Lysoretic

The medicine Lysoretic is a combination of two active ingredients: hydrochlorothiazide and lisinopril. This medicine is used to treat hypertension (high blood pressure) and can also be used to treat heart failure.

Hydrochlorothiazide is a diuretic that helps the body get rid of excess fluid and salts by increasing urine output. This helps to reduce blood volume and lower blood pressure.

Lisinopril belongs to a class of medicines known as angiotensin-converting enzyme inhibitors (ACEIs). It works by dilating blood vessels and reducing vascular resistance, which also results in lower blood pressure.

The combination of hydrochlorothiazide and lisinopril in the preparation "Lysoretic" allows to achieve more effective control of blood pressure compared to the use of each ingredient separately. However, before starting the use of this drug it is necessary to consult a doctor to determine the correct dosage and assess the indications and contraindications.

Indications Lysoretica

1. Hypertension (high blood pressure): The drug is used to reduce blood pressure in patients with hypertension. The combination of hydrochlorothiazide and lisinopril allows to achieve more effective control of blood pressure, because the effect of both components complements each other.
2. Heart failure: In some cases, Lysoretic may also be used to treat heart failure. Lisinopril, as an angiotensin-converting enzyme inhibitor (ACEI), helps improve heart function by dilating blood vessels and reducing vascular resistance, thereby reducing the workload on the heart.
3. Prevention of cardiovascular complications: In some cases, Lysoretic may be prescribed for the prevention of cardiovascular complications in high-risk patients, such as those with diabetes or long-term hypertension.

Release form

Lysoretic is usually available in tablet form. This form of release provides convenience of administration and allows accurate dosing of both active ingredients.

• Tablets: Each tablet contains a certain amount of lisinopril and hydrochlorothiazide. The dosages of the components in the tablets may vary to meet the different needs of patients depending on the degree of hypertension and response to treatment.

Pharmacodynamics

Let's review the pharmacodynamics of each of these components:

1. Hydrochlorothiazide:

   • Hydrochlorothiazide belongs to the class of thiazide diuretics. It acts on renal tubules, reducing the reabsorption of sodium, chlorine and water. This leads to increased excretion of electrolytes and water through the urine, which helps to reduce circulating blood volume and blood pressure.
   • Hydrochlorothiazide also reduces reabsorption of calcium in the kidneys, which may help reduce the risk of kidney stone formation.

2. Lisinopril:

   • Lisinopril belongs to the class of angiotensin-converting enzyme inhibitors (ACEIs). It blocks the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor. Thus, lisinopril promotes vasodilation and reduces vascular resistance.
   • In addition, lisinopril decreases aldosterone production, resulting in decreased reabsorption of sodium and water in the kidneys and decreased circulating blood volume.
   • Lisinopril also reduces cardiac and vascular remodeling, which has a positive effect on heart function and may reduce the risk of cardiovascular complications.

Pharmacokinetics

1. Hydrochlorothiazide:

   • Absorption: Hydrochlorothiazide is generally well absorbed from the gastrointestinal tract after oral administration.
   • Maximum concentration (Cmax): Reached in the blood approximately 1-2 hours after ingestion.
   • Metabolism: Hydrochlorothiazide is metabolized in the liver, mainly to inactive metabolites.
   • Excretion: It is eliminated from the body mainly through the kidneys as an unmetabolized drug.

2. Lisinopril:

   • Absorption: Lisinopril is usually rapidly and completely absorbed from the gastrointestinal tract after oral administration.
   • Maximum concentration (Cmax): Reached in the blood approximately 6-8 hours after ingestion.
   • Metabolism: It is metabolized in the liver to form the active metabolite, lisinoprilat.
   • Excretion: Lisinopril and its metabolites are eliminated from the body mainly through the kidneys.

3. Collaborative pharmacokinetics:

   • Interactions: Lisinopril has no clinically significant effect on the pharmacokinetics of hydrochlorothiazide, and vice versa. Therefore, their combined use is usually safe and effective.
   • Pharmacodynamics: The action of hydrochlorothiazide and lisinopril is combined to achieve a synergistic effect in reducing blood pressure.

Dosing and administration

Method of application

• Lysoretic is taken orally, regardless of food intake.
• To facilitate absorption and reduce the risk of gastrointestinal side effects, the tablet may be taken with a meal or immediately after a meal.
• The tablet should be swallowed whole with sufficient water.

Dosage

• Thestarting dose for most patients is usually one tablet of Lysoretic with a minimum dose of lisinopril and hydrochlorothiazide once daily.
• Dose adjustments may be made depending on the patient's response to treatment. It is important to monitor the patient's blood pressure and health status regularly to determine if dose adjustments are necessary.
• If a dose increase is necessary, caution and gradualness should be observed, taking into account the possible enhancement of diuretic effect and influence on electrolyte levels.

