This is an automatically translated article.
Hypertension is a common chronic disease today. The need to use drugs of patients is also increasing, requiring the introduction of many better drugs, overcoming the side effects of previous drugs. Accordingly, the receptor blocker group was born, overcoming the dry cough side effect of the ACE inhibitor group. A prominent active ingredient of this group is telmisartan found in the drug Cilzec 40.
1. What is Cilzec 40mg?
Cilzec 40 of the manufacturer MNS (India) has the main ingredient is Telmisartan. Cilzec 40mg drug is mainly used in the treatment of hypertension, can be used as monotherapy or in combination with other antihypertensive drugs.
Telmisartan is an active substance belonging to the group of specific antagonists at the AT1 receptor of angiotensin II, prepared in many strengths such as 20, 40, 80mg. In addition, Cilzec 40mg medicine also contains some other excipients such as Microcrystalline cellulose (PH101), Croscarmellose sodium, Meglumine, Poloxamer 188, Povidone K-30, Microcrystalline cellulose (PH 102), Magnesium stearate.
2. The effect of the drug Cilzec 40mg
Cilzec 40mg is mainly used in the treatment of hypertension, can be monotherapy or in combination with other antihypertensive drugs.
Angiotensin I is converted to Angiotensin II through the catalysis of ACE. Regarding the mechanism of hypertension of the Renin-Angiotensin system, Angiotensin II plays an important role due to its vasoconstriction effects, stimulation of aldosterone synthesis and release, cardiac stimulation, and increased renal sodium reabsorption. The active ingredient Telmisartan in Cilzec 40mg is capable of inhibiting the vasoconstrictor effect and aldosterone release of Angiotensin II through the mechanism of selectively blocking the binding of Angiotensin II to the AT1 receptor in many tissues in the body such as muscle. smooth blood vessels and adrenal glands. Thus, it can be seen that the antihypertensive effect of Cilzec 40mg is not related to the synthesis of Angiotensin II. According to research, active ingredient Telmisartan has strong affinity for AT1 receptor compared to AT2 receptor (over 3000 times).
A drug that acts on the same renin-angiotensin system as telmisartan is an ACE inhibitor. Another difference between the two groups is the breakdown of Bradykinin, a substance that requires the catalysis of ACE. At that time, the drugs of the ACE inhibitor group were accompanied by an inhibitory effect on the breakdown of Bradykinin and telmisartan did not. This is not known to have a clinical correlation but gives telmisartan the advantage of not causing a dry cough (Bradykinin causes a dry cough).
Cilzec 40mg is contraindicated in patients with hypersensitivity to any of the ingredients.
3. Dosage of the drug Cilzec 40mg
3.1. Dosage Cilzec 40mg Tablets can be used in combination with other antihypertensive drugs, and can be taken with or without food.
Dosage of Telmisartan depends on the individual patient:
The usual starting dose is 1 Cilzec 40mg tablet once a day; The dose response on blood pressure ranges from 20-80 mg. 3.2. Some notes on the use of Cilzec 40mg Patients with intravascular volume depletion need to be stabilized before starting Cilzec 40mg or need close monitoring of the doctor; Cases of biliary obstruction or liver failure when starting treatment with Cilzec 40mg should be closely monitored by a physician; Most patients using Cilzec 40 will control their blood pressure within 2 weeks and reach the maximum effect after 4 weeks. Some people who do not achieve the desired blood pressure results can increase the dose of Telmisartan to 80mg and add a diuretic; There is no need to adjust the starting dose of Telmisartan in the elderly or with renal impairment, including those on hemodialysis. 3.3. Overdosage of Cilzec 40 mg and its management There are limited data regarding overdose of Cilzec 40 mg in humans; Symptoms of Telmisartan overdose may include hypotension, dizziness, tachycardia or bradycardia due to parasympathetic stimulation; If the patient has low blood pressure, it is necessary to carry out supportive treatment measures; Note that the active ingredient Telmisartan in Cilzec 40mg cannot be eliminated by hemodialysis.
4. Side effects of Cilzec 40mg
The adverse events of Cilzec 40mg, such as back pain, sinusitis, diarrhea, and sore throat, occurred 1% more frequently in the Telmisartan group than in the placebo group.In addition, the following adverse events of Cilzec 40mg may occur at a frequency of 1%: Flu-like symptoms, dyspepsia, muscle pain, urinary tract infection, abdominal pain, headache, dizziness, fatigue fatigue, cough, hypertension, chest pain, nausea, peripheral edema. The incidence of cough that occurred in the telmisartan group was similar to that in the placebo group (1.6%).
5. Some cautions when taking Cilzec 40mg
5.1. In case of impaired liver function Most of telmisartan is excreted in the bile, so elimination is reduced if the patient has biliary obstruction or impaired liver function. Therefore, caution should be exercised when Cilzec 40 mg is used in these patients.
5.2. Impaired Renal Function Cilzec 40mg inhibits the renin-angiotensin-aldosterone system, which could theoretically affect renal function in susceptible individuals; Progressive oliguria and/or uremia, rarely acute renal failure or, more seriously, death, may occur when Cilzec 40mg users have renal function dependent on the activity of the renin-angiotensin-aldosterone system. ; The risk of renal function impairment may also occur in concurrent users of Cilzec 40mg and other products that also contain the active ingredient Telmisartan; Caution and close monitoring of renal function are recommended when co-inhibitors of the Renin-angiotensin-Aldosterone system, such as a combination of an ACE inhibitor and an angiotensin II receptor antagonist, are recommended. 5.3. Ability to drive and use machines There are no data on the effects of Cilzec 40mg on the ability to drive and use machines. However, when performing these tasks, patients should be aware that dizziness or drowsiness may occasionally occur during the use of antihypertensive drugs such as this product.
5.4. Pregnancy Telmisartan acts directly on the Renin-angiotensin system, thereby posing a risk of harm or even death to the fetus. Therefore, Cilzec 40mg is not indicated for women in the 2nd and 3rd trimesters, and if pregnancy is detected, Cilzec 40mg should be discontinued as soon as possible.
5.5. Lactation: Telmisartan is not known to be excreted in human milk, although it is present in the milk of lactating rats. However, due to the risk of adverse effects in nursing infants, a nursing mother must decide whether to discontinue Cilzec 40mg or to discontinue breast-feeding, depending on the individual circumstances.
5.6. Some notes of Cilzec 40mg drug on special subjects Elderly: In general, there is no difference in the level of safety and effectiveness of Cilzec 40mg in the elderly compared to the young; Children: The pharmacokinetics of Cilzec 40mg have not been studied in patients under 18 years of age; Gender: The plasma concentration of Cilzec 40mg in women is 2-3 times higher than in men. However, this had no effect on blood pressure or the risk of orthostatic hypotension in women. Therefore, no dose adjustment of Cilzec 40mg is required.
6. Drug interactions of Cilzec 40mg
Digoxin when co-administered with Cilzec 40mg may increase the peak plasma concentration of Digoxin (49%) and trough concentration (20%), so it is necessary to check the concentration of Digoxin at the beginning of treatment to adjust. dose or stop taking Cilzec 40mg to avoid the case of insufficient or overdose of Digoxin; Warfarin when co-administered with Cilzec 40 mg for 10 days slightly reduced mean plasma concentrations of Warfarin, but did not change INR; Co-administration of Cilzec 40mg with drugs Acetaminophen, Amlodipine, Glibenclamide, Simvastatin, Hydrochlorothiazide or Ibuprofen did not cause clinically significant drug interactions.
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