Mokhoa oa ho sebelisa lithethefatsi Mikardis 80?

Mikardis e hlahisoa ka mokhoa oa matlapa: oblong, mohlomong e tšoeu kapa e tšoeu, ka lehlakoreng le leng ho na le mongolo o ngotsoeng "51N" kapa "52N" (40 kapa 80 mg, ka ho latellana), ka lehlakoreng le leng - letšoao la k'hamphani (li-pcs tse 7. Litlatsetsong, e 'ngoe le e ngoe 2, 4, 8 kapa 14 mabokose ka lebokoseng la karete.

Moetso oa Letlapa le le leng o kenyelletsa:

Lintho tse sebetsang: telmisartan - 40 kapa 80 mg,
Likarolo tse thusang (40/80 mg ka 'ngoe): magnesium stearate - 4/8 mg, hydroxide ea sodium - 3.36 / 6.72 mg, meglumine - 12/4 mg, polyvidone (collidone 25) - 12/24 mg, sorbitol - 168.64 / 337.28 mg.

Fomu ea tokollo

Setlhare se na le matlapa a 'mala o mosoeu, o nang le sebopeho se nang le mohala oa 51H, le logo ea k'hamphani ka lehlakoreng le leng.

Matlapa a 7 a joalo a na le litekanyetso tsa 40 mg ho blister; 2 kapa 4 malepa a joalo ka lebokoseng la karete. Ho na le matlapa a joalo a 7 a nang le litekanyetso tsa 80 mg ka blister, 2, 4 kapa 8 blisters tse joalo ka lebokoseng la karete.

Pharmacodynamics le pharmacokinetics

Pharadodynamics

Telmisartan - blocker ea amohelang ea receptor angiotensin II. E na le tropism e phahameng e lebisang ho AT1 receptor subtype angiotensin II. Litlholisano le angiotensin II li-receptor tse ikhethang ntle le ho ba le phello e tšoanang. Ho tlama ho ntse ho tsoela pele.

Ha e bonts'e tropism ea li-subtypes tse ling tsa li-receptors. E fokotsa litaba aldosterone maling, ha e hatelle manonyeletso a plasma le li-ion lisele tse liseleng.

Qala tšusumetso e matla E bonoe nakong ea lihora tse tharo tsa pele kamora tsamaiso melisa. Ketso e phehella letsatsi kapa ho feta. Phello e phatlalalitsoeng e hlaha khoeli ka mor'a taolo e sa fetoheng.

Ho batho ba nang khatello ea kelello ea methapomelisa e fokotsa khatello ea mali ea systolic le diastolic, empa ha e fetole palo ea methapo ea pelo.

Ha e bake lefu la ho khaotsa.

Mofumahali

Ha e nkuoa ka molomo, e kenella ka potlako lipelong. Bioavailability e ntse e atamela 50%. Kamora lihora tse tharo, mahloriso a plasma a ba maholo. 99,5% ea ntho e sebetsang e tlama liprotheine tsa mali. E thehiloe ka ho araba ka glucuronic acid. Li-metabolites tsa lithethefatsi ha li sebetse. Ho felisoa ha halofo ea bophelo ho feta lihora tse 20. E pepisoa ka tšilo ea lijo, tšilo ea metsi ka har'a moroto e ka tlase ho 2%.

Contraindication

Matlapa a Micardis a kopantsoe le batho ka bomong allergy ka likarolo tsa moriana o boima mafusebete kapa seso, fructose mamello, nakong ea kemolo le lebone, bana ba ka tlase ho lilemo tse 18.

Litlamorao

Ho tsoa ho tsamaiso ea methapo e bohareng: khatello ea maikutloho tsekela hlooho e bohlokomokhathala, matšoenyeho, ho hloka boroko, cramps.
Ho tsoa ts'ebetsong ea ho phefumoloha: mafu a a ka holimo a phepelo ea ho phefumoloha (sinusitis, pharyngitis, bronchitis), khohlela.
Ho tsoa tsamaisong ea mali: phatlalatsoe ho fokotseha ha khatello, tachycardia, bradycardiabohloko ba sefuba.
Ho tsoa ts'ebetsong ea tšilo ea lijo: ho nyekeloa pelo, lets'ollo, dyspepsiaho eketsa bongata ba li-enzyme tsa sebete.
Ho tsoa ts'ebetsong ea musculoskeletal: myalgiabohloko bo tlase ba morao arthralgia.
Ho tsoa ts'ebetsong ea genitourinary: edema, ts'oaetso ea lefu la genitourinary system, hypercreatininemia.
Hypersensitivity Reaction: Skash Rash, angioedema, urticaria.
Matšoao a laboratori: phokolo ea mali, hyperkalemia.
Tse ling: erythemaho hlohlona dyspnea.

Mikardis, litaelo tsa tšebeliso

Ho latela litaelo tsa ho sebelisa Mikardis, lithethefatsi li nooa ka molomo. E khothalelitsoe batho ba baholo lethopa 40 mg hang ka letsatsi. Ho bakuli ba 'maloa, phello ea kalafo e se e bonoa ha u nka lethal dose 20 mg ka letsatsi. Haeba ho fokotseha ha khatello ho boemo bo lakatsehang ho sa bonoe, joale lethal dose le ka eketsoa ho 80 mg ka letsatsi.

Phello e phahameng ea lithethefatsi e fumanoa libeke tse hlano kamora ho qala kalafo.

Ho bakuli ba nang le mefuta e matla khatello ea kelello ea methapo sebelisa 160 mg lithethefatsi ka letsatsi.

Tšebelisano

Telmisartan e sebetsang tšusumetso e matla mekhoa e meng ea khatello ea ho theola.

Ha e sebelisoa hammoho melisa le digoxin Boikemisetso ba nako le nako ba ho tsepamisa maikutlo hoa hlokahala digoxin maling, kaha a ka tsoha.

Ha re sebelisa lithethefatsi hammoho lithium le Li-inhibitors tsa ACE keketseho ea nakoana ea litaba e ka bonoa lithium maling, a bonahatsang litlamorao.

Phekolo lithethefatsi tse seng khahlanong le ho tsoa mali mmoho le Mikardis ho bakuli ba nang le metsi a mangata ba ka lebisa nts'etsopele ea ho hloleha ha methapo ea matsoho.

Litaelo tse khethehileng

Bakeng sa bakuli ba nang le metsi (thibelo ea letsoai, kalafo diuretics, lets'ollo, ho hlatsa) ho fokotseha ha tekanyo ea Mikardis hoa hlokahala.

Ka tlhokomeliso, khetha batho ba tla stenosis tsa bobeli methapo ea kutlo, mitral valve stenosis kapa aortic hypertrophic cardiomyopathy e thibelang, e matla a masapo a pelo, a hepatic kapa a pelo, maloetse a tšilo ea lijo.

E thibetsoe ho sebelisa ha aldosteronism ea mantlha le fructose mamello.

Ka bokhachane bo reriloeng, pele u tlameha ho fumana sebaka sa Mikardis le se seng antihypertensive lithethefatsi.

Sebelisa ka hloko ha u khanna makoloi.

Ka tšebeliso e tšoanang le lithethefatsi lithium ho hlahlojoa ha litaba tsa lithium maling ho bontšitsoe, kaha keketseho ea nakoana ea boemo ba eona e ka khonahala.

Theko ea Mikardis

Russia, sephutheloana sa 80 mg No. 28 se tla bitsa ho tloha ho 830 ho isa ho 980 li-ruble. Naheng ea Ukraine, theko ea Mikardis ka mokhoa o ts'oanang oa khatiso e ntse e atamela 411 hhucnias.

Sehloohong sena, o ka bala litaelo tsa ho sebelisa lithethefatsi Mikardis. E fana ka maikutlo a tsoang ho baeti sebakeng sena - bareki ba moriana ona, le maikutlo a litsebi tsa bongaka mabapi le tšebeliso ea Mikardis mesebetsing ea bona. Kopo e kholo ke ho kenyelletsa maikutlo a hau ka sethethefatsi sena: moriana o thusitseng kapa o sa thusa ho felisa lefu lena, hore na ho bile le mathata afe kapa afe, mme mohlomong a sa phatlalatsoe ke moetsi ho phatlalatso. Mikardis analogues moo ho nang le li-analogue tse teng tsa sebopeho. Sebelisa bakeng sa kalafo ea khatello ea mali le ho fokotsa khatello ea mali ho batho ba baholo, bana, esita le nakong ea kemero le ho beleha. Sebopeho sa moriana.

Mikardis - lithethefatsi antihypertensive.

