{"id":57606,"date":"2024-02-27T17:52:19","date_gmt":"2024-02-27T17:52:19","guid":{"rendered":"https:\/\/medsname.com\/natrilix-sr\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"natrilix-sr","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/natrilix-sr\/","title":{"rendered":"Natrilix SR"},"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;\">&#9889; Quick Answer &mdash; What is Natrilix SR?<\/h3>\n<p style=\"margin:0;\"><strong>Natrilix SR<\/strong> je <strong>1.5 mg SR indapamide tablet<\/strong> from Servier &mdash; a <strong>thiazid\u016fm podobn\u00e9 diuretikum (indolin\/chlorosulfonamid)<\/strong> kter\u00fd p\u016fsob\u00ed na <strong>NCC (natrium-chloridov\u00fd kotransport\u00e9r) v dist\u00e1ln\u00edm tubulu, s dodate\u010dnou p\u0159\u00edmou vazodilata\u010dn\u00ed aktivitou<\/strong>. Indapamid byl uveden spole\u010dnost\u00ed Servier v roce 1977 jako <strong>Natrilix<\/strong>. Strukturn\u011b odli\u0161n\u00fd od thiazid\u016f (indolinov\u00fd kruh vs benzothiadiazin), ale sd\u00edl\u00ed mechanismus inhibice NCC; klinicky klasifikov\u00e1n jako \u201cthiazid\u016fm podobn\u00e9\u201d diuretikum spolu s chlortalidonem a metolazonem. Polo\u010das 14-18 hodin (IR) \/ 18 hodin (SR); n\u00e1stup \u00fa\u010dinku 1-2 hodiny; vrchol \u00fa\u010dinku 2 hodiny; trv\u00e1n\u00ed 24-36 hodin. Hlavn\u00ed indikace: <strong>hypertenze (l\u00e9\u010dba prvn\u00ed volby; zejm\u00e9na u star\u0161\u00edch pacient\u016f)<\/strong>. Typick\u00e9 d\u00e1vkov\u00e1n\u00ed: <strong>Hypertenze:<\/strong> 1,25-2,5 mg jednou denn\u011b (okam\u017eit\u00e1 forma) nebo 1,5 mg jednou denn\u011b (prodlou\u017een\u00e1 forma). N\u00edzk\u00e1 d\u00e1vka 1,25-1,5 mg poskytuje t\u00e9m\u011b\u0159 pln\u00fd \u00fa\u010dinek na TK s minim\u00e1ln\u00edmi metabolick\u00fdmi poruchami; 2,5 mg p\u0159id\u00e1v\u00e1 jen m\u00e1lo k \u00fa\u010dinku na TK, ale zvy\u0161uje riziko hypokal\u00e9mie. <strong>Preferovan\u00fd thiazid\u016fm podobn\u00fd p\u0159\u00edpravek u star\u0161\u00edch pacient\u016f<\/strong> na z\u00e1klad\u011b d\u016fkaz\u016f studie HYVET. Kl\u00ed\u010dov\u00e9 kontraindikace: viz \u00fapln\u00fd seznam n\u00ed\u017ee. Monitorujte 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\">What Is Natrilix SR?<\/h2>\n<p>Natrilix SR is an oral 1.5 mg SR indapamide tablet from Servier, supplied in 30-180 tablets. Indapamide was introduced by Servier in 1977 as <strong>Natrilix<\/strong>. Strukturn\u011b se li\u0161\u00ed od thiazid\u016f (indolinov\u00fd kruh vs. benzothiadiazin), ale sd\u00edl\u00ed mechanismus NCC inhibitoru; klinicky je klasifikov\u00e1n jako \u201cthiazid\u016fm podobn\u00e9\u201d diuretikum spolu s chlortalidonem a metolazonem.<\/p>\n<h2 class=\"wp-block-heading\">Jak indapamid funguje<\/h2>\n<p>Indapamid inhibuje <strong>NCC (natrium-chloridov\u00fd kotransport\u00e9r) v dist\u00e1ln\u00edm tubulu, s dodate\u010dnou p\u0159\u00edmou vazodilata\u010dn\u00ed aktivitou<\/strong>. N\u00e1sledn\u00e9 \u00fa\u010dinky:<\/p>\n<ul>\n<li><strong>Sn\u00ed\u017een\u00e1 reabsorpce sod\u00edku v dist\u00e1ln\u00edm tubulu<\/strong> \u2014 mechanismus thiazidov\u00e9 t\u0159\u00eddy<\/li>\n<li><strong>P\u0159\u00edm\u00e1 vazodilata\u010dn\u00ed aktivita<\/strong> \u2014 v\u00fdrazn\u011bj\u0161\u00ed ne\u017e u \u010dist\u00fdch thiazid\u016f (HCTZ); p\u0159isp\u00edv\u00e1 k plynulej\u0161\u00ed 24hodinov\u00e9 kontrole krevn\u00edho tlaku<\/li>\n<li><strong>Modulace kalciov\u00fdch kan\u00e1l\u016f<\/strong> ve vaskul\u00e1rn\u00edm hladk\u00e9m svalstvu p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch<\/li>\n<li><strong>Prodlou\u017een\u00fd antihypertenzn\u00ed \u00fa\u010dinek<\/strong> \u2014 24hodinov\u00e9 pokryt\u00ed p\u0159i jednodenn\u00edm d\u00e1vkov\u00e1n\u00ed (polo\u010das 