Cov tshuaj Telzap: cov lus qhia rau kev siv > Kev khomob thiab kev tiv thaiv

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov zaj duab xis-ntsiav tshuaj: los ntawm daj mus rau yuav luag dawb, oblong, biconvex, 40 mg txhua nrog rau txoj kab sib faib ntawm txhua sab, 80 mg txhua - cov duab kos "80" (10 pcs.) Tau siv. hauv cov hlwv, hauv pob duab los qhia ntawm 3, 6 lossis 9 lub hlwv thiab cov lus qhia rau kev siv Telzap).

1 ntsiav tshuaj muaj:

cov tshuaj nquag: telmisartan - 40 mg lossis 80 mg,
Cov khoom siv pabcuam: povidone 25, meglumine, sodium hydroxide, sorbitol, magnesium stearate.

Cov Tshuaj Hauv Tshuaj

Telzap yog ib qho tshuaj tiv thaiv kabmob, nws cov tshuaj ua haujlwm yog telmisartan - tus neeg tawm tsam tshwj xeeb ntawm angiotensin II receptors (subtype AT₁) Telmisartan muaj kev paub txog qib siab ntawm AT₁ (angiotensin)-kev paub txog uas yog qhov kev txiav txim ntawm angiotensin II pom tau hais. Tsis muaj qhov kev ua ntawm agonist nrog rau kev hwm, nws hloov chaw angiotensin II los ntawm nws txoj kev sib txuas thiab khi nkaus rau AT pawg subtype.₁receptors ntawm angiotensin II. Rau lwm cov angiotensin receptors (suav nrog AT₂receptors) telmisartan tsis muaj qhov sib txuam. Lawv cov txiaj ntsig tau ua haujlwm thiab muaj txiaj ntsig ntawm qhov muaj peev xwm dhau los ua kom lub siab xav nrog angiotensin II tseem tsis tau kawm. Telmisartan txo cov ntshav plasma aldosterone ntau ntau, tsis thaiv cov channel ion, tsis txo qhov kev ua si renin, thiab tsis thaiv qhov kev txiav txim ntawm angiotensin-hloov mus rau enzyme (kininase II), uas catalyzes kev puas tsuaj ntawm bradykinin. Qhov no zam kev loj hlob ntawm hnoos qhuav thiab lwm yam phiv vim qhov kev txiav txim ntawm bradykinin.

Nrog rau qhov tseem ceeb ntawm kev kub siab, noj Telzap hauv ib koob ntawm 80 mg muab thaiv kev cuam tshuam ntawm cov txiaj ntsig kev mob ntshav siab ntawm angiotensin II. Cov nyhuv antihypertensive tom qab thawj zaug thawj coj ntawm telmisartan tshwm sim hauv 3 teev thiab mob siab rau 24 teev, tshuav thaj chaw tseem ceeb li 48 teev. Ib cov lus tawm tsam antihypertensive yog tiav tom qab 28-56 hnub ntawm kev coj tus ib txwm siv tshuaj yaj yeeb.

Hauv cov kev mob ntshav siab, telmisartan txo qis systolic thiab diastolic ntshav siab (BP) tsis cuam tshuam rau lub plawv dhia (HR).

Kev tshem tawm tsis meej ntawm kev noj Telzap tsis yog nrog rau kev txhim kho ntawm qhov kev tshem tawm mob tawm, cov ntshav tawm maj mam rov qab mus rau nws qib qub dhau ob peb hnub.

Cov nyhuv tshuaj tiv thaiv ntawm telmisartan piv rau kev ua ntawm cov tshuaj tiv thaiv kab mob xws li amlodipine, enalapril, hydrochlorothiazide, atenolol, thiab lisinopril, tab sis nrog kev siv telmisartan muaj qhov qis dua ntawm kev hnoos qhuav tsis xws li angiotensin hloov enzyme (ACE) inhibitors.

Kev siv telmisartan rau kev tiv thaiv kev mob plawv hauv cov neeg mob laus (55 xyoo thiab laus dua) nrog kev hloov pauv ischemic nres, mob plawv coronary, peripheral arterial puas tsuaj, mob stroke lossis cov mob ntshav qab zib hom 2 mob ntshav qab zib (suav nrog retinopathy, sab laug ventricular hypertrophy, macro- lossis keeb kwm ntawm microalbuminuria) pab txhawb kom txo qis ntawm cov sib xyaw ua ke xaus: tsev kho mob vim kev mob plawv tsis ua hauj lwm, mob plawv tuag, myocar infarction los yog ib tug uas tsis yog-neeg tuag taus mob stroke. Cov nyhuv ntawm telmisartan zoo ib yam li ramipril hais txog kev txo cov zaus ntawm cov ntsiab lus thib ob: kev mob plawv tuag, myocardial infarction, lossis mob stroke tsis muaj qhov tshwm sim tuag taus. Tsis zoo li ramipril, nrog telmisartan, qhov tshwm sim ntawm hnoos qhuav thiab angioedema qis dua, thiab txoj hlab ntshav hypotension siab dua.

Cov Tshuaj Pharmacokinetics

Tom qab kev tswj hwm ntawm qhov ncauj, qhov nqus ntawm telmisartan los ntawm kev mob plab tshwm sim sai, nws txoj kev noj qab haus huv yog 50%. Kev noj ib txhij ua rau AUC txo qis (tag nrho cov ntshav ntshav), tab sis tsis pub dhau peb teev cov concentration ntawm telmisartan hauv cov ntshav ntshav yog sib npaug.

Piv rau Cov Txiv Neej Cov Poj Niam, C_max (qhov siab tshaj plaws nyob rau hauv cov ntshav ntshav) yog 3 zaug dua, thiab AUC - txog 2 zaug, tab sis qhov no tsis cuam tshuam loj heev rau cov txiaj ntsig ntawm Telzap.

Muaj tsis muaj txoj kab sib txuas ntawm qhov koob tshuaj thiab lub plasma concentration ntawm cov tshuaj. Thaum siv cov koob tshuaj txhua hnub saum toj no 40 mg C_max thiab AUC sib txawv tsis sib xws nrog cov koob tshuaj nce ntxiv.

Kev khi rau cov ntshav plasma proteins (feem ntau albumin thiab alpha₁acid glycoprotein) - ntau dua 99.5%.

Qhov nruab nrab pom meej ntim ntawm kev faib tawm yog 500 litres.

Telmisartan metabolism tshwm sim los ntawm kev sib txuas nrog glucuronic acid; lub conjugate tsis muaj kev ua haujlwm ntawm pharmacological.

T_1/2 (tshem tawm ib nrab-lub neej) - ntau dua 20 teev. Nws yog tawm tsis txawv txav feem ntau (99%) los ntawm txoj hnyuv, tsawg dua li 1% yog tawm hauv raum.

Kev tshem tawm ntshav tag nrho yog kwv yees li 1000 ml / min, ntshav ua rau ntshav - mus txog 1500 ml / min.

Nrog cov mob me me mus rau lub raum lub raum kev ua haujlwm, nrog rau cov neeg mob uas muaj hnub nyoog 65 xyoos, pharmacokinetics ntawm telmisartan tsis muaj qhov tsis zoo, yog li cov tshuaj kho yuav tsis tsim nyog.

Hauv kev mob raum tsis ua haujlwm thiab rau cov neeg mob hemodialysis, koob tshuaj yuav tsum tsis pub tshaj 20 mg rau ib hnub.

Telmisartan tsis raug ntiab tawm los ntawm hemodialysis.

Rau cov muaj mob me me mus rau me nyuam tsis muaj mob hnyav rau me nyuam (Me-Pugh kev faib tawm A thiab B), yuav tsum tau txhaj tshuaj ib hnub ib zaug txog 40 mg.

Kev ntsuas rau siv

tawg siab tseem ceeb,
ib qho kev txo qis hauv lub plawv ntawm cov kab mob plawv thiab kev tuag ntawm cov neeg mob cov neeg laus uas muaj cov kab mob ntawm cov hlab plawv ntawm atherothrombotic etiology (mob plawv, mob hlab ntsha puas tsuaj lossis keeb kwm mob stroke) thiab nrog lub hom phiaj ntawm kev hloov khoom nruab nrog hauv ntshav qab zib hom 2.

Cov Yuav Tsum Muaj

Hepatic cuam tshuam loj heev (Menyuam-Pugh chav C),
obstructive biliary huam mob, cholestasis,
kev siv aliskiren thaum lub raum tsis ua hauj lwm loj GFR (tus nqi ntawm lub ntsej muag glomerular) tsawg dua 60 ml / min / 1.73 m 2 ntawm lub cev saum npoo lossis nyob rau hauv cov ntshav qab zib mellitus,
concomitant kho nrog angiotensin-hloov enzyme (ACE) inhibitors hauv cov neeg mob ntshav qab zib nephropathy,
muaj keeb fructose tsis raug cai,
cev xeeb tub lub sij hawm
pub niam mis
hnub nyoog txog 18 xyoo
ua kom lub cev tsis haum rau cov tshuaj ntawm cov tshuaj.

Telzap yuav tsum tau siv nrog ceev faj thaum muaj mob hnyav rau lub plawv tsis ua haujlwm, hypertrophic obstructive cardiomyopathy, aortic thiab mitral valve stenosis, kev ua haujlwm tsis zoo rau lub raum, ob tog lub raum artery stenosis, mob ntshav ntawm ib qho kev ua haujlwm lub raum, mob me me mus rau mob siab rau lub cev tsis ua haujlwm, poob qis ntshav tawm (BCC) ) tiv thaiv keeb kwm ntawm kev noj haus tsawg tsawg ntawm sodium chloride, raws plab, ntuav lossis noj tshuaj diuretics, hyperkalemia, hyponatremia, thawj hyperaldost ronism hauv lub sijhawm tom qab kev phais mob raum, kev siv cov neeg mob ntawm cov haiv neeg Negroid.

