{"product_id":"fortekor-plus-1-25-2-5-mg-10-cp-for-dogs","title":"FORTEKOR PLUS 30 cp for Dogs \/\/ Benzepril + Pimobendan","description":"\u003cdiv\u003e\n\u003col\u003e\n\u003cli\u003e\u003cspan\u003e\u003cstrong\u003eNAME OF THE VETERINARY MEDICINAL PRODUCT\u003c\/strong\u003e\u003c\/span\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 1.25 mg\/2.5 mg tablets for dogs FORTEKOR PLUS 5 mg\/10 mg tablets for dogs\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003cspan\u003eQUALITATIVE AND QUANTITATIVE COMPOSITION\u003c\/span\u003e\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eEach tablet contains:\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eActive substances:\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003ePimobendan\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eBenazepril\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003ehydrochloride\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 1.25 mg\/2.5 mg tablets\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e1.25 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2.5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 5 mg\/10 mg tablets\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e10 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eExcipients:\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eBrown oxide\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eiron E172\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 1.25 mg\/2.5 mg tablets\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0.5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 5 mg\/10 mg tablets\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eFor the full list of excipients, see section 6.1.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003cspan\u003ePHARMACEUTICAL FORM\u003c\/span\u003e\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cspan\u003eOval, bilayer tablets, white and light brown, with a score line on both sides.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe tablets can be divided into equal halves.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003cspan\u003eCLINICAL PARTICULARS\u003c\/span\u003e\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cspan\u003e4.1  \u003cstrong\u003e    Target species\u003c\/strong\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDogs.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e4.2    \u003cstrong\u003e  Indications for use, specifying the target species\u003c\/strong\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eFor the treatment of congestive heart failure due to atrioventricular valve insufficiency or dilated cardiomyopathy in dogs. FORTEKOR PLUS is a fixed-dose combination and should only be used in subjects whose clinical signs are successfully treated by simultaneous administration of the same doses of the individual components (pimobendan and benazepril hydrochloride).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e4.3      \u003cstrong\u003eContraindications\u003c\/strong\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIt is not used in case of hypertrophic cardiomyopathies or clinical conditions in which increasing the heart rate is not possible for functional or anatomical reasons (e.g. aortic or pulmonary stenosis).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDo not use in case of hypotension, hypovolemia, hyponatremia or acute renal failure.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDo not use during pregnancy and lactation (see section 4.7).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDo not use in case of hypersensitivity to the active substances or any of the excipients.\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.4 Special warnings for each target species\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIt doesn't exist.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.5 Special precautions for use\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn the case of chronic kidney disease, it is recommended to check the dog's hydration status before starting therapy and to monitor plasma creatinine and the number of erythrocytes in the blood during therapy.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eAs pimobendan is metabolised in the liver, the product should not be administered to dogs suffering from severe hepatic impairment.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe efficacy and safety of the product have not been established in dogs weighing less than 2.5 kg or under 4 months of age.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eSpecial precautions to be taken by the person administering the veterinary medicinal product to animals\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eWash your hands after use.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePeople with known hypersensitivity to pimobendan or benazepril hydrochloride should avoid contact with the veterinary medicinal product.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn case of accidental oral ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePregnant women should take special care to avoid accidental oral exposure, as angiotensin-converting enzyme (ACE) inhibitors have been shown to affect the fetus during human pregnancy.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.6 Adverse reactions (frequency and seriousness)\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePimobendan\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn rare cases, a moderate positive chronotropic effect and vomiting may occur. These effects are, however, dose-dependent and can be avoided by reducing the dose in such situations.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn rare cases, transient diarrhea, anorexia or lethargy have been observed.