Mankhwala Lozap Plus

Mayina apadziko lonse lapansi - Lozap kuphatikiza

Kupanga ndi mawonekedwe a kumasulidwa

Mapiritsi okhala ndi mafilimu chikasu chopepuka, chamtundu wina, chokhala ndi mzere wogawika pakati mbali zonse ziwiri. Mu 1 tabu muli: losartan potaziyamu - 50 mg, hydrochlorothiazide - 12,5 mg.

Othandizira: mannitol - 89 mg, cellcrystalline cellulose - 210 mg, croscarmellose sodium - 18 mg, povidone - 7 mg, magnesium stearate - 8 mg, hypromellose 2910/5 - 6.5 mg, macrogol 6000 - 0,8 mg, talcum ufa - 1,9 mg, simethicone emulsion - 0,3 mg, utoto Opaspray chikasu M-1-22801 - 0,5 mg (madzi oyeretsedwa, titanium dioxide, ethanol denatured (methylated mowa BP: ethanol 99% ndi methanol 1%), hypromellose, utoto Quinolin Yellow (E104), utoto wa Pounceau 4R (E124).

Kutulutsa Fomu: Ma PC 10 - matuza (1, 3 kapena 9 ma PC) kapena 14 ma PC. - matuza (2) - mapaketi a makatoni.

Zachipatala ndi gulu la mankhwala

Gulu la Pharmacotherapeutic

Kuphatikiza kwa antihypertensive (angiotensin II receptor blocker + diuretic)

Zotsatira za pharmacological

Mankhwala a antihypertensive. Enieniotensin II wolandila wapadera (subtype AT 1). Sizimaletsa kininase II, puloteni yomwe imathandizira kusintha kwa angiotensin I kukhala angiotensin II. Imachepetsa OPSS, kuchuluka kwa magazi a adrenaline ndi aldosterone, kuthamanga kwa magazi, kuthamanga kwa kufalikira kwa m'mapapo, kumachepetsa pambuyo pake, kumakhudzanso diuretic. Zimasokoneza kukula kwa hypertrophy ya myocardial, kumawonjezera kulolera kwa odwala omwe ali ndi vuto la mtima. Losartan sikuletsa ACE kininase II ndipo, motero, sikulepheretsa kuwonongeka kwa bradykinin, chifukwa chake, zotsatira zoyipa zomwe zimagwirizanitsidwa ndi bradykinin (mwachitsanzo, angioedema) ndizosowa kwenikweni.

Odwala omwe ali ndi matenda oopsa osaneneka a shuga ogwirizana ndi proteinuria (oposa 2 g / tsiku), kugwiritsa ntchito mankhwalawa kumachepetsa proteinuria, kuchuluka kwa albumin ndi immunoglobulins G.

Imakhazikika pamlingo wa urea m'madzi am'magazi. Sichikukhudzana ndi mawonekedwe akumasamba ndipo siyikhala ndi mphamvu yayitali pakulimbikitsidwa kwa norepinephrine mu plasma yamagazi. Losartan muyezo mpaka 150 mg / tsiku sizikhudza kuchuluka kwa triglycerides, cholesterol yathunthu ndi cholesterol ya HDL mu seramu yamagazi mwa odwala omwe ali ndi matenda oopsa. Pa mlingo womwewo, losartan sichikhudzana ndi kusala kwamwazi wamagazi.

Pambuyo pakamwa kamodzi, mphamvu ya hypotensive (systolic ndi diastolic magazi imatsika) imafika pazowonjezera pambuyo pa maola 6, kenako amayamba kuchepa mkati mwa maola 24.

Kuzindikira kwakukulu kumayamba masabata 3-6 pambuyo pa kuyamba kwa mankhwalawa.

Pharmacokinetics

Ikamamwa, losartan imatengedwa bwino, ndipo imagwira metabolism panthawi "yoyamba" kudzera m'chiwindi ndi carboxylation ndi gawo la cytochrome CYP2C9 isoenzyme ndikupanga metabolite yogwira. Systemic bioavailability wa losartan pafupifupi 33%. Pazipita ndende ya losartan ndi yogwira metabolite zimatheka mu seramu ya magazi pambuyo pafupifupi ola limodzi ndi maola 3-4 atatha kudya, motero. Kudya sikumakhudza bioavailability wa losartan.

Zoposa 99% za losartan ndipo metabolite yake yogwira imamangiriza mapuloteni a plasma, makamaka okhala ndi albumin. V d losartan - 34 l. Losartan mothandizidwa samalowa mu BBB.

Pafupifupi 14% ya osapsa omwe amapatsidwa mankhwala mkati kapena pakamwa amasinthidwa kukhala metabolite yogwira.

Chilolezo cha plasma cha losartan ndi 600 ml / min, ndipo metabolite yogwira ndi 50 ml / min. Kuvomerezeka kwa impso kwa losartan ndi metabolite yake yogwira ndi 74 ml / min ndi 26 ml / min, motsatana. Mukamamwa, pafupifupi 4% ya mlingo womwe umatengedwa ndi impso yake osasinthika ndipo pafupifupi 6% imachotsedwa impso ndi mawonekedwe a metabolite yogwira. Losartan ndi metabolite yake yogwira imadziwika ndi ma linear pharmacokinetics akaperekedwa pakamwa Mlingo mpaka 200 mg.

Pambuyo pakamwa, plasma woipa wa losartan ndi yogwira metabolite amachepetsa kwambiri ndi theka lomaliza la moyo wa losperan pafupifupi 2 hours, ndi yogwira metabolite pafupifupi maola 6-9. Mukamamwa mankhwalawa mlingo wa 100 mg / tsiku, osayika kapena metabolite yogwira amadzaza kwambiri magazi a m'magazi. Losartan ndi metabolites ake amuchotsa m'matumbo ndi impso. Ogwira ntchito zathanzi, atatha kugwiritsa ntchito losotan yolembedwa ndi 14 C-isotope, pafupifupi 35% ya zilembo zama radio amapezeka mumkodzo ndi 58% mu ndowe.

Pharmacokinetics mu milandu yapadera yamankhwala

Odwala omwe ali ndi vuto loledzeretsa makamaka matenda osokoneza bongo omwe anali oledzera anali maulendo 5, ndipo metabolite yogwira inali yokwanira nthawi 1,7 kuposa antchito odzipereka aamuna athanzi.

