{"id":57515,"date":"2024-02-27T17:47:54","date_gmt":"2024-02-27T17:47:54","guid":{"rendered":"https:\/\/medsname.com\/hyros\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"hyros","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/hyros\/","title":{"rendered":"Hyros"},"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 Hyros?<\/h3>\n<p style=\"margin:0;\"><strong>Hyros<\/strong> je <strong>12,5 \/ 25 mg tableta hydrochlorothiazidu<\/strong> od Zydus Cadila \u2014 <strong>thiazidov\u00e9 diuretikum (benzothiadiazin sulfonamid)<\/strong> kter\u00fd p\u016fsob\u00ed na <strong>NCC (sodno-chloridov\u00fd kotransport\u00e9r) v dist\u00e1ln\u00edm sto\u010den\u00e9m tubulu<\/strong>. Hydrochlorothiazid byl uveden v roce 1959 spole\u010dnost\u00ed Merck Sharp &amp; Dohme jako <strong>HydroDiuril<\/strong> \u2014 odvozen od sulfanilamidu b\u011bhem programu sulfonamidov\u00fdch antibiotik, kdy byla jeho diuretick\u00e1 aktivita n\u00e1hodn\u011b zpozorov\u00e1na. HCTZ se stala referen\u010dn\u00edm thiazidem a od t\u00e9 doby je l\u00e9kem prvn\u00ed volby p\u0159i l\u00e9\u010db\u011b hypertenze. Polo\u010das 6-15 hodin; n\u00e1stup \u00fa\u010dinku za 2 hodiny; vrchol \u00fa\u010dinku za 4-6 hodin; d\u00e9lka \u00fa\u010dinku 6-12 hodin. Hlavn\u00ed indikace: <strong>hypertenze (l\u00e9\u010dba prvn\u00ed volby; doporu\u010dov\u00e1na v guidelines spolu s ARB, ACE inhibitory a CCB).<\/strong>. Typick\u00e9 d\u00e1vkov\u00e1n\u00ed: Za\u010dn\u011bte s 12,5 mg jednou denn\u011b r\u00e1no. C\u00edlov\u00e1 d\u00e1vka 12,5-25 mg. <strong>Nep\u0159ekra\u010dujte 25 mg<\/strong> u hypertenze \u2014 vy\u0161\u0161\u00ed d\u00e1vky p\u0159in\u00e1\u0161ej\u00ed sn\u00ed\u017een\u00fd \u00fa\u010dinek na krevn\u00ed tlak, ale zhor\u0161uj\u00ed metabolick\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky (ur\u00e1ty, gluk\u00f3za, lipidy). Modern\u00ed guidelines se odkl\u00e1n\u011bj\u00ed od historick\u00e9 antihypertenzn\u00ed d\u00e1vky 50 mg. Kl\u00ed\u010dov\u00e9 kontraindikace: viz \u00fapln\u00fd seznam n\u00ed\u017ee. Sledujte elektrolyty, kreatinin a gluk\u00f3zu. <strong>Nekombinujte s lithiem<\/strong> (thiazidov\u00e1\/smy\u010dkov\u00e1 diuretika mohou vyvolat toxicitu lithia). <strong>U\u017eit\u00ed v t\u011bhotenstv\u00ed je p\u0159\u00edpad od p\u0159\u00edpadu<\/strong> (viz pozn\u00e1mka k t\u011bhotenstv\u00ed). U v\u011bt\u0161iny hypertonik\u016f funguj\u00ed diuretika nejl\u00e9pe jako <strong>druh\u00fd nebo t\u0159et\u00ed l\u00e9k<\/strong> \u2014 obvykle v kombinaci s ARB, ACE inhibitorem nebo blok\u00e1torem kalciov\u00fdch kan\u00e1l\u016f sp\u00ed\u0161e ne\u017e samostatn\u011b.<\/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 Hyros?<\/h2>\n<p>Hyros jsou peror\u00e1ln\u00ed tablety hydrochlorothiazidu v d\u00e1vk\u00e1ch 12,5\/25 mg od Zydus Cadila, dod\u00e1van\u00e9 v balen\u00ed po 30\u2013180 tablet\u00e1ch. Hydrochlorothiazid byl uveden na trh v roce 1959 spole\u010dnost\u00ed Merck Sharp &amp; Dohme jako <strong>HydroDiuril<\/strong> \u2014 odvozen od sulfanilamidu b\u011bhem programu sulfonamidov\u00fdch antibiotik, kdy byla jeho diuretick\u00e1 aktivita n\u00e1hodn\u011b zpozorov\u00e1na. HCTZ se stala referen\u010dn\u00edm thiazidem a od t\u00e9 doby je l\u00e9kem prvn\u00ed volby p\u0159i l\u00e9\u010db\u011b hypertenze.