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eBenazepril hydrochloride\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eA small number of dogs may experience transient vomiting, incoordination, or signs of fatigue. In dogs with chronic kidney disease, benazepril may increase plasma creatinine levels at the beginning of therapy. The modest increase in plasma creatinine levels following administration of ACE inhibitors is consistent with the reduction in glomerular hypertension induced by these agents, so there is no reason to stop treatment in the absence of other signs.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eThe frequency of adverse reactions is defined using the following convention:\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- very common (more than 1 in 10 animals showing adverse reactions during a treatment)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- common (more than 1 but less than 10 animals in 100 animals)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- uncommon (more than 1 but less than 10 animals in 1,000 animals)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- rare (more than 1 but less than 10 animals in 10,000 animals)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- very rare (less than 1 animal in 10,000 animals, including isolated reports)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.7 Use during pregnancy or lactation Do not use during pregnancy or lactation.\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe safety of FORTEKOR PLUS has not been tested in dogs during breeding, gestation or lactation.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLaboratory studies in rats and rabbits with pimobendan have shown fetotoxic effects at maternally toxic doses. Laboratory studies in rats and rabbits with pimobendan have shown no effect on fertility. Laboratory studies in rats have shown that pimobendan is excreted in milk.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLaboratory studies in rats with benazepril have shown fetotoxic effects (fetal urinary tract malformation) at maternally non-toxic doses. It is not known whether benazepril is secreted in the milk of lactating bitches.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.8 Interaction with other medicinal products and other forms of interaction\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn dogs with congestive heart failure, benazepril hydrochloride and pimobendan have been administered in combination with digoxin and diuretics without demonstrable adverse interactions.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn pharmacological studies, no interaction was detected between the cardiac glycoside ouabain and pimobendan. The increase in cardiac contractility induced by pimobendan is attenuated in the presence of the calcium antagonist verapamil and the β-antagonist propranolol.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn humans, the combination of angiotensin converting enzyme (ACE) inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs) may lead to reduced antihypertensive efficacy or renal impairment. Therefore, the concomitant use of FORTEKOR PLUS with NSAIDs or any other drug with a hypotensive effect should be carefully considered before using such combinations.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe combination of FORTEKOR PLUS and other antihypertensive agents (e.g. calcium channel blockers, β-blockers or diuretics), anaesthetics or sedatives may lead to additive hypotensive effects. Renal function and signs of hypotension (lethargy, weakness, etc.) should be closely monitored and treated as necessary.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eInteractions with potassium-sparing diuretics such as spironolactone, triamterene or amiloride cannot be excluded. Therefore, monitoring of plasma potassium levels is recommended when FORTEKOR PLUS is used in combination with potassium-sparing diuretics due to hyperkalemia.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.9 Amounts to be administered and route of administration\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eOral administration.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDosage and treatment regimen\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS is a fixed combination product that should only be used in dogs that require both active substances to be administered concomitantly at this fixed dose.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe recommended dose range for FORTEKOR PLUS is 0.25 - 0.5 mg pimobendan per kg body weight and 0.5 - 1 mg benazepril hydrochloride per kg body weight divided into two daily doses. FORTEKOR PLUS tablets should be administered orally, twice daily, 12 hours apart (morning and evening) and approximately 1 hour before feeding.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe tablets can be broken along the midline.\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cspan\u003eThe table below can be used for guidance.\u003c\/span\u003e\u003c\/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003eWeight\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"5\"\u003e\n\u003cp\u003e\u003cspan\u003eStrength and number of tablets to be administered\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 1.25 mg\/2.5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 5 mg\/10 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003edog (kg)\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003etablet\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003etablet\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eMorning\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eEvening\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eMorning\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eEvening\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2.5 - 5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0.5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0.5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e5 - 10\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e10 - 20\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0.5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0.5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003e20 - 40\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eOver 40 kg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.10 Overdose (symptoms, emergency procedures, antidotes), as appropriate\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn case of overdose, the dog should be treated symptomatically. Transient reversible hypotension may occur in case of accidental overdose. Therapy will consist of intravenous infusion (IV) of warm isotonic saline as required.