Irbesartan

Tus neeg sawv cev antihypertensive, tshwj xeeb kev tsis sib tw angiotensin II receptor antagonist (hom AT1). Tshem tawm cov nyhuv vasoconstrictor ntawm angiotensin II thiab txo qhov kev xav ntawm aldosterone hauv ntshav ntshav. Tsis inhibit kinase II - ib qho enzyme uas rhuav tshem bradykinin. Txo OPSS, ua rau txo qis tom qab, txo qis ntshav kev ntshav thiab ntshav siab rau hauv cov ntsws ntsig. Qhov siab tshaj plaws tau tshwm sim hauv 3-6 teev tom qab siv ib zaug. Cov nyhuv antihypertensive tseem mob rau 24 teev .Txoj kev kho mob ruaj khov ua tiav tom qab 1-2 lub lim tiam ntawm kev siv tshuaj irbesartan. Tom qab nres cov kev noj kom tsawg ntawm cov ntshav siab rov qab mus rau nws qib qub. Irbesartan tsis cuam tshuam rau kev xav ntawm TG, qib ntawm cov cholesterol, piam thaj, uric acid nyob rau hauv cov ntshav ntshav lossis qhov tsis pom ntawm uric acid nyob rau hauv cov zis.
Tom qab lub qhov ncauj tswj hwm, nws zoo tawm los ntawm cov hnyuv. Qhov siab tshaj plaws ntawm irbesartan hauv ntshav plasma tau mus txog tom qab 1.5-2 teev tom qab noj. Bioavailability yog 60-80%. Noj zaub mov ua ke tsis cuam tshuam dab tsi txog kev noj qab haus huv. Kev khi cov protein ntau yog kwv yees li 90%. Irbesartan yog metabolized hauv lub siab vim kev sib xyaw nrog kev tsim cov glucuronide thiab vim muaj oxidation. Lub ntsiab metabolite yog irbesartan glucuronide (li 6%). Kev tshem tawm ib nrab-lub neej yog 11-15 teev. Hauv cov neeg mob uas muaj lub siab thiab / lossis lub raum tsis zoo, cov chaw muag tshuaj tsis haum ntawm irbesartan tsis hloov pauv ntau.

Kev siv tshuaj yeeb yaj kiab Irbesartan

Qhov tshuaj thawj zaug yog 150 mg ib hnub ib zaug, tom qab ntawd cov koob tshuaj yuav raug nce mus rau 300 mg ib hnub ib zaug, noj nrog zaub mov lossis ntawm lub plab khoob. Nws raug nquahu kom noj txhua txhua hnub nyob rau tib lub sijhawm. Yog tias koj tsis nco qab noj ib zaug, koob tshuaj ntxiv rau ib hnub yuav tsum tsis txhob suav ntxiv. Kev sib xyaw ua ke nrog irbesartan hauv kev sib xyaw nrog tshuaj diuretics (hydrochlorothiazide) lossis lwm yam tshuaj tiv thaiv kabmob muaj peev xwm ua tau.

Cov lus qhia tshwj xeeb rau kev siv tshuaj Irbesartan

Kev siv tshuaj diuretics ntau ua ntej ua rau tsis tuaj yeem ua rau lub cev qhuav dej thiab nce qhov kev pheej hmoo ntawm hypotension thaum pib kho. Nrog rau lub cev qhuav dej ntau dhau los yog hyponatremia los ntawm kev siv tshuaj kho mob ntau dua, ua kom lub cev tsis muaj mob hyponatrium, zawv plab lossis ntuav, nrog rau cov neeg mob ntawm hemodialysis, qhov tshuaj ntawm irbesartan yuav tsum tau txo.
Yog tias tsim nyog, kev teem sij hawm ntawm irbesartan thaum pub mis niam yuav tsum txiav txim siab txog kev txiav kev pub niam mis. Kev nyab xeeb thiab kev ua tau zoo ntawm irbesartan hauv cov menyuam yaus tseem tsis tau txhim tsa.

Kws Tshuaj

Muaj kev cuam tshuam zoo thiab tsis meej, txwv cov tshuaj angiotensin II (AT subtype)₁) Tshem tawm cov vasoconstrictor nyhuv ntawm angiotensin II, txo qis qhov kev coj ntawm aldosterone hauv plasma, txo OPSS, tom qab ua haujlwm ntawm lub siab, ntshav siab thiab ntshav siab hauv lub ntsws ntsig. Tsis cuam tshuam rau kinase II (ACE), uas rhuav tshem bradykinin thiab muaj kev koom tes nrog kev tsim cov tshuaj angiotensin II. Nws ua haujlwm maj mam, tom qab ib koob tshuaj, cov txiaj ntsig siab tshaj plaws tshwm sim tom qab 3-6 teev. Cov nyhuv antihypertensive tseem mob txuas ntxiv mus li 24 teev.

