Каптоприл Велфарм Таблетки, пачка, 40 шт, 25 мг, для приема внутрь, для сердечно-сосудистой системы, для взрослых

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Режим дозирования устанавливается индивидуально. Для обеспечения нижеприведенного режима дозирования, возможно применение препарата Каптоприл в лекарственной форме: таблетки по 12.5 мг."}},{"type":"paragraph","data":{"text":"При артериальной гипертензии препарат назначают в начальной дозе 25 мг 2 раза/сут. При необходимости дозу постепенно (с интервалом 2-4 недели) увеличивают до достижения оптимального эффекта. При мягкой или умеренной артериальной гипертензии обычная поддерживающая доза составляет 25 мг 2 раза/сут; максимальная доза - 50 мг 2 раза/сут. При тяжелой артериальной гипертензии максимальная доза - 50 мг 3 раза/сут. Максимальная суточная доза - 150 мг."}},{"type":"paragraph","data":{"text":"Для лечения хронической сердечной недостаточности каптоприл назначают в тех случаях, когда применение диуретиков не обеспечивает адекватного эффекта. Начальная доза составляет 6.25 мг 2-3 раза/сут, которую затем постепенно (с интервалом не менее 2-х недель) увеличивают. Средняя поддерживающая доза составляет 25 мг 2-3 раза/сут. В дальнейшем, при необходимости дозу постепенно (с интервалом не менее 2-х недель) увеличивают. Максимальная доза - 150 мг/сут."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: выраженное снижение артериального давления, тахикардия, ортостатическая гипотензия, периферические отеки."}},{"type":"paragraph","data":{"text":"Со стороны мочевыделительной системы: протеинурия, нарушение функции почек (повышение уровня мочевины и креатинина в крови)."}},{"type":"paragraph","data":{"text":"Со стороны системы кроветворения: редко - нейтропения, анемия, тромбоцитопения, агранулоцитоз."}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы: головокружение, головная боль, атаксия, парестезии, сонливость, нарушение зрения, чувство усталости, астения."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы: сухой кашель, проходящий после отмены препарата, бронхоспазм, отек легких."}},{"type":"paragraph","data":{"text":"Аллергические и иммунопатологические реакции: ангионевротический отек конечностей, лица, губ, слизистых оболочек, языка, глотки и гортани, а также интестинальный отек (очень редко), сывороточная болезнь, лимфоаденопатия, в редких случаях - появление антиядерных антител в крови."}},{"type":"paragraph","data":{"text":"Дерматологические реакции: сыпь, обычно макуло-папулезного характера, реже вазикулярного или буллезного характера, зуд, повышенная фоточувствительность."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта, печени, поджелудочной железы: нарушение вкусовых ощущений, сухость во рту, стоматит, тошнота, снижение аппетита, редко - диарея, боли в животе, повышение активности печеночных трансаминаз, гипербилирубинемия, гепатит."}},{"type":"paragraph","data":{"text":"Лабораторные показатели: гиперкалиемия, гипонатриемия, ацидоз. Сообщалось о случаях развития гипогликемии у пациентов с сахарным диабетом, которые принимали инсулин и пероральные гипогликемические препараты."}},{"type":"paragraph","data":{"text":"Прочие: парестезии."}},{"type":"paragraph","data":{"text":"ангионевротический отек, в т.ч. наследственный, в анамнезе (в т.ч. в анамнезе после применения других ингибиторов АПФ);"}},{"type":"paragraph","data":{"text":"выраженные нарушения функции почек, азотемия, гиперкалиемия, двусторонний стеноз почечных артерий или стеноз единственной почки с прогрессирующей азотемией, состояние после трансплантации почки, первичный гиперальдостеронизм;"}},{"type":"paragraph","data":{"text":"стеноз устья аорты, митральный стеноз, наличие других препятствий оттоку крови из левого желудочка сердца;"}},{"type":"paragraph","data":{"text":"выраженные нарушения функции печени;"}},{"type":"paragraph","data":{"text":"артериальная гипотензия;"}},{"type":"paragraph","data":{"text":"кардиогенный шок;"}},{"type":"paragraph","data":{"text":"беременность и период лактации;"}},{"type":"paragraph","data":{"text":"возраст до 18 лет (эффективность и безопасность не установлены)."}},{"type":"paragraph","data":{"text":"повышенная чувствительность к каптоприлу и другим ингибиторам АПФ."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: выраженное снижение артериального давления, вплоть до коллапса, инфаркт миокарда, острое нарушение мозгового кровообращения, тромбоэмболические осложнения."}},{"type":"paragraph","data":{"text":"Лечение: уложить больного с приподнятыми нижними конечностями; меры, направленные на восстановление АД (увеличение ОЦК, в т.ч. в/в вливание физиологического раствора), симптоматическая терапия. Возможно применение гемодиализа; перитонеальный диализ неэффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Диуретические средства и вазодилататоры (например, миноксидил) потенцируют гипотензивное действие каптоприла."}},{"type":"paragraph","data":{"text":"При совместном применении каптоприла с индометацином (и, возможно, с другими НПВС) может отмечаться снижение гипотензивного действия."}},{"type":"paragraph","data":{"text":"Гипотензивный эффект каптоприла могут снижать эстрогены (задержка Na+)."