Noliprel A mapiritsi 2, 5, 0, 625 mg 30 ma PC

Chonde, musanagule Noliprel A, mapiritsi a 2,5 + 0,625 mg 30 ma PC., Onani zambiri za nkhaniyi ndi zomwe zili patsamba lawebusayiti la wopangiralo kapena tchulani mtundu wa mtundu winawake ndi woyang'anira kampani yathu!

Zomwe zikuwonetsedwa patsamba lino sizoperekedwa pagulu. Wopangayo ali ndi ufulu wosintha kapangidwe kake, kapangidwe kake ndi katengedwe ka katundu. Zithunzi zamalonda pazithunzi zomwe zaperekedwa pamndandanda wazomwe zili patsamba lino zimasiyana ndi zomwe zidachokera.

Zambiri pamutengo wa zinthu zomwe zawonetsedwa pamndandanda wa masamba tsambalo zingasiyane ndi zenizeni panthawiyo yokhazikitsa dongosolo la zomwe zikugwirizana.

Wopanga

Zosakaniza: yogwira perindopril arginine, indapamide,

Omwe amathandizira: wowonda wa sodium carboxymethyl (mtundu A) - 2.7 mg, anoserous colloidal silicon dioxide - 0,27 mg, lactose monohydrate - 74.455 mg, magnesium stearate - 0,45 mg, maltodextrin - 9 mg,

Filimu sheath: macrogol 6000 - 0,087 mg, premix ya white film 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,

Zotsatira za pharmacological

Noliprel ® A ndi chophatikiza chophatikizidwa chomwe chili ndi perindopril arginine ndi indapamide. Pharmacological zimatha mankhwala Noliprel ® A kuphatikiza umunthu wa aliyense wa zigawo zikuluzikulu.

1. Makina ochitira

Kuphatikiza kwa perindopril ndi indapamide kumawonjezera mphamvu ya antihypertensive ya aliyense wa iwo.

Perindopril ndi choletsa wa enzyme yomwe imatembenuza angiotensin I kukhala angiotensin II (ndi ACE inhibitor).

ACE, kapena kininase II, ndi exopeptidase yomwe imakwaniritsa kutembenuka konse kwa angiotensin I kukhala vasoconstrictor chinthu angiotensin II, ndi chiwonongeko cha bradykinin, chomwe chili ndi vasodilating, ku heptapeptide yogwira ntchito. Zotsatira za perindopril:

- Imachepetsa kubisika kwa aldosterone,

- motsatira malingaliro amathandizidwe achulukitsa ntchito ya renin m'madzi a m'magazi,

- kugwiritsa ntchito nthawi yayitali kumachepetsa OPSS, yomwe imachitika makamaka chifukwa cha zovuta m'matumbo ndi impso. Zotsatira izi siziphatikizidwa ndi kuchepetsedwa kwa sodium ndi madzi ion kapena kukula kwa Refx tachycardia.

Perindopril imasinthasintha myocardium, kuchepetsa kutsitsa ndi kutsitsa.

Pophunzira hemodynamic magawo mwa odwala omwe ali ndi vuto la mtima, adawululidwa:

- kuchepa kwa kudzaza kwa mpweya kumanzere kwamanja ndi kumanja kwamtima,

- kuchuluka mtima,

- Kuchulukitsa kwamitsempha yamagazi.

Indapamide ndi ya gulu la sulfonamides, munthawi yama pharmacological ili pafupi ndi thiazide diuretics. Indapamide imalepheretsa kubwezeretsanso kwa mafuta a sodium orto m'chigawo cha Henle, komwe kumabweretsa kuwonjezereka kwa excretion wa sodium, chlorine ndipo, pocheperako, potaziyamu ndi magnesium ion ndi impso, potero kumawonjezera diuresis ndikuchepetsa kuthamanga kwa magazi.

2. Antihypertensive zotsatira

Noliprel ® A ali ndi mphamvu yodalira antihypertensive pa onse a DBP ndi SBP onse poyimirira ndi pakama. Mphamvu ya antihypertensive imapitirira kwa maola 24. Njira yokhazikika yodalirika imakhazikika pasanathe mwezi umodzi pambuyo poyambira kuchipatala ndipo simumayenderana ndi tachycardia. Kuchotsa chithandizo sikuyambitsa matenda obwera nawo.

Noliprel ® A imachepetsa kuchuluka kwa michere yamitsempha yamanzere (GTL), imayenda bwino kwambiri, imachepetsa OPSS, sizikhudza metabolidi ya lipid metabolism (cholesterol yonse, cholesterol ya HDL ndi LDL cholesterol, triglycerides).

Zotsatira zakugwiritsa ntchito kuphatikiza kwa perindopril ndi indapamide pa GTL zidatsimikiziridwa poyerekeza ndi enalapril. Odwala omwe ali ndi matenda oopsa komanso GTL, wothandizidwa ndi perindopril erbumin 2 mg (wofanana ndi 2,5 mg perindopril arginine) / indapamide 0,625 mg kapena enalapril pa mlingo wa 10 mg kamodzi patsiku, komanso kuwonjezeka kwa mlingo wa perindopril erbumin mpaka 8 mg (wofanana ndi 10 perindopril arginine) ndi indapamide mpaka 2.5 mg, kapena enalapril mpaka 40 mg kamodzi patsiku, kuchepa kwakukulu kwa gulu lamanzere lamitsempha yama cell (LVMI) m'gulu la perindopril / indapamide poyerekeza ndi gulu la enalapril. Pankhaniyi, mphamvu yayikulu kwambiri pa LVMI imawonedwa pogwiritsa ntchito perindopril erbumin 8 mg / indapamide 2.5 mg.

Mphamvu yodziwika kwambiri ya antihypertensive idawonekeranso motsutsana ndi maziko a mankhwala ophatikizika ndi perindopril ndi indapamide poyerekeza ndi enalapril.

Odwala omwe ali ndi matenda a shuga 2 a mellitus (amatanthauza zaka makumi asanu ndi limodzi ndi zitatu (66)), kuchuluka kwa thupi 28 kg / m 2, glycosylated hemoglobin (HbA1c) 7.5%, kuthamanga kwa magazi 145/8 mm Hg) kuphatikiza kwa perindopril / indapamide kwa zovuta zazing'ono zazing'ono komanso zazikulu mtima kuphatikiza njira zonse ziwiri zamankhwala olimbana ndi glycemic komanso njira zolimbana kwambiri ndi glycemic control (IHC) njira (chandamale HbA1c

Matenda oopsa a arterial adawonedwa mu 83% ya odwala, zovuta zazikulu za macro- ndi microvascular mu 32 ndi 10%, ndi microalbuminuria mu 27%. Odwala ambiri panthawi yophatikizidwa phunzirolo amalandila chithandizo cha hypoglycemic, 90% ya odwala adalandira ma hypoglycemic othandizira pakamwa (47% ya odwala adalandira monotherapy, 46% adalandira chithandizo chamankhwala awiri, 7% adalandira chithandizo cha mankhwala atatu). 1% ya odwala adalandira chithandizo cha insulin, 9% - chithandizo chokha chamadokotala. Zothandiza kuchokera ku sulfonylureas zidatengedwa ndi odwala 72%, metformin - 61%. Monga chithandizo chothandizirana, 75% ya odwala adalandira antihypertensive mankhwala, 35% ya odwala adalandira mankhwala ochepetsa lipid (makamaka HMG-CoA reductase inhibitors (statins) - 28%), acetylsalicylic acid ngati othandizira antiplatelet, ndi othandizira ena antiplatelet (47%).