Ndi CC> 10 ml / min, kuchuluka kwa losartan m'madzi a m'magazi sikusiyana ndi kwachilendo. Odwala omwe amafunikira hemodialysis, AUC ndi yokwanira 2 times kuposa odwala omwe ali ndi vuto laimpso.

Palibe wolartan kapena metabolite wake wogwira ntchito samachotsedwa mthupi ndi hemodialysis.

Kuzungulira kwa losartan ndi metabolite yake yogwira m'magazi am'magazi okalamba omwe ali ndi vuto losakanikirana kwa matenda oopsa samasiyana mosiyanasiyana ndi zomwe matendawa amagwira kwa anyamata omwe ali ndi vuto lodana ndi matenda oopsa.

Kuzungulira kwa plasma kwa losartan mwa azimayi omwe ali ndi matenda oopsa kwambiri kunthawi ziwiri kuposa momwe amagwiritsidwira ntchito amuna omwe ali ndi matenda oopsa. Kuzindikira kwa metabolite yogwira amuna ndi akazi sikusiyana. Kusiyana kwa pharmacokinetic kumeneku sikofunikira.

• ochepa matenda oopsa (monga gawo la mankhwala ophatikiza odwala omwe mtundu uwu wa mankhwalawa ndi wabwino koposa),
• kuchepetsa chiopsezo chokhala ndi matenda amtima komanso kufa kwa odwala omwe ali ndi matenda oopsa ndipo amasiya zamitsempha yamagazi.

Contraindication

• mankhwala othana ndi hypokalemia kapena hypercalcemia,
• kukanika kwambiri kwa chiwindi,
• Matenda oletsa kupezeka m'mimba,
• Hyponatremia
• Hyperuricemia ndi / kapena gout,
• kukanika kwa aimpso (CC ≤ 30 ml / min),
• anuria
• mimba
• nthawi yoyamwitsa,
• zaka mpaka 18 - (kuchita bwino ndi chitetezo sizinakhazikitsidwe),
• Hypersensitivity pazinthu zilizonse za mankhwala kapena mankhwala ena omwe amapezeka ndi sulfonylamide.

Ndi kusamala Kufotokozera odwala omwe ali ndi vuto limodzi la impso kapena stenosis ya mtsempha wama impso, vuto la hypovolemic (kuphatikizapo kutsekula m'mimba, kusanza), hyponatremia (chiwopsezo chowopsa cha matenda oopsa mwa odwala omwe alibe mchere kapena zakudya zopanda mchere), hypochloremic alkalosis, hypomagnesemia Matenda ophatikizika a minofu (kuphatikiza SLE), odwala omwe ali ndi vuto la chiwindi kapena omwe akudwala matenda a chiwindi, matenda oopsa a m'matumbo, chifuwa cha bronchial (kuphatikizapo mbiri), wodwala matendawa cal mbiri, imodzi ndi NSAIDs, kuphatikizapo COX-2 inhibitors, komanso oimira mpikisano wa Negroid.

Mlingo komanso njira yogwiritsira ntchito Lozapa Plus

Mankhwala amatengedwa pakamwa, ngakhale chakudyacho.

At ochepa matenda oopsa Pafupifupi 1 piritsi / tsiku. Ngati mukugwiritsa ntchito mankhwalawa muyezo, sizingatheke kukwaniritsa kuthamanga kwa magazi, mlingo wa mankhwala a Lozap Plus utha kuwonjezereka ku mapiritsi a 2. 1 nthawi / tsiku

Mlingo waukulu ndi mapiritsi awiri. 1 nthawi / tsiku Pazonse, kufalikira kwakukulu kumachitika mkati mwa masabata atatu atayamba chithandizo.

Palibe chifukwa chosankhidwa mwapadera kwa mlingo woyambirira wa odwala okalamba.

Ndi Kuchepetsa chiopsezo chokhala ndi matenda amtima komanso kufa kwa odwala omwe ali ndi matenda oopsa ndipo amasiya zamitsempha yamagazi losartan (Lozap) zotchulidwa muyezo koyamba mlingo wa 50 mg / tsiku. Odwala omwe alephera kukwaniritsa kuchuluka kwa kuthamanga kwa magazi pomwe akugwiritsa ntchito losartan pa 50 mg / tsiku amafunikira chithandizo ndi kuphatikiza kwa losartan ndi hydrochlorothiazide muyezo wotsika (12.5 mg), womwe umatsimikiziridwa ndi kukhazikitsidwa kwa mankhwala Lozap Plus. Ngati ndi kotheka, mlingo wa Lozap Plus ungakulitsidwe kumapiritsi 2. (100 mg ya losartan ndi 25 mg ya hydrochlorothiazide) 1 nthawi / tsiku.

Zotsatira zoyipa Lozapa Plus

Zotsatira zoyipa zimagawidwa malinga ndi kuchuluka kwa chitukuko motere: pafupipafupi (≥ 1/10), pafupipafupi (≥ 1/100 mpaka mpaka

Chifukwa chiyani kusanthula kwa EMIS kumachitika mwa kusabereka?

Kuchulukitsa kuchuluka kwa mapapu ndi chithandizo - werengani zonse zokhudzana ndi khansa patsamba la European Clinic.

Kutulutsa mawonekedwe ndi kapangidwe kake

Lozap Plus ikupezeka mu mawonekedwe a mapiritsi okhala ndi filimu: oblong, ndi chiopsezo mbali zonse, ma chikasu opepuka (ma PC 10. M'matumba, pamatumba a 1, 3 kapena 9 matuza, ma PC 14. M'matumba, pamakatoni, makatoni paketi ya matuza awiri).

Mapangidwe piritsi limodzi:

• yogwira zinthu: hydrochlorothiazide - 12,5 mg, potaziyamu - 50 mg,
• othandizira: microcrystalline cellulose, povidone, mannitol, magnesium stearate, croscarmellose sodium,
• zokutira filimu: macrogol 6000, simethicone emulsion, kapezi utoto wa Ponso 4R, hypromellose 2910/5, talc, titanium dioxide, utoto wachikasu wa quinoline.

Mankhwala

Lozap kuphatikiza ndi mankhwala osakanikirana omwe ali ndi vuto loti hypotensive. Losartan ndi angiotensin II receptor blocker, ndipo hydrochlorothiazide ndi thiazide diuretic.

Zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimawonetsa synergistic, zimachepetsa kuthamanga kwa magazi kuphatikiza kwakukulu kwambiri kuposa munthu aliyense payekhapayekha.

