Ke huahana Telzap 40: nā ʻōkuhi no ka hoʻohana > He hoʻomaʻemaʻe a me ke pale aku

Loaʻa ka lāʻau lapaʻau i ke ʻano o nā papa kiʻi ʻoniʻoni kiʻi: mai ka melemele a hiki i ke keʻokeʻo, ʻolo, biconvex, 40 mg kēlā me kēia me ka laina e hoʻokaʻawale i kēlā me kēia ʻaoʻao, 80 mg i kēlā me kēia - i kahakaha ʻia me "80" (10 pcs. i nā pōpō, ma kahi pūlima o nā pahu 3, 6 a 9 paha a i nā ʻōlelo no ke hoʻohana ʻana iā Telzap).

Pākaukau 1 papa:

mea kūlohelohe: telmisartan - 40 mg a i ole 80 mg,
Nā mea kōkua: povidone 25, meglumine, sodium hydroxide, sorbitol, magnesium stearate.

Lapaʻau lāʻau

ʻO Telzap kahi lāʻau lapaʻau antihypertensive, ʻo ia ka mea kaha o ka telmisartan - kahi antagonist kikoʻī o nā ʻalemakiotensin II (subtype AT₁) Loaʻa i Telmisartan kahi kūlana kiʻekiʻe loa no ka AT₁ (angiotensin) -receptors kahi i maopopo ai ka hana a ka angiotensin II. ʻO ka hoʻokaʻawale ʻana i ka hana a kahi kanaka ʻona me ka mahalo i ka mea i hōʻea aku, ua neʻe i ka angiotensin II mai kāna pilina a hoʻopaʻa ʻia wale nō i ka subtype AT₁nā ʻĀina o ka angiotensin II. I nā poʻe ʻokoʻa ʻē aʻe angiotensin (me AT₂nā mea hoʻokele) telmisartan ʻaʻohe o ka pilina. ʻO kā lākou hana koʻikoʻi a me ka hopena o kahi hiki ke hoʻoulu ʻia me ka angiotensin II ʻaʻole i aʻo ʻia ʻia. Ke hōʻemi nei ʻo Telmisartan i nā pae aldosterone plasma, ʻaʻole paʻa i nā kahe wai, ʻaʻole ia e hōʻemi i ka hana renin, ʻaʻole ia e pale i ka hana a ka angiotensin-hoʻohuli o ka enzyme (kininase II), ka mea e kuhi me ka luku ʻana i ka bradykinin. Hōʻalo kēia i ka hoʻomohala ʻana o ka ʻōpala maloʻo a me nā hopena ʻē aʻe ma muli o ka hana o ka bradykinin.

Me ke ʻano o ka hypertension koʻikoʻi, e lawe ana iā Telzap i kahi waihona o 80 mg e hāʻawi ana i ke pani ʻia ʻana o ka hopena hypertensive o ka angiotensin II. ʻO ka hopena antihypertensive ma hope o ka hoʻokele mua o ka telmisartan e hele nei i loko o 3 mau hola a mau i nā hola 24, e noho mau nei i nā maʻi nui a hiki i 48 mau hola. Loaʻa ka hopena antihypertensive hopena ma hope o 28-56 mau lā o ka hoʻokele maʻamau o 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).

ʻO kahi hana wehe ʻoki loa o ka lawe ʻana iā Telzap ʻaʻole i hoʻopili ʻia e ka hoʻomohala ʻana i kahi maʻi hoʻomaha, hoʻohaʻahaʻa kahe koko i kona kumu mua i kekahi mau lā.

Hoʻohālikelike ka hopena antihypertensive o ka telmisartan ma ka hana o nā ʻāpana antihypertensive e like me ka amlodipine, enalapril, hydrochlorothiazide, atenolol, a lisinopril, akā me ka hoʻohana ʻana o telmisartan aia kekahi hopena haʻahaʻa o ka ʻokiʻoki ma ke ʻano he kūmole e pili ana i ka kaiotiotin e hoʻohuli ai i ka enzyme (ACE) inhibitors.

Ka hoʻohana ʻana o telmisartan no ka pale ʻana o ka maʻi cardiovascular i nā maʻi pākeke (55 mau makahiki a ʻoi aku) me ka neʻe ʻana i ka ischemic attack, coronary heart heart, peripheral arterial damage, stroke a i ʻole nā hoʻopiʻi o ka maʻi type 2 (me ka retinopathy, haʻalele ventricular hypertrophy, macro- or ka mōʻaukala o microalbuminuria) i kōkua i ka hōʻemi o ka hopena i hui pū ʻia: ʻoihana hoʻokipa ma muli o ka ʻeha ʻole o ka naʻau, ka maʻi cardiovascular, ka myocar infarction a me ka ole-ona e hahau ana. Hoʻohālikelike ka hopena o ka telmisartan me ka ramipril i ka ʻōlelo o ka hōʻemi ʻana i ka nui o nā pihi ʻelua: make ka cardiovascular, myocardial infarction, a i ʻole hōʻeha ʻole me ka hopena o ka mea make. ʻAʻole i like ka ramipril, me ka telmisartan, ʻo ka nui o ke kumu o ka umauma maloʻo a me ka angioedema he haʻahaʻa, a ʻoi aku ka kiʻekiʻe o ka hypotension arterial.

Lapaʻau lāʻau

Ma hope o ka lawelawe waha, ʻo ka hoʻokomo ʻana o ka telmisartan mai ka gastrointestinal tract e wikiwiki koke ana, ʻo kona bioavailability 50%. ʻO ka ʻai ʻoliʻoli hiki i ka hoʻohaʻahaʻa ʻana i AUC (piha i ka nānā ʻana o ka plasma), akā i loko o ʻekolu mau hola, ua like ke kūpaʻa o ka telmisartan ma loko o ke koko.

Hoʻohālikelike i nā kāne i ka wahine, C_max (ʻoi loa ka ʻike i loko o ka kaila koko) he 3 manawa ʻoi aku ka nui, a me AUC - e pili ana i 2 mau manawa, akā ʻaʻole kēia i hopena i ka hopena o Telzap.

Aia kekahi hapa o ka pilina laina ma waena o ka hopena a me ka hoʻoneʻe ʻana o ka wai o ka lāina. Ke hoʻohana nei i nā hōkū i kēlā me kēia lā ma luna o 40 mg C_max a i ʻole ʻo AUC e loli i ka ʻokoʻa me ka piʻi ʻana o ka nui.

Hoʻohālikelike i nā protein plasma koko (ma ka albumin a me ka alpha₁waikawa glycoprotein) - ʻoi aku ma mua o 99.5%.

ʻO ka laulā ka nui o ka hoʻolaha ʻana he 500 lita.

Hoʻomoe ka metabolism Telmisartan e ka hoʻokūkū me ka waikawa glucuronic; ʻaʻohe o ka hui lāʻau lapaʻau ka mea kipi.

T_1/2 (elimination half-life) - ʻoi aku ma mua o 20 mau hola. Hoʻokuʻu ʻia ia i loli nui loa (99%) ma o nā ʻōpū, liʻiliʻi ma lalo o 1% i hoʻopā ʻia e nā keiki.

ʻO ka huina piha piha plasma e pili ana i ka 1000 ml / min, ke kahe koko hepatic - a hiki i 1500 ml / min.

Me ka hana maʻi papalole ʻole a me ka hopena, a me ka poʻe maʻi ma waena o nā makahiki he 65, ʻaʻole loaʻa nā pharmacokinetics o telmisartan, no laila ʻaʻole koi ʻia ka hoʻoponopono ʻana.

In the renal fail failed and for hemodialysis patients, ʻaʻole pono ka hopena mua o ka 20 mg i kēlā me kēia lā.

ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis.

No ka hōʻemi ʻana i ka maʻi hepatic paʻakai (hoʻākoakoa ʻo nā keiki-Pugh A a me B), kahi laʻana i kēlā me kēia lā a hiki i 40 mg.

Nā hōʻailona no ka hoʻohana ʻana

pono hypertension,
ka hoʻohaʻahaʻa o nā maʻi o ka maʻi cardiovascular a me ka make ma nā poʻe maʻi maʻi me nā maʻi o ka pūnaehana cardiovascular o ka atherothrombotic etiology (coronary heart heart, peripheral arterial damage a stroke history) a me ka hopena o ka hōʻino kino kino ma ka type 2 diabetes.

Nā Hoʻohui

hōʻeha paʻakikī hepatic (Child-Pugh papa C),
maʻi hopu āpana, kolestasis,
ka hoʻohana ʻana i ka aliskiren i ka hoʻopilikia kino ʻana i ka maʻi GFR (glomerular filtration rate) emi ma mua o 60 ml / min / 1.73 m 2 o ka kino o ke kino a i ʻole ka hopena o ka maʻi mellitus,
hui ʻoihana me ka angiotensin-hoʻohuli i ka enzyme (ACE) inhibitors i nā maʻi me ka maʻi nephropathy maʻi,
he launa ʻōpiopio hoʻoilina,
wā hāpai
hana waiū
makahiki i 18 makahiki
hypersensitivity i nā ʻāpana o ka lāʻau.

