Yadda ake amfani da Cozaar? > Jiyya da rigakafin

Abinda yake aiki shine dan adawamasu karɓa angiotensin 2. Abubuwan gaba daya sun toshe duk illa. antiotensin, ko da kuwa hanyar hakan da enzyme daga inda aka samo shi, ko daga wane ne aka samo shi. An san hakan angiotensin 2(mai iko vasoconstrictor) muhimmin cigaba ne mai mahimmanci hauhawar jini. Bugu da kari, abu mai aiki baya aiki kamar antagonensin antagonist.

Cibiyar za ayi aiki tare da takamaiman Masu karɓa na AT1ba tare da shafi masu karban wasu ba ion tashoshi da kwayoyin. Losartan ba shi da wani tasiri kininase 2 da bradykinin. An tabbatar da cewa abu mai amfani da maganin ba shine sanadin hakan ba edema.

Bayan shan maganin, alaƙar damuwa tsakanin ɓacin rai ya ɓace angiotensin 2 da rufin asiri reninaiki ARPyana ƙaruwa.

Bayan jiyya tare da miyagun ƙwayoyi na makonni 6, maida hankali angiotensin 2 yana ƙaruwa sau 2-3. Kyakkyawan toshewar takaddara masu karɓa na faruwa, wanda ke nuna kanta sosai kwanaki 14-48 bayan fara shan miyagun ƙwayoyi.

An tabbatar da cewa maganin ba shi da tasiri ciyayi n.s. da reflexes, taro sugar a ciki jini. Losartan yana da matukar bambancin magunguna daga ACE masu hanawayana toshe tasirin angiotensin 1 da 2ba tare da tasiri ba bradykinin(ACE masu hanawa yi gaba da wannan hanyar).

Tare da karuwa a sashi na miyagun ƙwayoyi, sakamakon tasirinsa yana ƙaruwa.

Lokacin gudanar da nazari tare da maza masu lafiya, bayan sun ɗauki 100 MG na miyagun ƙwayoyi, a ƙarƙashin ƙarancin gishiri ko gishiri mai yawa abincisaurin filirƙirarin dunƙule,ctionirgar yankikuma aikin koda koda yaushe bai canza ba. Koyaya, karin urinary acid excretion da kodan da kuma urinary sodium abun ciki ya ƙaru.

A cikin mata a menopause da lokacin bayan wahala daga karuwa hawan jinitare da cin abinci na yau da kullum na 50 MG na magani don matakin wata daya PGba a canza ba.

A cikin gwaje-gwaje na asibiti, manufar wanda ya kasance don tantance dogara da jin daɗin rayuwa, mace-mace da bugun zuciya, a cikin marasa lafiya CNS daga sashi na yau da kullun losartan, an tabbatar da cewa magani a cikin sashi na 150 MG yafi tasiri fiye da 50 MG. An gudanar da karatun ne tsawon shekaru 4.

Bayan allunan suna ciki Gastrointestinal fili, kayan aiki mai aiki na Cozaar yana da kyau kuma yana ɗaukar hanzari, yana shiga cikin wurare dabam dabam na jini kuma metabolized (14%) a cikin kyallen hanta. Losartan siffofin aiki (bazai) kuma marasa aiki (N-2-tetrazole-glucuronide) metabolites. Bioavailability kusan 30%. Ana lura da mafi girman yawan losartan bayan minti 60, ana amfani da metabolites - bayan sa'o'i 3.5. Pharmacokinetic sigogi ne masu zaman kansu daga cin abinci.

Magungunan suna da babban matsayi na rataye ga sunadaran plasma - kusan kashi 99%. Abunda yake aiki baya shigajini-kwakwalwa kwakwalwa.

Magungunan an cire su ta hanyar metabolites ko ba su canzawa da kodan da feces, cikin minti 120 da awanni 5-6. Lokacin ɗaukar 100 MG na miyagun ƙwayoyi kowace rana, ba ya karkatar da tarawa a cikin jiki.

Magungunan Pharmacokinetic kar a dogara da shekaru. Koyaya, a cikin mata, ƙwayar plasma na abu mai aiki ya ninka 2 sau da yawa fiye da na maza.

A cikin marasa lafiya da cutar hanta (tare da cirrhosis) Cutar plasma shine sau da yawa sama da mutane masu lafiya.

Akeɓancewar ƙirar fiye da 10 ml minti daya, a cikin mutane ba maganin hemodialysis, alamomin magungunan ba su da bambanci sosai. Ba a fitar da samfurin ba lokacin maganin hemodialysis.

Alamu don amfani

mutane fama da hauhawar jini,
don kare kodan lokacin da ciwon sukariNau'ikan 2 tare da furotinururia,
don rage hadarin kamuwa da ciwon zuciya (bugun zuciya, bugun zuciya) ko mace-mace a cikin marasa lafiya dahagu ventricular hauhawar jini kuma ya karu BOKA,
tare da raunin zuciya, da rashin haƙuri ko rashin inganci ACE masu hanawa,
don rage aukuwar ci gaba Ciwon mara na wucin gadi (a cikin matakin tashar, idan ana buƙatar juyawa ko maganin hemodialysis).

Contraindications

a rashin lafiyan mutum akan kayan aikinta,
tare da rashin haƙuri lactose,glucose galactose malabsorption syndromeko kasawa lactases,
Mutanen da ke fama da mummunar cutar hanta
a karkashin shekara 18,
a tare Aliskiren,
mata masu juna biyu da masu shayarwa.

