Telmisartan (Mikardis)

Bayanin da ya dace da 04.11.2016

• Sunan Latin: Telmisartan
• Lambar ATX: C09CA07
• Aiki mai aiki: Kansu
• Mai masana'anta: Kamfanin shuka magunguna na TEVA, JSC na Ratiopharm International GmbH, Hungary / Jamus

Ya danganta da nau'in sakin, kwamfutar hannu guda ɗaya ta ƙunshi 80 ko 40 MG na kayan aiki.

Pharmacodynamics

Telmisartan mai zaɓar antagonist na karɓa ne na angiotensin II. Yana gasa tare da angiotensin don ɗaure wa masu karɓar AT1. Babu wata dangantaka da sauran masu karɓar ra'ayoyin da aka lura.

Telmisartan ba ya hana aikin renin, ACE, ba ya toshe tashoshin da ke da alhakin ion, rage abun ciki aldosterone a jini.

A kashi na 80 MG kusan gaba ɗaya yana kawar da haɓaka hawan jinilalacewa ta hanyar angiotensin II. Matsakaicin sakamako yana ɗaukar sa'o'i 24, sannan sannu a hankali yana raguwa. A wannan yanayin, ana jin babban tasirin maganin aƙalla sa'o'i 48 bayan ɗaukar allunan.

Telmisartan yana rage duka matsa lamba na systolic da diastolic, amma ba ya shafar kumburin bugun jini. Babu wani sakamako game da jaraba ko tarawa mai yawa a cikin jikin da aka lura.

Pharmacokinetics

Bayan allurar, likitan ya warke da sauri. Bioavailability kusan 50%. Yana ɗaure da ƙarfi ga ƙwayoyin plasma.

Matsakaicin yawan ƙwayar plasma yawanci mafi girma ne a cikin mata yayin shan allurai iri ɗaya. Amma wannan ba zai tasiri tasiri ba.

Tsarin rayuwa yana faruwa a cikin hanta. Wannan ya zama babu aiki metaboliteCire wanda yafi faruwa ta hanjin hanji. Rabin rayuwar mutum kamar awanni 20 ne.

Alamu don amfani

Ana amfani dashi don magancewa hauhawar jini da kuma rigakafin mace-mace daga cututtuka na tsarin zuciya da jijiyoyin jini bayan bugun jini, bugun zuciyana ciki na jijiyoyin jini cuta hagu ventricular hauhawar jini.

Contraindications

An hana shi wajabta Telmisartan tare da:

• hanawa cututtuka na biliary fili,
• mai tsanani gazawar hanta,
• na farko akida,
• rashin jituwa,
• wuce kima hankali ga abu mai aiki ko wani abin da ke cikin miyagun ƙwayoyi,
• ciki,
• a karkashin shekara 18.

Side effects

Tasirin sakamako yana da wuya

Ofaya daga cikin marasa lafiya 100-1000 waɗanda ke shan maganin yana da alamun bayyanar:

A cikin 1 na 1000-10000 marasa lafiya sun lura:

• cututtuka na urinary da na numfashi (cystitis, pharyngitis, sinusitis) ko sepsis,
• thrombocytopenia,
• matakin ragewa hawan jini,
• jin damuwa
• rikicewar gani
• samarin,
• sauke cikin karfin jini lokacin da kake canza matsayin jikin (daga kwance zuwa sama),
• rashin jin daɗin ciki
• bushe bakin
• aikin hanta mai rauni,
• kara yawan hanta enzymes,
• increasedara yawan ƙwayar plasma na uric acid,
• hadin gwiwa zafi
• erythema,
• angioedema,
• mai guba rashes,
• eczematous rash.

Sakamakon sakamako wanda ba kasafai yake faruwa ba ko kuma ba zai iya tantance yawan sa daidai ba

• zafin jijiya mai kama da tendonitis,
• increasedara yawan matakan eosinophils a cikin jini.

