Herbesser 30mg treatment of high blood pressure, angina (10 blisters x 10 tablets)
Dosage form Box of 10 blisters x 10 tablets
Specifications Diltiazem hydrochloride
Ingredient
| Composition information | Content |
| Diltiazem hydrochloride | 30mg |
Uses
indications
Herbesser 30 drugs are indicated in the following cases:
affect myocardial ischemia
Improve the balance between supply and demand of myocardial oxygen
diltiazem hydrochlorid increases blood flow in the coronary arteries into the ischemic areas of myocardial ischemic by relaxing the main coronary artery and side branches (in dogs).
diltiazem hydrochlorid inhibits the artery spasm of the coronary artery (in monkeys and people).
Diltiazem hydrochloride reduces oxygen consumption in the heart muscle without reducing the heart flow due to reducing the post -burden and heart rate through peripheral dilatation (on dogs).
Heart muscle protection effect
diltiazem hydrochlorid maintains heart function and myocardial metabolism, reduces the size of myocardial infarction, due to inhibition of excessive calcium ionic into cells in the state of myocardial ischemia (in rats).
Effects on blood pressure
diltiazem hydrochlorid gradually reduces hypertension, although this drug has a strong impact on normal blood pressure (in rats, humans); The drug also reduces hypertension due to severe exercise (in humans).
diltiazem hydrochlorid reduces blood pressure, without reducing kidney and brain blood (in dogs, humans).
diltiazem hydrochlorid reduces vascular and heart muscle hypertrophy while lowering blood pressure (in rats).
Effects on sinus rhythm and heart transmission system
diltiazem hydrochlorid prolongs the spontaneous sinus rhythm distance, prolonging the time of the atrial transmission - Hiss bundle, but there is no effect on the time of Hiss - ventricular transmission (on dogs, people).
Toxicity with a single dose
When the dose 2, 10, 25 and 125 mg/kg/day and 10, 20, 40 mg/kg/day Diltiazem hydrochlorid is used in the mouth of the oral rats, respectively for rats SD and hunting dogs for 6 months. With rats, there are cases of death in the group taking a dose of 125 mg/kg/day, the group takes the dose of 25 and 125 mg/kg/day there are signs of impaired liver and kidney function, but in groups 2mg and 10 mg/kg/day are not affected. For hunting dogs, the group takes a dose of 40 mg/kg/day there are cases of death and abnormalities of electrocardiograms, GOT and GPT increases in the group using the dose of 20 mg/kg/day. Birth For CFY rats, before mating, during pregnancy and lactation, when taking diltiazem hydrochloride oral doses at a dose of 12.5, 25, 50 and 100 mg/kg/day, there is no adverse effect on the reproductive function of parents and no pregnancy and developmental retardation for pregnancy and child mouse. In the formation of fetal organs diltiazem hydrochloride with doses: 10, 25, 50, 100, 200 and 400 mg/kg/day and 10, 50, 100, 200 and 400 mg/kg/day in order for the following two types of mice: ICR - JCL. Wistar rats. Consequences of pregnancy death appear in all groups of rats and in rat groups use 200 and 400 mg/kg/day. The monsters are observed in groups of mice used dose 50, 100, 200 and 400 mg/kg/day but for rats, they are not found to cause teratogen even with a group of 400 mg/kg/day. Used during the period of birth and after birth 50, 100, 200 and 400 mg/kg/day Diltiazem hydrochloride mouth for mice wistar. Because the mouse's general condition is worse, the rate of birth, the rate of feeding and the survival rate as well as the weight of the child's mouse decreases in the group using 200 and 400 mg/kg/day, but there is no remarkable change with the group using the dose of 10, 50 and 100 mg/kg/day. antigen No observations of antigen of Diltiazem hydrochlorid on mice, rats and mice. GM The gene change of diltiazem hydrochlorid is not observed through the reverse and repair test (repair) with bacteria, chromosomal deviations in mammal cells cultured or small nuclear cells in mice. Cancer No observations of cancer causing cancer of diltiazem hydrochlorid through mouse testing. Clinical research Angina, variant of angina The great benefits of Herbesser 30 to treat angina are proven by clinical trials that compare double blindness, single blind comparison and clinical trial with open labels. The great benefits of this drug to treat the variant of angina are shown by clinical trials with open labels, including Holter electrocardiogram research. Hypertension
Dynamic pharmacokinetics
blood concentration
Healthy adults take 2 herbesser 30 tablets (60 mg of diltiazem hydrochlorid), the peak concentration in plasma reaches 3-5 hours after drinking, then gradually decreases with the selling time of about 4.5 hours. Take daily doses, diltiazem concentration in plasma is stable after starting 2 days. Long -term use, continuous drink at a dose of 90 mg, (30 mg x 3 times) per day, the concentration of diltiazem hydrochlorid in plasma is about 40 ng/ml after drinking 2-4 hours.
Metabolism
Healthy adults drink diltiazem hydrochlorid, the drug will metabolize mainly through oxidation reactions loss of amino, oxidation of methyl loss, loss of acetyl and conjugated reactions.
