{"id":51987,"date":"2023-09-20T09:27:34","date_gmt":"2023-09-20T09:27:34","guid":{"rendered":"https:\/\/medsname.com\/vymada\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"vymada","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/vymada\/","title":{"rendered":"Vymada"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Vymada?<\/h3>\n<p style=\"margin:0;\"><strong>Vymada<\/strong> je 50 a 100 mg <strong>sacubitril\/valsartan<\/strong> tablety od spole\u010dnosti Novartis \u2014 <strong>inhibitor receptoru angiotensinu a neprilisinu (ARNI)<\/strong>. Sacubitrilov\u00e1 slo\u017eka inhibuje neprilisyn (enzym, kter\u00fd degraduje natriuretick\u00e9 peptidy, bradykinin a adrenomedulin), \u010d\u00edm\u017e posiluje prosp\u011b\u0161nou vazodilata\u010dn\u00ed a natriuretickou dr\u00e1hu; valsartanov\u00e1 slo\u017eka blokuje receptor angiotensinu-II, \u010d\u00edm\u017e zabra\u0148uje vazokonstrikci a retenci sod\u00edku zp\u016fsoben\u00e9 aldosteronem. <strong>L\u00e9\u010dba prvn\u00ed volby pro HF-REF (EF \u226440%)<\/strong> podle doporu\u010den\u00ed ESC z roku 2021 a AHA\/ACC z roku 2022 \u2014 nahrazuje ACE inhibitory nebo ARB u v\u011bt\u0161iny stabiln\u00edch pacient\u016f s HF-REF (studie PARADIGM-HF z roku 2014 prok\u00e1zala 20% ni\u017e\u0161\u00ed kardiovaskul\u00e1rn\u00ed mortalitu nebo hospitalizaci pro srde\u010dn\u00ed selh\u00e1n\u00ed ve srovn\u00e1n\u00ed s enalaprilem). D\u00e1vkov\u00e1n\u00ed: 50 a 100 mg dvakr\u00e1t denn\u011b; titrujte ka\u017ed\u00e9 2-4 t\u00fddny na c\u00edlovou d\u00e1vku 97\/103 mg dvakr\u00e1t denn\u011b. <strong>Absolutn\u011b kontraindikov\u00e1no v t\u011bhotenstv\u00ed, p\u0159i anamn\u00e9ze angioed\u00e9mu zp\u016fsoben\u00e9ho ACE inhibitory nebo ARB a do 36 hodin po jak\u00e9koli d\u00e1vce ACE inhibitoru.<\/strong> (je nutn\u00e1 vy\u010dk\u00e1vac\u00ed doba, aby se p\u0159ede\u0161lo angioed\u00e9mu).<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>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<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>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<h2 class=\"wp-block-heading\">Co je Vymada?<\/h2>\n<p>Vymada jsou tablety sacubitrilu\/valsartanu v d\u00e1vk\u00e1ch 50 a 100 mg od spole\u010dnosti Novartis, dod\u00e1van\u00e9 v balen\u00ed po 28-84 tablet\u00e1ch. P\u016fvodn\u011b Novartis Entresto (2015); prvn\u00ed z\u00e1stupce t\u0159\u00eddy inhibitor\u016f angiotenzinov\u00e9ho receptoru a neprilysinu (ARNI).<\/p>\n<h2 class=\"wp-block-heading\">Jak funguje ARNI<\/h2>\n<p>Dva komplement\u00e1rn\u00ed mechanismy:<\/p>\n<ul>\n<li><strong>Sacubitril<\/strong> (prodrog aktivovan\u00e1 na LBQ657) inhibuje <strong>neprilysin<\/strong>, membr\u00e1nov\u011b v\u00e1zanou endopeptid\u00e1zu, kter\u00e1 degraduje natriuretick\u00e9 peptidy (ANP, BNP, CNP), bradykinin a adrenomedulin. Inhibice zvy\u0161uje hladiny t\u011bchto prosp\u011b\u0161n\u00fdch peptid\u016f, co\u017e vede k vazodilataci, natriur\u00e9ze, antifibrotick\u00fdm \u00fa\u010dink\u016fm a sn\u00ed\u017een\u00ed sympatick\u00e9ho tonu.