Sai sai thiab tag nrho nqus los ntawm cov hnyuv, tus nqi ntawm nqus yog ywj siab ntawm kev nqus zaub mov. Bioavailability - 60-80%, C_max txiav txim siab tom qab 1.5-2 teev. Muaj qhov sib txawv ntawm cov koob tshuaj irbesartan thiab nws cov kev mob siab hauv cov ntshav (hauv qhov ntau ntawm 10-600 mg). Kev sib luag plasma ntshav sib luag yog nce mus txog hauv 3 hnub tom qab pib kev kho mob. Plasma protein khi yog 96%, cov khoom faib tawm yog 53–93 L, tag nrho Cl yog 157–176 ml / min, lub raum Cl yog 3–3,5 ml / min. Nws ua rau biotransformation nyob rau hauv daim siab los ntawm oxidation nrog kev koom tes ntawm isoenzyme CYP2C 9 ntawm cytochrome P450 thiab tom qab kev sib txuas nrog kev tsim cov tsis muaj zog metabolites, lub ntsiab ntawm yog irbesartan glucuronide (6%). T_1/2 - 11-15 teev .Txoj kev nyiam lub raum (20%, uas tsawg dua 2% tsis hloov pauv) thiab lub siab.

Kev tswj hwm rau cov tsiaj (nas, macaques) hauv kev txhaj tshuaj ntau dua (ntau dua 500 mg / kg / hnub) nrog kev loj hlob ntawm kev hloov pauv hauv lub raum (interstitial nephritis, tubular nthuav dav thiab / lossis kev nqus ntshav ntawm lub raum rov qab, nce siab ntawm uric acid thiab creatinine hauv ntshav) thiab txo qis lub raum perfusion. Ntawm kev noj tshuaj ntau dua 90 mg / kg / hnub (nas tsuag) thiab 110 mg / kg / hnub (macaques) ua rau cov ntshav tsis haum / hyperplasia ntawm juxtaglomerular hlwb.

Raws sijhawm (2 xyoos) kev tswj hwm mus rau kev sim cov tsiaj ntawm kev txhaj tshuaj ntau dua MPD, 3 zaug (nas txiv neej), 3-5 zaug (txiv neej thiab poj niam nas) thiab 21 zaug (nas txiv neej) tsis muaj cov nyhuv carcinogenic. Hauv kev kawm ntawm lwm hom kev mob toxicity tshwj xeeb, mutagenic thiab teratogenic tsis tau kuaj pom.

Phiv cov tshuaj Irbesartan

Los ntawm cov leeg hlwb thiab cov haujlwm hauv lub cev: ≥1% - mob taub hau, kiv taub hau, nkees, ntxhov siab / zam rau.

Los ntawm cov hlab plawv system thiab ntshav (hematopoiesis, hemostasis): ≥1% - tachycardia.

Los ntawm tus txheej txheem ua pa: ≥1% - mob ntsig txog lub ntsws ua pa (kub taub hau, thiab lwm yam), mob ntsws, mob ntsws, mob pharyngitis, rhinitis, hnoos.

Los ntawm cov hnyuv: ≥1% - raws plab, xeev siab, ntuav, mob dyspeptic, kub siab.

Los ntawm cov leeg musculoskeletal: ≥1% - kev mob musculoskeletal (suav nrog myalgia, mob hauv pob txha, hauv siab).

Kev tsis haum tshuaj: 1% - ua pob.

Lwm yam: ≥1% - mob plab hauv plab, tso zis mob txeeb zig.

Kev sib txuam

Diuretics thiab lwm yam tshuaj tiv thaiv antihypertensive. Thiazide diuretics txhim kho cov nyhuv. Cov kev kho mob ua ntej nrog cov tshuaj diuretics hauv siab siab tuaj yeem ua rau lub cev qhuav dej thiab nce qhov kev pheej hmoo ntawm txoj hlab ntshav thaum pib kho nrog irbesartan. Irbesartan yog sib xyaw nrog lwm cov tshuaj tiv thaiv kabmob (beta-blockers, calcium channel blockers).

Poov tshuaj pab thiab potassium-sparing diuretics. Nce kev pheej hmoo ntawm hyperkalemia thaum siv ua ke nrog potassium-sparing diuretics thiab poov tshuaj npaj.

Lithium: qhov kev thim rov qab nce ntxiv nyob rau hauv cov ntshiab lithium ntau ntau lossis muaj tshuaj lom tau pom nrog kev siv tib lub sijhawm ntawm lithium nrog angiotensin hloov mus rau enzyme inhibitors. Txog ntawm irbesartan, cov teebmeem zoo sib xws tau tsis tshua muaj lub sijhawm, tab sis ua tib zoo saib xyuas ntawm cov roj ntsha lithium raug pom zoo thaum lub sijhawm sib txig siv tshuaj.

NSAIDs: nrog kev tswj hwm tib lub sijhawm ntawm angiotensin II antagonists thiab NSAIDs (piv txwv li, xaiv COX-2 inhibitors, acetylsalicylic acid> 3 g / hnub thiab tsis xaiv-NSAIDs), cov nyhuv hypotensive yuav tsis muaj zog.