Telzap, cov lus qhia rau kev siv: txoj kev thiab ntau npaum li cas

Cov ntsiav tshuaj Telzap tau noj ntawm qhov ncauj nrog cov kua txaus, tsis hais txog ntawm cov pluas noj.

Qhov txiaj ntsig ntawm kev noj tshuaj yog 1 zaug nyob rau ib hnub.

Pom zoo kom noj tshuaj txhua hnub:

arterial hypertension: thawj koob tshuaj yog 20-40 mg. Thaum tsis muaj qhov ntsuas hypotensive txaus tom qab 28-56 hnub ntawm kev kho, qhov kev xub pib tuaj yeem nce ntxiv. Qhov nyiaj pab ntau tshaj txhua hnub yog 80 mg. Raws li lwm txoj hauv kev, kev sib xyaw ntawm Telzap nrog thiazide diuretics (suav nrog hydrochlorothiazide) yog qhia,
txo cov neeg tuag thiab cov zaus ntawm cov kab mob plawv: 80 mg, thaum pib kho nws yog tsim nyog los tswj cov theem ntawm cov ntshav siab. Yog tias tsim nyog, kev tiv thaiv mob ntsws yuav tsum kho.

Hauv kev mob raum tsis ua haujlwm lossis cov neeg mob hemodialysis raug nquahu kom siv cov koob tshuaj txhua hnub tsis pub tshaj 20 mg.

Rau cov me me mus rau lub raum lub raum kev ua haujlwm, tsis tas yuav hloov kho dua.

Hauv nruab nrab me me mus rau mob hepatic tsis txaus (Me-Pugh kev faib tawm ntawm cov chav A thiab B), koob tshuaj txhua hnub ntawm Telzap yuav tsum tsis pub tshaj 40 mg.

Sab sij huam

cov teeb meem dav dav: tsis sib xws - asthenia, mob hauv siab, tsis tshua muaj - xws li mob khaub thuas,
cov kab mob sib kis thiab cov kab mob sib kis: tsis xws luag - mob txeeb zig (nrog rau mob cystitis), mob ua pa sab saud (suav nrog rau mob ntsws, pharyngitis), tsis tshua muaj - mob sepsis (suav nrog kev tuag),
los ntawm cov hlab plawv: ua tsis tiav - bradycardia, orthostatic hypotension, qhov cim txo qis hauv cov ntshav siab, tsis tshua muaj - tachycardia,
los ntawm cov kab ke ntshav thiab cov ntshav: tsis tshua muaj - ntshav txhaws, tsis tshua muaj - thrombocytopenia, eosinophilia,
los ntawm kev tiv thaiv kab mob: tsis tshua muaj - kev ua kom tsis haum lub cev, qhov tsis haum tshuaj,
los ntawm psyche: infrequently - kev nyuaj siab, insomnia, tsis tshua - ntxhov siab vim,
los ntawm ib sab ntawm cov metabolism thiab khoom noj khoom haus: pheej: hyperkalemia, tsis tshua muaj - hypoglycemia tiv thaiv cov ntshav qab zib mellitus,
los ntawm lub plab zom mov: ua haujlwm hauv plab - ntuav, mob plab, ntuav, dyspepsia, flatulence, raws plab, tsis tshua muaj - lub qhov ncauj qhuav, tsis hnov qab saj, tsis xis nyob hauv plab,
los ntawm cov kab mob hepatobiliary: tsis tshua muaj - daim siab puas, ua haujlwm cuam tshuam ntawm daim siab,
los ntawm lub paj hlwb: ncus - fainting, tsis tshua muaj - tsaug zog,
nyob rau ntawm ib feem ntawm qhov hnov, muaj kev cuam tshuam hauv lub tsev: tsis xws luag - vertigo,
nyob rau ib feem ntawm kev hloov khoom nruab nrog: kev pom kev tsis sib xws,
los ntawm cov kab mob ua pa, hauv siab thiab mediastinal plab hnyuv siab: ua haujlwm ntxiag - hnoos, txog siav, tsis tshua muaj tshwm sim - kab mob ntsws,
dermatological tshua: ua tsis xws luag - khaus, tawv nqaij ua pob, hyperhidrosis, tsis tshua muaj - tshuaj pob, urticaria, erythema, eczema, mob tawv nqaij ua pob khaus, angioedema (suav nrog kev tuag)
los ntawm cov kab mob urinary: ib txwm - tsis hnov mob raum lub raum, mob raum tsis ua haujlwm,
los ntawm cov leeg mus rau lub cev thiab cov nqaij sib txuas: ua tsis xws luag - mob leeg, mob nraub qaum (sciatica), myalgia, tsis tshua muaj - mob mob rau hauv qhov kawg, mob caj dab, mob leeg (leeg ntshav-zoo li syndrome),
lub cim ntsuas: ua haujlwm tsis xws luag - nce ntshav plasma creatinine, tsis tshua muaj tsawg - txo ntshav hemoglobin hauv ntshav ntshav, nce ntxiv hauv kev ua haujlwm ntawm hepatic enzymes thiab creatine phosphokinase, kev nce siab ntawm uric acid hauv ntshav ntshav.

Noj ntau dhau

Cov tsos mob: cim txo hauv cov ntshav siab, tachycardia, kiv taub hau, bradycardia, muaj zog ntau ntxiv ntawm cov ntshav creatinine, mob raum tsis ua haujlwm.

Kev Kho Mob: kho lub plab zom mov sai, ntxias ntuav, noj hluav ncaig hluav taws xob. Qhov mob hnyav ntawm cov tsos mob thiab cov neeg mob yuav tsum tau ua tib zoo saib xyuas. Sau tshuaj rau kev mob tus yam ntxwv thiab kev pab txhawb nqa. Nws yog ib qho tseem ceeb kom ntseeg tau tias kev kuaj ntshav tsis tu ncua rau ntshav ntshav electrolytes thiab creatinine. Nrog lub cim txo qis hauv cov ntshav siab, tus neeg mob yuav tsum muab tso los ntawm nce nws ob txhais ceg. Nqa cov haujlwm los ntxiv rau bcc thiab electrolytes.

Kev siv tshuaj kho mob hemodialysis tsis muaj zog.

Cov lus qhia tshwj xeeb

Thaum xaiv Telzap rau cov neeg mob uas muaj ob leeg lub raum mob ntshav siab los yog txoj hlab ntsha tsis zoo ntawm lub raum ua haujlwm tsuas yog, nws yuav tsum tau yug los rau hauv lub siab tias kev noj cov tshuaj tuaj yeem ua rau muaj kev pheej hmoo ntawm txoj kev mob ntshav qis thiab lub raum tsis ua haujlwm.

Pib kho nrog cov tshuaj tsuas yog tom qab tshem tawm cov tsis muaj peev xwm ntawm bcc thiab / lossis sodium hauv cov ntshav ntshav.

Kev siv Telzap hauv cov neeg mob uas lub raum tsis ua hauj lwm zoo raug pom zoo kom nrog kev soj ntsuam ib ntus ntawm cov ntsiab lus ntawm cov poov tshuaj thiab creatinine hauv ntshav ntshav.

Kev txwv tsis pub ntawm RAAS (renin-aldosterone-angiotensin system) tuaj yeem tshwm sim hauv cov neeg mob predisposed rau qhov no thiab thaum noj telmisartan nrog lwm tus RAAS kev tawm tsam. Nws tuaj yeem ua rau cov hlab ntsha hypotension, tsaus muag, kev txhim kho hyperkalemia, thiab ua haujlwm tsis zoo rau lub raum (suav nrog mob raum tsis ua haujlwm).

Hauv kev mob plawv tsis ua haujlwm, mob raum, lossis lwm yam kab mob sib kis nrog kev vam meej ntau ntawm RAAS kev ua haujlwm, Telzap tswj hwm tuaj yeem ua rau txoj kev loj hlob ntawm txoj kev mob ntshav qis, hyperazotemia, oliguria, thiab qee yam tsis tshua muaj, mob raum tsis ua haujlwm.

Nrog tus thawj hyperaldosteronism, kev siv cov tshuaj yog qhov tsis muaj txiaj ntsig.

Thaum kho nrog telmisartan nyob rau hauv cov neeg mob ntshav qab zib mellitus tau txais insulin los yog qhov ncauj hypoglycemic, hypoglycemia yuav tshwm sim, yog li yuav tsum tau ceev faj soj ntsuam ntawm ntshav qabzib ntau yuav tsum tau. Yog tias tsim nyog, kev hloov kho tshuaj ntawm cov tshuaj insulin lossis hypoglycemic tus neeg sawv cev yuav tsum tau nqa tawm.

Kev saib xyuas tshwj xeeb yuav tsum tau saib xyuas thiab tshwj xeeb yuav tsum tau saib xyuas thaum sau ntawv Telzap rau cov neeg mob uas muaj kabmob sib luag xws li lub raum tsis ua haujlwm, mob ntshav qab zib mellitus, cov neeg mob tau txais kev kho mob nrog cov tshuaj uas ua rau muaj ntau ntxiv ntawm cov potassium nyob hauv ntshav ntshav, cov neeg laus (laus dua 70 xyoo), txij li cov no cov pab pawg ntawm cov neeg mob yog cov muaj pheej hmoo ua mob hyperkalemia, suav nrog kev tuag.

