After oral absorption from the gastrointestinal tract su 250 testosterone mix is about 30-40% degree of absorption is independent of food intake, but the rate of absorption may be delayed. The fast and practically complete hydrolysis to form the pharmacologically active mucosal occurs fozinoprilata liver and small intestine. One hour after ingestion concentration fosinopril unaltered serum – less than 1%. fozinoprilata – 75% inactive glucuronide fozinoprilata – 15-20%, active metabolite 4-gidroksifozinoprilata-about 5%.
The maximum concentration fozinoprilata plasma levels achieved in 3 hours and is independent of the dose. Distribution and metabolism. Binding plasma proteins is greater than 95%. Therefore fozinoprilat has a relatively small volume of distribution and to a small extent with the associated cellular components of blood. Excretion. Fozinoprilat excreted equally excreted by the kidneys and in the intestine. When hypertension in patients with normal renal function, and hepatic elimination half-life fozinoprilata is about 11.5 hours. In heart failure, increased to 14 hours. In patients with impaired renal function fozinoprilata total clearance from the body about two times lower than in patients with normal renal function. At the same time, the absorption, bioavailability, and protein binding is not significantly changed.Decreased renal excretion is compensated by an increased excretion by the liver. Moderate increase in the area of values under the curve “concentration-time fozinoprilata plasma (less than half compared to the norm) was observed in patients with renal impairment of varying degrees, including renal failure, end-stage .
The clearance fozinoprilata in hemodialysis and peritoneal dialysis averages 2% and 7% (in relation to the values of urea clearance). in patients with impaired hepatic function (in alcoholic or biliary cirrhosis) a significant change in the degree of hydrolysis fosinopril does not, however, possible to reduce the rate of occurrence of this biochemical reaction. The total su 250 testosterone mix clearance fozinoprilata from the body of these patients is approximately twice lower than in patients with normal liver function. in men aged 65 to 74 years with clinically normal renal and hepatic function noticeable differences fozinoprilata pharmacokinetic parameters compared with younger patients (20-35 years old) is not observed.
- Arterial hypertension;
- Chronic heart failure (in combination therapy).Contraindications
: Hypersensitivity to fozinoprigu, other ingredients and other inhibitors; angioedema in history (hereditary, idiopathic or associated with the use of su 250 testosterone mix inhibitors); pregnancy: breastfeeding; age of 18 years; lactose intolerance, lactase deficiency. gapaktoznaya glucose malabsorption.
Concomitant use with diuretics, nitrates, vasodilators. potassium drugs, heparin, potassium-sparing diuretics, antacids, drugs lithium, nonsteroidal anti-inflammatory , insulin, hypoglycemic agents for oral, tricyclic antidepressants, antipsychotics, opioid analgesics, drugs for general anesthesia, immunosuppressive agents, sympathomimetics, cytostatics, corticosteroids , procainamide, allopurinol; Chronic heart failure functional class classification; state, accompanied by a decrease in circulating blood volume su 250 testosterone mix; Coronary heart disease su 250 testosterone mix; cerebrovascular diseases: hypertension, renovascular; bilateral renal artery stenosis; stenosis of the artery to a solitary kidney; systemic connective tissue diseases (scleroderma, systemic lupus erythematosus);hyperkalemia; stenosis of the aortic valve; hypertrophic obstructive cardiomyopathy: uncontrolled diabetes; hemodialysis; plasmapheresis; when desensitization or desensitization procedures; inhibition of bone marrow hematopoiesis, old age, condition after kidney transplantation.