Skopryl plus 20 mg. /12.5 mg. 30 tablets

What is SKOPRYL PLUS and what is it used?
SKOPRYL PLUS Tablets containing the ingredients lisinopril and hydrochlorothiazide and are used to treat high blood pressure. If high blood pressure is not controlled, it can increase the risk of heart disease or stroke.
Lisinopril belongs to a group of medicines called angiotensin-converting enzyme (ACE) inhibitors. It works by widening the blood vessels, which helps reduce high blood pressure.
Hydrochlorothiazide belongs to a group of medicines called diuretics (water tablets). It increases the amount of urine through which your body releases extra water.
Skopril plus work by reducing blood pressure, reducing the risk of heart disease or stroke.

2. WHAT YOU SHOULD KNOW BEFORE YOU TAKE SKOPRYL PLUS?
Do not take SKOPRYL PLUS
if you are allergic (hypersensitive) to the active substance or to any other ingredients of SKOPRYL PLUS
if you are treated with drugs called ACE inhibitor and have had allergic reactions with swelling of the face, lips, tongue and / or throat with difficulty in swallowing or breathing (a condition called angioedema).
if you are diagnosed with angioedema, which are inherited from a parent or angioedema of unknown cause.
if you are allergic to medicines derived from sulfonamides, which include some antibiotics and drugs for diabetes (ask your doctor if you are unsure).
If you suffer from an inability to separate water (anuria).
if you suffer from severe liver or kidney failure.
if you are pregnant more than three months. (It is also better to avoid Skopril Plus in early pregnancy - see pregnancy section).
Skopril is not for use in children.

Take special care when taking SKOPRYL PLUS
Tell your doctor if:
- You have or have had any allergies or asthma.
- Suffer from liver disease, kidney or heart.
- You have a certain type of cardiovascular and lung disease called aortic stenosis. You are told that you have elevated levels of these natural chemicals of the body: potassium, calcium, urea, creatinine, uric acid, cholesterol or triglycerides are on dialysis.
- You have recently suffered from excessive vomiting or diarrhea, suffer from diabetes.
- You have gout (swollen painful joints caused by the buildup of uric acid) have systemic lupus erythematosus or SLE (chronic autoimmune disease that can affect any part of the body).
You should tell your doctor if you think you are (or plan to become pregnant). Skopril not recommended in early pregnancy, and must not be taken if pregnancy is after the third month since its use in this phase can cause serious harm to your baby (see. Pregnancy and lactation).
You should tell your doctor if you are on a diet with restriction of salt if you take potassium supplements, potassium-sparing agents or potassium-containing salt substitutes. If you are treatment called LDL apheresis, which is removal of cholesterol from the blood by a machine, you should inform your doctor that you are taking Skopril plus. Please note that the intake of this drug can affect all blood and urine that your doctor can perform. Please remind your doctor that you are taking Skopril plus if asked to do such research. Before surgery and anesthesia (even at the dentist), you should inform your doctor or dentist that you are taking Skopril plus, as may occur sudden drop in blood pressure.
If you are desensitisation treatment, it is a treatment to reduce the effects of an allergy to bee stings or wasp, you should inform your doctor that you are taking Skopril plus.

Taking other medicines
Please tell the doctor or pharmacist if you are taking or have recently taken any medicines, including medicines obtained without a prescription. It is extremely important for your doctor to know if you are taking:
- Insulin or tablets to lower blood sugar (medicines used to treat diabetes)
- Diuretics (water pills) and other drugs used to reduce blood pressure.
- Medicines to treat mental disorders such as lithium, antipsychotics or tricyclic antidepressants.
- Tubocurarine (muscle relaxant used in the anesthesia), nonsteroidal antiinflammatory drugs (NSAIDs).
- Allopurinol used for gout, drugs for the treatment of cancer.
- Immunosuppressive agents such as cyclosporin used after gransplantatsiya or treatment of diseases such as rheumatoid arthritis.
- Steroids for the treatment of various conditions such as rheumatism, arthritis, allergic conditions, certain skin diseases, asthma or a disease of the blood.
- Cardiac glycosides, used to treat heart disease such as digoxin or sotalol procainamide, used to treat abnormal heart rhythms.
- Trimethoprim (a medicine used to treat infections).
- Drugs such as ephedrine, norepinephrine or epinephrine (adrenaline), which are used for
- The treatment of hypertension, shock, heart failure, asthma or allergies.
- Cholestyramine, colestipol or lovastatin, which are used for the treatment of hyperlipidemia (high cholesterol levels in the blood).
- ACTH test if your adrenal glands are working properly.
- Potassium supplements, potassium-sparing diuretics such as amiloride or potassium-containing salt substitutes.
- Injectable gold salts (used to treat rheumatoid arthritis)
- Calcium salts

Use of SKOPRYL PLUS food and drinks
You can take this medicine with or without food. The effects of drugs used to lower blood pressure may increase when taken with alcohol, and may cause dizziness or lightheadedness.
If you are concerned about how much alcohol you can drink while taking Skopril plus, discuss this with your doctor.

