Ibertan ea lithethefatsi: litaelo tsa tšebeliso

Lebitso la machabeng - ibertan

Sebopeho le mofuta oa tokollo.

Matlapa a koahetsoeng ka filimi, Letlapa le le leng le na le hydrochlorothiazide - 12,5 mg, irbesartan - 150 mg.

Matlapa ho koahela lifilimi, 12,5 mg + 150 mg: 28 kapa 30 li-pcs.

7 likhomphutha - marangrang (4) - lipakete tsa karete.
Li-pcs tse 10 - lithutsoana (3) - lipakete tsa karete.
14 li-PC. - Mabokose (2) - lipakete tsa karete.
Li-pcs tse 15. - Mabokose (2) - lipakete tsa karete.

Ketso ea pharmacological.

Ibertan Plus ke sethethefatsi se kopaneng le antihypertensive effect. Motsoako ona o kenyelletsa mohanyetsi oa li-receptor oa angiotensin II le thiazide diuretic. Motsoako oa lithethefatsi tsena o na le phello e tlatsetsang ea antihypertensive, e theola khatello ea mali ka tekanyo e kholo ho feta e ngoe le e ngoe ea lithethefatsi ka thoko.

Irbesartan ke mohanyetsi ea khethang li-receptors tsa angiotensin II (mofuta oa AT1) bakeng sa tsamaiso ea molomo. Irbesartan e thiba litlamorao tsohle tsa bohlokoa tsa 'mele tsa angiotensin II tse kopantsoeng le li-receptors tsa AT1, ho sa tsotelehe mohloli kapa tsela ea synthesis ea angiotensin II. Litlhaselo tse khethiloeng tsa li-receptor tsa angiotensin II (AT1) li lebisa ho eketseha ha maikutlo a plasma a renin le angiotensin II le ho fokotseha ha khatello ea aldosterone ho plasma ea mali. Litaba tsa serum potasiamo hangata ha li fetohe haholo ha o nka irbesartan ho litekanyetso tse khothalelitsoeng; irbesartan ha e thibele kininase II. Irbesartan ha e hloke ts'ebetso ea metabolic. Phoka khatello ea mali le phetoho e fokolang ea sekhahla sa pelo.

Hydrochlorothiazide ke thiazide diuretic. E ama ho reabsorption ea li-electrolyte ka har'a li-renal tubules, ka kotlolloho ea ka kotloloho ea li-ion tsa sodium le chlorine ka bongata bo lekanang. Phello ea diuretic ea hydrochlorothiazide e lebisa ho fokotseha ha bongata ba plasma ea mali, keketseho ea mesebetsi ea renin ho plasma ea mali, keketseho ea secretion ea aldosterone le keketseho ea litaba tsa potasiamo le li-bicarbonate ka har'a moroto le hypokalemia. Tsamaiso e ts'oanang ka irbesartan e lebisa ho fokotseha ha tahlehelo ea ions ea potasiamo, haholo-holo ka lebaka la thibelo ea sistimi ea renin-angiotensin-aldosterone. Ha hydrochlorothiazide e nooa ka molomo, keketseho ea liresissi e etsahala kamora lihora tse peli ebe e fihla sehlohlolong kamora lihora tse 4. Ketso ea hydrochlorothiazide e nka lihora tse ka bang 6-12.

Ho fokotseha ha khatello ea mali ha u hlahisa irbesartan hammoho le hydrochlorothiazide ho se ho bonahala ha o qala ho sebelisa moriana kahare mme o qeta libeke tse 1-2, o lateloa ke keketseho ea hae ea butle-butle le nts'etsopele ea phello e phahameng ka libeke tse 6-8.

Mofumahali.

Tsamaiso e ts'oanang ea hydrochlorothiazide le irbesartan ha e ame li-pharmacokinetics tsa lithethefatsi ka bomong.

Suction. Kamora ho tsamaisoa ka molomo, bioavailability e felletseng ea irbesartan ke 60-80%, hydrochlorothiazide 50-80%. Ho ja ha ho ame bioavailability ea bona. Cmax ea irbesartan ka plasma ea mali e fihlelloa kamora lihora tse 1.5-2 kamora ho tsamaisoa ha molomo, hydrochlorothiazide - kamora lihora tse 1-2,5.

Tsamaiso. Irbesartan e 96% e tlameletsoe liprotheine tsa plasma. Boholo ba phepelo (Vd) ea irbesartan ke lilithara tse 53-93. Litekanyetso tsa pharmacokinetic tsa irbesartan li tsamaellana ebile li lekana lethathamong la litekanyetso ho tloha ho 10 mg ho isa ho 600 mg. Ka litekanyetso tse kaholimo ho 600 mg (lethalinyana le kopaneng habeli tekanyetso e phahameng), pharmacokinetics ea irbesartan ha e sa ba mola (ho fokotseha ha ho kenoa).

Hydrochlorothiazide e 68% e tlameletsoe liprotheine tsa plasma, V d - 0.83-1.14 l / kg.

Metabolism. Irbesartan e tšeloa ka har'a sebete ka ho kopana le glucuronic acid le oxidation. Metabolite ea eona e ka sehloohong maling e irbesartan g.tukuronid (hoo e ka bang 6%). Boithuto ba invitro bo bontšitse hore irbesartan e feta le oxidation haholo ka CYP2C9 isoenzyme ea cytochrome P450. Matla a CYP3A4 isoenzyme ha a na taba.

Hydrochlorothiazide ha e hlahisoe. E kenella ka har'a sethopo sa placental 'me e pepesitsoe lebeseng la matsoele. Ha e tšele mekoallo ea mali le bokong.

Ho tsala. Ho hlakisoa ka botlalo le ho ba le lipholiso ke 157-176 le 3.0-3.5 ml / min, ka ho latellana. T1 / 2 ea irbesartan ke lihora tse 11-15. Irbesartan le metabolites tsa eona li epolloa ka mala (80%) le liphio (20%). ka tlase ho 2% ea tekanyetso ea irbesartan e nkuoeng e supa ke liphio li sa fetoloe.

T 1/2 hydrochlorothiazide - lihora tse 5-15. E fepuoa ke liphio. Bonyane ba 61% ea tekanyetso ea molomo ha e fetoloe ka nako ea lihora tse 24.

Pharmacokinetics maemong a khethehileng a kliniki. Likarolo tse nyane haholo tsa plasma ea irbesartan li bonoa ho bakuli ba basali. Leha ho le joalo, liphapang tsa T1 / 2 cumulation ea irbesartan ha lia ka tsa fumanoa. Phetoho ea tekanyetso ea Irbesartan ho bakuli ba basali ha e hlokahale.

Litaelo li ne li le ka tlase ho nako ea mahloriso (AUC) le C max ea irbesartan ka plasma ea mali li ne li phahame haholo ho bakuli ba tsofetseng (ba lilemo tse fetang 65) ho feta ho bakuli ba banyenyane (ba ka tlase ho lilemo tse 65). T 1/2 irbesartan e ne e sa fapana haholo. Phokotso ea litheko tsa irbesartan ho bakuli ba tsofetseng ha e hlokehe.

Ts'ebetso ea renal e sa sebetseng hantle: ho bakuli ba nang le ts'ebetso ea renal e sa sebetseng kapa e amanang le hemodialysis, litekanyetso tsa pharmacokinetic tsa irbesartan li fetotsoe hanyane.

Ts'ebetso ea sebete e sa sebetseng: ho bakuli ba nang le bothata ba sebete bo sa sebetseng hantle kapa bo itekanetseng, litekanyetso tsa pharmacokinetic tsa irbesartan li fetotsoe hanyane. Bakeng sa bakuli ba nang le ts'ebetso ea sebete e sa sebetseng hantle, ha ho lithuto tse entsoeng.

Arterial hypertension (kalafo ea bakuli ba bontšitsoeng kalafo ea ho kopanya).

Mokhoa oa kalafo ea litekanyetso le mokhoa oa ts'ebeliso ea Ibertan hammoho.

Ka hare, hang ka letsatsi, ho sa tsotelehe lijo tse jang. Ibertan Plus 12.5 / 150 mg (matlapa a nang le hydrochlorothiazide / irbesartan 12. 5/150 mg, ka ho latellana) a ka laeloa bakuli bao khatello ea mali e sa laoloeng ka ho lekana ka ho khethoa ha hydrochlorothiazide feela (12,5 mg / letsatsi) kapa irbesartan ( 150 mg / letsatsi) ho monotherapy. Ibertan Plus 12.5 / 300 mg (matlapa a nang le hydrochlorothiazide / nrbesartan 12.5 / 300 mg, ka ho latellana) a ka laeloa bakuli haeba khatello ea mali e sa laoloe ka nepo ke irbesartan (300 mg / letsatsi) kapa Ibertan Plus (12, 5/150 mg).

Ibertan Plus 25-300 mg (matlapa a nang le hydrochlorothiazide / irbesartan 25/300 mg, ka ho latellana) a ka laeloa bakuli haeba khatello ea mali e sa laoloe ka nepo ke tsamaiso ea Ibertan Plus (12. 5/300 mg). Ho khethoa ha litekanyetso li kaholimo ho 25 mg ea hydrochlorothiazide / 300 mg ea irbesartan nako e le ngoe ka letsatsi ha e khothalletsoe. Haeba ho hlokahala, moriana Ibertan Plus o ka laeloa hammoho le litlhare tse ling tsa antihypertensive.

Ts'ebetso ea renal e senyehileng: ka lebaka la taba ea hore motsoako oa lithethefatsi Ibertan Plus o kenyelletsa hydrochlorothiazide. setlhare ha se khothalletsoe ho bakuli ba nang le bothata ba ho ruruha ha renal (ho pepesoa tumellano ea 30 ml / min.) Ho senyeha hoa ts'ebetso: tšebeliso ea lithethefatsi Ibertan Plus ha e khothaletsoe ho bakuli ba nang le bothata ba ho kula ho matla ba hepatic. Ha ho hlokahale hore ho sebelisoe mofuta oa Ibertan Plus.le bakuli ba tsofetseng: Phetoho ea li-Ibertan Plus ha e hloke ho bakuli ba tsofetseng. Ka Ibertan Plus, ho hlokahala ho fetola molumo oa mali o potoloha le / kapa sethala sa sodium.

Litla-morao ibertana le.

Litlamorao tse latelang li fanoa ho latela lits'ebetso tse latelang tsa khafetsa tsa liketsahalo tsa tsona: hangata haholo (> 1/10), hangata /> 1/100, 1/1 000, 1/10 000, 30 ml / min.

Tšebeliso ea lithethefatsi baneng.

E kopantsoe le bana ba ka tlase ho lilemo tse 18.

Sebelisa ho bakuli ba tsofetseng.

Ha ho hlokahale hore ho etsoe phetoho ea lethal dose ea Ibertan Plus ho bakuli ba tsofetseng.

Litaelo tse khethehileng tsa ho amoheloa ibertana le.

Bakuli ba nang le arterial hypotension le phallo ea mali e potolohileng: ho bakuli ba nang le lefu la khatello ea mali, Ibertan Plus ke ka seoelo e bakang matšoao a methapo ea kutlo. Matšoao a arterial hypotension a ka bonoa ho bakuli ba nang le phallo ea mali e fokotsehileng kapa ea sodium e tlase nakong ea phekolo ea diuretic, ka lijo tse nang le letsoai le nang le letsoai le ho hlatsa kapa ho hlatsa. Maemo a joalo a tlameha ho lokisoa pele kalafo le Ibertan Plus e qala.

Litlamorao tsa Metabolic le endocrine. Liuretics tsa Thiazndic li ka fokotsa mamello ea tsoekere. Ho bakuli ba nang le lefu la tsoekere, ho ka hlokahala hore ho sebelisoe litekanyetso tsa li-insulin kapa li-hypoglycemic. Ka tšebeliso ea li-thiazide diuretics, nts'etsopele ea lefu la tsoekere ea lefu la tsoekere e ka khonahala.