Ya kamata a yi taka tsantsan:

a stenosis na biyu na asali na koda na asali artery stenosis (idan mara lafiya yana da koda daya)
mara lafiya tare da tsananin rauni na zuciyamusamman a hade kuma na gazawar,
aCiwon zuciya na Ischemic ko zuciya arrhythmias,
bayan sakewan koda,
a mitral ko aortic stenosis,
marasa lafiya tare da cuta na cerebrovascular, Harshen Quincke's edema, gami da tarihin
a rage Bcc.

Side effects

Marasa lafiya tare da ƙaruwa BOKA an yarda da maganin gaba ɗaya. Abubuwan da ba su dace ba sune yanayin nutsuwa, wuce tare da lokaci, ba a buƙatar cire magani ba.

Mafi sau da yawa bayyana: tsananin farin cikifata fitsari orthostatic halayen.

barci damuwa, ciwon kai, asthenia,
palpitations, kirji zafi, rauni, gajiya, na waje edema,
samarinzafi cikin yankin epigastric,
ƙarancin cikitashin zuciya zawo,
jijiyoyin jiki, ciwon baya,
rhinitistari sinusitis, pharyngitis da sauran cututtukan cututtukan tsokoki na sama wanda ke haifar da kamuwa da cuta.

A nau'in ciwon sukari na 2 mafi yawan ci gaba: rauni, tsananin farin ciki, hyperkalemia, jijiyoyin jini.

Mitar da yanayin halayen da ba ta dace ba sun dogara ne da yawan maganin da mai haƙuri yake ɗauka. Don haka, lokacin shan 150 na Cozaar kowace rana sau da yawa ya faru: hyperkalemiagazawar koda, raguwa BOKAmatakin karuwa creatininepotassium da urea a cikin jini.

A cikin lokacin da rajista na miyagun ƙwayoyi, an gano sakamako masu illa:

amai, rashin hanta, hepatitis,
thrombocytopenia, myalgia,
dysgeusia da migraine,
anemia, arthralgia,
rage libido da rashin ƙarfi,
cututtukan mahaifaja da rashes akan fata, yanayin fata ga haske.

Umarnin don amfani da Cozaar (hanya da sashi)

An tsara miyagun ƙwayoyi a baki, ko da abinci.

Dole ne a tantance magunguna da tsarin likita ta hanyar halartar, yayin da za'a iya hada magungunan tare da wasu magunguna don hauhawar jini.

Umarnin don amfani da Cozaar

Tare da karuwar hawan jini, kashi na farko = 50 MG kowace rana.

Bayan kwanaki 21-42 bayan fara magani, miyagun ƙwayoyi sun isa mafi girman tasiri.

Idan ya cancanta, ana iya ƙara yawan zuwa 100 MG kowace rana.

Ga marasa lafiya da karuwa BOKA tare da shi hagu ventricular hauhawar jini ko nau'in ciwon sukari na 2 kashi na farko shima = 50 MG kowace rana (sannan an kara shi zuwa 100 MG).

Mutane tare da CHF a cikin matakan farko na magani, zaku iya ɗaukar 12.5 MG na magani sau ɗaya a rana. Ana ƙaruwa da sashi kowane kwana 7 (25 MG, 50 MG, 100 MG da 150 MG) kamar yadda mai haƙuri yake.

A low kewaya jini(bayan shan kamuwa da cuta) Maganin farko shine 25 MG kowace rana.

Hakanan, daidaita sashi ya wajaba don cututtukan hanta mai tsanani.

Yawan abin sama da ya kamata

Babu wata shaida game da yawan shan ƙwayoyi. Ana tsammanin cewa ɗaukar manyan magunguna zai haifar da raguwa mai ƙarfi BOKAda samarin.

A matsayin magani, yana gudanar da bayyanar cututtuka da tallafin magani. Kwarewar Zuciyam.

Haɗa kai

Ba za a iya hada magunguna tare da ba Aliskirena ciwon sukari ko tare da gazawar koda.

Idan aka hade masu hana COX-2 masu hanawa, magungunan anti-mai hana kumburi tare da Losartan da tasiri na duka kungiyoyin magunguna yana raguwa.

Hadin cozaar tare da Spironolactone, Amiloride, Triamterenda sauransu potassium-spure diureticsyana haifar da ƙara yawan matakan potassium a cikin jini.

An san hakan Rifampicin ya sami damar rage ƙwayar cutar plasma ta wannan ƙwayar.

Losartan yana rikitar da tsarin cire lithium daga jiki.

Tare da tsananin taka tsantsan, magani da PNVS, wannan na iya haifar da (musamman a cikin tsofaffi, marasa lafiya da rashin ruwa a jiki) don ƙara nauyi a kan kodan. Canje-canje na juyawa, yawanci yakan ɓace bayan an soke ɗayan magungunan.

Umarni na musamman

Magungunan ba shi da tasiri don rage yawan bugun zuciya ga marasa lafiya na tseren Negroid. A wannan yanayin, atenolol ya fi tasiri. Wannan yana kaiwa ga ƙarshe cewa ACE masu hanawa da antagonensin antagonistskasa da tasiri a cikin marasa lafiya na tseren Negroid.

Magani baiyi ma'ana ba lokacin da aka tsara na farko hyperaldosteronism, ba ya rageBOKA.

