Noliprel Allunan guda 2, 5, 0, 625 mg 30 inji mai kwakwalwa

Don Allah, kafin ku sayi Noliprel A, Allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa., Bincika bayanin game da shi tare da bayani akan shafin yanar gizon hukuma na masu samarwa ko ƙayyadadden takamaiman samfurin tare da manajan kamfaninmu!

Bayanin da aka nuna akan shafin ba tayin jama'a bane. Mai sana'anta ya tanadi haƙƙin yin canje-canje a cikin ƙira, ƙira da marufi na kaya. Hotunan kaya a cikin hotunan da aka gabatar a cikin kundin adireshin a shafin zai iya bambanta da asalin.

Bayanai kan farashin kaya da aka nuna a cikin kundin adireshin a shafin zai iya bambanta da ainihin lokacin a lokacin sanya oda don samfurin da ya dace.

Mai masana'anta

Abubuwa masu aiki: perindopril arginine, indapamide,

Wadanda suka karu: sittin carboxymethyl sitaci (nau'in A) - 2.7 mg, anhydrous colloidal silicon dioxide - 0.27 mg, lactose monohydrate - 74.455 mg, magnesium stearate - 0.45 mg, maltodextrin - 9 mg,

Tushe a cikin fim: macrogol 6000 - 0.087 MG, premix don farin fim bawan SEPIFILM 37781 RBC (glycerol - 4.5%, hypromellose - 74.8%, macrogol 6000 - 1.8%, magnesium stearate - 4.5%, titanium dioxide (E171) - 14.4%) - MG 2.913,

Aikin magunguna

Noliprel ® A wani shiri ne wanda ya containingunshi pantopril arginine da indapamide. Propertiesungiyoyin magunguna na Noliprel drug Haɗin kayan haɗin kowane ɗayan abubuwan haɗin.

1. Hanyar aiwatarwa

Haɗin perindopril da indapamide yana haɓaka sakamako na antihypertensive kowane ɗayansu.

Perindopril shine mai hana enzyme wanda ke canza angiotensin I zuwa angiotensin II (inhibitor ACE).

ACE, ko kininase II, shine exopeptidase wanda ke aiwatar da duka juyawa na angiotensin I cikin wani abu mai vasoconstrictor angiotensin II, da lalata bradykinin, wanda ke da tasirin vasodilating, zuwa heptapeptide mai aiki. A sakamakon perindopril:

- yana rage ɓoyewar ƙwayoyin (aldosterone),

- ta hanyar ka’idar mayar da martani mara kyau yana kara ayyukan renin a cikin jini,

- tare da yin amfani da tsawan lokaci yana rage OPSS, wanda yafi shine saboda tasirin tasoshin a cikin tsokoki da kodan. Wadannan tasirin ba su da jinkiri a cikin sodium da ions na ruwa ko haɓakar tachycardia na reflex.

Perindopril yana daidaita myocardium, yana rage preload da saukarwa.

Lokacin nazarin sigogin hemodynamic a cikin marasa lafiya tare da raunin zuciya, an bayyana shi:

- raguwa cikin matsin lamba a cikin hagu da dama ventricles na zuciya,

- karuwar fitowar zuciya,

- muscleara yawan jijiyoyin motsi na jini.

Indapamide yana cikin rukunin sulfonamides, a cikin kayan magunguna yana da kusanci da thiazide diuretics. Indapamide yana hana sake dawowa da abubuwa na sodium ion a cikin cortical sashi na Henle madauki, wanda ke haifar da karuwa a cikin ƙwayar sodium, chlorine kuma, a cikin mafi ƙarancin, ƙwayoyin potassium da magnesium ion ta ƙodan, hakan yana ƙara diuresis da rage karfin jini.

2. Tasirin antihypertensive

Noliprel ® A yana da tasirin maganin rigakafi mai mahimmanci akan DBP da SBP duka a tsaye da kwance. Tasirin antihypertensive yana ci gaba na awanni 24. Tasiri mai warkewa yana tasowa ƙasa da wata 1 bayan farawar magani kuma baya tare da tachycardia. Rashin magani ba ya haifar da ciwo na cirewa.

Noliprel ® A yana rage digiri na hauhawar jini ventricular hagu (GTL), inganta ƙwaƙwalwar jijiya, yana rage OPSS, baya tasiri metabolism (jimlar cholesterol, HDL cholesterol da LDL cholesterol, triglycerides).

An tabbatar da sakamakon amfani da haɗin haɗarin perindopril da indapamide akan GTL idan aka kwatanta da enalapril. A cikin marasa lafiya tare da hauhawar jini na jijiya da GTL, an bi da su tare da perindopril erbumin 2 mg (daidai da 2.5 mg perindopril arginine) / indapamide 0.625 mg ko enalapril a kashi na 10 MG sau ɗaya a rana, kuma tare da karuwa a cikin kashi na perindopril erbumin zuwa 8 MG (daidai yake da 10 perindopril arginine) da indapamide har zuwa 2.5 MG, ko enalapril har zuwa 40 MG sau ɗaya a rana, mafi mahimmancin raguwa a cikin ventricular taro index (LVMI) a cikin rukuni na perindopril / indapamide idan aka kwatanta da kungiyar enalapril. A wannan yanayin, ana lura da mafi girman tasiri akan LVMI tare da yin amfani da perindopril erbumin 8 mg / indapamide 2.5 mg.

An kuma lura da mafi kyawun sakamako na antihypertensive akan asalin hadewar jiyya tare da perindopril da indapamide idan aka kwatanta da enalapril.

A cikin marasa lafiya da nau'in ciwon sukari na 2 na sukari (wanda ke nufin shekaru 66 shekaru, ƙididdigar jiki na jiki 28 kg / m 2, glycosylated haemoglobin (HbA1c) 7.5%, karfin jini 145/81 mm Hg), sakamakon gyarawa hadaddun magunguna na perindopril / indapamide don rikitarwa na micro-da macro-vascular rikice-rikice ban da duka daidaitattun hanyoyin kwantar da hankali don sarrafa glycemic da dabarun glycemic iko (IHC) (manufa HbA1c

An lura da hauhawar jini a cikin 83% na marasa lafiya, rikicewar macro- da microvascular a cikin 32 da 10%, da microalbuminuria a cikin 27%. Yawancin marasa lafiya a lokacin haɗuwa a cikin binciken sun karɓi maganin hypoglycemic, 90% na marasa lafiya sun karɓi wakilai na hypoglycemic don sarrafa maganganu (47% na marasa lafiya sun karɓi monotherapy, 46% sun karbi maganin maganin magunguna biyu, 7% sun karɓi maganin kwayoyi uku). 1% na marasa lafiya sun karbi maganin insulin, 9% - maganin rage cin abinci kawai. Abubuwan da ke cikin maganin sulfonylureas sun dauki 72% na marasa lafiya, metformin - 61%. A matsayin maganin concomitant, 75% na marasa lafiya sun karɓi magungunan antihypertensive, 35% na marasa lafiya sun karɓi magunguna masu rage ƙarfin jini (akasarin HMG-CoA reductase inhibitors (statins) - 28%), acetylsalicylic acid a matsayin wakilin antiplatelet, da sauran wakilan antiplatelet (47%).

