I-Noliprel Bee ingumuthi ohlanganisa izingxenye ezi-2 ezisebenzayo - i-perindopril arginine ne-indapamide. Njengomphumela wesenzo esihlanganisiwe, kungenzeka ukuqinisa umfutho wegazi ngokumelene nesizinda somphumela omnene we-diuretic. Umuthi awuhloselwe ukusetshenziswa ezinganeni nakwabesifazane abakhulelwe.
Igama Lezwe elingafanele
I-Perindopril + Indapamide.
I-Noliprel Bee ingumuthi ohlanganisa izingxenye ezi-2 ezisebenzayo - i-perindopril arginine ne-indapamide.
I-ATX
C09BA04.
Khipha amafomu nokwakheka
Umuthi uyatholakala ngesimo samathebulethi amhlophe e-biconvex enendawo yokubopha ifilimu. Iyunithi yezokwelapha iqukethe i-arginine noma i-tert-butylamine usawoti, i-10 mg ye-perindopril ne-2.5 mg ye-indapamide. Iqembu lezinto ezengeziwe lifaka:
- I-silika colloidal ye-dehydrogenated;
- ushukela wobisi;
- isitashi se-sodium carboxymethyl;
- maltodextrin;
- i-magnesium stearate.
Ifilimu yangaphandle yethebhulethi iqukethe i-macrogol 6000, titanium dioxide, glycerol, magnesium stearate ne-hypromellose.
Isenzo se-Pharmacological
Umuthi unomphumela we-hypotensive ne-diuretic emzimbeni. Umuthi ohlangene usiza ukucindezela i-angiotensin-converting enzyme (ACE). Izici ze-pharmacological zomuthi zitholakala ngenxa yethonya lomuntu ngamunye entweni ethile esebenzayo. Ukuhlanganiswa kwe-indapamide ne-perindopril kukhulisa umphumela we-antihypertensive.
Ngenxaomphumela we-diuretic womuthi, umfutho wegazi lesiguli uyancipha.
Usawoti we-Perindopril tertbutylamine uvimbela ukuguqulwa kwe-angiotensin I ibe uhlobo II angiotensin ngenxa yokuvinjwa kwe-kinase II (ACE). Lesi sakamuva yi-peptidase yangaphandle, ebandakanyeka ekuqhekekeni kwe-vasodilating bradykinin kune-heptapeptide, i-metabolite engasebenzi. I-ACE ivimbela ukuguqulwa kohlobo lwamakhemikhali we-angitensin kuhlobo lwe-vasoconstrictor.
I-Indapamide ingeyesigaba se-sulfonamides. Izakhiwo ze-Pharmacological ziyefana ngendlela yokusebenza kwe-thiazide diuretics. Ngenxa yokuvimba ukuvalwa kabusha kwama-molecule e-sodium ku-glomerulus yezinso, ukuphuma kwe-chlorine ne-sodium ion kuyanda, futhi ukuphuma kwe-magnesium ne-potassium kunciphisa. Kukhona ukwanda kwe-diuresis. Njengomphumela we-diuretic, umfutho wegazi uyancipha.
I-Pharmacokinetics
Lapho kuthathwa ngomlomo, ithebhulethi yephula izibilini zamathumbu. I-Perindopril ne-indapamide idedelwa emathunjini amancane, lapho izinto zidonswa yi-villi ekhethekile. Lapho bengena embhedeni we-vascular, zombili izinhlanganisela ezisebenzayo zifinyelela amazinga aphezulu we-plasma kungakapheli ihora.
Lapho i-perindopril ingena emgodini wegazi, iphula i-perindoprilat ngo-27%, onomphumela we-antihypertensive futhi uvimbele ukwakheka kwe-angiotensin II. Kubalulekile ukukhumbula ukuthi ukudla kudambisa kancane ukuguqulwa kwe-perindopril. Umkhiqizo we-metabolic ufinyelela ekugxileni kwe-plasma ephezulu kungakapheli amahora angama-3-4. Ukuphila kwesigamu se-perindopril yimizuzu engama-60. Isakhiwo samakhemikhali sidalulwa ngohlelo lobuchwepheshe.
