Noliprel Bee ndi mankhwala omwe amaphatikiza 2 yogwira ntchito - perindopril arginine ndi indapamide. Chifukwa chophatikizika, ndikotheka kukhazikika kwa magazi motsutsana ndi maziko a kufatsa kwambiri okodzetsa. Mankhwalawa sanapangidwe kuti azigwiritsidwa ntchito mwa ana ndi amayi apakati.
Dzinalo Losayenerana
Perindopril + Indapamide.
Noliprel Bee ndi mankhwala omwe amaphatikiza 2 yogwira ntchito - perindopril arginine ndi indapamide.
ATX
C09BA04.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapezeka mu mawonekedwe a mapiritsi oyera a biconvex okhala ndi filimu yophimba. Chipinda cha mankhwala chili ndi mchere wa arginine kapena tert-butylamine, 10 mg ya perindopril ndi 2.5 mg ya indapamide. Gulu lazinthu zowonjezera limaphatikizapo:
- dehydrogenated silika colloidal;
- shuga mkaka;
- sodium carboxymethyl wowuma;
- maltodextrin;
- magnesium wakuba.
Filimu yakunja ya phale ili ndi macrogol 6000, titanium dioxide, glycerol, magnesium stearate ndi hypromellose.
Zotsatira za pharmacological
Mankhwalawa ali ndi hypotensive komanso okodzetsa thupi. Mankhwala ophatikizidwa amathandizira kupondereza angiotensin-converting enzyme (ACE). Pharmacological zimatha mankhwala zimatheka chifukwa cha zochita za aliyense wa zomwe zikuchitika. Kuphatikiza kwa indapamide ndi perindopril kumawonjezera mphamvu ya antihypertensive.
Chifukwa cha kukodzetsa kwamankhwala, magazi a wodwalayo amachepa.
Mchere wa Perindopril tertbutylamine umalepheretsa kusintha kwa angiotensin I kukhala mtundu II angiotensin chifukwa cha kuletsa kwa kinase II (ACE). Chotsirizachi ndi peptidase yakunja, yomwe imakhudzidwa ndi kuphulika kwa brodkinin wa vasodilating mpaka heptapeptide, metabolite wosagwira. ACE ikuletsa kusandulika kwa mtundu I angitensin mankhwala ophatikizika kukhala fomu ya vasoconstrictor.
Indapamide ndi ya gulu la sulfonamides. Pharmacological katundu ali ofanana ndi limagwirira a thiazide diuretics. Chifukwa chotseka kubwezeretsanso kwa mamolekyulu a sodium mu glomerulus ya impso, kuchuluka kwa chlorine ndi sodium ion kumawonjezeka, ndipo kuchuluka kwa magnesium ndi potaziyamu kumachepa. Pali kuwonjezeka kwa diuresis. Zotsatira za diuretic, kuthamanga kwa magazi kumachepa.
Pharmacokinetics
Mukamwa, piritsi limaphwanyidwa ndi matumbo am'mimba. Perindopril ndi indapamide amatulutsidwa m'matumbo aang'ono, pomwe zinthuzo zimapangidwa ndi villi yapadera. Akalowa pabedi lamankhwala, onse ophatikizika amapanga milingo yambiri ya plasma mkati mwa ola limodzi.
Pamene perindopril amalowa m'mitsempha wamagazi, imaphwanya mpaka perindoprilat ndi 27%, yomwe imakhala ndi antihypertensive kwambiri ndipo imalepheretsa mapangidwe a angiotensin II. Ndikofunika kukumbukira kuti kudya kumachepetsa kusintha kwa perindopril. Pulogalamu ya metabolic imafikira ndende yambiri ya plasma mkati mwa maola 3-4. Hafu ya moyo wa perindopril ndi mphindi 60. Pawiri pakupangidwamo amayamba kudzera mu mkodzo.
Pulogalamu ya metabolic imafika pamazenera ambiri a plasma mkati mwa maola 3-4, ndipo theka la moyo ndi mphindi 60.
Indapamide imamangiriza ku albumin ndi 79% ndipo chifukwa cha mapangidwe ake zimagawika minofu yonse. Kutha kwa theka-moyo pafupifupi kumatenga maola 14 mpaka 24. Ndi mobwerezabwereza makonzedwe, kuphatikizira kwazinthu zomwe sizigwira ntchito sikunawonedwe. 70% ya indapamide mu mawonekedwe a zinthu za metabolic amasiya thupi kudzera mu impso, 22% - yokhala ndi ndowe.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa cholinga chake ndi kuchepetsa kuthamanga kwa magazi pamaso pa odwala omwe amafunikira mankhwala osokoneza bongo omwe ali ndi indapamide pa 2,5 mg ndi 10 mg perindopril.
