Micardis Plus® [Tapentadol]
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Clinical Pharmacology
Micardis PLUS - antihypertensive agent, angiotensin II receptor antagonist (type AT1). It has a very high affinity for this receptor subtype. Selectively and by long-term binding to the receptors, telmisartan displaces angiotensin II from its association with the AT1 receptors. Does not show affinity for other AT receptor subtypes. The functional significance of other receptor subtypes and the effect of elevated (as a result of administration of telmisartan) level of angiotensin II on them is not known. Telmisartan reduces the level of aldosterone in the blood plasma, does not inhibit plasma renin, does not block the ion channels, does not inhibit ACE (kinase II), which also destroys bradykinin. Therefore, side effects associated with bradykinin are not observed.
Indications
Arterial hypertension.
Composition
1 tablet contains:
Active ingredients:
Telmisartan 80 mg.
Hydrochlorothiazide 12.5 mg.
Excipients:
Povidone, meglumine, sodium hydroxide, sorbitol, magnesium stearate, microcrystalline cellulose, iron red oxide, sodium starch glycolate, lactose monohydrate, corn starch.
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Dosage and Administration
For adults, the daily dose is 20-40 mg (1 time / day.). In some patients, the hypotensive effect can be achieved at a dose of 20 mg / day. If necessary, the dose can be increased to 80 mg / day.
Patients with impaired renal function, as well as elderly patients do not need dose adjustment.
For patients with impaired liver function, the daily dose is 40 mg.
Adverse reactions
From the side of the central nervous system: headache, dizziness, fatigue, insomnia, anxiety, depression, seizures.
From the digestive system: abdominal pain, dyspepsia, nausea, diarrhea, increased activity of hepatic transaminases.
On the part of the respiratory system: cough, pharyngitis, upper respiratory tract infection.
From the hemopoietic system: decreased hemoglobin level.
Allergic reactions: rash; in a single case, angioedema.
From the urinary system: peripheral edema, urinary tract infection, increased uric acid levels, hypercreatininemia.
Since the cardiovascular system: marked decrease in blood pressure, palpitations, chest pain.
From the musculoskeletal system: lower back pain, myalgia, arthralgia.
From the laboratory indicators: hyperkalemia, anemia, hyperuricemia.
Other: flu-like syndrome.
Contraindications
Obstruction of the biliary tract, severe violations of the liver and kidneys, pregnancy, lactation (breastfeeding), hypersensitivity to telmisartan.
Drug interactions
With simultaneous use with antihypertensive drugs may increase antihypertensive action.
When used simultaneously with potassium-sparing diuretics, heparin, dietary supplements, potassium-containing salt substitutes, hyperkalemia may develop.
With simultaneous use with lithium preparations may increase the concentration of lithium in the blood plasma.
With simultaneous use may increase the concentration of digoxin in the blood plasma.
Pregnancy and Lactation
Telmisartan does not have a teratogenic effect, but has a fetotoxic effect. Therefore, MikardisPlyus should not be used in the first trimester of pregnancy. In the case of a planned pregnancy, MikardisPlus should be replaced with drugs approved for use during pregnancy. If pregnancy is established, you should immediately stop taking the drug.
In the II and III trimesters, the use of the drug can cause electrolyte abnormalities in the fetus, and possibly other disorders that are known in adults. The development of neonatal thrombocytopenia, jaundice (in the fetus or in the newborn) has been reported in the case of the mother taking thiazide diuretics (including hydrochlorothiazide). Therefore, the drug is contraindicated in the II and III trimester of pregnancy.
It is not yet known whether telmisartan passes into breast milk, hydrochlorothiazide passes into breast milk and may inhibit lactation. Therefore, MikardisPlyus is contraindicated for use during lactation.
Special instructions
Influence on ability to drive motor transport and control mechanisms:
A special study of the effect of the drug on the ability to drive and work with mechanisms was not conducted. However, when driving and working with mechanisms, one should remember about the possibility of dizziness and drowsiness when using the drug Micardis Plus.
Overdosage
Symptoms of telmisartan overdose: marked reduction in blood pressure, tachycardia and / or bradycardia.
An overdose of hydrochlorothiazide is accompanied by a loss of electrolytes (hypokalemia, hypochloraemia) and dehydration, resulting from massive diuresis. The most common signs and symptoms of hydrochlorothiazide overdose are nausea and drowsiness.Hypokalemia can lead to muscle spasms and / or increase cardiac arrhythmias caused by the simultaneous use of cardiac glycosides or certain antiarrhythmic drugs.
Treatment: symptomatic and supportive therapy, the nature of which depends on the time elapsed from the moment of taking the drug, and on the severity of the symptoms. It is recommended to induce vomiting and / or gastric lavage, to appoint activated charcoal. Requires frequent monitoring of electrolytes and serum creatinine. In the event of arterial hypotension, the patient should be placed on his back and quickly undergo therapy aimed at replacing electrolytes and BCC. Telmisartan is not removed by hemodialysis. The degree of removal of hydrochlorothiazide during hemodialysis has not been established.
- Brand name: Micardis Plus
- Active ingredient: Telmisartan, Hydrochlorthiazide
- Dosage form: Pills.
Studies and clinical trials of Tapentadol (Click to expand)
- Neutral effects of the novel analgesic tapentadol on cardiac repolarization due to mixed ion channel inhibitory activities
- Tapentadol and its two mechanisms of action: Is there a new pharmacological class of centrally-acting analgesics on the horizon?
- Four stereoisomers of the novel μ-opioid receptor agonist tapentadol hydrochloride
- Absorption, metabolism, and excretion of14C-labeled Tapentadol HCl in healthy male subjects
- Tapentadol: mit zwei Mechanismen in einem Molekül wirksam gegen nozizeptive und neuropathische Schmerzen
- Unerwünschte Nebenwirkungen von Tapentadol im Vergleich zu Oxycodon
- Efficacy and safety of tapentadol prolonged release for chronic osteoarthritis pain and low back pain
- Erratum to: Efficacy and safety of tapentadol prolonged release for chronic osteoarthritis pain and low back pain
- Comparable efficacy and superior gastrointestinal tolerability (nausea, vomiting, constipation) of tapentadol compared with oxycodone hydrochloride
- A randomised, placebo-controlled trial comparing the effects of tapentadol and oxycodone on gastrointestinal and colonic transit in healthy humans
- Long-term Safety and Tolerability of Tapentadol Extended Release for the Management of Chronic Low Back Pain or Osteoarthritis Pain
- Tapentadol: a novel analgesic for treating moderate to severe pain
- Tapentadol: new oral opioid for acute and chronic severe pain