Telmisartan (Mikardis)

Tlhaloso e amanang le 04.11.2016

• Lebitso la Latin: Telmisartan
• Khoutu ea ATX: C09CA07
• Lintho tse sebetsang: Telmisartan (Telmisartan)
• Moetsi: Semela sa meriana sa TEVA, JSC bakeng sa Ratiopharm International GmbH, Hungary / Germany

Ho latela sebopeho sa tokollo, Letlapa le le leng le na le 80 kapa 40 mg ea ntho e sebetsang.

Mofumahali

Telmisartan ke mohanyetsi ea khethiloeng oa angiotensin II. E phehisana le angiotensin bakeng sa ho tlama li-receptors tsa AT1. Ha ho setsoalle bakeng sa li-receptor tse ling se hlokometsoe.

Telmisartan ha e hatelle ketso ea renin, ACE, ha e thibele liteishene tse ikarabellang bakeng sa ho tsamaisa li-ion, e fokotsa litaba tse kahare aldosterone ka madi.

Tekanyo ea 80 mg e batla e felisa keketseho ka botlalo khatello ea malie bakoang ke angiotensin II. Phello e phahameng e nka lihora tse 24, ebe butle-butle ea fokotseha. Tabeng ena, phello e kholo ea lithethefatsi e utluoa bonyane lihora tse 48 kamora ho nka matlapa.

Telmisartan e theola khatello ea systolic le diastolic ka bobeli, empa ha e ame sekhahla sa pulse. Ha ho na tšusumetso ea ho lemalla kapa ho bokella hoa bohlokoa 'meleng' meleng ho boletsoeng.

Mofumahali

Kamora ho kenella, moriana o hantle ebile o ananeloa kapele. Bioavailability ke hoo e ka bang 50%. E amana hantle le liprotheine tsa plasma.

Kakaretso e phahameng ea plasma hangata e phahame ho basali ha ba nka tekanyetso e tšoanang. Empa sena ha se ame katleho.

Metabolism le hlaha ka har'a sebete. Sena se sebetsa se sa sebetse metaboliteHo felisoa ha eona ho etsahala haholo ka mala. Bophelo ba halofo ea 'mele bo nka lihora tse 20.

Matšoao a ho sebelisoa

E sebelisoa ho phekola khatello ea kelello ea methapo le bakeng sa thibelo ea ho shoa hoa mafu a lefu la pelo le kamorao ho moo stroke, lefu la pelolefu la methapo ea pelo hypertrophy ea letsoho le letšehali.

Contraindication

Ha hoa lumelloa ho fana ka lengolo la Telmisartan le:

• maloetse a thibelang
• matla ho hloleha ha sebete,
• ea mantlha aldosteronism,
• fructose mamello,
• ho ikutloa ka mokhoa o feteletseng ho ntho e sebetsang kapa motsoako ofe kapa ofe o karolo ea motsoako,
• ea boimana,
• ka tlase ho lilemo tse 18.

Litlamorao

Litlamorao ha li na seoelo.

E mong oa bakuli ba 100-1000 ba noang moriana o na le matšoao a latelang:

Ho 1 ho bakuli ba 1000-10000 ba hlokometseng:

• tšoaetso ea methapo ea methapo le ea ho hema (cystitis, pharyngitis, sinusitis) kapa sepsis,
• thrombocytopenia,
• fokotsa maemo hemoglobin,
• boikutlo ba ho tšoenyeha
• likhathatso tsa pono
• tachycardia,
• ho theoha ha khatello ea mali ha u fetola boemo ba 'mele (ho tloha ka leqheka ho isa ho lethekeng),
• ho opeloa ke mpa
• molomo o omileng
• ho se sebetse hantle ha sebete,
• mosebetsi o eketsehileng oa sebete Li-enzyme,
• uric acid e ngata haholo,
• bohloko bo kopaneng
• erythema,
• angioedema,
• makhopho a nang le chefo,
• makhopho a sefahleho.

Litlamorao tse sa tloaelehang haholo kapa tseo maqhubu a tsona a sa khoneng ho tsejoa hantle:

• bohloko ba tendon bo tšoanang le tendonitis,
• litekanyetso tse eketsehileng tsa eosinophils maling.

