Ọgwụ Ibertan: ntuziaka maka ojiji

Aha mba ofesi - ibertan gbakwunyere

Ngwakọta na ụdị ntọhapụ.

Mbadamba ihe eji etinye fim, mbadamba 1 nwere hydrochlorothiazide - 12.5 mg, irbesartan - 150 mg.

Mbadamba ụrọ mkpuchi ihe nkiri, 12.5 mg + 150 mg: 28 ma ọ bụ 30 PC.

7 pcs - blisters (4) - ngwugwu nke kaadiboodu.
10 PC. - blisters (3) - ngwugwu nke kaadiboodu.
14 pi. - blisters (2) - ngwugwu nke kaadiboodu.
15 PC. - blisters (2) - ngwugwu nke kaadiboodu.

Omume ọgwụ.

Ibertan Plus bụ ọgwụ ejikọtara ọnụ na mmetụta antihypertensive. Ihe mejupụtara a gụnyere antagonensin II receagonor antagonist na thiazide diuretic. Njikọ ọgwụ ndị a nwere mmetụta ọgwụ mgbochi na-agbakwunye, na-ebelata ọbara mgbali elu ka ukwuu karịa ọgwụ ọ bụla iche.

Irbesartan bụ onye na-ahọta onye nnabata angiotensin II (ụdị AT1) maka nchịkwa ọnụ. Irbesartan na-egbochi mmetụta physiologically n'ụzọ dị egwu nke angiotensin II nke ndị nabatara AT1 na-agbagha, n'agbanyeghị isi iyi ma ọ bụ ụzọ njikọta nke angiotensin II. Nhọrọ antagonensin II (AT1) na-anabata ndị na-anabata ihe na-eduga n'ịba ụba nke mkpokọta plasma nke renin na angiotensin II na mbelata mkpokọta aldosterone na plasma ọbara. Ihe ndị dị na soda a anaghị agbanwe agbanwe nke ukwuu mgbe ị na-ewere irbesartan na usoro a tụrụ aro ya; irbesartan adịghị egbochi kininase II. Irbesartan achọghị ka ọ rụọ ọrụ metabolism. Na-ebelata ọbara mgbali elu na obere mgbanwe n'ọbara obi.

Hydrochlorothiazide bụ thiazide diuretic. Ọ na-emetụta nlọghachi nke electrolytes na tọọles akụrụ, na-abawanye mkpachapụ nke sodium na lorlor ion dị mkpo nha. Mmetụta diuretic nke hydrochlorothiazide na-eduga n'ịbelata ọkwa plasma ọbara, mmụba nke ọrụ renin na plasma ọbara, mmụba na nzuzo nke aldosterone na mmụba nke ọdịnaya ion potassium na bicarbonates na mmamịrị na hypokalemia. Nlekọta nke otu oge na irbesartan na-eduga na mbelata nke ion potassium, nke kachasị n'ihi mgbochi nke sistemụ renin-angiotensin-aldosterone. Mgbe ejiri ọnụ na-akpọ hydrochlorothiazide, mmụba nke diuresis na-apụta mgbe elekere abụọ gachara wee rute karịa mgbe awa anọ gachara. Ihe hydrochlorothiazide dị ihe dị ka awa 6-12.

Mbelata ọbara mgbali elu mgbe ị na-edepụta irbesartan na hydrochlorothiazide apụtalarị mgbe mbụ ị theụ ọgwụ ahụ n'ime ya wee nọrọ ruo izu 1-2, na-esochi mmụba ya na mmụba nke mmepe kachasị na izu 6-8.

Mlọ ọgwụ.

Nlekọta nke hydrochlorothiazide na irbesartan anaghị emetụta ọgwụ ọgwụ nke ọgwụ ọ bụla.

Egwu. Mgbe nchịkwa ọnụ gachara, bioavailability zuru oke nke irbesartan bụ 60-80%, hydrochlorothiazide 50-80%. Iri nri anaghị emetụta ndu ha. A na-enweta Cmax nke irbesartan na plasma ọbara mgbe awa 1.5-2 gachara site na nchịkwa ọnụ, hydrochlorothiazide - mgbe awa 1-2.5 gasịrị.

Nkesa. Ndi protein protein plasma nwere 96%. Olu nke nkesa (Vd) nke irbesartan bụ lita 53-93. Usoro ọgwụ irbesartan dị larịị bụ nke kwụụrụ agbakwunyere na oke nke oke sitere na 10 mg ruo 600 mg. Na usoro onunu ogwu kariri 600 mg (otu ugboro okpukpu abụọ a na-atụ aro ka ọ were maka ya), ọgwụ ọgwụ nke irbesartan na-aghọ ndị na-abụghị ahịrị (belata na ntinye).

Hydrochlorothiazide bụ 68% jikọtara protein protein, V d - 0.83-1.14 l / n'arọ.

Metabolism. A na-agunye Irbesartan n'ime imeju site na njikọta glucose na acid. Ya isi metabolite na-ekesa n'ime ọbara bụ irbesartan g.tukuronid (ihe dị ka 6%). Ọmụmụ akwụkwọ Invitro egosila na irbesartan na-enyocha sọlfọ nke tumadi site na CYP2C9 isoenzyme nke cytochrome P450. Nsonaazụ nke CYP3A4 isoenzyme bụ nke ileghara anya.

Hydrochlorothiazide adịghị metabolized. Penetrates site na placental ihe mgbochi ma pụọ ​​na mmiri ara. Ọ dịghị agafe mgbochi ụbụrụ ọbara.

Ojiji. Mkpokọta mkpochapụ na mkpochapụ bụ 157-176 na 3.0-3.5 ml / min, n'otu n'otu. T1 / 2 nke irbesartan bụ awa 11-15. A na-ahụpụta Irbesartan na metabolites ya na eriri afọ (80%) yana akụrụ (20%). ihe na-erughị 2% nke irbesartan iwere bụ nke akụrụ na-agbanweghi.

T 1/2 hydrochlorothiazide - awa 5-15. Ọ bụ ụmụ akụrụ wepụta ya. Opekata mpe, iri isii na isii nke ọgwụ a na-apughi ịgbanwe agbanwe n'ime awa iri abụọ na anọ.

Pharmacokinetics n'ihe gbasara ọrịa. A na-ahụkarị ọkwa plasma nke irbesartan na ndị ọrịa nwanyị. Ka osi di, achoputaghi ihe di iche na T1 / 2 nke irbesartan. Uzo a ghaghi imeghari udiri irbesartan na ndi oria nwanyi.

Thekpụrụ ndị a dị n'okpuru usoro ịta ahụhụ (AUC) na C max nke irbesartan na plasma ọbara dịtụ elu na ndị ọrịa agadi (karịa afọ 65) karịa ndị okenye na-arịa ọrịa (ndị dị afọ 65). T 1/2 irbesartan adịchaghị iche. Ọchọghị ịmegharị irbesartan n'ime ndị ọrịa agadi.

Renrụ ọrụ ezumike arụrụ ọrụ: na ndị ọrịa nwere ọrụ ezumike arụ ọrụ ma ọ bụ na-anabataghị usoro akụrụngwa, a na-agbanwe ntakịrị ọgwụ ọgwụ nke irbesartan.

Ọrụ imeju na - arụ ọrụ: n'ime ndị ọrịa nwere ọrụ imeju na - arụ ọrụ nke ịdị nwayọọ ma ọ bụ agafeghị oke, a na - agbanwe ntakịrị ọgwụ ọgwụ nke irbesartan. N'ime ndị ọrịa nwere nnukwu ọrụ imeju, enweghị nnyocha emere.

Ọbara mgbali elu (ọgwụgwọ ndị ọrịa gosipụtara ọgwụgwọ ịgwọ ọrịa).

Usoro ọgwụgwọ usoro na usoro iji Ibertan gbakwunyere.

N'ime, otu ugboro n'ụbọchị, n'agbanyeghị nri ị na-eri. Ibertan Plus 12.5 / 150 mg (mbadamba nwere hydrochlorothiazide / irbesartan 12. 5/150 mg, n'otu n'otu) ka a ga-enye ndị ọrịa ọgwụ mgbali ọbara ọfụma nke ọma site na nhọpụta naanị hydrochlorothiazide (12.5 mg / ụbọchị) ma ọ bụ irbesartan ( 150 mg / ụbọchị) na monotherapy. A pụrụ inye ndị ọrịa ọgwụ Ibertan Plus 12.5 / 300 (mbadamba nwere hydrochlorothiazide / nrbesartan 12.5 / 300, karị) ma ọ bụrụ na irbesartan (300 mg / ụbọchị) ma ọ bụ Ibertan Plus (12, 5/150 mg).

A pụrụ inye ndị ọrịa Ibertan Plus 25-300 mg (mbadamba nwere hydrochlorothiazide / irbesartan 25/300 mg, n'otu n'otu) ka ndị ọrịa ma ọ bụrụ na nchịkwa nke Ibertan Plus (12. mg 5/300 mg). A naghị atụ aro ịhọpụta doses karịa 25 mg nke hydrochlorothiazide / 300 mg nke irbesartan 1 otu oge kwa ụbọchị. Ọ bụrụ na ọ dị mkpa, enwere ike ịcribedụ ọgwụ Ibertan Plus na njikọ ọgwụ ndị ọzọ na - egbochi ọgwụ mgbochi.

Renrụ ọrụ ezumike mkpirikpi: n'ihi eziokwu ahụ na nchịkọta nke ọgwụ Ibertan Plus gụnyere hydrochlorothiazide. a naghị akwado ọgwụ ahụ maka ndị ọrịa nwere nnukwu akụrụ oke (mwepu nke 30 ml / min.) arụ ọrụ imeju: a naghị atụ aro iji ọgwụ Ibertan Plus na ndị ọrịa nwere nnukwu ịba ọcha ọria. Achọghị ọgwụ Ibertan Plus Ndị okenye mepere emezi: a chọghị ịhazi Ibertan Plus na ndị ọrịa agadi .. Mbelata olu nke inye ọbara: tupu Na Ibertan Plus, ọ dị mkpa iji dozie olu nke inye ọbara na / ma ọ bụ ọdịnaya sodium.

Mmetụta akụkụ ibertana gbakwunyere.

Enyere mmetụta ndị a na-esote dabere na ihe ndị a na-esote gram nke ugboro ole ha na-eme: ọtụtụ mgbe (> 1/10), ọtụtụ mgbe /> 1/100, 1/1 000, 1/10 000, 30 ml / min.

Ojiji nke ogwu n’ime umuaka.

Contraindicated n'ime ụmụaka na-erubeghị afọ 18.

Jiri ndị ọrịa agadi.

Enweghị mmezi ọgwụ Ibertan Plus na ndị ọrịa agadi chọrọ.

Ntụziaka pụrụ iche maka nnabata ibertana gbakwunyere.

Ndị ọrịa nwere ike ịda mba na mbelata ọbara: n'ime ndị ọrịa nwere ọbara mgbali elu, Ibertan Plus adịkarịghị ebute ọbara ọgbụgba Symptomatic. A na-ahụ hypotension Symptomatic artpot hypotension na ndị ọrịa nwere mbelata ọbara dị ala ma ọ bụ ọdịnaya sodium dị ala n'oge ọgwụgwọ diuretic, yana nri nwere mmachi nnu, yana afọ ọsịsa ma ọ bụ vomiting. A ga-emezi ọnọdụ ndị ahụ tupu ịmalite ọgwụgwọ Ibertan Plus.

Ọ na-ahụkarị ọgwụ metabolism na endocrine. Thiazndic diuretics nwere ike belata nnabata glucose. N'ime ndị ọrịa nwere ọrịa shuga, ọ ga-adị mkpa ịgbanwe mgbanwe insulin ma ọ bụ ọgwụ hypoglycemic maka nchịkwa ọnụ. Site na iji thiazide diuretics, mmepe nke ọrịa shuga mellitus latent ga-ekwe omume.

N'oge ọgwụgwọ na thiazide diuretics, hyperuricemia ma ọ bụ iwe ọkụ nke gout nwere ike ime na ụfọdụ ndị ọrịa.

