Pali mankhwala ambiri omwe amathandizira pa matenda ashuga a 2. Komabe, metformin yakhala ikugwira mwamphamvu kanjedza pakati pawo kwazaka zambiri - chifukwa cha kuthamanga kwake komanso chitetezo. Nkhaniyi ikufotokozera za momwe amagwiritsidwira ntchito imodzi mwazosiyanasiyana za mankhwala omwe ali ndi metformin - Metformin - Richter.

Maziko a Metformin-Richter mankhwalawo ndiformform, yomwe ili mgulu la Biguanides. Hypoglycemic mphamvu ya metformin imadziwika msanga chifukwa cha mitundu ingapo ya zochita:

kuteteza kuyamwa kwa shuga m'mimba,
kuteteza kaphatikizidwe ka shuga m'magazi a chiwindi (mankhwalawa amachepetsa izi ndi 30%),
kuchuluka kwa zotumphukira zimakhala kuti insulin (kwambiri mu minofu kuposa adipose minofu).

Mwambiri, metformin imakhala ndi zotsatira zopindulitsa kagayidwe kachakudya kambiri mthupi, imathandiza kuchepetsa kuchuluka kwa cholesterol yoyipa m'magazi, imakhala ndi fibrinolytic, imayang'anira kuchuluka kwa mahomoni opatsa chithokomiro m'thupi, komanso kupewa thrombosis.

Metformin siyimakhudzana ndi kapangidwe ka insulin mu kapamba, chifukwa chake kuchuluka kwa insulin komwe amapanga sikungokhala kosalekeza. Izi zikutanthauza kuti metformin sikuti imathandizira kulemera, mosiyana ndi insulin yaubwino. Ndi kugwiritsa ntchito metformin pafupipafupi mwa odwala, kukhazikika kwa thupi kumadziwika. Fibrinolytic zotsatira zimadziwikanso ndi metformin. Kuphatikiza apo, kusadziwika kwa kapamba kumatanthawuza kuti zida zamtunduwu sizimatha nthawi isanakwane. Mosiyana ndi ma biguanides ena, metformin ili ndi chiopsezo chochepa chotenga lactic acidosis. Komanso, monotherapy, metformin sikumatsogolera ku hypoglycemia, ngakhale atakhala kuti mulingo wambiri.

Pharmacokinetics

The bioavailability wa mankhwalawa ndi 50-60%. Kwambiri ndende amawona maola 2.5 pambuyo makonzedwe. Metformin imagawidwa mu minofu ndipo sikuti imagwirizana ndi mapuloteni a plasma. Imatha kulowa m'magazi ofiira. Amapukusika pang'ono, amachotsedwa makamaka ndi impso. Kutha kwa theka-moyo ndi maola 6.5. Mapulogalamu a pharmacokinetic mwa ana ali ofanana ndi achikulire. Mu vuto laimpso, kuwonongeka kwa mankhwala m'thupi ndikotheka.

Chizindikiro chachikulu chogwiritsa ntchito Metformin-Richter ndi matenda amtundu wa 2, ndiye kuti, shuga yemwe amadalira insulin. Ndi mtundu wamtunduwu wa shuga, palibe kuchepa pakupanga insulin ndi maselo a kapamba, komabe, chidwi cha zotumphukira zake kuti insulini ichepe, ndipo kupanga shuga ndi ma cell a chiwindi kumakulanso.

Mu gawo loyambirira la shuga, ndikofunikira kugwiritsa ntchito njira zosagwiritsira ntchito mankhwalawa - zakudya, masewera olimbitsa thupi, kuchepa thupi. Komabe, ngati njira zotere sizikubweretsa zotsatira, ndiye kuti mankhwala amaperekedwa. Choyamba, ndi metformin. Pankhaniyi, zakudya nthawi zambiri zimasungidwa.

