Pharmacological properties : Pharmacodynamics: Omnadren 250 ephedrine buy cycle diuretics average duration of action. It has a diuretic effect, it violates the reabsorption of sodium, chlorine, potassium, magnesium, water in the distal nephron. The diuretic effect is 1-2 hours, reaches a maximum after 4 hours and lasts 6-12 hours. Effect decreases with a decrease in glomerular filtration rate and stops when a value of not less than 30 ml \ min. Patients having diabetes insipidus antidiuretic effect (reduced urine volume and increases its concentration). It has antihypertensive properties and can be used for this purpose both in monotherapy and to enhance the antihypertensive action of other drugs. The hypotensive effect is due to expansion of the arterioles. Omnadren 250 cycles do not affect the normal blood pressure. The antihypertensive effect occurs within 3-4 days, but may need 3-4 weeks to achieve the optimal therapeutic effect. Omnadren 250 cycle diuretics reduce calcium excretion in the urine and thereby reduce the formation of kidney stones. Pharmacokinetics Absorbed from the gastrointestinal tract is incomplete (60-80% of an oral dose).Communication to plasma proteins is 40%, the apparent volume of distribution – 3-4 l / kg. The maximum plasma concentration is determined after 2-5 hours. The half-life is 6-15 hours. Do not metabolized by the liver. 95% excreted by the kidneys in unchanged form and about 4% of the hydrolyzate, 2-amino-4-chloro-m-benzenedisulfonamida (decrease in alkaline urine) by glomerular filtration and tubular secretion of active in the proximal part of the nephron. It penetrates through the placental barrier and into breast milk.
- hypertension (used as a monotherapy or in combination with other agents);
- edematous syndrome of different genesis (chronic heart failure, nephrotic syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, treatment with corticosteroids, premenstrual syndrome);
- control polyuria, preferably at nephrogenic diabetes insipidus;
- prevention of stone formation in the urinary tract (decrease hypercalciuria).Contraindications
- hypersensitivity to the drug or other sulfonamides;
- severe renal (creatinine clearance below 30 ml / min) or hepatic impairment;
- Hard-controlled diabetes mellitus;
- Addison’s disease;
- Refractory hypokalaemia, hyponatraemia, hypercalcaemia.
Be wary of hypokalemia, hyponatremia, hypercalcemia in patients with coronary heart disease, cirrhosis of the liver, in the elderly, in patients with lactose intolerance, while taking cardiac glycosides, in gout.Pregnancy and lactation
HydrochloroOmnadren 250 cycle crosses the placental barrier and into breast milk. Do not use this drug in the first trimester of pregnancy. In the second and third trimesters of pregnancy, the drug can be administered only in case of urgent need when the benefit to the mother outweighs the potential risk to the fetus and / or child (there is a risk of fetal or neonatal jaundice, thrombocytopenia, and other effects). If necessary, the appointment during lactation breast-feeding should be discontinued.Dosing and Administration
Inside, after a meal. Dosage is determined individually. With constant medical control sets the minimum effective dose. Adults as antihypertensive agents: the usual initial daily dose is 25-50 mg once daily, as an agent alone or in combination with other antihypertensive agents. For some patients, it may be sufficient initial dose of 12.5 mg as a monotherapy or in combination. It is necessary to apply the minimum effective dose should not exceed 100 mg per day. If hydrochloroOmnadren 250 cycle is combined with other antihypertensive drugs, it may be necessary to reduce the dose of another drug in order to prevent an excessive reduction in blood pressure. The antihypertensive effect occurs within 3-4 days, but in order to achieve optimal therapeutic effect may require 3-4 weeks. After cessation of treatment hypotensive effect lasts for one week. Edematous syndrome of various etiologies: the usual initial daily dose is 25-100 mg 1 time 1 day or every two days. Depending on the therapeutic effect, the dose may be reduced to 25-50 mg 1 time per day or one time every two days. In some severe cases, early treatment may require doses up to 200 mg per day. Premenstrual Syndrome: The usual dose is 25 mg per day and applied from the onset of symptoms before menstruation. Nephrogenic Diabetes Insipidus: the usual daily dose is 50-150 mg in divided receptions. Children Doses are established on the basis of the child’s body weight. Normal pediatric daily dose is 2.1 mg / kg body weight, or 30-60 mg per square meter of body surface area, administered once a day. The total daily dose for children up to 2 years of age is 12.5 – 37.5 mg; from 2 to 12 years – 37.5 – 100 mg.
