Trandolapril Instructions for Provisions. Trandolapril: Instructions from Provisions and Special Recommendations

Angibitories of ACE are most widely used for the treatment of heart failure and arterial hypertension.

Until the number іngіbіtorіv APF The speech of trandolapril should be submitted.

The Danish component, which is a hypotensive and vasodilating drug, is included before the warehouse of drugs for secondary prevention of heart failure for myocardial infarction, hypertension and heart failure.

Likas on the basis of trandolapril priznachayut to grow up patients. 3 pharmacies are available with a prescription.

Pharmacological diya

Є Ingibitor ACE. Nadaє vasodilating and hypotensive effect. Testing the approval of angiotensin II, changing the vision of aldosterone.

Expanding veni in the menshy world, lower arteries. I lower post- and frontal vantage, arterial vise, OPSS. Reflector adjustment of the frequency and the speed of the heart in the day. Improved synthesis of propylene glycol, reducing the degradation of bradykinin.

The link between the activity of the renin plasmas and the hypotensive effect of the daytime: with a normal or a decrease in the concentration of the hormone AT, the decrease is due to the effect of the tissue on the renin-angiotensin systems. With trivial stasis, the turn of the hypertrophy of the myocardium, the arteries of the resistive type, decrease.

Pidsilyu nirkovy, coronary blood flow. Veda to complete blood flow of the ischemic myocardium. Pidvischuє in the reperfusion ischemic zones of the myocardium with the concentration of phosphocreatine.

Zatrimu vivedennya kaliyu, zbilshu dyurez. Reduces platelet aggregation. In people who have suffered myocardial infarction, the development of LS dysfunction is encouraging. Children with CHF have a triviality of life.

In addition, the lowering of the arterial grip is spared to stretch out two dib.

Absorption from the shlunkovo-intestinal tract є shvidkoy. Bioavailability with implantation does not change. Seeing with mother's milk. Vivoditsya nirkami (33%) and through the intestines (67%).

Shown to sucking

I mean Trandolapril for the treatment of CHF (as a component of combined therapy), arterial hypertension, as well as for the second prevention of heart failure in the case of myocardial infarction.

how to receive

Capsules of Trandolapril are taken right from the hour taken, washed down with a ridinoy. Kovtayut їkh whole. Skіlki b mg Trandolapril is not prescribed a drug, the drug is taken once a day at one and the same hour.

Fakhivets is guilty of taking an individual dose.

Form vipusku, warehouse

Dispensed in capsules or tablets. The active ingredient is trandolapril.

Interaction with other drugs

Efect Trandolapril drink alcoholic beverages, diuretic, Інші hypotensive drugs, including beta-blockers.

Weaken the effect of Trandolapril Refinery, estrogen and liquor, which activate the renin-angiotensin-aldosterone system.

Myelodepressants increase the development of agranulocytosis and / or lethal neutropenia; procainamide and alopurinol neutropenia.

Calcium diuretics (triamterene, amiloride, spironolactone, etc.), calcium supplements and potassium-containing cakes, salt substitutes and cyclosporin increase the hyperpathy.

Antacids increase absorption.

Trandolapril is a potentially adaptable infusion of alcohol on the central nervous system, causing a toxic diet for increasing concentration, reducing hypokalemia and symptoms of hyperaldosteronism by diuretics.

Pobichna diya

Overdose

Vyavlyayetsya nabrya and guest hypotensive.

To look for changes in the dose of the drug or changes in the dose, the treatment of the slunker, the transfer of the patient to horizontal position, Conducted visits to improve the blood volume

Symptomatic therapy is based on the introduction of hydrocortisone (i.v.), adrenaline (i.v. abo n / c), as well as the sign of antihistamines.

Prototype

Trandolapril does not recognize vaginal women, people who are hyper-sensitive to trandolapril, or even those who are in the ACE, as they are good for children.

Perestorogi is necessary to survive in case of storing leads in case of:

with vaginosti

It is unacceptable for the vagina children to be assigned.

For an hour of therapy breast year bath pin up.

Mind that term zberigannya

It can be saved at temperatures up to 30 degrees for three rockets.

Price

Participation in business start up to trade naming. Orintovna price of drugs, for revenge trandolapril in Russia, Become 500 p. per packing.

Preparations for revenge trandolapril, in Ukraine are on sale for a price from 60 to 850 UAH. for one pack.

analogs

Gopten, Trandolapril Ratiopharm, as well as drug combinations Tarka, to take revenge on the verapamil.

Trandolapril should be carried up to the number of іngіbіtorіv, as vikoristovyu for treatment of arterial hypertension and heart failure. The drug develops a high level of safety during therapy, it can be victorious as a self-contained medicinal drug, as well as when combined use get sick. Before the ear, the recipient is recommended to respectfully familiarize himself with the instructions for the reception and the reception.

Before taking the drug

Trandolapril is dispensed in the form of tablets and capsules with worms. The medication is sold in carton packs, in the middle of which there are blister with tablets.

The active component of the liquor is trandolapril, which is 2 mg in one tablet.

Before the warehouse, the preparation itself includes corn starch, povidone, glucose monohydrate. The shell of the capsules is stored in gelatin and titanium dioxide. It is recommended to take the medication in stolen from sleepy exchanges, at temperatures not more than 30 degrees Celsius. The chemical formula for the drug is shown below the illustration.

Mechanism of Diya

trandolapril nada vyrazhenu hypotensive effect, pleasantly infused into viroblenya aldosterone, quickly її. Zdebіlshy capsules expand veins, in the smallest world they nadayut diu on arteries.

Taking the medication allows you to reduce the fasting rate. Trandolapril literally reduces the level of degradation of bradykinin. With normal plasma renin, the arterial grip starts to decrease. A trivial course of treatment with the drug will allow the symptoms of myocardial hypertrophy and arterial hypertrophy symptoms.

I will take the drug to increase blood circulation, and in my heart I will reduce the blood circulation and shedding myocardium. By taking capsules, you can get the calories into the body.

Trandolapril rapidly accelerates platelet aggregation. Pomitny infusion of capsules on the body of the patient is spared after 2 days after the first reception. Trandolapril increased the triviality of life and the hopeful development of dysfunction of the little heart.

Capsules are quickly absorbed, it is possible to take them, both at once with a meal, and without a meal. The price does not infuse into the effectiveness of the drug.

The medication is vivoditsya from the body for the support of the intestine. The active components can penetrate into the mother's milk, which is why they are tied to the preparation taken for an hour.

Demonstration and method of storing

trandolapril is required accept at times, as a patient suffering from arterial hypertension or heart failure. Capsules fit in the middle, wash them down with a sufficient amount of time, without rozzhovuvannya. It is possible to take the medication without administration at the reception.

The dosage of the drug can be varied, however, in the absence of a capsule, it is possible only once in a row. The medication should be taken at about one and the same hour. The dosage of the medication will become an elusive drug, spiraling to the type of ailment of the patient and the patient's body.

Trandolapril Instructions for storing:

• In case of hypertension - the cob dose of the drug is varied from 0.5 mg to 2 mg per dose. For wash, so the patient is not destructive in the robotic ovens and nirok, as well as getting sick heart-vascular system... Dose is indicated for patients who cannot take capsules at once. Pochatkova dosage for African Americans is 2 mg. The minimum dose of 0.5 mg appears to be ineffective in this form. If the necessary therapeutic effect is not reached, then the dosage is increased to 4-8 mg for the supplement. However, it is necessary to work in 2-3 days.

If the patient’s camp is not spared, then it is recognized that the therapy is combined with other medications, including blockers of calcium channels;

• For infarction of myocardium and in the event of dysfunction of the heart - you can take the capsule only after a few days of infarction, starting dosage of 0.5-1 mg per day. Then the dosage is gradually increased to 4 mg. If a patient has a shit to transfer an increase in the amount of mg of the drug per day, then by taking the drug, you can pinch it for a while or turn to the victorian of 1 mg for doba;
• When Trandolapril is received by lіtnіm patients - if the patients do not have a robotic stove, then coriguvannya vicoristic dose is not required. With special protection, it is necessary to take a dose of these people, in some of the wadi's hearts, in robots, or even for an hour to take certain medications;

• In case of admission of other diuretics - for patients, in case of some changes in the water-salt balance, a few days before the ear, the course of taking capsules will be skewed by the rate of sectoral diseases. Tse allow reducing the risk of hypertension development;
• In case of heart failure - a cob dose of the drug in stock of 0.5 mg. The patient is guilty of being overused by the permanent control of the doctor at the stationary. In times positive reaction the organism of the dose can grow;
• In case of nirkovy deficiency - for patients with not very severe symptoms of ill health, the dose of corrections is not sufficient. If the dose is equal to 30 ml / min for creatine, then the cob dose is not to blame for 0.5 mg per dose. Then you can move smoothly for the signs of the liquor;
• If the liver is lacking, the use of trandolapril is indicated for special protection, and the minimum dosage of 0.5 mg is possible with the possibility of step-by-step adjustment. Therapy is carried out with a visual aid.

If the intake of the drug is hardened?

Prototype indications prior to the release of capsules to serve as a special intolerance to the components in the medication, the manifestation of angioeurotic embryos, lack of cure (up to 18 years).

The active components of the liquid can penetrate through the breast milk and the placental bar, which, with Trandolapril, can only be used in extreme cases, if the acridity from the vicious woman in the form of changing the moss for the child.

In case of an overdose of the drug, tachycardia, shock, and a decrease in arterial vise, electrical damage... In this case, it is necessary to consider the intake of capsules and symptomatic treatment.