Nakong ea phekolo e nang le thiazide diuretics, hyperuricemia kapa ho mpefala ha leqeba ho ka hlaha ho bakuli ba bang.

Tlolo ea tekano ea motlakase-oa motlakase. Liazine diuretics, ho kenyelletsa hydrochlorothiazide. ho ka baka tlolo ea tekanyo ea-electrolyte ea metsi (hypokalemia, hyponatremia le hypochloremic alkalosis). Leha nts'etsopele ea hypokalemia e khoneha ka thiazide diuretics, tšebeliso e kopaneng le irbesartan e ka fokotsa hypokalemia e bakoang ke diuretic. Kotsi ea hypokalemia e eketseha ho bakuli ba fumanang li-glucocorticosteroids kapa li-adrenocorticotropic hormone. Ho fapana le hoo, ka lebaka la irbesartan, eo e leng karolo ea litokisetso tsa Ibertan Plus, hyperkalemia e ka etsahala, haholoholo moo ho nang le ho se sebetse hantle ha pelo le / kapa ho nyekeloa ke pelo kapa lefu la tsoekere. Ho hlahlojoa khafetsa ha serum potasiamo ho bakuli ba kotsing e khothalletsoa.

Thiazide diuretics e ka fokotsa ts'oarelo ea ion ea calcium ka liphio mme ea baka nakoana nakoana hypercalcemia ha ho na metabolism ea calcium e senyehileng. Hypercalcemia e matla e ka supa hyperparathyroidism ea morao. Liazine diuretics e lokela ho emisoa pele ho thuto ea parathyroid.

Ho bontšitsoe hore thiazide diuretics e ka eketsa tlhahiso ea li-ion tsa magnesium ke liphio, e leng se ka lebisang ho nts'etsopele ea hypomagnesemia.

Phaello ea methapo ea kutlo. Ho bakuli ba nang le pelo ea methapo ea methapo ea methapo kapa lesapo la mokokotlo le sebetsang feela, ha u sebelisa lithethefatsi tse amang RAAS, ho na le menyetla ea ho ba le hypotension e matla ea arterial le ho hlleha ha renal. Le ha datha tse joalo li sa ka tsa fumanoa ha u ntse u nka Ibertan Plus, litlamorao tse ts'oanang li ka lebelloa nakong ea ts'ebeliso ea bahanyetsi ba angiotensin II receptor.

Ho hloleha ha nama le boemo ka mora ho fetisoa ha meno. Tabeng ea ts'ebeliso ea lithethefatsi Ibertan Plus ho bakuli ba nang le ts'ebetso ea renal e lemalitsoeng, ho hlahlojoa nako le nako ha litaba tsa potasiamo, creatinine le uric acid e serum ea mali. Ha ho na boiphihlelo ka tšebeliso ea Ibertan Plus ho bakuli kamora ho fetisoa ha menoana haufinyane.

Aortic kapa mitral valve stenosis, hypertrophic obstriers cardiomyopathy. Joalo ka ts'ebeliso ea li-vasodilator tse ling, ho hlokahala tlhokomeliso ha ho fana ka Ibertan Plus ho bakuli ba nang le aortic kapa mitral stenosis kapa hypertrophic obstriers Cardiomyopathy.

Hyperaldosteronism ea mantlha. Lithethefatsi tsa antihypertgency tse sebetsang ka ho thibela ts'ebetso ea renin-angiotensin-aldosterone hangata ha li na thuso ho bakuli ba nang le hyperaldostronism ea mantlha. Ka hona, tšebeliso ea lithethefatsi Ibertan Plus maemong a joalo ha e na thuso.

Liteko tsa ho hlola matla: hydrochlorothiazide e ka baka phello e ntle nakong ea taolo ea doping.

Tse ling. Joalo ka lithethefatsi tse ling tsa antihypertgency tse amang tsamaiso ea renin-angiotensin-aldosterone, ho fokotseha ho hoholo ha khatello ea mali ho bakuli ba nang le lefu la pelo le / kapa atherosclerosis ea methapo ea kelello ho ka lebisa ho holisoeng ha myocardial infarction kapa stroke. Phekolo ea bakuli ba joalo e lokela ho etsoa ke iodine ka taolo e matla ea khatello ea mali.

Ho na le litlaleho tsa ho mpefala kapa ho mpefala ha systemic lupus erythematosus nakong ea ho khethoa ha diaztiti tsa thiazide.

Tšusumetso ho bokhoni ba ho khanna makoloi le ho sebetsa ka mekhoa

Kameho ea Ibertan Plus mabapi le bokhoni ba ho khanna makoloi le ho etsa mosebetsi o hlokang tlhokomelo e eketsehileng ha e ithutoe. Leha ho le joalo, nakong ea ho sebelisa moriana, tlhokomeliso e tlameha ho ba hlokolosi ha ho khanna makoloi le ho sebetsa ka methapo, hobane nakong ea ho tsekela le ho tepella ho eketsehileng hoa khoneha.

Bongata.

Matšoao (a belaelloa): irbesartan - ho fokotseha ho phatlalalitsoeng ha khatello ea mali, tachycardia, bradycardia. Hydrochlorothiazide - hypokalemia, hyponatremia, ho haelloa ke metsi ka lebaka la ho tsosetsana ho feteletseng. Matšoao a atileng haholo a overdose ke ho nyekeloa le ho otsela. Hypokalemia e ka lebisa ho tsitsipano le / kapa nts'etsopele ea pelo e amanang le ts'ebeliso e kopaneng ea methapo ea pelo le lithethefatsi tsa antiarrhythmic.

Phekolo: ho latela nako e se e fetile ho tloha nakong ea tsamaiso le ho teba ha matšoao. Mehato e reriloeng e kenyelletsa ho hlatsa le ho hlatsa ka mpeng, ts'ebeliso ea k'habone e hlokometsoeng, ho lekola boemo ba mokuli ka hloko le kalafo e nang le matšoao le e tšehetsang. Hoa hlokahala ho laola bongata ba li-electrolyte le creatinine maling a mali. Maemong a nts'etsopele ea phokotso e kholo ea khatello ea mali, mokuli o tlameha ho beoa mokokotlong oa hae ka maemo a tlase mme kapele kamoo ho ka khonehang ho etsa puseletso ea letsoai le metsi. Irbesartan ha e qhekelle nakong ea hemodialysis.

Ho sebelisana le lithethefatsi tse ling.

Lithethefatsi tse ling tsa antihypertensive: litlamorao tsa antihypertensive tsa lithethefatsi Ibertan Plus li ka matlafatsoa ke tšebeliso e tšoanang ea lithethefatsi tse ling tsa antihypertensive. Hydrochlorothiazide le irbesartan (ka tekanyetso e ka bang 25 mg ea hydrochlorothiazide / 300 mg ea irbesartan) e ka sebelisoa ka mokhoa o sireletsehileng hammoho le lithethefatsi tse ling tsa antihypertensive, ho kenyeletsoa li-blockers tsa "calcium" tse liehang ho feta. Pele e neng e phekoloa ka litekanyetso tse phahameng tsa diuretics e ka lebisa ho nyekelo ea pelo le ho eketsa kotsi ea lefu la sethoathoa.

Lithium: Ho na le litlaleho tsa keketseho e feto-fetohang ea mohopolo oa serum ea lithium le chefo ka ts'ebeliso e kopaneng ea litokisetso tsa lithium le li-inhibitors tsa angiotensin-converting enzyme. Bakeng sa irbesartan, litlamorao tse tšoanang li bile ka seoelo haholo kajeno. Ntle le moo, netefatso ea renal ea lithium e fokotseha ka tšebeliso ea li-thiazide diuretics, ka hona, ha ho ngoloa Ibertan Plus, ho na le monyetla oa ho ba le tšusumetso e matla ea lithium. Haeba sepheo sa ho kopanya sena se hlokahala, ho kgothaletswa ho lekola ka hloko litaba tsa lithium tse serumeng ea mali.

Meriana e amang potasiamo maling: phello ea hypokalemic ea hydrochlorothiazide e fokotsoa ke matla a bolokang potasiamo ea irbesartan.Leha ho le joalo, ts'ebetso ena ea hydrochlorothiazide e kanna ea ntlafatsoa ke lithethefatsi tse ling, sepheo sa sona se amanang le tahlehelo ea potasiamo le gnococalpemia (mohlala, diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, litlolo tse tsoang ho salicelic acid) Ho fapana le seo, ho latela boiphihlelo ba ho sebelisa lithethefatsi tse fokotsang tšebetso. Angiotensin-aldosterone sistimi, tšebeliso e tšoanang ea ts'oaetso ea potasiamo. x dpureshkov. li-additives tsa oiologically tse sebetsang, li-substitute tsa letsoai la potasiamo, kapa lithethefatsi tse ling tse ka lebisang keketseho ea serum potasiamo (joalo ka sodium heparin) e ka baka kholo ea serum Katya. Ho khothalletsoa hore ho hlahlojoe ka nepo serum potasiamo ho bakuli ba nang le kotsi ea hyperkalemia.

Meriana e anngoeng ke tlolo ea tekanyetso ea potasiamo serumeng ea mali: Ho khothalletsoa hore ho hlahlojoe ka hloko litaba tsa potasiamo tse serum ea mali ha ho etsoa Ibertan Plus hammoho le lithethefatsi tse anngoeng ke tlolo ea tekanyetso ea potasiamo ka serum ea mali (mohlala, glycosides ea pelo, lithethefatsi tsa antiarrhythmic).

Lithethefatsi tse sa hlaselong tsa ho ruruha: ha o fana ka lingoloa tsa li-angotensin II receptor antagonists hammoho le lithethefatsi tse seng tsa steroidal le tse thibelang mafu (mohlala, ka li-inhibitors tsa cycloo oxygenase-2 (COX-2), li-acetylsalicylic acid (> 3 g / letsatsi) le lithethefatsi tse seng khahlanong le ts'oaetso tse se nang steroidal tse fokotsang matla,) li ka fokolisa matla a antihypertgent. Joalo ka ts'ebeliso ea angiotensin e fetolang li-enzyme inhibitors le li-angiotensin II receptor antagonists hammoho le NSAIDs, ho na le menyetla e eketsehileng ea ts'ebetso ea mokokotlo oa mokokotlo, ho fihlela nts'etsopele ea ho hloleha ha renal e matla, potasiamo e eketsehileng ea serum, haholoholo ho bakuli ba seng ba senyehile ke ts'ebetso ea renal. Motsoako ona oa lithethefatsi o lokela ho laeloa ka hloko, haholoholo ho bakuli ba tsofetseng. Bakuli ha baa lokela ho omelloa ke metsi. Ho lekola mesebetsi ea matsoho ho lokela ho etsoa kamora ho qala kalafo ea ho kopanya le nako le nako nakong e tlang.

Tlhahisoleseling e eketsehileng mabapi le tšebelisano ea lithethefatsi ea irbesartan: hydrochlorothiazide ha e ame pharmacokinetics ea irbesartan. Ha ho ne ho ngoloa irbesartan hammoho le warfarin, e thehiloeng ke bahloekisi ba CYP2C9 isoenzyme, ha ho na ts'ebelisano e kholo ea pharmacokinetic le pharmacodynamic. Matla a CYP2C9 isoenzyme inducers, joalo ka rifampicin, ho pharmacokinetics ea irbesartan ha e so hlahlojoe. Ka ho khethoa ha irbesartan hammoho le digoxin, li-pharmacokinetics tsa morao ha lia ka tsa fetoha.

Tlhahisoleseling e eketsehileng mabapi le tšebelisano ea lithethefatsi ea hydrochlorothiazide:

Meriana e latelang e ka sebelisana le thiazide diuretics ha u ntse u fana ka taelo:

Ethanol, barbiturates kapa lithethefatsi tsa narcotic: hypotension e eketsehileng ea orthostatic e ka bonoa.

Catecholamines (mohlala, norepinephrine): katleho ea meriana ena e ka fokotsoa.

