<\/p>\n
Irovel H<\/strong> je 150\/12,5 mg fixn\u00ed kombinace tablety<\/strong> irbesartanu 150 mg a hydrochlorothiazid<\/strong> od spole\u010dnosti Sun Pharma \u2014 kombinace antihypertenziv 2. volby<\/strong> pro pacienty, jejich\u017e krevn\u00ed tlak nen\u00ed kontrolov\u00e1n Irovel<\/a> (pouze irbesartan). P\u0159id\u00e1n\u00ed thiazidov\u00e9ho diuretika obvykle p\u0159in\u00e1\u0161\u00ed dal\u0161\u00ed pokles systolick\u00e9ho tlaku o 5-10 mmHg<\/strong> ve srovn\u00e1n\u00ed s monoterapi\u00ed ARB. Ob\u011b slo\u017eky p\u016fsob\u00ed prost\u0159ednictv\u00edm komplement\u00e1rn\u00edch mechanism\u016f<\/strong> (ARB blokuje receptor pro angiotensin-II; HCTZ odstra\u0148uje sod\u00edk a vyvol\u00e1v\u00e1 m\u00edrnou volumovou kontrakci) a maj\u00ed vz\u00e1jemn\u011b vyva\u017euj\u00edc\u00ed profily vedlej\u0161\u00edch \u00fa\u010dink\u016f<\/strong> \u2014 HCTZ sni\u017euje hladinu drasl\u00edku, zat\u00edmco ARB ji m\u00e1 tendenci zvy\u0161ovat, tak\u017ee kombinace je m\u00e9n\u011b pravd\u011bpodobn\u00e1 p\u0159i vzniku hypokal\u00e9mie nebo hyperkal\u00e9mie ne\u017e ka\u017ed\u00fd l\u00e9k samostatn\u011b v ekvivalentn\u00edch d\u00e1vk\u00e1ch. Obvykl\u00e9 d\u00e1vkov\u00e1n\u00ed: jedna tableta jednou denn\u011b. Absolutn\u011b kontraindikov\u00e1n v t\u011bhotenstv\u00ed<\/strong> (ob\u011b slo\u017eky), anurie nebo t\u011b\u017ek\u00e9 ren\u00e1ln\u00ed posti\u017een\u00ed (eGFR <30)<\/strong>, p\u0159ecitliv\u011blost na thiazidy (sulfonamidy)<\/strong>, a symptomatick\u00e1 hyponatr\u00e9mie<\/strong>. Monitorujte drasl\u00edk, sod\u00edk, ur\u00e1ty a kreatinin b\u011bhem l\u00e9\u010dby.<\/p>\n<\/div>\n \ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n Irovel H je peror\u00e1ln\u00ed tableta s fixn\u00ed kombinac\u00ed obsahuj\u00edc\u00ed irbesartan 150 mg<\/strong> a hydrochlorothiazid (HCTZ)<\/strong> v jedn\u00e9 tablet\u011b, vyr\u00e1b\u011bn\u00fd spole\u010dnost\u00ed Sun Pharma a dod\u00e1van\u00fd v balen\u00ed po 30-90 tablet\u00e1ch. Kombinuje dv\u011b prvn\u00ed volby antihypertenzn\u00edch l\u00e9\u010div v pom\u011bru vhodn\u00e9m pro v\u011bt\u0161inu pacient\u016f, kte\u0159\u00ed ji\u017e p\u0159ekro\u010dili monoterapii ARB. Irbesartan (Sanofi \/ BMS jako Avapro \/ Aprovel, 1997) se v\u00e1\u017ee na AT1<\/sub> receptor s polo\u010dasem 11-15 hodin a nejsiln\u011bj\u0161\u00edmi d\u016fkazy pro diabetickou nefropatii ze v\u0161ech ARB. Stabiln\u00ed d\u00e1vka 150 nebo 300 mg jednou denn\u011b poskytuje rovnom\u011brn\u00e9 24hodinov\u00e9 pokryt\u00ed TK; nevy\u017eaduje aktivn\u00ed metabolit.<\/p>\n Hydrochlorothiazid (HCTZ) je thiazidov\u00e9 diuretikum zaveden\u00e9 v roce 1959 (MSD jako HydroDiuril). St\u00e1le pat\u0159\u00ed mezi nej\u010dast\u011bji p\u0159edepisovan\u00e1 antihypertenziva na sv\u011bt\u011b a je \u010dtvrtou t\u0159\u00eddou doporu\u010denou v guidelines<\/strong> pro hypertenzi vedle ARB, ACE inhibitor\u016f a blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f.