MOEX table. 15 mg. 30 tablets
(alone as initial therapy or in combination with other groups of antihypertensive agents).
MOEX table. 15 mg. 30 tablets
Treatment of hypertension
(Alone as initial therapy or in combination with other groups of antihypertensive agents).
MOEH should not be used in patients with:
hypersensitivity to MOEH ;
there is a history of angioedema related to previous treatment with ACE inhibitors - naspedsteen / idiopathic angioneurotic edema;
pregnancy (must pre-was ruled out pregnancy, and the possibility of conception should be prevented);
lactation (infants should be weaned).
Parades lack of therapeutic experience, MOEH should not be used in:
patients with liver diseases, such as liver disease or primary liver dysfunction;
MOEH can be used in the following situations only after much careful evaluation of the benefit / risk ratio and constant monitoring of certain clinical and laboratory findings:
'aortic or mitral valve or other obstruction in the outflow from the left sardechnakamera (eg, hypertrophic cardiomyopathy);
stenosis (narrowing) of a.renalis (unilateral or bilateral);
severe disorder of renal function (creatinine clearance below 40 ml / min);
lovisheno separation of protein. Urine (more than 1 g / day);
severe disorders of electrolyte metabolism;
impaired immune responsiveness, or collagen (eg pupus erythematosus, scleroderma);
concomitant treatment with drugs inhibiting protective effects (eg, corticosteroids, cytotoxic agents, antimetabolites), allopurinol, procainamide or lithium;
Before applying MOEH should be examined renal function. In these patients, especially in early treatment M0EH . Should only be used for regular monitoring of blood pressure and / or certain abnormalities:
Patients with salt-depletion and / or dehydration
patients with severe hypertension caused by renal or other disease;
Patients over 65 vyzrast;
patients with concomitant heart failure.
Monitoring of serum electrolytes and serum creatinine concentrations and control kraanata picture shown in 'over a short' period / especially in early treatment and visakoriskovi patients (patients with impaired renal function, collagen, or patients treated with preparations suppressing protective effects or allopurinol or procainamide). If during treatment with MOEH symptoms such as fever, swollen lymph nodes and / or sore throat, you should consult your doctor immediately and do levkograma.Po during treatment with MOEH should not is held blood purification (hemodialysis or he-mofiltratsiya) with visokoprolusklivi membranes poliaktrilonitril-metal-sulfonate (eg, AN 69) as hemodialysis are related i.hemofiltratsiyata risk of reactions of hypersensitivity (anafipaktoidni events) and life-threatening shock
For these reasons, when the need to undertake a hemodialysis or hemofil-tration, drug treatment of hypertension need to be replaced with this, 'is not an ACE inhibitor. 'I have to inform your doctor that MOEH or that you need dialysis to allow that to bidet considered for treatment.
During apheresis LDL (low density lipoprotein) (pri.tezhka hiperholesteropemiya) in patients treated with ACE inhibitors may experience life-threatening hypersensitivity reactions.
During desensitisation therapy against insect venom [eg. stings bee or wasp) if simultaneously held with ACE inhibitors, may appear relatively life-threatening hypersensitivity reactions (eg, a drop in blood pressure, difficulty breathing, vomiting, allergic skin reactions).
In cases where it is necessary to conduct apheresis LDL. or desensitisation therapy against insect venom, ACE inhibitors should be replaced temporarily with different antihypertensive drug.
Use in pregnancy and lactation
Before beginning "therapy MOEH in women able to give birth to exclude pregnancy. During MOEH therapy in these women should be given adequate contraception. If women receiving MOEH confirm pregnancy should be done change of therapy less risky for detetgZ'antihipertenzivna therapy as taking ACE inhibitors, especially during the last six months of pregnancy "may adversely affect the fetus. During lactation nursing mothers should not take MOEH .
Effects on ability to drive and use machines
Treatment with this drug requires regular check-ups. Reactions to the drug, which serazlichavat in individuals' may impair ability to drive or operate machinery. This is particularly true for the beginning of treatment, a change in drug and alcohol priemanes.
