Yuav siv cov tshuaj Mikardis 80 li cas? > Kev khomob thiab kev tiv thaiv

Mikardis yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj: oblong, yuav luag dawb lossis dawb, ntawm ib sab muaj tus txaug "51N" lossis "52N" (40 lossis 80 mg, ntsig txog), nyob rau lwm qhov - cov cim ntawm lub tuam txhab (7 pcs. Hauv cov hlwv, txhua 2, 4, 8 lossis 14 lub hlwv hauv lub thawv ntawv).

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

Cov tshuaj yeeb tshuaj: telmisartan - 40 lossis 80 mg,
Ntu cov khoom siv (40/80 mg txhua): magnesium stearate - 4/8 mg, sodium hydroxide - 3.36 / 6.72 mg, meglumine - 12/24 mg, polyvidone (collidone 25) - 12/24 mg, sorbitol - 168.64 / 337.28 mg.

Daim ntawv tso tawm

Cov tshuaj yog dawb, oblong-puab ntsiav tshuaj nrog 51H engraving rau ntawm ib sab thiab lub tuam txhab logo ntawm lwm ntug.

7 xws li cov ntsiav tshuaj nrog qhov tshuaj 40 mg hauv lub hlwv; 2 lossis 4 xws li lub hlwv rau hauv ib lub thawv ntawv. Xws li 7 cov ntsiav tshuaj nrog qhov ntau npaum 80 mg rau hauv lub hlwv, 2, 4 lossis 8 xws li cov hlwv hauv lub thawv ntawv

Pharmacodynamics thiab pharmacokinetics

Cov Tshuaj Hauv Tshuaj

Telmisartan - xaiv cov tshuaj tiv thaiv blocker angiotensin IICov. Muaj siab tropism ntawm AT1 receptor subtype angiotensin IICov. Sib tw nrog angiotensin II hauv cov kis tshwj xeeb uas tsis muaj tib cov txiaj ntsig. Cov ntawv cog lus yog qhov txuas ntxiv.

Nws tsis muaj ua tropism rau lwm qhov loj me ntawm receptors. Txo cov ntsiab lus aldosterone hauv cov ntshav, tsis txwv ntshav plasma renin thiab ion channels hauv cov hlwb.

Pib hypotensive nyhuv nyob rau thawj peb teev tom qab kev tswj hwm telmisartanCov. Qhov kev ua mob tsawv rau ib hnub lossis ntau dua. Cov nyhuv hais tawm tuaj ib hlis tom qab tswj hwm tas mus li.

Hauv cov neeg nrog leeg ntshav siabtelmisartan txo systolic thiab diastolic ntshav siab, tab sis tsis hloov pauv ntau ntawm lub plawv mob.

Tsis ua kom tus mob thim rov qab.

Cov Tshuaj Pharmacokinetics

Thaum noj ntawm qhov ncauj, nws nrawm dua los ntawm cov hnyuv. Bioavailability cuag tau 50%. Tom qab peb teev, lub plahaum plasma ua qhov siab tshaj plaws. 99.5% ntawm cov tshuaj nquag khi rau cov ntshav protein. Metabolized los ntawm kev teb nrog glucuronic acidCov. Cov metabolites ntawm cov tshuaj tsis ua haujlwm. Kev tshem tawm ib nrab-lub neej yog ntau tshaj 20 teev. Nws raug tawm los ntawm cov hnyuv, feem ntau hauv cov zis yog tsawg dua 2%.

Cov Yuav Tsum Muaj

Micardis ntsiav tshuaj yog contraindicated hauv cov neeg nrog ua xua ntawm cov tshuaj ntawm cov tshuaj, hnyav kab mobmob siab lossis raum, fructose intolerance, thaum cev xeeb tub thiab kev pub mis, menyuam muaj hnub nyoog qis dua 18 xyoo

Sab sij huam

Los ntawm lub hauv nruab nrab hauv lub paj hlwb: kev nyuaj siabkiv taub hau mob taub hauqaug zog, ntxhov siab vim, insomnia, cramps.
Los ntawm cov txheej txheem ua pa: kab mob ntawm cov pa hauv siab (mob hlab ntsws, pharyngitis, mob ntsws), hnoos.
Los ntawm cov kab mob ntshav: cov lus txo hauv siab, tachycardia, bradycardiamob hauv siab.
Los ntawm lub plab zom mov: xeev siab, zawv plab, dyspepsiance qhov concentration ntawm daim siab enzymes.
Los ntawm cov leeg musculoskeletal: myalgiaqis rov qab mob arthralgia.
Los ntawm cov kab ke genitourinary: edema, kis kab mob ntawm cov genitourinary system, hypercreatininemia.
Hypersensitivity tshua: Cov tawv nqaij ua pob, angioedema, urticaria.
Kev ntsuas ntsuas: anemia, hyperkalemia.
Lwm yam: erythemakhaus dyspnea.

Mikardis, cov lus qhia rau kev siv

Raws li cov lus qhia rau kev siv Mikardis, cov tshuaj no noj ntawm qhov ncauj. Pom zoo rau cov laus koob tshuaj 40 mg ib hnub. Hauv ntau tus neeg mob, txoj kev kho kom zoo yog twb pom thaum noj ib koob 20 mg ib hnub. Yog tias qhov txo qis rau qhov siab mus rau qib yam tsis xav tau, tsis yog li ntawd, ces qhov koob tshuaj yuav raug nce ntxiv txog 80 mg rau ib hnub.

Qhov ua tau zoo tshaj plaws ntawm cov tshuaj tau tiav tsib lub lis piam tom qab pib kev kho mob.

Hauv cov neeg mob uas muaj cov ntawv hnyav leeg ntshav siab siv tau 160 mg tshuaj ib hnub.

Kev sib txuam

Telmisartan activates hypotensive nyhuv lwm txhais tau tias ntawm kev txo qis siab.

Thaum siv ua ke telmisartan thiab digoxin kev txiav txim siab kom raws sij hawm yog qhov tsim nyog digoxin hauv cov ntshav, vim tias nws tuaj yeem nce ntxiv.

Thaum noj tshuaj ua ke lithium thiab ACE inhibitors yuav muaj txoj cai nyob ib ntus hauv cov ncauj lus lithium hauv cov ntshav, ua kom paub los ntawm kev phiv tshuaj lom.

Kev Kho Mob non-steroidal anti-inflammatory tshuaj tiv thaiv ua ke nrog Mikardis hauv cov neeg mob lub cev qhuav dej tuaj yeem ua rau txoj kev txhim kho ntawm lub raum tsis ua haujlwm.

Cov lus qhia tshwj xeeb

Rau cov neeg mob lub cev qhuav dej (ntsev kev txwv, kho mob tshuaj kho mob, zawv plab, ntuav) kev txo qis hauv Mikardis yog qhov tsim nyog.

Nrog ceev faj, taw cov neeg nrog stenosis ntawm ob qho tib si lub raum hlab ntsha, mitral valve stenosis lossis aortic hypertrophic cardiomyopathy obstructive, lub raum loj, mob ntshav lossis lub plawv tsis ua haujlwm, kab mob ntawm lub plab zom mov.

Nws yog txwv tsis pub siv thaum thawj aldosteronism thiab fructose intolerance.

Nrog kev npaj cev xeeb tub, koj yuav tsum xub pom qhov hloov rau Mikardis nrog lwm tus antihypertensive siv yeeb siv tshuaj.

Siv nrog ceev faj thaum tsav tsheb.

Nrog rau qhov sib xyaw nrog cov tshuaj lithium saib xyuas ntawm lithium cov ntsiab lus hauv cov ntshav tau qhia, txij li kev txhim kho ib ntus hauv nws theem yog ua tau.

Mikardis Nqe

Hauv Lavxias, ib pob khoom ntawm 80 mg No. 28 yuav raug nqi los ntawm 830 txog 980 rubles. Nyob rau hauv Ukraine, tus nqi ntawm Mikardis nyob rau hauv tib daim ntawv ntawm qhov teeb meem yog nce 411 hryvnias.

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb MikardisCov. 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 tawm tswv yim ntawm cov kws kho mob tshwj xeeb txog kev siv Mikardis hauv lawv qhov 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. Mikardis analogues nyob rau hauv muaj cov qauv txheej txheem qauv. Siv rau kev kho mob ntshav siab thiab txo ntshav siab rau cov neeg laus, menyuam yaus, nrog rau thaum cev xeeb tub thiab lactation. Cov tshuaj muaj pes tsawg leeg.

Mikardis - Cov tshuaj antihypertensive.

Telmisartan (cov tshuaj yeeb tshuaj uas yog Mikardis) yog ib qho tshwj xeeb ntawm kev tiv thaiv kabmob ntawm angiotensin 2 Nws tau muaj qhov muaj txiaj ntsig zoo rau AT1 receptor subtype ntawm angiotensin 2, los ntawm cov tshuaj angiotensin 2 yog pom tau hais. Nws tsim kev sib txuas nkaus xwb ntawm AT1 receptor subtype ntawm angiotensin 2. Kev khi yog tas mus li. Telmisartan tsis muaj kev sib nyiam rau lwm tus txais tshuaj (suav nrog AT2 receptors) thiab lwm qhov tsis tshua muaj kev kawm txog tshuaj angiotensin. Lub luag haujlwm tseem ceeb ntawm cov receptors, nrog rau cov txiaj ntsig ntawm lawv qhov kev xav tau dhau los nrog angiotensin 2, qhov kev cia siab ntawm uas nce nrog kev teem sijhawm telmisartan, tseem tsis tau kawm. Nws txo nws cov concentration ntawm aldosterone hauv cov ntshav, tsis inhibit renin hauv ntshav ntshav thiab tsis thaiv cov ion ion. Nws tsis inhibit ACE (kininase 2), ib qho enzyme uas kuj rhuav tshem bradykinin, yog li ntawd, kev nce ntxiv los ntawm cov kev mob tshwm sim los ntawm bradykinin tsis xav.

