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It stimulates the formation of nitric oxide (endothelium-derived relaxing factor) in the vascular endothelium, causing intracellular activation of guanylate cyclase, resulting in an increase in the cGMP (vasodilation mediator). It reduces myocardial oxygen demand by reducing preload and afterload. It has koronarorasshiryayuschee action. Reduces blood flow to the right atrium, it helps reduce the pressure in the pulmonary circulation and the regression of symptoms of pulmonary edema. Promotes redistribution of coronary blood testosterone propionate 100mg flow in the area of reduced circulation. It increases exercise tolerance in patients with ischemic heart disease (IHD), angina pectoris. It extends the vessels of the brain, the dura mater, which may be accompanied by headache. It inhibits platelet aggregation, reduces the synthesis of thromboxane Thrombocyte. As to other nitrates cross-tolerance develops.After the abolition of (treatment interruption) sensitivity to it recovers quickly. Antianginal effect occurs within 30-45 minutes after ingestion and lasts up to 8-10 hours.

Pharmacokinetics
After oral administration of isosorbide mononitrate is rapidly and completely absorbed from the gastrointestinal tract (GIT). It has high bioavailability – about 100%, since there is no effect of “first pass” through the liver. The maximum concentration in plasma after oral administration is achieved within hour. Individual differences in plasma concentration after oral administration is small. The effective level of isosorbide mononitrate in the blood of about 100 mg / mL. The drug does not bind to plasma proteins.Pharmacokinetics after doses of 10-80 mg is linear, and, unlike the isosorbide dinitrate is not metabolized in the liver and kidney, where isosorbide and formed two-glucuronide isosorbide 5 -mononitrata. The half-life is about 4-5 hours. It reports the news, mainly in the form of glucuronic metabolite, 2% – unchanged. The renal clearance of the drug 115 ml / min. When hepatocellular and renal failure pharmacokinetics of isosorbide mononitrate are not significantly altered.

Indications

 

  • Ischemic heart disease: prevention of angina attacks;
  • Chronic heart failure (in combination therapy);Contraindications
  • Hypersensitivity to organic nitrates or other ingredients;
  • Acute circulatory disorders (shock, circulatory collapse);
  • Cardiogenic shock, if you do not provide a sufficiently high end-diastolic pressure in the left ventricle through the use of intra-aortic counterpulsation or by introducing tools that have a positive inotropic effect;
  • Toxic pulmonary edema;
  • Severe hypotension (systolic blood pressure less than 100 mmHg, diastolic blood pressure less than 60 mmHg)
  • Simultaneous administration of phosphodiesterase-5 inhibitors including sildenafil, vardenafil, tadalafil, since they potentiate the effect of nitrates antihypertensive;
  • Hereditary galactose intolerance, testosterone propionate 100mg lactase deficiency or malabsorption syndrome of glucose and galactose;
  • Age 18 years (effectiveness and safety have been established).Carefully
  • Hypertrophic cardiomyopathy, constrictive pericarditis, pericardial tamponade;
  • Low filling pressure in acute myocardial infarction, left ventricular failure. There should be no reduction in systolic blood pressure less than 90 mm Hg. v.).
  • The aortic and / or mitral stenosis;
  • The tendency to orthostatic vascular disorders of regulation;
  • Angle-closure glaucoma;
  • thyrotoxicosis;
  • Severe anemia;
  • Diseases accompanied by increased intracranial pressure (including hemorrhagic stroke, traumatic brain injury);
  • Severe renal failure;
  • Liver failure;Pregnancy and lactation
    For security reasons Monosan can be used during pregnancy and lactation only strictly prescribed by a doctor, after a thorough evaluation of the benefits and possible risks, because to date, little is known about the consequences of its use in pregnant women and nursing mothers. If a nursing mother still takes, set parental supervision for the development of the possible effects of the drug.

    Dosing and Administration
    The tablets should be taken orally, after meals, swallowed whole with a little liquid.
    The dose and dosing frequency is determined individually depending on the severity of the disease. Begin with 10-20 mg 1-3 times a day (10 mg dose corresponds to 2.1 mg of 20 tablets). Depending on the severity of the clinical effect from 3-4 day dose can be increased up to 20-40 mg two times a day, if necessary, increasing the dose to 60 mg / day (20 mg tablet) and 80 mg / day. (40 mg tablet). The maximum daily dose of 80 mg.

