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Is it possible to break tablets in half? Discussion: expert comments, live broadcasts with participating cities

Today, quite a lot of people suffer from various heart diseases. Thanks to the fact that modern medicine does not stand still, these ailments can be fought. The most important thing is not to delay and contact qualified specialist. “Lerkamen”, reviews of which will be presented by cardiologists at the end of the article, went on sale not so long ago, but has already managed to win the trust of not only consumers, but also doctors as one of the best medicines for lowering high blood pressure.

  • peripheral edema;
  • skin rashes;
  • pain in muscle tissue;
  • "Lercanidipine hydrochloride";
  • "Zanidip Recordati".
  • "Amlodipine."
  • "Zanifed."
  • "Agen."
  • "Sakur."
  • "Cardilopin".
  • "Foridon" and others.

(Guest) Denis 21.07.2016 11:30

(Guest) E. Guglin 21.07.2016 12:44

You're right. 120 mg (!) is an obvious technical error (misprint). Such doses do not exist.

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One of the most commonly prescribed medications for essential hypertension is Lerkamen tablets, instructions for use, at what pressure and other nuances of which are described in detail in this article.

Before you start taking the drug, it is important to know not only the frequency of use and dose, but also the interaction with other drugs and side effects.

As a rule, the doctor does not have the opportunity to describe all this to the patient during the appointment, which is why we provide detailed instructions.

Lerkamen, produced in the form of yellow tablets, is a calcium channel blocker; its main effect is aimed directly at blood vessels. The tablets are biconvex, with a score in the middle on one side, allowing them to be easily divided in half if necessary. They are packed 7 pieces per film shell, which is placed in a cardboard box.

Lerkamen tablets

Main active substance Lerkamena, conditioning positive influence drug on blood vessels is lercanidipine hydrochloride, which each tablet contains 10 mg. The composition also includes lactose monohydrate, microcrystalline cellulose, sodium carboxymethyl starch, magnesium stearate and povidone K30.

The yellow shell contains the following excipients and compounds: macrogol 6000, hypromellose, talc, yellow iron oxide dye, titanium dioxide. In the pharmacy chain you can also find tablets with an increased dosage of the active substance; they contain 20 mg of lercanidipine hydrochloride.

Lerkamen is prescribed to patients suffering from essential hypertension of I and II degrees of severity.

Lercanidipine hydrochloride has a relaxing effect on cells smooth muscle of all vessels, as a result of which peripheral resistance is significantly reduced.

You can find a lot about the drug Lerkamen positive feedback both from doctors and patients. The antihypertensive effect of the drug is prolonged, on average 24 hours.

The instructions for use accompanying the medicine Lerkamen 5, 10 and 20 mg emphasize that when taking it, weakness, dizziness, and increased drowsiness sometimes occur, so you should avoid driving or performing work that requires increased concentration.

According to the instructions, Lerkamen should not be taken if the patient has the following problems and diseases:

  • unstable angina;
  • heart failure;
  • severe obstruction of the vessels through which blood flows from the left ventricle of the heart;
  • severe liver failure;
  • myocardial infarction suffered less than a month ago;
  • renal failure with CC less than 30 ml/min.

In addition, the drug should strictly not be used by persons under 18 years of age, pregnant, lactating women, people taking cyclosprorines, Ketoconazole, Ritonavir, Erythromycin, Itraconazole, Troleandomycin, and patients with lactose deficiency, lactase intolerance or high sensitivity to dihydropyridine derivatives .

Also, doctors do not recommend drinking Lerkamen to women of childbearing age who are planning a pregnancy or do not use reliable contraception. Studies were conducted on rats, which showed that the active substance has a teratogenic effect.

There is a list of conditions in which the drug is taken with caution:

  • old age;
  • weakness sinus node without the use of a pacemaker;
  • left ventricular dysfunction;
  • mild, moderate severity of renal disease, liver failure;

Lerkamen is taken once a day, better in the morning, and you need to make sure that the next meal is at least 15 minutes later.

There is no need to chew the tablet, just swallow it and drink it with the required amount of water.

It must be remembered that the therapeutic effect is not observed immediately, but only 2 weeks after the start of the course, so you should not increase the dose prematurely, because in this case the risk of all sorts of complications increases. side effects.

Only after 14 days, if there is no visible effect, you can consult a doctor about changing the dosage of Lerkmen. This is not recommended for older people.

Also, only in critical cases, the dose of the medicine can be increased for patients with kidney or liver failure or other health problems for which, according to the instructions, caution should be exercised.

In case of overdose, peripheral vasodilation occurs with a significant decrease in blood pressure and reflex tachycardia.

In this case, it is necessary to promptly relieve the symptoms, especially if loss of consciousness is observed: it is necessary to immediately administer intravenous Atropine, and then carry out cardiovascular therapy.

Lerkamen should not be consumed simultaneously with grapefruit juice.

When taking Lerkamen, certain side effects may occur with varying frequencies.

Rarely (that is, in a maximum of one patient out of a thousand), drowsiness, angina pectoris, pain localized behind the sternum, nausea, vomiting, dyspepsia, diarrhea, abdominal pain, skin rash, myalgia, polyuria, increased reactions from the side may occur. immune system, asthenia, fatigue.

Infrequently (that is, in one patient out of 100-1000) may occur headache, there are sensations of increased heartbeat, dizziness, tachycardia, a sharp rush of blood in the skin of the face, severe peripheral edema.

Very rarely, that is, one in 10,000 may experience fainting, increased attacks of angina, and finally, in isolated cases, a sharp decrease in blood pressure, a noticeable increase in the frequency of urination, gum hyperplasia, severe pain in the chest and myocardial infarction.

If side effects occur, you should discuss with your doctor the possibility of further taking Lerkamen.

There is enough medical research on the possibility of interaction of Lerkamen with a number of medicines. The drug can be used simultaneously with ACE inhibitors, various diuretics, and beta-blockers.

Metoprolol tablets

IN the latter case The bioavailability of lercanidipine is partially reduced; an increase in the dose of the drug may be required to obtain a therapeutic effect. This is especially true when taken simultaneously with Metoprolol. Midazolam, on the contrary, increases bioavailability by approximately 40%, especially in elderly patients, this should also be taken into account when conducting therapy.

If the patient takes inhibitors, inducers of the CYP3A4 isoenzyme (these are Ketoconazole, Ritonavir, Itraconazole, Erythromycin, Troleandomycin), the metabolism and process of elimination of lercanidipine changes, so it is better to avoid taking these drugs together.

Caution is advised when using lercanidipine and the following drugs:

  • Cyclosporine;
  • Terfenadine;
  • Astemizole;
  • Amiodarone, Quinidine and other class III antiarrhythmic drugs;
  • Phenytoin, Carbamazeline and other anticonvulsants that are CYP3A4 inducers;
  • Rifampicin.

If your doctor still allows you to use these drugs at the same time, you need to regularly monitor your blood pressure. Lercanidipine does not have a significant effect on the pharmacokinetics of Warfarin and Fluoxetine.

It is undesirable to drink alcohol while taking Lerkamen, since ethanol potentiates the effect of the active substance.

All existing groups of drugs for high blood pressure in the medical classification:

Lerkamen, sold strictly by prescription, is a well-tolerated drug with a prolonged antihypertensive effect that has proven its effectiveness and is therefore often used in therapy.

(Guest) Denis 21.07.2016 11:30

(Guest) E. Guglin 21.07.2016 12:44

You're right. 120 mg (!) is an obvious technical error (misprint). Such doses do not exist.

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Today, quite a lot of people suffer from various heart diseases. Thanks to the fact that modern medicine does not stand still, these diseases can be combated. The most important thing is not to delay and contact a qualified specialist in a timely manner. “Lerkamen”, reviews of which will be presented by cardiologists at the end of the article, went on sale not so long ago, but has already managed to win the trust of not only consumers, but also doctors as one of the best medicines for lowering high blood pressure.