Saboda gaskiyar cewa wasu daga cikin cututtukan sakamako na iya shafar gudu da daidaito na halayen psychomotor, ana ba da shawarar guji tuki yayin amfani da miyagun ƙwayoyi.

Analogs na Cozaar

Magungunan asali suna da yawan analogues tare da rukuni mai kama da rukuni mai aiki:Angizar, Cardomin-Sanovel, Giperzar, Ksartan, Lozap, Closart, Lozartin, Lorista, Losar, Presartan, Pulsar, Erinorm.

Hakanan analogues na miyagun ƙwayoyi sune: Advantan, Votum, Aprovel, Vasar, Valsacor, Vanatex, Diovan, Diocor, Irbetan, Candesar, Cantab, Kasark, Mikardis, Teveten, Firmasta, Hizart, Edarbi.

Kasuwancin magunguna na Cozaar

Pharmacodynamics
Angiotensin II shine mai ƙarfi na vasoconstrictor, hormone mai aiki na tsarin renin-angiotensin kuma ɗayan mahimman abubuwan da ke cikin cututtukan hawan jini. Angiotensin II yana ɗaure wa mai karɓa na AT1 wanda aka samo a cikin kyallen takarda da yawa (misali, jijiyoyin jijiya mai santsi, ƙwayar fata, hanta, da zuciya), kuma yana ƙaddara ƙaddarar tasirin abubuwa masu mahimmanci, ciki har da vasoconstriction da sakin aldosterone. Angiotensin II kuma yana karfafa haɓaka ƙwayoyin tsoka mai santsi. A cikin yanayin a cikin vitro da a cikin vivo losartan da makamashinta na aiki - carboxylic acid (E-3174) suna toshe duk mahimmancin illolin ilimin likita na anigotensin II ba tare da la’akari da tushen ko hanyar aikin ba. Losartan wanda aka zaɓa yana ɗaure wa mai karɓa na AT1, baya ɗaure ko toshe wasu masu karɓar ƙwayoyin hormone da tashoshin ion. Losartan baya hana ACE (kininase II), wani enzyme wanda ke inganta rushewar bradykinin. Sakamakon haka, tasirin da ba shi da alaƙa kai tsaye da toshewar mai karɓar mai karɓar AT1 (alal misali, haɓaka da tsananin tasirin bradykinin) ba a da alaƙa da amfani da losartan.
Yin amfani da losartan na iya rage yawan mutuwar mutum daga cututtukan zuciya, yawan lokuta na bugun jini da myocardial infarction a cikin marasa lafiya tare da hauhawar jini (hauhawar jijiya) da hauhawar ventricular hagu, yana da tasirin nephroprotective a cikin marasa lafiya da nau'in ciwon sukari na II na mellitus tare da proteinuria.
Pharmacokinetics
Baƙon
Bayan sarrafawa na baka, losartan yana da kyau kuma yana fuskantar metabolism na farko tare da ƙirƙirar metabolite mai aiki na carbonxylic acid da metabolites marasa aiki. Tsarin bioavailability na tsirrai na losartan shine kusan 33%. Matsakaicin mafi girman losartan da aiki na metabolite suna aiki bayan awa 1 da awa 3-4, bi da bi .. Shan shan miyagun ƙwayoyi tare da abinci ba zai tasiri taro na losartan a cikin jini ba.
Rarraba
Theullaƙar losartan da aiki na metabolite tare da ƙwayoyin plasma, galibi tare da albumin, sun fi 99%. Volumearar watsawa - 34 l. Binciken ya gano cewa losartan mara kyau ya ratsa cikin BBB ko kuma baya shiga kwata-kwata.
Cirewa
Bayyanar Plasma na losartan da aiki na metabolite shine kusan 600 da 50 ml / min, bi da bi. Clearasar dan ƙasa na losartan da metabolite ɗinsa mai aiki kusan 74 da 26 ml / min, bi da bi. Bayan gudanarwar bakin, kusan 4% na kashi an cire shi a cikin fitsari kuma kusan 6% na kashi a matsayin mai aiki metabolite. Tare da sarrafawa na baka na potassium na losartan a cikin kashi har zuwa 200 MG, magungunan magunguna na miyagun ƙwayoyi da metabolite mai aiki shine layi.
Bayan gudanar da baki, maida hankali ne na miyagun ƙwayoyi da aiki metabolite a cikin jini yana raguwa da yawa tare da ƙarshen rabin rayuwar 2 hours don losartan da 6-9 na sa'o'i don aiki metabolite. Bayan gudanar da magana ta baki na C14 mai taken losartan, kusan kashi 35% na aikin rediyo ana gano shi cikin fitsari, 58% a cikin feces.
Pharmacokinetics a cikin rukunin masu haƙuri na musamman
Tsofaffi marasa lafiya
Hankali na losartan da kuma aiki na metabolite a cikin jini na tsofaffi marasa lafiya da ke fama da hauhawar jini (jijiyoyin jini) ba su da bambanci sosai da wannan a cikin marasa lafiya da hawan jini (hauhawar jijiya) na kungiyoyin matasa.
Jinsi
Hankalin losartan a cikin jini na jini ya kasance sau 2 mafi girma a cikin marasa lafiya tare da hauhawar jini (hauhawar jini) na mata. Natsuwa na aiki metabolite a cikin jini na jini a cikin mata da maza marasa lafiya bai bambanta ba. Wannan bambance-bambancen magani ba shi da mahimmanci a asibiti.
Marasa lafiya tare da rauni na hanta da koda
Lokacin da aka yi magana da baki a cikin marasa lafiya da masu saukin kamuwa da ƙwayar cuta a cikin hanta, yawan ƙwaƙwalwar losartan da ƙwaƙwalwar ƙwaƙwalwa mai aiki a cikin jini na jini ya kasance sau 5-1.7, bi da bi, idan aka kwatanta da matasa masu sa kai.
Hulɗar da losartan a cikin plasma na jini a cikin marasa lafiya tare da keɓantar da kerawa da fiye da 10 ml / min bai bambanta da wannan a cikin mutane masu aiki na al'ada. AUC a cikin marasa lafiya da ke fuskantar hemodialysis ya ninka 2 sau mafi yawa idan aka kwatanta da marasa lafiya da ke da aikin na al'ada. Mayar da hankali daga ƙwayar metabolite mai aiki a cikin jini na jini ba ya canzawa a cikin marasa lafiya da ke fama da rauni na aikin ƙirar ko a cikin marasa lafiya da ke fuskantar hemodialysis. Losartan da aiki metabolite ba su keɓance ta hanyar motsa jiki ba.

