Description of the drug TENORIK
Slow calcium channel blockers (SCBs, e.g. verapamil, diltiazem)
- increased negative inotropic effect of atenolol, especially in patients with reduced myocardial contractility and/or with impaired sinoatrial or AV conduction. This may lead to the development of severe hypotension, bradycardia or heart failure. Slow calcium channel blockers should not be used intravenously within 48 hours after discontinuation of beta-blockers.
Class I antiarrhythmic drugs (disopyramide) and amiodarone
- it is possible to increase the atrial conduction time and enhance the negative inotropic effect of atenolol; the cardiodepressive effect may be additive.
Norepinephrine (norepinephrine), epinephrine (adrenaline)
- possible significant increase in blood pressure
Cardiac glycosides, reserpine, alpha-methyldopa, guanfacine or clonidine
- due to the possible appearance of potassium and/or magnesium deficiency in connection with taking this combination of beta-blockers, the sensitivity of the heart muscle to cardiac glycosides may increase, and, accordingly, the frequency of their side effects may increase.
Clonidine
- Abrupt withdrawal of clonidine can lead to an increase in blood pressure, so discontinuation of clonidine should be done gradually and only a few days after discontinuation of beta-blockers.
Tricyclic antidepressants, barbiturates, phenothiazines, diuretics, vasodilators and other antihypertensive drugs, ethanol
- the antihypertensive effect may be enhanced.
ACE inhibitors (captopril, enalapril)
- at the beginning of therapy, a sharp increase in the antihypertensive effect of the drug is possible.
Salicylates and other NSAIDs
- a decrease in the antihypertensive effect of beta-blockers is possible, and with a high dose of salicylates - an increase in the toxic effect of salicylates on the central nervous system. With simultaneous use of this combination with NSAIDs, the diuretic and hypotensive effects may be weakened.
Lithium
- decreased excretion of lithium and increased cardio- and neurotoxic effect of lithium.
Curare-like muscle relaxants (tubocurarine)
- it is possible to strengthen or weaken the neuromuscular blockade.
GCS, carbenoxolone, amphotericin B, furosemide
- it is possible to increase the excretion of potassium ions.
Allopurinol
- may increase the incidence of hypersensitivity reactions to chlorthalidone.
Lorthalidone may increase the risk of adverse reactions due to amaptadine.
Anticholinergic drugs (eg, atropine, biperiden) may increase the bioavailability of chlorthalidone, reducing gastrointestinal motility and gastric emptying.
The pharmacological effects of calcium salts and vitamin D may be increased to clinically significant levels when used concomitantly with chlorthalidone.
Concomitant use with cyclosporine increases the risk of developing hyperuricemia and complications such as gout.
Cholestyramine interferes with the absorption of chlorthalidone (the pharmacological effect of chlorthalidone may be reduced).
The simultaneous use of chlorthalidone with methotrexate and cyclophosphamide can lead to potentiation of the pharmacological effect of anticancer drugs. Interactions caused by the combination of chlorthalidone and atenolol, which are part of the drug Atenolol compositum San dose*.
Insulin and hypoglycemic agents for oral administration, the effect of the latter may be enhanced. It is necessary to regularly monitor the concentration of glucose in the blood, since signs of hypoglycemia (tremor, tachycardia) may be masked or weakened by taking Atenolol compositum Sandozk
Drugs for general anesthesia: enhancing the antihypertensive effect and summing up the negative inotropic effect of both drugs. Slow calcium channel blockers (SCBs), dihydropyridine derivatives (for example, nifedipine): the risk of arterial hypotension may increase; in patients with latent heart failure, signs of circulatory disorders may appear . Baclofen: may enhance antihypertensive effect
Compound
The drug Tenorik contains 2 active ingredients: atenolol and chlorthalidone . Today, this drug is available in 2 dosages. 1 tablet may contain 50 mg of atenolol and 12.5 mg of chlorthalidone and 100 mg of atenolol and 25 mg of chlorthalidone , respectively.
The excipients in the drug include corn starch, lactose, sodium lauryl sulfate, polyvinylpyrrolidone , talc, as well as isopropanol , silicon dioxide and magnesium stearate. The film coating of the tablets consists of isopropanol, methylene chloride, hypromellose, talc, titanium dioxide, as well as petroleum jelly and macrogol.
Pharmacodynamics and pharmacokinetics
The combined use of atenolol and chlorthalidone slightly affects the pharmacokinetics and pharmacodynamics of each of the active ingredients of the drug.
Atenolol
Absorption and distribution When taking the drug orally, the active substance atenolol is approximately 45-50% absorbed from the gastrointestinal tract. Cmax of this active substance in blood plasma was recorded 2-3 hours after administration. The binding to plasma proteins is quite weak and amounts to only 5-15%.
Metabolism and excretion It has been proven that atenolol does not exhibit significant hepatic metabolism . More than 90% of atenolol , which is absorbed into the systemic circulation, is excreted from the body completely unchanged. And T1/2 reaches about 6-9 hours, but severe renal failure can cause an increase in this indicator, since the kidneys are the main organ through which atenolol .
