Malangizo a Noliprel a ntchito

• Pharmacokinetics
• Zizindikiro zogwiritsidwa ntchito
• Njira yogwiritsira ntchito
• Zotsatira zoyipa
• Contraindication
• Mimba
• Kuchita ndi mankhwala ena
• Bongo
• Malo osungira
• Kutulutsa Fomu
• Kupanga

Noliprel Bi-forte kuphatikiza kwa ACE inhibitor perindopril arginine ndi indapamide sulfonamide diuretic. Mankhwala amakhudzana ndi mankhwalawa chifukwa cha zomwe gawo lililonse limapanga (perindopril ndi indapamide) ndi zowonjezera synergism.
Perindopril ndi choletsa cha ACE. ACE amasintha angiotensin I kukhala angiotensin II (chinthu cha vasoconstrictor), kuwonjezera pamenepo imalimbikitsa kubisalira kwa aldosterone ndi adrenal cortex ndi kuwonongeka kwa bradykinin (chinthu chopangira vasodilating) kukhala heptapeptides.
Indapam imachokera ku sulfonamides yokhala ndi mphete ya indole, yogwirizana ndi mankhwala a thiazide okodzetsa, mwa kuletsa kuyamwa kwa sodium mu gawo la impso. Izi zimawonjezera kuchulukitsidwa kwa sodium ndi chloride mumkodzo, ndikucheperachepera, potaziyamu ndi magnesium, potero kumawonjezera kukodza ndikupereka antihypertensive kwambiri.
Chizindikiro cha antihypertensive action.
Noliprel Bi-forte amachepetsa kuthamanga kwa magazi kwa systolic ndi diastolic kwa odwala omwe ali ndi matenda amiseche iliyonse, onse okhala pamalo apamwamba komanso oyimirira. Mphamvu ya antihypertensive ya mankhwalawa imadalira mlingo.
Zotsatira zabwino kwambiri pakuchepetsa kumanzere kwamitsempha yama cell ambiri zidakwaniritsidwa ndi 8 mg perindopril (ofanana ndi 10 mg perindopril arginine) + 2,5 mg indapamide.
Kuthamanga kwa magazi kunachepa kwambiri mu gulu la perindopril / indapamide: kusiyana kutanthauza kuti kuchepa kwa BP pakati pa magulu awiri a odwala anali -5.8 mm Hg chifukwa cha kupanikizika kwa systolic. Art. (95% CI (-7.9, -3.7), p 15 mg / L (> 135 μmol / L) mwa amuna ndi> 12 mg / L (> 110 μmol / L) mwa akazi.
Mitundu yokhala ndi ayodini yokhala ndi ayodini. Pankhani ya kuchepa madzi m'thupi chifukwa chogwiritsa ntchito ma okosijeni, chiopsezo chokhala ndi vuto laimpso chimachulukitsa, makamaka mukamagwiritsa ntchito ayodini. Ndikofunikira kubwezeretsa madzi asanasankhidwe a ayodini okhala ndi ayodini.
Mchere wamchere. Hypercalcemia imatha kuchitika chifukwa kutsika kwamkodzo wa calcium kwamkodzo.
Cyclosporin. Ndikothekanso kukulitsa kuchuluka kwa metabolinine m'madzi am'magazi osakhudza kuchuluka kwa kuzungulira kwa cyclosporin, ngakhale pakalibe madzi ndi kusowa kwa sodium.

Bongo

Pankhani ya mankhwala osokoneza bongo, njira yovuta kwambiri yomwe imachitika ndi ochepa hypotension, yomwe nthawi zina imatha kutsagana ndi mseru, kusanza, kupsinjika, chizungulire, kugona, kusokonezeka, oliguria, komwe kumatha kupita ku anuria (chifukwa cha hypovolemia), kugunda kwa magazi. Kuphwanya mphamvu yamagetsi-electrolyte (kuchepa kwa potaziyamu ndi sodium m'madzi am'magazi), kulephera kwa impso, hyperventilation, tachycardia, palpitations (palpitation), bradycardia, nkhawa, ndi chifuwa.
Thandizo loyamba limaphatikizapo kuchotsedwa kwachangu kwa mankhwalawo m'thupi: kupweteka kwam'mimba ndi / kapena kukhazikitsidwa kwa makala okhathamiritsa, ndiye kuphatikiza kwa mawonekedwe osungirako madzi mu chipatala.
Pakachitika chidwi chachikulu, wodwalayo ayenera kupatsidwa mwayi wokhala pansi wokhala ndi bolodi yotsika. Ngati ndi kotheka, iv yoyendetsa isotonic sodium chloride solution iyenera kuchitika kapena njira ina iliyonse yobwezeretsanso magazi iyenera kuyikiridwa.
Perindoprilat, mtundu wogwira wa perindopril, amatha kuchotsedwa m'thupi ndi hemodialysis (onani Pharmacokinetics).

Kodi ogula akuyenera kudziwa chiyani za mankhwalawa?

Kapangidwe ka mapiritsi monga chojambulira kunaphatikizapo lactose monohydrate. Izi zimakonda kugwiritsidwa ntchito popanga mankhwala osiyanasiyana.

Ngakhale lactose ili ndi mphamvu zake zamthupi, lactose ndiye olimba kwambiri. Kwa anthu omwe akuvutika ndi tsankho la mkaka payekha, malangizo omwe angagwiritsidwe ntchito amaletsa kumwa mankhwalawa.

Kuphatikiza apo, odwala omwe amatsatira zakudya zosasunthika zopanda mchere, mankhwalawa ayenera kugwiritsidwa ntchito mosamala kwambiri. Kumwa mapiritsi kungachititse kuti magazi achepetse kwambiri. Komabe, ngati izi zidachitika atagwiritsa ntchito koyamba, ndiye kuti choyambitsa chikhoza kukhala cholakwika.

Udindo wofunikira umachitika ndi kumwa madzi okwanira. Simuyenera kuwonjezera kuchuluka kwa madzimadzi, koma nyengo yotentha ndi bwino kumwa 25 peresenti kuposa masiku onse. Kuchulukitsa thukuta limodzi ndi mankhwalawa kungayambitse kuchepa kwamadzi.

Zotsatira zoyipa

Ngakhale mankhwala omwe adalimbikitsidwa ndi katswiri angayambitse mavuto ena mwa anthu ena. Noliprel A Be Forte, ndemanga zomwe zimatsimikizira izi, zingayambitsenso mavuto.

Gawo 3. Zotsatira zoyipa

Pakati mantha dongosolo	Kusakwiya, kuda nkhawa, kusokonezeka kwa tulo, etc.
Dongosolo la genitourinary	Kuchulukitsa kwa diuresis, kutsika kwa libido, kutsika kwa potency, etc.
Thupi lawo siligwirizana	Kugwedezeka kwa anaphylactic, urticaria, eczema, angioedema, etc.
Ziwalo zopumira	Chibayo, chifuwa chowuma, rhinitis ndi zina zambiri.
Matumbo	Kusanza, kusanza, kutsekula m'mimba, matenda a chiwindi, etc.
Zosangalatsa	Tinnitus owonjezera, kukoma kwazitsulo, ndi zina zambiri.
Zina	Thukuta kwambiri.

