{"id":51913,"date":"2023-09-20T09:26:35","date_gmt":"2023-09-20T09:26:35","guid":{"rendered":"https:\/\/medsname.com\/repace\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"repace","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/repace\/","title":{"rendered":"Repace"},"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 R\u0103spuns rapid \u2014 Ce este Repace?<\/h3>\n<p style=\"margin:0;\"><strong>Repace<\/strong> este un <strong>Comprimat de losartan 25 \/ 50 mg<\/strong> de la Sun Pharma \u2014 un <strong>blocator al receptorilor de angiotensin\u0103 II (ARB)<\/strong>. BRA sunt <strong>terapie antihipertensiv\u0103 de prim\u0103 inten\u021bie<\/strong> al\u0103turi de inhibitori ACE, CCB \u0219i tiazide conform ghidurilor NICE, AHA\/ACC \u0219i ESC\/ESH \u2014 \u0219i sunt <strong>alternativa preferat\u0103 atunci c\u00e2nd un inhibitor ACE nu este tolerat<\/strong> (de obicei din cauza tusei uscate, care afecteaz\u0103 p\u00e2n\u0103 la 20% dintre utilizatorii de inhibitori ACE). Primul ARB aprobat pentru uz clinic (DuPont Merck 1995, ca <strong>Cozaar<\/strong>) \u2014 agentul de referin\u021b\u0103 al clasei. Losartanul este un prodrog activat de CYP2C9 \u0219i CYP3A4 \u00een metabolitul s\u0103u activ E-3174 (EXP-3174). Medicamentul parinte are o timp de \u00eenjum\u0103t\u0103\u021bire de ~2 ore; metabolitul activ are timp de \u00eenjum\u0103t\u0103\u021bire de 6-9 ore. Doza tipic\u0103 pentru hipertensiune: <strong>\u00eencepe\u021bi cu 50 mg o dat\u0103 pe zi (25 mg la v\u00e2rstnici, pacien\u021bi cu volum sc\u0103zut sau afec\u021biuni hepatice), \u021bint\u0103 50-100 mg o dat\u0103 pe zi (\u00eemp\u0103r\u021bit \u00een 50 mg de dou\u0103 ori pe zi la unii pacien\u021bi)<\/strong>. Losartan are un efect <strong>uricosuric moderat<\/strong> \u2014 reduce acidul uric seric (unic printre ARB; celelalte ARB sunt neutre fa\u021b\u0103 de acidul uric sau \u00eel cresc u\u0219or). Deosebit de util la pacien\u021bii cu hipertensiune <strong>\u0218I gut\u0103 sau hiperuricemie<\/strong>, unde combina\u021biile pe baz\u0103 de HCTZ sunt problematice. <strong>Contraindica\u021bie absolut\u0103 \u00een sarcin\u0103<\/strong> (toate trimestrele \u2014 acela\u0219i profil teratogen ca inhibitorii ACE: agenezie renal\u0103 fetal\u0103, oligohidramnios, hipoplazie pulmonar\u0103), <strong>stenoz\u0103 bilateral\u0103 a arterei renale<\/strong>, \u0219i <strong>administrare concomitent\u0103 de sacubitril\/valsartan sau aliskiren<\/strong>. Monitoriza\u021bi potasiul \u0219i creatinina.<\/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>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<h2 class=\"wp-block-heading\">Ce este Repace?<\/h2>\n<p>Repace sunt comprimate orale de losartan 25\/50 mg de la Sun Pharma, disponibile \u00een cutii de 30-180 comprimate. Primul ARB aprobat pentru uz clinic (DuPont Merck 1995, sub denumirea <strong>Cozaar<\/strong>) \u2014 agentul de referin\u021b\u0103 al clasei. Losartan este un prodrug activat de CYP2C9 \u0219i CYP3A4 \u00een metabolitul s\u0103u activ E-3174 (EXP-3174). Medicamentul parinte are o timp de \u00eenjum\u0103t\u0103\u021bire de ~2 ore; metabolitul activ are un timp de \u00eenjum\u0103t\u0103\u021bire de 6-9 ore.