Noliprel mbadamba 2, 5, 0, 625 mg 30 pcs > Ọgwụgwọ na mgbochi

Biko, tupu ịzụrụ Noliprel A, mbadamba 2.5 + 0.625 mg 30 PC., Lelee ozi banyere ya yana ozi dị na weebụsaịtị webụsaịtị nke onye na-emepụta ma ọ bụ kọwapụta otu ụdị akọwapụtara ya na onye njikwa ụlọ ọrụ anyị!

Ozi a gosiputara na saịtị ahụ abụghị onyinye ọha. Onye rụpụtara ya nwere ikike ịme mgbanwe n ’okike, imewe na ịkwakọ ngwaahịa. Foto nke ngwongwo na foto nke egosiri na katalọgụ saịtị ahụ nwere ike ịdị iche na mbido mbụ.

Ozi banyere ọnụahịa nke egosiri na katalọgụ saịtị ahụ nwere ike ịdị iche na nke ahụ n'ezie n'oge etinyebere iwu maka ngwaahịa kwekọrọ.

Emeputa

Ihe eji eme ihe: perindopril arginine, ebepamide,

Ndị pụrụ iche: sodium carboxymethyl stachi (ụdị A) - 2.7 mg, anhydrous colloidal silicon dioxide - 0.27 mg, lactose monohydrate - 74.455 mg, magnesium stearate - 0.45 mg, maltodextrin - 9 mg,

N'ọbọ ihe nkiri: macrogol 6000 - 0.087 mg, premix for white white sheath SEPIFILM 37781 RBC (glycerol - 4.5%, hypromellose - 74.8%, macrogol 6000 - 1.8%, magnesium stearate - 4.5%, titanium dioxide (E171) - 14.4%) - 2.913 mg,

Omume ọgwụ

Noliprel ® A bụ nkwadebe ejikọtara ya na perindopril arginine na ebepamide. Ngwakọta ọgwụ nke Noliprel drug A na - ejikọta njirimara nke nke ọ bụla n'ime ihe ndị mejupụtara ya.

1. ofzọ omume

Njikọ nke perindopril na indapamide na-eme ka mmetụta antihypertensive nke ọ bụla n'ime ha dịkwuo mma.

Perindopril bụ onye na - egbochi enzyme nke na - agbanwe angiotensin nke m na angiotensin II (onye na - egbochi ihe ACE).

ACE, ma ọ bụ kininase nke abụọ, bụ exopeptidase nke na-ebugharị ma ntụgharị nke angiotensin nke m n'ime ihe nnabata vasoconstrictor angiotensin II, na mbibi nke bradykinin, nke nwere mmetụta vasodilating, na heptapeptide na-adịghị arụ ọrụ. N'ihi nke perindopril:

- na-ebelata nzuzo nke aldosterone,

- site n'ụkpụrụ nke nzaghachi na-adịghị mma na-abawanye ọrụ nke renin na plasma ọbara,

- iji ogologo oge na-ebelata OPSS, nke kachasị n'ihi mmetụta na arịa dị na akwara na akụrụ. Ihe mmetụta ndị a esoghị na sodium na ion mmiri ma ọ bụ mmepe nke tachycardia reflex.

Perindopril na-ahụ maka myocardium, na -ebelata preload na mbubata.

Mgbe amụrụ hemodynamic parameters na ndị ọrịa nwere nkụda mmụọ na-adịghị ala ala, ekpughere ya:

- belata iji jupụta nrụgide n'aka ekpe na ventricles nke obi,

- mụbaa mmepụta obi,

- musclebawanye uru anụ ahụ na - erugharị.

Indapamide bụ otu nke sulfonamides, na Njirimara ụlọ ọgwụ ọ dị nso na thiazide diuretics. Indapamide na-egbochi iweghachi sodium ion na akụkụ cortical nke Henle loop, nke na-eduga na mmụba nke sodium, chlorine na, ruo ntakịrị ala, potassium na ion magnesium site na akụrụ, si otú a na-abawanye diuresis na iwetulata ọbara mgbali.

2. Mmetụta antihypertensive

Noliprel ® A nwere mmetụta antihypertensive na-adabere na DBP na SBP ma na-akwụ ọtọ ma na-agha ụgha. Mmetụta antihypertensive na-adịgide ruo awa 24. Mmetụta ọgwụgwọ kwụsiri ike na-etolite ihe na-erughị ọnwa 1 mgbe mmalite nke ọgwụgwọ ahụ esoghịkwa tachycardia. Contkwụsị ọgwụgwọ anaghị akpata ọrịa ndọrọ ego.

Noliprel ® A na -ebelata ogo nke hypertrophy ekpe ventricular (GTL), na-akwalite ịgbatị akwara, belata OPSS, anaghị emetụta metabolism (kọlestrọl ọnụ, HDL cholesterol na LDL cholesterol, triglycerides).

E gosipụtara mmetụta ojiji nke njikọta nke perindopril na ebepamide na GTL ma e jiri ya tụnyere enalapril. N'ime ndị ọrịa nwere ọbara mgbali elu na GTL, a na-emeso perindopril erbumin 2 mg (nke pụtara 2.5 mg perindopril arginine) / ebepamide 0.625 mg ma ọ bụ enalapril na dose nke 10 mg otu ugboro kwa ụbọchị, yana mmụba na dose nke perindopril erbumin na 8 mg (nke ruru 10 perindopril arginine) na ebepamide ruo 2.5 mg, ma ọ bụ enalapril ruo 40 mg otu ugboro kwa ụbọchị, mbelata ihe dị ịrịba ama na ndepụta ventricular mass index (LVMI) na perindopril / ebepamide otu ma e jiri ya tụnyere ìgwè enalapril. N'okwu a, a na-ahụ mmetụta kachasị dị na LVMI site na iji perindopril erbumin 8 mg / ebepamide 2.5 mg.

A na-ahụkarị mmetụta antihypertensive dị iche iche na-emegide usoro njikọta ọgwụ na perindopril na ebepamide ma e jiri ya tụnyere enalapril.

N'ime ndị ọrịa nwere ụdị ọrịa shuga mellitus nke 2 (ọ dị afọ iri isii na isii, ntụgharị nke ahụ mmadụ 28 n'arọ / m 2, glycosylated haemoglobin (HbA1c) 7.5%, ọbara mgbali 145/81 mm Hg), mmetụta nke ofu. nkwonkwo nke perindopril / ebepamide maka isi micro- na nnukwu nje na mgbakwunye na usoro ọgwụgwọ abụọ maka njikwa glycemic na atụmatụ nchịkwa glycemic siri ike (IHC) iche (lekwasịrị HbA1c)

A hụrụ ọbara mgbali elu na 83% nke ndị ọrịa, nnukwu nsogbu na microvascular na 32 na 10%, na microalbuminuria na 27%. Imirikiti ndị ọrịa n'oge itinye aka n'ọmụmụ ihe ahụ natara ọgwụ hypoglycemic, 90% nke ndị ọrịa natara ndị ọrụ hypoglycemic maka nchịkwa ọnụ (47% nke ndị ọrịa natara monotherapy, 46% natara ọgwụ abụọ, ọgwụ 7% natara ọgwụ ọgwụ atọ). 1% nke ndị ọrịa natara ọgwụ insulin, 9% - naanị ọgwụgwọ nri. Nchịkọta nke sulfonylureas bụ ndị 72% nke ndị ọrịa, metformin - 61% were. Dịka ọgwụgwọ concoitant, 75% nke ndị ọrịa natara ọgwụ antihypertensive, 35% nke ndị ọrịa natara ọgwụ na-egbusi ike (ọkachasị HMG-CoA reductase inhibitors (statins) - 28%), acetylsalicylic acid dịka onye na-ahụ maka antiplatelet, yana ndị nnọchianya antiplatelet ndị ọzọ (47%).