Yayin ciki da lactation

An hana yin maganin sosai lokacin ɗauka ciki. Ya kamata a canza shi zuwa wasu magungunan antihypertensive.

Ko dai an cire maganin a cikin nono ba a san shi daidai ba. Saboda haka, yayin jiyya tare da Cozaar nono shawarar shawarar daina.

Formaddamar da tsari da abun da ke ciki

Fuskar sashi na Cozaar - allunan da aka sanya a fim: farare, allunan siffofi masu siffa suna da hadarin rabuwa ta bangare daya da kuma zane "952" a daya gefen, siffofin da aka zana - kwarzana "960" a gefe daya kuma shimfidar shimfidar wuri a daya gefen (a cewar MG 50 don guda 14., 100 MG don 7 ko guda 14. A cikin blisters, a cikin kwali na kwali na 1 ko blisters).

Abunda yake aiki shine potassium losartan, a cikin kwamfutar hannu 1 - 50 ko 100 MG.

Abubuwan taimako: pregelatinized masara sitaci, lactose monohydrate, microcrystalline cellulose, magnesium stearate.

Harshen Shell: hypromellose, hyprolose (tare da 0.3% silicon dioxide), carnauba da kakin zuma, dioxide titanium.

Yin amfani da miyagun ƙwayoyi Cozaar

Ana iya ɗaukar Cozaar ba tare da la’akari da abinci ba. Ana iya ba da maganin Cozaar a lokaci guda tare da sauran magungunan antihypertensive.
AH (hauhawar jini)
Matsakaicin da aka saba da kuma kulawa na mafi yawan marasa lafiya shine 50 MG 1 lokaci ɗaya kowace rana. Ana samun tasirin antihypertensive matsakaici a cikin makonni 3-6 daga farkon far. A cikin wasu marasa lafiya, don cimma sakamako mai faɗi, yana iya zama dole don ƙara kashi zuwa 100 MG sau ɗaya a rana.
Lokacin da ake tsara magunguna ga marasa lafiya da rage yawan BCC (alal misali, saboda magani tare da allurai na diuretics), kashi na farko na iya zama 25 MG sau ɗaya a rana (duba CIKIN CIKIN SAUKI).
Babu buƙatar zaɓar kashi na farko don marasa lafiya tsofaffi ko marasa lafiya da gazawar renal, ciki har da marasa lafiya akan hemodialysis. Ana iya ba marasa lafiya da tarihin cutar hanta ƙasa da kashi na yau da kullun.
Don rage haɗarin rikice-rikice da mace-mace saboda dalilai na zuciya da jijiyoyin jini a cikin marasa lafiya tare da hauhawar jini (hauhawar jini) da hauhawar jini na ventricular.
Maganin farko na Cozaar shine 50 MG 1 lokaci ɗaya kowace rana. Dangane da canji a cikin karfin jini, ana amfani da ƙarin kashi kaɗan na hydrochlorothiazide kuma / ko kuma ana iya ƙara yawan kashi na Cozaar zuwa 100 MG sau ɗaya a rana.
Nephroprotection a cikin marasa lafiya da nau'in sukari na II na sukari mellitus tare da furotinurur
Yawan farawa na yau da kullun shine 50 mg sau ɗaya kowace rana. Za'a iya ƙara yawan zuwa 100 mg sau ɗaya a rana, gwargwadon canje-canje a cikin karfin jini. Ana iya ba da maganin Cozaar a lokaci guda tare da sauran magungunan antihypertensive (diuretics, masu hana tashar alli, α- ko β-adrenoreceptor blockers da magungunan tsakiya), tare da insulin da sauran magungunan hypoglycemic da yawa da aka yi amfani da su (misali sulfonylureas, glitazones da glucoidase inhibitors).