Ib yam li ACE inhibitors, kev sib xyaw ua ke ntawm angiotensin II antagonists thiab NSAIDs tuaj yeem ua rau muaj kev pheej hmoo ntawm lub raum tsis ua haujlwm, suav nrog kev muaj feem ntawm kev mob raum tsis ua haujlwm, thiab nce qib cov poov tshuaj ntau ntau, tshwj xeeb tshaj yog nyob rau cov neeg mob uas twb muaj lub raum lub raum. Nrog rau kev qhia txog kev sib xyaw ua ke no, yuav tsum muaj kev ceev faj, tshwj xeeb tshaj yog rau cov neeg laus. Cov neeg mob yuav tsum tau nqa cov dej uas tsim nyog thiab soj ntsuam lub raum thaum lub sij hawm tag nrho cov kev sib txuas ua ke thiab tsis tseg tom qab ua tiav.

Hydrochlorothiazide. Cov chaw muag tshuaj ntawm irbesartan tsis hloov pauv thaum ua ke nrog hydrochlorothiazide.

Irbesartan metabolized feem ntau yog nrog kev koom tes ntawm CYP2C9 thiab, rau qee qhov qis qis dua, glucuronidation. Tsis muaj ib qho tseem ceeb ntawm cov chaw muag tshuaj los yog kev sib txuam sib raug zoo tau pom nrog kev coj ua ke ntawm irbesartan nrog warfarin, cov tshuaj tiv thaiv los ntawm CYP2C9. Qhov cuam tshuam ntawm CYP2C9 qhov kev txhawb zog xws li rifampicin rau ntawm pharmacokinetics ntawm irbesartan tsis tau raug ntsuas.

Irbesartan tsis hloov pauv cov khw muag tshuaj ntawm digoxin.

Ceev faj Irbesartan

Nws siv nrog ceev faj hauv cov neeg mob hyponatremia (kev kho mob nrog diuretics, txwv tsis pub muaj ntsev ntau nrog kev noj zaub mov, raws plab, ntuav), hauv cov neeg mob ntawm hemodialysis (kev txhim kho ntawm cov tsos mob hypotension yog ua tau), zoo li hauv cov neeg mob lub cev qhuav dej. Kev ceev faj yuav tsum siv lub cev rau cov neeg mob uas kho lub plawv tsis ua haujlwm vim muaj ob leeg lub raum mob ntshav siab los yog lub raum mob ntshav ntawm lub raum ib leeg (muaj kev pheej hmoo ntawm kev mob ntshav siab thiab lub raum tsis ua haujlwm), aortic lossis mitral stenosis, ob leeg mob hypertrophic cardiomyopathy, lub plawv tsis ua haujlwm loj (theem III - IV kev faib tawm) NYHA) thiab mob plawv ua haujlwm (muaj kev pheej hmoo ntawm myocardial infarction, angina pectoris). Tawm tsam ntawm cov keeb kwm yav dhau los ntawm kev ua haujlwm tsis zoo hauv lub raum, tshuaj xyuas cov poov tshuaj poov tshuaj thiab creatinine qib pom zoo. Nws tsis pom zoo rau cov neeg mob uas muaj hyperaldosteronism thawj zaug, nrog rau lub raum tsis ua haujlwm loj (tsis muaj kev kuaj mob), hauv cov neeg mob uas nyuam qhuav hloov raum (tsis muaj kev kuaj mob).

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Daim ntawv tsuas tshuaj ntawm Irbesartan yog cov yeeb yaj kiab-cov ntsiav tshuaj: biconvex, puag ncig, lub plhaub thiab cov tub ntxhais yuav luag txhua qhov muag dawb lossis dawb (hauv cov hlwv ntim ntawm 3, 4, 7, 10, 14, 15, 20, 25 lossis 30 pcs.) 1-8 lossis 10 pob tau muab tso rau, hauv cov kaus poom ntawm polyethylene terephthalate 10, 14, 20, 28, 30, 40, 50, 60 lossis 100 pcs. Hauv daim ntawv thawv ntawv, 1 tuaj yeem tso).

Cov muaj pes tsawg leeg ntawm 1 ntsiav tshuaj suav nrog:

• cov tshuaj nquag: irbesartan - 75, 150 lossis 300 mg,
• cov khoom siv ntxiv (75/150/300 mg): microcrystalline cellulose - 24/48/96 mg, lactose monohydrate (mis nyuj qab zib) - 46.6 / 93.2 / 186.4 mg, colloidal silicon dioxide - 0.8 / 1 , 6 / 3.2 mg, croscarmellose sodium - 7.2 / 14.4 / 28.8 mg, magnesium stearate - 1.6 / 3.2 / 6.4 mg, povidone-K25 - 4.8 / 9, 6 / 19,2 mg
• plhaub (75/150/300 mg): titanium dioxide - 1.2 / 2.4 / 4.8 mg, macrogol-4000 - 0.6 / 1.2 / 2.4 mg, hypromellose - 2.2 / 4 4 / 8.8 mg.