Haɗa kai

Yin hulɗa da Telmisartan tare da wasu magunguna:

• Baclofen, Amifostine da sauran jami'ai na antihypertensive - ana inganta sakamako mai kyau,
• barbiturates, narcotic kwayoyi, ethanol da antidepressants - bayyanar cututtukan orthostatic hypotension suna cikin haɗari ko haɗarin faruwar hakan,
• Furosemide, Hydrochlorothiazide da sauran wasu cututtukan diuretics - tasirin mai girma yana karuwa,
• Digoxin - karuwar taro Digoxin a cikin jini
• Shirye-shiryen lithium - karuwa da aka sake yin yawa a cikin taro na lithium a cikin jini, lura da wannan alamar ya zama dole,
• NSAIDs - haɗarin alamun bayyanar cututtuka yana ƙaruwa na gazawarmusamman tare da bushewa
• potassium-sparing diuretics, potassium, Heparin, Sankarini, Tacrolimus, Gagarinka - increasedara maida hankali kan potassium a cikin jini,
• GCS - an rage tasirin rigakafin,
• Amlodipine - Tasirin Telmisartan yana ƙaruwa.

Aikin magunguna

Angiotensin II mai karɓar taƙi.

Telmisartan takamaiman mai adawa ne na masu karɓar angiotensin II. Yana da babban kusanci ga AT1 receptor subtype na angiotensin II, ta hanyar wanda an fahimci aikin angiotensin II. Telmisartan ya kori angiotensin II daga ɗaurinsa zuwa mai karɓa, ya rasa aikin gwani a dangane da wannan mai karɓa. Telmisartan kawai yana ɗaure zuwa nau'in mai karɓa na AT1 na angiotensin II. Yin shinge mai ci gaba ne. Telmisartan bashi da alaƙa ga sauran masu karɓar (hade da masu karɓar AT2) da sauran masu karɓar angiotensin marasa ƙarancin karatu. Babban mahimmancin mahimmancin waɗannan masu karɓar, har ma da tasirin tasirin tasirinsu mai yawa tare da angiotensin II, wanda yake ƙaruwa wanda yake ƙaruwa tare da alƙawarin telmisartan, ba a yi nazari ba. Yana rage maida hankali na aldosterone a cikin jini, baya hana renin a cikin jini plasma kuma baya hana tashoshin ion, baya hana ACE (kininase II, enzyme wanda shima yana lalata bradykinin). Saboda haka, haɓaka sakamako masu illa da aka haifar da bradykinin ba a tsammanin.

Telmisartan a kashi na 80 MG gaba daya yana toshe sakamakon tasirin hauhawar jini na angiotensin II. An lura da fara aiki na hypotensive a cikin sa'o'i 3 bayan farawa na farko na telmisartan. Tasirin maganin yana tsawan sa'o'i 24 kuma yana ci gaba har zuwa awanni 48. Tasirin sakamako mai ƙarfi yakan haifar da makonni 4-8 bayan cin abinci na yau da kullun.

A cikin marasa lafiya tare da hauhawar jini na jijiya, telmisartan yana rage karfin systolic da hauhawar jini, ba tare da shafi yawan zuciya ba.

Game da sakewa na telmisartan ba zato ba tsammani, hawan jini sannu a hankali ya dawo zuwa matakinsa na asali ba tare da ci gaba da cirewar cutar ba.

Sashi da gudanarwa

An wajabta maganin a baka, ba tare da la'akari da yawan abincin ba.

Tare da hauhawar jini na jijiya, kashi na farko da aka ba da shawarar maganin shine 1 kwamfutar hannu (40 MG) sau ɗaya a rana. A cikin yanayin inda ba a sami tasirin warkewa ba, maganin ya kai har zuwa 80 MG sau ɗaya a rana. Lokacin yanke shawara ko ƙara yawan ƙwayar, ya kamata a la'akari da cewa mafi girman tasirin antihypertensive ana samun mafi yawa a cikin makonni 4-8 bayan fara magani.

Don rage cututtukan zuciya da mace-mace, shawarar da aka bada shawarar ita ce kwamfutar hannu 1 (80 MG) sau ɗaya a rana. A lokacin farkon magani, ana buƙatar ƙarin gyaran hawan jini.

Marasa lafiya tare da gazawar renal (ciki har da waɗanda ke kan hemodialysis), tsofaffin marasa lafiya, ba a buƙatar daidaita sashi na maganin ba.

A cikin marasa lafiya da ke fama da rauni na matsakaici zuwa matsakaici (aji A da B akan sikelin Yara-Pugh), kashi na yau da kullun kada ya wuce 40 MG.

