Telzap - nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana, nā loiloi, nā analogs a me nā ʻano dosis (papa 40 mg, 80 mg, Plus 80 mg 12, 5 mg me ka diuretic hydrochlorothiazide) mau lāʻau no ka mālama ʻana i ka maʻi hypertension a hoʻoemi i ke koko koko i ka pākeke, nā keiki a me ka wā hāpai

I kēiaʻatikala, hiki iā ʻoe ke heluhelu i nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau Telzap. ^ E Ha yM. Hāʻawi i ka hoihoi mai 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 o Telzap 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 paha e hoʻolaha ʻia e ka mea hana ma ka palapala. Nā kikowaena o Telzap ma ke alo o nā kikowaena hoʻonohonoho ʻenehana o mua. Hoʻohana no ka mālama ʻana i ka hypertension koʻikoʻi a hoʻoemi i ka pume ma ka pākeke, nā keiki, a me ka wā hapai a me ka lactation. ʻO ka hiʻohiʻona o ka lāʻau lapaʻau.

Telzap - ka lāʻau antihypertensive.

ʻO Telmisartan (ka hana ikaika o ka lāʻau Telzap) he antagonist kikoʻī o ka angiotensin 2 receptors (type AT1), ka hana i ka wā e lawe ʻia ai. He wahi pilikino loa ia no ka AT1 receptor subtype, ma laila e maopopo ai i ka hana o ka angiotensin 2 ua paʻa ʻo Telmisartan angiotensin 2 mai kahi paʻa i ka ʻona, me ka ʻole o ka hana a kahi agonist e pili ana i kēia mea hoʻokipa, e kāohi wale ana i ka AT1 suburika subtype o ka angiotensin. ʻAʻole ʻae ʻia ka Telmisartan no nā mea ʻē aʻe i hiki mai, incl. i nā ʻāpana AT2 a me nā mea ʻimi ʻē aʻe i hoʻowahāwahā ʻia na lehulehu. 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. Ke hōʻemi nei ʻo Telmisartan i ka hoʻoneʻeʻana o ka ald testosterone i ka plasma koko, ʻaʻole e hōʻemi i ka hana o renin, ʻaʻole paʻa i nā kahawai ion. ʻAʻole keʻae ʻo Telmisartan i ka ACE (kininase 2), kahi e hoʻomaʻamaʻa nei i ka luku ʻana o ka bradykinin. Hōʻalo kēia i nā hopena ʻaoʻao pili i ka hana o ka bradykinin (no ka laʻana, ka ʻōpala maloʻo).

ʻO Telzap i kahi aniani o 80 mg paʻa maoli i ka hopena hypertensive o ka angiotensin 2. Hoʻomaka ka hoʻomaka ʻana o ka hana antihypertensive ma loko o 3 mau hola ma hope o ka hopena o ka telmisartan mua loa. Noho ka hopena o ka lāʻau no 24 mau hola a noho mau i ka maʻi nui a hiki i nā hola 48. Hoʻomaka pinepine kahi hopena antihypertensive e hoʻomaka i ka 4-8 mau pule ma hope 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.

Ma ka hihia o kahi koi o ka lawe ʻana iā Telzap, ke kahe ana ke koko ma luna o ke mau lā he nui ka lā e hoʻi hou i kona pae mua me ka ʻole o ka hoʻomohala ʻana i kahi maʻi hoʻomaha.

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 ka maʻi me ka maʻi ʻalopona coronary, stroke, hōʻeha me ka puʻuwai ischemic, peripheral arterial damage, a me nā hoʻopiʻi o nā ʻano maʻi mellitus type 2 (e.g., retinopathy, waiho i ka hypertrophy ventricular, macro- a i ʻole microalbuminuria) me kahi mōʻaukala o ka hopena cardiovascular. nā hanana, ʻo Telzap kahi hopena e like me ka hopena o ka ramipril ma ka hoʻohaʻahaʻa ʻana i ka hopena i hui pū ʻia: ʻo ka maʻi cardiovascular mai ka make myocardial me ka hopena o ka mea make, ka uha ʻole a me ka hopena hōʻeha a me ka mokuʻāina ʻO kaʻaiʻai ma muli o ka nele o ka puʻuwai kani.

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 angioneurotic edema i ʻike pinepine ʻia me ka telmisartan i hoʻohālikelike ʻia me ramipril, ʻoiai he hypotension arterial pinepine me ka telmisartan.

ʻO Hydrochlorothiazide ma ke ʻano o ka Telzap Plus kahi diuretic thiazide. Hoʻokomo ʻia ʻo Thiazides i ka hoʻihoʻi ʻana o nā electrolytes i nā pākōkō, a me ka hoʻonui ʻana i nā kūmole o ka pā o ka sodium a me nā klorida, ma kahi o nā nui like. Hoʻonui ka hopena diuretic o ka hydrochlorothiazide i ka hoʻohaʻahaʻa i ka BCC, kahi hoʻonui i ka hana o ka plasma renin, he hoʻonui i ka hana o aldosterone, e ukali ana i ka hoʻonui ʻia o ka pāhana me ka bicarbonates i loko o ka urine a me kahi hoʻēmi ʻana ma ka waihona o ka pāima i loko o ka plasma koko. ʻO ka hoʻohana like ʻana o ka telmisartan kōkua i ka hōʻemi i ka nalowale o ka potasi i lawe ʻia ma kēia diuretic, ma muli paha o RAAS blockade. Ma hope o ka lawe ʻana i ka hydrochlorothiazide, hoʻonui ka diuresis ma hope o 2 mau hola, e ulu ka hopena nui ma hope o ka hola 4, ua mau ka hopena e pili ana i nā hola 6-12.

Ua ʻike ʻia nā haʻawina ʻo Epidemiological e hoʻolōʻihi i ka hoʻomehana hydrochlorothiazide e hōʻemi i ka hopena o ka morbidity cardiovascular a me ka make.

Hōʻike

Nā poʻe Telmisartan + poʻe keu.

Telmisartan + Hydrochlorothiazide + Hoʻokomo (Telzap Plus).

Lapaʻau lāʻau

Ke lawe hewa ʻia, lawe nui ʻia ʻo Telzap mai ke kaʻe ʻana o ka huina. ʻO Bioavailability 50%. Hoʻopaʻa ikaika ka Telmisartan i nā protein plasma, ʻo ka mea nui me ka albumin a me nā alpha-1 acid glycoprotein. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic. ʻAʻohe o ka conjugate i ka hana lapaʻau. Hoʻokuʻu ʻia kēia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 1%.

ʻAʻole ka hanu o ka Hydrochlorothiazide i nā kānaka. Ke keʻakeʻa ʻia nei ua loli ʻole ia i loko o ka urine. Ma kahi o 60% o nā momona i lawe ʻia ma ka waha he hoʻololi i loko o nā hola 48. ʻO ka hoʻomaʻemaʻe Renal ʻo 250-300 ml / min.

ʻO ka Pharmacokinetics i nā hui hoʻomanawanui kūikawā

Aia ka ʻokoʻa ma nā kaohū o plasma i ka telmisartan i nā kāne a me nā wahine. ʻO Cmax lāua ʻo AUC ma kahi kokoke i 3 a me 2 mau manawa i kēlā me ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me ka loaʻa ʻole o kahi hopena koʻikoʻi.

I nā wahine, aia ka manaʻo o nā kikowaena kiʻekiʻe o ka hydrochlorothiazide i loko o ke kaila koko, ʻaʻole iʻike nui kēia.

ʻO nā pharmacokinetics o telmisartan i nā maʻi maʻi ma mua o 65 mau makahiki he ʻokoʻa ʻole nā maʻi ʻōpio. ʻAʻole pono ke hoʻoponopono ʻia.

I nā mea maʻi me ka malia functionally renal impable, ʻaʻole koi ʻia ka hoʻoponopono ʻana o ka telmisartan. ʻO nā mea maʻi me ka hikiʻole o ka pilikia a me nā mea maʻi ma ka hemodialysis e hōʻike ʻia ana i kahi haʻahaʻa mua o 20 mg i ka lā. ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis.

I nā maʻi me ka pēpē palupalu a me ka hana maʻalahi (kahi A a me B e like me ka helu ʻana o nā keiki-Pugh), ʻaʻole pono ka lāʻau o kēlā me kēia lā e 40 mg.

Nā Hōʻike

pono hypertension,
ka hoʻohaʻahaʻa o ka maʻi maʻamau a me nā maʻi cardiovascular i nā poʻe maʻi pākeke me nā maʻi cardiovascular o ka hopena atherothrombotic origin (IHD, stroke a i ʻole o ka mōʻaukala o ka maʻi pāpaʻi peripheral) a me ka type 2 diabetes mellitus me nā pōpoki organ target.

E hoʻokuʻu i nā palapala

Nā Papa 40 mg a me 80 mg.

Nā Papa Helu 80 mg + 12.5 mg (Telzap Plus).

Nā ʻōkuhi no ka hoʻohana a me ka helu ʻana

Lawe ʻia ka lāʻau lapaʻau, 1 ka manawa i kēlā me kēia lā, me ka ʻai o ka meaʻai, pono e holoi ʻia nā papa me ka wai.

