Lorista - cov lus qhia rau kev siv, tshuaj xyuas, tshuaj tiv thaiv kab mob thiab cov ntawv tso tawm (ntsiav tshuaj 12, 5 mg, 25 mg, 50 mg thiab 100 mg, N thiab ND - ntxiv nrog diuretic hydrochlorothiazide) tshuaj rau kev kho mob ntshav siab hauv cov neeg laus, menyuam yaus thiab cev xeeb tub

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb LoristaCov. Muab tswv yim los ntawm cov neeg tuaj saib rau ntawm thaj chaw - cov neeg tau txais kev pab ntawm cov tshuaj no, nrog rau kev xav ntawm cov kws kho mob tshwj xeeb txog kev siv Lorista hauv lawv cov kev coj ua. Qhov kev thov loj yog nquag ntxiv kev tshuaj xyuas koj ntawm cov tshuaj: cov tshuaj tau pab lossis tsis pab ua kom tshem tawm ntawm tus kabmob, muaj dab tsi tshwm sim thiab cov kev mob tshwm sim, tejzaum nws tsis tshaj tawm los ntawm tus tsim khoom hauv cov lus piav qhia. Analogs Lorista nyob rau hauv muaj cov qauv txheej txheem qauv. Siv rau kev kho mob ntshav siab hauv cov neeg laus, menyuam yaus, nrog rau lub sijhawm cev xeeb tub thiab lactation.

Lorista - Xaiv cov tshuaj angiotensin 2 receptor antagonist hom AT1 tsis muaj protein.

Losartan (cov tshuaj ua ke ntawm cov tshuaj Lorista) thiab nws cov tshuaj lom neeg lub cev carboxy metabolite (EXP-3174) thaiv tag nrho cov kev mob tshwm sim ntawm cov tshuaj angiotensin 2 ntawm AT1 receptors, tsis hais txog txoj kev ntawm nws cov lus sib xyaw: nws ua rau muaj kev nce ntshav ntau ntxiv thiab muaj kev txo qis ntawm aldosterone hauv ntshav ntshav.

Losartan tsis ncaj qha ua rau kev ua kom AT2 receptors los ntawm kev nce qib ntawm angiotensin 2. Losartan tsis cuam tshuam cov kev ua ntawm kininase 2, ib qho enzyme uas koom nrog hauv cov metabolism hauv ntawm bradykinin.

Nws txo OPSS, siab hauv lub ntsws ntsig, txo qis tom qab, muaj cov nyhuv diuretic.

Nws cuam tshuam nrog kev txhim kho myocardial hypertrophy, ua rau lub cev muaj zog ntau dua nyob rau hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev.

Kev Txais Txais Lorista ib hnub ib zaug ua rau muaj kev txo qis ntawm cov ntshav systolic thiab diastolic ntshav siab. Nruab hnub, losartan tusyees tswj ntshav siab, thaum cov nyhuv antihypertensive sib raug rau lub ntuj circadian atherosclerosis. Qhov kev txo qis hauv cov ntshav siab thaum kawg ntawm qhov kawg ntawm cov tshuaj yog kwv yees li 70-80% ntawm cov nyhuv ntawm qhov kawg ntawm cov tshuaj, 5-6 teev tom qab kev tswj hwm. Ntsoos ntsoos mob los tsis pom, thiab losartan tsis muaj kev cuam tshuam loj ntawm lub plawv dhia.

Losartan muaj txiaj ntsig zoo rau tus txiv neej thiab poj niam, nrog rau cov laus (≥ 65 xyoo) thiab cov neeg mob me (≤ 65 xyoo).

Hydrochlorothiazide yog thiazide diuretic uas nws cov nyhuv diuretic yog cuam tshuam nrog kev ua txhaum ntawm kev rov ua kom rov qab los ntawm sodium, chlorine, poov tshuaj, magnesium, dej ions nyob rau hauv distal nephron, ncua kev nthuav dav ntawm calcium ions, uric acid. Nws muaj cov khoom tiv thaiv kabmob, hypotensive nyhuv los vim yog qhov nthuav tawm ntawm cov hlab ntsha. Zoo tsis muaj kev cuam tshuam dab tsi rau ntshav siab. Cov nyhuv diuretic tshwm sim tom qab 1-2 teev, nce mus txog qhov siab kawg tom qab 4 teev thiab kav ntev li 6-12 teev.

Cov nyhuv antihypertensive tshwm sim tom qab 3-4 hnub, tab sis nws yuav siv sij hawm 3-4 lub lis piam kom ua tiav cov txiaj ntsig zoo tshaj plaws.

Muaj pes tsawg leeg

Losartan poov tshuaj + excipients.

Cov paib potassium losartan + hydrochlorothiazide + excipients (Lorista N thiab ND).

Cov Tshuaj Pharmacokinetics

Cov tshuaj pharmacokinetics ntawm losartan thiab hydrochlorothiazide nrog rau siv tib txhij tsis txawv ntawm qhov uas lawv sib cais siv.

Nws yog zoo nqus los ntawm cov hnyuv. Noj tshuaj nrog zaub mov noj tsis muaj kev cuam tshuam loj hauv nws txoj kev kuaj ntshav. Yuav luag tsis txeem cov ntshav-hlwb (BBB). Txog 58% ntawm cov tshuaj tawm hauv cov kua tsib, 35% - hauv cov zis.

Tom qab kev tswj hwm ntawm qhov ncauj, qhov nqus ntawm hydrochlorothiazide yog 60-80%. Hydrochlorothiazide tsis yog metabolized thiab ua sai tawm los ntawm lub raum.

Cov Khoom Qhia

leeg ntshav siab
txo kev pheej hmoo ntawm mob hlab ntsha tawg hauv cov neeg mob ntshav liab thiab tawm hauv ventricular hypertrophy,
mob plawv tsis ua hauj lwm (raws li ib feem ntawm kev sib xyaw ua ke, nrog kev tsis tuaj yeem lossis tsis muaj txiaj ntsig ntawm kev kho nrog ACE inhibitors),
tiv thaiv lub raum kev ua haujlwm hauv cov neeg mob ntshav qab zib hom 2 mob ntshav qab zib mellitus nrog proteinuria txhawm rau txo proteinuria, txo qhov kev vam meej ntawm lub raum ua puas, txo qhov kev pheej hmoo ntawm kev tsim cov davhlau ya nyob twg (tiv thaiv qhov xav tau kev lim ntshav, qhov ntxim nyiam ntawm kev nce ntshav ntshiab).

Tso Tawm Cov Ntawv

Cov ntsiav tshuaj 12,5 mg, 25 mg, 50 mg thiab 100 mg.

Lorista N (ntxiv rau 12,5 mg ntawm hydrochlorothiazide).

Lorista ND (ntxiv rau muaj 25 mg ntawm hydrochlorothiazide).

Cov lus qhia rau kev siv thiab ntau npaum li cas

Cov tshuaj tau noj ntawm qhov ncauj, tsis hais txog ntawm pluas noj, qhov ntau zaus ntawm kev tswj hwm - 1 zaug hauv ib hnub.

Nrog rau cov hlab ntsha o, qhov nruab nrab txhua hnub koob yog 50 mg. Qhov siab tshaj plaws antihypertensive siv tau tiav hauv 3-6 lub lis piam ntawm kev kho. Nws yog ua tau kom ua tiav qhov kev tawm suab ntau dua los ntawm kev nce hauv koob tshuaj rau 100 mg rau ib hnub hauv ob koob lossis ib koob tshuaj.

Thaum noj cov tshuaj diuretics hauv koob tshuaj ntau, nws pom zoo kom pib Lorista txoj kev kho nrog 25 mg ib hnub hauv ib koob.

Cov neeg laus laus, cov neeg mob uas tsis ua haujlwm lub raum (nrog rau cov neeg mob ntawm hemodialysis) tsis tas yuav kho qhov pib ntawm cov tshuaj.

Hauv cov neeg mob uas muaj lub siab tsis ua hauj lwm zoo, cov tshuaj yuav tsum tau sau tseg nyob rau hauv qis dua.

Hauv kev mob plawv tsis ua hauj lwm ntev, qhov pib txhaj tshuaj yog 12,5 mg rau ib hnub hauv ib koob. Txhawm rau kom ua tiav qhov kev saib xyuas li niaj zaus ntawm 50 mg rau ib hnub, qhov tshuaj yuav tsum tau nce ntxiv qeeb, nyob rau ntawm ncua sijhawm ntawm 1 lub lis piam (piv txwv li 12,5 mg, 25 mg, 50 mg ib hnub). Lorista feem ntau yog kho ua ke nrog cov tshuaj diuretics thiab lub plawv glycosides.

Txhawm rau txo txoj kev pheej hmoo ntawm mob hlab ntsha tawg hauv cov neeg mob ntshav siab thiab ntshav tawm ntawm lub plawv tawg ventricular hypertrophy, tus qauv kev noj tshuaj pib yog 50 mg rau ib hnub. Yav tom ntej, hydrochlorothiazide tuaj yeem raug ntxiv rau hauv koob tshuaj tsawg thiab / lossis koob tshuaj Lorista tuaj yeem raug nce rau 100 mg ib hnub twg.

Txhawm rau tiv thaiv lub raum hauv cov neeg mob uas muaj ntshav qab zib hom 2 nrog proteinuria, cov koob tshuaj thawj zaug ntawm Lorista yog 50 mg rau ib hnub. Cov koob tshuaj ntawm cov tshuaj tuaj yeem nce ntxiv rau 100 mg ib hnub twg, xav txog qhov txo qis hauv cov ntshav siab.

Nyoo

kiv taub hau
asthenia
mob taub hau
nkees
insomnia
kev txhawj xeeb
kev ntxhov siab vim pw tsaug zog
tsaug zog
nco tsis meej
peripheral neuropathy,
paresthesia
kev mob siab ntsws
mob taub hau
tshee hnyo
kev nyuaj siab
orthostatic hypotension (koob tshuaj-siv tshuaj),
lub plawv dhia
tachycardia
bradycardia
arrhythmias
angina pectoris
txhaws ntswg
hnoos
mob ntsws
o ntawm lub ntswg ntswg,
xeev siab, ntuav,
zawv plab
mob plab
kev tsis nco qab
qhov ncauj qhuav
mob hniav
flatulence
cem quav
xav tso zis
lub raum tsis ua hauj lwm zoo,
txo qis libido
impotence
cramps
mob mob nraub qaum, hauv siab, ceg,
coov hauv pob ntseg
saj kev ua txhaum
pom kev pom
pom mob pob txha
anemia
Shenlein-Genoch liab doog
daim tawv nqaij qhuav
nce hws
alopecia
mob gout
urticaria
daim tawv nqaij ua pob
khaus
angioedema (suav nrog o ntawm lub suab nrov thiab ntawm tus nplaig, ua rau thaiv ntawm txoj hlab pas thiab / lossis o ntawm lub ntsej muag, daim di ncauj, pharynx).

Cov Yuav Tsum Tau Ua

arterial hypotension,
hyperkalemia
lub cev qhuav dej
lactose intolerance,
galactosemia los yog glucose / galactose malabsorption syndrome,
cev xeeb tub
kev pub mis
hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb rau cov menyuam tsis tau tsim),
hypersensitivity rau losartan thiab / lossis lwm yam tshuaj ntawm cov tshuaj.

Cev xeeb tub thiab lactation

Tsis muaj ntaub ntawv qhia txog kev siv Lorista thaum cev xeeb tub. Kev rov ua kom zoo nkauj ntawm cov menyuam hauv plab, uas nyob ntawm kev txhim kho ntawm cov txheej txheem renin-angiotensin, pib ua haujlwm hauv lub sijhawm 3 lub hlis ntawm cev xeeb tub. Txoj kev pheej hmoo rau cov menyuam hauv plab nce thaum noj losartan hauv lub thib 2 thiab thib 3 txiav plaub hau. Thaum cev xeeb tub yog tsim los, txoj kev kho losartan yuav tsum tsum tsis ua sai sai.

