. . . . . . . "Pod\u00E1v\u00E1n\u00ED ACE inhibitor\u016F b\u011Bhem prvn\u00EDho trimestru t\u011Bhotenstv\u00ED nen\u00ED doporu\u010Deno (viz bod 4.4). Pod\u00E1v\u00E1n\u00ED ACE inhibitor\u016F v\u00A0druh\u00E9m a t\u0159et\u00EDm trimestru t\u011Bhotenstv\u00ED je kontraindikov\u00E1no (viz bod 4.3, 4.4).\nT\u011Bhotenstv\u00ED:\nEpidemiologick\u00E9 d\u016Fkazy vztahuj\u00EDc\u00ED se k riziku teratogenity n\u00E1sledkem expozice inhibitor\u016F ACE b\u011Bhem prvn\u00EDho trimestru t\u011Bhotenstv\u00ED nejsou p\u0159esv\u011Bd\u010Div\u00E9; nicm\u00E9n\u011B mal\u00E9 zv\u00FD\u0161en\u00ED rizika nem\u016F\u017Ee b\u00FDt vylou\u010Deno. Nen\u00ED-li pokra\u010Dov\u00E1n\u00ED l\u00E9\u010Dby inhibitorem ACE pova\u017Eov\u00E1no za nezbytn\u00E9, m\u011Bly by pacientky pl\u00E1nuj\u00EDc\u00ED t\u011Bhotenstv\u00ED zm\u011Bnit l\u00E9\u010Dbu na alternativn\u00ED antihypertenzn\u00ED l\u00E9\u010Dbu, kter\u00E1 m\u00E1 zaji\u0161t\u011Bn\u00FD bezpe\u010Dnostn\u00ED profil pro u\u017E\u00EDv\u00E1n\u00ED v t\u011Bhotenstv\u00ED. Kdy\u017E je diagnostikov\u00E1no t\u011Bhotenstv\u00ED, l\u00E9\u010Dba inhibitory ACE mus\u00ED b\u00FDt okam\u017Eit\u011B zastavena a mus\u00ED b\u00FDt zah\u00E1jena vhodn\u00E1 alternativn\u00ED l\u00E9\u010Dba. \nJe toti\u017E zn\u00E1mo, \u017Ee vystaven\u00ED plodu l\u00E9\u010Db\u011B inhibitorem ACE b\u011Bhem druh\u00E9ho a t\u0159et\u00EDho trimestru indukuje hum\u00E1nn\u00ED fetotoxicitu (pokles ren\u00E1ln\u00EDch funkc\u00ED, oligohydramnion, retardace osifikace lebky) a neonat\u00E1ln\u00ED toxicitu (ren\u00E1ln\u00ED selh\u00E1n\u00ED, hypotenze, hyperkal\u00E9mie) (viz bod 5.3). \nPokud by od druh\u00E9ho trimestru t\u011Bhotenstv\u00ED do\u0161lo k\u00A0l\u00E9\u010Db\u011B inhibitory ACE, doporu\u010Duje se ultrazvukov\u00E1 kontrola funkce ledvin a lebky.\nKojenci, jejich\u017E matky u\u017E\u00EDvaly inhibitory ACE, by m\u011Bli b\u00FDt d\u016Fkladn\u011B sledov\u00E1ni stran hypotenze (viz bod 4.3 a 4.4).\nIndapamid je chlorosulfonylov\u00E9 diuretikum a nesm\u00ED b\u00FDt pod\u00E1v\u00E1n t\u011Bhotn\u00FDm \u017Een\u00E1m. Diuretika by nem\u011Bla b\u00FDt nikdy l\u00E9kem volby fyziologick\u00FDch otok\u016F u t\u011Bhotn\u00FDch.\nVystaven\u00ED lidsk\u00E9ho plodu p\u016Fsoben\u00ED thiazid\u016F b\u011Bhem t\u0159et\u00EDho trimestru t\u011Bhotenstv\u00ED m\u016F\u017Ee sn\u00ED\u017Eit objem plasmy a uteroplacent\u00E1rn\u00ED krevn\u00ED perf\u00FAzi u matky, co\u017E m\u016F\u017Ee vyvolat fetoplacent\u00E1rn\u00ED isch\u00E9mii a retardaci r\u016Fstu. D\u00E1le byly zaznamen\u00E1ny vz\u00E1cn\u00E9 p\u0159\u00EDpady hypoglyk\u00E9mie a trombocytopenie u novorozenc\u016F po vystaven\u00ED p\u016Fsoben\u00ED thiazid\u016F kr\u00E1tce p\u0159ed term\u00EDnem porodu.\nKojen\u00ED:\nProto\u017Ee nejsou dostupn\u00E9 informace ohledn\u011B u\u017E\u00EDv\u00E1n\u00ED perindoprilu b\u011Bhem kojen\u00ED, nen\u00ED perindopril doporu\u010Dov\u00E1n a je preferov\u00E1na alternativn\u00ED l\u00E9\u010Dba s\u00A0l\u00E9pe dolo\u017Een\u00FDm bezpe\u010Dnostn\u00EDm profilem b\u011Bhem kojen\u00ED, zejm\u00E9na u kojen\u00ED novorozenc\u016F a nedono\u0161en\u00FDch d\u011Bt\u00ED.\nIndapamid je kontraindikov\u00E1n b\u011Bhem kojen\u00ED. Indapamid je vylu\u010Dov\u00E1n do mate\u0159sk\u00E9ho ml\u00E9ka.Thiazidov\u00E1 diuretika jsou spojov\u00E1na s\u00A0poklesem nebo dokonce potla\u010Den\u00EDm laktace b\u011Bhem kojen\u00ED. M\u016F\u017Ee se vyskytnout p\u0159ecitliv\u011Blost na l\u00E9ky zalo\u017Een\u00E9 na deriv\u00E1tech sulfonamidu, hypokal\u00E9mie a novorozeneck\u00E1 \u017Eloutenka.\nJeliko\u017E u kojenc\u016F se mohou objevit z\u00E1va\u017En\u00E9 ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky, rozhodnut\u00ED, zda p\u0159eru\u0161it kojen\u00ED nebo p\u0159eru\u0161it l\u00E9\u010Dbu, mus\u00ED b\u00FDt provedeno vzhledem k d\u016Fle\u017Eitosti l\u00E9\u010Dby matky.\n"@cs . . "4.6\tT\u011Bhotenstv\u00ED a kojen\u00ED"@cs . . . "004.006" . . .