NATRIXAM Tablet

គុណភាពព្យាបាល
ឱសថនេះគឺរួមបញ្ចូលគ្នារវាងឱសថ2មុខគឺ Indapamide (ជាប្រភេទឱសថបញ្ចុះទឹកនោម) និង Amlodipine (ជាប្រភេទឱសថជួយធ្វើអោយឈាមរត់ស្រួលក្នុងសរសៃឈាម)។
ឱសថនេះប្រើសំរាប់ព្យាបាលជំងឺលើសសំពាធឈាម ចំពោះអ្នកជំងឺដែលធ្លាប់ប្រើឱសថគ្រាប់ Indapamide និង Amlodipine ក្នុងកំរិតដូចគ្នា និងដាច់ដោយឡែកពីគ្នា។
កម្រិតនិងរបៀបប្រើ
- កំរិតណែនាំអោយប្រើគឺ លេបម្ដង 1គ្រាប់ ក្នុង1ថ្ងៃ ជាការល្អប្រសើរគួរលេបឱសថនេះនៅពេលព្រឹក។
- ឱសថនេះត្រូវលេបទាំងមូល ហើយមិនត្រូវទំពារទេ។
- ការប្រើឱសថនេះចាំបាច់ត្រូវមានការណែនាំពីគ្រូពេទ្យ។
- មិនត្រូវប្រើឱសថនេះហួសកម្រិតណែនាំអោយប្រើទេ ព្រោះវាអាចធ្វើអោយសំពាធឈាមថយចុះខ្លាំង។
- ប្រសិនបើអ្នកភ្លេចលេបឱសថនេះពេលព្រឹក អ្នកអាចលេបវានៅពេលយប់បាន ជៀសវាងការលេបត្រួតកម្រិតប្រើ។

 

For treatment of high blood pressure (hypertension) in patients already taking indapamide and amlodipine form separate tablets in the same strength.

Dosage

Oral use.

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is 1 tablet once a day, preferably in the morning. The tablet should be swallowed as whole with water and should not be chewed.

ឱសថនេះត្រូវហាមប្រើចំពោះ
- អ្នកជំងឺដែលធ្លាប់ងាយមានប្រតិកម្ម Indapamide ឬជាមួយ Sulfonamide ឬជាមួយ Amlodipine ឬជាមួយឱសថក្នុងក្រុម Calcium channel blockers ដទៃទៀត ឬជាមួយនឹងសារធាតុផ្សំណាមួយនៃឱសថនេះ។
- អ្នកជំងឺដែលមានសំពាធឈាមថយចុះធ្ងន់ធ្ងរ
- អ្នកជំងឺមានបញ្ហាត្បៀតប្រើសបេះដូង
- អ្នកជំងឺខ្សោយបេះដូង
- អ្នកជំងឺឈឺតម្រងនោមធ្ងន់ធ្ងរ
- អ្នកជំងឺឈឺថ្លើមធ្ងន់ធ្ងរ
- អ្នកជំងឺដេលមានកម្រិតជាតិប៉ូតាស្យុមទាបក្នុងឈាម
- ស្ត្រីបំបៅដោះកូន
- ឱសថនេះមិនត្រូវបានណែនាំអោយប្រើចំពោះកូនក្មេង និងមនុស្សវ័យជំទង់ទេ។

 

- if you are allergic to indapamide or any other sulfonamide (class of medicinal product for the treatment of hypertension), or to amlodipine or any other calcium antagonist (class of medicinal product for the treatment of hypertension) or to any of the other ingredients of this medicine. This may itching, reddening of the skin or difficulty in breathing,

- if you have severe low blood pressure (hypotension),

- if you have narrowing of the aortic heart value (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body),

- if you suffer from heart failure after a heart attack,

- if you have severe kidney disease,

- if you have severe liver disease or suffer from a condition called hepatic encephalopathy (disease of the brain caused by liver illness),

- if you have low potassium levels in your blood,

- if you are breastfeeding.

ផលរំខានរួមមាន៖ ឈឺក្បាល វិលមុខ ងងុយដេក បេះដូងដើរញាប់ ឈឺក្នុងទ្រូង ឈឺពោះ ចង្អោរ ថយចុះកំរិតជាតិប៉ូតាស្យូមក្នុងឈាម ហើមខ្នងជើង អស់កំលាំង ដេកមិនលក់ ធ្លាក់ទឹកចិត្ត ញ័រខ្លួន មិនសូវដឹងរសជាតិ បាត់ស្មារតី ល្ហិតល្ហៃ ភ្នែកស្រវាំង ហ៊ឹងក្នុងត្រចៀក សំពាធឈាមថយចុះ ស្ងួតមាត់ រាក ក្អយត ទល់លាមក ហើមពោះ មិនរំលាយអាហារ ជ្រុះសក់ ស្បែកឡើងកម្រហម កន្ទួល រមាស់ នោមច្រើន ក្អក ឈឺពោះ ឈឺសាច់ដុំ ឈឺសន្លាក់ឆ្អឹង ឈឺខ្នង ហើម អស់កំលាំង ឡើងទម្ងន់ឬថយចុះទម្ងន់។