    Side effect On the part of the cardiovascular system: “nitrate” headache, dizziness, transient facial flushing, heat sensation, tachycardia, marked reduction of blood pressure (BP). In rare cases – increase in angina attacks (paradoxical reaction), orthostatic collapse. From the digestive system: nausea, vomiting, may occur feeling light burning tongue, dry mouth. On the part of the central nervous system:stiffness, drowsiness, blurred vision, decreased ability to to rapid mental and motor reactions (especially at the beginning of treatment). Allergic reactions: skin rash, in some cases – exfoliative dermatitis.other: the development of tolerance (including cross to the other nitrates).

    Overdose Symptoms: Collapse, syncope, reflex tachycardia, weakness, dizziness, confusion, headache, visual disturbances, pyrexia, redness of the skin, increased sweating, nausea, vomiting, diarrhea, methemoglobinemia (cyanosis, anoxia -Usually in chronic overdose), hyperpnoea , dyspnea, increased intracranial pressure, convulsions, paralysis, coma. Treatment: in testosterone propionate 100mg addition to general recommendations, such as gastric lavage and laying the patient in a horizontal position with raised legs, should monitor the main indicators of vital signs and adjust if necessary. Patients with severe hypotension and / or shock should make up the blood volume; in exceptional cases, to improve blood circulation can be performed infusion of norepinephrine and / or dopamine. Introduction of epinephrine (adrenaline) and related compounds is contraindicated. When methemoglobinemia depending on the severity administered intravenously in the form of ascorbic acid sodium salt (previously methylthioninium chloride (methylene blue) 0.1-0.15 ml / kg of a 1% solution to 50 ml); Oxygen therapy, hemodialysis, exchange transfusion.

     

    Interaction with other drugs
    increases the concentration of dihydroergotamine in the blood plasma.
    Reduces the effect of vasopressors.
    Barbiturates accelerate biotransformation and reduce the concentration of isosorbide mononitrate in the blood.
    When combined with other vasodilators, ACE inhibitors, beta-blockers, blockers “slow” calcium channel blockers, diuretics, , antipsychotics or tricyclic antidepressants, inhibitors of phosphodiesterase-5 including sildenafil, vardenafil, tadalafil, and ethanol may potentiation of the antihypertensive action of isosorbide mononitrate.
    in combination with amiodarone, propranolol blockers “slow” calcium channel blockers (verapamil, nifedipine and et al.) may increase the anti-anginal effect. Under the influence of beta-agonists, alpha-blockers (dihydroergotamine, etc.) May reduce the severity of antianginal effects (tachycardia, excessive reduction of blood pressure).
    The combined use with m-holinoblokatorami (atropine, and others.) Increases the likelihood of increased intraocular pressure.
    Adsorbents, binders and enveloping means reduce the absorption of isosorbide mononitrate in the gastrointestinal tract.
    The therapeutic effect of norepinephrine (noradrenaline) decreases while admission to nitro compounds.

    Special instructions:
    The drug is not used for the relief of angina attacks.
    During treatment requires monitoring of blood pressure and heart rate. If necessary, use the drug on a background of arterial hypotension, it should at the same time to take testosterone propionate 100mg drugs with positive inotropic effect.Frequent purpose and high doses can cause the development of tolerance; In this case, after 3-6 weeks of regular intake, recommended removal of the drug for 24-48 hours, or a break in the treatment  3-5 days with his replacement at this time other antianginal drugs.
    It is necessary to avoid abrupt withdrawal of the drug and reduce dose gradually.
    in the period of drug treatment should be deleted alcohol.
    It is possible decrease in the ability to rapid mental and motor reactions, so care should be taken to drive and engage in potentially hazardous activities during the period of drug therapy.

