Diroton - instructions for packaging tablets, warehouse, indications, side effects, analogues and price. Diroton: under any pressure to take, instructions from stagnation, vodguki and analogues Chi joins diroton with valerian

Zmist

The drug Diroton is administered to hypotensive patients with vasodilatory peripheral action. It is being circulated by Ukrainian and Russian pharmaceutical companies as the active ingredient in the market is lisinopril, an angiotensin-converting enzyme (ACE) inhibitor. Please read the instructions before taking the drug.

Warehouse and form

Instructions for use with Diroton include information about the fact that this drug is only available in one form. Tablet warehouse:

Pharmacodynamics and pharmacokinetics

The drug Diroton reduces the level of angiotensin, which shortens the production of aldosterone. This results in a greater proliferation of prostaglandins. The medication reduces arterial pressure, increasing tension in the pulmonary capillaries. Deroton dilates the arteries larger than the lower veins. The drug begins to work after one year, reaches its maximum effect after 6.5 years and maintains its effect over time.

Following the instructions for treated arterial hypertension, the result appears in the first days of therapy, a stable state is achieved after a second month. If you press the preparation sharply, the pressure will not move. The use of Diroton reduces albuminuria, normalizes the functions of the damaged endothelium in hyperglycemia, does not change the level of glucose in the blood and does not lead to hypoglycemia in maternal diabetes.

After taking lisinopril, it reaches a limiting concentration after this year, where the average absorption reaches 25%, so do not lie in wait. Rechovina is not amenable to metabolism in the body, it is excreted by alcohol, the absorption period is about 12 years. Clearance and absorption of the active component decreases in summer age. To remove lisinopril from the body, use hemodialysis.

What does Diroton help with?

You can take the medicine for the treatment of any illness. Instructions from standstill see the steps:

• essential, renovascular arterial hypertension;
• acute myocardial infarction;
• chronic heart failure;
• diabetic nephropathy (the drug reduces albuminuria in insulin-dependent diabetes).

How to take Diroton

The tablets are taken daily and taken daily. For essential hypertension, take 10 mg, the booster dose is 20 mg, the maximum dose is 40 mg. The effect of therapy becomes noticeable after 0.5-1 month of taking the tablets. If the result is insufficient, you can combine Diroton with other antihypertensive drugs.

If, before treatment with the drug, the patient has taken off diuretics, they should be taken after 2-3 days. As this is not possible, the daily dose of Diroton is 5 mg per dose. For renovascular hypertension, 2.5-5 mg per dose is prescribed. In case of impaired functioning or nitric deficiency, the dose of lisinopril is determined individually, depending on the clearance and level of creatinine.

According to the instructions, if the patient has chronic heart failure, then the initial dose is 2.5 mg per dose. Dosage can be gradually increased after 3-5 days to 5-20 mg, which can be maintained. If diuretics are taken at the same time, their dose is reduced. Before using the vegetable, it is necessary to monitor the level of sodium and potassium in the blood, erythrocyte sedimentation rate (erythrocyte sedimentation rate).

For acute infarction, 5 mg is prescribed for the first and second dose, 10 mg for the third, and a supporting dose of 10 mg for a course of at least 1.5 months. For low systolic pressure (less than 120 mmHg), a low dose of 2.5 mg per dose is prescribed. When the reading is reduced to 100 mm Hg. Art. The maintenance dose is reduced to 5 mg per dose, and to 90 mmHg. Art. -The therapy is starting.

For diabetic nephropathy, patients with type 1 diabetes should take 10 mg per dose, gradually increasing the dose to 20 mg. Instructions for sealing Diroton and its particular inserts:

1. Often the pressure decreases with reduced blood pressure due to the use of diuretics, reduced salt intake, dialysis or vomiting. In severe chronic heart failure, the pressure drops sharply. In such patients, treatment with Diroton should be carried out with care. Similar rules should be followed when treating patients with ischemic heart disease and cerebrovascular insufficiency.
2. A transient hypotensive reaction does not lead to a change in the current dose of medication.
3. Following the instructions, before starting therapy, monitor the sodium concentration and replace the volume of food and food.
4. Symptomatic arterial hypotension occurs due to bed rest and the syndrome is associated with internal administration of physiotherapy.
5. According to the instructions, you cannot take tablets if you have cardiogenic shock or proteinuria.
6. In case of bilateral stenosis of the arteries or stenosis of a single artery, self-induced hypotension can lead to a decrease in the function of the arteries.
7. In some patients, during therapy with Diroton, angioneurotic swelling of the face, lips, tongue, and ends developed. It can be relieved by taking antihistamines, administering epinephrine or adrenaline, or glucocorticosteroids.
8. When carrying out desensitization against arthropod allergens, treat with ACE inhibitors to eliminate hypersensitivity reactions.
9. Toward the hour of bathing, a dry, hacking cough may appear.
10. During therapy with the drug, it is recommended not to drink alcohol, so be careful when playing sports.
11. If side reactions develop from the side of the central nervous system, it is possible to avoid transport.

When you are pregnant

Diroton is a drug that is contraindicated for vaginosis, since its active substance is detected in the placenta. If the patient, who refuses treatment with the drug, becomes sick, the therapy is interrupted earlier. If the use of ACE inhibitors occurs in the 2nd and 3rd trimesters, the fetus may experience decreased tension, the appearance of nicotine deficiency, hyperkalemia, and cranial hypoplasia. Some types of therapy can lead to intrauterine death of the embryo. Suspension is not recommended by the instructions for breastfeeding.

Medical mutualism

The instructions for taking Diroton describe its drug interactions with other drugs. Combinations and effects:

1. The use of potassium-sparing diuretics, spornolactone, amiloride, triamterene, potassium preparations, potassium-based salt substitutes increases the risk of hyperkalemia.
2. Combage to the drug Z β-adreno-blocks, blockers of the rolled kalzivikh canal, diraretics, gypotentic bolts, vasodilators, phenothysin, triciklichny antidepressants, Etanol, Barbiliturates of the yogo gpotentenziv era.
3. A one-time use of Diroton with gold preparations can lead to fatigue, hyperemia, arterial hypotension, and vomiting.
4. Non-steroidal antihypertensive drugs, estrogen, adrenomimetics reduce the antihypertensive power of the drug.
5. The combination of tablets with lithia drugs will increase the cardiotoxicity and neurotoxicity of lithia.
6. Antacids and cholestyramine reduce the absorption of lisinopril.
7. The drug can potentiate the neurotoxic effect of salicylates, weaken the effects of oral hypoglycemic drugs, norepinephrine, epinephrine, antigout drugs, oral contraceptives. It increases the possibility of developing side effects of cardiac glycosides, peripheral muscle relaxants, and reduces the excretion of quinidine.
8. The combination of Diroton and Methyldopa causes hemolysis.

Side activities

The instructions for use of the drug indicate side effects that may develop during the course of therapy. It is clear to them:

• myocardial infarction, decreased pressure and blood flow, heart failure, chest pain, bradycardia, tachycardia, orthostatic hypotension;
• boredom, increased activity of liver enzymes, vomiting, hyperbilirubinemia, abdominal pain, nausea, dry mouth, hepatitis, diarrhea, pancreatitis, dyspepsia, impaired taste, anorexia;
• hair loss (alopecia), urticaria, skin itching, photosensitivity, increased sweating;
• confusion of information, mood instability, cramping, paresthesia, drowsiness, increased fatigue;
• apnea, dyspnea, bronchospasm, dry cough;
• erythrocytopenia, leukopenia, thrombocytopenia, anemia, agranulocytosis, neutropenia;
• allergy, angioedema, vasculitis, eosinophilia, anaphylactic shock;
• decreased potency, uremia, anuria, oliguria;
• hyper-or hypokalemia, hypertriglyceridemia, hyponatremia, hypercholesterolemia, hypomagnesemia, hyperuricemia, hypochloremia, hypercalcemia;
• arthralgia, myalgia, arthritis;
• fever;
• chronic gout.

Overdose

Symptoms of overdose of tablets are described in the instructions as decreased tension, dry mouth, increased abrasiveness, decreased secretion, and restlessness. To bathe the patient, rinse the scutum, give active fluids, place the patient in a horizontal position with raised legs, and administer plasma exchange agents. You can remove excess lisinopril for additional hemodialysis.

Contraindicated

Barriers to the diagnosis of Diroton include a history of idiopathic angioneurotic lesion, Quincke's lesion, age up to 18 years, increased sensitivity to the components of the warehouse or other ACE inhibitors. The instructions allow you to use caution when:

• stan after transplantation of nirka;
• hypertrophic obstructive cardiomyopathy;
• nirka deficiency;
• aortic stenosis;
• scleroderma, systemic red sheep;
• primary hyperaldosteronism;
• ischemic heart disease;
• arterial hypotension;
• lack of cerebral blood circulation;
• suppressed cystic cerebral hematopoiesis;
• hyponatremia;
• at the summer age.

Think about selling and saving

You can get Diroton for a prescription. Keep it at a normal temperature of 15-30 degrees for three periods.

Analogs

You can replace the medication with other drugs from the ACE inhibitor group with the same active ingredient. It is clear to them:

• Aurolaise is a drug against hypertension;
• Vitopril – tablets for reducing arterial pressure;
• Dapril is an antihypertensive drug based on the same component;
• Lizinocor is a drug for the treatment of hypertension.

What’s better – Diroton and Lisinopril

Analog of Diroton Lisinopril similar to the original. Both drugs are available in tablet format and are taken once per dose; diroton is prescribed at 10 mg per day, and lisinopril at 5 mg per day. The effect of both medications develops over 2-4 days of treatment. In other respects, the indications, contraindications and effects on the body of the drugs are similar, since they, however, still have active speech.