Zotsatira zoyipa zimatha kusiyana ndi zomwe zalembedwa pagome. Mndandanda wathunthu ukhoza kupezeka mu malangizo ogwiritsa ntchito.

Mukakambirana ndi Dr. Noliprel AB Forte, analogue yomwe ndi yosavuta kugula pa pharmacy iliyonse, mutha kuyimitsa ndi:

• Indapamide + Perindopril,
• Ko-Perineva,
• Noliprel (A, Bi, A Forte), etc.

Analogs Noliprel Be Forte nthawi zambiri amakhala ndi mawonekedwe ofanana / ofanana komanso ofanana. Komabe, Mlingo ndi mtengo wake zimatha kusiyanasiyana.

Zambiri zothandiza pazomwe zimayambitsa kuthamanga kwa magazi zimapezeka mu vidiyo yotsatirayi:

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amamasulidwa ngati mapiritsi okhala ndi filimu: biconvex, ozungulira, oyera (29 kapena 30 aliyense m'botolo la polypropylene wokhala ndi chotulutsira komanso choletsa chomwe chili ndi gel yonyowetsa madzi, botolo limodzi mu bokosi la makatoni okhala ndi mawonekedwe oyamba otsegula, a zipatala - Ma PC 30 mu botolo la polypropylene lokhala ndi chotulutsira, mabotolo atatu m'bokosi lamakatoni okhala ndi mawonekedwe oyamba otsegulira, mabotolo 30 mu chikwama cha makatoni, pabokosi lamakhadi okhala ndi koyamba kutsegula 1 pallet ndi malangizo ogwiritsira ntchito Noliprel A Bi-f pakamwa).

Piritsi 1:

• yogwira zinthu: perindopril arginine - 10 mg (ofanana ndi perindopril mu 6,79 mg), indapamide - 2,5 mg,
• zina zowonjezera: anhydrous colloidal silicon dioxide, magnesium stearate, lactose monohydrate, maltodextrin, sodium carboxymethyl wowuma (mtundu A),
• kujambula kwama film: magnesium stearate, macrogol 6000, titanium dioxide (E171), hypromellose, glycerol.

Zotsatira za pharmacological

NOLIPREL BI-FORTE ndi mitundu iwiri yogwira, perindopril ndi indapamide. Ichi ndi mankhwala oopsa, amagwiritsidwa ntchito pochiza kuthamanga kwa magazi (matenda oopsa). NOLIPREL BI-FORTE imalembedwa kwa odwala omwe atenga kale perindopril 0 mg ndi indapamide 2,5 mg payokha. M'malo mwake, odwala oterewa amatha kutenga piritsi limodzi la NOLIPREL BI-FORTE, lomwe lili ndi zonsezi.

Zizindikiro zogwiritsidwa ntchito

Perindopril ndi m'gulu la mankhwala otchedwa ACE inhibitors. Imagwira ndikuwonjezera mphamvu yamitsempha yamagazi, yomwe imathandizira jakisoni wamagazi. Indapamide ndi okodzetsa. Ma diuretics amawonjezera mkodzo womwe umapangidwa ndi impso. Komabe, indapamide ndi yosiyana ndi ma diuretics ena, chifukwa amangokulitsa pang'ono mkodzo womwe umapangidwa. Chilichonse mwazida zomwe zimagwira zimachepetsa kuthamanga kwa magazi ndipo mogwirizana zimayendetsa magazi anu.

Contraindication

- ngati mukusowa chifukwa cha perindopril, mtundu wina uliwonse wa ACE inhibitor, indapamide, sulfonylamides kapena chinthu china chilichonse cha NOLIPREL BI-FORT,

- ngati m'mbuyomu, mukamamwa zoletsa zina za ACE kapena munthawi zina, inu kapena wachibale wanu mudawonetsa zizindikiro monga kugudubuza, kutupa kwa nkhope kapena lilime, kuyabwa kwambiri, kapena kuyambitsa khungu pakhungu (angiotherapy).

- ngati muli ndi matenda oopsa a chiwindi kapena hepatic encephalopathy (matenda oopsa aubongo),

- ngati mwayamba kuvulala ndi impso kapena mukukayikira,

- ngati magazi anu ali ndi potaziyamu kwambiri kapena otsika kwambiri,

- ngati mukukayikira kuti sanapatsidwe phindu, mtima kusowa (kuthira mchere kwambiri, kupuma movutikira)

- ngati muli ndi pakati komanso zaka zoyeserera zitha kupitirira miyezi itatu (ndibwinonso kupewa kuti musatenge. NOLIPRELA B-FORT koyambirira kwam'mimba - onani "Mimba ndi mkaka wa m'mawere"),

- ngati mukuyamwitsa.

Lankhulani ndi dokotala wanu musanatenge NOLIPREL BI-FORTE ngati zina mwa izi zikugwirira ntchito:

ngati mukuvutika ndi aortic stenosis (kuchepa kwamitsempha yamagazi yayikulu kuchokera pansi pamtima), hypertrophic cardiomyopathy (matenda a minofu ya mtima), kapena aimpso artery stenosis (kuchepa kwa mtsempha wamagazi kumapereka magazi ku impso), ngati mukudwala matenda ena a mtima, ngati muli ndi vuto la chiwindi.

ngati muli ndi matenda a collagen mtima (khungu) monga systemic lupus erythematosus kapena scleroderma,

ngati mukuvutika ndi atherosulinosis (kuumitsa makoma amitsempha yamagazi),

ngati mukuvutika ndi hyperparathyroidism (kuchuluka kwa ntchito ya parathyroid),

ngati mukuvutika ndi gout,

ngati muli ndi matenda ashuga

ngati mukumwa zakudya zochepa zamchere kapena mukumwa mchere wamchere wina,

ngati mukumwa mankhwala a lithiamu kapena potaziyamu (spironolactone, triamteren), chifukwa simuyenera kuwatenga nthawi yomweyo NOLIPREL BI-FORT (onani "Kutenga mankhwala ena").

Muyenera kuchenjeza dokotala wanu ngati mukuganiza kuti muli ndi pakati. (kapena akukonzekeramimba). Sitikulimbikitsidwa kutenga NOLIPREL BI-FORT mukangoyamba kumene kutenga pakati. Mankhwalawa sayenera kumwa kwa nthawi yayitali kuposa miyezi itatu, chifukwa izi zitha kuwononga thanzi la mwana (onani "Mimba ndi mkaka wa m'mawere").

Mukamamwa NOLIPREL BI-FORT, muyenera kudziwitsani dokotala kapena ogwira ntchito kuchipatala za awa:

ngati muli ndi opaleshoni kapena opaleshoni yayikulu,

ngati mwadwala m'mimba posanza kapena kusanza, kapena ngati thupi lanu lawonongeka.

ngati mukukumana ndi matenda a LDL (kuchotsera kwa mafuta a cholesterol m'mwazi),

ngati mukukakamira, zomwe zimachepetsa thupi kugwidwa ndi njuchi kapena mavu.

ngati mukupita kokayezetsa kuchipatala komwe kumafuna kuyang'aniridwa kwa chinthu chopangira ayodini (chinthu chomwe chimapangitsa kupenda ziwalo zamkati, monga impso kapena m'mimba, pogwiritsa ntchito ma x-ray).