ʻO ka inumapa mua o Telzap ma mua o 40 mg (1 papa) i hoʻokahi lā. I kekahi mau mea maʻi, lawe i ka lāʻau lapaʻau ma ke ʻano o 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 therapeutic, hiki ke hoʻonui ʻia i loko o ka manaʻo i loko o Telzap i ke kiʻekiʻe o 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.

E hoʻemi i ke kumu make a me ka lohi o nā maʻi cardiovascular

ʻO ka dosis ʻona ʻo Telzap e 80 mg hoʻokahi i ka lā. I ka manawa mua o ka mālama ʻana, e mālama ʻia ka nānā ʻana i ke koko, e koi ʻia ka hoʻoponopono ʻana i ka lāʻau antihypertensive.

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. Kuhi ʻia kēia mau mea maʻi ma kahi haʻahaʻa haʻahaʻa haʻahaʻa o 20 mg i kēlā me kēia lā. No ka mea maʻi me ka maluhia o ka renal hāmeʻa maʻalahi, ʻaʻole koi.

ʻO ka hoʻohana mau ʻana o Telzap me ka aliskiren ua contraindicated i ka poʻe maʻi me ka pilikia ole (GFR ma mua o 60 ml / min / 1.73 m2 o ka pālahalaha ʻike o ke kino).

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 haʻahaʻa o ka maʻi hepatic moderate (ʻo nā keiki-Pugh papa A me ka B) e pono e kuhikuhi ʻia me ka mālama akahele, ʻaʻole pono ka lāʻau i ka 40 mg hoʻokahi i ka lā. 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 poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

I loko, hoʻokahi lā i ka lā, holoi ʻia me ka wai ʻole, me ka ʻaʻa o ka meaʻai.

ʻO nā mea maʻi e hiki ʻole ke pulehu ʻia ʻo BP me ka monotherapy me ka telmisartan a i ʻole hydrochlorothiazide e lawe i ka Telzap Plus. Ma mua o ka hoʻololi ʻana i kahi hui paʻa-paʻa paʻa, ʻomi ʻia nā kaha titration o kēlā me kēia mahele. I kekahi mau kūlana maʻi, hiki ke noʻonoʻo pono i kahi hoʻololi kūwaho mai ke monotherapy i ka mālama ʻana me ka hui pūnaʻina paʻa i ka hopena paʻa.

ʻO ka lāʻau Telzap Plus, hiki ke hoʻohana ʻia i hoʻokahi manawa no ka poʻe maʻi ʻaʻole hiki ke mālama pono i ke kahe koko i ka wā e lawe ai i ka telmisartan i kahi maʻi o 80 mg i kēlā me kēia lā.

Loaʻa ka hopena

nā maʻi ʻeha pūpū, me ka cystitis,
nā maʻi ʻeha hanu luna hou, ʻo ia hoʻi ka pharyngitis a me ka sinusitis,
sepsis, hui pū hoʻokoe
anemia, eosinophilia, thrombocytopenia,
hopena anaphylactic,
haaheo
hyperkalemia
hypoglycemia (i loko o nā maʻi me ka maʻi mellitus),
ʻōpala
manaʻo ʻino
hopohopo
mai nāwaliwali
hiamoe
nā hui ʻike
vertigo
brieociaia
kahe nui ʻana i ke koko,
orthostatic hypotension,
tachycardia
ʻaʻano pōkole
huhū
maʻi ʻino interstitial
ʻeha ka ʻōpū
nā ninia
ʻĀpepsia
he ʻano hūnā
utuka
ka malo maloʻo
ʻeha ma loko o ka ʻōpū
kuʻe ʻana o ka hoʻāʻo
haalulu ʻia nā hana holo / ʻeha pio,
kaʻiliʻili
hipehuxikisis
ʻohiʻala
hoʻopea
eczema
erythema
urticaria
lāʻau lapaʻau hoʻoluhi
nā ʻili kino ʻili
sciatica
wahī ʻaʻe
myalgia
huhuhu,
ʻeha hōʻeha
tendon-like syndrome,
functioning renal akea, me ka hoʻohui pūpū o ka renal hana ole,
ua hoʻonui plasma hana,
hemoglobin hoʻemi,
ua hoʻonui plasma uric acid,
i ka hana o ka pānao naʻau a me ka CPK,
ʻeha ka ʻōpū
ʻaiaiaia
maʻiʻo-lepe maʻi.

Nā Hoʻohui

maʻi hoʻomehana biliary tract
uha o ka pepeha hanohano (keiki-Pugh papa C),
hui me ka aliskiren i nā mea maʻi me ka maʻi mellitus o ka maʻi mellitus a i ʻole ka hopena o ka renal impairment (GFR ma lalo o 60 ml / min / 1.73 m2 o ka ʻōpū o ke kino o ke kino),
hana like me ACE inhibitors i loko o nā maʻi me ka nephropathy maʻi,
he olakolosia fructose uluʻala (ma muli o ka hiki ʻana o ka sorbitol i ke ʻano o ka lāʻau lapaʻau),
hapai
umauma umauma,
a hiki i 18 makahiki (ʻaʻole i hoʻokumu ʻia ka pono a me ka palekana),
hypersensitivity i ka mea ikaika a i ʻole nā mea kuʻi o ka lāʻau.

ʻŌpū a me ka lactation

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 hoʻohana ʻana o ka lāʻau Telzap i ka wā hāpai.

Inā makemake ʻoe i ka mālama lōʻihi me Telzap, ʻo nā mea maʻi e hoʻolālā ana i kahi wā hāpai e koho i kahi lāʻau lapaʻau antihypertensive hou e ʻike ʻia ka ʻike palekana palekana 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.

Wahi a nā nānā loea, ʻo ka hoʻohana ʻana o ka antagonist reseptor angiotensin 2 i nā mea aloha a me ka 3 trimesters o ka hāpai ʻana he hopena ʻona i ka ʻōpio (hana renal functioning, oligohydramnios, lohi ossification o ka ʻōpala) a me ka pēpē (renal failed, hypotension a hyperkalemia). Ke hoʻohana nei i ka angiotensin 2 antagonist receptor i ka 2 mau trimester o ka hāpai ʻana, e nānā ʻia ana ka ultrasound o nā pūpū a me ke ʻōpala o ka pūpū. ʻO nā keiki i loaʻa i ka mau makuahine nā angiotensin 2 antagonist reseptor i ka wā hapai e pono e nānā pono ʻia e ʻike i ka hypotension arterial.

ʻAʻole loaʻa ka ʻike i ka hoʻohana ʻana o telmisartan i ka wā o ka umauma. Ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau Telzap i ka wā o ka umauma. Pono e hoʻohana ʻia kahi lāʻau antihypertensive hou me ka maikaʻi ʻoi ka maikaʻi palekana maikaʻi, ʻoi loa ia e hānai ana i kahi pēpē a hānau keiki maoli paha.

Hoʻohana i nā keiki

Ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau Telzap ma lalo o ke 18 makahiki (ʻaʻole paʻa i ka pono a me ka palekana).

Hoʻohana i nā mea maʻi maʻi

I nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

Nā ʻōlelo kikoʻī

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. Ke manaʻoʻiʻo nei ua hōʻemi nā mea maʻi i ka maʻi 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.

ʻO ka maʻi me ka bilateral renal aren stenosis a i ʻole ka stenosis arterial o ka hoʻokahi hana hana e hoʻonui ai i ka hōʻeha o ka hypotension arterial nui a me ka hoʻokau ʻole ʻana i ka wā e mālama ʻia me nā lāʻau lapaʻau e hana ana ma RAAS.

Hoʻopiʻi ka hana a pau a me ka hoʻololi ʻana i ka huehue

Ke hoʻohana nei i ke Telzap i nā maʻi me ka hana pūpū o ka ʻole o ka hana, ka nānā ʻana i ka manawa maʻamau o ka waihona o ka pāima a me ka hana i loko o ke koko koko. ʻAʻoheʻike lāʻau lapaʻau me Telzap i nā maʻi nā mea i hoʻohālikelike hou i nā maʻi hoʻololi keiki.

ʻO ka hypotension arterial Symptomatic, ʻoiai ma hope o ka hoʻokele mua o Telzap, hiki i nā mea maʻi me ka hoʻohaʻahaʻa i ka BCC a me / a i ka sodium i loko o ke kaila koko me ka mua o ka mālama mua ʻana me ka diuretics, nā mea paʻa ma ka kōkuhi o ka paʻakai, ka ʻeha ʻana, a me ka hoʻomau. ʻO kēlā mau ʻano (wai a me / wai ʻole o ka paʻakai) pono e hoʻopau ʻia ma mua o ka lawe ʻana iā Telzap.

Kāua pahu pā o RAAS

ʻO ka hoʻohana pinepine ʻana o ka telmisartan me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ke kaulahao (GFR ma mua o 60 ml / min / 1.73 m2 o ka ʻōpū o ka ʻōpū o ke kino).

ʻO ka hoʻohana like ʻana o Telzap a me ACE inhibitors cont conticated i loko o nā mea maʻi me ka nephropathy maʻi.