Umkhiqizo we-metabolic ufinyelela ekugxileni kwe-plasma ephezulu kungakapheli amahora angama-3-4, kanti impilo yengxenye yimizuzu engama-60.
I-Indapamide ibopha i-albhamuin ngo-78% futhi ngenxa yokwakheka kwenkimbinkimbi isatshalaliswa kuzo zonke izicubu. Ukuqedwa kwesigamu sempilo ngokwesilinganiso kuthatha amahora ayi-14 kuye kwangama-24. Ngokuphathwa okuphindaphindiwe, ukubalwa kwento esebenzayo akubonwa. U-70% we-indapamide osesimweni semikhiqizo ye-metabolic ushiya umzimba ungene ezinso, ama-22% - onama ndunduma.
Izinkomba zokusetshenziswa
Umuthi kuhloswe ngawo ukunciphisa umfutho wegazi lapho kukhona umfutho wegazi ophakeme ezigulini ezidinga ukwelashwa kwezidakamizwa nge-indapamide ngethamo le-2,5 mg ne-10 mg perindopril.
Contraindication
Umuthi awunqunyelwe emacaleni alandelayo:
- ukuphathwa kanyekanye kwezidakamizwa okwandisa isikhathi se-QT, nezidakamizwa eziqukethe i-lithium ne-potassium ions, ngokumelene nesizinda se-hyperkalemia;
- hypersensitivity kwezinto ezakha umuthi;
- ifa lokuthola ukungabekezelelani kwe-lactose, i-galactosemia, ukuntuleka kwe-lactase, ukungasebenzi kahle kwe-monosaccharides;
- imvume ye-creatinine (Cl ngaphansi kwama-60 ml / min) - ukwehluleka okukhulu kwe-renal;
- ukwehluleka kwenhliziyo okungapheli esigabeni sokubuyiselwa;
- ngaphansi kweminyaka eyi-18.
Ukuqapha kumele kusetshenziswe lapho kuthathwa iNoliprel lapho kunenqubo ye-patological in the connective tis (lupus erythematosus, sclerodermaem), ukucindezelwa kwe-hematopoiesis, isifo senhliziyo se-coronary, hyperuricemia.
Ungayithatha kanjani iNoliprel Bi
Amatafula kufanele athathwe ngomlomo, ucezu olu-1 kanye ngosuku. Kunconywa ukuphuza umuthi ekuseni ngaphambi kokudla kwasekuseni, ngoba ukudla kubambezela ukumuncwa futhi kunciphisa i-bioavailability yezingxenye ezisebenzayo.
Ungaselapha kanjani isifo sikashukela sohlobo 2
Umuthi awuthinti ukukhululeka kwama-hormone amaseli we-pancreatic beta futhi akushintshi ukugcwala koshukela egazini le-plasma, ngakho-ke, iziguli ezinesifo sikashukela esingaxhamli nge-insulin azidingi ukulungiswa kwamthamo.
Imiphumela emibi ye-noliprel bi
Imiphumela emibi yenzeka ngokungemuva kwerejimeni engalungile ye-doses noma lapho kunezicubu ezengeziwe zokuthambekela kwezakhi zezakhi.
Amapheshana wesisu
Ukuphendula okungalungile endaweni yokugaya ukudla kubonakaliswa:
- umlomo owomile
- ukunambitheka komoya;
- Ubuhlungu be-epigastric;
- ukwehla kwesifiso sokudla;
- ukugabha, uhudo, i-dyspepsia kanye nokuqunjelwa okuhleliwe.
Ezimweni ezingavamile, ukubonakala kwe-pancreatitis, i-cholestatic jaundice ngokumelene nesizinda se-hyperbilirubinemia, i-angioedema yamathumbu.
Izitho zeHematopoietic
Egazini kanye ne-lymph, ukwehla kwenombolo nokuvinjwa ukwakhiwa kwamaplatelet, ama-neutrophils nama-leukocytes kungabonakala. Ngokuntuleka kwamangqamuzana abomvu egazi, kuvela i-anemia yohlobo lwe-aplastic ne-hemolytic. Ukuvela kwe-agrenulocytosis kungenzeka. Ezimweni ezikhethekile: iziguli ze-hemodialysis, isikhathi sokuvuselelwa ngemuva kokufakwa kwezinso - inhibitors ye-ACE ivusa ukuthuthukiswa kwe-anemia.
