DOCSLIB.ORG

Medokinal Film-Coated Tablet

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Medokinal Film-Coated Tablet IT/H/250/001-004/IB/011 Formatiert: Rechts, Einzug: Links: 2,3 cm PSUSA ACEI_2019_01 SUMMARY OF THE PRODUCT CHARACTERISTICS Formatiert: Schriftart: 14 Pt., Nicht Kapitälchen, Großbuchstaben, Unterschneidung ab 16 Pt. 1 NAME OF THE MEDICINAL PRODUCT Formatiert: Überschrift 1, Zentriert Formatiert: Schriftart: Quinapril Zentiva 5 mg film-coated tablet Formatiert: Standard Quinapril Zentiva 10 mg film-coated tablet Formatiert: Schriftart: 12 Pt., Nicht Kapitälchen, Quinapril Zentiva 20 mg film-coated tablet Großbuchstaben Quinapril Zentiva 40 mg film-coated tablet Formatiert: Überschrift 2;2 SmPC, Einzug: Links: 0 cm, Hängend: 1 cm, Mit Gliederung + Ebene: 1 + Nummerierungs formatvorlage: 1, 2, 3, … + Beginnen bei: 1 + Ausrichtung: 2 QUALITATIVE AND QUANTITATIVE COMPOS ITION Links + Ausgerichtet an: 0 cm + Tabstopp nach: 0 cm + Einzug bei: 0 cm, Tabstopps: Nicht an 0 cm Formatiert: Schriftart: 12 Pt., Nicht Kapitälchen, Quinapril Zentiva 5 mg film-coated tablets: Großbuchstaben Each film-coated tablet contains 5 mg quinapril (as quinapril hydrochloride). Formatiert: Überschrift 2;2 SmPC, Einzug: Links: 0 cm, Hängend: 1 cm, Mit Gliederung + Ebene: 1 + Nummerierungs Quinapril Zentiva 10 mg film-coated tablets: formatvorlage: 1, 2, 3, … + Beginnen bei: 1 + Ausrichtung: Links + Ausgerichtet an: 0 cm + Tabstopp nach: 0 cm + Each film-coated tablet contains 10 mg quinapril (as quinapril hydrochloride). Einzug bei: 0 cm, Tabstopps: Nicht an 0 cm Quinapril Zentiva 20 mg film-coated tablets: Each film-coated tablet contains 20 mg quinapril (as quinapril hydrochloride). Quinapril Zentiva 40 mg film-coated tablets: Each film-coated tablet contains 40 mg quinapril (as quinapril hydrochloride). Excipient with known effect: sodium. Each tablet contains less than 1 mmol sodium (23 mg). For the full list of excipients, see section 6.1. Formatiert: Schriftart: 12 Pt., Nicht Kapitälchen, Großbuchstaben Formatiert: Überschrift 2;2 SmPC, Einzug: Links: 0 cm, 3 PHARMACEUTICAL FORM Hängend: 1 cm, Mit Gliederung + Ebene: 1 + Nummerierungs formatvorlage: 1, 2, 3, … + Beginnen bei: 1 + Ausrichtung: Film-coated tablet Links + Ausgerichtet an: 0 cm + Tabstopp nach: 0 cm + Einzug bei: 0 cm, Tabstopps: Nicht an 0 cm Quinapril Zentiva 5 mg is an oval, biconvex, red-brown film-coated tablet, scored on both Formatiert: Standard sides and imprinted with "I" on one side. Size 4.5 x 8.7 mm. Formatiert: Abstand Vor: 0 Pt., Nach: 0 Pt. Quinapril Zentiva 10 mg is an oval, biconvex, red-brown film-coated tablet, scored on both Formatiert: Schriftart: 12 Pt., Nicht Kapitälchen, Großbuchstaben sides and imprinted with "L" on one side. Size 5.8 x 11.3 mm. Formatiert: Überschrift 2;2 SmPC, Einzug: Links: 0 cm, Quinapril Zentiva 20 mg is a round, biconvex, red-brown film-coated tablet, scored on both Hängend: 1 cm, Mit Gliederung + Ebene: 1 + Nummerierungs sides and imprinted with "I" on one side. Diameter 7 mm. formatvorlage: 1, 2, 3, … + Beginnen bei: 1 + Ausrichtung: Links + Ausgerichtet an: 0 cm + Tabstopp nach: 0 cm + Quinapril Zentiva 40 mg is an oval, biconvex, red-brown film-coated tablet, scored on both Einzug bei: 0 cm, Tabstopps: Nicht an 0 cm sides and imprinted with "I" on one side. Size 6.5 x 12.7 mm. Formatiert: Schriftart: Formatiert: Standard, Links, Nicht vom nächsten Absatz The tablet can be divided into equal doses. trennen Formatiert: Abstand Vor: 0 Pt., Nach: 0 Pt. 4 CLINICAL PARTICULARS Formatiert: Abstand Vor: 0 Pt., Nach: 0 Pt., Keine 4 Aufzählungen oder Nummerierungen 4.1 Therapeutic indications Formatiert: Schriftart: Nicht Kursiv 4.1 Formatiert: Schriftart: Nicht Kursiv Essential hHypertension. Formatiert: Schriftart: Nicht Kursiv Congestive heart failure. Formatiert: Schriftart: Nicht Kursiv Formatiert: Schriftart: Nicht Kursiv IT/H/250/001-004/IB/011 Formatiert: Rechts, Einzug: Links: 2,3 cm PSUSA ACEI_2019_01 4.2 Posology and method of administration Formatiert: Abstand Vor: 0 Pt., Nach: 0 Pt. For different dosage regimens, appropriate strengths of Quinapril Zentiva are available. If a satisfactory response has not been achieved within 3 months, a change of therapy should be considered. Posology Adults Essential Hypertension Monotherapy: The recommended initial dose is 10 mg once daily in hypertension. Depending upon clinical response, patient’s dosage may be titrated (by doubling the dose allowing 3-4 weeks for dosage adjustment) to a maintenance dosage of 20 to 40 mg/day given as a single dose or divided into 2 doses. Long term control is maintained in most patients with a single daily dosage regimen. The usual maximum maintenance dose is 40 mg/day. Concomitant diuretic: Symptomatic hypotension may occur following initiation of therapy with quinapril. This is more likely in patients who are being treated currently with diuretics. Caution is therefore recommended, since these patients may be volume and/or salt depleted. If possible, the diuretic should be discontinued 2-3 days before beginning therapy with quinapril. In order to determine if excess hypotension will occur, an initial dosage of 2.5 mg of Quinapril Zentiva is recommended in patients who are being treated with a diuretic. After this, the dosage of Quinapril Zentiva Tablets should be titrated (allowing adequate time for dosage adjustment) to the optimal response (see section 4.5). Congestive heart failure In order to closely monitor patients for symptomatic hypotension, a single 2.5 mg initial dosage is recommended. After this, patients should be titrated (allowing 2-3 weeks for dosage adjustment) to an effective dose: (up to 40 mg/day) given in 1-2 doses, with concomitant diuretic and/or cardiac glycoside therapy. Patients are usually maintained effectively on doses of 10-20 mg/day given in 1-2 doses with concomitant therapy. The maximum dose of 40 mg/day should not be exceeded. Patients who are considered to be at higher risk should have treatment initiated in hospital (see section 4.4). Elderly (>65 years) Formatiert: Nicht vom nächsten Absatz trennen As renal function tends to be reduced with age, this should also be taken into consideration in elderly patients. An initial dosage in essential hypertension of 2.5 mg is recommended followed by titration to the optimal response. IT/H/250/001-004/IB/011 Formatiert: Rechts, Einzug: Links: 2,3 cm PSUSA ACEI_2019_01 Renal impairment: The initial dose of quinapril should be reduced in patients with impaired renal function as the plasma concentration of quinaprilat increases with reduced creatinine clearance. The following doses are recommended: Creatinine clearance (ml/min) Maximum recommended initial daily dose Formatierte Tabelle (mg) > 60 10 30-60 5 10-30 2.5 < 10 Insufficient experience There is currently no information available about patients with creatinine clearance below 10 ml/min. Dialysis has no appreciable effect on the elimination of quinaprilat. If a satisfactory response has not been achieved within 3 months, a change of therapy should be considered. Paediatric population Efficacy and safety of use in children and adolescents has not been established. Use in children and adolescents is therefore not recommended. Method of administration For oral use. 4.3 Contraindications Formatiert: Abstand Vor: 0 Pt., Nach: 0 Pt. - Hypersensitivity to quinapril, to any of the excipients listed in section 6.1 or any other Formatiert: Rechtschreibung und Grammatik nicht prüfen ACE inhibitor. Formatiert: Einzug: Links: 0 cm, Hängend: 1 cm, Aufgezählt - Concomitant use of Quinapril Zentiva with aliskiren-containing products is + Ebene: 