Ma muli o ke kāohi ʻana o RAAS, i ka hypotension arterial, syncope, hyperkalemia, a me nā hana ʻole a me ka pale ʻole (me ka hopena ʻole o ka renal) i ʻike ʻia i nā mea maʻi e hoʻomaka ana i kēia, ʻoiai inā hoʻohui pū me nā lāʻau lapaʻau e hana nei i kēia ʻōnaehana. No laila, ʻaʻole i ʻōlelo ʻia kahi papa pālua ʻelua o ka RAAS (no ka laʻana, ʻoiai ke lawe nei i ka telmisartan me nā mea ʻē aʻe RAAS).

Ma nā hihia i hilinaʻi ʻia ai ke ʻano vascular a me ka hana ʻana i ka hana nui ma luna o ka hana RAAS (no ka laʻana, i nā mea maʻi me ka maʻi ʻole o ka naʻau a i ʻole ka maʻi puʻuwai, ʻo ia hoʻi me ka stenosis renal a i ʻole stenosis o hoʻokahi arteritis kū hoʻokahi), ka hoʻohana ʻana i nā lāʻau lapaʻau e pili ana i kēia ʻōnaehana paha i hui pū ʻia me ka hoʻomohala ʻana o ka maʻi arterial hypotension, hyperazotemia, oliguria, a ma nā hihia e loaʻa ʻole, ka hopena hana ʻole.

I ka poʻe maʻi me ka hyperaldosteronism maʻamau, mālama ʻia me nā lāʻau antihypertensive, ʻo ka hopena i loaʻa ia e ka hoʻopaʻa ʻana iā RAAS, ka mea maʻamau ʻole ka maikaʻi. Ma kēia e nānā ʻole ʻia ai ka hoʻohana ʻia ʻana o ka lāʻau Telzap.

ʻO ka stenosis aortic a me ka mitral, stenosis hypertrophic obstructive

E like me nā vasodilator'ē aʻe, ʻo nā maʻi me ka stenosis aortic a mitral, a me ka cardiomyopathy obertive hypertrophic, pono e akahele loa i ka wā e hoʻohana ai iā Telzap.

ʻO nā mea maʻi me ka maʻi maʻi maʻi i loaʻa a i ʻole a me hypoglycemic agents no ka hoʻokō waha

E kūʻē i ke kūleʻa o ka mālama ʻana me Telzap, hiki i kēlā mau maʻi ke hōʻeha i ka hypoglycemia. Pono ka mana o ka glycemia e like me aia paha he pono no ka hoʻoponopono hoʻoponopono ʻana i ka insulin a i ʻole a hypoglycemic agent.

Hiki i ka hoʻohana ʻana i nā lāʻau lapaʻau e hana ana ma RAAS hiki i ka hyperkalemia. I nā poʻe maʻi ʻelemakule, nā mea maʻi me ka maikaʻi ʻole a me ka diabetes mellitus, nā mea maʻi e lawe nei i nā lāʻau lapaʻau e hoʻonui ana i ka kiʻekiʻe o ka potassium potassium, a / a i ʻole nā mea maʻi me nā maʻi concomitant, hiki i ka maʻi hyperkalemia.

I ka hoʻoholo ʻana i ka hoʻohana pono ʻana i nā lāʻau lapaʻau e hana ana ma ka RAAS, pono ia e loiloi i ka pae o ke kūleʻa a me ka loaʻa. ʻO nā mea koʻikoʻi e pili i ka hyperkalemia e pono e noʻonoʻo ʻia.

diabetes mellitus, renal gagal, ʻelemakule (nā mea maʻi ma mua o 70 mau makahiki),
hui pū me hoʻokahi a i ʻole he mau lāʻau lapaʻau e hana ana ma ka RAAS, a me / a i ʻole ʻāpono i hoʻohui ʻia nā meaʻai. ʻAno i nā hopena o nā lāʻau lapaʻau e hiki ai i ka maʻi hyperkalemia ke kālele i ka paʻakai ka paʻakai, ka diuretics potassium-sparing, na ACE inhibitor, angiotensin 2 antagonist receptor, nā lāʻau anti-inflammatory non-steroidal (NSAIDs) (me nā poʻe koho COX-2 inhibitor). heparin, immunosuppressants (cyclosporine a i ʻole tacrolimus) a me ka trimethoprim,
nā maʻi kūwaho, ka nui o ka make me ka mālama ʻole o ka puʻuwai, ka hōʻemi o ka metabolic acidosis, ka hopena o ka renal functioning, cytolysis syndrome (e.g., ischemia paleka paleka, rhabdomyolysis, nui trauma).

Hoʻomaopopo ʻia nā mea maʻi i ka pilikia e nānā pono i ka manaʻo o ka potassium ma loko o ke kaila koko.

ʻO ka telzap ka sorbitol (E420). ʻO ka mea maʻi me ka lōlō o ka frolose nehu lehulehu ʻaʻole lawe i ka lāʻau.

E like me ka mea nāna i hoʻopaʻa aku i ka ACE, telmisartan a me nā maniotensin 2 receptor antagonist e emi iho nei i ke kahe o ke koko e emi ana ka hopena i nā mea maʻi o ka lāhui Negroid ma mua o nā lāhui ʻē aʻe, aia paha ma muli o ka predisposition nui i ka emi ʻana o ka hana i loko o ka lehulehu kanaka.

E like me nā lāʻau āpau antihypertensive, ʻo ka nui o ka hoʻemi ʻana o ke kaomi koko i loko o nā mea maʻi me ka ischemic cardiomyopathy a i ʻole ka maʻi ʻeha coronary hiki ke alakaʻi i ka hoʻomohala ʻana i ka maʻi myocardial or stroke.

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

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 e pono ai ka hoʻonui ʻana o ka makaʻala, pono mālama ʻia luhi a hiki ʻole ke luhi me ka luhi a me ka hoʻohana ʻana o Telzap.

Hoʻohui nūhou

Kāua pahu pā o RAAS

ʻO ka hoʻohana mau ʻana o Telzap me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ka pale ʻana i ka maʻi (GFR ma mua o 60 ml / min / 1.73 m2 o ka ʻona papa o ke kino) a ʻaʻole i'ōlelo ʻia no nā maʻi ʻē aʻe.

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors ke contraindicated i nā maʻi me nā nephropathy maʻi.

Ua hōʻike ʻia nā haʻawina haukaʻi ʻo ka blockade pālua o RAAS ma muli o ka hoʻohana hoʻohui ʻana o ka ACE inhibitors, angiotensin 2 receptor antagonists, a aliskiren pili pū me ka nui o ka hanana o ka hanana ʻino e like me ka arotial hypotension, hyperkalemia, a me ka hana ʻole i ka hana (me ka hana ʻole ʻoi ʻole) i hoʻohālikelike ʻia me ka hana hoʻokahi ka lāʻau lapaʻau e hana ana ma RAAS.

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). Inā pono, e kū'ē i ka ʻikepili o ka hypokalemia i hoʻopaʻa ʻia, pono e lawe ʻia ka hoʻohana ʻana i nā lāʻau lapaʻau me ka mālama aka a kiaʻi pinepine ʻia i nā manaʻo o ka pāhana i ke kaila koko.

Me ka hoʻohana pū ʻana o ka telmisartan me digoxin, kahi hoʻonui hoʻonui Cmax o ka digoxin i plasma a 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.

Pāʻai paʻakai-sparing a i ʻole kai piha i loko o nā lako momona

ʻO Angagonensin 2 receptor antagonist, e like me ka telmisartan, e hōʻemi ana i ka potoma potoma diuretic. Potae-sparing diuretics (e.g., spironolactone, eplerenone, triamteren, a i amiloride), pākuhi ʻai me nā paʻakai, a i ʻole he paʻakai paʻakai e alakaʻi i ka hoʻonui nui ʻana i ka paʻakai plasma. Inā hōʻike ʻia ka hoʻohana concomitant, no ka mea i kākau ʻia ka hypokalemia, pono e hoʻohana ʻia me ka akahele a me ke kūkaʻi ʻana o ka mālama pinepine ʻana o ka pāima i ka kaila koko.

Me ka hui pū ʻana o ka hoʻomākaukau o ka lithium me ka ACE inhibitors a me ka angiotensin 2 antagonist receptor, me ka telmisartan, he hoʻonui hou ʻana i ka neʻe o ka lithium i loko o ke kō koko a me kona hopena makeʻe. Inā makemake ʻoe e hoʻohana i kēia hui o nā lāʻau lapaʻau, pono ia e mālama pono i ka nānā ʻana o ka lithium ma ka plasma koko.

ʻO NSAIDs (i.e., acetylsalicylic acid i loko o nā inika i hoʻohana ʻia no ka hoʻōla kino anti-inflammatory, COX-2 inhibitors a non-selective NSAIDs) hiki ke hoʻonāwaliwali i ka hopena antihypertensive o ka angiotensin 2 antagonist reseptor. hana hanohano lima ʻole) hoʻohana hoʻohana i ka angiotensin 2 antagonist receptor a me nā lāʻau lapaʻau e kālai ana i ka COX-2 hiki ke hoʻomohala hou aʻe i ka hana ʻoi, me ka hoʻomohala ʻia tatochnosti, i mea IeAUPIIe, IAa IO reversible. No laila, ʻo ka hui pū ʻana i nā lāʻau lapaʻau e pono e mālama ʻia me ka makaʻala, ʻoi loa i nā poʻe maʻi maʻi. Pono e mālama ʻia ka hoʻohana ʻana i ka wai ʻauʻau, ʻo ia hoʻi, i ka hoʻomaka ʻana o ka hoʻohui pū ʻana a me ia manawa i ka wā e hiki mai ana, e nānā pono nā māka o ka hana.

