Cov tshuaj Ibertan: cov lus qhia rau kev siv

Lub npe thoob ntiaj teb - ibertan ntxiv

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm.

Cov ntsiav tshuaj ua yeeb yaj kiab, 1 ntsiav tshuaj muaj hydrochlorothiazide - 12,5 mg, irbesartan - 150 mg.

Ntsiav tshuaj zaj duab xis txheej, 12.5 mg + 150 mg: 28 lossis 30 pcs.

7 Pcs - hlwv (4) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
14 pcs. - hlwv (2) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (2) - pob khoom los ntawm cardboard.

Pharmacological kev txiav txim.

Ibertan Plus yog cov tshuaj sib xyaw nrog cov nyhuv antihypertensive. Cov nkauj muaj xws li angiotensin II receptor antagonist thiab thiazide diuretic. Kev sib xyaw ntawm cov tshuaj no muaj cov nyhuv tawm tsam ntxiv, txo cov ntshav siab rau qhov ntau dua li txhua cov tshuaj cais tawm.

Irbesartan yog tus xaiv cov kev tawm tsam ntawm angiotensin II receptors (hom AT1) rau kev tswj hwm qhov ncauj. Irbesartan thaiv tag nrho cov kev mob physiologically tseem ceeb ntawm angiotensin II kev kho kom haum xeeb los ntawm AT1 receptors, tsis hais txog qhov chaw los yog txoj kev ntawm synthesis ntawm angiotensin II. Xaiv cov kev tsis sib haum ntawm cov tshuaj angiotensin II (AT1) ua rau cov ntshav plasma ntau ntxiv ntawm renin thiab angiotensin II thiab qhov txo qis ntawm aldosterone hauv cov ntshav ntshav. Cov poov tshuaj poov tshuaj ntsiab lus feem ntau tsis hloov pauv thaum noj irbesartan ntawm cov koob tshuaj pom zoo; irbesartan tsis inhibit kininase II. Irbesartan tsis xav tau kev ua haujlwm metabolic. Lowers ntshav siab nrog qhov hloov me me hauv lub plawv.

Hydrochlorothiazide yog thiazide diuretic. Nws cuam tshuam rau kev rov kho cov roj ntsha hauv cov hlab ntsws, rov nce tawm ncaj qha ntawm sodium thiab chlorine ions hauv kwv yees sib npaug. Cov nyhuv diuretic ntawm hydrochlorothiazide ua rau cov ntshav plasma txo qis, qhov kev ua si hauv renin ntau dua nyob rau hauv cov ntshav ntshav, nce ntxiv ntawm kev tso cai ntawm aldosterone thiab nce ntxiv hauv cov ntsiab lus ntawm potassium ions thiab bicarbonates hauv cov zis thiab hypokalemia. Tib lub sij hawm tswj hwm nrog irbesartan ua rau kom txo qis ntawm cov potassium potassium ions, feem ntau vim yog qhov thaiv ntawm cov renin-angiotensin-aldosterone system. Thaum hydrochlorothiazide noj ntawm qhov ncauj, qhov nce ntawm diuresis tshwm sim tom qab 2 teev thiab nce mus txog qhov siab kawg tom qab 4 teev. Qhov kev ua ntawm hydrochlorothiazide kav ntev li 6-12 teev.

Qhov kev poob qis hauv cov ntshav siab thaum sau ntawv rau irbesartan hauv kev sib xyaw nrog hydrochlorothiazide yog qhov pom meej meej thaum koj thawj zaug noj tshuaj hauv thiab kav ntev li 1-2 lub lis piam, tom qab ntawd nws nce zuj zus thiab kev loj hlob ntawm lub siab tshaj plaws ntawm 6-8 lub lis piam.

Cov Tshuaj Pharmacokinetics.

Kev tswj hwm tib lub sij hawm ntawm hydrochlorothiazide thiab irbesartan tsis cuam tshuam rau pharmacokinetics ntawm txhua cov tshuaj.

Xuas. Tom qab qhov ncauj tswj hwm, qhov tseeb txog kev tsis txaus ntseeg ntawm irbesartan yog 60-80%, hydrochlorothiazide 50-80%. Noj mov tsis muaj kev cuam tshuam lawv lub cev. Cmax ntawm irbesartan nyob rau hauv cov ntshav plasma tau mus txog tom qab 1.5-2 teev tom qab kev tswj hwm qhov ncauj, hydrochlorothiazide - tom qab 1-2.5 teev.

Kev xa Khoom. Irbesartan yog 96% ua txhua yam rau cov ntshav protein. Qhov ntim ntawm kev faib tawm (Vd) ntawm irbesartan yog 53-93 litres. Cov tshuaj pharmacokinetic ntawm irbesartan yog qhov tso cai thiab sib npaug hauv cov koob tshuaj ntau ntau los ntawm 10 mg txog 600 mg. Ntawm koob tshuaj ntau dua 600 mg (koob tshuaj ob zaug qhov ntau tshaj qhov xav tau ntau), cov khw muag tshuaj ntawm irbesartan dhau los ua tsis-tawm (txo kom haum).

Hydrochlorothiazide yog 68% ua txhua yam rau cov ntshav plasma, V d - 0.83-1.14 l / kg.

Kev zom zaub mov. Irbesartan yog metabolized hauv daim siab los ntawm kev sib txuas nrog glucuronic acid thiab oxidation. Nws lub cev metabolite ncig hauv cov ntshav yog irbesartan g.tukuronid (li 6%). Cov kev tshawb fawb Invitro tau qhia tias irbesartan yauv ua kom oxidation feem ntau dhau los ntawm CYP2C9 isoenzyme ntawm cytochrome P450. Cov nyhuv ntawm CYP3A4 isoenzyme yog qhov tsis lees paub.

Hydrochlorothiazide tsis yog metabolized. Nkag tau los ntawm qhov chaw tso cov nyom thiab tso rau hauv niam cov kua mis. Nws tsis tuaj yeem hla cov ntshav-lub hlwb teeb meem.

Chaw Sau Ntawv. Tag nrho kev tshem tawm thiab tshuaj raum yog 157-176 thiab 3.0-3.5 ml / min, feem. T1 / 2 ntawm irbesartan yog 11-15 teev. Irbesartan thiab nws cov metabolites yog tawm hauv cov hnyuv (80%) thiab los ntawm lub raum (20%). tsawg dua 2% ntawm koob tshuaj tiv thaiv irbesartan noj yog raug tawm los ntawm lub raum tsis hloov pauv.

T 1/2 hydrochlorothiazide - 5-15 teev.Nws yog tawm los ntawm lub raum. Qhov tsawg kawg nkaus ntawm 61% ntawm qhov ncauj noj tau pom tsis txawv txav hauv 24 teev.

Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb. Pom ntshav ntau dua me ntsis ntawm irbesartan pom hauv cov neeg mob poj niam. Txawm li cas los xij, kev sib txawv hauv T1 / 2 kev sib txuam ntawm irbesartan tsis tau pom. Irbesartan koob tshuaj hloov kho hauv cov neeg mob poj niam tsis tas yuav.

Cov txiaj ntsig tau qis dua qhov qis-qhov nkhaus-sijhawm (AUC) thiab C max ntawm irbesartan hauv cov ntshav ntshav tau siab dua rau cov neeg laus (laus dua 65 xyoos) dua li cov neeg mob hluas (qis dua 65 xyoos). T 1/2 irbesartan tsis txawv txav. Koob tshuaj hloov kho ntawm irbesartan nyob rau hauv cov neeg laus cov laus tsis tas yuav.

Lub raum khiav tsis zoo: hauv cov neeg mob uas tsis muaj mob raum los yog mob hemodialysis, qhov tsis muaj tshuaj ntawm qhov chaw ntawm lub cev hloov pauv me ntsis.

Lub siab ua haujlwm tsis zoo: hauv cov neeg mob uas muaj lub siab ua haujlwm tsis txaus siab los ntawm mob hnyav lossis mob hnyav, qhov txiav txim ntawm pharmacokinetic ntawm irbesartan tau hloov me ntsis. Hauv cov neeg mob uas muaj lub siab ua haujlwm tsis zoo, tsis muaj kev tshawb nrhiav.

Arterial hypertension (kev kho mob ntawm cov neeg mob uas pom tias kev sib xyaw ua ke).

Dosage regimen thiab cov qauv ntawm kev siv Ibertan ntxiv rau.

Sab hauv, ib hnub ib zaug, tsis hais txog ntawm cov khoom noj. Ibertan Ntxiv 12.5 / 150 mg (cov ntsiav tshuaj muaj hydrochlorothiazide / irbesartan 12. 5/150 mg, feem) tuaj yeem kho rau cov neeg mob uas ntshav siab tsis txaus los ntawm kev teem sijhawm tsuas yog hydrochlorothiazide (12.5 mg / hnub) lossis irbesartan ( 150 mg / hnub) hauv tshuaj tua kab mob. Ibertan Ntxiv 12.5 / 300 mg (ntsiav tshuaj muaj hydrochlorothiazide / nrbesartan 12.5 / 300 mg, feem ntau) tuaj yeem kho rau cov neeg mob yog tias ntshav siab tsis txaus tswj los ntawm irbesartan (300 mg / hnub) lossis Ibertan Plus (12, 5/150 mg).

Ibertan Ntxiv 25-300 mg (ntsiav tshuaj muaj hydrochlorothiazide / irbesartan 25/300 mg, feem) tuaj yeem kho rau cov neeg mob yog tias ntshav siab tsis txaus tswj los ntawm cov thawj coj ntawm Ibertan Plus (12. 5/300 mg). Kev teem caij ntawm cov koob tshuaj ntau dua 25 mg ntawm hydrochlorothiazide / 300 mg ntawm irbesartan 1 zaug hauv ib hnub tsis pom zoo. Yog tias tsim nyog, cov tshuaj Ibertan Plus tuaj yeem kho nyob rau hauv nrog lwm cov tshuaj tiv thaiv antihypertensive.

Lub raum khiav tsis zoo: vim qhov tseeb tias cov tshuaj muaj pes tsawg leeg tshuaj Ibertan Plus suav nrog hydrochlorothiazide. Cov tshuaj tsis pom zoo rau cov neeg mob uas muaj mob tsis zoo rau lub raum (pom kev tsim muaj 30 ml / min. Kev mob siab rau lub siab: kev siv cov tshuaj Ibertan Plus tsis pom zoo rau cov neeg mob uas muaj mob tsis txaus siab rau qhov tsis txaus siab. Cov neeg laus cov neeg laus: tsis tas yuav tsum txhaj tshuaj Ibertan Plus kev kho mob rau cov neeg laus laus. Txo cov ntshav ntim mus los: Nrog Ibertan Plus, nws yog qhov tsim nyog yuav tau kho cov ntim ntawm cov ntshav ntshav thiab / lossis cov ntsiab lus sodium.

Sab sij huam ibertana ntxiv.

Cov kev mob tshwm sim hauv qab no yog muab raws li kev paub qib hauv qab no ntawm qhov muaj ntau zaus ntawm lawv qhov kev tshwm sim: ntau zaus (> 1/10), feem ntau /> 1/100, 1/1 000, 1/10 000, 30 ml / min.

Kev siv cov tshuaj nyob hauv cov menyuam yaus.

Contraindicated rau cov menyuam yaus hnub nyoog qis dua 18 xyoo.

Siv rau cov neeg mob laus.

Tsis tas yuav txhaj koob tshuaj ntawm Ibertan Plus nyob rau cov neeg laus laus yuav tsum tau txhaj.

Cov lus qhia tshwj xeeb rau kev txais neeg kawm ibertana ntxiv.

Cov neeg mob nrog kev mob ntshav hypotension thiab txo qis ntshav cov ntshav ncig: hauv cov neeg mob uas mob ntshav liab, Ibertan Plus tsis tshua muaj tshwm sim ua kom pom kev mob ntshav ntawm lub cev. Cov tsos mob ntawm txoj hlab ntshav liab tuaj yeem pom hauv cov neeg mob uas txo qis ntshav tsawg los yog muaj cov tshuaj sodium tsawg dua thaum siv cov tshuaj diuretic, nrog cov khoom noj uas muaj ntsev ntau, nrog zawv plab lossis ntuav. Cov xwm txheej zoo li no yuav tsum raug kho ua ntej kev kho mob nrog Ibertan Plus pib.

Kev cuam tshuam txog metabolic thiab endocrineCov. Thiazndic diuretics zoo tuaj yeem txo cov piam thaj hauv qab. Hauv cov neeg mob ntshav qab zib, kev kho cov tshuaj insulin lossis cov tshuaj hypoglycemic rau kev tswj hwm ntawm qhov ncauj yuav tsum tau ua. Nrog kev siv ntawm thiazide diuretics, kev txhim kho mob latent mob ntshav qab zib mellitus yog ua tau.

Thaum lub sij hawm kho nrog thiazide diuretics, hyperuricemia lossis exacerbation ntawm gout yuav tshwm sim hauv qee cov neeg mob.

