Knil
Generic Name
Knilostatin
Manufacturer
Meditopix Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| knil 10 mg tablet | ৳ 10.00 | N/A |
Description
Overview of the medicine
Knil 10 mg Tablet is an Angiotensin Receptor Blocker (ARB) used to treat high blood pressure (hypertension) and heart failure. It helps relax blood vessels, allowing blood to flow more easily.
Uses & Indications
Dosage
Adults
For hypertension, the usual starting dose is 10 mg once daily. The dose can be increased to 20 mg daily based on blood pressure response. For heart failure, the usual starting dose is 5 mg once daily, gradually titrating upwards.
Elderly
No initial dose adjustment is typically required, but caution should be exercised. A lower starting dose of 5 mg may be considered.
Renal_impairment
No initial dose adjustment is generally required for patients with mild to moderate renal impairment. For severe renal impairment or dialysis patients, a lower starting dose (e.g., 5 mg) and careful monitoring are recommended.
How to Take
Take Knil 10 mg Tablet orally, with or without food. It is recommended to take it at approximately the same time each day to maintain consistent blood levels.
Mechanism of Action
Knilostatin selectively blocks the binding of angiotensin II to the AT1 receptor, which is found in many tissues, including vascular smooth muscle and the adrenal gland. This blockage prevents the vasoconstrictor and aldosterone-secreting effects of angiotensin II, thus leading to vasodilation, reduced blood pressure, and decreased fluid retention.
Pharmacokinetics
Onset
Antihypertensive effect typically begins within 1-2 hours after a single oral dose.
Excretion
Approximately 35% of the dose is excreted in the urine (primarily as metabolite), and about 60% is excreted in the feces via bile.
Half life
The elimination half-life is approximately 6-9 hours for Knilostatin and 9-12 hours for its active metabolite.
Absorption
Well absorbed orally, with an average bioavailability of approximately 30-35%. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Undergoes extensive first-pass metabolism in the liver, primarily to an active carboxylic acid metabolite (Knilostatate) which contributes significantly to its pharmacological activity.
Side Effects
Contraindications
- Hypersensitivity to Knilostatin or any component of the formulation
- Pregnancy (especially second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes or moderate to severe renal impairment (GFR <60 mL/min/1.73 m²)
- Severe hepatic impairment
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity have been reported with concomitant use of ARBs. Monitor lithium levels.
Diuretics
Increased risk of symptomatic hypotension (low blood pressure), especially after initiating therapy or increasing dosage.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Knilostatin and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia (high potassium levels). Close monitoring of serum potassium is advised.
Storage
Store below 30°C in a dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose typically include profound hypotension, dizziness, and tachycardia. Bradycardia may occur. Management is supportive: promptly discontinue the drug, monitor vital signs, and provide symptomatic treatment. Intravenous fluids may be administered to correct hypotension.
Pregnancy & Lactation
Knil is contraindicated during pregnancy, particularly in the second and third trimesters, due to the risk of fetal morbidity and mortality. It is not recommended during breastfeeding as it is unknown whether Knilostatin is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to Knilostatin or any component of the formulation
- Pregnancy (especially second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes or moderate to severe renal impairment (GFR <60 mL/min/1.73 m²)
- Severe hepatic impairment
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity have been reported with concomitant use of ARBs. Monitor lithium levels.
Diuretics
Increased risk of symptomatic hypotension (low blood pressure), especially after initiating therapy or increasing dosage.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Knilostatin and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia (high potassium levels). Close monitoring of serum potassium is advised.
Storage
Store below 30°C in a dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose typically include profound hypotension, dizziness, and tachycardia. Bradycardia may occur. Management is supportive: promptly discontinue the drug, monitor vital signs, and provide symptomatic treatment. Intravenous fluids may be administered to correct hypotension.
Pregnancy & Lactation
Knil is contraindicated during pregnancy, particularly in the second and third trimesters, due to the risk of fetal morbidity and mortality. It is not recommended during breastfeeding as it is unknown whether Knilostatin is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture when stored under recommended conditions.
Availability
Available in all pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety profile of Knilostatin in the treatment of hypertension, heart failure, and diabetic nephropathy, showing significant reductions in cardiovascular events and improved patient outcomes.
Lab Monitoring
- Serum potassium levels (before and periodically during treatment, especially in patients with renal impairment or those on potassium-sparing diuretics)
- Renal function tests (e.g., serum creatinine, BUN) periodically
- Liver function tests (baseline and if symptoms of hepatic dysfunction occur)
Doctor Notes
- Emphasize the importance of consistent medication adherence, even if the patient feels well.
- Regularly monitor blood pressure, renal function (creatinine, GFR), and serum potassium levels, especially during dose titrations or concomitant use with other interacting drugs.
- Educate patients on symptoms of angioedema and hyperkalemia and advise them to seek immediate medical attention if these occur.
Patient Guidelines
- Take Knil exactly as prescribed by your doctor, even if you feel well.
- Do not stop taking Knil without consulting your doctor, as this may cause your blood pressure to rise.
- Regularly monitor your blood pressure at home and keep a record.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If you miss a dose of Knil, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Knil may cause dizziness or lightheadedness, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Adopt a healthy lifestyle including a balanced diet (low in sodium, rich in fruits and vegetables)
- Engage in regular moderate physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Maintain a healthy weight.
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