<\/p>\n<h2 class=\"wp-block-heading\">Cum scade Losartan tensiunea arterial\u0103<\/h2>\n<p>BRA blocheaz\u0103 <strong>receptorul de tip 1 pentru angiotensin II (AT<sub>1<\/sub>),<\/strong> prevenind direct legarea angiotensinei II \u0219i efectele sale vasoconstrictorare \u0219i de eliberare a aldosteronului. Acesta este un receptor situat \u00een aval de locul de ac\u021biune al inhibitorilor ACE (care blocheaz\u0103 formarea angiotensinei II) \u0219i produce efecte clinice echivalente:<\/p>\n<ul>\n<li><strong>Vasodilata\u021bie arterial\u0103 direct\u0103<\/strong> \u2014 rezisten\u021b\u0103 vascular\u0103 sistemic\u0103 mai mic\u0103 = tensiune arterial\u0103 mai sc\u0103zut\u0103<\/li>\n<li><strong>Secre\u021bie redus\u0103 de aldosteron<\/strong> \u2014 reten\u021bie mai mic\u0103 de sodiu \u0219i ap\u0103<\/li>\n<li><strong>Reducerea activ\u0103rii sistemului nervos simpatic<\/strong><\/li>\n<li><strong>\u00cembun\u0103t\u0103\u021birea func\u021biei endoteliale \u0219i reducerea remodel\u0103rii ventriculare<\/strong> \u2014 mecanismul de protec\u021bie vascular\u0103 dincolo de simpla sc\u0103dere a TA<\/li>\n<li><strong>NICIO acumulare de bradikinina<\/strong> \u2014 aceasta este diferen\u021ba clinic\u0103 cheie fa\u021b\u0103 de inhibitorii ACE. ARB nu provoac\u0103 tusea uscat\u0103 care afecteaz\u0103 p\u00e2n\u0103 la 20% dintre utilizatorii de ACEi, deoarece nu interfereaz\u0103 cu metabolismul bradikininei.<\/li>\n<\/ul>\n<p>Consecin\u021ba clinic\u0103 a acestui mecanism: ARB realizeaz\u0103 un control echivalent al tensiunii arteriale fa\u021b\u0103 de inhibitorii ACE, cu rate mai sc\u0103zute de tuse (0-3% fa\u021b\u0103 de 20% pentru ACEi) \u0219i angioedem (cu aproximativ 30-50% mai pu\u021bin dec\u00e2t ACEi, de\u0219i nu zero).<\/p>\n<h2 class=\"wp-block-heading\">Utiliz\u0103ri aprobate \u0219i bazate pe dovezi<\/h2>\n<ul>\n<li><strong>Hipertensiune arterial\u0103<\/strong> \u2014 indica\u021bie primar\u0103; de prim\u0103 linie conform ghidurilor interna\u021bionale<\/li>\n<li><strong>Hipertensiune cu gut\u0103 sau hiperuricemie<\/strong> \u2014 unic uricosuric<\/li>\n<li><strong>Nefropatie diabetic\u0103 la diabetul zaharat tip 2<\/strong> \u2014 studiul RENAAL<\/li>\n<li><strong>Hipertensiune cu hipertrofie ventricular\u0103 st\u00e2ng\u0103<\/strong> \u2014 studiul LIFE<\/li>\n<li><strong>Insuficien\u021b\u0103 cardiac\u0103 cu frac\u021bie de ejec\u021bie redus\u0103<\/strong> \u2014 alternativ\u0103 la inhibitorii ACE c\u00e2nd tusea este intolerabil\u0103<\/li>\n<li><strong>Intoleran\u021b\u0103 la inhibitorii ACE<\/strong> (tuse, mai rar angioedem) \u2014 \u021bint\u0103 standard de schimb<\/li>\n<\/ul>\n<p><strong>Dovezile din studiile pivotale:<\/strong> <strong>STUDIUL LIFE (2002)<\/strong> \u2014 terapia bazat\u0103 pe losartan a redus accidentul vascular cerebral, decesul CV \u0219i infarctul miocardic cu 13% fa\u021b\u0103 de terapia bazat\u0103 pe atenolol la pacien\u021bii cu hipertensiune \u0219i hipertrofie ventricular\u0103 st\u00e2ng\u0103, stabilind preferin\u021ba modern\u0103 pentru ARB-uri \u00een locul beta-blocantelor vechi \u00een HTN. <strong>RENAAL + IDNT<\/strong> \u2014 protec\u021bie renal\u0103 \u00een nefropatia diabetic\u0103. <strong>HEAAL<\/strong> \u2014 losartan la doz\u0103 mare (150 mg) vs doz\u0103 mic\u0103 (50 mg) \u00een IC-REF; doza mare a redus spitalizarea.