ILosartan vs. lisinopril: Umehluko, ukufana, nokuthi yikuphi okungcono kuwe
Izidakamizwa Vs. UmnganiUkubuka konke kwezidakamizwa nokwehluka okuyinhloko | Izimo zilashwa | Ukusebenza | Ukutholakala komshuwalense nokuqhathaniswa kwezindleko | Okuqhamuka uma udla imishanguzo | Ukusebenzisana kwezidakamizwa | Izexwayiso | Imibuzo evame ukubuzwa
Uma ungomunye wabantu baseMelika abayizigidi eziyi-103 abane umfutho wegazi ophakeme , Udokotela wakho kungenzeka ukuthi ukhulume ngokukuqala ngemithi yokwehlisa umfutho wegazi. ILosartan ne-lisinopril yimithi ejwayelekile kadokotela esetshenziselwa ukwelapha umfutho wegazi ophezulu ( umfutho wegazi ophezulu ). ILosartan iyi-angiotensin II receptor blocker (ARB) futhi lisinopril i-angiotensin-converting enzyme inhibitor (i-ACE inhibitor).
Zombili lezi zidakamizwa zisebenza engxenyeni yomzimba ebizwa nge-renin-angiotensin system kodwa ngezindlela ezahlukene. Kuhlelo lwe-renin-angiotensin, i-ACE inhibitors ivimba into ebizwa nge-angiotensin II ekubeni yenziwe. I-Angiotensin II inciphisa imithambo yegazi futhi inyuse umfutho wegazi, ngakho-ke ngokuvimba ukukhiqizwa kwe-angiotensin II, umfutho wegazi wehliswe. Ama-ARBs avimba i-angiotensin II kusuka ekubophweni kuya kuma-receptors, ngaleyo ndlela yehlisa umfutho wegazi.
Yini umehluko omkhulu phakathi kwe-losartan ne-lisinopril?
ILosartan iyi-ARB, etholakala ngegama lomkhiqizo nefomu lethebulethi, njenge-Cozaar (noma i-Hyzaar uma ihlanganiswe ne-hydrochlorothiazide, isisu esivame ukufushaniswa njenge-HCTZ). Izilinganiso ezijwayelekile zomthamo zisuka ku-25 mg ziye ku-100 mg nsuku zonke.
ILisinopril iyi-ACE inhibitor etholakala ngethebula ngamagama ezimpawu uPrinivil noma uZestril (noma iZestoretic uma ihlanganiswe ne-HCTZ). Futhi iyatholakala njengesisombululo somlomo esibizwa ngeQbrelis. Izilinganiso ezijwayelekile zomthamo zisuka ku-5 mg ziye ku-40 mg nsuku zonke.
OKUSHIWO: Imininingwane yaseLosartan | Imininingwane yeLisinopril
| Umehluko omkhulu phakathi kwe-losartan ne-lisinopril | ||
|---|---|---|
| ILosartan | I-Lisinopril | |
| Isigaba sezidakamizwa | I-Angiotensin receptor blocker (i-ARB) | I-ACE inhibitor |
| Isimo somkhiqizo / ejwayelekile | Umkhiqizo nokujwayelekile | Umkhiqizo nokujwayelekile |
| Ngubani igama lomkhiqizo? | UCozaar IHyzaar (losartan / HCTZ) | Prinivil Zestril Qbrelis (isisombululo somlomo) I-Zestoretic (lisinopril / HCTZ) |
| Izidakamizwa zingena ngaziphi izinhlobo? | Ithebhulethi (iyodwa futhi ihlangene ne-HCTZ) | Ithebhulethi (iyodwa futhi ihlangene ne-HCTZ) |
| Uyini umthamo ojwayelekile? | 25 kuya ku-100 mg nsuku zonke | 5 kuya ku-40 mg nsuku zonke |
| Yelashwa isikhathi esingakanani? | Isikhati eside | Isikhati eside |
| Ubani ovame ukusebenzisa umuthi? | Abantu abadala, izingane (kuya ngesibonakaliso) | Abantu abadala, izingane (kuya ngesibonakaliso) |
Ufuna intengo engcono kakhulu ku-lisinopril?