Ua txhaum ntawm cov dej-electrolyte tshuavCov. Thiazide diuretics, suav nrog hydrochlorothiazide. tuaj yeem ua rau tus neeg ua txhaum cov dej-electrolyte tshuav nyiaj (hypokalemia, hyponatremia thiab hypochloremic alkalosis). Txawm hais tias kev txhim kho ntawm hypokalemia ua tau nrog thiazide diuretics, siv cov tshuaj sib xyaw nrog irbesartan tuaj yeem txo hypokalemia los ntawm diuretic. Txoj kev pheej hmoo ntawm hypokalemia tau nce rau hauv cov neeg mob uas tau txais glucocorticosteroids lossis adrenocorticotropic hormone. Ntawm qhov tsis sib xws, ua tsaug rau irbesartan, uas yog ib feem ntawm kev npaj Ibertan Plus, hyperkalemia muaj peev xwm, tshwj xeeb tshaj yog nyob rau ntawm qhov muaj mob raum thiab / lossis lub plawv tsis ua haujlwm lossis ntshav qab zib mellitus. Yuav tsum saib xyuas cov poov tshuaj poov tshuaj ntau ntau hauv cov neeg mob uas yuav kis tau tus mob.

Thiazide diuretics tuaj yeem txo qhov kev nthuav dav ntawm calcium ions los ntawm ob lub raum thiab ua rau muaj kev hloov pauv hypercalcemia thaum tsis muaj qhov tsis txaus ntseeg tias tsis muaj cov calcium metabolism. Kev mob hypercalcemia ntau yuav qhia tias mob latent hyperparathyroidism. Thiazide diuretics yuav tsum tau txiav ua ntej kawm ua haujlwm ntawm parathyroid muaj nuj nqi.

Nws tau qhia tias thiazide diuretics tuaj yeem nce qhov ntxiv ntawm magnesium ions los ntawm ob lub raum, uas tuaj yeem ua rau muaj kev loj hlob ntawm hypomagnesemia.

Renovascular tawgCov. Hauv cov neeg mob uas muaj ob sab lub raum artery stenosis los yog txoj hlab ntshav ntawm lub raum tsuas ua haujlwm raum, thaum noj tshuaj uas cuam tshuam rau RAAS, muaj kev pheej hmoo ntawm kev txhim kho kev mob ntshav qis thiab lub raum tsis ua haujlwm. Txawm hais tias cov ntaub ntawv zoo li no tsis pom thaum siv Ibertan Plus, cov txiaj ntsig zoo li tuaj yeem xav pom thaum lub sijhawm siv angiotensin II receptor antagonists.

Mob raum tsis ua hauj lwm thiab mob tom qab hloov raumCov. Kev siv tshuaj Ibertan Plus nyob rau hauv cov neeg mob uas lub raum lub raum tsis ua haujlwm, kev tshuaj xyuas lub sijhawm ntawm cov ntsiab lus ntawm cov poov tshuaj, creatinine thiab uric acid nyob rau hauv cov ntshav cov ntshav tau qhia. Tsis muaj kev paub nrog kev siv Ibertan Plus hauv cov neeg mob tom qab hloov raum tsis ntev los no.

Aortic lossis mitral valve stenosis, hypertrophic obstructive cardiomyopathyCov. Ib yam li kev siv lwm cov vasodilators, yuav tsum ceev faj thaum sau ntawv rau Ibertan Plus rau cov neeg mob aortic lossis mitral stenosis lossis hypertrophic obstructive cardiomyopathy.

Thawj HyperaldosteronismCov. Cov tshuaj tiv thaiv kev ua qias neeg ua yeeb yam los ntawm kev ua kom tsis txhob muaj cov tshuaj renin-angiotensin-aldosterone feem ntau tsis muaj txiaj ntsig rau cov neeg mob uas muaj hyperaldostronism thawj zaug. Yog li, kev siv tshuaj Ibertan Plus nyob rau hauv cov rooj plaub zoo li no yog impractical.

Doping kev ntsuam xyuas: hydrochlorothiazide tuaj yeem ua rau muaj txiaj ntsig zoo thaum lub sijhawm tswj cov phom sij.

Lwm yamCov. Raws li nrog rau lwm cov tshuaj tiv thaiv kabmob uas cuam tshuam rau renin-angiotensin-aldosterone system, qhov txo qis ntshav siab hauv cov neeg mob mob plawv thiab / lossis atherosclerosis ntawm cov hlab ntsha tuaj yeem ua rau txoj kev loj hlob ntawm myocardial infarction lossis mob stroke. Kev kho mob ntawm cov neeg mob no yuav tsum tau nqa tawm los ntawm iodine nrog kev tswj hwm ntshav siab.

Muaj cov ntawv ceeb toom ntawm kev hnyav lossis exacerbation ntawm cov kab mob lupus erythematosus thaum lub sijhawm teem thiazide diuretics.

Kev cuam tshuam rau lub peev xwm tsav tsheb thiab ua haujlwm nrog cov txheej txheem

Cov txiaj ntsig ntawm Ibertan Plus ntawm kev muaj peev xwm tsav tsheb thiab ua haujlwm uas xav tau kev saib xyuas ntau ntxiv tsis tau kawm. Txawm li cas los xij, thaum lub sijhawm noj cov tshuaj, yuav tsum ceev faj thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem, txij li thaum kho mob kiv taub hau thiab nce zog yuav ua tau.

Noj ntau dhau.

Cov tsos mob (xav tias tsam): irbesartan - lub suab txo qis hauv cov ntshav siab, tachycardia, bradycardia. Hydrochlorothiazide - hypokalemia, hyponatremia, lub cev qhuav dej yog qhov tshwm sim ntawm kev haus dej ntau dhau. Qhov feem ntau pom ntawm kev haus ib ce yog xeev siab thiab nkees nkees. Hypokalemia tuaj yeem ua rau ua rau nrhoo thiab / lossis kev txhim kho kev mob plawv tsis ua haujlwm cuam tshuam nrog kev sib txuas ntawm kev siv cov tshuaj glycosides thiab tshuaj tiv thaiv kab mob tsis xws luag.

Kev Kho Mob: nyob ntawm lub sijhawm elapsed txij li lub sijhawm tswj hwm thiab qhov mob hnyav ntawm cov tsos mob. Cov kev ntsuas pom muaj xws li ntxias cov ntuav thiab / lossis mob plab, siv cov pa roj carbon activated, ua tib zoo saib xyuas tus neeg mob, thiab cov tsos mob thiab txhawb kev kho. Nws yog ib qho tsim nyog los tswj cov kev nkag siab ntawm electrolytes thiab creatinine hauv ntshav ntshav. Thaum muaj kev txhim kho ntawm qhov cim tseg rau hauv cov ntshav siab, tus neeg mob yuav tsum tau pw ntawm nws sab nraub qaum nrog sab hauv qis thiab kom sai li sai tau nqa tawm cov nyiaj them rov qab ntawm ntsev thiab kua dej. Irbesartan tsis raug tawm thaum lub sij hawm hemodialysis.

Kev sib cuam tshuam nrog lwm yam tshuaj.

Lwm cov tshuaj tiv thaiv antihypertensive: cov nyhuv antihypertensive ntawm cov tshuaj Ibertan Plus tuaj yeem txhim kho qhov kev sib txuas ntxiv ntawm lwm cov tshuaj tiv thaiv kev tsis txaus siab. Hydrochlorothiazide thiab irbesartan (hauv kev suav txog 25 mg ntawm hydrochlorothiazide / 300 mg ntawm irbesartan) tuaj yeem siv nrog kev siv tshuaj tiv thaiv lwm yam tshuaj, nrog rau qeeb calcium calcium blockers thiab beta-blockers. Yav dhau los kho nrog cov koob tshuaj diuretics zoo tuaj yeem ua rau xeev siab thiab ua rau muaj kev pheej hmoo ntawm txoj hlab ntshav o.

Lithium: Muaj cov ntawv tshaj tawm txog qhov kev rov qab nce siab hauv cov ntshiab lithium cov tshuaj lom thiab muaj tshuaj lom nrog kev siv cov roj ntsha lithium npaj thiab angiotensin-hloov mus rau enzyme inhibitors. Rau irbesartan, cov teebmeem zoo sib xws tau muaj tsawg kawg hnub. Tsis tas li ntawd, kev ua kom lub ntsej muag ntawm cov roj ntsha lithium poob qis nrog kev siv thiazide diuretics, yog li thaum Ibertan Plus tau raug tshaj tawm, muaj kev pheej hmoo ntawm kev tsim cov tshuaj lom ntawm lithium. Yog tias lub hom phiaj ntawm kev sib xyaw no yog qhov tsim nyog, nws raug nquahu kom ua tib zoo saib xyuas cov roj ntsha lithium hauv cov ntshav cov ntshav.

Cov tshuaj uas cuam tshuam rau cov poov tshuaj hauv cov ntshav: cov nyhuv hypokalemic ntawm hydrochlorothiazide ua kom tsis muaj zog los ntawm cov tshuaj tua ntawm potassium-sparing ntawm irbesartan.Txawm li cas los xij, qhov kev cuam tshuam ntawm hydrochlorothiazide tuaj yeem txhim kho los ntawm lwm cov tshuaj, lub hom phiaj uas cuam tshuam nrog poob ntawm cov poov tshuaj thiab gnococalpemia (piv txwv li diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, salicylic acid derivatives) Ntawm qhov tsis sib xws, raws li kev paub siv cov tshuaj uas txo cov kev ua si angiotensin-aldosterone system, concomitant siv cov potassium-sparing. x dpureshkov. oiologically active additives, hloov ntsev ntsev ntxiv, lossis lwm yam tshuaj uas tuaj yeem ua rau muaj ntau ntxiv cov poov tshuaj poom ntsev (xws li heparin sodium) tuaj yeem ua rau muaj qhov dej ntshiab Katya ntau ntxiv. Nws raug nquahu kom ua tib zoo saib xyuas ntawm cov poov tshuaj poov tshuaj hauv cov neeg mob uas muaj kev pheej hmoo ntawm hyperkalemia.

Cov tshuaj noj uas cuam tshuam los ntawm kev ua txhaum ntawm cov potassium nyob hauv ntshav cov ntshav: Nws raug nquahu kom ua tib zoo saib xyuas cov ntsiab lus ntawm poov tshuaj nyob rau hauv cov ntshav cov ntshav thaum ua Ibertan Plus yog cov tshuaj ua ke nrog cov tshuaj uas cuam tshuam los ntawm kev ua txhaum ntawm kev noj cov poov tshuaj hauv cov ntshav ntshav (piv txwv li, mob glycosides, tshuaj tua kab mob).

Cov tshuaj nonsteroidal anti-inflammatory: thaum sau tshuaj rau angotensin II receptor antagonists ua ke nrog cov tshuaj tsis-steroidal thiab anti-inflammatory tshuaj tiv thaiv (piv txwv, nrog xaiv cyclooxygenase-2 inhibitors (COX-2), acetylsalicylic acid (> 3 g / hnub) thiab tsis xaiv xaiv tsis muaj tshuaj tiv thaiv kev tiv thaiv kab mob), ua kom tsis muaj zog ntawm cov tshuaj tiv thaiv antihypertensive (lub zog) tuaj yeem xav tau. Ib yam li kev siv cov tshuaj mob angiotensin hloov mus rau enzyme inhibitors thiab angiotensin II receptor antagonists txuam nrog NSAIDs, muaj kev pheej hmoo ntawm lub raum lub raum kev ua haujlwm, mus txog rau kev txhim kho ntawm lub raum tsis ua haujlwm, nce ntshav ntau ntxiv, tshwj xeeb tshaj yog nyob rau cov neeg mob uas twb ua tsis tau haujlwm lub raum. Qhov sib xyaw ua ke ntawm cov tshuaj no yuav tsum tau txiav txim nrog ceev faj, tshwj xeeb tshaj yog rau cov neeg laus. Cov neeg mob yuav tsum tsis pub kom lub cev qhuav dej. Kev tswj hwm lub raum yuav tsum tau ua tom qab pib kev sib txuas ua ke thiab ib ntu yav tom ntej.

Cov ntaub ntawv ntxiv ntawm kev sib txuam tshuaj ntawm irbesartan: hydrochlorothiazide tsis cuam tshuam rau pharmacokinetics ntawm irbesartan. Thaum sau tshuaj rau cov tshuaj irbesartan ua ke nrog warfarin, metabolized los ntawm inducers ntawm CYP2C9 isoenzyme, tsis muaj kev cuam tshuam loj ntawm pharmacokinetic thiab pharmacodynamic. Cov nyhuv ntawm CYP2C9 isoenzyme inducers, xws li rifampicin, rau ntawm pharmacokinetics ntawm irbesartan tsis tau raug ntsuas. Nrog rau kev teem caij ntawm irbesartan hauv kev sib xyaw nrog digoxin, cov chaw muag tshuaj ntawm tom kawg tsis hloov.

Cov ntaub ntawv ntxiv txog kev sib txuam tshuaj ntawm hydrochlorothiazide:

Cov tshuaj hauv qab no tuaj yeem cuam tshuam nrog thiazide diuretics thaum muab tshuaj:

Ethanol, barbiturates lossis tshuaj yeeb: nce orthostatic hypotension tau pom.