Mgbe izu isii nke nnabata oge ahụ nke ndị ọrịa natara ọgwụ perindopril / ebepamide, e kewara ha n'usoro otu nchịkwa glycemic ma ọ bụ ndị otu IHC (Diabeton ® MV nwere ike ịbawanye ọgwụ ahụ na ọnụọgụ 120 mg / ụbọchị ma ọ bụ ịgbakwunye onye nnọchianya hypoglycemic ọzọ).

N'ime otu IHC (pụtara oge sochiri - afọ 4.8, pụtara HbA1c - 6.5%) ma e jiri ya tụnyere otu njikwa ọkọlọtọ (pụtara HbA1c - 7.3%), mbelata dị 10% n'ihe ọghọm nke otu oge ejikọtara ọnụ nke macro- na microvascular nsogbu.

E nwetara uru ahụ site na mbelata dị egwu n'ihe ọghọm: nnukwu nsogbu microvascular site na 14%, mmalite na ọganihu nke nephropathy site na 21%, microalbuminuria site na 9%, macroalbuminuria site na 30% na mmepe nke nsogbu site na akụrụ site 11%.

Uru nke usoro ọgwụgwọ antihypertensive adabereghị na uru ndị a na-enweta na IHC.

Perindopril dị irè n'ịgwọ ọbara mgbali elu ọ bụla.

Mmetụta antihypertensive nke ọgwụ ahụ ruru ogo elekere anọ na isii ka otu nchịkwa ọnụ na-adịgide ruo awa 24. N'ime awa 24 mgbe ị takingụ ọgwụ ahụ, a na-ahụpụta ihe dị ka 80% inhibition ACE inhibition.

Perindopril nwere mmetụta antihypertensive na ndị ọrịa nwere ọrụ renin plasma dị ala na nke nkịtị.

Nchịkọta oge nke thiazide diuretics na-akwalite ịdị njọ nke mmetụta antihypertensive. Na mgbakwunye, njikọta nke ACE inhibitor na thiazide diuretic na-ebelata ihe ize ndụ nke hypokalemia na diuretics.

A na-egosipụta mmetụta antihypertensive mgbe ị na-eji ọgwụ na doses nwere ntakịrị diuretic mmetụta.

A na - ejikọta mmetụta antihypertensive nke ebepamide na mmelite akụrụngwa na-agbanwe agbanwe nke nnukwu akwara na mbelata OPSS.

Indapamide na-ebelata GTL, anaghị emetụta ịta nke lipids na plasma ọbara: triglycerides, cholesterol mkpokọta, LDL, HDL, metabolism carbohydrate (gụnyere na ndị ọrịa nwere ọrịa mellitus concomitant).

Nchikota nke perindopril na ebepamide agbanweghi akparamagwa ogwu ha dika nke ochichi nke di iche.

Mgbe a na-etinye ọgwụ perindopril ngwa ngwa. Bioavailability bụ 65-70%.

Ihe dị ka 20% nke mkpokọta perindopril ahụ na-agbanwe ka ọ bụrụ perindoprilat, metabolite na-arụ ọrụ. Akingakingụ ọgwụ ahụ na nri na-esochi mbelata metabolism nke perindopril gaa perindoprilat (mmetụta a enweghị uru ụlọ ọgwụ bara uru).

C_max Perindoprilat dị na plasma ọbara na-erufe awa 3-4 mgbe ịghasịrị.

Nkwukọrịta na protein plasma ọbara erughị 30% ma dabere na ntinye uche nke perindopril n'ọbara.

Mmebi nke perindoprilat metụtara ACE na-eji nwayọ nwayọ. N'ihi ya, ihe dị irè T_1/2bụ elekere 25. Nhazigharị nke perindopril adịghị eduga na nchịkọta ya, na T_1/2Site na nchịkwa ugboro ugboro, perindoprilat kwekọrọ na oge nke ọrụ ya, yabụ, steeti etolite etolite ka ụbọchị anọ gachara.

Perindoprilat wepụrụ anụ ahụ site na akụrụ. Ndi_1/2 metabolite ahụ bụ awa 3-5

Mgbatị nke perindoprilat na-eji nwayọ nwayọ, yana ndị ọrịa nwere obi na akụrụ.

Nwepu nke onyunyo nke perindoprilat bu 70 ml / min.

A na-agbanwe ọgwụ ọgwụ nke perindopril na ndị ọrịa nwere ọrịa imeju: mkpochapu hepatic na-ebelata ugboro abụọ. Agbanyeghị, ọnụọgụ nke perindoprilat guzobere anaghị ibelata, yabụ na achọrọ ngbanwe usoro ahụ adịghị mkpa.

Perindopril na-agafe Plasenta.

Indapamide na-abanye ngwa ngwa ma zuo ezu na ngọngọ nri.

C_max ọgwụ dị na plasma ọbara a na-ahụ ka otu elekere 1 gachara.

Nkwurita okwu na protein ndi na - eme ka plasma - 79%.

Ndi_1/2 bụ 14 awa iri abụọ na anọ (nkezi awa iri na iteghete). Imeghari ọgwụ ugboro ugboro anaghị edunye ya aru. Ọ bụ nke akụrụ ga - abụkarị site na akụrụ (70% nke nchịkwa nchịkwa) yana site na eriri afọ (22%) n'ụdị metabolites na-adịghị arụ ọrụ.

Aclọ ọgwụ ọgwụ anaghị agbanwe n’ebe ndị ọrịa nwere ọdịda akwara.

Ọbara mgbali dị mkpa, ndị ọrịa nwere ọbara mgbali elu na ụdị ọrịa shuga 2 nke ọrịa mellitus iji belata ihe egwu nsogbu (site na akụrụ) yana nsogbu macrovascular site na ọrịa obi.

Ime na lactation

A na-egbochi ọgwụ a n'afọime.

Mgbe ị na-eme atụmatụ ịtụrụ ime ma ọ bụ mgbe ọ na-ewere Noliprel ® A, ịkwesịrị ịkwụsị ị takingụ ọgwụ ahụ ozugbo wee depụta usoro ọgwụgwọ ọzọ.

Ejila Noliprel ® A n'ime oge izizi nke ịtụrụ ime.

Emebeghi ihe omumu omumu kwesiri ekwesi nke ndi ACE n’ime ndi nwanyi ime. Ihe amachibidoro data banyere ihe ndị na - egbochi ACE n’oge ọnwa atọ nke ịtụrụ ime na-egosi na ị inụ ihe mgbochi ACE anaghị eduga n’ihu mmebi nke nwa ebu n’emetụ, ma na agaghị enwe ike kagbuo mmetụta fetotoxic nke ọgwụ ahụ.