Losartan lowers OPSS (okwana zotumphukira mtima kukana), amachepetsa kuchuluka kwa aldosterone ndi adrenaline m'magazi, amachepetsa kuthamanga mu kufalikira kwa mapapu, amatulutsa diuretic zotsatira ndikuchepetsa pambuyo. Odwala omwe ali ndi vuto la mtima wosakhazikika, owonda amataya kukana kuchita zolimbitsa thupi, amalepheretsa kuchitika kwa hypertrophy ya minofu ya mtima.

Hydrochlorothiazide imathandizira kuphipha kwa phosphates ya mkodzo, bicarbonate ndi potonium ion, kumachepetsa kubwezeretsanso kwa ayoni a sodium. Kuchepetsa kuthamanga kwa magazi kumatheka chifukwa chosinthanso makina amitsempha, kuchepetsa kuchuluka kwa magazi, kumawonjezera kukhumudwa kwa ganglia komanso kuchepetsa kukanikiza kwa zinthu za vasoconstrictor.

Mphamvu ya antihypertensive ya Lozap kupatula maola 24. Kumwa mapiritsi sikuthandizira kuchuluka kwa mtima. Mankhwalawa amachepetsa kuthamanga kwa magazi kwa amuna ndi akazi, okalamba ndi odwala omwe ali ndi odwala, omwe ali ndi vuto la Negroid komanso mitundu ina, komanso mwamphamvu iliyonse ya matenda oopsa.

Pharmacokinetics

Losartan imatengeka mwachangu kuchokera mumimba. Ku bioavailability wake kuli pafupifupi 33% chifukwa cha gawo loyambira kudzera pachiwindi. Metabolism imachitika ndi carboxylation, zomwe zimapangitsa kuti pakhale metabolite yogwira - carboxylic acid. 99% losartan imagwira mapuloteni a plasma. Kuchuluka kwake kwa plasma kumachitika pambuyo pa ola limodzi, komanso kuchuluka kwa metabolite yogwira pambuyo pa maola 3-4. Kudya sikukhudza kwambiri plasma ya losartan. Kuchuluka kwa magawa ndi 34 malita. Losartan kwenikweni simalowera mu zotchinga magazi muubongo. Hafu ya moyo wa losartan ndi maola 1.5-2, carboxylic acid ndi maola 3-4. Pafupifupi 35% ya mankhwalawa amatengedwa mumkodzo ndipo pafupifupi 60% mumadzimadzi.

Mafuta a hydrochlorothiazide amakhalanso achangu, samapangidwa ndi chiwindi. Hydrochlorothiazide samadutsa chotchinga ndi magazi ndipo satulutsidwa ndi mkaka wa m'mawere, koma umalowa mu chotchinga chachikulu. Kutha kwa theka-moyo ndi maola 5.8-14.8. Pafupifupi 61% ya hydrochlorothiazide amachotsedwa osagwirizana ndi impso.

Ma paracokinetic magawo a Lozap kuphatikiza odwala okalamba samasiyana kwambiri ndi omwe ali ndi odwala ochepa.

Ndi cirrhosis ya chiwindi yofatsa kapena yolimbitsa thupi, kuchuluka kwa plasma kwa losartan ndipo metabolite yake yogwira imakhala yokwanira 5 ndi 1.7, motero, kuposa antchito odzipereka athanzi. Hemodialysis siyothandiza.

Contraindication

• kukanika kwambiri kwa chiwindi,
• kukanika kwa aimpso (kulengedwa kwa creatinine kosakwana 30 ml / min),
• cholestatic syndrome
• matenda otupa a m'mimba,
• kusowa kwa mkodzo mu chikhodzodzo (anuria),
• hypercalcemia kapena hypokalemia (kugonjetsedwa ndi chithandizo),
• gout ndi / kapena Hyperuricemia
• Hyponatremia
• Mimba ndi kuyamwa
• ana ndi achinyamata osakwana zaka 18,
• mogwirizana ndi aliskiren odwala aimpso kulephera (kulengedwa kwa creatinine zosakwana 60 ml / min) ndi matenda osokoneza bongo,
• Hypersensitivity ku zigawo zikuluzikulu kapena zothandiza za mankhwalawa.

Wachibale (Lozap kuphatikizira imagwiritsidwa ntchito mosamala):

• Hypovolemia (kuphatikizapo kusanza kapena kutsegula m'mimba),
• Hypomagnesemia, hyponatremia, hypochloremic alkalosis, hypokalemia,
• Hyperkalemia
• matenda a mtima
• kulephera kwamtima kwambiri,
• kulephera kwamtima, limodzi ndi kulephera kwakamphumo,
• kulephera kwa mtima ndi chiopsezo cha moyo,
• mitral kapena aortic stenosis,
• hypertrophic obstriers cardiomyopathy,
• chiwindi ntchito,
• matenda a chiwindi omwe amapita patsogolo,
• bilatal kapena unilateral (ngati impso imodzi) a impso artery stenosis,
• pambuyo pakutsala impso,
• mphumu ya bronchial (kuphatikizapo mbiri),
• matenda a minyewa
• chachikulu hyperaldosteronism,
• Mbiri ya edema ya Quincke,
• mbiri yakuwala yonse,
• matenda amisala
• pachimake kuwukira kwa khungu-kutsekedwa glaucoma ndi myopia,
• kugwiritsa ntchito nthawi yomweyo ndi mankhwala osapweteka a antiidal
• a mtundu wakuda,
• okalamba zaka zopitilira 75.

Lozap kuphatikiza, malangizo ogwiritsira ntchito (njira ndi Mlingo)

Ma piritsi a Lozap amatengedwa pakamwa, ngakhale chakudyacho.

Odwala ochepa matenda oopsa, mankhwala zotchulidwa koyamba ndi kukonza piritsi 1 patsiku. Ngati mulingo womwe ukunenedwa sikukwanira kuchepetsa kuthamanga kwa magazi, ndizotheka kuwonjezera kuchuluka kwa mapiritsi awiri kamodzi patsiku.

Mlingo wapamwamba wa tsiku lililonse wa mankhwalawa ndi mapiritsi a 2, ndipo kuphatikiza kwakukulu kwa hypotensive kumatheka mkati mwa masabata atatu atayamba chithandizo.

Kwa odwala okalamba, Lozap kuphatikiza imafotokozedwa muyezo woyambira.

