Telzid 80/12.5 Medisun medicine for hypertension (6 blisters x 10 tablets)
Dosage form Box of 6 blisters x 10 tablets
Specifications Telmisartan, hydrochlorothiazide
Ingredient
| Composition information | Content |
| Telmisartan | 80mg |
| Hydrochlorothiazide | 12.5mg |
Uses
indications
Telzid 80/12.5 drugs are indicated in the following cases:
telmisartan
Telmisartan is a specific antagonist of Angiotensin II receptor (Type AT1) in smooth and adrenal glands. In the Renin - Angiotensin system, angiotensin II is made up of angiotensin I thanks to the catalyst of the enzyme transferring Angiotensin (ACE). Angiotensin II is a vascular contraction agent, stimulating synthetic adrenal skin and releasing aldosteron, stimulating the heart. Aldosteron reduces sodium excretion and increases potassium excretion in the kidneys. Telmisartan prevents selectively the attachment of angiotensin II into the AT1 receptor in the blood vessel and adrenal glands, causing vasodilation and reducing the effect of aldosteron.
Telmisartan has a strong affinity for AT1 receptor, 3,000 times higher than the AT2 receptor.
Telmisartan does not inhibit the breaking of Bradykinin, so it does not cause persistent dry cough.
Telmisartan reduces systolic and diastolic blood pressure without changing the heart frequency.
When stopping treatment of Telmisartan suddenly, the blood pressure again gradually again for a few days as not yet treated, but there is no strong increase in the phenomenon.
hydrochlorothiazide
hydrochlorothiazid is a thiazid diuretic. Thiazids affect the mechanism of electrolyte reabsorption in kidney sub -trailers, directly increasing sodium and chloride waste of similar amounts.
The diuretic activity of hydrochlorothiazid reduces plasma volume, increases plasma rennin activity, increases aldosteron secretion, resulting in an increased secretion of potassium and bicarbonate secretion in urine, and reducing serum potassium. It can be inferred from the Renin - Angiotensin - Aldosteron blocker blocking, simultaneous use of Telmisartan tends to reduce the amount of potassium lost due to these diuretics.Dynamic pharmacokinetics
absorption
telmisartan
After taking the peak concentrations of Telmisartan achieved after 0.5 - 1.5 hours. The absolute bioavailability of Telmisartan 40 mg is 42%. Feeds that mitigate the bioavailability of Telmisartan with a reduction in the area of the concentration curve in plasma over time (AUC) about 6% for 40 mg tablets.
After 3 hours the plasma concentrations are equivalent.
hydrochlorothiazide
After taking the peak of the peak concentrations of hydrochlorothiazid achieved after 1.0 to 3.0 hours. Due to the excretion through the kidneys, absolute bioavailability is about 60%.
distribution
telmisartan
Telmisartan is strongly connected to plasma proteins (> 99.5%), mainly albumin and alpha-acid glycoprotein. Telmisartan distribution volume is about 500 liters showing additional tissue cohesion.
hydrochlorothiazide
Hydrochlorothiazid is connected 64% with plasma proteins and distribution integral is 0.8 + 0.3 I/kg.
metabolism and elimination
telmisartan
After taking Telmisartan mounted 14C, most dose (> 97%) are excreted in biliary tract. Only a small amount found in urine.
Telmisartan is metabolized by the incompatance of formation of acelglucuronid without pharmacological activity. Glucuronid of the original compound is the only metabolic product determined in humans. After a dose of Telmisartan mounted 14C, Glucuronid accounts for about 11% of radioactive activity measured in plasma.
Cytochrom P450 isoenzyme is not involved in the metabolism of Telmisartan. Telmisartan elimination speed in total plasma after taking the drug is> 1500 ml/min. Telmisartan's ending time is> 20 hours.
hydrochlorothiazide
Hydrochlorothiazid is not metabolized in the human body and is almost completely eliminated in the form of unchanged urine. About 60% of oral doses are eliminated in the form of unchanged within 48 hours. The speed of the kidney is about 250 - 300 ml/min. Hydrochlorothiazid's waste time is 10 - 15 hours.
Before taking Telzid 80/12.5 Medisun medicine for hypertension (6 blisters x 10 tablets)
How to use
can drink Telzid 80/12.5 with or not food.
Dosage
Adults
Used in patients does not fully control the blood pressure when using Telmisartan 80 mg or combined Telmisartan 40 mg/hydrochlorothiazid 12.5 mg.
.Normally: take 1 tablet/day.
Anti -hypertension effect is usually achieved after 4 - 8 weeks of treatment.
kidney failure
Creatinine clearance
Creatinine clearance 30 - 60 ml/minute: No need to adjust the dose.
