Cov tshuaj Telzap 40: 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 tsum 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.

Cov npe ntawm cov lus txhais thiab cov qauv ntawm Telzap

Telpres (ntsiav tshuaj) → cov lus sib dhos: 29 Saum

Cov analogue yog pheej yig dua los ntawm 77 rubles.

Chaw tsim tshuaj paus:
Cov Ntawv Tso Tawm:

Ntsiav tshuaj, 20 mg, No. 28

Nqe rau Telpres hauv cov khw muag tshuaj: los ntawm 187 rubles. mus txog 855 rub. (795 muaj)
Telpres (cov lus sib piv) - tsim tawm hauv Spain thiab Cyprus. Nws muaj tib yam tshuaj thiab cov txheej txheem ntawm kev txiav txim raws li telzap. Nws yog siv rau hauv cov neeg mob ntshav siab, nrog rau cov tib neeg muaj kev pheej hmoo siab ntawm cov hlab plawv mob atherothrombotic keeb kwm (ischemic stroke, hloov ischemic nres, mob myocardial infarction, kab mob ntawm cov hlab ntsha ntawm qhov qis qis) rau lawv thawj hauv kev tiv thaiv theem nrab, txo kev xiam oob qhab thiab kev tuag los ntawm cov kabmob no. Nws yog siv los tiv thaiv vascular spasm theem nrab thiab kev txhim kho ntawm cov ischemia theem nrab hauv cov neeg mob nrog txoj hlab ntshav khov. Cov kev tshwm sim tsis zoo muaj peev xwm ua tau rau hauv daim tawv nqaij ua pob khaus thiab khaus, angioedema, anaphylactic kev ua xua, hnoos qhuav, xeev siab, ntuav, tsis xis nyob hauv lub qhov ncauj, tsam plab thiab mob plab, txo ntshav siab, kiv taub hau, qaug zog, nce ntxiv ntawm transaminases, urea thiab creatinine, anemia, thrombocytopenia. Nws tsis tuaj yeem siv rau kev tsis tuaj yeem, cuam tshuam ntawm cov hlab ntsha, mob ntshav siab, raum thiab mob ntshav siab tsis txaus, ob tog ntawm cov hlab ntsha hauv plab, fructose tsis haum, cov neeg tsis tau muaj 18 xyoo, cov poj niam muaj menyuam thiab cov niam laus.

Cov analogue yog pheej yig dua los ntawm 70 rubles.

Lorista yog analogue, cov chaw tsim tshuaj paus yog lub tuam txhab Slovenian Slovenian KRKA thiab nws cov chaw sawv cev hauv Lavxias KRKA-RUS. Nws yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj hauv lub plhaub 12,5 mg (No. 30), 25 mg (No. 30), 50 mg (No. 30, 60 thiab 90) thiab 100 mg (No. 30, 60 thiab 90). Nws nplov AT1 receptors rau angiotensin-2, txwv tsis pub tsim cov tshuaj angiotensin-2 los ntawm angiotensin-1, yog li thaiv cov vasoconstrictor nyhuv ntawm angiotensin ntawm hom thib ob. Cov tshuaj txo cov ntshav siab, tsis cuam tshuam rau lub plawv dhia. Nws yog siv rau qhov tseem ceeb ntawm kev kub siab, kom txo tau kev pheej hmoo ntawm lub plawv nres thiab atherothrombotic subtype ntawm ischemic mob hlab ntsha hauv cov neeg predisposed rau cov kab mob no, nrog kev mob ntshav txhav txhav los tiv thaiv spasm theem nrab ntawm cov hlab ntsha hlwb, uas ua rau kev mob siab rau ntawm tus neeg mob. Haus cov tshuaj ib hnub ib zaug. Nws tuaj yeem ua rau ua xua, dyspepsia, hypotension, lub raum thiab lub siab tsis ua haujlwm, ua kom tsis muaj zog, kiv taub hau, hloov pauv hloov ntshav noj ntshav, ua kom mob ntshav siab, ua kom mob nqaij. Contraindicated nyob rau hauv cov tsis txaus ntseeg, hypotension, loj pathology ntawm daim siab thiab ob lub raum, cov menyuam, cev xeeb tub thiab lactating poj niam.

Telsartan (ntsiav tshuaj) onym txhais tau zoo qho Ntsuas: 17 Up

Cov analogue yog pheej yig dua los ntawm 14 rubles.