Lub sijhawm kho mob nrog rau cov tshuaj, kev sib txig sib luag ntawm lwm cov tshuaj yuav tsum tau ua tsuas yog qhia los ntawm tus kws kho mob tuaj koom.

Kev txo qis hauv cov ntshav siab thaum lub sij hawm ischemic cardiomyopathy lossis mob plawv tuaj yeem ua rau txoj kev loj hlob ntawm myocardial infarction lossis mob hlab ntsha tawg.

Hauv cov neeg mob ntawm cov haiv neeg Negroid, tau txo qis qis hauv ntshav siab yog sau tseg.

Cev xeeb tub thiab lactation

Kev siv cov Telzap ntsiav tshuaj thaum lub sijhawm cev xeeb tub thiab pub niam mis yog contraindicated.

Tom qab tsim qhov tseeb ntawm kev xeeb tub, cov neeg mob noj Telzap yuav tsum tso tseg txoj kev kho telmisartan tam sim ntawd thiab hloov mus rau kev kho mob nrog lwm txoj kev tiv thaiv tshuaj tiv thaiv nrog kev tsim kev nyab xeeb rau kev siv thaum cev xeeb tub thiab lactation.

Nrog lub raum tsis ua haujlwm

Kev siv Telzap yog contraindicated nyob rau hauv cov neeg mob uas lub raum tsis ua haujlwm (GFR tsawg dua 60 ml / min / 1,73 m 2) uas tau nyob nrog kev kho mob nrog conisitant nrog aliskiren.

Nrog kev ceev faj, Telzap yuav tsum yog cov tshuaj rau lub raum ua rau lub raum, ob tog lub raum leeg ntshav hlab ntsha, txoj hlab ntshav ntawm lub raum tsuas ua haujlwm raum.

Hauv kev mob raum tsis zoo thiab cov neeg mob hemodialysis raug nquahu kom siv cov koob tshuaj txhua hnub tsis pub tshaj 20 mg.

Rau cov me me mus rau lub raum lub raum kev ua haujlwm, tsis tas yuav tsum hloov kho dua.

Nrog lub siab ua haujlwm tsis zoo

Lub sijhawm teem ntawm Telzap rau kev kho mob ntawm cov neeg mob uas muaj kev tiv thaiv kabmob hepatic tsis txaus (chav C raws li Tus Menyuam-Pugh kev faib tawm) yog contraindicated.

Nrog kev ceev faj, cov tshuaj yuav tsum noj nrog me me mus rau me ntsis tsis tshua muaj siab mob hepatic (Me thiab Pugh chav A thiab B). Cov koob tshuaj txhua hnub ntawm telmisartan yuav tsum tsis pub tshaj 40 mg.

Yeeb tshuaj sib cuam tshuam

Nrog rau kev siv tib lub sijhawm ntawm Telzap:

aliskiren: hauv cov neeg mob raum tsis ua haujlwm los yog mob ntshav qab zib mellitus, kev sib xyaw ua ke nrog telmisartan thiab aliskiren ua rau muaj kev cuam tshuam ob npaug ntawm RAAS, uas ua rau muaj kev cuam tshuam ntau zaus ntawm cov xwm txheej tsis zoo hauv daim ntawv ntawm txoj hlab ntshav hypotension, hyperkalemia thiab lub raum tsis ua haujlwm,
ACE inhibitors: hauv cov neeg mob ntshav qab zib nephropathy, ua ke nrog ACE inhibitors ua rau muaj kev cuam tshuam ob zaug ntawm RAAS, yog li kev sib xyaw ntawm telmisartan thiab ACE inhibitors yog contraindicated,
potassium-sparing diuretics (suav nrog spironolactone, eplerenone, amiloride, triamteren), cov khoom noj muaj cov potassium ntxiv rau cov tshuaj noj ntsev ntxiv, tsis siv tshuaj tsis haum tshuaj (NSAIDs), heparin, cyclosporine, tacrolimus, trimethoprim: nce qhov muaj feem ntau ntawm hyperkalemia. Yog tias siv kev sib koom tes yog qhov tsim nyog, cov theem ntawm cov poov tshuaj concentration hauv cov ntshav ntshav yuav tsum tau saib xyuas tsis tu ncua,
digoxin: muaj qhov nce ntxiv ntawm qhov nruab nrab ntawm kev txiav txim siab ntawm digoxin hauv cov ntshav ntshav (C_max - 49%, C_min - los ntawm 20%), yog li ntawd, thaum xaiv cov koob tshuaj telmisartan lossis txiav nws txoj kev tswj hwm, theem ntawm digoxin hauv cov ntshav ntshav yuav tsum raug saib xyuas, zam dhau qhov txwv ntawm nws txoj kev kho kom zoo,
lithium npaj: nws yuav tsum raug sau tseg tias tiv thaiv keeb kwm yav dhau los ntawm kev sib xyaw ua ke nrog angiotensin II receptor antagonists thiab ACE inhibitors, cov concentration ntawm lithium hauv cov ntshav plasma yuav nce mus rau theem ntawm nws cov nyhuv ua kom muaj kuab lom,
non-selective NSAIDs, acetylsalicylic acid (koob tshuaj siv rau kev kho mob tiv thaiv), cyclooxygenase-2 inhibitors (COX-2): pab txhawb kom cov tsis muaj zog ntawm hypotensive nyhuv ntawm telmisartan. Thaum muaj teeb meem lub raum khiav tsis zoo, kev sib xyaw nrog COX-2 inhibitors tuaj yeem ua rau muaj kev cuam tshuam ntawm lub raum ua haujlwm,
diuretics: kev kho mob ua ntej nrog kev txhaj tshuaj thiazide thiab lub voj diuretics ua rau muaj kev pheej hmoo ntawm hypovolemia thiab arterial hypotension thaum pib kho nrog telmisartan,
lwm cov tshuaj tiv thaiv kabmob: txhim kho cov nyhuv ntawm telmisartan,
Cov tshuaj tiv thaiv kab mob siab, ethanol, barbiturates, cov tshuaj yeeb tshuaj yeeb tshuaj: nce qhov kev pheej hmoo ntawm orthostatic hypotension,
corticosteroids rau kev siv thev naus laus zis: ua rau tsis muaj zog ntawm cov nyhuv hypotensive ntawm Telzap.

Cov Lus Qhia ntawm Telzap yog: Telmista, Mikardis, Telsartan, Telpres.

Nosological kev faib tawm (ICD-10)

Zaj duab xis-coated ntsiav tshuaj	1 tab.
yam tshuaj:
telmisartan	40/80 mg
tus zam: meglumine - 12/24 mg, sorbitol - 162,2 / 324,4 mg, sodium hydroxide - 3.4 / 6.8 mg, povidone 25 - 20/40 mg, magnesium stearate - 2.4 / 4.8 mg

Cov Lus Qhia Telzap ®

kev txo qis kev tuag thiab kev mob plawv hauv cov neeg mob cov neeg laus:

- nrog cov kab mob plawv ntawm atherothrombotic keeb kwm (mob plawv, mob hlab ntsha hlwb los yog keeb kwm ntawm cov hlab ntsha txhaws),

- nrog hom 2 mob ntshav qab zib mellitus nrog phiaj hloov khoom nruab nrog.

Cev xeeb tub thiab lactation

Tam sim no, cov ntaub ntawv txhim khu kev qha ntawm kev nyab xeeb ntawm telmisartan hauv cov poj niam cev xeeb tub tsis muaj. Hauv kev tshawb fawb tsiaj, kev ua me nyuam muaj mob toxicity ntawm cov tshuaj tau txheeb xyuas. Kev siv Telzap ® yog contraindicated thaum cev xeeb tub (saib "Contraindications").

Yog tias kev kho mob mus ntev nrog Telzap ® yog qhov tsim nyog, cov neeg mob npaj lub cev xeeb tub yuav tsum xaiv lwm cov tshuaj tiv thaiv kev tiv thaiv mob nrog kev tiv thaiv kev nyab xeeb rau kev siv thaum cev xeeb tub. Tom qab tsim qhov tseeb ntawm cev xeeb tub, kev kho mob nrog Telzap ® yuav tsum nres tam sim ntawd thiab, yog tias tsim nyog, kev kho mob lwm yam yuav tsum tau pib.

Raws li pom los ntawm cov kev soj ntsuam hauv kev soj ntsuam, kev siv tshuaj ARA II hauv II thiab III trimesters cev xeeb tub muaj lub cev tsis zoo rau lub plab (mob raum tsis ua haujlwm, oligohydramnios, ncua ossification ntawm pob txha taub hau) thiab cov menyuam yug tshiab (lub raum tsis ua haujlwm, ntshav tawm ntshav thiab hyperkalemia). Thaum siv tshuaj ARA II nyob rau lub sijhawm peb lub hlis thib ob ntawm cev xeeb tub, ultrasound ntawm lub raum thiab pob txha taub hau ntawm tus me nyuam yog tau pom zoo.

Cov menyuam yaus uas lawv niam siv ARA II thaum cev xeeb tub yuav tsum ua tib zoo saib kom muaj ntshav tsis xwm yeem.

Cov ntaub ntawv hais txog kev siv telmisartan thaum pub mis niam tsis muaj. Noj Telzap ® thaum pub niam mis yog contraindicated (saib "Contraindications"), lwm txoj kev tiv thaiv tshuaj tiv thaiv nrog ntau qhov kev nyab xeeb tshaj plaws yuav tsum tau siv, tshwj xeeb tshaj yog thaum pub mis rau cov menyuam mos lossis cov menyuam yug ntxov.