Catecholamines (piv txwv li, norepinephrine): qhov ua tau zoo ntawm cov tshuaj no tej zaum yuav raug txo kom tsawg.

Kev tsis ua rau cov leeg ua kom mob siab (xws li tubocurarine): hydrochlorothiazide tuaj yeem ua rau muaj kev cuam tshuam los ntawm cov neeg ua kom lub cev tsis xis nyob.

Kev siv tshuaj hypoglycemic (tshuaj tiv thaiv kab mob hauv qhov ncauj thiab insulin): Yuav tsum tau txhaj tshuaj kho cov ntshav hypoglycemic nyob.

Colestyramine thiab colestipol: nyob rau hauv muaj anion txauv resins, nqus ntawm hydrochlorothiazide yog ntxhov. Lub sijhawm nruab nrab ntawm kev noj cov tshuaj no yuav tsum yog tsawg kawg 4 teev.

Glucocorticosteroids, adrenocorticotropic hormone: cim kev ua txhaum ntawm cov dej-electrolyte tshuav nyiaj, tshwj xeeb, kev nce siab hypokalemia.

Cov tshuaj tiv thaiv mob gout: kev kho tshuaj ntau ntawm cov tshuaj siv los kho gout tej zaum yuav tsum tau ua, vim hydrochlorothiazide tuaj yeem nce cov ntsiab lus ntawm uric acid hauv cov ntshav ntshav. Kev nce ntxiv ntawm koob tshuaj probenenide lossis sulfinpyrazone yuav tsum muaj. Co-administration nrog thiazide diuretics tuaj yeem ua rau muaj qhov tshwm sim ntawm kev tsis haum lub cev tsis haum rau allopurinol.

Tshuaj ntsev calcium: thiazide diuretics tuaj yeem nce ntshav plasma calcium vim qhov txo qis hauv nws txoj kev nthuav dav. Yog tias nws yuav tsum tau sau cov tshuaj calcium los yog tshuaj uas cuam tshuam rau cov ntsiab lus calcium (piv txwv li, vitamin D), nws yuav tsum hloov cov tshuaj ntawm cov tshuaj no thiab tswj cov calcium nyob hauv cov ntshav ntshav.

Lwm yam kev sib txuam ntawm yeeb tshuaj: thiazide diuretics tuaj yeem txhim kho cov nyhuv hyperglycemic ntawm beta-blockers thiab diazoxide. Anticholinergics (e.g., atropine) tuaj yeem nce qhov kev siv nyiaj ntawm thiazide diuretics los ntawm kev txo qis plab zom mov thiab lub plab zom cov pa tuaj. Thiazide diuretics tuaj yeem ua rau muaj kev pheej hmoo mob tshwm sim los ntawm amantadine. Thiazide diuretics tuaj yeem txo qhov kev nthuav tawm ntawm cov tshuaj cytotoxic los ntawm lub raum (piv txwv, cyclophosphamide, methotrexate) thiab potentiate lawv cov nyhuv myelosuppressive.

So haujlwm los ntawm cov chaw muag tshuaj.

Cov lus thiab cov xwm txheej ntawm kev cia.

Nyob rau qhov kub thiab txias tsis tshaj 25 ° C. Txhob nyob ze cov me nyuam. Txee lub neej yog 2 xyoos.

Kev siv ntawm cov tshuaj ibertan ntxiv tsuas yog raws li kws kho mob tau sau tseg, cov lus qhia tau muab rau siv!

Cov Yuav Tsum Muaj

- Ua rau lub ntsej muag tsis haum rau lub cev lossis lwm yam tshuaj,

- kev mob tsis haum rau galactose tsis txaus ntseeg, lactase deficiency lossis malabsorption ntawm qabzib thiab galactose,

- lub hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis tau tsim tsa).

Hyponatremia, kev noj zaub mov noj nrog kev txwv ntsev ntau, kev noj qab haus huv ob lub raum txhaws hlab ntsha hauv lub raum los yog lub cev ua haujlwm hauv lub raum, lub cev qhuav dej (suav nrog kev zawv plab, ntuav), kev kho mob diuretic dhau los, kev mob raum tsis ua haujlwm, kev mob ntshav hauv lub cev, mob ntshav qab zib, mob tom qab lub raum hloov pauv (tsis muaj kev soj ntsuam), lub siab ua haujlwm tsis zoo (tsis muaj kev paub txog kev kuaj mob), hyperkalemia, concomitant siv nrog lithium npaj, stenosis ntawm aortic thiab mitral li qub, gy hnoos qeev muaj mob plawv (GOKMP), hyperaldosteronism thawj zaug, mob plawv tsis ua hauj lwm (NYHA chav III-IV ua haujlwm chav), mob plawv (CHD) thiab / lossis kab mob atherosclerotic cerebrovascular, cov neeg mob laus dua 75 xyoo.

Kev piav qhia ntawm qhov kev txiav txim ntawm pharmacological

Antihypertensive tus neeg sawv cev, angiotensin II receptor antagonist. Nws nplov AT1 receptors, uas ua rau txo qis hauv caj ces hauv lub hlwb mob hlwb ntawm angiotensin II, suav nrog vasoconstrictor effect, txhawb kev cuam tshuam rau qhov kev tso tawm ntawm aldosterone thiab ua kom muaj kev cuam tshuam ntawm cov leeg hlwb sympathetic. Raws li qhov tshwm sim, ntshav siab poob qis.

Txo OPSS, txo qis tom qab. Nws txo cov ntshav siab (nrog kev hloov me ntsis hauv lub plawv) thiab nias lub plawv ntsig, thiab txo ntshav siab yog los ntawm koob tshuaj.

Nws tsis cuam tshuam rau qhov kev xav ntawm triglycerides, cov ntsiab lus ntawm cov cholesterol, qabzib, uric acid hauv ntshav ntshav lossis qhov tsis pom ntawm uric acid nyob rau hauv cov zis.

Cov Tshuaj Hauv Tshuaj

Cov lus piav qhia tshwj xeeb thiab tsis meej, txwv cov tshuaj angiotensin II (subtype AT1).

Tshem tawm cov vasoconstrictor nyhuv ntawm angiotensin II, txo qis qhov kev coj ntawm aldosterone hauv plasma, txo OPSS, tom qab ua haujlwm ntawm lub siab, ntshav siab thiab ntshav siab hauv lub ntsws ntsig.

Tsis cuam tshuam rau kinase II (ACE), uas rhuav tshem bradykinin thiab muaj kev koom tes nrog kev tsim cov tshuaj angiotensin II.

Nws ua maj mam, tom qab ib koob tshuaj, cov txiaj ntsig siab tshaj plaws tshwm sim tom qab 3-6 teev.

Antihypertensive nyhuv mob tsawv rau 24 teev.

Nrog rau kev siv tsis tu ncua tsis pub dhau 1-2 lub lis piam, cov nyhuv kis tau ruaj khov thiab nce mus txog qhov siab tshaj plaws tom qab 4-6 lub lis piam

Cov Tshuaj Pharmacokinetics

Tom qab lub qhov ncauj tswj hwm, nws zoo tawm los ntawm cov hnyuv. Cmax ntawm irbesartan hauv ntshav ntshav tau tiav 1.5-2 teev tom qab kev noj haus. Bioavailability yog 60-80%. Noj zaub mov ua ke tsis cuam tshuam rau qhov kev nyab xeeb ntawm cov neeg tsis tuaj yeem.

Plasma protein khi yog li ntawm 96%. Vd - 53-93 liv. Css tau mus txog tsis pub dhau 3 hnub tom qab pib noj cov tshuaj irbesartan 1 zaug / Nrog rov qab siv 1 zaug / muaj kev txwv tsawg ntawm irbesartan hauv ntshav (tsawg dua 20%).

Tom qab lub qhov ncauj tswj hwm ntawm 14C-irbesartan, 80-85% ntawm kev zom zaws hauv cov ntshav ntws mus rau cov ntshav tsis hloov pauv.

Irbesartan yog metabolized hauv daim siab los ntawm kev sib xyaw ua ke rau tsim glucuronide thiab los ntawm oxidation. Lub ntsiab metabolite yog irbesartan glucuronide (li 6%).

Hauv kev kho mob ntau ntxiv, irbesartan yog tus yam ntxwv ntawm cov tshuaj pharmacokinetics, nrog T1 / 2 hauv lub davhlau ya nyob twg yog 11-15 teev .Txhua tag nrho cov tshuaj thiab rho tawm yog 157-176 ml / min thiab 3-3.5 ml / min, feem. Irbesartan thiab nws cov metabolites ua rau cov kua tsib thiab tso zis.

Hauv cov neeg mob uas lub raum ua rau lub raum khiav tsis zoo, mob pes tsawg, mob pes nkees ntawm qhov chaw tsis muaj pauv.

Sab sij huam

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

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

Los ntawm cov kab mob ua pa: ≥1% - sab sauv ntawm txoj hlab ua pa (kub taub hau, thiab lwm yam), mob ntsws, mob ntsws, pharyngitis, rhinitis, hnoos.

Los ntawm cov khoom noj hauv plab: ≥1% - raws plab, xeev siab, ntuav, mob plab zom mov, kub siab.

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

Ua xua: %1% - ua pob.

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

Tsuas tshuaj thiab tswj hwm

Qhov kev pib siv yog 150 mg, yog tias tsim nyog, nce qhov koob tshuaj kom txog 300 mg. Muaj qee kis (noj zaub mov hypochloride, kho mob nrog qee cov diuretics, ua ntej kho mob ntuav lossis raws plab, hemodialysis), qhov pib qis dua yog siv.

Irbesartan tau noj qhov ncauj 1 teev / hnub, nyiam dua tib lub sijhawm ntawm ib hnub.

Kev sib cuam tshuam nrog lwm yam tshuaj

Nrog rau kev siv ua ke nrog cov potassium-sparing diuretics, cov tshuaj poov tshuaj npaj, kev nce siab hauv cov ntsiab lus hauv cov ntshav hauv ntshav yog ua tau.

Nrog rau kev siv tib lub sijhawm nrog hydrochlorothiazide, qhov sib ntxiv ntawm cov nyhuv hypotensive yog manifested.

Nrog tib lub sij hawm siv nrog lithium carbonate, ib qho kev nce ntxiv hauv cov concentration ntawm lithium hauv cov ntshav ntshav yog ua tau.

Nrog rau kev siv tib lub sij hawm ntawm fluconazole tuaj yeem tiv thaiv cov metabolism hauv ntawm irbesartan.

Cov kev ceev faj rau kev siv

Nws siv nrog ceev faj hauv cov neeg mob hyponatremia (kev kho mob nrog diuretics, txwv tsis pub muaj ntsev ntau nrog kev noj zaub mov, raws plab, ntuav), hauv cov neeg mob ntawm hemodialysis (kev txhim kho ntawm cov tsos mob hypotension yog ua tau), zoo li hauv cov neeg mob lub cev qhuav dej.

Kev ceev faj yuav tsum siv lub cev rau cov neeg mob uas kho lub plawv tsis ua haujlwm vim muaj ob leeg lub raum mob ntshav siab los yog lub raum mob ntshav ntawm lub raum ib leeg (muaj kev pheej hmoo ntawm kev mob ntshav siab thiab lub raum tsis ua haujlwm), aortic lossis mitral stenosis, ob leeg mob hypertrophic cardiomyopathy, lub plawv tsis ua haujlwm loj (theem III - IV kev faib tawm) NYHA) thiab mob plawv ua haujlwm (muaj kev pheej hmoo ntawm myocardial infarction, angina pectoris).

Tawm tsam ntawm cov keeb kwm yav dhau los ntawm kev ua haujlwm tsis zoo hauv lub raum, tshuaj xyuas cov poov tshuaj poov tshuaj thiab creatinine qib pom zoo.

Nws tsis pom zoo rau cov neeg mob uas muaj hyperaldosteronism thawj zaug, nrog rau lub raum tsis ua haujlwm loj (tsis muaj kev kuaj mob), hauv cov neeg mob uas nyuam qhuav hloov raum (tsis muaj kev kuaj mob).

Cov lus qhia tshwj xeeb rau kev txais neeg kawm

Hauv kev sim hauv kev sim hauv cov tsiaj txhu, qhov kev hloov ntawm mutagenic, clastogenic, thiab carcinogenic ntawm irbesartan tsis tau tsim.

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

Tsis muaj qhov taw qhia ntawm cov nyhuv ntawm irbesartan ntawm kev muaj peev xwm tsav tsheb thiab kev siv tshuab ua haujlwm.