Komanso Metformin-Richter imatha kulembedwa kwa anthu omwe amachepetsa glucose (prediabetes) ngati prophylactic. Komabe, nthawi zambiri ndi prediabetes, kudya ndi kuchita masewera olimbitsa thupi ndizothandiza kuposa kumwa mankhwala.

Metformin ndi njira yoyamba yochizira matenda ashuga. Itha kugwiritsidwa ntchito ngati mankhwala okhawo komanso ngati gawo la zovuta mankhwala.

Nthawi zina metformin imagwiritsidwanso ntchito pochiza matenda ena, monga matenda a ovary polycystic kapena kunenepa kwambiri. Komabe, mankhwala ovomerezeka samalimbikitsa kugwiritsa ntchito metformin kuti athane ndi kunenepa kwambiri.

Kutulutsa Fomu

Pali mankhwala ambiri okhala ndi metformin pamsika. Metformin-Richter ndi mitundu yosiyanasiyana ya mankhwala omwe amapangidwa ndi kampani yaku Hungary a George Richter. Njira yokhayo ya mankhwalawa amapangidwa - mapiritsi. Piritsi lililonse lili ndi 500 kapena 850 mg yogwira ntchito.

Zoyeserera zomwe ndi gawo la mapiritsi a Metformin-Richter:

kopovidone
polyvidone
cellcrystalline mapadi,
silika
magnesium wakuba.

Ndikofunikira kudziwa kuti mapiritsi awiri a 500 mg siofanana ndi piritsi limodzi la 850 mg. Mankhwalawa atha kugulidwa ku malo ogulitsa mankhwala osagwiritsa ntchito mankhwala.

Contraindication

Metformin Richter ilibe zotsutsana zingapo. Analoleza mankhwala kwa ana azaka 12. Komabe, panthawi yoyembekezera komanso yoyamwitsa, mankhwalawa samalimbikitsidwa. Chinsinsi china chachikulu ndikulephera kwa impso (kulengedwa kwa creatinine zosakwana 60 ml / min). Popeza mankhwalawa amachotsedwa m'thupi ndi impso, kulephera kwa impso kumatha kuyambitsa chidwi cha mankhwala mthupi, chomwe chimakhala ndi zotsatirapo zoyipa, zomwe zikufotokozedwa pansipa mu gawo la "bongo".

Metformin-Richter imaphatikizidwanso mu:

matenda a shuga
matenda ashuga ketoacidosis,
pachimake myocardial infaration,
kulephera kwamtima,
pachimake kupuma kulephera
kusowa kwamadzi
matenda opatsirana opatsirana
lactic acidosis (kuphatikizapo mbiri ya)
uchidakwa wosatha
njira zodziwitsa anthu pogwiritsa ntchito mankhwala okhala ndi ayodini (masiku awiri asanafike patsikulo ndi masiku awiri pambuyo pake),
opaleshoni ya opaleshoni ya opaleshoni (masiku awiri asanafike patsikulo ndi masiku awiri pambuyo),
lactase akusowa ndi lactose tsankho.

Simungathe kumwa mankhwalawa kwa anthu omwe amakhala pachakudya chamafuta ochepa (osakwana 1000 kcal / tsiku)

Mosamala, Metformin-Richter amalembera anthu okalamba (azaka zopitilira 60) omwe amagwira ntchito zolimbitsa thupi. Izi zimagwirizanitsidwa ndi chiopsezo chowonjezeka cha lactic acidosis m'gulu ili la odwala. Pazovuta zazikulu za metabolic, kuchepetsa mlingo kumafunika.

Metformin Richter 500, 850, 1000: malangizo, ndemanga, ma analogie

Mwambiri, biguanides amadziwika ngati mankhwala oyamba kwa odwala matenda a shuga. Metformin-Richter ndi amodzi mwa mankhwala ambiri okhudzana ndi gulu ili la othandizira a hypoglycemic. Phaleli limapangidwa ndi nthambi yaku Russia ya kampani yaku Hungary a Gideon-Richter, omwe ndi amodzi mwa omwe amapanga zazikulu kwambiri ku Europe.

