Logimax, 50 mg+5 mg 30 pcs

Logimax is a hypotensive.

Blocks myocardial beta₁-adrenoreceptors (metoprolol) and inhibits calcium ion entry into vascular smooth muscle cells (felodipine).

Pharmacodynamics

Metoprolol reduces the stimulatory effects of catecholamines on the myocardium, cardiac output and BP.

Phelodipine relaxes vascular wall smooth muscle, decreases ROS and potentiates (reciprocally) metoprolol-induced hypotension.

Pharmacokinetics

It is completely absorbed from the gastrointestinal tract. Systemic bioavailability of felodipine is 15%, that of metoprolol – 50%. Binding to plasma proteins in felodipine is 99%. T_1/2 of felodipine is 25 h, metoprolol is 3-5 h. The active substances are metabolized in the liver. 70% of felodipine is excreted as metabolites in the urine, the rest in the feces. Less than 5% of metoprolol is excreted unchanged by the kidneys.

Indications

Hypertension, symptomatic arterial hypertension.

Active ingredient

Composition

Active ingredients:

felodipine 5 mg;

metoprolol succinate (as 50 mg metoprolol tartrate) 47.5 mg;

Associates:

ethylcellulose;

hydroxypropyl methylcellulose;

hydroxypropylcellulose;

/p>

hydrous lactose;

Polyoxyl 40 hydrogenated castor oil;

MCC;

paraffin;

polyethylene glycol;

propyl gallate;

silicon dioxide;

Sodium aluminum silicate;

Sodium stearyl fumarate;

Titanium dioxide (E171);

Iron oxides (E172).

How to take, the dosage

In the morning, in the mouth, without chewing, with water. The initial dose is 1 tablet once a day, the dose is doubled if necessary.

There is no need to adjust the regimen in patients with impaired renal function. Usually it is not necessary to correct the regimen in patients with liver dysfunction, including patients with cirrhosis.

In the presence of symptoms of severe hepatic impairment (e.g., in patients who have a history of bypass surgery), reduction of the dose should be considered.

In elderly patients, 1 tablet once a day is usually sufficient, if necessary, 2 times a day.

Interaction

Calcium channel blockers such as verapamil potentiate negative and chronotropic effects.

It enhances the negative in- and drootropic effects of antiarrhythmic drugs (quinidine analogues, amiodarone), cardiodepressant – of inhaled anesthetics.

Metoprolol concentration in plasma is increased by cimetidine, hydralazine, alcohol, and decreased by rifampicin.

Indomethacin and other prostaglandin synthetase inhibitors weaken the hypotensive effect.

Contraindications

Hypersensitivity, acute myocardial infarction, unstable angina pectoris, significant sinus bradycardia, grade II-III AV blockade, sinus node weakness syndrome, severe peripheral circulatory disorders, decompensated heart failure, cardiogenic shock, pregnancy.

Side effects

Nervous system and sense organs: headache, weakness; dizziness, paresthesia, depression, decreased concentration, drowsiness or insomnia; nervousness, anxiety, visual disturbances, dry or irritated eyes, conjunctivitis; amnesia, confusion, hallucinations, tinnitus, taste disorders.

Cardiovascular and blood (hematopoiesis, hemostasis): redness of face, bradycardia, palpitation, postural abnormalities, cold extremities, peripheral edema; tachycardia, 1st degree AV blockade, pain in heart region; syncope; gangrene in patients with severe peripheral circulatory disorders, thrombocytopenia.

Respiratory system disorders: dyspnea with physical effort; rhinitis.

Gastrointestinal system disorders: nausea, abdominal pain, diarrhea or constipation; vomiting, weight loss; dry mouth, altered liver function tests; mucosal hyperplasia, increased concentration of liver enzymes.

Urogenital system disorders: impotence, sexual dysfunction.

Motor system disorders: myalgia, arthralgia.

Skin disorders: rash (in the form of urticaria psoriasiform), dystrophic skin lesions; hair loss; photosensitization.

Allergic reactions: angioedema.

Overdose

Symptoms: hypotension, sinus bradycardia, AV blockade, heart failure, cardiogenic shock, cardiac arrest, bronchospasm, nausea, vomiting, cyanosis. The first signs appear 20 minutes to 2 hours after ingestion.

Treatment: induction of vomiting, gastric lavage; symptomatic therapy: in case of severe hypotension, bradycardia or threat of heart failure – beta1-agonist (IV at 2-5 min intervals or infusion); or dopamine (IV) or atropine sulfate to block the vagus nerve; dobutamine, noradrenaline, glucagon (1-10 mg). If necessary, the use of a cardiac rhythm driver. To relieve bronchospasm – intravenous beta2-agonist.

Pregnancy use

It is contraindicated in pregnancy.

Breastfeeding should be stopped during treatment.