<\/p>\n<h2 class=\"wp-block-heading\">Jak hydrochlorothiazid funguje<\/h2>\n<p>Hydrochlorothiazid inhibuje <strong>NCC (sodno-chloridov\u00fd kotransport\u00e9r) v dist\u00e1ln\u00edm sto\u010den\u00e9m tubulu<\/strong>. N\u00e1sledn\u00e9 \u00fa\u010dinky:<\/p>\n<ul>\n<li><strong>Sn\u00ed\u017een\u00e1 reabsorbce sod\u00edku<\/strong> v dist\u00e1ln\u00edm sto\u010den\u00e9m kan\u00e1lku \u2014 m\u00edrn\u00e9 (~5%) zv\u00fd\u0161en\u00ed vylu\u010dov\u00e1n\u00ed sod\u00edku mo\u010d\u00ed<\/li>\n<li><strong>Objemov\u00e1 kontrakce<\/strong> b\u011bhem prvn\u00edch 1-2 t\u00fddn\u016f \u2014 to je dominantn\u00ed \u010dasn\u00fd mechanismus sni\u017eov\u00e1n\u00ed krevn\u00edho tlaku<\/li>\n<li><strong>P\u0159\u00edm\u00e1 vazodilata\u010dn\u00ed aktivita<\/strong> vyv\u00edjej\u00edc\u00ed se b\u011bhem 2-6 t\u00fddn\u016f \u2014 dominantn\u00ed dlouhodob\u00fd mechanismus sni\u017eov\u00e1n\u00ed krevn\u00edho tlaku; thiazidy v ust\u00e1len\u00e9m stavu sni\u017euj\u00ed syst\u00e9movou c\u00e9vn\u00ed rezistenci nez\u00e1visle na pokra\u010duj\u00edc\u00ed objemov\u00e9 kontrakci<\/li>\n<li><strong>Pos\u00edlen\u00e1 reabsorpce kalcia v dist\u00e1ln\u00edch tubulech<\/strong> \u2014 m\u00edrn\u011b zvy\u0161uje s\u00e9rov\u00fd kalcium a sni\u017euje vylu\u010dov\u00e1n\u00ed kalcia mo\u010d\u00ed (vyu\u017e\u00edv\u00e1 se p\u0159i prevenci kalciov\u00fdch kamen\u016f)<\/li>\n<li><strong>Sn\u00ed\u017een\u00e1 clearance voln\u00e9 vody<\/strong> \u2014 m\u016f\u017ee u vn\u00edmav\u00fdch pacient\u016f zp\u016fsobit hyponatr\u00e9mii<\/li>\n<li><strong>Aktivace syst\u00e9mu renin-angiotensin-aldosteron<\/strong> jako kompenza\u010dn\u00ed odpov\u011b\u010f \u2014 \u010d\u00e1ste\u010dn\u011b tlum\u00ed \u00fa\u010dinek monoterapie na krevn\u00ed tlak; neutralizov\u00e1no kombinac\u00ed s ARB nebo ACE inhibitorem (od\u016fvodn\u011bn\u00ed pro FDC jako <a href=\"https:\/\/medsbase.com\/cs\/telma-h\/\">Telma H<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/cosart-h\/\">Cosart H<\/a>)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Hypertenze (l\u00e9\u010dba prvn\u00ed volby; doporu\u010deno v guidelines spolu s ARB, ACEi a CCB)<\/strong> \u2014 prim\u00e1rn\u00ed indikace<\/li>\n<li><strong>M\u00edrn\u00fd ed\u00e9m p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed<\/strong> \u2014 p\u0159i nedostate\u010dn\u00e9 kontrole p\u0159ej\u00edt na kli\u010dkov\u00fd diuretikum<\/li>\n<li><strong>Opakovan\u00e9 kalciov\u00e9 ledvinov\u00e9 kameny<\/strong> \u2014 d\u00e1vka 12,5-25 mg sni\u017euje vylu\u010dov\u00e1n\u00ed kalcia a recidivu kamen\u016f o 30-50%<\/li>\n<li><strong>Nefrogenn\u00ed diabetes insipidus<\/strong> \u2014 paradoxn\u00ed sn\u00ed\u017een\u00ed diur\u00e9zy p\u0159i d\u00e1vce 25 mg 2\u00d7 denn\u011b<\/li>\n<li><strong>Osteopor\u00f3za<\/strong> \u2014 m\u00edrn\u00fd benefit d\u00edky sn\u00ed\u017een\u00fdm ztr\u00e1t\u00e1m kalcia mo\u010d\u00ed (pouze adjuvantn\u00ed l\u00e9\u010dba)<\/li>\n<\/ul>\n<p><strong>Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> <strong>ALLHAT (2002)<\/strong> \u2014 chlortalidon (bl\u00edzk\u00fd analog thiazid\u016f) nebyl hor\u0161\u00ed ne\u017e amlodipin a lisinopril v mortalit\u011b a kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod\u00e1ch u &gt;33 000 hypertonik\u016f; potvrdil thiazidy jako l\u00e9\u010dbu prvn\u00ed volby. <strong>SHEP (1991)<\/strong> \u2014 terapie zalo\u017een\u00e1 na chlortalidonu sn\u00ed\u017eila v\u00fdskyt c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody o 36 % u izolovan\u00e9 systolick\u00e9 hypertenze u star\u0161\u00edch pacient\u016f. <strong>MRFIT, HDFP<\/strong> (70. a\u017e 80. l\u00e9ta) \u2014 d\u0159\u00edv\u011bj\u0161\u00ed v\u011bdeck\u00e9 podklady. Rozs\u00e1hl\u00e1 data o konkr\u00e9tn\u00edch v\u00fdstupech pro HCTZ jsou slab\u0161\u00ed ne\u017e u chlortalidonu, ale p\u0159edpokl\u00e1d\u00e1 se t\u0159\u00eddn\u00ed efekt.