Kutchuka kwa metformin kumafotokozedwa ndikuyenda bwino kwambiri koyambirira kwa matendawa, kuchuluka kwake kwakubwera, zotsatira zabwino pamtima wamtima komanso kulemera kwa odwala matenda ashuga. Mosasamala za njira yachikhalidwe kapena yatsopano yomwe dokotala amatenga, atazindikira kuti ali ndi matenda ashuga, adzakufotokozerani zakudya, kayendedwe ndi metformin.

Zambiri pazamankhwala

Metformin Richter imapezeka mu mawonekedwe a mapiritsi oyera a convex. Wopanga ndiye kampani yanyumba GEDEON RICHTER-RUS CJSC. Piritsi 1 ili ndi metformin hydrochloride, komanso talc, magnesium stearate ndi wowuma wa chimanga pang'ono. Amapangidwa mosiyanasiyana: 500 mg, 850 mg ndi 1000 mg.

Wothandizidwa ndi hypoglycemic amatha kutumizidwa ndi endocrinologist wa matenda a shuga a 2 ngati wodwala sakukonzekera kukula kwa ketoacidosis, komanso kuphatikiza jakisoni wa insulin. Mankhwala amatengedwa ndi osakwanira zakudya zopatsa thanzi komanso maphunziro olimbitsa thupi.

Wodwala akamatenga mapiritsi a Metformin Richter, amawamwa. Kuchoka kwa mankhwalawa kumachitika kudzera mu impso osasinthika. The pharmacological zochita za mankhwala ndi:

Kuchepetsa shuga m'magazi.
Kukhathamiritsa kwa kufalikira kwa kufalikira kwa shuga.
Kutsika kwa kuchuluka kwa mahomoni olimbikitsa chithokomiro mu seramu yamagazi.
Kuletsa kwa glucogeneis - njira ya kupanga shuga m'magazi.
Kuchuluka kwamphamvu ya zotumphukira kwa insulin.
Kuchepa mphamvu kwa kupanga magazi.
Kukhathamiritsa kwa njira yogwirizananso kwa magazi kuwundana.
Kutsika kwa triglycerides, komanso ochepa otsika linoprotein.
Kuchuluka mafuta acid oxidation.
Kuchepa kwa ndende ya mafuta m'thupi.

Kuphatikiza apo, kugwiritsa ntchito mankhwalawa kumakhazikika ndikuchepetsa thupi.

Malangizo ogwiritsira ntchito mapiritsi

Mankhwalawa sangagulidwe popanda mankhwala a dokotala. Mlingo wa mankhwalawa ungasiyane kutengera kuchuluka kwa shuga m'magazi, kuopsa kwa matendawa, matendawo komanso momwe wodwalayo alili. Pambuyo pogula Metformin Richter, malangizo a wodwalayo kuti agwiritse ntchito ayenera kuphunzira bwino.

Anthu omwe ali ndi matenda ashuga omwe amayamba kulandira chithandizo amaloledwa kumwa ma milligram wani miliyoni mpaka chikwi chimodzi. Pambuyo pa milungu iwiri ya chithandizo, kuchuluka kwa mankhwalawa ndikotheka. Ndi zoletsedwa motsimikiza kuwonjezera kuchuluka kwa mankhwalawa, ndi dokotala yekha yemwe angayese kuthekera kowonjezera.

Akuluakulu ayenera kutenga mpaka 1000 mg patsiku. Mlingo wokonzanso akuti ndi 1500 mg mpaka 2000 mg. Nthawi yomweyo, mpaka 3000 mg amathanso kumudya kwambiri patsiku. Mu chomata cholumikizidwa, amalangizidwa kuti amwe mankhwalawo nthawi yakudya kapena itatha, kumwa mapiritsi ndi madzi.