Zoo tshuaj:

• Berlipril (Berlipril) Cov ntsiav tshuaj ntawm lub qhov ncauj
• Moxogamma (Moxogamma) Qhov ncauj ntsiav tshuaj
• Diacordin 60 (Diacordin 60) Cov ntsiav tshuaj ntawm qhov ncauj
• Captopril-AKOS (Captopril-AKOS) Cov ntsiav tshuaj ntawm lub qhov ncauj
• Moxonitex (Moxonitex) Ntsiav Tshuaj
• Adelphan-Esidrex (Adelphane-Es> Ntsiav Tshuaj
• Captopril (Captopril) Qhov Ncauj Lus
• Valz (tshuaj noj hauv qhov ncauj)
• Valz H (Valz H) Cov ntsiav tshuaj ntawm qhov ncauj
• Moxonidine (Moxon> Qhov Ncauj Tshuaj

** Qhia Txog Kev Siv Tshuaj Kho Mob yog rau cov lus qhia xwb. Xav paub ntau ntxiv, thov hu rau cov khw muag khoom ntim ntawv. Tsis txhob noj tshuaj rau yus tus kheej, ua ntej koj pib siv Ibertan, koj yuav tsum sab laj nrog kws kho mob. EUROLAB tsis yog lub luag haujlwm rau lub txim vim tshwm sim los ntawm kev siv cov ntaub ntawv tshaj tawm ntawm lub portal. Txhua yam ntaub ntawv ntawm lub vev xaib tsis hloov cov kws kho mob cov lus qhia thiab tsis tuaj yeem ua lub luag haujlwm ntawm lub luag haujlwm zoo ntawm cov tshuaj.

Txaus siab rau Ibertan? Koj puas xav paub cov ncauj lus ntxaws ntxaws lossis koj puas xav ntsib kws kho mob? Lossis koj puas xav tau tshuaj xyuas? Koj ua tau teem sijhawm nrog tus kws kho mob - chaw kho mob Euro lab ib txwm nyob ntawm koj qhov kev pabcuam! Cov kws kho mob zoo tshaj plaws yuav tshuaj xyuas koj, tawm tswv yim, muab kev pabcuam tsim nyog thiab ua kev kuaj mob. Koj tuaj yeem ua tau hu kws kho mob tom tsevCov. Chaw Kho Mob Euro lab qhib rau koj ib ncig ntawm lub moos.

** Mloog! Cov lus qhia hauv phau ntawv qhia tshuaj no yog npaj rau cov kws kho mob thiab tsis yog lub hauv paus rau kev siv tus kheej. Cov lus piav qhia txog cov tshuaj Ibertan tau muab rau cov ntaub ntawv thiab tsis yog tsim los rau kev kho mob yam tsis muaj kev koom tes los ntawm kws kho mob. Cov neeg mob xav tau tswv yim tshwj xeeb!

Yog tias koj txaus siab rau lwm yam tshuaj thiab cov tshuaj, lawv cov lus piav qhia thiab cov lus qhia rau kev siv, cov lus qhia txog kev tsim thiab cov qauv ntawm kev tso tawm, qhia txog kev siv thiab kev phiv, txoj kev siv, nqi thiab tshuaj xyuas cov tshuaj, lossis koj puas muaj ib yam lwm cov lus nug thiab cov lus qhia - sau ntawv rau peb, peb yuav sim pab koj.

Tso cov ntaub ntawv thiab cov nyob ua ke

Koj tuaj yeem tuaj yeem yuav tus neeg sawv cev tiv thaiv kab mob hauv cov yeeb yaj kiab-ntim cov ntsiav tshuaj. Txoj haujlwm ua ntawm cov tshuaj nquag yog irbesartan. Cov cuab yeej yog ib qho-tivthaiv, uas txhais tau tias qhov sib txuas ntxiv hauv cov lus tsis qhia cov haujlwm antihypertensive. Cov concentration ntawm irbesartan hauv 1 ntsiav tshuaj: 75, 150 thiab 300 mg. Koj tuaj yeem yuav cov khoom hauv cov hlwv (14 pcs.). Lub thawv ntawv thawv muaj 2 lub pob ntawv me.

Pharmacological kev txiav txim

Cov tshuaj muab cov nyhuv hypotensive. Cov khoom tseem ceeb hauv nws cov muaj pes tsawg leeg ua cov receptor antagonist. Qhov no txhais tau hais tias irbesartan cuam tshuam nrog kev txiav txim ntawm angiotensin II receptors, uas pab ua kom muaj kev cuam tshuam vascular phab ntsa hauv suab (txo qhov tshem ntawm cov leeg, hlab ntsha). Raws li qhov tshwm sim, tus nqi ntawm cov ntshav ntws poob qis me ntsis.

Kev ua haujlwm ntawm hom 2 angiotensin tsis yog tsuas yog txoj kev nqaim ntawm cov hlab ntsha nrog rau qhov nce ntxiv ntawm kev nyuaj siab, tab sis kuj yog txoj cai ntawm platelet aggregation thiab lawv cov adhesion. Kev sib cuam tshuam ntawm cov txais thiab cov tshuaj no los tiv thaiv kev tsim cov nitric oxide, uas yog vasorelaxating tau. Hauv qab ntawm Ibertan, cov txheej txheem piav qhia tau qeeb.

Tsis tas li ntawd, muaj qhov txo qis ntawm kev nyeem ntawm aldosterone. Qhov no yog cov tshuaj hormones ntawm pab pawg mineralocorticoid. Nws yog tsim los ntawm adrenal cortex.Nws lub luag haujlwm tseem ceeb yog kev tswj hwm kev thauj los ntawm sodium thiab potassium cations thiab chlorine anions. Qhov cov tshuaj no txhawb rau cov cuab yeej ntawm cov ntaub so ntswg ua hydrophilicity. Aldosterone yog ua ke nrog kev koom tes ntawm hom 2 angiotensin. Yog li, nrog ib qho kev txo qis hauv kev ua si ntawm tom kawg, txoj haujlwm ntawm thawj ntawm cov tshuaj hormones yog suppressed.

Cov tshuaj muab cov nyhuv hypotensive.

Txawm li cas los xij, tsis muaj ib qho kev cuam tshuam zoo rau kinase II, uas koom nrog kev rhuav tshem cov bradykinin thiab ua rau muaj kev tsim cov hom 2 angiotensin. Irbesartan tsis muaj kev cuam tshuam tseem ceeb rau lub plawv dhia. Raws li qhov tshwm sim, txoj kev pheej hmoo ntawm cov teeb meem los ntawm cov hlab plawv tsis nce ntxiv. Nws raug sau tseg tias cov khoom siv hauv cov lus nug tsis cuam tshuam rau kev tsim cov roj triglycerides, cov roj (cholesterol).

Nrog saib xyuas

Ib tug xov tooj ntawm cov txheeb ze contraindications raug sau tseg, nyob rau hauv uas nws yog qhov yuav tsum tau ua kom pom kev mloog ntxiv, suav nrog:

• ua txhaum ntawm kev thauj mus los ntawm sodium cations,
• ntsev tsis muaj zaub mov noj
• lub raum khiav tsis zoo, tshwj xeeb, qhov nqaim ntawm lub lumen ntawm lub raum leeg,
• kev nrawm nrawm kev tshem tawm cov kua hauv lub cev, nrog rau kev mob pathological, nrog ntuav, zawv plab,
• tsis ntev los no siv ntawm thiazide diuretics,
• lub sij hawm rov qab tom qab lub raum hloov,
• Kev ua kom qeeb los ntawm cov ntshav hla ntawm cov caj ces, aortic li qub, uas tuaj yeem tshwm sim los ntawm stenosis,
• tib lub sij hawm siv nrog kev npaj muaj lithium,
• cov kab mob endocrine cuam tshuam nrog cuam tshuam aldosterone synthesis,
• atherosclerotic hloov hauv hlab ntsha hlwb,
• kab mob ntawm cov hlab plawv: ischemia, tsis txaus ntawm kev ua haujlwm ntawm cov khoom no.

Nrog kev ceev faj, cov tshuaj yog tawm rau cov kab mob ntawm cov hlab plawv.

Yuav ua li cas noj Ibertan?

Thaum pib theem ntawm kev kho, qhov tshuaj ntawm irbesartan yog tsawg heev (150 mg). Tshaj tawm ntawm kev pub nkag - 1 zaug nyob rau ib hnub. Cov tshuaj tuaj yeem noj ntawm lub plab khoob, thaum lub sijhawm lossis tom qab noj mov. Txawm li cas los xij, hauv qee kis, qhov kev siv tshuaj ntau dua yuav tsum muaj - txog 75 mg rau ib hnub. Qhov taw qhia rau qhov no yog lub cev qhuav dej, qhov txo qis hauv cov ntshav ntawm cov ntshav mus ncig, kev noj tshuaj uas pab txhawb lub cev kom tsis ua kua, thiab kom tsis muaj ntsev noj.

Yog tias lub cev ua tsis zoo rau qhov kev siv tshuaj tsawg kawg nkaus, ces tus nqi ntawm irbesartan tau nce rau 300 mg rau ib hnub. Nws tau sau tseg tias kev noj tshuaj ntau dua ntawm 300 mg tsis nce qhov kev cuam tshuam antihypertensive ntawm cov tshuaj. Thaum hloov qhov ntau ntawm cov tshuaj nce siab, so yuav tsum tswj xyuas (txog 2 lub lis piam).

Kev kho mob ntawm nephropathy: cov tshuaj yog kho 150 mg ib hnub. Yog tias tsim nyog, qhov koob tshuaj ntawm cov tshuaj nquag raug nce ntxiv rau 300 mg (tsis pub ntau tshaj 1 zaug hauv ib hnub).

Yuav siv li cas: noj ntau thiab hom tshuaj kho

Sab hauv, 1 zaug hauv ib hnub, tsis hais txog ntawm cov khoom noj, ntxuav nrog dej.

Feem ntau cov kev pom zoo kom pib thiab txij nkawm cov koob tshuaj yog 150 mg ib hnub ib zaug. Cov neeg mob lub cev qhuav dej, nrog lub cev txo qis ntawm cov ntshav (BCC) (nrog rau mob raws plab, ntuav), nrog hyponatremia, thaum kho nrog diuretics lossis noj zaub mov nrog kev noj tsawg sodium sodium, lossis rau hemodialysis, lossis cov neeg mob hnub nyoog laus dua 75 xyoo pom zoo kom pib siv tshuaj - 75 mg rau ib hnub.

Nrog rau qhov tsis txaus ntseeg ntawm kev kho cov nyhuv, qhov koob tshuaj tau nce rau 300 mg rau ib hnub. Ib qho kev nce ntxiv ntawm koob tshuaj nrog rau ncua sijhawm 1-2 lub lis piam (ntau dua 300 mg ib hnub) tsis nce qhov hnyav ntawm cov nyhuv hypotensive. Yog tias tsis muaj tshwm sim thaum lub sij hawm monotherapy, kev sib xyaw nrog lwm cov tshuaj tiv thaiv kev tiv thaiv kab mob, piv txwv li, nrog cov koob tshuaj diuretics tsawg (hydrochlorothiazide), ua tau.

Txog kev kho mob nephropathy, cov neeg mob ntshav siab thiab mob ntshav qab zib hom 2 ntshav qab zib mellitus raug pom zoo kom pib siv Ibertan 150 mg ib hnub ib zaug, yog tias qhov kev kho mob tsis txaus, qhov tshuaj tuaj yeem nce (nrog lub sijhawm ntawm 2 lub lis piam) txog 300 mg ib zaug ib hnub.

Cov neeg mob uas lub raum tsis ua hauj lwm tsis tas yuav mus txhaj tshuaj.

Cov neeg mob uas muaj lub siab ua haujlwm tsis txaus siab hloov kho me me mus rau qhov hnyav hnyav tsis tas yuav tsum ua kom haum. Tsis muaj kev sim kho mob nrog cov neeg mob uas muaj lub siab ua haujlwm tsis zoo.

Ibertan - cov lus qhia rau kev siv, nqi, xyuas

Nyob rau hauv pem hauv ntej ntawm koj yog cov ntaub ntawv hais txog kev npaj Ibertan - qhov kev qhia yog qhia nyob rau hauv kev txhais lus pub dawb thiab muab tso rau ib leeg rau kev paub. Cov lus tshaj tawm hauv peb lub vev xaib tsis yog vim li cas rau kev siv tshuaj rau tus kheej.

Chaw tsim tshuaj paus: Polpharma S.A. Zaklady Farmaceutyczne SA, PL

Yam tshuaj muaj yees
Chav kawm ntawm cov kab mob

• Qhov tseem ceeb ntawm Ib Ce tawg
• Thib Ob kub siab

Cov chaw soj ntsuam thiab chaw muag tshuaj

• Tsis teev. Saib cov lus qhia

Pharmacological kev txiav txim
Pharmacological pawg

• Angiotensin II receptor antagonists (AT1 subtype)

Kev cuam tshuam nrog lwm yam tshuaj

Nrog rau kev siv ua ke nrog cov potassium-sparing diuretics, cov tshuaj poov tshuaj npaj, kev nce siab hauv cov ntsiab lus hauv cov ntshav hauv ntshav yog ua tau.

Nrog rau kev siv tib lub sijhawm nrog hydrochlorothiazide, qhov sib ntxiv ntawm cov nyhuv hypotensive yog manifested. Nrog tib lub sij hawm siv nrog lithium carbonate, ib qho kev nce ntxiv hauv cov concentration ntawm lithium hauv cov ntshav ntshav yog ua tau.