The drug is used to treat various diseases cardiovascular system and has long-term action. One tablet lasts for 24 hours, so it is enough to take the medicine once a day. One of the key advantages of the drug is that it does not affect blood glucose and cholesterol levels. Let's figure out whether this drug is really effective and whether it is better than its analogues.

"Lerkamen", the composition of which can be read in the instructions, is highly effective compared to other drugs in this group. Main active ingredient is lercanidipine hydrochloride, which belongs to the group of Ca2 ion antagonists. They interfere with the absorption of calcium into muscle tissue, resulting in blood vessels expand and blood flow improves significantly, and pressure gradually normalizes.

Today, Lerkamen is one of the most effective and fast-acting drugs compared to other drugs in this group. Thanks to this, it can be used for the prevention and treatment of many heart diseases and circulatory system among patients of any age category.

“Lerkamen”, reviews from cardiologists about the drug confirm its high effectiveness, it is available only in tablet form, dosage active substance which may contain 10 or 20 milligrams.

More and more cardiologists are prescribing Lerkamen to their patients.

Indications for use in this drug the following:

  • arterial hypertension, which is at the initial and progressive stages;
  • essential hypertension of the first and second stages.

The drug shows excellent results because, in addition to high efficiency and long-lasting, it practically does not cause any side effects, regardless of the duration of treatment. To increase the effectiveness of therapy and speed up the patient’s recovery, cardiologists can prescribe Lerkamen together with other antihypertensive drugs.

“Lerkamen” (the instructions for the drug are included in the box of tablets) should be taken one pill once a day. It is recommended to do this in the morning 15 minutes before meals. The tablets should be swallowed whole, without chewing and with a moderate amount of liquid.

At the very beginning of therapy, the daily dose of the drug is 10 milligrams. Gradually the dosage is increased by 2 times. The duration of treatment is determined by the doctor individually depending on clinical picture patient and the effectiveness of therapy.

As shown medical practice, "Lerkamen", reviews from cardiologists do not contain negative information about the drug, it can cause deterioration of attention and a decrease in the ability of spatial orientation in patients, therefore, while taking the drug, it is recommended to refrain from driving, since people may sometimes experience dizziness, drowsiness and neuropsychic weakness. When drinking grapefruit juice, these manifestations will only intensify.

Ethanol neutralizes the effect of lercaledilin, therefore during treatment the consumption of any alcoholic beverages is strictly prohibited.

Despite large number positive reviews from experienced cardiologists about the drug “Lerkamen”, side effects may occur when taking medications. This:

  • peripheral edema;
  • nausea and vomiting, upset stomach, disruption of the normal functioning of the digestive system;
  • pathological growth of soft gum tissue;
  • dizziness, drowsiness and increased fatigue;
  • skin rashes;
  • increased heart rate, chest pain, loss of consciousness, heart attack;
  • pain in muscle tissue;
  • frequent urge to urinate.

If you are taking Lerkamen (the instructions for use should be mandatory be studied) and you have any side effects, it is recommended to interrupt the course of therapy and immediately contact an experienced cardiologist to undergo an examination and make the necessary adjustments to the treatment program.

If you take the drug in accordance with your doctor's recommendations, the possibility of an overdose is completely excluded. If you have exceeded your dose and taken more medication daily norm, then an overdose may occur increased heart rate and a significant decrease in blood pressure. If the overdose was very strong, the patient may experience bradycardia and loss of consciousness. In case of overdose, you should immediately go to hospital.

Not all patients who have been diagnosed with any diseases of the vascular system can take Lerkamen.

The contraindications for this drug are as follows:

  • individual intolerance to any of the components included in the drug;
  • lactose intolerance and galactosemia;
  • heart failure, vascular obstruction, coronary heart disease, aortic stenosis, as well as patients who have had a heart attack;
  • carrying a child or breastfeeding.

In addition to all of the above, taking this medication is prohibited for persons under 18 years of age. Also, doctors do not recommend taking Lerkamen to people suffering from sick sinus syndrome.

"Lerkamen", reviews of cardiologists about which note that side effects when taking the drug are very rare, can react with quite a large number medications, which is why it is often combined to increase the effectiveness of therapy.

As a rule, it is combined with the following medications:

  1. In some cases, the drug is prescribed together with diuretics and angiotensin-converting enzyme inhibitors.
  2. In the treatment of some diseases, Lerkamen is prescribed together with cardiac glycosides, but in this case, treatment is carried out under the strict supervision of a cardiologist.
  3. Good compatibility of the drug is observed together with Cimetidine. In this case, no significant changes in the blood plasma are observed.
  4. It is necessary to be extremely careful when taking the drug simultaneously with inhibitors of the CYP3A4 group, since in this case the effectiveness of the drug may significantly decrease.
  5. While taking Lerkamen, it is recommended to avoid drinking grapefruit juice and any alcoholic beverages, as they also reduce the effect of the medicine on the body.

It is worth noting that 5 mg of Lerkamen is the minimum dosage of the drug; it is not recommended to combine it with any other medications on your own, as this can cause various negative manifestations that can pose a threat to human health and life.

Similar medications with identical composition are:

  • "Lercanidipine hydrochloride";
  • "Zanidip Recordati".

In addition, there are several products on sale that have different compositions, but have a similar effect.

Among such funds are:

  • "Amlodipine."
  • "Zanifed."
  • "Agen."
  • "Sakur."
  • "Cardilopin".
  • "Foridon" and others.

It is important to understand here that in no case should you replace “Lerkamen” with any drug without the doctor’s permission, since even though they have a similar composition and have similar action, however, the effectiveness of treatment can be completely different. Many drugs that are used to treat blood pressure-related ailments are not able to combat pathological diseases, but will have only a short-term effect. Therefore, if you have been prescribed Lerkamen tablets, analogues may simply be useless. In addition, self-medication can be very dangerous, so you should not take unnecessary risks.

Every person who has been diagnosed with any disease of the vascular system is interested in the question of how much Lerkamen costs. You can buy this drug in almost every pharmacy, and its average cost is 390 rubles, which is not much in these days. Therefore, given the high effectiveness of the drug, replace it with similar medications there's absolutely no point.

The vast majority of cardiologists who already have experience working with this drug note its high effectiveness. In addition, the big advantage of “Lerkamen” is that it is perfectly combined with many other means, which allows you to create the most effective program therapy and fight many diseases of the cardiovascular system.

Many doctors prescribe Lerkamen to their patients also because it is not excreted from the body along with urine and does not create a large load on the liver and kidneys, so it can be safely prescribed to patients suffering from renal or hepatic failure.

“Lerkamen” has earned great recognition not only among cardiologists, but also among patients themselves. Most people choose this drug because of its low cost, high efficiency and long-lasting action. Most people find that it is enough to take one tablet a day, and wellness will be stored for 24 hours. As for side effects, they are an isolated case and occur extremely rarely. The vast majority of people do not experience any negative manifestations even with long-term use of Lerkamen. Not all drugs in this group on the market today can boast of this.

If you are looking good medicine from high blood pressure affordable price, then “Lerkamen” will be an ideal choice. But we should not forget that if you have any health problems, you must first be examined by a specialist, and only then start taking medications. Always take care of your health, because it cannot be bought for any money.

Lerkamen is a drug called lercanidipine. Production - Germany. Member of the group cardiovascular drugs, is a calcium channel blocker. Available in cardboard packs, the tablets are film-coated.

The main purpose of the drug is to reduce blood pressure. Lerkamen also has a positive effect on the body in other diseases of the cardiovascular system.

The main active ingredient of the drug is lercanidipine. Lerkamen is mainly aimed at the vascular network; it has the highest selectivity index. Because of this, the negative effects on the heart are reduced.

Lercandipine is classified as a long-acting drug, because its effect can last up to 24 hours.

