Mykaridis

width = Mycargis is a drug prescribed to patients to reduce arterial hypertension.

The drug has a strong antihypertensive effect, the dosage of the drug is selected in each case strictly individually. The main active substance of the drug is Telmisartan. In one tablet it can contain 80, 40 or 20 mg.

When taken orally, it is quickly absorbed from the intestine. Bioavailability approaches 50%. After three hours, the concentration in the plasma becomes maximum. 9,% of the active substance binds to blood proteins. Metabolized by reacting with glucuronic acid.

Clinical and pharmacological group

Angiotensin II receptor antagonist.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Mykardis? The average price in pharmacies is at the level of1 000 rubles.

Form of issue and composition

The medicine is white tablets, oblong, with an engraving "51N" on one edge and a company logo on the other side.

One Micardis tablet contains 40 or 80 mg of telmisartan (active substance).
Excipients: sodium hydroxide, polyvidone, meglumine, sorbitol, magnesium stearate.

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Seven such tablets with a dosage of 40 mg in a blister, 2 or 4 such blisters in a cardboard bundle. Either 7 such tablets with a dosage of 80 mg in a blister, 2, 4 or 8 such blisters in a cardboard bundle

Pharmacological effect

The maximum effect develops 3 hours after a single dose. The hypotensive effect lasts more than 24 hours, including the last 4 hours before taking the next dose. A stable clinical result is achieved after 4-8 weeks of course use and is maintained for a long time. With a sharp discontinuation of blood pressure gradually (within a few days), returns to the initial values without manifesting a "ricochet" hypertension.

Indications for use

Mycargis is a drug for the treatment of hypertension.

Also, the drug is used to reduce the cardiovascular morbidity and, respectively, mortality in people older than 55 years with a high risk of developing diseases of cardio-vascular system.

Contraindications

As indicated in the instructions to Mikardis, this drug is contraindicated:

Patients with obstructive diseases of the biliary tract;
During pregnancy;
Breastfeeding women;
With intolerance to fructose;
With insufficiency of sucrose / isomaltose;
Children and adolescents under 18 years of age (due to the lack of data on the safety of telmisartan in this age group);
With increased sensitivity to the active or any auxiliary component of the drug;
People with severe hepatic impairment (in the Child-Pugh category C);
In violation of absorption of glucose-galactose.

Assign the drug, but with special care and under medical supervision to patients with:

Hyponatremia;
Hyperkalemia;
Primary aldosteronism;
Chronic heart failure;
Impaired renal / hepatic function;
Two-sided stenosis of both renal arteries or stenosis of the artery of a single kidney;
Idiopathic hypertrophic subaortic stenosis;
Stenosis of the mitral and aortic valve.

Care should be taken when treating Mikardis following people after kidney transplantation, as well as patients who have a decrease in the volume of circulating blood is a consequence of previous diuretic therapy, vomiting or diarrhea, salt.

Use in pregnancy and lactation

It is forbidden to use in pregnant and lactating women.

Dosage and route of administration

The instructions for use indicate that Mikaridis is prescribed inside, regardless of food intake.

To reduce cardiovascular morbidity and mortality, the recommended dose is 1 tab. (80 mg) 1 time / day. In the initial period of treatment, an additional correction of blood pressure may be required.
With arterial hypertension, the recommended initial dose of the drug Mikardis is 1 tab. (40 mg) 1 time / day. In cases where the therapeutic effect is not achieved, the dose of the drug can be increased to 80 mg 1 time / day. When deciding whether to increase the dose, it should be taken into account that the maximum antihypertensive effect is usually achieved within 4-8 weeks after the start of treatment.

Patients with renal insufficiency (including those on hemodialysis) do not need a dose adjustment.

In patients with impaired hepatic and mild liver function (class A and B on the Child-Pugh scale), the daily dose of the drug should not exceed 40 mg.

Dosing regimen in elderly patients does not require changes.

Side effects

During therapy with the drug Mikardis, these side effects were recorded:

From the musculoskeletal system: myalgia, back pain, arthralgia.
From the genitourinary system: edema, infection of the genitourinary system, hypercreatininaemia.
Hypersensitivity reactions: skin rash, angioedema, hives.
Laboratory indicators: anemia, hyperkalemia.
From the central nervous system: depression, dizziness, headache, fatigue, anxiety, insomnia, convulsions.
On the part of the respiratory system: diseases of the upper respiratory tract (sinusitis, pharyngitis, bronchitis), cough.
On the part of the circulatory system: marked lowering of pressure, tachycardia, bradycardia, chest pain.
On the part of the digestive system: nausea, diarrhea, dyspepsia, increased concentration of liver enzymes.
Other: erythema, itching, dyspnea.

Overdose

Cases of drug overdose are not registered.

When symptoms such as: marked decrease in blood pressure, tachycardia, bradycardia, require symptomatic therapy. Hemodialysis is ineffective.

special instructions

In cases of vascular tone and kidney function, mainly from RAAS activity (for example, in patients with chronic cardiac deficiency or kidney disease, incl. with stenosis of the renal arteries or stenosis of the artery of a single kidney), administration of drugs, influencing this system, can be accompanied by the development of acute arterial hypotension, hyperaemia, oliguria and, in rare cases, acute renal insufficiency.