Pono e hoʻohana ʻia ʻo Telzap me ka mālama nui ʻole o ka puʻuwai nui o ka puʻuwai, hypertrophic obstructive cardiomyopathy, aortic a me mitral valen stenosis, hana ʻino ʻole, bilateral renal artery stenosis, aren stenosis o hoʻokahi hana hana, ʻoluʻolu i ke kāʻei hepatic hōʻemi, hoʻemi i ka nui o ke koko (BCC ) e kū'ē ana i ke kua o ka pau ʻana o ka pākī o ka sodium chloride, nā maʻi maʻi, ka luaʻi a i ʻole ka lawe ʻana i ka diuretics, hyperkalemia, hyponatremia, hyperaldost mua ronism i ka manawa ma hope o ka hoʻoulu ʻana o ka maʻi kidney, ka hoʻohana o nā mea maʻi o ka lāhui Negroid.

ʻO Telzap, nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana: ʻano a me ka helu ʻana

Lawe ʻia nā papa telzap ma ke alo me ka nui o ka wai, me ka ʻaʻa ʻole.

ʻO ka pinepine o ka lawe ʻana i ka lāʻau lapaʻau he 1 manawa i kēlā me kēia.

Palapala ʻia i kēlā me kēia lā:

hypertension arterial: ʻo ka mua ma mua o ka 20-40 mg. I ka hana ʻole ʻana o ka hopena hypotensive kūpono ma hope o nā lā 28-56 o ka lapaʻau, hiki ke hoʻonui ʻia i kaʻaila mua. ʻO ka palena kiʻekiʻe loa o kēlā me kēia lā he 80 mg. Ma kahi koho hou aʻe, e hōʻike ʻia ana kahi hui o Telzap me ka diuret thiazide (komo pū kekahi hydrochlorothiazide)
ka hoʻemi ʻana o ka make a me ka pinepine o nā maʻi cardiovascular: 80 mg, i ka mua o ka mālama ʻana pono e mālama i ke koko. Inā pono, pono e hoʻoponopono ʻia ka lāʻau antihypertensive.

In the renal failed or or hemodialysis patients is Recommended to use a first day dosis not not more than 20 mg.

No ka maʻalahi o ka hana i ka pōkole o ka pale, ʻaʻole pono ke hoʻoponopono ʻia.

I ka hoʻololi ʻana i ka maʻi hepatic haʻahaʻa (hoʻākoakoa ʻana o nā keiki-Pugh o nā papa A me ka B), nā awina o Telzap i kēlā me kēia lā ʻaʻole pono e oi aku he 40 mg.

Nā hopena hopena

nā maʻi maʻamau: pinepine - as asiaia, ʻeha ʻeha, ʻā kekahi - maʻi like ka maʻi maʻi
maʻi a me nā maʻi pāpaʻi: pinepine - ka maʻi urinary tract (me ka cystitis), nā maʻi ʻōpū o ka ʻōpū hanu (e pili ana i ka sinusitis, pharyngitis), ʻaʻole loaʻa - sepsis (me ka make).
mai ka pūnaehana cardiovascular: pinepine - - bradycardia, orthostatic hypotension, kahi hōʻailona i hoʻokaʻina i ke kahe o ke koko, loaʻa pinepine ʻole - tachycardia,
mai ka ʻōnaehana lymphatic a me ke koko: jarang - anemia, jarang - thrombocytopenia, eosinophilia,
mai ka pahū: he luhi - kūlike ke ʻano o ka hypersensitivity, ka hopena anaphylactic,
mai ka psyche: pinepine - nā kaumaha, ka ʻōpū, ʻaʻole luhi - hopohopo,
mai ka ʻaoʻao o ka metabolism a me kaʻaiʻai: pinepine - - hyperkalemia, ʻike pinepine ʻole - hypoglycemia kūʻē diabetes mellitus,
mai ka ʻōpū o ka gastrointestinal: pinepine - i ka ʻeha o ka ʻōpū, ka luaʻi ʻana, ka dyspepsia, ka lemela, ke ʻeha, ʻeha, ka maloʻo maloʻo, ka ʻono ʻole i loko o ka ʻōpū.
mai ka ʻōnaehana hepatobiliary: ʻā pinepine - nā huhū hema, nā hana maʻi o nā ate,
mai nā ʻōnaehana oʻelima: pinepine - nāwaliwali, ʻike pinepine - nā hiamoe ʻole.
ma ka ʻāpana o ka hui hoʻolohe, nā maʻi labyrinth: pinepine - vertigo,
ma ka ʻāpana o ke ʻano o ka ʻike.
mai ka papa hana hanu, ka umauma a me nā ʻōpū mediastinal: pinepine - ka umauma, ka pōkole o ka hanu, kokoke loa - maʻi maʻi interstitial,
ke ʻano o ka dermatological: nā kala, ka hōʻeha, ka ʻāʻī o ke kino, ka hyperhidrosis, līpoki - ʻo ka ʻōpala lāʻau, urticaria, erythema, eczema, nā ʻehaʻeha o ka ʻili, ka angioedema (komo i ka make)
mai nā urinary system: pinepine - hana i ʻole ke kau o ka pono, a me ka renal failed,
mai ka ʻōnaehana musculoskeletal a me ka kiko konohiki: pinepine - pinepine i ka ʻeha o ka naʻau, nā ʻeha ʻeha (sciatica), myalgia, loaʻa ʻole ka ʻeha o ka wāwae, arthralgia, tendon pain (tendon-like syndrome).
nā mea hoʻohālike o ka laboratory: pinepine - ka mahuahua o nā mea hana i ka plasma, i ka liʻiliʻi - i ka hoʻemi ʻana o ka hemoglobin i loko o ke kaila koko, ke hoʻonui ʻana i ka hana o nā huaka hepatic a me ka phosphokinase creatine, he hoʻonui i ka hoʻoilo ʻana o ka waikika uric i ka plasma koko.

Ke keu

Nā hōʻailona: ka hōʻailona i ka emi ʻana o ke koko, tachycardia, dizziness, bradycardia, hoʻonui i ka holo ʻana o ka serum creatinine, ʻoi aku ka hopena o ka renal.

Hoʻolālā: ka waile o ka gastric hana, ka luaʻi kūlohelohe, lawe ʻia i ka ulana. ʻO ka mānoino o nā hōʻailona a me ke kūlana o ka mea maʻi e mālama pono ʻia. E kuhikuhi i ka maʻi hōʻailona a me ke kākoʻo. He mea nui e hōʻoia i nā hoʻokolohua koko maʻamau no nā electrolytes plasma a me ka mea hana. Me kahi emi o ka hoʻokahe koko, pono e kau i ka mea maʻi ma ka hāpai ʻana i kona mau wāwae. E hoʻokau i nā hana e hoʻopiha hou i nā bcc a me nā electrolytes.

ʻAʻole kūpono ka hoʻohana ʻana i ka hemodialysis.

Nā ʻōlelo kikoʻī

Ke koho nei iā Telzap i nā maʻi me ka bilateral renal artery stenosis a me ka stenosis arterial o ke kino wale nō ka hana e hana ana, pono ia e noʻonoʻo pono i ka lawe ʻana i ka lāʻau e hiki ke hoʻonui i ka nui o ka hypotension arterial a me ka maikaʻi ʻole.

E hoʻomaka i ka mālama ʻana me ka lāʻau lapaʻau ma hope wale o ka hoʻopau ʻana i ka nele o ka bcc a me / a ʻo ka sodium i loko o ke kaila koko.

Hoʻohana ʻia ka hoʻohana ʻana o Telzap i nā maʻi me ka hana renal impaired i ka ukali pū ʻana me ka nānā maʻamau ʻana i ka ʻike o ka pāhana a me ka likone i loko o ke koko koko.

ʻO ka hoʻohālikelike o ka RAAS (renin-aldosterone-angiotensin system) hiki ke hele mai i nā mea maʻi e predisposed a me ka lawe ʻana i ka telmisartan me nā mea hoʻohālikelike RAAS. Hiki iā ia ke hana i ka hypotension arterial, nāwaliwali, ka hoʻomohala ʻana o ka hyperkalemia, a me ka hana o ka renal function (e pili ana i ka hala o ka renal failed).

Ma ka hana ʻole o ka puʻuwai maʻi, nā maʻi ʻeha, a me nā mea āpau me nā mea hilinaʻi nui i ka hana RAAS, hiki i ka lawelawe Telzap ke hoʻomohala i ka ulu ʻana o ka hypotension arterial, hyperazotemia, oliguria, a ma nā hihia lohi, ʻo ia ka hopena o ka renal.