Tšebelisano

Ho sebelisana le Telmisartan le meriana e meng:

• Baclofen, Amifostine le baemeli ba bang ba antihypertgency - phello e matlafatsang e matlafalitsoe,
• barbiturates, lithethefatsi tsa narcotic, ethanol le antidepressants - lipontšo tsa hypotension ea orthostatic lia eketseha kapa kotsi ea ho hlaha ha eona e eketseha,
• Furosemide, Hydrochlorothiazide le li-diuretics tse ling - phello e matlafatsang e eketseha,
• Digoxin - khatello ea maikutlo Digoxin ka plasma
• Litokisetso tsa lithium - keketseho e khutlisetsang moqoqong oa lithium maling, ho hlokahala hore ho netefatsoe letšoao lena,
• Li-NSAIDs - menyetla ea matšoao a hlobaetsang ea eketseha ho hloleha ha remshaholoholo ka ho omella
• potasiamo e sireletsang diuretics, potasiamo, Heparin, Cyclosporin, Tacrolimus, Trimethoprim - khatello e matla ea potasiamo e serumeng ea mali,
• GCS - matla a antihypertensive a fokotsehile,
• Amlodipine - Katleho ea Telmisartan ea eketseha.

Ketso ea pharmacological

Angiotensin II receptor antagonist.

Telmisartan ke mohanyetsi ea itseng oa li-receptors tsa angiotensin II. E na le tšebelisano e phahameng ea AT1 receptor subtype ea angiotensin II, eo ka eona ketso ea angiotensin II e fumanehang. Telmisartan dragins angiotensin II ho tloha e tlamang ho ea ho receptor, e haelloa ke ketso ea agonist mabapi le receptor ena. Telmisartan e tlama feela ho AT1 receptor subtype ea angiotensin II. Ho tlama ho ntse ho tsoela pele. Telmisartan ha e na kamano ea li-receptor tse ling (ho kenyeletsoa li-receptor tsa AT2) le li-receptors tse ling tse ithutoang tsa angiotensin. Bohlokoa ba tšebetsong ba li-receptor tsena, hammoho le phello ea ho tsosa ha tsona ho fetelletseng le angiotensin II, mohopolo oa eona o eketsehang ha ho khethoa telmisartan, ha o so ithutoe. E fokotsa mokokotlo oa aldosterone maling, ha e thibele renin ho plasma ea mali ebile ha e thibele mecha ea ion, ha e thibele ACE (kininase II, enzyme e boetse e senya bradykinin). Ka hona, keketseho ea litlamorao tse bakoang ke bradykinin ha e lebelloe.

Telmisartan ka tekanyo ea 80 mg e thibela ka botlalo phello ea khatello ea mali ea angiotensin II. Ho qala hoa ts'ebetso ea hypotensive ho bonoa nakong ea lihora tse 3 kamora ts'ebetso ea pele ea telmisartan. Tšusumetso ea lithethefatsi e nka lihora tse 24 'me e lula e le bohlokoa ho fihlela lihora tse 48. Phello e phatlalalitsoeng ea hypotensive hangata e hlaha libeke tse 4 ho8 kamora ho nona hangata.

Ho bakuli ba nang le khatello ea mali ea methapo, telmisartan e fokotsa khatello ea mali le systolic, ntle le ho ama lebelo la pelo.

Tabeng ea ho hlakoloa ha telmisartan ka tšohanyetso, butle-butle khatello ea mali e khutlela boemong ba eona ba pele ntle le nts'etsopele ea lefu la ho tlohela.

Tekanyetso le tsamaiso

Setlhare se fanoe ka molomo, ho sa tsotelehe lijo tse jang.

Ka khatello ea mali ea methapo, litekanyetso tsa pele tsa moriana ke pilisi e le 1 (40 mg) hang ka letsatsi. Maemong moo phello ea kalafo e sa fihleheng, tekanyetso e fihla ho 80 mg hang ka letsatsi. Ha u etsa qeto ea ho eketsa tekanyetso, ho lokela ho tsotelloa hore phello e phahameng ea antihypertensive hangata e fihlella ka libeke tse 4 ho8 kamora ho qala kalafo.

