Dalneva tabs 10mg + 8mg #30

Dalneva instruction for use

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Composition

Amlodipine besylate, perindopril erbumine, microcrystalline cellulose, pregelatinized starch, sodium starch glycollate, sodium hydrogen carbonate, anhydrous colloidal silicon dioxide, magnesium stearate.

Form of issue

Tablets 10 mg + 8 mg of round form biconvex white in contour pack in cardboard pack No. 30 and 90.

pharmachologic effect

Antihypertensive, antianginal.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Antihypertensive drug with a combination of active ingredients.
Perindopril is an active ACE inhibitor that converts angiotensin I to angiotensin II, which has a pronounced vasoconstrictive effect. Also, ACE has a disruptive effect on bradykinin, which has a vasodilating effect. Inhibition of ACE increases the activity of the kallikrein-kinin system.
Pharmacological action Perindopril is determined by its active metabolite-perindoprilat, which has a pronounced therapeutic effect in arterial hypertension of any degree, in any position of the body, reducing systolic and diastolic pressure. As a consequence, the OPSS decreases and peripheral blood flow increases, while the heart rate remains unchanged.
The hypotensive effect is maximum manifested 4-6 hours after taking perindopril and persists throughout the day. Reduction of blood pressure is rapid, and the pronounced therapeutic effect occurs 3-4 weeks after the start of the drug and is not accompanied by tachycardia. There is no withdrawal syndrome. In addition to vasodilating action. Perindopril reduces hypertrophy of the left ventricle and restores the elasticity and structure of the blood vessels.
Amlodipine - a blocker of slow calcium channels, refers to dihydropyridine derivatives, has a pronounced hypotensive and antianginal effect. Having a blocking effect reduces the process of transition of calcium ions into the cell. Antianginal action is caused by the expansion of the vessels of the cardiac muscle and peripheral arteries: reduces afterload on the myocardium, OPSS, myocardial oxygen demand, and reduces spasm of the coronary arteries. In patients with angina pectoris reduces the severity of cardiac muscle ischemia, reduces the number of angina attacks, increases exercise tolerance, reduces the need for nitroglycerin.
Has a pronounced dose-dependent hypotensive effect, which is due to the vasodilating effect on vascular muscle. Reduces the hypertrophy of the left ventricle muscles, while it does not affect the conductivity and contractility of the myocardium, inhibits platelet aggregation, does not cause an increase in heart rate, has a weakly expressed natriuretic effect. Does not affect the metabolism and concentration of lipids in the blood and can be prescribed to patients with diabetes mellitus, bronchial asthma, gout. The pronounced therapeutic effect comes in 6-10 hours and lasts an average of about 24 hours.

Pharmacokinetics

Perindopril - is rapidly absorbed into the digestive tract after ingestion, while the bioavailability of perindopril decreases with ingestion. Cmax in the blood is reached within one hour. Low connection with blood proteins (20%). Pharmacological activity is achieved due to the metabolite - perindoprilata. It is excreted in the urine. T1 / 2 perindopril is about one hour.
Amlodipine - well absorbed in the digestive tract, an absolute bioavailability of 80%, food intake for bioavailability has no effect. Cmax in the blood comes in 8-10 hours. Metabolised in the liver with the formation of metabolites that do not have activity. It is excreted mainly with urine.

Indications for use

In the therapy of ischemic heart disease and hypertension.

Contraindications

High sensitivity to the drug, age to 18 years, kidney failure, pregnancy, lactation.
Take with caution patients with CHF, therapy with immunosuppressants, cardiomyopathy, mitral / aortic stenosis, atherosclerosis, cerebrovascular diseases, hemodialysis, diabetes mellitus, with the intake of potassium-sparing diuretics, estramustine, dantrolene, lithium preparations, scleroderma, lupus erythematosus, patients of Negroid race.

Side effects

Local allergic reactions, nausea, dyspepsia, diarrhea, weight loss, tinnitus, agranulocytosis, leukopenia / neutropenia, thrombocytopenia, visual impairment, headache, drowsiness, sleep disturbance, dizziness, insomnia, tremor, mood lability, fainting, palpitations, cough, shortness of breath, abdominal pain, vomiting, constipation, hepatitis, skin rash and itching, alopecia, excessive sweating, myalgia, photosensitivity, muscle spasms, arthralgia, frequent urination, peripheral edema, impotence, fatigue, asthenia, not omoganie.

Dalneva, instructions for use (Method and dosage)

Dalneva tablets are taken orally before meals, preferably before breakfast, 1 tablet once a day.
Patients with stable angina or arterial hypertension dose selected according to the results of titration doses: amlodipine and perindopril. The maximum daily dosage of amlodipine is 10 mg; perindopril - 8 mg.
The preparation of Dalneva can not be administered to patients with CK less than 60 ml / min. The use of Dalneva requires caution in patients with hepatic insufficiency, since there is no recommendation for dosage of the drug for such patients. Patients after 60 years of dose adjustment is not required.

Overdose

No data available.

Interaction

With the joint administration of Dalneva with Baclofen, there is a risk of increasing the hypotensive effect of the drug. With the simultaneous use of the drug with drugs with antihypertensive effect, α-adrenoblockers (Tamsulosin, alfuzozin, prazosin, terazozin, doxazosin), antipsychotics, general anesthetic agents, tricyclic antidepressants, hypotensive effect and orthostatic hypotension may increase. Corticosteroids, tetracosactide reduce the hypotensive effect of Dalneva.

Terms of sale

The prescription is not required to buy Dalneva online.

Storage conditions

At a temperature of 10 - 25 ° C.
Shelf life - 3 years.

Reviews about Dalneva

Reviews about the drug among patients suffering from hypertension are mostly favorable.
"... Hypertensive with an experience of almost 30 years. Accepted various preparations. At the last appointment, the doctor prescribed Dalneva's medicine. Saw the pills for almost 2 months, the pressure after the month of intake is almost stabilized. I drink the minimum dosage. There are no pills, except bitterness in the mouth. I recommend this drug to everyone with a problem of pressure. "