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Hyrosu<\/h2>\n<p><strong>D\u00e1vka pro hypertenzi:<\/strong> Za\u010dn\u011bte s 12,5 mg jednou denn\u011b r\u00e1no. C\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed 12,5\u201325 mg. <strong>Nep\u0159ekra\u010dujte 25 mg<\/strong> u hypertenze \u2014 vy\u0161\u0161\u00ed d\u00e1vky p\u0159in\u00e1\u0161ej\u00ed klesaj\u00edc\u00ed \u00fa\u010dinek na krevn\u00ed tlak, ale zhor\u0161uj\u00ed metabolick\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky (ur\u00e1ty, gluk\u00f3za, lipidy). Modern\u00ed doporu\u010den\u00ed se od historick\u00e9 antihypertenzn\u00ed d\u00e1vky 50 mg odkl\u00e1n\u011bj\u00ed.<\/p>\n<p><strong>Dal\u0161\u00ed indikace:<\/strong> <strong>M\u00edrn\u00fd ed\u00e9m p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed:<\/strong> 25\u201350 mg\/den; p\u0159i nedostate\u010dn\u00e9 kontrole p\u0159ej\u00edt na kli\u010dkov\u00e1 diuretika (furosemid). <strong>Idiopatick\u00e1 hyperkalciurie (opakovan\u00e9 kalciov\u00e9 kameny):<\/strong> 12,5-25 mg\/den \u2014 thiazidy podporuj\u00ed reabsorpci v\u00e1pn\u00edku v dist\u00e1ln\u00edm tubulu a sni\u017euj\u00ed recidivu ledvinov\u00fdch kamen\u016f o 30-50 %. <strong>Nefrogenn\u00ed diabetes insipidus:<\/strong> 25 mg dvakr\u00e1t denn\u011b paradoxn\u011b sni\u017euje objem mo\u010di.<\/p>\n<p><strong>Pod\u00e1v\u00e1n\u00ed:<\/strong> jednou denn\u011b (nebo dvakr\u00e1t denn\u011b u vysok\u00fdch d\u00e1vek kli\u010dkov\u00fdch diuretik p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed), r\u00e1no. Ve\u010dern\u00ed pod\u00e1v\u00e1n\u00ed zp\u016fsobuje nykturii a m\u011blo by b\u00fdt pokud mo\u017eno vynech\u00e1no. U\u017e\u00edvejte ve stejnou denn\u00ed dobu. Potrava v\u00fdznamn\u011b neovliv\u0148uje vst\u0159eb\u00e1v\u00e1n\u00ed \u017e\u00e1dn\u00e9ho z t\u011bchto diuretik.<\/p>\n<p><strong>Monitorovac\u00ed pl\u00e1n:<\/strong><\/p>\n<ul>\n<li><strong>Vstupn\u00ed vy\u0161et\u0159en\u00ed:<\/strong> mo\u010dovina, elektrolyty (zejm\u00e9na drasl\u00edk a sod\u00edk), kreatinin, eGFR, gluk\u00f3za, s\u00e9rov\u00fd ur\u00e1t. Dom\u00e1c\u00ed nebo klinick\u00e9 m\u011b\u0159en\u00ed TK a denn\u00ed v\u00e1ha u pacient\u016f se srde\u010dn\u00edm selh\u00e1n\u00edm.<\/li>\n<li><strong>1-2 t\u00fddny po zah\u00e1jen\u00ed nebo zm\u011bn\u011b d\u00e1vky:<\/strong> opakujte U&amp;E a kreatinin. O\u010dek\u00e1vejte m\u00edrn\u00e9 zm\u011bny elektrolyt\u016f; vy\u0161et\u0159te v\u00fdrazn\u00e9 odchylky.<\/li>\n<li><strong>4-6 t\u00fddn\u016f:<\/strong> Kontrola krevn\u00edho tlaku a kompletn\u00ed metabolick\u00fd panel.<\/li>\n<li><strong>Pr\u016fb\u011b\u017en\u00e9:<\/strong> Ro\u010dn\u00ed vy\u0161et\u0159en\u00ed U&amp;E, ur\u00e1t\u016f, gluk\u00f3zy a lipidov\u00e9ho panelu po stabilizaci. \u010cast\u011bj\u0161\u00ed u CKD, srde\u010dn\u00edho selh\u00e1n\u00ed nebo p\u0159i kombinovan\u00e9 terapii.<\/li>\n<li><strong>P\u0159eru\u0161it l\u00e9\u010dbu nebo sn\u00ed\u017eit d\u00e1vkov\u00e1n\u00ed p\u0159i:<\/strong> sod\u00edk &lt;130 s p\u0159\u00edznaky, drasl\u00edk 5,5, vzestup kreatininu &gt;30 %, nov\u00e1 dna, p\u0159\u00edznaky t\u011b\u017ek\u00e9 dehydratace.<\/li>\n<\/ul>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> \u017d\u00e1dn\u00fd abstinen\u010dn\u00ed syndrom, ale n\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee zp\u016fsobit rebound retenci tekutin u pacient\u016f se srde\u010dn\u00edm selh\u00e1n\u00edm na chronick\u00e9 vysok\u00e9 d\u00e1vce kli\u010dkov\u00fdch diuretik \u2014 pokud mo\u017eno postupn\u011b sni\u017eovat a monitorovat hmotnost.<\/p>\n<ul>\n<li><strong>Ztr\u00e1c\u00ed \u00fa\u010dinnost p\u0159i eGFR &lt;30.<\/strong> P\u0159i pokro\u010dil\u00e9m CKD p\u0159ejd\u011bte na kli\u010dkov\u00e1 diuretika (furosemid, torasemid) \u2014 thiazidy vy\u017eaduj\u00ed funk\u010dn\u00ed dod\u00e1vku sod\u00edku do dist\u00e1ln\u00edho tubulu.