Селективный агонист имидазолиновых рецепторов. Отвечает за р... Инструкция
Показания к применению
— артериальная гипертензия.
Противопоказания
Наследственная непереносимость лактозы, дефицит лактазы или глюкозо-галактозная мальабсорбция
Выраженные нарушения ритма сердца (выраженная брадикардия (менее 50 уд./мин в покое), синдром слабости синусового узла или синоатриальная блокада, AV-блокада II и III степени)
Хроническая сердечная недостаточность (III-IV ФК по классификации NYHA)
Почечная недостаточность тяжелой степени (КК меньше 30 мл/мин, концентрация креатинина в сыворотке крови >160 мкмоль/л) и проведение гемодиализа
Селективный агонист имидазолиновых рецепторов. Отвечает за рефлекторный контроль над симпатической нервной системой (рецепторы локализованы в вентро-латеральном отделе продолговатого мозга). Незначительно связывается с центральными α .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
Наследственная непереносимость лактозы, дефицит лактазы или глюкозо-галактозная мальабсорбция
Выраженные нарушения ритма сердца (выраженная брадикардия (менее 50 уд./мин в покое), синдром слабости синусового узла или синоатриальная блокада, AV-блокада II и III степени)
Хроническая сердечная недостаточность (III-IV ФК по классификации NYHA)
Почечная недостаточность тяжелой степени (КК меньше 30 мл/мин, концентрация креатинина в сыворотке крови >160 мкмоль/л) и проведение гемодиализа
Одновременное применение с трициклическими антидепрессантами
Возраст до 18 лет
Период грудного вскармливания
Повышенная чувствительность к моксонидину или любому другому компоненту препарата. С осторожностью следует применять препарат при AV-блокаде I степени (риск развития брадикардии), заболеваниях коронарных артерий (в т.ч. ИБС, нестабильная стенокардия, ранний постинфарктный период), заболеваниях периферического кровообращения (в т.ч. перемежающаяся хромота, синдром Рейно), эпилепсии, болезни Паркинсона, депрессии, глаукоме, почечной недостаточности средней степени (КК 30-60 мл/мин, креатинин сыворотки 105-160 мкмоль/л), печеночной недостаточности, беременности
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
Моксонитекс назначают внутрь, независимо от приема пищи, запивая достаточным количеством жидкости. Режим дозирования подбирается индивидуально. Начальная доза - 200 мкг утром. При недостаточном терапевтическом эффекте дозу через 3 недели увеличивают до 400 мкг/сут однократно или в 2 приема. Максимальная суточная доза - 600 мкг, максимальная разовая доза - 400 мкг. У пациентов с умеренно выраженными нарушениями функции почек (КК 30-60 мл/мин) разовая доза не должна превышать 200 мкг, максимальная суточная доза - 400 мкг.
Побочное действие
По данным ВОЗ побочные эффекты классифицированы в соответствии с их частотой развития следующим образом: часто (>1/100, меньше 1/10), нечасто (>1/1000, меньше 1/100), редко (>1/10 000, меньше 1/1000) и очень редко ( меньше 1/10 000), включая отдельные сообщения. Со стороны сердечно-сосудистой системы: нечасто - брадикардия, выраженное снижение АД (в т.ч. ортостатическая гипотензия). Со стороны ЦНС: часто - головокружение (вертиго), головная боль, сонливость, бессонница . нечасто - обморок, повышенная возбудимость. Со стороны органа слуха и лабиринтные нарушения: нечасто - звон в ушах. Со стороны пищеварительной системы: очень часто - сухость слизистой оболочки полости рта . часто - диарея, тошнота, рвота, диспепсия. Со стороны кожи и подкожных тканей: часто - кожный зуд, кожная сыпь . нечасто - ангионевротический отек (отек Квинке). Со стороны костно-мышечной системы: часто - боль в спине . нечасто - боль в области шеи. Общие расстройства и нарушения в месте введения: часто - астения . нечасто - периферические отеки.
Особые указания
По данным ВОЗ побочные эффекты классифицированы в соответствии с их частотой развития следующим образом: часто (>1/100, меньше 1/10), нечасто (>1/1000, меньше 1/100), редко (>1/10 000, меньше 1/1000) и очень редко ( меньше 1/10 000), включая отдельные сообщения. Со стороны сердечно-сосудистой системы: нечасто - брадикардия, выраженное снижение АД (в т.ч. ортостатическая гипотензия). Со стороны ЦНС: часто - головокружение (вертиго), головная боль, сонливость, бессонница . нечасто - обморок, повышенная возбудимость. Со стороны органа слуха и лабиринтные нарушения: нечасто - звон в ушах. Со стороны пищеварительной системы: очень часто - сухость слизистой оболочки полости рта . часто - диарея, тошнота, рвота, диспепсия. Со стороны кожи и подкожных тканей: часто - кожный зуд, кожная сыпь . нечасто - ангионевротический отек (отек Квинке). Со стороны костно-мышечной системы: часто - боль в спине . нечасто - боль в области шеи. Общие расстройства и нарушения в месте введения: часто - астения . нечасто - периферические отеки.
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