Walsakor H 160: instructions for use
- Walsakor H 160: instructions for use
Pharmacotherapeutic group : drugs that affect the system of renin-angiotensin. Combined antihypertensive. Angelotenzin II receptor antagonist + diuretic.
Dosage form : tablets.
Form of issue : biconvex tablets of pink oval form, covered with a film membrane.
Antihypertensive drug that affects specific receptors of angiotensin II. Has a pronounced hypotensive effect, normalizes cardiac output and systolic pressure, reduces overall peripheral vascular resistance.
Active substance :
Auxiliary components :
- Lactose monohydrate;
- Colloidal anhydrous silicon dioxide;
- Magnesium stearate;
- Sodium croscarmellose;
- Red oxide (iron dye);
- Titanium dioxide.
Valsacor (H160) is an antihypertensive drug of combined action, which includes 2 active components.
Valsartan (selective antagonist of angiotensin II receptors) is a non-protein preparation intended for internal use. It has an antagonistic selective effect on the AT receptors. By blocking AT-1 receptors, it increases the plasma concentration of angiotensin II, which, in turn, stimulates the unblocked AT-2 receptors, balancing the effects associated with blockade. This active ingredient has no effect on ACE, does not potentiate the effects of substance P and bradykinin. Therefore, when taking the drug is unlikely to develop a dry cough. The drug does not interact and does not block the ion channels and receptors of hormones involved in the regulation of the cardiovascular system, lowers blood pressure without affecting the heart rate.
After taking a single dose of the drug antihypertensive effect develops within two hours and persists throughout the day. After 4-6 hours there is a maximum decrease in blood pressure. With repeated use of the drug, maximal decrease in blood pressure occurs in 2-4 weeks, remaining at the reached level during long-term therapy.
An additional significant reduction in blood pressure is due to the combination of valsartan with hydrochlorothiazide. A sudden discontinuation of the drug is not accompanied by withdrawal syndrome.
The thiazide diuretic, hydrochlorothiazide, which breaks the reabsorption of water, magnesium, potassium, chlorine and sodium ions in the distal nephron, delays the excretion of uric acid and calcium ions. The hypotensive effect of this active component is due to its ability to expand the arterioles. Virtually does not affect normal blood pressure. The development of diuretic effect is observed 1-2 hours after taking the drug and remains for 6-12 hours. The maximum decrease in blood pressure is observed after 4 hours. Antihypertensive effect occurs in 3-4 days, however, in order to achieve the most optimal therapeutic effect, it may take 3-4 weeks.
The drug after ingestion is quickly absorbed into the blood, but the degree of its absorption can vary within wide limits. The average absolute bioavailability is 23%, the half-life is 2 hours. With a single daily use, a slight cumulation is observed. In women and men, plasma concentrations are the same. The connection with serum proteins (mainly with albumin) is 94-97%. The equilibrium volume of distribution of the drug is about 17 liters. Plasma clearance - 2l / h.
Valsartan H160 undergoes metabolism under the influence of the CYP2C9 isoenzyme. About 70% is excreted through the intestine, 30% through the kidneys. When taken with food AUC drug is reduced by 48%. At the same time, 8 hours after the application of the tablets, the plasma concentration of active components taken on an empty stomach or with food is the same. Therefore, Valsartan is allowed to use regardless of food intake.
The absorption of hydrochlorothiazide after is 60-80%. The maximum concentration in the blood is observed after 2 hours. Binding to plasma proteins - 40-70%. The active ingredient is not metabolized. About 95% is excreted by the kidneys in practically unchanged form. The half-life is 6-15 hours.
Patients with impaired renal function (renal clearance about 30% of the total) do not need to adjust the dose. Since the degree of binding of the active ingredient with plasma proteins is very high, its excretion in the process of hemodialysis is unlikely.
In patients with bile duct obstruction or biliary cirrhosis, the AUC of the drug is doubled.
In patients of advanced age there is a decrease in systemic clearance of hydrochlorothiazide.
Indications for use
Correction of arterial hypertension in patients on combined therapy.
