5 October

Lokren - instructions for use , indications, dosage

Lokren - selective beta1-blocker.

release form and composition

dosage form - tablets, film-coated: round biconvex shaped, white, engraved with "KE 20" on one side and break line - on the other (14 pcs. In blisters in a carton box1 blister).

active substance Locri - betaxolol hydrochloride, in 1 tablet - 20 mg.

Auxiliary ingredients: microcrystalline cellulose, lactose monohydrate, sodium carboxymethyl starch (type A), magnesium stearate, colloidal silicon dioxide.

composition of film-coating: macrogol 400, hypromellose, titanium dioxide (E171).

Indications

  • monotherapy and combination treatment of hypertension;
  • prevention of attacks of angina (monotherapy or combination therapy).

  • Contraindications Cardiogenic shock;
  • Acute heart failure;
  • Cardiomegaly (in the absence of symptoms of heart failure);
  • Chronic heart failure decompensation (with ineffective therapy inotropic agents, diuretics, angiotensin converting enzyme inhibitors and other vasodilators);
  • atrioventricular (AV) bl
    ock II and III degree (without pacemaker);
  • sick sinus syndrome (SSS), including sinoatrial block;
  • hypotension (systolic blood pressure (BP) of less than 100 mm Hg);
  • Severe bradycardia (heart rate (HR) is less than 45-50 beats per minute);
  • Monotherapy Prinzmetal angina;
  • Severe pathologies occlusive peripheral arterial disease, and Raynaud's disease;
  • Severe chronic obstructive pulmonary disease and asthma;
  • Metabolic acidosis;
  • Pheochromocytoma in the absence of simultaneous use of alpha-blockers;
  • Concomitant use with sultopride, floctafenine, monoamine oxidase inhibitors;
  • lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
  • the age of 18;
  • period of breastfeeding;
  • Anaphylactic reactions in history;
  • hypersensitivity to the drug.

Precautions recommended to appoint Lokren patients with chronic heart failure in the stage of compensation, AV-blockade of I degree, non-severe forms of obliterating peripheral arterial disease and Raynaud's syndrome, Prinzmetal angina (only in combination with vasodilators), asthma and chronic obstructive pulmonary diseasewith an average severity of illness in patients with untreated pheochromocytoma, liver and / or renal insufficiency, diabetes mellitus, psoriasis, during desensitizing treatment and in the treatment of elderly patients.

recommends no Lokren during pregnancy and breastfeeding, unless the anticipated benefits of therapy for the mother outweighs the potential risk to the health of the fetus or child.

Dosage and Administration

tablets taken orally, without chewing, with a small amount of liquid.

The recommended daily dosage for each clinical indication: 10 mg or ½ tablet.If 7-14 days after application of the initial dose fails to reach the target value of blood pressure, the dose should be increased to 20 mg.Assigning

daily dose usually does not exceed 20 mg, the maximum is 40 mg per day.

Patients with renal insufficiency appointment should be made taking into account the renal function.When creatinine clearance (CC) more than 20 ml / min Lokren administered at the recommended dose, but at the beginning of therapy (the first 4-7 days) should conduct regular clinical follow-up, while the level of concentration of betaxolol in blood reaches equilibrium.

When CC less than 20 ml / min, the initial daily dose is 5 mg, including patients on hemodialysis.To achieve the clinical effectiveness may be increased doses every 1-2 weeks to 2 times, but not more than 20 mg per day.

When liver failure drug administered in the usual dose, but requires careful clinical monitoring of patients.

Side effects

  • Cardiovascular system: often - bradycardia (including severe), decrease in skin temperature of the upper and lower limbs;rarely - the development or worsening symptoms of heart failure (swelling of feet, ankles, legs), vasospasm symptoms: increased peripheral circulatory disorders (intermittent claudication), Raynaud's syndrome, frequent angina, slowing AV-conduction, a strong decrease in blood pressure;
  • nervous system: often - insomnia, headache, dizziness, asthenia;rarely - depression;very rarely - nightmares, hallucinations, paresthesia, confusion;
  • digestive system: often - nausea, vomiting, gastralgia, diarrhea;
  • Authority of: rare - decrease of intraocular pressure, dry eye;very rarely - visual impairment;
  • metabolism: very rarely - hyperglycemia, hypoglycemia;
  • respiratory system: rarely - bronchospasm;
  • Laboratory findings: rare - occurrence of antinuclear antibodies, in exceptional cases, accompanied by a transient clinical signs volchanochnopodobnogo syndrome;
  • Dermatological reactions: seldom - skin rash, pruritus, urticaria, aggravation of psoriasis or psoriasis-like rash;
  • Genitals: often - impotence;
  • Effect on the fetus: hypoglycemia, fetal growth restriction, bradycardia;
  • Allergic reactions: skin rash, pruritus, urticaria;
  • Other: withdrawal syndrome (increased blood pressure, increased or increased angina attacks).