<\/li>\n<li><strong>Zvy\u0161uje s\u00e9rov\u00fd v\u00e1pn\u00edk<\/strong> (paradox: thiazidy zvy\u0161uj\u00ed dist\u00e1ln\u00ed reabsorpci v\u00e1pn\u00edku). U\u017eite\u010dn\u00e9 u pacient\u016f s osteopor\u00f3zou; problematick\u00e9 u hyperkalcemick\u00fdch stav\u016f (prim\u00e1rn\u00ed hyperparatyre\u00f3za, sarkoid\u00f3za).<\/li>\n<li><strong>Fotosensitivn\u00ed vyr\u00e1\u017eka<\/strong> je specifick\u00fd \u00fa\u010dinek thiazid\u016f \u2014 doporu\u010dte ochranu p\u0159ed sluncem v oblastech s intenzivn\u00edm slune\u010dn\u00edm z\u00e1\u0159en\u00edm.<\/li>\n<li><strong>K\u0159\u00ed\u017eov\u00e1 reaktivita se sulfonamidy<\/strong> \u2014 vyhn\u011bte se p\u0159i t\u011b\u017ek\u00e9 alergii na sulfonamidy (vz\u00e1cn\u00e9; neantibiotick\u00e9 sulfonamidy m\u00e1lokdy k\u0159\u00ed\u017eov\u011b reaguj\u00ed).<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9 (&gt;1 %):<\/strong><\/p>\n<ul>\n<li><strong>Hypokal\u00e9mie<\/strong> (3-5 %) \u2014 \u010dast\u011bj\u0161\u00ed p\u0159i d\u00e1vk\u00e1ch &gt;25 mg; v\u011bt\u0161inou prevenci p\u0159i kombinaci s ACEi\/ARB<\/li>\n<li><strong>Hyponatr\u00e9mie<\/strong> (2-5 %) \u2014 zejm\u00e9na u star\u0161\u00edch \u017een na n\u00edzkosoln\u00fdch diet\u00e1ch; m\u016f\u017ee b\u00fdt z\u00e1va\u017en\u00e9<\/li>\n<li><strong>Hyperurik\u00e9mie<\/strong> a vyvol\u00e1n\u00ed dny<\/li>\n<li><strong>M\u00edrn\u00e9 zhor\u0161en\u00ed gluk\u00f3zov\u00e9 tolerance<\/strong> (pr\u016fm\u011brn\u00e9 zv\u00fd\u0161en\u00ed glyk\u00e9mie nala\u010dno o 5-8 mg\/dl)<\/li>\n<li><strong>M\u00edrn\u00e9 zv\u00fd\u0161en\u00ed LDL a triglycerid\u016f<\/strong><\/li>\n<li><strong>Erektiln\u00ed dysfunkce<\/strong> u n\u011bkter\u00fdch mu\u017e\u016f \u2014 z\u00e1vislost na d\u00e1vce<\/li>\n<li><strong>Hyperkalc\u00e9mie<\/strong> (obvykle m\u00edrn\u00e9)<\/li>\n<li><strong>Fotosensitivn\u00ed vyr\u00e1\u017eka<\/strong><\/li>\n<\/ul>\n<p><strong>Nep\u0159\u00edli\u0161 \u010dast\u00e9, ale klinicky v\u00fdznamn\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>T\u011b\u017ek\u00e1 hyponatr\u00e9mie<\/strong> \u2014 zejm\u00e9na u star\u0161\u00edch osob na n\u00edzkosoln\u00fdch diet\u00e1ch, p\u0159i stavech n\u00e1chyln\u00fdch k SIADH nebo v kombinaci se SSRI. M\u016f\u017ee se projevit zmatenost\u00ed, p\u00e1dy nebo z\u00e1chvaty.<\/li>\n<li><strong>Pankreatitida<\/strong> \u2014 vz\u00e1cn\u00fd t\u0159\u00eddn\u00ed \u00fa\u010dinek thiazid\u016f\/smy\u010dkov\u00fdch diuretik; okam\u017eit\u011b vysadit p\u0159i bolesti v nadb\u0159i\u0161ku se vzestupem lip\u00e1zy<\/li>\n<li><strong>Trombocytopenie, leukopenie, agranulocyt\u00f3za<\/strong> \u2014 vz\u00e1cn\u00e9 hypersenzitivn\u00ed reakce (\u010dast\u011bj\u0161\u00ed u thiazid\u016f ne\u017e u smy\u010dkov\u00fdch diuretik)<\/li>\n<li><strong>Akutn\u00ed myopie a uzav\u0159en\u00fd \u00fahel glaukomu<\/strong> \u2014 vz\u00e1cn\u00e1 reakce sulfonamidov\u00e9 t\u0159\u00eddy b\u011bhem hodin a\u017e dn\u016f od za\u010d\u00e1tku pod\u00e1v\u00e1n\u00ed; okam\u017eit\u011b vysadit p\u0159i n\u00e1hl\u00e9 bolesti oka nebo zm\u011bn\u011b vid\u011bn\u00ed<\/li>\n<li><strong>Stevens-Johnson\u016fv syndrom \/ toxick\u00e1 epiderm\u00e1ln\u00ed nekrol\u00fdza<\/strong> \u2014 extr\u00e9mn\u011b vz\u00e1cn\u00e9, ale popsan\u00e9<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li>Anurie nebo t\u011b\u017ek\u00e9 ren\u00e1ln\u00ed posti\u017een\u00ed (eGFR &lt;30) \u2014 ztr\u00e1c\u00ed \u00fa\u010dinnost<\/li>\n<li>P\u0159ecitliv\u011blost na sulfonamidy (sulfa)<\/li>\n<li>Symptomatick\u00e1 hyponatr\u00e9mie (Na &lt;130) nebo hypokal\u00e9mie (K &lt;3,0) p\u0159i v\u00fdchoz\u00edm vy\u0161et\u0159en\u00ed<\/li>\n<li>Hyperkalc\u00e9mie<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed (Child-Pugh C)<\/li>\n<li>Addisonova choroba (prim\u00e1rn\u00ed adren\u00e1ln\u00ed insuficience)<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> obecn\u011b se nedoporu\u010duje \u2014 thiazidy proch\u00e1zej\u00ed placentou a mohou zp\u016fsobit novorozeneckou \u017eloutenku a trombocytopenii. Pou\u017e\u00edvat pouze pokud p\u0159\u00ednos jasn\u011b p\u0159eva\u017euje riziko (rezistentn\u00ed hypertenze v pozdn\u00edm t\u011bhotenstv\u00ed), pod odborn\u00fdm dohledem.