<\/p>\n<h2 class=\"wp-block-heading\">Doza Repace<\/h2>\n<p><strong>Hipertensiune arterial\u0103:<\/strong><\/p>\n<ul>\n<li><strong>Doza ini\u021bial\u0103:<\/strong> 50 mg o dat\u0103 pe zi (25 mg la v\u00e2rstnici, pacien\u021bi cu deple\u021bie de volum sau afec\u021biuni hepatice)<\/li>\n<li><strong>Doza \u021bint\u0103:<\/strong> 50-100 mg o dat\u0103 pe zi (divizat \u00een 50 mg de dou\u0103 ori pe zi la unii pacien\u021bi)<\/li>\n<li><strong>Maximum:<\/strong> 100 mg\/zi<\/li>\n<li>Titra\u021bi la fiecare 2-4 s\u0103pt\u0103m\u00e2ni; efect antihipertensiv complet la 3-6 s\u0103pt\u0103m\u00e2ni<\/li>\n<\/ul>\n<p><strong>Insuficien\u021b\u0103 cardiac\u0103:<\/strong> \u00cencepe\u021bi cu 12,5 mg o dat\u0103 pe zi, titra\u021bi s\u0103pt\u0103m\u00e2nal p\u00e2n\u0103 la 50-150 mg o dat\u0103 pe zi (\u021bint\u0103 HEAAL)<\/p>\n<p><strong>Administrare:<\/strong> o dat\u0103 pe zi, cu sau f\u0103r\u0103 m\u00e2ncare. Lua\u021bi la aceea\u0219i or\u0103 zilnic pentru control stabil al TA.<\/p>\n<p><strong>Monitorizare:<\/strong><\/p>\n<ul>\n<li>Valori de baz\u0103: uree, electroli\u021bi (\u00een special potasiu), creatinin\u0103, eGFR. Tensiune arterial\u0103 de baz\u0103 acas\u0103.<\/li>\n<li>Dup\u0103 1-2 s\u0103pt\u0103m\u00e2ni: repetare U&amp;E. O u\u0219oar\u0103 cre\u0219tere a creatininei (p\u00e2n\u0103 la 30%) este a\u0219teptat\u0103 \u0219i acceptabil\u0103. O u\u0219oar\u0103 cre\u0219tere a potasiului este frecvent\u0103.<\/li>\n<li>Dup\u0103 cre\u0219terea dozei: repeta\u021bi analizele U&amp;E dup\u0103 1-2 s\u0103pt\u0103m\u00e2ni.<\/li>\n<li>Pe termen lung: analize U&amp;E anual odat\u0103 stabilizat.<\/li>\n<li><strong>Opri\u021bi \u0219i investiga\u021bi:<\/strong> creatinin\u0103 crescut\u0103 &gt;30%, sc\u0103dere eGFR &gt;25%, potasiu &gt;5.5, hipotensiune simptomatic\u0103.<\/li>\n<\/ul>\n<p><strong>\u00centrerupere:<\/strong> nu exist\u0103 sindrom de sevraj; totu\u0219i, \u00eentreruperea brusc\u0103 poate cauza revenirea tensiunii arteriale pe parcursul a c\u00e2teva zile. Reduce\u021bi treptat doza pe parcursul a 1-2 s\u0103pt\u0103m\u00e2ni la \u00eentrerupere.<\/p>\n<h2 class=\"wp-block-heading\">Efecte Secundare<\/h2>\n<p><strong>Frecvente (&gt;1%, de obicei u\u0219oare):<\/strong><\/p>\n<ul>\n<li>Ame\u021beli, hipotensiune postural\u0103 (de obicei u\u0219oar\u0103; mai frecvente la \u00eenceputul terapiei)<\/li>\n<li>Hiperkaliemie u\u0219oar\u0103<\/li>\n<li>Cre\u0219tere mic\u0103 a\u0219teptat\u0103 a creatininei (p\u00e2n\u0103 la ~30% este acceptabil\u0103; modificare hemodinamic\u0103 intrarenal\u0103, nu nefrotoxicitate)<\/li>\n<li>Oboseal\u0103, cefalee<\/li>\n<li>Simptome respiratorii superioare, nazofaringit\u0103<\/li>\n<li>Durere lombar\u0103, crampe musculare<\/li>\n<\/ul>\n<p><strong>Pu\u021bin frecvente, dar importante:<\/strong><\/p>\n<ul>\n<li><strong>Angioedem<\/strong> \u2014 rat\u0103 mai mic\u0103 dec\u00e2t la inhibitorii ACE, dar tot posibil\u0103. Inciden\u021b\u0103 ~0,1%. NU utiliza\u021bi un ARB dac\u0103 pacientul are istoric documentat de angioedem la un inhibitor ACE \u00een primele 4 s\u0103pt\u0103m\u00e2ni; utilizarea cu precau\u021bie pe termen lung este adesea acceptabil\u0103.