Моксонидин является антигипертензивным средством с центральным механизмом действия. В стволовых структурах мозга (ростральный слой боковых желудочков) моксонидин селективно стимулирует имидазолин-чувствительные рецепторы, принимающие участие в тонической и рефлекторной регуляции симпатической нервной системы. Стимуляция имидазолиновых рецепторов снижает периферическую симпатическую активность и АД.; Моксонидин отличается от других симпатолитических антигипертензивных средств более низким сродством к 2-адренорецепторам, что объясняет меньшую вероятность развития седативного эффекта и сухости слизистой оболочки полости рта.; Прием моксонидина приводит к снижению системного сосудистого сопротивления и АД.; Моксонидин улучшает индекс чувствительности к инсулину у пациентов с ожирением, инсулинорезистентностью и умеренной степенью артериальной гипертензии.
Показания к применению
— артериальная гипертензия.
Противопоказания
Выраженные нарушения ритма сердца
СССУ
AV-блокада II и III степени
Выраженная брадикардия (ЧСС менее 50 уд./мин)
Острая и хроническая сердечная недостаточность (III-IV функциональный класс по классификации NYHA)
Одновременное применение с трициклическими антидепрессантами
Почечная недостаточность тяжелой степени (КК менее 30 мл/мин), включая пациентов, находящихся на гемодиализе
Возраст старше 75 лет
Возраст до 18 лет (эффективность и безопасность моксонидина не установлены)
Повышенная чувствительность к активному веществу, другим компонентам препарата
С осторожностью;
Нарушения функции почек (КК более 30 мл/мин)
Печеночная недостаточность тяжелой степени (более 9 баллов по классификации Чайлд-Пью)
AV-блокада I степени
Тяжелые заболевания коронарных сосудов
Тяжелая ИБС или нестабильная стенокардия (опыт применения недостаточен)
Хроническая сердечная недостаточность
Применение при беременности и в период грудного вскармливания
Клинические данные о лечении беременных препаратом Моксарел; отсутствуют.; Назначать Моксарел; при беременности следует с осторожностью только после тщательной оценки соотношения риска и пользы, когда польза для матери превышает потенциальный риск для плода.; Моксонидин проникает в грудное молоко. Кормящим женщинам в период лечения рекомендуется прекратить грудное вскармливание или отменить препарат.
Способ применения и дозы
Внутрь, независимо от приема пищи.; В большинстве случаев начальная доза препарата Моксарел; составляет 200 мкг/сут. Максимальная разовая доза составляет 400 мкг. Максимальная суточная доза, которую следует разделить на 2 приема, составляет 600 мкг.; Начальная доза для пациентов с почечной недостаточностью средней или тяжелой степени, а также для пациентов, находящихся на гемодиализе, составляет 200 мкг/сут. В случае необходимости и при хорошей переносимости суточная доза может быть увеличена до 400 мкг.
Побочное действие
Частота развития побочных эффектов, приведенных ниже, определялась соответственно следующему: очень часто (≥10%); часто (≥1%, но <10%); нечасто (≥0.1%, но <1%); редко (≥ 0.01%, но <0.1%); очень редко (<0.01%, включая единичные случаи).; Со стороны ЦНС: часто - головная боль, головокружение (вертиго), сонливость; нечасто - обморок.; Нарушения психики: часто - бессонница; нечасто - нервозность.; Со стороны органа слуха и лабиринтные нарушения: нечасто - звон в ушах.; Со стороны сердечно-сосудистой системы: нечасто - выраженное снижение АД, ортостатическая гипотензия, брадикардия.; Со стороны ЖКТ: очень часто - сухость слизистой оболочки полости рта; часто - тошнота, диарея, рвота, диспепсия.; Со стороны кожи и подкожных тканей: часто - кожная сыпь, зуд; нечасто - ангионевротический отек.; Со стороны скелетно-мышечной системы и соединительной ткани: часто - боль в спине; нечасто - боль в области шеи.; Общие расстройства и нарушения в месте введения: часто - астения; нечасто - периферические отеки.
Передозировка
Симптомы: головная боль, седативный эффект, сонливость, выраженное снижение АД, головокружение, повышенная утомляемость, астения, брадикардия, сухость слизистой оболочки полости рта, рвота и боль в эпигастральной области, угнетение дыхания, нарушение сознания. Потенциально возможны также кратковременное повышение АД, тахикардия, гипергликемия.; Лечение: специфического антидота не существует. В случае выраженного снижения АД рекомендуется введение жидкости для восстановления ОЦК и допамина. Брадикардия может быть купирована атропином. Антагонисты -адренорецепторов могут уменьшать или устранять парадоксальные гипертензивные эффекты при передозировке моксонидином. В тяжелых случаях передозировки рекомендуется тщательно контролировать нарушения сознания и не допускать угнетения дыхания. Моксонидин в незначительной степени выводится при проведении гемодиализа.