Hoʻopuni (thiazide a loop)

Ma mua o ka hoʻōla ʻana me ka diuretosis kiʻekiʻe, e like me ka furosemide (kahi "diuretic" diuretic) a me ka hydrochlorothiazide (kahi diuretic thiazide), hiki ke alakaʻi i ka hypovolemia a me ka hopena o ka hypotension ma ka hoʻomaka ʻana o ka hoʻomaʻamaʻa telmisartan.

ʻO nā lāʻau lapaʻau antihypertensive

Hiki ke hoʻonui ʻia ka hopena o Telzap e ka hoʻohui hoʻohui ʻana o nā lāʻau lapaʻau antihypertensive ʻē aʻe.

Wahi a nā mea kanu lāʻau o ka baclofen a me amifostine, hiki ke manaʻo ʻia e hoʻonui lākou i ka hopena therapeutic o nā lāʻau antihypertensive āpau, me ka telmisartan. Eia kekahi, hiki ke hoʻonui ʻia i ka hypotension orthostatic ma ka hoʻohana ʻana o ka ethanol (wai inu), barbiturates, nā lāʻau a i ʻole ka antidepressants.

ʻO nā corticosteroids (no ka hoʻohana ʻana i nā ʻōnaehana pono)

Ua hoʻonāwī iho ʻo Corticosteroids i ka hopena o ke telmisartan.

Nā kuʻina o ka lāʻau Telzap

Hoʻololi nā kumu hoʻohālike o ka waiwai ikaika:

Mikardis,
Mikardis Plus
Koiā ʻia
Tanidol
Eni,
Hoʻolālā,
Telmisartan
Telmista
Telpres
Hoʻouka Telpres,
Nā Telsartan
Kahalehua N.

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

ʻApeleka,
Apolo
Artinova,
Atacand
Blocktran
Brozaar
Vasotens,
Valz
Valz N,
Valsartan
Kāleka
Vamloset
Gizaar
Hyposart,
Diovan
Paopopa,
Zisakar
Ibertan
Irbesartan
Irsar
Kukuiono
Candesartan
Kāleka
Nā kāleka,
Kāleka
Cardosten
Karzartan
Hoʻoikaika Co-Exforge,
Coaprovel
Keola
Xawai
Lozap,
Lozap Plus,
Lozarel
Losartan
Losartan n
Lorista
Kālehu
Mikardis,
Naviten
Nortian
Olimestra
Hoʻōla
Koiā ʻia
Presartan,
Renicard
Sartavel
Tanidol
Tareg
Kauakae
Teveten
Telmisartan
Telpres
Nā Telsartan
Hoʻolaha
Edarby
Pāʻauhau
Kipakuo,
Eprosartan Mesylate.

Nosological ʻano papa (ICD-10)

Nā papa hana ʻulaʻī	1 kōpō.
mea ikaika:
telmisartan	40/80 mg
nā mea hoʻowalewale: meglumine - 12/24 mg, sorbitol - 162.2 / 324.4 mg, sodium hydroxide - 3.4 / 6.8 mg, povidone 25 - 20/40 mg, magnesium stearate - 2.4 / 4.8 mg

Lapaʻau lāʻau

ʻO Telmisartan kahi kikoʻī ARA II (AT subtype₁), kūpono inā lawe ʻia ma ke ʻano. He inoa nui loa ka Telmisartan no ka AT₁-receptors ma o ke aha ka hopena o ka hana angiotensin II. Ua haʻalele i ka angiotensin II mai ka pilina me ka mea nāna i hopu, ʻaʻole i loaʻa ka hana a kahi agonist e pili ana i kēia receptor. Hoʻopaʻa wale ʻia ʻo Telmisartan i ka AT subtype₁nā ʻĀina o ka angiotensin II. Hoʻomau ke kamaʻilio ʻana. ʻAʻole ʻae ʻia ka Telmisartan no nā mea ʻē aʻe i hiki mai, incl. AT₂nā mea nānā aku a me nā mea hou aku i hoʻopaʻa ʻia i ka ʻāaoe hou. 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 hōʻemi nei ʻo Telmisartan i ka hoʻoneʻeʻana o ka ald testosterone i ka plasma koko, ʻaʻole e hōʻemi i ka hana o renin, ʻaʻole paʻa i nā kahawai ion. ʻAʻole keʻae ʻo Telmisartan i ka ACE (kininase II), kahi e hoʻomaʻamaʻa nei i ka luku ʻana o ka bradykinin. Hōʻalo kēia i nā hopena ʻaoʻao pili i ka hana o ka bradykinin (no ka laʻana, ka ʻōpala maloʻo).

Koi nui ʻia. 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. Noho ka hopena o ka lāʻau no 24 mau hola a noho mau i ka maʻi nui a hiki i nā hola 48. Hoʻomaka pinepine kahi hopena antihypertensive e hoʻomaka i ka 4-8 mau pule ma hope o ka hoʻohana maʻamau.

I nā poʻe maʻi me ka hypertension arterial, hōʻemi ka telmisartan i ke koko a me nā makuakāne me ka ʻole e hoʻopi i ka holo naʻau.

I ka hihia o ka pau ʻana o ka telmisartan, ke kahe ana ke koko i kekahi mau lā i ka hoki i hoʻi i kona pae mua me ka ʻole o ka hoʻomohala ʻana i kahi maʻi withdrawal.

Kākoʻo o ka maʻi cardiovascular. ʻO nā mea maʻi he 55 a ʻoi aku ka makahiki me ka maʻi ʻōpū o ka coronary, stroke, ka hōʻeha ischemic attack, peripheral arterial damage, a i nā hoʻopiʻi o nā ʻano maʻi diabetes mellitus (e.g. retinopathy, waiho i ka hypertrophy ventricular, macro- a i ʻole microalbuminuria) me ka mōʻaukala o nā hanana cardiovascular, telmisartan i like ka like me ka ramipril i ka hoʻemi ʻana i ka hopena i hui pū ʻia: make mortvascular, non-fatal myocardial infarction, non-fatal stroke and manao o ka pili me CHF.

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.

ʻO nā poʻe maʻi o ke wā ʻōpiopio a me ka wā ʻōpio. ʻAʻole paʻa i ka palekana a me ka hana pono o ka telmisartan i nā keiki a me nā wā'ōpiopio ma lalo o 18 makahiki o kona mau makahiki.

Lapaʻau lāʻau

Kapehu. I ka wā e lawelawe ʻia, ka wikiwiki o ka telmisartan mai ka digestive tract. ʻO Bioavailability 50%. I ka manawa like i ka manawa like me ka meaʻai, ke kahe ʻana o ka AUC ma waena o 6% (ma kahi iki o 40 mg) a 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 me ka manaʻo ʻole o ka telmisartan i lawe ʻia i ka manawa like o ka meaʻai a ʻaʻole paha. Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. C_max a ʻo AUC i like me 3 a me 2 mau manawa i kahi kiʻekiʻe i nā wahine i hoʻohālikelike ʻia me nā kāne no ka loaʻa ʻole kahi hopena nui o ka efficacy.

ʻAʻohe pilina pili ʻole ma waena o ke ʻano o ka lāʻau a me kona kaila plasma. C_max a, ma kahi liʻiliʻi, hoʻonui nui ʻo AUC i ka disproportionately i ka piʻi ʻana i ka wā e hoʻohana ana i nā dosis ma luna o 40 mg / lā.

Kahele. Hoʻopili loa ʻo Telmisartan i nā protein plasma (> 99.5%), ʻo ka nui me ka albumin a me ka alpha₁-acid glycoprotein.

Wanana V_{ai ʻo ss} aneane 500 lita.

Hāpai. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic.

ʻAʻohe o ka conjugate i ka hana lapaʻau.

Leʻaleʻa. T_1/2 ʻoi aku ia ma mua o nā hola o 20. Ua hoʻopiʻi ʻia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 1%. Kūpono ka huina piha piha plasma (ma kahi o 1000 ml / min) i hoʻohālikelike ʻia me ke kahe koko hepatic (ma kahi o 1500 ml / min).

ʻO nā papalapa kanaka kūikawā

Mamua. ʻO nā pharmacokinetics o telmisartan i nā maʻi ma mua o 65 mau makahiki he ʻokoʻa ʻole nā maʻi ʻōpio. ʻAʻole pono ke hoʻoponopono ʻia.

Hola paʻa kino hana. I nā mea maʻi me ka malia functionally renal impable, ʻaʻole koi ʻia ka hoʻoponopono ʻana o ka telmisartan.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka renal a me ka poʻe ma ka hemodialysis e kuhikuhi ʻia i kahi haʻahaʻa haʻahaʻa o 20 mg / lā (e ʻike i nā "Nānā Manaʻo kūikawā"). ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis.

Hōʻeha ka hana ʻoluʻolu. I nā maʻi me ka pēpē palupalu a me ka hana maʻalahi (kahi A a me B e like me ka helu ʻana o nā keiki-Pugh), ʻaʻole pono ka lāʻau o kēlā me kēia lā e 40 mg.