Special Instructions

• At the beginning of treatment and during dose increase it is recommended to control blood pressure, renal function and electrolyte levels in blood.
• Caution should be used in patients with renal impairment, heart failure and other conditions that may be worsened by taking diuretics or ACE inhibitors.
• If you experience symptoms of low blood pressure, such as dizziness or fainting, you should contact your doctor immediately.

Use Lysoretica during pregnancy

The use of medicines, especially combination medicines, during pregnancy requires special attention and caution. As a rule, preparations containing ACE inhibitors, including lisinopril, are not recommended for use during pregnancy because of the risk of birth defects in the fetus. This is due to possible adverse effects on the developing fetal kidney.

Also, hydrochlorothiazide, as a diuretic, can affect body fluid volume and electrolyte levels, which can also affect the developing fetus.

Therefore, it is recommended that you avoid using Lysoretic or any other medication during pregnancy without consulting your doctor. If you are pregnant or plan to become pregnant and are taking Lysoretic or other medicines, discuss this with your doctor.

Contraindications

1. Hypersensitivity: Patients with known hypersensitivity to hydrochlorothiazide, lisinopril, or other angiotensin-converting enzyme inhibitors (ACEIs) should not use this drug because of the risk of allergic reactions.
2. True arterial hypotension: The use of Lysoretic may cause a decrease in blood pressure, therefore it should be used with caution in patients with true arterial hypotension (excessively low blood pressure) to avoid the development of hypotensive reactions.
3. Renal artery stenosis: Lysoretic should be used with caution in patients with renal artery stenosis as it may impair renal function.
4. Pregnancy: The use of Lysoretic during pregnancy may lead to the development of serious fetal malformations, therefore it should be avoided during pregnancy, especially in the trimester of pregnancy.
5. Breastfeeding: Both hydrochlorothiazide and lisinopril may be excreted into breast milk. Therefore, the use of Lysoretic during breastfeeding may be contraindicated or require a change of treatment.
6. Angioedema: The use of lisinopril may cause angioedema, especially in patients with a previous history of such reactions.
7. Hyperkalemia: Lisinopril may cause an increase in blood potassium levels and should therefore be used with caution in patients with hyperkalemia.

Side effects Lysoretica

1. Headaches
2. Nausea and vomiting
3. Weakened immune system
4. Allergic reactions
5. High blood pressure
6. Drowsiness or insomnia
7. Increased blood sugar levels
8. Digestive problems
9. Loss of appetite or weight gain

Overdose

Overdose of the drug Lysoretic may lead to serious consequences, including acute hypotension (severe drop in blood pressure), electrolyte disturbances, kidney dysfunction, and other possible complications. Symptoms of overdose may include dizziness, weakness, drowsiness, loss of consciousness, orthostatic hypotension (decrease in blood pressure when moving from lying to sitting or standing), rapid heartbeat, nausea, vomiting, and other symptoms.

Treatment of Lysoreticum overdose usually includes symptomatic therapy aimed at maintaining cardiovascular function and restoring electrolyte balance. This may include administration of intravenous fluids, correction of electrolytes, use of vascular agents to maintain blood pressure at an acceptable level, and other supportive measures depending on the specific symptoms and condition of the patient.

In case of suspected Lysoreticum overdose, seek immediate medical attention or contact your local poison control center. It is also important to avoid self-medication and follow the advice of a doctor or specialist.

Interactions with other drugs

1. Other blood pressure-lowering drugs: The use of Lysoretic with other blood pressure-lowering drugs, such as beta-blockers or calcium antagonists, may lead to synergistic effect and enhance hypotensive effect. However, it may also increase the risk of hypotension, especially in elderly patients.
2. Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen or diclofenac, may reduce the efficacy of the diuretic component of Lysoretic and lead to a decrease in its antihypertensive effect.
3. Drugs that increase the level of potassium in the blood (potassium-containing supplements, potassium-saving diuretics): Concomitant use of Lysoretic with such drugs may lead to the development of hyperkalemia, especially in patients with impaired renal function.
4. Drugs that increase the risk of hypokalemia (lactose, aminoglycoside antibiotics): Lisinopril contained in Lysoretica may increase the hypokalemic effect of such drugs, which may lead to an increased risk of hypokalemia.
5. Lithium: Lisinopril may increase lithium levels in the blood, which may increase the risk of lithium toxicity.
6. Drugs affecting renal function: Lysoretic may increase diuretic effect, especially in patients with impaired renal function, in concomitant use with other drugs affecting renal function.