Dopegit
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Dopegit is a drug with an antihypertensive effect.
Release form and composition
Dopegit is produced in the form of tablets: grayish-white or white, round, flat, with a chamfer and the inscription "DOPEGYT" on one side, without or almost odorless (50 pcs. In brown glass bottles, 1 bottle in a cardboard box).
The composition of 1 tablet includes:
- Active ingredient: methyldopa - 250 mg (in the form of methyldopa sesquihydrate - 282 mg);
- Auxiliary components: talc - 6 mg; stearic acid - 3 mg; corn starch - 45.7 mg; sodium carboxymethyl starch - 3.5 mg; ethyl cellulose - 8.8 mg; magnesium stearate - 1 mg.
Indications for use
Dopegit is prescribed for arterial hypertension.
Contraindications
- Hemolytic anemia;
- Depression;
- Pheochromocytoma;
- Acute myocardial infarction;
- Liver cirrhosis, acute hepatitis;
- History of liver disease (when taking methyldopa);
- Concomitant therapy with monoamine oxidase inhibitors;
- Age up to 3 years;
- Hypersensitivity to drug components.
For nursing and pregnant women, Dopegit can only be taken after assessing the benefit / risk ratio for the health of the mother and child.
Dopegit should be taken with caution in children from 3 years of age, in elderly patients, as well as in patients with renal insufficiency (dose adjustment is necessary) and diencephalic syndrome.
Method of administration and dosage
Dopegit should be taken orally, it is possible to take the drug before or after meals.
The doctor sets the dosage regimen individually.
In the first 2 days of treatment, Dopegit is recommended for adult patients to take 0.25 g (1 tablet) 2-3 times a day. In the future, depending on the degree of reduction in blood pressure, the dose can be gradually reduced or increased. The duration of the breaks between dose increases / decreases should not be less than 2 days.
Due to the fact that within a few days after the start of treatment, as well as with an increase in the dose, side effects of the drug may occur, it is recommended to first increase the dose taken in the evening.
The standard maintenance daily dose of Dopegit is 0.5-2 g (maximum 3 g), which is taken in 2-4 doses. If, when taking the drug in a daily dose of 2 g, an insufficiently effective lowering of blood pressure is noted, Dopegit is recommended to be taken simultaneously with other antihypertensive drugs. After 2-3 months of treatment, tolerance may develop to the active substance of the drug (methyldopa). An effective decrease in blood pressure can be achieved by increasing the dose of Dopegit or the concomitant use of diuretics. After stopping treatment, blood pressure usually returns to baseline after 48 hours without developing a "rebound effect".
Dopegit can be used by patients who are already taking other antihypertensive drugs, subject to their gradual withdrawal. In this case, the initial daily dose of Dopegit should not be more than 0.5 g. If necessary, with interruptions of at least 2 days, you can increase the dose. To implement a smooth transition, it may be necessary to adjust the doses of antihypertensive drugs.
For elderly patients, Dopegit is prescribed in a minimum daily dose not exceeding 0.25 g. If necessary, the dose is gradually increased. The maximum daily dose is 2 g.
In this group of patients, fainting is more often observed, which may be associated with increased susceptibility to the action of Dopegit and pronounced atherosclerotic vascular lesions. To avoid fainting, you may need to reduce the dose of the drug.
For children from 3 years of age, Dopegit is prescribed at an initial daily dose of 0.010 g / kg of body weight, which is divided into 2-4 doses. If necessary, until the desired effect is achieved, the dose is gradually increased. The maximum daily dose is 0.065 g / kg of body weight, but not more than 3 g per day.
Patients with mild renal failure (at a glomerular filtration rate of 60-89 ml / min / 1.73 sq. M.), The interval between doses of the drug should be increased to 8 hours, with moderate severity (at a glomerular filtration rate of 30-59 ml / min / 1.73 sq.m.) - up to 8-12 hours, with severe renal failure (with a glomerular filtration rate of less than 30 ml / min / 1.73 sq.m.) - up to 12-24 hours.
After a hemodialysis session, to prevent an increase in blood pressure, it is recommended to take an additional dose of Dopegit (0.25 g).
Side effects
At the beginning of treatment, as well as with an increase in the dose of Dopegita, headache, transient sedative effects, increased fatigue and general weakness may occur.