Bayan makonni 6 na lokacin gabatarwa lokacin da marasa lafiya suka karɓi maganin ƙwaƙwalwar ƙwayar cuta ta perindopril / indapamide, an rarrabasu cikin daidaitaccen tsarin kulawa na glycemic ko ƙungiyar IHC (Diabeton ® MV tare da yiwuwar kara yawan zuwa girman 120 mg / rana ko ƙara wani wakili na hypoglycemic).

A cikin rukunin IHC (yana nufin lokacin binne - shekaru 4.8, yana nufin HbA1c - 6.5%) idan aka kwatanta da ƙungiyar kulawa ta daidaitacce (ma'anar HbA1c - 7.3%), raguwa 10% a cikin haɗarin haɗari na haɗakar haɗarin macro- da microvascular rikitarwa.

An samu fa'idar saboda raguwa cikin haɗarin dangi: manyan rikicewar ƙwayoyin cuta ta hanyar 14%, farawa da ci gaban nephropathy ta hanyar 21%, microalbuminuria ta 9%, macroalbuminuria da 30% da haɓakar rikice-rikice daga kodan ta 11%.

Amfanin rigakafin cutar rashin motsa jiki bai dogara da fa'idodin da aka samu tare da IHC ba.

Perindopril yana da tasiri a cikin lura da hauhawar jini na kowane tsananin.

Tasirin rigakafin magungunan ya kai iyakar sa'o'i 4-6 bayan umarnin baka daya kuma ya ci gaba na tsawon awanni 24. Bayan awanni 24, bayan an sha maganin, ana ganin (kusan kashi 80%) na hanawar ACE.

Perindopril yana da tasiri na antihypertensive a cikin marasa lafiya tare da ƙananan low da al'ada aiki renin aiki.

Lokaci guda na gudanar da aikin thiazide diuretics yana haɓaka tsananin wahala na sakamako na antihypertensive. Bugu da ƙari, haɗuwa da inhibitor na ACE da turezide diuretic suma suna rage haɗarin hypokalemia tare da diuretics.

An bayyana tasirin antihypertensive lokacin amfani da miyagun ƙwayoyi a allurai waɗanda ke da sakamako ƙarancin diuretic.

Sakamakon antihypertensive na indapamide yana da alaƙa da haɓakawa a cikin ɗakunan jijiyoyin jijiyoyin jijiyoyin jini da kuma raguwa a cikin OPSS.

Indapamide yana rage GTL, baya tasiri kan yawan lipids a cikin jini na jini: triglycerides, total cholesterol, LDL, HDL, metabolism metabolism (ciki har da marasa lafiya tare da masu ciwon sukari mellitus concomitant).

Haɗin perindopril da indapamide bai canza halayen magungunan su ba idan aka kwatanta da rarrabe gudanarwar waɗannan magungunan.

Lokacin da aka sarrafa perindopril yana cikin hanzari. Bioavailability shine kashi 65-70%.

Kusan 20% na jimlar perindopril da aka juya zuwa perindoprilat, metabolite mai aiki. Shan miyagun ƙwayoyi tare da abinci yana haɗuwa da raguwa a cikin metabolism na perindopril zuwa perindoprilat (wannan tasirin ba shi da ƙimar asibiti).

C_max Ana samun Perindoprilat a cikin jini na plasma na 3-4 bayan haila.

Sadarwa tare da sunadaran plasma na jini ba su da ƙasa da 30% kuma yana dogara ne akan narkar da perindopril cikin jini.

Rashin daidaituwa na perindoprilat da ke hade da ACE yana raguwa. A sakamakon haka, tasiri T_1/2shine sa'o'i 25. Sake sake alƙawarin perindopril baya haifar da tarawa, kuma T_1/2Tare da sake maimaitawa, perindoprilat ya dace da lokacin aikinsa, saboda haka an cimma matsayin daidaituwa bayan kwanaki 4.

Perindoprilat an cire shi daga jiki ta hanyar kodan. T_1/2 metabolite shine 3-5 awanni

Yawan rage abubuwan perindoprilat yana raguwa a cikin tsufa, haka kuma a cikin marasa lafiya da zuciya da gajiya koda.

Tsabtace dial na perindoprilat shine 70 ml / min.

Magunguna na perindopril an canza su a cikin marasa lafiya da ke fama da hanta: keɓaɓɓen hepatic yana raguwa sau 2. Koyaya, adadin perindoprilat da aka kafa baya raguwa, saboda haka ba a buƙatar canje-canje na kashi.

Perindopril ya haye mahaifa.

Indapamide yana hanzari kuma yana ɗauke shi gaba ɗaya daga narkewa.

C_max ana lura da miyagun ƙwayoyi a cikin jini na jini 1 awa bayan fitowar.

Sadarwa tare da ƙwayoyin plasma - 79%.

T_1/2 shine 14-24 hours (matsakaici 19 hours). Maimaita tsarin magani ba ya haifar da tarawa a cikin jiki. Ana cire shi ta hanyar kodan (70% na maganin da aka gudanar) kuma ta cikin hanji (22%) a cikin yanayin metabolites mara aiki.

Magungunan magunguna ba su canzawa a cikin marasa lafiya tare da gazawar renal.

Mahimmancin hauhawar jini, marasa lafiya da hauhawar jijiyoyin jini da nau'in ciwon sukari guda 2 na jini don rage haɗarin rikicewar microvascular (daga kodan) da rikicewar macrovascular daga cututtukan zuciya.

Haihuwa da lactation

An sanya maganin a cikin juna biyu.

Lokacin da kake shirin daukar ciki ko lokacin da ta faru yayin shan Noliprel ® A, ya kamata ka dakatar da shan maganin nan da nan kuma shirya wani sabon maganin rigakafi.

Kada kayi amfani da Noliprel ® A a farkon farkon lokacin ciki.