Bhalisela izexwayiso zentengo ye-lisinopril bese uthola ukuthi intengo ishintsha nini!
Thola izexwayiso zentengo
Imibandela ephathwa yi-losartan vs. lisinopril
ILosartan ikhonjisiwe ekwelapheni umfutho wegazi ophezulu (i-HTN), noma umfutho wegazi ophakeme. Ibuye isetshenziselwe ukunciphisa ubungozi bokushaywa yizifo ezigulini ezinomfutho wegazi ophakeme kanye ne-hypertrophy engakwesokunxele ye-ventricular, futhi isetshenziselwa ukwelapha ukuphazamiseka kwesifo sikashukela ezigulini ezithile.
I-Lisinopril ikhonjisiwe ekwelapheni i-HTN, njengokwelashwa okuhlanganyele ekuhlulekeni kwenhliziyo, nokwenza ngcono ukusinda ngemuva kokuhlaselwa yinhliziyo.
Zombili lezi zidakamizwa zinokusetshenziswa okungekho kwelebula, okuchazwe ngezansi.
| Isimo | ILosartan | I-Lisinopril |
| Ukwelashwa komfutho wegazi ophezulu (HTN) | Yebo | Yebo |
| Nciphisa ubungozi bokushaywa unhlangothi ezigulini ezine-HTN kanye ne-ventricular hypertrophy (LVH) | Yebo | Ngaphandle kwelebula |
| Ukwelashwa kwe-nephropathy yesifo sikashukela nge-serum creatinine ephakeme kanye ne-proteinuria ezigulini ezinesifo sikashukela sohlobo lwe-2 nomlando we-HTN | Yebo | Ngaphandle kwelebula |
| Ukwelashwa okuhambisanayo ekuphathweni kokuhluleka kwenhliziyo ezigulini ezingaphenduli ngokwanele kuma-diuretics nase-digitalis | Ngaphandle kwelebula | Yebo |
| Ukwelashwa kweziguli ezizinzile ngokwe-hemodynamically kungakapheli amahora angama-24 we-acute myocardial infarction (MI) ukwenza ngcono ukusinda | Ngaphandle kwelebula | Yebo |
| Ukwehluleka kwenhliziyo ngengxenyenamba yokukhipha encishisiwe | Ngaphandle kwelebula | Ngaphandle kwelebula |
| IMarfan syndrome ukunciphisa izinga lokwehla kwe-aorta | Ngaphandle kwelebula | Ngaphandle kwelebula |
| Ukuphathwa kweziguli ezine-non-ST-elevation acute coronary syndrome | Ngaphandle kwelebula | Ngaphandle kwelebula |
| Abamukeli bokufakelwa izinso | Ngaphandle kwelebula | I-Off-label (ezigulini ezine-post-transplant erythrocytosis) |
| Iziguli ezinesifo sezinso esingapheli se-proteinuric | Ngaphandle kwelebula (ezigulini ezinesifo sikashukela) | I-Off-label (kwiziguli ezinesifo sikashukela noma ezingekho emthethweni) |
| Umkhuhlane we-coronary disease ozinzile | Ngaphandle kwelebula | Ngaphandle kwelebula |
Ingabe i-losartan noma i-lisinopril iyasebenza kakhulu?
Ekubuyekezweni kwezifundo ezingama-61 eziqhathanisa ama-ARB (kufaka phakathi i-losartan) ne-ACE inhibitors (kufaka phakathi i-lisinopril), zombili izigaba zemithi zitholakale imiphumela yesikhathi eside efanayo ngomfutho wegazi. Ababhali baphinde baphetha ngokuthi womabili amakilasi ezidakamizwa anomphumela ofanayo ekufeni, imicimbi yenhliziyo, imicimbi emikhulu emibi, ikhwalithi yempilo, nezici zobungozi ezinjengamazinga e-lipid, isifo sikashukela, kanye nobukhulu bomsebenzi we-ventricular.
Kancane funda zeziguli ezinesifo sezinso, i-losartan ne-lisinopril zibe nemiphumela efanayo ekusebenzeni kwezinso nomfutho wegazi.