Telmisartan (ntho e sebetsang ea lithethefatsi Mikardis) ke mohanyetsi ea ikhethang oa li-receptor tsa angiotensin 2. E na le kamano e phahameng bakeng sa AT1 receptor subtype ea angiotensin 2, eo ka eona angiotensin 2 e fumanehang. E theha khokahano feela le AT1 receptor subtype ea angiotensin 2. 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 ka angiotensin 2, mohopolo oa eona o eketsehang 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. Ha e thibelle ACE (kininase 2), enzyme e senyang hape bradykinin, ka hona, keketseho ea litlamorao tse bakoang ke bradykinin ha e lebelloe.

Mikardis ka tekanyo ea 80 mg e thibela ka botlalo phello ea khatello ea mali ea angiotensin 2. Ho qala ha ts'ebetso ea hypotensive ho lemohuoa ka nako ea lihora tse 3 ka mor'a taolo ea pele ea telmisartan. Tšusumetso ea lithethefatsi e nka lihora tse 24 mme e lula e le bohlokoa ho fihlela lihora tse 48. Phello e boletsoeng e tšosang hangata e ba teng ka mor'a libeke tse 4 ho8 tsa ts'ebeliso e tloaelehileng.

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 Mikardis ka tšohanyetso, butle-butle AD e khutlela boemong ba eona ba pele ntle le kholo ea ho ntša mpa.

Hydrochlorothiazide (ntho e sebetsang ea lithethefatsi Mikardis Plus) ke diaztite ea thiazide. Liazine diuretics e ama ho ts'oaroa ha li-electrolyte ka har'a lipompo tsa renal, e eketsang ka kotloloho tlhahiso ea sodium le chloride (e batlang e lekana le e lekanang). Matla a diuretic a hydrochlorothiazide a lebisa ho fokotseha ha bcc, keketseho ea tšebetso ea plasma renin, keketseho ea secretion ea aldosterone mme e tsamaisana le keketseho ea potasiamo le bicarbonate, 'me ka lebaka leo, ho fokotseha ha potasiamo ho plasma ea mali. Ka tšebeliso e tšoanang ea telmisartan, ho na le tšekamelo ea ho emisa tahlehelo ea potasiamo e bakoang ke diuretics tsena, mohlomong ka lebaka la RAAS blockade.

Kamora ho nka hydrochlorothiazide, diuresis ea eketseha kamora lihora tse peli, 'me phello e phahameng e bonoa kamora lihora tse ka bang 4. Phello ea diuretic ea lithethefatsi e tsoela pele lihora tse ka bang 6-12.

Ts'ebeliso ea nako e telele ea hydrochlorothiazide e fokotsa kotsi ea mathata a lefu la pelo le lefu le tsoang ho bona.

Phello e phahameng ea antihypertensive ea lithethefatsi Mikardis Plus hangata e fihlelloa libeke tse 4-8 kamora ho qala kalafo.

Sebopeho

Telmisartan + excipients (Mikardis).

Telmisartan + hydrochlorothiazide + excipients (Mikardis Plus).

Mofumahali

Ha e sebelisoa, telmisartan e kenella ka potlako ho tsoa mokokotlong oa lijo. Bioavailability ke 50%. Ha e nooa ka mokhoa o ts'oanang le lijo, phokotso ea boleng ba AUC e tsoa ho 6% (ha e sebelisoa ka tekanyo ea 40 mg) ho 19% (ha e sebelisoa ka tekanyo ea 160 mg). Kamora lihora tse tharo kamora ts'ebetso, ho kenella ka bongata plasma ea mali ho kenyelitsoe ho sa tsotelehe nako ea ho ja. E tšelisoa ke khokahano le glucuronic acid. Li-metabolism ha li sebetse ka mokhoa oa meriana. E pepisoa ka hore mala a se ke a fetoha, a etsoa ke liphio - ka tlase ho 2% ea lethal dose.

Ho na le phapang lipapisong tsa likamano lipakeng tsa banna le basali. Ho basali, Cmax le AUC li ne li le makhetlo a 3 ho isa ho a 2 ka tatellano ho feta ho banna (ntle le phello e kholo ea katleho).

Li-pharmacokinetics tsa telmisartan ho bakuli ba tsofetseng ha li fapana le pharmacokinetics ho bakuli ba banyenyane. Phetoho ea mori ha e hlokehe.

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

Bakeng sa bakuli ba nang le bothata ba sebete sa 'mele bo fokolang ho isa tekanyong e itekanetseng (sehlopha sa A le B ka sekhahla sa ngoana), lethal dose la letsatsi le letsatsi la lithethefatsi ha lea lokela ho feta 40 mg.

Matšoao a mantlha a pharmacokinetics ea telmisartan ho bana le bacha ba lilemo tse 6 ho isa ho 18 ka mor'a 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 fumaneng kalafo ea batho ba baholo, mme e tiisa bonnete ba litaba tsa pharmacokinetics telmisartan, haholo-holo mabapi le Cmax.

Kamora ho tsamaisoa ka molomo, Mikardis Plus Cmax hydrochlorothiazide e fihlella ka nako ea lihora tse 1-3. Ho nepahala ha bioavailability ho hakantsoe ke cumulative renal excretion ea hydrochlorothiazide mme e ka ba 60%. E amana le liprotheine tsa plasma ea mali ka 64%. Ha e tšeloe 'meleng oa motho' me e pepesitsoe ka har'a moroto hoo e ka bang e sa fetohe. Hoo e ka bang 60% ea tekanyetso e nkuoeng ka molomo e felisoa ka nako ea lihora tse 48.

Ho na le phapang lipapisong tsa plasma ho banna le basali. Ho basali, ho na le tloaelo ea keketseho e kholo ea kliniki ea hydrochlorothiazide.

Bakeng sa bakuli ba nang le ts'ebetso ea renal e sa sebetseng hantle, tekanyo ea ho felisoa ha hydrochlorothiazide e fokotsehile.

Matšoao

khatello ea kelello ea methapo (khatello ea khatello),
Phokotso ea ho fokolloa ke pelo le lefu ho bakuli ba lilemo li 55 le ho feta ba nang le kotsi e kholo ea lefu la pelo.

Lokolla liforomo

Matlapa a 40 mg le 80 mg.

Letlapa 40 mg + 12.5 mg le 80 mg + 12.5 mg (Mikardis Plus).

Litaelo tsa tšebeliso le litekanyetso

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

Ka khatello ea mali ea methapo, lethalamo la pele la khothalletso ea Mikardis ke Letlhare le le leng (40 mg) hang ka letsatsi. Maemong moo phello ea kalafo e sa fihleheng, tekanyetso ea moriana e ka eketsoa 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 le ba nang le hemodialysis) tokiso ea lithethefatsi ha e hlokehe.

Lenaneo la litekanyetso ho bakuli ba tsofetseng ha le hloke liphetoho.

Mikardis Plus e lokela ho nkuoa ka molomo nako e le 'ngoe ka letsatsi, ho sa tsotelehe lijo tse ngata.

Mikardis Plus 40 / 12,5 mg e ka fuoe bakuli bao tšebeliso ea lithethefatsi Mikardis ka tekanyo ea 40 mg kapa hydrochlorothiazide e sa lebiseng taolong e lekaneng ea khatello ea mali.

Mikardis Plus 80 / 12,5 mg e ka fuoe bakuli bao tšebeliso ea lithethefatsi Mikardis ka tekanyo ea 80 mg kapa Mikardis Plus 40 / 12,5 mg e sa lebiseng taolong e lekaneng ea khatello ea mali.

Ho bakuli ba nang le khatello e matla ea methapo ea methapo, lethal dose e phahameng ea letsatsi le letsatsi ea telmisartan ke 160 mg ka letsatsi. Tekanyetso ena e ne e sebetsa ebile e mamellehile hantle.

