Captopril Sandoz tablets 25 mg 40 pcs. pack (Captopril)
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$20.40
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Tablets Buy Captopril Sandoz tablets 25 mg 40 pcs. pack (Captopril) in newyork free shipping. Fast international shipping USA, AU, EU, UK and others.
Tablets Buy Captopril Sandoz tablets 25 mg 40 pcs. pack (Captopril) in newyork free shipping. Fast international shipping USA, AU, EU, UK and others.
Release form
Tablets
Pharmacological action of
Captopril is an ACE inhibitor. Reduces the formation of angiotensin II from angiotensin I. A decrease in the content of angiotensin II leads to a direct decrease in the release of aldosterone. At the same time, OPSS, blood pressure, post- and preload on the heart are reduced. Expands arteries to a greater extent than veins. It causes a decrease in the degradation of bradykinin (one of the effects of ACE) and an increase in the synthesis of Pg. The antihypertensive effect does not depend on the activity of plasma renin, a decrease in blood pressure is noted at normal and even reduced hormone concentrations, which is due to the effect on tissue renin-angiotensin systems. Enhances coronary and renal blood flow. With prolonged use, it reduces the severity of myocardial hypertrophy and the walls of the arteries of the resistive type. Improves blood supply to the ischemic myocardium. Reduces platelet aggregation. Helps reduce Na + content in patients with heart failure. At doses of 50 mg / day, it exhibits angioprotective properties in relation to the vessels of the microvasculature and can slow the progression of chronic renal failure in diabetic nephroangiopathy. Decrease in blood pressure in contrast to direct vasodilators (hydralazine, minoxidil, etc. ) is not accompanied by reflex tachycardia and leads to a decrease in myocardial oxygen demand. When heart failure in an adequate dose does not affect the value of blood pressure. The maximum decrease in blood pressure after oral administration is observed after 60-90 minutes. The duration of the hypotensive effect is dose-dependent and reaches optimal values within a few weeks.
Indications
- Arterial hypertension (including renovascular).
- Chronic heart failure (as part of combination therapy).
Contraindications
- Quincke's edema (including a history of ACE inhibitors).
- Severe renal impairment.
- Azotemia.
- Hyperkalemia.
- Bilateral renal artery stenosis or single kidney stenosis with progressive azotemia.
- Condition after kidney transplantation.
- Primary hyperaldosteronism.
- Stenosis of the aortic orifice.
- Mitral stenosis.
- The presence of two obstacles to the outflow of blood from the left ventricle of the heart.
- Hypersensitivity to captopril and other ACE inhibitors.
- Severe impaired liver function.
- Arterial hypotension.
- Cardiogenic shock.
- Children under 18 years old.
Special instructions
Before starting, as well as regularly during treatment with Captopril, kidney function should be monitored.
In chronic heart failure, the drug is used subject to close medical supervision.
With extreme caution, captopril is prescribed to patients with diffuse connective tissue diseases or systemic vasculitis to patients receiving immunosuppressants, especially in the presence of impaired renal function (risk of developing serious infections that are not amenable to antibiotic therapy). In such cases, the peripheral blood picture should be monitored before captopril is used, every 2 weeks during the first 3 months of therapy and periodically in the subsequent treatment period.
The drug is used with caution during treatment with allopurinol or procainamide, as well as during treatment with immunosuppressants (including azathioprine, cyclophosphamide), especially in patients with impaired renal function.
The likelihood of developing arterial hypotension during treatment can be reduced if you stop using diuretics 4-7 days before starting Captopril or significantly reduce their dose. In case of symptomatic arterial hypotension after taking Captopril, the patient should take a horizontal position with raised legs.
In the case of severe arterial hypotension, a positive effect is noted with the intravenous administration of an isotonic sodium chloride solution. In the case of the development of angioedema, the drug is canceled and a thorough medical observation is carried out. If the edema is localized on the face, special treatment is usually not required (antihistamines can be used to reduce the severity of symptoms) if the edema extends to the tongue, pharynx or larynx and there is a risk of respiratory tract obstruction, adrenaline should be injected subcutaneously immediately (0 5 ml at a dilution of 1: 1000).
Use with caution in patients with a history of kidney disease, since there is an increased risk of developing proteinuria. In such cases, the amount of protein in the urine should be monitored monthly during the first 9 months of captopril treatment. If the protein level in the urine exceeds 1 g / day, it is necessary to decide on the appropriateness of further use of the drug. With caution, Captopril is prescribed to patients with renal artery stenosis, as there is a risk of impaired renal function in the event of an increase in the level of urea or creatinine in the blood, a dose reduction of Captopril or withdrawal of the drug may be required.