<\/p>\n Hypertenze je jen z\u0159\u00eddka kontrolov\u00e1na jedin\u00fdm l\u00e9kem v c\u00edlov\u00e9 d\u00e1vce. Studie jako ALLHAT, ACCOMPLISH a ASCOT prok\u00e1zaly, \u017ee v\u011bt\u0161ina hypertonik\u016f pot\u0159ebuje dva nebo t\u0159i l\u00e9ky z r\u016fzn\u00fdch t\u0159\u00edd<\/strong> k dosa\u017een\u00ed c\u00edlov\u00fdch hodnot krevn\u00edho tlaku dle doporu\u010den\u00ed (<140\/90 u v\u011bt\u0161iny dosp\u011bl\u00fdch, <130\/80 u diabetik\u016f a pacient\u016f s CKD). Kombinace ARB + thiazid je jednou ze t\u0159\u00ed v\u011bdecky podlo\u017een\u00fdch dvoul\u00e9kov\u00fdch kombinac\u00ed (dal\u0161\u00ed dv\u011b jsou ARB + CCB a CCB + thiazid).<\/p>\n Dv\u011b slo\u017eky p\u0159\u00edpravku Irovel H se vz\u00e1jemn\u011b dopl\u0148uj\u00ed na \u010dty\u0159ech farmakologick\u00fdch os\u00e1ch<\/strong>:<\/p>\n Irbesartan m\u00e1 nejrobustn\u011bj\u0161\u00ed d\u016fkazy o renoprotekci u diabetu 2. typu s manifestn\u00ed nefropati\u00ed<\/strong> (studie IDNT a IRMA-2) \u2014 u\u017eite\u010dn\u00fd kontext pro pacienty s diabetickou CKD stadia 3, kte\u0159\u00ed pot\u0159ebuj\u00ed jak kontrolu krevn\u00edho tlaku, tak sn\u00ed\u017een\u00ed proteinurie. Kombinace irbesartanu + HCTZ je standardn\u00ed volbou druh\u00e9ho kroku u diabetick\u00e9 i nediabetick\u00e9 hypertenze, kdy krevn\u00ed tlak nen\u00ed kontrolov\u00e1n samotn\u00fdm irbesartanem.<\/p>\n D\u016fkazy pro ARB+HCTZ:<\/strong> IDNT (2001)<\/strong> \u2014 irbesartan 300 mg sn\u00ed\u017eil kombinovan\u00fd ukazatel zdvojn\u00e1soben\u00ed s\u00e9rov\u00e9ho kreatininu, termin\u00e1ln\u00edho selh\u00e1n\u00ed ledvin nebo \u00famrt\u00ed o 20 % u 1 715 pacient\u016f s diabetem 2. typu a manifestn\u00ed nefropati\u00ed. IRMA-2 (2001)<\/strong> \u2014 irbesartan sn\u00ed\u017eil progresi z mikroalbuminurie na manifestn\u00ed nefropatii o 70 % p\u0159i d\u00e1vce 300 mg ve srovn\u00e1n\u00ed s placebem. Tyto v\u00fdsledky renoprotekce jsou z velk\u00e9 \u010d\u00e1sti nez\u00e1visl\u00e9 na krevn\u00edm tlaku a potvrzuj\u00ed irbesartan jako preferovan\u00fd ARB u diabetick\u00e9 nefropatie 2. typu.<\/p>\n Standardn\u00ed d\u00e1vka:<\/strong> jedna tableta 150\/12,5 mg jednou denn\u011b, obvykle r\u00e1no (HCTZ zp\u016fsobuje m\u00edrnou diur\u00e9zu; ve\u010dern\u00ed pod\u00e1n\u00ed m\u016f\u017ee naru\u0161it sp\u00e1nek no\u010dn\u00edm mo\u010den\u00edm).<\/p>\n Kdy zah\u00e1jit Irovel H:<\/strong><\/p>\n Titrace:<\/strong> Pokud TK z\u016fst\u00e1v\u00e1 nekontrolovan\u00fd po 4-6 t\u00fddnech na po\u010d\u00e1te\u010dn\u00ed FDC, lze nahradit tabletou s vy\u0161\u0161\u00ed silou (v\u011bt\u0161ina v\u00fdrobc\u016f nab\u00edz\u00ed kombinace 50\/12,5, 100\/12,5, 80\/12,5, 160\/12,5 a 160\/25 p\u0159\u00edslu\u0161n\u00e9ho ARB s HCTZ). P\u0159\u00edpadn\u011b p\u0159idat t\u0159et\u00ed t\u0159\u00eddu \u2014 typicky blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f (amlodipin)<\/a>.