Noliprel A papa 2, 5, 0, 625 mg 30 pcs > He hoʻomaʻemaʻe a me ke pale aku

E ʻoluʻolu, ma mua o kou kūʻai ʻana iā Noliprel A, nā papa 2.5 + 0.625 mg 30 pcs., E nānā i ka ʻikepili e pili ana i ia mea me ka ʻikepili ma ka pūnaewele mana o ka mea hana a e kuhikuhi paha i ka manaʻo kikoʻī o kahi ʻano kikoʻī me ka luna o kā mākou hui!

ʻO ka ʻike i hōʻike ʻia ma ka pūnaewele ʻaʻole i hāʻawi i ka lehulehu. Mālama ka mea hana i nā kuleana e hana i nā loli i ka hoʻolālā, hoʻolālā ʻana a me ka hoʻopili ʻana i nā huahana. Hiki i nā kiʻi o nā huahana i nā kiʻi i hōʻike ʻia i loko o ke kākuhi ma ka pūnaewele ke ʻokoʻa i nā kumu kumu.

ʻOkoʻa ka ʻike ma ke kumukūʻai o nā huahana i hōʻike ʻia i loko o ka katala ma ka pūnaewele ma mua o ka manawa e waiho i ke kauoha no ka huahana like.

Mea hana

Nā mea waiwai: perindopril arginine, indapamide,

Nā mea hoʻihoʻi: sodium carboxymethyl starch (type A) - 2.7 mg, anhydrous colloidal silicon dioxide - 0.27 mg, monactose lactose - 74.455 mg, magnesium stearate - 0.45 mg, maltodextrin - 9 mg,

He poʻokela kiʻi: macrogol 6000 - 0,087 mg, ka mua o ka lole keokeo keʻokeʻo SEPIFILM 37781 RBC (glycerol - 4,5%, hypromellose - 74.8%, macrogol 6000 - 1.8%, magnesium stearate - 4,5%, titanium Hōʻailona (E171) - 14.4%) - 2.913 mg,

Ka hana lāʻau lapaʻau

ʻO Noliprel ® A kahi hui pūkaukau e hui ana me ka perindopril arginine a me ka indapamide. ʻO nā huahana Pharmacological o ka lāʻau Noliprel ® A hoʻohui i nā pilikino o kēlā me kēia o nā māhele.

1. ka 'mana i ka hana

Hoʻohui ka hui ʻana o perindopril a me indapamide i ka hopena antihypertensive o kēlā me kēia.

ʻO Perindopril kahi mea hoʻohui i ka hoʻoneʻe o ka huina e hoʻohuli i ka angiotensin I ka angiotensin II (kahi ACE inhibitor).

ʻO ACE, a i kininase II, he exopeptidase e lawe nei i ka loli o ka angiotensin I ma kahi o nā vasoconstrictor substitut angiotensin II, a me ka luku ʻana o ka bradykinin, he hopena vasodilating, i ka heptapeptide ka mea i ʻole. Ma ka hopena o ka perindopril:

- hōʻemi ʻoe i ka mea huna o ka aldosterone,

- ma ke kumu o ka manaʻo hoihoi kino e hoʻonui ai i ka hana a renin i ka plasma koko,

- me ka hoʻohana mau ʻana e hōʻemi ana i ka OPSS, ka mea nui ma muli o ka hopena i nā moku ma nā ʻōpū a me nā ʻeha. ʻAʻole kēia mau hopena me ka lohi i ka sodium a me nā koola wai, a me ka hoʻomohala ʻana i ka tachycardia reflex.

Hoʻololiʻo Perindopril i ka myocardium, hoʻohaʻahaʻa i ka preload a ma hope.

Ke aʻo nei i nā ʻāpana hemodynamic i nā maʻi me ka puʻuwai puʻuwai, ua hōʻike ʻia:

- hōʻemi i ka hoʻopiha ʻana i ka paila i ka hema a me ka ʻūlū ʻana o ka naʻau,

- hoʻonui hua cardiac,

- Hoʻonui i ke kahe koko peripheral.

Aia ʻo Indapamide i ka hui o sulfonamides, i loko o nā wahi lāʻau lapaʻau kokoke ia i ka diuretics thiazide. Mālama ʻo Indapamide i ka hoʻihoʻi ʻana o ka paʻakai sodium i ka māhele cortical o ka loiloi Henle, kahi e piʻi ai i ka hoʻonui ʻana o ka sodium, klorine a, ma kahi liʻiliʻi, pālolo a me nā paʻakai magnesium e nā keiki, ma laila e hoʻonui ai i ka diuresis a hoʻohaʻahaʻa i ke koko.

2. hopena hopena Antihypertensive

Loaʻa iā Noliprel ® A ka hopena antihypertensive e pili ana i ka DBP a me SBP ʻelua i ke kū a kū ana hoʻi. Ke hoʻomau nei ka hopena antihypertensive no nā hola 24. ʻO ka hopena therapeutic paʻa e hoʻomohala ma mua o ka 1 mahina ma hope o ka hoʻomaka ʻana o ka lāʻau, ʻaʻole i hui pū ʻia e ka tachycardia. ʻAʻole he kumu hoʻokuʻi o ka hoʻomaʻamaʻa.

Noliprel ® A hōʻemi i ka palena o ka hypertrophy ventricular hema (GTL), hoʻomaikaʻi i ka elastisation arterial, hōʻemi ʻana i ka OPSS, ʻaʻole i hoʻopilikia i ka metabolism lipid (piha kolesterol, HDL cholesterol a me LDL cholesterol, triglycerides).

Ua hoʻohālikelike ʻia ka hopena o ka hoʻohana ʻana o ka hui pūʻana o perindopril a me indapamide ma GTL i ka hoʻohālikelike ʻana me enalapril. I ka poʻe maʻi me ka ha maʻi hypertension a me GTL nāna i loaʻa i ka terapi perindopril me ka erbumin 2 mg (e like me ka 2.5 mg perindopril arginine) / indapamide 0.625 mg a enalapril ma kahi ʻomaʻi o 10 mg hoʻokahi i ka lā, a me ka piʻi ʻana o ka maʻa o ka perindopril erbumin i 8 mg (e like me ka 10 perindopril arginine) a me indapamide a hiki i ka 2.5 mg, a i ʻole enalapril a hiki i ka 40 mg i hoʻokahi lā i ka lā, he nui ka nui o ka hōʻuluʻulu nui o ka mokulele ventricular hema (LVMI) i ka hui perindopril / indapamide i hoʻohālikelike ʻia me ka hui enalapril. Ma kēia hihia, ʻike nui ʻia ka hopena koʻikoʻi ma LVMI me ka hoʻohana ʻana o perindopril erbumin 8 mg / indapamide 2.5 mg.

Ua ʻike ʻia kekahi hopena antihypertensive hou i ke ʻano o ke hoʻohui ʻana i ka hopena me ka perindopril a me ka indapamide i hoʻohālikelike ʻia me enalapril.

I nā maʻi me ka maʻi diabetes mellitus type 2 (ʻoi aku ka makahiki 66 mau makahiki, ka nui o ka waihona kikoʻī o ke kino 28 kg / m 2, he hemoglobin glycosylated (HbA1c) 7.5%, ka pehu koko 145/81 mm Hg), ka hopena o ka paʻa nā hui puʻuwai o perindopril / indapamide no nā hoʻopiʻi micro-a me ka macro-vascular hou aku i ka hoʻohui ʻana i nā maʻi maʻamau no ka hoʻomohala ʻana i ka glycemic control a me nā hana hoʻolālā glycemic control (IHC) (target HbA1c

Ua nānā ʻia ka hypertension arterial ma 83% o nā maʻi, nā maʻi macro- a me nā hoʻopiʻi microvascular i ka 32 a me 10%, a me ka microalbuminuria ma 27%. ʻO ka hapa nui o nā mea maʻi i ka manawa o ke komo ʻana i ke aʻo ʻana ua loaʻa i ka terapi hypoglycemic, 90% o nā mea maʻi i loaʻa i nā māka hypoglycemic no ka ʻaha waha (47% o nā mea maʻi i loaʻa he monotherapy, 46% loaʻa ʻelua-lāʻau lapaʻau, 7% loaʻa ʻekolu-lāʻau lapaʻau). Ua loaʻa ka 1% o nā maʻi i ka maʻi insulin, 9% - ʻoi wale nō ka mālama ʻana i ka ʻai. Ua lawe ʻia nā kumulā o nā sulfonylureas e ka 72% o nā mea maʻi, metformin - 61%. E like me ka terapi paʻa ʻana, ua loaʻa ka 75% o nā mea maʻi i nā lāʻau antihypertensive, 35% o nā mea maʻi i loaʻa i nā lāʻau lapaʻau lipid (ʻoi aku ka nui o ka HMG-CoA reductase inhibitors (statins) - 28%), acetylsalicylic acid ma ke ʻano he antiplatelet agent, a me nā mea hoʻohui antiplatelet (47%).