Tsis muaj ntaub ntawv hais txog kev faib cov losartan nrog rau niam mis. Yog li, qhov teebmeem ntawm kev txwv tsis pub mis niam lossis tso tseg kev kho mob nrog losartan yuav tsum txiav txim siab ua qhov tseem ceeb rau leej niam.

Cov lus qhia tshwj xeeb

Cov neeg mob uas txo qis ntshav ncig mus los (piv txwv li, thaum siv tshuaj kho mob ntshav ntau ntau) yuav muaj cov tsos mob ntawm txoj hlab ntshav thim ntshav. Ua ntej noj cov tshuaj losartan, nws yog qhov tsim nyog los tshem tawm cov kev ua txhaum uas twb muaj lawm, lossis pib kho nrog kev siv tshuaj me me.

Hauv cov neeg mob uas muaj mob me me thiab mob qog ua rau lub siab, cov concentration ntawm losartan thiab nws cov metabolite hauv ntshav plasma tom qab kev tswj hwm qhov ncauj ntau dua li cov noj qab nyob zoo. Yog li, cov neeg mob uas muaj keeb kwm muaj kab mob siab yuav tsum tau txhaj tshuaj qis dua.

Hauv cov neeg mob uas lub raum tsis zoo lub cev, ob qho tib si nrog thiab tsis muaj ntshav qab zib, hyperkalemia feem ntau muaj kev txhim kho, uas yuav tsum tau yug hauv siab, tab sis tsuas yog qee qhov teeb meem vim qhov no, kev kho mob tau tso tseg. Thaum lub sijhawm kev kho mob, cov concentration ntawm cov poov tshuaj nyob rau hauv cov ntshav yuav tsum tau saib xyuas tsis tu ncua, tshwj xeeb tshaj yog nyob rau cov neeg laus, nrog lub raum tsis ua haujlwm.

Cov tshuaj noj ua yeeb yaj kiab rau renin-angiotensin system tuaj yeem nce cov leeg urea thiab creatinine rau cov neeg mob uas muaj ob leeg lub raum leeg mob stenosis los yog ob leeg ib leeg mob cov leeg ntawm lub raum. Kev hloov pauv hauv lub raum kev ua haujlwm tuaj yeem thim rov qab tom qab tsis ua tiav ntawm kev kho. Thaum kho, nws yog ib qho tsim nyog yuav tsum tau soj ntsuam kom tsis tu ncua cov tshuaj creatinine hauv cov ntshav ntawm cov ntshav ib zaug.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Tsis muaj cov ntaub ntawv hais txog cov nyhuv ntawm Lorista ntawm kev muaj peev xwm tsav tsheb los yog lwm txoj kev txhais tau tias.

Yeeb tshuaj sib cuam tshuam

Tsis muaj kev sib cuam tshuam hauv cov tshuaj tseem ceeb nrog cov tshuaj hydrochlorothiazide, digoxin, cov tshuaj tiv thaiv tsis tseem ceeb, cimetidine, phenobarbital, ketoconazole thiab erythromycin tau pom.

Thaum siv cov tshuaj concomitant nrog rifampicin thiab fluconazole, ib qho kev txo qis hauv theem ntawm lub cev nquag ntawm cov plua tshauv losartan potassium tau sau tseg. Cov kab mob kev nkeeg tshwm sim ntawm cov kab mob no tsis paub.

Siv tib lub sijhawm nrog cov tshuaj potassium-sparing diuretics (piv txwv li, spironolactone, triamteren, amiloride) thiab cov tshuaj potassium npaj ua rau muaj kev pheej hmoo ntawm hyperkalemia.

Kev siv tib lub sij hawm ntawm cov tshuaj uas tsis yog tshuaj steroidal, suav nrog cov tshuaj COX-2 inhibitors, tuaj yeem txo cov nyhuv ntawm diuretics thiab lwm cov tshuaj tiv thaiv antihypertensive.

Yog tias Lorista raug kho kom zoo ib txhij nrog thiazide diuretics, qhov txo qis hauv ntshav siab yog kwv yees qhov ntxiv ntawm qhov. Txhim kho (ob leeg) cov nyhuv ntawm lwm cov tshuaj tiv thaiv kabmob (diuretics, beta-blockers, sympatholytics).

Cov tshuaj ntawm cov tshuaj Lorista

Cov qauv ntawm cov qauv ua haujlwm:

Blocktran
Brozaar
Vasotens,
Vero Losartan
Zisakar
Cardomin Sanovel,
Karzartan
Cozaar
Lakea
Lozap,
Lozarel
Losartan
Losartan poov tshuaj,
Losacor
Lotor
Tubkawm Presartan
Los Tsuas.

Kev taw qhia Lorista

Dab tsi pab Lorista ntsiav tshuaj? Cov tshuaj yog qhia rau cov kab mob thiab mob:

Arterial hypertension (yog kev sib xyaw ua ke yog qhia)
Sab laug ventricular hypertrophy thiab kub siab txhawm rau txhawm rau txo txoj kev pheej hmoo ntawm mob hlab ntsha tawg,
CHF ua ib feem ntawm txoj kev kho ua ke,
Mob ntsws (tiv thaiv raum) nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus thiaj li yuav txo qis protenuria,
Kev tiv thaiv ntawm kev mob plawv, nrog rau kev ua neeg tuag taus, hauv cov neeg mob uas muaj kev pheej hmoo siab.

Raws li cov lus qhia, Lorista N pab nrog kev xav tau kev kho mob ua ke nrog antihypertensive tshuaj thiab diuretics.

Lorista ntsiav tshuaj 50 100 mg - cov lus qhia rau kev siv

Kuv noj ntawm ncauj, tsis hais kev noj mov, haus dej huv ntau. Nws raug nquahu kom coj Lorista thaum sawv ntxov.
Nrog rau cov hlab ntsha o, qhov nruab nrab txhua hnub koob yog 50 mg. Qhov siab tshaj plaws antihypertensive siv tau tiav hauv 3-6 lub lis piam ntawm kev kho.

Nws yog ua tau kom ua tiav qhov kev tawm suab ntau dua los ntawm kev nce hauv koob tshuaj rau 100 mg / hnub.

Cov koob tshuaj ntawm cov tshuaj yuav tsum tau nce raws li cov phiaj xwm hauv qab no:

Lub lim tiam 1 (1st - 7 hnub) - 1 kab. Lorista 12,5 mg / hnub.
Lub lim tiam thib 2 (8-14 hnub) - 1 lub rooj. Lorista 25 mg / hnub.
Lub lim tiam 3 (15-21 hnub) - 1 daim. Lorista 50 mg / hnub.
Lub lim tiam 4 (22-28 hnub) - 1 kab. Lorista 50 mg / hnub.

Tawm tsam keeb kwm yav dhau los ntawm kev noj tshuaj diuretics hauv siab kawg, nws raug nquahu kom pib Lorista txoj kev kho nrog 25 mg / hnub. Qhov siab tshaj plaws cov nyhuv antihypertensive tiav tom qab 3 lub lis piam ntawm kev kho.

Hauv cov neeg mob uas lub raum tsis ua haujlwm (CC 30-50 ml / min), kev kho ntawm thawj zaug tshuaj ntawm Lorista tsis tas yuav ua haujlwm.

Txhawm rau txo cov kev pheej hmoo ntawm cov hlab plawv pathologies thiab kev tuag hauv cov neeg mob ntshav siab thiab ntshav tawm ntawm txoj hlab ntsws tawg, qhov pib thiab txij nkawm ntawm losartan yog siv - 50 mg 1 lub sijhawm / hnub (1 ntsiav tshuaj ntawm Lorista 50).

Yog tias thaum lub sij hawm kho mob nws tsis tuaj yeem ua kom tiav lub hom phiaj ntawm cov ntshav siab thaum thov Lorista N 50, kev kho ntawm kev kho yuav tsum ua tiav. Yog tias tsim nyog, nce ntxiv ntawm koob tshuaj (Lorista 100) nyob rau hauv kev sib xyaw nrog hydrochlorothiazide ntawm koob tshuaj 12,5 mg / hnub yog ua tau.

Cov koob tshuaj pom zoo ntawm cov tshuaj Lorista® N 100 -1 tab. (100 mg / 12.5 mg) 1 lub sijhawm / hnub.

Qhov siv tshuaj ntau tshaj txhua hnub yog 1 tab. tshuaj Lorista N 100.

Tshwj xeeb:

Hauv cov neeg mob uas lub raum tsis ua hauj lwm, tsis tas yuav hloov kho dua.

Hauv cov neeg laus cov neeg mob, tsis tas yuav txhaj tshuaj.

Hauv cov neeg mob uas lub siab tsis ua hauj lwm, kev noj tshuaj ntawm Lorista yuav tsum raug txo kom tsawg. Hauv CHF, kev muab tshuaj thawj zaug yog 12,5 mg / hnub. Tom qab ntawd cov koob tshuaj tau maj mam nce kom txog thaum siv tshuaj kom tsawg. Qhov nce tshwm sim ib zaug ib lub lim tiam (piv txwv li 12,5 mg, 25 mg, 50 mg / hnub). Cov neeg mob zoo li no, Lorista ntsiav tshuaj feem ntau yog txuam nrog cov tshuaj diuretics thiab mob plawv glycosides.

Txhawm rau tiv thaiv lub raum hauv cov neeg mob ntshav qab zib hom 2 uas muaj proteinuria, cov tshuaj pib ntawm Lorista yog 50 mg / hnub. Cov koob tshuaj ntawm cov tshuaj tuaj yeem nce ntxiv txog 100 mg / hnub, suav txog qhov txo qis hauv cov ntshav siab. Kev nce ntxiv ntau dua 1 lub ntsiav tshuaj ntawm Lorista® N 100 ib hnub yog tsis xav tau thiab ua rau muaj kev cuam tshuam ntau ntxiv.

Kev siv ua ke ntawm losartan thiab ACE inhibitors cuam tshuam lub raum kev ua haujlwm, yog li qhov sib xyaw no tsis pom zoo.

Siv rau hauv cov neeg mob uas muaj qhov txo qis hauv cov kua dej hauv lub cev - kho cov kua qog ua kom lub cev tsis txaus ua ntej pib losartan.

Cov Tshaj Tawm Lorista

cov tshuaj tiv thaiv tsis haum rau losartan thiab sulfonamide derivatives (hydrochlorothiazide), lossis lwm yam kev zam,
mob raum tsis ua hauj lwm zoo (kev tshem tawm creatinine)
2 xyoos

Cia rau cov neeg mob
Hauv qhov chaw qhuav, ntawm qhov kub tsis tshaj 30 ° C.

Tso Tawm Cov Ntawv

10 - hlwv (3) - pob khoom los ntawm cardboard. 30 daim nyob rau hauv txoj kev lag luam uas tsis muaj chaw nyob 7 - cov hlwv (14) - pob khoom los qhia. 7 - hlwv (14) - pob khoom los ntawm cardboard. 7 - hlwv (2) - pob khoom los ntawm cardboard. 7 - hlwv (4) - pob khoom los ntawm cardboard. 7 - hlwv (8) - pob khoom los ntawm cardboard. 7 - hlwv (12) - pob khoom los ntawm cardboard. 7 - hlwv (14) - pob khoom los ntawm cardboard. 100 mg + 25 mg zaj duab xis-coated ntsiav tshuaj - 30 tab. 100 mg + 25 mg zaj duab xis-ntsiav tshuaj - 60 ntsiav tshuaj ntim 30 ntsiav tshuaj pob 60 ntsiav tshuaj pob 90 ntsiav tshuaj

Kev piav qhia ntawm daim ntawv tshuaj

Cov ntsiav tshuaj ua yeeb yaj kiab Cov ntsiav tshuaj, zaj duab xis-daj daj rau daj nrog lub pob ntsuab ntsuab, yog oval, me ntsis biconvex, muaj kev pheej hmoo ntawm ib sab. Cov ntsiav tshuaj, zaj duab xis-coated los ntawm daj mus rau daj nrog lub tint greenish, yog oval, me ntsis biconvex.

