Noliprel Ib ntsiav tshuaj 2, 5, 0, 625 mg 30 pcs > Kev khomob thiab kev tiv thaiv

Thov, ua ntej koj yuav Noliprel A, ntsiav tshuaj 2.5 + 0.625 mg 30 pcs., Xyuas cov ntaub ntawv nrog nws nrog cov ntaub ntawv ntawm lub vev xaib ntawm lub chaw tsim khoom lossis hais kom meej cov qauv tshwj xeeb nrog tus thawj tswj haujlwm ntawm peb lub tuam txhab!

Cov ntaub ntawv qhia ntawm lub xaib tsis yog pej xeem kev pom zoo. Lub chaw tsim khoom muaj txoj cai los hloov cov qauv tsim, tsim qauv thiab ntim khoom. Cov duab ntawm cov khoom hauv cov duab tau tshaj tawm hauv phau ntawv teev npe rau ntawm lub xaib yuav txawv ntawm cov hauv paus chiv keeb.

Cov ntaub ntawv ntawm tus nqi ntawm cov khoom tau hais hauv phau ntawv qhia rau ntawm lub xaib yuav txawv qhov tseeb ntawm ib tus neeg thaum lub sijhawm tso daim ntawv txiav txim rau cov khoom lag luam.

Chaw tsim tshuaj paus

Cov khoom xyaw dhia: perindopril arginine, indapamide,

Cov neeg muaj mob: sodium carboxymethyl hmoov txhuv nplej siab (hom A) - 2.7 mg, anhydrous colloidal silicon dioxide - 0.27 mg, lactose monohydrate - 74.455 mg, magnesium stearate - 0.45 mg, maltodextrin - 9 mg,

Cov hnab riam zaj duab xis: macrogol 6000 - 0.087 mg, premix rau lub tsho dawb zaj duab xis SEPIFILM 37781 RBC (glycerol - 4.5%, hypromellose - 74.8%, macrogol 6000 - 1.8%, magnesium stearate - 4.5%, titanium dioxide (E171) - 14.4%) - 2.913 mg,

Pharmacological kev txiav txim

Noliprel ® A yog kev sib koom ua ke npaj muaj perindopril arginine thiab indapamide. Pharmacological cov yam ntxwv ntawm cov tshuaj Noliprel ® Ua ke cov khoom ntiag tug ntawm txhua qhov sib xyaw.

1. Lub tshuab txiav txim ntawm

Kev sib xyaw ntawm perindopril thiab indapamide ua rau kom muaj cov nyhuv antihypertensive ntawm lawv.

Perindopril yog ib qho inhibitor ntawm qhov enzyme uas hloov angiotensin I rau angiotensin II (ib qho ACE inhibitor).

ACE, lossis kininase II, yog ib qho exopeptidase uas nqa tawm ob qho kev hloov pauv ntawm angiotensin Kuv mus rau vasoconstrictor tshuaj angiotensin II, thiab kev ua kom puas tsuaj ntawm bradykinin, uas muaj cov vasodilating effect, rau qhov tsis muaj zog heptapeptide. Raws li qhov tshwm sim ntawm perindopril:

- txo qis kev zais ntawm aldosterone,

- los ntawm lub hauv paus ntsiab lus ntawm qhov kev xav tsis zoo nce qhov kev ua si ntawm renin hauv ntshav ntshav,

- nrog rau kev siv ntev siv txo OPSS, uas yog qhov tseem ceeb vim qhov cuam tshuam rau cov hlab ntsha hauv cov leeg thiab ob lub raum. Cov teebmeem no tsis nrog nrog qeeb hauv sodium thiab kua ions lossis kev txhim kho ntawm reflex tachycardia.

Perindopril normalizes myocardium, txo kev ua ntej thiab tom qab thau khoom.

Thaum kawm hemodynamic tsis nyob hauv cov neeg mob uas muaj lub plawv tsis ua hauj lwm ntev, nws tau raug qhia:

- txo qis hauv kev nias hauv sab laug thiab sab xis ventricles ntawm lub plawv,

- muaj cov zis ntau lawm,

- Muaj cov leeg ntshav ua pab rau kom ntshav ntau ntxiv.

Indapamide belongs rau cov pab pawg ntawm sulfonamides, hauv cov tshuaj pharmacological nws tau ze rau thiazide diuretics. Indapamide inhibits reabsorption ntawm sodium ions nyob rau hauv lub cortical ntu ntawm Henle lub voj voos, uas ua rau muaj kev nce ntxiv hauv kev tshem tawm ntawm sodium, kua tshuaj thiab, rau qhov tsawg dua, potassium thiab magnesium ions los ntawm ob lub raum, yog li nce diuresis thiab txo cov ntshav siab.

2. Cov nyhuv antihypertensive

Noliprel ® A muaj cov tshuaj tiv thaiv kab mob cuam tshuam rau ob qho DBP thiab SBP ob qho tib si hauv kev sawv thiab dag chaw. Cov nyhuv antihypertensive tseem mob rau 24 teev. Ib qho kev kho mob ruaj khov tsim muaj tsawg dua 1 hlis tom qab pib kho thiab tsis nrog tachycardia. Kev txiav tsis siab ntawm kev kho mob tsis ua rau muaj kev tshem tawm tus mob.

Noliprel reduces A txo cov neeg kawm tiav ntawm laug ventricular hypertrophy (GTL), txhim kho cov hlab ntsha elasticity, txo OPSS, tsis cuam tshuam rau lipid metabolism (tag nrho cov roj, HDL cholesterol thiab LDL roj cholesterol, triglycerides).

Cov nyhuv ntawm kev siv ntawm kev sib xyaw ntawm perindopril thiab indapamide ntawm GTL tau ua pov thawj hauv kev sib piv nrog enalapril. Hauv cov neeg mob uas muaj mob ntshav tawm hauv ntshav thiab GTL uas tau txais kev kho perindopril nrog erbumin 2 mg (sib npaug rau 2.5 mg perindopril arginine) / indapamide 0.625 mg lossis enalapril ntawm koob tshuaj 10 mg ib hnub ib zaug, thiab nrog nce ntxiv ntawm perindopril erbumin txog 8 mg (sib npaug rau 10 perindopril arginine) thiab indapamide txog li 2.5 mg, los yog enalapril txog 40 mg ib hnub ib zaug, qhov tseem ceeb txo qis rau sab laug ventricular huab hwm loj index (LVMI) hauv perindopril / indapamide pawg piv nrog enalapril pab pawg. Hauv qhov xwm txheej no, qhov tseem ceeb tshaj plaws ntawm LVMI tau pom nrog kev siv perindopril erbumin 8 mg / indapamide 2.5 mg.

Ib cov lus tshaj tawm los tiv thaiv kev tiv thaiv kuj tseem pom tawm tsam keeb kwm ntawm kev sib xyaw ua ke nrog perindopril thiab indapamide piv nrog enalapril.

Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus (txhais tau tias lub hnub nyoog 66 xyoo, lub cev qhov hnyav 28 kg / m 2, glycosylated hemoglobin (HbA1c) 7.5%, ntshav siab 145/81 hli Hg), cov nyhuv ntawm kev hloov kho kev sib xyaw ntawm perindopril / indapamide rau cov kab mob loj - thiab macro-vascular muaj teeb meem ntxiv rau ob qho kev kho mob zoo rau kev tswj glycemic thiab kev tswj hwm glycemic (IHC) cov tswv yim (phiaj HbA1c

Arterial hypertension tau pom nyob rau hauv 83% ntawm cov neeg mob, loj heev - thiab microvascular cov kev tsis sib haum xeeb hauv 32 thiab 10%, thiab microalbuminuria hauv 27%. Cov neeg mob feem ntau thaum lub sij hawm koom nrog hauv txoj kev tshawb no tau txais kev kho mob ntshav qab zib, 90% ntawm cov neeg mob tau txais kev kho mob hypoglycemic rau kev tswj hwm qhov ncauj (47% ntawm cov neeg mob tau txais kev kho mob monotherapy, 46% tau txais ob-tshuaj kho, 7% tau txais peb-tshuaj kho). 1% ntawm cov neeg mob tau txais kev kho mob insulin, 9% - tsuas yog txoj kev kho kev noj haus. Cov peev xwm ntawm sulfonylureas tau noj los ntawm 72% ntawm cov neeg mob, metformin - 61%. Raws li kev kho mob kom ncaj, 75% ntawm cov neeg mob tau txais cov tshuaj tiv thaiv kabmob, 35% ntawm cov neeg mob tau txais tshuaj lipid-txo qis (feem ntau HMG-CoA reductase inhibitors (statins) - 28%), acetylsalicylic acid ua tshuaj tiv thaiv kab mob, thiab lwm cov tshuaj tiv thaiv kab mob (47%).

