Universal reference book for medicines
Name of the preparation: KAMIREN ® (KAMIREN)

Active substance: doxazosin

Type: Alpha 1- adrenoblocker.
Antihypertensive drug. The drug used for urinary disorders in benign prostatic hyperplasia
Manufacturer: KRKA (Slovenia)
Composition, form of production and packaging
Tablets of
white color, round, slightly biconcave, with oblique margins.

1 tab.

Doxazosin mesylate 1.21 mg

which corresponds to the content of doxazosin 1 mg

Excipients: microcrystalline cellulose, sodium starch glycolate, magnesium stearate, sodium lauryl sulfate, lactose monohydrate.

10 pieces.
- packings cellular planimetric (2) - packs cardboard.
10 pieces.
- packings cellular planimetric (3) - packs cardboard.
Tablets are white, round, flat, with beveled edges and notched (risk) on one side.

1 tab.

doxazosin mesylate 2.43 mg,

which corresponds to the content of doxazosin 2 mg

Excipients: microcrystalline cellulose, sodium starch glycolate, magnesium stearate, sodium lauryl sulfate, lactose monohydrate.

10 pieces.
- packings cellular planimetric (2) - packs cardboard.
10 pieces.
- packings cellular planimetric (3) - packs cardboard.
Tablets are white, round, flat, with beveled edges and notched (risk) on one side.

1 tab.

doxazosin mesylate 4.86 mg,

which corresponds to the content of doxazosin 4 mg

Excipients: microcrystalline cellulose, sodium starch glycolate, magnesium stearate, sodium lauryl sulfate, lactose monohydrate.

10 pieces.
- packings cellular planimetric (2) - packs cardboard.
10 pieces.
- packings cellular planimetric (3) - packs cardboard.
INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the print edition of 2007.

PHARMACHOLOGIC EFFECT

A selective antagonist?
1- adrenoreceptors. Causes the expansion of peripheral vessels, which leads to a decrease in OPSS and a decrease in blood pressure. The effect of the drug on heart function is insignificant and transient. Doxazosin reduces the level of total cholesterol, Xc-LDL and triglycerides, increases the level of HDL-C in the blood serum. Thus, the drug helps prevent the development of atherosclerosis and IHD. Doxazosin has a neutral or normalizing effect on the content of insulin and glucose in the blood, so the drug can be used in patients with diabetes mellitus. Inhibits the aggregation of platelets. With prolonged treatment, doxazosin reduces the mass of the left ventricle.
Doxazosin prevents the contraction of the smooth muscles of the upper part of the urethra and the muscles of the prostate gland that surround the urethra.
Relaxation of these muscles leads to relief of urination, which significantly reduces the unpleasant symptoms observed with benign prostatic hyperplasia. The therapeutic effect manifests itself during the first 2 weeks of treatment and is strengthened with subsequent therapy. The effect of doxazosin on normal blood pressure is negligible.
Camiren can be used in patients with renal failure, chronic obstructive pulmonary disease, peripheral angiopathy and gout.

With a single admission of Camyrin, the duration of action is 24 hours. The effect on blood pressure is most pronounced within 2-6 hours after taking the drug.
The maximum effect is achieved after several weeks of regular intake. If the therapeutic effect is not enough, patients can be prescribed other antihypertensive agents: beta-blockers, diuretics, calcium channel blockers and ACE inhibitors.
PHARMACOKINETICS

Suction

After oral administration, doxazosin is well absorbed from the digestive tract.
C max is achieved after 1.5-3 h.
Distribution

Doxazosin almost completely binds to plasma proteins.

Metabolism

Metabolised in the liver.

Excretion

T 1/2 is 16-22 hours.

It is excreted with feces in the form of metabolites.
Less than 10% of the dose is excreted in the urine.
INDICATIONS

- treatment of mild and moderate arterial hypertension (in the form of monotherapy or in combination with other antihypertensive drugs);

- symptomatic treatment of benign prostatic hyperplasia.

DOSING MODE

Established individually and adjusted depending on the effectiveness of treatment and / or the development of side effects.

With arterial hypertension, the initial dose of doxazosin is 1 mg / day.
The first dose should be taken in the evening before bedtime. Depending on the effect of the drug on blood pressure, the dose can be gradually increased at intervals of 1-2 weeks to 2 mg, 4 mg, 8 mg 1 time / day. Typically, the average daily dosage is from 2 mg to 8 mg. The maximum daily dose is 16 mg.
In benign prostatic hyperplasia in patients with normal BP, the initial dose is 1 mg / day.
The first dose should be taken in the evening before bedtime. Depending on the response to treatment, the dose can be gradually increased at intervals of 1-2 weeks to 2 mg, 4 mg, 8 mg 1 time / day. The average daily dose is from 2 mg to 4 mg.The maximum daily dose is 8 mg.
With benign prostatic hyperplasia in patients with hypertension, the drug is prescribed in the same doses as patients with only hypertension.

In patients with hepatic insufficiency, the drug is used in smaller doses (due to delayed metabolism of doxazosin).