Boikhathollo ba mesifa e sa nyenyefatseng (mohlala, tubocurarine): hydrochlorothiazide e ka baka litlamorao tsa phomolo e sa nyenyefatso ea mesifa.

Hypoglycemic lithethefatsi (li-agents tsa molomo le insulin): tokiso ea tekanyetso ea li-hypoglycemic agents e ka hlokahala.

Colestyramine le colestipol: boteng ba li-resin tsa phapanyetsano ea anion, ho monya ha hydrochlorothiazide hoa khathatseha. Nako e pakeng tsa ho sebelisa meriana ena e lokela ho ba bonyane lihora tse 4.

Glucocorticosteroids, hormone ea adrenocorticotropic: tšoaetso e tšoailoeng ea tekanyetso ea motlakase oa motlakase, haholoholo, ho eketseha hoa hypokalemia.

Meriana ea anti-gout: ho lokisoa ha lithethefatsi tse ngata tse sebelisoang ho phekola gout ho ka hlokahala, hobane hydrochlorothiazide e ka eketsa litaba tsa uric acid ka plasma ea mali. Keketseho ea tekanyetso ea probenenide kapa sulfinpyrazone e kanna ea hlokahala. Ts'ebetso ea tšebelisano 'moho le diaztiti tsa thiazide e ka eketsa liketsahalo tsa hypersensitivity reaction ho allopurinol.

Kalsiamo ea calcium thiazide diuretics e ka eketsa khalsiamo ea plasma ka lebaka la ho fokotseha ha mantle a eona. Haeba ho hlokahala ho fana ka litlatsetso tsa khalsiamo kapa lithethefatsi tse amang khalsiamo (ka mohlala, vithamine D), ho hlokahala hore o fetole tekanyo ea lithethefatsi tsena ka mokhoa o nepahetseng le ho laola sethala sa calcium ho plasma ea mali.

Mefuta e meng ea ts'ebeliso ea lithethefatsi: Li-thiazide diuretics li ka ntlafatsa phello ea hyperglycemic ea beta-blockers le diazoxide. Anticholinergics (kk., Atropine) e ka eketsa bioavailability ea thiazide diuretics ka ho fokotsa sekhahla sa lefu la gastrointestinal and gastric sheding rate. Thiazide diuretics e ka eketsa kotsi ea ho etsa lintho tse mpe tse bakoang ke amantadine. Thiazide diuretics e ka fokotsa tlhahiso ea lithethefatsi tsa cytotoxic ke liphio (mohlala, cyclophosphamide, methotrexate) le ho hlahisa phello ea myelosuppression.

Maemo a phomolo a tsoang litlolong tsa litlama.

Lipehelo le maemo a polokelo.

Ka mocheso o sa feteng 25 ° C. Qoba hole le bana. Bophelo ba Shelf ke lilemo tse 2.

Ts'ebeliso ea lithethefatsi ibertan hammoho le feela joalokaha u laetsoe ke ngaka, tlhaloso e fanoa bakeng sa ho buuoa!

Contraindication

- Hypersensitivity ho irbesartan kapa likarolo tse ling tsa lithethefatsi,

- lefutso la lefutso la galactose, khaello ea lactase kapa malabsorption ea tsoekere le galactose,

- dilemo tse fihlang ho dilemo tse 18 (katleho le polokeho ha di so thehwe).

Hyponatremia, sejo se nang le lithibelo tsa ho ja letsoai, pelo le methapo ea methapo ea kutlo e le 'ngoe e sebetsang, ho omella (ho kenyeletsa le lets'ollo, ho hlatsa), kalafo ea diuretic ea nakong e fetileng, ho se sebetse hantle ha masapo, hemodialysis, boemo ka mora ho fetisoa ha meno (ho hloka tsebo ea bongaka), ho hloleha ho matla ha sebete (ho hloka tsebo ea bongaka), hyperkalemia, tšebeliso e kopanetsoeng le litokisetso tsa lithium, stenosis ea li-valve tsa aortic le mitral, gy pertrophic obstruction cardiomyopathy (GOKMP), hyperaldosteronism ea mantlha, ho se sebetse hantle ha pelo (NYHA sehlopha sa IV-IV se sebetsang), lefu la pelo (CHD) le / kapa lefu la pelo le bakuli ba lilemo tse fetang 75.

Tlhaloso ea tšebetso ea pharmacological

Moemeli oa antihypertgency, angiotensin II receptor antagonist. E thibela li-receptor tsa AT1, tse lebisang ho fokotseha hoa litlamorao tsa likokoana-hloko tsa angiotensin II, ho kenyelletsa vasoconstrictor effect, e tsosang phello ea ho lokolloa ha aldosterone le ts'ebetso ea tsamaiso ea methapo e nang le kutloelo-bohloko. Ka lebaka leo, khatello ea mali ea fokotseha.

E fokotsa OPSS, e fokotsa boima ba morao. E fokotsa khatello ea mali (ka phetoho e nyane haholo ea sekhahla sa pelo) le khatello ea phallo ea mali, 'me ho fokotseha ha khatello ea mali ho its'etleha ka tekanyetso.

Ha e ame ho kenella ha triglycerides, dikahare tsa k'holeseterole, tsoekere, uric acid e ho plasma ea mali kapa excretion ea uric acid ka har'a moroto.

Pharadodynamics

Li-receptor tse hlakileng tse hlakileng le tse sa fetoheng bo-angiotensin II (subtype AT1).

E felisa phello ea vasoconstrictor ea angiotensin II, e theola khatello ea methapo ea aldosterone ho plasma, e fokotsa OPSS, kamora ho teba pelong, khatello ea mali le khatello ea mali maling.

Ha e ame kinase II (ACE), e senyang bradykinin mme e ameha ho thehoeng ha angiotensin II.

E sebetsa butle butle, kamora tekanyetso e le 'ngoe, phello e phahameng e hlaha kamora lihora tse 3-6.

Matla a antihypertensive a phehella lihora tse 24.

Ka tšebeliso ea kamehla ka har'a libeke tse 1-2, phello e ba le botsitso hape e fihla hofihlella ka mor'a libeke tse 4-6.

Mofumahali

Kamora ho tsamaisoa ka molomo, e kenella hantle ho tsoa ho tšilo ea lijo. Cmax ea irbesartan ka plasma ea mali e fihlella lihora tse 1.5-2 ka mor'a ho kenella. Bioavailability ke 60-80%. Ho ja ka nako e tšoanang ha ho ame bioavailability ea irbesartan.

Plasma e tlamang protheine e ka ba 96%. Vd - lilithara tse 53-93. Css e fihlelloa nakong ea matsatsi a 3 kamora ho qala ho nka irbesartan 1 nako / Ka tekanyetso e phetoa ea 1 nako / ho na le pokello e lekanyelitsoeng ea irbesartan ho plasma (ka tlase ho 20%).

Kamora ho kenella 14C-irbesartan, 80-85% ea radioacaction maling a potoloha e oela ho irbesartan e sa fetoheng.

Irbesartan e tšeloa ka har'a sebete ka ho kopanngoa le eona ho theha glucuronide le oxidation. Metabolite e ka sehloohong ke "irbesartan glucuronide" e ka bang 6%).

Lenaneong la kalafo ea kalafo, irbesartan e tšoauoa ka li-pharmacokinetics tse mola, ha T1 / 2 mokhatlong oa ho qetela e le lihora tse 11-15. Ho hlakisoa ka botlalo le ho hlaphoheloa ha lipholiso ke 157-176 ml / min le 3-3.5 ml / min, ka ho latellana. Irbesartan le metabolites ea eona li epiloe ka har'a lera le moroto.

Ho bakuli ba nang le bothata ba ho sebetsa ha renal, cirrhosis e leka-lekaneng, litekanyetso tsa pharmacokinetic tsa irbesartan ha li fetoloe haholo.

Litlamorao

Ho tsoa ho tsamaiso ea methapo ea kutlo le litho tsa kutlo: ≥1% - hlooho ea hlooho, ho tsekela, mokhathala, ho tšoenyeha / thabo.

Ho tsoa ho tsamaiso ea pelo le mali (hematopoiesis, hemostasis): ≥1% - tachycardia.

Ho tsoa ts'ebetsong ea phefumoloho: ≥1% - ts'oaetso ea phepelo ea phepelo e phahameng (feberu, joalo-joalo), sinusopathy, sinusitis, pharyngitis, rhinitis, khohlela.

Ho tsoa ho tšilo ea lijo: ≥1% - lets'ollo, ho nyekeloa le pelo, ho hlatsa, matšoao a dyspeptic, letsoalo la pelo.

Ho tsoa ts'ebetsong ea musculoskeletal: ≥1% - bohloko ba musculoskeletal (ho kenyeletsa myalgia, bohloko masapong, sefubeng).

Litla-morao: ≥1% - lekhopho.

Tse ling: ≥1% - bohloko ba ka mpeng, ts'oaetso ea pampitšana ea urinari.

Tekanyetso le tsamaiso

Tekanyetso ea pele ke 150 mg, haeba ho hlokahala, eketsa tekanyetso ho 300 mg. Maemong a mang (lijo tsa hypochloride, kalafo e nang le diuretics tse ling, kalafo ea pele ea ho hlatsa kapa lets'ollo, hemodialysis), ho sebelisoa lethal e ka tlase le qalang.

Irbesartan e nkuoa ka molomo nako e le 1 / letsatsi, ka ho khetheha ka nako e tšoanang ea letsatsi.

Ho sebelisana le lithethefatsi tse ling

Ka ts'ebeliso e ts'oanang le diuretics tsa potasiamo tse sa hlokeng nako, litokisetso tsa potasiamo, keketseho ea litaba tsa potasiamo ho plasma ea mali e ka etsahala.

Ka tšebeliso e tšoanang le hydrochlorothiazide, mofuta oa tlatsetso oa phello ea hypotensive o bonahala.

Ka tšebeliso e tšoanang le lithium carbonate, keketseho ea khatello ea lithium ho plasma ea mali e ka etsahala.

Ka tšebeliso e tšoanang ea fluconazole e ka thibela metabolism ea irbesartan.

Litlhoko tsa ts'ebeliso

E sebelisoa ka hloko ho bakuli ba nang le hyponatremia (kalafo e nang le diuretics, thibelo ea ho ja lijo tse nang le letsoai le lijo, lets'ollo, ho hlatsa) ho bakuli ba hemodialysis (nts'etsopele ea matšoao a tšoaetso e ka etsahala), hammoho le ho bakuli ba nang le metsi.

Ho lokela hore ho sebelisoe tlhokomeliso ho bakuli ba nang le khatello ea methapo ea kutlo ka lebaka la khatello ea methapo ea methapo kapa lesapo la mokokotlo la lehlaba le le leng (kotsi e eketsehileng ea khatello e matla ea methapo le ho se sebetse hantle hoa mokokotlo), aortic kapa mitral stenosis, hypertrophic cardiomyopathy, lefu la pelo le matla haholo (sethala sa IV - IV NYHA) le lefu la pelo la mokokotlo (kotsi e eketsehileng ea infyo ea myocardial, angina pectoris).

Khahlano le nalane ea ts'ebetso ea ho renal e sa sebetseng hantle, ho khothaletsoa ho lekola maemo a serum potasiamo le a creatinine.

Ha e khothalletsoe bakuli ba nang le hyperaldosteronism ea mantlha, ba nang le bothata bo matla ba ho hlaphoheloa (ha ho na boiphihlelo ba bongaka), ho bakuli ba nang le phetisetso ea liphio tsa morao-rao (ha ho na boiphihlelo ba bongaka).

Litaelo tse khethehileng tsa ho amoheloa

Boithutong ba liteko tsa liphoofolo tse sebelisang maiketsetso, mutagenic, clastogenic, le carcinogenic litlamorao tsa irbesartan ha li e-so theoe.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Ha ho na matšoao a phello ea irbesartan ho bokhoni ba ho khanna makoloi le ho sebelisa mechini.