Ho fokotsa ho fokolloa ke pelo le lefu la motho, moriana o khothalletsoang ke pilisi e le 'ngoe (80 mg) hang ka letsatsi. Nakong ea kalafo ea pele, ho ka hlokahala tokiso e eketsehileng ea khatello ea mali.

Bakuli ba nang le bothata ba ho phekoloa ka lipholiso (ho kenyeletsa ba nang le hemodialysis), bakuli ba tsofetseng, ho lokisoa ha litekanyetso tsa moriana ha ho hlokehe.

Ho bakuli ba nang le ts'ebetso ea sebete e itekanetseng ho isa tekanyong e fokolang (sehlopha sa A le B ka sekhahla sa ngoana), lethal dose la letsatsi le letsatsi ha lea lokela ho feta 40 mg.

Litla-morao

Maemo a hlokometsoeng a litlamorao a ne a sa tsamaellane le bong, lilemo kapa mofuta oa bakuli.

Ts'oaetso: sepsis, ho kenyelletsa le sepsis e bolaeang, tšoaetso ea phepelo ea moroto (ho kenyeletsoa cystitis), ts'oaetso ea pampiri ea phefumoloho e holimo.

Ho tsoa ho tsamaiso ea hemopoietic: ho fokotseha ha hemoglobin, anemia, eosinophilia, thrombocytopenia.

Ho tloha lehlakoreng la tsamaiso ea methapo e bohareng: ho hloka boroko, ho tšoenyeha, khatello ea maikutlo, ho tsekela.

Ho tsoa ho tsamaiso ea pelo le pelo: ho fokotseha ha khatello ea mali (ho kenyeletsa le hypotension ea orthostatic), bradycardia, tachycardia, ho akheha.

Ho tsoa ho sistimi ea ho hema: ho hema hanyane.

Ho tsoa ho ts'ebetso ea tšilo ea lijo: molomo o omileng, bolulo bo sa thabiseng ka mpeng, ho hlatsa, dyspepsia, lets'ollo, bohloko ba ka mpeng, ts'ebetso ea sebete e sa sebetseng, ts'ebetso e eketsehileng ea li-transaminase tsa hepatic.

Ho tsoa ts'ebetsong ea moroto: ts'ebetso ea ho hlonama e sa sebetseng (ho kenyelletsa le ho hloleha ha methapo ea methapo), edema ea pherekano, hypercreatininemia.

Ho tloha tsamaisong ea musculoskeletal: arthralgia, bohloko ba morao, mesifa ea mesifa (mesifa ea mesifa ea namane), bohloko bo lipheletsong tse tlase, myalgia, bohloko bo ka har'a tendon (matšoao a tšoanang le ponahatso ea tendonitis), bohloko sefubeng.

Litla-morao: karohano ea anaphylactic, karabelo ea hypersensitivity ho ntho e sebetsang kapa likarolo tse thusang tsa lithethefatsi, angioedema, eczema, erythema, ho hlohlona ha letlalo, lekhopho (ho kenyelletsa le lithethefatsi), urticaria, lekhopho le nang le chefo.

Matšoao a laboratori: hyperuricemia, litekanyetso tse eketsehileng tsa CPK ea mali, hyperkalemia.

Tse ling: hyperhidrosis, syndrome e kang ntaramane, ho senyeha ha pono, asthenia (bofokoli).

Ts'ebeliso ea lithethefatsi MIKARDIS® nakong ea kemolo le lactation

Mikardis® e kopantsoe le bokhachane le pelehi.

Ka moimana o reriloeng, Mikardis ® e lokela ho nkeloa sebaka ke sethethefatsi se seng sa antihypertensive. Ha bokhachane bo thehiloe, Mikardis e lokela ho emisoa kapele kamoo ho ka khonehang.

Lithutong tsa preclinical, ha ho na phello ea teratogenic ea lithethefatsi e fumanoeng, empa phello ea fetoto e ile ea bonoa.

