Arifon retard

"Arifon retard" is a trade name for a drug whose main active ingredient is indapamide. Indapamide belongs to a class of drugs known as thiazide-like diuretics.

Diuretics are used to reduce swelling and remove excess fluid and sodium from the body by stimulating urination. They are widely used to treat hypertension (high blood pressure), heart failure, and other conditions that involve fluid retention.

"Arifon retard" is produced in the form of extended-release tablets, which allows maintaining a stable therapeutic effect of the drug over a long period of time.

Indications Arifona retard

• Hypertension (High Blood Pressure): Arifon Retard helps lower blood pressure by increasing the excretion of sodium and water from the body through the urinary system. This helps reduce the pressure in the blood vessels and reduces the load on the heart.
• Edema: Indapamide has a diuretic effect, which helps reduce edema associated with fluid retention in the body.
• Heart failure: The drug can be used to treat heart failure, especially when it is associated with hypertension or edema.

Release form

"Arifon retard" is usually available in the form of extended-release tablets. Such tablets are specially designed to gradually release the active substance over a long period of time after taking them. This allows maintaining a stable level of the drug in the body and ensuring its therapeutic effect over a long period of time.

Pharmacodynamics

• Diuresis: Indapamide increases the excretion of sodium and water from the body by stimulating urine formation. This results in a decrease in circulating blood volume and a decrease in blood pressure.
• Relaxation of blood vessels: Indapamide is able to dilate blood vessels, which improves blood supply to tissues and reduces resistance to blood flow. This also helps to reduce blood pressure.
• Improving the response of arterial vessels to vasoconstrictor factors: Indapamide can reduce the sensitivity of arteries to vasoconstrictor substances such as angiotensin II, which helps to lower blood pressure.

Pharmacokinetics

• Absorption: After tablet administration, indapamide is rapidly and completely absorbed from the gastrointestinal tract.
• Distribution: Indapamide is well distributed throughout the body, including the vascular bed, kidneys and skin.
• Metabolism: Indapamide is metabolized in the liver to form metabolites that also have a diuretic effect.
• Excretion: Indapamide and its metabolites are excreted primarily via the kidneys.
• Half-life: The half-life of indapamide in the body is approximately 14-18 hours. This allows the use of "Arifon retard" in the form of extended-release tablets to ensure a stable therapeutic effect over a long period of time.

Dosing and administration

For the treatment of hypertension:

• The starting dose is usually 1.5 mg per day, taken as a single dose in the morning before meals. If necessary, the dose can be increased to 2.5 mg per day.
• The maximum recommended daily dose is usually 5 mg.

For the treatment of edema:

• The usual starting dose is 2.5 mg per day, taken in one dose in the morning before meals. If necessary, the dose can be increased to 5 mg per day.

The medicine should be taken whole with a sufficient amount of water. Do not split or crush the tablets.

Use Arifona retard during pregnancy

• Postpartum use:

  • A study has shown that indapamide may be effective and safe for the treatment of postpartum hypertension. The study included women with postpartum hypertension and found no significant differences in blood pressure levels between the indapamide and methyldopa groups. However, indapamide showed a significant reduction in body weight, microalbuminuria, and left ventricular mass index, which may be useful for cardiovascular prevention (Gaisin et al., 2013).

• Pharmacokinetics and safety:

  • Studies show that indapamide is safe and effective in lowering blood pressure in patients with normal renal function and in patients with varying degrees of renal failure. It does not accumulate in the blood of patients with impaired renal function and is not dialyzable, indicating its potential safety in these conditions (Acchiardo & Skoutakis, 1983).

• Effect on the myometrium:

  • An experimental study showed that indapamide can affect the electrical and mechanical properties of the myometrium in pregnant rats, reducing the amplitude and frequency of contractions, which may indicate its effect on the smooth muscle of the uterus (Mironneau et al., 1986).

Contraindications

• Hypersensitivity: People with known hypersensitivity to indapamide or any of the ingredients of the drug should avoid using it.
• Severe renal impairment: "Arifon retard" may accumulate in the body in cases of renal impairment, therefore its use may be contraindicated in severe forms of renal failure.
• Severe liver dysfunction: In case of severe liver dysfunction, especially in case of liver cirrhosis, the use of "Arifon retard" may be undesirable due to possible disruption of metabolism and elimination of the drug.
• Hypokalemia: Indapamide, like other diuretics, may promote potassium loss, so its use in patients with existing hypokalemia may be undesirable.
• Bladder compartment syndrome: Due to the diuretic effect of indapamide, its use may be contraindicated in bladder compartment syndrome.
• Pregnancy and lactation: The use of "Arifon retard" may be contraindicated during pregnancy and lactation if the benefits of its use do not outweigh the potential risks to the fetus or child.

Side effects Arifona retard

• Hypokalemia: Loss of potassium can lead to various symptoms such as muscle weakness, abnormal heart rhythms, and even arrhythmia.
• Hyperkalemia: Although indapamide primarily causes potassium loss, in rare cases it can also cause an increase in blood potassium levels.
• Hyponatremia: Low sodium levels in the blood can cause irritability, headache, seizures, drowsiness, and other symptoms.
• Hyperuricemia: Uric acid levels in the blood may increase, which may lead to gout attacks in susceptible individuals.
• Hypotension: Low blood pressure can lead to dizziness, weakness, and fainting.
• Dry mouth: This is a fairly common side effect.
• Abdominal pain: You may experience discomfort or pain in the abdominal area.
• Chest pain: This side effect may be related to heart function.
• Muscle spasms: Spasms of various localizations may occur.
• Drowsiness or insomnia: Changes in sleepiness may also occur as a side effect.

Overdose

An overdose of "Arifon retard" may lead to increased side effects such as severe loss of potassium, hyperkalemia, hypotension, arterial hypotension, possibly syncope (fainting), and other cardiovascular complications.

Interactions with other drugs

• Medicines that increase potassium in the blood: Medicines such as spironolactone, eplerenone, as well as potassium salts and potassium-sparing diuretics may enhance the effect of indapamide and lead to hyperkalemia.
• Medicines that decrease potassium in the blood: Medicines such as thiazide diuretics, lactix, amphotericin B, and some drugs used to treat asthma and chronic obstructive pulmonary disease (corticosteroids) may increase potassium loss when used with indapamide.
• Medicines that increase blood pressure: Combination of indapamide with other drugs used to treat hypertension, such as beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor antagonists, may result in increased hypotensive effect.
• Medicines affecting the cardiovascular system: When used simultaneously with drugs affecting the cardiovascular system (eg, digoxin, antiarrhythmic drugs), their effect may be enhanced or weakened.
• Nephrotoxic drugs: When indapamide is used concomitantly with drugs that have a toxic effect on the kidneys (for example, some antibiotics or non-steroidal anti-inflammatory drugs), their negative effect on the kidneys may be increased.
• Medicines affecting blood glucose and lipids: Indapamide may increase blood glucose and cholesterol levels, so when used concomitantly with antihyperglycemic and lipid-lowering drugs, dosage adjustments may be required.