Cautions

cancel or change the dose Locri should be made only after consulting a doctor, doing it gradually, so as not to cause a temporary deterioration of the heart in the form of increased frequency of angina attacks.Dose reduction is achieved within 2 weeks, with simultaneous substitution destination antianginal therapy.Sudden interruption of treatment in patients with coronary heart disease can cause severe cardiac arrhythmias, myocardial infarction, or cardiac arrest.

At the beginning of treatment, patients should be monitored blood pressure and heart rate every day, and then - at least 1 time in 3-4 months.In addition, 1 every 4-5 months in patients with diabetes need to check the level of glucose in the blood, and in elderly patients - kidney function.

Patients should be trained in self-counting heart rate, and remember that in the case of heart rate below 50 beats per minute is necessary to consult a doctor immediately.

inefficient application of beta-blockers is observed in 1/5 patients with angina due to severe coronary atherosclerosis with a low threshold of ischemia (a heart rate less than 100 beats per minute at the beginning of the development of angina attack) and increased end-diastolic pressure of the left ventricle, violating subendocardial blood flow.

The drug should be temporarily canceled when a planned study in the blood antinuclear antibody titers or concentrations Normetanephrine level, vanilinmindalnoy acid and catecholamines in blood and urine.

application of clonidine can be terminated only after the abolition of Locri, a few days later.

Appointment drug to patients with bronchial asthma and chronic obstructive pulmonary disease possible with a moderate degree of severity of the disease and after an assessment of respiratory function.Treatment should start with small doses, beta1-selective betaxolol allows to stop emerging attacks of asthma receiving beta2-agonists.

treatment-controlled heart failure should be under strict medical supervision beginning with low doses.When you save a chronic heart failure in the compensated state may gradually increase the dose.

If bradycardia with resting heart rate below 50-55 beats per minute is necessary to reduce the dose of the drug.

required careful monitoring, including monitoring the patient's ECG, with AV-blockade of I degree.

Application Locri Prinzmetal angina can cause increased frequency of angina attacks, and the drug is recommended to be prescribed only in the treatment of mild disease or angina mixed type in combination with vasodilators.

case of violation of the peripheral circulation receiving betaxolol may cause deterioration of the patient.

Appointment drug with hypertension on the background of pheochromocytoma requires the simultaneous use of alpha-blockers and blood pressure control.

Treatment of elderly patients start with a low dose of destination under strict supervision of a physician.Correction

dosing for patients with renal failure depends on the spacecraft or creatinine concentration in blood plasma.

Precautions should take the drug to patients with diabetes, especially at the beginning of treatment as possible to reduce the severity of symptoms of hypoglycemia.The patient should regularly monitor the concentration of glucose in the blood.

action of beta-blockers exacerbate psoriasis.

When treating patients prone to anaphylactic reactions, especially on the background floctafenine or desensitization, it is necessary to take into account the property of Locri increase susceptibility to allergens and the severity of anaphylactic reactions.The use of epinephrine (adrenaline) for the treatment of anaphylactic reactions is not always clinically effective.

During surgery with general anesthesia, you must inform the anesthesiologist of the patient receiving beta-blockers.If necessary, discontinuation of the drug, it is advisable to do so gradually, completing the reception of the drug for 48 hours prior to anesthesia.

In case of emergency surgery, inability to cancel betaxolol or surgery in patients with coronary artery disease patient is prescribed the appropriate premedication with atropine, without interrupting the reception of betaxolol.General anesthesia in these patients should include materials with mild myocardial depression.During the operation, it is necessary to replenish blood loss and take into account the risk of anaphylactic reactions.

Beta-blockers may mask the symptoms of hyperthyroidism.

During treatment contraindicated use of alcoholic beverages.

Patients with contact lenses need to take into account a possible reduction in production of tear fluid during therapy.

clinical effect of beta-blockers in patients smoking less.

Betaxolol during doping control tests in athletes can produce a positive reaction.

Because of the risk of side effects of the drug in the form of weakness and dizziness, caution should be exercised in the management of vehicles and mechanisms.

Drug Interactions

Simultaneous use of Locri with other drugs can be determined only by the attending physician based on clinical indications and patient related pathologies.

Terms and conditions of storage

Store at temperatures up to 25 ° C.Keep away from children.

Shelf life - 5 years.

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