Tiyenera kudziwa kuti chifukwa chotenga Metformin Richter, machitidwe ena amthupi amatha. Amalumikizidwa ndi chizolowezi chake cha zomwe zimagwira. Kwa milungu iwiri yoyambirira, wodwalayo amatha kudandaula kuti zakhumudwa, monga kuphwanya thupi, kutsegula m'mimba, kusintha kukoma, kusowa kudya, kuchuluka kwa mpweya, kupweteka kwam'mimba. Nthawi zambiri, zizindikirozi sizimapita zokha. Kuti muchepetse kuopsa kwa zovuta zomwe zimachitika, mankhwalawa amayenera kugawidwa kangapo.

Metformin Richter iyenera kusungidwa kuti isachitike ndi madzi, kutali ndi ana aang'ono. Kutentha sikuyenera kupitirira +25 digiri Celsius.

Pambuyo pazaka ziwiri kuyambira tsiku lotulutsira mankhwalawo, kayendetsedwe kake koletsedwa.

Zochita zina zamankhwala

Pali mankhwala omwe amasiyana mu machitidwe awo pakuchiritsa kwa mankhwala ena. Chifukwa chake, ena a iwo amachepetsa mphamvu ya hypoglycemic ya Metformin Richter, potero amachititsa kuchuluka kwa shuga. Ena, M'malo mwake, amangowonjezera zotsatira za mankhwalawo ndipo amatha kutsitsa kwambiri shuga.

Chifukwa chake, zomwe zimaphatikizidwa ndi Metformin Richter, zomwe zingayambitse hyperglycemia, ndi danazol, glucocorticosteroids, kulera, epinofrin, "loop" ndi thiazide diuretics, sympathomimetics, mahomoni a chithokomiro, nicotinic acid ndi phenothiazine.

Kukhazikitsa kwa munthawi yomweyo kwa Metformin Richter wokhala ndi ma ACE ndi Mao zoletsa, sulfonylurea ndi zotumphukira zochokera ku NSAIDs, oxytetracycline, cyclophosphamide, insulin, acarbose ndi beta-blockers kumawonjezera kuchepa kwa shuga.

Kuphatikiza apo, kugwiritsa ntchito zakumwa zoledzeretsa pamankhwala osokoneza bongo, kupanga lactic acidosis ndikotheka, makamaka ngati wodwalayo sanatsatire zakudya zoyenera. Cimetidine amathanso kukulitsa vuto lactic acidosis mu mtundu 2 wa matenda ashuga, chifukwa amachepetsa kuyamwa kwa mankhwala omwe amagwira.

Pofuna kupewa zoterezi, mitundu yonse ya mankhwalawa iyenera kukambidwa ndi katswiri wopezekapo, komanso kuwerenga mosamala mafotokozedwe a mankhwalawo m'mawu omwe aphatikizidwa.

Mitengo, ndemanga ndi fanizo

Wodwala, kupeza mankhwala enaake, samangoyang'ana pachithandizo chake.

Popeza chiwerengerochi chimakhala ndi zopeza zosiyanasiyana, aliyense angathe kupeza mankhwalawa malinga ndi momwe angapezere ndalama. Mtengo wa mankhwalawa umasiyana malinga ndi kuchuluka kwa mankhwala othandizira.

Mtengo wa Metformin Richter:

500 mg (mapiritsi 60 pa paketi): mtengo kuchokera ku 165 mpaka 195 ma ruble,
850 mg (mapiritsi 60 pa paketi): mtengo kuchokera ku ma ruble 185 mpaka 250,
1000 mg (mapiritsi 60 pa paketi iliyonse): mtengo kuchokera ku 220 mpaka 280 rubles.

Ndemanga za anthu ambiri odwala matenda ashuga komanso madokotala ndiabwino. Metformin Richter amathandiza kupewa matenda ashuga wodwala akapezeka ndi boma la prediabetes. Mankhwala amachepetsa shuga. Zotsatira zoyipa, kuphatikiza kudzimbidwa, sizowonetsedwa. Mankhwalawa amathandizanso kutaya mapaundi owonjezera ochepa.

