Drug reference
Oedema ▶BY MOUTH ▶Adult: Initially 40 mg daily, dose to be taken in the morning, increased if necessary to 80 mg daily, higher dose to be used in resistant cases; maintenance 20 mg daily, dose to be taken in the morning Hypertension ▶BY MOUTH ▶Adult: 20 mg daily, dose to be taken in the morning
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Acute porphyrias p. 1120
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→Appendix 1: thiazide diuretics
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▶Common or very common Anxiety. gastrointestinal discomfort. gouty arthritis. hyperhidrosis. lethargy. muscle complaints. palpitations ▶Rare or very rare Cholecystitis acute. hyperlipidaemia. jaundice. nephritis acute interstitial. pancreatitis haemorrhagic. vision disorders
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No information available.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Diurexan (Mylan) Cardiovascular system Xipamide 20 mg Diurexan 20mg tablets | 140 tablet P £19.46 DT = £19.46 10 Vascular disease Peripheral vascular disease Classification and management Peripheral vascular disease can be either occlusive (e.g. intermittent claudication) in which occlusion of the peripheral arteries is caused by atherosclerosis, or vasospastic (e.g. Raynaud’s syndrome). Peripheral arterial occlusive disease is associated with an increased risk of cardiovascular events; this risk is reduced by measures such as Smoking cessation p. 520, effective control of blood pressure, regulating blood lipids, optimising glycaemic control in diabetes, taking aspirin p. 130 in a dose of 75 mg daily, and possibly weight reduction in obesity. Exercise training can improve symptoms of intermittent claudication; revascularisation procedures may be appropriate. Naftidrofuryl oxalate p. 247 can alleviate symptoms of intermittent claudication and improve pain-free walking distance in moderate disease. Patients taking naftidrofuryl oxalate should be assessed for improvement after 3–6 months. Cilostazol below is licensed for use in intermittent claudication to improve walking distance in patients without peripheral tissue necrosis who do not have pain at rest; use is restricted to second-line treatment where lifestyle modifications and other appropriate interventions have failed to improve symptoms. Cilostazol should be initiated by those experienced in the management of intermittent claudication. Patients receiving cilostazol should be assessed for improvement after 3 months; consider discontinuation of treatment if there is no clinically relevant improvement in walking distance. Inositol nicotinate p. 247 and pentoxifylline p. 248 are not established as being effective for the treatment of intermittent claudication. Intravenous iloprost p. 197 is a treatment option for critical limb ischaemia in patients unsuitable for surgery. Management of Raynaud’s syndrome includes avoidance of exposure to cold and Smoking cessation p. 520. More severe symptoms may require vasodilator treatment, which is most often successful in primary Raynaud’s syndrome. Nifedipine p. 174 is useful for reducing the frequency and severity of vasospastic attacks. Alternatively, naftidrofuryl oxalate may produce symptomatic improvement; inositol nicotinate (a nicotinic acid derivative) may also be considered. Pentoxifylline, prazosin p. 827, and moxisylyte p. 247 are not established as being effective for the treatment of Raynaud’s syndrome. Vasodilator therapy is not established as being effective for chilblains. Advanced Pharmacy Services Patients with peripheral vascular disease may be eligible for the Medicines Use Review service provided by a community pharmacist. For further information, see Advanced Pharmacy Services in Medicines optimisation p. 18. ANTITHROMBOTIC DRUGS › ANTIPLATELET DRUGS
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Initially 40 mg daily, dose to be taken in the
First-line fragment. Read the complete Indications and Dose section above.
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20 mg daily, dose to be taken in the morning
First-line fragment. Read the complete Indications and Dose section above.
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