Litla-morao

lefu la khatello ea matšoafo (ho kenyeletsa pneumonia le pulmonary edema),
ho hema hanyane
arrhythmias
tachycardia
bradycardia
letšoao le fokotsehileng la khatello ea mali (ho kenyeletsa hypotension orthostatic),
ho akheha
paresthesia
likhathatso tsa boroko
ho hloka boroko
ho tsekela
ho tšoenyeha
khatello ea maikutlo
ho se khonehe
hlooho e bohloko
lets'ollo, ho sokela,
mucosa e ommeng ea molomo,
botlaela
bohloko ba ka mpeng
ho hlatsa
gastritis
takatso e fokotsehileng
anorexia
hyperglycemia
hypercholesterolemia,
pancreatitis
ho se sebetse hantle ha sebete,
jaundice (hepatocellular kapa cholestatic),
dyspepsia
ho fufuleloa ho eketsehileng
bohloko ba morao
mesifa ea mesifa
myalgia
arthralgia,
thole
arthrosis,
matšoao a kang a tendonitis
bohloko ba sefuba
anemia ea haelloang ke iron, anemia ea aplasiki, anemia ea hemolytic, thrombocytopenia, eosinophilia, leukopenia, agranulocytosis, thrombocytopenia,
ho hloleha ha rems, ho kenyeletsa le ho hloleha ho matla ha renal,
nephritis ea mahareng
glucosuria
ho sitisoa ha pono
pono e fifatsang ea nakoana
glaucoma ea hlobaetsang
ho hloka matla
sepsis, ho kenyeletsa le linyeoe tse bolaeang,
tšoaetso e phahameng ea phepelo ea ("bronchitis, pharyngitis, sinusitis)",
ts'oaetso ea pampitšana ea urinary (ho kenyeletsa cystitis),
ho ruruha ha litšoelesa tse hlabang.
mosebetsi o eketsehileng oa li-enzyme tsa sebete,
ts'ebetso e eketsehileng ea CPK,
bongata ba uric acid e maling,
hypertriglyceridemia,
hypokalemia, hyperkalemia,
hyponatremia,
hyperuricemia
hypoglycemia (ho bakuli ba nang le lefu la tsoekere),
mamello ea tsoekere e sa sebetseng hantle,
Ho fokotseha ha hemoglobin maling,
angioedema (ho kenyeletsoa le linyeoe tse bolaeang),
erythema
letlalo la letlalo le boreleli
makhopho
anaphylactic reaction,
eczema
lekhopho la lithethefatsi
chefo e ka fokolisang
lipus-like
ho mpefatsa kapa ho eketsa matšoao a systemic lupus erythematosus,
necrotic vasculitis,
systema vasculitis
photosensitivity reaction,
khutlela ho systemic lupus erythematosus,
vasculitis
lefu-flu
feberu
bofokoli.

Contraindication

lefu le thibelang lefu la biliary
ts'ebetso e matla ea ho holofala ha sebete (sehlopha sa bana-Pugh C),
kalafo e matla ea renal (CC ka tlase ho 30 ml / min),
Reflexory hypokalemia, hypercalcemia,
Tšebeliso e le 'ngoe le aliskiren ho bakuli ba nang le lefu la tsoekere le lefu la ho hlaba lipelong (GFR ka tlase ho 60 ml / min / 1.73 m2),
lefutso la lefutso (lithethefatsi li na le sorbitol),
khaello ea lactase, ho se mamellane ha lactose, tsoekere ea malabsorption ea glucose-galactose,
lilemo ho isa ho lilemo tse 18 (polokeho le katleho ha e thehiloe),
boimana
letsoalo (lactation),
hypersensitivity ho ntho e sebetsang kapa likarolo tse thusang tsa sethethefatsi kapa tse ling tse tsoang ho sulfonamide.

bilteryal renal stenosis kapa artery stenosis ea a le mong,
ts'ebetso ea ho se sebetse hantle ha sebete kapa lefu la sebete le ntseng le tsoela pele (sehlopha sa A le B ka sekhahla sa bana),
fokotseha ha BCC ka lebaka la kalafo ea diuretiki e fetileng, lithibelo ho ja letsoai, lets'ollo kapa ho hlatsa,
hyperkalemia
boemo kamora ho fetisoa ha menoana (ha ho na boiphihlelo ka ts'ebeliso),
lefu la pelo le sa foleng 3-4 FC ho latela sehlopha sa Mokhatlo oa pelo oa New York,
stenosis of aortic le methapo ea maqhubu,
idiopathic hypertrophic subaortic stenosis,
hypertrophic obstriers cardiomyopathy,
lefu la tsoekere
aldosteronism ea mantlha,
gout
angle-ukuvalwa glaucoma (ka lebaka la ho ba teng ha hydrochlorothiazide sebopeho).

Bokhachane le pelehi

Ts'ebeliso ea Mikardis le Mikardis Plus e hanyetsoa nakong ea kemaro.

Ho sebelisoa ha lingiotensin 2 receptor antagonists ho 1st trimester ea bokhachane ha ho khothalletsoe, lithethefatsi tsena ha lia lokela ho laeloa nakong ea kemolo. Ha ho ima ho etsahala, moriana o lokela ho emisoa hang-hang. 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 lingiotensin 2 receptor antagonists ho 2nd le 3rd trimesters ea bokhachane e hanyetsitsoe. Lithutong tsa pele tsa telmisartan, litlamorao tsa teratogenic ha lia ka tsa bonoa, empa ho ile ha thehoa fetotoxicity. Hoa tsebahala hore litlamorao tsa lihanyetsi tsa li-receptor tse 2 tsa receptor ho karolo ea 2 le ea 3 ea moimana li baka fetoto ho motho (mosebetsi o fokotsehileng oa kutlo, oligohydramnios, ho liehisa ossation ea lehata), hammoho le toonity ea chefo (ho se sebetse hantle hoa mokokotlo, hypotka, hyperkalemia). Bakuli ba rerileng ho ima ba lokela ho fuoa kalafo e 'ngoe. Haeba kalafo e mabapi le lihanyetsi tsa "receptor" ea antiotensin e ile ea etsoa ka mokokotlong oa bobeli oa boimana, ho khothalletsoa hore ho etsoe lipopelo tsa liphio le masapo a lehata la mpa.

Masea a sa tsoa tsoaloa ao bo-'m'ae ba amohetseng lingiotensin 2 receptor antagonists ba lokela ho shebelloa haholo bakeng sa hypotension ea methapo.

Boiphihlelo ba nang le hydrochlorothiazide nakong ea kemolo, haholo-holo ho trimester ea pele, e na le moeli. Hydrochlorothiazide e tšela sethala sa placental. Ha ho fanoa ka mochine oa ts'ebetso oa pharmacological oa ts'ebetso ea hydrochlorothiazide, ho nahanoa hore ts'ebeliso ea eona ho li-trimesters tsa 3 le tsa 3 tsa moimana li ka sitisa ho koptjoa ha fetoplacental mme ea baka liphetoho mokhoeng oa pelehi le mofuteng o mong, tse kang jaundice, ho se leka-lekane ha electrolyte, le thrombocytopenia. Hydrochlorothiazide ha ea lokela ho sebelisoa bakeng sa edema ea basali baimana, ho basali baimana ba nang le khatello ea mali ea methapo, kapa nakong ea preeclampsia, joalo ka ho na le kotsi ea ho fokotseha ha molumo oa plasma le ho fokotseha ha setlolo sa placental, mme ha ho na phello e ntle maemong ana a kliniki.

Hydrochlorothiazide ha ea lokela ho sebelisoa ho phekola khatello ea maikutlo e bohlokoa ho basali ba bakhachane, ntle le maemong ao a sa tloaelehang moo lingaka tse ling li ke keng tsa sebelisoa.

Phekolo ka sethethefatsi Mikardis le Mikardis Plus e kopantsoe nakong ea kanyeso.

Ho lithuto tsa liteko tsa liphoofolo, litlamorao tsa telmisartan le hydrochlorothiazide mabapi le kemolo ha lia ka tsa bonoa.

Boithuto ba mabapi le litlamorao ho tsoalo ea motho ha bo so etsoa.

Sebelisa ho bana

Lithethefatsi Mikardis le Mikardis Plus li ngotsoe ka molao bakeng sa tšebeliso ho bana le bacha ba ka tlase ho lilemo tse 18, hobane data mabapi le katleho le polokeho mokhahlelong ona oa bakuli ha e fumanehe.

Sebelisa ho bakuli ba tsofetseng

Liphetoho molemong oa litekanyetso ho bakuli ba tsofetseng ha li hlokehe.

Litaelo tse khethehileng

Maemo a eketsang ts'ebetso ea RAAS

Ho bakuli ba bang, ka lebaka la khatello ea tšebetso ea RAAS, haholo-holo ka ts'ebeliso e le 'ngoe ea lithethefatsi tse sebetsang tsamaisong ena, ts'ebetso ea liphokojoe (ho kenyeletsa le ho hloleha ho hlaphoheloa ke mokokotlo) e senyehile. Ka hona, kalafo e tsamaeang le thibelo e ts'oanang ea habeli ea RAAS (mohlala, le kenyelletso ea ACE inhibitor kapa renin inhibitor e tobileng, aliskiren, ho angiotensin 2 receptor antagonist blockers), e lokela ho etsoa ka matla ka bo eona le ka ho lekola nako le nako ts'ebetso ea renal (ho kenyelletsa le ho lekola potassium nako le nako. serum creatinine).

