ʻO Mikardis 80 mau ʻōlelo hoʻohana no ka hoʻohana ʻana

ʻO Mikardis i hana ʻia i nā papa: oblong, kokoke i ke keʻokeʻo a i ʻole keʻokeʻo, ma ka ʻaoʻao kekahi kahakaha "51N" a i ʻole "52N" (40 a 80 mg paha), ma kekahi - ke hōʻailona o ka hui (7 pcs. In blisters, each) 2, 4, 8 a i ʻole 14 mau blisters i loko o kahi pahu pahu.

Aia ka hoʻonohonoho ʻana o ka papa pākuhi 1:

• Mea waiwai: telmisartan - 40 a 80 mg,
• ʻO nā mea kōkua (40/80 mg i kēlā): magnesium stearate - 4/8 mg, sodium hydroxide - 3.36 / 6.72 mg, meglumine - 12/24 mg, polyvidone (collidone 25) - 12/24 mg, sorbitol - 168.64 / 337.28 mg.

E hoʻokuʻu i ke ʻano

Ke keʻokeʻo, he mau keokeo nā lāʻau lapaʻau me ka kākau ʻana o ka 51H ma kekahi ʻaoʻao a me ka logo ʻoihana ma kēlā ʻaoʻao.

7 nā papa papa ʻia me kahi ala o 40 mg i loko o kahi palaha; 2 a 4 paha mau kīleʻe i loko o kahi pahu pepa. Nā kumulāʻau e 7 paha me kahi ala he 80 mg ma ke kue, 2, 4 a i ʻole 8 mau blisters i loko o kahi pahu pahu

Pharmacodynamics a me ka pharmacokinetics

Lapaʻau lāʻau

Telmisartan - nā mea koho pani koho angiotensin II. ^ E Ha yM. He tropism kiʻekiʻe ma AT1 kūloko subtype angiotensin II. ^ E Ha yM. Nā hoʻokūkū me angiotensin II i nā mea kikoʻī kūikawā me ka ʻole o ka hopena like. ʻO ka hoʻomau ka hoʻomau.

ʻAʻole ia e hōʻike i kahi tropism no nā subtypes o nā receptors. Hoʻemi i ka ʻike aldosterone i loko o ke koko, ʻaʻole e kaohi i ka plasma renin a me nā kaila ion i loko o nā hale.

Hoʻomaka hopena hypotensive nānā ʻia i loko o nā hola ʻekolu i hala ma hope o ka hoʻokele ʻana telmisartan. ^ E Ha yM. Hana wale ka hana no kahi lā a i ʻole. Hoʻoulu ka hopena ʻōlelo i ka mahina ma hope o ka hoʻokele mau ʻana.

I nā poʻe me haehae maʻitelmisartan hōʻemi i ka systolic a me ke kaomi diastolic, akā ʻaʻole ia e hoʻololi i ka nui o ka pūhaka puʻuwai.

ʻAʻole ia e hoʻokau i ka maʻi hoihoi.

Lapaʻau lāʻau

Ke lawe wale ʻia, lawe koke ʻo ia mai nā ʻōpū. ʻO ka bioavailability e kokoke ana i ka 50%. Ma hope o ʻekolu mau hola, lilo ka lōʻihi o ke kaila plasma. 99.5% o ka mea hana ikaika e hoʻopili ai i nā ʻōnaehana koko. Metabolized by pane me waikawa glucuronic. ^ E Ha yM. ʻAʻole ikaika ka metabolites o ka lāʻau. ʻO ka hoʻopau hapa hapa-ola e ʻoi aku ma mua o 20 mau hola. Hoʻokuʻu ʻia ia ma o ka hoʻowalewale ʻana, ʻo ka excretion i loko o ka urine ma lalo o 2%.

Nā Hoʻohui

Nā contardicated nā papa Micardis i kēlā me kēia me nā pepeke ma luna o nā māhele o ka lāʻau lapaʻau, kaumaha nui maʻinā ate a i ʻole ʻōpala, kuʻi ʻole ʻauʻai, i ka wā hāpai a lactation, mau keiki malalo o na makahiki he 18.

Nā hopena hopena

• Mai ka pūnaehana neʻe o waena: manaʻo ʻinoāhāhuʻe lie kanikelaluhi, hopohopo, ʻōpala, nahoa.
• Mai ka papa hana hanu: nā maʻi o ka ʻalihi hanu kiʻekiʻe (sinusitis, pharyngitis, ʻOluomini), kauā.
• Mai ka pūnaehana neʻe: haʻi i ka hoʻohemo ʻana ma ka manaʻo, tachycardia, brieociaiaʻeha ka ʻeha.
• Mai ka pūnaehana hana ʻana: mualea, nā ninia, ʻumiinake hoʻonui nei i nā kao o nā ʻoli ate.
• Mai ka ʻōnaehana musculoskeletal: myalgiaʻeha ʻeha hope aolaila.
• Mai ka pūnaehana genitourinary: edema, nā maʻi o ka ʻōnaehana genitourinary, luhi.
• Hypersensitivity Mea Hoʻoikaika: Skin Rash, angioedema, urticaria.
• Nā hōʻailona hana Laboratory: anemia, hyperkalemia.
• Nā ʻili: erythemahuu dyspnea.

Mikardis, nā ʻōlelo aʻoaʻo no ka hoʻohana

Wahi a nā ʻōlelo kuhikuhi no ka hoʻohana ʻana o Mikardis, lawe ʻia ka lāʻau lapaʻau. Hoʻolako ʻia no nā pākeke dosis 40 mg i ka la hou i. I kekahi mau o nā mea maʻi, ua nānā ʻia ka hopena therapeutic i ka wā e lawe ana i ka pākōʻai 20 mg i ka la. Inā ʻaʻole mālama ʻia kahi emi ʻana o ke kaomi i ka pae i makemake ʻia, a laila hiki ke hoʻonui ʻia ka nui i ka 80 mg i kēlā me kēia lā.

Loaʻa ka hopena kiʻekiʻe o ka lāʻau i ʻelima mau pule ma hope o ka hoʻomaka ʻana o ka lāʻau.

I ka poʻe maʻi me nā maʻi koʻikoʻi haehae maʻi hiki ke hoʻohana 160 mg lālapa i kēlā lā.

Hoʻohui

Telmisartan hoʻōla hopena hypotensive ʻano ʻē aʻe o ka hoʻohaʻahaʻa ʻana.

Ke hoʻohana pū ʻia telmisartan a kāmakua pono pika noonoo no ka lohi kāmakua i ke koko, ʻoiai e hiki ke hoʻonui.

Ke lawe pū pū ʻia nā lāʻau lithium a ACE paleai ʻike ʻia kahi manawa liʻiliʻi o nā ʻike lithium i loko o ke koko, i hōʻike ʻia e nā hopena ʻona.

Hoʻomaʻamaʻa ole-lāʻau lapaau anti-inflammatory a me Mikardis ma nā maʻi dehydrated hiki ke alakaʻi i ka hoʻomohala ʻana o ka hiki ʻole o ka hana renal.

Nā ʻōlelo kikoʻī

No ka maʻi nā maʻi (ka palena paʻakai, mālama hoʻoiho, nā ninia, ka luaʻi) kahi mea i pono ai ʻo Mikardis he mea pono.

Me ka mālama aka, koho i nā kānaka me stenosis o laua nā hāmeʻa maʻi, méni valve stenosis a i ʻole aortic hypertrophic cardiomyopathy obstrive, renal koʻikoʻi, hepatic a i ʻole ʻole ka naʻau, nā maʻi o ka ʻalā.

Pāpā ʻia ka hoʻohana ʻana i ka wā aldosteronism maʻamau a kuʻi ʻole ʻauʻai.

Me kahi hoʻohala hoʻolālā, pono ʻoe e loaʻa mua i kahi mea ku pono no Mikardis me kekahi ka lāʻau antihypertensive.

E hoʻohana me ka akahele inā ka holo kaʻa.

Me ka hoʻohana me ka lāʻau lapaʻau lithium hōʻike ʻia nā nānā 'ana o ka lithium ma ke koko, no ka mea, he hiki ke hoʻonui iki.

Palena Mikardis

Ma Lūkia, he kumukūʻai o 80 mg No. 28 mai ke kumukūʻai mai 830 a 980 mau rubles. I Ukraine, ke kūʻai aku ke kumukūʻai o Mikardis i kahi ʻano like me ka 411 o ka hryvnias.

I kēiaʻatikala, hiki iā ʻoe ke heluhelu i nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau Mikardis. ^ E Ha yM. Hāʻawi i ka manaʻo o ka poʻe kipa i ka pūnaewele - nā mea kūʻai o kēia lāʻau lapaʻau, a me nā manaʻo o nā loea lapaʻau e pili ana i ka hoʻohana ʻana iā Mikardis i kā lākou hoʻomaʻamaʻa. ʻO kahi noi nui, ʻo ia ke hoʻoikaika ikaika i kāu mau loiloi e pili ana i ka lāʻau lapaʻau: kōkua ka lāʻau lapaʻau a ʻaʻole hoʻi i kōkua i ka hoʻopiʻi ʻana i ka maʻi, nā mea hoʻopiʻi a me nā hopena ʻaoʻao, ua ʻike ʻia, ʻaʻole i hoʻolaha ʻia e ka mea hana ma ka annotation. ʻO Mikardis analogues ma ke alo o nā mea hoʻokūkū hoʻokūkū loaʻa. Hoʻohana no ka mālama ʻana o ka maʻi hypertension a hoʻoemi i ke koko i ka pākeke, nā kamaliʻi, a me ka wā hapai a me ka lactation. ʻO ka hiʻohiʻona o ka lāʻau lapaʻau.

