Telzap® (Telzap®)

Ọgwụ ahụ dị n'ụdị mbadamba ihe eji eme ihe nkiri: site na edo edo ruo ihe fọrọ nke nta ka ọ bụrụ ọcha, oblong, biconvex, 40 mg nke ọ bụla nwere ahịrị n ’akụkụ ọ bụla, 80 mg nke ọ bụla - nke a na-etinye“ 80 ”(10 PC.). na blisters, na ngwungwu 3, 6 ma ọ bụ 9 blisters na ntuziaka maka iji Telzap).

Otu mbadamba 1 nwere:

• ihe na-arụ ọrụ: telmisartan - 40 mg ma ọ bụ 80 mg,
• ihe inyeaka: povidone 25, meglumine, sodium hydroxide, sorbitol, magnesium stearate.

Mlọ ọgwụ

Telzap bụ ọgwụ antihypertensive, ihe na - arụ ọrụ ya bụ telmisartan - onye na - emegide ya nke nnabata angiotensin II (subtype AT)₁) Telmisartan nwere mmekọrịta dị elu maka AT₁ (angiotensin) - ndi nwere ncheghari nke eji enyocha ihe anakpo angiotensin II. Na-enweghị ihe onye na - akpata ihe gbasara agonist na-anabata onye na - anabata ya, ọ na - eme ka angiotensin nke abụọ ghara ịdị na njikọ ya ma kechie naanị AT₁ndị na-anabata angiotensin II. Maka ndị ọzọ na-anabata ndị na-anabata angiotensin (gụnyere AT₂ndị na-anabata ya) telmisartan enweghị mmekọrịta. Emebeghị ka ha mata uru ọrụ ha na nsonaazụ nke mkpali nwere ike ime na angiotensin II. Telmisartan na-ebelata ọkwa plasma aldosterone, anaghị egbochi ọwa ion, ọ naghị ebelata ọrụ ntanetị, ọ naghị egbochi ọrụ nke enzyme angiotensin (kininase II), nke na-eweta mbibi nke bradykinin. Nke a na - egbochi mmepe nke ụkwara akọrọ na mmetụta ndị ọzọ na - emetụta ya n'ihi ọrụ nke bradykinin.

Site n'ọbara dị mkpa, ịre Telzap na ọgwụ nke 80 mg na-enye aka igbochi mmetụta ọbara mgbali elu nke angiotensin II. Mmetụta antihypertensive mgbe nchịkwa izizi nke telmisartan pụtara n'ime awa 3 wee dịgide ruo awa 24, na-anọgide na-adịkarị mkpa ruo awa 48. A na - enweta mmetụta antihypertensive ka emesịrị ụbọchị 28-56 nke nchịkwa ọgwụ mgbe niile.

Na ọbara mgbali elu, telmisartan lowers systolic na diastolic ọbara mgbali (BP) na-enweghị emetụta mmetụ obi (HR).

Mkagbu siri ike nke iwere Telzap adịghị eso ya na mmepe nke ọrịa mwepụ, ọbara mgbali jiri nwayọ laghachi ọkwa mbụ ya n'ime ọtụtụ ụbọchị.

Mmetụta antihypertensive nke telmisartan bụ nke a tụnyere ọrụ nke ndị ọrụ antihypertensive dị ka amlodipine, enalapril, hydrochlorothiazide, atenolol, na lisinopril, mana site na iji telmisartan nwere obere okpukpu okpukpu okpukpo na iche na angiotensin na-agbanwe enzyme (ACE) inhibitors.

Ojiji nke telmisartan maka mgbochi ọrịa obi na ọrịa okenye (afọ 55 gbagoro) na ọrịa transient ischemic ọgụ, ọrịa obi na-efe efe, mbibi akwara mkpụrụ obi, ọnya afọ ma ọ bụ nsogbu nke ọrịa shuga 2 (gụnyere ọrịa ọrịa retinopathy, hypertrophy በግራ, akro-maro akụkọ ihe mere eme nke microalbuminuria) nyere aka na mbenata ebumnuche ejikọtara ọnụ: ụlọ ọgwụ n'ihi ọrịa obi na-adịghị ala ala, ọrịa obi ọgụ, infarction myocar. ma ọ bụ a na-abụghị ndị na-egbu egbu ọrịa strok. Mmetụta nke telmisartan yiri ramipril n'ihe banyere ibelata ugboro ole nke isi ihe: ọnwụ obi, infarction myocardial, ma ọ bụ ọrịa strok na-enweghị nsonaazụ na-egbu egbu. N'adịghị ka ramipril, nke telmisartan, ihe kpatara akpịrị akọrọ na ọrịa angioedema dị ntakịrị, ọnya ọgbụgba akwara dị elu.

Mlọ ọgwụ

Mgbe nchịkwa ọnụ gachara, nnara nke telmisartan site na eriri afọ na-apụta ngwa ngwa, bioavailability ya bụ 50%. Imekọ nri ọnụ n’otu oge na -ebelata AUC (mkpokọta ụbara plasma), mana n’ime elekere atọ atụnyere telmisartan n’ọbara plasma na-arụkọ ọrụ.

Tụnyere ndị nwoke na ụmụ nwanyị, C_max (ntinye uche kachasị na plasma ọbara) bụ okpukpu atọ dị elu, yana AUC - ihe dị ka ugboro 2, mana nke a anaghị emetụta oke arụmọrụ nke Telzap.

Onweghi nmekorita nke n’agbata ogwu na ogwe ogwu nke ogwu. Mgbe ị na-eji usoro ọgwụ kwa ụbọchị karịa 40 mg C_max na AUC dịgasị iche iche na mmụba ọ̀tụ̀tụ̀.

Ihe ndi ozo n’agbata protein plasma nke ọbara (karisia albumin na alfa)₁acid glycoprotein) - kariri 99.5%.

Ọdịdị pụtara ogo nke ọkara bụ lita 500.

Metabolism nke Telmisartan na-eme site na conjugation na glucuronic acid; conjugate enweghị ọrụ ọgwụ.

Ndi_1/2 (iwepu ọkara ndụ) - ihe karịrị elekere iri abụọ. Ọ na - adịkarịghi agbanwegharị (99%) site na eriri afọ, akụrụ na - erughi 1%.

Mkpochapu plasma zuru oke ruru 1000 ml / min, ọbara ịba ọcha n'anya - ruru 1500 ml / min.

Site n'ịrụ ọrụ mkpado nwere obere, yana ndị ọrịa karịa afọ 65, ọgwụ anaghị agabigaghị ọgwụ, n'ihi ya ọ naghị achọ nhazigharị dose.

Na nnukwu nsogbu akụrụngwa na maka ndị ọrịa ịba n'ọrịa, usoro izizi ekwesịghị gafere 20 mg kwa ụbọchị.

Telmisartan adịghị agwọ ọrịa.

Maka obere nsogbu ịba ọcha n'anya na-agafe agafe (ịhapụ Amụaka-Pugh nke A na B), ekwesịrị iji ọgwụ ruru 40 mg kwa ụbọchị.

Ihe ngosi maka ojiji

• ọbara mgbali elu,
• mbelata ugboro ugboro ọrịa obi na ọrịa na ndị okenye nwere ọrịa nke ọrịa obi nke ọrịa atherothrombotic etiology (ọrịa obi na-efe efe, mbibi akwara akwara ma ọ bụ akụkọ ọnya isi) yana mmebi anụ ahụ na ụdị ọrịa shuga 2.

Ihe ngbanwe

• oke nsogbu ịba ọcha n'anya (Ahụike Childmụaka P),
• ọrịa biliary tract ọrịa cholestasis,
• n'otu oge ahụ aliskiren na oke mkpọnwụ akụrụngwa GFR (ọnụego nhicha nke ụwa) ihe na-erughị 60 ml / min / 1.73 m 2 nke ahụ dị elu ma ọ bụ bụrụ ọrịa mellitus,
• concomitant therapy with angiotensin-converting enzyme (ACE) na-egbochi ndị ọrịa nwere ọrịa nephropathy,
• n'ihi na mmadụ nwere ike inweta mkpụrụ osisi
• oge ime
• inye ara
• afọ ruo afọ 18
• hypersensitivity na ọgwụ nke ọgwụ.

Ekwesịrị iji ya kpachara anya ma ọ bụrụ na ọ nwere ọrịa obi na-adịghị ala ala, ọbara ọgbụgba hyperrophic, mgbochi na mitral valve stenosis, ọrụ akwara nwere nsogbu, akwara mkpọnwụ akwara, ọnya akwara nke otu akụrụ na-arụ ọrụ, dị nwayọ ruo na-adịghị ala ala ịba ọcha ume, belatara agbasa olu ọbara. ) megide nzụlite nwere obere sodium chloride, afọ ọsịsa, vomiting ma ọ bụ ị diụ ọgwụ, hyperkalemia, hyponatremia, hyperaldost ronism n'oge emesịa ịwa ahụ akụrụ, ojiji nke ndị ọrịa nke agbụrụ Negroid.