<\/li>\n<li><strong>Valsartan<\/strong> blokuje angiotenzin-II AT<sub>1<\/sub> receptor, br\u00e1n\u00ed vazokonstrikci a retenci sod\u00edku zp\u016fsoben\u00e9 aldosteronem.<\/li>\n<li><strong>Pro\u010d kombinovat?<\/strong> Neprilysin tak\u00e9 degraduje angiotensin-II; izolovan\u00e9 inhibov\u00e1n\u00ed neprilysinu tedy zvy\u0161uje angiotensin-II. Sp\u00e1rov\u00e1n\u00ed s ARB tomuto probl\u00e9mu p\u0159edch\u00e1z\u00ed. (D\u0159\u00edv\u011bj\u0161\u00ed kombinace, omapatrilat, spojovala inhibici neprilysinu s inhibic\u00ed ACE a zp\u016fsobovala nep\u0159ijateln\u011b vysokou frekvenci angioed\u00e9mu \u2014 proto ARNI pou\u017e\u00edv\u00e1 ARB m\u00edsto ACE inhibitoru a proto je nutn\u00e1 vysazovac\u00ed lh\u016fta ACE inhibitoru p\u0159ed p\u0159echodem.)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u016fkazy<\/h2>\n<p><strong>PARADIGM-HF (2014)<\/strong> \u2014 8 442 pacient\u016f s HF-REF (EF \u226440%) ji\u017e na optim\u00e1ln\u00ed medikaci randomizovan\u00fdch na sacubitril\/valsartan nebo enalapril 10 mg 2\u00d7 denn\u011b. Studie p\u0159ed\u010dasn\u011b ukon\u010dena pro prosp\u011bch: <strong>20% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00ed mortality nebo hospitalizace pro HF<\/strong> (prim\u00e1rn\u00ed endpoint), 16% sn\u00ed\u017een\u00ed celkov\u00e9 mortality. Toto byla prvn\u00ed terapie, kter\u00e1 v p\u0159\u00edm\u00e9m srovn\u00e1n\u00ed p\u0159ekonala plnou d\u00e1vku ACE inhibitoru u HF-REF. Zavedla ARNI jako terapii prvn\u00ed volby u HF-REF v guidelines od roku 2016.<\/p>\n<p><strong>PARAGON-HF (2019)<\/strong> \u2014 4 822 pacient\u016f se srde\u010dn\u00edm selh\u00e1n\u00edm s preserved ejek\u010dn\u00ed frakc\u00ed (HF-PEF, EF \u226545%); nedos\u00e1hla prim\u00e1rn\u00edho endpointu (13% sn\u00ed\u017een\u00ed, p=0,06), ale prok\u00e1zala benefit v podskupin\u011b s EF 45-57%. FDA v roce 2021 schv\u00e1lila \u0161ir\u0161\u00ed indikaci v\u010detn\u011b HF-PEF; guidelines jsou opatrn\u011bj\u0161\u00ed a umis\u0165uj\u00ed ARNI u HF-PEF sp\u00ed\u0161e p\u0159i m\u00edrn\u011b sn\u00ed\u017een\u00e9 EF.<\/p>\n<p><strong>TRANSITION a PIONEER-HF (2019)<\/strong> \u2014 zah\u00e1jen\u00ed ARNI b\u011bhem akutn\u00ed hospitalizace pro HF je bezpe\u010dn\u00e9 a vede k v\u011bt\u0161\u00edmu sn\u00ed\u017een\u00ed NT-proBNP ne\u017e pozd\u011bj\u0161\u00ed p\u0159echod.