Kev sib txuam

Ob chav thaiv ntawm RAAS. Kev siv cov tshuaj telmisartan nrog aliskiren yog qhov ua rau cov neeg mob ntshav qab zib mellitus lossis lub raum tsis ua haujlwm (GFR tsawg dua 60 ml / min / 1.73 m 2) thiab tsis pom zoo rau lwm cov neeg mob.

Siv tib lub koob tshuaj ntawm telmisartan thiab ACE inhibitors yog qhov tsis sib haum xeeb hauv cov neeg mob uas mob ntshav qab zib nephropathy (saib "Contraindications").

Cov kev tshawb fawb soj ntsuam tau pom tias ob zaug thaiv ntawm RAAS vim kev siv tshuaj los ntawm ACE inhibitors, ARA II, lossis aliskiren yog cuam tshuam nrog kev muaj mob tshwm sim ntau ntxiv xws li arterial hypotension, hyperkalemia, thiab lub raum tsis zoo (suav nrog kev mob raum tsis ua haujlwm), piv nrog kev siv ntawm ib qho tshuaj xwb Ua yeeb yam rau RAAS.

Txoj kev pheej hmoo ntawm kev mob hyperkalemia yuav nce ntxiv thaum siv ua ke nrog lwm cov tshuaj uas tuaj yeem ua rau hyperkalemia (cov poov tshuaj muaj cov khoom noj ntxiv thiab ntsev hloov pauv muaj cov poov tshuaj, potassium-sparing diuretics (piv txwv li spironolactone, eplerenone, triamterene lossis amiloride), NSAIDs, suav nrog xaiv COX-2 inhibitors, hepari , immunosuppressants (cyclosporine lossis tacrolimus) thiab trimethoprim.Yog hais tias tsim nyog, tawm tsam keeb kwm yav dhau los ntawm cov ntaub ntawv hypokalemia, kev siv tshuaj ua ke yuav tsum tau nqa tawm yuav tsum ceev faj thiab soj ntsuam cov ntsiab lus ntawm potassium nyob hauv ntshav ntshav.

Digoxin. Nrog kev tswj hwm ntawm telmisartan nrog digoxin, qhov nruab nrab nce hauv C tau sau tseg_max ntshav digoxin ntawm 49% thiab C_min los ntawm 20%. Thaum pib ntawm kev kho mob, thaum xaiv cov koob tshuaj thiab txiav tawm kev kho mob nrog telmisartan, cov concentration ntawm digoxin hauv cov ntshav plasma yuav tsum tau ua tib zoo saib xyuas kom nws nyob hauv qhov kev kho mob kom ntau.

Poov tshuaj-sparing diuretics los yog poov tshuaj uas muaj cov tshuaj pab noj haus. ARA II, xws li telmisartan, txo cov poob poov tshuaj los ntawm lub diuretic. Potassium-sparing diuretics, piv txwv li spironolactone, eplerenone, triamteren lossis amiloride, cov tshuaj ntxiv potassium los yog cov zaub mov hloov ntsev tuaj yeem ua rau nce siab ntxiv hauv potassium hauv cov ntshav ntshav. Yog tias kev pom zoo siv tau qhia tau, txij li muaj cov ntaub ntawv sau tseg hypokalemia, lawv yuav tsum siv nrog kev ceev faj thiab tiv thaiv keeb kwm ntawm kev saib xyuas cov poov tshuaj tsis tu ncua hauv cov ntshav ntshav.

Kev npaj lithium. Thaum cov roj ntsha lithium tau noj ua ke nrog ACE thiab ARA II inhibitors, suav nrog telmisartan, qhov thim rov nce ntxiv hauv plasma cov ntau ntawm lithium thiab nws cov kev ua kom muaj kuab lom. Yog tias koj xav siv cov tshuaj sib xyaw no, nws raug nquahu kom koj ua tib zoo saib xyuas cov kua roj lithium hauv cov ntshav ntshav.

NSAIDs. NSAIDs (i.e., acetylsalicylic acid hauv koob tshuaj siv rau kev kho mob tiv thaiv kab mob, COX-2 inhibitors thiab tsis xaiv tshuaj NSAIDs) tuaj yeem ua kom tsis muaj zog tiv thaiv kev tiv thaiv ntawm ARA II. Hauv qee tus neeg mob uas lub raum tsis zoo (piv txwv, lub cev qhuav dej, cov neeg laus uas lub raum tsis ua haujlwm), kev siv tshuaj tiv thaiv ntawm ARA II thiab tshuaj uas cuam tshuam COX-2 tuaj yeem ua rau muaj kev cuam tshuam ntawm lub raum ntxiv, nrog rau kev txhim kho ntawm lub raum tsis ua haujlwm, uas, raws li txoj cai, yog reversible. Yog li, kev siv tshuaj sib xyaw ua ke yuav tsum ua nrog ceev faj, tshwj xeeb tshaj yog nyob rau cov neeg laus laus. Nws yog ib qho tsim nyog kom ntseeg tau tias cov kua dej txaus, ntxiv rau, thaum pib sib koom tes thiab tsis tseg nyob rau yav tom ntej, cov ntsuas kev ua haujlwm lub raum yuav tsum raug saib xyuas.

Diuretics (thiazide lossis ntxig). Cov kev kho mob dhau los nrog cov koob tshuaj diuretics, xws li furosemide (loop diuretic) thiab hydrochlorothiazide (thiazide diuretic), tuaj yeem ua rau hypovolemia thiab muaj kev pheej hmoo ntawm hypotension thaum pib kho mob nrog telmisartan.

Lwm cov tshuaj tiv thaiv antihypertensive. Cov nyhuv ntawm telmisartan tuaj yeem txhim kho nrog kev siv ua ke ntawm lwm cov tshuaj tiv thaiv antihypertensive. Raws li cov tshuaj pharmacological ntawm baclofen thiab amifostine, nws tuaj yeem xav tias lawv yuav txhim kho cov kev ua kom zoo ntawm txhua yam tshuaj tiv thaiv kab mob, nrog rau telmisartan. Ntxiv rau, orthostatic hypotension yuav nce ntxiv nrog cawv, barbiturates, tshuaj, lossis antidepressants.

Corticosteroids (rau kev siv tshuaj muaj txiaj ntsig). Corticosteroids ua kom cov nyhuv ntawm telmisartan tsis muaj zog.

Tsuas tshuaj thiab tswj hwm

Sab hauv, ib hnub ib zaug, ntxuav tawm nrog kua, tsis hais txog ntawm cov khoom noj.

Arterial tawg. Cov koob tshuaj pom zoo thawj zaug ntawm Telzap ® yog 1 ntsiav tshuaj. (40 mg) ib hnub ib zaug. Qee tus neeg mob yuav tau txais kev pab zoo txog 20 mg / hnub. Qhov koob tshuaj 20 mg tuaj yeem muab tau los ntawm kev faib 40 mg ntsiav tshuaj hauv ib nrab ntawm qhov pheej hmoo. Hauv qhov xwm txheej qhov kev kho mob tsis ua tiav, qhov koob tshuaj pom zoo ntawm Telzap ® tuaj yeem nce ntxiv mus txog 80 mg ib zaug ib hnub. Raws li lwm txoj kev xaiv, Telzap ® tuaj yeem coj los ua ke nrog thiazide diuretics, piv txwv li, hydrochlorothiazide, uas, thaum siv ua ke, muaj cov nyhuv antihypertensive ntxiv.

Thaum txiav txim siab tias yuav nce qhov ntau npaum li cas, nws yuav tsum raug coj mus rau hauv tus account tias qhov siab tshaj plaws antihypertensive feem ntau ua tiav tsis pub dhau 4-8 lub lis piam tom qab pib kho.

Txo cov neeg tuag thiab zaus ntawm cov kab mob plawv. Cov koob tshuaj pom zoo ntawm Telzap ® yog 80 mg ib hnub ib zaug. Hauv thawj lub sijhawm ntawm kev kho mob, kev pom zoo ntsuas ntshav siab; kev kho ntawm antihypertensive kev kho mob yuav tsum tau.

Cov neeg mob tshwj xeeb

Lub raum khiav tsis zoo. Cov kev paub nrog telmisartan hauv cov neeg mob uas mob raum tsis zoo los sis cov neeg mob ntawm cov mob hemodialysis muaj tsawg. Cov neeg mob no tau pom zoo kom txhaj tshuaj qis dua 20 mg / hnub (saib. "Kev khomob tshwj xeeb"). Rau cov neeg mob mentsis mus txog qib qis muaj lub raum khiav tsis zoo, tsis tas yuav hloov kho dua. Kev siv yooj yim ntawm Telzap ® nrog aliskiren yog contraindicated rau cov neeg mob raum tsis ua haujlwm (GFR tsawg dua 60 ml / min / 1,73 m 2) (saib. "Contraindications").

Kev siv tib lub sijhawm ntawm Telzap ® nrog ACE inhibitors yog contraindicated nyob rau hauv cov neeg mob uas mob nephropathy (saib "Contraindications").

Lub siab ua haujlwm tsis zoo. Telzap ® yog pom qhov tsis zoo rau cov neeg mob uas muaj mob tsis haum hnyav (Me-Pugh chav C) (saib "Contraindications"). Hauv cov neeg mob uas tsis tshua mob mus rau me ntsis hepatic tsis txaus (chav A thiab B raws li menyuam-Pugh kev faib tawm, feem), cov tshuaj tau raug txiav txim nrog ceev faj, qhov tshuaj yuav tsum tsis pub tshaj 40 mg ib hnub ib zaug (saib "Nrog ceev faj").

