Medical expert of the article
New publications
Preparations
Accused
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Akkudid has diuretic and antihypertensive properties.
Indications Akkuzida
It is used for complex treatment at elevated values of blood pressure in people who have indications for using quinapril with hydrochlorothiazide.
Release form
Release of the medication is realized in tablets, inside the blister, 30 pieces per box.
Pharmacodynamics
A complex drug with hypotensive properties, which includes 2 active elements: quinapril (is ACE inhibitor), and hydrochlorothiazide (a diuretic drug). These components can occur in 3 dosage combinations.
Hinapril is a catalyst for the binding of angiotensin 2-one, stimulating the adrenal cortex (aldosterone production), affects vascular tone and has a vasoconstrictive effect. The substance slows the activity of ACE (circulating and tissue), and also reduces vasopressor activity together with the secretion of aldosterone. By eliminating the negative effect of angiotensin 2 on the production of renin, the activity of the latter is enhanced.
Decrease in blood pressure indicators accompanies the processes of reduction in OPSS and resistance of renal vessels. At the same time, changes in heart rate, cardiac output, blood circulation inside the kidneys and glomerular filtration rate are insignificant or absent altogether.
Hinapril does not significantly decrease the loss of potassium, which develops under the influence of hydrochlorothiazide, and it, having a diuretic effect, increases the activity of blood renin, raises the blood values of potassium and its renal secretion, and also potentiates the release of aldosterone. Hypotensive influence develops in the period of 60 minutes, reaching its maximum after 3 hours and lasting for 24 hours.
Hydrochlorothiazide is a diuretic medicine and has an effect on renal activity, potentiating the excretion of potassium with sodium, bicarbonate ions with chlorides and water, and also reducing calcium excretion. The diuretic effect develops after 120 minutes, and the maximum effect is observed after 4 hours (the total duration of the action is about 6-12 hours).
The combination of the active components of the drug helps to provide a more significant reduction in blood pressure than with the exposure exerted by these elements individually.
Pharmacokinetics
The active components of the drug do not interfere with each other.
The peak of quinapril is observed after 2 hours. The absorption of the substance is about 60%. Hinapril is synthesized in large quantities with a blood protein. Inside the liver is biotransformation, turning into quinaprilate, which is a powerful ACE inhibitor. The element does not pass through the BBB, it is excreted mainly by the kidneys; half-life is approximately 3 hours.
Hydrochlorothiazide has a slower absorption, the degree of which is about 50-80%. Cmax values are noted after 1 to 3 hours. The substance does not pass through the BBB and is not metabolized internally. Excretion of the unchanged component - through the kidneys. The half-life is about 4-15 hours.
Dosing and administration
The medication should be taken only once a day, regardless of the time of eating.
The size of the recommended initial portion per day (for people who do not take diuretics) is 10 mg + 12.5 mg (form of the pill - Akkuzit 10). If required, this dosage is allowed to be raised to the maximum allowable per day of 20 mg + 25 mg (form of the 1st tablet - Akkuzit 20).
Therapeutic effect usually develops with the use of drugs in the range of portions 10 + 12.5 / 20 + 12.5 mg / day.
If the patient has marked forms of renal disorders, it is better not to use a medicine for initial treatment.
[2]
Use Akkuzida during pregnancy
It is not allowed to prescribe Accompanion to nursing and pregnant women.
Contraindications
The main contraindications:
- the presence of hypersensitivity to the therapeutic agent;
- the presence of edema of Quincke in the anamnesis (caused by treatment with the use of ACE inhibitors);
- diabetes;
- hypokorticism;
- anuria;
- failure of hepatic or renal function to a significant extent;
- gastro-lactase.
Side effects Akkuzida
Often the use of any combination of active elements of drugs leads to the appearance of headaches and dizziness, as well as the unproductive form of cough.
More rarely there is tachycardia, a decrease in pressure, palpitations, asthenia and a feeling of intense excitability. In addition, in this category, nausea, diarrhea or constipation, fainting, dryness in the throat, anaphylactic symptoms, hepatitis with pancreatitis and bloating. Alopecia, rashes on the epidermis, itching, peripheral puffiness and arthralgia are also rare.
[1]
Overdose
Among the main symptoms of poisoning after prolonged use of medicines in too large portions is a persistent decrease in the values of blood pressure and a disturbance of the water-electrolyte balance, which manifests itself in the form of hyponatremia with hypochloraemia and hypokalemia.
Interactions with other drugs
After combined use of the drug with tetracyclines, the degree of absorption of the latter decreases by one third.
It is forbidden to combine lithium drugs with diuretics, because the latter reduce the level of lithium clearance inside the kidneys, which increases the likelihood of poisoning very much.
Simultaneous use of Akkoolid with ethyl alcohol, opiates, drugs for general anesthesia and barbiturates increases the likelihood of orthostatic collapse.
Combination of the drug with insulin or antidiabetic agents requires adjustment of the dosages of the latter.
Hydrochlorothiazide is able to potentiate the effectiveness of antihypertensive drugs in their combined use.
The combination of an accoda with corticosteroids can increase the volume of lost potassium and other electrolytes.
The use of NSAIDs leads to a decrease in diuretic, hypotensive and natriuretic properties of diuretic drugs.
Combination of medication with muscle relaxants can cause the potentiation of their therapeutic effect.
Storage conditions
The tank must be kept at temperatures not exceeding 25 ° C.
Shelf life
The tank is allowed to be used for 36 months from the date of manufacture of the medicinal product.
Application for children
The medicine is not used if the patient is under 18 years of age.
Analogues
Analogues of the medication are preparations of Quinapril with Quinard.
Attention!
To simplify the perception of information, this instruction for use of the drug "Accused" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.