<\/p>\n<p><strong>Kojen\u00ed:<\/strong> obecn\u011b p\u0159ijateln\u00e9 v n\u00edzk\u00fdch d\u00e1vk\u00e1ch; vysok\u00e9 d\u00e1vky mohou potla\u010dit laktaci (zejm\u00e9na thiazidy). Preferuj\u00ed se alternativn\u00ed antihypertenziva (propranolol, nifedipin), pokud je to mo\u017en\u00e9.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Lithium \u2014 KRITICK\u00c1 INTERAKCE.<\/strong> Thiazidov\u00e1 a kli\u010dkov\u00e1 diuretika sni\u017euj\u00ed ren\u00e1ln\u00ed clearance lithia a mohou vyvolat lithiovou toxicitu. Pokud je to mo\u017en\u00e9, kombinaci se vyhn\u011bte; pokud je to nevyhnuteln\u00e9, monitorujte hladiny lithia t\u00fddn\u011b po prvn\u00ed m\u011bs\u00edc a sni\u017ete d\u00e1vku lithia o 25-50 %.<\/li>\n<li><strong>NSAID<\/strong> \u2014 sni\u017euj\u00ed diuretick\u00fd \u00fa\u010dinek (blok\u00e1dou prostaglandin\u016f) a v\u00fdrazn\u011b zvy\u0161uj\u00ed riziko akutn\u00edho po\u0161kozen\u00ed ledvin (AKI) v kombinaci s ACEi\/ARB (tzv. \u201ctriple whammy\u201d). P\u0159i chronick\u00e9 bolesti up\u0159ednost\u0148ujte paracetamol.<\/li>\n<li><strong>ACE inhibitory a ARB<\/strong> \u2014 tato kombinace je standardn\u00ed a prosp\u011b\u0161n\u00e1 u hypertenze; p\u0159id\u00e1n\u00ed ACEi\/ARB blokuje kompenza\u010dn\u00ed aktivaci RAAS a zesiluje diuretick\u00fd \u00fa\u010dinek. Monitorujte hladinu drasl\u00edku a kreatininu.<\/li>\n<li><strong>Drasl\u00edkov\u00e9 dopl\u0148ky a \u0161et\u0159\u00edc\u00ed diuretika<\/strong> \u2014 \u010dasto jsou pot\u0159eba k vyrovn\u00e1n\u00ed hypokal\u00e9mie vyvolan\u00e9 kli\u010dkov\u00fdmi\/thiazidov\u00fdmi diuretiky. Monitorujte hladinu drasl\u00edku; vyhn\u011bte se nadm\u011brn\u00e9 korekci.<\/li>\n<li><strong>Digoxin<\/strong> \u2014 hypokal\u00e9mie zesiluje toxicitu digoxinu (kli\u010dkov\u00e1 a thiazidov\u00e1 diuretika); spironolakton p\u0159\u00edmo sni\u017euje clearance digoxinu. Monitorujte hladiny digoxinu a drasl\u00edku p\u0159i zah\u00e1jen\u00ed nebo zm\u011bn\u011b diuretick\u00e9 l\u00e9\u010dby.<\/li>\n<li><strong>Peror\u00e1ln\u00ed kortikosteroidy, amfotericin B, stimula\u010dn\u00ed laxativa<\/strong> \u2014 aditivn\u00ed hypokal\u00e9mie (kli\u010dkov\u00e1\/thiazidov\u00e1 diuretika) nebo maskovan\u00e1 pot\u0159eba drasl\u00edku (spironolakton).<\/li>\n<li><strong>Peror\u00e1ln\u00ed antidiabetika, inzulin<\/strong> \u2014 thiazidy a (m\u00e9n\u011b) kli\u010dkov\u00e1 diuretika zhor\u0161uj\u00ed gluk\u00f3zovou toleranci; m\u016f\u017ee b\u00fdt nutn\u00e1 \u00faprava d\u00e1vkov\u00e1n\u00ed.<\/li>\n<li><strong>Cholestyramin \/ colestipol<\/strong> \u2014 sni\u017euj\u00ed absorpci thiazid\u016f a kli\u010dkov\u00fdch diuretik o 40\u201385%. D\u00e1vkov\u00e1n\u00ed odd\u011blte 4hodinov\u00fdm intervalem.<\/li>\n<li><strong>Alkohol<\/strong> \u2014 aditivn\u00ed ortostatick\u00e1 hypotenze.