Before taking Herbesser 30mg treatment of high blood pressure, angina (10 blisters x 10 tablets)
How to use
Herbesser 30 drugs for oral use.
Take the medicine from the packet before drinking, do not chew the tablet (because it will reduce the slow release of the pill).
Dosage
angina, variant of angina
The usual oral dose for adults each time is 30 mg of diltiazem hydrochlorid daily use 3 times (90 mg per day). The dose can be increased each time 60 mg, 3 times a day (ie 180 mg/day), when necessary.
Definitely hypertension (from light to medium)
The usual oral dose for adults each time is 30 - 60 mg of diltiazem hydrochlorid, using 3 times a day (ie 90 - 180 mg/day). The dose can be adjusted depending on the age and symptoms of the patient.
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?
Symptoms
Slow heart rate, completely atrial block - ventricular, heart disease, hypotension, etc. These symptoms are also reported as harmful reactions.
Treatment
In case of overdose, it is necessary to stop Herbesser 30 and use the following appropriate treatment measures; When needed, pull out the drug with gastric lavage.
Slow heart rate, atrial block - completely ventricular: use atropin sulfate, isoproterenol, etc. and/or using a pacemaker.
Heart disease, hypotension: using heart tonic, hypertension, infusion, etc. and/or help support circulation.
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 Herbesser 30, you may experience unwanted effects (ADR).
The harmful reaction caused by Herbesser 30 in 442 out of 9 630 patients (4.6%). The most common reactions are in 1.4%digestive system (0.2%stomach disorders, 0.2%constipation, 0.1%abdominal pain, etc.), in the cardiovascular system of 1.4%(0.5%dizziness, 0.4%slow heart rate, 0.2%hot heat, atrial block - ventricular 0.2%etc.), hypersensitivity 1.2%, 0.2%headache, etc.
The reaction is harmful to the clinical significance (rare:
Atrial block - completely ventricular, serious slow heartbeat (the beginning symptoms are slow heart rate, dizziness, delusion, etc.) rare ( Can be congested heart failure. If you encounter abnormalities, need to stop the drug and take appropriate measures, such as using heart stimulants.
Mucus syndrome - Skin - Eye (Stevens - Johnson syndrome), poisoned epidermal necrosis (Lyell syndrome), skin redness (flaking dermatitis), etc. When there is an erythema, swelling of the skin, itching, fever, it is necessary to stop the drug and use appropriate treatments.
There may be liver and jaundice disorders accompanied by an increase in AST (SGOT), Salt (GPT), E - GTP, etc. Need to follow the patient. If anything is abnormal, need to stop the medicine and find appropriate treatments.
Other harmful reactions
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
Herbesser 30 contraindicated drug in the following cases:
People with serious congestive heart disease (can worsen heart disease symptoms).
People with atrial block - ventricular 2 and 3 or have weak sinus node syndrome (continuous sinus rhythm (less than 50 beats/minute), sinus stop, sinus block - atrial, etc.)
People with a history of hypersensitivity to any component of the drug.
Pregnant or pregnant (read the section of pregnancy).
Be cautious when using
Use herbesser 30 carefully in the following patients:
People with congestive heart failure (symptoms of heart disease may be worse).
People with heartbeat too slow (less than 50 spans per minute) or atrial block - ventricular 1 (sinus rhythm and heart transmission may be excessive inhibition).
People with severe hypotension (blood pressure may be reduced further).
People with serious disorders in liver and kidney function (the effect of the drug may increase due to metabolic reduction, elimination reduction).
Important caution:
Sudden stopping of calcium antagonists will make the symptoms worse. So when you want to stop using Herbesser 30, it is necessary to gradually reduce the dose and carefully monitor the patient. Instruct patients not to stop the drug if they have not consulted the physician.
Due to the effect of lowering the blood pressure of the drug, it is possible to encounter dizziness, etc., patients need to be cautious when participating in activities with great risks that require alertness, such as driving, working on high, contact with machines.
Using other anti -arrhythmic drugs (disopyramid phosphate) along with terfenadine can cause long -term QT of the electrocardiogram and ventricular arrhythmia.
Be cautious when coordinating with drugs that can interact with Herbesser 30 (see drug interaction).
The ability to drive and operate machinery
Due to the effect of lowering the blood pressure of the drug, it is possible to encounter dizziness, patients need to be cautious when participating in activities with great risks that require alertness, such as driving and operating machinery.
Pregnancy
contraindicated herbesser 30 in pregnant people or people may be pregnant (studying on animals, seeing this drug causes teratogenicity: abnormalities in skeletal and dysplasia in mice and poison with embryos, causing mice and rats).
The period of breastfeeding
should not use this medication during breastfeeding. If it is considered that the drug is too needed for the mother, it is necessary to stop breastfeeding during the time the mother uses the drug (diltiazem hydrochlorid excreted through breast milk).
Interactive drug
Caution when combining Herbesser 30 with the following drugs:
Name of drug (anti -hypertension drugs, nitrates ...)
diltiazem hydrochlorid increases blood digitalis preparations.
Storage
Store in closed boxes, below 30 ° C. Avoid sunlight.
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