Side effects: From the water-electrolyte metabolism and acid-base balance occur more frequently during long-term administration of high doses:
- may cause hypokalemia and alkalosis hypochloremic: dry mouth, increased thirst, heart rhythm disturbances, mood changes and mental, cramps or muscle aches, nausea, vomiting, unusual tiredness and weakness. Gipohloremichesky alkalosis may cause hepatic encephalopathy or hepatic coma;
- Hyponatremia: confusion, convulsions, lethargy, slowing of thought processes, fatigue, irritability;
- hypomagnesemia: arrhythmia; Hematopoietic system: agranulocytosis, thrombocytopenia and hemolytic and aplastic anemia, leykotsitopeniya, Cardio-vascular system: arrhythmia, tachycardia, orthostatic hypotension, thrombosis, thromboembolism. From the urogenital system: acute interstitial nephritis, vasculitis, giperkreatinemiya in rare cases, may decrease the potency. On the part of the gastrointestinal tract: cholecystitis, or pancreatitis, jaundice, diarrhea, sialadenitis, constipation, anorexia, epigastric pain, the nervous system: dizziness, temporary blurred vision, headache, paresthesia, xanthopsia ;Metabolic: hyperglycemia, glycosuria, hyperuricemia and gout exacerbation, hypercalcemia, hyperlipidemia; Other: allergic reactionsOverdose
Symptoms of hypokalemia (weakness, paralysis, constipation, arrhythmia), somnolence, decreased blood pressure dry mouth, oliguria, tachycardia.
Treatment: Rinse stomach, take activated charcoal, to introduce drugs potassium infusion of electrolyte solutions. Symptomatic treatment, no specific antidote.Interaction with other medicinal products
In a joint application of the drug with digitalis glycosides may increase the possibility of toxicity of digitalis drugs (eg, irritability ventricle) associated with hypokalemia and hypomagnesemia.
Enhances the effect of non-depolarizing muscle relaxants.
The combined use of amiodarone with Omnadren 250 cycle diuretics may increase the risk of arrhythmias, associated with hypokalaemia.
The action of antihypertensive drugs can be enhanced if they are applied in conjunction with Omnadren 250 cycle.
When combined with corticosteroids or calcitonin increases the risk of hypokalemia.
in an application reduces the effectiveness of oral hypoglycemic agents.
Non-steroidal anti-inflammatory drugs, especially indomethacin, reduce the antihypertensive effect Omnadren 250 cycles.
Concomitant use of diflunisal with hydrochloroOmnadren 250 cycle causes a significant increase in the level of the latter in plasma and reduces its hyperuricemic action.
Omnadren 250 cycles may reduce the action of noradrenaline on blood pressure.
Omnadren 250 cycle funds may increase sensitivity to tubocurarine.
Ethanol and phenobarbital, diazepam may increase the antihypertensive effect of Omnadren 250 cycle diuretics.
Kolestiramin can inhibit the absorption of Omnadren 250 cycle diuretics in the gastrointestinal tract (absorption reducing by 85%).
in an application can increase the blood concentration of lithium salts to a toxic level. Avoid joint use of these drugs.
Use with caution in renal disease and expressed violations of their function.
In patients with renal disease, Omnadren 250 cycles may cause azotemia. In patients with impaired renal function may develop the cumulative effect of the drug. If the progression of kidney disease is not in doubt, it should suspend or discontinue therapy with diuretics.
Since Omnadren 250 cycle diuretics lose their therapeutic efficacy when glomerular filtration rate of less than 39 ml \ min., In these patients the treatment of choice is a loop diuretic.
Omnadren 250 cycles should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of electrolyte and water balance may precipitate hepatic coma.
Allergic reactions are more likely in patients with allergy or bronchial asthma in history.
We describe the possibility of exacerbation of systemic connective tissue diseases (systemic lupus erythematosus) .
With long-term use of the drug should regularly monitor the blood electrolytes and creatinine clearance. During the period of the drug should be recommended to patients a diet rich in potassium. If signs of potassium deficiency, as well as the simultaneous application of cardiac glycosides, corticosteroids and adrenocorticotropic hormone drugs shows the assignment of potassium or potassium-sparing diuretics.
The antihypertensive effect of the drug may be enhanced in patients after sympathectomy.
Calcium excretion is decreased by Omnadren 250 cycle. Some patients with long-term treatment of Omnadren 250 cycle observed pathological changes in the parathyroid glands.
The concentration of serum bilirubin may be increased when using hydrochloroOmnadren 250 cycle due to the displacement of the binding site to albumin.
Cholesterol and triglyceride levels may increase.
To prevent potassium deficiency and magnesium prescribe a diet with a high content these trace elements, potassium-sparing diuretics, potassium and magnesium salts.
A regular control of the content of potassium in the blood plasma glucose, uric acid, lipids, creatinine.
in the period of treatment must be careful when driving and occupation of other potentially hazardous activities that require high concentration and psychomotor speed reactions.
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