Walsakor
A relatively new drug that has the effect of lowering blood pressure, based on the blocking of oligopeptide hormone-angiotensin II receptors. Variants h and hd of this preparation are a complex combining valsartan and hydrochlorothiazide in various doses, which reduces blood pressure in arteries, affecting the renin-angiotensin-aldosterone system.
Pharmacodynamics
The main active ingredient is valsartan - an angiotensin II receptor blocker (subtype AT1). This is the main peptide of the system regulating blood pressure and its volume in the body, acting as follows - narrowing the vessels and increasing their peripheral resistance, the angiotensin receptors of the second subtype connect to the receptors of the first subtype. These physiological effects lead to a jump in blood pressure. The active ingredient, blocking the AT-1 angiotensin (A II) receptors, promotes quantitative increase in free AII in the blood serum and increases the level of the AT2-subtype receptors that bind to each other in the absence of free AT-1 receptors. This leads to an antihypertensive effect, a decrease in systemic peripheral vascular resistance, and a systolic blood volume.
The action of Valsakor does not affect the contractile activity of the myocardium, effectively eliminates puffiness and normalizes breathing in patients with impaired cardiac function.
Valsacor H and HD are complex medicines containing another active ingredient - diuretic hydrochlorothiazide, which lowers arterial pressure and helps to eliminate Na, Cl, K and water from the body.
The active ingredients of the complex preparation synergistically supplement the effectiveness of each other and reduce the likelihood of undesirable effects of admission.
At the end of two weeks from the start of the therapeutic course, there is a significant normalization of blood pressure. The maximum effect of treatment with this drug is fixed about a month later. One-time oral medication provides a 24-hour effect.
Pharmacokinetics
The active ingredients are well absorbed in the gastrointestinal tract. Valsartan binds to serum proteins almost completely (about 98%), hydrochlorothiazide - by 40-70%. The greatest diuretic effect develops after four hours and remains about 12.
Valsartan excretion occurs mainly through the intestine, a small part is excreted in the urine. Hydrochlorothiazide is eliminated through the kidneys, the bulk - in an unchanged form.
Contraindications
Sensitization to the active and additional ingredients of the drug, variants h and hd + to sulfonamides.
Pregnancy, lactation and age group 0-17 years.
Variants h and hd are not recommended for patients with severe hepatic pathologies, cholestasis, anuria, renal insufficiency (creatinine release rate less than 30ml per minute) on hemodialysis, after kidney transplantation, with narrowing of the renal artery and diseases, where the functioning of the kidneys is conditioned by the RAAS system renin-angiotensin-aldosterone).
Valsacor h and hd are contraindicated in cases of reduced serum Na and Ca content, low plasma concentration of K ions and elevated blood uric acid (symptomatic), diabetes mellitus to patients receiving aliskiren.
With the spiciness of dosing valsartan to patients after a heart attack and with impaired cardiac muscle function. This category of patients during treatment with Valsacor requires regular monitoring of kidney function.
Care should be taken when prescribing and dispensing this medication to the following categories of patients:
- with Liebman-Sachs disease;
- with a narrowing of the lumen of the renal artery;
- water-electrolyte imbalance;
- with a narrowing of the aortic lumen or a two-leaf valve;
- hypertrophy of the walls of the left and right ventricles of the heart;
And also people whose work is associated with increased concentration of attention.
Side effects of the valsacora
Therapy with Valsacor may lead to the following undesirable consequences:
- infection with viruses and bacteria with the development of respiratory infections (inflammation of the nasal sinuses and pharyngeal mucosa, runny nose, cough);
- dyspepsia, dizziness, weakness, pain in the head, muscles, joints during treatment;
- hyperkalemia, allergic rashes, negative effects on renal function.
