Lisinoton, 28 pcs., 5 mg, tablets
Symptomatic hypotension.
Most often, a pronounced decrease in blood pressure occurs with a decrease in fluid volume caused by diuretic therapy, reducing the amount of salt in food, dialysis, diarrhea or vomiting. In patients with chronic heart failure with or without simultaneous renal failure, a pronounced decrease in blood pressure is possible. It is more often detected in patients with severe chronic heart failure, as a result of the use of large doses of diuretics, hyponatremia or impaired renal function. In such patients, treatment with Lisinoton should be started under the strict supervision of a physician (with caution in selecting the dose of the drug and diuretics). Similar rules must be followed when prescribing to patients with coronary artery disease and cerebrovascular insufficiency, in whom a sharp decrease in blood pressure can lead to myocardial infarction or stroke. A transient hypotensive reaction is not a contraindication for taking the next dose of the drug. When using Lisinoton, some patients with chronic heart failure, but with normal or low blood pressure, may experience a decrease in blood pressure, which is usually not a reason to stop treatment. Before starting treatment with Lisinoton, if possible, the sodium concentration should be normalized and/or the lost volume of fluid should be replenished, and the effect of the initial dose of Lisinoton on the patient should be carefully monitored. In case of renal artery stenosis (especially with bilateral stenosis, or in the presence of stenosis of the artery of a single kidney), as well as with circulatory failure due to lack of sodium and/or fluid, the use of Lisinoton can also lead to impaired renal function, acute renal failure, which usually turns out to be irreversible after discontinuation of the drug.
In acute myocardial infarction.
The use of standard therapy (thrombolytics, acetylsalicylic acid, beta-blockers) is indicated. Lisinotone can be used in conjunction with intravenous administration or with the use of therapeutic transdermal nitroglycerin systems.
Surgery/general anesthesia.
During extensive surgical interventions, as well as when using other drugs that cause a decrease in blood pressure, lisinopril, by blocking the formation of angiotensin II, can cause a pronounced, unpredictable decrease in blood pressure.
In elderly patients
the same dose leads to a higher concentration of the drug in the blood, so special care is required when determining the dose, although no differences in the antihypertensive effect of Lisinoton have been identified between elderly and young people. Since the potential risk of agranulocytosis cannot be excluded, periodic monitoring of the blood picture is required. When using the drug under dialysis conditions with a polyacrylonitrile membrane, anaphylactic shock may occur, so either a different type of dialysis membrane or the prescription of other antihypertensive drugs is recommended.
There is no data on the effect of lisinopril, used in therapeutic doses, on the ability to drive vehicles and machines, however, it must be borne in mind that dizziness may occur, so caution should be exercised.
Instructions for use LISINOPRIL
Special caution is required when prescribing to patients with bilateral renal artery stenosis or stenosis of the artery of a single kidney (possible increase in the concentration of urea and creatinine in the blood), patients with ischemic heart disease or cerebrovascular disease, with decompensated chronic heart failure (possible arterial hypotension, myocardial infarction, stroke). ). In patients with chronic heart failure, the resulting arterial hypotension can lead to deterioration of renal function. A pronounced decrease in blood pressure during treatment most often occurs with a decrease in blood volume caused by diuretic therapy, restriction of salt intake, dialysis, diarrhea or vomiting. Treatment with lisinopril for acute myocardial infarction is carried out against the background of standard therapy (thrombolytics, ASA, beta-blockers). Compatible with intravenous administration of nitroglycerin or TTS of nitroglycerin. When using drugs that lower blood pressure in patients undergoing major surgery or during anesthesia, lisinopril may block the formation of angiotensin II, secondary to compensatory release of renin. Before surgery (including dental surgery), the surgeon/anesthetist should be informed about the use of an ACE inhibitor. Based on the results of epidemiological studies, it is assumed that the simultaneous use of ACE inhibitors and insulin, as well as oral hypoglycemic drugs, can lead to the development of hypoglycemia. The greatest risk of development is observed during the first weeks of combination therapy, as well as in patients with impaired renal function. In patients with diabetes mellitus, careful glycemic control is required, especially during the first month of ACE inhibitor therapy. Before starting treatment, it is necessary to compensate for the loss of fluid and salts. Risk factors for the development of hyperkalemia include chronic renal failure, diabetes mellitus, and concomitant use of potassium-sparing diuretics (spironolactone, triamperene, or amiloride), K+ preparations, or salt substitutes containing K+. Periodic monitoring of K+ concentration in blood plasma is recommended. In patients taking ACE inhibitors during desensitization to Hymenoptera, it is extremely rare that a life-threatening anaphylactoid reaction may occur. It is necessary to temporarily stop treatment with an ACE inhibitor before starting a course of desensitization. Anaphylactoid reactions may occur during simultaneous hemodialysis using high-flow membranes (including AN 69). The use of a different type of dialysis membrane or another antihypertensive drug should be considered. The safety and effectiveness of lisinopril in children has not been established. Use during pregnancy is contraindicated, except in cases where other drugs cannot be used or are ineffective (the patient should be informed of the potential risk to the fetus).
