Arterial hypertension (hypertension, AH) is a disease of the cardiovascular system in which the blood pressure in the arteries of the systemic (large) circle of blood circulation is stably increased. In the development of the disease, both internal (hormonal, nervous systems) and external factors (excessive consumption of sodium chloride, alcohol, smoking, obesity) are important. In more detail what this disease is, we will consider further.
Such patients have a headache (especially in the mornings) in the occipital region, causing a feeling of heaviness and freshness of the head. In addition, patients complain of poor sleep, poor performance and memory, as well as characteristic irritability. Some patients complain of pain behind the sternum, shortness of breath after doing physical work, and visual impairment.
"Mikardis Plus" is a drug that is prescribed to patients in order to reduce hypertension. This medicine has a stable hypotensive effect, the dosage of the drug is selected individually in each case. Immediately before use, you should definitely read the instructions for use, which indicate contraindications with the features of treatment with this medication. In our article, we will study in detail the instructions for Mikardis Plus, and also learn what patients tell about its effectiveness.
Composition and pharmacological effects of the drug
The main active ingredient of the drug is telmisartan. One tablet of this component contains 80, 40, and 20 milligrams. Excipients of the medication that improve the absorption of the main component are: meglumine, sodium hydroxide, polyvidone, sorbitol and magnesium stearate. This medicine, in addition to telmisartan, contains an additional 12.5 milligrams of hydrochlorothiazide - a substance that is a diuretic. The combination of diuretics and angiotensin antagonists makes it possible to achieve greater hypotensive effects. The diuretic effect occurs approximately two hours after taking the pill.
"Mikardis Plus" is an antagonist drug for the receptors of the hormone angiotensin. This hormone increases the tone of the vascular walls, which leads to a decrease in the clearance of blood vessels. Telmisartan is identical in chemical structure to the subspecies of angiotensin receptors.
After entering the body, this drug forms a bond with the receptors, which leads to the displacement of angiotensin, thus eliminating the main reason for the increase in blood pressure. Telmisartan leads to a decrease in systolic and, in addition, diastolic pressure, but this substance does not change its strength in any way with the number of contractions of the heart muscle. What does the Mikardis Plus manual tell us?
Already the first use of the drug leads to a gradual stabilization of pressure: it slowly decreases over a couple of hours. Antihypertensive effect after taking the tablets is observed for at least one day. Thus, in order to keep the pressure normal and under control, it is required to drink the medicine only once a day. The maximum, and at the same time, persistent decrease in pressure occurs a month later from the start of treatment with the presented drug. In cases where the medicine is abruptly canceled, the effect of withdrawal does not occur, that is, the pressure returns to the original indicator not sharply, but, as a rule, this happens in a few weeks.
All components of Mikardis Plus, when taken orally from the intestine, are rapidly absorbed, the bioavailability of the drug reaches almost fifty percent. The maximum concentration of the active component in plasma is determined after three hours. The metabolization process occurs through the reaction of telmisartan with glucuronic acid. The resulting metabolites are inactive. The half-life of the drug is more than twenty hours. The processed drug is excreted in feces. As for urine, less than two percent of the drug comes out with it.
Mikardis Plus tablets are available in three versions: 80, 40 and 20 milligrams of telmisartan. Regardless of the amount of active ingredient, all tablets have an oblong shape and white color. An engraving of the company is printed on one side of the tablet. 40 milligram tablets also have 51N embossed. Those of them, which are 80 milligrams each, are engraved with the value "52N". In one package there are from two to eight blisters, each of which contains seven tablets.
When should you use the drug?
According to the instructions, Mikardis Plus (80 + 12, 5 mg) was developed for the treatment of hypertension. Some doctors prescribe this medicine for patients over fifty-five years of age who have been found to have an increased risk of severe cardiological pathologies that are associated with arterial hypertension. It is worth noting that the drug is prescribed in the case when it is not possible to achieve the required pressure reduction while taking the usual form of this drug.
It is not recommended to prescribe this medicine for yourself and choose its dosage, since only a doctor can find out any contraindications by correctly evaluating the patient's analyzes. The likelihood of side effects also depends on how correctly the treatment regimen was chosen.
When is a medication considered contraindicated?
Treatment with the drug should not be carried out in the following cases:
- In situations where there is hypersensitivity to the main or additional substances of this medicinal product.