In some patients, due to inhibition of RAAS, especially when using a combination of agents acting on this system, renal function (including acute renal failure) is impaired. Therefore, therapy accompanied by a similar double blockade of RAAS (eg, with the addition of ACE inhibitors or a direct inhibitor of renin-aliskiren to antagonist blockers receptors of angiotensin II), should be carried out strictly individually and with careful monitoring of kidney function (including periodic monitoring of potassium and creatinine concentrations in serum).

In patients with diabetes mellitus and an additional cardiovascular risk, for example, in patients with diabetes mellitus and ischemic heart disease, in the case of drugs, lowering blood pressure, such as angiotensin II receptor antagonists or ACE inhibitors, may increase the risk of fatal myocardial infarction and sudden cardiovascular of death. In patients with diabetes, IHD can be asymptomatic and therefore can be undiagnosed. Before starting the use of the drug Mikardis for the identification and treatment of coronary artery disease, appropriate diagnostic tests should be carried out, incl. a test with physical activity.

Based on the experience of using other drugs that affect RAAS, while prescribing the drug Mikaridis and potassium-sparing diuretics, potassium-containing additives, potassium-containing edible salt, other agents that increase the concentration of potassium in the blood (for example, heparin), this indicator should be monitored patients.

In patients with primary aldosteronism, antihypertensive drugs, whose mechanism of action is inhibition of RAAS, are usually not effective.

Alternatively, the Mycardis preparation can be used in combination with thiazide diuretics, such as hydrochlorothiazide, which additionally have an antihypertensive effect (for example, the preparation Mikardis Plus 40 mg / 12.5 mg, 80 mg / 12.5 mg).

Care should be taken when applying the preparation Mikardis (as well as others vasodilators) in patients with aortic or mitral stenosis and with hypertrophic obstructive cardiomyopathy.

In patients with severe arterial hypertension, the dose of telmisartan 160 mg / day in combination with hydrochlorothiazide 12.5-25 mg was effective and well tolerated.

Telmisartan is excreted mainly with bile. In patients with obstructive diseases of the biliary tract or liver failure, a decrease in the clearance of the drug can be expected.

Disorders of liver function in the appointment of telmisartan in most cases were observed in the inhabitants of Japan.

Mycida is less effective in patients of the Negroid race.

Drug Interactions

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

Telmisartan may increase the antihypertensive effect of other antihypertensive agents. Other types of interactions that have clinical relevance have not been identified.
With the simultaneous use of telmisartan and ramipril, AUC0-24 and Cmax ramipril and ramiprilat increased 2.5-fold. The clinical significance of this phenomenon is not established.
Combined use with digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin and amlodipine does not lead to clinically significant interaction. An increase in the average concentration of digoxin in the blood plasma was observed on average by 20% (in one case by 39%). With the simultaneous administration of telmisartan and digoxin, it is advisable to periodically determine the concentration of digoxin in the blood.
Treatment with NSAIDs, including acetylsalicylic acid, COX-2 inhibitors and nonselective NSAIDs, can cause the development of acute renal failure in patients with dehydration. Drugs acting on RAAS may have a synergistic effect. In patients receiving NSAIDs and telmisartan, at the beginning of treatment should compensate for BCC and conduct a study of kidney function.
With the simultaneous use of ACE inhibitors and lithium preparations, a reversible increase in the concentration of lithium in the blood was noted, accompanied by a toxic effect. In rare cases, such changes are registered with the appointment of angiotensin II receptor antagonists. With the simultaneous administration of lithium preparations and angiotensin II receptor antagonists, it is recommended to determine the concentration of lithium in the blood.
Reduction of the effect of antihypertensive agents, such as telmisartan, by inhibiting the vasodilating effect of prostaglandins was noted with simultaneous therapy with NSAIDs.

Reviews

We picked up some reviews of people taking the drug Mikaridis:

Natalia. I'm terrified. I am 59 years old. Hypertension. When taking the drug, the feet began to "buzz", complained to the doctor, she began to insist on continuing to take the drug, arguing that the pressure numbers were good. I still trusted these words of the doctor. Began to "buzz" hands. I was frightened (a month and a half of treatment had passed). Has stopped to accept a medicine. His hands "calmed down", his legs swollen for three months.
Catherine. My doctor prescribed the drug Mikaridis. Initially, the dosage was 40 mg, then it was increased to 80. The medicine really helped stop the development of hypertension, side effects manifested only in the form of periodic dizziness. I would continue to be treated with joy by Mikardis, but his high cost was too expensive for me. The doctor picked up a cheaper analog.
Semen. After a heart attack, he suffered from dizziness and pressure surges, the cardiologist prescribed this drug. I've been drinking for a year. A month after receiving, the pressure stopped jumping, it became normal - 120/70. Now Mykaridis is drunk by his wife and sister.