Me ka hyperaldosteronism maʻamau, ʻaʻole maikaʻi ka hoʻohana ʻana o ka lāʻau lapaʻau.

I ka wā o ka mālama ʻana me ka telmisartan i nā maʻi me ka diabetes mellitus e loaʻa ana i ka inikini a i ʻole a me nā mea maʻi hypoglycemic waha, hiki mai ka hypoglycemia, no laila e koi pono ka mālama ʻana i nā pae o ka glucose o ke koko. Inā kūpono, e mālama ʻia ka hoʻoponopono ʻana o ka inikua a me ka laikini hypoglycemic.

Pono e mālama pono i ka mālama kūikawā a mālama pono ʻia i ka wā ke kau aku nei iā Telzap i nā mea maʻi me nā maʻi concomitant e like me ka renal failed, ka maʻi mellitus, nā mea maʻi e hoʻomaʻamaʻa pū ana me nā lāʻau lapaʻau e hōʻoli ai i ka nui o ka pāhana i ka plasma koko, nā mea maʻi maʻi (ma mua o 70 mau makahiki), mai kēia mau mea hopohopo nā maʻi o nā maʻi i ke koʻikoʻi no ka hoʻomohala ʻana i ka hyperkalemia, e like me ka make.

I loko o ka wā lapaʻau me ka lāʻau lapaʻau, pono e hana ʻia ke ʻano hoʻonaninani o nā lāʻau ʻē aʻe e like me ka alakaʻi ʻana i ke kauka.

ʻO ka emi nui o ke kahe o ke koko i ka wā ischemic cardiomyopathy a i ʻole ka maʻi naʻau coronary hiki ke alakaʻi i ka hoʻomohala ʻana o ka myocardial infarction a i ʻole ka hahau ʻana.

I nā poʻe maʻi o ka lāhui Negroid, ua hoʻomaopopo ʻia kahi emi ʻana o ke kahe koko.

ʻŌpū a me ka lactation

ʻO ka hoʻohana ʻana o nā papa Telzap i ka manawa o ka gestation a me nā umauma umauma ua contraindicated.

Ma hope o ka hoʻokau ʻana i ka ʻoiaʻiʻo o nā kuhi ʻana, pono e hoʻōki ka poʻe maʻi e lawe iā Telzap i ka maʻi telmisartan a hoʻololi i ka hoʻōla me ka lāʻau lapaʻau hou antihypertensive me kahi paʻa palekana paʻa no ka hoʻohana ʻana i ka wā hapai a me ka lactation.

Papa inoa o nā ʻimi a me nā kikoʻī o Telzap

Telpres (papa) → hoʻohanohano Rating: 29 Top

ʻOi like ka analogue mai ka 77 mau rubles.

Mea Hana: -
Kuhi puka:

Nā Papaha, 20 mg, No. 28

Kumukūʻai no Telpres i nā lāʻau lapaʻau: mai 187 mau rubles. a hiki i ka 855 rub. (795 hāʻawi)
Telpres (kahaluna) - hana ʻia ma Sepania a me Pokukala. Loaʻa iā ia ka waiwai mau like a me ka hoʻolālā o ka hana e like me telzap. Hoʻohana ʻia ia i nā mea maʻi me ka hypertension, a me ka poʻe ma ka nui o ka hopena o ka hoʻopiʻi ʻana o nā maʻi hōʻeha o ka hoʻopiʻi ʻana i ka atherothrombotic origin (ischemic stroke, transient ischemic attack, acute myocardial infarction, nā maʻi o nā kaila o ka hopena haʻahaʻa) no kā lākou maʻa mua i ka pale ʻana i ka pale kēia mau maʻi. Hoʻohana ia e pale i ka spasm vascular kūhaka a me ka hoʻomohala ʻana i ka ischemia lua i nā mea maʻi me ka hemorrhage intracerebral. Hiki i nā hanana hōʻeha ke ʻano i ka ʻāʻī o ka ʻili a me ka haki, ka angioedema, anaphylactic ka hopena, ke kō maloʻo, ke kala ʻana, ka luaʻi ʻana, ka ʻoluʻolu ma ka waha, pupū a me ka ʻōpū o ka ʻōpū, hoʻohaʻahaʻa i ke koko, puhaʻeha, nāwaliwali, hoʻonui i ka hana o ka transaminases, urea a me ka likina. anemia, thrombocytopenia. ʻAʻole hiki ke hoʻohana ʻia no ka intolerance, ālai ʻana i ka pā biliary, hypotension, renal and hepatic insufficiency, bilateral stenosis of renal arteries, fructose intolerance, nā kānaka ma lalo o 18 makahiki o nā makahiki, nā wahine e hāpai ana i kahi keiki a me nā makuahine hānai.

ʻOi like ka analogue mai ka 70 rubles.

ʻO Lorista kahi mea hoʻohālike, ʻo ka mea hana i hana i ka Belarusian ʻo KRKA a me kāna keʻena kūhelu Lūkini KRKA-RUS. Kuhi ʻia ia ma ke ʻano o nā papa i loko o kahi pūpū o 12.5 mg (ʻAe. 30), 25 mg (Helu 30), 50 mg (No. 30, 60 a 90) a me 100 mg (ʻAnakū 30, 60 a me 90). Hoʻopili ia i ka hopena o ka AT1 no ka angiotensin-2, e pale ana i ka hoʻokumu ʻana o ka angiotensin-2 mai angiotensin-1, a laila ke kāohi nei i ka hopena vasoconstrictor o ka angiotensin o ka ʻano lua. ʻO ka lāʻau lapaʻau e hōʻemi i ke koko, me ka hoʻopiʻi ʻole ʻana i ka helu o ka puʻuwai. Hoʻohana ʻia no ka hypertension pono, me ka hōʻemi ʻana i ka hōʻeha o ka hōʻeha ʻana i ka puʻuwai a me ka atherothrombotic subtype o ka ischemic stroke ma ka poʻe i kuhi ʻia i kēia mau maʻi, me ka hemacac intracranial e pale ai i ka spasmal lua o nā moku cerebral, e alakaʻi ai i ka hōʻemi o ke kūlana o ka mea maʻi. E inu i ka lāʻau i hoʻokahi manawa i ka lā. Hiki iā ia ke hana i nā mālamalama, ka dyspepsia, hypotension, renal a me ka maikaʻi ʻole o ka nāwaliwali, nāwaliwali, huki, nā hoʻololi i ke ʻano o ke koko, hyperkalemia, ʻehaʻeha o ka naʻau. Contraindicated ma ka hihia o ka intolerance, hypotension, pathology koʻikoʻi o nā pēpē a me nā pepeha, nā keiki, ka wahine a me ka lactating wahine.

Telsartan (nā papa āpau) → maikaʻi ʻaʻōlelo: 17 Up

ʻOi like ka analogue mai ka 14 mau rubles.

Mea Hana: -
Kuhi puka:

Nā Pihi, 40 mg, No. 30

ʻO ke kumu kūʻai o Telsartan i kahi lāʻau lapaʻau: mai 232 mau rubles. a hiki i ka 556 rub. (577 hāʻawi)
ʻO Telsartan kahi synodo o India no ka telzap. Kuhi puka - nā papa o 40 a me 80 mg (ʻAoʻao 30). He mea poʻomanaʻo koho aniotensin-2 receptors. Hoʻohana ʻia ia i nā mea maʻi me ka hypertension arterial primert, a me nā poʻe hoʻi ma luna o 55 mau makahiki he nui ka nui o ka hōʻeha o ka maʻi cardiovascular catastrophes o ka atherothrombotic kumu no ka pale ʻana i ka hala mua a me ka hoʻokuʻi ʻana i ka myocardial infarction a me nā ischemic strokes, hōʻea i ka wā ischemic attack, arterial disease haʻahaʻa haʻahaʻa, hoʻemi i ka hopena o ke kīnā a me ka make ma o kēia mau maʻi. Hoʻohana nui ʻia ia ma ka hana neʻe a me ka hana neurosurgical no ka hoʻōho a me ka traumatic hemorrhages ma ke ʻano o ke kāohi ʻana i ka spasm lua o nā moku cerebral, ka mea e alakaʻi ai i ka hoʻopiʻi o ke kūlana o ka mea maʻi. ʻO ka hoʻohana ʻana i ka lāʻau maʻi ua contraindicated inā he hypersensitivity i kāna mau ʻāpana, nā kūlana i hui pū ʻia me ka hypotension, me ka bilateral renal artery stenosis a i ʻole stenosis stanosis o hoʻokahi pēpē, me ka maʻi nui o ka renal a me ka maʻi hepatic, ka mea pili o ka papa hala, ma ka wā hāpai a me ka hānai, no nā keiki a me nā ʻōpio.

ʻOi ka mea kūʻai aku i ka mea kūʻai mai ka 6 mau rubles.

