Thyperopa Forte Ha Tay medicine for hypertension (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Methyldopa

Ingredient

Composition information	Content
Methyldopa	500mg

Uses

indications

Thyperopa Forte drug used in hypertension treatment.

Pharmacokology

Methyldopa is a structural antihypertensive drug related to catecholamine and their precursors. Although the mechanism of action also needs to be verified, the anti -hypertension effect of methyldopa is probably because the drug is metabolized in the central nervous system to Alpha Methyl Norepinephrin, this substance stimulates alpha adrenergic receptors leading to sensitive hypertension and reducing blood pressure. Therefore, Methyldopa is considered a sympathetic drug with a central impact. Methyldopa also reduces lyin activity in plasma and contributes to the hypotension effect of the drug. Methyldopa inhibits carboxyl reduction of dihydroxyphenylalanin (DOPA) (the precursor of norepinephrin) and 5 - hydroxytryptophan (the precursor of serotonin). Although the main hypotension of the drug is not due to decarboxylase inhibition, it is not possible to eliminate the contribution of peripheral mechanism. Methyldopa has been shown to reduce the concentration of serotonin, dopamine, norepinephrin and epinephrin in tissues.

Methyldopa lowers blood pressure both in a standing position and a lying position. The drug does not directly affect the kidney and heart function. Cardiac supply is usually maintained; No heart frequency increases. In some cases, it can be seen that the heart rate slows down. The supply of kidney, glomerular filtration, or filter fraction is usually not affected, so the effect of reducing blood pressure can be maintained even in patients with renal impairment. Rarely have symptoms of posture hypotension, hypotension during activity and blood pressure changes during the day.

methyldopa can be used in combination with other antihypertensive drugs, especially thiazid diuretic, including combinations of thiazid and amilorid. Methyldopa can also be combined with beta blockers.

Dynamic pharmacokinetics

absorption: The absorption of methyldopa is incomplete. The average biological use only reaches 25% of the dose, and changes a lot among patients. The maximum concentration in the plasma of the drug is achieved within 2-4 hours after drinking, the anti-hypertension effect is maximum after 4-6 hours.

Distribution: Linking drugs with plasma proteins. The distribution of the drug is 0.6 liters/kg. The drug can pass the placenta and breast milk. The maximum concentration in the plasma of the drug is achieved within 2-4 hours after drinking, the anti -hypertension effect is maximum after 4-6 hours.

Metabolism: The first liver metabolism should be bioavailable by low gastrointestinal tract (about 25%).

Elimination: The half -life in the plasma of the drug is 1-2 hours for people with normal renal function and increases when the kidney function decreases. About 70% are excreted through the kidneys, of which 60% are free methyldopa, the rest is metabolites in the form of combined.

Before taking Thyperopa Forte Ha Tay medicine for hypertension (10 blisters x 10 tablets)

How to use

Thyperopa Forte drug used oral.

Dosage

adults

The starting treatment: Methyldopa's usual starting dose is 250 mg, 2 to 3 times a day, in the first 48 hours. This dose is then adjusted depending on the response of each patient. To minimize sedative effects, should start increasing the dose in the evening.

Maintenance treatment: The usual dose of methyldopa is 0.5 - 2 g/day, divided 2-4 times. The maximum daily dose is recommended for 3 g.

Should be used in combination with thiazid diuretics if not started with thiazid or if the effect of reducing blood pressure is not met with methyldopa doses of 2 g/day.

Methyldopa is excreted in large quantities through the kidneys and people with renal impairment may respond to a smaller dose. Fainting in the elderly may be related to an increase in drug sensitivity or atherosclerosis. This can be avoided by lower doses.

Elderly

Initial dose 125 mg/ time, drink 2 times/ day, the dose may increase gradually. Maximum dose of 2g/day.

Children

The starting dose is 10 mg/kg body weight/day, divided into 2-4 times. The maximum dose is 65 mg/kg or 3 g/day.

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?

Expression:

Extremely overdose can cause hypotension with dysfunction of the brain and the digestive system (excessive sedation, slow vessels, constipation, flatulence, diarrhea, nausea, vomiting).

Management:

Cases of overdose, usually only treat symptoms and support. When taken medication, you can wash your stomach or cause vomiting. If the drug has been absorbed, it can be transmitted to increase the elimination of the drug through the urine. Special attention should be paid to heart frequency, blood flow, electrolyte balance, intestinal paralysis and brain activity.

