Tenorik

Tenorik - a combined antihypertensive drug that is able to have a prolonged hypotensive effect.

The therapeutic effect of this drug is due to the two components that make up its composition. Atenolol is a blocker that suppresses the activity of receptors in blood vessels and heart. Chlortalidone is a component that has a diuretic property, which has a positive effect on lowering the pressure.

The maximum concentration of active components of Tenoric in the patient's blood is observed 2-3 hours after taking the pill, and its hypotensive effect persists throughout the day. The diuretic effect of the drug can be observed about 24-48 hours.

By the end of the second week of the course, Tenoric patients have a persistent hypotensive effect.

Clinical and pharmacological group

Antihypertensive drug.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Tenoric cost in pharmacies? The average price is at the level of190 rubles.

Composition and form of release

The tenor is produced in the form of tablets or tablets of forte coated with a film shell: almost white or white, biconvex, round, with a dividing risk on one side (10 pcs. in strips, 10 strips in a cardboard bundle; for 14 pcs. in strips or blisters, 2 strips or blisters in a cardboard bundle).

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The composition of 1 tablet includes the active substances:

Atenolol - 50 (tablets) or 100 (tablets forte) mg;
Chlortalidone - 12.5 (tablets) or 25 (tablets of forte) mg.

Auxiliary components: corn starch, lactose, polyvinylpyrrolidone, sodium lauryl sulfate, talc, isopropanol, colloidal silicon dioxide, magnesium stearate.

The composition of the film shell: methylene chloride, isopropanol, vaseline oil, hypromellose, talc, titanium dioxide, macrogol.

pharmachologic effect

Atenolol refers to cardioselective β1-adrenoblockers. Its selectivity decreases with increasing dosage. Atenolol has a negative inotropic effect, it decreases the heart rate.

Chlortalidone refers to diuretics that enhance the excretion of sodium, chlorine, potassium, magnesium and bicarbonate. It is not completely clear what is involved with its antihypertensive effect, possibly with sodium excretion.

Actions from the drug persists throughout the day. After ingestion, 40 to 50% of atenolol is adsorbed from the digestive tract. Its maximum concentration is observed after 2-4 hours after taking the pill, only from 6 to 16% binds to plasma proteins. Almost 90% of atenolol is excreted unchanged, its half-life can vary from 6 up to 9 hours, it can increase with renal pathologies, since atenolol is excreted mainly with urine.

After ingestion, about 60% of chlorthalidone is adsorbed from the digestive tract, up to 75% of it is bound to proteins. The maximum concentration of the diuretic is reached after 12 hours, it is excreted by the kidneys, the half-life period is about 50 hours.

Indications for use

The only medical indication for the use of Tenoric tablets is arterial hypertension (increased systemic blood pressure level).

Contraindications

Absolute:

pheochromocytoma (without combined use with alpha-blockers);
syndrome of weakness of the sinus node;
acute heart failure and chronic heart failure in the stage of decompensation;
hepatitis in acute course;
hereditary lactose intolerance, galactose / glucose malabsorption syndrome and lactase deficiency;
collapse, cardiogenic shock;
severe peripheral circulatory disturbances;
arterial hypotension in severe course (with systolic pressure below 90 mm Hg. item);
myasthenia gravis;
gout;
metabolic acidosis;
refractory hypokalemia;
atrioventricular blockade of II and III degree;
kidney failure (with creatinine clearance less than 35 ml / min);
age under 18 years (safety profile for this group of patients has not been studied);
individual intolerance of the drug components.

Relative (use of Tenorik requires caution in the presence of the following diseases / conditions):

thyrotoxicosis;
diabetes;
angina of Prinzmetal;
atrioventricular blockade of the 1st degree;
chronic obstructive pulmonary disease, bronchial asthma;
disorders of renal function and water-electrolyte balance of blood;
elderly age.

Prescribing Tenoric to nursing and pregnant women is not recommended.