Composition
1 tablet contains:
Active ingredient: 25 mg captopril.
Excipients: microcrystalline cellulose, milk sugar, corn starch, magnesium stearic acid.
Dosage and administration of
captopril is prescribed an hour before meals. The dosage regimen is set individually.
With arterial hypertension, the drug is prescribed in an initial dose of 25 mg 2 times a day. If necessary, the dose is gradually (with an interval of 2-4 weeks) increased until the optimal effect is achieved.
With mild or moderate arterial hypertension, the usual maintenance dose is 25 mg 2 times a day. The maximum dose is 50 mg 2 times a day.
In severe arterial hypertension, the maximum dose is 50 mg 3 times a day. The maximum daily dose is 150 mg.
For the treatment of chronic heart failure, captopril is prescribed in cases where the use of diuretics does not provide an adequate effect. The average maintenance dose is 25 mg 2-3 times a day. In the future, if necessary, the dose is gradually increased (with an interval of at least 2 weeks). The maximum dose is 150 mg per day.
Patients with impaired renal function with a moderate degree of impaired renal function (creatinine clearance of at least 30 ml / min / 1.73 m 2) Captopril can be prescribed at a dose of 75-100 mg / day. With a more pronounced degree of impaired renal function (creatinine clearance less than 30 ml / min / 1.73 m 2), the initial dose should be no more than 12.5-25 mg / day in the future, if necessary, with sufficiently long intervals, the dose of Captopril is gradually increased, but use a smaller than usual daily dose of the drug.
Side effects
From the CCC: tachycardia, marked decrease in blood pressure, orthostatic hypotension, peripheral edema.
From the nervous system: dizziness, headache, ataxia, paresthesia, drowsiness, visual impairment.
From the urinary system: impaired renal function.
From the side of hematopoietic organs: neutropenia, anemia, thrombocytopenia, agranulocytosis.
Allergic reactions: angioedema of the extremities, face, lips, mucous membranes, tongue, pharynx and larynx, as well as the small intestine (very rare).
From the digestive system: violation of taste, dry oral mucosa, stomatitis, abdominal pain, diarrhea, increased activity of hepatic transaminases, hyperbilirubinemia, hepatitis.
From the respiratory system: dry cough, passing after drug withdrawal, bronchospasm, pulmonary edema.
Laboratory indicators: hyperkalemia, hyponatremia, proteinuria, increased urea nitrogen, hypercreatininemia, acidosis, the appearance of antinuclear antibodies in the blood. Cases of hypoglycemia have been reported in patients with diabetes who took insulin and oral hypoglycemic drugs.
Drug interactions
Diuretics and vasodilators (e.g. minoxidil) potentiate the hypotensive effect of captopril.
When combined with captopril and indomethacin (and possibly with other non-steroidal anti-inflammatory drugs), a decrease in hypotensive effect may be noted.
The antihypertensive effect of captopril may be slowed when prescribed to patients receiving clonidine.
Concomitant use with potassium-sparing diuretics or potassium preparations can lead to hyperkalemia.
With the simultaneous use of lithium salts, an increase in serum lithium concentration is possible. The use of captopril in patients taking allopurinol or procainamide increases the risk of neutropenia and / or Stevens-Johnson syndrome.
The use of captopril in patients taking immunosuppressants (e.g. cyclophosphacin or azathioprine) increases the risk of hematologic disorders.
Overdose
Symptoms: severe arterial hypotension, up to collapse, myocardial infarction, acute cerebral circulation disorder, thromboembolic complications.
Treatment: to put the patient with the raised lower extremities measures directed on restoration of arterial pressure (increase in volume of circulating blood, including intravenous infusion of isotonic solution of sodium chloride), symptomatic therapy. Possible use of hemodialysis peritoneal hemodialysis is ineffective.
Storage conditions
Store in a dry, dark place at a temperature not exceeding 25 ° C.
Shelf life
2 years
Deystvuyushtee substance
Captopril
Terms of dispatch from
pharmacies prescription
dosage form
tablets
Possible product names
Captopril Sandoz tablets 25 mg 40 pcs.