Price

You can buy Diroton tablets via the Internet or pharmacies for a price, depending on the amount of the active ingredient in the package. Estimated prices in Moscow:

Concentration of lisinopril, number of tablets per patient	Internet price list, rubles	Pharmacy price, rubles
10 mg 56 pcs.
20 mg 56 pcs.
20 mg 28 pcs.
10 mg 28 pcs.

Due to its pharmacology, Diroton belongs to the group of angiotensin converting factor or ACE inhibitors.

When taken, it reduces the volume of the atrial support, which does not affect the frequency of the heart rate.

When taking nitric acid, blood flow increases, thereby increasing the volume of blood that passes through the patient’s heart to the heart.

Formi vypusku, warehouse

Available in the form of tablets, taken instead of the active ingredient in 4 forms:

• 2.5 mg. Round tablets, white color. The disc is marked “2.5” on one side, and on the other side;
• 5 mg. Flat disk in white color. On one side there is a marking “5”, on the other side there is a vest;
• 10 mg. This form of release is almost double-shaped and has a white or slightly white color. On one side of the tablet is marked “10”, on the other - rizika;
• 20 mg. Double pentagonal white or even white tablets. Marking “20” on one side and a rizoik on the other.

The active ingredient in the tablets is lisinopril, and the additional ingredients are talc, magnesium stearate, corn starch, manitol, calcium hydrogen phosphate dihydrate. The percentage of supply of warehouse medicinal drugs is in direct storage in the form of release.

I will accept the order

As a starting therapy for essential hypertension diseases, a dose of 10 mg per dose is recommended, with a maximum additional dose of 40 mg. For supportive therapy, the dosage should be 20 mg.

Often the patient suffers, so that the pressure decreases completely and asks the doctor to increase the dosage.

So we are glad to know that the maximum effect from taking the liquids occurs after only 2-4 days with steady use.

And if the effect is still constant, then to reduce the pressure, a different product is used. Before starting to take lisinopril, patients should take diuretics for about 2-3 days.

If it is impossible to work, then the starting dose of diroton is reduced to 5 mg. na dobu.

For renovascular hypertension, the starting dose should be 2.5-5 mg. In case of heart failure, the drug is combined with diuretics.

In case of chronic hemodialysis or narcotic deficiency, the starting dose varies according to creatinine levels:

• Clearance is still 30-70 ml/m, then the dose is 5-10 mg per dose;
• With a clearance of 10-30 ml/m – 2.5-5 mg/m.
• If the clearance is less than 10 ml/s, then take less than 2.5 mg/s per ear of the disease.

During this process, total control over the functionality of the patient's device is required.

In all cases, the intake of liquids is carried out in one program - 1 time per day. Drink with a small amount of water. The appointment must be carried out within one hour. When taken, it is not obligatory to prepare before eating.

I must carry out the procedure for taking the drug at the wound’s earliest hour.

Coronavirus power or pharmacological action

The main component of the drug is lisinopril, which has hypotensive and peripheral vasodilating properties. In a word, it effectively reduces arterial pressure.

Also, during the systematic use of a drug, the level of blood pressure decreases, as well as the tension in the pulmonary capillaries, as a result of which the blood volume increases.

The drug begins to work no earlier than 1 year after taking it, and its effect is maintained over time.

Trivala is most effective for the drug after regular use over a two-month course of treatment.

Diroton is prescribed for patients diagnosed with:

1. Heart failure in a chronic form as part of complex therapy;
2. In acute myocardial infarction, the kidney after the attack;
3. For chronic hypertensive illness;
4. To reduce albuminuria in diabetic nephropathy.

Side effects

Taking medication on your own without consulting a doctor is not recommended, and you may experience side effects of an offensive nature:

1. Chest pain, bradycardia, tachycardia, myocardial infarction, sharp decrease in arterial pressure;
2. Reactions of an allergic nature in the appearance of swelling in the form of weeds, itching, as well as sweating, swelling of the ends and skin, vasculitis;
3. The drug may cause sputum pain, boredom, diarrhea, vomiting, dry mouth, mucus problems, hepatitis in cholestatic or hepatocellular forms, symptoms of pancreatitis or pancreatic signs;
4. The respiratory system may react to the drug with symptoms of dry cough, apnea and bronchospasms;
5. The central nervous system is characterized by such symptoms as increased fatigue, decreased concentration of energy, nervous tics, drowsiness, asthenic syndrome, confusion of fluid;
6. Symptoms of neurological deficiency, uremia, decreased potency are typical for the sechostatic area;
7. Reduced hemoglobin in the blood, increased cerebral hemoglobin, neutropenia, thrombocytopenia;
8. Fever, persistent gout.

When overdosed, the drug causes symptoms of dry mouth, increased blood pressure, difficulty in bleeding, drowsiness, and similar fatigue and restlessness.

Contraindicated

It is categorically against taking Diroton if you have an allergy to the main components of the drug, lisonopril or similar elements. Decompensated nitric deficiency is also a problem when prescribed the drug. It is unacceptable to administer diroton to children who have reached the age of 16 years.

Patients who have undergone surgery for transplantation of the artery, which may be associated with stenosis of the artery, with primary aldosteronism, stenosis of the aortic hilum, with changes in parameters of a biochemical nature, such as movements of the Even potassium.

Diroton is blocked until drying during the period of gestation and further breastfeeding.

After taking the drug, you should not travel by car or other means of transport, or do any other work related to the risk.

Level of compatibility of diroton with other medications

One-time use of diroton with potassium-sparing drugs is unacceptable, as there is a risk of hyperkalemia.

In order to take the drugs immediately, systematic laboratory tests are required to monitor the level of potassium in the blood serum.

There are a lot of patients who may have a history of nitric deficiency.

When taken in combination with diuretics and hypertensive drugs, the hypertensive effect becomes stronger.

Immediate use of gold preparations is accompanied by arterial hypotension, facial hyperemia, fatigue and vomiting.

One-time use with non-steroidal anti-inflammatory drugs prevents a decrease in the antihypertensive effect of lisinopril.

Access from pharmacies and savings

Price

The drug Diroton is sold in dosages of 2.5 – 5.10 and 20 mg, the number of tablets per package is 14, 28, 56 pcs.

Diroton is found in the middle price range. Depending on the manufacturer's regulations and the number of tablets in the package, the cost of the drug will be 90 to 650 rubles.

In Kiev, the volume of diroton varies from 70 to 250 g.

Analogs

Due to the absence of the drug, for other reasons, it is possible that its analogues – medications, similar in composition and spectrum of action, which belong to the inhibitory group of drugs.

Thus, among the closest analogues can be called hydrochlorothiazide - a drug that has antihypertensive properties, which combines a decrease in arterial pressure with an additional dilation of arterioles.

Among other analogues we can name:

• Diropres;
• Zonixem;
• Lizacard;
• Lisinaton;
• Lizonorm;
• Sinopril.

ACE inhibitor

Dyucha rechovina

Lisinopril

Release form, warehouse and packaging

Pigulki white or slightly white color, flat disc shape with a chamfer, with “2.5” markings on one side and with a rhizome on the other.

Additional ingredients: magnesium stearate, talc, corn starch, calcium hydrogen phosphate dihydrate.

Pigulki white or slightly white color, flat disc shape with a chamfer, with “5” markings on one side and with a rhizome on the other.

14 pcs. - blisters (2) - cardboard packs.

Pigulki white or slightly white color, quarter-cut, doubly, with “10” markings on one side and with a ricochet on the other.

Additional ingredients: magnesium stearate, talc, manitol, corn starch, calcium hydrogen phosphate dihydrate.

14 pcs. - blisters (2) - cardboard packs.
14 pcs. - blisters (4) - cardboard packs.

Pigulki white or slightly white color, pentagonal, double-shaped, with markings “20” on one side and with a rhizome on the other.

Additional ingredients: magnesium stearate, talc, manitol, corn starch, calcium hydrogen phosphate dihydrate.

14 pcs. - blisters (2) - cardboard packs.
14 pcs. - blisters (4) - cardboard packs.

Pharmacological action

Action mechanism

Lisinopril inhibits the enzyme peptidyl peptidase (angiotensin-converting enzyme (ACE)), which catalyzes the conversion of angiotensin I to the vasoconstrictor peptide, angiotensin II. Angiotensin II also stimulates the secretion of aldosterone by the supragraneal cortex. Inhibition of ACE leads to a decrease in the concentration of angiotensin II, as a result of which vasopressor activity decreases and the secretion of aldosterone changes. A decrease in the balance can lead to an increase in potassium levels in the blood.

Clinical effectiveness and safety

Arterial hypertension

It is important that the mechanism by which lisinopril reduces arterial pressure (AT) is based primarily on suppression of the renin-angiotensin-aldosterone system (RAAS), lisinopril reduces arterial pressure in patients with arterial hypertension with low renin concentration. ACE is identical to kininase II, an enzyme similar to bradykinine, which is also a potent vasodilator peptide. Lisinopril interferes with the degradation of bradykinine.

The beginning of antihypertensive treatment - after 1 year. The maximum effect is observed after 6-7 years and lasts for 24 years. The severity of the effect also depends on the dose size. In case of arterial hypertension, the effect is visible in the first days after the start of treatment; a stable effect develops after 1-2 months. With chronic administration of lisinopril, the severity of myocardial hypertrophy and the walls of resistive arteries changes. With rapid administration of lisinopril, there is no risk of significant displacement of arterial pressure.