Laus lub caij nyoog. Rau cov neeg mob laus, tsis tas yuav hloov cov tshuaj.

Menyuam yaus thiab tub ntxhais hluas. Kev siv Telzap ® rau cov menyuam yaus thiab cov neeg hluas hnub nyoog qis dua 18 xyoo yog qhov tsis pom zoo vim tsis muaj cov ntaub ntawv kev nyab xeeb thiab ua tau zoo (saib "Contraindications").

Chaw tsim tshuaj paus

Zentiva Saalyk Yurunleri Sanayi ve Tijaret A.Sh., Qaib ntxhw.

Koog Tsev Kawm Kucukkaryshtyran, st. Merkez, No. 223 / A, 39780, Buyukkaryshtyran, Luleburgaz, Kırklareli, Qaib Cov Txwv.

Tuav nrog daim ntawv pov thawj rau npe. Sanofi Russia JSC. 125009, Russia, Moscow, ul. Tverskaya, 22.

Kev thov rau qhov zoo ntawm cov tshuaj yuav tsum raug xa mus rau qhov chaw nyob ntawm Sanofi Russia JSC: 125009, Russia, Moscow, ul. Tverskaya, 22.

Xov Tooj: (495) 721-14-00, fev: (495) 721-14-11.

Tso cov ntaub ntawv thiab cov nyob ua ke

Muaj nyob hauv ntsiav tshuaj daim ntawv. Txhua lub ntsiav tshuaj muaj 0.04 lossis 0.08 g ntawm lub zog tshuaj telmisartan.

Txuas ntxiv, qhov cuab yeej suav nrog cov khoom siv:

meglumine
sorbitol
sodium hydroxide
povidone
stearic magnesium ntsev.

Cov ntsiav tshuaj tau ntim rau hauv cov hlwv ntawm 10 daim.

Pharmacological kev txiav txim

Cov tshuaj yog rau antagonists ntawm angiotensin receptors ΙΙ. Siv ua kev txhais tau rau kev tswj hwm qhov ncauj. Txom cov tshuaj angiotensin ΙΙ, tsis pub nws tiv tauj nrog receptors. Nws khi rau AT I angiotensin цццп receptor, thiab txoj kev sib txuas no tau raug qhia tas li.

Cov tshuaj noj tshuaj txo cov tshuaj aldosterone hauv plasma tsis txo cov nyhuv renin. Tsis thaiv cov ion ion. Tsis rhuav tshem cov txheej txheem ntawm ACE synthesis. Cov khoom zoo li no pab kom tsis txhob muaj qhov tsis zoo siab los ntawm kev noj tshuaj.

Kev noj tshuaj rau hauv ib lub koob tshuaj 0.08 g tshem tawm cov kev ua ntawm angiotensin ΙΙ. Ua tsaug rau qhov no, cov tshuaj muaj peev xwm raug coj los kho kev mob ntshav siab. Ntxiv mus, qhov pib ntawm kev ua tau pib 3 teev tom qab kev tswj hwm qhov ncauj.

Cov nyhuv pharmacological tseem ua mob li ib hnub tom qab kev coj noj coj ua, tseem pom tau li 2 hnub ntxiv.

Cov nyhuv hypotensive lawm muaj kev tsim tawm hauv 4 lub lis piam tom qab pib kho.

Tom qab cov tshuaj txiav tawm, cov ntsuas siab tau maj mam rov qab mus rau lawv yav dhau los yam tsis muaj kev cuam tshuam ntawm kev tshem tawm cov tsos mob.

Arterial tawg

Thawj koob tshuaj pom zoo ntawm Telzap yog 40 mg (1 ntsiav tshuaj) ib hnub ib zaug. Hauv qee tus neeg mob, noj cov tshuaj ntawm ib koob tshuaj 20 mg rau ib hnub yuav ua tau zoo. Qhov koob tshuaj 20 mg tuaj yeem muab tau los ntawm kev faib 40 mg ntsiav tshuaj hauv ib nrab ntawm qhov pheej hmoo. Nyob rau hauv rooj plaub uas qhov kev kho mob ua tsis tiav, qhov koob tshuaj pom zoo ntawm Telzap tuaj yeem raug nce txog qhov ntau kawg ntawm 80 mg ib hnub ib zaug.

Raws li lwm txoj kev xaiv, Telzap tuaj yeem nqa ua ke nrog thiazide diuretics, piv txwv li, hydrochlorothiazide, uas, thaum siv ua ke, muaj cov nyhuv antihypertensive ntxiv. Thaum txiav txim siab tias yuav nce qhov ntau npaum li cas, nws yuav tsum raug coj mus rau hauv tus account tias qhov siab tshaj plaws antihypertensive feem ntau ua tiav tsis pub dhau 4-8 lub lis piam tom qab pib kho.

Cov kev paub nrog telmisartan hauv cov neeg mob uas mob raum tsis zoo los sis cov neeg mob ntawm cov mob hemodialysis muaj tsawg. Cov neeg mob no tau pom zoo kom txhaj tshuaj qis dua li 20 mg rau ib hnub. Rau cov neeg mob mentsis mus txog qib qis muaj lub raum khiav tsis zoo, tsis tas yuav hloov kho dua.

Kev siv yooj yim ntawm Telzap nrog aliskiren yog contraindicated rau cov neeg mob raum tsis ua haujlwm (GFR tsawg dua 60 ml / min / 1.73 m2 ntawm lub cev nqaij daim tawv hauv cheeb tsam).

Kev siv tib lub sijhawm ntawm Telzap nrog ACE inhibitors yog contraindicated rau cov neeg mob uas mob ntshav qab zib.

Cov neeg mob uas mob me mus txog rau daim siab tsis ua hauj lwm (hoob A thiab B raws li kev faib menyuam yaus-Pugh) yuav tsum muaj kev ceeb toom, qhov koob tshuaj yuav tsum tsis pub tshaj 40 mg ib hnub ib zaug. Telzap yog contraindicated rau hauv cov neeg mob uas muaj mob rau cov kabmob hepatic hnyav (chav kawm C raws li menyuam-Pugh kev faib tawm).

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

Telzap Ntxiv

Siv ncauj, ib hnub ib zaug, ntxuav nrog kua, tsis hais noj mov dabtsi.

Cov neeg mob uas nws lub BP tsis tuaj yeem tswj hwm tau zoo nrog kev kho mob monotherapy nrog telmisartan lossis hydrochlorothiazide yuav tsum siv Telzap Plus.

Ua ntej hloov mus rau qhov sib xyaw-koob tshuaj sib txuam, pom zoo koob tshuaj ib feem ntawm ib qho twg. Hauv qee qhov xwm txheej hauv tsev kho mob, kev hloov ncaj qha los ntawm monotherapy mus rau kev kho mob nrog kev sib txuam nrog koob tshuaj yuav suav tau.

Cov tshuaj Telzap Plus, tuaj yeem siv ib hnub ib zaug rau cov neeg mob uas tsis tuaj yeem tswj ntshav siab thaum noj telmisartan ntawm koob ntawm 80 mg rau ib hnub.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Ntawm kev muag hnub no yog ob hom tshuaj noj uas sib txawv hauv muaj pes tsawg leeg thiab qee cov yam ntxwv.

Cov tshuaj muaj pes tsawg leeg ntawm Telzap ntsiav tshuaj suav nrog kev ua haujlwm nquag: telmisartan 40 thiab 80 mg.

Muaj pes tsawg leeg ntawm Telzap Plus ntsiav tshuaj suav nrog:

cov khoom xyaw nquag: telmisartan - 80 mg, hydrochlorothiazide - 12.5 mg,
cov khoom siv ntxiv: sorbitol - 348.3 mg, sodium hydroxide - 6.8 mg, povidone - 25,4 mg, magnesium stearate - 4,9 mg.

Dab tsi pab Telzap?

Raws li cov lus qhia rau kev siv, cov tshuaj yog tawm rau cov neeg uas tseem ceeb arterial hypertension.

Cov cim tseem ceeb rau kev siv tshuaj:

IHD rau cov neeg mob hnub nyoog tshaj 55 xyoos.
Raws li ib feem ntawm cov kev kho mob nyuaj tom qab mob stroke lossis ischemic nres.
Kev tiv thaiv ntawm cov teeb meem los ntawm lub siab thiab cov hlab ntsha hauv hom 2 ntshav qab zib.
Yuav tsum muaj ntshav siab - siab dua 140/90 rau qhov tseem ceeb thiab qee yam tsos mob siab ntsig.
Kev tiv thaiv kab mob ntawm cov kab mob plawv.
Kev tiv thaiv kev ploj tuag vim kev mob plawv hauv cov neeg mob uas muaj kev pheej hmoo (rau kev tiv thaiv lub plawv nres, mob hlab ntsha tawg, plawv tsis ua hauj lwm nrog rau cov neeg tuag taus).

Tseem Ceeb! Tus kws kho mob yuav tsum txiav txim siab txog qhov xav tau ntawm chav kawm ntawm txoj kev kho mob tshuaj. Kev noj tshuaj rau tus kheej yog qhov tsis lees txais.