Lerkamen mainly penetrates cell membranes and not blood plasma. It has a high degree of lipophilicity, which allows it to penetrate into the membrane cellular component at a high speed and be released at a slow speed. The medicine is excreted through the kidneys.

The medicine also protects the organs. This consists in the fact that the hypertrophy of the heart muscle becomes smaller and slows down. The medicine also has an antiplatelet effect, that is, it does not allow high activity coagulation system. The drug prevents atherosclerotic changes in vascular cells and has a positive effect on fat metabolism.

The medicine is taken orally. The tablets should not be divided into pieces or crushed. Lerkamen is taken on an empty stomach and washed down with plenty of water. The treatment period and dosage are prescribed only by a specialist, taking into account individual characteristics sick.

Patients in the older age category are prescribed a dosage of 10 mg per day

If the hypotensive effect is weak, an increase in dosage is required after 14 days. The maximum will be 20 mg. Further increases will not produce greater effect, but the risk of harmful effects will increase.

If blood pressure control is insufficient when taking Lerkamen 20 mg per day, antihypertensive medications are prescribed in addition. For patients over 65 years of age and with kidney or liver pathologies, the dosage is increased very carefully. In cases of severe liver pathologies, it is sometimes necessary to adjust the dosage of lercanidipine.

One tablet “Lerkamen 10” contains:

  • Lercanidipine – 10 mg;

One tablet “Lerkamen 20” contains:

  • Lercanidipine – 20 mg;
  • Excipients and lactose monohydrate.

Lerkamen has a number of contraindications:

  • Individual intolerance to the components of the drug;
  • Lactose deficiency, galactosemia or glucose-galactose malabsorption;
  • Age less than 18 years;
  • Breastfeeding;
  • Pregnancy;
  • Heart diseases;
  • Kidney or liver failure in a very severe form.

The following manifestations occur:

  • Increased heart rate;
  • Decreased pressure;
  • Weakness;
  • Angina;
  • Flushes of blood to the face;
  • Asthenia;
  • Peripheral edema;
  • Dizziness;
  • Headaches;
  • Diarrhea;
  • Vomit;
  • Increased activity of liver enzymes;
  • Pain in the epigastrium;
  • Nausea;
  • Dyspepsia;
  • Heart attack;
  • Gingival hyperplasia;
  • Rashes on the skin;
  • Feeling sleep deprived;
  • Myalgia;
  • Polyuria.

The listed side effects are very rare, but if you suspect intolerance to the drug, you should immediately consult a doctor.


Overdose has not yet been observed. Experts believe that blood pressure may drop and a violation will occur heart work. Therapy in this case is prescribed depending on the symptoms.

The approximate cost in capital pharmacies of the drug “Lerkamen 10” is 370 rubles, “Lerkamen 20” - 614 rubles.

Lerkamen can be used together with some other medications. Can be carried out combination therapy with beta-blockers, diuretics and ACE inhibitors. If the drug is used with cardiac glycosides, a study for digoxin intoxication should be performed.

When using Cimetidine, no significant changes are observed in the presence of Lercanidipine in the blood plasma. With a large dosage of Cimetidine, the bioavailability and hypotensive effect of Lercanidipine sometimes increases.

Particular care should be taken when using Lerkamen with ketoconazole, erythromycin and itraconazole. When combined with rifampicin and antidepressants, the hypotensive effect is sometimes reduced. Also, its decrease can be observed when products with grapefruit are added to the diet. Ethanol sometimes potentiates the effect of the drug.

The drug has the following analogues:

  • Amlorus is based on amlodipine. The maximum dosage is 10 mg per day. The cost starts from 15 rubles.
  • Vero-Amlodipine is produced in Russia. Prescribed for diseases of the heart and blood vessels. The drug begins to act after two hours, the effect continues throughout the day. The cost starts from 35 rubles.
  • Amlodipine comes in 3 dosages. It is also prescribed for diseases of the heart and blood vessels. The cost starts from 50 rubles.
  • Amlodifarm is available in tablets. It dilates blood vessels and reduces the load on the heart. The drug is prohibited for use in childhood, during pregnancy and lactose intolerance. Price - from 50 rubles.
  • Manufacturer of Cordafen - Poland. The active ingredient is nifedipine. It is taken for hypertension and diseases of the cardiac system. It should be used as prescribed by a doctor, three to four times a day. Price – from 61 rub.
  • Amlotop is a common replacement for Lerkamen. Based on amlodipine. Available in the form of tablets of 10 and 5 mg. It can be taken alone or together with other medications. Price – from 97 rubles.
  • Kalchek is available in 5 mg tablets. Produced in India, cost from 168 rubles.
  • Amlovas is produced in India, the cost is from 310 rubles. Discharged when cardiovascular diseases. During pregnancy, it should be used with extreme caution. Contraindication – individual intolerance.

The drug should not be stored for more than three years. Leave in its original packaging. Storage temperature – no more than 25 degrees.

Reviews about taking Lerkamen often show a misunderstanding of the use of this medicine. Many people, especially older people, do not know that the medicine does not act immediately, and the peak is observed after 12 hours. Some create their own dosage regimen, divide the tablets into parts, which should not be done. It is important to follow the instructions.

With a correct understanding of the action of the medicine, the reviews are positive and its tolerability is good. Before use, it is important to consult with your doctor; self-medication with this drug can lead to dangerous consequences.

Olga, doctor, 37 years old, Moscow“I prescribe Lerkamen quite often along with other medications. It is well tolerated and gently reduces blood pressure. You only need to use it once a day, which is very convenient.”

Mikhail, patient, 48 years old, Omsk“Lerkamen was prescribed to me recently, I’ve been taking it for about 3 months. It helped lower my blood pressure. The doctor prescribed it as a replacement for another medicine that was causing my legs to swell. The cost is quite high, but you don’t mind spending money on your health.”

In this article you can read the instructions for use of the drug Lerkamen. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Lerkamen in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Lerkamen in the presence of existing structural analogues. Use for the treatment of essential hypertension and blood pressure reduction in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Lerkamen- a selective blocker of slow calcium channels with a predominant effect on blood vessels, a dihydropyridine derivative. Inhibits the transmembrane flow of calcium ions into vascular smooth muscle cells. The mechanism of the antihypertensive effect of lercanidipine (the active ingredient of the drug Lerkamen) is due to a direct relaxing effect on smooth muscle cells vessels, resulting in a decrease in peripheral vascular resistance.

Despite its relatively short plasma half-life, lercanidipine has a prolonged antihypertensive effect due to its high membrane distribution coefficient. Due to its high vascular selectivity, it does not have a negative inotropic effect. Acute arterial hypotension with reflex tachycardia occurs rarely due to the gradual development of vasodilation when taking lercanidipine.

Duration therapeutic action— 24 hours

Compound

Lercanidipine hydrochloride + excipients.

Pharmacokinetics

Lercanidipine is completely absorbed after oral administration. Due to the “first pass” effect through the liver, the absolute bioavailability of lercanidipine when taken orally after meals is approximately 10%; when taken on an empty stomach, the bioavailability value decreases by 1/3. When taking lercanidipine no later than 2 hours after administration fatty foods its bioavailability increases 4 times, so Lerkamen should not be taken after meals. When lercanidipine is administered orally, its plasma concentration is not directly proportional to the dose taken (nonlinear kinetics). Saturation of presystemic metabolism occurs gradually. Thus, bioavailability increases with increasing dose. Distribution from blood plasma to tissues and organs occurs quickly and extensively. Plasma protein binding exceeds 98%. About 50% of the dose taken is excreted by the kidneys (about 50% is excreted by the intestines). Elimination occurs mainly through biotransformation. There is no accumulation of lercanidipine upon repeated oral administration.

Indications

  • essential hypertension of 1-2 severity.

Release forms

Film-coated tablets 10 mg and 20 mg.

