药品信息:
药品名称
中文通用名称：赖诺普利
英文通用名称：Lisinopril
中文其它名称：利生普利, 利斯普利, 捷赐瑞, 苯丁赖脯酸, 帝益洛, 麦道心宁, 易集康, 益迈欧, 青朗, 赖诺普利片, 赖诺普利胶囊, 里西普利, 麦道欣宁
英文其它名称：Zestril, Lisinopril Dihydrate, Listril, tersil, Dapril, Acerbon, liprene, Carace, Prinivil, Acemin, Alapril, Cipril, Irumed, Lisopress, Longes, Novatec, Prinil, Prinizil, Sinopril, Tensopril, Vivatec, Lisinopril Capsules, Lisinopril Tablets, Lisinopril Orally Disintegrating Tablets
产品所属分类：心血管系统用药\降血压药\肾素－血管紧张素系统抑制药\血管紧张素转换酶抑制药
规格
赖诺普利片 5mg, 10mg, 20mg, 30mg, 40mg
适应症
1.用于原发性高血压及肾性高血压，可单独应用或与其它降压药合用。
2.用于充血性心力衰竭，作为对洋地黄和(或)利尿药疗效不佳的辅助治疗。
3.用于急性心肌梗死后。
用法用量
成人
•常规剂量
•口服给药
1.原发性高血压：
(1)胶囊：建议起始剂量为2.5-5mg。有效维持剂量为一日10-20mg。可根据血压的变化调整剂量，一日最大剂量为40mg。原使用利尿药的高血压患者，使用本药时可能会出现症状性低血压，同时使用利尿药的患者更易出现，故联用时宜谨慎。在使用本药前2-3日应停用利尿药，对不能停用者(如严重或恶性高血压者)，本药宜从小剂量(5mg)开始用药，以后根据血压的变化逐渐调整剂量。必要时，可重新加用利尿药。
(2)片剂：初始剂量为一次10mg，一日1次，常用剂量为一次10-40mg，一日1次，餐后服用。可根据血压的变化调整用量，最大剂量为80mg。
2.肾性高血压：建议从低剂量(2.5mg或5mg)开始用药，以后根据血压的变化调整剂量。
3.充血性心力衰竭：起始剂量为一次2.5mg，一日1次。有效剂量范围为5-20mg。
4.急性心肌梗死：在心肌梗死24小时内应用，首剂5mg，24小时及48小时后再分别给予5mg、10mg，以后一日10mg。收缩压不大于16kPa(120mmHg)的患者或心肌梗死3日内的患者应给予较低剂量(2.5mg)。如出现收缩压不大于13.3kPa(100mmHg)，必要时维持量可从5mg暂减为2.5mg。如低血压持续存在，收缩压小于12kPa(90mmHg)，持续1小时以上者应停药。
•肾功能不全时剂量
肾功能受损者应根据肌酐清除率(Ccr)调整本药的剂量：Ccr为31-70ml/min者，初始剂量为一日5-10mg；Ccr为10-30ml/min者，初始剂量为一日2.5-5mg；Ccr小于10ml/min者，初始剂量为一日2.5mg。可根据血压的变化调整本药的剂量和给药次数，宜逐渐增加剂量直至血压被控制或达到最大日剂量40mg。
•老年人剂量
老年人宜减量。
给药说明
1.给药剂量须遵循个体化原则，按疗效予以调整。
2.其它ACE抑制药(如卡托普利)与别嘌醇合用可引起超敏反应，故本药如与别嘌醇合用应谨慎。
3.卡托普利与布比卡因合用，由于对肾素-血管紧张素系统的抑制，可引起严重心动过缓和低血压，甚至意识丧失，故本药如与布比卡因合用应谨慎。
4.在ACE抑制药治疗过程中，使用某些高流量膜(如聚丙烯腈膜)进行透析时，可出现危及生命的类过敏样超敏反应，在使用硫酸葡聚糖进行低密度脂蛋白分离过程中也可观察到同样的反应。