Sandoz, Switzerland
Captopril Sandoz tablets 25 mg 40 pcs. pack (Captopril) florida in pharmacy online. Cheap price, instruction, side effects, dosage. Captopril Sandoz tablets 25 mg 40 pcs. pack - Sale. PayPal accept. Free shipping florida. Fast international shipping.
Tablets
Pharmacological action of
Captopril is an ACE inhibitor. Reduces the formation of angiotensin II from angiotensin I. A decrease in the content of angiotensin II leads to a direct decrease in the release of aldosterone. At the same time, OPSS, blood pressure, post- and preload on the heart are reduced. Expands arteries to a greater extent than veins. It causes a decrease in the degradation of bradykinin (one of the effects of ACE) and an increase in the synthesis of Pg. The antihypertensive effect does not depend on the activity of plasma renin, a decrease in blood pressure is noted at normal and even reduced hormone concentrations, which is due to the effect on tissue renin-angiotensin systems. Enhances coronary and renal blood flow. With prolonged use, it reduces the severity of myocardial hypertrophy and the walls of the arteries of the resistive type. Improves blood supply to the ischemic myocardium. Reduces platelet aggregation. Helps reduce Na + content in patients with heart failure. At doses of 50 mg / day, it exhibits angioprotective properties in relation to the vessels of the microvasculature and can slow the progression of chronic renal failure in diabetic nephroangiopathy. Decrease in blood pressure in contrast to direct vasodilators (hydralazine, minoxidil, etc. ) is not accompanied by reflex tachycardia and leads to a decrease in myocardial oxygen demand. When heart failure in an adequate dose does not affect the value of blood pressure. The maximum decrease in blood pressure after oral administration is observed after 60-90 minutes. The duration of the hypotensive effect is dose-dependent and reaches optimal values within a few weeks.
Indications
- Arterial hypertension (including renovascular).
- Chronic heart failure (as part of combination therapy).
Contraindications
- Quincke's edema (including a history of ACE inhibitors).
- Severe renal impairment.
- Azotemia.
- Hyperkalemia.
- Bilateral renal artery stenosis or single kidney stenosis with progressive azotemia.
- Condition after kidney transplantation.
- Primary hyperaldosteronism.
- Stenosis of the aortic orifice.
- Mitral stenosis.
- The presence of two obstacles to the outflow of blood from the left ventricle of the heart.
- Hypersensitivity to captopril and other ACE inhibitors.
- Severe impaired liver function.
- Arterial hypotension.
- Cardiogenic shock.
- Children under 18 years old.
Special instructions
Before starting, as well as regularly during treatment with Captopril, kidney function should be monitored.
In chronic heart failure, the drug is used subject to close medical supervision.
With extreme caution, captopril is prescribed to patients with diffuse connective tissue diseases or systemic vasculitis to patients receiving immunosuppressants, especially in the presence of impaired renal function (risk of developing serious infections that are not amenable to antibiotic therapy). In such cases, the peripheral blood picture should be monitored before captopril is used, every 2 weeks during the first 3 months of therapy and periodically in the subsequent treatment period.
The drug is used with caution during treatment with allopurinol or procainamide, as well as during treatment with immunosuppressants (including azathioprine, cyclophosphamide), especially in patients with impaired renal function.
The likelihood of developing arterial hypotension during treatment can be reduced if you stop using diuretics 4-7 days before starting Captopril or significantly reduce their dose. In case of symptomatic arterial hypotension after taking Captopril, the patient should take a horizontal position with raised legs.
In the case of severe arterial hypotension, a positive effect is noted with the intravenous administration of an isotonic sodium chloride solution. In the case of the development of angioedema, the drug is canceled and a thorough medical observation is carried out. If the edema is localized on the face, special treatment is usually not required (antihistamines can be used to reduce the severity of symptoms) if the edema extends to the tongue, pharynx or larynx and there is a risk of respiratory tract obstruction, adrenaline should be injected subcutaneously immediately (0 5 ml at a dilution of 1: 1000).
Use with caution in patients with a history of kidney disease, since there is an increased risk of developing proteinuria. In such cases, the amount of protein in the urine should be monitored monthly during the first 9 months of captopril treatment. If the protein level in the urine exceeds 1 g / day, it is necessary to decide on the appropriateness of further use of the drug. With caution, Captopril is prescribed to patients with renal artery stenosis, as there is a risk of impaired renal function in the event of an increase in the level of urea or creatinine in the blood, a dose reduction of Captopril or withdrawal of the drug may be required.