Noliprel ® A nwere contraindicated na oge nke II na III nke afọ ime (lee. "Contraindications").

A maara na ịdị ogologo oge ikpughere ndị na-egbochi ACE na nwa ebu n’afọ n’ime oge nke abụọ na nke atọ nke afọ ime nwere ike ibute mmepe (ọrụ nwatakịrị, oligohydramnios, igbu oge n’ọkpụkpụ nke okpokoro isi) na mmepe nke nsogbu n’ime nwa amụrụ ọhụrụ (ọdịda akwara, hypotension, hyperkalemia).

Ogologo oge iji thiazide diuretics n'ime ọnwa atọ nke ịtụrụ ime nwere ike ime hypovolemia nne na mbelata ọbara mgbali nke uteroplacental, nke na-eduga na azụmazụ fetoplacental na nlọghachi azụ nwa ebu n’afọ. N'ọnọdụ ndị a na-adịghị ahụkebe, mgbe ha na-a diụ ọgwụ mkpirikpi obere oge tupu a mụọ ha, ụmụ amụrụ ọhụrụ na-ebute hypoglycemia na thrombocytopenia.

Ọ bụrụ na onye ọrịa ahụ natara ọgwụ ahụ Noliprel ® A n'oge oge nke abụọ nke II ma ọ bụ III nke afọ ime, a na-atụ aro ka ọ duzie ultrasound nke nwa amụrụ ọhụrụ iji chọpụta ọnọdụ nke okpokoro isi na akụrụ.

Nnukwu ọbara ọgbụgba nwere ike ibilite n’ebe ụmụ amụrụ ọhụrụ nọ, nke ndị nne natara ọgwụgwọ na ndị na-egbochi ACE, ya mere ụmụ amụrụ ọhụrụ kwesịrị ịnọ n'okpuru nlekọta ahụike.

Noliprel ® A na - enye contraindicated n'oge ara.

Amabeghị ma perillopril nwere mmiri ara ara ga-apụ.

Indapamide bụ mmiri ara ehi. Diakingụ ọgwụ osisi thiazide na-eme ka mbelata oke mmiri ara ara ma ọ bụ belata ịwa ahụ. N'okwu a, nwa amụrụ ọhụrụ nwere ike ịmalite ịmịnye anya na ihe ndị sitere na sulfonamide, hypokalemia na jaundice nuklia.

Ebe ọ bụ na ojiji nke perindopril na indapamide n'oge a na-enye nwa ara nwere ike ibute nnukwu nsogbu na nwa ọhụrụ, ọ dị mkpa iji mata mkpa ọgwụgwọ dị maka nne ma kpebie nkwụsị ara ya ma ọ bụ ị takingụ ọgwụ ahụ.

Ihe ngbanwe

hypersensitivity na perindopril na ndị ọzọ na-egbochi ACE, ebepamide, sulfonamides ndị ọzọ, yana ndị ọzọ inyeaka na-eme ọgwụ ahụ,
akụkọ banyere anakedeede (gụnyere ndị ọzọ na-egbochi ACE),
hereditary / idiopathic angioedema, hypokalemia, nnukwu akụrụ okpu (creatinine Cl erughị 30 ml / min),
stenosis nke otu akụrụ, akwara gbasara akwara akwara
nnukwu umeji imeju (tinyere encephalopathy),
n'otu oge iji ọgwụ ọjọọ eme ihe na-agbatị oge QT,
n'otu oge ị useụ ọgwụ antiarrhythmic nke nwere ike ibute ọrịa obi abụọ,
ime
oge lactation.

Nchịkọta ọgwụ a na ọgwụ ndị nwere sọsọ potassium, potassium na lithium, na njikwa ndị ọrịa nwere oke ọgwụ plasma dị elu adịghị atụ aro ya.

N'ihi enweghị ahụmịhe ọhụụ zuru ezu, Noliprel ® A ekwesighi iji ndị ọrịa na-enyocha hemodialysis, yana ndị ọrịa nwere nkụchi obi na-enweghị ọgwụgwọ.

N'iji nlezianya: ọrịa systemic nke anụ ahụ na - ejikọta ya (gụnyere sistemu lupus erythematosus, scleroderma), ọgwụgwọ immunosuppressive (ihe ize ndụ nke neutropenia, agranulocytosis), mgbochi nke ụmị ọkpụkpụ, belatara BCC (ọnya ụkwara, nri na-enweghị nnu, vomiting, afọ ọsịsa, n'ọbara). ọrịa angina pectoris, ọrịa cerebrovaskụla, ọbara ọgbụgba renovascular, ọrịa shuga, ọrịa obi na-adịghị ala ala (NYHA nhazi ọkwa IV), hyperuricemia (ọkachasị ndị gout na urate nephrolithiasis). lability ọbara mgbali, ịka nká, hemodialysis na-eji membranes na-elu-elu ma ọ bụ desensitization, tupu LDL apheresis, ọnọdụ mgbe akụrụ akụrụ, aortic valve stenosis / hypertrophic cardiomyopathy, erughi lactase, galactosemia ma ọ bụ glucose-galactose malabsorption syndrome (afọ 18, afọ 18, afọ iri, 18 anaghi etinyekwa nchekwa.

Nsonaazụ

Site na sistemu hemopoietic na lymphatic: ọ dịkarịsịrị ike - thrombocytopenia, leukopenia / neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia.

Ọrịa ọgbụgba: n'ọrịa ọnọdụ ụfọdụ (ndị ọrịa gbasasịrị akụrụ akụrụ, ndị ọrịa na hemodialysis) Ndị na - egbochi ACE nwere ike ibute ọgbụgba (hụ "Ntuziaka Pụrụ Iche").

Site n'akụkụ nke sistemụ akwara etiti: oge - paresthesia, isi ọwụwa, ọgbụgbọ, asthenia, vertigo, ugboro ugboro - nsogbu nke ụra, nnwere onwe nke ọnọdụ, adịghị adịkarị - ọgba aghara, oge a na - ekwughị oge - ịkụda.

Site n'akụkụ akụkụ ahụ nke ọhụụ: ọtụtụ mgbe - imerụ anya.

Na akụkụ anụ ahụ na-anụ ihe: ọtụtụ mgbe - tinnitus.

Site na CCC: ọtụtụ mgbe - nkwupụta mbelata ọbara mgbali, ya. orthostatic hypotension, ọ na-adịkarịkarị - obi mgbagasị obi, incl. bradycardia, ventricular tachycardia, firamillation atonia, yana angina pectoris na infarction myocardial, ikekwe n'ihi oke ọbara mgbali elu na ndị ọrịa nwere nnukwu nsogbu (lee “Ntuziaka Pụrụ Iche”), ugboro ugboro - ụdị pịpeepe na-egbu egbu (ikekwe egbu egbu - lee “ Mmekorita ”).

N’akuku akụkụ iku ume, akwara na akụkụ ahụ: mgbe mgbe - megide nzụlite iji ACE inhibitors, ụkwara pụrụ ịdapụta, nke ga-adịgide ruo ogologo oge ka ị na - a thisụ ọgwụ ndị a ma kwụsịchaa mgbe ha kagbuo, mkpụmkpụ ume, adịkarịghị - bronchospasm, ọ na - adịkarịkarị - eosinophilic pneumonia, rhinitis .