Tom qab 6 lub hlis ntawm lub sijhawm pib thaum lub sijhawm cov neeg mob tau txais kev kho mob perindopril / indapamide, lawv tau muab faib ua pawg glycemic tswj pab pawg lossis IHC pawg (Diabeton with MV nrog kev muaj peev xwm ntxiv cov koob tshuaj rau ntau txog 120 mg / hnub lossis ntxiv lwm tus neeg sawv cev hypoglycemic).

Hauv IHC pab pawg (txhais tau tias soj qab taug qab lub sijhawm - 4.8 xyoo, txhais tau tias HbA1c - 6.5%) piv nrog pawg pab pawg tswj hwm (txhais tau tias HbA1c - 7.3%), qhov tseem ceeb txo 10% hauv qhov kev pheej hmoo txheeb ze ntawm kev sib koom ua ke ntawm macro- thiab microvascular lwm yam nyuaj.

Qhov kom zoo dua tau ua tiav vim qhov txo qis hauv kev pheej hmoo txheeb ze: kev cuam tshuam loj ntawm microvascular los ntawm 14%, qhov pib thiab kev loj hlob ntawm nephropathy los ntawm 21%, microalbuminuria los ntawm 9%, macroalbuminuria los ntawm 30% thiab kev loj hlob ntawm cov teeb meem los ntawm lub raum los ntawm 11%.

Cov txiaj ntsig ntawm kev tiv thaiv mob ntsws tsis ua raws cov txiaj ntsig tau ua tiav nrog IHC.

Perindopril ua tau zoo rau kev kho mob ntshav siab ntawm ib qho mob loj.

Cov nyhuv antihypertensive ntawm cov tshuaj nce mus txog nws qhov siab tshaj 4-6 teev tom qab kev tswj hwm ib qhov ncauj thiab tseem mob siab rau 24 teev. 24 teev tom qab noj cov tshuaj, ib qho tawm (txog 80%) seem ACE inhibition yog pom.

Perindopril muaj cov nyhuv antihypertensive rau cov neeg mob uas muaj ob qho qis thiab ib txwm plasma renin kev ua si.

Kev tswj hwm tib lub sij hawm ntawm thiazide diuretics kho qhov hnyav ntawm cov nyhuv antihypertensive. Ntxiv rau, kev sib xyaw ntawm ACE inhibitor thiab thiazide diuretic kuj txo qhov kev pheej hmoo ntawm hypokalemia nrog diuretics.

Cov nyhuv antihypertensive yog tshwm sim thaum siv cov tshuaj nyob rau hauv cov koob tshuaj uas muaj tsawg tshaj plaws diuretic nyhuv.

Cov nyhuv antihypertensive ntawm indapamide yog txuam nrog kev txhim kho ntawm cov khoom ntiag tug ntawm cov hlab ntsha loj thiab qhov txo qis ntawm OPSS.

Indapamide txo qis GTL, tsis cuam tshuam rau kev mloog ntawm lipids hauv cov ntshav plasma: triglycerides, cov roj (cholesterol) tag nrho, LDL, HDL, metabolism metabolism (suav nrog cov neeg mob uas muaj ntshav qab zib ua ntshav qab zib mellitus).

Kev sib xyaw ntawm perindopril thiab indapamide tsis hloov pauv lawv tus yam ntxwv pharmacokinetic piv nrog kev tswj hwm cais cov tshuaj no.

Thaum muab cov tshuaj perindopril nrawm nrawm. Bioavailability yog 65-70%.

Kwv yees li 20% ntawm tag nrho cov tshuaj perindopril tau hloov pauv mus rau perindoprilat, ib qho metabolite. Kev noj cov tshuaj nrog zaub mov yog nrog los txo qis hauv cov metabolism ntawm perindopril rau perindoprilat (cov nyhuv no tsis muaj qhov tseem ceeb hauv cov nqi kuaj mob).

C_max Perindoprilat nyob rau hauv cov ntshav ntshav tau mus txog 3-4 teev tom qab kev noj mov.

Kev sib txuas lus nrog cov ntshav plasma protein tsawg dua 30% thiab nyob ntawm qhov kev xav ntawm perindopril hauv cov ntshav.

Kev cuam tshuam ntawm perindoprilat cuam tshuam nrog ACE yog qeeb. Yog li ntawd, cov ua haujlwm zoo T_1/2yog 25 teev. Lub sijhawm rov qab teem dua ntawm perindopril tsis ua rau nws nruas, thiab T_1/2Nrog kev rov ua dua, perindoprilat sib raug rau lub sijhawm ntawm nws cov kev ua, yog li lub xeev qhov sib luag yog tau mus txog tom qab 4 hnub.

Perindoprilat ua tawm ntawm lub cev los ntawm lub raum. T_1/2 Cov metabolite yog 3-5 teev

Kev nqhis dej ntawm perindoprilat qeeb qeeb rau lub hnub nyoog laus, nrog rau cov neeg mob plawv thiab lub raum tsis ua haujlwm.

Kev lim ntshav hauv lub ntsej muag kom pom tseeb ntawm perindoprilat yog 70 ml / min.

Tus pharmacokinetics ntawm perindopril tau hloov pauv hauv cov neeg mob uas muaj lub siab ua mob rau daim siab: nws cov kev mob rau daim siab txo qis 2 zaug. Txawm li cas los xij, tus nqi ntawm perindoprilat tsim tsis txo, yog li kev hloov pauv koob tsis tas yuav tsum.

Perindopril hla nqaij tawv.

Indapamide nrawm thiab nrawm los ntawm lub plab zom mov.

C_max cov tshuaj nyob rau hauv cov ntshav ntshav yog pom 1 teev tom qab noj.

Kev sib txuas lus nrog cov ntshav plasma protein - 79%.

T_1/2 yog 14-24 teev (nruab nrab 19 teev). Rov ua dua ntawm cov tshuaj tsis ua rau nws txoj kev khaws cia hauv lub cev. Nws yog tsuas yog tawm los ntawm lub raum (70% ntawm kev siv tshuaj) thiab los ntawm txoj hnyuv (22%) hauv kev siv tshuaj tiv thaiv kev tsis haum.

Lub pharmacokinetics ntawm cov tshuaj tsis hloov pauv hauv cov neeg mob uas lub raum tsis ua haujlwm.

Qhov tseem ceeb tawg, cov neeg mob ntshav liab thiab hom 2 mob ntshav qab zib mellitus los txo cov kev pheej hmoo ntawm microvascular cov teeb meem (los ntawm ob lub raum) thiab macrovascular muaj teeb meem los ntawm cov kab mob plawv.

Cev xeeb tub thiab lactation

Cov tshuaj yog contraindicated nyob rau hauv cev xeeb tub.

Thaum npaj kev cev xeeb tub lossis thaum nws tshwm sim thaum noj Noliprel ® A, koj yuav tsum tsis txhob noj tshuaj tam sim ntawd thiab sau ntawv rau lwm txoj kev kho tshuaj tiv thaiv kab mob siab.

Tsis txhob siv Noliprel ® A nyob rau thawj peb lub hlis thaum cev xeeb tub.

