Mikardis Plus amatanthauza mankhwala opaka pakamwa. Mankhwala ali ndi kuphatikiza kwa mitundu iwiri yogwira - telmisartan ndi diuretic. Chifukwa cha kuphatikiza kwamankhwala awa, mphamvu yayitali imatheka, imatha maola 6-12. Kuphatikiza kwa hydrochlorothiazide ndi telmisartan kumakupatsani mphamvu yotulutsa magazi.
ATX
C09DA07.
Mikardis Plus amatanthauza mankhwala opaka pakamwa.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwala amapangidwa mwanjira ya mapiritsi, omwe ali ndi 2 yogwira mankhwala - telmisartan ndi hydrochlorothiazide.
| Maulalo Ogwira | Kuphatikiza Mlingo wothandizila, mg | ||
| Telmisartan | 80 | 80 | 40 |
| Wodzikongoletsa | 12,5 | 25 | 12,5 |
| Mapiritsi amtundu | Wofiyira mkati ndi pinki | Mtundu wachikasu wokhala ndi chikasu | Pinki |
Monga zowonjezera zomwe zimapangitsa kuti mayendedwe azikhala othamanga komanso kuti zitheke, ndi:
- wowuma chimanga;
- shuga mkaka;
- ma cellcose a microcrystalline;
- sodium hydroxide;
- utoto wa oxide wachitsulo;
- povidone;
- sorbitol;
- meglumine.
Mapiritsi amapangidwa ozungulira ndi biconvex kumtunda. Wothandizira antihypertgency samapangidwa ngati njira yothira mafuta, gel, kapena yankho la makolo.
Mankhwala amapangidwa mwanjira ya mapiritsi, omwe ali ndi 2 yogwira mankhwala - telmisartan ndi hydrochlorothiazide.
Zotsatira za pharmacological
Telmisartan imakhala ndi antihypertensive chifukwa chomangira ma angiotensin II receptors. Ndi kupangidwa kwa zovuta zoterezi, gawo lokhazikika limasokoneza ntchito ya vasoconstrictor enzyme ndikuchepetsa kuchuluka kwa aldosterone m'magazi. Angiotensin II sangayambitse kuwonongeka kwa bradykinin, chifukwa imaletseka ndi telmisartan. Chifukwa chake, kapangidwe ka bradykinin akupitilira - vasodilator imawonjezera lumen m'magazi.
Mphamvu ya vasodilating imathandizira hydrochlorothiazide chifukwa cha diuretic. A thiazide diuretic amathandiza kuchepetsa kuthamanga kwa magazi ndi matenda oopsa. Pogwiritsa ntchito nthawi yayitali, hydrochlorothiazide imachepetsa chiopsezo chokhala ndi mtima ndi matenda amtunduwu.
Kwambiri achire zotsatira zimatheka mwa maola 3.5-4.
Zizindikiro za kuthamanga kwa magazi zimakhazikika kwa maola 6-12.
Pharmacokinetics
Mukatha kugwiritsa ntchito, piritsi limasweka ndi michere yamatumbo.
Akamasulidwa, zigawo zogwira ntchito za mankhwala a Mikardis Plus zimatengedwa mwachangu khoma la matumbo ang'ono.
Mukamasulidwa, ziwalo zomwe zimagwira zimayamwa mwachangu kukhoma la matumbo ochepa ndikulowa m'magazi. Pakufalikira kwazinthu, telmisartan ndi hydrochlorothiazide amafika pazowonjezera pazaka 30-90. The bioavailability wa mtundu wachiwiri wa angiotensin receptor antagonist ukufika 50%, hydrochlorothiazide mkati 60%. Zinthu zogwira zimasinthidwa mu hepatocytes.
Hafu ya moyo ndi pafupifupi maola 6. Telmisartan imasiya thupi ndi zinthu zopanda ntchito zowonongeka kudzera mu kwamikodzo ndi 60-70%. Hydrochlorothiazide amuchotsa mu mkodzo ndi 95%.
Zizindikiro zogwiritsidwa ntchito
Mankhwala ndikofunikira kuti muchepetse kuthamanga kwa magazi ndi kusagwira bwino ntchito kwa chithandizo cha telmirsartan monga monotherapy.
Contraindication
Mankhwalawa sanapangidwire zochizira odwala omwe ali ndi vuto limodzi ndi la Micardis Plus. Njira zotsatirazi za m'magazi zimagwiranso ntchito monga zotsutsana:
- bile duct kulowetsedwa ndi concomitant cholestasis;
- ntchito chiwindi matenda;
- kuchepa kwakukulu kwa impso;
- matenda akulu a shuga;
- kuchuluka kwa calcium ndi miyeso yochepa ya potaziyamu;
- cholowa mawonekedwe a galactose, fructose, lactose.
