Диуретик. Антигипертензивный препарат. Относится к производным сульфонамида и по фармакологическим свойствам близок к тиазидным диуретикам. Ингибирует абсорбцию натрия в кортикальном сегменте петли Генле, что приводит к увеличению выведения с мочой ионов натрия, хлора и приводит к усилению диуреза. В меньшей степени повышает выведение ионов калия и магния.
Дополнительно к диуретическому эффекту индапамид повышает эластичность стенок артерий и снижает ОПСС.
Оказывает антигипертензивное действие в дозах, не вызывающих выраженный диуретический эффект.
При назначении в высоких дозах не влияет на степень снижения АД, несмотря на увеличение диуреза.
Уменьшает гипертрофию левого желудочка.
Не влияет на липидный и углеводный обмен.
Фармакокинетика
Всасывание
Быстро и практически полностью всасывается из ЖКТ. Прием пищи несколько замедляет абсорбцию, но не влияет на количество всосавшегося препарата. После приема внутрь Cmax досигается через 12 ч.
Распределение
При повторных приемах колебания концентрации препарата в плазме в интервале между приемами двух доз уменьшаются. Однако имеются индивидуальные различия у пациентов.
Связывание с белками плазмы - 79%. При повторном приеме не накапливается в организме.
Метаболизм
Метаболизируется в печени.
Выведение
T1/2 - 14-26 ч (в среднем 18 ч). 70% индапамида выводится почками в виде метаболитов, в неизмененном виде выводится около 5%. Около 20% выводится с калом в виде неактивных метаболитов.
Фармакокинетика в особых клинических случаях
У больных с почечной недостаточностью фармакокинетика индапамида существенно не меняется.
Показания к применению
артериальная гипертензия.
Противопоказания
гипокалиемия;
тяжелая почечная недостаточность (стадия анурии);
тяжелая печеночная недостаточность (в т.ч. с энцефалопатией);
детский и подростковый возраст до 18 лет (эффективность и безопасность не установлены);
повышенная чувствительность к препарату и другим производным сульфонамида.
С осторожностью
С осторожностью следует назначать препарат при нарушениях функции печени и/или почек, нарушении водно-электролитного баланса, гиперпаратиреозе, больным с увеличенным интервалом QT на ЭКГ или получающим сочетанную терапию, гиперурикемии (особенно, сопровождающейся подагрой и уратным нефролитиазом).
Применение при беременности и в период грудного вскармливания
Индапамид Ретард-Акрихин не рекомендуется применять при беременности, т.к. препарат может вызывать фетоплацентарную ишемию и приводить к замедлению развития плода.
В связи с тем, что индапамид выделяется с грудным молоком, также не рекомендуется назначение препарата в период грудного вскармливания.
Способ применения и дозы
Препарат назначают внутрь по 1 таб. 1 раз/сут, предпочтительнее в утренние часы, запивая достаточным количеством жидкости.
Побочное действие
Со стороны пищеварительной системы: запор или диарея, диспепсия, тошнота, боль в животе; возможно развитие печеночной энцефалопатии; редко - панкреатит.
Со стороны ЦНС: головная боль, головокружение, нервозность, астения.
Со стороны дыхательной системы: кашель, фарингит, синусит.
Со стороны сердечно-сосудистой системы: ортостатическая гипотензия, изменения на ЭКГ (гипокалиемия), аритмия, сердцебиение.
Со стороны мочевыделительной системы: частые инфекции, никтурия, полиурия.
Со стороны системы кроветворения: редко - тромбоцитопения, лейкопения, агранулоцитоз, аплазия костного мозга, гемолитическая анемия.
Прочие: возможно обострение течения системной красной волчанки.
Передозировка
Симптомы: возможны нарушения водно-электролитного баланса (гипонатриемия, гипокалиемия), тошнота, рвота, снижение АД, судороги, головокружение, сонливость, заторможенность, полиурия или олигурия, заканчивающаяся анурией (вследствие гиповолемии).
Лечение: неотложные меры, направленные на удаление препарата из организма: промывание ЖКТ и/или назначение активированного угля с последующим восстановлением нормального водно-электролитного баланса. Показана симптоматическая терапия. Специфического антидота нет.