Mmebi nke mmiri-electrolyte itule. Thiazide diuretics, tinyere hydrochlorothiazide. nwere ike ibute mmebi nke mmiri-electrolyte (hypokalemia, hyponatremia na hypochloremic alkalosis). Ọ bụ ezie na mmepe nke hypokalemia ga-ekwe omume na nsị nke thiazide, iji ya na irbesartan nwere ike belata hypokalemia kpatara diuretic kpatara. Ewu nke hypokalemia na-abawanye na ndị ọrịa na-anata glucocorticosteroids ma ọ bụ hormone adrenocorticotropic. Kama nke ahụ, ekele irbesartan, nke bụ akụkụ nke nkwadebe Ibertan Plus, hyperkalemia ga-ekwe omume, ọkachasị na ọnụnọ nke akụrụ itu na / ma ọ bụ nkụda obi ma ọ bụ ọrịa shuga mellitus. A na-atụ aro ka a na-ahụ maka ịgbanye ọgwụ potassium n'ụfọdụ ndị ọrịa nọ n'ihe egwu.

Ọrịa akụrụngwa Thiazide nwere ike belata akụrụ kalsia nke kalsia ma mee ka hypercalcemia dị mkpụmkpụ na-enweghị enwetara metabolism na-emetụta. Nnukwu hypercalcemia siri ike nwere ike igosi hyperparathyroidism latent. Ekwesịrị ịkwụsị diski Thiazide tupu ọmụmụ banyere ọrụ parathyroid.

Egosiwo ya na akwara di ya na thiazide nwere ike iwelite mkpirisi nke akionium ion site na akụrụ, nke nwere ike iduba mmepe nke hypomagnesemia.

Ọbara mgbali elu. N'ime ndị ọrịa nwere akwara mkpụrụ ndụ akwara stenosis ma ọ bụ stenosis akwara nke naanị akụrụ na-arụ ọrụ, mgbe ị na-a drugsụ ọgwụ ọjọọ nke na-emetụta RAAS, enwere ohere dị ukwuu nke ịmalite hypotension akwara na ọdịda akwara. Ọ bụ ezie na achọtaghị data dị otú ahụ mgbe ị na-ewere Ibertan Plus, enwere ike ịtụ anya mmetụta yiri nke a n'oge ndị na-emegide antiotensin II antagonist.

Ọdịda ntaramahụhụ na ọnọdụ mgbe akụrụ akụrụ. N'ihe banyere iji ọgwụ ọjọọ eme ihe bụ Ibertan Plus na ndị ọrịa nwere ọrụ mkpo ya na-arụ ọrụ, a na-egosipụta nyocha nke ọdịnaya nke potassium, creatinine na uric acid n'ime ọbara ọbara. Enweghị ahụmịhe banyere iji Ibertan Plus na ndị ọrịa mgbe mmịnwụ akụrụ na-adịbeghị anya.

Aortic ma ọ bụ mitral valve stenosis, hypertrophic na-egbochi cardiomyopathy. Dị ka ọ dị n'iji ndị vasodilata ndị ọzọ, a chọrọ ịkpachara anya mgbe ị na-edebanye aha ndị ọrịa Ibertan Plus ka ọ bụrụ ndị nwere ọrịa aortic ma ọ bụ mitral stenosis ma ọ bụ ndị na-egbochi cardiomyopathy hypertrophic.

Isi hyperaldosteronism. Ọgwụ antihypertensive na-arụ ọrụ site na mgbochi nke sistemụ renin-angiotensin-aldosterone na-adịkarị arụ ọrụ na ndị ọrịa nwere ọrịa hyperaldostronism. Ya mere, iji ọgwụ ọjọọ eme ihe bụ Ibertan Plus n'ọnọdụ ndị ahụ enweghị isi.

Ule ule: hydrochlorothiazide nwere ike ibute nsonaazụ dị mma n'oge nchịkwa doping.

Ndị ọzọ. Dị ka ọgwụ ndị ọzọ na-egbochi ọgwụ na-emetụta usoro renin-angiotensin-aldosterone, mbelata ọbara mgbali elu na ndị ọrịa nwere ọrịa obi na / ma ọ bụ atherosclerosis nke arịa ụbụrụ nwere ike iduga mmepe nke infarction myocardial ma ọ bụ ọrịa strok. Ekwesịrị iji ayodiin gwọọ ndị ọrịa dị otú a ma ọ bụrụ na njikwa ike nke ọbara mgbali kwesịrị.

Enwere akụkọ banyere mkpagbu ma ọ bụ njọ nke sistemụ lupus erythematosus n'oge a na-ahọpụta ọgwụ thiazide.

Mmetụta ikike ịkwọ ụgbọ ala ma jiri usoro rụọ ọrụ

Achoghi uto Ibertan Plus na ikike igha ugbo ala na oru ndi choro nlebara anya. Agbanyeghị, n'oge ị drugụ ọgwụ ahụ, a ga-akpachara anya mgbe ị na-anya ụgbọ ala ma jiri usoro rụọ ọrụ, ebe ọ bụ na n'oge nsogbu ike ọgwụgwụ na ike ọgwụgwụ ike kwere omume.

Dodoụbiga ya ókè.

Mgbaàmà (a na-enyo enyo): irbesartan - mbelata ọbara mgbali, tachycardia, bradycardia. Hydrochlorothiazide - hypokalemia, hyponatremia, akpịrị ịkpọ nkụ n'ihi oke diuresis. Ihe ngosi a na - ahụkarị maka ịdoụbiga mmanya ókè bụ ọgbụgbọ na ụra. Hypokalemia nwere ike iduga nkwarụ na / ma ọ bụ mmepe nke ọrịa arrhythmias jikọtara ya na ojiji nke glycosides cardiac na ọgwụ antiarrhythmic.

Ọgwụgwọ: Nke a dabere na oge gafere kemgbe oge nchịkwa na ogo ihe mgbaàmà ahụ. Usoro ndị a tụrụ aro gụnyere iwebata ọgbụgbọ na / ma ọ bụ eriri afọ, ojiji nke carbon na-arụ ọrụ, nlezianya banyere ọnọdụ onye ọrịa, yana usoro ọgwụgwọ na usoro nkwado. Ọ dị mkpa ịchịkwa ịta nke electrolytes na creatinine na plasma ọbara. Ọ bụrụ na mmepe nke mmụba dị ọbara nke ukwuu, a ga-atọrịrị onye ọrịa ahụ na azụ ya ma bulie ya elu ozugbo o kwere omume iji mezuo ụgwọ nnu na mmiri. Achọpụtabeghị Irbesartan n'oge usoro ọgwụgwọ.

Mmekọrịta na ọgwụ ndị ọzọ.

Ọgwụ ndị ọzọ na - egbochi mmiri ara: Enwere ike ịkwalite mmetụta antihypertensive nke ọgwụ Ibertan Plus site na iji concoitant ọgwụ ndị ọzọ antihypertensive ọgwụ. Enwere ike iji Hydrochlorothiazide na irbesartan (na doses ruo 25 mg nke hydrochlorothiazide / 300 mg nke irbesartan) n'enweghị nsogbu na ngwakọta ndị ọzọ antihypertensive, gụnyere ngwa ngwa ndị na-egbochi calcium na mgbochi beta. Ọgwụ ịba ọcha n'anya nwere mbụ nwere ike ibute ọgbụgbọ ma bulie ihe ọghọm ọgbụgba.

Lithium: Enwere akụkọ banyere mmụba a na-atụgharị anya na nchịkọta lithium serumum na ihe na-egbu egbu yana ijikọtara nkwadebe lithium na ndị na-egbochi enzyme enzyme. Maka irbesartan, ụdị mmetụta a adịkarịbeghị ụnọdụ taa. Na mgbakwunye, mwepụ nke akụrụngwa lithium na-ebelata site na iji thiazide diuretics, yabụ mgbe edepụtara Ibertan Plus, enwere ohere dị elu nke ịmalite uto nsị lithium. Ọ bụrụ na ebumnuche nke njikọ a dị mkpa, a na-atụ aro iji nlezianya nyochaa ọdịnaya lithium dị na ọbara ọbara.

Ọgwụ ndị na-emetụta potassium n’ime ọbara: mmetụta hypokalemic nke hydrochlorothiazide na-akụda ike site na mkpụrụ ọgwụ na-akpata irbesartan.Agbanyeghị, enwere ike ịkwalite mmetụta a nke hydrochlorothiazide site na ọgwụ ndị ọzọ, ebumnuche nke ejikọtara ya na ọnwụ nke potassium na gnococalpemia (dịka ọmụmaatụ, diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, ihe ndị na-eme ka salicylic acid) Kama nke ahụ, dabere na ahụmịhe nke iji ọgwụ na-ebelata ihe omume ijegharị. usoro angiotensin-aldosterone, ojiji nke potassium-sparing. x dpureshkov. mgbakwunye oyologically na-arụ ọrụ, nnọchi nnu nnu, ma ọ bụ ọgwụ ndị ọzọ nwere ike ibute mmụba na potassium serum (dị ka sodium heparin) nwere ike ime ka mmụba na ọbara Katya. A na-atụ aro maka nleba anya kwesịrị ekwesị nke potassium serum n'ime ndị ọrịa nwere ihe ize ndụ nke hyperkalemia.

Ọgwụ ndị ọ na-emetụtaburu na nguzobe potassium na ọbara ọbara: A na-atụ aro ka ejiri nlezianya nyochaa ihe ndị dị na potassium na ọbara ọbara mgbe edepụtara Ibertan Plus yana ọgwụ ndị na-emetụta mmebi nke nguzo ọka potassium na ọbara ọbara (dịka ọmụmaatụ, cardiac glycosides, ọgwụ antiarrhythmic).

Ọgwụ mgbochi mkpali na - achọghị ọgwụ: mgbe ị na-ede ọgwụ antagonist angotensin II na ọgwụ mgbochi na-abụghị nke steroidal na mgbochi mkpali (dịka ọmụmaatụ, yana nhọrọ cyclooxygenase-2 inhibitors (COX-2), acetylsalicylic acid (> 3 g / day) na ọgwụ mgbochi na-abụghị steroidal anti-inflammatory ọgwụ), na-akụda ike mmetụta antihypertensive. Dị ka iji nke angiotensin n'ịtụgharị enzyme inhibitors na angiotensin II receptor antagonists na NSAIDs, enwere ọghọm nke ọrụ ezigharị adịghị arụ ọrụ, ruo na mmepe nke nnukwu gbasara akụrụ na-ada mba, ụba potassium serum, ọkachasị ndị ọrịa nwere ọrụ mkpado arụ ọrụ ugbua. Ekwesịrị iji nlezianya kee ọgwụ a, ọ kachasị ndị ọrịa. Ndi oria ekwesighi ka akpachapu ha anya. Ekwesịrị igosipụta usoro ntaramahụhụ mgbe mmalite nke usoro njikọta ọgwụ na oge n'ọdịnihu.

Ihe omuma ndi ozo banyere nmekorita ogwu nke irbesartan: hydrochlorothiazide anaghị emetụta ọgwụ ọgwụ nke irbesartan. Mgbe ị na-edepụta irbesartan na jikọtara warfarin, metadolized site induce CYP2C9 isoenzyme, achọpụtaghị mmekọrịta dị iche iche nke ọgwụ na ọgwụ. Ntinye ihe omumu nke CYP2C9 isoenzyme, dị ka rifampicin, na pharmacokinetics nke irbesartan enyochabeghị. Site na nhọpụta nke irbesartan yana digoxin, ọgwụ ọgwụ nke ikpeazụ agbanweghị.

Ihe omuma ndi ozo banyere mmekorita ogwu nke hydrochlorothiazide:

Ọgwụ ndị a nwere ike ịmekọrịta ihe gbasara thiazide diuretics mgbe ị na-ede akwụkwọ:

Etaniol, barbiturates ma ọ bụ ọgwụ ọjọọ: enwere ike ịhụ hypotension orthostatic mụbara.

Catecholamines (dịka ọmụmaatụ, norepinephrine): ịdị irè nke ọgwụ ndị a nwere ike belata.