Cov kev tshawb fawb pom zoo tsim nyog ntawm ACE inhibitors hauv cov poj niam cev xeeb tub tsis tau ua. Tsuas muaj cov ntaub ntawv hais txog qhov tshwm sim ntawm ACE inhibitors nyob rau thawj lub hlis thaum cev xeeb tub tau qhia tias kev noj ACE inhibitors tsis ua rau cov leeg tsis xws luag ua rau fetotoxicity, tab sis cov nyhuv fetotoxic ntawm cov tshuaj tsis tuaj yeem txiav txim siab tag nrho.

Noliprel ® A yog sib kis ntawm lub sijhawm xyoo II thiab III ntawm cev xeeb tub (saib. "Contraindications").

Nws paub tias ncua ntev mus rau ACE inhibitors ntawm tus me nyuam hauv plab thib ob thiab thib peb hauv plab cev xeeb tub tuaj yeem ua rau muaj kev txhim kho tsis zoo (txo lub raum tsis ua haujlwm, oligohydramnios, ncua ossification ntawm cov pob txha pob txha taub hau) thiab kev txhim kho ntawm cov teeb meem hauv cov menyuam mos (lub raum tsis ua haujlwm, ntshav siab, hyperkalemia).

Kev siv ntev ntawm thiazide diuretics nyob rau lub sijhawm peb lub hlis ntawm cev xeeb tub tuaj yeem ua rau niam lub cev hypovolemia thiab txo qis ntshav ntawm cov ntshav uteroplacental, uas ua rau fetoplacental ischemia thiab kev loj hlob ntawm lub plab. Muaj qee zaus, thaum noj cov tshuaj diuretics ua ntej yug menyuam, cov menyuam mos yug los muaj ntshav qab zib tsawg thiab thrombocytopenia.

Yog tias tus neeg mob tau txais tshuaj Noliprel ® A thaum lub sijhawm II lossis III ntawm lub sijhawm cev xeeb tub, nws raug nquahu kom ua qhov ntsuas ntawm tus menyuam yug los txhawm rau ntsuas tus mob ntawm pob txha taub hau thiab lub raum kev ua haujlwm.

Kev mob ntshav siab tuaj yeem tshwm sim hauv cov menyuam tshiab uas lawv niam tau txais kev kho mob nrog ACE inhibitors, thiab yog li ntawd cov menyuam yug tshiab yuav tsum muaj kev saib xyuas mob nkeeg zoo.

Noliprel ® A yog contraindicated thaum lactation.

Nws tsis paub meej tias puas yog perindopril nrog rau niam mis yog tawm los.

Indapamide ua tawm hauv niam cov kua mis. Kev noj thiazide diuretics ua rau txo qis hauv niam mis lossis kev tawm ntawm lactation. Hauv qhov no, tus menyuam mos liab yuav muaj qhov mob hypersensitivity rau sulfonamide derivatives, hypokalemia thiab nuclear jaundice.

Txij li thaum siv cov perindopril thiab indapamide thaum lactation tuaj yeem ua rau muaj kev phom sij ntau hauv cov menyuam mos, nws yog qhov yuav tsum tau soj ntsuam qhov tseem ceeb ntawm kev kho mob rau leej niam thiab txiav txim siab txog kev txiav kev pub niam mis lossis noj tshuaj.

Cov Yuav Tsum Muaj

muaj qhov tsis haum rau perindopril thiab lwm yam ACE inhibitors, indapamide, lwm yam sulfonamides, ntxiv rau lwm cov ntu pabcuam ntxiv uas ua cov tshuaj,
keeb kwm ntawm mob hlwb (suav nrog nrog ACE lwm yam tshuaj tiv thaiv kab mob),
mob rau tus mob muaj keeb / idiopathic angioedema, hypokalemia, lub raum khiav tsis zoo (creatinine Cl tsawg dua 30 ml / min),
stenosis ntawm ib lub raum leeg ntshav, ob tog lub raum leeg ntshav stenosis,
mob rau daim siab hnyav (suav nrog encephalopathy),
ib txhij tswj hwm tshuaj uas txuas ntxiv QT luv,
tib lub sij hawm siv nrog cov tshuaj tiv thaiv tsis zoo uas tuaj yeem ua rau pirouette hom arrhythmias,
cev xeeb tub
lactation lub sijhawm.

Kev tswj hwm ntawm cov tshuaj nrog cov tshuaj potassium-sparing diuretics, potassium thiab lithium npaj, thiab kev tswj hwm rau cov neeg mob uas muaj ntshav ntau ntau potassium tsis pom zoo.

Vim tias tsis muaj kev sim tshuaj txaus, Noliprel ® A yuav tsum tsis txhob siv rau cov neeg mob kho mob hemodialysis, zoo li cov neeg mob tsis muaj qhov kho lub plawv tsis ua haujlwm zoo.

Nrog ceev faj: cov kab mob ntawm cov kab mob sib txuas (nrog rau cov kab mob lupus erythematosus, scleroderma), kev siv tshuaj tiv thaiv kab mob (muaj kev phom sij rau neutropenia, agranulocytosis), inhibition ntawm pob txha mob hematopoiesis, poob qis BCC (diuretics, noj tsis muaj ntsev, ntuav, raws plab, hemodialysis), angina pectoris, kab mob cerebrovascular, kev kho mob ntshav siab, mob ntshav qab zib mellitus, mob plawv tsis ua hauj lwm (NYHA kev faib tawm IV theem), hyperuricemia (tshwj xeeb yog nrog gout thiab urate nephrolithiasis), ntshav siab lability lability, muaj hnub nyoog laus, hemodialysis siv ntshav siab ua kua lossis desensitization, ua ntej LDL apheresis, mob tom qab hloov raum, aortic valve stenosis / hypertrophic cardiomyopathy, lactase deficiency, galactosemia lossis glucose-galactose malabsorption syndrome (hnub nyoog 18 xyoo, ua kom tau zoo, muaj hnub nyoog 18 xyoo, thiab kev ruaj ntseg tsis raug ntsia).

Sab sij huam

Los ntawm cov kab mob hemopoietic thiab lymphatic: tsis tshua muaj tshwm sim - thrombocytopenia, leukopenia / neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia.

Anemia: Hauv qee qhov chaw kho mob (cov neeg mob tom qab hloov raum, cov neeg mob ntawm hemodialysis) ACE inhibitors tuaj yeem ua rau ntshav tsis txaus (saib "Cov Lus Qhia Tshwj Xeeb").

Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb: feem ntau - paresthesia, mob taub hau, kiv taub hau, asthenia, vertigo, tsis xws luag - pw tsaug zog, lability ntawm mus ob peb vas, tsis tshua muaj - tsis meej pem, tsis paub tseeb-fainting.

Los ntawm ob sab ntawm cov khoom ntawm kev pom: ntau zaus - pom kev tsis hnov lus.

Ntawm ib feem ntawm cov khoom hnov: feem ntau - tinnitus.

Los ntawm CCC: feem ntau - cov lus txo qis hauv ntshav siab, incl. orthostatic hypotension, tsis tshua muaj tshwm sim - lub plawv cuam tshuam cuam tshuam, incl. bradycardia, ventricular tachycardia, atrial fibrillation, as Well as angina pectoris thiab myocardial infarction, muaj vim tias muaj ntshav nce siab ntau nyob hauv cov neeg mob uas muaj kev phom sij (saib "Cov Lus Qhia Tshwj Xeeb"), tsis tau hais tawm ntau zaus - pirouette hom arrhythmia (muaj neeg tuag taus - saib “ Kev sib cuam tshuam ").

Ntawm ib feem ntawm kev ua pa, hauv siab thiab mediastinal plab hnyuv siab raum: feem ntau - tiv thaiv keeb kwm yav dhau los ntawm kev siv ACE inhibitors, hnoos qhuav yuav tshwm sim, uas mob siab rau ntev ntev thaum noj cov tshuaj no thiab ploj mus tom qab lawv tau tso tseg, ua tsis taus pa, tsis tshua muaj - bronchospasm, tsis tshua muaj - kab mob ntsws, mob ntsws, mob ntsws. Cov.

