Noliprel A Fort > Jiyya da rigakafin

Sunan Latin: Noliprel A forte

Lambar ATX: C09BA04

Aiki mai aiki: perindopril arginine (perindopril arginine) + indapamide (indapamide)

Mai samarwa: Laboratories Servier masana'antu (Faransa), Serdix, LLC (Russia)

Bayanin sabuntawa da hoto: 11/27/2018

Farashin kuɗi a cikin kantin magani: daga 564 rubles.

Noliprel A forte shine magungunan antihypertensive hade, gami da maganin angiotensin wanda ke canza enzyme inhibitor (ACE) da diuretic.

Formaddamar da tsari da abun da ke ciki

Ana amfani da miyagun ƙwayoyi a cikin nau'ikan allunan da aka sanya fim: oblong, fararen fata (a cikin kwalabe polypropylene tare da mai rarraba: 14 ko 29 inji mai kwakwalwa., A cikin kwali mai kwali tare da iko na farko na buɗe kwalban 1, 30 inji mai kwakwalwa., A cikin kwali na kwali tare da sarrafa bude farko Kwalabe 1 ko 3, a cikin kunshe-kunshe na asibitoci - kwalabe 30 a cikin kwali na kwali, a akwatunan kwali 1 pallet da umarnin don amfani da Noliprel A forte).

Kwamfutar hannu 1 ya ƙunshi:

abubuwa masu aiki: perindopril arginine - 5 MG (daidai yake da abun ciki na 3.395 mg perindopril), indapamide - 1.25 mg,
abubuwan taimako: lactose monohydrate, silikion siliki na anhydrous, maltodextrin, sitaci carboxymethyl sitiri (nau'in A), magnesium stearate,
abun rufe fim: premix ga farin fim mai suna SEPIFILM 37781 RBC hypromellose, macrogol 6000, glycerol, titanium dioxide (E171), magnesium stearate, macrogol 6000.

Magungunan "Noliprel forte": abun da ke ciki da nau'in sakinsa

Ana samun maganin ta hanyar nau'ikan allunan da aka rufe tare da fim mai kariya. Wannan magani ya hada da abubuwa da yawa masu aiki lokaci daya, wanda ya samar da tasirin da yake hadewa. Musamman, kowane kwamfutar hannu yana da 10 mg perindopril arginine (wannan adadin ya dace da 6.79 mg perindopril) da 2.5 ml indapamine.

A cikin yin magungunan, ana amfani da abubuwa kamar magnesium stearate, colloidal anhydrous silicon dioxide, lactose monohydrate, maltodextrin, hypromellose, macrogol 6000, glycerol da wasu mutane kuma ana amfani dasu azaman wakilai masu taimakawa.

Kayan magunguna na maganin

Tabbas, kaddarorin magungunan "Noliprel forte" suna haɗuwa da farko tare da tasiri akan jikin abubuwan haɗin jikin mutum. Amma ga masu farawa, yana da mahimmanci a lura cewa miyagun ƙwayoyi suna da tasirin sakamako mai ƙarfi, kuma yana shafar duka systolic da matsa lamba na diastolic. Yawan tsananin tasirin a wannan yanayin ya dogara da kashi. Sakamakon da ya ci gaba yana bayyana ba a ƙarshen wata guda ba bayan fara magani.

Perindopril shine ɗayan manyan magunguna. Wannan abu shine mai hana wani nau'in enzyme. Yana daidaita tasoshin jini da dawo da tsarin ganuwar su. Yawancin bincike sun nuna cewa perindropril yana rage karfin jini, kuma janyewar magunguna baya haifar da tsalle mai tsayi. Wani sinadari mai aiki, indapamide, yana kama da sifofin sa na thiazide diuretics. Wannan bangaren yana hana shan sinadarin ion potassium a cikin nephron, wanda ke haifar da karuwar diuresis da fitowar klorine da ion sodium tare da fitsari.

Perindopril yana fita a cikin fitsari. Ana lura da matsakaicin nisan sa'o'i 3-4 bayan gudanarwa. Amma game da indapamide, yakan fara yin aiki da ƙarfi bayan awa ɗaya, kuma yana fitar da fitsari da jijiyoyi.

Pharmacodynamics

Noliprel A forte magani ne mai narkewa, sakamakon hakan yana faruwa ne sakamakon abubuwan da suka lalace na farji da haɓaka, wanda aka inganta sakamakon haɗuwar su.

Perindopril shine mai hanawar ACE wanda ke da alhakin juyawa da angiotensin I cikin vasoconstrictor abu angiotensin II. Bugu da ƙari, ACE (ko kininase II) yana canza bradykinin cikin heptapeptide mara aiki. Bradykinin a cikin jikin yana da tasirin vasodilating. Sakamakon inhibition na ACE, ɓoyewar aldosterone yana raguwa, tsari mai kyau mara kyau yana farawa, wanda ke ƙara aikin renin a cikin jini. Saboda ƙananan fitowar kaya da bayan saukowa, aikin myocardial aikin al'ada ne. Dogon amfani da perindopril yana taimakawa rage jimirin jijiyoyin bugun jini (OPSS), wanda yafi dacewa saboda tasirinsa akan tasoshin a cikin tsokoki da kodan. Ana samun sakamako ba tare da bata lokaci ba na sodium da ion ruwa ko kuma ci gaban tachycardia na reflex.

An tabbatar da cewa idan akwai rauni a cikin zuciya (CHF), perindopril yana samar da raguwa a cike matsin lamba a cikin hagu da dama ventricles na zuciya, raguwa a cikin zuciya, haɓakar fitowar zuciya da karuwa a cikin jijiyoyin jini na jini.

Indapamide shine sulfonamide wanda kayan aikin magunguna suna da alaƙa da thiazide diuretics. Yana hana farfadowa daga sinadarin sodium ion a cikin hadin gwiwa na Henle madauki, yana haɓaka fitowar sinadarin chloride, sodium, har zuwa ƙarancin magnesium da ions potassium ta hanjin kodan. Wannan yana ƙaruwa diureis kuma yana haifar da raguwar hauhawar jini (BP).

Tasirin antihypertensive na Noliprel A forte shine ya dogara da yanayi, yayin da yake tsaye da kwance an kuma nuna shi daidai da batun narkewa da hawan jini na systolic. Bayan shan kwaya, sakamakon maganin ya ci gaba har na awanni 24. Tasirin warkewa ya isa kwanciyar hankali bayan kwanaki 30 na magani.

Rashin kwanciyar hankali ba tare da raunin ciwo ba.

Tare da yin amfani da Noliprel A forte, akwai raguwa a cikin OPSS, raguwa a cikin digiri na hauhawar jini ventricular hagu (GTL), da haɓakawa a cikin ƙwayar jijiya. A miyagun ƙwayoyi ba zai tasiri metabolism na lipids da abun ciki na jimlar cholesterol, cholesterol, babban lipoprotein yawa (HDL) da ƙarancin lipoprotein (LDL) ko triglycerides.

Tare da hauhawar jini a cikin jijiyoyin jini da kuma GTL, dangane da amfani da haɗuwa da perindopril da indapamide, ana lura da raguwa mafi mahimmanci a cikin ventricular taro index (LVMI) da sakamako na antihypertensive idan aka kwatanta da enalapril.

Binciken tasirin Noliprel A Forte akan babban macro- da microvascular rikice-rikice a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 wanda aka zartar a matsayin ƙari ga duka daidaitattun hanyoyin kwantar da hankali don kulawar glycemic da glycemic control (IHC) (manufa HbA)_1c kasa da 6.5%). Groupungiyar rukuni na marasa lafiya sun shiga cikin binciken, matsakaicin alamu waɗanda suke: shekaru 66 shekaru, hawan jini - 145/81 mm Hg, nauyin taro mai nauyi - 28 kilogiram 1 a 2 na farjin jiki, HbA1c (glycosylated haemoglobin) - 7.5%. Yawancin marasa lafiya sun kasance akan maganin hypoglycemic da concomitant therapy (ciki har da antihypertensive, hypolipPs, antiplatelet).

Sakamakon bincike (tsawon lokacin kallo yana kusan shekaru 5) ya nuna raguwa 10% a cikin haɗarin haɗarin haɗarin mitar macro- da rikitarwa na microvascular a cikin rukunin IHC (matsakaita HbA_1c 6.5%) idan aka kwatanta da daidaitaccen ƙungiyar kulawa (HbA matsakaici)_1c 7,3%).