Lisinoton, 20 mg, tablets, 28 pcs.
Symptomatic hypotension.
Most often, a pronounced decrease in blood pressure occurs with a decrease in fluid volume caused by diuretic therapy, reducing the amount of salt in food, dialysis, diarrhea or vomiting. In patients with chronic heart failure with or without simultaneous renal failure, a pronounced decrease in blood pressure is possible. It is more often detected in patients with severe chronic heart failure, as a result of the use of large doses of diuretics, hyponatremia or impaired renal function. In such patients, treatment with Lisinoton should be started under the strict supervision of a physician (with caution in selecting the dose of the drug and diuretics). Similar rules must be followed when prescribing to patients with coronary artery disease and cerebrovascular insufficiency, in whom a sharp decrease in blood pressure can lead to myocardial infarction or stroke. A transient hypotensive reaction is not a contraindication for taking the next dose of the drug. When using Lisinoton, some patients with chronic heart failure, but with normal or low blood pressure, may experience a decrease in blood pressure, which is usually not a reason to stop treatment. Before starting treatment with Lisinoton, if possible, the sodium concentration should be normalized and/or the lost volume of fluid should be replenished, and the effect of the initial dose of Lisinoton on the patient should be carefully monitored. In case of renal artery stenosis (especially with bilateral stenosis, or in the presence of stenosis of the artery of a single kidney), as well as with circulatory failure due to lack of sodium and/or fluid, the use of Lisinoton can also lead to impaired renal function, acute renal failure, which usually turns out to be irreversible after discontinuation of the drug.
In acute myocardial infarction.
The use of standard therapy (thrombolytics, acetylsalicylic acid, beta-blockers) is indicated. Lisinotone can be used in conjunction with intravenous administration or with the use of therapeutic transdermal nitroglycerin systems.
Surgery/general anesthesia.
During extensive surgical interventions, as well as when using other drugs that cause a decrease in blood pressure, lisinopril, by blocking the formation of angiotensin II, can cause a pronounced, unpredictable decrease in blood pressure.
In elderly patients
the same dose leads to a higher concentration of the drug in the blood, so special care is required when determining the dose, although no differences in the antihypertensive effect of Lisinoton have been identified between elderly and young people. Since the potential risk of agranulocytosis cannot be excluded, periodic monitoring of the blood picture is required. When using the drug under dialysis conditions with a polyacrylonitrile membrane, anaphylactic shock may occur, so either a different type of dialysis membrane or the prescription of other antihypertensive drugs is recommended.
There is no data on the effect of lisinopril, used in therapeutic doses, on the ability to drive vehicles and machines, however, it must be borne in mind that dizziness may occur, so caution should be exercised.