Los ntawm cov txheej txheem hauv plab: feem ntau - dryness ntawm lub qhov ncauj mucosa, xeev siab, ntuav, mob plab, epigastric mob, tsis hnov qab, tsis qab los, tsis qab los, mob plab, cem quav, raws plab, tsis tshua muaj - angioedema ntawm txoj hnyuv, cholestatic jaundice, pancreatitis, qhov tsis paub tseeb tias muaj pes tsawg zaus - hepatic encephalopathy hauv cov neeg mob uas tsis muaj peev xwm kho mob hepatic (saib. "Contraindications", "Cov Lus Qhia Tshwj Xeeb"), kab mob siab.

Ntawm ib feem ntawm daim tawv nqaij thiab cov roj ntsha subcutaneous: feem ntau - tawv nqaij ua pob khaus, khaus, maculopapular pob, ua tsis xws luag - angioedema ntawm lub ntsej muag, daim di ncauj, nqaj, mucous membrane ntawm tus nplaig, lub suab nrov thiab / lossis larynx, urticaria (saib "Cov lus qhia tshwj xeeb") , qhov tsis haum lub cev nyob hauv cov neeg mob predisposed rau bronchial obstructive thiab kev ua xua, purpura, hauv cov neeg mob uas muaj mob qis lupus erythematosus, cov chav kawm ntawm tus kab mob no yuav loj zuj zus, tsis tshua muaj erythema multiforme, tshuaj lom neeg muaj peev xwm necrolysis, Stevens-Johnson syndrome. Tau muaj cov xwm txheej ntawm cov tshuaj tiv thaiv kev ua txhaum (saib. "Cov Lus Qhia Tshwj Xeeb").

Los ntawm cov leeg musculoskeletal thiab cov leeg sib txuas: feem ntau - leeg mob leeg.

Los ntawm cov kab mob zis: tso zis - lub raum tsis ua haujlwm, tsis tshua muaj tshwm sim - mob raum tsis ua haujlwm.

Los ntawm kev yug me nyuam: ntxiag - impotence.

Kev cuam tshuam dav dav thiab cov tsos mob: feem ntau - asthenia, ua tsis xws luag - nce hws.

Kev ntsuas qhov ntsuas: hyperkalemia, ntau zaus hloov pauv, qhov kev nce siab hauv creatinine ntau hauv cov zis thiab ntshav ntshav tom qab kev kho mob tsis ua haujlwm, ntau zaus rau cov neeg mob raum leeg mob hlwb, nyob rau hauv kev kho mob ntshav siab nrog diuretics thiab thaum lub raum tsis ua haujlwm, tsis tshua muaj hypercalcemia, tsis paub meej heev - qhov nce hauv QT ntu nruab nrab ntawm ECG (saib "Cov Lus Qhia Tshwj Xeeb"), kev nce siab ntawm cov tshuaj uric acid thiab cov piam thaj hauv cov ntshav, kev nce siab hauv kev ua haujlwm ntawm daim siab enzymes, hypokalemia, uas tshwj xeeb tshaj yog rau atsientov, muaj kev pheej hmoo (saib. "qhia tshwj xeeb"), hyponatremia thiab hypovolemia, ua rau lub cev qhuav dej thiab orthostatic hypotension. Ib txhij hypochloremia tuaj yeem ua rau kom muaj kev tiv thaiv metabolic alkalosis (qhov tshwm sim thiab qhov mob ntawm cov nyhuv no tsawg tsawg).

Sab kev tshwm sim muaj nyob rau hauv kev soj ntsuam kuaj mob

Cov kev mob tshwm sim thaum ADVANCE txoj kev kawm tau zoo sib xws nrog cov ntawv pov thawj kev nyab xeeb yav dhau los rau kev sib xyaw ntawm perindopril thiab indapamide. Cov kev mob tshwm sim hnyav tau sau tseg hauv qee cov neeg mob hauv cov pab pawg tau kawm: hyperkalemia (0.1%), mob raum tsis ua hauj lwm (0.1%), mob ntshav tawm ntshav (0.1%) thiab hnoos (0.1%).

Hauv 3 tus neeg mob nyob rau hauv pab pawg perindopril / indapamide, angioedema tau pom (tiv thaiv 2 hauv cov pawg placebo).

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Noliprel yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj: dawb, oblong, muaj kev pheej hmoo ntawm ob sab (hauv cov hlwv ntawm 14 thiab 30 pcs., 1 blister hauv cardboard lub thawv).

Cov muaj pes tsawg leeg ntawm 1 lub tshuaj suav nrog cov tshuaj nquag:

Perindopril tertbutylamine ntsev - 2 mg,
Indapamide - 0.625 mg.

Ntu cov khoom siv: microcrystalline cellulose, lactose monohydrate, magnesium stearate, hydrophobic colloidal silicon dioxide.

Cov Tshuaj Hauv Tshuaj

Noliprel® A yog kev sib koom ua ke npaj muaj perindoprilarginin (ib qho angiotensin hloov enzyme inhibitor) thiab indapamide (ib qho diuretic los ntawm sulfonamide derivative pawg). Pharmacological cov yam ntxwv ntawm cov tshuaj Noliprel® A sib txuas cov khoom ntiag tug ntawm txhua qhov sib xyaw.

Kev sib xyaw ntawm perindopril thiab indapamide txhim kho kev txiav txim siab ntawm lawv. Noliprel® A muaj cov tshuaj tiv thaiv qhov cuam tshuam ntawm kev txhaj tshuaj rau ob leeg diastolic thiab ntshav siab (BP) hauv cov haujlwm "dag" thiab "sawv". Cov nyhuv ntawm cov tshuaj no kav 24 teev. Kev kho mob tshwm sim tsawg dua 1 hlis tom qab pib kho thiab tsis nrog tachycardia. Kev txiav tsis siab ntawm kev kho mob tsis ua rau muaj kev tshem tawm tus mob.

Noliprel® A txo qhov tsis txaus ntawm sab laug ventricular hypertrophy, txhim kho arterial elasticity, txo tag nrho peripheral vascular tsis kam, tsis cuam tshuam rau lipid metabolism (tag nrho cov cholesterol, qhov siab lipoprotein roj (HDL) thiab tsis tshua muaj ntom (LDL), triglycerides)).

Perindopril

Perindopril yog ib qho inhibitor ntawm qhov enzyme uas hloov angiotensin I rau angiotensin II (ib qho ACE inhibitor).

Angiotensin-hloov enzyme, lossis kinase, yog ib qho exopeptidase uas nqa tawm kev hloov pauv ntawm angiotensin Kuv mus rau hauv vasoconstrictor tshuaj angiotensin II, thiab kev puas tsuaj ntawm bradykinin, uas muaj cov vasodilating siv, ua rau tsis muaj zog ntawm heptapeptide. Raws li qhov tshwm sim ntawm perindopril:

txo cov kev zais ntshis ntawm aldosterone,
los ntawm lub ntsiab cai ntawm kev hais lus tsis zoo nce qhov kev ua si ntawm renin hauv ntshav ntshav,
nrog lub caij nyoog siv, nws txo qis tag nrho peripheral vascular tsis kam, uas yog qhov tseem ceeb vim qhov cuam tshuam rau cov hlab ntsha hauv cov leeg thiab ob lub raum.

Cov teebmeem no tsis yog nrog los khaws cov ntsev thiab kua dej los yog txoj kev loj hlob ntawm reflex tachycardia.

Perindopril muaj kev cuam tshuam hypotensive rau hauv cov neeg mob uas muaj ob qho qis thiab ib txwm plasma renin kev ua si.

Nrog rau kev siv perindopril, muaj kev poob qis hauv ob qho systolic thiab diastolic ntshav siab (BP) hauv "dag" thiab "sawv" txoj haujlwm. Kev tshem tawm ntawm cov tshuaj tsis ua rau muaj ntshav siab.