Lithethefatsi tse tšoanang:

• Matlapa a molomo oa Berlipril (Berlipril)
• Matlapa a molomo oa Moxogamma (Moxogamm)
• Diacordin 60 (Diacordin 60) Matlapa a molomo
• Captopril-AKOS (Captopril-AKOS) matlapa a molomo
• Moxonitex (Moxonitex) Matlapa a molomo
• Adelphan-Esidrex (Adelphane-Es> Lipilisi)
• Captopril (Captopril) Matlapa a molomo
• Valz (matlapa a molomo)
• Matlapa a molomo oa Valz H (Valz H)
• Moxonidine (Moxon> Matlapa a Oral

** Tataiso ea ho fana ka litlhare ke bakeng sa tlhahisoleseling. Bakeng sa tlhaiso-leseling e batsi, ka kopo sheba litlhaloso tsa moetsi. Se ke oa ikoetlisa, pele u qala ho sebelisa Ibertan, o lokela ho etela ngaka. EUROLAB ha e ikarabelle bakeng sa litlamorao tse bakoang ke ts'ebeliso ea tlhaiso-leseling e hatisitsoeng portal. Tlhahiso-leseling efe kapa efe e teng sebakeng sa marang-rang ha e nke sebaka sa keletso ea ngaka ebile e ke ke ea fana ka tiiso ea litlamorao tsa lithethefatsi.

O khahloa ke Ibertan? Na u batla ho tseba lintlha tse qaqileng kapa u hloka ho bona ngaka? Kapa o hloka tlhahlobo? O ka khona etsa tumellano le ngaka - Euro tleliniki lab kamehla ts'ebetsong ea hau! Lingaka tse ntle li tla u hlahloba, ho u eletsa, ho fana ka thuso e hlokahalang le ho etsa tlhahlobo ea mafu. U ka khona letsetsa ngaka lapeng. Clinic Euro lab e buletsoe nako eohle.

** Hlokomela! Tlhahisoleseling e hlahisitsoeng tataisong ena ea meriana e etselitsoe litsebi tsa bongaka 'me ha ea lokela ho ba mabaka a ho itlhalosa. Tlhaloso ea lithethefatsi Ibertan e fanoa bakeng sa tlhaiso-leseling ebile ha ea rereloa ho fana ka kalafo ntle le ho nka karolo ha ngaka. Bakuli ba hloka boeletsi bo ikhethang!

Haeba o ntse o thahasella meriana le litlhare tse ling, litlhaloso tsa bona le litaelo tsa tšebeliso, tlhaiso-leseling mabapi le sebopeho le mofuta oa tokollo, matšoao a ts'ebeliso le litlamorao, mekhoa ea ts'ebeliso, litheko le litlhahlobo tsa meriana, kapa na u na le lipotso tse ling le litlhahiso - re ngolle, ka sebele re tla leka ho u thusa.

Lokolla liforomo le sebopeho

U ka reka moemeli oa li-antihypertgency litafoleng tse koahetsoeng ka filimi. Ts'ebetso ea ntho e sebetsang ke irbesartan. Sesebelisoa ke karolo e le 'ngoe, ho bolelang hore metsoako e setseng ha e bontše ts'ebetso ea antihypertensive. Khatello ea irbesartan ka letlapeng le le leng: 75, 150 le 300 mg. U ka reka sehlahisoa seo ka marang-rang (li-pcs tse 14). Lebokose la karete e na le lipakete tse peli tsa sele.

Ketso ea pharmacological

Setlhare se fana ka phello e matlafatsang. Ntho ea mantlha ka sebopeho sa eona e sebetsa e le mohanyetsi oa li-receptor. Sena se bolela hore irbesartan e kena-kenana le ketso ea li-receptor tsa angiotensin II, tse thusang ho boloka marako a methapo ka molumo (fokotsa ho hlaka ha methapo, methapo ea methapo). Ka lebaka leo, sekhahla sa phallo ea mali se fokotseha hanyane.

Ts'ebetso ea angiotensin ea mofuta oa 2 ha e fokotse feela methapo ea mali le keketseho e latelang ea khatello, empa le molao oa tsamaiso ea liplatelete le ho khomarela ha tsona. Ho sebelisana ha li-receptor le lihormone tsena ho thibela tlhahiso ea nitric oxide, e leng ntho e bakang matla. Tlas'a tšusumetso ea Ibertan, mekhoa e hlalositsoeng e ea lieha.

Ntle le moo, ho na le ho fokotseha ha mahloriso a aldosterone. Ena ke hormone ea sehlopha sa mineralocorticoid. E hlahisoa ke adrenal cortex.Mosebetsi oa eona o ka sehloohong ke ho tsamaisa phepelo ea li-cations tsa sodium le potasiamo le anions ea chlorine. Hormone ena e tšehetsa thepa e joalo ea lisele e le hydrophilicity. Aldosterone e kopantsoe le ho nka karolo ha mofuta oa 2 angiotensin. Kahoo, ka ho fokotseha hoa ts'ebetso ea morao-rao, ts'ebetso ea lihomo tsa pele e hatelloa.

Setlhare se fana ka phello e matlafatsang.

Leha ho le joalo, ha ho na phello e mpe ho kinase II, e amehang ho feliseng bradykinin mme e kenya letsoho ho thehoeng ha mofuta oa 2 angiotensin. Irbesartan ha e na phello e kholo tekanyo ea pelo. Ka lebaka leo, kotsi ea mathata a tsoang tsamaisong ea pelo le pelo ha e eketsehe. Ho hlokomeloa hore sesebelisoa se botsoang ha se ame tlhahiso ea triglycerides, cholesterol.

Ka tlhokomelo

Lits'oaetso tse 'maloa tse amanang le tsona li lemohuoa, moo ho hlokahalang ho bonts'a tlhokomelo e eketsehileng, ho kenyelletsa:

• tlolo ea molao oa ho tsamaisa sodium cations,
• lijo tse se nang letsoai
• mosebetsi o sa sebetseng oa renal, haholo, o fokotsa leseli la methapo ea kutlo,
• ho tlosa leqhubu le potlakileng ho tsoa 'meleng, ho kenyeletsa le maemo a pheliso, a tsamaeang le ho hlatsa, lets'ollo,
• tšebeliso ea morao-rao ea thiazide diuretics,
• Nako ea ho hlaphoheloa kamora ho fola
• ho fokotsa phallo ea mali ka methapo ea methapo, e ka bakoang ke stenosis,
• Ho sebelisoa ka nako e le ngoe le litokisetso tse nang le lithium,
• maloetse a endocrine a amanang le ho senyeha ha aldosterone synthetic,
• liphetoho tsa atherosselotic likepeng tsa likhoerekhoere,
• mafu a tsamaiso ea methapo ea pelo: ischemia, ho haella ha tšebetso ea setho sena.

Ka hlokolosi, sethethefatsi se laeloa mafu a lefu la pelo le methapo.

U ka nka Ibertan joang?

Boemong ba pele ba kalafo, tekanyetso ea irbesartan e nyane (150 mg). Phapang e mengata ea ho amoheloa - nako e le 'ngoe ka letsatsi. Moriana o ka nooa ka mpeng e se nang letho, nakong ea lijo kapa kamora ho ja. Leha ho le joalo, maemong a mang, ho hlokahala hore ho fokotsoe tekanyetso e matla le ho feta ea li-mg mg ho isa ho 75 mg ka letsatsi. Letšoao la sena ke ho felloa ke metsi 'meleng, ho fokotseha ha mali a potoloha, ho sebelisa meriana e khothalletsang ho tsoa ha metsi, le lijo tse se nang letsoai.

Haeba 'mele o amohela hampe bonyane litekanyetso tse itseng, joale palo ea irbesartan e nyolleloa ho 300 mg ka letsatsi. Hoa tsebahala hore ho nka tekanyetso e fetang 300 mg ha e eketse phello ea antihypertensive ea lithethefatsi. Ha u fetola tekanyo ea lithethefatsi, likhahla li lokela ho bolokoa (ho fihlela libeke tse 2).

Phekolo ea nephropathy: lithethefatsi li fanoe ka li-150 mg ka letsatsi. Haeba ho hlokahala, tekanyetso ea ntho e sebetsang e eketsoa ho 300 mg (eseng nako e fetang 1 ka letsatsi).

Mokhoa oa ho sebelisa: litekanyetso le kalafo

Ka hare, nako e le 'ngoe ka letsatsi, ho sa tsotelehe lijo, a hlatsuoa ka metsi.

Ka tloaelo tekanyetso e khothalletsoang ea ho qala le ho lokisa ke 150 mg hang hang ka letsatsi. Bakuli ba nang le khaello ea metsi, le palo e fokolisitsoeng ea mali a potileng (BCC) (ho kenyelletsa le lets'ollo, ho hlatsa), le hyponatremia, nakong ea kalafo ka diuretics kapa lijo tse nang le phepo e fokolang ea sodium chloride, kapa hemodialysis, kapa bakuli ba lilemo tse fetang 75 ba khothaletsoa tekanyetso ea pele ea moriana. - 75 mg ka letsatsi.

Ka boholo bo sa lekaneng ba phello ea kalafo, lethal dose le eketseha ho isa ho 300 mg ka letsatsi. Keketseho e 'ngoe ea lethal dose le nako ea libeke tse 1-2 (ho feta 300 mg ka letsatsi) ha e phahamise ho teba ha phello ea hypotensive. Haeba ho se na phello nakong ea monotherapy, ho kopantsoe le lithethefatsi tse ling tsa antihypertgency, mohlala, ka litekanyetso tse tlase tsa diuretics (hydrochlorothiazide), hoa khoneha.

Bakeng sa kalafo ea nephropathy, bakuli ba nang le khatello ea methapo ea kutlo le mofuta oa 2 lefu la tsoekere ba khothalletsoa lethal dose la Ibertan 150 mg hang ka letsatsi, haeba phello ea kalafo e sa lekana, tekanyo e ka eketsoa (ka nako ea libeke tse peli) ho isa ho 300 mg hang ka letsatsi.

Bakuli ba nang le ts'ebetso ea renal e sa sebetseng ha ba hloke phetoho ea tekanyetso.

Bakuli ba nang le ts'ebetso ea sebete e sa sebetseng ha hoa hlokahala. Ha ho na boiphihlelo ba tsa bongaka le bakuli ba nang le ts'ebetso ea sebete e matla haholo.

Ibertan - litaelo tsa tšebeliso, litheko, litekolo

Ka pela hao ho na le leseli mabapi le boitokisetso ba Ibertan - taelo e hlahisoa phetolelong ea mahala mme e romelloa feela bakeng sa tlhaiso-leseling. Lipolelo tse hlahisitsoeng webosaeteng ea rona hase lebaka la ho ikoetlisa.

Bahlahisi: Polpharma S.A. Zaklady Farmaceutyczne SA, PL

Lintho tse sebetsang
Sehlopha sa mafu

• Bohlokoa Hypertension ea mantlha
• Sekolo se phahameng sa khatello ea mali

Sehlopha sa tliliniki le meriana

• Ha e hlalositsoe. Bona litaelo

Ketso ea pharmacological
Sehlopha sa mahlale

• Angiotensin II receptor antagonists (AT1 subtype)

Ho sebelisana le lithethefatsi tse ling

Ka ts'ebeliso e ts'oanang le diuretics tsa potasiamo tse sa hlokeng nako, litokisetso tsa potasiamo, keketseho ea litaba tsa potasiamo ho plasma ea mali e ka etsahala.

Ka tšebeliso e tšoanang le hydrochlorothiazide, mofuta oa tlatsetso oa phello ea hypotensive o bonahala. Ka tšebeliso e tšoanang le lithium carbonate, keketseho ea khatello ea lithium ho plasma ea mali e ka etsahala.

Ka tšebeliso e tšoanang ea fluconazole e ka thibela metabolism ea irbesartan.

