Classification of the incidence of side effects: very often> 1/10; often> 1/100, <1/10; infrequently> 1/1000, <1/100; rarely> 1/10000, <1/1000; very rarely <1/10000, including individual messages.
The incidence of adverse events is not dose dependent, with the exception of dizziness, visual impairment, and bradycardia.
In patients with chronic heart failure
From the central nervous system: very often - dizziness, headache (especially at the beginning of treatment or when changing doses), asthenia (including increased fatigue), depression.
From the side of the cardiovascular system: often - bradycardia, postural hypotension, marked decrease in blood pressure, peripheral edema (including generalized edema, perineal edema, lower extremities, fluid retention); infrequent - exacerbation of the course of chronic heart failure (in the period of increasing doses), syncopal conditions (including presyncopal), AV blockade II-III degree.
From the digestive system: often - nausea, diarrhea, vomiting.
From the side of metabolism: often - an increase in body weight, a violation of glycemic control.
From the hematopoiesis: rarely - thrombocytopenia; very rarely - leukopenia.
From the urinary system: rarely renal failure and renal dysfunction in patients with diffuse vasculitis and / or renal dysfunction, severe renal dysfunction.
Laboratory indicators: often - hypercholesterolemia, hyper- or hypoglycemia in patients with diabetes mellitus.
Other: often - visual impairment.
In patients with hypertension and ischemic heart diseasea
The nature of side effects from the cardiovascular system in the treatment of arterial hypertension and coronary heart disease is similar to that of chronic heart failure, but their frequency is less.
From the central nervous system: often - dizziness, headache, general weakness (especially at the beginning of treatment or when changing doses); infrequently - mood lability, sleep disturbances, paresthesia.
From the side of the cardiovascular system: often - postural hypotension, bradycardia; infrequently - the development or exacerbation of chronic heart failure, peripheral edema, angina (pain in the chest), AV blockade II-III degree, syncopal conditions (especially at the beginning of therapy), peripheral circulation disorders (cold extremities, exacerbation of the "intermittent" lameness syndrome and Raynaud's syndrome).
From the digestive system: often - dyspeptic disorders (including nausea, abdominal pain, diarrhea); infrequently - constipation, vomiting.
From the respiratory system: often - shortness of breath and bronchospasm (in predisposed patients); rarely - nasal congestion.
From the skin: infrequently - itchy skin, rash, dermatitis and urticaria.
From the side of metabolism: often - the manifestation of latent diabetes mellitus, decompensation of already existing diabetes mellitus or oppression of the contrinular system.
On the part of the organs of hematopoiesis: very rarely - thrombocytopenia, leukopenia.
From the urinary system: rarely - violation of urination, very rarely - urinary incontinence in women, reversible after discontinuation of the drug.
From the genitourinary system: infrequent - a decrease in potency.
Laboratory indicators: very rarely - increased activity of "liver" transaminases.
Other: often - pain in the limbs, reducing tear and eye irritation; infrequently - impaired vision; rarely dryness of the oral mucosa; very rarely - flu-like syndrome, sneezing, exacerbation of psoriasis, alopecia.