Nrog rau kev siv tib lub sij hawm ntawm fluconazole tuaj yeem tiv thaiv cov metabolism hauv ntawm irbesartan.

Nws siv nrog ceev faj hauv cov neeg mob hyponatremia (kev kho mob nrog diuretics, txwv tsis pub muaj ntsev ntau nrog kev noj zaub mov, raws plab, ntuav), hauv cov neeg mob ntawm hemodialysis (kev txhim kho ntawm cov tsos mob hypotension yog ua tau), zoo li hauv cov neeg mob lub cev qhuav dej.

Kev ceev faj yuav tsum siv lub cev rau cov neeg mob uas kho lub plawv tsis ua haujlwm vim muaj ob leeg lub raum mob ntshav siab los yog lub raum mob ntshav ntawm lub raum ib leeg (muaj kev pheej hmoo ntawm kev mob ntshav siab thiab lub raum tsis ua haujlwm), aortic lossis mitral stenosis, ob leeg mob hypertrophic cardiomyopathy, lub plawv tsis ua haujlwm loj (theem III - IV kev faib tawm) NYHA) thiab mob plawv ua haujlwm (muaj kev pheej hmoo ntawm myocardial infarction, angina pectoris). Tawm tsam ntawm cov keeb kwm yav dhau los ntawm kev ua haujlwm tsis zoo hauv lub raum, tshuaj xyuas cov poov tshuaj poov tshuaj thiab creatinine qib pom zoo.

Nws tsis pom zoo rau cov neeg mob uas muaj hyperaldosteronism thawj zaug, nrog rau lub raum tsis ua haujlwm loj (tsis muaj kev kuaj mob), hauv cov neeg mob uas nyuam qhuav hloov raum (tsis muaj kev kuaj mob).

Irbesartan: analogues, cov lus qhia rau kev siv, nqi thiab tshuaj xyuas

Kev mob ntshav siab tas li, txwv tsis pub ntshav siab yog ib qho ntawm cov kabmob tshwm sim ntawm peb lub sijhawm. Nws tsis muaj hnub nyoog los yog poj niam txiv neej. Tus kabmob muaj plaub theem ntawm kev loj hlob, txhua tus sib raug rau kev kho nws tus kheej. Irbesartan yog ib qho ntawm cov tshuaj uas pab tiv thaiv kev kub siab thiab tswj kev noj qab haus huv.

Cov lus qhia rau kev siv, tus nqi thiab tshuaj xyuas ntawm hloov Irbesartan nrog cov khoom lag luam pheej yig, nyeem hauv qab no.

Daim ntawv thov rau lub raum khiav tsis zoo

Cov raum tsis ua hauj lwm tsis yog qhov laj thawj los mus txiav txoj kev kho. Thaum noj tshuaj tiv thaiv cov keeb kwm yav dhau los ntawm tus kab mob pathological no, yuav tsum ceev faj.

Kev txhim kho ntawm lub siab me mob pathologies tsis yog ib qho laj thawj rau kev tshem tawm tshuaj.

Ibertan Kev Tsiv Hla

Feem ntau, cov neeg mob txo qis ntshav siab, tsawg dua qhov kev txhim kho ntawm tachycardia. Hauv cov xwm txheej cais, cov tsos mob tshwm sim ntawm bradycardia tshwm sim. Txo cov kev siv ntawm qhov tshwm sim tsis zoo yuav pab txhim kho lub plab zom mov, kev teem caij ua haujlwm ntawm sorbents (muab tias cov tshuaj nyuam qhuav noj). Txhawm rau tshem tawm cov tsos mob ntawm ib tus neeg, cov tshuaj tshwj xeeb muaj ntawv sau tseg, piv txwv li, yuav ua kom lub plawv atherosclerosis, qib siab.

Cawv tau zoo

Muab hais tias ethanol ua rau muaj kev nthuav dav ntawm cov hlab ntshav, nws tsis pom zoo kom siv cov cawv uas muaj cawv thaum kho nrog Ibertan. Hauv qhov no, qhov kev ua los tiv thaiv kev tiv thaiv ntawm cov tshuaj nce.

Muab hais tias ethanol ua rau muaj kev nthuav dav ntawm cov hlab ntshav, nws tsis pom zoo kom siv cov cawv uas muaj cawv thaum kho nrog Ibertan.

Cov kev xaiv raug rau kev hloov cov tshuaj hauv cov lus nug:

• Irbesartan
• Irsar
• Aprovel
• Telmisartan.

Thawj txoj kev xaiv yog kev hloov ncaj qha rau Ibertan. Cov cuab yeej no muaj cov khoom siv tib yam. Nws qhov ntau npaum li cas yog 150 thiab 300 mg hauv 1 ntsiav tshuaj. Raws li cov ntsiab lus tseem ceeb, Irbesartan tsis txawv ntawm Ibertan.

Irsar yog lwm qhov tshuaj ntawm cov tshuaj hauv nqe lus nug. Nws tsis txawv hauv cov muaj pes tsawg leeg, kev haus tshuaj ntawm cov tshuaj nquag, ntsuas thiab contraindications. Cov nyiaj no suav nrog tib qho nqi. Lwm qhov hloov chaw (Aprovel) raug nqi me ntsis ntxiv (600-800 rubles). Daim ntawv tso tawm - ntsiav tshuaj. Hauv 1 pc muaj 150 thiab 300 mg ntawm irbesartan. Raws li, cov tshuaj yeeb tshuaj kuj tuaj yeem ua tau kom txhob siv cov tshuaj hauv cov lus nug.

Telmisartan muaj cov khoom siv sib xyaw nrog tib lub npe. Nws cov nyiaj yog 40 thiab 80 mg hauv 1 ntsiav tshuaj. Lub hauv paus ntsiab lus ntawm kev ua yeeb tshuaj yog ua raws kev thaiv ntawm kev ua haujlwm ntawm cov neeg txais kev cuam tshuam nrog angiotensin II. Raws li qhov tshwm sim, txo qis hauv kev siab tau sau tseg. Yog li, raws li cov txheej txheem ntawm kev txiav txim, Telmisartan thiab cov tshuaj hauv cov lus nug zoo sib xws. Kev qhia rau kev siv: kev kub siab, kev tiv thaiv ntawm kev txhim kho ntawm cov teeb meem (suav nrog kev tuag) hauv cov kab mob ntawm cov hlab plawv.

Telmisartan muaj ntau yam sib kis. Kev txwv tsis pub siv cov tshuaj no thaum cev xeeb tub, lactation, hauv menyuam yaus, nrog kev ua txhaum ntawm txoj cai biliary, daim siab yog sau tseg. Nws tsis pom zoo kom muab nws sib xyaw nrog cov tshuaj los ntawm cov pab pawg ntawm angiotensin-hloov enzyme inhibitors. Ntawm cov peev nyiaj tau txiav txim siab, Telmisartan tsuas yog kev hloov pauv uas tuaj yeem siv hloov chaw ntawm Ibertan, tau muab qhov ntawd nkag rau lub zog tsis haum yog irbesartan.

Muaj pes tsawg leeg thiab lub zog

Cov nyhuv antihypertensive ntawm cov tshuaj muab cov eponymous lub ntsiab tivthaiv. Irbesartan yog ib qho inhibitor ntawm cov tshuaj hormones angiotensin, uas ua rau voos voos txhav.

Kev ua haujlwm ntawm irbesartan yog los txhawm rau cov nyhuv vasoconstrictor thiab txo cov load ntawm lub siab. Cov tshuaj yog tsim rau kev siv mus sij hawm ntev. Qhov siab tshaj plaws tau tshwm sim ntawm 4-5 teev tom qab noj tshuaj.

Cov nyhuv mob tsawv thoob plaws ib hnub. Tom qab 10-14 hnub ntawm kev nquag ua haujlwm, kev ua kom pom tseeb yog ua tiav.

Cov tshuaj cuam tshuam sai sai los ntawm txoj hnyuv hauv lub plab. Tus nqi ntawm cov tshuaj yeeb tshuaj kom ncav cuag qhov chaw tam sim ntawm kev txiav txim ncav 80%. Qhov siab tshaj plaws hauv cov ntshav tau pom ob xuaj moos tom qab noj tshuaj. Irbesartan tsis zwm rau hauv lub cev, txheej txheem kev tshem tawm yog nqa los ntawm lub siab txog li 80%, qhov seem yog dhau los ntawm lub raum.

Kev taw qhia thiab contraindications

Cov tshuaj yog siv los kho qhov tseem ceeb (mob ntev) ntshav siab. Tshuaj zoo rau kev kho mob ntshav siab ua ke nrog mob raum mob ntshav qab zib hauv ntshav qab zib (mob ntshav qab zib nephropathy).

Irbesartan kev kho mob tsis yog raws li txoj cai hauv qab no:

• lub sijhawm uas xeeb menyuam thiab kev pub niam mis,
• siab rhiab heev rau cov khoom xyaw tshuaj,
• cov mob muaj keeb muaj qhov tsis haum ntawm monosaccharides nyob rau hauv lub plab zom mov (glucose-galactose malabsorption),
• hnub nyoog me (muaj txog 18 xyoo).

Ceev faj yog qhov tsim nyog thaum kho tshuaj yog tias tus neeg mob muaj cov kab mob no:

• nqaim ntawm lumen (stenosis) ntawm aortic valve,
• mob plawv decompensation,
• lub cev qhuav dej
• muaj zog sodium siab hauv lub cev,
• nqaim ntawm lub raum leeg,
• lub plab zom mov.

Rau cov neeg mob hnub nyoog 75+, tsis muaj tshuaj kho.

Nws tsis xav kom siv cov tshuaj rau hepatic decompensation, vim tias tsis muaj cov ntaub ntawv tshuaj.

Daim ntawv tso tawm thiab ntau npaum li cas

Cov tshuaj muaj nyob hauv ntsiav tshuaj daim ntawv ntawm 75, 150, 300 mg.

Kev tswj hwm tus qauv pib nrog ib koob tshuaj 150 mg. Nyob ntawm seb tus neeg mob lub cev, ntau npaum li cas ntxiv tau nce rau 300 mg, lossis txo mus rau 75 mg. Rau cov neeg mob raum, mob siab hloov kho pib ntawm 75 mg.

Qhov kev kho mob yog nyob rau hauv kev saib xyuas cov ntshav siab tas li.

Nta

Cov tshuaj muaj cov kev mob tshwm sim, los ntawm cov tsos mob hauv qab no:

Normodipine thiab analogues ntawm cov tshuaj.

• qaug zog thiab kiv taub hau,
• txhob lam npau taws,
• lub plawv dhia (tachycardia),
• paroxysmal hnoos
• lub plab zom mov (raws plab, mob plab zom mov),
• kev fab tshuaj tsis haum
• mob leeg
• ua txhaum ntawm kev ua haujlwm erectile rau tus txiv neej.

Hauv cov neeg mob ntshav qab zib nephropathy, txo qis ntshav hauv cov ntshav ntshav yog qhov ua tau.

Cov nyhuv ntawm cov tshuaj tau txhim kho kom zoo dua qub nrog kev siv tshuaj diuretics thiab lwm yam tshuaj noj kom ntshav qis.

Thaum noj ua ke nrog cov tshuaj potassium, qhov kev pheej hmoo ntawm kev txhim kho hyperkalemia nce.

Kev cuam tshuam nrog cov tshuaj tsis-tshuaj steroidal cuam tshuam tsis zoo rau lub raum kev ua haujlwm.

Kev noj tshuaj ntau dhau yog ib qho ua rau muaj kev phom sij rau lub siab. (tachycardia, bradycardia).

Irbesartan yog tsim los ntawm Kern Pharma S.L. (Spain). Tus nqi ntawm kev ntim yog 350 rubles.

Hloov chaw kho mob tuaj yeem ua qhov chaw sib txawv nrog irbesartan. Txij li cov lus qhia rau kev siv yog tib yam, feem ntau xws li cov tshuaj thiab cov tshuaj raws li amlodipine siv.

Muaj nyob hauv ntsiav tshuaj daim ntawv. Cov khoom xyaw pabcuam yog: ntsev ntsev ntawm magnesium thiab stearic acid, silicon dioxide, lactose, cellulose, croscarmellose sodium, hypromellose. Cov tshuaj muaj tib lub zog ib yam li Irbesartan.

Nws yog siv los kho thawj theem thib ob thiab qib ntshav siab, thiab kho mob ntshav siab hauv ntshav qab zib. Kev kho mob pib nrog qhov tsawg kawg yog 150 mg, thaum tsis muaj qhov zoo ntawm qhov muaj zog, qhov ntau npaum yog ob npaug.

Cov analogue txawv ntawm tus thawj hauv qhov ntawd cov neeg mob raum tsis xav tau kev hloov koob tshuaj. Lub chaw tsim khoom yog lub tuam txhab Fabkis Sanofi-Winthrop Industrie. Tus nqi yog los ntawm 350 txog 700 rubles, nyob ntawm qhov ntim.

Cov tshuaj Lavxias, qhov tseeb tshaj plaws ntawm Ibersartan.