Ts'ebeliso ea li-thiazide diuretics ho bakuli ba nang le ts'ebetso ea mokokotlo ea mokokotlo e ka lebisa azotemia. Ho khothaletsoa ho lekola nako le nako ts'ebetso ea liphio.

Ho bakuli ba nang le pelo ea methapo ea methapo ea methapo kapa lesapo la mokokotlo le sebetsang ka boeona, ka ts'ebeliso ea lithethefatsi tse amang RAAS, monyetla oa ho ba le khatello ea methapo ea kutlo le ho se sebetse hantle ha renal o eketseha.

Ts'ebetso ea sebete e sa sebetseng

Ho bakuli ba nang le ts'ebetso ea sebete e sa sebetseng kapa lefu la sebete le ntseng le tsoela pele, MikardisPlus e lokela ho sebelisoa ka hloko, hobane le liphetoho tse nyane tekong ea motlakase oa motlakase li ka kenya letsoho kholisong ea komello ea hepatic.

Kameho ho metabolism le tšebetso ea litšoelesa tsa endocrine

Ho bakuli ba nang le lefu la tsoekere, ho ka hlokahala hore ho be le phetoho ea tekanyetso ea li-insulin kapa li-hypoglycemic. Nakong ea phekolo e nang le thiazide diuretics, mellitus ea lefu la tsoekere e ka hlaha.

Maemong a mang, tšebeliso ea thiazide diuretics e ka ba le hyperuricemia le ho mpefatsa ha nako ea gout.

Ho bakuli ba nang le lefu la tsoekere le lefu la pelo le eketsehileng, ka mohlala, ho bakuli ba nang le lefu la tsoekere le lefu la pelo, tšebeliso ea lithethefatsi tse fokotsang khatello ea mali, tse kang angiotensin 2 receptor antagonists kapa ACE inhibitors, li ka eketsa kotsi ea ho bolaoa ke lefu la pelo le lefu la pelo ka tšohanyetso. lefu la vascular. Ho bakuli ba nang le lefu la tsoekere, lefu la pelo le ho ruruha le ka ba le tšoaetso 'me ka hona le ka' na la se ke la fumanoa. Pele o qala ts'ebeliso ea lithethefatsi Mikardis le Mikardis Plus bakeng sa ho fumana le ho phekola lefu la pelo, ho lokela ho etsoa lithuto tse nepahetseng tsa tlhahlobo, ho kenyeletsa liteko ka ho ikoetlisa.

Acute myopia le sekhahla se koalang-koaloa glaucoma

Hydrochlorothiazide, kaha e tsoa ho sulfonamide, e ka baka karabelo ea idiosyncratic ka sebopeho se matla sa ho sisinyeha ha nakoana le mofere-fere. Matšoao a mafu ana ke ho fokotseha ho sa lebelloang ha mahlo a mahlo kapa bohloko ba mahlo, boo maemong a tloaelehileng bo hlahang ka mor'a lihora tse 'maloa ho isa ho libeke tse' maloa ka mor'a ho qala ha moriana. Haeba glaucoma e sa phekoloe, e ka baka tahlehelo ea pono. Phekolo ea mantlha ke ho tlohela hydrochlorothiazide kapele kamoo ho ka khonehang. Re lokela ho hopola hore haeba khatello ea methapo ea kutlo e lula e sa laoloe, ho ka hlokahala hore ho sebelisoe tlhokomelo e potlakileng kapa kalafo ea kalafo. Lisosa tsa kotsi bakeng sa nts'etsopele ea glaucoma e hlobaetsang ea ho koaloa e kenyelletsa nalane ea lintho tse ling tse ka kulisang ho sulfonamides kapa penicillin.

Tlolo ea tekano ea motlakase-oa motlakase

Ha u sebelisa lithethefatsi Mikardis Plus, joalo ka kalafo ea diuretic, ho hlokahala hore ho hlahlojoe nako le nako tsa se ka har'a li-electrolyte tse serum ea mali.

Thiazide diuretics, incl. hydrochlorothiazide, e ka baka tsitsipano mokhoeng oa ho lekanya metsi le boemo ba acid-base (hypokalemia, hyponatremia le hypochloremic alkalosis). Matšoao a mafu ana a kenyelletsa mucosa e ommeng ea molomo, lenyora, bofokoli bo akaretsang, ho otsela, ho tšoenyeha, myalgia kapa ho choachoasela ha mesifa ea namane (crumpi), bofokoli ba mesifa, ho fokotseha ha khatello ea mali, oliguria, tachycardia, le gastrointestinal e joalo. mathata a ka mpeng a kang ho nyekeloa kapa ho hlatsa.

Ha thiazide diuretics e sebelisoa, hypokalemia e ka nts'etsopele, empa telmisartan e sebelisoang ka nako e ts'oanang e ka eketsa litaba tsa potasiamo maling. Kotsi ea hypokalemia e eketseha haholo ho bakuli ba nang le lefu la cirrhosis, le li-diuresis tse eketsehileng, le lijo tse se nang letsoai hape le maemong a ts'ebeliso e tšoanang ea gluco- le mineralocorticosteroids kapa corticotropin. Telmisartan, e leng karolo ea litokisetso tsa Mikardis le Mikardis Plus, ho fapana le moo, e ka lebisa ho hyperkalemia ka lebaka la ho hanyetsa li-angiotensin 2 receptors (subtype AT1). Le ha hyperkalemia ea bohlokoa ho tsa bongaka e sa tlaleheloa ka ts'ebeliso ea Mikardis Plus, lintlha tse behang kotsing ea ho hola li kenyelletsa renal le / kapa ho nyekeloa ke pelo le lefu la tsoekere.

Ha ho na bopaki ba hore lithethefatsi Mikardis Plus e ka fokotsa kapa ea thibela hyponatremia e bakoang ke diuretics. Hypochloremia hangata e nyane ebile ha e hloke phekolo.

Thiazide diuretics e ka fokotsa ts'oarelo ea khalsiamo ke liphio le sesosa (ho sa bonahaleng ha phallo e totobetseng ea metabolism ea calcium) keketseho ea nakoana le keketseho e nyane ea calcium calcium. Hypercalcemia e matla haholo e ka ba sesupo sa hyperparathyroidism ea morao-rao. Pele ho hlahloba ts'ebetso ea litšoelesa tsa parathyroid, diuretics ea thiazide e lokela ho emisoa.

Ho bontšitsoe hore thiazide diuretics e eketsa tlhahiso ea magnesium ke liphio, e leng se ka lebisang ho hypomagnesemia.

Ho bakuli ba nang le lefu la pelo, ho sebelisoa ha moriana o mong le o mong oa antihypertgency, maemong a fokotsehang haholo a khatello ea mali, ho ka lebisa ho ruruha ha myocardial kapa stroke.

Ho na le litlaleho tsa nts'etsopele ea systemic lupus erythematosus e nang le thiazide diuretics.

Mikardis le Mikardis Plus li ka sebelisoa haeba ka nako e tšoanang le baemeli ba bang ba antihypertgency.

Ho se sebetse ha sebete ka ho khethoa ha telmisartan maemong a mangata ho ile ha bonoa har'a baahi ba Japane.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Lithuto tse khethehileng tsa kliniki ho hlahloba litlamorao tsa sethethefatsi Mikardis Plus mabapi le bokhoni ba ho khanna makoloi le ho sebetsa ka mekhoa e hlokang tlhokomelo e nyolohileng ha e so etsoa. Leha ho le joalo, ha u khanna le ho etsa lintho tse ka bang kotsi, monyetla oa ho ba le tsitsipano le ho otsela o lokela ho tsotelloa, e leng se hlokang tlhokomeliso.