Side sakamako

Abubuwan da aka lura da sakamako na sakamako masu illa basu yi daidai da jinsi ba, shekaru ko tseren marasa lafiya ba.

Kamuwa da cuta: sepsis, gami da kamuwa da cuta mai narkewa, cututtukan urinary fili (ciki har da cystitis), cututtukan zuciya na sama.

Daga tsarin hawan jini: raguwar haemoglobin, anemia, eosinophilia, thrombocytopenia.

Daga gefen tsarin juyayi na tsakiya: rashin bacci, damuwa, damuwa, farin ciki.

Daga tsarin zuciya: raguwar alama a cikin karfin jini (gami da tashin hankali na orthostatic hypotension), bradycardia, tachycardia, fainting.

Daga tsarin numfashi: gajeriyar numfashi.

Daga tsarin narkewa: bushe baki, flatulence, rashin jin daɗi a ciki, amai, dyspepsia, zawo, zafin ciki, aikin hanta mai rauni, haɓaka ayyukan ƙwayoyin hepatic.

Daga tsarin urinary: lalacewar aikin renal (ciki har da gazawar ƙarancin koda), gurɓataccen edema, hypercreatininemia.

Daga tsarin musculoskeletal: arthralgia, ciwon baya, raunin ƙwayar tsoka (ƙwanƙwasa tsokoki maraƙin), jin zafi a cikin ƙananan ƙarshen, myalgia, jin zafi a cikin tendons (alamu masu kama da bayyanar tendonitis), jin zafi a kirji.

Allergic halayen: anaphylactic halayen, hypersensitivity halayen ga aiki abu ko karin kayan taimako na miyagun ƙwayoyi, angioedema, eczema, erythema, fata itching, fashin (ciki har da miyagun ƙwayoyi), urticaria, mai guba mai guba.

Manuniyar dakin gwaje-gwaje: hyperuricemia, ƙara yawan jini CPK, hyperkalemia.

Sauran: hyperhidrosis, mura-like syndrome, raunin gani, asthenia (rauni).

Yin amfani da miyagun ƙwayoyi MIKARDIS® a lokacin daukar ciki da lactation

Mikardis® yana cikin ciki da lactation.

Tare da yin shirin haihuwa, ya kamata a maye gurbin Mikardis® tare da wani magani na antihypertensive. Lokacin da aka kafa ciki, ya kamata a daina barin Mikardis da wuri-wuri.

A cikin binciken kwaskwarima, ba a gano tasirin teratogenic na miyagun ƙwayoyi ba, amma an lura da tasirin fetotoxic.

Umarni na musamman

A cikin wasu marasa lafiya, saboda dakatarwar RAAS, musamman lokacin amfani da haɗuwa da kwayoyi da ke aiki akan wannan tsarin, aikin renal (gami da gazawar cutar koda). Sabili da haka, farjin tare da wannan nau'in shinge na RAAS ya kamata a aiwatar da su a daidaiku kuma tare da kulawa da hankali akan aikin koda

A cikin maganganu na dogaro da sautin jijiyoyin bugun gini da aikin koda na musamman a kan aikin RAAS (alal misali, a cikin marasa lafiya da raunin zuciya, ko cutar koda, hade da tare da ƙwaƙwalwar ƙwayar ƙwayar ƙwayar mahaifa ko ƙwayar jijiya ta koda), nadin magungunan da ke shafar wannan tsarin, na iya kasancewa tare da haɓakar jijiyoyin jini, hyperazotemia, oliguria, kuma, a lokuta da dama, rashin lafiyar koda.

Dangane da kwarewar yin amfani da wasu magunguna waɗanda ke shafar RAAS, tare da haɗin gwiwa na Mikardis® da sinadarin-potaring diuretics, abubuwan da ke ƙunshe da ƙwayoyin potassium, gishirin da ke ɗauke da sinadarin potassium, da sauran magunguna waɗanda ke haɓaka taro na potassium a cikin jini (alal misali, heparin), wannan alamar ya kamata a sa ido a cikin marasa lafiya.

A madadin, za a iya amfani da Mikardis® a hade tare da diuretics na thiazide, kamar hydrochlorothiazide, wanda ƙari kuma yana da tasirin sakamako (misali, MikardisPlus® 40 mg / 12.5 mg, 80 mg / 12.5 mg).