Ba a gudanar da binciken da ya dace ba na masu hana yara ACE cikin mata masu ciki. Limitedayyadaddun bayanai game da tasirin masu hana ACE a farkon farkon watanni na ciki sun nuna cewa shan abubuwan ACE ba su haifar da lalata ayyukan tayin da ke tattare da fetotoxicity, amma tasirin maganin ƙwaƙwalwar maganin ba zai iya yanke hukunci gaba daya ba.

Noliprel ® A yana cikin kwanciyar hankali na ciki na II da III na ciki (duba. "Contraindications").

An sani cewa tsawan lokaci bayyanar da inhibitors na ACE a tayin a cikin na biyu da na uku na ciki na iya haifar da ci gaban nakasa (rage aiki na renal, oligohydramnios, jinkirta ossification na kasusuwa kwanyar) da haɓaka rikice-rikice a cikin jariri (gazawar renal, hypotension, hyperkalemia).

Yin amfani da thiazide diuretics na tsawon lokaci a cikin kashi uku na ciki na iya haifar da hypovolemia na mahaifiya da kuma raguwar kwararar jini na uteroplacental, wanda ke kaiwa zuwa ischemia fetoplacental da kuma ci gaban tayin. A cikin mafi yawan lokuta, yayin shan diuretics jim kaɗan kafin haihuwa, jarirai suna haɓaka ƙwanƙwasa jini da thrombocytopenia.

Idan mai haƙuri ya karɓi magungunan Noliprel ® A yayin watanni II ko III na ciki, ana ba da shawarar yin duban dan tayi na jariri don tantance yanayin kwancen da aikin koda.

Tsammar jini na iya faruwa a cikin jarirai waɗanda uwayensu sun sami jiyya tare da masu hana ACE, don haka ya kamata jarirai su kasance a ƙarƙashin kulawa ta fuskar lafiya.

Noliprel ® A yana contraindicated yayin lactation.

Ba a san ko za a cire ɓacin ran tare da madarar nono ba.

Indapamide yana fita a cikin madarar nono. Shan thiazide diuretics yana haifar da raguwar yawan nono ko ragewa da lactation. A wannan yanayin, jariri na iya haɓaka ƙwarin jini zuwa abubuwan gado na sulfonamide, hypokalemia da kuma makamin nukiliya.

Tunda amfani da perindopril da indapamide yayin shayarwa na iya haifar da rikice-rikice a cikin jariri, wajibi ne don tantance mahimmancin farji don mahaifiyar da yanke shawara game da dakatar da shayarwa ko shan magani.

Contraindications

hypersensitivity to perindopril da sauran masu hana ACE, indapamide, wasu abubuwan sulfonamides, da kuma sauran abubuwan taimako wadanda suka hada magunguna,
tarihin cutar anjedeede (tare da sauran masu hana ACE),
hereditary / idiopathic angioedema, hypokalemia, rauni mai yawa na koda (creatinine Cl kasa da 30 ml / min),
stenosis na akidar koda daya, da jijiyoyin biyu na koda,
mai tsanani hanta (ciki har da encephalopathy),
na lokaci daya na kulawa da magunguna wanda ke kara QT tazara,
amfani da lokaci daya tare da magungunan antiarrhythmic wadanda zasu iya haifar da nau'in ƙwayar cuta irinta,
ciki
lactation zamani.

Ba a ba da shawarar haɗin gwiwar yin amfani da miyagun ƙwayoyi tare da diuretics na potassium, yaduwar potassium da shirye-shiryen lithium, da gudanarwa ga marasa lafiya da ke da ƙwayoyin cutar plasma masu ƙarfi

Saboda ƙarancin ƙwarewar asibiti, Noliprel ® A bai kamata a yi amfani da shi ba a cikin marasa lafiya da ke fama da cutar sankarar jijiyoyin jijiyoyin wuya, haka kuma a cikin marasa lafiya waɗanda ba a kula da ƙarancin zuciya.

Tare da taka tsantsan: cututtukan cututtukan cututtukan nama na haɗuwa (da suka hada da tsarin lupus erythematosus, scleroderma), rigakafin immunosuppressive (haɗarin neutropenia, agranulocytosis), hanawar jini na jini, raguwar BCC (diuretics, abinci mai ƙoshin gishiri, amai, gudawa, hemodialysis), angina pectoris, cututtukan cerebrovascular, hauhawar jijiyoyin jini, ciwon sukari mellitus, gajiyawar zuciya (NYHA rashi matakin III), hauhawar jini (musamman tare da gout da urate nephrolithiasis), lability na jini, tsufa, tsufa ta amfani da membranes mai haɓaka ko rashin ƙarfi, kafin cutar LDL, yanayin bayan sauyawar koda, aortic valve stenosis / hypertrophic cardiomyopathy, rashi lactase, galactosemia ko glucose-galactose malabsorption syndrome (shekara 18, shekara 18, shekaru 18, shekaru, 18, shekaru kuma ba a shigar da tsaro ba).

Side effects

Daga tsarin cutar haemopoietic da lymphatic: da wuya - thrombocytopenia, leukopenia / neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia.

Cutar rashin damuwa: a wasu yanayi na asibiti (marasa lafiya bayan sake haɓakar koda, marasa lafiya akan maganin hemodialysis) Masu hana ACE na iya haifar da rashin jini (duba "Umarnin na Musamman").

Daga gefen tsarin juyayi na tsakiya: sau da yawa - paresthesia, ciwon kai, dizziness, asthenia, vertigo, infrequently - damuwa ta bacci, yanayin ƙarfin yanayi, da wuya - rikicewa, mita ba a bayyana ba - suma.

Daga gefen kwayoyin hangen nesa: sau da yawa - raunin gani.

A bangare na ji mai ji: sau da yawa - tinnitus.

Daga CCC: sau da yawa - raguwa mai yawa a cikin hawan jini, incl. orthostatic hypotension, wuya da wuya - bugun zuciya rudani, incl. bradycardia, ventricular tachycardia, firamillation atonia, da angina pectoris da infarction na myocardial, watakila saboda raguwar hauhawar jini a cikin marassa lafiyar masu haɗari (duba “Umarnin na Musamman”), mitar da ba'a bayyana ba - nau'in cuta mai huɗar cuta (wataƙila mai kisa - duba ") Haɗin kai ").

A ɓangaren tsarin numfashi, kirji da gabobin ƙwayar cuta: sau da yawa - a kan tushen amfani da inhibitors na ACE, tari na iya faruwa, wanda ke ci gaba na dogon lokaci yayin ɗaukar wannan rukuni na kwayoyi kuma ya ɓace bayan an soke su, gajeriyar numfashi, da wuya - bronchospasm, da wuya - eosinophilic huhu, rhinitis .