Chronic deficiency

The effect of lisinopril on sickness and mortality in CHF was influenced by the comparison of high and low doses of lisinopril (32.5 mg or 35 mg 1 time per dose and 2.5 mg or 5 mg 1 time per dose) during the middle period of the attack. caution, which is equivalent to 46 months (for those who see) patients). The high dose of lisinopril provided a 12% reduction in the risk of combined endpoints: mortality from all causes and hospitalization from all causes (p = 0.002) and an 8% reduction in the risk of death from all causes x reasons and hospitalization due to cardiovascular disease (p = 0.036) equalized with a low dose. There was a decrease in the risk of death from all causes (8%; p=0.128) and death from cardiovascular disease (10%; p=0.073). In a retrospective analysis, the number of hospitalizations due to CHF decreased by 24% (p = 0.002) in patients who took high doses of lisinopril compared with patients who took low doses. The overall profiles of adverse events in patients treated with high or low doses of lisinopril were similar in both character and clinical parameters. Predicted unforeseen phenomena that resulted from ACE inhibition, such as hypotension and impaired function of the nervous system, responded well to correction and rarely resulted in treatment discontinuation. Cough improved less often in patients who took high doses of lisinopril than in patients who took low doses.

ACE inhibitors reduce the discomfort of life in patients with CHF, increase the progression of dysfunction of the left sac in patients who have suffered a myocardial infarction without clinical manifestations of the heart ї insufficiency.

Acute myocardial infarction

Lisinopril reduces bleeding of ischemic myocardium. The efficacy and safety of lisinopril (up to 10 mg per dose) was assessed in patients with acute myocardial infarction (AMI). Lisinopril, which was prescribed in the first 24 years after GIM, lasting 6 years, resulted in a statistically significant reduction in global mortality by 11% (2p = 0.03).

Diabetic nephropathy

The drug lisinopril, which reduces arterial pressure, reduces albuminuria. In a double-blind, randomized, multi-center follow-up study comparing lisinopril with a calcium channel blocker in patients with arterial hypertension and type 2 diabetes in the early stage of nephropathy, which manifests itself as microalbuminuria, 10-20 mg of lysine reduces systolic/diastolic AT by 13/10 mmHg, and excretion from the section by 40%.

In patients with hyperglycemia, lisinopril helps to normalize the function of the damaged glomerular endothelium.

Lisinopril does not increase blood concentrations in patients with diabetes and does not lead to frequent episodes of hypoglycemia.

Pharmacokinetics

Vsmotuvannya

The average absorption rate of lisinopril is approximately 25% with significant inter-individual variability (6-60%). Hedgehogs do not respond to lisinopril infusion.

Rozpodil

After internal administration, the maximum concentration (Cmax) of lisinopril in plasma is reached after 7 years. Lisinopril does not bind to plasma proteins, due to the circulating angiotensin-converting enzyme. Penetration through the blood-brain and placental barrier is low.

Metabolism

Lisinopril is not metabolized.

Vivedennya

Lisinopril is eliminated without any change in appearance. After multiple doses, the effective dosage period (T 1/2) for lisinopril becomes 12.6 years. The clearance of lisinopril in healthy volunteers is approximately 50 ml/min. Lisinopril can be removed from the body through additional hemodialysis.

Pharmacokinetics in special groups of patients

Patients with chronic heart failure. In patients with CHF, absorption and clearance of lisinopril is reduced. In this category of patients, the absolute bioavailability of lisinopril decreases by approximately 16%; however, AUC (area under the concentration-hour curve) increased by an average of 125% compared with healthy volunteers.

Patients with acute myocardial infarction. In patients with acute myocardial infarction, lisinopril reaches TS max (TC max) of 8-10 years.

Patients with nitric deficiency. Impaired functions may lead to an increase in the AUC and T1/2 of lisinopril, but the changes become clinically significant if the glomerular filtration rate (GFR) drops below 30 ml/xv/1 .73 m 2 flat surface of the body. With mild to moderate nitric deficiency (creatinine clearance (CR) 31 to 80 ml/h), the average AUC value increases by 13%, the same as for severe nitric deficiency (CC 5 up to 30 ml/x) beware of an increase in the average AUC value in 4.5 times.

Patients with liver failure. In patients with liver cirrhosis, lisinopril absorption is reduced (by approximately 30%), drug exposure (AUC) is increased (by approximately 50%), equal to that of healthy volunteers through decreased clearance.

Elderly patients (over 65 years of age). In elderly patients, the concentration of lisinopril in the blood plasma and the area under the concentration-hour curve was 2 times higher than in young patients.

Showing

• essential and renovascular arterial hypertension (in the form of monotherapy or in combination with others);
• chronic heart failure (in combination therapy);
• early treatment of acute myocardial infarction (in patients with stable hemodynamic indicators for the first 24 years to prevent dysfunction of the left ventricle and heart failure);
• Diabetic nephropathy (by means of decreased albuminuria in patients with type 1 diabetes with normal arterial pressure and in patients with type 2 diabetes with arterial hypertension Ieyu).

Contraindicated

• increased sensitivity to lisinopril and other components of the drug;
• history of angioedema (including those associated with the use of ACE inhibitors);
• Idiopathic angioneurotic plaque;
• Quincke's slump;
• vagusness;
• period of breastfeeding;
• age to 18 (efficiency and safety have not been established);
• immediate treatment with aliskiren and drugs that replace aliskiren in patients with diabetes and/or mild or severely impaired liver function (GFR less than 60 ml/xv/1.73 m 2 area i surface of the body);
• immediate treatment with angiotensin II receptor antagonists (ARA II) in patients with diabetic nephropathy.

With caution: aortic stenosis, hypertrophic obstructive cardiomyopathy, mitral stenosis, bilateral stenosis of the nitric arteries, stenosis of the unilateral artery, stoma after nirconic transplantation, nirconic insufficiency (creatinine clearance less than 30 ml/h ), primary hyperaldosteronism, arterial hypotension, arterial hypotension, immediate administration of alopurinol or procainamide , or a combination of significant composting factors (risk of development of neutropenia and agranulocytosis), hyponatremia (risk of development of arterial hypotension in patients who are on low-salt diet on a salt-free diet), hypovolemic conditions (including diarrhea, sickness of tissue (including including systemic bloodworm, scleroderma), vascular diabetes, gout, hyperuricemia, hyperkalemia, ischemic heart disease, cerebrovascular disease (including insufficiency of cerebral blood flow), chronic heart failure, hemodialysis with high-permeability high-dialysis membranes (AN69 ), summer age (over 65 years of age), immediate treatment with potassium-sparing diuretics, potassium preparations, potassium salt substitutes, immediate treatment with lithium preparations, severe allergy history , one-time desensitization and low-density lipoprotein apheresis (LDL-apheresis) with vicors dextran sulfate, cured during major surgical procedures or during general anesthesia, cured in patients of black race.

Dozuvannya

The drug should be taken internally 1 time per dose, regardless of the meal, most importantly at the same hour of dosing.

To adjust the lower dosing regimen to select the optimal dose of lisinopril, for all indications, before starting the drug, take the drug Diroton tablets 2.5 mg, 5 mg, 10 mg and 20 mg.

Essential hypertension

The recommended daily dose of lisinopril for patients who do not take antihypertensive medications is 10 mg 1 time per dose. For the duration of the therapeutic effect, the skin dose should be increased over 2-3 days by 5 mg per dose to the average therapeutic dose of 20-40 mg per dose. The initial booster dose is 20 mg 1 time per dose; If there are signs of AT, the dose can be increased to 30 mg per dose. The maximum dose of lisinopril is 40 mg 1 time per dose (in clinical studies, the maximum dose of lisinopril was 80 mg per dose; increasing the dose above 40 mg per dose did not lead to a further decrease in arterial pressure). The therapeutic effect develops after 2-4 days of treatment, which is followed by higher doses. If the therapeutic effect is insufficient, lisinopril can be combined with other antihypertensive drugs.

If the patient has previously stopped treatment with diuretics, they should be taken 2-3 days before starting lisinopril administration. However, it is difficult to say that the daily dose of Diroton should not exceed 5 mg per dose. After taking the first dose, the doctor will need to be careful for several years, because You may experience a decrease in arterial pressure (the maximum effect appears 6 years after taking the drug).

Renovascular hypertension and other conditions associated with increased activity of the RAAS

The recommended daily dose is 2.5-5 mg/dose, at which it is recommended to ensure careful medical care of the patient, control of arterial pressure, blood function, and potassium concentration in the blood serum. The booster dose is selected carefully depending on the dynamics of arterial pressure, and the patient must be under constant medical supervision.

The fragments of lisinopril are eliminated by nircami, the dose of the drug Diroton should be stored according to the QC indicators: with CC 30-80 ml/xv- 5-10 mg/day, at CC 10-30 ml/xv- 2.5-5 mg/day, at CC less than 10 ml/xv, zocrema. in patients undergoing hemodialysis- 2.5 mg per doba. The maintenance dose is determined by clinical effect and is selected by regular monitoring of indicators of blood function, potassium and sodium concentrations in the blood.

Recommendations for dosage patients with mild or mild liver failure have not yet been dissected, therefore, when selecting doses for such patients, proceed with caution and start with the minimum possible dose.

Chronic heart failure

For CHF, the dose of lisinopril should be 2.5 mg once per dose. The first dose of lisinopril should be started under close supervision in order to assess the effect of the drug on AT. The dose of lisinopril was gradually increased by 2.5 mg at intervals of 3-5 days to 5-10-20 mg per dose. It is not recommended to exceed the maximum dose of lisinopril 20 mg (in clinical studies, the maximum dose of lisinopril in patients with CHF was 35 mg 1 time per dose). In case of one-hour treatment with diuretics, change the dose of the diuretic first, if possible.