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">M\u00edsto Hyrosu v t\u0159\u00edd\u011b diuretik<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">T\u0159\u00edda<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Z\u00e1stupci<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Typick\u00e9 pou\u017eit\u00ed<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Thiazid<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">HCTZ<\/a>, chlortalidon<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prvn\u00ed volba u hypertenze, ledvinov\u00e9 kameny, nefrogenn\u00ed diabetes insipidus<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Thiazid\u016fm podobn\u00e9<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/natrilix-sr\/\">Indapamid<\/a>, metolazon<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Hypertenze (u star\u0161\u00edch pacient\u016f, d\u016fkazy z HYVET), sekven\u010dn\u00ed blok\u00e1da nefronu<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kli\u010dkov\u00e1 (kr\u00e1tkodob\u00e1)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/lasix\/\">Furosemid<\/a>, bumetanide<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Akutn\u00ed plicn\u00ed ed\u00e9m, m\u011bstnav\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed, ascites, hyperkalc\u00e9mie<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Akutn\u00ed plicn\u00ed ed\u00e9m, CHF, ascites, hyperkalc\u00e9mie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/dytor\/\">Kli\u010dkov\u00e1 diuretika (dlouhodob\u00e1)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Chronick\u00e9 CHF, HTN (jen kli\u010dkov\u00e1 diuretika s d\u016fkazy HTN), ed\u00e9m p\u0159i CKD<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Chronick\u00e9 CHF, hypertenze (pouze kli\u010dkov\u00e1 diuretika s prok\u00e1zan\u00fdm \u00fa\u010dinkem p\u0159i hypertenzi), ed\u00e9m p\u0159i CKD<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/aldactone\/\">Spironolakton<\/a>, Antagonist\u00e9 aldosteronu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HF-REF (RALES), resistant HTN (PATHWAY-2), Conn\u2019s, cirrhotic ascites<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">eplerenon<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HF-REF (RALES), rezistentn\u00ed hypertenze (PATHWAY-2), Conn\u016fv syndrom, cirhotick\u00fd ascites<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prevence hypokal\u00e9mie p\u0159i p\u0159id\u00e1n\u00ed ke kli\u010dkov\u00e9mu\/thiazidov\u00e9mu diuretiku<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Amilorid, triamteren (obvykle v kombinac\u00edch)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prevence hypokal\u00e9mie p\u0159i p\u0159id\u00e1n\u00ed ke kli\u010dkov\u00fdm\/thiazidov\u00fdm diuretik\u016fm<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">v\u00fd\u0161kov\u00e1 nemoc, glaukom, metabolick\u00e1 alkal\u00f3za<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte Hyros p\u0159i teplot\u011b 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\">Kdy m\u00e1m u\u017e\u00edvat Hyros \u2014 r\u00e1no nebo ve\u010der?<\/h3>\n<p><strong>R\u00e1no<\/strong> v t\u00e9m\u011b\u0159 v\u0161ech p\u0159\u00edpadech. Diuretick\u00fd \u00fa\u010dinek zp\u016fsobuje zv\u00fd\u0161enou produkci mo\u010di po dobu 2-4 hodin po pod\u00e1n\u00ed. Ve\u010dern\u00ed d\u00e1vkov\u00e1n\u00ed zp\u016fsobuje nokturii a naru\u0161uje sp\u00e1nek. Pacienti u\u017e\u00edvaj\u00edc\u00ed kli\u010dkov\u00e1 diuretika dvakr\u00e1t denn\u011b obvykle d\u00e1vkuj\u00ed p\u0159i sn\u00eddani a v \u010dasn\u00e9m odpoledni (ne p\u0159ed span\u00edm).<\/p>\n<h3 class=\"wp-block-heading\">Je Hyros l\u00e9kem prvn\u00ed volby na krevn\u00ed tlak?<\/h3>\n<p>Ano \u2014 thiazidy (HCTZ, chlortalidon) a thiazid\u016fm podobn\u00e9 l\u00e1tky (indapamid) pat\u0159\u00ed mezi <strong>\u010dty\u0159i t\u0159\u00eddy antihypertenziv prvn\u00ed volby<\/strong> vedle ARB, ACE inhibitor\u016f a blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f. U v\u011bt\u0161iny nov\u011b diagnostikovan\u00fdch hypertonik\u016f je thiazid rozumnou prvn\u00ed nebo druhou volbou a t\u00e9m\u011b\u0159 v\u0161ichni pacienti na v\u00edcel\u00e9kov\u00e9 terapii jej u\u017e\u00edvaj\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Ovlivn\u00ed Hyros m\u016fj drasl\u00edk?