Артериальная гипертензия (пациентам, которым показана комбинированная терапия).
Противопоказания
Повышенная чувствительность к действующим или вспомогательным веществам препарата; повышенная чувствительность к другим производным дигидропиридина; - беременность; период грудного вскармливания; обструктивные заболевания желчевыводящих путей; тяжелая артериальная гипотензия (систолическое АД менее 90 мм рт.ст.); - обструкция выходящего тракта левого ...
Артериальная гипертензия (пациентам, которым показана комбинированная терапия).
Противопоказания
Повышенная чувствительность к действующим или вспомогательным веществам препарата; повышенная чувствительность к другим производным дигидропиридина; - беременность; период грудного вскармливания; обструктивные заболевания желчевыводящих путей; тяжелая артериальная гипотензия (систолическое АД менее 90 мм рт.ст.); - обструкция выходящего тракта левого желудочка (в том числе и высокая степень аортального стеноза); гемодинамически нестабильная сердечная недостаточность после перенесенного острого инфаркта миокарда; тяжелые нарушения функции печени (класс С по классификации Чайлд-Пью); шок (включая кардиогенный шок); - одновременное применение с алискиреном у пациентов с сахарным диабетом или нарушением функции почек (скорость клубочковой фильтрации менее 60 мл/мин/1,73 м2); одновременное применение с ингибиторами ангиотензин- превращающего фермента у пациентов с диабетической нефропатией; возраст до 18 лет (эффективность и безопасность не установлены).
Способ применения и дозы
Внутрь, 1 раз в сутки, вне зависимости от времени приема пищи.
Препарат ТелсартанАМ может назначаться пациентам, получающим те же дозы амлодипина и телмисартана в виде отдельных таблеток, для удобства терапии и увеличения приверженности лечению. Препарат ТелсартанАМ может назначаться пациентам, у которых применение одного амлодипина или одного телмисартана не приводит к адекватному контролю АД. Пациенты, принимающие амлодипин в дозе 10 мг, у которых отмечаются нежелательные реакции, ограничивающие прием препарата, например, периферические отеки, могут перейти на прием комбинированного препарата в дозе 5 мг + 40 мг 1 раз в сутки, что позволит уменьшить дозу амлодипина, но не снизит общее антигипертензивное действие.
Лечение артериальной гипертензии у пациента может начинаться с применения препарата ТелсартанАМ в том случае, когда предполагается, что достижение контроля АД с помощью какого-либо одного препарата маловероятно.
Обычная начальная доза препарата ТелсартанАМ – 5 мг + 40 мг 1 раз в сутки. Пациенты, у которых необходимо более значительное снижение АД, могут начинать прием препарата ТелсартанАМ в дозе 5 мг + 80 мг 1 раз в сутки. Если, по крайней мере, через 2 недели лечения потребуется дополнительное снижение АД, доза препарата может быть постепенно увеличена до максимальной дозы 80 мг + 10 мг 1 раз в сутки.
Препарат ТелсартанАМ может применяться вместе с другими гипотензивными препаратами. Нарушения функции почек. Опыт применения телмисартана у пациентов с тяжелой почечной недостаточностью или пациентов, находящихся на гемодиализе, ограничен. Таким пациентам рекомендована более низкая начальная доза телмисартана – 20 мг в сутки. Для обеспечения указанного режима дозирования рекомендуется применение монокомпонентных препаратов телмисартана в дозировке 20 мг или 40 мг с риской.
Нарушения функции печени. У пациентов с нарушениями функции печени легкой и умеренной степени тяжести (класс А и В по классификации Чайлд-Пью) препарат ТелсартанАМ должен применяться с осторожностью. Доза телмисартана не должна превышать 40 мг 1 раз в сутки.
Побочное действие
Головокружение; периферические отёки.
Перечень всех побочных действий представлен в инструкции по медицинскому применению.
Передозировка
Случаи передозировки не выявлены. Возможные симптомы передозировки складываются из симптомов со стороны отдельных компонентов препарата.
Лечение: гемодиализ не эффективен, амлодипин и телмисартан не удаляются из организма при его проведении. Требуется контроль за состоянием пациента, терапия должна быть поддерживающей.
Взаимодействие с другими лекарственными средствами
Ортостатическая гипотензия может усиливаться этанолом, барбитуратами, наркотическими средствами или антидепрессантами. Требуется соблюдать особую осторожность при применении с ингибиторами изофермента CYP3A4, индукторами изофермента CYP3A4, симвастатином, иммуносупрессантами, силденафилом, такролимусом, альфа-1- адреноблокаторами, нейролептиками, препаратами лития, трициклическими антидепрессантами, средствами для общей анестезии, антиаритмическими средствами,вызывающими удлинение интервала QT, противовирусными средствами (ритонавир), препаратами кальция, кортикостероидами (минерало- и глюкокортикостероиды), препаратами, действующими на ренин-ангиотензин-альдостероновую систему, нестероидными противовоспалительными препаратами, калийсберегающими диуретиками и заменителями соли, содержащей калий, петлевыми и тиазидными диуретиками, дигоксином, литием, другими гипотензивными средствами, системными кортикостероидами.
Особые указания
Несмотря на отсутствие у БМКК синдрома «отмены», прекращение лечения амлодипином желательно проводить, постепенно уменьшая дозу препарата. Одновременное назначение ингибиторов АПФ, АРА II или алискирена повышает риск развития гипотензии, гиперкалиемии и нарушения функции почек (включая острую почечную недостаточность). У пациентов с сахарным диабетом с дополнительным сердечно-сосудистым риском (то есть сопутствующей ишемической болезнью сердца (ИБС)), риск фатального инфаркта миокарда и внезапной сердечно-сосудистой смерти может быть увеличен при лечении гипотензивными средствами, такими как АРА II и ингибиторами АПФ.
Влияние на способность управлять автомобилем и движущимися механизмами
Следует принимать во внимание, что во время лечения могут отмечаться такие нежелательные эффекты, как обморок, сонливость или головокружение. Поэтому во время управления автотранспортом или механизмами следует соблюдать осторожность.
Условия отпуска
По рецепту.
Полная информация представлена в инструкции по медицинскому применению.
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