Антигипертензивное средство. Является непептидным блокатором... Инструкция
Показания к применению
Артериальная гипертензия.
Снижение риска развития сердечно-сосудистых заболеваний и смертности у пациентов с артериальной гипертензией и гипертрофией левого желудочка.
Хроническая сердечная недостаточность (в составе комбинированной терапии, при непереносимости или неэффективности терапии ингибиторами АПФ).
У пациентов с сахарным диабетом 2 типа с протеинурией для замедления прогрессирования почечной недостаточности, проявляющейся снижением частоты гиперкреатининемии, частоты развития терминальной стадии хронической почечной недостаточности, требующей проведения диализа или трансплантации почки, показателей смертности, а также снижение протеинурии.
Противопоказания
Повышенная чувствительность к активному веществу или к другим компонентам препарата.
Артериальная гипотензия.
Тяжелая печеночная недостаточность (более 9 баллов по шкале Чайлд-Пью).
Антигипертензивное средство. Является непептидным блокатором рецепторов ангиотензина II.
Обладает высокой селективностью и аффинитетом к рецепторам типа AT1 (при участии которых реализуются основные эффекты ангиотензина II).
Блокируя указанные рецепторы, лозартан предупреждает и устраняет сосудосуживающее действие ангиотензина II, его стимулирующее влияние на секрецию альдостерона надпочечниками и некоторые другие эффекты ангиотензина II.
Характеризуется длительным действием (24 ч и более), что обусловлено образованием его активного метаболита.
Показания к применению
Артериальная гипертензия.
Снижение риска развития сердечно-сосудистых заболеваний и смертности у пациентов с артериальной гипертензией и гипертрофией левого желудочка.
Хроническая сердечная недостаточность (в составе комбинированной терапии, при непереносимости или неэффективности терапии ингибиторами АПФ).
У пациентов с сахарным диабетом 2 типа с протеинурией для замедления прогрессирования почечной недостаточности, проявляющейся снижением частоты гиперкреатининемии, частоты развития терминальной стадии хронической почечной недостаточности, требующей проведения диализа или трансплантации почки, показателей смертности, а также снижение протеинурии.
Противопоказания
Повышенная чувствительность к активному веществу или к другим компонентам препарата.
Артериальная гипотензия.
Тяжелая печеночная недостаточность (более 9 баллов по шкале Чайлд-Пью).
Первичный гиперальдостеронизм.
Одновременное применение с алискиреном у пациентов с сахарным диабетом и пациентов с почечной недостаточностью (клиренс креатинина менее 60 мл/мин).
Беременность, период грудного вскармливания.
Возраст до 18 лет (эффективность и безопасность не установлены).
С осторожностью
Нарушение водно-электролитного баланса крови (гипонатриемия, гипохлоремический алкалоз, гипомагниемия, гипокалиемия, гиперкалиемия).
Снижение объема циркулирующей крови (ОЦК).
Двусторонний стеноз почечных артерий или стеноз артерии единственной почки, почечная недостаточность.
Состояние после трансплантации почки (отсутствует опыт применения).
Аортальный и митральный стеноз, гипертрофическая обструктивная кардиомиопатия, сердечная недостаточность с сопутствующей тяжелой почечной недостаточностью, тяжелая хроническая сердечная недостаточность (IV функциональный класс по классификации NYHA), сердечная недостаточность с угрожающими жизни аритмиями, ишемическая болезнь сердца.
Цереброваскулярные заболевания.
Печеночная недостаточность (менее 9 баллов по шкале Чайлд-Пью).
Ангионевротический отек в анамнезе.
Способ применения и дозы
Внутрь, независимо от приема пищи. Таблетки проглатывают, не разжевывая, запивая водой. Кратность приема – 1 раз/сутки, желательно в одно и то же время, утром.
Артериальная гипертензия
Начальная и поддерживающая доза составляет 50 мг/сутки. При необходимости суточная доза может быть увеличена до максимальной 100 мг. Если однократный прием препарата не обеспечивает целевого значения уровня АД, суточную дозу следует разделить на 2 приема: по 25 мг (возможно применение лозартана в таблетках 25 мг или в таблетках 50 мг с риской) 2 раза в сутки или по 50 мг 2 раза в сутки.