Kuchepetsa chiopsezo cha matenda amtima komanso kufa, mlingo woyambirira wa losartan ndi 50 mg kamodzi patsiku (piritsi 1 la Lozap). Ngati chithandizo sichikuthandiza, ndikofunikira kusankha chithandizo chamankhwala osakanikirana ndi mapiritsi ochepa a hydrochlorothiazide (piritsi 1 la mankhwala Lozap + 1 piritsi la Lozap kuphatikiza patsiku). M'tsogolomu, ndizotheka kuwonjezera kuchuluka kwa mapiritsi 2 a mankhwala a Lozap kuphatikiza kamodzi patsiku.

Zotsatira zoyipa

Zotsatira zoyipa za mankhwalawa chifukwa cha kuphatikiza kwa losartan + hydrochlorothiazide:

• chiwindi ndi biliary thirakiti: kawirikawiri - chiwindi,
• mtima dongosolo: pafupipafupi osadziwika - orthostatic zotsatira (amadalira mlingo),
• mantha dongosolo: kawirikawiri - chizungulire, mafupipafupi osadziwika - kuphwanya kwa malingaliro ozindikira,
• khungu ndi subcutaneous minofu: pafupipafupi osadziwika - systemic lupus erythematosus (mawonekedwe a khungu),
• zasayansi ndi othandizira maphunziro: kawirikawiri - kuchuluka kwa chiwindi michere, hyperkalemia.

Zotsatira zoyipa za mankhwala a Lozap kuphatikiza, chifukwa cha zomwe losartan zimapangidwa:

• m'mimba thirakiti, chiwindi ndi biliary thirakiti: kawirikawiri - nseru, kusowa kwa magazi, kupweteka kwam'mimba, mapando otayirira, mosapumira - pakamwa pouma, kusanza, kupweteka mano, gastritis, kudzimbidwa, kusefukira, kusadziwika kosadziwika - kuwonongeka kwa chiwindi,
• mtima dongosolo: pafupipafupi - orthostatic hypotension, angina pectoris, m`mnyewa wamtima infarction, arrhythmias, utachepa magazi, kupweteka sternum, vasculitis, atrioventricular block II degree, palpitations,
• lymphatic dongosolo ndi magazi: pafupipafupi - zotupa pakhungu kapena mucous nembanemba, kuchepa magazi, matenda a erythrocytosis, matenda a Shenlein-Genoch, kusadziwika pafupipafupi - thrombocytopenia,
• kupuma dongosolo: Nthawi zambiri - m`mphuno kuchulukitsa, chifuwa, sinusitis, chapamwamba kupuma thirakiti matenda, pafupipafupi - laryngitis, bronchitis, rhinitis, pharyngitis, dyspnea, nosebleeds,
• dongosolo lamanjenje ndi psyche: Nthawi zambiri - chizungulire, kusowa tulo, kupweteka mutu, mosakhazikika - kuda nkhawa, kusokonezeka kwa tulo, kusokonekera, nkhawa, maloto osazolowereka, kugwedezeka, mantha, nkhawa, kugona, paresthesia, migraine, kusokonezeka kukumbukira, kuperewera kwa mitsempha, kukomoka,
• ziwalo zam'malingaliro: infrequently - conjunctivitis, kusawona bwino, kuchepa kupenya kwakhungu, moto woyaka m'maso, kulira m'makutu, vertigo,
• dongosolo la minofu: mafupa pafupipafupi - kupweteka kwamiyendo ndi kumbuyo, sciatica, minofu kukokana, pafupipafupi - kupweteka m'mafupa ndi minofu, nyamakazi, kufooka kwa minofu, kutupa kwa mafupa, kufupika kwa mafupa, mafupa amadziwika - myoglobinuria
• kwamikodzo dongosolo: Nthawi zambiri - aimpso kulephera, aimpso ntchito, pafupipafupi - kwamikodzo thirakiti matenda, pafupipafupi pokodza, kuchuluka kwa usiku diuresis masana,
• Njira yolerera: pafupipafupi - kukanika kwa erectile, kuchepa kwa libido,
• khungu ndi subcutaneous minofu: pafupipafupi - dermatitis, erythema, photosensitivity, zotupa pakhungu, kuchepa kwa tsitsi, khungu lowuma, hyperemia, kuyabwa pakhungu, thukuta,
• chitetezo chamthupi: kawirikawiri - edema ya Quincke, anaphylactic reaction,
• kagayidwe ndi zakudya: pafupipafupi - gout, anorexia,
• maphunziro a labotale ndi othandizira: nthawi zambiri - kuchepa pang'ono kwa hemoglobin ndi hematocrit, hyperkalemia, infrequent - kuwonjezeka pang'ono kwa plasma creatinine ndi urea, kawirikawiri - kuwonjezeka kwa ntchito ya bilirubin ndi enzyme ya chiwindi, pafupipafupi sikudziwika - kuchepa kwa kuchuluka kwa seramu sodium,
• zotulukapo zina: nthawi zambiri - kutopa, kupweteka pachifuwa, asthenia, pafupipafupi - kutentha thupi, kutupa kumaso, mafupipiridwe ake samadziwika - kufooka, zizindikiro za matenda ofanana ndi chimfine.

Zotsatira zoyipa za mankhwala a Lozap kuphatikiza, chifukwa cha zomwe hydrochlorothiazide ikuchokera:

• m'mimba thirakiti, chiwindi ndi biliary thirakiti: pafupipafupi - nseru, kukokana, kusanza, kupweteka kwamatumbo, kutupa kwa tiziwalo totsekemera, kudzimbidwa kapena kutsegula m'mimba, cholecystitis, jaundice ya cholestatic,
• mtima dongosolo: pafupipafupi - vasculitis (khungu kapena necrotic),
• Mitsempha yamagazi ndi magazi: pafupipafupi - kuchepa kwa magazi (hemolytic kapena aplastic), agranulocytosis, thrombocytopenia, purpura, leukopenia,
• kupuma dongosolo: pafupipafupi - kupuma kwambiri kulephera, kuphatikizapo non-cardiogenic pulmonary edema ndi pneumonitis,
• dongosolo lamanjenje ndi psyche: Nthawi zambiri - mutu, pafupipafupi - kusowa tulo,
• ziwalo zam'malingaliro: pafupipafupi - kuwona zinthu zachikasu, kuchepa kwakanthawi kwamawonekedwe owoneka,
• minofu: Mafupa a minyewa,
• kwamikodzo dongosolo: pafupipafupi - aimpso kulephera, interphitial nephritis, kupezeka kwa shuga mu mkodzo,
• khungu ndi subcutaneous minofu: pafupipafupi - zotupa tating'onoting'ono, photosensitivity, poyizoni epermermal necrolysis,
• chitetezo chamthupi: kawirikawiri - zosankha zingapo za anaphylactic (nthawi zina zimatha kugwedeza),
• kagayidwe ndi zakudya: pafupipafupi - anorexia,
• zasayansi ndi othandizira maphunziro: pafupipafupi - kuchepa kwa kuchuluka kwa sodium ndi potaziyamu mu seramu, kuchuluka kwa uric acid m'magazi, hyperglycemia,
• zochita zina: pafupipafupi - chizungulire, kutentha thupi.