1 + Ausgerichtet an: 0,63 cm + Tabstopp nach: 1,59 cm + Einzug bei: 1,59 cm, Vom nächsten Absatz contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 trennen, Diesen Absatz nicht zusammenhalten, Keine ml/min/1.73 m2) (see sections 4.5 and 5.1). Silbentrennung, Tabstopps: Nicht an 1,59 cm - Quinapril Zentiva is contraindicated in the second and third trimester of pregnancy (see Formatiert: Rechtschreibung und Grammatik nicht prüfen, sections 4.4 and 4.6). Nicht Hochgestellt/ Tiefgestellt - Quinapril Zentiva is contraindicated in patients with a history of angioedema related to Formatiert: Rechtschreibung und Grammatik nicht prüfen previous treatment with ACE inhibitors. Formatiert: Schriftart: 12 Pt., Nicht Kursiv, Rechtschreibung - Quinapril Zentiva is contraindicated in patients with hereditary/idiopathic angioneurotic und Grammatik nicht prüfen oedema. Formatiert: Rechtschreibung und Grammatik nicht prüfen - Concomitant use with sacubitril/valsartan therapy. Quinapril Zentiva must not be initiated earlier than 36 hours after the last dose of sacubitril/valsartan (see sections 4.4 and 4.5). Formatiert: Einzug: Links: 0 cm 4.4 S pecial warnings and precautions for use Formatiert: Abstand Vor: 0 Pt., Nach: 0 Pt. Formatiert: Nicht vom nächsten Absatz trennen Dual blockade of the renin-angiotensin-aldosterone system (RAAS) There is evidence that the concomitant use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren increases the risk of hypotension, hyperkalaemia and decreased renal function (including acute renal failure). Dual blockade of RAAS through the combined use of ACE- inhibitors, angiotensin II receptor blockers or aliskiren is therefore not recommended (see sections 4.5 and 5.1). IT/H/250/001-004/IB/011 Formatiert: Rechts, Einzug: Links: 2,3 cm PSUSA ACEI_2019_01 If dual blockade therapy is considered absolutely necessary, this should only occur under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and
Load more

Recommended publications
  • Accupril® (Quinapril Hydrochloride Tablets)
    Accupril® (Quinapril Hydrochloride Tablets) WARNING: FETAL TOXICITY When pregnancy is detected, discontinue ACCUPRIL as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See Warnings: Fetal Toxicity DESCRIPTION ACCUPRIL® (quinapril hydrochloride) is the hydrochloride salt of quinapril, the ethyl ester of a non-sulfhydryl, angiotensin-converting enzyme (ACE) inhibitor, quinaprilat. Quinapril hydrochloride is chemically described as [3S-[2[R*(R*)], 3R*]]-2-[2-[[1- (ethoxycarbonyl)-3-phenylpropyl]amino]-1-oxopropyl]-1,2,3,4-tetrahydro-3- isoquinolinecarboxylic acid, monohydrochloride. Its empirical formula is C25H30N2O5 •HCl and its structural formula is: Quinapril hydrochloride is a white to off-white amorphous powder that is freely soluble in aqueous solvents. ACCUPRIL tablets contain 5 mg, 10 mg, 20 mg, or 40 mg of quinapril for oral administration. Each tablet also contains candelilla wax, crospovidone, gelatin, lactose, magnesium carbonate, magnesium stearate, synthetic red iron oxide, and titanium dioxide. CLINICAL PHARMACOLOGY Mechanism of Action: Quinapril is deesterified to the principal metabolite, quinaprilat, which is an inhibitor of ACE activity in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor, angiotensin II. The effect of quinapril in hypertension and in congestive heart failure (CHF) appears to result primarily from the inhibition of circulating and tissue ACE activity, thereby reducing angiotensin II formation. Quinapril inhibits the elevation in blood pressure caused by intravenously administered angiotensin I, but has no effect on the pressor response to angiotensin II, norepinephrine or epinephrine. Angiotensin II also stimulates the secretion of aldosterone from the adrenal cortex, thereby facilitating renal sodium and fluid reabsorption.