Intended use for pregnancy and lactation

In most cases, the Tenoric is not prescribed to women during pregnancy or lactation, because its components are capable of penetrate the placental barrier and into breast milk, having a negative effect on the health of the fetus or child.

Dosage and route of administration

As indicated in the instructions for use, the dosing regimen is given in terms of atenolol.

The average dose of the drug Tenorik for adults is 100 mg; the initial dose is 50 mg 1 time / day.

As a rule, the use of the drug in a dose corresponding to 100 mg of atenolol, gives a good clinical effect. The subsequent increase in the dose or does not lead to a further decrease in blood pressure, or reduces it very slightly. If necessary, an additional antihypertensive agent may be prescribed.

For the elderly, the drug should be given in lower doses.
When prescribing the drug, patients with impaired renal function should reduce the frequency of taking the drug.

After prolonged use of Tenoric, the drug should be discontinued gradually.

Side effects

The drug is very well tolerated, and side effects are usually mild and transient.

When taking the drug, the following side effects are possible:

Intermittent claudication, AV blockade, arrhythmia and Raynaud's syndrome;
paresthesia, apathy, fatigue, visual impairment, disorientation;
Orthostatic hypotension, bradycardia, increased symptoms of heart failure, cold extremities - from the side of the cardiovascular system;
side effects of the nervous system: dizziness, confusion, mood swings, headache, hallucinations, acute psychosis, sleep disturbances;
alopecia, photosensitivity, exacerbation of psoriasis, skin rash, dry eyes.

Sometimes, the drug may cause side effects from the GI tract and hematopoiesis system, but they are much less common.

Overdose

Of the symptoms that indicate an overdose, we can distinguish the following manifestations:

arterial hypotension,
the expressed degree of a bradycardia,
bronchospasm,
increased drowsiness,
acute heart failure.

Treatment is symptomatic, while careful monitoring of the doctor for the patient's condition, in severe cases are shown hospitalization, gastric lavage, intake of laxatives and activated charcoal.

With the emerging bronchospasm, bronchodilators are used, with a significant decrease in pressure, plasma or plasma substitutes are injected, with diuresis injected with liquid.

special instructions

Before you start using the drug, read the special instructions:

Strictly to cancel Tenorik at patients with an ischemic illness of heart does not follow.
Reduction of the therapeutic effect of the drug may be observed in smokers.
It should be borne in mind that the use of Tenorik can mask the phenomena of hypoglycemia and thyrotoxicosis.
With the development during the treatment of bradycardia (with a heart rate of up to 50 beats per minute) with clinical symptoms, it is necessary to reduce the dose or cancel therapy.
Reception Tenorika must be stopped 2 days before surgery, and as an anesthetic is recommended to choose the drug with possibly the smallest negative inotropic effect.
Tenoric is prescribed with caution to patients with bronchial obstructive syndrome, and with worsening of bronchial conductivity, beta-adrenomimetics should be prescribed.
When using Tenorika, it is possible to reduce the production of tear fluid, which is important for patients using contact lenses.
Tenoric should be administered with caution to patients with AV-blockade I degree, as well as with functional disorders of the kidneys.
During therapy, there is a possibility of glucose tolerance impairment, in connection with which the drug should be used with caution in patients with a predisposition to diabetes mellitus.
Treatment may develop hyperuricemia, usually minor, but in some cases, the use of drugs that promote the excretion of uric acid may be required.
During therapy, it is possible to increase sensitivity to allergens and the development of severe anaphylactic reactions. In this regard, patients receiving desensitizing therapy should take Tenorik with great care. Such patients may not respond to the average doses of epinephrine (epinephrine) used in the treatment of allergic reactions.
With the use of the drug, hypokalemia may develop, so you need to monitor the serum potassium content. This is especially true for patients receiving cardiac glycosides for cardiac insufficiency (possibly arrhythmia), patients with an unbalanced diet (with a low potassium content) and patients with complaints of gastrointestinal disorders.