Mikardis - ka lāʻau antihypertensive.

ʻO Telmisartan (ke ʻano hana o ka lāʻau ʻo Mikardis) he antagonist kūmole o ka ʻimi o ka angiotensin 2. He pilina nui loa no ka AT1 receptor subtype o ka angiotensin 2, ma o laila ua maopopo ai ka angiotensin 2. Kūkulu ʻia kahi pilina me ka AT1 receptor subtype o ka angiotensin 2. Hoʻomau ka paʻa. 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 kā lākou hiki ke hoʻōla maoli me ka angiotensin 2, ʻo ke ʻano o ka piʻi ʻana me ka koho o 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 kao wai. ʻAʻole ia i ke pale aku i ka ACE (kininase 2), kahi hua me ka mea e hoʻopau ai i ka bradykinin, no laila, ʻaʻole i manaʻo ʻia ka hoʻonui ʻana o ka hopena i hōʻino ʻia e bradykinin.

ʻO Mikardis ma kahi pakanina o 80 mg mau poloka i ka hopena hypertensive o ka angiotensin 2. Hoʻomaka 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. Hoʻomoku pinepine kahi hopena hypotensive i hōʻea ma hope o 4-8 mau pule o ka hoʻohana maʻamau.

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 Mikardis, hoʻi hou ka AD i kona pae mua me ka ʻole o ka hoʻomohala ʻana i ka maʻi withdrawal.

ʻO Hydrochlorothiazide (ka hana ikaika o ka lāʻau Mikardis Plus) kahi diuretic thiazide. Hoʻopilikia ka Thiazide diuretics i ka reabsorption o nā electrolytes i loko o nā renal renal, e hoʻonui pinepine i ka hoʻonui ʻana o ka sodium a me nā chlorides (ma kahi kokoke i nā helu like). Ka hopena o ka diuretic o ka hydrochlorothiazide i ka hoʻohaʻahaʻa i ka bcc, he hoʻonui i ka hana ʻo renin plasma, he nui o ka huna ʻana o ka ald testosterone a ua hele pū ʻia me ka piʻi ʻana o ka pā i ka paʻakai a me ka bicarbonates, a ma muli o ia, he hōʻemi i ka pāima i loko o ka plasma koko. Me ka hoʻohana like ʻana o ka telmisartan, aia ka manaʻo e hoʻōki i ka nalowale o ka pākani i kumu ʻia e nā diuretics nei, ma muli paha o ka blockade RAAS.

Ma hope o ka lawe ʻana i ka hydrochlorothiazide, hoʻonui ʻia ka diuresis ma hope o 2 mau hola, a ʻike ʻia ka hopena nui loa ma hope o ka hola 4. ʻO ka hopena diuretic o ka lāʻau e hoʻomau nei no nā hola 6-12.

ʻO ka hoʻohana wā lōʻihi o ka hydrochlorothiazide e hōʻemi i ka hopena o ka hoʻopiʻi o ka maʻi cardiovascular a me ka make ma o lākou nei.

ʻO ka hopena antihypertensive kiʻekiʻe o ka lāʻau ʻo Mikardis Plus e hana pinepine ʻia ma nā 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Hōʻike

Telmisartan + mea waiwai (Mikardis).

Telmisartan + hydrochlorothiazide + nā mea waiwai (Mikardis Plus).

Lapaʻau lāʻau

I ka wā e lawelawe ʻia, ka wikiwiki o ka telmisartan mai ka digestive tract. ʻO Bioavailability 50%. Ke lawe like ʻia me ka meaʻai, ka hōʻemi ʻana o nā waiwai AUC mai ka 6% (i ka wa i hoʻohana ʻia ma kahi maʻa o 40 mg) a i 19% (i ka wa i hoʻohana ʻia ma ke ʻano o 160 mg). Ma hope o 3 mau hola ma hope o ka hoʻokele ʻana, hoʻonui ʻia ka manaʻo i loko o ke kaila koko me ka manaʻo ʻole o ka manawa e ʻai ai. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic. ʻAʻole hana ikaika ʻo Metabolites. 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.

Aia kekahi ʻokoʻa ma waena o nā kāne a me nā wahine. I nā wahine, ʻo Cmax a me AUC paha ma kahi o 3 a me 2 mau manawa i ʻoi aku i ke kiʻekiʻe o nā kāne (me ka loaʻa ʻole o ka hopena koʻikoʻi).

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

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.

I nā mea maʻi me ka hana aho o ka pelekane i ka pāpaʻomaʻi o ke ʻano maʻalahi o ka haʻahaʻa (kahi A me B ma ke ʻano o ke keiki-Pugh), ʻaʻole pono ka nui o ka lā o ka lāʻau i ka 40 mg.

ʻO nā hōʻailona nui o ka pharmacokinetics o ke telmisartan i nā keiki a me nā ʻōpio mau makahiki 6 a 18 mau makahiki ma hope o ka lawe ʻana i ka telmisartan ma ke ʻano he 1 mg / kg a 2 mg / kg no 4 mau pule, i ka laulā, e hoʻohālikelike ʻia me nā ʻikepili i loaʻa i ka mālamaʻana i nā pākeke, a hōʻoia i ka nonlineity o pharmacokinetics telmisartan, e pili pū me ka mahalo iā Cmax.

Ma hope o ka hoʻoponopono waha, ua ʻike ʻia ʻo Mikardis Plus Cmax hydrochlorothiazide i loko o nā hola 1-3. Ua manaʻo ʻia ka bioavailability piha ʻana e ka ʻolima renalative excretion o hydrochlorothiazide a ma kahi o 60%. Hoʻohālikelike ia i nā protein plasma koko ma 64%. ʻAʻole ia i hoʻohālikelike ʻia i ke kino o ke kanaka a hoʻopio ʻia i loko o ka urine a loli ʻole. Ma kahi o 60% o ka nui i lawe ʻia ma ke alo he 48 mau hola.

Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. I nā wahine, aia kekahiʻano koʻikoʻi i ka piʻi nui o ka hōʻola o ka plasma o ka hydrochlorothiazide.

I ka poʻe maʻi me ka hana renal impaired, hoʻemi ʻia ka helu o ka haʻalele ʻana o ka hydrochlorothiazide.

Nā Hōʻike

• hypertension aʻai (hoʻoliʻiliʻi i ke kaomi),
• ka hōʻemi ʻana o ka morbidity cardiovascular a me ka make ma ka poʻe maʻi ma waena o 55 mau makahiki a ʻoi aku me ka nui o ka maʻi o ka maʻi cardiovascular.

E hoʻokuʻu i nā palapala

Nā Papa 40 mg a me 80 mg.

Nā Papa Helu 40 mg + 12.5 mg a me 80 mg + 12.5 mg (Mikardis Plus).

Nā ʻōkuhi no ka hoʻohana a me ka helu ʻana

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

Me ka hypertension arterial, ʻo ka pona ʻukana mua o Mikardis i 1 papa (40 mg) hoʻokahi i ka lā. I nā hihia ʻaʻole i loaʻa ka hopena therapeutic, hiki ke hoʻonui ʻia ka nui o ka lāʻau i ka 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 nele o ka renal (me ka poʻe o ka hemodialysis) e hoʻoponopono ʻia ai ka lāʻau ʻaʻole pono.

I nā mea maʻi me ka hana aho o ka pelekane i ka pāpaʻomaʻi o ke ʻano maʻalahi o ka haʻahaʻa (kahi A me B ma ke ʻano o ke keiki-Pugh), ʻaʻole pono ka nui o ka lā o ka lāʻau i ka 40 mg.

ʻO ka hoʻoponopono dosage i nā poʻe maʻi maʻi ʻaʻole pono i nā loli.

Pono ʻo Mikardis Plus e lawe laka i ka manawa 1 i kēlā me kēia lā, ʻaʻohe o ka ʻai.

Hiki ke kuhikuhi ʻia ʻo Mikardis Plus 40 / 12.5 mg i nā mea maʻi i ʻike ʻia ai ka hoʻohana ʻana i ka lāʻau Mikardis ma kahi o 40 mg a i ʻole ka hydrochlorothiazide e alakaʻi i ka lawa o ke kahe koko.

Hiki ke kuhikuhi ʻia ʻo Mikardis Plus 80 / 12.5 mg i nā mea maʻi i hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau Mikardis ma kahi o 80 mg a i ʻole ʻo Mikardis Plus 40 / 12.5 mg, ʻaʻole i alakaʻi i ka hiki ke lawa o ke koko.

I ka poʻe maʻi me ka maʻi hypertension arterial, ʻoi loa ka nui o ka nui o ka nui o ka telmisartan o 160 mg i kēlā me kēia lā. Hoʻohana maikaʻi ʻia kēia pāpaʻi.