Daga tsarin narkewa: sau da yawa - bushewar bakin mucosa, tashin zuciya, amai, raɗaɗin ciki, ciwon ciki, ƙarancin abinci, asarar ci, dyspepsia, maƙarƙashiya, zawo, da wuya - angioedema na hanji, cholestatic jaundice, pancreatitis, ƙayyadadden tsari - encephalopathy na hepatic a cikin marasa lafiya da rashin isasshen hepatic (duba. "Contraindications", "Umarnin na Musamman"), hepatitis.

A wani ɓangaren fata da fat mai subcutaneous: sau da yawa - fatar fata, ƙaiƙayi, maculopapular rash, infrequently - angioedema of the face, lebe, reshe, mucous membrane of the harshe, muryoyin kiɗa da / ko maƙogwaro, urticaria (duba "Umarni na Musamman") , halayen rashin hankali a cikin marasa lafiya sun yanke shawarar hanawar hanji da kuma halayen rashin lafiyan, purpura, a cikin marasa lafiya tare da m systemic lupus erythematosus, hanya na cutar na iya yin muni, da wuya erythema multiforme, guba epidermal necrolysis, Stevens-Johnson ciwo. An sami lokuta game da daukar hoto (duba. "Umarnin na Musamman").

Daga cikin tsarin musculoskeletal da nama mai haɗuwa: sau da yawa - spasms muscle.

Daga urinary system: akai-akai - na koda gazawa, da wuya sosai - m renal gazawar.

Daga tsarin haifuwa: akai-akai - rashin ƙarfi.

Babban rikice-rikice da alamu: sau da yawa - asthenia, ba tare da ɓata lokaci ba - karuwar gumi.

Manuniyar dakin gwaje-gwaje: hyperkalemia, mafi yawan lokuta na dan lokaci, dan kadan karuwa a cikin samar da hankula a cikin fitsari da jini bayan an daina jinya, a mafi yawan lokuta a cikin marasa lafiya da ke fama da cutar sankarar jijiya, a cikin lura da hauhawar jini tare da cutar sikari, kuma da wuya gazawar cutar, ba a bayyana yawan mita - karuwa a tazara ta QT akan ECG (duba "Umarnin na Musamman"), haɓakar taro uric acid da glucose a cikin jini, haɓaka ayyukan enzymes hanta, hypokalemia, wanda ke da muhimmanci musamman ga atsientov, a hadarin (gani. "Special Umarnin"), hyponatremia da hypovolemia, abu don dehydration da orthostatic hypotension. Hypochloremia na lokaci daya na iya haifar da rashi ga alkalal na rayuwa (rashin yuwuwar da zafin wannan tasiri yayi kadan).

An gano tasirin sakamako a cikin gwaji na asibiti

Abubuwan sakamako da aka lura yayin binciken ADVANCE sun yi daidai da bayanin martaba na aminci wanda aka riga aka kafa don haɗuwar perindopril da indapamide. An lura da mummunan lamari mai banƙyama a cikin wasu marasa lafiya a cikin rukunin masu binciken: hyperkalemia (0.1%), ƙarancin ƙwayar ƙwayar yara (0.1%), ciwon jijiyoyin jini (0.1%) da tari (0.1%).

A cikin marasa lafiya 3 a cikin rukuni na perindopril / indapamide, an lura da angioedema (a kan 2 a cikin rukunin placebo).

Formaddamar da tsari da abun da ke ciki

An samar da Noliprel a cikin nau'ikan allunan: fari, oblong, tare da haɗari a bangarorin biyu (a cikin blisters na 14 da 30 inji mai kwakwalwa, 1 blister a cikin kwali na kwali).

Tsarin kwamfutar hannu 1 ya hada da abubuwa masu aiki:

Perindopril tertbutylamine gishiri - 2 MG,
Indapamide - 0.625 mg.

Abubuwan taimako: microcrystalline cellulose, lactose monohydrate, magnesium stearate, hydrophobic colloidal silicon dioxide.

Pharmacodynamics

Noliprel® A wani shiri ne wanda ya kunshi perindoprilarginin (an angiotensin wanda ke canza enzyme inhibitor) da kuma indapamide (mai diuretic din daga gungun sulfonamide). Abubuwan da ke cikin magunguna na magunguna Noliprel® A hada kayan haɗin kowane ɗayan abubuwan haɗin.

Haɗin perindopril da indapamide yana haɓaka aikin kowane ɗayansu. Noliprel® A yana da tasiri mai amfani da nauyin-jini wanda ya shafi karfin jini da hauhawar jini na jini (BP) a cikin “kwance” da “tsayawa”. A miyagun ƙwayoyi yana 24 hours. Tasirin warkewa yana faruwa ƙasa da wata 1 bayan farawar magani kuma baya tare da tachycardia. Rashin magani ba ya haifar da ciwo na cirewa.

Noliprel® A yana rage matakin hauhawar jini a ventricular hagu, yana inganta jijiyoyin jijiyoyi, yana rage juriya na jijiyoyin jiki, baya shafar haɓakar ƙwayar lipid (jimlar ƙwayoyin cuta, ƙwaƙwalwar lipoprotein mai yawa (HDL) da ƙarancin ƙima (LDL), triglycerides).

Perindopril

Perindopril shine mai hana enzyme wanda ke canza angiotensin I zuwa angiotensin II (inhibitor ACE).

Angiotensin-mai juya enzyme, ko kinase, shine exopeptidase wanda ke aiwatar da juyar da angiotensin I cikin vasoconstrictor abu na angiotensin II, da lalata bradykinin, wanda ke da tasirin vasodilating, zuwa heptapeptide mai aiki. A sakamakon perindopril:

yana rage ɓoyewar ƙwayoyin (aldosterone),
ta hanyar ka’idar gurbataccen bayani yana kara ayyukan renin a cikin jini,
tare da tsawaita amfani da shi, yana rage juriya na gaba ɗaya naƙasa, wanda yake shine saboda tasirin tasoshin a cikin tsokoki da kodan.

Wadannan tasirin ba su da riƙewar riƙe gishiri da ruwa ko ci gaban tachycardia na reflex.

Perindopril yana da mummunar tasiri a cikin marasa lafiya da ke da ƙananan aiki da kuma aiki na plasma renin na al'ada.

Tare da yin amfani da perindopril, an sami raguwa a cikin duka systolic da dastolic matsa lamba (BP) a cikin "kwance" da "tsaye". Rashin maganin ba ya kara karfin jini.