Carrying out the last few days showed that the drug can be produced before the onset of side effects:

important types

Acceptance of capsules can reduce the loss of concentration and decrease the concentration of respect, then, before the hour of taking, it is recommended to change the situation and control the mechanisms, as in the case of the quick reaction from the side of the people. For an hour to receive Trandolapril, it is necessary to change alcoholic beverages, Which can become the cause of side effects.

So it is self-recommended to lead healthier eating and follow the instructions of the doctor who is correct to your race. During the hour, it is important to control the vagu, to adjust it to the required level at the same time as the norm, and to reduce it, if it is oversized.

How can you take Trandolapril with other medicines?

Complex treatment with capsules and other medications. side-by-side... Priyom Trandolapril with other diuretics can be reduced to a stronger hypotensive effect.

Preparations, which can be taken in their warehouses, may not be safe for quiet patients, who have a nirkov deficiency. Tom complex therapy the guilty person passes under the control of the doctor with the selection of personal reconciliation.

Immediately victorious capsules and preparations, aimed at reducing the amount of sugar in the blood, can lead to the development of hypoglycemia. Medicines from a lithium in a warehouse - to produce to a very low amount of lithium to the body.

Trandolapril - prices and analogues

As soon as you take the capsules of Wiklik, you have negative reactions from the side of the body, then you can try to replace it with analogous methods, as it looks like it’s injected:

• Kvinafar;
• Akurenal;
• Berlipril®;
• Vitopril;
• Dapril;

Preparations for revealing Trandolapril (Trandolapril, ATC code (ATC) C09AA10)

Gopten (Trandolapril) - Office of the Instructions for the Organization. Prescription drug, the information is designated only for the health protection fahivts!

Clinical-pharmacological group:

Angiotensin converting enzyme (ACE)

Pharmacological diya

Non-peptidic ACE Ingibitor, which reveals a carboxyl group, without a sulfhydryl group. For the quick release of trandolapril, it is susceptible to nonspecific hydrolysis until it is approved by trandolapril, a circulating active metabolite. Trandolaprylate volodya high spore to ACE. The interaction of the yogi with the enzyme is a nasichu process.

The stagnation of the drug is reduced to a decrease in the concentration of angiotensin II, aldosterone and atrial natriuretic factor, as a result of which the activity of renin plasmas and the concentration of angiotensin I.

Trandolapril, a modulator of RAAS, shows a role in the regulation of BCC and AT, which is the most antihypertensive effect in the world of zoom.

Stagnation of the drug in special therapeutic doses in patients with arterial hypertension to a significant decrease in the arterial grip, before and at the heart. The obvious antihypertensive effect spontaneously persists after 1 year after receiving the appointment, reaching a maximum of between 8 and 12 hours and taking up to 24 years.

Trandolapril reduced the incidence of myocardial hypertrophy, in the hope of progressing dysfunction of the little one, but in general, the triviality of life in patients with heart failure.

Pharmacokinetics

soaktuvannya

When I get it, I’ll get wet from the shlunkovo-intestinal tract. Bioavailability to become 40-60% and not to accumulate as a result of the intake. Cmax of trandolapril in blood plasma is determined after 30 min. Trandolapril is much more familiar with plasmas, and it takes less than 1 hour for T1 / 2. Plasma trandolapril undergoes hydrolysis to trandolaprilat, which is an ACE inhibitor. The hour of reaching Cmax of trandolaprylate in plasma becomes 4-6 years, and the number of times it is accepted that trandolaprilate does not remain in the plasma.

rospodil

The connection of trandolaprilate with blood plasma proteins is 80%. A great part of the circulating trandoprilate clinks with albumin; ringing є non-ravaged.

When the drug is consumed 1 time for a good equitable camp in healthy volunteers, as well as young and sick people arterial hypertension reach in approx. 4 days.

metabolism

Metabolize in the liver with the statements of the active metabolite - trandolaprilate.

vivedennya

The effective T1 / 2 becomes 16-24 hours, and the thermal T1 / 2 varies from 47 to 98 years old in the fallow period from the dose. The thermal phase, imovirno, depicts the kinetics of the interaction of trandolapril with the APF and the dissociation of the complex, which is accepted.

10-15% of the dose of trandolapril is given in the viglyadi of the indispensable trandolaprilat from the cross. For the consumed trandolapril, 33% of radioactivity occurs in the section and 66% in feces.

Pharmacokinetics in special clinical forms

Nirkovy cleansing trandolaprylate lyno corelyu z KK. In ailments with CC less than 30 ml / hv, the increase in the concentration of trandolaprylate in plasma is indicated. With repeated intake of the drug in ailments with chronic nirk deficiency An equally important camp can also be reached in 4 days directly from the step of the deterioration of the function of nirok.

Shown before consumption for GOPTEN®

• essential arterial hypertension;
• heart failure (second prevention of myocardial infarction due to changes in the fraction of the wicker of the louse for 3 additional development).

dosage regimen

Capsules are taken right away from the reception, kovtati tsilimi, washed down with a sufficient amount of ridini.

Regardless of the size of the dose, Gopten® should be given 1 time per dose. The drug should be taken in one and the same hour. The individual dose of the drug is responsible for the drug.

In patients with arterial hypertension, who do not take diuretics, with normal functioning of the liver and with daily chronic heart failure, the dose should be taken from 0.5-1 mg to 2 mg per dose. Even in insignificant numbers of patients, a dose of 0.5 mg was clinically effective. The dose can be administered through 1-4 dose of the drug up to maximum dose- 4-8 mg per doba. If there is an effect on the reception of Gopten in doses of 4-8 mg, then the possibility of combined therapy with diuretics and / or calcium channel blockers should be seen.

Patients with dysfunctional dysfunctions of the lіkuvannya Goptenom can be repaired in 3 days for a hospitable myocardial infarction. The pochatkova dose is 0.5-1 mg per dose, then a one-time daily dose is gradually increased to 4 mg. Due to the tolerance of the therapy (if there is a moment - the development of the hypotension), the increase in dosage can be increased for a short time. The development of hypotensiveness during suppression therapy with vasodilators, including nitrates and diuretics, serve as a reason for the decrease in dosage. The dose of Gopten should change only because of the ineffectiveness or the unhappiness of the therapy.

In patients with chronic heart failure and arterial hypertension, without any impairment of the function of nirok, if the ear was treated by ACE angibians, symptoms of hypotension were indicated. For a whole group of ailments, the therapy should be repaired with a dose of Gopten in a dose of 0.5-1 mg per day in a hospital for a sawing patient.

In patients with the risk of activation of the renin-angiotesin system (so that in patients with damaged water-salt exchange), 2-3 days before the prescribed Hopten in a dose of 0.5 mg, it is necessary to take the therapy of this drug, it is necessary If necessary, more therapy with diuretics is possible.

Young people have normal function nirok i stove correction of the dose is not required. With the protection and control of the arterial grip after taking a dose of Hopten in young patients with chronic heart deficiency, impaired liver function and nirok, as they take the drug.

In patients with a nirkovy lack of the middle degree of severity (CC from 30 to 70 ml / h), it is recommended to take Gopten at a specific dose. When CC is 10 to 30 ml / xv the pochatkova dose is 0.5 mg 1 time per dose; if necessary, the dose can be increased. at QC< 10 мл/мин начальная доза не должна превышать 0.5 мг в сутки, в дальнейшем доза не должна превышать 2 мг в сутки. Терапия Гоптеном у подобных больных должна проводиться под тщательным наблюдением врача.

The ability to give trandolapril or to trandolaprylate during dialis is not exactly established, it is possible to cleanse it, but the concentration of trandolaprylate for one hour changes, which can lead to the loss of control of the arterial clutch. For this, for an hour, it is recommended to retaliate monitoring of the arterial vise with a quick correction (if necessary) dose of the drug.

Patients with severe hepatic deficiency due to a decrease in the metabolic function of the liver can be promoted to increase in plasma levels of both trandolaprylate and its active metabolism of trandolaprylate. Likuvannya should be repaired with 0.5 mg for doba, with the help of the drug.

Pobichna diya

At the table, there are undesired reactions, which were spontaneous in the trivial classroom preliminaries of trandolapril. All reactions of distribution for organ systems and frequency:

The most clinically significant side effects, registered in the clinical preliminaries of the IV phase or post-marketing practice:

On the side of the hematopoietic system: agranulocytosis, leukopenia, pancytopenia.

Allergic reactions: reactions of increased sensitivity, including sverbіzh and visip, angioedema.

Three sides mental systems: Dyspnoea, bronchitis.

On the side of the herbal system: tediousness, bloating, abdominal pain, diarrhea, dryness in the mouth, increased activity of liver enzymes (including ACT and ALT).

Dermatological reactions: alopecia, pidvishennya sweat.

On the side of the secular system: the adjustment of surplus nitrogen and serovate creatine.

Інші: prodigy.

Lower pererakhovani fatal effects, which were restructuring in case of stagnation of all ingibitoriv ACE:

On the side of the hematopoietic system: pancytopenia.

On the side of the central nervous system: transient ischemic attacks, insult.

On the side of the cardiovascular system: angina pectoris, myocardial infarction, AV blockade, bradycardia, heart disease, tachycardia.

On the side of the herbal system: pancreatitis.

Dermatological reactions: multiforme erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis.

Three sides kistkovo-m'yazovoy system: Міалгія.

Three sides laboratory dosages: Decrease in hemoglobin level, decrease in hematocrit.

Prototype indication prior to consumption for HOPTEN®

• angioneurotic nabars, incl. in the case of the frontal treatment by the ACE inhibitors;
• decay / idiopathic angioedema;
• vagіtnіst;
• period of lactation (breastfeeding);
• childish and adult age up to 18 years;
• sensitivity to the drug has been adjusted.

The drug is not a sign of ailment due to aortic stenosis, or obstruction of the lateral tract of the lynx.