Chlorthalidone
Absorption and distribution When taking the drug Tenoric orally, the active substance is chlorthalidone by 60-65%. absorbed from the gastrointestinal tract. Cmax is recorded in blood plasma after approximately 10-12 hours. Chlorthalidone has a strong binding to plasma proteins, which is approximately 70-75%.
Excretion Chlorthalidone is excreted by the kidneys and its T1/2 varies within 50 hours.
Tenorika price, where to buy
The average price of Tenorik in Ukraine is 35 UAH.
You can buy the medicine Tenorik in Moscow for 102 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Tenoric tablets p.p.o.
50mg+12.5mg 28 pcs. Ipca Laboratories Ltd RUB 168 order - Tenoric tablets p.p.o. 100mg+25mg 28 pcs. Ipca Laboratories Ltd
RUB 222 order
Pharmacy Dialogue
- Tenoric tablets 50/12.5 mg No. 28) Ipka Laboratoris
RUB 152 order
- Tenoric tablets 100/25 mg No. 28) Ipka Laboratoris
RUB 209 order
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Pharmacy24
- Tenorik 62.5 mg No. 28 tablets IPKA Laboratories Limited, India
61 UAH order - Tenorik 125 mg No. 28 tablets IPKA Laboratories Limited, India
78 UAH order
PaniPharmacy
- Tenoric tablets Tenoric tablets. 125 mg No. 28 India, IPCA
98 UAH order
- Tenoric tablets Tenoric tablets. 62.5 mg No. 28 India, IPCA
70 UAH order
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Contraindications
It is not recommended to use Tenoric tablets in the treatment regimen:
- with severe attacks of bradycardia ;
- in the presence of cardiogenic shock ;
- with severe and progressive arterial hypotension ;
- with metabolic acidosis ;
- with severe peripheral circulatory disorders;
- with AV blockade of the first and third degree;
- at SSSU ;
- with pheochromocytoma ;
- for heart failure (acute and chronic);
- with vasospastic angina (so-called Prinzmetal angina );
- with progressive bronchial asthma ;
- with obstructive bronchitis ;
- for diabetes mellitus ;
- for hypoglycemia ;
- for gout ;
- with myasthenia gravis ;
- for acute hepatitis ;
- in acute renal failure ;
- in childhood and adolescence up to 18 years of age;
- with hypersensitivity to the components of the drug.
Reviews of Tenorique
Tenorik's average rating on the forums is only 3.3 on a 5-point scale.
The main advantages of the drug Tenorik forum visitors include:
- efficiency;
- low price.
Discussion participants believe that the disadvantages of this drug are that these blood pressure pills:
- may become a cause of hair loss and impotence ;
- cause convulsions .
Having analyzed the reviews of doctors about Tenorik on the forums, we can conclude that before starting to use it, it is necessary to consult with your doctor. Also, reviews of Tenorik often contain a recommendation that older people should not take this drug.
In search engines, one of the most common questions is “Tenoric Tablets for what?” Experts answer that these tablets are used in treatment regimens exclusively for arterial hypertension.
There is no information about the drug Tenoric on Wikipedia.
Side effects
When using Tenoric tablets in a treatment regimen, patients may experience discomfort from the following side effects:
From the cardiovascular system: from bradycardia, increased symptoms of heart failure, orthostatic hypotension, cold extremities, the appearance of arrhythmias, AV blockade, symptoms of intermittent claudication, Raynaud's syndrome.
From the central nervous system and peripheral nervous system: from confusion, dizziness, headache, mood swings, acute psychosis, hallucinations, paresthesia, sleep disturbances, increased fatigue, apathy, disorientation, visual impairment.
From the digestive system: from dry mouth, gastrointestinal disorders, increased levels of liver transaminases, hepatotoxicity with intrahepatic cholestasis, nausea (associated with the use of chlorthalidone), constipation, pancreatitis, anorexia.
From the hematopoietic system: leukopenia, purpura, thrombocytopenia, agranulocytosis, eosinophilia.
Dermatological reactions: alopecia, dry eyes, psoriasis-like reactions, exacerbation of psoriasis, skin rash, photosensitivity.
From the respiratory system: from bronchospasm .
From laboratory parameters: hyperuricemia, hyponatremia, hypokalemia .
Other: from an increase in the number of antinuclear antibodies, decreased potency, impaired glucose tolerance .
However, the drug Tenorik is most often well tolerated by patients. Side effects are rare and so mild that they are rather transient in nature.
Overdose
In case of an overdose of Tenoric, the patient may experience severe discomfort from severe bradycardia, arterial hypotension, acute heart failure, bronchospasm, convulsions, and increased drowsiness.
To relieve these symptoms, in some cases, hospitalization in the ICU may be necessary, where gastric lavage . In case of severe arterial hypotension and severe shock, it is recommended to administer plasma or a plasma substitute, and in case of bronchospasm , use bronchodilators. If necessary, hemodialysis or hemoperfusion is also performed.