Abun hulɗa na miyagun ƙwayoyi Cozaar

A cikin karatun pharmacokinetic, ba a lura da ma'amala mai mahimmanci ta losartan tare da hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole da erythromycin. Warfarin da fluconazole an ba da rahoton su rage matakin metabolite mai aiki na losartan. Ba a tantance sakamakon asibiti na waɗannan hulɗa ba.
Kamar yadda yake tare da sauran masu hana angiotensin II, yawan amfani da sinadarin da ake amfani da su wajen daskarar da sinadarai (spirinolactone, triamteren, amiloride), abubuwan da ke dauke da sinadarin potassium ko kuma kara gishiri na iya haifar da cutar hyperkalemia.
NSAIDs, ciki har da masu hana COX-2 masu hanawa, na iya rage tasirin diuretics da sauran magungunan antihypertensive. Sabili da haka, tasirin antihypertensive na kwayoyi - angiotensin II antagonists na iya rage tare da yin amfani da NSAIDs a lokaci guda, ciki har da masu hana inuwa na COX-2.
A cikin wasu marasa lafiya da ke fama da rauni na aiki a cikin kulawa da NSAIDs (ciki har da masu hana COX-2), gudanarwar haɗin gwiwar masu karɓar angiotensin II masu tayar da hankali na iya haifar da raguwa a cikin aikin renal. Wadannan illolin yawanci ana iya jujjuya su.

Ra'ayoyi game da Cozaar

A kan tattaunawa a yanar gizo game da miyagun ƙwayoyi suna magana sosai. Tare da gudanar da tsari na yau da kullun, ƙwayar ƙwayar cuta tana daidaita karfin jini kuma da wuya ya haifar da sakamako masu illa. A saukin yanayi, shanshi bashi da nasaba da cin abinci.

Reviews game da Cozaar:

"Magunguna na yau da kullun, amma ba a taimaka nan da nan ba, amma wani wuri kawai a kusa da mako na 3 na gudanarwa",

“Bayan tiyata, na kwashe mako guda ina daukar Cozaar. Yunkuri ya ragu daga 220 116 zuwa 130 87. Sakamakon sakamako shine rauni, amma na yi zunubi akan maganin sa barci. Kafin wannan na gwada wasu magunguna - ba su taimake ni ba. "

Pharmacokinetics

Lokacin da aka sha shi da baki, losartan yana sha kuma metabolized sosai. An nuna shi sakamakon tasirin "hanyar farko" ta hanta tare da ƙirƙirar metabolite na metabolic tare da aikin magunguna, da kuma metabolites marasa aiki. Tsarin bioavailability na kayan a cikin kwamfutar hannu shine kusan 33%. Matsakaicin mafi yawan losartan da aiki metabolite suna rikodin su a kan matsakaici bayan awa 1 da awa 3-4 bayan gudanarwa, bi da bi. Lokacin cinye Cozaar yayin cin abinci na yau da kullun, bayanan maida hankali akan abubuwan da ke aiki a cikin jini yana canzawa.

Matsakaicin ɗaukar nauyin losartan da aiki na metabolite tare da ƙwayoyin plasma (galibi tare da albumin) ya kai 99%. Ofimar rarraba losartan shine lita 34. Gwaje-gwaje a kan beraye sun tabbatar da cewa abin da ke hana kwakwalwar jini cikon abu ne a gare shi.

Aƙalla kusan 14% na adadin Cozaar, lokacin da aka sha shi ta bakin ko a cikin ciki, ya wuce zuwa cikin metabolite ɗin da yake aiki. Baya ga shi, an gano magungunan ƙwayoyin marasa aiki a cikin magunguna, daga cikinsu akwai manyan metabolites guda biyu, waɗanda aka kafa saboda hydroxylation na sarkar butyl, da kuma metabolite daya - N-2-tetrazole-glucuronide.

Theaddamar da aikin plasma na abu mai aiki na Cozaar da metabolite mai aiki shine kimanin 600 ml / min da 50 ml / min, bi da bi. Tabbatar da ɗayan waɗannan mahadi ya kusan 74 ml / min da 26 ml / min, bi da bi. Tare da gudanar da maganin baka na losartan, kusan 4% na kashi da aka ɗauka an cire shi a cikin fitsari kuma kusan kashi 6% na kashi an keɓance su a hanya guda a cikin hanyar metabolite mai aiki. Don losartan da metabolite mai aiki, sigogi na sigogi na pharmacokinetic tare da sarrafawa na bakin Cozaar a allurai har zuwa 200 MG shine halayyar.

Bayan gudanarwar baka, abun cikin losartan da kuma metabolite din dake aiki a cikin jini yana raguwa sosai, tare da rabin rayuwar karshe na kimanin awa 2 zuwa 6 zuwa 9, bi da bi. Lokacin shan Cozaar a sashi na 100 MG sau ɗaya a rana, ba a lura da yawan losartan ko metabolite mai aiki a cikin jiki. Ana aiwatar da haɓakar losartan da aiki metabolites ta hanjin kodan, haka kuma ta cikin hanji da bile. Bayan sarrafawar magana na losartan wanda aka yiwa alama tare da kwayoyin 14 C, a cikin marasa lafiyar maza, kusan kashi 35% na isotope na rediyo ana samun su a cikin fitsari, kuma 58% a cikin feces. Tare da gudanarwa na ciki na 14 C na losartan, kimanin 43% na aikin rediyo yana ƙaddara a cikin fitsari kuma 50% a cikin feces.

Matakan Plasama na plasama a cikin mata da ke fama da hauhawar jijiyoyi sun kasance sau 2 sama da na mazajen da suke da yanayin guda. Mayar da hankali na aiki metabolite a cikin marasa lafiya na mata da maza kusan bai bambanta ba. Koyaya, wannan sabon abu ba shi da wata mahimmanci a asibiti.