Perindopril yana da tasirin vasodilating, yana taimakawa wajen dawo da haɓaka manyan jijiyoyin jini da kuma tsarin bangon jijiyoyin kananan jijiyoyi, sannan kuma yana rage haɓakar ventricular hagu.

Amfani da thiazide diuretics yana haɓaka ƙayyadadden sakamako na antihypertensive. Bugu da ƙari, haɗuwa da inhibitor na ACE da turezide diuretic suma suna haifar da raguwa cikin haɗarin hypokalemia a cikin marasa lafiya da ke karɓar diuretics.

Perindopril yana daidaita aikin zuciya, rage haɓakawa da saukarwa.

Lokacin nazarin sigogin hemodynamic a cikin marasa lafiya tare da raunin zuciya, an bayyana shi:

rage karfin cika matsa lamba a hagu da dama ventricles na zuciya,
rage a cikin jimlar na jijiyoyin bugun jini,
karuwar fitowar zuciya da karuwar indexiac,
ƙara tsoka yankin jini ya kwarara.

Indapamide yana cikin rukunin sulfonamides - ta hanyar kayan magunguna yana kusa da thiazide diuretics. Indapamide yana hana sake dawowar ion sodium ion a cikin cortical sashi na Henle madauki, wanda ke haifar da karuwa a cikin yanayin sodium, chloride kuma, a cikin mafi ƙarancin, potassium da magnesium ion ta kodan, don haka yana ƙara diuresis.

An bayyana tasirin antihypertensive a allurai wanda galibi basa haifar da sakamako na diuretic.

Indapamide yana rage yawan jijiyoyin bugun jini dangane da adrenaline. Indapamide ba ya shafar lipids na plasma: triglycerides, cholesterol, LDL da HDL, metabolism metabolism (ciki har da marasa lafiya tare da mellitus na sukari concomitant).

Taimakawa rage haɓakar ventricular hagu.

Sashi da gudanarwa

A ciki, zai fi dacewa da safe, kafin abinci, 1 kwamfutar hannu na miyagun ƙwayoyi Noliprel® A lokaci 1 a rana.

Idan ba a sami sakamako mai ƙarfin da ake buƙata ba wata daya bayan fara maganin, ana iya ninka kashi biyu zuwa sashi na 5 mg + 1.25 MG (wanda kamfanin ya ƙera a ƙarƙashin sunan kasuwanci Noliprel® A forte).

Rashin wahala

An sanya ƙwayar maganin a cikin marasa lafiya da gazawar haɓaka mai yawa (CC kasa da 30 ml / min.).

Ga marasa lafiya da matsataccen haɓakar renal (CC 30-60 ml / min), matsakaicin adadin Noliprel® A shine kwamfutar hannu 1 kowace rana.

Marasa lafiya tare da CC daidai yake da ko mafi girma na mil 60 / min. Kada a buƙatar daidaita sashi. Yayin maganin, lura na yau da kullun game da matakan plainma creatinine da potassium wajibi ne.

Yi amfani da lokacin daukar ciki da lactation

Bai kamata a yi amfani da miyagun ƙwayoyi ba a farkon watanni na ciki.

Lokacin shirin yin ciki ko lokacin da ya faru yayin shan Noliprel® A, ya kamata ka dakatar da shan maganin nan da nan kuma shirya wani sabon maganin rigakafi.

Ba a gudanar da binciken da ya dace ba na masu hana yara ACE cikin mata masu ciki. Limitedarancin bayanai game da tasirin maganin a farkon watanni uku na ciki yana nuna cewa shan miyagun ƙwayoyi bai haifar da mummunar lalacewa da ke tattare da rashin lafiyar ba.

Noliprel® A yana cikin kwanciyar hankali na II da III na ciki (duba sashin "Contraindications").

An sani cewa tsawan lokaci bayyanar da inhibitors na ACE akan tayin a cikin karo na biyu da na uku na ciki na iya haifar da ci gaba mai rauni (rage aiki na renal, oligohydramnios, jinkirin samar da kashi na kwanyar) da haɓaka rikice-rikice a cikin jariri (gazawar renal, hypotension, hyperkalemia).

Idan mai haƙuri ya karɓi magungunan Noliprel® A a cikin shekarun II ko III na ciki, yana da shawarar yin nazarin duban dan tayi na tayin don tantance yanayin kwancen da aikin koda.

Yawan damuwa

Mafi alama alamar yawan yawan zubar jini shine raguwar alama a cikin karfin jini, wani lokacin a hade tare da tashin zuciya, amai, amai, danshi, nutsuwa, rudewa, da oliguria, wanda zai iya shiga cikin auria (sakamakon hypovolemia). Hakanan zai iya faruwa a lokacin tashin hankali na lantarki (hyponatremia, hypokalemia).

An rage matakan gaggawa don cire miyagun ƙwayoyi daga jiki: wanke ciki da / ko kuma sarrafa carbon da ke kunnawa, tare da maido da ma'aunin ruwan-lantarki.

Tare da raguwa mai mahimmanci a cikin karfin jini, ya kamata a tura mai haƙuri zuwa matsayin supine tare da kafafu masu tsayi. Idan ya cancanta, daidai hypovolemia (alal misali, jiko na ciki na 0.9% sodium chloride bayani). Perindoprilat, metabolite mai aiki na perindopril, za'a iya cire shi daga jiki ta hanyar dialysis.

Ba da shawarar haɗuwa ba

Shirye-shiryen Lithium: tare da yin amfani da shirye-shiryen lithium da kuma hanawar ACE, karuwa mai yuwuwar yaduwar lithium a cikin jini yana haɗuwa da cutarwa mai guba. Additionalarin amfani da cututtukan cututtukan thiazide na iya ƙara ƙaruwa da haɓakar lithium da ƙara haɗarin haɗarin guba. Yin amfani da haɗin haɗin kai na perindopril da indapamide tare da shirye-shiryen lithium ba'a bada shawarar ba. Idan ya cancanta, irin wannan lamuran yakamata a sanya idanu a kan abubuwan da ke cikin lithium a cikin jini (duba sashin "Umarni na Musamman").

Magunguna, haɗuwa wanda ke buƙatar kulawa ta musamman

Baclofen: na iya kara tasirin sakamako. Ya kamata a sa ido kan cutar hawan jini da aikin koda; idan ya cancanta, ana buƙatar daidaita sashi na magungunan rigakafi.

