Tenorik - instructions for use, analogs, reviews and release forms (tablets 50 mg + 12.5 mg, Fort 100 mg + 25 mg) drugs for the treatment of hypertension and pressure reduction in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Tenorik. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Tenoric in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Tenoric in the presence of existing structural analogs. Use to treat hypertension and reduce blood pressure in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Tenorik - Combined antihypertensive drug, has a prolonged hypotensive effect. The effect is due to the action of two components: a beta1-adrenoblocker (atenolol) and a diuretic (chlorthalidone).

Atenolol is a cardioselective beta-1 blocker. Selectivity decreases with increasing dose. Atenolol has no internal sympathomimetic and membrane-stabilizing effects. Like other beta-adrenoblockers it has a negative inotropic effect, it reduces the heart rate.

Chlortalidone is a non-iodide sulfonamide diuretic, enhances the release of sodium and chlorine. Increases the secretion of potassium, magnesium and bicarbonate. The mechanism of antihypertensive action is probably associated with sodium excretion. The combination of atenolol with diuretics is more effective than using each of the components separately.

The effect of the drug Tenorik persists for 24 hours after a single oral intake in a daily dose.

Composition

Atenolol + Chlortalidone + auxiliary substances.

Pharmacokinetics

The simultaneous use of atenolol and chlorthalidone has little effect on the pharmacokinetics of each of the active substances.

Atenolol

After taking the drug inside, atenolol is absorbed from the digestive tract by 40-50%. Atenolol is not exposed to pronounced hepatic metabolism, more than 90% (absorbed into the systemic bloodstream) is excreted unchanged. Excretion of atenolol occurs mainly by the kidneys.

Chlorthalidone

After taking the drug inside chlortalidone is absorbed from the digestive tract by 60%. It is excreted by the kidneys.

Indications

• arterial hypertension.

Forms of release

Forte pills coated with 50 mg + 12.5 mg, Fort 100 mg + 25 mg.

Instructions for use and dosing regimen

Dosing regimen is given in terms of atenolol.

The average dose of the drug Tenorik for adults is 100 mg; the initial dose is 50 mg once a day.

As a rule, the use of the drug in a dose corresponding to 100 mg of atenolol, gives a good clinical effect. The subsequent increase in the dose or does not lead to a further decrease in blood pressure, or reduces it very slightly. If necessary, an additional antihypertensive agent may be prescribed.

For the elderly, the drug should be given in lower doses.

When prescribing the drug, patients with impaired renal function should reduce the frequency of taking the drug.

After prolonged use of Tenoric, the drug should be discontinued gradually.

Side effect

• bradycardia;
• increased symptoms of heart failure;
• orthostatic hypotension (may be accompanied by syncope);
• coldness of limbs;
• AV blockade;
• symptom of intermittent claudication;
• Raynaud's syndrome;
• confusion of consciousness;
• dizziness;
• headache;
• change of mood;
• acute psychosis;
• hallucinations;
• paresthesia;
• sleep disturbance;
• increased fatigue;
• apathy;
• visual impairment;
• dry mouth;
• gastrointestinal disorders;
• nausea (associated with taking chlorthalidone);
• constipation;
• pancreatitis;
• anorexia;
• leukopenia, purpura, thrombocytopenia, agranulocytosis, eosinophilia;
• alopecia;
• dry eyes;
• psoriasis-like reactions;
• exacerbation of psoriasis;
• skin rash;
• photosensitization;
• bronchospasm (in patients with bronchial asthma or with indications of bronchospasm in the anamnesis);
• decreased potency;
• violation of glucose tolerance.

Contraindications

• severe bradycardia;
• cardiogenic shock;
• severe arterial hypotension;
• metabolic acidosis;
• severe peripheral circulatory disturbances;
• AV-blockade of 2 and 3 degrees;
• SSSU;
• untreated pheochromocytoma;
• acute heart failure;
• chronic heart failure;
• vasospastic angina (Prinzmetal angina);
• bronchial asthma;
• obstructive bronchitis;
• diabetes;
• hypoglycemia;
• gout;
• myasthenia gravis;
• acute hepatitis;
• acute renal insufficiency;
• children and adolescents under 18;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

The drug Tenorik is contraindicated for use in pregnancy and lactation (breastfeeding).

Application in elderly patients

For the elderly, the drug should be given in lower doses.

Use in children

The effectiveness and safety of the use of Tenoric in children and adolescents under 18 years have not been established, so do not prescribe the drug to patients of this age group.

special instructions

Conditioned beta-adrenoblocker atenolol, which is part of Tenorik

Be wary appoint patients with AV-blockade 1 degree.

It should be borne in mind that the use of the drug can mask the phenomena of thyrotoxicosis and hypoglycemia.

With the development of bradycardia (heart rate to 50 beats per minute) with clinical symptoms, the dose should be reduced or the drug should be withdrawn.

Do not abruptly cancel Tenoric in patients with ischemic heart disease.

Smokers may experience a decrease in the therapeutic effect of the drug.

Special care should be taken in cases where surgical intervention is required with general anesthesia. The drug should be discontinued 48 hours before surgery, and as an anesthetic should choose the drug with the possible minimum negative inotropic effect.

Against the background of taking the drug may increase sensitivity to allergens and the development of severe anaphylactic reactions, and therefore patients receiving desensitizing therapy should take the drug with great care. Such patients may not respond to the average dose of epinephrine (adrenaline) used to treat allergic reactions.

Caution should be given to patients with bronchoobstructive syndrome, and in case of worsening of bronchial conductivity, beta-adrenomimetic therapy should be administered.

With the use of atenolol, tear production can be reduced, which is important for patients using contact lenses.

Due to the diuretic chlorthalidone, which is part of Tenorik

Against the background of the drug may occur hypokalemia. Serum potassium should be monitored, especially in patients receiving cardiac glycosides for the treatment of heart failure, in patients with an unbalanced diet (low in potassium) or in patients with complaints of gastrointestinal disorders. The development of hypokalemia in patients receiving cardiac glycosides can lead to arrhythmia.

With caution apply the drug in patients with impaired renal function.

Against the background of the use of the drug, there may be a violation of glucose tolerance. Caution is necessary to prescribe the drug to patients with a predisposition to diabetes mellitus.

Against the background of the drug may develop hyperuricemia, usually minor, but in some cases, it may be necessary to use funds that promote the excretion of uric acid.

With the simultaneous intake of alcohol, dizziness and fatigue may occur.

Impact on the ability to drive vehicles and manage mechanisms

The use of Tenorics, as a rule, does not affect the ability to drive vehicles and control mechanisms. Nevertheless, the question of the possibility of driving a vehicle should be addressed after assessing the individual tolerability of the drug.

Drug Interactions

The simultaneous use of Tenoric with derivatives of dihydropyridine (nifedipine) may increase the risk of developing arterial hypotension, in patients with latent cardiac insufficiency, signs of circulatory disturbance may appear.

Cardiac glycosides in combination with beta-blockers can increase the AV-conduction time.

Beta-adrenoblockers can aggravate the ricochet hypertension that may occur after the withdrawal of clonidine. If both drugs are prescribed, the beta-blocker should be discontinued a few days before cessation of clonidine. If you need to replace clonidine with a beta-blocker, the latter should be administered a few days after cessation of clonidine therapy.

It is necessary to use caution in prescribing a beta-blocker in combination with antiarrhythmic drugs of class 1 (disopyramide), cardiodepressive effect can be summarized.

The concomitant use of sympathomimetic drugs, for example, epinephrine (adrenaline), norepinephrine (noradrenaline) can neutralize the effect of beta-blockers and lead to a significant increase in blood pressure.

Salicylates and non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin), estrogens can reduce the hypotensive effect of beta-adrenoblockers, and when salicylates are used in high dosage, the toxic effect of salicylates on the central nervous system may be increased.

Preparations containing lithium should not be used with diuretics. they can reduce renal clearance of lithium.

The use of beta-blockers along with the means for general anesthesia can lead to an increased risk of developing arterial hypotension and a summation of the negative inotropic effect of both drugs (an anesthetic with a minimal negative inotropic effect should be used). It is also possible to intensify the action of curare-like muscle relaxants.

When using the drug Tenorik with MAO inhibitors, it is possible to increase blood pressure (this combination should be avoided).

With the simultaneous use of the preparation Tenorik with ACE inhibitors (captopril, enalapril) at the beginning of therapy, a sharp increase in the antihypertensive effect is possible.

With the combined use of Tenoric with glucocorticosteroids (GCS), amphotericin B, furosemide, potassium excretion is possible.

When combined with Tenorik, the action of insulin and oral hypoglycemic agents may decrease (blood glucose levels should be monitored).

Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators and other antihypertensives can enhance the antihypertensive effect of Tenoric.

The use of beta-blockers in combination with calcium channel blockers, which have a negative inotropic effect, such as verapamil, diltiazem, may lead to an increase in this effect, especially in patients with reduced myocardial contractility and / or with a violation of sinoatrial or AV conduction,which can cause severe arterial hypotension, severe bradycardia and heart failure (the calcium channel blocker should not be used intravenously within 48 hours after the abolition of the beta-blocker).

With the simultaneous appointment of Tenoric with reserpine, clonidine, guanfacin, there may be a pronounced bradycardia.

Analogues of the drug Tenorik

Structural analogs for the active substance:

• Athexal compositum;
• Atenolol compositum;
• Tenonorm;
• Tenoretik;
• Tenorox.

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