Contraindication
Mankhwalawa sanatchulidwe zotsatirazi:
- munthawi yomweyo mankhwala omwe amalimbitsa QT nthawi, komanso mankhwala okhala ndi lithiamu ndi potaziyamu ayoni, motsutsana ndi maziko a hyperkalemia;
- Hypersensitivity pazinthu zomwe zimapanga mankhwala;
- cholowa chamtundu wa lactose tsankho, galactosemia, kuperewera kwa lactase, malabsorption a monosaccharides;
- creatinine chilolezo (Cl osakwana 60 ml / min) - kulephera kwambiri kwaimpso;
- kuperewera kwa mtima kosagwirizana ndi gawo;
- wosakwana zaka 18.
Chenjezo liyenera kuchitidwa pamene mukumwa Noliprel mu kukhalapo kwa njira yothandizira kupuma kwa minyewa yolumikizira (lupus erythematosus, sclerodermaem), kuponderezana kwa ziwalo zopanga magazi, matenda a mtima, hyperuricemia.
Momwe mungatenge Noliprel Bi
Mapiritsi ayenera kumwedwa pakamwa, chidutswa chimodzi kamodzi patsiku. Ndikulimbikitsidwa kumwa mankhwalawa m'mawa musanadye chakudya cham'mawa, chifukwa kudya kumachepetsa mayamwidwe ndikuchepetsa bioavailability ya magawo othandizira.
Momwe mungachiritsire matenda ashuga amtundu wa 2
Mankhwalawa sakukhudzana ndi mahomoni obisalira a maselo a kapamba ndipo samasintha kuchuluka kwa shuga m'magazi am'magazi, chifukwa chake, odwala omwe samadalira matenda a shuga sakufunika kusintha kwa mlingo.
Zotsatira zoyipa za noliprel bi
Zotsatira zoyipa zimachitika motsutsana ndi kumbuyo kwa cholondola cha dosing yolakwika kapena pamaso pa kuchuluka kwa minofu yomwe ikuwoneka kuti yapangira zigawo zikuluzikulu.
Matumbo
Zotsatira zoyipa zamagetsi zomwe zimapezeka m'mimba zimadziwika ndi:
- kamwa yowuma
- vuto la kukoma;
- kupweteka kwa epigastric;
- kuchepa kwa chakudya;
- kusanza, kutsegula m'mimba, kuperewera kwa thupi ndi kudzimbidwa kwamtundu.
Nthawi zina, kuoneka pancreatitis, cholestatic jaundice motsutsana maziko a hyperbilirubinemia, angioedema wamatumbo.
Hematopoietic ziwalo
M'magazi ndi zamitsempha, kuchepa kwa chiwerengero ndi kuletsa kwa mapangidwe a mapulateleti, ma neutrophils ndi leukocytes amatha kuonedwa. Ndikusowa kwa maselo ofiira am'magazi, kuchepa kwa magazi m'thupi la aplastic ndi hemolytic. Maonekedwe a agrenulocytosis ndi otheka. Mwapadera: hemodialysis odwala, kukonzanso nthawi pambuyo kupatsirana kwa impso - ACE zoletsa kumayambitsa kukula kwa magazi m'thupi.
Pakati mantha dongosolo
Ndi kuphwanya kwa chapakati mantha dongosolo, zimachitika:
- vertigo;
- mutu;
- paresthesia;
- Chizungulire
- kusokonezeka kwa kugona komanso kulephera kudziletsa.
Mwapadera, wodwala m'modzi pa 10,000 amatha kusokonezeka komanso kuwonongeka.
Zotsatira zoyipa m'maso amodzi zimadziwika ndi kuchepa kwa maonedwe owoneka, pomwe kuwonongeka kwamakutu kumawonetsedwa mwa mawonekedwe akulira m'makutu.
Kuchokera kwamikodzo
Nthawi zina, kulephera kwa impso ndi kukokoloka kwa erectile kumayamba.
Kuchokera ku kupuma
Potengera momwe mankhwalawa amathandizira, mankhwala osokoneza bongo a ACE amatha kupuma chifuwa, kupuma movutikira, bronchospasm, kugaya kwammphuno ndi chibayo cha eosinophilic.
Matupi omaliza
Pali zotheka zotupa, erythema ndi kuyabwa pakhungu. Nthawi zina, angioedema a nkhope komanso malekezero amakula, edema ya Quincke, urticaria, vasculitis. Makamaka pamaso pa lingaliro la anaphylactoid zimachitika. Pamaso pa systemic lupus erythematosus, chithunzi cha matenda chikuwonjezereka. Muzochita zamankhwala, milandu ya photosensitivity ndi epidermal necrolysis ya subcutaneous mafuta alembedwa.