Telzap, ntuziaka maka ojiji: usoro na usoro onunu ogwu

Miri mbadamba Telzap ka a na-ewere ọnụ mmiri nwere ọnụ zuru ezu, n'agbanyeghị nri.

Ọtụtụ ọgwụ ị theụ ọgwụ ahụ bụ oge 1 kwa ụbọchị.

Na-atụ aro dosing kwa ụbọchị:

• ọbara mgbali ọbara: usoro izizi bụ 20-40 mg. Na enweghị oge zuru oke hypotensive mgbe 28-56 ụbọchị ọgwụgwọ, enwere ike ịba ụba nke mbụ. Oke kachasị kwa ụbọchị bụ 80 mg. Dika ozo, egosiputara ngwakọta nke Telzap na thiazide diuretics (tinyere hydrochlorothiazide),
• mbelata onwu na ugboro ole ọrịa obi: 80 mg, na mbido ọgwụgwọ ọ dị mkpa ijikwa ọkwa ọbara mgbali. Ọ bụrụ na ọ dị mkpa, ekwesịrị idozi ọgwụ mgbochi.

Na mmebi akwara siri ike ma ọ bụ ndị ọrịa ịba ha n'ọbara, a na-atụ aro ka ha jiri ọgwụ izizi nke ụbọchị ọ bụla erughi 20 mg.

Maka ịrụ ọrụ ahazi oruru na-agbanwe agbanwe, ọchọghị usoro iji gbanwee ya.

Na obere ọrịa ịba ọcha n'anya na-agafe agafe (nhazi nke ụmụaka-Pugh nke klas A na B), kwa ụbọchị, Telzap agaghị agafe 40 mg.

Nsonaazụ

• nkwarụ izugbe: nke oge - asthenia, obi mgbu, ọ na - adịkarịghị - ọrịa na-efe efe,
• ọrịa na-efe efe na nje: na - adịghị ala ala - ọrịa urinary tract (gụnyere cystitis), ọrịa okuku ume na elu (gụnyere sinusitis, pharyngitis), adịkarịghị - sepsis (gụnyere ọnwụ),
• sitere na akwara obi: ugboro ugboro - bradycardia, hyperension orthostatic, mbelata ọbara mgbali elu, adịkarịghị - tachycardia,
• sitere na sisitemu ọbara na ọbara: adịkarịghị - anaemia, adịkarịghị - thrombocytopenia, eosinophilia,
• si dịghịzi usoro: adịghị - hypersensitivity mmeghachi omume, anaphylactic Jeremaya,
• sitere na psyche: enweghi oge - ịda mba, enweghi nsogbu, ura - nchekasị,
• site na akụkụ nke metabolism na nri nri: nke oge - hyperkalemia, adịkarịghị - hypoglycemia megide ọrịa shuga mellitus,
• site na akwara afọ: ugboro ugboro - mgbu afọ, ọgbụgbọ, dyspepsia, flatulence, afọ ọsịsa, adịkarịghị - akpọnwụ akpọnwụ, uto na-egbu mgbu, ahụ erughị ala na afọ,
• site na sistemụ ịba ọcha n'anya: adịkarịghị - mmebi imeju, nsogbu nke imeju.
• site na sistem ụjọ: nwa oge - ada mba, obere oge - ụra ụra,
• n’akụkụ akụkụ anụ ahụ na-anụ ihe, ọgba aghara labyrinth: ugboro ugboro - vertigo,
• na akụkụ ahụ nke ọhụụ: ọgba aghara a na-ahụ anya,
• site na sistem iku ume, obi na akụkụ akụkụ ahụ: n'ime oge - ụkwara, mkpụmkpụ ume, ọ dịkarịsịrị - ọrịa ngụgụ,
• mmeghachi omume nke akpụkpọ ahụ: ugboro ugboro - itching, ọnya anụ ahụ, hyperhidrosis, adịkarịghị - ọgwụ ọkụ, urticaria, erythema, eczema, akpukpo aru aru, angioedema (gụnyere nke na-egbu egbu)
• sitere na sistemụ urinary: ugboro ugboro - arụ ọrụ ezumike ọrụ na-arụ ọrụ nke ukwuu, akụrụ gbasara akụrụ,
• site na mọzụlụ na akwara anụ ahụ: adịghị ala ala - olu mgbu, azụ mgbu (sciatica), myalgia, adịkarịghị - mgbu na nsọtụ, ogbu na nkwonkwo, mgbu akwara (mgbu akwara dị ka ọrịa),
• ndị na-egosi ụlọ nyocha: ugboro ugboro - mmụba na plasma plainma, adịkarịghị - mbelata hemoglobin na plasma ọbara, mmụba na ọrụ nke enzyme hepatic na creatine phosphokinase, mmụba nke mkpokọta uric acid na plasma ọbara.

Dodoụbiga ya ókè

Mgbaàmà: mbelata nke ọbara mgbali, tachycardia, dizziness, bradycardia, ịba ụba nke serum creatinine, nnukwu gbasara akụrụ.

Ọgwụ: lavage gastric ozugbo, vomiting nke mmadụ, na-ewere unyi arụ ọrụ. E kwesịrị iji nlezianya nyochaa ịdị njọ nke mgbaàmà ya na ọnọdụ onye ọrịa ahụ. Denye symptomatic na nkwado ọgwụ. Ọ dị mkpa iji hụ na nyocha ọbara mgbe niile maka plasma electrolytes na creatinine. Site n'ịbelata ọbara mgbali elu, a ga-etinye onye ọrịa ahụ site n'ịwelite ụkwụ ya. Na-eme ihe omume iji mejupụta bcc na electrolytes.

Ojiji nke akụrụngwa akwara adịghị mma.

Ntụziaka pụrụ iche

Mgbe ị na-ahọpụta Telzap ndị ọrịa nwere akwara azụ akwara ma ọ bụ stenosis akwara nke akụrụ na-arụ ọrụ, ekwesịrị iburu n’uche na ị theụ ọgwụ ahụ nwere ike ibute oke nsogbu nke nnukwu akwara ike ọgwụgwụ na ọdịda akụrụ.

Bido gwọọ ọgwụ ọgwụ naanị mgbe ị kpochasịrị erughi bcc na / ma ọ bụ sodium dị na plasma ọbara.

A na-atụ aro iji Telzap na ndị ọrịa nwere ọrụ gbasara akụrụngwa ka a na-agbaso ya site na inyocha oge nke ọdịnaya potassium na creatinine na plasma ọbara.

Mgbochi nke RAAS (usoro renin-aldosterone-angiotensin) nwere ike ịdakwasị ndị ọrịa ahụ buru amụma na nke a ma na-ewere telmisartan na ndị ọzọ na-emegide RAAS. Ọ nwere ike ibute ọgbụgba akwara anụ ahụ, nkụda mmụọ, mmepe nke hyperkalemia, yana arụ ọrụ na-arụ ọrụ na-arụ ọrụ (gụnyere nnukwu gbasara akụrụ oke).

Na nkụda obi na-adịghị ala ala, ọrịa akụrụ, ma ọ bụ ọrịa ndị ọzọ nwere oke ịdabere na ọrụ RAAS, nchịkwa Telzap nwere ike ime ka mmepe nke nnukwu akwara hypotension, hyperazotemia, oliguria, na n'ọnọdụ ndị obere, nnukwu ọdịda gbasara akụrụ.

Na hyperaldosteronism bụ isi, ojiji nke ọgwụ adịghị arụ ọrụ.

N'oge ọgwụgwọ na telmisartan na ndị ọrịa na-arịa ọrịa shuga mellitus na-anata insulin ma ọ bụ onodu hypoglycemic na-arịa mmadụ, hypoglycemia nwere ike ime, ya mere achọrọ nlezianya ịchọrọ ọkwa glucose ọbara. Ọ bụrụ na ọ dị mkpa, ekwesịrị imeghari insulin ma ọ bụ ọgwụ hypoglycemic.

Ekwesịrị ilebara anya nke ọma ma ekwesịrị ilebara anya pụrụ iche mgbe a na-ekwupụta Telzap ndị ọrịa nwere oria akwara dịka ọdịda akwara, ọrịa shuga, ndị ọrịa na-a therapyụ ọgwụ ọgwụ na ọgwụ ndị na-akpata oke ụba nke potassium na plasma ọbara, ndị ọrịa agadi (karịa afọ 70), ebe ndị a ụdị dị iche iche nke ndị ọrịa nọ n'ihe egwu dị elu nke ịmalite hyperkalemia, gụnyere ọnwụ.