Mankhwala amaletsedwa kuti agwiritsidwe ntchito kwa odwala omwe ali ndi vuto la impso ndi matenda a shuga omwe amagwiritsidwa ntchito limodzi ndi Aliskiren.
Momwe angatenge
Ndi matenda ocheperapo pang'ono a matenda, Mikardis amatengedwa nthawi imodzi patsiku, osafuna kutafuna. Kudya kwakanthawi imodzi sikukhudza pharmacokinetics of Mikardis.
Ndi matenda ocheperapo pang'ono a matenda, Mikardis amatengedwa nthawi imodzi patsiku, osafuna kutafuna.
Akuluakulu
Mlingo watsiku ndi tsiku umapereka mlingo umodzi wa piritsi wokhala ndi 80 mg wa telmisartan ndi 12,5 mg wa hydrochlorothiazide. Ngati hypotensive zotsatira zake sizikwanira, koma ndi kulolera bwino, muyenera kumwa mapiritsi okhala ndi 80 mg ya telmisartan ndi 25 mg ya hydrochlorothiazide.
Pazipita kwambiri hypotensive zotsatira zimawonedwa pakatha miyezi iwiri chiyambire kuyambika kwa mankhwala ochepetsa mphamvu.
Odwala omwe ali ndi matenda oopsa ayenera kumwa mapiritsi 2 patsiku. Pankhaniyi, kuchuluka kwa hydrochlorothiazide ndi mankhwala omwe amapezeka ndi dokotala malinga ndi kuchuluka kwa matenda omwe wodwala ali nawo.
Kuika Mikardis Plus kwa ana
Mankhwalawa adapangidwa kuti agwiritse ntchito kufikira zaka 18 chifukwa cha kusowa kwa chidziwitso pazomwe zimachitika pokhudzana ndi chitukuko cha anthu mu sukulu yaukalamba komanso unyamata.
Mankhwala a Mikardis Plus ndi ophatikizidwa kuti agwiritse ntchito zaka 18.
Kumwa mankhwala a shuga
Odwala omwe ali ndi matenda ashuga ayenera kuyang'anitsitsa kuchuluka kwawo kwa seramu. Pa mankhwala ndi Mikardis, pamakhala chiopsezo cha hypoglycemia chifukwa cha diuretic mphamvu ya hydrochlorothiazide.
Zotsatira zoyipa
Zotsatira zoyipa zimawonekera chifukwa cha Mlingo wosankhidwa mosayenera ndipo amadziwika nthawi zambiri ndi zovuta zapafupipafupi.
Matumbo
Pali chiopsezo chotenga zilonda zam'mimba zam'mimba komanso gastritis. Odwala ena amamva kupweteka kwa epigastric, kudzimbidwa, kutsegula m'mimba, ndi mseru.
Hematopoietic ziwalo
Mlingo wa zinthu zopangidwa m'magazi amachepetsa.
Pakati mantha dongosolo
Ndi kukhumudwa kwa chapakati mantha dongosolo ndi kukula kwa mavuto amisala mwa munthu, kapangidwe kake kamasintha - mkhalidwe wokhumudwitsa, malingaliro a nkhawa amawonekera.
Chizungulire, kupweteka mutu, paresthesia, kufooka wamba, kusokonezeka kwa tulo kumatha kuchitika.
Kuchokera kwamikodzo
Odwala ndi mkodzo wa mkodzo kutuluka (ndi chosaopsa Prostatic hyperplasia, prostatitis), pokodza kwamikodzo, kuperewera kwa chikhodzodzo ndikotheka. Nthawi zina, pali kuchuluka kwa plasma ndende ya uric acid.
Kuchokera ku kupuma
Potengera maziko a angioedema, kuwoneka kwa kutsekeka kwa mpweya, kuwoneka kwa bronchospasm ndikotheka.
Kuchokera ku minculoskeletal system
Zosiyanasiyana mu masculoskeletal system zimadziwika ndi mawonekedwe a kukokana m'matumbo a ng'ombe, kupweteka m'malo ndi minofu, makamaka kumbuyo.
Matupi omaliza
Pochita malonda pambuyo pake, zochitika za mawonekedwe a systemic lupus erythematosus, angioedema, ndi zochitika pakhungu zidalembedwa.
Malangizo apadera
Mankhwala ali mosalekeza vasodilating kwenikweni. Pokhala ndi magazi ochepa ozungulira (BCC), kuthamanga kwa magazi kumatsika, chifukwa madzi ndi kuchuluka kwa magazi sikungakhale koyenera kuzungulira bwino. Chifukwa chotha kukhala ndi hypotension yodziwika bwino, odwala omwe amadya mchere wochepa wamkati, omwe amatsegula m'mimba ndi kusanza, akalandira mankhwala okodzetsa musanatenge Mikardis Plus, ndikofunikira kubwezeretsa BCC.