Bongo

Ndi mankhwala osokoneza bongo a Lozap kuphatikiza, zizindikiro zotsatirazi zimawonedwa: chifukwa cha zomwe losartan - bradycardia, tachycardia, kuchepa kwa magazi chifukwa cha zomwe zili ndi hydrochlorothiazide - kuchepa kwa ma elekitiroma ndi kuchepa madzi m'thupi.

Chithandizo chachikulu cha mankhwala osokoneza bongo ndichizindikiro. Ndikofunikira kusiya kumwa mankhwalawa, muzitsuka m'mimba ndikuchita zinthu zothandiza kubwezeretsanso madzi osakanikirana ndi magetsi. Ndi kuchepa kwambiri kwa magazi, kukonzekera kulowetsedwa kumasonyezedwa. Hemodialysis kuchotsa losartan sikugwira ntchito. Mulingo wa hydrochlorothiazide kuchotsedwa ndi hemodialysis sunakhazikitsidwe.

Malangizo apadera

Malinga ndi malangizo, Lozap Plus ikhoza kugwiritsidwa ntchito nthawi imodzi ndi mankhwala ena a antihypertensive.

Pa mankhwala, ndikofunikira kuwongolera mawonekedwe amtundu uliwonse wa kuphwanya kwamanja-electrolyte, kukulira motsutsana ndi maziko akusanza kapena kutsegula m'mimba. Mwa odwala, ma serum electrolyte amayenera kuyang'aniridwa nthawi ndi nthawi.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Kafukufuku wapadera wazokhudza mphamvu ya mankhwala a Lozap kuphatikiza luso la psychomotor la anthu sanachitike. Komabe, ziyenera kukumbukiridwa kuti mukamalandira mankhwala a antihypertensive, makamaka kumayambiriro kwa mankhwala, kugona kapena chizungulire kumatha kuchitika, zomwe zingakhudze kuchuluka kwa mayankho ndi kuzunza.

Mimba komanso kuyamwa

Mankhwala omwe amakhudza mwachindunji dongosolo la renin-angiotensin amalembedwa kuti agwiritse ntchito phula lachiwiri komanso lachitatu la amayi, chifukwa amatha kupha mwana wosabadwayo. Mimba ikachitika, kuphatikizanso kwa Lozap kuyenera kusiyidwa.

Kukhazikitsidwa kwa ma diuretics kwa amayi apakati sikulimbikitsidwa, popeza pali chiopsezo cha jaundice mwana wosabadwa ndi wakhanda, komanso thrombocytopenia mwa mayi.

Lozap kuphatikiza imakhudzana ndi akazi opaka mkaka, chifukwa thiazides amatha kuyambitsa digesis komanso kuletsa mkaka kupanga.

Kuyanjana kwa mankhwala osokoneza bongo

Kugwiritsa ntchito pamodzi kwa Lozap kuphatikiza ndi potaziyamu woleketsa okodzetsa, mankhwala omwe ali ndi potaziyamu kapena mankhwala okhala ndi m'malo a mchere wa potaziyamu osavomerezeka (kuchuluka kwa potaziyamu m'magazi ndikotheka).

Losartan amalimbikitsa njira zochizira zama mankhwala ena kuti achepetse magazi. Palibe zovuta zamankhwala zomwe zimachitika ndi losperan ndi cimetidine, ketoconazole, hydrochlorothiazide, phenobarbital, erythromycin, anticoagulants ndi digoxin osadziwika.

Ndi munthawi yomweyo kugwiritsa ntchito thiazide diuretics ndi mankhwala ena, machitidwe awa akhoza kuchitika:

• Hypoglycemic mankhwala akumwa pakamwa ndi insulini - angafunike kusintha kwa ndalama zomwe zalembedwa,
• ethanol, narcotic analgesics, barbiturates - chiopsezo cha postural (orthostatic) hypotension chikuchulukitsidwa,
• adrenocorticotropic timadzi, corticosteroids - kutayika kwa ma elekitiroma, makamaka potaziyamu, kumalimbikitsidwa
• Kukonzekera kwa lithiamu - kuopsa kwa kuledzera kwa lithiamu kumachulukitsa,
• colestyramine, colestipol - mayamwidwe a hydrochlorothiazide yafupika,
• Mankhwala osokoneza bongo a anti-yotupa - ndikotheka kuchepetsa kukodzetsa, hypotensive ndi natriuretic zotsatira za okodzetsa,
• ma Pressor amines (adrenaline, etc.) - kuchepa pang'ono kwa mphamvu zawo kumawonedwa,
• kupuma kosakhumudwitsa minofu (tubocurarine chloride, etc.) - ndizotheka kuwonjezera zochita zawo,
• probenecid, allopurinol, sulfinpyrazone - angafune kusintha kwa mankhwalawa mankhwalawa,
• salicylates - ndizotheka kupititsa patsogolo poizoni wama salicylates pakatikati wamanjenje,
• cytotoxic mankhwala - mphamvu yanga ya myelosuppressive ikhoza kukulitsidwa,
• cyclosporine - mwina kupsinjika kwa gout komanso chiopsezo cha hyperuricemia,
• methyldopa - milandu yachilendo ya hemolytic anemia inawonedwa,
• anticholinergics - kuchuluka kwa bioavailability wa hydrochlorothiazide ndikotheka,
• mankhwala ena a antihypertensive - chowonjezera chowonekera chitha kuonedwa.