Tej yam kev mob tshwj xeeb

1 tab poov tshuaj losartan 100 mg hydrochlorothiazide 25 mg Cov Qhua: pregelatinized hmoov txhuv nplej siab - 69.84 mg, microcrystalline cellulose - 175,4 mg, lactose monohydrate - 126.26 mg, magnesium stearate - 3.5 mg. Cov tshuaj sib xyaw ua ke ntawm cov zaj duab xis membrane: hypromellose - 10 mg, macrogol 4000 - 1 mg, zas quinoline daj (E104) - 0.11 mg, titanium dioxide (E171) - 2.89 mg, talc - 1 mg. losartan poov tshuaj 100 mg hydrochlorothiazide 12.5 mg Cov Cim: pregelatinized hmoov txhuv nplej siab, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Lub plhaub muaj pes tsawg leeg: hypromellose, macrogol 4000, quinoline daj zas xim (E104), titanium dioxide (E171), talc. losartan potassium 100 mg hydrochlorothiazide 25 mg Cov Qhua: pregelatinized hmoov txhuv nplej siab, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Lub plhaub muaj pes tsawg leeg: hypromellose, macrogol 4000, quinoline daj zas xim (E104), titanium dioxide (E171), talc. potassium losartan 50 mg hydrochlorothiazide 12.5 mg Cov Cim: pregelatinized hmoov txhuv nplej siab, microcrystalline cellulose, lactose monohydrate, magnesium stearate Plhaub muaj pes tsawg leeg: hypromellose, macrogol 4000, quinoline daj zas xim (E104), titanium dioxide (E171), tal. losartan poov tshuaj 50 mg hydrochlorothiazide 12.5 mg Cov tsis muaj zog: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Lub plhaub muaj pes tsawg leeg: hypromellose, macrogol 4000, quinoline daj zas xim (E104), titanium dioxide (E171), talc.

Lorista N contraindications

Cov tshuaj tiv thaiv kab mob rau losartan, rau cov tshuaj uas los ntawm sulfonamides thiab lwm yam tshuaj, anuria, mob tsis zoo lub raum muaj nuj nqi (creatinine tshem tawm (CC) tsawg dua 30 ml / min.), Hyperkalemia, lub cev qhuav dej (suav nrog thaum noj cov tshuaj diuretics zoo) mob siab rau lub siab tsis ua haujlwm, refractory hypokalemia, cev xeeb tub, lactation, hlab ntsha hypotension, qis dua 18 xyoo (kev ua tau zoo thiab kev nyab xeeb tsis tau tsim), lactase deficiency, galactosemia, lossis ntshav qabzib / gal malabsorption syndrome Kev cai. Nrog ceev faj: dej-electrolyte ntshav tshuav kev puas tsuaj cuam tshuam (hyponatremia, hypochloremic alkalosis, hypomagnesemia, hypokalemia), ob leeg lub raum artery stenosis lossis mob ntshav qab zib ntawm ib lub raum artery, ntshav qab zib mellitus, hypercalcemia, hyperuricemia thiab / lossis gout, mob siab rau qee qhov kev tsis haum ntshav ntawm lub raum. tsim ua ntej nrog lwm cov tshuaj, suav nrog AP inhibitors

Lorista N phiv

Ntawm ib feem ntawm cov ntshav thiab cov lymphatic system: ua haujlwm yam tsis muaj tseeb: ntshav liab, Shenlane-Genokha purpura. Ntawm ib feem ntawm lub cev tiv thaiv kab mob: tsis tshua muaj: phiv tshuaj tiv thaiv mob, mob hlwb (nrog rau o rau ntawm lub ntsej muag thiab tus nplaig, ua rau ob leeg txoj hlab pas thiab / lossis o ntawm lub ntsej muag, daim di ncauj, pharynx). Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb thiab lub paj hlwb: feem ntau: mob taub hau, mob plab thiab tsis raws plab, pw tsaug zog, qaug zog, tshwm sim: migraine. Los ntawm cov hlab plawv system: feem ntau: orthostatic hypotension (koob tshuaj-siv tshuaj), palpitations, tachycardia, tsis tshua muaj: vasculitis. Los ntawm cov kab mob ua pa: feem ntau: hnoos, mob ntsws sab sauv, pharyngitis, o ntawm lub qhov ntswg mob. Los ntawm kev mob plab hnyuv: feem ntau: raws plab, dyspepsia, xeev siab, ntuav, mob plab. Los ntawm kab mob hepatobiliary: tsis tshua muaj: kab mob siab, ua kom lub siab ua haujlwm. Los ntawm daim tawv nqaij thiab cov rog rog subcutaneous: ncaw: urticaria, tawv nqaij khaus. Los ntawm cov leeg musculoskeletal thiab cov nqaij sib txuas: feem ntau: myalgia, rov qab mob, tshwm sim: mob pob txha. Lwm yam: feem ntau: asthenia, tsis muaj zog, peripheral edema, mob hauv siab. Qhov ntsuas pom: feem ntau: hyperkalemia, nce concentration ntawm hemoglobin thiab hematocrit (tsis yog qhov tseem ceeb hauv kev kho mob), ua tsis xws luag: muaj kev nce qib hauv cov ntshav urea thiab creatinine, tsis tshua muaj: kev ua si ntawm daim siab thiab bilirubin enzymes.

25 mg, 50 mg thiab 100 mg zaj duab xis-cov ntsiav tshuaj

Ib ntsiav tshuaj muaj

cov tshuaj heev - losartan poov tshuaj 25 mg, 50 mg thiab 100 mg,

hauvpabcuamhauvtseem: cellulose, pregelatinized hmoov txhuv nplej siab, pob kws nplej siab, microcrystalline cellulose, anhydrous colloidal silicon dioxide, magnesium stearate

plhaub muaj pes tsawg leeg: hypromellose, talc, propylene glycol, titanium dioxide (E171) (rau ntau npaum li 25 mg, 50 mg, 100 mg), quinoline daj (E104) (rau ntau npaum li 25 mg)

Cov ntsiav tshuaj yog oval, nrog me ntsis biconvex nto, them nrog txheej xim daj zaj duab xis, muaj kev pheej hmoo ntawm ib sab (rau ntau npaum li 25 mg).

Cov ntsiav tshuaj yog puag ncig cov duab, nrog me ntsis biconvex nto, coated nrog cov xim dawb zaj duab xis txheej, nrog qhov siab tshaj ntawm ib sab thiab ib chamfer (rau qhov ntau npaum ntawm 50 mg).

Dawb cov ntsiav tshuaj nrog me ntsis biconvex nto, coated nrog cov xim zaj duab xis dawb (rau qhov ntau npaum li 100 mg)

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Tom qab noj, losartan yog zoo nqus los ntawm txoj hnyuv hauv plab, yauv ua rau cov metabolism tseem ceeb thaum thawj daim pib los ntawm daim siab, ua rau lub cev muaj cov metabolite - carboxylic acid thiab lwm yam kev siv lub cev tsis ua haujlwm. Cov txheej txheem ib puag ncig ntawm lub cev ntawm losartan yog kwv yees li 33%. Qhov nruab nrab lub siab nruab nrab ntawm losartan tau tiav hauv 1 teev, thiab nws cov nquag metabolite hauv 3-4 teev.

Ntau tshaj li 99% ntawm losartan thiab nws cov nquag metabolite khi rau cov ntshav muaj protein ntau, feem ntau yog albumin. Qhov ntim ntawm kev faib tawm ntawm losartan yog 34 litres.

Kwv yees li 14% ntawm losartan, muab ntawm qhov ncauj, yog hloov dua siab tshiab rau nws cov nquag metabolite.

Lub plasma tshem ntawm losartan thiab nws cov metabolite yog kwv yees li 600 ml / min thiab 50 ml / min, feem. Lub raum tshem tawm ntawm losartan thiab nws cov metabolite nquag ntev li 74 ml / min thiab 26 ml / min, feem. Nrog rau kev tswj hwm ntawm qhov ncauj ntawm losartan, kwv yees li 4% ntawm cov koob tshuaj tau pom tias tsis hloov pauv hauv cov zis, thiab kwv yees li 6% ntawm kev siv tshuaj tiv thaiv metabolite. Lub chaw muag tshuaj ntawm losartan thiab nws cov tshuaj metabolite yog txig nrog kev tswj hwm ntawm losartan potassium hauv koob tshuaj txog 200 mg.

Tom qab noj, qhov ntau ntawm losartan thiab nws cov metabolite nyob rau hauv cov ntshav ntshav txo exponentially, kawg ib nrab-lub neej yog kwv yees li 2 teev thiab 6-9 teev, feem. Thaum lub koob tshuaj 100 mg tau noj ib hnub ib zaug, tsis yog losartan lossis nws lub zog metabolite txuam nrog hauv cov ntshav hauv qhov ntau.

Losartan thiab nws cov metabolites yog cov tawm hauv cov kua tsib thiab tso zis: txog 35% thiab 43%, feem, ua rau cov zis tawm, thiab li 58% thiab 50%, feem, ua rau cov quav tso quav.

Cov Tshuaj Pharmacokineticsntawmtus neeg mob pab pawg

Hauv cov neeg mob laus uas muaj kev mob ntshav siab, cov ntsiab lus ntawm losartan thiab nws cov metabolite hauv cov ntshav ntshav tsis txawv ntawm cov uas pom muaj hauv cov neeg mob hluas uas mob ntshav liab.

Hauv cov neeg mob uas poj niam lub plawv dhia, qhov theem ntawm losartan hauv ntshav ntshav yog ob zaug ntau dua hauv cov neeg mob txiv neej arterial hypertension, thaum qib ntawm cov metabolite hauv ntshav plasma tsis txawv tus txiv neej thiab poj niam.

Hauv cov neeg mob uas mob hnyav thiab cawv hnyav lub siab ua lub siab, cov theem ntawm losartan thiab nws cov metabolite hauv ntshav plasma tom qab kev tswj hwm qhov ncauj yog 5 thiab 1.7 npaug, feem, ntau dua li cov txiv neej hluas.

Hauv cov neeg mob nrog creatinine tshem tawm saum toj 10 ml / min, ntshav ntau ntawm losartan tsis hloov. Piv nrog cov neeg mob uas lub raum zoo li qub, hauv cov neeg mob ntawm hemodialysis, qhov chaw AUC (thaj chaw nyob hauv qhov chaw cia khoom thaum lub caij nplooj zeeg) rau losartan yog kwv yees li 2 zaug siab dua.

Hauv cov neeg mob uas lub raum tsis ua haujlwm lossis hauv cov neeg mob ua rau mob hemodialysis, cov ntshav plasma qhov ntau ntawm cov nquag metabolite tsis tau hloov pauv.

Neither losartan thiab lub zog metabolite yuav raug tshem tawm los ntawm hemodialysis.