N'oge ịgwọ ọgwụ ahụ, otu oge nke ọgwụ ndị ọzọ ka aga-eme naanị dị ka dọkịta na-aga ya kwuru.

Mbelata nke ọbara mgbali elu n'oge ọrịa ischemic cardiomyopathy ma ọ bụ ọrịa obi obi nwere ike iduga mmepe nke infarction myocardial infarction ma ọ bụ ọrịa strok.

N'ime ndị ọrịa nke agbụrụ Negroid, a na-ahụta mbelata ọbara na-adịchaghị mma.

Ime na lactation

Ihe ndị dị na mbadamba ụrọ Telzap n'oge mmebi na inye ara na-egbochi imebi.

Mgbe emechara eziokwu nke ịtụrụ ime, ndị ọrịa na-a Telụ Telzap kwesịrị ịkwụsị ọgwụgwọ telmisartan ozugbo ma gbanwee usoro ọgwụgwọ ọzọ antihypertensive ọgwụ nwere profaịlụ nchekwa iji maka n'oge ime na lactation.

Na arụ ọrụ ezumike ọrụ

Ojiji nke Telzap bụ contraindicated na ndị ọrịa nwere akụrụ akwara (GFR erughị 60 ml / min / 1.73 m 2) ndị na-eji ọgwụ ahụ emekọ ihe ọnụ na aliskiren.

N'iji nlezianya mee, a ga-edobe Telzap maka ọrụ akụrụ nwere nsogbu, akwara akwara stenosis akwara akwara, arter stenosis nke naanị akụrụ na-arụ ọrụ.

Na mmebi akwara siri ike na ndị ọrịa ịba n'ọrịa ka a na-atụ aro ka ha jiri ọgwụ izizi nke ụbọchị ọ bụla erughi 20 mg.

Maka ịrụ ọrụ ahazi oruru na-agbanwe agbanwe, ọchọghị usoro iji gbanwee ya.

Na arụ ọrụ imeju

Nkwekọ nke Telzap maka ịgwọ ndị ọrịa nwere oke ịba ọcha n'anya (klas C dị ka nhazi nke nwatakịrị).

N'iji nlezianya mee, ekwesịrị iji mbadamba ụrọ na nwayọ nwayọ nwayọ gbadaa na-aga (obere klas ụmụaka A na B). Bọchị kwa ụbọchị nke telmisartan ekwesịghị gafere 40 mg.

Mkparịta ụka ọgwụ ọjọọ

Site n'otu oge a na-eji Telzap:

• aliskiren: n'ime ndị ọrịa nwere akwara akwara ma ọ bụ ọrịa mellitus, njikọta ọgwụ na telmisartan na aliskiren na-eduga na mgbochi abụọ nke RAAS, na-ebute mmụba ugboro ugboro nke ihe ọjọọ na ụdị artpot hypotension, hyperkalemia na arụ ọrụ ezigharị na-adịghị mma,
• ACE inhibitors: n'ime ndị ọrịa na-arịa ọrịa mamịrị nephropathy, ọgwụgwọ oge na ACE inhibitors na-akpata mgbochi abụọ nke RAAS, ya mere njikọta nke telmisartan na ACE inhibitors bụ,
• Mgbakwunye potassium-sparing diuretics (gụnyere spironolactone ,plepleone, amiloride, triamteren), mgbakwunye nri nwere potassium nke nwere mkpụrụ ọgwụ nnu na-adịghị steroidal, ọgwụ mgbochi mkpali (NSAIDs), heparin, cyclosporine, tacrolimus, trimethoprim: mụbaa ike hyperkalemia. Ọ bụrụ na ọ dị mkpa, iji nkwonkwo ahụ kwesịrị ilebara ọkwa nke ndọta potassium anya na plasma ọbara.
• digoxin: enwere mmụba na ngụkọta nke digoxin na plasma ọbara (C_max - 49%, C_min - site na 20%), yabụ, mgbe ị na-ahọrọ usoro nke telmisartan ma ọ bụ ịkwụsị ọrụ ya, ekwesịrị ilebara ọkwa nke digoxin na plasma ọbara, na-ezere oke ókè nke usoro ọgwụgwọ ya,
• ịkwado nke lithium: ekwesiri iburu n'uche na site na nzụlite nke usoro njikọta ọgwụ na antiotensin II receptor antagonists na ndị na-egbochi ACE, itinye uche nke lithium na plasma ọbara nwere ike ịbawanye ruo n'ọkwa nke nsonaazụ ya.
• NSAIDs na-ahọpụtaghị, acetylsalicylic acid (ọgwụ ndị a na-eji maka ọgwụgwọ mgbochi mkpali), cyclooxygenase-2 inhibitors (COX-2): na-enye aka na-eme ka ike gwụ ike nke telmisartan. Bụrụ na arụ ọrụ ezumike ezumike, nchikota ya na ndị na - egbochi COX-2 nwere ike ibute ndagwurugwu ọrụ akwara,
• diuretics: tupu usoro ọgwụgwọ nwere nnukwu ọgwụ thiazide na akaghị mmiri na-eme ka ohere nke hypovolemia na hypotension dị na mmalite nke ọgwụgwọ na telmisartan,
• ọgwụ ndị ọzọ na - egbochi ọgwụ ike: welie mmetụta nke telmisartan,
• antidepressants, ethanol, barbiturates, ọgwụ ọjọọ: na-abawanye ihe ọghọm orthostatic hypotension,
• corticosteroids maka iji usoro: na-eme ka ike gwụ ike nke mmetụta dị egwu nke Telzap.

Analogs nke Telzap bụ: Telmista, Mikardis, Telsartan, Telpres.

Nhazi ọkwa nosological (ICD-10)

Na-egosi Telzap ®

mbelata onwu na ọrịa obi na ndị okenye:

- yana ọrịa obi nke ọrịa atherothrombotic sitere (ọrịa obi na-efe efe, ọrịa strok ma ọ bụ akụkọ banyere akwara akwara).

- nwere ụdị ọrịa shuga mellitus nke 2 nwere ihe mebiri emebi.

Ime na lactation

Ugbu a, ozi a pụrụ ịdabere na nchekwa nke telmisartan na ụmụ nwanyị dị ime adịghị. N'ime ọmụmụ anụmanụ, achọpụtawo nsị na ọgwụ ọjọọ nke ọgwụ. A machiri iji Telzap ® n'oge afọ ime (lee “Contraindications”).

Ọ bụrụ na ọ dị mkpa iji ogologo oge agwọ ọrịa na Telzap ®, ndị ọrịa na-eme atụmatụ ịtụrụ ime kwesịrị ịhọrọ ọgwụ mgbochi antihypertensive ọzọ nwere profaịlụ nchekwa pụtara iji maka n’oge ime. Mgbe emechara eziokwu banyere afọ ime, a ga-akwụsị ọgwụgwọ na Telzap immediately ozugbo a ga-amalite ọgwụgwọ ọzọ ma ọ bụrụ na ọ dị mkpa.

Dị ka nsonaazụ nke nyocha ụlọ ọgwụ gosipụtara, ojiji nke ARA II na ọkara nke afọ atọ na nke III nwere afọ ojuju na nwa ebu n'afọ (ọrụ ezigharị ọrụ, oligohydramnios, igbu oge okpokoro isi) na nwa amụrụ ọhụrụ (ọdịda akụrụ, ọdịda hypotension na hyperkalemia). Mgbe ị na-eji ARA II n’oge ọnwa nke abụọ nke ịtụrụ ime, a na-atụ aro ultrasound nke akụrụ na okpokoro isi nke nwa ebu n’afọ.

Shouldmụaka ndị nne ha buru ARA II n’oge a dị ime ha kwesịrị ka ejiri nlezianya na-enyocha ha.

Ihe omuma banyere ojiji nke telmisartan n'oge inye umu ara adighi adi. Telnara Telzap ® n'oge ị na-a breastụ ara na - egbochi ọgwụ (lee "Contraindications"), a ga - eji ọgwụ antihypertensive ọzọ nwere profaịlụ nchekwa ka mma, ọkachasị mgbe ị na - enye nwa amụrụ ọhụrụ ma ọ bụ amụtabeghị nwa.

Mmekorita

Ihe mgbochi abụọ nke RAAS. A na - eme contrainditant nke telmisartan na aliskiren n'ime ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m 2) na akwadoghị ndị ọrịa ndị ọzọ.

Inye aka nke telmisartan na ACE inhibitors na-abụkarị ndị ọrịa nwere ọrịa nephropathy (lee "Contraindications").