Instructions for use and dosage

The drug is taken orally, at least 15 minutes before meals, preferably in the morning, without chewing, with a drink. sufficient quantity water.

Prescribe 10 mg 1 time per day. Depending on the patient’s individual tolerance of the drug, the dose can be increased to 20 mg.

The therapeutic dose is selected gradually, because The maximum antihypertensive effect develops approximately 2 weeks after starting the drug. It is unlikely that the effectiveness of the drug will increase with increasing doses above 20 mg per day, and at the same time the risk of side effects increases.

Pharmacokinetic profile and data clinical trials show that in elderly patients no dose adjustment of Lerkamen is required. However, caution should be exercised when initial stage treatment with Lerkamen in this group of patients.

When using the drug Lerkamen in patients with mild and mild renal and hepatic insufficiency medium degree severity, caution should be exercised.

At renal failure(creatinine clearance more than 30 ml/min) or mild or moderate liver failure, the initial dose is 10 mg, then increase the dose with caution to 20 mg per day. The antihypertensive effect may be enhanced in patients with mild or moderate hepatic impairment and dose adjustment (reduction) may be required.

In case of renal failure (creatinine clearance less than 30 ml/min) and severe liver failure, the use of Lerkamen is contraindicated.

Side effect

  • headache;
  • dizziness;
  • drowsiness;
  • feeling of heartbeat;
  • tachycardia;
  • “flushes” of blood to the skin of the face;
  • angina pectoris;
  • chest pain;
  • fainting;
  • nausea, vomiting;
  • dyspepsia;
  • diarrhea;
  • epigastric pain;
  • skin rash;
  • myalgia;
  • polyuria;
  • hypersensitivity reactions;
  • peripheral edema;
  • asthenia;
  • increased fatigue;
  • myocardial infarction (rare);
  • pollakiuria (increased frequency of urination);
  • chest pain.

Contraindications

  • untreated heart failure;
  • unstable angina;
  • obstruction of blood vessels originating from the left ventricle of the heart;
  • period within 1 month after myocardial infarction;
  • severe liver failure;
  • severe renal failure (creatinine clearance less than 30 ml/min);
  • simultaneous use with CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin, ritonavir, troleandomycin);
  • simultaneous use with cyclosporine;
  • simultaneous use with grapefruit juice;
  • lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome;
  • pregnancy;
  • lactation period ( breastfeeding);
  • use in women of childbearing age who do not use reliable methods of contraception;
  • children's and adolescence up to 18 years of age (efficacy and safety have not been studied);
  • hypersensitivity to the components of the drug;
  • hypersensitivity to other dihydropyridine derivatives.

Use during pregnancy and breastfeeding

The use of the drug Lerkamen during pregnancy and breastfeeding, as well as in women of childbearing age in the absence of reliable contraception contraindicated.

Preclinical studies did not reveal a teratogenic effect of lercanidipine in rats and rabbits, reproductive function rats was unchanged.

Due to the lack clinical experience use of lercanidipine during pregnancy and breastfeeding and since other dihydropyridine derivatives are known to have a teratogenic effect in animals, lercanidipine is not recommended for use during pregnancy or in women of childbearing potential who do not use reliable methods of contraception.

Due to the high lipophilicity of lercanidipine, it can be assumed that it penetrates into breast milk, therefore the drug is not recommended for use during breastfeeding

Use in elderly patients

Use with caution in elderly patients.

Use in children

The drug is contraindicated in children and adolescents under 18 years of age

Special instructions

It should be used with caution in renal (creatinine clearance more than 30 ml/min) and/or liver failure of mild to moderate severity, in elderly patients, with CVS (without a pacemaker), coronary artery disease, and left ventricular dysfunction.

Impact on the ability to drive vehicles and operate machinery

Since dizziness, asthenia, fatigue and, in rare cases, drowsiness may occur during therapy with Lerkamen, patients should be especially careful when using the drug to drive vehicles and engage in other potentially dangerous activities. dangerous species activities requiring high speed psychomotor reactions.

Drug interactions

Lerkamen can be used simultaneously with beta-blockers, diuretics, and ACE inhibitors.

When used simultaneously with metoprolol, the bioavailability of lercanidipine is reduced by 50%. This effect may also occur when used concomitantly with other beta-blockers, so dose adjustment of lercanidipine may be required to achieve a therapeutic effect with this combination.

Lercanidipine is metabolized with the participation of the CYP3A4 isoenzyme, therefore inhibitors and inducers of this isoenzyme, when used simultaneously, can affect the metabolism and excretion of lercanidipine. Concomitant use of lercanidipine with CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, erythromycin, troleandomycin) is not recommended.

Caution should be exercised when lercanidipine is used concomitantly with other CYP3A4 substrates (terfenadine, astemizole, class 3 antiarrhythmic drugs, e.g. amiodarone, quinidine).

When lercanidipine 20 mg is coadministered with midazolam, the bioavailability of lercanidipine in elderly patients may increase by approximately 40%.

Lercanidipine should be used with caution concomitantly with CYP3A4 inducers, e.g. anticonvulsants(phenytoin, carbamazepine) and rifampicin, since the antihypertensive effect of the drug may be reduced. Regular blood pressure monitoring is necessary.

Patients receiving digoxin and lercanidipine concomitantly should be monitored for signs of digoxin toxicity.

The simultaneous use of lercanidipine with cimetidine (up to 800 mg) does not cause significant changes in the concentration of lercanidipine in the blood plasma. At high doses cimetidine may increase the bioavailability and antihypertensive effect of lercanidipine.

With simultaneous use of Lerkamen (20 mg) and simvastatin (40 mg), the AUC value for simvastatin increased by 56%, and the same value for its active metabolite - beta-hydroxy acid - by 28%. When taking medications in different times days (lercanidipine - in the morning, simvastatin - in the evening) you can avoid unwanted interactions.

With simultaneous use of lercanidipine at a dose of 20 mg and warfarin in healthy volunteers, no changes in the pharmacokinetics of warfarin were observed.

Concomitant use with fluoxetine (an inhibitor of CYP2D6 and CYP3A4) in elderly patients did not have a clinical effect significant changes pharmacokinetics of lercanidipine.

The antihypertensive effect may be enhanced by simultaneous administration of grapefruit juice and lercanidipine.

Ethanol (alcohol) may potentiate the antihypertensive effect of lercanidipine.

Analogues of the drug Lerkamen

Structural analogues of the active substance:

  • Zanidip Recordati;
  • Lerkamen 10;
  • Lerkamen 20;
  • Lercanidipine hydrochloride.

Analogs by pharmacological group (calcium channel blockers):

  • Agent;
  • Adalat;
  • Acridipine;
  • Altiazem RR;
  • Amlodipine;
  • Amlotop;
  • Verapamil;
  • Vertizin;
  • Diltiazem;
  • Isoptin;
  • Kalchek;
  • Cardilopin;
  • Cordaflex;
  • Cordipin;
  • Corinfar;
  • Corinfar retard;
  • Lekoptin;
  • Lomir;
  • Nicardia;
  • Nimotop;
  • Nifedicap;
  • Nifedipine;
  • Nifecard;
  • Nifelate;
  • Normodipine;
  • Prestance;
  • Procorum;
  • Stamlo;
  • Tenochek;
  • Felodipine;
  • Finoptin;
  • Cinnarizine;
  • Equacard;
  • Equator;
  • Exforge;
  • Enanorm.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Tablet splitting is traditionally used in pharmaceutical practice to select the required dose of a drug if a dosage form with the required dose is not available. It is also used to reduce the cost of therapy. Although this practice does provide some economic benefits, there are concerns about dosing accuracy, compliance, and clinical outcome of therapy.