Should regularly monitor kidney function.
Hepatic failure
Not used.
Elderly
No dose adjustment.
Children and patients under 18 years old
No report.
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?
Overdose from hydrochlorothiazid is associated with electrolyte reduction (hypokalemia, hypoglycemia) and dehydration due to excessive diuretic. The most common signs and symptoms of overdose are nausea and sleep. Hematuria reduction can cause muscle spasms and/or worsen the arrhythmia associated with simultaneous use with Digital Glycosid or some anti -arrhyths.
There is no specific information about the treatment of overdose. Patients should be closely monitored, symptomatic treatment and supportive treatment depending on the time from the absorption of drugs and the severity of symptoms. The electrolytes and serum creatinine should be monitored regularly. If low blood pressure occurs, patients should be placed in a lying position, quickly compensate for the volume and salt. Telmisartan is not eliminated through dialysis. The level of hydrochlorothiazid is removed by dialysis.
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 Telzid 80/12 you can experience unwanted effects (ADR).
CommonTesting: increased creatinin, hyper enzyme, increased blood phosphokinase, hyper uric acid, 3 times triglyceric.
heart disorders: arrhythmia, tachycardia.
Nervous system disorders: fainting, dizziness, paresthesia, sleep disorders, insomnia.
Eye disorders: abnormal vision, fuzzy vision.
Disorders of mesmerizing ears and ears: Dizziness.
Respiratory, chest, medium ventricular disorders: Acute respiratory disease (including pneumonia and pulmonary edema), shortness of breath.
Disorders of gastrointestinal tract: diarrhea, dry mouth, flatulence, abdominal pain, constipation, digestive disorders, vomiting, gastritis.
Liver disorders - biliary tract: abnormal liver/liver disorders.
Skin and subcutaneous disorders: Evaluation (deadly), erythema, itching, rash, increased tissue secretion, urticaria.
Bone and connective tissue whip, musculoskeletal system: back pain, muscle spasm, muscle pain, joint pain, leg pain, cramps in the legs.
Metabolic and nutrition disorders: Hemoto hypoachine, hypociprosis, hyperuricemia.
Infections and parasites: bronchitis, sore throat, sinusitis.
immune system disorders: serious condition or progression of lupus erythematosus.
vascular disorders: hypotension (posture hypotension).
Common puppet and place of use: chest pain, influenza syndrome, pain.
Breast disorders and reproductive systems: helpless.
Mental disorders: Anxiety, depression.
Disorders of musculoskeletal, connective tissue and bone: Weak.
Kidney and urinary tract disorders: interstitial nephritis, kidney dysfunction, urinary glucose.
Testing: Increase triglycerides.
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
Telzid 80/12.5 drug contraindicated in the following cases:
Hypersensitivity to any ingredient of the drug.
Pregnant women.
Breastfeeding period.
Cholestical and bile congestion disorders.
liver failure.
Severe renal failure (Creatinine clearance rate
Hypotension, hyperacture does not respond to treatment.
Contraindicated drug combination with Aliskiren in diabetes patients and renal function impairment.
Caution when using
because taking medicine may experience unwanted effects such as fainting, dizziness, abnormalities, sleep disorders, insomnia, abnormal vision, fuzzy vision, muscle weakness, leg cramps ... should be cautious for this object.
Hepatic failure
Do not use drugs for patients with bile stasis, bile congestion or severe liver failure because patients with liver function or liver disease are progressing, because only small changes in water and electrolytes can lead to liver coma.
Hypertension caused by kidney artery
Has the ability to increase the risk of severe hypotension and renal failure when the patient has narrowed kidney stenosis on both sides or the kidney stenosis to the only kidney is still functioning to be treated with drugs that affect the Renin - Angiotensin - Aldosteron system.
kidney failure and kidney transplant.
Intravascular volume loss
Symptomatic hypotension, especially after the first dose, can occur in patients with volume loss and/or sodium loss due to excessive diuretic therapy, too strict salt abstinence, diarrhea or vomiting. Such conditions should be overcome before taking the drug.
Double Renin - Angiotesin - Aldosteron System
As a consequence of the inhibition of the Renin - Angiotesin - Aldosteron system, there has been a report on changing renal function (next to acute renal failure) in sensitive patients, especially if used in combination with drugs that affect this system. Therefore, the limit of the Dual Renin - Angiotensin - Aldosteron system should be limited (for example, a combination of an enamel inhibitor with an angiotensin II receptor inhibitor) in some cases specifically defined along with the closely monitoring of the kidney function.