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Srde\u010dn\u00ed selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed (HF-REF, EF \u226440%)<\/strong> \u2014 terapie prvn\u00ed volby nam\u00edsto ACE inhibitoru nebo ARB u v\u011bt\u0161iny pacient\u016f<\/li>\n<li><strong>Srde\u010dn\u00ed selh\u00e1n\u00ed s preserved nebo m\u00edrn\u011b sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed<\/strong> \u2014 schv\u00e1leno FDA; pozice v guidelines se li\u0161\u00ed podle podskupin EF<\/li>\n<li>Zah\u00e1jen\u00ed l\u00e9\u010dby b\u011bhem hospitalizace pro akutn\u00ed srde\u010dn\u00ed selh\u00e1n\u00ed (TRANSITION, PIONEER-HF)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed<\/h2>\n<p>Dostupn\u00e9 s\u00edly (mg sakubitril \/ mg valsartan):<\/p>\n<ul>\n<li>24\/26 mg (n\u00edzk\u00e1)<\/li>\n<li>49\/51 mg (st\u0159edn\u00ed)<\/li>\n<li>97\/103 mg (c\u00edlov\u00e9)<\/li>\n<\/ul>\n<p><strong>Typick\u00e9 titrov\u00e1n\u00ed:<\/strong> za\u010dn\u011bte s 49\/51 mg dvakr\u00e1t denn\u011b u pacient\u016f stabiln\u00edch na ACE inhibitoru nebo ARB; za\u010dn\u011bte s 24\/26 mg dvakr\u00e1t denn\u011b u pacient\u016f bez p\u0159edchoz\u00ed l\u00e9\u010dby ACE inhibitorem, s n\u00edzk\u00fdm krevn\u00edm tlakem, ren\u00e1ln\u00ed insuficienc\u00ed nebo v\u011bkem nad 75 let. Titrujte ka\u017ed\u00e9 2-4 t\u00fddny na 97\/103 mg dvakr\u00e1t denn\u011b.<\/p>\n<p><strong>Kritick\u00e9 pravidlo pro p\u0159echod z ACE inhibitoru:<\/strong> <strong>zachovejte 36hodinovou vyrovn\u00e1vac\u00ed dobu<\/strong> po posledn\u00ed d\u00e1vce ACE inhibitoru p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby p\u0159\u00edpravkem Vymada \u2014 kombinovan\u00e1 inhibice ACEi a neprilisinu v\u00fdrazn\u011b zvy\u0161uje riziko angioed\u00e9mu. P\u0159i p\u0159echodu z ARB nen\u00ed vyrovn\u00e1vac\u00ed doba nutn\u00e1.<\/p>\n<p><strong>Monitorov\u00e1n\u00ed:<\/strong> Monitorujte krevn\u00ed tlak, drasl\u00edk a kreatinin na za\u010d\u00e1tku, po 1-2 t\u00fddnech a ka\u017ed\u00e9 3-4 m\u011bs\u00edce. O\u010dek\u00e1vejte m\u00edrn\u00fd vzestup kreatininu (podobn\u011b jako u ACEi\/ARB). NT-proBNP pro sledov\u00e1n\u00ed odpov\u011bdi (pozn\u00e1mka: BNP nelze pou\u017e\u00edt, proto\u017ee neprilisinu degraduje BNP; pou\u017eijte NT-proBNP, kter\u00fd nen\u00ed substr\u00e1tem neprilisinu).<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li><strong>Hypotenze<\/strong> \u2014 \u010dast\u011bj\u0161\u00ed ne\u017e u samotn\u00fdch ACE inhibitor\u016f\/ARB; u mnoha pacient\u016f limituj\u00edc\u00ed d\u00e1vkov\u00e1n\u00ed<\/li>\n<li><strong>Hyperkal\u00e9mie<\/strong> \u2014 monitorujte hladinu drasl\u00edku<\/li>\n<li><strong>Vzestup kreatininu<\/strong> \u2014 o\u010dek\u00e1van\u00fd, podobn\u011b jako ACEi\/ARB<\/li>\n<li><strong>Angioed\u00e9m<\/strong> \u2014 vz\u00e1cn\u00fd (~0,5 %); \u010dast\u011bj\u0161\u00ed u \u010dernoch\u016f<\/li>\n<li><strong>Ka\u0161el<\/strong> \u2014 vz\u00e1cn\u011bj\u0161\u00ed ne\u017e u ACEi<\/li>\n<li>Z\u00e1vrat\u011b, \u00fanava, mdloby<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li>Historie angioed\u00e9mu s ACEi nebo ARB<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed ACE inhibitoru nebo do 36 hodin po posledn\u00ed d\u00e1vce ACEi<\/li>\n<li>T\u011bhotenstv\u00ed (teratogenn\u00ed \u2013 slo\u017eka valsartanu)<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed (Child-Pugh C)<\/li>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed aliskirenu u diabetick\u00fdch pacient\u016f<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>ACE inhibitory \u2013 KRITICK\u00c9.