Magungunan anti-inflammatory Nonsteroidal (NSAIDs), gami da allurai na acetylsalicylic acid (fiye da 3 g / day): NSAIDs na iya haifar da raguwa a cikin diuretic, natriuretic da tasirin antihypertensive. Tare da asarar ruwa mai mahimmanci, gazawar ƙirar ƙarancin ƙila na iya haɓaka (saboda raguwa a cikin ƙirar tacewa ta duniya). Kafin fara magani tare da miyagun ƙwayoyi, ya zama dole don gyara don asarar ruwa da saka idanu akan aikin koda koda yaushe a farkon magani.

Haɗin magunguna waɗanda ke buƙatar hankali

Magungunan ƙwayoyin cuta na Tricyclic, antipsychotics (antipsychotics): kwayoyi na waɗannan azuzuwan suna haɓaka tasirin antihypertensive kuma suna ƙara haɗarin maganin orthostatic hypotension (ƙari mai tasiri).

Corticosteroids, tetracosactide: raguwa a cikin tasirin antihypertensive (ruwa da riƙe sodium ion riƙewa saboda corticosteroids).

Sauran magungunan antihypertensive: na iya haɓaka tasirin antihypertensive.

Umarni na musamman

Yin amfani da miyagun ƙwayoyi Noliprel® A 2.5 mg + 0.625 MG, yana dauke da ƙananan kashi na indapamide da perindopril arginine, ba a haɗa tare da raguwa mai yawa a cikin tasirin sakamako masu illa, ban da hypokalemia, idan aka kwatanta da perindopril da indapamide a mafi ƙarancin allurai da aka yarda (duba sashe ") Rashin sakamako "). A farkon farawa tare da magunguna guda biyu masu karewa, waɗanda mai haƙuri bai karɓa da wuri ba, ba za a iya kawar da haɗarin idiosyncrasy ba. Kulawa da haƙuri game da haƙuri yana rage wannan haɗarin.

Paarancin aiki na haya

An kwantar da hankali a cikin marasa lafiya tare da gazawar na koda (CC kasa da 30 ml / min). A wasu marasa lafiya da ke fama da hauhawar jini ba tare da wani rauni a fili na rashin lafiya ba, za a iya nuna alamun dakin gwaje-gwaje na rashin aiki na koda. A wannan yanayin, ya kamata a dakatar da magani. A nan gaba, zaku iya cigaba da haɗuwa da magani ta amfani da ƙarancin magunguna, ko kuma kuyi amfani da magungunan a cikin maganin monotherapy.

Irin waɗannan marasa lafiya suna buƙatar saka idanu na yau da kullun na ƙwayoyin serum da matakan creatinine - makonni 2 bayan farawa da kowane watanni 2 bayan haka. Rashin ƙarfi a koda yaushe yakan faru ne a cikin marasa lafiya da rauni mai rauni a zuciya ko kuma farkon aiki na nakasassu, wanda ya hada da aikin koda.

Tsinkayar jijiya da rashin daidaituwa na ruwa da warkarwa

Hyponatremia yana da alaƙa da haɗarin ci gaba kwatsam na rashin lafiyar jijiya (musamman a cikin marasa lafiya da keɓaɓɓen ƙwayar koda na jijiya da jijiyoyin ƙwayar cutar guda biyu). Sabili da haka, lokacin da ake kulawa da marasa lafiya a hankali, yakamata a kula da yiwuwar bayyanar cututtuka na rashin ruwa a jiki da raguwar matakan electrolyte a cikin jini, misali, bayan zawo ko amai. Irin waɗannan marasa lafiya suna buƙatar saka idanu na yau da kullun akan ƙwayar plasma electrolytes.

Tare da matsanancin jijiya na jijiya, ana iya buƙatar gudanarwar maganin 0.9% sodium chloride mafita.

Kwancen jijiyoyin jijiyoyin jini ba sabawa bane don ci gaba da warkarwa. Bayan dawo da girman bugun jini da hauhawar jini, ana iya sake farawa ta amfani da karamin allurai, ko kuma ana iya amfani da magunguna a yanayin monotherapy.

Matsayin potassium

Haɗewar amfani da perindopril da indapamide baya hana ci gaban hypokalemia, musamman a cikin marasa lafiya da ke fama da ciwon sukari mellitus ko gazawar na koda. Kamar yadda yake game da haɗuwa da magungunan antihypertensive da diuretic, saka idanu na yau da kullun game da matakin potassium a cikin jini yana da mahimmanci.

Sharuɗɗan hutu na kantin

Magungunan magani ne.

Kamar yadda maganin monotherapy, likitanci yakan ba da shawara ga perindopril da indapamide daban. Analogues na miyagun ƙwayoyi sun hada da Co-pimid ko Prestarium Arginine Combi. Bugu da kari, masana'antun suna samar da Noliprel a wasu sigogin.

Matsakaicin farashin Noliprel A Allunan 2.5 mg + 0.625 MG a cikin magungunan Moscow shine 540-600 rubles.

Haɗa kai

1. Ba a shawarar haɗuwa da haɗuwa ba

Shirye-shiryen Lithium: tare da yin amfani da shirye-shiryen lithium da kuma hanawar ACE, karuwa mai yuwuwar yaduwar lithium a cikin jini yana haɗuwa da cutarwa mai guba. Additionalarin amfani da cututtukan cututtukan thiazide na iya ƙara ƙaruwa da haɓakar lithium da ƙara haɗarin haɗarin guba. Yin amfani da haɗin haɗin kai na perindopril da indapamide tare da shirye-shiryen lithium ba'a bada shawarar ba. Idan irin wannan ilimin ya zama dole, dole ne a kula da abubuwan da ke cikin lithium a cikin jini (duba "Umarnin na Musamman").

2. Magunguna, haɗuwa wanda ke buƙatar kulawa ta musamman da taka tsantsan

Baclofen: na iya kara tasirin sakamako. Ya kamata a sa ido kan cutar hawan jini da aikin koda; kuma ana buƙatar daidaita sakin magungunan rigakafi idan ya cancanta.

NSAIDs, ciki har da babban allurai na acetylsalicylic acid (fiye da 3 g / rana): NSAIDs na iya rage diuretic, natriuretic da antihypertensive. Tare da asarar ruwa mai mahimmanci, gazawar ƙirar ƙarancin ƙila na iya haɓaka (saboda raguwa a cikin ƙirar tacewa ta duniya). Kafin fara magani tare da miyagun ƙwayoyi, ya zama dole don gyara don asarar ruwa da saka idanu akan aikin koda koda yaushe a farkon magani.

3. Haɗin magunguna waɗanda ke buƙatar kulawa

Corticosteroids, tetracosactide: raguwa a cikin tasirin antihypertensive (ruwa da riƙe sodium ion riƙewa saboda corticosteroids).