An danganta raguwa sosai game da haɗarin dangi da raguwar 14% a cikin rikitattun ƙananan ƙwayoyin cuta, 21% don faruwa da ci gaban nephropathy, 9% don microalbuminuria, 30% don macroalbuminuria, da 11% don haɓakar rikicewar koda.

Amfanin maganin rigakafin cutar bai dogara da fa'idodin da aka samu tare da IHC ba.

An tabbatar da ingancin antihypertensive na perindopril don lura da hauhawar jijiya ta kowane tsananin. Bayan gudanar da maganin baka guda ɗaya, ana samun mafi girman tasirin Noliprel A Forte bayan sa'o'i 4-6 kuma zai kai tsawon awanni 24. An ayyana saura (kusan 80%) hanawar ACE ana yin sa'o'i 24 bayan gudanarwarsa.

Perindopril yana da tasiri mai ƙarfi tare da ƙaramin aiki da kuma aikin plasma renin na al'ada.

Haɗin tare da thiazide diuretics yana ƙaruwa da mummunan tasirin antihypertensive, rage haɗarin hypokalemia saboda yawan diuretics.

Harkokin haɗin gwiwa tare da mai hanawa na ACE da mai hana antagonist angioensin II (ARA II) a cikin marasa lafiya da tarihin cututtukan zuciya ko cuta na cerebrovascular, marasa lafiya da ke da nau'in ciwon sukari na 2 (tare da tabbatar da lalacewar ƙwayar cuta), nau'in ciwon sukari na 2 da masu ciwon sikila ba su kasance a asibiti ba. babban tasiri mai kyau kan abin da ya faru na renal da / ko abubuwan da ke faruwa na zuciya ko a cikin yawan mace-mace. Amma bayan kwatanta shi da monotherapy, an gano cewa a kan asalin haɗin haɗakar ACE da injinar ARA II, haɗarin haɓaka hyperkalemia, ƙarancin renal renal da / ko hypotension hypotension yana ƙaruwa.

Yin la'akari da cewa kayan aikin inshora na intragroup na ACE inhibitors da ARA II suna kama da juna, ana iya tsammanin waɗannan sakamakon tare da haɗakar perindopril da ARA II.

Ba'a ba da shawarar yin amfani da inhibitors na ACE da ARA II a lokaci guda a cikin marasa lafiya da ke fama da cutar sankarar hanta ba.

Alarin aliskiren zuwa nau'in ciwon sukari na 2 na ƙwayar cuta da cutar koda da / ko cututtukan zuciya zuwa daidaitaccen ACE ko ARA II inhibitor therapy yana kara haɗarin sakamako masu illa, ciki har da mutuwar zuciya, bugun jini, haɓakar hyperkalemia, hauhawar jini da kuma aiki na ƙarancin aiki .

Amfani da indapamide a allurai wadanda suke da tasirin diuretic kadan suna haifar da raguwa a cikin OPSS, yana inganta kwatancen roba na manyan jijiya, wanda ke samar dashi da sakamako mai tsauri. Ba tare da cutar da matakin lipids a cikin jini plasma (triglycerides, jimlar cholesterol, LDL, HDL) da metabolism metabolism (ciki har da marasa lafiya da ciwon sukari mellitus), indapamide yana taimakawa rage GTL.

Pharmacokinetics

Abubuwan da ke tattare da tsarin magunguna na asali a cikin monotherapy tare da kowane ɗayan magunguna ba su canza tare da haɗuwa da perindopril da indapamide.

Bayan gudanar da baki, shayewar perindopril yana faruwa da sauri, takaddar bioavinsa zai iya kasancewa daga 65 zuwa 70%. Kimanin 20% na adadin ƙwayar da aka tunawa ana yin biotransformed zuwa cikin ƙwayar metabolites mai aiki. Matsakaicinsa (C_max) a cikin jini yana isa bayan awa 3-4. Inarancin lokaci guda yana rage juyi na perindopril zuwa perindoprilat ba tare da babban sakamako na asibiti ba.

Bayan saurin daukar ruwa kusa da indapamide daga hancin ciki da cikakke akan kashi da aka dauka, C_max A cikin jini (plasma) ana kai jini a cikin awa 1 daga lokacin shigar.

Shafin furotin na Plasma: perindopril - kasa da 30%, indapamide - 79%.

Rashin daidaituwa na ACE da ke da alaƙa perindoprilat yana da jinkiri, saboda haka, ingantaccen rabin rayuwar (T_1/2) perindopril - 25 hours. An cimma matsayin daidaituwa bayan awa 96.

Perindopril ya ƙetare shinge na jini.

Yawan Noliprel na yau da kullun A forte ba ya haifar da tarawa a cikin jikin abubuwan haɗinsa.

Perindoprilat ne ke cire kodan, T_1/2 Yana da awanni 3-5.

T_1/2 indapamide yayi kimanin awa 19. An cire shi a cikin nau'in metabolites mara aiki: ta hanyar kodan - 70% na kashi da aka ɗauka, ta cikin hanji - 22%.

Addamar da perindoprilat yayin dialysis shine 70 ml / min.

Tare da na koda da gazawar zuciya, haka kuma a cikin tsofaffi marasa lafiya, ƙwanƙwalwar perindoprilat yana raguwa.

Tare da cirrhosis na hanta, ƙarancin hepatic na perindopril an rage shi sau 2, amma wannan bai shafi adadin perindoprilat ba, saboda haka ba a buƙatar daidaita sashi.

A cikin marasa lafiya da gazawar renal, magunguna na indapamide ba ya canzawa.

Contraindications

mai tsanani hanta, ciki har da rikitarwa ta hanyar encephalopathy,
mai tsanani gazawar koda tare da keɓantar da kerawa (CC) ƙasa da 30 ml / min,
sasantawa biyu na koda
daya na aikin koda,
da amfani da hemodialysis,
hypokalemia
rashin kulawa da ɓacin zuciya
concomitant far tare da kwayoyi da ke mika QT tazara,
haɗuwa tare da magungunan antiarrhythmic waɗanda zasu iya haifar da arrhythmias ventricular kamar "pirouette",
amfani da lokaci daya tare da kwayoyi masu dauke da aliskiren a cikin marasa lafiya da masu ciwon sukari mellitus ko kuma aikin nakasassu na aiki (GFR kasa da 60 ml / min ta 1.73 m2 na yankin farfajiyar jiki),
cututtukan glucose-galactose malabsorption, galactosemia, rashi lactase,
gado ko gado na angioedema,
alama ce ta tarihi na rashin lafiyar angioedema, gami da amfani da masu hana masu cutar ta ACE,
lokacin haihuwa
nono
shekaru zuwa shekaru 18
tabbatar da rashin kwanciyar hankali ga sauran hanawa na ACE ko hanawar sulfonamides,
mutum haƙuri zuwa ga abubuwan da miyagun ƙwayoyi.

Tare da taka tsantsan, an ba da shawarar cewa Noliprel A forte an tsara shi ga marasa lafiya tare da raunin zuciya na rauni na aji na aiki na IV bisa ga ƙaddamar da NYHA (Yorkungiyar Zuciyar New York), angina pectoris, hauhawar jini, tashin jini na katako, aortic valve stenosis, bugun jini na jini mai ƙoshin jini, haɓakar haɓakar haɓaka jini (rage yawan jini jini) (haɗe da sakamakon shan diuretics, bin abinci mai ƙoshin gishiri, tare da amai, gudawa ko maganin hemodialysis), cerebrovascular abolevaniyami, ciwon sukari, hanta gazawar, tsari connective nama cututtuka (ciki har da scleroderma, tsari lupus erythematosus), tare da lability na jini, hyperuricemia (musamman tare urate gout kuma nephrolithiasis), a cikin tsofaffi, kazalika da masu sana'a da 'yan wasa da kuma marasa lafiya baƙar fata.

Bugu da kari, ana bada shawara don yin taka tsantsan tare da yin amfani da lokaci guda na immunosuppressants, shirye-shiryen lithium, hemodialysis ta amfani da membranes mai haɓaka mai ƙarfi, desensitization, a cikin lokaci kafin tsarin LDL apheresis apheresis, maganin sa barci, da juyawa na koda.

