International generic name Combined product
Drug form and composition Tablets. One tablet contains: 0.150 mg Clonidine hydrochloride; 20 mg Chlortalidone.
Indications Arterial hypertension (appropriate in cases with resistant to other antihypertensive preparations).
Dosage and administration The usual initial dose is ½ -1 tablet daily. If necessary the dose may be graduately enhanced up to ½ - 1 tablet 2-3 times daily. The dosage and duration of the treatment is determined by the doctor with the lowest effective dose to be used in order to avoid the side effects of the preparation. Tablets should be taken with meal.
Contraindications Hypersensitivity to any of preparation components; sick sinus sindrome; AV-block II or III degree; peripheral circulation disorders; severe renal failure; hepatal comma; cerebrovascular diseases; recent myocardial infarction or coronary artery insufficiency; depressive syndrome; hypokalemia.
Special warnings and precautions In patients with preexisting heart diseases administration of Chlophadon may cause cardiac arrhythmias (bradycardia, arrhythmia). If renal failure exists the preparation should be used under doctor’s control with monitoring of the creatine clearance. Abrupt interruption of the medication may cause neurovegetative disorders including anxiety, insomnia, headache, nausea, elevation of the blood pressure (discontinuation syndrome). During the treatment with Clophadon alcohol should be avoided. In pregnant women the preparation is indicated only in case the expected benefit exceeds the adverse effect on the fetus. As the preparation components are eliminated in the mother milk chlophadon should be used with care in nursing women, only in urgency. In drivers and machinery operating persons the preparation should be administered carefully, as it may provoke dizziness and orthostatic reactions.
Drug interactions Tricycled antidepressants reduce effectivity of the preparation. Concomitant administration with cardiac glycosides may cause bradycardia and AV - block. Chlophadon reduces the hypoglycemic effect of the anti-diabetic preparations, which requires correction of the dose. In concomitant treatment with nonsteroid antiinflammatory drugs the diuretic and atihypertensive activity of the preparation is reduced. In concomitant treatment with glycocorticoid preparations and carbenoxolone the hypokalemic effect of Chlophadon is accentuated.
Adverse reactions Fatigue; headache; orthostatic hypotension; “discontinuation syndrome” in case of abrupt interruption of the treatment; A-V conduction disorders; bradycardia; tremor; allergy rashes; photosensitization; nausea; vomiting. In long-term treatment: gynecomasty; hypokalemia; tubular necrosis and interstitial nephritis; elevation of the serum level of the cholesterol and triglycerides.
Pharmacological mechanisms Chlophadon is an antihypertensive preparation, being combined medicine containing the α-adrenergic agonist clonidine and the diuretic chlortalidone. Clonidine stimulates the postsynaptic α 2 - receptors in the hypothalamus and presynaptic α 2 - receptors in the nucleus of the tractus solitarius and in the peripheral synapses. The net effect is reducing of the blood pressure, of the heart rate and of the general peripheral vessel resistance. The renin plasma level is also reduced, whereas the renal circulation and glomerular filtration remain unchanged. Conversely to reserpine, clonidine does not stimulate, but reduces the stomach secretion. For this reason Chlophadon is preferable in hypertensive patients with ulcer disease. Chlortalidone is a diuretic, acting predominantly on the distal tubules and on the cortical segment of the ascending limb of the Henle loop. This enhances excretion of the Na+ and Cl- in equivalent quantities, i. e. potentiates the salt elimination. The preparation possesses moderate antihypertensive effect, which is due to reduction of the blood volume and to reduction of the sensitivity of the vessel wall to catecholamines and angiotensine II.
Supplied 50 tablets.
Expiry 2 years. |