Perindopril muaj cov nyhuv vasodilating, pab kho qhov ywj pheej ntawm cov hlab ntsha loj thiab cov qauv ntawm cov leeg ntshav ntawm cov hlab ntsha me, thiab kuj tseem txo cov leeg ntshav ventricular hypertrophy.

Qhov kev siv ntau yam ntawm thiazide diuretics kho qhov hnyav ntawm cov nyhuv antihypertensive. Ntxiv rau, kev sib xyaw ntawm ACE inhibitor thiab thiazide diuretic kuj ua rau txo qis kev pheej hmoo ntawm hypokalemia hauv cov neeg mob uas tau txais diuretics.

Perindopril normalizes kev ua haujlwm ntawm lub siab, txo qis ua ntej thiab tom qab thauj.

Thaum kawm hemodynamic tsis nyob hauv cov neeg mob uas muaj lub plawv tsis ua hauj lwm ntev, nws tau raug qhia:

txo hauv kev sau siab hauv sab laug thiab sab xis ventricles ntawm lub plawv,
txo nyob rau hauv tag nrho peripheral vascular tsis kam,
ntau zog cov zis thiab cov plawv mob ntau zog ntxiv,
ntxiv rau cov leeg ntshav khiav hauv cheeb tsam.

Indapamide belongs rau cov pab pawg ntawm sulfonamides - los ntawm pharmacological thaj chaw nws yog ze rau thiazide diuretics. Indapamide inhibits reabsorption ntawm sodium ions nyob rau hauv lub cortical ntu ntawm Henle voj, uas ua rau kom muaj kev nce ntxiv ntawm cov kev zam ntawm sodium, chlorine thiab, rau qhov tsawg dua, potassium thiab magnesium ions los ntawm ob lub raum, yog li nce diuresis.

Cov nyhuv antihypertensive yog manifested nyob rau hauv cov koob tshuaj uas xyaum tsis ua rau mob diuretic.

Indapamide txo qis vascular hyperreactivity nrog kev hwm rau adrenaline. Indapamide tsis cuam tshuam rau cov ntshav lipids: triglycerides, cov roj cholesterol, LDL thiab HDL, cov metabolism hauv cov khoom noj (suav nrog cov neeg mob ntshav qab zib ua ntshav qab zib mellitus).

Pab txo qis sab laug ventricular hypertrophy.

Tsuas tshuaj thiab tswj hwm

Sab hauv, nyiam dua thaum sawv ntxov, ua ntej noj mov, 1 ntsiav tshuaj ntawm cov tshuaj Noliprel® A 1 zaug hauv ib hnub.

Yog tias ib hlis tom qab pib txoj kev kho mob qhov xav tau hypotensive tsis tau tiav, qhov koob tshuaj yuav muab ob npaug rau koob tshuaj 5 mg + 1.25 mg (tsim los ntawm cov tuam txhab nyob hauv cov npe lag luam Noliprel® A forte).

Tsis hlauv

Cov tshuaj yog contraindicated rau hauv cov neeg mob uas mob raum tsis zoo (CC tsawg dua 30 ml / min.).

Rau cov neeg mob uas mob raum tsawg (CC 30-60 ml / min), qhov siab tshaj plaws ntawm Noliprel® A yog 1 ntsiav tshuaj ib hnub.

Cov neeg mob uas mob CC sib npaug los yog ntau dua 60 ml / min. Tsis tas yuav hloov kho cov koob tshuaj. Thaum txoj kev kho, kev saib xyuas ntshav plasma creatinine thiab poov tshuaj ntau yog tsim nyog.

Siv thaum cev xeeb tub thiab lactation

Cov tshuaj yuav tsum tsis txhob siv nyob rau thawj lub hlis thaum cev xeeb tub.

Thaum npaj kev cev xeeb tub lossis thaum nws tshwm sim thaum noj Noliprel® A, koj yuav tsum tsis txhob noj tshuaj tam sim ntawd thiab sau ntawv tawm lwm txoj kev kho mob antihypertensive.

Cov kev tshawb fawb pom zoo tsim nyog ntawm ACE inhibitors hauv cov poj niam cev xeeb tub tsis tau ua. Cov ntaub ntawv tsis tshua muaj txiaj ntsig txog kev cuam tshuam ntawm cov tshuaj nyob rau thawj lub hlis thaum cev xeeb tub tau qhia tias kev noj cov tshuaj tsis ua rau muaj kev cuam tshuam tsis zoo cuam tshuam nrog fetotoxicity.

Noliprel® A yog sib kis ntawm lub sijhawm xyoo II thiab III ntawm cev xeeb tub (saib ntu "Contraindications").

Nws paub tias ncua ntev mus rau ACE inhibitors ntawm tus me nyuam hauv plab thib ob thiab thib peb lub cev xeeb tub tuaj yeem ua rau lub cev tsis muaj zog (txo lub raum tsis ua haujlwm, oligohydramnios, ua rau cov pob txha qeeb ntawm pob txha taub hau) thiab kev txhim kho ntawm cov teeb meem hauv cov menyuam yug tshiab (lub raum tsis ua haujlwm, ntshav siab, hyperkalemia).

Yog tias tus neeg mob tau txais tshuaj Noliprel® A thaum lub sijhawm II lossis III ntawm lub sijhawm cev xeeb tub, nws raug nquahu kom ua qhov kev kuaj mob ntawm tus menyuam hauv plab txhawm rau txhawm rau ntsuas tus mob ntawm pob txha taub hau thiab lub raum kev ua haujlwm.

Noj ntau dhau

Feem ntau cov tsos mob ntawm kev haus ntau tshaj yog qhov cim tseg rau hauv cov ntshav siab, qee zaum ua ke nrog xeev ntuav, ntuav, ua tsis taus pa, kiv taub hau, tsaug zog, tsis meej pem, thiab oliguria, uas tuaj yeem mus rau hauv anuria (vim los ntawm hypovolemia). Kev xoo hluav taws xob tsis sib xws (hyponatremia, hypokalemia) kuj yuav tshwm sim.

Kev ntsuas kub ntxhov yog txo kom tshem tawm cov tshuaj tawm hauv lub cev: ntxuav lub plab thiab / lossis tshuaj kho cov pa roj carbon tshuab, tom qab ntawd rov kho cov dej-electrolyte tshuav nyiaj li cas.

Nrog rau qhov txo qis hauv cov ntshav siab, tus neeg mob yuav tsum tsiv mus rau qhov chaw supine nrog tsa ceg tsa ceg. Yog tias tsim nyog, kho qhov tseeb hypovolemia (piv txwv li, tso dej tshuaj ntawm 0.9% sodium chloride tov). Perindoprilat, qhov ua kom nquag plias ntawm perindopril, tuaj yeem tshem tawm hauv lub cev los ntawm lim ntshav.

Tsis pom zoo kev sib txuas ua ke

Kev npaj lithium: nrog rau kev siv lithium npaj txhij thiab ACE inhibitors, kev thim rov qab nce siab nyob rau hauv cov concentration ntawm lithium hauv cov ntshav ntshav thiab cov tshuaj lom cuam tshuam nrog yuav tshwm sim. Kev siv ntxiv ntawm thiazide diuretics tuaj yeem txuas ntxiv kom cov concentration ntawm lithium thiab nce qhov kev pheej hmoo ntawm kev ua kom tsis muaj kuab lom. Kev siv ua ke ib txhij ntawm kev sib xyaw ntawm perindopril thiab indapamide nrog lithium npaj tsis pom zoo. Yog tias tsim nyog, txoj kev kho kom zoo yuav tsum tau saib xyuas cov roj ntsha lithium hauv cov ntshav ntxiv (saib ntu "Cov lus qhia tshwj xeeb").

Tshuaj, kev sib txuam ntawm uas yuav tsum tau saib xyuas tshwj xeeb

Baclofen: yuav nce hypotensive nyhuv. Ntshav siab thiab lub raum kev ua haujlwm yuav tsum tau saib xyuas; yog tias tsim nyog, kev hloov kho tshuaj ntawm cov tshuaj tiv thaiv ntshav siab yuav tsum tau ua.