Can use drugs that are similar to sympathetic effects such as Levarterenol, Epinephrin, Metaraminol.

methyldopa can be excluded from circulation by hemorrhage.

When the overdose symptoms should be stopped, the drug should be stopped immediately and to the nearest medical facility.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

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

When treated with methyldopa lasts long, 10-20% of patients have positive Coombs reaction and in some rare circumstances that can be combined with hemolytic anemia. It may lead to deadly complications.

The most common is sedative effect, at least 30%; 18% dizziness and 10% dry mouth. Headache when treated, after all (10%).

Common, ADR> 1/100

Systemic: headache, dizziness, fever. Meet, 1/1000

Body: weakness.

Blood: Bone marrow failure, leukopenia, granulocytosis, platelets, hemolytic anemia, huge red blood cell anemia. secretion: amenorrhea, big breasts, milk secretion. Peroding, diseases like lupus erythematosus.

Instructions on how to handle ADR:

If hemolytic anemia occurs with a positive cooom reaction (this reaction usually occurs after 6 - 12 months of treatment), the cause may be due to methyldopa, in this case, the drug should be stopped. The lowest incidence if the daily dose is equal to or less than 1 g. Usually the symptoms of anemia decrease rapidly. If not supported, corticosteroids can be used, in case of need for blood transfusion, and should consider other causes of anemia. If hemolytic anemia is associated with methyldopa, it is not advisable to continue taking the drug.

Hemolysis is occasionally occurring not related to positive or negative cooom reactions. This case occurs in people with a deficiency of glucose - 6 - phosphate dehydrogenase, with a higher rate in residential areas exposed to malaria compared to residential areas not exposed to malaria.

Sedative effects can occur at the beginning of the drug or when increasing the dose, but this unwanted effect will end up when performing maintenance treatment.

When using methyldopa, the main effect is mainly fever due to drugs. The fever occasionally accompanied by eosin leukemia and/or liver dysfunction on testing, fever that may occur in stages, but usually only occurs in the first 3 weeks of the treatment. Jaundice may occur but also usually in the first 2 or 3 months of taking the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Thyperopa Forte drugs contraindicated in the following cases:

Active liver disease such as acute hepatitis and progressive cirrhosis.

Be cautious when using

drugs with lactose excipients, should not be used for patients with lactose intolerance, Lapp Lactase deficiency or glucose-galactose absorption disorders.

methyldopa should be used carefully in the following cases:

History of liver disease or liver dysfunction in advance; Parkinson's disease; Mental depression; Porphyrin metabolism disorders; Brain atherosclerosis. This can be avoided with lower doses. In this case, in a rare number of cases, it may be combined with hemolytic anemia, and then it can lead to deadly complications. If hemolytic anemia is related to methyldopa, it is not advisable to continue taking the drug. Only occurs in the first 3 weeks of the treatment. Jaundice may occur but also usually in the first 2 or 3 months of taking the drug. Should periodically quantify white blood cells and test the liver for the first 6 - 12 weeks of treatment or when the patient has unexplained fever.

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

methyldopa can cause drowsiness or unwanted effects on the central nervous system (dizziness, headache, sedation ...) so it is not used for this object.

Use drugs for women during pregnancy and lactation

Pregnant women:

The drug can pass through the placenta, consider the risk of the risk when taking the drug for pregnant women.

breastfeeding women:

methyldopa is excreted in breast milk, the dose of treatment commonly used for nursing mothers can cause risks to children. So do not use medication for breastfeeding people.

Drug interaction

should be cautious when methyldopa is used simultaneously with the following drugs:

Other hypertension treatments: may increase the effect of lowering blood pressure, increased adverse reactions or therapeutic reactions.

Anesthesia: Must reduce the dose of anesthetic; If hypotension during anesthesia can take vasoconstrictor drugs.

Lithi: Increasing the toxicity of lithium.

Monoamine inhibitors (Mao): Because of excessive hypotension.

Amphetamine, central nerve stimulants, 3 -round antidepressants: because of the antagonism to treat hypertension and loss of blood pressure control.

iron hematopsius has: Methyldopa's concentration in plasma and reducing anti -hypertension effects of methyldopa.

Oral contraceptives: Because of the increased risk of vascular damage and causing difficulty in control of blood pressure.

Storage

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

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