Before the start of treatment with the drug Diroton and further during the treatment, regularly monitor AT, the function of nirk, the concentration of potassium and sodium in the blood serum, in order to avoid the development of arterial hypotension and associated the function of the nirok is impaired.

Early treatment of acute myocardial infarction

Initial therapy (first 3 to acute myocardial infarction)

In the first 24 years after acute myocardial infarction, lisinopril 5 mg is prescribed once. After 24 years (one dose), 5 mg lisinopril is prescribed once, after 48 years (two doses) - 10 mg lisinopril once.

It is not possible to start treatment if the systolic arterial pressure is less than 100 mm Hg. Patients with low systolic blood pressure (≤120 mmHg) are given a lower dose of lisinopril – 2.5 mg once daily after acute myocardial infarction.

Supportive therapy

The booster dose of lisinopril should be 10 mg once per dose. Likuvannya course – not less than 6 years. The next step is to evaluate the usefulness of continued therapy. Patients with symptoms of heart failure are advised to continue taking lisinopril.

In case of development of arterial hypotension (systolic arterial pressure ≤100 mm Hg), the dose of lisinopril should be immediately reduced to 5 mg, if necessary – to 2.5 mg. In cases of severe severe decrease in blood pressure (systolic blood pressure below 90 mm Hg for more than 1 year), lisinopril should be taken.

Diabetic nephropathy

The initial dose of lisinopril should be set to 10 mg per dose, and if necessary, increase to 20 mg per dose until the target diastolic blood pressure is achieved (diastolic blood pressure is less than 75 mm Hg in a sitting patient). in type 1 diabetes and below 90 mm. ). Hg, in a sedentary position in patients with type 2 diabetes).

For patients with diabetic nephropathy, the maximum dose of Diroton 30 mg is 1/2 tablet/dose (15 mg lisinopril).

At Impaired nirofunction (CC less than 80 ml/xv) The corn dose is indicated separately from QC (wonderful).

U elderly patients (over 65 years of age) The drug should be congealed with care.

Side activities

During treatment with lisinopril, adverse drug reactions (ADRs) were reported. ADRs presented in systemic organ classes are consistent with MedDRA classification and the frequency of culprits: very often - 1/10 sign (≥10%), often - 1/100 sign (≥1%, less<10%), нечасто - 1/1000 назначений (≥0.1%, но <1%), редко - 1/10 000 назначений (≥0.01%, но <0.1%), очень редко - менее 1/10 000 назначений (<0.01%), частота неизвестна - невозможно оценить на основании имеющихся данных.

Within the skin frequency group, unrelated reactions are presented in order of decreasing severity.

On the side of the hematopoietic system: very rarely - suppressed cystic cerebral hematopoiesis, agranulocytosis, leukopenia, neutropenia, thrombocytopenia, hemolytic anemia, anemia, lymphadenopathy.

On the side of the immune system: very rarely – autoimmune disorders; frequency unknown – anaphylactic/anaphylactoid reaction.

On the side of the endocrine system: rarely – syndrome of inadequate secretion of antidiuretic hormone.

On the side I will exchange speeches and food: very rarely – hypoglycemia.

Mental breakdown: infrequently – mood changes, sleep disturbances, hallucinations; rarely – mental disorders; frequency of the unknown – depression.

On the side of the nervous system: often - confusion, headache; uncommon – vertigo, paresthesia, dysgeusia; rarely – confusion, drowsiness, blood vessels, back pain, parosmia (impaired sense of smell); frequency of the unknown - incomprehensibility.

On the side of the cardiovascular system: often - a decrease in arterial pressure, orthostatic hypotension and symptoms associated with it; infrequently – myocardial infarction (as a result of a pronounced decrease in blood pressure in groups of patients with advanced risk), tachycardia, accelerated heart rate, acute disorder of cerebral blood flow (as a result of a pronounced decrease in blood pressure in groups of patients) ntiv pіdvushchennogo rhiziku), Raynaud's syndrome.

On the side of the dichotomy system: often – cough; infrequently – pain in the breasts, rhinitis; very rarely – bronchospasm, allergic alveolitis/eosinophilic pneumonia, sinusitis.

On the side of the grass system: often – diarrhea, vomiting; infrequently - abdominal pain, tiredness, swelling; rarely – dry mouth; very rarely - pancreatitis, anorexia, angioneurotic intestinal swelling.

On the side of the liver and the yellow paths: very rarely – liver failure, liver-hepatic or cholestatic hepatitis, hepatitis.

On the side of the skin and under the skin fabrics: infrequently - skin visip, itching of the skin; rarely - psoriasis, urticaria, alopecia, hypersensitivity/angioneurotic swelling of the face, hands and feet, lips, tongue, glottis and/or larynx; very rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema richa, pustulosa vulgaris, hyperhidrosis, pseudolymphoma of the skin*.

On the side of the cysto-muscular system: rarely - more at the end.

On the side of the thyroid system: often - impaired function of the eyes; rarely – hypothyroidism deficiency, uremia; very rarely – oliguria/anuria.

On the side of the state organs and mammary organs: infrequently – impotence; rarely – gynecomastia, sexual dysfunction.

Underworld discord and destruction at the place of introduction: infrequently – increased fatigue, asthenia.

Laboratory and instrumental data: infrequently – increased concentration of serum and creatinine in blood syringation, hyperkalemia, increased activity of liver enzymes; rarely – decreased hemoglobin and hematocrit, hyperbilirubinemia, hyponatremia.

* It was reported about a symptom complex that can include one or more of the following symptoms: fever, vasculitis, myalgia, arthralgia/arthritis, positive reaction to antinuclear antibodies (ANA), increased fluid density trocytes (SOE), eosinosia and eosinophilia and other side changes skins

Overdose

Symptoms: data about overdose in people. Symptoms associated with overdose of ACE inhibitors may include arterial hypotension, circulatory shock, electrolyte imbalance, nitric deficiency, hyperventilation, tachycardia, rapid heart rate, palpitations icardia, confusion, anxiety and cough.

Likuvannya: rinsing the vulva, taking activated vugill, giving the patient a horizontal position with raised legs, replenishing the volume of circulating blood (CBV) - internal administration, symptomatic therapy, control of cardiovascular and respiratory functions nal systems, blood volume, control of blood indicators, creatinine and electrolyte levels blood, as well as diuresis. If bradycardia develops and is resistant to drug therapy, placement of a pacemaker is indicated. Lisinopril may be removed from the body in addition to hemodialysis.

Medical mutualism

Suppressive blockade of the RAAS

In patients with atherosclerotic diseases, heart failure or fibrotic diabetes with target organ damage, one-hour therapy with an ACE inhibitor and angiotensin II receptor antagonists (ARA II) is increasing is known to have a high frequency of development of arterial hypotension, restlessness, hyperkalemia and hyperkalemia; deficiency) is due to the stagnation of only one drug that affects the RAAS.

Subsequent blockade (for example, when an ACE inhibitor is combined with ARA II) must be accompanied by close episodes with continuous monitoring of the function of the liver, instead of potassium and regular monitoring of arterial pressure.

Acute administration of ACE inhibitors with drugs to replace aliskiren is contraindicated in patients with fibrotic diabetes and/or mild or severe nitric deficiency (GFR less than 6 0 ml/xw/1.73 m 2 flat body surface) and is not recommended for other patients.

Co-administration of ACE inhibitors with angiotensin II receptor antagonists (ARA II) is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.

Potassium-sparing diuretics, potassium preparations, grub salt substitutes and other medicinal preparations that replace potassium, can be used instead of potassium in blood serum.

With one-hour administration of lisinopril with potassium-sparing diuretics (spironolactone, triamterene, amiloride, eplerenone), potassium preparations or potassium substitutes for grub, kitchen salt and other medicinal products drugs that increase potassium in the blood serum (including ARA II, heparin; and co-trimoxazole ( trimethoprim + sulfamethoxazole)), there is a risk of development of hyperkalemia (especially in patients with impaired thyroid function). Therefore, these combinations are prescribed with caution, under the control of potassium in the blood plasma and the function of the blood.

In elderly patients and patients with impaired function, one-hour use of ACE inhibitors with sulfamethoxazole/trimethoprim was accompanied by severe hyperkalemia, which is important Yes, I was taking trimethoprim, so lisinopril should be used with caution with drugs to replace trimethoprim. regularly monitoring blood plasma potassium instead.

Potassium-sparing diuretics

With one-hour infusion of lisinopril with potassium-sparing diuretics, the hypokalemia caused by their infusion may be reversed.

Other hypotensive drugs

When taken simultaneously with vasodilators, beta-blockers, calcium channel blockers, diuretics and other antihypertensive drugs, the antihypertensive effects of lisinopril increase.

Medicines for the summer

When lisinopril is ingested for one hour with medications, the elimination of toxicity from the body is reduced (the risk of increased cardiotoxicity and neurotoxicity). Simultaneous administration of lisinopril with drugs is not recommended. When it is necessary to stagnate this combination, regularly monitor the concentration of lithium in blood plasma.

Non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors and high doses (≥3 g/dose)

Non-steroidal anti-inflammatory agents (including selective COX-2 inhibitors) and acetylsalicylic acid in doses greater than 3 g/dose reduce the antihypertensive effect of lisinopril.

In some patients with impaired function (for example, in elderly patients or patients with anemia, including those taking diuretics), it is necessary to initiate therapy with NSAIDs (including selective COX-2 inhibitors), immediate stagnation of ACE inhibitors or ARA II may result in impaired function of nitric acid, including the development of acute nitric deficiency and hyperkalemia. These effects call werewolves. The immediate administration of ACE inhibitors and non-steroidal anti-inflammatory drugs should be carried out with caution (especially in patients with advanced age and in patients with impaired function of the brain). Patients are responsible for maintaining adequate strength of life. It is recommended to carefully control the function both on the cob and during the curing process.