Cov Tshuaj Hauv Tshuaj

Irbesartan, yog tus xaiv los tiv thaiv cov tshuaj tiv thaiv kab mob angiotensin II (hom AT1), pab tshem tawm cov nyhuv vasoconstrictor ntawm angiotensin II, txo qis ntshav plasma concentration ntawm aldosterone hauv cov ntshav (tsis muaj kinase II, uas rhuav tshem bradykinin), txo tag nrho cov hlab ntshav tsis kam, thiab txo cov ntshav siab (AD) , tom qab thauj thiab siab nyob rau hauv cov ntsws. Nws tsis muaj dab tsi cuam tshuam rau lub plasma concentration ntawm cov roj cholesterol, triglycerides, qabzib, uric acid thiab txoj kev tsis haum ntawm uric acid.

Qhov siab tshaj plaws nyob rau hauv cov ntshav siab tau tiav tom qab 3-6 teev tom qab kev tswj hwm qhov ncauj ntawm cov tshuaj, cov nyhuv antihypertensive raug tswj tsawg kawg yog 24 teev. Ib hnub tom qab kev tswj hwm, qhov txo qis hauv ntshav siab yog 60-70% piv nrog qhov siab tshaj plaws hauv diastolic / systolic siab nyob rau hauv kev teb rau kev noj tshuaj. Thaum noj 150-300 mg 1 zaug nyob rau ib hnub, qhov kev ntsuas ntshav siab txo qis kawg ntawm qhov sib deev nruab nrab (i.e., 24 teev tom qab noj tshuaj) hauv tus neeg mob zaum lossis pw txoj haujlwm yog qhov nruab nrab 5-8 / 8-13 hli Hg. Kos duab. (feem) ntau tshaj li cov placebo. Qhov tshuaj tiv thaiv kab mob los tiv thaiv los ntawm kev siv tshuaj ntawm qhov tshuaj ntawm 150 mg 1 zaug hauv ib hnub tsis txawv ntawm kev siv cov tshuaj no hauv 2 koob tshuaj. Cov nyhuv antihypertensive ntawm irbesartan kev tsim kho tsis pub dhau 1-2 lub lis piam, thiab cov txiaj ntsig siab tshaj plaws tau ua tiav tom qab 4-6 lub lis piam los ntawm kev pib kho. Tom qab txiav tawm cov tshuaj, ntshav siab maj mam rov qab los rau nws tus nqi qub, tsis muaj kev txhim kho ntawm tus mob huam yeeb tshuaj. Yuav kom ua tiav cov txiaj ntsig antihypertensive, kev kho mob ntev yog tsim nyog.

Qhov ua tau zoo ntawm irbesartan tsis nyob ntawm poj niam txiv neej thiab hnub nyoog.

Cov neeg mob ntawm cov kev sib tw Negroid teb tau tsawg dua kev kho mob monotherapy nrog rau cov tshuaj.

Cov Tshuaj Pharmacokinetics

Kev nqus: Irbesartan tom qab kev tswj hwm qhov ncauj tau zoo nqus los ntawm txoj hnyuv plab. Qhov siab tshaj plaws ntshav plasma hauv cov ntshav tau mus txog tom qab 1.5-2 teev tom qab kev tswj hwm ntawm qhov ncauj, qhov qhia tseeb txog bioavailability yog 60-80%. Noj tsis cuam tshuam loj heev txog kev noj qab haus huv. Irbesartan muaj qhov sib npaug sib npaug thiab cov tshuaj kws kho mob hauv qhov ntau ntawm 10-600 mg, ntawm kev txhaj tshuaj ntau dua (2 zaug siab dua qhov pom zoo tshaj plaws), kinetics ntawm cov tshuaj yuav tsis-tawm.

Kev faib khoom: qhov khi ntawm ib yam khoom rau cov ntshav plasma protein yog kwv yees li 96%. Txuas nrog lub xovtooj ntawm tes ntawm cov ntshav tsis tseem ceeb. Qhov ntim ntawm kev faib tawm yog 53-93 liv. Qhov sib xyaw ua ke nrog qhov xav tau kom tsawg li 1 zaug ib hnub twg tau mus txog tom qab 3 hnub. Nrog cov koob tshuaj rov qab, muaj kev txwv ntau ntawm cov tshuaj nyob rau hauv cov ntshav ntshav (9 cov ntsiab lus ntawm Child-Pugh scale),

Tus txheeb ze (kab mob / mob uas muaj nyob rau qhov uas cov thawj coj ntawm Irbesartan yuav tsum ceev faj):

• hypertrophic obstructive cardiomyopathy,
• mitral / aortic valve stenosis,
• kev npau suav,
• hypovolemia,
• ua raws li cov zaub mov noj nrog ntsev tsawg,
• raws plab, ntuav,
• ob leeg lub raum leeg mob stenosis,
• unilateral stenosis ntawm ib lub raum leeg,
• mob plawv thiab / lossis atherosclerotic qhov txhab ntawm cov hlab ntsha ntawm paj hlwb,
• mob ntsws tsis ua hauj lwm hauv chav III - IV chav ua haujlwm raws li NYHA kev faib tawm,
• lub raum tsis ua hauj lwm
• hyperkalemia
• mob tom qab hloov raum,
• hemodialysis
• thawj hyperaldosteronism,
• ua ke nrog kev kho mob nrog diuretics,
• ua ke siv nrog cov tshuaj uas tsis yog tshuaj steroidal, suav nrog cyclooxygenase II inhibitors, angiotensin-hloov enzyme inhibitors lossis aliskiren,
• hnub nyoog tshaj 75 xyoo.

