Noliprel A matlapa a 2, 5, 0, 625 mg 30 likhomphutha

Ka kopo, pele u reka Noliprel A, matlapa a 2,5 + 0,625 mg 30 likhomphutha. Lekola tlhaiso-leseling ka eona le tlhaiso-leseling e fumanehang sebakeng sa semmuso sa moetsi kapa hlakisa lintlha tse ikhethang tsa mofuta o itseng le molaoli oa k'hamphani ea rona!

Tlhahisoleseling e bontšitsoeng sebakeng sena sa marang-rang hase tlhahiso ea sechaba. Moetsi o na le tokelo ea ho etsa liphetoho moralo, moralo le liphutheloana tsa thepa. Litšoantšo tsa thepa tse lifoto tse hlahisitsoeng lethathamong la sebaka sa marang-rang li ka fapana le tsa pele.

Tlhahisoleseling mabapi le theko ea thepa e bontšitsoeng lethathamong la sebaka sa marang-rang e kanna ea fapana ka nako ea ho beha odara bakeng sa sehlahisoa se tsamaellanang.

Moetsi

Lithako tse sebetsang: perindopril arginine, indapamide,

Baeti: sodium carboxymethyl starch (mofuta A) - 2.7 mg, anhydrous colloidal silicon diode - 0,27 mg, lactose monohydrate - 74,455 mg, magnesium stearate - 0,45 mg, maltodextrin - 9 mg,

Filimi sheath: macrogol 6000 - 0,087 mg, prox bakeng sa tšoeu sheath SEPIFILM 37781 RBC (glycerol - 4,5%, hypromellose - 74,8%, macrogol 6000 - 1.8%, magnesium stearate - 4,5%, titanium dioksiamo (E171) - 14.4%) - 2.913 mg,

Ketso ea pharmacological

Noliprel ® A ke litokisetso tse kopaneng tse nang le perindopril arginine le indapamide. Melemo ea pharmacological ea lithethefatsi Noliprel ® A e kopanya likarolo tsa motho ka mong tsa likarolo.

1. Mochine oa ketso

Ho kopana ha perindopril le indapamide ho ntlafatsa phello ea antihypertensive ea e mong le e mong oa bona.

Perindopril ke inhibitor ea enzyme e fetolang angiotensin I ho angiotensin II (inhibitor ea ACE).

ACE, kapa kininase II, ke exopeptidase e phethang phetoho ea bobeli ea angiotensin I e le vasoconstrictor ntho angiotensin II, le tšenyo ea bradykinin, e nang le phello e ntle haholo, ho heptapeptide e sa sebetseng. Ka lebaka la perindopril:

- e fokotsa secretion ea aldosterone,

- ka molao-motheo oa maikutlo a mabe o eketsa tšebetso ea renin ho plasma ea mali,

- ka tšebeliso ea nako e telele, e fokotsa OPSS, e bakoang haholo ke phello ea lijana methapong ea meno le ea liphio. Litlamorao tsena ha li tsamaisane le ho lieha ha ion ea sodium le fluid kapa nts'etsopele ea Reflex tachycardia.

Perindopril e tloaelehileng ea myocardium, e fokotsa ho jarolla le ho jarolla ka morao.

Ha ho ithutoa likarolo tsa hemodynamic ho bakuli ba nang le lefu la pelo le sa foleng, ho ile ha senoloa:

- fokotseha ho tlatsa khatello maemong a pelo,

- Ho eketseha ha pelo,

- Ho eketseha ha mali ho potoloha ha mesifa.

Indapamide ke ea sehlopha sa sulfonamides, maemong a meriana e haufi le thiazide diuretics. Indapamide e thibela ho kopanngoa ha ion ea sodium karolong ea cortical ea lebenkele la Henle, e lebisang keketseho ea tlhahiso ea sodium, chlorine le, ka tekanyo e nyane, potasiamo le ionesi ea magnesium ke liphio, ka tsela eo li eketsa diuresis le ho theola khatello ea mali.

2. Matla a antihypertensive

Noliprel ® A e na le litlamorao tse fokotsang litekanyetso tsa antihypertensive ho DBP le SBP ka bobeli maemong a emeng le a ho bua leshano. Matla a antihypertensive a tsoela pele ho qeta lihora tse 24. Phello e tsitsitseng ea phekolo e ba ka tlase ho khoeli e le 'ngoe kamora ho qala kalafo mme ha e tsamaisane le tachycardia. Ho khaotsa ho phekoloa ha ho bake lefu la ho khaotsa.

Noliprel ® A e fokotsa sekhahla sa "ventricular hypertrophy" (GTL) e ntlafalitsoeng ea methapo, e ntlafatsa maemo a rarahaneng, e fokotsa OPSS, ha e ame metabolism ea lipid (cholesterol e felletseng, cholesterol ea HDL le cholesterol ea LDL, triglycerides).

Kameho ea ts'ebeliso ea motsoako oa perindopril le indapamide ho GTL e bonahetse ha e bapisoa le enalapril. Ho bakuli ba nang le arterial hypertension le GTL, e tšoaroang ka perindopril erbumin 2 mg (e lekanang le 2,5 mg perindopril arginine) / indapamide 0,625 mg kapa enalapril ka tekanyo ea 10 mg hang ka letsatsi, le ka keketseho ea tekanyetso ea perindopril erbumin ho 8 mg (e lekanang le 10 perindopril arginine) le indapamide ho fihlela ho 2,5 mg, kapa enalapril ho fihlela ho 40 mg hang ka letsatsi, ho fokotseha ho hoholo sehlopheng sa li-ventricular mass index (LVMI) se leqeleng kapa sehlopha sa indapamide ha se bapisoa le sehlopha sa enalapril. Tabeng ena, phello e kholo ka ho fetisisa ho LVMI e bonoa ka ts'ebeliso ea perindopril erbumin 8 mg / indapamide 2,5 mg.

Phello e tsebahalang haholo ea antihypertensive e boetse e bonoe khahlanong le bokantle ba kalafo ea motswako le perindopril le indapamide ha bo bapisoa le enalapril.

Ho bakuli ba nang le lefu la tsoekere la mofuta oa 2 lefu la tsoekere (ho bolela lilemo tse 66, boima ba 'mele 28 kg / m 2, glycosylated hemoglobin (HbA1c) 7.5%, khatello ea mali 145/08 mm Hg) metsoako ea perindopril / indapamide bakeng sa mathata a maholo a micro- le macro-vascular ho kenyeletsa kalafo e tloaelehileng ea taolo ea glycemic le maano a matla a taolo ea glycemic (IHC) (HCA1c

Hypertension ea methapo ea kutlo e ile ea bonoa ho bakuli ba bang le ba bang ba mashome a robeli a metso e robeli le metso e robeli (32) le 32%, le microalbuminuria ka 27%. Boholo ba bakuli nakong ea ho kenyelletsoa thupelong ba fumane kalafo ea hypoglycemic, 90% ea bakuli ba amohetse li-hypoglycemic agents bakeng sa tsamaiso ea molomo (47% ea bakuli ba amohetseng monotherapy, 46% ba fumana kalafo ea lithethefatsi tse peli, 7% e fumane kalafo ea lithethefatsi tse tharo). 1% ea bakuli ba fumane kalafo ea insulin, 9% - ke feela kalafo ea ho ja. Liphetho tsa sulfonylureas li nkuoe ke bakuli ba mashome a supileng a metso e mehlano, metformin - 61%. Joalo ka kalafo e kopanetsoeng, 75% ea bakuli ba fumane lithethefatsi tse felisang kalafo, 35% ea bakuli ba amohela lithethefatsi tse fokotsang lipid (haholo-holo HMG-CoA reductase inhibitors (li-statins) - 28%), acetylsalicylic acid e le moemeli oa antiplatelet, le li-antiplatelet agents tse ling (47%).