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.11 Waiting time\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThat's not the case.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e5.1 Pharmacodynamic properties\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eBenazepril hydrochloride is a prodrug that is hydrolyzed in vivo to its active metabolite, benazeprilat. Benazeprilat is a highly potent and selective ACE inhibitor, preventing the conversion of inactive angiotensin I to active angiotensin II, thereby reducing aldosterone synthesis. Benazepril therefore blocks the effects mediated by angiotensin II and aldosterone, including vasoconstriction of arteries and veins, sodium and water retention by the kidneys, and remodeling effects (including pathological cardiac hypertrophy and degenerative renal changes).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn dogs with congestive renal failure, benazepril hydrochloride reduces blood pressure and volume load on the heart. Benazepril prolonged the time to worsening heart failure and death, improved clinical status, reduced coughing, and improved exercise tolerance in dogs with symptomatic congestive heart failure caused by valvular disease or dilated cardiomyopathy.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePimobendan, a benzimidazole-pyridazinone derivative, is a non-sympathomimetic, non-glycoside, inotropic agent with effective vasodilator properties. It increases the calcium sensitivity of cardiac myofilaments and inhibits phosphodiesterase (type III). It also exhibits vasodilator action by inhibiting the activity of phosphodiesterase type III.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e5.2 Pharmacokinetic particularities\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eAbsorption\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eAfter oral administration of pimobendan alone, the absolute bioavailability of the active ingredient is 60-63%. As this bioavailability is considerably reduced when pimobendan is administered with food or shortly thereafter, it is recommended to treat animals approximately 1 hour before feeding.\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cspan\u003eFollowing oral administration of benazepril hydrochloride alone, systemic bioavailability is incomplete (~13%) in dogs due to incomplete absorption (38%) and first-pass metabolism. Benazepril levels decline rapidly as the drug is partially metabolized to benazeprilat by hepatic enzymes. There is no significant difference in the pharmacokinetics of benazeprilat when benazepril hydrochloride is administered to fed or fasted dogs.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eFollowing oral administration of FORTEKOR PLUS tablets at twice the recommended dose in dogs, peak levels of both components are reached rapidly (Tmax 0.5 hours for benazepril hydrochloride and 0.85 hours for pimobendan), with peak concentrations (Cmax) for benazepril hydrochloride of 35.1 ng\/ml and 16.5 ng\/ml for pimobendan. Peak levels of benazeprilat were observed after 1.9 hours with peak concentrations (Cmax) of 43.4 ng\/ml.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eDistribution\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe steady-state volume of distribution is 2.6 l\/kg after intravenous administration of pimobendan alone, indicating that pimobendan has already distributed into tissues. The mean in vitro plasma protein binding is 93%.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eBenazeprilat concentrations decline in a biphasic manner: the initial, rapid phase (t1\/2 = 1.7 hours) represents the elimination of free drug, while the terminal phase (t1\/2 = 19 hours) reflects the release of benazeprilat that has been bound to ACE, primarily from tissues. Benazepril and benazeprilat are extensively bound to plasma proteins (85-90%), and in tissues they are found primarily in the lungs, liver, and kidneys.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eRepeated administration of benazepril hydrochloride leads to a slight bioaccumulation of benazeprilat (R = 1.47), with steady state being achieved within a few days (4 days).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eMetabolism\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePimobendan is oxidatively demethylated to its main metabolite, O-desmethyl pimobendan.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe next metabolic pathways are phase II, glucuronides and sulfates.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eBenazepril hydrochloride is partially metabolized by liver enzymes to the active metabolite benazeprilat.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eElimination\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe elimination half-life of pimobendan dosed with FORTEKOR PLUS tablets is 0.5 hours, consistent with the high clearance of the compound. The major active metabolite of pimobendan is eliminated with a half-life of 2.6 hours. Pimobendan is excreted primarily in the feces and, to a lesser extent, in the urine.