Mikardis ntawm ib koob ntawm 80 mg ua rau tag nrho cov txiaj ntsig kev mob siab ntawm angiotensin 2. Qhov pib ntawm kev ua haujlwm hypotensive raug sau tseg tsis pub dhau 3 teev tom qab thawj zaug thawj coj ntawm telmisartan. Cov nyhuv ntawm cov tshuaj no kav rau 24 teev thiab tseem ceeb txog li 48 teev. Tshaj tawm cov nyhuv hypotensive feem ntau muaj kev txhim kho tom qab 4-8 lub lim tiam ntawm kev siv tas li.

Hauv cov neeg mob ntsig txog kev mob ntshav siab, telmisartan txo qis systolic thiab diastolic ntshav siab, tsis cuam tshuam rau lub plawv dhia.

Nyob rau hauv cov ntaub ntawv ntawm kev tshem tawm sai sai ntawm Mikardis, AD maj mam rov qab mus rau nws thawj qib tsis muaj kev txhim kho ntawm qhov kev tshem tawm mob tawm.

Hydrochlorothiazide (cov tshuaj ua kom nquag ntawm cov tshuaj Mikardis Plus) yog thiazide diuretic. Thiazide diuretics cuam tshuam rau kev rov qab cov roj hluav taws xob hauv cov hlab ntsws, rov nce ncaj qha rau qhov tsis pom kev ntawm sodium thiab chlorides (kwv yees li qhov sib npaug). Cov nyhuv diuretic ntawm hydrochlorothiazide ua rau txo bcc, kev nce hauv plasma renin kev ua si, kev nce siab ntawm kev tso cai ntawm aldosterone thiab yog los ntawm kev nce hauv cov zis potassium thiab bicarbonates, thiab yog li ntawd, txo qis potassium nyob hauv ntshav ntshav. Nrog rau kev siv telmisartan tib lub sijhawm, muaj lub siab nyiam kom tsis txhob muaj cov poov tshuaj los ntawm cov diuretics, txawm tias yog vim RAAS thaiv.

Tom qab noj hydrochlorothiazide, diuresis ntau ntxiv tom qab 2 teev, thiab cov nyhuv siab tshaj plaws yog pom tom qab txog 4 teev. Cov diuretic nyhuv ntawm cov tshuaj tseem nyob ntev li 6-12 teev.

Kev siv lub sijhawm ntev ntev ntawm hydrochlorothiazide txo cov kev pheej hmoo ntawm cov teeb meem ntawm cov kab mob plawv thiab kev tuag ntawm lawv.

Qhov siab tshaj plaws antihypertensive nyhuv ntawm cov tshuaj Mikardis Plus feem ntau ua tiav 4-8 lub lis piam tom qab pib ntawm kev kho mob.

Muaj pes tsawg leeg

Telmisartan + excipients (Mikardis).

Telmisartan + hydrochlorothiazide + excipients (Mikardis Ntxiv).

Cov Tshuaj Pharmacokinetics

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 ntawm AUC qhov tseem ceeb yog li ntawm 6% (thaum siv los ntawm ib koob 40 mg) txog 19% (thaum siv los ntawm koob ntawm 160 mg). Tom qab 3 teev tom qab kev coj noj coj ua, kev xav hauv cov ntshav plasma yog qib tsis hais lub sij hawm noj mov li cas. Nws yog metabolized los ntawm kev sib txuas nrog glucuronic acid. Metabolites tsis yog kws tshuaj hauv tsev. Nws yog tawm los ntawm txoj hnyuv tsis hloov, nthuav tawm los ntawm ob lub raum - tsawg dua 2% ntawm qhov muab tshuaj.

Muaj qhov sib txawv ntawm qhov ntau ntawm cov txiv neej thiab poj niam. Hauv cov poj niam, Cmax thiab AUC yog kwv yees li 3 thiab 2 npaug piv dua li tus txiv neej (tsis muaj qhov cuam tshuam rau lub txiaj ntsig).

Cov tshuaj pharmacokinetics ntawm telmisartan hauv cov neeg laus laus tsis txawv ntawm pharmacokinetics hauv cov neeg mob hluas. Koob tshuaj yuav tsis haum.

Kev hloov pauv hauv cov neeg mob lub raum tsis ua haujlwm, tsis suav nrog cov neeg mob ntawm hemodialysis. Telmisartan tsis raug tshem tawm los ntawm hemodialysis.

Hauv cov neeg mob uas muaj lub siab ua haujlwm tsis txaus ntawm kev ua haujlwm me me mus txog qib kawm (chav A thiab B ntawm Kev Siv Me Nyuam-Pugh nplai), koob tshuaj txhua hnub yuav tsum tsis pub tshaj 40 mg.

Cov cim tseem ceeb ntawm pharmacokinetics ntawm telmisartan hauv cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog 6 txog 18 xyoo tom qab noj telmisartan ntawm koob tshuaj 1 mg / kg lossis 2 mg / kg rau 4 lub lis piam feem ntau piv nrog cov ntaub ntawv tau txais kev kho mob ntawm cov neeg laus thiab paub meej tias tsis-linearity ntawm pharmacokinetics telmisartan, tshwj xeeb tshaj yog nrog kev hwm Cmax.

Tom qab kev tswj hwm ntawm qhov ncauj, Mikardis Plus Cmax hydrochlorothiazide tau mus txog li ntawm 1-3 teev. Kev tsis txaus siab txog kev noj qab haus huv ntawm lub cev yog kwv yees los ntawm kev ua kom lub plawv rov qab ua kom zoo ntawm hydrochlorothiazide thiab yog li 60%. Nws khi rau cov ntshav plasma protein li 64%. Nws tsis yog metabolized hauv tib neeg lub cev thiab tawm hauv cov zis yuav luag tsis hloov. Li ntawm 60% ntawm cov koob tshuaj uas tau noj ntawm qhov ncauj yog raug tshem tawm hauv 48 teev.

Muaj qhov sib txawv ntawm ntshav ntau nyob rau hauv cov txiv neej thiab poj niam. Rau cov poj niam, muaj qhov nyiam ua rau lub chaw kuaj ntshav nce siab ntxiv hauv hydrochlorothiazide.

Hauv cov neeg mob uas lub raum lub raum tsis ua haujlwm, tus nqi ntawm kev tshem tawm ntawm hydrochlorothiazide yog txo.

Cov Khoom Qhia

arterial hypertension (txo hauv siab),
txo qis hauv kev mob plawv thiab cov neeg tuag hauv cov neeg mob hnub nyoog 55 xyoos thiab laus dua nrog qhov pheej hmoo ntawm cov kab mob plawv.

Tso Tawm Cov Ntawv

Cov ntsiav tshuaj 40 mg thiab 80 mg.

Ntsiav tshuaj 40 mg + 12.5 mg thiab 80 mg + 12.5 mg (Mikardis Plus).

Cov lus qhia rau kev siv thiab ntau npaum li cas

Cov tshuaj yog tawm hauv lub qhov ncauj, tsis hais los ntawm cov khoom noj.

Nrog rau cov hlab ntsha o, qhov kev xav kom pib ntawm Mikardis yog 1 ntsiav tshuaj (40 mg) ib hnub ib zaug. Nyob rau hauv rooj plaub uas qhov kev kho mob ua tsis tiav, qhov koob tshuaj yuav raug nce ntxiv rau 80 mg ib hnub ib zaug. 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.

Txhawm rau txo qis kev mob plawv thiab tuag, cov koob tshuaj pom zoo yog 1 ntsiav tshuaj (80 mg) ib hnub ib zaug. Hauv thawj lub sijhawm ntawm kev kho mob, yuav tsum tau kho ntshav ntxiv thiaj li tsim nyog.

Cov neeg mob uas lub raum tsis ua haujlwm (nrog rau cov neeg mob hemodialysis) yuav tsum tau txhaj tshuaj ntau dua ntawm cov tshuaj.

Kev muab tshuaj rau hauv cov neeg mob cov neeg laus tsis tas yuav hloov pauv.

Mikardis Plus yuav tsum noj qhov ncauj 1 zaug nyob rau ib hnub, tsis hais txog ntawm cov zaub mov noj.

Mikardis Plus 40 / 12.5 mg tuaj yeem muab rau cov neeg mob nyob rau hauv uas siv cov tshuaj Mikardis ntawm ib koob ntawm 40 mg lossis hydrochlorothiazide tsis ua rau muaj kev tswj hwm ntshav siab txaus.

Mikardis Plus 80 / 12.5 mg tuaj yeem muab rau cov neeg mob uas siv tshuaj Mikardis ntawm koob tshuaj 80 mg lossis Mikardis Plus 40 / 12.5 mg tsis ua rau muaj kev tswj ntshav siab txaus.

Hauv cov neeg mob uas mob ntshav siab tshaj plaws, ntau tshaj plaws niaj hnub noj tshuaj ntawm telmisartan yog 160 mg rau ib hnub. Cov koob tshuaj no tau ua tiav thiab zam tau zoo.

Sab sij huam

mob ntsws ua pa nyuaj (nrog rau mob ntsws thiab mob ntsws),
txog siav
arrhythmias
tachycardia
bradycardia
lub cim txo nyob rau hauv cov ntshav siab (nrog rau orthostatic hypotension),
tsaus muag
paresthesia
pw tsaug zog
insomnia
kiv taub hau
ntxhov siab
kev nyuaj siab
txob taus
mob taub hau
raws plab, cem quav,
hnoos qeev qhuav,
flatulence
mob plab
ntuav
mob plab
tsis qab los
kev tsis nco qab
hyperglycemia
hypercholesterolemia,
pancreatitis
lub siab ua tsis taus haujlwm,
daj ntseg (hepatocellular lossis cholestatic),
dyspepsia
nce hws
rov qab mob
mob leeg
myalgia
arthralgia
plab hlaub mob leeg,
arthrosis,
leeg zoo li cov tsos mob
mob hauv siab
cov ntshav tsis muaj zog, ntshav khov aplastic, ntshav tsis txaus ntshav ntshav, ntshav hlab plawv ntshav hlab ntsha, mob hlab ntsha hlwb, eosinophilia, leukopenia, agranulocytosis, thrombocytopenia,
lub raum tsis ua hauj lwm, suav nrog mob raum tsis ua haujlwm,
interstitial nephritis,
glucosuria
pom kev pom
transient blurred lub zeem muag
mob lub kaum ntse ntse-kaw ntsej muag,
impotence
sepsis, suav nrog tus neeg mob uas tuag taus,
sab sauv ntawm txoj hlab ua pa (mob ntsws, pharyngitis, hlab ntsws),
mob txeeb zig (suav nrog cystitis),
o cov qog ua kua qaub ncaug,
nce kev ua si ntawm daim siab enzymes,
nce kev ua haujlwm ntawm CPK,
muaj zog concentration ntawm uric acid nyob rau hauv cov ntshav,
hypertriglyceridemia,
hypokalemia, hyperkalemia,
kev npau suav,
hyperuricemia
hypoglycemia (hauv cov neeg mob ntshav qab zib mellitus),
tsis hnov lus qabzib zoo,
ua kom ntshav tsawg nyob rau hauv cov ntshav,
angioedema (suav nrog qhov mob tuag),
erythema
khaus tawv
ua pob
tshuaj tiv thaiv anaphylactic,
eczema
tshuaj pob khaus
lom epidermal necrolysis,
lupus-zoo li kev tsis haum
exacerbation los yog intensification ntawm cov tsos mob ntawm systemic lupus erythematosus,
necrotic vasculitis,
mob hlwb vasculitis
kev tawm tsam qhov tsis haum,
rov ua dua ntawm cov kab mob lupus erythematosus,
vasculitis
khaub thuas zoo li mob aws
npaws
tsis muaj zog.