14-18 hodin)<\/li>\n<li><strong>Zachovan\u00e1 \u00fa\u010dinnost p\u0159i m\u00edrn\u00e9m a\u017e st\u0159edn\u00edm CKD<\/strong> (eGFR 30-60) \u2014 lep\u0161\u00ed ne\u017e HCTZ v tomto rozsahu GFR<\/li>\n<li><strong>Men\u0161\u00ed metabolick\u00e9 zat\u00ed\u017een\u00ed p\u0159i n\u00edzk\u00e9 d\u00e1vce<\/strong> (1,25\u20131,5 mg) ne\u017e u HCTZ p\u0159i typick\u00e9 d\u00e1vce 25 mg \u2014 podobn\u00fd \u00fa\u010dinek na krevn\u00ed tlak s men\u0161\u00edm vlivem na gluk\u00f3zu a lipidy<\/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 (prvn\u00ed volba; zejm\u00e9na u star\u0161\u00edch pacient\u016f)<\/strong> \u2014 prim\u00e1rn\u00ed indikace<\/li>\n<li><strong>Hypertenze u velmi star\u00fdch pacient\u016f (\u226580 let)<\/strong> \u2014 d\u016fkaz z studie HYVET, thiazid\u016fm podobn\u00fd l\u00e9k prvn\u00ed volby<\/li>\n<li><strong>Hypertenze u diabetu 2. typu<\/strong> \u2014 d\u016fkaz z studie ADVANCE (v kombinaci s perindoprilem)<\/li>\n<li><strong>Sekund\u00e1rn\u00ed prevence c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody<\/strong> \u2014 d\u016fkaz z studie PROGRESS (v kombinaci s perindoprilem)<\/li>\n<li><strong>Izolovan\u00e1 systolick\u00e1 hypertenze<\/strong><\/li>\n<\/ul>\n<p><strong>Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> <strong>HYVET (2008)<\/strong> \u2014 p\u0159elomov\u00e1 studie u velmi star\u00fdch (\u226580 let) hypertenzn\u00edch pacient\u016f; indapamid 1,5 mg SR \u00b1 perindopril sn\u00ed\u017eil celkovou \u00famrtnost o 21%, c\u00e9vn\u00ed mozkovou p\u0159\u00edhodu o 30% a srde\u010dn\u00ed selh\u00e1n\u00ed o 64% ve srovn\u00e1n\u00ed s placebem. Potvrdil indapamidovou terapii jako prvn\u00ed volbu u velmi star\u00fdch pacient\u016f s hypertenz\u00ed. <strong>ADVANCE (2007)<\/strong> \u2014 indapamid + perindopril sn\u00ed\u017eil makrovaskul\u00e1rn\u00ed p\u0159\u00edhody a kardiovaskul\u00e1rn\u00ed \u00famrt\u00ed o 18% u 11 140 pacient\u016f s diabetem 2. typu. <strong>PROGRESS (2001)<\/strong> \u2014 stejn\u00e1 kombinace sn\u00ed\u017eila recidivu c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody o 28% u pacient\u016f s p\u0159edchoz\u00ed mrtvic\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Natrilix SR Dosage<\/h2>\n<p><strong>D\u00e1vka pro hypertenzi:<\/strong> <strong>Hypertenze:<\/strong> 1,25-2,5 mg jednou denn\u011b (okam\u017eit\u00e1 forma) nebo 1,5 mg jednou denn\u011b (prodlou\u017een\u00e1 forma). N\u00edzk\u00e1 d\u00e1vka 1,25-1,5 mg poskytuje t\u00e9m\u011b\u0159 pln\u00fd \u00fa\u010dinek na TK s minim\u00e1ln\u00edmi metabolick\u00fdmi poruchami; 2,5 mg p\u0159id\u00e1v\u00e1 jen m\u00e1lo k \u00fa\u010dinku na TK, ale zvy\u0161uje riziko hypokal\u00e9mie. <strong>Preferovan\u00fd thiazid\u016fm podobn\u00fd p\u0159\u00edpravek u star\u0161\u00edch pacient\u016f<\/strong> dle d\u016fkaz\u016f z HYVET.<\/p>\n<p><strong>Dal\u0161\u00ed indikace:<\/strong> Indapamid se pou\u017e\u00edv\u00e1 t\u00e9m\u011b\u0159 v\u00fdhradn\u011b pro hypertenzi. Nen\u00ed typicky pou\u017e\u00edv\u00e1n pro otoky p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed (preferuj\u00ed se kli\u010dkov\u00e1 diuretika) ani pro ascites.<\/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>P\u0159\u00edm\u00e1 vazodilata\u010dn\u00ed aktivita<\/strong> Nad r\u00e1mec inhibice NCC \u2014 p\u0159isp\u00edv\u00e1 k plynulej\u0161\u00ed 24hodinov\u00e9 kontrole TK.<\/li>\n<li><strong>O n\u011bco lep\u0161\u00ed metabolick\u00fd profil<\/strong> ne\u017e HCTZ p\u0159i srovnateln\u00e9m \u00fa\u010dinku na TK (men\u0161\u00ed vliv na gluk\u00f3zu a lipidy p\u0159i n\u00edzk\u00e9 d\u00e1vce).<\/li>\n<li><strong>Z\u016fst\u00e1v\u00e1 \u00fa\u010dinn\u00fd u m\u00edrn\u00e9 a\u017e st\u0159edn\u00ed CKD<\/strong> (eGFR 30-60) \u2014 lep\u0161\u00ed ne\u017e HCTZ, podobn\u011b jako chlortalidon.