 

Stop taking the medicinal product and visit your doctor immediately if you experience any of the following side effects:

- swelling of eyelids, face or lips (very rare),

- swelling of the tongue and throat which causes great difficulty breathing (very rare),

- severe skin reactions including intense skin rash, hives, reddening of the skin over your whole body, severe itching, blistering, peeling and swelling of the skin, inflammation of mucous membranes (Stevens Johnson Syndrome) or other allergic reactions (very rare),

- heart attack (very rare),

- abnormal heart beat (uncommon),

- life-threatening irregular beat (torsade de points) (frequency not known),

- inflamed pancreas which may cause severe abdominal and back pain accompanied with feeling very unwell (very rare).

The following common side-effects have been reported. If any of these cause you problems or if they last for more than one week, you should contact your doctor.

Very common: oedema

Common: headache, dizziness, sleepiness (especially at the beginning of treatment), visual impairment, double vision, palpitations (awareness of your heart beat), flushing, shortness of breath, abdominal pain, feeling sick (nausea), change of bowel habit, diarrhoea, constipation, indigestion, ankle swelling, tiredness, weakness, muscle spasms, low potassium in the blood, which may cause muscle weakness, skin rashes.

Uncommon: mood altered, anxiety, depression, sleeplessness, trembling, taste abnormalities, numbness or tingling sensation in your limbs, loss of pain sensation, ringing in the ears, low blood pressure, fainting, sneezing/running nose caused by inflammation of the lining of the nose (rhinitis), cough, dry mouth, vomiting (being sick), hair loss, increased sweating, itchy skin, red patches on skin, skin discolouration, hives, disorder in passing urine, increased need to urinate at night, increased number of times of passing urine, inability to obtain an erection; discomfort or enlargement of the breasts in men, pain, feeling unwell, joint or muscle pain, back pain, weight increased or decreased.

Rare: confusional state, feeling of dizziness,

Very rare: changes in blood cells, such as thrombocytopenia (decrease in the number of platelets which causes easy bruising and nasal bleeding), leucopenia (decrease of white blood cells which may cause unexplained fever, soreness of the throat or other flu-like symptoms- if this occurs, contact your doctor) and anaemia (decrease in red blood cells), excess sugar in blood (hyperglycaemia), increase of calcium in blood, a disorder of the nerves which can cause weakness, tingling or numbness, swelling of the gums, abdominal bloating (gastritis), hepatic function abnormal, inflammation of the liver (hepatitis), yellowing of the skin (jaundice), liver enzyme increase which may have an effect on some medical tests; in cases of liver failure, there is a possibility of getting hepatic encephalopathy (disease in the brain caused by liver illness), kidney disease, increased muscle tension, inflammation of blood vessels, often with skin rash, sensitivity to light.

Not known: changes may occur in your laboratory parameters and your doctor may need to give you blood tests to check your condition. The following changes in laboratory parameters may occur; low sodium in the blood that may lead to dehydration and low blood pressure, increase in uric acid, a substance which may cause or worsen gout (painful joint(s) especially in the feet, increase in blood glucose levels in diabetic patients, abnormal ECG tracing, short sightedness (myopia), vision blurred, trembling, rigid posture, mask-like face, slow movements and shuffling, unbalanced walk.

If you suffer from systemic lupus erythematosus (a type of collagen disease), this might get worse.

ឱសថនេះអាចមានអន្តរកម្មជាមួយឱសថផ្សេងទៀតដូចខាងក្រោម៖ Lithium, Dantrolen, Antiarrythmia drugs (Quinidine, Hydroquinidine, Disopyramide, Amiodarone, Sotalol, Ibutilide, Dofetilide), Antidepressants, Antipsychotic drugs, Antiangianl drugs (Bepridil), Cisapride, Diphemanil, Sparfloxacine, Moxifloxacine, Vincamine IV, Halofantrine, Mizolastine, Non steroid anti-inflammatory drugs, Angiotensin converting enzyme, Oral corticosteroids, Digitalic preparations, Stimulant laxatives, Baclofen, Potassium-sparing diuretics (Amiloride, Spironolactone, Triamterence), Antidiabetic (Metformine), Iodinated contrast media, Calcium tablet or calcium supplements, Ciclosporin, Taccrolimus, Tetracosactide, Itraconazole, Amphoterin B, Rifampicin, Erythromycin, Clarithromycin, Hypericum perforatum, Ritonavir, Indinavir, Nefinavir, Verapamil, Diltiazem, Simvastatin, ផ្លែក្រូចថ្លុងឬទឹកផ្លែក្រូចថ្លុង។

 

You should not take Natrixam:

- with lithium due to the risk of increased levels of lithium in the blood,

- with dantrolene.