<\/strong> P\u0159ed p\u0159echodem na ARNI je nutn\u00e1 36hodinov\u00e1 p\u0159est\u00e1vka. Nikdy nekombinujte.<\/li>\n<li><strong>Aliskiren<\/strong> \u2014 kontraindikovan\u00e1 kombinace u diabetu; jinak se vyhn\u011bte.<\/li>\n<li><strong>Dopl\u0148ky drasl\u00edku, \u0161et\u0159\u00edc\u00ed diuretika<\/strong> \u2014 aditivn\u00ed hyperkal\u00e9mie.<\/li>\n<li><strong>NSAID<\/strong> \u2014 oslaben\u00ed antihypertenzn\u00edho \u00fa\u010dinku; zv\u00fd\u0161en\u00e9 riziko AKI (trojit\u00fd efekt s diuretikem).<\/li>\n<li><strong>Lithium<\/strong> \u2014 sn\u00ed\u017een\u00e1 ren\u00e1ln\u00ed clearance; monitorujte hladiny.<\/li>\n<li><strong>Inhibitory PDE5<\/strong> \u2014 aditivn\u00ed riziko hypotenze.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte Vymadu pod 25\u00b0C v p\u016fvodn\u00edm blistru. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Mus\u00edm p\u0159estat u\u017e\u00edvat ACE inhibitor p\u0159ed Vymadou?<\/h3>\n<p>Ano \u2014 p\u0159esta\u0148te u\u017e\u00edvat ACE inhibitor a po\u010dkejte 36 hodin p\u0159ed zah\u00e1jen\u00edm u\u017e\u00edv\u00e1n\u00ed Vymady. Kombinovan\u00e1 inhibice neprilysinu + ACE inhibitoru zp\u016fsobuje nep\u0159ijateln\u00e9 riziko angioed\u00e9mu (pou\u010den\u00ed z ne\u00fasp\u011b\u0161n\u00e9 studie OVERTURE s omapatrilatem). P\u0159i p\u0159echodu z ARB nen\u00ed nutn\u00e1 p\u0159est\u00e1vka.<\/p>\n<h3 class=\"wp-block-heading\">Nahrad\u00ed Vymada m\u00e9 dal\u0161\u00ed l\u00e9ky na srde\u010dn\u00ed selh\u00e1n\u00ed?<\/h3>\n<p>Ne. Vymada nahrazuje ACE inhibitor nebo ARB v l\u00e9\u010db\u011b srde\u010dn\u00edho selh\u00e1n\u00ed. Pokra\u010dujte v u\u017e\u00edv\u00e1n\u00ed beta-blok\u00e1toru, antagonisty mineralokortikoidn\u00edho receptoru (spironolakton, eplerenon), SGLT2 inhibitoru a diuretik beze zm\u011bny. Modern\u00ed \u201c\u010dty\u0159kombinace\u201d l\u00e9\u010dby HF-REF je: ARNI + beta-blok\u00e1tor + MR antagonist + SGLT2i.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se m\u011b\u0159\u00ed NT-proBNP a ne BNP?<\/h3>\n<p>Neprilysin (kter\u00fd Vymada inhibuje) degraduje BNP, ale ne NT-proBNP. P\u0159i l\u00e9\u010db\u011b ARNI hladiny BNP um\u011ble stoupaj\u00ed (proto\u017ee je m\u00e9n\u011b degradov\u00e1no), co\u017e zkresluje m\u011b\u0159en\u00ed. NT-proBNP je \u0161t\u011bpn\u00fd produkt, kter\u00fd nen\u00ed substr\u00e1tem neprilysinu, a proto i nad\u00e1le odr\u00e1\u017e\u00ed z\u00e1va\u017enost srde\u010dn\u00edho selh\u00e1n\u00ed p\u0159i l\u00e9\u010db\u011b ARNI.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Vymadu v t\u011bhotenstv\u00ed?