<\/li>\n<li><strong>Volba ov\u011b\u0159en\u00e1 studi\u00ed HYVET u velmi star\u00fdch pacient\u016f.<\/strong>, kombinovan\u00fd s perindoprilem.<\/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> (z\u00e1visl\u00e9 na d\u00e1vce; obvykle m\u00edrn\u00e9 p\u0159i 1,25\u20131,5 mg)<\/li>\n<li><strong>Hyponatr\u00e9mie<\/strong> \u2014 zvl\u00e1\u0161t\u011b n\u00e1chyln\u00e9 jsou star\u0161\u00ed \u017eeny na n\u00edzkosoln\u00fdch diet\u00e1ch; m\u016f\u017ee b\u00fdt z\u00e1va\u017en\u00e1<\/li>\n<li><strong>Hyperurik\u00e9mie<\/strong> \u2014 vz\u00e1cn\u011b m\u016f\u017ee vyvolat dnu i p\u0159i n\u00edzk\u00fdch d\u00e1vk\u00e1ch<\/li>\n<li><strong>Fotosensitivn\u00ed vyr\u00e1\u017eka<\/strong><\/li>\n<li><strong>Erektiln\u00ed dysfunkce<\/strong> (m\u00e9n\u011b \u010dast\u00e1 ne\u017e u HCTZ)<\/li>\n<li><strong>M\u00edrn\u00e1 hyperglyk\u00e9mie<\/strong> (m\u00e9n\u011b v\u00fdrazn\u00e1 ne\u017e u HCTZ)<\/li>\n<li><strong>Prodlou\u017een\u00ed QT intervalu<\/strong> \u2014 obvykle klinicky nev\u00fdznamn\u00e9 v terapeutick\u00fdch d\u00e1vk\u00e1ch; probl\u00e9m m\u016f\u017ee nastat p\u0159i kombinaci s jin\u00fdmi l\u00e9ky prodlu\u017euj\u00edc\u00edmi QT interval a hypokal\u00e9mi\u00ed<\/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)<\/li>\n<li>P\u0159ecitliv\u011blost na sulfonamidy<\/li>\n<li>Symptomatick\u00e1 hyponatr\u00e9mie nebo hypokal\u00e9mie v\u00fdchoz\u00ed<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed posti\u017een\u00ed (Child-Pugh C) \u2014 riziko jatern\u00ed encefalopatie<\/li>\n<li>Zn\u00e1m\u00e9 prodlou\u017een\u00ed QT intervalu nebo anamn\u00e9za torsades de pointes (opatrnost)<\/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\">Where Natrilix SR Fits in the Diuretic Class<\/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>\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:#fff3cd;\">\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;\">bumetanid<\/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;\">Torasemid<\/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;\">Ostatn\u00ed \u0161et\u0159\u00edc\u00ed drasl\u00edk<\/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;\">Inhibitory karboanhydr\u00e1zy<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Store Natrilix SR below 25&deg;C in the original blister pack. Keep out of reach of children.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">When should I take Natrilix SR &mdash; morning or evening?<\/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 tvorbu mo\u010di po dobu 2-8 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 brzy odpoledne (ne p\u0159ed span\u00edm).<\/p>\n<h3 class=\"wp-block-heading\">Is Natrilix SR a first-line blood-pressure drug?<\/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\">Will Natrilix SR affect my potassium?<\/h3>\n<p>Yes &mdash; Natrilix SR <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> Natrilix SR with an ARB or ACE inhibitor &mdash; which is the standard combination in hypertension anyway. If potassium drops below 3.5 in isolated diuretic use, add potassium supplementation, a potassium-rich diet, or a small dose of a potassium-sparing agent (spironolactone, eplerenone, or an <a href=\"https:\/\/medsbase.com\/cs\/amifru\/\">kombinaci obsahuj\u00edc\u00ed amilorid<\/a>).<\/p>\n<h3 class=\"wp-block-heading\">I have gout &mdash; can I take Natrilix SR?<\/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>) whose losartan component is uniquely uricosuric and offsets the thiazide urate rise. If Natrilix SR is already in use and gout flares, add or continue urate-lowering therapy (allopurinol) rather than stopping Natrilix SR outright.