Cov Yuav Tsum Muaj

obstructive biliary huam kab mob,
ua rau lub siab ua haujlwm tsis zoo (Menyuam-Pugh chav C),
mob raum mob raum (CC tsawg dua 30 ml / min),
refractory hypokalemia, hypercalcemia,
ib txhij siv nrog aliskiren hauv cov neeg mob ntshav qab zib mellitus thiab lub raum tsis ua haujlwm (GFR tsawg dua 60 ml / min / 1.73 m2),
roj ntsha kab mob fructose intolerance (cov tshuaj muaj sorbitol),
lactase deficiency, lactose intolerance, qabzib-galactose malabsorption syndrome,
hnub nyoog txog 18 xyoo (kev nyab xeeb thiab ua tsis tau zoo),
cev xeeb tub
lactation (lactation),
hypersensitivity rau cov nquag yam tshuaj lossis koom nrog cov tshuaj lossis lwm yam tshuaj sulfonamide.

ob leeg lub raum leeg mob stenosis los yog leeg ntshav ntawm ib raum,
Lub siab ua rau lub siab ua haujlwm lossis mob siab ua daim siab (chav A thiab B ntawm Menyuam-Pugh nplai),
txo qis hauv BCC vim kev kho mob diuretic dhau los, kev txwv tsis pub muaj ntsev, raws plab lossis ntuav,
hyperkalemia
mob tom qab lub raum hloov chaw (tsis muaj kev paub nrog kev siv),
mob plawv tsis ua hauj lwm 3-4 FC raws li kev faib tawm ntawm New York Lub Plawv Koom Tes,
stenosis ntawm aortic thiab mitral valve,
idiopathic hypertrophic subaortic stenosis,
hypertrophic obstructive cardiomyopathy,
mob ntshav qab zib mellitus
thawj aldosteronism,
mob gout
kaum sab xis-kaw lub ntsej muag daj (vim muaj cov hydrochlorothiazide hauv cov nkauj).

Cev xeeb tub thiab lactation

Kev siv ntawm Mikardis thiab Mikardis Plus yog contraindicated thaum cev xeeb tub.

Kev siv cov tshuaj angiotensin 2 receptor antagonists nyob rau lub sijhawm 1 hlis ntawm kev xeeb tub tsis pom zoo, cov tshuaj no yuav tsum tsis txhob siv tshuaj thaum cev xeeb tub. Thaum cev xeeb tub tshwm sim, cov tshuaj yuav tsum tau txiav tam sim ntawd. Yog tias tsim nyog, lwm txoj kev kho yuav tsum raug kho (lwm cov chav kawm ntawm cov tshuaj tiv thaiv kev tiv thaiv uas pom zoo siv thaum cev xeeb tub).

Kev siv cov tshuaj angiotensin 2 receptor antagonists hauv qib 2 thiab qib thib 3 ntawm cev xeeb tub yog contraindicated. Hauv kev kawm txog kev ua ntej ntawm telmisartan, cov teebmeem teratogenic tsis pom, tab sis fetotoxicity tau tsim. Nws raug paub tias cov teebmeem ntawm angiotensin 2 receptor antagonists hauv qib thib 2 thiab thib 3 ntawm cev xeeb tub ua rau fetotoxicity hauv tus neeg (txo lub raum kev ua haujlwm, oligohydramnios, ncua ossification ntawm pob txha taub hau), zoo li neonatal toxicity (lub raum tsis ua haujlwm, hypotension, hyperkalemia). Cov neeg mob npaj lub cev xeeb tub yuav tsum tau txais lwm txoj kev kho ntxiv. Yog tias kev kho mob nrog angiotensin 2 receptor antagonists tau nqa tawm hauv 2 lub hlis ntawm cev xeeb tub, ultrasound ntawm lub raum thiab pob txha pob txha ntawm tus me nyuam yog qhov pom zoo.

Cov menyuam mos uas lawv niam tau txais cov tshuaj angiotensin 2 receptor antagonists yuav tsum tau saib zoo rau lub plawv tsis muaj ntshav ntau.

Cov kev paub nrog hydrochlorothiazide thaum cev xeeb tub, tshwj xeeb tshaj yog nyob rau thawj peb hlis, muaj tsawg. Hydrochlorothiazide hla lub teeb meem ntawm thaj chaw. Muab cov tshuaj pharmacological ntawm kev ua ntawm hydrochlorothiazide, nws xav tias nws siv nyob rau hauv koob thib 3 thiab thib 3 ntawm cev xeeb tub tuaj yeem cuam tshuam lub fetoplacental perfusion thiab ua rau muaj kev hloov pauv ntawm lub cev thiab tus menyuam, xws li mob daj, electrolyte tsis txaus, thiab thrombocytopenia. Hydrochlorothiazide yuav tsum tsis txhob siv rau edema ntawm cov poj niam cev xeeb tub, rau cov poj niam cev xeeb tub uas muaj mob ntshav o, lossis thaum lub sijhawm preeclampsia, raws li muaj qhov pheej hmoo ntawm qhov txo qis hauv ntshav ntim thiab txo qis hauv placental perfusion, thiab tsis muaj ib qho txiaj ntsig zoo hauv cov xwm txheej no.

Hydrochlorothiazide yuav tsum tsis txhob siv los kho qhov kub siab tseem ceeb hauv cov poj niam cev xeeb tub, tshwj tsis yog nyob rau qhov xwm txheej tsis tshua muaj lwm txoj kev kho mob.

Kev kho mob nrog cov tshuaj Mikardis thiab Mikardis Plus yog contraindicated thaum pub niam mis.

Hauv kev sim tsiaj cov kev sim, cov teebmeem ntawm telmisartan thiab hydrochlorothiazide txog kev muaj lub cev tsis tau pom.

Cov kev tshawb fawb txog cov kev cuam tshuam rau tib neeg kev muaj peev xwm tsis tau ua.

Siv rau menyuam yaus

Cov tshuaj Mikardis thiab Mikardis Plus yog contraindicated rau kev siv rau menyuam yaus thiab tub ntxhais hluas hnub nyoog qis dua 18 xyoo, vim tias tsis muaj ntaub ntawv qhia txog kev ua tau zoo thiab kev nyab xeeb hauv pawg neeg mob no.

Siv rau cov neeg mob laus

Hloov pauv qhov ntau npaum cov tshuaj rau cov neeg laus cov neeg mob tsis tas yuav tsum tau ua.

Cov lus qhia tshwj xeeb

Cov xwm txheej uas ua rau RAAS Kev Ua Haujlwm Ntxiv

Hauv qee cov neeg mob, vim tias kev tsuj ntawm kev ua haujlwm ntawm RAAS, tshwj xeeb tshaj yog nrog kev sib txig ntawm cov tshuaj ua yeeb yam ntawm cov kab ke no, lub raum muaj nuj nqi (suav nrog mob raum tsis ua haujlwm) yog qhov tsis taus. Yog li, kev kho nrog nrog qhov zoo sib xws ob zaug ntawm RAAS (piv txwv li, nrog ntxiv ntawm ACE inhibitor lossis qhov ncaj qha renin inhibitor, aliskiren, mus rau angiotensin 2 receptor antagonist blockers), yuav tsum tau nqa tawm ncaj qha ntawm tus kheej thiab nrog kev soj ntsuam tas li ntawm kev ua haujlwm lub raum (suav nrog rau kev soj ntsuam ib zaug ntawm cov poov tshuaj thiab ntshiab dej creatinine).

Kev siv ntawm thiazide diuretics hauv cov neeg mob uas lub raum tsis ua haujlwm zoo tuaj yeem ua rau azotemia. Pom zoo sij hawm xyuas raum ua haujlwm lub raum.

Hauv cov neeg mob uas muaj ob leeg lub raum artery stenosis los yog txoj hlab ntsha tsis zoo ntawm lub raum tsuas ua haujlwm, nrog kev siv cov tshuaj uas cuam tshuam rau RAAS, kev pheej hmoo ntawm kev txhim kho kev mob ntshav qis thiab lub raum tsis ua haujlwm tau nce.

Lub siab ua haujlwm tsis zoo

Hauv cov neeg mob uas muaj lub siab tsis ua haujlwm lossis mob siab rau daim siab, MikardisPlus yuav tsum siv nrog ceev faj, vim tias txawm muaj kev hloov me me ntawm cov dej-electrolyte tshuav nyiaj tuaj yeem ua rau muaj kev txhim kho hepatic tsis nco qab.

Kev cuam tshuam ntawm cov metabolism thiab ua haujlwm ntawm cov qog endocrine

Hauv cov neeg mob ntshav qab zib, kev hloov pauv ntawm cov koob tshuaj insulin lossis hypoglycemic rau kev tswj hwm qhov ncauj yuav tsum xav tau. Thaum lub sij hawm kho nrog thiazide diuretics, mob ntshav qab zib latent mellitus tuaj yeem tshwm sim.

