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The drug is prescribed orally, regardless of food intake. With arterial hypertension, the recommended initial dose of the drug Micardis® is 1 tab. (40 mg) 1 time / day. In cases where the therapeutic effect is not achieved, the dose of the drug can be increased to 80 mg 1 time / day. When deciding whether to increase the dose, it should be taken into account that the maximum antihypertensive effect is usually achieved within 4-8 weeks after the start of treatment. To reduce cardiovascular morbidity and mortality, the recommended dose is 1 tab. (80 mg) 1 time / day. In the initial period of treatment, additional correction of blood pressure may be required. Patients with renal insufficiency (including those on hemodialysis) no dose adjustment is required. In patients with mild and moderate hepatic impairment (class A and B on the Child-Pugh scale) the daily dose of the drug should not exceed 40 mg. The dosage regimen in elderly patients does not require changes.
The observed cases of side effects did not correlate with the gender, age or race of the patients. Infections: sepsis, including fatal sepsis, urinary tract infections (including cystitis), upper respiratory tract infections. From the hematopoiesis system: anemia, eosinophilia, thrombocytopenia. From the Central nervous System: insomnia, anxiety, depression, fainting, vertigo. From the side of the organ of vision: visual disorders. From the cardiovascular system: marked decrease in blood pressure, orthostatic hypotension, bradycardia, tachycardia. From the respiratory system: shortness of breath. From the digestive system: abdominal pain, diarrhea, dry mouth, dyspepsia, flatulence, stomach discomfort, vomiting, liver dysfunction/liver disease* (*according to the results of post-marketing observations, in most cases liver dysfunction/liver disease were detected in Japanese patients). Allergic reactions: anaphylactic reactions, hypersensitivity (erythema, urticaria, angioedema), eczema, itching, rash (including medicinal), angioedema (fatal), toxic rash, hyperhidrosis. From the musculoskeletal system: arthralgia, back pain, muscle spasms (cramps of the calf muscles), pain in the lower extremities, myalgia, tendon pain (symptoms similar to the manifestation of tendinitis). From the urinary system: impaired renal function (including acute renal failure). From the laboratory indicators: decrease in hemoglobin, increased concentration of uric acid and creatinine in the blood, increased activity of liver enzymes, increased activity of CPK, hyperkalemia, hypoglycemia (in patients with diabetes mellitus). Other: chest pain, flu-like syndrome, general weakness.