Chaw tsim tshuaj paus:
Cov Ntawv Tso Tawm:

Ntsiav tshuaj, 40 mg, No. 30

Tus nqi ntawm Telsartan hauv cov khw muag tshuaj: los ntawm 232 rubles. mus txog 556 rub. (577 muaj)
Telsartan yog lus Indian rau telzap. Daim foos tso tawm - cov ntsiav tshuaj ntawm 40 thiab 80 mg (No. 30). Nws yog ib tus xaiv kws thaiv ntawm angiotensin-2 receptors. Nws yog siv rau hauv cov neeg mob nrog thawj (qhov tseem ceeb) kev mob ntshav tawm tsam, nrog rau cov neeg muaj hnub nyoog tshaj 55 xyoos uas muaj kev pheej hmoo siab ntawm lub plawv mob ntawm atherothrombotic keeb kwm rau kev tiv thaiv ob qho tshwm sim thawj zaug thiab rov ua myocardial infarction thiab ischemic strokes, hloov chaw ischemic tawm tsam, mob hlab ntsha qis qis dua, txo txoj kev pheej hmoo ntawm kev tsis taus thiab kev tuag los ntawm cov kab mob no. Nws yog dav siv nyob rau hauv kev kho mob hlwb thiab neurosurgical kev coj ua rau kev kho tus kheej thiab mob ntawm cov ntshav sib luag rau kev tiv thaiv ntawm theem nrab spasm ntawm cerebral txog ntsha, uas ua rau kev tsim txom ntawm tus neeg mob. Kev siv cov tshuaj yog contraindicated nyob rau hauv kev kub siab rau nws lub Cheebtsam, tej yam kev mob nrog hypotension, nrog ob leeg lub raum artery stenosis los yog lub raum leeg mob stenosis ntawm ib lub raum, nrog mob raum thiab mob siab tsis txaus, ua kom mob plab, txhawm rau lub sijhawm cev xeeb tub thiab pub niam mis, rau menyuam yaus thiab tub ntxhais hluas.

Cov analogue yog kim dua los ntawm 6 rubles.

Telmista (cov lus txhais rau Telzap) - yog tsim nyob rau hauv Slovenia hauv ntsiav tshuaj ntawm 40 mg (No. 28 thiab 30) thiab 80 mg (No. 28). Cov tshuaj yeeb dej caw tseem yog telmisartan. Tus txheej txheem ntawm kev ua yog zoo ib yam li cov tshuaj saum toj no. Ib ntsiav tshuaj tau noj ib hnub ib zaug rau kev kawm ntev. Lawv siv rau hauv cov neeg mob uas tseem ceeb arterial hypertension thiab nyob rau hauv cov tib neeg muaj kev pheej hmoo ntawm cov hlab plawv mob ntawm athero-thrombotic keeb kwm (mob plawv, mob stroke, obliterating kab mob ntawm cov hlab ntsha ntawm qhov qis qis) rau lawv cov kev tiv thaiv theem pib thiab theem nrab, txo kev xiam oob qhab thiab kev tuag ntawm cov kab mob no. Nws yog siv rau hauv cov neeg mob uas mob hlwb txhav txhawm rau txhawm rau txhawm rau txhawm rau vasoconstriction nyob rau hauv cheeb tsam no thiab necrosis ntawm lub hlwb cov ntaub so ntswg ib ncig ntawm lub hemorrhage. Thaum noj tshuaj, kev tsis haum tshuaj, hnoos, mob khaub thuas xws li syndrome, dyspepsia, hypotension, kiv taub hau, tsis muaj zog, cov qauv ntshav, raum thiab mob siab, kev mob edema yuav tshwm sim.

Cov analogue kim dua los ntawm 227 rubles.