Muaj qee kis, kev siv tshuaj thiazide diuretics tuaj yeem txhim kho hyperuricemia thiab exacerbation ntawm chav kawm ntawm gout.

Hauv cov neeg mob ntshav qab zib mellitus thiab kev pheej hmoo mob hlab plawv ntxiv, piv txwv li, hauv cov neeg mob ntshav qab zib mellitus thiab mob plawv, kev siv cov tshuaj uas txo cov ntshav siab, xws li angiotensin 2 receptor antagonists lossis ACE inhibitors, tuaj yeem ua rau muaj kev pheej hmoo tuag taus myocardial infarction thiab mob plawv sai. leeg tuag leeg. Hauv cov neeg mob ntshav qab zib, mob plawv tuaj yeem tsis nco qab thiab yog li tsis tuaj yeem kuaj pom. Ua ntej pib siv cov tshuaj Mikardis thiab Mikardis Plus rau kev tshawb pom thiab kho cov kab mob plawv, kev tshawb fawb tsim nyog yuav tsum tau nqa tawm, suav nrog kuaj nrog kev tawm dag zog.

Mob myopia thiab mob lub kaum ob lub qhov ncauj txhaws

Hydrochlorothiazide, yog ib lub sulfonamide derivative, tuaj yeem ua rau idiosyncratic cov tshuaj tiv thaiv nyob rau hauv daim ntawv ntawm mob tsis muaj myopia thiab mob lub kaum ntse ntse-kaw tsis pom kev. Cov tsos mob ntawm cov kev tsis zoo no yog qhov tsis pom txog qhov zoo nkauj lossis qhov muag, uas feem ntau tshwm sim li ntawm ob peb teev mus rau ntau lub lis piam tom qab pib siv tshuaj. Yog tias tsis kho, mob lub ntsej muag raug kaw lub ntsej muag yuav ua rau tsis pom kev. Cov kev kho mob tseem ceeb yog kom tsum tsis txhob hydrochlorothiazide sai li sai tau. Nws yuav tsum tau yug los rau hauv lub siab tias yog tias kev tso dej siab ntawm lub cev tseem tsis tau tswj hwm, tau ceev faj siv tshuaj lossis phais mob yuav tsum tau ua. Cov teeb meem pheej hmoo rau kev txhim kho ntawm lub ntsej muag tsis sib haum xws li keeb kwm ntawm kev ua xua rau sulfonamides lossis penicillin.

Kev ua txhaum ntawm cov dej-electrolyte tshuav

Thaum siv cov tshuaj Mikardis Plus, zoo ib yam li kev kho mob diuretic, kev saib xyuas txhua lub sijhawm ntawm cov ntsiab lus ntawm electrolytes hauv cov ntshav cov ntshav yog tsim nyog.

Thiazide diuretics, incl. hydrochlorothiazide, tuaj yeem ua rau cuam tshuam hauv dej-electrolyte tshuav nyiaj li cas thiab cov kua qaub-puag hauv lub xeev (hypokalemia, hyponatremia thiab hypochloremic alkalosis). Cov tsos mob ntawm cov kev tsis zoo no suav nrog lub qhov ncauj qhuav, nqhis dej, dav dav tsis muaj zog, nkees nkees, ntxhov siab, myalgia lossis ua kom tawv ncauj ntawm lub plab hlaub (pob txha), leeg tsis muaj zog, cim tau poob qis hauv cov ntshav siab, oliguria, tachycardia, thiab xws li lub plab zom mov. plab hnyuv tsis zoo xws li xeev siab lossis ntuav.

Thaum thiazide diuretics siv, hypokalemia tuaj yeem txhim kho, tab sis telmisartan siv tib lub sijhawm tuaj yeem nce cov ntsiab lus poov tshuaj hauv cov ntshav. Txoj kev pheej hmoo ntawm hypokalemia feem ntau yog nce ntxiv hauv cov neeg mob uas muaj kab mob siab, nrog rau cov diuresis ntau dua, muaj ntsev ntau, nrog rau cov zaub mov dawb ntawm gluco- thiab mineralocorticosteroids lossis corticotropin. Telmisartan, uas yog ib feem ntawm kev npaj Mikardis thiab Mikardis Plus, ntawm qhov tsis sib xws, tuaj yeem ua rau hyperkalemia vim antagonism mus rau angiotensin 2 receptors (subtype AT1). Txawm hais tias thaj chaw kho mob tseem ceeb hyperkalemia tsis tau tshaj tawm nrog kev siv Mikardis Plus, qhov kev pheej hmoo rau nws txoj kev loj hlob muaj xws li lub raum thiab / lossis lub plawv tsis ua haujlwm thiab ntshav qab zib mellitus.

Tsis muaj pov thawj qhia tias cov tshuaj Mikardis Plus tuaj yeem txo lossis tiv thaiv hyponatremia tshwm sim los ntawm diuretics. Kev mob Hypochloremia yog yam me thiab tsis tas kho.

Thiazide diuretics tuaj yeem txo qhov kev nthuav dav ntawm calcium los ntawm ob lub raum thiab ua rau (thaum tsis muaj qhov cuam tshuam pom tseeb hauv cov calcium calcium) kev hloov pauv thiab nce me ntsis hauv cov calcium calcium. Tshaj hypercalcemia hnyav tuaj yeem yog qhov pom ntawm mob latent hyperparathyroidism. Ua ntej kev ntsuas lub luag haujlwm ntawm cov roj ntsha parathyroid, thiazide diuretics yuav tsum tau txiav tawm.

Nws tau qhia tias thiazide diuretics ua rau kom muaj qhov tsis nco qab ntawm magnesium los ntawm ob lub raum, uas tuaj yeem ua rau hypomagnesemia.

Hauv cov neeg mob uas muaj kab mob plawv, siv cov tshuaj tiv thaiv ntshav, nyob rau hauv cov ntshav ntau dhau los, tuaj yeem ua rau myocardial infarction lossis mob stroke.

Muaj cov ntawv tshaj tawm ntawm kev nthuav dav cov kab mob lupus erythematosus nrog thiazide diuretics.

Mikardis thiab Mikardis Plus tuaj yeem, yog tias tsim nyog, yuav siv tau ib txhij nrog lwm cov tshuaj tiv thaiv kab mob siab.

Kev tsis ua haujlwm ntawm lub siab ua haujlwm nrog kev teem caij telmisartan nyob rau hauv Feem ntau tau pom ntawm cov neeg nyob hauv Nyij Pooj.

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

Cov kev tshawb nrhiav tshwj xeeb los ntsuam xyuas cov txiaj ntsig ntawm cov tshuaj Mikardis Plus ntawm kev muaj peev xwm tsav tsheb thiab ua haujlwm nrog cov txheej txheem uas xav tau kev nce siab tsis tau ua. Txawm li cas los xij, thaum tsav tsheb thiab koom tes nrog cov haujlwm uas muaj peev xwm ua tau, kev muaj peev xwm ntawm kiv taub hau thiab qaug zog yuav tsum ua tib zoo xav, uas yuav tsum tau ceev faj.

Yeeb tshuaj sib cuam tshuam

Nrog tib lub sijhawm siv ntawm telmisartan nrog:

lwm cov tshuaj tiv thaiv kev tiv thaiv tuaj yeem txhim kho cov nyhuv antihypertensive. Hauv ib txoj kev tshawb nrhiav, nrog kev siv ua ke ntawm telmisartan thiab ramipril, qhov nce 2.5-qhov nce ntawm AUC0-24 thiab Cmax ntawm ramipril thiab ramipril tau pom. Cov kab mob tseem ceeb hauv kev sib txuam no tsis tau tsim. Kev soj ntsuam ntawm qhov tshwm sim tsis zoo uas ua rau cuam tshuam kev kho mob thiab kev soj ntsuam ntawm qhov tshwm sim tsis zoo uas tau txais thaum lub sijhawm kev sim tshuaj kuaj pom tias hnoos thiab mob caj dab muaj feem ntau tshwm sim nrog ramipril, thaum cov ntshav liab hypotension muaj ntau dua nrog telmisartan. Cov neeg mob ntawm hyperkalemia, lub raum tsis ua hauj lwm, arterial hypotension thiab syncope raug pom ntau dua nrog kev siv tib lub sijhawm ntawm telmisartan thiab ramipril,
lithium kev npaj tau sau tseg tias qhov thim rov qab nce ntxiv nyob rau hauv cov kev ua tau zoo ntawm cov roj ntsha lithium hauv cov ntshav, nrog cov tshuaj lom los ntawm kev siv ACE inhibitors. Hauv qee qhov tsis tshua muaj tshwm sim, cov kev hloov pauv no tau hais qhia nrog kev tswj hwm ntawm angiotensin 2 receptor antagonists, tshwj xeeb hauv telmisartan. Nrog rau kev siv lithium npaj txhij thiab angiotensin 2 receptor antagonists, nws raug nquahu kom txiav txim siab lithium cov ntsiab lus hauv cov ntshav,
nonsteroidal anti-inflammatory tshuaj (NSAIDs), suav nrog cov tshuaj acetylsalicylic acid hauv kev siv tshuaj tiv thaiv kab mob, COX-2 inhibitors thiab tshuaj tsis muaj NSAIDs, tuaj yeem ua rau mob raum tsis ua haujlwm hauv cov neeg mob uas txo BCC. Cov tshuaj uas cuam tshuam rau RAAS tej zaum yuav muaj qhov sib txuam. Hauv cov neeg mob uas tau txais NSAIDs thiab telmisartan, BCC yuav tsum tau them nyiaj rau thaum pib kho thiab kev kawm txog lub raum kev ua haujlwm yuav tsum tau ua. Qhov kev poob qis hauv cov nyhuv ntawm cov neeg sawv cev tiv thaiv kab mob, xws li telmisartan, los ntawm kev cuam tshuam ntawm vasodilating cov nyhuv ntawm prostaglandins tau sau tseg nrog kev kho mob ua ke nrog NSAIDs. Nrog rau kev siv tib lub telmisartan nrog ibuprofen lossis paracetamol, tsis muaj qhov cuam tshuam loj hauv kev kuaj mob tau pom.
digoxin, warfarin, hydrochlorothiazide, glibenclamide, simvastatin thiab amlodipine tsis tau qhia txog kev cuam tshuam hauv chaw khomob. Ib qho kev nce siab hauv nruab nrab cov concentration ntawm digoxin hauv ntshav ntshav los ntawm qhov nruab nrab ntawm 20% (hauv ib kis, los ntawm 39%). Nrog rau kev tswj hwm tib lub sijhawm ntawm telmisartan thiab digoxin, nws raug nquahu kom qee lub sijhawm txiav txim siab qhov concentration ntawm digoxin hauv cov ntshav.