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Testosterone propionate dosageis a powerful vasoconstrictor, it also stimulates the secretion of aldosterone from the adrenal cortex, thereby contributing to sodium retention and fluid in the body. The antihypertensive effect of Monopril is mainly the result of the specific competitive ACE suppression. This leads to a decrease in angiotensin-II levels in the bloodstream, causing a reduction in vasoconstriction and aldosterone secretion reduction, as a consequence, reduction of sodium and water retention in the body.
Monopril also inhibits biodegradation bradykinin peptide having potent vasodilating properties. It is possible that this effect contributes to the therapeutic effect.Further, inhibition of tissue ACE may also contribute to the antihypertensive effect of Monopril and be an important element in its protective effect. During normal daily dose Monopril antihypertensive effect lasts for 24 hours.
The drug is equally effective for all ages, including young adults and elderly patients. Antihypertensive efficacy of Monoprix is maintained during the course of treatment, tolerance to the drug does not develop. The sudden cancellation of Monoprix does not cause high blood pressure according to the type recoil effect.Unlike other ACE inhibitors, which are excreted primarily through the kidneys, Monoprix has a dual mechanism of allocation: the liver and the kidneys. This provides a compensatory allocation by way of an alternative in patients with renal insufficiency or liver function. In renal insufficiency, reduction of isolation through the kidney is offset by the release of the liver and bile, so that the total clearance from the body fozinoprilata will not vary greatly in violation of kidney function over a wide range (creatinine clearance values <10 to 80 ml / min, ie including renal insufficiency in terminal stage.

 Indications for use:

Monopril indicated for the treatment of hypertension.
Monopril may be used alone or in combination with other antihypertensive agents; testosterone propionate dosage is particularly useful combination with a diuretic.

 Dosage and administration:

Daily dosages to maintain blood pressure comprise 10-40 mg of the required level.
The recommended daily intake is 10 mg Monopril. The dose should be adjusted according to the dynamics of the patient’s blood pressure, it can be increased to 20 mg once a day or twice a day, if necessary. If you can not sufficiently reduce blood pressure MONOPRILOM, the treatment regimen can include a diuretic.
The aged patients do not require a special dose adjustment. Neither the pharmacokinetic parameters, blood pressure or reaction to treatment is not different from those of younger patients.

Contraindications

The use Monopril is contraindicated in patients with hypersensitivity to the drug, as well as patients who have angioedema observed when using any other ACE inhibitor.
Side effect

Usually, the side effects of Monopril appear mild and transient in nature, and it is typical for young patients and for patients with more advanced age.
The most common testosterone propionate dosage side effects of Monopril include dizziness, cough, upper respiratory tract symptoms, disorders of the gastrointestinal tract, heart / chest pain, rash / pruritus, musculoskeletal pain / sensory disturbances, fatigue and changes in taste sensations. In rare cases, possible hypotension and angioedema. buy anabolic steroids online bruce lee’s workout anabolic steroids online uk

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It has vasodilating and antianginal effects. Reduces preload (through the expansion of peripheral veins) and afterload (due to a decrease in total peripheral vascular resistance) reduces the myocardial oxygen demand, increases coronary artery and improves coronary blood flow, contributes to its redistribution in the ischemic area, reduces end-diastolic volume of the left ventricle and reduced systolic tension of its walls. Increases exercise tolerance in patients with coronary heart disease, lowers blood pressure in the testosterone cypionate vs propionate pulmonary circulation.
Isosorbide mononitrate is relaxation of the muscles of the bronchi, the urinary tract, muscle of the gallbladder, biliary tract and esophagus, as well as small and large intestines, including the sphincters.
The drug is rapidly and completely absorbed in the intestine after ingestion. Bioavailability is 90 to 100%. There is a direct relationship between blood concentration of the drug dose received. Isosorbide mononitrate is derived almost exclusively via the kidneys as metabolites. Approximately 2% is excreted unchanged. The half-life is 4-5 hours.

Indications

 