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThe elimination half-lives of benazepril hydrochloride and benazeprilat, when dosed with FORTEKOR PLUS tablets, are 0.36 hours and 8.36 hours, respectively. Benazeprilat is excreted via the biliary (54%) and urinary (46%) routes in dogs. Benazeprilat clearance is not affected in dogs with impaired renal function; therefore, no dosage adjustment of FORTEKOR PLUS is necessary in dogs with renal impairment.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.2 Incompatibilities\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eThat's not the case.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.3 Shelf life\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eShelf life of the veterinary medicinal product as packaged for sale: 18 months\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eAny remaining half tablets should be discarded after 1 day.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.4 Special precautions for storage\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eStore below 25°C.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eKeep the blister in the outer carton in order to protect from moisture.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eAny remaining half tablet should be placed back in the opened blister and kept (for no more than 1 day) in the original carton, out of the sight and reach of children.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.5 Nature and composition of primary packaging\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eTablets of both strengths are packaged in aluminum\/aluminum blisters placed in an outer cardboard box.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e1.25 mg\/2.5 mg tablets: pack size of 30 \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e5 mg\/10 mg tablets: pack size of 30\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cdiv\u003e\n\u003col\u003e\n\u003cli\u003e\u003cspan\u003e\u003cstrong\u003eDENOMINAZIONE DEL MEDICINALE VETERINARIO\u003c\/strong\u003e\u003c\/span\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 1,25 mg\/2,5 mg compresse per cani FORTEKOR PLUS 5 mg\/10 mg compresse per cani\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003cspan\u003eCOMPOSIZIONE QUALITATIVA E QUANTITATIVA\u003c\/span\u003e\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eOgni compressa contiene:\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eSostanze attive:\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003ePimobendano\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eBenazepril\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003ecloridrato\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS compresse da 1,25 mg\/2,5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e1,25 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2,5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS compresse da 5 mg\/10 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e5mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e10mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eEccipienti:\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eOssido marrone\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eferro E172\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS compresse da 1,25 mg\/2,5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0,5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS compresse da 5 mg\/10 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePer l'elenco completo degli eccipienti, vedere paragrafo 6.1.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003cspan\u003eFORMA FARMACEUTICA\u003c\/span\u003e\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cspan\u003eCompresse ovali, a doppio strato, di colore bianco e marrone chiaro, con una linea di frattura su entrambi i lati.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe compresse possono essere divise in metà uguali.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003cspan\u003ePARTICOLARI CLINICI\u003c\/span\u003e\u003c\/strong\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cspan\u003e4.1  \u003cstrong\u003e    Specie bersaglio\u003c\/strong\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eCani.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e4.2    \u003cstrong\u003e  Indicazioni per l'uso, specificando le specie di destinazione\u003c\/strong\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePer il trattamento dell'insufficienza cardiaca congestizia dovuta a insufficienza della valvola atrioventricolare o a cardiomiopatia dilatativa nei cani. FORTEKOR PLUS è una combinazione a dose fissa e deve essere utilizzato solo nei soggetti i cui segni clinici sono trattati con successo mediante la somministrazione simultanea delle stesse dosi dei singoli componenti (pimobendan e benazepril cloridrato).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e4.3      \u003cstrong\u003eControindicazioni\u003c\/strong\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon viene utilizzato in caso di cardiomiopatie ipertrofiche o condizioni cliniche in cui l'aumento della frequenza cardiaca non è possibile per ragioni funzionali o anatomiche (ad esempio stenosi aortica o polmonare).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon usare in caso di ipotensione, ipovolemia, iponatriemia o insufficienza renale acuta.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon usare durante la gravidanza e l'allattamento (vedere paragrafo 4.7).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon usare in caso di ipersensibilità ai principi attivi o ad uno qualsiasi degli eccipienti.\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.4 Avvertenze speciali per ciascuna specie bersaglio\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon esiste.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.5 Precauzioni speciali per l'uso\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn caso di malattia renale cronica, si raccomanda di controllare lo stato di idratazione del cane prima di iniziare la terapia e di monitorare la creatinina plasmatica e il numero di eritrociti nel sangue durante la terapia.