E sebelisoa ka hloko ho bakuli ba nang le hyponatremia (kalafo e nang le diuretics, thibelo ea ho ja lijo tse nang le letsoai le lijo, lets'ollo, ho hlatsa) ho bakuli ba hemodialysis (nts'etsopele ea matšoao a tšoaetso e ka etsahala), hammoho le ho bakuli ba nang le metsi.

Ho lokela hore ho sebelisoe tlhokomeliso ho bakuli ba nang le khatello ea methapo ea kutlo ka lebaka la khatello ea methapo ea methapo kapa lesapo la mokokotlo la lehlaba le le leng (kotsi e eketsehileng ea khatello e matla ea methapo le ho se sebetse hantle hoa mokokotlo), aortic kapa mitral stenosis, hypertrophic cardiomyopathy, lefu la pelo le matla haholo (sethala sa IV - IV NYHA) le lefu la pelo la mokokotlo (kotsi e eketsehileng ea infyo ea myocardial, angina pectoris). Khahlano le nalane ea ts'ebetso ea ho renal e sa sebetseng hantle, ho khothaletsoa ho lekola maemo a serum potasiamo le a creatinine.

Ha e khothalletsoe bakuli ba nang le hyperaldosteronism ea mantlha, ba nang le bothata bo matla ba ho hlaphoheloa (ha ho na boiphihlelo ba bongaka), ho bakuli ba nang le phetisetso ea liphio tsa morao-rao (ha ho na boiphihlelo ba bongaka).

Irbesartan: analogues, litaelo tsa tšebeliso, litheko le litlhahlobo

Khatello e phahameng ea khatello ea mali, ho seng joalo khatello e phahameng ea mali ke e 'ngoe ea maloetse a atileng haholo mehleng ena ea rona. Ha a na lilemo kapa bong. Boloetse bona bo na le methati e mene ea ntlafatso, 'me e' ngoe le e 'ngoe e tsamaisana le kalafo ea eona. Irbesartan ke e 'ngoe ea lithethefatsi tse thusang ho sebetsana le khatello ea mali le ho boloka bophelo bo botle.

Litaelo tsa ts'ebeliso, litheko le litlhahlobo mabapi le ho khutlisa Irbesartan ka li-analogues tse theko e tlaase, bala ka tlase.

Kopo ea ts'ebetso ea renal e senyehileng

Ho sitoa ke lefu lena ha se lebaka la ho tlohela kalafo. Ha u ntse u sebelisa lithethefatsi khahlanong le semelo sa boemo bona ba methapo, ho lokela ho sebelisoe tlhokomeliso.

Nts'etsopele ea li-pathologies tsa sebete tse bonolo hase lebaka la ho tlohela lithethefatsi.

Bongata ba Ibertan

Hangata, bakuli ba theola khatello ea mali haholo, ha ho atisang ho ba le tachycardia. Maemong a ikhethileng, matšoao a bradycardia a etsahala. Ho fokotsa botebo ba lipontšo tse mpe ho tla thusa ho senya sefuba, ho beoa ha linohe (ha feela hore moriana o sa tsoa nkuoa). Ho felisa matšoao a motho ka mong, ho fanoa ka litlhare tse ikhethang tse khethehileng, ka mohlala, ho etsa hore morethetho oa pelo o be le maemo, khatello ea khatello.

Ho tsamaisana le joala

Kaha ethanol e kenya letsoho katolosong ea methapo ea mali, ha ho kgothaletswe ho sebelisa lino tse nang le joala nakong ea kalafo le Ibertan. Tabeng ena, ts'ebetso ea antihypertgency ea lithethefatsi ea eketseha.

Kaha ethanol e kenya letsoho katolosong ea methapo ea mali, ha ho kgothaletswe ho sebelisa lino tse nang le joala nakong ea kalafo le Ibertan.

Likhetho tse sebetsang tsa ho fetola sethethefatsi seo ho buuoang ka sona:

• Irbesartan
• Irsar
• Aprovel
• Telmisartan.

Khetho ea pele ke e nkang Iberta ka kotloloho. Sesebelisoa sena se na le motsoako o tšoanang o sebetsang. Litekanyetso tsa eona ke 150 le 300 mg ho 1 Letlapa. Ho ea ka liparamente tse ka sehloohong, Irbesartan ha e tšoane le Ibertan.

Irsar ke analogue e 'ngoe ea lithethefatsi tseo ho buuoang ka tsona. Ha e fapana ka sebopeho, litekanyetso tsa ntho e sebetsang, matšoao le li-contraindication. Lichelete tsena ke tsa mokhahlelo o tšoanang oa theko. Sebaka se seng hape (Aprovel) se bitsa chelete e nyane ho feta (li-ruble tse 600-800). Fomu ea tokollo - matlapa. Ho 1 pc e na le 150 le 300 mg ea irbesartan. Ka lebaka leo, lithethefatsi li ka hlalosoa hape ho e-na le lithethefatsi tseo ho buuoang ka tsona.

Telmisartan e na le karolo ea lebitso le tšoanang. Palo ea eona ke 40 le 80 mg ho 1 Letlapa. Molao-motheo oa ts'ebetso ea lithethefatsi o thehiloe ho thibela ts'ebetso ea li-receptors tse sebetsanang le angiotensin II. Ka lebaka leo, khatello e fokotsehile. Kahoo, ho ea ka mochine oa ts'ebetso, Telmisartan le lithethefatsi tse ho buuoang ka tsona lia tšoana. Matšoao a sebelisoang: khatello ea mali, thibelo ea nts'etsopele ea mathata (ho kenyeletsa le lefu) ho mafu a pelo.

Telmisartan e na le likhohlano tse ling hape. Thibelo ea ts'ebeliso ea lithethefatsi nakong ea kemolo, ho lactation, bongoaneng, le tlolo ea mokhoa oa biliary, sebete e boletsoe. Ha ho khothalletsoe ho e kopanya le lithethefatsi tse tsoang sehlopheng sa li-inhibitors tsa angiotensin-converting. Ka chelete e nahanoang, Telmisartan ke eona feela e ka sebelisang sebaka sa Ibertan, ha feela ho se mamellehe ho karolo e sebetsang ea irbesartan.

Sebopeho le thepa

Matla a antihypertensive a lithethefatsi a fana ka motsoako o ka sehloohong oa epusive. Irbesartan ke inhibitor ea angiotensin ea hormone, e bakang spasms ea vascular.

Ts'ebetso ea irbesartan ke ho hatella phello ea vasoconstrictor le ho fokotsa mojaro pelong. Setlhare se etselitsoe tšebeliso ea nako e telele. Khokahanyo ea tlhoro e etsahala ka lihora tse 4-5 kamora hore u noe moriana.

Matla a phehella letsatsi lohle. Kamora matsatsi a 10-14 a ho ja khafetsa, ho tsitsa hoa atleha.

Setlhare se kenngoa ka potlako ke pampitšana ea ka mpeng. Palo ea lihlahisoa tsa lithethefatsi tse fihlang locus ea ts'ebetso e fihla ho 80%. Khatello e phahameng maling e bonoa lihora tse peli kamora ho sebelisa moriana. Irbesartan ha e bokelle 'meleng, ts'ebetso ea ho tlosa e etsoa ke sebete ho fihlela 80%, se phomotsang se pepesetsoa ke liphio.

Matšoao le contraindication

Setlhare se sebelisetsoa ho alafa khatello ea mali e bohlokoa (e sa foleng). Lithethefatsi e sebetsang bakeng sa kalafo ea khatello ea mali hammoho le lefu la methapo ea methapo ho lefu la tsoekere (lefu la tsoekere).

Phekolo ea Irbesartan ha e khethoe maemong a latelang:

• nako ea ho beleha ngoana le ho anyesa,
• maikutlo a phahameng kahare ho metsoako ea lithethefatsi,
• lefu la lefutso la lefutso le sa lokang la li-monosaccharides ka seterateng sa gastrointestinal (glucose-galactose malabsorption),
• lilemo tse nyane (ho fihlela lilemo tse 18).

Ho hlokahala tlhokomeliso nakong ea kalafo ea lithethefatsi haeba mokuli a e-na le mafu a latelang:

• fokotseha ha lumen (stenosis) ea aortic valve,
• pelo e sa foleng,
• ho omella
• Keketseho ea sodium 'meleng,
• furu ea methapo ea kutlo,
• ho koenya ho koatile.

Bakeng sa bakuli ba lilemo li 75+, ha ho mori o boletsoeng.

Ha ho bohlale ho sebelisa lithethefatsi bakeng sa ho buoa ka hepatic, kaha ha ho na data ea bongaka.

Fomola foromo le litekanyetso

Moriana o fumaneha ka foromo ea lipilisi ho 75, 150, 300 mg.

Mokhoa o tloaelehileng oa kalafo o qala ka tekanyetso ea 150 mg. Ho latela boemo ba mokuli, litekanyetso li ka eketsoa ho 300 mg, kapa tsa fokotsoa ho 75 mg. Bakeng sa bakuli ba nang le lefu la liphio, phetoho ea litekanyetso e qala ho 75 mg.

Phekolo ena e lula e behiloe leihlo khatello ea mali.

Litšobotsi

Moriana o na le litlamorao, o bonahatsoang ke matšoao a latelang:

Normodipine le analogues tsa moriana.

• mokhathala le ho tsekela,
• ho tšoenyeha ho sa utloahaleng,
• lebelo le phahameng la pelo (tachycardia),
• paroxysmal khohlela
• ho ts'oaroa ke lets'ollo (lets'ollo, tšilo ea lijo tse bohloko),
• karabelo
• mesifa ea mesifa
• mosebetsi o senyehileng oa erectile ho banna.

Ho bakuli ba nang le lefu la tsoekere le lefu la tsoekere, ho fokotseha ha maemo a hemoglobin maling ho a khonahala.

Matla a sethethefatsi a ntlafatsoa le tšebeliso e ts'oanang ea diuretics le meriana e meng e theolang khatello ea mali.

Ha e kenngoa hammoho le li-supplement tsa potasiamo, menyetla ea ho ba le hyperkalemia e eketseha.

Ho sebelisana le lithethefatsi tse e seng tsa steroid tse thibelang mafu ho ama ts'ebetso ea liphio.

Ho sebelisa lithethefatsi tse ngata ho feta tekano ho kotsi bakeng sa mathata a pelo. (tachycardia, bradycardia).

Irbesartan e etsoa ke Kern Pharma S.L. (Spain). Litsenyehelo tsa ho paka ke li-ruble tse 350.

Phekolo ea Substitution e ka etsoa ka mokhoa o ts'oanang le irbesartan. Kaha litaelo tsa tšebeliso li tšoana, hangata ho sebelisoa meriana le meriana e thehiloeng ho amlodipine.

E fumaneha ka foromo ea letlapa. Lithako tse thusang ke: letsoai la magnesium le acid e tsoekere, silicon dioxide, lactose, selulose, croscarmellose sodium, hypromellose. Setlhare se na le thepa e tšoanang le ea Irbesartan.

E sebelisoa ho phekola khatello ea methapo ea methapo ea pele le ea bobeli, le kalafo ea khatello ea mali ho batho ba lefu la tsoekere. Phekolo e qala ka tekanyetso e fokolang ea 150 mg, kamora ho ba le matla a matla, litekanyetso li imena habeli.

Analogue e fapana le ea mantlha ho seo bakuli ba nang le lefu la liphio ha ba hloke phetoho ea litekanyetso. Moqapi ke k'hamphani ea Fora ea Sanofi-Winthrop Industrie. Theko e tsoa ho li-ruble tse 350 ho isa ho 700, ho latela sephutheloana.

Lithethefatsi tsa Russia, analogue e phethahetseng ea Ibersartan.

E na le matšoao a tšoanang, li-contraindication le litla-morao. E fanoe ka tekanyetso e tšoanang le ea mantlha. E entsoe ke Canonfarm Production CJSC.

Theko ea lithethefatsi ke li-ruble tse 250.