Pambuyo pa masabata 6 am'mawu oyambira omwe odwala amalandila chithandizo cha perindopril / indapamide, adagawika pagulu lolamulira la glycemic kapena gulu la IHC (Diabeteson ® MV kuti athe kukulitsa mlingo mpaka kufika pa 120 mg / tsiku kapena kuwonjezeranso wina wothandizira hypoglycemic).

Mu gulu la IHC (kutanthauza nthawi yotsatirira - zaka 4.8, zikutanthauza HbA1c - 6.5%) poyerekeza ndi gulu lolamulira wamba (zikutanthauza HbA1c - 7.3%), kuchepetsedwa kwakukulu kwa 10% pachiwopsezo chopezeka pafupipafupi cha macro- ndi microvascular zovuta.

Ubwino unatheka chifukwa cha kuchepa kwakukulu kwa chiwopsezo chaching'ono: zovuta zazikulu za microvascular ndi 14%, kuyambika ndi kupitilira kwa nephropathy ndi 21%, microalbuminuria ndi 9%, macroalbuminuria ndi 30%, ndi kukula kwa zovuta kuchokera ku impso ndi 11%.

Ubwino wa mankhwala a antihypertensive sizidalira phindu lomwe limapezeka ndi IHC.

Perindopril ndi othandiza pa matenda a matenda oopsa.

Mphamvu ya antihypertensive ya mankhwalawa imafika patapita maola angapo a 4-6 pambuyo pakulankhula pakamwa kamodzi ndikulimbikira kwa maola 24. Maola 24 atatha kumwa mankhwalawo, choletsa chotsalira cha (pafupifupi 80%) chimawonedwa.

Perindopril ali ndi antihypertensive kwambiri odwala omwe ali ndi ntchito yotsika komanso yachilendo ya plasma.

Makonzedwe a munthawi yomweyo a thiazide diuretics amawonjezera kukula kwa mphamvu ya antihypertensive. Kuphatikiza apo, kuphatikiza kwa ACE inhibitor ndi thiazide diuretic kumachepetsa chiopsezo cha hypokalemia ndi diuretics.

Mphamvu ya antihypertensive imawonetsedwa mukamagwiritsa ntchito mankhwala osokoneza bongo omwe amakhala ndi mphamvu yochepa yotsitsa.

Mphamvu ya antihypertensive ya indapamide imalumikizidwa ndi kusintha kwa zotanuka bwino zama mitsempha yayikulu komanso kuchepa kwa OPSS.

Indapamide imachepetsa GTL, sichikhudzanso kuchuluka kwa lipids m'magazi am'magazi: triglycerides, cholesterol yathunthu, LDL, HDL, metabolism ya carbohydrate (kuphatikiza odwala omwe ali ndi vuto la matenda a shuga).

Kuphatikiza kwa perindopril ndi indapamide sikumasintha machitidwe awo a pharmacokinetic poyerekeza ndi kapangidwe kake ka mankhwalawa.

Ikaperekedwa kwa perindopril imalowa mwachangu. Bioavailability ndi 65-70%.

Pafupifupi 20% ya ma perindopril omwe amamwa nthawi zonse amasinthidwa kukhala perindoprilat, metabolite yogwira. Kutenga mankhwalawa ndi chakudya kumayendera limodzi ndi kuchepa kwa kagayidwe ka perindopril mpaka perindoprilat (izi sizikhala ndi phindu lachipatala).

C_max Perindoprilat m'madzi am'magazi amafikira maola 3-4 atatha kumwa.

Kuyankhulana ndi mapuloteni am'madzi am'magazi ndi ochepera 30% ndipo zimatengera kuchuluka kwa perindopril m'magazi.

Kudzipatula kwa perindoprilat komwe kumalumikizidwa ndi ACE kumachepetsedwa. Zotsatira zake, wogwira T_1/2ndi maola 25. Kukonzanso kwa perindopril sikumatsogolera pakupanga kwake, ndipo T_1/2Ndi kayendetsedwe mobwerezabwereza, perindoprilat imafanana ndi nthawi ya ntchito yake, motero boma lofanana likufikiridwa pakatha masiku 4.

Perindoprilat imachotsedwa m'thupi ndi impso. T_1/2 metabolite ndi maola 3-5

Excretion ya perindoprilat imachepetsedwa pakukalamba, komanso mwa odwala ndi mtima ndi impso.

The dialysis chilolezo cha perindoprilat ndi 70 ml / min.

Pharmacokinetics ya perindopril imasinthidwa mwa odwala matenda a chiwindi: chiwonetsero chake cha hepatic amachepetsa nthawi 2. Komabe, kuchuluka kwa ma perindoprilat omwe amapangidwa sikuchepa, kotero kuti kusintha kwa mlingo sikofunikira.

Perindopril amawoloka placenta.

Indapamide imagwira mwachangu komanso kwathunthu kuchokera kumimba.

C_max mankhwala mu madzi am`magazi zimawonedwa 1 ora pambuyo ingestion.

Kuyankhulana ndi mapuloteni a plasma - 79%.

T_1/2 ndi maola 14-24 (pafupifupi maola 19). Mobwerezabwereza kayendetsedwe ka mankhwalawa sikupangitsa kuti pakhale thupi. Imafufutidwa makamaka ndi impso (70% ya mlingo woperekedwa) komanso m'matumbo (22%) mwa mawonekedwe a metabolites osagwira.

Ma pharmacokinetics a mankhwalawa sasintha mwa odwala omwe ali ndi vuto la impso.

Chofunikira pa matenda oopsa, odwala omwe ali ndi matenda oopsa komanso mtundu wachiwiri wa matenda osokoneza bongo kuti achepetse chiopsezo cha zovuta za mtima (kuchokera ku impso) ndi zovuta zina pamatenda amtima.

Mimba komanso kuyamwa

Mankhwala ndi contraindicated pa mimba.

Mukakonzekera kukhala ndi pakati kapena pakachitika pamene mukumwa Noliprel ® A, muyenera kusiya kumwa mankhwalawo ndikuwapatsanso mankhwala ena a antihypertensive.

Osagwiritsa ntchito Noliprel ® A mu trimester yoyamba ya kubereka.

