochlorothiazide excreted into human milk, but it is not known whether Lisinopril will excrete in human milk or not. Because strong side effects on the child, therefore, should consider stopping the drug or stop breastfeeding depending on the importance of the drug for the mother.

Drug interaction

drugs that increase serum potassium:

Lisinopril reduces the loss of blood potassium caused by thiazide diuretic.

Potassium diuretic should only be used in case of hypokalemia, should be used carefully and often monitor patients because it can lead to significant increase in serum potassium.

Be cautious when using salt substances containing potassium.

Affects of sympathetic activity:

Be cautious when using the agents affecting sympathetic activity.

Beta-adrenergic blockers add to Lisinopril's treatment of hypertension.

Indomethacin: Indomethacin can reduce the effect of treating hypertension when used simultaneously with lisinopril.

Liti: Do not use lithium simultaneously with diuretics or ACEi inhibitors. Diuretics and ACEi inhibitors can reduce the liti clearance through the kidneys and thus increase the risk of liti toxicity.

corticosteroid (ACTH): Increases power outages, especially hypokalemia may occur when coordinating treatment with thiazide diuretics.

Steroid anti -inflammatory drugs: In patients whose kidney function is treated with nonsteroidal anti -inflammatory drugs (NSAID), the simultaneous use of Lisinopril will increase the destruction of kidney function.

tubocurarine: Thiazide can increase the response of tuboCurarine.

insulin: Thiazide can reduce glucose tolerance. The adjustment of the dosage of diabetes, including insulin is necessary.

Alcohol, barbiturate or narcotic: The presence of thiazide diuretics can cause vertical hypotension.

Amine turbocharger: Thiazide can reduce response to amine turbocharger but do not need to quit the use of the drug.

Storage

Leave a cool dry place, avoid heat, light and moisture, store in closed packaging at room temperature below 30 ° C.

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