Drugs with ACE inhibitors and diuretics: combinations
For the treatment of hypertension specialists often prescribe a combination of diuretic and ACE inhibitor (angiotensin converting enzyme inhibitors). Most relevant to this plan during bezdeystvuete monotherapy, and for patients with chronic heart failure, if necessary, to eliminate swelling. Determine the combination of medicines should be exclusively the doctor, is absolutely contraindicated to self-medicate.
The expediency of complex therapy
Elevated blood pressure when receiving antihypertensive drugs does not give positive results, it is reasonable to combine drugs to achieve the desired effect. The most effective combination of pharmaceutical agents are diuretics and ACE inhibitors. These groups of medications in mutual work smooth side effects, reducing the negative manifestations of the therapeutic course.
For example, if diuretic therapy, there is a risk of reduction in plasma potassium, so eating a diuretic drug with ACE inhibitors, the effect of which is aimed at the conservation of potassium in the body, the development of hypokalemia becomes impossible. Conversely, the treatment with inhibitors may increase potassium levels and lead to hyperkalemia, but if the treatment regimen to include a diuretic, this side effect is completely eliminated.
An important advantage of combined treatment of high pressure inhibitor and diuretic, is a mild coughing fit, which is a common negative consequence of receiving the aceis. The tandem of these drugs with high blood pressure enables the use of diuretics to patients with diabetes that previously was prescribed diuretics to such patients with extreme caution, with the integrated use of diuretics and inhibitors obtained a positive result.
To use the described drugs can only be prescribed by a doctor, as, in spite of the increased joint performance, their combination may result in undesirable consequences. For example, an inhibitor and a diuretic together reduce high blood pressure, but incorrect use can significantly decrease systemic blood pressure and blood flow in the kidneys.
For the past 30 years to normalize blood pressure use ACE inhibitors. Used they were after research, which gave a comparative evaluation of the impact on pressure diuretics, aceis — «Captopril», the beta-blocker. Significant differences were found, however, «Captopril» showed the best results for the prevention of complications in diabetes mellitus.
In addition to this study, there was another, which was designed to compare drugs with respect to their negative impact on the cardiovascular system. In the comparison group got diuretic medications, beta-blocker, and ACE, and a calcium antagonist. All the analyzed drugs showed the same results.
Protection of kidneys
A fairly common question among patients with hypertension as effect of ACE inhibitors on the kidneys? Experts in one voice say that the angiotensin-converting enzyme inhibitors is better than many medicines for high blood pressure have a protective effect on the kidneys. It is recommended to take their patients with high blood pressure and kidney conditions chronic. It is necessary to slow the development of renal dysfunction and for lowering high blood pressure.
It is believed that aceis is the best protection of kidneys in patients with severe secretion in urine is protein. It was found that angiotensin converting enzyme inhibitors significantly improve kidney function in patients with chronic renal dysfunction. However, in some cases during therapy with aceis is observed deterioration of the health of the kidneys, and in diseases characterized by damage to the blood vessels of the kidneys, ACE inhibitors in combination with diuretics are quite effective for blood pressure control in many patients. But was seen in some cases have developed severe renal failure in patients with one kidney.
The combination of diuretics with drugs ACE inhibitors
Often, for normalization of blood pressure resort to combination therapy with diuretics and angiotensin converting enzyme inhibitors. This approach doctors for treatment of hypertension due to their ability to quickly reach normal blood pressure. However, it is worth considering that in some cases diuretics can lead to excessive competitive pressure and to reduce renal blood flow with a significant deterioration of renal function. Especially careful with a combined treatment should be patients who are already faced with such violations. The co-administration of a diuretic with the «Captopril» yields positive results, it means that the AD is reduced almost to normal level. In addition, taking these medicines, it becomes possible to completely control blood pressure in patients with severe disease.
In medicine combine drugs the following way:
- «receptor blocker to angiotensin II diuretic medications/calcium channel blocker»;
- «angiotensin-converting enzyme inhibitor—calcium channel blocker».
Doctors do not rule out the possibility of taking each type of medication in a single pill or combination of active ingredients within the medications. For example, a pharmaceutical «Equator» includes is a calcium antagonist and an ACE inhibitor. This drug is used often when there are contraindications to using a diuretic. The most popular and effective interaction weekly a diuretic, combined with the «Captopril».
Many patients wonder why you selected such a combination of drugs? Rational combinations ― those that meet specific requirements, namely:
- don’t have long side effects;
- prescribed at optimal dosages;
- affect various mechanisms of increasing pressure;
- showed high efficiency in the various studies.
Not assigned to ACE — inhibitor and potassium-sparing diuretics, as both a tool contributes to the accumulation in plasma potassium that may lead to hyperkalemia — a dangerous disease with possible cardiac arrest in diastole. When you use one of the drugs, the patient will need regular checks of blood levels of potassium. It is not recommended to combine ACE inhibitors with pharmaceuticals «Diltiazem», «Nifedipine», «Verapamil», «Lercanidipine». Contraindicated combination of inhibitors with beta-blockers, which include «Atenolol», «Pindolol», «Propranolol», «Metoprolol».