Cautions Symptomatic hypotension is most often pronounced decrease in blood pressure occurs with a decrease in fluid volume caused by diuretic therapy, reduction of salt in food, dialysis, diarrhea or vomiting. In patients with chronic heart failure with simultaneous renal failure buy primobolan depot or without her, perhaps marked reduction in blood pressure. It is often diagnosed in patients with severe heart failure as a result of application of high doses of diuretics, hyponatremia or impaired renal function.
In these patients, treatment should start under close medical supervision (with caution in selection of dosage and diuretics).Such rules to follow when assigning patients with ischemic heart disease, cerebrovascular insufficiency, in which a sharp decrease in blood pressure can lead to heart attack or stroke. The transient hypotensive response is not a contraindication for the next dose of the drug. In applying Sinoprila, in some patients with chronic heart failure but with normal or low blood pressure, there may be a decrease in blood pressure, which is usually not a cause for discontinuation of treatment.
Before treatment Sinoprilom on possible, to normalize the concentration of sodium and / or compensate for the lost volume of liquid carefully control action starting dose Sinoprila on blood pressure of the patient. in the case of renal artery stenosis (especially with bilateral stenosis or in the presence of artery stenosis single kidney) and circulatory failure due to lack of sodium buy primobolan depot liquids, Sinopril may lead to renal dysfunction, acute renal failure, which is usually reversible after discontinuation of the drug. in acute myocardial infarction The application of standard therapy (thrombolytics, acetylsalicylic acid, beta-blockers). Sinopril may be used in conjunction with intravenous or using transdermal nitroglycerin systems.
Surgery / general anesthesia. With extensive surgical interventions, as well as the use of other drugs that cause a decrease in blood pressure, lisinopril blocking the formation of angiotensin II of, can cause pronounced unpredictable blood pressure reduction. in elderly patients , the same dose results in a higher drug concentration in the blood, thus requiring special care in determining the dose, despite the fact that the differences in Sinoprila antihypertensive action among the elderly and young people are not detected. Due to the fact that one can not rule out the potential risk of agranulocytosis, requires periodic monitoring of blood picture. In applying the drug in a dialysis polyacryl-nitrile membrane can occur anaphylactic shock, it is recommended that a different type of dialysis membrane or administration of other antihypertensive drugs. Effects on ability to drive vehicles and mechanisms No data on the effect of lisinopril, applied buy primobolan depot in therapeutic doses on the ability to drive vehicles and mechanisms, however, be aware that you may experience dizziness, so be careful.