ATEHEXAL 25 mg. 30 tablets

What is AteHEXAL "25 tablets?
AteHEXAL25 be used in functional cardiovascular diseases (e. Hyperkinetic heart syndrome).

When you should not take AteHEXAL 25 tablets?
AteHEKSAL 25 must not be administered to:
- Hypersensitivity to atenolol, other beta-adrenergic blockers or any of the other ingredients of the product
- Weakness of the heart muscle (overt cardiac failure)
- Shock
- Disturbances in the conduct of the atria to the cameras (AV-block II-nd and III-A grade)
- Sinus node disease (syndrome sick sinus)
- Abnormal conduction between the sinus node and the atria of the heart (sinoatrial block)
- Rest heart rate below 50 beats per minute before the start of therapy (bradycardia)
- Significantly reduced blood pressure (hypotension, systolic blood pressure below 90 mmHg)
- Increased acidity of the blood (acidosis)
- Tendency to bronchial spasm (bronchial hyperreactivity, eg. Asthma)
- Late stages of peripheral blood flow disorders
- Simultaneous administration of MAO inhibitors (except MAO B) inhibitors (drugs to treat depression)
- Untreated pheochromocytoma (hormone-producing tumor of the adrenal gland)
Intravenous administration of calcium antagonists from the group consisting of verapamil and diltiazem or other antiarrhythmics (such as disopyramide) in patients treated with AteHEXAL 25 is contraindicated (except for acute treatment).

In which case you can apply AteHEXAL 25 tablets only after consulting a doctor?
In the following conditions may take 25 tablets AteHEXAL only extreme caution.
Please consult your doctor. This also applies if you have any of these conditions in the past.
AteHEKSAL 25 can be applied only after careful evaluation of the benefit / risk ratio in the following cases:
- Slow impulse conduction of the cardiac atria to the ventricles (AV-block CAA degree)
- Patients suffering from diabetes with highly variable blood glucose (there are conditions for significantly lowering blood sugar)
- Long strict diet and heavy exercise (there are conditions for significantly lowering blood sugar)
- Patients with hormone-producing tumor of the adrenal medulla (pheochromocytoma; it is necessary to conduct pre-treatment with alpha-blockers)
- Patients with impaired renal function (see "Dosage, method and duration of administration")
- Patients with psoriasis in their personal and family history of disease
In patients suffering from overactive thyroid gland (hyperthyroidism), clinical symptoms of thyrotoxicosis may be masked (eg. Tachycardia, tremor) during therapy with AteHEKSAL 25. In patients with vasospastic angina (Prinzmetal's Prinzmetal) atenolol can to increase the number and duration of attacks of pain in the heart, due to contraction of blood vessels resulting in lack of adverse effect on alpha-receptors. AteHEXAL 25 is a selective beta-blocker, therefore, its use can be considered, but only the strictly necessary, and careful monitoring of the patients. Improvements needed caution in patients with mild abnormalities in peripheral blood supply