<\/h3>\n<p>Ne \u2014 slo\u017eka valsartanu je teratogenn\u00ed (fet\u00e1ln\u00ed ren\u00e1ln\u00ed ageneze, oligohydramnion). P\u0159eru\u0161te l\u00e9\u010dbu ARNI p\u0159ed pl\u00e1novan\u00fdm t\u011bhotenstv\u00edm nebo p\u0159i potvrzen\u00ed nepl\u00e1novan\u00e9ho t\u011bhotenstv\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Kde si mohu koupit Vymada online?<\/h3>\n<p>Vymadu (sacubitril\/valsartan 50 a 100 mg, 28-84 tablet) m\u016f\u017eete zakoupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed kardiovaskul\u00e1rn\u00ed l\u00e9ky<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/abana\/\">Abana \u2014 \u00e1jurv\u00e9dsk\u00e1 kardi\u00e1ln\u00ed formulace<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ambrican\/\">Ambrican \u2014 Ambrisentan 5 mg (ERA pro PAH)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cardace\/\">Cardace \u2014 Ramipril (ACE inhibitor)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cordarone\/\">Cordarone \u2014 Amiodarone 100\/200 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lonitab\/\">Lonitab \u2014 Minoxidil 5 mg (or\u00e1ln\u00ed vazodilat\u00e1tor)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/xarelto-20\/\">Xarelto 20 \u2014 Rivaroxaban 20 mg (DOAC)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Vymada je p\u0159\u00edpravek spole\u010dnosti Novartis obsahuj\u00edc\u00ed sacubitril\/valsartan v tablet\u00e1ch 50\/100 mg \u2014 prvn\u00ed inhibitor receptoru angiotensinu a neprilisinu (ARNI), kter\u00fd je na trhu pod n\u00e1zvem Entresto. Studie PARADIGM-HF (2014) prok\u00e1zala 20% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00ed mortality nebo hospitalizace pro srde\u010dn\u00ed selh\u00e1n\u00ed ve srovn\u00e1n\u00ed s enalaprilem u pacient\u016f s HF-REF. Podle doporu\u010den\u00ed ESC z roku 2021 a AHA\/ACC z roku 2022 je l\u00e9kem prvn\u00ed volby pro stabiln\u00ed HF-REF nam\u00edsto ACE inhibitor\u016f nebo ARB. D\u016eLE\u017dIT\u00c9: P\u0159i p\u0159echodu z ACE inhibitoru je nutn\u00e1 36hodinov\u00e1 p\u0159est\u00e1vka (riziko angioed\u00e9mu). BNP nelze pou\u017e\u00edt ke sledov\u00e1n\u00ed odpov\u011bdi \u2014 pou\u017eijte NT-proBNP.<\/p>","protected":false},"featured_media":51988,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3437,3438,3439],"class_list":{"0":"post-51987","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-sacubitril","11":"product_tag-valsartan","12":"product_tag-vymada","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\/51987","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=51987"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51988"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51987"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51987"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51987"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}