Cov lus qhia rau kev siv Irbesartan: txoj kev thiab ntau npaum li cas

Irbesartan tau noj ntawm qhov ncauj, nqos tag nrho cov ntsiav tshuaj thiab dej haus. Koj tuaj yeem siv cov tshuaj tsis hais lub sijhawm noj mov.

Cov koob tshuaj tiv thaiv thawj zaug / txij nkawm yog 150 mg ib hnub ib zaug (muab kev tswj hwm ntshav siab zoo thaum nruab hnub, qee kis, tshwj xeeb tshaj yog rau cov neeg mob hemodialysis, lossis hauv cov neeg mob laus dua 75 xyoo, thawj koob tshuaj yog 75 mg). Yog tias kev kho mob tsis ua tiav, qhov koob tshuaj yuav tau nce ntxiv 2 zaug.

Thaum tsis muaj peev xwm txo qis hauv cov ntshav siab li kev kho mob ntshav qab zib, diuretics lossis lwm yam tshuaj tiv thaiv kab mob tuaj yeem ntxiv rau Irbesartan.

Nrog rau kev mob ntshav siab thiab hom 2 mob ntshav qab zib mellitus, kev kho mob yuav tsum tau pib nrog 150 mg ib hnub ib zaug thiab maj mam nce mus rau 300 mg - qhov koob tshuaj uas zoo dua hauv kev kho mob ntawm nephropathy.

Yeeb tshuaj sib cuam tshuam

Nrog rau kev siv ua ke ntawm Irbesartan nrog rau qee cov tshuaj / tshuaj, cov teebmeem hauv qab no tuaj yeem tsim:

• tshuaj muaj aliskiren: kev sib xyaw ua ke yog contraindicated rau cov neeg mob ntshav qab zib mellitus los yog mob raum / mob raum tsis txaus, hauv lwm tus neeg mob tsis pom zoo,
• angiotensin hloov mus rau enzyme inhibitors: kev sib xyaw ua ke yog contraindicated rau cov neeg mob ntshav qab zib nephropathy, hauv lwm tus neeg mob nws tsis pom zoo,
• diuretics (kev kho mob ua ntej hauv kev txhaj tshuaj siab): lub cev qhuav dej thiab nce siab ntawm txoj kev mob ntshav liab thaum pib ntawm kev siv tshuaj Irbesartan,
• diuretics thiab lwm cov tshuaj tiv thaiv antihypertensive: muaj cov nyhuv tshuaj tiv thaiv kab mob ntau ntxiv (muaj peev xwm ua ke nrog kev kho mob nrog β-adrenergic thaiv cov kab mob, kev ua haujlwm ntev calcium channel blockers thiab thiazide diuretics),
• lithium npaj: ib qho kev hloov pauv rov qab hauv cov ntshiab lithium concentration hauv cov ntshav lossis nws cov tshuaj lom (yog tias tsim nyog, siv ua ke yuav tsum tau ceev faj soj ntsuam ntawm lithium concentration),
• poov tshuaj npaj, aqueous electrolyte kev daws teeb meem muaj cov poov tshuaj, potassium-sparing diuretics, tshuaj uas tuaj yeem nce cov poov tshuaj ntau ntxiv hauv cov ntshav, suav nrog rau heparin: nce ntshav ntau ntxiv hauv cov ntshav,
• nonsteroidal anti-inflammatory tshuaj: tsis muaj zog tiv thaiv antihypertensive nyhuv ntawm irbesartan, nce qhov ntau ntxiv ntawm kev txhim kho kev ua haujlwm ntawm lub raum, nrog rau kev pheej hmoo ntawm mob raum tsis ua haujlwm, thiab nce ntshav poov tshuaj, tshwj xeeb tshaj yog nrog twb dhau los ua kom lub raum muaj nuj nqi (kev sib xyaw yuav tsum ceeb toom, tshwj xeeb tshaj yog nyob rau cov neeg laus thiab cov mob hypovolemia , koj yuav tsum tau rov qab kho qhov ntim ntawm cov ntshav ncig thoob plaws hauv tag nrho lub sijhawm ntawm kev kho mob sib xyaw, nrog rau ntu tom qab nws Kawg ib tug, saib xyuas lub raum muaj nuj nqi).

Cov lus qhia ntawm Irbesartan yog: Aprovel, Firmasta, Ibertan, Irsar, thiab lwm yam.