A cikin marasa lafiya tare da matsanancin hauhawar jini, kashi na telmisartan na 160 MG kowace rana a hade tare da hydrochlorothiazide 12.5-25 mg an yarda da shi sosai kuma yana da tasiri.

Mikardis® ba shi da tasiri a cikin marasa lafiya na tseren Negroid.

Formaddamar da tsari da abun da ke ciki

Fitar sashi - allunan: zagaye, lebur-sililin, tare da sikeli da chamfer, fararen ko fari-yellowish cikin launi (5, 7, 10 da 20. guda 20) A cikin fakito mai laushi, a cikin kwali na 1, 2, 3, 4, 5, 8 ko fakitoci 10, 10, 20, 28, 30, 40, 50, da guda 100 kowannensu, a cikin kwalba da aka yi amfani da su tare da kayan jan-taya tare da sarrafawa ta farko-farko ko dunƙule-kan lika tare da tura-juyawa ko tare da sarrafa madaidaiciya na farko, a cikin kwali. kowane kunshin ya ƙunshi umarnin amfani da Telmisartan).

Abun ciki 1 kwamfutar hannu:

• bangaren aiki: telmisartan - 40 ko 80 MG,
• magabata (allunan 40/80 MG): croscarmellose sodium –12/24 mg, sodium hydroxide –- 3.35 / 6.7 mg, povidone-K25 –– 12/24 mg, lactose monohydrate (sukari madara) –– 296.85 / 474.9 mg, magnesium stearate - 3.80 / 6.4 mg, meglumine - 12/24 mg.

Hawan jini

Yin amfani da telmisartan a cikin kashi 80 na MG gaba daya yana toshe tasirin cutar ta AT II. Tasirin antihypertensive yana tasowa a cikin kimanin awanni 3 bayan kashi na farko, yana ɗaukar tsawon awanni 24 sannan ya kasance mai mahimmanci har zuwa sa'o'i 48. Tasirin warkewar magani yakan haifar da yawa bayan makonni 4-8 na amfani da miyagun ƙwayoyi.

A cikin hauhawar jini, tsoka mai santsi, telmisartan lowers systolic da diastolic pressure (BP) ba tare da shafi yawan zuciya ba (HR).

Bayan dakatarwar magani sosai, matakin karfin jini ya koma darajar sa na yau da kullun. Cutar da mutum ba ya ci gaba.

Dangane da nazarin asibiti na kwatancen, mummunan tasirin telmisartan yana daidai da na kwayoyi na wasu azuzuwan (alal misali, atenolol, hydrochlorothiazide, enalapril, lisinopril, amlodipine). Koyaya, busasshen tari a cikin marasa lafiya da ke karɓar telmisartan ya faru sau da yawa ƙasa da yadda marasa lafiya ke ɗaukar masu hana ACE.

Rashin Cutar zuciya

A cikin marasa lafiya 55 shekara da haihuwa tare da rauni na iskemic Attack, bugun jini, na zuciya da jijiyoyin jini (CHD), na gefe jijiya rauni da kuma rikitarwa na type 2 ciwon sukari (kamar hagu ventricular hawan jini, micro- ko macroalbuminuria, retinopathy) tare da tarihin zuwa rukunin haɗari don rikitarwa na zuciya, telmisartan yana da tasirin kama da na ramipril a cikin rage babban haɗin gwiwa: asibiti saboda rauni na zuciya. bugun jini na ciki, rauni na mahaifa, rashin lafiyar zuciya.

Har ila yau, an nuna Telmisartan, mai kama da ramipril, yana da tasiri don rage yawan maki na sakandare: rashin bugun jini, rashin ƙarfi mai rauni, da mutuwar zuciya.

Ba a yi nazarin tasirin telmisartan a allurai na ƙasa da 80 MG don rage haɗarin kamuwa da cutar zuciya.

Ba kamar ramipril ba, telmisartan ya kasance mai yiwuwa ya haifar da sakamako masu illa kamar bushewar tari da angioedema. Koyaya, yanayin jijiyoyin jini yafi faruwa lokacin gudanarwa.