Prolongation of the drug HOPTEN® for vaginosis and breastfeeding

The drug is contraindicated before pregnancy in vaginosis and in the period of lactation (breastfeeding).

Slid to turn on the visibility of the vagina before the ear of the drink by Hopten and the uniqueness of the vagueness before the hour of the visit. Vikoristannya іngіbіtorіv ACE in the middle, or in a larger period of vaginosti, led to a lack of water and to neonatal hypotension, which supervises over anurі or lack of function nyrok.

Stagnation in case of deterioration of the function of the liver

For patients with pechinka deficiency, the treatment is repaired with a dose of 0.5 mg, and, moreover, in the fallowness due to clinical efficiency, step by step increase.

Zasosuvannya in case of destructive functions of nirok

In patients with a small nirkovy deficiency (CC from 30 to 70 ml / hv), it is recommended to take Gopten at a specific dose. When CC is 10 to 30 ml / xv the pochatkova dose is 0.5 mg 1 time per dose; stepwise increase up to 2 mg. With creatine clearing<10 мл/мин начальная доза не должна превышать 0.5 мг в сутки, в дальнейшем доза не должна превышать 1 мг в сутки. Терапия Гоптеном у подобных больных должна проводиться под тщательным наблюдением врача.

special requests

Trandolapril is a prodrug, as it is transformed into an active form in a cookie, so it is necessary to take special care of the ailments for the damaged functions, which are known to be guilty by visual demonstration.

In ailments with persistent arterial hypertension after receiving the first dose of Hopten, as well as the development of hypotensiveness, which was accompanied by key symptoms. Rizik of the development of hypotensiveness in children, who may have a deficiency in childbirth and salt, as a result of trivial diuretic therapy, intercourse with the development of salt, carried out with a diolysis, diarrhea and blues. In such ailments, before the ear of therapy with Hopten, it is necessary to prescribe the therapy with diuretics and memorize the BCC and / or instead of salt.

In case of treatment with ACE inhibitors, there are descriptions of agranulocytosis and asphyxiation of the cystic marrow. Quite often, non-essential things are often seen in case of deterioration of the function of nirok, especially in ailments with diffuse incapacitation of the resulting fabric. In such patients (for example, with VKV or systemic scleroderma), the number of leukocytes in the blood is regularly monitored and the blood cell counts, especially with impaired function of hypochondriasis and antihypertensives and antihypertensives.

Zastosuvannya trandolaprila may be an angioeurotic swelling of the face, kintzivok, language, pharynx and / or larynx.

For people with ailments, like rymuyut diuretics (especially recently), because of the sign of trandolapril, the tendency is to reduce the arterial grip.

With a nirkovy lack of a severe step, a decrease in the dose of trandolapril can be known; function nirok sl_d rettelno kontrolyuvati.

In ailments with nirkovy deficiency, chronic heart deficiency, bilateral stenosis of nirkovy arteries or unilateral stenosis of the arteries of a single functional nirkuyuchi nirku of pidvischenii rizik of degradation of the function of nirkina. In people with ailments for arterial hypertension without dehydration, when trandolapril is recognized in combination with a diuretic, it can be promoted to increase blood nitrogen and serum creatine levels. I can see the proteinuria.

In ailments with arterial hypertension with impaired function of nirok on the background of stasis, Hopten may experience hypertension.

In case of operative involvement of abnormal anesthesia with vikorstanny drugs, which vyklikayut arterial hypotension, trandolapril can block the second approval of angiotensin II, associated with compensatory wikid renin.

In case of hemodialysis of high-permeable membranes from polyacrylonitrile in ailments, when an ACE reaction is detected, anaphylactoid reactions have been described. Stagnation of similar membranes is unique in patients with ACE ingibitoris, who are on hemodialysis.

Vikoristannya in pediatrics

Safety and efficiency of storing Gopten in children has not been adopted, so it is not recommended to storing it in children.

Inflow to the building of keruvati by transport means and mechanisms

Vyhodyach from the pharmacological authorities of trandolapril, the health of the keruvath by transport means, or even to the robot with the folding technology, it is not guilty. However, in children with a one-hour intake of alcoholic beverages, especially on cob stages of treatment by ACE inhibitors, if one substitutes one drug for the least possible, it is possible to increase the amount of alcohol in the blood. As a result, alcohol can be improved. Therefore, with a one-hour drink with alcohol, for the first drink, or with a significant increase in dose, Hopten is not recommended for a long period of time by car, or by folding mechanisms.

Overdose

Symptoms may include: a decrease in arterial pressure, shock, stupor, bradycardia, electrolytic damage, nirkov lack of.

likarska vzaєmodiya

Diuretics, or even antihypertensive drugs, can be used in case of a one-hour consumption of trandolapril hypotensive effects. Adrenoblokatori slid zastosovuvati in combination with trandolapril only with retinal caution.

With a one-hour consumption of trandolapril with preparations of calories, high-calorie diuretics (spironolactone, amiloride, triamterene), it is important to increase the concentration of calories in the blood, especially the function of deterioration. Trandolapril can reduce the loss of calories in case of consuming thiazide diuretics.

Immediately consuming trandolapril with hypoglycemic drugs (insulin or oral hypoglycemic drugs) can be used for other reasons and lead to the development of the rizik of hypoglycemia.

With a one-hour consumption of trandolapril with drugs, the concentration of lithium in the syrovatz blood will increase to the extent of the loss of its life.

With a one-hour intake of trandolapril due to the use of inhalational anesthesia, it is necessary to improve the hypotensive activity.

With a one-hour consumption of trandolapril with cytostatics, systemic corticosteroids and immunosuppressive drugs, the development of leukopenia is increased.

There are clinically significant signs of the relationship between trandolapril and thrombolytics, acetylsalicylic acid, beta-blockers, calcium channel blockers, nitrates, anticoagulants, or digoxin, if there is a lack of arthritis

Mind that term zberigannya

The drug is available for a prescription.

Mind that term zberigannya

The list of Zberigati is inaccessible for children at temperatures of 25 ° C. Term of accessibility - 4 rocks.

Formula: C24H34N2O5, chemical name: (2S, 3aR, 7aS) -1 - [(S) -N - [(S) -1-carboxy-3-phenylpropyl] alanyl] hexahydro-2-indolincarboxylic acid 1-ethyl ether.
Pharmacological group: Organotropicity of the cat / heart-vascular system / angibitorium ACE.
Pharmacological diya: hypotensive, cardioprotective, vasodilatory, natriyuretic.

