Diroton

Dirotone is a medicine whose active ingredient is lisinopril. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure (hypertension), heart failure, and to protect the kidneys in diabetic nephropathy.

The action of the drug is aimed at dilating blood vessels, which helps to reduce blood pressure and facilitates the work of the heart. This drug should be taken strictly as prescribed by a doctor, as it is necessary to take into account possible side effects and interaction with other drugs taken.

Indications Dirotona

1. Arterial hypertension (high blood pressure): Diroton helps control high blood pressure, thus preventing the risk of cardiovascular diseases such as stroke and myocardial infarction.
2. Heart failure: The drug is used to treat patients with heart failure, especially in combination with other drugs, to improve survival and slow disease progression.
3. Treatment after myocardial infarction: The drug may be prescribed after a myocardial infarction to improve survival and reduce the risk of heart failure and other complications.
4. Diabetic nephropathyI: In some cases, Diroton is prescribed to patients with diabetes to protect the kidneys from the development or progression of diabetic nephropathy, a condition that can lead to chronic kidney failure.

Dirotone and other ACE inhibitors are often preferred to treat patients with certain comorbidities because of their protective effects on the kidneys and their ability to improve survival in patients with cardiovascular disease.

Release form

1. Tablets: This is the most common form of lisinopril. Tablets usually have different dosages, such as 5 mg, 10 mg, 20 mg, etc.
2. Capsules: Lisinopril may also be available as capsules, but this is a less common form.

Pharmacodynamics

Lisinopril prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor that plays a key role in blood pressure regulation. Angiotensin II also stimulates the release of aldosterone by the adrenal glands, which leads to sodium and water retention in the body, contributing to high blood pressure. By inhibiting the action of ACE, lisinopril reduces the concentration of angiotensin II, which leads to a decrease in the production of aldosterone, decreased vasoconstriction, lower blood pressure, and, as a result, a reduction in the load on the heart.

Therapeutic effects

• Blood pressure reduction: Effectively reduces both systolic and diastolic blood pressure in both supine and standing positions.
• Improving heart function: Can be used to treat heart failure. Reduces symptoms and increases survival in patients with heart failure.
• Kidney Protection: Useful in the treatment of some forms of chronic kidney disease, especially in patients with type 2 diabetes and early stage nephropathy.

Pharmacokinetics

Diroton pharmacokinetics is associated with its ability to block the conversion of angiotensin I to angiotensin II, which leads to a decrease in the level of aldosterone in the blood, a decrease in atrial resistance, an increase in minute blood volume and renal blood flow. The maximum effect is achieved within 6 hours after administration and persists overnight. Bioavailability of lisinopril is about 25-30%, and it does not bind to plasma proteins. The drug is excreted from the body in unchanged form, mainly through the kidneys, within 12 hours.

Dosing and administration

The method of use and dosage of Diroton depend on the specific instructions of the doctor, who takes into account the individual characteristics of the patient, including his state of health, the presence of comorbidities, as well as the response to treatment. However, there are general recommendations for the use and dosage of lisinopril, the active substance of the drug.

Initial dosage

• Hypertension: The starting dose is usually 10 mg once daily. For patients whose blood pressure is not controlled effectively enough, the dose can be increased gradually. The maximum daily dose is 40 mg.
• Heart failure: The starting dose is usually 2.5-5 mg once daily. Depending on tolerability, the dose may be gradually increased to the maximum recommended dose of 35 mg per day divided into several doses.

Method of application

• Diroton should be taken at the same time every day, regardless of meals, to maintain a stable level of the medicine in the blood.
• The tablet should be swallowed whole, drinking enough water.

Special Instructions

• When treating hypertension, blood pressure should be monitored regularly to determine the optimal dose.
• At the beginning of therapy and with dose increase hypotension may develop, especially in patients with concomitant heart failure or disorders of water-electrolyte balance. Therefore, it is important to perform regular medical control.
• Dehydration or hypovolemia should be corrected before starting Diroton.
• Patients with renal impairment or those on dialysis may require a dose adjustment.