Pregnancy and lactation
Ask your doctor or pharmacist before taking any medicine. pregnancy
You should tell your doctor if you think you are (or plan to become pregnant). Your doctor will normally advise you to stop taking Skopril Plus before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead Skopril plus. Skopril Plus is not recommended in early pregnancy and must not be taken if pregnancy is after the third month, as it may cause serious harm to your baby after the third month of pregnancy.

breastfeeding
Tell your doctor if you are breastfeeding or plan to breastfeed. SKOPRYL PLUS is not recommended for nursing mothers, and your doctor may choose another treatment if you wish to breastfeed, especially if your baby is newborn, or was born prematurely.

Driving and using machines
Your tablets are unlikely to affect your ability to drive or operate machinery.
However, you should not perform tasks that require special attention until you know how the medicine affects you. If you feel tired or dizzy, do not drive or operate machinery until you discuss this with your doctor.

3. HOW TO TAKE SKOPRYL PLUS?
Always take SKOPRYL PLUS just as you have been told by your doctor. If you're not sure, ask your doctor or pharmacist. The usual dose is one tablet taken once daily. If necessary, the dose may be increased to 2 tablets once daily. Be especially careful when taking your first dose or if your dose is increased. Tell your doctor as soon as possible if you experience dizziness or lightheadedness. If you are already taking diuretics, your doctor may tell you to reduce the dose of the diuretic or even stop taking it before you start taking Skopril plus. The effect of Skopril Plus tablets lasts 24 hours, so you have to take the tablets only once a day.
Skopril plus can not be accepted at any time of the day before, during or after meals. Choose a time that is convenient for you and take your tablet at this time each day. This will help you to remember if you have taken a tablet on this day. Skopril Plus is not for use in children.
Take SKOPRYL PLUS , unless your doctor tells you to stop. If you take more dose SKOPRYL PLUS

If you take more than plus SKOPRYL PLUS should visit your doctor as soon as possible.
The most likely overdose symptoms are a feeling of light-headedness or dizziness due to low blood pressure.

If you forget to take Skonril plus
Do not take a double dose to make up, just take the tablet the next day when you usually take it.

4. POSSIBLE SIDE EFFECTS
Like all medicines, SKOPRYL PLUS can cause side effects, although not everybody gets them.
Skopril plus contains two drugs: lisinopril and hydrochlorothiazide. The following adverse reactions have been reported with these individual drugs. This means that they may also occur with Skopril plus.
Your doctor may occasionally take blood samples to check whether Skopril plus had no effect on your blood.
Possible side effects associated with lisinopril
Severe allergic reactions (rare, may affect up to 1 in 1000 people) If you have a severe allergic reaction, stop taking Skonril plus and go immediately.

Signs can include sudden onset of:
• Swelling of the face, lips, throat or tongue This can make swallowing difficult.
• Severe or sudden swelling of hands, feet or ankles.
• Difficulty breathing.
• Strong itchy skin (with raised lumps).

Severe liver problems (very rare, may affect up to 1 in 10 000) Signs may include:
• Yellowing of the skin or eyes, dark urine or loss of appetite.
• If this happens, immediately see a doctor.

Other possible side effects: Common (may affect up to 1 in 10 people)
• Headache.
• Feeling dizzy or light-headed, especially if you stand up quickly.
• Fainting.
• Diarrhea.
• Vomiting.
• Cough.
• Kidney problems (in blood tests).

