Hypersensitivity to zofenopril and other ACE inhibitors, a history of angioedema associated with primobolan depot for sale treatment with ACE inhibitors, porphyria, expressed human liver, pregnancy, lactation, at the age of 18 years (effectiveness and safety have not been established), severe renal insufficiency.
The caution should be applied 7.5 with primary peraldosteronizme, bilateral renal artery stenosis, stenosis of the artery to a solitary kidney, hyperkalemia, condition after kidney transplantation;aortic stenosis, mitral stenosis (with impaired hemodynamics), idiopathic hypertrophic subaortic stenosis, connective tissue diseases, cerebrovascular diseases, diabetes, renal disease (proteinuria greater than 1 g / day), liver failure, patients on a diet with restriction of salt or under on hemodialysis, at simultaneous reception with immunosuppressants and saluretikami in the elderly (over 75 years), psoriasis.
caution should be exercised when administered to patients with reduced volume of circulating blood (as a result of diuretic therapy, while limiting salt intake, dialysis, diarrhea and vomiting) – are at primobolan depot for sale increased risk of sudden and pronounced reduction in blood pressure after the application of even the initial dose of the ACE inhibitor.
Pregnancy and breast-feeding
The drug 7.5 can not be used during pregnancy and should not be used in women of childbearing age in the absence of effective contraception. Because zofenopril calcium is released in breast milk, the drug should not be used nursing Meter.
Dosage and administration:
Zokardis ® 7.5 administered orally, regardless of meal times (before, during or after a meal), drinking plenty of fluids.
Hypertension Patients with normal renal and hepatic function to achieve optimal blood pressure treatment should start with the two tablets of the drug Zokardis ® 7.5, I received once a day, and gradually, with the lack of severity of the hypotensive effect, increase the dose at intervals of 4 weeks. Generally effective dose of 4 tablets of the preparation Zokardis ® 7.5 1 taken once per day. The maximum primobolan depot for sale daily dose of eight tablets Zokardis preparation ® 7.5 per day taken once or divided into two doses every 4 tablets. Patients with impaired water – salt balance Initial therapy with ACE inhibitors requires correction of salt and / or water scarcity, stopping ongoing diuretic therapy for 2-3 days prior to initiation of an ACE inhibitor and begins with a dose of 2 tablets of the drug Zokardis ® 7.5 1 times a day. If this is not possible, you should start with a dose of 1 tablet of the drug Zokardis ® 7.5 a day. Patients with impaired renal function or are on hemodialysis in patients with mild renal impairment (creatinine clearance (CC)> 45 ml / min) no dose reduction is required. Patients with moderate to severe renal impairment (creatinine clearance <45 ml / min) should be given a therapeutic dose of 1 1/2 times a day. The starting dose for patients on dialysis, is 1/4 the dose used for patients with normal renal function. dosage in elderly patients in elderly patients with normal QC does not require dose adjustments. In elderly patients with creatinine clearance <45 ml / min is recommended to take half the daily dose. Dosage in hepatic dysfunction in patients with mild to moderate impaired liver function the initial dose of the drug Zokardis ®7.5 is half the dose used in patients with normal liver function. in patients with severe hepatic dysfunction Zokardis ® 7.5 should not be used. Acute myocardial infarction (in combination therapy).
Symptoms: marked reduction of blood pressure until the development of collapse, myocardial infarction, acute stroke or thromboembolic complications, convulsions, stupor. Treatment: the patient is transferred to a horizontal position with a low headboard. In mild cases shows gastric lavage and ingestion of saline, in more severe cases – measures aimed at stabilizing the blood pressure: intravenous infusion of 0.9% sodium chloride solution, plasma substitutes, if necessary, in a nutshell angiotensin II. hemodialysis (elimination rate enalaprilata- 62 ml / min).
Interaction with other drugs
The antihypertensive effect of ACE inhibitors may be enhanced by other antihypertensives, diuretics. . general anesthetics, analgesics and antipyretics, ethanol
When concomitant administration of zofenopril with nonsteroidal anti-inflammatory drugs may reduce the hypotensive effect of zofenopril; potassium-sparing diuretics – hyperkalemia; with lithium salts -. slowdown lithium excretion
immunodepressants, allopurinol, cytostatics reinforce haematotoxicity.
Hypoglycemic agents – increase the risk of hypoglycemia.
Transient pronounced reduction in blood pressure is not a contraindication for continuation of treatment after stabilization of blood pressure. In the case of re-pronounced reduction in blood pressure, reduce the dose or stop the drug.
With the development of excessive blood pressure lowering the patient is transferred to a horizontal position with a low headboard, if necessary, introduce 0.9% chloride and plasma substituting drugs sodium solution.
The use of vysokoprotochnyh dialysis membranes increases the risk of an anaphylactic reaction. Correction of the dosing regimen on the days free from dialysis should be performed depending on the level of blood pressure. Before and after treatment with ACE inhibitors is necessary to monitor blood pressure, blood parameters (hemoglobin, potassium, urea, creatinine, activity of “liver” enzymes), protein in the urine.
It should be carefully observed for patients with severe heart failure, coronary heart disease and diseases of the brain vessels, in where a sharp decrease in blood pressure can lead to heart attack, stroke, or renal dysfunction. The sudden cancellation of treatment does not lead to the syndrome of “lifting” (a sharp rise in blood pressure).
In patients with an indication for the development of angioedema in history, there is an increased risk of developing cancer while taking ACE inhibitors.
For newborns and babies who were in utero effects of ACE inhibitors. should be closely monitored for timely detection of significant decrease in blood pressure, oliguria, hyperkalemia, and neurological disorders, possible due to the decrease in renal and cerebral blood flow while reducing blood pressure, called ACE inhibitors, If oliguria need to maintain blood pressure and renal primobolan depot for sale perfusion through the introduction of appropriate fluids and vasoconstrictor.
In patients with reduced kidney function should be to reduce the single dose or increase the interval between doses of the drug.
during the selection of a therapeutic dose should refrain from driving motor vehicles and activities potentially hazardous activities that require high concentration and speed of psychomotor reactions, becausedizziness, especially after the initial dose of ACE inhibitor in patients taking diuretics.
Use caution when exercising in hot weather (risk of development of dehydration and excessive reduction of blood pressure due to a decrease in blood volume). Before surgery (including dental) must notify the surgeon / anesthetist on the use of ACE inhibitors.
During treatment is not recommended to drink alcoholic beverages, as Alcohol enhances the hypotensive effect of the drug.
The simultaneous use of hypoglycemic agents, increases the risk of hypoglycemia.
Tablets coated on 7.5mg.
At 7 or 14 tablets in a blister made of PVC / aluminum foil.
According to the blister 1 or 2 together with instructions for use placed in a cardboard box.
The temperature is not above 25 ° C, store vnedostupnom children! eminence labs