Sometimes splitting tablets is necessary. This is a recognized method of obtaining the required dose if it is not available in a finished dosage form, which may occur in a number of circumstances:

  • prescribing the drug to children or elderly people in the absence of specially developed dosage forms with a low concentration of the drug,
  • dose selection or reduction,
  • the need for frequent dose adjustments.

Sometimes this practice is caused by economic reasons. Existing pricing policy is that many drugs have similar or similar prices per dosage unit. Thus, the cost of a course of treatment can be reduced by almost 50% by separating tablets with a concentration twice as high as required.

Opponents of this procedure cite a number of arguments, the main one of which is the inability to ensure accurate dosing of the drug. Many factors influence the correct division of the tablet, including its size, shape, characteristics, the division technique and equipment used for this, and the ability and experience of the person performing the operation. Even in tablets divided by a pharmacist, the dose may differ from the ideal dose. One study showed that 5.7% of tablet halves divided by pharmacists were different from ideal weight more than 15% and only 7 (31.8%) of the 22 fragments met USP standards. Not surprisingly, even greater differences are observed when patients split the pills themselves. However, how important is this fact? A number of studies have been undertaken to compare clinical effectiveness therapy in patients receiving the same dose of drugs in the form of whole and split tablets, during which no differences were noted in the effectiveness of both treatment regimens.

Also not detected negative influence practices of dividing tablets for compliance. A survey of 1617 patients was conducted, all of them did not report any problems in connection with the division of tablets. Moreover, only 4% of respondents said that having to split pills reduced their willingness to follow the course of therapy. A survey of patients in another study showed they were willing to follow the procedure if it would reduce the cost of treatment, despite some inconvenience. On the other hand, 97% of the volunteers who took part in the pill splitting study preferred to use lower dose official drugs medicinal substance, and 77% were willing to pay for it.

Separating tablets by pharmacists can improve compliance, but this procedure has certain material costs. It has been shown that it takes an average of 5 seconds to separate 1 tablet. Taking into account the hourly cost of a pharmacist (according to a Canadian study), the cost of dividing 1 tablet is about 10 Canadian cents. In the case of patients dividing tablets independently, receiving advance instructions can reduce the frequency of errors during the procedure, but the pharmacist spends about 1 minute of working time, which is the equivalent of 1 Canadian dollar, explaining to each patient. Tablet splitters cost $6-$10 CAD.

Moreover, although tablet splitting potentially promises significant economic benefits, for only a small number of currently commonly used drugs, splitting is not only feasible but also economically beneficial. Such preparations must have the following characteristics:

  • availability in successively doubling doses (for example, tablets containing 10 and 20 mg of active substance),
  • suitable shape and size (the most suitable are large, film-coated, elongated tablets with wide edges),
  • sufficiently high cost to provide economic benefits,
  • lack of specific features associated with the release of the drug dose,
  • long course of therapy.

Of the 200 most commonly used drugs in Canada (1998 data), only 14 met the above criteria. A similar study conducted in the USA found 11 similar drugs. These include ACE inhibitors(enalapril, lisinopril), statins (atorvastine, lovastine, pravastin), antidepressants (cialopram, paroxetine, nefazadone), antipsychotics (olanzapine, risperidone) and a number of other drugs (warfarin, clonazepam, doxazosin).

As practice shows, tablet splitting is undertaken more often for clinical than for economic reasons. The economic benefit of separating the 11 most commonly treated drugs in the United States is less than 2%.

Summarizing the above, we can conclude that the introduction of tablet separation into widespread practice as a means of reducing the cost of therapy is not economically justified and can create a number of problems, such as incorrect use of drugs, incorrect dosing of drugs associated with errors in tablet separation, and reduced compliance. This practice should be used only in certain clinical situations in order to select the required dose of the drug.


The usefulness of splitting tablets as a cost-saving strategy is limited.


tablet separation, pharmacoeconomics, economic benefit, drug dose, compliance

    In my opinion, almost everything.

    For example, my child was prescribed the drug, but not in the dosage of a whole tablet, but only half, since he is small and one tablet is too much for him.

    What about half and half, sometimes I had to divide the tablet into four parts and nothing.

    Of course, this is not very convenient, but usually I cut the tablet with a regular knife and it turns out quite evenly.

    You can safely divide tablets that are not coated. But covered ones, even with a characteristic stripe, should not be divided. The shell can not only hide bad taste or the smell of a medicine, but also not to allow the substance to break down in the stomach, if its place of work is, say, in the intestines.

    Only those tablets that have a dividing line can be divided into 2 parts, this is precisely what it is intended for, and those tablets that do not have this line are undesirable to divide, because when breaking, the structure is disrupted and it will crumble unevenly and the weight parts will be still different.

    There is such a science - pharmaceutical economics. It has been calculated that if you buy drugs in larger dosages and divide them into 2-3 doses, it will be more profitable for the buyer - the patient.

    Notch, dividing line, dividing line, depression on the surface of the tablet, and exists for this purpose.

    There is one transverse - longitudinal risk on the tablet, yes cruciform. Some tablets are engraved with the name of the drug or dose. I respect manufacturers who care about the patient. But, we must remember that some drugs consist of microgranules If you divide them, some of the granules will be destroyed and the dose will be inaccurate.

    There's more in the tablet chamfer- this is its processed edge.

    It should be remembered that the drug Capsule form cannot be divided, pour out the contents of the granule and drink without the shell. Such gelatin shells are specially created to ensure that the drug is absorbed in a specific part of the intestine.

    It is generally not advisable to divide tablets, even those that are divided in half. It happens that a doctor prescribes 25 mg of a drug that is released in a minimum of 50 mg. We have to divide, because there is a dividing strip. So the oblique parts come out. One part has to be thrown away, it is small, and the other has to be cut.

    According to the rules, it is of course not advisable to divide the tablets into two parts, but if there is such a need, then nothing bad will happen from this. You also need to know that the tablets are formulated in such a way that one part may contain more active ingredient than another part.

    If the tablets have a dividing strip, then you can safely divide them.

    Capsules cannot be divided at all, since they cannot be divided exactly. It is also necessary to remember that almost all capsules must dissolve in the stomach, they are designed for this.

    Tablets that have a dividing strip in the middle can generally be divided in half. Another thing is that if the tablet is coated, then when broken, the bitter part of the tablet may open - and it will be unpleasant to swallow.

    Tablets in capsule form cannot be divided in half.. The capsule is specially designed to protect the active substance from absorption in the stomach until the capsule reaches the right place - for example, the intestines.

    Tablets (not coated capsules) can be divided if this division is part of the treatment regimen and is recommended by a specialist. This is possible even if there is no special strip on the tablet itself. Yes, sometimes the halves turn out to be very different, but since it’s necessary... We even divided rectal suppositories in half.

    You can’t just divide the pills yourself so that, for example, you can take half as much medicine as the doctor prescribed! For example, someone decided that he was no longer seriously ill and began to take an antibiotic in a dosage half as much as prescribed; as a result, the medicine does not work as it should, the disease does not completely go away, plus the surviving bacteria develop an addiction to the drug.

If the tablet is coated, then it is not allowed.

We need to share! If the prescribed dosage suggests half, then you need to take exactly half. I once divided an almost round tablet into 3 parts, because this was prescribed by the doctor. What can you do?

Can all tablets be divided into 2 parts?

Some tablets have marks on them, and some are smooth. Does this mean anything?

You can split the tablets in half if your doctor recommends it. The tablet must be divided strictly along a certain stripe, the dividing line. I once had to deal with such a case when it was necessary to split the tablet, but there was no split line. In this case, I very carefully tried to divide equally. Otherwise, almost all tablets have a line along which they need to be divided.

There is such a science - pharmaceutical economics. It has been calculated that if you buy drugs in larger dosages and divide the doses, it will be more profitable for the buyer - the patient.

A mark, a dividing strip, a dividing line, a recess on the surface of the tablet, exists for this purpose.