Ihe na - emegharị ahụ adịghị mma (dịka ọmụmaatụ tubocurarine): hydrochlorothiazide nwere ike ime ka ihe ndị mmadụ na-eme ghara ime ka ike gwụ nro.

Ọgwụ hypoglycemic (ihe ndị na-egbu mmụọ na insulin): enwere ike ịchọ nhazi nke hypoglycemic na-elekọta mmadụ.

Colestyramine na colestipol: n'ihu ọnụnọ mgbanwe nke anion, mmiri nke hydrochlorothiazide na-ama jijiji. Oge dị n'etiti ị drugsụ ọgwụ ndị a kwesịrị ị dịkarịa ala 4 awa.

Glucocorticosteroids, hormone adrenocorticotropic: akara akara nke mmiri mmiri elektrik, ọkachasị, mụbara hypokalemia.

Ọgwụ mgbochi gout: Enwere ike ịchọ mgbazi nke ọtụtụ ọgwụ ejiri iji gwọọ gout, ebe hydrochlorothiazide nwere ike ịbawanye ọdịnaya nke uric acid na plasma ọbara. Enwere ike ịbawanye elu na dose nke probenenide ma ọ bụ sulfinpyrazone. Njikọ ọnụ na thiazide diuretics nwere ike ịbawanye nrịba nke hypersensitivity mmeghachi omume na allopurinol.

Calcium nnu: thiazide diuretics nwere ike ịbawanye ụrọ nke plasma n'ihi nkwụsị ya. Ọ bụrụ na ọ dị mkpa ịdebe mmeju nke calcium ma ọ bụ ọgwụ ndị na-emetụta ọdịnaya calcium (dịka ọmụmaatụ, vitamin D), ọ dị mkpa iji dozie dose nke ọgwụ ndị a otu yana ịchịkwa ọdịnaya calcium na plasma ọbara.

Typesdị mmekọrịta ọgwụ ndị ọzọ: thiazide diuretics nwere ike iwelie mmetụta hyperglycemic nke beta-blockers na diazoxide. Anticholinergics (wdg., Atropine) nwere ike iwelie bioavailability nke ọrịa dihiaiti thiazide site na mbenata akwara na mbuze afọ. Thiazide diuretics nwere ike ịbawanye ohere nke mmeghachi omume ọjọọ nke amantadine kpatara. Ihe akwara nke Thiazide nwere ike belata oke ọgwụ ọgwụ cytotoxic site na akụrụ (dịka ọmụmaatụ, cyclophosphamide, methotrexate) ma nwee ike myelosuppressive mmetụta ha.

Ọnọdụ ezumike si ụlọ ahịa ọgwụ.

Usoro na ọnọdụ nchekwa.

Mgbe ọ naghị erute ogo 25 Celsius. Mee ka ụmụaka ghara iru. Ndụ shelf bụ afọ 2.

Ojiji nke ọgwụ ibertan gbakwunyere naanị dị ka dọkịta si kwuo, a na-enye nkọwa maka ntụnye!

Ihe ngbanwe

- Hybesensitivity na irbesartan ma ọ bụ ihe ndị ọzọ dị na ọgwụ ahụ,

- enweghị nkwekọrịta nke galactose, ụkọ lactase ma ọ bụ nnabata nke glucose na galactose,

- gbara afọ 18 (agbadobeghị ịdị irè na nchekwa).

Hyponatremia, nri nwere mmachi nnu, nnabata akụrụ akwara akwara ma ọ bụ stenosis nke otu akụrụ na-arụ ọrụ, akpịrị ịkpọ nkụ (gụnyere afọ ọsịsa, ọgbụgbọ), ọgwụgwọ akwara gara aga, ọdịda akụrụ, ọrịa akwara, ọnọdụ mgbe ịmụrụ akụrụ (enweghị ahụike a na-ahụ maka ya), oke mmebi imeju (enweghi ahụmịhe nke ụlọ ọgwụ), hyperkalemia, ojiji a na-eji nkwadebe lithium, stenosis nke aortic na mitral valves, gy pertrophic na-egbochi cardiomyopathy (GOKMP), isi hyperaldosteronism, nkụchi obi na-adịghị ala ala (NYHA klas ọrụ III-IV na-arụ ọrụ), ọrịa obi obi (CHD) na / ma ọ bụ ọrịa atherosclerotic cerebrovascular, ndị ọrịa karịa afọ 75.

Nkọwapụta nke ọgwụ ọgwụ

Onye na-ahụ maka antihypertensive, angiotensin II antagonist na-anabata ihe. Ọ na - egbochi ndị nnabata AT1, nke na - eduga n'ịbelata ihe ndu nke ọrịa angiotensin II, gụnyere Mmetụta vasoconstrictor, mmetụta na-akpali akpali na mwepụta nke aldosterone na mmegharị nke sistemụ ọmịiko. N'ihi ya, ọbara mgbali na-ebelata.

OPSS na-ebelata, belata nbudata. Ọ na-ebelata ọbara mgbali (na obere mgbanwe n'ọbara obi) yana nrụgide na mgbasa akwara, yana mbelata ọbara mgbali elu na-adabere.

Ọ dịghị emetụta ịta triglycerides, ọdịnaya nke cholesterol, glucose, uric acid na plasma ọbara ma ọ bụ mpụta nke uric acid na mmamịrị.

Mlọ ọgwụ

Kpamkpam amachibidoro ndị nnabata angiotensin II n'ụzọ doro anya (ụdị AT1).

Na-egbochi mmetụta vasoconstrictor nke angiotensin II, na-ebelata itinye uche nke aldosterone na plasma, na-ebelata OPSS, ibubata obi, usoro ọbara mgbali na nrụgide na mgbasa akwara.

Nke a anaghị emetụta kinase II (ACE), nke na-emebi bradykinin ma na-etinye aka na nguzobe nke angiotensin II.

Ọ na - arụ ọrụ nwayọ, mgbe ị doseụ otu ọgwụ, nsonaazụ kachanụ na - etolite mgbe awa 3-6 gachara.

Antihypertensive mmetụta na-adịgide ruo awa 24.

Site n'iji ya eme ihe mgbe ọ bụla n’ime izu 1-2, ọ na - enwe mmetụta nkwụsi ike ma rute karịa mgbe izu 4-6 gachara.

Mlọ ọgwụ

Mgbe nchịkwa ọnụ gasịrị, ọ na-etinye obi gị dum na ngọngọ nri. A na - enweta Cmax nke irbesartan na plasma ọbara ọbara ruo 1.5-2 mgbe ịghasịrị. Bioavailability bụ 60-80%. Iri nri ugbua anaghị emetụta ndu nke irbesartan.

Njikọ protein protein Plasma bụ ihe dịka 96%. Vd - 53-93 lita. A na-enweta Css n'ime ụbọchị 3 mgbe mmalite nke ị irụ irbesartan 1 oge / Site na usoro onyonyo ugboro ugboro 1 enwere obere irbesartan na plasma (erughị 20%).

Mgbe ịbata 14C-irbesartan, 80-85% nke redioaktivu dị na ọbara na-ekesa daa na irbesartan na-agbanweghi.

A na-agunye Irbesartan n'ime imeju site na conjugation iji mepụta glucuronide yana oxidation. Ihe bụ isi metabolite bụ irbesartan glucuronide (ihe dị ka 6%).

N'ime usoro ọgwụgwọ ọgwụgwọ, a na-egosipụta irbesartan site na ọgwụ ọgwụ linear, yana T1 / 2 nọ n'ọgbọ agha bụ awa 11-15. Mwepụ na mkpo ya bụ 157-176 ml / min na 3-3.5 ml / min, karị. Irbesartan na metabolites ya na-abụ ihe dị na bele na mmamịrị.

N'ime ndị ọrịa nwere ọrụ akwara nwere nsogbu, cirrhosis na-agafe agafe, a naghị agbanwe usoro ọgwụ pharmacokinetic nke irbesartan.

Nsonaazụ

Site na usoro ụjọ na akwara anụ ahụ: ≥1% - isi ọwụwa, ọgbụgbọ, ike ọgwụgwụ, nchekasị / ikewapụta.

Site na sisitemu obi na obara (hematopoiesis, hemostasis): ≥1% - tachycardia.

Site na usoro iku ume: ≥1% - ọrịa akụkụ okuku ume na elu (fever, wdg), sinusopathy, sinusitis, pharyngitis, rhinitis, ụkwara.

Site na mgbaze: ≥1% - afọ ọsịsa, ọgbụgbọ, ọgbụgbọ, ọnyụnyụ dyspeptik, obi mgbawa.

Site na usoro akwara: ≥1% - olu mgbu (gụnyere myalgia, ihe mgbu na ọkpụkpụ, na obi).

Mmeghachi omume nfụkasị: ≥1% - nsogbu.

Ndị ọzọ: ≥1% - afọ mgbu, urinary tract ọrịa.

Usoro onunu ogwu na nhazi

Ọgwụ nke mbụ bụ 150 mg, ma ọ bụrụ na ọ dị mkpa, mee ka ọgwụ ahụ gaa na 300 mg. N'ọnọdụ ụfọdụ (nri hypochloride, ọgwụgwọ ya na ụfọdụ ihe ọticsụureụ ọria, ọgwụgwọ tupu maka ọgbụgbọ ma ọ bụ afọ ọsịsa), a na-eji obere mbido mbụ.

A na-ewere Irbesartan ọnụ 1 oge / ụbọchị, ọkacha mma n'otu oge ahụ.

Mmekọrịta na ọgwụ ndị ọzọ

N'iji ọgwụ ndị na-eme ka ọnụọgụ potassium na-emekọ ihe ọnụ, ịkwado potassium, mmụba nke ọdịnaya potassium na plasma ọbara dị mfe.

N'iji ojiji nke hydrochlorothiazide, a na-egosipụta ọdịdị mmụba nke mmetụta hypotensive.

N'iji carbonate lithium mee ihe n'otu oge, mmụba nke mkpo lithium na plasma ọbara.

Iji otu oge a na eji fluconazole nwere ike gbochie metabolism nke irbesartan.

Kpachara anya maka iji ya

A na-eji nlezianya mee ya na ndị ọrịa nwere hyponatremia (ọgwụgwọ ya na diuretics, igbochi oriri nnu na nri, afọ ọsịsa, vomiting), na ndị ọrịa na hemodialysis (mmepe nke hypotension hypotension ga-ekwe omume), yana ndị ọrịa akpịrị.

Ekwesịrị iji nlezianya gosipụta ndị ọrịa nwere ọbara mgbali elu n'ihi akwara azụ akwara stenosis ma ọ bụ akụrụ akwara stenosis nke otu akụrụ (ohere dị ukwuu nke hypotension na akụrụ siri ike), aortic ma ọ bụ mitral stenosis, mgbochi mkpụrụ obi na-egbochi ọbara ọgbụgba, nnukwu obi ike (ọkwa III III). NYHA) yana ọrịa obi na-arịa ọrịa obi (oke nsogbu nke infarction myocardial infarction, angina pectoris).

Megide ndabere nke ọrụ akụrụma nwere nsogbu, a na-atụ aro ileba anya nke potassium potassium na ọkwa creatinine.

A naghị akwado ya maka ndị ọrịa nwere hyperaldosteronism nke mbụ, yana nnukwu akwara na-ada mba (enweghị ahụike na-adakarị), na ndị ọrịa nwere mmịnye akụrụ na nso nso a (enweghị ahụike ọhụụ)

Ntụziaka pụrụ iche maka nnabata

Na omumu ihe omumu na anumanu ulo nyocha, emebeghi mutagenic, clastogenic na carcinogenic nke irbesartan.

Mmetụta ikike ịkwọ ụgbọ ala na usoro nchịkwa

Onweghi ihe ngosi gosiputara ihe nsogbu a irbesartan n’ikike inya ugboala na igwe.