    [Show full text]
  • Quinapril, an ACE Inhibitor, Reduces Markers of Oxidative Stress in the Metabolic Syndrome
    Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes ORIGINAL ARTICLE Quinapril, an ACE Inhibitor, Reduces Markers of Oxidative Stress in the Metabolic Syndrome 1 3 BOBBY V. KHAN, MD, PHD W. CRAIG HOOPER, PHD ing the link between inflammation, met- 1 1 SRIKANTH SOLA, MD REKHA G. MENON, MD abolic disorders, and cardiovascular 1 1 WRIGHT B. LAUTEN, BS STAMATIOS LERAKIS, MD 2 1 disease (5,6). Chronic inflammation and RAMA NATARAJAN, PHD TAREK HELMY, MD an abnormal pro-oxidant state are both found in the metabolic syndrome and may play a role in its pathogenesis (7,8). The renin-angiotensin system (RAS) plays a central role in the pathogenesis of OBJECTIVE — Patients with the metabolic syndrome often have abnormal levels of proin- atherosclerosis-related diseases. Angio- flammatory and pro-oxidative mechanisms within their vasculature. We sought to determine tensin II, the central molecule in the RAS, whether the ACE inhibitor quinapril regulates markers of oxidative stress in the metabolic syndrome. has multiple effects on inflammation, ox- idation, atherosclerotic plaque initiation, RESEARCH DESIGN AND METHODS — Forty patients with the metabolic syndrome and progression (9). In the present study, were randomized in a double-blind manner to either the ACE inhibitor quinapril (20 mg/day) or we determine potential mechanisms by matching placebo for 4 weeks. Serum markers of vascular oxidative stress were measured. which the administration of the ACE in- hibitor quinapril regulates mechanisms of RESULTS — After 4 weeks of therapy, serum 8-isoprostane was reduced by 12% in the oxidative stress in subjects with the met- Ϯ Ϯ quinapril group when compared with placebo (quinapril, 46.7 1.0; placebo, 52.7 0.9 abolic syndrome.
    [Show full text]
  • Quinapril Tablets USP8289921/0720Frx Only
    QUINAPRIL- quinapril tablet American Health Packaging ---------- Quinapril Tablets USP 8289921/0720F Rx only WARNING: FETAL TOXICITY When pregnancy is detected, discontinue quinapril tablets as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See WARNINGS: Fetal Toxicity DESCRIPTION Quinapril hydrochloride is the hydrochloride salt of quinapril, the ethyl ester of a non- sulfhydryl, angiotensin-converting enzyme (ACE) inhibitor, quinaprilat. Quinapril hydrochloride is chemically described as [3S-[2[R*(R*)], 3R*]]-2-[2-[[1- (ethoxycarbonyl)-3-phenylpropyl]amino]-1-oxopropyl]-1,2,3,4-tetrahydro-3- isoquinolinecarboxylic acid, monohydrochloride. Its empirical formula is C 25H 30N 2O 5•HCl and its structural formula is: Quinapril hydrochloride is a white to off-white amorphous powder that is freely soluble in aqueous solvents. Quinapril tablets USP contain 5 mg (equivalent to 5.416 mg Quinapril Hydrochloride), 10 mg (equivalent to 10.832 mg Quinapril Hydrochloride), 20 mg (equivalent to 21.664 mg Quinapril Hydrochloride), or 40 mg (equivalent to 43.328 mg Quinapril Hydrochloride) of quinapril for oral administration. Each film-coated tablet also contains crospovidone, iron oxide yellow, lecithin, magnesium carbonate, magnesium stearate, microcrystalline cellulose, polyvinyl alcohol, povidone, talc, titanium dioxide and xanthan gum. CLINICAL PHARMACOLOGY Mechanism of Action Quinapril is deesterified to the principal metabolite, quinaprilat, which is an inhibitor of ACE activity in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor, angiotensin II. The effect of quinapril in hypertension and in congestive heart failure (CHF) appears to result primarily from the inhibition of circulating and tissue ACE activity, thereby reducing angiotensin II formation.