Also, when using the drug, it is possible to develop disorders from some body systems, manifesting themselves with different frequencies:
- Central nervous system: very rarely - parkinsonism; in some cases - Bell's palsy (peripheral palsy of the facial nerve), involuntary choreoathetotic motor activity, decreased intelligence, decreased libido, mental disorders (including nightmares, depression and mild psychosis), paresthesias, symptoms of cerebrovascular insufficiency, headache, dizziness, sedation, increased fatigue or general weakness;
- Cardiovascular system: very rarely - pericarditis, myocarditis, progression of angina pectoris; in some cases - prolonged hypersensitivity of the carotid sinus, congestive heart failure, orthostatic hypotension (lowering the Dopegit dose is recommended), weight gain, peripheral edema, sinus bradycardia (as a rule, an increase in body weight and peripheral edema regress against the background of diuretic therapy. heart failure or with an increase in edema, the drug should be discontinued);
- Digestive system: very rarely - pancreatitis; in some cases - vomiting, colitis, inflammation of the salivary glands, diarrhea, constipation, nausea, bloating, dryness of the oral mucosa, flatulence, necrotizing hepatitis, hepatitis, jaundice, cholestasis, dark discoloration of the tongue or pain;
- Respiratory system: in some cases - nasal congestion;
- Endocrine system: in some cases - gynecomastia, hyperprolactinemia, amenorrhea, galactorrhea;
- Musculoskeletal system: in some cases - myalgia, mild joint pain with or without edema;
- Immune system: in some cases - lupus syndrome, vasculitis, eosinophilia, drug fever;
- Skin: in some cases - a rash resembling lichen, toxic epidermal necrolysis or eczema;
- Laboratory indicators: very often - positive Coombs test; rarely - leukopenia, hemolytic anemia, thrombocytopenia, granulocytopenia; in some cases - an increase in the activity of hepatic transaminases, inhibition of bone marrow function, LE-cells and rheumatoid factor, an increased concentration of urea in the blood, positive test results for antinuclear antibodies;
- Others: in some cases - violations of ejaculation, impotence.
special instructions
In some cases, hemolytic anemia may develop during therapy. When symptoms of the disease appear, it is necessary to determine the hematocrit and the concentration of hemoglobin. When confirming the diagnosis, it is necessary to additionally assess the degree of hemolysis. With the development of hemolytic anemia, Dopegit is discontinued.
With prolonged therapy, a positive Coombs test can be determined. If this phenomenon did not occur during the first year of taking Dopegit, its further detection is unlikely. Less often, this violation is observed in patients taking the drug in a daily dose of less than 1 g. If a positive direct Coombs test is detected while taking the drug, it is necessary to exclude the presence of hemolytic anemia in the patient and determine the clinical significance of this phenomenon.
In rare cases, when using Dopegit, the occurrence of reversible leukopenia and granulocytopenia may occur. As a rule, after stopping treatment, the number of granulocytes returns to normal.
In some patients, during the first 21 days of therapy, fever develops, which in rare cases is accompanied by eosinophilia or increased activity of hepatic transaminases. In addition, the use of Dopegit may be accompanied by the development of jaundice, which appears during the first 2-3 months of therapy. In some cases, cholestasis and fatal necrotizing hepatitis may develop. In the event of an unexplained fever, it is recommended to determine the activity of hepatic transaminases and a complete blood count with a leukocyte formula.
With the development of jaundice, fever or with an increase in the activity of hepatic transaminases, therapy should be stopped immediately. If the appearance of these symptoms is associated with hypersensitivity to the active substance of the drug, then after discontinuation of Dopegit, the fever disappears, and the functional liver function tests return to normal values. Such patients are not recommended to resume therapy. Patients with a history of liver pathology should take Dopegit with extreme caution.
Some patients experience peripheral edema and weight gain during therapy. Such side effects are easily eliminated with diuretics. With the onset of symptoms of heart failure and an increase in edema, therapy should be discontinued.
Patients taking Dopegit may require lower doses of anesthetics. If hypotension develops during general anesthesia, vasopressor therapy should be used.
With bilateral lesions of the cerebral vessels (cerebrovascular disease), Dopegit's intake may be accompanied by involuntary choreoathetic movements. In this case, therapy is stopped.
The drug should be used with great caution in the treatment of patients with hepatic porphyria and their close relatives.
Dopegit may interfere with serum uric acid, creatinine and aspartate aminotransferase measurements. It is also possible to obtain false positive results for the determination of the content of catecholamines in urine by the fluorescence method, which can complicate the diagnosis of pheochromocytoma.
Alcoholic beverages should not be consumed during therapy.
Reception of Dopegita may be accompanied by sedative effects, which, as a rule, are transient and develop at the beginning of therapy or with an increase in the dose taken. In this case, patients should not perform work that requires increased attention, for example, drive vehicles or mechanisms.
Drug interactions
Special care is required for the simultaneous use of Dopegit with the following drugs:
- Sympathomimetics, tricyclic antidepressants, phenothiazines, oral iron preparations, estrogenic drugs, non-steroidal anti-inflammatory drugs: decrease in the antihypertensive effect of Dopegit;
- Other antihypertensive drugs, general anesthetics, anxiolytic drugs, beta-blockers, levodopa with carbidopa: increased antihypertensive effect of Dopegit;
- Levodopa, lithium, anticoagulants, ethanol and other drugs that depress the central nervous system, haloperidol, bromocriptine: changing the effects of these drugs and Dopegita.
Dopegit cannot be used simultaneously with monoamine oxidase inhibitors.
Analogs
Dopegita's analogs are: Aldomet, Dopanol.
Terms and conditions of storage
Keep out of reach of children at a temperature of 15-25 ° C.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