Telmista (kahi hōʻailona no Telzap) - i hana ma Slovenia i nā papa o 40 mg (No. 28 a 30) a me 80 mg (No. 28). ʻO ke ʻano hana ka mea telmisartan. ʻO ka hana o ke ʻano he kūlike me nā lāʻau lapaʻau i luna. Hoʻokahi ka papa papaʻa i hoʻokahi manawa i kahi lā no ka lōʻihi. Hoʻohana ʻia lākou i nā mea maʻi me ka hypertension pono koʻikoʻi a ma ka poʻe i hōʻeha nui i nā hoʻopiʻi cardiovascular o ka maʻi athero-thrombotic (puʻuwai paʻi, hōʻeha, a hōʻemi i nā maʻi o nā moku o nā lalo haʻahaʻa) no kā lākou pale mua a pae ma hope, ka hōʻemi o ka maʻi a me ka make ma kēia ala. Hoʻohana ʻia ia i nā mea maʻi me nā hemorrhages cerebral e pale ai i ka vasoconstriction kūloko ma kēia wahi a me ka necrosis o nā kumumea o ka lolo a puni ka hemorrhage. Ke lawe nei i ka lāʻau, maʻi kūloko, pālua, maʻi like-flu, dyspepsia, hypotension, dizziness, nawaliwali, ʻōwili, koko a me ka puʻuwai hemahema, edema paha.

Ua ʻoi aku ka uku o ka analogue mai ka 227 mau rubles.

ʻO Edarbi - kahi kuʻuna o Telzap, ua hoʻopuka ʻia ma Tenemaka, Iapana, ʻIkelani a me USA i nā papa o 40 a 80 mg (No. 28). ʻO ka mea hoʻoikaika he azilsartan. Hoʻopili ia i nā mea hoʻonaninakina angiotensin-2, ke kāohi nei i ka hana o ka papa inoa renin-angiotensin-aldosterone, kahi e loaʻa ai ka hopena antihypertensive o ka lāʻau. Hoʻohana ʻia ia i nā mea maʻi me ka hypertension koʻikoʻi (pono), nā poʻe me ka pilikia nui o ka catovropio cardiovascular no ko lākou pae mua a me ke kaulike papa ʻelua, a me ke neʻe ʻana i ka hopena o ka maʻi a me ka make mai o kēia mau maʻi. Hoʻohana ʻia ia no ka hemorrhagic stroke a me ka trorratic hemorrhage traumatic no ka pale ʻana o ka spasm lua o nā moku cerebral. ʻO nā hopena ʻaoʻao (ka maʻa mau a i ʻole ka hōʻino paha) e hiki mai i ke ʻano o ka hopena o ka maʻi, ka hopena dyspeptic, ka ʻilihune, ka nāwaliwali nui, ka hoʻonui ʻana o ka CPK o ke koko, hypotension, leg edema, hoʻonui i ka hana o ka ate, urea, a me nā transaminases creatinine. ʻO kahi contraindication i ka hoʻohana ʻia ʻana o ka lāʻau lapaʻau ʻo kona intolerance, hoʻokele pū me nā aliskiren a me ACE inhibitors i nā mea maʻi me ka maʻi mellitus, ka wā kamaliʻi a me nā wā'ōpiopio, hapai a me ka lactation.

Ua ʻoi aku ka uku o ka analogue mai 249 mau rubles.

ʻO Mikardis (kahi hōʻailona no Telzap) kahi lāʻau lapaʻau Keleman i hana ʻia ma nā papa he 40 mg (No. 14 a me 28) a me 80 mg (ʻAukake 28). Loaʻa iā ia kahi waiwai like me ke telzap a me kahi ʻano hana like. Hoʻohana ʻia e mālama i ka hypertension arterial prim, a me ka hōʻemi ʻana i ka hōʻemi o ka catastrophes cardiovascular (e like me ka maʻi coronary heart, kaila myocardial infarction, atherothrombotic subtype o ischemic stroke, hōʻeha i ka ischemic atake, hōʻemi i ka maʻi ʻōpū o ka ʻōpū, a me nā mea ʻē aʻe). maʻi a me ka make kino mai kēia mau maʻi. Hoʻohana pū ʻia ia no ka hemorrhagic stroke, sporraneous subarachnoid hemorrhage a me ka trorratic intracranial hemorrhage no ka pale ʻana i ka vasospasm lua, kahi e alakaʻi ai i ka hoʻokumu ʻana o kahi rohe necrosis tissue ma kahi kokoke i ke kikowaena hemorrhagic a alakaʻi i ka hoʻonui ʻana i ka pale neurological a me ka hōʻeha ʻana i ke ʻano o ka mea maʻi. ʻAʻole hiki iā ʻoe ke hoʻohana i ka lāʻau lapaʻau me kona intolerance, ke kāohi i ka pā biliary, ʻeha hōʻeha a me nā pathology, bilateral renal artery stenosis, i nā mea maʻi me ka lolo o ka lolo maʻi maʻi a me nā pale o ACE a me aliskiren, me ka intolerance fructose, i nā keiki a me nā ʻōpio, nā wahine hāpai a me ka lactating.

Pākuʻi helu

Aia ma ka papa papa

mea waiwai: 40,000 telmisartan a i ʻole 80,000 mg, kēlā,

hydrochlorothiazide 12.500 mg a 25.000 mg, kēlā,

nā mea hoʻowalewale: sorbitol, sodium hydroxide, povidone 25, magnesium stearate

Nā papa papa ʻōlelo i hoʻohiki ʻia me kahi papa biconvex mai ke keʻokeʻo a hiki i ka melemele, me kahi helu extruded "41" ma kahi ʻaoʻao o ka pākaukau, he 12 mm ka lōʻihi a ma kahi a 6 mm ākea (no ka helu 40 mg / 12.5 mg).

Nā papa papa i kaha pololei ʻia me kahi papa biconvex mai ke keʻokeʻo a hiki i ka melemele, me kahi helu extruded "81" ma kahi ʻaoʻao o ka pākaukau, he 16,5 mm lōʻihi, e pili ana iā 8,3 mm ākea (no ka helu ana iā 80 mg / 12.5 mg).

ʻO nā papa pālona pololei me ka pā biconvex mai ke keʻokeʻo a hiki i ka melemele, me kahi helu extruded "82" ma kahi ʻaoʻao o ka pākaukau, he 16 mm lōʻihi, he 8 mm ākea (no nā kakio no 80 mg / 25 mg).

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.

Telmisartan: Ma hope o ka lawelawe waha, ua hōʻea nā kiʻekiʻe telmisartan ma hope o nā hola 0.5 - 1.5. ʻO ka bioavailability piha loa o ka telmisartan ma ke ʻano he 40 mg a ʻo 160 mg ka 42% a 58%, ʻokoʻa. Ke lawe nei i ka telmisartan me ka meaʻai, ka nui o ka kaila o AUC (ma lalo o ka pihi ʻana i ka manawa o ka paʻa) ma waena o 6% (ma kahi iki o 40 mg) ka 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. ʻO kahi emi iki o AUC ʻaʻole ka mea e hoʻoemi ai i ka hopena o ka therapeutic efficacy. Kuhi ole nā pharmacokinetics o ka telmisartan waha i nā inika o 20-160 mg me ka hoʻonui hou aʻe o ka hoʻonui ʻana i ka hoʻoulu ʻana i ka plasma (Cmax a me AUC) me ka hoʻonui nui ʻana. ʻAʻole i ʻike ʻia kekahi kumulāʻau koʻikoʻi o ke telmisartan.

ʻO ka hole waiwai: Ma hope o ka hoʻoponopono waha ʻana o Telzap Plus, ua hōʻea ka ʻike o ka hydrochlorothiazide ma kahi o 1.0 a 3 mau hola ma hope o ka lawe ʻana i ka lāʻau. Hoʻokumuʻia i ka excretion renalative renal of hydrochlorothiazide, kahi o ka bioavailability kūʻokoʻa e pili ana i ka 60%.

Telmisartan haki loa ia i nā protein plasma (ma mua o 99.5%), ka mea nui me ka albumin a me nā alpha-1-acid glycoprotein. ʻO ka nui o nā puʻupuʻu e pili ana i ka 500 L, e hōʻike ana i nā kikoo ʻē aʻe.

ʻO ka hole waiwai 68% i hoʻopaʻa ʻia i nā protein plasma a me ka nui o ka hoʻolaha i 0.83 - 1.14 l / kg.

Telmisartan ka hoʻāliʻi ʻana e ka conjugation me ke kūkulu ʻana i nā acylglucuronide pharmacologically inactive. ʻO ka glucuronide o ka ʻōlelo a ka makua ka mea i ʻike ʻia i loko o ka poʻe. Ma hope o kahi wai hoʻokahi o ka telmisartan hōʻailona inoa 14C, ʻo ka glucuronide e pili ana i 11% o ka radioactivity plasma i hoʻopaʻa ʻia. ʻAʻole i komo ka Cytochrome P450 a me nā isoenzymes i ka metabolism o ke telmisartan.