Ma hope o 6 mau pule o ka manawa hoʻolilo i loaʻa i nā maʻi nā maʻi perindopril / indapamide, ua māhele ʻia lākou i ka pūʻulu mana glycemic maʻamau a i ka hui ʻo IHC (Diabeton ® MV me ka nui o ka hoʻonui ʻana i ka make i ka lōʻihi o 120 mg / lā a i ʻole ka hoʻohui ʻana i kahi mea hypoglycemic āpau).

Ma ka hui ʻo IHC ('īmua' ia paha ka manawa like - 4.8 mau makahiki, 'o HbA1c - 6,5%) i ho'ākāka' ia me ka pa alima paepae ('a ʻo HbA1c - 7.3%), he nui mau ho'ēmi o 10% i ka hopena pili o ka hoʻohui pinepine' ana o nā māka a me nā microvascular pohala.

Loaʻa ia ka maikaʻi ma muli o ka hōʻemi nui ʻana i ka hopena pili: ka hoʻopiʻi nui o nā mikoleka mikimoka ma ka 14%, ka hoʻomaka a me ka holomua o nephropathy e 21%, microalbuminuria e 9%, macroalbuminuria e 30% a me ka hoʻomohala ʻana o nā hoʻopiʻi mai nā kolo e 11%.

ʻAʻole pili nā mea pōmaikaʻi o ka antihypertensive therapy i nā pono i loaʻa me ka IHC.

Hoʻohana ʻo Perindopril i ka mālamaʻana i ka maʻi hypertension o kekahi hōʻeha.

Kuhi ka hopena antihypertensive o ka lāʻau i ka lōʻihi o kona hiki ʻana i nā hola 4-6 ma hope o ka lawelawe waha hoʻokahi a hoʻomau no 24 mau hola 24 mau hola ma hope o ka lawe ʻana i ka lāʻau, ua haʻi ʻia (e pili ana i 80%) mau koina ACE inhibition.

Loaʻa ka Perindopril i ka hopena antihypertensive ma nā mea maʻi me ka hoʻohaʻahaʻa haʻahaʻa a me nā hana renin plasma emi haʻahaʻa.

ʻO ka hui like o ka diuret thiazide e hoʻonui i ka nui o ka hopena antihypertensive. Eia kekahi, ʻo ka hui pū ʻana o kahi ACE inhibitor a me kahi diuretic thiazide e hōʻemi ana i ka hopena o ka hypokalemia me ka diuretics.

Hōʻike ka hopena antihypertensive i ka wā e hoʻohana ai i ka lāʻau lapaʻau i nā inalena liʻiliʻi i liʻiliʻi ka hopena diuretic.

Hoʻohui ʻia ka hopena antihypertensive o ka indapamide me ka hoʻomaikaʻi i nā elastic waiwai o nā māhina nui a me ka hoʻēmi ʻana i OPSS.

Hoʻopau ʻo Indapamide i ka GTL, ʻaʻole i hoʻopilikia i ka ʻike pinepine ʻana o nā lipids i ka plasma koko: triglycerides, total cholesterol, LDL, HDL, ka pāhaʻi kalapuna (me nā mea maʻi me ka maʻi mellitus concomitant).

ʻAʻole e loli nā hui o perindopril a me indapamide i kā lākou ʻano pharmacokinetic i hoʻohālikelike ʻia me ka hoʻokūkū kaʻawale o kēia mau lāʻau.

Ke hoʻokele ʻia ka perindopril e hopu koke. Bioavailability ʻo 65-70%.

Ma kahi o 20% o ka nui o ka perindopril i hoʻololi ʻia i perindoprilat, kahi metabolite kūlohelohe. ʻO ka lawe ʻana i ka lāʻau lapaʻau me ka meaʻai ua ukali ʻia e ka hoʻohemo ʻana o ka hoʻomakaʻana o ka perindopril e perindoprilat (ʻaʻole i loaʻa i kēia waiwai koʻikoʻi kauka i kēia hopena).

C_max ʻO ka Perindoprilat i loko o ke koko koko ua hōʻea i nā hola 3-4 ma hope o ka nānā ʻana.

ʻO ka kamaʻilio ʻana me nā protein plasma koko he liʻiliʻi ka emi ma ka 30% a i ʻole ka hilinaʻi ʻana o ka perindopril i ke koko.

ʻO ka weheʻole o perindoprilat e pili ana me ka ACE, e lohi nei. ʻO ke hopena, ʻo ka maikaʻi o T_1/2he 25 mau hola 25. ʻAʻole ke alakaʻi hou ʻana i perindopril i ke alakaʻi ʻia ʻana o ia, a me T_1/2Me ka hoʻokele pinepine ʻana, pili ka perindoprilat i ka manawa o kāna hana, no laila ua loaʻa ka kīʻaha kaulike ma hope o 4 lā.

Hoʻopili ʻia ʻo Perindoprilat mai ke kino i ka maʻi o nā keiki. T_1/2 ka mika ka mea maʻi he 3-5 mau hola

Hoʻololi ʻia ka hoʻomaʻemaʻe ʻana o perindoprilat i ka wā ʻelemakule, like hoʻi i nā mea maʻi me ka puʻuwai a me nā hemahema.

ʻO ka weheʻana o ka dialysis o perindoprilat ʻo 70 ml / min.

Hiki ke hoʻololi i ka pharmacokinetics o perindopril i nā mea maʻi me ka cirrhosis o ka ate: ua hōʻemi ʻia ka hoʻomaʻemaʻe hepatic i nā manawa 2 mau. Eia nō naʻe, ʻaʻole e emi ka nui o ka perindoprilat, no laila ʻaʻole pono nā loli loli.

Hoʻopau ʻo Perindopril i ka pleka.

E wikiwiki koke a paʻa paha ʻo Indapamide mai ka papa hana ʻana.

C_max ka lāʻau lapaʻau i loko o ke koko koko i ʻike ʻia i ka hola 1 ma hope o ke kau ʻana.

Ke kamaʻilio pū ʻana me nā protein plasma - 79%.

T_1/2 ʻo 14-24 mau hola (awelika 19 mau hola). ʻO ke alakaʻi hou ʻana i ka lāʻau lapaʻau ʻaʻole alakaʻi i kāna cumulation i ke kino. Hoʻokuʻu ʻia ia ma nā ʻōpū (70% o ka nui i hoʻolele ʻia) a ma o nā ʻōpū (22%) i loko o ke ʻano o nā metabolite hana ʻole.

ʻAʻole loli nā pharmacokinetics o ka lāʻau i ka mea maʻi me ka maikaʻi ʻole.

Nā pono hypertension, nā mea maʻi me ka hypertension arterial a me nā type 2 diabetes mellitus e hōʻemi i ka hiki o nā ʻōmole microvascular (mai nā lolo) a me nā hoʻopiʻi macrovascular mai nā maʻi cardiovascular.

ʻŌpū a me ka lactation

Hoʻokomo ʻia ka lāʻau lapaʻau ma ka wā hāpai.

Ke hoʻolālā nei i ka hapai a i ka wā e hāpai ana i ka lawe ʻana iā Noliprel ® A, pono ʻoe e kāpae i ka lawe ʻana i ka lāʻau lapaʻau a kuhikuhi i kahi lāʻau antihypertensive hou.

Mai hoʻohana iā Noliprel ® A i ka mea mua o ka mākeke.