}},{"type":"paragraph","data":{"text":"Гипотензивное действие каптоприла может быть замедлено при назначении его пациентам, получающим клонидин."}},{"type":"paragraph","data":{"text":"Одновременное применение с калийсберегающими диуретиками или с препаратами калия может приводить к гиперкалиемии."}},{"type":"paragraph","data":{"text":"При одновременном применении солей лития возможно увеличение концентрации лития в сыворотке крови."}},{"type":"paragraph","data":{"text":"Применение каптоприла у пациентов, принимающих аллопуринол или прокаинамид, повышает риск развития нейтропении и/или синдрома Стивенса-Джонсона."}},{"type":"paragraph","data":{"text":"Применение каптоприла у пациентов, принимающих иммунодепрессанты, (например, циклофосфацин или азатиоприн) повышает риск развития гематологических нарушений."}},{"type":"paragraph","data":{"text":"При одновременном применении ингибиторов АПФ и препаратов золота (натрия ауротиомалат) описан симптомокомплекс, включающий гиперемию лица, тошноту, рвоту и снижение АД."}},{"type":"paragraph","data":{"text":"Одновременное применение инсулина и пероральных гипогликемических ЛС повышает риск развития гипогликемии."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Перед началом, а также регулярно в процессе лечения препаратом каптоприл следует контролировать функцию почек."}},{"type":"paragraph","data":{"text":"При хронической сердечной недостаточности препарат применяют при условии тщательного медицинского наблюдения."}},{"type":"paragraph","data":{"text":"С исключительной осторожностью назначают каптоприл пациентам с диффузными заболеваниями соединительной ткани или системными васкулитами; больным, получающим иммунодепрессанты, особенно при наличии нарушений функции почек(риск развития серьезных инфекций, не поддающихся терапии антибиотиками). В таких случаях следует проводить контроль картины периферической крови до начала применения каптоприла, через каждые 2 недели в течение первых 3 месяцев терапии и периодически - в последующий период лечения."}},{"type":"paragraph","data":{"text":"Препарат с осторожностью применяют на фоне лечения аллопуринолом или прокаинамидом, а также на фоне лечения иммунодепрессантами (в т.ч., азатиоприном, циклофосфамидом), особенно у пациентов с нарушениями функции почек."}},{"type":"paragraph","data":{"text":"С осторожностью применяют у пациентов с указаниями в анамнезе на заболевания почек, поскольку повышается риск развития протеинурии. В таких случаях в течение первых 9 месяцев лечения каптоприлом следует ежемесячно контролировать количество белка в моче. Если уровень белка в моче превышает 1 г/сут, необходимо решить вопрос о целесообразности дальнейшего применения препарата. С осторожностью назначают каптоприл пациентам со стенозом почечных артерий, т.к. существует риск развития нарушений функции почек; в случае повышения уровня мочевины или креатинина в крови может потребоваться снижение дозы каптоприла или отмены препарата."}},{"type":"paragraph","data":{"text":"При проведении гемодиализа у пациентов, получающих каптоприл, следует избегать использование диализных мембран с высокой проницаемостью (в т.ч. AN69), т.к. это повышает риск развития анафилактоидных реакций."}},{"type":"paragraph","data":{"text":"Вероятность развития артериальной гипотензии в процессе лечения можно уменьшить, если за 4-7 дней до начала лечения каптоприлом прекратить применение диуретиков или существенно уменьшить их дозу."}},{"type":"paragraph","data":{"text":"В случае возникновения после приема каптоприла симптоматической артериальной гипотензии пациенту следует принять горизонтальное положение с приподнятыми ногами."}},{"type":"paragraph","data":{"text":"В случае выраженной артериальной гипотензии положительный эффект отмечается при в/в введении изотонического раствора хлорида натрия."}},{"type":"paragraph","data":{"text":"В случае развития ангионевротического отека препарат отменяют и осуществляют тщательное медицинское наблюдение. Если отек локализуется на лице, специального лечения обычно не требуется (для уменьшения выраженности симптомов могут быть применены антигистаминные препараты); в том случае, если отек распространяется на язык, глотку или гортань и имеется угроза развития обструкции дыхательных путей, следует немедленно ввести эпинефрин (адреналин) п/к (0.5 мл в разведении 1:1000)."}},{"type":"paragraph","data":{"text":"Влияние на способность к вождению автотранспорта и управлению механизмами"}},{"type":"paragraph","data":{"text":"В период лечения каптоприлом необходимо воздерживаться от вождения автотранспорта и занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций, т.к. возможно головокружение, особенно после приема начальной дозы."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом месте при температуре ниже 30°С. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Препарат отпускается по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Велфарм."}}]}],"source":null},"description_toggle":false,"short_description":"Благодаря сосудорасширяющему действию, уменьшает общее периферическое сосудистое сопротивление (постнагрузку), давление заклинивания в легочных капиллярах (преднагрузку) и сопротивление в легочных сосудах; повышает минутный объем сердца и толерантность к нагрузке. 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