There is one transverse - longitudinal mark on the tablet, and there is a cruciform one. Some tablets are engraved with the name of the drug or dose. I respect manufacturers who care about the patient. But, we must remember that some drugs consist of microgranules; if they are divided, a certain amount of granules will be destroyed and the dose will be inaccurate.

The tablet also has a chamfer - this is its processed edge.

It should be remembered that the drug in capsule form cannot be divided by pouring out the contents of the granule and drinking without the shell. Such gelatin shells are specially created to ensure that the drug is absorbed in a specific part of the intestine.

According to the rules, it is of course not advisable to divide the tablets into two parts, but if there is such a need, then nothing bad will happen from this. You also need to know that the tablets are formulated in such a way that one part may contain more active ingredient than another part.

If the tablets have a dividing strip, then you can safely divide them.

Capsules cannot be divided at all, since they cannot be divided exactly. It is also necessary to remember that almost all capsules must dissolve in the stomach, they are designed for this.

In my opinion, almost everything.

For example, my child was prescribed the drug, but not in the dosage of a whole tablet, but only half, since he is small and one tablet is too much for him.

What about half and half, sometimes I had to divide the tablet into four parts and nothing.

Of course, this is not very convenient, but usually I cut the tablet with a regular knife and it turns out quite evenly.

Tablets that have a dividing strip in the middle can generally be divided in half. Another thing is that if the tablet is coated, then when broken, the bitter part of the tablet may open - and it will be unpleasant to swallow.

Tablets in capsule form cannot be divided in half. The capsule is specially designed to protect the active substance from absorption in the stomach until the capsule reaches the right place - for example, the intestines.

Only those tablets that have a dividing line can be divided into 2 parts, this is precisely what it is intended for, and those tablets that do not have this line are undesirable to divide, because when breaking, the structure is disrupted and it will crumble unevenly and the weight parts will be still different.

Tablets (not coated capsules) can be divided if this division is part of the treatment regimen and is recommended by a specialist. This is possible even if there is no special strip on the tablet itself. Yes, sometimes the halves turn out very different, but that’s the way it’s needed. We once even divided rectal suppositories in half.

You can’t just divide the pills yourself so that, for example, you can take half as much medicine as the doctor prescribed! For example, someone decided that he was no longer seriously ill and began to take an antibiotic in a dosage half as much as prescribed; as a result, the medicine does not work as it should, the disease does not completely go away, plus the surviving bacteria develop an addiction to the drug.

If the tablet has indentations for division, then such tablets can be taken in 1/2 or 1/4 portions.

The annotation for any tablets contains doses and methods of use - it all depends on the drug. There are tablets that cannot be split, as they are coated with a special coating. But this, again, will be written in the annotation.

It is generally not advisable to divide tablets, even those that are divided in half. It happens that a doctor prescribes 25 mg of a drug that is released in a minimum of 50 mg. We have to divide, because there is a dividing strip. So the oblique parts come out. One part has to be thrown away, it is small, and the other has to be cut.

You can safely divide tablets that are not coated. But covered ones, even with a characteristic stripe, should not be divided. The coating can not only hide the unpleasant taste or smell of the medicine, but also prevent the substance from breaking down in the stomach if its place of “work” is, say, in the intestines.

Atoris against cholesterol

The drug Atoris is a drug related to cholesterol-lowering drugs. As an active ingredient, the drug Atoris contains active ingredient Atorvastatin. Atoris is trade name drug, which is assigned to it by the manufacturer. Common name, or international generic name(INN) of drugs containing this component - Atorvastatin. Atoris tablets are produced in Slovenia by the company KRKA Novo Mesto. The tablets have several dosages - Atoris 10 mg, Atoris 20 mg, Atoris 30 mg, Atoris 40 mg, Atoris 60 mg, Atoris 80 mg. A wide range of dosages of the drug is created for ease of use of the drug.

The active ingredient of Atoris is Atorvastatin.

When can you split the tablet?

For example, if a person is prescribed Atoris 10 mg, tablets with an amount of active ingredient of 20 mg or 30 mg will be inconvenient to use. Those dosage forms whose design is provided for this purpose can be divided. So, is it possible to split an Atoris tablet? A divisible tablet must have a special score, which will allow the dosage form to be divided into equal parts. Atoris tablets, the instructions for which contain information about the structure of the dosage form, indicate that this drug has no risks. Therefore, the use of Atoris is possible only in the form of a whole tablet.

Why can't you split the tablet without risk? This is explained by the fact that the presence of marks on the dosage form is the manufacturer’s “guarantee” about the uniform distribution of the active substance in each part of the divided tablet.

If there is no risk, this means that the manufacturing technology of the medicinal product guarantees the presence a certain amount active ingredient only in the entire tablet.

Diet before starting statin treatment

Atoris belongs to the drugs – statins. The prescription of Atoris is indicated for lipid metabolism disorders and the ensuing consequences. Currently used for cholesterol various medications and biologically active additives. However, before prescribing statins or other drugs, you should try to normalize fat metabolism by following a special diet.

If cholesterol levels in the blood are high, a special diet is prescribed

Diet for high cholesterol should contain a minimum of fat, an average amount of carbohydrates and proteins, and a lot of fiber. The calorie content of food per day should not exceed calories.

  1. The consumption of animal fats should be strictly limited. It is allowed to use butter for seasoning porridge or vegetable puree. If you have high cholesterol, this product should not be eaten in its pure form. In addition, lard, bacon, jellied meat, smoked and dry-cured sausages, sausages, bacon, fatty sausages, canned meat, pork in any form, fatty fish, mayonnaise and sauces made from it are excluded from the diet.
  2. As a source of protein, cottage cheese dishes prepared without the use of cream and sour cream are used, as well as dishes prepared from lean varieties of meat - rabbit, chicken, veal, lean fish, seafood. Allowed for consumption chicken eggs, but no more than three pieces per week. Dairy products, in addition to cottage cheese, include kefir, low-fat milk, bifidoc, and acidobiphyllin.
  3. Dishes should be prepared by steaming, boiling or stewing. It is permissible to bake foods without the use of oils and fatty sauces. Frying and smoking as methods of preparing dishes during and after treatment should be completely avoided.
  4. The diet should contain a large amount of fiber, which is rich in fruits and vegetables. Vegetables can be used to prepare salads, stews, juices and other dishes. Fruits are best consumed in fresh. Fiber contained in vegetables and fruits “works” in the human intestines as an enterosorbent. It promotes excretion excess fat from the body.
  5. You should also avoid drinking alcohol and smoking. Sometimes you can drink dry red wine small quantities.

If you have hypercholesterolemia, you should stop smoking and alcohol

If therapeutic diet doesn't bring desired result, the prescription of statins is indicated. However, a person taking statins must still adhere to dietary rules.

Indications for use

So, what indications for use must a patient have in order to be prescribed a drug containing Atorvastatin?

  • increased cholesterol due to genetic factors, and not controlled by diet;
  • hypercholesterolemia of mixed origin;
  • increased triglycerides in the blood;
  • for atherosclerotic changes in blood vessels for prevention ischemic complications;
  • secondary prevention in people who have suffered ischemic complications;
  • increased risk of developing ischemic complications in the absence of clinical manifestations in patients over 60 years of age, smokers, high level C-reactive protein and others.

The use of Atoris in the above cases is usually long-term. How long should you take statins? The time course of treatment is selected individually in each case. Sometimes, statin therapy is combined with treatment with drugs from other pharmacological groups. For example, Atoris is often prescribed in combination with Cardiomagnyl. These drugs have good compatibility with each other and, in the absence of contraindications, are successfully used in the treatment of heart and vascular diseases.

