Telmisartan (Mikardis)

ʻO ka wehewehe e pili ana i 04.11.2016

• Palapala Latin: Telmisartan
• ʻĀkau ATX: C09CA07
• Mea waiwai: Kelea Telmisartan (Telmisartan)
• Mea Hana: TEVA Pharmaceutical Plant, JSC no Ratiopharm International GmbH, Hungary / Kelemānia

Aia ma ke ʻano o ka hoʻokuʻu ʻana, aia kahi papa i 80 a 40 mg o ka mea ikaika.

Lapaʻau lāʻau

ʻO Telmisartan kahi koho ākea koho kaomiensin II. E hoʻokūkū ana me nā angiotensin no ka paʻa ʻana i ka mea hoʻokipa AT1. ʻAʻole i ʻike inoa ʻole ʻia nā mea ʻē aʻe.

ʻAʻole keʻae ʻo Telmisartan i ka hana a renin, ACE, ʻaʻole ia i kāohi i nā kahawai kuleana e alakaʻi ai i nā ions, e hōʻemi i nā mea o ka manaʻo. aldosterone i loko koko.

ʻO kahi dosis i 80 mg aneane e hoʻopau loa i ka hoʻonui he pili kokomeinga e ka angiotensin II. Pono ka hopena kiʻekiʻe 24 mau hola, a laila e emi ka emi ʻana. I kēia hihia, ua loaʻa ka hopena koʻikoʻi o ka lāʻau lapaʻau ma kahi o nā hola 48 ma hope o ka lawe ʻana i nā papa.

Hoʻololi ʻo Telmisartan i nā kaila systolic a me ka diastolic, akā ʻaʻole i hoʻopilikia i ka holo pulse. ʻAʻole i hōʻike ʻia kahi hopena o ke hoʻohui ʻana a i ʻole ka hōʻiliʻili koʻikoʻi i loko o ke kino.

Lapaʻau lāʻau

Ma hope o ka nānā ʻana, ua mālama maikaʻi ʻia ka lāʻau a hoʻōla koke. ʻO ka bioavailability e pili ana i ka 50%. Hoʻopili maikaʻi loa i nā protein plasma.

ʻOi aku ka kiʻekiʻe o ka plasma plasma nui loa i ka wā e lawe ai i nā like like. Akā ʻaʻole pili kēia i ka hopena.

Hāpai e kū ana i nā leʻa. Hoʻopau ia i kēia hana hoʻonaneaʻO ka hoʻopau ʻia ʻana o ka mea nui ma o nā ʻōpū. ʻO ka hapalua o ke ola he 20 mau hola.

Nā hōʻailona no ka hoʻohana ʻana

Hoʻohana ʻia e mālama ia haehae maʻi a no ka pale ʻana i ka make ma mua o nā maʻi o ka ʻōnaehana cardiovascular ma hope o māhā, puʻuwai puʻuwaimaʻi maʻi vascular haʻalele hipertrophy ventricular.

Nā Hoʻohui

Pāpā ʻia ka kuhikuhi ʻana iā Telmisartan me:

• pilikia maʻi o ka biliary tract,
• uona pūpū hema,
• mahele moome kahalike,
• kuʻi ʻole ʻauʻai,
• ka huhū nui loa i nā mea ikaika a i ʻole ia mea ʻē aʻe o kahi ʻāpana o ka lāʻau,
• o ka hāpai ʻana,
• malalo o na makahiki he 18.

Nā hopena hopena

Loaʻa nā hopena ʻaoʻao.

ʻO kekahi o nā maʻi 100-1000 e lawe i ka lāʻau lapaʻau me nā hōʻailona aʻe:

I nā 1 o nā 1000-10000 nā mea maʻi i nānā:

• nā maʻi urinary a me nā eapūnana cystitis, pharyngitis, sinusitis) ai ʻole sepsis,
• thrombocytopenia,
• hōʻemi iki ka pae hemoglobin,
• hopohopo o ke kaumaha
• nā hui ʻike
• tachycardia,
• kahe ana i ke kahe o ke koko i ka wā e hoʻololi ai i ke kūlana o ke kino (mai kahi kikoo a kū i ke kikowaena),
• ʻeha paʻakikī ʻeha
• ka malo maloʻo
• lawelawe aho ʻaia,
• māhuahua ka hana naʻau ʻaʻano enehana,
• hoonui kumukuai plasma o ka uric acid,
• ʻōpū paʻa
• erythema,
• angioedema,
• huʻaula pōpole,
• kāohiā hewazematous.