Loaʻa ka hopena

• ʻeha ka hanu ʻana o ka ʻōpū (me ka pneumonia a me ka edema pulmonary),
• ʻaʻano pōkole
• nā arrhythmias
• tachycardia
• brieociaia
• ka hoʻokaʻawale ʻana i ke koko (me ka hypotension orthostatic),
• mai nāwaliwali
• aloha
• nā wahi hiamoe hiamoe
• ʻōpala
• āhāhuʻe
• hopohopo
• manaʻo ʻino
• huhū
• lie kanikela
• nā ʻeha, hoʻohemo ʻana,
• maloʻo mucosa kala,
• he ʻano hūnā
• ʻeha ka ʻōpū
• utuka
• gaugitis
• hoʻemi i ka momona
• anorexia
• pālahalaha maʻi
• hipololeka,
• lōkohu
• lawelawe aho ʻaia,
• jaundice (hepatocellular a cholestatic) paha.
• ʻumiina
• hoʻonui hoʻonui ʻia
• ʻeha ke kaumaha
• wahī ʻaʻe
• myalgia
• aolaila
• kau pipi
• huhuhu,
• Nā hōʻailona like-tendonitis
• ʻeha ka ʻeha
• anemia pale hao, anemia aplastic, anemia hemolytic, thrombocytopenia, eosinophilia, leukopenia, agranulocytosis, thrombocytopenia,
• renal gagal, e komo pū 'ana
• nephritis interstitial,
• glucosuria
• ʻike maka
• i ka ʻike maka blurrurr
• pahu ākea-kikina glaucoma,
• huakai
• sepsis, e komo ai i nā hihia o nā mea make,
• nā maʻi ʻeha hanu luna hou (bronchitis, pharyngitis, sinusitis),
• nā maʻi urinary tract (komo i ka cystitis),
• ka mumū o nā kohu salivary,
• i ka ulu ʻana o nā ate enzyme,
• ua hoʻonui ʻia ka hana o CPK,
• mahuahua o ka uric acid i ke koko,
• paulakowalik
• hypokalemia, hyperkalemia,
• hyponatremia,
• pālahalaha maʻi
• hypoglycemia (i loko o nā maʻi me ka maʻi mellitus),
• pale ʻia ka hoʻonaninani glucose
• hoʻemi i ka hemoglobin i loko o ke koko,
• angioedema (me nā hihia o ka mea make),
• erythema
• kaʻiliʻili
• ʻohiʻala
• anaphylactic mau hiʻohiʻona,
• eczema
• lāʻau lapaʻau hoʻoluhi
• ʻO ka mea make ʻole o ka epidermal,
• like me ka hua mele
• exacerbation a i ʻole e hoʻonui i nā hōʻailona o ka systemus lupus erythematosus,
• vasculitis necrotic,
• ʻōnaehana ʻōnaehana vasculitis
• paulele
• kabale o ka systemus lupus erythematosus,
• vasculitis
• maʻiʻo-lepe maʻi
• fiva
• nāwaliwali.

Nā Hoʻohui

• maʻi hoʻomehana biliary tract
• hana ikaika paʻa 'āina kūpilikiʻi (keiki-Pugh papa C),
• pilikia hōʻeha paʻakikī (CC ma mua o 30 ml / min),
• hipokalemia Refractory, hypercalcemia,
• hoʻohana i ka manawa like me ka aliskiren i nā maʻi me ka maʻi mellitus a me nā hana ʻole ʻole (GFR e emi mai ka 60 ml / min / 1.73 m2),
• intolerance fructose hoʻoilina (pili i ka lāʻau lapaʻau ka sorbitol),
• lactase kakali, lactose intolerance, glucose-galactose malabsorption syndrome,
• mau makahiki a hiki i 18 mau makahiki (ʻaʻole palekana i palekana a kūpono ʻole)
• hapai
• lactation (lactation),
• hypersensitivity o ka hana ikaika a i ʻole nā ​​mea kōkua o ka lāʻau lapaʻau a i ʻole nā ​​kumulepala sulfonamide.

• bilateral renal aren stenosis a i ʻole stenosis kahi o hoʻokahi keiki,
• ka hana aho a pau ʻole i ka maʻi ʻōpiopio holomua (papa A a me B ma ke ʻano kamaliʻi-Pugh),
• hōʻemi i ka BCC ma muli o ke kuʻuna diuretic ma mua, nā mea kau i ka hoʻopiʻi ʻana i ka paʻakai, ka ʻeha a me ka luaʻi paha,
• hyperkalemia
• kūlana ma hope o ka mālama ʻana i ka lula (ʻaʻohe ʻike me ka hoʻohana ʻana),
• maʻi hōʻeha kūloko 3-4 FC e like me ka helu ʻana o ka New York Heart Association,
• nā kaena o ka aortic a me mitral valve,
• stenosis idiopathic hypertrophic subaortic,
• hypventrophic pono e hoʻonani,
• maʻi mellitus maʻiʻi
• konukua,
• kohola
• koki-kikina glaucoma (ma muli o ka piha o ka hydrochlorothiazide i ka hoʻohui).

ʻŌpū a me ka lactation

Hoʻopili ʻia ka hoʻohana ʻana o ka Mikardis a me Mikardis Plus i ka wā hāpai.

ʻAʻole hoʻohana ʻia nā hoʻohana o nā angiotensin 2 antagonist receptor i ka 1st trimester o ka hāpai ʻana, ʻaʻole pono e kuhikuhi ʻia kēia mau lāʻau i ka wā hāpai. Ke ulu mai ka wā hānau, 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 angiotensin 2 antagonist receptor i ka trimesters 2 a me 3. Ma nā noi preclinical o telmisartan, ʻaʻole i ʻike ʻia nā hopena teratogenic, akā ua hoʻokū ʻia ka fetotoxicity. Ua ʻike ʻia nā hopena o ka angiotensin 2 antagonist receptor i nā mea aloha a me ka 3 trimesters o ka hapai e hāpai i ka fetotoxicity i kahi kanaka (hoʻoneʻe i ka hana renalula, oligohamoamnios, lohi i ka oslula), a me ka meaʻawaʻawa neonatal (hiki ʻole ke hoʻololi, hypotension, hyperkalemia). ʻO ka poʻe maʻi e hoʻolālā ana i kahi wā hāpai e hāʻawi ʻia i nā ʻano aʻoaʻo. Inā hana ʻia ka mālama ʻana me ka angiotensin 2 antagonist receptor 2 i ka trimester 2 o ka hapai ʻana, e ʻōlelo ʻia ana ka pēpē o nā ʻōpū a me nā iwi ʻōpio o ka pūpū.

ʻO nā pēpē i loaʻa i nā makuahine nā angiotensin 2 antagonist reseptor e pono e nānā pono ia no ka hypotension arterial.

Loaʻa ka ʻike me ka hydrochlorothiazide i ka wā hapai, ʻoi aku hoʻi i ka trimester mua. Hoʻopaʻa ka Hydrochlorothiazide i ka papale placental. Hāʻawi ʻia i ka papa hana lāʻau o ka hana hydrochlorothiazide, e manaʻo ʻia ai i kona hoʻohana ʻana i ka poʻe hapahana 3 a me 3 o ka hapaha hiki ke hōʻeha i ka hoʻōla ʻana o ka fetoplacental a ma muli o nā loli i ka embryo a me ka fetus, e like me ka jaundice, ka hoʻolilo ʻana i ka electrolyte, a me ka thrombocytopenia. ʻAʻole pono e hoʻohana ʻo Hydrochlorothiazide no edema o nā wahine hāpai, no nā wahine hāpai me ka hypertension arterial, a i ka wā preeclampsia, e like me aia kekahi hopena o ka emi ʻana o ka nui o ka plasma a me kahi hoʻohaʻahaʻa i ka palamaha plasenta, a ʻaʻohe hopena maikaʻi ʻole i kēia mau hanana maʻi.

ʻAʻole pono e hoʻohana ʻo Hydrochlorothiazide e mālama i ka hypertension koʻikoʻi i loko o nā wahine hāpai, koe wale nō i kēlā mau kūlana hanana i ʻole e hiki ai ke hoʻohana ʻia nā lāʻau ʻē aʻe.

ʻO ka maʻi me ka lāʻau lapaʻau ʻo Mikardis a me Mikardis Plus ua contraindicated i ka wā o ka hoʻoulu ʻana.

I nā hoʻokolohua holoholona hōʻike, ʻaʻole i ʻike ʻia nā hopena o ka telmisartan a me ka hydrochlorothiazide ma ka hānai.

ʻAʻole i hele ʻia nā haʻawina o nā hopena i ka ulu kanaka.

Hoʻohana i nā keiki

ʻO nā lāʻau lapaʻau ʻo Mikardis a me Mikardis Plus e hoʻohālikelike ʻia no ka hoʻohana ʻana i nā keiki a me nā ʻōpio ma lalo o nā makahiki 18, no ka mea ʻaʻole i ʻike nā ʻikepili i ka holomua a me ka palekana ma kēia māhele o nā maʻi.

Hoʻohana i nā mea maʻi maʻi

ʻAʻole koi ʻia nā loli i loko o ka noho ʻai ʻana i nā maʻi maʻi ʻelemakule.

Nā ʻōlelo kikoʻī

ʻO nā kūlana e hoʻonui ai i ka hana a RAAS

I kekahi mau mea maʻi, ma muli o ka pani o ka hana o ka RAAS, ka mea nui me ka hoʻokaʻawale ʻana o nā lāʻau i ke ʻano e hana ana i kēia ʻōnaehana, hana like ʻole (me ke aloha renal failed). No laila, ʻo ka hoʻomohala hana i hui pū ʻia e ka pahu blockade like o RAAS (no ka laʻana, me ka hoʻohui ʻana o ka inhibitor ACE a i ʻole he renin inhibitor, aliskiren, i ka hisiotensin 2 receptor antagonist blockers), pono e hana pono ʻia me ka nānā pinepine ʻana o ka hana renal (me ka nānā o ka nānā wā maʻamau i ka pāleka a me nā pā. serum hana).