Ọgwụ ndị yiri ya:

• Mbadamba ụrọ Berlipril (Berlipril)
• Mpempe akwụkwọ nke Moxogamma (Moxogamma)
• Diacordin 60 (mbadamba 60) mbadamba ụrọ
• Mpempe akwụkwọ nke Captopril-AKOS (Captopril-AKOS)
• Mpempe Akwụkwọ Moxonitex (Moxonitex)
• Adelphan-Esidrex (Adelphane-Es> ọgwụ)
• Mpempe Akwụkwọ. Captopril (Captopril)
• Valz (mbadamba onu)
• Mbadamba ụbụrụ Valz H (Valz H)
• Moxonidine (Moxon> Mbadamba ụrọ)

** Ntuziaka ọgwụgwọ bụ maka ebumnuche ọhụụ. Maka ozi ndị ọzọ, biko rụtụ aka na nkọwapụta onye nrụpụta. Emela ọgwụ onwe, tupu ịmalite iji Ibertan, ịkwesịrị ịkpọ dọkịta. EUROLAB abụghị onye na-ata ahụhụ nsonaazụ ya site na iji ozi ezigara na portal. Ozi ọ bụla dị na saịtị a anaghị agbanwe ndụmọdụ nke dọkịta ma ọ nweghị ike ịbụ nkwa maka mmetụta dị mma nke ọgwụ ahụ.

Nwere mmasị na Ibertan? Want chọrọ ịmatakwu nkọwa zuru ezu ma ọ bụ ịchọrọ ịhụ dọkịta? Ka ịchọrọ nyocha? Nwere ike gi na dọkịta gharia - Euro ọgwụ ụlọ nyocha mgbe niile n’ozi gị! Ndị dọkịta kachasị mma ga-enyocha gị, nye ndụmọdụ, nye enyemaka dị mkpa ma mee nchoputa. I nwekwara ike kpọọ dọkịta n'ụlọ. Euro Clinic ụlọ nyocha gheghe gi oghe.

** Ntị! Ihe omuma a gosiputara n’ime ndu ogwu a bu ndi okacha amara nke aru ike ya abughi ihe ndabere maka inyocha ogwu. A na-akọwa nkọwa nke ọgwụ Ibertan maka ozi ma ebughị n'obi ịkọ ọgwụ na enweghị dọkịta. Ndị ọrịa chọrọ ndụmọdụ ọkachamara!

Ọ bụrụ na ị ka nwere mmasị na ọgwụ na ọgwụ ndị ọzọ, nkọwa ha na ntuziaka maka ojiji, ozi gbasara ihe mejupụtara na ụdị ntọhapụ, ihe ngosi maka ojiji na nsonaazụ, ụzọ ojiji, ọnụahịa na nyocha nke ọgwụ, ma ọ bụ nwere nke ọ bụla ajụjụ ndị ọzọ na ntinye - dee anyị akwụkwọ, anyị ga-anwa inyere gị aka.

Weputara udi ya na ihe mebere ya

You nwere ike ịzụta ihe eji eme ọgwụ mgbochi na mbadamba ihe mkpuchi. Ọrụ nke ihe na-arụ ọrụ bụ irbesartan. Ngwá ọrụ bụ otu ihe mejupụtara, nke pụtara na ngwakọta ndị ọzọ dị na ihe mejupụtara ahụ anaghị egosipụta ọrụ antihypertensive. Irta ihe irbesartan na mbadamba 1: 75, 150 na 300 mg. Nwere ike ịzụta ngwaahịa a na blisters (14 PC.). Igbe nke kaadiboodu nwere ngwugwu sel abuo.

Omume ọgwụ

Ọgwụ na-eweta mmetụta hypotensive. Isi ihe dị na ya mejupụtara bụ onye na-anabata onye na-emegide ya. Nke a pụtara na irbesartan na-egbochi ihe nke ndị na-anabata angiotensin II, nke na-enyere aka idozi mgbidi vaskụla n’olu (belata lumen nke veins, akwara). N’ihi nke a, ọnụego ọbara ọbara na-ebelata ntakịrị.

Ọdịdị nke ụdị angiotensin nke 2 abụghị naanị warara nke arịa ọbara nwere mmụba na-esote, kamakwa ụkpụrụ nke nchịkọta platelet na nrapado ha. Mmekọrịta nke ndị na-anabata ya na homonụ a na - egbochi mmepụta nitric oxide, nke bụ ihe na - akpata vasorelaxating. N'okpuru nduzi nke Ibertan, usoro ndị a kọwara na-akwụsịlata.

Na mgbakwunye, enwere mbelata aldosterone. Nke a bụ homonụ nke otu mineralocorticoid. Ọ bụ cortex adrenal na-emepụta ya.Isi ọrụ ya bụ ịhazi njem nke sodium na cationsine na anlor chlorine. Homonụ a na-akwado ụdị ihe anụ ahụ dịka hydrophilicity. Aldosterone na-arụ ọrụ na ntinye nke ụdị angiotensin ụdị 2. Yabụ, na mbelata nke ọrụ nke ikpeazụ, a na-ebelata ọrụ nke homonụ nke mbụ.

Ọgwụ na-eweta mmetụta hypotensive.

Agbanyeghị, enweghi mmetụta na-adịghị mma na kinase II, nke na-etinye aka na mbibi nke bradykinin ma na-enye aka na ịmepụta ụdị angiotensin nke 2. Irbesartan enweghị mmetụta dị ukwuu n'ọbara obi. N’ihi nke a, ọghọm nsogbu nke sisitemu akụrụngwa ebulighi. Achọpụtala na akụrụngwa dị na ajụjụ a anaghị emetụta mmepụta nke triglycerides, cholesterol.

Jiri nlezianya

Egosiputara otutu ihe ndi ozo megidere ihe ndi ozo, nke odi nkpa igosi oke anya, tinyere:

• imebi nke njem nke sodium cations,
• nri nnu-enweghị
• adịghị arụ ọrụ akụrụngwa, ọkachasị, warara nke lumen nke akwara gbasara akwara,
• mkpochapu mmiri nke aru na aru aru, tinyere onodu ojoo, tinyere onomu, oria,
• ojiji nke thiazide diuretics n'oge na-adịbeghị anya,
• oge mgbake mgbe akụrụ gachara,
• na-agbada ụzọ ọbara site na mitral, aortic valves, nke nwere ike ịbụ site na stenosis,
• n'otu oge iji nkwadebe nwere lithium,
• endocrine ọrịa metụtara arụmọrụ aldosterone,
• atherosclerotic mgbanwe na arịa arịa,
• ọrịa nke usoro akwara obi: ischemia, ezughi oke oru nke aru a.

N'iji nlezianya mee, ọgwụ ahụ ka edepụtara maka ọrịa nke usoro akwara.

Etu esi ewere Ibertan?

Na usoro ọgwụgwọ mbụ, usoro irbesartan dị ntakịrị (150 mg). Otutu maka ntinye - oge 1 kwa ụbọchị. Enwere ike ị drugụ ọgwụ ahụ na afọ efu, n'oge nri ma ọ bụ mgbe nri gasịrị. Agbanyeghị, n'ọnọdụ ụfọdụ, a ga-achọ ịkwụsị mbelata nke siri ike - ihe ruru 75mg kwa ụbọchị. Ihe ngosipụta maka nke a bụ mmiri akpọnwụ akpọnwụ, mbelata nke olu ọbara na-ekesa, ị takingụ ọgwụ ndị na-akwalite mmiri ịmụba, na nri nnu na-enweghị.

Ọ bụrụ na anụ ahụ na-eme ka ọfụma ka usoro nke pere mpe, mgbe ahụ ọnụego irbesartan na-abawanye 300 mg kwa ụbọchị. Achọpụtala na ị doụ ntụtụ karịa 300 mg anaghị eme ka mmetụta ọgwụ ọgwụ ahụ dịkwuo elu. Mgbe ị na-agbanwe ọnụego ọgwụ ahụ ka ọ dị elu, ekwesịrị idobe nkwụsịtụ (ruo izu abụọ).

Ọgwụ nke nephropathy: a na-enye ọgwụ ọgwụ 150 mg kwa ụbọchị. Ọ bụrụ na ọ dị mkpa, a na-abawanye dose nke ihe na-arụ ọrụ na 300 mg (ọ bụghị ihe karịrị 1 oge kwa ụbọchị).

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

N'ime, oge 1 kwa ụbọchị, n'agbanyeghị nri nri, ejiri mmiri sachaa ya.

Oge a na-atụ aro ka ịmalite ịmalite na usoro mmezi ya bụ mg mg 150 kwa ụbọchị. Ndị ọrịa nwere nkụda mmụọ, na -ebelata olu nke ọbara na-ekesa (BCC) (gụnyere afọ ọsịsa, ọgbụgbọ), na hyponatremia, n'oge ọgwụgwọ na diuretics ma ọ bụ nri nwere oke oriri nke sodium chloride, ma ọ bụ na hemodialysis, ma ọ bụ ndị ọrịa karịa afọ 75 ka a na-atụ aro ka ị nweta ọgwụ mbụ. - 75 mg kwa ụbọchị.

Site na ogo adịghị ike nke ọgwụgwọ ọgwụgwọ, a na-abawanye dose ahụ ruo 300 mg kwa ụbọchị. Mmụba na-abawanye na oge nke 1-2 izu (karịa 300 mg kwa ụbọchị) anaghị eme ka ike nke mmetụta hypotensive dị. Ọ bụrụ na enweghị nsonaazụ n'oge monotherapy, ijikọ ya na ọgwụ ọgwụ mgbochi ọzọ, dịka ọmụmaatụ, yana obere usoro nke diuretics (hydrochlorothiazide), enwere ike.

Maka ọgwụgwọ nke nephropathy, a na-atụ aro ndị ọrịa nwere ọbara mgbali elu na ụdị ọrịa shuga 2 nke ọrịa Ibertan 150 mg otu ugboro n'ụbọchị, ọ bụrụ na ọgwụgwọ ahụ ezughi oke, enwere ike ịbawanye dose ahụ (na etiti oge izu abụọ) na 300 mg otu ugboro n'ụbọchị.

Ndị ọrịa nwere nsogbu gbasara akụrụngwa achọghị nrụzi usoro.

Ọchọghị ndị ọrịa nwere nsogbu imeju dị nro ma ọ bụ ghazigharị. Enweghị ahụmike a na-adakarị na ndị ọrịa nwere nnukwu ọrụ imeju.

Ibertan - ntuziaka maka ojiji, ọnụahịa, nyocha

N'iru gi ihe omuma banyere nkwadebe nke Ibertan - a na-egosi nkuzi a na ntughari n'efu ma edebanye ya naanị maka ịmara. Nkọwa ndị e gosipụtara na weebụsaịtị anyị abụghị ihe kpatara eji etinye onwe gị ọgwụ.

Ndị na-emepụta ihe: Polpharma S.A. Zaklady Farmaceutyczne SA, PL

Bekee arụ ọrụ
Klas nke ọrịa

• Ọbara mgbalike nke dị mkpa
• Ọbara nke abụọ

Linlọ ọgwụ na ọgwụ ọgwụ

• Akọwapụtaghị ya. Lee ntuziaka

Omume ọgwụ
Ndị na-ahụ maka ọgwụ

• Angiotensin II nnabata ndị na - emegide ibe (AT1 subtype)

Mmekọrịta na ọgwụ ndị ọzọ

N'iji ọgwụ ndị na-eme ka ọnụọgụ potassium na-emekọ ihe ọnụ, ịkwado potassium, mmụba nke ọdịnaya potassium na plasma ọbara dị mfe.

N'iji ojiji nke hydrochlorothiazide, a na-egosipụta ọdịdị mmụba nke mmetụta hypotensive. N'iji carbonate lithium mee ihe n'otu oge, mmụba nke mkpo lithium na plasma ọbara.

Iji otu oge a na eji fluconazole nwere ike gbochie metabolism nke irbesartan.

A na-eji nlezianya mee ya na ndị ọrịa nwere hyponatremia (ọgwụgwọ ya na diuretics, igbochi oriri nnu na nri, afọ ọsịsa, vomiting), na ndị ọrịa na hemodialysis (mmepe nke hypotension hypotension ga-ekwe omume), yana ndị ọrịa akpịrị.

