Lesson
Lesson: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Urocard
ATX code: C02CA04
Active ingredient: doxazosin (Doxazosin)
Producer: TATHIMFARMPREPARATY, JSC (Russia)
Description and photo updated: 30.11.2018
Prices in pharmacies: from 119 rubles.
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Urokard - alpha1-blocker; an antihypertensive drug used for urination disorders caused by benign prostatic hyperplasia.
Release form and composition
Dosage form - tablets: round, flat-cylindrical, from white to white with a creamy or yellowish shade of color, with a score and a chamfer (10, 14 or 15 pcs. In a blister contour packaging, in a cardboard box 1 pack of 14 tablets, 2 packs of 15 tablets or 3 packs of 10 tablets and instructions for use of the Lesson).
Composition of 1 tablet:
- active substance: doxazosin (in the form of mesylate) - 2 or 4 mg;
- auxiliary components: sodium carboxymethyl starch (primogel), microcrystalline cellulose, magnesium stearate, sodium lauryl sulfate, lactose monohydrate.
Pharmacological properties
Pharmacodynamics
The active substance of Urocard is doxazosin, a selective competitive blocker of postsynaptic alpha 1 -adrenergic receptors (affinity for alpha 1 -receptors is 600 times higher than for alpha 2 receptors). The drug reduces total peripheral vascular resistance (OPSR) and prevents the development of vasoconstriction caused by catecholamines, which ultimately leads to a decrease in high blood pressure (BP). This process is not accompanied by the occurrence of reflex tachycardia. Doxazosin reduces pre- and afterload. Reduces the risk of developing coronary heart disease.
Urocard is effective in arterial hypertension, including in patients with metabolic disorders (obesity, decreased glucose tolerance). In patients with normal blood pressure, doxazosin does not cause further pressure drops.
After a single oral administration of the drug, the decrease in blood pressure develops gradually, reaching a maximum after 2–6 hours and lasts up to 24 hours. The decrease in blood pressure is noted both in the patient's lying position and standing.
Patients taking doxazosin for a long time develop tolerance.
Urocard reduces the plasma concentration of total cholesterol and triglycerides. During the therapy period, there is a slight increase (by 4–13%) in the high-density lipoprotein / total cholesterol ratio.
With prolonged use, doxazosin promotes regression of left ventricular hypertrophy, inhibits platelet aggregation, and increases the activity of tissue plasminogen activator.
Due to the blocking of alpha 1 -adrenergic receptors located in the bladder neck, stroma and capsule of the prostate gland, there is a decrease in pressure and resistance in the urethra, and the resistance of the internal sphincter decreases. In this regard, in benign prostatic hyperplasia, doxazosin significantly improves urodynamic parameters and reduces the severity of the clinical symptoms of the disease. The effect is observed in 66-71% of patients. The action begins to develop in 1-2 weeks after the start of taking Urokard, the maximum reaches after 14 weeks. The effect persists for a long time.
Pharmacokinetics
After oral administration, doxazosin is absorbed by 80–90%. With the simultaneous intake of food, absorption slows down by 1 hour.
The maximum plasma concentration is noted after 3 hours. If the Urocard is taken in the evening, this period increases to 5 hours.
The bioavailability of the substance is 60–70%. It is characterized by a high degree of binding to plasma proteins - 98%.
Doxazosin is excreted from the blood plasma in two phases with a final half-life of 19-22 hours, so that Urocard can be taken once a day.
Doxazosin is extensively metabolized in the liver by hydroxylation and o-demethylation. The process of biotransformation of the Urocard can be upset with a functional disorder of the liver and the simultaneous administration of drugs that can change hepatic metabolism.
The drug is excreted mainly through the intestines: 63-65% - in the form of metabolites, 5% - unchanged. Approximately 10% is excreted by the kidneys.
In studies of the pharmacokinetics of doxazosin in the elderly and patients with kidney disease, significant differences in the parameters of the Urocard were not revealed.
Indications for use
- arterial hypertension - in combination with other antihypertensive agents, such as angiotensin-converting enzyme (ACE) inhibitors, slow calcium channel blockers (BMCC), beta-blockers, thiazide diuretics;
- benign prostatic hyperplasia in patients with and without arterial hypertension.
Contraindications
Absolute:
- lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
- age up to 18 years;
- hypersensitivity to any component of the drug or other quinazoline derivatives.
The lesson should be used with caution in the following cases:
- tendency to arterial hypotension (orthostatic disturbances in the regulation of blood circulation);
- mitral / aortic stenosis;
- impaired liver function;
- the period of pregnancy and lactation.
Lesson, instructions for use: method and dosage
Urokard tablets are taken orally, 1 time per day (morning or evening), swallowing whole and drinking plenty of water. Meal time does not matter.
It is recommended to start treatment with the drug with a dose of 1 mg (½ tablet at a dosage of 2 mg) in order to avoid the development of orthostatic hypotension and / or fainting.
Patients with arterial hypertension after taking the first dose should be in bed for 6-8 hours so as not to be at risk of developing the phenomenon of the first dose (orthostatic reactions), especially in the case of previous use of diuretics. If a dose of 1 ml is not enough to achieve the required therapeutic effect, after 1-2 weeks the daily dose is increased to 2 mg. In the future, it is possible to increase the dose by 2 mg every 1-2 weeks. In most episodes, the optimal daily dose of Urocard is 8 mg. The maximum allowable dose is 16 mg per day. After achieving a stable effect, the daily dose is reduced to a maintenance dose, usually 2–4 mg.
In case of benign prostatic hyperplasia, in case of insufficient effect when taking Urokard 1 mg per day, the dose is increased to 2-4 mg with an interval of 1-2 weeks, depending on the severity of the symptoms of the disease and urodynamic parameters. Subsequently, it is possible to increase the daily dose, but not more than up to 8 mg. The recommended daily maintenance dose is 2–4 mg.
The duration of taking Urokard is determined by the doctor, the treatment is long.
Side effects
Possible side effects (classified in frequency as follows: often -> 1%, infrequently -> 0.1% and 0.01% and <0.1%, very rarely - <0.01%):
- on the part of the cardiovascular system: often - a feeling of increased heartbeat, peripheral edema; infrequently - fainting (the phenomenon of the first dose), arrhythmia, orthostatic hypotension, angina pectoris, myocardial infarction;
- on the part of the genitourinary system: often - frequent urination, delayed ejaculation; infrequently - dysuria; rarely - priapism, impotence;
- on the part of the central and peripheral nervous system: often - sleep disturbance, increased fatigue, dizziness, headache; infrequently - dysphoria, nightmares, memory impairment; rarely - paresthesia, depression;
- on the part of the senses: often - a violation of taste, impaired lacrimation, photophobia, tinnitus, violation of accommodation; rarely - conjunctivitis, blurred visual perception; against the background of preliminary use of tamsulosin and in cases of surgical treatment of cataracts - atonic iris syndrome;
- laboratory data: infrequently - hypokalemia; rarely - leukopenia, hypoglycemia, thrombocytopenia, transient increase in the activity of liver enzymes; very rarely - uremia, erythrocytopenia, creatininemia;
- others: often - chest pain, asthenia; infrequently - muscle and joint pain, muscle weakness, gout, nosebleeds, cough, facial redness, alopecia; rarely - hyperhidrosis; in elderly patients, hypothermia.
Overdose
In case of an overdose of Urokard, a pronounced decrease in blood pressure occurs, in some cases this may be accompanied by fainting.
The patient should be laid down and his legs raised. Treatment is symptomatic. Replenishment of the circulating blood volume is required. Hemodialysis is ineffective.
special instructions
In order to avoid the development of orthostatic reactions, patients are advised to refrain from abrupt and sudden changes in body posture, for example, to get up suddenly from a prone position.
Patients with functional disorders of the liver should be under constant supervision during the period of therapy, especially in the case of the simultaneous use of drugs that can affect hepatic metabolism, for example, tricyclic antidepressants, barbiturates, phenylbutazone, cimetidine, ethanol. In case of deterioration of hepatic parameters, Urocard should be immediately canceled.
Influence on the ability to drive vehicles and complex mechanisms
At the beginning of treatment and during the period of increasing the dose of Urokard, orthostatic reactions may develop, therefore patients are advised to refrain from performing potentially hazardous work and driving a car.
Application during pregnancy and lactation
According to experimental studies, doxazosin does not have teratogenic and embryotoxic effects. However, the experience with the use of doxazosin in pregnant women with hypertension is limited.
During pregnancy and lactation, Urocard can be used only after a careful assessment of the expected benefits and possible risks.
Pediatric use
Urocard tablets are not used to treat children and adolescents under 18 years of age.
With impaired renal function
No dosage adjustment is required.
For violations of liver function
In case of impaired liver function, Urocard should be used with extreme caution.
Use in the elderly
No dosage adjustment is required.
Drug interactions
- antihypertensive drugs: the hypotensive effect is enhanced (dose adjustment is required);
- epinephrine: its alpha-adrenostimulating effects are eliminated, which leads to the development of arterial hypotension and tachycardia;
- sulfonylpiperazine derivatives (selective phosphodiesterase type 5 inhibitors), such as vardenafil, sildenafil, tadalafil: possible development of arterial hypotension;
- sympathomimetic drugs, estrogens, non-steroidal anti-inflammatory drugs (especially indomethacin): a decrease in the antihypertensive effect of doxazosin is possible;
- inhibitors of microsomal oxidation in the liver: the effect of doxazosin decreases;
- inducers of microsomal oxidation in the liver (tricyclic antidepressants, barbiturates, phenylbutazone, ethanol): the effect of doxazosin is enhanced;
- phenytoin, digoxin: simultaneous use with Urocard does not affect the degree of their binding to blood plasma proteins;
- beta-blockers, BMCC, ACE inhibitors, thiazide diuretics, furosemide, uricosuric drugs, indirect anticoagulants, antibacterial agents, oral hypoglycemic drugs: no negative interaction reactions were noted when used simultaneously with doxazosin.
Analogs
Urokard's analogues are Artezin, Doxazosin, Zoxon, Kamiren, Kardura, Terazosin, Tonokardin and others.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C in a dry, dark place out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about the Lesson
Reviews about the Lesson are few, but mostly positive. Most often, there are reports from men who have been prescribed the drug in connection with benign prostatic hyperplasia. They note a significant improvement in well-being and a decrease in the manifestations of the disease.
Patients with arterial hypertension also speak well of Urocard: the drug effectively lowers high blood pressure, eliminates the associated headache and fatigue.
Of the negative aspects, one can note the development of orthostatic reactions, up to loss of consciousness, after the first dose of the drug, especially in the elderly. Because of this, doctors recommend taking the first dose at bedtime.
Price for Urocard in pharmacies
Average prices for the Lesson are:
- 2 mg tablets, 30 pcs. in the package - 110 rubles;
- 4 mg tablets, 30 pcs. in the package - 212 rubles.
Lesson: prices in online pharmacies
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Drug name Price Pharmacy |
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Urocard 2 mg tablets 30 pcs. 119 RUB Buy |
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Urocard 4 mg tablets 30 pcs. 179 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