Kev txheeb xyuas ntawm Irbesartan

Raws li kev txheeb xyuas, Irbesartan yog ib qho ntawm cov tshuaj muaj rau kev kho mob ntev ntev ntawm mob me / mob ntshav siab. Nws cov hauj lwm zoo hauv kev mob ntshav siab (nrog rau kev noj tshuaj ib hnub 300 mg) thiab qhov nce ntshav siab thaum hmo ntuj kuj tseem sau tseg. Cov tshuaj, raws li txoj cai, zoo zam thiab coj mus rau kev txhim kho cov kev mob tshwm sim (feem ntau yog nyob rau hauv daim ntawv ntawm cov tsis muaj zog thiab kiv taub hau) tsuas yog hauv qee qhov tsis tshua muaj.

Tseem muaj kev txheeb xyuas txog qhov ua tau zoo ntawm Irbesartan tiv thaiv cov ntshav qab zib thiab ntshav qab zib nephropathy.

Cov Yuav Tsum Muaj

• hnub nyoog txog 18 xyoo
• kev tiv thaiv tsis haum
• cev xeeb tub,
• pub niam mis.

Nrog ceev faj yog kws kho thaum aortic valve stenosis, CHF, lub cev qhuav dej, zawv plabntuav tshuaj mob siab ntsws, stenosislub raum leeg (unilateral thiab ob sab sib dho).

Irbesartan, cov lus qhia rau kev siv (Txoj kev thiab ntau npaum li cas)

Cov ntsiav tshuaj tau noj ntawm lub plab khoob lossis nrog zaub mov, nqos tag nrho. Pib kho nrog 150 mg ib hnub twg. Cov koob tshuaj no muab kev tswj kom zoo thaum nruab hnub piv rau 75 mg / hnub.

Tom qab, lawv nce mus rau 300 mg rau ib hnub, tab sis tsis muaj ntxiv, txij li ib qho kev nce ntxiv tsis ua rau muaj qhov nce ntawm cov nyhuv hypotensive. Hauv qhov no, nws pom zoo kom ntxiv cov tshuaj diuretics. Hauv cov neeg mob laus dua 75 xyoo, hauv cov ntawd hemodialysis thiab nrog lub cev qhuav dej pib kho mob nrog 75 mg, raws li cov tsos mob arterial hypotensionCov. Hauv cov neeg mob nrog lub raum tsis ua hauj lwm xav kom tswj tau lub siab neeg tsim tswv thiab poov tshuaj nyob rau hauv cov ntshav. Nyob rau hauv loj CH nce kev pheej hmoo azotemia thiab oliguriantawm cardiomyopathies - qhov pheej hmoo myocardial infarctionCov. Muab hais tias kev kho mob yog ua tau kiv taub hau thiab qaug zog, siv kev ceev faj thaum tsav tsheb.

Noj ntau dhau

Neej Neeg tachycardia lossis bradycardiatxo qis ntshav siab, cev qhuav dejCov. Txoj kev kho yog pib mob plab zom mov thiab sau ntawv yuav tshuaj. tshuab txais carbonCov. Hauv qab no yog kev kho mob cov tsos mob.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Cov tshuaj no yog ua lag luam nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj coated. Lub ntsiab nquag ua haujlwm ntawm cov tshuaj yog irbesartan nws tus kheej. Cov tshuaj no belongs rau cov tshuaj tiv thaiv lub ntsej muag. Irbesartan yog tus pheej yig. Hauv cov khw muag tshuaj, nyob ntawm tus neeg xa khoom, nws tuaj yeem yuav rau 260-300 p. (28 ntsiav tshuaj).

Kev taw qhia thiab contraindications rau siv

Analogs ntawm Irbesartan, cov lus qhia rau kev siv uas yuav los tham txog hauv qab no, tej zaum yuav raug txiav txim siab siv cov tshuaj no tsam tsis nkag rau tus neeg mob ntawm nws cov khoom siv lossis qhov tsis tuaj yeem tau vim yog tsis muaj tshuaj hauv lub tsev muag tshuaj. Ntxiv rau hauv tsab xov xwm peb yuav tham txog kev hloov rau cov cuab yeej no. Tam sim no peb yuav to taub yam tshuaj no nws tus kheej yog dab tsi, thiab yuav ua li cas kom noj nws.

Cov tshuaj no yog kho tshwj xeeb rau kev mob ntshav siab. Qee lub sij hawm nws yog kho rau theem nrab. Tsis tas li, cov tshuaj yuav muaj txiaj ntsig zoo rau lub cev ntawm cov neeg mob uas muaj tus kab mob xws li nephropathy nrog hom 2 mob ntshav qab zib thiab kub siab. Txawm li cas los xij, hauv qhov xwm txheej no, cov tshuaj "Irbesartan" tsuas yog siv ua ke nrog lwm cov tshuaj.

Nws tsis muaj qhov tshwj xeeb sau tseg txog cov tshuaj no. Koj tsis tuaj yeem coj nws tsuas yog rau cov neeg uas ua xua rau qee yam ntawm nws cov khoom siv. Tsis tas li, kev siv cov tshuaj no tsis raug tso cai rau cov poj niam cev xeeb tub thiab pub niam mis, menyuam muaj hnub nyoog qis dua 18 xyoo. Hauv qee kis, cov tshuaj no yuav tsum tau ua nrog ceev faj. Hauv kev saib xyuas mob zoo, lawv haus nws, piv txwv, hauv cov kab mob xws li hyponatremia thiab lub cev qhuav dej.