Kafukufuku woyesedwa woyenera wa ACE zoletsa mwa amayi apakati sanachitike. Zambiri zochepa za zotsatira za ACE zoletsa m'nthawi yoyamba ya kubereka zimawonetsa kuti kutenga ma Aitor zoletsa sikunayambitse kusokonezeka kwa fetal komwe kumayenderana ndi fetotoxicity, koma zotsatira za fetotoxic za mankhwalawa sizingatheke.

Noliprel ® A imalembedwa mu II ndi III trimester ya mimba (onani. "Contraindication").

Amadziwika kuti kukhudzana kwa nthawi yayitali kwa ACE zoletsa mwana wosabadwayo mu wachiwiri ndi wachitatu trimesters wa mimba kungachititse kuti chiwonetsero chazovuta (kuchepa kwa impso, oligohydramnios, kuchedwa kwa mafupa a mafupa a chigaza) ndikukula kwa zovuta pakubadwa kwatsopano (kulephera kwa impso, hypotension, hyperkalemia).

Kugwiritsidwa ntchito kwa nthawi yayitali kwa thiazide diuretics mu nthawi yachitatu yomwe mayi ali ndi pakati kumatha kuyambitsa vuto la amayi ndi kuchepa kwa magazi a chiberekero, komwe kumayambitsa fetoplacental ischemia ndi kukula kwa fetal. Nthawi zina, akamamwa mankhwala okodzetsa atangobadwa kumene, akhanda amakhala ndi hypoglycemia ndi thrombocytopenia.

Ngati wodwalayo alandira mankhwalawa Noliprel ® A panthawi ya II kapena III trimester yokhala ndi pakati, tikulimbikitsidwa kuti tichite kafukufuku wa wakhanda kuti adziwe momwe chigaza ndi impso zimachitikira.

Hyperension hypertension imatha kupezeka mwa akhanda omwe amayi awo amalandila ndi ACE zoletsa, chifukwa chake akhanda amayenera kuyang'aniridwa ndi achipatala.

Noliprel ® A imakhudzidwa panthawi ya mkaka wa m`mawere.

Sizikudziwika ngati ma perindopril omwe ali ndi mkaka wa m'mawere amachotsedwa.

Indapamide imakumbidwa mkaka wa m'mawere. Kutenga thiazide diuretics kumapangitsa kuchepa kwa kuchuluka kwa mkaka wa m'mawere kapena kutsekemera kwa mkaka wa m`mawere. Poterepa, khanda limatha kukhala ndi hypersensitivity to sulfonamide derivatives, hypokalemia ndi jaundice ya nyukiliya.

Popeza kugwiritsidwa ntchito kwa perindopril ndi indapamide panthawi ya mkaka wa m'mawere kumatha kuyambitsa zovuta mu khanda, ndikofunikira kuyesa kufunikira kwa chithandizo chamankhwala cha mayi ndikuganiza zakutseka kuyamwitsa kapena kumwa mankhwalawa.

Contraindication

Hypersensitivity to perindopril ndi zina za ACE zoletsa, indapamide, sulfonamide ena, komanso zinthu zina zothandiza zomwe zimapanga mankhwalawo.
mbiri ya angioedema (kuphatikiza ndi zoletsa zina za ACE),
cholowa / idiopathic angioedema, hypokalemia, kulephera kwambiri kwaimpso (creatinine Cl osakwana 30 ml / min),
stenosis ya mtsempha wamagulu a impso,
kulephera kwambiri kwa chiwindi (kuphatikizapo ndi encephalopathy),
kugwiritsa ntchito munthawi yomweyo mankhwala omwe amakulitsa nthawi ya QT,
Kugwiritsa ntchito munthawi yomweyo ndi mankhwala omwe angayambitse matenda a pirouette arrhythmias,
mimba
Nthawi yonyamula mkaka.

Co-makonzedwe a mankhwala ndi potaziyamu osamala okodzetsa, potaziyamu ndi lifiyamu kukonzekera, ndi makonzedwe kwa odwala omwe ali ndi plasma potaziyamu ambiri osavomerezeka.

Chifukwa cha kusowa kwa kachipatala kokwanira, Noliprel ® A sayenera kugwiritsidwa ntchito mwa odwala omwe akuvutika ndi hemodialysis, komanso kwa odwala omwe sanadziwike mtima kulephera mtima.

Mochenjera: matenda a minofu yolumikizira (kuphatikizapo zokhudza zonse lupus erythematosus, scleroderma), chitetezo cha immunosuppressive (chiopsezo cha neutropenia, agranulocytosis), kuletsa kwamitsempha, angina pectoris, cerebrovascular matenda, renovascular matenda oopsa, matenda ashuga, kulephera kwa mtima (NYHA gulu IV gawo), hyperuricemia (makamaka limodzi ndi gout ndi urate nephrolithiasis), kuthamanga kwa magazi, kukalamba, hemodialysis pogwiritsa ntchito kuthamanga kapena kufalikira, LDL isanachitike, vuto pambuyo pakupatsirana kwa impso, aortic valve stenosis / hypertrophic cardiomyopathy, kuchepa kwa lactase, galactosemia kapena glucose-galactose malabsorption syndrome (zaka 18 zakubadwa, zaka 18, zaka, 18 ndipo chitetezo sichinayikidwe).

Zotsatira zoyipa

Kuchokera ku hemopoietic ndi lymphatic system: kawirikawiri - thrombocytopenia, leukopenia / neutropenia, agranulocytosis, kuchepa kwa magazi m'thupi, kuchepa kwa magazi m'thupi.

Matenda a m'magazi: m'malo ena azachipatala (odwala atatha kupatsirana kwa impso, odwala hemodialysis) ACE inhibitors angayambitse kuchepa kwa magazi (onani "Maupangiri Apadera").

Kuchokera kumbali ya dongosolo lamkati lamanjenje: nthawi zambiri - paresthesia, kupweteka mutu, chizungulire, asthenia, vertigo, pafupipafupi - kusokonezeka kwa tulo, kuvutikira kwa magonedwe, kawirikawiri - chisokonezo, mafupipafupi osatchulidwa - kukomoka.

Kuchokera kumbali ya gawo la masomphenyawo: nthawi zambiri - kuwonongeka kowoneka.

Pa gawo lakumva: nthawi zambiri - tinnitus.

Kuchokera ku CCC: Nthawi zambiri - kuchepa kwa magazi, incl. orthostatic hypotension, kawirikawiri - kusokonezedwa kwa phokoso la mtima, incl. bradycardia, ventricular tachycardia, atrive fibrillation, komanso angina pectoris ndi myocardial infarction, mwina chifukwa cha kuchepa kwambiri kwa kuthamanga kwa magazi kwa odwala omwe ali pachiwopsezo chachikulu (onani "Maupangiri apadera"), kusadziwika kosasintha - pirouette mtundu arrhythmia (mwina kupha - - " Kuchita ").