<\/li>\n<li><strong>Hiperkaliemie sever\u0103<\/strong> \u2014 \u00een special cu diuretice economisitoare de potasiu (spironolacton\u0103), suplimente de potasiu, AINS sau BCR<\/li>\n<li><strong>Leziune renal\u0103 acut\u0103 \u00een stenoz\u0103 bilateral\u0103 a arterei renale<\/strong> \u2014 acela\u0219i mecanism ca inhibitorii ACE<\/li>\n<li><strong>Hipotensiune la prima doz\u0103<\/strong> la pacien\u021bii cu volum sc\u0103zut (de ex. sub tratament cu diuretice \u00een doze mari, insuficien\u021b\u0103 cardiac\u0103 sever\u0103)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contraindica\u021bii<\/h2>\n<ul>\n<li><strong>Sarcina \u2014 contraindica\u021bie ABSOLUT\u0102 \u00een toate trimestrele<\/strong>. Acela\u0219i profil teratogen ca inhibitorii ACE. \u00centrerupe\u021bi imediat la confirmarea sarcinii; trece\u021bi la <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a>, metildopa, nifedipin\u0103 sau hidralazin\u0103.<\/li>\n<li>Istoric de angioedem cu orice inhibitor ACE sau ARB (\u00een ultimele 4 s\u0103pt\u0103m\u00e2ni)<\/li>\n<li>Stenoz\u0103 bilateral\u0103 a arterei renale sau stenoz\u0103 la un singur rinchi func\u021bional<\/li>\n<li>Insuficien\u021b\u0103 hepatic\u0103 sever\u0103 (Child-Pugh C) \u2014 \u00een special pentru ARB-uri prodrog<\/li>\n<li>Hiperkaliemie &gt;5,5 mmol\/L la evaluarea ini\u021bial\u0103<\/li>\n<li>Utilizare concomitent\u0103 cu sacubitril\/valsartan (Entresto) \u2014 necesar\u0103 \u00eentrerupere de 36 de ore la schimbarea tratamentului<\/li>\n<li>Utilizare concomitent\u0103 cu aliskiren \u00een diabet sau BCR (studiul ALTITUDE a demonstrat risc crescut)<\/li>\n<li>Utilizare concomitent\u0103 cu inhibitor ACE \u2014 studiul ONTARGET a demonstrat risc f\u0103r\u0103 beneficii<\/li>\n<li>Hipersensibilitate la losartan<\/li>\n<\/ul>\n<p><strong>Al\u0103ptarea:<\/strong> evita\u021bi \u00een primele s\u0103pt\u0103m\u00e2ni dup\u0103 na\u0219terea unui copil prematur. Utilizarea pe termen lung \u00een timpul al\u0103pt\u0103rii este \u00een general considerat\u0103 acceptabil\u0103 dat\u0103 transferul sc\u0103zut \u00een lapte, dar antihipertensive alternative (propranolol, nifedipin\u0103) sunt preferate atunci c\u00e2nd este posibil.<\/p>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>Diuretice economisitoare de potasiu<\/strong> (spironolacton\u0103, eplerenon\u0103, amilorid\u0103, triamteren\u0103) \u2014 risc adi\u021bional de hiperkaliemie; monitoriza\u021bi \u00eendeaproape<\/li>\n<li><strong>Suplimente de potasiu \u0219i \u00eenlocuitoare de sare<\/strong> \u2014 risc de hiperkaliemie<\/li>\n<li><strong>AINS<\/strong> \u2014 reduce efectul antihipertensiv \u0219i cre\u0219te riscul de insuficien\u021b\u0103 renal\u0103 acut\u0103 (\u00een special \u201ctripla lovitur\u0103\u201d: ARB + diuretic + AINS)<\/li>\n<li><strong>Litiu<\/strong> \u2014 ARB-urile reduc clearance-ul litiului; monitoriza\u021bi nivelurile<\/li>\n<li><strong>Inhibitori ACE<\/strong> \u2014 NU combina\u021bi (deteriorare ONTARGET)<\/li>\n<li><strong>\u2014 nu combina\u021bi; este necesar\u0103 o perioad\u0103 de eliminare de 36 de ore pentru a evita riscul de angioedem<\/strong> \u2014 nu combina\u021bi; perioad\u0103 