Product Overview
[Drug Name]
Generic Name: Compound Dibazole Hydrochlorothiazide Capsules
Trade Name: Honeysuckle Compound Dibazole Hydrochlorothiazide Capsules, 60 Capsules
Pinyin Code: inYinHuFuFanDiaZuQingLZuoZuoloNan60L
[Main Ingredients]
Dibazole, promethazine hydrochloride, chloroquine phosphate, guanidine sulfate, vitamin B6, potassium chloride, reserpine, chlordiazepoxide, hydrochlorothiazide, calcium lactate, vitamin B1, magnesium trisilicate.
[Properties]
This product consists of white or off-white granules or powder.
[Indications/Main Functions]
For hypertension.
[Specifications]
60 capsules
[Dosage and Administration]
Oral. The usual dosage is one capsule three times daily, or as directed by a physician.
[Adverse Reactions]
1. Long-term use of this product may cause diarrhea, dizziness, fatigue, weakness, dry mouth, drowsiness, loss of appetite, nausea, vomiting, and nasal congestion. Symptoms may also include tinnitus, rash, headache, dizziness, depression, and bradycardia. If symptoms persist, exercise caution. 2. Be aware of orthostatic hypotension, electrolyte imbalance, hypokalemia, hyponatremia, and hypoxemia. 3. This product contains reserpine, which may cause parkinsonism, depression, and worsening symptoms of peptic ulcers. 4. The nitrogen in this product may cause withdrawal symptoms, including insomnia, abnormal irritability, and nervousness after discontinuation. The elderly, frail, and patients with liver disease are more sensitive to its central nervous system inhibitory effects.
[Contraindications]
1. Contraindicated for pregnant and lactating women. 2. Contraindicated for infants and young children. 3. Contraindicated for patients with severe hepatic and renal insufficiency. 4. Contraindicated for patients with severe heart failure. 5. Contraindicated for patients allergic to any of the ingredients in this product.
[Drug Interactions]
1. Myostatin sulfate: (1) When used with ethanol, barbiturates, and sleeping pills, it may aggravate orthostatic hypotension. (2) When used with amphetamine or other appetite suppressants, phenothiazines, tricyclic antidepressants, etc., the orthostatic hypotensive effect is weakened. (3) When used with hypoglycemic drugs, it may enhance the hypoglycemic effect and the dose must be adjusted. (4) When used with nonsteroidal anti-inflammatory analgesics, the antihypertensive effect of this product is weakened because the former may inhibit renal prostaglandin synthesis and cause water and sodium retention. (5) When used with other antihypertensive drugs such as reserpine, α or β blockers, it may increase orthostatic hypotension. It is generally not recommended to use it with minoxidil. (6) When used with sympathomimetics, the antihypertensive effect of this product is weakened and the pressor effect of sympathomimetics is enhanced. When used with metaraminol, this product may cause hypertensive crisis. . 2. Promethazine hydrochloride: (1) When ethanol or other central nervous system depressants, especially anesthetics, barbiturates, monoamine oxidase inhibitors or tricyclic antidepressants are used together with this product, they can enhance the effects of promethazine or (and these drugs, the dosage needs to be adjusted separately, (2) When anticholinergic drugs, especially atropine drugs, are used together with promethazine, the antimuscarinic effect of the latter is enhanced. (3) When antihypertensive drugs such as brombenzylamine, debrisoquine or guanethidine are used together with promethazine, the antihypertensive effect of the former is enhanced. When epinephrine is used together with promethazine, the α effect of epinephrine can be blocked, and the β effect is dominant. (4) When ototoxic drugs such as cisplatin, baromone toxin and other aminoglycoside antibiotics, salicylic acid preparations and vancomycin are used together with promethazine, their ototoxicity Sexual symptoms can be masked. 