Adelphane

Adelfan is a combination drug that helps lower blood pressure. The active ingredients of the drug are reserpine and dihydralazine.

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Indications Adelphane

The medicine is used for hypertension (in moderate and mild forms), especially if this disease arose for an unknown reason.

Release form

Available in tablet form. One package contains 250 tablets.

Pharmacodynamics

Reserpine has a neurotropic vasodilatory effect on the body. Adelfan lowers blood pressure and improves sleep. As a result of using the drug, the saturation of neurotransmitters in neurons decreases, which causes its antipsychotic effect.

The tablets improve gastrointestinal motility, enhance glomerular reaction, and increase the volume of blood flow in the liver. In addition, the drug reduces the metabolic rate, causes miosis and hypothermia. It also promotes deepening of respiratory movements. The permanent effect of Adelfan begins to appear after 2-3 weeks from the start of therapy.

Under the influence of dihydralazine, the tone of smooth myocytes of arterioles decreases, blood flow increases, and the resistance force in the vessels of organs such as the kidneys, brain, as well as the skin and heart, decreases.

Pharmacokinetics

After oral administration, reserpine is quickly absorbed, with systemic bioavailability of 50%. The relative average Vd of reserpine is 9.1 l/kg (with variations within 6.4-11.8 l/kg). More than 96% is bound to plasma proteins (albumins and lipoproteins). The active substance is metabolized in the liver and also in the intestine. The main metabolic products are trimethoxybenzoic acid and methylreserpate. It is excreted from the blood plasma together with metabolites in 2 stages: the half-life in the α-phase is 4.5 hours, and in the β-phase - 271 hours. The average half-life of the unchanged component is 33 hours. The overall clearance rate of reserpine has an average value of 245 ml/minute. During the first 96 hours after oral administration, 8% of the dose taken by the patient is excreted through the kidneys (mainly as metabolites), and another 62% through the intestines (often as unchanged substance).

After oral administration, dihydralazine is quickly absorbed, mainly remaining unchanged in the blood plasma. During the metabolism of this component, hydrazone substances are also formed. About 10% of dihydralazine is present in the blood plasma as hydralazine. The substance is metabolized mainly by oxidation (in which hydrazones are formed) and acetylation. The half-life of the unchanged main component is on average 4 hours. The average total clearance rate is 1450 ml/minute. In the first 24 hours after oral administration, approximately 46% of the dose taken is excreted from the body (mainly through the intestines), mainly in the form of metabolites. About 0.5% of the dose of the drug is excreted unchanged in the urine.

Dosing and administration

At the first stage of treatment, Adelfan is prescribed in a dosage of 1 tablet three times a day after meals. If necessary, the dosage can be increased to 2 tablets three times a day. After the therapeutic effect is achieved, the daily dosage of the drug is gradually reduced.

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Use Adelphane during pregnancy

Adelfan should be prescribed with caution in the 1st and 2nd trimesters of pregnancy. If the patient is in the 3rd trimester of pregnancy, the drug should be discontinued, since in the later stages it can cause lethargy in the child or anorexia.

Contraindications

Among the contraindications to taking Adelfan:

• State of depression;
• Parkinson's disease;
• Recent history of myocardial infarction;
• Epilepsy;
• Aggravated ulcer;
• Arrhythmia or severe angina;
• Severe tachycardia;
• Problems with liver function;
• Severe renal failure;
• Hypersensitivity to the components of the drug - reserpine or dihydralazine;
• Breastfeeding period;
• Age under 18 years.

Side effects Adelphane

Side effects of taking the drug include the following disorders:

Redness of the eyes, skin rash, disturbances in the motor function of the digestive process, development of bradycardia, dizziness, feeling of general weakness, and shortness of breath. In some cases, a depressive state, a feeling of anxiety, insomnia, and manifestations of Parkinsonism (disorder of motor coordination with the occurrence of tremors, as well as a decrease in the range of motion) may be observed.

Interactions with other drugs

Other drugs that lower blood pressure enhance the hypotensive effect of Adelfan. The combination of reserpine with cardiac glycosides reduces the heart rate, thereby increasing the risk of arrhythmia. Reduces the effectiveness of antiparkinsonian drugs, as well as morphine and anticholinergics. When combined with methyldopa, the likelihood of developing a depressive state increases. Increases the central effect of hypnotics, drugs used as inhalation anesthetics, barbiturates, antihistamines, medications containing ethanol, and tricyclics. In case of combined use with MAO inhibitors, an increase in blood pressure and the development of hyperreactivity are observed.

Tricyclics, antipsychotic drugs, drugs containing ethanol, and diazoxide in combination with Adelfan increase the hypotensive effect of hydralazine sulfate.

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Storage conditions

It is recommended to store the medicine in a dry place, protected from sunlight, at a maximum temperature of no more than 30°C.

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Shelf life

Adelfan is permitted to be used for 5 years from the date of manufacture.