One tablet of Atacand Plus contains 12.5 mg hydrochlorothiazide and 16 mg cilexetil candesartan.
Excipients: hyprolose, calcium carmellose, magnesium stearate, lactose monohydrate, starch, dye yellow iron oxide, macrogoldye red iron oxide.
Atacand Plus is a pink oval, biconvex tablet with serifs on both edges and an “A / CS” pattern on one edge.
Blocks receptors angiotensin the first type, has diuretic and pressure reducing action.
Pharmacodynamics and pharmacokinetics
Atacand Plus is an antihypertensive combination drug. Angiotensin the second type is important in pathogenesis heart failure, hypertension and other diseases of the circulatory system. Main effects angiotensin the second type are vasoconstriction, stimulation of synthesis aldosteronecorrection water-electrolyte state and activation of cell growth. Effects Associated with Interaction angiotensin second type with receptors angiotensin type 1.
Candesartan - Electoral Antagonist angiotensin receptor 2 does not suppress angiotensin converting enzyme (converts angiotensin of the first type in I to angiotensin of the second type, which inactivates bradykinin) does not cause accumulation bradykinin and substance P. Dose-dependent increase in content angiotensin first type renin, angiotensin second type and reduction aldosteronein the blood occurs as a result of suppression of type receptors AT1 angiotensinsecond type.
Candesartan does not interact with receptors other than the above, and does not inhibit ion channels.
Hydrochlorothiazide - a diuretic from the group thiazidesinhibits active reverse absorption sodium ions in the distal parts of the renal tubules and stimulates the secretion chloride ions, sodium and water. Breeding magnesium and potassiumkidney stimulated dose-dependently, and calcium reabsorbed to a much greater extent than before.
It reduces the volume of extracellular fluid and plasma, inhibits the intensity of blood transport through the heart, lowers blood pressure. After long-term treatment, the effect develops due to the increase arterioles.
Candesartan and hydrochlorothiazide have summed up antihypertensive Effect. In persons with arterial hypertensionthe drug causes a prolonged decrease in pressure without increasing the contractile activity of the heart. Orthostatic hypotension at the initial stages of treatment is not observed, after completion of treatment, arterial hypertension does not increase.
After one dose antihypertensive the effect is detected after 2 hours. Using the drug once a day gently and effectively lowers blood pressure for 24 hours. With prolonged treatment, a steady decrease in pressure occurs after four weeks.
The effectiveness of the drug does not depend on age or gender.
Candesartan cilexetil. Prodrug for internal use. When absorbed from the intestines cilexetil candesartanundergoing ethereal hydrolysisquickly transforms into an active substance firmly bound to receptors of the type AT1 - candesartan. Absolute bioavailability reaches 14%. Eating does not affect pharmacokinetics.
The maximum concentration in the blood occurs four hours after taking the drug. Interaction candesartan with plasma proteins reaches 99%. Pharmacokinetic parameters do not depend on the gender of the patient.
It is excreted in the urine and bile in its original form, and to a very small extent undergoes changes in the liver. Half-life candesartan approaching 9 o’clock. The accumulation of the drug in the body is not detected.
Hydrochlorothiazide. Quickly absorbed from the intestines. Bioavailability reaches 70%. Consumption with food increases the level of absorption by 15%. Interaction with plasma proteins is 60%. It is not metabolized and excreted through the kidneys. The elimination half-life is 8 hours. 70% of the dose is excreted by the kidneys within two days.
Indications for use
Arterial hypertensionif the patient is recommended complex therapy.
- Liver damage or cholestasis.
- Damage to the kidneys.
- Refractory hypercalcemia and hypokalemia.
- Age less than 18 years.
- Hypersensitivity to derivatives sulfonamides.
- Hypersensitivity to the components of the drug.
Use caution with Atacand Plus in severe forms heart failure chronic type, bipolar renal artery stenosishemodynamically significant narrowing aortic or mitral valve disease, cerebrovascular disease, coronary heart disease, obstructive hypertrophic cardiomyopathy, liver cirrhosisreduced blood volume primary hyperaldosteronism, lactose intolerance, renal failure, hyponatremia, surgery, kidney transplantation and diabetes.
Side effects cilexetil candesartan:
- from the hematopoietic system - neutropenia, leukopenia, agranulocytosis;
- from the digestive system - nausea, liver damage, increased content hepatic enzymes;
- from the musculoskeletal system - arthralgia, lumbalgia, myalgia;
- from the nervous system - headache, dizziness;
- from the genitourinary system - kidney damage;
- from the side of metabolism - hyponatremia, hyperkalemia;
- allergic reactions - hives, rash, angioedema, itching.