Litaelo tse khethehileng

Ho bakuli ba bang, ka lebaka la khatello ea khatello ea RAAS, haholo ha ba sebelisa motsoako oa lithethefatsi tse sebelisang sisteme ena, ho sebetsa ha renal (ho kenyeletsa le ho hloleha ho hlaphoheloa ka mpeng) hoa senyeha. Ka hona, kalafo e tsamaeang le thibelo e joalo e habeli ea RAAS e lokela ho etsoa ka mokhoa o ikhethileng mme e be le leihlo le hlokolosi la ts'ebetso ea liphio (ho kenyelletsa le ho lekola nako le nako ha u bala li-serum potasiamo le tsepamiso ea creatinine).

Maemong a itšetlehileng ka molumo oa methapo ea kutlo le tšebetso ea renal haholo mesebetsing ea RAAS (mohlala, ho bakuli ba sa foleng ba pelo, kapa lefu la liphio, ho kenyelletsa renal artery stenosis kapa artery stenosis ea leino le le leng), ho beoa ha lithethefatsi tse amang mokhoa ona. e ka tsamaisana le nts'etsopele ea methapo ea methapo ea methapo, hyperazotemia, oliguria, 'me maemong a sa tloaelehang, ho hloleha ho sa sebetseng hantle haholo.

Ho ipapisitsoe le boiphihlelo ba ho sebelisa lithethefatsi tse ling tse amang RAAS, ka tšebeliso e kopaneng ea Mikardis ® le li-diuretics tse nang le potasiamo, li-additives tse nang le potasiamo, letsoai le nang le phepo, le lithethefatsi tse ling tse eketsang khatello ea potasiamo maling (ka mohlala, heparin), letšoao lena le lokela ho shebeloa ho bakuli.

Ntle le moo, Mikardis ® e ka sebelisoa hammoho le diaztiti tsa thiazide, tse kang hydrochlorothiazide, eo ka ntle e nang le litlamorao (mohlala, MikardisPlus® 40 mg / 12.5 mg, 80 mg / 12.5 mg).

Ho bakuli ba nang le khatello e matla ea methapo ea kutlo, lethal dose ea telmisartan 160 mg ka letsatsi hammoho le hydrochlorothiazide 12,5-25 mg e mamelletsoe hantle ebile e sebetsa.

Mikardis® ha e sebetse hantle ho bakuli ba mofuta oa Negroid.

Sokolla foromo le sebopeho

Foromo ea litekanyetso - matlapa: pota-pota, sephara-cylindrical, e nang le scaffold le chamfer, e tšoeu kapa e tšoeu-e sootho ka 'mala (li-pcs tse 5, 7, 10 le tse 20. Ka mekotla e metenya, ka lebokoseng la karete ea 1, 2, 3, 4, 5, 8 kapa liphutheloana tse 10, likotoana tsa 10, 20, 28, 30, 40, 50, le 100, e 'ngoe le e' ngoe, lijaneng tse koaelitsoeng ka marako a hulang ka taolo ea "tamper control" kapa "screw-on lids" e nang le sisteme ea phetoho kapa taolo ea taolo ea pele. sephutheloana ka seng se na le litaelo tsa tšebeliso ea Telmisartan).

Letlapa la 1

• karolo e sebetsang: telmisartan - 40 kapa 80 mg,
• excipients (matlapa a 40/80 mg): croscarmellose sodium - 12/24 mg, sodium hydroxide - 3,35 / 6.7 mg, povidone-K25 - 12/250 mg, lactose monohydrate (tsoekere ea lebese) - 296.85 / 474.9 mg, magnesium stearate - 3.80 / 6.4 mg, meglumine - 12/24 mg.

Pherekano ea methapo

Ts'ebeliso ea telmisartan ka tekanyetso ea 80 mg e thibela ka botlalo phello ea khatello ea maikutlo ea AT II. Tšusumetso ea antihypertgency e hlaha ka nako e ka bang lihora tse 3 kamora ho ba tekanyetso ea pele, e nka lihora tse 24 mme e lula e le bohlokoa ho fihlela lihora tse 48. Phello e boletsoeng ea kalafo hangata e hlaha kamora libeke tse 4 ho isa ho tse nne tsa taolo e tloaelehileng ea lithethefatsi.