Nthawi zina, mankhwalawa amayambitsa khungu.
Kutenga wothandizirana ndi chidwi kungayambitse kukula kwa ngozi ya mtima kapena kuwonongeka kwa mtima mwa odwala omwe ali ndi mtima wamisala ischemia.
Hydrochlorothiazide imatha kupangitsa mtundu wovuta wa myopathy kapena mawonekedwe a khungu-kutsekeka kwa glaucoma. Chizindikiro choyambirira cha njira za pathological ndizopweteka m'maso, zomwe sizichoka kwa nthawi yayitali. Ngati mukumva kupweteka komanso kuchepa kwa maonekedwe owoneka, muyenera kusiya kumwa Mikardis Plus.
Kuyenderana ndi mowa
Pa mankhwala a antihypertensive, osavomerezeka kumwa zakumwa zoledzeretsa.
Mowa wa Ethyl umatha kufooketsa mphamvu ya antihypertensive, umapangitsanso kukodzetsa kwa hydrochlorothiazide ndikupangitsa kuphipha kwa mtima endothelium mu zotumphukira.
Zokhudza mphamvu pakuwongolera njira
Mankhwalawa sakhudza kugwira ntchito kwa mitsempha ndi luso labwino lamagalimoto. Pankhaniyi, muyenera kuyang'anitsitsa chitetezo mukamayendetsa magwiridwe antchito komanso poyendetsa, chifukwa ndikotheka kutaya chikumbumtima, mawonekedwe a mavuto (kugona. Chizungulire). Zotsatira zoyipa zingayambitse kuchepa kwa chidwi komanso kuthamanga kwa zochitika zama psychomotor zofunikira poyendetsa.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Amayi panthawi yoyembekezera amaletsedwa kutenga Mikardis chifukwa cha chiwopsezo cha kubereka kwa fetus.
Mukukonzekera kwa embryonic, kuyika kwa mtima ndi kwamikodzo machitidwe amatha kuwonongeka.
Mukamalandira mankhwala, ndikofunikira kusiya kuyamwitsa.
Mukamalandira mankhwala osokoneza bongo, Mikardis Plus iyenera kusiya kuyamwitsa.
Bongo
Ndi gawo limodzi la mlingo waukulu wopitilira muyeso womwewo, chiopsezo cha kuchuluka kwa mankhwala ochulukirapo chikuwonjezeka. Zizindikiro zake zimaphatikizapo:
- kutsitsa magazi;
- kuchuluka kapena kuchepa kwa mtima;
- nseru
- chisokonezo cha chikumbumtima;
- kugona
Nthawi zina, zimakhala zodzetsa mphamvu zimayamba. Chifukwa cha kutayika kwamadzi ambiri, thupi limasowa madzi am'mimba, ndipo kuchuluka kwa ma electrolyte kumachepa. Maonekedwe a hypoglycemia amachititsa kukokana kwa minofu kapena kumapangitsa arrhasmia.
Ngati mankhwala osokoneza bongo, wodwala amafuna kuchipatala. M'malo okhwimitsa zinthu, chithandizo chimayang'aniridwa ndikuchotsa zofooka ndi kukhazikitsanso mulingo wamagetsi wamadzi.
Kuchita ndi mankhwala ena
Ndi kugwiritsa ntchito pamodzi kwa Mikardis ndi ma lithiamu okhala ndi ma lithiamu, kuwonjezereka kwamphamvu mu seramu lifiyamu ndende ndikotheka.
Pankhaniyi, kufalitsa impso kwa lithiamu kumachepa ndipo kuledzera kumayamba, ndichifukwa chake sikulimbikitsidwa kupereka mankhwala omwe ali ndi mankhwala a lithiamu ndi antihypertensive. Zofananazo zimawonedwa ndikukonzekera kwa potaziyamu.
Mankhwala omwe amachepetsa potaziyamu omwe amapezeka m'madzi am'magazi amathandizira kukulitsa hypokalemia. Ndi kayendetsedwe kawo munthawi yomweyo ndi Mikardis, ndikofunikira kuwongolera kuchuluka kwa potaziyamu m'thupi.
Mankhwala osagwirizana ndi ma antisteroidal anti-yotupa (NSAIDs) angayambitse kuchepa kwamadzi, ndichifukwa chake anthu azaka zopitilira 50 ali ndi chiopsezo chowonjezeka cha impso. NSAIDs amachepetsa achire zotsatira za okodzetsa ndi mankhwala a antihypertensive.
Mankhwala a Anticholinergic limodzi ndi Mikardis Plus amachepetsa kuyenda kwa minofu yosalala ya m'mimba.