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).

Nā Kauka Telzap ®

ka hōʻemi ʻana o ka make a me ka maʻi cardiovascular i nā maʻi maʻi makua.

- me nā maʻi cardiovascular o ka puka atherothrombotic kumu (coronary heart heart, stroke a me ka moʻolelo o nā peripheral arteri),

- me ke ʻano maʻi diabetes mellitus 2 me nā mea ʻoki kino huna.

Nā Hoʻohui

hypersensitivity o ka hana ikaika a i ʻole nā mea kuʻi o ka lāʻau lapaʻau,

hapai a me lactation,

maʻi hoʻomehana biliary tract

uha o ka pepeha hanohano (keiki-Pugh papa C),

hoʻohui me aliskiren i nā mea maʻi me ka maʻi mellitus o ka maʻi mellitus a i ʻole ka hopena ʻole o ka ʻōpū (GFR ma lalo o 60 ml / min / 1.73 m 2) (e nānā i "Interaction" a "Manaʻo Nānā Manaʻo)".

he olakolino fructose uluola (ma muli o ka hiki ʻana o ka sorbitol i ka papa),

ka manawa like me nā ACE inhibitors i loko o nā maʻi me ka nephropathy maʻi maʻi (e ʻike i "Interaction" a "" Manaʻo Hoʻohālikelike "),

ʻoi aku a hiki i 18 makahiki (ʻaʻole maikaʻi ʻia ka maikaʻi a me ka palekana).

Me ka mālama: stenosis bilateral renal arenial o ka stenosis arterial o ka hoʻokahi hana hana, ka hoʻopihapiha hana ʻole, ʻoluʻolu a me ke ʻano hepatic hōʻemi, hoʻoneʻe ʻo BCC i hoʻohālikelike ʻia me ka hana mua o ka diuretics, ka palena o ka inu ʻana i ka sodium klorida, ʻeha a hoʻoweliweli, hyponatremia, hyperkalemia, ʻokoʻa ma hope o ka hoʻololi ʻana i ka maʻi o ka diuretics, ka palena o ka ʻai ʻana i ka sodium klorida, ʻeha a hoʻohuihui, hyponatremia, hyperkalemia, ʻokoʻa ma hope o ka hoʻololi ʻana i ka maʻi. ka haʻalele ʻana), ke kaumaha nui o ka puʻuwai paʻakikī, stenosis aortic and mitral valen stenosis, hypertrophic obstructive cardiomyopathy, hyperaldosta kumu onizm (hopenaʻoi loa a me ka maluhia i ole, ua hoʻokumu 'ia), hana maikaʻiʻole o ka Naʻau nā mea maʻi.

ʻŌpū a me ka lactation

Inā pono ka lōʻihi o ka mālama ʻana me Telzap ®, pono i nā mea maʻi e hoʻolālā ana i ka hapai e 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 ke ʻano lāʻau lapaʻau.

E like me nā hōʻike o ka nānā ʻana o ka lāʻau lapaʻau, ʻo ka hoʻohana ʻana o ARA II i nā mea hoʻomaʻamaʻa II a me III nā mea hoʻomaʻamaʻa o ka hāpai ʻana he hopena ʻona i ka ʻōpio (hana renal functioning, oligxidamnios, lohi ossification o ka ʻōpala) a me ka pēpē (renal failed, hypotension arterial a hyperkalemia). Ke hoʻohana nei i ka ARA II i ka wā ʻelua o ka hapō ʻana o ka hapai ʻana, ʻōlelo ʻia ke ultrasound o nā pūpū a me ke ʻūhā o ka pūpū.

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

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 hoʻoulu ʻana i ka maʻi (see "Contraindications"), he ʻano lapaʻau hou antihypertensive me kahi ʻoluʻolu palekana e hoʻohana pono ʻia, ʻo ia hoʻi no ka hānai ʻana i kahi pēpē a hānau keiki mua paha.

Nā hopena hopena

Wahi a ka WHO, helu like ʻole nā hopena i like me ko lākou pinepine i ka neʻe ʻana i lalo: mau pinepine (≥1 / 10), pinepine (mai ≥1 / 100 a hiki i ka mea hōʻeha.

Ma ka ʻāpana o ke koko a me ka ʻōnaehana lymphatic: pinepine - anemia, luhi - eosinophilia, thrombocytopenia.

Mai ka pānaʻi: lohi - reaksi anaphylactic, hypersensitivity.

Mai ka ʻaoʻao o ka metabolism a me kaʻaiʻai: pinepine - hyperkalemia, luhi - hypoglycemia (i loko o nā maʻi me ka maʻi mellitus).

Mai ka ʻaoʻao mai o ka psyche: pinepine - insomnia, kaumaha, luhi - hopohopo.

Mai ka ʻōnaehana hoʻonāukiuki: pinepine - nāwaliwali, luhi - hiamoe.

Mai ka ʻaoʻao o ke kino o ka hihio: nā hui ʻike.

Ma ka ʻāpana o ka hui hoʻolohe a me nā pilikia labyrinth: ʻohi - vertigo.

Mai ka naʻau: pinepine - bradycardia, līkeke - tachycardia.

Mai nā kī: pinepine - he mau maka o ka hoʻokahe koko, a me hypotension orthostatic.

Mai ka papa hanu, umauma a me nā ʻōpū mediastinal: pinepine - hapa o ka hanu, ka ʻōpala, kahi liʻiliʻi loa - maʻi maʻi interstitial.

Mai ka palaki kuʻekuʻe: pinepine - ʻeha o ka ʻōpū, ka ʻōpū, ka ʻōpū, ka palupalu, aʻiʻaʻi ʻole, loaʻa ʻole - kūwaho maloʻo, ʻeha ʻole i loko o ka ʻōpū, ka hōʻemi ʻana i nā naʻau o ʻono.

Ma ka ʻāpana o ka ate a me ka pēpē biliary: hoʻokaʻawale - hōʻino nā mākaʻawaʻawa / kāpili.

Ma ka ʻāpana o ka ʻili a me ka kiko. infrequent - ʻeha ka ʻāʻī, hyperhidrosis, ʻāʻī, ʻaʻohe - angioedema (pū kekahi), ʻola, erythema, urticaria, lāʻau lapaʻau, hōʻeha ʻeha o ke kino.

Mai ka ʻōnaehana musculoskeletal a me nā ʻili pili: pinepine - ʻehaʻeha (sciatica), nā ʻeha o ka naʻau, myalgia, loaʻa ʻole - arthralgia, ʻeha hōʻeha, nā ʻeha tendon (like me tendon-like syndrome).

Mai nā pūpū a me ka maʻi urinary: pinepine - hana i ka hana renal hana, me ka nui o ka renal hina ʻole.

ʻO nā maʻi maʻamau a me nā pilikia i ka pūnaewele hōʻola: pinepine - ʻehaʻeha umauma, asthenia (nāwaliwali), nāwaliwali - maʻi like-flu.

Hoʻokomo ka hopena i nā hopena o ka hoʻokolohua a me nā haʻawina kōkua: i ka pinepine - he hoʻonui i ka neʻe o ka creatinine i loko o ke koko koko, ʻokoʻa - ka hoʻemi ʻana o nā ʻike o Hb, ka nui o ka ʻike o ka waikū uric i loko o ke kaila koko, he hoʻonui i ka hana o nā huina o ka huina a me ka CPK.

Hoʻohui

Kāua pahu pā o RAAS. ʻO ka hoʻohana nui ʻana o ka telmisartan me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ka hopena ʻole (GFR ma mua o 60 ml / min / 1.73 m 2) a ʻaʻole i'ōlelo ʻia no nā maʻi ʻē aʻe.

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors ke contraindicated i loko o ka poʻe maʻi me ka nephropathy maʻi (ʻike "Contraindications").

Ua hōʻike ʻia nā haʻawina haukaʻi i ka pālua o RAAS ma muli o ka hoʻohana ʻana o ka inhibitions ACE, ARA II, a i ʻole aliskiren i pili me ka nui o nā hanana ʻino e like me ka hypotension arterial, hyperkalemia, a me nā hana ʻole i ke kīlohelohe (e komo pū ana me ka hana ʻole ʻoi) a hoʻohālikelike ʻia. e hana ana ma RAAS.

Ma ka hopena o ka ulu ʻana i ka hyperkalemia e hoʻonui paha i ka wā i hoʻohana pū ʻia me nā lāʻau ʻē aʻe e hiki ai ke kumu i ka hyperkalemia (kālai ʻia i ka ʻai me ka paʻakai a me nā paʻakai pākuhi e pili ana i ka potassium, potassium-sparing diuretics (e.g. spironolactone, eplerenone, triamterene a amiloride), NSAIDs, me nā selective COX-2 inhibitors, hepari , nā immunosuppressants (cyclosporine a i tacrolimus) a me ka trimethoprim.Ike pono, e kūʻē ana i ke ʻano o ka hypokalemia i hoʻopaʻa ʻia, pono e lawe ʻia aku ka hoʻohana pono ʻana i nā lāʻau lapaʻau. e makaʻala a kiaʻi mau i ka ʻike o ka potassium ma loko o ke kaila koko.