  • Prevention of angina attacks.
  • Treatment of chronic heart failure in combination with cardiac glycosides, diuretics, ACE inhibitors, arterial vasodilators.-Increase The pressure in the pulmonary circulation (pulmonary hypertension).Contraindications
  • hypersensitivity to organic nitrates
  • acute circulatory disorders (shock, circulatory collapse)
  • cardiogenic shock, if you do not provide a sufficiently high end-diastolic pressure in the left ventricle through the use of intra-aortic counterpulsation or by the administration of drugs that have a positive inotropic effect
  • concomitant use of phosphodiesterase inhibitor sildenafil (of Viagra ® , Viagra), because sildenafil potentiates the antihypertensive effect of nitrates
  • severe hypotension (systolic blood pressure less than 90 mm Hg, diastolic blood pressure less than 60 mmHg)
  • hemorrhagic stroke, angle-closure glaucoma, traumatic brain injury, hyperthyroidism, idiopathic hypertrophic subaoralny stenosis, deficiency of glucose-6-phosphate dehydrogenase, liver and kidney failure, age 18 years
    Monolong should be taken with caution in the following cases:
  • constrictive pericarditis, pericardial tamponade
  • low filling pressure in acute myocardial infarction, impaired function of the left chamber of the heart (left ventricular failure). There should be no reduction in systolic blood pressure below 90 mm Hg
  • aortic and / or mitral stenosis, a tendency to orthostatic vascular disorders of regulation expressed cerebral atherosclerosis, diseases accompanied by intracranial hypertension
    Monolong should not be used for the relief of acute attacks of angina and acute myocardial infarction.Pregnancy and lactation
    For security reasons Monolong can be used during pregnancy and lactation only if the benefit to the mother outweighs the potential risk to the fetus / child, because to date, little is known about the consequences of its use in pregnant testosterone cypionate vs propionate women and lactating mothers.

    Effects on ability to drive and use machines
    During treatment is not recommended to drive vehicles and doing other potentially hazardous activities that require a rapid psychomotor reactions.
    In the period of treatment should be deleted alcohol.

    Dosage and administration
    Capsules swallowed whole with water. For a more rapid absorption of the drug it is preferred to take 1 hour or 2 hours after meals.
    The dosage should be adjusted according to the characteristics and tolerability individual patients. With the deterioration of the patient, or reducing the effectiveness of the drug may need to increase the dose.
    Treatment is recommended to start with the lowest dosage form containing isosorbide mononitrate, that is 40 mg once a day. If the dose is insufficient – it is possible to increase the 1 to 60 mg once daily.
    In rare cases, the dose can be increased to 80 mg per day (2 capsules of 40 mg). The duration of treatment and increasing the dose determined by the physician. The efficacy and safety of the drug has not been established in children.

    Side effect
    “Nitrate” headache may occur at the beginning of treatment. With continued therapy, it usually decreases after a few days.
    After the first dose or after increasing the dose of the drug can occur lowering blood pressure and / or the development of orthostatic hypotension, which may be accompanied by tachycardia, dizziness, and weakness.
    May very rarely celebrated nausea, vomiting, redness . face and allergic skin reactions
    in rare cases, a pronounced reduction in blood pressure is accompanied by worsening angina (a paradoxical reaction to nitrates).
    occasionally there were cases collaptoid states, sometimes with bradyarrhythmia and syncope. Notes: Describes the development of tolerance, as well as cross-tolerance to other nitro compounds at long-term continuous treatment with high doses of isosorbide mononitrate. To prevent degradation or loss of effectiveness, to avoid continuous administration of high doses of the drug and drug administration more than 2 times per day. The use Monolonga can lead to transient hypoxia due to the relative blood flow redistribution gipoventiliruemye alveolar segments. It can be a trigger of ischemia in patients with coronary heart disease.

     

    Overdose Symptoms of overdose: Lowering blood pressure with orthostatic dysregulation, reflex tachycardia, and headache. May develop fatigue, dizziness, somnolence, sweating, hot flushes, nausea and vomiting, diarrhea hyperpnoea, dyspnea, bradycardia, increased intracranial pressure, paralysis, coma. In chronic overdose may cause a higher level of methemoglobin. Therapy with overdose In addition to general recommendations such as washing stomach and placing the patient in a horizontal position, legs raised high, with marked decrease srterialnogo pressure and / or patients in shock should be the introduction of fluid; in exceptional cases, to improve blood circulation can be performed infusion of norepinephrine and / or dopamine. Introduction of epinephrine and related compounds is contraindicated.When methemoglobinemia – intravenous injection of 1% methylene blue solution, 1.2 mg / kg.