ʻO ka hoʻohana ʻana i ka diuretika thiazide i nā maʻi me nā hana ʻole i hoʻopalapiha i hana ʻia hiki ke alakaʻi i ka azotemia. Hoʻomaopopo ʻia ka nānā ʻana no ka hana ʻana i nā hana o ka lolo

I nā mea maʻi me ka stenosis bilateral renal stenosis a i ʻole ka stenosis arterial o ke kino wale nō e hana nei, me ka hoʻohana ʻana i nā lāʻau lapaʻau e ʻeha ana i ka RAAS, ka hopena o ka ulu ʻana o ka hypotension arterial koʻikoʻi a me ka hana ʻole ke hoʻonui.

Hōʻeha ka hana ʻoluʻolu

I nā mea maʻi me ka hana aho o ka pehu a me ka maʻi ʻōpiopio holomua, pono ʻo MikardisPlus e mālama me ka akahele, no ka mea, ʻo nā loli liʻiliʻi o ka pauna wai-electrolyte hiki ke kōkua i ka hoʻomohala ʻana i ka comp hepatic.

Hoʻohālikelike i ka metabolism a me ka hana o nā kūpaʻa endocrine

I nā maʻi me ka maʻi maʻi, e loli paha ke ʻano o ka nui o nā inikua o ka insulin a i ʻole ka hypoglycemic agent no ka hoʻokūkū waha. I ka wā maʻi me ka diuret thiazide, hiki i ka maʻi diabetes mellitus ke hōʻike.

I kekahi mau hihia, hiki i ka hoʻohanaʻana o ka diuret th thiazide i hoʻomohala i ka hyperuricemia a me ka hoʻonuiʻana i ke ʻano o ka gout.

I ka poʻe maʻi me ka maʻi mellitus a me ka hopena o ka puʻuwai cardiovascular hou aku, no ka laʻana i ka poʻe maʻi me ka mellitus maʻi mellitus a me ka maʻi puʻuwai coronary, ka hoʻohana ʻana i nā lāʻau lapaʻau e hōʻemi i ke koko, e like me angiotensin 2 receptor antagonist a i nā ACE inhibitors, e hoʻonui i ka nui o ka make myocardial infarction make vascular. I nā poʻe maʻi me ka maʻi maʻi, maʻi maʻi coronary e hiki ke nānā i ka asymptomatic a no laila ʻaʻole loaʻa ke maʻi. Ma mua o ka hoʻomaka ʻana i ka hoʻohana ʻana i ka lāʻau ʻo Mikardis a me Mikardis Plus no ka ʻike a me ka mālama ʻana i ka maʻi naʻau coronary, pono e ʻike ʻia nā haʻawina hoʻāla a kūpono. hōʻike ma ka ʻike kino.

Kaona myopia a me ka pōkole piko-uhi pani

ʻO Hydrochlorothiazide, he huaʻai sulfonamide, hiki ke hana i kahi hopena idiosyncratic ma ke ʻano o ka myopia transient aikiliki a me nā kuli pupono uhi uhi. ʻO nā ʻōmaʻomaʻo o kēia mau pilikia i ka emi mai o ka ʻike ʻole ʻia ʻana o ka ʻike maka a ʻike paha, aia i nā hanana maʻamau i loaʻa i loko o kekahi mau hola i kekahi mau pule ma hope o ka hoʻomaka ʻana o ka lāʻau lapaʻau. Inā ʻaʻole i hoʻomaʻemaʻe ʻia, hiki i ka nui o ke kuʻina e pani i ka glaucoma hiki ke alakaʻi i ka ʻike. ʻO ka papa hana koʻikoʻi ʻo ka hoʻokuʻu ʻana i ka hydrochlorothiazide i ka hiki ke hiki. Pono e noʻonoʻo ʻia inā inā paʻa loa ka paʻakikī intraocular, hiki ke koi ʻia i ka ʻimi a mālama ʻia paha. ʻO nā mea pilikia no ka hoʻomohala ʻana i ka glaucoma ʻoi ke pani a me ka penalillin.

Haki i ka pae wai-electrolyte kaulike

Ke hoʻohana nei i ka lāʻau lapaʻau Mikardis Plus, e like me ka maʻi o ka diuretic therapy, nānā pono ʻia ka ʻike ʻana i nā ʻike o nā electrolytes i loko o ka serum koko.

Thaizide diuretics, incl. Hiki i ka hydrochlorothiazide ke hoʻonāukiuki i ka pale o ka wai-electrolyte a me nā kūlana acid-base (hypokalemia, hyponatremia a me hypochloremic alkalosis). ʻO nā ʻōmaʻomaʻo o kēia mau pilikia ka hopena o ka wahaosa maloʻo maloʻo, make wai, nāwaliwali maʻamau, ka hiamoe, ke kaumaha, ka myalgia a i ʻole ke ahonui ʻana o nā ʻeha puʻupaʻa (crumpi), nāwaliwali o ka naʻau, ka hoʻoluhi ʻana i ka hoʻokaʻina o ke koko, oliguria, tachycardia, a me kēlā gastrointestinal nā maʻi ʻawaʻawa e like me ka nausea a hoʻomau paha.

Ke hoʻohana ʻia ka diuretika thiazide, hiki i ka hypokalemia ke ulu, akā hiki i ka telmisartan i ka manawa like ke hoʻonui i ka paʻakai pākaʻi i ke koko. Hoʻopili ʻia ka hopena o ka hypokalemia i nā mea maʻi me ka cirrhosis, me ka diuresis i hoʻonui ʻia, me ka ʻai paʻakai ʻole a me ka ʻai, me ka ʻaina no ka hoʻohana like ʻana o ka gluco- a me mineralocorticosteroids a i ʻole corticotropin. ʻO Telmisartan, ʻo ia kahi o ka hoʻomākaukau ʻana o ka Mikardis a me Mikardis Plus, ma ke ʻano he mea hiki ke alakaʻi i ka hyperkalemia ma muli o ke antagonism i ka ʻaeʻana o ka angiotensin 2 (subtype AT1). ʻOiai ʻaʻole i hōʻike ʻia nā maʻi hyperkalemia koʻikoʻi me ka hoʻohana ʻana o Mikardis Plus, ʻo nā mea koʻikoʻi no ka hoʻolālā ʻana me ka renal a me / a me ka naʻau ʻole a me ka maʻi mellitus.

ʻAʻohe mea iʻike i ka lāʻau ʻo Mikardis Plus e hiki ke hōʻemi a pale paha i ka hyponatremia i kumu e ka diuretics. ʻO ka hypyploremia maʻamau ka maʻi liʻiliʻi a ʻaʻole pono e mālama i ka mālama ʻana.

Hiki i ka Thiazide diuretics ke hōʻemi i ka excretion o ka calcium e nā keiki a me ke kumu (i ka ʻike ʻole ʻana o nā haunaele ʻike ma ka calcium metabolism) he ulu a hoʻonui iki hoʻi i ka calcium sima. ʻOi aku ka maʻi hypercalcemia koʻikoʻi paha kahi hōʻailona o ka hyperparathyroidism latent. Ma mua o ka loiloi ʻana i ka hana o nā kūloko o ka parathyroid, pono e hoʻokuʻu i ka diuretika thiazide.

Ua hōʻike ʻia ka hoʻonuiʻana o ka diuret thiazide i ka excretion o ka magnesium e nā keiki, e hiki ai i ka hypomagnesemia.

I ka poʻe maʻi me ka maʻi puʻukui coronary, ka hoʻohana ʻana o kekahi lāʻau antihypertensive, inā he nui ka nui o ke kahe koko, hiki ke alakaʻi i ka myocardial infarction a i ʻole hahau.

Aia nā mea e pili ana i ka hoʻolālāʻana i ka systemus lupus erythematosus me thiazide diuretics.

Hiki iā Mikardis a me Mikardis Plus ke hoʻohana pū ia me nā mea hana ʻē aʻe antiihypertensive.

ʻO ka mālama ʻana o ka puʻuwai me ke koho ʻana i ka telmisartan ma nā hihia he nui i ʻike ʻia ma waena o nā kamaʻāina o Iapana.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini

ʻO nā haʻawina loea kūikawā e loiloi i ka hopena o ka lāʻau Mikardis Plus i ka hiki ke hoʻokele i nā kaʻa a hana me nā mīkini e koi nui ai ka makaʻala ʻaʻole i lawe ʻia. Eia naʻe, i ka hoʻokele ʻana a me ka hana ʻana i nā hana e pili ana i ka mea pōʻino, hiki i ka hoʻomohala ʻana ke hoʻomāhaʻi ʻia a me ka pohō i ka moe.

