Ihybes-H 150 Agimexpharm treatsdate hypertension (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Irbesartan, hydrochlorothiazid

Ingredient

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Composition information	Content
Irbesartan	150mg
Hydrochlorothiazid	12.5mg

Uses

Indications

Ihybes-H 150mg drug is indicated in the case of treatment of idiopathic hypertension in adults, especially in case of uncontrolled blood pressure with one drug.

Pharmacology

ihybes-H 300 is a combination of an angiotensin-II, Irbesartan receptor countermonds, and the thiazid diuretic is hydrochlorothiazid. The combination of these ingredients creates an anti -hypertension effect, reducing blood pressure at a better degree than when used separately from each component.

Irbesartan is a tetrazol derivative, an maple of the type 1 receptor of angiotensin II type at AT.

Irbesartan inhibits the physiological effects of angiotensin-II, including the effect of secretion of aldosteron and vasoconstriction, due to the selective inhibition of AT1 receptors of Angiotensin II in many tissues, including adrenal and smooth muscle walls.

When using Irbesartan with the recommended dose of blood potassium concentration does not change much unless there is kidney failure or heart failure.

Medications that lower blood pressure but the heart frequency changes very little. Hypotension effect depends on the dose and tends to not lower when taking a dose higher than 300 mg/time per day.

Maximum lower blood pressure for 3-6 hours after drinking. Anti -hypertension effect maintained at least 24 hours.

Anti -hypertension effect is manifested within 1-2 weeks. The maximum efficiency is achieved within 4-6 weeks from the beginning of treatment and maintenance when long -term treatment. If the blood pressure stops gradually returning to the original value, but there is no sudden serious illness when stopping the drug.

hydrochlorothiazide:

hydrochlorothiazid is a drug in the group of thiazid diuretics, increasing the secretion of sodium chloride and water attached to the mechanism of inhibiting the reabsorption of sodium and chlorine ions in the distance.

The excretion of other electrolytes also increases, especially potassium and magnesi, and calcium decreases. Hydroclorothiazid also reduces the activity of the carbon dioxide, so it increases the excretion of bicarbonate but this effect is usually small compared to the CL - and does not significantly change the urine pH.

Thiazids have a moderate diuretic effect, because about 90% of sodium ions have been reabsorbed before reaching the distance, the main position is effective.

hydrochlorothiazid has the effect of lowering blood pressure, firstly due to a decrease in plasma volume and extracellular fluid related to sodium cards.

Then during the use of the drug, the effect of lowering blood pressure depends on the decrease in peripheral resistance, through the gradual adaptation of blood vessels from the reduction of Na+concentration. Therefore, the hypotension effect of hydrochlorothiazid is shown slowly after 1-2 weeks, while the diuretic effect occurs quickly and can be seen right after a few hours. Hydrochlorothiazid increases the effects of other antihypertensive drugs.

The combination of Irbesartan and hydrochlorothiazid creates a decrease in a combination of blood pressure through their treatment levels. Using a single dose on 150 mg of Irbesartan and 12.5 mg of hydrochlorothiazid that reduces the centrifugal/centrifugal blood pressure (24 hours later medication) is 12.9/6.9 mmHg in patients with mild to moderate hypertension.

This efficiency peaks for 3-6 hours. When assessing the effectiveness through continuous hypertension monitoring 24 hours, the combination of Irbesartan 150 mg and 12.5 mg used once/day reduces blood pressure constant for 24 hours with a decrease in systolic blood pressure 24 hours compared to placebo is 15.8/10.0 mmHg.

In patients with blood pressure that is not controlled in an adaptive way with only hydrochlorothiazid, the combination of Irbesartan adds to reduce systolic/diastolic blood pressure compared to the average placebo is 11.1/7.2mmHg.

The hypotension effect of Irbesartan when combined with hydrochlorothiazid is a clear appearance since the first dose and most clearly after 1-2 weeks, and this effect is maximum after 6-8 weeks. In long -term monitoring studies, the effectiveness of Irbesartan/hydrochlorothiazid is maintained for more than 1 year.

The effect of Irbesartan is not affected by age and gender.

Dynamic pharmacokinetics

The combination of Irbesartan with hydrochlorothiazid does not affect the pharmacokinetics of each drug ingredient.

Irbesartan

absorption:

After drinking, Irbesartan is quickly absorbed through the gastrointestinal tract with bioavailability of 60-80%. Food does not change much of the bioavailability of the drug. The peak concentration of plasma is about 1-2 hours after 1 oral dose. The concentration of drugs in the blood reached a stable balance after 3 days of taking medicine.