    Interaction with other drugs
    When using with other vasodilators, antihypertensive drugs, beta-blockers, blockers “slow” calcium channel blockers, antipsychotics or tricyclic anti-depressants, amiodarone, a phosphodiesterase inhibitor sildenafil testosterone cypionate vs propionate and alcohol may potentiation of anti-anginal action drug.
    with the simultaneous introduction Monolonga and dihydroergotamine can occur raising dihydroergotamine and potentiation of the hypertensive action.
    The therapeutic effect of noradrenaline is reduced when taken with nitropreparatov.
    The combined use with M-holinoblokatorami (atropine, and others.) increases the likelihood of increased intraocular pressure .
    Adsorbents, binders and overlying means reduce the absorption of isosorbide mononitrate in the digestive tract.
    Under the influence of sympathomimetic alpha-blockers (dihydroergotamine, etc.) may reduce the severity of anti-anginal effect (excessive reduction in blood pressure and, as a consequence, coronary perfusion). Barbaturaty accelerate the metabolism and reduce the concentration of isosorbide mononitrate in the blood.

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Absorption testosterone propionate results negligible. After 8 hours after the single application on intact skin (without occlusive dressings) detected in the systemic circulation of about 0.4% of the active substance. Mometasone is extensively metabolized in the liver, kidneys displayed mainly in small quantities in the bile.

Indications
Inflammation and itching dermatoses with measurable glucocorticosteroid therapy.

Contraindications

  • Hypersensitivity to any component of the formulation or to the SCS.
  • Rosacea, perioral dermatitis.
  • Bacterial, viral (Herpes simplex, chicken pox, Herpes zoster), or a fungal infection of the skin.
  • Tuberculosis, syphilis.
  • Post-vaccination reactions.
  • Pregnancy (treatment of large areas of skin, long-term treatment).
  • Lactation (used in large doses and / or for a long time).

Carefully

  • Application to the skin of the face and intertriginous skin, the use of occlusive dressings, as well as the treatment of large areas of skin and / or long-term treatment (particularly in children).

Use during pregnancy and lactation
The safety of mometasone furoate during pregnancy and lactation has not been studied.
Corticosteroids cross the placental barrier. Avoid long-term treatment and the use of large doses during pregnancy due to the risk of negative impact on fetal development.
Corticosteroids are excreted in breast milk. In the case where the use of corticosteroids expected at high doses and / or for a long time, discontinue breastfeeding.

Dosage and administration:
Outwardly.
Cream Momat thin layer is applied to the affected skin once daily.
The duration of treatment is determined by its efficiency, as well as the tolerance of the patient, presence and severity of side effects.

Side effects:
Rarely – skin irritation and dryness, burning sensation, pruritus, folliculitis, hypertrichosis, acne, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, the accession of secondary infection, signs of skin atrophy, striae, miliaria. Less than 1% of -. The formation of papules, pustules
When applying external shapes SSC for a long time and / or for the treatment of large areas testosterone propionate results of skin, or with occlusive dressings, especially in children and adolescents, the side effects characteristic of corticosteroids may occur systemic effects, including adrenal insufficiency and Cushing’s syndrome.

Overdose Symptoms : inhibition of the function of the hypothalamic-pituitary-adrenal system, including secondary adrenal insufficiency. Treatment : symptomatic, if necessary – correction of electrolyte imbalance, removal of the drug (for long-term treatment – phasing out).

Interaction with other drugs
cream drug interaction studies have not been conducted Momat with other drugs.

Cautions
When applied to large areas of the skin for a long time, especially in the application of occlusive dressings may develop corticosteroids systemic effects.
In view of this, patients should be observed for signs of suppression of the hypothalamic-pituitary-adrenal system and the development of Cushing’s syndrome.
Avoid getting cream Momat eyes.
Propylene glycol, which is part of the drug may cause irritation at the site of application. In such cases, discontinue use Momat cream and appropriate treatment.
It should be borne in mind that corticosteroids are able to change some of the manifestations of skin diseases that can complicate diagnosis. In addition, the use of corticosteroids may be the cause of the delay wound healing.
In long-term treatment of GCS sudden cessation of therapy can lead to rebound syndrome, which manifests itself in the form of dermatitis with intense redness and burning sensation. Therefore, after the long course of treatment abolition of the drug must be carried out gradually, for example, switching to intermittent treatment regimen before it is completely stopped. Paediatric use in connection with the fact that the children value surface testosterone propionate results area ratio and body mass is greater than in adults children are at greater risk of suppressing the function of the hypothalamic-pituitary-adrenal system and the development of Cushing’s syndrome when applying any topical corticosteroids. Long-term corticosteroids treatment of children can lead to violations of their growth and development. children should receive the minimum dose sufficient to achieve the effect. eminence labs balkan pharmaceuticals

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Selective imidazoline receptor agonists responsible for the reflex control of the sympathetic nervous system (localized in the ventral-lateral medulla). Slightly communicates with the central alpha2-adrenergic receptors reduces systolic and diastolic blood testosterone propionate buy pressure (BP) and after a single long-term use.

