DIRONORM 20 mg. 30 tablets

DIRONORM WHAT IS AND WHAT IT IS USED

Dironorm is a combination product of amlodipine, which belongs to the group of medicines called calcium channel blockers and lisinopril, which belongs to the group of medicines called angiotensin converting enzyme (ACE). Dironorm used to treat hypertension (high blood pressure). It is too high your blood pressure does not show any symptoms, but it can increase the risk of developing some complications (such as stroke or heart attack), if you do not take your regular antihypertensive medication.

 BEFORE YOU TAKE DIRONORM

Do not take Dironorm

You should not take this medicine:

 If you are allergic (hypersensitive) to the active substances or any of the other ingredients of Dironorm.

 If you are allergic to other ACE inhibitors (such as enalapril, captopril and ramipril) or other calcium channel blockers (such as nifedipine, felodipine and nimodipine).

 If you had angioedema / symptoms such as itching, hives, wheezing and swelling of the hands, throat, mouth or eyelids), or not related to treatment with an ACE inhibitor.

 If your blood pressure is too low (severe hypotension).

 If bleeding from the left ventricle, ie if you have severe narrowing of the aorta (aortic stenosis).

 If you have disturbed circulation (including shock that arises in the heart and is called "cardiogenic shock").

 If you had a heart attack (myocardial infarction) of heart failure in the last 28 days.

 If you are pregnant after 3 months (early pregnancy is also better not to take Dironorm - refer. Spot "Pregnancy").

Take special care with Dironorm

Before treatment, you should consult your doctor if:

 You have heart problems

 Have kidney problems

 Have liver problems

 You are on dialysis

 Have a treatment called LDL apheresis (to remove cholesterol)

 Are over 65 years

 If you are on a diet low in salt and use potassium-containing salt substitutes or supplements

You have diarrhea or vomiting

desensitisation treatment to reduce allergy to bee sting or wasp

 If you are black, as is possible ACE inhibitors are less effective, but you can more easily get angioedema

 Taking any of the medicines listed below

You should tell your doctor if you think you are (or might become) pregnant. Dironorm not recommended in early pregnancy, and must not be taken if you are pregnant after 3 months, as it may cause serious harm to your baby if used at that stage (see section "Pregnancy and lactation").

Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Potassium-sparing diuretics (such as spironolactone, amiloride, triamterene used to reduce fluid retention / can be taken together with Dironorm under close medical supervision.

Special care is required when Dironorm was taken with the following medicines:

 diuretics (used to reduce fluid retention]

 other medicines used to lower blood pressure (antihypertensives)

 medicines used to treat heart disease

 non-steroidal anti-inflammatory drugs (NSAIDs) such as Ace tilsalitsilova acid (used to treat arthritis, muscle pain, headache, inflammation, fever)

 lithium, antipsychotic drugs (used to treat mental disorders)

 insulin and antidiabetics mouth

 autonomous nervous system stimulants (sympathomimetic), such as ephedrine, xylometazoline and salbulamol (used to treat nasal congestion, cough, cold and asthma)

 immunosuppressants (used to prevent transplant rejection)

 allupurinol (used for gout)

 drugs, morphine and related drugs (used to treat severe pain)

 cancer drug

 drugs (used in surgery or some dental procedures). Tell your doctor or dentist that you are taking Dironorm before placing a local or general anesthesia due to the risk of rapid reduction of blood pressure

 anticonvulsants (such as carbamazepine, phenobarbital and phenytoin), used to treat epilepsy

 medicines used to treat bacterial (rifampi-ching), HIV (ritonavir) or fungal infections (ketoconazole)

 gold salts, particularly when administered intravenously (used to treat the symptoms of rheumatoid arthritis)

Herbal products containing St. John's Wort

Taking Dironorm with food and drink

Dironorm can be taken with or without food, but alcohol should be avoided during treatment. It is possible that grapefruit juice can interact with amlodipine increase its effect, as a whole, however, the increase is not significant.

Pregnancy and lactation

Ask your doctor or pharmacist before taking any medicine.

Pregnancy

You should tell your doctor if you think you are (or might become) pregnant. Generally, your doctor will advise you to take another medicine instead Dironorm as Dironorm not recommended in early pregnancy and may cause serious harm to your baby if used after the third month of pregnancy.

Breastfeeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Dironorm not recommended for intake by nursing mothers, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your child is a newborn or preterm:

Driving and operating machinery

Dironorm can affect your ability to safely drive or operate machinery.

  HOW TO TAKE DIRONORM

Always Dironorm exactly as your doctor has told

If you're not sure, ask your doctor or pharmacist. The usual dose is 1 tablet Dironorm day. Dironorm can be taken with or without food. With prolonged treatment strive to take your tablet at the same time each day.

If you think that the effect of Dironorm is too strong or too weak, talk to your doctor or pharmacist.

If you take more than the dose Dironorm

Contact your doctor immediately or go to the emergency room of the nearest hospital.

Overdose is likely to lead to very low blood pressure should be closely monitored, and if you develop symptoms such as dizziness and headaches, to lie face up. Your doctor will take further measures.

POSSIBLE SIDE EFFECTS

You should stop taking Dironorm and seek immediate medical attention if you develop any of the following symptoms of angioedema:

 Difficulty breathing with or without swelling of the face, lips, tongue and / or throat

 Swelling of the face, lips, tongue and / or throat that may cause difficulty in swallowing.

 Severe itching of the skin

Other adverse reactions reported with the use of amplodipin or lisinopril and which also can occur when using Dironorm:

Amlodipine:

Common - headache, edema, fatigue, lethargy, malaise, dizziness, abdominal pain, polpitatsii, nausea, flushing.

Uncommon - skin rash, itchy skin, indigestion, shortness of breath, muscle cramps, irregular bowel movement rhythm, muscle or joint pain, back pain, chest pain, mood swings, depression, insomnia, visual disturbances, hypotension, difficulty breathing, taste, temple, increased need to urinate, dry mouth, thirst, loss of sense of pain, increased sweating, fainting, weakness, impotence, weight loss.

Rare - confusion

Very rare - allergic reactions, abnormal liver function, inflammation of the liver, yellowing of the skin, reducing the number of white blood cells and platelets in the blood, heart attack, irregular heartbeats, cough, severe skin reactions, swelling of the lips, eyelids and genitals, swollen gums, inflammation of the pancreas, inflammation of the stomach lining, formation of red patches of skin sensitivity to light.

Lisinopril:

Common - headache, dizziness or vertigo, especially when standing up quickly, diarrhea, cough, vomiting, kidney problems, skin rash, itching.

Uncommon - mood swings, angioedema, discoloration and / or numbness or tingling in fingers or toes, taste changes, fatigue, drowsiness or difficulty sleeping, abnormal dreams, feelings of dizziness, abnormal sensation of the skin, increased heart rhythm, heart attack, stroke, fever, nausea, stomach pain or indigestion, impotence, fatigue, muscle weakness, changes in the results of some laboratory tests

Rare - confusion, severe kidney problems, dry mouth, hair loss, psoriasis, breast enlargement in men.

Deterioration of blood counts: a reduction of red blood cells.

Very rare - lower blood sugar, sinus pain, wheezing, lung inflammation, yellowing of the skin and / or eyes, inflammation of the liver or pancreas, severe skin conditions, sweating.

Not known - fainting, depression

Additional Information:

The active ingredients are lisinopril and amlodipine.

The other ingredients are microcrystalline cellulose, microcrystalline cellulose 12, sodium starch glycolate, magnesium stearate.