Distribution:

The ratio of plasma protein is about 96%. The distribution of the drug is about 53-93 liters.

Metabolism:

Irbesartan is partially metabolized in the liver mainly by CYP 2C9 and possibly by both conjugated with glucuronic acid. Metabolic products are not active.

Era:

Eliminating drugs through bile and urine, after taking about 20% of the amount of excretion of urine in the form of metabolism and less than 2% in non -metabolic form. Half of the semi-excreted life is 11-15 hours.

hydrochlorothiazide

After taken, hydrochlorothiazid is relatively fast, about 65-75% of the dose, but this ratio can be reduced in heart failure. 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 adjustments need to be adjusted. Hydrochlorothiazid passes through the placenta, distributed and reached high concentrations in the fetus.

Diuretelli effects appear after drinking 2 hours, reaching maximum after 4 hours and lasting about 12 hours.

Anti -hypertension effect is much slower than diuretic effects and can only achieve adequate effect after 2 weeks, even with the optimal dose between 12.5 - 25 mg/day. It is important to know that the anti -hypertension effect of hydrochlorothiazid is usually optimal at 12.5 mg (half -tablet 25 mg).

Modern clinical treatment and clinical trial guidelines emphasize the lowest and optimal use, which reduces the risk of harmful effects. The important issue is to wait enough time to assess the body's response to the hypotension effect of hydrochlorothiazid, because the effect on the peripheral resistance takes time to be clear.

Before taking Ihybes-H 150 Agimexpharm treatsdate hypertension (3 blisters x 10 tablets)

How to use

Ihybes-H 150mg oral, orally or orally or after meals.

Dosage

Starting and maintaining daily dose daily is taking 1 capsule/1 time/day. This dose usually controls blood pressure in 24 hours better than the dose ½ capsule.

iHybes-H 150 is used for hypertension patients who are not controlled adequately by each single hydrochlorothiazid or Irbesartan 150mg.

Renal failure: Due to the ingredient with hydrochlorothiazid, iHybes-H 150 is not recommended for patients with severe renal function (creatinine clearance

In these patients, diuretics should be used more than thiazid. There is no need to adjust the dose in patients with renal failure with creatinine clearance of the kidney> 30 ml/min.

Should take a low starting dose ½ capsules for patients with dialysis.

Reducing blood volume: Before using Ihybes-H 150, it is necessary to adjust the reduction of blood volume or dehydration and salt.

Hepatic failure: There is no need to adjust the dose in patients with mild or moderate liver failure. There is no clinical experience for patients with severe liver failure.

Elderly: Although the starting dose is ½ tablet, for patients over 75 years of age, often do not need to adjust the dose for the elderly.

Children: Not determined in terms of safety and effectiveness of Ihybes-H 150 in children.

Dosage should be adjusted after 1-2 months if the blood pressure is not controlled. May need treatment for many months to control the blood pressure well.

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?

What to do when you forget 1 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

Unwanted effects (ADR) when using Ihybes-H 150mg that you may encounter:

do Irbesartan

Unwanted effects caused by Irbesartan are generally light and transient.

Common, ADR> 1/100:

dizziness; headache and hypotension stands related to dosage; Hemorrhage drops can occur especially in patients with hypoglycemia (as when the patient is taking high doses of dosage).

skin rash, urticaria, itching, angioedema, liver enzyme.

cough, respiratory disorders, back pain.

digestive disorders, fatigue, neutropenia.

hydrochlorothiazid may cause excessive potassium loss. This effect depends on the dose and can be reduced when low doses (12.5 mg/day), the best dose for hypertension treatment, while minimizing harmful reactions.

Common, ADR> 1/100:

Fatigue, dizziness, dizziness, headache.

Lower blood pressure, arrhythmia. 1/1000:

Anaphylactic reaction, fever; leukopenia, grain leukemia, platelet reduction, property anemia, hemolytic anemia; Disorders of sleep, depression. Hepatitis, jaundice in the liver, pancreatitis. renal failure, interstitial and impotence; blurred vision. The posture of hypotension may occur when used with alcohol, anesthesia and sedative.

When experiencing side effects of the drug, patients need 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

Ihybes-H 150mg contraindications in the following cases:

Hypersensitivity to the ingredients of the drug.

Caution when using

by Irbesartan

Reducing blood volume: may occur symptomatic hypotension, especially after taking the first dose, in patients with reduced blood volume such as salt loss and water due to strong diuretic groups, salt -limiting diet, diarrhea or vomiting should adjust these conditions before starting treatment with Irbesartan.