<\/p>\n<h3 class=\"wp-block-heading\">I&rsquo;m diabetic &mdash; is Natrilix SR safe?<\/h3>\n<p>Ano \u2014 indapamid je <strong>dob\u0159e podlo\u017een u diabetu 2. typu<\/strong> studiemi ADVANCE (indapamid + perindopril sn\u00ed\u017eil kardiovaskul\u00e1rn\u00ed p\u0159\u00edhody o 18% u 11 140 diabetik\u016f). N\u00edzk\u00e1 d\u00e1vka indapamidu (1,25-1,5 mg) m\u00e1 men\u0161\u00ed vliv na gluk\u00f3zu ne\u017e 25 mg HCTZ p\u0159i stejn\u00e9m \u00fa\u010dinku na TK. Monitorujte HbA1c ro\u010dn\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Can I take ibuprofen with Natrilix SR?<\/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> of Natrilix SR (prostaglandin blockade) and substantially raise the AKI risk when combined with an ACE inhibitor or ARB &mdash; the &#8220;triple whammy.&#8221; Use paracetamol preferentially for chronic pain.<\/p>\n<h3 class=\"wp-block-heading\">Budu v noci v\u00edce mo\u010dit?<\/h3>\n<p>Usually no, if you take Natrilix SR in the morning. The diuretic effect peaks 2-8 hours after dosing and has mostly worn off by evening. Nocturia is a common complaint when patients switch to evening dosing; switch back to morning dosing and nocturia resolves within 1-3 days.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Natrilix SR in pregnancy?<\/h3>\n<p>Rutinn\u011b se nedoporu\u010duje. Indapamid prostupuje placentou a m\u016f\u017ee 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\">Where can I buy Natrilix SR online?<\/h3>\n<p>You can buy Natrilix SR (1.5 mg SR indapamide, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.<\/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\/amlode\/\">Amlode \u2014 Amlodipin 5\/10 mg (BKK)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">Aquazide &mdash; Hydrochlorothiazide (HCTZ) thiazide<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lasix\/\">Lasix \u2014 Furosemid 40 mg (kli\u010dkov\u00e9 diuretikum)<\/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\/telma-h\/\">Telma H &mdash; Telmisartan + HCTZ fixed combination<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">Telmaheal &mdash; Telmisartan (ARB partner for diuretic)<\/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\/nebicard\/\">Nebicard<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/pramirol-sr\/\">Pramirol SR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/intagesic-mr\/\">Intagesic MR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/listril-plus\/\">Listril Plus<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/flexabenz-gel\/\">Flexabenz Gel<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Natrilix SR is Servier&#8217;s indapamide 1.5 mg sustained-release tablets \u2014 thiazide-like diuretic with additional direct vasodilator activity. HYVET trial (2008) validated indapamide + perindopril in very elderly (\u226580 years): 21% mortality reduction, 30% stroke reduction. ADVANCE and PROGRESS extend to type 2 diabetes and secondary stroke prevention. 24-36 hour duration; better metabolic profile than HCTZ at equivalent BP effect.<\/p>","protected":false},"featured_media":57607,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3394,4334],"class_list":{"0":"post-57606","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-indapamide","11":"product_tag-natrilix-sr","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\/57606","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=57606"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/57607"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=57606"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=57606"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=57606"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=57606"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}