Kamora libeke tse 6 tsa kenyelletso nakong eo bakuli ba fumanang kalafo ea perindopril / indapamide, ba ile ba aroloa ka sehlopha se tloaelehileng sa taolo ea glycemic kapa sehlopha sa IHC (Diabeteson ® MV ka monyetla oa ho eketsa tekanyo ho fihla ho 120 mg / ka letsatsi kapa moemeli e mong oa hypoglycemic).

Sehlopheng sa IHC (bolela ho latela nako - lilemo tse 4,8, bolela HbA1c - 6.5%) ha e bapisoa le sehlopha se laoloang se tloaelehileng (bolela HbA1c - 7.3%), phokotseho e kholo ea 10% kotsing e atamelaneng ea maqhubu a kopaneng a macro- le microvascular mathata.

Monyetla ona o fumanoe ka lebaka la phokotso e kholo ea likotsi tse ka bang teng: mathata a maholo a Micropa ka 14%, ho qala le ho nyoloha ha nephropathy ka 21%, microalbuminuria ka 9%, macroalbuminuria ka 30% le nts'etsopele ea mathata a tsoang liphihlelong ka 11%.

Melemo ea kalafo ea antihypertensive ha ea ka ea itšetleha ka melemo e fumanoeng ka IHC.

Perindopril e sebetsa kalafo ea khatello ea mali ea khatello e matla ea methapo.

Tšusumetso ea antihypertensive ea lithethefatsi e fihla ho eona ka lihora tse ngata tsa 4-6 kamora ho tsamaisoa ka molomo a le mong mme e phehella lihora tse 24. Kamora lihora tse 24 ka mor'a ho nka moriana ona, ho phatlalalitsoe thibelo (e ka bang 80%) ea thibelo e setseng ea ACE.

Perindopril e na le phello ea antihypertgent ho bakuli ba nang le mesebetsi e meng e tlaase le e tloaelehileng ea plasma.

Ts'ebetso e ts'oanang ea li-thiazide diuretics e ntlafatsa botebo ba phello ea antihypertensive. Ntle le moo, ho kopana ha ACE inhibitor le thiazide diuretic hape ho fokotsa kotsi ea hypokalemia e nang le diuretics.

Matla a antihypertensive a bonahala ha o sebelisa moriana ho litekanyetso li nang le phello e fokolang ea diuretic.

Matla a antihypertensive a indapamide a amahanngoa le ntlafatso ea thepa ea methapo e meholo ea methapo e meholo le ho fokotseha ha OPSS.

Indapamide e fokotsa GTL, ha e ame ho kenella ha lipids ka plasma ea mali: triglycerides, cholesterol e felletseng, LDL, HDL, metabolism ea carbohydrate (ho kenyelletsa le ho bakuli ba nang le lefu la tsoekere la mellitus).

Motsoako oa perindopril le indapamide ha o fetole litšobotsi tsa bona tsa pharmacokinetic ha li bapisoa le tsamaiso e arohaneng ea lithethefatsi tsena.

Ha li-perindopril tse fanoang li kenella ka potlako. Bioavailability ke 65-70%.

Hoo e ka bang 20% ea "perindopril" e amohelang kaofela e fetoloa ho perindoprilat, metabolite e sebetsang. Ho nka sethethefatsi ka lijo ho tsamaea le ho fokotseha ha metabolism ea perindopril ho perindoprilat (phello ena ha e na boleng ba bohlokoa ba kliniki).

C_max Perindoprilat ka plasma ea mali e fihlella lihora tse 3-4 kamora ho kenella.

Puisano le liprotheine tsa plasma ea mali ha e tlase ho 30% 'me ho latela khatello ea mali ea "perindopril" maling.

Ho arohana ha perindoprilat e amanang le ACE ho lieha. Ka lebaka leo, T e sebetsang_1/2ke lihora tse 25. Ho khethoa hoa perindopril ha ho lebise ho tumello ea eona, 'me T_1/2Ka tsamaiso e pheta-phetoang, perindoprilat e tsamaisana le nako ea ts'ebetso ea eona, ka hona boemo ba tekano bo fihlelloa kamora matsatsi a 4.

Perindoprilat e ntšoa 'meleng ke liphio. T_1/2 metabolite ke lihora tse 3-5

Excretion ea perindoprilat e lieha ho tsofala, le ho bakuli ba nang le pelo le ho hloleha ha meno.

Tlhahiso ea dialysis ea perindoprilat ke 70 ml / min.

Pharmacokinetics ea perindopril e fetoloa ho bakuli ba nang le lefu la sebete la pele: tumello ea eona ea hepatic e fokotseha ka makhetlo a 2. Leha ho le joalo, palo ea li-perindoprilat tse entsoeng ha e fokotsehe, ka hona, liphetoho tsa tekanyetso ha li hlokehe.

Perindopril o tšela placenta.

Indapamide e kenella ka potlako ebile e kenelletse ka botlalo ho tsoa ho tšilo ea lijo.

C_max sethethefatsi se plasma ea mali se bonoa hora e le 'ngoe ka mor'a ho kenella.

Puisano le liprotheine tsa plasma - 79%.

T_1/2 ke lihora tse 14-24 (karolelano ea lihora tse 19). Tsamaiso e pheta-phetoang ea lithethefatsi ha e lebise ho lintšing tsa eona 'meleng. E hloekisoa haholo ke liphio (70% ea lethal dose e laetsoeng) le ka mala (22%) ka sebopeho sa metabolites se sa sebetseng.

The pharmacokinetics ea lithethefatsi ha e fetohe ho bakuli ba nang le ho se sebetse hantle ha methapo.

Phekolo ea methapo e hlokahalang, bakuli ba nang le khatello ea methapo ea kutlo le mofuta oa 2 lefu la tsoekere ho fokotsa kotsi ea mathata a methapo ea methapo (le liphio) le mathata a maholo a mafu a pelo.

Bokhachane le pelehi

Moriana o kopantsoe le ho ima.

Ha u rera ho ima kapa ha e etsahala ha u ntse u nka Noliprel ® A, o lokela ho emisa hang hang ho sebelisa meriana le ho fana ka kalafo e 'ngoe ea antihypertensive.

Se ke oa sebelisa Noliprel ® A ho trimester ea pele ea bokhachane.