Analogs a Lozapa kuphatikiza ndi: Lozartan, Lozartan-N Canon, Lozartan-N Richter, Lorista, Lorista N, Lorista N 100, Lakea, Lozarel, Cozaar, Centor, Presartan.

Ndemanga pa Lozap Plus

Malinga ndi ndemanga, Lozap Plus ndi mankhwala othandiza kuchepetsa kuthamanga kwa magazi. Odwala amadziwa kuti sizingothandizanso ndi matenda oopsa, komanso zimalepheretsa chitukuko cha matenda ena a mtima. Lozap kuphatikiza imachepetsa kuthamanga ndipo imagwira ntchito masana. Mwa zabwino za mankhwalawa, kudalirika kwake, kugwiritsa ntchito mosavuta (kamodzi patsiku), kufatsa ndi chitetezo zimadziwika.

Zovuta za mankhwalawa m'mawunikidwe ena zimaphatikizapo zoyipa zomwe Lozap kuphatikiza zingayambitse, komanso chakuti mankhwalawa amagwira ntchito pokhapokha ngati amagwiritsidwa ntchito nthawi zonse. Odwala ena amadandaula chifukwa cha kukwera kwake mtengo (ndizopindulitsa kwambiri kugula mankhwalawo m'mapaketi akuluakulu).

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Mankhwala "Lozap kuphatikiza" ndi a gulu la antihypertensive mankhwala. Kunja, awa ndi magome amtundu wachikaso kapena pafupifupi woyera, wopindika. Kanemayo amakwirira mankhwala. Pali Mzere mbali zonse ziwiri za mapiritsi. Mu chithuza chokhala ndi mapiritsi 10 kapena 15, odzaza m'makatoni. Mapiritsi a Lozap ali ndi zosankha ziwiri - potaziyamu losartan ndi hydrochlorothiazide. Piritsi lawo lili ndi 50 mg ndi 12.5 mg, motsatana. Zinthu zothandiza ndi:

Zisonyezero zakudikirira

Malangizo ogwiritsira ntchito akuti "Lozap Plus" angagwiritsidwe ntchito ngati mankhwala ena padera pochiza kapena ngati cholumikizira zovuta kuchipatala. Musanagwiritse ntchito, funsani kwa dokotala. Ndikofunikira kudziwa kuti "Lozap" ndi "Lozap kuphatikiza" ali ndi magawo ofanana azikhalidwe komanso zithandizo. Zizindikiro zogwiritsidwa ntchito ndi:

• kuchuluka kwakukulu kwa kuthamanga kwa magazi kwa mtundu wokhazikika kapena wapadera,
• monga gawo la mankhwala ochizira matenda a mtima akulephera,
• monga kupewa matenda a mtima dongosolo,
• ndi mawonekedwe a shuga ndi matenda oopsa.

Malangizo ogwiritsira ntchito ndi Mlingo wa mankhwala "Lozap plus"

Njira yogwiritsira ntchito komanso othandizira Mlingo ndizomwe zimasiyanitsa Lozap kuchokera ku Lozap Plus. Kukhala cholondola kumwa piritsi limodzi la 50 mg wa losartan patsiku. Palibe cholumikizira chakudya. Ngati pakupita nthawi, kukakamiza sikutsika monga momwe munthu akufunira, mulingo uyenera kuchuluka. Ndikwabwino kuti musamwe mapiritsi oposa 2 patsiku. Izi ndizodzala ndi zotsatira zaumoyo. Pofuna kupewa matenda amtima, ndikokwanira kumwa piritsi limodzi patsiku. Ngati dokotala atafotokozera kuti Lozap 100, theka la piritsi patsiku (50 mg) ndilokwanira. Musanayambe chithandizo, muyenera kufunsa dokotala ndi kukayezetsa.

Kugwirizana kwa mankhwala

Mankhwala "Lozap Plus" amalembedwa ndi madokotala monga kuwonjezera kwa chithandizo chachikulu. ndikofunikira kuganizira momwe zimagwirizanirana komanso magwiridwe antchito. Wopangayo akuwonetsa zotsatira za losartan pazinthu zina zamankhwala zomwe zimakonzedwa. Ndi makonzedwe munthawi yomweyo ndi mankhwala a antihypertensive, kupanikizika kumatsika mofulumira. Miyezi yambiri ya potaziyamu imawonedwa ikaphatikizidwa ndi othandizira a potaziyamu. Kutsika kwa zotsatirapo kumawonedwa ndikuphatikizidwa ndi mankhwala omwe si a antiidal. Chiyambidwe chokha chogwiritsa ntchito mitundu ingapo ya mankhwala nthawi yomweyo ndi oletsedwa.

Mimba komanso kuyamwa

"Lozap Plus" kapena "Lozap" panthawi yomwe ali ndi pakati ndizoletsedwa. Izi ndizowona makamaka kwa amayi omwe akukonzekera kutenga pakati komanso miyezi itatu yoyamba kubereka mwana. Izi ndichifukwa chakuipa kwa zinthu zomwe zikuchokera pa mwana wosabadwa. Losartan amatha kudutsa mkaka wa m'mawere. Pazifukwa izi, kudyetsa kuyenera kuyimitsidwa panthawi ya chithandizo. Mutha kumubwezera mwana ku chakudya chachilengedwe patatha masiku awiri atamwa.

Ana ndi ukalamba

Zaka zofika zaka 18 ndizoletsedwa kutenga "Lozap Plus". Wopanga akuchenjeza za kuopsa kovomerezeka. Kwa odwala okalamba, mlingo woyambirira ndi 50 mg patsiku. Pankhaniyi, muyenera kuwunikira nthawi zonse kuti mukhale ndi thanzi labwino ndikuyesa mayeso a labotale. Ngati sizothandiza, mankhwalawo asinthidwe kukhala mankhwala ofanana kapena ofanana.

Kwa mavuto a impso ndi chiwindi

"Lozap kuphatikiza" imagwiritsidwa ntchito mosamala pakagwiritsidwa ntchito kwa chiwindi chovutikira osachepera 9 pamlingo wa Child-Pugh. Mlingo si oposa 1 piritsi patsiku. Ndi chitukuko cha chiwindi kulephera, kulandira sikuletsedwa. Zovuta mu ntchito ya ziwalo za genitourinary dongosolo amafuna kusankha mosamala mlingo ndi nthawi ya mankhwala. Chofunikira ndikuwunika mkodzo wa Laborator.