Loaʻa nā hopena ʻokoʻa a ʻaʻole hiki ke hoʻoholo ʻia ka neʻe ʻole o ka neʻe:

• tendon pain like like tendonitis,
• nā hoʻonui kiʻekiʻe o nā eosinophils i loko o ke koko.

Hoʻohui

Hoʻohui ʻia o Telmisartan me nā lāʻau lapaʻau ʻē aʻe:

• Baclofen, Amifostine a me nā mea āpau antihypertensive - hoʻonui ʻia ka hopena hypotensive,
• barbiturates, nā lāʻau narcotic, ethanol a me antidepressants - e hōʻike ʻia ana kahi hōʻike o orthostatic hypotension a i ʻole ka pohō ʻana o kona hopena.
• Puʻu, ʻO ka hole waiwai a me kekahi mau diuretics ʻē aʻe - hoʻonui ka hopena hypotensive,
• Digoxin - hoʻonui piʻi Digoxin i loko o plasma
• lithium mākaukau - kahi hoʻi e hoʻihoʻi ʻoliu o ka lilo o ka lithium i ke koko, pono ke nānā ʻana i kēia mākaukau.
• Nā NSAID - e hoʻonui ka hopena o nā hōʻailona o ka maʻi nā mālamalama maikaʻi ʻolewaiwai pū me ka huhū
• pākūkū-sparing diuretics, pālala, Heparin, Cyclosporin, Tacrolimus, Trimethoprim - hoʻonui i ka paʻū o ka pāhana i ka serum o ke koko,
• GCS - ua hoʻemi ʻia ka hopena antihypertensive,
• Amlodipine - Ke ulu nei ka hopena o Telmisartan.

Ka hana lāʻau lapaʻau

ʻO ka ʻāneʻa ala ala Angiotensin II.

He telagonist kikoʻī ʻo Telmisartan o ka ʻĀkau e huhū ana i ka ʻā. He wahi kūlana kiʻekiʻe ia no ka AT1 receptor subtype o ka angiotensin II, kahi i ʻike ʻia ai ka hana a ka angiotensin II. Hoʻololi ʻo Telmisartan angiotensin II mai kona mākaʻikaʻi ʻana i ka mea nāna i hopu, me ka nele i ka hana a kahi agonist e pili ana i kēia receptor. Hoʻopili wale nei ʻo Telmisartan i ka subpipe AT1 receptor o ka angiotensin II. Ke hoʻomau nei ka ʻili ʻana. ʻAʻole loaʻa ka Telmisartan i ka pilina no nā mea ʻē aʻe i komo aku (me nā mea ʻaeʻaʻi AT2) a me nā mea ʻimi ʻē aʻe a me nā mea hou aku i ʻike ʻia i nā kaʻi. Ka hana koʻikoʻi o kēia mau mea nānā, a me ka hopena o ko lākou hiki ke hoʻoulu ʻia me ka angiotensin II, ke ʻano o ka piʻi ʻana me ke koho ʻana i ka telmisartan, ʻaʻole i aʻo ʻia ʻia. Hoʻemi ia i ka hoʻololi o ka aldosterone i loko o ke koko, ʻaʻole pale i ka renin i ka plasma koko a ʻaʻole paʻa i nā kaila wai, ʻaʻole ia e kāohi i ka ACE (kininase II, he enzyme e hōʻino hoʻi i ka bradykinin). No laila, ʻaʻole i manaʻo ʻia ka hoʻonui ʻana o nā hopena i hoʻopiʻi ʻia e bradykinin.

ʻO Telmisartan ma ke ʻano o 80 mg mau poloka i ka hopena hypertensive o ka angiotensin II. Hoʻomaka ʻia ka hoʻomaka ʻana o ka hana hypotensive ma loko o 3 mau hola ma hope o ka hoʻokele mua o ka telmisartan. Noho ka hopena o ka lāʻau no 24 mau hola a kū mau i nā hola 48. He hopena hypotensive e haʻi ʻia he 4-8 mau pule ma hope o ka hoʻokomo pinepine.

I nā mea maʻi me ka hypertension arterial, hoʻemi ka telmisartan i ka hoʻokahe koko systolic a me ka diastolic, me ka hoʻopi ʻole ʻana i ka hapa o ka puʻuwai.

I ka hihia o ka hōʻano pani ʻana o ka telmisartan, pane iki ka maʻi koko i kona pae kumu me ka ʻole o ka hoʻomohala ʻana i ka maʻi withdrawal.