Pa mbali ya kupuma kwam'mimba, chifuwa ndi ziwalo zam'mimba: pafupipafupi - motsutsana ndi kugwiritsidwa ntchito kwa ma inhibitors a ACE, chifuwa chouma chitha kuchitika, chomwe chimapitilira kwa nthawi yayitali mukamamwa gulu ili la mankhwala ndikusowa pambuyo poti kuthetsedwa, kupuma movutikira, kawirikawiri - bronchospasm, kawirikawiri - eosinophilic chibayo, rhinitis .

Kuchokera pamimba yodyetsera: nthawi zambiri - kuuma kwa mucosa wamlomo, kusanza, kupweteka kwam'mimba, kupweteka kwa epigastric, kulawa kwamkati, kuchepa kwa chilakolako chofuna kudya, kusowa kwa magazi, kudzimbidwa, kutsegula m'mimba, kawirikawiri - angioedema wamatumbo, jaundice, cholestatic, pancreatitis, pafupipafupi osadziwika - hepatic encephalopathy odwala omwe ali ndi hepatic insuffence (onani. "Contraindication", "Maupangiri Apadera"), hepatitis.

Pa khungu ndi mafuta opanikizika: Nthawi zambiri - zotupa pakhungu, zotupa za maculopapular, pafupipafupi - angioedema a nkhope, milomo, miyendo, mucous membrane wa lilime, makutu am'kamwa ndi / kapena larynx, urticaria (onani "Malangizo apadera") , hypersensitivity zimachitika mwa odwala oganiza za bronchial yotupa ndi matupi awo sagwirizana, phenura, odwala omwe ali ndi vuto lambiri lupus erythematosus, matendawa amatha kuchuluka, kawirikawiri erythema multiforme, poyizoni wam'mimba. necrolysis, Stevens-Johnson syndrome. Pakhala zochitika za photosensitivity reaction (onani. "Maupangiri Apadera").

Kuchokera ku minculoskeletal system ndi minofu yolumikizana: pafupipafupi - minofu ya minofu.

Kuchokera kwamikodzo dongosolo: pafupipafupi - kulephera kwa impso, kawirikawiri - kulephera kwaimpso.

Kuchokera ku kubereka: mosalekeza - kusabala.

Mavuto ndi Zizindikiro Zambiri: nthawi zambiri - asthenia, pafupipafupi - thukuta limachulukirachulukira.

Laborator Zizindikiro: hyperkalemia, pafupipafupi, kuwonjezeka pang'ono kwa creatinine ndende mu mkodzo ndi madzi am`magazi pambuyo mankhwala anasiya, nthawi zambiri odwala aimpso a stenosis, mankhwalawa matenda oopsa ndi okodzetsa komanso vuto la aimpso, kawirikawiri hypercalcemia, osadziwika pafupipafupi - kuwonjezeka kwa gawo la QT pa ECG (onani "Maupangiri Apadera"), kuwonjezereka kwa kuchuluka kwa uric acid ndi glucose m'magazi, kuwonjezeka kwa ntchito ya michere ya chiwindi, hypokalemia, yomwe ndiyofunikira kwambiri kwa atsientov, pa chiopsezo (onani. "Malangizo Special"), hyponatremia ndi hypovolemia, zikubweretsa madzi m'thupi ndipo orthostatic hypotension. Hypochloremia munthawi yomweyo kumatha kubweretsa zolakwika kagayidwe kachakudya matenda (kuthekera ndi kuopsa kwa izi ndi zotsika).

Zotsatira zoyipa zomwe zimadziwika mu mayesero azachipatala

Zotsatira zoyesedwa panthawi ya kafukufuku wa ADVANCE ndizogwirizana ndi mbiri yomwe idakhazikitsidwa kale yophatikiza perindopril ndi indapamide. Zochitika zoyipa zazikulu zidadziwika mwa ena mwa magulu omwe adaphunziridwa: hyperkalemia (0%), kulephera kwaimpso (0.1%), ochepa hypotension (0%) ndi chifuwa (0%).

Mwa odwala 3 mu gulu la perindopril / indapamide, angioedema adawonedwa (motsutsana ndi 2 mu gulu la placebo).

Kutulutsa mawonekedwe ndi kapangidwe kake

Noliprel imapangidwa ngati mapiritsi: yoyera, yodutsa, yokhala ndi chiopsezo mbali zonse ziwiri (m'matumba a 14 ndi 30 ma PC., 1 chithuza mu bokosi la makatoni).

Piritsi limodzi limaphatikizira:

Mchere wa Perindopril tertbutylamine - 2 mg,
Indapamide - 0,625 mg.

Zothandiza: cellcrystalline cellulose, lactose monohydrate, magnesium stearate, hydrophobic colloidal silicon dioxide.

Mankhwala

Noliprel® A ndi kuphatikiza komwe kumakhala ndi perindoprilarginin (angiotensin wotembenuza enzyme inhibitor) ndi indapamide (okodzetsa kuchokera ku gulu la sulfonamide linalake). Pharmacological zimatha mankhwala Noliprel® A kuphatikiza umunthu wa aliyense wa zigawo zikuluzikulu.

Kuphatikiza kwa perindopril ndi indapamide kumathandizira zochita za aliyense wa iwo. Noliprel® A imadalira kuthamanga kwa magazi mu diastoli ndi systolic magazi (BP) m'malo “abodza” komanso “oimirira”. Zotsatira za mankhwalawa zimatha maola 24. The achire zotsatira amapezeka osakwana mwezi umodzi kuchokera chiyambi cha mankhwala ndipo si limodzi ndi tachycardia. Kuchotsa chithandizo sikuyambitsa matenda obwera nawo.

Noliprel® A amachepetsa kuchuluka kwamanzere kwamitsempha yamagazi, kumapangitsa kuti magazi azikhala ochepa, kumachepetsa kupuma kwamitsempha, sikukhudzana ndi lipid metabolism (cholesterol yathunthu, kupsinjika kwa lipoprotein cholesterol (HDL)) komanso kachulukidwe kochepa (LDL), triglycerides.

Perindopril

Perindopril ndi choletsa wa enzyme yomwe imatembenuza angiotensin I kukhala angiotensin II (ndi ACE inhibitor).

Angiotensin-converting enzyme, kapena kinase, ndi exopeptidase yomwe imakwaniritsa kutembenuka kwa angiotensin I kukhala vasoconstrictor chinthu angiotensin II, ndikuwonongeka kwa bradykinin, komwe kumakhala ndi vasodilating, ku heptapeptide yogwira ntchito. Zotsatira za perindopril:

Imachepetsa kubisika kwa aldosterone,
Chifukwa cha ndemanga zoyipa zimachulukitsa ntchito ya renin m'madzi a m'magazi,
kugwiritsa ntchito nthawi yayitali, kumachepetsa kupindika kwamitsempha, komwe kumachitika makamaka chifukwa cha mphamvu ya ziwiya zam'misempha ndi impso.

Zotsatira izi siziphatikizidwa ndi kusunga kwamchere ndi zamadzimadzi kapena kukula kwa Reflex tachycardia.