- This medicine is not suitable for women who are in position, and, in addition, if breastfeeding is carried out.
- The drug is not suitable even when patients have biliary tract pathologies that affect their general patency.
- In the presence of serious violations in the functioning of the kidneys and liver.
- In situations where there is inherited fructose intolerance.
Analogs should be selected in the treatment of hypertension in children or adolescents. This is primarily due to the fact that the effect of telmisartan on an organism that has not yet fully formed has not been established. Instructions for use with Mikardis Plus indicate that this medicine, in addition to all the above contraindications, cannot be prescribed to patients suffering from refractory hypercalcemia, and, moreover, it is not suitable for hypokalemia, deficiency due to intolerance to galactose and lactose.
Relative contraindications are also given to the Mikardis Plus drug (80 mg). For example, doctors should be especially careful and prescribe a low-dose treatment in cases where in the history of hypertensive patients there are the following pathologies:
- The development of hyponatremia or hyperkalemia.
- The presence of cardiac ischemia in patients.
- The development of various heart diseases, for example, in the form of chronic insufficiency, valve stenosis or cardiomyopathy.
- The appearance of stenosis of both arteries of the kidneys. In situations where the patient has only one kidney, special care should be taken during the administration of the drug when there is stenosis of the only artery that performs the function of blood supply.
- The development of dehydration, which is caused by diseases accompanied by vomiting or diarrhea.
- Previous diuretic therapy.
- Recovery of patients after a kidney transplant.
In addition to the above diseases, with the appointment of "Mikardis Plus," one should also be especially careful if patients have diabetes and gout.
Probable side effects during administration
Reviews about "Mikardis Plus" are not always distinguished by a positive rating. Some patients report the appearance of various uncomfortable changes in their well-being. It should be immediately emphasized that the development of undesirable effects directly depends on the dosage of the drug, and, in addition, on the age of the patients and the presence of concomitant pathologies. So, it is often possible to observe the following changes while taking this medication:
- The appearance of periodic dizziness, headache, fatigue and anxiety along with a depressed state, insomnia, and, in more rare cases, convulsions are not excluded.
- A significant increase in susceptibility from the respiratory system to infectious pathogens, which in turn becomes the main cause of pharyngitis, sinusitis, bronchitis, paroxysmal cough and the like.
- The appearance of dyspeptic disorders in the form of nausea, colic, and, in addition, diarrhea. In some patients, tests may also show an increase in hepatic enzyme.
- The appearance of hypotension - pain in the chest area. Also, the development of tachycardia or, conversely, bradycardia is not excluded.
- The occurrence of muscle pain and arthralgia. The appearance of pain in the lumbar region.
- The development of infectious lesions of the genitourinary tract along with fluid retention in the body.
- The occurrence of allergic reactions in the form of skin rashes, urticaria along with angioedema, itching or erythema.
- As part of laboratory tests, hyperkalemia with signs of anemia can be detected.
In the framework of preclinical studies of the drug “Mikardis Plus,” the fetotoxic effect of the drug was established. Given this factor, it is undesirable to take this drug throughout pregnancy. In the event that conception is planned, then the woman, according to the doctor’s recommendation, should switch to less dangerous antihypertensive drugs. In cases of conception, the use of this medicine is immediately stopped.
Features of use
The medicine "Mikardis Plus" should be prescribed exclusively by a doctor. It can be used alone or with other pharmaceutical preparations, the effect of which is aimed at improving the functioning of the cardiovascular system. The medicine manufacturer recommends a daily intake of Mikardis Plus to be limited to one tablet with a dosage of 40 milligrams of the active substance. But it is important to take into account that in patients suffering from a mild form of hypertension, a persistent hypotensive effect can sometimes develop while taking a twenty-milligram dosage.
The selection of a therapeutic dose is carried out for at least four weeks. So much time is needed for this drug to show its full therapeutic effect. In the event that the desired result has not been achieved during this time, the patient is recommended to take "Mikardis Plus" in a dosage of 80 milligrams. In the presence of more severe forms of hypertension, the administration of the drug in the amount of 160 milligrams of telmisartan is allowed, that is, therefore, two tablets of 80 milligrams are required. It should be noted that due to the diuretic included in Mikardis Plus (80 + 12, 5 mg), the pressure in patients decreases much faster and better than when taking the usual version of this medicine.