Other conditions that stimulate the Renin - Angiotensin - Aldosteron system
On patients with vascular tone and renal function depend largely on the activity of the Renin - Angiotensin - Aldosterone system (for example, patients with severe congestive heart failure or basic kidney disease, including kidney artery stenosis), the treatment with other drugs affects the Renin - Angiotensin - Aldosteron system related to acute hypotension, increased urban urban.
Increasing primary aldosteron
It is not recommended to use Telzid 80/12.5.
Aortic valve stenosis and mitral valve, hypertrophic myocardial disease.
Metabolic and endocrine effects
Thiazid therapy may reduce glucose tolerance. In patients with diabetes may need to adjust insulin dose or oral hypoglycemic drugs. Potential diabetes can become an entity during thiazid treatment. Increasing the concentration of cholesterol and triglyerids related to thiazid diuretic therapy, but very few or almost no such effects are reported at a dose of 12.5 mg contained in Telzid 80/12.5.
For any patient who uses thiazid therapy, the periodic test of electrolytes in serum must be performed according to the appropriate time. Thiazid drugs, including hydrochlorothiazid, can cause water and electrolyte balance (hypotension, sodium hypoglycemia and bleeding due to hemorrhage). The warning signs of electrolyte imbalance are dry mouth, thirst, weakness, sleep, drowsiness, restlessness, muscle pain or cramping, muscle weakness, reducing blood pressure, urinary decrease, tachycardia and gastrointestinal disorders such as nausea or vomiting.
Although hypokalemia may appear when using thiazid diuretics, simultaneous treatment with Telmisartan can reduce the ability to lower potassium potassium due to diuretics. The risk of hypokalemia will be the highest in patients with cirrhosis, on patients who are taking fast diuretics, on patients who are not compensating for enough electrolytes through oral and on patients treated simultaneously with corticosteroids or ACTH.
In contrast, due to the antagonism mechanism of the Angiotensin II receptors (AT1) by Telmisartan component of Telzid 80/12.5, the condition of hyperkalemia may occur. Although clinically significant hyperkalemia has not been recorded with Telzid 80/12.5, risk factors leading to hyperkalemia include kidney failure and/or heart failure and diabetes.
Potassium diuretic, potassium supplements or potassium salts should be used to be used carefully with Telzid.
Thiazids can reduce the excretion of calcium in the urinary tract and cause slight increase, temporary serum calcium in the condition that no other calcium metabolic disorders. Significant hypercalcemia may be evidence of the hyperpigonomic gland. Thiazids should be stopped before conducting adjacent function tests.
Thiazids have shown to increase the elimination of magnesium through the urinary tract, which can lead to lowering blood mages.
The ability to drive and operate machinery
because taking the medicine may experience unwanted effects such as fainting, dizziness, abnormalities, sleep disorders, insomnia, abnormal vision, fading glance, muscle weakness, leg cramps ... should be cautious for this object.
Unable to use pregnancy
.
Nursing period
cannot be used.
Drug interaction
Telmisartan
Lithium and toxic lithium concentration of recovery lithium has been reported during simultaneous use of lithium with enzyme inhibitors Angiotensin. In some cases, it has also been reported when used with Angiotensin II receptor antagonists, including Telmisartan. Moreover, the lithium's kidney clearance rate is reduced by thiazids so the risk of lithium poisoning can increase when using Telzid 80/12.5. Lithium and Telzid 80/12.5 should only be used simultaneously under medical supervision and need to monitor serum lithium concentration during simultaneous use.
The effect of potassium loss of hydrochlorothiazid is reduced due to the potassium -keeping effect of Telmisartan.
However, this effect of hydrochlorothiazide for serum potassium can become potential due to other drugs related to loss and lower potassium (e.g. diuretics that cause potassium excretion in the urinary tract, laxatives, corticosteroids, acth, amphotericin, carbenoxolone, penicillin g sodium, salicylic acid and guide acid).hydrochlorothiazide
When used simultaneously, the following drugs may interact with thiazid diuretics:
metformin: There is a risk of lactic acidic acidosis when used simultaneously with hydrochlorothiazid.
Cholestyramin and Colestipol plastic: Hydrochlorothiazid absorption may be reduced in the presence of anion exchange resin.
Digitalis glycosides: Hypoach and blood magnesium due to thiazid creating favorable conditions for the appearance of rhythm due to digital.
Amines that cause hypertension (noradrenalin wallet): The effect of amines that cause hypertension may be reduced.
Non -reducing muscle muscle relaxants (eg tuboCurarin): The effect of these drugs can be enhanced by hydrochlorothiazide.
Gout treatment: The adjustment of the dose of urinus medications can be necessary.
Storage
In a dry place, temperatures below 30 oC.
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