Triplixamamamamamamamamamamamham medicine 5mg/10mg Servier Treatment of hypertension (30 tablets)

Unstable hemodynamic heart failure after acute myocardial infarction.

Simultaneously used with Sacubitril/Valsartan.

Serial treatments lead to blood contact with negative charge surfaces.

narrowing of the kidney artery on both sides or significant artery stenosis leads to kidney function on one side.

Be cautious when using

All warnings related to each component, listed below, should be applied in the fixed dose combination of Triplixamamamamamamamamamamamamamamamamamamplaret.

Warning

lithium

Combining lithium with combination of perindopril/indapamid is usually not recommended.

Dual maple pills Renin - Angiotensin - Aldosteron (RAAS)

There has been evidence of simultaneous use of angiotensin -shaped enzyme inhibitors, angiotensin II or Aliskiren receptor inhibitors that increase the risk of hypotension, hyperkalemia and impaired renal function (including acute renal failure). Therefore, the Dual Renin - Angiotensin - Aldosteron Solder System by combining Angiotensin -shifting enzyme inhibitors with Angiotensin II receptor inhibitors (ARB) or Aliskiren is not recommended.

If the double closed maple therapy is really necessary, this treatment should only be performed under the supervision of health experts and patients should be closely monitored for kidney, electrolytes and blood pressure.

Do not use the enzyme inhibitors in the form of angiotensin shifting and angiotensin II receptor inhibitors in patients with diabetes.

Potassium diuretics, potassium supplements or alternative salts contain potassium

Combining Perindopril with potassium diuretic, potassium supplements or replacement salts containing conventional potassium is not recommended.

Neutral leukemia/grain leukemia/thrombocytopenia/anemia

Neutral leukemia/grain leukemia, thrombocytopenia and anemia have been reported in patients using angiotensin -shaped enzyme inhibitors. In patients with normal renal function and no risk factors, neutrophils are rarely occurring.

Perindopril should be used with special caution in patients with glue -generating hematopathy, being treated with immunosuppressive drugs, being treated with Allopurinol or Procainamid, or the combination of these complex elements, especially if there has been impaired renal function before.

Some patients will develop severe infections, but in some cases, they do not respond to strong antibiotics. If Perindopril is used in these patients, the number of white blood cells should be checked periodically and the patient should be instructed on how to report the signs of infection (for example, sore throat, fever).

Aortic hypertension

There is the risk of increasing the risk of hypotension and renal failure when the patient has narrowed kidney narrowing on both sides or the kidney stenosis leads to the kidney function on the one hand is treated with inhibition of enzyme. Treatment with diuretics may be a contributing factor. Kidney failure may even appear with slight changes in serum creatinine in patients with kidney stenosis on one side.

Hypersensitivity/eagles

Facility on the face, limb, lips, tongue, subjects and/or larynx have been reported rare in patients treated with angiotensin -shift enzyme inhibitors, including perindopril. This reaction may appear at any time during treatment.

In such cases, it is advisable to stop using Perindopril in time and start the appropriate monitoring process, continue until the symptoms appear completely retreat. During this period, the symptoms of facial swelling and lips are usually stopped without treatment, even if antihistamine drugs can effectively reduce symptoms.

Thiche related to the subject can be fatal. When symptoms of edema in the tongue, bar or larynx appear, it can lead to obstruction of the airway, appropriate measures including subcutaneous injection of the Epinephrine solution 1/1000 (0.3 ml - 0.5 ml) and/or or measures to ensure good airways should be applied promptly.

Black skin patients have been reported to have a higher rate of angioedema than other patients when using angiotensin -shifting enzyme inhibitors.

Patients with a history of angioedema are not related to the treatment of enzyme inhibitors that can increase the risk of angiotic angiotensin when using angiotensin -shifting enzyme inhibitors.

The gastrointestinal angioedema has been recognized as rare in patients treated with enzyme inhibitors in the form of angiotensin. These patients appear symptoms of abdominal pain (with or without nausea or vomiting); In some cases, there is no front edema and C1 esterase concentration is normal. The diagnosis of angioedema includes abdominal CT scan, or ultrasound, or by surgery and loss of symptoms after stopping taking an angiotensin -shaped enzyme inhibitor.

Differentiate diagnosis of gastrointestinal angioedema in patients using enzyme inhibitors in the form of angiotensin shifting abdominal pain.