Tawg siab

Qhov ntau thiab tsawg ntawm cov tshuaj yog raws li kev kuaj mob. Nws pom zoo tias kev kho mob siab yuav tsum tau pib nrog kev noj 1 ntsiav tshuaj ib hnub (40 mg). Qee tus neeg mob tswj tau txais cov nyhuv xav tau thaum noj 20 mg / hnub. Txhawm rau kom tau txais qhov koob tshuaj 20 mg, nws txaus los faib ib lub ntsiav tshuaj 40 mg ua ob ntu.

Yog tias cov txiaj ntsig xav tau tsis tuaj yeem ua tau txawm tias thaum noj 40 mg, tus kws kho mob tuaj yeem sau tshuaj ntau tshaj plaws rau cov neeg mob, i.e. 80 mg.

Yog tias xav tau, cov tshuaj tuaj yeem ua ke nrog thiazide diuretics, uas muaj cov nyhuv tshuaj tiv thaiv kab mob ntxiv, piv txwv li, hydrochlorothiazide.

Thaum txiav txim siab nce qhov koob tshuaj, koj yuav tsum xav txog: qhov siab tshaj plaws antihypertensive nyhuv loj hlob tuaj tom qab 1-2 lub hlis ntawm kev kho.

Ua rau neeg tuag tsawg, cov kab mob plawv

Hauv qhov no, cov tshuaj raug pom zoo kom noj ntawm 80 mg / hnub. Thaum pib kho, koj yuav tsum saib xyuas ntshav siab thiab, yog tias tsim nyog, hloov pauv ntawm kev kho mob.

Cov kev paub ntawm kev siv Telzap hauv cov neeg uas mob hemodialysis lossis kev txom nyem los ntawm kev mob raum tsis zoo muaj tsawg. Thawj koob tshuaj rau cov neeg mob zoo li no tsis pub tshaj 20 mg / hnub. Yog tias tus neeg muaj mob qis qis lossis me me ntawm lub raum kev ua haujlwm, qhov koob tshuaj yuav tsis raug txo.

Nrog raum tsis ua hauj lwm thiab mob ntshav qab zib nephropathy, txoj kev siv sib txuam ntawm Telzap thiab Aliskiren yog contraindicated.
Hauv lub siab ua tsis zoo, kev kho mob tsis raug xaj tau. Kev siv Telzap hauv kev mob siab thiab mob hnyav daim siab yog ua tau rau hauv koob tshuaj txog 40 mg / hnub.

Cov neeg laus tsis tas yuav hloov tshuaj dua.

Cov teeb meem Pharmacological

Cov tshuaj Telzap yog cov siv tshwj xeeb. Los ntawm kev hu mus rau lub cev cov receptors, cov tshuaj thaiv cov tom kawg, tiv thaiv lwm yam tshuaj uas lub luag hauj lwm nce ntshav siab (BP) los ntawm "ua lawv txoj haujlwm."

Hauv cov neeg mob uas mob ntshav nce siab, cov ntsiav tshuaj muab qhov txo qis hauv cov ntshav siab, ob leeg diastolic thiab systolic. Hauv qhov no, cov tshuaj tsis cuam tshuam rau lub plawv dhia.

Rau cov ntsiav tshuaj, kev tshem tawm tus mob tsis yog yam ntxwv. Nrog rau qhov kev tso tseg tsis zoo ntawm kev kho nrog cov ntsiav tshuaj, ntsuas ntshav siab maj mam rov qab mus rau lawv qib dhau los nyob rau ob peb hnub tom ntej.

Qhov kev nqis tes ntawm Telzap piv nrog cov tshuaj tiv thaiv antihypertensive ntawm lwm cov tshuaj, qhov zoo ib yam los ntawm lwm cov chav kawm - Enalapril, Lisinopril, thiab lwm yam.

Sab sij huam

Txawm hais tias nws ua tau zoo, Telzap siab tshuaj muaj ntau cov kev mob tshwm sim:

hloov pauv txoj haujlwm qub ntawm ob lub raum thiab mob siab,
tsaug zog
kiv tob hau, nyob tsis ntev ntawm kev nco qab,
txo qis hauv hemoglobin thiab platelet suav,
nce poov tshuaj nyob rau hauv cov ntshav,
leeg thiab leeg mob
lub plab zom mov tsis txaus siab, hloov pauv hloov, nce roj ntxiv,
txo lub plawv dhia,
ua pob ua xua, erythema, tawv nqaij khaus,
lability ntawm cov mus ob peb vas, tsis tshua ntxhov siab,
txo cov ntshav qabzib hauv siab,
hnov lus tsis zoo.

Tus neeg mob yuav tsum tau ua tib zoo saib xyuas nws tus mob. Cov tsos ntawm tej yam txawv txav hauv lub cev yuav qhia tau qhov ua tsis muaj txiaj ntsig ntawm kev kho.

Cov tshuaj ntawm cov tshuaj Telzap

Txog kev kho mob, siv tshuaj tiv thaiv kab mob sib xyaw ua ke:

Tshuab luam ntawv
Telsartan
Telsartan H,
Telmisartan
Telpres
Cov no,
Telmista
Tanidol
Telpres Ntxiv,
Mikardis,
Mikardis Ntxiv,
Telzap Ntxiv.

Angiotensin 2 receptor antagonists suav nrog cov duab:

Sartavel
Tubkawm Presartan
Mikardis,
Lozarel
Tweensta
Artinova,
Exfotans,
Tshuas
Khov Siab
Irbesartan
Lorista
Telmisartan
Blocktran
Valz N,
Ibertan
Cozaar
Los Tsuas
Cardosten
Losartan
Naviten
Brozaar
Coaprovel
Lozap Ntxiv,
Valz
Lozap,
Telsartan
Aprovel
Cardomin
Tareg
Telpres
Hloov
Olimestra
Nortian
Tus Cwj Pwm,
Duopress,
Vasotens,
Irsar
Gizaar
Zisakar
Edarby
Valsacor
Hyposart,
Losartan n
Aprovask,
Tshuab luam ntawv
Candesartan
Diovan
Teveten
Eprosartan Mesylate,
Cardos,
Cardosal
Co-Exforge,
Karzartan
Xarten
Losacor
Valsartan
Tanidol
Atacand
Vamloset.

Cov mob tshwj xeeb

Nyob rau ntawm qhov muaj qee yam hauv qab no, tsuas yog tus kws tshaj lij tuaj yeem sau tshuaj thiab suav tshuaj ntau npaum li cas:

Mob hnyav lub raum tsis ua haujlwm. Rau cov neeg mob uas ua tsis zoo rau lub raum, tsis tas yuav hloov qhov tshuaj tshwj xeeb. Txawm li cas los xij, nyob rau hauv cov ntaub ntawv thaum lub raum ua rau mob tsis zoo, qhov tshuaj yuav tsum tau txo kom 20 mg. Yog hais tias tus neeg mob nyob rau ntawm qhov mob hemodialysis, Telzap yuav tsum tsis txhob noj.
Mob ntshav qab zib Cov tshuaj txo qis cov ntshav qabzib, yog li cov neeg mob yuav tsum saib xyuas lawv cov piam thaj kom tsawg.
Cardiomyopathy, nqaim ntawm cov qhov aortic lossis mitral li qub. Telzap yuav nthuav dav lumen ntawm cov hlab ntsha, yog li cov neeg mob uas muaj cov kab mob no xav tau kev tswj tshwj xeeb ntawm kev kho tshuaj.
Ob chav thaiv ntawm RAAS. Kev txwv tsis pub ntawm RAAS yuav ua rau kom muaj zog txo cov ntshav siab, ntau lawm cov poov tshuaj ntau ntxiv thiab cov tshuaj ua haujlwm rau lub raum.
Renovascular tawg. Pathology tshwm sim thaum cov ntshav ncig yog cuam tshuam vim yog stenosis ntawm cov hlab ntsha hlaus. Thaum siv cov tshuaj, lub raum tsis ua haujlwm yuav tshwm sim.
Lub siab ua haujlwm tsis zoo. Rau kev mob me me hauv nruab nrab lub cev tsis muaj zog, yuav tsum tau txhaj tshuaj kom tsis haum. Nrog txoj kev loj, kev noj tshuaj yog txwv.

Nqe thiab nqe lus ntawm hnub so

Cov pob khoom txheem ntawm Telzap 40 mg nyob rau hauv Moscow raug nqi 380 rubles. Txog tshuaj rau hauv kev muab ob npaug hauv cov chaw muag tshuaj koj yuav tsum tau them txog 435 rubles. Cov tshuaj yuav tuaj yeem yuav los ntawm cov khw muag tshuaj nrog cov tshuaj noj.

Cov tshuaj Telzap cov lus thov kev qhia pom zoo kom ceev nws kom ncav cuag cov menyuam yaus txog 2 xyoos. Yog li kom cov ntsiav tshuaj tsis poob lawv lub zog, koj yuav tsum saib xyuas qhov kub ntawm huab cua hauv chav. Nws tsis pub tshaj 25 degrees.

Kev sib xyaw thiab kev piav qhia

Ntsiav tshuaj 80 mg: oblong, biconvex ntsiav tshuaj los ntawm yuav luag dawb mus rau daj daj hauv xim nrog lub pob zeb "80" ntawm ib sab.

Txhua 80 mg ntsiav tshuaj muaj:

cov tshuaj nquag: telmisartan - 80,000 mg,
kev zam: meglumine - 24,000 mg, sorbitol - 324,400 mg, sodium hydroxide - 6,800 mg, povidone 25 - 40,000 mg, magnesium stearate - 4,800 mg.