Снижение риска развития сердечно-сосудистых заболеваний и смертности у пациентов с артериальной гипертензией и гипертрофией левого желудочка
Начальная доза препарата составляет 50 мг 1 раз/сутки. В дальнейшем может быть добавлен гидрохлоротиазид в низких дозах или увеличена доза препарата Лозартан до максимальной 100 мг в один или два приема с учетом снижения АД.
Хроническая сердечная недостаточность
Начальная доза для пациентов с хронической сердечной недостаточностью составляет 12,5 мг (возможно применение лозартана в таблетках по 25 мг с риской) 1 раз/сутки. Доза титруется 2 раза, в зависимости от переносимости препарата пациентом, с недельным интервалом, т.е. 12,5 мг/сут, 25 мг/сут, 50 мг/сут до средней поддерживающей дозы 50 мг/сут. У пациентов пожилого возраста с почечной недостаточностью коррекция дозы не требуется.
У пациентов с сахарным диабетом 2 типа с протеинурией для замедления прогрессирования почечной недостаточности
Начальная доза составляет 50 мг 1 раз/сутки с дальнейшим повышением дозы до максимальной 100 мг/сутки (с учетом степени снижения АД) в один или в два приема.
Особые группы пациентов
У пациентов со сниженным объемом циркулирующей крови (ОЦК) (например, при приеме диуретиков в высоких дозах) рекомендуемая начальная доза препарата Лозартан составляет 25 мг (возможно применение лозартана в таблетках 25 мг или в таблетках 50 мг с риской).
Пациентам с печеночной недостаточностью (менее 9 баллов по шкале Чайлд-Пью), при проведении процедуры гемодиализа, а также пациентам старше 75 лет рекомендуется более низкая начальная доза препарата 25 мг (возможно применение лозартана в таблетках 25 мг или в таблетках 50 мг с риской) 1 раз в сутки.
Недостаточно опыта применения препарата у пациентов с тяжелой печеночной недостаточностью, поэтому препарат не рекомендован у данной категории пациентов (см. раздел «Противопоказания»).
У пациентов с умеренным нарушением функции почек (КК 20-30 мл/мин) коррекция дозы не требуется.
Побочное действие
Нарушения со стороны системы крови и лимфатической системы:
Редко: анемия, тромбоцитопения.
Нарушения со стороны нервной системы:
Часто: головокружение, головная боль, нарушение сна, бессонница.
Нарушения со стороны органа зрения:
Нарушения со стороны органа слуха и лабиринтные нарушения:
Часто: тошнота, диарея, боль в животе, диспепсические расстройства.
Нарушения со стороны печени и желчевыводящих путей:
Нечасто: нарушение функции печени.
Нарушения со стороны кожи и подкожных тканей:
Нарушения со стороны скелетно-мышечной и соединительной ткани:
Часто: судороги в мышцах нижних конечностей, миалгии, боль в спине, грудной клетке, ногах.
Нарушения со стороны почек и мочевыводящих путей:
Нарушения со стороны половых органов и молочной железы:
Общие нарушения:
Часто: астения, повышенная утомляемость.
Лабораторные и инструментальные данные:
Часто: гиперкалиемия.
Нечасто: умеренное повышение уровня мочевины и креатинина в сыворотке крови, гипогликемия, гипонатриемия, гиперурикемия.
Очень редко: повышение активности «печеночных» ферментов, гипербилирубинемия.
Передозировка
Симптомы: выраженное снижение артериального давления (АД), тахикардия. Брадикардия может возникнуть вследствие парасимпатической (вагусной) стимуляции.
Лечение: форсированный диурез, симптоматическая терапия. Гемодиализ не эффективен.
Особые указания
С осторожностью следует применять при артериальной гипотензии, снижении ОЦК, нарушениях водно-электролитного баланса, двустороннем стенозе почечных артерий или стенозе артерии единственной почки, при почечной/печеночной недостаточности
Пациентам, у которых имеется дефицит жидкости и/или натрия, перед началом лечения необходимо провести коррекцию водно-электролитных нарушений или применять более низкую первоначальную дозу.
