Diroton pills 2,5mg №28

Active ingredient and dosage form

Pills: 1 pill contains lisinopril 2.5 mg, 5 mg, 10 mg, 20 mg;
Excipients: magnesium stearate, talc, mannitol, corn starch, Calcium phosphate;
14 or 28 pcs. packaged.

Mechanism of action

Dyroton - an ACE inhibitor, reduces the formation of angiotensin II from angiotensin I. A decrease in the content of angiotensin II leads to a direct decrease in the release of aldosterone. Reduces the degradation of bradykinin and increases prostaglandin synthesis. Reduces the OPSS, blood pressure, preload, pressure in the pulmonary capillaries, causes an increase in the minute volume of blood and an increase in myocardial tolerance to stress in patients with chronic heart failure. Expands arteries to a greater extent than veins. Some effects are attributed to effects on tissue renin-angiotensin systems. With prolonged use, hypertrophy of the myocardium and the walls of resistive arteries is reduced. Improves blood supply to ischemic myocardium.

ACE inhibitors prolong life expectancy in patients with chronic heart failure, slow down the progression of left ventricular dysfunction in patients who have had a myocardial infarction without clinical manifestations of heart failure.

The onset of action of the drug - after 1 h, reaches a maximum after 6-7 hours and lasts for 24 hours. The duration of the effect also depends on the size of the dose taken. In case of arterial hypertension, the effect is noted in the first days after the start of treatment, a stable action develops in 1-2 months. With the abrupt cancellation of the drug did not observe a pronounced increase in blood pressure.

Diroton reduces albuminuria. In patients with hyperglycemia, it helps normalize the function of the damaged glomerular endothelium. It does not affect the concentration of glucose in the blood of patients with diabetes mellitus and does not lead to an increase in cases of hypoglycemia.

Indications and usage

Arterial hypertension (as monotherapy or in combination with other antihypertensive drugs);
Chronic heart failure (as part of combination therapy for the treatment of patients taking digitalis and / or diuretics);
Acute myocardial infarction (in the first 24 hours with stable hemodynamic parameters to maintain these indicators and prevent left ventricular dysfunction and heart failure);
Diabetic nephropathy (to reduce albuminuria in patients with insulin-dependent diabetes mellitus in patients with normal blood pressure and in patients with insulin-dependent diabetes mellitus with arterial hypertension).

The drug is taken orally once a day, in the morning, with all indications, before or after eating, always at about the same time of day.

With essential hypertension patients who do not receive other antihypertensive drugs are prescribed 10 mg once a day. The usual daily maintenance dose is 20 mg. The maximum daily dose is 40 mg.

The full effect usually develops after 2-4 weeks from the start of treatment, which should be considered when increasing the dose. With insufficient clinical effect, it is possible to combine the drug with other antihypertensive drugs.

If the patient has received prior treatment with diuretics, then they should be discontinued 2-3 days before the use of Diroton. If it is impossible to cancel diuretics, then the initial dose of Diroton should not exceed 5 mg / In this case, after taking the first dose, medical monitoring is recommended for several hours (the maximum effect is reached after about 6 hours), because A pronounced decrease in blood pressure may develop.

Renovascular hypertension or other conditions with increased activity of the renin-angiotensin-aldosterone system, it is also advisable to prescribe a lower initial dose of 2.5–5 mg per day under enhanced medical control (control of blood pressure, kidney function, serum potassium concentration). Maintenance dose should be determined depending on the dynamics of blood pressure.

In case of renal failure, due to the fact that lisinopril is excreted by the kidneys, the initial dose should be determined depending on creatinine clearance, then a maintenance dose should be established in accordance with the reaction of frequent renal function, serum potassium and sodium concentrations.

In chronic heart failure The initial dose is 2.5 mg once a day, which can be increased to the usual maintenance daily dose of 5-20 mg. The daily dose should not exceed 20 mg.

In acute myocardial infarction (in combination therapy), 5 mg is prescribed on the first day, then 5 mg every other day, 10 mg — in two days, and then 10 mg 1 time per day. In patients with acute myocardial infarction, the drug should be used for at least 6 weeks. At the beginning of treatment or during the first 3 days after acute myocardial infarction in patients with low systolic blood pressure (