Isistimu yezinzwa ephakathi
Ngokuphulwa kohlelo lwezinzwa oluyinhloko, ukwenzeka kwe:
- vertigo;
- ikhanda;
- i-paresthesia;
- Isiyezi
- ukuphazamiseka kokulala kanye nokulahleka kokulawulwa okungokomzwelo.
Ezimweni ezihlukile, isiguli esisodwa kweziguli eziyi-10,000 singathola ukudideka nokulahlekelwa ukwazi.
Imiphumela emibi esehlweni lamehlo ibonakala ngokuncipha kwe-acuity ebonakalayo, ngenkathi ukuthikamezwa kwezindlebe kubonakaliswa ngendlela yokukhala ezindlebeni.
Kusuka ohlelweni lomchamo
Ezimweni ezingavamile, ukwehluleka kwezinso kanye nokungasebenzi kahle kwe-erectile.
Kusuka ohlelweni lokuphefumula
Ngokuphikisana nesizinda sokulashwa kwezidakamizwa, ama-inhibitors e-ACE angathuthukisa ukukhwehlela owomile, ukuphefumula, i-bronchospasm, ukucinana kwamakhala ne-pneumonia eosinophilic.
Allergies
Kukhona ithuba lokuqhuma, i-erythema nokulunywa esikhunjeni. Kwezinye izimo, i-angioedema yobuso namaphethelo iba, i-edema ye-Quincke's, i-urticaria, i-vasculitis. Ikakhulu phambi kobukhona bokubikezela kokuphendula kwe-anaphylactoid. Lapho kukhona i-lupus erythematosus ehlelekile, isithombe somtholampilo sesi sifo siba sibi. Emsebenzini wezokwelapha, kubhalwe amacala we-photosensitivity ne-necyolal necrolal yama-subcutaneous fat.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti amandla wokugxilisa ingqondo futhi awinciphisi ijubane lokuphendula, kepha ngenxa yengozi yemiphumela emibi ohlelweni lwezinzwa oluphakathi, ukunakekelwa kumele kuthathwe lapho kusebenza ngamadivaysi ayinkimbinkimbi, ezemidlalo ezedlulele, ukushayela.
Imiyalo ekhethekile
Ukuthatha umuthi ohlanganisiwe akukuvimbeli ukuthuthukiswa kwe-hypokalemia, kufaka phakathi iziguli ezingasebenzi kahle kwezinso nesifo sikashukela. Kulesi simo, kuqashwa njalo ukuhlushwa kwe-potassium ku-plasma kuyadingeka.
Ngesikhathi sokulashwa, ukwehla kokuqukethwe kwe-sodium emzimbeni kungenzeka ngenxa yokuthuthukiswa kwe-hypotension. Ingozi ye-hyponatremia inyuka nge-stenosis ehlukanisiwe yemithambo yezinso, ngakho-ke kulezi zimo kuyadingeka ukwazisa udokotela ngokuphelelwa ngamandla emzimbeni, ukuhlanza kanye nesifo sohudo. Ukwehla kwesikhashana kwengcindezi yegazi akuvimbi ukuphathwa okwengeziwe kweNoliprel.
Sebenzisa ebudaleni
Iziguli ezineminyaka engaphezu kwengama-65 ubudala ezinokusebenza okujwayelekile kwezinso azidingi ukulungiswa okuthe xaxa komthamo. Ngokwesimo esehlukile, umthamo nesikhathi sokwelashwa kuyalungiswa ngokuya ngeminyaka, isisindo somzimba kanye nobulili besiguli.