Lorista® - antihypertensive tshuaj, yog qhov ncauj xaiv tshuaj angiotensin II receptor antagonist (hom AT1). Angiotensin II yog ib yam tshuaj lom ntawm lub cev renin-angiotensin thiab yog ib qho tseem ceeb tshaj plaws ntawm cov kab mob pathophysiology ntawm kev mob ntshav siab. Angiotensin II khi rau AT1 receptors pom nyob rau hauv ntau cov ntaub so ntswg (piv txwv li, vascular du leeg, qog adrenal, raum, thiab plawv) thiab ua rau ntau cov teebmeem kev lom neeg, suav nrog vasoconstriction thiab aldosterone tso tawm. Angiotensin II tseem muaj kev cuam tshuam cov kev loj hlob ntawm cov leeg hlwb muaj zog.

Losartan thiab nws cov pharmacologically nquag metabolite E3174 thaiv tag nrho cov kev cuam tshuam ntawm lub cev ntawm angiotensin II, tsis hais nws lub hauv paus thiab txoj kev biosynthesis.

Lorista® xaiv tau txwv tsis pub AT1 receptors thiab tsis thaiv cov receptors los ntawm lwm cov tshuaj hormones lossis ion channel uas yog lub luag haujlwm rau cov kev cai ntawm cov kab mob plawv. Ntxiv mus, losartan tsis inhibit qhov kev ua ntawm angiotensin-hloov enzyme (kinase II), ib qho enzyme uas koom nrog kev tawg ntawm bradykinin.

Ib koob tshuaj ntawm losartan hauv cov neeg mob uas mob sib khuav ntawm cov mob ntshav liab los ntawm cov leeg ntshav siab qhia pom kev txo qis systolic thiab diastolic ntshav siab. Nws cov txiaj ntsig siab tshaj plaws tsim tawm 6 teev tom qab kev tswj hwm, kho qhov ua tau zoo li 24 teev, yog li nws txaus noj nws ib hnub ib zaug. Cov nyhuv antihypertensive nthuav dav thaum thawj lub lim tiam ntawm kev kho, thiab tom qab ntawd maj mam nce thiab ruaj khov tom qab 3-6 lub lis piam

Lorista® yog sib npaug zoo rau txiv neej thiab poj niam, nrog rau cov neeg laus (≥ 65 xyoo) thiab cov neeg mob yau (≤ 65 xyoo).

Kev tsum tsis dhau losartan hauv cov neeg mob ntshav siab tsis ua rau nce ntshav siab. Txawm hais tias qhov cim txo qis hauv cov ntshav siab, losartan tsis muaj kev cuam tshuam loj hauv kev kho lub plawv.

Kev ntsuas rau siv

- kev kho mob qhov tseem ceeb ntawm txoj hlab ntshav hauv cov neeg laus

- kev kho mob ntawm lub raum hauv cov neeg laus cov neeg mob ntshav siab

thiab hom 2 mob ntshav qab zib mellitus nrog proteinuria ≥ 0.5 g / hnub, ua ib feem

- kev kho mob ntawm lub plawv tsis ua haujlwm ntev hauv cov neeg laus

(sab laug ventricular ejection feem ≤40%, thaj chaw kho mob ruaj khov

kev mob) thaum siv cov angiotensin-hloov pauv cov tshuaj tiv thaiv

qhov enzyme tau txiav txim siab tsis yooj yim sua vim yog intolerance, tshwj xeeb

nrog txoj kev loj hlob ntawm hnoos, lossis thaum lawv lub hom phiaj yog contraindicated

- txo qis kev pheej hmoo ntawm mob hlab ntsha tawg hauv cov neeg laus cov neeg mob ntshav liab

ECT-paub tseeb hypertrophy thiab sab laug ventricular hypertrophy

Tsuas tshuaj thiab tswj hwm

Sab hauv, tsis hais txog pluas noj. Cov ntsiav tshuaj tau nqos tsis tau zom, ntxuav nrog ib khob ntawm dej. Tshaj tawm ntawm kev pub nkag - 1 zaug nyob rau ib hnub.

Rau feem ntau cov neeg mob, cov koob tshuaj thawj zaug thiab txij nkawm yog 50 mg ib hnub ib zaug. Qhov siab tshaj plaws antihypertensive siv tau tiav hauv peb mus rau rau lub lis piam tom qab pib kho.

Qee tus neeg mob yuav tsum tau txhaj ntau ntxiv txog 100 mg ib hnub ib zaug (thaum sawv ntxov).

Arterial hypertension rau cov neeg mob uas muaj ntshav qab zib hom II mellitus nrog proteinuria ≥ 0.5 g / hnub

Qhov kev pib noj ib txwm ib txwm yog 50 mg ib hnub ib zaug. Qhov ntau npaum li cas tuaj yeem raug nce rau 100 mg ib hnub ib zaug raws li cov txiaj ntsig ntawm ntshav siab hauv ib hlis tom qab pib kho. Losartan tuaj yeem coj nrog rau lwm cov tshuaj tiv thaiv kabmob (piv txwv li diuretics, calcium channel blockers, alpha lossis beta blockers thiab central tshuaj) nrog rau cov tshuaj insulin thiab lwm yam tshuaj tiv thaiv hypoglycemic feem ntau (piv txwv li sulfonylurea, glitazone, glucosidase inhibitor) Cov.

Thawj koob tshuaj Lorista® nyob rau hauv cov neeg mob lub siab tsis txaus yog 12,5 mg rau ib hnub nyob rau hauv ib koob. Txhawm rau kom tau txais qhov kev saib xyuas txij nkawm ntawm 50 mg rau ib hnub, uas feem ntau zoo tiv thaiv los ntawm cov neeg mob, cov koob tshuaj yuav tsum tau nce ntxiv los ntawm 12,5 mg, nyob rau ntawm ncua sijhawm ntawm ib lub lis piam (i.e., 12,5 mg rau ib hnub, 25 mg rau ib hnub, 50 mg ib hnub, 100 mg ib hnub twg, txog qhov ntau tshaj plaws ntawm 150 mg ib hnub ib zaug).

Cov neeg mob uas lub plawv tsis ua hauj lwm uas nws tus mob tau ruaj khov nrog kev siv tshuaj ACE inhibitor yuav tsum tsis txhob pauv mus rau kev kho losartan.

Txoj kev pheej hmoo txokev txhim khomob hlab ntsha tawg hauv cov neeg mob cov neeg mob ntshav siabthiabhypertrophy ntawm sab laugventricle paub tseebthECG.

Qhov kev pib noj ib txwm yog 50 mg ntawm losartan ib hnub ib zaug. Qhov koob tshuaj hydrochlorothiazide tsawg kawg yuav ntxiv thiab / lossis koob tshuaj yuav tsum tau nce ntxiv txog 100 mg rau ib hnub raws li cov txiaj ntsig ntshav siab.

Cov Tshuaj Hauv Tshuaj

Lorista ® N yog kev sib koom ua ke uas nws cov khoom sib xyaw ua rau muaj qhov kev tiv thaiv kom zoo thiab ua rau cov ntshav nce siab ntau dua piv nrog kev sib cais. Vim yog cov nyhuv diuretic, hydrochlorothiazide ua rau kom muaj kev ua si plasma renin, qhov zais ntshis ntawm aldosterone, txo cov ntshiab poov tshuaj ntsiab lus thiab nce qib ntawm angiotensin II hauv ntshav ntshav. Losartan thaiv cov kev mob ntawm lub cev ntawm angiotensin II thiab, vim yog inhibition of aldosterone secretion, tuaj yeem tawm txawm tias cov poov tshuaj ions poob los ntawm cov diuretic.

Losartan muaj qhov ua kom uricosuric. Hydrochlorothiazide ua rau muaj kev nce hauv nruab nrab ntawm kev saib xyuas ntawm uric acid, nrog kev siv losartan ib txhij nrog hydrochlorothiazide, hyperuricemia tshwm sim los ntawm diuretic txo qis.

Cov nyhuv los tiv thaiv hydrochlorothiazide / losartan sib xyaw ua ke tau 24 teev. Txawm hais tias ntshav siab los ntshav tseem ceeb, kev siv ua ke nrog hydrochlorothiazide / losartan tsis muaj kev cuam tshuam loj hauv lub plawv.

Kev sib xyaw ntawm hydrochlorothiazide / losartan zoo rau cov txiv neej thiab poj niam, zoo li hauv cov neeg mob uas muaj hnub nyoog yau dua (hluas dua 65 xyoos) thiab cov laus (txij li 65 xyoo thiab laus dua).

Losartan yog tus neeg tawm tsam ntawm angiotensin II receptors rau qhov ncauj tswj hwm ntawm qhov tsis muaj protein ntau. Angiotensin II yog ib qho muaj zog vasoconstrictor thiab lub ntsiab hormone ntawm RAAS. Angiotensin II khi rau AT 1 receptors, uas pom nyob rau hauv ntau cov ntaub so ntswg (xws li, cov leeg ntawm cov leeg ntshav, cov qog adrenal, ob lub raum thiab myocardium) thiab sib kho ntau yam kev mob caj ces ntawm angiotensin II, suav nrog vasoconstriction thiab aldosterone tso tawm. Ntxiv rau, angiotensin II txhawb kev ua kom loj hlob ntawm cov leeg hlwb.

Losartan xaiv kev txwv AT 1 receptors. Hauv vivo thiab hauv vitro losartan thiab nws txoj kev lom neeg lub cev carboxy metabolite (EXP-3174) thaiv tag nrho cov kev mob tshwm sim ntawm lub cev angiotensin II ntawm AT 1 receptors, tsis hais txoj kev ntawm nws cov synthesis. Losartan tsis muaj qhov teeb meem thiab tsis thaiv lwm cov tshuaj hormonal lossis ion channels uas yog qhov tseem ceeb hauv kev tswj hwm ntawm CCC. Losartan tsis inhibit kev ua si ntawm ACE (kininase II), ib qho enzyme uas koom nrog hauv cov metabolism hauv ntawm bradykinin. Raws li, nws tsis ua rau muaj kev nce ntxiv hauv lub zaus ntawm cov kev tsis xav tau kev sib kho los ntawm bradykinin.

Losartan tsis ncaj qha ua rau kev ua kom AT 2 receptors los ntawm kev nce qib ntawm angiotensin II hauv ntshav ntshav.

Kev tsuj ntawm txoj cai ntawm renin kev zais cia los ntawm angiotensin II los ntawm lub tswv yim tsis zoo lub tswv yim thaum kho nrog losartan ua rau muaj kev nce plasma renin ntau ntxiv, uas ua rau muaj kev nce siab ntawm cov tshuaj angiotensin II hauv ntshav ntshav. Txawm li cas los xij, cov nyhuv antihypertensive thiab kev tawm tsam ntawm aldosterone secretion ntxiv, qhia tias muaj kev cuam tshuam zoo ntawm cov tshuaj angiotensin II.Tom qab tshem tawm losartan, lub plasma renin kev ua si thiab qhov kev cia siab ntawm angiotensin II txo qis rau thawj cov nqi li ntawm 3 hnub.

Losartan thiab nws cov metabolite tseem ceeb muaj qhov kev cuam tshuam zoo dua rau AT 1 receptors piv rau AT 2 receptors. Cov nquag metabolite surpasses losartan hauv kev ua si los ntawm 10-40 zaug.

Cov zaus ntawm kev txhim kho hnoos tau sib piv thaum siv losartan lossis hydrochlorothiazide thiab muaj qis dua qis dua thaum siv ACE inhibitor.

Hauv cov neeg mob uas mob ntshav lub plawv thiab mob proteinuria, tsis raug kev mob ntshav qab zib mellitus, kev kho mob nrog losartan txo cov proteinuria ntau, kev nthuav tawm ntawm albumin thiab IgG. Losartan txhawb glomerular pom thiab txo qhov pom kev txaus. Losartan txo cov ntshav uric acid concentration (feem ntau tsawg dua 0.4 mg / dl) thoob plaws hauv chav kawm ntawm kev kho. Losartan tsis muaj qhov cuam tshuam ntawm qhov tsis txaus ntshai ntawm tus kheej thiab tsis muaj kev cuam tshuam cov tshuaj norepinephrine hauv cov ntshav ntshav.