Yam kev mob tshwm sim tuaj yeem muaj

Kev siv ntawm "Irbesartan" yog ua tau tsuas yog raws li qhia los ntawm kws kho mob. Hauv cov khw muag tshuaj, qhov cuab yeej no yog muag los ntawm tshuaj noj. Cov kev mob tshwm sim Irbesartan tuaj yeem muab ntau yam. Piv txwv, tus neeg mob yuav ntsib cov teeb meem nram qab no:

mob taub hau lossis kiv taub hau,

cov kab mob ua pa, rhinitis nrog kub taub hau,

raws plab, kub siab, xeev siab thiab ntuav,

Qee zaum cov tshuaj no tseem ua rau kom qhov mob tsis txaus siab xws li tso zis mob los yog mob plab.

Cov tshuaj ua haujlwm li cas?

Cov tshuaj Irbesartan los ntawm lub plab zom tau sai sai thiab zoo. Nws cov khoom nquag mus txog nws qhov siab tshaj plaws hauv cov ntshav ntshav tom qab 1.5-2 teev tom qab kev tswj hwm. Hauv cov neeg mob lub cev, cov tshuaj no thaiv AT1 receptors, txo cov kev lom neeg los ntawm agiotensin II, txhawb kev tso tawm ntawm aldosterone thiab ua kom lub siab tsis txaus siab ntawm lub hlwb. Raws li qhov txiaj ntsig ntawm tag nrho cov no, tus neeg mob tau txo qis ntshav siab.

Cov tshuaj no tau tawm los ntawm tus neeg mob lub cev nrog zis thiab tso tawm.

Qhov zoo tshaj plaws analogues ntawm Irbesartan

Yog tias muaj contraindications rau noj cov tshuaj no lossis rau lwm qhov laj thawj, tus kws kho mob tuaj yeem sau ntawv hloov chaw rau tus neeg mob. Feem ntau feem ntau, cov tshuaj siv nrog cov nyhuv tshuaj zoo xws li Aprovel, Valzan, Losartal, lossis Irsar, yog siv rau kev kho mob.

Tag nrho cov analogues ntawm Ibersartan tseem tau txais cov kev txheeb xyuas zoo los ntawm cov neeg mob thiab cov kws kho mob.

Aprovel tshuaj: daim ntawv tso tawm thiab qhov ntsuas

Lub hauv paus ntsiab lus tseem ceeb nyob rau hauv cov tshuaj no yog irbesartan. Ntawd yog, qhov tseeb, nws hais txog cov lus txhais ntawm cov txhais tau piav qhia los ntawm peb. Kev qhia rau siv nrog cov tshuaj no zoo ib yam nkaus nrog Irbesartan. Siv nws feem ntau yog rau kev tiv thaiv kab mob ntshav siab thiab mob hlwb ua ke nrog lwm tus neeg sawv cev. Nws kev phiv yog tib yam li cov neeg ntawm Irbesartan. Cov tshuaj no yog sau rau hauv tib lub tshuaj.

Ntau qhov analogues ntawm Irbesartan kev kuaj xyuas neeg mob tsim nyog zoo. Tab sis qhov kev xav zoo tshaj plaws ntawm cov neeg mob thiab kws kho mob yog hais txog Aprovel hloov chaw. Cov tshuaj no tseem kim dua Irbesartan. Rau 28 ntsiav tshuaj ntawm cov cuab yeej no yuav tau them 550-650 p. Txawm li cas los xij, cov tshuaj lag luam yog tsim los ntawm lub npe nrov Fabkis tuam txhab Sanofi-Winthrop. Ntawd yog, qhov tseeb, yog hom muaj npe zoo hloov rau Irbesartan.

Cov tshuaj "Irsar"

Cov kws kho mob tau sau daim ntawv noj tshuaj no rau cov roj ntsha tseem ceeb heev. Cov tshuaj nquag hauv nws yog irbesartan. Cov tshuaj no tau muag hauv cov lag luam zoo nrog kev pheej hmoo. Cov lus qhia, contraindications thiab cov lus qhia rau siv nrog nws tsis txawv ntawm Irbesartan. Cov tshuaj no muaj nqis txog 350-450 p. rau 28 ntsiav tshuaj. Tab sis qee zaum hauv cov chaw muag tshuaj nws kuj tseem muab rau 600-650 r.

Cov tshuaj "Valzan"

Tus Irbesartan analogs uas tau piav qhia saum toj no yog muab raws li qhov kev ua zoo li qub. Tab sis cov tshuaj no hloov tau nrog cov muaj pes tsawg leeg sib txawv. Cov khoom tseem ceeb hauv cov tshuaj "Valzan", piv txwv li, yog hydrochlorothiazite thiab valsartan. Cov tshuaj no tau muab rau cov lag luam hauv daim ntawv ntawm cov ntsiav tshuaj hauv lub hlwv. Hloov ntawm Irbesartan, nws tuaj yeem raug kho rau cov ntshav cov ntshav liab. Tsis tas li, kev qhia rau kev siv cov tshuaj no yog lub plawv tsis ntev los no thiab lub plawv mob ntev.