Pharmacological authorities

Trandolapril is a prodrug, ethylovium ether of a non-sulfhydryl ingibitor of angiotensin converting enzyme. Trandolapril quickly gets wet and nonspecifically hydrolyzes into trandolaprilat, which is a pharmacologically active metabolite. Trandolapril mintally triggers and drives an angiotensin-converting enzyme and drives angiotensin II products, which is a vasoconstrictor action. Takozh vіdbuvaєtsya znizhennya kontsentratsії aldosterone peredserdnogo natrіyuretichnogo factor i zbіlshuєtsya plazmova aktivnіst renіnu i kontsentratsіya angіotenzinu I. So rank, trandolapril modulyuє angіotenzin-aldosterone system, yak vіdіgraє major role in regulyuvannі obsyagu tsirkulyuyuchoї krovі, arterіalnogo vise i poslіdovno nadaє antigіpertenzivnudіyu. Trandolapril lowered the posterior peripheral op_r of the sudin, the systemic arterial vise and the post on the myocardium. Trandolapril with a decrease in the hypertrophy of the sudin (aorta, stegnum and mesenteric arteries). Trandolapril for the reduction of the tissue renin-angiotensin system of the heart, prior to the development of the dilatation of the louse and the hypertrophy of the myocardium or the sprit of the regression (nadaє cardioprotective effect). Trandolapril in reperfusion ischemic zones of the myocardium with increased concentration of phosphocreatin. Trandolapril stabіlіzuє bradikіnіn in krovі i tkaninah (zmenshuєtsya degradatsіya bradikіnіnu to inactive peptidіv) prignіchuє utvorennya aldosterone nadnirkovih zalozah, zbіlshuє aktivnіst kalіkreїn-kіnіnovoї system pіdvischuє vidіlennya bіologіchno activity rechovin (peredserdny natrіyuretichny factor endotelіalny relaksuyuchy factor, prostaglandin E2 i I2), as a result of the bladder expansion and natriyuretic action and the blood flow in the nirks. Trandolapril changed the approval of endotelin-1 and arginin-vasopresin, which volodynuyut by the court-sounding authorities. The hypotensive effect of trandolapril develops approximately in 1 year after receiving, it becomes maximum after 8 - 12 years, and up to 24 - 36 years. The maximum concentration of the angiotensin-converting enzyme in the blood is restructuring after 2 - 4 years, and after the additional activity of the enzyme, it will be 80% lower than that of the enzyme. The activity of the angiotensin-converting enzyme in blood, hearts, legends, nirkas normalizes for 7 days after the change of treatment, and in the arteries of the won’s it will be too low. The efficiency of trandolapril is explained by the statements of trandolaprylate (diacid metabolite), which is 2200 times more active than the verbal speech. In patients with postinfarction dysfunction of a lonely dysfunction (25% of wikidum is not more than 35%) for a dose of 4 mg for another 24 - 50 months due to a decrease in mortality in cases of heart failure by 24%, important heart failure by 29%. Today, the triviality of life among the category of patients is about 15 months old (27%). For a more reliable diagnosis of myocardial infarction, only patients with an arterial vise of 125/90 mm Hg were registered.
There is no sign of carcinogenicity in the past on pike and misha when doses of trandolapril are consumed up to 8 mg / kg for additional doses of up to 25 mg / kg for additional reasons. Trandolapril is not volodya genotoxic and mutagenic powers.
At doses up to 100 mg / kg per doba (1250 times the maximum recommended dose for humans), trandolapril does not spoil the unpleasant infusion on the fertile function of shchuriv. When trandolapril is consumed in mavp at doses of 25 mg / kg for dobu, in schurivs - 1000 mg / kg for dobu, in rabbits - 0.8 mg / kg for dobu (312, 1250, 10 times the maximum recommended dose for humans is ) there was no teratogenic effect. Ale neobhіdno vrahovuvati scho zastosuvannya іnshih іngіbіtorіv angіotenzinperetvoryuyuchogo enzyme at vagіtnostі Mauger cause pіdvischennya neonatalnoї that fetalnoї smertnostі and vikoristannya pid 2 i 3 trimesters vagіtnostі suprovodzhuєtsya zatrimkoyu okostenіnnya kіstyaka, znizhennyam Masi placenta rozvitkom malovoddya (via znizhennya funktsії nirok) nirkovoї nedostatnostі y fetus, anuria, right up to a lethal result, contractures of the kidneys, hypoplasia of the genital tissue, undergrowth of the Botallov's duct, craniofascial deformations, toxic effect on the mother's organisms.
Trandolapril is wet in the intestinal tract when it is received. For trandolapril, the absolute bioavailability is 10% and for trandolaprilat it is approximately 40-60%. The maximum concentration of trandolapril is reached after 1 year, trandolaprilat - after 4 - 10 years. The maximum concentration and area under the curve of concentration - do not lie down for an hour at a time. The trandolapril plasmas are bound by 80% and do not accumulate as a concentration, trandolaprilate, in the presence of a concentration, it is linked by 65% ​​at a concentration of 1000 ng / ml and up to 94% at a concentration of 0.1 ng / ml. With a repeated intake of 2 mg and more, an important concentration is reached in 4 days. Osyag rozpodіlu trandolaprіla to become approximately 18 liters. Trandolapril in slizovіy obolontsі shlunkovo-kishkovogo path i pechіnki gіdrolіzuєtsya (pіddaєtsya deesterifіkatsії) of utvorennyam active metabolіtu - trandolaprilat, yaky Got virazhenu lіpofіlnіst, yak obumovlyuє znizhennya aktivnostі angіotenzinperetvoryuyuchogo enzyme not tіlki in krovі, ale i in Nirk, legenyah, Especially in nadnirkovih zalozah i heart. Concentration of trandolapril in syrovattsi blood quickly decreases, the period of time becomes 0.7 - 1.3 years. Trandolaprilate is produced in 2 or 3 phases: the period of the alpha date becomes 3.3 - 4.5 years, the period of the beta period is 16 - 24 years. The thermal period for trandolaprylate is 100 years old (it can be seen as a result of dissociation from the complex with membrane angiotensin converting enzyme). Nirkovy clearence of trandolaprylate variyuє from 0.15 l / year to 4 l / year fallow in doses. The drug is administered to the organism from the cross section (1/3) and the gum (2/3). In insignificant quantities (less than 0.5%), trandolapril is transported in an uninterrupted viglyad through nirki.
Pharmacokinetic parameters of trandolapril do not lie as a patient. Concentration of trandolaprilu in the blood of syrovatz is getting better at the sick of the kidnapped veterinarian. Alle the plasma concentration of trandolaprylate and its pharmacological activity in patients with arterial hypertension of the young and young age.
In case of important liver damage, the growth of trandolapril in syrovatz blood is approximately 10 times higher than in healthy people.
In case of normal deficiency in case of glomerular filtration rate of less than 30 ml / h and in case of hemodialysis of plasma concentration of trandolapril and trandolaprilate by about 2 times, and by about 85% decrease by about 85%. It is necessary to koriguvati pochatkovu and add a dose of the drug.

showing

Arterial hypertension (at the warehouse of monotherapy and combined therapy), heart failure (additional therapy), dysfunction of the lingering dysfunction due to myocardial infarction.

How to store trandolapril and dose

Trandolapril is taken in the middle, right away from the reception, 2 - 4 mg per dose in 1 - 2 doses, if you need to adjust the doses, it should be carried out at a minimum after 2 - 4 hours. To patients of a group of risiks, they should be given in a cob dose of 1 mg per doba; when the functional stanchion of the liver is damaged, the liver is repaired with 0.5 mg of vrance, or no more than 2 mg for dobu; in case of hemodialysis, it is prescribed in a cob dose of 0.5 mg of vrance.
During the first hour of treatment, the necessary control of the arterial grip, the storage of peripheral blood, during the first 3 - 6 months of treatment, and sometimes with periodic intervals up to 1 period, especially in patients with cancer nitrogen sechovina, masi tila, functions of nirok, dotrimannya children.
Therapy with trandolapril is guilty of being carried out with regular drug control.
Pidbir dose to patients with a severe heart deficiency, or an evil arterial hypertension, must be carried out in the minds of a stationary.
In people with ailments, such as taking diuretics, for the sign of trandolapril, it is possible to promote an overwhelming decrease in the arterial grip. In patients with persistent arterial hypertension with the first dose of trandolapril, as well as with the first dose of trandolapril, the development of symptomatic arterial hypertension was indicated. Rizik її development is more high in ailments with hyponathology and hypovolemia, which developed as a result of trivial diuretic therapy, dialogue, interdependence with the living of kitchen salt, brutes. To reduce the risk of symptomatic hypotensiveness 7 days before the cob of therapy, it is necessary to quickly improve the water-electrolyte balance and hypotensive treatment, including the prescribed diuretics (which means lowering the dose).
During the therapy with angiotensin re-converting enzyme with the help of angiotensin-converting enzyme, the decrease in the function of the cystic brain and agranulocytosis is described. Rizik the development of neutropenia є dose-overlapping, to lie in the form of a sick person and because of the type of drug. Quite often the reaction is not expected among the ailments due to the deterioration of the functional camp, especially with the diffuse incapacitation of the resulting fabric. Such ailments recommend regular monitoring of the number of leukocytes in the blood and the concentration of blood cells, especially in the case of impaired functional status of antimetabolites and glucocorticosteroids. The turnover reactions and turn to the norms for the fixing of the reaction with the angiotensin converting enzyme.
Trandolapril can wicklate angioeurotic contractions, revealing, language, larynx, vocal folds. Angioneurotic napryak at vicorian ingibitoriv angiotensin converting enzyme is often developed in ailments of the negro race. With the therapy of angiotensin-reversible enzyme with the help of angiotensin-converting enzyme, the development of angiotensin intestinal obstruction is also necessary, but it is necessary to reduce the development of pain in the abdomen on the lymph of trandolapril. In ailments with a blockage, it is necessary to securely pinch the drug with the drug and sposter the patient until the patient gets rid of the blockage. Angioneurotic flare-ups in the area of ​​denunciations, letting go spontaneously. Nabryak, which expands not only on the face, but on the voices folds, which can be life-threatening through the rizik of the obstruction of the wicked nobles. In case of angioedema of the tongue, larynx, and vocal folds, it is not necessary to introduce adrenaline (epinephrine), and also to carry out the first therapeutic visits, if necessary.
Ingibitories of angiotensin converting enzyme can be vicious until the ear of vasorenal hypertension, or in quiet vapors, if it does not work. In ailments with bilateral or unilateral stenosis of the nirkovy arteries, the development of nirkovo deficiency and circulating arterial hypotension during therapy with angiotensin converting enzyme by angiotensin is increased. Vikoristannya diuretikіv can be zbіlshiti risik. The deterioration of the functional stan- dard can be manifested by minor changes in the concentration of creatine in the plasma in patients with unilateral stenosis of the nerve artery. In such ailments, therapy should be considered in the minds of the hospital with small doses of trandolapril with a further dose selection and medical supervision. Vikoristannya diuretics is necessary to skasuvati. Concentration of calories in plasma and the function of nirok slid control by pulling the first pregnancy.
Patients with creatine cleansing less than 30 ml / hv may need to reduce the dose of trandolapril; functional mill is necessary to control it. Risks of degradation of the function of nircovykh arteries in ailments with chronic heart failure, impairment of the function of nirok, unilateral or bilateral stenosis of nirkovy arteries, one functional transplantation of nirkoe or malpractice. In people with arterial hypertension, who do not have any pathology, when trandolapril is detected at the same time with a diuretic, it is possible to increase the concentration of creatine and blood nitrogen in the blood. Proteinuria can also develop, especially in patients with deterioration of the functional state, even if they accept albeit high doses of angiotensin converting enzyme.
For an hour, you need to look at the patients with the damaged functions of the liver. With the progression of fulminant liver necrosis and the development of cholestatic liver disease, it is necessary to skasuvati.
Є Information about those, which are in the history of angiotensin converting to the enzyme and blockers in the receptors to angiotensin II, and aliskiren increasing the risk of hypotensive, reducing the function of the number of state For reasons of subjunction of blockade of the renin-angiotensin-aldosterone system and the path of the spilial reaction of angiotensin converting enzyme, blockers of receptors in angiotensin II, aliskiren is not recommended. While it is absolutely necessary to use the subway blockade of the renin-angiotensin-aldosterone system, it is absolutely necessary, it is only guilty that it is carried out only before the control of the fachivts and in the case of retarding the functional concentration of energy, arterial Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are not guilty of alcoholism in patients with diabetic nephropathy.
In ailments with arterial hypertension, especially due to the deterioration of the functional stance of nirok, trandolapril can be affected by hypertension. Prior to the factors in the development of hypertension, there is a lack of high blood pressure, no shortage of drugs for the therapy of hypochondriasis, dysfunction of the transfer of hypochondriacal disease
When vikorystanny іngіbіtorіv angiotensin converting enzyme, you can get a dry unproductive cough, which is caused by the change of lіkuvannya.
When carrying out operative interventions (including stomatological ones), care is required, especially in case of stagnant anesthetics in order to induce a hypotensive effect. Trandolapril can block the second approval of angiotensin II, when tied with a compensatory wikid to renin.
Hyposensitizing drug reactions can increase the development of anaphylactic reactions. When desensitizing the organisms is carried out until the retinaculum is often lost in the ailments, as they recognize the angiotensin converting enzyme, the development of anaphylactic reactions (including those that are life-threatening) is possible.
It is necessary to uniquely conduct hemofiltration, hemodialysis through highly productive membranes from polyacrylonitrilemetaalyl sulfate (for example, AN69), for apheresis of lipoproteins of low power, such as possible
For an hour of therapy, I will be able to get into alcohol.
With the protection of vicoristovuvati trandolapril to the transport forces and people, whose profession is connected with the increased concentration of respect and the speed of psychomotor reactions.