Qhov tseem ceeb tawg

Hauv cov neeg mob, telmisartan ntawm ib koob ntawm 80 mg ua rau tag nrho cov kev cuam tshuam ntawm kev mob siab ntawm angiotensin II. Qhov pib ntawm kev tawm tsam qhov kev tiv thaiv tau sau tseg tsis pub dhau 3 teev tom qab thawj thawj coj ntawm telmisartan. Cov nyhuv ntawm cov tshuaj no kav rau 24 teev thiab tseem nyob hauv chaw kho mob tseem ceeb txog li 48 teev. Ib cov lus hais tawm tsam antihypertensive feem ntau muaj 4-8 lub lis piam tom qab noj ib txwm.

Hauv cov neeg mob uas mob ntshav lub plawv, telmisartan txo qis systolic thiab diastolic ntshav siab (BP) tsis cuam tshuam rau lub plawv dhia (HR).

Thaum tsis muaj xov tooj ntawm telmisartan, cov ntshav siab maj mam rov qab mus rau nws qhov qub dhau ob peb hnub yam tsis muaj kev txhim kho ntawm "kev tshem tawm" tus mob.

Raws li cov txiaj ntsig ntawm kev sib piv hauv cov chaw kho mob tau qhia, cov nyhuv ntawm cov tshuaj telmisartan piv rau cov txiaj ntsig antihypertensive ntawm cov tshuaj ntawm lwm cov chav kawm (amlodipine, atenolol, enalapril, hydrochlorothiazide thiab lisinopril).

Qhov tshwm sim ntawm hnoos qhuav tau qis dua nrog telmisartan piv rau ACE inhibitors.

Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob

Cov neeg mob hnub nyoog 55 xyoos lossis laus dua nrog mob plawv mob plawv, mob stroke, hloov ischemic nres, mob hlab plawv ntshav, lossis muaj cov teeb meem ntshav qab zib hom 2 (piv txwv, retinopathy, sab laug ventricular hypertrophy, macro- lossis microalbuminuria) muaj keeb kwm ntawm kev pheej hmoo mob plawv -vascular cov xwm txheej, telmisartan muaj cov txiaj ntsig zoo ib yam li cov ramipril hauv kev txo cov kev sib txuam ua ke: kev mob plawv tuag los ntawm myocardial infarction yam tsis muaj kev tuag tshwm sim, mob stroke tsis muaj txoj kev tuag los yog tsev kho mob vim mob hauv lub plawv tsis ua hauj lwm.

Telmisartan tau ua haujlwm zoo li ramipril hauv kev txo cov zaus ntawm cov ntsiab lus thib ob: kev mob plawv tuag, tsis muaj mob ntshav tuag ntau, lossis mob tsis tuag. Cov hnoos qhuav thiab mob caj dab tsis tshua tau piav qhia feem ntau nrog telmisartan piv nrog ramipril, thaum arterial hypotension feem ntau tshwm sim nrog telmisartan.

Xuas

Thaum muab tshuaj, telmisartan nrawm nrawm los ntawm lub plab zom mov. Bioavailability yog 50%. Thaum noj ib txhij nrog zaub mov noj, qhov txo qis hauv AUC (thaj chaw hauv qab qhov xav txog lub sijhawm-nkhaus) yog li ntawm 6% (ntawm ib koob 40 mg) txog 19% (ntawm ib koob ntawm 160 mg). Tom qab 3 teev tom qab kev tswj hwm, cov ntsiab lus hauv cov ntshav plasma yog qib, ywj siab, telmisartan tau noj tib lub sijhawm cov zaub mov lossis tsis. Muaj qhov sib txawv ntawm ntshav ntau nyob rau hauv cov txiv neej thiab poj niam. Stach (qhov siab tshaj plaws) thiab AUC yog kwv yees li 3 thiab 2 zaug, ntsig txog, ntau dua hauv cov poj niam piv nrog cov txiv neej tsis muaj qhov cuam tshuam txog kev ua tau zoo.

Tsis muaj txoj kab sib txuas ntawm qhov tshuaj ntawm cov tshuaj thiab nws cov plasma concentration. Stach thiab, ntawm qhov tsawg dua, AUC nce ntau ntawm cov koob tshuaj ntau dua thaum siv cov koob tshuaj saum toj no 40 mg ib hnub twg.

Kev zom zaub mov

Nws yog metabolized los ntawm kev sib txuas nrog glucuronic acid. Lub conjugate tsis muaj pharmacological kev ua si.

Ib nrab-lub neej (T. / 2) yog ntau tshaj 20 teev. Nws raug tso tawm los ntawm txoj hnyuv tsis hloov pauv, ua kom lub cev tawm los ntawm lub raum - tsawg dua 1%. Tag nrho cov ntshav hauv lub plasma yog qhov siab (txog 1000 ml / min) piv nrog "hepatic" ntshav txaus (li 1500 ml / min).

Kev qhia rau kev siv Telzap 80 mg ntsiav tshuaj yog:

tawg siab tseem ceeb,
kev txo qis kev tuag thiab kev mob plawv hauv cov neeg mob cov neeg laus uas muaj cov kab mob plawv ntawm atherothrombotic keeb kwm (IHD, mob stroke lossis keeb kwm ntawm cov leeg ntshav ib leeg) thiab hom 2 mob ntshav qab zib mellitus nrog phiaj hloov khoom nruab nrog

Nrog saib xyuas

Cov tshuaj Telzap yuav tsum tau sau ntawv nrog kev ceev faj nyob rau hauv cov xwm txheej hauv qab no:

Ob leeg lub raum leeg mob stenosis los yog txoj hlab ntshav ntawm lub raum
lub raum tsis ua hauj lwm zoo,
me me mus rau mob me me tsis hnov lus zoo,
txo qis hauv cov ntshav hauv lub cev (BCC) tiv thaiv keeb kwm yav dhau los ntawm kev noj cov tshuaj diuretics, kev txwv kev haus dej ntawm sodium chloride, raws plab lossis ntuav,
kev npau suav,
hyperkalemia
mob tom qab lub raum hloov chaw (tsis muaj kev paub nrog kev siv),
mob plawv tsis ua hauj lwm ntev,
stenosis ntawm aortic thiab mitral valve,
hypertrophic obstructive cardiomyopathy,
thawj hyperaldosteronism (kev ua tau zoo thiab kev nyab xeeb tsis tau tsim)

Cov neeg mob uas lub raum tsis ua hauj lwm zoo

Cov kev paub nrog telmisartan hauv cov neeg mob uas mob raum tsis zoo los sis cov neeg mob ntawm cov mob hemodialysis muaj tsawg. Cov neeg mob no tau pom zoo kom txhaj tshuaj qis dua 20 mg rau ib hnub (saib ntu "Saib xyuas tshwj xeeb"). Rau cov neeg mob mentsis mus txog qib qis muaj lub raum khiav tsis zoo, tsis tas yuav hloov kho dua.

Kev siv yooj yim ntawm Telzap nrog aliskiren yog contraindicated hauv cov neeg mob uas lub raum tsis ua haujlwm.

Kev siv tib lub sijhawm ntawm Telzap nrog ACE inhibitors yog contraindicated rau cov neeg mob uas mob ntshav qab zib.

Cov neeg mob uas muaj lub siab ua haujlwm tsis zoo

Telzap yog contraindicated rau hauv cov neeg mob uas muaj mob rau cov kabmob hepatic hnyav (chav kawm C raws li menyuam-Pugh kev faib tawm). Hauv cov neeg mob uas tsis tshua mob mus rau me ntsis hepatic tsis txaus (chav kawm A thiab B raws li menyuam-Pugh kev faib tawm, feem), cov tshuaj tau raug txiav txim nrog ceev faj, qhov tshuaj yuav tsum tsis pub tshaj 40 mg ib hnub ib zaug.

Cev xeeb tub

Tam sim no, cov ntaub ntawv txhim khu kev qha ntawm kev nyab xeeb ntawm telmisartan hauv cov poj niam cev xeeb tub tsis muaj. Hauv kev tshawb fawb tsiaj, kev ua me nyuam muaj mob toxicity ntawm cov tshuaj tau txheeb xyuas. Kev siv Telzap yog contraindicated thaum cev xeeb tub (saib ntu "Contraindications").

Yog tias kev kho mob mus ntev nrog Telzap yog tsim nyog, cov neeg mob npaj lub cev xeeb tub yuav tsum xaiv lwm txoj kev tiv thaiv tshuaj tiv thaiv kab mob nrog cov ntawv pov thawj kev nyab xeeb rau kev siv thaum cev xeeb tub. Tom qab tsim qhov tseeb ntawm cev xeeb tub, kev kho mob nrog Telzap yuav tsum nres tam sim ntawd thiab, yog tias tsim nyog, lwm txoj kev kho yuav tsum tau pib.

Raws li pom los ntawm cov kev soj ntsuam hauv kev soj ntsuam, kev siv ARAP thaum lub sijhawm thib ob thiab thib peb lub cev xeeb tub muaj lub cev tsis zoo rau lub cev hauv plab (qia tsis zoo ua haujlwm, oligohydramnios, ncua ossification ntawm pob txha taub hau) thiab cov menyuam yug tshiab (lub raum tsis ua haujlwm, ntshav tawm ntshav thiab hyperkalemia). Thaum siv ARAN lub sijhawm zaum ob ntawm cev xeeb tub, kev kuaj xyuas ultrasound ntawm ob lub raum thiab pob txha taub hau ntawm tus me nyuam yog xav kom siv.

Cov menyuam yaus uas lawv niam kis ARAP thaum cev xeeb tub yuav tsum ua tib zoo saib kom muaj ntshav tsis xwm yeem.