Koj tsis tuaj yeem noj "Valzan" rau kab mob siab, mob hauv plab, thaum pub niam mis. Tsis tas li, qhov kev hais daws no tsis raug siv rau cov menyuam hnub nyoog qis dua 18 xyoo. Kev phiv los ntawm cov tshuaj no tuaj yeem muab yuav luag tib yam li Irbesartan. Cov tshuaj "Valzan" tsis muaj nqi. Txog 30 ntsiav tshuaj ntawm cov khoom no hauv ib lub tsev muag tshuaj koj yuav tsum tau them nyiaj li 15-20 p.

Thawj qhov tshuaj thawj zaug ntawm cov tshuaj no yog 80 mg ib hnub ib zaug. Ntawm ob lub lis piam tom ntej no, feem ntau nws nce rau 160 mg rau ib hnub. Hauv cov kis mob tshwj xeeb, tus neeg mob tuaj yeem nqa txog 320 mg ib hnub.

Cov tshuaj "Losartan"

Qee qhov ntsuas qhov tsis zoo ntawm Irbesartan hauv Russia tuaj yeem yuav cov pheej yig dua. Qhov kev txhawj xeeb no tsis tsuas yog cov tshuaj Valzan, tab sis kuj, piv txwv li, cov tshuaj Lozartan. Nws tseem yog qhov hloov tau zoo rau Irbesartan. Lub hauv paus tseem ceeb cov tshuaj hauv cov tshuaj no yog losartan potassium. Cov tshuaj yog tsim hauv cov ntsiav tshuaj coated. "Losartan" tuaj yeem raug kho rau cov neeg mob ntshav liab, lub plawv tsis ua haujlwm, thiab qee qhov xwm txheej.

Cov tshuaj no muaj ob peb ntxiv contraindications dua li cov tshuaj tau piav saum toj no. Ntxiv rau kev xeeb tub thiab menyuam yaus, cov tshuaj no yuav tsum tsis txhob haus dej, piv txwv li, nrog lub cev qhuav dej, lub raum tsis ua haujlwm, tib lub sijhawm Aliskiren. Cov tshuaj no raug nqi txog 60-100 rubles ntawm kev ua lag luam rau ib pob ntawm 30 ntsiav tshuaj.

Lub tswv yim ntawm cov neeg mob txog cov tshuaj "Irbesartan"

Yog li, peb xam tawm qhov kev npaj Irbesartan nws tus kheej sawv cev (cov lus qhia rau kev siv, analogues). Kev txheeb xyuas txog cov tshuaj no feem ntau tsuas zoo. Tus siab txo cov tshuaj kom zoo. Txawm li cas los xij, noj nws kom txais cov txiaj ntsig zoo tshaj plaws, raws li ntau tus neeg mob, yuav tsum siv sijhawm ntev.

Dosage daim ntawv

Cov ntsiav tshuaj zaj duab xis-75 mg, 150 mg lossis 300 mg

Ib ntsiav tshuaj muaj

cov tshuaj heev irbesartan - 75 mg lossis 150 mg, lossis 300 mg

hauvtus pabstshuaj yeeb dej cawtab sis: microcrystalline cellulose PH 101, calcium carmellose, povidone K-30, silicon dioxide colloidal anhydrous, calcium stearate, dej lim

plhaub muaj pes tsawg leeg: Opadry dawb OY-S-38956, ua kom huv dej

muaj pes tsawg leeg opadry dawb OY-S-38956: hypromellose, titanium dioxide E171, talc.

Cov tshuaj ntsiav zoo li tus kheej, nrog lub ntsej muag biconvex, txheej nrog lub plhaub zaj duab xis ntawm cov xim dawb lossis yuav luag xim dawb nrog lub ntsej muag "158" ntawm ib sab tes thiab "H" nyob rau lwm qhov (rau ntau npaum ntawm 75 mg).

Tshuaj ntsiav zoo li lub pob, nrog lub ntsej muag biconvex, txheej nrog lub plhaub zaj duab xis ntawm cov xim dawb lossis yuav luag xim dawb nrog lub ntsej muag "159" ntawm ib sab thiab "H" nyob rau sab nraud (rau ntau npaum ntawm 150 mg).

Tshuaj ntsiav zoo li lub pob, nrog lub ntsej muag biconvex, txheej nrog lub plhaub zaj duab xis ntawm cov xim dawb lossis yuav luag xim dawb nrog lub ntsej muag "160" ntawm ib sab thiab "H" nyob rau sab nraud (rau ntau npaum ntawm 300 mg).

Farmacotherapeutic pab pawg

Cov tshuaj uas cuam tshuam rau renin-angiotensin system. Angiotensin II cov kev tawm tsam. Irbesartan

ATX Code C09CA04