Prototype

Gіperchutlivіst (in addition chislі to іnshih іngіbіtorіv angіotenzinperetvoryuyuchogo enzyme) nayavnіst in anamnezі angіonevrotichnogo nabryaku at zastosuvannі іngіbіtorіv angіotenzinperetvoryuyuchogo enzyme spadkovy (іdіopatichny) angіonevrotichny nabryak, aortic stenosis, mіtralny stenozі, obstruktsіya vihіdnogo path lіvogo shlunochka, vagіtnіst, goduvannya gruddyu, vіk 18 rockiv (efficiency and safety is not established), sleeping with aliskiren and aliskiren-containing drugs in ailments with diabetic and / or impaired functions of nirok.

Obmezheniya to zasuvannya

Torn down funktsії nirok abo / she pechіnki, autoіmunnі zahvoryuvannya (sklerodermіya, system Chervoniy vovchak that INSHI sistemnі kolagenozi) gіperkalієmіya, symptomatic arterіalna gіpotenzіya, prignіchennya kіstkovomozkovogo Hematopoiesis, will at yakih mozhlive znizhennya ob'єmu tsirkulyuyuchoї krovі (vklyuchayuchi dіareyu, blyuvotu, dієtu of intercourse of birth and / or kitchen salt, hemodialis), malnutrition of the body, impaired coronary artery blood circulation, stenosis of the artery of a single nirk, one or two-sided stenosis of the artery deficiency, serous artery deficiency hypertrophic cardiomyopathy; Diabetes mellitus; gіponatrієmіya, Sukhiy nonproductive cough, zastosuvannya in patsієntіv negroїdnoї Rasi, spіlne vikoristannya of beta-blockers, holding dіalіznih procedures odnochasne Venue of apheresis lіpoproteїdіv nizkoї schіlnostі, hіrurgіchnі vtruchannya abo zagalna anestezіya of vikoristannyam zasobіv, SSMSC viklikayut arterіalnu gіpotenzіyu, under study is terapіya dіuretikami, odnochasne Venue of desensitization of the body to the detachment often

Stagnation during vaginosis and breastfeeding

Vikoristannya trandolapril is contraindicated in vaginosis. Before an hour of therapy with trandolapril, it is necessary to choose the best methods of contraception. If the vagina is insisted before the hour of taking the drug, then it is necessary to safely skasuvati and, if necessary, to designate an alternative therapy. The reasons for the teratogenic effects of the angiotensin converting enzyme in the first trimester of vaginal activity during the day, otherwise, this is not possible. Women who plan to have a vagina need to prescribe hypotensive medications, for those who do not bake a healthy condition, the bullet has been brought up, rather quietly, if there is a continuation of the therapy. Vіdomo scho at vikoristannі іngіbіtorіv angіotenzinperetvoryuyuchogo enzyme in another i tert trimestrі vagіtnostі mozhlivo fetotoksіcheskoe dіyu (malovoddya, torn down funktsії nirok, upovіlnennya osifіkatsії skull kіstok) i dіyu toxicity (arterіalna gіpotenzіya, nirkova nedostatnіst, gіperkalієmіya) on novonarodzhenu ditinu. In case of vicorian trandolapril, repairing for another trimester of vaginosity, an ultrasound assessment of the cranial cysts and fetal function is recommended. Newly born women, whose mothers have taken an angiotensin converting enzyme for an hour, have been responsible for re-using it by visual means for the inclusion of arterial hypotensives.
For an hour of therapy with trandolapril, it is necessary to pinch the breast. Danikh about the penetration of trandolapril into breast milk is dumb. For a given group of patients, it is more important to prescribe the preparation with a safety profile, especially when the premature and newborn babies are born.

Little children of trandolapril

Heart-sudin system and roof (blood formation, hemostasis): rіzke znizhennya arterіalnogo vise (Especially when terapії dіuretikami, y patsієntіv of torn down water-solovogo obmіnu) priplivi krovі to shkіri oblichchya, ortostatichnagіpotenzіya, angіopatіya, arterіalna gіpertenzіya, sertsebittya, bіl in grudnіy klіttsі, bradikardіya, tahіkardіya, stenokardіya, aritmіya, іnfarkt mіokarda , іshemіya mіokarda, shlunochkova tahіkardіya, Sertsevy nedostatnіst, atrіoventrikulyarna blockade zupinka sericite, varicose rozshirennya veins periferichnі sudinnі rozladi, znizhennya hematocrit, rіvnya gemoglobіnu, neytropenіya, platelet rozladi, leykotsitarnі rozladi, leykopenіya, agranulocytosis, anemіya (vklyuchayuchi gemolіtichnu) trombotsitopenіya, erythrocytopenia, pancytopenia, eosinophilia.
Nervous system and organi chutta: Headend bіl, zapamorochennya, nepritomnіst, torn down sleep Bezsonov, astenіya, mіgren, sonlivіst, vіdchuttya misrepresented galyutsinatsії, azhitatsіya, trivoga, apatіya, dinamіchnі torn down Mozkovy krovoobіgu, zagalmovanіst, splutanіst svіdomostі, torn down rіvnovagi, depresіya, parestezіya, cerebral іnsult, court , transient ischemic attack, bleeding in the brain, loss of relish, loss of savory impressions, loss of vision, uncleanness of healthy spirits, blepharitis, clogging of the eyes, swelling of the muffled shell of the eye, clouding, noise, noise.
Dichny system: dyspnoea, rhinitis, cough, bronchospasm, sinusitis, bronchitis, pharyngitis, lagging of the upper respiratory tract, burning of the upper respiratory tract, infection of the upper and lower respiratory tract.
Herbal system: dryness in mouth, glositis, dyspepsia, nudity, diarrhea, bloating (including blood), constipation, liver damage, anorexia, gastrointestinal disease, intestinal lump, flatulence, flatulence, gastritis apathy, cholestatic abdominal pain, abdominal pain, fulminant necrosis of the liver with a lethal end, pancreatitis, hepatitis, intestinal laxity, angioedema,
Shkirni pokrivi: psoriatic zmіni shkіri, shkіrnі alergіchnі reaktsії, visip, sverbіzh shkіri, fotosensibіlіzatsіya, buloznі pemphigus, alopetsіya, onycholysis, gіpergіdroz, angіonevrotichny nabryak, ekzema, acne, suhіst shkіri, zahvoryuvannya shkіri, dermatitis, eritema multiforme, Stіvensa-Johnson syndrome, psorіaz, psorіazopodіbnі dermatitis, epidermal necrolysis, kropivyanka.
Roche support system: malgia, arthritis, arthralgia, sudomi, muscle spasms, more in the back, more in children, osteoarthritis, more in cysts.
Sechostatev system: impairment of the function of nirok, proteinuria, nirkova deficiency, infection of secular nobles, embryo, impotence, weakening of libido, pollakiuria, polyuria, azotemia, recurrent dysfunction.
Інші: vrodzheny vice rozvitku arterіy, іhtіoz, enzymatic disfunktsіya, bіl in grudnіy klіttsі, more peripheral nabryak, slabkіst, torn down samopochuttya, nabryak, pіdvischena stomlyuvanіst, angіonevrotichny nabryak, rozvitok іnfektsіy, lihomanka, vіdhilennya od normalized pokaznikіv elektrokardіogrami, reaktsії gіperchutlivostі, gout, trauma, gіperglіkemіya , gіperkalієmіya, uratemіya, gіperholesterinemіya, gіperurikemіya, gіperlіpіdemіya, gіponatrієmіya, gіperproteїnemіya, pіdvischennya kontsentratsії bіlіrubіnu, kreatinіnu that pechіnkovih fermentіv in plazmі krovі, pіdvischennya aktivnostі gammaglutamіltransferazi, pіdvischennya rіvnya іmunoglobulіnu, pіdvischennya aktivnostі laktatdegіdrogenazi, luzhnoї phosphatase aspartatamіnotransferazi, alanіnamіnotransferazi, pіdvischennya aktivnostі lіpazi.