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePoiché il pimobendan viene metabolizzato nel fegato, il prodotto non deve essere somministrato a cani affetti da grave compromissione epatica.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eL'efficacia e la sicurezza del prodotto non sono state stabilite nei cani di peso inferiore a 2,5 kg o di età inferiore a 4 mesi.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePrecauzioni speciali che devono essere adottate dalla persona che somministra il medicinale veterinario agli animali\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLavarsi le mani dopo l'uso.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe persone con nota ipersensibilità al pimobendan o al benazepril cloridrato devono evitare il contatto con il medicinale veterinario.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn caso di ingestione orale accidentale, consultare immediatamente un medico mostrandogli il foglietto illustrativo o l'etichetta.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe donne incinte devono prestare particolare attenzione a evitare l'esposizione orale accidentale, poiché è stato dimostrato che gli inibitori dell'enzima di conversione dell'angiotensina (ACE) possono avere effetti sul feto durante la gravidanza umana.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.6 Reazioni avverse (frequenza e gravità)\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePimobendano\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn rari casi possono verificarsi un moderato effetto cronotropo positivo e vomito. Questi effetti, tuttavia, dipendono dal dosaggio e possono essere evitati riducendo la dose in tali situazioni.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn rari casi sono stati osservati diarrea transitoria, anoressia o letargia.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eBenazepril cloridrato\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eUn piccolo numero di cani può presentare transitoriamente vomito, mancanza di coordinazione o segni di affaticamento. Nei cani affetti da malattia renale cronica, il benazepril può aumentare le concentrazioni plasmatiche di creatinina all'inizio della terapia. L'aumento moderato delle concentrazioni plasmatiche di creatinina dopo somministrazione di ACE inibitori è compatibile con la riduzione dell'ipertensione glomerulare indotta da questi agenti, pertanto non vi è motivo di interrompere il trattamento in assenza di altri sintomi.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eLa frequenza delle reazioni avverse è definita utilizzando la seguente convenzione:\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- molto comune (più di 1 animale su 10 mostra reazioni avverse durante un trattamento)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- comune (più di 1 ma meno di 10 animali su 100 animali)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- non comune (più di 1 ma meno di 10 animali su 1.000 animali)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- raro (più di 1 ma meno di 10 animali su 10.000 animali)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003e- molto raro (meno di 1 animale su 10.000 animali, comprese le segnalazioni isolate)\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.7 Uso durante la gravidanza o l'allattamento Non usare durante la gravidanza o l'allattamento.\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLa sicurezza di FORTEKOR PLUS non è stata testata nei cani durante la riproduzione, la gestazione o l'allattamento.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eStudi di laboratorio su ratti e conigli con pimobendan hanno dimostrato effetti fetotossici a dosi maternotossiche. Studi di laboratorio condotti su ratti e conigli con pimobendan non hanno evidenziato effetti sulla fertilità. Studi di laboratorio sui ratti hanno dimostrato che il pimobendan viene escreto nel latte.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eStudi di laboratorio sui ratti con benazepril hanno dimostrato effetti fetotossici (malformazione del tratto urinario fetale) a dosi non tossiche per la madre. Non è noto se il benazepril venga secreto nel latte delle cagne in allattamento.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.8 Interazioni con altri medicinali ed altre forme di interazione\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNei cani con insufficienza cardiaca congestizia, il benazepril cloridrato e il pimobendan sono stati somministrati in combinazione con digossina e diuretici senza interazioni avverse dimostrabili.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNegli studi farmacologici non è stata rilevata alcuna interazione tra il glicoside cardiaco ouabaina e il pimobendan. L'aumento della contrattilità cardiaca indotto dal pimobendan risulta attenuato in presenza del calcio antagonista verapamil e del β-antagonista propranololo.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNegli esseri umani, la combinazione di inibitori dell'enzima di conversione dell'angiotensina (ACE) e farmaci antinfiammatori non steroidei (FANS) può portare a una ridotta efficacia antipertensiva o a disfunzione renale. Pertanto, l'uso concomitante di FORTEKOR PLUS con FANS o qualsiasi altro farmaco con effetto ipotensivo deve essere attentamente valutato prima di ricorrere a tali combinazioni.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eL'associazione di FORTEKOR PLUS con altri farmaci antipertensivi (ad esempio calcio antagonisti, beta-bloccanti o diuretici), anestetici o sedativi può portare ad effetti ipotensivi additivi. La funzionalità renale e i segni di ipotensione (letargia, debolezza, ecc.) devono essere attentamente monitorati e trattati secondo necessità.