ʻAʻole i mālama ʻia nā haʻawina kūpono o nā inhibitor ACE i nā wahine hāpai. Pau ka ʻikepili i nā hopena o nā inhibitor ACE ma ka palena mua o ka hānau ʻana i ka hōʻike ʻana i ka lawe ʻana i ka ACE inhibitors ʻaʻole i alakaʻi i ka malalations e pili ana i ka fetotoxicity, akā ʻaʻole hiki i ka hopena fetotoxic i ka lāʻau.

Noliprel ® A ua hoʻohālikelike ʻia ma ka trimester ʻo II a me III o ka hāpai ʻana (e ʻike. "Contraindications").

ʻIke ʻo ka lōʻihi o ka ʻike ʻana i nā inhibitor ACE ma ka ʻōpū o ka pēpē lua a me ke kolu o ka hapala o ka hapai hiki ke alakaʻi i ka hoʻopōmaʻa ʻana (hōʻemi i ka hana renalula, oligxidamnios, lohi i ka pīpī o nā iwi o ka ʻōpala) a me ka hoʻomohala ʻana i nā hoʻopiʻi i ka pēpē (hana hou ʻole, renal, hypotension, hyperkalemia).

Hoʻohana lōʻihi ka lōʻihi o ka diuret thiazide i ke kolu o ka hapala o ka hapai hiki ke hoʻōho i ka hypovolemia maternal a me ka hoʻohaʻahaʻa ʻana i ke kahe koko uteroplacental, ka mea e alakaʻi ai i ka ischemia fetoplacental a me ka luhi o ka ulu ʻana o ka maʻi fetal. I nā hihia pinepine, ʻoiai e lawe ana i ka diuretics ma mua o ka hānau ʻana, hoʻomōhala nā pēpē i ka hypoglycemia me ka thrombocytopenia.

Inā loaʻa ka mea maʻi i ka lāʻau lapaʻau Noliprel ® A i ka wā o ka trimester II a i ʻole ʻo III o ke hāpai ʻana, pono ia e hana i kahi ultrasound o ka pēpē hou e nānā ai i ke ʻano o ka ʻōpala a me nā hana maʻamau.

Hiki paha i ka hypotension arterial i loko o nā keiki hou i loaʻa i ka maʻi a me nā maʻi me ACE inhibitors, a no laila he mea ma lalo o ke alakaʻi olakino.

Noliprel ® A ua pāpā ʻia i ka wā lactation.

ʻAʻole i ʻike ʻia a pau paha nā perindopril me ka waiū umauma.

Hoʻokā ʻia ka Indapamide i ka waiū umauma. ʻO ka lawe ʻana i ka diuret thiazide e hoʻoulu ai i ka hōʻemi o ka nui o ka waiū umauma a i ʻole ka pani ʻana o ka lactation. I kēia hihia, hoʻomohala ʻia kahi pēpē hypersensitivity i nā derivatives sulfonamide, hypokalemia a me ka jaundice nuklea.

Mai ka hoʻohana ʻana o perindopril a me indapamide i ka wā lactation hiki ke hōʻeha i nā hoʻopiʻi koʻikoʻi i loko o ke pēpē, pono ia e loiloi i ke ʻano o ka therapy no ka makuahine a hoʻoholo i ka hoʻōki o ka umauma a lawe ʻana i ka lāʻau lapaʻau.

Nā Hoʻohui

hypersensitivity no perindopril a me nā mea ʻē aʻe o ka ACE, indapamide, a me sulfonamides, a me nā mea ʻē aʻe i kūkulu ʻia i ka lāʻau,
ka mōʻaukala o ka angioedema (me nā mea ʻē aʻe ACE).
hoʻoilina hoʻoilina / idiopathic angioedema, hypokalemia, pilikia hōʻeha ʻole (ʻoi aku ʻo Clin a emi mai 30 ml / min),
he stenosis o hoʻokahi ālia kani, bilateral renal aren stenosis,
nā koikoi maʻi nui (me ka encephalopathy),
ka manawa like me ka lāʻau lapaʻau e hoʻolalelale ana i ka manawa QT,
hoʻohana i ka wā like me nā lāʻau antiarrhythmic hiki ke hana i ka arrhythmias ʻano pirouette,
hapai
lactation wā.

Co-hoʻokele o ka lāʻau lapaʻau me ka diuretics potassium-sparing, potassium a me ka hoʻomākaukau lithium, a me ka hoʻokele ʻana i nā maʻi i nā kiʻekiʻe potassium potassium kiʻekiʻe, ʻaʻole i ʻōlelo ʻia.

Ma muli o ka hapa ʻole o ka ʻike loea pono lāʻau pono, ʻaʻole pono e hoʻohana ʻia ʻo Noliprel ® A i nā mea maʻi e hoʻomaʻamaʻa ana i ka hemodialysis, a me nā mea maʻi e loaʻa ʻole nā decompensated decompensated heart failed.

Me ka mālama aku: nā maʻi ʻōnaehana o ka ʻili o nā kiko (me ka systemus lupus erythematosus, scleroderma), ka maʻi immunosuppressive (ka hopena o ka neutropenia, agranulocytosis), kaohi ʻana o ka hematopoiesis pumehana o nā iwi, hoʻemi i ka BCC (diuretics, ka ʻai-paʻakai, ʻaihue, ʻeha, hemodialysis), kaina pectoris, maʻi cerebrovascular, renovascular hypertension, diabetes mellitus, ʻeha naʻau paʻakikī (NYHA hoʻokumu ʻana IV stage), hyperuricemia (pili pū me ka gout a me urate nephrolithiasis), ka hana nui o ke koko, ke ʻōpio, ka hemodialysis e hoʻohana ana i ka membranes kiʻekiʻe a i ʻole he desensitization, ma mua o ka LDL apheresis, ke ʻano ma hope o ka hoʻololi ʻana i ka maʻi o ka maʻi, aortic valve stenosis / hypertrophic cardiomyopathy, ka hapa lactase, galactosemia a me ka glucose-galactose malabsorption syndrome (18 mau makahiki, ka mālamalama, 18 mau makahiki, ʻaʻole hoʻokomo ʻia ka palekana).

Nā hopena hopena

Mai ka pūnaehana hemopoietic a me ka lymphatic: paʻakikī loa - thrombocytopenia, leukopenia / neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia.

Anemia: i kekahi mau kauka maʻi (nā maʻi ma hope o ka hoʻololi ʻana i nā keiki, ʻo nā mea maʻi ma ka hemodialysis) hiki i nā mea mālama ACE ke hoʻoulu i ka anemia (e nānā i "Nā ʻōlelo aʻoaʻo".

Mai ka ʻaoʻao o ka pūnaehana neʻe o ka waena: pinepine - paresthesia, ʻeha, hōʻeha, asthenia, vertigo, maʻamau - nā haunaele hiamoe, hana luhi, ʻano liʻiliʻi - hilahila, piʻi pinepine ʻole - nāwaliwali.

Mai ka ʻaoʻao o ke kino o ka hihiʻo: pinepine - ʻike maka ʻole.

Ma ka ʻāpana o ka hui hoʻolohe: pinepine - tinnitus.

Mai i ka CCC: pinepine - kahi i emi ai ka nui o ke koko, incl. orthostatic hypotension, ʻano liʻiliʻi loa - nā ʻōpū kuʻuna o ka naʻau, incl. bradycardia, tachycardia ventricular, atifal fibrillation, a me ka angina pectoris a me ka myocardial infarction, hiki ma muli o ka emi nui ʻana o ke kahe koko i nā maʻi maʻi kiʻekiʻe (e ʻike i "Nā Kūlana Kūʻokoʻa"), ka maʻamau kīnā ʻole - ka pirouette type arrhythmia (malia paha ka ʻike - ʻike ʻia " Hoʻohui ").

Ma ka ʻaoʻao o ka papa ʻōpū, ka umauma a me nā ʻōpū mediastinal: pinepine - e pili ana i ke kua ʻana o ka hoʻohana ʻana o nā inhibitor ACE, hiki mai kahi ʻōmole maloʻo, e hoʻomau ana no ka manawa lōʻihi e lawe nei i kēia pūʻulu o nā lāʻau lapaʻau a nalowale ma hope o ke kau ʻana o ka hanu, pōkole o ka hanu, ʻano liʻiliʻi - bronchospasm, ʻehā pinepine - ʻo eosinophilic pneumonia, rhinitis . ^ E Ha yM.

