Tiurex® is indicated for the treatment of arterial hypertension, edema of cardiac, hepatic or renal origin, edema of hepatic origin, most often in combination with potassium-sparing diuretics.
Composition
Active ingredient: hydrochlorothiazide.
1 tablet contains: 12.5 mg or 25 mg or 50 mg of hydrochlorothiazide.
Excipients: lactose monohydrate, microcrystalline cellulose, hydroxypropylcellulose, red iron oxide (E 172), yellow iron oxide (E 172), magnesium stearate.
Contraindication
Hypersensitivity to GH, other thiazides, sulfonamides or any other component of the drug. Severe renal impairment (creatinine clearance less than 30 ml/min and/or serum creatinine above 1.8 mg/100 ml). Anuria. Acute glomerulonephritis. Hepatic coma or precoma. Refractory hypokalemia, hyponatremia or hypercalcemia. Hypovolemia. Symptomatic hyperuricemia/gout. Arterial hypertension of pregnancy.
Method of application
The dose of the drug is selected and adjusted by the doctor individually. The tablets should be taken orally, washed down with water, after meals. The daily dose of the drug can be divided into one or two doses.
The initial dose is 12.5 or 25 mg once daily. The maintenance dose is 12.5 mg once daily.
Hyponatremia or dehydration should be corrected before use in combination with ACE inhibitors, ARBs or direct renin inhibitors. Otherwise, treatment should be initiated under close medical supervision.
Application features
Pregnant women
Given the pharmacological effects of GHZ, it can be predicted that the use of the drug during the second and third trimesters of pregnancy may reduce fetoplacental blood flow and cause such phenomena in the fetus or newborn as jaundice, electrolyte imbalance, and thrombocytopenia.
Children
It is not recommended to use the drug in children.
Drivers
Treatment of high blood pressure with GCS requires regular medical supervision. The ability to drive and use machines may be impaired in individual reactions. This applies in particular to the initial stage of treatment, increasing the dose of GCS, replacing it, and concomitant use with alcohol.
Overdose
Symptoms.
The clinical picture of acute or chronic overdose of GCS depends on the degree of dehydration and electrolyte loss. With significant loss of fluid and sodium, overdose may manifest as thirst, weakness, dizziness, vomiting, muscle pain and muscle spasms (e.g., calf muscle cramps), headache, tachycardia, orthostatic hypotension caused by dehydration and hypovolemia, which leads to hemoconcentration, seizures, drowsiness, lethargy, confusion, vascular collapse, and acute renal failure. Electrolyte imbalance may lead to cardiac arrhythmias.
Hypokalemia may manifest as fatigue, muscle weakness, paresthesias, paresis, apathy, flatulence, constipation, or lead to cardiac arrhythmias. Severe hypokalemia may lead to paralytic ileus and impaired consciousness up to hypokalemic coma.
Treatment.
In case of symptoms of overdose, the drug should be discontinued immediately. In all cases of overdose, general supportive measures should be taken. Treatment includes restoration of water and electrolyte balance and, in case of vascular collapse, transfer to the intensive care unit, if necessary, anti-shock therapy.
Side effects
In the post-marketing period, the following adverse reactions have been reported after the use of medicinal products containing GHTZ: aplastic anemia, angle-closure glaucoma, erythema multiforme, muscle cramps, acute renal failure, renal dysfunction, fever, asthenia, NMSR (BCC and PCC).
Interaction
Other drugs that enhance the antihypertensive effect of GHZ.
The antihypertensive effect of GHZ may be enhanced by other diuretics, antihypertensive drugs, guanethidine, methyldopa, calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), direct renin inhibitors, β-blockers, nitrates, barbiturates, phenothiazine derivatives, tricyclic antidepressants, vasodilators and alcohol.
Storage conditions
Store at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Shelf life - 2 years.