Site na usoro nri: oge - nkụ nke mucosa nke onu, ọgbụgbọ, ọgbụgbọ, mgbu afọ, mgbu epigastric, uto na-egbu egbu, agụụ, nri dyspepsia, afọ ntachi, afọ ọsịsa, ọ na - adịkarịghị - angioedema nke eriri afọ, cholestatic jaundice, pancreatitis, Achọpụtaghị ugboro - encephalopathy hepatic na ndị ọrịa nwere ọrịa imeju (lee. "Contraindications", "Ntuziaka Pụrụ Iche"), ịba ọcha n'anya.

Na akụkụ anụ ahụ na abụba subcutaneous: mgbe mgbe - ọnya ọnya, itching, maculopapular friji, infrequently - angioedema of the face, egbugbere ọnụ, aka, mucous akpụkpọ ahụ, olu na-ekwu okwu na / ma ọ bụ larynx, urticaria (lee "Ntuziaka pụrụ iche") , mmeghachi omume hypersensitivity na ndị ọrịa na-enwe nsogbu mgbochi nke bronchial na mmeghachi ahụ nfụkasị, purpura, na ndị ọrịa nwere nnukwu systemic lupus erythematosus, usoro nke ọrịa ahụ nwere ike ịkawanye njọ, ọ dịkarịsịrị ike erythema multiforme, epidermal toxic necrolysis, Stevens-Johnson syndrome. Enweela ikpe banyere mmeghachi omume foto (lee. "Ntuziaka pụrụ iche").

Site na usoro akwara na akwara nke ahụ: mgbe mgbe - akwara nke akwara.

Site na sistemụ urinary: ugboro ugboro - akwara gbasara akwara, ọ na - adịkarịghị - nnukwu akwara ịre.

Site na usoro ọmụmụ: enweghi ike - enweghi ike.

Ọrịa niile na ihe mgbaàmà: mgbe mgbe - asthenia, ugboro ugboro - ịba ụba aja.

Na-egosi ụlọ nyocha: hyperkalemia, oge na-adịkarị ala, ntakịrị mmụba na nsụpụta creatinine na mmamịrị na plasma ọbara mgbe a kwụsịrị ọgwụgwọ, ọtụtụ mgbe na ndị ọrịa nwere akwara akwara stenosis, na ọgwụgwọ nke ọbara mgbali elu na diuretics ma bụrụ nke ọdịda akụrụ, ike adịghị adị, ugboro ole a na-akọwapụtaghị - mmụba na oge QT na ECG (lee "Ntuziaka Pụrụ Iche"), mmụba nke mkpokọta uric acid na glucose n'ọbara, mmụba nke ọrụ enzymes imeju, hypokalemia, nke kachasị mkpa maka atsientov, na n'ihe ize ndụ (lee. "Special Ntuziaka"), hyponatremia na hypovolemia, na-eduga akpịrị ịkpọ nkụ na orthostatic hypotension. Otutu hypochloremia nwere ike iduga mmeghachi nke alkalal metabolism (ihe gbasara nke puru iche na ike nke ihe a di ala).

Nsonaazụ ndị a chọpụtara na ule nke ụlọ ọgwụ

Nsonaazụ ndị edepụtara n'oge ọmụmụ ADVANCE kwekọrọ na nchekwa nchekwa ebidoro maka maka njikọta nke perindopril na ebepamide. Achọpụtara ihe ojoo dị njọ na ụfọdụ ndị ọrịa nọ na otu ọmụmụ ahụ: hyperkalemia (0.1%), nnukwu akụrụ oke (0.1%), hypotension art 0 (0.1%) na ụkwara (0.1%).

N'ime ndị ọrịa 3 nọ na perindopril / ebepamide otu, a hụrụ angioedema (ọ dịkarịrị abụọ na ìgwè abụọ).

Mwepụta wepụtara ya na ihe mejupụtara

A na-emepụta Noliprel n'ụdị mbadamba: ọcha, na-acha ọcha, na-enwe ihe ize ndụ n'akụkụ abụọ (na blisters nke 14 na 30 PC., 1 ọnya na igbe kaadi).

Ngwakọta nke mbadamba 1 gụnyere ihe ndị na-arụ ọrụ:

Perindopril tertbutylamine nnu - 2 mg,
Indapamide - 0.625 mg.

Ihe inyeaka: microcrystalline cellulose, lactose monohydrate, magnesium stearate, hydrophobic colloidal silicon dioxide.

Mlọ ọgwụ

Noliprel® A bụ ngwakọta jikọtara nke nwere perindoprilarginin (angiotensin na - atụgharị enzyme inhibitor) na ebepamide (ọnya na - esite n'ụgbụpo sulfonamide). Ngwakọta ọgwụ nke ọgwụ ọgwụ Noliprel drug A na - agwakọta ihe ndị dị na ya.

Nchikota nke perindopril na ebepamide na-eme ka ihe nke ọ bụla n'ime ha dịkwuo mma. Noliprel® A nwere mmetụta na -eche hypotensive na ma diastolic na systolic ọbara mgbali (BP) n'ọnọdụ “dina” na “guzo”. Ọgwụ ahụ dị awa 24. Mmetụta ọgwụgwọ ahụ na-apụta ihe na-erughị ọnwa 1 mgbe mmalite ọgwụgwọ yana tachycardia esoghị. Contkwụsị ọgwụgwọ anaghị akpata ọrịa ndọrọ ego.

Noliprel® A na -ebelata ogo nke ogwe aka ekpe ventricular, mee ka elasticity arterial, belata ngụkọta akwara vaskụla, anaghị emetụta metabolism (ngụkọta cholesterol, ịdị elu nke lipoprotein cholesterol (HDL) na njupụta dị ala (LDL), triglycerides).

Perindopril

Perindopril bụ onye na - egbochi enzyme nke na - agbanwe angiotensin nke m na angiotensin II (onye na - egbochi ihe ACE).

Enzyme Ang Angensensin na-emegharị, ma ọ bụ kinase, bụ ihe exopeptidase nke na-ebughari ntụgharị nke angiotensin nke m n'ime ọgwụ vasoconstrictor angiotensin II, na mbibi nke bradykinin, nke nwere mmetụta vasodilating, na heptapeptide na-adịghị arụ ọrụ. N'ihi nke perindopril:

na-ebelata nzuzo nke aldosterone,
site na ụkpụrụ nke nzaghachi na-adịghị mma na-abawanye ọrụ nke renin na plasma ọbara,
site na iji ogologo oge, ọ na-ebelata mkpụkọ akwara nke mkpanaka, nke kachasị n'ihi mmetụta na arịa dị na akwara na akụrụ.

Mmetụta ndị a esoghị na njigide nke nnu na mmiri ma ọ bụ mmepe nke Reflex tachycardia.

Perindopril nwere mmetụta hypotensive na ndị ọrịa nwere ọrụ renin plasma dị ala na nke nkịtị.

Site n'iji perindopril mee ihe, mgbada agbadatala ọbara ma systolic na diastolic ọbara (BP) n'ọnọdụ “ịgha ụgha” na “nguzo”. Drawepụ ọgwụ ọjọọ ahụ anaghị eme ka ọbara mgbali elu.