Assignment Rules

Treatment with Atoris begins with the selection of an individual initial dosage. This takes into account baseline cholesterol at the start of treatment, the presence of restrictions on the use of statins, individual characteristics of the body. In most cases, treatment begins with the prescription of Atoris tablets containing 10 mg of the active substance. Instructions for use of the drug Atoris contain information about the rules for prescribing the drug, which describes the sequence for determining the individual dosage. Two to four weeks after starting treatment with Atoris, a control blood test for cholesterol is prescribed. In case of positive dynamics, treatment is continued using the same dose.

If cholesterol levels have not decreased during this time, the dosage is increased to 20 mg.

When is Atoris banned?

Instructions for use of the drug Atoris describe a number of diseases and physiological conditions when the use of the drug is prohibited or highly undesirable. The main contraindications to prescribing the drug are:

  • The childbearing period in women who, due to various reasons do not use reliable contraceptive methods.
  • Women planning to become pregnant soon.
  • The period of breastfeeding the baby.

There is no information about the excretion of atorvastatin into breast milk.

  • The period of bearing a child.
  • Liver diseases in the active phase.
  • An increase in liver parameters by more than three times of unknown origin.
  • Previous history of diseases of the muscular system.
  • Severe renal dysfunction.
  • Some metabolic diseases.
  • Other.

The ban on the use of the drug during pregnancy is due to the fact that it is unknown whether Atorvastatin has a toxic effect on the fetus or not. Therefore, to avoid pregnancy complications, you should not use the medicine during this period. And if pregnancy occurs during treatment with Atoris, statin treatment should be stopped immediately. In addition, there is no data on whether the drug taken by a nursing woman can pass into breast milk. Therefore, you cannot use statins when feeding your baby.

Medicines containing Atorvastatin and other statins can only be prescribed by a doctor! Independent use of these medications is strictly prohibited! Together with statins and special diet a specialist can recommend dietary supplements that help normalize lipid metabolism. Such additives include Atheroclefit Bio, Chitosan Evalar and other additives.

Since courses of treatment with statins are always long, if the dose is incorrectly selected or the dosage recommended by the doctor is exceeded, as well as due to the individual characteristics of the body, adverse reactions from various organs and systems may occur. The most serious complications of Atorvastatin therapy are allergic reactions and myopathic processes with the development of renal failure. Therefore, the patient should be warned about the need to discontinue the drug and consult a doctor if signs of allergies or pain in muscles and bones appear during statin treatment. The attending physician will decide to replace the drug and prescribe all the necessary procedures to eliminate the symptoms of treatment complications.

Drug analogues and cost

Medicine from the group of statins

The pharmaceutical market currently offers a large number of drugs belonging to the group of statins. As active ingredients, drugs may contain Atorvastatin, Simvastatin, Rosuvastatin and others. All products are presented in a wide range, including the original drug and a number of generic drugs. For example, original drug containing Atorvastain is Liprimar. Other drugs, such as Atoris, Atorvastatin-Alsi, Torvacard, Atorvastatin-SZ, Tulip and others are generics. The cost of drugs depends on the price of the registered manufacturer's price, the number of dosage forms in the consumer package and the dosage of the drug.

Society Not every tablet should be broken

Is it great wisdom to take medicine?! He put a pill in his mouth, washed it down with something that came to hand... But if you want this pill to really help you, then you should take it, following certain rules. It is about them that Elena Aleksandrovna Fomicheva, a clinical pharmacologist at Petrozavodsk Polyclinic No. 2, talks about them. Similar specialists have now been available in all clinics for several years. This position was introduced for a reason. There have been so many medications recently that it is sometimes difficult even for a doctor to understand them. What can we say about the patient?!

6 tablets at once is dangerous

We all know that in mathematics or grammar there are rules that need to be memorized - without any explanation. They are an axiom. The same applies to the rules for using medications. They must be remembered and followed unquestioningly. Because if you are not a doctor, then any explanations will only confuse you. If you don’t follow the rules for taking medications, you won’t be cured.

First a few numbers. Up to 25% of all patients in the world are hospitalized due to improper use of medications, and not due to illness. More than 20% of drug complications are due to drug interactions. The more medications you take at the same time, the more sensitive your body is to them. Taking three medications at once risks developing side effects in 20% of cases, and if you take 6 medications at once (without a doctor’s prescription), then the likelihood of developing side effects increases to 80%!

A short general instruction

For treatment to be effective, adhere to the following rules for taking medications.

It is best to take medications with clean boiled water, since many drugs are incompatible with a number of products, for example:

– milk and dairy products reduce the effectiveness of antibiotics taken to treat respiratory and sexually transmitted infections, as well as tetracycline;

– alcohol enhances (not in better side) the effect of sedatives and drugs containing paracetamol and lowering blood pressure (hypotensive). Alcohol can affect the absorption of almost all medications, however, this depends on the individual characteristics of the body;

– grapefruit juice may cause unpredictable drug side effects;

– tea and coffee often reduce the effect of medications;

– mineral water interferes with the absorption of certain drugs.

Do not chew the coated tablets; swallow the capsules whole, as such “external protection” of the drug promotes proper absorption of the active substance and protects the mucous membrane gastrointestinal tract from irritation.

Do not self-medicate. Remember that it is very undesirable to take more than three medications at the same time, even if these are vitamins and herbs.

Medicine and alcohol are incompatible

All alcoholic drinks interact with most drugs. This not only reduces the effectiveness of drug therapy, but also increases the likelihood of adverse side effects. Ethyl alcohol not only excites you and affects you emotionally, but also changes the behavior of the drug in the body.

The combination of antibiotics and alcohol significantly reduces the effectiveness of the former, so it is strictly not recommended. If a patient takes phenobarbital and abuses alcohol, he risks dying from respiratory arrest. Joint reception alcohol and antidepressants, sleeping pills, antiallergic drugs significantly enhances them sedative effect, which can have a sad effect on your well-being. The interaction of alcohol and nitroglycerin can lead to a sharp decrease in blood pressure, even to the point of fainting. Under the influence of alcohol, the hypoglycemic effect of insulin and other drugs for the treatment of diabetes is enhanced, and this threatens the development of diabetic coma. Drinking alcohol with diuretics and digoxin can cause changes in potassium balance and, as a result, heart rhythm disturbances.

This is about nicotine. It and other substances that make up cigarettes reduce the therapeutic effect of many drugs - psychotropic (amitriptyline, haloperidol, diazepam, phenobarbital), cardiovascular (metoprolol, nitrates), "pulmonary inhalers", oral contraceptives.

Don't drink tea with pills

Now we will try to say at least a little about the mechanism of interaction of drugs with our body, and in connection with this, about the peculiarities of taking certain drugs.

A leaflet indicating the time of administration is included in the medicine package, and the doctor must write in the prescription when and how to take this or that medicine. What do doctors base their prescriptions on?

One of the fundamental laws of pharmacology states that a drug begins to act only when it accumulates in sufficient concentration in the tissues of the diseased organ. This is called the "threshold phenomenon". If the concentration is below the threshold, the medicine will not have the desired effect. Required to obtain therapeutic effect the concentration of the drug in the blood, and therefore in the organ, is created when the optimal dose is introduced into the body.

The path of the medicine to its destination is complex, especially if it is taken orally. This method of drug administration has its advantages: the drug content in the blood is maintained at the maximum level for longer. What then is the difficulty? Yes, the fact is that drugs are not absorbed directly in the stomach. First, they must pass into the intestine, dissolve in its contents and not be destroyed by hydrochloric acid, enzymes, or food components.

If the tablet has a special coating, for example, thrombo-ACC, chewing or crushing it is not recommended: the coating protects the medicine from action hydrochloric acid stomach or gastric mucosa from the medicine.

It is better to take medications with a glass boiled water. Tea is not suitable. The tannin contained in it forms insoluble and, therefore, non-absorbable compounds with many substances. Tannin is especially active in binding papaverine, amidopyrine, cardiac glycosides, enzymes, and active ingredients in herbal infusions and decoctions.