ʻO ka hole waiwai ʻaʻole i hoʻopaʻa ʻia i loko o nā kānaka

Telmisartan: Ma hope o ka lawe ʻana i ka telmisartan a me ka waha o ka telmisartan, ua hōʻea ʻia ka nui o nā kaila i hoʻoponopono ʻia (> 97%). Loaʻa nā helu liʻiliʻi i loko o ka pāʻai.

ʻO ka huina piha o ka plasma o ka telmisartan ma hope o ka hoʻoponopono waha he> 1500 ml / min. ʻO ka hapa hapa o ke ola he> 20 mau hola.

ʻO ka hole waiwai excreted aneane i loli ole i loko o ka uki. Ma kahi o 60% o kahi kūlohelohe waha e excreted i loko o 48 mau hola. ʻO ka wehe ʻana o Renal ma kahi o 250 - 300 ml / min. ʻO ka hapalua noho ola he 10 a me 15 hola.

Nā maʻi maʻi maʻi

ʻAʻole ʻokoʻa nā pharmacokinetics o telmisartan i nā poʻe kahiko a me nā poʻe maʻi i ʻoi aku ma mua o 65 makahiki o kona mau makahiki.

ʻO 2-3 ka nui o nā hui o ka telmisartan i nā manawa he 2-3 i ʻoi aku ka nui o nā kāne ma mua o nā kāne. I nā haʻawina loiloi, ʻaʻohe nui o ka piʻi o ka pane o ke koko a i ʻole ka piʻi o ka hypthension orthostatic i nā wahine. ʻAʻole pono ke hoʻoponopono ʻia. Ke nānā nei i ka piʻi o ka plasma kiʻekiʻe o ka hydrochlorothiazide i nānā ʻia i loko o nā wahine ma mua o nā kāne. ʻAʻole ia he hōʻailona koʻikoʻi.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

ʻAʻole pili ʻo ka excretion Renal i ka hoʻomaʻamaʻa telmisartan. Wahi a nā hualoaʻa o ka ʻike liʻiliʻi me Telzap Plus i nā mea maʻi me ka hōʻola ʻana i ka renal moderole (hōʻoki ʻana i hana ʻia o 30-60 ml / min, ka waiwai o ka nui o 50 ml / min), ʻaʻole pono ke hoʻoponopono ʻia. ʻAʻole lawe ʻia ke Telmisartan mai ke koko e ka 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 pōpoki maʻi ʻole, hoʻopau ʻia ka hapalua-ola he 34 mau hola.

ʻO nā maʻi me ka palaualohi maʻa

I ka poʻe maʻi me ka maʻi hepatic, ʻo ka bioavailability piha loa o ka telmisartan e hoʻonui i ka 100%. ʻO ka hapalua hapalua no ke akeʻai ʻaʻole loli.

Farmakoi ka lāmika

ʻO Telzap Plus ka hui ʻana o kahi anagonensin II receptor antagonist (ARAII), telmisartan, a me kahi diuretic thiazide, hydrochlorothiazide. ʻO ka hui pū ʻana o kēia mau māhele he hopena hoʻohui antihypertensive, e hoʻohaʻahaʻa ana i ke kahe koko i ka nui ma mua o kēlā me kēia ʻāpana. ʻO Telzap Plus ke lawe ʻia i hoʻokahi manawa i kahi lā e alakaʻi i ke emi o ke kaila o ka neʻe koko.

ʻO Telmisartan kahi hana kūpono a me ka kikoʻī (koho) angiotensin II receptor antagonist (type AT1) no ka hoʻoponopono waha. ʻO Telmisartan me ka like a me ka mea like loa i ka huki angiotensin II mai kāna mau wahi paʻa i nā ʻāpana o ka subtype 1 (AT1), nona ka hopena i ʻike ʻia o ka angiotensin II. ʻAʻole i hōʻike ʻo Telmisartan i kahi hana agonist ʻokoʻa kū'ē i ka mea hoʻokipa AT1. Hoʻopili paʻa a Telmisartan i nā mea hoʻokipa AT1. ʻO ka wā paʻa. ʻAʻole i hōʻike ʻo Telmisartan i ka pilina no nā mea hoʻohana ʻē aʻe, e komo pū ana me ka ʻĀpana AT2 a me nā mea ʻē aʻe, i haʻahaʻa ʻia nā mea i ʻae ʻia ʻo 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.

Hoʻopau ʻo Telmisartan i nā pae aldosterone plasma, ʻaʻole pale i ka renin i ka plasma o ke kanaka a me nā kaila ion.

ʻAʻole ʻo Telmisartan i kāohi i ka angiotensin-hoʻololi i ka enzyme (kinase II), e hōʻemi ana i ka hana o ka bradykinin. No laila, ʻaʻohe mea hoʻoikaika o nā hopena ʻili e pili ana i ka hana a bradykinin.

ʻO kahi 80 mg dosis o telmisartan, hoʻolako ʻia i nā limahana olakino, aneane ʻae loa i ka hoʻonui ʻana i ke kaomi ma o ka loaʻa ʻana o ka angiotensin II. Ke hoʻomau nei ka hopena pale i nā 24 hola (a hiki i 48 mau hola).

Ma hope o ka lawe ʻana i ka hapa mua o ka telmisartan, hoʻemi ʻia ke koko ma hope o 3 mau hola. ʻO ka haʻahaʻa loa i ke kahe o ke koko, i mea lula, ua hoʻokau ma 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka hoʻomaʻamaʻa ʻana a hoʻomau i ka mālama lōʻihi.

E mau ana ka hopena antihypertensive no 24 mau hola ma hope o ka lawe ʻana i ka lāʻau, me ka 4 mau hola ma mua o ka lawe ʻana i ka hopena hou, e hōʻoia ʻia ana e ke ana ʻana o ke koko, a me ka pae o ka outpatient (ma luna o 80%) o nā kuʻina o ka liʻiliʻi a me ka lōʻihi o ka hōʻemi ma hope o ka lawe ʻana a 40 a me 80 mg o telmisartan i loko o kahi plebo-control mau haʻawina loiloi.

I ka poʻe maʻi me ka hypertension, hoʻemi ka telmisartan i nā kaila koko systolic a me ka diastolic me ka hoʻopi ʻole ʻana i ka hapa o ka puʻuwai. Hoʻohālikelike ka pono o ka antihypertensive o ka telmisartan me nā ʻelele o nā papa inoa 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, a me lisinopril).

Ma kahi ʻelua makapō, nā hoʻokolohua olakino hoʻokele (N = 687 nā mea maʻi i loiloi ʻia no ka pono), ʻo nā poʻe i kū ʻole i ka hopena o 80 mg / 12.5 mg hōʻike i kahi hopena hōʻemi i ka hoʻohaʻahaʻa ʻana i ke koko o ka 80 mg / 25 mg hui hoʻohālikelike ʻia me ka lōʻihi o ka mālama ʻana i ka hopena lōʻihi 80 mg / 12.5 mg 2.7 / 1.6 mmHg (SBP / DBP) (ʻokoʻa i ka loli hoʻololi maʻamau i ka pae waihona pili). Ma kahi noiʻi me ka hui pū o 80 mg / 25 mg, ua hoʻemi ʻia ke koko, e kū ana i kahi hōʻemi holoʻokoʻa o 11.5 / 9.9 mmHg. (GARDEN / DBP).

ʻO kahi loiloi laulā o ʻelua mau wiki he 8, ʻelua-makapō, nā maʻi ʻohiʻoki o ka pleboebo i hoʻohālikelike ʻia i ka hoʻowalewale o valsartan / hydrochlorothiazide 160 mg / 25 mg (N = 2121 nā mea maʻi i loiloi ʻia no ka hana mau) hōʻike ʻoi i ka hopena nui o ka hoʻohaʻahaʻa i ke koko koko 2.2 / 1.2 mm Hg . ^ E Ha yM. (SBP / DBP) (ʻokoʻa i ka loli hoʻololi maʻamau mai ka palena, kēlā me kēia) i ke ʻano o ka hui ʻana o telmisartan / hydrochlorothiazide 80 mg / 25 mg.

Ma hope o ka pau ʻana o ka hoʻomaʻamaʻa ʻia me ka telmisartan, hoʻemi kahe koko i kona waiwai nui ma mua o kekahi mau lā me ka ʻole o nā hōʻailona o ke ʻano "rebound" hypertension.

I nā haʻawina hōʻike hoʻohālikelike hoʻohālikelike i nā hanana ʻelua, ʻo ka ulu ʻana o ka umī maloʻo ka haʻahaʻa o ka maʻi i ka poʻe maʻi e loaʻa ana i ka telmisartan ma mua o ka mea e loaʻa ana i ka angiotensin-hoʻololi ʻana i ka enzyme inhibitors.