de abstinen\u021b\u0103 de 36 de ore<\/li>\n<li><strong>\u2014 evita\u021bi combina\u021bia \u00een diabet \u0219i BCR (studiul ALTITUDE oprit prematur din cauza riscului)<\/strong> \u2014 evita\u021bi \u00een diabet sau boal\u0103 renal\u0103 cronic\u0103 (deteriorare ALTITUDE)<\/li>\n<li><strong>Fluconazol<\/strong> \u2014 reduce activarea losartanului \u00een E-3174 (inhibi\u021bie CYP2C9); poate reduce efectul asupra tensiunii arteriale<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Clasa ARB pe scurt<\/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;\">ARA<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Timp de \u00eenjum\u0103t\u0103\u021bire<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Nis\u0103 distinctiv\u0103<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/losar\/\">Losartan (Losar, Cosart)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">2 h \/ 6-9 h (metabolit)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Uricosuric (util \u00een gut\u0103); reducerea accidentului vascular cerebral \u00een studiul LIFE<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/olmin\/\">Olmesartan (Olmin, Olmeheal, Olmesar)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">13 h<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Puternic pe mg; avertisment FDA pentru enteropatie sprue-like<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/telmaheal\/\">Telmisartan (Telmaheal, Cresar, Targit)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">24 h (cel mai lung)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Beneficiu metabolic (PPAR-\u03b3); protec\u021bie cardiovascular\u0103 ONTARGET<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/diovan-160\/\">Valsartan (Diovan 160, Valent)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">6 h (efect 24 h)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Dovezi \u00een insuficien\u021b\u0103 cardiac\u0103 (Val-HeFT, VALIANT); precursor ARNI (Entresto)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/irovel\/\">Irbesartan (Irovel)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">11-15 h<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Nefropatie diabetic\u0103 (IRMA-2, IDNT)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Candesartan<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">9 h<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Dovezi de insuficien\u021b\u0103 cardiac\u0103 (CHARM); nu este disponibil la MedsBase<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">ARB vs inhibitor ACE \u2014 C\u00e2nd s\u0103 alegi un ARB<\/h2>\n<p>Inhibitori ACE (<a href=\"https:\/\/medsbase.com\/ro\/ramcor\/\">ramipril<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/enapril\/\">enalapril<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/lispro\/\">lisinopril<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/coversyl\/\">perindopril<\/a>) \u0219i ARB-urile ac\u021bioneaz\u0103 pe aceea\u0219i cale renin\u0103-angiotensin\u0103 \u0219i produc efecte echivalente de sc\u0103dere a tensiunii \u0219i protec\u021bie cardiovascular\u0103. Alege un ARB c\u00e2nd:<\/p>\n<ul>\n<li><strong>Tuse provocat\u0103 de inhibitor ACE<\/strong> apare (la p\u00e2n\u0103 la 20% dintre