Uncommon (may affect up to 1 in 100 people)
• Changes in mood, including feelings of depression.
• Numbness as numbness in the limbs.
• Dizziness (Vertigo).
• Changes in taste.
• Sleep disorders.
• Heart attack or stroke.
• Unusual heartbeat.
• Change the color in the fingers or toes.
• Runny nose.
• Feeling sick (nausea).
• Pain in the stomach and indigestion.
• Changes in blood tests that check how the liver is working.
• Rash.
• Itching.
• Inability to obtain an erection (impotence).
• Feeling of weakness.
• Feeling tired.
• Increased levels of certain substances in the blood (urea, creatinine and calcium). Rare (may affect up to 1 in 1000 people)
• Changes in some of the cells or other parts of the blood. Signs may include feeling tired and pale skin.
• Confusion.
• Dry mouth.
• Skin rash with dark red, raised, itchy bumps (hives).
• Hair loss (alopecia).
• Psoriasis (skin problem).
• Kidney failure.
• Enlarged breasts in men.
• Low levels of sodium in the blood, which can lead to weakness, fatigue, headache, nausea, being sick (vomiting) and cramps.
Very rare (may affect up to 1 in 10,000 people)
• Problems with your bone marrow or reduced number of blood cells and / or platelets in your blood. You may notice fatigue, infection (which can be severe), fever, shortness of breath, easy bruising or bleeding. Swollen glands (lymph nodes). Increased immune response (autoimmune disease).
• Low blood sugar (hypoglycemia). Signs may include feeling hungry or weak, sweating and rapid heart beat. Suddenly feeling wheezy or wheezing (bronchospasm). Inflammation of the lung (which may cause shortness of breath). Sinusitis (feeling of pain and fullness behind your cheeks and eyes).
• Eosinophilic pneumonia. Signs include a combination of the following: sinusitis, flu-like symptoms, feeling stronger suffocation, pain in the stomach or intestines, skin rash, feeling of "pins and needles" or numbness in the hands or feet. Inflammation of the pancreas. This causes moderate to severe stomach pain. Swelling of the lining of the intestines. This can cause sudden stomach pain, diarrhea, nausea (feeling sick). Sweating. severe skin disease or rash. Symptoms include redness, blistering and peeling of the skin, which can be develop rapidly and can include blisters in the mouth and nose.
• Separation of less water (urine) than normal or non-releasable water.
Possible side effects of hydrochlorothiazide (frequency can not be established from the available data)
Inflammation of the salivary glands.
Reducing the number of blood cells and / or platelets in your blood. You may notice fatigue, infection (which can be severe), fever, shortness of breath, easy bruising or bleeding. Loss of appetite.
Increase in sugar (glucose) in your blood. Sugar in urine.
Increase in uric acid in your blood.
Changed in levels of substances in the blood (eg, low sodium and potassium). You may notice muscle weakness, thirst, numbness, cramps or nausea. Elevated levels of blood fats (including cholesterol) or uric acid. Anxiety. Depression. Sleep disorders.
Tingling like pins and needles. Feeling dizzy.
Changes in vision, that can make things look yellow. Vision problems for a short time. Dizziness (vertigo). Fainting (especially when standing).
Damage to blood vessels causing red or purple spots on the skin. Difficulty breathing. Feeling short of breath if lungs are inflamed or have liquid in them
• Gastrointestinal irritation.
• Diarrhea.
• Constipation.
• Inflammation of the pancreas. This causes moderate to severe pain in the stomach.
• Yellowing of the skin or whites of the eyes (jaundice).
• Skin problems including rash caused by sensitivity to sunlight, rash, severe rash that develops quickly with blistering or peeling of the skin and possibly blistering in the mouth, worsening of existing similar to lupus erythematosus reactions or appearance of unusual skin reactions.
• Allergic reactions.
• Muscle cramps and muscle weakness.
• Renal problems may be severe (for blood tests).
• Fever.
• Weakness.
If you get any side effects, contact your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

5. How to store SKOPRYL PLUS
This medicine does not require any special storage conditions. Keep out of reach of children.
Do not use this medicine after the expiry date stated on the carton after "EXP". The expiry date refers to the last day of that month. Do not use this medicine if you notice that the pack is damaged. Do not dispose of medications in wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer use. These measures will help to protect the environment.

6. Contents of the pack and other information
What SKOPRYL PLUS
The active substances in Skopril plus 20 mg / 12,5 mg tablets are lisinopril and hidrohlorotnazid. Each tablet contains 20 mg lisinopril (as dihydrate) and 12,5 mg hidrohlorotnazid. The other ingredients are mannitol, calcium phosphate dibasic anhydrous, maize starch, pregelatinised maize starch, povidone, magnesium stearate and iron oxide pigment brown 75f 1 72 (contains iron oxide, black and red iron oxide).

Looks Skopryl plus and contents of the pack?
Skopryl plus 20 mg / 12,5 mg tablets are pale brown-purple round biconvex tablets scored on one side. The score line is not intended for breaking the tablet.
Skopril plus 20 mg / 12,5 mg tablets are available in packs of 30 tablets.