Nthawi zina Metformin Richter singagwiritsidwe ntchito chifukwa cha kupezeka kwa zotsutsana, komanso kuwoneka kosiyanasiyana. Pankhaniyi, adotolo atha kutumiza wodwalayo m'njira inanso yofananira. Popeza metformin ndi othandizira odziwika padziko lonse lapansi, pali mankhwala ambiri omwe ali ndi chipangizochi. Kusiyana kwa njira kungakhale pazomwe zimalandidwa. Mankhwala Metformin Richter ali ndi ma fanizo otsatirawa omwe wogulitsa zamankhwala angawone ku mankhwala aliwonse amtunduwu mdziko, kukonzekera kungasiyane kapangidwe kake koma ndizofanana ndi lingaliro.

Gliformin (500mg No. 60 - 108 ma ruble).
Glucophage (500mg No. 30 - 107 rubles).
Metfogamma (850mg No. 30 - 130 ma ruble).
Metformin Teva (500mg No. 30 - 90 ma ruble).
Fomu (500mg No. 30 - 73 ma ruble).
Siofor (500mg No. 60 - 245 rubles).
Metformin Canon (500mg No. 60 - 170 rubles).
Metformin Zentiva (500mg No. 60 - 135 ma ruble).

Zofanizira zonse pamwambazi zimagwiritsidwa ntchito posagwirizana ndi shuga omwe amadalira insulin, kusiyana kumangokhala mu contraindication komanso kuvulaza komwe kungakhalepo. Pogwiritsa ntchito moyenera, mutha kukwaniritsa kuchepa ndi kukhazikika kwa misempha ya glucose, ndipo Metformin Richter samapeza zotsatira zoyipa.

Kanemayo munkhaniyi, woperekedwa pansipa, adzalankhula za mawonekedwe a pharmacological a Metformin.

Mapiritsi a Metformin Richter

Mankhwala a odwala matenda ashuga amapezeka m'mitundu itatu ya mapiritsi a 500 kapena 850 mg a metformin: biconvex, ozungulira, oblong mu chipolopolo choyera. Mu phukusi la zidutswa 10. Mankhwala amaperekedwa kuchokera ku malo ogulitsa mankhwalawa malinga ndi mankhwala omwe adokotala amapita.

Kuphatikizika kwa mankhwalawa kumaphatikizapo zinthu zomwe zimawotcha shuga mthupi, zomwe zimapangitsa kuti wodwalayo akhale bwino:

colloidal silicon dioxide - 2%, cellcrystalline cellulose - 98%

White Opadrai II

hypromellose - 40%, titanium dioxide - 25%, lactose monohydrate - 21%, macrogol 4000 - 8%, triacetin - 6%

Pharmacodynamics ndi pharmacokinetics

Mankhwala a gulu la Biguanide amachepetsa shuga la magazi. Imwani mankhwalawa pakamwa malinga ndi malangizo. Njira ya mayamwidwe a glucose m'chiwindi imapanikizidwa kuchokera ku 30% ndi kupitirira, pomwe chinsinsi cha mahomoni ena amakhalabe osasinthika. Izi zimabweretsa kuchepa kwa chakudya chamafuta.

Chuma chinanso cha mankhwalawo ndikutchinga wamafuta ndikuwamasula kwawo kupita ku plasma. Mankhwala a hypoglycemic amagwiritsidwa ntchito ngati njira yochepetsera thupi, koma simuyenera kusiya kudya zakudya zamafuta ochepa. Chipangizocho chimayendetsa makulidwe a oxidation amafuta acids, amalepheretsa biosynthesis ya cholesterol, kukulitsa chidwi cha thupi kwa insulin.