Composition
1 tablet contains:
Active ingredient: 25 mg captopril.
Excipients: microcrystalline cellulose, milk sugar, corn starch, magnesium stearic acid.
Dosage and administration of
captopril is prescribed an hour before meals. The dosage regimen is set individually.
With arterial hypertension, the drug is prescribed in an initial dose of 25 mg 2 times a day. If necessary, the dose is gradually (with an interval of 2-4 weeks) increased until the optimal effect is achieved.
With mild or moderate arterial hypertension, the usual maintenance dose is 25 mg 2 times a day. The maximum dose is 50 mg 2 times a day.
In severe arterial hypertension, the maximum dose is 50 mg 3 times a day. The maximum daily dose is 150 mg.
For the treatment of chronic heart failure, captopril is prescribed in cases where the use of diuretics does not provide an adequate effect. The average maintenance dose is 25 mg 2-3 times a day. In the future, if necessary, the dose is gradually increased (with an interval of at least 2 weeks). The maximum dose is 150 mg per day.
Patients with impaired renal function with a moderate degree of impaired renal function (creatinine clearance of at least 30 ml / min / 1.73 m 2) Captopril can be prescribed at a dose of 75-100 mg / day. With a more pronounced degree of impaired renal function (creatinine clearance less than 30 ml / min / 1.73 m 2), the initial dose should be no more than 12.5-25 mg / day in the future, if necessary, with sufficiently long intervals, the dose of Captopril is gradually increased, but use a smaller than usual daily dose of the drug.
Side effects
From the CCC: tachycardia, marked decrease in blood pressure, orthostatic hypotension, peripheral edema.
From the nervous system: dizziness, headache, ataxia, paresthesia, drowsiness, visual impairment.
From the urinary system: impaired renal function.
From the side of hematopoietic organs: neutropenia, anemia, thrombocytopenia, agranulocytosis.
Allergic reactions: angioedema of the extremities, face, lips, mucous membranes, tongue, pharynx and larynx, as well as the small intestine (very rare).
From the digestive system: violation of taste, dry oral mucosa, stomatitis, abdominal pain, diarrhea, increased activity of hepatic transaminases, hyperbilirubinemia, hepatitis.
From the respiratory system: dry cough, passing after drug withdrawal, bronchospasm, pulmonary edema.
Laboratory indicators: hyperkalemia, hyponatremia, proteinuria, increased urea nitrogen, hypercreatininemia, acidosis, the appearance of antinuclear antibodies in the blood. Cases of hypoglycemia have been reported in patients with diabetes who took insulin and oral hypoglycemic drugs.
Drug interactions
Diuretics and vasodilators (e.g. minoxidil) potentiate the hypotensive effect of captopril.
When combined with captopril and indomethacin (and possibly with other non-steroidal anti-inflammatory drugs), a decrease in hypotensive effect may be noted.
The antihypertensive effect of captopril may be slowed when prescribed to patients receiving clonidine.
Concomitant use with potassium-sparing diuretics or potassium preparations can lead to hyperkalemia.
With the simultaneous use of lithium salts, an increase in serum lithium concentration is possible. The use of captopril in patients taking allopurinol or procainamide increases the risk of neutropenia and / or Stevens-Johnson syndrome.
The use of captopril in patients taking immunosuppressants (e.g. cyclophosphacin or azathioprine) increases the risk of hematologic disorders.
Overdose
Symptoms: severe arterial hypotension, up to collapse, myocardial infarction, acute cerebral circulation disorder, thromboembolic complications.
Treatment: to put the patient with the raised lower extremities measures directed on restoration of arterial pressure (increase in volume of circulating blood, including intravenous infusion of isotonic solution of sodium chloride), symptomatic therapy. Possible use of hemodialysis peritoneal hemodialysis is ineffective.
Storage conditions
Store in a dry, dark place at a temperature not exceeding 25 ° C.
Shelf life
2 years
Deystvuyushtee substance
Captopril
Terms of dispatch from
pharmacies prescription
dosage form
tablets
Possible product names
Captopril Sandoz tablets 25 mg 40 pcs.
Sandoz, Switzerland
Captopril Sandoz tablets 25 mg 40 pcs. pack (Captopril) florida in pharmacy online. Cheap price, instruction, side effects, dosage. Captopril Sandoz tablets 25 mg 40 pcs. pack - Sale. PayPal accept. Free shipping florida. Fast international shipping.
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