Use Dirotona during pregnancy

The use of Diroton during pregnancy is strictly prohibited, except when the use of the drug is absolutely necessary for vital indications. If it is necessary to take the drug during lactation, breastfeeding should be discontinued.

Contraindications

1. Allergic reaction: The use of this drug is contraindicated in people who are allergic to the drug or other angiotensin-converting enzyme inhibitors.
2. Pregnancy: Diroton may be harmful to the fetus during pregnancy, especially in the second and third trimesters, and may cause the development of serious fetal abnormalities.
3. Condition after renal transplantation: In patients who have undergone renal transplantation, the use of lisinopril may be undesirable.
4. Condition after myocardial infarction: In some cases, in patients after myocardial infarction, the use of the drug may be contraindicated.
5. Heart failure: Some patients with heart failure may be contraindicated with IAPs, including Dirotone.
6. Renal problems: In people with impaired renal function, dose adjustment or withdrawal of lisinopril may be required.
7. Hyperkalemia: The drug may cause an increase in blood potassium levels, which can be dangerous, especially in people with kidney disease or when taking other potassium-boosting drugs at the same time.
8. Carotid artery stenosis: Diroton may be contraindicated in patients with significant carotid artery stenosis.

Side effects Dirotona

• Dizziness and headache
• Cough
• Fatigue
• Renal dysfunction
• Elevated potassium levels in the blood
• Hypotension (low blood pressure)
• Fainting spells

There may also be changes in blood laboratory values, such as an increase in serum creatinine or urea levels.

Overdose

In case of overdose with Diroton, the active substance of which is lisinopril, the main manifestation is arterial hypotension, that is, a significant decrease in blood pressure. Treatment of overdose includes symptomatic therapy and correction of water-electrolyte balance. In severe cases, hemodialysis may be required.

Interactions with other drugs

1. Non-steroidal anti-inflammatory drugs (NSAIDs): Taking NSAIDs together with Diroton may reduce the antihypertensive effect of the latter. In addition, combined use may increase the risk of renal failure in some patients, especially in the elderly.
2. Diuretics: Administration of the drug with diuretics may lead to excessive decrease in blood pressure, especially at the beginning of treatment. Dose adjustment may be required.
3. Lithium: Co-administration of Diroton and lithium may result in increased blood concentrations of lithium and enhance its toxic effect. Careful monitoring of lithium levels in the blood is recommended with this combination.
4. Antihypertensive drugs: Diroton may increase the effect of other antihypertensive drugs, which requires careful dosage adjustment to avoid excessive reduction of blood pressure.
5. Potassium-containing diuretics, potassium supplements, potassium salts: Co-administration with Diroton may lead to hyperkalemia (increased blood potassium levels), which requires regular monitoring of potassium levels.
6. Insulin and oral hypoglycemic agents: Lisinopril may enhance the hypoglycemic effect of these agents, increasing the risk of hypoglycemia, especially in the first weeks of co-treatment.
7. Gold-containing drugs: The use of lisinopril with injectable gold preparations may increase the risk of nitroid reactions such as facial redness, nausea, vomiting, and decreased blood pressure.

Storage conditions

Diroton storage conditions may vary depending on the specific form of the drug (e.g., tablets, capsules, solution for injection, etc.), manufacturer, and doctor's recommendations or instructions for use. However, in general:

1. Diroton should be stored out of the reach of children.
2. The drug should be stored at room temperature, usually between 15 and 30 degrees Celsius.
3. The drug should be stored in a place protected from light, preferably in the original package.
4. Avoid storing lisinopril in areas with high humidity, such as bathrooms.
5. Do not allow the preparation to be frozen or heated to high temperatures.
6. Follow the directions for use or your doctor's instructions regarding storage of the specific form of lisinopril, as requirements may vary.