Zoniksem

Zoniksem is a tool from the category of ACE inhibitors.

Indications Zonixema

It is used in such conditions:

• primary hypertension (in the form of monotherapy or in combination with other antihypertensive drugs);
• CHF (as an element of the combined treatment);
• exacerbation of myocardial infarction in patients with normal hemodynamics and the absence of signs of cardiogenic shock;
• renal disorders associated with diabetes mellitus - to reduce albuminuria in non-insulin-dependent patients with increased blood pressure.

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Release form

The release of the drug is made in pill form, 14 pieces inside a cellular packaging, in the amount of 1, 2 or 4 packages inside the pack. Also inside the plate can contain 10 tablets - in a pack of such plates 2, 3 or 6.

Pharmacodynamics

Zonixem is an inhibitor of the peptidyl dipeptidase component. The drug inhibits the activity of ACE, which is a catalyst for the transformation of angiotensin-1 into a vasoconstrictor peptide, angiotensin-2 (it also helps stimulate the release of aldosterone through the adrenal cortex). Suppression of the ACE element causes a decrease in angiotensin-2, which reduces vasoconstrictor activity and the release of aldosterone. The latter process can trigger an increase in serum potassium values.

Lisinopril reduces the values of blood pressure - mainly through the mechanisms of suppression of the activity of the RAAS. This component has a hypotensive effect even in individuals with hypertension and low renin values. The ACE element (kinase-2) is an enzyme that lowers the level of bradykinin. At the moment, it is not known whether the increased rates of bradykinin, which is considered a powerful vasodilating peptide, are important when medicamentally exposed to lisinopril.

[2], [3], [4]

Pharmacokinetics

Lisinopril is an ACE inhibitor with high activity. It does not have sulfhydryl.

Suction.

When ingested, serum Cmax values of lisinopril are observed approximately after 7 hours. In people with exacerbation of myocardial infarction, there is a tendency to develop a small delay in the time required to obtain serum Cmax. Considering the urinary recovery, the level of the average lysinopril suction volume is approximately 25% with individual fluctuations (in the range of 6-60%) for any doses given (5-80 mg).

Absolute bioavailability rates fall by about 16% in people with HF. The presence of food inside the gastrointestinal tract does not affect the expression of lysinopril absorption.

Distribution processes.

Lisinopril is not involved in protein synthesis within blood serum, excluding the ACE circulating inside the blood. Tests using rats demonstrate that the substance does not pass well through the BBB.

Excretion.

The drug is not involved in metabolic processes, excreted in the urine in an unchanged state. When used repeatedly, the substance shows a half-life of accumulation of 12.6 hours.

Dosing and administration

It is necessary to take the medication by mouth, once a day, approximately at the same time. Eating does not affect the absorption of the drug.

The portion size is selected personally, taking into account the disease and the response of the patient's blood pressure indicators.

Primary hypertension.

At the initial stage, an adult with increased blood pressure values who do not use other antihypertensive drugs should be treated with 10 mg of the substance per day. Basically, the size of the effective maintenance portion is 20 mg with a single dose per day.

Taking into account the values of blood pressure, the size of the dosage portion can be increased to 40 mg per day. With a weak medicinal effect, it is required to supplement the treatment with another antihypertensive medication.

In case of increasing the portion, it is necessary to take into account that for the full development of the antihypertensive effect 0.5-1 month should pass.

With RVG or hypertension, marked during conditions associated with enhanced activity of the RAAS.

First, you need to use 2.5-5 mg of medicine per day, carefully monitoring the values of blood pressure, kidney work and serum levels of potassium. The size of the maintenance dosage is determined by the level of blood pressure and is selected during the implementation of the above monitoring.

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Use Zonixema during pregnancy

It is forbidden to prescribe medication during pregnancy. If pregnancy has been detected in the patient, you should immediately abandon the use of Zonixeme (except for situations in which this is a vital need for a woman).

The use of an ACE inhibitor, among which lisinopril, on the 2nd and 3rd trimesters can provoke a negative effect on the fetus and its subsequent death. The appearance of kidney failure, hyperkalemia, or hypotension in a pregnant woman (from the 9th to the 12th week) is due to the negative effect on the renal activity of the fetus. Due to the decrease in the volume of amniotic fluid, the fetus may be affected, which results in developmental abnormalities of the face with the skull, problems with the development of the extremities, as well as intrauterine death. Information about the negative effects on the fetus with the introduction of the 1st trimester is missing.

With the strict need to use the drug in a pregnant woman, it is necessary to control the development of the fetus through ultrasound. In the case of a decrease in the volume of amniotic fluid, the use of drugs should be canceled (if the medicament does not have an absolute vital need). Both the doctor and the patient should be aware that a decrease in the volume of amniotic fluid occurs in cases where incurable changes in the fetus have already occurred. It is necessary to inform the patient about the possibility of a negative effect of the drug on the fetus.

It is necessary to monitor the condition of the newborn infant in order to determine the possible presence of hyperkalemia, hypotension or oliguria.