Nrog tib lub sijhawm siv nrog:

ethanol (cawv), barbiturates lossis opioid analgesics, muaj kev pheej hmoo ntawm kev txhim kho orthostatic hypotension,
hypoglycemic tshuaj rau qhov ncauj tswj hwm thiab insulin yuav xav tau koob tshuaj hypoglycemic tshuaj rau cov tswj hwm qhov ncauj thiab cov tshuaj insulin,
metformin muaj kev pheej hmoo ntawm tus mob lactic acidosis,
kolestiraminom thiab kolestipolom - nyob rau hauv muaj anionic pauv resins qhov nqus ntawm hydrochlorothiazide yog cuam tshuam,
mob glycosides nce rau qhov kev pheej hmoo ntawm kev tsim hypokalemia los yog hypomagnesemia los ntawm thiazide diuretics, kev txhim kho ntawm arrhythmias tshwm sim los ntawm mob glycosides,
pressor amines (piv txwv li norepinephrine) tej zaum yuav ua rau cov nyhuv ntawm cov tshuaj hem ua kom lub zog tsawg,
non-depolarizing cov leeg ua si (xws li tubocurarine chloride) hydrochlorothiazide tuaj yeem txhim kho cov nyhuv uas tsis ua rau cov leeg ua kom lub cev tsis ua haujlwm,
antigout cov neeg sawv cev tuaj yeem ua rau nce siab ntawm uric acid hauv cov ntshav cov ntshav, thiab yog li, hloov pauv ntawm cov tshuaj uricosuric yuav tsum muaj. Kev siv ntawm thiazide diuretics ua rau muaj qhov tshwm sim ntawm kev tsis haum lub cev tsis haum rau txhua yam allopurinol,
calcium npaj - thiazide diuretics tuaj yeem nce cov ntshiab calcium cov ntsiab lus vim qhov txo qis hauv nws kev nthuav dav los ntawm lub raum. Yog tias koj xav siv cov tshuaj calcium npaj, koj yuav tsum saib xyuas cov calcium nyob hauv cov ntshav thiab, yog tias tsim nyog, hloov cov koob tshuaj calcium npaj,
beta-blockers thiab diazoxide thiazide diuretics tuaj yeem txhim kho hyperglycemia tshwm sim los ntawm beta-blockers thiab diazoxide,
m-anticholinergics (piv txwv li, atropine, biperidine) - qhov txo qis hauv lub plab zom mov, ua kom muaj kev nyab xeeb ntawm thiazide diuretics,
amantadine thiazide diuretics tuaj yeem ua rau muaj kev pheej hmoo tsis txaus ntseeg tshwm sim los ntawm amantadine,
cytotoxic tus neeg sawv cev (piv txwv li, cyclophosphamide, methotrexate) - qhov txo qis hauv lub raum ua rau cov neeg ua haujlwm cytotoxic thiab nce ntxiv hauv lawv cov nyhuv myelosuppressive,
NSAIDs - ua ke siv nrog thiazide diuretics tuaj yeem ua rau txo qis hauv diuretic thiab antihypertensive nyhuv,
cov tshuaj uas ua rau kom tshem tawm cov poov tshuaj thiab hypokalemia (piv txwv li, diuretics uas tshem cov poov tshuaj, laxatives, gluco- thiab mineralocorticosteroids, corticotropin, amphotericin B, carbenoxolone, benzylpenicillin, derivatives ntawm acetylsalicylic acid) - muaj cov nyhuv hypokalemic ntau dua. Hypokalemia tshwm sim los ntawm hydrochlorothiazide raug pab txhawb los ntawm cov ntsiab lus ntawm potassium-sparing ntawm telmisartan,
kev loj hlob ntawm hyperkalemia yog ua tau nrog potassium-sparing diuretics, npaj poov tshuaj, lwm yam txhais tau tias tuaj yeem nce cov poov tshuaj ntsiab lus (piv txwv li, heparin) lossis hloov sodium hauv sodium chloride nrog cov ntsev ntsev. Kev tshuaj xyuas cov sijhawm ntawm cov poov tshuaj hauv cov ntshav ntshav yog pom zoo rau cov tshuaj Mikardis Plus siv ib txhij nrog cov tshuaj uas tuaj yeem ua rau mob hypokalemia, nrog rau cov tshuaj uas tuaj yeem nce cov poov tshuaj potassium.

Cov tshuaj ntawm cov tshuaj Mikardis

Cov yam ntxwv ntawm cov tshuaj nquag:

Cov tshuaj tiv thaiv hauv cov pab pawg tshuaj (angiotensin 2 receptor antagonists):

Angiakand
Aprovel
Atacand
Blocktran
Vasotens,
Valz
Valsartan
Valsafors,
Valsacor
Hyposart,
Diovan
Zisakar
Ibertan
Irbesartan
Irsar
Tus Cwj Pwm,
Candesartan
Cardosal
Cardosten
Cardostin
Karzartan
Cozaar
Xarten
Lakea
Lozap,
Lozarel
Losartan
Lorista
Losacor
Lotor
Mikardis Ntxiv,
Naviten
Nortian
Olimestra
Hloov
Tshuab luam ntawv
Tubkawm Presartan
Los Tsuas
Sartavel
Tanidol
Tantordio
Tareg
Teveten
Cov no,
Telzap
Telmisartan
Telmista
Telsartan
Khov Siab
Edarby.

Kev sau npe: P N015387 / 01

Lub npe kev lag luam ntawm cov tshuaj: Mikardis ®

Lub Npe Tsis Muaj Lwm Lub Npe (INN): telmisartan

Dosage daim ntawv: ntsiav tshuaj

Muaj pes tsawg leeg: 1 ntsiav tshuaj muaj:
Cov khoom siv yam muaj sia: - Telmisartan 40 mg lossis 80 mg,
Cov Txwv: - sodium hydroxide 3.36 mg / 6.72 mg, polyvidone (Kollidon 25) 12 mg / 24 mg, meglumine 12 mg / 24 mg, sorbitol 168.64 mg / 337.28 mg, magnesium stearate 4 mg / 8 mg

Kev piav qhia
40 mg ntsiav tshuaj
Ntsiav tshuaj dawb los yog yuav luag dawb oblong ntsiav tshuaj, ntawm ib sab engraving "51H", nyob rau lwm sab - cim ntawm lub tuam txhab.
80 mg ntsiav tshuaj
Ntsiav tshuaj dawb los yog yuav luag dawb muaj koob muaj npe, ntawm ib sab kos "52H", nyob rau sab nraud - cim ntawm lub tuam txhab.

Cov tshuaj pab pawg kho mob: angiotensin II receptor antagonist.
ATX Cov Cai C09CA07

Cov chaw muag tshuaj
Cov Tshuaj Hauv Tshuaj
Telmisartan yog qhov kev paub tseeb angiotensin II receptor antagonist (hom AT1), siv tau thaum noj ntawm qhov ncauj. Nws muaj qhov ua tau zoo rau AT1 subtype ntawm angiotensin II receptors, los ntawm qhov kev txiav txim ntawm angiotensin II tau pom. Displaces angiotensin Kuv los ntawm kev sib txuas nrog lub receptor, tsis muaj cov kev ua ntawm agonist in relation to no receptor.
Telmisartan khi nkaus xwb rau AT1 subtype ntawm angiotensin II receptors. Cov kev sib txuas tas mus li. Nws tsis muaj kev sib nyiam rau lwm tus txais, suav nrog AT2 receptor thiab lwm qhov tsawg kawm angiotensin receptors. Lub luag haujlwm tseem ceeb ntawm cov receptors, nrog rau cov txiaj ntsig ntawm lawv qhov kev xav tau dhau los nrog angiotensin II, qhov kev tsub zuj zus uas nce nrog kev teem sijhawm ntawm telmisartan, tsis tau kawm. Nws txo nws cov concentration ntawm aldosterone hauv cov ntshav, tsis inhibit renin hauv ntshav ntshav thiab tsis thaiv cov ion ion. Telmisartan tsis inhibit lub angiotensin hloov enzyme (kininase II) (ib qho enzyme uas tseem zom bradykinin). Yog li, kev nce qib hauv kev phiv los ntawm bradykinin tsis yog kev cia siab.
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 ua haujlwm ntawm hypotensive raug sau tseg tsis pub dhau 3 teev tom qab thawj thawj coj ntawm telmisartan. Cov nyhuv ntawm cov tshuaj no mob tsawv rau 24 teev thiab 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).
Nyob rau hauv cov ntaub ntawv ntawm kev tshem tawm sai ntawm telmisartan, ntshav siab maj mam rov qab los rau nws thawj qib tsis muaj kev txhim kho ntawm "kev tshem tawm" syndrome.