5.血容量减少和(或)血钠降低、血液透析、肾损害、严重心力衰竭、不能中断利尿药治疗的患者用药后可能突然出现严重的低血压，宜从小剂量开始用药。
6.伴肾功能损伤充血性心力衰竭者接受ACE抑制药治疗后产生的低血压可能会导致肾功能进一步损伤，出现急性肾衰竭(通常是可逆的)。
7.单侧或双侧肾动脉狭窄患者接受ACE抑制药治疗后可出现血尿素氮和肌酸酐升高，停药后可恢复。部分无肾血管疾病的高血压患者用药后也可出现血尿素氮和肌酸酐升高(一般为轻度、暂时性，多见于与利尿药联用时)，原已有肾损害的患者用药后更易出现，可能需要减少本药剂量或停用本药和(或)利尿药。
8.如出现以下情况，应监护患者，并调整本药和(或)利尿药的剂量：
(1)无并发症的高血压患者用药后罕见症状性低血压。
(2)已有血容量减少(如利尿治疗、限盐饮食、透析、腹泻或呕吐)的患者用药后可能发生低血压。
(3)充血性心力衰竭者，无论是否伴肾功能不全，均可发生症状性低血压，重度心力衰竭者更易发生。
9.正常血压或低血压的充血性心力衰竭者用药后可引起血压进一步降低，通常无需中断治疗。如低血压出现症状，必要时应减少本药剂量或停药。
10.用药后出现以下情况的处理：
(1)血管神经性水肿：发生于面部和唇部的水肿，一般不经治疗即可消退，但可给予抗组胺药以缓解症状；发生于舌部、声门、喉部的水肿，可导致气道阻塞，应立即给予1:1000的肾上腺素约0.3-0.5ml皮下注射，其它给予对症治疗。
(2)如出现黄疸或明显的肝酶值升高，须停止用药并进行监护。
(3)用药后如出现低血压，应使患者处于平卧位，必要时可静脉输入生理盐水。对一过性的低血压，经扩容使血压升高后，可继续服用本药。在手术或麻醉时出现低血压，可扩容纠正。
11.用药过量可出现低血压，一旦发生，通常输注生理盐水纠正，必要时可采用血液透析治疗。
不良反应
1.较常见头痛、眩晕、疲乏、嗜睡、恶心、咳嗽。最常见的停药原因是头痛和咳嗽。
2.少见症状性低血压、直立性低血压、晕厥、心悸、胸痛、周围性水肿、血管神经性水肿、皮疹、皮炎、便秘、胃炎、肝细胞性或胆汁淤积性肝炎、肝硬化、焦虑、失眠、感觉异常、尿量减少或无尿、肾功能不全、急性肾衰竭、性功能障碍、关节痛、肌痛、哮喘等。
3.其它：
(1)血尿素氮、血肌酸酐、血清肝酶值、血钾(轻度)升高。
(2)血红蛋白和血细胞比容稍降低。/br>(3)蛋白尿(发生率为0.7%)。
[国外不良反应参考]
1.血液
可使血红蛋白和血细胞比容轻度降低，也有引起紫癜的报道。很少引起骨髓抑制。
2.心血管系统
可引起心绞痛、胸痛、直立性低血压、心悸、心律失常、血管炎和周围性水肿。心律失常的发生率约1%，包括室性和房性心动过速、心房颤动、室性期前收缩和心动过缓。也可导致心绞痛，甚至急性心肌梗死。其它发生率在0.3%-1%之间的不良反应有脑血管意外、肺栓塞及肺梗死、短暂性缺血发作、夜间呼吸困难。
3.中枢神经系统
可引起眩晕、头痛、倦怠、疲乏、失眠、感觉异常、卒中、神经过敏、精神错乱、抑郁和嗜睡。
4.代谢/内分泌系统
可引起高钾血症，发生高血钾的危险因素有肾功能不全、糖尿病以及同时使用保钾利尿药、补钾药或含钾药。也可引起高尿酸血症、痛风。罕见男子乳腺发育。
5.消化系统
可引起口干、畏食、恶心、呕吐、消化不良、腹痛、腹泻、便秘、味觉障碍和胃肠胀气。很少引起肝酶值增高。
6.泌尿生殖系统
可引起血肌酸酐和血尿素氮轻微增高。泌尿道感染率增高可能与本药有关。也有报道，本药可引起阳萎和性欲降低。
7.呼吸系统
可引起咳嗽。可能与本药有关的更严重的呼吸系统不良反应有肺恶性肿瘤、咯血、肺浸润性疾病、嗜酸粒细胞性肺炎、支气管痉挛以及胸腔积液。
8.眼
有报道引起视物模糊或视力丧失、复视和畏光。
9.皮肤
可出现皮疹、潮红、荨麻疹、出汗和瘙痒。血管性水肿可出现于面部、四肢、口唇、舌或喉部。也有引起光过敏、天疱疮或银屑病的报道。罕见中毒性表皮松解坏死。