Kugwiritsa ntchito mankhwalawa pafupipafupi kumapangitsa kuti muchepetse thupi. Chifukwa cha izi, mankhwalawa ndi otchuka pakati pa anthu odwala matenda amtundu wa 2 omwe ali onenepa kwambiri. Pakaperekedwa, metformin imatulutsidwa m'matumbo, ndipo pazinthu zomwe zimakhala zogwira ntchito siziyenera kuyembekezeredwa kale kuposa maola 2-3.

Mankhwalawa amagawidwa mosiyanasiyana, kuphatikiza kwakukulu kumawonedwa mu minofu ya minyewa, chiwindi, tiziwindi tating'onoting'ono, komanso a impso parenchyma.Chidacho chimaperekedwa kudzera mu ntchito ya msambo ndipo izi zimachitika mkati mwa maola 1-4, kutengera mawonekedwe a thupi.

Kupanga ndi mafomu omasulira

Mankhwalawa (1 tabu.) Muli ndi chinthu chokhacho chomwe chimagwira metformin, kachigawo kake kachulukidwe kamakhala 500 mg ndi 850 mg. Zowonjezereka zimaperekedwa:

Magnesium Stearate
Polyvidone
Aerosil
Copovidone
MCC.

500 mg ndi mapiritsi a 850 mg ndi apamwamba, oyera. Mapiritsi amayikidwa m'matumba a 10 ma PC. Mkatikati mwa phukusi pali matuza 5.

Kuchiritsa katundu

Mothandizidwa ndi metformin, kuletsa kwa gluconeogenesis m'maselo a chiwindi kumayang'aniridwa, kuyamwa kwa glucose ndi matumbo a matumbo kumachepetsedwa, ndipo njira yake yogwiritsira ntchito njira zake imagwirira ntchito. Nthawi yomweyo, kuwonjezereka kwa chiwopsezo cha minyewa kuchitira insulin kwalembedwa popanda kukhudza kupanga kwa insulin ndi ma cell a cell omwe amapezeka mu kapamba, chifukwa chomwe chitha kuchepetsa cholesterol yathunthu, LDL, ndi triglycerides m'magazi.

Kupanga kwakukulu kwamankhwala kumawonetsedwa:

Kukhathamiritsa kwa dongosolo la kufalikira kwa glucose komanso kuchepa mayamwidwe mu chiwindi
Kuwongolera kwa mulingo wa mahomoni olimbikitsa chithokomiro
Kuletsa kwa gluconeogeneis
Kuchepa kwamphamvu kwa thrombosis
Kupititsa patsogolo njira yobwezeretsanso magazi kuwundana
Kutsitsa ma linoprotein ndi triglycerides
Kuthamangitsa makutidwe ndi okosijeni amitundu yambiri yamafuta
Matenda a cholesterol.

Pambuyo pa kugwiritsa ntchito mapiritsi, pamakhala kuyamwa mwachangu kwa chinthu chogwira ntchito m'mimba. Chizindikiro cha bioavailability sichidutsa 60%. Kuzungulira kwakukulu kwa plasma kulembedwa pambuyo pa maola 2,5. Mukamadya, phindu limatsitsidwa ndi 40% ndipo kukwaniritsa kwake kumalepheretsa pafupifupi mphindi 35.

Metformin imadziwika ndi kufalitsa mwachangu mkati mwa minofu, komanso kuchuluka kochepa kwa metabolic. Ubwenzi wa metformin wokhala ndi mapuloteni a plasma ndi ochepa.

Njira yochotsera ikuchitika ndi kutenga gawo la impso. Ndizofunikira kudziwa kuti theka la moyo ndi maola 6.5.

Metformin Richter: malangizo onse ogwiritsira ntchito

Mtengo: kuchokera ku 162 mpaka 271 rubles.

Mankhwala amawonongeka ndi chakudya kapena pambuyo pake. Mapiritsi ayenera kutsukidwa ndi madzi okwanira. Kuchepetsa kwambiri mwayi wokhala ndi zovuta zoyipa, ndimamwa mlingo wa tsiku lililonse wa 2-3 r.