Perindopril ali ndi vuto lodana ndi odwala omwe ali ndi ntchito yotsika komanso yachilendo ya plasma.

Pogwiritsa ntchito perindopril, pakhala kutsika kwa ma systolic ndi diastolic magazi (BP) m'malo “onama” ndi “oyimirira”. Kuthawa mankhwala sikuchulukitsa magazi.

Perindopril imakhala ndi vasodilating effect, imathandizira kubwezeretsa kukula kwa mitsempha yayikulu ndi kapangidwe ka khoma lamitsempha yama mitsempha yaying'ono, komanso kumachepetsa hypertrophy yamanzere yamanzere.

Kugwiritsidwa ntchito kwina kwa thiazide diuretics kumathandizira kuwopsa kwa mphamvu ya antihypertensive. Kuphatikiza apo, kuphatikiza kwa ACE inhibitor ndi thiazide diuretic kumathandizanso kuchepa kwa chiwopsezo cha hypokalemia mwa odwala omwe amalandila diuretics.

Perindopril imasinthasintha magwiridwe antchito a mtima, kuchepetsa kutsitsa ndi kutsitsa.

Pophunzira hemodynamic magawo mwa odwala omwe ali ndi vuto la mtima, adawululidwa:

kuchepa kwa kudzaza kwa mtima kumanzere kwamanja ndi kumanja kwamtima,
kuchepa kwathunthu kwamphamvu mtima kukana,
kuchuluka kwa mtima komanso kuchuluka kwamtima.
kuchuluka kwamitsempha yamagazi.

Indapamide ndi ya gulu la sulfonamides - mwa mankhwala a cellacological ili pafupi ndi thiazide diuretics. Indapamide imalepheretsa kubwezeretsanso kwa ayoni a sodium mu gawo lachigawo cha Henle loop, yomwe imapangitsa kuwonjezeka kwa excretion wa sodium, chlorine ndipo, pocheperako, potaziyamu ndi magnesium ion ndi impso, potero kuwonjezeka kukondoweza.

Mphamvu ya antihypertensive imawonetsedwa mu Mlingo womwe sachititsa kuti pakhale diuretic.

Indapamide amachepetsa hyperreacaction mtima ponena za adrenaline. Indapamide sichikhudza plasma lipids: triglycerides, cholesterol, LDL ndi HDL, metabolism ya carbohydrate (kuphatikiza odwala omwe ali ndi vuto la matenda a shuga a mellitus).

Zimathandizira kuchepetsa kumanzere kwamitsempha yam'mimba.

Mlingo ndi makonzedwe

Mkati, makamaka m'mawa, musanadye, piritsi 1 la Noliprel® 1 nthawi patsiku.

Ngati patatha mwezi umodzi chiyambireni chithandizo mankhwala ofunikira osakwaniritsidwa, mankhwalawa amatha kuwonjezeredwa ku mlingo wa 5 mg + 1.25 mg (wopangidwa ndi kampani pansi pa dzina la Noliprel® A forte).

Kulephera kwina

Mankhwalawa amadziwikiratu odwala omwe amalephera kwambiri aimpso (CC ochepera 30 ml / min.).

Kwa odwala omwe amalephera kupweteka aimpso (CC 30-60 ml / min), mlingo waukulu wa Noliprel® A ndi piritsi limodzi patsiku.

Odwala omwe ali ndi CC ofanana kapena opitilira 60 ml / mphindi. Musafune kusintha kwa mlingo. Mankhwala, kuwunika kawirikawiri plasma creatinine ndi potaziyamu ndikofunikira.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mankhwala sayenera kugwiritsidwa ntchito mu nthawi yoyambirira ya mimba.

Mukakonzekera kutenga pakati kapena pakakhala kumwa Noliprel® A, muyenera kusiya kumwa mankhwalawo ndikuwapatseni mankhwala ena a antihypertensive.

Kafukufuku woyesedwa woyenera wa ACE zoletsa mwa amayi apakati sanachitike. Zambiri zochepa zamavuto a mankhwalawa mu nthawi yoyambirira ya mimba zimawonetsa kuti kumwa mankhwalawa sikunachititse kuti pakhale zovuta zina zomwe zimakhudzana ndi fetotoxicity.

Noliprel® A imalembedwa mu II ndi III trimester ya mimba (onani gawo "Contraindication").

Amadziwika kuti kukhudzana kwanthawi yayitali kwa ACE zoletsa mwana wosabadwayo mu wachiwiri ndi wachitatu trimesters wa mimba kungachititse kuti chiwonetsero chazovuta (kuchepa aimpso, oligohydramnios, kuchepa kwa mafupa chigaza) ndi kukula kwa zovuta mu wakhanda (kulephera kwa impso, hypotension, hyperkalemia).

Ngati wodwala alandira mankhwalawa Noliprel® A panthawi ya II kapena III nyengo yovomerezeka, tikulimbikitsidwa kuti tichite kafukufuku wa mwana wosabadwa kuti mupeze mawonekedwe a chigaza ndi impso.

Bongo

Chizindikiro chodziwika bwino cha mankhwala osokoneza bongo ndi kuchepa kwa kuthamanga kwa magazi, nthawi zina kuphatikiza mseru, kusanza, kupsinjika, chizungulire, kugona, kusokonezeka, ndi oliguria, komwe kumatha kulowa mu anuria (chifukwa cha hypovolemia). Zosokoneza za electrolyte (hyponatremia, hypokalemia) zingachitike.

Njira zodzidzimutsa zimachepetsedwa ndikuchotsa mankhwalawa mthupi: kutsuka m'mimba ndi / kapena kukhazikitsa kaboni yokhazikitsidwa, ndikutsatira kubwezeretsanso kwa selere yamagetsi yamagetsi.

Ndi kuchepa kwakukulu kwa kuthamanga kwa magazi, wodwalayo ayenera kusunthidwa kumalo a supine ndi miyendo yokwezeka. Ngati ndi kotheka, cholondola hypovolemia (mwachitsanzo, kulowetsedwa kwa 0,9% sodium kolorayidi yankho). Perindoprilat, metabolite yogwira ya perindopril, imatha kuchotsedwa m'thupi ndi dialysis.

Osavomerezeka kuphatikiza

Kukonzekera kwa Lithium: kugwiritsa ntchito munthawi yomweyo kukonzekera kwa lifiyamu ndi zoletsa za ACE, kuwonjezereka kosinthika kwa kuchuluka kwa lifiyamu m'magazi am'magazi komanso zovuta zomwe zingayambitse. Kugwiritsanso ntchito kwa thiazide diuretics kumatha kuwonjezera kuchuluka kwa lithiamu ndikukulitsa ngozi ya kawopsedwe. Kugwiritsa ntchito nthawi yomweyo kuphatikiza kwa perindopril ndi indapamide yokhala ndi kukonzekera kwa lifiyamu sikulimbikitsidwa. Ngati ndi kotheka, chithandizo choterechi chimayenera kuwunika zonse zomwe zili mu plasma yamagazi (onani gawo "Malangizo apadera").