Lisinoton h
Most often, a pronounced decrease in blood pressure occurs with a decrease in blood volume caused by diuretic therapy, reducing the amount of salt in food, dialysis, diarrhea or vomiting. In patients with chronic heart failure with or without concurrent renal failure, symptomatic hypotension may develop. It is more often detected in patients with severe forms of heart failure, as a result of the use of large doses of diuretics, hyponatremia or impaired renal function. In such patients, treatment should begin under the strict supervision of a physician. Similar rules should be followed when prescribing to patients with coronary artery disease, cerebrovascular insufficiency, in whom a sharp decrease in blood pressure can lead to myocardial infarction or stroke.
A transient hypotensive reaction is not a contraindication for taking the next dose of the drug.
In patients with chronic heart failure, a marked decrease in blood pressure after initiation of treatment with ACE inhibitors may lead to further deterioration of renal function.
Cases of acute renal failure have been reported.
In patients with bilateral renal artery stenosis or solitary renal artery stenosis treated with ACE inhibitors, increases in serum urea and creatinine were observed, usually reversible after discontinuation of treatment. More common in patients with renal failure.
Angioedema of the face, extremities, lips, tongue, epiglottis and/or larynx (may occur during any period of treatment) was rarely observed in patients treated with ACE inhibitors, including lisinopril. In this case, treatment with lisinopril should be stopped as soon as possible and the patient should be monitored until complete regression of symptoms. In cases where swelling occurs only on the face and lips, the condition most often goes away without treatment, however, antihistamines may be prescribed. Angioedema with laryngeal edema can be fatal. When the tongue, epiglottis or larynx are involved, airway obstruction may occur, so appropriate therapy (0.3-0.5 ml epinephrine/adrenaline/1:1000 subcutaneous solution) and/or measures to ensure airway patency should be immediately administered.
Patients with a history of angioedema not associated with previous treatment with ACE inhibitors may be at increased risk of developing it during treatment with an ACE inhibitor.
Cough has been reported when using an ACE inhibitor. The cough is dry and prolonged, which disappears after stopping treatment with an ACE inhibitor. When making a differential diagnosis of cough, cough caused by the use of an ACE inhibitor must also be taken into account.
Anaphylactic reactions have also been observed in patients undergoing hemodialysis using high-permeability dialysis membranes who are also taking ACE inhibitors. In such cases, a different type of dialysis membrane or another antihypertensive agent should be considered.
When using drugs that lower blood pressure in patients undergoing major surgery or during general anesthesia, lisinopril can block the formation of angiotensin II.
A pronounced decrease in blood pressure, which is considered a consequence of this mechanism, can be eliminated by increasing the volume of blood volume.
Before surgery (including dentistry), the surgeon/anesthesiologist must be warned about the use of ACE inhibitors.
In some cases, hyperkalemia was observed.
Risk factors for the development of hyperkalemia include renal failure, diabetes mellitus, and taking potassium supplements or drugs that increase potassium levels in the blood (eg, heparin), especially in patients with impaired renal function. In patients at risk of symptomatic hypotension (those on a low-salt or salt-free diet) with or without hyponatremia, as well as in patients who have received high doses of diuretics, the above conditions must be compensated for (loss of fluid and salts) before starting treatment.
Thiazide diuretics may affect glucose tolerance, so dosages of antidiabetic medications may need to be adjusted.
Thiazide diuretics can reduce urinary calcium excretion and cause hypercalcemia. Severe hypercalcemia may be a symptom of latent hyperparathyroidism; it is recommended to discontinue treatment with thiazide diuretics until a test to assess parathyroid function is performed.
During treatment with Lisinoton N, regular monitoring of blood plasma potassium, glucose, urea, fats and creatinine is necessary.
During the treatment period, it is not recommended to drink alcoholic beverages, because alcohol enhances the hypotensive effect of the drug.
Caution should be exercised when performing physical exercises in hot weather (risk of dehydration and excessive reduction in blood pressure due to a decrease in blood volume).
Impact on the ability to drive vehicles and operate machinery
During the treatment period, patients should refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions, because Dizziness is possible, especially at the beginning of treatment.