Edarbi - ib qho tshuaj ntawm Telzap, yog tsim hauv Denmark, Nyiv, Ireland thiab Tebchaws Asmeskas hauv cov ntsiav tshuaj ntawm 40 thiab 80 mg (No. 28). Cov tshuaj phiv yog azilsartan. Nws nplov angiotensin-2 receptors, txwv tsis pub muaj kev ua haujlwm ntawm renin-angiotensin-aldosterone system, uas ua rau cov nyhuv antihypertensive. Nws yog siv rau hauv cov neeg mob nrog thawj (qhov tseem ceeb) tawg, cov neeg muaj kev pheej hmoo siab heev ntawm kev mob plawv rau lawv cov kev tiv thaiv theem pib thiab theem ob, nrog rau txo qis kev pheej hmoo thiab kev tuag ntawm cov kab mob no. Nws yog siv rau hemorrhagic mob stroke thiab mob hlab ntsha tawg intracerebral hemorrhage rau kev tiv thaiv ntawm theem nrab spasm ntawm cerebral hlab ntsha. Cov kev mob tshwm sim (feem ntau me me lossis mob pes tsawg) yuav tshwm sim nyob rau hauv daim ntawv ntawm kev ua xua, cov tsos mob dyspeptic, kiv taub hau, dav dav tsis muaj zog, CPK ntau ntawm cov ntshav, hypotension, ceg txhawm, nce kev ua haujlwm ntawm daim siab, urea, thiab creatinine transaminases. Qhov kev tsis sib haum xeeb ntawm kev siv tshuaj yog nws qhov kev tsis haum siab, kev tswj hwm ua ke nrog aliskiren thiab ACE inhibitors hauv cov neeg mob ntshav qab zib mellitus, menyuam yaus thiab tub ntxhais hluas, cev xeeb tub thiab lactation.

Cov analogue kim dua los ntawm 249 rubles.

Mikardis (cov lus txhais rau Telzap) yog tshuaj German tsim nyob rau hauv cov ntsiav tshuaj ntawm 40 mg (No. 14 thiab 28) thiab 80 mg (No. 28). Nws muaj tib yam khoom siv zoo ib yam li telzap thiab cov txheej txheem zoo sib xws. Nws yog siv los kho thawj kev mob plawv hauv lub plawv, nrog rau kev txo qis kev pheej hmoo ntawm cov hlab plawv kev puas tsuaj (xws li mob plawv, mob ntshav tawm ntawm lub cev tsis muaj zog, atherothrombotic subtype ntawm ischemic stroke, hloov ischemic nres, txo nqua ntawm cov leeg ntshav ntawm lub cev, thiab lwm yam) hauv cov neeg muaj kev cuam tshuam thiab txo qhov ntxim nyiam kev tsis taus thiab kev tuag los ntawm cov kab mob no. Nws kuj tseem siv rau hemorrhagic mob stroke, spontaneous subarachnoid hemorrhage thiab mob ntshav hlab plawv rau kev tiv thaiv ntawm vasospasm ມັດ ທະ ຍົມ, uas ua rau kev tsim ntawm cov nqaij mos necrosis cheeb tsam ze ntawm thaj chaw hemorrhagic tsom thiab ua rau kev nce siab ntawm cov leeg mob thiab ua rau lub siab mob ntawm tus neeg mob. Koj tuaj yeem siv tsis tau cov tshuaj nrog nws tsis nkag siab, kev cuam tshuam ntawm lub plab, mob siab rau lub raum thiab lub raum pathology, ob tog lub raum mob leeg, rau cov neeg mob ntshav qab zib mob raum nrog rau ACE inhibitors thiab aliskiren, nrog fructose intolerance, hauv cov menyuam yaus thiab cov hluas, cev xeeb tub thiab lactating cov poj niam.

Dosage daim ntawv

Ib ntsiav tshuaj muaj

yam tshuaj: telmisartan 40,000 lossis 80,000 mg, feem,

hydrochlorothiazide 12.500 mg lossis 25.000 mg, feem,

tus zam: sorbitol, sodium hydroxide, povidone 25, magnesium stearate

Lub sijhawm ntev dua cov ntsiav tshuaj nrog lub ntsej muag biconvex los ntawm dawb mus rau xim daj, nrog tus lej extruded "41" ntawm ib sab ntawm lub ntsiav tshuaj, txog 12 hli ntev thiab txog 6 hli dav (rau qhov ntau npaum 40 mg / 12.5 mg).

Cov ntsiav tshuaj zoo li ntev ntev nrog lub ntsej muag biconvex los ntawm dawb mus rau xim daj, nrog tus lej extruded “81” ntawm ib sab ntawm lub ntsiav tshuaj, ntev txog 16.5 hli ntev, txog 8.3 mm dav (rau qhov ntau npaum ntawm 80 mg / 12.5 mg).

Cov ntsiav tshuaj zoo li ntev ntev nrog lub ntsej muag biconvex los ntawm dawb mus rau xim daj, nrog tus lej extruded “82” ntawm ib sab ntawm lub ntsiav tshuaj, ntev txog 16 hli ntev, txog 8 hli dav (rau qhov ntau npaum ntawm 80 mg / 25 mg).