Lithuto tse loketseng tse laoloang tsa li-inhibitors tsa ACE ho basali ba bakhachane ha li e-so tšoaroe. Lintlha tse lekantsoeng mabapi le litlamorao tsa li-inhibitors tsa ACE nakong ea pele ea kemaro li bonts'a hore ho nka li-inhibitors tsa ACE ha hoa ka ha lebisa ho ho se sebetse hantle ho amanang le fetoto, empa phello ea fetoto ea lithethefatsi e ke ke ea hlakoloa ka botlalo.

Noliprel ® A e tšoaelitsoe ho trimester ea II le ea boraro ea bokhachane (bona. "Contraindication").

Hoa tsebahala hore ho pepesetsoa nako e telele ea li-inhibitors tsa ACE ka popelong ka nako ea bobeli le ea boraro ea bokhachane ho ka lebisa ho holofatsong e fokolisitsoeng (tšebetso e fokolisitsoeng ea renal, oligohydramnios, ho liehisa ossization ea masapo a sekhahla) le nts'etsopele ea mathata matsatsing a macha (ho hloleha ha methapo, hypotension, hyperkalemia).

Ts'ebeliso ea nako e telele ea thiazide diuretics ka kotareng ea boraro ea kemaro e ka baka ho phahama ha bokhachane le ho fokotseha ha phallo ea mali ea uteroplacental, e lebisang ho isopia ea fetoplacental le ho khutla ha "fetus". Maemong a sa tloaelehang, ha a ntse a nka li-diuretics nakoana pele a hlaha, masea a sa tsoa tsoaloa a ba le hypoglycemia le thrombocytopenia.

Haeba mokuli a fumane lithethefatsi Noliprel ® A nakong ea moimana oa II kapa oa boraro oa bokhachane, ho kgothaletswa ho etsa lipatlisiso tsa lesea le sa tsoa tsoaloa ho lekola boemo ba tšebetso ea lehata le a liphio.

Hypotension ea methapo e ka hlaha ho bana ba sa tsoa tsoaloa bao bo-'m'a bona ba fumaneng kalafo ka li-inhibitors tsa ACE, ka hona, masea a sa tsoa tsoaloa a lokela ho ba tlas'a tlhokomelo e haufi ea bongaka.

Noliprel ® A e kopantsoe nakong ea lebollo.

Ha ho tsejoe hore na perindopril e nang le lebese la matsoele e ntšoa.

Indapamide e hloekisoa lebeseng la matsoele. Ho nka li-thiazide diuretics ho baka ho fokotseha hoa lebese la matsoele kapa khatello ea lebone. Maemong ana, lesea le sa tsoa tsoaloa le ka ba le hypersensitivity to sulfonamide derivatives, hypokalemia le jaundice ea nyutlelie.

Kaha tšebeliso ea perindopril le indapamide nakong ea lebele e ka baka mathata a maholo ho lesea, ho bohlokoa ho hlahloba bohlokoa ba pheko ho mme le ho etsa qeto ea ho khaotsa ho anyesa kapa ho sebelisa moriana.

Contraindication

hypersensitivity ho perindopril le tse ling tsa ACE inhibitors, indapamide, li-sulfonamide tse ling, hammoho le likarolo tse ling tse thusang tse etsang moriana,
nalane ea angioedema (ho kenyeletsoa le li-inhibitors tse ling tsa ACE),
hereditary / idiopathic angioedema, hypokalemia, ho se sebetse hantle haholo ha a utloe bohloko (moeinine Cl ka tlase ho 30 ml / min),
stenosis ea methapo e le 'ngoe ea methapo, mokokotlo oa methapo ea mokokotlo,
ho hloleha ho matla ha sebete (ho kenyeletsa le encephalopathy),
tšebeliso e tšoanang ea lithethefatsi tse eketsang nako ea QT,
Tšebeliso e le 'ngoe le lithethefatsi tsa antiarrhythmic tse ka bakang mofuta oa pirouette arrhythmias,
boimana
nako ea kemolo.

Ts'ebetso ea tšebeliso ea lithethefatsi ka li-diuretics tsa potasiamo, ho lokisoa ha potasiamo le lithium, le tsamaiso ho bakuli ba nang le maemo a phahameng a potasiamo ha e khothalletsoe.

Ka lebaka la ho haelloa ke boiphihlelo bo lekaneng ba kliniki, Noliprel ® A ha ea lokela ho sebelisoa ho bakuli ba nang le hemodialysis, hammoho le ho bakuli ba nang le pelo e sa sebetseng e sa sebetseng.

Ka tlhokomeliso: maloetse a methapo ea methapo e sebetsang (ho kenyeletsa le systemic lupus erythematosus, scleroderma), kalafo ea immunosuppressive (kotsi ea neutropenia, agranulocytosis), thibelo ea masapo a hematopoiesis, ho fokotseha ha BCC (diuretics, lijo tse se nang letsoai, ho hlatsa, lets'ollo, hemodialysis), angina pectoris, lefu la letsoalo la mokokotlo, khatello ea methapo ea pelo, lefu la tsoekere, ho nyekeloa ke pelo ho sa feleng (sethala sa IVHA sa IV), hyperuricemia (haholoholo e tsamaeang le gout le urate nephrolithiasis), lability AD hōlileng, hemodialysis sebelisa lera la vysokoprotochnyh kapa desensitization, la boemo bo Tsamaiso apheresis LDL mora liphio transplantation, aortic belofo stenosis / hypertrophic cardiomyopathy, boteng ba khaello lactase, galactosemia lefu kapa tsoekere-galactose malabsorption, lilemo lilemo tse 18 (bokgoni le polokeho ha e kentsoe).

Litlamorao

Ho tsoa ho tsamaiso ea hemopoietic le lymphatic: ka seoelo - thrombocytopenia, leukopenia / neutropenia, agranulocytosis, anemia ea aplasiki, anemia ea hemolytic.

Anemia: maemong a itseng a kliniki (bakuli kamora ho fetisoa ha meno, bakuli ba hemodialysis) Lits'ireletso tsa ACE li ka baka phokolo ea mali (bona "Litaelo tse Khethehileng").

Ho tloha lehlakoreng la ts'ebetso ea methapo e bohareng: khafetsa - paresthesia, hlooho, ho tsekela, asthenia, vertigo, ka mokhoa o sa lekanyetsoang - ho ts'oaroa ha boroko, ho thatafala ha maikutlo, hangata haholo - pherekano, khafetsa e sa hlalosoang - ho akheha.

Ho tloha lehlakoreng la setho sa pono: khafetsa - ho senyeha hoa pono.

Karolong ea setho se utloang: hangata - tinnitus.

Ho tsoa ho CCC: khafetsa - ho fokotseha ho phatlalalitsoeng ha khatello ea mali, incl. orthostatic hypotension, haholo ka seoelo - likotsi tsa morethetho oa pelo, incl. bradycardia, ventricular tachycardia, atraya fibrillation, hammoho le angina pectoris le myocardial infarction, mohlomong ka lebaka la ho fokotseha ho hoholo ha khatello ea mali ho bakuli ba kotsing e kholo (bona "Litaelo tse Khethehileng"), khafetsa bo sa boleloang - mofuta oa pirouette arrhythmia (mohlomong o bolaeang) - Tšebelisano ").