Ho sebelisana le lithethefatsi

Ka tšebeliso e tšoanang ea telmisartan le:

li-antihypertgency tse ling li ka ntlafatsa sephetho sa antihypertensive. Phuputsong e le 'ngoe, ka ts'ebeliso e kopaneng ea telmisartan le ramipril, ho bile le keketseho e fetang 2,5 ea AUC0-24 le Cmax ea ramipril le ramipril. Bohlokoa ba ts'ebelisano ena ha bo so theoe. Tlhahlobo ea liketsahalo tse bohloko tse lebisang ho tlohelleng kalafo le ho sekaseka liketsahalo tse mpe tse mpe tse fumanoeng nakong ea teko ea bongaka ho ile ha senola hore ho khohlela le angioedema ho na le monyetla oa ho etsahala ka ramipril, athe hypotension ea methapo e ne e atile haholo ka telmisartan. Litaba tsa hyperkalemia, ho se sebetse hantle ha masapo a mokokotlo, ho ts'oarana ka methapo le syncope li ile tsa bonoa hangata haholo ka ts'ebeliso e tšoanang ea telmisartan le ramipril,
Litokisetso tsa lithium li hlokometse keketseho e feto-fetohang ea khatello ea lithium maling, e tsamaisana le litlamorao tsa chefo ka ts'ebeliso ea li-inhibitors tsa ACE. Maemong a sa tloaelehang, liphetoho tse joalo li tlalehiloe le tsamaiso ea lihanyetsi tsa li-receptor 2, haholo-holo telmisartan. Ka tšebeliso e le 'ngoe ea litokisetso tsa lithium le lingiotensin 2 anteptonists, ho kgothaletswa ho tseba litaba tsa lithium maling.
lithethefatsi tse seng khahlanong le ho ruruha (NSAIDs), ho kenyeletsa acetylsalicylic acid ho litekanyetso tse sebelisoang e le lithethefatsi tse thibelang mafu, li-inhibitors tsa COX-2 le li-NSAID tse sa khethang, li ka baka ho hloleha ho matla ha renal ho bakuli ba nang le BCC e fokotsehileng. Lithethefatsi tse amang RAAS li ka ba le phello ea synergistic. Ho bakuli ba fumanang li-NSAIDs le telmisartan, BCC e lokela ho lefuoa qalong ea kalafo mme ho lokela ho etsoa phuputso ea tšebetso ea liphio. Ho fokotseha hoa phello ea li-antihypertgency agents, joalo ka telmisartan, ka thibelo ea phello ea vasodilating ea li-prostaglandins ho bontšitsoe ka kalafo e kopaneng le ea NSAIDs. Ka tšebeliso e tšoanang ea telmisartan e nang le ibuprofen kapa paracetamol, ha ho na phello e bohlokoa ea bongaka e fumanoeng,
Digoxin, warfarin, hydrochlorothiazide, glibenclamide, simvastatin le amlodipine ha lia ka tsa senola tšebelisano 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.

E sebelisoa ka nako e le 'ngoe le:

ethanol (joala), barbiturates kapa opioid analgesics, ho na le kotsi ea ho ba le hypotension ea orthostatic,
Litlhare tsa hypoglycemic bakeng sa tsamaiso ea molomo le insulin li ka hloka ntlafatso ea tekanyetso ea li-hypoglycemic agents bakeng sa tsamaiso ea molomo le insulin,
metformin ho na le kotsi ea lactic acidosis,
kolestiraminom le kolestipolom - ha ho e-na le phapanyetsano ea anionic e rarolla ho monya ha hydrochlorothiazide e senyehile,
pelo glycosides e eketsa kotsi ea ho ba le hypokalemia kapa hypomagnesemia e bakoang ke diaztiti tsa thiazide, nts'etsopele ea arrhythmias e bakoang ke pelo glycosides,
Mechine ea khatello ea khatello (ka mohlala, norepinephrine) e ka fokolisa matla a khatello ea amine,
hydrochlorothiazide e sa nyenyefatseng (kk. tubocurarine chloride) hydrochlorothiazide e ka ntlafatsa litlamorao tsa phomolo e sa nyenyefatse ea mesifa,
li-antigout agents li ka eketsa bongata ba li-uric acid ka serum ea mali, ka hona ho ka hlokahala liphetoho ho tekanyetso ea li-uricosuric agents. Ts'ebeliso ea li-thiazide diuretics e eketsa lebelo la nts'etsopele ea maikutlo a hypersensitivity ho allopurinol,
Litokisetso tsa khalsiamo - thiazide diuretics e ka eketsa sethala sa serum ka lebaka la phokotso ea tlhahiso ea eona ea liphio. Haeba u batla ho sebelisa litokisetso tsa khalsiamo, o lokela ho beha leihlo la calcium kamehla maling, 'me ha ho hlokahala, fetola litekanyetso tsa calcium,
beta-blockers le diazoxide thiazide diuretics li ka eketsa hyperglycemia e bakoang ke beta-blockers le diazoxide,
m-anticholinergics (mohlala, atropine, biperidine) - ho fokotseha ha matla a ka mpeng, keketseho ea bioavailability ea thiazide diuretics
amantadine thiazide diuretics e ka eketsa kotsi ea litlamorao tse mpe tse bakoang ke amantadine,
li-cytotoxic agents (mohlala, cyclophosphamide, methotrexate) - ho fokotseha ha phello ea renal ea li-cytotoxic agents le keketseho ea matla a tsona a myelosuppressive,
Li-NSAIDs - tšebeliso e kopantsoeng le thiazide diuretics e ka lebisa ho fokotseha ha diuretic le antihypertensive effect,
lithethefatsi tse lebisang ho feliseng potasiamo le hypokalemia (mohlala, li-diuretics tse tlosang potasiamo, li-laxatives, gluco- le mineralocorticosteroids, corticotropin, amphotericin B, carbenoxolone, benzylpenicillin, litlamorao tsa acetylsalicylic acid) - hypokalemic athari. Hypokalemia e bakoang ke hydrochlorothiazide e felisoa ke phello e bolokang potasiamo ea telmisartan,
Nts'etsopele ea hyperkalemia e ka khonahala ka diuretics tsa potasiamo-sparing, litokisetso tsa potasiamo, mekhoa e meng e ka eketsang sethala sa potasiamo ea serum (mohlala, heparin) kapa nka sebaka sa sodium chloride le salate ea potasiamo. Ho hlahlojoa khafetsa ha potasiamo ho plasma ea mali ho khothalletsoa maemong ao ho eona lithethefatsi Mikardis Plus e sebelisoang ka nako e ts'oanang le lithethefatsi tse ka bakang hypokalemia, hammoho le lithethefatsi tse ka eketsang serum potasiamo.

Likhakanyo tsa lithethefatsi Mikardis

Analogue ea sebopeho sa ntho e sebetsang:

Analogs sehlopheng sa pharmacological (angiotensin 2 receptor antagonists):

Angiakand
Aprovel
Atacand
Bolbok
Vasotens,
Bohlokoa
Valsartan
Lithane,
Valsacor
Hyposart,
Diovan
Zisakar
Ibertan
Irbesartan
Irsar
Lenaneo
Mokhanni
Cardosal
Cardosten
Cardostin
Karzartan
Cozaar
Xarten
Lakea
Lozap,
Lozarel
Losartan
Lorista
Losacor
Lotor
Mikardis Plus,
Naviten
Se-Nortian
Olimestra
Ordiss
Prirator
Presartan
Renicard
Sartavel
Tanidol
Tantordio
Tareg
Tevete
Tsena,
Telzap
Telmisartan
Telmista
Telsartan
Firmast
Edarby.

Nomoro ea ngoliso: P N015387 / 01

Khoebo lebitso la lithethefatsi: Mikardis ®

Lebitso le sa Ts'oaneleheng la Machabeng (INN): telmisartan

Foromo ea litekanyetso: matlapa

SebopehoLetlapa le 1 le na le:
Lintho tse sebetsang: - Telmisartan 40 mg kapa 80 mg,
Baeti: - sodium hydroxide 3.36 mg / 6.72 mg, polyvidone (Kollidon 25) 12 mg / 24 mg, meglumine 12 mg / 24 mg, sorbitol 168.64 mg / 337.28 mg, magnesium stearate 4 mg / 8 mg

Tlhaloso
Matlapa a 40 mg
Matlapa a tšoeu kapa a batlang a soeufetse ka lehlakoreng le leng, ka lehlakoreng le leng a ngola "51H", ka lehlakoreng le leng - letšoao la k'hamphani.
Matlapa a 80 mg
Matlapa a bosoeu bo bosoeu kapa bo batlang bo le bosoeu, ka lehlakoreng le leng a ngola "52H", ka lehlakoreng le leng - letšoao la k'hamphani.

Sehlopha sa Pharmacotherapeutic: angiotensin II receptor antagonist.
Khoutu ea ATX C09CA07

Melemo ea pharmacological
Pharadodynamics
Telmisartan ke mohanyetsi oa mofuta oa angiotensin II receptor antagonist (mofuta oa AT1), o sebetsang ha o nkuoa ka molomo. E na le kamano e phahameng bakeng sa li-receptors tsa II1 tsa angiotensin II, tseo ka tsona ketso ea angiotensin II e fumanehang. Displaces angiotensin I ho tloha khokahanong le li-receptor, e se nang ketso ea agonist mabapi le receptor ena.
Telmisartan e tlama feela ho li-subtype tsa AT1 tsa li-angiotensin II receptors. Puisano e nka nako e telele. Ha e na kamano ea li-receptor tse ling, ho kenyelletsa le receptor ea AT2 le li-receptor tse ling tse ithutoang haholo 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 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 angiotensin 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 hoa ts'ebetso ea hypotensive 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 fetoha libeke tse 4 ho8 kamora ho nona hangata.
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 ka tšohanyetso, butle-butle khatello ea mali e khutlela boemong ba eona ba pele ntle le nts'etsopele ea "ho hula" lefu.

