EBITAC 25 10mg/25mg Farmak Treatment of hypertension (2 blisters x 10 tablets)

Dosage form Box of 2 blisters x 10 tablets
Specifications Hydrochlorothiazide, enalapril

Ingredient

Composition informationContent
Hydrochlorothiazide25mg
Enalapril10mg

Uses

indications

EBITAC drugs are indicated in the following cases:

  • Hypertension.

    Enalapril is an angiotensin transferring enzyme inhibitor, which works by enalaprilat as an enalapril metabolism after taken.

    Enalapril lowers blood pressure in normal blood pressure, hypertension, and has a good effect on hemodynamics in people with congestion heart failure, mainly due to inhibition of the renin - angiotensin - aldosteron system. Enalapril prevents angiotensin I transform into angiotensin II (strong vascular contractions) thanks to the inhibition of angiotensin conversion enzymes (ACE). Enalapril also reduces serum aldosteron, leading to a decrease in sodium retention, increasing the Kallikrein - Kinin vasodilation system and can change Prostanoid metabolism and inhibit sympathetic nervous system.

    Because the enzyme converts angiotensin plays an important role of decomposition, enalapril also inhibits Bradykinin decomposition. Because Bradykinin is also a powerful vasodilator, these two effects of Enalapril can explain why there is no relevance proportional between the Renin concentration and clinical response to Enalapril treatment.

    hydrochlorothiazide

    hydrochlorothiazid and thiazid diuretics increase the secretion of sodium chloride and water attached to the mechanism of inhibiting the reabsorption of chloride and sodium ions in the distance. The excretion of other electrolytes also increases, especially potassium and magnesi, and calcium decreases.

    pharmacokinetics

    enalapril

    After drinking, about 60% of Enalapril dose is absorbed from the gastrointestinal tract. The peak concentration of the serum is reached within 0.5 - 1.5 hours. Half life elimination of the drug is about 11 hours. Hemorrhagic effect lasts about 24 hours. Food does not affect the absorption of drugs. After absorption, Enalapril is hydrolyzed in the liver into Enalaprilat.

    The peak concentration of enalaprilate in serum appears within 3-4 hours. Take an Enalapril dose of hypotension usually about 1 hour after drinking, lowering up to 4-6 hours and usually lasts for 12 - 24 hours. Blood pressure may be slowly reduced and must be treated for a number of weeks to achieve adequate effects.

    about 50 - 60% Enalapril binds to plasma proteins.

    About 60% of oral dose is excreted into urine in the form of enalaprilat and non -metabolic form, the rest of the drug eliminates in feces.

    hydrochlorothiazide

    After taken, hydrochlorothiazid is relatively fast, about 65 - 75% of the dose of use, but this ratio may decrease in heart failure people. Hydrochlorothiazid accumulated in red blood cells. The drug excreted mainly through the kidneys, mostly in the form of non -metabolic. Half of the lifetime of hydrochlorothiazid is about 9.5 - 13 hours, but may last in the case of renal failure so the dose should be adjusted.

    • Before taking EBITAC 25 10mg/25mg Farmak Treatment of hypertension (2 blisters x 10 tablets)

    How to use

    Take oral use.

    Dosage

    The dose of EBITAC is determined mainly by the dosage and how to use with Enalapril Maleate components. The dosage of the drug must be adjusted depending on the individual.

    Adults

    Hypertension

    The usual dose is a tablet, once a day. If necessary, the dosage can be increased to two tablets, once a day.

    Simultaneous treatment with diuretics

    Hypotension can occur after the beginning of EBITAC. Therefore, diuretic treatment should be stopped for 2-3 days before starting treatment with EBITAC.

    Dosage for patients with renal failure

    Thiazide is not suitable for patients with renal impairment and ineffective at the values ​​of creatinine 30 ml/min or lower (i.e. average or severe renal failure). In patients with creatinine clearance> 30 and It is necessary to adjust the special dose during treatment in combination with other antihypertensive drugs. Within 4 weeks, if the treatment results are not achieved, the dose increases or the addition of other anti -hypertensive drugs must be considered.

    heart failure

    should use EBITAC under the monitoring of a doctor. If the patient has severe heart failure (degree 4), impaired renal function and/or an abnormal trend of electrolytes, it must be carefully monitored at the hospital right from the beginning of treatment. This principle is also applied when combined with enalapril with vasodilators.

    The appropriate dose in the first week is 2.5 mg of enalapril used daily for the first 3 days, using 2.5 mg of Enalapril twice daily for the next 4 days. The dose may then be increased to a normal dose of 20 mg (2 EBITAC tablets) daily, disposable or divided into 2 times in the morning and evening. In a rare number of cases, there may be a dose of up to 4 EBITAC tablets 25/day. Adjust the dose for 2 - 4 weeks.

    Interpreted left ventricular failure function

    The initial dose is 2.5 mg of Enalapril used 2 times/day in the morning and evening, adjusting the dose continuously to the appropriate dose as described above to the dose of 2 EBITAC tablets/day, divided into 2 times, used in the morning and evening. Hypertension and kidney function must be monitored before and after starting treatment to avoid severe hypotension and renal failure. If possible, diuretics should be reduced before starting with enalapril. Should monitor serum potassium concentration and adjust to normal levels.

