Селективный агонист имидазолиновых рецепторов. Отвечает за р... Инструкция
Показания к применению
Артериальная гипертензия.
Противопоказания
ангионевротический отек в анамнезе; СССУ или синоатриальная блокада; AV-блокада II и III степени; выраженная брадикардия (менее 50 уд./мин в покое); выраженные нарушения ритма сердца; хроническая сердечная недостаточность (III-IV функциональный класс по классификации NYHA); нестабильная стенокардия; выраженная печеночная недостаточность; почечная недостаточность ...
Действующее вещество: Моксонидин (Moxonidine); Концентрация действующего вещества (мг): 0,4
Фармакологические свойства
Селективный агонист имидазолиновых рецепторов. Отвечает за рефлекторный контроль над симпатической нервной системой (рецепторы локализованы в вентро-латеральном отделе продолговатого мозга). Незначительно связывается с центральными 2-адренорецепторами, снижает систолическое и диастолическое АД при однократном и продолжительном приеме.; При длительном применении уменьшает гипертрофию миокарда левого желудочка, нивелирует признаки миокардиального фиброза, микроартериопатии, нормализует капиллярное кровоснабжение миокарда, снижает ОПСС, легочное сосудистое сопротивление, в то время как сердечный выброс и ЧСС существенно не изменяются.; На фоне лечения снижается активность норэпинефрина и эпинефрина, ренина, ангиотензина II в покое и при нагрузке, предсердного натрийуретического пептида (при нагрузке) и альдостерона плазмы крови.; Уменьшает резистентность тканей к инсулину на 21% в сравнении с плацебо у пациентов, страдающих ожирением, и инсулинрезистентных пациентов с умеренной степенью тяжести артериальной гипертензии, стимулирует высвобождение гормона роста. Не влияет на обмен глюкозы и липидов.; Продолжительность действия - более 12 ч.
Показания к применению
Артериальная гипертензия.
Противопоказания
ангионевротический отек в анамнезе; СССУ или синоатриальная блокада; AV-блокада II и III степени; выраженная брадикардия (менее 50 уд./мин в покое); выраженные нарушения ритма сердца; хроническая сердечная недостаточность (III-IV функциональный класс по классификации NYHA); нестабильная стенокардия; выраженная печеночная недостаточность; почечная недостаточность тяжелой степени (КК менее 30 мл/мин, содержание сывороточного креатинина - более 160 мкмоль/л); возраст до 18 лет; период лактации; непереносимость галактозы, дефицит лактазы или синдром мальабсорбции глюкозы-галактозы; повышенная чувствительность к моксонидину или любому другому компоненту препарата.
С осторожностью и под контролем врача следует применять препарат у пациентов после недавно перенесенного инфаркта миокарда или при нарушениях периферического кровообращения (перемежающаяся хромота, синдром Рейно); у пациентов с умеренно выраженными нарушениями функции почек (КК 30-60 мл/мин; содержание сывороточного креатинина 105-160 мкмоль/л), с нарушениями функции печени, при беременности, депрессии, глаукоме, эпилепсии, болезни Паркинсона.
Применение при беременности и в период грудного вскармливания
Достоверных исследований применения моксонидина у беременных не проводилось. Исследования на животных показали эмбриотоксический эффект. Клинических данных о негативном влиянии на течение беременности нет. Однако следует применять препарат Моксонитекс беременным только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода.; Моксонидин выделяется с грудным молоком, женщинам в период лечения рекомендуется прекратить грудное вскармливание или отменить препарат.
Способ применения и дозы
Внутрь, независимо от приема пищи, запивая достаточным количеством жидкости. Режим дозы подбирается индивидуально.; При отсутствии иных предписаний Моксонитекс следует назначать в следующих дозах: в качестве начальной дозы назначают 0,2 мг препарата утром. При недостаточном терапевтическом эффекте дозу через 3 недели увеличивают до 0,4 мг в сутки однократно или в 2 приема. Максимальная суточная доза — 0,6 мг; максимальная однократная доза — 0,4 мг.; У пациентов с умеренно выраженными поражениями функции почек (Cl креатинина 30–60 мл/мин) однократная доза не должна превышать 0,2 мг, а максимальная суточная доза — 0,4 мг.
Побочное действие
Со стороны сердечно-сосудистой системы: редко - симптомы вазодилатации; иногда - выраженное снижение АД, синкопальные состояния, синдром Рейно, периферические отеки.; Со стороны ЦНС: часто - головокружение, головная боль, сонливость, повышенная утомляемость, нарушение сна; иногда - парестезии, депрессия, тревожность.; Со стороны пищеварительной системы: часто - сухость слизистой оболочки полости рта, тошнота, анорексия, запор.; Со стороны мочеполовой системы: иногда - задержка или недержание мочи, импотенция и/или снижение либидо.; Со стороны органа чувств: иногда - сухость глаз, вызывающая зуд или чувство жжения.; Аллергические реакции: иногда - крапивница, кожный зуд, экзантема, ангионевротический отек.; Прочие: иногда - гинекомастия, болезненность околоушных желез.
Передозировка
Симптомы: головная боль, выраженное снижение АД, брадикардия, сердцебиение, слабость, сонливость, сухость слизистой оболочки полости рта; редко - рвота и боль в эпигастрии. Потенциально возможны парадоксальная артериальная гипертензия и гипергликемия.; Лечение: симптоматическое. Специфического антидота нет. При выраженном снижении АД рекомендуется восстановление ОЦК за счет введения жидкости. Антагонисты -адренорецепторов способны уменьшить или устранить преходящую артериальную гипертензию при передозировке моксонидина.
Особые указания
Во время лечения требуется регулярный контроль АД, ЧСС и ЭКГ.; При необходимости отмены одновременно принимаемых бета-адреноблокаторов и препарата Моксонитекс первыми отменяют бета-адреноблокаторы и лишь спустя несколько дней - Моксонитекс. В настоящее время нет подтверждения того, что прекращение применения препарата Моксонитекс приводит к повышению АД. Однако не следует резко прекращать применение препарата Моксонитекс.; У пациентов пожилого возраста может быть повышен риск развития сердечно-сосудистых осложнений вследствие применения гипотензивных препаратов, поэтому терапию препаратом Моксонитекс следует начинать с минимальной дозы.; Влияние на способность к вождению автотранспорта и управлению механизмами; Влияние препарата Моксонитекс на способность к вождению транспортных средств или управлению техникой не изучено. Принимая во внимание возможное возникновение головокружения и сонливости, пациентам следует соблюдать осторожность при занятии потенциально опасными видами деятельности, такими как вождение автотранспорта или управление техникой, требующими повышенной концентрации внимания.
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