Myden 4 mg. 30 tablets

What MYDEN and what it is used
MYDEN is an angiotensin converting enzyme (ACE). It works by widening the blood vessels, which helps the heart to pump blood through them more easily.

MYDEN used for:
treatment of high blood pressure (hypertension);
treatment of heart failure (a condition in which the heart is unable to pump enough blood to meet the needs of the organism);
reduce the risk of heart complications such as heart attack in patients with stable coronary artery disease (a condition in which blood supply to the heart is reduced or blocked) and who have already had a heart attack and / or surgery to improve blood flow to the heart by expanding vessels that feed it.

2. What you need to know before taking MYDEN
Do not take MYDEN
if you are allergic to perindopril, to any other ACE inhibitor or any of the other ingredients of this medicine (listed in section 6);
if you are pregnant after 3 months or breast-feeding. (It is good to avoid Mussel in early pregnancy);
If you have had symptoms such as wheezing, swelling of the face, tongue or throat, intense itching or severe skin rashes with previous treatment with an ACE inhibitor or if you or a member of your family have had these symptoms in any other circumstances (a condition called angioedema);
if you have diabetes or impaired kidney function and you are treated with medication to lower blood pressure containing aliskiren.
Warnings and Precautions
Talk to your doctor or pharmacist before taking MYDEN use:
if you have aortic stenosis (narrowing of the main blood vessel leaving the heart), hypertrophic cardiomyopathy (heart muscle disease) or renal artery stenosis (narrowing of the artery supplying the kidney with blood);
if you have other heart problems;
if you have liver problems;
if you have kidney problems or are on dialysis;
if you have collagen vascular disease (disease of the connective tissue) such as systemic lupus erythematosus or scleroderma;
if you have diabetes;
if you are on a diet, limiting salt and use salt substitutes that contain potassium;
if you are anesthesia and / or major surgery, if you are LDL-apheresis (removal of cholesterol from the blood through a machine) or if you are undergoing treatment for desensitization to reduce the effects of an allergy to bee stings or wasp;
If you have recently had diarrhea or vomiting or are dehydrated;
if you are told by your doctor that you have an intolerance to some sugars;
if you are of Afro-Caribbean origin;
if you are taking any of these medicines used to treat high blood pressure:
angiotensin II-receptor blocker (ARB) (also known as sartans - for example valsartan, telmisartan, irbesartan), especially if you have kidney problems associated with diabetes;
aliskiren.
Your doctor may periodically check your kidney function, blood pressure and the amount of electrolytes (eg. Potassium) in your blood.
See also the information titled "Do not take MYDEN
You should tell your doctor if you think you are (or plan to become pregnant). Mussel is not recommended in early pregnancy and must not be taken if pregnancy after 3 months, as it may cause serious harm to your baby (see. Pregnancy, breastfeeding and fertility).

Children and adolescents
Mussel is not recommended for use in children and adolescents under 18 years of age.

Other medicines and MYDEN
Tell your doctor or pharmacist if you are taking, you have recently taken or might take any other medicines.

MYDEN treatment can be affected by other medicines. Among them are:
other medicines for high blood pressure, including diuretics (drugs that increase the amount of urine from the kidneys);
potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium supplements or potassium-containing salt substitutes;
lithium for mania or depression;
NSAIDs (eg., ibuprofen) relieve pain or high doses of aspirin;
drugs for the treatment of diabetes (such as insulin or metformin);
baclofen (used for the treatment of muscle stiffness in diseases such as multiple sclerosis);
medicines to treat psychiatric disorders such as depression, anxiety, schizophrenia and others. (Eg. Tricyclic antidepressants, antipsychotics);
immunosuppressants (medicines that reduce the body's defenses) used for the treatment of autoimmune diseases or after transplant surgery (eg. cyclosporin, drugs with gold as the active ingredient);
trimethoprim (to treat infection);
estramustine (used in the treatment of cancer);
allopurinol (for gout);
procainamide (to treat irregular heart beat);
vasodilators, including nitrates (products that widen blood vessels);
heparin (medicines used to thin the blood);
drugs used for treating low blood pressure, shock or asthma (eg. ephedrine, noradrenaline or adrenaline);
gold salts, in particular when administered intravenously (used to treat the symptoms of rheumatoid arthritis).
You may need your doctor may change your dose and / or take other precautions: If you are taking an angiotensin II-receptor blocker (ARB) or aliskiren (see also information entitled "Do not take Mussel" and "Warnings and Precautions".

Mussel with food and drink:
It is recommended MYDEN be taken before meals.

Pregnancy, lactation and fertility
If you are pregnant or breast-feeding, you think you may be pregnant or planning to become pregnant, ask your doctor or pharmacist before taking this medicine.

pregnancy
You should tell your doctor if you think you are (or plan to become pregnant). Your doctor will advise you to stop taking Mussel before you become pregnant or as soon as you know you are pregnant and taking another medicine instead of Mussel.
Mussel is not recommended in early pregnancy, and should not be accepted if the pregnancy after 3 months, 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. Mussel is not recommended for nursing mothers, and your doctor may choose another treatment if you want to breastfeed ocobeno if your baby is newborn, or was born prematurely.