<\/p>\n Monitorovac\u00ed pl\u00e1n:<\/strong><\/p>\n Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> \u017e\u00e1dn\u00fd abstinen\u010dn\u00ed syndrom, ale n\u00e1hl\u00e9 vysazen\u00ed zp\u016fsob\u00ed postupn\u00fd n\u00e1vrat TK b\u011bhem dn\u016f. Postupn\u00e9 vysazen\u00ed nahrazen\u00edm kombinac\u00ed s ni\u017e\u0161\u00ed silou nebo n\u00e1vrat k monoterapii ARB pod kontrolou TK.<\/p>\n Vedlej\u0161\u00ed \u00fa\u010dinky se p\u0159ekr\u00fdvaj\u00ed s \u00fa\u010dinky obou slo\u017eek l\u00e9ku. Kombinace je obvykle l\u00e9pe sn\u00e1\u0161ena<\/strong> ne\u017e kter\u00e1koli slo\u017eka v maxim\u00e1ln\u00ed d\u00e1vce monoterapie, proto\u017ee d\u00e1vky pou\u017e\u00edvan\u00e9 v fixn\u00edch kombinac\u00edch jsou ni\u017e\u0161\u00ed ne\u017e \u0161pi\u010dkov\u00e9 d\u00e1vky monoterapie.<\/p>\n \u010cast\u00e9 (>1 % u\u017eivatel\u016f):<\/strong><\/p>\n Nep\u0159\u00edli\u0161 \u010dast\u00e9, ale klinicky v\u00fdznamn\u00e9:<\/strong><\/p>\n Kojen\u00ed:<\/strong> HCTZ se vylu\u010duje do ml\u00e9ka a m\u016f\u017ee potla\u010dovat laktaci p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch; obecn\u011b se vyh\u00fdb\u00e1 v prvn\u00edch t\u00fddnech po porodu p\u0159ed\u010dasn\u011b narozen\u00e9ho d\u00edt\u011bte. Preferuj\u00ed se alternativn\u00ed antihypertenziva (propranolol, nifedipin), pokud je to mo\u017en\u00e9.<\/p>\n Irovel H je l\u00e9k 2. volby<\/strong>, nikoli prvn\u00ed volby. U nov\u011b diagnostikovan\u00e9 hypertenze bez komplikac\u00ed:<\/p>\n Pacienti s nekomplikovanou hypertenz\u00ed 2. stupn\u011b (\u2265160\/100) mohou rozumn\u011b za\u010d\u00edt p\u0159\u00edmo s Irovel H \u2014 sou\u010dasn\u00e9 sm\u011brnice AHA\/ACC up\u0159ednost\u0148uj\u00ed \u010dasn\u00e9 zah\u00e1jen\u00ed dvoul\u00e9kov\u00e9 terapie u t\u011b\u017ek\u00e9 hypertenze p\u0159ed titrac\u00ed jedn\u00e9 l\u00e9kov\u00e9 t\u0159\u00eddy.<\/p>\n Skladujte Irovel H p\u0159i teplot\u00e1ch pod 25\u00b0C v p\u016fvodn\u00edm blistru. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n Ne \u2014 fixn\u00ed kombinace ARB\/thiazid nejsou l\u00e9ky druh\u00e9 volby<\/strong>. Standardn\u00ed postup je za\u010d\u00edt s monoterapi\u00ed ARB (Irovel<\/a> (monoterapie irbesartanem), titrovat na c\u00edlovou d\u00e1vku a p\u0159ej\u00edt na Irovel H pouze pokud nen\u00ed krevn\u00ed tlak kontrolov\u00e1n po 4-6 t\u00fddnech. V\u00fdjimka: hypertenze 2. stupn\u011b (\u2265160\/100) m\u016f\u017ee podle doporu\u010den\u00ed AHA\/ACC rozumn\u011b za\u010d\u00edt p\u0159\u00edmo dvoul\u00e9kovou terapi\u00ed.