Взаимодействие с другими лекарственными средствами
При одновременном применении индапамида и препаратов лития возможно повышение концентрации лития в плазме крови, сопровождающееся появлением признаков передозировки (вследствие уменьшения выведения лития с мочой). При необходимости назначения данной комбинации следует контролировать концентрацию лития в плазме крови и при необходимости корректировать его дозу.
При одновременном применении индапамида с астемизолом, бепридилом, эритромицином (для в/в введения), галофантрином, пентамидином, сультопридом, терфенадином, винкамином, антиаритмическими препаратами класса IА (в т.ч. хинидина, гидрохинидина, дизопирамида, амиодарона, бретилия, соталола) повышается вероятность возникновения аритмий типа "пируэт". Этому состоянию может способствовать гипокалиемия, брадикардия или удлиненение интервала QT.
При одновременном применении с НПВС (для системного применения), салицилатами в высоких дозах возможно развитие острой почечной недостаточности у обезвоженных пациентов (из-за резкого снижения скорости клубочковой фильтрации). При необходимости назначения НПВС на фоне терапии препаратом Индапамид Ретард-Акрихин следует компенсировать потерю жидкости и тщательно контролировать функцию почек.
При одновременном применении индапамида с амфотерицином B (для в/в введения), глюко- и минералокортикоидами (при системном применении), тетракозактидом, слабительными средствами, стимулирующими моторику кишечника, сердечными гликозидами повышается риск развития гипокалиемии (аддитивный эффект). Следует контролировать уровень калия в плазме крови и показатели ЭКГ, при необходимости показано соответствующее лечение.
При одновременном применении индапамида с баклофеном отмечается усиление гипотензивного эффекта.
При одновременном применении индапамида и циклоспорина возможно увеличение содержания креатинина в плазме крови при неизмененной концентрации циклоспорина.
При одновременном применении индапамида и трициклических антидепрессантов, нейролептиков отмечается усиление гипотензивного действия и повышение риска развития ортостатической гипотензии (аддитивный эффект).
При одновременном применении индапамида и солей кальция возможно развитие гиперкальциемии вследствие снижения экскреции ионов кальция с мочой.
При одновременном приеме индапамида с ингибиторами АПФ увеличивается риск развития артериальной гипотензии.
При комбинации индапамида с калийсберегающими диуретиками (амилорид, спиронолактон, триамтерен) повышается риск развития гипо- или гиперкалиемии, особенно у больных сахарным диабетом и у пациентов с нарушением функции почек.
При одновременном приеме индапамида с йодсодержащими контрастными средствами в высоких дозах возможно развитие обезвоживания организма и увеличение риска развития острой почечной недостаточности. Перед применением йодсодержащих контрастных веществ больным необходимо компенсировать потерю жидкости.
Особые указания
При назначении тиазидных диуретиков пациентам с нарушениями функции печени возможно развитие печеночной энцефалопатии. В таких случаях прием препарата следует немедленно прекратить.
До начала лечения следует определить содержание ионов натрия в плазме крови. В процессе лечения необходим регулярный контроль этого показателя, т.к. первоначальное снижение концентрации натрия в плазме крови может быть бессимптомным. Особенно часто такой анализ следует проводить у больных с циррозом печени и у лиц пожилого возраста.
При терапии тиазидными диуретиками основной риск заключается в развитии гипокалиемии. У определенной категории пациентов (пациенты пожилого возраста, ослабленные пациенты и/или получающие сочетанную терапию, при циррозе печени с развившимися отеками или асцитом, ИБС, хронической сердечной недостаточности) необходимо избегать развития гипокалиемии (<3.4 ммоль/л). Гипокалиемия у этих больных приводит к усилению токсического действия сердечных гликозидов и повышает риск развития аритмий. Кроме того, к группе повышенного риска относятся больные с брадикардией или с увеличенным интервалом QT на ЭКГ, при этом неважно, вызвано такое увеличение врожденными причинами или наличием патологического процесса.