Cov Tshuaj Pharmacokinetics
Thaum noj ntawm qhov ncauj, nws nrawm nrawm los ntawm lub plab zom zaub mov. Bioavailability ntawm -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). 3 teev tom qab noj, qhov kev nkag siab hauv cov ntshav ntshav tawm ntau, tsis hais cov pluas noj dab tsi. Muaj qhov sib txawv ntawm ntshav ntau nyob rau hauv cov txiv neej thiab poj niam. Cmax (qhov siab tshaj plaws) thiab AUC yog kwv yees li 3 thiab 2 npaug, ntsig txog, ntau dua hauv cov poj niam piv nrog cov txiv neej tsis muaj qhov cuam tshuam txog kev ua tau zoo.
Kev sib txuas lus nrog cov ntshav plasma protein - 99.5%, feem ntau nrog albumin thiab alpha-1 glycoprotein.
Tus nqi nruab nrab ntawm pom meej qhov ntim ntawm kev faib tawm hauv qhov sib npaug ntawm cov tshuaj siab yog 500 litres. Nws yog metabolized los ntawm kev sib txuas nrog glucuronic acid. Metabolites yog tus tsis muaj tshuaj nyob hauv tsev muag tshuaj. Kev tshem tawm ib nrab-lub neej (T½) ntau tshaj 20 teev. Nws yog tawm los ntawm txoj hnyuv tsis hloov, nthuav tawm los ntawm ob lub raum - tsawg dua 2%. Tag nrho cov ntshav ua kom ntshav tsawg (900 ml / min.) Piv nrog "ntshav siab" ntshav khiav (li 1500 ml / min.).
Cov neeg laus cov neeg mob
Tus kws tshuaj ntawm telmisartan hauv cov neeg laus laus tsis txawv ntawm cov neeg mob hluas. Koob tshuaj yuav tsis haum.
Cov neeg mob raum tsis ua haujlwm
Kev hloov pauv hauv cov neeg mob lub raum tsis ua haujlwm, tsis suav nrog cov neeg mob ntawm hemodialysis.
Telmisartan tsis raug tshem tawm los ntawm hemodialysis.
Cov neeg mob mob siab tsis ua haujlwm
Hauv cov neeg mob uas muaj me me mus txog qib qog ua lub siab ua haujlwm (chav A thiab B ntawm Kev Ntsuas Me-Pugh), koob tshuaj txhua hnub yuav tsum tsis pub tshaj 40 mg.
Hauv menyuam yaus
Cov cim tseem ceeb ntawm pharmacokinetics ntawm telmisartan hauv cov menyuam hnub nyoog 6 txog 18 xyoo, feem ntau, piv nrog cov ntaub ntawv tau txais hauv kev kho mob ntawm cov neeg laus, thiab paub meej tias tsis tseem ceeb ntawm cov kws kho mob ntawm telmisartan, tshwj xeeb tshaj yog cuam tshuam nrog Cmax.

Kev ntsuas rau siv

Arterial tawg.
Txo cov kab mob plawv thiab tuag ntawm cov neeg mob hnub nyoog 55 xyoos thiab laus dua nrog qhov pheej hmoo ntawm cov kab mob plawv.

Cov Yuav Tsum Muaj

Hypersensitivity rau cov tshuaj nquag lossis ntu Cheebtsam ntawm cov tshuaj
Cev xeeb tub
Lub sijhawm lactation
Obstructive kab mob ntawm biliary ib ntsuj av
Hepatic cuam tshuam loj heev (Me Nyuam Pugh chav C)
Tus mob muaj keeb fructose intolerance (muaj sorbitol)
Muaj hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis pom zoo)

Nrog saib xyuas

Ob leeg lub raum leeg mob stenosis los yog leeg ntshav ntawm ib raum,
Lub siab thiab lub raum tsis zoo (saib cov Lus Qhia Tshwj Xeeb),
Txo cov ntshav kom tsawg (BCC) vim yog kev kho tus mob dhau los, txwv ntsev, raws plab, lossis ntuav
Ntshav Qab Zib,
Hyperkalemia
Cov mob tom qab hloov raum (tsis muaj kev paub nrog kev siv),
Mob plawv nres
Stenosis ntawm aortic thiab mitral valve,
Idiopathic hypertrophic subaortic stenosis,
Thawj aldosteronism (kev ua tau zoo thiab kev nyab xeeb tsis tau tsim)

Tsuas tshuaj thiab tswj hwm
Sab hauv, tsis hais txog pluas noj.
Arterial tawg
Thawj qhov pom zoo kom siv cov tshuaj Mikardis ® yog 1 kab. (40 mg) ib hnub ib zaug. Nyob rau hauv rooj plaub uas qhov kev kho mob ua tsis tiav, qhov siab tshaj plaws pom zoo ntawm cov tshuaj Mikardis ® tuaj yeem nce ntxiv txog 80 mg ib hnub ib zaug. 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 hlab ntsha hauv lub plawv thiab tuag
Cov koob tshuaj pom zoo yog 1 ntsiav tshuaj ntawm cov tshuaj Mikardis ® 80 mg, kuv ib hnub ib zaug.
Hauv thawj lub sijhawm ntawm kev kho mob, yuav tsum tau kho ntshav ntxiv thiaj li tsim nyog.
Lub raum khiav tsis zoo
Hauv cov neeg mob uas lub raum tsis ua haujlwm, suav nrog cov neeg mob kho mob hemodialysis, kev noj tshuaj zoo yuav tsis tas siv.
Lub siab ua haujlwm tsis zoo
Hauv cov neeg mob uas muaj me me mus rau lub cev tsis ua haujlwm zoo (chav A thiab B ntawm Child-Pugh nplai, feem), koob tshuaj Mikardis daily txhua hnub yuav tsum tsis pub tshaj 40 mg.
Cov neeg laus cov neeg mob
Qhov ntau npaum ntawm qhov tshuaj tsis tas yuav hloov pauv.

Sab sij huam
Cov kev soj ntsuam txog qhov tshwm sim tsis cuam tshuam nrog tus tub los ntxhais, hnub nyoog lossis haiv neeg ntawm cov neeg mob.
Cov kab mob:
Sepsis, suav nrog rau qhov mob tuag tes tuag taw, mob txeeb zig (nrog rau mob cystitis), mob ua pa sab saud.
Los ntawm cov circulatory thiab lymphatic systems:
Mob ntshav liab, eosinophilia, thrombocytopenia.
Los ntawm lub hauv nruab nrab hauv lub paj hlwb:
Kev ntxhov siab, pw tsaug zog, kev ntxhov siab, tsaus muag.
Los ntawm cov plab hnyuv siab raum ntawm lub zeem muag thiab lub rooj sib hais:
Pom kev ntxhov, kiv taub hau.
Los ntawm cov kab mob plawv:
Bradycardia, tachycardia, cim tseg txo hauv ntshav siab, orthostatic hypotension
Los ntawm tus txheej txheem ua pa:
Txog siav.
Los ntawm lub plab zom mov:
Mob plab, mob raws plab, lub qhov ncauj qhuav, dyspepsia, pom kev tsis txaus siab, tsis xis nyob hauv plab, ntuav, ua kom lub siab ua haujlwm tsis zoo.
Kev tsis haum tshuaj:
Kev phiv tshuaj tiv thaiv kab mob, ua rau lub ntsej muag tsis haum rau cov tshuaj muaj yees lossis koom nrog tshuaj, angioedema (tuag taus), eczema, erythema, tawv nqaij ua pob khaus, tawm pob (nrog rau cov tshuaj), hyperhidrosis, urticaria, pob khaus lom.
Los ntawm cov leeg musculoskeletal:
Arthralgia, mob nraub qaum, mob leeg (mob nqaij ntawm cov leeg plab hlaub), qhov mob ntawm qhov qis qis, mob myalgia, mob hauv cov leeg (mob tshwm sim zoo li qhov tshwm sim ntawm pob txha caj qaum).
Los ntawm ob lub raum thiab mob txeeb zig:
Lub raum khiav tsis zoo, suav nrog mob raum tsis ua haujlwm.
Dav:
Kev mob hauv siab, mob khaub thuas xws li mob ntsws, asthenia (tsis muaj zog), hyperkalemia, hypoglycemia (hauv cov neeg mob ntshav qab zib mellitus).
Kev ntsuas ntsuas:
Kev txo qis ntawm cov ntshav ntawm hemoglobin, kev nce siab ntawm uric acid, creatinine hauv cov ntshav, nce ntxiv hauv cov kev ua haujlwm ntawm "daim siab" enzymes, kev nce siab hauv cov concentration ntawm creatine phosphokinase (CPK).

Noj ntau dhau
Tsis muaj cov tsos mob ntawm kev haus ntau tshaj tau pom.
Cov tsos mob: cim txo nyob rau hauv cov ntshav siab, tachycardia, bradycardia.
Kev Kho Mob: Cov tsos mob kho, kev mob hemodialysis siv tsis tau.

Kev cuam tshuam nrog lwm yam tshuaj
Telmisartan yuav ua rau muaj kev cuam tshuam hypotensive ntawm lwm cov neeg sawv cev antihypertensive. Lwm hom kev sib txuam ntawm cov tseem ceeb hauv chaw kho mob tsis tau txheeb xyuas. Kev siv ua ke nrog digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin thiab amlodipine tsis ua rau muaj kev sib cuam tshuam hauv chaw kho mob. Ib qho kev nce siab hauv nruab nrab cov concentration ntawm digoxin hauv ntshav ntshav los ntawm qhov nruab nrab ntawm 20% (hauv ib kis, los ntawm 39%). Nrog rau kev tswj hwm tib lub sijhawm ntawm telmisartan thiab digoxin, nws raug nquahu kom qee lub sijhawm txiav txim siab qhov concentration ntawm digoxin hauv cov ntshav.
Nrog tib lub sijhawm siv ntawm telmisartan thiab ramipril, kev nce ntxiv ntawm AUC0-24 thiab Cmax ntawm ramipril thiab ramiprilat tau pom 2.5 zaug. Cov kab mob tseem ceeb hauv qhov tshwm sim no tsis tau teeb tsa.
Nrog kev tswj hwm tib lub sijhawm ntawm angiotensin-hloov pauv enzyme (ACE) cov tshuaj tiv thaiv kab mob thiab cov roj ntsha lithium, cov thim rov nce ntxiv hauv cov concentration ntawm lithium hauv cov ntshav tau pom, nrog cov tshuaj lom. Hauv qee qhov tsis tshua muaj tshwm sim, cov kev hloov pauv no tau hais qhia nrog kev tswj hwm ntawm angiotensin II antagonist receptors. Nrog rau kev tswj hwm tib lub sijhawm ntawm lithium thiab angiotensin II receptor antagonists, nws raug nquahu kom txiav txim siab qhov concentration ntawm lithium hauv cov ntshav.
Kev kho nrog cov tshuaj uas tsis yog tshuaj steroidal (NSAIDs), suav nrog acetylsalicylic acid, cyclooxygenase-2 inhibitors (COX-2) thiab tsis siv tshuaj NSAIDs, tuaj yeem ua rau mob raum tsis ua haujlwm hauv cov neeg mob lub cev qhuav dej. Cov yeeb tshuaj ua yeeb yam rau renin-angiotensin-aldosterone system (RAAS) tej zaum yuav muaj cov nyhuv synergistic. Hauv cov neeg mob uas tau txais NSAIDs thiab telmisartan, bcc yuav tsum tau them nyiaj rau thaum pib kho thiab lub raum rov qab saib xyuas.
Kev poob qis hauv cov nyhuv ntawm cov neeg sawv cev tiv thaiv kab mob, xws li telmisartan, los ntawm kev cuam tshuam ntawm vasodilating cov nyhuv ntawm prostaglandins tau pom nrog kev sib koom tes nrog NSAIDs.