Combining Perindopril with Sacubitril/Valsartan is contraindicated due to increased risk of angioedema. Sacubitril/Valsartan is only started to use 36 hours after the end of Perindopril's last dose.

If treated with Sacubitril/Valsartan, Perindopril therapy is only started 36 hours after the last dose of Sacubitril/Valsartan. The simultaneous use of NEP inhibitors (such as racecadotril) and enzyme inhibitors may also increase the risk of angioedema. Therefore, it is necessary to evaluate benefits - risks carefully before starting treatment with NEP inhibitors (such as racecadotril) on patients taking Perindopril.

Simultaneously used with MTor inhibitors (such as syrolimus, Everolimus, Temsirolimus)

Patients with simultaneous use with MTor inhibitors (such as syrolimus, Everolimus, temsirolimus) may increase the risk of angioedema (such as respiratory or tongue, with or without respiratory decline).

Anaphylactic reactions in the sensitive process

Individual reports in patients who have experienced life -threatening anaphylaxis when using angiotensin -shifting enzyme inhibitors in the sensitive solution to the venom of some insects (bees, bees).

Angiotensin -shifting enzyme inhibitors should be used with caution in allergens who have been treated sensitive, and avoid used in patients who are using therapeutic immunity. However, these reactions can be prevented by temporarily stopping the angiotensin -shifting enzyme inhibitors within 24 hours before treating patients who need both angiotensin -shaped enzyme inhibitors and sensitive solutions.

Anaphylactic reactions in the process of filtering low density lipoprotein (LDL)

Anaphylactic reactions that are life -threatening are rarely seen in patients using angiotensin -shifting enzyme inhibitors in the process of filtering low density lipoprotein as dextran sulphate. These anaphylactic reactions can be avoided by temporarily stop taking enzyme inhibitors in the form of angiotensin before each filter.

Patient with blood viaer

Anaphylactic reaction has been reported in patients with high -speed filters (for example, An 69®) is treated simultaneously with enzyme inhibitors in the form of angiotensin. In these patients, it is advisable to consider the use of other blood membranes or use other anti -hypertension drugs.

Increase Aldosterone Tien Phat

Patients with hypertrophy of primary aldosterone are generally not responding to anti -hypertension drugs operating through inhibition of the Renin - Angiotensin system. Therefore the use of this drug is not recommended.

Pregnant women

Do not start using enzyme inhibitors in the form of angiotensin during pregnancy. Unless it is necessary to continue treatment with enzyme inhibitors in the form of angiotensin, patients intend to become pregnant, they should change to treatment with other anti -hypertension drugs and safety when used for pregnant women. When diagnosed with pregnancy, it is advisable to stop taking angiotensin -shifting enzyme inhibitors immediately and should start replacement treatment with another medication if appropriate.

Hepatitis

When liver failure, thiazid diuretics and thiazid medications can cause liver's brain disease. Should stop diuretics immediately if this happens.

Sensitive to light

Cases of light sensitivity when using thiazid diuretics or thiazid varieties have been reported. If light -sensitive reactions occur during treatment, stop the drug. If the use of diuretics is really necessary, patients should avoid the skin in contact with sunlight or artificial UVA rays.

Precautions when using

kidney failure

In these patients medical monitoring include potassium and creatinine control, after 2 weeks of treatment and every 2 months during stable treatment. Renal failure is reported mainly in patients with severe heart failure or have a renal failure platform including kidney stenosis.

This drug is not recommended in the case of kidney artery narrowing on both sides or only one kidney function.

The risk of arterial hypotension and/or kidney failure (in case of heart failure, dehydration and electrolyte ...). The significant disorder of the Renin - Angiotensin - Aldosteron system has been observed with Perindopril when dehydrated and clearly electrolyte (salt diet or prolonged diuretic treatment), in patients with initial blood pressure, in case of kidney stenosis, congestor or cirrhosis with edema and ascites.

This system inhibitors with an enzyme inhibitor in the form of angiotensin can cause sudden hypotension and/or increase plasma creatinine levels, indicating impaired renal function, during the first time of treatment and in the first 2 weeks of treatment. In some cases, this becomes acute at the beginning, although rare, and onset at different times.

In these cases, treatment should be started at low doses and gradually increase the dose. In patients with heart anemia and cerebrovascular disease, excessive hypotension can cause myocardial infarction or stroke.

thiazid diuretics and thiazid diuretics are completely effective when normal kidney function or slight decline (plasma creatinine levels below 25 mg/l, meaning 220 µmol/l in adults).