Side effects hydrochlorothiazide:
- from the hematopoietic system - neutropenia, leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia, bone marrow depression;
- from the nervous system - dizziness, headache, depression, sleep disturbance, paresthesia;
- from the side of sensory organs - blurred image;
- from the circulatory system - orthostatic hypotension, necrotic vasculitis, arrhythmia, skin vasculitis;
- from the respiratory system - shortness of breath;
- from the digestive system - pancreatitis, diarrhea, constipation, cholestatic jaundice;
- from the musculoskeletal system - myalgia;
- from the genitourinary system - glucosuriakidney damage nephritis;
- from the side of metabolism - hyperuricemia, hyperglycemia, hypokalemia, hyponatremia, hypertriglyceridemia, hypercholesterolemia, level increase creatinine;
- allergic reactions - anaphylactic reactions, rash, hives, erythematous skin reactions.
Instructions for use Atacand Plus (Method and dosage)
The drug should be taken once a day for 1 tablet. It is advisable to titrate candesartan before starting Atacand Plus therapy. A confident hypotensive effect develops 4 weeks after the start of therapy.
For individuals at risk of developing arterial hypotension, titration is recommended. candesartan (Atacand monotherapy) starting with a dosage of 4 mg.
In older people, dose adjustment is not required.
Symptoms: the main manifestations of an overdose candesartan- expressed pressure reduction and dizziness. The main symptoms of an overdose hydrochlorothiazide - acute loss of water and electrolytes. Symptoms such as dizziness, low blood pressure, ventricular arrhythmia, tachycardiamuscle cramps.
Treatment: symptomatic, stabilization of the patient's condition. A recumbent position with raised legs is recommended. If it is necessary to increase the volume of circulating blood, an isotonic solution is administered intravenously sodium chloride. Hemodialysis not effective.
Hydrochlorothiazide, digoxin, warfarin, glibenclamide, oral contraceptives, nifedipine and Enalapril do not reveal the features of interaction with the components of Atacanda Plus.
Using Atacanda Plus with others antihypertensive agents enhances the hypotensive effect. Effects Ghydrochlorothiazidecausing potassium loss can be potentiated by other stimulants hypokalemia and loss of potassium (diuretics, amphotericin, laxatives, penicillin G sodium, carbenoxolone,derivatives salicylic acid).
Potassium-sparing diuretics, potassium-containing salt substitutes, potassium preparations and other drugs that increase the potassium content in the blood when taken together with Atacand Plus lead to the appearance of hyperkalemia.
Concurrent therapy drugs lithium causes a reversible increase in the concentration of lithium in the blood and the development of characteristic toxic reactions.
Absorption Ghydrochlorothiazide attenuated by application TOolestipol and TOolestyramine.
Thiazide-like diuretics cause an increase in content calcium in the blood, strengthen hyperglycemic beta blocker effect and Diazoxideincrease glucose sensitivity, slow down excretion cytostatics(Tscyclophosphamide, Methotrexate) and activate them myeloid suppression act.
Effects non-depolarizing muscle relaxants amplified by hydrochlorothiazide.
Anticholinergics (BIperidine, Atropine) increase the bioavailability of diuretics from the group of thiazides due to weakened intestinal motility.
Hydrochlorothiazide able to weaken the effect vasoconstrictor amines (epinephrine) and increase the probability of occurrence acute renal failure.
Terms of sale
The drug can be purchased only by medical prescription.
Store at temperatures up to 30 degrees. Keep out of the reach of children.
Appearance allergic reactions to hydrochlorothiazide most often in patients suffering bronchial asthma, hypersensitivity reactions in the anamnesis; however, the appearance of similar symptoms in other patients is not excluded.
When applying thiazide-like diuretics there have been cases of signs congestive seborrhea.
The drug contains in its composition lactosetherefore it is forbidden to accept it to patients with low tolerance to lactose deficient lactase or impaired absorption glucose or lactose.
Caution must be exercised during treatment with Atacand Plus when driving.
AnalogsMatches for ATX Level 4 code:DiocorGizaarTeveten PlusKo diovanMikardis PlusVasar NValz NLorista N / N
Analogs Atacanda Plus: Candecor h, Candecor HD, Hizart N-DS.
The safety of the drug when used in children has not been established.
Alcohol consumption during treatment with Atacand Plus may increase the incidence of symptoms orthostatic hypotension.
In pregnancy (and lactation)
The drug is contraindicated in of pregnancy. Can be used according to strict indications in time breastfeeding.
Atacand Plus Reviews
In general, Atakand Plus received good marks, both for doctors and patients.
Price, where to buy
The average price of the drug in Ukraine is 478 hryvnia. In Russian pharmacies, the price ranges from 1380 to 1770 rubles.
- Online Pharmacies in Russia
LuxPharma * special offer
- Atakand PLUS tab. 16mg / 12.5mg No. 281780 rub. Order
- Atakand plus (tab. 16mg / 12.5mg No. 28) 2515 rub.
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- Atakand plus 12.5 mg + 16 mg No. 28 tablAstraZeneca AB / AstraZeneca Industries LLC3140 rub.order