The drug can be taken before, during or after a meal.

If the medication is missed at the usual time, then this dose should be taken as soon as possible.
If the time is right for taking the next dose, you should only take it without doubling the dose of the drug. It is important to take the drug regularly. If the patient did not take the drug for several days, the new therapeutic course should begin with the lowest dose.
SIDE EFFECT

From the side of the cardiovascular system: at the beginning of treatment and with an increase in the dose of the drug, a tendency to fainting is possible (especially when going from a prone position or sitting to a standing position), dizziness, headache.
These effects disappear on their own, but if they are severe or persist for a long time, the dose should be reduced or discontinued; in some cases, possible tachycardia, a feeling of heartbeat.
Rarely (the connection with doxazosin is not clearly established) - aggravation of angina pectoris, myocardial infarction, cerebrovascular stroke, heart rhythm disturbances.

From the side of the central nervous system and peripheral nervous system: a feeling of fatigue, drowsiness, muscle weakness.

From the side of the digestive system: nausea is possible;
rarely - violations of liver function indicators, cholestasis, hepatitis.
From the respiratory system: possible bronchitis, dyspnea, a feeling of nasal congestion, discharge from the nose.

From the coagulation system: rarely - thrombocytopenia, purpura, nosebleeds.

From the urinary system: rarely - hematuria;
in some cases - incontinence.
Other: possible swelling of the ankles and legs, flu-like symptoms;
rarely - skin rash; in single cases (communication with doxazosin is not clearly established) - impotence.
CONTRAINDICATIONS

- obstruction of the gastrointestinal tract or esophagus;

- narrowing of the gastrointestinal tract of any degree;

- childhood;

- hypersensitivity to doxazosin and other components of the drug;

- hypersensitivity to other quinazoline derivatives (prazosin, terazosin).

PREGNANCY AND LACTATION

The use of Camiren in pregnancy is possible only for life indications, when the expected benefit of therapy for the mother exceeds the potential risk to the fetus.

If it is necessary to use the drug during lactation, breastfeeding should be interrupted, because
safety Camiren in infants is not established.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS

In patients with hepatic insufficiency, the drug is used in smaller doses (due to delayed metabolism of doxazosin.

APPLICATION FOR CHILDREN

The drug is contraindicated in childhood.

SPECIAL INSTRUCTIONS

Doxazosin does not affect the concentration of PSA (specific antigen of the prostate).

When taking Camyrin, especially the first dose, orthostatic hypotension (syncope) is possible.
To avoid such phenomena, treatment should be started at a dose of 1 mg in the evening before bedtime. The dose should be increased gradually at intervals of 1-2 weeks. The patient should be warned about the possibility of developing orthostatic hypotension and recommend cautiously climbing from a lying or sitting position. This is especially true for elderly patients and patients receiving other antihypertensive drugs or diuretics. Use with caution in combination with other antihypertensive agents, especially at the beginning of treatment, because possibly increased antihypertensive effect.
Doxazosin is not recommended for patients with arterial hypotension.
Before starting therapy, patients with symptoms due to benign prostatic hyperplasia should undergo a urological examination.
In patients with hepatic insufficiency, doxazosin is metabolized more slowly, so increasing the dose should be done with caution.

Use in Pediatrics

Safety and effectiveness of use in pediatrics is not established, so the drug is not recommended for children.

Impact on the ability to drive vehicles and manage mechanisms

At the beginning of treatment with Camiren and when changing the dose, excessive blood pressure reduction may occur, which may be accompanied by dizziness.Therefore, in such cases it is not recommended to drive and engage in potentially hazardous activities.

OVERDOSE

Symptoms: excessive arterial hypotension, dizziness, fainting possible.

Treatment: in most cases, it is sufficient to reduce the dose or interrupt the therapy.
The patient should be given a supine position on the back with a low head and slightly raised legs. Do not induce vomiting. To remove the nonabsorbed preparation from the digestive tract, it is necessary to wash the stomach, prescribe activated charcoal, laxative. Prescribe agonists? -adrenoceptors (for example, norepinephrine). Hemodialysis is ineffective (as doxazosin almost completely binds to plasma proteins).
DRUG INTERACTION

With the simultaneous use of Camirin with other antihypertensive agents (blockers of? -adrenoceptors, diuretics, calcium channel blockers, ACE inhibitors), there is an increase in antihypertensive effect (this combination is possible, but caution, especially at the beginning of treatment).

With simultaneous application of Camirin with nitrates, anesthetics, tricyclic antidepressants, as well as with ethanol, hypotensive effect may increase (this combination is possible, but caution, especially at the beginning of treatment).

With the simultaneous use of Camirin with drugs that affect the metabolic rate in the liver, it is possible to slow or accelerate the metabolism of doxazosin (should be used with caution).

TERMS OF RELEASE FROM PHARMACY

The drug is released by prescription.

TERMS AND CONDITIONS OF STORAGE

The drug should be stored at a temperature of no higher than 30 ° C.
Shelf life - 3 years.
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