In the elderly, plasma creatinine levels should be adjusted according to age, weight and gender.

Decreased secondary blood volume caused by dehydration and salt caused by diuretic at the beginning of the treatment may cause reduced filtration of glomerular filtration. This can lead to increased blood urea and plasma creatinine. This transient kidney function fails to cause consequences in individuals with normal kidney function but it can worsen the previous impaired renal function.

Amlodipin can be used in patients with kidney failure in normal doses. Change plasma amlodipine concentration is not related to renal failure.

The effect of combining in Triplixam has not been tested in patients with renal abnormalities. In patients with renal failure, the dosage of Triplixam should respect the dose of the ingredients when drinking individually.

Hypotension and dehydration and sodium

There is a surprising risk of hypotension when there is a previous sodium loss (especially in patients with kidney artery stenosis). Therefore, the whole body test should be conducted when there are clinical signs of dehydration and electrolytes, which may appear when diarrhea or vomiting. Regular monitoring of plasma electrolytes should be conducted in these patients.

Significant hypotension may need an isotonic intravenous line.

Hypotension is not contraindicated to continue the treatment. After re -establishing the volume of circulatory and blood pressure, treatment may start again or by reducing the dose or with only one ingredient.

Sodium concentration decline may have no initial symptoms, so regular testing should be conducted. Should conduct tests more often in elderly patients and cirrhosis.

Any treatment with diuretics can cause sodium hypothermia, sometimes very serious consequences.

Hypoglycocytic hypoglycemia, accompanied by a decrease in blood volume may be the cause of dehydration and hypotension. The loss of chlorid ions can lead to metabolic alkali infection with secondary compensation: the frequency and level of this influence are light.

Potassium

The combination of indapamid with perindopril and amlodipine does not prevent hypokalemia triggers especially in diabetics or patients with renal impairment. Like all other antihypertensive drugs when coordinating with diuretics, plasma testing should be conducted.

Increasing plasma potassium has been observed in some patients who have been treated with angiotensin -shaped enzyme inhibitors, including Perindopril. Các yếu tố nguy cơ làm tăng kali máu bao gồm suy thận, giảm chức năng thận, tuổi (> 70 tuổi), tiểu đường, các biến cố xảy ra đồng thời, đặc biệt là mất nước, mất bù tim cấp, nhiễm toan chuyển hóa và sử dụng đồng thời với các thuốc lợi tiểu giữ kali (như spironolacton, eplerenon, triamteren hoặc amilorid), chế phẩm bổ sung kali và các muối thay thế có chứa kali hoặc bệnh nhân sử dụng các thuốc khác làm tăng Serum potassium (eg heparin, co - trimoxazole is known as trimethoprim/sulfamethoxazole). The use of potassium supplements, potassium diuretics or alternative salts containing special potassium in patients with renal impairment may increase the meaning of serum potassium concentration. Hyperbysical hyperkalemia can cause serious arrhythmia, sometimes can lead to death. If the same use of the above drugs is considered necessary, it is necessary to use caution and regularly monitor serum potassium.

Potassium loss and hematuria are the main risks of thiazid diuretics and thiazid diuretics. The risk of hypokalemia (

In this case, hypokalemia increases the heart toxicity of heart glycosides and the risk of arrhythmia.

Individuals with long QT distance are also at risk, whether due to congenital or drug use.

Hypotension, as well as a slow heart rate, is a factor leading to serious arrhythmia, especially twisted, which can be life -threatening.

Potassium control more frequently required in all of the above cases. Plasma potassium measurement should be conducted in the first week after the beginning of treatment. If the level of potassium is detected, the adjustment is necessary.

calcium

thiazid diuretics and thiazid diuretics can reduce the amount of calcium excreted through urine and increase the amount of plasma calcium. Significant hypercalcemia may be because the thyroid gland has not been detected earlier. In this case, the treatment should be stopped before exploring the thyroid function.

Aortic hypertension

Treatment of kidney hypertension is rejuvenation. However, the angiotensin -shaped enzyme inhibitors may work in patients with hypertension of the kidneys that are waiting for surgery or cannot be surgery.

If Triplixamamamamamamamamamamamamamamamamamamamamamamamamamist is prescribed for patients who have known or suspected kidney stenosis, treatment should be started in the hospital with monitoring of kidney and potassium function, because some patients will have renal failure recovered when stopping treatment.

ho