3. Reserpine: (1) When used in combination with ethanol or CNS depressants, it can aggravate the central nervous system inhibitory effect; (2) When used in combination with other antihypertensive drugs or diuretics, it can enhance the antihypertensive effect and requires dose adjustment. When used in combination with β-blockers, it can enhance the effect of the latter; (3) When used in combination with digitalis or quinidine, large doses can cause arrhythmias; (4) When used in combination with levodopa, it can deplete dopamine and lead to Parkinson's disease; (5) When used in combination with indirect adrenergic drugs such as ephedrine, phenylephrine, etc., it can deplete catecholamine storage and inhibit the effect of adrenergic drugs; (6) When used in combination with direct adrenergic drugs such as epinephrine, isoproterenol, norepinephrine, metaraminol, phenylephrine, etc., it can prolong the effect; (7) When used in combination with tricyclic antidepressants When used together, the effects of reserpine and antidepressants are weakened; (8) Barbiturates can enhance the central sedative effect of reserpine. 4. Hydrochlorothiazide: (1) Adrenocortical hormone, adrenocorticotropic hormone, estrogen, and amphotericin B (intravenous administration) can reduce the diuretic effect of this drug and increase the chance of electrolyte imbalance, especially hypokalemia. (2) Non-steroidal anti-inflammatory analgesics, especially indomethacin, can reduce the diuretic effect of this drug, which is related to the former's inhibition of prostaglandin synthesis. (3) When used together with sympathomimetic amines, the diuretic effect is weakened. (4) Cholestyramine (cholestyramine) can reduce the gastrointestinal absorption of this drug, so this drug should be taken 1 hour before or 4 hours after oral administration of cholestyramine. (5) When used together with dopamine, the diuretic effect is enhanced. (6) When used together with antihypertensive drugs, the diuretic effect is reduced. The antihypertensive effect is enhanced. (7) When used in combination with anti-gout drugs, the latter should adjust the dosage. (8) It weakens the effect of anticoagulants, mainly because the plasma volume of the body decreases after diuresis, the level of coagulation factors in the blood increases, and diuresis improves the blood supply to the liver, which increases the synthesis of coagulation factors. (9) It reduces the effect of hypoglycemic drugs. (10) When digitalis drugs, amiodarone, etc. are used in combination with this drug, side effects caused by hypokalemia should be carefully prevented. (11) When used in combination with lithium preparations, this drug can reduce the kidney's clearance of lithium and increase the nephrotoxicity of lithium. (12) When hexamethylenetetramine is used in combination with this drug, the former is inhibited from converting to formaldehyde, and the efficacy is reduced. (13) It enhances the effect of non-depolarizing muscle relaxants, which is related to the decrease in blood potassium. (14) When used in combination with sodium bicarbonate, the chance of hypoxic alkalosis increases. 5. Oxygen and nitrogen: (1) When this product is used in combination with addictive and other potentially addictive drugs, the risk of addiction increases. (2) When used in combination with alcohol and general anesthetics, clonidine, analgesics, monoamine oxidase inhibitors and tricyclic antidepressants, they can enhance each other's effects. (3) When used in combination with antacids, the absorption of this product can be delayed. (4) When this product is used in combination with antihypertensive drugs or diuretic antihypertensive drugs, the antihypertensive effect can be enhanced. (5) When this product is used in combination with calcium channel antagonists, hypotension can be aggravated. (6) When this product is used in combination with cimetidine, it can inhibit the liver metabolism of this product, thereby slowing down its clearance and increasing the blood concentration. (7) When this product is used in combination with propranolol, the type and (or) frequency of epileptic seizures can be changed, and the dose should be adjusted in time. (8) When this product is used in combination with carbamazepine, due to the liver microsome Enzyme induction can reduce the blood concentration of both drugs and shorten the elimination half-life. (9) When this product is used in combination with levodopa, the latter's efficacy can be reduced. (10) When this product is used in combination with the antifungal drugs ketoconazole and itraconazole, the efficacy of this product can be improved and its toxicity can be increased.