Karolong ea sistimi ea ho hema, sefuba le methapo ea methapo: hangata - khahlano le nalane ea ts'ebeliso ea li-inhibitors tsa ACE, ho ka hlaha khohlela e omileng, e phehellang nako e telele ha e ntse e nka sehlopha sena sa lithethefatsi mme e nyamela kamora hore e hlakoloe, ho hema ka thata, ka seoelo - bronchospasm, hangata - eosinophilic pneumonia, rhinitis .

Ho tsoa ho tšilo ea lijo: khafetsa - ho omella ha mucosa ea molomo, ho nyekeloa, ho hlatsa, bohloko ba ka mpeng, bohloko ba epigastric, ho senyeha ha takatso, ho felloa ke takatso ea lijo, dyspepsia, ho sokela, lets'ollo, ka seoelo - angioedema ea mala, cholestatic jaundice, pancreatitis, maqhubu a sa hlalosoang - hepatic encephalopathy ho bakuli ba nang le ho fokola hoa hepatic (bona. "Contraindication", "Litaelo tse Khethehileng"), hepatitis.

Karolong ea letlalo le mafura a potolohileng: hangata - ho senyeha ha letlalo, ho hlohlona, makhopho a maculopapular, hangata - angioedema ea sefahleho, molomo, maoto le matsoho, membrane ea leleme, mela le melumo le / kapa larynx, urticaria (bona "Litaelo tse ikhethang") , hypersensitivity reactions ho bakuli ba rerileng ho ba le ts'oaetso ea mokokotlo oa mokokotlo le lefu la mokokotlo, phenura, ho bakuli ba nang le lefu la sethoathoa la lupus erythematosus, lefu lena le ka mpefala, hangata erythema multiforme, lefu le kotsi la lefu la sethoathoa. necrolysis, Stevens-Johnson lefu. Ho bile le maemo a karabelo ea photosensitivity (bona. "Litaelo tse Khethehileng").

Ho tsoa ho sistimi ea musculoskeletal le lisele tse sebetsanang: khafetsa - mesifa ea mesifa.

Ho tsoa ts'ebetsong ea moroto: khafetsa - ho hlleha ha liphio, ka seoelo - ho hloleha ho hlaphoheloa ke methapo.

Ho tsoa ts'ebetsong ea ho tsoala: hangata - ho hloka matla.

Mathata a akaretsang le matšoao: khafetsa - asthenia, hangata - ho eketsa mofufutso.

Matšoao a laboratori: hyperkalemia, hangata e ba ea nakoana, keketseho e nyane ea tlhahiso ea "metabolinine" ka har'a moroto le plasma ea mali kamora kalafo e khaotsoe, hangata ho bakuli ba nang le methapo ea methapo ea methapo, kalafong ea khatello ea mali ka methapo ea methapo le maemong a ho hloleha ha methapo, hangata "hypercalcemia" - keketseho ea karohano ea QT ho ECG (bona "Litaelo tse Khethehileng"), keketseho ea ho bokellana ha uric acid le tsoekere maling, keketseho ea tšebetso ea li-enzyme tsa sebete, hypokalemia, e bohlokoa haholo bakeng sa atsientov, kotsing (bona. "Litaelo Special"), hyponatremia le hypovolemia, ea isang ho dehydration le orthostatic hypotension. Hypochloremia e le 'ngoe e ka lebisa ho alkalosis ea "metabolism" (menyetla le khatello ea phello ena e tlaase).

Litla-morao tse lemohileng litekong tsa bongaka

Litla-morao tse anngoeng nakong ea lipatlisiso tsa ADVANCE li lumellana le profil ea polokeho ea pejana bakeng sa ho kopanya ha perindopril le indapamide. Liketsahalo tse mpe tse mpe li ile tsa bonoa ho bakuli ba bang lihlopheng tsa ho ithuta: hyperkalemia (0,1%), ho hloleha ha methapo ea pelo (0.1%), lefu la methapo ea methapo (0.1%) le khohlela (0,1%).

Ho bakuli ba 3 sehlopheng sa perindopril / indapamide, angioedema e ile ea bonoa (bapisa le 2 sehlopheng sa placebo).

Sokolla foromo le sebopeho

Noliprel e hlahisoa ka mokhoa oa matlapa: a tšoeu, a karolelano, a nang le kotsi ka mahlakoreng ka bobeli (ka lithutsoana tsa 14 le 30 likhomphutha., 1 blister ka lebokoseng la karete ea karete).

Sebopeho sa letlapa le le leng le kenyelletsa lintho tse sebetsang:

Perindopril tertbutylamine letsoai - 2 mg,
Indapamide - 0,625 mg.

Likarolo tse thusang: "cellcose" cellcose "cellulose", "lactose monohydrate", "magnesium stearate", hydrophobic colloidal silicon dioxide.

Mofumahali

Noliprel® A ke tlhophiso e kopaneng e nang le perindoprilarginin (angiotensin e fetolang enzyme inhibitor) le indapamide (diuretic e tsoang sehlopheng sa sulfonamide derivative). Melemo ea pharmacological ea lithethefatsi Noliprel® A e kopanya likarolo tsa motho ka mong tsa likarolo.

Ho kopana ha perindopril le indapamide ho matlafatsa tšebetso ea e mong le e mong oa bona. Noliprel® A e na le tšusumetso e matla e tsoang ho lethal dose, khatello ea mali ea diastole le systolic maemong a "ho bua leshano" le "ho ema". Setlhare sena se nka lihora tse 24. Phello ea kalafo e etsahala ka tlase ho khoeli e le 'ngoe kamora ho qala kalafo mme ha e tsamaisane le tachycardia. Ho khaotsa ho phekoloa ha ho bake lefu la ho khaotsa.

Noliprel® A e fokotsa sekhahla sa "hypertrophy" e tsoang ka morao, e ntlafatsa maemo a rarahaneng a mokokotlo, e sa ame metabolite ea lipid (cholesterol e felletseng, density lipoprotein cholesterol (HDL) le density e tlase (LDL), triglycerides).

Perindopril

Perindopril ke inhibitor ea enzyme e fetolang angiotensin I ho angiotensin II (inhibitor ea ACE).

Angiotensin-converting enzyme, kapa kinase, ke exopeptidase e phethang phetoho ea angiotensin I e le vasoconstrictor ntho ea angiotensin II, le tšenyo ea bradykinin, e nang le phello ea vasodilating, ho heptapeptide e sa sebetseng. Ka lebaka la perindopril:

e fokotsa secretion ea aldosterone,
ka molao-motheo oa maikutlo a mabe o eketsa tšebetso ea renin ho plasma ea mali,
ka tšebeliso ea nako e telele, e fokotsa khatello ea methapo ea methapo, e bakoang haholo ke phello ea lijana methapong ea meno le ea liphio.

Litlamorao tsena ha li tsamaisane le ho bolokoa ha letsoai le metsi kapa nts'etsopele ea Reflex tachycardia.

Perindopril e na le phello e matlafatsang ho bakuli ba nang le mesebetsi e meng e tlase le e tloaelehileng ea plasma.

Ka tšebeliso ea perindopril, ho fokotsoe khatello ea mali ea systolic le diastolic (BP) maemong a "ho bua leshano" le "ho ema". Ho lahla lithethefatsi ha ho eke khatello ea mali.