Zithandizo zofananira

Ngati pali zotsutsana ndi mankhwalawa "Lozap kuphatikiza" kapena ngati pali osowa mu mankhwala, muyenera kusankha cholowa m'malo. Pankhaniyi, chida chiyenera kukhala chofanana ndi choyambirira, pomwe chikuyenererana ndi wodwalayo. Kusankhidwa kumeneku kumachitika ndi dokotala wodziwa za mbiri ya wodwala. Omwe angathe mmalo awo ndi Cardomin, Co-Centor, Losartan, Lorista, Nostasartan, Logzartik Plus, Kandekor ndi Valsartan.

Zizindikiro zogwiritsidwa ntchito

Lozap Plus ikulimbikitsidwa kuti igwiritsidwe ntchito ngati gawo limodzi la zovuta zochizira matenda oopsa mwa odwala omwe njira iyi ya chithandizo ndiyabwino. Mankhwalawa amatengedwanso ngati matenda oopsa ndipo anasiya kumanzere kwamitsempha yamagazi kuti achepetse chiopsezo chokhala ndi matenda amtima komanso kufa.

Malangizo ogwiritsira ntchito Lozap Plus: njira ndi mlingo

Mapiritsi a Lozap Plus amatengedwa pakamwa, mosasamala nthawi yakudya.

Mlingo wovomerezeka malinga ndi zisonyezo:

• ochepa matenda oopsa: kuyambira ndi kukonza mankhwalawa - piritsi 1 patsiku, osakwanitsa kuthana ndi magazi, mankhwalawa amatha kuwonjezereka mpaka mapiritsi 2 pa 1 tsiku patsiku, kuchuluka kwakukulu kwa mankhwalawa kumatheka pakadutsa masabata atatu kuyambira chiyambi cha mankhwala.
• Kuchepetsa chiopsezo cha mtima wamitsempha yamagazi ndi kufa kwa odwala omwe ali ndi vuto lalikulu kwambiri lamanzere am'mimba: mankhwalawa oyambira ndi 50 mg / tsiku, pakalibe kuwongolera kokwanira komanso kuchuluka kwa kuthamanga kwa magazi ndi losothera monotherapy, kuphatikiza kwa losartan ndi hydrochlorothiazide muyezo wotsika ndikufunika ( 12,5 mg), yomwe imatsimikiziridwa ndikugwiritsa ntchito mankhwalawa Lozap Plus, ngati kuli kotheka, mlingowo ungathe kuwonjezeka mpaka mapiritsi 2 1 nthawi patsiku (100 mg ya losartan + 25 mg ya hydrochlorothiazide).

Ndi chiwindi ntchito

Malinga ndi kafukufuku wa pharmacokinetic mwa odwala omwe ali ndi vuto lodana ndi cirrhosis, kuchuluka kwakukulu kwa plasma kwa losartan kumawonedwa. Thiazide diuretics, kuphatikizapo hydrochlorothiazide, imatha kuyambitsa intrahepatic cholestasis, komanso kusokonezeka pang'ono muyezo wamagetsi wamagetsi kumatha kubweretsa kukula kwa hepatic coma. Mothandizirana ndi izi, Lozap Plus imayikidwa mosamala kuti vuto la chiwindi lisokonezeke (kuphatikizapo mbiri yakale) kapena matenda a chiwindi omwe amapita patsogolo. Aphwanya kwambiri chiwindi ntchito, ntchito mankhwala otsutsana.

Hydrochlorothiazide

• barbiturates, mowa, opioid analgesics, antidepressants: chiwopsezo cha orthostatic hypotension chikuwonjezeka,
• mankhwala a antidiabetesic (insulin ndi hypoglycemic wothandizira pakamwa): hydrochlorothiazide imatha kukhudza kulolerana kwawo kwa glucose, komwe kungafune kusintha kwa mlingo,
• metformin: kukulitsa kwa lactic acidosis ndikotheka, chifukwa cha kulephera kwa ntchito kwaimpso chifukwa chogwiritsa ntchito hydrochlorothiazide, kusamala kuyenera kugwiritsidwa ntchito limodzi.
• Mankhwala ena a antihypertensive: ma synergies a zochita amathandizira kuti pakhale zowonjezera,
• colestyramine, colestipol: ion-exchange resins imalepheretsa kuyamwa kwa hydrochlorothiazide, mlingo umodzi wa colestyramine / colestipol umabweretsa kumanga kwa hydrochlorothiazide ndikuchepetsa kuyamwa kwake kuchokera m'mimba thirakiti ndi 85% / 43%,
• corticosteroids, adrenocorticotropic hormone (ACTH): imatha kukulitsa kuchepa kwa ma elekitirodiya, makamaka hypokalemia,
• Pressor amines (adrenaline): mwina kuchepa kwa kuchitapo kanthu, osapatula kugwiritsa ntchito kwawo,
• non-depolarizing minofu relaxants (tubocurarine chloride): hydrochlorothiazide ingalimbikitse zotsatira zawo,
• Kukonzekera kwa lithiamu: okodzetsa, kuphatikizapo hydrochlorothiazide, amachepetsa chilolezo, kuwonjezeranso chiopsezo cha zotsatira zoyipa za lithiamu, kugwiritsa ntchito munthawi yomweyo kumalimbikitsidwa kupewa.
• anti-gout mankhwala (sulfinpyrazone, probenecid, allopurinol): kusintha kwa mlingo kungafunike, popeza hydrochlorothiazide amatha kuwonjezera kuchuluka kwa serum uric acid, mwina akuwonjezera kuwonetseredwa kwa thupi lawo siligwirizana ndi allopurinol,
• mankhwala a anticholinergic (atropine, biperidine): amatha kuonjezera kuchuluka kwa bioavailability wa hydrochlorothiazide chifukwa chopinga cham'mimba motility komanso kuchepa kwa kuchuluka kwa m'mimba,
• cytotoxins (methotrexate, cyclophosphamide): ndizotheka kuletsa kutulutsa kwawo kudzera mu impso ndikuwonjezera mphamvu ya myelosuppressive,
• salicylates: akamagwiritsa ntchito Mlingo wambiri, poizoni wawo wamavuto m'thupi amatha kuchepa
• methyldopa: magawo akutali a chitukuko cha hemolytic anemia akufotokozedwa,
• cyclosporine: chiwopsezo cha hyperuricemia ndi zovuta za gout,
• mtima glycosides: hypokalemia / hypomagnesemia yoyambitsidwa ndi hydrochlorothiazide ingathandizire kukulitsa kwa digitis-ikiwaletsa arrhythmias,
• digitis glycosides, antiarrhythmic mankhwala (achire zotsatira zomwe zimatengera mulingo wa potaziyamu), kalasi IA antiarrhythmic mankhwala (hydroquinidine, quinidine, disopyramide), gulu lachitatu antiarrhythmic mankhwala (amiodarone, dofetilide, ibutilide, sotaloline, lexprepsakidepsapuloput. , trifluoperazine, cyamemazine, sultopride, sulpiride, amisulpride, pimozide, tiapride, droperidol, haloperidol), mankhwala ena omwe angapangitse tachycardia yamitsempha yamtundu wa pirouette (difemanil, bepridil, cisapride, erythromycin intravenly, halofantrine, pentamidine, misolastine, terfenadine, vincamycin kudzera m'mitsempha): tikulimbikitsidwa kuwunika pafupipafupi kuchuluka kwa serum potaziyamu, popeza hypokalemia imayang'anira kukula kwa pyruet tachycardia, ndikuwunikiranso njira ya electrocortard (inpritoteacardard), ndikuwunikanso njira yachiyero (potocracardard), ndikuwunikiranso njira yotsogola, komanso kuwongolera kwa potrogardard, komanso kuwunika kwa potrogate
• mchere wamchere: hydrochlorothiazide ikhoza kuwonjezera kuchuluka kwa calcium mu seramu chifukwa kuchepa kwa kutulutsa kwake, ndikofunikira kuwongolera kuchuluka kwa calcium ya seramu ndikukonzanso koyenera kwa mlingo wa kukonzekera kwa calcium, chifukwa cha zotsatira za calcium metabolism, hydrochlorothiazide ikhoza kupotoza zotsatira za kuyesa kwa parathyroid ntchito,
• carbamazepine: kuyan'anila za kuchipatala ndi kuwunika kwa zasayansi m'magazi omwe ali ndi carbamazepine ndikofunikira, chifukwa chiopsezo chokhala ndi hyponatremia,
• okhala ndi ayodini wokhala ndi vuto: kuperewera kwa madzi m'thupi chifukwa cha okodzetsa, chiopsezo chokhala ndi vuto la aimpso kumawonjezeka, makamaka mukamakonzekera ayodini kwambiri, motero kuyambiranso kumafunikanso pakukhazikitsidwa
• amphotericin B (parenteral), glucocorticosteroids, ACTH yolimbikitsa laxatives kapena glycyrrhizin (wopezeka mu licorice): hydrochlorothiazide ingayambitse kuchepa kwa electrolyte, makamaka hypokalemia.

