After intake of rapidly and completely absorbed from the gastrointestinal tract; bioavailability – high (93%). Food intake slows down the absorption rate, but does not affect the completeness of absorption.Maximum plasma concentration – 12 hours after ingestion. Repeated receptions indapamide fluctuations in plasma concentrations in the range between the two doses decreased techniques. The equilibrium concentration is set at 7 days of regular admission. The methenolone enanthate side effects, connection with blood plasma proteins – 79%. Associated also with elastin smooth muscles of the vascular wall. It has a high volume of distribution, passes through the blood-tissue barriers (including placental) passes into breast milk. It is metabolized in the liver. The kidneys remove 60 – 80% in the form of metabolites (unchanged output of about 5%), through the intestines – 20%. In patients with renal insufficiency The pharmacokinetics does not change. Not accumulates.
: Hypersensitivity to indapamide and other ingredients, as well as to other sulfonamide derivatives, severe renal insufficiency (creatinine clearance less than 30 ml / min), hypokalemia, hepatic encephalopathy or severe liver dysfunction, pregnancy, lactation, age 18 years ( efficacy and safety have not been established); concomitant use of drugs prolonging the interval.
Precautions: in the human liver and / or kidney disease, disorders of water and electrolyte balance, hyperparathyroidism, in debilitated patients or in patients receiving concomitant therapy with other antiarrhythmics, while taking drugs, prolonging the interval QT (see “Interaction section with others. drugs “), diabetes, hyperuricemia (especially accompanied by gout and urate nephrolithiasis).
Use during pregnancy and lactation
During pregnancy should not prescribe diuretic drugs. Do not use these drugs to treat physiological edema of pregnancy. Diuretic methenolone enanthate side effects drugs can cause fetoplacental ischemia and lead to impaired development of the fetus (malnutrition).
Application Tenzar drug is not recommended during pregnancy. Indapamide is excreted in breast milk. Given the possibility of occurrence of adverse events in infants, breast-feeding during treatment with Tenzar not recommended.
Dosage and administration
Capsules taken orally without chewing. The daily dose – 1 capsule 1 Tenzar drug once a day (in the morning), drinking plenty of fluids. In the treatment of patients with hypertension dose should not exceed 2.5 mg (increased risk of side effects without increasing the antihypertensive effect).
Elderly patients are
elderly patients should be monitored plasma concentration of creatinine according to the age, weight and sex.
Tenzar drug at a dose of 2.5 mg / day (1 capsule) can be administered to elderly patients with normal or mildly impaired renal function (see. “Contraindications”),
Most adverse reactions (clinical and laboratory parameters) are dose-dependent.
The frequency of adverse reactions that can be caused by thiazide diuretics, including indapamide, given by the following grading: very often (> 10.1); common; very rare (<1/10000); unspecified frequency (frequency can not be calculated from the available data).
From the circulatory and lymphatic system
Very rare: thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, hemolytic anemia.
On the part of the central nervous system
Rare: dizziness, fatigue, headache, paresthesia.
Cardio-vascular methenolone enanthate side effects system
Very rare: arrhythmia, lowering blood pressure.
From the digestive system
Rare:. Nausea, constipation, dryness of the oral mucosa
is very rare: pancreatitis.
From the urinary system
Very rare: renal insufficiency.
On the part of the liver and biliary tract
Very rare: abnormal liver function.
Unspecified frequency: the possibility of the development of hepatic encephalopathy in case of hepatic insufficiency (see sections “Contraindications”, “Special Instructions”.).
For the skin
reactions of hypersensitivity, dermatological mainly in patients predisposed to allergic and asthmatic reactions:
- Common: maculopapular rash.
- Uncommon: hemorrhagic vasculitis.
- Very rare: angionevroticheskny edema and / or urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome.
- Unspecified frequency: possible deterioration in the presence of an acute form of disseminated lupus erythematosus.
Cases of photosensitivity reactions.
Very rarely: hypercalcaemia.
, Unspecified frequency:
- decrease in potassium content and the development of hypokalemia, especially significant for patients at risk (see “Special Instructions” section.)
- hyponatremia, accompanied by hypovolemia, dehydration and orthostatic hypotension. Simultaneous loss of chloride ions may lead to compensatory metabolic methenolone enanthate side effects alkalosis, but the incidence of alkalosis and its expression is negligible;
- increased concentration of uric acid and plasma glucose. Thiazide and thiazide diuretics should be used with caution in patients with gout and diabetes.