Side effects

daga tsarin juyayi na tsakiya: sau da yawa - ciwon kai, vertigo, dizziness, asthenia, paresthesia, infrequently - mood mood, tashin hankali na bacci, da wuya - rikicewa, mita ba a kafa ba - suma,
daga cikin hanyoyin lymphatic da wurare dabam dabam: da wuya - leukopenia, neutropenia, thrombocytopenia, agranulocytosis, aplastic anemia, hemolytic anemia, anemia (bayan kamuwa da koda, hemodialysis),
daga tsarin jijiyoyin jini: sau da yawa - raguwar alama a cikin karfin jini (ciki har da maganin orthostatic hypotension), da wuya - cardiac arrhythmias (gami da bradycardia, achricular tachycardia, atrial fibrillation), angina pectoris, infarction na myocardial, mita ba a kafa - pirouette type arrhythmia, gami da kisa,
daga gabobin azanci: sau da yawa - tinnitus, hangen nesa mai rauni,
daga tsarin numfashi, kirji da gabobin jiki: sau da yawa - bushewar bacci na lokaci-lokaci (saboda tsawan lokaci na amfani da haɓakar perindopril), gajeriyar numfashi, sau da yawa - bronchospasm, da wuya - rhinitis, eosinophilic huhu,
daga tsarin narkewa: sau da yawa - cin zarafin dandano, bushewar bushe, ciwan ci, tashin zuciya, amai, ciwon mara, ciwon ciki, maƙarƙashiya, zawo, dyspepsia, da wuya - pancreatitis, angioedema, cholestatic jaundice, cytolytic ko cholestatic hepatitis, mitar ba a kafa - hepatic encephalopathy (tare da ciwan hanta rashin nasara),
halayen rashin lafiyan: akai-akai - urticaria, angioedema na fuska, lebe, harshe, wata gabar jiki, da hancin muryoyin guda biyu da / ko kuma larynx, idan akwai wani yanayi wanda zai iya haifar da toshewar hanji da kuma halayen rashin lafiyan - halayen rashin hankali,
halayen cututtukan cututtukan fata: sau da yawa - itching, fatar fata, fitsarin maculopapular, da wuya - haɓaka da mummunar yanayin tsarin lupus erythematosus, purpura, da wuya - mai guba da cututtukan cututtukan cututtukan ƙwaƙwalwa, erythema multiforme, cututtukan Stevens-Johnson, yanayin daukar hoto,
daga tsarin jijiyoyin wuya: sau da yawa - spasms muscle,
daga tsarin haifuwa: akai-akai - rashin ƙarfi,
daga urinary system: akai-akai - na kiwo gazawar, da wuya sosai - m renal gazawar,
alamomin dakin gwaje-gwaje: da wuya - hypercalcemia, mitar ba a kafa ta ba - karuwa a cikin tsaka-tsakin QT akan ƙwayar elektrogram, haɓaka matakin glucose da uric acid a cikin jini, karuwa a cikin ayyukan hanta enzymes, hypokalemia, hypoatlemia, hypovolemia, hyperkalemia, ƙaramin haɓakawa cikin hanji da jini,
halayen gabaɗaya: sau da yawa - asthenia, ba tare da ɓata lokaci ba - karuwar gumi

Yawan abin sama da ya kamata

Bayyanar cututtuka: raguwar hauhawar jini a cikin jini, wanda ke haɗuwa da tashin zuciya, amai, amai, amai, damuwa, rikicewar, oliguria, wani lokacin juyewa zuwa cikin rashin lafiyar a sakamakon hypovolemia, rashin daidaituwa na ruwa-electrolyte (hyponatremia da hypokalemia).

Jiyya: lavage na ciki na nan da nan, alƙawarin carbon da ke aiki, sake dawo da ma'aunin ruwa da lantarki. Tare da matsanancin hypotension, ya kamata a saka mara lafiyar a bayan sa kuma kafafunsa su tashi. Don tabbatar da kulawa da hankali game da yanayin haƙuri, tare da hypovolemia - don aiwatar da haɓakar iv (jiko) na 0.9% sodium chloride bayani.

Wataƙila amfani da dialysis.

Umarni na musamman

Amfani da Noliprel A forte yana haɗuwa da halayen sakamako masu illa na monotherapy tare da perindopril da indapamide a mafi ƙasƙanci warkewa. A cikin marasa lafiyar da ba su karɓi magani a baya tare da magungunan antihypertensive guda biyu ba, akwai karuwar haɗarin idiosyncrasy, sabili da haka ana buƙatar saka idanu sosai don rage wannan haɗarin.

Idan ana samun alamun dakin gwaje-gwaje na lalacewa na aiki yayin aikin jiyya, ya kamata a dakatar da magani tare da miyagun ƙwayoyi. Don ci gaba da haɗuwa da magani, ana bada shawara don amfani da ƙananan allurai na kowane magani ko kuma a rubuta ɗaya daga cikinsu. A wannan yanayin, marasa lafiya suna buƙatar saka idanu akai-akai na ƙwayoyin ƙwayoyin serum da matakan creatinine. Ana gudanar da karatun ne kwanaki 14 bayan fara magani sannan kuma 1 lokaci cikin kwanaki 60.

A cikin marasa lafiya da mummunan rauni na zuciya da fara aiki rashi aiki (ciki har da na koda artery stenosis), gazawar koda yana faruwa akai-akai.

Kwatsam haɓakar jijiyoyin jini ya fi yiwuwa tare da farkon hyponatremia, musamman a cikin marasa lafiya da ke fama da cutar sankarar jijiya. Sabili da haka, bayan zawo ko amai, ya zama dole yin la'akari da yiwuwar fitarwar jiki da raguwa a cikin abubuwan da ke cikin jini a cikin jini. Tare da matsanancin yanayin jijiya, ana nuna kulawa na 0.9% sodium chloride bayani.

Kwancen jijiyoyin jijiyoyin jiki ba dalili bane na katse jiyya. Bayan dawo da BCC da hawan jini, ana iya sake dawo da magani ta amfani da karancin allurai biyu masu aiki ko kuma ɗayansu.

Jiyya ya kamata ya kasance tare da saka idanu na yau da kullum na potassium a cikin jini, musamman tare da ciwon sukari mellitus da gazawar koda.

Yin amfani da Noliprel A Fort ya kamata a dakatar da sa'o'i 24 kafin fara tashin hankali.

Kafin kowane tsarin maganin LDL ta amfani da dextran sulfate, ya kamata a dakatar da aikin inhibitor na ACE na ɗan lokaci.

A cikin marasa lafiyar da ke cikin jijiyoyin perindopril, membranes mai haɓaka mai zurfi ba za a iya amfani da su ba yayin hemodialysis. Yakamata a maye gurbinsu da sauran membranes ko madadin maganin rigakafin jini ya kamata a tsara wa mai haƙuri ta yin amfani da kwayoyi na wani rukunin magunguna.

A cikin bayyanar cututtukan tari na bushewa wanda ya tashi a lokacin jiyya, ya kamata a ɗauka a zuciya cewa amfani da inhibitor na ACE na iya zama sanadin bayyanar ta.

Saboda babban haɗarin ci gaban neutropenia, agranulocytosis, thrombocytopenia, da anemia, ya kamata a kula da kulawa ta musamman lokacin da ake tsara perindopril ga marasa lafiya da cututtukan cututtukan ƙwayoyin cuta na haɗin haɗin gwiwa suna ɗaukar immunosuppressants, procainamide ko allopurinol, musamman tare da fara aiki na nakasassu na aiki. Wadannan marasa lafiya suna cikin haɗarin kamuwa da cuta mai saurin kamuwa da cuta, akasari suna tsayayya da maganin rigakafi mai guba. Yin amfani da Noliprel A Forte a cikin wannan rukuni na marasa lafiya ana bada shawarar a haɗa tare da saka idanu na lokaci-lokaci na yawan leukocytes a cikin jini. Yakamata a sanar dasu game da bukatar tuntuɓi likita nan da nan idan akwai ciwon makogwaro, zazzabi da sauran alamun cutar na ƙwayar cuta.