Nnyocha ọmụmụ gosipụtara na mgbochi abụọ nke RAAS n'ihi ojiji nke ACE inhibitors ejikọtara ọnụ, ARA II, ma ọ bụ aliskiren jikọtara ya na mmụba nke ihe omume dịka artpot hypotension, hyperkalemia, na ọrụ ịgbazigharị arụmọrụ (gụnyere nnukwu gbasara gbasara akụrụ), ma e jiri ya tụnyere naanị otu ọgwụ eme ihe na RAAS.

Ihe ọghọm nke ịbawanye hyperkalemia nwere ike ịba ụba mgbe ejiri ọgwụ ndị ọzọ nwere ike ibute hyperkalemia (mgbakwunye nri nri na mgbakwunye nnu nke nwere potassium, spredinolactone, eplerenone, triamterene ma ọ bụ amiloride), NSAIDs, gụnyere nhọrọ COX-2 inhibitors, hepari , immunosuppressants (cyclosporine ma ọ bụ tacrolimus) na trimethoprim.Ọ bụrụ na ọ dị mkpa, megide ndabere nke akwụkwọ hypokalemia, ọgwụ ejikọtara ọnụ kwesịrị ịme. kpachara anya ma na-enyocha ihe ndị dị na potassium n'ime plasma ọbara.

Digoxin. Site na njikọta nke telmisartan na digoxin, agara ịrị elu na C_max plasma digoxin na 49% na C_min site na 20%. Na nmalite ọgwụgwọ, mgbe ị na-ahọrọ otu ọgwụ na ịkwụsị ọgwụgwọ na telmisartan, a ga-elezi anya itinye uche nke digoxin na plasma ọbara iji kwado ya n'ime usoro ọgwụgwọ ahụ.

Mkpụrụ ọgwụ na-eme ka ọ̀ na-egbu puruum ma ọ bụ na-enwe ihe oriri na-eme ka ihe ndị ọzọ na-edozi ahụ. ARA II, dika telmisartan, na -ebelata mmebi nke potassium nke diuretic kpatara. Ihe ndị na-enye ume n’ahụ́ bekee na-eme ka ihe n’ahụ bụrụ potassium, dịka ọmụmaatụ spironolactone, eplerenone, triamteren ma ọ bụ amiloride, mgbakwunye nri nwere nri ma ọ bụ nnọchi nnu nwere ike ibute oke ihe na potassium n’ime plasma ọbara. Ọ bụrụ na egosiputara iji ihe oriri, ebe enwere hypokalemia edepụtara, ekwesịrị iji ha kpachara anya ma megide ngbanyechi mgbe niile ilekọta potassium na plasma ọbara.

Nkwadebe Lithium. Mgbe emechara lithium ya na ndị mgbochi ACE na ARA II, gụnyere telmisartan, mmụba na-emetụta ọnya mmiri nke lithium na nsonaazụ ya. Ọ bụrụ na ịchọrọ iji ọgwụ a jikọtara ọnụ, a na-atụ aro ka ị jiri nlezianya nyochaa oke nke lithium na plasma ọbara.

Ndị NSAID. NSAIDs (i.e., acetylsalicylic acid na doses eji maka ọgwụgwọ mgbochi, COX-2 inhibitors na NSAIDs na-adịghị ahọrọ) nwere ike ịkụda mmetụta antihypertensive nke ARA II. N’ebe ụfọdụ ndị ọrịa nwere nsogbu gbasara akụrụngwa (dịka ọmụmaatụ, ịhydụ mmiri, ndị ọrịa nwere nsogbu gbasara akụrụngwa), jikọtara ọnụ nke ARA II na ọgwụ ndị na-egbochi COX-2 nwere ike ibute mmebi nke ọrụ akụrụ, gụnyere mmepe nke nnukwu gbasara akụrụ, nke, dịka iwu, agbanwee. Ya mere, ejikọtara ọgwụ ọnụ ka akpachara anya jiri nlezianya mee ya, ọkachasị ndị agadi. Ọ dị mkpa iji hụ na a ga-enyocha mmiri kwesịrị ekwesị, na mgbakwunye, na mmalite nke ijikọ ọnụ na oge ụfọdụ n'ọdịnihu, a ga-enyocha ihe ndị na-egosi ọrụ akụrụ.

Diuretics (thiazide ma ọ bụ akaghị). Ọgwụ gara aga nwere nnukwu ọgwụ mkpịsị akwara, dị ka furosemide (loop diuretic) na hydrochlorothiazide (thiazide diuretic), nwere ike ibute hypovolemia na nsogbu nke hypotension na mbido ọgwụgwọ na telmisartan.

Ọgwụ ndị ọzọ na - alụ ọgụ. Enwere ike imeziwanye mmetụta nke telmisartan site na iji ọgwụ ndị ọzọ na - egbochi ihe mgbochi. Dabere na Njirimara ọgwụ nke baclofen na amifostine, enwere ike iche na ha ga-ebulite mmetụta ọgwụgwọ nke ọgwụ niile na - egbochi ọgwụ, gụnyere telmisartan. Na mgbakwunye, hypotension orthostatic nwere ike ịbawanye na mmanya, barbiturates, ọgwụ, ma ọ bụ ọgwụ antidepressants.

Corticosteroids (maka iji usoro). Corticosteroids na-ebelata ike nke telmisartan.

Usoro onunu ogwu na nhazi

N'ime, otu ugboro n'ụbọchị, were mmiri mmiri sachaa ya, n'agbanyeghị nri ị na-eri.

Ọbara ọbara. Usoro izizi nke Telzap ® bụ 1 mbadamba. (40 mg) otu ugboro n'ụbọchị. Patientsfọdụ ndị ọrịa nwere ike ịnwe nnabata 20 mg / ụbọchị. Enwere ike inweta 20 mg site na ịkekọrịta mbadamba 40 mg na ọkara n'ihe ize ndụ. N'ọnọdụ ebe enweghị ọgwụgwọ ọgwụgwọ, enwere ike ịba ụba dose a tụrụ aro nke Telzap ® ka ọ bụrụkarị 80 mg otu ugboro n'ụbọchị. Dika ozo, enwere ike iburu Telzap combination yana thiazide diuretics, imaatu, hydrochlorothiazide, nke, mgbe ejikọtara ya, nwere ihe mmetuta ozo.

Mgbe ị na-ekpebi ma ịbawanye ọgwụ ahụ, ekwesịrị iburu n'uche na mmetụta antihypertensive kachasị na-arụkarị n'ime izu 4-8 mgbe mmalite nke ọgwụgwọ.

Na-ebelata na ọnwụ na ugboro nke ọrịa obi. Usoro akwadoro nke Telzap ® bụ 80 mg otu ugboro n'ụbọchị. N'oge izizi ọgwụgwọ, a na-atụ aro ilegide ọbara mgbali anya; enwere ike ịchọ mgbazi ọgwụgwọ antihypertensive.

Onu ogugu ndi mmadu puru iche

Alrụ ọrụ na-arụ ọrụ na ụlọ. Ahụmịhe na telmisartan na ndị ọrịa nwere nnukwu akụrụ okpu ma ọ bụ ndị ọrịa na-agwọ ọrịa metụtara akwara dị oke. A na-atụ aro ka ndị ọrịa a obere mbido ọgwụ nke 20 mg / ụbọchị (lee. "Ọgwụ pụrụ iche"). Maka ndị ọrịa nwere nnukwu ọrụ mkpado na-adịghị ala ala, a naghị achọ ndozi ya. A na - eme contraindicated na Telzap ® na aliskiren n'ime ndị ọrịa nwere ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m 2) (lee. "Contraindications").

A na - eme contraindicated na Telzap ® na ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy (lee "Contraindications").

Ọrụ imeju na-arụ ọrụ. A na - akpọ Telzap ® n'ime ndị ọrịa nwere nnukwu ọrịa ịba ọcha n'anya (Nwa-Pugh klas C) (lee "Contraindications"). N'ime ndị ọrịa nwere obere ịba ọcha n'anya ruo na obere (klaasị A na B dị ka nhazi nke ụmụaka-Pugh, dị iche iche), a na-enye ọgwụ ahụ ka ọ kpachara anya, ọnye ahụ agaghị agafe 40 mg otu ugboro n'ụbọchị. "Jiri nlezianya").

Agadi. Maka ndị ọrịa agadi, ọ chọghị ime mgbanwe dose.

Umuaka na umuaka. A na - ekwekọrịta ojiji nke Telzap ® n'ime ụmụaka na ndị nọ n'afọ iri na asatọ n'ihi enweghị nchekwa na arụmọrụ dị mma (lee "Contraindications").

Emeputa

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

Mpaghara Kucukkaryshtyran, St. Merkez, Nke 223 / A, 39780, Buyukkaryshtyran, Luleburgaz, Kırklareli, Turkey.

Onye jidere asambodo idebanye aha. Sanofi Russia JSC. 125009, Russia, Moscow, ul. Tverskaya, 22.