ʻO ka haʻawina ʻo PRoFESS i mālama ʻia i nā mea maʻi ma mua o 50 mau makahiki i hala iho nei i kahi hōʻeha ua hōʻike i ka nui o ka sepsis me ka telmisartan hoʻohālikelike ʻia me ka placebo, 0.70% hoʻohālikelike ʻia me 0.49% OR ʻO 1,33 (95% kikowaena hilinaʻi 1.00 - 2.06), ʻo ka nui o ka make mai ka sepsis ke kiʻekiʻe i ka poʻe maʻi e lawe ana i ka telmisartan (0.33%) hoʻohālikelike ʻia me nā mea maʻi e lawe nei i ka placebo (0.16%) OR 2.07 (95% kikowaena hilinaʻi 1.14 - 3.76). ʻO ka hoʻonui ʻia i ka ulia o ka sepsis e pili ana me ka hoʻohana ʻana o telmisartan, he hanana a he hanana maoli paha a hui ʻia paha me kahi ʻano ʻike i kēia wā i ʻike ʻole ʻia.

ʻAʻole ʻike ʻia nā hopena o ka telmisartan ma ka make me ke aniani morbidity. ʻO ka Hydrochlorothiazide kahi diuretic thiazide. ʻO ka mīkini o ka hopena antihypertensive o ka diuretics thiazide ʻaʻole maopopo loa. Ua hoʻopilikia ʻo Thiazides i nā hana ʻoi o ka hana reabsorption o nā electrolytes i nā pālolo, hoʻomāhuahua i ka hoʻonui ʻana o ka sodium a me ka klorika i nā mea like. Hoʻonui ka hopena diuretic o ka hydrochlorothiazide i ka nui o ka plasma, hoʻonui i ka hana ʻana i ka plasma renin, hoʻonui i ka huna kino o ka aldosterone, e ukali ʻia ana e ka nui o ka pāima i loko o ka urine, lilo i ka bicarbonate a me ka hoʻemi ʻana i ka kāʻai sima. ʻĀnō ma o ka blockade o ka ʻōnaehana renin-angiotensin-ald testosterone, ka hui pū ʻana o ka telmisartan, ma ke ʻano he kānāwai, pale i ka nalowale o ka pāhare pili me kēia mau diuretics. Ke hoʻohana nei i ka hydrochlorothiazide, hoʻomaka ka diuresis ma hope o 2 mau hola, a loaʻa ke hopena hopena ma hope o ka hola 4 paha, ʻoiai ka hopena e pili ana no 6-12 mau hola.

Ua hōʻike ʻia nā haʻawina ʻo Epidemiological i ka lōʻihi o ka mālama ʻana me ka hydrochlorothiazide e hoʻemi ana i ka hopena o ka maʻi cardiovascular a me ka morbidity.

ʻLoe a me ke kākele

Kuhi ʻia nā papa Telzap Plus no ka hoʻohana waha, me ka ʻole o ka ʻai ʻana, e lawe ʻia i hoʻokahi lā i ka lā a e holoi ʻia me ka wai.

Hoʻolālā ʻia ʻo Telzap Plus no nā poʻe maʻi e ʻike ʻole ʻia ke kahe koko me ka monmisartan monotherapy. Hoʻomaopopo ʻia ka lāʻau titration o kēlā me kēia māhele o ka ʻelua o ka neʻe ma mua o ka hoʻololi ʻana i ka hui pūnaʻe paʻa paʻa Ma ka hoʻokō koʻikoʻi, hiki ke noʻonoʻo ʻia kahi hoʻololi kū mai ka monotherapy i kahi hui paʻa.

Hiki ke lawe ʻia ka Telzap Plus 40 mg / 12.5 mg i hoʻokahi lā no ka poʻe maʻi ʻaʻole hiki ke hoʻokela ʻia ka nui o ke koko me ka 40 mg telmisartan monotherapy.

Hiki ke kiʻi ʻia ka Telzap Plus 80 mg / 12.5 mg i hoʻokahi lā no ka poʻe maʻi no ka ʻike ʻole ʻana o ke koko i ka manawa e ʻohi ʻole ʻia e ka telmisartan monotherapy 80 mg.

Hiki ke kiʻi ʻia ka Telzap Plus 80 mg / 25 mg i hoʻokahi lā no nā poʻe maʻi ʻaʻole i ʻona ʻia ka nui o ke koko i ka wā e hoʻopili ana iā Telzap Plus 80 / 12.5 mg a i loko o nā maʻi nā maʻi koko i hoʻokau mua ʻia ma ka telmisartan a me ka hydrochlorothiazide ʻokoʻa.

Hoʻohana ma ka pākeke

ʻAʻole pono ke hoʻoponopono ʻia.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

Hoʻomaopopo ʻia ka nānā ʻana o ka hana hakahaka i ka hana maʻamau (ʻike i nā "Nānā Kūlana kūikawā))

ʻO nā maʻi me ka palaualohi maʻa

I nā mea maʻi me ka maʻi hepatic palupalu a maʻalahi, ʻaʻole pono ka nui o ka nui o ka nui ma mua o Telzap Plus 40 mg / 12.5 mg i hoʻokahi lā. ʻAʻole ia i hōʻike ʻia no Telzap Plus no nā maʻi me nā hana heʻeha koʻikoʻi. Pono e hoʻohana ʻia ʻo Thiazides me ka makaʻala i nā mea maʻi me ka hana o ka puʻuwai maʻi (ʻike i ka ʻāpana "ʻōlelo aʻoaʻo").

ʻAʻole paʻa i ka palekana a me ka hana pono o Telzap Plus i nā keiki a me nā ʻōpio ma lalo o ka makahiki 18. ʻAʻole i loaʻa ka ikepili.

Me ka hana pūnāwai paʻa ʻole

Ua hoʻohana nui ʻia ka hoʻohana ʻana o Telzap i nā mea maʻi me ka pilikia ʻole ʻole (GFR ma mua o 60 ml / min / 1.73 m 2) e pili ana i ka maʻi concomitant me ka aliskiren.

Me ka makaʻala, pono ke kuhikuhi ʻia ʻo Telzap no ka hana ʻole ʻana i ka pilikia, bilateral renal aren stenosis, stenosis artery o ke keiki e hana nei.

In the renal gagal a me nā maʻi hemodialysis e kuhikuhi ʻia e hoʻohana i kahi pā mua o kēlā me kēia lā ʻaʻole nui o ka 20 mg.

No ka maʻalahi o ka hana i ka pōkole o ka pale, ʻaʻole pono ke hoʻoponopono ʻia.

Ka Hoʻolālā Nui

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. Pono ka hopena o ka lāʻau lapaʻau no 24 mau hola a noho mau i ka maʻi nui a hiki i 48 mau hola. 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 pau ʻana o ka telmisartan, hoʻemi kahe kahe i ke koko i kona pae mua i nā lā he nui me ka hoʻomohala ʻana i ka maʻi "withdrawal".

E like me nā hōʻike o nā haʻawina hoʻohālikelike hoʻohālikelike, hoʻohālikelike ʻia ka hopena antihypertensive o ka telmisartan i ka hopena antihypertensive o nā lāʻau lapaʻau o nā papa ʻē aʻe (amlodipine, atenolol, enalapril, hydrochlorothiazide a lisinopril).

ʻO ka ulu ʻana o ka ʻōpala maloʻo nui loa me ka telmisartan i hoʻohālikelike ʻia me nā mea hoʻohana o ACE.

Kāohi pilikia Cardiovascular

ʻO nā mea maʻi 55 mau makahiki a ʻoi aku paha me ka maʻi puʻukū coronary, stroke, hōʻeha hōʻeuʻeu ischemic, peripheral arterial poino, a me nā hoʻopiʻi o nā maʻi maʻi type 2 (no ka laʻana, retinopathy, haʻalele i ka hypertrophy ventricular, macro- a i ʻole microalbuminuria) me kahi mōʻaukala o ka hopena cardiac -vascular hanana, telmisartan he hopena like i ka ramipril i ka hōʻemi ʻana i ka hopena i hui pū ʻia: makehovovial mortalally mai myocardial infarction me ka hopena o ka mea make, stroke me ka make ole hospitalization no i ka maʻi naʻau ole.

ʻO Telmisartan e like me ka ramipril i ka hoʻemi ʻana i ke kahe o nā kekona: ʻo ka make ʻana o ka maʻi cardiovascular, non-fatal myocardial infarction, a i ʻole he momona i hōʻeha. ʻO ka umauma maloʻo a me ka angioedema i ʻike pinepine ʻia me ka telmisartan i hoʻohālikelike ʻia me ramipril, ʻoiai he hypotension arterial pinepine pinepine me telmisartan.