Tare da raguwa a cikin jini plasma jini da hypovolemia mai ƙarfi, da farko saukar karfin jini, renal artery stenosis, ƙwaƙwalwar ajiyar zuciya, ko cirrhosis na hanta tare da edema da ascites, babban kunnawa na renin-aldosterone-angiotensin system (RAAS) na iya faruwa saboda toshewar wannan tsarin ta perindopril. Halin mai haƙuri na iya haɗuwa tare da raguwa mai yawa a cikin karfin jini, haɓaka ƙirar creatinine a cikin jini, haɓakar rashin aiki na koda. Yawanci, ana ganin waɗannan abubuwan mamaki a cikin kwanakin 14 na farko na maganin. Ana bada shawara don sake fara shan maganin tare da ƙananan kashi.

Don hauhawar jini a cikin marasa lafiya da ke fama da cututtukan zuciya na zuciya (CHD), karancin ƙwayoyin cuta, gazawar zuciya mai tsanani da / ko nau'in ciwon sukari na 1, ya kamata a fara amfani da ƙarancin allurai. Marasa lafiya tare da cututtukan jijiyoyin zuciya yakamata su ɗauki alluran ACE tare da masu hanawa.

Sakamakon haɗarin haɓakar anemia a cikin marasa lafiya waɗanda ke fuskantar jigilar ƙwayar koda ko fuskantar hemodialysis, magani ya kamata ya kasance tare da gwaje gwajen jini.

Kafin a yi masa tiyata sosai, za a dakatar da Noliprel A Fort cikin sa'o'i 24 kafin a fara maganin babban jijiya.

Ya kamata a ɗauka a cikin zuciya cewa a cikin marasa lafiya na tseren Neroid, sakamakon antihypertensive na perindopril ba shi da ƙima.

Idan akwai aiki na hanta mai rauni, indapamide zai iya haifar da haɓakar encephalopathy hepatic, yana buƙatar dakatar da maganin nan da nan.

Wa'adin Noliprel A forte ya kamata a yi la'akari da sakamakon binciken daidaituwar ma'aunin ruwan-electrolyte (gami da sinadarin sodium, potassium da alli na alli a cikin jini) na mai haƙuri, bayan wannan kulawa na yau da kullun wajibi ne.

Hypokalemia a cikin tsofaffi marasa lafiya, marasa lafiya marasa lafiya, marasa lafiya tare da raunin zuciya, cututtukan zuciya na zuciya, cirrhosis (tare da edema ko ascites) yana inganta tasirin mai guba na ƙwayar bugun zuciya kuma yana kara haɗarin arrhythmias.

A yayin maganin diuretic, matakan plaicma uric acid na farfajiya na iya kara yawan faruwar harin gout.

Ingantaccen aikin magani tare da thiazide da thiazide-like diuretics na iya samun cikakken tabbacin kawai tare da aiki na al'ada ko kuma dan ƙaramin rauni na aiki. Concentarfafa ƙwaƙwalwar ƙwaƙwalwar ƙwayar plasma a cikin marasa lafiya ya kamata ya kasance a ƙasa da 2.5 mg / dL ko 220 μmol / L. Ga tsofaffi marasa lafiya, an daidaita shi don shekaru, jinsi, da nauyi ta amfani da tsarin Cockcroft. Ana nuna daidaitaccen ma'aunin plasma creatinine a cikin maza ta hanyar ninka bambanci (shekarun ƙarar 140) ta nauyin mai haƙuri a cikin kilo da rarrabuwa sakamakon sakamakon ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwayar plasma (μmol / L), wanda ya ninka 0.814. Don ƙaddara wannan alamar ga mata, sakamakon ƙarshe dole ne ya ninka 0.85.

Ga marasa lafiya da keɓaɓɓen aikin na koda, bayyanar da rashin aiki na ɗan lokaci ba shi da haɗari. Tare da gazawar asali na asali, raguwa a cikin GFR, haɓakawa game da yawan urea da creatinine a cikin jini na jini na iya samun halayen da aka ambata da mummunan sakamako.

Saboda haɗarin halayen daukar hoto yayin amfani da Noliprel A Forte, ana bada shawara don guji haɗuwa da hasken rana kai tsaye ko radiation na wucin gadi.

Ya kamata a ɗauka a cikin zuciya cewa lokacin yin gwajin doping a cikin 'yan wasa, indapamide zai iya ba da kyakkyawar amsawa.

Tasiri a kan ikon tuka motoci da abubuwa masu rikitarwa

Noliprel A forte ba ya haifar da cin zarafin halayen psychomotor. Koyaya, saboda haɗarin da ke tattare da haɓakar haɗari wanda ke faruwa a kan asalin rage karfin jini ko yayin gyaran jiyya, ana ba da shawara sosai yayin tuki motocin da keɓaɓɓun hanyoyin, musamman a farkon farfaɗo.

Haihuwa da lactation

Amfani da Noliprel A Forte shine contraindicated yayin lokacin haihuwa da shayarwa.

Lokacin da ake shirin yin juna biyu ko kuma idan aka sami juna biyu a lokacin jiyya, to yakamata a daina amfani da maganin kuma dole ne a wajabta maganin wakili wanda aka yarda dashi don amfani da shi yayin daukar ciki.

Yin amfani da inhibitors na ACE a cikin II - III trimesters na ciki na iya haifar da mummunan rauni na ci gaban tayi (rage aiki na renal, jinkirta ossification na kasusuwa kwanyar, oligohydramnios) da haɓaka rikice-rikice a cikin jariri (gazawar renal, hypotension da / ko hyperkalemia).

Bugu da ƙari, yin amfani da magani na dogon lokaci tare da thiazide diuretics a cikin watanni uku na ciki na ciki yana cutar da utero-placental jini na gudana, kuma yana haifar da hypovolemia a cikin mahaifiyar.

Tare da nakasa aiki na koda

Yin amfani da Noliprel A Forte yana cikin lalacewar cikin lalacewa mai ƙarfi (CC kasa da 30 ml / min).

A cikin gazawar renal a cikin marasa lafiya tare da CC 30-60 ml / min, alƙawarin hada magunguna ya kamata a yi bayan na farko monotherapy tare da kowane ɗayan abubuwan aiki. Wajibi ne don amfani da allurai waɗanda zasu ba da damar cimma sakamako mafi warkewa.

A cikin gazawar koda tare da CC na 60 ml / min da sama, ana sanya allurai saba na Noliprel A forte, tare da kulawa tare da saka idanu akai-akai na ƙwayoyin plainma creatinine da potassium.