A cikin marasa lafiya masu laushi zuwa matsakaici giya na hanta tare da gudanar da baki na Cozaar, abun ciki na losartan da aiki metabolite a cikin jini na jini ya kasance 5 da 1.7 sau mafi girma, bi da bi, fiye da samari masu lafiya waɗanda suka sa hannu cikin aikin gwajin.

Umarnin don amfani da Cozaar: hanya da sashi

Ana amfani da allunan Cozaar a baki sau ɗaya a rana, a kowane lokaci da ya dace, ba tare da la'akari da cin abinci ba.

Ana amfani da maganin ne ta hanyar likita dangane da alamun asibiti.

Shawarar sashi na Cozaar:

Hauhawar jini na jijiya: 50 mg a matsayin farko da kuma gwargwado, idan ya cancanta, don cimma sakamako mafi girma, ana iya ɗaukar 100 MG. A barga hypotensive sakamako bayan 3-6 makonni na far. Ga marasa lafiya da rage yawan BCC, an wajabta farkon maganin a cikin adadin 25 MG. Idan aka nuna tarihin ilimin cututtukan hanta, to yakamata a rage yawan maganin. Marasa lafiya na tsufa kuma tare da gazawar renal, ciki har da marasa lafiya akan dialysis, basu buƙatar daidaita satin farko,
Ciwon zuciya mai rauni: kashi na farko shine 12.5 MG, ana bada shawarar titration sau daya a sati, dan kawowa mutum kulawa (12.5 mg, 25 mg ko 50 mg),
Nau'in ciwon sukari na 2 na sukurite tare da proteinuria: kashi na farko shine 50 MG, yin la'akari da raguwar hauhawar jini (BP), yakamata a ƙara yawan zuwa 100 mg. Haɗewar yin amfani da miyagun ƙwayoyi tare da diuretics, alpha da beta adrenoblockers, masu hana tashar alli, magunguna masu mahimmanci, sauran wakilai na hypoglycemic (glitazones, sulfonylureas, glucosidase inhibitors) da insulin,
Hauhawar jini a cikin jijiyoyin jini da haguwar jini a cikin hagu: Yankin farko don rage yiwuwar haɓaka cutar cututtukan zuciya da mace-mace shine 50 MG. Bayar da matsayin raguwa a cikin karfin jini, ƙarin ilimin ya haɗa da kara yawan zuwa 100 MG ko kuma kwatanta ƙananan allurai na hydrochlorothiazide.

Side effects

A cikin gwaje gwaje na asibiti na amfani da Cozaar, an lura da sakamako masu illa:

Daga tsarin zuciya: tachycardia, palpitations,
Daga tsarin numfashi: kumburin hanci, hanci, hanji, hanji, hanji,
Daga tsarin narkewa: tashin zuciya, dyspepsia, zawo,
Daga tsarin juyayi: rashin bacci, ciwon kai, farin ciki,
Daga tsarin musculoskeletal: cramps muscle, ciwon baya,
Daga jiki gaba daya: gajiya da rauni, jin zafi a kirji da / ko ciki, kumburi,
A ɓangaren sigogi na dakin gwaje-gwaje: hyperkalemia (matakan haɓaka na alanine aminotransferase bayan karban magunguna yawanci sun koma al'ada).

Rashin halayen da aka samu tare da gwamnatin Cozaar an lura dashi a cikin ɗakunan ɗakunan asibiti:

Tsarin abinci: narkewar aikin hanta, da wuya hepatitis,
Tsarin hematopoietic: thrombocytopenia, anemia,
Tsarin Musculoskeletal: arthralgia, myalgia, da wuya - rhabdomyolysis,
Tsarin mara lafiyar: migraine, da wuya dysgeusia,
Tsarin numfashi: tari,
Abubuwan kula da cututtukan cututtukan fata: itching, urticaria, fitar da fata,
Allergic halayen: da wuya - vasculitis, Shenlein-Genoch cuta, angioedema, ciki har da kumburi na glottis, maƙogwaron, tare da toshewar hanji, da / ko kumburi da lebe, fuska, harshe da / ko pharynx (wasu daga cikin marasa lafiya sun sha wahala halayen rashin kulawar su tare da wani sashi na baya ACE masu hanawa).

Gabaɗaya, Cozaar yana da haƙuri da kyau, sakamako masu illa suna da nutsuwa kuma suna bayyana a cikin tsari mai sauƙi wanda baya buƙatar dakatar da miyagun ƙwayoyi.

Tsarin magunguna na Cozaar

Umarnin zuwa Cozaar yana nuna cewa wannan magani yana da ikon rage juriya na jijiyoyi, matsin lamba a cikin karamin da'irar kwararar jini, karfin jini, bayan kaya, sannan kuma yana da tasirin diuretic.

Bugu da ƙari, kamar yadda sake dubawa ga Cozaar ya nuna, wannan magani ba ya ƙyale abin da ya faru na hauhawar jini na myocardial. Ga marasa lafiya da raunin zuciya, an wajabta Cozaar don mafi kyawun canja wurin motsa jiki.

Dangane da sake dubawa game da Cozaar, shan miyagun ƙwayoyi kawai 1 lokaci, bayan 6 hours, systolic da diastolic hauhawar jini ya ragu. Irin wannan sakamako yana da awanni 24. Hanya ta gaba ɗaya na magani tare da miyagun ƙwayoyi don cimma sakamako mafi kyawun kada ta kasance ƙasa da makonni 3-6.