Nyob rau hauv cov neeg mob uas sab laug ventricular tsis txaus, losartan nyob rau hauv koob tshuaj 25 thiab 50 mg muaj qhov zoo hemodynamic thiab neurohumoral cov yam ntxwv, tus cwj pwm los ntawm kev nce rau hauv lub plawv mob thiab qhov poob qis hauv lub siab ntawm jamming ntawm cov hlab ntsws, OPSS, txhais tau hais tias ntshav siab thiab lub plawv dhia thiab txo qis ntshav ntau ntxiv ntawm aldosterone thiab norepinephrine. Txoj kev pheej hmoo ntawm kev tsim muaj cov hlab ntsha hypotension hauv cov neeg mob plawv tsis ua hauj lwm yog nyob ntawm qhov koob tshuaj losartan.

Kev siv cov tshuaj losartan ib hnub ib zaug hauv cov neeg mob uas tsis tshua mob mus txog qhov hnyav yuav ua rau muaj teeb meem loj hauv SBP thiab DBP. Cov nyhuv antihypertensive kav rau 24 teev thaum tswj lub ntuj circadian atherosclerosis ntawm cov ntshav siab. Qeb ntawm kev txo cov ntshav siab thaum kawg ntawm kev noj tshuaj dua yog 70-80% piv nrog cov nyhuv hypotensive 5-6 teev tom qab noj losartan.

Losartan muaj txiaj ntsig zoo rau tus txiv neej thiab poj niam, zoo li hauv cov neeg laus (65 xyoo rov hauv thiab laus dua) thiab cov neeg mob yau (hnub nyoog qis dua 65 xyoos). Kev tshem tawm ntawm losartan nyob rau hauv cov neeg mob uas mob ntshav lub plawv tsis ua rau muaj ntshav nce siab ntau ntxiv (nws tsis muaj qhov txiav tawm yeeb tshuaj). Losartan tsis muaj kev cuam tshuam loj rau lub plawv dhia.

Thiazide diuretic, lub tshuab ntawm kev ua haujlwm hypotensive uas tsis yog thaum kawg tsim los. Thiazides hloov cov reabsorption ntawm electrolytes nyob rau hauv qhov tsis sib luag ntawm nephron thiab nce ntxiv kev tsis haum ntawm sodium thiab chlorine ions muaj kwv yees sib npaug. Cov nyhuv diuretic ntawm hydrochlorothiazide ua rau txo bcc, kev nce plasma renin kev ua si thiab aldosterone secretion, uas ua rau muaj kev nce ntxiv ntawm qhov tsis pom ntawm potassium ions thiab bicarbonates los ntawm lub raum thiab txo qis ntshav poov tshuaj ntau ntxiv. Cov kev sib raug zoo ntawm renin thiab aldosterone yog kev sib kho los ntawm angiotensin II, yog li kev siv ARA II ib txhij cuam tshuam qhov kev ploj ntawm potassium ions hauv kev kho thiazide diuretics.

Tom qab kev tswj hwm ntawm qhov ncauj, cov nyhuv diuretic tshwm sim tom qab 2 teev, nce mus txog qhov siab kawg tom qab txog 4 teev thiab kav ntev li 6-12 teev, cov nyhuv hypotensive tseem muaj nyob rau 24 teev.

Cov Tshuaj Pharmacokinetics

Tus kws tshuaj ntawm losartan thiab hydrochlorothiazide thaum noj nws tsis txawv ntawm qhov ntawd thaum lawv siv cais.

Xuas. Losartan: tom qab kev tswj hwm ntawm qhov ncauj, losartan yog qhov zoo thiab yoog tawm thaum pib nkag los ntawm daim siab nrog rau kev tsim lub zog carboxy metabolite (EXP-3174) thiab lub cev tsis muaj zog. Txheej txheem kev nyab xeeb ntawm cov neeg nruab nrog kom txog 33%. C max hauv cov ntshav plasma ntawm losartan thiab nws cov metabolite ua haujlwm tau tiav tom qab 1 h thiab 3-4 teev, ua ntu zus. Hydrochlorothiazide: tom qab kev tswj hwm ntawm qhov ncauj, qhov nqus ntawm hydrochlorothiazide yog 60-80%. C max ntawm hydrochlorothiazide hauv cov ntshav ntshav tau tiav 1-5 teev tom qab noj.

Kev xa Khoom. Losartan: ntau dua 99% ntawm losartan thiab EXP-3174 khi rau cov ntshav muaj protein ntau, feem ntau yog nrog albumin. V d ntawm losartan yog 34 litres. Nws nkag mus ntau heev los ntawm BBB. Hydrochlorothiazide: kev sib txuas lus nrog cov ntshav protein yog 64%, hla lub tsho me me, tab sis tsis dhau los ntawm BBB, thiab tawm hauv cov kua mis.

Biotransformation. Losartan: kwv yees li 14% ntawm ib koob tshuaj losartan, muab iv lossis qhov ncauj, yog tshuaj tiv thaiv los tsim cov tshuaj metabolite. Tom qab lub qhov ncauj tswj hwm thiab / lossis iv kev tswj hwm ntawm 14 C-losartan potassium, cov xov tooj cua ntshav khov ntawm cov ntshav plasma feem ntau tau txiav txim los ntawm losartan thiab nws cov metabolite.

Ntxiv nrog rau cov nquag metabolite, lub cev tsis muaj zog metabolites yog tsim, suav nrog ob lub ntsiab metabolites tsim los ntawm hydroxylation ntawm pawg butyl ntawm cov saw, thiab muaj cov metabolite me - N-2-tetrazole glucuronide.

Noj tshuaj nrog zaub mov noj tsis muaj kev cuam tshuam loj hauv nws txoj kev kuaj ntshav.

Hydrochlorothiazide: tsis muaj qhov tshwj xeeb.

Chaw Sau Ntawv. Losartan: lub plasma tshem ntawm losartan thiab nws cov metabolite yog 600 thiab 50 ml / min, feem, thiab lub raum tshem ntawm losartan thiab nws cov metabolite yog 74 thiab 26 ml / min, feem. Tom qab cov tshuaj noj ntawm qhov ncauj, tsuas yog kwv yees li 4% ntawm cov koob tshuaj uas tau hloov yog tsis hloov pauv los ntawm ob lub raum thiab li 6% nyob rau hauv daim ntawv ntawm kev siv tshuaj metabolite. Cov tshuaj pharmacokinetic ntawm losartan thiab nws cov metabolite thaum noj ntawm qhov ncauj (hauv koob li 200 mg) yog tawm.

T 1/2 nyob rau hauv lub davhlau ya nyob twg theem ntawm losartan thiab nquag metabolite yog 2 teev thiab 6-9 teev, ua ntu zus. Tsis muaj qhov khaws cia ntawm losartan thiab nws cov metabolite thaum siv nyob rau hauv ib koob ntawm 100 mg ib hnub ib zaug.

Nws yog tawm los tsuas yog los ntawm txoj hnyuv nrog cov kua tsib - 58%, ob lub raum - 35%.

Hydrochlorothiazide: nrawm dhau los ntawm lub raum. T 1/2 yog 5.6-14.8 teev. Kwv yees li 61% ntawm qhov tau noj yog muab tsis hloov.

Cov neeg mob ib leeg

Hydrochlorothiazide / losartan. Plasma ntau ntawm losartan thiab nws cov metabolite thiab hydrochlorothiazide rau cov neeg laus uas mob ntshav tawm tsis txawv ntawm cov neeg mob hluas.

Losartan. Hauv cov neeg mob uas mob hnyav thiab cawv hnyav ua rau lub siab tom qab noj losartan, qhov ntau ntawm losartan thiab cov nquag metabolite hauv cov ntshav ntshav tau 5 thiab 1.7 npaug siab dua ntawm cov txiv neej ua haujlwm pab dawb, feem.

Losartan thiab nws cov metabolite nquag tsis tshem tawm los ntawm hemodialysis.

Cev xeeb tub thiab lactation

Kev siv ntawm ARA II hauv thawj peb lub hlis thaum cev xeeb tub tsis pom zoo.

Cov tshuaj Lorista ® N yuav tsum tsis txhob siv thaum cev xeeb tub, zoo li hauv cov poj niam npaj cev xeeb tub. Thaum npaj kev cev xeeb tub, nws raug nquahu tias tus neeg mob hloov mus rau lwm txoj kev kho los tiv thaiv kev tiv thaiv kev noj qab haus huv coj mus rau hauv tus account muaj kev nyab xeeb. Yog tias kev xeeb tub yog paub tseeb, tsum tsis txhob noj Lorista ® N thiab, yog tias tsim nyog, hloov tus neeg mob mus rau lwm txoj kev kho mob tiv thaiv kab mob siab.

Cov tshuaj Lorista ® N, zoo li lwm yam tshuaj uas muaj kev cuam tshuam ncaj qha rau RAAS, tuaj yeem ua rau muaj qhov tsis txaus siab nyob rau hauv cov menyuam hauv plab (lub raum tsis ua haujlwm, ncua ossification ntawm cov pob txha pob txha taub hau ntawm lub cev, oligohydramnios) thiab cov tshuaj tiv thaiv neonatal tshuaj lom neeg mob (lub raum tsis ua haujlwm, mob ntshav qis, ntshav siab). Yog tias koj tseem siv cov tshuaj Lorista ® N hauv II-III txiav tawm hauv plab thaum cev xeeb tub, nws yog ib qhov tsim nyog los ua qhov ntsuas ntawm lub raum thiab pob txha ntawm pob txha taub hau me nyuam hauv plab.

Hydrochlorothiazide hla lub tsho me me. Thaum thiazide diuretics raug siv nyob rau hauv II-III lub sijhawm cev xeeb tub, qhov txo qis ntawm utero-placental ntshav txaus, kev loj hlob ntawm thrombocytopenia, daj ntseg, thiab kev cuam tshuam ntawm cov dej-electrolyte sib npaug hauv tus menyuam lossis tus menyuam yug tshiab tau.

Hydrochlorothiazide yuav tsum tsis txhob siv los kho tus mob gestosis nyob rau lub sijhawm thib ob ntawm cev xeeb tub (edema, mob hlab ntsha tawg los yog preeclampsia (nephropathy)) vim qhov pheej hmoo ntawm kev txo qis bcc thiab txo qis ntshav ntshav khiav tsis txaus nyob rau hauv lub sijhawm ua haujlwm. Hydrochlorothiazide yuav tsum tsis txhob siv los kho tus mob ntshav siab tseem ceeb hauv cov poj niam cev xeeb tub, tsuas yog muaj qee tus neeg mob uas tsis tshua pom muaj thaum siv lwm tus neeg sawv cev.

Cov menyuam mos uas lawv niam coj Lorista ® N thaum cev xeeb tub yuav tsum tau saib xyuas, ib yam li kev loj hlob tau ntawm txoj kev loj hlob ntawm txoj hlab ntaws hauv tus menyuam mos.

Nws tsis paub tseeb tias puas yog losartan nrog cov kua mis pub tawm.

Hydrochlorothiazide kis mus rau leej niam cov kua mis hauv qhov ntau thiab tsawg. Thiazide diuretics nyob rau hauv cov koob tshuaj siab ua rau lub zog diuresis, yog li inhibiting lactation.

