Tepirace Davipharm treatment for hypertension (3 blisters x 10 tablets)

Clonidine reduces secretion in the sympathetic lymph nodes of the nerves as well as in the sympathetic lymph nodes of the heart nerves.

Clonidin reduces the excretion through urine and noradrenalin levels in plasma. In addition, the drug also reduces the levels of renin and aldosteron in some people with hypertension.

The main pharmacological effect of clonidin includes changes in blood pressure and heart rate.

However, the drug also has other important effects such as analgesic, reducing symptoms when quitting opium, opaque pressure, etc. About 2 hours after using the drug has seen the maximum anti -hypertension effect and the long -lasting effect depends on the dose.

About 10 hours after a single dose of 75 micrograms, the maximum anti -hypertension effect is still 70 to 75%. About 24 to 48 hours later, usually blood pressure is not affected. Clonidin can be combined with most anti -hypertension drugs and with diuretics.

Clonidin epidural injection may relieve pain at Adrenergic Alpha2 receptors before sinap and after sinap in the spine due to the prevention of pain signals. Only pain relief in the body areas are distributed by the spinal cord segments that have enough concentrations of clonidine pain relief. Because clonidine is acting through the alphaz receptor in the brain (in the green core, Locus Ceruleus), it reduces the symptoms of cessation occurs in patients who stop using opium forms.

Anti -hypertension effect is achieved when the plasma concentration is from 0.2 to 2.0ng/ml in patients with normal kidney function. The effect of lowering blood pressure is weakened or reduced when the plasma concentration in plasma is over 2.0 ng/ml.

pharmacokinetic

absorption

Clonidin after drinking is well absorbed and bioactive is 75% to 95%. There is a close correlation between clonidine levels in plasma and anti -hypertension effects of the drug. The peak concentration in plasma and the maximum hypotension effect is from 1 to 3 hours after taking the medicine.

distribution

In the blood of the drug is attached to protein at 20 to 40%. Clonidin soluble in lipids should be distributed to most organizations in the body and can integrate 2.1 kg, so removing clonidin from the body by hemorrhage will not be effective.

In the body, the drug is concentrated in the highest concentration in the kidneys, liver, stomach - intestines. Although distributed into cerebrospinal fluid, the concentration in the brain is very low. Clonidin passed through the placenta. Clonidin excreted milk, however, information about the effect on breastfeeding is not sufficient

transformation

Clonidin is metabolized mainly in the liver to create 4 non -activity metabolites. The main metabolite is p-hydroxy-clonidin.

Elimination

The drug is excreted mainly through the kidneys in the form of metabolic or unprocessed. The drug has a bowel cycle. In people with normal kidney function, the sale time of the drug ranges from 6 to 24 hours.

About 70% of the drug is eliminated through the kidneys, mainly in a constant form (40 to 60% of the dose). About 20% of the dose is eliminated through feces.

pharmacokinetics in special subjects

There is no clear information about the effects of food or race on the pharmacokinetics of the drug.

Renal failure: The increase in the sale time of the drug may increase from 18 to 41 hours in renal failure. Therefore, the dosage needs to be adjusted for severe renal failure.

The report is sometimes abnormal in liver function tests, hepatitis has also been reported.

Instructions on how to handle ADR

Parameters need to be carefully monitored: blood pressure measured in standing and sitting/lying on their backs, frequency and respiratory depth, pain relief, mental state, slow heart rate (can be treated with atropine).

When unwanted effects occur, the dosage can be reduced.

When stopping the drug, it is necessary to gradually reduce the dose in a week or longer, to avoid corresponding hypertension.

Recommended patients must not stop the drug.

Be cautious when using

Prisestation when taking drugs for patients with Raynauds or other peripheral vascular diseases. Like other medications for hypertension, cautious when using clonidin cerebral vascular disease or coronary insufficiency.

Be cautious when using clonidin for patients with mild to medium -sized slow heartbeats such as slow sinus rhythms, and multiple nerve disease or constipation.

Careful monitoring patients with a history of depression when treated for prolonged treatment with clonidin because there is a recurrent depression report when taking clonidin hydrochloride in some patients.

Like other hypertension medications, especially careful monitoring when treated with hydrochloride clonidin in patients with heart failure.

Clonidin hydrochloride may not be effective when treating hypertension due to chrome cell tumors.

Clonidin and its metabolites are excreted mainly in urine. The dose must be adjusted depending on the treatment of hypertension of each patient. The response can be transformed in patients with renal impairment, so it is necessary to monitor carefully. Because only a small amount of clonidine is removed when the blood separator, no additional dose of clonidine after the appraisal.