ʻLoe a me ke kākele

Ua kuhikuhi ʻia ka lāʻau lapaʻau ma ke ʻano, me ka manaʻo ʻole o ka meaʻai.

Me ka hypertension arterial, ʻo ka lāʻau mua i ʻōlelo ʻia e like me 1 papa (40 mg) hoʻokahi i ka lā. I nā hihia ʻaʻole i hoʻokō ʻia ka hopena therapeutic, ʻoi ka dosis ma kahi o 80 mg hoʻokahi i ka lā. Ke hoʻoholo nei inā he hoʻonui i ka maʻa, pono e noʻonoʻo pono i ka hopena antihypertensive ka hopena e loaʻa pinepine ma loko o 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

No ka hōʻemi o ka morbidity cardiovascular a me ka make, he mau papa ʻaina i hōʻike ʻia i kahi papa 1 tablet (80 mg) hoʻokahi i ka lā. I ka hoʻomaka mua o ka mālama ʻana, pono paha ke hoʻoponopono hou ʻia i ke koko.

ʻO nā mea maʻi me ka hiki ʻole o ka renal (me ka poʻe ma ka hemodialysis), nā mea maʻi, nā maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka lāʻau lapaʻau.

I nā mea maʻi me ka pīhoihoi haʻahaʻa a me ke ʻano o ka maʻi (class A a me B ma ke keiki-Pugh scale), ʻaʻole pono ka lāʻau o kēlā me kēia lā e 40 mg.

Loaʻa ka hopena

ʻO nā hihia i ʻike ʻia i nā hopena maikaʻi ʻaʻole i hoʻoponopono me ka wahine, ka makahiki a me ka lāhui o nā mea maʻi.

Nā maʻi maʻi: sepsis, me ka sepsis momona, nā maʻi urinary tract (e pili ana i ka cystitis), nā maʻi ʻeha o ka ʻōpū.

Mai ka pūnaehana hemopoietic: kahi hōʻemi o ka hemoglobin, anemia, eosinophilia, thrombocytopenia.

Mai ka ʻaoʻao o ka pūnaehana neʻe i loko: nā insomnia, ka hopohopo, ke kaumaha, kaumaha.

Mai ka pūnaehana cardiovascular: he mau hōʻailona hōʻemi i ke koko (me ke ʻano orthostatic hypotension), bradycardia, tachycardia, nāwaliwali.

Mai ka papa hana hanu: pōkole o ka hanu.

Mai ka pūnaehana ʻana: ka waha maloʻo, utuloli, ʻeha ʻole i loko o ka ʻōpū, ka luaʻi ʻana, ka dyspepsia, ka ʻeha, ka ʻeha o ka ʻōpū, nā hana ʻōpio āpau, hoʻonui i ka hana o nā transaminases hepatic.

Mai ka pūnaehana urinary: hana renal impaired (komo me ke kūleʻa o ka pono renal), perema peripheral, hypercreatininemia.

Mai ka pūnaehana musculoskeletal: arthralgia, ʻeha ʻeha, nā kuʻekuʻe wāwae (nā umauma o nā ʻeha o ke keiki bipi), ʻeha ma ka lalo o nā haʻalulu, myalgia, ʻeha i nā tendons (mau hōʻailona e like me ka hōʻike ʻana o ka tendonitis), ka ʻeha ma ka umauma.

Nā ʻano maʻi: anaphylactic reaction, hypersensitivity reaksyon i ke ʻano ikaika a ʻole nā ​​mea kōkua o ka lāʻau lapaʻau, angioedema, eczema, erythema, hōʻeha o ka ʻili, ʻeha (komo i ka lāʻau), urticaria, ʻalo ʻole.

Nā hōʻailona hana Laboratory: hyperuricemia, hoʻonui kiʻekiʻe o CPK koko, hyperkalemia.

Nā mea'ē aʻe: hyperhidrosis, maʻi like-flu, ʻike maka, asthenia (nāwaliwali).

ʻO ka hoʻohana ʻana i ka lāʻau MIKARDIS® i ka wā hāpai a me ka lactation

Contardicated ʻo Mikardis® i ka wā hāpai a me ka lactation.

Me kahi wahine hapaha i hoʻolālā ʻia, pono e hoʻololi ʻia ʻo Mikardis® me kekahi lāʻau lapaʻau antihypertensive. I ka wā e paʻa ai ka hapai, ʻo Mikardis e hoʻokuʻu koke ʻia i ka hiki.