The use of lisinopril in combination with acetylsalicylic acid as an antiplatelet agent is not contraindicated.

Hypoglycemic drugs

Concurrent use of lisinopril and insulin, as well as oral hypoglycemic agents, can lead to the development of hypoglycemia. The greatest risk of development is observed during the first stages of severe stagnation, as well as in patients with impaired function of the brain.

Tricyclic antidepressants/neuroleptics/general anesthesia/narcotic drugs

When taken simultaneously with tricyclic antidepressants, neuroleptics, gastric anesthesia, barbiturates, muscle relaxants, an increase in the antihypertensive effect of lisinopril is avoided.

Alpha-beta adrenergic agonists

Alpha-beta adrenergic agents (sympathomimetics), such as epinephrine (adrenaline), isoproterenol, dobutamine, dopamine, may reduce the antihypertensive effect of lisinopril.

Baclofen

Strengthens the antihypertensive effect of ACE inhibitors. Carefully monitor arterial pressure and, whenever needed, adjust the dose of antihypertensive drugs.

Ethanol

When stagnated for one hour, ethanol enhances the antihypertensive effect of lisinopril.

Estrogens

Estrogens weaken the antihypertensive effect of lisinopril through suppression.

Alopurinol, procainamide, cytostatics, immunosuppressants, glucocorticosteroids (for systemic congestion)

The combination of ACE inhibitors with alopurinol, procainamide, and cytostatics increases the risk of developing neutropenia/agranulocytosis.

Preparations of gold

With one-hour administration of lisinopril and gold preparations internally (sodium aurothiomalate), a complex of symptoms is described that includes facial hyperemia, boredom, vomiting and decreased arterial pressure.

Selective inhibitors of renal serotonin storage

Acute coadministration of lisinopril with selective serotonin release inhibitors can lead to severe hyponatremia.

Medicinal drugs that can promote the development of angioedema

mTOR inhibitors (mammalian Target of Rapamycin) (for example, temsirolimus, sirolimus, everolimus)

Patients who simultaneously took ACE inhibitors and mTOR inhibitors (temsirolimus, sirolimus, everolimus) experienced an increased incidence of angioedema.

Dipeptideptidase type IV (DPP-IV) inhibitors (gliptin), for example, sitagliptin, saxagliptin, villdagliptin, linagliptin

In patients who simultaneously took ACE inhibitors and dipeptidyl peptidase inhibitors type IV (gliptin), there was an increased incidence of angioedema.

Estramustin

Increased incidence of angioedema with one-hour treatment with ACE inhibitors.

Neutral endopeptidase (NEP) inhibitors

It was reported that there was an increase in the risk of developing angioedema with one-hour administration of ACE inhibitors and racecadotril (enkephalinase inhibitor).

When ACE inhibitors are ingested for one hour with drugs, in addition to sacubitril (a nelysin inhibitor), the risk of developing angioedema increases, after which the use of drugs is contraindicated. . ACE inhibitors should be prescribed no earlier than 36 years after discontinuation of medications such as sacubitril. The use of drugs that replace sacubitril is contraindicated in patients who are taking off ACE inhibitors, as well as for a period of 36 years after the removal of ACE inhibitors.

Tissue plasminogen activators

Observational studies revealed an increased incidence of angioedema in patients who received ACE inhibitors after treatment with alteplasia for thrombolytic therapy of ischemic stroke .

Pharmacokinetic interactions

Antacids and cholestiramine reduce the uptake of lisinopril into the GCT.

special inserts

Symptomatic arterial hypotension

The manifestation of a decrease in AT most often occurs with a decrease in BCC, for example, as a result of taking diuretics, a diet with limited kitchen salt, dialysis, diarrhea or vomiting. In patients with CHF, there may be a decrease in arterial pressure due to the presence of nitric deficiency or without it. It is most often detected in patients with severe CHF, as a result of ingestion of large doses of diuretics, hyponatremia, or impaired thyroid function. In such patients, the trace should be taken under close medical supervision (with caution when adjusting the dose of the drug and diuretics). The same recommendations apply to patients with ischemic heart disease, cerebrovascular insufficiency, in whom a sharp decrease in arterial pressure can lead to myocardial infarction or stroke. Transient hypotension is not a contraindication for taking the current dose of the drug. Before the start of treatment, if possible, after replenishing the volume of blood volume and/or the concentration of sodium in the blood serum, conduct close monitoring of patients who experience the development of symptomatic hypotension in the group of advanced rhizics. ії for treatment and dose correction. When arterial hypotension develops, the patient should be placed on his back and, if necessary, given an internal infusion of physiological treatment.

The transient hypotensive reaction is not contraindicated until further administration of the drug Diroton, which can therefore be administered after the increase in arterial pressure after an increase in blood volume.

Arterial hypotension in acute myocardial infarction

Treatment with Diroton is contraindicated in cases of cardiogenic shock and acute myocardial infarction, since the use of a vasodilator can significantly worsen hemodynamic parameters, for example, if systolic BP does not exceed 100 mm Hg.

In acute myocardial infarction, treatment with lisinopril should not be started in patients with signs of neuronal dysfunction, as measured by serum creatinine concentrations that exceed 177 µmol/l, and/or proteinuria, which exceeds 500 mg/24 year. hour of therapy with lisinopril (the concentration of creatinine in serum, which exceeds 265 µmol/l or is 2 times higher than the same value before the start of treatment), the doctor is obliged to consider the duration of the session lisinopril.

Aortic and mitral valve stenosis/hypertrophic cardiomyopathy

As with other ACE inhibitors, lisinopril should be used with caution in patients with mitral valve stenosis and obstruction of the left ventricle tract, such as aortic stenosis or hypertrophy for cardiomyopathy.

Nirkova lack of availability

In cases of nitric deficiency (QC<80 мл/мин) начальную дозу лизиноприла следует подбирать в зависимости от КК у пациента, а затем в зависимости от реакции пациента на лечение. Рутинный контроль концентрации калия и креатинина в сыворотке крови является частью стандартной медицинской практики лечения таких пациентов.

In some patients with bilateral stenosis of the unilateral arteries or stenosis of the unilateral artery, when ACE inhibitors were removed, there was an increase in the concentration of steroid and creatinine In cases of bleed, as a rule, a werewolf with drunkenness. This is especially possible in patients with nitric deficiency. In cases of concomitant vasorenal arterial hypertension, there is a risk of developing severe hypotension and nitric deficiency. In such patients, treatment should be started under close medical supervision at low doses and the dose titrated carefully. Remnants of treatment with diuretics may cause the development of vitally important conditions, the diuretic should be reduced, and its function should not be controlled during the first course of therapy with lisinopril.

In some patients with arterial hypertension without severe anterior vasorenal hypertension, there was an increased concentration of serum creatinine and creatinine in the serum, sometimes slightly and transiently , especially in these episodes, if lisinopril was combined with a diuretic at the same time. This is especially possible in patients with anterior nitric deficiency. A reduced dose of either diuretic or lisinopril may be necessary.

Increased sensitivity, angioedema

Angioneurotic swelling of the face, ends, lips, tongue, epiglottis and/or larynx was rarely observed in patients who were treated with ACE inhibitors, including the drug Diroton. Angioneurotic swelling may disappear at any time during the hour of bathing. In such cases, carefully discontinue the drug Diroton, provide appropriate treatment and ensure medical care until further regression of symptoms. In case of seizures with a swollen tongue, which is not accompanied by respiratory failure, patients may need extreme caution, and treatment with antihistamines and corticosteroids may be insufficient. Angioedema, which is accompanied by swelling of the larynx, can lead to death. Swelling of the tongue, vocal folds or larynx can lead to obstruction of the respiratory tract. When such symptoms appear, simple therapy is required: administration of epinephrine (0.3-0.5 ml dilution of epinephrine (adrenaline) 1:1000 subcutaneously, administration of glucocorticoids, antihistamines) and/or protection of permeability of the trails. The patient is responsible for staying under medical supervision until symptoms continue to subside.

In very few cases of aphid therapy with ACE inhibitors, angioedema of the intestine developed. In this case, patients had pain in the abdomen, as an isolating symptom, or in the presence of boredom and vomiting, in certain episodes without anterior angioedema, and with a normal level of C1-esterase. The diagnosis is made using computed tomography of the cranial region, ultrasound examination or surgical intervention. Symptoms began after taking an ACE inhibitor. Therefore, in patients with abdominal pain who are recovering from ACE inhibitors, when carrying out differential diagnostics it is necessary to take into account the possibility of developing angioedema in the intestines.

Patients with a history of angioedema unrelated to treatment with ACE inhibitors may be at greater risk of developing angioedema when the inhibitor is used. ACE (division "Contraindications").

ACE inhibitors cause angioedema in patients of black race more often than in patients of other races.

Immediate administration of mTOR inhibitors (mammalian Target of Rapamycin - meta rapamycin in the cells of sedatives), for example, sirolimus, everolimus, temsirolimus

Patients who are discontinued simultaneously with ACE inhibitors and mTOR inhibitors (eg, sirolimus, everolimus, temsirolimus) may have an increased risk of developing angioedema (eg, mucous membranes of the tongue or tongue, with or without dysphagia).

Anaphylactoid reactions in patients undergoing hemodialysis

Anaphylactoid reactions have been reported in patients undergoing dialysis with high-flux, high-permeability high-flow dialysis membranes (for example, AN69) and the inhibition was immediately removed APF tor. Such patients should consider the importance of using a different type of dialysis membrane or a different class of antihypertensive drug.