Nws muaj cov cim qhia tau zoo ib yam, contraindications thiab cov kev mob tshwm sim. Nws yog tawm hauv cov tshuaj ntau npaum li daim tseem. Tsim Los Ntawm Canonfarm Ntau Lawm CJSC.

Tus nqi ntawm cov tshuaj yog 250 rubles.

Cov tshuaj tsis txawv hauv cov tshuaj pharmacological los ntawm Irbesartan.

Muaj nyob hauv ntsiav tshuaj daim ntawv. 75 mg ntsiav tshuaj Teem lub sij hawm thiab muab tshuaj rau cov thawj.

Cov tshuaj yog tsim hauv tebchaws Poland, los ntawm cov chaw siv tshuaj cog tshuaj ntawm Polpharma S.A. Tus nqi yog li 200 rubles.

Cov tshuaj pharmacokinetics thiab cov teebmeem ntawm cov tshuaj yog zoo tib yam rau thawj. Nws yog tshuaj hauv qhov ntau npaum ntawm 150 mg. Thaum tsis muaj cov tshuaj kho, qhov tshuaj tau nce ntxiv rau 300 mg. Cov neeg mob raum lub ntsws cov ntshav tau pom zoo kom pib kho nrog 75 mg. Cov tshuaj yog tsim los ntawm KRKA d.d. (Slovenia). 150 mg ntsiav tshuaj

Irbesartan thiab nws cov analogues feem ntau zoo tiv thaiv los ntawm cov neeg mob. Yog tias cov koob tshuaj uas kws kho mob tau sau tseg yuav pom, cov kev mob tshwm sim tsis tshua muaj tshwm sim. Cov tshuaj yog siv hauv kev kho mob thiab plawv plawv.

Niam yog 60 xyoo. Nws tau raug mob ntshav siab txog 10 xyoo. Kuv tau sim siv tshuaj sib txawv, tab sis cov kev mob tshwm sim tas li. Tus kws kho mob tau sau ntawv rau Irbesartan, tab sis ceeb toom tias cov tshuaj yuav tsum noj ntev ntev. Cov cuab yeej no zoo meej rau niam. Tsis muaj "phiv". Nws tau noj rau ob lub hlis, lub siab tau ruaj khov.

Nrog lub hnub nyoog, Kuv pib ua qhov tsis txaus ntseeg, tsis hnov ​​suab hauv kuv lub pob ntseg, thiab mob taub hau. Tus kws kho mob qhia Fabkis Aprovel.Cov tshuaj tau pab kuv zoo, tab sis tus nqi kuj nce siab. Muab hais tias nws yog qhov tsim nyog los haus nws nyob rau qhov txuas ntxiv, Kuv tau thov kom hloov nws nrog ib qho Lavxias zoo sib xws. Tam sim no kuv haus Irsar. Tsis muaj qhov sib txawv hauv kev hnov, tab sis nws raug nqi tsawg dua.

Irbesartan categorically tsis haum kuv. Tom qab txais tos, kuv lub siab pib tawv. Tus mob tsis zoo, tab sis zuj zus. Kuv yuav tsum tau hloov nws nrog lwm qhov, zoo tshuaj rau kuv.

Ibertan Ntxiv

Lwm cov tshuaj tiv thaiv antihypertensive: cov nyhuv antihypertensive ntawm cov tshuaj Ibertan Plus tuaj yeem txhim kho qhov kev sib txuas ntxiv ntawm lwm cov tshuaj tiv thaiv kev tsis txaus siab.

Hydrochlorothiazide thiab irbesartan (hauv kev suav txog 25 mg ntawm hydrochlorothiazide / 300 mg ntawm irbesartan) tuaj yeem siv nrog kev siv tshuaj tiv thaiv lwm yam tshuaj, nrog rau qeeb calcium calcium blockers thiab beta-blockers.

Yav dhau los kho nrog cov koob tshuaj diuretics zoo tuaj yeem ua rau xeev siab thiab ua rau muaj kev pheej hmoo ntawm txoj hlab ntshav o.

Lithium: Muaj cov ntawv tshaj tawm txog qhov kev rov qab nce siab hauv cov ntshiab lithium cov tshuaj lom thiab muaj tshuaj lom nrog kev siv cov roj ntsha lithium npaj thiab angiotensin-hloov mus rau enzyme inhibitors. Rau irbesartan, cov teebmeem zoo sib xws tau muaj tsawg kawg hnub.

Tsis tas li ntawd, kev ua kom lub ntsej muag ntawm cov roj ntsha lithium poob qis nrog kev siv thiazide diuretics, yog li thaum Ibertan Plus tau raug tshaj tawm, muaj kev pheej hmoo ntawm kev tsim cov tshuaj lom ntawm lithium.

Yog tias lub hom phiaj ntawm kev sib xyaw no yog qhov tsim nyog, nws raug nquahu kom ua tib zoo saib xyuas cov roj ntsha lithium hauv cov ntshav cov ntshav.

Cov tshuaj uas cuam tshuam rau cov poov tshuaj hauv cov ntshav: cov nyhuv hypokalemic ntawm hydrochlorothiazide ua kom tsis muaj zog los ntawm cov tshuaj tua ntawm potassium-sparing ntawm irbesartan.

Txawm li cas los xij, qhov kev cuam tshuam ntawm hydrochlorothiazide tuaj yeem txhim kho los ntawm lwm cov tshuaj, lub hom phiaj uas cuam tshuam nrog poob ntawm cov poov tshuaj thiab gnococalpemia (piv txwv li diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, salicylic acid derivatives) Ntawm qhov tsis sib xws, raws li kev paub siv cov tshuaj uas txo cov kev ua si angiotensin-aldosterone system, concomitant siv cov potassium-sparing. oiologically active additives, hloov ntsev ntsev ntxiv, lossis lwm yam tshuaj uas tuaj yeem ua rau muaj ntau ntxiv cov poov tshuaj poom ntsev (xws li heparin sodium) tuaj yeem ua rau muaj qhov dej ntshiab Katya ntau ntxiv. Nws raug nquahu kom koj saib xyuas cov poov tshuaj poov tshuaj zoo rau hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev mob hyperkalemia.

Cov tshuaj noj uas cuam tshuam los ntawm kev ua txhaum ntawm cov potassium nyob hauv ntshav cov ntshav: Nws raug nquahu kom ua tib zoo saib xyuas cov ntsiab lus ntawm poov tshuaj nyob rau hauv cov ntshav cov ntshav thaum muab tshuaj rau Ibertan Plus hauv kev sib xyaw nrog cov tshuaj uas cuam tshuam los ntawm kev ua txhaum ntawm cov potassium nyob hauv ntshav cov ntshav (piv txwv li, mob plawv glycosides, tshuaj tiv thaiv kab mob).

Cov tshuaj nonsteroidal anti-inflammatory: thaum sau tshuaj rau angotensin II receptor antagonists ua ke nrog cov tshuaj tsis haum tshuaj tiv thaiv kab mob thiab siv tshuaj tiv thaiv kab mob (piv txwv, nrog tshuaj cyclooxygenase-2 inhibitors (COX-2), acetylsalicylic acid (> 3 g / hnub) thiab tsis xaiv tshuaj tsis xeb tshuaj tiv thaiv kev tiv thaiv kab mob), ua rau cov tshuaj tiv thaiv tsis muaj zog tuaj yeem tsis tuaj yeem. Ib yam li kev siv cov tshuaj mob angiotensin hloov mus rau enzyme inhibitors thiab angiotensin II receptor antagonists txuam nrog NSAIDs, muaj kev pheej hmoo ntawm lub raum lub raum kev ua haujlwm, mus txog rau kev txhim kho ntawm lub raum tsis ua haujlwm, nce ntshav ntau ntxiv, tshwj xeeb tshaj yog nyob rau cov neeg mob uas twb ua tsis tau haujlwm lub raum. Qhov sib xyaw ua ke ntawm cov tshuaj no yuav tsum tau txiav txim nrog ceev faj, tshwj xeeb tshaj yog rau cov neeg laus. Cov neeg mob yuav tsum tsis pub kom lub cev qhuav dej. Kev tswj hwm lub raum yuav tsum tau ua tom qab pib kev sib txuas ua ke thiab ib ntu yav tom ntej.

Cov ntaub ntawv ntxiv ntawm kev sib txuam tshuaj ntawm irbesartan: hydrochlorothiazide tsis cuam tshuam rau pharmacokinetics ntawm irbesartan.

Thaum sau tshuaj rau cov tshuaj irbesartan ua ke nrog warfarin, metabolized los ntawm inducers ntawm CYP2C9 isoenzyme, tsis muaj kev cuam tshuam loj ntawm pharmacokinetic thiab pharmacodynamic.

Cov nyhuv ntawm CYP2C9 isoenzyme inductors, xws li rifampicin, rau ntawm pharmacokinetics ntawm irbesartan tsis tau raug ntsuas. Nrog rau kev teem caij ntawm irbesartan hauv kev sib xyaw nrog digoxin, cov chaw muag tshuaj ntawm tom kawg tsis hloov.

Cov ntaub ntawv ntxiv txog kev sib txuam tshuaj ntawm hydrochlorothiazide:

Cov tshuaj hauv qab no tuaj yeem cuam tshuam nrog thiazide diuretics thaum muab tshuaj:

Ethanol, barbiturates lossis tshuaj yeeb: nce orthostatic hypotension tau pom.

Kev siv tshuaj hypoglycemic (tshuaj tiv thaiv kab mob hauv qhov ncauj thiab insulin): Yuav tsum tau txhaj tshuaj kho cov ntshav hypoglycemic nyob.

Colestyramine thiab colestipol: nyob rau hauv muaj anion txauv resins, nqus ntawm hydrochlorothiazide yog ntxhov. Lub sijhawm nruab nrab ntawm kev noj cov tshuaj no yuav tsum yog tsawg kawg 4 teev.

Glucocorticosteroids, adrenocorticotropic hormone: cim kev ua txhaum ntawm cov dej-electrolyte tshuav nyiaj, tshwj xeeb, kev nce siab hypokalemia.

Catecholamines (piv txwv li, norepinephrine): qhov ua tau zoo ntawm cov tshuaj no tej zaum yuav raug txo kom tsawg.

Kev tsis ua rau cov leeg ua kom mob siab (xws li tubocurarine): hydrochlorothiazide tuaj yeem ua rau muaj kev cuam tshuam los ntawm cov neeg ua kom lub cev tsis xis nyob.

Cov tshuaj tiv thaiv mob gout: kev kho tshuaj ntau ntawm cov tshuaj siv los kho gout tej zaum yuav tsum tau ua, vim hydrochlorothiazide tuaj yeem nce cov ntsiab lus ntawm uric acid hauv cov ntshav ntshav. Kev nce ntxiv ntawm koob tshuaj probenenide lossis sulfinpyrazone yuav tsum muaj. Co-administration nrog thiazide diuretics tuaj yeem ua rau muaj qhov tshwm sim ntawm kev tsis haum lub cev tsis haum rau allopurinol.

Tshuaj ntsev calcium: thiazide diuretics tuaj yeem nce ntshav plasma calcium vim qhov txo qis hauv nws txoj kev nthuav dav. Yog tias nws yuav tsum tau sau cov tshuaj calcium los yog tshuaj uas cuam tshuam rau cov ntsiab lus calcium (piv txwv li, vitamin D), nws yuav tsum hloov cov tshuaj ntawm cov tshuaj no thiab tswj cov calcium nyob hauv cov ntshav ntshav.

Lwm yam kev sib txuam ntawm yeeb tshuaj: thiazide diuretics tuaj yeem txhim kho cov nyhuv hyperglycemic ntawm beta-blockers thiab diazoxide.

Anticholinergics (e.g., atropine) tuaj yeem nce qhov kev siv nyiaj ntawm thiazide diuretics los ntawm kev txo qis plab zom mov thiab lub plab zom cov pa tuaj. Thiazide diuretics tuaj yeem ua rau muaj kev pheej hmoo mob tshwm sim los ntawm amantadine.

Thiazide diuretics tuaj yeem txo qhov kev nthuav tawm ntawm cov tshuaj cytotoxic los ntawm lub raum (piv txwv, cyclophosphamide, methotrexate) thiab potentiate lawv cov nyhuv myelosuppressive.

Cov lus piav qhia, cov lus qhia rau kev siv:

Cov lus qhia rau kev siv Ibertan tab. 150mg No. 28 Yuav Ibertan tab. 150mg No. 28

Dosage Cov Ntawv

Cov Neeg Tsim Khoom

Polfa SA (Poland)

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Ibertan zaj duab xis-coated ntsiav tshuaj

1 tab muaj cov irbesartan (hauv daim ntawv ntawm hydrochloride) 75, 150 thiab 300 mg, hauv ib pob ntawm 28 pcs.

Pharmacological kev txiav tximIbertan yog ib tus neeg sawv cev hypotensive, ib qho angiotensin II (hom AT1) receptor blocker.

Nws txo qhov kev nkag siab ntawm aldosterone hauv plasma (tsis txwv kinase II, uas rhuav tshem bradykinin), tshem tawm cov nyhuv vasoconstrictor ntawm angiotensin II, txo OPSS, txo qis tom qab, mob ntshav siab thiab ntshav siab hauv lub voj voog "me" ntawm cov ntshav ncig.