Mai ka papa hana ʻana: pinepine - ka maloʻo o ka wahaosa waha, nilo, hoʻopuka, ka ʻōpū o ka ʻōpū, ka ʻōpū o ka epigastric, ka hoʻoluhi luhi, nā kala ʻole, dyspepsia, constipation, ʻeha, ʻeha loa - angioedema o ka ʻōpū, ka laʻi palestatic, pancreatitis, frequency unspecified - hepatic encephalopathy i loko o nā mea maʻi me ka maikaʻi ʻole o ka pūʻai (ʻike. "Contraindications", "" Nānā Manaʻo Kūʻai "), hepatitis.

Ma ka ʻāpana o ka ʻili a me ka momona o ka subcutaneous: pinepine - ka ʻāʻī o ka ʻili, ka ʻāʻī, ke kanikele maculopapular, pinepine - ka angioedema o ka maka, nā lehelehe, ʻūlū, he membrane hina o ka alelo, nā leo kīʻaha a me / a o ka larynx, urticaria (ʻike ʻia "ʻōlelo aʻoi aku") , ka hopena hypersensitivity i nā maʻi e predisposed i ka bronchial obstruktive a me nā hopena alerine, purpura, i nā mea maʻi me ka systemic lupus erythematosus, ʻoiai ke ʻano o ka maʻi e weliweli loa, ʻeha loa erylehema multiforme, toxic epidermal necrolysis, Stevens-Johnson maʻi pale. Aia nā hanana hewa i ka pue photosensitivity (ʻike. "Kūlana Kūlana").

Mai ka ʻōnaehana musculoskeletal a me ka hoʻopili hoʻohui: pinepine - nā mākino o ka naʻau.

Mai ka ʻōnaehana urinary: pinepine - pili ʻole i ka renal, loaʻa ʻole - maikaʻi ʻole o ka hopena renal.

Mai ka ʻōnaehana hana huawa: pinepine - hemahema.

ʻO nā maʻi maʻamau a me nā hōʻailona: pinepine - asthenia, pinepine - hoʻonui ʻia mai.

Nā hōʻailona Laboratory: hyperkalemia, pinepine iki ka helehelena, ka liʻiliʻi iki i ka hoʻoneʻe ʻana i ka likinine i loko o ka urine a me ke koko plasma ma hope o ka mālama ʻana i ka mālama ʻana, ʻoi aku ka nui o nā mea maʻi me nā stenosis renal, ma ka mālama ʻana i ka maʻi hypertension me ka diuretics a ma kahi o ka hopena o ka renal, ʻoi ʻole ka hypercalcemia, pinepine ʻole i ka ʻike ʻia. - ke hoʻonui i ka waena o ka QT ma ka ECG (e nānā i "Nānā Hana"), ke hoʻonui nei i ka kao o ka waikika uric a me ka glucose i loko o ke koko, kahi hoʻonui i ka hana o nā enme o ka huina, hypokalemia, kahi mea kūikawā nui no ka atsientov, ma kamepiula (e nānā. "Special Na Ke Kumu"), a me ka hyponatremia hypovolemia, e alakai i ka dehydration a me orthostatic hypotension. Hiki i ke hypochloremia māmā hiki ke alakaʻi i ka alkalosis compensatory (ʻo ka hopena a me ka paʻakikī o kēia hopena he haʻahaʻa).

Nā hopena hopena i hōʻike ʻia i nā hoʻokolohua hoʻokolohua

ʻO nā hopena ʻaoʻao i hōʻike ʻia ma ka haʻawina ADVANCE e kūlike me ka ʻōlelo palekana i kau ʻia ma mua no ka hui pū ʻana o ka perindopril a me indapamide. ʻO nā hanana pōʻino koʻikoʻi i ʻike ʻia i kekahi mau mea maʻi ma nā pūʻulu aʻo: hyperkalemia (0.1%), ʻoi aku ka hopena o ka renal oono (0.1%), hypotension arterial (0.1%) a me ka waiʻai (0.1%).

I nā mea maʻi 3 i ka hui perindopril / indapamide, ua nānā ʻia ka angioedema (kū'ē i 2 i loko o ka hui placebo).

E hoʻokuʻu i ke ʻano a me ka ʻano

Hoʻohana ʻia ʻo Noliprel i loko o ke ʻano o nā papa: keokeo, ʻōpū, me ka pilikia o nā ʻaoʻao ʻelua (i loko o kaʻaila o 14 a me 30 mau pcs., 1 paleka i loko o kahi pahu pahu).

ʻO ka hoʻonohonohoʻana o 1 papa e komo pū nā mea ikaika:

ʻO ka paʻakai Perindopril tertbutylamine - 2 mg,
Indapamide - 0.625 mg.

ʻO nā mea kōkua: microcrystalline cellulose, lactose monohydrate, magnesium stearate, hydrophobic colloidal silicon dioxide.

Lapaʻau lāʻau

ʻO Noliprel® A ka hui pū ʻana me ka perindoprilarginin (kahi angiotensin e hoʻohuli ai i ka enzyme inhibitor) a me ka indapamide (kahi diuretic mai ka hui derivative sulfonamide). ʻO nā huahana Pharmacological o ka lāʻau Noliprel® A hoʻohui i nā mea kū hoʻokahi o kēlā me kēia mahele.

ʻO ka hui pūʻana o perindopril a me indapamide e hoʻonui i ka hana o kēlā me kēia. Noliprel® A he hopena hypotensive hilinaʻi i ka hopena ma ka diastolic a me ke kaila toto systolic (BP) i nā kūlana "hoʻopunipuni" a "kū". Noho mau ka lāʻau i 24 mau hola. ʻO ka hopena therapeutic e emi mai ma mua o 1 ka mahina ma hope o ka hoʻomaka ʻana o ka hopena a ʻaʻole i hele pū ʻia e tachycardia. ʻAʻole he kumu hoʻokuʻi o ka hoʻomaʻamaʻa.

Hoʻololi ʻo Noliprel® A i ka palena o ka hypertrophy ventricular hema, hoʻomaikaʻi i ka elastial arterial, hōʻemi i ka huakaʻi kūloko peripheral, ʻaʻole ia e hoʻopilikia i ka metabolism lipid (kūlou kolamu, nā lipoprotein kūloko kiʻekiʻe (HDL) a me ka haʻahaʻa haʻahaʻa (LDL), triglycerides).

Perindopril

ʻO Perindopril kahi mea hoʻohui i ka hoʻoneʻe o ka huina e hoʻohuli i ka angiotensin I ka angiotensin II (kahi ACE inhibitor).

ʻO Angiotensin-hoʻohuli o ka enzyme, a i kinase, he exopeptidase e lawe ana i ka hoʻololi ʻana o ka angiotensin I i kahi o nā vasoconstrictor ka nui o ka angiotensin II, a me ka luku ʻana o ka bradykinin, ka hopena he vasodilating, i ka heptapeptide hana ʻole. Ma ka hopena o ka perindopril:

ho'ēmi i ka hunihine o aldosterone,
e ke kumu o nā manaʻo hoihoi kino e hoʻonui ai i ka hana o renin i ka plasma koko,
me ka hoʻohana mau ʻana, hoʻemi ʻia ia i ka pale kūloko peripheral aoao, ka mea nui ma muli o ka hopena i nā moku i loko o nā ʻōpū a me nā puʻuwai.

ʻAʻole i hoʻopili ʻia kēia mau hopena me ka paʻa o nā paʻakai a me nā wai o ka make ʻana o ka tachycardia reflex.

Loaʻa ka Perindopril i ka hopena hypotensive i nā maʻi me ka hoʻohaʻahaʻa haʻahaʻa a me ke ʻano o ka renin plasma.

Me ka hoʻohana ʻana o ka perindopril, ua emi ka nui o ka systolic a me ka diastolic blood pressure (BP) i nā kūlana "hoʻopunipuni" a me "kū". ʻO ka haʻaleleʻana o ka lāʻau ʻaʻole e hoʻonui i ke kahe koko.