Hoʻohui nūhou

Me ka hoʻohana ʻana o ka telmisartan me:

• hoʻoikaika hou nā antihypertensive i ka hopena antihypertensive. I loko o hoʻokahi haʻawina, me ka hoʻohana pono ʻana o ka telmisartan a me ramipril, kahi hoʻonui 2.5-pi i AUC0-24 a me Cmax o ka ramipril a me ramipril. ʻAʻole paʻa i ke kumu koʻikoʻi o kēia pilina. ʻO kahi huli ʻana o nā hanana pōʻino e alakaʻi ana i ka hoʻokuʻu ʻia o ka mālama ʻana a me ka nānā ʻana i nā hanana ʻino koʻikoʻi i loaʻa i ka wā hoʻokolohua lapaʻau i hōʻike ʻia ka uʻi a me ka angioedema e ulu pinepine ʻia me ramipril, ʻoiai he hanana maʻamau loa me ka telmisartan. ʻO nā hihia o ka hyperkalemia, ka maikaʻi ʻole o ka renal, ka hypotension arterial a me ka syncope i nānā pinepine ʻia me ka hoʻohana pinepine ʻana o ka telmisartan a me ramipril,
• Ua hoʻomaopopo ka mākaukau lithium i ka hoʻonui ʻana i ka lohi o ka lithium i ke koko, i hele pū ʻia me nā hopena o nā mea ʻalapona me ka hoʻohana ʻana o A inhibitors. I nā hihia pinepine, ua hōʻike ʻia nā loli like me ka hoʻomoe ʻana o ka angiotensin 2 antagonist receptor, i loko o ka telmisartan. Me ka hoʻohana like ʻana o ka hoʻomākaukau lithium a me ka angiotensin 2 antagonist receptor, ua ʻōlelo ʻia e hoʻoholo i ka ʻike lithium ma ke koko,
• ʻO nā lāʻau anti-inflammatory nonsteroidal (NSAID), me ka acetylsalicylic acid i nā inika i hoʻohana ʻia he lāʻau anti-inflammatory, COX-2 inhibitors a non-selective NSAIDs, hiki ke hana i ka hopena renal i ʻole i nā mea maʻi me ka hōʻemi i ka BCC. Hiki i ka hopena ke hōʻili ʻia me RAAS ka hopena synergistic. I ka poʻe maʻi e loaʻa ana i nā NSAID a me ke telmisartan, pono e uku ʻia ka BCC ma ka hoʻomaka ʻana o ka mālama ʻana a me kahi haʻawina o ka hana o ke keiki e pono ai. ʻO ka hoʻohaʻahaʻa o ka hopena o nā mea antihypertensive, e like me ka telmisartan, ma o ke kaohi ʻia ʻana o ka hopena vasodilating o ka prostaglandins i hoʻomaopopo ʻia me ka hui pū ʻana me nā NSAID. Me ka hoʻohana like ʻana o ka telmisartan me ka ibuprofen a i ka paracetamol, ʻaʻohe hopena kino i ʻike ʻia.
• digoxin, warfarin, hydrochlorothiazide, glibenclamide, simvastatin a me amlodipine ʻaʻole i hōʻike i kahiʻoihana koʻikoʻi i pili i ka maʻi. ʻO ka hoʻonuiʻana o ka hoʻololi ʻana o ka Digoxin i loko o ke koko koko ma o ka awelika o 20% (ma ka hihia hoʻokahi, ma ka 39%) i hoʻomaopopo ʻia. 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 ʻana me:

• ethanol (waiʻona), barbiturates a i ʻole analīpio opioid, aia kahi pilikia o ka hoʻomohala ana i ka hypotension orthostatic,
• Nā lāʻau lapaʻau hypoglycemic no ka hoʻokūkū waha a me ka insulin e koi ai i ka hoʻoponopono ʻana o nā maʻi hypoglycemic i ka hoʻoponopono o ka waha a me ka insulin.
• metformin aia kekahi pilikia o ka lactic acidosis,
• ua kolestiraminom a me kolestipolom - i ke alo o ke anionic hoʻololi i ka hoʻopili ʻana o ka hydrochlorothiazide ua hoʻopau ʻia,
• hoʻonui i ka glycosides cardiac i ka hopena o ka hoʻomohala i ka hypokalemia a i ʻole hypomagnesemia i loaʻa e ka thiazide diuretics, ka hoʻomohala ʻana o ka arrhythmias i kumu o ka glycosides cardiac,
• nā mea hōʻino lima (e.g. norepinephrine) e hoʻonāwaliwali i ka hopena o ka pressor amines,
• hiki ʻole ke hōʻoluʻolu i ka hoʻomaha o nā musolamo (e.g. tubocurarine chloride) hydrochlorothiazide hiki ke hoʻonui i ka hopena o nā hoʻomaha hoʻomaha non-depolarizing.
• e hoʻonui paha nā ʻaina antigout i ka hoʻomohala ʻana i ka waikiko uric i loko o ka serum o ke koko, a no laila, pono paha nā loli i ke ʻano o nā ʻaina uricosuric. ʻO ka hoʻohana ʻana i ka diuret thiazide e hoʻonui i ka pinepine o ka hoʻomohala ʻana o nā hopena hypersensitivity i allopurinol,
• Hoʻomākaukau kalala - hiki i ka diuretika thiazide ke hoʻonui i ka piha o ka calcium serum ma muli o kahi kaheʻana o kona excretion e nā keiki. Inā makemake ʻoe e hoʻohana i ka hoʻomākaukau ʻana o ka calcium, pono ʻoe e kiaʻi pinepine i ka ʻike o ka calcium ma ke koko a, inā pono, e hoʻololi i ka nui o ka hoʻomākaukau ʻana o ka calcium
• Hiki i nā beta-blockers a me Diazoxide thiazide diuretics ke hoʻonui i ka hyperglycemia i hoʻoulu ʻia e nā beta-blockers a me diazoxide,
• m-anticholinergics (no ka laʻana, ka atropine, biperidine) - kahi emi o ka gastrointestinal motility, kahi hoʻonui i ka bioavailability o ka diuretya thiazide,
• Hiki ke hoʻonui i ka diuretant amantadine thiazide i ka hopena o nā hopena i hiki ʻole i ka amantadine,
• ʻo nā huaʻai cytotoxic (no ka laʻana, cyclophosphamide, methotrexate) - kahi hoʻohaʻahaʻa i ka renal excretion o nā cytotoxic a me ka hoʻonui ʻana i kā lākou myelosuppressive hopena,
• Nā NSAID - hiki i ka hoʻohana me ka thiazide diuretics hiki ke piʻi i ka hopena o ka diuretic a me ka hopena antihypertensive,
• nā lālani e alakaʻi ana i ka kinai o ka pāhana potassium a me ka hypokalemia (no ka laʻana, diuretics e hoʻoneʻe ana i ka potassium, laxatives, gluco- a me mineralocorticosteroids, corticotropin, amphotericin B, carbenoxolone, benzylpenicillin, derivatives o acetylsalicylic acid) - i hoʻonui ʻia hypokalemic. ʻO ka hypokalemia i kumu o ka hydrochlorothiazide e hoʻonāukiuki ʻia e ka hopena o ka potassium-sparing o telmisartan,
• hiki i ka hoʻomohala ʻana o ka hyperkalemia hiki me ka diuretics potassium-sparing, ʻoi ka hoʻomākaukau ʻana o ka pālala, i nā ʻano ʻē aʻe e hiki ai ke hoʻonui i ka momona potassium serum (no ka laʻana, heparin) a i ʻole ka hoʻololi i ka paʻakai o ka sodium chloride me nā paʻakai paʻakai. Hoʻomaopopo ʻia ka nānā ʻana o ka potassium i ka plasma koko i loko o nā hihia i hoʻohana ʻia ai ka lāʻau Mikardis Plus i ka manawa like me nā lāʻau lapaʻau e hiki ai i ka hypokalemia, pū kekahi me nā lāʻau lapaʻau e hiki ke hoʻonui i ka potassium sima.

Nā inoa o ka lāʻau Mikardis

Hoʻololi nā kumu hoʻohālike o ka waiwai ikaika:

Nā kikowaena i ka hui lāʻau lapaʻau (angiotensin 2 antagonist receptor):

• Angiakand
• Apolo
• Atacand
• Blocktran
• Vasotens,
• Valz
• Valsartan
• Kūwila,
• Kāleka
• Hyposart,
• Diovan
• Zisakar
• Ibertan
• Irbesartan
• Irsar
• Kukuiono
• Candesartan
• Kāleka
• Cardosten
• Cardostin
• Karzartan
• Keola
• Xawai
• Lakea
• Lozap,
• Lozarel
• Losartan
• Lorista
• Kālehu
• Lotor
• Mikardis Plus
• Naviten
• Nortian
• Olimestra
• Hoʻōla
• Koiā ʻia
• Presartan,
• Renicard
• Sartavel
• Tanidol
• Tantordio
• Tareg
• Teveten
• Eni,
• Telzap
• Telmisartan
• Telmista
• Nā Telsartan
• Hoʻolaha
• Edarby.

Ka helu helu inoa: P N015387 / 01

Trade inoa o ka lāʻau lapaʻau: Mikardis ®

Ka inoa ʻUha Paʻaʻike ʻole (INN): telmisartan

Pākuʻi helu: papa papa

Hōʻike: 1 papa i loaʻa:
Mea hana koʻikoʻi: - Telmisartan 40 mg a i ole 80 mg,
Nā mea hoʻihoʻi: - sodium hydroxide 3.36 mg / 6.72 mg, polyvidone (Kollidon 25) 12 mg / 24 mg, meglumine 12 mg / 24 mg, sorbitol 168.64 mg / 337.28 mg, magnesium stearate 4 mg / 8 mg

ʻO keʻano
40 mg papa
ʻO ka papa ʻaina keʻokeʻo a i ʻole paha he keʻokeʻo paha, ma kahi ʻaoʻao i kālai ʻia "51H", ma kēlā ʻaoʻao ʻē aʻe - ʻo ka hōʻailona o ka hui.
80 papa papa
ʻO ka papa ʻaina keʻokeʻo a i ʻole hoʻi he keʻokeʻo paha, ma kahi ʻaoʻao i kālai ʻia "52H", ma kēlā ʻaoʻao ʻē aʻe - ʻo ka hōʻailona o ka hui.