Perindopril e na le phello e matlafatsang, e thusa ho khutlisetsa ho elasticity ea methapo e meholo le sebopeho sa lerako la methapo ea methapo e menyenyane ea methapo, hape e fokotsa hypertrophy ea ventricular ea setseng.

Ts'ebeliso e kopantsoeng ea thiazide diuretics e ntlafatsa botebo ba phello ea antihypertensive. Ntle le moo, ho kopana ha ACE inhibitor le thiazide diuretic ho boetse ho lebisa ho fokotseha hoa menyetla ea hypokalemia ho bakuli ba fumanang diuretics.

Perindopril e boetse e sebetsa ts'ebetso ea pelo, e fokotsa ho jarolla le ho jarolla.

Ha ho ithutoa likarolo tsa hemodynamic ho bakuli ba nang le lefu la pelo le sa foleng, ho ile ha senoloa:

fokotseha ho tlatsa khatello ea methapo ea pelo,
fokotseha ha kakaretso ea khatello ea methapo,
keketseho ea pelo le lenane la pelo le eketsehang,
phallo ea mali ea tikoloho ea mesifa.

Indapamide ke ea sehlopha sa sulfonamides - ka thepa ea meriana e haufi le thiazide diuretics. Indapamide e thibela ho kopanngoe ha ion ea sodium karolong ea cortical ea lebenkele la Henle, e lebisang keketseho ea tlhahiso ea sodium, chloride le, ka tekanyo e nyane haholo, potasiamo le ion ea magnesium ke liphio, ka tsela eo li eketsa diuresis.

Matla a antihypertensive a bonahala ho litekanyetso li sa hlahise phello ea diuretic.

Indapamide e fokotsa khatello ea methapo mabapi le adrenaline. Indapamide ha e ame lipids tsa plasma: triglycerides, cholesterol, LDL le HDL, metabolism ea carbohydrate (ho kenyelletsa le ho bakuli ba nang le lefu la tsoekere la mellitus).

E thusa ho fokotsa hypertrophy ea "ventricular" e tloheletsoeng.

Tekanyetso le tsamaiso

Kahare, ka ho khetheha hoseng, pele ho lijo, Letlapa le le leng la lithethefatsi Noliprel® Nako e le 1 ka letsatsi.

Haeba phello e lakatsehang ea hypotensive ha e so fihlehe kamora khoeli e qalile kalafo, tekanyetso e ka phetoa ka makhetlo a mabeli ho litekanyetso tsa 5 mg + 1.25 mg (e entsoeng ke k'hamphani tlasa lebitso la khoebo Noliprel® A forte).

Ho hloleha hape

Setlhare sena se kopantsoe le ho bakuli ba nang le bothata bo matla ba ho hlaphoheloa ba masapo (CC ka tlase ho 30 ml / min.).

Bakeng sa bakuli ba nang le bothata ba ho leka-lekanya ha reculical hantle (CC 30-60 ml / min), lethal dose le phahameng la Noliprel® A ke letlapa le le leng ka letsatsi.

Bakuli ba nang le CC ba lekanang kapa ba kholo ho feta 60 ml / min .. Ha u hloke phetoho ea litekanyetso. Nakong ea phekolo, ho hlokahala hore ho hlahlojoe khafetsa maemo a plasma a creatinine le potasiamo.

Sebelisa nakong ea bokhachane le pelehi

Moriana ha oa lokela ho sebelisoa trimester ea pele ea boimana.

Ha u rera ho ima kapa ha e etsahala ha u ntse u nka Noliprel® A, o lokela ho emisa hang hang ho sebelisa litlhare le ho fana ka kalafo e 'ngoe ea antihypertensive.

Lithuto tse loketseng tse laoloang tsa li-inhibitors tsa ACE ho basali ba bakhachane ha li e-so tšoaroe. Lintlha tse lekanyelitsoeng mabapi le litlamorao tsa lithethefatsi ho trimester ea pele ea bokhachane li bonts'a hore ho nka moriana ona ha hoa ka ha lebisa ho sebetsaneng le phoso ea fetoto.

Noliprel® A e hanyetsitsoe ho trimester ea II le ea boraro ea bokhachane (bona karolo "Contraindication").

Hoa tsebahala hore ho pepesetsoa nako e telele ho li-inhibitors tsa ACE ka popelong ka nako ea bobeli le ea boraro ea bokhachane ho ka lebisa ho holofatsong e fokolitsoeng (tšebetso e fokolitsoeng ea renal, oligohydramnios, ho lieha ho etsoa ha lesapo) le nts'etsopele ea mathata a bophelo bo botle ba lesea (ho se sebetse hantle ka mokokotlo, hypotension, hyperkalemia).

Haeba mokuli a amohela lithethefatsi Noliprel® A nakong ea kemaro ea II kapa ea boraro ea bokhachane, ho kgothaletswa ho etsa tlhahlobo ea ultrasound ea lesea ho lekola boemo ba mokokotlo le ts'ebetso ea meno.

Bongata

Letšoao le ka 'nang la hlaha ke ho fokotseha ha khatello ea mali, ka linako tse ling ho kopantsoe le ho nyekeloa, ho hlatsa, ho tsitsipana, ho tsekela, ho otsela, pherekano le oliguria, tse ka oang ka ho kenella kelellong (ka lebaka la hypovolemia). Meferefere ea electrolyte (hyponatremia, hypokalemia) le eona e ka hlaha.

Mehato ea maemo a tšohanyetso e ea fokotsoa ho tlosa sethethefatsi sena mmeleng: ho hlatsoa mpa le / kapa ho hlahisa khabone e ts'oeroeng, e lateloe ke ho khutlisetsa tekanyo ea motlakase oa motlakase.

Ka ho fokotseha ho hoholo ha khatello ea mali, mokuli o lokela ho isoa sebakeng sa supine ka maoto a phahamisitsoeng. Haeba ho hlokahala, hypovolemia e nepahetseng (mohlala, infravenous infravenous ea 0,9% sodium chloride solution). Perindoprilat, metabolite e sebetsang ea perindopril, e ka tlosoa 'meleng ka dialysis.

Ha e khothalletsoe motsoako

Litokisetso tsa Lithium: ka tšebeliso e le 'ngoe ea litokisetso tsa lithium le li-inhibitors tsa ACE, keketseho e khutlisetsang moqoqong oa lithium ho plasma ea mali le litlamorao tse amanang le tsona li ka hlaha. Ts'ebeliso e eketsehileng ea thiazide diuretics e ka eketsa ho eketseha ha li-lithium le ho eketsa monyetla oa ho ba le chefo. Ts'ebeliso e ts'oanang ea motsoako oa perindopril le indapamide e nang le litokisetso tsa lithium ha e khothalletsoe. Haeba ho hlokahala, kalafo e joalo e lokela ho lula e lekola litaba tsa lithium ka plasma ea mali (bona karolo "Litaelo tse ikhethang").

Lithethefatsi, ho kopana ha tsona ho hloka tlhokomelo e khethehileng

Baclofen: e ka eketsa phello ea hypotensive. Khatello ea mali le ts'ebetso ea liphio li lokela ho beoa leihlo; haeba ho hlokahala, ho lokisoa litekanyetso tsa meriana ea antihypertensive.