Ochita masewera ayenera kudziwa kuti NOLIPREL BI-FORTE ili ndi chinthu chogwira ntchito (indapamide), chomwe chingapereke zotsatira zabwino poyendetsa doping control.

NOLIPREL BI-FORT sayenera kupatsidwa kwa ana.

Mimba komanso kuyamwa

Funsani kwa dokotala kapena wamankhwala musanamwe mankhwala.

Muyenera kuchenjeza dokotala wanu ngati mukuganiza kuti muli ndi pakati.kapena kukonzekeramimba).

Dokotala wanu akukulangizani kuti musiye kumwa NOLIPREL BI-FORTE musanakhale ndi pakati kapena mukangotsimikizira kuti mayi ali ndi pakati, ndikupatseni mankhwala ena m'malo mwa NOLIPREL BI-FORT. Sitikulimbikitsidwa kutenga NOLIPREL BI-FORT mukangoyamba kumene kutenga pakati. Mankhwalawa sayenera kumwa kwa nthawi yayitali kuposa miyezi itatu, chifukwa izi zitha kuwononga thanzi la mwana.

Ngati mukuyamwitsa kapena mukufuna kuyamwitsa, dziwitsani dokotala. NOLIPREL BI-FORTE imaphatikizidwa mwa amayi oyamwitsa. Dokotala wanu angakupatseni mankhwala ena ngati mukufuna kuyamwitsa, makamaka ngati khanda lili lobadwa chatsopano kapena tsiku lobadwa lisanachitike.

Lankhulani ndi dokotala nthawi yomweyo.

Mlingo ndi makonzedwe

Mukamamwa NOLIPREL BI-FORT, nthawi zonse tsatirani malangizo a dokotala. Ngati mukukayikira kulondola kwa mankhwalawa, muyenera kufunsa dokotala kapena wamankhwala. Mlingo wokhazikika ndi piritsi limodzi patsiku: Ndikofunika kumwa mapiritsi m'mawa, musanadye. Finyani piritsi ndi kapu yamadzi.

Zotsatira zoyipa

Monga mankhwala ena aliwonse, NOLIPREL BI-FORTE, ngakhale si odwala onse, amatha kuyambitsa mavuto.

Siyani kumwa mankhwalawa nthawi yomweyo ndikulankhula ndi dokotala ngati muli ndi amodzi mwa otsatirawa:

Nkhope yanu, milomo, kamwa, lilime kapena khosi tatupa, mumalephera kupuma, mumakhala chizungulire kapena simukuzindikira, muli ndi vuto la mtima mwachangu kapena losasangalatsa.

Zotsatira zoyipa zingaphatikizepo (pakuchepa kwa pafupipafupi):

Zodziwika bwino (zosakwana 1 mwa 10, koma opitilira 1 mwa 100 odwala): mutu, chizungulire, vertigo, kumva kuwawa ndi kumva kugunda, kusawona bwino, tinnitus, kuwala kwa mutu chifukwa cha kuthamanga kwa magazi, kutsokomola, kufupika, kupumira m'mimba, kusokonezeka m'mimba , kusanza, kupweteka kwam'mimba, kusokonezeka kwa kukoma, pakamwa pouma, kukanika kapena kugaya movutika, kutsegula m'mimba, kudzimbidwa), thupi lawo siligwirizana (monga zotupa pakhungu, kuyabwa), kukokana kwa minofu, kutopa.

Zosagwira (zosakwana 1 mwa 100, koma opitilira 1 mwa odwala 1000): kusinthasintha kwa kugona, kusokonezeka kwa kugona, chifuwa, kupumira: ndi kupuma movutikira), angioedema (Zizindikiro monga kuuma kapena kutupa kwa nkhope ndi lilime) , urticaria, purpura (mawanga ofiira pakhungu), mavuto a impso, kusabala, kuchuluka thukuta.

Osowa kwambiri (osakwana 1 mwa odwala 10,000): chisokonezo, zovuta zamtima (kugunda kwamtima kosagwirizana, vuto la mtima), chibayo cha eosinophilic (mtundu wachilendo wa chibayo), rhinitis (mphuno ya m'mphuno kapena mphuno yothina), zotupa zamkhungu zambiri monga multiforme erythema. Ngati mukuvutika ndi systemic lupus erythematosus (mtundu wa matenda a collagen-vascular), ndiye kuti kuwonongeka ndikotheka. Pali malipoti a milandu yokhudzana ndi kusintha kwa photosensitivity (kusintha maonekedwe, khungu

Kusokonezeka m'magazi, impso, chiwindi, kapamba kapena kusintha kwa ma labotale (kuyezetsa magazi) kumatha kuchitika. Dokotala wanu atha kukulemberani kuyezetsa magazi kuti mudziwe momwe muliri.

Ngati vuto la chiwindi likulephera (matenda a chiwindi), kuyambika kwa hepatic encephalopathy (matenda oopsa aubongo) ndikotheka.

Zotsatira zoyipa zitakula kwambiri kapena ngati mwazindikira kuti zinalembedwazo sizinalembedwe patsamba ili, auzeni dokotala kapena wamankhwala.

Kuchita ndi mankhwala ena

Nthawi zonse uzani dokotala kapena wamankhwala omwe mumamwa kapena mankhwalawo omwe mwamwa posachedwapa, ngakhale ngati awa ndi mankhwala osokoneza bongo.

Pewani kugwiritsa ntchito NOLIPREL BI-FORTE ndi mankhwala otsatirawa:

- lithiamu (amagwiritsidwa ntchito pochiza nkhawa),

- potaziyamu woleketsa okodzetsa (spironolactone, triamteren), mchere wam potaziyamu.

Kugwiritsa ntchito mankhwala ena kungakhudze chithandizo cha NOLIPREL B-FORT. Onetsetsani kuti mwadziwitsa dokotala ngati mukumwa mankhwalawa, chifukwa muyenera kusamala mukamamwa:

- mankhwala omwe amagwiritsidwa ntchito pochiza matenda oopsa,

- procainamide (zochizira nthito yamtima yosasinthika),

- allopurinol (zochizira gout),

- terfenadine kapena astemizole (antihistamines zochizira matenda a hay fever kapena chifuwa),

- corticosteroids, omwe amagwiritsidwa ntchito pochiza machitidwe osiyanasiyana, kuphatikizapo mphumu yayikulu ndi nyamakazi,

- mankhwala a immunosuppressive omwe amagwiritsidwa ntchito pochiza matenda a autoimmune kapena pambuyo pothana ndi ntchito kuti aletse kukanidwa (mwachitsanzo.

- Mankhwala kufotokoza

- erythromycin kudzera mu mankhwala

- halofantrine (imagwiritsidwa ntchito pochiza mitundu ina ya malungo),

- pentamidine (amagwiritsidwa ntchito pochiza chibayo).