What special precautions should be taken?
Beta-adrenergic blocking agents may increase the sensitivity to allergens, and the severity of hypersensitivity reactions, e. general acute allergic reactions. In patients with severe hypersensitivity reactions in the history of the disease, and in patients treated for weight loss and suppress the allergic reactivity (desensitisation therapy) can be observed serious anaphylactic reactions). Since the warning signs of low blood sugar - mainly fast heart beat (tachycardia) and tremors of the fingers (tremor) may be masked in patients with diabetes, it is imperative that blood sugar levels monitored regularly. When you wear contact lenses, you should consider the possibility of reduced salzoobrazuvane. As with severe renal dysfunction observed worsening of kidney function in some cases in patients treated with other beta-adrenergic blockers, AteHEKSAL 25 should be used only with adequate monitoring of renal function. Since therapy with other beta-adrenergic blockers may arise severe hepatic impairment, liver values should be monitored at regular intervals during therapy AteHEKSAL 25.Tay as during therapy with other beta-adrenergic blockers may appear small punctate hemorrhages in the skin and mucous membranes with or without concomitant reduction in the number of platelets (thrombocytopenic purpura or netrombotsitopenichna), it is necessary to pay attention to these symptoms during treatment with AteHEKSALEdnovremennoto application AteHEKSAL-25 and calcium antagonists group verapamil or diltiazem or other antiarrhythmics (such as disopyramide) requires careful monitoring of the patient, as it may not be a strong drop in blood pressure (hypotension), significantly 'slow heart rate (bradycardia) or other abrupt rhythm narusheniya.Sled treatment with clonidine and concomitant AteHEKSAL 25 blood pressure can sharply increase. For this reason, treatment with clonidine may be suspended only if the application of AteHEKSAL 25 was suspended a few days before. Then clonidine can be stopped gradually.
What other products influence the effect of AteHEXAL 25 tablets or can be influenced by the product?
You should tell your doctor if you take other medicines produkti.Opisani following interactions when administering AteHEKSAL 25:
- Medicines that lower blood pressure, drainage products (diuretics), vasodilatory substances (vasodilators) triiiklichni antidepressants, barbiturates, phenothiazines, raising lowering effect of AteHEKSAL 25 on blood pressure
- Drugs used in heart rhythm disorders (antiaritmiii); enhancing the effect of weakening the heart (cardiodepressive effect) of 25 AteHEKSAL
- Calcium antagonists from the group consisting of verapamil and diltiazem and other antiarrhythmics (e. Disopyramide): an increased drop in blood pressure (hypotension), significantly slowing the heart rate (bradycardia) or other arrhythmias
- Calcium antagonists from the group consisting of nifedipine, increased blood pressure lowering, and in some cases, the development of the weakness of the heart muscle (heart failure) - cardiac glycosides, reserpine, alpha-methyldopa, guanfacine, clonidine, significantly slow heart rate, decrease in the cardiac conduction
- Medicines that lower blood sugar by mouth, insulin, enhance blood glucose lowering effect of AteHEKSAL 25. The warning symptoms of low blood sugar (hypoglycemia) - especially tachycardia and tremor of the fingers (tremor) are masked or reduced
- Norepinephrine, epinephrine, possibly excessively high blood nalyaganeprotivovazpalitelni medicinal products (eg. Indomethacin), blood pressure lowering effect of AteHEKSAL 25 may be reduced
- Drugs, anestetiii: increased drop in blood pressure, increased cardiodepressive effect (negative inotropic effect); the anesthetist should be informed of therapy AteHEKSAL 25
- Peripheral muscle relaxants (eg, suksametoniev halide tubocurarine): strengthening and extension of the muscle-relaxant effect resulting from the application of AteHEKSAL 25 (anesthetist should be informed of therapy AteHEKSAL® 25) Please note that these data refer also to the recently adopted medicinal products.


What foods and herbs should avoid?
No evidence of foods and spices that must be avoided.
What must comply children and elderly patients when administering AteHEXAL 25 tablets?
Children should not be treated with AteHEKSAL 25 due to insufficient data. Dosage in the elderly (over 65 years) should be adjusted depending on the extent of any impairment of renal function (see "Dosage, method and duration of administration").
What special precautions should be taken during pregnancy and lactation?
You should tell your doctor if you are pregnant or karmite.AteHEKSAL 25 can be used during pregnancy only after strict assessment of the benefit / risk ratio. Newborns should be monitored for signs of beta blockade at least 48 hours after birth. Atenolol accumulates in breast milk and reached higher concentrations than in the maternal blood. Due tazi.prichina during lactation is necessary especially carefully follow the child's physician regarding the effects of beta-blockade.
What to be aware when driving or operating machinery, or in a precarious situation (eg. Climbing stairs)?
Treatment with this product requires regular follow-up by a doctor. Because of the different individual reactions. reactivity can be reduced so that the ability to drive, operate machinery or work in precarious situation may be impaired. This applies particularly at the start of treatment with this medicine, increases or changes in dosage as well as in combination with alcohol.

Dosage, route and duration of administration:

Unless otherwise AteHEKSAL prescription of 25 tablets your doctor following dosages are recommended. Please adhere to the instructions for use, as otherwise AteHEKSAL 25 tablets will not work properly.