Umuthi osebenza kahle kakhulu kuwe kufanele unqunywe udokotela wakho, ongabuka isithombe esigcwele sesimo (se) sakho sezempilo, umlando, neminye imithi oyiphuzayo.
Ukuqhathaniswa kanye nezindleko zokuqhathaniswa kwe-losartan vs. lisinopril
Kokubili i-losartan ne-lisinopril zimbozwe umshuwalense kanye ne-Medicare Part D ngendlela ejwayelekile. Izinhlobo zegama lomkhiqizo zingambozwa ku-copay ephakeme. Izindleko eziphuma ephaketheni zamathebulethi angama-30 we-losartan 100 mg zingahle zisuke ku- $ 28- $ 70, kanti i-Medicare Part D copay icishe ibe ngu- $ 0- $ 13. Ngekhuphoni le-SingleCare, ibanga lentengo lingu- $ 9- $ 16 kuya ngekhemisi elibambe iqhaza. Izindleko eziphuma ephaketheni zamathebulethi angama-30 we-10 mg lisinopril cishe zingama- $ 15, kanti i-Medicare Part D copay icishe ibe ngu- $ 0- $ 7. Ungonga imali kwi-lisinopril ngokusebenzisa ikhadi lesaphulelo le-SingleCare noma isigqebhezana.
Zama ikhadi lesaphulelo somuthi we-SingleCare
| ILosartan | I-Lisinopril | |
| Ngokuvamile embozwe umshwalense? | Yebo | Yebo |
| Imbozwe ngokujwayelekile yi-Medicare? | Yebo | Yebo |
| Umthamo ojwayelekile | # 90, 100 mg amaphilisi | # 90, 20 mg amaphilisi |
| I-Medicare copay ejwayelekile | $ 0- $ 13 | $ 0- $ 7 |
| Izindleko ze-SingleCare | $ 28- $ 70 | $ 9- $ 26 |
Imiphumela emibi ejwayelekile ye-losartan vs. lisinopril
Imiphumela emibi ejwayelekile ye-losartan ifaka ukukhwehlela, isiyezi, ukutheleleka okuphezulu kokuphefumula, ukukhathala, nohudo.
Imiphumela emibi kakhulu ye-lisinopril ifaka ukukhwehlela, isiyezi, ikhanda, ukukhathala, nohudo.
Eminye imiphumela emibi ingavela. Xhumana nochwepheshe wezokunakekelwa kwempilo ukuthola uhlu oluphelele lwemiphumela engemihle.
| ILosartan | I-Lisinopril | |||
| Imiphumela emibi | Kusebenza? | Imvamisa | Kusebenza? | Imvamisa |
| Khwehlela | Yebo | 17-29% | Yebo | 3.5-69% |
| Isiyezi | Yebo | 3% | Yebo | 5.4% |
| Ukuphefumula okuphezulu ukutheleleka | Yebo | 8% | Yebo | 2.1% |
| Ukuminyana emakhaleni | Yebo | amaphesenti amabili | Yebo | 0.4% |
| Ukuhlungu obusemhlane | Yebo | amaphesenti amabili | Akunjalo | - |
| Ukukhathala | Yebo | > 4% | Yebo | 2.5% |
| Uhudo | Yebo | > 4% | Yebo | 2.7% |
| Isicanucanu | Yebo | Akubikiwe | Yebo | amaphesenti amabili |
| Ubuhlungu bekhanda | Yebo | Akubikiwe | Yebo | 5.7% |
Umthombo: DailyMed (losartan) , I-DailyMed (lisinopril)
Ukusebenzisana kwezidakamizwa kwe-losartan vs. lisinopril
ILosartan noma i-lisinopril akufanele isetshenziswe nge-potassium noma eminye imishanguzo ekhulisa i-potassium (njenge-diuretics ye-potassium-sparing), ngenxa yengozi ye-hyperkalemia. Ngokwengeziwe, buza udokotela wakho mayelana ne-potassium ekudleni kwakho nokuthi kufanele yini ugweme ukudla okunothe nge-potassium kanye nezindawo zikasawoti eziqukethe i-potassium.
Ama-NSAID (izidakamizwa ezingezona ezokulwa nokuvuvukala) akufanele zisetshenziswe ngokuhlangana ne-losartan noma i-lisinopril, ngoba inhlanganisela ingadala ukulimala kwezinso noma ukwehluleka kwezinso.