- vincamine (womwe umagwiritsidwa ntchito ngati chithandiziro pochiritsa matenda obisika mwa okalamba, kuphatikizapo kukumbukira kukumbukira).

- bepridil (amagwiritsidwa ntchito pochiza angina pectoris),

- sultoprid (zochizira psychosis),

- ntchito mankhwala a mtima arrhythmias (mwachitsanzo, quinidine, hydroquinidine, disopyramide, amiodarone, sotalol).

- digoxin kapena mtima wina glycosides (wochizira matenda a mtima),

- baclofen (zochizira minofu yolimba, yomwe imapezeka m'matenda ena, mwachitsanzo, ndi sclerosis),

- mankhwala a shuga monga insulin kapena metformin,

- calcium, kuphatikiza calcium,

- mankhwala othandizira othandizira (mwachitsanzo senna),

- mankhwala osapweteka a antiidal (mwachitsanzo ibuprofen) kapena makulidwe apamwamba a salicylates (mwachitsanzo, aspirin),

- amphotericin B kudzera m'mitsempha (pochizira matenda oyamba ndi fungus),

- Mankhwala ochizira matenda amisala, monga kupsinjika, kuda nkhawa, schizophrenia, ndi zina (mwachitsanzo, ma antidepressants, trpsclic antidepressants, antipsychotic),

- tetracosactide (pochiza matenda a Crohn).

Zolemba ntchito

Kuyendetsa magalimoto ndi makina owongolera, ..

NOLIPREL BI-FORTE nthawi zambiri sizimakhudzika kukhala maso, koma mwa odwala ena, chifukwa cha kuthamanga kwa magazi, kusintha kosiyanasiyana kumawonekera, mwachitsanzo, chizungulire kapena kufooka. Zotsatira zake, kutha kuyendetsa galimoto kapena njira zina kumatha kusokonezeka.

NOLIPREL BI-FORTE ili ndi lactose (tinthu tating'onoting'ono). Ngati dokotala anakuwuzani kuti mumalolera mitundu ina ya shuga, ndiye kufunsa dokotala musanamwe mankhwalawa.

Malo osungira

Pewani kuwona ndi kuwona kwa ana.

Tsekani chidebe mwamphamvu kuti muchepetse chinyezi.

Mankhwalawa amayenera kusungidwa pa kutentha osapitirira 30 ° C.

Musamatsanulira mankhwalawo m'madzi oyipa kapena zonyansa. Funsani wopanga mankhwala anu momwe mungachiritsire mankhwala omwe ayimitsidwa. Izi zimapangidwa pofuna kuteteza chilengedwe.

Mankhwala

Noliprel A Bi-Forte ndi othandizira ophatikiza omwe amaphatikizapo angiotensin kutembenuza enzyme inhibitor (ACE) ndi sulfonamide diuretic. Mankhwala amadziwika ndi mankhwala omwe amaphatikiza zomwe akuchita chilichonse. Mphamvu za antihypertensive zomwe zimapangidwa chifukwa chogwirizana nazo.

Perindopril ndi choletsa ACE, wotchedwa. kininase II - exopeptidase yomwe ili nawo pakusintha kwa angiotensin I kukhala vasoconstrictor chinthu angiotensin II, komanso pakuwonongeka kwa bradykinin, yomwe imakhala ndi vasodilating, kupanga heptapeptide yosagwira. Izi zimapereka kuchepa kwa kupanga kwa aldosterone, mu plasma imathandizira kukonzanso ntchito ya renin pogwiritsa ntchito mayankho olakwika, kugwiritsa ntchito nthawi yayitali kumafooketsa zotumphukira zamitsempha zosagwirizana (OPSS), zomwe zimagwirizanitsidwa kwambiri ndi mphamvu ya minofu ndi impso. Izi sizichulukitsa chiopsezo chokhala ndi tachycardia ndipo sizimapangitsa kuti madzi asungidwe komanso sodium.

Kuthandizira kuchepetsa kutsitsa ndi kutsitsa, perindopril imasintha ndipo imathandizira kugwira ntchito kwa minofu ya mtima. Odwala omwe ali ndi vuto la mtima (CHF), chifukwa cha machitidwe ake (malinga ndi zomwe hemodynamic zizindikiro) zimapangitsa, kuthamanga kwa mtima kumanzere kwamtima kumachepa, kugunda kwa mtima kumachepa, kutulutsa kwamtima ndi mtima kumawonjezeka, komanso kutsika kwamitseko ya minofu.

Indapamide ndi gulu la sulfonamide ndipo limawonetsa zamankhwala ofanana ndi a thiazide diuretics. Mwa kuletsa kuyambiranso kwa sodium mu gawo lachigawo cha Henle, thunthu limapereka chimbudzi cha impso za sodium ndi chlorine, ndikuchepera - magnesium ndi potaziyamu ayoni, komwe kumayambitsa kukodza kwamkodzo komanso kutsika kwa magazi.

Noliprel A Bi-Forte akuwonetsa kuchuluka kwa magazi omwe amadalira diastoli ndi systolic kuthamanga kwa magazi, onse atayimirira ndi kugona. Mphamvu ya antihypertensive ya mankhwala imawonedwa kwa maola 24. Pasanathe mwezi umodzi chichitikireni maphunzirowa, njira yokhazikika yochizira imatheka, pomwe kumachitika tachyphylaxis sikumawonedwa. Kutsiliza kwa mankhwalawa sikupangitsa kuti muchoke. Wothandizira antihypertensive amathandizira kuchepetsa milingo yamanzere yamitsempha yamitsempha yamagazi (GTL), kusintha kutukuka kwa mitsempha, kuchepetsa OPSS, sikumasokoneza kusinthana kwa lipids - triglycerides, cholesterol yathunthu, cholesterol, otsika komanso yapamwamba kachulukidwe lipoproteins (LDL ndi HDL).

Zotsatira zophatikizidwa za perindopril ndi indapamide pa GTL zimatsimikiziridwa poyerekeza ndi enalapril. Odwala omwe ali ndi matenda oopsa ndipo GTL, yemwe adatenga perindopril erbumin mu 2 mg (womwe umafanana ndi perindopril arginine mu 2,5 mg) + indapamide muyezo wa 0,625 mg / enalapril mu 10 mg kamodzi patsiku, atakulitsa mlingo wa perindopril erbumin kuti 8 mg (yomwe ikufanana ndi perindopril arginine wambiri 10 mg) + indapamide - mpaka 2,5 mg / enalapril - mpaka 40 mg, ndi kuchuluka kofananira kwa kayendedwe ka gulu la perindopril / indapamide mukayerekezera ndi gulu la enalapril, kuchepa kwakukulu pamzere wamanzere wamitsempha yama cell kumawonedwa ( LVMI). Zotsatira zazikulu kwambiri za LVMI zidadziwika pomwe amagwiritsa ntchito perindopril erbumin 8 mg + indapamide 2.5 mg.