Mofumahali
Ha e nooa ka molomo, e kenella ka potlako maling a tsoang ka mpeng. Bioavailability ea -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 methapo ea mali e tsoa, ho sa tsotelehe lijo. Ho na le phapang lipapisong tsa plasma ho banna le basali. Cmax (boholo ba mahloriso) le AUC li ne li lekana makhetlo a 3 le a 2, ka ho latellana, li ne li phahame ho basali ha li bapisoa le banna ntle le tšusumetso e kholo ea katleho.
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 (T½) ho feta lihora tse 20. E pepesitsoe ka mpeng e sa fetohe, 'me e entsoe ke liphio - ka tlase ho 2%. 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.).
Bakuli ba baholo
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 kenyelletsa le bakuli ba nang le hemodialysis.
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.
Mo baneng
Matšoao a mantlha a pharmacokinetics ea telmisartan ho bana ba lilemo tse 6 ho isa ho tse 18, ka kakaretso, li bapisoa le data e fumanoeng kalafong ea batho ba baholo, mme e tiisa ho se ts'oanehe ha pharmacokinetics ea telmisartan, haholo kamanong le Cmax.

Matšoao a ho sebelisoa

Phekolo ea methapo.
Fokotsa ho fokola ha pelo le lefu ho bakuli ba lilemo li 55 le ho feta ba nang le kotsi e kholo ea lefu la pelo.

Contraindication

Hypersensitivity ho ntho e sebetsang kapa likarolo tse thusang tsa sethethefatsi
Boimana
Nako ea lebone
Maloetse a kotsi a pampiri ea biliary
Ho senyeha ho matla ha hepatic (Kharebe ea ngoana oa Prag C)
Hereditary fructose nonlerance (e na le sorbitol)
Lilemo tse ho fihlela lilemo tse 18 (ho sebetsa hantle le polokeho ha e ea thehoa)

Ka tlhokomelo

Bilteryal renal stenosis kapa artery stenosis ea leino le le leng,
Ts'ebetso e mpe ea sebete le / kapa ts'ebetso ea liphio (bona le litaelo tse ikhethang),
Boloetse ba mali bo potolohileng (BCC) bo theohileng ka lebaka la kalafo e tlositsoeng ea diuretic, thibelo ea letsoai, lets'ollo, kapa ho hlatsa.
Hyponatremia,
Hyperkalemia
Maemo ka mora ho fetisoa ha menoana (ha ho na boiphihlelo ka tšebeliso),
Ho satalla ha pelo ho sa feleng
Stenosis ea aortic le mitral valve,
Idiopathic hypertrophic subaortic stenosis,
Aldosteronism ea mantlha (katleho le polokeho ha e ea thehoa)

Tekanyetso le tsamaiso
Ka hare, ho sa tsotelehe lijo.
Pherekano ea methapo
Tekanyo ea pele e khothalletsoang ea lithethefatsi Mikardis ® ke 1 tab. (40 mg) hang ka letsatsi. Maemong moo phello ea kalafo e sa fihleheng, tekanyo e phahameng e khothalletsoang ea lithethefatsi Mikardis ® e ka eketsoa 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.
Fokotseha ha bophelo bo botle ba 'mele le lefu
Motsoako o khothalelitsoeng ke Letlapa le le leng la lithethefatsi Mikardis ® 80 mg, hanngoe ka letsatsi.
Nakong ea kalafo ea pele, ho ka hlokahala tokiso e eketsehileng ea khatello ea mali.
Ts'ebetso ea mokokotlo e sa sebetseng
Bakeng sa bakuli ba nang le bothata ba ho phekoloa ka methapo, ho kenyelletsa le bakuli ba nang le hemodialysis, phetoho ea dosing regimen ha e hlokehe.
Ts'ebetso ea sebete e sa sebetseng
Ho bakuli ba nang le ts'ebetso ea sebete e fokolang le e leka-lekaneng (sehlopha sa A le B seleng ea bana-Pugh, ka tatellano), lethal dose la letsatsi le letsatsi la Mikardis ® ha lea lokela ho feta 40 mg.
Bakuli ba baholo
Reimi ea litekanyetso ha e hloke liphetoho.

Litla-morao
Maemo a hlokometsoeng a litlamorao a ne a sa tsamaellane le bong, lilemo kapa mofuta oa bakuli.
Ts'oaetso:
Sepsis, ho kenyeletsa le sepsis e bolaeang, tšoaetso ea pampiri ea urine (ho kenyelletsa le cystitis), tšoaetso ea phepelo ea phepelo ea mafu a ka holimo.
Ho tsoa lits'ebetsong tsa potoloho le ea li-lymphatic:
Anemia, eosinophilia, thrombocytopenia.
Ho tsoa ho tsamaiso ea methapo e bohareng:
Matšoenyeho, ho hloka boroko, khatello ea maikutlo, ho akheha.
Ho tsoa ho litho tsa pono le kutlo:
Ho ferekanya ho bonahalang, ho tsekela.
Ho tsoa ho tsamaiso ea pelo le pelo:
Bradycardia, tachycardia, letšoao le fokotsehileng la khatello ea mali, hypotension ea orthostatic
Ho tsoa ts'ebetsong ea phefumoloho:
Ho hema hanyane.
Ho tsoa ts'ebetsong ea tšilo ea lijo:
Bohloko ba ka mpeng, lets'ollo, molomo o ommeng, dyspepsia, flatulence, ho se khotsofale ka mpeng, ho hlatsa, ts'ebetso ea sebete e senyehileng.
Litla-morao:
Karabelo ea anaphylactic, hypersensitivity ho ntho e sebetsang kapa likarolo tse thusang tsa lithethefatsi, angioedema (leqeba), eczema, erythema, ho hlohlona ha letlalo, lekhopho (ho kenyeletsa le lithethefatsi), hyperhidrosis, urticaria, lefutso le kotsi.
Ho tsoa ts'ebetsong ea musculoskeletal:
Arthralgia, bohloko ba morao, mokokotlo oa 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).
Ho tsoa liphio le pampitšana ea ho ntša metsi:
Mosebetsi o sa sebetseng oa renal, ho kenyelletsa le ho hloleha ha rekerese haholo.
Kakaretso:
Bohloko ba sefuba, syndrome e kang ntaramane, asthenia (bofokoli), hyperkalemia, hypoglycemia (ho bakuli ba nang le lefu la tsoekere).
Matšoao a laboratori:
Ho fokotseha ha mokokotlo oa hemoglobin, keketseho ea palo ea li-uric acid, creatinine maling, keketseho ea tšebetso ea li-enzymes tsa "sebete", keketseho ea khatello ea "metaboline phosphokinase" (CPK).

Bongata
Ha ho na linyeoe tsa overdose tse fumanoeng.
Matšoao: Ho fokotseha ha khatello ea mali, tachycardia, bradycardia.
Phekolo: kalafo ea matšoao, hemodialysis ha e sebetse.

Ho sebelisana le lithethefatsi tse ling
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 ea AUC0-24 le Cmax ea ramipril le ramiprilat e ile ea bonoa makhetlo a 2,5. Bohlokoa ba bongaka ba ketsahalo ena ha bo e-so fumanoe.
Ka tsamaiso e le 'ngoe ea li-inhibitors tsa angiotensin-converting enzyme (ACE) le litokisetso tsa lithium, keketseho e feto-fetohang ea khatello ea li-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 lithethefatsi tse seng khahlanong le 'mele tse sireletsang mali (NSAIDs), ho kenyeletsa acetylsalicylic acid, cycloo oxygenase-2 inhibitors (COX-2) le li-NSAIDs tse sa khethang, e 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-antihypertgency agents, joalo ka telmisartan, ka thibelo ea phello ea vasodilating ea li-prostaglandins e hlokometsoe ka ts'ebelisano 'moho le NSAIDs.