Zokhudza mphamvu pakuwongolera njira
Mankhwalawa samakhudza kuthekera kwambiri komanso sikuchepetsa liwiro la zomwe zimachitika, koma chifukwa cha chiwopsezo cha zotsatira zoyipa zamagetsi chapakati, chisamaliro chimayenera kuchitika mukamagwira ntchito ndi zida zovuta, masewera owonjezera, kuyendetsa.
Malangizo apadera
Kumwa mankhwala osakanikirana sikulepheretsa kukula kwa hypokalemia, kuphatikiza odwala omwe ali ndi vuto laimpso komanso matenda a shuga. Pankhaniyi, kuyang'anira kawirikawiri kuchuluka kwa potaziyamu mu plasma kumafunika.
Panthawi yamankhwala, kuchepa kwa mankhwala a sodium m'thupi kumatha chifukwa chakukula kwa hypotension. Chiwopsezo cha hyponatremia chimachulukana ndi stenosis ya impso yamtundu wamatumbo, motero muzochitika izi ndikofunikira kudziwitsa dokotala za kusowa kwamadzi, kusanza ndi kutsekula m'mimba. Kutsika kwapang'onopang'ono kwa kuthamanga kwa magazi sikulepheretsanso kukonzanso kwa Noliprel.
Gwiritsani ntchito mu ukalamba
Odwala a zaka zopitilira 65 ndi matenda abwinobwino a impso safuna kusintha kowonjezera. Mosiyana ndi izi, muyeso ndi nthawi ya mankhwalawa imasinthidwa malinga ndi zaka, kulemera kwa thupi komanso jenda la wodwalayo.
Kupangira noliprel bi kwa ana
Chifukwa cha kusowa kwa chidziwitso pazinthu zomwe zikugwira ntchito pakukula ndi chitukuko muubwana ndi unyamata, mankhwalawo amaletsedwa kuti azigwiritsidwa ntchito ndi ana osakwana zaka 18.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Kutenga mankhwalawa mu II ndi III trimester ya embryonic kungayambitse impso ndi mafupa a chigaza, oligohydramnios, komanso kumawonjezera chiopsezo cha ochepa hypotension ndi aimpso kukanika. Chifukwa chake, kugwiritsa ntchito kwa Noliprel mwa amayi apakati ndizoletsedwa.
Mankhwalawa, imitsani kuyamwa.
The ntchito aimpso kuwonongeka
Ndi chilolezo cha creatinine pamtunda wa 60 ml / min, ndikofunikira kuyang'anitsitsa kuchuluka kwa creatinine ndi potaziyamu ayoni mu plasma.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Mankhwala amaletsedwa kugwiritsidwa ntchito mwa odwala omwe ali ndi vuto lalikulu la chiwindi.
Mankhwala osokoneza bongo a Noliprel Bi
Ndi limodzi lokha mlingo waukulu wa mankhwalawa, chithunzi cha mankhwala osokoneza bongo chimawonekera:
- dontho lakuthwa la kuthamanga kwa magazi, limodzi ndi kusanza ndi mseru;
- minofu kukokana;
- Chizungulire
- oliguria ndi chitukuko cha anuria;
- kuphwanya mulingo wamchere wamchere;
- chisokonezo, kufooka.
Wovutikayo amafunikira chithandizo chamankhwala mwachangu kuti apewe kumuwonjezera mankhwala. Mu chipatala, wodwalayo amatsukidwa ndi m'mimba, atayikidwa kaboni ndi mankhwala. Ndi dontho lamphamvu la kuthamanga kwa magazi, wodwalayo amasunthidwa pamalo opingasa ndipo miyendo imakwezedwa. Ndi chitukuko cha hypovolemia, njira ya 0,9% ya sodium kolorayidi imayendetsedwa kudzera mkati.
Kuchita ndi mankhwala ena
Ndi munthawi yomweyo makonzedwe a antipsychotic mankhwala ndi antidepressants, n`zotheka kuwonjezera antihypertensive kwenikweni, zomwe zimapangitsa mwayi wa compensatory orthostatic hypotension. Glucocorticosteroids ndi tetracosactides amachititsa kuti madzi azisungidwa ndi sodium, kufooketsa okodzetsa kwenikweni. Zotsatira zake, kuchuluka kwa magazi kumayamba. Njira zochitira opaleshoni yambiri zimachulukitsa kuchepa kwa magazi m'mitsempha.
Ndi chisamaliro
Chenjezo limalangizidwa popereka mankhwala awa:
- Mankhwala osapatsirana omwe amaletsa kutupa, acetylsalicylic acid wokhala ndi tsiku lopitilira 3000 mg. Pali kuchepa kwa mphamvu ya antihypertensive, yomwe kulephera kwa impso ndi serum hyperkalemia kumayamba.