Sauran magungunan antihypertensive: na iya haɓaka tasirin antihypertensive.

1. Ba a shawarar haɗuwa da haɗuwa ba

Abubuwan da ke haifar da daskararre na potassium (amiloride, spironolactone, triamteren) da shirye-shiryen potassium: Inhibitors na ACE yana rage asarar potassium ta ƙodan da ke haifar da diuretic. Abubuwan da ke dauke da sinadarin potassium-misali, misali, spironolactone, triamteren, amiloride), shirye-shiryen potassium, da kuma abubuwan da ke dauke da gishiri wanda ke dauke da sinadarin na iya haifar da karuwa mai yawa a cikin tarin potassium a cikin jinin jini har zuwa mutuwa. Idan amfani da inhibitor na ACE na lokaci guda da magungunan da ke sama (a yanayin tabbatar da hypokalemia) ya zama dole, yakamata a yi taka tsantsan tare da sanya ido akai-akai game da abubuwan da ke cikin potassium a cikin jini da kuma matakan ECG.

2. Haɗin magungunan da ke buƙatar kulawa ta musamman

Abubuwan hypoglycemic na sarrafawa na bakin magana (abubuwan da suka samo asali na sulfonylurea) da insulin: an bayyana tasirin da ke gaba don captopril da enalapril. ACE inhibitors na iya haɓaka tasirin hypoglycemic na insulin da abubuwan ƙira na sulfonylurea a cikin marasa lafiya da masu ciwon sukari na mellitus. Haɓakar haɓakar hypoglycemia yana da wuya sosai (saboda karuwa da haƙuriwar glucose da raguwa a cikin buƙatar insulin).

3. Haɗin magunguna waɗanda ke buƙatar kulawa

Allopurinol, magungunan cytostatic da immunosuppressive, corticosteroids (don amfani da tsari) da procainamide: amfani da lokaci ɗaya tare da masu hana ACE na iya haɗuwa da haɓakar haɗarin cutar leukopenia.

Yana nufin don maganin sa barci na gaba ɗaya: yawan amfani da inhibitors na ACE da jami'ai don maganin hana ƙanƙancewa na gaba ɗaya na iya haifar da haɓaka sakamako na antihypertensive.

Diuretics (thiazide da madauki): yin amfani da diuretics a cikin manyan allurai na iya haifar da hypovolemia, kuma ƙari na perindopril zuwa far zai iya haifar da hauhawar jini.

Shirye-shiryen zinare: lokacin amfani da masu hana ACE, incl. perindopril, a cikin marasa lafiya da ke karɓar shirin iv na zinari (sodium aurothiomalate), an bayyana hadadden alamun, ciki har da: hyperemia na fata, tashin zuciya, amai, tashin zuciya.

1. Haɗin magungunan da ke buƙatar kulawa ta musamman

Magunguna waɗanda zasu iya haifar da ƙwayar cuta na huhu: saboda haɗarin hypokalemia, yakamata a yi taka tsantsan yayin amfani da indapamide tare da kwayoyi waɗanda zasu iya haifar da ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta, alal misali, magungunan antiarrhythmic (quinidine, hydroquinidine, rashin biyayya, amiodarone, dofetilide, ibutilide , bretilia tosylate, sotalol), wasu antipsychotics (chlorpromazine, cyamemazine, levomepromazine, thioridazine, trifluoperazin), benzamides (amisulpride, sulpiride, sultopride, tiapride), butyrophenones (droperidol, gallop Ridola), sauran neuroleptics (pimozide), da sauran magunguna, kamar bepridil, cisapride, difemanila methylsulfate, erythromycin (w / w), halofantrine, mizolastine, moxifloxacin, pentamidine, sparfloxacin, vincamine (w / w), methadone, astemizole, terfenadine . Amfani na lokaci guda tare da magungunan da ke sama ya kamata a guji, haɗarin hypokalemia kuma, idan ya cancanta, gyarawa, sarrafa tazara na QT.

Magunguna waɗanda zasu iya haifar da hypokalemia: amphotericin B (iv), corticosteroids da mineralocorticosteroids (don amfani da tsari), tetracosactides, laxatives wanda ke motsa motsin hanji: ƙaruwar haɗarin hypokalemia (sakamako mai ƙari). Wajibi ne don sarrafa abubuwan da ke cikin potassium a cikin jini, idan ya cancanta, gyara shi. Ya kamata a ba da kulawa ta musamman ga marasa lafiya lokaci guda suna karɓar glycosides na zuciya. Ya kamata a yi amfani da tabarau waɗanda basu motsa motsawar hanji ba.

Cardiac glycosides: hypokalemia yana haɓaka sakamako mai guba na cututtukan zuciya. Ta amfani da indapamide da cardiac glycosides lokaci guda, yakamata a kula da abubuwan da ke cikin potassium a cikin jini da kuma abubuwan shigar ECG kuma idan ya cancanta, za'a gyara farjin.

2. Haɗin kwayoyi masu buƙatar hankali

Metformin: gazawar aiki na koda wanda zai iya faruwa yayin ɗaukar diuretics, musamman maɗaɗan madauki, yayin gudanar da metformin yana ƙara haɗarin lactic acidosis. Bai kamata a yi amfani da Metformin ba idan ƙwayar halittarine cikin ƙwayar jini ya wuce 15 mg / l (135 μmol / l) a cikin maza da 12 mg / l (110 μmol / l) a cikin mata.

Iodine-wanda ke dauke da wakilai masu bambanci: rashin ruwa a jiki yayin shan magungunan diuretic yana kara hadarin rashin lafiyar koda, musamman lokacin amfani da manyan allurai na aidin. Kafin yin amfani da wakilan kwantar da aidin, marasa lafiya suna buƙatar rama don asarar ruwa.

Calts salts: tare da gudanarwa na lokaci daya, hypercalcemia na iya haɓakawa saboda rage ƙyalcin ions wanda ke cikin kodan.

Cyclosporin: haɓakar haɗuwa da ƙwaƙwalwar creatinine a cikin jini jini yana yiwuwa ba tare da canza taro na cyclosporin a cikin jini ba, har ma da abubuwan da ke cikin ruwa da ions sodium ion.

Yadda ake ɗauka, hanya ta gudanarwa da sashi

A ciki, zai fi dacewa da safe, kafin cin abinci.

1 kwamfutar hannu na miyagun ƙwayoyi Noliprel ® A lokaci 1 a rana.

Idan za ta yiwu, ƙwayar ta fara da zaɓi na allurai na magunguna guda-guda. Idan akwai buƙatar buƙatar asibiti, zakuyi la'akari da yuwuwar rubuta magani tare da Noliprel ® A kai tsaye bayan monotherapy.