Tsari sashi:

Kwamfutar hannu 1 ya ƙunshi:

sashi 40 MG

abu mai aiki: telmisartan - 40 MG

magabata: sodium hydroxide - 3.4 mg, povidone K 30 (polyvinylpyrrolidone matsakaici matsakaiciyar kwayoyin) - 12.0 mg, meglumine - 12.0 mg, mannitol - 165.2 mg, magnesium stearate - 2.4 mg, talc - 5.0 mg .

sashi na 80 MG

abu mai aiki: telmisartan - 80 MG

magabata: sodium hydroxide - 6.8 mg, povidone K 30 (polyvinylpyrrolidone matsakaici matsakaiciyar ƙwayar ƙwayar kwayoyi) - 24.0 mg, meglumine - 24.0 mg, mannitol - 330.4 mg, magnesium stearate - 4.8 mg, talc - 10.0 mg.

Allunan suna da fari ko kusan fararen fata, zagaye, lebur-silsila tare da bevel da daraja.

Kayan magunguna

Pharmacodynamics

Telmisartan takamaiman mai karɓa ne na angiotensin II (mai nau'in AT₁), mai tasiri idan aka sha shi da baki. Yana da babban kusanci ga AT subtype₁ masu karɓar angiotensin II ta hanyar wanda an gano aikin angiotensin II. Bayyanar da angiotensin II daga haɗin tare da mai karɓa, ba mallakan aikin agonist dangane da wannan mai karɓa ba.

Telmisartan ya ɗaura kawai da ƙirar AT₁ masu karɓar angioensensin II. Sadarwa na daɗewa. Ba shi da wata dangantaka ta sauran masu karɓa, gami da ƙwayoyin cuta₂ mai karɓar karɓa da sauran masu karɓar angiotensin marasa ƙarancin karatu. Babban mahimmancin mahimmancin waɗannan masu karɓar, har ma da tasirin tasirin tasirinsu mai yawa tare da angiotensin II, wanda yake ƙaruwa wanda yake ƙaruwa tare da alƙawarin telmisartan, ba a yi nazari ba. Yana rage tarowar aldosterone a cikin jini, baya hana renin cikin jini jini kuma baya toshe tashoshin ion.Telmisartan ba ya hana enzyme angiotensin-mai canzawa (kininase II) (enzyme wanda shima ya rushe bradykinin). Saboda haka, haɓaka sakamako masu illa da aka haifar da bradykinin ba a tsammanin.

A cikin marasa lafiya, telmisartan a kashi na 80 MG gaba daya yana toshe sakamakon tasirin hauhawar jini na angiotensin II. An lura da fara aikin rigakafi a cikin sa'o'i 3 bayan aiwatarwa na farko na telmisartan. Tasirin magungunan ya ci gaba na tsawon awanni 24 kuma ya kasance har zuwa 48 hours. Cedwaƙwalwar ƙwayar cuta mai narkewa yakan haifar da makonni 4-8 bayan gudanar da maganin yau da kullun.

A cikin marasa lafiya tare da hauhawar jini na jijiya, telmisartan lowers systolic da diastolic pressure (BP) ba tare da shafi yawan zuciya ba (HR).

Game da sakewa na telmisartan ba zato ba tsammani, saukar karfin jini a hankali zai dawo zuwa matakin sa na asali ba tare da ci gaba da cutar "sakewa" ba.

Pharmacokinetics

Lokacin da aka sha shi a baki, yana narkewa da sauri daga hanji. Bioavailability shine 50%. Lokacin da aka ɗauka lokaci guda tare da abinci, raguwa a cikin AUC (yanki a ƙarƙashin lokutan taro) yana girma daga 6% (a kashi 40 na MG) zuwa 19% (a kashi na 160 mg). 3 hours bayan shigowa, maida hankali a cikin jini yana gudana, ba tare da la'akari da lokacin cin abinci ba. Akwai bambanci a cikin yawan ƙwayar plasma a cikin maza da mata. Tare da_max(mafi yawan maida hankali) da AUC sun kasance kusan sau 3 da 2, bi da bi, mafi girma a cikin mata idan aka kwatanta da maza ba tare da tasiri mai mahimmanci ba.