Lithethefatsi tse seng khahlanong le ho ruruha (NSAIDs), ho kenyelletsa le litekanyetso tse phahameng tsa acetylsalicylic acid (ho feta 3 g / ka letsatsi): li-NSAID li ka lebisa ho fokotseha hoa litlamorao tsa diuretic, natriuretic le antihypertensive. Ka tahlehelo ea bohlokoa ea mokelikeli, ho hloleha ha reef haholo ho ka hlaha (ka lebaka la ho fokotseha hoa sekhahla sa ho sefuba sa glomerular). Pele o qala kalafo ka setlhare, ho a hlokahala hore a etse pheko ya metsi mme a lekole ts'ebetso ea liphio qalong ea kalafo.

Motsoako o kopaneng oa lithethefatsi o hlokang tlhokomelo

Tricyclic antidepressants, antipsychotic (antipsychotic): lithethefatsi tsa litlelase tsena li matlafatsa phello ea antihypertensive le ho eketsa kotsi ea hypthension ea orthostatic (matla a eketsang).

Corticosteroids, tetracosactide: ho fokotseha ha phello ea antihypertensive (ho bolokoa ha metsi le sodium ion ka lebaka la corticosteroids).

Lithethefatsi tse ling tsa antihypertensive: li ka ntlafatsa phello ea antihypertensive.

Litaelo tse khethehileng

Ts'ebeliso ea lithethefatsi Noliprel® A 2,5 mg + 0,625 mg, e nang le lethal e fokolang la indapamide le perindopril arginine, ha e tsamaisane le ho fokotseha ho hoholo hoa makunutu a litlamorao, ntle le hypokalemia, ha ho bapisoa le perindopril le indapamide ka tekanyetso e tlase e lumelletsoeng (bona karolo " Litlamorao "). Qalong ea kalafo ka lithethefatsi tse peli tse antihypertensive, tseo mokuli a sa kang a li fumana pejana, kotsi e eketsehileng ea idiosyncrasy e ke ke ea qheleloa ka thoko. Ho hlokomela mokuli ka hloko ho fokotsa kotsi ena.

Ts'ebetso ea mokokotlo e sa sebetseng

Phekolo e kopantsoe le ho bakuli ba nang le bothata bo matla ba ho lemala (CC ka tlase ho 30 ml / min). Ho bakuli ba bang ba nang le khatello ea methapo ea methapo ea methapo ea methapo ntle le tšenyo e bonahalang e le teng ea liphio, kalafo e ka bontša matšoao a laboratori a ho hloleha ha tšebetso ea renal. Tabeng ena, kalafo e lokela ho khaotsa. Nakong e tlang, o ka qalella hape ho sebelisa litlhare o sebelisa litekanyetso tse tlase tsa lithethefatsi, kapa oa sebelisa litlhare ho monotherapy.

Bakuli ba joalo ba hloka ho hlahlojoa khafetsa ha serum potasiamo le li-creatinine - libeke tse 2 kamora ho qala ha kalafo le likhoeli tse ling le tse ling tse peli ka mor'a moo. Ho hloleha ha molomo hangata ho hlaha ho bakuli ba nang le bothata bo matla ba pelo bo sa foleng kapa ho ba le ts'ebetso ea pele ea mokokotlo ea mokokotlo, ho kenyelletsa le renal artery stenosis.

Arterial hypotension le boemo bo sa lekanyetsoang ba metsi-electrolyte

Hyponatremia e amahanngoa le kotsi ea kholo ea tšohanyetso ea methapo ea methapo (haholo ho bakuli ba nang le artery stenosis e le 'ngoe le methapo ea methapo ea methapo). Ka hona, ha ho hlahlojoa bakuli ka matla, ho lokela ho lebisoa tlhokomelo ho bona matšoao a ho felloa ke metsi le ho fokotseha ha maemo a electrolyte ho plasma ea mali, mohlala, kamora ho hlaba kapa ho hlatsa. Bakuli ba joalo ba hloka ho hlahlojoa khafetsa ka li-electrolyte tsa mali tsa mali.

Ka hypotension ea methapo e matla, tsamaiso e kenelletseng ea tharollo ea sodium chloride ea 0,9% e ka hlokahala.

Ho fokotseha ha nakoana ka linako tse ling ha se ho sitisa phekolo e tsoelang pele. Kamora ho khutlisetsa boholo ba potoloha mali le khatello ea mali, kalafo e ka qalisoa hape ka ho sebelisa litekanyetso tse tlase tsa lithethefatsi, kapa lithethefatsi li ka sebelisoa ka mokhoa oa monotherapy.

Boemo ba potasiamo

Ts'ebeliso e kopaneng ea perindopril le indapamide ha e thibele tsoelo-pele ea hypokalemia, haholo-holo ho bakuli ba nang le lefu la tsoekere kapa lefu la ho fokola ha masapo. Joalo ka ts'ebeliso e kopaneng ea lithethefatsi tse antihypertensive le diuretic, ho hlokahala hore ho hlahlojoe boemo ba potasiamo ka plasma ea mali kamehla.

Lipehelo tsa Maemo a Phomolo ea meriana

Setlhare ke ngaka.

Ha e le monotherapy, ngaka hangata e eletsa perindopril le indapamide ka thoko. Melemo ea lithethefatsi e kenyelletsa Co-preness kapa Prestarium Arginine Combi. Ntle le moo, moetsi o hlahisa Noliprel ho litekanyetso tse ling.

Litšenyehelo tse tloaelehileng tsa Noliprel A matlapa a 2,5 mg + 0,625 mg ka har'a litlama tsa meriana ea meriana ke li-ruble tse 540-600.

Tšebelisano

1. Motsoako ha o khothalletsoe hore o sebelisoe

Litokisetso tsa Lithium: ka tšebeliso e le 'ngoe ea litokisetso tsa lithium le li-inhibitors tsa ACE, keketseho e khutlisetsang moqoqong oa lithium ho plasma ea mali le litlamorao tse amanang le tsona li ka hlaha. Ts'ebeliso e eketsehileng ea thiazide diuretics e ka eketsa ho eketseha ha li-lithium le ho eketsa monyetla oa ho ba le chefo. Ts'ebeliso e ts'oanang ea motsoako oa perindopril le indapamide e nang le litokisetso tsa lithium ha e khothalletsoe. Haeba kalafo e joalo e hlokahala, litaba tsa lithium tse ka plasma ea mali li lokela ho lula li beiloe leihlo (bona "Litaelo tse Khethehileng").

2. Lithethefatsi, motsoako oa tsona o hloka tlhokomelo e khethehileng le tlhokomeliso

Baclofen: e ka eketsa phello ea hypotensive. Khatello ea mali le ts'ebetso ea liphio li lokela ho hlahlojoa; ho fetoloa ha lithethefatsi tsa antihypertensive hoa hlokahala haeba ho hlokahala.