Anaphylactoid reactions during apheresis of low-density lipoproteins (LDL)

In isolated cases, patients who were treated with ACE inhibitors during LDL apheresis with dextran sulfate experienced life-threatening anaphylactic reactions. Such reactions can be avoided by taking an ACE inhibitor for an hour before the skin apheresis procedure.

Desensitization

Sometimes, patients who took ACE inhibitors developed anaphylactic reactions during desensitization of the open epithelium (for example, os or bjil). Such life-threatening situations can be avoided with the immediate use of an ACE inhibitor.

Nirka transplantation

There is no evidence of lisinopril use in patients after breast transplantation. Treatment with lisinopril in post-transplant patients is not recommended.

Pechinkova deficiency

In very isolated cases, taking ACE inhibitors was accompanied by a syndrome that began with cholestatic hepatitis, progressing to fulminant necrosis of the liver and (inodes) leading to a fatal result. The mechanism of development of this syndrome of mental retardation. Patients who are weaning off lisinopril and who are developing redness or significantly increased liver enzyme activity should begin taking lisinopril and should be treated under appropriate medical supervision.

Neutropenia/agranulocytosis

Neutropenia/agranulocytosis, thrombocytopenia and anemia have been reported in patients treated with ACE inhibitors. Neutropenia rarely develops in patients with normal function without other complicating factors. Neutropenia and agranulocytosis are reversed and occur after discontinuation of the ACE inhibitor.

Lisinopril should be administered with special care to patients with systemic diseases of the tissue, when treated with immunosuppressants, when treated with alopurinol or procainamide, or when consumed by these heaviness factors , especially for the evidence of anterior impairment of the function of the eyes. Some of these patients developed serious infectious diseases, and some did not respond to intensive antibiotic therapy. Periodically, before treatment with Diroton, it is recommended to carry out laboratory tests (blood test with leukocyte count) in such patients, and also inform them about the need to notify about the appearance of first a sign of infectious disease.

Primary hyperaldosteronism

In patients who suffer from primary hyperaldosteronism, ACE inhibitors are ineffective, and lisinopril administration is not recommended.

Race

ACE inhibitors are more likely to cause the development of angioedema in patients of black race as compared with patients of other races. ACE inhibitors are less effective as hypotensive agents in patients of black race. This effect is associated with the importance of low-renin status in patients of black race with arterial hypertension.

Surgical/general anesthesia

In patients undergoing extensive surgery or under general anesthesia with drugs that lead to hypotension, lisinopril may block the release of angiotensin II after compensatory renin activity. As arterial hypotension develops, it is likely that, as a result of the induced mechanism, it is possible to correct the increased volume of blood volume.

Old age patients

In elderly patients, standard doses of lisinopril should be used to increase the concentration of lisinopril in the blood plasma, which requires special care in dosing, regardless of those with antihypertensive properties. No effect of lisinopril was detected in summer or young patients.

Cough

When taking ACE inhibitors, coughing is often avoided. As a rule, the cough is non-productive, persistent and persistent after administration of an ACE inhibitor. In case of differential diagnosis, cough requires medical treatment and cough caused by ACE inhibitors.

Hyperkalemia

In some patients who were discontinued from ACE inhibitors, including lisinopril, there was an increase in potassium concentrations in the blood sirovat. Those most at risk for the development of hyperkalemia include patients with nitric deficiency, type 2 diabetes mellitus, or patients who take potassium-sparing diuretics (for example, spironolactone, Triam) at the same time. terene, amiloride, eplerenone), potassium food supplements or potassium salt substitutes, as well as drugs that increase concentration potassium in blood serum (for example, heparin, trimethoprim/sulfamethoxazole combination, also known as cotrimoxazole). When taking one-hour medications, it is recommended to regularly monitor the concentration of potassium in the blood.

Patients with blood diabetes

In patients with hepatic diabetes who are taking hypoglycemic drugs internally or supplementing with insulin, treatment with an ACE inhibitor for the first month will continue to improve. Close glycemic control.

Medicines for the summer

Ethanol

Subsequent blockade of the RAAS with angiotensin II receptor antagonists, ACE inhibitors or aliskiren

It has been proven that with one-hour ingestion of ARA II, ACE inhibitors or aliskiren there is a risk of developing hypotension, hyperkalemia, impaired function of nitric acid (including acute nitric insufficiency sti). For these reasons, it is not recommended to combine ARA II, ACE inhibitors or aliskiren. If continuation of this therapy is necessary, caution is recommended, close monitoring of blood function, arterial pressure and electrolyte concentrations in blood serum.

The immediate administration of ACE inhibitors with aliskiren and drugs to replace aliskiren is contraindicated in patients with celiac diabetes and/or moribund or severely impaired function above 60 ml/hv/1.73 m2 flat body surface) and is not recommended for other patients.

Concomitant administration of ACE inhibitors with angiotensin II receptor antagonists is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.

Ferrying to the building to the center by vehicles and controlling the mechanisms

When using transport means or robots with mechanisms, there is a possibility of the development of confusion and damage. When significant symptoms develop, it is not recommended to use keratin by transport means or mechanisms.

Vaginism and lactation

Vaginism

Administration of lisinopril in case of pregnancy is contraindicated. If you are sick with the drug, take the yakmog earlier. Lisinopril penetrates the placental barrier. Taking ACE inhibitors in the 2nd and 3rd trimesters of vagusity causes an unpleasant influx into the fetus (possibly manifested as a decrease in arterial pressure, nitric insufficiency, hyperkalemia, hypoplasia of the cranial cysts, internal womb death). Epidemiological data on the risk of teratogenicity associated with the use of ACE inhibitors in the first trimester of pregnancy are not conclusive, and cannot be excluded if the risk increases slightly. For newborns and babies who have been diagnosed with intrauterine influx of ACE inhibitors, it is recommended to monitor them for prompt detection of a pronounced decrease in AT, oliguria, and hyperkalemia.

Umovi dispensers from pharmacies

The drug is available with a prescription.

Understand the term saving

Keep the drug out of the reach of children at a temperature not exceeding 30°C. The term of attribution is 3 rocks. Do not seal after completing the terms of accession indicated on the package.

Arterial hypertension (AH) is a pathological condition in which the systolic and diastolic arterial pressure (AT) is greater than 140/90 mm Hg. Art. Physically, the mechanism for moving the pressure lies in the sounded lumen of the blood vessels.

To facilitate this process, a special group of drugs is used - angiotensin-converting enzyme (ACE) inhibitors. Before them is Diroton, the instructions for the use of which describe it as a highly effective drug (LS) for the treatment of arterial hypertension.

Liki Diroton is an independent, non-combined drug based on the main active substance of Diroton. Liki is available in four forms - tablets of 2.5, 5, 10 and 20 mg. The drug claims to be an antihypertensive and vasodilator drug.

Virobnik ta formi vipusku

In pharmacies you can buy Diroton tablets under the brand Gedeon Richter, which is the official distributor of Diroton. You can also know the same LZ of the Russian lineage Gedeon Richter RUS. The Diroton warehouse, as well as the dosage of the drug and the Ugric and Russian approach are absolutely identical. Available in blisters of 1, 2 and 4 in cardboard packaging.

What do these walks help with?

The drug (prescription Diroton in Latin - Diroton or Lisinoprilum) is known as it allows you to clearly understand what Diroton walks help. This group of medications is used for the correction of arterial hypertension (essential, secondary and renovascular).

Also, the instructions for how to stop the drug attribute it to a pronounced hypotensive effect, which is necessary to treat high arterial pressure.

Showing before confession

Before the overflow, show before the stagnation of Diroton to enter:

• primary, secondary, renovascular;
• myocardial infarction, myocardial infarction;
• Nephropathological conditions in cardiovascular diabetes.

The target group gets sick when taking this ACE inhibitor, according to the instructions from stagnation, - arterial hypertension. The cardioprotective power of the muscles is also indicated.

Instructions for drying

Diroton, as an ACE inhibitor, has this mechanism of action. Having entered the bloodstream through the passage into the small intestine, it binds the ACE enzyme, which converts the hormone angiotensin I into angiotensin II. The rest is a hormone that promotes the process of vasoconstriction, causing the lumen of the blood vessels to sound.

An ACE blocker neutralizes this enzyme, thereby slowing down the process of blood vessels (especially arteries and great veins). As a result, the blood pressure turns at the boundary of physiological norms.

What kind of vice should I take?

The instructions for using the Diroton do not indicate at what pressure you need to use it. It is obvious that LD is diagnosed when diagnosing arterial hypertension. For this purpose I will be able to move the vice in a stable and stable manner to 140/90 mmHg. Art. and more. There are different levels of severity of arterial hypertension, when each doctor prescribes different doses of the antihypertensive drug.

Diroton tablets can only be taken after being prescribed by a doctor and only as prescribed.

Dozuvannya

There are several dosage forms for lisinopril in one tablet, which makes it easy to increase the dosage of lisinopril within the normal range. The initial dose is 5 mg of Diroton. If it is necessary to increase the dose, for example, due to the hypotensive effect, according to the instructions, you can choose higher doses of the drug - Diroton 10 mg or 20 mg in one tablet.

In accordance with the instructions for use, Diroton is prescribed in a dose of 5 mg to patients with mild to moderate severity of hypertension.

The minimum dosage of Diroton 2.5 mg is suitable for patients for whom, for various reasons, it is not recommended to increase the dose of the ACE inhibitor. For example, patients with neurological dysfunction, as well as elderly people over 65 years of age, should use the minimal form of Diroton in dosages of 2.5 mg.

If necessary, the dose can be increased to 5 mg to avoid any significant hypotensive effect.