ILosartan noma i-lisinopril akufanele isetshenziswe ngokuhlangana nenye i-ACE inhibitor, i-ARB, noma i-Tekturna (aliskiren) ngoba inhlanganisela yandisa ingozi yomfutho wegazi ophansi, i-potassium ephezulu, ukuquleka, ukulimala kwezinso, noma ukwehluleka kwezinso.
Xhumana nomhlinzeki wakho wezokunakekelwa kwempilo ukuthola uhlu oluphelele lokuhlangana kwezidakamizwa.
| Izidakamizwa | Isigaba Sezidakamizwa | ILosartan | I-Lisinopril |
| I-potassium | I-Electrolyte | Yebo | Yebo |
| I-Midamor (amiloride) I-Aldactone (spironolactone) I-Dyrenium (triamterene) I-Inspra (eplerenone) | Ama-diuretics asindisa i-Potassium | Yebo | Yebo |
| I-Aspirin I-Motrin, Advil (ibuprofen) I-Aleve (naproxen) I-Mobic (meloxicam) I-Celebrex (celecoxib) I-Relafen (nabumetone) | Ama-NSAID | Yebo | Yebo |
| I-Vasotec (enalapril) I-Lotensin (benazepril) I-Accupril (quinapril) I-Altace (ramipril) | Ama-ACE inhibitors | Yebo | Yebo |
| I-Diovan (valsartan) Edarbi Ukuhlasela (candesartan) I-Avapro (irbesartan) I-Micardis (telmisartan) I-Benicar (olmesartan) | Ama-ARB | Yebo | Yebo |
| I-Tekturna (aliskiren) | I-Renin inhibitor | Yebo | Yebo |
| ILithium | Umenzeli we-Antimanic | Yebo | Yebo |
Izexwayiso ze-losartan ne-lisinopril
ILosartan ne-lisinopril zombili ziza nesixwayiso esibhokisi, okuyisixwayiso esiqine kakhulu njengoba kudingwa yi-FDA. Izidakamizwa (ezifana ne-losartan ne-lisinopril) ezisebenza ohlelweni lwe-renin-angiotensin zingadala ukulimala okungathi sína komntwana / ukukhubazeka kokuzalwa noma ukufa futhi kufanele zinqamuke lapho kutholakala ukukhulelwa.
Ezinye izexwayiso ezisebenza ku-losartan nase-lisinopril:
- Iziguli eziphelelwe amanzi emzimbeni noma ezithatha isisu zingakhula umfutho wegazi ophansi (hypotension).
- Izinguquko ekusebenzeni kwezinso, kufaka phakathi ukwehluleka okukhulu kwezinso, kungenzeka. Ingozi iphezulu ezigulini ezinenkinga yezinso noma ukwehluleka okukhulu kwenhliziyo. Lezi ziguli kungenzeka zingabi yilungele i-ACE inhibitor noma i-ARB. Uma kuqalwa eyodwa yalezi zidakamizwa, kufanele kubhekwe ukusebenza kwezinso.
- Amazinga e-potassium kufanele abhekwe.
ILisinopril inezexwayiso ezingeziwe:
- Kukhona amathuba okusabela kwe-anaphylactic (ukusabela okweqile komzimba), kufaka phakathi i-angioedema (ukuvuvukala) kobuso, imikhawulo, izindebe, ulimi, i-glottis, kanye / noma i-larynx. Lokhu kusabela kungenzeka noma kunini ngesikhathi sokwelashwa. I-Angioedema ehlotshaniswa ne-edema yelaryngeal ingaba yingozi. Lapho kukhona ukubandakanyeka kolimi, i-glottis noma i-larynx, okungenzeka kubangele ukuvinjelwa komoya, ukwelashwa okuphuthumayo kuyadingeka. I-Lisinopril kufanele inqanyulwe uma lokhu kuphendula kwenzeka.
- Kukhona ingozi encane yezinkinga zesibindi; ama-enzyme wesibindi kufanele aqashwe.