Perindopril nwere mmetụta nke vasodilating, na-enyere aka iweghachi ịdị nkọ nke nnukwu akwara na nhazi nke mgbidi vaskụla nke obere akwara, na-ebelata ọbara mgbali elu ventricular.

Ojiji a na-eji thiazide diuretics na-akwalite ịdị njọ nke mmetụta antihypertensive. Na mgbakwunye, ngwakọta nke ACE inhibitor na thiazide diuretic na-eduga n'ịbelata ihe ize ndụ nke hypokalemia na ndị ọrịa na-enweta diuretics.

Perindopril na-ahụ maka ịrụ ọrụ obi, na -ebelata mbubata na mbugharị.

Mgbe amụrụ hemodynamic parameters na ndị ọrịa nwere nkụda mmụọ na-adịghị ala ala, ekpughere ya:

belata imeju nrụgide na aka ekpe na aka nri nke obi,
ibelata ngụkọta ngụgụ nke akwara,
mụbaa mmepụta obi yana ụba indexiiti,
mpaghara ọbara tozuru oke muscle.

Indapamide bụ otu nke sulfonamides - site na Njirimara ọgwụ ọgwụ ọ dị nso na thiazide diuretics. Indapamide na-egbochi iweghachi sodium ion na akụkụ cortical nke Henle loop, nke na-eduga na mmụba nke mmịpụta sodium, chlorine na, ruo ntakịrị ala, potassium na magnesium ion site na akụrụ, si otú ahụ na-abawanye diuresis.

A na-egosipụta mmetụta antihypertensive na usoro onunu ogwu nke na - anaghị ebute mmetụta diuretic.

Indapamide belata hyperreactivity vaskụla na nkwanye ugwu maka adrenaline. Indapamide anaghị emetụta plasma lipids: triglycerides, cholesterol, LDL na HDL, metabolism metabolism (gụnyere na ndị ọrịa nwere ọrịa mellitus concomitant).

Na-enyere aka belata hypertrophy aka ekpe.

Usoro onunu ogwu na nhazi

N'ime, ọkacha mma n'ụtụtụ, tupu nri, 1 mbadamba ọgwụ ọgwụ Noliprel® A otu oge kwa ụbọchị.

Ọ bụrụ na enwetaghị mmetụta hypotensive ka ọnwa na-amalite ọgwụ, ọgwụ ahụ nwere ike okpukpu abụọ ka usoro nke 5 mg + 1.25 mg (nke ụlọ ọrụ mepụtara n'okpuru aha ahia Noliprel® A forte).

Ọdịda ya

A na-egbochi ọgwụ a na ndị ọrịa nwere nnukwu akụrụ oke (CC erughi 30 ml / min.).

Maka ndị ọrịa nwere obere akwara ezughị oke (CC 30-60 ml / min), oke kachasị nke Noliprel® A bụ mbadamba 1 kwa ụbọchị.

Ndị ọrịa nwere CC hà ma ọ bụ karịa 60 ml / min. requirechọghị mmezi dose. N'oge usoro ọgwụgwọ, ịdị mkpa mgbe niile ilele ọkwa plasma creatinine na potassium dị mkpa.

Jiri n'oge ime na lactation

Ekwesighi iji ọgwụ a mee ihe n'oge ọnwa atọ nke ime.

Mgbe ị na-eme atụmatụ ịtụrụ ime ma ọ bụ mgbe ọ na-ewere Noliprel® A, ị kwesịrị ị kwụsị ị stopụ ọgwụ ahụ ozugbo wee depụta usoro ọgwụgwọ ọzọ.

Emebeghi ihe omumu omumu kwesiri ekwesi nke ndi ACE n’ime ndi nwanyi ime. Ihe amachibidoro data banyere nsonye ọgwụ a n'oge ọnwa atọ nke ịtụrụ ime na-egosi na ị theụ ọgwụ ahụ edugaghị mmebi nke metụtara fetotoxicity.

Noliprel® A bụ nke afọime n'afọ II na nke III nke ịtụrụ ime (lee ngalaba “Contraindications”).

A maara na ịdị ogologo oge ikpughere ndị na-egbochi ACE na nwa ebu n’afọ n’ime nke abụọ na nke atọ nke afọ ime nwere ike ibute mmepe (ọrụ nwatakịrị kwụsịrị, oligohydramnios, ịkpụ ụkpụkpụ nke okpokoro isi) na mmepe nke nsogbu n’ime nwa amụrụ ọhụrụ (ọdịda akwara, hypotension, hyperkalemia).

Ọ bụrụ na onye ọrịa ahụ natara ọgwụ Noliprel® A n'oge oge nke abụọ nke afọ II ma ọ bụ III, a na-atụ aro ka ọ mee nyocha nke nwa ebu n’afọ iji chọpụta ọnọdụ okpokoro isi na akụrụ.

Dodoụbiga ya ókè

Mgbaàmà nke ị ofụbiga mmanya ókè bụ mbelata ọbara mgbali elu, oge ụfọdụ yana ọgbụgbọ, ọgbụgbọ, ọgbụgbọ, ọgbụgbọ, iro ụra, ọgba aghara, na oliguria, nke nwere ike ịba na nsogbu (n'ihi hypovolemia). Electrolyte nsogbu (hyponatremia, hypokalemia) nwekwara ike ime.

A na-ebelata usoro ihe mberede iji wepụ ọgwụ ahụ n'ahụ: ịsa afọ na / ma ọ bụ ịkọwa carbon na-arụ ọrụ, mweghachi nke nguzo mmiri-electrolyte.

Site n'ịbelata ọbara mgbali elu, a ga-atụgharịrị onye ọrịa ahụ ka ọ kwụrụ n'ọkwa ụkwụ nwere ụkwụ. Ọ bụrụ na ọ dị mkpa, hypovolemia ziri ezi (dịka ọmụmaatụ, infusion intravenous nke 0.9% sodium chloride solution). Perindoprilat, metabolite na-arụ ọrụ nke perindopril, nwere ike wepụrụ ya n'ahụ site na usoro ọgwụgwọ.

Ngwakọta agwaghị ya

Nkwadebe nke lithium: site na imeghari nke lithium na ACE inhibitors n'otu oge, mmụba a na-atụgharị uche na lithium na plasma ọbara na nsonaazụ nsonaazụ nwere ike ime. Ozo nke thiazide diuretics nwere ike mee ka ị nwekwuo lithium ma mee ka ihe ojoo too. A naghị atụ aro ka ejikọtara ọnụ nke perindopril na ebepamide na lithium n'otu oge. Ọ bụrụ na ọ dị mkpa, ụdị ọgwụgwọ ahụ kwesịrị ịdị na-enyocha ọdịnaya lithium na plasma ọbara (lee akụkụ "ntuziaka pụrụ iche").

Ọgwụ, nchikota nke chọrọ nlebara anya pụrụ iche

Baclofen: nwere ike iwelie mmetụta hypotensive. Ekwesịrị inyocha ọbara mgbali na ọrụ akụrụ; ọ bụrụ na ọ dị mkpa, achọrọ nhazi nke ọgwụ mgbochi.

