Antihypertensive drugs are a group of drugs used when blood pressure is too high.
The goal of a healthy person is to have systolic blood pressure between 130 and 140 mmHg and diastolic blood pressure below 90 mmHg. Treatment is long-term with regular monitoring of blood pressure and an electrocardiogram to check the effectiveness of the treatment.
If one drug is not enough to reduce high blood pressure, two antihypertensive agents may be prescribed to the patient.
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Blood pressure or arterial pressure is the pressure of blood in the arteries of the systemic circulation.
It is naturally regulated at different levels: the renal, hormonal, and nervous levels. In addition, it varies with the rhythm of the heart and is expressed in two quantities: the first is the systolic pressure, which is the maximum pressure during the contraction of the heart, and the second is the diastolic pressure, which is the minimum pressure during the relaxation of the heart.
In addition, pressure changes according to various situations such as stress or sleep.
Antihypertensive drugs have a variety of actions and include diuretics, ACE inhibitors, calcium channel blockers (antagonists), vasodilators, antihypertensives, angiotensin II receptor antagonists, beta-blockers, and antihypertensives.
Diuretics are the oldest drugs and also the most studied. They remove some of the water and sodium from the blood by the kidneys and reduce the amount of fluid circulating in the arteries to reduce pressure on the walls of the heart and blood vessels. There are two families of diuretics: thiazide diuretics and hyperkalemic diuretics. The former enhances the natural excretion of water by the kidneys, reducing blood volume and blood pressure. The latter also contributes to the excretion of water by the kidneys but has an effect opposite to that of aldosterone. Indeed, they make it easier to extract water and sodium instead of potassium.
Lasix prevents the absorption of sodium, chlorides, and water filtered from the fluid into the renal tubules, causing a significant increase in diuresis. The onset of action after oral administration occurs within an hour, sometimes suddenly, and lasts about 5-8 hours. The action after the injection occurs faster – after 10 minutes, and diuresis persists for 2-3 hours. The diuretic action of furosemide can destroy sodium chloride and other minerals in the body. Therefore, during treatment, careful medical supervision is necessary.
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Lasix is a powerful diuretic used to treat severe body edema resulting from heart failure, liver cirrhosis, chronic kidney disease, and nephrotic syndrome. It is usually used alone or in combination with other high blood pressure pills.
Lasix is a loop diuretic. Due to the increased release of sodium ions, a secondary (osmotic water binding) increase in water excretion and an increase in the secretion of potassium ions in the distal parts of the renal tubules occur. Simultaneously, the excretion of calcium and magnesium ions increases.
Heart failure quickly leads to a decrease in the preload on the heart due to the expansion of large veins. It has a hypotensive effect by increasing the excretion of sodium chloride and reducing the response of vascular smooth muscle to vasoconstrictive effects. The action of furosemide after ingestion – after 30-60 minutes, the maximum effect – after 1-2 hours, the duration of the effect – 2-3 hours (with reduced kidney function – up to 8 hours). During the period of action, the excretion of sodium ions increases significantly, but after its completion, the rate of excretion decreases below the initial level (“withdrawal” syndrome).
After oral administration, absorption is from 60 to 70%. In severe renal failure or chronic heart failure, the degree of absorption is reduced.
Dosage and method of application of Lasix
The daily dose and regimen of the drug are set individually, depending on the therapeutic response, while determining the minimum effective dose. The medicine can be taken every day or every other day.
Adults: The initial single dose is 40 mg. Until a maintenance dose is reached, further dosage adjustments may be required. In mild cases, a dose of 40 mg every other day may be sufficient. For resistant edema, the usual dose is 80 mg/day or more, once or twice daily or as needed. With severe edema, a gradual increase in dose up to 600 mg/day is possible. The maximum daily dose for adults is 1500 mg.
Edema syndrome in chronic renal failure: the recommended initial dose is 40 to 80 mg/day. Patients with chronic renal failure require careful dose selection, and its gradual increase, so that fluid loss occurs gradually. In patients on hemodialysis, the usual maintenance dose is 250 to 1500 mg/day.
Edema in nephrotic syndrome: the initial dose is from 40 to 80 mg/day. The required dose is selected depending on the diuretic reaction.
Edema syndrome in liver diseases: initial dose – 40-80 mg/day. Lasix is indicated in addition to treatment with aldosterone antagonists if these are not effective enough. To prevent the development of complications, such as impaired orthostatic regulation of blood flow or impaired electrolyte status or acid-base balance, careful dose selection is necessary so that fluid loss occurs gradually (at the beginning of treatment, fluid loss is up to about 0.5 kg). / day).
High blood pressure: Lasix can be used alone or in combination with other antihypertensive agents. The usual maintenance dose is 40 mg/day. When adding furosemide to already prescribed drugs, their dose should be reduced by 2 times. With an increase in blood pressure associated with chronic renal failure, higher doses of the drug may be required.
Elderly patients. In elderly patients, furosemide is excreted more slowly, therefore, if necessary, dose adjustment is possible to achieve a therapeutic effect.
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Influence on the ability to drive a car and other vehicles. Some side effects (for example, a significant decrease in blood pressure) can impair the ability to concentrate and reduce psychomotor reactions, which can be dangerous when driving a car or engaging in other potentially hazardous activities. This is especially true when starting a treatment or increasing the dose of the drug, as well as in cases of simultaneous use of antihypertensive drugs or alcohol. In such cases, it is not recommended to drive vehicles or engage in potentially hazardous activities.