KORDAKER table. 20 mg
KORDAKER table. 20 mg
KORDAKER WHAT IS AND WHAT IT IS USED
Kordaker is an angiotensin-converting enzyme inhibitors / ACE /. It belongs to the group of antihypertensive drugs. Can be administered alone or be used in complex therapy with other drugs.
Lisinopril is a medicine that reduces blood pressure and gives good effects in patients with heart failure, mainly through inhibition of the renin-angiotensin-aldosterone.
Each contains tablekta of 10 or 20 mg lizonopril.
Kordaker is indicated for the treatment of essential hypertension and renal - alone as initial therapy or with other classes of antihypertensive agents.
This medicine is also used to manage all stages of heart failure - as adjunctive therapy in patients who do not respond adequately to standard therapy with diuretics and digitalis drugs and acute myocardial infarction in patients with stable hemodynamics in the first 24 hours of heart attack - to prevent disturbances in the function of the left ventricle.
BEFORE YOU TAKE KORDAKER
Do not use Kordaker:
If you are allergic to lizonopril or other converting enzyme inhibitors, as well as to any of the excipients of the medicinal product.
If you have or have had a diagnosis of angioedema / swelling of the face, tongue / related to previous treatment with an inhibitor of converting enzyme.
It is important to tell your doctor if you have or have had any of the above problems.
Take special care with Kordaker
If you have kidney disease and narrowing of the aortic valve in which there is an obstacle in the blood ejected from the left ventricle.
As a consequence of inhibiting the renin-angiotensin-aldosterone system in certain individuals, particularly those with impaired renal function may be anticipated in renal function. Particular attention is required during the first 2-5 weeks of treatment, if necessary, your doctor may decide to reduce the dose or discontinue therapy with lisinopril.
Caution should be exercised with co-administration of lisinopril and diuretics for further reducing blood pressure effect. Similar considerations are also present in patients with acute myocardial infarction, in which a significant drop in blood pressure can lead to heart attack or cerebrovascular accident.
In patients with a history of hereditary or idiopathic angioedema treatment with lisinopril or other angiotensin-converting enzyme inhibitors should be avoided because of increased risk of angioedema.
Special attention is required when initiating therapy with lisinopril in patients receiving diuretics, patients with limited intake of salts in patients on dialysis, dehydration or congestive heart failure as can occur with hypotension maximum blood pressure 6 to 8 hours after dosing.
Patients with severe congestive heart failure are the most susceptible to renal impairment and treatment with converting enzyme inhibitors may lead to oliguria and / or progressive azotemia and rarely to acute renal failure.
In patients with unilateral or bilateral renal artery stenosis may be an increase in blood urea and serum creatinine, usually reversible upon discontinuation of lisinopril. In such patients during the first weeks of treatment renal function should be monitored.
Special care is needed in patients with peripheral vascular disease or generalized arteriosclerosis, taking lizinpril, the possible presence of asymptomatic renal disease.
In patients with acute myocardial infarction, treatment with lisinopril should not be taken in evidence of renal dysfunction, defined by a serum creatinine above 177 ?ol / l and / or proteinuria exceeding 500 mg/24 hours in patients with low blood pressure below 100 mmHg should not be initiated lisinopril.
Patients who have a surgery under general anesthetic should inform their doctor that they are taking lisinopril.
During treatment with ACE inhibitors may develop persistent nonproductive cough. This cough is reversible upon discontinuation of therapy.
Patients receiving ACE inhibitors during the purification of blood low-density lipoproteins in patients with high cholesterol at specific desensitization against insect venom and hemodialysis with high-flux membranes, it is possible that life-threatening anaphylactoid reactions.
In patients with renal impairment due to connective tissue disease require periodic monitoring of blood counts, especially leukocytes.
If you are pregnant or breast-feeding, tell your doctor before starting treatment with lisinopril. Pregnancy is a relative contraindication to the use of lisinopril as it is found that angiotensin-converting enzyme inhibitors can cause fetal harm. If you become pregnant during treatment, tell your doctor immediately, since the adoption of lisinopril in this case should be discontinued.
There is a potential drug to be excreted in the milk so that the use of lisinopril during breastfeeding is not recommended.
HOW TO TAKE KORDAKER
The tablets can be taken before, during or after meals.
Dosage is individual and may vary depending on the patient's condition.