Setlhare ha se fapana maemong a pharmacological ho tsoa ho Irbesartan.

E fumaneha ka foromo ea letlapa. Matlapa a 75 mg Khetho le litekanyetso li tšoana le tsa mantlha.

Setlhare sena se hlahisoa Poland, ke semela sa limela sa polpharma S.A. Litšenyehelo li ka ba li-ruble tse 200.

Li-pharmacokinetics le litlamorao tsa lithethefatsi li tšoana le tsa mantlha. E khethoa ka tekanyetso ea 150 mg. Ha ho na le phello ea kalafo, lethal dose le eketseha ho 300 mg. Bakuli ba nang le methapo ea kutlo e khothalletsoang ho qala kalafo ka 75 mg. Setlhare sena se etsoa ke KRKA d.d. (Slovenia). Matlapa a 150 mg

Hangata Irbesartan le li-analogues tsa eona li mamelloa hantle ke bakuli. Haeba tekanyetso e boletsoeng ke ngaka e bonoa, litla-morao li ka hlaha. Setlhare se sebelisoa ho tsa bongaka le tsa pelo.

Mme o lilemo li 60. O bile le khatello ea khatello e phahameng ea mali ka lilemo tse ka bang 10. Ke lekile ho sebelisa lithethefatsi tse fapaneng, empa litla-morao li lula li hlaha. Ngaka e laetse Irbesartan, empa ea lemosa hore moriana o lokela ho nooa nako e telele. Sesebelisoa sena se ne se sebetsa hantle bakeng sa mme. Ha ho litla-morao. E se e nkile likhoeli tse peli, khatello e tsitsitse.

Ha ke le lilemo li kae, ke ile ka qala ho ba le likeleli tsa khatello kelellong, tsebe e lerata litsebeng tsa ka, 'me hlooho ea ka ea utloa bohloko. Ngaka e ile ea eletsa French Aprovel.Setlhare sena se nthusitse hantle, empa theko e holimo haholo. Ka lebaka la hore hoa hlokahala ho e noa kamehla, ke ile ka kopa ho e nkela e tšoanang le ea Serussia. Hona joale ke noa Irsar. Ha ho na phapang ea sensations, empa e bitsa tlase.

Ka molao, Irbesartan ha ea ka ea nkama. Kamora kamohelo, pelo ea ka e ile ea qala ho otla ka thata. Boemo ha boa ka ba ntlafala, empa bo mpefala. Ke ile ka tlameha ho e nkela sethethefatsi se seng se sebetsang hantle ho 'na.

Ibertan Plus

Lithethefatsi tse ling tsa antihypertensive: litlamorao tsa antihypertensive tsa lithethefatsi Ibertan Plus li ka matlafatsoa ke tšebeliso e tšoanang ea lithethefatsi tse ling tsa antihypertensive.

Hydrochlorothiazide le irbesartan (ka tekanyetso e ka bang 25 mg ea hydrochlorothiazide / 300 mg ea irbesartan) e ka sebelisoa ka mokhoa o sireletsehileng hammoho le lithethefatsi tse ling tsa antihypertensive, ho kenyeletsoa li-blockers tsa "calcium" tse liehang ho feta.

Pele e neng e phekoloa ka litekanyetso tse phahameng tsa diuretics e ka lebisa ho nyekelo ea pelo le ho eketsa kotsi ea lefu la sethoathoa.

Lithium: Ho na le litlaleho tsa keketseho e feto-fetohang ea mohopolo oa serum ea lithium le chefo ka ts'ebeliso e kopaneng ea litokisetso tsa lithium le li-inhibitors tsa angiotensin-converting enzyme. Bakeng sa irbesartan, litlamorao tse tšoanang li bile ka seoelo haholo kajeno.

Ntle le moo, netefatso ea renal ea lithium e fokotseha ka tšebeliso ea li-thiazide diuretics, ka hona, ha ho ngoloa Ibertan Plus, ho na le monyetla oa ho ba le tšusumetso e matla ea lithium.

Haeba sepheo sa ho kopanya sena se hlokahala, ho kgothaletswa ho lekola ka hloko litaba tsa lithium tse serumeng ea mali.

Meriana e amang potasiamo maling: phello ea hypokalemic ea hydrochlorothiazide e fokotsoa ke matla a bolokang potasiamo ea irbesartan.

Leha ho le joalo, ts'ebetso ena ea hydrochlorothiazide e kanna ea ntlafatsoa ke lithethefatsi tse ling, sepheo sa sona se amanang le tahlehelo ea potasiamo le gnococalpemia (mohlala, diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, litlolo tse tsoang ho salicelic acid) Ho fapana le seo, ho latela boiphihlelo ba ho sebelisa lithethefatsi tse fokotsang tšebetso. Angiotensin-aldosterone sistimi, tšebeliso e tšoanang ea ts'oaetso ea potasiamo. li-additives tsa oiologically tse sebetsang, li-substitute tsa letsoai la potasiamo, kapa lithethefatsi tse ling tse ka lebisang keketseho ea serum potasiamo (joalo ka sodium heparin) e ka baka kholo ea serum Katya. Ho khothalletsoa hore u lekole ka nepo serum potasiamo ho bakuli ba kotsing ea ho ba le hyperkalemia.

Meriana e anngoeng ke tlolo ea tekanyetso ea potasiamo serumeng ea mali: Ho khothalletsoa hore ho fanoe ka hloko ho lekola dikahare tsa potasiamo tse serumeng sa mali ha ho laeloa Ibertan Plus hammoho le lithethefatsi tse anngoeng ke tlolo ea tekanyetso ea potasiamo e serum ea mali (mohlala, glycosides ea pelo, lithethefatsi tsa antiarrhythmic).

Lithethefatsi tse sa hlaselong tsa ho ruruha: ha o fana ka lingoloa tsa li-angotensin II receptor antagonists hammoho le lithethefatsi tse seng tsa steroid le tse khahlanong le ho ruruha (mohlala, le li-inhibitors tse khethiloeng tsa cycloo oxygenase-2 (COX-2), lithethefatsi tse seng khahlanong le ts'oaetso tsa anti-inflammatory), li ka fokolisa li-antiglertins. Joalo ka ts'ebeliso ea angiotensin e fetolang li-enzyme inhibitors le li-angiotensin II receptor antagonists hammoho le NSAIDs, ho na le menyetla e eketsehileng ea ts'ebetso ea mokokotlo oa mokokotlo, ho fihlela nts'etsopele ea ho hloleha ha renal e matla, potasiamo e eketsehileng ea serum, haholoholo ho bakuli ba seng ba senyehile ke ts'ebetso ea renal. Motsoako ona oa lithethefatsi o lokela ho laeloa ka hloko, haholoholo ho bakuli ba tsofetseng. Bakuli ha baa lokela ho omelloa ke metsi. Ho lekola mesebetsi ea matsoho ho lokela ho etsoa kamora ho qala kalafo ea ho kopanya le nako le nako nakong e tlang.

Tlhahisoleseling e eketsehileng mabapi le tšebelisano ea lithethefatsi ea irbesartan: hydrochlorothiazide ha e ame pharmacokinetics ea irbesartan.

Ha ho ne ho ngoloa irbesartan hammoho le warfarin, e thehiloeng ke bahloekisi ba CYP2C9 isoenzyme, ha ho na ts'ebelisano e kholo ea pharmacokinetic le pharmacodynamic.

Matla a CYP2C9 isoenzyme inductors, joalo ka rifampicin, ho pharmacokinetics ea irbesartan ha a hlahlojoa. Ka ho khethoa ha irbesartan hammoho le digoxin, li-pharmacokinetics tsa morao ha lia ka tsa fetoha.

Tlhahisoleseling e eketsehileng mabapi le tšebelisano ea lithethefatsi ea hydrochlorothiazide:

Meriana e latelang e ka sebelisana le thiazide diuretics ha u ntse u fana ka taelo:

Ethanol, barbiturates kapa lithethefatsi tsa narcotic: hypotension e eketsehileng ea orthostatic e ka bonoa.

Hypoglycemic lithethefatsi (li-agents tsa molomo le insulin): tokiso ea tekanyetso ea li-hypoglycemic agents e ka hlokahala.

Colestyramine le colestipol: boteng ba li-resin tsa phapanyetsano ea anion, ho monya ha hydrochlorothiazide hoa khathatseha. Nako e pakeng tsa ho sebelisa meriana ena e lokela ho ba bonyane lihora tse 4.

Glucocorticosteroids, hormone ea adrenocorticotropic: tšoaetso e tšoailoeng ea tekanyetso ea motlakase oa motlakase, haholoholo, ho eketseha hoa hypokalemia.

Catecholamines (mohlala, norepinephrine): katleho ea meriana ena e ka fokotsoa.

Boikhathollo ba mesifa e sa nyenyefatseng (mohlala, tubocurarine): hydrochlorothiazide e ka baka litlamorao tsa phomolo e sa nyenyefatso ea mesifa.

Meriana ea anti-gout: ho lokisoa ha lithethefatsi tse ngata tse sebelisoang ho phekola gout ho ka hlokahala, hobane hydrochlorothiazide e ka eketsa litaba tsa uric acid ka plasma ea mali. Keketseho ea tekanyetso ea probenenide kapa sulfinpyrazone e kanna ea hlokahala. Ts'ebetso ea tšebelisano 'moho le diaztiti tsa thiazide e ka eketsa liketsahalo tsa hypersensitivity reaction ho allopurinol.

Kalsiamo ea calcium thiazide diuretics e ka eketsa khalsiamo ea plasma ka lebaka la ho fokotseha ha mantle a eona. Haeba ho hlokahala ho fana ka litlatsetso tsa khalsiamo kapa lithethefatsi tse amang khalsiamo (ka mohlala, vithamine D), ho hlokahala hore o fetole tekanyo ea lithethefatsi tsena ka mokhoa o nepahetseng le ho laola sethala sa calcium ho plasma ea mali.

Mefuta e meng ea ts'ebeliso ea lithethefatsi: Li-thiazide diuretics li ka ntlafatsa phello ea hyperglycemic ea beta-blockers le diazoxide.

Anticholinergics (kk., Atropine) e ka eketsa bioavailability ea thiazide diuretics ka ho fokotsa sekhahla sa lefu la gastrointestinal and gastric sheding rate. Thiazide diuretics e ka eketsa kotsi ea ho etsa lintho tse mpe tse bakoang ke amantadine.

Thiazide diuretics e ka fokotsa tlhahiso ea lithethefatsi tsa cytotoxic ke liphio (mohlala, cyclophosphamide, methotrexate) le ho hlahisa phello ea myelosuppression.

Tlhaloso, litaelo tsa ts'ebeliso:

Litaelo tsa ho sebelisa Ibertan tab. 150mg No. 28 Reka Ibertan tab. 150mg No. 28

Mefuta ea Litekanyetso

Baetsi

Polfa SA (Poland)

Sebopeho le mofuta oa tokollo

Letlapa le koahetsoeng ka filimi ea Ibertan

1 tab e na le irbesartan (ka sebopeho sa hydrochloride) 75, 150 le 300 mg, ka har'a sephutheloana sa 28 likhomphutha.

Ketso ea pharmacologicalIbertan ke moemeli oa hypotensive, angiotensin II (mofuta AT1) receptor blocker.

E fokotsa khatello ea methapo ea aldosterone ho plasma (ha e hatelle kinase II, e senya bradykinin), e tlosa phello ea vasoconstrictor ea angiotensin II, e fokotsa OPSS, e fokotsa khatello ea mali, khatello ea mali le khatello ea "potoloho" e nyane ea potoloho ea mali.

Ha e ame ho sithabela ha TG, cholesterol, tsoekere, uric acid ho plasma le excretion ea uric acid ka har'a moroto.

Phello e phahameng e ba teng ka mor'a lihora tse 3-6 kamora tekanyetso e le 'ngoe, nako ea ts'ebetso ke lihora tse 24, kamora libeke tse 1-2 ho latela ts'ebeliso ea phello e tsitsitseng ea kliniki e fumanehang.