Described are the following interactions between MOEH or other ACE inhibitors when coadministered with;
potassium potassium sparing diuretics (eg spiranolakton,; amipurid, triamterene) and other agents' - (eg heparin). Which can lead to increases of serum potassium concentration;
preparations lowering blood pressure occurs Bass antihypertensive effect of MOEH products are particularly lovishavat urine output (diuretics);
Lithium 'increase in serum, lithium concentration (need regular follow-up);
hypnotics, anesthetic agents for: pronounced drop in blood pressure (the anesthetist should be informed therapy MOEH );
allopurinol preparations suppressing protective effects (cytostatics rmunosulresanti, system - kortikosgeroidi), procainamide, reduced number of leukocytes in levkogramata (leukopenia);
preparations for the treatment of pain and inflammation (eg, aspirin, indomethacin): possible attenuation of the antihypertensive effect of MOEH ;
table salt: the antihypertensive effect of weakening MOEH ®; alcohol: to enhance the effects of alcohol;
blood glucose lowering agents (insulin or sulphonylureas): Increase the effect of reducing blood sugar.
Dosage, method and duration of administration
Early treatment with MOEH can be observed excessive drop in blood pressure, especially in patients with solevi'defitsit and / or dehydration (eg, dialysis, vomiting / diarrhea, diuretic therapy), heart failure or severe hypertension caused by renal or other disease.
If possible, salt depletion and / or dehydration should be corrected before treatment with MOEH ®, or already ongoing treatment with agents that increase urine flow (diuretics) should be reduced or discontinued if necessary. In these patients, treatment with MOEH should be initiated at the lowest dose of a uniform 3.75 mg (corresponding to 1/2tabletka MOEH-7.5), taken in the morning.
After applying lyrvata dose and the dose of MOEH and / or saluretitsite increases, these patients should bydat placed under medical observation for at least 2 hours to avoid svryhspad uncontrolled blood pressure.
In patients with severe hypertension (malignant hypertension), treatment with MOEH seprovede to a hospital to stabilize the situation.
In other cases, unless otherwise specified, the following dosage:
Usually the initial dose is 7.5 mg (corresponding to 1 tablet MOEH 7.5 or 1/2 tabletkaMOEH ® 15), taken in the morning.
If you do not achieve normalization of blood pressure with this dose, the dosage may be increased to 15 mg daily (corresponding to 2 tablets MOEH 7.5 or 1 tablet MOEH 15). The usual maintenance dose is 7.5 mg daily or 15 (corresponding to 1 tablet MOEH 7.5 or 2 tablets MOEH 7.5, respectively, or 1 tablet MOEH 15), the maximum dose of 30 mg daily (corresponding to 2 tablets MOEH 15) is not should not be exceeded.
The addition of a diuretic may increase the blood pressure lowering effect of moeksipril.Dozirovka in patients with moderate renal impairment (creatinine kliryns> 40 ml / min), the elderly (over 65 years) and in patients with liver cirrhosis: Based on existing studies usually do not require dose adjustment. But doctor should decide individually whether to reduce the initial dose of 3.75 mg as moeksipril (corresponding to 1/2 tablet MOEH 7.5).
Dosage in patients with severely impaired renal function (creatinine kliryns <40 ml / min): These patients are recommended initial daily dose of 3.75 mg moeksipril (corresponding to 1/2 tablet MOEH 7.5).
That daily dose should be administered as a single dose daily. In rare and exceptional cases may fit two doses a day. The duration of application is determined by the doctor.
They may experience the following symptoms depending on the level of overdose: A sharp drop in blood pressure, bradycardia, systemic shock, electrolyte metabolism disorders, kidney failure.
Immediately go to your doctor!
Heart and blood vessels
Excessive drop in blood pressure (orthostatic hypotension and collapse) with symptoms such as dizziness, fatigue and blurred vision, and often also brief loss of consciousness (syncope) can occur in some cases, especially in early treatment MOEH , when patients with salt-depletion and / or dehydration (eg, current treatment with agents that reduce the excretion of urine (diuretics), heart failure or severe hypertension caused by renal or other disease, and also with increasing dose MOEH ® and / or diuretics . In isolated cases, in conjunction with pronounced reductions in blood pressure were observed following side effects of ACE inhibitors:
Fast heart beat (tachycardia), palpitations, heart rhythm disorders, angina light-Thoris, heart attack, symptomatic transient ischemic attack (PUFA) and stroke (cerebrovascular accident).
In individual cases may appear impaired renal function or exacerbate existing ones. Although not yet seen the case of acute renal failure during treatment with moeksipril as in other preparations, lowering blood pressure, it can generally occur in isolated sluchai.V rare cases an increased excretion of protein in urine (proteinuria ), sometimes with simultaneous disruption of renal function.