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, qhov siab tshaj plaws ntawm telmisartan tau mus txog tom qab 0.5 - 1.5 teev. Qhov tsis txaus ntseeg ntawm telmisartan ntawm koob tshuaj 40 mg thiab 160 mg yog 42% thiab 58%, feem. Thaum noj cov tshuaj telmisartan 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 koob tshuaj 160 mg). 3 teev tom qab noj, qhov kev nkag siab hauv cov ntshav ntshav tawm ntau, tsis hais cov pluas noj dab tsi. Qhov kev txo qis hauv AUC tsis ua rau txo qis kev kho kom zoo. Cov tshuaj pharmacokinetics ntawm qhov ncauj telmisartan yog nonlinear ntawm koob tshuaj ntawm 20-160 mg nrog ntau dua ntawm cov xwm txheej nce ntxiv hauv plasma ntau (Cmax thiab AUC) nrog kev nce siab. Tsis pom qhov kev sib txuam tseem ceeb hauv cov tshuaj telmisartan.

Hydrochlorothiazide: Tom qab qhov ncauj tswj hwm ntawm Telzap Plus, cov ntsiab lus ntau ntawm hydrochlorothiazide tau mus txog kwv yees li 1.0 mus rau 3.0 teev tom qab noj cov tshuaj. Raws li kev ua kom lub raum khiav tawm ntawm hydrochlorothiazide, qhov tseeb txog kev nyab xeeb yog li 60%.

Telmisartan qhov tseem ceeb khi rau cov ntshav plasma protein (ntau dua 99.5%), feem ntau nrog albumin thiab alpha-1-acid glycoprotein. Qhov kev xa khoom faib tawm yog kwv yees li 500 L, uas qhia tau tias yuav tsum muaj ntaub so ntswg ntxiv.

Hydrochlorothiazide 68% ua txhua yam rau cov plasma protein thiab qhov ntim ntawm kev faib tawm yog 0.83 - 1.14 l / kg.

Telmisartan metabolized los ntawm kev sib txuas nrog kev tsim cov pharmacologically tsis nquag acylglucuronide. Cov glucuronide ntawm leej niam leej txiv lub cev tsuas yog cov metabolite uas tau txheeb pom hauv tib neeg. Tom qab ib koob nkaus xwb ntawm 14C-sau npe telmisartan, glucuronide yog kwv yees li 11% ntawm kev ntsuas ntshav ntshav radioactivity. Cytochrome P450 thiab isoenzymes tsis koom nrog hauv cov metabolism ntawm telmisartan.

Hydrochlorothiazide tsis metabolized hauv tib neeg

Telmisartan: Tom qab tso ntshav lossis tswj lub qhov ncauj ntawm 14C-daim ntawv qhia hu ua telmisartan, feem ntau ntawm kev siv tshuaj (> 97%) tau tawm hauv cov quav los ntawm cov kua tso tawm. Cov kua me me tau pom nyob hauv cov zis.

Tag nrho cov ntshav pliav tshem tawm ntawm telmisartan tom qab kev tswj hwm ntawm qhov ncauj yog> 1500 ml / min. Lub davhlau ya nyob twg ib nrab-lub neej yog> 20 teev.

Hydrochlorothiazide cia tawm yuav luag tsis hloov pauv ntawm cov zis. Li ntawm 60% ntawm qhov ncauj noj tau tawm hauv 48 teev. Kev kho lub raum yog li 250 - 300 ml / min. Lub davhlau ya nyob twg ib nrab-lub neej yog 10 mus rau 15 teev.

Cov neeg laus cov neeg mob

Cov chaw muag tshuaj ntawm telmisartan tsis txawv hauv cov neeg laus thiab cov neeg mob hnub nyoog qis dua 65 xyoos.

Plasma cov ntsiab lus ntawm telmisartan yog 2-3 zaug siab dua hauv poj niam ntau dua li txiv neej. Hauv qhov kev tshawb fawb soj ntsuam, tsis muaj ib qho tseem ceeb ntxiv hauv cov lus teb ntawm ntshav siab lossis ntau zaus ntawm orthostatic hypotension rau cov poj niam. Koob tshuaj yuav tsis haum. Ib tug nyiam mus rau qhov ntshav siab ntau dua ntawm hydrochlorothiazide tau pom hauv cov poj niam dua li tus txiv neej. Nws tsis muaj qhov tseem ceeb hauv tsev kho mob.