Ọgwụ antisteroidal anti-inflammatory (NSAIDs), gụnyere nnukwu ọgwụ acetylsalicylic acid (karịa 3 g / ụbọchị): NSAID nwere ike ibute mbelata diuretic, natriuretic na mmetụta antihypertensive. Site na mfu mmiri dị egwu, ọdịda akụrụ oke nwere ike ịmalite (n'ihi mbelata ọnụego mkpokọ ọnụ). Tupu ịmalite ịgwọ ọgwụ ahụ, ọ dị mkpa iji mepụta maka mfu mmiri ma nyochaa ọrụ akụrụ oge niile na mmalite ọgwụgwọ.

Nchikota ogwu nke choro nlebara anya

Ngwakọta ọgwụ anti Trisyclic, antipsychotics (antipsychotics): ọgwụ nke klaasị ndị a na-eme ka mmetụta antihypertensive dịkwuo elu ma bulie ohere nke hypolatin orthostatic (mmụba mgbakwunye).

Corticosteroids, tetracosactide: mbelata na mmetụta antihypertensive (mmiri na njigide sodium ion n'ihi corticosteroids).

Ọgwụ antihypertensive ndị ọzọ: nwere ike ịkwalite mmetụta antihypertensive.

Ntụziaka pụrụ iche

Ojiji nke ọgwụ ọjọọ Noliprel® A 2.5 mg + 0.625 mg, nwere obere ala nke ebepamide na perindopril arginine, esonyeghị ngbanwe dị ukwuu na mmetụta nke nsonaazụ, ewezuga hypokalemia, ma e jiri ya tụnyere perindopril na ebepamide na usoro nke kachasị ala kwere (lee akụkụ " Mmetụta akụkụ ”). Na mbido ọgwụgwọ ogwu ọgwụ abụọ, nke onye ọrịa ahụ enwetabeghị na mbụ, ọ ga - apụtacha ihe ize ndụ nke idiosyncrasy. Nlezi anya nke onye ọrịa belata ihe egwu a.

Alrụ ọrụ na-arụ ọrụ na ụlọ

Usoro ọgwụgwọ a na - egbochi ndị ọrịa nwere nnukwu akụrụ oke (CC erughi 30 ml / min). Somefọdụ ndị ọrịa nwere ọbara mgbali elu na-enweghị nkwarụ ọhụụ nke akụrụngwa, usoro ọgwụgwọ nwere ike igosi akara ụlọ nyocha nke ọdịda akụrụngwa nke arụrụala. N'okwu a, ekwesịrị ịkwụsị usoro ọgwụgwọ. N’ọdịnihu, inwere ike ịmaliteghachi ọgwụgwọ ijikọ ọgwụ site na iji ọgwụ were obere ọgwụ, ma ọ bụ were ọgwụ ndị ahụ na monotherapy.

Patientsdị ndị ọrịa a chọrọ nlebara anya oge niile nke protein serum na creatinine - izu abụọ ka ebido ịmalite ọgwụgwọ yana ọnwa abụọ ọ bụla. Ọdịdị ọgbụgba na-abịakarị na ndị ọrịa nwere nkụchi obi na-adịghị ala ala ma ọ bụ ọrụ izizi nwere nsogbu metụtara akwara, gụnyere akụrụ akwara akwara stenosis.

Nnukwu ọbara ọgbụgba na nrụgide mmiri-electrolyte

A na - ejikọ Hyponatremia na ihe egwu nke mmepe mberede na arterial hypotension (ọkachasị ndị ọrịa nwere akụrụ akwara stenosis na akwara gbasara akwara stenosis). Ya mere, mgbe a na-eleba anya na ndị ọrịa ike, ekwesịrị ị attentiona ntị n'ihe ngosipụta nke nkụda mmụọ yana mbelata nke ọkwa electrolyte na plasma ọbara, dịka ọmụmaatụ, mgbe afọ ọsịsa ma ọ bụ ọgbụgbọ gasịrị. Ọ dị ndị ọrịa dị otú a mkpa ka a na-enyocha plasma electrolytes ọbara kwa mgbe.

Site na ọgbụgba akwara siri ike, enwere ike ịchọrọ nchịkwa nke 0.9% sodium chloride solution.

Ọbara mgbatị oge a abụghị ọgwụ mgbochi maka ọgwụgwọ gara aga. Mgbe mweghachi nke olu na-ekesa ọbara na ọbara mgbali, a nwere ike ịmaliteghachi ọgwụgwọ iji obere ọgwụ, ma ọ bụ enwere ike iji ọgwụ monotherapy.

Ọkpụkpọ potassium

Njikọ nke perindopril na indapamide adịghị egbochi mmepe nke hypokalemia, karịsịa na ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụ. Dị ka ọ dị n'iji ọgwụ ọgwụ ọnụ jikọtara ọnụ na diuretic, ọ dị mkpa ileba anya na ọkwa nke potassium na plasma ọbara.

Usoro ahịa ọgwụ ahịa

Ogwu gi bu ogwu.

Dika monotherapy, dọkịta na-adụ ọdụ perindopril na ebepamide iche. Analogues nke ọgwụ ahụ gụnyere Co-preness ma ọ bụ Prestarium Arginine Combi. Na mgbakwunye, onye rụpụtara emepụtara Noliprel na usoro ndị ọzọ.

Ọnụ ego Noliprel A mbadamba mbadamba 2.5 mg + 0.625 mg na ọgwụ ọgwụ Moscow bụ 540-600 rubles.

Mmekorita

1. A naghị akwado njikọta maka ojiji

Nkwadebe nke lithium: site na imeghari nke lithium na ACE inhibitors n'otu oge, mmụba a na-atụgharị uche na lithium na plasma ọbara na nsonaazụ nsonaazụ nwere ike ime. Ozo nke thiazide diuretics nwere ike mee ka ị nwekwuo lithium ma mee ka ihe ojoo too. A naghị atụ aro ka ejikọtara ọnụ nke perindopril na ebepamide na lithium n'otu oge. Ọ bụrụ na ụdị ọgwụgwọ a dị mkpa, ekwesịrị ilebara ọdịnaya lithium dị na plasma ọbara anya (lee “Ntuziaka Pụrụ Iche”).

2. Ọgwụ, nchikota nke chọrọ nlebara anya na nlebara anya pụrụ iche

Baclofen: nwere ike iwelie mmetụta hypotensive. Ekwesịrị inyocha ọbara mgbali na ọrụ akụrụ; imeghari dose ọgwụ antihypertensive ka achọrọ ma ọ bụrụ na ọ dị mkpa.

NSAIDs, gụnyere oke ọnụọgụ acetylsalicylic acid (karịa 3 g / ụbọchị): NSAID nwere ike belata nsị, natriuretic na mmetụta antihypertensive. Site na mfu mmiri dị egwu, ọdịda akụrụ oke nwere ike ịmalite (n'ihi mbelata ọnụego mkpokọ ọnụ). Tupu ịmalite ịgwọ ọgwụ ahụ, ọ dị mkpa iji mepụta maka mfu mmiri ma nyochaa ọrụ akụrụ oge niile na mmalite ọgwụgwọ.

3. Ngwakọta ọgwụ chọrọ nlebara anya

Corticosteroids, tetracosactide: mbelata na mmetụta antihypertensive (mmiri na njigide sodium ion n'ihi corticosteroids).