Ekwesịrị izipu maka ịdị mma nke ọgwụ ahụ na adreesị nke Sanofi Russia JSC: 125009, Russia, Moscow, ul. Tverskaya, 22.

Tẹ.: (495) 721-14-00, faksị: (495) 721-14-11.

Weputara udi ya na ihe mebere ya

Ọ dị n'ụdị mbadamba. Mbadamba ụrọ nke ọ bụla nwere 0.04 ma ọ bụ 0.08 g nke telmisartan nke nọ n'ọrụ.

Ọzọkwa, ngwá ọrụ gụnyere ihe ndị dị otú a:

• meglumine
• sorbitol
• sodium hydroxide
• povidone
• nnu magnesium.

Mbadamba ụrọ dị mbadamba iri.

Mbadamba ụrọ dị mbadamba iri.

Omume ọgwụ

Ọgwụ a sitere n'aka ndị na-emegide ndị anakpo angiotensin ΙΙ. Etinyere ya dịka otu esi ejikwa ọnụ mee ihe. Na-egosiputa angiotensin ΙΙ, anaghị anabata kọntaktị ya na ndị na-anabata ya. Ọ na ejikọ na AT I angiotensin рецеп receptor, a na-ekwuputakwa njikọ a ugboro ugboro.

Ọgwụ na -ebelata mkpụkọ aldosterone na plasma na-ebelatalata nsonaazụ renin. Anaghị egbochi ọwa ion. Anaghị egbochi usoro ACE njikọta. Ngwongwo ndị dị otú a na-enyere aka izere mmetụta ndị na-adịghị mma ị fromụ ọgwụ.

A Tụ ọgwụ na ọgwụ nke 0.08 g na-ewepụ ọrụ nke angiotensin ΙΙ. N'ihi nke a, enwere ike ị drugụ ọgwụ ahụ iji lebara ọbara mgbali elu. Ọzọkwa, mmalite nke ụdị ihe ahụ na-amalite awa 3 mgbe nchịkwa ọnụ gasịrị.

Mmetụta ọgwụ ahụ na-adịgide maka otu ụbọchị mgbe nchịkwa, ka bụ nke a na-ahụ maka ụbọchị 2 ọzọ.

Mmetụta hypotensive na-adịgide adịgide na-ebilite n'ime izu anọ mgbe ịmalite ọgwụgwọ.

Mgbe kwụsịrị ọgwụ ahụ, ndị na-egosi nrụgide na-eji nwayọọ nwayọọ laghachi n'ọnọdụ mbụ ha na-enweghị ngosipụta nke mgbaàmà mgbapụta.

Ọbara ọbara

Ọgwụ mbụ a tụrụ aro Telzap bụ 40 mg (1 mbadamba) otu ugboro n'ụbọchị. Somefọdụ ndị ọrịa, ị theụ ọgwụ ahụ n'ihe dị ka 20 mg kwa ụbọchị nwere ike ịdị irè. Enwere ike inweta 20 mg site na ịkekọrịta mbadamba 40 mg na ọkara n'ihe ize ndụ. N'ọnọdụ ebe enweghị ọgwụgwọ ọgwụgwọ, enwere ike ịba ụba dose a tụrụ aro nke Telzap ruo 80 mg otu ugboro n'ụbọchị.

Dika ozo, enwere ike iburu Telzap yana aru oyuzu nke thiazide, dika imaatu hydrochlorothiazide, nke, mgbe ejikọtara ya, nwere uto antihypertensive. Mgbe ị na-ekpebi ma ịbawanye ọgwụ ahụ, ekwesịrị iburu n'uche na mmetụta antihypertensive kachasị na-arụkarị n'ime izu 4-8 mgbe mmalite nke ọgwụgwọ.

Ahụmịhe na telmisartan na ndị ọrịa nwere nnukwu akụrụ okpu ma ọ bụ ndị ọrịa na-agwọ ọrịa metụtara akwara dị oke. A na-atụ aro ndị ọrịa a obere mbido ọgwụ nke 20 mg kwa ụbọchị. Maka ndị ọrịa nwere nnukwu ọrụ mkpado na-adịghị ala ala, a naghị achọ ndozi ya.

A na-egbochi contraccantant nke Telzap na aliskiren n'ime ndị ọrịa nwere ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ ahụ dị elu).

Inwe oge eji eme Telzap ya na ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy.

Ekwesịrị iji nlezianya debe ndị ọrịa nwere nsogbu imeju dị nro na nke kwesịrị ekwesị (klas A na B), ọgwụ ekwesịghị ịkarị 40 mg otu ugboro n'ụbọchị. A na-eke Telzap na ndị ọrịa nwere nnukwu ahụ ọria ya ịba ọcha n'anya (klas C dịka nhazi nke nwatakịrị).

N'ime ndị ọrịa agadi, anaghị achọ mmegharị dose.

Telzap gbakwunyere

Were ọnụ, otu ugboro n'ụbọchị, were mmiri mmiri sachaa ya, n'agbanyeghị nri ahụ.

Ndị ọrịa nke enweghị ike ịchịkwa BP nke ọma na monotherapy na telmisartan ma ọ bụ hydrochlorothiazide kwesịrị ịnara Telzap Plus.

Tupu ịgbanwee nha nha maka oge edobere, a na-atụ aro itinye otu ụzọ maka nkeji ọ bụla. N'ọnọdụ ụfọdụ, a pụrụ ịtụle mgbanwe site na monotherapy gaa ọgwụgwọ yana nchikota nke ịke.

Enwere ike iji ọgwụ a bụ Telzap Plus otu ugboro n'ụbọchị maka ndị ọrịa nke enweghị ike ịchịkwa ọbara mgbali ya nke ọma mgbe ha na-ewere telmisartan na ọgwụ 80 mg kwa ụbọchị.

Ngwakọta na ụdị ntọhapụ

N'izu ahia taa bu uzo ogwu abuo di iche na ihe ndi ozo.

Ngwakọta nke mbadamba Telzap gụnyere ihe ndị mejupụtara: telmisartan 40 na 80 mg.

Ihe mebere mbadamba nkume nke Telzap Plus gụnyere:

• ihe eji arụ ọrụ: telmisartan - 80 mg, hydrochlorothiazide - 12.5 mg,
• ihe ndi ozo: sorbitol - 348.3 mg, sodium hydroxide - 6.8 mg, povidone - 25.4 mg, magnesium stearate - 4.9 mg.

Gịnị na-enyere Telzap aka?

Dabere na ntuziaka maka ojiji a na-enye ọgwụ a maka ndị nwere oke ọbara mgbali elu.

Isi ihe eji egosi ogwu a:

• IHD n’ime ndị ọrịa karịrị afọ 55.
• Dịka akụkụ nke usoro ọgwụgwọ siri ike ma ọsịsọ ọrịa strok.
• Mgbochi nsogbu sitere na obi na arịa ọbara gbasara ọrịa shuga nke 2.
• Nnukwu ọbara mgbali elu - dị elu karịa 140/90 maka ụdị dị oke mkpa ọbara mgbali.
• Mgbochi ọrịa nke usoro obi.
• Mgbochi nke ọnwụ n'ihi ọgụ ọgụ na ọrịa na ọrịa (maka mgbochi nke nkụchi obi, ọnya obi, nkụchi obi na nsonaazụ na-egbu egbu).

Dị Mkpa! Dọkịta ga-ekpebi na ọ ga-achọ ka e nye ya ọgwụ ọgwụ. Onweghi ogwu zuru oke.

Ọbara mgbali elu

Edere usoro ị theụ ọgwụ ahụ dabere na nchoputa A na-atụ aro ka ịmalite ọgwụgwọ nke ọbara mgbali elu site na ị were mbadamba ọgwụ 1 kwa ụbọchị (40 mg). Patientsfọdụ ndị ọrịa na-ejikwa nweta mmetụta ha chọrọ mgbe ha na-eri 20 mg / ụbọchị. Iji nara ọgwụ nke 20 mg, o zuru ezu iji kee mbadamba 40 mg na akụkụ abụọ.

Ọ bụrụ na enweghi ike ị nweta nsonaazụ achọrọ ọbụlagodi mgbe ị na-ewere 40 mg, dọkịta nwere ike inye onye ọrịa ahụ ọgwụ kachasị, i.e. 80 mg.

Ọ bụrụ na achọrọ, enwere ike ijikọ ọgwụ ahụ na thiazide diuretics, nke nwere mmetụta antihypertensive ọzọ, dịka ọmụmaatụ, hydrochlorothiazide.

Mgbe ị na-ekpebi ịbawanye dose, ịkwesịrị ịtụle: mmetụta kachasị mma nke antihypertensive na-etolite mgbe ọnwa 1-2 gasịrị.