Loaʻa ʻo Perindopril i ka hopena vasodilating, e kōkua i ka hoʻihoʻi i ka elasticity o nā lāʻau nui a me ke ʻano o ka pā vascular o nā lāʻau liʻiliʻi, a me ka hoʻēmi ʻana hoʻi i ka hypertrophy hema.

ʻO ka hoʻohana kūpono ʻana o ka diuret thiazide e hoʻonui i ka nui o ka hopena antihypertensive. Eia kekahi, ʻo ka hui pū ʻana o kahi mea ACE inhibitor a me kahi diuretic thiazide e alakaʻi ana i kahi hōʻemi o ka hopena o ka hypokalemia i loko o ka poʻe maʻi e loaʻa ana i ka diuretics.

Hoʻololi ʻo Perindopril i ka hana o ka puʻuwai, e hōʻemi ana i ka preload a ma hope.

Ke aʻo nei i nā ʻāpana hemodynamic i nā maʻi me ka puʻuwai puʻuwai, ua hōʻike ʻia:

hoʻemi i ka hoʻopihapiha ʻana i ka paila i ka hema a me ka ʻoli ʻana o ka naʻau,
hoemi i ka huina pale balota holoʻokoʻa.
mahuahua i ulu hōʻano a hoʻonui i ka index cardiac,
hoonui nui ana i nā kahe koko.

Aia ʻo Indapamide i ka hui o sulfonamides - e nā waiwai lāʻau lapaʻau i kokoke loa ia me ka diuret thiazide. Mālama ʻo Indapamide i ka hoʻihoʻi ʻana o ka paʻakai sodium i ka māhele cortical o ka loiloi Henle, kahi e piʻi ai i ka hoʻonui ʻana o ka sodium, klorine a, ma kahi liʻiliʻi, pālolo a me nā paʻakai magnesium e nā keiki, a laila e hoʻonui ai i ka diuresis.

Hōʻike ʻia ka hopena antihypertensive ma nā iniha ʻaʻole e hoʻopuka i kahi hopena diuretic.

ʻO ka Indapamide e hōʻemi i ka hyperreactivity vascular e pili ana i ka adrenaline. ʻAʻole pā ʻo Indapamide i nā lipids plasma: triglycerides, cholesterol, LDL a me HDL, ka pākuʻina o ka kalapika (me nā mea maʻi i ka maʻi mellitus concomitant).

Kōkua e hōʻemi i ka hypertrophy hema hema.

ʻLoe a me ke kākele

I loko, ʻoi aku ka maikaʻi ma ke kakahiaka, ma mua o ka papaʻaina, 1 papa o ka lāʻau Noliprel® A 1 mau manawa i ka lā.

Inā ʻaʻole i hoʻokō ʻia ka hopena hypotensive makemake i hoʻokahi mahina ma hope o ka hoʻomaka ʻana o ka ho'ōla, hiki i ka pāpālua ke pālua i ka hapa i ka 5 mg + 1.25 mg (hana ʻia e ka ʻoihana ma lalo o ka inoa kālepa ʻo Noliprel® A forte).

ʻO Renal hiki ʻole

Hoʻokomo ʻia ka lāʻau lapaʻau i nā mea maʻi me nā pilikia ʻole o ke aokalula (CC ma lalo o 30 ml / min.).

No ka poʻe maʻi me ka hikiʻole o ka renal moderate (CC 30-60 ml / min), ʻo ka nui loa o ka nui o Noliprel® A he 1 papa i kēlā me kēia lā.

ʻO nā maʻi me ka CC like a i ʻole a heʻoi aku ma mua o 60 ml / min. ʻAʻole pono e hoʻoponopono i ka hoʻoponopono. I ka wā o ka papa hana, pono ka mālama pono ʻana i ka plasma creatinine a me nā pae pākia.

Hoʻohana i ka wā hāpai a me ka lactation

ʻAʻole pono e hoʻohana ʻia ka lāka i ka trimester mua o ka hāpai ʻana.

Ke hoʻolālā nei i ka hapai a i ka wā e hāpai ana i ka lawe ʻana iā Noliprel® A, pono ʻoe e kāpae i ka lawe ʻana i ka lāʻau lapaʻau a kuhikuhi i kahi lāʻau antihypertensive hou.

ʻAʻole i mālama ʻia nā haʻawina kūpono o nā inhibitor ACE i nā wahine hāpai. Pau ka ʻikepili i nā hopena o ka lāʻau i ka mea mua o ka mākeke i hōʻike ʻia ʻaʻole i lawe ka lāʻau i ka malformations e pili ana me ka fetotoxicity.

Noliprel® A i hoʻohālikelike ʻia ma ka trimester ʻo II a me III (ʻike i ka ʻāpana "Contraindications").

ʻIke ʻo ka lōʻihi o ka ʻike ʻana i nā inhibitor ACE ma ka ʻōpū o ka pēpē lua a me ke kolu o ka hapala o ka hapai hiki ke alakaʻi i ka hoʻopōmaʻa ʻana (hōʻemi i ka hana renalula, oligohydramnios, hoʻolōʻihi i ka hana o ka iwi) a me ka hoʻomohala ʻana i nā hoʻopiʻi i ka pēpē (renal failed, hypotension, hyperkalemia).

Inā loaʻa ka mea maʻi i ka lāʻau lapaʻau Noliprel® A i ka wā o ka trimester II a i ʻole ʻo III o ka hāpai ʻana, e manaʻo ʻia e hana i kahi loiloi ultrasound o ka pūpū e nānā i ke ʻano o ka ʻihi a me nā hana o ke keiki.

Ke keu

ʻO ka hōʻailona nui loa o ka overdose he hōʻailona i emi ai ke kahe o ke koko, i kekahi manawa ke hui pū me ka nausea, ka luaʻi, nā mea hoʻolilo, hilahila, ka hiamoe, ke kuhihewa, a me ka oliguria, hiki iā ia ke hele i loko o kahi anuria (ma muli o ka hypovolemia). ʻO nā haunaele eletika (hyponatremia, hypokalemia) hiki paha i kekahi.

Hoʻemi ʻia nā hana ʻona no ka wehe ʻana i ka lāʻau mai ke kino: e holoi ana i ka ʻōpū a me / a i ʻole ke kuhikuhi ʻana i ka carbon carbon activated, ukali ʻia e ka hoʻihoʻi ʻana o ka kaila wai-electrolyte.

Me ka emi nui o ke kahe koko, pono e hoʻoneʻe i ka mea maʻi i ke kūlana ʻoi aku me nā wāwae i hāpai ʻia. Inā pono, e hoʻoponopono i ka hypovolemia (no ka laʻana, ka infusion intravenous o 0.9% sodium chloride solution). ʻO Perindoprilat, ka metabolite hoʻoikaika o perindopril, hiki ke hoʻopau ʻia i ke kino ma ka dialysis.

ʻAʻole i hāʻawi ʻia

Hoʻomoe lithium: me ka hoʻohana like ʻana o ka hoʻomākaukau lithium a me nā pale o ACE, he hoʻonui hoʻi i ka hoʻoneʻe ʻana o ka lithium i ka plasma koko a me nā hopena pili i nā mea pili ʻole. Hoʻohui hou ka hoʻohana ʻana o ka diuret thiazide e hoʻonui hou i ka makaʻapa o ka lithium a hoʻonui i ka pilikia o nā meaʻala. ʻAʻole hoʻolako ʻia ka hoʻohana pinepine ʻana o ka hui me ka perindopril a me ka indapamide me ka hoʻomākaukau ʻana o ka lithium. Inā pono, pono e hoʻomau nā lāʻau maʻi i ka ʻike lithium i loko o ke koko koko (e ʻike i ka mahele "Nā ʻōlelo aʻoaʻo").

ʻO nā lāʻau lapaʻau, ka hui ʻana o ka mea e pono ai ka nānā kūikawā

Baclofen: hiki i ka hopena hopena. Pono ke nānā ʻia ke koko a me nā hana a ke keiki; inā he pono, e koi ʻia ka hoʻoponopono ʻana o nā lāʻau antihypertensive.

