Fosicard N®

The drug is intended for oral administration. It is recommended to swallow the pill whole, without chewing or grinding, drinking plenty of liquid. The drug is taken regardless of the meal. The duration of the course of treatment and the dose of the drug is determined by the attending physician individually for each patient.
Adults are usually prescribed 1 tablet of the drug 1 time per day. If necessary, the dose can be increased to 2 pills per day.
The maximum daily dose of the drug is 2 pills.
Dose adjustment is not required for patients with impaired renal function of moderate severity and impaired liver function.
Patients with severe impaired renal function and creatinine clearance less than 30 ml / min do not prescribe the drug Fosicard N.

Before starting therapy with Fosicard N, correction of water and electrolyte balance should be carried out.
Fosinopril can cause symptomatic hypotension, which is most likely in patients with reduced BCC as a result of prolonged prior treatment with diuretics, restriction of salt intake, dialysis, diarrhea, or vomiting.
Hypotension is not an absolute contraindication for further use of the drug Fosicard N.
The maximum decrease in blood pressure is observed in the early stages of treatment and usually stabilizes at 2 weeks of therapy. With further use of the drug, its therapeutic efficacy is not reduced.
When using ACE inhibitors, included fosipopril may develop angioedema. With swelling of the tongue, pharynx, larynx may develop airway obstruction. Patients should stop taking the drug and immediately inform the doctor about the appearance of swelling in the face, eyes, lips and tongue, spasm of the muscles of the larynx or difficulty breathing. In such cases, rapid emergency measures are necessary.
Caution should also be exercised in the use of ACE during desensitization procedures.
During hemodialysis through highly permeable membranes, as well as during the apheresis of LDL with adsorption on dextran sulfate, anaphylactic reactions may occur. In these cases, you should use a dialysis membrane of another type or another drug treatment.
Patients with impaired renal function, especially in the presence of systemic diseases of the connective tissue, can develop agranulocytosis and suppression of bone marrow function. In this case, the blood leukocyte count should be monitored. Such patients should be warned about the need to report the appearance of any signs of infection, incl. fever, sore throat.
In patients with arterial hypertension with stenosis of the renal artery of one or both kidneys, as well as the simultaneous use of diuretics during treatment with ACE inhibitors, it is possible to increase the level of urea nitrogen and serum creatinine. These effects are reversible and disappear after cessation of treatment. In these patients, it is necessary to monitor renal function during the first 2 weeks of treatment. May require dose reduction of the drug.
In patients with severe heart failure, oliguria and / or progressive azotemia, in the presence or absence of renal insufficiency, treatment with ACE inhibitors may cause an excessive hypotensive effect, as a result, oliguria or azotemia may be enhanced, and in rare cases - fatal. Therefore, in these patients, drug treatment should begin with a minimum therapeutic dose and under strict control of blood pressure, especially during the first 2 weeks of treatment.
Hydrochlorothiazide can cause hypokalemia, hyponatremia and hypochloremic alkalosis. In the presence of fosinopril sodium, the risk of hypokalemia decreases. Hydrochlorothiazide helps reduce the excretion of calcium ions from the body to increase the excretion of magnesium ions in the urine, which can lead to hypomagnesemia. Periodic monitoring of electrolyte concentration in blood serum is necessary.
An increase in the concentration of uric acid in the blood is possible, and in some patients taking thiazide diuretics, an acute attack of gout can develop.
In patients with diabetes mellitus, a change in insulin requirements is possible; latent forms of diabetes mellitus may acquire a manifest form during the use of thiazides.
Increasing the concentration of triglycerides and cholesterol is associated with treatment with thiazide diuretics.
A cough caused by ACE inhibitors, including fosinopril, is usually unproductive and persistent, and goes away after stopping the medication. Cough caused by ACE inhibitors should be considered as one of the options for the differential diagnosis of cough.
In rare cases, the use of ACE inhibitors can lead to cholestatic jaundice with the development of fulminant hepatocyte necrosis.

With the use of excessive doses of the drug in patients, development of headache, dizziness, arterial hypotension, stupor and bradycardia is noted. With a further increase in dose, the development of circulatory shock, renal failure and impaired water and electrolyte balance is possible.
There is no specific antidote. In case of overdose, gastric lavage is indicated (in case no more than 30 minutes passed after taking the drug) and enterosorbent taking. If necessary, symptomatic therapy is carried out, in particular in the development of bradycardia, atropine is prescribed, in case of severe arterial hypotension, administration of angiotensin II is indicated.
In case of severe overdose, measures are also taken to maintain the function of the cardiovascular system.
Therapy of drug overdose Fosicard N should be carried out in a hospital.