Mbelata na onwu, ọnụ ọgụgụ ọrịa obi

N'okwu a, a na-atụ aro ị theụ ọgwụ ahụ na 80 mg / ụbọchị. Na mmalite ọgwụgwọ, ịkwesịrị inyocha ọbara mgbali elu ma, ọ bụrụ na ọ dị mkpa, mee mgbanwe na usoro ọgwụgwọ.

Ahụmahụ nke iji Telzap na ndị mmadụ na-arịa ọrịa metụtara ọrịa ma ọ bụ na-ata ahụhụ oke akụrụ oke nwere oke. Ọgwụ izizi maka ndị ọrịa dị otú a abụghị ihe karịrị 20 mg / ụbọchị. Ọ bụrụ na mmadụ nwere erughị ala ma ọ bụ na-enwe ọfụma nke ọrụ akụrụngwa, a naghị ebelata dose ahụ.

• Na ọdịda akụrụ na ọrịa mamịrị nephropathy, ojiji ihe myiri ojiji nke Telzap na Aliskiren bụ contraindicated.
• N’ime ọrịa imeju dị nnukwu, e deghị ọgwụ. Ojiji nke Telzap na oke ọgbụgba imeju dị nfe ma dịkwa nfe ga - ekwe omume na ọgwụ ruru 40 mg / ụbọchị.

Ndị okenye anaghị achọ mgbanwe onwongodu.

Mmetụta ọgwụ

Ọgwụ Telzap dị irè karị. Site na ịkpọtụrụ ndị na-anabata ya, ọgwụ ahụ na-egbochi nke ikpeazụ, na-egbochi ihe ndị ọzọ nwere ibu ọrụ maka ịba ụba ọbara mgbali (BP) "ịrụ ọrụ ha."

N'ime ndị ọrịa nwere ọbara mgbali elu, mbadamba ihe na-ebute mbelata ọbara mgbali elu, ma diastolic na systolic. N'okwu a, ọgwụ anaghị emetụta ọnụego obi.

Maka mbadamba ihe, mwepu ọrịa abụghị ihe njiri mara. Site na iji mbadamba ọgwụ wee belata usoro ọgwụgwọ, ndị na - egosi ọbara mgbali jiri nwayọ laghachi ọkwa ha gara aga ụbọchị ole na ole sochirinụ.

Omume nke Telzap yiri ka antihypertensive mmetụta nke ọgwụ ndị ọzọ, a yiri ihe si na klas ndị ọzọ - Enalapril, Lisinopril, wdg.

Nsonaazụ

N'agbanyeghị ịdị elu ya dị mma, ọgwụ nrụgide Telzap nwere ọtụtụ nsonaazụ:

• Ngbanwe nke akụrụ na akụrụ
• iro ụra
• ọgbụgba, nkụda mmụọ na-adị obere oge.
• ibelata na haemoglobin na platelet,
• na-abawanye potassium na ọbara,
• akwara na mgbu
• nsogbu digestive, mgbanwe uto, ịmụba mmanụ,
• mbelata obi,
• rashes, friza, akpụkpọ ahụ,
• ike ọgwụgwụ nke mmụọ, ụjọ na-atụkarị
• ibelata glucose ịta,
• ntị anụrị.

Onye ọrịa ahụ ga-akpachara anya nyochaa ọnọdụ ya. Ọdịdị nke mgbanwe ọ bụla na-adịghị mma na ahụ nwere ike igosipụta arụmọrụ adịghị mma.

Analogs nke ọgwụ Telzap

Maka ọgwụgwọ, edepụtara ọgwụ analogues na ihe mejupụtara:

1. Ochichi
2. Telsartan
3. Telsartan H,
4. Telmisartan
5. Telpres
6. Itinye
7. Telmista
8. Tanidol
9. Telpres Plus,
10. Mikardis,
11. Mikardis Gụnyere,
12. Telzap gbakwunyere.

Ndị na-emegide Angiotensin 2 na-emegide analogues:

1. Sartavel
2. Presartan,
3. Mikardis,
4. Lozarel
5. Tweensta
6. Artinova,
7. Ndi Exfotans,
8. Ike
9. Firmast
10. Irbesartan
11. Lorista
12. Telmisartan
13. Ngọngọ
14. Valz N,
15. Ibertan
16. Cozaar
17. Nkọwapụta
18. Cardosten
19. Losartan
20. Naviten
21. Brozaar
22. Coaprovel
23. Lozap Plus,
24. Valz
25. Lozap,
26. Telsartan
27. Aprovel
28. Cardomin
29. Tareg
30. Telpres
31. Ordiss
32. Olimestra
33. Nortian
34. Candecor
35. Duopress,
36. Vasotens,
37. Izar
38. Gizaar
39. Zisakar
40. Edarby
41. Valsacor
42. Hyposart,
43. Losartan n
44. Azu,
45. Ochichi
46. Candesartan
47. Diovan
48. Gụrụ
49. Eprosartan Mesylate,
50. Cardos,
51. Cardosal
52. Ngalaba Exforge,
53. Karzartan
54. Xarten
55. Losacor
56. Aha ya bụ Valsartan
57. Tanidol
58. Atacand
59. Vamloset.

Ọnọdụ pụrụ iche

Na ọnụnọ nke ihe ndị a, naanị ọkachamara ruru eru nwere ike ịkọ ọgwụ ahụ ma gbakọọ usoro ọ ga-esi:

• Nnukwu akụrụ arụ. Maka ndị ọrịa nwere obere arụ ọrụ akụrụ, a chọghị ndozi pụrụ iche. Agbanyeghị, ọ bụrụ na enwere nnukwu nsogbu gbasara akụrụ, usoro ọgwụgwọ kwesiri ka belata 20 mg. Ọ bụrụ na onye ọrịa ahụ nọ n'ọrịa metụtara akwara ụkwụ, ekwesighi ịhapụ Telzap.
• Ọria mamiri Ọgwụ na-ebelata glucose ọbara, yabụ ndị ọrịa kwesịrị ịdị na-atụle ọkwa shuga ha mgbe niile.
• Cardiomyopathy, mbelata nke aortic ma ọ bụ mitral valves. Telzap ga-agbasa oghere nke arịa ahụ, yabụ ndị ọrịa nwere ụdị ọrịa a chọrọ njikwa ọgwụgwọ pụrụ iche.
• Ihe mgbochi abụọ nke RAAS. Mgbochi nke RAAS ga - eduga nbelata ike nke ọbara mgbali elu, ịba ụba mmepụta nke potassium na mgbochi nke ọrụ akụrụ.
• Ọbara mgbali elu. Ọrịa ọgbụgba na-apụta mgbe ọbara na - agbagha n'ihi ọbara nke akwara. Mgbe ị na-a theụ ọgwụ, ọdịda akụrụ nwere ike ime.
• Ọrịa imeju na-arụ ọrụ. Maka nrụrụ hepatic na-agafeghị oke, a chọghị ndozi dose. N'iji ọrịa ọrịa siri ike, amachibidị mbadamba osisi amachibidoro.

Ọnụahịa na usoro ezumike

Ihe ngwungwu ọkọlọtọ nke Telzap 40 mg na Moscow na-efu 380 rubles. Maka ọgwụ na okpukpu abụọ nke usoro ọgwụ ọgwụ dị mkpa ka ị kwụọ ụgwọ 435 rubles. Enwere ike ịzụta mbadamba nkume site na ndị na-ere ọgwụ na ọgwụ.

Ogwu Telzap nke nkuzi a na-atụ aro ka edobe ya ka ọ ghara iru ụmụaka ruru afọ abụọ. Ka mbadamba osisi ahụ ghara imebi ihe ha nwere, ọ dị mkpa ka ị nyochaa ọnọdụ ikuku dị n'ime ụlọ ahụ. Ọ gaghị agafe ogo 25.

Ngwakọta na nkọwa

Mbadamba 80 mg: telong, mbadamba biconvex site n’ihe fọrọ nke nta ka ọ bụrụ na-acha ọcha na-acha odo odo na agba nwere “80” a na-ete n’otu akụkụ.

Mbadamba 80 mg ọ bụla nwere:

• ihe na-arụ ọrụ: telmisartan - 80,000 mg,
• ndị na-enye ọgwụ: meglumine - 24,000 mg, sorbitol - 324,400 mg, sodium hydroxide - 6,800 mg, povidone 25 - 40,000 mg, magnesium stearate - 4,800 mg.

