Ишемическая болезнь сердца, сопровождающаяся симптомами сердечной недостаточности (в составе комбинированной терапии с диуретиками и сердечными гликозидами)
Противопоказания
Детский и подростковый возраст до 18 лет
Беременность
Повышенная чувствительность к компонентам препарата
Антигипертензивный препарат, специфический антагонист рецепторов ангиотензина II типа ( AT2). He подавляет киназу II - фермент, который разрушает брадикинин. Снижает ОПСС, уменьшает постнагрузку, снижает системное АД и давление в малом круге кровообращения.
Показания к применению
Артериальная гипертензия
Ишемическая болезнь сердца, сопровождающаяся симптомами сердечной недостаточности (в составе комбинированной терапии с диуретиками и сердечными гликозидами)
Противопоказания
Детский и подростковый возраст до 18 лет
Беременность
Повышенная чувствительность к компонентам препарата
Применение при беременности и в период грудного вскармливания
Препарат противопоказан к применению при беременности.; Неизвестно, выделяется ли лозартан с грудным молоком. При небходимости назначения Презартана в период лактации следует принять решение о прекращении грудного вскармливания.
Способ применения и дозы
При артериальной гипертензии начальная суточная доза препарата составляет 25 мг, средняя суточная доза - 50 мг, кратность приема - 1 раз/сут.; Максимальный гипотензивный эффект развивается через 3-6 недель после начала приема препарата. При необходимости доза может быть увеличена до 100 мг/сут, при этом возможен прием препарата 2 раза/сут.; При сердечной недостаточности начальная доза составляет 12.5 мг 1 раз/сут. Как правило, доза титруется с недельным интервалом (т.е. 12.5 мг/сут, 25 мг/сут, 50 мг/сут) до средней поддерживающей дозы 50 мг 1 раз/сут в зависимости от переносимости терапии.; При назначении препарата пациентам, получающим диуретики в высоких дозах, начальную дозу следует снизить до 25 мг 1 раз/сут.; Пациентам с нарушением функции печени следует назначать лозартан в более низких дозах.; У лиц пожилого возраста, а также у пациентов с нарушением функции почек, включая находящихся на гемодиализе, нет необходимости в коррекции начальной дозы препарата.; Презартан можно назначать совместно с другими антигипертензивными препаратами.; Таблетки можно принимать вне зависимости от приема пищи.
Побочное действие
Со стороны пищеварительной системы: диарея, диспепсия; редко - повышение активности печеночных трансаминаз и уровня билирубина в крови.; Со стороны ЦНС: головокружение, нарушение сна, головная боль.; Со стороны дыхательной системы: редко – нарушения дыхания, кашель.; Аллергические реакции: редко - ангионевротический отек (включая отеки лица, губ, глотки и/или языка), крапивница.; Прочие: миалгии, отечность, гиперкалиемия (калий в крови более 5.5 мэкв/л); редко – тахикардия.; Препарат обычно хорошо переносится.
Передозировка
Симптомы: артериальная гипотензия, тахикардия.; Лечение: при необходимости проводят симптоматическую терапию. Гемодиализ не эффективен.
Особые указания
У пациентов с дегидратацией (например, при терапии диуретиками в высоких дозах) в начале лечения Презартаном может возникнуть симптоматическая артериальная гипотензия. Необходимо проводить коррекцию водно-электролитного баланса до назначения Презартана или начать лечение с низкой дозы.; Фармакологические данные указывают на то, что концентрация лозартана в плазме крови больных циррозом печени значительно увеличивается, поэтому пациентам с заболеванием печени в анамнезе следует назначать препарат в низких дозах. Некоторые препараты, оказывающие воздействие на систему кинин-ангиотензин, могут увеличивать уровень мочевины в крови и креатинина в сыворотке у пациентов с нарушениями функции почек.
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