In the article, we consider the instructions for use, price and reviews for the Arifon (Arifon Retard) tool.
It is a thiazip-like diuretic, antihypertensive agent. It contributes to a decrease in the tonus of arterial smooth muscle, a decrease in OPSS, and also has moderate saluretic activity, which is caused by the destruction of reabsorption of sodium ions, water and chlorine in the Henle loop (in the e cortical segment) and in the proximal curved tubule of the nephron. OPSS decreases due to several mechanisms: there is a decrease in sensitivity to angiotensin 2 and vascular wall norepinephrine; increased synthesis of prostaglandins, which have vasodilating activity; the channel of calcium ions is inhibited into the smooth muscle structures of the vessel wall. When used in recommended therapeutic doses, it practically does not affect the metabolism of lipids and carbohydrates.
According to the instructions for use with Arifon, an antihypertensive effect is observed only if the blood pressure was increased initially. It develops a week after the start of the course of therapy, and reaches its maximum after 3 months of regular use.
Composition and form of release
As the instructions for use indicate, Arifon is produced by the manufacturer in only one pharmacological form - in tablets. They are covered with a film membrane, packed in a cardboard box, in each box there is 1 blister, on which 30 tablets are located.
Each contains 2.5 mg of indapamine, which is the main active ingredient.
As additional components, talc, corn starch, lactose monohydrate, povidone, magnesium stearate are used.
The film coating of the tablets consists of glycerol, macrogol 6000, magnesium stearate, hypromellose, sodium laurisulfate, titanium dioxide and white beeswax.
This is confirmed by the instructions for use. The price of Arifon Retard will be presented below.
Pharmacodynamics
Indapamide is a sulfonamide derivative whose pharmacological properties are similar to those of thiazide diuretics. Under its influence, the excretion of sodium and chloride ions through the kidneys increases, to a slightly lesser extent - potassium and magnesium ions, which provokes an increase in diuresis. A characteristic feature of Arifon is its ability to exert an antihypertensive effect when taking a dose that does not cause a pronounced diuretic effect. The effectiveness of indapamide has also been proven in patients with a single kidney.
The active component of Arifon acts on the vessels by activating the synthesis of prostaglandin PGE2 (an inhibitor of aggregation of a vasodilator and platelets) and prostacyclin PGI2, as well as by changing the transmembrane current of ions (calcium, in the first place). As a result, vascular smooth muscle cells relax. Indapamide is able to reduce left ventricular hypertrophy. It is important to note that short, medium, long-term Arifon therapy does not cause changes in carbohydrate metabolism, even in patients with diabetes mellitus, arterial hypertension, and lipid metabolism, including the levels of low and high density lipoproteins, triglycerides, and cholesterol.
The antihypertensive effect of Arifon does not increase when the therapeutic dose is exceeded, but it can provoke the development of pronounced negative reactions. In the absence of the necessary therapeutic effect, increasing the dosage of the drug is undesirable.
Pharmacokinetics
In accordance with the instructions for use with Arifon, the bioavailability of indapamide is at 93%. The maximum concentration of the main component in the blood after a single oral administration of Arifon is observed after 2 hours.
With proteins in the blood plasma, an average of 75% of indapamide binds. The half-life of a substance can vary in the range from 14 to 24 hours, an average of 18 hours. Regular intake of Arifon provides an increase in the equilibrium saturation of the blood with the active component in comparison with a single dose. The achieved equilibrium level is maintained for a rather long time, which suggests that there is no cumulation of indapamide in the body when taking the medication again.
As a result of biotransformation of indapamide, metabolites are formed that do not have pharmacological activity. About 60-80% of the drug taken is excreted by the kidneys. The unchanged part of the substance (on average 5%) is excreted from the body along with urine. It should be noted that the pharmacokinetic parameters of indapamide do not change when used in patients with severe renal dysfunction.
Indications for use
In accordance with the instructions for use, Arifon is indicated for use in patients with diagnosed arterial hypertension. The drug is prescribed by a doctor.
Contraindications
The main contraindications that prevent the use of "Arifon" include:
- The age of the patient is up to 18 years.
- The presence of lactose intolerance, galactosemia, impaired glucose and galactose absorption processes.
- Lactation period.
- Severe liver failure.
- Hypokalemia.
- Individual hypersensitivity to any of the components that make up Arifon.
It should be taken with caution if the patient has hepatic or renal failure, impaired water-electrolyte balance, hyperparathyroidism, hyperuricemia (in particular with gout or urate nephrolithiasis), pregnancy.
Dosage, method of application
What else does the instructions for use tell us? Arifon 1.5 mg should be taken orally, preferably at the same morning time. Reception should begin with a minimum dosage of 1.25 to 2.5 mg.
In the absence of the desired effect of therapy for one to two months, the dosage should not be increased, since this does not enhance the effect, but can provoke the development of undesirable concomitant effects.
Side effects
According to the instructions for use and reviews of "Arifon Retard", against the background of therapy, such negative effects as may develop:
- ECG changes, orthostatic hypotension due to hypokalemia, arrhythmia, palpitations (from the CCC).
- Muscle spasm, irritability, anxiety, tension, general malaise, depression, increased fatigue, vertigo, headaches, dizziness, nervousness, asthenia, insomnia, drowsiness (from the NS).
