Dopegyt drug 250mg Egis Pharma treat hypertension (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Methyldopa
Ingredient High blood pressure

Ingredient

Composition information	Content
Methyldopa	250mg

Uses

Indications

dopegyt is indicated in the treatment of hypertension.

Pharmacokological

Methyldopa is a central effect of hypotension. The mechanism of action of the drug is not known correctly. When entering the central nervous system, the metabolic substance has the activity of methyldopa, alpha - methyl - noradrenaline, acting by mechanisms that are hypothesized as follows:

Reduces the sympathetic tone by stimulating the alpha - 2 central si -si -inhibited money receptors. The tissue of dopamine, serotonine, noradrenaline and adrenaline by inhibiting Dopa - decarboxylase enamel. In some cases, the drug may slow down the heart rate. The drug hypoglycemia effectively in both standing and lying posture, rarely causing posture lowering.

pharmacokinetic

absorption

The absorption of methyldopa in the digestive system is changing and incomplete. The average bioavailability of the drug after taken is 25%. The drug reaches the peak concentration in plasma after 2 to 3 hours.

After taking a single dose will have the maximum effect within 4 - 6 hours and lasts about 12 - 24 hours. After drinking many times, the blood pressure will minimize within 2-3 days. After stopping the drug, blood pressure will return to the original value before treatment within 1-2 days.

Distribution

Little drug is attached to plasma proteins (

Metabolism

The active ingredient is strongly metabolized and occurs in the liver. Active metabolites, Alpha - Methyl - Noradrenaline, established in neurons causing adrenaline secretion at the central level. There are also many other known metabolites, they are discharged through the kidneys.

Elimination

About two -thirds of methyldopa absorbing is excreted in the form of unchanged or in the form of a SUFATE in urine, the rest is excreted in the form of unchanged in the feces. Elimination of the drug has two -phase characteristics. If the function of the kidney is normal, the selling time is 1.8 ± 0.2 hours. The active ingredient is completely eliminated from the body within 36 hours.

There may be methyldopa from the blood with the fertilizer. Hemolysis in 6 hours will eliminate about 60% of the absorbed quantity, if the peritoneal fertilizer lasts for 20 - 30 hours, about 22-39% is removed.

Before taking Dopegyt drug 250mg Egis Pharma treat hypertension (10 blisters x 10 tablets)

How to use

oral tablets. Can be taken before studying after meals, should follow the doctor's prescription.

Dosage

Dosage should be adjusted for each patient.

Adults:

The usual starting dose of the first two days is 250 mg/time x 2-3 times/day, then it may increase or decrease the dose gradually depending on the degree of hypotension. The distance of each dose adjusts is not less than 2 days. Because there may be side effects that cause drowsiness to last two or three days at the beginning of treatment and every time the dose increases, the dose should be started in the evening.

Normal maintenance dose is 500-2000 mg/day, divided into 2-4 times. The maximum dose is 3 g/day. With a dose of 2 g/day but blood pressure is still not satisfactory, it is advisable to coordinate with other lower blood pressure drugs.

After 2-3 months of methyldopa treatment may occur tolerance. The appropriate reduction of blood pressure can be done by increasing methyldopa or by coordinating with diuretics.

Blood pressure usually returns to the initial value (before treatment) for 48 hours after the dopegyt stops without reBound Effect.

can be used dopegyt for patients being treated with other antihypertensive drugs by gradually stopping these hypotension drugs. In these cases, the starting dose of Dopegyt must not exceed 500 mg/day and increase the dose if necessary (the distance each time increases the dose not less than 2 days).

When adding methyldopa to an antihypertensive therapy is applied, the dosage of these antihypertensive drugs should be adjusted to have a smooth transition.

Elderly:

Start treatment with the lowest dose possible, no more than 250 mg/day. Increase the dose if necessary (the distance each time increases the dose not less than 2 days), not exceeding 2 g/day.

Fainting occurs more often in the elderly, related to an increase in drug sensitivity and arteriosclerosis, can avoid it by lower doses.

Children:

The starting dose is 10 mg/kg/day, divided into 2-4 times. Increase the dose if necessary (the distance each time increases the dose not less than 2 days) until the appropriate effect. The maximum dose is 65 mg/kg/day or a maximum of 3 g/day.

Dopegyt movie tablets 250 mg is not an appropriate form of preparation to start treatment with methyldopa and to accurately calculate the drug -based drug -based doses.

Dopegyt 250 mg film tablets are only suitable for maintenance treatment in children, blood pressure can be satisfactorily controlled by methyldopa with a dose of 250 mg/day, divided into 2-4 times to 750 mg/day, divided into 2-4 times, after calculating the dose with another drug containing methyldopa.

kidney failure:

Methyldopa is excreted mainly through the kidneys, so the dosgyt doser is needed in patients with renal impairment.

Should extend the distance each time to take up to 8 hours if there is a mild kidney failure (EGFR: 60 - 89 ml/min/1.73 m2); 8 - 12 hours if medium renal failure (EGFR: 30 - 59 ml/min/1.73 m2); 12 - 24 hours in severe renal failure (EGFR

Because methyldopa may be removed from the blood with the fertilizer, an additional dose of 250 mg is recommended to prevent hypertension after hemolysis.

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 using overdose?

Overdose by gastrointestinal or vomiting can reduce the amount of drug absorption.