Nws tsis cuam tshuam rau qhov kev xav ntawm TG, cov roj (cholesterol), piam thaj, uric acid hauv ntshav thiab kev tawm ntawm cov uric acid hauv cov zis.

Cov txiaj ntsig siab tshaj plaws tsim tawm 3-6 teev tom qab ib koob nkaus xwb, lub sijhawm ua haujlwm yog 24 teev, tom qab 1-2 asthiv kev kawm siv cov tshuaj tiv thaiv kev noj tshuaj nyob ruaj khov ua tiav.

Cov Khoom Qhia
Arterial hypertension, suav nrog thaum muab tso ua ke nrog hom mob ntshav qab zib hom 2.

Cov Yuav Tsum MuajKev tsis haum lub cev, kev xeeb tub, lactation, lub hnub nyoog txog 18 xyoo.

Nrog ceev faj. CHF, GOKMP, stenosis ntawm aortic lossis mitral valve, lub cev qhuav dej, hyponatremia, hemodialysis, hypo-ntsev noj, raws plab, ntuav, unilateral lossis ob leeg lub raum mob leeg, mob raum tsis ua haujlwm.

Tsuas tshuaj thiab tswj hwmIbertan noj ntawm qhov ncauj, thaum noj mov lossis hauv plab tas, cov ntsiav tshuaj nqos tag nrho, ntxuav nrog dej.

Qhov pib thiab kev saib xyuas qhov koob tshuaj yog 150 mg / hnub hauv ib koob, yog tias tsim nyog, qhov koob tshuaj tau nce rau 300 mg / hnub (ntxiv ib koob ntxiv tsis nce qhov hnyav ntawm cov nyhuv hypotensive).

Yog tias tsis muaj tshwm sim thaum lub sij hawm monotherapy, kev txhaj tshuaj qis ntawm diuretics (hydrochlorothiazide) yog ntxiv rau kev kho mob.

Thawj koob tshuaj hauv cov neeg mob lub cev qhuav dej, hyponatremia (los ntawm kev kho mob nrog diuretics, txwv tsis pub muaj ntsev ntau vim kev noj haus, raws plab, ntuav) ntawm hemodialysis yog 75 mg.

Sab sij huamKev txo ntshav siab ntau dhau (hauv 0.4% ntawm cov neeg mob) - mob taub hau, kiv taub hau, xeev siab, ntuav, tsis muaj zog.

Muaj qee zaus, kev soj ntsuam tom qab kev tshaj tawm suav nrog asthenia, dyspepsia (suav nrog mob raws plab), kiv taub hau, mob taub hau, hyperkalemia, myalgia, xeev siab, tachycardia, ua kom lub siab ua haujlwm tsis zoo (suav nrog

mob rau daim siab) thiab lub raum (nrog rau lub raum tsis ua hauj lwm hauv cov neeg mob uas muaj mob hnyav).

Irbesartan tsis tau zoo nyob rau hauv thawj aldosteronism (nws siv tsis pom zoo)

Cov lus qhia tshwj xeebTxoj kev kho yuav tsum ua kom tswj tau cov ntshav siab.

Hauv cov neeg mob lub cev qhuav dej, nrog rau Na + tsis muaj peev xwm (vim los ntawm kev kho mob ntau ntxiv nrog diuretics, raws plab lossis ntuav, txwv tsis pub ntsev nrog zaub mov) thiab hauv cov neeg mob ntawm hemodialysis, hypotension mob tshwm sim tuaj yeem loj hlob, tshwj xeeb tshaj yog tom qab noj thawj koob ntawm cov tshuaj.

Hauv cov neeg mob uas lub raum tsis ua haujlwm, kev tshuaj xyuas lub sijhawm ntawm kev saib xyuas ntau tshaj ntawm K + thiab creatinine hauv ntshav yuav tsum tau nqa tawm. Hauv kev mob plawv tsis ua haujlwm, lub raum mob (nrog rau lub raum leeg ntshav hlab ntsha), qhov kev pheej hmoo ntawm kev txo qis ntshav siab, azotemia, oliguria, nce mus rau lub raum tsis ua haujlwm, nce nrog ischemic cardiomyopathy - qhov kev pheej hmoo ntawm angina pectoris thiab myocardial infarction.

Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab koom nrog cov haujlwm uas muaj kev phom sij uas yuav tsum muaj kev xav ntau ntxiv thiab ceev ntawm cov kev puas hlwb psychomotor (kiv taub hau thiab nce rog yuav ua tau).

Yeeb tshuaj sib cuam tshuamDiuretics thiab lwm yam tshuaj tiv thaiv kabmob ua rau txhim kho cov nyhuv. Cov kev kho mob ua ntej nrog cov tshuaj diuretics hauv qhov siab siab tuaj yeem ua rau lub cev qhuav dej thiab nce qhov kev pheej hmoo ntawm txo ntshav siab ntau dhau.

Kev kho tib lub sijhawm nrog heparin, potassium-sparing diuretics, lossis lwm yam tshuaj uas muaj K + tuaj yeem ua rau muaj kev nce ntxiv hauv cov concentration ntawm K + hauv ntshav. Hauv cov kev tshawb fawb hauv vitro tau pom tias muaj peev xwm ua tau rau cov metabolism hauv ntawm cov tshuaj irbesartan metabolized nrog kev koom tes ntawm CYP2C9 isoenzyme lossis nws cov inhibitors.

Cov nyhuv ntawm qhov ua kom txaus ntshai ntawm CYP2C9 isoenzyme (suav nrog rau phom ravicin) tsis tau kawm. Kev sib cuam tshuam nrog tshuaj, cov metabolism hauv uas nyob ntawm isoenzymes CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2D6, CYP2E1, CYP3A4, hauv vitro tsis tau kuaj pom.

Muaj peev xwm, qhov rov qab ua dua nyob hauv plasma Li + cov peev xwm yog tau (kev saib xyuas yog qhov tsim nyog). Tsis cuam tshuam rau qhov pharmacokinetic ntawm digoxin.

Hydrochlorothiazide, nifedipine tsis cuam tshuam rau qhov tsis muaj pharmacokinetic ntawm irbesartan.

Noj ntau dhau Cov tsos mob: tachy- lossis bradycardia, ntshav siab ntau dhau los, ntshav qis.

Kev Kho Mob: pais plab lav, kev teem sijhawm ntawm cov pa roj carbon activated, kev kho tus mob, hemodialysis ua tsis tau zoo.

Cia rau cov neeg mob
Hauv qhov chaw tsaus nyob ntawm qhov kub ntawm qhov tsis muaj siab tshaj + 25 ° C.

Muaj thiab cov nqi hauv Stolichki Cov Khw Muag Khoom:

Cov khoom tsis pom nyob rau hauv cov khw muag tshuaj Stolichki. Txawm li cas los xij, koj yuav tsum sim hu rau tel. 8 (495) 215-5-215 rau cov ntaub ntawv ntau ntxiv txog kev muaj khoom muag hauv khw muag tshuaj hauv Moscow. Cov ntaub ntawv ntawm lub vev xaib tuaj yeem tsis muaj sijhawm yuav tsum hloov.

Tso daim ntawv, ntim thiab muaj pes tsawg leeg Ibertan Plus

7 Pcs - hlwv (4) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
14 pcs. - hlwv (2) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (2) - pob khoom los ntawm cardboard.

7 Pcs - hlwv (4) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
14 pcs. - hlwv (2) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (2) - pob khoom los ntawm cardboard.

7 Pcs - hlwv (4) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
14 pcs. - hlwv (2) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (2) - pob khoom los ntawm cardboard.

Kev noj tshuaj ntxiv

Sab hauv, ib hnub ib zaug, tsis hais txog ntawm cov khoom noj.

Ibertan Ntxiv 12.5 / 150 mg (ntsiav tshuaj muaj hydrochlorothiazide / irbesartan 12,5 / 150 mg, feem) yuav muab rau cov neeg mob uas ntshav siab tsis txaus los ntawm kev teem sijhawm tsuas yog hydrochlorothiazide (12.5 mg / hnub) lossis irbesartan (150 mg / hnub) hauv monotherapy.

Ibertan Ntxiv 12.5 / 300 mg (ntsiav tshuaj muaj hydrochlorothiazide / nrbesartan 12,5 / 300 mg, feem) yuav muab rau cov neeg mob yog tias ntshav siab tsis txaus tswj los ntawm irbesartan (300 mg / hnub) lossis Ibertan Plus (12.5 / 150 mg).

Ibertan Ntxiv 25-300 mg (ntsiav tshuaj muaj hydrochlorothiazide / irbesartan 25/300 mg, feem) tuaj yeem kho rau cov neeg mob yog tias ntshav siab tsis txaus tswj los ntawm cov thawj coj ntawm Ibertan Plus (12.5 / 300 mg). Kev teem caij ntawm cov koob tshuaj ntau dua 25 mg ntawm hydrochlorothiazide / 300 mg ntawm irbesartan 1 zaug hauv ib hnub tsis pom zoo.

Yog tias tsim nyog, cov tshuaj Ibertan Plus tuaj yeem kho nyob rau hauv nrog lwm cov tshuaj tiv thaiv antihypertensive.

Lub raum khiav tsis zoo: vim qhov tseeb tias cov tshuaj muaj pes tsawg leeg tshuaj Ibertan Plus suav nrog hydrochlorothiazide. cov tshuaj tsis pom zoo rau cov neeg mob uas muaj kev tsis zoo hauv lub raum (creatinine tshem tawm 30 ml / min).

Lub siab ua haujlwm tsis zoo: kev siv Ibertan Plus tsis pom zoo rau cov neeg mob uas tsis muaj peev xwm mob hepatic tsis txaus. Hauv cov neeg mob uas muaj me ntsis mus rau mob hepatic tsis txaus, koob tshuaj Ibertan Plus yuav tau kho kom haum.

Cov neeg laus laus: kev kho mob koob tshuaj Ibertan Plus tsis tas yuav tsum muaj nyob rau cov neeg laus.

Kev txo qis ntshav cov ntshav ntau: ua ntej sau ntawv qhia rau Ibertan Plus, nws yog qhov yuav tsum tau hloov kho cov ntshav ntim ntshav thiab / lossis cov ntsiab lus sodium.

Sab sij huam

Cov kev mob tshwm sim hauv qab no yog muab raws li kev paub qib hauv qab ntawm qhov nquag ntawm lawv qhov tshwm sim: ntau zaus (> 1/10), feem ntau /> 1/100, 1/1 000, 1/10 000, Kev Sib xyaw ntawm hydrochlorothiazide / irbesartan:

Los ntawm ib sab ntawm lub hauv nruab nrab lub paj hlwb: feem ntau - kiv taub hau, txhoj puab heev orthostatic kiv taub hau.

Ntawm ib feem ntawm cov hlab plawv: ua haujlwm qoj ib ce, tsis tshua pom kev txo ntshav siab, tachycardia, peripheral edema, "tso tawm" cov ntshav mus rau ntawm daim tawv nqaij ntawm lub ntsej muag.

Los ntawm lub plab zom mov: feem ntau - xeev siab, ntuav, zawv plab zawv.

Los ntawm cov kab mob tso zis: feem ntau - ua txhaum ntawm tso zis.

Los ntawm cov kab ke genitourinary: ua haujlwm tsis xws luag - muaj kev sib daj sib deev, tsis muaj peev xwm libido.

Lwm yam: feem ntau - nkees.

Qhov ntsuas qhov ntsuas: feem ntau - kev nce siab ntawm cov tshuaj urea nitrogen, creatinine thiab plasma creatine phosphokinase, ua tsis tau zoo - txo qis ntawm cov ntsiab lus ntawm cov poov tshuaj thiab sodium hauv ntshav cov ntshav. Cov kev hloov hauv chav sim tsis tshua pom muaj nuj nqis.

Cov kev phiv tshuaj pom tshwm sim thaum noj cov tshuaj hydrochlorothiazide / irbesartan, uas tau tshaj tawm nyob rau lub sijhawm tom qab tau tshaj tawm:

Ua xua: tsis tshua muaj pob - tawv nqaij ua pob, mob ua paug, mob khaus.

Los ntawm ib sab ntawm cov metabolism: tsis tshua muaj - hyperkalemia.

Los ntawm lub hauv nruab nrab hauv lub paj hlwb: tsis tshua muaj - mob taub hau.

Los ntawm cov hloov khoom hauv lub cev: tsis tshua muaj tshwm sim - nrov nrov hauv lub pob ntseg.

Los ntawm kev ua pa: tsis tshua muaj heev - hnoos.

Los ntawm cov txheej txheem hauv plab: tsis tshua muaj tshwm sim - dyspepsia, dysgeusia, hnoos qeev qhuav, mob siab, ua kom lub siab ua haujlwm tsis zoo.

Los ntawm cov leeg musculoskeletal: tsis tshua muaj neeg arthralgia, myalgia.

Los ntawm cov kab mob txeeb zis: tsis tshua muaj tshwm sim - mob raum lub raum, nrog rau cov neeg mob raum tsis ua hauj lwm hauv cov neeg mob uas muaj pheej hmoo siab heev.