Ma nā noi preclinical, ʻaʻohe hopena teratogenic o ka lāʻau, akā ua ʻike ʻia kahi hopena fetotoxic.

Nā ʻōlelo kikoʻī

I kekahi mau mea maʻi, ma muli o ka hoʻokauʻi ʻana o RAAS, ka mea nui i ka wā e hoʻohana ai i ka hui pū ʻana o nā lāʻau lapaʻau e hana ana i kēia ʻōnaehana, hana ʻole i ka māka (me ke ʻano o ke aloha ʻole) No laila, pono e hana ʻia nā lāʻau me ke ʻano o ka blockade pālua o RAAS ka lāʻau hoʻokahi a me ka mālama pono ʻana i nā hana renal (e komo pū ana me ka nānā wā maʻamau o ka serum potassium a me nā hana ʻoi.)

Ma nā hihia i hilinaʻi ʻia ai ke ʻano vascular a me ka hana ʻana i ka hana nui ma luna o ka hana RAAS (no ka laʻana, ma ka mea maʻi me ka puʻuwai naʻau ʻole, a me nā maʻi lā paha, me ka stenosis renal a i nā stenosis artery hoʻokahi pūlau), ka koho i nā lāʻau lapaʻau e hoʻopilikia nei i kēia ʻōnaehana. hiki ke hele pū me ka hoʻomohala ʻana o ka maʻi arterial hypotension, hyperazotemia, oliguria, a, i nā hihia eʻe ʻole, ʻoi aku ka maikaʻi o ka renal.

Hoʻokumu i ka ʻike i ka hoʻohana ʻana i nā lāʻau lapaʻau ʻē aʻe e pili ana i ka RAAS, me ka hoʻohana pū ʻana o Mikardis® a me ka diuretics pākia-paʻakai, pākili waiwai a ka paʻakai, nā paʻakai paʻakai, a me nā lāʻau ʻē aʻe e hoʻonui ai i ka kao o ka pāima i loko o ke koko (ma ka laʻana, heparin), pono ka nānā ʻana i kēia ʻōkuhi i nā maʻi.

Eia kekahi, hiki ke hoʻohana ʻia ʻo Mikardis® e hui pū me ka diuret thiazide, e like me hydrochlorothiazide, kahi he hopena hypotensive (no ka laʻana, ʻo MikardisPlus® 40 mg / 12.5 mg, 80 mg / 12.5 mg).

I ka poʻe maʻi me ka maʻi hypertension arterial, ʻo ka nui o ka telmisartan 160 mg i kēlā me kēia lā i hui pū ʻia me hydrochlorothiazide 12.5-25 mg ma mua a ʻoluʻolu hoʻi.

ʻOi aku ka maikaʻi o Mikardis® i nā mea maʻi o ka lāhui Negroid.

E hoʻokuʻu i ke ʻano a me ka ʻano

Ka puka helu - nā papa: pōpō, pāpaʻi-cylindrical, me ka scaffold a me ka chamfer, keʻokeʻo a ʻulaʻula paha-keʻokeʻo ma ke kala (5, 7, 10 a me nā pcs 20 i loko o nā pā blister, i kahi pū kāleka pepa 1, 2, 3, 4, 5, 8 a i ʻole he 10 mau ʻeke, 10, 20, 28, 30, 40, 50, a me 100 mau mea pākahi i kēlā me kēia, i nā ipu i hili ʻia me nā laka huki me ka mana o ka puʻu mua a i ʻole nā ​​lihi ʻōpiopio me kahi ʻōnaehana ʻōpiopio a me nā hoʻokele mua mua, i kahi pahu pahu 1 kēlā me kēia pūpū kēlā me nā kauoha no ka hoʻohana ʻana o Telmisartan).

Helu 1 papa:

• wae kaha: telmisartan - 40 a 80 mg,
• nā mea waiwai (nā papa o 40/80 mg): sodium croscarmellose - 12/24 mg, sodium hydroxide - 3.35 / 6.7 mg, povidone-K25 - 12/24 mg, lactose monohydrate (waiū waiʻa) - 296.85 / 474.9 mg, magnesium stearate - 3.80 / 6.4 mg, meglumine - 12/24 mg.

He maʻi haole

ʻO ka hoʻohana ʻana o ka telmisartan ma loko o kahi lāʻau o 80 mg e hoʻopaʻa piha i ka hopena hypertensive o ka II II. Hoʻopilikia ka hopena antihypertensive ma loko o kahi he 3 mau hola ma hope o ka manawa mua, e lōʻihi no 24 mau a noho mau i ka nui a hiki i nā hola 48. Hoʻohā pinepine ʻia ka hopena therapeutic ma hope o 4-8 mau pule o ka hoʻohana maʻamau i ka lāʻau.