In patients with mild essential hypertension recommended starting dose is 10 mg once daily. The dosage should be adjusted according to the response in terms of blood pressure values. The usual dose is 20 to 40 mg daily in a single dose. The daily dose was increased in weekly intervals up to 80 mg. If blood pressure is normal for 1-3 months, your doctor may add to your treatment and low-dose diuretic, a calcium antagonist or beta-bloker.12, 5 mg once daily hidrohloritiazid best combination. In patients with renal hypertension, particularly those with bilateral renal artery narrowing or stenosis of the artery to a solitary kidney, which react very rapidly to the first dose of ACE inhimitori, Kordaker initial dose should be lower. In such cases, the recommended dose is 2.5 mg. The dose is determined by the physician and the usual maintenance dose is 20 mg once daily.
In patients with congestive heart failure, the starting dose should be lower. The recommended starting dose is 2.5 mg to 5 mg once daily. The dose is gradually increased in all patients within 2 to 4 weeks until the usual effective dose range from 5 to 20 mg once daily.
Acute myocardial infarction
In patients with stable hemodynamics in the full 24 hours of acute myocardial Kordaker apply as follows:
Patients with a systolic pressure above 120 mmHg initial dose of lisinopril is 5 mg in the first 24 hours after onset of symptoms, followed by a further dose of 5 mg in the next 24 hours, then 10 mg after a further 24 hours and continue with 10 mg prodalzhanie once daily for six weeks.
In patients with low systolic pressure is applied to the lower dose of 2.5 mg lisinopril during the first two days after infarction, followed by 5 mg daily for 6 weeks. If it comes to hypotension daily maintenance dose of 5 mg was reduced to 2.5 mg. If hypotension remained lizinoppril therapy should be abandoned.
In patients with acute myocardial infarction, treatment with lisinopril lasts six weeks.
Dosage in renal impairment:
In patients with impaired renal function dosing comply with creatinine clearance. In patients with creatinine clearance 10-30 ml / min initial dose is 5 mg once daily in patients with a creatinine clearance <10 ml / min recommended initial dose is 2.5 mg. The dose may be increased to normalize blood pressure, up to 40 mg per day.
In acute myocardial infarction, treatment with Kordaker should be dosed with caution in patients with underlying renal dysfunction.
Dosing with concomitant treatment with a diuretic
When concomitant treatment with Kordaker diuretic, the diuretic should be discontinued 2-3 days before starting treatment with Kordaker. In patients with hypertension, when the diuretic can not be discontinued, therapy Kordaker should start with a dose of 5 mg, then is adjusted by your doctor depending on the blood pressure. If necessary, at the discretion of the treating physician, diuretic therapy may be resumed.
POSSIBLE SIDE EFFECTS:
During treatment with angiotensin-converting enzyme inhibitors can experience various allergic reactions including angioedema - swelling of the face, lips, tongue, in severe cases, cover and upper respiratory tract. In the event of such a swelling intake of lisinopril should be discontinued immediately and notify your doctor.
Lisinopril is welcomed. Treatment with lisinopril rarely side effects requiring discontinuation of therapy in patients with high blood pressure and slightly more often appear as a reason for discontinuation of therapy in patients with acute myocardial infarction or congestive heart failure.
Very common side effects are hypotension, worsening renal function, angioedema, rash, urticaria, pruritus, dry cough and other symptoms of upper respiratory tract such as rhinitis, sinusitis and sore throat, and by the gastrointestinal tract is observed dry mouth, nausea, vomiting, abdominal pain, dyspepsia, anorexia, diarrhea and constipation. Patients receiving lisinopril may occur: angina, vasculitis, chest pain, orthostatic effects, palpitations, peripheral edema, tachycardia, atrial fibrillation, premature ventricular contractions and bradycardia. Cerebrovascular accident, pulmonary embolism and infarction, transient isfemichni attacks, nocturnal dyspnea appear very rarely.
As uncommon side effects include worsening of renal function, including increased plasma levels of urea and creatinine, which is reversible upon discontinuation of lisinopril. Cases with proteinuria, which in some patients progressed to nephrotic syndrome. Can occur hyperkalemia, particularly in patients with severe renal insufficiency and / or diabetes.
Rare reported side effects are changes in liver function tests, resulting in elevated levels of liver enzymes and alkaline fonfataza, cholestatic jaundice, heratit, pancreatitis.
Rarely, and changes in blood counts, including thrombocytopenia, neutropenia, and hemolytic anemia.
Rarely intake inhibitors angiotnzin - converting enzyme inhibitors can cause liver damage. In the event of yellowing of the skin and / or eyes, the patient should inform the doctor.
Other side effects include headache, dizziness, tiredness, sleeplessness, altered sense of taste, paresthesia, pain in muscles and joints, arthritis, bronchospasm, mental confusion, mood, asthenia, impotence and alopecia.