There is no evidence that lisinopril can be excreted in human milk. The introduction of the drug during lactation is prohibited.

Contraindications

Main contraindications:

• strong sensitivity to the elements of the drug or other ACE inhibitors;
• the presence in the history of Quincke edema, which developed due to the introduction of an ACE inhibitor, and also for Quincke edema, having idiopathic or hereditary character;
• hemodynamic significance of stenosis (mitral valve or aortic orifice);
• hypertrophic cardiomyopathy, accompanied by obstruction in the area of outflow paths;
• cardiogenic shock;
• with hemodynamics, having an unstable nature, after suffering an exacerbation of myocardial infarction;
• stenosis affecting the arteries inside the kidneys (1- or 2-sided);
• Conn's syndrome.

Side effects Zonixema

The use of a therapeutic substance can lead to the appearance of separate side signs:

• disorders associated with the activity of the cardiovascular system: orthostatic collapse often develops. Increased palpitations, myocardial infarction, orthostatic symptoms (including hypotension) and tachycardia are rarely observed;
• problems with the function of NS: often there are headaches or dizziness. Occasionally, a stroke develops (it may be associated with a strong drop in blood pressure in people with high inclinations), mood lability, a feeling of confusion and paresthesia;
• disorders of the respiratory system, mediastinum and sternum: sternum pain or cough often appears. Occasionally, bronchial spasm develops;
• lesions in the gastrointestinal tract: often vomiting, diarrhea or nausea. Occasionally, there is dryness in the mouth, pain in the abdominal area, hepatitis with cholestatic or hepatocellular character, and in addition pancreatitis or jaundice. The intestinal angioedema appears singly;
• problems associated with the renal activity and urethra: occasionally there is an acute renal failure, proteinuria, anuria or oliguria, and also uremia and a disorder of the renal function;
• lesions of the subcutaneous tissue and the epidermis: a rash is often observed. Alopecia, pruritus or urticaria with diaphoresis are occasionally recorded, and in addition, angioedema affecting the tongue with the lips, and besides this limb, larynx or glottis, as well as limbs;
• systemic disorders: a feeling of weakness often appears. Occasionally, asthenia develops;
• disorders affecting the mammary glands and the reproductive system: impotence is rarely observed.

There is evidence of the development of a complex of manifestations, including myalgia, arthritis or arthralgia, fever, eosinophilia, vasculitis, increased ESR values, leukocytosis and a positive response to the anti-nuclear factor test. Perhaps the appearance of photosensitization, rashes or other dermatological signs.

Hypersensitivity reactions may cause angioedema, which causes puffiness in the lips, throat, face, palate and tongue and extremities. With the development of such symptoms, you should immediately cancel the use of lisinopril, and then the patient should stay under medical supervision until the disorder is completely cured.

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Overdose

Among the signs of ACE inhibitors poisoning are circulatory shock, renal failure, a decrease in blood pressure, electrolyte imbalance, tachycardia with hyperventilation, and also dizziness, bradycardia, cough, and anxiety.

If signs of hypotension appear, symptomatic measures should be taken and vital signs should be monitored. The patient is laid horizontally, lifting the legs.

When the need for replacement of fluid loss, you need to enter in / in the method of saline. It is necessary to monitor important vital functions, blood pressure values, blood parameters of creatinine and electrolytes, correcting them, if necessary.

It is possible to excrete lisinopril from the systemic circulation through the hemodialysis procedure.

Interactions with other drugs

Diuretic substances.

When using a diuretic substance during treatment with Zonixem, antihypertensive activity is usually potentiated.

In individuals who use diuretic drugs (especially those who have just started their use), an excessive decrease in blood pressure can occur since the start of drug administration. To reduce the risk of developing signs of hypotension from Zonixema, it is necessary to cancel the administration of a diuretic before starting treatment with the drug.

It is necessary to apply very carefully lisinopril in combination with similar medicines.

Diuretic potassium-sparing character, salt substitutes, which contain potassium, or additives of element K.

The appearance of hyperkalemia is possible with diabetes mellitus, kidney failure, and also combined with potassium-sparing diuretics (for example, amiloride, spironolactone or triamterene), potassium supplements or potassium-containing salt substitutes.

The use of the elements indicated in the subtitle, especially in individuals with disorders in renal work, can provoke a significant increase in serum potassium values.

When using the medication together with diuretics, which provoke the loss of potassium, the hypokalemia enhanced by the influence of the latter can even be potentiated. In this regard, the combination of such drugs is allowed only after evaluating the possible consequences, as well as subject to continuous monitoring of serum indicators of potassium and renal activity.

[7], [8]

Storage conditions

Zonixem must be kept in a place closed to small children. Temperature values - not higher than 25 ° C.

Shelf life

Zoniksem can be used for a period of 3 years from the date of release of the pharmaceutical product.

Application for children

You can not use Zonixem in pediatrics.

Analogs

Analogues of drugs are drugs Iruzid, Liten N, Ko-Dyroton, as well as Lysoretik with Lisinoton N.

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