Ukunquma i-noliprel bi ezinganeni
Ngenxa yokuntuleka kwedatha kumthelela wezinto ezisebenzayo ekukhuleni nasekwakhuleni ebusheni nasebusheni, umuthi uvunyelwe ukusetshenziswa yizingane ezingaphansi kweminyaka engu-18.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ukuthatha umuthi ku-II ne-III trimester yokukhula kombungu kungavusa ukubekwa okungafanele kwezinso namathambo egebhezi, i-oligohydramnios, futhi futhi kwandise nengozi yokuqothuka kwe-arterial hypotension kanye ne-renal dysfunction kumntwana osanda kuzalwa. Ngakho-ke, ukusetshenziswa kweNoliprel kwabesifazane abakhulelwe akuvunyelwe.
Ngesikhathi sokwelashwa, yeka ukukhishwa kwengqondo.
Isicelo sokusebenza kokulimala kwezinso
Ngokucaciswa kwe-creatinine ngenhla kwe-60 ml / min, kuyadingeka ukubheka njalo izinga le-creatinine ne-potassium ions ku-plasma.
Sebenzisa umsebenzi wesibindi okhubazekile
Umuthi awuvunyelwe ukusetshenziswa ezigulini ezinokwehluleka kakhulu kwesibindi.
Ukweqisa kweNoliprel Bi
Ngomthamo owodwa womthamo omkhulu womuthi, isithombe somtholampilo se-overdose siyabonakala:
- ukwehla okubukhali kwengcindezi yegazi, kuhambisana nokuhlanza kanye nenausea;
- izicubu zomsipha;
- Isiyezi
- i-oliguria ngokuthuthukiswa kwe-anuria;
- ukwephulwa kwemali esele kasawoti;
- ukudideka, ubuthakathaka.
Isisulu sidinga ukunakekelwa okusheshayo kwezokwelapha okuhloswe ngaso ukuvimbela ukumuncwa komuthi okunye. Esibhedlela, isiguli sihlanjwa ngesisu, kusebenze ikhabhoni esebenzayo. Ngokuwohloka okuqinile kwengcindezi yegazi, isiguli siyiswa endaweni evundlile futhi imilenze iphakanyisiwe. Ngokuthuthukiswa kwe-hypovolemia, isisombululo se-0.9% sodium chloride siphathwa ngaphakathi.
Ukuxhumana nezinye izidakamizwa
Ngokuphathwa kanyekanye kwezidakamizwa ze-antipsychotic kanye nama-antidepressants, kungenzeka ukwandisa umphumela we-antihypertensive, okwandisa amathuba okuba ne-hypotension ye-orthostatic compensatory. I-Glucocorticosteroids ne-tetracosactides ibangela ukugcinwa kwamanzi nesodium, yenze buthaka umphumela we-diuretic. Ngenxa yalokhu, kukhuphuka umfutho wegazi. Izindlela zokubulala izinzwa okuvamile zandisa ukwehla kwengcindezi yegazi emithanjeni yemithambo yegazi.
Ngokunakekela
Ukuqapha kuyalulekwa lapho kunqunywa ama-ejenti alandelayo ngokufana:
- Izidakamizwa ezingahambisani nokuvuvukala, i-acetylsalicylic acid enomthamo wansuku zonke we-3000 mg. Kukhona ukwehla komphumela we-antihypertensive, lapho ukwehluleka kwezinso kanye ne-serum hyperkalemia kukhula khona.
- ICyclosporin. Ubungozi bokwanda kwamazinga we-creatinine ngaphandle kokushintsha ukugcwala kwe-cyclosporine enokuqukethwe okujwayelekile kwamanzi kuyakhuphuka.
- I-Baclofen ingandisa umphumela wokwelapha umuthi, ngakho-ke uma ubekiwe, kubalulekile ukubheka umfutho wegazi kanye nesimo sezinso. Uma kunesidingo, irejimeni yemithamo yayo yomibili imishanguzo iyaguqulwa.
Inhlanganisela ayinconywa
Lapho uthatha imikhiqizo equkethe i-lithium kanye neNoliprel Bi-Forte, ukungafani kwemithi kuyabonakala. Ngokwelashwa kanyekanye kwezidakamizwa, ukugcwala kwe-plasma ye-lithium kuyakhula okwesikhashana kanye nengozi yokuthola ubuthi iyanda.