Driving and using machines
MYDEN usually does not affect alertness, but some patients may experience dizziness or weakness due to low blood pressure. If you are affected in this way, the ability to drive or operate machinery may be impaired. Contact your doctor if you are unsure.

MYDEN contains lactose. If you are told by your doctor that you have an intolerance to some sugars, contact him before taking this medicine.

3. How to use MYDEN
Always take this medicine exactly as you have been told by your doctor or pharmacist. If you're not sure, ask your doctor or pharmacist. Your doctor will determine the correct dose for you. Perindopril may be used alone or with other medicines that lower blood pressure.
If you are taking water tablets (diuretics), your doctor may decide to reduce or even discontinue their use in early therapy with perindopril.
Swallow the tablet with a glass of water, preferably at the same time each day, in the morning before eating.

Customary dosages are as follows:
High blood pressure
The usual starting and maintenance dose is 4 mg once daily. After a month, can be increased to 8 mg once daily, if necessary. 8 mg per day is the maximum recommended dose for high blood pressure.
If you are over 65, the usual starting dose is 2 mg once daily. After a month, it may be increased to 4 mg once daily and then, if necessary, to 8 mg once daily.

Heart failure
The usual starting dose is 2 mg once daily. After two weeks it may be increased to 4 mg once daily, which is the maximum recommended dose for heart failure.

Stable coronary artery disease
The usual starting dose is 4 mg once daily. After two weeks it may be increased to 8 mg once daily, which is the maximum recommended dosage for this disease.
If you are over 65, the usual starting dose is 2 mg once daily. After a week, it may be increased to 4 mg once daily, and after another week to 8 mg once daily.

kidney problems
If you have kidney problems, your doctor may prescribe a different dosing schedule.

Use in children and adolescents
Mussel is not recommended for use in children and adolescents under 18 years of age.
The tablet can be divided into equal doses.

If you take more than the amount MYDEN
If you take more than the prescribed dose, contact your nearest emergency room or your doctor immediately. Bring the medicine pack with you.
The most likely effect in case of overdose is low blood pressure which can make you feel dizzy or weak. If this happens, lying down with elevation of feet high can help.

Other symptoms of overdose include:
circulatory shock;
electrolyte abnormalities;
kidney failure;
hyperventilation (rapid breathing);
tachycardia (faster than normal heart rate);
bradycardia (slower than normal heart rate);
palpitations (irregular and / or strong heartbeat);
dizziness, anxiety;
cough.
If you forget to take MYDEN
Do not take a double dose to make up the missed dose. If you forget to take a dose Mussel, take the next dose at the usual time.

If you stop taking Mussel
As Mussel treatment is usually lifelong, you should consult with your doctor before you stop taking this medicine.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

If you have any of these symptoms, stop taking the drug immediately and contact your doctor immediately:
swelling of the face, lips, mouth, tongue or throat;
difficulty breathing;
severe dizziness or fatigue;
unusually fast or irregular heartbeat;
severe abdominal pain.
It has also been reported the following adverse reactions:
Common (may affect up to 1 in 10 users):
headache, dizziness, vertigo;
tingling of the extremities;
visual disturbances, tinnitus (sensation of tinnitus);
dizziness due to low blood pressure;
cough, shortness of breath;
gastrointestinal disturbances (nausea, vomiting, abdominal pain, taste disturbances, dyspepsia or difficulty of digestion, diarrhea, constipation);
Allergic reactions (eg skin rashes, itching);
muscle cramps;
fatigue, weakness.
Uncommon (may affect up to 1 in 100 users):
mood swings;
sleep disturbances;
bronchospasm (chest tightness, wheezing and shortness of breath);
dry mouth;
angioedema (symptoms such as wheezing, swelling of the face, tongue or throat, intense itching or severe skin rashes);
kidney problems;
erectile dysfunction;
sweating;
hypoglycaemia (very low blood sugar) can occur in patients with diabetes;
vasculitis (inflammation of blood vessels);
changes in laboratory parameters: high blood potassium reversible on stopping low level of sodium;
drowsiness, loss of consciousness;
palpitations, tachycardia;
photosensitivity reaction (increased skin sensitivity to the sun), pemphigoid;
arthralgia (joint pain), myalgia (muscle pain);
chest pain, malaise, peripheral edema, fever.
Very rare (may affect up to 1 in 10,000 users):
confusion;
cardiovascular disorders (cardiac rhythm disorders, angina, heart attack and stroke), eosinophilic pneumonia (a rare type of pneumonia), rhinitis (stuffy or runny nose);
erythema multiforme (acute, self-limiting inflammatory skin rash);
diseases of the blood, pancreas or liver;
acute renal failure.

By reporting side effects, you can do your bit for getting more information on the safety of this medicine.

5. How to store MYDEN
Keep out of reach of children.
Store at temperatures below 25 ° C. Store in the original container and keep blisters in the laminated bag, which protects them from moisture. Use within 60 days after opening the bag.
The package contains a desiccant which should not be swallowed.
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.