Nonsteroidal anti-inflammatory tshuaj (NSAIDs), suav nrog kev siv tshuaj ntau ntawm acetylsalicylic acid (ntau dua 3 g / hnub): NSAIDs tuaj yeem ua rau txo qis diuretic, natriuretic thiab antihypertensive cuam tshuam. Nrog rau cov kua dej hauv lub cev poob qis, mob raum tsis ua haujlwm tuaj yeem tsim muaj (vim yog txo qis ntawm cov qog ua kua). Ua ntej pib kev kho mob nrog cov tshuaj, nws yog ib qho tsim nyog yuav tsum ua rau cov kua dej tsis txaus thiab ua tib zoo tshuaj saib lub raum kev ua haujlwm thaum pib kho.

Kev sib txuam ntawm cov tshuaj uas yuav tsum tau saib xyuas

Tricyclic antidepressants, antipsychotics (tshuaj tiv thaiv kev tiv thaiv): cov tshuaj ntawm cov chav kawm no txhim kho cov nyhuv antihypertensive thiab ua rau muaj kev pheej hmoo ntawm orthostatic hypotension (ntxiv cov nyhuv).

Corticosteroids, tetracosactide: txo cov nyhuv antihypertensive (ua kua thiab sodium ion tuav tseg vim yog corticosteroids).

Lwm cov tshuaj tiv thaiv antihypertensive: yuav txhim khu cov nyhuv antihypertensive.

Cov lus qhia tshwj xeeb

Kev siv cov tshuaj Noliprel® A 2.5 mg + 0.625 mg, muaj qhov qis ntawm indapamide thiab perindopril arginine, tsis yog nrog los txo qhov tseem ceeb ntawm qhov nquag ntawm cov kev mob tshwm sim, nrog rau kev zam ntawm hypokalemia, piv nrog perindopril thiab indapamide ntawm cov koob tshuaj qis kawg uas tau tso cai (saib ntu " Sab Nyaj "). Thaum pib ntawm txoj kev kho nrog ob yam tshuaj tiv thaiv kabmob, uas tus neeg mob tsis tau txais ua ntej, kev pheej hmoo ntawm idiosyncrasy tsis tuaj yeem txiav txim siab tau. Kev ua tib zoo saib xyuas tus neeg mob txo txoj kev pheej hmoo no.

Lub raum khiav tsis zoo

Kev kho yog contraindicated nyob rau hauv cov neeg mob uas mob raum tsis zoo (CC tsawg dua 30 ml / min). Hauv qee tus neeg mob ntshav siab tsis muaj lub plawv yav dhau los uas tsis pom kev mob raum ua ntej, txoj kev kho yuav qhia pom qhov ntsuas qog ua haujlwm tsis zoo. Hauv qhov no, kev kho yuav tsum tsis ua mus ntxiv. Yav tom ntej, koj tuaj yeem rov pib kho ua ke nrog kev siv tshuaj tsawg kawg, lossis siv cov tshuaj siv hauv kev kho tshuaj monotherapy.

Cov neeg mob zoo li no yuav tsum tau soj ntsuam cov poov tshuaj poov tshuaj thiab cov tshuaj creatinine ntau ntxiv - 2 lub lis piam tom qab pib kho thiab txhua 2 lub hlis tom qab. Cov raum tsis ua hauj lwm feem ntau tshwm sim rau cov neeg mob lub plawv mob raum tsis zoo los yog ua rau lub raum tsis ua haujlwm zoo, suav nrog lub raum leeg ntshav hlab plawv.

Arterial hypotension thiab ua tsis taus dej-electrolyte tshuav

Hyponatremia cuam tshuam nrog kev pheej hmoo ntawm txoj kev loj hlob sai ntawm cov hlab ntsha hypotension (tshwj xeeb tshaj yog nyob rau cov neeg mob uas muaj lub raum mob ntshav ntawm lub raum thiab ob leeg lub raum artery stenosis). Yog li, thaum saib xyuas cov neeg mob yam ntxwv, kev saib xyuas yuav tsum tau them rau cov tsos mob ntawm lub cev qhuav dej thiab txo qis hauv cov roj ntsha hauv ntshav, piv txwv, tom qab zawv plab lossis ntuav. Cov neeg mob no xav tau kev soj ntsuam cov ntshav ntshav electrolytes txhua lub sijhawm.

Nrog rau txoj kev mob ntshav ntau heev ntawm cov ntshav liab, kev tswj hwm ntawm 0.9% sodium chloride tov yuav tsum tau.

Kev hloov pauv ntawm cov roj ntsha tsis txuas yog ib qho kev sib cuam tshuam rau kev kho mob txuas ntxiv. Tom qab kho rov qab ntawm lub ntim ntawm cov roj ntsha thiab cov ntshav siab, txoj kev kho tuaj yeem rov qab siv qhov kev siv tshuaj tsawg kawg, lossis tshuaj yeeb tshuaj tuaj yeem siv hom monotherapy.

Poov tshuaj ntau ntau

Kev siv sib xyaw ua ke ntawm perindopril thiab indapamide tsis tiv thaiv kev txhim kho ntawm hypokalemia, tshwj xeeb tshaj yog rau cov neeg mob ntshav qab zib mellitus lossis lub raum tsis ua haujlwm. Xws li kev siv tshuaj los tiv thaiv cov tshuaj tiv thaiv thiab cov tshuaj diuretic, kev saib xyuas tsis tu ncua ntawm cov theem ntawm cov poov tshuaj hauv cov ntshav ntshav yog tsim nyog.

Cov Cai Siv Tshuaj So

Cov tshuaj yog ntawv yuav tshuaj.

Raws li kev kho mob monotherapy, tus kws kho mob feem ntau qhia rau perindopril thiab indapamide cais. Analogues ntawm cov tshuaj suav nrog Co-preness lossis Prestarium Arginine Combi. Ntxiv rau, cov chaw tsim khoom tsim cov Noliprel hauv lwm qhov tshuaj.

Tus nqi nruab nrab ntawm Noliprel Ib ntsiav tshuaj 2.5 mg + 0.625 mg hauv Moscow cov khw yog 540-600 rubles.

Kev sib txuam

1. Kev sib xyaw tsis pom zoo siv

Kev npaj lithium: nrog rau kev siv lithium npaj txhij thiab ACE inhibitors, kev thim rov qab nce siab nyob rau hauv cov concentration ntawm lithium hauv cov ntshav ntshav thiab cov tshuaj lom cuam tshuam nrog yuav tshwm sim. Kev siv ntxiv ntawm thiazide diuretics tuaj yeem txuas ntxiv kom cov concentration ntawm lithium thiab nce qhov kev pheej hmoo ntawm kev ua kom tsis muaj kuab lom. Kev siv ua ke ib txhij ntawm kev sib xyaw ntawm perindopril thiab indapamide nrog lithium npaj tsis pom zoo. Yog tias kev kho mob li ntawd yog qhov tsim nyog, cov ntsiab lus lithium hauv cov ntshav plasma yuav tsum tau soj ntsuam tas li (saib "Cov Lus Qhia Tshwj Xeeb").

2. Tshuaj, kev sib txuam ntawm qhov uas yuav tsum tau saib xyuas tshwj xeeb thiab ceev faj

Baclofen: yuav nce hypotensive nyhuv. Ntshav siab thiab lub raum kev ua haujlwm yuav tsum raug saib xyuas; koob tshuaj tiv thaiv kab mob antihypertensive yog tsim nyog yog tias tsim nyog.

NSAIDs, suav nrog kev siv tshuaj ntau ntawm acetylsalicylic acid (ntau dua 3 g / hnub): NSAIDs yuav txo qis cov diuretic, natriuretic thiab antihypertensive cuam tshuam. Nrog rau cov kua dej hauv lub cev poob qis, mob raum tsis ua haujlwm tuaj yeem tsim muaj (vim yog txo qis ntawm cov qog ua kua). Ua ntej pib kev kho mob nrog cov tshuaj, nws yog ib qho tsim nyog yuav tsum ua rau cov kua dej tsis txaus thiab ua tib zoo tshuaj saib lub raum kev ua haujlwm thaum pib kho.