Ọbara Mgbali Dị Mkpa

N'ime ndị ọrịa, telmisartan na ọgwụ nke 80 mg kpamkpam egbochi mmetụta ọbara mgbali nke angiotensin II. A na-ahụ mmalite mmalite nke ọgụ ọgwụ mgbochi n'ime awa 3 mgbe nchịkwa izizi nke telmisartan. Mmetụta nke ọgwụ ahụ na-adịgide ruo awa 24 ma na-adị ọrịka dị ka awa 48. Mmetụta antihypertensive na-ebikarị izu anọ 4-8 mgbe ị regularụsịrị ya.

N'ime ndị ọrịa nwere ọbara mgbali elu, telmisartan lowers systolic na ọbara mgbali ọbara (BP) na-enweghị emetụta mmetụ obi (HR).

N'ihe banyere njiri siri ike nke telmisartan, ọbara mgbali ji nwayọọ nwayọọ na-alaghachikwa n'ọkwa mbụ ya karịa ọtụtụ ụbọchị na-enweghị mmepe nke ọrịa "ndọrọpụ".

Dika nsonaazụ nke ihe omumu ihe omumu gosiputara, mmetụta antihypertensive nke telmisartan nwere ike imetụta mmetụta antihypertensive nke ọgwụ nke klas ndị ọzọ (amlodipine, atenolol, enalapril, hydrochlorothiazide na lisinopril).

Ọnụnọ nke okpukpu okpukpu dara nke ukwu na telmisartan ma e jiri ya tụnyere ndị na-egbochi ACE.

Mgbochi Ọrịa Obi

Ndị ọrịa dị afọ iri ise ma ọ bụ karịa nwere ọrịa obi, ọrịa strok, ọrịa ọnụnọ, ọrịa ọgụ, ma ọ bụ nsogbu nke ọrịa shuga 2 (dịka ọmụmaatụ, retinopathy, hypertrophy ekpe, macro- ma ọ bụ microalbuminuria) na akụkọ ihe mere eme nke ihe egwu obi. emume-egwu, telmisartan nwere mmetụta yiri nke ramipril n'ibelata njedebe ejikọtara ọnụ: mkpụrụ ndụ akwara sitere na infarction myocardial na-enweghị nsonaazụ na-egbu egbu, ọrịa strok. enweghị ọnwụ ma ọ bụ ụlọ ọgwụ n'ihi na-adịghị ala ala obi ọdịda.

Telmisartan rụpụtara ọrụ dị ka ramipril n'ibelata ugboro ole isi ihe: ọnwụ obi, infarction myocardial na-adịghị egbu egbu. A naghị akọwakarị ọkọchị akpịrị na angioedema na telmisartan ma e jiri ya tụnyere ramipril, ebe hypotension arterial na-adịkarịkarị na telmisartan.

Egwu

Mgbe etinyere ya, a na-etinye telmisartan ngwa ngwa site na eriri afọ. Bioavailability bụ 50%. Mgbe ewere nri n'otu oge, mbelata na AUC (mpaghara dị n'okpuru usoro ịta ahụhụ) sitere na 6% (na dose 40 mg) ruo 19% (na dose 160 mg). Mgbe awa 3 gachara nlekọta ahụ, a na-etinye uche ịta ahụ na plasma ọbara n’onweghị onwe, a na-ewere telmisartan n’otu oge ahụ ka nri ma ọ bụ. Enwere ọdịiche na mkpokọta plasma na ụmụ nwoke na ụmụ nwanyị. Stach (ntinye kachasị) na AUC dị ihe dịka ugboro atọ na ugboro abụọ, otu n'otu, ọ kachasị elu na ụmụ nwanyị ma e jiri ya tụnyere ụmụ nwoke na-enweghị nnukwu mmetụta na arụmọrụ.

Enweghị mmekọrịta kwụ ọtọ n'etiti ị theụ ọgwụ ahụ yana ịta ụbara plasma ya. Stach na, ruo ntakịrị dị nta, AUC na-abawanye nke ukwuu na ịba ụba dose ahụ mgbe ị na-eji ọgwụ dị elu karịa 40 mg kwa ụbọchị.

Metabolism

A na-agagharị ya site na conjugation na glucuronic acid. Na conjugate enweghị ọrụ ọgwụ.

Ọkara ndụ (T. / 2) karịrị awa 20. Ọ gafere site na eriri afọ na - agbanweghi, site na akụrụ ya - erughi 1%. Nchịkọta zuru oke nke plasma dị elu (ihe dị ka 1000 ml / min) ma e jiri ya tụnyere ọbara ọbara "ọria" (ihe dị ka 1500 ml / min).

Ihe ngosiputa eji eji mbadamba 80 mg Telzap bu:

• ọbara mgbali elu,
• mbelata onwu na ọrịa obi na ndị okenye nwere ọrịa obi nke ọrịa atherothrombotic sitere (IHD, ọrịa strok ma ọ bụ akụkọ banyere akwara akwara) yana ụdị ọrịa shuga 2 nke ọrịa mebiri emebi.

Jiri nlezianya

Ekwesịrị iji ọgwụ ndị Telzap dezie ya na ọnọdụ ndị a:

• Stenosis abụọ akụrụngwa akwara ma ọ bụ stenosis nke otu akụrụ na-arụ ọrụ,
• ọrụ ezughi oke,
• obere ịba ọcha n'anya.
• mbelata n'ọbara ọbara (BCC) megide nrịgo iribiga nri nke gara aga, mgbochi nke sodium chloride, afọ ọsịsa ma ọ bụ vomiting,
• hyponatremia,
• hyperkalemia
• Ọnọdụ mgbe akụrụgharị akụrụ (enweghị ahụmịhe iji ya),
• obi ike ọgwụgwụ,
• stenosis nke aortic na valvụ valve,
• ike obara nke obara,
• isi hyperaldosteronism (oru adighi na nchekwa guzobere)

Ndị ọrịa nwere ọrụ mgbazinye nsogbu

Ahụmịhe na telmisartan na ndị ọrịa nwere nnukwu akụrụ okpu ma ọ bụ ndị ọrịa na-agwọ ọrịa metụtara akwara dị oke. A na-atụ aro ka ndị ọrịa a obere mbido ọgwụ nke 20 mg kwa ụbọchị (lee mpaghara "Nlekọta pụrụ iche"). Maka ndị ọrịa nwere nnukwu ọrụ mkpado na-adịghị ala ala, a naghị achọ ndozi ya.

Ikwe ntinye ọnụ nke Telzap na aliskiren bụ contraindicated na ndị ọrịa nwere ọdịda akụrụ.

Inwe oge eji eme Telzap ya na ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy.

Ndị ọrịa nwere ọria imeju

A na-eke Telzap na ndị ọrịa nwere nnukwu ahụ ọria ya ịba ọcha n'anya (klas C dịka nhazi nke nwatakịrị). N'ime ndị ọrịa nwere obere ịba ọcha n'anya ruo na obere (klaasị A na B dị ka nhazi ụmụaka-Pugh, dị iche iche), a na-eji ọgwụ akpachara anya iji ọgwụ ahụ, ọnụọgụ ekwesịghị ịfe 40 mg otu ugboro n'ụbọchị.

Ime

Ugbu a, ozi a pụrụ ịdabere na nchekwa nke telmisartan na ụmụ nwanyị dị ime adịghị. N'ime ọmụmụ anụmanụ, achọpụtawo nsị na ọgwụ ọjọọ nke ọgwụ. Ihe eji eme Telzap contraindicated n'oge ime (lee mpaghara “Contraindications”).

Ọ bụrụ na ọ dị mkpa ịgwọ ọrịa ogologo oge na Telzap, ndị ọrịa na-eme atụmatụ ịtụrụ ime kwesịrị ịhọrọ ọgwụ mgbochi ọgwụ ọzọ na profaịlụ nchekwa enwetara maka iji n'oge afọ ime. Mgbe emechara eziokwu banyere afọ ime, a ga-akwụsị ọgwụgwọ na Telzap ozugbo, ma ọ bụrụ na ọ dị mkpa, ekwesịrị ịmalite usoro ọgwụgwọ ọzọ.

Dị ka nsonaazụ nke nyocha ụlọ ọgwụ gosipụtara, ojiji nke ARAP n'oge ọnwa nke abụọ na nke atọ nke afọ ime nwere mmetụta na-egbu egbu na nwa ebu n'afọ (ọrụ ezigharị nke arụ ọrụ, oligohydramnios, igbu oge okpokoro isi) na nwa amụrụ ọhụrụ (ọdịda akụrụ, ọdịda hypotension na hyperkalemia). Mgbe ị na-eji ARAN n’oge ọnwa nke abụọ nke ịtụrụ ime, a na-atụ aro inyocha ultrasound nke akụrụ na okpokoro isi nke nwa ebu n’afọ.

Shouldmụaka ndị nne ha buru ọgwụ ARAP n'oge afọ ime kwesịrị ka ejiri nlezianya nyochaa ha niile.