Гипокалиемия, так же как и брадикардия, является состоянием, способствующим развитию тяжелых сердечных аритмий, особенно типа "пируэт". Во всех описанных выше случаях необходимо более часто определять содержание ионов калия в плазме крови. Первое измерение концентрации ионов калия в крови следует провести в течение первой недели от начала лечения.
При развитии гипокалиемии требуется ее коррекция.
При назначении препарата Индапамид Ретард-Акрихин пациентам с сахарным диабетом важно контролировать уровень глюкозы, особенно при наличии гипокалиемии.
У пациентов с повышенным содержанием мочевой кислоты отмечается тенденция к увеличению числа приступов подагры.
Тиазидные диуретики проявляют свою эффективность в полной мере только в случае отсутствия нарушений или при умеренно выраженных нарушениях функции почек (содержание креатинина в крови менее 2.5 мг/дл или 220 мкмоль/л).
У пациентов пожилого возраста нормальный уровень креатинина в плазме крови рассчитывают с учетом возраста, массы тела и пола.
Следует учитывать, что в начале лечения у пациентов может наблюдаться снижение клубочковой фильтрации, обусловленное гиповолемией, которая вызвана потерей воды и ионов натрия на фоне приема диуретиков. Как следствие, в плазме крови может увеличиваться концентрация мочевины и креатинина. Если функция почек не нарушена, такая временная почечная недостаточность, как правило, проходит без последствий. Однако при уже имеющейся почечной недостаточности состояние больного может ухудшиться.
На фоне приема индапамида возможен положительный результат при проведении допинг-контроля у спортсменов.
Влияние на способность к управлению транспортными средствами и механизмами
В некоторых случаях при понижении АД могут возникать индивидуальные реакции (особенно в начале терапии или при сочетании нескольких антигипертензивных препаратов). В этом случае способность к занятию видами деятельности, требующими повышенного внимания и быстроты психомоторных реакций, может быть снижена.
Условия хранения
Препарат следует хранить в сухом, защищенном света, недоступном для детей месте при температуре не выше 25°С.
Для описания товара использована информация от партнера 36.6
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Антигипертензивный препарат. Относится к производным сульфонамида и по фармакологическим свойствам близок к тиазидным диуретикам. Ингибирует абсорбцию натрия в кортикальном сегменте петли Генле, что приводит к увеличению выведения с мочой ионов натрия, хлора и приводит к усилению диуреза. В меньшей степени повышает выведение ионов калия и магния."}},{"type":"paragraph","data":{"text":"Дополнительно к диуретическому эффекту индапамид повышает эластичность стенок артерий и снижает ОПСС."}},{"type":"paragraph","data":{"text":"Оказывает антигипертензивное действие в дозах, не вызывающих выраженный диуретический эффект."}},{"type":"paragraph","data":{"text":"При назначении в высоких дозах не влияет на степень снижения АД, несмотря на увеличение диуреза."}},{"type":"paragraph","data":{"text":"Уменьшает гипертрофию левого желудочка."}},{"type":"paragraph","data":{"text":"Не влияет на липидный и углеводный обмен."}},{"type":"header","data":{"text":"Фармакокинетика","level":4}},{"type":"paragraph","data":{"text":"\u003ci\u003eВсасывание\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Быстро и практически полностью всасывается из ЖКТ. Прием пищи несколько замедляет абсорбцию, но не влияет на количество всосавшегося препарата. После приема внутрь C\u003csub\u003emax\u003c/sub\u003e досигается через 12 ч."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРаспределение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При повторных приемах колебания концентрации препарата в плазме в интервале между приемами двух доз уменьшаются. Однако имеются индивидуальные различия у пациентов."}},{"type":"paragraph","data":{"text":"Связывание с белками плазмы - 79%. При повторном приеме не накапливается в организме."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Метаболизируется в печени."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"T\u003csub\u003e1/2\u003c/sub\u003e - 14-26 ч (в среднем 18 ч). 70% индапамида выводится почками в виде метаболитов, в неизмененном виде выводится около 5%. Около 20% выводится с калом в виде неактивных метаболитов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФармакокинетика в особых клинических случаях\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"У больных с почечной недостаточностью фармакокинетика индапамида существенно не меняется."