Matšoao
Phekolo ea methapo, ho kenyeletsa ha e kopantsoe le lefu la tsoekere la mofuta oa 2.

ContraindicationHypersensitivity, moimana, ho lactation, lilemo tse ho fihlela lilemo tse 18.

Ka tlhokomeliso. CHF, GOKMP, aortic kapa mitral valve stenosis, ho omella, hyponatremia, hemodialysis, hypo-letsoai ja lijo, lets'ollo, ho hlatsa, ho se sebetse hantle kapa lefu la methapo ea methapo.

Tekanyetso le tsamaisoIbertan e nooa ka molomo, nakong ea lijo kapa ka mpeng e se nang letho, letlapa leo le metsoa kaofela, le hlatsuoa ka metsi.

Motsoako oa pele le oa ho hlokomela ke 150 mg / letsatsi ka tekanyetso e le 'ngoe, haeba ho hlokahala, lethal dose le eketseha ho isa ho 300 mg / ka letsatsi (keketseho e eketsehileng ea lethalamo ha e eketse ho teba ha phello ea hypotensive).

Haeba ho se na phello nakong ea monotherapy, litekanyetso tse tlase tsa diuretics (hydrochlorothiazide) li kenyelletsoa ka mokhoa o tšoanang.

Tekanyetso ea pele ho bakuli ba nang le khaello ea metsi, hyponatremia (ka lebaka la kalafo e nang le diuretics, thibelo ea tšebeliso ea letsoai ka lebaka la lijo, lets'ollo, ho hlatsa) ho hemodialysis ke 75 mg.

LitlamoraoHo fokotseha ho feteletseng ha khatello ea mali (ho 0,4% ea linyeoe) - hlooho ea hlooho, ho tsekela, ho nyekelwa ke pelo, ho hlatsa, bofokoli.

Maemong a sa tloaelehang, ho shebella ho bapatsa ka morao ho marang-rang ho kenyelletsa asthenia, dyspepsia (ho kenyelletsa le lets'ollo), ho tsekela, ho opeloa ke hlooho, hyperkalemia, myalgia, ho nyekeloa ke pelo, tachycardia, ts'ebetso ea sebete e sa sebetseng (ho kenyeletsa le

hepatitis) le a liphio (ho kenyelletsa ho hloleha ha renal ho bakuli ba kotsing e kholo).

Irbesartan ha e sebetse ho aldosteronism ea mantlha (tšebeliso ea eona ha e khothalletsoe)

Litaelo tse khethehilengPhekolo e lokela ho ba tlasa khatello ea mali.

Ho bakuli ba nang le metsi 'meleng, hammoho le bofokoli ba Na + (ka lebaka la kalafo e matla e nang le diuretics, lets'ollo kapa ho hlatsa, thibelo ea tšebeliso ea letsoai le lijo) le ho bakuli ba hemodialysis, matšoao a tšoaetso a ka hlaha, haholoholo kamora ho nka tekanyetso ea pele ea moriana.

Ho bakuli ba nang le bothata ba ho phekoloa ka lipholiso, ho lokela ho etsoa ho shebella nako le nako ha khatello ea K + le creatinine e le plasma. Ka ho se sebetse hantle ha pelo, mafu a liphio (ho kenyeletsa le renal artery stenosis), kotsi ea ho fokotseha ho hoholo ha khatello ea mali, azotemia, oliguria, ho fihlela ho se sebetse hantle ha renal, ho eketseha ka ischemic cardiomyopathy - kotsi ea angina pectoris le infyo ea myocardial.

Nakong ea kalafo, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlaka haholo ha maikutlo a psychomotor (ho tsekela le ho tepella ho eketsehileng hoa khoneha).

Ho sebelisana le lithethefatsiDiuretics le lithethefatsi tse ling tsa antihypertensive li matlafatsa phello. Pele kalafo e nang le diuretics ka tekanyetso e phahameng e ka lebisa ho omella 'me ea eketsa menyetla ea ho fokotseha ho feteletseng ha khatello ea mali.

Ho phekoloa ka nako e le 'ngoe le heparin, potrateum-sparing diuretics, kapa lithethefatsi tse ling tse nang le K + ho ka lebisa ho eketseha ha mahloriso a K + plasma. Boithuto ba in vitro bo bontšitse phello e ka khonehang ho metabolism ea lithethefatsi tsa irbesartan tse entsoeng ka tšebetso ea CYP2C9 isoenzyme kapa li-inhibitors tsa eona.

Kameho ea li-inducers tsa CYP2C9 isoenzyme (ho kenyeletsa le rifampicin) ha e so ithutoe. Ho sebelisana le lithethefatsi, metabolism ea eona e itšetlehile ka isoenzymes CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2D6, CYP2E1, CYP3A4, ha ea ka ea fumanoa ka vitro.

Ka mokhoa o ka khonehang, keketseho e feto-fetoheng ea plasma Li + mahloriso e ka khona (ho hlokahala hore ho be leihlo). Ha e ame likarolo tsa pharmacokinetic tsa digoxin.

Hydrochlorothiazide, nifedipine ha e ame litekanyetso tsa pharmacokinetic tsa irbesartan.

Bongata Matšoao: tachy- kapa bradycardia, ho fokotseha ho feteletseng ha khatello ea mali, ho oa.

Phekolo: Motsoako o mongata oa gastric, ho ts'oaroa ha khabone e sebetsoang, kalafo ea matšoao, hemodialysis ha e na thuso.

Maemo a polokelo
Sebakeng se lefifi ka mocheso o sa phahame ho feta + 25 ° C.

Ho fumaneha le litheko ho Stolichki Apotek:

Lihlahisoa ha li fumanehe litlhare tsa meriana tsa Stolichki. Leha ho le joalo, o lokela ho leka ho ikopanya le tel. 8 (495) 215-5-215 bakeng sa tlhaiso-leseling e batsi ka phumaneho ea thepa likhoebong tsa meriana ho la Moscow. Tlhahisoleseling e mabapi le sebaka sa marang-rang e ne e ke ke ea ba le nako ea ho nchafatsoa.

Theolelo ea ho lokolla, ho paka le ho bopa Ibertan Plus

7 likhomphutha - marangrang (4) - lipakete tsa karete.
Li-pcs tse 10 - lithutsoana (3) - lipakete tsa karete.
14 li-PC. - Mabokose (2) - lipakete tsa karete.
Li-pcs tse 15. - Mabokose (2) - lipakete tsa karete.

7 likhomphutha - marangrang (4) - lipakete tsa karete.
Li-pcs tse 10 - lithutsoana (3) - lipakete tsa karete.
14 li-PC. - Mabokose (2) - lipakete tsa karete.
Li-pcs tse 15. - Mabokose (2) - lipakete tsa karete.

7 likhomphutha - marangrang (4) - lipakete tsa karete.
Li-pcs tse 10 - lithutsoana (3) - lipakete tsa karete.
14 li-PC. - Mabokose (2) - lipakete tsa karete.
Li-pcs tse 15. - Mabokose (2) - lipakete tsa karete.

Melemo ea litekanyetso

Ka hare, hang ka letsatsi, ho sa tsotelehe lijo tse jang.

Ibertan Plus 12.5 / 150 mg (matlapa a nang le hydrochlorothiazide / irbesartan 12.5 / 150 mg, ka ho latellana) a ka fuoa bakuli bao khatello ea mali e sa laoloeng ka ho lekana ka ho khethoa ha hydrochlorothiazide feela (12,5 mg / letsatsi) kapa irbesartan (150 mg / letsatsi) ka monotherapy.

Ibertan Plus 12.5 / 300 mg (matlapa a nang le hydrochlorothiazide / nrbesartan 12.5 / 300 mg, ka ho latellana) a ka fuoa bakuli haeba khatello ea mali e sa laoloe ka nepo ke irbesartan (300 mg / letsatsi) kapa Ibertan Plus (12.5 / 150 mg).

Ibertan Plus 25-300 mg (matlapa a nang le hydrochlorothiazide / irbesartan 25/300 mg, ka ho latellana) a ka laeloa bakuli haeba khatello ea mali e sa laoloe ka nepo ke tsamaiso ea Ibertan Plus (12,5 / 300 mg). Ho khethoa ha litekanyetso li kaholimo ho 25 mg ea hydrochlorothiazide / 300 mg ea irbesartan nako e le ngoe ka letsatsi ha e khothalletsoe.

Haeba ho hlokahala, moriana Ibertan Plus o ka laeloa hammoho le litlhare tse ling tsa antihypertensive.

Ts'ebetso ea renal e senyehileng: ka lebaka la taba ea hore motsoako oa lithethefatsi Ibertan Plus o kenyelletsa hydrochlorothiazide. setlhare ha se khothalletsoe ho bakuli ba nang le bothata ba ho ruruha ba masapo a mantle (tumello ea creatinine 30 ml / min.

Ts'ebetso ea sebete e senyehileng: ts'ebeliso ea Ibertan Plus ha e khothalletsoe ho bakuli ba nang le bothata bo matla ba ho ba le hepatic. Bakeng sa bakuli ba nang le bothata bo fokolang ba ho leka-lekana ha hepatic, ho hlokahala hore ho fetotsoe litekanyetso tsa lithethefatsi tsa Ibertan Plus.

Bakuli ba tsofetseng: Phetoho ea tekanyetso ea Ibertan Plus ha e hloke ho bakuli ba tsofetseng.

Boholo ba mali bo potolohang bo fokotsehile: pele ho lengolo la Ibertan Plus, hoa hlokahala ho lokisa bophahamo ba mali le / kapa litaba tsa sodium.

Litla-morao

Litlamorao tse latelang li fanoa ho latela lits'ebetso tse latelang tsa khafetsa tsa liketsahalo tsa tsona: khafetsa (> 1/10), hangata /> 1/100, 1/1 000, 1/10 000, motsoako oa hydrochlorothiazide / irbesartan:

Ho tloha lehlakoreng la methapo ea methapo e bohareng: hangata - ho tsekela, ho tloaetse ho etsa lintho tse ling kapa ho soetseha ha meno.

Karolong ea tsamaiso ea methapo ea pelo: syncope e sa fetoheng, ho fokotseha ho hoholo ha khatello ea mali, tachycardia, edema ea pheriti, "ho thunya" ha mali letlalong la sefahleho.

Ho tsoa ho ts'ilo ea lijo: hangata - ho nyekeloa, ho hlatsa, lets'ollo le sa sebetseng.

Ho tsoa ts'ebetsong ea moroto: khafetsa - tlolo ea ho ntša urination.

Ho tsoa ts'ebetsong ea genitourinary: hangata - ho se sebetse ka thobalano, libido e senyehileng.

Tse ling: khafetsa - ho tepella.

Matšoao a laboratori: khafetsa - keketseho ea khatello ea urea naetrojene, creatinine le plasma creatine phosphokinase, hangata - ho fokotseha ha litaba tsa potasiamo le sodium e serum ea mali. Liphetoho tsena tsa li-paramethara tsa laboratori li ne li sa bohlokoa haholo ho tsa bongaka.

Liphetoho tse mpe tse bonts'itsoeng ha o nka motsoako oa hydrochlorothiazide / irbesartan, tse tlalehiloeng nakong ea ho bapatsa:

Litla-morao: Ha ho na nako - letlalo lekhopho, urticaria, angioedema.

Ho tloha ka lehlakoreng la metabolism: ka seoelo - hyperkalemia.

Ho tsoa ho tsamaiso ea methapo e bohareng: ka seoelo - hlooho e bohloko.

Ho tsoa ho setho sa sensory: ka seoelo - ho lla litsebeng.

Ho tsoa ts'ebetsong ea ho hema: ka seoelo - khohlela.

Ho tsoa ho tsamaiso ea tšilo ea lijo: ka seoelo - dyspepsia, dysgeusia, mucosa e ommeng ea molomo, hepatitis, ts'ebetso ea sebete e senyehileng.