3. Kev sib txuam ntawm cov tshuaj uas yuav tsum tau saib xyuas

Corticosteroids, tetracosactide: txo cov nyhuv antihypertensive (ua kua thiab sodium ion tuav tseg vim yog corticosteroids).

Lwm cov tshuaj tiv thaiv antihypertensive: yuav txhim khu cov nyhuv antihypertensive.

1. Kev sib xyaw tsis pom zoo siv

Potassium-sparing diuretics (amiloride, spironolactone, triamteren) thiab cov poov tshuaj npaj: ACE inhibitors txo qis cov poov tshuaj los ntawm lub raum los ntawm cov diuretic. Potassium-sparing diuretics (piv txwv li, spironolactone, triamteren, amiloride), cov tshuaj potassium, thiab cov ntsev ntxiv ntsev tuaj yeem ua rau muaj kev nce siab ntau ntxiv hauv cov concentration ntawm cov potassium hauv cov ntshav cov ntshav kom txog thaum tuag. Yog tias siv kev sib xyaw ua ke ntawm ACE inhibitor thiab cov tshuaj saum toj no (qhov tseeb ntawm hypokalemia) yog qhov tsim nyog, kev ceev faj yuav tsum tau siv kev soj ntsuam thiab kev soj ntsuam cov ntsiab lus poov tshuaj nyob hauv cov ntshav ntshav thiab ECG tsis tas yuav tsum nqa tawm.

2. Ua ke ntawm cov tshuaj uas xav tau kev saib xyuas tshwj xeeb

Cov kab mob hypoglycemic rau kev tswj hwm qhov ncauj (sulfonylurea derivatives) thiab tshuaj insulin: cov teebmeem hauv qab no tau piav qhia rau captopril thiab enalapril. ACE inhibitors tuaj yeem txhim kho cov nyhuv hypoglycemic ntawm insulin thiab sulfonylurea derivatives hauv cov neeg mob ntshav qab zib mellitus. Kev txhim kho ntawm cov ntshav qog nqaij hlav ntshav yog muaj tsawg kawg (vim muaj kev nce ntxiv hauv cov ntshav qabzib thiab qhov txo qis hauv qhov xav tau ntawm insulin).

3. Kev sib txuam ntawm cov tshuaj uas yuav tsum tau saib xyuas

Allopurinol, cytostatic thiab cov tshuaj tiv thaiv kab mob, corticosteroids (rau kev siv tshuaj) thiab procainamide: ib txhij siv nrog ACE inhibitors yuav cuam tshuam nrog kev pheej hmoo ntawm leukopenia.

Txhais tau rau kev siv tshuaj loog: kev siv ACE inhibitors thiab cov neeg sawv cev rau cov tshuaj loog tshwj xeeb tuaj yeem ua rau nce ntxiv hauv cov nyhuv antihypertensive.

Diuretics (thiazide thiab lub voj): kev siv cov tshuaj diuretics hauv kev txhaj tshuaj siab tuaj yeem ua rau hypovolemia, thiab ntxiv ntawm perindopril rau kev kho tuaj yeem ua rau mob hypotension arterial.

Kev npaj kub: thaum siv ACE inhibitors, incl. perindopril, nyob rau hauv cov neeg mob uas tau txais iv kub npaj (sodium aurothiomalate), cov tsos mob nyuaj tau piav qhia, suav nrog: ntsej muag ntawm daim tawv nqaij hyperemia, xeev siab, ntuav, ntshav liab hypotension.

1. Ua ke ntawm cov tshuaj uas xav tau kev saib xyuas tshwj xeeb

Cov tshuaj uas tuaj yeem ua rau pirouette arrhythmias: vim tias muaj kev pheej hmoo ntawm hypokalemia, ceev faj yuav tsum tau siv thaum siv indapamide nrog cov tshuaj uas tuaj yeem ua rau pirouette arrhythmias, piv txwv li, cov tshuaj tiv thaiv kab mob (quinidine, hydroquinidine, disopyramide, amiodarone, dofetilide, ibutilide , bretilia tosylate, sotalol), qee cov tshuaj tiv thaiv kev puas tsuaj (chlorpromazine, cyamemazine, levomepromazine, thioridazine, trifluoperazin), benzamides (amisulpride, sulpiride, sultopride, tiapride), butyrophenones (droperidol, gallop) ridol), lwm yam tshuaj tiv thaiv kab mob ua paug (pimozide), lwm yam tshuaj, xws li bepridil, cisapride, diphemanil methyl sulfate, erythromycin (iv), halofantrine, misolastine, moxifloxacin, pentamidine, sparfloxacin, vincaminin (iv), methadone astrogen Cov. Kev siv tib lub sij hawm nrog cov tshuaj saum toj no yuav tsum raug zam, qhov kev pheej hmoo ntawm hypokalemia thiab, yog tias tsim nyog, nws txoj kev kho, tswj lub sijhawm QT.

Cov tshuaj uas tuaj yeem ua rau hypokalemia: amphotericin B (iv), corticosteroids thiab mineralocorticosteroids (rau kev siv tshuaj), tetracosactides, laxatives uas ua rau lub plab hnyuv: ua rau muaj kev pheej hmoo ntawm hypokalemia (ntxiv cov nyhuv). Nws yog qhov tsim nyog los tswj cov ntsiab lus potassium hauv cov ntshav ntshav, yog tias tsim nyog, nws txoj kev kho. Kev saib xyuas tshwj xeeb yuav tsum tau muab rau cov neeg mob ib txhij txais cov mob glycosides. Cov tshuaj kho kab mob uas tsis txhawb kev mob plab hnyuv yuav tsum tau siv.

Mob glycosides: hypokalemia ua rau kom muaj kev phiv rau cov mob glycosides. Nrog tib lub sijhawm siv ntawm indapamide thiab mob glycosides, cov ntsiab lus hauv potassium nyob hauv cov ntshav ntshav thiab ECG qhov ntsuas yuav tsum tau saib xyuas thiab, yog tias tsim nyog, kho kev kho.

2. Qhov sib xyaw ntawm cov tshuaj uas yuav tsum tau saib xyuas

Metformin: ua haujlwm lub raum tsis ua haujlwm uas yuav tshwm sim thaum noj cov tshuaj diuretics, tshwj xeeb tshaj yog voj diuretics, thaum lub sijhawm tswj hwm metformin ua rau muaj kev pheej hmoo ntawm lactic acidosis. Metformin yuav tsum tsis txhob siv yog tias qhov kev tsim creatineine hauv ntshav ntshav ntau dua 15 mg / l (135 μmol / l) hauv cov txiv neej thiab 12 mg / l (110 μmol / l) ntawm cov poj niam.

Iodine-muaj cov tshuaj zoo sib xws: lub cev qhuav dej ntawm lub cev thaum noj cov tshuaj diuretic ua rau muaj kev pheej hmoo ntawm lub raum tsis ua haujlwm, tshwj xeeb tshaj yog thaum siv cov tshuaj iodine ntau ntau nrog. Ua ntej siv cov tshuaj iodine uas muaj cov tshuaj tiv thaiv zoo sib xws, cov neeg mob yuav tsum tau them cov tshuaj rau qhov ua kua dej.

Cov tshuaj ntsev calcium: nrog rau kev tswj hwm tib lub sijhawm, hypercalcemia tuaj yeem txhim kho vim tias tsis muaj cov quav calcium calcium los ntawm lub raum.

Cyclosporin: kev nce siab ntawm cov creatinine hauv cov ntshav ntshav yog ua tau yam tsis muaj kev hloov pauv ntawm cyclosporin hauv cov ntshav ntshav, txawm tias muaj cov ntsiab lus ntawm dej thiab sodium ions.