Sashi da gudanarwa

Kamar yadda aka fada a cikin umarnin zuwa Cozaar, an sha maganin kafin, lokacin ko bayan abinci. Don lura da takamaiman cuta, Cozaar kawai za'a iya amfani dashi ko za'a iya haɗuwa dashi tare da wasu magunguna waɗanda ke yaƙi da hauhawar jini.

Idan mai haƙuri yana fama da hauhawar jini, ya kamata a fara amfani da maganin Cozaar tare da sashi na 50 MG ba fiye da lokaci 1 a rana ba. Mafi kyawun sakamakon shan wannan magani yana faruwa makonni 3-6 bayan amfani da farko na miyagun ƙwayoyi. Idan ya cancanta, likita zai iya ƙara yawan adadin yau da kullun zuwa 100 MG (1 lokaci a cikin awanni 24).

A cikin sake dubawar Cozaar, an nuna cewa marasa lafiya tare da rage yawan ƙwayar jini yana ya kamata su fara jiyya tare da matsakaicin sashi na 25 MG kawai 1 lokaci a rana.

Tsofaffi mutane, harma da marasa lafiya da karancin abinci na koda, wadanda har yanzu suna kan siyarwar dial, basa buƙatar yin gyare-gyare ga sashin da aka nuna a cikin umarnin zuwa Cozaar.

Ya kamata a wajabta masu haƙuri da ƙarancin hepatic rage yawan adadin Cozaar a kowace rana.

Don rage abin da ya faru na cututtukan zuciya, kazalika da rage mace-mace a cikin mutanen da ke fama da hauhawar jini na jini da hawan jini, ga duk marassa lafiya, ba tare da togiya ba, ana ƙaddamar da matakin farko na 50 MG na Cozaar ba fiye da 1 lokaci a cikin sa'o'i 24 ba. Nazarin game da Cozaar sun nuna cewa bayan wani lokaci na lokaci, likita ya kara da cewa yana bada karamin sashi na hydrochlorothiazide, ko zaku iya ƙara yawan ci Cozaar (har zuwa 100 MG sau ɗaya a rana). A wannan yanayin, wajibi ne don la'akari da alamun rage karfin jini.

Don tallafawa aikin koda na al'ada a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 da furotinur, ya kamata a fara jiyya tare da sashi na 50 mg sau ɗaya a rana. Bayan wannan, ana amfani da Cozaar yau da kullun zuwa 100 MG, yayin lura da raguwar hauhawar jini. Za'a iya haɗaka magungunan da aka bincika tare da insulin, diuretics, wakilai na tsakiya, da kuma magungunan hypoglycemic daban-daban.

Idan mai haƙuri ya sha wahala daga rauni na zuciya, kashi na farko na Cozaar ba zai iya wuce 12.5 mg ba yayin rana, wanda ake ci gaba kowace rana yayin makon farko na magani. A cikin mako na biyu, sashi yana ƙaruwa zuwa 25 MG kowace rana, a cikin na uku - har zuwa 50 MG kowace rana.

Abun ciki da nau'i na saki

Sashi na 25 yana dauke da adadin daidai da 25 MG na potassium losartan. Kowane farin kwamfutar hannu fara ce, mai rufi tare da fim, alama 951 a gefe ɗaya.

Allunan tare da sashi na 50 sun bambanta da magungunan 25 marasa ƙarfi ta hanyar alama da adadin abu mai aiki a cikin 50 mg na potassium losartan. Kowane kwaya mai farar fata tana da launi, mai rufe fim, mai alama 952

Allunan tare da mafi girma na 100 mg losartan potassium suna da bayyanar farin kwaya a cikin nau'i na digo tare da alamar 960

Tasiri a kan ikon tuka motoci da abubuwa masu rikitarwa

Karatun don tantance tasirin Cozaar akan iya tuki motoci da aiki tare da sabbin hanyoyin da ba'a gudanar dasu ba. Koyaya, lokacin ɗaukar hanyar maganin cututtukan ƙwaƙwalwar ƙwaƙwalwa, ana ba da shawara sosai yayin tuki ko yin aikin da ke da haɗari wanda ke buƙatar ƙara haɗuwa da halayen psychomotor nan da nan. Wannan yana da alaƙa da haɗarin rashin jin tsoro da amai yayin shan ƙwayoyi, musamman a farkon jiyya ko tare da karuwa da kashi.

Hanyar da fasalin aikace-aikace

Ana amfani da Cozaar ba tare da la'akari da tsarin abinci mai gina jiki ba, kawai yana da mahimmanci a bi hanyar da aka zaɓa na ɗaukar allunan a kowace rana. Umarnan yana ba da shawarar yin amfani da kwayoyin magungunan haɗiye ba tare da taunawa tare da ruwan sha ba.

Ya danganta da yanayin mai haƙuri, an zaɓi adadin magani da ake buƙata kowace rana. Matakin farko ya ƙunshi amfani da kashi 50 ko 100 na Cozaar a cikin sa'o'i 24. Maganan da ke rubuta ƙananan maida hankali na miyagun ƙwayoyi a 25 MG kowace rana an san su. Dokaitaccen bin umarnin don amfani kuma kada ku wuce kashi 100 na MG cikin sa'o'i 24. Adadin yawan maganin yana ƙaddara ta hanyar halartar mahaɗan.

An ƙididdige daidaitaccen ka'ida ga marasa lafiya daga shekaru 6 zuwa 16 ana yin lissafin gwargwadon nauyin jikin yaron.