ʻĀpana Pharmacotherapeutic: angiotensin II antagonist receptor.
ʻĀlelo ATX C09CA07

ʻO nā waiwai Pharmacological
Lapaʻau lāʻau
ʻO Telmisartan kahi mauʻā heʻōmaʻomaʻo ala ākea neʻeneʻe (ke ʻano AT1), i ka wā e lawe ʻia ai. He wahi kūlana kiʻekiʻe ia no ka AT1 subtype o ka ʻĀina ʻānō o ka angiotensin II, kahi i ʻike ʻia ai ka hana a ka angiotensin II. Hōʻike i ka angiotensin I 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 ʻo Telmisartan i ka AT1 subtype o nā ʻalem hoʻi ma ka angiotensin II. Ke hoʻomau nei ka pilina. ʻAʻohe ia i kahi pilina no nā poʻe ʻē aʻe i komo, me ka mea i komo i ka AT2 receptor a me nā mea hou aku i lilo ʻole i nā kaila ʻona ʻē aʻe i hoʻopaʻa ʻia. 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 kao 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. Hoʻomaka ʻia ka hoʻomaka ʻana o ka hana hypotensive ma 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. Hoʻokomo pinepine ʻia kahi hopena antihypertensive e hoʻomaka i ka wā 4-8 mau pule ma hope o ka hoʻokomo pinepine ʻana.
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. 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 ke ʻano he 40 mg) a i 19% (ma kahi kikoʻī o 160 mg). 3 mau hola ma hope o ke kauā ʻana, ka ʻike ʻana i ke kahe o ka plasma koko i waho, me kahi ʻaʻai ʻole. Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. ʻO Cmax (ʻoi loa ka ʻike) a me AUC ma kahi kokoke i 3 a me 2 mau manawa, kēlā, ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me kahi hopena ʻole o ka hana pono.
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 hoʻopauʻana hapa-ola (T½) he 20 mau hola. Hoʻokuʻu ʻia ʻo ia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 2%. 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.).
ʻO nā maʻi maʻi
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.
I nā keiki
Nā hōʻailona nui o ka pharmacokinetics o telmisartan i nā keiki i keiki a 6 a 18 paha makahiki, ma ka laulā, i hoʻohālikelike ʻia me ka ʻikepili i loaʻa i ka mālama ʻana o nā pākeke, a hōʻoia i ka kuhi like ʻole o ka pharmacokinetics o telmisartan, ka mea pili i ka Cmax.

Nā hōʻailona no ka hoʻohana ʻana

• He maʻi haole.
• Hoemi ʻia ka morbidity cardiovascular a me ka make ma ka poʻe maʻi 55 mau makahiki a ʻoi aku ka nui me ka maʻi kiʻekiʻe o ka maʻi cardiovascular.

Nā Hoʻohui

• ʻO ka hypersensitivity i nā mea ikaika a me nā mea kōkua o ka lāʻau
• Kahawai
• Lactation wā
• ʻO nā maʻi hoʻopukapuka biliary
• ʻO ka maʻi hepatic hōʻeha (kahi keiki-Pugh papa C)
• Intolerance fructose frederose (loaʻa sorbitol)
• He makahiki a hiki i 18 mau makahiki (ʻaʻole i hoʻokū ʻia ka maikaʻi a me ka palekana)

Me ka mālama pono

• ʻO ka pili ʻana o ka renal araline stenosis a i ʻole ka nui o ka stenosis o ke keiki hoʻokahi.
• Pākuʻi ʻia a me nā hana a i ʻole a nānā (ʻike hoʻi i nā ʻōlelo kikoʻī)
• Hoʻemi i ka puʻuwai koko (BCC) ma muli o ka diuretic therapy i kaupalena ʻia, kaupalena ʻana o ka paʻakai, ka ʻōpū ʻana, a me ka luaʻi paha.
• Hyponatremia,
• Hyperkalemia
• Nā kūlana ma hope o ka hoʻololi ʻana i ke keiki (ʻaʻohe ʻike me ka hoʻohana ʻana),
• Hoʻopau ʻole nā ​​puʻuwai naʻau
• ʻO ka stenosis o ka aortic a me ka mitral valve,
• Ienopathic hypertrophic subaortic stenosis,
• Aldosteronism pae (ʻaʻole kūpono i hoʻokō a maikaʻi ʻole)

ʻLoe a me ke kākele
I loko, e pili ʻole i ka ʻahaʻaina.
He maʻi haole
ʻO ka ʻōmapa mua i ʻōlelo ʻia o ka lāʻau Mikardis ® ke kō. (40 mg) hoʻokahi i ka lā. I nā hihia ʻaʻole i loaʻa ka hopena therapeutic, hiki ke hoʻonui ʻia i ka nui o ka lāʻau lapaʻau ʻo Mikardis ® i 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.
Hoʻemi i ka morbidity cardiovascular a me ka make
ʻO ka ʻōlelo i kauoha ʻia ʻo 1 papa o ka lāʻau Mikardis ® 80 mg, hoʻokahi i ka lā.
I ka hoʻomaka mua o ka mālama ʻana, pono paha ke hoʻoponopono hou ʻia i ke koko.
Hola paʻa kino hana
I nā mea maʻi me ka maikaʻi ʻole o ka renal, me nā mea maʻi e komo ana i ka hemodialysis, ʻaʻole pono ka hoʻoponopono ʻia ʻana o ka hoʻoponopono regimen.
Hōʻeha ka hana ʻoluʻolu
I nā mea maʻi me ka pīhoihoi haʻalulu maʻalahi i ke ʻano o ka maʻi (kahi A a me B ma ke kiʻekiʻe Child-Pugh, ma kēlā me kēia), ʻo ka nui o kēlā me kēia lā o Mikardis ® ʻaʻole eʻoi aku ma mua o 40 mg.
ʻO nā maʻi maʻi
ʻAʻole pono ka regimen dosage i nā loli.

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:
Sepsis, komo me ka sepsis momona, nā maʻi ʻalepihi urinary (komo i ka cystitis), nā maʻi ʻeha o ka ʻōpū.
Mai nā pae uila a me nā limahana:
Anemia, eosinophilia, thrombocytopenia.
Mai ka pūnaehana neʻe o waena:
Ka hopohopo, ʻāina, hopohopo.
Mai nā lālā o ka ʻike a me ka hoʻolohe.
ʻO nā haunaele, ʻike ʻia.
Mai ka pūnaehana cardiovascular:
ʻO Bradycardia, tachycardia, hōʻailona hōʻailona i ka hoʻokahe nui i ke koko, a me hypotension orthostatic
Mai ka papa hana hanu:
Hoʻopili iki i ka hanu.
Mai ka pūnaehana hana ʻana:
ʻEha ka puʻuwai, ka ʻōpū, ka maloʻo maloʻo, ka dyspepsia, nā lemulewa, nā ʻeha ʻole i loko o ka ʻōpū, ka luaʻi, ke ake o ka hana ʻōpū.
Nā maʻi kūwaha:
Nā hopena anaphylactic, hypersensitivity o ka mea ikaika a me nā mea kōkua o ka lāʻau, angioedema (fatal), eczema, erythema, hōʻeha o ka ʻili, ka ʻeha (me ka lāʻau lapaʻau), hyperhidrosis, urticaria, ʻalo ʻole.
Mai ka ʻōnaehana musculoskeletal:
ʻO Arthralgia, ʻeha hoʻi, ka ʻeha o ka naʻau (nā ʻeha o nā hoī o ke keiki), ka ʻeha ma nā haʻahaʻa haʻahaʻa, myalgia, ʻeha i nā tendons (mau hōʻailona e like me ka hōʻike ʻana o ka tendonitis).
Mai nā pūpū a me ka maʻi urinary:
Hana hana huehue, ʻoi pūpono me ka maikaʻi ʻole o ka māla hana ʻole.
Kinohi:
ʻO ka ʻehaʻeha o ka puʻuwai, nā maʻi like flu, like asthenia (nāwaliwali), hyperkalemia, hypoglycemia (i nā maʻi me nā maʻi mellitus).
Nā hōʻailona kuhikuhi:
ʻO ka emi ʻana o ka neʻe o ka hemoglobin, ka nui o ka piʻi ʻana o ka uric acid, ka mea hana i loko o ke koko, ka nui o ka hana o nā "enzyme" enzymes, kahi nui o ke kahe o ka phosphokinase (CPK).

Ke keu
ʻAʻole i hōʻike ʻia nā hihia o ka overdose.
Nā hōʻailona: ka hōʻailona i ka emi o ke koko, tachycardia, bradycardia.
Hoʻomaʻamaʻa: nā maʻi hōʻailona, ​​ʻaʻole hemodialysis.

Hoʻopili pū me nā lāʻau ʻē aʻe
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. ʻO ka hoʻonuiʻana o ka hoʻololi ʻana o ka Digoxin i loko o ke koko koko ma o ka awelika o 20% (ma ka hihia hoʻokahi, ma ka 39%) i hoʻomaopopo ʻia. 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, kahi ulu o AUC0-24 a me Cmax o ka ramipril a me ramiprilat i nānā mau ʻia i nā manawa he 2.5. ʻAʻole paʻa i ke kumu koʻikoʻi o kēia hanana.
Me ka hoʻokolohua hoʻohālikelike o ka angiotensin e hoʻohuli ai i ka hoʻōla o ka enzyme (ACE) a me ka hoʻomākaukau ʻana i ka lithium, kahi māliʻi hou i ka ʻike ʻana o ka lithium i ke koko i nānā ʻia, i hoʻopiʻi ʻia e ka hopena o nā 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 hopena me nā lāʻau anti-inflammatory non-steroidal (NSAIDs), me ka acetylsalicylic acid, cyclooxygenase-2 inhibitors (COX-2) a i ole-selective NSAIDs, hiki ke hōʻeha i ka hopena 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 hoʻohaʻahaʻa o ka hopena o nā mea antihypertensive, e like me ka telmisartan, ma o ke kaohi ʻana i ka hopena o vasodilating o ka prostaglandins i mālama ʻia me ka launa ʻana me ka hana me nā NSAID.