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 hlahlobe ka hloko ts'ebetso ea liphio (ho kenyelletsa le ho lekola nako le nako ha u bala li-serum potasiamo le tsepamiso ea creatinine)
Maemong a ho itšetleha ka ts'ebetso ea methapo ea kutlo le ts'ebetso ea liphio haholo mesebetsing ea RAAS (mohlala, ho bakuli ba nang le ho nyeleha ho sa feleng ha 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 latela boiphihlelo ba ho sebelisa lithethefatsi tse ling tse amang RAAS, ka tšebeliso e kopaneng ea lithethefatsi Mikardis ® le diuretics tse nang le potasiamo, li-additives tse nang le potasiamo, letsoai le nang le phepo, lithethefatsi tse ling tse eketsang phallo ea potasiamo maling (mohlala, heparin), letšoao lena le lokela ho beoa leihlo ho bakuli.
Ntle le moo, Mikardis ® e ka sebelisoa hammoho le diaztiti tsa thiazide, tse kang hydrochlorothiazide, eo ka ho eketsehileng e nang le phello ea hypotensive (mohlala, Mikardis Plus ® 40 mg / 12.5 mg, 80 mg /) 2.5 mg).
Ho bakuli ba nang le khatello e matla ea methapo ea methapo, lethal dose ea telmisartan ea 160 mg / letsatsi mme hammoho le hydrochlorothiazide 12,5-25 mg e mamelletsoe hantle ebile e sebetsa. Mikardis ® ha e sebetse hantle ho bakuli ba mofuta oa Negroid.

Tšusumetso ho bokhoni ba ho khanna koloi le ho sebetsa ka mekhoa
Boithuto bo ikhethileng ba kliniki ea phello ea lithethefatsi ho bokhoni ba ho khanna koloi le mekhoa ha e so ka e etsoa. Leha ho le joalo, ha u khanna le ho sebetsa ka mekhoa, ho ka nahanoa ka monyetla oa ho holofatsa ho tsekela le ho otsela, mme ho hloka tlhokomeliso.

Fomu ea tokollo
Matlapa a 40 mg le 80 mg.
Matlapa a 7 ka blister e 'ngoe e entsoeng ka polyamide / aluminium / PVC. Marang-rang a mabeli kapa a mane a nang le litaelo tsa ho sebelisoa lebokoseng la karete (bakeng sa litekanyetso tsa 40 mg). Bakeng sa maleiri a 2, 4 kapa 8 a nang le litaelo tsa ho sebelisoa ka lebokoseng la karete (bakeng sa litekanyetso tsa 80 mg).

Maemo a polokelo
Lenane B.
Boloka ka mocheso o sa feteng 30 ° C sebakeng se sirelelitsoeng ke mongobo.
Qoba hole le bana!

Letsatsi la ho felloa ke nako
Lilemo tse 4 Se ke oa sebelisa kamora letsatsi la ho felloa ke nako.

Lipehelo tsa Maemo a Phomolo ea meriana
Ka lengolo la ngaka.

Lebitso le aterese ea mokhatlo oa molao eo lengolo la ngoliso le fanoeng
Beringer Ingelheim International GmbH Bingsr Strasse 173,
55216, Ingelheim am Rhein, Jeremane

Moetsi
Beringer Ingelheim Pharma GmbH & CoKG
Bingerstrasse 173, 55216 Ingelheim am Rhein, Jeremane

O ka fumana leseli le eketsehileng ka lithethefatsi, hammoho le ho romella litletlebo tsa hau le tlhahisoleseling mabapi le liketsahalo tse bohloko atereseng e latelang ea Russia
Beringer Ingelheim LLC 125171, Moscow, Leningradskoye Shosse, 16A leq. 3

Foromo ea litekanyetso

Letlapa 80 mg / 12,5 mg, 80 mg / 25 mg

Letlapa le leng le na le

Lintho tse sebetsang: telmisartan 80 mg

hydrochlorothiazide 12,5 mg kapa 25 mg, ka ho latellana

Baeti: sodium hydroxide, polyvidone K 25 (povidone), meglumine, sorbitol, magnesium stearate, lactose monohydrate, cellulose ea microcrystalline, starch ea poone, tšepe (III) red oxide (E172) (bakeng sa litekanyetso 80 / 12,5), tšepe (ІІІ) oxide e tshehla (Е172) (bakeng sa litekanyetso tsa 80/25), sodium starch glycolate (mofuta A).

80 mg / 12.5 mg: matlapa a nang le sebopeho sa oval se nang le biconvex bokaholimo ba likarolo tse peli: lera le le leng le le bosoeu 'mala o nang le "H8" khatiso le "logo" ea k'hamphani,' me o na le "pinki" e lumellehang e khubelu.

80 mg / 25 mg: matlapa a bopehileng joaloka o biconvex bokaholimo ba mela e 'ngoe e tšoeu e nang le "H9" khatiso le logo ea k'hamphani,' me karolo e 'ngoe e le' mala o mosehla.

Melemo ea pharmacological

Mofumahali

Tšebeliso e tšoanang ea hydrochlorothiazide le telmisartan ha e ame li-pharmacokinetics tsa lithethefatsi tsena.

Telmisartan: kamora ho tsamaisoa ka molomo, telmisartan e kenella ka potlako, khatello e phahameng ea telmisartan e fihlella ka lihora tse 0.5-1,5.

Tekanyetso e akaretsang ea bioavailability ea telmisartan e ka ba 50%. Ho ja hanyane ho fokotsa bioavailability ea telmisartan ka ho fokotseha hoa tikoloho tlasa "curasma concentration-time" (AUC) ho tloha ho 6% ha ho nooa tekanyetso ea 40 mg ho isa ho 19% ha ho nooa tekanyetso ea 160 mg. Lihora tse 3 kamora ho nka telmisartan, khatello ea mali ka setsing sa mali e tsitsitse ebile ha e ea itšetleha ka tšebeliso ea lijo. Ho fokotseha hanyane ho AUC ha ho bake ho fokotseha hoa katleho ea kalafo.

The pharmacokinetics of telmisartan ha e nkuoa ka molomo ha e na mola ho litekanyetso ho tloha ho 20 mg ho isa ho 160 mg ka keketseho e fetang ea tekano ea likhakanyo tsa plasma (Cmax le AUC) ka tekanyetso e ntseng e eketseha. Telmisartan ha e ipokelletse ka har'a plasma ea mali ho isa tekanyong e kholo ha e sebelisoa khafetsa.

Hydrochlorothiazide: kamora tsamaiso ea molomo, boholo ba mahloriso a hydrochlorothiazide a fihlelloa lihora tse ka bang 1,3,3.0 kamora ho busa. Tekanyo e felletseng ea hydrochlorothiazide ke hoo e ka bang 60%.

Telmisartan: e na le litekanyetso tse phahameng tsa ho tlama liprotheine tsa plasma (> 99.5%), haholo-holo ka albin le alpha-1 acid glycoprotein. Boholo ba phepelo e batla e le lithara tse 500.

Hydrochlorothiazide: 64% e tlameletsoe ho liprotheine tsa plasma mme bosholu ba eona bo bonahalang ke 0,80.3 l / kg.

Metabolism le excretion

Telmisartan: kamora taolo ea molomo ea telmisartan ea 14C, boholo ba lethal dose (> 97%) bo ile ba qheleloa ka mantle ka biliary excretion, 'me ha fumanoa tse nyane haholo morong. E tšelisoa ke ho kopanya lintho tse qalang le acylglucuronide ea meriana e sa sebetseng, e leng eona feela glucuronide e khethiloeng ho batho.

Kamora ho tsamaisoa ha tekanyetso e le 'ngoe ea telmisartan ea 14C, glucuronide e fumanoe hoo e ka bang 11% ea radioactivity e lekantsoeng ea plasma. Li-cyenzchym tsa cytochrome P450 ha li kenye letsoho ho metabolism ea telmisartan. Tlhahiso ea plasma ka botlalo ea telmisartan e batla e le 1500 ml / min, nako ea bophelo bo fetang lihora tse 20.

Hydrochlorothiazide: ho batho, ha e tšeloe 'mele' me e pepesetsoa hoo e ka bang e sa fetohe ka ho feteletseng ka har'a moroto. Hoo e ka bang 60% ea tekanyetso ea molomo e hlahisoa e le ntho e sa fetoloang ka nako ea lihora tse 48. Ho hlakisoa ha molao ka molao ke hoo e ka bang 250-300 ml / min. Bophelo ba halofo ea ho qetela ea hydrochlorothiazide ke lihora tse 10-15.

Bakuli ba tsofetseng: pharmacokinetics ea telmisartan ho bakuli ba tsofetseng le ba ka tlase ho lilemo tse 65 ha e fapana.

