To Tritatsa Plus

Тритаце Плюс Drug photo

The description is actual on 27.04.2015

  • Latin name: Tritace Plus
  • ATH code: C09BA05
  • Active ingredient: Hydrochlorothiazide + Ramipril (Hydrochlorothiazide + Ramipril)
  • Producer: SANOFI-AVENTIS CANADA (Canada)

Structure

The tablet to Tritatsa Plus contains 2 active components Hydrochlorthiazidum and ramiprit in combinations: 5+12.5; 10+12.5; 5+25; 10+25.

Additional components: fumarating stearit sodium, iron oxide (red dye or yellow depending on a dosage of active agents), gelated corn starch, microcrystallic cellulose, a gidroksipropilmetiltsellyuloza.

Release form

To Tritatsa Plus is issued in the tableted look.

5 + 12.5

Tablets of oblong shape of a pink color, from each party are dividing risk. From above the stamp 41/AV is located. Single dark impregnations are allowed.

10 + 12.5

Tablets of oblong shape of an orange color, on both sides it is located dividing risk. From above there is a stamp 42/AY. Single dark impregnations are allowed.

5 + 25

Tablets of almost white, cream color from dividing risky, oblong shape. On both sides there is a logo of the company and a stamp of HNW.

10 + 25

Tablets of a pink color of oblong shape. On both sides it is located dividing risk. From above stamp 39/AV. Single dark asperges are allowed.

Pharmacological action

The combined antihypertensive which part 2 active components are.

Ramipril

The operating component is APF enzyme inhibitor. The principle of influence is based on preventing of transition of one form of angiotensin (I) in another (II).

At the same time there is no increase of ChSS on the compensatory mechanism; development of Aldosteronum does not decrease, pressure level in capillaries of pulmonary system does not change, does not strengthen coronary blood supply, filtering speed in balls of renal system does not change, and resistance in vessels of pulmonary system remains at the initial level.

Clinical trials showed that long therapy leads to reduction of expressiveness of a hypertrophy in a myocardium at the patients suffering from an idiopathic hypertensia. In an ischemic myocardium Ramipril strengthens blood circulation, reduces the frequency of reperfusion of a myocardium and risk of development of arrhythmia.

Cardiotyre-tread (heart + protection) the effect is reached due to impact on process of synthesizing of prostaglandins, and also thanks to induction of forming of nitrogen oxide in cells endotheliocytes. Active component is capable to reduce platelet aggregation.

Hydrochlorthiazidum

The operating component is thiazide diuretic means and is capable to change a reabsorption of potassium ions, chlorine, sodium, magnesium. Active agent detains uric acid in an organism, slows down process of removal of calcium ions, changes a water reabsorption in nephrons (distal department).

The hypotensive effect is reached due to strengthening of a depressor effect in the relation gangliyev, decrease in expressiveness of pressor effect of noradrenaline, adrenaline and other vasoconstrictive amines; due to decrease in an indicator of OTsK. At a normal blood pressure the hypotensive effect is not shown.

The additive action is characteristic of Ramipril and Hydrochlorthiazidum. Hydrochlorthiazidum washes away potassium from an organism, and Ramipril levels this effect, interfering with loss of K+.

Pharmacodynamics and pharmacokinetics

Hypotensive action of Ramipril is registered in 90 minutes after reception of a tablet, and the maximum result is observed in 5-9 hours. The effect remains for days. Upon completion of therapy the syndrome of "cancellation" does not form. Diuretic action of Hydrochlorthiazidum is shown in 1-2 hours.

The maximum result is observed in 4 hours and can remain till 12 o'clock. The anti-hypertensive effect is observed 3-4 days later, however it is possible to reach optimal therapeutic effect only in 3-4 weeks.

Indications to use

To Tritatsa Plus it is applied to treatment of an idiopathic hypertensia at patients for whom is suitable given combinations. Medicine is not intended for initial therapy.

Seldom symptomatic hypotonia develops. Selection of a dose is carried out individually.

Contraindications

  • stenosis of arteries of kidneys (bilateral);
  • Quincke's disease;
  • individual hypersensitivity;
  • mitral stenosis with hemodynamically significant changes;
  • primary hyper aldosteronism;
  • pregnancy;
  • stenosis of arteries of a kidney at the only kidney;
  • breastfeeding;
  • state after transplantation of a kidney;
  • aortal stenosis in hemodynamically significant changes;
  • hemodialysis at which dialysis membranes of the AN69 type are used;
  • hyponatremia;
  • hypercalcemia;
  • gout;
  • pathology of renal system;
  • diabetes mellitus (heavy current);
  • hypopotassemia (refractory form).