Mankhwala osokoneza bongo, kuphatikiza komwe kumafunikira chisamaliro chapadera

Baclofen: imatha kuwonjezera hypotensive. Kupsinjika kwa magazi ndi ntchito ya impso kuyenera kuyang'aniridwa; ngati kuli koyenera, kusintha kwa mankhwala a antihypertensive kumafunika.

Mankhwala osagwirizana ndi nonsteroidal anti-kutupa (NSAIDs), kuphatikizapo milingo yayikulu ya acetylsalicylic acid (oposa 3 g / tsiku): NSAIDs ingayambitse kuchepa kwa diuretic, natriuretic ndi antihypertensive zotsatira. Ndikutayika kwakukulu kwamadzimadzi, kulephera kwa impso kumatha kukhazikika (chifukwa cha kuchepa kwa kuchuluka kwa kusefedwa kwa glomerular). Musanayambe chithandizo ndi mankhwalawa, ndikofunikira kuti mupange kutaya kwa madzimadzi ndikuwunikira ntchito ya impso koyambirira koyambira.

Kuphatikiza kwa mankhwala omwe amafunikira chisamaliro

Tricyclic antidepressants, antipsychotic (antipsychotic): mankhwala omwe amapezeka m'maguluwa amathandizira antihypertensive kwambiri ndikuwonjezera chiopsezo cha orthostatic hypotension (zotsatira zowonjezera).

Corticosteroids, tetracosactide: kuchepa kwa mphamvu ya antihypertensive (madzimadzi ndi posungira sodium ion chifukwa cha corticosteroids).

Mankhwala ena a antihypertensive: angalimbikitse mphamvu ya antihypertensive.

Malangizo apadera

Kugwiritsa ntchito kwa mankhwala Noliprel® A 2.5 mg + 0,625 mg, wokhala ndi mlingo wochepa wa indapamide ndi perindopril arginine, sikuyenda ndi kuchepa kwakukulu pamafupipafupi a zotsatira zoyipa, kupatula hypokalemia, poyerekeza ndi perindopril ndi indapamide pamiyeso yotsika kwambiri (onani gawo " Zotsatira zoyipa "). Kumayambiriro kwamankhwala ndimankhwala awiri a antihypertensive, omwe wodwalayo sanalandirepo, chiwopsezo cha idiosyncrasy sichingathe kudziwika. Kuyang'anira wodwala mosamala kumachepetsa ngozi imeneyi.

Matenda aimpso

Chithandizo cha mankhwala chimaperekedwa kwa odwala omwe amalephera kwambiri aimpso (CC ochepera 30 ml / min). Odwala ena ochepa matenda oopsa popanda kudziwika ngati aimpso m'mbuyomu, mankhwalawa angawonetse chizindikiro chakulephera kwa aimpso. Pankhaniyi, chithandizo chiyenera kusiyidwa. M'tsogolomu, mutha kuyambiranso kuphatikiza pogwiritsa ntchito mankhwala ochepa, kapena kugwiritsa ntchito mankhwalawa monotherapy.

Odwala otere amafunika kuwunika pafupipafupi ma seramu potaziyamu ndi ma satinine - masabata awiri pambuyo poyambira chithandizo ndi miyezi iwiri iliyonse pambuyo pake. Kulephera kwamkati kumachitika kawirikawiri kwa odwala omwe ali ndi vuto lalikulu la mtima kapena matenda aimpso oyamba, kuphatikizanso aimpso.

Arterial hypotension ndi kusowa kwamanja kwamadzi-electrolyte bwino

Hyponatremia imagwirizanitsidwa ndi chiopsezo cha kukula kwadzidzidzi kwa hypotension (makamaka kwa odwala omwe ali ndi vuto limodzi la impso stenosis). Chifukwa chake, mukamayang'anira odwala mwamphamvu, kuyenera kuthandizidwa kuti muzindikire kuchepa kwa madzi komanso kuchepa kwa ma electrolyte m'magazi am'magazi, mwachitsanzo, atatha kutsekula m'mimba kapena kusanza. Odwala otere amafunika kuwunika pafupipafupi ma electrolyte am'madzi.

Ndi wowopsa ochepa hypotension, intravenous makonzedwe a 0,9% sodium kolorayidi njira angafunike.

Osakhalitsa ochepa hypotension si kuphwanya lamulo kwa kupitiliza mankhwala. Pambuyo pobwezeretsa kuchuluka kwa kuzungulira magazi ndi kuthamanga kwa magazi, mankhwalawa atha kuyambiranso pogwiritsa ntchito milingo yochepa, kapena mankhwala angagwiritsidwe ntchito monotherapy mode.

Mulingo wa potaziyamu

Kugwiritsira ntchito pamodzi kwa perindopril ndi indapamide sikulepheretsa kukula kwa hypokalemia, makamaka kwa odwala matenda a shuga kapena kulephera kwaimpso. Monga momwe zimagwirira ntchito pophatikizira mankhwala a antihypertensive komanso okodzetsa, kuyang'anira kuchuluka kwa potaziyamu m'madzi am'magazi ndikofunikira.

Terms a Tchuthi cha Pharmacy

Mankhwala ndi mankhwala.

Monga monotherapy, dokotala nthawi zambiri amalangiza perindopril ndi indapamide padera. Zotsatira za mankhwalawa zimaphatikizapo Co-preness kapena Prestarium Arginine Combi. Kuphatikiza apo, wopanga amapanga Noliprel mumankhwala ena.

Mtengo wamba wa mapiritsi a Noliprel A mapiritsi a 2,5 mg + 0,625 mg ku pharmacies aku Moscow ndi ma ruble 540-600.

Kuchita

1. Kuphatikiza komwe sikulimbikitsidwa kuti mugwiritse ntchito

Kukonzekera kwa Lithium: kugwiritsa ntchito munthawi yomweyo kukonzekera kwa lifiyamu ndi zoletsa za ACE, kuwonjezereka kosinthika kwa kuchuluka kwa lifiyamu m'magazi am'magazi komanso zovuta zomwe zingayambitse. Kugwiritsanso ntchito kwa thiazide diuretics kumatha kuwonjezera kuchuluka kwa lithiamu ndikukulitsa ngozi ya kawopsedwe. Kugwiritsa ntchito nthawi yomweyo kuphatikiza kwa perindopril ndi indapamide yokhala ndi kukonzekera kwa lifiyamu sikulimbikitsidwa. Ngati chithandizo choterocho nchofunikira, zomwe zili mu plasma yamagazi ziyenera kuyang'aniridwa nthawi zonse (onani "Maupangiri Apadera").

2. Mankhwala osokoneza bongo, kuphatikiza komwe kumafunikira chisamaliro chapadera komanso kusamala

Baclofen: imatha kuwonjezera hypotensive. Kuthamanga kwa magazi ndi ntchito ya impso kuyenera kuyang'aniridwa; kusintha kwa mankhwalawa kwa antihypertensive mankhwala ndikofunikira ngati pakufunika.