Digoxin. Me ka hoʻokele ʻana o ka telmisartan me digoxin, ua hoʻonui ʻia kahi hoʻonui iki ma C_max Hōʻike ka plasma digoxin i 49% a me C_min e 20%. 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.

Pāʻai paʻakai-sparing a i ʻole kai piha i loko o nā lako momona. ʻO ARA II, e like me ka telmisartan, hoʻemi i ka nalowale o ka pāhana potassium e hoʻoulu ʻia e kahi diuretic. Pane ka paʻakai pākēneka, e like me spironolactone, eplerenone, triamteren a amiloride, pākuhi ʻai me ka paʻakai, a i ʻole he paʻakai paʻakai e alakaʻi i ka hoʻonui nui ʻana i ka paʻakai plasma. Inā hōʻike ʻia ka hoʻohana concomitant, no ka mea i kākau ʻia ka hypokalemia, pono e hoʻohana ʻia me ka akahele a me ke kūkaʻi ʻana o ka mālama pinepine ʻana o ka pāima i ka kaila koko.

Hoʻomākaukau lithium. I ka wā i lawe maikaʻi ʻia ai ka hoʻomākaukau ʻana lithium me ka ACE me ARA II inhibitors, me ka telmisartan, he hoʻonui hou i ka hoʻoliʻi ʻana o ka plasma lithium a kū mai kona hopena makeʻe. Inā makemake ʻoe e hoʻohana i kēia hui o nā lāʻau lapaʻau, pono ia e mālama pono i ka nānā ʻana o ka lithium ma ka plasma koko.

Nā NSAID. ʻO nā NSAIDs (i.e., acetylsalicylic acid i loko o nā inikua i hoʻohanaʻia no ka hoʻōla anti-inflammatory, a me nā māhā COX-2 a me nā NSAID ʻaʻole i koho) hiki ke hoʻonāwaliwali i ka hopena antihypertensive o ka ARA II. I kekahi mau mea maʻi me ka hana renal impaired (e.g., dehydration, nā mea maʻi me nā maʻi renal impaired), ʻo ka hui pū ʻana o ka ARA II a me nā lāʻau e hoʻokaʻawale ana i ka COX-2 hiki ke hoʻomau i ka hana hou ʻana i ka hana renal, me ka hoʻomohala ʻana o ka maikaʻi ʻole o ka renal, ʻo ia hoʻi, ma ke ʻano he kānāwai. he pili hou. No laila, ʻo ka hui pū ʻana i nā lāʻau lapaʻau e pono e mālama ʻia me ka makaʻala, ʻoi loa i nā poʻe maʻi maʻi. Pono e mālama i ka hoʻohana ʻana i ka wai kūpono, ʻo ia hoʻi, i ka hoʻomaka ʻana o ka hoʻohana pū ʻana a i kēlā me kēia manawa i ka wā e hiki mai ana, e nānā pono nā māka o ka hana.

Diuretics (thiazide a loop). ʻO ka mālama ʻana ma mua o nā diuretics kiʻekiʻe, e like me ka furosemide (loop diuretic) a me hydrochlorothiazide (thiazide diuretic), hiki ke alakaʻi i ka hypovolemia a me nā hopena o ka hypotension i ka hoʻomaka ʻana o ka mālama ʻana me ka telmisartan.

ʻO nā lāʻau lapaʻau antihypertensive. Hiki ke hoʻonui ʻia ka hopena o ka telmisartan me ka hoʻohana pū ʻana me nā lāʻau ʻala antihypertensive. Wahi a nā mea kanu lāʻau o ka baclofen a me amifostine, hiki ke manaʻo ʻia e hoʻonui lākou i ka hopena therapeutic o nā lāʻau antihypertensive āpau, me ka telmisartan. Eia kekahi, hoʻonui paha nā orthostatic hypotension me ka waiʻona, barbiturates, nā lāʻau lapaʻau, a i ʻole antidepressants.

Corticosteroids (no ka hoʻohana ʻana i nā ʻōnaehana pono). Ua hoʻonāwī iho ʻo Corticosteroids i ka hopena o ke telmisartan.

ʻLoe a me ke kākele

I loko, i hoʻokahi lā, i holoi ʻia me ka wai ʻole, me kahi manaʻo ʻole o ka meaʻai.

He maʻi haole. ʻO ka papa ʻōlelo aʻo mua loa o Telzap® 1 papa. (40 mg) hoʻokahi i ka lā. Hiki i kekahi mau mea maʻi ke hoʻoikaika ikaika o 20 mg / lā. 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, hiki ke hoʻonui ʻia i loko o ka manaʻo i loko o Telzap® ka nui o 80 mg hoʻokahi i ka lā. ʻO kahi koho hou, hiki ke lawe ʻia ke Telzap ® me ka hoʻohui me ka thaizide diuretics, no ka laʻana, ka hydrochlorothiazide, ka mea i hoʻohana pū ʻia, 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.

Hoʻopau i ka make ma ke ala a me ka piʻi o nā maʻi cardiovascular. ʻO ka ʻōlelo aku ʻānō ʻo Telzap® he 80 mg hoʻokahi i ka lā. I ka manawa mua o ka mālama ʻana, e mālama ʻia ka nānā ʻana i ke koko, e koi ʻia ka hoʻoponopono ʻana i ka lāʻau antihypertensive.

ʻO nā papalapa kanaka kūikawā

Hola paʻa kino hana. 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 maʻi ma kahi haʻahaʻa haʻahaʻa haʻahaʻa o 20 mg / lā (ʻike. "Hoʻopapa kūikawā"). No ka mea maʻi me ka maluhia o ka renal hāmeʻa maʻalahi, ʻaʻole koi. ʻO ka hoʻohana mau ʻana o Telzap ® me ka aliskiren ua contraindicated i ka poʻe maʻi me ka pilikia ole (GFR ma mua o 60 ml / min / 1.73 m 2) (e nānā. "Contraindications").

ʻO ka hoʻohana like ʻana o Telzap ® me nā inhibitor ACE ua contraindicated i loko o nā poʻe maʻi me ka nephropathy maʻi (e nānā "Contraindications").

Hōʻeha ka hana ʻoluʻolu. Ua hoʻohālikelike ʻia ʻo Telzap ® i nā mea maʻi me nā maʻi hepatic koʻikoʻi (Anak-Pugh class C) (see "Contraindications"). I nā maʻi me ka maʻi maʻi hepatic maʻalahi (haʻawina A a me B e like me ke ʻano 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 (ʻike. "Me ka mālama").

Mamua. No nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

Nā keiki a ʻōpio. ʻO ka hoʻohana ʻana o Telzap ® i nā keiki a me nā ʻōpio ma lalo o ka makahiki 18 he contraindicated ma muli o ka nele o ka palekana a me ka waiwai efficacy (e ʻike i "Contraindications").

Ke keu

Nā Hoʻomaka nā hōʻike keu a pau o ka overdose i hōʻike ʻia i ke emi ʻana o ke kahe o ke koko a me ka tachycardia, a me ka bradycardia, ka ʻōpū, kahi i hoʻonui ʻia i loko o ka serum creatinine a me ke kūleʻa o nā hana renal i hōʻike ʻia.

Lāʻau: ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis. ʻO ka poʻe maʻi e nānā pono ʻia a me ka hōʻailona a me ka mālama pono ʻana e pono hoʻi e mālama. Ma muli o ke ala e pili ai i ka mālama ʻana i ka manawa i hala ma hope o ka lawe ʻana i ka lāʻau, a me ka nui o nā hōʻailona. Hoʻokomo ʻia nā hana i hāpai ʻia me ka hoʻoulu ʻana i ka luaʻi a me / a i ʻole ka gastric lavage; ʻO nā electrolytes Plasma a me ka hana hana pono e nānā mau ʻia. Inā hele ʻia kahi hōʻailona i ka hoʻokahe koko, pono e lawe ka mea maʻi i kahi kūlana me nā wāwae i hāpai ʻia, ʻoiai e pono e hoʻopiha hou i ka bcc a me nā electrolytes.

Nā ʻōlelo kikoʻī

Hōʻeha ka hana ʻoluʻolu. ʻO ka hoʻohana ʻana o Telzap ® i contraindicated i ka poʻe maʻi me ka cholestasis, kaʻaina o ka biliary tract a i ʻole ka hopena o ka ʻeha a ke kaumaha (keiki-Pugh C) (e nānā i "Contraindications"), 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 maʻi me ka maʻi palupalu haʻahaʻa a me ke ʻano (kahi A a me B e like me ke ʻano o ke keiki-Pugh), pono ʻo Telzap ® me ka akahele (e nānā Me ka mālama pono).

Hōʻano maʻi renovascular. I ka mālama ʻia ʻana o nā lāʻau lapaʻau e hana ana ma RAAS i nā mea maʻi me ka stenosis aralula ginalula a i ʻole ka nui o ka stenosis o ke keiki hoʻokahi, e hōʻeha ʻia ka hypotension arterial a me nā hana ʻole.

Hoʻopiʻi ka hana a pau a me ka hoʻololi ʻana i nā keiki. Ke hoʻohana nei i Telzap ® i nā mea maʻi me ka hana renal impaired, mālama ʻia ka manawa o nā waihona o ka pāima a me ka creatinine i loko o ke koko koko. ʻAʻoheʻike lāʻau lapaʻau me Telzap ® i nā maʻi i loaʻa i ka wā hou ka hoʻohālikelike keiki.