Relative contraindications:

  • the expressed defeats cerebral, coronary arteries (at sharp falling of a blood pressure the blood stream can be broken);
  • arrhythmias of ventricular character;
  • hyponatremia;
  • liver failure;
  • heart failure;
  • unstable form of stenocardia;
  • "pulmonary heart" (decompensation);
  • hyperpotassemia;
  • renal failure;
  • advanced age;
  • the vomiting, diarrheal syndrome and other states accompanied with reduction of OTsK;
  • oppression of marrowy blood circulation;
  • system pathology of connecting fabric;
  • ISCHEMIC HEART DISEASE;
  • hypercalcemia;
  • hepatic cirrhosis;
  • diabetes mellitus.

Side effects

Cardiovascular system:

  • arrhythmia;
  • falling of a blood pressure;
  • orthostatic form of hypotonia;
  • tachycardia;
  • myocardial infarction;
  • stenocardia.

Urinogenital path:

  • decrease in a libido;
  • proteinuria;
  • decrease in diuresis;
  • strengthening of expressiveness of symptomatology of a renal failure.

Nervous system:

  • nervous irritability;
  • ischemic changes in a brain;
  • dizzinesses;
  • weakness;
  • paresthesias;
  • the increased drowsiness;
  • concern;
  • uneasiness;
  • sleep disorders, sleeplessness;
  • emotional instability;
  • faints;
  • confusion of consciousness;
  • depressive mood;
  • tremor of extremities.

Sense bodys:

  • change of flavoring perception;
  • disturbances of visual perception;
  • vestibular disturbances;
  • sonitus.

Digestive tract:

  • thirst;
  • vomiting;
  • diarrheal syndrome;
  • nausea;
  • stomatitis;
  • glossitis;
  • dryness in a mouth;
  • locks;
  • epigastric pains;
  • cholestatic jaundice;
  • intestinal impassability;
  • hepatitises;
  • appetite disturbance.

Respiratory system:

Allergic answers:

  • Quincke's disease of language, lips, a laryngopharynx or on front part of the head;
  • skin rashes;
  • Quincke's disease of extremities;
  • serositis;
  • pemphigus;
  • Lyell's disease;
  • photosensitization;
  • vasculitis;
  • exfoliative dermatitis;
  • skin itch;
  • small tortoiseshell;
  • miositis;
  • arthritis;
  • onikholizis;
  • eosinophilia.

Bodies of a hemopoiesis:

  • pancytopenia;
  • decrease in hemoglobin;
  • agranulocytosis;
  • thrombocytopenia;
  • hemolitic anemia;
  • erythropenia.

Possible influence on a fruit:

  • deformation of bones of a skull;
  • hyperpotassemia;
  • identification of antinuclear antibodies;
  • hyponatremia;
  • contracture of extremities;
  • hyperazotemia;
  • changes in work of renal system;
  • falling of a blood pressure;
  • oligogidramnion;
  • hypoplasia of bones of a skull.

Laboratory reactions:

  • identification antinuclear antibodies;
  • hyperpotassemia;
  • hyperazotemia;
  • giperkreatininemiya;
  • hyperbilirubinemia;
  • increase of ALT, nuclear heating plant, bilirubin.

Other reactions:

Negative reactions characteristic of Hydrochlorthiazidum:

  • arrhythmia;
  • irritability;
  • confusion of consciousness;
  • lability of mentality and mood;
  • gipokhloremichesky alkalosis;
  • diarrheal syndrome;
  • cholecystitis;
  • tachycardia;
  • anemia (aplastic, hemolitic);
  • orthostatic hypotonia;
  • epigastric pains;
  • sialadenitis;
  • pancreatitis;
  • anorexia;
  • hyperuricemia;
  • hyperglycemia;
  • exacerbation of gout;
  • necrotizing vasculitis;
  • skin rashes;
  • pneumonitis;
  • fluid lungs of not cardiogenic genesis.

The instruction on Tritatsa Plus (A way and a dosage)

Dosing is carried out taking into account specific features. The recommended reception time – morning hours. As much as possible in days 5+25 or 4 tablets in a dose 2.5+12.5 are allowed to take 2 pill in a dose that corresponds to 50 mg of Hydrochlorthiazidum and 10 mg of Ramipril.

At the admission of a dose it is tried to be accepted as fast as possible. Independent doubling of a dose is not allowed. Tablets need to be washed down with water, the razlamyvaniye and chewing is not allowed. Meal does not influence expressiveness of therapeutic effect to Tritatsa Plus.

Overdose

  • weakness;
  • dryness in a mouth;
  • bradycardia;
  • falling of a blood pressure;
  • drowsiness;
  • changes in water and electrolytic balance;
  • shock;
  • stupor;
  • acute renal failure.

Therapy: the patient is given horizontal position, legs raise. The gastric lavage, administration of sodium sulfate and enterosorbiruyushchy medicines the first 30 minutes after poisoning is effective.