    Elderly

    In effective clinical studies and tolerance of Enalapril Maleatate and Hydrochlorothiazide use simultaneously, similar to hypertension patients in both the elderly and young.

    Children

    has not been determined effectively and safety when using drugs in children. Ask your doctor before using.

    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? The outstanding feature of Enalapril overdose is severe hypotension. When an overdose occurs, Enalapril should be stopped and monitor patients closely, apply symptomatic and supportive treatments such as vomiting, gastric lavage, plasma intravenous and sodium chloride to maintain blood pressure and treat electrolyte imbalance. Hemodiac can eliminate enalapril from circulation.

    Overdose of hydrochlorothiazide is mainly water and electrolyte disorders due to a lot of urinary tract. If using digitalis, hypoglycemia increases arrhythmia.

    What to do when forgetting 1 dose?

    Not recorded.

    Side Effects

    When using EBITAC, you may experience unwanted effects (ADR).

    Common, ADR> 1/100

  • Nervous system: headache, dizziness, fatigue, insomnia, paresthesia, sensuality.
    • Digestive: taste disorders, diarrhea, nausea, vomiting and abdominal pain. Cardiovascular: angioedema, severe hypotension, hypotension with standing posture, fainting, brushing chest drum, and chest pain.
  • DA: rash.
  • Respiratory: dry cough, possibly due to increased kinin in tissue or prostaglandin in the lungs.

    • Other: kidney failure.

    Uncommon, 1/1000

  • Hematology: Hemoglobin and hematocrite, granulocytes, neutropenia.
  • urine: proteinuria.
  • Central nervous system: panic, agitation, severe depression.

    • Instructions on how to handle ADR

    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

    EBITAC drugs contraindicated in the following cases:

  • Allergy or hypersensitivity to Enalapril Maleatate, hydrochlorothiazide, or any excipients of the drug.

    • History of veins associated with ACE inhibitors. Idiopathic or genetic angioedema.

    Narrow renal artery narrowing on both sides of the kidneys or narrowing of the kidney artery in a person has only one kidney.

  • Aortic valve stenosis and severe congestion cardiac disease.
  • Hypotension previously.

    • Severe renal failure (Creatinine clearance

  • Anaturia.
  • Porphyrin metabolic disorders.
  • Gout and severe diabetes.
  • Hypersensitivity to drugs derived from sulfonamide.

    • Pregnant women phase 2 and phase 3 (from the 4th month onwards).

    Be cautious when used

    Be careful when taking the drug with people with severe renal failure, liver failure, gout.

    For suspected people with kidney stenosis, blood creatinine is required before starting treatment.

    Be cautious when taking medicine with the elderly because it is easy to imbalance electrolytes.

    The ability to drive and operate machinery

    There is no information on the effects of Enalapril and Hydrochlorothiazide on the ability to drive and operate machinery.

    pregnancy

    enalapril

    Like other ACE inhibitors, Enalapril can cause disease and death for the fetus and infants when the pregnant mother uses the drug. Using drugs in the middle 3 months and the last 3 months of pregnancy can cause disease leading to pregnancy and damage to newborns, including: lowering blood pressure, renal failure to recover or not recover and death. Enalapril must be stopped as soon as possible after detecting pregnancy.

    hydrochlorothiazide

    There are many notifications proving, thiazid diuretics are through the placenta into the fetus, causing electrolytes, platelets and jaundice in newborns. So do not use this group of drugs for the last 3 months of pregnancy.

    breastfeeding period

    enalapril

    Excreted into breast milk. With the usual dose of treatment, the risk of harmful effects for breastfeeding is very low.

    hydrochlorothiazide

    The drug enters breast milk with the amount of child harmful and inhibits milk secretion. Therefore, it is necessary to consider not using medication or stop breastfeeding depending on the degree of need for the drug for the mother.

    drug interaction

    enalapril

    Use enalapril simultaneously with a number of other vasodilators (eg nitrate) or anesthetic drugs that can cause severe hypotension.

    Use enalapril simultaneously with lenin release drugs: Enalapril's hypotension effects increased by drugs that release lenin with anti -hypertension effect (for example, diuretics).

    Using enalapril simultaneously with lithium may increase blood lithium levels leading to lithium poisoning.

    hydrochlorothiazide

    When used with the following drugs can interact with thiazid.

  • Alcohol, barbiturate or addictive sleeping pills: Increased risk of vertical hypotension.
  • corticosteroid, ACTH: increases power outages, especially hypokalemia.
  • amino hypertension (for example, norepinephrin): may reduce response to hypertension but not enough to prevent use.
  • Muscle relaxants: may increase response to muscle relaxants.
  • lithium: should not be used with diuretics, because of reducing lithium clearance in the kidneys and increasing the toxicity of this substance.
  • Non -steroid anti -inflammatory drugs: may reduce diuretic, sodium urinary effects and lower blood pressure effects in some patients.
  • quinidine: easily causing torsion, vibration of death.

    • Storage

    Store less than 30 ° C, avoid light.

    Other drugs

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