Cov lus qhia tshwj xeeb
Hauv qee cov neeg mob, vim tias kev tsuj ntawm RAAS, tshwj xeeb tshaj yog thaum siv cov tshuaj sib xyaw ua ke ntawm cov kab ke no, lub raum muaj nuj nqi (suav nrog mob raum tsis ua haujlwm) yog qhov tsis taus. Yog li, txoj kev kho nrog nrog ob qhov kev cuam tshuam ntawm RAAS yuav tsum tau nqa tawm ntawm tus kheej thiab nruj me ntsis ntawm kev ua haujlwm lub raum (nrog rau kev saib xyuas qee zaus ntawm cov poov tshuaj potassium thiab creatinine ntau).
Thaum muaj kev vam khom rau lub suab vascular thiab lub raum kev ua haujlwm feem ntau ntawm RAAS kev ua haujlwm (piv txwv, hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, lossis lub raum mob, suav nrog lub raum mob hlwb, lossis cov leeg ntshav ntawm ib lub raum), kev teem sijhawm siv tshuaj uas cuam tshuam rau cov kab mob no, tej zaum yuav muaj nrog los ntawm kev txhim kho ntawm cov mob ntsig txog ntshav khiav ceev, hyperazotemia, oliguria, thiab, muaj qee zaus, mob raum tsis ua haujlwm.
Raws li kev paub ntawm kev siv lwm yam tshuaj uas cuam tshuam rau RAAS, nrog kev siv ua ke ntawm cov tshuaj Mikardis potassium thiab potassium-sparing diuretics, muaj cov tshuaj ntxiv potassium, cov ntsev-taum pauv ntsev, lwm yam tshuaj uas ua rau muaj kev nce siab ntau ntawm cov tshuaj potassium nyob rau hauv cov ntshav (piv txwv li heparin), qhov ntsuas no yuav tsum raug soj ntsuam hauv cov neeg mob.
Hloov lwm txoj kev, Mikardis ® tuaj yeem siv nrog kev sib xyaw nrog thiazide diuretics, xws li hydrochlorothiazide, uas ntxiv rau muaj cov nyhuv hypotensive (piv txwv li, Mikardis Plus ® 40 mg / 12.5 mg, 80 mg /) 2.5 mg).
Hauv cov neeg mob uas muaj mob ntshav liab ntau dhau los, ib koob tshuaj telmisartan ntawm 160 mg / hnub thiab nrog hydrochlorothiazide 12.5-25 mg tau pom zoo zoo thiab ua tau zoo. Mikardis ® muaj siv tau tsawg dua hauv cov neeg mob ntawm cov haiv neeg Negroid.

Cawv rau ntawm kev muaj peev xwm tsav lub tsheb thiab ua haujlwm nrog cov tshuab
Cov kev tshawb nrhiav tshwj xeeb ntawm kev cuam tshuam ntawm cov tshuaj ntawm lub peev xwm tsav lub tsheb thiab cov tshuab tsis tau ua. Txawm li cas los xij, thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem, muaj peev xwm txhim kho kiv taub hau thiab qaug zog yuav tsum ua tib zoo xav, uas yuav tsum ceev faj.

Daim ntawv tso tawm
Cov ntsiav tshuaj 40 mg thiab 80 mg.
7 ntsiav tshuaj rau ib lub blister ua los ntawm polyamide / aluminium / PVC. 2 lossis 4 lub hlwv nrog cov lus qhia rau kev siv rau hauv thawv ntawv thawv (rau qhov kom tau 40 mg). Txog 2, 4 lossis 8 lub hlwv nrog cov lus qhia rau kev siv hauv thawv ntawv thawv (rau qhov tsuas tshuaj 80 mg).

Cia rau cov neeg mob
Sau B.
Khaws ntawm qhov kub tsis tshaj 30 ° C hauv qhov chaw tiv thaiv los ntawm ya raws.
Khaws tsis ncav cuag ntawm cov menyuam yaus!

Hnub tas sij hawm
4 xyoos Tsis txhob siv tom qab hnub tas sij hawm.

Cov Cai Siv Tshuaj So
Los ntawm tshuaj.

Lub npe thiab chaw nyob ntawm qhov chaw muaj cai nyob rau hauv uas lawv lub npe pov thawj rau npe tau muab
Beringer Ingelheim Thoob Ntiaj Teb GmbH Bingsr Strasse 173,
55216, Ingelheim yog Rhein, Yelemes

Chaw tsim tshuaj paus
Beringer Ingelheim Pharma GmbH & Co.KG
Bingerstrasse 173, 55216 Ingelheim am Rhein, Lub Tebchaws Yelemees

Koj tuaj yeem tau txais cov ntaub ntawv ntxiv ntsig txog cov tshuaj, nrog rau xa koj cov kev tsis txaus siab thiab cov ntaub ntawv ntsig txog cov xwm txheej tsis zoo mus rau qhov chaw nyob hauv Russia hauv qab no
Beringer Ingelheim LLC 125171, Moscow, Leningradskoye Shosse, 16A p. 3

Dosage daim ntawv

Ntsiav tshuaj 80 mg / 12.5 mg, 80 mg / 25 mg

Ib ntsiav tshuaj muaj

yam tshuaj: telmisartan 80 mg

hydrochlorothiazide 12.5 mg lossis 25 mg, feem

tus zam: sodium hydroxide, polyvidone K 25 (povidone), meglumine, sorbitol, magnesium stearate, lactose monohydrate, microcrystalline cellulose, pob kws nplej, hlau (III) liab oxide (E172) (rau qhov ntau npaum 80 / 12.5), hlau (ІІІ) oxide daj (Е172) (rau tshuaj 80/25), sodium hmoov txhuv nplej siab glycolate (hom A).

80 mg / 12.5 mg: oval-puab cov ntsiav tshuaj nrog biconvex nto, ob-txheej: ib txheej yog dawb xim nrog “H8” luam tawm thiab tuam txhab logo, nrog kev tso cai suav liab, lwm txheej yog paj yeeb.

80 mg / 25 mg: oval-puab cov ntsiav tshuaj nrog biconvex nto, ob-txheej: ib txheej yog dawb nrog tus “H9” luam tawm thiab tuam txhab logo, nrog rau txaws ntawm daj, lwm txheej yog daj.

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Kev siv tib lub sij hawm ntawm hydrochlorothiazide thiab telmisartan tsis cuam tshuam rau pharmacokinetics ntawm cov tshuaj no.

Telmisartan: tom qab kev tswj hwm ntawm qhov ncauj, telmisartan yog nqus sai sai, qhov siab tshaj plaws ntawm telmisartan tau mus txog hauv 0.5-1.5 teev.

Qhov nruab nrab meej txog kev ua haujlwm ntawm telmisartan yog li 50%. Noj ib nyuag txo qhov kev noj qab haus huv ntawm telmisartan nrog kev txo qis hauv thaj chaw hauv qab nkhaus "plasma concentration-sijhawm" (AUC) los ntawm 6% thaum noj hauv ib koob ntawm 40 mg txog 19% thaum noj hauv koob 160 160 mg. 3 teev tom qab noj telmisartan, qhov kev txiav txim siab hauv cov ntshav ntshav yog ruaj khov thiab tsis vam khom kev noj zaub mov. Qhov kev txo qis hauv AUC tsis ua rau txo qis kev kho kom zoo.

Lub chaw muag tshuaj ntawm telmisartan thaum noj ntawm qhov ncauj tsis yog-tus nyob rau hauv cov koob tshuaj ntev li 20 mg txog 160 mg nrog qhov ntau dua ntawm cov feem ntau nce ntawm plasma ntau (Cmax thiab AUC) nrog kev nce ntxiv. Telmisartan tsis tuaj yeem nyob hauv ntshav ntshav mus rau qhov ntau nrog kev siv ntau zaus.

Hydrochlorothiazide: tom qab kev tswj hwm ntawm qhov ncauj, qhov siab tshaj plaws ntawm hydrochlorothiazide yog tiav kwv yees li 1.0-3.0 teev tom qab kev tswj hwm. Qhov tsis txaus ntseeg txog bioavailability ntawm hydrochlorothiazide yog kwv yees li 60%.

Telmisartan: muaj qib siab ntawm kev khi rau plasma protein (> 99.5%), feem ntau nrog albumin thiab alpha-1 acid glycoprotein. Qhov ntim ntawm kev faib tawm yog kwv yees li 500 litres.

Hydrochlorothiazide: 64% ua txhua yam rau cov protein plasma thiab nws cov ntim faib tawm kom pom tseeb yog 0.8-0.3 l / kg.

Kev ntsuas phoo thiab nthuav tawm

Telmisartan: tom qab qhov ncauj tswj hwm ntawm 14C-daim ntawv qhia hu ua telmisartan, feem ntau cov koob tshuaj (> 97%) tau tawm hauv cov quav los ntawm cov kua tso tawm, thiab cov kua me me tau pom hauv zis. Nws yog metabolized los ntawm kev sib txuas cov khoom pib nrog kev siv tshuaj tsis haum acylglucuronide, tsuas yog glucuronide nrhiav pom hauv tib neeg.

Tom qab tswj hwm ntawm ib qho kev txhaj tshuaj ntawm 14C-daim ntawv hu ua telmisartan, glucuronide raug kuaj pom kwv yees li 11% ntawm kev ntsuas ntshav ntshav radioactivity. Cytochrome P450 isoenzymes tsis koom nrog hauv cov metabolism hauv ntawm telmisartan. Tag nrho cov ntshav pliav tshem ntawm telmisartan yog kwv yees li 1500 ml / min, lub davhlau ya nyob twg ib nrab-lub neej ntawm ntau tshaj 20 teev.