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["артериальная гипертензия."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["гипокалиемия;","тяжелая почечная недостаточность (стадия анурии);","тяжелая печеночная недостаточность (в т.ч. с энцефалопатией);","печеночная энцефалопатия;","одновременный прием препаратов, удлиняющих интервал QT;","детский и подростковый возраст до 18 лет (эффективность и безопасность не установлены);","повышенная чувствительность к препарату и другим производным сульфонамида."]}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eС осторожностью \u003c/i\u003eследует назначать препарат при нарушениях функции печени и/или почек, нарушении водно-электролитного баланса, гиперпаратиреозе, больным с увеличенным интервалом QT на ЭКГ или получающим сочетанную терапию, гиперурикемии (особенно, сопровождающейся подагрой и уратным нефролитиазом)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Индапамид Ретард-Акрихин не рекомендуется применять при беременности, т.к. препарат может вызывать фетоплацентарную ишемию и приводить к замедлению развития плода."}},{"type":"paragraph","data":{"text":"В связи с тем, что индапамид выделяется с грудным молоком, также не рекомендуется назначение препарата в период грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Препарат назначают внутрь по 1 таб. 1 раз/сут, предпочтительнее в утренние часы, запивая достаточным количеством жидкости."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны пищеварительной системы: \u003c/i\u003eзапор или диарея, диспепсия, тошнота, боль в животе; возможно развитие печеночной энцефалопатии; редко - панкреатит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны ЦНС: \u003c/i\u003eголовная боль, головокружение, нервозность, астения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны дыхательной системы: \u003c/i\u003eкашель, фарингит, синусит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы: \u003c/i\u003eортостатическая гипотензия, изменения на ЭКГ (гипокалиемия), аритмия, сердцебиение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны мочевыделительной системы: \u003c/i\u003eчастые инфекции, никтурия, полиурия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны системы кроветворения:\u003c/i\u003e редко - тромбоцитопения, лейкопения, агранулоцитоз, аплазия костного мозга, гемолитическая анемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e пятнисто-папулезнаясыпь, крапивница, кожный зуд, геморрагический васкулит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛабораторные показатели: \u003c/i\u003eгиперурикемия, гипергликемия, гипонатриемия, гипохлоремия, гиперкальциемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e возможно обострение течения системной красной волчанки."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы:\u003c/i\u003e возможны нарушения водно-электролитного баланса (гипонатриемия, гипокалиемия), тошнота, рвота, снижение АД, судороги, головокружение, сонливость, заторможенность, полиурия или олигурия, заканчивающаяся анурией (вследствие гиповолемии)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e неотложные меры, направленные на удаление препарата из организма: промывание ЖКТ и/или назначение активированного угля с последующим восстановлением нормального водно-электролитного баланса\u003ci\u003e. \u003c/i\u003eПоказана симптоматическая терапия. Специфического антидота нет."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При одновременном применении индапамида и препаратов лития возможно повышение концентрации лития в плазме крови, сопровождающееся появлением признаков передозировки (вследствие уменьшения выведения лития с мочой). При необходимости назначения данной комбинации следует контролировать концентрацию лития в плазме крови и при необходимости корректировать его дозу."}},{"type":"paragraph","data":{"text":"При одновременном применении индапамида с астемизолом, бепридилом, эритромицином (для в/в введения), галофантрином, пентамидином, сультопридом, терфенадином, винкамином, антиаритмическими препаратами класса IА (в т.ч. хинидина, гидрохинидина, дизопирамида, амиодарона, бретилия, соталола) повышается вероятность возникновения аритмий типа \"пируэт\". Этому состоянию может способствовать гипокалиемия, брадикардия или удлиненение интервала QT."