Kapehu

I ka wā e lawelawe ʻia, ka wikiwiki o ka telmisartan mai ka gastrointestinal tract. ʻO Bioavailability 50%. I ka manawa like me ka ʻai, ʻo ka emi ʻana o AUC (ʻo ka māhele ma lalo o ka cur-time kukū) ma waena o 6% (ma kahi kiko o 40 mg) a hiki i 19% (ma kahi kikoʻī o 160 mg). Ma hope o 3 mau hola ma hope o ka hoʻokele ʻana, hoʻāla ʻia ka manaʻo o ke plasma koko, kūʻokoʻa kūʻokoʻa, ua lawe ʻia ka telmisartan i ka manawa like me ka meaʻai a i ʻole. Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. ʻO Stach (ʻoi loa ka ʻike) a me AUC paha ma kahi o 3 a 2 mau manawa, ʻoi aku ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me ka loaʻa ʻole o kahi hopena kūpono.

ʻAʻohe pilina pili ʻole ma waena o ke ʻano o ka lāʻau a me kona kaila plasma. E kaʻai a, i kahi haʻahaʻa, hoʻonui nui ʻo AUC i ka hoʻonui ʻana i ka nui e hoʻonui ai i nā pākahi ke hoʻohana ʻia nā ʻōmole ma luna o 40 mg i kēlā me kēia lā.

Hāpai

Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic. ʻAʻohe o ka conjugate i ka hana lapaʻau.

ʻO ka hapa-ola (T. / 2) iʻoi aku ma mua o nā hola 20. Ua hoʻopiʻi ʻia ma o ka ʻōpū o ka ʻōpū, kūʻai ʻia e nā ʻōpū - ua emi mai ka 1%. Ke kiʻekiʻe nei ka hoʻopiha ʻana o ka plasma holoʻokoʻa (ma kahi o 1000 ml / min) i hoʻohālikelike ʻia me ke kahe koko "hepatic" (ma kahi o 1500 ml / min).

Me ka mālama pono

ʻO ka hua'ōlelo Telzap e pono ke kuhikuhi me ka makaʻala ʻana i kēia mau ʻano.

bilateral renal aren stenosis a i ʻole stenosis kahi o ka hoʻokahi hana hana,
huakaʻi renal function,
mālie i ka maʻi lēpa hepatic,
hōʻemi i ka neʻe ʻana o ke koko koko (BCC) e kū i ka hope o ka hoʻokomo o ka diuretics i nā palena, ka palena o ka hoʻohana ʻana i ka sodium chloride, huʻi a maʻi paha paha,
hyponatremia,
hyperkalemia
kūlana ma hope o ka mālama ʻana i ka lula (ʻaʻohe ʻike me ka hoʻohana ʻana),
u me ka pohō nui o ka naʻau,
nā kaena o ka aortic a me mitral valve,
hypventrophic pono e hoʻonani,
mua o ka hyperaldosteronism (maikaʻi a paʻa ʻole)

He maʻi haole

ʻO ka papa ʻōlelo mua o Telzap ma 1 papa (40 mg) hoʻokahi i ka lā. I kekahi mau maʻi, 20 mg i kēlā me kēia lā e kūpono paha. Hiki ke loaʻa ka hopena o 20 mg ma ka hoʻokaʻawale ʻana i kahi papa 40 mg ma ka hapalua i ka pilikia. I nā hihia i loaʻa ʻole ka hopena o ka therapeutic, e hoʻonui ʻia ke ʻano ʻōlelo o Telzap a me ka nui o ka 80 mg hoʻokahi i ka lā.

Ma kahi koho aʻe, hiki ke lawe ʻia ʻo Telzap i hoʻohui pū me ka diuret thiazide, no ka laʻana, ka hydrochlorothiazide, kahi i hoʻohana pū ʻia ai he hopena antihypertensive hou. 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.

ʻO ka maʻi me ka hana renal impaired

Loaʻa ka ʻike me ka telmisartan i nā mea maʻi me ka maikaʻi ʻole o ka pilikia a i ʻole nā maʻi ma ka hemodialysis. A ʻōlelo ʻia kēia mau mea ma kahi haʻahaʻa haʻahaʻa haʻahaʻa o 20 mg i kēlā me kēia lā (e ʻike i ka ʻāpana "Mālama kūikawā"). No ka mea maʻi me ka maluhia o ka renal hāmeʻa maʻalahi, ʻaʻole koi.

ʻO ka hoʻohana ʻana ma Telzap me ka aliskiren ua contraindicated i nā maʻi me nā pilikia ʻole.

ʻO ka hoʻohana like ʻana o Telzap me nā inhibitor ACE ua contraindicated i ka poʻe maʻi me ka nephropathy maʻi.

ʻO nā mea maʻi me ka hana pūlima hemahema

Contzicated ʻo Telzap i nā maʻi me nā maʻi hepatic koʻikoʻi (papa C e like me ka helu ʻana o nā keiki-Pugh). I nā maʻi me ka maʻi palupalu i ke lēpaʻa (kahi A a me B e like me ka helu ʻana o nā keiki-Pugh, ma kēlā me kēia), ua kauoha ʻia ka lāʻau lapaʻau me ka mālama ʻana, ʻaʻole pono ka nui o ka dosis ma mua o 40 mg hoʻokahi i ka lā.

Kahawai

I kēia manawa, ʻaʻohe ʻike ka ʻike e pili ana i ka palekana o ka telmisartan i nā wahine hāpai. Ma nā noiʻi holoholona, ua hōʻike pono ʻia nā huaʻawaʻi o ka pono o ka lāʻau. Hoʻopili ʻia ka lilo ʻana o Telzap i ka wā hāpai (ʻike i ka ʻāpana "Contraindications").

Inā pono ka lōʻihi o ka mālama ʻana me Telzap, ʻo nā mea maʻi e hoʻolālā ana i ka hapai e pono ke koho i kahi lāʻau lapaʻau antihypertensive hou me ka ʻaoʻao palekana e hōʻoia ʻia no ka hoʻohana ʻana i ka wā hāpai. Ma hope o ka hoʻokumu ʻana i ka ʻoiaʻiʻo o ka hāpai ʻana, e hoʻopau koke ʻia ka mālama ʻana me Telzap a, inā pono, pono e hoʻomaka ʻia nā ʻano aʻoaʻo.

E like me nā hōʻike o ka nānā ʻana o ka lāʻau lapaʻau, ʻo ka hoʻohana ʻana o ARAP i ka wā o ka ʻoi a me ke kolu o ka hapala o ka hāpai ʻana he hopena ʻona i ka ʻōpio (hana renal functioning, oligohamoamnios, lohi ossification o ka ʻōpala) a me ka pēpē (renal failed, hypotension arterial a me hyperkalemia). Ke hoʻohana nei ʻo ARAN i ka wā ʻelua o ka hapalua o ka hāpai ʻana, e hōʻike ʻia ana kahi loiloi ultrasound o ke akeʻa a me ke ʻūhā o ka pūpū.

ʻO nā keiki i lawe i kā ARAP makuahine i ka wā hāpai, e mālama pono ʻia lākou no ka hypotension arterial.

ʻ periodmeʻa

ʻAʻole loaʻa ka ʻike i ka hoʻohana ʻana o telmisartan i ka wā o ka umauma. ʻO ka lawe ʻana iā Telzap i ka wā o ka umauma i contraindicated, he pono hou e hoʻohana ʻia nā lāʻau antihypertensive me kahi ʻoluʻolu palekana e hoʻohana pono, ʻoi aku ka mea e hānai ana i kahi pēpē a hānau keiki maoli paha.