Hulɗa da ƙwayoyi

shirye-shiryen lithium: haɗuwa da inhibitor na ACE da shirye-shiryen lithium suna kara haɗarin haɗarin sakewa mai haɗari a cikin taro na lithium a cikin jini da haɓakar cutarwa mai guba. Kasancewar cututtukan cututtukan thiazide kawai yana ƙara ɓarkewar ayyukan. Ba a bada shawarar kwantar da hankali tare da shirye-shiryen lithium ba. Idan ya zama dole don gudanar da aikin hadewar jiki, ana buƙatar saka idanu na yau da kullun game da abubuwan da ke cikin lithium a cikin jini,
baclofen: haɓaka tasirin sakamako. Don daidaita takaddar magunguna na lokaci, aikin koda da hawan jini ya kamata a sa ido.
magungunan anti-mai kumburi mai guba (NSAIDs) (ciki har da kwayar yau da kullun na acetylsalicylic acid mafi girma daga 3 g): cyclooxygenase-2 inhibitors (COX-2), NSAIDs marasa zaɓaɓɓen rigakafin rigakafin ƙwayoyin cutar acetylsalicylic acid suna rage tasirin antihypertensive na perindopril da ƙara haɗarin rauni haɓaka abun ciki na potassium (musamman tare da rage ƙarancin aikin koda)
tricyclic antidepressants, antipsychotics (antipsychotics): tare da yin amfani da Noliprel A lokaci guda, suna haɓaka tasirin mai haɓaka, suna ƙara haɗarin tashin hankali na orthostatic,
corticosteroids, tetracosactide: haifar da raguwa a cikin tasirin antihypertensive. Ayyukan corticosteroids yana haɓaka riƙe riƙewar ions da sodium ion,
sauran magungunan rigakafin jini da masu bugun jini: na iya haɓaka mummunan sakamako na miyagun ƙwayoyi. Nitroglycerin, nitrates da vasodilators na iya kara rage karfin jini,
Abubuwan da ke tattare da potassium-sparing diuretics (gami da amiloride, spironolactone, eplerenone, triamteren), shirye-shiryen potassium, abubuwan da ke dauke da sinadarin potassium don cike gishirin da ake ci: wadannan jami'ai na iya haifar da karuwa sosai a matakin karuwar potassium a cikin jini, wanda ya hada da masu rauni. A wannan batun, tare da tabbatar da hypokalemia, haɗuwarsu tare da miyagun ƙwayoyi dole ne a haɗa tare da saka idanu na yau da kullum game da abubuwan da ke cikin potassium a cikin jini da kuma matakan ECG,
estramustine: haɗarin haɓakar angioedema da lamurra masu kama da juna suna ƙaruwa
Abubuwan insulin da abubuwan samowar jini na (maganganu na bakin jini): a cikin marasa lafiya da ke dauke da cutar siga, za a iya inganta tasirin insulin da abubuwan da ke haifar da sinadarin sulfonylurea,
allopurinol, immunosuppressive da cytostatic jami'ai, corticosteroids don amfani da tsari, procainamide: haɗuwa tare da waɗannan wakilai na iya ƙara yiwuwar haɓaka leukopenia,
general maganin kwayoyi: yin amfani da magungunan cutar sa barci na gaba daya yana inganta tasirin antihypertensive,
thiazide da “madauki” diuretics: yawan allurai na diuretics na iya haifar da rashin karfin jiki da kuma jijiyoyin jini,
linagliptin, sitagliptin, vildagliptin, saxagliptin (gliptins): kara hadarin angioedema,
tausayawar mai yiwuwa: zai yiwu rauni na antihypertensive sakamako,
Shirye-shiryen zinare: a bango na aikin jijiyoyin zuciya na shirye-shiryen zinare, yanayin-nitrate na iya haɓaka (hyperemia na fata, tashin hankali, tashin zuciya, tashin zuciya, amai),
quinidine, melopyramide, hydroquinidine (antiarrhythmic kwayoyi na aji IA), ibutilide, amiodarone, dofetilide, bretilia tosylate (antiarrhythmic kwayoyi na aji na III), sotalol, chlorpromazine, ciamemazine, levomepromazine, thioridazine, sitiri, sitiri droperidol, haloperidol, pimozide, bepridil, diphenyl methyl sulfate, cisapride, erythromycin da vincamine (iv), misolastine, moxifloxacin, pentamidine, halofantrine, sparfloxacin, methadone, terfenadine, astemizole: indapamide zai iya ba da gudummawa ga raguwar potassium a cikin jini da kuma abin da ya faru na nau'in ƙwayoyin cuta na huhu na jini. Idan ya zama dole don tsara wadannan kudaden, dole ne a kula da kulawa ta musamman don sarrafa abubuwan da ke cikin potassium a cikin jini da kuma tazara ta QT,
amphotericin B (iv), glucocorticoids da kuma mineralocorticoids, tetracosactides da laxatives wanda ke motsa motsin hanji: ƙara haɗarin hypokalemia,
cardiac glycosides: ya kamata a ɗauka a hankali cewa hypokalemia na iya haɓaka sakamakon mai guba na cardiac glycosides, sabili da haka, an bada shawara don sarrafa abubuwan da ke cikin potassium a cikin jini da sigogin ECG kuma suyi gyaran da ya dace na maganin,
metformin: kasancewar lalacewar aikin koda wanda ya faru yayin ɗaukar diuretic, wanda idan aka haɗu da metformin, yana ƙara haɗarin lactic acidosis, ya kamata a yi la'akari. Idan ƙwaƙwalwar creatinine a cikin jini na jini a cikin maza ya wuce 15 mg / l, kuma a cikin mata - 12 mg / l, bai kamata a tsara metformin ba,
aidin-dauke da sabani jami'ai: babban allurai na aidin-dauke da kwatankwacin jami'ai akan asalin rashin ruwa (sakamakon shan magunguna) na jiki yana kara hadarin rashin lafiyar koda, wanda ke bukatar diyya ga asarar ruwa kafin amfani da aidin mai dauke da aidin,
alli na salula: raguwa a cikin fitowar alli na alli da kodan na yiwuwa, wanda ke kara hadarin haɓakar hauhawar jini,
cyclosporine: maida hankali na cyclosporine a cikin jini ba ya canzawa, amma yana yiwuwa a ƙara creatinine a cikin jini, ciki har da abubuwan da ke cikin ruwa da ions sodium ion.

Analogs na Noliprel A forte sune: Noliprel, Noliprel A Bi-forte, Perindopril PLUS Indapamide, Co-Parnavel, Indapamide / Perindopril-Teva, Co-Perineva, Co-Preness, Perindapam, Perindide, Perindopril-Indapamide Richter.

Bayanin kwayoyin hana daukar ciki

Abun da ke ciki na allunan sun hada da Perindopril da Indapamide. Duk abubuwan biyu suna da tasirin maganin rigakafi, amma ƙaramin tonometer ta hanyoyi daban-daban.

Perindopril shine mai hanawa ACE, kuma Indapamide ya kasance cikin rukunan sulfonamide diuretics. A hade, waɗannan abubuwan haɗin suna inganta aikin juna.

Adana magani don rage karfin cutar alama. Sau da yawa, likita ya haɗa da Noliprel a cikin lura da cututtukan jini na kullum.

Matsakaicin sakamako mai lalacewa yana tasowa bayan watanni na gudanarwa kuma ya ci gaba na dogon lokaci. Wannan magani yana da tasiri ko da wasu magungunan antihypertensive basu taimaka ba.

A lokaci guda, farashin allunan sun ɗan ƙaranci. Mutane da yawa suna saya Noliprel, amma ba su san yadda za su ɗauka ba. Saboda wannan, gunaguni sau da yawa yakan haifar da cewa samfurin ba ya aiki ko rage ƙimar tonometer sosai.

Neman bita kan Noliprel A Fort

Nazarin game da Noliprel A Fort suna da kyau. Marasa lafiya tare da ƙwarewa game da jiyya game da cutar hawan jini wanda ya nuna cewa sauya sheka zuwa shan Noliprel A forte ya basu damar daidaita haɓakawar jini, kuma cin abinci na yau da kullun ya tabbatar da kwanciyar hankali. Da ke nuni da tasirin maganin, an shawarci masu amfani da kar su fara shan maganin ba tare da tuntuɓar likita ba.

Dosages na Noliprel

An fito da Noliprel ta hanyoyi da yawa. Yana da amfani ga marasa lafiya da likitoci su fahimci irin wannan tsari.

Noliprel A Bi-Forte

An bambanta nau'ikan haɗewar allunan:

Noliprel (ya ƙunshi 2 mg perindopril da 0.625 mg diuretic),
Noliprel Forte (sashi na indapamide shine 1.25 mg, kuma perindopril shine 4 MG),
Noliprel A Forte (indapamide - 1.25 mg, perindopril - 5 mg),
Noliprel A Bi-Forte (perindopril yana ƙunshe a cikin kashi 10 MG, da kuma diuretic - 2.5 MG),
Noliprel A (2.5 mg perindopril da 0.625 mg indapamide).

Noliprel A Bi-Forte an tsara shi sau da yawa saboda girman sashi. Idan akwai da yawa na wannan kashi, likita ya zaɓi Allunan tare da ƙananan abun ciki na perindopril da indapamide.

Magungunan Noliprel A, A Bi-Forte da A Forte sun ƙunshi arginine amino acid, wanda ke da tasiri mai amfani akan tsarin zuciya.

Sabili da haka, idan akwai matsalolin zuciya, yana da daraja amfani da magungunan da ke sama. Ga kowane mai haƙuri, an zaɓi sashi ɗaya daban-daban, yin la'akari da hanyoyin kwantar da hankali, shekaru. An ba da shawarar masu haƙuri masu ƙwaƙwalwa na tsufa don fara magani tare da kwamfutar hannu ɗaya.

Yaya za a sha Allunan?

Ana amfani da maganin hade kai sau daya a rana. Yana da matukar dacewa, musamman ga mutane da ke aiki da kuma shagala.

Idan likita ya ba da umarnin Noliprel, yadda za a sha wannan magani kafin ko bayan abinci, magana ce mai zafi ga yawancin marasa lafiya.

Umarni a hukumance ba shi da amsa. An nuna kawai cewa maganin ya kamata ya bugu da safe.

Likitoci sun bada shawarar amfani da maganin kafin karin kumallo. Yana da kyau a sha Allunan a lokaci guda. Sannan sakamakon cutar zai kara bayyana kuma babu cutarwa da zata haifar.