<\/p>\n R\u00e1no<\/strong> je v\u00fdchoz\u00ed volba. Slo\u017eka HCTZ je diuretikum \u2014 zvy\u0161uje tvorbu mo\u010di po dobu 2-4 hodin po pod\u00e1n\u00ed. Ve\u010dern\u00ed pod\u00e1n\u00ed m\u016f\u017ee naru\u0161it sp\u00e1nek no\u010dn\u00edm mo\u010den\u00edm. N\u011bkter\u00fdm pacient\u016fm s no\u010dn\u00ed hypertenz\u00ed (nedostate\u010dn\u00fd no\u010dn\u00ed pokles tlaku, chronick\u00e9 onemocn\u011bn\u00ed ledvin) m\u016f\u017ee b\u00fdt doporu\u010deno p\u0159ej\u00edt na ve\u010dern\u00ed pod\u00e1n\u00ed k ovlivn\u011bn\u00ed rann\u00edho krevn\u00edho tlaku; konzultujte se sv\u00fdm l\u00e9ka\u0159em.<\/p>\n P\u0159ibli\u017en\u011b v pr\u016fm\u011bru o 5-10 mmHg systolick\u00e9ho a 3-6 mmHg diastolick\u00e9ho tlaku nav\u00edc<\/strong> m\u011b\u0159eno 4-6 t\u00fddn\u016f po zah\u00e1jen\u00ed u\u017e\u00edv\u00e1n\u00ed Irovel H. Aditivn\u00ed efekt vznik\u00e1 blok\u00e1dou kompenza\u010dn\u00ed aktivace RAAS, kter\u00e1 norm\u00e1ln\u011b oslabuje \u00fa\u010dinek thiazidov\u00e9 monoterapie; tato blok\u00e1da umo\u017e\u0148uje pln\u00fd \u00fa\u010dinek HCTZ.<\/p>\n Obvykle z\u016fst\u00e1v\u00e1 v norm\u00e1ln\u00edm rozmez\u00ed. Ztr\u00e1ta drasl\u00edku zp\u016fsoben\u00e1 thiazidy je \u010d\u00e1ste\u010dn\u011b kompenzov\u00e1na tendenc\u00ed ARB zvy\u0161ovat drasl\u00edk<\/strong>. Mal\u00fd po\u010det pacient\u016f skute\u010dn\u011b vyvine hypokal\u00e9mii \u2014 z\u00e1kladn\u00ed a kontroln\u00ed vy\u0161et\u0159en\u00ed U&E po 1-2 t\u00fddnech je rutinn\u00ed. Pokud drasl\u00edk klesne pod 3,5, p\u0159idejte strategii \u0161et\u0159\u00edc\u00ed drasl\u00edk (eplerenon, dietu bohatou na drasl\u00edk nebo p\u0159\u00edle\u017eitostn\u011b dopln\u011bn\u00ed drasl\u00edku) sp\u00ed\u0161e ne\u017e vysazen\u00ed Irovel H.<\/p>\n HCTZ zvy\u0161uje s\u00e9rovou kyselinu mo\u010dovou; Irbesartan je neutr\u00e1ln\u00ed v\u016f\u010di ur\u00e1t\u016fm. Zv\u00fd\u0161en\u00ed o 0,5-1,5 mg\/dl je b\u011b\u017en\u00e9. Dnav\u00e9 z\u00e1chvaty jsou neobvykl\u00e9, ale mo\u017en\u00e9 u n\u00e1chyln\u00fdch pacient\u016f (anamn\u00e9za dny, CKD, obezita, vysok\u00fd p\u0159\u00edjem alkoholu). Pokud se u v\u00e1s objev\u00ed nov\u00e1 dna, zeptejte se na p\u0159echod na na b\u00e1zi losartanu<\/strong> kombinace ARB+HCTZ (Cosart-H<\/a>, Cozartan-H<\/a>, Losatec H<\/a>) \u2014 losartan je urikosurick\u00fd a \u010d\u00e1ste\u010dn\u011b kompenzuje zvy\u0161uj\u00edc\u00ed \u00fa\u010dinek HCTZ na hladinu ur\u00e1t\u016f.<\/p>\n Ano, ale m\u011bjte na pam\u011bti, \u017ee thiazidy m\u00edrn\u011b zhor\u0161uj\u00ed gluk\u00f3zovou toleranci<\/strong> (pr\u016fm\u011brn\u00fd vzestup hladiny gluk\u00f3zy nala\u010dno o 5-8 mg\/dL, vzestup HbA1c o 0,1-0,3%). U v\u011bt\u0161iny diabetik\u016f p\u0159eva\u017euje benefit sn\u00ed\u017een\u00ed krevn\u00edho tlaku nad t\u00edmto \u00fa\u010dinkem a t\u011bsn\u011bj\u0161\u00ed kontrola krevn\u00edho tlaku v\u00edce sni\u017euje komplikace ledvin a o\u010d\u00ed u diabetu, ne\u017e vzestup gluk\u00f3zy tyto komplikace zvy\u0161uje. Monitorujte HbA1c ro\u010dn\u011b. Pokud se kontrola diabetu p\u0159i u\u017e\u00edv\u00e1n\u00ed Irovel H zhor\u0161\u00ed, zeptejte se na p\u0159echod na Telma H<\/a> (telmisartan + HCTZ), kter\u00fd m\u00e1 \u010d\u00e1ste\u010dnou metabolicky protektivn\u00ed aktivitu.