Marasa lafiya tare da hauhawar jijiyoyin jini da kuma nau'in ciwon sukari guda 2 na jini don rage haɗarin rikicewar microvascular (daga kodan) da rikicewar macrovascular daga cututtukan zuciya.

Noliprel 1 kwamfutar hannu time Lokaci 1 a rana. Bayan watanni 3 na maganin, ƙarƙashin haƙuri mai kyau, yana yiwuwa a ƙara yawan zuwa allunan 2 na Noliprel ® A lokaci 1 a rana (ko 1 kwamfutar hannu na Noliprel ® A forte 1 lokaci a rana).

Tsofaffi marasa lafiya

Dole ne a ba da magani tare da miyagun ƙwayoyi bayan saka idanu akan aikin koda da hawan jini.

An sanya ƙwayar maganin a cikin marasa lafiya da gazawar haɓakar koda (creatinine Cl ƙasa da 30 ml / min).

Ga marasa lafiya da ke fama da gazawar ƙarancin ɗan adam (Cl creatinine 30-60 ml / min), ana bada shawara don fara amfani da magunguna masu mahimmanci (a cikin nau'in monotherapy), waɗanda sune ɓangare na Noliprel ® A.

Ga marasa lafiya tare da Cl creatinine daidai ko sama da 60 ml / min, ba a buƙatar daidaita sashi. Yayin maganin, lura na yau da kullun game da matakan plainma creatinine da potassium wajibi ne.

Magungunan yana cikin contraindicated a cikin marasa lafiya da mummunan hepatic rashi.

A cikin lalacewar hanta na matsakaici, ba a buƙatar daidaita sashi ba.

Yara da matasa

Noliprel ® A bai kamata a tsara wa yara da matasa masu shekaru 18 ba saboda ƙarancin bayanai game da inganci da amincin miyagun ƙwayoyi a cikin marasa lafiya na wannan rukunin shekarun.

Umarni na musamman

Amfani da miyagun ƙwayoyi Noliprel ® A MG na 2.5 mg + 0.625, yana da ƙananan kashin na indapamide da perindopril arginine, ba a haɗa shi da raguwa mai yawa a cikin tasirin sakamako masu illa, ban da hypokalemia, idan aka kwatanta da perindopril da indapamide a cikin mafi ƙarancin allurai waɗanda aka ba da izinin amfani (duba) "Mugu ayyuka ”). A farkon farawar tare da magunguna guda biyu masu karewa, wadanda mai haƙuri bai karɓa da wuri ba, ba za a iya kawar da haɗarin haɓakawa ba. Kulawa da haƙuri game da haƙuri yana rage wannan haɗarin.

Paarancin aiki na haya

An kwantar da hankali a cikin marasa lafiya da gazawar haɓaka na koda (creatinine Cl ƙasa da 30 ml / min). A wasu marasa lafiya da ke fama da hauhawar jini ba tare da wani rauni a fili na rashin lafiya ba, za a iya nuna alamun dakin gwaje-gwaje na rashin aiki na koda. A wannan yanayin, ya kamata a dakatar da magani. A nan gaba, zaku iya cigaba da haɗuwa da magani ta amfani da ƙarancin magunguna, ko kuma kuyi amfani da magungunan a cikin maganin monotherapy.

Irin waɗannan marasa lafiya suna buƙatar saka idanu na yau da kullun na ƙwayoyin serum da matakan creatinine - makonni 2 bayan farawa da kowane watanni 2 bayan haka. Rashin ƙarfi a koda yaushe yakan faru ne a cikin marasa lafiya da rauni mai rauni a zuciya ko kuma na farko rashi aiki, ciki har da tare da renal artery stenosis.

Tsinkayar jijiya da rashin daidaituwa na ruwa da warkarwa

Tare da matsanancin ƙwayar jijiya, ana iya buƙatar iv na 0.9% maganin sodium chloride bayani.

Kwancen jijiyoyin jijiyoyin jini ba sabawa bane don ci gaba da warkarwa. Bayan maido da BCC da hauhawar jini, zaku iya sake farawa ta amfani da karancin magunguna, ko kuma kuyi amfani da magungunan a yanayin monotherapy.

Haɗewar amfani da perindopril da indapamide baya hana ci gaban hypokalemia, musamman a cikin marasa lafiya da ke fama da ciwon sukari mellitus ko gazawar na koda. Kamar yadda yake game da haɗarin amfani da ƙwayar tsohuwar ƙwayar cuta da diuretic, saka idanu na yau da kullun game da matakin potassium a cikin jini yana da mahimmanci.

Ya kamata a ɗauka a hankali cewa abubuwan da ke tattare da tsoffin magunguna sun haɗa da lactose monohydrate. Noliprel ® A bai kamata a wajabta shi ga marasa lafiya da ke fama da rashin haƙuri ba, ƙarancin lactase da malambor-gluct-galactose malabsorption.

Yin amfani da lokaci ɗaya na haɗuwa da perindopril da indapamide tare da shirye-shiryen lithium ba da shawarar (duba. "Contraindications", "Haɗin kai").

Hadarin kamuwa da cutar neutropenia yayin shan inhibitors na ACE yana da dogaro-da-magani kuma ya dogara da magungunan da aka ɗauka da kasancewar cututtukan haɗin gwiwa. Neutropenia da wuya yakan faru a cikin marasa lafiya ba tare da cututtukan concomitant ba, amma haɗarin yana ƙaruwa ga marasa lafiya da ke fama da rauni na aikin koda, musamman kan cututtukan cututtukan tsoka mai haɗari (gami da lupus erythematosus, scleroderma). Bayan cirewar inhibitors na ACE, alamun neutropenia sun ɓace akan nasu.

Don nisantar ci gaban irin halayen

Abinda ya warkarwa Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.? Mafi kyawun Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.. Zabi Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.. Yanayin ajiya Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.. Farashin al'ada don Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.. Shan amfani Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.. Kawai ɗauka Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa.. Noliprel A allunan 2.5 + 0.625 mg 30 inji mai kwakwalwa. saya kan layi.

marasa lafiya, jini, perindopril, Noliprel® A, miyagun ƙwayoyi, plasma, gudanarwa, far, magunguna, haɓaka, indapamide, potassium, may, koda, yakamata, gazawa, ma'ana, hannu, gaza, bayan, farfajiya, alamomi, perindopril, ciki, Indapamide, sodium, diuretics, sau da yawa -, haɗari, ga marasa lafiya, lithium, aiki, ta hanyar, taro, da wuya -