Hoʻolaha i BCC. ʻO ka hypotension arterial Symptomatic, ʻoiai ma hope o ka hoʻokele mua o Telzap ®, hiki i nā mea maʻi me ka BCC haʻahaʻa a me / a me ka sodium i loko o ke koko koko i ka wā e pili ana i ka mua o ka mālama ʻana me ka diuretics, nā mea paʻa ma ka komo ʻana o ka paʻakai, ka ʻeha a me ka luaʻi.

ʻO kēlā mau ʻano (wai a me / wai ʻole o ka paʻakai ʻoi ʻia) e hoʻopau ʻia ma mua o ka lawe ʻana i ka Telzap ®.

Kāua pahu pā o RAAS. ʻO ka hoʻohana pinepine ʻana o ka telmisartan me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ka hopena ʻole (GFR ma mua o 60 ml / min / 1.73 m 2) (e nānā. "Contraindications").

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors ke contraindicated i loko o ka poʻe maʻi me ka nephropathy maʻi (ʻike "Contraindications").

Ma muli o ke kāohi ʻana o RAAS, i ka hypotension arterial, nāwaliwali, hyperkalemia, a me ka hana ʻole o ka renal function (me ka hopena ʻole o ka hopena o ka renal) i ʻike ʻia i nā mea maʻi e pili ana i kēia, ʻoiai inā i hui pū ʻia me nā lāʻau lapaʻau e hana nei i kēia ʻōnaehana. No laila, ʻaʻole i ʻōlelo ʻia kahi papa pālua ʻelua o ka RAAS (no ka laʻana, ʻoiai ke lawe nei i ka telmisartan me nā mea ʻē aʻe RAAS).

Ma nā hihia i hilinaʻi ʻia ai ke ʻano vascular a me ka hana ʻana i ka hana nui ma luna o ka hana RAAS (no ka laʻana, i ka poʻe maʻi me ka puʻuwai o ka naʻau a i ʻole ka maʻi puʻuwai, ʻo ia hoʻi o ka stenosis renal a i ʻole stenosis o ke kino kani hoʻokahi), ʻo ka hana ʻana i nā lāʻau e pili ana i kēia ʻōnaehana me ka hoʻopili ʻia ʻana o ka maʻi hypotension arterial, hyperazotemia, oliguria a ma nā hihia līkia, hanaʻole i ka hopena o ka renal.

ʻO ka hyperaldosteronism mua. I ka poʻe maʻi me ka hyperaldosteronism maʻamau, mālama ʻia me nā lāʻau antihypertensive, ʻo ka hopena i loaʻa ia e ka hoʻopaʻa ʻana iā RAAS, ka mea maʻamau ʻole like ʻole. Ma kēia e nānā ʻole ʻia ai ka hoʻohana ʻana o ka lāʻau ʻo Tezap ®.

ʻO ka Stenosis o aveic a me ka mitral valves, hypomyrophic obstract cardiomyopathy. E like me nā vasodilator ʻē aʻe, ʻo nā maʻi me ka stenosis aortic a mitral, a me ka cardiomyopathy obertive hypertrophic, pono e akahele loa i ka wā e hoʻohana ai iā Telzap ®.

ʻO nā mea maʻi me ka maʻi maʻi maʻi i loaʻa a i ʻole a me hypoglycemic agents no ka hoʻokō waha. E kūʻē i ke kūleʻa o ka mālama ʻana me Telzap ®, hiki i kēia mau maʻi ke loaʻa i ka hypoglycemia. I kēlā mau mea maʻi, pono e hoʻoikaika ʻia ka mana glycemic, like aia paha he pono no ka hoʻoponopono hoʻoponopono ʻana i ka insulin a i ʻole a hypoglycemic agent.

Hyperkalemia Hiki i nā lāʻau lapaʻau e hana ana ma ka RAAS ke kumu i ka hyperkalemia. I nā poʻe maʻi ʻelemakule, hiki i ka mea maʻi me ka hoʻopiʻi o ka palaka a me ka maʻi mellitus paha, nā mea maʻi e lawe ana i nā lāʻau lapaʻau e hoʻonui pū ana i ka potassium potassium, a / a i ʻole nā mea maʻi me nā maʻi concomitant, hiki i ka maʻi hyperkalemia.

I ka hoʻoholo ʻana i ka hoʻohana pono ʻana i nā lāʻau lapaʻau e hana ana ma ka RAAS, pono e loiloi i ka pae e loaʻa ana i ka hopena o ka hopena. ʻO nā mea koʻikoʻi e pili i ka hyperkalemia e pono e noʻonoʻo ʻia.

- ka maʻi diabetes mellitus, ka hopena renal, ka makahiki (nā maʻi i ʻoi aku ma mua o 70 mau makahiki),

- ka hui pū me nā mea hoʻokahi a keu paha nā lāʻau e hana ana ma ka RAAS, a me / a me nā mea hoʻohui kai me kā potassium. ʻO nā hopena a me nā papa lāʻau o nā lāʻau lapaʻau e hiki ai ke hana i ka hyperkalemia he mau paʻakai paʻakai e loaʻa ana i ka paʻakai, potassium-sparing diuretics, ACE inhibitors, ARA II, NSAIDs, including nā mākeke COX-2, heparin, immunosuppressants (cyclosporin a tacrolimus) a me ka trimethoprim,

- nā kūlana / waena o nā maʻi, i ka lula, ka palaualelo o ka naʻau, ka acidababae acidab, heʻō i hana pono, hana cytolysis syndrome (no ka laʻana, ischemia umauma mākala, rhabdomyolysis, nui trauma).

Manaʻo ʻia nā mea maʻi i ka pilikia e nānā pono i ka manaʻo o ka potassium ma loko o ke koko koko (e ʻike i ka "Interaction").

ʻO Sorbitol. ʻO kēia lāʻau lāʻau ka maʻi sorbitol (E420). ʻO nā mea maʻi me ka intolerance fructose i loaʻa ʻole i ka ʻai ʻana, ʻaʻole pono e lawe i ka Telzap ®.

ʻOkoʻa nā ʻano ʻē. E like me ka mea nāna i hoʻopaʻa aku i ka ACE, telmisartan a me nā mea ARA II e hoʻohaʻahaʻa iho i ke kahe koko ke emi iki i ka poʻe maʻi o nā lāhui Negroid ma mua o nā ʻelele o nā lāhui ʻē aʻe, aia paha ma kahi o ka predisposition nui i ka hōʻemi o ka hana ʻo renin ma ka lehulehu o kēia mau maʻi.

Misc. E like me nā lāʻau āpau antihypertensive, ʻo ka hoʻohaʻemi nui o ke kahe koko i loko o nā mea maʻi me ka ischemic cardiomyopathy a i ʻole CHD hiki ke alakaʻi i ka hoʻomohala ʻana i ka myocardial infarction a i ʻole ka hahau ʻana.

Hoʻokomo i ka hiki ke lawe i nā kaʻa, nā mīkini. 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 e pono ai ka hoʻonui ʻana o ka makaʻala, pono mālama ʻia luhi a hiki ʻole luhi i ka luhi a ka wā e lawe ai i ke Telzap ®.

Mea hana

Zentiva Saalyk Yurunleri Sanayi ve Tijaret A.Sh., Turkey.

Apana Kucukkaryshtyran, st. Merkez, No. 223 / A, 39780, Buyukkaryshtyran, Luleburgaz, Kırklareli, Turkey.

Ka mea paʻa o kahi palapala hoʻopaʻa inoa. Sanofi Lūkia JSC. 125009, Rusia, Moscow, ul. Tverskaya, 22.

ʻO nā hoʻopiʻi e pili ana i ka maikaʻi o ka lāʻau lapaʻau e pono e hoʻouna ʻia i ka helu o Sanofi Russia JSC: 125009, Russia, Moscow, ul. Tverskaya, 22.

Tel .: (495) 721-14-00, fax: (495) 721-14-11.

E hoʻokuʻu i ke ʻano a me ka ʻano

Loaʻa ke Telzap i ke ʻano o nā papa i hoʻopili ʻia me ka uhi ʻana o ka film me 40 mg a me 80 mg. Kuhi ʻia nā ʻāpana he 10 i nā blisters, i loko o kahi pūlama pepa aia he 3, 6 a 9 mau blisters a me nā ʻōkuhi no ka hoʻohana ʻana iā Telzap.

1 papa i nā mea waiwai: telmisartan - 40 mg a i ʻole 80 mg a me nā ʻāpana kōkua: povidone 25, meglumine, sodium hydroxide, sorbitol, magnesium stearate.

Hoʻopau hou i nā papa Telzap Plus 80 mg + 12.5 mg, nona ka 80 mg o ka telmisartan a me 12,5 mg o ka hydrochlorothiazide - kahi diuretic.