Ekwesịrị iji nlezianya gosipụta ndị ọrịa nwere ọbara mgbali elu n'ihi akwara azụ akwara stenosis ma ọ bụ akụrụ akwara stenosis nke otu akụrụ (ohere dị ukwuu nke hypotension na akụrụ siri ike), aortic ma ọ bụ mitral stenosis, mgbochi mkpụrụ obi na-egbochi ọbara ọgbụgba, nnukwu obi ike (ọkwa III III). NYHA) yana ọrịa obi na-arịa ọrịa obi (oke nsogbu nke infarction myocardial infarction, angina pectoris). Megide ndabere nke ọrụ akụrụma nwere nsogbu, a na-atụ aro ileba anya nke potassium potassium na ọkwa creatinine.

A naghị akwado ya maka ndị ọrịa nwere hyperaldosteronism nke mbụ, yana nnukwu akwara na-ada mba (enweghị ahụike na-adakarị), na ndị ọrịa nwere mmịnye akụrụ na nso nso a (enweghị ahụike ọhụụ)

Irbesartan: analogues, ntuziaka maka ojiji, ọnụahịa na nyocha

Ọbara mgbali elu na - agbanwe agbanwe, ma ọ bụghị ọbara mgbali elu bụ otu n'ime ọrịa ndị a na - ahụkarị n'oge anyị. O nweghi ogo ma obu okike. Ọrịa ahụ nwere usoro mmepe anọ, nke ọ bụla dabara na ọgwụgwọ nke ya. Irbesartan bụ otu ọgwụ na-enyere aka ịnagide ọbara mgbali elu ma na-enwe ahụike.

Ntuziaka maka iji, ọnụahịa na nyocha banyere iji dochie Irbesartan na analogues dị ọnụ ala, gụọ n'okpuru.

Ngwa maka ọrụ ezughi oke ọrụ

Ọdịda ntaramahụhụ abụghị ihe mere anyị ga-eji kwụsị ịgwọ ọrịa. Mgbe ị na-a theụ ọgwụ ahụ megidere ọnọdụ nke ọrịa a, ọ kwesịrị ịkpachara anya.

Mmepe nke ọrịa ọnya dị nro abụghị ihe mere eji ewepụ ọgwụ.

Mfefe nke Ibertan

Ọtụtụ mgbe, ndị ọrịa na-agbada ọbara mgbali elu ngwa ngwa, obere oge mmepe nke tachycardia. N'ọnọdụ ndị dịpụrụ adịpụ, akara nke bradycardia na-apụta. Mbelata ike nke ngosipụta ndị na-adịghị mma ga-enyere aka ịghakọta ọnya afọ, nhọpụta nke ịgba afa (ọ bụrụhaala na a takenụrụ ọgwụ ahụ). Iji kpochapu ihe mgbaàmà nke mmadu, a na-enye ọgwụ ndị ama ama dị ka ihe atụ, dịka ọmụmaatụ, iji zụlite mgbatị obi, ọkwa mgbali.

Mmanya ndakọrịta

Nyere na ethanol na-enye aka na mgbasawanye nke akwara ọbara, a naghị atụ aro ka ị useụ mmanya nwere mmanya mgbe ị na-eme ya na Ibertan. N'okwu a, ọrụ antihypertensive nke ọgwụ na-abawanye.

Nyere na ethanol na-enye aka na mgbasawanye nke akwara ọbara, a naghị atụ aro ka ị useụ mmanya nwere mmanya mgbe ị na-eme ya na Ibertan.

Nhọrọ dị mma maka dochie ọgwụ a nọ na ajụjụ:

• Irbesartan
• Izar
• Aprovel
• Telmisartan.

Nhọrọ izizi bụ onye dochie anya Ibertan. Ngwá ọrụ a nwere otu arụ ọrụ arụ ọrụ. Ọgwụ ya bụ 150 na 300 mg na mbadamba 1. Dabere na nha ndị isi, Irbesartan adịghị iche na Ibertan.

Irsar bu analog nke ozo eji eme ogwu. Ọ dịghị iche na nhazi, usoro nke ihe arụ ọrụ, ihe ngosi na contraindications. Ego ndị a so na otu ụdị ọnụahịa. Onye ọzọ dochiri anya (Aprovel) na-akwụ ntakịrị ihe (600-800 rubles). Mwepụta weputara - mbadamba. Na 1 pc nwere 150 na 300 mg nke irbesartan. N'ihi ya, a nwekwara ike ịkọrị ọgwụ ahụ kama ị theụ ọgwụ a na-ekwu.

Telmisartan nwere mpaghara nke otu aha ahụ. Ọnụ ego ya bụ 40 na 80 mg na mbadamba 1. Principlekpụrụ nke usoro ọgwụ a na-egbochi igbochi ọrụ nke ndị na-anabata ndị na-emekọrịta na angiotensin II. N'ihi ya, a na-achọpụta mbelata nke nrụgide. Yabụ, dịka usoro eji arụ ọrụ, Telmisartan na ọgwụ a na-atụle bụ otu. Ihe ngosi maka ojiji: ọbara mgbali elu, mgbochi nke mmepe nke nsogbu (gụnyere ọnwụ) na ọrịa nke usoro akwara.

Telmisartan nwere ọtụtụ contraindications. Amachibidoro iji ọgwụ n'oge afọ ime, lactation, n'oge nwata, yana imebi ọnya biliary, imeju ka amara. A naghị akwado ya ka ị gwakọta ya na ọgwụ ọjọọ site na otu nke ndị na - egbochi enzyme enhibme enzyme. N'ime ego ndị a tụlere, Telmisartan bụ naanị ihe enwere ike iji kama Ibertan, ma ọ bụrụhaala na ntinye ahụ na-arụ ọrụ, irbesartan.

Ngwakọta na akụrụngwa

Mmetụta antihypertensive nke ọgwụ ahụ na-enye akụkụ dị mkpa. Irbesartan bụ ihe mgbochi nke homonụ angiotensin, nke na-ebute akasi vaskụla.

Ọrụ nke irbesartan bụ imechi mmetụta vasoconstrictor ma belata ibu ahụ n'obi. Ezubere ọgwụ a maka iji ogologo oge. Ugwu kachasị elu pụtara na awa 4-5 mgbe ị theụsịrị ọgwụ.

Mmetụta ahụ dịgidere ụbọchị dum. Mgbe ụbọchị iri ruo ụbọchị iri na anọ ga-emechi ihe anya, a na-enweta mgbatị ahụ.

Ọkpụkpụ na-eburu ngwa ngwa n’akpo eriri afọ. Onu ogugu ogwu gha eme ihe ozugbo ruru 80%. A na-ahụta ihe kachasị n’ime ọbara elekere abụọ ka ị takingụsịrị ọgwụ. Irbesartan adịghị agbakọ n'ime ahụ, mkpochasị ahụ na-eme site na umeji na-ebu ihe ruru 80%, akụrụ na-ewepụ ihe ndị ọzọ.

Ihe ngosi na contraindications

A na-eji ọgwụ ahụ agwọ ọrịa ọbara (oke ala). Ọgwụ dị irè maka ọgwụgwọ ọbara mgbali elu yana ọrịa ọrịa akụrụ gbasara akwara (ọrịa mamịrị nephropathy).

Edeghị ọgwụgwọ Irbesartan na okwu ndị a:

• oge ịmụ nwa na ị breastụ ara,
• mmetụta dị ukwuu nke ọgwụ ahụ,
• ọrịa akụrụngwa nke mmịpụta nke monosaccharides na eriri afọ (glucose-galactose malabsorption),
• obere afọ (ruo afọ 18).

Ọ dị mkpa ịkpachara anya n'oge ọgwụ ọgwụ ma ọ bụrụ na onye ọrịa ahụ nwere ọrịa ndị a:

• warara nke lumen (stenosis) nke valvụ aortic,
• obi adịghị ala ala,
• akpịrị ịkpọ nkụ
• ịba ụba nke sodium ke ahu,
• warara nke akwara gbasara akwara,
• nri digestive.

Maka ndị ọrịa dị afọ iri asaa na asaa, ọ nweghị ọgwụ ọ bụla edepụtara.

Ọ bụghị ihe amamihe dị na ya iji ọgwụ ọjọọ eme ihe maka ịba ọcha n'anya hepatic, ebe obu na enweghi ulo ogwu.

Mwepụta ewepụtara na usoro onunu ogwu

Ọgwụ dị n'ụdị mbadamba na 75, 150, 300 mg.

Usoro ọgwụgwọ ọkọlọtọ na-amalite site na iji 150 mg. Dabere na ọnọdụ onye ọrịa, enwere ike ịbawanye ọgwụ ahụ ruo 300 mg, ma ọ bụ belata 75 mg. Maka ndị ọrịa nwere ọrịa akụrụ, mmezi dose na-amalite na 75 mg.

Ọgwụ a na-ahụ maka mgbali ọbara mgbe niile.

Njirimara

Ọgwụ nwere mmetụta dị n'akụkụ, bụ nke ihe mgbaàmà ndị a gosipụtara:

Normodipine na analogues nke ọgwụ.

• ike ọgwụgwụ na ike ọgwụgwụ,
• nchegbu na-enweghị isi,
• ụba obi (tachycardia),
• paroxysmal ụkwara
• nri digestive (afọ ọsịsa, mgbaze na-egbu mgbu),
• mmeghachi omume nfụkasị ahụ
• akwara mgbu
• imebi arụ ọrụ nwoke.

N'ime ndị ọrịa nwere nephropathy mamịrị, mbelata hemoglobin n'ọbara ga-ekwe omume.

A na-eme ka mmetụta nke ọgwụ ahụ ka njọ site na ojiji nke diuretics na ọgwụ ndị ọzọ na-ebelata ọbara mgbali elu.

Mgbe ejikọtara ya na ọgwụ ndị a na-enye potassium, ihe egwu nke ịbawanye hyperkalemia na-abawanye.

Mmekọrịta na ọgwụ ndị na-alụ ọgụ na-abụghị ọgwụ steroid na-emetụta ọrụ akụrụ.

Dodoụbiga ọgwụ ókè bụ ihe dị ize ndụ maka nsogbu obi. (tachycardia, bradycardia).

Emeputara Irbesartan nke Kern Pharma S.L. (Spain). Ọnụ ego maka nkwakọ ngwaahịa bụ 350 rubles.

Enwere ike ịme ọgwụ ụdị ọgwụ na - eme ihe ma ọ bụrụ na irbesartan. Ebe ọ bụ na ntuziaka maka iji ya bụ otu, a na-ejikarị ụdị ọgwụ na ọgwụ ndị dị na amlodipine eme ihe.

Ọ dị n'ụdị mbadamba. Ihe inyeaka a bu: nnu nke magnesium na stearic acid, silicon dioxide, lactose, cellulose, ssumum croscarmellose, hypromellose. Ogwu ahu nwere otu ihe ahu dika Irbesartan.

A na-eji ya agwọ ọbara mgbali elu nke mbụ na nke abụọ, yana ọgwụgwọ ọbara ọgbụgba na ndị ọrịa mamịrị. Usoro ọgwụgwọ na-amalite site na opekata mpe nke 150 mg, na-enweghị mgbanwe dị mma, usoro ịba ahụ dị okpukpu abụọ.

Ntụnyere ahụ dị iche na nke mbụ na nke ahụ ndị ọrịa nwere ọrịa akụrụ anaghị achọ mmegharị dose. Onye rụpụtara ya bụ ụlọ ọrụ French Sanofi-Winthrop Industrie. Ọnụahịa ahụ sitere na 350 ruo 700 rubles, dabere na nkwakọ ngwaahịa.

Ogwu Russia, analogue nke Ibersartan zuru oke.

O nwere njiri mara, contraindications na nsonaazụ ya. Edere ya n'otu usoro onodu ogwu dika nke mbu. Onye Canonfarm Production CJSC mepụtara.

Ọnụahịa ọgwụ ahụ bụ 250 rubles.

Ọgwụ adịghị iche na Njirimara ọgwụ si Irbesartan.