Higher doses – 10 and 20 mg of lisinopril – are prescribed to people who do not suffer from serious complications before taking it. The maximum dose of lisinopril is 40 mg per dose.

Types of arterial hypertension

Drink before you go and after?

The instructions for taking Diroton prescribe taking one tablet per dose according to the dosage prescribed by the doctor, but how to take Diroton based on AT indications is not indicated. It is optimal to stagnate Diroton at the early hour. The instructions for immobilization do not describe the interactions between the use and the method of immobilization of the drug. Well, it doesn’t make a big difference how you take Diroton – before and after. It is recommended to wash down the tablet with a sufficient amount of radish, approximately one bottle of clean water.

How to take it under a high vice?

There are no special instructions in the instructions on how to take Diroton with a high vice. The dosage is then selected individually based on the AT dynamics. The daily daily dose for health should be 5 or 10 mg per dose. Supportive therapy involves taking one tablet of Diroton 20 mg per dose.

If there is a need to increase dosage, the dose of lisinopril can be increased to 40 mg per dose upon the doctor's recommendation. Drinking liquids above the established food norm will be blocked from stagnation according to the instructions.

After how many years do the hands begin to reduce the pressure?

The duration of antihypertensive treatment is determined individually. The drying instructions indicate how many years after the Diroton begins to reduce the pressure - in the middle one year after receiving. The therapeutic effect lasts for 4-6 years.

Depending on the severity level of hypertension, the severity of the disease may be greater or less.

Contraindicated

As with other formulations based on an ACE inhibitor, the instructions for curing before diroton contain the following contraindications:

• individual hypersensitivity to the drug;
• susceptibility to anaphylactoid reactions, including Quincke's disease (due to evidence of a history of angioedema due to the use of other ACE inhibitors);
• a severe form of nitric deficiency, an operation was undergone from a nitric transplant, arterial damage to one or both arteries, associated with impaired thyroid function;
• Vaginism and breastfeeding;
• century younger than 18 years.

Summer century in the age of 65 years and mental contraindications before use. If it is necessary to take lisinopril, according to the instructions for insulation, the minimum dosage of the drug is 2 to 2.5 mg per dose.

Side activities

Assigned by the manufacturer in the instructions due to the stagnation of side effects, Diroton is similar to most drugs of the same pharmacological group.

Some side effects of Diroton, similar to other ACE inhibitors, include:

• intolerance to components in the warehouse;
• allergic reactions;
• angioneurotic lesions;
• a decrease in tension is observed and weakness, headache, and restlessness are associated with them;
• dry cough.

Dyspeptic symptoms such as boredom, vomiting and diarrhea are rarely avoided. The instructions for avoiding side effects include decreased hemoglobin and hematocrit, agranulocytosis, as well as increased erythrocyte sedimentation rate. Such a camp must be careful not to take too much trouble. It is also possible to increase the level of creatinine, potassium and nitrogen.

Madness from alcohol

In accordance with most instructions, all ACE inhibitors should not be taken with alcohol before they are frozen. The remaining power has the power to force the action of many people, and it is also bad to pour the hearts and vessels into the work, causing the first expansion, and then the spasm of the vessels. Due to the infusion of alcohol into blood vessels, the affinity of Diroton and alcohol is very low and it is not recommended to take them immediately.

Patients who took the drug under pressure

Presumably, patients who have taken the drug Diroton are highly effective in reducing arterial pressure. At that very hour, LZ describes how to fill an expensive and highly accessible drug at a low price. These patients indicate that Diroton analogues are cheaper based on lisinopril, but are more effective.

What is more beautiful than Diroton chi...

Both Deroton and Lisinopril are different structural analogues that combine the same active substance - an inhibitor of the angiotensin-converting enzyme lisinopril. Well, all the drugs and equal characteristics - especially Diroton or Lisinopril - can be considered subjective.

Like Diroton, Enalapril has an ACE inhibitor in stock, but there are completely different substances that may have a similar pharmacological effect. It is impossible to say for sure which is better - Diroton or Enalapril. More exposure to Enalapril is associated with more available drugs. Enalapril and drugs based on it are cheaper, and Diroton in the middle of the afternoon.

This drug belongs to a completely different pharmacological group. This is an angiotensin receptor antagonist, so it is not possible to give an unambiguous assessment; more simply, Diroton and Lozap. Losartan is available at the medicinal plant warehouse. According to the instructions, the stagnant losartan selectively binds to the receptors of the angiotensin-converting enzyme, but does not interfere with other hormones in the blood, which allows it to maintain the normal function of the heart. o-judicial system. Among the reviews of the drug, the possibility of taking it for patients with dysfunction is positively described, which cannot be said about ACE inhibitors.

This drug is based on the ACE inhibitor perindopril. Obviously, the speech lies with the same pharmacological group, but there may still be therapeutic power. The advantages and disadvantages of one drug over another in older patients can also be considered subjective. However, after a group of speeches, it is easy to equate even more simply - Diroton or Prestarium.

These should be placed before the ACE inhibitors and stored in the same warehouse. This drug, regardless of those related to the same pharmacological group and exhibits a similar therapeutic effect, is approximately 40% cheaper than Diroton. Otherwise, the same characteristics are better - Diroton or, show approximately the same number of advantages and disadvantages.

This is a selective beta-blocker, which is important for its effective hypotensive effect, but may have a completely different mechanism for reducing arterial pressure. Among the positive drugs, Concor is highly effective in treating arterial hypertension. ACE inhibitors and beta-blockers are completely different in principle, but the same is true - Diroton or Concor, incorrectly.

Beta-blockers are prescribed for the correction of arterial hypertension in patients who have other functional disorders in the heart, which is not always available for ACE inhibitors and diuretics.

Indapamide

This drug is a diuretic that removes sodium molecules and sodium ions from the body, reducing pressure on the heart and blood vessels. At the same time, veins do not have a mechanism for a stable decrease in arterial pressure, especially in important forms of hypertension. Most often, Indapamide is prescribed as a basic treatment for acute hypertension. The usefulness of Indapamide and Diroton as an ACE inhibitor and diuretic is good, allowing you to take them at the same time.

Ko-Diroton

This drug is a combined antihypertensive drug based on lisinopril. Another active ingredient is the diuretic hydrochlorothiazide.

Compared with Diroton, which also contains lisinopril, Co-Diroton can be used in a more effective way to reduce the stress of both combinations. This drug immediately works to enlarge the blood vessels and reduce the pressure on the heart and reduce the swelling of the heart.

What can I replace it with?

If side effects occur, the drug inode is used to prescribe another drug to correct arterial pressure. What can be used to replace Diroton and mean a medicine? It is prohibited to bathe other skins at the pharmacy on your own instead of prescribed by a specialist.

When a cough appeared

Cough is one of the most common side effects of ACE inhibitors, including lisinopril. How can I replace Diroton if I have a cough or reduce the dose of the ACE inhibitor? Upon the doctor's recommendation, you can replace it with a drug of another pharmacological group, for example, a calcium channel blocker, an angiotensin-converting enzyme antagonist, etc.

Is the drug no longer helpful?

A decrease in the effectiveness of drug therapy may be associated with various internal and external factors. It is possible that you just need to increase the dose, but if there is any problem, you need to tell the doctor and ask what to replace it with, if Deroton is no longer helping. The doctor can change the drug to one that belongs to a different pharmacological group. It is important to note that the effects of the ACE inhibitor may be enhanced by one-hour ingestion of alcohol, as well as other drugs (as indicated in the instructions for Diroton).

Analogs are cheaper

The most accessible analogues of Diroton can be called:

• Lisinopril;
• Irumed;
• Listril;
• Lysinoton and others.

These are generics Diroton and their structural analogues, which are in stock of the same ACE inhibitor lisinopril.

Korisne video

For additional information about arterial pressure, see this video:

Visnovok

1. The drug Diroton is an ACE inhibitor based on lisinopril in four dosage options.
2. The recipe for Diroton in Latin in the instructions from the standpoint sounds like Diroton or Lisinoprilum.
3. This is an effective antihypertensive drug that allows you to stably relieve pressure in patients who suffer from hypertension. At the same time, LZ has a low contraindication and side effects.
4. Diroton products describe how to obtain an effective dose for reducing tension, although, in the minds of many patients, this is not an even expensive drug.

One tablet of Diroton may contain 2.5 mg or 5 mg / 10 mg / 20 mg lisinopril (Vikoristany in the form of dihydrate).

Magnesium stearate, talc, mannitol, corn starch, calcium dihydrate and hydrogen phosphate are included in the list of additional components of the drug.

Vipusu form

Diroton tablets of 2.5 mg doses are sold in aluminum/PVC blisters of 14 tablets, one package contains 1 or 2 blisters.

Tablets in dosages of 5 mg/10 mg/20 mg are also sold in aluminum/PVC blisters of 14 tablets, in one package there may be 1, 2 or 4 blisters.

Pharmacological action

Hypotensive and peripherally vasodilating.

Pharmacodynamics and pharmacokinetics

Diroton (INN: Lisinopril) is an angiotensin-transforming factor inhibitor, you can overcook the lancet, which will leave you with angiotensin II - V I . Lisinopril reduces the rate of vascular and sound effects of speech angiotensin II , at which the concentration in the bloodstream changes.

Lisinopril accepts a reduced burden of pre-cardiac support. The drug Diroton, which is used to reduce pressure, does not flow onto heart rate (HR) and lead to increased blood volume, as well as increased blood flow. It takes 6 years to achieve the maximum effect. Next, the wine is saved close to the required amount and can be injected regularly while dosing the drug. Deroton in a vice with heavy stagnation reduces its effectiveness.

