Universal reference book for medicines
Product name: DAPRIL (DAPRIL)

Active substance: lisinopril

Type: ACE inhibitor

Manufacturer: MEDOCHEMIE (Cyprus) distribution in RF PRO.MED.CS Praha (Czech Republic)
Composition, form of production and packaging
Tablets
1 tab.

lisinopril 5 mg

- "- 10 mg

Excipients: mannitol, calcium hydrophosphate, E172, starch, gelatinized starch, magnesium stearate.

10 pieces.
- packings cellular planimetric (3) - packs cardboard.
Tablets 1 tab.

lisinopril 20 mg

Excipients: mannitol, calcium hydrophosphate, E172, starch, gelatinized starch, magnesium stearate.

10 pieces.
- packings cellular planimetric (2) - packs cardboard.
INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2005.

PHARMACHOLOGIC EFFECT

ACE inhibitor.
Antihypertensive drug. The mechanism of action is associated with ACE blockade, which leads to suppression of angiotensin I transition into angiotensin II. Reducing the concentration of angiotensin II leads to an increase in plasma renin activity and a decrease in aldosterone secretion.
Reduces OPSS, blood pressure, pre- and postnagruzku.
Helps reduce blood pressure in the small circulation and in the right atrium. Reduces the synthesis of aldosterone in the adrenal glands.
The onset of action occurs after 2 hours after taking the drug, the maximum effect occurs after 4-6 hours and lasts at least 24 hours.

INDICATIONS

- arterial hypertension, incl.
Renovascular (in the form of monotherapy or in combination with other antihypertensive agents);
- Chronic heart failure (as part of a combination therapy with digitalis and / or diuretics).

DOSING MODE

With arterial hypertension, the dose is selected individually, depending on the level of blood pressure.

The initial dose of the drug is 10 mg 1 time / day;
Supporting - 20 mg 1 time / day. After a week of therapy, if necessary, it is possible to increase the dose to 40 mg / day.
The maximum daily dose is 80 mg.

In chronic heart failure, the initial dose of Dapril is 2.5 mg / day.
The maintenance dose varies from 5 to 20 mg / day.
Patients with impaired renal function dose established depending on the clearance of creatinine.
With QC more than 30 ml / min, the recommended daily dose is 10 mg; with SC from 10 to 30 ml / min - 5 mg / day; with SC less than 10 ml / min - 2.5 mg / day.
SIDE EFFECT

From the side of the central nervous system: dizziness, headache, fatigue;
in some cases - lability of mood, confusion.
On the part of the digestive system: nausea;
rarely - abdominal pain, diarrhea, dry mouth; in some cases - an increase in the activity of hepatic transaminases, an increase in the concentration of bilirubin in the blood serum.
On the part of the hematopoiesis system: neutropenia, agranulocytosis, a decrease in the level of hemoglobin and the number of erythrocytes.

From the cardiovascular system: rarely - orthostatic hypotension, tachycardia.

From the respiratory system: dry cough.

Allergic reactions: rarely - skin rash;
in some cases - angioedema.
Other: in some cases, kidney dysfunction, hyperkalemia.

CONTRAINDICATIONS

- severe renal dysfunction;

- azotemia;

- Hyperkalemia;

- bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney with progressive azotemia;

- condition after kidney transplantation;

- stenosis of the aortic aorta (or similar hemodynamic disorders);

- primary hyperaldosteronism;

- childhood;

- II and III trimester of pregnancy;

- lactation (breastfeeding);

- angioedema in history;

- hypersensitivity to lisinopril and other ACE inhibitors.

PREGNANCY AND LACTATION

The use of Dapril in the second and third trimesters of pregnancy is contraindicated.
Lizinopril penetrates the placental barrier.
There is no data on the penetration of lisinopril into breast milk.
If it is necessary to prescribe Dapril during lactation it is necessary to stop breastfeeding.
APPLICATION FOR FUNCTIONS OF THE LIVER

Patients with impaired renal function dose established depending on the clearance of creatinine.
With QC more than 30 ml / min, the recommended daily dose is 10 mg; with SC from 10 to 30 ml / min - 5 mg / day; with SC less than 10 ml / min - 2.5 mg / day.
APPLICATION FOR CHILDREN

The drug is contraindicated in childhood.

SPECIAL INSTRUCTIONS

It should be borne in mind that a pronounced decrease in blood pressure occurs with a decrease in the volume of fluid caused by diuretic therapy, with a decrease in salt in food, during dialysis and in patients with diarrhea or vomiting.
In such patients, treatment should be started under the strict supervision of the doctor (with care to select the dose of the drug and diuretics).
It should be noted that in patients taking ACE inhibitors and being on hemodialysis using dialysis membranes with high permeability, an anaphylactic reaction can develop.
In such cases, one should consider the possibility of using another type of membrane for dialysis or another antihypertensive drug.
With the use of ACE inhibitors, a cough (dry, prolonged, which disappears after the cessation of treatment with an ACE inhibitor) is noted.
With a differential diagnosis of cough, one should also consider a cough caused by the use of an ACE inhibitor.
OVERDOSE

Symptoms: arterial hypotension, electrolyte balance disorders, impaired renal function.

Treatment: in / in the introduction of saline, hemodialysis.

DRUG INTERACTION

With the simultaneous use of Dapril with potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium preparations, salt substitutes containing potassium, the risk of hyperkalemia increases, especially in patients with impaired renal function.

With the simultaneous use of Dapril with diuretics, antidepressants, there is a marked decrease in blood pressure.

With the simultaneous use of Dapril with NSAIDs, the antihypertensive effect of lisinopril decreases.

With the simultaneous use of Dapril with lithium preparations, lithium removal from the body slows down.

Ethanol enhances the hypotensive effect of lisinopril.

TERMS AND CONDITIONS OF STORAGE

The drug should be stored in a dry, protected from light and out of reach of children at a temperature of no higher than 25 ° C.
Shelf life - 4 years.
Conditions of leave from pharmacies

The drug is released by prescription.

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