utilizatori; cel mai frecvent motiv pentru schimbare)<\/li>\n<li>Angioedem anterior provocat de inhibitor ACE (folose\u0219te un ARB cu pruden\u021b\u0103, nu \u00een decurs de 4 s\u0103pt\u0103m\u00e2ni dup\u0103 episodul de angioedem)<\/li>\n<li>Unii pacien\u021bi prefer\u0103 profilul de ac\u021biune odinioar\u0103 al ARB-urilor cu ac\u021biune \u00eendelungat\u0103 precum telmisartanul pentru control uniform pe 24 de ore<\/li>\n<li>Indica\u021bii specifice pe molecule \u2014 losartan pentru HTA+gut\u0103, irbesartan pentru nefropatie diabetic\u0103 tip 2, valsartan ca precursor pentru ARNI \u00een insuficien\u021b\u0103 cardiac\u0103<\/li>\n<\/ul>\n<p><strong>NU combina ARB + inhibitor ACE.<\/strong> Studiul ONTARGET (2008) a demonstrat c\u0103 combina\u021bia produce MAI MULTE evenimente adverse (hiperkaliemie, leziune renal\u0103 acut\u0103, hipotensiune) f\u0103r\u0103 beneficii cardiovascular suplimentare. Dac\u0103 un pacient ia ambele, \u00eentrerupe unul.<\/p>\n<h2 class=\"wp-block-heading\">Depozitare<\/h2>\n<p>Depozita\u021bi Repace la temperaturi sub 25\u00b0C \u00een ambalajul original. P\u0103stra\u021bi \u00een afara accesului copiilor.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">C\u00e2t dureaz\u0103 p\u00e2n\u0103 Repace reduce tensiunea arterial\u0103?<\/h3>\n<p>Sc\u0103derea ini\u021bial\u0103 a tensiunii arteriale \u00een 1-2 ore; efectul antihipertensiv complet la <strong>3-6 s\u0103pt\u0103m\u00e2ni<\/strong>. M\u0103sura\u021bi tensiunea acas\u0103 la aceea\u0219i or\u0103 \u00een fiecare zi pentru a monitoriza r\u0103spunsul. Dac\u0103 tensiunea nu a atins \u021binta la 6 s\u0103pt\u0103m\u00e2ni, fie cre\u0219te\u021bi doza, fie ad\u0103uga\u021bi un agent din a doua clas\u0103 (blocante ale canalelor de calciu sau tiazide sunt ad\u0103ug\u0103rile standard la un ARB).<\/p>\n<h3 class=\"wp-block-heading\">Am trecut de la un inhibitor ACE din cauza tusei \u2014 va disp\u0103rea tusea mea?<\/h3>\n<p>Da. Tusa provocat\u0103 de inhibitorii ACE este cauzat\u0103 de acumularea de bradikinin\u0103; ARB nu cresc nivelul de bradikinin\u0103. Tusa dispare de obicei \u00een <strong>1-4 s\u0103pt\u0103m\u00e2ni<\/strong> la \u00eentreruperea inhibitorului de ACE. Dac\u0103 tusea persist\u0103 dup\u0103 6 s\u0103pt\u0103m\u00e2ni de la trecerea la Repace, investiga\u021bi alte cauze (reflux, scurgere postnasal\u0103, astm).<\/p>\n<h3 class=\"wp-block-heading\">Pot lua Repace \u00een timpul sarcinii?<\/h3>\n<p><strong>Nu \u2014 ARB sunt absolut contraindicate \u00een sarcin\u0103<\/strong>, la fel ca inhibitorii ACE. Acestea provoac\u0103 agenezie renal\u0103 fetal\u0103, oligohidramnios, hipoplazie pulmonar\u0103 \u0219i defecte craniene. \u00centrerupe\u021bi imediat dac\u0103 apare sarcina. Femeile \u00een v\u00e2rst\u0103 fertil\u0103 ar trebui s\u0103 foloseasc\u0103 metode contraceptive sigure; pentru cele care planific\u0103 sarcin\u0103, trece\u021bi la <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a>, methyldopa, sau nifedipine \u00eenainte de concep\u021bie.<\/p>\n<h3 class=\"wp-block-heading\">Creatinina mea a crescut pu\u021bin dup\u0103 ce am \u00eenceput Repace \u2014 ar trebui s\u0103 \u00eencetez?