Uses of Lamotel

Lamotel is an angiotensin II receptor blocker, used in the treatment of hypertension. Lamotel can be used alone or in combination with other drugs during treatment.

Lamotel has the main active ingredient is Telmisartan, the drug is made in the form of tablets with the strength of 40mg and 80mg.
Telmisartan is an angiotensin II receptor antagonist with effects similar to losartan. Telmisartan does not exhibit detailed partial activity at the AT1 receptor. Telmisartan binds selectively to the AT1 receptor, this binding is long-lasting. Telmisartan has no affinity for other receptors including AT2 and the less typical AT receptor. Telmisartan reduces plasma aldosterone concentrations. Telmisartan does not inhibit human plasma renin or block ion channels. Telmisartan does not inhibit angiotensin-converting enzyme (kinase II), which also degrades bradykinin. It is therefore unlikely to increase bradykinin-mediated side effects.
Telmisartan is used to lower blood pressure, because it selectively blocks AT1 receptors and as a result reduces the hypertensive effect of angiotensin II in patients with essential hypertension, especially patients with essential hypertension. cough when taking ACE inhibitors and to reduce the risk of stroke in patients with left ventricular hypertrophy, and in the treatment of diabetic nephropathy. Telmisartan is also used prophylactically in patients at risk for heart failure and myocardial infarction.
In humans, a dose of 80 mg Telmisartan has almost completely inhibited angiotensin II-induced hypertension. This inhibitory effect is maintained for 24 hours and can be seen for up to 48 hours.

Indications for use of Lamotel in the following cases:
Treatment of essential hypertension: used alone or in combination with other antihypertensive drugs. Reduces the risk of cardiovascular events: myocardial infarction, stroke and death in high-risk patients 55 years of age and older who cannot take ACE inhibitors. Lamotel is contraindicated in the following cases:
Allergy or hypersensitivity to Telmisartan or any ingredient of Lamotel. Pregnant women. Women are breastfeeding. Severe renal failure: serum creatinine ≥ 250 micromol/liter, creatinine clearance ≤ 30 ml/min, blood potassium ≥ 5 mmol/liter. Severe liver failure. Obstructive biliary tract disease.

Lamotel is taken orally. The time of taking Lamotel is not related to the meal because food only slightly reduces the bioavailability of the drug.
Treatment of essential hypertension
Oral dose of 40mg / day (taken once or divided into 2 times), maximum dose 80mg / day (taken once or divided into 2 times). Telmisartan can be used in combination with thiazide diuretics, because the antihypertensive effect is synergistic with Telmisartan. When it is necessary to increase the dose of Lamotel, it should be borne in mind that the maximum antihypertensive effect is usually achieved 4 to 8 weeks after initiation of therapy. Patients with severe hypertension can be treated with Lamotel at a dose of 160mg/day, divided into 2-3 times, used alone or in combination with hydrochlorothiazide 12.5-25mg/day. Prevention of cardiovascular disease
Recommended dose of 80mg/day (taken once or divided into 2 times), the dose can be adjusted to achieve more effective treatment. Blood pressure should be monitored at the initiation and regularly during treatment with telmisartan to prevent cardiovascular disease. Hepatic Impairment: The daily dose should not exceed 40 mg once daily as monotherapy in patients with mild and moderate hepatic impairment. Severe liver failure has contraindications to the use of Lamotel.
Patients with renal impairment: No dose adjustment is required in patients with renal impairment with creatinine clearance >30ml/min. Telmisartan is not removed from the circulation by dialysis.
Currently, there is limited information on Lamotel overdose in humans. Symptoms of overdosage with Telmisartan may include bradycardia (due to parasympathetic stimulation), tachycardia, dizziness, lightheadedness, and hypotension.
Treatment of Lamotel drug overdose is mainly symptomatic and supportive treatment.

Undesirable effects when using Lamotel are uncommon, usually mild and transient, rarely requiring discontinuation of the drug.
Whole body: fatigue, headache, edema of limbs, angioedema, edema of limbs, excessive sweating. Cardiovascular: tachycardia, hypotension or syncope (common in hypovolemic or salt-depleted patients, treated in combination with diuretics, especially in the standing position). Central nervous system: agitation. Eyes: visual disturbances. Gastrointestinal: dry mouth, loss of appetite, dyspepsia, flatulence, nausea, reflux, abdominal pain, diarrhea. Gastrointestinal bleeding is rare. Urinary: impaired renal function, urinary tract infections, increased creatinine and blood urea. Respiratory: upper respiratory tract infection, flu-like symptoms (runny nose, sneezing, nasal congestion, sore throat, cough, earache, fever), pharyngitis, sinusitis. Metabolic: hyperkalemia, rarely increased uric acid and blood cholesterol. Bones - joints: back pain, pain and muscle spasms. Skin: urticaria, skin rash, pruritus. In case the patient develops excessive hypotension: the patient can be placed in the supine position, if the hypotension is severe, it is necessary to administer an intravenous infusion of physiological saline solution to increase the circulating volume.