NSAIDs, kuphatikiza waukulu Mlingo wa acetylsalicylic acid (oposa 3 g / tsiku): NSAIDs ingachepetse mayendedwe a diuretic, natriuretic ndi antihypertensive. Ndikutayika kwakukulu kwamadzimadzi, kulephera kwa impso kumatha kukhazikika (chifukwa cha kuchepa kwa kuchuluka kwa kusefedwa kwa glomerular). Musanayambe chithandizo ndi mankhwalawa, ndikofunikira kuti mupange kutaya kwa madzimadzi ndikuwunikira ntchito ya impso koyambirira koyambira.

3. Kuphatikiza kwa mankhwala omwe amafunikira chisamaliro

Corticosteroids, tetracosactide: kuchepa kwa mphamvu ya antihypertensive (madzimadzi ndi posungira sodium ion chifukwa cha corticosteroids).

Mankhwala ena a antihypertensive: angalimbikitse mphamvu ya antihypertensive.

1. Kuphatikiza komwe sikulimbikitsidwa kuti mugwiritse ntchito

Potaziyamu yosawononga okodzetsa (amiloride, spironolactone, triamteren) ndi kukonzekera kwa potaziyamu: zoletsa za ACE zimachepetsa kutayika kwa potaziyamu ndi impso zomwe zimayambitsa diuretic. Potaziyamu yosawononga okodzetsa (mwachitsanzo, spironolactone, triamteren, amiloride), kukonzekera kwa potaziyamu, komanso m'malo mwa mchere wa potaziyamu kungayambitse kuchuluka kwakukulu kwa potaziyamu mu seramu ya magazi mpaka kufa. Ngati munthawi yomweyo kugwiritsa ntchito mankhwala a ACE inhibitor komanso mankhwala omwe ali pamwambapa kuli kofunikira, muyenera kusamala ndikuwunika kawirikawiri zomwe zili mu potaziyamu yamagazi ndi magawo a ECG ziyenera kuchitika.

2. Kuphatikiza kwa mankhwala omwe amafunikira chisamaliro chapadera

Othandizira a Hypoglycemic operekera pakamwa (zotumphukira za sulfonylurea) ndi insulin: zotsatirazi zafotokozedwa za Captopril ndi enalapril. ACE inhibitors amatha kupititsa patsogolo hypoglycemic momwe insulin ndi zotumphukira kuchokera kwa odwala matenda a shuga. Kukula kwa hypoglycemia ndikosowa kwambiri (chifukwa cha kuchuluka kwa kulekerera kwa glucose komanso kuchepa kwa kufunika kwa insulin).

3. Kuphatikiza kwa mankhwala omwe amafunikira chisamaliro

Mankhwala a Allopurinol, cytostatic and immunosuppressive, corticosteroids (ogwiritsa ntchito mwadongosolo) ndi procainamide: Kugwiritsa ntchito pamodzi ndi ACE zoletsa kungagwirizane ndi chiwopsezo cha leukopenia.

Njira zochitira opaleshoni: kugwiritsa ntchito nthawi imodzi ya ACE zoletsa ndi othandizira opaleshoni yayitali kungayambitse kuchuluka kwa antihypertensive.

Diuretics (thiazide ndi loop): kugwiritsidwa ntchito kwa okodzetsa kwambiri Mlingo wambiri ungayambitse hypovolemia, ndipo kuphatikiza kwa perindopril ku chithandizo chamankhwala kumatha kubweretsa ochepa hypotension.

Kukonzekera kwa golide: mukamagwiritsa ntchito ACE inhibitors, incl. perindopril, mu odwala omwe amalandiridwa ndi golide kukonzekera (sodium aurothiomalate), chizindikiro chofotokozedwacho chikufotokozedwa, kuphatikizapo: nkhope yamkhungu hyperemia, nseru, kusanza, hypotension.

1. Kuphatikiza kwa mankhwala omwe amafunikira chisamaliro chapadera

Mankhwala omwe angayambitse pirouette arrhythmias: chifukwa cha chiopsezo cha hypokalemia, kusamala kuyenera kugwiritsidwa ntchito mukamagwiritsira ntchito indapamide ndi mankhwala omwe angayambitse pirouette arrhythmias, mwachitsanzo, mankhwala a antiarrhythmic (quinidine, hydroquinidine, disopyramide, amiodarone, dofetilide, ibutilide , bretilia tosylate, sotalol), ma antipsychotic ena (chlorpromazine, cyamemazine, levomepromazine, thioridazine, trifluoperazin), benzamides (amisulpride, sulpiride, sultopride, tiapride), butyrophenones (droperidol, ndulu ridol), ma antipsychotic (pimozide), mankhwala ena, monga bepridil, cisapride, diphemanil methyl sulfate, erythromycin (iv), halofantrine, misolastine, moxifloxacin, pentamidine, sparfloxacin, vincamine (iv), methadone, astadoneadin . Kugwiritsa ntchito pamodzi ndi mankhwala omwe ali pamwambapa kuyenera kupewedwa, chiwopsezo cha hypokalemia ndipo, ngati kuli koyenera, kukonzanso kwake, kuwongolera nthawi ya QT.

Mankhwala osokoneza bongo omwe angayambitse hypokalemia: amphotericin B (iv), corticosteroids ndi mineralocorticosteroids (ogwiritsa ntchito mwadongosolo), tetracosactides, mankhwala othandizira othandizira matumbo: chiwopsezo cha hypokalemia (chowonjezera). Ndikofunikira kuyendetsa potaziyamu m'magazi am'magazi, ngati kuli koyenera, kukonza kwake. Chisamaliro makamaka chikuyenera kuperekedwa kwa odwala omwe amalandila ndi mtima glycosides. Zithandizo zoyipa zomwe sizimalimbikitsa matumbo zimayenera kugwiritsidwa ntchito.

Mtima glycosides: hypokalemia imawonjezera poizoni wama mtima glycosides. Pogwiritsa ntchito munthawi yomweyo mankhwala a indapamide ndi mtima glycosides, zomwe zili mu plasma yamagazi ndi mafayilo a ECG ziyenera kuyang'aniridwa ndipo ngati pakufunika kutero, muthanso mankhwala.

2. Kuphatikiza kwa mankhwala omwe amafunikira chisamaliro

Metformin: kulephera kwa aimpso komwe kumatha kuchitika pakudya m'mimba, makamaka kupukusa okodze, pomwe kuyang'anira metformin kumawonjezera chiopsezo cha lactic acidosis. Metformin sayenera kugwiritsidwa ntchito ngati kuchuluka kwa creatinine mu plasma ya magazi kudutsa 15 mg / l (135 μmol / l) mwa amuna ndi 12 mg / l (110 μmol / l) mwa akazi.