10.肌肉骨骼系统
可引起肌肉痛性痉挛、背痛、关节痛和肩痛。也有引起系统性红斑狼疮的报道。
11.耳
少见耳鸣。
注意事项
1.禁忌症
(1)对本药或其它ACE抑制药过敏者。
(2)有使用其它ACE抑制药引起血管神经性水肿史或血管神经性水肿(如遗传性、特发性血管神经性水肿)患者。
(3)孤立肾、移植肾、双侧肾动脉狭窄而肾功能减退者。
(4)高钾血症患者。
(5)孕妇。
2.慎用
(1)自身免疫性疾病(如严重系统性红斑狼疮)患者(可能致白细胞或粒细胞减少)。
(2)骨髓抑制患者。
(3)脑或冠状动脉供血不足患者(可因血压降低致缺血加重)。
(4)低血压或血容量不足的患者。
(5)外科手术及麻醉患者。
(6)肾功能损害者(可致血钾升高、白细胞及粒细胞减少等)。
(7)肝功能障碍患者(国外资料)。
(8)咳嗽患者(国外资料)。
(9)主动脉瓣狭窄或肥厚型心肌病患者(国外资料)。
3.药物对儿童的影响
小儿用药的研究资料尚不充分。新生儿和婴儿用药后可能出现少尿和神志异常，可能与血压降低后导致肾及脑缺血有关。
4.药物对老人的影响
尚未观察到年龄对本药的疗效和安全性的影响，但伴有肾功能减退的老年患者应慎用。
5.药物对妊娠的影响
妊娠中后期用药可致胎儿和新生儿损害(包括低血压、肾衰竭、新生儿颅骨发育不全、无尿、可逆性或不可逆性肾衰竭及死亡)，还有羊水过少(可能与胎儿四肢挛缩、颅骨表面畸形及肺发育不良有关)、早熟、宫内生长迟缓、动脉导管未闭的报道，故孕妇禁用。妊娠早期未见对胎儿的上述不良反应，尽管如此，一旦发现妊娠，仍应尽快停药。美国药品和食品管理局(FDA)对本药的妊娠安全性分级为C级(妊娠早期)和D级(妊娠中、晚期)。
6.药物对哺乳的影响
尚不清楚本药是否经乳汁分泌，哺乳妇女应慎用。
7.用药前后及用药时应当检查或监测
(1)用药前应检测血压、血电解质(血钠、血钾、总二氧化碳)、血尿素氮和肌酸酐，并定期复查。
(2)肾功能障碍或白细胞缺乏的患者，在最初3个月内应每2周检查白细胞计数及分类计数1次，此后定期检查。
(3)尿蛋白检查，每月1次。
Zestril - Used for: Treating high blood pressure alone or with other medicines. It is used along with other medicines to manage heart failure or improve survival after a heart attack. It may also be used for other conditions as determined by your doctor. Zestril is an angiotensin-converting enzyme (ACE) inhibitor. It works by relaxing blood vessels. This helps to lower blood pressure.
Zestril, an angiotensin-converting enzyme (ACE) inhibitor, is used to treat hypertension, congestive heart failure (CHF), postmyocardial infarction, and diabetic nephropathy or retinopathy. Although it is the lysine ester of enalaprilat, the active form of the prodrug enalapril, Zestril is active unchanged.