Vzaєmodiya trandolaprіla with іnshih speeches

The effect of trandolapril is mutually transient (additive type) of other hypotensive drugs, including methyldopa, terazosin, risperidone, diuretic drugs, nitrati, blockers in adolescent canals, beta-
Beta-adrenergic blockers slid vikoristovuvati at the same time with trandolapril only under the control of the drug.
Hypoglycemic drugs (insulin, hypoglycemic drugs for use)
Danі klіnіchnih doslіdzhen shown scho podvіyna blockade renіn-angіotenzin-aldosteronovoї sistemi Shlyakhov spіlnogo vikoristannya іngіbіtorіv angіotenzinperetvoryuvalnogo enzyme that blokatorіv retseptorіv angіotenzinu II abo alіskіren pov'yazana of bіlsh temple frequency rozvitku pobіchnih reaktsіy such gіperkalієmіya yak, arterіalna gіpotenzіya, znizhennya funktsії nirok (in In addition, there is a shortage of GOSTR nirkov) in the production of one drug, which is poured into the renin-angiotensin-aldosterone system.
The trandolapril effect relieves sympathomimetics, non-steroidal antiapaline substances (acetylsalicylic acid, ibuprofen, ketorolac, meloxicam, naproxen, hydroxycam and іnshі), estrogen, drugs, which activate the angiostenotensive system.
With a one-hour stagnation of angiotensin converting enzyme and preparations of gold (sodium aurothomalate), a nitrate-like reaction was indicated (boring, add blood to the surface of the face, blues, vomiting.
Trandolapril can be used for antihypertensive drugs for inhalational anesthesia.
Cyclosporine, high-grade diuretics (amiloride, spironolactone, triamterene and other), high-grade additives, substitutes for salt and potassium-containing foods in case of alcohol congestion with tranperolapril increased
Myelodepressants stimulate the development of lethal neutropenia and / or agranulocytosis in case of spinal congestion with trandolapril.
Procainamide and alopurinol in case of alcohol intake with trandolapril stimulate the development of neutropenia.
Antacids can reduce the bioavailability of trandolapril.
Trandolapril changes hypokalemia caused by diuretics and signs of hyperaldosteronism, alleviation of alcohol to the central nervous system, causing a toxic effect (for an increase in concentration).
In case of alcoholic vikorystanny trandolapril with tricyclic antidepressants, neuroleptics, the development of orthostatic hypotension is improved.
When spilny vikorystannі trandolaprіla with non-steroidal anti-pyretic methods, the development of the deteriorated function of nirok is increased.
In case of hemodialysis of high-flow membranes from polyacrylonitrile in ailments, who were treated with angiotensin converting enzyme, the anaphylactoid reactions were described. Victory of such membranes is necessary to be unique in the case of detection of angiotensin converting enzyme into the enzyme, we are sick, as it is used for processing.

Overdose

In case of overdosed with trandolapril, gostra arterial hypotension, stupor, shock, bradycardia, nirkova deficiency, water-electrolyte degradation, angioedema nagging develop.
lykuvannya: Outside skasuvannya abo change the dose of the drug; promivannya shlunka i intestine pereklad patsієnta in a horizontal position, retelny control arterіalnogo vise, holding on zahodіv zbіlshennyu ob'єmu tsirkulyuyuchoї krovі (Introduction fіzіologіchnogo rozchinu іnshih krovozamіnnikіv i), i scho pіdtrimuє symptomatic lіkuvannya: adrenalіn (vnutrіshnovenno abo pіdshkіrno) gіdrokortizon (vnutrіshnovenno ), antihistamines drugs. Specific antidote to trandolapril nevidomy. There is no information about the possibility of providing trandolapril or trandolaprilat for additional hemodialysis.

Pharmacological diya

Tarka - a combination of a drug, before the warehouse, which includes verapamil prolonged diy and trandolapril.

Trandolapril cethylovium ether (prodrug) of non-sulfhydric ACE inhibitor trandolaprilat.

Verapamil hydrochloride is a blocker of large calcium channels (BMCC).

trandolapril

Trandolapril induces the activity of the renin-angiotensin-aldosterone system and blood plasma. Renin is an enzyme that is synthesized by nirks and enters the bloodstream, de-viclating angiotensinogen into angiotensin I (an inactive decapeptide). It remains to be transformed into angiotensin II - a tense vasoconstrictor, which induces arterial tension and arterial pressure, as well as stimulation of the supraspinal muscles

Angiotensin II in blood plasma to reduce the concentration of angiotensin II in blood plasma, in order to supervise changes in vasopressor activity and secretion of aldosterone. If you want to change aldosterone insignificantly, protest, you can make a small increase in the concentration of calories in syrovatz in addition to the second sodium and water.

Reducing the concentration of angiotensin II for the mechanism of the ringing sound to produce an increase in the activity of the renin in the blood plasma. The main function of ACE is the ruining of kinin (bradykinin), which will be forced to dilute the power, to inactive metabolites. At the connection with the cym, the suppression of the ACE should be brought before the adduction of circulating and tissue concentrations of the calcareous-kinin system, as well as the enlargement of the sudins for the activation of the prostaglandin system. The whole mechanism, in a very frequent way, is the reason for the hypotensive effect of the ACE ingibitors and the cause of some side effects.

In ailments with arterial hypertension, the reduction of the arterial pressure in the position "lying" and "standing" without a compensatory increase in the frequency of the heart rate. OPSS go down, the heart wikid does not change, for it does not go down, the blood flow goes down, and the glomerular filtration speed does not change. Rizke the therapy was not supervised by the smarty ABs.

The antihypertensive effect of trandolapril manifests itself after 1 year when it is taken in the middle and takes a stretch, for 24 hours. With trivial therapy, a hypotensive effect is obtained. Trandolapril did not use the circadian profile of AT.

verapamil

Verapamil ingibu potik іonіv calcium through the "povіlі" calcіvі channels of membranes of smooth mucous membranes of sudin, which conduct і fast-felt cardiomyocytes. Verapamil viklikє reduction of the arterial grip, both in calm and in case of physical expansion of peripheral arterioles. As a result of a decrease in OPSS (postnavantage), the need for myocardium in energy and energy consumption decreases. Verapamil reduces the rate of myocardium. Negative inotropic effect of the drug can be compensated for by changes in OPSS. The heart index does not fall, for the blame of ailments with dysfunction of the lone scum.

Verapamil does not infuse into a nice regulation of heart activity, it does not block β-adrenergic receptors. bronchial asthma and bronchospastic creeps are not contraindicated until the sign of veralamil.

Tarka

In pre-adolescents on healthy volunteers, there was no sign of modulation between verapamil and trandolapril on the basis of pharmacokinetic parameters or AAS. Otzhe, synergy of two lykarskih zasobіv in imaging and modifying pharmacodynamic faults. In preschool children, the drug Tarka is reduced in AT in a larger world, and the drug is less offensive to the drug okremo.

Pharmacokinetics

trandolapril

soaktuvannya

When I was taken in the middle of the trandolapril I was getting wet. The absolute bioavailability is close to 10%. TC max in blood plasma is close to 1 year.

rospodil

The linkage of trandolapril with blood plasmas becomes close to 80% and does not lie in the concentration. V d trandolaprila close to 18 y. T 1/2<1 ч. При многократном применении C ss достигается примерно через 4 дня, как у здоровых добровольцев, так и у пациентов молодого и пожилого возраста с артериальной гипертензией.

metabolism

In the blood plasma, trandolapril undergoes hydrolysis until the active metabolism of trandolapril is established. TK max trandolaprilat in blood plasma to become 3-8 years. C max і AUC do not stay at all. The absolute availability of trandolaprilat when taking trandolapril is close to 13%. The ligament with blood cells should be at a concentration and varying from 65% (at a concentration of 1000 ng / ml) to 94% (at a concentration of 0.1 ng / ml). At an equally important level of concentration of effective T 1/2, trandolaprilate at once with a small fraction of the drug taken from 15 to 23 years old, which, immediately, appears to be connected with plasma and tissue APF.

vivedennya

Trandolaprylate volodya high spore to ACE. 9-14% of the dose of trandolapril is given in viglyadi trandolaprilat with nirkami. When the received trandolapril was administered, 33% of the drug was vivodilos with nirkami and 66% through the intestines. In an insignificant number, it is brought into the unconfined view through the nirki (less than 0.5%).

Nirkovy clearence of trandolaprylate variyuє from 0.15 to 4 l / year in fallow doses.

Children. The pharmacokinetics of trandolapril was not introduced into children under 18 years of age.

Lіtnі paciєnti. The concentration of trandolapril in blood plasma is improved in young patients with arterial hypertension (older than 65 years). However, the plasma concentration of trandolaprylate and its ACE-inhibiting activity in patients with arterial hypertension and young patients is the same. Pharmacokinetics of trandolapril and trandolaprilat, as well as ACE-inhibiting activity in young patients in both articles are the same.

Nirkov's lack. In healthy volunteers in patients on hemodialysis and QC<30 мл/мин плазменная концентрация трандолаприлата примерно в 2 раза выше, а почечный клиренс снижен приблизительно на 85%. Пациентам с почечной недостаточностью рекомендована коррекция дозы препарата.

Pechinkova lack. In patients with healthy volunteers in patients with alcoholic liver cirrhosis, the plasma concentration of trandolapryl and trandolaprylate increases 9 or 2 times, apparently, but the ACE-inhibiting activity does not occur. Patients with pechinkal deficiency may have lower doses of the drug.

verapamil

soaktuvannya

Closely 90% of the taken internal dose of verapamil quickly gets wet in the small intestine. Bioavailability to become only 22% through the "first pass" through the oven. With repeated retention of the average, the bioavailability can be up to 30%. Acceptance of їzhі does not pour on the bioavailability of the drug. TK max to become 4-15 years. The maximum plasma concentration for norverapamil is reached approximately in 5-15 years after taking the drug.

rospodil

C ss at bagatorazovy zasosuvannі 1 time / day to reach in 3-4 days. The connection with blood plasmas becomes close to 90%.

metabolism

One of the 12 metabolites that occur in the section, є norverapamil, the pharmacological activity of which becomes 10-20% of such verapamil; this part becomes 6% of the given drug. C ss norverapamil і verapamilu podіbnі.

vivedennya

T 1/2 when re-storing the door in the middle of the 8th year. 3-4% of the dose should be taken with nirkami in an unchanged viglyad. Metabolism is carried out by nirkami (70%) and through the intestines (16%).