Amma game da kashi, likita farko wajabta kwamfutar hannu daya a rana. Amma, idan wata daya bayan fara magani ba a samo sakamakon da ake so ba, an wajabta Noliprel Forte tare da sashi na 4 MG perindopril da 1.25 indapamide. Wasu lokuta likitoci suna tsara wasu magunguna. Misali, an kara masu maganin tashin zuciya. A wannan yanayin, sashi na antihypertensive wakili an dan kadan rage.

Idan kashi ya yi yawa, ana ganin alamun cututtukan:

tashin zuciya da amai
nutsuwa
rashin kulawa
tsananin farin ciki
rauni
bradycardia
katsewa
suma
gumi mai sanyi
faduwa mai karfi a cikin jini,
daina fitowar fitsari ko yawan urin yawan ci.

Idan irin waɗannan alamun suka bayyana, ya kamata ka kira motar asibiti nan da nan. Kuma lokacin da kuka ji daɗi, dole ne ku yi alƙawari tare da likitan ku don daidaita sashi.

Yarda da lokacin daukar ciki

Yayin shirin haihuwa, ba da shawarar ɗaukar Noliprel.

Idan mace a baya ta yi amfani da irin wannan kwayoyin, ya kamata a kammala karatun kuma a nemi likita don ba da wani magani.

Ba a gudanar da nazarin sakamakon tasirin masu hana masu cutar ACE a kan mata masu juna biyu ba. Har yanzu ba a san ainihin yadda miyagun ƙwayoyi ke shafan ci gaban tayin ba.

Sabili da haka, dole ne a kula. Bayan duk wannan, akwai haɗarin cewa abubuwan da ke cikin aikin magani na iya haifar da mummunar tasiri ga samuwar ƙasusuwa, aikin ƙodan jarirai. Hakanan yana kara yiwuwar yanayin tashin zuciya.

Hakanan an sanya maganin a cikin shayarwa, saboda yana hana lactation kuma yana rage yawan nono a cikin karamar yarinya. A kan tushen ɗaukar irin wannan magani, jariri na iya samun hypokalemia, jaundice.

Tsawon lokacin jiyya

Noliprel yawanci shine babban magani da ake amfani dashi don magance hauhawar jini.

An yarda da kwayoyin hana daukar ciki na dogon lokaci, amma yana da kyau a dauki gajerun hutu. In ba haka ba, miyagun ƙwayoyi na iya cutar da aikin ƙodan da hanta.

Har yaushe za a sha Noliprel, allurai - duk wannan ya kamata likita ya yanke shawara, ya ba da yanayin mai haƙuri.

An sanya ƙwayar maganin a cikin marasa lafiya tare da gazawar na koda. Tare da gazawar matsakaici matsakaici, sashi bai kamata ya zama ya wuce kwamfutar hannu ɗaya ba kowace rana.

A cikin wasu marasa lafiya da ke fama da rauni na aiki yayin shan miyagun ƙwayoyi, alamun dakin gwaje-gwaje na karancin wannan sashin jiki suna bayyana. A wannan yanayin, an dakatar da magani. A nan gaba, ana ba da damar sake dawo da maganin haɗin gwiwa, amma a mafi ƙarancin yiwuwar sashi da gajere.

Doctor na dogon lokaci tare da Noliprel ba a ba da shawarar irin waɗannan cututtukan ba:

angina kayazaman,,
scleroderma,
hawan jini
ciwon sukari mellitus
na tsari lupus erythematosus,
dansani, anananana,
aortic bawul stenosis,
rashin karfin zuciya na kullum.

Magungunan yana taimakawa wajen kula da matsin lamba a matakin 130-140 / 80-90 mm. Hg. Art. kuma a kasa.

Don haka, an rage haɗarin bugun zuciya, bugun zuciya da gazawar koda. Likitoci sun tabbatar da ingancin maganin.

Likitoci sun lura cewa kayan aikin da sauri yana ba ka damar kwantar da mitomita kuma yawanci ba sa haifar da illa. Yawancin matsalolin da ke faruwa a cikin marasa lafiya masu hauhawar jini yayin shan Noliprel suna da alaƙa da gaskiyar cewa marasa lafiya ba su ɗauki allunan daidai ba, kada ku bi shawarar da likitan halartar.

Marasa lafiya masu tsinkaye sun lura cewa Noliprel mai araha ne, ana iya siye shi a kowane kantin magani. Amma a wasu lokuta kwayoyin hana sayarwa. A wannan yanayin, ana yarda da analogues. Misali, Co-perineva, Prestarium, Perindopril da Indapamide Forte, Co-prenes, Quinard, Mipril, Lysopres, Capotiazide, Iruzid. Hakanan madadin da ya cancanci shine Ena sandoz, wanda ya dace don lura da hawan jini mai mahimmanci, raunin zuciya, da kuma rigakafin yaduwar cututtukan zuciya.

Bidiyo masu alaƙa

Wannan bidiyo yayi bayani game da maganin warkar da hauhawar jini Noliprel. Suna gaya wa wanda aka wajabta shi da kuma a cikin abin da ya aikata:

Don haka, ɗayan ingantattun magungunan haɗin gwiwar zamani shine Noliprel. Magungunan a hankali amma da sauri yana tsayar da matsa lamba. Akwai shi a cikin magunguna daban-daban. Godiya ga wannan, yafi sauƙin zaɓi mafi kyawun kashi. Amma ba a iya amfani da maganin kai. Dole ne likita ya tsara magungunan kwayoyi kuma kawai bayan cikakken binciken mai haƙuri.

Yana kawar da abubuwan tashin hankali
Normalizes matsin lamba a cikin minti 10 bayan gudanarwa

Noliprel Forte: abun da ke ciki da nau'i na fitarwa

Don daidaita matsin lamba, ana amfani da magunguna na sakamako iri iri. Ainihin, waɗannan sune diuretics - diuretics waɗanda ke cire wuce haddi mai narkewa da gwal mai narkewa daga jini, rage yawanta da inganta hawan jini. Hakanan ana haɗasu tare da abubuwa waɗanda aikinsu yana da niyyar hana ayyukan enzyme wanda ke canza angiotensin I zuwa angiotensin II.

Tare da raguwa a matsin lamba na koda, ana samar da prorenin, wanda, lokacin da ya shiga cikin jini, an canza shi zuwa renin, ya ɗaura zuwa angiotensinogen, yana samar da angiotensin I. Wannan fili yana aiki da angiotensin II a cikin aikin aikin enzymes jini. A lokaci guda, jijiyoyin jini suna zama karami, ƙarancin zuciya yana raguwa, tsarin juyayi mai juyayi, wanda ke da alhakin matsin lamba, ya zama mai farin jini, an samar da aldosterone, wanda ke riƙe salts da ruwa, kuma yana ƙara ɗaukar kaya akan tsarin jijiyoyin jini. Wannan tsari yana tilasta ku shan magungunan antihypertensive sau da yawa.

Noliprel A Forte (Noliprel Forte) - kayan aiki na zamani na aiki tare: diuretic da aikin hanawa na enzyme angiotensin. Theara tasirin magani, rage tasirin sakamako da rikitarwa.

Hakanan ana iya samun wannan magani a cikin rage yawan kayan masarufi da ake kira Noliprel A. An nuna shi ga marasa lafiya ga waɗanda ba shi yiwuwa a gudanar da jiyya tare da ingantaccen aiki.

Magungunan ya ƙunshi abubuwa biyu masu aiki:

indapamide (1.25 mg),
perindopril arginine (5 MG).

sitaci carboxymethyl sitaci (2.7 mg),
silica (0.27 MG),
lactose as monohydrate (71.33 mg),
magnesium stearate (0.45 mg),
maltodextrin (9 mg).

Ana yin magungunan a cikin nau'i na convex m white Allunan. Sanannun cikin kwalabe filastik tare da mai watsawa da murfin-daskararru na 14 ko 30 inji mai kwakwalwa.

Tsarin magani

Indapamide da Perindopril sune magungunan antihypertensive na rukuni daban-daban, amma an samu nasarar hada su cikin hadadden hanyoyin kwantar da hankali. Abubuwan abubuwa suna daidaitawa, haɓaka aikin juna, taimaka wajan rage sashi da rage tasirin sakamako.