Ho tsoa ts'ebetsong ea musculoskeletal: ka seoelo arthralgia, myalgia.

Ho tsoa ts'ebetsong ea moroto: ka seoelo - ts'ebetso ea renal e sa sebetseng hantle, ho kenyeletsoa linyeoe tse ikhethileng tsa ho hlaba a liphio ho bakuli ba kotsing e kholo.

Tlhahisoleseling e ngoe mabapi le likarolo tsa motho ka mong:

Ntle le litlamorao tse seng li boletsoe, litla-morao tse ling tse neng li tlalehiloe ka nako eo mabapi le karolo ka 'ngoe, e ka bang litlamorao tse mabapi le tšebeliso ea lithethefatsi Ibertan Plus, li thathamisitsoe ka tlase.

Tse ling: hangata - bohloko ba sefuba.

Hydrochlorothiazide (ntle le ho supa makgetlo a hlahang)

Litho tsa Hematopoietic: anemia ea aplasiki, mokhathala oa masapo, hemolytic anemia, leukopenia, neutropenia / agranulocytosis, thrombocytopenia.

Ho tsoa ho tsamaiso ea methapo e bohareng: khatello ea maikutlo, likhathatso tsa boroko, ho tsekela, paresthesia, matšoenyeho.

Ho tloha lehlakoreng la setho sa maikutlo: pono ea nakoana e lerootho, xantopsia.

Ho tsoa ho tsamaiso ea pelo: arrhythmias, hypotension ea postural.

Ho tsoa ts'ebetsong ea phefumoloho: syndrome ea khatello ea matšoafo (ho kenyelletsa pneumonitis le pulmonary edema).

Ho tsoa ts'ebetsong ea tšilo ea lijo: jaundice (intrahepatic cholestatic jaundice).

Litla-morao: ho fetoha ha anaphylactic, checrosis ea chefo ea morao-rao, lesapo la mokokotlo, lesapo la mokokotlo la mokokotlo (vasculitis, letlalo vasculitis), ts'ebetso ea photosensitivity, rash ea letlalo, ho ata ha systemic lupus erythematosus, urticaria.

Ho tsoa ho tsamaiso ea musculoskeletal: mesifa cramp, bofokoli.

Ho tsoa ts'ebetsong ea moroto: interstitial nephritis, dysfunction ea renal.

Tse ling: feberu.

Matšoao a laboratori: ho ts'oenyeha ho tekanyetso ea metsi-electrolyte (ho kenyelletsa hypokalemia le hyonatremia), glucosuria, hyperglycemia, hyperuricemia, cholesterol e eketsehileng le triglycerides.

Bokhachane le pelehi

Ho nka Ibertan Plus hoa qhekelloa nakong ea kemaro, kaha ho pepesetsoa ka popelong ea lithethefatsi tse amang mokhoa oa renin-angiotensin-aldosterone ho ka baka tšenyo le lefu la lesea le ntseng le eketseha. Li-diaztics tsa li-Thiazide li tšela mokoallo oa limela 'me li fumanoa maling a likhoele. Ka tloaelo, ts'ebeliso ea li-diuretics ho basali ba phetseng hantle ha e khothalletsoe mme e pepesetsa 'm'a le lesea kotsing e sa hlokahaleng, ho kenyelletsa le nts'etsopele ea bokhachane kapa "neundatal jaundice", "thrombocytopenia" mme mohlomong le tse ling tse mpe tse bonoang tse bonoang ho batho ba baholo. Hydrochlorothiazide ha e kgothaletswe ho trimester ea pele ea boimana. Setlhare se kopantsoe ho "trimesters" ea II le III tsa boimana. Haeba ho ima ho fumanoa, joale Ibertan Plus e lokela ho emisoa kapele kamoo ho ka khonehang. Haeba mokuli a nkile lithethefatsi ho tsoa ho trimester ea bobeli ea boimana, ho hlokahala ho etsa tlhahlobo ea ultrasound ea lehata le a liphio. Sethethefatsi Ibertan Plus se kopantsoe nakong eohle ea kemolo.

Ho sebelisana le lithethefatsi

Lithethefatsi tse ling tsa antihypertensive: phello ea antihypertensive ea lithethefatsi Ibertan Plus e ka matlafatsoa ke tšebeliso e tšoanang ea lithethefatsi tse ling tsa antihypertensive. Hydrochlorothiazide le irbesartan (ka tekanyetso e ka bang 25 mg ea hydrochlorothiazide / 300 mg ea irbesartan) e ka sebelisoa ka mokhoa o sireletsehileng hammoho le lithethefatsi tse ling tsa antihypertensive, ho kenyeletsoa li-blockers tsa "calcium" tse liehang ho feta. Pele e neng e phekoloa ka litekanyetso tse phahameng tsa diuretics e ka lebisa ho nyekelo ea pelo le ho eketsa kotsi ea lefu la sethoathoa.

Lithium: ho na le litlaleho tsa keketseho e feto-fetohang ea mohopolo oa serum le tahi ka ts'ebeliso e kopaneng ea litokisetso tsa lithium le li-inhibitors tsa angiotensin-converting enzyme. Bakeng sa irbesartan, litlamorao tse tšoanang li bile ka seoelo haholo kajeno. Ntle le moo, netefatso ea renal ea lithium e fokotseha ka tšebeliso ea li-thiazide diuretics, ka hona, ha ho ngoloa Ibertan Plus, ho na le monyetla oa ho ba le tšusumetso e matla ea lithium. Haeba sepheo sa ho kopanya sena se hlokahala, ho kgothaletswa ho lekola ka hloko litaba tsa lithium tse serumeng ea mali.

Meriana e amang dikahare tsa potasiamo maling: phello ea hypokalemic ea hydrochlorothiazide e fokotsoa ke phello ea ho boloka potasiamo ea irbesartan. Leha ho le joalo, ts'ebetso ena ea hydrochlorothiazide e kanna ea ntlafatsoa ke lithethefatsi tse ling, sepheo sa sona se amanang le tahlehelo ea potasiamo le gnococalpemia (mohlala, diuretics, laxatives, amphotericin, carbenoxolone, penicillin G sodium, litlolo tse tsoang ho salicelic acid) Ho fapana le seo, ho latela boiphihlelo ba ho sebelisa lithethefatsi tse fokotsang tšebetso. Angiotensin-aldosterone sistimi, tšebeliso e tšoanang ea ts'oaetso ea potasiamo. li-additives tsa oiologically tse sebetsang, li-substitute tsa letsoai la potasiamo, kapa lithethefatsi tse ling tse ka lebisang keketseho ea serum potasiamo (joalo ka sodium heparin) e ka baka kholo ea serum Katya. Ho khothalletsoa hore u lekole ka nepo serum potasiamo ho bakuli ba kotsing ea ho ba le hyperkalemia.

Moriana e anngoeng ke tlolo ea tekanyetso ea potasiamo ka serum ea mali: ho khothalletsoa hore ho fanoe ka hloko ho lekola dikahare tsa potasiamo ka serum ea mali ha ho fanoa ka taelo ea Ibertan Plus hammoho le lithethefatsi tse anngoeng ke tlolo ea tekanyetso ea potasiamo e serum ea mali (mohlala, methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo).

Lithethefatsi tse seng khahlanong le ho ruruha: ha ho etsoa lingaka tsa li-angotensin II tse kopantsoeng le lithethefatsi tse seng tsa mali le tse thibelang mafu (jk. ketso. Joalo ka ts'ebeliso ea angiotensin e fetolang li-enzyme inhibitors le li-angiotensin II receptor antagonists hammoho le NSAIDs, ho na le menyetla e eketsehileng ea ts'ebetso ea mokokotlo oa mokokotlo, ho fihlela nts'etsopele ea ho hloleha ha renal e matla, potasiamo e eketsehileng ea serum, haholoholo ho bakuli ba seng ba senyehile ke ts'ebetso ea renal. Motsoako ona oa lithethefatsi o lokela ho laeloa ka hloko, haholoholo ho bakuli ba tsofetseng. Bakuli ha baa lokela ho omelloa ke metsi. Ho lekola mesebetsi ea matsoho ho lokela ho etsoa kamora ho qala kalafo ea ho kopanya le nako le nako nakong e tlang.

Tlhahisoleseling e eketsehileng mabapi le tšebelisano ea lithethefatsi ea irbesartan: hydrochlorothiazide ha e ame pharmacokinetics ea irbesartan. Ha ho ne ho ngoloa irbesartan hammoho le warfarin, e thehiloeng ke bahloekisi ba CYP2C9 isoenzyme, ha ho na ts'ebelisano e kholo ea pharmacokinetic le pharmacodynamic. Matla a CYP2C9 isoenzyme inductors, joalo ka rifampicin, ho pharmacokinetics ea irbesartan ha a hlahlojoa. Ka ho khethoa ha irbesartan hammoho le digoxin, li-pharmacokinetics tsa morao ha lia ka tsa fetoha.

Tlhahisoleseling e eketsehileng mabapi le tšebelisano ea lithethefatsi ea hydrochlorothiazide:

Meriana e latelang e ka sebelisana le thiazide diuretics ha u ntse u fana ka taelo:

Ethanol, barbiturates kapa lithethefatsi tsa narcotic: hypotension e eketsehileng ea orthostatic e ka bonoa.

Litlhare tsa Hypoglycemic (li-agent tsa molomo le insulin): tokiso ea litekanyetso tsa lithethefatsi tsa hypoglycemic e ka hlokahala.

Colestyramine le colestipol: boteng ba libaka tsa phapanyetsano ea anion, ho monya ha hydrochlorothiazide hoa khathatseha. Nako e pakeng tsa ho sebelisa meriana ena e lokela ho ba bonyane lihora tse 4.

Glucocorticosteroids, hormone ea adrenocorticotropic: tlolo ea molao e boletsoeng e le tlolo ea motlakase, haholoholo, e eketsang hypokalemia.

Catecholamines (mohlala, norepinephrine): katleho ea lithethefatsi tsena e kanna ea fokotsoa.

Li-restores tsa mesifa tse sa nyenyefatseng (mohlala, tubocurarine): hydrochlorothiazide e ka baka litlamorao tsa phomolo e sa nyenyefatse ea mesifa.

Mekhoa ea litlhare ea anti-gout: e kanna ea hloka tokiso ea lithethefatsi tse ngata tse sebelisoang ho phekola gout, hobane hydrochlorothiazide e ka eketsa litaba tsa uric acid maling a mali. Keketseho ea tekanyetso ea probenenide kapa sulfinpyrazone e kanna ea hlokahala. Ts'ebetso ea tšebelisano 'moho le diaztiti tsa thiazide e ka eketsa liketsahalo tsa hypersensitivity reaction ho allopurinol.

Chelete ea letsoai la calcium: thiazide diuretics e ka eketsa calcium calcium ka lebaka la ho fokotseha ha tlhahiso ea eona. Haeba ho hlokahala ho fana ka litlatsetso tsa khalsiamo kapa lithethefatsi tse amang khalsiamo (ka mohlala, vithamine D), ho hlokahala hore o fetole tekanyo ea lithethefatsi tsena ka mokhoa o nepahetseng le ho laola sethala sa calcium ho plasma ea mali.

Mefuta e meng ea ts'ebelisano ea lithethefatsi: thiazide diuretics e ka ntlafatsa phello ea hyperglycemic ea beta-blockers le diazoxide. Anticholinergics (kk., Atropine) e ka eketsa bioavailability ea thiazide diuretics ka ho fokotsa sekhahla sa lefu la gastrointestinal and gastric sheding rate. Thiazide diuretics e ka eketsa kotsi ea ho etsa lintho tse mpe tse bakoang ke amantadine. Thiazide diuretics e ka fokotsa tlhahiso ea lithethefatsi tsa cytotoxic ke liphio (mohlala, cyclophosphamide, methotrexate) le ho hlahisa phello ea myelosuppression.