Cov lus qhia ntxiv ntawm cov khoom sib txawv:

Ntxiv rau cov kev mob tshwm sim uas tau hais dhau los, lwm cov kev mob tshwm sim uas tau qhia yav dhau los nrog rau txhua yam ntawm cov khoom siv, uas tuaj yeem muaj cov kev mob tshwm sim nyob rau hauv cov ntaub ntawv ntawm kev siv tshuaj Ibertan Plus, tau teev hauv qab no.

Lwm yam: ua tsis tau - mob hauv siab.

Hydrochlorothiazide (yam tsis qhia tias muaj pes tsawg zaus tshwm sim)

Hematopoietic plab hnyuv siab raum: aplastic anemia, pob txha hlwb kev nyuaj siab, mob ntshav khov hemolytic, mob leukopenia, neutropenia / agranulocytosis, thrombocytopenia.

Los ntawm lub hauv nruab nrab hauv lub paj hlwb: kev nyuaj siab, pw tsaug zog, kiv taub hau, pliaj caj dab, ntxhov siab.

Los ntawm sab hauv ntawm cov khoom muag pom: hloov zuj zus qhov muag plooj, xantopsia.

Los ntawm cov hlab plawv system: arrhythmias, postural hypotension.

Los ntawm cov kab mob ua pa: mob ntsws ua pa nyuaj (suav nrog pneumonitis thiab pulmonary edema).

Los ntawm lub plab zom mov: jaundice (mob nqaij hlav cholestatic jaundice).

Ua xua: anaphylactic kev ua xua, tshuaj lom epidermal necrolysis, lupus-zoo li cov tsos mob, necrotizing angiitis (vasculitis, tawv nqaij vasculitis), tshuaj tiv thaiv kev tsis haum, tawv nqaij ua pob, ua kom mob ntawm lub cev lupus erythematosus, urticaria.

Los ntawm cov leeg ua haujlwm: pob leeg mob, tsis muaj zog.

Los ntawm cov kab mob urinary: interstitial nephritis, lub raum ua haujlwm.

Lwm yam: ua npaws.

Kev ntsuas ntsuas: cuam tshuam hauv dej-electrolyte sib npaug (suav nrog hypokalemia thiab hyonatremia), glucosuria, hyperglycemia, hyperuricemia, muaj cov cholesterol thiab triglycerides.

Cev xeeb tub thiab lactation

Noj Ibertan Plus yog contraindicated thaum cev xeeb tub, txij li thaum kov cov menyuam hauv tshuaj uas cuam tshuam rau renin-angiotensin-aldosterone system tuaj yeem ua rau kev puas tsuaj thiab tuag ntawm kev tsim tus me nyuam. Thiazide diuretics hla chaw placental thiab pom hauv cov ntshav qaum. Feem ntau, kev siv cov tshuaj diuretics hauv cov poj niam cev xeeb tub noj qab haus huv tsis raug pom zoo thiab ua rau tus niam thiab tus menyuam muaj teeb meem tsis tsim nyog, suav nrog kev loj hlob ntawm tus me nyuam hauv plab lossis lub cev nqaij daim tawv daj, mob plab thrombocytopenia thiab, tej zaum muaj lwm cov kev tsis zoo uas tau pom hauv cov neeg laus. Hydrochlorothiazide tsis pom zoo hauv thawj lub hlis thaum cev xeeb tub. Cov tshuaj yog contraindicated nyob rau hauv II thiab III trimesters ntawm cev xeeb tub. Yog tias kuaj pom lub cev muaj zog, ces Ibertan Plus yuav tsum tsis ua haujlwm ntxiv sai li sai tau. Yog tias tus neeg mob tau siv tshuaj los ntawm lub hlis thib ob ntawm cev xeeb tub, nws yog qhov yuav tsum tau ua txoj kev kuaj mob ultrasound ntawm lub pob txha taub hau thiab lub raum kev ua haujlwm. Cov tshuaj Ibertan Plus yog contraindicated nyob rau tag nrho lub sijhawm ntawm lactation.

Yeeb tshuaj sib cuam tshuam

Lwm cov tshuaj tiv thaiv antihypertensive: cov nyhuv antihypertensive ntawm cov tshuaj Ibertan Plus tuaj yeem txhim kho qhov kev sib txuas ntxiv ntawm kev siv tshuaj los tiv thaiv lwm yam tshuaj tiv thaiv kev kub ntxhov. Hydrochlorothiazide thiab irbesartan (hauv kev suav txog 25 mg ntawm hydrochlorothiazide / 300 mg ntawm irbesartan) tuaj yeem siv nrog kev siv tshuaj tiv thaiv lwm yam tshuaj, nrog rau qeeb calcium calcium blockers thiab beta-blockers. Yav dhau los kho nrog cov koob tshuaj diuretics zoo tuaj yeem ua rau xeev siab thiab ua rau muaj kev pheej hmoo ntawm txoj hlab ntshav o.

Lithium: muaj cov lus tshaj tawm txog qhov kev hloov pauv ntawm cov dej ntshiab lithium ntau ntau thiab muaj tshuaj lom nrog kev siv cov roj ntsha lithium npaj thiab angiotensin-hloov enzyme inhibitors. Rau irbesartan, cov teebmeem zoo sib xws tau muaj tsawg kawg hnub. Tsis tas li ntawd, kev ua kom lub ntsej muag ntawm cov roj ntsha lithium poob qis nrog kev siv thiazide diuretics, yog li thaum Ibertan Plus tau raug tshaj tawm, muaj kev pheej hmoo ntawm kev tsim cov tshuaj lom ntawm lithium. Yog tias lub hom phiaj ntawm kev sib xyaw no yog qhov tsim nyog, nws raug nquahu kom ua tib zoo saib xyuas cov roj ntsha lithium hauv cov ntshav cov ntshav.

Cov tshuaj noj uas cuam tshuam cov ntsiab lus potassium hauv cov ntshav: cov nyhuv hypokalemic ntawm hydrochlorothiazide tsis muaj zog los ntawm cov tshuaj potassium-sparing nyhuv ntawm irbesartan. Txawm li cas los xij, qhov kev cuam tshuam ntawm hydrochlorothiazide tuaj yeem txhim kho los ntawm lwm cov tshuaj, lub hom phiaj uas cuam tshuam nrog poob ntawm cov poov tshuaj thiab gnococalpemia (piv txwv li diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, salicylic acid derivatives) Ntawm qhov tsis sib xws, raws li kev paub siv cov tshuaj uas txo cov kev ua si angiotensin-aldosterone system, concomitant siv cov potassium-sparing. oiologically active additives, hloov ntsev ntsev ntxiv, lossis lwm yam tshuaj uas tuaj yeem ua rau muaj ntau ntxiv cov poov tshuaj poom ntsev (xws li heparin sodium) tuaj yeem ua rau muaj qhov dej ntshiab Katya ntau ntxiv. Nws raug nquahu kom koj saib xyuas cov poov tshuaj poov tshuaj zoo rau hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev mob hyperkalemia.

Cov tshuaj noj uas cuam tshuam los ntawm kev ua txhaum ntawm cov potassium ntxiv hauv cov ntshav cov ntshav: nws raug nquahu kom ua tib zoo saib xyuas cov ntsiab lus ntawm cov potassium nyob hauv cov ntshav cov ntshav thaum muab tshuaj Ibertan Plus nrog rau cov tshuaj uas cuam tshuam los ntawm kev ua txhaum ntawm cov potassium ntxiv hauv cov ntshav ntshav (piv txwv li, mob plawv glycocrysts. Cov tshuaj tiv thaiv kab mob).

Nonsteroidal anti-inflammatory drugs: thaum sau tshuaj rau angotensin II receptor antagonists ua ke nrog cov tshuaj tsis muaj tshuaj tiv thaiv thiab tsis siv tshuaj tiv thaiv kab mob (piv txwv li, xaiv cyclooxygenase-2 inhibitors (COX-2), acetylsalicylic acid (> 3 g / hnub) thiab cov tshuaj uas tsis xaiv los tiv thaiv kev tiv thaiv kab mob tuaj yeem cia siab. ntawv. Ib yam li kev siv cov tshuaj mob angiotensin hloov mus rau enzyme inhibitors thiab angiotensin II receptor antagonists txuam nrog NSAIDs, muaj kev pheej hmoo ntawm lub raum lub raum kev ua haujlwm, mus txog rau kev txhim kho ntawm lub raum tsis ua haujlwm, nce ntshav ntau ntxiv, tshwj xeeb tshaj yog nyob rau cov neeg mob uas twb ua tsis tau haujlwm lub raum. Qhov sib xyaw ua ke ntawm cov tshuaj no yuav tsum tau txiav txim nrog ceev faj, tshwj xeeb tshaj yog rau cov neeg laus. Cov neeg mob yuav tsum tsis pub kom lub cev qhuav dej. Kev tswj hwm lub raum yuav tsum tau ua tom qab pib kev sib txuas ua ke thiab ib ntu yav tom ntej.

Cov ntaub ntawv ntxiv txog kev sib cuam tshuam yeeb tshuaj ntawm irbesartan: hydrochlorothiazide tsis cuam tshuam rau pharmacokinetics ntawm irbesartan. Thaum sau tshuaj rau cov tshuaj irbesartan ua ke nrog warfarin, metabolized los ntawm inducers ntawm CYP2C9 isoenzyme, tsis muaj kev cuam tshuam loj ntawm pharmacokinetic thiab pharmacodynamic. Cov nyhuv ntawm CYP2C9 isoenzyme inductors, xws li rifampicin, rau ntawm pharmacokinetics ntawm irbesartan tsis tau raug ntsuas. Nrog rau kev teem caij ntawm irbesartan hauv kev sib xyaw nrog digoxin, cov chaw muag tshuaj ntawm tom kawg tsis hloov.

Cov ntaub ntawv ntxiv txog kev sib txuam tshuaj ntawm hydrochlorothiazide:

Cov tshuaj hauv qab no tuaj yeem cuam tshuam nrog thiazide diuretics thaum muab tshuaj:

Ethanol, barbiturates lossis narcotic tshuaj: kev tiv thaiv orthostatic hypotension ntau tuaj yeem pom.

Kev siv tshuaj hypoglycemic (tshuaj tiv thaiv kab mob hauv qhov ncauj thiab insulin): yuav tsum tau kho cov tshuaj hypoglycemic nyob rau hauv lub koob tshuaj.

Colestyramine thiab colestipol: nyob rau hauv muaj anion txauv resins, nqus ntawm hydrochlorothiazide yog ntxhov. Lub sijhawm nruab nrab ntawm kev noj cov tshuaj no yuav tsum yog tsawg kawg 4 teev.

Glucocorticosteroids, adrenocorticotropic hormone: qhov ua txhaum cai ntawm cov dej-electrolyte tshuav nyiaj, tshwj xeeb, nce hypokalemia.

Catecholamines (piv txwv li, norepinephrine): qhov ua tau zoo ntawm cov tshuaj no yuav raug txo kom tsawg.

Tsis-depolarizing nqaij relaxants (xws li tubocurarine): hydrochlorothiazide tuaj yeem ua rau muaj kev cuam tshuam ntawm cov tsis ua rau cov leeg ua kom mob.

Cov tshuaj tiv thaiv gout: tej zaum yuav tsum tau kho qhov ntau ntawm cov tshuaj siv los kho gout, vim tias hydrochlorothiazide tuaj yeem nce cov ntsiab lus ntawm uric acid hauv cov ntshav ntshav. Kev nce ntxiv ntawm koob tshuaj probenenide lossis sulfinpyrazone yuav tsum muaj. Co-administration nrog thiazide diuretics tuaj yeem ua rau muaj qhov tshwm sim ntawm kev tsis haum lub cev tsis haum rau allopurinol.

Cov tshuaj ntsev calcium: thiazide diuretics tuaj yeem nce ntshav plasma calcium vim qhov txo qis hauv nws txoj kev nthuav dav. Yog tias nws yuav tsum tau sau cov tshuaj calcium los yog tshuaj uas cuam tshuam rau cov ntsiab lus calcium (piv txwv li, vitamin D), nws yuav tsum hloov cov tshuaj ntawm cov tshuaj no thiab tswj cov calcium nyob hauv cov ntshav ntshav.

Lwm yam kev sib cuam tshuam txog tshuaj: thiazide diuretics tuaj yeem txhim kho cov nyhuv hyperglycemic ntawm beta-blockers thiab diazoxide. Anticholinergics (e.g., atropine) tuaj yeem nce qhov kev siv nyiaj ntawm thiazide diuretics los ntawm kev txo qis plab zom mov thiab lub plab zom cov pa tuaj. Thiazide diuretics tuaj yeem ua rau muaj kev pheej hmoo mob tshwm sim los ntawm amantadine. Thiazide diuretics tuaj yeem txo qhov kev nthuav tawm ntawm cov tshuaj cytotoxic los ntawm lub raum (piv txwv, cyclophosphamide, methotrexate) thiab potentiate lawv cov nyhuv myelosuppressive.