With long-term use reduces hypertrophy of the left ventricular myocardium, eliminates signs of myocardial fibrosis, mikroarteriopatii normalizes capillary blood flow to the myocardium, reduces the total peripheral vascular resistance, pulmonary vascular resistance, while cardiac output and heart rate (HR) did not change significantly. The treatment reduces the activity of norepinephrine and epinephrine, renin, angiotensin II at rest and during exercise, the atrial natriuretic peptide (load), and plasma aldosterone. Decreases Resistance to insulin by 21% compared to placebo in patients with obesity and insulin-resistant patients with moderate hypertension, it stimulates the release of growth hormone. It does not affect glucose metabolism and lipid.

Pharmacokinetics
Absorption.
Once inside quickly and almost completely absorbed from the gastrointestinal tract (about 90%). Eating on the amount of absorption is not affected. Maximum plasma concentration (Cmax) is reached after 30-180 minutes and after oral administration is 1-3 ng / ml. The interval between reaching Cmax and pronounced decrease in blood pressure at rest varies on average by 10%, with a load – by 7.7%. Duration -. The bioavailability of more than 12 hours after a single application of 88% inside, indicating no significant effect of “primary” passing through the liver.

Distribution.
It penetrates the blood-brain barrier. Not accumulates long-term use.
The volume of distribution – 1,4-3 l / kg. Communication plasma protein 7%.

Metabolism.
Metabolized 10-20% of moxonidine to form 4,5-degidromoksonidina and aminometanamidinovogo derivative.

. Elimination
half-life (T 1/2 ) is 2-3 hours in the first 24 hours the kidneys derived more than 90% (50-75% – unchanged, 20% – in the form of metabolites)., And about 1% – with bile. In testosterone propionate buy a small amount of Moxonidine appears in hemodialysis.

Special patient groups
Elderly age
No significant differences in pharmacokinetics in younger patients and elderly patients were found. Correction dose is not required under normal renal function.

Renal impairment
In patients with mild (creatinine clearance (CC) of 30-60 mL / min) and severe (creatinine clearance <30 mL / min) in violation of the plasma equilibrium concentration of kidney function and the final T 1/2about 2 or 3 times respectively higher than in hypertensive patients with normal renal function (creatinine clearance of> 90 ml / min). Therefore, patients with severe renal impairment is contraindicated drug, and with moderate kidney dysfunction drug should be used with caution, the dose should be individualized.

Abnormal liver function
no reliable trials of moxonidine in patients with impaired liver function no. Since moxonidine practically not metabolized in the liver, disturbance of its function does not have a pronounced effect on the pharmacokinetics of the drug.

Indications for use:

Arterial hypertension.

Contraindications:

 

  • hypersensitivity to moxonidine or any other component of the drug;
  • Hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption;
  • The expressed disturbances of heart rhythm (bradycardia (less than 50 beats / min at rest), sick sinus syndrome or sinoatrial block, atrioventricular block grade II and III);
  • Chronic heart failure (III-IV functional class NYHA classification);
  • severe renal insufficiency (creatinine clearance <30 mL / min creatinine concentration in the serum of> 160 mmol / l) and hemodialysis;
  • the simultaneous use of tricyclic antidepressants;
  • age of 18 years;
  • during breastfeeding.

 

Precautions
atrioventricular block of I degree (risk of bradycardia), coronary artery disease (including coronary heart disease, unstable angina, myocardial early period), diseases of the peripheral circulation (including intermittent claudication, Raynaud’s syndrome), epilepsy Parkinson’s disease, depression, glaucoma; moderate renal insufficiency (creatinine clearance 30-60 ml / min, serum creatinine 105-160 mmol / l), liver failure; pregnancy.