Ukuhambisana notshwala
Kwenqatshelwe ngokuphelele ukusebenzisa utshwala ngesikhathi sokwelashwa ngezidakamizwa. I-ethyl alcohol ithuthukisa isimo sesibindi futhi yenze buthaka umphumela wezokwelapha umuthi, ithuthukise umphumela wokuvimbela izinzwa nezinzwa ze-hepatobiliary.
Ama-Analog
Izikhwanyana ezinendlela yokwenza efanayo zifaka lokhu:
- I-Ko-perineva;
- INoliprel A;
- INoliprel A-Forte;
- ngasikhathi sinye sithathe i-Perindopril ne-Indapamide, ezithengiswa ngemali ephansi kunama-generics.
Ungashintshela komunye umuthi ngemuva kokubonisana nodokotela.
Imibandela yekhefu lekhemisi
Kuthengiswe ngomuthi.
Ngingakwazi ukuthenga ngaphandle kadokotela
Ukuthengiswa kwamahhala kukhawulelwe ngenxa yobungozi bokweqisa ngokweqile nemiphumela emibi lapho kuthathwe ngaphandle kokuthola umuthi oqondile wezokwelapha.
Intengo ye-noliprel bi
Izindleko ezimaphakathi zomuthi zingama-ruble angama-540., E-Ukraine - 221 UAH.
Izimo zokugcina zomuthi
Kunconywa ukugcina endaweni yokushisa + 15 ... + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Izinyanga ezingama-36.
Umkhiqizi
Umkhakha Wezabasebenzi Labs, eFrance.
Ukubuyekezwa mayelana Noliprel Bi
Ezithangamini ze-Intanethi kukhona ukubuyekeza okuhle kosokhemisi neziguli mayelana nomuthi.
Izazi zezenhliziyo
U-Olga Dzhikhareva, udokotela wezifo zenhliziyo, eMoscow
Ngibheka umuthi ohlangene we-antihypertensive njengekhambi elisebenzayo. Umuthi ngokwemvelo unciphisa umfutho wegazi ngenxa ye-indapamide enomphumela wokugaya. Umuthi unqunyelwe iziguli 1 ngosuku ngosuku ekuseni. Inkambo yokwelashwa isungulwa ngamunye.
USvetlana Kartashova, udokotela wezifo zenhliziyo, uRyazan
Umuthi omuhle wokulashwa okuyisisekelo kwe-antihypertensive ngokulungiswa okulandelayo kwerejimeni yemithamo. Umuthi usiza ukunciphisa i-hypertrophic yasesinxele futhi ithuthukisa ukuqina kwezicubu zenhliziyo nezindonga zemithambo. Lesi sidakamizwa sokuqala sokwelashwa kwe-hypertension.
Iziguli
U-Anastasia Yashkina, oneminyaka engama-37 ubudala, iLipetsk
Umuthi ubekelwe umuthi wegazi ophakeme. Ingcindezi ayizange iphakanyiswe kakhulu, ngakho-ke angizange ngiye kudokotela. Lapho kuvela ubunzima be-hypertensive, ingcindezi yenyuka yaba ngu-230/50. Beka esibhedlela. Amaphilisi we-Noliprel Bi-Fort abekiwe. Ngemuva kwezinsuku eziyi-14 zokudla njalo, ingcindezi ibuyele kwesejwayelekile. Kwakungekho nhlobo yokungezwani komzimba, amaphilisi eza emzimbeni. Ukucindezela kuzinze iminyaka emi-3.
USergey Barankin, oneminyaka engama-26, u-Irkutsk
Ngonyaka owedlule, ingcindezi yenyuka yaba ngu-170/30. Wafuna usizo lodokotela - udokotela wanquma u-10 mg weNoliprel futhi wathi ukuthatha ipilisi eli-1 ekuseni esiswini esingenalutho. Ekuqaleni, ngangizizwa ngingasasebenzi futhi ngijuluka kakhulu. Nginqume ukuthatha uhhafu wethebhulethi. Isimo nengcindezi kubuyela kokujwayelekile. Izibalo zifinyelele ku-130/80.