At bradycardia apply a pacemaker; at sharp falling of a blood pressure intravenously enter catecholamines. The hemodialysis did not prove the efficiency.

Interaction

The salty food reduces expressiveness of hypotensive effect. Ramipril is capable to strengthen the oppressing impact of etanolsoderzhashchy drinks and solutions on work of TsNS.

The hypotensive effect amplifies at simultaneous use of tricyclic antidepressants, diuretic medicines, the general anesthetics, nitrates. Reception of kaliysberegayushchy diuretic means (Amiloride, Veroshpiron, Triamterenum) and drugs of potassium can provoke a hyperpotassemia.

The Gipotenzivy effect to Tritatsa Plus decreases at treatment by angiotonic types of sympathomimetics (Norepinephrinum, Epinephrinum). The risk of a gematotoksichnost increases at treatment by cytostatics, immunodepressants, Allopyrinolum, Prokainamid and glucocorticosteroids.

Active component Ramipril is capable to reduce excretion (to slow down removal) lithium ions that can lead to strengthening of expressiveness of negative toxic reactions.

Strengthening of effect of hypoglycemic medicines (derivative sulfonilmochevina, insulin) is characteristic of inhibitors of APF enzyme that can provoke a hypoglycemia. The hypotensive effect to Tritatsa Plus is weakened at treatment by Indometacin, Acetylsalicylic acid and other drugs of NPVS group. Heparin is capable to provoke a hyperpotassemia.

Toxicity of glycosides considerably increases under the influence of Hydrochlorthiazidum that is explained by a hypomagnesiemia and a hypopotassemia. Anticoagulants of indirect influence, NPVS, Clofibratum and other drugs contacting proteins highly are capable to strengthen diuretic effect of medicine.

Hypotensive action of a medicine amplifies at reception of tricyclic antidepressants, Fenotiazinov, barbiturates, beta-blockers, vazodilatiruyushchy means, ethanol.

The neurotoxicity of salicylates, cardiotoxicity of drugs of lithium and action of muscle relaxants of peripheral action increase against use of Hydrochlorthiazidum.

The diuretic component of drug slows down Quinidine removal, weakens effects of oral contraceptives, antigouty medicines, Epinephrinum, hypoglycemic means and Norepinephrinum.

Hemolysis at treatment by Hydrochlorthiazidum and Metildopoy is registered. Absorption of Hydrochlorthiazidum decreases at use of Colestyraminum.

Terms of sale

According to the recipe.

Storage conditions

Transportation and storage demand observance of temperature condition – to 30 degrees.

Period of validity

3 years.

Special instructions

The assessment of a functional condition of renal system before the beginning hypotensive therapy is obligatory for Tritatsa Plus. In group of special supervision there are patients with defeats of vascular system of kidneys (stenoses). Level of creatinine and urea are the main indicators of a condition of renal system.

At a chronic renal failure the hyperpotassemia can be shown. At pathology of hepatic system forming of an active metabolite is slowed down, metabolism speed decreases.

The risk of falling of a blood pressure considerably increases at patients who are on electrolyte-deficient (or low-salt) a diet. Symptomatic hypotonia develops at reduced OTsK.

At a tranzitorny form of arterial hypotonia therapy by drug to Tritatsa Plus can be carried out only after stabilization of a blood pressure.

At patients who are on a hemodialysis using special dialysis membranes of the AN69 type the risk of anaphylactoid answers and hypersensitivity increases. Similar reactions were observed at reduction of an aferez of LPNP by a sulfate dextran.

Analogs

  • Amprilan ND;
  • Amprilan NL;
  • Hartil D;
  • Ramazid N.

Apteka24

  • To Tritatsa plus28
  • To Tritatsa plus28

Paniapteka

  • To Tritatsa plus 10mg/12.5mg tab. No. 28sanofi of Sintelabo
  • To Tritatsa plus 10mg/12.5mg tab. No. 28sanofi of Sintelabo
  • To Tritatsa plus 10mg/12.5mg tab. No. 28sanofi of Sintelabo
  • To Tritatsa plus 10mg/12.5mg tab. No. 28sanofi of Sintelabo
Section: Cardiological Cardiovascular
in more detail

Education: Graduated from the Bashkir state medical university majoring in "Medical business". In 2011 gained the diploma and the certificate in Therapy. In 2012 received 2 certificate and the diploma in "Functional diagnosis" and "Cardiology". In 2013 completed courses on "Topical issues of otorhinolaryngology in therapy". In 2014 completed advanced training courses in "A clinical echocardiography" and courses in "Medical rehabilitation".

Experience: From 2011 to 2014 the Policlinic No. 33 Ufa worked as the therapist and the cardiologist in MBUZ. Since 2014 the Policlinic No. 33 Ufa works as the cardiologist and the doctor of functional diagnosis in MBUZ.

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