Lamotel drug should be used with caution in the following cases:
Aortic valve stenosis, mitral stenosis. Obstructive hypertrophic cardiomyopathy. Renal artery stenosis. Elderly patients, patients with renal failure: it is necessary to monitor blood potassium levels during the use of Lamotel. Reduce the starting dose in some cases in these patients. Severe congestive heart failure (may be particularly sensitive to changes in the renin-angiotensin-aldosterone system, accompanied by oliguria, uremia, potentially fatal acute renal failure). Dehydration (hypovolemia and hyponatremia due to diarrhea, vomiting, prolonged use of diuretics, dietary salt restriction, dialysis) increases the risk of excessive hypotension. Correct this disturbance prior to administration of Lamotel or reduce the dose of the drug and the patient should be monitored at the start of treatment. An increase in the dose of Lamotel is not contraindicated in the presence of transient hypotension, but therapy should be closely monitored after the patient's blood pressure has stabilized (e.g. volume expansion). Active gastric - duodenal ulcer, other gastrointestinal disease (due to the use of Lamotel there is a risk of gastrointestinal bleeding). Mild and moderate liver failure, use of Lamotel requires close monitoring. Caution should be exercised in patients with biliary obstruction because telmisartan is excreted in the bile and cleared by the liver. History of angioedema with or without an angiotensin II receptor blocker or an ACE inhibitor: caution should be exercised when Lamotel is used in these patients. Telmisartan can interfere with porphyrin metabolism, Lamotel should be used only when no other safer alternative is available and with caution in critically ill patients. Sorbitol: Lamotel medicine contains sorbitol. Patients with fructose intolerance should not use Lamotel. Ethnic Variation: Telmisartan and other angiotensin II receptor antagonists are less effective in lowering blood pressure in blacks than in non-blacks, possibly because of the higher prevalence of renin status low in high blood pressure blacks. Use caution when using Lamotel when driving and operating machinery, or doing other concentrated work because Lamotel can cause dizziness, lightheadedness due to hypotension. Pregnancy: Use caution and should not be used in pregnant women in the first 3 months of pregnancy. If you intend to become pregnant, you should replace Lamotel with another drug before becoming pregnant. Telmisartan is contraindicated after the 3rd month of pregnancy. Telmisartan can directly affect the renin-angiotensin system causing adverse effects on the fetus such as hypotension, anuria, renal failure with or without rebound recovery, neonatal skull hypoplasia, fetal death or neonatal death. oligohydramnios (possibly due to decreased fetal renal function), craniofacial deformity, limb spasticity, and pulmonary hypoplasia have been reported with the use of telmisartan in pregnant women. Stop using Lamotel as soon as possible when pregnancy is detected. Lactation: Lamotel is contraindicated because it is not known whether the drug is excreted in breast milk. To ensure the safety of breastfeeding, consideration should be given to discontinuing nursing or discontinuing Lamotel, depending on the importance of the drug to the mother.

Use of Telmisartan with Aliskiren is contraindicated in patients with diabetes mellitus or renal failure (glomerular filtration rate <60 ml/min). Telmisartan is not metabolized by cytochrome P450, and cytochrome P450 inhibitors or inducers have virtually no pharmacokinetic interactions. Telmisartan does not inhibit CYP isoenzymes except CYP2C19. Digoxin: Telmisartan increases the serum concentration of digoxin when administered concomitantly, with mean increases in peak plasma concentrations of digoxin (49%) and trough concentrations (20%) observed. When initiating, adjust dose and possibly discontinue telmisartan, monitor digoxin levels to maintain levels within the therapeutic range. Like other drugs acting on the renin-angiotensin-aldosterone system, telmisartan may cause hyperkalemia. The risk is increased in the case of combination therapy of telmisartan with drugs that can cause hyperkalemia (potassium-containing salt substitutes, ACE inhibitors, angiotensin II receptor antagonists, nonsteroidal anti-inflammatory drugs, heparin, drugs). Immunosuppressive). Lithium: Increased rebound blood levels and lithium toxicity have been reported during co-administration of lithium with angiotensin II-converting enzyme inhibitors, including telmisartan. If concurrent use is necessary, closely monitor serum lithium levels. Nonsteroidal anti-inflammatory drugs: These drugs may reduce the antihypertensive effect of angiotensin II receptor antagonists. In patients with compromised renal function (dehydrated patients, elderly patients with compromised renal function), concomitant administration of angiotensin II receptor antagonists and cyclo-oxygenase inhibitors may cause Severe impairment of renal function, including acute renal failure, is however usually reversible. Patients should be adequately hydrated and renal function monitored after concomitant therapy with these drugs and periodically thereafter. The antihypertensive effect of telmisartan may be increased when used concomitantly with other antihypertensive agents. Orthostatic hypotension may be more severe when telmisartan is co-administered with alcohol, barbiturates, narcotics or antidepressants. Corticosteroids: reduce the antihypertensive effect of Lamotel.