How much and how often you can take AteHEXAL 25 tablets?
Functional cardiovascular symptoms (eg. Hyperkinetic heart syndrome) 1 film-coated tablet once daily AteHEKSAL 25 (corresponding to 25 mg of atenolol) .In case of a drop in heart rate and / or when blood pressure requires treatment or other complications, treatment with AteHEKSAL 25 should be discontinued immediately.
Remark
In patients with renal impairment, the dose of atenolol should be determined according to renal clearance. If creatinine clearance is reduced to values 10-30 ml / min (serum creatinine less than 1.2-5 mg / dl), recommended dose reduced by half. If creatinine clearance was less than 10 ml / min (serum creatinine> 5 mg / dl), the standard recommended dosage is reduced to a quarter.
When and how you can take AteHEXAL 25 tablets?
The film-coated tablets should be swallowed and not chewed with sufficient liquid (eg. A glass of water) before eating. _
How long you can apply AteHEXAL 25 tablets?
The duration of treatment is determined by the attending physician.

What should I do if AteHEXAL 25 tablets was adopted in very large amounts (intentional or inadvertent overdose)?
Depending on the extent of possible overdose the following symptoms: fatigue, dizziness, increased sweating, visual disturbances, drowsiness, loss of consciousness, vomiting, slow heart to heart failure, myocardial failure, cardiogenic shock, difficulty breathing, and rarely generalized seizures . In case of a suspected overdose severe You need medical help! What to do if you take less than the prescribed dose of 25 tablets AteHEXAL or you forget to take the product? Do not take a double dose the next intake, but continue treatment with the prescribed dose.
What you need to know if you have discontinued or have it terminated prematurely?
Treatment may be discontinued or the dosage changed only on prescription. If you need to break long-term treatment with AteHEKSAL 25, the dosage should be reduced gradually and slowly, since abrupt withdrawal may lead to reduced blood supply to the heart (cardiac ischemia) with a further worsening of angina pectoris or lead to myocardial infarction or repeated increase of blood nalyagane.Ryazkoto discontinuation of AteHEKSAL 25 may lead to further deterioration of the hyperfunctioning thyroid (hyperthyroidism) in patients suffering from "overactive thyroid gland.

What side effects can cause the application of AteHEXAL 25 tablets?
Rarely, especially early in treatment may occur disorders of the central nervous system such as fatigue, dizziness, headache, visual disturbances sweating, drowsiness, confusion, hallucinations, psychosis; nightmares or increased dreaming activity, narushteniya sleep and depressive mood swings.
Rarely can a significant decrease in blood pressure (hypotension), significantly slow heart rate (bradycardia), fainting (syncope), impaired atrio-ventricular conduction and worsening heart nedostatachnost.V individual cases among patients suffering from a bout of pain in the heart (angina) can not be excluded enhancing cardiac pristapi.Ryadko may occur temporary gastrointestinal complaints (nausea, vomiting, constipation, diarrhea) .Ryadko may occur allergic skin reactions (erythema, itching, rash) .Ryadko observe tingling and feeling of numbness and cold (paraesthesia); rarely muscle weakness or muscle cramps. There have been complaints strengthening in patients with impaired peripheral blood flow - including patients with spasm of the arteries of the fingers (Raynaud's disease). As a result of potentially increased resistance to airway patients prone to bronchospastic reactions (especially those with obstructive pulmonary disease), can get into difficulties dishaneto.Ryadko may appear dry mouth, conjunctivitis or reduced salzoobrazuvane.V rare cases diabetes mellitus, who was not identified, signs or existing diabetes mellitus to vloshi.Sled long periods on a strict diet or heavy exercise therapy AteHEKSAL 25 may lead to lower blood sugar (hypoglycemic conditions). Warning signs of diminished 'blood sugar - especially increased heart rate (tachycardia) and tremors of the fingers (tremor) can be maskirani.V occasionally beta-adrenergic blockers (eg. AteHEXAL25) can cause psoriasis to worsen symptoms this disease or cause psoriasiform skin changes (rash) .Nablyudavani were separate cases of violations in libido and impotence. During treatment with AteHEKSAL 25 may occur disturbances in lipid metabolism. In patients with most normal levels of total cholesterol were observed to reduce the level of HDL-cholesterol, and increase plasma levels of triglitseridite.Pri patients suffering from overactive thyroid gland (hyperthyroidism), clinical symptoms of thyrotoxicosis may be masked ( eg. tachycardia, tremor) during therapy with AteHEKSAL 25.

What measures should be taken in relation to side effects?
If you are experiencing side effects not listed in this leaflet, please tell your doctor or pharmacist.
Storage Instructions:
The expiry date of the medicine is printed on the packaging. Do not use after the expiry date stated on the packaging.