    [Show full text]
  • Angioedema After Long-Term Use of an Angiotensin-Converting Enzyme Inhibitor
    J Am Board Fam Pract: first published as 10.3122/jabfm.10.5.370 on 1 September 1997. Downloaded from BRIEF REPORTS Angioedema After Long-Term Use of an Angiotensin-Converting Enzyme Inhibitor Adriana]. Pavietic, MD Angioedema is an uncommon adverse effect of cyclobenzaprine, her angioedema was initially be­ angiotensin-converting enzyme (ACE) inhib­ lieved to be an allergic reaction to this drug, and itors. Its frequency ranges from 0.1 percent in pa­ it was discontinued. She was also given 125 mg of tients on captopril, lisinopril, and quinapril to 0.5 methylprednisolone intramuscularly. Her an­ percent in patients on benazepril. l Most cases are gioedema did not improve, and she returned to mild and occur within the first week of treat­ the clinic the following day. She was seen by an­ ment. 2-4 Recent reports indicate that late-onset other physician, who discontinued lisinopril, and angioedema might be more prevalent than ini­ her symptoms resolved within 24 hours. Mter her tially thought, and fatal cases have been de­ ACE inhibitor was discontinued, she experienced scribed.5-11 Many physicians are not familiar with more symptoms and an increased frequency of late-onset angioedema associated with ACE in­ palpitations, but she had no change in exercise hibitors, and a delayed diagnosis can have poten­ tolerance. A cardiologist was consulted, who pre­ tially serious consequences.5,8-II scribed the angiotensin II receptor antagonist losartan (initially at dosages of 25 mg/d and then Case Report 50 mg/d). The patient was advised to report any A 57-year-old African-American woman with symptoms or signs of angioedema immediately copyright.
    [Show full text]
  • THE DOSE an Estimation of Equivalent Doses Between Arbs and Aceis
    THE DOSE An estimation of equivalent doses between ARBs and ACEIs ARBs still currently available as of Jan 26, 2020: Twynsta (telmisartan/amlodipine): 40/5mg. 40/10mg, 80/5mg, 80mg/ 10mg Note: ~$0.73/tablet (ODB covered) Candesartan/Hydrochlorothiazide:16mg/12.5mg, 32mg/12.5mg, 32mg/25mg Irbesartan/Hydrochlorothiazide: 150/12.5mg, 300/12.5mg, 300/25mg Olmesartan/Hydrochlorothiaizde: 20/12.5mg, 40/12.5mg Valsartan/Hydrochlorothiazide: 80/12.5mg, 160/12.5mg, 160/25mg, 320/12.5mg, 320/25mg Note: Availability changes daily. Some pharmacies are able to get candesartan (4mg, 8mg, and 32mg) and irbesartan (300mg). Considerations Patients renal function and hepatic function should be taken into consideration Patients should have blood pressure, lytes and SCr checked with rotation from ARB to ACEI as clinically indicated in 1-4 weeks ACEIs can cause a dry cough in 5-35% of patients and carry a risk of angioedema (0.1-0.2%) Comparable dosages between ACEIs and ARBs- Summary of trials Lisinopril 20mg Enalapril 20mg Perindopril 4mg Ramipril 10mg Candesartan 16mg 8mg 16mg Irbesartan 150mg Telmisartan 80mg 40-80mg 40mg ~80mg Valsartan 160mg 80mg Note: There are variations for approximate equivalent dosages between ACEIs and ARBs in clinical trials. Approximate equivalent doses of ACEI for blood pressure lowering Drug Approximate Initial Daily Dose Usual Daily Maintenance Dose Maximum Daily Duration of Dose Dose Action Equivalence Between ACEIs Cilazapril 2.5mg 2.5-5mg 2.5-5mg dailya 10mg 12-24 hr Enalapril maleate 5mg 2.5-5mg 10-40mg daily (or divided bid)a 40mg 12-24 hr Fosinopril 10mg 10mg 10-40mg daily (or divided bid)a 40mg 24hr Lisinopril 10mg 2.5-10mg 10-40mg daily 80mg 24hr Perindopril 2mg 2-4mg 4-8mg daily 8mg 24hr Quinapril 10mg 5-10mg 10-20mg dailya 40mg 24hr Ramipril 2.5mg 1.25mg-2.5mg 2.5-10mg daily (or divided bid)a 20mg ~24hr a: Some patients may experience a diminished antihypertensive effect toward the end of a 24-hour dosing interval.