}},{"type":"paragraph","data":{"text":"При одновременном применении с НПВС (для системного применения), салицилатами в высоких дозах возможно развитие острой почечной недостаточности у обезвоженных пациентов (из-за резкого снижения скорости клубочковой фильтрации). При необходимости назначения НПВС на фоне терапии препаратом Индапамид Ретард-Акрихин следует компенсировать потерю жидкости и тщательно контролировать функцию почек."}},{"type":"paragraph","data":{"text":"При одновременном применении индапамида с амфотерицином B (для в/в введения), глюко- и минералокортикоидами (при системном применении), тетракозактидом, слабительными средствами, стимулирующими моторику кишечника, сердечными гликозидами повышается риск развития гипокалиемии (аддитивный эффект). Следует контролировать уровень калия в плазме крови и показатели ЭКГ, при необходимости показано соответствующее лечение."}},{"type":"paragraph","data":{"text":"При одновременном применении индапамида с баклофеном отмечается усиление гипотензивного эффекта."}},{"type":"paragraph","data":{"text":"При одновременном применении индапамида и циклоспорина возможно увеличение содержания креатинина в плазме крови при неизмененной концентрации циклоспорина."}},{"type":"paragraph","data":{"text":"При одновременном применении индапамида и трициклических антидепрессантов, нейролептиков отмечается усиление гипотензивного действия и повышение риска развития ортостатической гипотензии (аддитивный эффект)."}},{"type":"paragraph","data":{"text":"При одновременном применении индапамида и солей кальция возможно развитие гиперкальциемии вследствие снижения экскреции ионов кальция с мочой."}},{"type":"paragraph","data":{"text":"При одновременном приеме индапамида с ингибиторами АПФ увеличивается риск развития артериальной гипотензии."}},{"type":"paragraph","data":{"text":"При комбинации индапамида с калийсберегающими диуретиками (амилорид, спиронолактон, триамтерен) повышается риск развития гипо- или гиперкалиемии, особенно у больных сахарным диабетом и у пациентов с нарушением функции почек."}},{"type":"paragraph","data":{"text":"При одновременном приеме индапамида с йодсодержащими контрастными средствами в высоких дозах возможно развитие обезвоживания организма и увеличение риска развития острой почечной недостаточности. Перед применением йодсодержащих контрастных веществ больным необходимо компенсировать потерю жидкости."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При назначении тиазидных диуретиков пациентам с нарушениями функции печени возможно развитие печеночной энцефалопатии. В таких случаях прием препарата следует немедленно прекратить."}},{"type":"paragraph","data":{"text":"До начала лечения следует определить содержание ионов натрия в плазме крови. В процессе лечения необходим регулярный контроль этого показателя, т.к. первоначальное снижение концентрации натрия в плазме крови может быть бессимптомным. Особенно часто такой анализ следует проводить у больных с циррозом печени и у лиц пожилого возраста."}},{"type":"paragraph","data":{"text":"При терапии тиазидными диуретиками основной риск заключается в развитии гипокалиемии. У определенной категории пациентов (пациенты пожилого возраста, ослабленные пациенты и/или получающие сочетанную терапию, при циррозе печени с развившимися отеками или асцитом, ИБС, хронической сердечной недостаточности) необходимо избегать развития гипокалиемии (<3.4 ммоль/л). Гипокалиемия у этих больных приводит к усилению токсического действия сердечных гликозидов и повышает риск развития аритмий. Кроме того, к группе повышенного риска относятся больные с брадикардией или с увеличенным интервалом QT на ЭКГ, при этом неважно, вызвано такое увеличение врожденными причинами или наличием патологического процесса."}},{"type":"paragraph","data":{"text":"Гипокалиемия, так же как и брадикардия, является состоянием, способствующим развитию тяжелых сердечных аритмий, особенно типа \"пируэт\". Во всех описанных выше случаях необходимо более часто определять содержание ионов калия в плазме крови. Первое измерение концентрации ионов калия в крови следует провести в течение первой недели от начала лечения."}},{"type":"paragraph","data":{"text":"При развитии гипокалиемии требуется ее коррекция."}},{"type":"paragraph","data":{"text":"При назначении препарата Индапамид Ретард-Акрихин пациентам с сахарным диабетом важно контролировать уровень глюкозы, особенно при наличии гипокалиемии."}},{"type":"paragraph","data":{"text":"У пациентов с повышенным содержанием мочевой кислоты отмечается тенденция к увеличению числа приступов подагры."