ʻO nā lāʻau anti-inflammatory nonsteroidal (NSAIDs), me nā kaila kiʻekiʻe o ka acetylsalicylic acid (ʻoi aku ma mua o 3 g / lā): Hiki i nā NSAID ke alakaʻi i ka hopena o ka hopena diuretic, natriuretic a me nā hopena antihypertensive. Me ka pohō nui o ka wai, hiki i ke aloha renal ka ulu ʻana (ma muli o ka emi o ka hopena o ka filtration glomerular). Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me ka lāʻau lapaʻau, pono ia e hoʻomaʻamaʻa no ka pohō i ka wai a mālama pono i ka hana o ka maʻi ma ka hoʻomaka ʻana o ka mālama ʻana.

ʻO ka hui pūʻana o nā lāʻau lapaʻau e pono ai ka makaʻala

Tricyclic antidepressants, antipsychotics (antipsychotics): nā mea lapaʻau o kēia mau papa e hoʻomaikaʻi i ka hopena antihypertensive a hoʻonui i ka pilikia o ka hypthension orthostatic (hopena hoʻohui).

Corticosteroids, tetracosactide: hoʻohaʻahaʻa i ka hopena antihypertensive (ka wai a me ka hoʻopaʻa o ka paʻakai sodium ma muli o corticosteroids).

ʻO nā lāʻau lapaʻau antihypertensive: hoʻonui i ka hopena antihypertensive.

Nā ʻōlelo kikoʻī

ʻO ka hoʻohana ʻana i ka lāʻau Noliprel® A 2.5 mg + 0.625 mg, loaʻa i ka hapa haʻahaʻa o indapamide a me perindopril arginine, ʻaʻole i ukali ʻia e ka hapa nui o ka hopena o nā hopena ʻaoʻao, me ka ʻokoʻa o ka hypokalemia, hoʻohālikelike ʻia me perindopril a me indapamide ma nā ʻāpana loa i ʻae ʻia (ʻike i ka ʻāpana " Nā hopena ʻaoʻao "). I ka hoʻomaka ʻana o nā lāʻau me nā lāʻau antihypertensive ʻelua, ʻaʻole i loaʻa i ka mea maʻi ma mua, he piʻi nui ka nui o ka idiosyncrasy ʻaʻole e hoʻoholo ʻia. ʻO ka mālama ponoʻana i ka mea maʻi e hoʻemi i kēia pilikia.

Hola paʻa kino hana

Contraindicated ʻo ka maʻi i loko o nā mea maʻi me ka pilikia ʻole o ka ukana (CC ma mua o 30 ml / min). I kekahi mau mea maʻi me ka hypertension arterial me ka ʻole o ka mua o ka pohō papaha ʻole, hiki i ka lāʻau ke hōʻike i nā hōʻailona o ke kikowaena o ka hiki ʻole o ka hana renal. I kēia hihia, pono e hoʻokuʻu ʻia ka mālama ʻana. I ka wā e hiki mai ana, hiki iā ʻoe ke hoʻomau i ka hoʻohui hoʻohui ʻana me ka hoʻohana ʻana i nā dole o nā lāʻau lapaʻau, a i ʻole hoʻohana i nā lāʻau i ka monotherapy.

Pono kēlā mau mea maʻi e kiaʻi maʻamau e pili ana i ka paʻakai serum a me nā pae creatinine - 2 mau pule ma hope o ka hoʻomaka ʻana o ka lapaʻau a me kēlā me kēia 2 mau mahina ma hope mai. Hoʻopilikia pinepine ʻo Renal i nā mea maʻi me ka puʻuwai koʻikoʻi o ka puʻuwai a i ʻole ka hana mua ʻole o ka hana renal, me ka stalosis aralula.

Hypotension arterial a me ka hoʻopiha wai-electrolyte kaulike

Hoʻopili ʻia ka hyponatremia me ka pilikia o ka hoʻolālā koke ʻana o ka hypotension arterial (ʻo ka nui o nā mea maʻi me ka stenosis artery kidney hoʻokahi a me ka bilateral renal artery stenosis). No laila, i ka nānā ʻana i nā mea maʻi i ka hoʻonaninani kuʻuna, pono e mālama i nā hōʻailona hiki i ke ʻano o ka maloʻo a me ka hoʻēmi ʻana ʻana i ka pae o nā electrolyte i loko o ke koko koko, no ka laʻana, ma hope o ke ʻano o ka maʻi ʻa a i ʻole ka luaʻi. Pono kēlā mau maʻi e kiaʻi pinepine i nā electrolytes plasma koko.

Me ka hypotension arterial koʻikoʻi, koi pono ka lawelawe ʻana i ka wai o 0.9% sodium chloride.

ʻO ka hypotension arential ʻaʻole ia he contraindication no ka hoʻomau i ka hoʻomau. Ma hope o ka hoʻihoʻi hou ʻana i ka nui o ke kaila o ke koko a me ke koko, hiki ke hoʻomau i ka lāʻau e hoʻohana ana i nā hōʻemi o nā laiki haʻahaʻa, a hiki ke hoʻohana ʻia nā lāʻau i ka mode monotherapy.

Papa pāhau

ʻO ka hoʻohana pū ʻana o ka perindopril a me ka indapamide ʻaʻole i pale i ka hoʻomohala ʻana o ka hypokalemia, keu i nā mea maʻi me ka maʻi mellitus a i ʻole ka hopena ʻole. E like me ka hoʻohana pono ʻana o nā lāʻau antihypertensive a me kahi diuretic, ka mālama pinepine ʻana o ka pae o ka paʻakai i ka plasma koko.

Hoʻohui Kūʻai Kūʻai

Ke kūleʻa aku nei ka lāʻau lapaʻau.

E like me monotherapy, ʻōlelo pinepine ke kauka i ka perindopril a me ka indapamide ʻokoʻa. Nā kikowaena o ka lāʻau loaʻa nā Co-preness a Prestarium Arginine Combi wale nō. Eia kekahi, hana ka mea hana iā Noliprel i nā dosage ʻē aʻe.

ʻO ke kumukūʻai kumukūʻai o Noliprel A papa 2.5 mg + 0.625 mg ma nā lāʻau lapaʻau a Moscow he 540-600 rubles.

Hoʻohui

1. ʻAʻole e ʻae ʻia nā hoʻohui no ka hoʻohana ʻana

Hoʻomoe lithium: me ka hoʻohana like ʻana o ka hoʻomākaukau lithium a me nā pale o ACE, he hoʻonui hoʻi i ka hoʻoneʻe ʻana o ka lithium i ka plasma koko a me nā hopena pili i nā mea pili ʻole. Hoʻohui hou ka hoʻohana ʻana o ka diuret thiazide e hoʻonui hou i ka makaʻapa o ka lithium a hoʻonui i ka pilikia o nā meaʻala. ʻAʻole hoʻolako ʻia ka hoʻohana pinepine ʻana o ka hui me ka perindopril a me ka indapamide me ka hoʻomākaukau ʻana o ka lithium. Inā pono ia mau ʻano, pono e kiaʻi mau ʻia nā ʻike lithium i loko o ke koko koko (e ʻike i "Nā Kūlana Kūlana").

2. ʻO nā lāʻau lapaʻau, ka hui pū ʻana o ka mea e pono ai ka mālama kūikawā a me ka mālama

Baclofen: hiki i ka hopena hopena. Pono e nānā ʻia ke koko a me ke kaʻi ʻana o ka hana pono; e hoʻoponopono ʻia ka hoʻoponopono ʻana i nā lāʻau antihypertensive inā pono.

ʻO NSAID, me ka nui o nā wai acetylsalicylic acid (ʻoi aku ma mua o 3 g / lā): Hiki i nā NSAID ke hōʻemi i ka hopena diuretic, natriuretic a me nā antihypertensive. Me ka pohō nui o ka wai, hiki i ke aloha renal ka ulu ʻana (ma muli o ka emi o ka hopena o ka filtration glomerular). Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me ka lāʻau lapaʻau, pono ia e hoʻomaʻamaʻa no ka pohō i ka wai a mālama pono i ka hana o ka maʻi ma ka hoʻomaka ʻana o ka mālama ʻana.

3. ka hui ʻana o nā lāʻau lapaʻau e koi ana i ka makaʻala

Corticosteroids, tetracosactide: hoʻohaʻahaʻa i ka hopena antihypertensive (ka wai a me ka hoʻopaʻa o ka paʻakai sodium ma muli o corticosteroids).