Pharmacokinetics in special clinical forms

Pharmacokinetics of verapamil does not change in case of impaired function of nirok. The deterioration of the function of nirok is not infused into the vivedennya of verapamila.

Bioavailability and T 1/2 verapamil increases in patients with liver cirrhosis. However, the pharmacokinetics of verapamil can be lost without changes in patients with compensated liver damage.

Tarka

There is no information about the pharmacokinetic interaction between verapamil and trandolapril / trandolaprylate, that is, the pharmacokinetics of both drugs in case of combined congestion are not recognized as such in case of such signs.

showing

- Essential arterial hypertension (in patients, combined therapy is indicated).

dosage regimen

grow up priznachayut 1 caps. 1 time / day The drug should be taken all the way through, but it shouldn't be wrong. The capsule is cooked with a tsilimi, washed down with water.

Pobichna diya

Lower induction of side effects, as I may have any connection with the medication taken Tarka every hour of the day of the day.

often (from ≥1 / 100 to<1/10): головная боль, головокружение.

often (from ≥1 / 100 to<1/10): AV-блокада I степени.

(From ≥1 / 100 to<1/10): кашель.

Damage from the side of the shlunkovo-intestinal tract:(From ≥1 / 100 to<1/10): запор.

Headquarters: often (from ≥1 / 100 to<1/10): астения.

Krym reactions, emerging from the hour of the schoolchildren, in the process of the development of the bully, the onset of side effects:

Infectious diseases: bronchitis.

leukopenia, thrombocytopenia.

Damage from the side of the exchange of speech: hyperkalієmiya.

Disruption of the psyche: anxiety, sleeplessness.

Damage to the side of the nervous system: deterioration of the condition, paresthesia, drowsiness, unpredictability.

Damage from the side to the organ zoru: ruined zoru, "shroud" before ochima.

labyrinthsruin: zamorochennya.

Damage from the side of the heart-vascular system: povna AV block, angina pectoris, bradycardia, vidchuttya
sercebitty, tachycardia.

arterial hypotensiveness, hyperemia of shkirny curves, heat up the blood to the shkiri of disguise.

Damage from the side of the dyshal system, organs of the breast and middle: zadishka, nasal congestion.

Damage from the side of the shlunkovo-intestinal tract: nudity, diarrhea, dryness of the mucous membrane of an empty company.

Stevens-Johnson syndrome, angioedema, sverbіzh shkіri, visip.

Damage from the side of the skeletal tissue and the resulting tissue: arthralgia, mialgia.

pollakiuria, polyuria.

The collar on the side of the statuary organs: erectile dysfunction.

Headquarters: lump in the breasts, bulges, weakness.

adjustment of LDH activity, activity of pool phosphatase, concentration of creatine, concentration of serovine, activity of ALT, AST blood.

verapamil:

hypersensitivity.

Damage to the side of the endocrine system: hyperprolactinemia.

Destruction from the side of the heart: AV-blockade of I, II, III stages, sinus node zupinka ("sinus-aresht"), heart failure.

hyperplasia is clear, abdominal pain, abdominal discomfort.

Damage from the side of the shkiri and the pediatric fabrics: kropiv'yanka.

Damage from the side of the milk: gynecomastia, galactorrhea.

Є kіlka okremikh, occasionally, about the growth of parallich (tetraparesis), tied with spilny
verapamil and colchicine. This could be linked to the penetration of colchicine through the hematoencephalic bar in connection, with the suppression of the activity of the CYP 3A4 enzyme and P-glucoprotein along with the verapamil. Sleeping is not recommended for colchicine and verapamil.

Additional significant side effects, which were spontaneous in case of stagnation trandolaprila:

Damage from the side of the blood and lymphatic system: agranulocytosis.

Damage from the side of the immune system: hypersensitivity.

Damage from the side of the shlunkovo-intestinal tract: bloating, abdominal pain, pancreatitis.

Damage from the side of the shkiri and the pediatric fabrics: alopecia.

Headquarters: feverish woman.

Lower pererakhovanі pobіchnі efekti, such as bully zaestrovanі at stasosuvannі іnshikh іngіbіtorіv APF:

Damage from the side of the blood and lymphatic system: pancytopenia.

Damage to the side of the nervous system: less damage to cerebral blood circulation.

Destruction from the side of the heart: myocardial infarction, heart zupinka.

Destruction from the side of the Sudin: hemorrhagic in the brain.

Damage from the side of the herbal system:іntestіnalny angіoneuroticnіbryak.

Damage from the side of the shkiri and the pediatric fabrics: bagatoforma erythema, toxic epidermal necrolysis.

Destruction from the side of the nirok and secular nobles: gostra nirkova lack.

Laboratory and instrumental data: Decrease in hemoglobin and hematocrit.

Prototype

- angioedema in the anamnesis, dressings with the admission of ingibitoriv ACE;

- slumpy and idiopathic quill of Kvinke;

- cardiogenic shock;

- chronic heart failure of III and IV functional class for the NYHA classification;

- AV-blockade of the II і III stage (for a vignette of ailments with a piece of water rhythm);

- sinoatrial blockade;

- myocardial infarction gostry;

- Prototype (for a vignette of ailments with piece water rhythm);

- Gostra sertseva lack of;

- fibrillation / thrill of the atrium in ailments with Wolff-Parkinson-White syndrome;

- bradycardia is rotated;

- severe arterial hypertension;

- severely damaged function of nirok (CC<30 мл/мин);

- availability;

- the period of the year of the breast;

- up to 18 rockets (efficiency and safety is not established);

- one-hour reception with colchicine and dantrolene;

- aortic stenosis or obstruction of the lateral tract of the lone slut;

- hypertrophic obstructive cardiomyopathy;

- overnight consumption of beta-blockers (i.v.) (for
a vignette of ailments, like being caught up in an intensive therapy);

- lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome (a drug to revenge lactose);

- sensitivity is adjusted to any component of the drug, or to any other ACE inhibitor.

Z protection: hypercalm; violating the function of the liver
і / abo function of nirok (CC more than 30 ml / min); under systemic
ailments with a good tissue (including systemic chervonia vovchak, scleroderma), especially on a lіkuvannya
corticosteroids and antimetabolites; development of agranulocytosis and neutropenia; imputation of cystic carcinoma hematopoiesis, AV-blockade of the I stage; bradycardia; arterial hypertension; patients who suffer from lower blood volume (including diarrhea, blues), bilateral stenosis of the nirkoval arteries, stenosis of the artery of a single nyrka (for example, when transplantation), miastenia gravis, Lambert-Iton syndrome, the importance of Duchenne dystrophy); at the children who are looking for children from the kitchen salt; before the procedure for apheresis of lipoproteins of low concentration (LPNS), one hour
carrying out desensitizing therapy of allergens (for example, with a spit of often peretin) - risky development of anaphylactoid reactions (in some cases - life-threatening); surgical involvement (general anesthesia) - risky development of the overworld
Decrease in arterial vise, hemodialysis from high-flow polyacrylonitrile membranes - development of anaphylactic membranes
reactions.

Stagnation during vaginosis and breastfeeding

availability

Bezpeka for the drug Tarka has not been established in vagіtnykh. Zastosuvannya with vaginosti is contraindicated.
Є okremi caution about the development of hypoplasia legends in newborns, catching the intrauterine development of the fetus, open arterial duct and hypoplasia of the cranial cysts
vaginosti.

There is no evidence of teratogenicity or abdominal / fetotoxicity of the effects of ACE in the first trimester of vaginosis, but this is not possible. For patients who plan to have a stay, it is necessary to indicate hypotensive drugs, for those who do not have a drink, the need for an hour of vaginal capacity has been brought, for the sake of quiet problems, if the need for an APF is needed. As long as the vagina is insisted in the process of receiving an ACE engineer, it is necessary to securely pin it and signify a greater likelihood.

Seemingly, in case of stagnation of angibitoris ACE in another and third trimester of vaginosis, it may be fetotoxic
diyu drugs (impaired function of nirok, lack of water, control of the ossification of cranial cysts) and toxic infusion on a newborn (nirkova deficiency, arterial hypotension, hypercalculation). In case of trandolapril storage, repairing for another trimester of vaginosity, an ultrasound assessment of the function of the fetus and the cranium is recommended. Newborns, whose mothers have taken an ACE Ingibitorium for an hour, have been guilty of overreaching a drug for the inclusion of arterial hypotensives.

Period of breastfeeding

Zastosuvannya drug Tarka in the period of chest vigodovannya is contraindicated. Verapamil is seen in breast milk.

Dani about the stasis of trandolapril during the period of breastfeeding during the day. Sliddavaty pryvagu medications with vivchenny profile of safety for this group of patients, especially when new-born and premature babies are born.

Zasosuvannya in children

Prototype testimony in a childish and adult life up to 18 years.

Overdose

In clinical patients, the maximum dose of trandolapril was 16 mg. At the same time, there was no sign of their intolerance.

symptoms, wiklican verapamil: Decreased arterial vise, AV blockade, bradycardia, asystole. Recorded deaths from overdose.

In case of an overdose of the drug Tarka, symptoms, wiklican trandolapril: Virazhena reduction of arterial grip, shock, stupor, bradycardia, electrolyte damage, nirkova lack.

lykuvannya: symptomatic. Treatment of overdosing with verapamil includes parenteral administration of calcium preparations, intake of beta-adrenergic drugs, and preparation of a slurry. I’ll look around at the hope of getting wet to the prolonged preparation, after controlling the patient’s body for 48 years; In the whole period, the hospital can be known. Verapamil is not seen in hemodialysis.

likarska vzaєmodiya

Vzaєmodii, supplemented with verapamil

Doslіdzhennya in vitro to indicate that verapamil is metabolized before the enzymes CYP3A4, CYP1A2, CYP2C8, CYP2C9 and CYP2C18.