Ọgwụ antihypertensive ndị ọzọ: nwere ike ịkwalite mmetụta antihypertensive.

1. A naghị akwado njikọta maka ojiji

Ihe ndị na-enye mmadụ nri n’ahụ́ bekee na-egbu egbu (amiloride, spironolactone, triamteren) na nhazi nke potassium: ndị na-egbochi ACE na-ebelata ọnwụ nke akụrụ site na diuretic ahụ. Ọgwụ potassium na-eme ka mkpụrụ ndụ (dịka ọmụmaatụ, spironolactone, triamteren, amiloride), ịkwado potassium, na mgbakwunye nnu nwere mmanụ nwere ike ibute oke mmụba na potassium nke ọbara n'ọbara ruo ọnwụ. Y’oburu n’otu ihe eji egbochi ACE inhibitor na ọgwụ di n’elu (n’ihe banyere hypokalemia enwetara), ekwesịrị ịkpachara anya ma na-elele ọdịnaya potassium n’ime plasma ọbara ya na paradaịs ECG.

2. Ngwakọta ọgwụ chọrọ nlekọta pụrụ iche

Ndị ọrụ hypoglycemic maka nchịkwa ọnụ (n'ụkpụrụ sulfonylurea) na insulin: a kọwapụtara mmetụta ndị na-esonụ maka captopril na enalapril. Ndị na - egbochi ACE nwere ike ịkwalite mmetụta hypoglycemic nke insulin na usoro sulfonylurea na ndị ọrịa nwere ọrịa mellitus. Mmepe nke hypoglycemia dị obere (n'ihi mmụba nke nnabata glucose na mbelata nke mkpa insulin).

3. Ngwakọta ọgwụ chọrọ nlebara anya

Allopurinol, cytostatic na ọgwụ immunosuppressive, corticosteroids (maka iji sistemu) na procainamide: ojiji n'otu oge na ndị na-egbochi ACE nwere ike ịnwekwu ihe egwu leukopenia.

Ihe ọ pụtara maka anesthesia izugbe: iji otu oge ACE inhibitors na ndị na-ahụ maka ọgwụ na-akụnwụ ahụ, nwere ike ibute mmụba na antihypertensive.

Diuretics (thiazide na loop): iji ọgwụ ndị na-eme ka a na-eme ya na nnukwu doses nwere ike ibute hypovolemia, mgbakwunye nke perindopril na ọgwụgwọ nwere ike ibute ọgbụgba akwara.

Nkwadebe ọla edo: mgbe ị na-eji ihe mgbochi ACE, incl. perindopril, n'ime ndị ọrịa na-anata nkwadebe iv ọla edo (sodium aurothiomalate), akọwapụtara usoro mgbaàmà, gụnyere: hyperemia ihu anụ ahụ, ọgbụgbọ, ọgbụgbọ, hypotension artial.

1. Ngwakọta ọgwụ chọrọ nlekọta pụrụ iche

Ọgwụ ndị nwere ike ibute ọrịa nje: n'ihi ihe ize ndụ nke hypokalemia, a kwesịrị ịkpachara anya mgbe ị na-eji ebepamide na ọgwụ ndị nwere ike ibute ọrịa obi nke nwere ike ibute pirouette arrhythmias, dịka ọmụmaatụ, ọgwụ antiarrhythmic (quinidine, hydroquinidine, nnupụisi, amiodarone, dofetilide, ibutilide , bretilia tosylate, sotalol), ụfọdụ antipsychotics (chlorpromazine, cyamemazine, levomepromazine, thioridazine, trifluoperazin), benzamides (amisulpride, sulpiride, sultopride, tiapride), butyrophenones (droperidol, gallop ridol), ogwu ndi ozo (pimozide), ogwu ndi ozo, dika bepridil, cisapride, diphemanil methyl sulfate, erythromycin (iv), halofantrine, misolastine, moxifloxacin, pentamidine, sparfloxacin, vincamine (iv), metone, mmụọ, metonamone, mmụọamomo, astonemadine, astonemadine, astonmadine, astonemadine, astonemadine, astonemadine, astonemadine, astonemadine, metone, mmụọ, metonamone, mmụọamomo, astonmadine, astonemadone, mmụọ, goomon, mmụọ, metonamone, mmụọ, madiamam, mmụọ, madiamam, mmụọm, metonamone, mmụọaka, mịnịstam, astonmadine, mmụọ, na-agba mmụọ, sọọsọ mmụọ, mmụọ metamone, mmụọamomo, mmụọamomo, mmụọamomo, mmụọ mmụọ, madiamam, mmụọ, madiamam, mmụọ, na-efe efe, na-agbakasị mmụọ; . Ekwesịrị iji gbochie otu oge iji ọgwụ ndị dị n'elu, ihe ize ndụ nke hypokalemia na, ọ bụrụ na ọ dị mkpa, mmezi ya, na-ejikwa oge QT.

Ọgwụ ndị nwere ike ịkpata hypokalemia: amphotericin B (iv), corticosteroids na mineralocorticosteroids (maka iji usoro), tetracosactides, ọgwụ ndị na-akpali motility eriri afọ: ịba ụba nke hypokalemia (mmụba mmetụta). Ọ dị mkpa ijikwa ọdịnaya potassium na plasma ọbara, ọ bụrụ na ọ dị mkpa, mmezi ya. Ekwesịrị ilebara ndị ọrịa anya n'otu oge na-anata cardiac glycosides. Ekwesịrị iji ọgwụ ndị dị na mmiri ndị na-adịghị akpali motility eriri afọ.

Cardiac glycosides: hypokalemia na-eme ka mmetụta uto nke cardiac glycosides dịkwuo mma. Iji otu oge nke ebepamide na cardiac glycosides, ekwesịrị ilebara ọdịnaya potassium na ọkwa plasma ọbara na ECG anya ma, ọ bụrụ na ọ dị mkpa, usoro ọgwụgwọ ịhazi.

2. Ngwakọta ọgwụ chọrọ nlebara anya

Metformin: ọdịda ọdịda nke na-arụ ọrụ nke nwere ike ịto mgbe ị na-a diụ mkpụrụ ndụ, ọkachasị loop diuretics, ebe nchịkwa nke metformin na - ebulite ihe egwu lactic acidosis. Ekwesighi iji Metformin mee ihe ma ọ bụrụ na itinye uche nke creatinine na plasma ọbara karịrị 15 mg / l (135 μmol / l) n'ime ụmụ nwoke na 12 mg / l (110 μmol / l) na ụmụ nwanyị.

Iodine nwere ihe dị iche iche: akpọnwụ nke anụ ahụ mgbe ị na-a drugsụ ọgwụ diuretic na-abawanye ohere nke nnukwu gbasara akụrụ oke, ọkachasị mgbe ị na - eji ọgwụ dị iche iche nke iodine nwere ihe dị iche. Tupu iji iodine nwere ihe dị iche na - ahụ maka ọrịa, ọ dị mkpa ka ndị ọrịa kwụọ ụgwọ mmefu mmiri.

Ngwunye Calcium: ya na nchịkwa nke imegharị ya, hypercalcemia nwere ike ịmalite n'ihi mbelata nke mkpụbelata ion na-aga site na akụrụ.