Na kusa da sulfonamides, abu ne mai diuretic. Ta hanyar hana shan sinadarin sodium ion a cikin jini, yana saurin cire su zuwa kodan tare da wuce haddi, yana kara urination. Irin wannan aikin zai iya saurin saukar da matsa lamba na kwayar a cikin tasoshin, inganta kwararar jini, rage bugun zuciya.

Indapamide yana rage yiwuwar bangon jijiyoyin jiki don aiwatar da aikin angiotensin II. Kari akan haka, sinadarin yana rage yawan fitar da sinadarin kalsiya a cikin jini saboda tsallakewar shi a cikin fitsari, wanda ke rage yawan kwatancen da yake shiga cikin fitsarin myocardial.

Calcium yana haifar da tsokoki don yin aiki mai wahala, wanda ke haifar da ƙimar zuciya da haɓaka matsin lamba.

Indapamide yana rage ƙarni na radicals masu lalacewa, wanda ke haifar da tsufa na jiki da kuma bayyanar neoplasms.

Abun yana ɗauka da sauri ta hanyar ɗaure shi ga furotin plasma, ƙwayar ƙwayar tsoka. Ana cire shi da kodan. Kimanin kashi 30% na hanta an cire shi ta hanyar metabolites ko yanayin farkon.

Indapamide yana da tasirin tallafin-kashi, sabili da haka, an wajabta shi don lokacin jiyya.

Perindopril

Abun da ke hana bayyanar angiotensin II - vasoconstrictor mai ƙarfi. Hakanan yana da wasu maganganu waɗanda ke shafar ingancin alamomin hawan jini:

yana rage samar da aldosterone,
yana ƙaruwa renin aiki,
yana rage yawan zuciya ba tare da canza salon su ba.

Perindopril yana haɓaka kwararar jini, rage nauyin a kan ƙwayar zuciya, rage haɗarin bugun zuciya, hana haɓakar hyperplasia ko hauhawar ƙwayar tsoka na zuciya, aiki da jijiyoyin jini da kuma sakamako na angioprotective.

Don rage karfin jini, ana ɗaukar abu a cikin lokaci ɗaya - sakamakon yana faruwa bayan sa'o'i 4 kuma yana ɗaukar kwana ɗaya - kuma hanya. Tare da yin amfani da yau da kullun, ana bayyana tasirin warkewa bayan wata daya kuma ya ci gaba na dogon lokaci.

Aikace-aikacen na tsawon watanni 6 ko sama da haka yana rage nauyin a zuciya da jijiyoyin jini kuma yana ƙaruwa da juriya ta jiki a cikin marasa lafiya da raunin zuciya. Perindopril ba jaraba bane.

Lokacin da aka sha, yana cikin hanzari, yana ɗaure shi da ƙyallin jini, hanta ya mamaye shi, ƙodan ya zauna.

An wajabta magungunan don lura da mahimmancin hauhawar jini - tsari ((sau 3-4 a rana) matsin lamba yana ƙaruwa sama da 140/90. Mafi yawanci ana bincikar lafiya a cikin marasa lafiya masu shekaru 35-40 shekaru kuma basu da dalilai bayyanannu.

Kulawa na yau da kullun na miyagun ƙwayoyi "Noliprel Forte" a farkon farkon cutar ta sami damar daidaita matsin lamba gaba ɗaya. A cikin mawuyacin hali, mataki na uku, lokacin da hauhawar jini ya tashi zuwa 180/110, yana riƙe da ƙarami, yana rage haɗarin zubar jini da ciwon zuciya.

An nuna magungunan don amfani a cikin marasa lafiya tare da hauhawar jini a lokaci guda da nau'in ciwon sukari na 2 a matsayin hanyar kariya daga rikice-rikice na cututtukan haɗin gwiwa.

Kwayoyin Noliprel Forte

Magungunan suna da tasiri sosai a cikin yaƙar hauhawar jini. Saboda keɓaɓɓen abun da ke tattare da ƙwayar cuta, haɗuwa mai nasara cikin manyan abubuwan haɗin gwiwa (perindopril, indapamide), Noliprel da sauri yana tsayar da hawan jini kuma yana kawar da ruwa mai yawa daga jiki. Sakamakon warkewar lafiyar Noliprel yana faruwa bayan makonni 3-4 daga farkon jiyya kuma baya tare da tachycardia. An tsara maganin don magani a gida, tare da kulawar likita ta lokaci-lokaci don daidaita sashi.

Abun Noliprel

Ana samun maganin a cikin allunan farin fari. Noliprel yana da nau'ikan da yawa waɗanda ke ɗauke da nau'ikan sashi na manyan abubuwa: perindopril, indapamide. An gabatar da cikakken abun da ke cikin miyagun ƙwayoyi a cikin tebur:

Perindopril taro, a cikin MG

Cakuda indapamide, a mg

lactose monohydrate, microcrystalline cellulose, hydrophobic colloidal silicon, arginine (an haɗa su a cikin sakin saki tare da kari "A")

Noliprel A Bi-Forte

Noliprel A Santa A

Aikin magunguna

Magungunan Noliprel hade ne da manyan abubuwa guda biyu waɗanda suke da takamaiman kayansu kuma suna da tasiri iri-iri:

Perindopril. Yana rage karfin jini zuwa matakin al'ada, yana rage juriya a cikin jijiyoyin jini, yana sanya bangon artery ya fi na roba, kwantar da jijiyoyin zuciya, rage haɓakar ventricular hagu, zai rage nauyin da aka kunna akan ƙwayar zuciya.
Indapamide. Yana cire yawan ruwa mai yalwa ta hanjin kodan, yana da tasirin diuretic da vasoconstrictor.

Alamu don amfani

Allunan don matsin lamba Noliprel ana amfani dashi don kawai nuni don warkarwa - mahimmanci (na farko) hauhawar jijiya. Wannan cuta ta haifar da cututtukan cututtukan ƙwayar thyroid, koda. Koyaya, bisa ga umarnin, ana iya tsara magungunan don dalilai na prophylactic don lura da cututtukan jijiyoyin bugun gini a cikin marasa lafiya na ƙungiyoyi na musamman (hauhawar jini mai ƙarfi, nau'in ciwon sukari na II).

Kwatance Noliprel Forte

Kyakkyawan gefen maganin shine cewa dole ne a sha shi sau ɗaya a rana. Wannan ya dace da tsofaffi, waɗanda sau da yawa suna fama da mantuwa. Mafi kyawun lokacin shan magunguna shine safiya. Ya kamata a hadiye kwamfutar hannu 1 (kar a tauna, kada a raba su kashi biyu) kafin abinci, a sha mai yawa. Aikin allunan an bayyana shi awanni 2-5 bayan an yi amfani da shi kuma ya kai tsawon awanni 24. Bayan wata daya da rabi na shan ƙwayar, likitan ya daidaita sashi.

A lokacin daukar ciki

An hana yin amfani da miyagun ƙwayoyi Noliprel a kan matsa lamba a yayin haihuwar haihuwa da shayarwa. Lokacin shirin ko samun juna biyu, ya kamata a dakatar da maganin rigakafin cutar kai tsaye. Abubuwa masu aiki na Noliprel na iya yin illa ga ci gaban tayin, suna haifar da:

na gazawar
raguwar ƙwayar ruwa,
rage aiki na koda a cikin jariri,
bata lokaci ba a cikin ci gaban tayin da ke tattare da rashin lafiyar fetotoxicity,
rage gudu daga kasusuwa na kwanyar yaro,
hauhawar jini.

Yayin shayarwa, yakamata a daina Noliprel. Abubuwan da ke cikin magani suna rage adadin madarar nono da hana lactation. Bugu da ƙari, Noliprel na iya cutar lafiyar lafiyar yarinyar, yana haifar da jaundice ko hypokalemia. Idan miyagun ƙwayoyi suna da mahimmanci ga lafiyar mahaifiyar kuma babu wani abin da zai musanya shi, dole ne a tura ɗan jariri na ɗan lokaci zuwa abinci mai wucin gadi.

A lokacin ƙuruciya

Noliprel ba da shawarar don kula da yara da matasa masu shekaru 18 da haihuwa ba. Ba a kafa sakamako, sakamako masu illa da tasirin magani a jikin yaran ba. Yin watsi da wannan contraindication zai iya haifar da lalata cikin lafiyar mai haƙuri da kuma asibiti nan da nan don dawo da mahimman alamun haƙuri.