Thus, the doctor selects the dose of the combined drug based on the severity of the course of hypertension. Reviews about "Mikardis Plus" often confirm its pronounced hypotensive effect. The medicine presented is taken absolutely at any time of the day. In this case, the use of food does not affect the digestibility of the substances of the drug. The total duration of admission is determined by the doctor, depending on the patient’s condition, the doctor may recommend switching to a maintenance dosage of 20 milligrams.
Patients who have a history of renal impairment do not need to be given an individual dose. In the event that there are moderate pathological changes in liver function in the anamnesis, only the dosage “40” is required. It should be noted that any increase in dose leads to a deterioration in the work of the body. As for elderly patients, they do not need dose adjustment.
Interaction with other drugs
If there is a need to use drugs with telmisartan, the doctor must definitely find out which drugs are still being taken by the patient. With the simultaneous use of a number of drugs, their effect or the effect of Mikardis Plus may increase:
- The substance telmisartan can enhance the hypotensive property of other drugs with a similar effect.
- With the simultaneous treatment of Digoxinoma and Mikardis Plus (40 + 12, 5 mg), the concentration of the substances of the first drug may increase.
- There is an increase of almost two and a half times the concentration of Ramipril. True, the clinical significance of the interaction of both drugs has not been determined.
- There is an increase in the percentage concentration of products that contain lithium, which may be accompanied by increased toxic effects on the body.
- With the simultaneous use of non-steroidal anti-inflammatory drugs and telmisartan in people with dehydration, the risk of kidney failure may increase, and, in addition, a decrease in the hypotensive effect of the drug is likely.
Drug overdose
According to the instructions for use with Mikardis Plus, in case of an overdose of this drug, the following symptoms may occur:
- The appearance of arterial hypotension.
- The development of tachycardia.
- The occurrence of bradycardia, nausea and drowsiness.
An overdose is usually associated with a decrease in the level of electrolytes (hypokalemia), and, in addition, with dehydration as a result of significant diuresis. Hypokalemia can lead to muscle cramps and increased arrhythmias, which will be associated with the combined use of cardiac glycosides, and, in addition, with some antiarrhythmic drugs.
The recommended treatment in this case should be symptomatic therapy. In this case, patients should be closely monitored. Thus, symptomatic and supportive therapy should be carried out depending on the elapsed time after taking an excessive amount of the drug and the severity of the symptoms. Serum electrolytes should be monitored at frequent intervals. In the event of the development of arterial hypotension, the patient must be laid on his back, and, in addition, electrolyte compensation should be urgently performed. In this case, hemodialysis is considered not effective.
The effect of the active component of the drug on the ability of patients to control mechanisms
The attached instructions for the use of the drug "Mikardis Plus" (40 and 80 milligrams) reports that no special tests have been carried out regarding the effect of the drug on concentration of attention, as well as on the speed of the reaction. But, nevertheless, while taking drugs with a hypotensive effect of exposure, one should always bear in mind that pharmaceutical preparations of this category can cause drowsiness with periodic dizziness. In the event that workers who are associated with servicing mechanisms have similar symptoms, then they should be assigned analogues of Mikardis Plus (80 or 40 mg).
Features of storage of the drug and its cost
The drug must be stored where accessibility to children is excluded. The temperature in the storage room should not exceed thirty degrees. As a rule, tablets with a dosage of 40 and 80 milligrams can be stored without violating the integrity of the blister for no more than four years from the moment of their production. 20 milligram tablets have a shorter shelf life of three years. The price of the drug "Mikardis Plus" in a pharmacy directly depends on the dosage of the active ingredient in the drug:
- You can buy a drug for 40 milligrams, in which there are fourteen tablets, for about five hundred rubles.
- Mikardis Plus 80 milligrams with twenty-eight tablets in a pharmacy costs an average of nine hundred and fifty rubles.
- The cost of a drug of twenty-eight tablets starts from eight hundred and fifty rubles.
This information, however, is not in the instructions for use with Mikardis Plus.
Analogues of the drug
Reviews about the drug are mostly positive, since people who used this medicine note a rare occurrence of side effects and report that this medication is good, and, most importantly, quickly reduces pressure. , . , « » . , : «», «», «», «» «».
« » , , , . - , , , «», « «». , .
« »
, , . , . , . , , , – . .
, , . , « » , .
, , . , .
« » .
Doctors reviews
, . , . , , . -, .
« » .