- Ngenxa yokonakala kwento ebizwa nge-bradykinin, kungahle kube nokukhwehlela okomile. Lapho umuthi usumisiwe, ukukhwehlela kufanele kuphele.
Imibuzo ebuzwa njalo nge-losartan ne-lisinopril
Yini i-losartan?
ILosartan iyi-angiotensin receptor blocker esiza ukwehlisa umfutho wegazi. Ingasetshenziselwa nezinye izimo ezahlukahlukene, ezichazwe ngenhla.
Yini i-lisinopril?
ILisinopril iyi-ACE inhibitor esiza ukwehlisa umfutho wegazi. Isetshenziselwa nezinye izimo zezokwelapha, ezichazwe ngenhla.
Ngabe i-losartan vs. lisinopril iyafana?
Yize yomibili le mithi isebenza ohlelweni lwe-renin-angiotensin, isebenza ezindaweni ezahlukahlukene zohlelo, kepha yomibili le mithi yehlisa umfutho wegazi futhi isetshenziselwa ezinye izimo zenhliziyo noma izinso. Banokunye ukwehluka kokulinganisa, izexwayiso, nentengo.
Amanye ama-inhibitors ajwayelekile we-ACE (njenge-lisinopril) okungenzeka ukuthi uzwile ukuthi afaka phakathi i-Lotensin (benazepril), i-Vasotec (enalapril), i-Accupril (i-quinapril), ne-Altace (i-ramipril).
Amanye ama-ARB (afana ne-losartan) okungenzeka uke wezwa ngawo afaka i-Edarbi (azilsartan - akukho generic etholakalayo), Atacand (candesartan), Avapro (irbesartan), Micardis (telmisartan), Diovan (valsartan), neBenicar (olmesartan).
Ngabe i-losartan noma i-lisinopril ingcono?
Ucwaningo lukhombise ama-ARB afana ne-losartan ne-ACE inhibitors afana ne-lisinopril ukuba nemiphumela efanayo. Xhumana nomhlinzeki wakho wezokunakekelwa kwempilo ukuze ubone ukuthi ngabe eyodwa yale mithi ikulungele yini.
Ngingayisebenzisa yini i-losartan noma i-lisinopril ngenkathi ngikhulelwe?
ILosartan noma i-lisinopril AKUFANELE ithathwe ngenkathi ikhulelwe. Yomibili le mithi iyingozi kakhulu embungwini okhulayo futhi ingadala ukukhubazeka okukhulu kokuzalwa noma ngisho nokufa kombungu. Uma usuvele uthatha i-losartan noma i-lisinopril futhi uthola ukuthi ukhulelwe, thintana nodokotela wakho ngokushesha.
Ngingayisebenzisa yini i-losartan noma i-lisinopril ngotshwala?
Ukuphuza utshwala ngenkathi uthatha i-losartan noma i-lisinopril kungakhuphula isiyezi, noma kuthinte umfutho wegazi noma ezinye izimo zezempilo. Xhumana nodokotela wakho mayelana nokusetshenziswa kotshwala ne-losartan noma i-lisinopril.
Ingabe kufanele ngithathe i-lisinopril ne-losartan ndawonye?
Cha. Yize eminye imishanguzo yengcindezi yegazi isetshenziswa inhlanganisela (njenge-losartan noma i-lisinopril ihlanganiswe ne-diuretic), i-lisinopril ne-losartan akufanele zithathwe ndawonye. Ukwenza kanjalo kwandisa ingozi yomfutho wegazi ophansi, i-potassium ephezulu, nokulimala ezinsweni, okungaba kubi kakhulu noma kubulale.
Ingabe i-losartan i-ACE inhibitor noma i-beta blocker?
ILosartan iyi-block blocker ye-angiotensin. Akuyona i-ACE inhibitor noma i-beta blocker.
Ngabe i-losartan idala imiphumela emibi embalwa kune-lisinopril?
Zombili lezi zidakamizwa zinemiphumela emibi efanayo, yize i-lisinopril kungenzeka ukuthi ibangele ukukhwehlela okomile futhi inobungozi be-angioedema (ukusabela okweqile). Xhumana nochwepheshe wezokunakekelwa kwezempilo ukuthola uhlu olugcwele lwemiphumela engemihle.