Hydrochlorothiazide: nyob rau hauv tib neeg, nws tsis yog metabolized thiab ua rau yuav luag tsis hloov pauv ntawm cov zis. Li ntawm 60% ntawm qhov ncauj noj yog txau tawm tsis muaj yam hloov pauv nyob hauv 48 teev. Kev kho lub raum tam sim yog kwv yees li 250-300 ml / min. Qhov kawg ib nrab-lub neej ntawm hydrochlorothiazide yog 10-15 teev.

Cov neeg laus: lub pharmacokinetics ntawm telmisartan hauv cov neeg laus thiab cov hnub nyoog qis dua 65 xyoos tsis txawv.

Tub los ntxhais: ntshav plasma concentration ntawm telmisartan hauv cov poj niam yog 2-3 npaug siab dua li txiv neej. Txawm li cas los xij, hauv kev tshawb fawb soj ntsuam tsis muaj ib qho tseem ceeb nce ntshav ntxiv lossis qhov tshwm sim ntawm orthostatic hypotension rau cov poj niam. Tsis tas yuav tsum muaj hloov kho qhov tshuaj. Muaj ib qho kev xav txog qhov muaj ntau dua ntawm hydrochlorothiazide hauv cov ntshav ntshav hauv cov poj niam piv nrog txiv neej.

Tsis pom qhov kev sib txuam tseem ceeb hauv cov tshuaj telmisartan.

Cov neeg mob raum tsis ua haujlwm

Kev tsis pom lub pob zeb tsis cuam tshuam rau telmisartan tshem tawm. Raws li kev paub dhau los ntawm kev siv tshuaj hauv cov neeg mob uas tsis tshua mob mus rau lub raum tsis ua haujlwm (kev tsim kho lub peev xwm ntawm 30-60 ml / min, qhov nruab nrab kwv yees li 50 ml / min), nws tau pom tias koob tshuaj tsis haum rau cov neeg mob uas txo lub raum. Telmisartan tsis yog tawm thaum lub sij hawm hemodialysis. Hauv cov neeg mob uas lub raum lub raum tsis ua haujlwm, tus nqi ntawm kev tshem tawm ntawm hydrochlorothiazide yog txo.

Hauv kev tshawb nrhiav hauv cov neeg mob uas muaj qhov nruab nrab creatinine tshem tawm ntawm 90 ml / min, qhov kev siv ib nrab ntawm lub neej ntawm hydrochlorothiazide tau nce ntxiv. Hauv cov neeg mob uas lub raum tsis ua haujlwm, tshem tawm ib nrab-lub neej yog li 34 teev.

Cov neeg mob mob siab tsis ua haujlwm

Hauv cov neeg mob uas lub siab tsis ua haujlwm, muaj kev nce ntxiv hauv kev paub txog kev noj qab haus huv txog 100%. Ib nrab-lub neej tsis hloov nrog lub siab tsis ua haujlwm.

Cov Tshuaj Hauv Tshuaj

MIKARDIS Plus yog qhov sib xyaw ntawm cov tshuaj mob angiotensin II receptor antagonist - telmisartan thiab thiazide diuretic - hydrochlorothiazide. Kev sib xyaw ua ke ntawm cov khoom no muab qib siab dua ntawm cov nyhuv antihypertensive ntau dua li noj txhua yam ntawm cov khoom sib cais. Txais tos ntawm MIKARDIS Plus ib hnub ib zaug hauv kev kho mob muab tshuaj muaj txiaj ntsig thiab txo qis cov ntshav siab.

Telmisartan: Nws yog qhov ua tau zoo thiab tshwj xeeb (xaiv tau) angiotensin II receptor antagonist (hom AT1). Telmisartan nrog cov qib siab heev ntawm kev sib raug zoo ua rau txoj kev sib khi nkaus xwb nrog AT1 subtype, angiotensin II receptors. Telmisartan tsis muaj kev sib raug zoo rau lwm cov receptors, suav nrog AT2 - angiotensin receptors, thiab lwm yam, tsis tshua kawm, AT receptors. Lub luag haujlwm tseem ceeb ntawm cov receptors, nrog rau cov txiaj ntsig ntawm lawv qhov kev xav tau dhau los nrog angiotensin II, qhov kev tsub zuj zus uas nce nrog kev teem sijhawm ntawm telmisartan, tsis tau kawm.

Telmisartan ua rau txo qis cov ntshav aldosterone ntau ntau. Telmisartan tsis inhibit renin hauv tib neeg cov ntshav thiab tsis thaiv cov ion ion. Telmisartan tsis inhibit qhov kev ua ntawm angiotensin hloov enzyme (kinase II), nrog kev koom tes ntawm uas muaj qhov txo qis hauv cov synthesis ntawm bradykinin. Yog li, tsis muaj kev nce ntxiv hauv cov kev mob tshwm sim los ntawm bradykinin.

Hauv cov neeg mob, telmisartan ntawm koob tshuaj 80 mg yuav luag txhua qhov cuam tshuam cov txiaj ntsig hypertensive ntawm angiotensin II. Cov nyhuv inhibitory tseem muaj nyob rau 24 teev thiab tseem ceeb txog li 48 teev.

Tom qab noj thawj koob ntawm telmisartan, cov tshuaj tiv thaiv kev tiv thaiv kab mob maj mam dhau los ua neeg pom tau hauv 3 teev. Qhov siab tshaj plaws nyob rau hauv cov ntshav siab yog maj mam tiav 4 lub lis piam tom qab pib ntawm kev kho mob thiab tau tswj hwm rau lub sijhawm ntev.

Hauv cov neeg mob ntshav siab, telmisartan txo qis systolic thiab diastolic ntshav tsis hloov lub plawv.

Qhov ua tau zoo ntawm telmisartan yog piv rau lwm cov chav kawm ntawm cov tshuaj antihypertensive (raws li qhia hauv cov kev tshawb fawb soj ntsuam piv rau telmisartan nrog amlodipine, atenolol, enalapril, hydrochlorothiazide, losartan, lisinopril, ramipril, thiab valsartan).

Nyob rau hauv cov ntaub ntawv ntawm kev tshem tawm sai ntawm telmisartan, ntshav siab maj mam rov qab los rau qhov tseem ceeb ua ntej kev kho mob rau ob peb hnub yam tsis muaj kev qhia tias muaj kev rov ua dua sai sai ntawm kev kub siab (tsis muaj "tshem tawm" syndrome).

Hauv cov kev tshawb fawb soj ntsuam nrog kev sib piv ncaj qha ntawm ob hom kev tiv thaiv kev tiv thaiv, qhov tshwm sim ntawm hnoos qhuav hauv cov neeg mob noj telmisartan tau qis dua li cov uas tau txais angiotensin-hloov enzyme inhibitors.

Hydrochlorothiazide: yog cov thiazide diuretic. Tus txheej txheem ntawm cov nyhuv los tiv thaiv thiazide diuretics tsis tau paub meej. Thiazides ua raws li cov hlaus tubular cov tshuab ntawm electrolyte reabsorption, ncaj qha nce ntxiv qhov tsis pom ntawm sodium thiab chloride kwv yees li qhov sib npaug. Cov nyhuv diuretic ntawm hydrochlorothiazide txo cov ntshav plasma ntau dua, nce plasma renin kev ua si, nce aldosterone secretion, tom qab kev nce ntxiv ntawm potassium thiab bicarbonate hauv cov zis thiab txo qis hauv poov tshuaj potassium. Qhov kawg-rau-kawg blockade ntawm renin-angiotensin-aldosterone system thaum ua ke nrog telmisartan nyhav rau kev rov qab cov poov tshuaj uas tsis cuam tshuam nrog cov diuretics.

Thaum noj hydrochlorothiazide, kev nce ntxiv ntawm diuresis yog pom tom qab 2 teev, cov nyhuv siab tshaj plaws tshwm sim tom qab txog 4 teev, thaum lub sijhawm ua ntawm 6-12 teev.

Kev tshawb xyuas kabmob kis tau pom tias kev kho mob ntev nrog hydrochlorothiazide txo txoj kev pheej hmoo ntawm cov hlab plawv mob thiab tuag ntawm lawv.

Tsuas tshuaj thiab tswj hwm

MIKARDIS Plus noj ib hnub ib zaug nrog me ntsis dej.

Thaum hloov los ntawm telmisartan mus rau MIKARDIS Ntxiv, qhov koob tshuaj telmisartan tuaj yeem nce ua ntej. Kev hloov ncaj qha los ntawm kev kho mob monotherapy rau kev noj tshuaj sib xyaw ua ke yog ua tau.

MIKARDIS Ntxiv 80 mg / 12.5 mg tuaj yeem muab rau cov neeg mob uas siv cov tshuaj telmisartan (MIKARDIS) 80 mg tsis ua rau cov ntshav khov.

MIKARDIS Ntxiv 80 mg / 25 mg tuaj yeem raug kho rau cov neeg mob uas siv MIKARDIS Plus 80 mg / 12.5 mg tsis kho ntshav siab los yog rau cov neeg mob uas yav tas los ua haujlwm los ntawm telmisartan lossis hydrochlorothiazide thaum siv cais.

Qhov siab tshaj plaws antihypertensive nyhuv feem ntau ua tiav tsis pub dhau 4-8 lub lis piam tom qab pib ntawm kev kho mob.

Yog tias tsim nyog, MIKARDIS Plus tuaj yeem ua ke nrog lwm cov tshuaj tiv thaiv antihypertensive.

Hauv cov neeg mob uas muaj mob ntshav liab ntau, telmisartan hauv koob ntau txog 160 mg ib hnub (ob qho tshuaj ntsiav ntawm MIKARDIS 80 mg) los yog sib xyaw nrog hydrochlorothiazide 12.5-25 mg ib hnub (ob qho tshuaj ntsiav ntawm MIKARDIS Ntxiv 80 mg / 12.5 mg lossis 80 mg / 25 mg) tau zoo thev taus thiab ua haujlwm tau zoo.

MIKARDIS Plus tuaj yeem siv tau yam tsis xav noj mov.

Vim tias muaj MIKARDIS Plus hydrochlorothiazide hauv kev npaj, nws yuav tsum tsis txhob raug rau cov neeg mob uas lub raum tsis ua haujlwm zoo (creatinine tshem tawm)