Ọ dị n'ụdị mbadamba. Mbadamba 75 mg Oge akara aka na usoro onunu ogwu kwekọrọ na nke mbu.

A na-emepụta ọgwụ ahụ na Poland, site na osisi ọgwụ nke Polpharma S.A. Ọnụ ego ahụ dị ihe dị ka ruble 200.

Aclọ ọgwụ ọgwụ na nsonaazụ nke ọgwụ a na mbụ. Edere ya na usoro onunu ogwu nke 150 mg. Na enweghị ọgwụgwọ ọgwụgwọ, a na-abawanye ọgwụ ahụ ruo 300 mg. A na-atụ aro ndị ọrịa nwere ọrịa gbasara akụrụngwa ịmalite ọgwụgwọ na 75 mg. Emeputara ogwu ahu site n’aka KRKA d.d. (Slovenia). Mbadamba 150 mg

A na-anabakarị Irbesartan na analogues ya site n'aka ndị ọrịa. Ọ bụrụ na a hụrụ usoro onunu ogwu nke dọkịta nyere, mmetụta ọgaghị adị na-eme. A na-eji ọgwụ ahụ eme ihe na usoro ọgwụgwọ na kadiology.

Mama m dị afọ 60. Ọ na-arịa ọbara mgbali elu ihe dị ka afọ 10. Agbalịrị m ị drugsụ ọgwụ dị iche iche, mana nsonaazụ ya na-apụta mgbe niile. Dọkịta ahụ tiri Irbesartan, mana dọrọ aka ná ntị na ekwesịrị ị theụ ọgwụ ahụ ogologo oge. Ngwá ọrụ a zuru oke maka mama. Enweghị mmetụta ọ bụla. Ọ were ọnwa abụọ, nrụgide ahụ akwụsịla.

Mgbe m mere agadi, amalitere m inwe nkụda mmụọ, mkpọtụ dara na ntị m, isi m na-afụkwa ụfụ. Dọkịta ahụ gwara French Aprovel.Ọgwụ nyeere m aka nke ọma, mana ọnụahịa ahụ dị elu. Nyere na ọ dị mkpa ị drinkụ ya na-aga n'ihu, agwara m iji nke Russia ọzọ yiri ya dochie ya. Ugbu a, m na-a Iụ Irsar. Onweghị ọdịiche dị na mmetụta uche, mana ọ na-efu obere.

Irbesartan enweghị m mma. Mgbe oriri a gachara, obi malitere ịkụda aka ike. Ọnọdụ ahụ adịghị mma, mana ọ kara njọ. Aghaghị m iji ọgwụ ọzọ ga-arụ ọrụ nke ka dochie m.

Ibertan Plus

Ọgwụ ndị ọzọ na - egbochi mmiri ara: Enwere ike ịkwalite mmetụta antihypertensive nke ọgwụ Ibertan Plus site na iji concoitant ọgwụ ndị ọzọ antihypertensive ọgwụ.

Enwere ike iji Hydrochlorothiazide na irbesartan (na doses ruo 25 mg nke hydrochlorothiazide / 300 mg nke irbesartan) n'enweghị nsogbu na ngwakọta ndị ọzọ antihypertensive, gụnyere ngwa ngwa ndị na-egbochi calcium na mgbochi beta.

Ọgwụ ịba ọcha n'anya nwere mbụ nwere ike ibute ọgbụgbọ ma bulie ihe ọghọm ọgbụgba.

Lithium: Enwere akụkọ banyere mmụba a na-atụgharị anya na nchịkọta lithium serumum na ihe na-egbu egbu yana ijikọtara nkwadebe lithium na ndị na-egbochi enzyme enzyme. Maka irbesartan, ụdị mmetụta a adịkarịbeghị ụnọdụ taa.

Na mgbakwunye, mwepụ nke akụrụngwa lithium na-ebelata site na iji thiazide diuretics, yabụ mgbe edepụtara Ibertan Plus, enwere ohere dị elu nke ịmalite uto nsị lithium.

Ọ bụrụ na ebumnuche nke njikọ a dị mkpa, a na-atụ aro iji nlezianya nyochaa ọdịnaya lithium dị na ọbara ọbara.

Ọgwụ ndị na-emetụta potassium n’ime ọbara: mmetụta hypokalemic nke hydrochlorothiazide na-akụda ike site na mkpụrụ ọgwụ na-akpata irbesartan.

Agbanyeghị, enwere ike ịkwalite mmetụta a nke hydrochlorothiazide site na ọgwụ ndị ọzọ, ebumnuche nke ejikọtara ya na ọnwụ nke potassium na gnococalpemia (dịka ọmụmaatụ, diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, ihe ndị na-eme ka salicylic acid) Kama nke ahụ, dabere na ahụmịhe nke iji ọgwụ na-ebelata ihe omume ijegharị. usoro angiotensin-aldosterone, ojiji nke potassium-sparing. mgbakwunye oyologically na-arụ ọrụ, nnọchi nnu nnu, ma ọ bụ ọgwụ ndị ọzọ nwere ike ibute mmụba na potassium serum (dị ka sodium heparin) nwere ike ime ka mmụba na ọbara Katya. A na-atụ aro ka ị nyochaa ọgwụ serum n'ụzọ ziri ezi na ndị ọrịa n'ihe ize ndụ nke ịmalite hyperkalemia.

Ọgwụ ndị ọ na-emetụtaburu na nguzobe potassium na ọbara ọbara: a na-atụ aro ka ejiri nlezianya nyochaa ihe ndị dị na potassium na ọbara ọbara mgbe ị na-ede akwụkwọ Ibertan Plus na ọgwụ ndị na-emetụta mmebi nke potassium na ọbara ọbara (dịka ọmụmaatụ, glycosides cardiac, ọgwụ antiarrhythmic).

Ọgwụ mgbochi mkpali na - achọghị ọgwụ: mgbe ị na-edepụta antagonists anendensin II na ọgwụ mgbochi na-abụghị nke steroidal na mgbochi mkpali (dịka ọmụmaatụ, yana nhọrọ cyclooxygenase-2 inhibitors (COX-2), acetylsalicylic acid (> 3 g / day) na ọgwụ mgbochi mgbochi na-abụghị nke a na-ahọrọ, na-akụda antiglertins ọgwụ. Dị ka iji nke angiotensin n'ịtụgharị enzyme inhibitors na angiotensin II receptor antagonists na NSAIDs, enwere ọghọm nke ọrụ ezigharị adịghị arụ ọrụ, ruo na mmepe nke nnukwu gbasara akụrụ na-ada mba, ụba potassium serum, ọkachasị ndị ọrịa nwere ọrụ mkpado arụ ọrụ ugbua. Ekwesịrị iji nlezianya kee ọgwụ a, ọ kachasị ndị ọrịa. Ndi oria ekwesighi ka akpachapu ha anya. Ekwesịrị igosipụta usoro ntaramahụhụ mgbe mmalite nke usoro njikọta ọgwụ na oge n'ọdịnihu.

Ihe omuma ndi ozo banyere nmekorita ogwu nke irbesartan: hydrochlorothiazide anaghị emetụta ọgwụ ọgwụ nke irbesartan.

Mgbe ị na-edepụta irbesartan na jikọtara warfarin, metadolized site induce CYP2C9 isoenzyme, achọpụtaghị mmekọrịta dị iche iche nke ọgwụ na ọgwụ.

Mmetụta nke ndị inductor CenP2C9, dịka rifampicin, na pharmacokinetics nke irbesartan enweghị nyocha. Site na nhọpụta nke irbesartan yana digoxin, ọgwụ ọgwụ nke ikpeazụ agbanweghị.

Ihe omuma ndi ozo banyere mmekorita ogwu nke hydrochlorothiazide:

Ọgwụ ndị a nwere ike ịmekọrịta ihe gbasara thiazide diuretics mgbe ị na-ede akwụkwọ:

Etaniol, barbiturates ma ọ bụ ọgwụ ọjọọ: enwere ike ịhụ hypotension orthostatic mụbara.

Ọgwụ hypoglycemic (ihe ndị na-egbu mmụọ na insulin): enwere ike ịchọ nhazi nke hypoglycemic na-elekọta mmadụ.

Colestyramine na colestipol: n'ihu ọnụnọ mgbanwe nke anion, mmiri nke hydrochlorothiazide na-ama jijiji. Oge dị n'etiti ị drugsụ ọgwụ ndị a kwesịrị ị dịkarịa ala 4 awa.

Glucocorticosteroids, hormone adrenocorticotropic: akara akara nke mmiri mmiri elektrik, ọkachasị, mụbara hypokalemia.

Catecholamines (dịka ọmụmaatụ, norepinephrine): ịdị irè nke ọgwụ ndị a nwere ike belata.

Ihe na - emegharị ahụ adịghị mma (dịka ọmụmaatụ tubocurarine): hydrochlorothiazide nwere ike ime ka ihe ndị mmadụ na-eme ghara ime ka ike gwụ nro.

Ọgwụ mgbochi gout: Enwere ike ịchọ mgbazi nke ọtụtụ ọgwụ ejiri iji gwọọ gout, ebe hydrochlorothiazide nwere ike ịbawanye ọdịnaya nke uric acid na plasma ọbara. Enwere ike ịbawanye elu na dose nke probenenide ma ọ bụ sulfinpyrazone. Njikọ ọnụ na thiazide diuretics nwere ike ịbawanye nrịba nke hypersensitivity mmeghachi omume na allopurinol.

Calcium nnu: thiazide diuretics nwere ike ịbawanye ụrọ nke plasma n'ihi nkwụsị ya. Ọ bụrụ na ọ dị mkpa ịdebe mmeju nke calcium ma ọ bụ ọgwụ ndị na-emetụta ọdịnaya calcium (dịka ọmụmaatụ, vitamin D), ọ dị mkpa iji dozie dose nke ọgwụ ndị a otu yana ịchịkwa ọdịnaya calcium na plasma ọbara.

Typesdị mmekọrịta ọgwụ ndị ọzọ: thiazide diuretics nwere ike iwelie mmetụta hyperglycemic nke beta-blockers na diazoxide.

Anticholinergics (wdg., Atropine) nwere ike iwelie bioavailability nke ọrịa dihiaiti thiazide site na mbenata akwara na mbuze afọ. Thiazide diuretics nwere ike ịbawanye ohere nke mmeghachi omume ọjọọ nke amantadine kpatara.

Ihe akwara nke Thiazide nwere ike belata oke ọgwụ ọgwụ cytotoxic site na akụrụ (dịka ọmụmaatụ, cyclophosphamide, methotrexate) ma nwee ike myelosuppressive mmetụta ha.

Nkọwa, ntuziaka maka ojiji:

Ntụziaka maka iji taabụ Ibertan. 150mg Nke 28 Zụta taabụ Ibertan. 150mg Nke 28

Sdị Usoro Ọgwụ

Ndị na-emepụta ihe

Polfa SA (Poland)

Ngwakọta na ụdị ntọhapụ

Mbadamba ihe eji egwuri egwu Ibertan

Taabụ 1 nwere irbesartan (n'ụdị hydrochloride) 75, 150 na 300 mg, na ngwugwu 28 pcs.

Omume ọgwụIbertan bụ onye na-ahụ ihe hypotensive, angiotensin II (ụdị AT1) onye na-anabata ihe nnabata.

Ọ na-ebelata mkpụkọ nke aldosterone na plasma (anaghị emechi kinase II, nke na-emebi bradykinin), na-ewepụ mmetụta vasoconstrictor nke angiotensin II, belata OPSS, belata mbubata, usoro ọbara na nrụgide dị na okirikiri "obere" nke mgbasa ọbara.

Ọ naghị emetụta mkpokọta TG, cholesterol, glucose, uric acid na plasma na excretion nke uric acid na mmamịrị.

Mmetụta kasịnụ na-etolite awa 3-6 mgbe ị singleụ otu ọgwụ, ogologo oge nke ime ihe bụ awa 24, mgbe izu 1-2 gachara iji rụpụta ọgwụ na-akwụsi ike na-adabere.