    [Show full text]
  • Estonian Statistics on Medicines 2016 1/41
    Estonian Statistics on Medicines 2016 ATC code ATC group / Active substance (rout of admin.) Quantity sold Unit DDD Unit DDD/1000/ day A ALIMENTARY TRACT AND METABOLISM 167,8985 A01 STOMATOLOGICAL PREPARATIONS 0,0738 A01A STOMATOLOGICAL PREPARATIONS 0,0738 A01AB Antiinfectives and antiseptics for local oral treatment 0,0738 A01AB09 Miconazole (O) 7088 g 0,2 g 0,0738 A01AB12 Hexetidine (O) 1951200 ml A01AB81 Neomycin+ Benzocaine (dental) 30200 pieces A01AB82 Demeclocycline+ Triamcinolone (dental) 680 g A01AC Corticosteroids for local oral treatment A01AC81 Dexamethasone+ Thymol (dental) 3094 ml A01AD Other agents for local oral treatment A01AD80 Lidocaine+ Cetylpyridinium chloride (gingival) 227150 g A01AD81 Lidocaine+ Cetrimide (O) 30900 g A01AD82 Choline salicylate (O) 864720 pieces A01AD83 Lidocaine+ Chamomille extract (O) 370080 g A01AD90 Lidocaine+ Paraformaldehyde (dental) 405 g A02 DRUGS FOR ACID RELATED DISORDERS 47,1312 A02A ANTACIDS 1,0133 Combinations and complexes of aluminium, calcium and A02AD 1,0133 magnesium compounds A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 811120 pieces 10 pieces 0,1689 A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 3101974 ml 50 ml 0,1292 A02AD83 Calcium carbonate+ Magnesium carbonate (O) 3434232 pieces 10 pieces 0,7152 DRUGS FOR PEPTIC ULCER AND GASTRO- A02B 46,1179 OESOPHAGEAL REFLUX DISEASE (GORD) A02BA H2-receptor antagonists 2,3855 A02BA02 Ranitidine (O) 340327,5 g 0,3 g 2,3624 A02BA02 Ranitidine (P) 3318,25 g 0,3 g 0,0230 A02BC Proton pump inhibitors 43,7324 A02BC01 Omeprazole
    [Show full text]
  • Patient Information Leaflet
    Package leaflet: Information for the user Accuretic® 10/12.5 mg film-coated tablets quinapril and hydrochlorothiazide Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. - If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet 1. What Accuretic is and what it is used for 2. What you need to know before you take Accuretic 3. How to take Accuretic 4. Possible side effects 5. How to store Accuretic 6. Contents of the pack and other information 1. What Accuretic is and what it is used for Accuretic contains the active substances quinapril and hydrochlorothiazide. Quinapril belongs to a group of medicines called angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors work by widening blood vessels in the body, which can help to reduce the pressure in the vessels. Hydrochlorothiazide belongs to a group of medicines called diuretics. Diuretics help the body to get rid of extra fluid and are used in patients with high blood pressure. Because they get rid of fluid diuretics are sometimes called ‘water tablets’. Accuretic is used to treat high blood pressure. You must talk to a doctor if you do not feel better or if you feel worse.
    [Show full text]
  • Angiotensin-Converting Enzyme (ACE) Inhibitors
    Angiotensin-Converting Enzyme (ACE) Inhibitors Summary Blood pressure reduction is similar for the ACE inhibitors class, with no clinically meaningful differences between agents. Side effects are infrequent with ACE inhibitors, and are usually mild in severity; the most commonly occurring include cough and hypotension. Captopril and lisinopril do not require hepatic conversion to active metabolites and may be preferred in patients with severe hepatic impairment. Captopril differs from other oral ACE inhibitors in its rapid onset and shorter duration of action, which requires it to be given 2-3 times per day; enalaprilat, an injectable ACE inhibitor also has a rapid onset and shorter duration of action. Pharmacology Angiotensin Converting Enzyme Inhibitors (ACE inhibitors) block the conversion of angiotensin I to angiotensin II through competitive inhibition of the angiotensin converting enzyme. Angiotensin is formed via the renin-angiotensin-aldosterone system (RAAS), an enzymatic cascade that leads to the proteolytic cleavage of angiotensin I by ACEs to angiotensin II. RAAS impacts cardiovascular, renal and adrenal functions via the regulation of systemic blood pressure and electrolyte and fluid balance. Reduction in plasma levels of angiotensin II, a potent vasoconstrictor and negative feedback mediator for renin activity, by ACE inhibitors leads to increased plasma renin activity and decreased blood pressure, vasopressin secretion, sympathetic activation and cell growth. Decreases in plasma angiotensin II levels also results in a reduction in aldosterone secretion, with a subsequent decrease in sodium and water retention.[51035][51036][50907][51037][24005] ACE is found in both the plasma and tissue, but the concentration appears to be greater in tissue (primarily vascular endothelial cells, but also present in other organs including the heart).
