By reducing doxazosin vascular muscle tone decreases total peripheral vascular resistance equipoise for horses which leads to lower blood pressure (BP). After a single ingestion maximum hypotensive effect observed in the period from 2 to 6 hours, and in general hypotensive effect is maintained for 24 hours. During treatment with doxazosin in hypertensive patients with no differences quantities of BP in the standing and lying down. It is effective in hypertension, including, accompanied by metabolic disorders (obesity, impaired glucose tolerance). Reduces the risk of developing coronary heart disease. The drug in ” normotensive “is not accompanied by a decrease in blood pressure. With prolonged use of doxazosin in patients with no observed change in tolerance to the therapeutic antihypertensive effect. During treatment with doxazosin a decrease in the level of concentration in the blood plasma triglycerides, total cholesterol. At the same time there is some total ratio cholesterol. Prolonged treatment doxazosin observed left ventricular hypertrophy regression, inhibition of platelet aggregation and improvement in their tissues active plasminogen. Due to the fact that doxazosin blocks alpha1-adrenergic receptors, located in the stroma and prostatic capsule and bladder neck, there is a decrease of resistance and pressure in the urethra, internal sphincter resistance decrease. Therefore, the appointment of doxazosin to patients with symptomatic equipoise for horses benign prostatic giterplazii leads to a significant improvement in urodynamics and reduce symptoms of the disease symptoms.
Following oral administration at therapeutic doses doxazosin well absorbed, absorption – 80-90% (together with food slows absorption at 1 hour), time to maximum concentration -3 hours in the evening reception -. Time to maximum concentration is prolonged to 5 hours.
bioavailability – 60-70% (first pass metabolism). Contact with blood plasma proteins – about 98%. Elimination from plasma takes place in 2 phases, with a terminal half-life -. 19-22 hours, allowing you to assign the drug 1 time per day.
Intensively metabolized in the liver by on-demethylation and hydroxylation. In patients with impaired liver function, as well as when taking drugs that may alter hepatic metabolism, the process can break down the drug biotransformation. The main excretion through the intestine, mainly in the form of metabolites, only 5% excreted in the urine in unchanged form. The kidneys remove 10%. Pharmacokinetic studies with doxazosin in the elderly and patients with kidney disease showed no significant pharmacokinetic differences.
Camiri should not be administered to patients with hypersensitivity to doxazosin and other derivatives equipoise for horses of quinazoline (prazosin, terazosin), or to other components of the drug, at the age of 18 years (effectiveness and safety have not been established).
Precautions: aortic or mitral stenosis, abnormal liver function , orthostatic hypotension.
Pregnancy and lactation
Pregnant women can be given the drug only for health reasons, when benefit to the mother outweighs the potential risk to the fetus / baby. Safety of the drug in infants has not been established, therefore, nursing mothers should stop feeding during treatment with doxazosin.
Dosing and Administration
Inside, 1 time a day (morning or evening), regardless of the meal, not chewing and drinking plenty of water.
The dose should be adjusted depending on the efficacy or potential side effects in certain patients. Patients with hepatic impairment require lower doses of the drug due to slow metabolism.
If the patient has forgotten to take the drug at the usual time, it should be as soon as possible to take the proper dose. If it is time for the next dose, you should only accept it (not doubling the dose). It is important to take the drug regularly. If the patient did not take the drug for a few days, the new course of therapy should be started with the lowest dose. Hypertension: Initial dose Camiri ® is 1 mg per day.The first dose should be taken at night before bedtime. After the first dose the patient must stay in bed for 6-8 hours. This is required because of the possibility of “first dose phenomenon”, especially expressed on the background of prior diuretics. Depending on the therapeutic action of the drug, the dose can be gradually increased at intervals of 1-2 weeks to 2 mg, 4 mg and 8 mg 1 time in a day. As a rule, the usual daily doses range from 2 mg to 8 mg. The maximum daily dose is 16 mg. If the therapeutic effect is not sufficient, patients may receive other antihypertensive agents at the same time:. Beta-blockers, diuretics, blockers “slow” calcium channel blockers and ACE inhibitors After achieving lasting therapeutic effect of the dose is usually somewhat lower (average therapeutic dose of maintenance therapy is usually 2-4 mg per day). Benign prostatic hyperplasia in patients with normal blood pressure: initial dose of 1 mg Camiri ® per day. The patient should take the first dose in the evening before bedtime. Depending on the drug, the dose can be gradually increased at intervals of 1-2 weeks to 2 mg, 4 mg, and 8 mg once daily. Typically, the average daily dose range from 2 mg to 4 mg. The maximum daily dose is 8 mg. Benign prostatic hyperplasia in patients with hypertension: . Dose are the same as in the case of hypertension without benign prostatic hyperplasia (. Cm dose in hypertension) drug is used for a long time. Duration of treatment is determined by the attending equipoise for horses physician.
Side effects Hypertension frequently observed in clinical trials, especially in the beginning of treatment, orthostatic hypotension, which in rare cases may cause fainting. Common reactions: asthenia, fatigue, malaise. Cardio-vascular system: edema, fainting. From the central and peripheral nervous system: dizziness, headache, somnolence. On the part of the gastrointestinal tract: nausea. The respiratory system: rhinitis.
Benign prostatic hyperplasia (BPH)
in patients with BPH found the same side effects as the patients with arterial hypertension, as well as: Systemic reactions: allergic reactions, skin rash, urticaria, back pain, feeling of heat ( “tides” of blood to the skin persons). on the part of the cardiovascular system: decrease in blood pressure, orthostatic hypotension. on the part of the central and peripheral nervous system: dry mouth, priapism, gipostezii, paresthesias, tremor, impotence, insomnia, irritability. From the endocrine: gynecomastia. From the gastrointestinal tract: abdominal pain, constipation, diarrhea, dyspepsia, flatulence, nausea, loss of appetite. From the side of hematopoiesis: leukopenia, purpura, thrombocytopenia. From the hepatobiliary system: increased activity of “liver” enzymes, cholestasis, hepatitis , jaundice. From the musculoskeletal system equipoise for horses: arthralgia, muscle cramps, muscle weakness, myalgia. The respiratory system: bronchospasm, cough, shortness of breath, nasal bleeding. With the skin: alopecia. From the senses: blurred vision , ringing in the ears. from the mochevydelitelnoy system: . dysuria, hematuria, violation of urination, nocturia, polyuria, urinary incontinence and notes the following adverse reactions in patients with arterial gipertepziey (cause-and-effect relationship has not been established): bradycardia, tachycardia, palpitations, pain chest, angina, myocardial infarction, cerebrovascular disease and arrhythmias.
Overdose Symptoms: marked reduction of blood pressure, sometimes accompanied by fainting. Treatment: The patient should be put immediately into a horizontal position with his head down, lift the leg.Symptomatic therapy. Dialysis is ineffective.
Interaction with other drugs
Doxazosin increases the hypotensive effect of antihypertensive drugs.
There were no adverse interaction with the simultaneous use of doxazosin and tiazidngh diuretics, furosemide, b – blockers, blockers “slow” calcium channel blockers, ACE inhibitors, antibiotics, oral hypoglycaemic agents, anticoagulants and urikozuricheskih . means
the simultaneous use of inducers equipoise for horses of microsomal oxidation in the liver may increase the effectiveness of doxazosin with inhibitors – reducing. Nonsteroidal anti-inflammatory drugs (especially indomethacin), estrogen (fluid retention) and sympathomimetic agents may reduce the antihypertensive effect of doxazosin. Eliminating alpha adrenostimuliruyuschee effects of epinephrine may cause tachycardia and hypotension.
Particular caution should be exercised in the appointment of the drug to patients with impaired liver function, especially in those cases where both are used drugs that can affect the liver. In case of deterioration of the functional state of the liver drug overturned immediately.
In order to prevent orthostatic reactions, patients should avoid unexpected and sudden shifts in body position (transition from the “lying” to “standing”).
In connection with the fact that doxazosin can cause orthostatic reactions at the beginning of treatment or during the period of increasing dosages to patients it is advisable to refrain from any potentially dangerous activities, in particular from road transport management and other vehicles and machinery.
drinking alcohol can increase adverse reactions.
Safety and efficacy of doxazosin in children has not been established, therefore, not appoint a drug to children.
The effect of the “first” of the drug is especially pronounced against the background of previous diuretic therapy and dietary sodium restriction.
Before therapy is necessary to exclude malignant degeneration of the prostate gland.
Tablets 1, 2 and 4 mg. 10 tablets in blister PVC / PVDC-aluminum foil. 2 or 3 blisters in a carton box together with instructions for use.
Store at a temperature not exceeding 30 ° C.
Keep out of reach of children.