Li-NSAIDs, ho kenyelletsa le litekanyetso tse phahameng tsa acetylsalicylic acid (ho feta 3 g / letsatsi): Li-NSAID li ka fokotsa litlamorao tsa diuretic, natriuretic le antihypertensive. Ka tahlehelo ea bohlokoa ea mokelikeli, ho hloleha ha reef haholo ho ka hlaha (ka lebaka la ho fokotseha hoa sekhahla sa ho sefuba sa glomerular). Pele o qala kalafo ka setlhare, ho a hlokahala hore a etse pheko ya metsi mme a lekole ts'ebetso ea liphio qalong ea kalafo.

3. Motsoako oa lithethefatsi tse hlokang ho tsotelloa

Corticosteroids, tetracosactide: ho fokotseha ha phello ea antihypertensive (ho bolokoa ha metsi le sodium ion ka lebaka la corticosteroids).

Lithethefatsi tse ling tsa antihypertensive: li ka ntlafatsa phello ea antihypertensive.

1. Motsoako ha o khothalletsoe hore o sebelisoe

Potassium-sparing diuretics (amiloride, spironolactone, triamteren) le litokisetso tsa potasiamo: ACE inhibitors e fokotsa tahlehelo ea potasiamo ke liphio tse bakoang ke diuretic. Potassium-sparing diuretics (mohlala, spironolactone, triamteren, amiloride), litokisetso tsa potasiamo, le tse nkang letsoai tse nang le potasiamo li ka lebisa keketseho e kholo phorong ea potasiamo e ka serum ea mali ho fihlela lefung. Haeba tšebeliso ea nako e le 'ngoe ea ACE inhibitor le lithethefatsi tse kaholimo (boemong ba hypokalemia e netefalitsoeng) e hlokahala, tlhokomeliso e lokela ho etsoa khafetsa' me ho hlahlojoe khafetsa litaba tsa potasiamo tse ka plasma ea mali le paramethara ea ECG li lokela ho etsoa.

2. Ho kopana ha lithethefatsi tse hlokang tlhokomelo e khethehileng

Basebeletsi ba Hypoglycemic bakeng sa tsamaiso ea molomo (sulfonylurea derivatives) le insulin: litlamorao tse latelang li hlalositsoe bakeng sa Captopril le enalapril. Li-inhibitors tsa ACE li ka ntlafatsa phello ea hypoglycemic ea melemo ea insulin le sulfonylurea ho bakuli ba nang le lefu la tsoekere. Nts'etsopele ea hypoglycemia ha e na seoelo (ka lebaka la keketseho ea mamello ea tsoekere le ho fokotseha ha tlhoko ea insulin).

3. Motsoako oa lithethefatsi tse hlokang ho tsotelloa

Lithethefatsi tsa Allopurinol, cytostatic le immunosuppression, corticosteroids (bakeng sa ts'ebeliso ea systemic) le procainamide: Ts'ebeliso e tšoanang le ACE inhibitors e kanna ea amahanngoa le kotsi e eketsehang ea leukopenia.

Mokhoa oa ho phekola ka kakaretso: ts'ebeliso e ts'oanang ea li-inhibitors tsa ACE le li-agents bakeng sa anesthesia ka kakaretso e ka lebisa ho eketseha ha phello ea antihypertensive.

Diuretics (thiazide le loop): ts'ebeliso ea li-diuretics ka tekanyetso e phahameng e ka lebisa ho hypovolemia, 'me ho eketsoa hoa perindopril ho kalafo ho ka lebisa ho arterial hypotension.

Litokisetso tsa khauta: ha u sebelisa li-inhibitors tsa ACE, incl. perindopril, ho bakuli ba fumanang tokiso ea khauta ea iv (sodium aurothiomalate), ho ne ho hlalositsoe mohopolo, ho kenyeletsa: hyperemia ea letlalo la sefahleho, ho nyekeloa ke pelo, ho hlatsa, hypotension ea methapo.

1. Ho kopana ha lithethefatsi tse hlokang tlhokomelo e khethehileng

Lithethefatsi tse ka bakang pirouette arrhythmias: ka lebaka la kotsi ea hypokalemia, tlhokomeliso e lokela ho sebelisoa ha u ntse u sebelisa indapamide ka lithethefatsi tse ka bakang pirouette arrhythmias, mohlala, lithethefatsi tsa antiarrhythmic (quinidine, hydroquinidine, disopyramide, amiodarone, dofetilide, ibutilide , bretilia tosylate, sotalol), li-antipsychotic tse ling (chlorpromazine, cyamemazine, levomepromazine, thioridazine, trifluoperazin), benzamides (amisulpride, sulpiride, sultopride, tiapride), butyrophenones (droperidol, gallop ridol), li-antipsychotic tse ling (pimozide), lithethefatsi tse ling tse joalo ka bepridil, cisapride, diphemanil methyl sulfate, erythromycin (iv), halofantrine, misolastine, moxifloxacin, pentamidine, sparfloxacin, vincamine (iv), methadonein, astadoneadin . Ts'ebeliso e tšoanang le lithethefatsi tse kaholimo e lokela ho qojoa, kotsi ea hypokalemia mme, haeba ho hlokahala, khalemelo ea eona, e laole nako ea QT.

Lithethefatsi tse ka bakang hypokalemia: amphotericin B (iv), corticosteroids le mineralocorticosteroids (bakeng sa ts'ebeliso ea ts'ebetso), tetracosactides, li-laxatives tse tsosang takatso ea mokokotlo: kotsi e eketsehileng ea hypokalemia (phello e eketsang). Hoa hlokahala ho laola litaba tsa potasiamo ka plasma ea mali, haeba ho hlokahala, khalemelo ea eona. Ho lebisoa tlhokomelo e khethehileng ho bakuli ka nako e tšoanang ba fumanang glycosides ea pelo. Methapo e sa khothalletseng tšusumetso ea mala e lokela ho sebelisoa.

Cardlyc glycosides: hypokalemia e ntlafatsa matla a chefo a pelo glycosides. Ka ts'ebeliso e le 'ngoe ea indapamide le pelo glycosides, litaba tsa potasiamo tse maling le li-indices tsa ECG li lokela ho betoa leihlo,' me ha ho hlokahala, kalafo e ntlafalitsoeng.

2. Ho kopana ha lithethefatsi tse hlokang ho tsotelloa

Metformin: ho hloleha ho sebetsa ha renal ho ka etsahalang ha o ntse o nka diuretics, haholo loop diuretics, ha tsamaiso ea metformin e eketsa kotsi ea lactic acidosis. Metformin ha ea lokela ho sebelisoa haeba boholo ba mahlahana a "metabolinine" a plasma ea mali a feta 15 mg / l (135 μmol / l) ho banna le 12 mg / l (110 μmol / l) ho basali.

Lisebelisoa tse nang le iodine e nang le iodine: ho felloa ke metsi 'meleng ha u ntse u sebelisa lithethefatsi tse tlotsang mmele ho eketsa menyetla ea ho hloleha ha rerelo haholo, haholoholo ha u sebelisa litekanyetso tse phahameng tsa li-iodine tse nang le phapang e fapaneng. Pele o sebelisa litlatsetso tse nang le iodineine tse nang le iodine, bakuli ba lokela ho etsa puseletso bakeng sa tahlehelo ea metsi.