Bong: khatello ea plasma ea telmisartan ho basali e phahame ka makhetlo a 2-3 ho feta ho banna. Leha ho le joalo, lithutong tsa bongaka ho ne ho se na keketseho e kholo ea khatello ea mali kapa liketsahalo tsa hypotension ea orthostatic ho basali. Ha ho na tlhoko ea tokiso ea litekanyetso. Ho ne ho na le tloaelo ea ho ba le khatello e phahameng ea hydrochlorothiazide maling a mali ho basali ha a bapisoa le banna.

Ha ho na tlhahiso ea bohlokoa ea telmisartan e fumanoeng.

Bakuli ba nang le ho hloleha ha meno

Tlhahiso ea lesapo la mokokotlo ha e ame tumello ea telmisartan. Motheong oa boiphihlelo ba ho sebelisa lithethefatsi ho bakuli ba nang le bothata bo fokolang ba ho hlaphoheloa ha reiti (creatinine clearance of 30-60 ml / min, karolelano ea 50 ml / min), ho ile ha bonts'oa hore phetoho ea tekanyetso ha e hlokahale ho bakuli ba nang le ts'ebetso ea renal e fokotsitsoeng. Telmisartan ha e qhekelle nakong ea hemodialysis. Bakeng sa bakuli ba nang le ts'ebetso ea renal e sa sebetseng hantle, tekanyo ea ho felisoa ha hydrochlorothiazide e fokotsehile.

Phuputsong ho bakuli ba nang le tumello ea creatinine e tloaelehileng ea 90 ml / min, halofo ea bophelo ba hydrochlorothiazide e ile ea eketseha. Ho bakuli ba nang le lesea le sa sebetseng, ho tlosoa ha halofo ea bophelo ke lihora tse ka bang 34.

Bakuli ba nang le bothata ba sebete

Ho bakuli ba nang le ho hloleha ha sebete, ho na le keketseho ea bioavailability e phethahetseng ho 100%. Bophelo ba halofo ha bo fetohe ka ho hloleha ha sebete.

Pharadodynamics

MIKARDIS Plus ke motsoako oa mohanyetsi oa li-receptor oa angiotensin II - telmisartan le thiazide diuretic - hydrochlorothiazide. Motsoako oa likarolo tsena o fana ka phello e matla ea antihypertensive ho fapana le ho nka karolo ka 'ngoe ka thoko. Ho amoheloa ha MIKARDIS Plus hang ka letsatsi ho tekanyetso ea kalafo e fana ka phokotso e sebetsang le e boreleli ea khatello ea mali.

Telmisartan: Ke antagonist e sebetsang le e ikhethileng (e khethang) angiotensin II (mofuta oa AT1). Telmisartan e nang le tekanyo e phahameng haholo ea tumellano e theha tlamo feela le AT1 subtype, angiotensin II receptors. Telmisartan ha e na kamano le li-receptor tse ling, ho kenyeletsa le AT2 - li-receptors tsa angiotensin, le tse ling, tse sa ithutoang haholo, li-receptors tsa AT. 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.

Telmisartan e lebisa ho fokotseha hoa maemo a aldosterone ea mali. Telmisartan ha e thibele renin ho plasma ea motho ebile ha e thibele liteishene tsa ion. Telmisartan ha e thibele tšebetso ea angiotensin e fetolang enzyme (kinase II), ka karolo eo ho eona ho nang le phokotseho ho motsoako oa bradykinin. Ka hona, ha ho na keketseho litlamorao tse bakoang ke bradykinin.

Ho bakuli, telmisartan ka tekanyo ea 80 mg e ka ba e thibela ka ho felletseng phello ea khatello ea mali ea angiotensin II. Phello ea inhibitory e phehella lihora tse 24 mme e lula e le bohlokoa ho fihlela lihora tse 48.

Kamora ho nka tekanyetso ea pele ea telmisartan, ts'ebetso ea antihypertgency butle-butle e bonahala ka nako ea lihora tse 3. Phokotso e phahameng ea khatello ea mali butle-butle e fihlelloa libeke tse 4 kamora ho qala kalafo mme e bolokoa nako e telele.

Ho bakuli ba nang le khatello ea mali, telmisartan lowers systolic le diastolic khatello ea mali ntle le ho fetola sekhahla sa pelo.

Bokhabane ba antihypertensive ba telmisartan bo ka bapisoa le lihlopha tse ling tsa lithethefatsi tsa antihypertensive (joalo ka ha ho bontšitsoe lithutong tsa kliniki ho bapisa telmisartan le amlodipine, atenolol, enalapril, hydrochlorothiazide, losartan, lisinopril, ramipril, le valsartan).

Tabeng ea ho hlakoloa ha telmisartan ka tšohanyetso, butle-butle khatello ea mali e khutlela litekanyetsong pele ho kalafo matsatsi a 'maloa ntle le matšoao a ho qala hape ka khatello ea mali (ha ho na "syndrome ea ho hula").

Lithutong tsa kliniki ka papiso e tobileng ea mefuta e 'meli ea kalafo ea antihypertgency, ts'oaetso ea ho khohlela ho omileng ho bakuli ba nkang telmisartan e ne e le tlase haholo ho feta ho ba amohelang li-inhibitors tsa angiotensin.

Hydrochlorothiazide: ke thiazide diuretic. Mochine oa antihypertensive effect oa thiazide diuretics ha o tsejoe ka botlalo. Li-Thiazides li sebetsa ka methapo ea methapo ea methapo ea mokokotlo ea electrolyte, e eketsa ka kotlolloho sodium le chloride ka bongata bo lekanang. Phello ea diuretic ea hydrochlorothiazide e fokotsa bophahamo ba plasma, e eketsa mosebetsi oa plasma renin, e eketsa secretion ea aldosterone, e lateloe ke tahlehelo e eketsehang ea potasiamo le bicarbonate ka moroto le ho fokotseha ha serum potasiamo. Ho ka etsahala hore sephethe-phethe se tsitsitseng sa renin-angiotensin-aldosterone ha se kopantsoe le telmisartan se lebisa tahlehelong ea potasiamo e amanang le diuretics tsena.

Ha o nka hydrochlorothiazide, keketseho ea diuresis e bonoa kamora lihora tse peli, phello e phahameng e hlaha kamora lihora tse ka bang 4, ha nako ea ts'ebetso e le lihora tse ka bang 6-12.

Boithuto ba Epidemiological bo bontšitse hore kalafo ea nako e telele le hydrochlorothiazide e fokotsa kotsi ea ho fokolloa ke pelo le lefu ho tsona.

Tekanyetso le tsamaiso

MIKARDIS Plus e nkuoa hang ka letsatsi ka metsi a manyane.

Ha ho fetoha ho tloha telmisartan ho MIKARDIS Plus, lethal dose la telmisartan le ka eketseha ka mokhoa oa pele. Phetoho e tobileng ho tloha ho monotherapy ho isa moriana o kopaneng oa etsahala.

MIKARDIS Plus 80 mg / 12.5 mg e ka fuoa bakuli bao ts'ebeliso ea telmisartan (MIKARDIS) 80 mg e sa fetoleng khatello ea mali ka ho lekana.

MIKARDIS Plus 80 mg / 25 mg e ka abeloa bakuli bao tšebeliso ea MIKARDIS Plus 80 mg / 12,5 mg e sa fetoleng khatello ea mali kapa ho bakuli bao boemo ba bona bo neng bo tsitsipane ka telmisartan kapa hydrochlorothiazide ha bo sebelisoa ka thoko.

Phello e phahameng ea antihypertensive hangata e fihlelleha nakong ea libeke tse 4-8 kamora ho qala kalafo.

Haeba ho hlokahala, MIKARDIS Plus e ka kopanngoa le litlhare tse ling tsa antihypertensive.

Ho bakuli ba nang le khatello e matla ea methapo ea kutlo, telmisartan e lekantsha ho fihlela ho 160 mg ka letsatsi (li-capsules tse peli tsa MIKARDIS 80 mg) kapa hammoho le hydrochlorothiazide 12,5-25 mg ka letsatsi (li-capsules tse peli tsa MIKARDIS Plus 80 mg / 12,5 mg kapa 80 mg / 25 mg) e ne e mamelletsoe hantle ebile e sebetsa.

MIKARDIS Plus e ka nkuoa ho sa tsotelehe takatso ea lijo.

Ka lebaka la ho ba teng ha MIKARDIS Plus hydrochlorothiazide ha e ntse e hlophisoa, ha ea lokela ho fuoa bakuli ba nang le bothata bo matla ba ho hlaba ba pelo (creatinine clearance