Make sure to tell your doctor if you are taking any of the following medicines, as special care may be required:

- other medicines for treating high blood pressure,

- medicines used for heart rhythm problems (e.g. quinidine, hydroquinidine, disopyramide, amiodarone, sterol, ibutilide, dofetilide),

- medicines used to treat mental disorders such as depression anxiety, schizophrenia… (e.g. tricyclic antidepressants, antipsychotic drugs, neuroleptics),

- bepridil,

- cisapride, diphemanil,

- sparfloxacin, moxifloxacin , erythromycin by injection,

- vincamineⅣ,

- halofantrine,

- pentamidine,

- mizolastine,

- NSAIDs for pain relief or high doses of acetylsalicylic acid,

- ACE inhibitors,

- oral corticosteroids used to treat various conditions including severe asthma and rheumatoid arthritis,

- digitalis preparations,

- stimulant laxatives,

- baclofen,

- potassium-sparing diuretics (amiloride, spironolactone, triamterene),

- metformin,

- iodinated contrast media (used for tests involving X-rays),

- calcium tablets or other calcium supplements,

- immunosupressants for the treatment of auto-immune disorders or following transplant surgery (e.g. ciclosporine, tacrolimus),

- tetracosactide,

- ketoconazole, itraconazole, amphotericin B by injection (anti-fungal medicines),

- ritonavir, indinavir, nelfinavir (so called protease inhibitors used to treat HIV),

- rifampicin, erythromycin, clarithromycin (antibiotics for infection caused by bacteria),

- hypericum perforatum (St. John’s Wort),

- verapamil, diltiazem,

- simvastatin,

- allopurinol.

Grapefruit juice and grapefruit should not be consumed by people who are taking Natrixam. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active ingredient amlodipine, which can cause an unpredictable increase in the blood pressure lowering effect of Natrixam.

Natrixam contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

This medicine is not recommended during pregnancy. When a pregnancy is planned or confirmed, the switch to an alternative treatment should be initiated as soon as possible.

You must not take Natrixam if you are breast-feeding. Tell your doctor immediately if you are breast-feeding or about to start breast-feeding.

ការប្រើឱសថនេះត្រូវមានការប្រុងប្រយ័ត្នដូចខាងក្រោម៖
- ប្រសិនបើអ្នកមានជំងឺបេះដូងផ្សេងទៀត ដូចជា ជំងឺគាំងបេះដូងថ្មីៗ
- ប្រសិនបើអ្នកមានជំងឺខ្សោយបេះដូង ចង្វាក់បេះដូងមិនប្រក្រតី ឬមានបញ្ហាសរសៃឈាមបេះដូង
- ប្រសិនបើអ្នកមានបញ្ហាតម្រងនោម
- ប្រសិនបើអ្នកមានសំពាធឈាមកើនឡើងធ្ងន់ធ្ងរ
- ប្រសិនបើអ្នកមានបញ្ហាកង្វះអាហារូបត្ថម្ភ
- ប្រសិនបើអ្នកមានបញ្ហាថ្លើម
- ប្រសិនបើអ្នកមានជំងឺទឹកនោមផ្អែម
- ប្រសិនបើអ្នកមានជំងឺរលាកឆ្អឹង សន្លាក់ឆ្អឹង
- ប្រសិនបើអ្នកងាយមានប្រតិកម្មជាមួយពន្លឺថ្ងៃ
- ប្រសិនបើអ្នកកំពុងប្រើឱសថដទៃទៀត
- ប្រសិនបើអ្នកកំពុងបើកបរ ឬបញ្ជាគ្រឿងចក្រផ្សេងៗ។

 

You should inform your doctor if you have or have had any of the following conditions:

- recent heart attack,

- if you have heart failure, any heart rhythm problems, if you have coronary artery disease (heart disease caused by poor blood flow in the blood vessels of the heart),

- if you have problems with your kidneys,

- severe increased in blood pressure (hypertensive crisis),

- you are elderly and your dose needs to be increased,

- if you take other medicines,

- if you are malnourished,

- if you have liver problems,

- if you have diabetes,

- if you suffer from gout,

- if you need to have a test to check how well your parathyroid gland is working,

- if you had photosensitivity reactions.

Your doctor may prescribe you blood tests to check for low sodium or potassium levels or high calcium levels.

If you think any of these situations may apply to you or you have any questions or doubts about taking your medicine, you should consult your doctor or pharmacist.

Natrixam is a combination of two active ingredients, indapamide and amlodipine.

Indapamide is a diuretic. Diuretics increase the amount of urine produced by the kidneys. However, indapamide is different from other diuretics, as it only causes a slight increase in the amount of urine produced. Amlodipine is a calcium antagonist (which belongs to a class of medicines called dihydropyridines) and it works by relaxing blood vessels, so that blood passes through them more easily.

Each of the active ingredients reduces blood pressure.