Yuav ua li cas coj, chav kawm ntawm kev tswj hwm thiab ntau npaum li cas

Sab hauv, nyiam dua thaum sawv ntxov, ua ntej noj mov.

1 ntsiav tshuaj ntawm cov tshuaj Noliprel ® Ib zaug 1 zaug nyob rau ib hnub.

Yog tias ua tau, cov tshuaj pib nrog xaiv cov koob tshuaj ntawm cov tshuaj siv ib feem. Yog tias xav tau kev kho mob, koj tuaj yeem xav txog qhov ua tau los ntawm kev muab tshuaj kho sib xyaw nrog Noliprel ® A sai tom qab kev kho mob monotherapy.

Cov neeg mob ntshav siab thiab ntshav qab zib hom 2 mob ntshav qab zib mellitus los txo cov kev pheej hmoo ntawm cov mob microvascular (los ntawm ob lub raum) thiab macrovascular muaj teeb meem los ntawm cov kab mob plawv

1 ntsiav tshuaj Noliprel ® Ib zaug 1 nyob rau ib hnub. Tom qab 3 lub hlis ntawm kev kho mob, yuav tsum tau txais txiaj ntsig zoo, nws muaj peev xwm nce qhov koob tshuaj ntxiv rau 2 ntsiav tshuaj ntawm Noliprel 1 A 1 zaug hauv ib hnub (lossis 1 ntsiav tshuaj ntawm Noliprel ® A forte 1 zaug hauv ib hnub).

Cov neeg laus cov neeg mob

Kev kho nrog cov tshuaj yuav tsum yog tom qab saib xyuas lub raum thiab lub ntsej muag ntshav siab.

Cov tshuaj yog contraindicated rau hauv cov neeg mob uas mob raum tsis ua haujlwm (creatinine Cl tsawg dua 30 ml / min).

Rau cov neeg mob uas mob raum tsis txaus (Cl creatinine 30-60 ml / min), nws raug nquahu kom pib kev kho mob nrog cov tshuaj tsim nyog (nyob rau hauv kev kho mob monotherapy), uas yog ib feem ntawm Noliprel ® A.

Rau cov neeg mob uas muaj Cl creatinine sib npaug los yog ntau dua 60 ml / min, tsis tas yuav hloov cov tshuaj. Thaum txoj kev kho, kev saib xyuas ntshav plasma creatinine thiab poov tshuaj ntau yog tsim nyog.

Cov tshuaj yog contraindicated rau hauv cov neeg mob uas muaj mob rau daim siab hnyav.

Hauv nruab nrab daim siab tsis ua hauj lwm, tsis tas yuav hloov kho qhov tshuaj.

Menyuam yaus thiab tub ntxhais hluas

Noliprel ® A yuav tsum tsis txhob raug rau cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo vim tsis muaj ntaub ntawv qhia txog kev ua haujlwm zoo thiab kev nyab xeeb rau cov tshuaj hauv cov neeg mob hnub nyoog no.

Cov lus qhia tshwj xeeb

Kev siv cov tshuaj Noliprel ® A 2.5 mg + 0.625 mg, muaj qhov qis ntawm cov tshuaj indapamide thiab perindopril arginine, tsis yog nrog txo qhov tseem ceeb txo cov ntau zaus ntawm cov kev mob tshwm sim, nrog rau kev zam ntawm hypokalemia, piv nrog perindopril thiab indapamide hauv kev txhaj tshuaj qis tshaj plaws uas tau tso cai siv (saib "Adverse Adverse) kev ua "). Thaum pib ntawm txoj kev kho nrog ob yam tshuaj tiv thaiv kabmob, uas tus neeg mob tsis tau txais ua ntej, kev pheej hmoo ntawm kev tsim idiosyncrasy tsis tuaj yeem txiav txim siab tau. Kev ua tib zoo saib xyuas tus neeg mob txo txoj kev pheej hmoo no.

Lub raum khiav tsis zoo

Kev kho yog contraindicated nyob rau hauv cov neeg mob uas mob raum tsis ua haujlwm (creatinine Cl tsawg dua 30 ml / min). Hauv qee tus neeg mob ntshav siab tsis muaj lub plawv yav dhau los uas tsis pom kev mob raum ua ntej, txoj kev kho yuav qhia pom qhov ntsuas qog ua haujlwm tsis zoo. Hauv qhov no, kev kho yuav tsum tsis ua mus ntxiv. Yav tom ntej, koj tuaj yeem rov pib kho ua ke nrog kev siv tshuaj tsawg kawg, lossis siv cov tshuaj siv hauv kev kho tshuaj monotherapy.

Cov neeg mob zoo li no yuav tsum tau soj ntsuam cov poov tshuaj poov tshuaj thiab cov tshuaj creatinine ntau ntxiv - 2 lub lis piam tom qab pib kho thiab txhua 2 lub hlis tom qab. Cov raum tsis ua haujlwm feem ntau tshwm sim hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev los yog lub raum tsis ua haujlwm zoo, suav nrog nrog raum leeg mob stenosis.

Arterial hypotension thiab ua tsis taus dej-electrolyte tshuav

Nrog rau txoj kev mob ntshav ntawm txoj hlab ntshav ntau heev, kev tswj hwm ntawm 0.9% sodium chloride tov yuav tsum tau.

Kev hloov pauv ntawm cov roj ntsha tsis txuas yog ib qho kev sib cuam tshuam rau kev kho mob txuas ntxiv. Tom qab kho rov qab los ntawm BCC thiab ntshav siab, koj tuaj yeem rov pib kho mob uas siv cov tshuaj tsawg kawg, lossis siv cov tshuaj siv hauv hom tshuaj monotherapy.

Kev siv sib xyaw ua ke ntawm perindopril thiab indapamide tsis tiv thaiv kev txhim kho ntawm hypokalemia, tshwj xeeb tshaj yog rau cov neeg mob ntshav qab zib mellitus lossis lub raum tsis ua haujlwm. Xws li kev siv tshuaj los ntawm kev siv tshuaj tiv thaiv cov tshuaj tiv thaiv kabmob (antihypertensive) thiab cov tshuaj diuretic, kev saib xyuas tsis tu ncua ntawm cov poov tshuaj nyob hauv cov ntshav ntshav yog qhov tsim nyog.

Nws yuav tsum tau yug hauv siab tias qhov muaj pes tsawg leeg ntawm excipients ntawm cov tshuaj suav nrog lactose monohydrate. Noliprel ® A yuav tsum tsis txhob raug rau cov neeg mob uas muaj keeb tiv thaiv tsis haum ntshav, lactase deficiency thiab glucose-galactose malabsorption.

Kev siv tib lub sij hawm ntawm kev sib xyaw ntawm perindopril thiab indapamide nrog lithium npaj tsis pom zoo (saib. "Contraindications", "Kev Sib Tham").

Txoj kev pheej hmoo ntawm kev tsim neutropenia thaum noj ACE inhibitors yog noj tshuaj-siv thiab nyob ntawm cov tshuaj noj thiab muaj cov kab mob sib xyaw. Neutropenia tsis tshua muaj tshwm sim rau cov neeg mob uas tsis muaj cov kab mob sib kis, tab sis qhov kev pheej hmoo ntau ntxiv hauv cov neeg mob uas lub raum tsis ua haujlwm, tshwj xeeb tshaj yog tiv thaiv cov kab mob ntawm cov kab mob sib txuas (nrog rau cov kab mob lupus erythematosus, scleroderma). Tom qab kev tshem ntawm ACE inhibitors, cov cim ntawm neutropenia ploj ntawm lawv tus kheej.

Txhawm rau zam kev txhim kho ntawm cov kev hloov pauv ntawd

Dab tsi kho Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.? Zoo Tshaj Plaws Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.Cov. Cov kev xaiv Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.Cov. Cia rau cov neeg mob Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.Cov. Nqe zoo rau Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.Cov. Siv yis ntau Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.Cov. Cia li coj Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs.. Noliprel Ib ntsiav tshuaj 2.5 + 0.625 mg 30 pcs. yuav online.

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