Autoimmune systemic diseases, including systemic lupus erythematosus, scleroderma; first appeared liver disease and liver failure; clinically significant proteinuria (more than 1 g / day); impairment of renal function (creatinine clearance 10-30 ml / min); cerebrovascular and cardiovascular diseases (including cerebrovascular primobolan for women insufficiency, coronary heart disease, coronary insufficiency); decompensated heart failure; inhibition of bone marrow hematopoiesis; diabetes; violations of water-electrolyte metabolism, including hyperkalemia, sodium restricted diet; state, accompanied by a decrease in circulating blood volume (including diarrhea, vomiting, diuretics); elderly age.
In patients with impaired renal function (creatinine clearance of 10-30 mL / min.), The recommended dose of the drug Quadropril ® tablets of 2.1 to 6 mg (3 mg / day), which was taken in the morning.Treatment starts with the establishment of careful clinical observation of the patient. Depending on the indicators of renal function in individual justified cases Quadropril drug dose ® can be increased to a maximum of 1 tablet (6 mg / day), which was taken in the morning. In primobolan for women patients with impaired renal function (creatinine clearance 30-60 ml / min) or hepatic impairment and in elderly patients a dose reduction is required.
The duration of treatment determined by the doctor.
Cardio-vascular system: decrease in blood pressure, orthostatic hypothetical-Zia, rarely – fainting, in rare cases – tachycardia, arrhythmia, angina, myocardial infarction, increased manifestations of insufficiency of peripheral circulation. From the urogenital system: the development or strengthening of chronic renal failure, proteinuria, reduced potency. On the part of the central nervous system: cerebral stroke, dizziness, headache, weakness, exacerbation of Raynaud’s disease; when used in high doses – insomnia, anxiety, depression, confusion, paraesthesia, sleep disturbances, impaired balance. From the senses: a violation of the vestibular apparatus, hearing and visual impairment, tinnitus; changes in taste, or a temporary loss of taste. From the digestive system: nausea, diarrhea, cholestatic jaundice, dyspepsia, constipation, anorexia, stomatitis, glossitis, dry mouth, in rare cases – intestinal obstruction; isolated cases have been described in human liver, hepatitis, pancreatitis. In a few cases were observed: a progressive necrosis of the liver, sometimes fatal. The respiratory system: the “dry” cough, pulmonary infiltrates, bronchospasm, dyspnea, rhinitis, rhinorrhea, sinusitis, pharyngitis, dysphonia.Allergic reactions: skin rash, pruritus, urticaria , photosensitivity; angioedema tissues of the face, extremities, lips, tongue, glottis and / or larynx, erythema multiforme, exfoliative dermatitis, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome). In very rare cases when taking ACE inhibitors observed angioedema of the intestine. From the side of blood:anemia, leukopenia, thrombocytopenia, rarely – eosinophilia, in rare cases – agranulocytosis, pancytopenia and hemolysis, elevated titers of antinuclear antibodies. Laboratory findings: hypercreatininemia, elevated levels urea, increased activity of “liver” transaminases, hyperbilirubinemia, hyperkalemia, hyponatremia. Effect on the fetus: the violation of fetal kidneys, lowering blood pressure in infants, renal dysfunction, hyperkalemia, hypoplasia of the skull, oligohydramnios, limb contractures, skull deformity, lung hypoplasia. Other: alopecia, onycholysis.
Symptoms: marked reduction of blood pressure, bradycardia, collapse, shock, disorders of water and electrolyte balance, acute renal failure. Treatment: symptomatic (gastric lavage, the appointment of absorbent material). In severe cases, -. Hospitalization and maintenance of vital functions of the body . For primobolan for women the removal of the drug from the body can be carried out hemodialysis session If hypotension, first of all, make up the blood volume intravenous infusion of normal saline. If necessary, an additional intravenous catecholamines. In severe bradycardia, which is not stopped by drugs, artificial pacemaker implanted. necessary to control the concentration of electrolytes in the blood, and creatinine.