Accusid

Accuzide has diuretic and antihypertensive properties.

Indications Accusida

It is used for complex treatment of elevated blood pressure in people who have indications for the use of quinapril with hydrochlorothiazide.

Release form

The drug is released in tablets, inside a blister, 30 pieces per box.

Pharmacodynamics

A complex drug with hypotensive properties, which includes 2 active elements: quinapril (is an ACE inhibitor), and hydrochlorothiazide (is a diuretic drug). These components can be found in 3 dosage combinations.

Quinapril is a catalyst for the binding of angiotensin 2 - it, stimulating the adrenal cortex (production of aldosterone), affects vascular tone and has a vasoconstrictor effect. The substance slows down the activity of ACE (circulating and tissue), and also reduces vasopressor activity along with the secretion of aldosterone. Due to the elimination of the negative effect exerted by angiotensin 2 on the production of renin, the activity of the latter increases.

The decrease in blood pressure is accompanied by the processes of decreasing total peripheral vascular resistance and renal vascular resistance. At the same time, changes in heart rate, cardiac output, intrarenal blood circulation and glomerular filtration rate are insignificant or absent altogether.

Quinapril slightly reduces the loss of potassium that develops under the influence of hydrochlorothiazide, and it, having a diuretic effect, increases the activity of blood renin, increases blood potassium values and its renal secretion, and also potentiates the release of aldosterone. The hypotensive effect develops within 60 minutes, reaching its maximum after 3 hours and continuing throughout the day.

Hydrochlorothiazide is a diuretic drug and affects renal function, potentiating the excretion of potassium with sodium, bicarbonate ions with chlorides and water, and reducing the excretion of calcium. The diuretic effect develops after 120 minutes, and the maximum effect is observed after 4 hours (the total duration of action is about 6-12 hours).

The combination of active components of the drug helps to provide a more significant reduction in blood pressure levels than the effect of these elements separately.

Pharmacokinetics

The active components of the drug do not affect each other.

The peak value of quinapril is observed after 2 hours. The absorption rate of the substance is approximately 60%. Quinapril is synthesized in large quantities with blood protein. Inside the liver, it undergoes biotransformation, turning into quinaprilat, which is a powerful ACE inhibitor. The element does not pass through the BBB, it is excreted mainly by the kidneys; the half-life is approximately 3 hours.

Hydrochlorothiazide has a slower absorption, the degree of which is approximately 50-80%. Cmax values are noted after 1-3 hours. The substance does not pass through the BBB and is not metabolized inside the body. Excretion of the unchanged component is through the kidneys. Half-life is about 4-15 hours.

Dosing and administration

The medication should be taken once a day, regardless of meal time.

The recommended initial daily dose (for people not taking diuretics) is 10 mg + 12.5 mg (tablet form - Accuzit 10). If necessary, this dosage can be increased to the maximum permissible daily dose of 20 mg + 25 mg (1st tablet form - Accuzit 20).

The therapeutic effect usually develops when using the drug in the range of doses of 10+12.5/20+12.5 mg/day.

If the patient has severe forms of renal disorders, it is better not to use the drug for initial treatment.

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Use Accusida during pregnancy

Accuzide should not be prescribed to pregnant or nursing women.

Contraindications

Main contraindications:

• the presence of hypersensitivity to the therapeutic agent;
• history of Quincke's edema (caused by treatment with ACE inhibitors);
• diabetes mellitus;
• hypocorticism;
• anuria;
• severe liver or kidney failure;
• hypolactasia.

Side effects Accusida

Often, the use of any combination of active drug elements leads to headaches and dizziness, as well as an unproductive form of cough.

Less commonly observed are tachycardia, decreased blood pressure, palpitations, asthenia, and a feeling of intense excitability. In addition, this category includes nausea, diarrhea or constipation, fainting, dry throat, anaphylactic symptoms, hepatitis with pancreatitis, and bloating. Alopecia, epidermal rashes, itching, peripheral edema, and arthralgia are also rare.

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Overdose

Among the main symptoms of poisoning after prolonged use of drugs in too large doses are a persistent decrease in blood pressure and a disorder of water-electrolyte balance, which manifests itself in the form of hyponatremia with hypochloremia and hypokalemia.

Interactions with other drugs

After combined use of the drug with tetracyclines, the degree of absorption of the latter is reduced by a third.

It is forbidden to combine lithium medications with diuretics, because the latter reduce the clearance rates of lithium in the kidneys, which greatly increases the risk of poisoning.

The simultaneous use of Accuzide with ethyl alcohol, opiates, general anesthetics and barbiturates increases the likelihood of orthostatic collapse.

The combination of the drug with insulin or antidiabetic agents requires adjustment of the dosage of the latter.

Hydrochlorothiazide can potentiate the effectiveness of antihypertensive drugs when used in combination.

The combination of Accuzide with corticosteroids may increase the amount of potassium and other electrolytes lost.

The use of NSAIDs leads to a decrease in the diuretic, hypotensive and natriuretic properties of diuretic drugs.

Combining the drug with muscle relaxants may result in potentiation of their therapeutic effect.

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Storage conditions

Accuzid must be kept at temperatures not exceeding 25°C.

Shelf life

Accuzide can be used for 36 months from the date of manufacture of the drug.

Application for children

The medicine is not used if the patient is under 18 years of age.

Analogues

Analogues of the drug are Quinapril and Quinard.