Iodine wokhala ndi mitundu yothandizira: kukomoka thupi ndikamamwa mankhwala okodzetsa kumawonjezera vuto laimpso kulephera, makamaka mukamagwiritsa ntchito Mlingo wa ayodini. Musanagwiritse ntchito mankhwala okhala ndi ayodini, odwala amafunika kulipilira kuti madzi atayika.

Mchere waku calcium: munthawi yomweyo makonzedwe, hypercalcemia imatha kuyamba chifukwa cha impso ya calcium ya impso.

Cyclosporin: kuwonjezeka kwa kuchuluka kwa creatinine m'madzi a m'magazi kungatheke popanda kusintha kuchuluka kwa cyclosporin m'madzi a m'magazi, ngakhale ndi madzi ndi madzi a sodium.

Momwe mungatenge, njira ya makonzedwe ndi kumwa

Mkati, makamaka m'mawa, musanadye.

Piritsi 1 la mankhwala Noliprel ® 1 nthawi imodzi patsiku.

Ngati ndi kotheka, mankhwalawa amayamba ndikusankha Mlingo wa mankhwala amodzi. Pankhani ya zosowa zamankhwala, mutha kulingalira za kupereka mankhwala othandizira ndi Noliprel ® A atangopezeka ndi monotherapy.

Odwala ochepa matenda oopsa ndi mtundu 2 matenda osokoneza bongo kuti muchepetse chiopsezo cha microvascular complication (kuchokera impso) ndi macrovascular zovuta chifukwa cha matenda amtima

Piritsi 1 Noliprel ® A 1 nthawi patsiku. Pambuyo pa chithandizo cha miyezi itatu, malinga ndi kulekerera kwabwino, ndizotheka kuwonjezera kuchuluka kwa mapiritsi awiri a Noliprel ® A 1 nthawi patsiku (kapena piritsi 1 la Noliprel ® A forte 1 nthawi patsiku).

Odwala okalamba

Chithandizo cha mankhwalawa ziyenera kuikidwa pambuyo poyang'anira ntchito yaimpso ndi kuthamanga kwa magazi.

Mankhwala ndi contraindicated kwa odwala kwambiri aimpso kulephera (creatinine Cl zosakwana 30 ml / min).

Kwa odwala omwe ali ndi kulephera kwapakati aimpso (Cl creatinine 30-60 ml / min), tikulimbikitsidwa kuti ayambe kugwiritsa ntchito mankhwala osokoneza bongo ofunikira (mu mawonekedwe a monotherapy), omwe ali gawo la Noliprel ® A.

Kwa odwala omwe ali ndi Cl creatinine wofanana kapena wamkulu kuposa 60 ml / min, kusintha kwa mankhwala sikofunikira. Mankhwala, kuwunika kawirikawiri plasma creatinine ndi potaziyamu ndikofunikira.

Mankhwalawa ali contraindified kwa odwala kwambiri chiwindi kuwonongeka.

Polephera chiwindi chokwanira, kusintha kwa mankhwalawa sikofunikira.

Ana ndi achinyamata

Noliprel ® A sayenera kulembedwa kwa ana ndi achinyamata ochepera zaka 18 chifukwa chosowa chidziwitso pakuyenda bwino komanso mankhwalawa kwa odwala a m'badwo uno.

Malangizo apadera

Kugwiritsa ntchito kwa Noliprel ® A 2.5 mg + 0.625 mg, wokhala ndi mlingo wochepa wa indapamide ndi perindopril arginine, sikuyenda ndi kuchepa kwakukulu pamafupipafupi a zotsatira zoyipa, kupatula kwa hypokalemia, poyerekeza ndi perindopril ndi indapamide pamiyeso yotsika kwambiri yomwe imaloledwa kugwiritsidwa ntchito (onani "Chosokoneza" machitidwe "). Kumayambiriro kwa mankhwala omwe ali ndi antihypertensive mankhwala, omwe wodwalayo sanalandirepo, chiwopsezo chokhala ndi idiosyncrasy sichingathe kudziwika. Kuyang'anira wodwala mosamala kumachepetsa ngozi imeneyi.

Matenda aimpso

Mankhwalawa ndi contraindicated kwa odwala kwambiri aimpso kulephera (creatinine Cl zosakwana 30 ml / min). Odwala ena ochepa matenda oopsa popanda kudziwika ngati aimpso m'mbuyomu, mankhwalawa angawonetse chizindikiro chakulephera kwa aimpso. Pankhaniyi, chithandizo chiyenera kusiyidwa. M'tsogolomu, mutha kuyambiranso kuphatikiza pogwiritsa ntchito mankhwala ochepa, kapena kugwiritsa ntchito mankhwalawa monotherapy.

Arterial hypotension ndi kusowa kwamanja kwamadzi-electrolyte bwino

Ndi ochepa ochepa hypotension, iv oyang'anira 0,9% sodium kolorayidi angafunike.

Osakhalitsa ochepa hypotension si kuphwanya lamulo kwa kupitiliza mankhwala. Pambuyo pobwezeretsa BCC ndi kuthamanga kwa magazi, mutha kuyambiranso mankhwala pogwiritsa ntchito mankhwala ochepetsa, kapena kugwiritsa ntchito mankhwalawa monotherapy.

Kugwiritsira ntchito pamodzi kwa perindopril ndi indapamide sikulepheretsa kukula kwa hypokalemia, makamaka kwa odwala matenda a shuga kapena kulephera kwaimpso. Monga momwe mungagwiritsire ntchito antihypertensive mankhwala komanso okodzetsa, muyenera kuwunika nthawi zonse potaziyamu ya madzi a m'magazi.

Tiyenera kudziwa kuti kapangidwe ka mankhwala omwe amapezeka ndi lactose monohydrate. Noliprel ® A sayenera kuperekedwa kwa odwala omwe ali ndi cholowa cha galactose, kusowa kwa lactase ndi glucose-galactose malabsorption.

Kugwiritsa ntchito munthawi yomweyo kuphatikiza kwa perindopril ndi indapamide kukonzekera kwa lifiyamu sikulimbikitsidwa (onani. Contraindication "," Kuchita ").

Chiwopsezo chotenga neutropenia pomwe mukumwa ma inhibitors a ACE kumadalira mlingo ndipo zimatengera mankhwala omwe amwedwa komanso kupezeka kwa matenda olimba. Neutropenia samapezeka mwa odwala omwe alibe matendawa, koma chiwopsezo chimawonjezeka mwa odwala omwe ali ndi vuto laimpso, makamaka motsutsana ndi matenda a minyewa yodziwika bwino (kuphatikizapo zokhudza lupus erythematosus, scleroderma). Pambuyo pa kuchoka kwa ACE zoletsa, zizindikiritso za neutropenia zimazimiririka zokha.

Pofuna kupewa izi

Zomwe amachiritsa Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.? Zabwino Kwambiri Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.. Kusankha Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.. Malo osungira Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.. Mtengo wamba wa Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.. Kwambiri Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.. Ingotengani Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC.. Noliprel A mapiritsi a 2,5 + 0,625 mg 30 ma PC. gulani pa intaneti.

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