У пациентов с дегидратацией (например, получающих лечение диуретиками в высоких дозах) в начале лечения лозартаном может возникать симптоматическая артериальная гипотензия.
При нарушениях функции почек может потребоваться уменьшение дозы лозартана.
У пациентов с указаниями в анамнезе на заболевания печени лозартан следует применять в низких дозах. При циррозе печени концентрация лозартана в плазме крови значительно увеличивается.
В период лечения следует регулярно контролировать уровень калия в крови, особенно у пациентов пожилого возраста, при нарушениях функции почек.
Следует избегать одновременного применения лозартана с калийсберегающими диуретиками.
Безопасность и эффективность применения лозартана у детей не установлены.
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вещества\u003c/i\u003e: крахмал прежелатинизированный 15 мг, лактозы моногидрат 35.1 мг, магния стеарат 1.9 мг, карбоксиметилкрахмал натрия 10 мг, целлюлоза микрокристаллическая 78 мг."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСостав пленочной оболочки:\u003c/i\u003e гипролоза 3.125 мг, титана диоксид (Е171) 1.875 мг."}}]},{"id":9,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\n\nАнтигипертензивное средство. Является непептидным блокатором рецепторов ангиотензина II."}},{"type":"paragraph","data":{"text":"Обладает высокой селективностью и аффинитетом к рецепторам типа AT1 (при участии которых реализуются основные эффекты ангиотензина II)."}},{"type":"paragraph","data":{"text":"Блокируя указанные рецепторы, лозартан предупреждает и устраняет сосудосуживающее действие ангиотензина II, его стимулирующее влияние на секрецию альдостерона надпочечниками и некоторые другие эффекты ангиотензина II."}},{"type":"paragraph","data":{"text":"Характеризуется длительным действием (24 ч и более), что обусловлено образованием его активного метаболита.\n\n"}}]},{"id":10,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["Артериальная гипертензия.","Снижение риска развития сердечно-сосудистых заболеваний и смертности у пациентов с артериальной гипертензией и гипертрофией левого желудочка.","Хроническая сердечная недостаточность (в составе комбинированной терапии, при непереносимости или неэффективности терапии ингибиторами АПФ).","У пациентов с сахарным диабетом 2 типа с протеинурией для замедления прогрессирования почечной недостаточности, проявляющейся снижением частоты гиперкреатининемии, частоты развития терминальной стадии хронической почечной недостаточности, требующей проведения диализа или трансплантации почки, показателей смертности, а также снижение протеинурии."]}}]},{"id":11,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Повышенная чувствительность к активному веществу или к другим компонентам препарата. ","Артериальная гипотензия. ","Тяжелая печеночная недостаточность (более 9 баллов по шкале Чайлд-Пью). ","Первичный гиперальдостеронизм.","Одновременное применение с алискиреном у пациентов с сахарным диабетом и пациентов с почечной недостаточностью (клиренс креатинина менее 60 мл/мин).","Беременность, период грудного вскармливания. ","Возраст до 18 лет (эффективность и безопасность не установлены). "]}}]},{"id":12,"name":"С осторожностью","slug":"cautions","body":[{"type":"list","data":{"style":"ordered","items":["Нарушение водно-электролитного баланса крови (гипонатриемия, гипохлоремический алкалоз, гипомагниемия, гипокалиемия, гиперкалиемия).","Снижение объема циркулирующей крови (ОЦК).","Двусторонний стеноз почечных артерий или стеноз артерии единственной почки, почечная недостаточность.","Состояние после трансплантации почки (отсутствует опыт применения).","Аортальный и митральный стеноз, гипертрофическая обструктивная кардиомиопатия, сердечная недостаточность с сопутствующей тяжелой почечной недостаточностью, тяжелая хроническая сердечная недостаточность (IV функциональный класс по классификации NYHA), сердечная недостаточность с угрожающими жизни аритмиями, ишемическая болезнь сердца.","Цереброваскулярные заболевания.","Печеночная недостаточность (менее 9 баллов по шкале Чайлд-Пью).","Ангионевротический отек в анамнезе."]