Cyclosporin: mmụba nke mkpokọta nke creatinine na plasma ọbara nwere ike ikwe omume n’agbanweghị ịta nke cyclosporin na plasma ọbara, ọbụlagodi ihe dị n’ime mmiri na sodium ion.

Etu ị ga-esi, usoro nchịkwa na usoro onunu ogwu

N'ime, ọkacha mma n'ụtụtụ, tupu iri nri.

1 mbadamba ọgwụ ogwu Noliprel ® A 1 oge kwa ụbọchị.

Ọ bụrụ na enwere ike, ọgwụ a na-ebido na nhọrọ nke usoro nke ọgwụ ndị mejupụtara ọgwụ. Maka mkpa ụlọ ọgwụ, ị nwere ike ịtụle ohere ọ ga - edepụta ọgwụ ịjikọ ọnụ na Noliprel ® A ozugbo ọgwụ monotherapy gasịrị.

Ndị ọrịa nwere ọbara mgbali elu na ụdị ọrịa shuga 2 nke ọrịa mellitus iji belata ihe ize ndụ nke nsogbu microvaskụla (site na akụrụ) yana nsogbu akwara site na ọrịa obi.

Noliprel mbadamba 1 ® Otu ugboro kwa ụbọchị. Mgbe ọnwa 3 nke ọgwụgwọ gasịrị, enwere ezigbo ndidi, ọ ga - ekwe omume ịbawanye ọgwụ ahụ na mbadamba abụọ nke Noliprel ® A 1 otu ugboro kwa ụbọchị (ma ọ bụ mbadamba 1 nke Noliprel ® A forte 1 oge kwa ụbọchị).

Ndị okenye na-arịa ọrịa

Ekwesịrị ịnye ọgwụ maka ọgwụ ahụ mgbe ị nyochachara ọrụ akụrụngwa yana ọbara mgbali.

A na - egbochi ọgwụ a na ndị ọrịa nwere nnukwu akụrụ oke (creatinine Cl erughi 30 ml / min).

Maka ndị ọrịa nwere obere akụrụ akwara na-adịghị ala ala (Cl creatinine 30-60 ml / min), a na-atụ aro ka ịmalite ọgwụ iji ọgwụ ndị dị mkpa (n'ụdị monotherapy), nke bụ akụkụ nke Noliprel ® A.

Maka ndị ọrịa nwere Cl creatinine ha nhata ma ọ bụ karịa 60 ml / min, ọ dịghị mkpa idozigharị dose. N'oge usoro ọgwụgwọ, ịdị mkpa mgbe niile ilele ọkwa plasma creatinine na potassium dị mkpa.

A na - agọnye ọgwụ a n'ime ndị ọrịa nwere nnukwu ịba ọcha n'anya.

Na ọdịda akwara na-agafeghị oke, a chọghị ndozi dose.

Childrenmụaka na ndị nọ n'afọ iri na ụma

Ekwesighi inye umuaka na umuaka ndi gbara aka n’agbata akwukwo iri n’agbughi akwukwo Noliprel ® nke n’enweghi data banyere odi nma na nchekwa nke ogwu n’ile ndi oria no.

Ntụziaka pụrụ iche

Ojiji nke ọgwụ Noliprel ® A mg mg + 0.625 mg, nke nwere obere ebepamide na perindopril arginine, anaghị esonye na ibelata oke mmetụta ọ bụla, ewezuga hypokalemia, ma e jiri ya tụnyere perindopril na ebepamide na usoro ọgwụgwọ kachasị nke akwadoro iji (lee “Ọdọrọ) omume "). Na mbido ọgwụgwọ nke ọgwụ mgbochi abụọ, nke onye ọrịa anabataghị n'oge mbụ, ihe egwu dịwanye elu nke ịmalite ịmụ anya enweghị ike ịkwụsị. Nlezi anya nke onye ọrịa belata ihe egwu a.

Alrụ ọrụ na-arụ ọrụ na ụlọ

Usoro ọgwụgwọ a na - egbochi ndị ọrịa nwere nnukwu akụrụ oke (creatinine Cl erughi 30 ml / min). Somefọdụ ndị ọrịa nwere ọbara mgbali elu na-enweghị nkwarụ ọhụụ nke akụrụngwa, usoro ọgwụgwọ nwere ike igosi akara ụlọ nyocha nke ọdịda akụrụngwa nke arụrụala. N'okwu a, ekwesịrị ịkwụsị usoro ọgwụgwọ. N’ọdịnihu, inwere ike ịmaliteghachi ọgwụgwọ ijikọ ọgwụ site na iji ọgwụ were obere ọgwụ, ma ọ bụ were ọgwụ ndị ahụ na monotherapy.

Nnukwu ọbara ọgbụgba na nrụgide mmiri-electrolyte

N'iburu oke ọgbụgba ike, ana-achọ nchịkwa 0.9% sodium chloride solution.

Ọbara mgbatị oge a abụghị ọgwụ mgbochi maka ọgwụgwọ gara aga. Mgbe mweghachi nke BCC na ọbara mgbali ọbara, ị nwere ike ịmaliteghachi usoro ọgwụgwọ site na iji usoro ọgwụ dị ala, ma ọ bụ jiri ọgwụ ahụ na ọnọdụ monotherapy.

Njikọ nke perindopril na indapamide adịghị egbochi mmepe nke hypokalemia, karịsịa na ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụ. Dị ka ọ dị na ojiji nke ọgwụ ọgwụ na-eme ka mmiri ọgwụ na ọgwụ a na-egbu egbu mee ihe, ọ dị mkpa ka a na-enyocha ọ̀tụ̀tụ̀ potassium na ọbara plasma mgbe niile.

Okwesiri iburu n’uche na ihe mejuputara ihe ndi n’ebu uzo ogwu ahu nwere lactose monohydrate. Noliprel patients A ekwenyeghị ya ndị ọrịa nwere ọrịa galactose ekweghị ibe nọrọ, ụkọ lactase na glucose-galactose malabsorption.

A naghị atụ aro ka ejikọtara ọnụ nke perindopril na ebepamide na lithium (lee. "Ntinye aka", "Mmekọrịta").

Ihe ọghọm nke ibido neutropenia mgbe ị na - a inụ ọgwụ mgbochi ACE bụ ọgwụ dabere ma dabere na ọgwụ a andụrụ na ọnụnọ nke ọrịa concomitant. Neutropenia adịkarịghị na ndị ọrịa na-enweghị ọrịa, mana ihe ize ndụ ahụ na-abawanye na ndị ọrịa nwere ọrụ gbasara akụrụ, karịsịa megide ọrịa nke akwara njikọ (gụnyere system lupus erythematosus, scleroderma). Mgbe ndọrọpụ nke ndị na - egbochi ACE, akara nke neutropenia na-apụ n'anya nke ha.

Iji zere mmepe nke mmeghachi omume ndị dị otú ahụ

Ihe gwọọ Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.? Nke kacha mma Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.. Nhọrọ Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.. Ọnọdụ nchekwa Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.. Nkịtị ụgwọ maka Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.. .Ụbiga mmanya ókè Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.. Naanị were ya Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC.. Noliprel mbadamba mbadamba 2.5 + 0.625 mg 30 PC. ịzụta n'ịntanetị.

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