- Cyclosporin. Chiwopsezo chowonjezera kuchuluka kwa creatinine popanda kusintha kuchuluka kwa cyclosporine yokhala ndi madzi abwinobwino kumachulukitsidwa.
- Baclofen imathandizira kuchiritsa kwa mankhwalawa, chifukwa chake akaperekedwa, ndikofunikira kuyang'anira kuthamanga kwa magazi ndi mawonekedwe a impso. Ngati ndi kotheka, dongosolo la mankhwala onse awiri limasinthidwa.
Kuphatikiza sikofunikira
Mukamamwa mankhwala okhala ndi lifiyamu limodzi ndi Noliprel Bi-Forte, kusagwirizana kwa mankhwala kumawonedwa. Ndi mankhwalawa munthawi yomweyo, kuchuluka kwa placma ya lithiamu kwakanthawi kumawonjezeka ndipo ngozi ya kawopsedwe imachulukanso.
Kuyenderana ndi mowa
Ndi zoletsedwa kumwa mowa pa mankhwala osokoneza bongo. Mowa wa ethyl umasintha mkhalidwe wa chiwindi ndikuchepetsa mphamvu ya mankhwalawa, umapangitsanso mphamvu ya inhibitory pamitsempha yamanjenje ndi hepatobiliary.
Analogi
Omvera omwe ali ndi njira yofananira ndiyophatikizira:
- Ko-perineva;
- Noliprel A;
- Noliprel A-Forte;
- nthawi yomweyo amatenga Perindopril ndi Indapamide, omwe amagulitsidwa otsika mtengo kuposa ma generics.
Mutha kusinthira kumankhwala ena mukapita kuchipatala.
Kupita kwina mankhwala
Kugulitsa ndi mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Kugulitsa kwaulere kumakhala kochepa chifukwa cha chiwopsezo cha bongo ndi zotsatira zoyipa mukamamwa popanda mankhwala mwachindunji.
Mtengo wa noliprel bi
Mtengo wapakati wa mankhwalawo ndi ma ruble 540., Ku Ukraine - 221 UAH.
Zosungidwa zamankhwala
Ndikulimbikitsidwa kusunga kutentha + 15 ... + 25 ° C.
Tsiku lotha ntchito
36 miyezi.
Wopanga
Labs Serviceier, France.
Ndemanga za Noliprel Bi
Pama intaneti pali ndemanga zabwino za akatswiri a zamankhwala ndi odwala za mankhwalawa.
Omvera zamtima
Olga Dzhikhareva, katswiri wa zamtima, Moscow
Ndimaona kuti mankhwala ophatikiza antihypertensive ndiwothandiza. Mankhwalawa mwachilengedwe amachepetsa kuthamanga kwa magazi chifukwa cha indapamide yomwe ili ndi diuretic. Mankhwala amathandizidwa ndi odwala 1 nthawi patsiku m'mawa. Njira ya chithandizo imakhazikitsidwa payekhapayekha.
Svetlana Kartashova, katswiri wamtima, Ryazan
Mankhwala abwino a pulayimale antihypertensive mankhwala omwe amakonzedwa ndi mtundu wina wa mankhwala. Mankhwalawa amathandizira kuchepetsa hypertrophy ya kumanzere yamitsempha yamagazi ndipo imathandizanso kutanuka kwa minofu ya mtima komanso makoma amitsempha. Awa ndi mankhwala oyamba ochizira matenda oopsa.
Odwala
Anastasia Yashkina, wazaka 37, Lipetsk
Mankhwalawa adalembera matenda oopsa. Kuponderezedwa sikunakwezedwa kwambiri, kotero poyamba sindinapite kwa dokotala. Pakawoneka vuto la matenda oopsa, kupanikizika kudakwera kufika pa 230/150. Ikani kuchipatala. Analemba mapiritsi a Noliprel Bi-Fort. Pambuyo masiku 14 akudya pafupipafupi, kupsinjika kunabwezeretsa masiku onse. Panalibe ziwengo, mapiritsiwo adafika m'thupi. Kupanikizika ndikukhazikika kwa zaka zitatu.
Sergey Barankin, wazaka 26, Irkutsk
Chaka chatha, kupanikizika kudakwera kufika pa 170/130. Adafunafuna chithandizo chamankhwala - adotolo adapereka 10 mg ya Noliprel ndipo adati amatenga piritsi limodzi m'mawa wopanda kanthu. Poyamba, sindinkamva bwino komanso ndinalumbira kwambiri. Ndinaganiza zotenga theka la piritsi. Mkhalidwe ndi kupsinjika kunabwezeretsa mwakale. Ziwerengerozi zafika pa 130/80.