ʻO nā lāʻau lapaʻau antihypertensive: hoʻonui i ka hopena antihypertensive.

1. ʻAʻole e ʻae ʻia nā hoʻohui no ka hoʻohana ʻana

Potoma-sparing diuretics (amiloride, spironolactone, triamteren) a me ka hoʻomākaukau ana i ka paʻakai: ʻae ʻana nā ACE inhibitors i ka nalowale ʻana o ka pāhala e nā ʻōpū ma muli o ka diuretic. Potoma-sparing diuretics (no ka laʻana, spironolactone, triamteren, amiloride), ka hoʻomākaukau ʻana i ka paʻakai, a me nā paʻuhū paʻakai o ka paʻakai hiki ke alakaʻi i kahi hoʻonui nui o ka paʻakai i ka serum koko a hiki i ka make. Inā hoʻohana pinepine ia i kahi inhibitor ACE a me nā lāʻau lapaʻau aʻe ma luna aʻe (ma ka hihia o ka hypokalemia i hōʻoia ʻia), pono e mālama ʻia a me ka mālama pono ʻana i ka pāhare pālolo ma loko o ke kaila koko a me nā ʻōhua ECG.

2. ka hui ʻana o nā lāʻau lapaʻau e pono ai ka makaʻala kūikawā

ʻO nā aihue Hypoglycemic no ka hoʻokūkū waha (sulfonylurea derivatives) a me ka insulin: ua wehewehe ʻia nā hopena e like me ka captopril a me enalapril. Hiki i nā pale o ACE ke hoʻoikaika i ka hopena hypoglycemic o ka insulin a me nā derivatives sulfonylurea i nā maʻi me nā maʻi mellitus. He loaʻa ʻole ka hoʻonui ʻia o ka hypoglycemia (ma muli o ka hoʻonui o ka hoʻohaʻahaʻa glucose a me ka hoʻohaʻahaʻa i ka pono o ka insulin).

3. ka hui ʻana o nā lāʻau lapaʻau e koi ana i ka makaʻala

Allopurinol, cytostatic a me immunosuppressive lāʻau, corticosteroids (no ka hoʻohana ʻana i ka ʻōnaehana system) a me ka procainamide: pili pū kekahi me ka ACE inhibitors e pili me ka nui o ka piʻi o ka leukopenia.

Meo no ka anesthesia aoao: ka hoʻohana like ʻana o nā inhibitor ACE a me nā mea ʻokoʻa no ka anesthesia aoao hiki ke piʻi i ka hopena i loko o ka hopena antihypertensive.

Diuretics (thiazide a me ka loop): ʻo ka hoʻohanaʻana i nā diuretics ma nā wai kiʻekiʻe e hiki ke alakaʻi i ka hypovolemia, a me ka hoʻohui o perindopril i ka therapy hiki ke alakaʻi i ka hypotension arterial.

Hoʻomākaukau gula: i ka wā e hoʻohana ai i ka pale o ACE, incl. perindopril, i nā mea maʻi e loaʻa ana ka mākaukau iv gula (sodium aurothiomalate), kahi wehewehe hōʻailona i wehewehe ʻia, ʻo ia hoʻi: ka hyperemia ʻili o ke alo, ʻaloha, hoʻopuka, a me hypotension arterial.

1. ʻO ka hui pūʻana o nā lāʻau lapaʻau e pono ai ka nānā kūikawā

ʻO nā lāʻau hōʻeha e hiki ai i ka arrhythmias pirouette: ma muli o ka ikehu o ka hypokalemia, pono e hoʻomaʻamaʻa ʻia i ka wā e hoʻohana ana i ka indapamide me nā lāʻau lapaʻau e hiki ai i nā arrhythmias pirouette, no ka laʻana, ka lāʻau antiarrhythmic (quinidine, hydroquinidine, disopyramide, amiodarone, dofetilide, ibutilide , bretilia tosylate, sotalol), kekahi antipsychotics (chlorpromazine, cyamemazine, levomepromazine, thioridazine, trifluoperazin), benzamides (amisulpride, sulpiride, sultopride, setiapride), butyrophenones (droperidol, gallop) ridol), nā antipsychotics (pimozide), nā lāʻau lapaʻau e like me ka bepridil, cisapride, diphemanil methyl sulfate, erythromycin (iv), halofantrine, misolastine, moxifloxacin, pentamidine, sparfloxacin, vincamine (iv), methademone, astademad, astademad, astademad, astademad . ^ E Ha yM. ʻO ka hoʻohana pū ʻana me nā lāʻau lapaʻau aʻe e luna, pono e ʻalo ʻia, ka hōʻeha o ka hypokalemia a, inā pono, ʻo ia hoʻi ka hoʻoponopono ʻana, ka kaohi o ka lālā QT.

ʻO nā hopena hōʻeha e hiki ai i ka hypokalemia: amphotericin B (iv), corticosteroids a me mineralocorticosteroids (no ka hoʻohana ʻana i nā ʻōnaehana system), tetracosactides, laxatives e hoʻoulu ai i ka maʻi o ka ʻōpū: hoʻonui i ka kuʻuna o ka hypokalemia (hopena hoʻohui). Pono e kāohi i ka ʻike o ka potassium ma loko o ke koko koko, inā pono, ʻo ia ka hoʻoponopono. Pono e hāʻawi ʻia ka nānā pono i nā poʻe maʻi e loaʻa i ka wā glycosides cardiac. Pono e hoʻohana ʻia nā lōpala e hoʻōla ʻole i ka pehu a me nā ʻōpala.

Hoʻopuka i nā glycosides Cardiac: hypokalemia e hoʻonui i ka hopena iʻa e pili ana i ka glycosides cardiac. Me ka hana like o ka indapamide a me ka glycosides cardiac, pono ka nānā ʻia o ka pāhare potassium i loko o ke koko koko a me nā ʻōkuhi ECG a inā pono, inā kūpono ʻia.

2. ka hui ʻana o nā lāʻau lapaʻau e koi ana i ka makaʻala

Metformin: hiki i ka hana renal ka hopena i hiki ke hele mai i ka wā e lawe ana i ka diuretics, ʻoiai ka diuretics loop, ʻoiai ke alakaʻi nei ka metformin e hoʻonui i ka hopena o ka maʻi lactic acidosis. ʻAʻole pono ke hoʻohana o ka metformin inā he kaila i hana ʻia ma ka plasma koko ma mua o 15 mg / l (135 μmol / l) i nā kāne a me 12 mg / l (110 μmol / l) i nā wahine.

Iodine i loko o nā mea hoʻokaʻawale i ka Iodine: hana hōʻino o ke kino i ka wā e lawe ana i nā lāʻau diuretic e hoʻonui i ka nui o ka hoʻonāukiuki ʻana i ka maʻi renal, ʻoi aku ka hoʻohana ʻana i nā dosis kiʻekiʻe o nā iodine e loaʻa nā mea kūlike. Ma mua o ka hoʻohana ʻana i nā mea ʻenehana iodine e pono ai, pono e hoʻopiʻi ka poʻe maʻi no ka nalowale i ka wai.

ʻO nā paʻakai kalima: me ka hoʻokolohua hoʻokahi, hoʻomohala ʻia ka hypercalcemia ma muli o ka emi ʻana o ka hana o ka calcium calcium e nā keiki.

Cyclosporin: ke hoʻonui ʻana o ka ʻike o ka creatinine i ka plasma koko me ka ʻole o ka hoʻololi ʻana o ka hoʻoulu ʻana o ka cyclosporin i loko o ke koko koko, me kahi ʻano maʻamau o ka wai a me nā paʻakai sodium.

Pehea e hana ai, papa o ka hoʻokele a me ka helu ʻana

I loko, ʻoi aku ka maikaʻi ma ke kakahiaka, ma mua o ka ʻai ʻana.

1 papa o ka lāʻau Noliprel ® ʻO ka manawa 1 i ka lā.