[Precautions]
1. Interference with diagnosis: This compound preparation contains promethazine, which can show increased glucose tolerance in the glucose tolerance test. It can interfere with the urine pregnancy immunoassay, resulting in false positive or false negative results. 2. Use with caution in the following situations: ① Those with a history of asthma may suffer from catecholamine depletion and aggravate the disease or aggravate it; ② Those with incomplete cerebral vascular blood supply may aggravate cerebral ischemia due to low blood pressure; ③ Heart failure caused by non-hypertension may be aggravated by fluid retention; ④ Those with insufficient coronary blood supply and those who have recently suffered myocardial infarction may Aggravation of myocardial ischemia due to decreased blood pressure; ④ This drug enhances the effects of hypoglycemic drugs in diabetes; In liver dysfunction, this drug's metabolism is slowed, leading to accumulation in the body; In patients with peptic ulcers, this drug may aggravate their condition due to the relative increase in parasympathetic tone; In patients with pheochromocytoma, this drug may aggravate their condition due to the initial increased release of catecholamines; In patients with renal insufficiency, this drug reduces glomerular filtration rate and renal blood flow, leading to hypotension and temporary urinary retention due to accumulation of this drug; this drug may aggravate bradycardia. 3. This compound preparation contains promethazine hydrochloride: Special attention should be paid to the presence of intestinal obstruction, drug overdose, or poisoning, as symptoms and signs may be masked by the antiemetic effect of promethazine; ② Cross-sensitivity. Patients with a known hypersensitivity to phenothiazines may also be allergic to this drug.
[Pediatric Use]
Antihistamines pose a significant risk to infants, especially newborns and premature infants, and are therefore contraindicated in infants and young children.
[Elderly Use]
Elderly individuals are sensitive to antihypertensive effects, and renal function may decline with aging, so the dosage should be reduced.
[Overdose]
Unclear information is available.
[Pharmacology and Toxicology]
This product is a combination antihypertensive drug. Dibazole has a direct relaxant effect on vascular smooth muscle, reducing external resistance and thus lowering blood pressure. It also has an antispasmodic effect on gastrointestinal smooth muscle. Reserpine achieves its antihypertensive, heart rate-lowering, and central nervous system-depressing effects by depleting norepinephrine from peripheral sympathetic nerve endings and depleting catecholamine and serotonin stores in the heart, brain, and other tissues. The antihypertensive effect is primarily achieved by reducing cardiac output, lowering peripheral resistance, and partially inhibiting cardiovascular reflexes. The heart rate-lowering effect is not significant in patients with a normal heart rate, but is noticeable in patients with sinus tachycardia. Reserpine acts on the hypothalamus to produce a sedative effect, but does not cause drowsiness or anesthesia. It does not alter the EEG during sleep and can relieve anxiety, tension, and headaches in patients with hypertension. In the early stages of treatment, hydrochlorothiazide, through diuresis and sodium excretion, reduces plasma and extracellular fluid volume, blood volume, and cardiac output, thereby lowering blood pressure. With prolonged administration, blood volume and cardiac output may return to their original levels, but total peripheral vascular resistance decreases, and blood pressure may still be lowered. Guanidine sulfate selectively acts on sympathetic postganglionic adrenergic nerve endings, slowly replacing and releasing stored norepinephrine. This depletes the norepinephrine that is normally present in nerve endings and tissues. It also blocks the normal release of norepinephrine in response to nerve stimulation, weakening vasoconstriction. This, in particular, blunts sympathetic nerve responses and reduces the expected excitation during changes in body position, thereby lowering blood pressure. The mechanism by which promethazine hydrochloride suppresses the central nervous system has not been fully elucidated, but it may indirectly reduce the excitability of the brainstem reticular activating system. It also has anti-motion sickness effects. The mechanism of action of chlordiazepoxide is related to its selective action on the limbic system, where it binds to central benzodiazepine receptors, promoting the release of gamma-aminobutyric acid and enhancing synaptic transmission. This drug also has central muscle relaxant and anticonvulsant effects. At low doses, it has anxiolytic effects, while increasing doses can produce sedation, hypnosis, and memory impairment. Potassium chloride and calcium lactate in the compound are used to supplement potassium and calcium. Magnesium trisilicate has a mild laxative effect. Nonclinical acute toxicity studies show an LD50 of 10.525 g/kg. (Feiller correction) 95% confidence interval = 9.5731-11.592 g/kg.