Petal stenosis: There is a risk of increased severity of blood pressure and renal failure when the patient has narrowed renal artery narrowing on both sides or artery stenosis of a functional kidney treated with drugs that act on the renin-angiotensin-irtosterone system.

Renal failure and kidney transplantation: When taking Irbesartan for patients with renal impairment, regular testing of potassium, creatinine in serum.

Hyperbysical hyperka: may experience hyperkalemia when using irbesartan, especially those with heart and kidney function. Potassium concentration should be regularly checked regularly in these patients. Avoid simultaneous use of Irbesartan with potassium diuretics.

Mitricous valve stenosis and aortic valve stenosis, hypertrophic congestion: Especially cautious for patients with 2 -leaf valve stenosis or aortic valve stenosis, or hypertrophic cardiomyopathy.

Increase Aldosteron Tien Phat: There is no recommendation to use Irbesartan.

do hydrochlorothiazid

Due to the drug ingredient with hydrochlorothiazid, the patient must be monitored in serum and urine periodically, especially patients using corticosteroids, acth or digitalis, quinidine (risk of vibration -causing torsion).

Severe kidney failure: increased blood urea and may impair renal function.

Hepatic failure: prone to liver coma.

gout: severe illness.

Diabetes: Pay attention to adjusting drugs (insulin, hypoglycemic drugs).

Hypotenoidal effect of hydrochlorothiazid increases in patients after sympathetic nerve removal.

hyperka cholesterol and triglycerides in the blood. Note when taking drugs in the elderly because it is easy to imbalance electrolytes.

Interactive drug

with other anti -hypertension drugs:

The hypotension effect of iHybes-H 150 may increase when used with other anti-hypertension drugs. Irbesartan and hydrochlorothiazid (at the dose of treatment) can be safely coordinated with other anti -hypertension drugs including beta blockers, calcium blockers.

All treatments with high doses in doses can create a decrease in blood volume and the risk of hypotension when starting treatment with Irbesartan with or without diuretics thiazid unless the loss is adjusted.

Medicines affect potassium:

The impact of potassium loss of hydrochlorothiazid is reduced by the potassium retention effect of Irbesartan. However, this impact of hydrochlorothiazid on serum potassium is likely to occur when used in combination with other drugs that cause potassium loss and potassium hypotension (for example, diuretic secretion of potassium urine, laxatives, amphoticin, carbenoxolone, sodium penicillin g, derivatives of salicylic acid).

On the contrary, based on the experience of using other drugs that reduce the renin-anidensin system, use with diuretics to keep potassium, potassium supplements, alternative salts containing potassium or other drugs that can increase serum levels (such as sodium heparin) can increase serum potassium.

The drugs are affected by serum potassium disorders:

Periodic monitoring of serum potassium is recommended when shared with Ihybes-H 150 with drugs affected by serum potassium disorders (such as glycoside digitalis, anti-arrhythmic drugs).

Lithi:

Increasing serum and recovery lithium concentration has been reported when combined with transferred enzyme inhibitors.

In addition, lithium kidney clearance is reduced by thiazid. Therefore, the risk of toxicity of lithium can be increased with Ihybes-H 150. Be careful when using lithium and ihybes-H 150 and carefully monitor serum lithium concentration.

Other information about Irbesartan's interaction:

Digoxin's

pharmacokinetics does not change when used in combination with 150mg Irbesartan in healthy people.

Other information about interaction of hydrochlorothiazide:

Do ihybes-H 150 contains hydrochlorothiazid of the group of thiazid diuretics, so it can occur when used with the following drugs:

Alcohol, barbiturate or addictive sleeping pills:

Increase the potential of hypotension.

Anti -diabetic drugs (oral and insulin):

Need to adjust the dose due to increased blood glucose.

corticosteroid, acth:

Increases electricity loss, especially hypokalemia.

Amines hypertension (eg norepinephrin):

may reduce the response to hypertension, but not enough to prevent use.

muscle relaxants (eg tuboCurarin):

can increase response to muscle relaxants.

Steroid anti -inflammatory drugs:

can reduce diuretic, sodium diuretic and hypotension effect of thiazid in some patients. So if used with, must monitor to see if it is effective for diuretic.

quinidine:

easily causes torsion, vibration causes death.

Reduce the effects of anticoagulants, gout drugs.

Increases the effects of anesthesia, glycosides, vitamin D.

cholestyramin or colestipol: potential to attach thiazid diuretics, reducing the absorption of these drugs through the gastrointestinal tract.

Storage

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

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