Indication: For the treatment of hypertension, heart failure and acute myocardial infarction. It may be used alone or in combination with thiazide diuretics
Zestril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.
Zestril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.
Zestril may also be used for other purposes not listed in this medication guide.
Zestril helps to keep your blood pressure under control. Zestril relaxes your blood vessels and this helps to lower your blood pressure. It may be used on its own or together with other medicines. Zestril may also be used to treat other conditions, for example, heart failure.
Zestril is a drug of the angiotensin converting enzyme (ACE) inhibitor class that is primarily used in treatment of hypertension, congestive heart failure, heart attacks and also in preventing renal and retinal complications of diabetes. It has been compared with omapatrilat which is of similar function.
Historically, Zestril was the third ACE inhibitor, after captopril and enalapril, and was introduced into therapy in the early 1990s. Zestril has a number of properties that distinguish it from other ACE inhibitors: it is hydrophilic, has long half-life and tissue penetration and is not metabolized by the liver.
Zestril was developed by Merck & Co. and is marketed worldwide as Prinivil or Tensopril and by AstraZeneca as Zestril. In India it is marketed by Micro Labs as Hipril. In the United States, a generic version is available. Like other ACE inhibitors, it is derived from the venom of the jararaca, a Brazilian pit viper (Bothrops jararaca). Zestril can also be used in conjunction with the diuretic Hydrochlorothiazide and also goes by the brand names Prinizide and Zestoretic.
Hypertension : Treatment of essential and renovascular hypertension. Zestril may be used alone or concomitantly with other classes of antihypertensive agents. Congestive Heart Failure: Management of congestive heart failure as an adjunctive treatment with diuretics and, where appropriate, digitalis. Acute Myocardial Infarction: Treatment of haemodynamically stable patients within 24 hrs of an acute myocardial infarction, to prevent the subsequent development of left ventricular dysfunction or heart failure and to improve survival. Patients should receive, as appropriate, the standard recommended treatment eg, thrombolytics, aspirin and β-blocker. Renal Complications of Diabetes Mellitus: In normotensive insulin-dependent and hypertensive non-insulin-dependent diabetes mellitus patients who have incipient nephropathy characterised by microalbuminuria, Zestril reduces urinary albumin excretion rate.
Hypertension : Treatment of essential hypertension and in renovascular hypertension. It may be used alone or concomitantly with other classes of antihypertensive agents. Congestive Heart Failure: Management of congestive heart failure as an adjunctive treatment with diuretics and, where appropriate, digitalis. Acute Myocardial Infarction: Treatment of haemodynamically stable patients within 24 hrs of an acute myocardial infarction, to prevent the subsequent development of left ventricular dysfunction or heart failure and to improve survival. Patients should receive, as appropriate, the standard recommended treatments eg, thrombolytics, aspirin and β-blocker. Renal Complications of Diabetes Mellitus: In normotensive insulin-dependent and hypertensive non-insulin dependent diabetes mellitus, patients who have incipient nephropathy characterised by microalbuminuria, Zestril reduces urinary albumin excretion rate.
Hypertension : For the treatment of hypertension. Zestril may be used as monotherapy or in combination with other classes of antihypertensive agents. Heart Failure: For the treatment of symptomatic heart failure as an adjunctive therapy to diuretics and, where appropriate, digitalis or β-blockers. Acute Myocardial Infarction: For the short-term (6 weeks) treatment of haemodynamically-stable patients within 24 hrs of an acute myocardial infarction. Patients should receive, as appropriate, the standard recommended treatments eg, thrombolytics, aspirin and β-blockers. Renal Complications of Diabetes Mellitus: In normotensive insulin-dependent and hypertensive non-insulin-dependent diabetes mellitus patients, who have incipient nephropathy characterized by microalbuminuria, Zestril reduces urinary albumin excretion rate (see Pharmacology under Actions).