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon si possono escludere interazioni con i diuretici risparmiatori di potassio, come spironolattone, triamterene o amiloride. Pertanto, si raccomanda il monitoraggio dei livelli plasmatici di potassio quando si utilizza FORTEKOR PLUS in combinazione con diuretici risparmiatori di potassio a causa dell'iperkaliemia.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.9 Dosi da somministrare e via di somministrazione\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eSomministrazione orale.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDosaggio e regime di trattamento\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS è un prodotto a combinazione fissa che deve essere utilizzato solo nei cani che necessitano della somministrazione concomitante di entrambi i principi attivi a questa dose fissa.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eL'intervallo di dose raccomandato per FORTEKOR PLUS è 0,25 - 0,5 mg di pimobendan per kg di peso corporeo e 0,5 - 1 mg di benazepril cloridrato per kg di peso corporeo, suddivisi in due dosi giornaliere. Le compresse di FORTEKOR PLUS devono essere assunte per via orale due volte al giorno, a distanza di 12 ore (mattina e sera) e circa 1 ora prima dei pasti.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe compresse possono essere rotte lungo la linea mediana.\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cspan\u003eLa tabella seguente può essere utilizzata come guida.\u003c\/span\u003e\u003c\/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003ePeso\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"5\"\u003e\n\u003cp\u003e\u003cspan\u003eDosaggio e numero di compresse da somministrare\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 1,25 mg\/2,5 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"3\"\u003e\n\u003cp\u003e\u003cspan\u003eFORTEKOR PLUS 5 mg\/10 mg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003ecane (kg)\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003etavoletta\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd colspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003etavoletta\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eMattina\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eSera\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eMattina\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eSera\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2,5 - 5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0,5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0,5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e5 - 10\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e10 - 20\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0,5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e0,5\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003e20 - 40\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd rowspan=\"2\"\u003e\n\u003cp\u003e\u003cspan\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003eOltre 40 kg\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u003cspan\u003e2\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.10 Sovradosaggio (sintomi, procedure di emergenza, antidoti), a seconda dei casi\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIn caso di sovradosaggio, il cane deve essere trattato in base ai sintomi. In caso di sovradosaggio accidentale può verificarsi un'ipotensione transitoria e reversibile. La terapia consisterà nella somministrazione di infusioni endovenose (infusioni endovenose) con soluzione salina isotonica calda, secondo necessità.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e4.11 Tempo di attesa\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon è così.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e5.1 Proprietà farmacodinamiche\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIl benazepril cloridrato è un profarmaco che viene idrolizzato in vivo nel suo metabolita attivo, ovvero il benazeprilato. Il benazeprilato è un ACE inibitore altamente efficace e selettivo, che impedisce la conversione dell'angiotensina I inattiva in angiotensina II attiva, riducendo così la sintesi di aldosterone. Il benazepril blocca quindi gli effetti mediati dall'angiotensina II e dall'aldosterone, tra cui la vasocostrizione di arterie e vene, la ritenzione di sodio e acqua da parte dei reni e gli effetti di rimodellamento (tra cui l'ipertrofia cardiaca patologica e le alterazioni renali degenerative).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNei cani affetti da insufficienza renale congestizia, il benazepril cloridrato riduce la pressione sanguigna e il carico di volume sul cuore. Il benazepril ha prolungato il tempo di peggioramento dell'insufficienza cardiaca e di decesso, ha migliorato lo stato clinico, ha ridotto la tosse e ha migliorato la tolleranza all'esercizio nei cani con insufficienza cardiaca congestizia sintomatica causata da valvulopatia o cardiomiopatia dilatativa.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIl pimobendan, un derivato benzimidazolo-piridazinone, è un agente inotropico non simpaticomimetico, non glicosidico, con efficaci proprietà vasodilatatrici. Aumenta la sensibilità al calcio dei miofilamenti cardiaci e inibisce la fosfodiesterasi (tipo III). Esibisce inoltre un'azione vasodilatatrice inibendo l'attività della fosfodiesterasi di tipo III.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e5.2 Particolarità farmacocinetiche\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eAssorbimento\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDopo somministrazione orale di solo pimobendan, la biodisponibilità assoluta del principio attivo è del 60 - 63%. Poiché questa biodisponibilità è notevolmente ridotta quando il pimobendan viene somministrato con il cibo o subito dopo, si raccomanda di trattare gli animali circa 1 ora prima del pasto.