I ka hypertension arterial, hoʻohaʻahaʻa ka telmisartan i ka systolic a me ke kahe koko diastolic (BP) me ka hoʻopiʻi ʻole ʻana i ka puʻuwai puʻuwai (HR).

Ma hope o ka hoʻokuʻu ʻole ʻana i ka lāʻau lapaʻau, hoʻi mai ka pae koko i ke ʻano waiwai i nā lā he nui. ʻAʻole hiki ke ulu i ka maʻi Withdrawal.

Wahi a nā haʻawina hoʻokūkū hoʻohālikelike, ʻo ka hopena hypotensive o ka telmisartan ua hoʻohālikelike ʻia i nā lāʻau lapaʻau o nā papa ʻē aʻe (no ka laʻana, atenolol, hydrochlorothiazide, enalapril, lisinopril, amlodipine). Eia nō naʻe, ua hōʻemi pinepine ka pipi i ka poʻe maʻi e loaʻa ana i ka telmisartan ma mua o nā mea maʻi i lawe aku i nā inhibitions ACE.

Kāohi pilikia Cardiovascular

I nā maʻi maʻi 55 mau makahiki a ʻoi aku me ka neʻe ischemic attack, stroke, coronary heart heart (CHD), peripheral artery lesions a me nā hoʻopiʻi o nā maʻi type 2 (e like me ka ventricular hypertrophy, micro- a i ʻole macroalbuminuria, retinopathy) me ka mōʻaukala. i kahi hui pilikia no nā pilikia cardiovascular, ua loaʻa i ka telmisartan ka hopena e like me ka ramipril i ka hōʻemi ʻana i ka hopena o ka hopena mua: ʻo ka hoʻokipa ma muli o ka pohihihi naʻau neostatal stroke, nonfatal myocardial infarction, cardiovascular mortally.

ʻO Telmisartan, e like me ramipril, ua hōʻike pū ʻia ka hopena i ka hoʻemi ʻana i ke kahe o nā pahu lua: ʻaʻole i ka momona, ka uha nonocardial non-fatal, a me ka make lima.

ʻO ka maikaʻi o ka telmisartan i loko o nā haʻahaʻa o lalo o ka 80 mg e hōʻemi i ka hopena o ka maʻi cardiovascular i aʻo ʻia.

ʻAʻole like me ka ramipril, ʻo ka telmisartan ka mea i liʻiliʻi e hoʻokaumaha i nā hopena hopena e like me ka paʻai maloʻo a me ka angioedema. Eia nō naʻe, ke kū nei i ka hope o kāna intake, ua hoʻonui pinepine ʻia ka hypotension arterial.

Nā palapala ʻano:

Pākaukau 1 papa:

dosis 40 mg

mea waiwai: telmisartan - 40 mg

nā mea hoʻohālikelike: sodium hydroxide - 3.4 mg, povidone K 30 (polyvinylpyrrolidone ke kāʻei molowa aila) - 12.0 mg, meglumine - 12.0 mg, mannitol - 165.2 mg, magnesium stearate - 2.4 mg, talc - 5.0 mg . ^ E Ha yM.

hewahewa o 80 mg

mea ikaika: telmisartan - 80 mg

nā mea hoʻowalewale: ʻO ka sodium hydroxide - 6,8 mg, povidone K 30 (polyvinylpyrrolidone ke kāʻei molohiki medium) - 24.0 mg, meglumine - 24.0 mg, mannitol - 330.4 mg, magnesium stearate - 4.8 mg, talc - 10,0 mg.

Ke keʻokeʻo a kokoke paha i keʻokeʻo nā papa papa, ʻūwī, papa ʻāina-cylindrical me ka bevel a me ka notch.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO Telmisartan kahi mauʻāmaʻomaʻo ala kaomi neʻe i ka ʻāpoʻopika (type AT₁), kūpono inā lawe ʻia ma ke ʻano. Aia kona pilina kiʻekiʻe no ka AT subtype₁ nā ʻolokeʻo angiotensin II kahi i ʻike ʻia ai ka hana o ka angiotensin II. Hōʻike i ka angiotensin II mai ka pilina me ka mea nāna i hopu, ʻaʻole i loaʻa ka hana a kahi agonist e pili ana i kēia receptor.

Hoʻopaʻa wale ʻia ʻo Telmisartan i ka AT subtype₁ ʻōpena ʻaopehu II. He lōʻihi ke kamaʻilio ʻana. ʻAʻohe ona pilina no nā mea ʻē aʻe e komo, me nā antibodies₂ nā mea ākea a me nā mea hou aku i ʻoluʻolu. Ka hana koʻikoʻi o kēia mau mea nānā, a me ka hopena o ko lākou hiki ke hoʻoulu ʻia me ka angiotensin II, ke ʻano o ka piʻi ʻana me ke koho ʻana i ka telmisartan, ʻaʻole i aʻo ʻia ʻia. Hoʻemi ia i ka hoʻoneʻeʻana o aldosterone i loko o ke koko, ʻaʻole pale i ka renin i ka plasma koko a ʻaʻole paʻa i nā kaila wai.ʻAʻole i lohi ʻo Telmisartan i ka angiotensin e hoʻohuli ana i ka enzyme (kininase II) (he enzyme e wāwahi ana hoʻi i ka bradykinin). No laila, ʻaʻole i manaʻo ʻia ka hoʻonui ʻana o nā hopena i hoʻopiʻi ʻia e bradykinin.

I ka poʻe maʻi, ka telmisartan ma ke ʻano o 80 mg paʻa i ka hopena hypertensive o ka angiotensin II. ʻO ka hoʻomaka ʻana o ka hana antihypertensive ua hoʻomaopopo ʻia i loko o 3 mau hola ma hope o ka hoʻokele mua o ka telmisartan. Ke hoʻomau nei ka hopena o ka lāʻau i 24 mau hola a kū mau i nā hola 48. Kūkulu ʻia kahi hopena antihypertensive e kūkulu i nā 4-8 mau pule ma hope o ka lawelawe waha.

I nā mea maʻi me ka hypertension arterial, hoʻohaʻahaʻa ka telmisartan systolic a me ka diastolic blood pressure (BP) me ka hoʻopiʻi ʻana i ka puʻuwai puʻuwai (HR).

Ma ka hihia o ka hōkole o ka telmisartan, hoʻemi kahe koko i kona pae mua me ka ʻole o ka hoʻomohala ʻana i ka maʻi "withdrawal".

Lapaʻau lāʻau

Ke lawe wale ʻia, lawe koke ʻia mai ka gastrointestinal tract. ʻO Bioavailability 50%. I ka manawa like me ka ʻai, ʻo ka emi ʻana o AUC (ma lalo o ke kahe o ke ʻano o ka paʻa) i waena o 6% (ma kahi iki o 40 mg) a i 19% (ma kahi kikoʻī o 160 mg). 3 mau hola ma hope o ka nānā ʻana, ua hoʻonaninā ʻia ka ʻike ʻana i ke plasma koko, me ka ʻole o ka manawa e ʻai ai. Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. Me ka_max(ka uka nui) a me AUC paha i like me 3 a me 2 mau manawa, ʻoi aku ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me ka loaʻa ʻole o kahi hopena koʻikoʻi.

Ke kamaʻilio pū ʻana me nā protein plasma koko - 99.5%, nui me ka albumin a me alpha-1 glycoprotein. ʻO ka ʻike kumukūʻai o ka nui ʻike o ka hoʻoili ʻana i ka hoʻoheheʻe kūlike ʻo 500 lita. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic. Lapaʻau nā metabolites me ka hana ʻole. ʻO ka hoʻopau hapa hapa-ola e ʻoi aku ma mua o 20 mau hola. Hoʻokuʻu ʻia kēia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 2% o ka nui i lawe ʻia. ʻO ke kūʻokoʻa o ka plasma holoʻokoʻa he kiʻekiʻe (900 ml / min) i hoʻohālikelike ʻia me ke kahe koko "hepatic" (ma kahi o 1500 ml / min.).

ʻAʻole ʻokoʻa nā pharmacokinetics o ke telmisartan i nā maʻi maʻi ma o nā mea maʻi ʻōpio. ʻAʻole pono ke hoʻoponopono ʻia.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

ʻAʻole koi ʻia nā loli i nā maʻi me nā pilikia ʻole, a me nā mea maʻi ma ka hemodialysis. ʻAʻole neʻe ʻia ka Telmisartan e ka hemodialysis.

ʻO nā maʻi me ka palaualohi maʻa

I nā mea maʻi me ka pīhoihoi haʻahaʻa a me ke ʻano o ka maʻi (class A a me B ma ke keiki-Pugh scale), ʻaʻole pono ka lāʻau o kēlā me kēia lā e 40 mg.

Hoʻohana ʻo Pediatric

ʻO nā hōʻailona nui o ka pharmacokinetics o telmisartan i nā keiki i keiki a 6 a 18 paha mau makahiki ma hope o ka lawe ʻana i ka telmisartan ma ke kūkaʻi o 1 mg / kg a i ʻole 2 mg / kg no 4 mau pule, i hoʻohālikelike ʻia me nā ʻikepili i loaʻa i ka mālamaʻana i ka pākeke, a hōʻoia i ka pili ʻole o ka pharmacokinetics o telmisartan ka niā C_max.

Hoʻohui nūhou

Hiki paha ke Telmisartan i ka hopena hypotensive o nā mea hana antihypertensive. ʻAʻole i ʻike ʻia nā ʻano ʻē aʻe o nā mea pili i ka haukapila.

ʻO ka hui pū me ka digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin a me amlodipine ʻaʻole alakaʻi i kahiʻoihana koʻikoʻi pili i nā maʻi. Ka hoʻonui iki i ka awelika o ka hoʻokaʻawale ʻana o digoxin i loko o ke koko koko ma o ka awelika o 20% (ma ka hihia hoʻokahi, ma ka 39%). Me ka hoʻokolohua hoʻohālikelike o ka telmisartan a me ka digoxin, ʻoi ke kaʻina o kēlā me kēia manawa i ka ʻike ʻana i ka ʻike o ka digoxin i loko o ke koko.

Me ka hoʻohana like ʻana o ka telmisartan a me ramipril, ua ʻike ʻia kahi hoʻonui 2.5-pi i ka AUC0-24 a me Cmax o ka ramipril a me ramipril. ʻAʻole paʻa i ke kumu koʻikoʻi o kēia hanana.

Me ka hoʻokolohua mau ʻana o nā inhibitor ACE a me ka hoʻomākaukau ʻana i ka lithium, kahi māliʻi hoʻi i hoʻihoʻi ʻia o ka loaʻa ʻana o ka lithium i loko o ke koko, ua mālama ʻia, me kahi hopena o ka mea make. I nā hihia loaʻa ʻole, ua hōʻike ʻia nā loli like me ka hoʻokele ʻana o nā ʻĀpio antagonist ngiotensin II. Me ka hoʻokolohua hoʻohālikelike o ka lithium a me ka angiotensin II antagonist receptor, ua manaʻo ʻia e hoʻoholo i ka ʻike o ka lithium ma ke koko.

ʻO ka hoʻōla me nā NSAID, e komo pū ai i ka acetylsalicylic acid, nā mea paʻa COX-2, a me nā NSAID ʻaʻole i koho ʻia, hiki ke hōʻeha i ka maʻi renal i nā maʻi maʻi dehydrated. Ke hana nei nā lāʻau lapaʻau e hana ana i ka renin-angiotensin-aldosterone system (RAAS) i kahi hopena synergistic. I nā poʻe maʻi e loaʻa ana i ka NSAIDs a me ka telmisartan, pono ka uku o ka bcc i ka hoʻomaka ʻana o ka mālama ʻana a me ka hana hoʻopōlohelohe i mālama ʻia.

ʻO ka emi ʻana o ka hopena o nā mea antihypertensive, e like me ka telmisartan, ma o ka lawe ʻana i ka hopena o vasodilating o ka prostaglandins i mālama ʻia me ka hui pū ʻana me NSAIDs.

ʻLoe a me ke kākele

Kuhi ʻia nā papa telmisartan no nā lānawa waha i kēlā me kēia lā a lawe ʻia me ka wai ʻole, me ka ʻole ʻole o ka meaʻai.

Ka hoʻomaʻamaʻa ʻana o nā hypertension arterial pono

ʻO ka dosis ʻōpiopio i ʻōlelo ʻia e 40 mg hoʻokahi i kēlā me kēia lā.

I nā hihia i loaʻa ʻole ai ke koko i makemake ʻia, hiki ke hoʻonui ʻia i loko o ke kao o Telsartan® ka nui o 80 mg hoʻokahi i ka lā.

Ke hoʻonui nei i ka pona, pono e noʻonoʻo ia i ka hopena antihypertensive ka hopena e hana pinepine ʻia ma loko o ʻehā a ʻewalu mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Hiki ke hoʻohana ʻo Telsartan® i ka hui pū me ka diuret thiazide, no ka laʻana, hydrochlorothiazide, i hui pū ʻia me ka telmisartan i kahi hopena hypotensive hou.