Ho khatello ea mali ea methapo, telmisartan lowers systolic le diastolic khatello ea mali (BP) ntle le ho ama sekhahla sa pelo (HR).

Kamora ho khaotsa lithethefatsi ka matla, sekhahla sa khatello ea mali se khutlela boleng ba sona ba pele matsatsi a 'maloa. Ho tlohela lefu lena ha ho tsoelepele.

Ho latela liphuputso tsa bongaka tse bapisang, phello e matla ea telmisartan e tšoantšoa le lithethefatsi tsa lihlopha tse ling (mohlala, atenolol, hydrochlorothiazide, enalapril, lisinopril, amlodipine). Leha ho le joalo, ho khohlela ho omileng ho bakuli ba fumanang telmisartan ho etsahetse hangata haholo ho feta ho bakuli ba nkang li-inhibitors tsa ACE.

Thibelo ea Maloetse a amanang le pelo le pelo

Ho bakuli ba lilemo li 55 le ho feta ba nang le lefu la nakoana la ischemic, stroke, lefu la pelo (CHD), lesapo la mokokotlo le mathata a mofuta oa lefu la tsoekere la 2 (joalo ka hypertrophy ea methapo ea methapo, micro- kapa macroalbuminuria, retinopathy) e nang le nalane ea ho sehlopha se kotsing ea mathata a pelo, telmisartan e bile le phello e ts'oanang le ea ramipril ho fokotsa sepheo sa mantlha se kopaneng: ho kena sepetlele ka lebaka la ho hloleha ha pelo ka nako e telele lefu la mokhopho, lefu la pelo le sa emeng.

Telmisartan, e tšoanang le ramipril, e boetse e bontšitsoe e sebetsa hantle ho fokotsa khafetsa ea lintlha tsa bobeli: lefu le sa bolaeang, lefu le sa bolaeang la myocardial, le lefu la pelo.

Ts'ebetso ea telmisartan ho litekanyetso tse ka tlase ho 80 mg ho fokotsa kotsi ea lefu la pelo ha e so ithutoe.

Ho fapana le ramipril, telmisartan e ne e le monyetleng oa ho baka litlamorao tse kang ho khohlela le komello e omileng. Leha ho le joalo, hypotension ea methapo e mengata hangata e etsahetse nakong ea tsamaiso.

Foromo ea boholo:

Letlapa le le leng le na le:

litekanyetso 40 mg

ntho e sebetsang: telmisartan - 40 mg

baamohelang: sodium hydroxide - 3,4 mg, povidone K 30 (polyvinylpyrrolidone Medi mole weight) - 12,0 mg, meglumine - 12,0 mg, mannitol - 165.2 mg, magnesium stearate - 2.4 mg, talc - 5.0 mg .

litekanyetso tsa 80 mg

ntho e sebetsang: telmisartan - 80 mg

Baeti: sodium hydroxide - 6,8 mg, povidone K 30 (polyvinylpyrrolidone Mediole boima ba limolek'hule) - 24.0 mg, meglumine - 24.0 mg, mannitol - 330.4 mg, magnesium stearate - 4,8 mg, talc - 10,0 mg.

Matlapa a tšoeu kapa a batla a soeufetse, a chitja, a sephara-cylindrical ka bevel le notch.

Melemo ea pharmacological

Mofumahali

Telmisartan ke mohanyetsi ea ikhethang oa "angiotensin II" receptor antagonist (mofuta oa AT₁), e sebetsa hantle ha e nkuoa ka molomo. E na le kamano e phahameng bakeng sa subtype ea AT₁ Angiotensin II receptors eo ka eona ketso ea angiotensin II e fumanehang. Displaces angiotensin II ho tloha khokahanong le li-receptor, e se na ts'ebetso ea agonist e amanang le receptor ena.