Recommended patients must not stop the drug without a doctor's opinion.

Sudden stopping clonidin, especially patients taking high doses, can cause corresponding hypertension. In some cases, sudden stopping clonidin can cause symptoms such as stress, agitation, chest drum, restlessness, headache, trembling or following the rapid increase in blood pressure and increased catecholamine levels in plasma.

Abdominal symptoms have also been reported. The reactions due to stopping this drug may increase after high doses of clonidin or continue to use simultaneously with beta blockers, so it is necessary to be especially cautious in these cases. There has been a rare report on hypertension, stroke and death after stopping clonidine. The dose should be reduced slowly every 2-4 days when stopping treatment with clonidin to avoid symptoms due to drug discontinuation.

Excessive hypertension after stopping treatment with clonidin can be treated by continuing clonidin or using sympathetic beta blockers.

If you stop taking the drug in patients who are concurrently taking clonidin and beta blockers, it is recommended to stop the beta blockers a few days before slowly stopping clonidin. Be cautious when using hydrochloride clonidin for patients with contact lenses because the drug can reduce tears.

should continue to use clonidin within 4 hours after surgery and continue as soon as possible. Need to monitor blood pressure carefully during surgery and have supportive measures to control blood pressure.

Do not use clonidin to relieve obstetric pain, after giving birth or around the surgery period, or in people with unstable hemodynamics due to the inability to withstand low blood pressure and slow heart rate.

There have been reports serious cases, including sudden death, occurring when used simultaneously with methylphenidat. Safety of coordination of methylphenidat and clonidin has not been fully evaluated.

tepirace contains lactose. Patients with rare genetic diseases with galactose tolerance, Lapp Lactase deficiency or glucose absorption disorders - Galactose should not be used.

Children: It is not recommended to use drugs for children and adolescents due to lack of information on safety and use of drugs in this age group. To be out of reach of children.

Use drugs for women during pregnancy and lactation

Pregnancy

Clonidin passes through the placenta and has not seen the risk of deformities due to the use of clonidin during pregnancy. However, up to now, there has been no research to fully assess the effects of drugs on pregnant women, so they only use the drug when necessary. This drug must be used carefully, because it is likely to cause serious hypertension when stopping the drug suddenly. For all anti -hypertension drugs used during pregnancy, it is important to consider and protect adequate blood flow to the placenta.

Breastfeeding period

Clonidin is excreted in milk. Seeing hypotension in breastfeeding children when the mother uses clonidin.

The effect of the drug on the ability to drive and operate machinery

The drug can cause chickens, dizziness or vision disorders. Must be very careful when driving or operating machinery.

Medicinal interaction

The antidepressant triple antidepressants against the effect of clonidin's hypotension and increases the risk of hypertension when clonidin stops suddenly. Combining three -round antidepressants with clonidin increases manifestations of corneal damage in the mouse.

Beta blockers can increase the possibility of slow heart rate in people who are using clonidin and may increase the risk of severe regression hypertension when stopping the drug, thus stopping beta blockers for a few days (7 to 10 days) before starting treatment with clonidine.

Because clonidin causes slow heart rate and inhibitor atrial transmission, it must be very careful when coordinating with guanethidin, calcium channel blockers, cardiac glycosides.

Sleep -causing painkillers can increase the effect of clonidine hypotension.

Ethanol and Barbiturat may increase the inhibition of the central nervous system.

Clonidin epidural injection can prolong the sense of sense and movement nerves of anesthetics.

Clonidin may increase the effects of alcohol and sedatives.

Clonidin has the effect of coordinating with other hypertension drugs, so when coordinated, you need to adjust the dose carefully.

Triple -round antidepressants and analgesic drugs with Alpha receptor blockers can reduce the effect of treating hypertension and increasing the effect of clonidin's posture lowering.

compounds that cause hypertension or water retention and sodium ion (Na+), such as nonsteroidal anti -inflammatory drugs, can reduce the effectiveness of clonidine treatment.

Compounds with alpha blockers, such as Mirtazapin may cause loss of dosage dependence of clonidin through Alpha2 receptor intermediaries.

Reports in some patients in a state of alcohol indicated that high -dose intravenous injections may increase the risk of right ventricular dysplasia (extending the QT, vibration) of high doses of intravenous haloperidol intravenously. The causal relationship and the relationship with Clonidin tablets are not yet set orally.

Simultaneous use of clonidin and beta blockers can cause or worsen peripheral vascular disorders.