Sadarwa tare da sunadaran plasma jini - 99.5%, akasarinsu tare da albumin da glycoprotein alpha-1. Matsakaicin darajar bayyana girman rarraba a cikin ma'aunin daidaitawa shine lita 500. Yana da metabolized ta conjugation tare da glucuronic acid. Metabolites ba su da magunguna. Rage rabin rayuwa ya fi awanni 20. An cire ta ta cikin hanji bai canzawa ba, excretion da kodan - kasa da 2% na maganin da aka dauka. Gabaɗayan aikin plasma yana da girma (900 ml / min) idan aka kwatanta da hawan jini na "hepatic" (kimanin 1500 ml / min.).

Magungunan magunguna na telmisartan a cikin tsofaffi marasa lafiya bai bambanta da matasa marasa lafiya ba. Ba a buƙatar gyaran gyaɗa.

Marasa lafiya tare da gazawar koda

Ba a buƙatar canje-canje na marasa lafiya a cikin marasa lafiya tare da gazawar renal, ciki har da marasa lafiya akan hemodialysis. Ba a cire Telmisartan ta hanyar ilimin motsa jiki ba.

Marasa lafiya tare da raunin hanta

A cikin marasa lafiya da ke fama da rauni na matsakaici zuwa matsakaici (aji A da B akan sikelin Yara-Pugh), kashi na yau da kullun kada ya wuce 40 MG.

Amfani da yara

Babban alamomin magunguna na telmisartan a cikin yara masu shekaru 6 zuwa 18 bayan shan telmisartan a kashi na 1 mg / kg ko 2 mg / kg tsawon sati 4, gabaɗaya daidai yake da bayanan da aka samo a cikin maganin manya, kuma sun tabbatar da rashin layi na likitan magunguna na telmisartan. musamman game da C_max.

Hulɗa da ƙwayoyi

Telmisartan na iya ƙaruwa da sakamako na hypoensive na sauran jami'ai na antihypertensive. Sauran nau'ikan hulɗa da mahimmancin asibiti ba a gano su ba.

Amfani mai amfani tare da digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin da amlodipine baya haifar da ma'amala mai mahimmanci a asibiti. Markedara yawan adadin digoxin a cikin plasma na jini da kimanin kashi 20% (a kashi ɗaya, cikin kashi 39%). Tare da gudanarwa na lokaci guda na telmisartan da digoxin, yana da kyau a tantance taro na lokaci-lokaci cikin jini.

Ta amfani da telmisartan da ramipril lokaci guda, an ƙara ƙaruwa sau biyu a cikin AUC0-24 da Cmax na ramipril da ramipril. Ba a kafa mahimmancin asibiti na wannan sabon abu ba.

Tare da gudanarwa na lokaci daya na masu hana ACE da shirye-shiryen lithium, an lura da karuwa mai yawa a cikin taro na lithium a cikin jini, tare da sakamako mai guba. A cikin mafi yawan lokuta, irin waɗannan canje-canje an bayar da rahoto tare da gudanar da masu karɓar antagonist antagonist II. Tare da gudanar da sinadarai na lithium da angiotensin II masu karɓar antagonists, an bada shawara don tantance taro na lithium a cikin jini.

Jiyya tare da NSAIDs, gami da acetylsalicylic acid, inhibitors na COX-2, da kuma waɗanda ba a zaɓa ba NSAIDs, na iya haifar da rashin lafiyar ƙirar ƙirar a cikin marasa lafiyar da ke fama da rashin ruwa. Magunguna masu aiki akan tsarin renin-angiotensin-aldosterone (RAAS) na iya samun tasirin gurguzu. A cikin marasa lafiya da ke karɓar NSAIDs da telmisartan, bcc dole ne a rama su a farkon jiyya da kuma kula da aikin na renal.

An lura da rage tasirin wakilai na rigakafi, kamar telmisartan, ta hanyar hana lalacewar tasirin vasodilating na prostaglandins tare da kulawa tare da NSAIDs.

Sashi da gudanarwa

Allunan Telmisartan an yi su ne don gudanarwa na maganin yau da kullun kuma ana ɗaukar su da ruwa, tare da ko ba tare da abinci ba.

Jiyya da mahimmancin jijiya

Yawan shawarar da aka bayar da shawarar manya shine 40 mg sau ɗaya kowace rana.