Особые указания
В настоящее время нет подтверждений того, что прекращение приема препарата Моксарел; приводит к повышению АД. Однако не рекомендуется прекращать прием препарата Моксарел; резко, вместо этого следует постепенно уменьшать дозу препарата в течение двух недель.; При необходимости отмены одновременно принимаемых бета-адреноблокаторов и препарата Моксарел; сначала отменяют бета-адреноблокаторы, и лишь через несколько дней моксонидин.; Во время лечения необходим регулярный контроль АД, ЧСС и регистрация ЭКГ. Прекращать прием препарата Моксарел; следует постепенно.; Во время лечения препаратом Моксарел; следует исключить употребление алкоголя.; Влияние на способность к вождению автотранспорта и управлению механизмами; Влияние препарата Моксарел; на способность к вождению транспортными средствами или управлению техникой изучено не было. Однако, принимая во внимание возможное возникновение головокружения и сонливости, пациентам следует соблюдать осторожность при занятии потенциально опасными видами деятельности, требующими повышенного внимания, таких как вождение автотранспорта или управление техникой, требующей повышенной концентрации внимания.
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В стволовых структурах мозга (ростральный слой боковых желудочков) моксонидин селективно стимулирует имидазолин-чувствительные рецепторы, принимающие участие в тонической и рефлекторной регуляции симпатической нервной системы. Стимуляция имидазолиновых рецепторов снижает периферическую симпатическую активность и АД.; Моксонидин отличается от других симпатолитических антигипертензивных средств более низким сродством к 2-адренорецепторам, что объясняет меньшую вероятность развития седативного эффекта и сухости слизистой оболочки полости рта.; Прием моксонидина приводит к снижению системного сосудистого сопротивления и АД.; Моксонидин улучшает индекс чувствительности к инсулину у пациентов с ожирением, инсулинорезистентностью и умеренной степенью артериальной гипертензии."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"— артериальная гипертензия."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Выраженные нарушения ритма сердца","СССУ","AV-блокада II и III степени","Выраженная брадикардия (ЧСС менее 50 уд./мин)","Острая и хроническая сердечная недостаточность (III-IV функциональный класс по классификации NYHA)","Одновременное применение с трициклическими антидепрессантами","Почечная недостаточность тяжелой степени (КК менее 30 мл/мин), включая пациентов, находящихся на гемодиализе","Возраст старше 75 лет","Возраст до 18 лет (эффективность и безопасность моксонидина не установлены)","Период лактации (грудного вскармливания)","Непереносимость лактозы, дефицит лактазы, глюкозо-галактозная мальабсорбция","Повышенная чувствительность к активному веществу, другим компонентам препарата"]}},{"type":"paragraph","data":{"text":"С осторожностью;"}},{"type":"list","data":{"style":"unordered","items":["Нарушения функции почек (КК более 30 мл/мин)","Печеночная недостаточность тяжелой степени (более 9 баллов по классификации Чайлд-Пью)","AV-блокада I степени","Тяжелые заболевания коронарных сосудов","Тяжелая ИБС или нестабильная стенокардия (опыт применения недостаточен)","Хроническая сердечная недостаточность"]}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Клинические данные о лечении беременных препаратом Моксарел; отсутствуют.; Назначать Моксарел; при беременности следует с осторожностью только после тщательной оценки соотношения риска и пользы, когда польза для матери превышает потенциальный риск для плода.; Моксонидин проникает в грудное молоко. Кормящим женщинам в период лечения рекомендуется прекратить грудное вскармливание или отменить препарат."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь, независимо от приема пищи.; В большинстве случаев начальная доза препарата Моксарел; составляет 200 мкг/сут. Максимальная разовая доза составляет 400 мкг. Максимальная суточная доза, которую следует разделить на 2 приема, составляет 600 мкг.; Начальная доза для пациентов с почечной недостаточностью средней или тяжелой степени, а также для пациентов, находящихся на гемодиализе, составляет 200 мкг/сут. 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Однако не рекомендуется прекращать прием препарата Моксарел; резко, вместо этого следует постепенно уменьшать дозу препарата в течение двух недель.; При необходимости отмены одновременно принимаемых бета-адреноблокаторов и препарата Моксарел; сначала отменяют бета-адреноблокаторы, и лишь через несколько дней моксонидин.; Во время лечения необходим регулярный контроль АД, ЧСС и регистрация ЭКГ. Прекращать прием препарата Моксарел; следует постепенно.; Во время лечения препаратом Моксарел; следует исключить употребление алкоголя.; Влияние на способность к вождению автотранспорта и управлению механизмами; Влияние препарата Моксарел; на способность к вождению транспортными средствами или управлению техникой изучено не было. Однако, принимая во внимание возможное возникновение головокружения и сонливости, пациентам следует соблюдать осторожность при занятии потенциально опасными видами деятельности, требующими повышенного внимания, таких как вождение автотранспорта или управление техникой, требующей повышенной концентрации внимания."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Моксонидин является антигипертензивным средством с центральным механизмом действия. В стволовых структурах мозга (ростральный слой боковых желудочков) моксонидин селективно стимулирует имидазолин-чувствительные рецепторы, принимающие участие в тонической и рефлекторной регуляции симпатической нервной системы. 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