<\/h3>\n<p>O cre\u0219tere a creatininei de p\u00e2n\u0103 la <strong>30%<\/strong> \u00een primele 1-2 s\u0103pt\u0103m\u00e2ni este <strong>este a\u0219teptat\u0103 \u0219i acceptabil\u0103<\/strong>. Aceasta reflect\u0103 o ajustare hemodinamic\u0103 intrarenal\u0103 normal\u0103 pe m\u0103sur\u0103 ce tonusul arteriolelor eferente mediat de angiotensin-II este eliminat. O cre\u0219tere &gt;30% sugereaz\u0103 stenoz\u0103 bilateral\u0103 a arterei renale, deple\u021bie de volum sau interac\u021biune cu AINS \u0219i necesit\u0103 investiga\u021bii (opri\u021bi medicamentul, face\u021bi imagistic\u0103 renal\u0103, revizui\u021bi medica\u021bia concurent\u0103).<\/p>\n<h3 class=\"wp-block-heading\">Ar trebui s\u0103 evit alimentele bogate \u00een potasiu c\u00e2nd iau Repace?<\/h3>\n<p>Un aport moderat de alimente bogate \u00een potasiu (banane, portocale, spanac, avocado, cartofi) este acceptabil pentru majoritatea utilizatorilor. Evita\u021bi suplimentele de potasiu (slow-K) \u0219i \u00eenlocuitorii de sare care con\u021bin potasiu, cu excep\u021bia cazului \u00een care sunt prescrise \u00een mod specific \u2014 acestea pot provoca hiperkaliemie periculoas\u0103 atunci c\u00e2nd sunt combinate cu BRA, \u00een special \u00een insuficien\u021b\u0103 renal\u0103 cronic\u0103 sau cu diuretice economisitoare de potasiu.<\/p>\n<h3 class=\"wp-block-heading\">Pot combina Repace cu alte medicamente pentru tensiune?<\/h3>\n<p>Da \u2014 BRA se combin\u0103 bine cu <strong>blocante ale canalelor de calciu<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">amlodipine<\/a>), <strong>diuretice tiazidice<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/aquazide\/\">HCTZ<\/a>), \u0219i <strong>beta-blocante<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/betablock-xl\/\">metoprolol succinat<\/a>). <strong>NU combina\u021bi un BRA cu un inhibitor ACE<\/strong> (ramipril, lisinopril, etc.) \u2014 studiul ONTARGET a demonstrat riscuri f\u0103r\u0103 beneficii.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua ibuprofen cu Repace?<\/h3>\n<p>Utilizarea ocazional\u0103 pe termen scurt este de obicei acceptabil\u0103; <strong>utilizarea cronic\u0103 zilnic\u0103 de AINS<\/strong> (ibuprofen, diclofenac, naproxen) reduc efectul antihipertensiv al BRA \u0218I cresc semnificativ riscul de insuficien\u021b\u0103 renal\u0103 acut\u0103 \u2014 mai ales atunci c\u00e2nd sunt combinate cu un diuretic (\u201ctriplu impact\u201d). Pentru dureri cronice, paracetamolul este mai sigur; pentru inflama\u021bie, discuta\u021bi alternative.<\/p>\n<h3 class=\"wp-block-heading\">Este Repace un tratament pe via\u021b\u0103?<\/h3>\n<p>Pentru majoritatea pacien\u021bilor cu hipertensiune arterial\u0103 esen\u021bial\u0103, da \u2014 terapia antihipertensiv\u0103 este pe via\u021b\u0103, deoarece \u00eentreruperea tratamentului duce la revenirea tensiunii arteriale la nivelul pre-tratament \u00een c\u00e2teva zile sau s\u0103pt\u0103m\u00e2ni. Unii pacien\u021bi \u00ee\u0219i pot ameliora hipertensiunea prin pierdere semnificativ\u0103 \u00een greutate, reducerea consumului de alcool sau somn mai bun; medicul lor poate \u00eencerca atunci o reducere gradual\u0103 sub monitorizarea tensiunii arteriale. Nu \u00eenceta\u021bi niciodat\u0103 Repace f\u0103r\u0103 consult medical.