Sharuɗɗan sayarwa da ajiya

Ana sayar da maganin ta hanyar takardar sayan magani. Babu yanayin ajiya na musamman, kuna buƙatar kuɓutar da Noliprel da isar yara a zazzabi da bai wuce digiri 30 ba. Rayuwar shiryayye na miyagun ƙwayoyi bai wuce shekaru 3 ba.

Bayar da babbar farashin Nolirel da kuma jerin abubuwan contraindications, ana iya maye gurbin far da wasu analogues. Yanke shawara ya zabi takamaiman kayan aiki don rage karfin jini ya kamata likita yayi. Anyi amfani da haɗuwa mai mahimmanci na indapamide da perindopril a cikin irin waɗannan magungunan:

Ko-Perineva,
Perindopril-Indapamide Richter,
Karin,
Co Parnawel
Mai ladabi
Noliprel A
Indapamide Perindopril-Teva,
Kwamfutar
Iruzid,
Mai daidaitawa
Dalneva.

Umarnin don amfani da maganin

A zahiri, sashi a wannan yanayin ya kamata ya zama mutum ɗaya, tunda ya dogara da shekaru da yanayin mai haƙuri, kazalika da cutar da aka gano a ciki. Koyaya, akwai babban allurai da aka bada shawarar da ƙa'idodi masu taimako. Ana amfani da allunan Noliprel da safe - wannan hanyar tasirin zai bayyana da sauri kuma zai wuce tsawon lokaci, kuma karuwar matsa lamba ba zai tsoma baki tare da hanyar yau da kullun ba.

Amma ga adadin, an shawarci manya da yawa su dauki kwamfutar hannu guda ɗaya a rana. Idan ya cancanta, likita, ba shakka, zai iya canza sashi ko ajiyar magani.

Magungunan "Noliprel forte": contraindications

Bugu da kari, gazawar hanta mai tsoka da kuma hypokalemia suma suna maganin contraindications. Hakanan kuma an haramta wa marassa lafiya da cutar koda koda. Kuma, hakika, ba a ba da shawarar maganin ga yara 'yan ƙasa da shekara 18 ba. Kuma tunda samfurin ya ƙunshi ƙwayar lactose monohydrate, ba a ba da umarnin ga mutanen da ke fama da raunin lactose da wasu cututtukan da ke da alaƙa da ƙwayar narkewar ƙwayar carbohydrate.

Wannan shine dalilin da ya sa kar ku manta cewa likitan da ke halartar za a iya tsara shi ta hanyar karɓar duk sakamakon gwaje-gwaje da karatu. Idan akwai contraindications, sakamakon farjin zai iya zama haɗari ga lafiya har ma da rayuwa.

Matsalar da za a iya samu

Lokaci-lokaci, magani yana haifar da cin zarafin tsarin numfashi - tari mai bushe, bronchospasm, rhinorrhea na iya faruwa. A cikin halayen da ba a sani ba, yin amfani da miyagun ƙwayoyi na iya haifar da angina pectoris, arrhythmias, bugun jini, bugun zuciya, ƙarancin rashin lafiyar koda.

Wani lokacin akwai tashin zuciya, amai, gurguwar ciki, bushewar baki. Da wuya sosai, magani yana haifar da ci gaban pancreatitis ko jaundice.

Informationarin Bayani

Yana da mahimmanci a lura cewa kashi na farko na miyagun ƙwayoyi na iya tayar da raguwa mai yawa a cikin karfin jini - ba bu buƙatar jin tsoro, wannan al'ada ce, musamman a cikin kwanakin farko. Amma irin wannan mara lafiya ya kamata ya kasance a karkashin kulawa ta yau da kullun na ma'aikatan lafiya.

Bugu da kari, ya zama dole a dauki gwaje-gwaje daga lokaci zuwa lokaci a yayin warkarwa - wannan yana taimakawa wajen lura da matakin creatinine da potassium a cikin jini, tunda karkacewa daga dabi'a zai yiwu a karkashin tasirin maganin.

Har ila yau, likitocin ba su ba da shawarar yin tuki a yayin warkarwa ba, suna aiki tare da nau'ikan hanyoyin daban-daban waɗanda ke buƙatar mafi yawan natsuwa da saurin amsawa. Kafin fara magani, tabbatar cewa gaya wa likitan ku game da magungunan da kuke karɓa, kamar yadda maganin Noliprel Forte a hade tare da wasu kwayoyi na iya zama haɗari.

Nazarin Abokan Ciniki

A gefe guda, maganin "Noliprel forte" yana da wasu rashi. Don farawa, ya dace a lura da tsadarsa - wannan farashin bai dace da kowa ba, musamman idan aka yi maganar magani na dogon lokaci. Bugu da kari, wasu marassa lafiyar da suka dauki maganin na dogon lokaci (watanni 2-3) sun haifar da wani sakamako mara kyau wanda bai dace ba - asarar gashi. A gaban irin wannan take hakkin, ya kamata ka tuntuɓi likita nan da nan: zaku iya buƙatar istigfari na Noliprel (alal misali, Enap N). Af, zaka iya siyan samfuran da ke ƙunshe da manyan abubuwan da ke tattare da ƙwayar cuta (perindopril da indapamide) - ɗaukarsu zasu taimaka wajen cimma kusan iri ɗaya, amma haɗarin faɗan inzarar zai zama ƙasa da yawa.

Tsarin kulawa

An bada shawara don shan kwamfutar hannu 1 kwamfutar hannu da safe kafin karin kumallo. Kashi ɗaya na Noliprel Forte ya isa ya kula da tasirin warkewa a duk rana.

An nuna masu haƙuri tare da ciwon sukari na mellitus, renal ko hepatic insula don fara jiyya tare da miyagun ƙwayoyi "Noliprel A".

Daidai gwargwado da shawarwari don shan maganin ana bayar da su ne ta wurin likitan halartar. Idan ana bin duk umarnin, haɗarin rikitarwa da rikicewar halayen sun ragu sosai, kuma tasirin magani yana da yawa.

A wasu halaye, idan ba zai yiwu a zabi sashi ba, an maye gurbin miyagun ƙwayoyi tare da magungunan monocomponent kuma indapamide da perindopril an wajabta su da daidaitaccen mutum.

M halayen

Abubuwan da ke tattare da mummunan tasiri na jiki bai kamata su bi tsarin aikin jiyya ba. Idan canji a cikin yanayin yana haifar da rashin jin daɗi ko haɗari ga rayuwa da lafiya, tabbatar cewa sanar da likitanka. Zai gyara sashi ko ya maye gurbin maganin.

Mafi yawan gunaguni na marasa lafiya sune:

jin zafi, ciki,
bayyanar cututtuka na waje na rashin lafiyan - hyperemia, urticaria, itching, bawo,
bayyanar tinnitus, hargitsi na gani,
abin da ya faru na orthostatic hypotension shine kishiyar sakamako,
dryara yawan bushewar ƙwayoyin bakin mucous na bakin da makogwaro, tari,
general rauni, tsoka cramps.

Rashin damuwa kamar bacci mara bacci, arrhythmia, tachycardia, edema, bayyanar cututtukan ƙwayar cuta mai ƙoshin ƙarfi, haɓaka gumi ba su da yawa.

Sakamakon canje-canje a cikin taro na jini, maganin yana iya shafar ayyukan aikin abubuwan jikin mutum. Saboda haka, ana ba da shawarar yin gwajin gwaje-gwaje na yau da kullun game da abubuwan da ke ciki.

Magungunan "Noliprel Forte" yana da tabbataccen tasirin warkewa a cikin jiyya na hauhawar jini.

A cikin marasa lafiya da ke shan magani, an lura:

m warkewa sakamako bayan makonni 2-3 na gudanarwa,
raguwa a cikin girman hypertrophied hagu ventricle,
haɓaka yanayin gaba ɗaya da kyautatawa,
cikakken daidaituwa na hawan jini a lura da matakin farko na hauhawar jini.

Gabaɗaya, Noliprel yana iya sauƙaƙe, kuma idan rashin haƙuri ya maye gurbinsa da wani magani na irin wannan aikin.

Kuna iya siyan magungunan a kantin magani. Ana fitar dashi ne kawai ta takardar sayan magani. An ba da izinin karbar bayan tattaunawa tare da gwani. Matsakaicin farashin magani shine 680 rubles a kowane fakiti guda 30.