    [Show full text]
  • Interactions Between Antihypertensive Drugs and Food B
    11. INTERACTIONS:01. Interacción 29/11/12 14:38 Página 1866 Nutr Hosp. 2012;27(5):1866-1875 ISSN 0212-1611 • CODEN NUHOEQ S.V.R. 318 Revisión Interactions between antihypertensive drugs and food B. Jáuregui-Garrido1 and I. Jáuregui-Lobera2 1Department of Cardiology. University Hospital Virgen del Rocío. Seville. Spain. 2Bromatology and Nutrition. Pablo de Olavide University. Seville. Spain. Abstract INTERACCIONES ENTRE FÁRMACOS ANTIHIPERTENSIVOS Y ALIMENTOS Objective: A drug interaction is defined as any alter- ation, pharmacokinetics and/or pharmacodynamics, Resumen produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. Objetivo: la interacción de medicamentos se define como These interactions can affect the antihypertensive drugs, cualquier alteración, farmacocinética y/o farmacodiná- altering their therapeutic efficacy and causing toxic mica, producida por diferentes sustancias, otros tratamien- effects. The aim of this study was to conduct a review of tos, factores dietéticos y hábitos como beber y fumar. Estas available data about interactions between antihyperten- interacciones pueden afectar a los fármacos antihipertensi- sive agents and food. vos, alterando su eficacia terapéutica y causando efectos Methods: The purpose of this review was to report an tóxicos. El objetivo de este estudio fue realizar una revisión update of main findings with respect to the interactions de los datos disponibles acerca de las interacciones entre los between food and antihypertensive drugs
    [Show full text]
  • Switching Ace-Inhibitors
    Switching Ace-inhibitors http://www.ksdl.kamsc.org.au/dtp/switching_ace_inhibitors.html Change to → Enalapril Quinapril Ramipril Change from ↓ (Once daily dosing) (Once daily dosing) (Once daily dosing) Captopril Captopril 12.5mg daily Enalapril 2.5mg1 Quinapril 2.5mg Ramipril 1.25mg Captopril 25mg daily Enalapril 5mg1 Quinapril 5mg Ramipril 1.25-2.5mg Captopril 50mg daily Enalapril 7.5mg1 Quinapril 10mg Ramipril 2.5-5mg Captopril 100mg daily Enalapril 20mg1 Quinapril 20mg Ramipril 5-10mg2 Captopril 150mg daily Enalapril 40mg Quinapril 40mg Ramipril 10mg Fosinopril Fosinopril 5mg daily Enalapril 5mg Quinapril 5mg Ramipril 1.25mg Fosinopril 10mg daily Enalapril 10mg Quinapril 10mg Ramipril 2.5mg Fosinopril 20mg daily Enalapril 20mg Quinapril 20mg Ramipril 5mg Fosinopril 40mg daily Enalapril 40mg Quinapril 40mg Ramipril 10mg Lisinopril Lisinopril 5mg daily Enalapril 5mg Quinapril 5mg Ramipril 1.25mg Lisinopril 10mg daily Enalapril 10mg Quinapril 10mg Ramipril 2.5mg Lisinopril 20mg daily Enalapril 20mg Quinapril 20mg Ramipril 5mg Lisinopril 40mg Enalapril 40mg Quinapril 40mg Ramipril 10mg Perindopril Perindopril 2mg daily Enalapril 5-10mg Quinapril 5-10mg Ramipril 2.5mg Perindopril 4mg daily Enalapril 10mg-20mg Quinapril 10mg-20mg Ramipril 5mg Perindopril 8mg daily Enalapril 20-40mg Quinapril 20-40mg Ramipril 10mg Trandolapril Trandolapril 0.5mg d Enalapril 5mg Quinapril 5mg Ramipril 1.25mg Trandolapril 1mg daily Enalapril 10mg Quinapril 10mg Ramipril 2.5mg Trandolapril 2mg daily Enalapril 20mg Quinapril 20mg Ramipril 5mg Trandolapril 4mg daily Enalapril 40mg Quinapril 40mg Ramipril 10mg There are few studies comparing equivalent doses of ACE-inhibitors, for specific indications. Therefore, the above recommendations are based on clinical experiences and are not specific for any indication.