Pharmacokinetic data

The process of winding up will proceed from the ShCT, then lisinopril , absorbing into blood plasma, does not bind to proteins. Make sure that the bioavailability of the food is more than 25-30%, and the food regime changes the absorption rate. The drug is administered after 12 years. Since the active substance is not subject to metabolism, it is excreted - invariably immediately from the section. Diroton does not cause urinary syndrome during acute drug therapy.

Indication for stagnation.

• the drug is effective for chronic heart failure (as a warehouse of combination therapy);
• because prevention is necessary dysfunction of the left ventricle , heart failure , as well as support for stable performance hemodynamics — The Diroton walks will become stagnant - why they appear to be effective, incl. at gostrium ;
• at diabetic nephropathy (lower albuminuria );
• indications before filling Diroton tablets also include essential і renovascular arterial hypertension (both monotherapy and combination therapy with other antihypertensive drugs).

Contraindicated

• anamnesis entry about idiopathic , including seizures due to vikoristan ACE inhibitors ;
• Quincke's mark spasmodic ;
• immature individuals (≤ 18 years old);
• Vaginal and yearly breasted women;
• at home hypersensitivity to the point of decorum lisinopril or additional components, as well as other ACE inhibitors .

Faces under the pressure of Diroton may be used for curing with care

• with stenosis of the arteries or girla aorti ;
• after nira transplantation ;
• patients with nitric deficiency with CC less than 30 ml/min;
• at obstructive hypertrophic cardiomyopathy ;
• at the first stage hyperaldosteronism ;
• at arterial hypotension ;
• patients with cerebrovascular diseases or lack of cerebral blood flow;
• important forms;
• at scleroderma , IXC , ;
• severe chronic heart failure;
• we are sick with depressed cystic-cerebral hematopoiesis;
• V hypovolemic become , at hyponatremia ;
• summer patients;
• persons on high-flow dialysis membranes (AN69) , fragments of mayweed anaphylactic reaction .

Side effects

These tablets may cause such unpleasant reactions as confusion and headaches (in approximately 5-6% of patients), possible weakness, diarrhea, sagging skin, fatigue, vomiting (in 3%), orthostatic hypotension , pain in the breasts (in 1-3%).

Other side effects with a frequency of occurrence less than 1% can be divided into organ systems from which the stench arises:

• SSS: decrease in AT, bradycardia , show heart failure, impaired atrioventricular conduction, possible myocardial infarction .
• Travna system: anorexia , dry mouth, lack of poisoning, loss of taste, development, hepatitis A , zhovtyanitsi , hyperbilirubinemia , increased activity of liver enzymes - transaminases
• Skin curves: , increased sweating, photosensitivity , alopecia , skin itching.
• CNS: sudden changes in mood, loss of respect, paresthesia fatigue and drowsiness, confusion of fluid, vessels of the ends and lips, asthenic syndrome .
• Dihal system: apnea , dyspnea , bronchospasm .
• Hematopoietic system: neutropenia , leukopenia , thrombocytopenia , anemia .
• Immune system: vasculitis , angioneurotic lesion positive reaction (screening) to antinuclear , eosinophilia .
• Sechostate system: decreased potency, anuria , uremia , oliguria , impaired function of nirok to acute nirk deficiency.
• Metabolism: increases or decreases in potassium in the blood, decreased concentration of sodium, magnesium, chlorine, increased concentration of calcium, sechoic acid , sechovini , hypertriglyceridemia .
• Among others: arthralgia , arthritis , myalgia , zagostrennya

Diroton tablets, instructions for use (Method of dosing)

Liki is taken internally once per day, regardless of the meal plan, most likely at approximately the same hour of the day.

For essential hypertension

If therapy with other drugs is not carried out antihypertensive methods , then the corn cob does not have to exceed 10 mg, as it encourages you to raise it to 20 mg. After investigation speakers It can be increased to a maximum of 40 mg in order to prevent further development of the effect for 2-4 days. If the patient does not have enough expression of the therapeutic effect, therapy should be supplemented with other antihypertensive drug .

Respect! Before taking Diroton, it is necessary to undergo therapy diuretic ways approximately 2-3 doses, otherwise the dose of Diroton should not exceed 5 mg/dose. Treatment is carried out under medical supervision in case of symptomatic development of a ligament with a rhizome. arterial hypotension .

For renovascular hypertension and other conditions caused by increased activity of the RAAS hormonal system

It is recommended to begin therapy with a larger dose in the range of 2.5–5 mg/day, in a hospital setting under close supervision, including monitoring AT , functioning of drugs, concentration of serum potassium The auxiliary dose is determined based on caution for AT dynamics.

Individuals with nirvania deficiency

Dosage adjustment is required based on regular assessment of creatinine clearance. So, when Cl is 30-70 ml/min, treatment begins with 5-10 mg lisinopril per day, at 10-30 ml/xw - 2.5-5 mg/day.

For chronic heart failure

The initial dose is 2.5 mg and can be incrementally increased in 3-5 increments to the standard dose of 5 to 20 mg. How have we stashed before? diuretics , then reduce the dose to the maximum possible. Treatment may begin with HIV and then be accompanied by control AT , functions of nirk, concentration of potassium and sodium, which allows to advance the developments arterial hypotension , and cause destruction to the robots.

For diabetic nephropathy

Instructions for taking Diroton for patients who have suffered acute myocardial infarction

In case 1, after experiencing a myocardial infarction, the patient is given an initial dose of 5 mg, in case 2 - again 5 mg, in case 3 - 10 mg, continued treatment with a continuous dose of no more than 10 mg thereafter. home 6 tyzhnіv. Patients have low blood pressure system , then it is recommended to administer the treatment at a lower dose - 2.5 mg.

Overdose

Possible symptoms

Znizhene AT , dry mouth, constipation, drowsiness, restlessness, suppression of secretions, increased fatigue.

Come in, there's a celebration going on

• recognition active vugill ;
• washing shlunka ;
• more BCC (for example, i.v. Plasmozamine applications );
• symptomatic therapy;
• hemodialysis ;
• control of vital functions

Interaction

• Therapy was carried out simultaneously with potassium-sparing diuretics (for example, Triamteren , Amiloride ) and other potassium-containing drugs increases the toxicity hyperkalemia .
• Z sodium aurothiomalate blames symptom complex , Which includes tediousness, vomiting, hyperemia individuals arterial hypotension .
• β-blockers , blockers of complete Ca channels , diuretics and other hypotensive individuals potentiate hypotensive action.
• Z NPZP , including selective COX inhibitors - 2 , adrenomimetics the antihypertensive effect decreases.
• Z vasodilators , tricyclic antidepressants , barbiturates , phenothiazines , ethanol-containing In some ways, the hypotensive effect is also enhanced.
• Increased excretion is achieved with drugs during the summer summer which will result in cardiotoxic and neurotoxic effects.
• Antacidi і Cholestyramine reduce the fluidity of the winding from the shkt.
• Lisinopril building potency neurotoxicity salicylates , relax your lips hypoglycemic conditions , Norepinephrine , anti-gout treatments , to enhance the effects (including unexpected ones) cardiac glycosides , peripheral muscle relaxants , change the fluidity of the output Khinidina .
• Reduces the price oral contraceptives .
• Z Methyldopa The risk of hemolysis is advancing.

Mind the sale

You can get the drug from the pharmacy with a prescription.

Umovi sberіgannya

The required temperature range is +15 +30 °C.

Term of attribution

36 months.

For gestation and lactation

Due to the fact that the drug can penetrate the placental barrier, there is a risk in the fetus (II and III trimester):

• hypoplasia of the skull ;
• change AT ;
• hyperkalemia ;
• nirkova lack of supply;
• Mozhlivy lethal ending — intrauterine death .

Newborns, who knew in passing ACE inhibitors , to extract diligent medical care through the rizik development of a stable decreased AT , hyperkalemia , oliguria .

Diroton's analogues

Search for the ATX code of the 4th level:

The price of Diroton analogues varies widely - in the range of 50-100 rubles. depending on the number of tablets, the cost of production and other pricing factors. Find out what you can replace this antihypertensive drug with, based on monitoring the dynamics of blood pressure and individual sensitivity of the body, consulting your doctor. And the drugs that are used for active speech, among them are:

• Aurolaise ;
• Vitopril ;
• Dapril ;
• Lizinocor .

Videos about Diroton

If you take Deroton, ask for the recommendation of a cardiologist, and they will tell you that you feel better, go through unpleasant treatment of the heart, and feel less dizzy. The comments about Deroton on the forums are also positive, but they also mean that you need a good doctor who can help you choose the right dosage.

Price of Diroton, where to buy

The average price for Diroton 5 mg (No. 14) is 92 rubles, 2.5 mg (No. 28) is 115 rubles, 20 mg (No. 28) is 450 rubles, and the same price as Diroton 10 mg is 515 rubles.

• Online pharmacies in Russia Russia
• Online pharmacies in Ukraine Ukraine
• Online pharmacies in Ukraine Kazakhstan

ZdravSiti

Diroton tab. 20mg n28Gedeon Richter-RUS ZAT

Diroton tab. 10mg No. 56Gedeon Richter-RUS ZAT

Diroton tab. 10mg n28Gedeon Richter-RUS ZAT

Co-diroton tab. 20mg+12.5mg n30Grodzisk Pharmaceutical Polfa/Gedeon-Richter

Diroton tab. 5mg No. 28Gedeon Richter-RUS ZAT

Pharmacy Dialog

Diroton (tab. 20 mg No. 28)

Diroton (20 mg tablet No. 56)

Diroton (table 5 mg No. 28)

Diroton (2.5 mg tablet No. 28)