Tenoric

Brand Ipka

In stock 1221 Items

Available since: 2019-09-19

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Clinical Pharmacology

Tenoric has an antihypertensive effect.

Indications

Arterial hypertension.

Composition

1 tablet contains atenolol 100 mg; chlorthalidone 25 mg.

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Dosage and Administration

The dosage regimen is given in terms of atenolol.
The average dose of Tenorica for adults is 100 mg; the initial dose is 50 mg 1 time / day.
As a rule, the use of the drug in a dose corresponding to 100 mg of atenolol, gives a good clinical effect. Subsequent increase in dose or does not lead to a further decrease in blood pressure, or reduces it very slightly. If necessary, an additional antihypertensive agent may be prescribed.
Elderly patients should be prescribed in lower doses.

Adverse reactions

Hyperuricaemia, hypokalaemia, impaired glucose tolerance, bradycardia, heart block, orthostatic hypotension, heart failure, cold extremities, intermittent claudication, Raynaud's syndrome, confusion, mood changes, hallucinations, insomnia, nightmares, dry eyes, dyspeptic disorders and visual disturbances , leukopenia, thrombocytopenia, purpura, alopecia, psoriasis, paresthesia, bronchospasm.

Contraindications

Hypersensitivity, AV blockade II-III century; CHF (resistant to treatment with cardiac glycosides); bradycardia; cardiogenic shock; hepatic and / or renal failure; bronchial asthma; pregnancy, lactation, child age.
With caution. AV block I Art., Chronic bronchitis, pulmonary emphysema, gout, arterial obliterans, disorders of water and electrolyte balance.

Drug interactions

Simultaneous use of tenoric with dihydropyridine derivatives (nifedipine) may increase the risk of arterial hypotension, in patients with latent heart failure, signs of circulatory disorders may appear.
Cardiac glycosides in combination with beta-blockers may increase AV conductivity time.
Beta-blockers may exacerbate ricochet hypertension, which may occur after clonidine withdrawal. If both drugs are prescribed, the beta-blocker should be stopped a few days before discontinuing clonidine. If it is necessary to replace clonidine with a beta-blocker, the latter should be administered a few days after discontinuation of therapy with clonidine.
It is necessary to carefully prescribe beta-blockers in combination with class I antiarrhythmic agents (disopyramide), since cardiodepressive effect can be added up.
The concomitant use of sympathomimetic drugs, such as epinephrine (adrenaline), norepinephrine (norepinephrine), can neutralize the effect of beta-blockers and lead to a significant increase in blood pressure.
Salicylates and NSAIDs (ibuprofen, indomethacin), estrogens can reduce the hypotensive effect of beta-blockers, and the use of salicylates in a high dose may increase the toxic effect of salicylates on the central nervous system.
Lithium preparations should not be used with diuretics, since they can reduce the renal clearance of lithium.
The use of beta-blockers together with general anesthesia can lead to an increased risk of arterial hypotension and the summation of the negative inotropic effect of both drugs (anesthetic should be used with minimal negative inotropic effect). It is also possible to enhance the action of curare-like muscle relaxants.
When using the drug Tenoric with MAO inhibitors, an increase in blood pressure is possible (this combination should be avoided).
With simultaneous use of the drug Tenoric with ACE inhibitors (captopril, enalapril) at the beginning of therapy, a sharp increase in the antihypertensive effect is possible.
When combined with tenoric corticosteroids, amphotericin B, furosemide may increase the excretion of potassium.
When combined with Tenoric, the effect of insulin and oral hypoglycemic agents may decrease (the level of glucose in the blood should be monitored).
Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators, and other antihypertensive drugs may enhance the anti-hypertensive effect of Tenoric.
The use of beta-blockers in combination with calcium channel blockers that have a negative inotropic effect, such as verapamil, diltiazem, can lead to an increase in this effect, especially in patients with reduced myocardial contractility and / or with impaired sinoatrial or AV conduction, which can be the cause of severe arterial hypotension, severe bradycardia and heart failure (calcium channel blocker should not be used in / for 48 hours after withdrawal of the beta-blocker) .
With the simultaneous appointment of Tenoric with reserpine, clonidine, guanfacin, the occurrence of severe bradycardia may occur.

Special instructions

Caused by beta-blocker atenolol, which is part of Tenoric
Be wary appoint patients with AV-blockade I degree.
It should be borne in mind that the use of the drug may mask the effects of thyrotoxicosis and hypoglycemia.
When developing against the background of the use of the drug bradycardia (heart rate up to 50 beats / min) with clinical symptoms, reduce the dose or discontinue the drug.
Do not abruptly cancel Tenoric in patients with coronary artery disease.
Smokers may experience a decrease in the therapeutic effect of the drug.
Special attention should be paid in cases where surgical intervention with general anesthesia is required. The drug should be discontinued 48 hours before surgery, and as an anesthetic one should choose a drug with the least possible negative inotropic effect.
While taking the drug, it is possible to increase sensitivity to allergens and develop severe anaphylactic reactions, and therefore patients receiving desensitization therapy should take the drug with great care. Such patients may not respond to the average dose of epinephrine (adrenaline) used to treat allergic reactions.
Precautions should be prescribed to patients with broncho-obstructive syndrome, and in case of worsening bronchial conduction, therapy with beta-adrenomimetics.
With the use of atenolol, it is possible to reduce the production of tear fluid, which is important for patients using contact lenses.
Caused by the chlororidine diuretic, which is part of Tenorica
On the background of the drug may occur hypokalemia. Serum potassium should be monitored, especially in patients receiving cardiac glycosides for treating heart failure, in patients with an unbalanced diet (low in potassium) or in patients with complaints of gastrointestinal disorders. The development of hypokalemia in patients receiving cardiac glycosides can lead to arrhythmias.
The drug is used with caution in patients with impaired renal function.
On the background of the use of the drug may cause impaired glucose tolerance. It should be used with caution in patients with a predisposition to diabetes.
On the background of the use of the drug may develop hyperuricemia, usually minor, but in some cases may require the use of agents that promote the excretion of uric acid.
Use in Pediatrics
The efficacy and safety of Tenoric in children and adolescents under 18 years of age have not been established, therefore, the drug should not be administered to patients in this age group.
Influence on ability to drive motor transport and control mechanisms
The use of Tenorica, as a rule, does not affect the ability to drive vehicles and control mechanisms.Nevertheless, the question of the possibility of driving a vehicle should be solved after assessing the individual tolerance of the drug.

Overdosage

Symptoms: severe bradycardia, arterial hypotension, acute heart failure, bronchospasm, convulsions, increased drowsiness.
Treatment: careful monitoring of the patient's condition, if necessary - hospitalization in an ICU, gastric lavage, the use of Activated charcoal and laxatives; in case of arterial hypotension and shock, administration of plasma or plasma substitutes; with brochospasm - the use of bronchodilators, with significant diuresis - the introduction of fluid and electrolytes. Hemodialysis or hemoperfusion is possible.