}}]},{"id":14,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nВнутрь, независимо от приема пищи. Таблетки проглатывают, не разжевывая, запивая водой. Кратность приема – 1 раз/сутки, желательно в одно и то же время, утром."}},{"type":"paragraph","data":{"text":"Артериальная гипертензия"}},{"type":"paragraph","data":{"text":"Начальная и поддерживающая доза составляет 50 мг/сутки. При необходимости суточная доза может быть увеличена до максимальной 100 мг. Если однократный прием препарата не обеспечивает целевого значения уровня АД, суточную дозу следует разделить на 2 приема: по 25 мг (возможно применение лозартана в таблетках 25 мг или в таблетках 50 мг с риской) 2 раза в сутки или по 50 мг 2 раза в сутки."}},{"type":"paragraph","data":{"text":"Снижение риска развития сердечно-сосудистых заболеваний и смертности у пациентов с артериальной гипертензией и гипертрофией левого желудочка"}},{"type":"paragraph","data":{"text":"Начальная доза препарата составляет 50 мг 1 раз/сутки. В дальнейшем может быть добавлен гидрохлоротиазид в низких дозах или увеличена доза препарата Лозартан до максимальной 100 мг в один или два приема с учетом снижения АД."}},{"type":"paragraph","data":{"text":"Хроническая сердечная недостаточность"}},{"type":"paragraph","data":{"text":"Начальная доза для пациентов с хронической сердечной недостаточностью составляет 12,5 мг (возможно применение лозартана в таблетках по 25 мг с риской) 1 раз/сутки. Доза титруется 2 раза, в зависимости от переносимости препарата пациентом, с недельным интервалом, т.е. 12,5 мг/сут, 25 мг/сут, 50 мг/сут до средней поддерживающей дозы 50 мг/сут. У пациентов пожилого возраста с почечной недостаточностью коррекция дозы не требуется."}},{"type":"paragraph","data":{"text":"У пациентов с сахарным диабетом 2 типа с протеинурией для замедления прогрессирования почечной недостаточности"}},{"type":"paragraph","data":{"text":"Начальная доза составляет 50 мг 1 раз/сутки с дальнейшим повышением дозы до максимальной 100 мг/сутки (с учетом степени снижения АД) в один или в два приема."}},{"type":"paragraph","data":{"text":"Особые группы пациентов"}},{"type":"paragraph","data":{"text":"У пациентов со сниженным объемом циркулирующей крови (ОЦК) (например, при приеме диуретиков в высоких дозах) рекомендуемая начальная доза препарата Лозартан составляет 25 мг (возможно применение лозартана в таблетках 25 мг или в таблетках 50 мг с риской)."}},{"type":"paragraph","data":{"text":"Пациентам с печеночной недостаточностью (менее 9 баллов по шкале Чайлд-Пью), при проведении процедуры гемодиализа, а также пациентам старше 75 лет рекомендуется более низкая начальная доза препарата 25 мг (возможно применение лозартана в таблетках 25 мг или в таблетках 50 мг с риской) 1 раз в сутки."}},{"type":"paragraph","data":{"text":"Недостаточно опыта применения препарата у пациентов с тяжелой печеночной недостаточностью, поэтому препарат не рекомендован у данной категории пациентов (см. раздел «Противопоказания»)."}},{"type":"paragraph","data":{"text":"У пациентов с умеренным нарушением функции почек (КК 20-30 мл/мин) коррекция дозы не требуется.\n\n"}}]},{"id":15,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Нарушения со стороны системы крови и лимфатической системы:"}},{"type":"paragraph","data":{"text":"Редко: анемия, тромбоцитопения."}},{"type":"paragraph","data":{"text":"Нарушения со стороны нервной системы:"}},{"type":"paragraph","data":{"text":"Часто: головокружение, головная боль, нарушение сна, бессонница."}},{"type":"paragraph","data":{"text":"Нарушения со стороны органа зрения:"}},{"type":"paragraph","data":{"text":"Нарушения со стороны органа слуха и лабиринтные нарушения:"}},{"type":"paragraph","data":{"text":"Нарушения со стороны органа вкуса:"}},{"type":"paragraph","data":{"text":"Нарушения со стороны сердца:"}},{"type":"paragraph","data":{"text":"Часто: ощущение сердцебиения, тахикардия, брадикардия, аритмия."