- Nocturia and polyuria (from the genitourinary system).
- the appearance of cough, pharyngitis, sinusitis, rhinitis (from the respiratory system).
- Hepatic encephalopathy as a result of liver failure, pancreatitis, anorexia, abdominal pain, dyspepsia, vomiting, nausea, constipation, diarrhea (from the gastrointestinal tract).
- Thrombocytopenia, bone marrow aplasia, leukopenia, hemolytic anemia, agranulocytosis (from the hemopoietic organs).
- Allergic reactions (hemorrhagic vasculitis, maculopapular rash, pruritus, urticaria).
While taking the drug in laboratory studies, an elevated level of urea nitrogen in the blood, hypercreatininemia, hyperglycemia, hypokalemia, hyponatremia, hypercalcemia, hyperuricemia, hypochloremia can be detected.
This is stated in the instructions for use. The price of Arifon is quite reasonable.
Overdose
Indapamide in high doses, significantly higher than recommended, does not have a toxic effect on the body.
When symptoms of an overdose of "Arifon" appear, one can judge a violation of the water-electrolyte balance (in particular, hyponatremia and hypokalemia). The main symptoms of an overdose are: seizures, drowsiness, arterial hypotension, dizziness, blurred consciousness, vomiting, nausea, oliguria and polyuria, which lead to anuria against the background of hypovolemia.
In such a situation, it is necessary to provide the patient with emergency care aimed at the early removal of indapamide from the body. Rinse the stomach immediately and take the recommended dose of activated carbon for poisoning. Further treatment is symptomatic and is aimed at eliminating the manifestations of an overdose and normalizing the water-electrolyte balance of the body.
This will confirm the instructions for use. The price and reviews for Arifon are presented at the end of the article.
Interaction with other medicines
Arifon is able to slow the elimination of lithium ions from the body, which entails its accumulation and nephrotoxic effects.
When taken in parallel with iodine-containing contrast agents in large doses, the risk of pathological conditions of the renal system develops. The introduction of such drugs in therapy requires a preliminary restoration of fluid deficiency.
In parallel with indirect anticoagulants, indandion derivatives, coumarin derivatives, a decrease in their effectiveness is possible.
"Arifon" is able to increase the severity of the blockade of neuromuscular transmission, formed using non-depolarizing muscle relaxants.
Combined therapy with glucocorticosteroids, thiazide and loop saluretics, tetracosactide, laxatives, amphotericin B can provoke hypokalemia.
Concomitant use with cardiac glycosides provokes the development of digitalis intoxication.
Intravenous use of bretilium tosylate, amiodoran, sotalol, quinidine, disopyramide, pentamidine, suloprid, trefenadine, vincamine, astemizole, erythromycin has a synergistic effect, as a result of which pirouette type arrhythmia is observed.
The antihypertensive effect of "Arifon" is reduced when taking adrenostimulants, glucocorticosteroids, tetracosactide. When taking baclofen, the opposite effect is observed.
An additional intake of ACE inhibitors contributes to the development of renal failure, as well as arterial hypotension.
The hypotensive effect is enhanced, the likelihood of manifestation of orthostatic hypotension increases significantly while taking antipsychotic medications, tricyclic, imipramine antidepressants.
Combined therapy "Arifon" and drugs of the cyclosporin group provoke hypercreatininemia.
special instructions
In accordance with the instructions for use with Arifon Retard, during therapy with the product, it is necessary to regularly check the level of potassium, sodium, magnesium ions in the blood, the concentration of residual nitrogen, sugar, uric acid. Patients taking laxatives and cardiac glycosides require monitoring potassium and creatinine levels.
The appearance of hypercalcemia while taking Arifon indicates that the patient has an undiagnosed hyperparathyroidism.
Careful observation of a specialist is necessary for patients with diagnosed cirrhosis and ascites.
It is very important to regularly monitor the dynamics of changes in the sugar curve.
The results of doping control may be unreliable while taking the drug.
Data on the safety of the drug in the treatment of children is not available.
We examined in detail the instructions for use.
Analogues of "Arifon"
Arifon has a wide range of structural analogues for the main component. These include: Tenzar, SR Indamed, Retapres, Ravel SR, Pamid, Lorvas, Ipres Long, Ionik, Indiur, Indipam, Indapsan , Indapres, Ionik Retard, Indapamide Retard, Indapamide, Indap, Vero Indapamide, Arifon Retard, Arindap, Akuter Sanover, Acripamide Retard, Acripamide .
Reviews on the use of the drug
Mostly reviews about "Arifon" are specialized doctors. It is reported that the drug is really effective if taken in strict accordance with the indications. Arifon has a mild effect, effectively normalizes blood pressure, and significantly reduces puffiness.
Nevertheless, negative reviews about the instructions for use for "Arifon" and the drug itself are also present. Most often, they come from patients who note the manifestation of serious side effects while taking the medication. Moreover, negative reactions are expressed quite intensely.
Price
The average price level for Arifon in Russian pharmacies is in the range of 350-400 rubles per package, containing 30 tablets with a dosage of 2.5 mg. It depends on the region and the pharmacy network.
The article presented instructions for use, price and reviews of "Arifon Retard".