Lub sijhawm pub mis niam

Cov ntaub ntawv hais txog kev siv telmisartan thaum pub mis niam tsis muaj. Noj Telzap thaum pub mis niam yog contraindicated, lwm txoj tshuaj tiv thaiv kev tiv thaiv nrog kev txhawb nqa kev nyab xeeb ntau dua yuav tsum tau siv, tshwj xeeb tshaj yog thaum pub mis rau menyuam mos lossis menyuam yug ntxov.

Sab sij huam

Thaum lub sij hawm siv cov tshuaj Ordiss, phiv yog ua tau:

Cov kab mob sib kis thiab cov kab mob parasitic: tsis ua haujlwm hnyav - tso zis mob txeeb zig, suav nrog cystitis, mob hlab pas sab saud, suav nrog pharyngitis thiab sinusitis, tsis tshua muaj - sepsis.
Los ntawm cov kab mob hemopoietic: ua haujlwm tsis xws luag - mob ntshav tsis txaus, tsis tshua muaj - eosinophilia, thrombocytopenia.
Los ntawm kev tiv thaiv kab mob: tsis tshua muaj - tshuaj tiv thaiv anaphylactic, kev ua haujlwm siab.
Los ntawm ib sab ntawm cov metabolism: ua tsis tau - hyperkalemia, tsis tshua muaj - hypoglycemia (hauv cov neeg mob ntshav qab zib mellitus).
Mob Hlwb: infrequently - insomnia, kev nyuaj siab, tsis tshua muaj - ntxhov siab vim.
Los ntawm cov kab mob hauv lub cev: tsis nyob hauv - fainting, tsis tshua muaj - tsaug zog.
Los ntawm ob sab ntawm qhov ntawm cov khoom ntawm kev pom: tsis tshua muaj - pom kev tab kaum.
Ntawm ib feem ntawm cov khoom hauv nruab nrog ntawm kev hnov thiab labyrinth cuam tshuam: ncaug - vertigo.
Los ntawm cov hlab plawv: ua rau tsis txaus - bradycardia, qhov cim txo qis hauv cov ntshav siab, orthostatic hypotension, tsis tshua muaj - tachycardia.
Los ntawm kev ua pa ntawm lub cev: ua tsis taus pa - ua tsis taus pa, hnoos, tsis tshua muaj - kab mob ntsws interstitial.
Los ntawm kev mob plab hnyuv: ua tsis xws luag - mob plab, raws plab, dyspepsia, flatulence, ntuav, tsis tshua muaj - lub qhov ncauj qhuav, tsis xis nyob hauv plab, ua txhaum ntawm saj hnov.
Los ntawm daim siab thiab daim tawv nqaij: tsis tshua muaj - lub siab ua haujlwm tsis ua haujlwm / lub siab ua haujlwm.
Nyob rau ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: ua tsis xws luag - khaus ntawm daim tawv nqaij, hyperhidrosis, tawv nqaij ua pob, tsis tshua muaj - angioedema (tseem ua rau neeg tuag taus), eczema, erythema, urticaria, pob tshuaj liab, lom pob tawv nqaij.
Los ntawm qhov system musculoskeletal: ua tsis xws luag - mob nraub qaum (sciatica), mob leeg mob, myalgia, tsis tshua muaj - mob caj dab, mob hauv nqua, qhov mob ntawm leeg (mob li cov leeg).
Los ntawm cov kab mob zis: tso zis - tsis pom kev raum kev ua haujlwm, suav nrog mob raum tsis ua haujlwm.
Ntawm ib feem ntawm kev kawm tshawb nrhiav thiab cuab yeej ua haujlwm: ua haujlwm tsis xws luag - kev nce siab ntawm creatinine nyob rau hauv cov ntshav ntshav, tsis tshua muaj - txo qis hauv cov ntsiab lus ntawm hemoglobin, kev nce hauv cov ntsiab lus ntawm uric acid hauv cov ntshav ntshav, kev nce hauv cov kev ua ntawm daim siab enzymes thiab CPK.
Lwm yam: ua tsis tau - mob hauv siab, asthenia, tsis tshua muaj - zoo li mob khaub thuas.

Ob chav thaiv ntawm RAAS

Kev siv ib txhij ntawm telmisartan nrog aliskiren los yog tshuaj muaj aliskiren yog contraindicated rau cov neeg mob ntshav qab zib mellitus thiab / lossis mob qis thiab mob raum tsis ua haujlwm (GFR tsawg dua 60 ml / min / 1.73 m2 ntawm lub cev nqaij hauv cheeb tsam) thiab tsis pom zoo rau lwm cov neeg mob.

Kev siv tib lub sijhawm ntawm telmisartan thiab ACE inhibitors yog qhov tsis sib haum xeeb hauv cov neeg mob uas mob ntshav qab zib thiab tsis pom zoo rau lwm cov neeg mob.

Cov kev tshawb fawb soj ntsuam pom tau tias ob zaug thaiv RAAS vim yog kev sib xyaw ua ke ntawm ACE inhibitors, angiotensin II receptor antagonists, lossis aliskiren cuam tshuam nrog kev muaj mob tshwm sim tsis zoo ntxiv xws li arterial hypotension, hyperkalemia, thiab lub plawv tsis zoo (nrog rau mob raum tsis ua haujlwm) piv rau kev siv tsuas yog ib qho tshuaj yeeb tshuaj ua yeeb yam rau RAAS.

Hyperkalemia

Qhov tshwm sim ntawm hyperkalemia nyob ntawm yam cuam tshuam nrog kev phom sij. Txoj kev pheej hmoo tau nce ntxiv thaum siv cov kev sib txuas saum toj no, thiab tshwj xeeb tshaj yog siab thaum siv tib lub sijhawm nrog cov potassium-sparing diuretics thiab ntsev hloov pauv uas muaj poov tshuaj. Kev siv telmisartan nrog ACE inhibitors lossis NSAIDs yuav tsis tshua muaj kev phom sij yog tias muaj kev ceev faj.

Lub siab ua haujlwm tsis zoo

Kev siv Telzap yog contraindicated nyob rau hauv cov neeg mob cholestasis, thaiv tus kab mob biliary lossis mob siab rau lub siab ua haujlwm (Menyuam-Pugh chav C), txij li telmisartan yog qhov tseem ceeb hauv cov kua tsib. Nws ntseeg tau hais tias nyob rau hauv cov neeg mob zoo li no, kab mob pob txha kho kabmob ntawm telmisartan yog txo qis. Hauv cov neeg mob uas muaj me me los sis me me ntawm lub siab tsis ua hauj lwm (chav kawm A thiab B raws li kev faib menyuam yaus-Pugh), Telzap yuav tsum siv nrog ceev faj.

Txo cov ntshav hauv lub cev kom tsawg (BCC)

Kev mob tshwm sim ntawm lub cev, tshwj xeeb tshaj yog tom qab thawj zaug kev siv tshuaj, tuaj yeem tshwm sim hauv cov neeg mob uas tsis tshua muaj BCC thiab / lossis sodium hauv cov ntshav plasma tiv thaiv keeb kwm yav dhau los ntawm kev kho mob yav dhau los nrog diuretics, txwv tsis pub noj ntsev, raws plab lossis ntuav.

Cov mob uas zoo sib xws (kua thiab / los yog sodium tsis txaus) yuav tsum tau muab tshem tawm ua ntej siv Telzap.

Lwm yam mob uas cuam tshuam nrog kev txhawb nqa RAAS

Hauv cov neeg mob uas lub suab vascular thiab lub raum ua haujlwm feem ntau yog nyob ntawm RAAS kev ua si (piv txwv li, cov neeg mob raum tsis ua haujlwm lossis lub raum, nrog rau mob raum mob hlwb los yog lub raum ntawm lub raum leeg nyob hauv ntshav), kev siv tshuaj uas cuam tshuam rau cov kab mob no, tej zaum yuav muaj nrog los ntawm kev txhim kho ntawm cov mob ntshav thiav ntsig, kev mob hlwb hyperazotemia, oliguria, thiab qee zaus, mob raum tsis ua haujlwm.

Qhov cuam tshuam rau kev muaj peev xwm tsav tsheb

Kev tshawb nrhiav tshwj xeeb los kawm txog kev cuam tshuam ntawm cov tshuaj ntawm kev muaj peev xwm tsav lub tsheb thiab cov tshuab tseem tsis tau ua. Thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem uas yuav tsum muaj kev xav ntau ntxiv, kev saib xyuas yuav tsum tau siv, vim tias kiv taub hau thiab tsaug zog yuav tsis tshua muaj tshwm sim nrog kev siv Telzap.

Cov menyuam yaus, thaum cev xeeb tub thiab lactation

Tsis muaj ntaub ntawv txaus ntseeg txog kev nyab xeeb ntawm cov tshuaj no thaum cev xeeb tub. Yog tias tus neeg mob npaj lub cev xeeb tub, thiab nws yuav tsum noj tshuaj kom txo qis, nws pom zoo kom siv lwm txoj hauv kev ntxiv.

Kev siv cov tshuaj los ntawm cov pab pawg ntawm inhibitors, angiotensin antagonists hauv qib thib 2 thiab thib 3 ua rau muaj kev txhim kho kev puas tsuaj rau lub raum, mob siab, ncua ossification ntawm lub pob txha taub hau hauv plab, oligohydramnion (txo qis hauv cov kua tshuaj amniotic kua).

Kev siv cov tshuaj thaum lub sijhawm pub niam mis yog nruj me ntsis.