Azilpres Plus

Introduction
Azilpres Plus is a combination medicine used in the treatment of hypertension (high blood pressure). It works by relaxing the blood vessels and making the heart more efficient at pumping blood throughout the body. It also removes extra water and certain electrolytes from the body. Azilpres Plus can be taken with or without food, but take it at the same time to get the most benefit. It should be taken as your doctor’s advice. The dose and how often you take it depends on what you are taking it for. Never skip any doses and finish a full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to the doctor as it may worsen your symptoms. It may cause side effects like tiredness, decreased potassium level in blood, decreased blood pressure, increased creatinine level in blood, and increased uric acid level in blood. It is advised to drink plenty of fluids while taking this medicine. It may cause dizziness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. Regular monitoring of blood pressure is required while taking this medicine. Before taking this medicine, tell your doctor if you are pregnant or breastfeeding if you have ever had any problems with your blood circulation or have liver or kidney problems. Your doctor should also know about all other medicines you are taking as many of these may make this medicine less effective or change the way it works.

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Uses of Azilpres Plus
Hypertension (high blood pressure)
Side effects of Azilpres Plus
Common
Dizziness
Tiredness
Decreased potassium level in blood
Decreased blood pressure
Increased creatinine level in blood
Increased uric acid level in blood
How to use Azilpres Plus
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Azilpres Plus may be taken with or without food, but it is better to take it at a fixed time.
How Azilpres Plus works
Azilpres Plus is a combination of two medicines: Azilsartan medoxomil and Chlorthalidone which lower blood pressure effectively. Azilsartan medoxomil is an angiotensin receptor blocker (ARB). It works by blocking the hormone angiotensin thereby relaxing blood vessels.This allows the blood to flow more smoothly and the heart to pump more efficiently. Chlorthalidone is a diuretic that removes extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow.
Quick Tips
You have been prescribed Azildac CT Tablet for the treatment of high blood pressure.
It can be taken with or without food.
Azildac CT Tablet may cause dehydration. Drink plenty of fluids and inform your doctor if you develop extreme thirst, very dry mouth or muscle weakness.
It may cause dizziness. Get up slowly when rising from a sitting or lying position.
Use of Azildac CT Tablet during pregnancy or breastfeeding is unsafe.
It may also decrease the risk of stroke and heart attacks.
Brief Description
Indication
Hypertension, Treatment of hypertension in patients not adequately controlled with monotherapy or as initial therapy in patients likely to need multiple drugs to help achieve blood pressure goals
Administration
May be taken with or without food.
Adult Dose
Adult Oral Hypertension 1 tab (40 mg/12.5 mg) once daily. May increase to 40 mg/25 mg after 2-4 weeks as needed to achieve blood pressure goals; not to exceed 40 mg/25 mg daily Switching from ARB or diuretic monotherapy: Initiate with 40 mg/12.5 mg PO qDay Hepatic impairment Mild-to-moderate: No dose adjustment required for azilsartan Severe: Azilsartan has not been studied in patients with severe hepatic impairment Chlorthalidone may cause mild alterations of fluid and electrolyte balance that may precipitate hepatic coma in patients with impaired hepatic function or progressive liver disease

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Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment Mild-to-moderate (eGFR 30 mL/min/1.73 sq.meter or greater): No dose adjustment required Severe (eGFR <30 mL/min/1.73 sq.meter): Safety and effectiveness not established Chlorthalidone may precipitate azotemia _ Contraindication Hypersensitivity. Patient w/ anuria. Concomitant use w/ aliskiren in patients w/ diabetes. Pregnancy. Mode of Action Angiotensin II blocker; displaces angiotensin II from AT1 receptor and may lower blood pressure by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water absorption, and hypertrophic responses Chlorthalidone produces diuresis with increased excretion of sodium and chloride at the cortical diluting segment of the ascending limb of Henle’s loop of the nephron _ Precaution Hyperuricemia Hyperuricemia may occur or frank gout may be precipitated in certain patients receiving chlorthalidone or other thiazide diuretics Fetal toxicity When pregnancy is detected, discontinue as soon as possible; drugs affecting renin-angiotensin system causing oligohydramnios, which may result in fetal injury and/or death Hypotension in volume or salt depleted patients Electrolytes Hypokalemia is a dose-dependent adverse reaction that may develop with chlorthalidone; Edarbyclor attenuates chlorthalidone-associated hypokalemia Coadministration of digitalis may exacerbate adverse effects of hypokalemia Thiazide diuretics can cause hyponatremia and hypokalemia; drugs that inhibit the renin angiotensin system can cause hyperkalemia; monitor serum electrolytes periodically Lactation: Unknown whether azilsartan distributed in breast milk, thiazide-like diuretics are excreted in human milk; consider alternate antihypertensive therapy or do not breastfeed _ Side Effect 1-10% Dizziness (8.9%) Fatigue (2%) Hypotension (1.7%) <1% Syncope (0.3%) _ Pregnancy Category Note Pregnancy Category: D Discontinue as soon as possible when pregnancy is detected; use during second and third trimesters affects renin-angiotensin system causing oligohydramnios, which may result in fetal injury and/or death (see Black Box Warnings and Cautions) Lactation: Unknown whether azilsartan distributed in breast milk, thiazide-like diuretics are excreted in human milk; consider alternate antihypertensive therapy or do not breastfeed _ Interaction Elderly, vol-depleted patients or w/ compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, w/ angiotensin II receptor antagonists (including azilsartan) may result in deterioration of renal function, including possible acute renal failure. Dual blockade of the renin angiotensin system w/ angiotensin receptor blockers, ACE inhibitors or aliskiren is associated w/ increased risks of hypotension, hyperkalemia & changes in renal function (including acute renal failure). Concomitant use w/ aliskiren. Reduced lithium clearance by diuretics eg, chlorthalidone increasing the risk of lithium toxicity. _