Mphamvu yotsutsa antihypertensive imawonedwanso pakaphatikizidwa mankhwala ndi perindopril ndi indapamide poyerekeza ndi enalapril.

Mphamvu ya perindopril idadziwika muzochitika zamankhwala oopsa zilizonse zoopsa, zokhala ndi ntchito yotsika komanso yachilendo ya plasma. Mphamvu yayitali kwambiri ya antihypertensive ya chinthu ichi imawonedwa patatha maola 4-6 pambuyo pakukonzekera pakamwa ndipo imapitirira maola opitilira 24. Pambuyo panthawiyi, gawo lalikulu (pafupifupi 80%) la zotsalira za ACE limadziwika.

Kugwiritsa ntchito kovuta kwa thiazide diuretics kumabweretsa kuwonjezeka kwa kuzungulira kwa mphamvu ya antihypertensive. Komanso kuphatikiza kwa ACE inhibitor ndi thiazide diuretic kumathandizira kuchepetsa chiopsezo cha hypokalemia pogwiritsira ntchito othandizira okodzetsa.

Kuphatikizidwa kwa ACE inhibitor ndi angiotensin II receptor antagonist (ARA II) blockade pawiri ya renin-angiotensin-aldosterone system (RAAS) sikulimbikitsidwa kwa odwala omwe ali ndi matenda ashuga. Izi zinatheka pamayeso azachipatala omwe odwala omwe anali ndi matenda amtima kapena matenda a m'matumbo, kapena mtundu wa matenda ashuga a 2 omwe ali ndi chitsulo chotsimikizika cha cholimbana ndi odwala komanso odwala matenda a shuga a 2 mtundu ndi matenda ashuga nephropathy. Malinga ndi zotsatira za kafukufuku mu odwala omwe amalandila chithandizo chophatikizira ichi, palibe zotsatira zabwino pakukula kwa aimpso ndi / kapena zochitika zamtima ndi ziwengo za anthu akufa. Pankhaniyi, chiwopsezo cha hyperkalemia, ochepa hypotension ndi / kapena kulephera kwaimpso pamilandu iyi chinakulitsidwa poyerekeza ndi gulu la odwala omwe adalandira monotherapy.

Mphamvu ya antihypertensive ya indapamide imadziwika pa mankhwala ndi mankhwala osokoneza bongo omwe amapereka ochepa okodzetsa. Katunduyu wa zinthu zomwe zikugwirika ndi chifukwa chowonjezeka pakukula kwa mitsempha yayikulu komanso kuchepa kwa OPSS. Indapamide lowers GTL, sizimakhudza magazi lipids (LDL, HDL, cholesterol yathunthu, triglycerides) ndi carbohydrate metabolism ngakhale kukhalapo kwa matenda ashuga.

Perindopril

Mukamamwa pakamwa, perindopril imalowa mwachangu. Kuzindikira kwakukulu kwa zinthu (C_max) m'magazi am'madzi amawonedwa ola limodzi mutatha kuperekera. Mankhwalawa sadziwika ndi zochitika zamankhwala. Hafu ya moyo (T_1/2) ndi ola limodzi. Pafupifupi 27% ya mlingo wa pakamwa wa perindopril uli m'magazi mu mawonekedwe a metabolite yake yogwira, perindoprilat. Mukukonzekera kwa biotransfform yogwira ntchito, kuwonjezera pa perindoprilat, ma metabolite ena 5 osapangika amapangidwa. Pambuyo pakamwa makonzedwe a madzi am'magazi C_max perindoprilat imafikiridwa pambuyo pa maola 3-4, kudya zakudya kumachepetsa kutembenuka kwa perindopril mpaka perindoprilat, motero, kukhudza bioavailability wa mankhwala.

Kudalira kwa mzere wa mulingo wa perindopril mu plasma pa mlingo wake kunakhazikitsidwa. Gawo Logawa (V_d) perboprilat yosasunthika ikhoza kukhala pafupifupi 0,5 l / kg. Ndi mapuloteni a plasma, makamaka ndi ACE, perindoprilat (kutengera ndende) amamanga pafupifupi 20%.

Yogwira metabolite yomwe impso zimagwira mthupi, wogwira T_1/2 gawo losasunthika ndi pafupifupi maola 17, boma lofanana likufikiridwa mkati mwa masiku 4.

Pamaso pa kulephera kwa mtima ndi impso, komanso odwala okalamba, mawonekedwe a perindoprilat amachepetsa. Dialization chilolezo cha zinthu ndi 70 ml / min.

Chithandizo chomwe chikugwiririka chimagwira mwachangu komanso chokwanira kuchokera ku m'mimba thirakiti (GIT). Ola limodzi mutatsitsa pakamwa, C imatheka_max indapamide mu madzi am'magazi. Pogwiritsa ntchito mobwerezabwereza, palibe kudziunjikira chinthu. Kulankhulana ndi mapuloteni a plasma ndi 79%, T_1/2 zimasiyanasiyana pamtunda kuchokera maola 14 mpaka 24 (avareji ya maola 18).

Indapamide imakumbidwa makamaka ndi impso (pafupifupi 70% ya mlingo womwe umatengedwa) komanso mawonekedwe a metabolites osagwira kudzera m'matumbo (pafupifupi 22%).

Ma paracokinetic magawo mwa odwala omwe ali ndi vuto la impso sasintha.

Malangizo apadera

Panthawi yamankhwala, kuthandizira kudziwa kuchepa kwa madzi m'thupi ndi kuchepa kwa plasma yama electrolyte kuyenera kukumbukiridwa, kuphatikizapo kutsegula m'mimba komanso / kapena kusanza, popeza pakuchitika kwa hyponatremia chiopsezo chachitukuko champhamvu cha ochepa hypotension. Zikatero, kuyang'anira pafupipafupi kuchuluka kwa ma electrolyte m'madzi a m'magazi kumafunika.

Ngati matenda oopsa am'magazi angadziwike, iv ikukonzekera njira ya 0,9% sodium kolorayidi.

Kutsika kwakanthawi kwakanthawi kochulukitsa sikungapikisane kuti muthandizidwe ndi Noliprel A Bi-Fort. Ndi matenda a kuthamanga kwa magazi ndi bcc, muthe kuyambiranso kugwiritsa ntchito mankhwalawa m'munsi, kapena mungogwiritsa ntchito chinthu chimodzi chokha chogwira ntchito.

Poyerekeza ndi chithandizo cha mankhwalawo, milandu ya zilonda zopatsirana zambiri, nthawi zina zosagwirizana ndi mankhwala opha maantibayotiki, zinajambulidwa. Pogwiritsa ntchito perindopril mwa odwala, ndikofunikira kuyang'anira kuchuluka kwa leukocytes m'magazi. Odwala ayenera kudziwitsa dokotala za zizindikiro zilizonse za matenda opatsirana (kuphatikizapo kutentha thupi ndi zilonda zapakhosi).