\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cspan\u003eDopo la somministrazione orale di solo benazepril cloridrato, la biodisponibilità sistemica è incompleta (~13%) nei cani a causa dell'assorbimento incompleto (38%) e del metabolismo di primo passaggio. I livelli di benazepril diminuiscono rapidamente poiché il farmaco viene parzialmente metabolizzato in benazeprilato dagli enzimi epatici. Non vi è alcuna differenza significativa nella farmacocinetica del benazeprilato quando il benazepril cloridrato viene somministrato a cani alimentati o a digiuno.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eDopo la somministrazione orale di compresse di FORTEKOR PLUS a una dose doppia rispetto a quella raccomandata nei cani, i livelli di picco di entrambi i componenti vengono raggiunti rapidamente (Tmax 0,5 ore per il benazepril cloridrato e 0,85 ore per il pimobendan), con concentrazioni di picco (Cmax) per il benazepril cloridrato di 35,1 ng\/ml e 16,5 ng\/ml per il pimobendan. I livelli di picco del benazeprilato sono stati osservati dopo 1,9 ore con concentrazioni di picco (Cmax) di 43,4 ng\/ml.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eDistribuzione\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIl volume di distribuzione allo stato stazionario è di 2,6 l\/kg dopo somministrazione endovenosa di solo pimobendan, il che indica che il pimobendan si è già distribuito nei tessuti. Il legame medio alle proteine ​​plasmatiche in vitro è del 93%.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe concentrazioni di benazeprilato diminuiscono in modo bifasico: la fase iniziale rapida (t1\/2 = 1,7 ore) rappresenta l'eliminazione del farmaco libero, mentre la fase terminale (t1\/2 = 19 ore) riflette il rilascio del benazeprilato legato all'ACE, principalmente dai tessuti. Il benazepril e il benazeprilato si legano ampiamente alle proteine ​​plasmatiche (85-90%) e, a livello tissutale, si trovano principalmente nei polmoni, nel fegato e nei reni.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLa somministrazione ripetuta di benazepril cloridrato determina un leggero bioaccumulo di benazeprilato (R = 1,47), con il raggiungimento dello stato stazionario entro pochi giorni (4 giorni).\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eMetabolismo\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIl pimobendan viene demetilato ossidativamente nel suo metabolita principale, l'O-desmetil pimobendan.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe successive vie metaboliche sono la fase II, glucuronidi e solfati.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eIl benazepril cloridrato viene parzialmente metabolizzato dagli enzimi epatici nel metabolita attivo benazeprilato.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003eEliminazione\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eL'emivita di eliminazione plasmatica del pimobendan somministrato con compresse di FORTEKOR PLUS è di 0,5 ore, il che è coerente con l'elevata clearance del composto. Il principale metabolita attivo del pimobendan viene eliminato con un'emivita di 2,6 ore. Il pimobendan viene escreto principalmente nelle feci e, in misura minore, nelle urine.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eL'emivita di eliminazione del benazepril cloridrato e del benazeprilato, quando somministrati con le compresse di FORTEKOR PLUS, è rispettivamente di 0,36 ore e 8,36 ore. Nei cani, il benazeprilato viene escreto per via biliare (54%) e urinaria (46%). La clearance del benazeprilato non è influenzata nei cani con funzionalità renale compromessa; pertanto non è necessario alcun aggiustamento del dosaggio di FORTEKOR PLUS nei cani con compromissione renale.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003c\/div\u003e\n\u003cdiv\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.2 Incompatibilità\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eNon è così.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.3 Durata di conservazione\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003ePeriodo di validità del medicinale veterinario confezionato per la vendita: 18 mesi\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eEventuali mezze compresse rimanenti devono essere eliminate dopo 1 giorno.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.4 Precauzioni speciali per la conservazione\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eConservare a temperatura inferiore a 25°C.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eConservare il blister nella scatola esterna per proteggerlo dall'umidità.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eL'eventuale mezza compressa rimanente deve essere riposta nel blister aperto e conservata (per non più di 1 giorno) nella confezione originale, fuori dalla vista e dalla portata dei bambini.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan\u003e6.5 Natura e composizione dell'imballaggio primario\u003c\/span\u003e\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eLe compresse di entrambi i dosaggi sono confezionate in blister di alluminio\/alluminio inseriti in una scatola di cartone esterna.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eCompresse da 1,25 mg\/2,5 mg: confezione da 30 \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan\u003eCompresse da 5 mg\/10 mg: confezione da 30 \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003c\/div\u003e","brand":"ELANCO","offers":[{"title":"1.25mg \/ 2.5mg","offer_id":50332152037723,"sku":"","price":64.2,"currency_code":"EUR","in_stock":true},{"title":"5mg \/ 10mg","offer_id":50332152070491,"sku":"","price":64.2,"currency_code":"EUR","in_stock":false}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0476\/3261\/3543\/files\/descarcare_16.jpg?v=1743426711","url":"https:\/\/www.petshopluna.com\/products\/fortekor-plus-1-25-2-5-mg-10-cp-for-dogs","provider":"Pet Shop Maya","version":"1.0","type":"link"}