In some cases, may appear dry, irritating cough and bronchitis: rarely observed respiratory distress, inflammation of the paranasal sinuses (sinusitis), cold (rhinitis), isolated cases of paroxysmal bronchoconstriction followed by respiratory distress (bronchospasm) inflammatory changes of the mucosa "of tongue (glossitis) and dry mouth. In isolated cases occur caused by ACE inhibitors swelling of tissues (angioedema) with coverage of the larynx, pharynx and / or tongue. Upon occurrence of this adverse reaction should immediately be 0.3-0.5 mg epinephrine administered subcutaneously or 0.1 mg epinephrine (subject to dilution instructions) by slow intravenous injection, with ECG monitoring and blood pressure monitoring, followed by administration of glucocorticoids.
It is also recommended intravenous antihistamines and receptor antagonists.
If diagnosed with a deficiency of C-inactivator, in addition to the use of epinephrine may also consider the use of C-inactivator.
In some cases there may be nausea, discomfort in the upper abdomen, digestive disorders, vomiting, diarrhea, constipation and loss of appetite. During treatment with ACE inhibitors are described isolated cases of jaundice due to stagnant 'bile (cholestatic jaundice), liver function abnormalities, inflammation of the liver (hepatitis), inflammation of the pancreas (pancreatitis) and intestinal obstruction (ileus)
Skin and blood vessels
In some cases there may be allergic reactions like skin rash (exanthem) may rarely occur hives (urticaria), itching (pruritus) and angioedema involving the lips, face and / or limbs.
In isolated cases there have been severe skin reactions such as erythema multiforme. Skin changes may be associated with chills, muscle and joint pains (myalgias and arthralgias), inflammation of the blood vessels (vasculitis) and certain changes in laboratory parameters (eosinophilia and / IME elevated titers of antinuclear antibodies).
Very rarely, skin reactions causing redness and blistering on the skin.
When there is suspicion of a severe skin reaction should immediately consult your doctor and, if necessary MOEH ® therapy should be discontinued.
During treatment with ACE inhibitors, isolated cases of psoriasiform skin lesions, sensitivity to light (fotosenzitivnost), hair loss (alopecia), separation of the nails (onycholysis) and increased vascular spasm in Raynaud's disease.
In some cases, can be observed headache or fatigue; rarely have drowsiness, depression, sleep disorders, impotence, tingling, numbness or coldness in the extremities (paraesthesia), impaired balance, confusion, tinnitus, blurred vision and changes taste or transient loss of taste.
In some cases there may be decreased hemoglobin, hematocrit and leukopenia or trom-botsitopeniya. In rare cases, particularly in patients with renal impairment or collagen, or in cases where both is treated with allopurinol, procainamide, or certain chemicals that inhibit the protective effects may have abnormalities in blood count (anemia, thrombocytopenia, neutropenia, eosinophilia), and in isolated cases, total loss of some or all forms structures in the blood (agranulocytosis or pancytopenia). While in therapy with ACE inhibitors have been observed hemolysis / hemolytic anemia in isolated cases also in connection with congenital glucose-6-phosphate dehydrogenase was not established causation.
In isolated cases there may be an increase in bilirubin and liver enzymes. May appear increased excretion of protein in urinata.V rare cases, particularly in patients with disorders of renal function may increase serum concentrations of urea, creatinine and potassium and serum sodium concentration may drop.
Since moeksipril decreased aldosterone secretion may occur increase in serum potassium. Potassium preparations, potassium-sparing diuretics should be used with caution and should be frequently monitored serum potassium. Increases in serum potassium were observed in patients with marked diabetes (diabetes mellitus mellitus).
The aforementioned laboratory parameters should be monitored before and regularly during treatment with MOEH ®.
If you notice any side effects not listed is this leaflet, tell them your doctor or pharmacist.
Shelf life and special storage instructions
Shelf life: 5 years from date of manufacture.
MOEH should not be used after the directions on the package shelf.
Store in a dry place at a temperature of 25r.
Keep out of children's reach untouchable.
One film-coated tablet contains 7.5 mg or 15 mg moexiprij hydrochloride.
Excipients: lactose, crospovidone, magnesium oxide (light), gelatin, magnesium stearate, cellulose metilhidroksipropil, hidrrksipropil cellulose, macrogol 6000 and colorant E171, E172