Fozicard, tablets 20 mg 28 pcs

Fosicard is an ACE inhibitor. Fosinopril is a complex ester from which the active metabolite, fosinoprilat, is formed in the body.

Fosinoprilat prevents the conversion of angiotensin I to the vasoconstrictor angiotensin II, which leads to vasodilation, decreased OPPS and decreased aldosterone secretion. By reducing the secretion of aldosterone there is a slight increase in serum potassium ions with a simultaneous loss of sodium ions and fluid from the body.

The drug has antihypertensive, vasodilatory, diuretic and potassium-saving effects. The antihypertensive effect is also due to inhibition of bradykinin metabolism, which has a marked vasodilator effect. The decrease of BP is not accompanied by changes in the blood circulation, cerebral and renal blood flow, blood supply of internal organs, skeletal muscles, skin, myocardial reflex activity.

The antihypertensive effect of the drug is maintained with long-term treatment, tolerance to the drug does not develop. After oral administration the antihypertensive effect develops within 1 hour, reaches a maximum after 2-6 hours and lasts for 24 hours.

Indications

– Arterial hypertension.

– Chronic heart failure (as part of combination therapy).

Active ingredient

Composition

1 Table contains:

Fosinopril sodium 20 mg.

Auxiliary substances:

lactose monohydrate,

croscarmellose sodium,

Pregelatinized corn starch (starch 1500),

Microcrystalline cellulose,

Glycerol dibegenate.

How to take, the dosage

In arterial hypertension: Before starting treatment of arterial hypertension, if possible, discontinue previously used antihypertensive treatment several days before starting Fozicard. The initial dose is 10 mg once daily. Subsequently, the dose should be adjusted depending on the dynamics of BP reduction. The average maintenance dose is 10-40 mg once daily. If there is no positive effect of Fozicard monotherapy, additional diuretics may be prescribed. If treatment with Fozicard is started against the background of diuretic therapy, the initial dose should not exceed 10 mg with careful medical supervision.

In treatment of chronic heart failure, the initial dose of Fozicard is 10 mg once daily. Further, the dose of the drug is adjusted according to the dynamics of therapeutic effectiveness, increasing by 10 mg at weekly intervals. The maximum dose is 40 mg/day. Additional prescription of diuretics is possible.

Interaction

Antihypertensive drugs, diuretics, opioid analgesics, general anesthetics, when used simultaneously with Fozicard, increase its hypotensive effect. NSAIDs and estrogenic agents when used concomitantly reduce the antihypertensive effect of Fozicard.

Concomitant use of Fozicard with potassium preparations, potassium-saving diuretics increases the risk of hyperkalemia. Fozicard increases the hypoglycemic effect of sulfonylurea derivatives, insulin.

Concomitant use of Fozicard with allopurinol, cytostatic drugs, immunosuppressants, procainamide increases the risk of leukopenia.

Concomitant use of Fozicard with lithium salts may increase the concentration of lithium in the blood.

Special Instructions

Patients with severe arterial hypertension or with concomitant decompensated chronic heart failure should start treatment with Fozicard in a hospital setting.

Before and during drug treatment it is necessary to control BP, renal function, potassium concentration, hemoglobin, creatinine, urea, electrolyte concentration and activity of liver enzymes in blood.

Peripheral blood leukocyte counts should be monitored periodically while taking Fozicard, especially in patients at increased risk of neutropenia (in renal dysfunction and systemic connective tissue diseases).

Because of the increased risk of arterial hypotension, caution should be exercised when prescribing the drug in patients on a low-salt or salt-free diet.

Contraindications

– Hereditary or idiopathic angioedema (including history) after taking other ACE inhibitors.
– Pregnancy.
– Period of lactation (breast-feeding).
– Children and adolescents under 18 years old.
– Hypersensitivity to fosinopril and other components of the preparation.

The drug should be used with caution in the following cases:

– Renal failure.
– Hyponatremia (risk of dehydration, arterial hypotension, chronic renal failure).
– Bilateral stenosis of the renal arteries or stenosis of the artery of the single kidney.
– Aortic stenosis.
– Post renal transplantation.
– Desensitization.
– Systemic connective tissue diseases, including SLE, scleroderma (increased risk of neutropenia or agranulocytosis).
– Hemodialysis.
– Cerebrovascular diseases (including insufficient cerebral circulation).
– CHD.
– Chronic heart failure III and IV functional class by NYHA classification.
– Diabetes.
– Inhibition of bone marrow hematopoiesis.
– Hyperkalemia.
– Elderly patients.
– In patients on a salt-restricted diet.
– In states accompanied by a decrease in the blood circulation (including diarrhea and vomiting).

Side effects

Cardiovascular system disorders: decreased BP, orthostatic hypotension, tachycardia, palpitations, arrhythmias, angina pectoris, myocardial infarction, chest pain.

In the digestive system: nausea, vomiting, constipation, intestinal obstruction, stomatitis, glossitis, dyspepsia, abdominal pain, anorexia, cholestatic jaundice, pancreatitis, hepatitis.

Respiratory system: dry cough, dyspnea, pharyngitis, laryngitis, sinusitis, pulmonary infiltrates, bronchospasm, dysphonia.

Urinary system disorders: development or worsening of symptoms of chronic renal failure, proteinuria, oliguria.

CNS and peripheral nervous system disorders: stroke, cerebral ischemia, dizziness, headache, weakness; when used in high doses – insomnia, anxiety, depression, confusion, paresthesia.

Sensory organs: hearing and vision disorders, tinnitus, disorders of the vestibular system.

Allergic reactions: skin rash, itching, angioedema.

Laboratory disorders: hypercreatininemia, increased concentration of urea, increased liver transaminase activity, hyperbilirubinemia, hyperkalemia, hyponatremia, decreased concentration of hemoglobin and hematocrit, neutropenia, leukopenia, eosinophilia, increased sedimentation rate.

Overdose

Symptoms: marked BP decrease, bradycardia, shock, water-electrolyte imbalance, acute renal failure, stupor.

Treatment: discontinue the drug, place the patient in a supine position with elevated legs. In mild cases of overdose – gastric lavage, administration of sorbents and sodium sulfate within 30 minutes after intake. In BP decrease – intravenous administration of catecholamines, angiotensin II; in bradycardia – use pacing agent. Hemodialysis is ineffective.

Similarities