}},{"type":"paragraph","data":{"text":"Тиазидные диуретики проявляют свою эффективность в полной мере только в случае отсутствия нарушений или при умеренно выраженных нарушениях функции почек (содержание креатинина в крови менее 2.5 мг/дл или 220 мкмоль/л)."}},{"type":"paragraph","data":{"text":"У пациентов пожилого возраста нормальный уровень креатинина в плазме крови рассчитывают с учетом возраста, массы тела и пола."}},{"type":"paragraph","data":{"text":"Следует учитывать, что в начале лечения у пациентов может наблюдаться снижение клубочковой фильтрации, обусловленное гиповолемией, которая вызвана потерей воды и ионов натрия на фоне приема диуретиков. Как следствие, в плазме крови может увеличиваться концентрация мочевины и креатинина. Если функция почек не нарушена, такая временная почечная недостаточность, как правило, проходит без последствий. Однако при уже имеющейся почечной недостаточности состояние больного может ухудшиться."}},{"type":"paragraph","data":{"text":"На фоне приема индапамида возможен положительный результат при проведении допинг-контроля у спортсменов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВлияние на способность к управлению транспортными средствами и механизмами\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В некоторых случаях при понижении АД могут возникать индивидуальные реакции (особенно в начале терапии или при сочетании нескольких антигипертензивных препаратов). В этом случае способность к занятию видами деятельности, требующими повышенного внимания и быстроты психомоторных реакций, может быть снижена."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Препарат следует хранить в сухом, защищенном света, недоступном для детей месте при температуре не выше 25°С."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"Срок годности - 2 года."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Препарат отпускается по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.vidal.ru/drugs/company/156\"\u003eМ. ДЖ. БИОФАРМ ПВТ.ЛТД. ПОДРАЗДЕЛЕНИЕ КОРПОРАЦИИ М. ДЖ. ГРУП\u003c/a\u003e (Индия). "}}]}],"source":null},"description_toggle":false,"short_description":"Диуретик. Антигипертензивный препарат. Относится к производным сульфонамида и по фармакологическим свойствам близок к тиазидным диуретикам. Ингибирует абсорбцию натрия в кортикальном сегменте петли Генле, что приводит к увеличению выведения с мочой ионов натрия, хлора и приводит к усилению диуреза. В меньшей степени повышает выведение ионов калия и магния. Дополнительно к диуретическому эффекту индапамид повышает эластичность стенок артерий и снижает ОПСС. Оказывает антигипертензивное действие в дозах, не вызывающих выраженный диуретический эффект. При назначении в высоких дозах не влияет на степень снижения АД, несмотря на увеличение диуреза. Уменьшает гипертрофию левого желудочка. Не влияет на липидный и углеводный обмен.ВсасываниеБыстро и практически полностью всасывается из ЖКТ. Прием пищи несколько замедляет абсорбцию, но не влияет на количество всосавшегося препарата. После приема внутрь Cmaxдосигается через 12 ч.РаспределениеПри повторных приемах колебания концентрации препарата в плазме в интервале между приемами двух доз уменьшаются. Однако имеются индивидуальные различия у пациентов. Связывание с белками плазмы - 79%. При повторном приеме не накапливается в организме.МетаболизмМетаболизируется в печени.ВыведениеT1/2- 14-26 ч (в среднем 18 ч). 70% индапамида выводится почками в виде метаболитов, в неизмененном виде выводится около 5%. Около 20% выводится с калом в виде неактивных метаболитов.Фармакокинетика в особых клинических случаяхУ больных с почечной недостаточностью фармакокинетика индапамида существенно не меняется.","substance":[{"id":21,"title":"Индапамид","title_latin":"Indapamidum","slug":"indapamid_21"}],"branding":null,"valid_for_quick_buy":false,"is_available_to_delivery":false,"comments":null,"image_alt":"Индапамид Ретард-Акрихин - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/120549/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/120549/share_default/"}},"diseases":[],"other_packages":[],"other_product_forms":[],"related_products":{"title":"Аналоги","type":"analogs","products":[{"id":200150,"title":"Индап","subtitle":{"full":"Таблетки, 30 шт, 2.5 мг, для приема внутрь","short":"Таблетки, 30 шт, 2.5 мг","package":"30 шт, 2.5 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