20-49 kg daidaituwar shan maganin shine 25 MG kowace rana, ana iya karuwa zuwa 50 MG na kwaya daya a rana.
50 kilogiram da ƙari - 50 MG kowace rana, na iya ƙaruwa zuwa 100 MG kowace rana.

Babu buƙatar canza sigar farawa don marasa lafiya da gazawar renal da waɗanda ke kan hemodialysis.

Idan akwai cin zarafin ingantaccen hanta a cikin tarihin likitan haƙuri, yakamata a yi la’akari da ƙaramin abu mai mahimmanci.Ainihin tabbatacce ƙwarewa a cikin inganci da amincin amfani da maganin Cozaar a cikin marasa lafiya tare da gazawar na koda, sabili da haka, ganawarsa ga wannan rukuni na marasa lafiya yana contraindicated.

A cikin marasa lafiya da suka girmi shekaru 75, ana iya la'akari da kashi 25 na farko na 25 MG, kodayake daidaita yawanci yawanci ba lallai ba ne ga waɗannan marasa lafiya.

Haihuwa da lactation

Dangane da umarnin, Cozaar an hana shi yin magani yayin daukar ciki. Shan miyagun ƙwayoyi a cikin shekaru II da III na ciki wanda ke shafar tsarin renin-angiotensin zai iya haifar da lahani mai girma ko ma mutuwa tayi, saboda haka, an soke maganin nan da nan bayan an tabbatar da gaskiyar daukar ciki. Rashin ƙanshin da ke da alaƙa da haɓaka renin - tsarin angiotensin yana faruwa a tayin a cikin watanni na biyu. Hadarin ga tayin yana karuwa idan an dauki Cozaar a cikin kashi na biyu ko na uku na ciki.

Ba'a bada shawarar maganin cozaar yayin lactation ba. Kwarewar yin amfani da losartan a cikin wannan rukuni na marasa lafiya bai isa ba, kuma ba a sani ba ko kayan sun shiga cikin madarar nono. Don haka, ya zama dole a daidaita irin fa'idar da amfani ga jijiyoyin ga mahaifiya da kuma yiwuwar hadarin ga jariri da yanke hukunci kan ko za a daina shayarwa ko kuma a soke Cozaar

Hulɗa da ƙwayoyi

Babban hulɗar asibiti ta Cozaar tare da digoxin, warfarin, hydrochlorothiazide, cimetidine, ketoconazole, phenobarbital, erythromycin ba a kafa ba.

Sakamakon raguwa a cikin matakin metabolite mai aiki yayin ɗaukar fluconazole da rifampicin akan sakamakon maganin ba a yi nazari ba.

Gudanarwa na lokaci guda na kayan abinci na potassium, triamteren, spironolactone, amiloride da sauran magungunan da ke hana samuwar angiotensin II, gyada mai dauke da potassium, na iya taimakawa wajen haɓaka matakin potassium a cikin jini.

Idan aka haɗu da shirye-shiryen lithium, losartan yana rage haɓakar haɓakar jiki kuma yana ƙaruwa da haɗuwa da ƙwaƙwalwa.

Magungunan rigakafin cututtukan da ba su da steroidal (NSAIDs), masu hana cyclooxygenase masu hana cyclooxygenase suna rage tasirin maganin.

A cikin marasa lafiya da ke fama da rauni na aiki na kayyayaki, amfani da jituwa tare da miyagun ƙwayoyi da NSAIDs, ciki har da masu hana COX-2 masu hanawa, na iya kara dagula aikin renal. Sakamakon wannan hulɗa yana juyawa.

Rage yawan ƙwayar plasma na metabolite mai aiki a yayin amfani da fluconazole a hade tare da Cozaar yana ƙara yawan losartan a cikin jini na jini.

Analagues na Cozaar sune: Blocktran, Lozap, Losartan, Lorista, Angizar, Kardomin-Sanovel, Giperzar, Ksartan, Klosart, Lozartin, Losar, Presartan, Pulsar, Erinorm, Advantan, Votum, Aprovel, Vazar, Valsacor, Vanatex, Vanatex Irbetan, Candesar, Cantab, Kasark, Mikardis, Teveten, Firmasta, Hizart, Edarbi.

Amfani da juna biyu

Mata masu juna biyu kada su dauki Cozaar saboda shan miyagun ƙwayoyi na iya zama haɗari ga tayin. Idan kuna shirin yin juna biyu, tattauna tare da likitan ku sauran magunguna da zaku iya sha don sarrafa hawan jini. Idan ciki ya faru yayin shan magani, dakatar da magani nan da nan kuma nemi shawarar likita.

Ba a san ko losartan ya shiga cikin madara ba. Ganin irin haɗarin da ke tattare da cutar marasa lafiyar yara a ƙarƙashin shekaru 6, kuna buƙatar dakatar da ciyar da tsawon lokacin amfani da miyagun ƙwayoyi.

Yanayin ajiya

Ka nisantar da magani daga hasken rana a zazzabi da bai wuce digiri 30 Celsius a wurin da yara da dabbobi ba za su iya samun sa ba.

Kowane kwamfutar hannu yana riƙe da 25, 50, ko 100 MG na potassium losartan sashi mai aiki. Microcrystalline cellulose da hydrated lactose, sitaci pregelatinized sitaci, magnesium stearate da hydroxyproxy cellulose da hydroxyproxy mluyl cellulose, titanium dioxide, carnauba ana amfani da su azaman ƙarin kayan abinci.