Cov neeg mob raum tsis ua haujlwm

Kev tsis pom lub pob zeb tsis cuam tshuam rau telmisartan tshem tawm. Raws li cov txiaj ntsig ntawm kev paub me me nrog Telzap Plus hauv cov neeg mob uas tsis tshua mob mus rau lub raum tsis ua hauj lwm (kev tshem tawm ntawm 30-60 ml / min, qhov nqi nruab nrab ntawm kwv yees li 50 ml / min), kev kho kom haum yog tsis tsim nyog rau cov neeg mob uas txo lub raum. Telmisartan tsis raug tshem tawm los ntawm cov ntshav los ntawm 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, kev tshem tawm ib nrab-lub neej yog li 34 teev.

Cov neeg mob mob siab tsis ua haujlwm

Hauv cov neeg mob uas muaj mob hepatic tsis txaus, qhov tiag ntawm bioavailability ntawm telmisartan nce txog 100%. Ib nrab-lub neej rau daim siab ua tsis hloov.

Yawg Nom Loobodinamika

Telzap Plus yog qhov sib xyaw ntawm cov tshuaj mob angiotensin II receptor antagonist (ARAII), telmisartan, thiab thiazide diuretic, hydrochlorothiazide. Kev sib xyaw ua ke ntawm cov cheebtsam no muaj qhov ua haujlwm ntxiv los tiv thaiv kabmob, txo cov ntshav siab rau ntau dua li ib ntu tivthaiv ib leeg. Telzap Plus thaum noj ib hnub ib zaug ua rau muaj kev txo qis zoo thiab txo qis cov ntshav siab.

Telmisartan yog qhov ua tau zoo thiab tshwj xeeb (xaiv tau) angiotensin II receptor antagonist (hom AT1) rau kev tswj hwm qhov ncauj. Telmisartan nrog qhov zoo sib xws siab hloov chaw angiotensin II los ntawm nws cov chaw khi hauv receptors ntawm subtype 1 (AT1), uas yog lub luag haujlwm rau paub txog cov nyhuv ntawm angiotensin II. Telmisartan tsis nthuav tawm ib qho kev ua kom muaj kev ua phem ntawm AT1 receptor. Telmisartan xaiv yeem khi rau AT1 receptor. Kev khi yog lub sijhawm ntev. Telmisartan tsis qhia txog kev sib raug zoo rau lwm cov receptors, suav nrog AT2 receptor thiab lwm yam, tsis tshua tau kawm txog 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 txo cov ntshav plasma aldosterone ntau ntau, tsis thaiv cov renin hauv tib neeg ntshav thiab ion channels.

Telmisartan tsis thaiv qhov kev mob angiotensin-hloov pauv enzyme (kinase II), uas txo cov khoom ntawm bradykinin ntau lawm. Yog li no, tsis muaj suab nrov nrov ntawm kev phiv cuam tshuam nrog kev txiav txim ntawm bradykinin.

Ib 80 mg koob tshuaj ntawm telmisartan, muab rau cov neeg tuaj yeem noj qab haus huv, yuav luag tag nrho qhov kev tiv thaiv qhov nce siab uas tshwm sim los ntawm kev chwv cov tshuaj angiotensin II. Cov nyhuv inhibitory tseem nyob ntev dua 24 teev (mus txog 48 teev).

Tom qab noj thawj koob ntawm telmisartan, ntshav siab poob qis tom qab 3 teev. Qhov siab tshaj plaws nyob rau hauv cov ntshav siab, raws li txoj cai, ua tiav 4-8 lub lis piam tom qab pib kho thiab mob siab rau kev kho mob mus ntev.

Cov nyhuv antihypertensive kav rau 24 teev tom qab noj cov tshuaj, suav nrog 4 teev ua ntej noj cov koob tshuaj txuas ntxiv, uas tau paub tseeb los ntawm kev ntsuas ntshav siab, nrog rau cov neeg mob nyob sab nraud (saum 80%) ntawm qhov tsawg kawg thiab ntau qhov ntau ntawm cov tshuaj tom qab noj 40 thiab 80 mg ntawm telmisartan nyob rau hauv qhov chaw tswj hwm. kev tshawb fawb soj ntsuam.

