Swelling in the course of heart failure, kidneys and liver. Hypertension (both in monotherapy and in combination with pindolol).
Composition:
1 tabl contains 20 mg of clopamide.
Action:
A heterocyclic, thiazine-like diuretic. It inhibits the reabsorption of chlorine and sodium in the kidney tubules, which results in increased excretion of water through the kidneys. The diuretic effect appears about 2 hours after oral administration, it reaches its maximum after a further 1-4 hours, and it lasts to about 24 hours from the moment of admission. In hypertension, full effect occurs 2-4 weeks from the beginning of the application. Klopamide is quickly and almost completely absorbed from the gastrointestinal tract. Pharmacokinetics in the range of therapeutic doses used are linear. With proteins, it is about 46%. It is metabolised in the liver and excreted mainly by the kidneys. T0,5 is about 6 hours.
Contraindications:
Hypersensitivity to clopamide, other ingredients of the preparation or to sulphonamides. Severe renal impairment (creatinine clearance <30 ml / min), acute glomerulonephritis and anuria. Severe hepatic failure and hepatic coma. Resistance-resistant hypokalemia, hypercalcemia, severe hyponatraemia, hypovolemia, hyperuricemia and gout. Pregnancy, breast-feeding.
Precautions:
It is not recommended to use the drug in children (no tests), and in patients with gout. In patients with mild to moderate renal and hepatic insufficiency, clopamide may cause water and electrolyte disturbances, especially hypokalaemia, and should be periodically determined in such patients as potassium levels in the blood. Exercise caution in elderly patients, due to the greater tendency to electrolyte abnormalities and dehydration. Exercise caution in patients with diabetes due to possible increase in blood glucose; if necessary, change the dosage of antidiabetic medicines.
Pregnancy and lactation:
The preparation is contraindicated in pregnancy and during breastfeeding. Klopamide penetrates the placental barrier and may cause water and electrolyte disturbances in pregnant women who may adversely affect the fetus. Use of the drug in the second half of pregnancy may cause thrombocytopenia in the newborn.
Side effects:
You may experience: a feeling of irregular heartbeat; changes in blood morphology (including neutropenia and thrombocytopenia); mild gastrointestinal discomfort, pancreatitis; hypersensitivity to sunlight, rashes; hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, hypochlora alkalosis, hyperuricemia, gout, hyperglycemia, hypercholesterolemia; orthostatic hypotension; weakness; hypersensitivity reactions (including inflammation and pulmonary edema); intrahepatic cholestasis; impotence (resolving after discontinuation of the drug).
Dosage:
Orally. Adults.edema: the starting dose is 20-40 mg per day, in a single dose (in the morning hours). In resistant cases, the dose may be increased to 60 mg in a single daily dose. As the edema regresses, the dose should be gradually reduced. In maintenance therapy, a dose of 10-40 mg daily is administered daily or every other day.Hypertension: the starting dose is 20 mg per day, in a single dose (in the morning hours). If after 1-3 weeks of treatment the desired effect is not achieved, the dose should be increased to 40 mg daily in a single dose (in the morning hours). Do not use doses higher than 60 mg daily. There is no need to change the dosage in the elderly.
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