The question of whether it is possible to drive vehicles should be addressed after evaluating the individual tolerance of Tenoric.

Interaction with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

With the simultaneous appointment of Tenoric with reserpine, clonidine, guanfacin, there may be a pronounced bradycardia.
The simultaneous use of Tenoric with derivatives of dihydropyridine (nifedipine) may increase the risk of developing arterial hypotension, in patients with latent heart failure may appear signs of circulatory disorders.
Cardiac glycosides in combination with beta-blockers can increase the AV-conduction time.
Preparations containing lithium should not be used with diuretics. they can reduce renal clearance of lithium.
The use of beta-blockers together with means for general anesthesia can lead to an increased risk of developing arterial hypotension and summation negative inotropic effect of both drugs (anesthetic should be used with minimal negative inotropic effect). It is also possible to intensify the action of curare-like muscle relaxants.
When using the drug Tenorik with MAO inhibitors, it is possible to increase blood pressure (this combination should be avoided).
With the simultaneous use of the preparation Tenorik with ACE inhibitors (captopril, enalapril) at the beginning of therapy, a sharp increase in the antihypertensive effect is possible.
With the combined use of Tenoric with GCS, amphotericin B, furosemide, potassium excretion is possible.
When combined with Tenorik, the action of insulin and oral hypoglycemic agents may decrease (blood glucose levels should be monitored).
Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators and other antihypertensives can enhance the antihypertensive effect of Tenoric.
Beta-adrenoblockers can aggravate the ricochet hypertension that may occur after the withdrawal of clonidine. If both drugs are prescribed, the beta-blocker should be discontinued a few days before cessation of clonidine. If you need to replace clonidine with a beta-blocker, the latter should be administered a few days after cessation of clonidine therapy.
It is necessary to use caution in prescribing a beta-blocker in combination with antiarrhythmic drugs of the first class (disopyramide), because cardiodepressive effect can be summarized.
The concomitant use of sympathomimetic drugs, for example, epinephrine (adrenaline), norepinephrine (norepinephrine) can neutralize the effect of beta-blockers and lead to a significant increase in blood pressure.
Salicylates and NSAIDs (ibuprofen, indomethacin), estrogens can reduce the antihypertensive effect of beta-blockers, and when salicylates are used in a high dose, it is possible to increase the toxic effect of salicylates on the central nervous system.
The use of beta-blockers in combination with calcium channel blockers, which have a negative inotropic effect, such as verapamil, diltiazem, can lead to an increase This effect, especially in patients with reduced contractility of the myocardium and / or with a violation of sinoatrial or AV-conduction, which can cause severe arterial hypotension, severe bradycardia and heart failure (the calcium channel blocker should not be used iv for 48 hours after the abolition of the beta-blocker).

Reviews

We offer you to read reviews of people who used the drug Tenorik:

Olga. Saw a tenor for 7 years everything is fine now sugar high memory no in the chest crushes all the simp is shorter. which in anotation and so I took them pressure 130 90 pulse 60 I was assigned to them at the Institute of Cardiology professor said they accept only those who have a high pulse and the second number, I did it on quarters took.
Alexander. Mother after a stroke "Tenorik" prescribed by the treating doctor, recommended as the most effective and in her situation a vital medicine for normalizing the pressure. The course drank for several years, and, I must say, the doctor was right, a very effective drug.
Lyudmila. A very good drug. I took a tenorik for a long time, but then He disappeared from sale in Kazakhstan. I had to stop taking these pills. Also has gone and has gone. That some tablets appoint doctors that others. They are now trying to "appoint" expensive drugs regardless of the incomes of their patients. Just-business has become something and not a cure for doctors. Which is very distressing to think that not only me.

Analogues

Structural analogs for the active substance:

Athexal compositum;
Atenolol compositum;
Tenonorm;
Tenoretik;
Tenorox.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

The shelf life of Tenorik tablets is 3 years. They should be stored in original factory packaging, dark, dry, inaccessible to children at an air temperature of no more than + 25 ° C.