Zofanizira za Lozap Plus ndi: Gizaar, Gizaar Forte, Hydrochlorothiazide + Lozartan TAD, Blocktran GT, Lozarel Plus, Lozartan-N Canon, Lozartan N, Lozartan / Hydrochlorothiazide-Teva, Presartan N, Lorista N 100, Lorista N, Siman Nd.

Ndemanga pa Lozap Plus

Odwala omwe asankha Lozap Plus kuti achepetse kupsinjika kwawo amasiya malingaliro abwino. Amalemba kuti kumwa mapiritsi kamodzi patsiku kumathandizira kukhala wathanzi, kumachepetsa kukakamiza, ndikuletsa chizungulire. Ena ali ndi nkhawa ndi kuperewera kwa mankhwalawa ndipo ali ndi chidwi chofuna kuvulaza ngati atagwiritsidwa ntchito kwa nthawi yayitali.

Odwala omwe amakonda kutupa amakakamizidwa kusiya mankhwala a Lozap Plus, chifukwa okodzetsa amaphatikizidwa pakayendetsedwe kake, kapena amasintha makonzedwe ake ndi mankhwala ena a antihypertensive.

Lozap kuphatikiza: malangizo ogwiritsira ntchito (Mlingo ndi njira)

Mapiritsi a Lozap amatengedwa pakamwa, mosasamala nthawi yakudya.

Zowalimbikitsa:

• ochepa matenda oopsa: koyamba ndi yokonza mlingo - piritsi 1 patsiku. Ngati palibe zotheka mwanjira yokwaniritsa kuthamanga kwa magazi, mlingowo ungathe kuwonjezeka mpaka mapiritsi 2 kamodzi patsiku. Mphamvu yotsika kwambiri imapezeka mkati mwa masabata atatu atayamba chithandizo,
• ochepa matenda oopsa ndi lamanzere yamitsempha yamagazi - kuchepetsa chiopsezo cha matenda a mtima ndi kufa: koyamba mlingo wa losartan ndi 50 mg kamodzi patsiku. Ngati, motsutsana ndi maziko a monotherapy ndi losartan, sizingatheke kukwaniritsa kuchuluka kwa kuthamanga kwa magazi, ndikofunikira kusankha njira yophatikiza ya losartan ndi hydrochlorothiazide muyezo wotsika (12,5 mg). Ngati ndi kotheka, mlingo wa losartan ukhoza kuwonjezeka mpaka 100 mg / tsiku osakanikirana ndi hydrochlorothiazide pa mlingo wa 12,5 mg / tsiku. M'tsogolomu, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa - mapiritsi 2 a Lozap kuphatikiza kamodzi patsiku.

Mu vuto laimpso

Malinga ndi malangizo, Lozap kuphatikiza iyenera kugwiritsidwa ntchito mosamala odwala omwe ali ndi vuto la mtima lamitsempha limodzi la impso, komanso kwa odwala omwe atulutsidwa kumene impso.

Pali umboni wa kakulidwe ka kulephera kwa impso chifukwa cha chopinga cha losartan mwa dongosolo la renin-angiotensin-aldosterone mwa odwala omwe ali ndi vuto lalikulu la mtima kapena chifukwa cha kuwonongeka kwa aimpso. Losartan ikhoza kukulitsa kuchuluka kwa urea ndi creatinine m'madzi am'magazi mwa odwala omwe ali ndi impso yamitsempha yamagazi ya minyewa kapena aimpso a stenosis a impso imodzi. Kusintha kwa impso kungathe kusintha komanso kuchepa pambuyo poti mwasiya mankhwala.

Cholinga cha Lozap kuphatikiza kuwonongeka kwakamphamvu kwa impso (kulengedwa kwa creatinine osakwana 30 ml / min) kumatsutsana.