<\/p>\n<h3 class=\"wp-block-heading\">Ce fac dac\u0103 uit o doz\u0103?<\/h3>\n<p>Lua\u021bi doza omis\u0103 imediat ce v\u0103 aminti\u021bi, cu excep\u021bia cazului \u00een care este aproape timpul pentru urm\u0103toarea doz\u0103 \u2014 \u00een acest caz, omite\u021bi doza ratat\u0103 \u0219i continua\u021bi conform programului normal. Nu lua\u021bi o doz\u0103 dubl\u0103. O singur\u0103 doz\u0103 omis\u0103 nu va afecta semnificativ controlul tensiunii arteriale pe termen lung.<\/p>\n<h3 class=\"wp-block-heading\">Unde pot cump\u0103ra Repace online?<\/h3>\n<p>Pute\u021bi cump\u0103ra Repace (losartan 25\/50 mg, 30-180 comprimate) de la MedsBase cu ambalaj discret \u0219i livrare la nivel mondial.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Antihipertensive \u00eenrudite pe MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/cosart\/\">Cosart \u2014 Losartan 25 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/cosart-h\/\">Cosart-H \u2014 Losartan + HCTZ<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/cozartan\/\">Cozartan \u2014 Losartan 50 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/cresar\/\">Cresar \u2014 Telmisartan 20 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/diovan-160\/\">Diovan 160 \u2014 Valsartan 160 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/targit\/\">Targit \u2014 Telmisartan 80 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/high-blood-pressure-medication\/\"><strong>R\u0103sfoi\u021bi toate medicamentele pentru hipertensiune arterial\u0103<\/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 Dezaprobare medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop informativ \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui medic calificat. Hipertensiunea, insuficien\u021ba cardiac\u0103 \u0219i aritmiile necesit\u0103 diagnostic, monitorizare \u0219i individualizarea dozei de c\u0103tre un medic \u2014 utiliza\u021bi \u00eentotdeauna beta-blocante sub \u00eendrumare medical\u0103.<\/div>","protected":false},"excerpt":{"rendered":"<p>Repace sunt comprimatele de losartan 25\/50 mg de la Sun Pharma \u2014 primul din clasa ARB \u0219i singurul cu efect uricosuric (scade acidul uric seric, fiind ARB-ul preferat \u00een hipertensiunea asociat\u0103 cu gut\u0103 sau hiperuricemie). Studii LIFE pentru reducerea accidentului vascular cerebral la pacien\u021bii cu hipertrofie ventricular\u0103 st\u00e2ng\u0103; studii RENAAL pentru nefropatia diabetic\u0103. Doz\u0103 ini\u021bial\u0103: 50 mg o dat\u0103 pe zi; doz\u0103 \u021bint\u0103: 50-100 mg.<\/p>","protected":false},"featured_media":51914,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3429],"class_list":{"0":"post-51913","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-repace","12":"first","13":"outofstock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/51913","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=51913"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/51914"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=51913"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=51913"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=51913"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=51913"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}