Ka hana lāʻau lapaʻau

ʻO ka telmisartan hāmeʻa ikaika ka waiwai o nā antagonis reseptor angiotensin II. Ke nānā ʻia, hiki i ka lāʻau lapaʻau ke hōʻole i ka angiotensin II mai kāna pilina me ka mea nāna i hopu. Eia kekahi, e pili ana i kēia mea i kēia mea manaʻo, ʻaʻole ia he agonist. Hoʻopili wale ʻia ʻo Telmisartan me nā ʻoniʻoni me ka angiotensin II ATl. ʻAʻole ia e hōʻike i ka waiwai i nā mea like me ko ka ʻĀpana AT2 a me kekahi.

Ma lalo o ka hopena o ka lāʻau i ka plasma koko, e emi ana ke ʻano o ka ald testosterone. I ka manawa like, noho ka hana renin i ka pae like a ʻaʻole i ʻae ʻia nā neʻe ion.

ʻO Angiotensin-hoʻohuli i ka enzyme e hoʻopili ai i ka luku ʻana i ka bradykinin ʻaʻole i kālai ʻia. Hāʻawi kēia hiʻohiʻona iā ʻoe e kāpae i ka hopena o ka hoʻomohala ʻana i nā hopena ʻaoʻao e like me ka pau ʻana maloʻo.

Ke hoʻohana nei i kahi maʻa o 80 mg i nā maʻi, ua pāpā ʻia nā hopena hypertensive o ka angiotensin II. Loaʻa ka hopena i nā hola 3 ma hope o ka hopena mua. Hana ka hana i 24 mau hola. Hoʻāʻo ʻia ia e paʻa pono ma nā hola 48. ʻO ka hoʻohana pinepine ʻana i nā papa no 4-8 mau wiki e alakaʻi i ka hopena antihypertensive.

ʻO ka hoʻohanaʻana o Telzap i nā maʻi me ka hypertension arterial hiki ke hoʻemi i ka hoʻokahe koko diastolic a me ka systolic. I ka manawa, ʻaʻole loli ka puʻuwai puʻuwai.

Hoʻohana ʻia ka lāʻau lapaʻau e mālama i nā maʻi cardiovascular. I nā poʻe maʻi maʻi me nā pathologies o ka ʻōnaehana cardiovascular, ua loaʻa i nā papa nā hopena o ka hōʻemi ʻana i ka nui o:

pohō
myocardial infarction
make kino ma muli o ka maʻi cardiovascular.

Nā hōʻailona no ka hoʻohana ʻana

He aha ka mea e kōkua ai iā Telzap? Nā hōʻailona nui no ka hoʻohana ʻana i nā papa:

ʻO IHD i nā maʻi ma mua o 55 mau makahiki keu.
ʻO ka paleʻana i nā maʻi o ka ʻōnaehana ponoʻī.
ʻO ka pale ʻana i ka make ma muli o nā hōʻeha cardiovascular ma nā maʻi e hōʻeha (no ka pale ʻana i ka hōʻeha ʻana o ka puʻuwai, hōʻeha, ka hōʻemi o ka naʻau me ka hopena hōʻeha).
ʻO ka pale ʻana i nā hoʻopiʻi mai ka naʻau a me nā kīʻaha koko i ke ʻano maʻi type 2.
He koko koko nui - ma luna o 140/90 no kekahi mea nui a me kekahi mau ʻano o ka hypertension hōʻailona.
Ma kahi ʻāpana o nā lāʻau paʻakikī ma hope o kahi hōʻeha a i ʻole ka ischemic attack.

He maʻi haole

ʻO ka hoʻohana mau ʻana o Telzap me ka aliskiren ua contraindicated i ka poʻe maʻi me ka pilikia ole (GFR ma mua o 60 ml / min / 1.73 m2 o ka pālahalaha ʻike o ke kino).

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

I nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

Hoʻolālā Plus

Lawe ʻia ma mua, i ka lā hoʻokahi, e holoi ʻia me ka wai ʻole, me ka ʻaʻa ʻole.

ʻO nā mea maʻi e hiki ʻole ke pulehu ʻia ʻo BP me ka monotherapy me ka telmisartan a i ʻole hydrochlorothiazide e lawe i ka Telzap Plus.

Ma mua o ka hoʻololi ʻana i kahi hui paʻa-paʻa paʻa, ʻomi ʻia nā kaha titration o kēlā me kēia mahele. I kekahi mau kūlana maʻi, hiki ke noʻonoʻo pono i kahi hoʻololi kūwaho mai ke monotherapy i ka mālama ʻana me ka hui pūnaʻina paʻa i ka hopena paʻa.

E heluhelu pū i kēia ʻatikala: Ma ke ʻano o ke koʻikoʻi e inu ai iā Corinfar: nā ʻōlelo aʻo, kumu a me nā loiloi

Nā hopena hopena

I kekahi mau mea maʻi, lawe i Telzap hiki ke hoʻonāukiuki i ka ʻano o nā hopena o nā ʻaoʻao.

Hoʻopele pinepine ʻia ka dyspnea a me ka ʻopa. Inā loaʻa pinepine ʻia ka maʻi maʻi interstitial.
Hoʻopiʻi kekahi poʻe maʻi i ka insomnia, ke kaumaha, hoʻonui nui i ka hopohopo. I nā hihia pinepine ʻole nā luhi.
I nā wahine, hiki ke hōʻeha nā maʻi maʻi o ka ʻōpiopio, i nā hihia kīnā ʻole, ʻike ʻia kahi hana hānai kāne. I nā kāne, hiki i kahi neʻe erectile.
Aia kahi hōʻike o ka hoʻolālāʻana o ka thrombocytopenia, eosinophilia a me ka hemoglobin haʻahaʻa.
I ka papa inoa o nā hopena like ʻole e kapa ʻia ʻo hyperhidrosis, ʻehaʻeha, ʻeha. ʻO ka eczema, angioedema, erythema, toxic a me nā lāʻau lapaʻau ʻokoʻa ke nānā pinepine ʻia.
I waena o nā hopena hopena i kapa ʻia ʻo ka fāaline renal function. I waena o kēia mau papa ʻaia he hāʻule ʻole.
Mai ka pūnaʻi ʻana o ka ʻōpū, ka ʻeha, ka ʻeha o ka ʻōpū, ka luaʻi ʻana, ka lemela a me nā dyspepsia i pinepine pinepine ʻia ma mua o ka poʻe. ʻO ka maʻi ʻeha, hoʻonāukiuki i ka wahi o ka epigastric, mucosa maloʻo i ka waha waha.

ʻAʻole palupalu ka ʻōnaehana cardiovascular i nā hanana pōʻino me ka ʻoihana Telzap. I ka manawa, hiki i nā mea maʻi:

hoʻohaʻahaʻa i ke koko i ka hoʻololi ʻana i ke kūlana o ke kino,
nāwaliwali maʻemaʻe
hōʻemi a hoʻonui paha i ka piʻi ʻana o ka naʻau.

ʻO nā maʻi āpau o ka puʻuwai a me nā puʻuwai ke loaʻa pinepine loa.

Hiki i ka lāʻau lapaʻau ke kumu i ka emi ʻana o ke kō koko a me ka hoʻoneʻe metabolic.

No nā maʻi kūlohelohe, hiki i nā mea penei:

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 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.

ʻO nā keiki, i ka wā hāpai a me ka lactation

ʻAʻole ʻike ka ʻike pili pono i ka palekana o kēia lāʻau lapaʻau i ka wā hāpai. Inā hoʻolālā kēia ka mea maʻi i ka hapai, a pono ʻo ia e lawe i ka lāʻau lapaʻau e hoʻohaʻahaʻa i ke kaumaha, pono ʻia e lawe i nā ʻano maʻi ʻē aʻe.

ʻO ka hoʻohana ʻana i nā lāʻau lapaʻau mai ka pūʻulu o nā mea paʻa, nā angiotensin antagonist i ka mea aloha a me ka 3 trimesters e kōkua i ka hoʻomohala ʻana i nā pōʻino o ka ʻōpū, ka ate, ka lūlū ʻana i ka ʻoki i ka ʻōpala, oligohydramnion (kahi hoʻemi i ka nui o nā wai amniotic).

ʻO ka hoʻohanaʻana i ka lāʻau lapaʻau i ka wā o ka hoʻouluʻana, ua contraindicated loa.

Hoʻohui nūhou

Hoʻohana pinepine ʻia ʻo Telzap ma ke ʻano o ka hoʻomaʻamaʻa paʻakikī, no laila pono ʻoe e noʻonoʻo e pili ana i ka like ʻana o nā papa me nā lāʻau ʻē aʻe.

ʻAʻole ʻae ʻia nā mea maʻi me ka maʻi diabetes type 2 e lawe i ka telmisartan me nā mea ʻē aʻe ACE kekahi i ka manawa like. I ka hapanui, he kumu kēia no hypoglycemia.

ʻAʻohe nā lāʻau lapaʻau i hoʻohana ʻia no ka hoʻohana ʻana:

ole-anti-lauleia anti-inflammatory,
Diuretics pākoleka-sparing
nā huahana e loaʻa ai nā hydrochlorothiazide,
immunosuppressants
Hoʻohui kalima
heparin.

Hiki ke koi ʻia ka mālama ʻana i nā lāʻau lapaʻau a me ka hoʻoponopono ʻia o ka dosage me ka hoʻohana pū ʻana o ka telmisartan a me nā lāʻau lapaʻau e hiki mai ana: