Dorover Plus Domesco Treatment Treatment of primary hypertension (1 blister x 30 tablets)

Dosage form Box of 1 blister x 30 tablets
Specifications Perindopril Tert-butylamine, indapamide
Ingredient High blood pressure

Ingredient

Composition information	Content
Perindopril Tert-butylamin	4mg
Indapamide	1.25mg

Uses

Indications

Dorover Plus drugs are indicated in the treatment of primary hypertension for non -controlled blood pressure patients with single treatment.

Pharmacokological

Dorover Plus is a combination of Perindopril's Tert-butylamine salt (is a transferred inhibitor) with indapamid (a chlorosulphamoyl urinary gum). The pharmacological properties of this drug are a combination of pharmacological properties of each component forming Dorover Plus, in addition to the increase in the effect of the same level and the plus combination of the two components mentioned above.

Mechanism of pharmacological effects:

Perindopril inhibits the conversion of enzymes (Acei), which converts angiotensin I to angiotensin II (is a vasoconstrictor); In addition, this enzyme stimulates the secretion of aldosteron from the adrenal shell and also stimulates Bradykinin's deserting (is a vasodilator) to make the hepteptides inactive.

Due to this inhibitor, the result is Perindopril:

Reduces aldosteron secretion. Low or normal renin concentration.

Perindopril is valid for the metabolite of Perindoprilat. Other metabolites are no longer active.

perindopril reduces the heart due to:

Varicose veins, possibly due to changing the metabolism of prostaglandin: reducing the burden.

There is a decrease in pumping pressure of the right and left ventricle.

indapamid is a sulfonamid derivative with indol nucleus, which is related to pharmacological with the diuretic gain group.

Indopamid inhibits sodium reabsorption through the dilution of the kidney shell. This drug increases the excretion of sodium and chlorid in the urine and also increases the excretion of a part of potassium and magnesi, thereby increasing the secretion of urine and has the effect of lowering blood pressure.

Characteristics of hypotension effects:

In patients with hypertension, not to mention age, the drug has the effect of lowering systolic and diastolic blood pressure both when lying on their backs or when standing, this effect depends on the dosage and takes effect for 24 hours. A decrease in blood pressure reached at least one month without a quick familiar medicine. When stopping the drug, there is no recurring phenomenon. In clinical trials, if combined with perindopril with indapamid will cause the effect of increasing the level of blood pressure reduction related to each effect of each drug when used separately. Perindopril is valid for all levels of hypertension, from light to medium or serious. There is a decrease in systolic and diastolic blood pressure in the lying position and when standing.

The effect of lowering blood pressure after taking a maximum dose between the 4th and 6th hours and keeps the effect in 24 hours.

Having a high level of enamel closing enzyme exists after 24 hours is about 80%. For patients who respond to drugs, blood pressure will be normal after 1 month and keep without the phenomenon of fast familiar medicine.

When stopping the drug, there is no recurring phenomenon of hypertension. Perindopril has the properties of vasodilation and restores the elasticity of the main artery body, corrected changes in histological morphology in resistance arteries and reduces the hypertrophy of the left ventricle.

When necessary, using additional diuretic gums will give the community effect.

Combining enzyme inhibitors with diuretics will reduce the risk of hypotension occurs when used separately.

Used separately, indapamid has the effect of lowering blood pressure exist for 24 hours. This effect is achieved immediately with doses where the diuretic properties of the drug are still very light.

The effect of lowering the blood pressure of the indapamid is proportional to the improvement in the response of the artery and with the decrease in the resistance of the whole vascular system and the peripheral artery.

indapamid reduces left ventricular hypertrophy.

When an overdose of the diuretics and is related to the thiazid group, the effect of lowering blood pressure will reach the maximum (Binh Nguyen) while the harmful effects continue to increase. So when treatment is not effective, do not continue to increase the dose.

Moreover, in patients with short -term hypertension, average number of days and for long -term users, replacing indapamid:

There is no effect on lipid metabolism (Triglycerid, LDL-C and HDL-Cholesterol). Change the pharmacokinetic properties of both drugs compared to separate use.

perindopril:

Perindopril absorbs quickly when drinking. Absorption amount 65 - 70% of the dose. Hydrolyzed for Perindoprilat is a specific inhibitor. The amount of Perindoprilat formed will be transformed when there is food. Perindoprilat's peak concentration in plasma is achieved after 3-4 hours. Attached to plasma proteins

After using many doses as well as the only dosage every day, the stable state of Perindopril reaches after an average of 4 days. Perindoprilat waste sale time is about 24 hours.

Perindoprilat concentration in plasma will be significantly higher, when used in patients with creatinine purification

For people with cirrhosis, Perindopril's dynamics are affected: Perindopril's liver purification is reduced by half. However, the amount of Perindoprilat formed does not decrease and thus, no dose adjustment.

The enzyme inhibitors are transferred to the placenta.

indapamid:

Indopamid absorbs quickly and completely through the digestive tract. The peak concentration of plasma is about an hour after taking indapamid. Nearly 79% attached to plasma proteins.

Selling time is about 14 and 24 hours (average 18 hours).

Continuous use does not see the accumulation of the drug. Elimination mainly through urine (70% of the dose) and feces (22% of the dose) in the form of active metabolites.

Indamid pharmacokinetics does not change in patients with renal failure.

Before taking Dorover Plus Domesco Treatment Treatment of primary hypertension (1 blister x 30 tablets)

How to use

Dorover Plus is taken or taken once in the morning before eating.

Dosage

1 tablet/day.

** Adjust the dosage for the elderly and patients with renal failure, calculated according to Perindopril Tert-butylamin:

For elderly patients: When treating hypertension, it is recommended to start a dose of 2mg/day, if needed after a month of treatment may increase to 4mg/day.

For patients with renal failure:

The dose is adjusted according to the degree of renal failure based on the Cockroft formula:

(140 - age) x Body weight (kg)

CLCR (Male) = ——————————————————————————

0.814 x Creatinin plasma (micromol/liter)

(140 - age) x Body weight (kg)

Clcr (female) = —————————————————————————————

0.85 x Creatinin plasma (micromol/liter)

Creatinine clearance 30 - 60ml/minute: 2mg/day.

Creatinine clearance 15 - 30ml/minute: 2mg every 2 days.

Creatinine clearance

What to do when overdose?

Management: gastric and intravenously with isothermal NaCl solution.

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

What to do when forgetting a 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 Dorover Plus, you may experience unwanted effects (ADR).Common

constipation, dry mouth, nausea, epigastric pain, anorexia, abdominal pain, taste disorders. When this symptom is encountered, it is necessary to care about the cause of the enzyme inhibitors.

Few:

Lower blood pressure or in a vertical or not. The rash is lumpy, rash, which can worsen the existing acute scattered lupus lupus, skin rash.

Rare:

Pancreatitis; When there is liver failure, it may be likely to start - liver disease.

platelet reduction, leukemia, granulocytosis, property anemia, hemolytic anemia. Anemia, encountered when using enzyme inhibitors in some special states (patients with kidney transplant, dialysis)

Notice the doctor unwanted effects when using the drug.

Warnings

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

Contraindicated

Dorover Plus 4/1.25 contraindications in the following cases:

Hypersensitivity to one of the ingredients of the drug or with sulfamid.

Caution when using

Precautions when using Dorover Plus 4/1.25 in the following cases:

Patients with liver failure, electrolyte disorders, leprosy, heart failure, kidney failure, kidney stenosis.

Elderly.

The ability to drive and operate machinery

should be cautious because the drug can cause drowsiness.

Pregnancy and nursing mothers

Not used for pregnant and lactating women.

Drug interaction

should not be coordinated with lithium.

Be cautious when combined with potassium salts, potassium diuretics, arrhythmic drugs, anesthesia, allopurinol, cell inhibitors and immunosuppressive inhibitors, corticosteroids, other anti -hypertension drugs because of increased lowering effects.

Storage

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

To be out of reach of children.

Other drugs

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