Inā hiki, hoʻomaka ka lāʻau lapaʻau me ke koho ʻana i nā kahena o nā lāʻau āpana hoʻokahi. I ka hihia o ka maʻi lapaʻau, hiki iā ʻoe ke noʻonoʻo i ka hiki o ke kahakaha ʻana i ka lāʻau hui pū me Noliprel® A i ka manawa koke o ka monotherapy.

ʻO nā mea maʻi me ka hypertension arterial a me ke ʻano type diabetes 2 mellitus e hōʻemi i ka hopena o nā hoʻopiʻi microvascular (mai nā lolo) a me nā hoʻopiʻi macrovascular mai nā maʻi cardiovascular

Nā 1 papa i ka Noliprel ® A ka manawa i ka lā. Ma hope o 3 mau maʻi o ke ʻano maʻi, e pili ana i ka hoʻomanawanui maikaʻi, hiki nō ke hoʻonui i ka maʻi i nā papa ʻelua o Noliprel ® A 1 ka manawa i kēlā me kēia lā (a i ʻole 1 papa pākauau o Noliprel ® A forte 1 manawa i ka lā).

ʻO nā maʻi maʻi

Pono e mālama ʻia ka lāʻau lapaʻau ma hope o ka mālama ʻana i ka hana o ka renal a me ke koko.

Hoʻokomo ʻia ka lāʻau lapaʻau i nā mea maʻi me ka pilikia ʻole o ka renal (ʻoi aku ʻo Clin ma mua o 30 ml / min).

No ka mea maʻi me ka hikiʻole o ka renal moderate (Cl creatinine 30-60 ml / min), ke noi ʻia e hoʻomaka i ka maʻi me nā kaha pono o nā lāʻau lapaʻau (ma ke ʻano ʻano monotherapy), ʻo ia kahi o Noliprel ® A.

No nā mea maʻi me Cl creatinine i like a ʻoi aku paha ma mua o 60 ml / min, ʻaʻole pono ka hoʻoponopono ʻana o nā lāʻau maʻi. I ka wā o ka papa hana, pono ka mālama pono ʻana i ka plasma creatinine a me nā pae pākia.

Hoʻokomo ʻia ka lāʻau i nā maʻi me nā maʻi hōʻeha hepatic koʻikoʻi.

I ka hōʻemi hema ʻana o ka naʻau, ʻaʻole pono ka hoʻoponopono ʻana o ka dosis.

Na keiki a ʻōpio

ʻAʻole pono e kuhikuhi ʻia ʻo Noliprel ® A i nā keiki a me nā ʻōpio ma lalo o 18 makahiki o ka makahiki ma muli o ka hemahema o ka ʻike i ka hopena a me ka palekana o ka lāʻau lapaʻau i nā mea maʻi o kēia ʻano makahiki.

Nā ʻōlelo kikoʻī

ʻO ka hoʻohana ʻana i ka lāʻau Noliprel ® A 2.5 mg + 0.625 mg, loaʻa i ka hapa haʻahaʻa o indapamide a me perindopril arginine, ʻaʻole i hele pū ʻia e ka hopena nui o ka hopena o nā ʻaoʻao, me ka ʻokoʻa o ka hypokalemia, i hoʻohālikelike ʻia me perindopril a me indapamide ma nā wai haʻahaʻa loa i ʻae ʻia no ka hoʻohana ʻana (e nānā "Adverse nā hana "). I ka hoʻomaka ʻana o nā lāʻau me nā lāʻau antihypertensive ʻelua, ʻaʻole i loaʻa i ka mea maʻi ma mua, he piʻi nui ka ulu ʻana o ka hoʻoulu idiosyncrasy. ʻO ka mālama ponoʻana i ka mea maʻi e hoʻemi i kēia pilikia.

Hola paʻa kino hana

Contraindicated ʻo ka maʻi i loko o nā mea maʻi me ka pilikia ʻole o ka renal (ʻoi aku ʻo Clin ma mua o 30 ml / min). I kekahi mau mea maʻi me ka hypertension arterial me ka ʻole o ka mua o ka pohō papaha ʻole, hiki i ka lāʻau ke hōʻike i nā hōʻailona o ke kikowaena o ka hiki ʻole o ka hana renal. I kēia hihia, pono e hoʻokuʻu ʻia ka mālama ʻana. I ka wā e hiki mai ana, hiki iā ʻoe ke hoʻomau i ka hoʻohui hoʻohui ʻana me ka hoʻohana ʻana i nā dole o nā lāʻau lapaʻau, a i ʻole hoʻohana i nā lāʻau i ka monotherapy.

Pono kēlā mau mea maʻi e kiaʻi maʻamau e pili ana i ka paʻakai serum a me nā pae creatinine - 2 mau pule ma hope o ka hoʻomaka ʻana o ka lapaʻau a me kēlā me kēia 2 mau mahina ma hope mai. Hoʻomaʻa pinepine pinepine ʻo Renal i nā mea maʻi me ka puʻuwai koʻikoʻi o ka puʻuwai kino a i ʻole ka hana mua ʻana o ka pūpū māmā, ʻo ia hoʻi me ka stenosis hāmeʻa ʻole.

Hypotension arterial a me ka hoʻopiha wai-electrolyte kaulike

Me ka hypotension nui koʻikoʻi, pono paha ka lawelawe ʻana iv o ka waiʻo 0.9% sodium chloride.

ʻO ka hypotension arential ʻaʻole ia he contraindication no ka hoʻomau i ka hoʻomau. Ma hope o ka hoʻihoʻi hou ʻana o BCC a me ke kahe koko, hiki iā ʻoe ke hoʻomau i ka lapaʻau ʻana me ka hoʻohana ʻana i nā papa liʻiliʻi o nā lāʻau lapaʻau, a i ʻole hoʻohana i nā lāʻau i ke ʻano monotherapy.

ʻO ka hoʻohana pū ʻana o ka perindopril a me ka indapamide ʻaʻole i pale i ka hoʻomohala ʻana o ka hypokalemia, keu i nā mea maʻi me ka maʻi mellitus a i ʻole ka hopena ʻole. E like me ka hoʻohana pono ʻana o ka lāʻau antihypertensive a me kahi diuretic, mālama pono ʻia ka mālama ʻana o ke kiʻekiʻe o ka paʻakai i ka plasma koko.

Pono e hāpai i ka noʻonoʻo o ka hoʻokomo ʻana o nā mea hoʻonani o ka lāʻau lapaʻau e pili ana i ka monabolat lactose. ʻAʻole pono ke palapala ʻia ʻo Noliprel ® A i ka poʻe maʻi me ka intolerance galactose hoʻoilina, lilo ka lactase a me ka malabsorption glucose-galactose.

ʻO ka hoʻohana like ʻana o ka hui ʻana o perindopril a me ka indapamide me ka hoʻomākaukau ʻana o ka lithium ʻaʻole ia e ʻōlelo ʻia (e ʻike. "Contraindications", "Interaction").

ʻO ka pilikia o ka hoʻomohala ʻana i ka neutropenia aʻo ka lawe ʻana i ka ACE inhibitors e hilinaʻi i ka dosis a e hilinaʻi ana i ka lāʻau lapaʻau i lawe ʻia a me ka loaʻa ʻana o nā maʻi concomitant. Maʻa pinepine ʻo Neutropenia i nā maʻi me ka ʻole e hoʻopalapula i nā maʻi, akā, piʻi ka mea i hoʻopilikia ʻia i nā mea maʻi me ka hana pūpū i ʻole ke ahonui, ʻoi aku hoʻi i nā maʻi o nā ʻōnaehana (ʻo ka systemus lupus erythematosus, scleroderma). Ma hope o ka hoʻoneʻe ʻana o ka ACE inhibitors, lilo nā hōʻailona o neutropenia iā lākou iho.

Hōʻalo i ka hoʻomohala ʻana o ia mau ʻano

He aha ia e hoʻōla ai Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.? Ala akula ka p? Maikaʻi o Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.. ^ E Ha yM. ʻO ka koho Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.. ^ E Ha yM. Nā kūlana mālama Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.. ^ E Ha yM. He kumukūʻai maʻamau no Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.. ^ E Ha yM. Ka lohi Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.. ^ E Ha yM. E lawe wale Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs.. Noliprel ʻO nā papa 2.5 + 0.625 mg 30 pcs. kūʻai pūnaewele.

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