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 ka hopena o ke aloha renal). 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 o ka hana nui ma luna o ka hana RAAS (no ka laʻana, i nā mea maʻi me ka puʻuwai naʻau ʻole, a me nā maʻi lā paha, me ka stenosis renal artery, a me ka stenosis artery o ke keiki hoʻokahi), 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 ʻē aʻe e pili ana i ka RAAS, me ka hoʻohana pono ʻana o ka lāʻau Mikardis ® a me ka diuretics pākeleka ana i ka paʻakai, hoʻohui i ka paʻakai, ka paʻakai paʻakai, nā lāʻau ʻē aʻe, a me nā lāʻau lapaʻau e hoʻonui ai i ka paʻū o ka pāima i loko o ke koko (ma ka laʻana, heparin), pono e nānā ʻia kēia mākeke i nā mea 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 Mikardis Plus ® 40 mg / 12.5 mg, 80 mg /) 2.5 mg).
I ka poʻe maʻi me ka hypertension arterial koʻikoʻi, kahi lāʻau o ka telmisartan o 160 mg / lā a me ka hui pū me ka hydrochlorothiazide 12.5-25 mg maʻa maikaʻi loa a me ka maikaʻi. ʻOi aku ka maikaʻi o Mikardis ® i nā mea maʻi ma ka lāhui Negroid.

Hoʻokomo i ka hiki ke alakaʻi i kahi kaʻa a hana pū me nā mīkini
ʻO nā haʻawina loiloele kūikawā o ka hopena o ka lāʻau lapaʻau ma ka hiki ke ke kaʻa i kahi kaʻa a ʻaʻole i lawe ʻia nā mīkini. Eia naʻe, i ka wā e hoʻokele a hana pū me nā hana hoʻohua, ʻo ka hiki ke hoʻomohala i ka mahanilua a me ka hiamoe hiki ke mālama pono ʻia, e pono ai e mālama.

E hoʻokuʻu i ke ʻano
Nā Papa 40 mg a me 80 mg.
Nā papa papa 7 i pā kule i hana ʻia e ka polyamide / alumini / PVC. 2 a i ʻole he 4 mau lepō me nā kauoha no ka hoʻohana ʻana i kahi pahu pahu (no kahi pāʻālua he 40 mg). No nā 2, 4 a i ʻole 8 mau bele me nā kauoha no ka hoʻohana ʻana i kahi pahu pahu (no ka laʻa o 80 mg).

Nā kūlana mālama
Heluhelu B
E mālama ma kahi wela i ke emi ʻana 30 ° C ma kahi e pale ʻia mai ka lepo.
E mālama i kahi hiki ʻana i nā keiki!

ʻO ka lā kau
ʻO 4 mau makahiki Mai hoʻohana ma hope o ka lā pau.

Hoʻohui Kūʻai Kūʻai
Ma ke kumu.

‘Andlelo a me ka helu o ka hui pili kānāwai nona ka inoa o ka palapala kākau inoa e kau nei
Paul No Ke Aloha GmbH Kaukahi 173,
55216, Ingelheim am Rhein, Kelemānia

Mea hana
Beringer Ingelheim Pharma GmbH & Co.KG
Bingerstrasse 173, 55216 Ingelheim am Rhein, Kelemānia

Hiki iā ʻoe ke loaʻa hou nā ʻike e pili ana i ka lāʻau lapaʻau, e hoʻouna pū ana i kāu hoʻopiʻi a me ka ʻike e pili ana i nā hanana ʻino i ka ʻōlelo ma hope nei ma Russia
Beringer Ingelheim LLC 125171, Moscow, Leningradskoye Shosse, 16A p. 3

Pākuʻi helu

Nā Papa 80 mg / 12,5 mg, 80 mg / 25 mg

Aia ma ka papa papa

mea waiwai: telmisartan 80 mg

hydrochlorothiazide 12.5 mg a i 25 mg, kēlā

nā mea hoʻowalewale: sodium hydroxide, polyvidone K 25 (povidone), meglumine, sorbitol, magnesium stearate, lactose monohidato, microcrystalline cellulose, mau keka palaoa, hao (III) ʻulaʻulaʻula (E172) (no ka helu 80 / 12.5), ʻoka (ІІІ) pua hāpana (Е172) (no nā kekeʻa 80/25), ka sodium starch glycolate (type A).

80 mg / 12.5 mg: nā papa ʻulaʻula me ka pā biconvex, ʻāpana ʻāpana: hoʻokahi keʻokeʻo ke keʻokeʻo a ʻulaʻula me kahi paʻi "H8" a me ka hōʻailona ʻoihana, me nā ʻāpana ʻulaʻula, he ʻulaʻula.

80 mg / 25 mg: nā ʻāpana oval i nā ʻāpana ʻulaʻula, he pālua-ʻāpana: hoʻokahi keʻokeʻo ke keʻokeʻo me kahi paʻi "H9" a me ka hōʻailona o ka hui, me nā ʻāpana lau o ka melemele, he ʻāpana ka hapa ʻokoʻa.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO ka hoʻohana pū ʻana o ka hydrochlorothiazide a me telmisartan, ʻaʻole i pili i ka pharmacokinetics o kēia mau lāʻau.

Nā Telmisartan: ma hope o ka lawelawe waha, ua hoʻopili koke ʻia ka telmisartan, hiki ke hōʻea i ka nui o ka telmisartan i 0.5-1,5 hola.

ʻO ka awelika kūlohelohe kūʻokoʻa o ka telmisartan ma kahi o 50%. Hoʻololi iki ka ʻai ʻana i ka bioavailability o ka telmisartan me ka hoʻohaʻahaʻa ʻana ma ka wahi ma lalo o ke kao "plasma concentr-time" (AUC) mai ka 6% i ka wā e lawe ʻia ai ma ka hopena o 40 mg i 19% i ka wā i lawe ai i loko o kahi pōpau o 160 mg. 3 mau hola ma hope o ka lawe ʻana i ka telmisartan, hoʻomāliʻi ʻia ka ʻike ʻana o ke kaila koko a ʻaʻole ia e hilinaʻi i ka kaʻai ʻana o ka meaʻai. ʻO kahi emi iki o AUC ʻaʻole ka mea e hoʻoemi ai i ka hopena o ka therapeutic efficacy.

ʻO ka pharmacokinetics o telmisartan i ka lawe ʻia ʻana i ke ala ʻole ʻaʻole linear i nā palahalaha mai 20 mg a 160 mg me kahi hoʻonui nui aʻe o nā kaila plasma (Cmax a me AUC) me ka hoʻonui ʻana i ka nui. ʻAʻole hōʻiliʻili ʻo Telmisartan i nā kaila koko me ka nui me ka hoʻohana pinepine.

Nonololaiik: ma hope o ka lawelawe waha, ua loaʻa ka nui o ka hydrochlorothiazide ma kahi o 1.0-3.0 mau hola ma hope o ka hoʻokō ʻana. ʻO ka bioavailability piha o hydrochlorothiazide ma kahi o 60%.

Nā Telmisartan: he palena nui kona e hoʻopili ai i nā protein plasma (> 99,5%), ka mea nui me ka albumin a me nā alpha-1 acid glycoprotein. ʻO ka nui o ka puʻuwai e like me 500 lita.

Nonololaiik: 64% nā mea paʻa i ka protein plasma a me kāna ʻike kiko e kū nei he 0.80.3 l / kg.

Metabolism a me ka hoʻopā ʻana

Nā Telmisartan: ma hope o ka lawe waha ʻana o ka telmisartan 14C-hōʻailona ʻia, ua kākī ʻia ka hapa nui o ka dosis (> 97%) i loko o nā loina ma o ka hala biliary, a me nā helu liʻiliʻi he nui i loaʻa i loko o ka urine. Hoʻomili ʻia ia e ka hui ʻana i ka mea hoʻomaka me ka acylglucuronide pharmacologically inactive, ʻo ia wale nō ka glucuronide i ʻike ʻia i loko o nā kānaka.

Ma hope o ka hoʻomoe ʻana i hoʻokahi dosis o ka telmisartan 14C-hōʻailona ʻia, ʻike ʻia ka glucuronide ma ka like me 11% o ka radioactivity plasma i hoʻopaʻa ʻia. ʻAʻole i komo ka Cytochrome P450 isoenzymes i ka hana o ka metabolism o telmisartan. ʻO ka huina piha o ka plasma o ka telmisartan ma kahi o 1500 ml / min, ka hapalua ma mua o nā hola he 20.

Nonololaiik: i nā kāne, ʻaʻole ia i hoʻonaninani a excreted a kokoke i loli maoli. Ma kahi o 60% o ka kūlohelohe waha e hoʻopiʻi ʻia me kahi mea hoʻololi ʻole i loko o nā hola 48. ʻO ka wehe ʻana o Renal ma kahi o 250-300 ml / min. ʻO ka hapalua o ka hapalua o ka manawa o ka hydrochlorothiazide e 10-15 mau hola.

Nā maʻi maʻi: ʻokoʻa ʻole ka pharmacokinetics o telmisartan i nā maʻi maʻi ʻōpio a i ʻoi aku ma lalo o 65 makahiki o kona mau makahiki.

Kakauolelo: Kōmike plasma o ka telmisartan i nā wahine he 2-3 manawa ʻoi aku i mua o nā kāne. Eia nō naʻe, ma nā haʻawina loiloi ʻaʻole nui ka piʻi o ke kahe koko a i ka loaʻa ʻana o ka hypthension orthostatic i nā wahine. ʻAʻohe pono no ka hoʻoponopono hoʻoponopono ʻia. Aia i kahi kuhi i ke kiʻekiʻe kiʻekiʻe o ka hydrochlorothiazide i loko o ke koko koko i nā wahine i hoʻohālikelike ʻia me nā kāne.

ʻAʻole i ʻike ʻia kekahi kumulāʻau koʻikoʻi o ke telmisartan.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

ʻAʻole pili ʻo ka excretion Renal i ka hoʻomaʻamaʻa telmisartan. Kālai i ka ʻike o ka hoʻohana ʻana i ka lāʻau lapaʻau i ka poʻe maʻi me ka hōʻemi a i ʻole ka hoʻololi ʻana i ka renal (hōʻea i ka hana ʻana o 30in60 ml / min, he awelika ma kahi o 50 ml / min), i hōʻike ʻia ʻaʻole pono ka hoʻoponopono ʻana i ka maʻi i loko o nā mea maʻi me ka hana hōʻoli. ʻAʻole kū ʻia ʻo Telmisartan i ka wā hemodialysis. I ka poʻe maʻi me ka hana renal impaired, hoʻemi ʻia ka helu o ka haʻalele ʻana o ka hydrochlorothiazide.

I loko o kahi noiʻi i nā mea maʻi me ka clearance creatinine awelika o 90 ml / min, i hoʻonui nui ʻia ka hapalua o ke ola o ka hydrochlorothiazide. I ka poʻe maʻi me ka pēpē ʻole functioning function, the eliminations half-life is about 34 hours.

ʻO nā maʻi me ka palaualohi maʻa

I nā maʻi me ka hōʻemi pale o ka ate, loaʻa ka nui o ka bioavailability piha loa i ka 100%. ʻAʻole loli ka hapalua.

Lapaʻau lāʻau

ʻO ka MIKARDIS Plus ka hui pū ʻana o kahi anagonistin II receptor antagonist - telmisartan a me kahi diuretic thiazide - hydrochlorothiazide. Hāʻawi ka hoʻohui pū ʻana o kēia mau mea i kahi kiʻekiʻe kiʻekiʻe o ka hopena antihypertensive ma mua o ka lawe ʻana i kēlā me kēia mahele. Loaʻa ka MIKARDIS Plus hoʻokahi i hoʻokahi lā i loko o nā wai me nā hopena therapeutic e hāʻawi i kahi emi kūpono a me ka hoʻonaninani i ke koko.

Telmisartan: He hana kūpono a me ka kikoʻī (selective) angiotensin II receptor antagonist (type AT1). ʻO Telmisartan me kahi kūlana kiʻekiʻe loa o ka pilina ka pilina me kahi lālani wale nō me ka AT1 subtype, angiotensin II receptors. ʻAʻole ʻae ʻia ka Telmisartan no nā mea hou ʻē aʻe, e komo pū ana i ka AT2 - nā ʻae ʻana o ka angiotensin, a me nā mea ʻē aʻe, i hana ʻole ʻia, ʻae ʻia nā ʻĀpana AT. 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.

Ke alakaʻi nei ʻo Telmisartan i kahi emi o nā pae ald testosterone. ʻAʻole ke kālai ʻo Telmisartan i ka renin i ka plasma o ke kanaka a ʻaʻole e poloka i nā kaila ion. ʻAʻole i hoʻoneʻe Telmisartan i ka hana o ka angiotensin e hoʻohuli ana i ka enzyme (kinase II), me ka komo ʻana o ia mea ke emi nei ka paʻakikī o ka bradykinin. No laila, ʻaʻohe mea i hoʻonui ʻia i nā hopena ʻaoʻao i loaʻa e ka bradykinin.

I ka poʻe maʻi, telmisartan ma ke ʻano o 80 mg aneane piha i ka hopena hypertensive o ka angiotensin II. Ke hoʻomau nei ka hopena pale no 24 mau hola a noho mau loa a hiki i 48 mau hola.

Ma hope o ka lawe ʻana i ka wai mua o telmisartan, hana maʻalahi ka hana antihypertensive i loko o 3 mau hola. ʻO ka manawa kiʻekiʻe o ke koʻi koko e hōʻemi pono nei i nā hebedoma 4 ma hope o ka hoʻomaka ʻana o ka mālama ʻana a mālama ʻia no ka manawa lōʻihi.

I ka poʻe maʻi me ka hypertension, hoʻohaʻahaʻa ka telmisartan i ka systolic a me ka diastolic blood pressure me ka ʻole o ka loli ʻana o ka puʻuwai puʻuwai.

ʻO ka hoʻohālikelike o ka antihypertensive o ka telmisartan i hoʻohālikelike ʻia i nā papa ʻē aʻe o nā lāʻau antihypertensive (e like me ka hōʻike ʻana ma nā noiʻi haukaʻi e hoʻohālikelike ana i ka telmisartan me ka amlodipine, atenolol, enalapril, hydrochlorothiazide, losartan, lisinopril, ramipril, a me valsartan).

I ka hihia o ka hōneʻe ʻana o ka telmisartan, hoʻoliihoi ka piʻi ʻana o ke koko i nā helu ma mua o ka mālama ʻana no kekahi mau lā me ka ʻole o nā hōʻailona o ka hoʻomau hou ʻana o ka maʻi hypertension (ʻaʻohe "withdrawal" syndrome).

I nā haʻawina hōʻike maʻi me ka hoʻohalike pololei ʻana o nā ʻano ʻelua antihypertensive, ʻo ka ulu ʻana o ka umu maloʻo ma nā mea maʻi e lawe nei i ka telmisartan, ua hoʻohaʻahaʻa nui loa ia ma mua o ka loaʻa ʻana o nā inhibitor enanthatorin-hoʻololi ʻana.

Nonololaiik: he diuretic thiazide. ʻO ka mīkini o ka hopena antihypertensive o ka diuretics thiazide ʻaʻole maopopo loa. E hana ana ʻo Thiazides i ka mīkini mololi tubular mekanism o ka hoʻopili hou o ka electrolyte reabsorption, hoʻonui pinepine i ka hoʻonui ʻana o ka sodium a me ka klorika ma kahi o nā kumukūʻai like. ʻO ka hopena diuretic o ka hydrochlorothiazide e hōʻemi i ka nui o ka plasma, hoʻonui i ka hana renin plasma, hoʻonui i ka huna ald testosterone, hahai ʻia e ka nui o ka paʻakai a me ka bicarbonate i loko o ka urine a me ka hoʻohaʻahaʻa ʻana i ka potassium sima. ʻO ka blockade ka hopena o ka hoʻopau ʻana o ka renin-angiotensin-aldosterone ke kālā i hui pū ʻia me telmisartan e hoʻohuli ai i ka lilo o ka potoma e hoʻohuli ai i kēia mau diuretics.

Ke lawe aku nei i ka hydrochlorothiazide, ke nānā nei ka nui o ka diuresis ma hope o 2 mau hola, hiki i ka hopena loa ke kūpono ma hope o 4 hola, ʻoiai ka lōʻihi o ka hana e pili ana i 6-12 mau hola.

Ua hōʻike ʻia nā haʻawina ʻo Epidemiological i ka lōʻihi o ka mālama ʻana me ka hydrochlorothiazide e hōʻemi ana i ka hopena o ka morbidity cardiovascular a me ka make ma mua o lākou.

ʻLoe a me ke kākele

Loaʻa ka MIKARDIS Plus i hoʻokahi lā me kahi wai liʻiliʻi.

Ke hoʻololi nei mai telmisartan i MIKARDIS Plus, hiki ke hoʻonui ʻia i loko o ke ʻano o ka telmisartan. Hiki i kahi hoʻololi kūlohelohe mai ka monotherapy i ka lawe ʻana i ka lāʻau lapaʻau hui hiki.

Hiki ke kuhikuhi ʻia ka MIKARDIS Plus 80 mg / 12.5 mg i nā mea maʻi e hoʻohana ai ka hoʻohana ʻana i ka telmisartan (MIKARDIS) 80 mg ʻaʻole i hoʻohālikelike i ke koko.

Hiki ke kuhikuhi ʻia ka MIKARDIS Plus 80 mg / 25 mg i nā mea maʻi i hoʻohana ʻia ai ka hoʻohana ʻana o MIKARDIS Plus 80 mg / 12.5 mg i ka hoʻokaʻawale ʻana i ke koko a i ʻole nā ​​mea maʻi i hoʻomau ʻia kona ʻano e ka telmisartan a i ʻole hydrochlorothiazide i ka wā i hoʻokaʻawale ʻia.

Loaʻa ka hopena kiʻekiʻe antihypertensive i loko o nā 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Inā pono, hiki ke hoʻohui pū ʻia ka MIKARDIS Plus me nā lāʻau lapaʻau antihypertensive.

I ka poʻe maʻi me ka maʻi hypertension arterial, telmisartan i nā inika a hiki i ka 160 mg i kēlā me kēia lā (ʻelua mau papa o MIKARDIS 80 mg) a i hui pū ʻia me hydrochlorothiazide 12.5-25 mg i kēlā me kēia lā (ʻelua mau pūpuna o MIKARDIS Plus 80 mg / 12.5 mg a i ʻole 80 mg / 25 mg) ua hoʻomaopopo maikaʻi ʻia a me ka maikaʻi.

Hiki ke lawe ʻia ka MIKARDIS Plus ma muli o ka ʻai kai.

Ma muli o ka hiki ʻana o MIKARDIS Plus hydrochlorothiazide i ka mākaukau, ʻaʻole pono e kau ʻia i nā poʻe maʻi me ka hōʻemi kino o ka maʻi (cleinine clearance