When the drug is taken on an empty stomach, after a minute it enters the intestines and is absorbed into the blood completely or almost completely.

Don't eat soup with pills

What happens to the pill if it is swallowed with food? The tablet will not dissolve in food, and since gastric juice gradually dilutes the contents of the stomach, then the hydrochloric acid present in it can completely destroy the medicine, and stomach enzymes will begin to digest the drug. In particular, this applies to herbal remedies: they leave pitiful residues.

But the main thing is different. Food stays in the stomach for about 4 hours. And fatty, sweet, or taken with alcohol and some medications (no-spa, digoxin) - even longer, up to 7 hours! Accordingly, the transition of the drug to the intestines is extended for the same period. Absorption will slow down so much that it will not be possible to create the required concentration in the blood. In addition, there is a risk of a toxic effect of the drug.

And medications prescribed for coronary disease hearts, it is preferable to take it not on an empty stomach, as some believe, but after a meal.

Aspirin: no joke!

Acetylsalicylic acid is known to be so irritating to the mucous membrane that it can cause ulcers in the stomach. Scientists have noticed that if this drug is taken after a meal, its irritating effect on the gastric mucosa is indeed reduced, but at the same time the therapeutic effect is weakened. Experts have determined that the concentration of the drug in the blood is highest if it is washed down with a warm alkaline solution or half a glass of warm milk.

By the way, acetylsalicylic acid is not recommended for pregnant women, as it helps reduce fetal growth. It is contraindicated in children under 12 years of age due to the possibility of a serious complication – liver necrosis. Let's also say a few unkind words about analgin. It is still sold in pharmacies, although it has not been used abroad since 1977, as it causes dangerous hematopoietic disorders. It is enough to take two tablets of analgin to cause a critical situation.

Not all herbs are beneficial

Seemingly harmless weeds are also unsafe. According to the pharmacological classification, they are classified as drugs, which means they have side effects. For example, aloe juice is contraindicated for inflammation of the kidneys and bladder, hemorrhoids, pregnancy, and uterine bleeding.

Chokeberry should not be taken if you have low blood pressure, stomach ulcers or duodenum.

But ordinary grapes and wine are contraindicated for diabetes and edema.

Oregano, which is now called oregano seasoning, is strictly prohibited for use by pregnant women. In old times, it was popularly used to terminate pregnancy.

Elecampane, like St. John's wort and lovage, can only be consumed in small quantities. These plants are basically poisonous. But poison in small quantities is medicine.

Rhodiola rosea, that is, golden root, in vodka tincture increases potency, relieves stress, and calms the nerves. Cool drink. But again, it is contraindicated for hypertension.

Correctly taken medicine is more effective

Proper administration of the drug also affects the duration of its action. For example, antacids used in the treatment of gastric and duodenal ulcers, when taken on an empty stomach, act for about half an hour, and when taken 1 hour after a meal, they “work” for 3-4 hours.

It should be remembered that in order to maintain a constant concentration of the drug in the blood, the medicine must be taken regularly at regular intervals. That is, the drug taken 3 times a day must be drunk every 8 hours, and not only during the day.

Some drugs are not swallowed, but dissolve in the mouth, under the tongue. A classic example is nitroglycerin for relieving heart pain. In this way, the substance taken is absorbed into the body faster, since the oral cavity is abundantly supplied with blood. The same method of taking captopril and nifedipine is recommended for hypertensive crisis.

In addition, the active substance, when absorbed in the oral cavity, does not immediately enter the liver, which means it does not undergo significant changes. This explains the speed and effectiveness of the drugs used under the tongue.

Cold medicines can increase blood pressure and make a broken tablet useless

Cold medicines like naphthyzin, which constrict blood vessels in the swollen mucous membrane and help breathe, are dangerous for people with high blood pressure: after all, they narrow all blood vessels, and not just in the nose, and this can provoke a hypertensive crisis.

Finally, remember that not every tablet can be broken. If there is a line on it dividing the tablet in half, or even a cross dividing it into four parts, you can safely break it in half or into quarters. In such a tablet, the drug is distributed evenly. If the tablet is smooth, without marks, it cannot be broken - the medicine is unevenly distributed in it. Having broken it into pieces, you can take the part where there is no medicine - it may be on the other side. You will eat filler without any benefit.

My other half: can I split the tablets in half?

Is it possible to crush the tablets, divide them into pieces and empty the contents from the capsules if you cannot swallow them whole?

The issue of splitting a tablet or opening a capsule before use touched many minds, but not everyone could decide to take such a step. Indeed, you should think several times before “breaking” the dosage form.

Tatyana Lapshina, pharmacist, biochemistry teacher (Moscow)

Such a production technology does not guarantee that the active substance is evenly distributed throughout the entire volume of the drug! This means that by getting half or a quarter of a tablet, you can exceed single dose drug, which is fraught with severe side effects.

Important: the presence of special notches indicates the safety of the idea, this is a kind of “green light” for these actions, but their absence is a “red light”.

With capsules, things are more complicated, because often the medicine that should be released in the intestines is placed in the capsule. AND main task Enteric coating – protects the contents from the effects of acid in the stomach.

It is impossible to determine by eye which shell the manufacturer placed the medicine in. Therefore, the contents of the capsule drunk without the shell may collapse under the influence of hydrochloric acid without having any effect. therapeutic effects on the body.

Summary: if you have a need and desire to divide the finished medicine into parts or open a capsule, consult a specialist: ask a doctor or, in extreme cases, a pharmacist at a pharmacy. Be careful - simply eating the contents of the tablet may not be enough to get the effect.

Comments

I also know about these features because I studied not to become a pharmacist, but to become a drug production technologist, and I am very ashamed that we have such pharmacists and pharmacists. Never trust such advice!!

What is more important here is the fact that it is almost impossible to divide a tablet into two equal parts that does not have a risk for this.

Taking this opportunity, I’ll add: it’s not because of a good life that our poor pensioners buy large dosages and then divide the pills into parts. But who can say why, in large dosages with the same package number, a large tablet sometimes turns out to be much cheaper?

Regarding what they wrote here, that in individual tablets there may be a different amount of active substance - there is no need to go from one extreme to another.

It's better to eat 2 tablas to get the right dosage rather than dividing one into 2 or more parts.

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Is it possible to split antibiotic tablets in half?

When to split an antibiotic tablet:

  • You can divide only those tablets that have a mark on them. There is a division into two parts and into four.

When to split an antibiotic tablet:

A tablet is a solid, dosed type of medication that is obtained by compressing the drug and excipients. When it enters the stomach, it first swells, then dissolves, allowing the active ingredient to be released.

Such a production technology does not guarantee that the active substance is evenly distributed throughout the entire volume of the drug. Accordingly, by taking half or a quarter of a tablet, a person exceeds the single dose of the drug, which threatens the occurrence of severe side effects.

  • You cannot split the tablets if they have no risks and are not indicated in the instructions.
  • The drug in capsule form cannot be divided by pouring out the contents of the granule and taken without the shell. Such gelatin shells are specially created to ensure that the drug is absorbed in a specific part of the intestine. Therefore, the contents of the capsule drunk without the shell can be destroyed under the influence of hydrochloric acid, without having a therapeutic effect on the body.
  • Also, tablets containing two or more components in their composition cannot be divided. For example, Amoxiclav has a dosage of 250+125 mg. (250 mg Amoxicillin and 125 mg Clavulanic acid), 500+125 mg, 875+125 mg. Naturally, people have a question: if the pharmacy does not have a dosage of 500+125 mg, is it possible to use a double dosage of 250+125 mg. ? This is not possible, because for Amoxicillin we reach the required dosage (500 mg), but for Clavulanic acid it is exceeded, instead of 125 mg. it will be 250 mg, the final tablet will be: 500+250 mg. The consequences may not be predictable.

Attention! Before using medications, you should consult your doctor. The information is provided for informational purposes only.