Hauv cov neeg mob ntshav siab, telmisartan txo qis ob qho systolic thiab diastolic ntshav siab tsis cuam tshuam rau lub plawv dhia. Qhov ua tau zoo ntawm telmisartan piv nrog cov neeg sawv cev ntawm lwm cov chav kawm ntawm cov tshuaj tiv thaiv kabmob (zoo li pom hauv kev tshawb fawb soj ntsuam cov sib piv ntawm telmisartan nrog amlodipine, atenolol, enalapril, hydrochlorothiazide, thiab lisinopril).

Hauv ob lub qhov muag dig, tswj kev soj ntsuam (N = 687 cov neeg mob uas tau raug soj ntsuam rau qhov ua tau zoo), cov tib neeg tsis teb rau 80 mg / 12.5 mg kev sib xyaw ua kom pom kev txo qis ntshav siab ntawm 80 mg / 25 mg sib xyaw piv nrog kev kho mob mus ntev nrog cov koob tshuaj 80 mg / 12.5 mg 2.7 / 1.6 mmHg (SBP / DBP) (qhov sib txawv ntawm kev hloov pauv qhov nruab nrab hauv kev txheeb tus kwv tij). Hauv kev kawm nrog kev sib xyaw ntawm 80 mg / 25 mg, ntshav siab poob qis, uas ua rau muaj kev txo qis tag nrho ntawm 11.5 / 9.9 mmHg. (VAJTSWV / DBP).

Kev ntsuam xyuas dav dav ntawm ob qhov zoo sib xws ntawm 8 lub lis piam ob zaug dig muag, cov tshuaj placebo tshuaj soj ntsuam sib piv valsartan / hydrochlorothiazide 160 mg / 25 mg (N = 2121 cov neeg mob uas tau raug soj ntsuam rau qhov ua tau zoo) pom tias muaj txiaj ntsig ntau dua ntawm kev txo ntshav siab 2.2 / 1.2 hli Hg Cov. (SBP / DBP) (qhov sib txawv ntawm kev hloov kho txhais tau hloov los ntawm lub hauv paus, ib feem) nyob rau hauv kev pom zoo ntawm kev sib xyaw ntawm telmisartan / hydrochlorothiazide 80 mg / 25 mg.

Tom qab qhov kev tso tseg tsis zoo ntawm kev kho mob nrog telmisartan, ntshav siab maj mam rov qab los rau nws cov nqi pib ntau hnub dhau los uas tsis muaj cov cim qhia "rov mob" tawg.

Hauv cov kev tshawb fawb soj ntsuam ncaj qha piv rau ob txoj kev kho, qhov tshwm sim ntawm kev hnoos qhuav tau qis dua hauv cov neeg mob uas tau txais telmisartan dua li cov uas tau txais angiotensin-hloov enzyme inhibitors.

Kev soj ntsuam PRoFESS tau ua nyob rau hauv cov neeg mob hnub nyoog qis dua 50 xyoo uas nyuam qhuav muaj mob stroke tam sim no pom tias muaj qhov sib luag ntawm sepsis nrog telmisartan piv nrog cov placebo, 0.70% piv nrog 0.49% LOSSIS 1.43 (95% kev cog qoob loo nyob nruab nrab 1.00 - 2.06), qhov ntau zaus ntawm kev tuag los ntawm sepsis yog ntau dua rau cov neeg mob noj telmisartan (0.33%) piv nrog cov neeg mob noj placebo (0.16%) LOSSIS 2.07 (95% kev ntseeg siab ib ntus 1.14 - 3.76). Qhov pom tau nce ntxiv ntawm qhov tshwm sim ntawm sepsis cuam tshuam nrog kev siv telmisartan tej zaum yuav yog ib qho kev tshwm sim random lossis yuav cuam tshuam nrog lub tshuab uas tsis tau paub tam sim no.