Zotupa za barbituric acid ndi ma antipsychotic zimapangitsa kukulitsa kwa hypotension ya orthostatic ndikutayika pambuyo pake.
Metformin imawonjezera chiopsezo cha lactic acidosis mukamayanjana ndi hydrochlorothiazide.
Mankhwala ena a antihypertensive osakanikirana ndi Mikardis ndi synergistic - mphamvu ya hypotensive imalimbikitsidwa kangapo kutengera umunthu wa wodwalayo.
Cholesterol amapuma kuchepetsa mayamwidwe a hydrochlorothiazide. Mankhwala a Anticholinergic amawonjezera bioavailability wa thiazide diuretics, chifukwa chomwe kuchepa kwa peristalsis kwa minofu yosalala ya m'mimba.
Wopanga
Beringer Ingelheim Ellas A.E., Koropi, Greece.
Mikardis Plus Analogs
Pokhapokha pakuchitika hypotensive, Mikardis akhoza m'malo mwa imodzi ya fanizo:
- Izi;
- Wotsogolera;
- Lozap Plus;
- Telmisartan;
- Telmisartan Richter;
- Telmista.
Kupita kwina mankhwala
Mankhwalawa atha kugulidwa mosamala ndi mankhwala.
Mtengo
Mtengo wapamwamba wamapiritsi umasiyana ndi 1074 mpaka 1100 rubles.
Malo osungira a Mikardis Plus
Ndikulimbikitsidwa kuti othandizira antihypertgency asungidwe m'malo osungidwa ndi radiation ya ultraviolet pamtunda wa + 8 ... + 25 ° C.
Tsiku lotha ntchito
Zaka zitatu
Ndemanga za Mikardis Plus
Malinga ndi akatswiri a mtima ndi odwala, Mikardis ndi chida chothandiza polimbana ndi matenda oopsa.
Omvera zamtima
Elena Bolshakova, katswiri wa zamtima, ku Moscow
Ndidachita kafukufuku monga gawo la zotsutsana ndimankhwala, chifukwa ndimatha kulankhula molimba mtima za momwe Mikardis amagwirira ntchito. Mankhwalawa amathandizira kukhazikika kwapakati pazipondedwe komanso kuchepetsa kuthamanga kwa mafunde amkati, zomwe zimayambitsa kukulitsa kwa matenda a mtima. Mankhwalawa amagwira ntchito bwino kwa achinyamata ndi okalamba. Zotsatira zoyipa zomwe zingafune chithandizo cholowa m'malo, machitidwe sizinachitike. Mankhwala samakhudzana ndende.
Sergey Mukhin, katswiri wamtima, Tomsk
Ndikuganiza kuti mankhwalawa ndi chida chothandiza kuchepetsa kuthamanga kwa magazi. Mukamamwa kamodzi patsiku, achire amalimbikira tsiku limodzi. Mtengo ndi wokwera. Mndandanda waukulu wamakampani. Koma mankhwalawa ndi othandizira odwala matenda amtundu wa 2, matenda a mtima okhazikika. Ndi zoletsedwa kugwiritsa ntchito odwala omwe ali ndi vuto la mtima. Thupi langa siligwirizana nthawi zambiri.
Mikardis Plus ikhoza kusinthidwa ndi Pritor, yomwe imasungidwa pamalo olekanitsidwa ndi radiation ya ultraviolet pamtunda wa + 8 ... + 25 ° C.
Odwala
Dmitry Gavriilov, wazaka 27, Vladivostok
Matenda oopsa a arterial anayamba, chifukwa chomwe madzulowo kunali thanzi lofooka, kusowa kwa mpweya, komanso kupindika. Madokotala adalemba mapiritsi a Mikardis. Mankhwalawa adayamba kugwira ntchito patsiku loyamba. Patatha maola atatu mutatha kumwa mapiritsi, kupanikizika kumatha maola 20 otsatira. Ndikofunika kumwa mankhwala ena omwe angakuthandizeni kukhalabe ndi vutoli. Ndikupangira kukambirana ndi dokotala wanu za zakudya zomwe zimayenderana ndi mavitamini.
Alexandra Matveeva, wazaka 45, St. Petersburg
Mokumana ndi matenda oopsa pambuyo pakuchita opaleshoni pa chithokomiro cha chithokomiro. Cardiologist adalemba mapiritsi a MikardisPlus a nthawi yayitali. Ndinkakonda mankhwala, amachepetsa magazi. Zotsatira za mankhwalawa sizikhudza thupi ndipo sizimayambitsa zovuta, anaphylactic. Kupanikizika kufikira 130/80 ndipo akukhalabe mulingo uwu. Ndikukulangizani kuti muchepetse masabata awiri mukamamwa mankhwalawa.