Verapamil є Ingibitor CYP3A4 and P-glucoprotein. Clinically significant interrelation is indicated in case of a one-hour consumption of CYP3A4 ingibitors, in the case of a rapid increase in the development of verapamyl in blood plasma, at that time, as a concentration of CYP3A4 induction cells was observed. Apparently, with a one-hour stagnation of some of them, there is a possibility of this interaction.

At the table of publicity data on likarskoy vzaєmodii, amoused by the wicked verapamil.

At the table of public information on likarskoy relationship, zoomed with verapamil.

You can see the interaction of verapamil

antiarrhythmic disorders and beta-blockers more power than an unpleasant inflow into the heart-vascular system (more AV-blockade, more lower heart rate, development of heart failure and more strength of hypotension).

With a one-hour stasis hinidin with the drug Tarka, it will be hypotensive. Patients with hypertrophic obstructive cardiomyopathy can develop a variety of legends.

With a one-hour stasis antihypertensive disorders, diuretics and vasodilators with the drug Tarka, it will be hypotensive.

With a one-hour consumption with the drug Tarka prazosin, terazosin will accept the hypotensive action.

With a one-hour consumption with the drug Tarka deyaki preparations for VIL-infection (ritonavir), To increase the metabolism of verapamil, to increase the concentration in blood plasma to an increase. With a one-hour zasosuvannі dose, the verapamіlu is guilty of a reduction.

With a one-hour stasis carbamazepine With the drug Tarka, the level of carbamazepin in the blood plasma is increased, so that we can supervise the carbamazepin with a side effect - diplopia, headache, ataxia or obstructions.

With a one-hour stasis lithia With the drug Tarka, neurotoxicity of lithium increases.

With a one-hour stasis rifampicin

colchicineє a substrate for the isoenzyme CYP3A4 and P-glucoprotein. It seems that verapamil induces the activity of the isoenzyme CYP3A and P-glycoprotein. Therefore, with a one-hour consumption of verapamil, the concentration of colchicine in the blood can be significant. The use of the drug is contraindicated.

For patients with ІХС, if verapamil is assigned to the reception dantrolene boules of hypopercal hyperplasia and the reduction of myocardial function. The use of drugs is contraindicated.

With a one-hour stasis sulfinpyrazone With the drug Tarka, you can change the hypotensive effect of verapamil.

With a one-hour consumption with the drug Tarka effective muscle relaxant you can do it.

With a one-hour stasis acetylsalicylic acid as an antiplatelet agent With verapamil, the strength can be increased to bleeding.

With a one-hour consumption of verapamil rіven ethanol in the blood plasma to move.

Overnight stagnation with verapamil can lead to an increase in syrovat ryvnya simvastatin / atorvastatin / lovastatin.

Patients who accept verapamil, likuvannya Ingibitor HMG-CoA reductase(Tobto simvastatin / atorvastatin / lovastatin) should be taken from the lowest possible doses with progressive adjustments in the course of therapy. If it is necessary to recognize verapamil patients, if they already perceive the HMG-CoA reductase inhibitors, then they should look over and lower their doses, based on the concentration of cholesterol in the blood.

Fluvastatin, pravastatin and rosuvastatin are not metabolized by the CYP3A4 isoenzyme;

Vzaєmodії, equipped with trandolapril

diuretics For some hypotensive drugs, you can help improve the hypotensive effect of trandolapril.

Calcium-sensitive diuretics (spironolactone, amiloride, triamterene), or preparations of calories, cause hypersensitivity reactions, especially in patients with nirkov deficiency. Trandolapril can reduce the loss of calories in case of alcohol consumption with thiazidnimidiuretics.

Overnight stasis of trandolapril hypoglycemic diseases (insulin or oral hypoglycemic diseases) You can achieve a hypoglycemic effect and bring the risk of hypoglycemia to the fore.

Trandolapril can be lost vivedennya lithia... Necessary control of the level of lithium in syrovatz blood.

інші vzaєmodії

When the hemodialysis of high-flow membranes from polyacrylonitrile is stagnant for an hour in ailments, who have eliminated the ingibitoria of ACE, anaphylactoid reactions have been described. In patients who receive the ACE Ingibitorium, there is a unique storage of membranes of a similar type for an hour of carrying out hemodialysis.

Non-steroidal anti-epileptic drugs (NSAIDs) can change the hypotensive effect of trandolapril, that is, if an NSAID is used before trandolapril therapy, any necessary congrol of AT is necessary.

Angibitorium ACE can be used for hypotensive activity for anesthesia.

Allopuripol, cytostatics, immunosuppressive drugs and systemic corticosteroids, or procainamide can increase the development of leukopenia in patients with ACE inhibitors.

Automation can reduce the availability of ACE Ingibitors.

The antihypertensive effect of ACE ingibitoris can be reduced in case of symptomatic symptoms of sympathomimetics. Such vipadkas require retail monitoring.

Both in times of stagnation of any other hypotensive disorders, as well as antipsychotics or tricyclic antidepressants, the development of orthostatic hypotensives.

Mind that term zberigannya

The drug is available for a prescription.

Mind that term zberigannya

At a temperature of 25 ° C. Keep out of the reach of children. Term of attachment - 3 rock.

Stagnation in case of deterioration of the function of the liver

To protect the drug should be given to patients with damaged liver function.

Zasosuvannya in case of destructive functions of nirok

Prototypically shown is the use of the drug for severe impairment of the function of nirok (CC<30 мл/мин.).

With protection a drug for bilateral stenosis of the nirkovy arteries, stenosis of the artery of the single nyrka, the stage of transplantation of nirok.

special requests

Damaged function of the stove

Oscillations of trandolapril are metabolized in the liver with the statements of an active metabolism, in the patients with the damaged liver function, the drug should be considered for the protection and in the case of the drug prevention.

arterial hypothesis

In ailments with persistent arterial hypertension after taking the first dose of trandolapril, or an increase in the dose of the drug, the development of hypotension was indicated, which was accompanied by clinical symptoms. The risk of hypotension is effective in the case of impaired water-electrolyte balance as a result of trivial therapy with diuretics, intercourse with salinity, dialis, diarrhea or blues. In such patients, before the ear of therapy with trandolapril, it is necessary to prescribe the therapy with diuretics and to memorize the BCC and / or instead of sodium.

Agranulocytosis / admission of cystic carcinoma hematopoiesis

In case of treatment with ACE inhibitors, a description of the effects of agranulocytosis and the adjustment of the function of the cystic brain is described. Quite often
to develop among ailments because of the deterioration of the function of nirok, especially with the systemic incapacitation of the resulting fabric. Have
such patients (for example, systemic chervonia vovchak or scleroderma) are regularly monitored
the number of leukocytes in the blood and instead of the blood in the section, especially in the case of impaired function of nirok, drug use with corticosteroids and antimetabolites.

angioedema

Trandolapril may have an ankyoneurotic swelling of the face, tongue, pharynx and / or larynx. Є Dani about those who often cause angioeurotic behavior in children of the Negro race.

On the lіkuvannya іngіbіtorov ACE also boiled in vіdlіkіvіnі vіdnіkіvіkіvіkіvіku otbryaty intestin. Such a possibility is followed by the development of pain in the abdomen (supravodzhuyutsya tediousness or bluishness, or without symptoms) on the tlі of trandolapril.

Sertseva lack

Before the warehouse of the drug Tarka, verapamil should be included, which is why the combination of symptoms of serum deficiency is common in patients with severe dysfunction of the louse (for example, due to the fractional wikidum of the louse is less than 30%, the chronicity of the disease is less than 30%). і in ailments, be a stage of dysfunction of a lone slunk, because the stench is to get rid of beta-blockers.

Special groups of patients

The drug Tarka was not used in children under 18 years of age, so it is not recommended to use it in the whole group.

Zapobizhnі come in zagalny character

For people with ailments, such as diagnosing diuretics (especially in the first days of treatment), because of the sign of trandolapril or an increase in the dose, it helps to reduce the arterial pressure.

Damaged function of nirok

In case of severe ailments on arterial hypertension, it is necessary to assess the function of nirok. Patients with CC less than 30 ml / hr require lower doses of trandolapril.

In ailments with impaired function of nirk, chronic heart failure, bilateral stenosis of nirk arteries and stenosis of the artery of a single nirka (for example, due to transplantation) In people suffering from arterial hypertension, without impaired function of the kidneys, when trandolapril is recognized in combination with a diuretic, it can be promoted by the adduction of nitrogen in the blood and serum creatine.

hyperkalієmіya

In patients with arterial hypertension, especially for impaired function of nirok, the drug Tarka can be affected by hypertension.

Surgery / general anesthesia

In case of operative involvement, or if anesthesia is performed on the basis of drug intake, in case of arterial hypertension, trandolapril can block the approval of angiotensin II, coupled with the compensatory wikid renin.

desensitization

For patients who receive the ACE Ingibitories for an hour on the course of desensitization (for example, a spit of overturned often), there are also a number of powerful developments that are threatening for the life of anaphylactic reactions.

LPNSh-apheresis

When LPNSH-apheresis is carried out in patients who recognize the ACE angiitis, the development of life-threatening anaphylactic reactions is promoted.

Inflow to the building of keruvati by motor transport and pratsyuvati with mechanisms

It is necessary to take care of the care in case of carriage by motor transport and those who are busy with the other potentially unsafe types of activity, as well as require an increased concentration of respect and speed of psychomotor reactions, especially on the cob. The drug Tarka can be taken as a substitute for alcohol in the blood and for a healthy life. The link with the cym of efficacy to alcohol can be overpowering.