- Hypersensitivity to the components of the drug;
- Severe violations of the liver (biliary cirrhosis, cholestasis);
- Light and moderate liver disorders of non-biliary origin;
- Clinical manifestations of hyperuricemia;
- Severe renal impairment, anuria;
- Age to 18 years;
- Pregnancy and lactation;
- Deficiency of lactase;
- Intolerance to galactose;
- Malabsorption syndrome;
- Primary hyperaldosteronism;
- Systemic lupus erythematosus ;
- Procedure of hemodialysis.
Dosing and Administration
Valsakor H160 is a drug for internal use, which is recommended to be taken once a day, regardless of food intake. It is allowed to be used in combination with other antihypertensive agents.
Patients who were not able to achieve the target blood pressure level during monotherapy with valsartan or hydrochlorothiazide failed to receive Valsacor H160 fixedly (once a day 160 / 12.5 mg).
Side effects when taking the drug Valsakor H 160 as a whole have a weakly passing character.
From the side of the central nervous system and PNS : general weakness, increased fatigue, dizziness, insomnia, asthenia. Seldom there is a headache, paresthesia, a depressed state, neuralgia. It is very rare (in the case of application after a previous myocardial infarction) fainting occurs.
From the digestive system : often develops diarrhea. Sometimes there is dyspepsia, nausea, pain in the abdomen. Rarely - constipation, lack of appetite, gastroenteritis. Very rarely - jaundice, intrahepatic cholestasis, pancreatitis .
On the part of the respiratory system: nasopharyngitis, ARVI, rhinitis, inflammation of the paranasal sinuses, cough. Very rarely - ARDS (respiratory distress syndrome), accompanied by pneumonitis and pulmonary edema.
On the part of the cardiovascular system : chest pain, pronounced decrease in blood pressure, orthostatic hypotension. In rare cases, arrhythmia develops, peripheral edema.
On the part of the genitourinary system: increased frequency of urination, urinary tract infection, very rarely impotence (less than 1%), decreased libido, impaired renal function.
From the musculoskeletal system : pain in the back and limbs, arthritis, arthralgia, tendon ruptures, muscle cramps , myalgia (very rarely).
From the skin: very rarely - itching, hives , photosensitivity, alopecia, hypersensitivity reactions, lupus-like reactions, angioedema.
Other disorders: tinnitus, conjunctivitis , visual disturbances, increased sweating, nasal bleeding.
With the simultaneous administration of Valsacor H160 and potassium-sparing diuretics, ACE inhibitors, cyclosporine, heparin, potassium-containing dietary supplements, the development of hypercalcemia is possible.
Simultaneous use of the drug and other antihypertensive drugs (including diuretics) increases the hypotensive effect.
At simultaneous reception with lithium preparations and antagonists of angiotensin receptors, a reversible increase in the serum of lithium ions is noted, which leads to an increase in its toxicity.
With simultaneous use with thiazide diuretics, the risk of developing orthostatic hypotension is potentiated.
When using insulin and other hypoglycemic agents, often a correction of their dose is required.
The simultaneous use of Valsacor H160 with corticosteroids, laxatives, antiarrhythmic drugs IA and III class, cardiac glycosides and neuroleptics, there is a risk of hypokalemia, hypomagnesemia, and piruetty arrhythmias.
When interacting with uricosuric agents there is an increase in the blood concentration of uric acid and the development of reactions of hypersensitivity to allopurinol.
Nonsteroidal anti-inflammatory drugs can reduce hypotensive, natriuretic and diuretic effect.
The simultaneous use of Valsacor H160 with vitamin D and calcium preparations increases the blood content of the ions of this trace element.
With special care, with regular monitoring of kidney function, patients suffering from severe chronic renal failure in the decompensated stage should be treated with patients with hyponatremia and a reduced volume of circulating blood.
Refers to medicines that are prescribed by a doctor.
Store in a dry place, protected from light, out of reach of children, at a temperature not exceeding 25 ° C.
Shelf life of the drug is 3 years from the date of issue. After the expiry date indicated on the package, the drug should not be used.
Average price in pharmacies in Moscow
Valsakor H160 analogues
Valsakor Hd 160;