Mlingo wa mankhwalawa amatsimikiziridwa payekhapayekha pogwiritsira ntchito index ya glucose.

Chithandizo cha mapiritsi okhala ndi mulingo wa ma milligram 500: yambani mankhwalawa tsiku lililonse ndi 0,5-1 g. Patatha masiku 10-15. Mlingo ukuwonjezeka pambuyo poyendetsa shuga. Nthawi zambiri, mankhwalawa pokonza tsiku ndi tsiku samapitilira 1.5-2 g, apamwamba kwambiri - 3 g.

Kugwiritsa ntchito mapiritsi omwe ali ndi mulingo wa mamiligalamu 850: m'masiku oyamba a mankhwalawa, tikulimbikitsidwa kutenga 850 mg ya metformin patsiku. Pambuyo masiku 10-15. adokotala angakulimbikitseni kuchuluka kwa mlingo wanu. Mankhwala akukonza, tsiku lililonse mankhwala a metformin amatengedwa kuchuluka kwa 1.7 g. Mlingo wapamwamba kwambiri sayenera kupitirira 2.55 g.

Odwala okalamba salimbikitsidwa kudya oposa 1 g ya metformin patsiku.

Pankhani ya zovuta zazikulu za kagayidwe kachakudya, mwayi wa lactic acidosis umachulukirapo, momwe mungathandizire kuchepetsa mlingo wa mankhwalawa.

Kuchita mankhwala osokoneza bongo

Pali kuwonjezeka kwa zotsatira za hypoglycemic panthawi imodzi:

Β-blockers
NWPS
Kukonzekera kochokera ku sulfonylurea zotumphukira, zonenepa
ACE zoletsa ndi Mao
Acarbose
Cyclophosphamide
Oxytetracycline
Insulin.

Kutsika kwa hypoglycemic zotsatira kulembedwa panthawi yomwe mukugwiritsa ntchito mankhwalawa:

COC
Sympathomimetics
Mahomoni a chithokomiro
GKS
Amachokera ku phenothiazine komanso nicotinic acid
Epinephrine
Ma diuretics ena ("loop" ndi magulu a thiazide)
Glucagon.

Cimetidine amatha kuletsa kuchotsedwa kwa metformin, komwe kumawonjezera chiopsezo cha lactic acidosis.

Pogwiritsa ntchito munthawi yomweyo ma anticoagulants, mphamvu ya mankhwala ozikidwa pa metformin itha kufooka.

Kumwa mankhwala osokoneza bongo omwe ali ndi ethanol kumatha kuyambitsa lactic acidosis.

Zotsatira zoyipa

Zotsatira zoyipa mukamamwa mankhwalawa zimatha kufotokozedwanso mosiyanasiyana, kupukusa m'mimba, kusanza, kusanza, kutsekemera, kutsekemera kwazitsulo mkamwa. Izi zimachitika kawirikawiri ndipo zimawonekera mwa munthu wopitilira mwa 10. Nthawi zambiri, zinthu zotere zimachitika kumayambiriro kwa zamankhwala ndipo zimatha kudzipangira zokha. Kuphatikiza apo, kuwonjezeka kwa pang'onopang'ono, monga lamulo, kumathandizanso kuchotsa mavuto. Ndi zochitika zosasangalatsa zomwe zimakhudzana ndi m'mimba, timalimbikitsidwa kutenga anticholinergics, antacids kapena antispasmodics.

Hypoglycemia monga zotsatira zoyipa nthawi zambiri zimagwirizanitsidwa ndi kugwiritsa ntchito munthawi yomweyo mankhwala ena. Mndandanda wa mankhwalawa umaperekedwa mu gawo la "Kuyanjana Ndi Mankhwala Ena". Lactic acidosis, ngati zotsatira zoyipa, imapezekanso kawirikawiri. Nthawi zambiri izi zimawonekera mwa anthu omwe ali ndi vuto laimpso. Zotsatira zoyipa zimafunika kuthetseratu mankhwala.