Telmisartan e tlama feela ho subtype ea AT₁ Angiotensin II receptors. Khokahano e ntse e tsoela pele. Ha e na kamano le li-receptor tse ling, ho kenyelletsa le li-antibodies₂ receptor le li-receptors tse ling tse ithutoang tse fokolang tsa angiotensin. Bohlokoa ba tšebetsong ba li-receptor tsena, hammoho le phello ea ho tsosa ha tsona ho fetelletseng le angiotensin II, mohopolo oa eona o eketsang ha ho khethoa telmisartan, ha e so ithutoe. E fokotsa khatello ea mali ea aldosterone maling, ha e thibele renin ho plasma ea mali ebile ha e thibele mecha ea ion.Telmisartan ha e thibele eniotensin-e fetolang enzyme (kininase II) (enzyme eo le eona e roba bradykinin). Ka hona, keketseho ea litlamorao tse bakoang ke bradykinin ha e lebelloe.

Ho bakuli, telmisartan ka tekanyo ea 80 mg e thibela ka botlalo phello ea khatello ea mali ea angiotensin II. Ho qala ha ts'ebetso ea antihypertensive ho bonoa nakong ea lihora tse 3 kamora ts'ebetso ea pele ea telmisartan. Tšusumetso ea lithethefatsi e tsoela pele lihora tse 24 mme e lula e le bohlokoa ho fihlela lihora tse 48. Phello e phatlalalitsoeng ea antihypertensive hangata e hlaha libeke tse 4-8 kamora ho tsamaisoa khafetsa ka molomo.

Ho bakuli ba nang le khatello ea mali ea methapo, telmisartan lowers systolic le diastolic khatello ea mali (BP) ntle le ho ama sekhahla sa pelo (HR).

Tabeng ea ho hlakoloa ha telmisartan, khatello ea mali butle-butle e khutlela boemong ba eona ba pele ntle le nts'etsopele ea "cancellation" syndrome.

Mofumahali

Ha e nooa ka molomo, e kenella ka potlako maling a tsoang ka mpeng. Bioavailability ke 50%. Ha e nooa ka mokhoa o ts'oanang le lijo, ho fokotseha ha AUC (sebaka se tlas'a nako ea khefu ea nako ea mahloriso) ho tloha ho 6% (ka tekanyo ea 40 mg) ho 19% (ka tekanyo ea 160 mg). Lihora tse 3 kamora ho kenella, khatello ea methapong ea mali e ea tsoa, ​​ho sa tsotelehe nako ea lijo. Ho na le phapang lipapisong tsa plasma ho banna le basali. Le_max(boholo ba mahloriso) le AUC li ne li lekana makhetlo a 3 le a mabeli, ka ho latellana, li ne li phahame ho basali ha li bapisoa le banna ntle le phello e kholo ea ho sebetsa hantle.

Puisano le liprotheine tsa plasma ea mali - 99,5%, haholo-holo ka albin le alpha-1 glycoprotein. Boleng bo bohareng ba bophahamo bo bonahalang ba thomello ea mahloriso a lekanang ke lilithara tse 500. E tšelisoa ke khokahano le glucuronic acid. Metabolites ha e sebetse ka mokhoa oa meriana. Ho felisoa ha halofo ea bophelo ho feta lihora tse 20. E pepisoa ka hore mala a se ke a fetoha, a etsoa ke liphio - ka tlase ho 2% ea lethal dose. Tlhahiso ea plasma ka kakaretso e phahame (900 ml / min) ha e bapisoa le phallo ea mali ea "hepatic" (hoo e ka bang 1500 ml / min.).

Pharmacokinetics ea telmisartan ho bakuli ba tsofetseng ha e fapana le bakuli ba banyenyane. Phetoho ea mori ha e hlokehe.

Bakuli ba nang le ho hloleha ha meno

Ha ho hlokahale hore ho etsoe liphetoho tse ngata ho bakuli ba nang le bothata ba ho phekoloa ka methapo, ho kenyeletsa le bakuli ba haemodialysis. Telmisartan ha e tlosoe ke hemodialysis.

Bakuli ba nang le bothata ba sebete

Ho bakuli ba nang le ts'ebetso ea sebete e itekanetseng ho isa tekanyong e fokolang (sehlopha sa A le B ka sekhahla sa ngoana), lethal dose la letsatsi le letsatsi ha lea lokela ho feta 40 mg.