<\/p>\n Ob\u010dasn\u00e9 kr\u00e1tkodob\u00e9 u\u017e\u00edv\u00e1n\u00ed je obvykle v po\u0159\u00e1dku. Chronick\u00e9 denn\u00ed u\u017e\u00edv\u00e1n\u00ed NSAID<\/strong> (ibuprofen, diklofenak, naproxen) je rizikov\u00e9 v kombinaci s jak\u00fdmkoli ARB + diuretikem \u2014 tzv. \u201ctrojit\u00e1 r\u00e1na\u201d (ARB + diuretikum + NSAID) m\u016f\u017ee vyvolat akutn\u00ed po\u0161kozen\u00ed ledvin p\u0159i dehydrataci, infekci nebo operaci. P\u0159i chronick\u00e9 bolesti u\u017e\u00edvejte paracetamol; p\u0159i z\u00e1n\u011btu proberte alternativy se sv\u00fdm l\u00e9ka\u0159em.<\/p>\n Ne \u2014 absolutn\u011b kontraindikov\u00e1no.<\/strong> Ob\u011b slo\u017eky jsou teratogenn\u00ed: ARB zp\u016fsobuje fet\u00e1ln\u00ed ren\u00e1ln\u00ed agenezi a oligohydramnion; HCTZ proch\u00e1z\u00ed placentou a m\u016f\u017ee zp\u016fsobit fet\u00e1ln\u00ed nebo novorozeneckou \u017eloutenku a trombocytopenii. \u017deny v reproduk\u010dn\u00edm v\u011bku by m\u011bly pou\u017e\u00edvat spolehlivou antikoncepci. Pro ty, kter\u00e9 pl\u00e1nuj\u00ed t\u011bhotenstv\u00ed, p\u0159ejd\u011bte na labetalol<\/a>, methyldopu nebo nifedipin p\u0159ed po\u010det\u00edm<\/strong>.<\/p>\n Obvykle ne, pokud tabletu u\u017e\u00edv\u00e1te r\u00e1no. Diuretick\u00fd \u00fa\u010dinek vrchol\u00ed 2-4 hodiny po pod\u00e1n\u00ed a ve\u010der je v\u011bt\u0161inou ji\u017e pry\u010d. Pacienti, kte\u0159\u00ed p\u0159ejdou na ve\u010dern\u00ed d\u00e1vkov\u00e1n\u00ed, \u010dasto poci\u0165uj\u00ed nokturii; n\u00e1vrat k rann\u00edmu d\u00e1vkov\u00e1n\u00ed tento probl\u00e9m vy\u0159e\u0161\u00ed b\u011bhem 1-3 dn\u016f.<\/p>\n Vezm\u011bte si ji, jakmile si vzpomenete, pokud to nen\u00ed n\u011bkolik hodin p\u0159ed dal\u0161\u00ed d\u00e1vkou \u2014 v tom p\u0159\u00edpad\u011b vynechejte vynechanou d\u00e1vku a pokra\u010dujte v obvykl\u00e9m re\u017eimu. Ned\u00e1vejte si dvojitou d\u00e1vku. Jedna vynechan\u00e1 d\u00e1vka nem\u00e1 v\u00fdznamn\u00fd vliv na kontrolu krevn\u00edho tlaku. Pokud vynech\u00e1te v\u00edce ne\u017e 2 dny, v\u00e1\u0161 krevn\u00ed tlak za\u010dne op\u011bt stoupat; pokra\u010dujte v obvykl\u00e9 d\u00e1vce (nen\u00ed t\u0159eba zvy\u0161ovat).<\/p>\n Irovel H (150\/12,5 mg irbesartan + HCTZ, 30-90 tablet) si m\u016f\u017eete koupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n <\/p>\n Irovel H je fixn\u00ed kombinace irbesartanu 150 mg a hydrochlorothiazidu 12,5 mg od spole\u010dnosti Sun Pharma \u2014 antihypertenzivn\u00ed kombinace druh\u00e9ho kroku. Irbesartan m\u00e1 nejrobustn\u011bj\u0161\u00ed d\u016fkazy pro diabetickou nefropatii ze v\u0161ech ARB (IDNT 2001 \u2014 20% sn\u00ed\u017een\u00ed zdvojn\u00e1soben\u00ed kreatininu, ESRD nebo \u00famrt\u00ed; IRMA-2 2001 \u2014 70% sn\u00ed\u017een\u00ed progrese mikroalbuminurie). HCTZ p\u0159id\u00e1v\u00e1 pokles systolick\u00e9ho TK o 5-10 mmHg prost\u0159ednictv\u00edm dopl\u0148kov\u00fdch mechanism\u016f nez\u00e1visl\u00fdch na RAAS. Hladina drasl\u00edku m\u00e1 tendenci z\u016fstat neutr\u00e1ln\u00ed (HCTZ sni\u017euje, ARB zvy\u0161uje). D\u00e1vkov\u00e1n\u00ed jednou denn\u011b r\u00e1no.