Description
Diroton Pharmacodynamics
ACE inhibitor, reduces the formation of angiotensin II from angiotensin I. Reduction of angiotensin II leads to a direct reduction of aldosterone excretion. Reduces bradykinin degradation and increases prostaglandin synthesis. Reduces RPS, BP, preload, pulmonary capillary pressure, causes an increase in the minute blood volume and increases myocardial tolerance to exercise in patients with chronic heart failure. Dilates arteries to a greater extent than veins. Some effects are explained by the effect on tissue renin-angiotensin systems. Long-term use reduces myocardial hypertrophy and resistive arterial wall hypertrophy. It improves the blood supply to the ischemic myocardium.
ACE inhibitors prolong life expectancy in patients with chronic heart failure, slow the progression of left ventricular dysfunction in patients who have had myocardial infarction without clinical manifestations of heart failure.
The onset of drug action is within 1 hour, reaches a maximum after 6-7 hours and lasts for 24 hours. The duration of the effect also depends on the dose taken. For arterial hypertension, the effect is noted during the first days after the start of treatment, the stable effect develops after 1-2 months. During abrupt withdrawal of the drug, no pronounced increase in BP was observed.
Diroton® reduces albuminuria. In patients with hyperglycemia, it normalizes the function of the damaged glomerular endothelium. It does not affect the blood glucose concentration in diabetic patients and does not lead to increased incidence of hypoglycemia.
- The drug is taken orally once a day for all indications, regardless of meals, preferably at the same time of day.
- In patients with essential hypertension who do not receive other antihypertensive agents, 10 mg 1 time/ The usual daily maintenance dose is 20 mg. The maximum daily dose is 40 mg.
- The full effect usually develops in 2-4 weeks from the beginning of treatment, which should be taken into account when increasing the dose. In case of insufficient clinical effect, it is possible to combine the drug with other hypotensive agents.
- If the patient received prior treatment with diuretics, their intake should be stopped 2-3 days before the start of Diroton. If it is impossible to cancel diuretics, the initial dose of Diroton should not exceed 5 mg / In this case, after taking the first dose, it is recommended to monitor the doctor for several hours (the maximum effect is achieved after about 6 hours), because a pronounced BP decrease may develop.
- In renovascular hypertension or other conditions with increased RAAS activity, it is also reasonable to prescribe a lower starting dose of 2.5-5 mg/ under increased medical supervision (BP, renal function, serum potassium concentration control). The maintenance dose should be determined depending on BP dynamics.