Pa chithandizo ndi Noliprel A Bi-Forte, kawirikawiri zochitika za kukhazikika kwa lilime, milomo, makutu ndi / kapena larynx, nkhope, ndi miyendo zinajambulidwa. Mavutowa amatha kuchitika nthawi iliyonse yamankhwala. Zizindikiro za angioneurotic edema zikawoneka, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo ndikuwunika momwe wodwala akuchiritsidwira mpaka zizindikirike. Ngati kutupako kufalikira kumaso ndi milomo, ndiye kuti nthawi zambiri zizindikiro zimapita zokha, ngakhale ngati kuli kofunikira, ma antihistamines amathanso kutumikiridwa. Edema ya Angioneurotic, yokhala ndi edema laryngeal, imatha kupha. Kutupa kwa makutu am'kamwa, lilime kapena larynx kumawonjezera chiopsezo cha kutsekeka kwa mpweya. Ndi kukula kwa zizindikirozi, tikulimbikitsidwa kuti nthawi yomweyo jekeseni epinephrine (adrenaline) pa dilution ya 1: 1000 (0.3-0.5 ml) kapena kuchitapo kanthu kuti zitsimikizire kuti airway patency.

Pali malipoti a chiwopsezo chachikulu cha angioedema mwa odwala a liwiro la Negroid.

Nthawi zina, munthawi ya chithandizo ndi ACE zoletsa, kukula kwa angioedema m'matumbo kumawonedwa, ndikuphatikizidwa ndi kupweteka kwam'mimba (ndi kusanza / kusanza), nthawi zina kumakhala kozungulira kwa C1 esterase komanso popanda mawonekedwe a angioedema a nkhope. Kuzindikira kwa chodabwitsachi kumakhazikitsidwa ndi computer tomography (CT) scan ya pamimba, ultrasound (ultrasound) kapena pa opaleshoni. Zizindikiro za zotupa zimayimitsidwa atachotsedwa kwa ACE zoletsa.

Odwala omwe ali ndi chifuwa, akumwa mtima wofuna kugwiritsidwa ntchito, ACE zoletsa ayenera kugwiritsidwa ntchito mosamala kwambiri. Odwala omwe amalandila immunotherapy ndi makonzedwe okhala ndi poizoni wa hymenopteran (kuphatikiza njuchi ndi mavu) ayenera kupewa kugwiritsa ntchito zoletsa za ACE, chifukwa izi zimawonjezera mwayi wokhala ndi anaphylactic reaction. Komabe, zotsatirazi zingathe kupewedwa mwa kuletsa kwakanthawi ACE zoletsa osachepera maola 24 asanafike njira yodziletsa.

Pamaso pa ochepa matenda oopsa komanso matenda a mtima munthawi ya chithandizo, odwala sayenera kugwiritsa ntchito beta-blockers.

Perindopril, monga ma AID enhibitors ena, amawonetsa mphamvu yofooka mu odwala a liwiro la Negroid poyerekeza ndi oyimira mafuko ena. Kusiyana kumeneku kumayesedwa kuti kumakhudzana ndi zochitika zotsika kwambiri za renin odwala omwe amathamanga mu mpikisano uno.

Potengera momwe mankhwalawo amathandizidwira ndi thiazide diuretics, pakhala pali zochitika zamtundu wa photosensitivity, zomwe zimapangitsa kuti mankhwalawo asiye. Ngati mukupitiliza kukodzetsa mankhwalawa, tikulimbikitsidwa kuteteza khungu kuti lisamatulutsidwe ndi kuwala kwa dzuwa ndi kuwala kozungulira kwa ultraviolet.

Indapamide imatha kupangitsa chidwi kwa othamanga pamasiku oyendetsa.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Zinthu zomwe zimagwira Noliprel A Bi-Forte sizimabweretsa zosokoneza pama psychomotor reaction. Koma ziyenera kukumbukiridwa kuti mwa odwala ena zimachitika izi chifukwa chakuchepa kwa magazi, makamaka kumayambiriro kwa chithandizo chamankhwala kapena kugwiritsa ntchito munthawi yomweyo ndi mankhwala ena a antihypertensive. Mwakutero, kuthekera koyendetsa magalimoto kapena kugwira ntchito ndi makina ena owopsa akhoza kuwonongeka.

Mimba komanso kuyamwa

Amayi oyembekezera komanso amayi omwe akukonzekera kutenga pakati sayenera kutenga Noliprel A Bi-Forte. Kafukufuku wovomerezeka wamankhwala omwe ali ndi ACE inhibitors mwa amayi apakati sanachitike. Zambiri zomwe zimapezeka pokhudzana ndi mankhwalawa m'nthawi yoyambirira ya mimba zimasonyezeratu kusowa kwa zolakwika zokhudzana ndi mankhwalawa zomwe zimakhudzana ndi fetotoxicity. Ngakhale izi zikuchitika, kuwonjezereka kwinakuwopseza matenda obwera chifukwa cha fetal sikungathetsedwe kokhazikika mukutenga zoletsa za ACE.

Ngati pakati pachitika mankhwala ndi mankhwala, ndikofunikira kusiya kugwiritsa ntchito Noliprel A Bi-Forte ndikuti mupatseni mankhwala ena a antihypertensive omwe ali ndi mankhwala ovomerezeka kugwiritsa ntchito panthawi yomwe ali ndi pakati. Mu II - III trimesters, wokhala nthawi yayitali ndi zoletsa za ACE pa mwana wosabadwayo, chiopsezo cha kusokonezeka, monga oligohydramnion, kufooka kwa impso, ndikuchedwa kufupika kwa mafupa a chigaza, amatha kukulitsidwa. Mwana wakhanda amatha kudwala matenda oopsa, kulephera kwa impso, kuchepa kwa magazi.

Ngati mayi alandila chithandizo ndi zoletsa za ACE mu II - ma trimesters oyimitsa pakati, mawonekedwe a mwana wosabadwayo amayenera kuchitidwa kuti awone zomwe zimachitika mu impso ndi vuto la chigaza. Makanda obadwa kumene omwe amayi awo adamwa mankhwalawa panthawi yomwe ali ndi pakati amafunika kuyang'aniridwa mosamala ndi kuchipatala kuti athe kuzindikira ndi kuwongolera komwe kungayambitse ochepa hypotension.

Mu wachitatu trimester ya mimba, chithandizo cha nthawi yayitali ndi thiazide okodzetsa chimatha kuyambitsa mato hypovolemia ndi kuchepa kwa magazi a uteroplacental, kupangitsa fetoplacental ischemia ndi kukula kwa fetal. Pochita ndi diuretics, atatsala pang'ono kubadwa, nthawi zina, akhanda anali ndi thrombocytopenia ndi hypoglycemia.

Kugwiritsa ntchito Noliprel A Bi-Forte pakuyamwa kumayesedwa. Sizikudziwika ngati perindopril amalowa mkaka wa m'mawere, koma zadziwika kuti indapamide imachotsedwa mkaka waumunthu ndipo imatha kutsogolera mwana wakhanda kukukula kwa hypokalemia, jaundice ya nyukiliya ndi hypersensitivity kuti sulfonamide derivatives. Kutenga diazture ya thiazide kumatha kupsinjitsa mkaka wa m'mawere kapena kuchepa kwa mkaka wa m'mawere.