Sab sij huam

Kev faib tawm ntawm qhov tshwm sim ntawm cov kev mob tshwm sim los ntawm WHO:

ntau zaus ≥1 / 10, feem ntau los ntawm ≥1 / 100 txog QT (kev pheej hmoo ntawm kev tsim ventricular tachycardia ntawm pirouette hom),

IA chav kawm ntawm cov tshuaj tua kab mob (xws li quinidine, disopyramide),

Hoob III antiarrhythmic tshuaj (piv txwv li amiodarone, sotalol, dofetilide).

Qee cov tshuaj tiv thaiv kab mob (piv txwv, thioridazine, chlorpromazine, levomepromazine, trifluoperazin, sulpiride, amisulpride, tiapride, haloperidol, droperidol).

Lwm yam tshuaj (piv txwv li cisapride, diphenyl methyl sulphate, erythromycin rau kev tswj hwm iv, halofantrine, ketanserin, misolastine, sparfloxacin, terfenadine, vincamine rau kev tswj hwm).

Vitamin D thiab ntsev cov ntsev calcium: kev siv tib lub sijhawm thiazide diuretics nrog vitamin D lossis ntsev ntsev ntxiv cov ntsev ntau ntxiv hauv lub cev, vim tias excreted calcium. Yog tias koj xav siv cov tshuaj calcium lossis vitamin D kev npaj, koj yuav tsum saib xyuas cov calcium nyob hauv cov ntshav thiab, tejzaum nws yuav tau hloov cov tshuaj no,

Carbamazepine: kev pheej hmoo ntawm kev tsim muaj cov tsos mob hyponatremia. Nws yog qhov tsim nyog los tswj cov ntsuas ntsuas ntsuas thiab lub cev roj ntsha.

Hydrochlorothiazide tuaj yeem ua rau muaj kev pheej hmoo ntawm kev tsim muaj lub raum tsis ua haujlwm, tshwj xeeb tshaj yog siv tib lub sijhawm ntawm cov tshuaj iodine uas muaj cov tshuaj tiv thaiv tsis zoo. Ua ntej siv lawv, nws yog qhov yuav tsum tau rov qab bcc.

Amphotericin B (rau kev tswj hwm mob), cov tshuaj laxatives los yog ammonium glycyrrhizinate (ib feem ntawm licorice): hydrochlorothiazide tuaj yeem nce dej-electrolyte tsis txaus, tshwj xeeb tshaj yog hypokalemia.

Noj ntau dhau

Tsis muaj cov ntaub ntawv hais txog kev siv tshaj ntawm hydrochlorothiazide / losartan ua ke.

Kev Kho Mob: mob thiab kev pab txhawb nqa. Lorista ® N yuav tsum tsis ua haujlwm ntxiv thiab tus neeg mob ua tib zoo tshuaj xyuas. Yog tias tsim nyog: ua rau ntuav (yog tias tus neeg mob nyuam qhuav noj cov tshuaj), rov ua dua bcc, kev kho qhov cuam tshuam hauv cov dej-electrolyte metabolism thiab ua rau muaj ntshav siab.

Losartan (cov ntaub ntawv txwv)

Cov tsos mob cim txo nyob rau hauv cov ntshav siab, tachycardia, bradycardia vim parasympathetic (poj niam qhov chaw mos) yog tau.

Kev Kho Mob: kev kho mob, kev hloov kho kho tsis tau zoo.

Cov tsos mob cov tsos mob tshwm sim feem ntau yog: hypokalemia, hypochloremia, hyponatremia thiab lub cev qhuav dej, ua rau muaj diuresis ntau dhau. Nrog kev tswj hwm tib lub sijhawm ntawm lub plawv glycosides, hypokalemia tuaj yeem ua rau phem chav kawm ntawm arrhythmias.

Cov lus qhia tshwj xeeb

Angioneurotic edema. Cov neeg mob uas muaj tus mob angioedema (ntsej muag, daim di ncauj, mob taub hau, thiab / lossis lub suab nrov) yuav tsum tau saib xyuas keeb kwm kom zoo.

Arterial hypotension thiab hypovolemia (lub cev qhuav dej). Hauv cov neeg mob uas hypovolemia (lub cev qhuav dej) thiab / lossis txo qis ntsev cov ntsiab lus hauv cov ntshav plasma thaum kho mob diuretic, kev txwv kev noj ntsev ntau, raws plab, lossis ntuav, mob hypotension yuav tshwm sim, tshwj xeeb yog tom qab noj thawj koob tshuaj Lorista ® N. Ua ntej siv tshuaj, nws yuav tsum rov qab BCC thiab / lossis sodium hauv ntshav.

Kev ua txhaum ntawm cov dej-electrolyte tshuav. Kev ua txhaum ntawm cov dej-electrolyte tshuav feem ntau pom nyob rau hauv cov neeg mob uas lub raum tsis ua haujlwm, tshwj xeeb yog tawm tsam ntshav qab zib mellitus. Hauv kev hais txog qhov no, nws yog ib qho tsim nyog yuav tsum ua tib zoo saib xyuas cov ntsiab lus poov tshuaj nyob hauv cov ntshav plasma thiab creatinine kev tshem tawm, tshwj xeeb tshaj yog nyob rau cov neeg mob plawv tsis ua hauj lwm thiab Cl creatinine 30-50 ml / min.

Kev siv tib lub sijhawm nrog cov tshuaj potassium-sparing diuretics, tshuaj poov tshuaj npaj, ntsev hloov cov ntsev uas muaj poov tshuaj, lossis lwm txoj kev tuaj yeem nce cov ntsiab lus poov tshuaj hauv cov ntshav ntshav (xws li heparin) tsis pom zoo.

Lub siab ua haujlwm tsis zoo. Qhov siab ntawm losartan nyob rau hauv cov ntshav ntshav ntxiv ntau dua rau cov neeg mob qog mob ntshav siab, yog li ntawd, cov tshuaj Lorista ® N yuav tsum siv nrog ceev faj hauv cov neeg mob uas tsis tshua mob siab lossis mob hnyav lub siab ua haujlwm.

Lub raum khiav tsis zoo. Muaj peev xwm ua rau lub raum khiav tsis zoo, suav nrog lub raum tsis ua haujlwm, vim kev tsis pom tseeb ntawm RAAS (tshwj xeeb tshaj yog nyob rau cov neeg mob uas lub raum ua haujlwm nyob ntawm RAAS, piv txwv li, muaj mob plawv tsis zoo lossis keeb kwm ntawm lub raum tsis ua haujlwm).

Plab leeg mob leeg. Hauv cov neeg mob uas muaj ob sab mob raum leeg txoj hlab ntsha, nrog rau cov leeg ntawm lub raum uas tsuas ua haujlwm raum, cov tshuaj uas cuam tshuam rau RAAS, suav nrog thiab ARA II, tuaj yeem hloov kho rov qab tso zis ntau ntawm urea thiab creatinine hauv ntshav ntshav.

Losartan yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas muaj ob sab lub raum leeg mob stenosis los yog lub raum leeg mob stenosis.

Raum lub raum. Tsis muaj kev paub nrog kev siv Lorista ® N hauv cov neeg mob uas nyuam qhuav tawm tsam raum hloov ntshav.

Thawj Hyperaldosteronism. Cov neeg mob uas muaj cov thawj hyperaldosteronism tiv thaiv cov tshuaj antihypertensive uas cuam tshuam rau RAAS, yog li kev siv Lorista ® N tsis pom zoo rau cov neeg mob no.

IHD thiab kab mob cerebrovascular. Ib yam li tej tshuaj antihypertensive, kev txo qis hauv cov ntshav siab rau cov neeg mob mob hlab ntsha hlwb los yog mob cerebrovascular tuaj yeem ua rau txoj kev loj hlob ntawm myocardial infarction lossis mob stroke.

Lub plawv tsis ua hauj lwm. Hauv cov neeg mob uas lub raum ua haujlwm nyob ntawm lub xeev RAAS (piv txwv li, NYHA kev faib tawm kev ua haujlwm ntawm chav kawm III-IV CHF, nrog lossis tsis mob raum), kev kho mob nrog tshuaj uas cuam tshuam rau RAAS tej zaum yuav muaj kev cuam tshuam los ntawm kev mob ntshav hauv lub cev, oliguria thiab / lossis kev vam meej. azotemia, nyob rau hauv tsis tshua muaj mob, mob raum tsis ua hauj lwm. Nws tsis tuaj yeem tshem tawm txoj kev loj hlob ntawm cov kev tsis txaus ntseeg no vim yog kev tsuj ntawm RAAS kev ua haujlwm hauv cov neeg mob uas tau txais ARA II.

Stenosis ntawm aortic thiab / lossis mitral valve, GOKMP. Cov tshuaj Lorista ® N, zoo li lwm cov vasodilators, yuav tsum tau siv nrog ceev faj hauv cov neeg mob nrog hemodynamically tseem ceeb stenosis ntawm aortic thiab / lossis mitral valve, lossis GOKMP.

Cov cim neeg txawv. Losartan (zoo li lwm yam tshuaj uas cuam tshuam rau RAAS) muaj qhov tsis tshua muaj txiaj ntsig hypotensive hauv cov neeg mob ntawm cov haiv neeg Negroid piv nrog cov neeg sawv cev ntawm lwm haiv neeg, tejzaum nws vim muaj ntau dua los ntawm hyporeninemia hauv cov neeg mob ntshav siab.

Arterial hypotension thiab ua tsis taus dej-electrolyte metabolism hauv. Nws yog ib qho tsim nyog los tswj cov ntshav siab, cov kab mob soj ntsuam ntawm qhov tsis txaus cov dej-electrolyte metabolism, suav nrog lub cev qhuav dej, hyponatremia, hypochloremic alkalosis, hypomagnesemia los yog hypokalemia, uas tuaj yeem tsim tiv thaiv ntawm keeb kwm ntawm zawv plab lossis ntuav.

Ntshav dej electrolytes yuav tsum tau saib xyuas tsis tseg.

Kev cuam tshuam txog metabolic thiab endocrine. Kev ceeb toom yog qhov tsim nyog hauv txhua tus neeg mob tau txais kev kho mob nrog hypoglycemic tus neeg sawv cev rau kev tswj hwm qhov ncauj lossis cov tshuaj insulin, vim hais tias hydrochlorothiazide tuaj yeem ua rau lawv tsis muaj zog. Thaum lub sij hawm kho nrog thiazide diuretics, mob ntshav qab zib latent mellitus tuaj yeem tshwm sim.

Thiazide diuretics, suav nrog hydrochlorothiazide, tuaj yeem ua rau dej-electrolyte tsis txaus (hypercalcemia, hypokalemia, hyponatremia, hypomagnesemia thiab hypokalemic alkalosis).

Thiazide diuretics tuaj yeem txo qhov kev nthuav dav ntawm calcium los ntawm ob lub raum thiab ua rau cov plua plav ib ntus thiab nce ntxiv hauv cov ntshav plasma.

Kev mob hypercalcemia ntau heev tuaj yeem yog qhov pom ntawm latent hyperparathyroidism. Ua ntej ua qhov kev tshawb fawb ntawm kev ua haujlwm ntawm cov qog parathyroid, thiazide diuretics yuav tsum tau tshem tawm.

Tawm tsam keeb kwm ntawm kev kho mob nrog thiazide diuretics, kev nce siab ntawm cov cholesterol thiab triglycerides hauv cov ntshav cov ntshav yog tau.

Thiazide diuretic txoj kev kho hauv qee cov neeg mob yuav ua rau lub zog hyperuricemia ntau dua thiab / lossis ua rau ntau qhov mob ntawm gout.

Losartan txo cov ntsiab lus ntawm uric acid hauv cov ntshav ntshav, yog li ntawd, nws siv ua ke nrog hydrochlorothiazide qib cov hyperuricemia tshwm sim los ntawm thiazide diuretic.