Hypertension : Treatment of essential hypertension and renovascular hypertension. Zestril may be used alone or concomitantly with other classes of antihypertensive agents. Congestive Heart Failure: Management of congestive heart failure as an adjunctive treatment with diuretics and, where appropriate, digitalis. Acute Myocardial Infarction: Treatment of haemodynamically stable patients within 24 hrs of an acute myocardial infarction, to prevent the subsequent development of left ventricular dysfunction or heart failure and to improve survival. Patients should receive, as appropriate, the standard recommended treatment, eg thrombolytics, aspirin and β-blocker.
Hypertension : Treatment of essential hypertension and renovascular hypertension. May be used alone or concomitantly with other classes of antihypertensive agents. Congestive Heart Failure: Management of congestive heart failure as an adjunctive treatment with diuretics, and where appropriate, digitalis. Acute Myocardial Infarction: Treatment of haemodynamically stable patients within 24 hrs of an acute myocardial infarction to prevent the subsequent development of left ventricular dysfunction or heart failure and to improve survival. Patients should receive, as appropriate, the standard recommended treatments eg, thrombolytics, aspirin and β-blocker. Renal Complications of Diabetes Mellitus: In normotensive insulin-dependent and hypertensive non-insulin-dependent diabetes mellitus patients who have incipient nephropathy characterised by microalbuminuria. Zestril reduces urinary albumin excretion rate.
Treatment of essential hypertension and renovascular hypertension. Zestril may be used alone or concomitantly with other classes of antihypertensive agents. Management of congestive heart failure as an adjunctive treatment with diuretics and, where appropriate, digitalis. Treatment of hemodynamically stable patients within 24 hrs of an acute myocardial infarction, to prevent the subsequent development of left ventricular dysfunction or heart failure and to improve survival. Patients should receive, as appropriate, the standard recommended treatments eg, thrombolytics, aspirin and β-blocker.
Indications: hypertension, heart failure, myocardial infarction, diabetic nephropathy
Treatment of hypertension; treatment of heart failure not responding to diuretics and digitalis; treatment of acute MI within 24 h in hemodynamically stable patients. Unlabeled UsesMigraine prophylaxis.
HypertensionZESTRIL is indicated for the treatment of hypertension. It may be used alone as initial therapy or concomitantly with other classes of antihypertensive agents. Heart FailureZESTRIL is indicated as adjunctive therapy in the management of heart failure in patients who are not responding adequately to diuretics and digitalis. Acute Myocardial InfarctionZESTRIL is indicated for the treatment of hemodynamically stable patients within 24 hours of acute myocardial infarction, to improve survival. Patients should receive, as appropriate, the standard recommended treatments such as thrombolytics, aspirin and beta blockers.
Hypertension Zestril is indicated for the treatment of hypertension. It may be used alone as initial therapy or concomitantly with other classes of antihypertensive agents. Heart Failure Zestril is indicated as adjunctive therapy in the management of heart failure in patients who are not responding adequately to diuretics and digitalis. Acute Myocardial Infarction Zestril is indicated for the treatment of hemodynamically stable patients within 24 hours of acute myocardial infarction, to improve survival. Patients should receive, as appropriate, the standard recommended treatments such as thrombolytics, aspirin and beta blockers. In using ZESTRIL, consideration should be given to the fact that another angiotensin-converting enzyme inhibitor, captopril, has caused agranulocytosis, particularly in patients with renal impairment or collagen vascular disease, and that available data are insufficient to show that Zestril does not have a similar risk. (See WARNINGS.) In considering the use of ZESTRIL, it should be noted that in controlled clinical trials ACE inhibitors have an effect on blood pressure that is less in Black patients than in non-Blacks. In addition, ACE inhibitors have been associated with a higher rate of angioedema in Black than in non-Black patients (see WARNINGS, Anaphylactoid and Possibly Related Reactions ).
Treatment of hypertension and symptomatic heart failure. Acute Myocardial Infarction: Short-term (6 weeks) treatment of haemodynamically stable patients within 24 hrs of an acute myocardial infarction. Renal Complications of Diabetes Mellitus: In normotensive insulin-dependent and hypertensive non-insulin-dependent diabetes mellitus patients, who have incipient nephropathy characterised by microalbuminuria, Zestril reduces urinary albumin excretion rate (see Pharmacology under Actions). |
国际免费电话：