A cikin yanayin inda ba'a sami karfin jini da ake so ba, ana iya karɓar kashi na Telsartan® zuwa iyakar 80 MG sau ɗaya a rana.

Lokacin da aka kara yawan ƙwayar, ya kamata a la'akari da cewa mafi girman tasirin antihypertensive ana samun mafi yawa a cikin makonni huɗu zuwa takwas bayan farawar magani.

Za'a iya amfani da Telsartan® a hade tare da diuretics thiazide, alal misali, hydrochlorothiazide, wanda a hade tare da telmisartan yana da ƙarin tasirin hypotensive.

A cikin marasa lafiya tare da matsanancin hauhawar jini, kashi na telmisartan shine 160 mg / day (Allunan guda biyu na Telsartan® 80 MG) kuma a haɗe tare da hydrochlorothiazide 12.5-25 mg / day ya kasance mai haƙuri kuma yana da tasiri.

Yin rigakafin cututtukan zuciya da mace-mace

Yawan shawarar da aka bada shawarar shine 80 MG sau ɗaya kowace rana.

Ba a tantance ko allurai da ke ƙasa da MG 80 na da tasiri wajen rage ƙwayar zuciya da mutuwa ba.

A matakin farko na amfani da miyagun ƙwayoyi na Telsartan® don rigakafin cututtukan zuciya da mace-mace, ana ba da shawarar sarrafa hawan jini (BP), da kuma daidaitawar hawan jini tare da kwayoyi waɗanda ke rage karfin jini.

Ana iya ɗaukar Telsartan® ba tare da la'akari da cin abinci ba.

Ba a buƙatar canje-canje na marasa lafiya a cikin marasa lafiya tare da gazawar renal, ciki har da marasa lafiya akan hemodialysis. Akwai ƙarancin gogewa a cikin lura da marasa lafiya tare da mummunan gazawar renal da hemodialysis. Ga irin waɗannan marasa lafiya, ana bada shawara don fara da ƙananan kashi na 20 MG. Ba a cire Telsartan® daga jini ba yayin zubar jini.

A cikin marasa lafiya da ke fama da rauni na matsakaici zuwa matsakaici, kashi na yau da kullun kada ya wuce 40 MG sau ɗaya a rana.

Ba a buƙatar gyaran gyaɗa.

Tsarin ilimin rayuwa (ICD-10)

Mai masana'anta:

Severnaya Zvezda CJSC, Rasha

Adireshin shari'a na masana'anta:

111141, Moscow, Zeleny prospekt, d. 5/12, shafi 1

Adadin adireshin da aka amsa da kuma yarda:

188663, yankin Leningrad., Gundumar Vsevolozhsk, mazaunin birane Kuzmolovsky, ginin bita A'a 188

Haihuwa da lactation

Yin amfani da Telmisartan-SZ yana contraindicated lokacin daukar ciki. Lokacin da ake bincika ciki, ya kamata a dakatar da maganin nan da nan. Idan ya cancanta, ya kamata a tsara madadin magani (wasu azuzuwan magungunan antihypertensive wadanda aka yarda dasu amfani dasu yayin daukar ciki).

Yin amfani da ARA II yayin watanni uku da na uku na ciki yana contraindicated.

A cikin binciken kwaskwarima na telmisartan, ba a gano tasirin cutar teratogenic ba, amma an kafa fetotoxicity. An sani cewa fallasa zuwa ARA II yayin watanni na biyu da na uku na ciki yana haifar da fetotoxicity a cikin mutum (rage aiki na renal, oligohydroamnion, jinkirta ossification na kwanyar), kazalika da cututtukan cututtukan cututtukan ƙwayar cuta na ciki (gazawar renal, hypotension, hyperkalemia). Ya kamata a bai wa marassa lafiyar dake shirin daukar ciki wata madadin magani. Idan jiyya na ARA II ya faru ne a cikin tsaka-biyu na ciki na ciki, ana ba da shawarar don kimanta aikin ƙirar da yanayin kwanyar cikin tayin ta hanyar duban dan tayi.

Jariri wanda mahaifiyarsa ta karɓi ARA II ya kamata a sa ido sosai don maganin ƙarfin jini.

An kwantar da hankali tare da Telmisartan-SZ lokacin shayarwa.

Babu karatuttukan akan haihuwa.