Ihe na-egosi
Ọbara mgbali elu, gụnyere mgbe ejikọtara ya na ụdị ọrịa shuga 2.

Ihe ngbanweHypersensitivity, ime, lactation, afọ ruo afọ 18.

Na-akpachara anya. CHF, GOKMP, stenosis nke aortic ma ọ bụ mital valve, akpịrị ịkpọ nkụ, hyponatremia, hemodialysis, nri hypo-salt, afọ ọsịsa, vomiting, njikọ aka ma ọ bụ azụmaahịa akwara azụ stenosis, ọdịda akụrụngwa.

Usoro onunu ogwu na nhaziA na-ewere okwu ọnụ Ibertan, n'oge nri ma ọ bụ na afọ efu, a na-elo mbadamba ahụ dum, jiri mmiri sachaa ya.

Oge mbido na mmezi bụ 150 mg / ụbọchị n’otu ọgwụ, ma ọ bụrụ na ọ dị mkpa, a na-abawanye ọgwụ ahụ ka 300 mg / ụbọchị (mmụba ọzọ na dose adịghị eme ka ogo mmetụta hypotensive dịkwuo elu).

Ọ bụrụ na enweghị nsonaazụ n'oge monotherapy, usoro ọgwụ dị ala (hydrochlorothiazide) ka etinyere n'iwu.

Ọgwụ nke mbụ n’ime ndị ọrịa nwere akpịrị ịkpọ nkụ, hyponatremia (n’ihi ọgwụgwọ n’ọrịa diuret, mmachi nnweta nnu n’ihi nri, afọ ọsịsa, vomiting) on ​​hemodialysis bụ 75 mg.

NsonaazụMbelata ọbara mgbali elu (na 0.4% nke ikpe) - isi ọwụwa, ọgbụgbọ, ọgbụgbọ, ọgbụgbọ, adịghị ike.

N'okwu banyere azụmaahịa, n'ọnọdụ ndị dị ụkọ - asthenia, dyspepsia (gụnyere afọ ọsịsa), dizzness, isi ọwụwa, hyperkalemia, myalgia, ọgbụgbọ, tachycardia, ọrụ imeju na - arụ ọrụ (gụnyere

ịba ọcha n'anya na akụrụ (gụnyere ọdịda akụrụngwa na ndị ọrịa nwere nnukwu nsogbu).

Irbesartan adịghị arụ ọrụ na aldosteronism bụ isi (a naghị atụ aro iji ya)

Ntụziaka pụrụ icheỌgwụ kwesịrị ịnwe n’okpuru ọgbụgba ọbara.

N’ebe ndị ọrịa akpọnwụ akpọnwụ nọ, yana ụkọ Na + (n’ihi ọgwụgwọ kpụ ọkụ n’ọnụ na-arịa diuretic, afọ ọsịsa ma ọ bụ vomiting, igbochi oriri nnu na nri) na ndị ọrịa n’arụ ọbara, enwere hypotension hypotension nwere ike ịmalite, ọkachasị mgbe ị takingụchara ọgwụ mbụ.

N'ime ndị ọrịa nwere nsogbu gbasara akụrụ, a ga-ebu ụzọ nyochaa oge nke itinye uche K + na creatinine na plasma. N’ime obi dara oke, ọrịa akụrụ (gụnyere akụrụ akwara stenosis), ihe ọghọm nke mbelata ọbara mgbali elu, azotemia, oliguria, rue akịrị gbasara akwara, na-abawanye na ischemic cardiomyopathy - ihe egwu nke angina pectoris na infarction myocardial.

N'oge usoro ọgwụgwọ, a ga-akpachara anya mgbe ị na-anya ụgbọ ala ma na-eme ihe nwere ike dị ize ndụ nke chọrọ ntinye uche na ọsọ nke mmeghachi omume psychomotor (ọgbụgba na ike ọgwụgwụ ike kwere omume).

Mkparịta ụka ọgwụ ọjọọDiuretics na ọgwụ ndị ọzọ na - egbochi ọgwụ ike na - akwalite mmetụta ahụ. Ọgwụ tupu a gwọọ ya n’ọrịa mgbadata dị elu nwere ike ibute akpịrị nkụ ma mee ka ohere nke mbelata ọbara rịa elu.

Na-emekọ ihe ọnụ na heparin, potassium na-eme ka ọnụọgụ, ma ọ bụ ọgwụ ndị ọzọ nwere K + nwere ike ibute ịba ụba nke K + na plasma. Na nyocha nke vitro gosipụtara mmetụta enwere ike na metabolism nke irbesartan ọgwụ metaraoli na ntinye nke CYP2C9 isoenzyme ma ọ bụ ndị na-egbochi ya.

Amụọ ihe ndị na-eweta inyocha nke CYP2C9 isoenzyme (gụnyere rifampicin). Mmekorita nke ogwu, achoputara metabolism nke dabere na isoonzymes CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2D6, CYP2E1, CYP3A4, in vitro achọpụtaghị.

Ikekwe, mmụba na-agbagharị na plasma Li + ga-ekwe omume (nleba anya dị mkpa). Onweghị emetụta ọgwụ ọgwụ digoxin.

Hydrochlorothiazide, nifedipine anaghị emetụta ụzọ ọgwụ pharmacokinetic nke irbesartan.

Dodoụbiga ya ókè Mgbaàmà: tachy- ma ọ bụ bradycardia, mbelata ọbara mgbali elu, daa.

Ọgwụ: lavage gastric, nhọpụta nke carbon na-arụ ọrụ, usoro ọgwụgwọ Symptomatic, hemodialysis adịghị arụ ọrụ.

Ọnọdụ nchekwa
N’ebe gbara ọchịchịrị na-adịghị elu karịa + 25 Celsius.

Ọdịdị na ọnụ ahịa ụlọ ahịa Stolichki:

Achọpụtaghị ngwaahịa na ụlọ ahịa ọgwụ Stolichki. Agbanyeghị, gbaa mbọ kpọtụrụ tel. 8 (495) 215-5-215 maka ịmatakwu gbasara ngwaahịa dị na ahịa ọgwụ na Moscow. Ihe omuma di na saịtị apughi inwe oge iji melite.

Leasedị mwepụta, nkwakọ ngwaahịa na ihe mebere Ibertan Plus

7 pcs - blisters (4) - ngwugwu nke kaadiboodu.
10 PC. - blisters (3) - ngwugwu nke kaadiboodu.
14 pi. - blisters (2) - ngwugwu nke kaadiboodu.
15 PC. - blisters (2) - ngwugwu nke kaadiboodu.

7 pcs - blisters (4) - ngwugwu nke kaadiboodu.
10 PC. - blisters (3) - ngwugwu nke kaadiboodu.
14 pi. - blisters (2) - ngwugwu nke kaadiboodu.
15 PC. - blisters (2) - ngwugwu nke kaadiboodu.

7 pcs - blisters (4) - ngwugwu nke kaadiboodu.
10 PC. - blisters (3) - ngwugwu nke kaadiboodu.
14 pi. - blisters (2) - ngwugwu nke kaadiboodu.
15 PC. - blisters (2) - ngwugwu nke kaadiboodu.

Usoro usoro onunu ogwu

N'ime, otu ugboro n'ụbọchị, n'agbanyeghị nri ị na-eri.

Ibertan Plus 12.5 / 150 mg (mbadamba nwere hydrochlorothiazide / irbesartan 12.5 / 150 mg, n'otu n'otu) ka a ga-enye ndị ọrịa oke ọbara mgbali ya nke ọma na nhọpụta nke naanị hydrochlorothiazide (12.5 mg / ụbọchị) ma ọ bụ irbesartan (150 mg / ubochi) na monotherapy.

A pụrụ inye ndị ọrịa ọgwụ Ibertan Plus 12.5 / 300 (mbadamba nwere hydrochlorothiazide / nrbesartan 12.5 / 300, karị) ma ọ bụrụ na irbesartan (300 mg / ụbọchị) ma ọ bụ Ibertan Plus (12.5 / 150 mg).

A pụrụ inye ndị ọrịa Ibertan Plus 25-300 mg (mbadamba nwere hydrochlorothiazide / irbesartan 25/300 mg, n'otu n'otu) ka ndị ọrịa ma ọ bụrụ na nchịkwa Ibertan Plus (12.5 / 300 mg) na-achịkwa nke ọma. A naghị atụ aro ịhọpụta doses karịa 25 mg nke hydrochlorothiazide / 300 mg nke irbesartan 1 otu oge kwa ụbọchị.

Ọ bụrụ na ọ dị mkpa, enwere ike ịcribedụ ọgwụ Ibertan Plus na njikọ ọgwụ ndị ọzọ na - egbochi ọgwụ mgbochi.

Renrụ ọrụ ezumike mkpirikpi: n'ihi eziokwu ahụ na nchịkọta nke ọgwụ Ibertan Plus gụnyere hydrochlorothiazide. a akwadoghị ọgwụ a maka ndị ọrịa nwere nnukwu akụrụkasị (mwepụ creatinine 30 ml / min.

Ọrụ imeju na-arụ ọrụ: A naghị akwado Ibertan Plus maka ndị ọrịa nwere nnukwu ịba ọcha n'anya. N'ime ndị ọrịa nwere ọrịa ịba ọcha ọwụwa ruo obere ruo n'ọtụtụ, a chọghị imezi ọgwụ nke Ibertan Plus ọgwụ.

Ọrịa ndị agadi agaghị adị: a chọpụtaghị nhazi nke Ibertan Plus na ndị ọrịa agadi.

Mbelata ọbara na-ebelata: tupu i dee Ibertan Plus, ọ dị mkpa idozi olu ọbara na / ma ọ bụ ọdịnaya sodium.

Mmetụta akụkụ

Enyere nsonaazụ ndị a na-esote na gradations ndị a na-esote ugboro ole ha mere: ọtụtụ mgbe (> 1/10), ọtụtụ mgbe>> 1/100, 1/1 000, 1/10 000, Nchikota hydrochlorothiazide / irbesartan:

Site n'akụkụ nke sistemụ akwara etiti: mgbe mgbe - ọgbụgba, dizziness orthostatic ugboro ugboro.

Na akụkụ nke sisitemu ụkwara akwara: syncope ugboro ugboro, mbelata ọbara mgbali, tachycardia, akụkụ ụsọ, 'ịsọpụ' ọbara ruo na agba nke ihu.

Site na usoro digestive: ọtụtụ mgbe - ọgbụgbọ, ọgbụgbọ, afọ ọsịsa.

Site na usoro urinary: ọtụtụ mgbe - mmebi nke urination.

Site na usoro mkpụrụ ndụ: enweghị oge - dysfunction mmekọahụ, libido nwere nsogbu.

Ndị ọzọ: ọtụtụ mgbe - ike ọgwụgwụ.

Ngosiputa ihe nlere: Mgbe mgbe - mmụba na ịta urea nitrogen, creatinine na plasma creatine phosphokinase, na-adịghị ala ala - mbelata ọdịnaya nke potassium na sodium na ọbara ọbara. Mgbanwe ndị a na paradaịs a na-ahụkarị adịkarịghị mkpa ọgwụgwọ.

Achọpụtara mmeghachi omume na-adịghị mma mgbe ị na-ewere njikọta hydrochlorothiazide / irbesartan, nke a kọrọ na mgbe azụmaahịa:

Mmeghachi omume nfụkasị: na - adịkarịghị - ọnya anụ ahụ, urticaria, angioedema.

Site n'akụkụ nke metabolism: ọ na - adịkarịghị - hyperkalemia.

Site na usoro ụjọ ahụ: ọ na - adịkarị obere - isi ọwụwa.

Site na anụ ahụ anụ ahụ: ọ dịkarịsịrị ike - na-akụ ntị.

Site na usoro iku ume: oke ụkwara - ụkwara.

Site na usoro nri: dịkarịsịrị - dyspepsia, dysgeusia, akọrọ mucosa a na-ede ede, ịba ọcha n'anya, ọrụ imeju na-arụ ọrụ.

Site na usoro akwara: arthralgia, myalgia na-adịkarị obere.