<\/h3>\n<p>Ano \u2014 Hyros <strong>sni\u017euje<\/strong> drasl\u00edk zv\u00fd\u0161en\u00edm jeho vylu\u010dov\u00e1n\u00ed v dist\u00e1ln\u00edm tubulu. Monitorujte na za\u010d\u00e1tku, po 1-2 t\u00fddnech a periodicky. Riziko hypokal\u00e9mie je <strong>minimalizov\u00e1no kombinac\u00ed<\/strong> Hyros s ARB nebo ACE inhibitorem \u2014 co\u017e je standardn\u00ed kombinace p\u0159i hypertenzi. Pokud drasl\u00edk klesne pod 3,5 p\u0159i izolovan\u00e9m u\u017e\u00edv\u00e1n\u00ed diuretika, p\u0159idejte dopln\u011bk drasl\u00edku, stravu bohatou na drasl\u00edk nebo malou d\u00e1vku \u0161et\u0159\u00edc\u00edho drasl\u00edk (spironolakton, eplerenon nebo <a href=\"https:\/\/medsbase.com\/cs\/amifru\/\">kombinaci obsahuj\u00edc\u00ed amilorid<\/a>).<\/p>\n<h3 class=\"wp-block-heading\">M\u00e1m dnu \u2014 m\u016f\u017eu u\u017e\u00edvat Hyros?<\/h3>\n<p>S opatrnost\u00ed. Thiazidy a (m\u00e9n\u011b) kli\u010dkov\u00e1 diuretika zvy\u0161uj\u00ed s\u00e9rovou hladinu kyseliny mo\u010dov\u00e9 konkurenc\u00ed o vylu\u010dov\u00e1n\u00ed v proxim\u00e1ln\u00edm tubulu. U pacient\u016f n\u00e1chyln\u00fdch k dn\u011b: preferujte kombinace s losartanem (<a href=\"https:\/\/medsbase.com\/cs\/cosart-h\/\">Cosart H<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/cozartan-h\/\">Cozartan H<\/a>) jeho\u017e slo\u017eka losartan je v\u00fdjime\u010dn\u011b urikosurick\u00e1 a vyrovn\u00e1v\u00e1 vzestup ur\u00e1t\u016f zp\u016fsoben\u00fd thiazidem. Pokud je Hyros ji\u017e u\u017e\u00edv\u00e1n a dojde k vzplanut\u00ed dny, p\u0159idejte nebo pokra\u010dujte v l\u00e9\u010db\u011b sni\u017euj\u00edc\u00ed hladinu ur\u00e1t\u016f (alopurinol) sp\u00ed\u0161e ne\u017e \u00fapln\u00fdm vysazen\u00edm Hyrosu.<\/p>\n<h3 class=\"wp-block-heading\">M\u00e1m cukrovku \u2014 je Hyros bezpe\u010dn\u00fd?<\/h3>\n<p>V\u011bt\u0161inou ano, ale m\u011bjte na pam\u011bti, \u017ee thiazidy a (v men\u0161\u00ed m\u00ed\u0159e) kli\u010dkov\u00e1 diuretika <strong>m\u00edrn\u011b zhor\u0161uj\u00ed gluk\u00f3zovou toleranci<\/strong> (pr\u016fm\u011brn\u00fd n\u00e1r\u016fst glyk\u00e9mie nala\u010dno o 5-8 mg\/dL, HbA1c o 0,1-0,3%). V\u00fdhoda sn\u00ed\u017een\u00ed TK tento efekt u v\u011bt\u0161iny diabetik\u016f p\u0159eva\u017euje. Pokud chcete metabolicky neutr\u00e1ln\u011bj\u0161\u00ed kombinaci, alternativou je ARB+CCB (<a href=\"https:\/\/medsbase.com\/cs\/olmezest-am\/\">Olmezest AM<\/a>).<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat ibuprofen s p\u0159\u00edpravkem Hyros?<\/h3>\n<p>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 (ibuprofen, diklofenak, naproxen) <strong>sni\u017euje diuretick\u00fd a antihypertenzn\u00ed \u00fa\u010dinek<\/strong> u p\u0159\u00edpravku Hyros (blok\u00e1da prostaglandin\u016f) a v\u00fdrazn\u011b zvy\u0161uje riziko AKI v kombinaci s ACE inhibitorem nebo ARB \u2013 tzv. \u201ctrojit\u00e1 r\u00e1na\u201d. P\u0159i chronick\u00e9 bolesti up\u0159ednost\u0148ujte paracetamol.<\/p>\n<h3 class=\"wp-block-heading\">Budu v noci v\u00edce mo\u010dit?<\/h3>\n<p>Obvykle ne, pokud u\u017e\u00edv\u00e1te Hyros r\u00e1no. Diuretick\u00fd \u00fa\u010dinek vrchol\u00ed 2-4 hodiny po pod\u00e1n\u00ed a ve\u010der je v\u011bt\u0161inou ji\u017e vy\u010derp\u00e1n. Nokturie je \u010dastou st\u00ed\u017enost\u00ed p\u0159i p\u0159echodu na ve\u010dern\u00ed d\u00e1vkov\u00e1n\u00ed; n\u00e1vrat k rann\u00edmu d\u00e1vkov\u00e1n\u00ed obvykle vede k vymizen\u00ed nokturie b\u011bhem 1-3 dn\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Hyros v t\u011bhotenstv\u00ed?