Lub siab ua haujlwm tsis zoo. Thiazide diuretics yuav tsum tau siv nrog kev ceeb toom rau cov neeg mob uas lub siab tsis ua haujlwm lossis mob siab, vim tias lawv tuaj yeem ua rau mob cholestasis, thiab txawm tias muaj kev cuam tshuam tsawg kawg hauv cov dej-electrolyte tshuav nyiaj tuaj yeem pab txhawb kev txhim kho hepatic tsis nco qab.

Cov tshuaj Lorista ® N tau sib kis hauv cov neeg mob uas muaj lub siab tsis ua haujlwm siab, vim tias tsis muaj kev paub dhau los ntawm kev siv tshuaj hauv hom tshuaj no ntawm cov neeg mob.

Mob hlwb myopia thiab theem nrab mob lub kaum ntse ntse-kaw ntsej muag. Hydrochlorothiazide yog sulfonamide uas tuaj yeem ua rau idiosyncratic cov tshuaj tiv thaiv uas ua rau kev txhim kho ntawm cov leeg mob myopia thiab lub kaum ntse ntse-kaw lub ntsej muag. Cov tsos mob muaj xws li: txo qis qhov muag pom lossis mob qhov muag, uas feem ntau pom tshwm li hauv ob peb teev lossis ob peb lim tiam txij li pib siv cov tshuaj kho hydrochlorothiazide. Yog tias tsis kho, mob lub ntsej muag raug kaw lub ntsej muag yuav ua rau tsis pom kev mus tas li.

Kev Kho Mob: tsum tsis txhob noj cov tshuaj hydrochlorothiazide sai li sai tau. Yog tias IOP tseem muaj kev tswj xyuas, kev kho mob ceev los yog phais mob yuav tsum tau. Cov teeb meem pheej hmoo rau kev txhim kho ntawm lub ntsej muag tsis sib haum xws li: keeb kwm kev ua xua ntawm sulfonamide lossis benzylpenicillin.

Hauv cov neeg mob noj thiazide diuretics, kev ua kom tsis haum lub ntsej muag tuaj yeem tshwm sim ob qho tib si nyob rau hauv lub sijhawm thiab tsis muaj keeb kwm muaj kev fab tshuaj lossis mob ntsws hawb pob, tab sis muaj feem ntau yog tias lawv muaj keeb kwm.

Muaj cov ntawv tshaj tawm ntawm exacerbation ntawm cov kab mob lupus erythematosus thaum lub sijhawm siv thiazide diuretics.

Cov Ntaub Ntawv Tshwj Xeeb ntawm Cov Muaj Nqes

Cov tshuaj Lorista ® N muaj lactose, yog li ntawd cov tshuaj yog contraindicated rau hauv cov neeg mob uas tsis txaus lactase, lactose tsis txaus siab, qabzib-galactose malabsorption syndrome.

Cuam tshuam rau lub peev xwm los ua cov haujlwm uas muaj kev phom sij uas xav tau kev saib xyuas tshwj xeeb thiab kev tawm tsam sai (piv txwv li kev tsav tsheb, ua haujlwm nrog cov txav mus los). Thaum pib ntawm txoj kev kho, cov tshuaj Lorista ® N tuaj yeem ua rau txo ntshav siab, kiv taub hau lossis tsaug zog, yog li tsis ncaj los ntawm kev cuam tshuam rau lub xeev kev xav. Txog kev nyab xeeb, ua ntej pib ib yam haujlwm uas xav tau kev nce siab ntxiv, cov neeg mob yuav tsum xub ntsuas lawv cov lus teb rau txoj kev kho mob.

Hom tshuaj

Cov tshuaj "Lorista" muaj nyob rau hauv ntau ntau yam: hauv daim ntawv ntawm ib qho kev npaj ib leeg "Lorista", cov ntaub ntawv sib xyaw ntawm "Lorista N" thiab "Lorista ND", uas txawv ntawm qhov ntau ntawm cov tshuaj yeeb dej caw. Ob-tivthaiv ntawm cov tshuaj muaj cov nyhuv antihypertensive thiab muaj cov nyhuv diuretic.

Lorista ntsiav tshuaj ntawm ib qho tshuaj tivthaiv npaj ib qho muaj nyob hauv peb txoj kev noj tshuaj uas muaj cov tshuaj nquag ntawm losartan poov tshuaj 12,5 mg, 25 mg, 50 mg txhua. Raws li cov khoom siv pabcuam, pob kws thiab pregelatinized hmoov txhuv nplej siab, kev sib xyaw ntawm cov mis nyuj muaj suab thaj nrog cellulose, aerosil, magnesium stearate yog siv. Cov qog ua yeeb yaj kiab ntawm cov tshuaj ntau npaum li 25 mg lossis 50 mg ntawm potassium losartan muaj hypromellose, talc, propylene glycol, titanium dioxide, thiab cov xim daj quinoline kuj yog siv rau koob tshuaj 12,5 mg.

Lorista N thiab Lorista ND ntsiav tshuaj muaj li ntawm tus tub ntxhais thiab lub plhaub. Cov tseem ceeb suav nrog ob qho kev ua haujlwm: potassium losartan 50 mg txhua (rau N daim ntawv) thiab 100 mg (rau N daim ntawv) thiab hydrochlorothiazide 12.5 mg (rau daim ntawv "N") thiab 25 mg (rau "N" daim ntawv). Rau kev tsim cov tub ntxhais, cov khoom siv ntxiv tau siv rau hauv txoj kev pregelatinized hmoov txhuv nplej siab, microcrystalline cellulose, mis qab zib, magnesium stearate.

Lorista N thiab Lorista ND ntsiav tshuaj yog coated nrog cov zaj duab xis txheej uas muaj hypromellose, macrogol 4000, quinoline daj zas, titanium dioxide thiab talc.

Cov tshuaj ua haujlwm li cas?

Cov tshuaj tiv thaiv kab mob sib xyaw ua ke (tshuaj Lorista) piav qhia cov lus qhia rau kev txiav txim ntawm pharmacological ntawm txhua tus muaj feem.

Ib qho tshuaj yeeb dej caw yog losartan, uas ua raws li kev xaiv antagonist ntawm enzyme angiotensin hom 2 ntawm cov tsis muaj protein ntau.

Hauv kev soj ntsuam hauv vitro thiab tsiaj tau qhia tias qhov kev txiav txim ntawm losartan thiab nws cov carboxyl metabolite yog tsom rau kev thaiv cov teebmeem ntawm angiotensin ntawm hom 1 angiotensin receptors. Qhov no ua kom cov renin hauv cov ntshav ntshav thiab ua rau muaj qhov txo qis ntawm cov tshuaj aldosterone hauv cov ntshav cov ntshav.

Ua rau kev nce ntxiv hauv cov ntsiab lus ntawm hom 2 angiotensin, losartan ua kom lub receptors ntawm no enzyme, thaum tib lub sijhawm nws tsis hloov pauv cov kev ua ntawm hom 2 kininase enzyme koom nrog cov metabolism hauv ntawm bradykinin.

Qhov kev txiav txim ntawm cov tshuaj nquag ntawm "Lorista" yog tsom rau txo tag nrho cov kev tawm tsam ntawm lub txaj vascular, kev nyuaj siab ntawm cov hlab ntsha ntawm cov hlab ntsws, tom qab ua kom tiav, thiab muab cov nyhuv diuretic.

Losartan tsis tso cai rau txoj kev txhim kho pathological nce hauv lub siab nqaij pob txha, txhim kho kev ua haujlwm ntawm tib neeg lub cev, uas hauv kev kho mob plawv tsis ua haujlwm.

Kev siv txhua hnub ntawm ib koob tshuaj losartan ua rau muaj kev hloov qis dua qub (systolic) thiab qis dua (diastolic) ntshav siab. Thoob plaws hnub, nyob rau hauv tus ntawm yam khoom no, ntshav siab yog tswj hwm yam tsis sib luag, thiab cov nyhuv antihypertensive coincides nrog lub ntuj circadian atherosclerosis. Ib qho kev poob siab hauv qhov kawg ntawm qhov kawg ntawm cov tshuaj ntawm losartan yog 80% piv nrog qhov siab tshaj ntawm qhov kev ua ub no. Nrog rau kev kho tshuaj, tsis muaj dab tsi cuam tshuam rau lub plawv dhia, thiab thaum koj tsum tsis siv tshuaj, tsis muaj cov cim ntawm kev tshem tawm yeeb tshuaj. Qhov ua tau zoo ntawm losartan txuas ntxiv mus rau txiv neej thiab poj niam lub cev ntawm txhua lub hnub nyoog.

Raws li ib feem ntawm cov kev sib txuas txhais tau tias, qhov kev ua ntawm hydrochlorothiazide ua thiazide diuretic yog cuam tshuam nrog kev nqus tsis tau ntawm cov tshuaj chlorine, sodium, magnesium, potassium thiab dej ions hauv thawj cov zis, rov qab rau hauv cov ntshav ntshav ntawm lub raum nephron. Cov khoom siv txhim kho kom tuav cov calcium thiab uric acid los ntawm cov ion. Hydrochlorothiazide tso tawm cov khoom tiv thaiv kabmob vim tias nthuav tawm ntawm cov hlab ntsha. Cov nyhuv diuretic pib tom qab 60-120 feeb, thiab cov siab kawg diuretic nyhuv ntev li ntawm 6 txog 12 teev. Qhov zoo tshaj plaws antihypertensive nyhuv ntawm kev kho mob nrog cov tshuaj tshwm sim tom qab 1 lub hlis.

Nws siv rau dab tsi?

Cov tshuaj "Lorista", ntsiav tshuaj, lus qhia rau kev siv pom zoo siv:

rau kev kho mob ntawm txoj kev mob ntshav siab, nyob rau hauv kev kho mob ua ke yog qhia,
los txo qhov ntxim nyiam ntawm cov kab mob ntawm cov hlab plawv thiab tus naj npawb ntawm kev tuag nrog thiab pathological hloov pauv ntawm sab laug ventricle.

Daim ntawv thov nta

Thaum kho nrog tshuaj "Lorista" (ntsiav tshuaj), cov lus qhia rau kev siv tso cai rau koj ntxiv rau lwm cov tshuaj tiv thaiv kev tsis haum tshuaj. Rau cov neeg laus, kev xaiv tshwj xeeb ntawm kev siv tshuaj thaum xub thawj tsis yog qhov yuav tsum tau ua.

Kev nqis tes ntawm cov tshuaj muaj peev xwm ua rau muaj kev nce siab ntxiv hauv kev tsim cov tshuaj creatinine thiab urea hauv cov ntshav cov ntshav ntawm cov neeg mob uas muaj ob leeg lub raum mob hlab ntsha hlwb los yog leeg ntshav ntawm ib lub raum.

Nyob rau hauv kev cuam tshuam ntawm hydrochlorothiazide, txoj hlab ntshav hypotension tsub zuj zus, electrolyte tshuav qhov tsis sib haum, uas yog tus cwj pwm los ntawm qhov txo qis hauv cov ntshav ntim hauv lub cev, hyponatremia, hypochloremic alkalosis, hypomagnesemia, hypokalemia. Cov txiaj ntsig ntawm lub diuretic yog tsom rau nce qhov kev nce siab ntawm cov roj (cholesterol) thiab triglycerides, hloov qhov kam rau ntawm lub cev mus rau cov kua nplaum kua nplaum, txo cov kev zam ntawm cov calcium ions hauv cov zis, uas ua rau lawv nce ntshav ntxiv. Hydrochlorothiazide tuaj yeem ua rau hyperuricemia thiab gout.