Loaʻa ka hopena

I ka wā o ka hoʻohanaʻana i ka lāʻau Ordiss, hiki ke hopena:

Nā maʻi maʻi pāpaʻi a me nā maʻi parasit: pinepine - ka pā ʻana i ka urinary tract, e pili ana i ka cystitis, nā maʻi ʻalihi o ka ʻaoʻao o ka papa hanu, me ka pharyngitis a me ka sinusitis, jarang - sepsis.
Mai ka ʻōnaehana hemopoietic: pinepine - - anemia, luhi - eosinophilia, thrombocytopenia.
Mai ka pānaʻi ʻana: jarang - ka hopena anaphylactic, hypersensitivity.
Mai ka ʻaoʻao o ka hana metabolism: pinepine - hyperkalemia, luhi - hypoglycemia (i nā maʻi me nā maʻi mellitus).
ʻO nā maʻi noʻonoʻo: pinepine - ka ʻōpala, ke kaumaha, ʻaʻole kaumaha - hopohopo.
Mai ka ʻōnaehana o ka pīpī: pinepine - palupalu, liʻiliʻi - hiamoe.
Mai ka ʻaoʻao o ke io o ka hihiʻo: jarang - nā pilikia keu.
Ma ka ʻāpana o ke kino o ka lohe a me nā maʻi labyrinth: pinepine - vertigo.
Mai ka pūnaehana cardiovascular: pinepine - - bradycardia, hōʻailona i ka emi ʻana o ke koko, a me ka hypotension orthostatic, i ʻole hanana - tachycardia.
Mai ka papa hana hanu: pinepine - kahe o ka hanu, ka mākeke, ʻeha loa - maʻi interstitial maʻi.
Mai ka ʻeha o ka gastrointestinal: pinepine - ʻeha o ka ʻōpū, ka ʻōpū, ka dyspepsia, ka lemela, ka luaʻi, ʻaʻole ka ʻuʻuku - maloʻo, ʻūhā i loko o ka ʻōpū, ka hōʻino ʻana i nā ʻano ʻaila.
Mai ka pūpū a me ka pāhau bili: jarang - hoʻonāukiuki i ka hana lohi / hōʻeha kino.
Ma ka ʻāpana o ka ʻili a me nā kiko o ka subcutaneous: pinepine - i ka ʻāʻī o ka ʻili, hyperhidrosis, ʻāwili ka ʻili, ʻaʻohe liʻiliʻi - angioedema (pūnaʻi pū kekahi), eczema, erythema, urticaria, drug rash, ʻeha ʻeha o ke kino.
Mai ka pūnaehana musculoskeletal: pinepine - hōʻeha i ke kaumaha (sciatica), nā māka ʻana o ka naʻau, myalgia, ʻeha - arthralgia, ʻeha ma ka wāwae, nā ʻeha ma nā tendons (like me tendon-hōʻailona).
Mai ka pūnaehana urinary: pinepine - hana i ʻole ke kau o ka pono, a me ka maikaʻi ʻole o ka renal ʻole.
Ma ka ʻāpana o ka ʻoihana a me nā haʻawina hoʻokolohua: pinepine - ka mahuahua o ka neʻe ʻana o ka creatinine i loko o ke kaila koko, ʻaʻole iki - ka hoʻokaʻawale ʻana o nā kiko o ka hemoglobin, he hoʻonui i ka ʻike o uric acid i ka plasma koko, he hoʻonui i ka hana o nā huina o nā pepi a me ka CPK.
Nā mea ʻē aʻe: pinepine - ʻeha o ka umauma, asthenia, ʻaʻole liʻiliʻi - like me ka maʻi flu.

Hoʻohui nūhou

Me ka hoʻohana like ʻana o ka telmisartan me ka digoxin, kahi hoʻonui hoʻonui Cmax o ka digoxin i loko o ke koko koko ma o 49% a Cmin ma 20% i kaulana. I ka hoʻomaka ʻana o ka mālama ʻana, i ka wā e koho ai i ka hoʻōla a me ka hoʻopau ʻana i ka mālama ʻana me ka telmisartan, ʻo ka nānā ʻana o ka digoxin i loko o ke koko koko e nānā pono ʻia e mālama i loko o ka laoa therapeutic.

Kāua pahu pā o RAAS

ʻO ka hoʻohana like ʻana o ka telmisartan me nā aliskiren a i nā mea ola paha e loaʻa ana i ka aliskiren, ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a me / a i ʻole ka hōʻemi a maikaʻi ʻole (GFR ma lalo o 60 ml / min / 1.73 m2 o ka ʻōpū o ke kino o ka wahi) a ʻaʻole i'ōlelo ʻia no nā maʻi ʻē aʻe.

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors cont conticated i loko o nā mea maʻi me ka nephropathy maʻi maʻi, ʻaʻole ia i kauoha ʻia no nā maʻi ʻē aʻe.

Ua hōʻike ʻia nā haʻawina haukaʻi ʻo ka blockade pālua o RAAS ma muli o ka hoʻohana ʻana o ka inhibitions ACE, angiotensin II receptor antagonists, a aliskiren pili paha me ka nui o nā hanana hōʻino e like me ke kīmole hypotension, hyperkalemia, a me ka hana ʻole i ke kīpē (me ka ʻoi aku ka hopena o ka renal) i hoʻohālikelike ʻia me ka nui o nā hanana hōʻino e like me ke kīmole arterial, hyperkalemia, a me ka hana hana ʻole (me ka hana ʻole ʻoi aku) me ka hoʻohālikelike ʻia. ka lāʻau lapaʻau e hana ana ma RAAS.

Hyperkalemia

Hiki ke hoʻonui paha i ka hopena o ka hoʻoulu ʻana i ka hyperkalemia inā hoʻohana pū ʻia me nā lāʻau ʻē aʻe e hiki ai ke kumu i ka hyperkalemia (hoʻohui ʻia ka meaʻai me ka paʻakai a me nā paʻuhi a paʻakai e loaʻa ana i ka potassium, potassium-sparing diuretics (no ka laʻana, spironolactone, eplerenone, triamterene a amiloride), NSAIDs (me nā koho o ka COX-2 pipili) , heparin, immunosuppressants (cyclosporine a tacrolimus) a me ka trimethoprim).

Hoʻokumu ka manaʻo o hyperkalemia i nā mea pili i pili i ka pilikia. Hoʻonui ʻia ka pilikia inā hoʻohana i nā hui i luna, a ʻoi loa ke kiʻekiʻe i ka wā e hoʻohana pū ʻia me ka diuretics pākeleka me ka paʻakai a me nā paʻakai o ka paʻakai. ʻO ka hoʻohana ʻana o ka telmisartan i hui pū me ACE inhibitors a i ʻole NSAID e emi iki ka hopena inā i mālama pono ʻia.

Hōʻeha ka hana ʻoluʻolu

ʻO ka hoʻohana ʻana o Telzap i kontraindicated i ka poʻe maʻi me ka cholestasis, ka ālai biliary a i ʻole hana koʻikoʻi o ka ate (keiki-Pugh class C), no ka mea, ua hoʻopuka ʻia ka telmisartan ma ka bile. I manaʻoʻiʻo ia ma kēlā mau maʻi, hoʻemi ʻia ka hoʻomaʻemaʻe hepatic o ka telmisartan. I nā mea maʻi me ka hoʻowahāwahā haʻahaʻa a me ke kaulike (kahi A a me B e like me ke ʻano o nā keiki-Pugh), pono ʻo Telzap e akahele me ka akahele.

Hoʻolaha i ka pun koko koko (BCC)

ʻO ka hypotension arterial Symptomatic, ʻoiai ma hope o ka hoʻokele mua o ka lāʻau, hiki ke hōʻeha i nā mea maʻi me ka BCC haʻahaʻa a me / a me ka sodium i loko o ke koko koko i ka hope o ka mālama ʻana i mua me ka diuretics, nā mea paʻa ma ka komo ʻana o ka paʻakai, ʻeha a hoʻoilo paha.

ʻO nā kūlana like (ka wai a me / wai ʻole ka liʻiliʻi o ka sodium) e hoʻopau ʻia ma mua o ka lawe ʻana iā Telzap.

ʻO nā kūlana ʻē aʻe e pili ana me ka hoʻoulu ʻana o RAAS

I ka poʻe maʻi e pili ana ka vascular tone a me ka hana renal i ka hana RAAS (no ka laʻana, ka poʻe maʻi me ka ʻeha ʻole o ka naʻau a i ʻole ka maʻi puʻuwai, ʻo ia hoʻi me ka stenosis renal a i ʻole stenosis o hoʻokahi artery kidney), ka hoʻohana ʻana i nā lāʻau e pili ana i kēia ʻōnaehana. hiki ke hele pū me ka hoʻomohala ʻana o ka maʻi arterial hypotension, hyperazotemia, oliguria, a ma nā hihia eʻe ʻole, ʻoi aku ka paʻakikī o ka renal.

Me ka hana pūpū hemahema

Ua koho ʻia ʻo Telzap no ka mālama ʻana i nā maʻi me ka maʻi hepatic koʻikoʻi (kahi C e like me ke ʻano o ke keiki-Pugh) i contraindicated.

Me ka mālama aka, pono e lawe ʻia nā papa me ke anuanu o ka maʻi hepatic i maʻalahi (Anak a me Pugh nā papa A a me B). ʻAʻole pono ʻo ia i kēlā me kēia lā o ka telmisartan ma mua o 40 mg.

Ka hopena ma ka hiki ke alakaʻi i nā kaʻa

Ma nā noiʻi noiʻi kūikawā e noiʻi ai i ka hopena o ka lāʻau lapaʻau ma ka hiki ke ke kaʻa i kahi kaʻa a ʻaʻole i lawe ʻia nā mīkini. Ke hoʻokele a hana a me nā hana me ka mea e pono ai ka nui o ka makaʻala, pono e mālama ʻia, no ka mea, hiki ʻole paha ke hanana a me ka luhiluhi me ka hoʻohana ʻana o Telzap.