<\/h3>\n<p>Rutinn\u011b se nedoporu\u010duje. Thiazidy proch\u00e1zej\u00ed placentou a mohou ovlivnit plod. P\u0159i hypertenzi v t\u011bhotenstv\u00ed p\u0159ejd\u011bte na <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a>, methyldopu nebo nifedipin. Diuretika se v t\u011bhotenstv\u00ed pou\u017e\u00edvaj\u00ed pouze pro specifick\u00e9 indikace (plicn\u00ed ed\u00e9m, rezistentn\u00ed srde\u010dn\u00ed selh\u00e1n\u00ed) pod dohledem specialisty.<\/p>\n<h3 class=\"wp-block-heading\">Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>U\u017eijte ho, jakmile si vzpomenete, pokud ji\u017e nen\u00ed bl\u00edzko \u010das dal\u0161\u00ed d\u00e1vky \u2014 v tom p\u0159\u00edpad\u011b vynechejte zapomenutou d\u00e1vku. Nezdvojujte d\u00e1vku. Jedna vynechan\u00e1 d\u00e1vka v\u00fdznamn\u011b neovlivn\u00ed dlouhodobou kontrolu krevn\u00edho tlaku ani tekutin.<\/p>\n<h3 class=\"wp-block-heading\">Kde lze koupit Hyros online?<\/h3>\n<p>P\u0159\u00edpravek Hyros (12,5 \/ 25 mg hydrochlorothiazidu, 30-180 tablet) m\u016f\u017eete zakoupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva a diuretika na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">Aquazide \u2014 Hydrochlorothiazid (HCTZ) thiazid<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cosart-h\/\">Cosart H \u2014 Losartan + HCTZ fixn\u00ed kombinace<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/hydrocl\/\">Hydrocl \u2014 Hydrochlorothiazid (HCTZ)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/losar\/\">Losar \u2014 Losartan (ARB v kombinaci s diuretiky)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">Ramcor \u2014 Ramipril (ACE inhibitor jako partner pro diuretikum)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/silectone\/\">Silectone \u2014 Spironolakton (antagonista aldosteronu)<\/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>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/coversyl\/\">Coversyl<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/p-nolol\/\">P-Nolol<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/sazo\/\">Sazo<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ciplar\/\">Ciplar<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cort-s-injection\/\">Cort-S Injection<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Hyros od Zydus Cadila jsou tablety hydrochlorothiazidu 12,5\/25 mg \u2014 klasick\u00e9 thiazidov\u00e9 diuretikum pro hypertenzi (prvn\u00ed volba), m\u00edrn\u00e9 otoky p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed a prevenci opakuj\u00edc\u00edch se ledvinov\u00fdch kamen\u016f z v\u00e1pn\u00edku. Dob\u0159e se kombinuje s ARB, ACE inhibitory nebo blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f. Modern\u00ed d\u00e1vkov\u00e1n\u00ed 12,5-25 mg; vy\u0161\u0161\u00ed d\u00e1vky p\u0159in\u00e1\u0161ej\u00ed men\u0161\u00ed sn\u00ed\u017een\u00ed krevn\u00edho tlaku s hor\u0161\u00edmi metabolick\u00fdmi vedlej\u0161\u00edmi \u00fa\u010dinky.<\/p>","protected":false},"featured_media":57516,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3401,4318],"class_list":{"0":"post-57515","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-hyros","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/57515","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=57515"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/57516"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=57515"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=57515"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=57515"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=57515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}