Ts'ebeliso ea bongaka

Matšoao a mantlha a pharmacokinetics ea telmisartan ho bana ba lilemo tse 6 ho isa ho tse 18 kamora ho nka telmisartan ka tekanyo ea 1 mg / kg kapa 2 mg / kg bakeng sa libeke tse 4, ka kakaretso, li bapisoa le data e fumanoeng kalafong ea batho ba baholo, mme e tiisa bonnete ba litaba tsa bongaka ba meriana. haholoholo mabapi le C_max.

Ho sebelisana le lithethefatsi

Telmisartan e ka eketsa phello ea hypotensive ea li-antihypertgency agents tse ling. Mefuta e meng ea litšebelisano tsa bohlokoa ba tliliniki ha e so tsejoe.

Ts'ebeliso e kopaneng le digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin le amlodipine ha e lebise tšebelisanong ea bohlokoa ka tliliniki. Keketseho e tšoaeang ho karolelano ea kakaretso ea digoxin ho plasma ea mali ka karolelano ea 20% (boemong bo le bong, ka 39%). Ka tsamaiso e ts'oanang ea telmisartan le digoxin, ho bohlokoa hore nako le nako ho khetholle khatello ea "digoxin" maling.

Ka tšebeliso e tšoanang ea telmisartan le ramipril, keketseho e habeli ho 2 ho AUC0-24 le Cmax ea ramipril le ramipril e hlokometsoe. Bohlokoa ba bongaka ba ketsahalo ena ha bo e-so fumanoe.

Ka tsamaiso e tšoanang ea ACE inhibitors le litokisetso tsa lithium, keketseho e khutlisetsang moqoqong oa lithium maling e ile ea bonoa, ea tsamaea le phello e chefo. Maemong a sa tloaelehang, liphetoho tse joalo li tlalehiloe le tsamaiso ea li-antagonist receptors tsa angiotensin II. Ka tsamaiso e le 'ngoe ea li-antumonist tsa li-lithium le angiotensin II, ho kgothaletswa ho tseba hore na liathomo tsa mali li maling.

Phekolo ka li-NSAID, ho kenyelletsa acetylsalicylic acid, li-inhibitors tsa COX-2, le li-NSAIDs tse seng khetho, li ka baka ho hloleha ho matla ha renal ho bakuli ba nang le metsi. Lithethefatsi tse sebetsang ho renin-angiotensin-aldosterone system (RAAS) li ka ba le phello ea synergistic. Ho bakuli ba fumanang li-NSAIDs le telmisartan, bcc e lokela ho lefshoa qalong ea kalafo le ts'ebetso ea ho hlaphoheloa ha liso e behiloe leihlo.

Ho fokotseha hoa phello ea li-antihypertensive agents, joalo ka telmisartan, ka thibelo ea phello ea vasodilating ea li-prostaglandins e hlokometsoe ka ts'ebelisano 'moho le NSAIDs.

Tekanyetso le tsamaiso

Matlapa a Telmisartan a etselitsoe tsamaiso ea molomo ea letsatsi le letsatsi mme a nkuoa ka metsi, a na le lijo kapa a se na tsona.

Phekolo ea khatello ea methapo ea kutlo

Tekanyetso ea batho ba baholo e khothalletsoang ke 40 mg hang hang ka letsatsi.

Maemong moo khatello ea mali e lakatsehang e sa fihleheng, tekanyetso ea Telsartan® e ka eketsoa ho fihla ho 80 mg hang ka letsatsi.

Ha o eketsa tekanyetso, ho lokela ho tsotelloa hore phello e phahameng ea antihypertensive hangata e fihlella ka libeke tse 'ne ho isa ho tse robeli kamora ho qala kalafo.

Telsartan® e ka sebelisoa hammoho le li-thiazide diuretics, mohlala, hydrochlorothiazide, eo hammoho le telmisartan e nang le sephetho se eketsehileng sa hypotensive.

