Механизм действия телмисартана заключается в блокировании ре... Инструкция
Показания к применению
- артериальная гипертензия;
- снижение сердечно-сосудистой заболеваемости и смертности у пациентов в возрасте 55 лет и старше с высоким риском сердечно-сосудистых заболеваний.
Противопоказания
Повышенная чувствительность к действующему веществу или вспомогательным компонентам препарата; беременность и период грудного вскармливания; обструктивные заболевания желчевыводящих путей; тяжелые нарушения функции печени (класс С по классификации Чайлд-Пью); одновременное применение с алискиреном и препаратами, содержащими алискирен, у пациентов с ...
Таблетки Телсартан обладают ярко выраженным антигипертензивным действием и широко применяется с целью контроля и поддержания артериального давления в пределах допустимых значений. Средство действует в течение всего дня, длительность эффекта после его применения наблюдается в течение 48 часов. Препарат начинает действовать уже через 3 часа после первичного приема, а всего через месяц после начала лечения Телмисартаном кровяное давление снижается до максимального уровня как в нижних, так и в верхних значениях, при этом не влияя на частоту пульса.
Фармакологические свойства
Механизм действия телмисартана заключается в блокировании рецепторов к гормону ангиотензину, который способствует повышению величины артериального давления. Вследствие блокировки этих рецепторов расширяется просвет кровеносных сосудов, снижается величина артериального давления. При этом у больных не развивается компенсаторное повышение сердечного ритма в ответ на спад давления. Кроме того, исследования показали, что телмисартан оказывает положительное действие на работу почек, борется с ишемией и атеросклерозом, улучшает периферическое кровообращение.
Показания к применению
- артериальная гипертензия;
- снижение сердечно-сосудистой заболеваемости и смертности у пациентов в возрасте 55 лет и старше с высоким риском сердечно-сосудистых заболеваний.
Противопоказания
Повышенная чувствительность к действующему веществу или вспомогательным компонентам препарата; беременность и период грудного вскармливания; обструктивные заболевания желчевыводящих путей; тяжелые нарушения функции печени (класс С по классификации Чайлд-Пью); одновременное применение с алискиреном и препаратами, содержащими алискирен, у пациентов с сахарным диабетом и/или умеренными или тяжелыми нарушениями функции почек (скорость клубочковой фильтрации (СКФ) менее 60 мл/мин/1,73 м2 площади поверхности тела); одновременное применение с ингибиторами ангиотензин-превращающего фермента у пациентов с диабетической нефропатией; возраст до 18 лет (эффективность и безопасность не установлены).
С осторожностью
Двусторонний стеноз почечных артерий или стеноз артерии единственной почки; легкие и умеренные нарушения функции печени и/или почек; снижение объема циркулирующей крови (ОЦК) вследствие предшествующей диуретической терапии, ограничения приёма поваренной соли, диареи или рвоты; гипонатриемия; гиперкалиемия; хроническая сердечная недостаточность.
Применение при беременности и в период грудного вскармливания
При беременности применение препарата Телсартан противопоказано. При планировании беременности или при ее подтверждении необходимо отменить препарат как можно раньше и назначить другую антигипертензивную терапию с известным профилем безопасности применения при беременности. Применение антагонистов рецепторов ангиотензина II , в т.ч. и телмисартана, в I триместре беременности не рекомендуется. Препарат противопоказан во II-III триместрах беременности, поскольку применение во II-III триместрах беременности может вызвать фетотоксические эффекты (снижение функции почек, маловодие, замедление окостенения костей черепа плода) и неонатальные токсические эффекты (почечную недостаточность, артериальную гипотензию, гиперкалиемию). В случае приема препарата во II-III триместрах беременности необходимо провести УЗИ почек и костей черепа плода. Применение препарата Телсартан в период грудного вскармливания не рекомендуется, в связи с отсутствием данных о возможности выделения телмисартана с грудным молоком. При необходимости применения препарата в этот период грудное вскармливание следует прекратить.
Способ применения и дозы
Внутрь, независимо от приема пищи, запивая водой.
Артериальная гипертензия. Начальная рекомендованная доза препарата Телсартан – 1 таблетка 40 мг один раз в сутки. Некоторым пациентам эффективной может оказаться доза 20 мг в сутки (1/2 таблетки 40 мг). В случаях, когда терапевтический эффект не достигается, максимальная рекомендованная доза препарата Телсартан может быть увеличена до 80 мг (1 таблетка 80 мг или 2 таблетки 40 мг) один раз в сутки. При решении вопроса об увеличении дозы следует принимать во внимание, что максимальный антигипертензивный эффект обычно достигается в течение 4-8 недель после начала лечения.
Снижение сердечно- сосудистой заболеваемости и смертности. Рекомендованная доза препарата Телсартан – 1 таблетка 80 мг один раз в сутки. В начальный период лечения может потребоваться дополнительная коррекция АД. Нарушение функции почек. Существует ограниченный опыт применения телмисартана у пациентов с тяжёлым нарушением функции почек или находящихся на гемодиализе. Таким пациентам требуется низкая начальная доза 20 мг. Нарушения функции печени. У пациентов с легкими и умеренными нарушениями функции печени суточная доза препарата Телсартан не должна превышать 40мг.
Побочное действие
Инфекции верхних дыхательных путей, в том числе фарингит и синусит, инфекции мочевыводящих путей (включая цистит); анемия; депрессия; бессонница, синкопе, вертиго; брадикардия; выраженное снижение АД*; одышка, кашель; боль в животе, диарея, диспепсия, метеоризм, рвота; гипергидроз, кожный зуд, сыпь; миалгия, боль в спине (например, ишиас), мышечные спазмы; почечная недостаточность, в том числе острая почечная недостаточность; гиперкалиемия; боль в груди, астения (слабость); повышение концентрации креатинина в крови. Перечень всех побочных действий представлен в инструкции по медицинскому применению.
Передозировка
Симптомы: наиболее значимые – выраженное снижение АД и тахикардия, также может наблюдаться брадикардия, головокружение, повышение концентрации креатинина в сыворотке крови и острая почечная недостаточность.
Лечение: симптоматическое и поддерживающее.
Взаимодействие с другими лекарственными средствами
Возможно лекарственное взаимодействие с дигоксином; калийсберегающими диуретиками и заменителями соли, содержащими калий; литием; нестероидными противовоспалительными препаратами; рамиприлом; петлевыми и тиазидными диуретиками; другими гипотензивными средствами; системными кортикостероидами.
Особые указания
При применении у пациентов с сахарным диабетом, получающих инсулин или гипогликемические средства для приема внутрь, возможно развитие гипогликемии. Рекомендовано регулярно контролировать концентрацию глюкозы крови и при необходимости проводить коррекцию дозы гипогликемических средств. Пациенты с первичным гиперальдостеронизмом резистентны к гипотензивным препаратам, влияющим на РААС, поэтому таким пациентам применение телмисартана не рекомендуется.
Влияние на способность управлять автомобилем и движущимися механизмами
При управлении автотранспортом и занятиях опасными видами деятельности следует принимать во внимание возможность развития головокружения и сонливости, что требует соблюдения осторожности.
Условия отпуска
По рецепту.
Полная информация представлена в инструкции по медицинскому применению.
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