<\/p>","protected":false},"featured_media":51735,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3401,3399,3402],"class_list":{"0":"post-51734","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-hydrochlorothiazide","11":"product_tag-irbesartan","12":"product_tag-irovel-h","14":"first","15":"outofstock","16":"shipping-taxable","17":"purchasable","18":"product-type-variable","19":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51734","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51734"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51735"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51734"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51734"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51734"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51734"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n
Co je Irovel H?<\/h2>\n
Pro\u010d kombinovat ARB s thiazidem?<\/h2>\n
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D\u00e1vkov\u00e1n\u00ed & Titrace<\/h2>\n
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Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n
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Kontraindikace<\/h2>\n
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Interakce s l\u00e9\u010divy<\/h2>\n
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Irovel H vs monoterapie ARB \u2013 kdy p\u0159ej\u00edt na vy\u0161\u0161\u00ed stupe\u0148<\/h2>\n
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Skladov\u00e1n\u00ed<\/h2>\n
\u010casto kladen\u00e9 dotazy<\/h2>\n
Je Irovel H l\u00e9kem prvn\u00ed volby na krevn\u00ed tlak?<\/h3>\n
Kdy bych m\u011bl u\u017e\u00edvat Irovel H \u2014 r\u00e1no nebo ve\u010der?<\/h3>\n
O kolik v\u011bt\u0161\u00ed pokles krevn\u00edho tlaku mohu o\u010dek\u00e1vat oproti Irovel<\/a> (monoterapii irbesartanem) samotn\u00e9?<\/h3>\n
M\u016fj drasl\u00edk je na ARB v norm\u011b \u2014 poklesne na Irovel H?<\/h3>\n
Zv\u00fd\u0161\u00ed Irovel H moji kyselinu mo\u010dovou nebo vyvol\u00e1 dnu?<\/h3>\n
M\u00e1m diabetes 2. typu \u2014 je Irovel H bezpe\u010dn\u00fd?<\/h3>\n
Mohu u\u017e\u00edvat ibuprofen s Irovel H?<\/h3>\n
Mohu u\u017e\u00edvat Irovel H v t\u011bhotenstv\u00ed?<\/h3>\n
Budu muset v noci \u010dast\u011bji mo\u010dit p\u0159i u\u017e\u00edv\u00e1n\u00ed Irovel H?<\/h3>\n
Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n
Kde si mohu koupit Irovel H online?<\/h3>\n
Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n
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