I ka poʻe maʻi me ka maʻi hypertension arterial, ʻo ka nui o ka telmisartan he 160 mg / lā (ʻelua papa o Telsartan® 80 mg) a hui pū me ka hydrochlorothiazide 12.5-25 mg / lā i hoʻohaʻomaʻi maikaʻi ʻia a ʻalahala.

Kāohi i ka morbidity cardiovascular a me ka make

ʻO ka dosis i ʻōlelo ʻia e 80 mg hoʻokahi i kēlā me kēia lā.

ʻAʻole i hoʻoholo ʻia inā he mau haʻahaʻa ma lalo o ka 80 mg i mea e hōʻemi ai i ka morbidity cardiovascular a me ka make.

I ka hoʻomaka mua o ka hoʻohana o ka lāʻau Telsartan® no ka pale ʻana o ka morbidity cardiovascular a me ka make kino, e pono ai e mālama i ke kahe o ke koko (BP), a he mea pono paha e hoʻoponopono i ke kahe koko me nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko.

Hiki ke lawe ʻia ka Telsartan® me ka manaʻo ʻole o ka kōʻai ʻana o ka meaʻai.

ʻAʻole koi ʻia nā loli i nā maʻi me nā pilikia ʻole, a me nā mea maʻi ma ka hemodialysis. He palena palena nō ka mālama ʻana i nā maʻi me nā pilikia ʻole ʻole a me ka hemodialysis. No kēlā mau maʻi maʻi, e aʻo ʻia e hoʻomaka me kahi haʻahaʻa o 20 mg. ʻAʻole i lawe ʻia ʻo Telsartan® mai ke koko i ka wā o ka hemofiltration.

I ka poʻe maʻi me ka pīhoihoi haʻalulu maʻalahi ke ʻano, ʻaʻole pono ka nui o ka lāʻau i kēlā me kēia lā he 40 mg hoʻokahi i ka lā.

ʻAʻole pono ke hoʻoponopono ʻia.

Nosological ʻano papa (ICD-10)

Mea Hana:

Severnaya Zvezda CJSC, Rusia

Kūlana kānāwai o ka mea hana:

111141, Moscow, Zeleny prospekt, d. 5/12, p. 1

Palapala i ka hana a me ka ʻae ʻana:

188663, ka ʻāina Leningrad., Moku ʻo Vsevolozhsk, kūloko Kuzmolovsky, kūkulu ʻana i papa hana no 188

ʻŌpū a me ka lactation

Hoʻopili ʻia ka hoʻohana ʻana o Telmisartan-SZ i ka wā hāpai. Ke hōʻike nei i ka hapai, pono e hoʻokuʻu koke i ka lāʻau. Inā kūpono, pono e koho ʻia nā lāʻau lapaʻau ʻē aʻe (me nā papa ʻē aʻe o nā lāʻau antihypertensive i ʻae ʻia no ka hoʻohana ʻana i ka wā hāpai).

Hoʻohana ʻia ka hoʻohana ʻana o ARA II i ka wā ʻelua a me ʻekolu o ka hapē ʻana o ka hapai.

Ma nā noi preclinical o telmisartan, ʻaʻole i ʻike ʻia nā hopena teratogenic, akā ua hoʻokū ʻia ka fetotoxicity. Ua ʻike ʻia ka hoʻolaha ʻana o ka ARA II i ka wā o ka hapalua a me ke kolu o ka hapalua i ka hapai ʻana i ka male ʻana i ka fetotoxicity i loko o kahi kanaka (hoʻōla i ka hana renal, oligohydroamnion, lohi i ka ossification o ka ʻōpala,) a me ka mea huʻipiʻi neonatal (ili ʻole hoʻokele, hypotension, hyperkalemia). ʻO ka poʻe maʻi e hoʻolālā ana i kahi wā hāpai e hāʻawi ʻia i nā ʻano aʻoaʻo. Inā hele ka mālama ʻana o ka ARA II i ka lua o ka hapalua o ka hapai ʻana, e kuhikuhi ʻia e loiloi i ka hana o ka hana a me ka ʻano o ka hana ʻana i ke ʻōpua i ka pūpū.

ʻO nā pēpē hou i loaʻa i ko lākou mau makuahine ARA II e nānā pono ʻia no ka hypotension arterial.

ʻO ka maʻi me Telmisartan-SZ i contraindicated i ka wā o ka hoʻouluʻana.

ʻAʻole i aʻo ʻia nā ʻike e pili ana i ka momona.