Letsoai la khalsiamo: Tsamaiso e ts'oanang, hypercalcemia e ka hlaha ka lebaka la phokotseho ea li-ion tsa calcium tse nang le liphio.

Cyclosporin: keketseho ea tlhahiso ea "metabolinine" ka plasma ea mali e ka etsahala ntle le ho fetola khatello ea cyclosporin ka plasma ea mali, leha e na le metsi a tloaelehileng le a ion ea sodium.

Mokhoa oa ho nka, oa tsamaiso le litekanyetso

Kahare, ka ho khetheha hoseng, pele u ja.

Letlapa le le leng la lithethefatsi Noliprel ® Nako e le 1 ka letsatsi.

Ha ho khoneha, lithethefatsi li qala ka ho khetha litekanyetso tsa lithethefatsi tse nang le motsoako o le mong. Tabeng ea tlhoko ea kliniki, o ka nahana ka monyetla oa ho fana ka kalafo ea ho kopanya le Noliprel ® A hang kamora ho latela monotherapy.

Bakuli ba nang le khatello ea methapo ea kutlo le mofuta oa lefu la tsoekere la 2 ho fokotsa kotsi ea mathata a methapo (ho tloha liphio) le mathata a maholo a mafu a pelo le methapo

Letlapa le le leng 1 Noliprel ® Nako e le 1 ka letsatsi. Kamora kalafo ea likhoeli tse 3, ho latela mamello e ntle, hoa khonahala ho eketsa tekanyetso ho matlapa a 2 a Noliprel ® Nako ea 1 ka letsatsi (kapa 1 Letlapa la Noliprel ® A forte 1 ka letsatsi).

Bakuli ba baholo

Phekolo ka moriana o lokela ho laeloa kamora ho lekola ts'ebetso ea renal le khatello ea mali.

Setlhare sena se kopantsoe ho bakuli ba nang le bothata bo matla ba ho hlaba ba masapo (creatinine Cl ka tlase ho 30 ml / min).

Bakeng sa bakuli ba nang le ho se sebetse hantle ha renal (Cl creatinine 30-60 ml / min), ho khothalletsoa ho qala kalafo ka litekanyetso tse hlokahalang tsa lithethefatsi (ka mofuta oa monotherapy), tseo e leng karolo ea Noliprel ® A.

Bakeng sa bakuli ba Cl creatinine e lekanang kapa e kholo ho feta 60 ml / min, phetoho ea lethal dose ha e hlokehe. Nakong ea phekolo, ho hlokahala hore ho hlahlojoe khafetsa maemo a plasma a creatinine le potasiamo.

Setlhare sena se kopantsoe le bakuli ba nang le ts'oaetso e matla ea hepatic.

Ho hloleha ho matla ha sebete, ha ho hloke phetoho ea tekanyetso.

Bana le bacha

Noliprel ® A ha ea lokela ho fuoa bana le bacha ba ka tlase ho lilemo tse 18 ka lebaka la tlhaiso-leseling mabapi le katleho ea ts'ebeliso ea lithethefatsi ho bakuli ba sehlopha sena sa lilemo.

Litaelo tse khethehileng

Ts'ebeliso ea lithethefatsi Noliprel ® A 2,5 mg + 0,625 mg, e nang le tekanyetso e tlase ea indapamide le perindopril arginine, ha e tsamaisane le phokotso ea bohlokoa khafetsa ea litlamorao, ntle le hypokalemia, ha e bapisoa le perindopril le indapamide ka tekanyetso e tlase e lumelletsoeng ho sebelisoa. liketso "). Qalong ea kalafo ka lithethefatsi tse peli tse antihypertensive, tseo mokuli a sa kang a li fumana pejana, kotsi e eketsehileng ea idiosyncrasy e ke ke ea qheleloa ka thoko. Ho hlokomela mokuli ka hloko ho fokotsa kotsi ena.

Ts'ebetso ea mokokotlo e sa sebetseng

Phekolo e kopantsoe le ho bakuli ba nang le bothata bo matla ba ho lemala (creatinine Cl ka tlase ho 30 ml / min). Ho bakuli ba bang ba nang le khatello ea methapo ea methapo ea methapo ea methapo ntle le tšenyo e bonahalang e le teng ea liphio, kalafo e ka bontša matšoao a laboratori a ho hloleha ha tšebetso ea renal. Tabeng ena, kalafo e lokela ho khaotsa. Nakong e tlang, o ka qalella hape ho sebelisa litlhare o sebelisa litekanyetso tse tlase tsa lithethefatsi, kapa oa sebelisa litlhare ho monotherapy.

Arterial hypotension le boemo bo sa lekanyetsoang ba metsi-electrolyte

Ka khatello e matla ea methapo ea kutlo, tsamaiso ea iv ea tharollo ea chloride ea 0,9% e ka hlokahala.

Ho fokotseha ha nakoana ka linako tse ling ha se ho sitisa phekolo e tsoelang pele. Kamora ho khutlisetsa BCC le khatello ea mali, o ka qalella kalafo o sebelisa litekanyetso tse tlase tsa lithethefatsi, kapa oa sebelisa lithethefatsi ka mokhoa oa monotherapy.

Ts'ebeliso e kopaneng ea perindopril le indapamide ha e thibele tsoelo-pele ea hypokalemia, haholo-holo ho bakuli ba nang le lefu la tsoekere kapa lefu la ho fokola ha masapo. Joalo ka ts'ebeliso e kopantsoeng ea lithethefatsi tse khahlanong le antihypertensive le diuretic, ho hlokahala hore ho hlahlojoe boemo ba potasiamo ka plasma ea mali kamehla.

Re lokela ho hopola hore sebopeho sa ba tlisoang ke sethethefatsi sena se kenyeletsa lactose monohydrate. Noliprel ® A ha ea lokela ho laeloa bakuli ba nang le lefutso la lefutso la galactose, khaello ea lactase le malabsorption ea glucose-galactose.

Tšebeliso e tšoanang ka nako e le 'ngoe ea motsoako oa perindopril le indapamide ka litokisetso tsa lithium ha e khothalletsoe (bona. "Contraindication", "Interaction").

Kotsi ea ho ba le neutropenia ha u ntse u sebelisa li-inhibitors tsa ACE e itšetlehile ka tekanyetso mme ho latela moriana o nooang le ho ba teng hoa mafu a kopaneng. Neutropenia ha e hlahe haholo ho bakuli ntle le mafu a kopaneng, empa kotsi e eketseha ho bakuli ba nang le ts'ebetso ea renal e sa sebetseng hantle, haholoholo khahlanong le mafu a methapo ea methapo (ho kenyeletsa systemic lupus erythematosus, scleroderma). Kamora ho tlosoa ha li-inhibitors tsa ACE, matšoao a neutropenia a nyamela a le mong.

Ho qoba nts'etsopele ea maikutlo a joalo

Tse fodisang Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.? E ntlehali ea Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.. Khetho Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.. Maemo a polokelo Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.. Theko e tloaelehileng ea Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.. Ts'ebeliso e feteletseng Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.. Nka feela Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha.. Noliprel A matlapa a 2,5 + 0,625 mg 30 likhomphutha. reka inthaneteng.

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