Therapy options h and hd in addition to those already mentioned can lead to:
- arrhythmias, attacks of angina pectoris, significant hypotension;
- anemia, liquefaction of blood and poor coagulation;
- hepatitis, stagnation of bile;
- mood swings, polarity of emotions, insomnia, drowsiness, numbness of limbs;
- malignant exudative erythema, edema Quincke, toxic epidermal necrolysis;
- sodium and / or potassium deficiency, tinnitus, hyperglycemia, hypercreatininemia, impaired renal excretion and bile outflow, inadequate auditory and visual disorders, excessive sweating.
Dosing and administration
This drug is dosed to each patient, taking into account his personal sensitization and the desired hypotensive effect.
At the beginning of treatment, a daily dosage of 80 mg of Valsacor is given once or in two divided doses. At the end of four weeks from the start of admission, when the greatest hypotensive effect is observed, corrections are introduced into the dosing.
The largest standard daily dose of the drug to reduce blood pressure - 160 mg is taken once or twice a day for 80 mg with an interval of 12 hours.
If this treatment scheme is ineffective, then
H or hd variants are used . Dosage is individual. Patients with hepatic dysfunction (without cholestasis) and at a rate of excretion of creatinine above 30ml per minute do not adjust the dose value.
With a decrease in the contractility of the heart muscle, a daily dosage of 80 mg of Valsacor is usually given in two divided doses. Gradually, taking into account the susceptibility to the active ingredient, a single dosage is increased to 160 mg and taken at intervals of 1/2 days.
The maximum possible daily amount of valsartan is 320 mg.
With the simultaneous appointment of a diuretic, the greatest amount is 160 mg per day.
In the postinfarction state, taking these tablets is prescribed from a daily dosage of 40 mg (it is divided into two doses using Valsakor 40 tablets with a separating notch), having
Sustained a time interval of at least 12 hours. Little by little, the dosage is adjusted upwards, taking into account the susceptibility to the active ingredient, the maximum possible dosage of which is 320 mg per day.
Overdose
No overdose of Valsakor was reported. A potential symptom of exceeding the dose of valsartan may be pronounced hypotension, it is permissible to assume a violation of consciousness, shock or collapse.
Exceeding the permissible dose of hydrochlorothiazide is manifested by lethargy, a decrease in the volume of circulating blood and electrolithic imbalance, possibly in combination with spasmodic contractions of the musculature and the development of heart failure.
First aid for clinically insignificant symptoms consists in the appropriate treatment and administration of enterosorbents. Clinically significant decrease in blood pressure is corrected by infusion of NaCl solution (0.9%).
Interactions with other drugs
The combination of Valsacor with drugs containing K, and diuretics, on deducing K, increases the likelihood of hyperkalemia.
The drug interaction of Valsacor h and hd is determined by the presence of hydrochlorothiazide.
Its combination with drugs containing Li or K increases the likelihood of excess serum content of these substances. When this combination is prescribed, it is recommended that the concentration of electrolytes in the blood be monitored.
Monitor the plasma concentration of K followed by its combination with antiarrhythmics and antipsychotics, which promote activation of contractions of the heart muscle (the so-called "pirouette").
The likelihood of hypercalcaemia increases when this active substance is combined with preparations of Ca and vitamin D3.
Simultaneous use of Valsacor h and hd with hypoglycemic, antidotal drugs, pressor amines and tubocurarine may require corrections in their dosing.
Hydrochlorothiazide increases the likelihood of an increase in blood glucose levels from the action of ß-adrenoblockers and a hyperstat.
Cholinolytics contribute to an increase in its bioavailability, and cholestyramine and cholestipol decrease.
This substance increases the likelihood of the development of myelosuppressive action of cytostatic drugs and undesirable actions of amantadine.
Nonsteroidal anti-inflammatory drugs reduce its effectiveness, and the likelihood of developing renal failure increases.
The combination with methyldopa can provoke a reduction in the life cycle of red blood cells, with ethyl alcohol - orthostatic hypotension, with cyclosporine antibiotics - symptomatology of gout.
The combination with antibiotics of the tetracycline series increases their content in the urine.
Attention!
To simplify the perception of information, this instruction for use of the drug "Walsakor" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.