Site na sistemụ urinary: ọ dịkarịsịrị - arụ ọrụ ezumike arụ ọrụ, gụnyere otu ikpe nke gbasara akụrụngwa ọdịda na ndị ọrịa nọ n'ihe ize ndụ dị elu.

Ihe omuma ndi ozo banyere ihe ndi mmadu:

Na mgbakwunye na nsonaazụ ndị a kpọtụrụ aha, a na-edepụta nsonaazụ ndị ọzọ a na-ekwu na mbụ banyere akụkụ nke ọ bụla, nke nwere ike ịme n'akụkụ mmetụta nke iji ọgwụ ahụ Ibertan Plus, edepụtara n'okpuru.

Ndị ọzọ: ugboro ugboro - mgbu obi.

Hydrochlorothiazide (n'egosighi ugboro ole ihe a na-eme)

Ahụhụ Hematopoietic: ọrịa aklatokia, ụmị ụmị ọkpụkpụ, ụbụrụ hemolytic, leukopenia, neutropenia / agranulocytosis, thrombocytopenia.

Site na usoro ụjọ ahụ nke etiti: nkụda mmụọ, ọgba aghara ụra, ọgbụgba, paresthesia, nchekasị.

Site n'akụkụ akụkụ anụ ahụ nke anụ ahụ: ọhụụ na-enye echiche dị nro, xantopsia.

Site na usoro obi: arrhythmias, hypotension postural.

Site na usoro iku ume: ọrịa mgbu nke iku ume (gụnyere pneumonitis na edema).

Site na usoro digestive: jaundice (intrahepatic cholestatic jaundice).

Mmeghachi omume nrịanrịa: mmeghachi omume anaphylactic, necrolysis na-egbu egbu, ọrịa lupus dị ka ọrịa, necrotizing angiitis (vasculitis, skin vasculitis), mmeghachi omume na-emetụta ahụ, ihe ọkụ anụ ahụ, njikarị nke sistem lupus erythematosus, urticaria.

Site na usoro akwara: uru ahụ, adịghị ike.

Site na usoro urinary: nephritis interstitial, dalfunction akụrụ.

Ndị ọzọ: ahụ ọkụ.

Ndị na-egosi ụlọ nyocha: ọgba aghara na nguzo mmiri-electrolyte (gụnyere hypokalemia na hyonatremia), glucosuria, hyperglycemia, hyperuricemia, ụba cholesterol na triglycerides.

Ime na lactation

Inweta Ibertan Plus bụ nke a machibidoro n'oge afọ ime, ebe ọ bụ na ikpughe nwa ebu n’ịgwụ ọgwụ na-emetụta usoro renin-angiotensin-aldosterone nwere ike ibute mmebi na ọnwụ nke nwa ebu n’afọ na-etolite. Thiazide diuretics na-agafe ihe mgbochi placental ma achọta ya na ọbara eriri. Ọtụtụ mgbe, a na-atụ aro iji ọgwụ ndị dị ime ahụike na-ekpughere nne na nwa nwa n’ihe ize ndụ na-enweghị isi, gụnyere mmepe nke nwa ebu n’afọ ma ọ bụ n’ọkpụkpụ nwa, thrombocytopenia na, ikekwe, mmeghachi omume ndị ọzọ a na-ahụ n’ebe ndị okenye nọ. A naghị akwado Hydrochlorothiazide n'oge ọnwa atọ mbụ nke ịtụrụ ime. A machibidoro ọgwụ a ọgwụ n'oge afọ II na III nke afọ ime. Ọ bụrụ na a chọpụta afọ ime, mgbe ahụ, a ga-akwụsị Ibertan Plus ozugbo enwere ike. Ọ bụrụ na onye ọrịa ahụ weere ọgwụ ahụ n'oge ọnwa nke abụọ nke afọ ime, ọ dị mkpa iji nyochaa nyocha ultrasound maka okpokoro isi na akụrụ ọrụ. A ogwu ogwu Ibertan Plus n'oge contraindicated nke oge nile nke lactation.

Mkparịta ụka ọgwụ ọjọọ

Ọgwụ ndị ọzọ na - egbu egbu: a na - eme ka mmetụta antihypertensive nke ọgwụ Ibertan Plus dịkwuo mma site na njiko nke ọgwụ ọgwụ antihypertensive ndị ọzọ. Enwere ike iji Hydrochlorothiazide na irbesartan (na doses ruo 25 mg nke hydrochlorothiazide / 300 mg nke irbesartan) n'enweghị nsogbu na ngwakọta ndị ọzọ antihypertensive, gụnyere ngwa ngwa ndị na-egbochi calcium na mgbochi beta. Ọgwụ ịba ọcha n'anya nwere mbụ nwere ike ibute ọgbụgbọ ma bulie ihe ọghọm ọgbụgba.

Lithium: enwere akụkọ banyere mmụba a na-atụgharị anya na mmiri lithium na ihe na-egbu egbu yana ijikọ ọrụ lithium na angiotensin na-eme ka ndị na - egbochi enzyme enzyme. Maka irbesartan, ụdị mmetụta a adịkarịbeghị ụnọdụ taa. Na mgbakwunye, mwepụ nke akụrụngwa lithium na-ebelata site na iji thiazide diuretics, yabụ mgbe edepụtara Ibertan Plus, enwere ohere dị elu nke ịmalite uto nsị lithium. Ọ bụrụ na ebumnuche nke njikọ a dị mkpa, a na-atụ aro iji nlezianya nyochaa ọdịnaya lithium dị na ọbara ọbara.

Ọgwụ ndị na-emetụta ọdịnaya potassium na ọbara: mmetụta hypokalemic nke hydrochlorothiazide na-eme ka ike gwụ mkpụrụ mmetụta nke irbesartan. Agbanyeghị, enwere ike ịkwalite mmetụta a nke hydrochlorothiazide site na ọgwụ ndị ọzọ, ebumnuche nke ejikọtara ya na ọnwụ nke potassium na gnococalpemia (dịka ọmụmaatụ, diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, ihe ndị na-eme ka salicylic acid) Kama nke ahụ, dabere na ahụmịhe nke iji ọgwụ na-ebelata ihe omume ijegharị. usoro angiotensin-aldosterone, ojiji nke potassium-sparing. mgbakwunye oyologically na-arụ ọrụ, nnọchi nnu nnu, ma ọ bụ ọgwụ ndị ọzọ nwere ike ibute mmụba na potassium serum (dị ka sodium heparin) nwere ike ime ka mmụba na ọbara Katya. A na-atụ aro ka ị nyochaa ọgwụ serum n'ụzọ ziri ezi na ndị ọrịa n'ihe ize ndụ nke ịmalite hyperkalemia.

Ọgwụ ndị ọ mebiri na nguzogide potassium n’ime ọbara ọbara: a na-atụ aro ka ejiri nlezianya nyochaa ihe ndị dị na mkpụrụ okwu potassium n’ime ọbara ọbara n’oge a na-edepụta Ibertan Plus na ọgwụ ndị metụtara mmebi nke nguzogide potassium n’ime ọbara ọbara (dịka ọmụmaatụ, cardiac glycocrysts. Antiarrhythmic ọgwụ).

Ọgwụ mgbochi ọrịa anti-inflammatory Nonsteroidal: mgbe ị na-edepụta antagonists anhurensin II na ọgwụ mgbochi na-abụghị steroidal na mgbochi mkpali (dịka ọmụmaatụ, cyclooxygenase-2 inhibitors (COX-2), acetylsalicylic acid (> 3 g / ụbọchị) na ọgwụ mgbochi anti-mbufụt anti-inflammatory nwere ike ịbụ anti-inflammatory anti-inflammatory anti-inflammatory. emereme. Dị ka iji nke angiotensin n'ịtụgharị enzyme inhibitors na angiotensin II receptor antagonists na NSAIDs, enwere ọghọm nke ọrụ ezigharị adịghị arụ ọrụ, ruo na mmepe nke nnukwu gbasara akụrụ na-ada mba, ụba potassium serum, ọkachasị ndị ọrịa nwere ọrụ mkpado arụ ọrụ ugbua. Ekwesịrị iji nlezianya kee ọgwụ a, ọ kachasị ndị ọrịa. Ndi oria ekwesighi ka akpachapu ha anya. Ekwesịrị igosipụta usoro ntaramahụhụ mgbe mmalite nke usoro njikọta ọgwụ na oge n'ọdịnihu.

Ihe omuma ndi ozo banyere nmekorita ọgwụ nke irbesartan: hydrochlorothiazide emetutaghi ọgwụ pharmacokinetics nke irbesartan. Mgbe ị na-edepụta irbesartan na jikọtara warfarin, metadolized site induce CYP2C9 isoenzyme, achọpụtaghị mmekọrịta dị iche iche nke ọgwụ na ọgwụ. Mmetụta nke ndị inductor CenP2C9, dịka rifampicin, na pharmacokinetics nke irbesartan enweghị nyocha. Site na nhọpụta nke irbesartan yana digoxin, ọgwụ ọgwụ nke ikpeazụ agbanweghị.

Ihe omuma ndi ozo banyere mmekorita ogwu nke hydrochlorothiazide:

Ọgwụ ndị a nwere ike ịmekọrịta ihe gbasara thiazide diuretics mgbe ị na-ede akwụkwọ:

Ethanol, barbiturates ma ọ bụ ọgwụ ọgwụ ọjọọ: enwere ike ịhụ hypotension orthostatic mụbara.

Ọgwụ hypoglycemic (ihe ndị na-egbu mmụọ na insulin): enwere ike ịchọ ndozi nke ọgwụ hypoglycemic.

Colestyramine na colestipol: n'ihu ọnụnọ mgbanwe anion, iwere mmiri hydrochlorothiazide na-enye nsogbu. Oge dị n'etiti ị drugsụ ọgwụ ndị a kwesịrị ị dịkarịa ala 4 awa.

Glucocorticosteroids, hormone adrenocorticotropic: nkwuputa ekwuru nke nguzo mmiri-electrolyte, ọkachasị, mụbara hypokalemia.

Catecholamines (dịka ọmụmaatụ, norepinephrine): enwere ike belata arụmọrụ ọgwụ ndị a.

Ndị na - adịghị eme ka akwara dị jụụ (dịka tubocurarine): hydrochlorothiazide nwere ike ịmịpụta mmetụta ndị na - adịghị eme ka uru ahụ dị jụụ.

Ọgwụ mgbochi gout: nwere ike ịchọ mgbazi nke ọtụtụ ọgwụ ejiri na-emeso gout, ebe hydrochlorothiazide nwere ike iwelie ọdịnaya uric acid na plasma ọbara. Enwere ike ịbawanye elu na dose nke probenenide ma ọ bụ sulfinpyrazone. Njikọ ọnụ na thiazide diuretics nwere ike ịbawanye nrịba nke hypersensitivity mmeghachi omume na allopurinol.

Ngwunye Calcium: thiazide diuretics nwere ike ịbawanye ụbụrụ plasma n'ihi mbelata nke mwepu ya. Ọ bụrụ na ọ dị mkpa ịdebe mmeju nke calcium ma ọ bụ ọgwụ ndị na-emetụta ọdịnaya calcium (dịka ọmụmaatụ, vitamin D), ọ dị mkpa iji dozie dose nke ọgwụ ndị a otu yana ịchịkwa ọdịnaya calcium na plasma ọbara.

Typesdị mmekọrịta ọgwụ ndị ọzọ: thiazide diuretics nwere ike iwelie mmetụta hyperglycemic nke beta-blockers na diazoxide. Anticholinergics (wdg., Atropine) nwere ike iwelie bioavailability nke ọrịa dihiaiti thiazide site na mbenata akwara na mbuze afọ. Thiazide diuretics nwere ike ịbawanye ohere nke mmeghachi omume ọjọọ nke amantadine kpatara. Ihe akwara nke Thiazide nwere ike belata oke ọgwụ ọgwụ cytotoxic site na akụrụ (dịka ọmụmaatụ, cyclophosphamide, methotrexate) ma nwee ike myelosuppressive mmetụta ha.