Kev npaj ua ke muaj cov piam thaj hauv mis, uas yog contraindicated hauv cov neeg mob kev txom nyem los ntawm qhov tsis muaj lactase enzyme, muaj galactosemia lossis piam thaj thiab galactose intolerance syndrome.

Thaum pib theem pib ntawm kev kho mob nrog tus neeg sawv cev hypotensive, kev txo qis hauv lub siab thiab kiv taub hau yog qhov ua tau, uas ua txhaum lub cev kev xav ntawm lub cev. Yog li, cov neeg mob uas ua haujlwm cuam tshuam nrog nce kev saib xyuas thaum tsav tsheb tsav lossis cov txheej txheem nyuaj yuav tsum txiav txim siab lawv tus mob ua ntej pib ua lawv cov haujlwm.

JSC Krka, hnub, Novo mesto yog lub chaw tsim khoom ntawm cov tshuaj tiv thaiv anti-hypertensive Lorista (ntsiav tshuaj). Analogues ntawm cov cuab yeej no hauv lawv cov muaj pes tsawg leeg muaj cov khoom ua si losartan poov tshuaj. Rau cov ntawv sib koom ua ke, cov tshuaj zoo sib xws muaj ob feem ua haujlwm: losartan potassium thiab hydrochlorothiazide.

Rau Lorista, cov analogue yuav muaj tib yam antihypertensive nyhuv thiab zoo sib xws phiv. Ib qho kev kho zoo li no yog Kozaar noj tshuaj, ntsiav tshuaj ntawm 50 lossis 100 mg ntawm potassium losertan. Lub chaw tsim khoom yog Merck Sharp & Dome B.V. Phiaj Los Nqis Tebchaws, Tebchaws Netherlands.

Rau cov ntawv sib txuas, cov qauv sib txuas yog Gizaar thiab Gizaar forte. Lub chaw tsim khoom yog Merck Sharp thiab Dome B.V., Lub Netherlands. Cov ntsiav tshuaj me dua yog suav nrog lub plhaub daj, lub ntsej muag daj, nrog tus cim "717" rau ib qho thiab kos tus cim rau ntawm sab nraud, thiab cov tshuaj loj dua lub qe kheej kheej yog xim txheej nrog cov zaj duab xis dawb nrog lub npe "745" ntawm ib sab.

Cov tshuaj muaj pes tsawg leeg ntawm cov tshuaj "Gizaar Forte" suav nrog potassium losartan hauv ib qho nyiaj ntawm 100 mg thiab hydrochlorothiazide, uas muaj 12,5 mg. Cov tshuaj muaj pes tsawg leeg ntawm cov tshuaj "Gizaar" suav nrog potassium losartan hauv ib qho nyiaj ntawm 50 mg thiab hydrochlorothiazide, uas muaj 12,5 mg.

Tsis zoo li cov tshuaj "Lorista ND", cov tshuaj "Gizaar forte" muaj ob zaug tsawg dua hydrochlorothiazide, thiab cov ntsiab lus ntawm cov potassium losertan coincides. Ob qho tshuaj muaj antihypertensive nyhuv nrog me ntsis diuretic nyhuv.

Lwm qhov txuas ntxiv ua ke yog cov tshuaj "Lozap ntxiv" tsim los ntawm "Zentiva A.S.", Czech koom pheej. Nws muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj elongated nrog kev pheej hmoo ntawm ob thaj chaw coated nrog zaj duab xis lub teeb daj. Cov tshuaj ntawm cov tshuaj muaj cov potassium losartan hauv ib qho nyiaj ntawm 50 mg thiab hydrochlorothiazide, uas muaj 12,5 mg.

Ib hom tshuaj zoo sib xws rau Lorista N yog cov tshuaj Vazotens N, tsim los ntawm Actavis Group a.o., Iceland. Muaj ob qhov tshuaj. Cov tshuaj noj qis dua muaj 50 mg ntawm losartan potassium thiab 12.5 mg ntawm hydrochlorothiazide, thaum cov tshuaj ntau dua muaj 100 mg ntawm losartan potassium thiab 25 mg ntawm hydrochlorothiazide.

Phab ntawv muaj cov lus qhia rau kev siv Lorists Cov. Nws muaj nyob rau hauv ntau cov tshuaj ntawm cov tshuaj (ntsiav tshuaj 12,5 mg, 25 mg, 50 mg thiab 100 mg, H thiab ND ntxiv nrog diuretic hydrochlorothiazide), thiab tseem muaj ib tug lej ntawm cov yeeb yaj kiab (analogues). Cov ntawv no tau qhia tseeb los ntawm cov kws tshaj lij. Cia koj cov lus tshaj tawm txog kev siv Lorista, uas yuav pab lwm tus qhua rau qhov chaw. Cov tshuaj yeeb yaj kiab yog siv rau ntau yam kabmob (kom txo qis siab hauv kev mob ntshav siab). Cov cuab yeej muaj tus naj npawb ntawm kev phiv thiab cov yam ntxwv ntawm kev sib cuam tshuam nrog lwm yam kev cuam tshuam. Cov koob tshuaj sib txawv rau cov neeg laus thiab menyuam yaus. Muaj kev txwv ntawm kev siv cov tshuaj thaum cev xeeb tub thiab thaum lactation. Lorista txoj kev kho mob tsuas yog los ntawm tus kws kho mob tsim nyog xwb. Lub sijhawm kho yuav txawv thiab nyob ntawm qee yam kabmob.

Cov lus qhia rau kev siv thiab ntau npaum li cas

Cov tshuaj tau noj ntawm qhov ncauj, tsis hais txog ntawm pluas noj, qhov ntau zaus ntawm kev tswj hwm - 1 zaug hauv ib hnub.

Thaum noj cov tshuaj diuretics hauv koob tshuaj ntau, nws pom zoo kom pib Lorista txoj kev kho nrog 25 mg ib hnub hauv ib koob.

Cov neeg laus laus, cov neeg mob uas tsis ua haujlwm lub raum (nrog rau cov neeg mob ntawm hemodialysis) tsis tas yuav kho qhov pib ntawm cov tshuaj.

Hauv cov neeg mob uas muaj lub siab tsis ua hauj lwm zoo, cov tshuaj yuav tsum tau sau tseg nyob rau hauv qis dua.

Cov ntsiav tshuaj 12,5 mg, 25 mg, 50 mg thiab 100 mg.

Lorista N (ntxiv rau 12,5 mg ntawm hydrochlorothiazide).

Lorista ND (ntxiv rau muaj 25 mg ntawm hydrochlorothiazide).

Losartan poov tshuaj + excipients.

Cov paib potassium losartan + hydrochlorothiazide + excipients (Lorista N thiab ND).

Lorista - Xaiv cov tshuaj angiotensin 2 receptor antagonist hom AT1 tsis muaj protein.

Nws txo OPSS, siab hauv lub ntsws ntsig, txo qis tom qab, muaj cov nyhuv diuretic.

Nws cuam tshuam nrog kev txhim kho myocardial hypertrophy, ua rau lub cev muaj zog ntau dua nyob rau hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev.

Kev Txais Txais Lorista ib hnub ib zaug ua rau muaj kev txo qis ntawm cov ntshav systolic thiab diastolic ntshav siab.Nruab hnub, losartan tusyees tswj ntshav siab, thaum cov nyhuv antihypertensive sib raug rau lub ntuj circadian atherosclerosis. Qhov kev txo qis hauv cov ntshav siab thaum kawg ntawm qhov kawg ntawm cov tshuaj yog kwv yees li 70-80% ntawm cov nyhuv ntawm qhov kawg ntawm cov tshuaj, 5-6 teev tom qab kev tswj hwm. Ntsoos ntsoos mob los tsis pom, thiab losartan tsis muaj kev cuam tshuam loj ntawm lub plawv dhia.

Losartan muaj txiaj ntsig zoo rau tus txiv neej thiab poj niam, nrog rau cov laus (≥ 65 xyoo) thiab cov neeg mob me (≤ 65 xyoo).

Cov nyhuv antihypertensive tshwm sim tom qab 3-4 hnub, tab sis nws yuav siv sij hawm 3-4 lub lis piam kom ua tiav cov txiaj ntsig zoo tshaj plaws.

Cov tshuaj pharmacokinetics ntawm losartan thiab hydrochlorothiazide nrog rau siv tib txhij tsis txawv ntawm qhov uas lawv sib cais siv.

Tom qab kev tswj hwm ntawm qhov ncauj, qhov nqus ntawm hydrochlorothiazide yog 60-80%. Hydrochlorothiazide tsis yog metabolized thiab ua sai tawm los ntawm lub raum.

leeg ntshav siab
txo kev pheej hmoo ntawm mob hlab ntsha tawg hauv cov neeg mob ntshav liab thiab tawm hauv ventricular hypertrophy,
mob plawv tsis ua hauj lwm (raws li ib feem ntawm kev sib xyaw ua ke, nrog kev tsis tuaj yeem lossis tsis muaj txiaj ntsig ntawm kev kho nrog ACE inhibitors),
tiv thaiv lub raum kev ua haujlwm hauv cov neeg mob ntshav qab zib hom 2 mob ntshav qab zib mellitus nrog proteinuria txhawm rau txo proteinuria, txo qhov kev vam meej ntawm lub raum ua puas, txo qhov kev pheej hmoo ntawm kev tsim cov davhlau ya nyob twg (tiv thaiv qhov xav tau kev lim ntshav, qhov ntxim nyiam ntawm kev nce ntshav ntshiab).

arterial hypotension,
hyperkalemia
lub cev qhuav dej
lactose intolerance,
galactosemia los yog glucose / galactose malabsorption syndrome,
cev xeeb tub
kev pub mis
hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb rau cov menyuam tsis tau tsim),
hypersensitivity rau losartan thiab / lossis lwm yam tshuaj ntawm cov tshuaj.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Tsis muaj cov ntaub ntawv hais txog cov nyhuv ntawm Lorista ntawm kev muaj peev xwm tsav tsheb los yog lwm txoj kev txhais tau tias.

kiv taub hau
asthenia
mob taub hau
nkees
insomnia
kev txhawj xeeb
kev ntxhov siab vim pw tsaug zog
tsaug zog
nco tsis meej
peripheral neuropathy,
paresthesia
kev mob siab ntsws
mob taub hau
tshee hnyo
kev nyuaj siab
orthostatic hypotension (koob tshuaj-siv tshuaj),
lub plawv dhia
tachycardia
bradycardia
arrhythmias
angina pectoris
txhaws ntswg
hnoos
mob ntsws
o ntawm lub ntswg ntswg,
xeev siab, ntuav,
zawv plab
mob plab
kev tsis nco qab
qhov ncauj qhuav
mob hniav
flatulence
cem quav
xav tso zis
lub raum tsis ua hauj lwm zoo,
txo qis libido
impotence
cramps
mob mob nraub qaum, hauv siab, ceg,
coov hauv pob ntseg
saj kev ua txhaum
pom kev pom
pom mob pob txha
anemia
Shenlein-Genoch liab doog
daim tawv nqaij qhuav
nce hws
alopecia
mob gout
urticaria
daim tawv nqaij ua pob
angioedema (suav nrog o ntawm lub suab nrov thiab ntawm tus nplaig, ua rau thaiv ntawm txoj hlab pas thiab / lossis o ntawm lub ntsej muag, daim di ncauj, pharynx).

Siv tib lub sijhawm nrog cov tshuaj potassium-sparing diuretics (piv txwv li, spironolactone, triamteren, amiloride) thiab cov tshuaj potassium npaj ua rau muaj kev pheej hmoo ntawm hyperkalemia.

Cov tshuaj ntawm cov tshuaj Lorista

Cov qauv ntawm cov qauv ua haujlwm: