methandienone side effects

Communication with plasma proteins , the apparent distribution. Concentration in blood plasma methandienone side effects. The half-life – about 3-4 hours.  Subject to significant metabolism. The primary way its elimination is renal excretion (filtration and secretion) unchanged drug. Hydrochlorothiazide crosses the placental barrier.
Triamterene quickly, but not completely is absorbed from the gastrointestinal tract. In moderate  bound to plasma proteins. Maximum plasma concentration is achieved in 2-4 hours. Treated biotransformation in the liver with the formation of both active and inactive metabolites. The half-life of unchanged drug normally is 1.5-2 hours (10 hours in anuria), metabolites -.. Up to 12 hours The main route of elimination triamterena – through the intestines, the secondary – the kidneys.

Indications

 

  • edematous syndrome of different genesis (chronic heart failure, nephrotic syndrome, cirrhosis);
  • arterial hypertension.

Contraindications

Hypersensitivity to the drug or to sulfonamides, chronic renal failure, anuria, acute glomerulonephritis, severe hepatic insufficiency, hepatic encephalopathy and precoma, hyperkalemia, lactation, age 18 years (effectiveness and safety have not been established), I trimester of pregnancy.

With care – diabetes, gout, patients with methandienone side effects impaired liver and / or kidney disease, folic acid deficiency (in patients with cirrhosis of the liver).

 

Dosing and Administration

The inside is not liquid, squeezed small amounts of water after eating. When edema initial dose is determined by the severity of violations of water-electrolyte metabolism and is usually 1 tablet 2 times a day after meals, then may increase the dose to a maximum daily (4 tablets per day): 2 tablets after breakfast and 2 tablets in the afternoon.
When compensation of swelling switching to maintenance therapy 1-2 tablets after 1 -2 days.
When hypertension – an initial dose of 1 tablet per day (in the morning, after breakfast), then gradually increase the dose. The maximum daily dose – 4 tablets.
In patients with impaired renal function (creatinine clearance – 30-50 ml / min.), The maximum daily dose – 1 tablet.

 

Side effect

From the digestive system: nausea, vomiting, and sometimes diarrhea (while taking the drug before meals), pain and discomfort in the epigastric region, colicky abdominal pain, constipation, dry mouth, thirst, and in rare cases – hemorrhagic pancreatitis, and in the presence gallstones – acute cholecystitis. On the part of the central nervous system: uncoordinated movements, sleepiness, fatigue, headache, nervousness. From the musculoskeletal system: muscle tension, muscle weakness, leg cramps. cardio-vascular system: palpitation , lowering blood pressure, cardiac arrhythmias, and circulatory disorders of regulation with dizziness, confusion, or a tendency to faint. Due to the large loss of fluid and reduction of circulating blood volume when using the drug in high doses and / or profuse discharge of urine can form clots develop embolism, in rare cases – seizures, confusion, circulatory collapse and acute renal failure. On the part of metabolism : a temporary increase in the concentration of nitrogen-containing substances emitted kidney (urea, creatinine) in the blood (mainly at the beginning of treatment), fluid and electrolyte balance, mainly reduction of sodium, magnesium, chloride levels, decrease or increase in the potassium content (at long-term continuous use of the drug), hypercalcemia, impaired glucose tolerance. Perhaps an increase in uric acid in the blood, on the basis of which some particularly predisposed patients may provoke an attack of gout, can be observed the formation of urinary stones.

In sensitive patients depending on the assumed methandienone side effects increase of lipid content in the blood can be observed total dose. In connection with the increase in blood glucose concentration may occur or worsen latent pre-existing form of diabetes. The drug may contribute to the accumulation of non-volatile blood acids (metabolic acidosis). On the part of the organs of vision: visual disturbances, worsening of existing myopia or a decrease in the production of tear fluid. From the hematopoietic system: aplastic anemia, leukopenia, thrombocytopenia, agranulocytosis, megaloblastic anemia in the previous deficiency of folic acid in the body, hemolysis resulting from the appearance of autoantibodies to the active substance hydrochlorothiazide, while the use of methyldopa. Allergic reactions: skin redness, itching, hives, systemic lupus erythematosus, photoallergic rash, fever, hypersensitivity reactions (anaphylactoid reactions ), severe inflammation of the blood vessels and non-bacterial inflammation of kidney tissue (aseptic interstitial nephritis). In a few cases it was described suddenly developing lung edema with symptoms of shock. The reason for this is probably an allergic reaction of patients on the active substance hydrochlorothiazide. Other: icteric coloration of the skin, mucous membranes and sclera.

Overdose

Symptoms:. Marked reduction of blood pressure
treatment: symptomatic.

Interaction with other drugs

Medicaments intensively binding to blood proteins (indirect anticoagulants, clofibrate, nonsteroidal anti-inflammatory drugs) increase the diuretic effect of the drug.
The hypotensive effect reinforce vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, ethanol.
Triampur enhances the neurotoxicity salicylates, reduces the effect of oral hypoglycemic drugs, norepinephrine, epinephrine and protivopodagricakih funds, enhances the effects (including spin), cardiac glycosides, cardiotoxic and neurotoxic effects of lithium, curariform effects methandienone side effects of muscle relaxants, reduces excretion of quinidine.
In simultaneous reception with methyldopa increased risk of hemolysis. Cholestyramine reduces absorption triampur.
Hlorpropamid while admission to triampur may cause severe hypokalemia.
In combination with non-steroidal anti-inflammatory drugs may develop acute renal failure.

special instructions

Long-term treatment is necessary to periodically monitor blood potassium, sodium, chloride, urea, creatinine, glucose, uric acid, peripheral blood picture (for suspected lack of folic acid).
At the beginning of the treatment of potentially hazardous avoid drug activities that require attention and psychomotor speed reactions (due to lower blood pressure – slow reaction rate).
Do not take two doses at the same time, if you miss a dose.