Qhov tshwm sim ntawm telmisartan ntawm kev tuag thiab cov mob plawv yog cov tseem tsis tau paub. Hydrochlorothiazide yog thiazide diuretic. Tus txheej txheem ntawm cov nyhuv los tiv thaiv thiazide diuretics tsis tau paub meej. Thiazides cuam tshuam rau lub raum kev rov ua haujlwm ntawm kev rov tsim cov roj ntsha hauv cov tub ntxhais, ncaj qha nce cov kev tsis haum ntawm sodium thiab chloride nyob hauv kwv yees li ntau dua. Cov nyhuv diuretic ntawm hydrochlorothiazide txo plasma ntim ntau dua, nce plasma renin kev ua si, nce zais pa ntawm aldosterone, tom qab kev nce poov tshuaj ntau ntxiv hauv cov zis, poob ntawm bicarbonate thiab txo qis hauv poov tshuaj potassium. Tej zaum dhau ntawm qhov thaiv ntawm cov renin-angiotensin-aldosterone system, kev sib koom tes ntawm telmisartan, raws li txoj cai, txwv tsis pub cov pa roj carbon ntau txuam nrog cov diuretics. Thaum siv hydrochlorothiazide, qhov pib ntawm diuresis tshwm sim tom qab 2 teev, thiab cov nyhuv siab tshwm sim tom qab li 4 teev, thaum cov nyhuv cuam tshuam txog li 6-12 teev.

Kev tshawb fawb tawm tsam pom tau tias kev kho mob ntev nrog hydrochlorothiazide txo txoj kev pheej hmoo ntawm lub plawv kev tuag thiab kev qoj ib ce.

Tsuas tshuaj thiab tswj hwm

Cov ntsiav tshuaj Telzap Plus yog npaj rau kev siv lub qhov ncauj, tsis hais txog ntawm cov pluas noj, noj ib hnub ib zaug thiab yuav tsum tau ntxuav nrog dej.

Telzap Plus tau txais kev kho mob rau cov neeg mob uas ntshav siab tsis txaus tswj nrog telmisartan monotherapy. Kev pom zoo rau ib tus zuj zus koob tshuaj ntawm ib ntawm ob qho kev sib xyaw ua ntej pom zoo ua ntej hloov mus rau txoj kev sib txuam nrog koob. Hauv kev soj ntsuam raws li kev kho mob, kev hloov ncaj qha los ntawm kev kho mob monotherapy rau kev sib txuam ruaj ruaj yuav suav tau.

Telzap Ntxiv 40 mg / 12.5 mg tuaj yeem noj ib hnub ib zaug rau cov neeg mob uas ntshav siab tsis txaus tswj nrog 40 mg telmisartan monotherapy.

Telzap Ntxiv 80 mg / 12.5 mg tuaj yeem noj ib hnub ib zaug rau cov neeg mob uas ntshav siab tsis txaus tswj nrog 80 mg telmisartan monotherapy.

Telzap Ntxiv 80 mg / 25 mg tuaj yeem noj ib hnub ib zaug rau cov neeg mob uas ntshav siab tsis txaus tswj thaum thov Telzap Plus 80 / 12.5 mg lossis hauv cov neeg mob uas cov ntshav siab tau ua yav tas los ntawm telmisartan thiab hydrochlorothiazide cais.

Siv rau cov neeg laus

Koob tshuaj yuav tsis haum.

Cov neeg mob raum tsis ua haujlwm

Pom zoo sij hawm saib xyuas lub raum kev ua haujlwm yog pom zoo (saib "Cov Lus Qhia Tshwj Xeeb")

Cov neeg mob mob siab tsis ua haujlwm

Hauv cov neeg mob uas muaj me ntsis mus rau mob hepatic tsis txaus, qhov ntau dua yuav tsum tsis pub tshaj Telzap Plus 40 mg / 12.5 mg ib hnub ib zaug. Telzap Plus tsis yog qhia rau cov neeg mob uas muaj lub siab ua haujlwm tsis zoo. Thiazides yuav tsum siv nrog ceev faj hauv cov neeg mob uas lub siab tsis ua hauj lwm (saib ntu "Cov lus qhia tshwj xeeb").

Cov kev nyab xeeb thiab kev ua haujlwm ntawm Telzap Plus nyob rau cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo tsis tau teeb tsa. Cov ntaub ntawv tsis muaj.

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.

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).

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)

Arterial tawg

Thawj koob tshuaj pom zoo ntawm Telzap yog 1 ntsiav tshuaj (40 mg) ib hnub ib zaug. Hauv qee tus neeg mob, 20 mg 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 hau kev, 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 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.

Yeeb tshuaj sib cuam tshuam

Nrog tib lub sijhawm siv ntawm telmisartan nrog digoxin, qhov nce nruab nrab ntawm Cmax ntawm digoxin hauv cov ntshav ntshav los ntawm 49% thiab Cmin los ntawm 20% tau sau tseg. 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.

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

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) , heparin, immunosuppressants (cyclosporine lossis tacrolimus) thiab trimethoprim).

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.

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.

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.