Oge ara

Ihe omuma banyere ojiji nke telmisartan n'oge inye umu ara adighi adi. Telnara Telzap n'oge inye ara ara, a ga-eji usoro ọgwụ mgbochi ọzọ nke nwere ezigbo nchekwa nchekwa, ọkachasị mgbe ị na-enye nwa amụrụ ọhụrụ ma ọ bụ amụtaghị nwa.

Mmetụta akụkụ

N'oge ị Orụ ọgwụ Ordiss, mmetụta ndị ọzọ ga-ekwe omume:

• Ọrịa na-efe efe na nje: na - adịghị ala ala - ọrịa urinary tract, gụnyere cystitis, ọrịa akụkụ okuku ume na elu, gụnyere pharyngitis na sinusitis, adịkarịghị - sepsis.
• Site na sistemụ hemopoietic: nwa oge - anaemia, adịkarịghị - eosinophilia, thrombocytopenia.
• Site na usoro ahụ ji alụso ọrịa ọgụ: adịkarịghị - mmeghachi omume anaphylactic, hypersensitivity.
• Site n'akụkụ nke metabolism: ugboro ugboro - hyperkalemia, adịkarịghị - hypoglycemia (na ndị ọrịa nwere ọrịa mellitus).
• Nsogbu uche: n ’enweghị oge - ehighi ura, ịda mba, na - adịkarịghị - ụjọ.
• Site na sistem ụjọ: nwa oge - ada mba, obere oge - ụra ụra.
• Site n'akụkụ akụkụ ahụ nke ọhụụ: a na - adịghị ahụkebe - mgbarụ anya.
• N'akụkụ akụkụ nke ntị ịnụ na nsogbu labyrinth: ugboro ugboro - vertigo.
• Site na usoro obi: ugboro ugboro - bradycardia, mbelata ọbara mgbali elu, orthostatic hypotension, adịkarịghị - tachycardia.
• Site na usoro iku ume: obere oge - ume iku ume, ụkwara, adịkarịsịrị - ọrịa ngụgụ.
• Site na eriri afọ: ugboro ugboro - mgbu afọ, afọ ọsịsa, dyspepsia, flatulence, vomiting, adịkarịghị - akpọnwụ akpịrị, ahụ erughị ala na afo, imebi ihe ụtọ.
• Site na imeju na traktị nke biliary: adịkarịghị - arụ ọrụ imeju / mmebi imeju.
• N’akụkụ anụ ahụ na akwara dị n’okpuru: n’oge na - adịghị mma - itching skin, hyperhidrosis, friji akpụkpọ, adịkarịghị - angioedema (yana egbu egbu), eczema, erythema, urticaria, fashfish ọgwụ, ihe nfụkasị anụ ahụ.
• Site na usoro akwara: n'adịghị ala - mgbu azụ (sciatica), olu mgbu, myalgia, adịkarịghị - arthralgia, ihe mgbu na aka, ihe mgbu na akwara (ihe mgbawara dịka akwara).
• Site na sistemụ urinary: ọrụ obere ọrụ na-arụ ọrụ akwara, gụnyere nnukwu akụrụ gbasara akụrụ.
• Na mpaghara nyocha na akụrụngwa: ugboro ugboro - mmụba na mkpokọta nke creatinine na plasma ọbara, adịkarịghị - mbelata ọdịnaya nke hemoglobin, mmụba nke ọdịnaya uric acid na plasma ọbara, mmụba na ọrụ nke enzymes imeju na CPK.
• Ndị ọzọ: oge ​​na - adịghị ala ala, mgbu obi, asthenia, adịkarịghị - ọrịa na-efe efe.

Ihe mgbochi abụọ nke RAAS

Oge telmisartan na aliskiren ma ọ bụ ọgwụ nwere aliskiren bụ contraindicated na ndị ọrịa na-arịa ọrịa shuga mellitus na / ma ọ bụ agafeghị oke na nnukwu akụrụ odida (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ elu ahụ) na akwadoghị ndị ọrịa ndị ọzọ.

A na - egbochi contraindial iji telmisartan na ACE inhibitors na ndị ọrịa nwere ọrịa nephropathy na - akwadoghị maka ndị ọrịa ndị ọzọ.

Omumu ihe omumu gosiputara na okpukpu abuo nke RAAS site na iji oru ACE inhibitors, angiotensin II antagonor antagonist, ma obu aliskiren nwere otutu ihe nke ihe ojoo dika akwara hypotension, hyperkalemia, na oru mkpuru akuko (tinyere akuko gbasara akwara). ọgwụ na-eme ọgwụ na RAAS.

Hyperkalemia

Ihe ọghọm nke ịba hyperkalemia nwere ike ịbawanye elu mgbe ejiri ọgwụ ndị ọzọ nwere ike ime ka hyperkalemia (mgbakwunye nri nri na mgbakwunye nnu nke nwere potassium, spredinolactone, eplerenone, triamterene ma ọ bụ amiloride), NSAIDs (gụnyere nhọrọ COX-2 inhibitors) , heparin, immunosuppressants (cyclosporine ma ọ bụ tacrolimus) na trimethoprim).

Ọnọdụ nke hyperkalemia sitere na ihe ndị dị n'ihe ize ndụ metụtara. Ọba ka a na-abawanye mgbe ị na - eji mkpokọ ndị dị n’elu, ọ kachasị elu mgbe ejiri ya mee ihe n’otu oge na -echekarị ọgwụ potassium na nnu nnu nwere potassium. Ojiji telmisartan na ACE inhibitors ma ọ bụ NSAID nwere ihe ọghọm ma ọ bụrụ na-akpachapụ anya.

Ọrụ imeju na-arụ ọrụ

Ojiji nke Telzap bụ contraindicated na ndị ọrịa nwere cholestasis, mgbochi nke biliary ma ọ bụ ọrụ imeju na-arụ ọrụ nke ọma (Child-Pugh klas C), ebe ọ bụ na telmisartan kachasị na bile. Ekwenyere na n'ime ndị ọrịa dị otú a, a na-ebelata mkpochapu hepatic nke telmisartan. N'ime ndị ọrịa nwere ogo imeju dị nwayọ ma ọ bụ na-agafe agafe (klas A na B dabere na nhazi nke Child-Pugh), ekwesịrị iji nlezianya mee ihe Telzap.

Mbelata ọbara dị ala (BCC)

Sympotomatic artpot hypotension, ọkachasị mgbe nchịkwa izizi mbụ gasịrị, nwere ike ịdakwasị ndị ọrịa nwere BCC dị ala na / ma ọ bụ sodium na plasma ọbara na-emegide usoro ọgwụgwọ gara aga yana mmachi, mmachi na iri nnu, afọ ọsịsa ma ọ bụ vomiting.

Ọnọdụ ndị yiri ya (mmiri na / ma ọ bụ ụkọ sodium) kwesịrị iwepụ tupu iwere Telzap.

Ọnọdụ ndị ọzọ metụtara mkpali nke RAAS

N'ime ndị ọrịa olu vaskụla olu na akụrụ ọrụ ya dabere na ọrụ RAAS (dịka ọmụmaatụ, ndị ọrịa nwere ọrịa obi na-adịghị ala ala ma ọ bụ ọrịa akụrụ, gụnyere ọrịa akwara ma ọ bụ stenosis nke otu akụrụ), iji ọgwụ na-emetụta usoro a, enwere ike ijikọ ya na mmepe nke hypotension hypotension, hyperazotemia, oliguria, na n'ọnọdụ ndị obere, nnukwu ọdịda akwara.

Mmetụta ikike ịkwọ ụgbọala

Eduzi omumu ihe omumu nke puru iche iji hu ihe ogwu riri na ike inya ugboala. Mgbe ị na-anya ma na-arụ ọrụ n'ụba ndị chọrọ nlebara anya nlebara anya, ekwesịrị ịkpachara anya, ebe ọ bụ na ure na ura nwere ike ọ gaghị adịkarị site na iji Telzap.

Childrenmụaka, n’oge ime na lactation

Enweghị ozi a pụrụ ịdabere na ya banyere nchekwa nke ọgwụ a n'oge afọ ime. Ọ bụrụ na onye ọrịa ahụ na-eme atụmatụ ịtụrụ ime, na ọ kwesiri ị medicineụọ ọgwụ iji belata nrụgide ahụ, a na-atụ aro ị takeụ ọgwụ ndị ọzọ.

Ojiji nke ọgwụ site na otu nke inhibitors, angiotensin antagonists na ọkara nke abụọ na nke atọ na - enye aka na mmepe nke mmebi akụrụ, imeju, igbu oge nke okpokoro isi nke nwa ebu n’afọ, oligohydramnion (mbelata oke nke mmiri ọmụmụ).

Iji ọgwụ eme ihe n'oge a na-enye nwa ara machibidoro iwu.