}},{"type":"paragraph","data":{"text":"Нарушения со стороны сосудов:"}},{"type":"paragraph","data":{"text":"Нарушения со стороны дыхательной системы, органов грудной клетки и средостения:"}},{"type":"paragraph","data":{"text":"Часто: кашель, инфекции верхних отделов дыхательных путей (фарингит, ринит, синусит, бронхит), отек слизистой носа."}},{"type":"paragraph","data":{"text":"Нарушения со стороны желудочно-кишечного тракта:"}},{"type":"paragraph","data":{"text":"Часто: тошнота, диарея, боль в животе, диспепсические расстройства."}},{"type":"paragraph","data":{"text":"Нарушения со стороны печени и желчевыводящих путей:"}},{"type":"paragraph","data":{"text":"Нечасто: нарушение функции печени."}},{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и подкожных тканей:"}},{"type":"paragraph","data":{"text":"Нарушения со стороны скелетно-мышечной и соединительной ткани:"}},{"type":"paragraph","data":{"text":"Часто: судороги в мышцах нижних конечностей, миалгии, боль в спине, грудной клетке, ногах."}},{"type":"paragraph","data":{"text":"Нарушения со стороны почек и мочевыводящих путей:"}},{"type":"paragraph","data":{"text":"Нарушения со стороны половых органов и молочной железы:"}},{"type":"paragraph","data":{"text":"Общие нарушения:"}},{"type":"paragraph","data":{"text":"Часто: астения, повышенная утомляемость."}},{"type":"paragraph","data":{"text":"Лабораторные и инструментальные данные:"}},{"type":"paragraph","data":{"text":"Часто: гиперкалиемия."}},{"type":"paragraph","data":{"text":"Нечасто: умеренное повышение уровня мочевины и креатинина в сыворотке крови, гипогликемия, гипонатриемия, гиперурикемия."}},{"type":"paragraph","data":{"text":"Очень редко: повышение активности «печеночных» ферментов, гипербилирубинемия."}}]},{"id":16,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003cb\u003eСимптомы:\u003c/b\u003e выраженное снижение артериального давления (АД), тахикардия. Брадикардия может возникнуть вследствие парасимпатической (вагусной) стимуляции."}},{"type":"paragraph","data":{"text":"\u003cb\u003eЛечение: \u003c/b\u003eфорсированный диурез, симптоматическая терапия. Гемодиализ не эффективен.\n\n"}}]},{"id":18,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nС осторожностью следует применять при артериальной гипотензии, снижении ОЦК, нарушениях водно-электролитного баланса, двустороннем стенозе почечных артерий или стенозе артерии единственной почки, при почечной/печеночной недостаточности"}},{"type":"paragraph","data":{"text":"Пациентам, у которых имеется дефицит жидкости и/или натрия, перед началом лечения необходимо провести коррекцию водно-электролитных нарушений или применять более низкую первоначальную дозу."}},{"type":"paragraph","data":{"text":"У пациентов с дегидратацией (например, получающих лечение диуретиками в высоких дозах) в начале лечения лозартаном может возникать симптоматическая артериальная гипотензия."}},{"type":"paragraph","data":{"text":"При нарушениях функции почек может потребоваться уменьшение дозы лозартана."}},{"type":"paragraph","data":{"text":"У пациентов с указаниями в анамнезе на заболевания печени лозартан следует применять в низких дозах. При циррозе печени концентрация лозартана в плазме крови значительно увеличивается."}},{"type":"paragraph","data":{"text":"В период лечения следует регулярно контролировать уровень калия в крови, особенно у пациентов пожилого возраста, при нарушениях функции почек."}},{"type":"paragraph","data":{"text":"Следует избегать одновременного применения лозартана с калийсберегающими диуретиками."}},{"type":"paragraph","data":{"text":"Безопасность и эффективность применения лозартана у детей не установлены.\n\n"}}]},{"id":20,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки."}}]},{"id":23,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]},{"id":24,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/alkaloid/\"\u003eАлкалоид АД Скопье, Республика Северная Македония\u003c/a\u003e."}}]}],"source":{"title":"('Эркафарм/Столетов',)","url":"https://stoletov.ru/"}},"description_toggle":false,"short_description":"Антигипертензивное средство. 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