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CadisAPC with a combination of 2 groups of angiotensin II receptor blockers and diuretics has vasodilator effects, increases urinary sodium excretion, causing hypotension.
1. What is CadisAPC?
The composition of CadisAPC includes Telmisartan and Hydrochlorothiazide - belonging to a group of drugs with antihypertensive effects.Ingredients Telmisartan:
Telmisartan is a specific antagonist of the angiotensin II receptor, with strong and long-lasting affinity at the binding site of the AT1 receptor. Telmisartan significantly reduces the amount of aldosterone in the blood. At the dose used, it inhibits the antihypertensive effect of angiotensin II. The drug lowers both systolic and diastolic blood pressure but does not affect heart rate. Telmisartan is rapidly absorbed after oral administration and is largely bound to plasma proteins. It is then eliminated in the faeces largely unchanged. Ingredients Hydrochlorothiazide:
Hydrochlorothiazide is a Thiazide diuretic. The drug increases the excretion of sodium chloride, potassium, magnesium and water in the urine, inhibits the reabsorption of sodium and chloride ions in the distal tubule. From there, the blood vessels will dilate due to a decrease in sodium ion concentration, causing a blood pressure lowering effect. Hydrochlorothiazide has a moderate diuretic effect, since about 90% of sodium ions have been reabsorbed before reaching the distal convoluted tubule, the primary site of action. Hydrochlorothiazide is rapidly absorbed after oral administration, then stored in erythrocytes. Most of the drug is eliminated by the kidneys as unchanged drug. Diuretics enhance the effects of other classes of antihypertensive drugs. Therefore, when combined with Telmisartan will increase the therapeutic effect of Cadisapc, patients can use 1 pill but can combine 2 different drug groups.
2. Indications of CadisAPC
CadisAPC drug is indicated in the following cases
Idiopathic hypertension. The drug can be combined with another antihypertensive drug.
3. Contraindications of CadisAPC
Cases where CadisAPC should not be used.
Allergy to Telmisartan, Thiazide groups or any of its ingredients. Pregnant or lactating women should not take CadisAPC because it crosses the placental barrier and breast milk. An anuria patient is being treated. Patients with severe renal impairment, glomerular filtration rate <30ml/min. Patients with severe liver failure, biliary obstruction. Patients with hypokalemia, hypercalcemia.
4. Possible drug interactions when taking CadisAPC
Other antihypertensive drugs: Can be combined to increase the effectiveness of treatment. However, do not combine Aliskiren (angiotensin II inhibitor) in patients with diabetes mellitus or renal failure (glomerular filtration rate < 60 ml/min). Telmisartan in CadisAPC will reduce the potassium-depleting effect of hydrochlorothiazide, however, when using drugs that affect potassium levels, caution should be exercised. The telmisartan component of CadisAPC increases serum lithium concentrations, in addition, renal clearance of lithium is reduced by thiazides. Patients with renal insufficiency may cause renal dysfunction when co-administered with NSAIDs, especially COX-2 inhibitors. Concomitant administration of CadisAPC with Digoxin increases the serum concentration of digoxin. Concomitant use for more than 10 days with Warfarin reduces the concentration of Warfarin in the blood. Alcohol and narcotic hypnotics increase the risk of orthostatic hypotension. CadisAPC increases blood glucose, so it is necessary to adjust the dose of antidiabetic drugs in diabetic patients. Dosage adjustment of oral drugs and insulin is required in diabetics receiving CadisAPC due to the risk of hyperglycemia. CadisAPC increases the effect of anesthetics, Glycosides, vitamin D when used concurrently. Herbs such as licorice, dong quai, ephedra, and ginseng reduce the diuretic effect of hydrochlorothiazide.
5. Dosage and how to use CadisAPC
How to use:
Take the medicine once in the morning, regardless of the meal. Dosage:
Adults: 1 tablet/time/day. Increase dose to 160 mg Telmisartan and 25 mg Hydrochlorothiazide (combined or used alone) if needed. Patients with hepatic impairment reduce the dose by 1⁄2 the usual dose.
6. Side effects of CadisAPC
Some unwanted effects when using CadisAPC:
Common:
Feeling tired, headache, dizziness. Postural hypotension. Decreased blood potassium, increased blood sugar, increased uric acid, high doses can increase blood lipids. Uncommon:
Excessive hypotension. Swollen limbs, increased sweating. Feelings of anxiety, restlessness, agitation. Dry mouth, nausea, epigastric pain, heartburn, flatulence, loss of appetite, diarrhea. Urinary tract infection. Upper respiratory tract infection, cough, sore throat, runny nose,... Musculoskeletal pain Hyperkalemia. Rare:
Anaphylactic reactions. Angioedema. Visual disturbances, blurred vision. Increased heart rate, excessive drop in blood pressure, or fainting. Gastrointestinal bleeding. Skin rash, itching, urticaria. Increase liver enzymes. Decrease in blood cell lines: hemoglobin, neutropenia. CadisAPC is a combination antihypertensive agent indicated in cases of essential hypertension. The drug can be used alone or in combination with other drug groups, but not in the case of newly diagnosed patients with hypertension.
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