There is no specific antidote.

Methyldopa can be removed by agitators, overdose treatment is symptomatic treatment. It is possible to increase the elimination through urine by infusion. In addition, it is necessary to closely monitor the heart rate, cardiac supply, blood volume, electrolyte balance, intestinal motility, kidney function and brain activity. It is possible to use drugs that are similar to sympathetic (like adrenaline) when needed. When suspected chronic overdose, Dopegyt must be stopped.

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

Common, ADR> 1/100

Blood and lymphatic system: positive Coombs test.

Uncommon, 1/1000

No report.

Rare, ADR

Cardiovascular system: worse angina. liver.

Not determined frequency

Cardiovascular system: congestion heart failure, prolonged sinus sinus sinus, posture hypotension, edema, weight gain, sinus slow heart rate. Mental disorders include nightmares, mental disorders or depression, headache, drowsiness, weakness, dizziness, abnormalities, sex reduction. The epidermis due to poisoning, eczema, liken form. Bile: cholestasis, jaundice, abnormal liver function tests

can usually reduce edema and reduce weight by using a diuretics. If the edema progresses, or the signs of heart failure appear, methyldopa must be stopped.

If hypotension should reduce the dose.

Warnings

Contraindicated

Dopegyt drugs contraindicated in the following cases:

Hypersensitivity to any component of the drug (just when the liver failure is used by methyldopa).

Precautions when used

Hemorrhagic anemia rarely occurs when using methyldopa. If so, must stop dopegyt. Often recover quickly when stopping the drug, whether or not it is accompanied by corticosteroids. However, there were cases of death. Do not use methyldopa for patients if anemia is caused by methyldopa.

Some patients when using methyldopa prolonged positive Coombs test, the average rate of occurrence is from 10% to 20%. Rarely occurred the positive Coombs test for the first six months of treatment, and once it had not occurred within 12 months, it was less likely to have long -term treatment. The positive Coombs test depends on the dose, the lowest rate occurs in patients using methyldopa at a dose of 1 g or less of the day. Coombs test will be negative if the drug is stopped for a few weeks or a few months.

Should perform the counting of red blood cells and Coombs test directly at the beginning of treatment, repeat the test after about 6 months.

If the Coombs test occurs directly while using methyldopa, it must be determined whether or not to have hemolytic anemia and the positive Coombs test is clinically significant.

Rarely reports on leukopenia, recovered leukopenia, the number of granulocytes will return to normal after stopping the drug. It is also possible to recover platelets but rarely.

In the first 3 weeks, fever may occur, sometimes with eosinophilia, abnormal liver function tests, jaundice. In some patients, cholestas can be confirmed based on symptoms. Deathly liver necrosis rarely occurs.

Should do liver function tests and count the number of white blood cells and the rate of white blood cells before treatment of methyldopa on the first and 12th week of treatment, or whenever the fever has unknown reasons.

If fever, abnormalities of liver function or jaundice must stop the drug immediately. If related to methyldopa hypersensitivity, when the drug is stopped, the liver function will return to normal. These patients must not reuse methyldopa.

Special prudence when using dopegyt for patients with a history of liver disease, liver dysfunction, porphyrin metabolism disorders.

may need to reduce anesthetic dose if the patient is using methyldopa.

Must stop the drug if edema increases or if the symptoms of heart failure appear or the movement of dance - dancing is not self -control in patients with 2 -sided brain disease.

methyldopa can affect the measurement of uric acid in urine by phosphotungstate method, measurement of creatinine in serum by alkaline picrate, and AST (SGOT) by color measurement (no SGOT measurement effect by spectral optical method).

When measuring the amount of catecholamine in urine by fluorescent method, methyldopa can give a fake positive result, so the diagnosis of chromium cell tumors may become more difficult. However, the drug does not affect the measurement of VMA in the urine.

Avoid using alcoholic beverages during methyldopa treatment.

The ability to drive and operate machinery

methyldopa can cause fleeting drowsiness, usually at the beginning of the treatment or when the dose increases, so be careful when driving or operating machinery.

Pregnancy

Methyldopa is used under strict medical supervision to treat pregnancy hypertension. There is no clinical evidence that the drug is harmful to the fetus or the newborn. Methyldopa passes through the placenta fence and appears in the umbilical cord blood, although there is no report on the teratogenicity but does not exclude the possibility of damage to the fetus. Therefore, it is not possible to use drugs for women who are or may be pregnant, planning to get pregnant unless the benefits are more than potential risks.

Breastfeeding period

Methyldopa entered the breast milk, so it is not allowed to use medication for women who are breastfeeding unless the benefits are more than potential risks.

Medicinal interaction

Avoid using methyldopa with Mao inhibitors because of excessive hypotension.

Medications reduces the hypotension effect of dopegyt:

The drug has the same sympathetic effect (further hypertension).

Non -steroid anti -inflammatory drugs (NSAID).

Medications that increase the hypotension effect of dopegyt:

Other antihypertensive drugs (can increase the effect of lowering blood pressure, increased adverse reactions or therapy reactions), phenothiazine.

Methyldopa combination with the following drugs can change each other's effectiveness:

Lithium (increased risk of lithium poisoning).

bromocriptine (effectively with methyldopa on prolactin levels).

Storage

Store at temperatures below 30 ° C, avoid direct light.

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