    [Show full text]
  • Oral Health Fact Sheet for Dental Professionals Adults with Congenital Cardiac Disorders
    Oral Health Fact Sheet for Dental Professionals Adults with Congenital Cardiac Disorders Congenital cardiac disorders are imperfections or malformations of the heart existing at, and usually before, birth regardless of their causation. (ICD9 code 746.9) Prevalence • Approximately 1% Manifestations Clinical varies with type of congenital defect (e.g. atrial/ventricular septal defects, pulmonary/aortic stenosis, transposition, heart valve abnormalities) • Pulmonary congestion/labored breathing • Heart murmur • Cardiomegaly • Congestive heart failure • Hypoxic spells • Cyanosis • Poor physical development • Clubbing of the terminal phalanges of the fingers Oral • Infective endocarditis risk from dental treatment • Post-operative bleeding risk in patients with anti-coagulated status following surgical procedures • May have oral manifestations caused by co-occurring disorders Other Potential Disorders/Concerns • Depression/Anxiety • Genetic and syndromic conditions (~11%) such as Down, Turner, Marfan and Ehler Danlos syndromes; osteogenesis imperfecta • Asthma • Intellectual disabilities • Esophageal atresia Management Medication The list of medications below are intended to serve only as a guide to facilitate the dental professional’s understanding of medications that can be used for Congenital Cardiac Disorders. Medical protocols can vary for individuals with Congenital Cardiac Disorders from few to multiple medications. MEDICATION TYPE MEDICATION SIDE EFFECTS/DRUG INTERACTIONS ACE inhibitors Benazepril (Lotensin) Cough, low blood pressure,
    [Show full text]
  • Effects of Intraoperative Angiotensin-Converting Enzyme Inhibition by Quinaprilat on Gastric Mucosal Blood Flow During Cardiopulmonary Bypass in Humans M
    Effects of intraoperative angiotensin-converting enzyme inhibition ... 43 Applied Cardiopulmonary Pathophysiology 14: 43-50, 2010 Effects of intraoperative angiotensin-converting enzyme inhibition by quinaprilat on gastric mucosal blood flow during cardiopulmonary bypass in humans M. Müller1, M. Kwapisz1, S. Klemm1, H. Maxeiner1, H. Akintürk2, K. Valeske2 University Hospital Gießen and Marburg GmbH, Campus Gießen: 1Department of Anaes- thesiology, Intensive Care Medicine and Pain Therapy; 2Department of Cardiovascular Sur- gery Abstract Laser Doppler flow (LDF) assessment and regional carbon dioxide measurements by air tonom- etry were performed to estimate the changes in gastric mucosal blood flow after angiotensin- converting enzyme (ACE) inhibition in patients undergoing cardiopulmonary bypass (CPB). Patients scheduled for elective CABG were prospectively assigned to group A (quinaprilat 0.02 mg/kg, n = 10), group B (quinaprilat 0.04 mg/kg, n = 10), or group C (control, n = 10). Base- line values were measured after induction of anesthesia (T0) and repeated during steady state CPB (T1). Thereafter either quinaprilat, a non-sulphydryl ACE inhibitor, (group A and B) or saline solution (group C) were given as an intravenous bolus. The LDF measurements were per- formed after 5 (T2), 10 (T3), 15 (T4) minutes during CPB as well as 5 minutes after weaning off CPB (T5) and at the end of surgery (T6). The tonometric measurements were repeated at T4, T5 and T6. During hypothermic CPB LDF decreased in all groups. In group B only, LDF returned to base- line after application of quinaprilat. At the end of surgery (T6) LDF returned to baseline in group A and C, too.
    [Show full text]