Ho bakuli ba nang le khatello e matla ea methapo ea methapo, lethal dose ea telmisartan ke 160 mg / letsatsi (matlapa a mabeli a Telsartan® 80 mg) mme hammoho le hydrochlorothiazide 12,5-25 mg / letsatsi le ne le mamelletsoe hantle 'me le ne le sebetsa.

Thibelo ea bokuli ba pelo le lefu

Tekanyo e khothalletsoang ke 80 mg hang hang ka letsatsi.

Ha ho so tsejoe hore na litekanyetso tse ka tlase ho 80 mg li sebetsa hantle ho fokotsa tsitsipano ea mmele le lefu.

Boemong ba pele ba ts'ebeliso ea lithethefatsi Telsartan® bakeng sa thibelo ea ho fokolloa ke pelo le lefu, ho kgothaletswa ho laola khatello ea mali (BP), hape ho ka hlokahala ho lokisa khatello ea mali le lithethefatsi tse theolelang khatello ea mali.

Telsartan® e ka nkuoa ho sa tsotelloe lijo tse ngata.

Ha ho hlokahale hore ho etsoe liphetoho tse ngata ho bakuli ba nang le bothata ba ho phekoloa ka methapo, ho kenyeletsa le bakuli ba haemodialysis. Ho na le boiphihlelo bo lekanyelitsoeng ba ho phekola bakuli ba nang le bothata bo matla ba ho lemala le hemodialysis. Bakeng sa bakuli ba joalo, ho khothalletsoa ho qala ka tekanyetso e tlase ea 20 mg. Telsartan ® ha e tlosoe maling nakong ea ha a na le hemofiltration.

Bakeng sa bakuli ba nang le ts'ebetso ea sebete e fokolang e leka-lekaneng, tekanyetso ea letsatsi le letsatsi ha ea lokela ho feta 40 mg hang ka letsatsi.

Phetoho ea mori ha e hlokehe.

Tlhophiso ea Nosological (ICD-10)

Moetsi:

Severnaya Zvezda CJSC, Russia

Aterese ea molao ea moetsi:

111141, Moscow, Zeleny treekt, d. 5/12, leq. 1

Kakaretso ea tlhahiso le aterese tsa kamohelo:

188663, sebaka sa Leningrad., Setereke sa Vsevolozhsk, litoropo tsa litoropo Kuzmolovsky, moaho oa seboka sa thuto Na. 188

Bokhachane le pelehi

Ts'ebeliso ea Telmisartan-SZ e tšoaetsanoa nakong ea kemolo. Ha u lemoha ho ima, setlhare se lokela ho emisoa hanghang. Haeba ho hlokahala, ho ka fanoa ka phekolo e 'ngoe (lihlopha tse ling tsa lithethefatsi tsa antihypertensive tse amoheloang bakeng sa tšebeliso nakong ea kemaro).

Ts'ebeliso ea ARA II nakong ea kotlo ea bobeli le ea boraro ea bokhachane e tiisitsoe.

Lithutong tsa pele tsa telmisartan, litlamorao tsa teratogenic ha lia ka tsa bonoa, empa ho ile ha thehoa fetotoxicity. Hoa tsebahala hore ho pepesetsoa ARA II nakong ea kotara ea bobeli le ea boraro ea bokhachane ho baka ho ruruha ho motho (ho fokotseha ha mosebetsi oa ho ruruha, oligohydroamnion, ho lieha ho qojoa ha lehata), hammoho le chefo e bitsoang neonatal toxicity (renal kushindwa, hypotka, hyperkalemia). Bakuli ba rerileng ho ima ba lokela ho fuoa kalafo e 'ngoe. Haeba kalafo ea ARA II e bile teng nakong ea kemaro ea bobeli ea boimana, ho kgothaletsoa ho hlahloba ts'ebetso ea lereko le boemo ba lehata ka popelong ka ultrasound.

Bana ba sa tsoa tsoaloa bao bo-'m'a bona ba amohetseng ARA II ba lokela ho shebelloa haholo bakeng sa khatello ea kelello.

Kalafo ka Telmisartan-SZ e tšoaetsanoa nakong ea ho anyesa.

Ha ho lithuto tse entsoeng mabapi le kemolo tse entsoeng.