Mu vuto laimpso

Odwala omwe ali ndi CC ≥60 ml / mphindi panthawi ya chithandizo amafunika kuwunika pafupipafupi kuchuluka kwa ndende ya potaziyamu ndi creatinine m'madzi a m'magazi.

Pamaso pa kufooka kwapakati mwamphamvu kwambiri (CC) osakwana 60 ml / min), Noliprel A Bi-Forte amatsutsana. Odwala ena ochepa matenda oopsa popanda chizindikiro chodziwikiratu cha matenda aimpso, zotsatira za labotale zitha kuwonetsa zizindikiro za kulephera kwaimpso. Zikatero, mankhwala osokoneza bongo ayenera kusiyidwa. Mutha kuyambiranso chithandizo pogwiritsa ntchito mankhwala ochepa, kapena amodzi mwa mankhwalawo. Odwala omwe ali pachiwopsezo chotere, serum creatinine ndi potaziyamu ayenera kuyang'aniridwa masabata awiri pambuyo poyambira kutenga Noliprel A Be-Forte ndipo pambuyo pake miyezi iwiri iliyonse. Nthawi zambiri, kulephera kwa impso kumachitika mwa odwala omwe ali ndi vuto lofooka la impso (kuphatikizapo a impso artery stenosis) kapena ndi mtima wambiri.

Ndi chiwindi ntchito

Pamaso pa kufooka kwambiri kwa chiwindi, kugwiritsa ntchito Noliprel A Bi-Forte kumatsutsana. Odwala omwe ali ndi hepatic osakwanira sayenera kusintha mlingo.

Nthawi zina, pogwiritsira ntchito zoletsa za ACE, kuwoneka kwa cholestatic jaundice kunadziwika. Poyerekeza ndi momwe kukula kwa mbali iyi kumapangidwira, kukulira kwa chiwindi chachikulu necrosis kumatheka, nthawi zina kumakhala ndi zotsatira zakupha. Njira zomwe zimapangidwira kuti izi zitheke sizikudziwika. Ngati munthawi ya kutenga Noliprel A Bi-Forte jaundice zikuchitika kapena ntchito ya michere ya chiwindi imachulukirachulukira, mankhwala ayenera kusiyidwa ndipo dokotala ayenera kuthandizidwa mwachangu.

Kutenga diazittics ya thiazide / thiazide wokhala ndi vuto la chiwindi lomwe lilipo kungayambitse kukula kwa hepatic encephalopathy. Pankhaniyi, ndikofunikira kusiya yomweyo chithandizo ndi Noliprel A Bi-Fort.

Gwiritsani ntchito mu ukalamba

Asanalandire chithandizo, okalamba odwala amafunika kuwunika magwiridwe antchito a impso ndi plasma ndende ya potaziyamu m'magazi. Mu gulu ili la odwala, kuchuluka kwa plasma creatinine kuyenera kutsimikiziridwa poganizira msinkhu, kulemera kwa thupi ndi jenda. Kumayambiriro kwamaphunziro a anthu okalamba, mlingo wa perindopril umakhazikitsidwa kutengera kutsika kwa magazi, makamaka ndi kuchepa kwa bcc komanso kuchepa kwa ma elekitirodi. Njira izi zimathandizira kuti magazi asachepetse.

Odwala okalamba omwe ali ndi vuto laimpso Noliprel A Bi-Forte akulimbikitsidwa kuti atenge piritsi 1 nthawi imodzi tsiku lililonse.

Kuyanjana kwa mankhwala osokoneza bongo

Kuphatikizidwa komwe Noliprel A Bi-Forte, kapena komwe kumagwira ntchito ndi zinthu zina / kukonzekera:

• Kukonzekera kwa lithiamu: chiwopsezo chowonjezereka chosinthika cha kuchuluka kwa lithiamu m'magazi am'magazi komanso zotsatira zoyipa mukamamwa ma ACE inhibitors, kuchuluka kowonjezera kwa thiazide diuretics kungapangitse kuwonjezeka kwa mulingo wa plasma ya lithiamu ndikuwonjezera chiopsezo cha zotsatira zoyipa, ngati kuphatikiza koteroko ndikofunikira, muyeso uyenera kuyang'aniridwa pafupipafupi plasma lithiamu,
• estramustine: kuopseza kuwonjezeka kwa pafupipafupi kwa zotsatira zosakhudzidwa, kuphatikizapo angioedema, kumakulitsidwa pakaphatikizidwa ndi perindopril,
• kukonzekera kwa potaziyamu, potaziyamu wolekerera okodzetsa (spironolactone, amiloride, triamteren, eplerenone), potaziyamu wokhala ndi mchere wotsekemera: kuchuluka kwa seramu potaziyamu sikungakhalepo koyenera, Hyperkalemia siimakhalapo - ikaphatikizidwa ndi ACE zoletsa, mankhwalawa onse amatengedwa chimodzimodzi ndi mankhwala zimatha kuyambitsa kuchuluka kwa seramu potaziyamu mpaka kumwalira, ndi hypokalemia yotsimikizika, chisamaliro chiyenera kutengedwa ndikuwunikira nthawi zonse g plasma ndende ya potaziyamu ndi ECG magawo.

Kuyanjana kotheka komwe kumafunikira chisamaliro chapadera komanso kusamala pakuphatikizidwa kwa Noliprel A Bi-Fort kapena zosakaniza zake zomwe zili ndi zotsatirazi mankhwala / zinthu:

• baclofen: antihypertensive zotsatira zimawonjezeka, kuthamanga kwa magazi ndi ntchito ya impso ziyenera kuwongoleredwa, ngati kuli koyenera, kusintha kwa mankhwala a antihypertensive kuyenera kuchitika,
• NSAIDs (kuphatikiza acetylsalicylic acid mu Mlingo wopitilira 3,000 mg patsiku, zosagwiritsa ntchito ma NSAIDs ndi COX-2 zoletsa): zotsatira za antihypertensive zitha kuchepa kuphatikizidwa ndi ACE inhibitors, chiwopsezo cha ntchito yaimpso yolakwika, kuphatikizapo kuwoneka kwa kulephera kwa impso, kumakulitsidwa, ndipo kuchuluka kwa seramu potaziyamu, makamaka odwala omwe ali ndi vuto la impso, odwala amayenera kubwezeretsa madzi komanso kuyang'anira pafupipafupi chiyambi cha kuphatikizana kwa mankhwalawa komanso panthawi yake ochek,
• Hypoglycemic m`kamwa othandizira amachokera ku sulfonylureas: kuchuluka kwa mankhwalawa ndi kuchuluka kwa insulini pakudya kwa odwala matenda a shuga ndikutenga ACE zoletsa, ndizosowa kwambiri kuti hypoglycemia ichitike chifukwa cha kuchuluka kwa kulekerera kwa glucose komanso kuchepa kwa insulin, kuwunika pafupipafupi kuchuluka kwa shuga m'magazi mwezi woyamba wa kuphatikiza uku,
• antiarrhythmics a kalasi IA (quinidine, disopyramide, gidrohinidin) ndi kalasi III (bretylium tosylate, dofetilide, amiodarone, ibutilide), sotalol, benzamides (sultopride, amisulpride, tiapride, sulpiride), neuroleptics (levomepromazine, chlorpromazine, tsiamemazin, trifluoperazine, thioridazine) , butyrophenones (droperidol, haloperidol), pimozide, difemanil methyl sulfate, sparfloxacin, bepridil, halofantrine, cisapride, moxifloxacin, erythromycin (iv), pentamidine, misolastine, vincamine (iv, astad, terfenad yambitsa a phokoso lamtundu wa pirouette): chiopsezo cha hypokalemia ndikugwiritsa ntchito indapamide chikukulitsidwa, kuwongolera kwapakati pa QT, potaziyamu ya plasma ndiyofunikira, ndipo ngati pakufunika kutero, kukonzanso hypokalemia,
• gluco- ndi mineralocorticoids (wokhala ndi zochita mwatsatanetsatane), amphotericin B (iv), tetracosactide, mankhwala othandizira omwe amayambitsa matumbo motility (othandizira omwe angapangitse hypokalemia): chifukwa chotsatira chowonjezera, chikaphatikizidwa ndi indapamide, chiwopsezo cha kuchuluka kwa potokosi chikufunika, mu plasma, ndipo ngati kuli kotheka kukonzanso kwake, odwala omwe amalandila mtima glycosides amafunikira kuwunika mosamala, tikulimbikitsidwa kugwiritsa ntchito mankhwala osokoneza bongo omwe salimbikitsa iruyut peristalsis,
• mtima glycosides: kuwopsa kwa mankhwalawa kumapangidwira ndi hypokalemia, chifukwa chake, akaphatikizidwa ndi indapamide, zomwe zili mu plasma komanso mafayilo a ECG ziyenera kuyang'aniridwa.
• Zomwe zimafunikira kuti anthu azigwiritsa ntchito Noliprel A Bi-Fort kapena zigawo zake pogwiritsa ntchito mankhwala / zinthu zotsatirazi:
• tetracosactide, corticosteroids: mphamvu ya antihypertgency imafooka, chifukwa chosungira madzimadzi ndi ma sodium ion chifukwa cha mphamvu ya corticosteroids,
• antipsychotic mankhwala (antipsychotic), ma tridclic antidepressants: mphamvu ya antihypertensive imawonjezeka ndipo kuwopseza kwa orthostatic hypotension kumakulitsidwa (zowonjezera zotsatira),
• Mankhwala ena a antihypertensive, vasodilators: akhoza kuonjezera mphamvu,
• Ma ARA II zoletsa, aliskiren: mukamamwa mankhwalawa ndi ACE inhibitor, kuchuluka kwa zotsatira zosayenera, monga hyperkalemia, ochepa hypotension, kuwonongeka kwa aimpso (kuphatikizapo kuperewera kwaimpso), kumawonjezereka poyerekeza ndi kugwiritsa ntchito mankhwala amodzi omwe amakhudza pa RAAS, chifukwa chomwe kuphatikiza kawiri kwa RAAS pogwiritsa ntchito chophatikizira cha ACE ndi ARA II kapena aliskiren sikulimbikitsidwa, ngati kuphatikiza uku ndikofunikira, amatenga moyang'aniridwa ndi achipatala, kuwunika pafupipafupi kuchuluka kwa potaziyamu mu plasma, ntchito yaimpso ndi kuthamanga kwa magazi,
• thiazide ndi loop diuretics (muyezo waukulu): hypovolemia ikhoza kukhala, mankhwalawa akaphatikizidwa ku chithandizo cha perindopril, chiopsezo cha ochepa hypotension
• cytostatic and immunosuppressive mankhwala, allopurinol, corticosteroids (omwe amagwiritsidwa ntchito mwatsatanetsatane), procainamide: chiwopsezo cha leukopenia chikuwonjezereka pamene mukumwa ma inhibitors a ACE,
• Kukonzekera kwa opaleshoni yayikulu: mphamvu ya antihypertensive imalimbikitsidwa ndikuphatikizidwa ndi perindopril, tikulimbikitsidwa kuti musiye kumwa Noliprel A Bi-Forte momwe mungathere maola 24 musanachite opaleshoni pogwiritsa ntchito mankhwala opaleshoni wamba,
• gliptins (sitagliptin, saxagliptin, linagliptin, vildagliptin): chiwopsezo cha angioedema chikuwonjezerekanso kuphatikizidwa ndi ACE zoletsa chifukwa chopewera dipeptidyl peptidase-4 ntchito ndi gliptin,
• sympathomimetics: antihypertensive zotsatira amachepetsa,
• kukonzekera kwa golide (iv), kuphatikizapo sodium aurothiomalate: kugwiritsa ntchito zoletsa za ACE, ma nitrate angayambike, monga mseru, kusanza, hypotension yokhudzana ndi khungu, hyperemia ya khungu la nkhope,
• okhala ndi ayodini wokhala ndi mitundu yambiri (makamaka pa Mlingo waukulu): chiopsezo chotenga matenda aimpso chifukwa cha kuchepa kwa madzi m'thupi mukamamwa mankhwala okodzetsa amayamba kuchuluka, izi zisanachitike, ndikofunikira kubwezeretsa madzi,
• metformin: chiopsezo cha lactic acidosis chifukwa cha kuperewera kwaimpso komwe kumagwirizana ndi kutenga okodzetsa (makamaka malupu) kumawonjezeka ndi plasma creatinine wa 15 mg / l (135 μmol / l) mwa amuna ndi 12 mg / l mwa azimayi ( 110 μmol / L) metformin sayenera kugwiritsidwa ntchito,
• mchere wamchere: hypercalcemia imatha kukhazikika chifukwa chakuchepa kwa impso kwa mayoni a calcium,
• cyclosporine: imawonjezera kuchuluka kwa creatinine mu madzi a m'magazi popanda kusintha kwake, ngakhale pamadzi ndi madzi a sodium.

Zofanizira za Noliprel A Bi-Fort ndi Noliprel A, Noliprel A forte, Ko-Perineva, Perindopril-Indapamide Richter, Co-Parnawel, Noliprel, Noliprel forte, Perindid, Perindapam, Perindopril PLUS Indapamide ndi ena.

Ndemanga za Noliprel A Bi-Fort

Ndemanga za Noliprel A Bi-Fort nthawi zambiri zimakhala zabwino. Odwala amadziwa kuti antihypertensive mankhwala ophatikizika amathandizanso kuthamanga kwa magazi, amathandizira kuchulukana kwa khoma lamitsempha yamagazi, komanso amathandizira kuchepetsa GTL. Odwala omwe ali ndi matenda ashuga, Noliprel A Bi-Forte sasokoneza shuga wamagazi, mosiyana ndi ena ofanana nawo. Madokotala ambiri amakhulupirira kuti ndi yoyenera kuti mankhwalawa athetse vuto lalikulu.

Zoyipa za mankhwalawa zimaphatikizapo kukhalapo kwa kuchuluka kwa ma contraindication komanso zotheka zomwe zingachitike.