Application of pregnancy and during breastfeeding

No significant trials of moxonidine in pregnant women have been conducted. Animal studies have shown embryotoxic effect. Clinical data on the negative impact on the course of pregnancy there. However, you should use the pregnancy only if the potential benefit to the mother outweighs the potential risk to the fetus.

Moxonidine passes into breast milk, women during treatment is recommended to stop breast-feeding or stop the drug.

Dosing and Administration

Moksoniteks appointed inside, regardless of meals, drinking plenty of fluids. the dose regime selected individually.

Unless otherwise Moksoniteks prescriptions should be administered in the following doses: as an initial dose of 0.2 mg of the drug administered in the morning. When insufficient therapeutic effect, the dose 3 weeks later increased to 0.4 mg / day in single or 2 divided doses. The maximum daily dose – 0.6 mg, the maximum single dose of 0.4 mg.

In patients with moderately severe renal function lesions (CC 30 – 60 ml / min), a single dose should not exceed 0.2 mg and the maximum daily dose – 0.4 mg.

Side effect

According to the World Health Organization (WHO) side effects are classified according to their rate of development as follows: common (> 1/100, <1/10), uncommon (> 1/1000, <1/100), rarely (> 1 / 10,000, <1/1000) and very rare (<1/10000), including isolated reports.

Cardio-vascular system
Uncommon: bradycardia, marked reduction in blood pressure (including orthostatic hypotension).

On the part of the central nervous system
often: dizziness (vertigo), headache, somnolence, insomnia
Uncommon: fainting, increased excitability.

On the part of the organ of hearing and labyrinth disorders
Uncommon: tinnitus.

From the digestive system
very often: dryness of the oral mucosa;
frequently: diarrhea, nausea, vomiting, dyspepsia.

Skin and subcutaneous tissue disorders
common: pruritus, rash,
rare: angioneurotic edema (angioedema).

On the part of the musculoskeletal and connective tissue disorders
common: pain testosterone propionate buy in the back,
rare: pain in the neck.

General disorders and administration site in
common: asthenia;
rare: peripheral edema.

Overdose

Symptoms: headache, marked reduction of blood pressure, bradycardia, palpitations, weakness, drowsiness, dryness of the oral mucosa, rarely – vomiting, and epigastric pain. Potentially possible paradoxical hypertension and hyperglycemia.

Treatment: symptomatic. No specific antidote.

In marked decrease in blood pressure it is recommended to restore the circulating blood volume due to fluid administration.

Alpha-adrenoceptor antagonists can reduce or eliminate transient hypertension moxonidine in overdose.

Interaction with other drugs

The combined use of Moxonidine with other antihypertensives leads to additive effect. Tricyclic antidepressants may decrease the effectiveness of antihypertensive drugs central action, and therefore it is not recommended taking them together with moxonidine.

Moxonidine may enhance the sedative effect of tricyclic antidepressants, tranquilizers, ethanol, sedatives and hypnotics.

Moxonidine is able to moderately improve cognitive impairment in patients receiving lorazepam.

Moxonidine may enhance the sedative effects of benzodiazepines in their simultaneous application.

Moxonidine is obtained by tubular secretion, so it is possible its interaction with other drugs that are excreted by tubular secretion.

special instructions

During treatment requires regular monitoring of blood pressure, heart rate and ECG. If necessary, cancel both received beta-blockers and drug Moksoniteks first cancel beta-blockers, and only after a few days of preparation Moksoniteks.

There is currently no evidence that discontinuation of Moksoniteks drug leads to increased blood pressure. But we should not abruptly stop the drug use Moksoniteks. Elderly patients may be at increased risk of cardiovascular complications due to the use of antihypertensive drugs, so drug therapy Moksoniteks should start with the lowest dose.

Effects on ability to drive vehicles and mechanisms

Effect of the drug Moksoniteks on ability to drive vehicles or operate machinery has not been studied. However, taking into account the possibility of dizziness, drowsiness, patients should be careful during the occupation of potentially hazardous activities that require attention, such as driving a vehicle or management technique, which requires high concentration testosterone propionate buy of attention. Anastrozole side effects, anastrozole 1 mg bodybuilding anastrozole for men.