Ndi chithandizo chakanthawi, kuchepa kwa vitamini B12 ndikotheka chifukwa chophwanya mayamwidwe ake am'matumbo, megaloblastic anemia. Kuwonjezeka kwa hepatic transaminases ndi hepatitis sikuwonetsedwanso. Izi zimatha pambuyo posiya mankhwala.

Zotsatira za mankhwala pa psychomotor zimachitika

Monotherapy ndi mankhwalawa sizikhudza dongosolo lamkati lamanjenje. Chifukwa chake, ngati wodwalayo atengedwa ngati metformin yokha, wodwalayo amatha kuyendetsa magalimoto kapena kugwira ntchito yofunikira kwambiri. Komabe, mukamagwiritsa ntchito mankhwala ena (sulfonylurea derivatives, insulin), zotheka za hypoglycemic ndizotheka. Odwala oterewa saloledwa kuchita nawo zinthuzi pamwambapa.

Bongo

Ngakhale mlingo wa mankhwalawa ukachulukitsidwa kakhumi, odwala samakumana ndi zinthu monga hypoglycemia. Komabe, pafupifupi pankhaniyi, mkhalidwe wa lactic acidosis udzachitika - owonjezera pazovomerezeka za lactic acid m'magazi. Matendawa ndi oopsa kwambiri ndipo atha kupha anthu popanda chithandizo choyenera. Zizindikiro za lactic acidosis:

kupweteka kwa minofu
minofu kukokana
dyspepsia
kuchepa kwa kutentha kwa thupi
kutayika kwa mgwirizano
kukomoka
kutsitsa magazi
bradycardia.

Popanda chithandizo chamankhwala, chikomokere chimayamba ndipo kumwalira. Chithandizo cha lactic acidosis chitha kuchitika kuchipatala chokha. Hemodialysis, symptomatic mankhwala tikulimbikitsidwa.

Kuti mupewe zovuta izi mukamamwa Metformin-Richter, ndikofunikira kuyang'ana ndende yamagazi a lactic acid kawiri pachaka. Tiyenera kukumbukira kuti chiopsezo cha lactic acidosis imachuluka ndi kumwa mopitirira muyeso, zakudya zama calorie otsika komanso chiwindi ntchito. Lactic acidosis imatha kuchitika mukamamwa mankhwala okhala ndi ayodini.

Mwa okalamba, kuchuluka kwa mankhwala a metabolinine kuyenera kuwunikidwa nthawi ndi nthawi kuti azindikire kuchepa kwa impso pakanthawi, popeza izi zimathandizanso pakuwonjezera metformin m'magazi komanso bongo wake. Ndondomeko ziyenera kuchitika kawiri pachaka.

Kuchita ndi mankhwala ena

Mankhwala sayenera kugwiritsidwa ntchito molumikizana ndi mowa chifukwa chowonjezera chiopsezo cha lactic acidosis. Zomwezi zimagwiranso ntchito pomwa mankhwala a cimetidine. Komanso, mankhwala ena amalimbikitsa mphamvu ya metformin ndipo amatha kubweretsa hypoglycemia. Gawoli lili ndi:

cyclophosphamide
Mao zoletsa
ACE zoletsa
NSAIDs
beta blockers,
zochokera sulfonylurea,
insulin
salicylates,
acarbose,
oxytetracycline

Kulera kwapakamwa, glucocorticosteroids, epinephrine, mahomoni a chithokomiro, zotumphukira za asidi a nicotinic, zotumphukira, ma dioletics amachepetsa mphamvu ya metformin.

Nawonso metformin imafooketsa mphamvu yokhudzana ndi coumarin.

Mankhwala okhala ndi iodine okhala ndi iodini angayambitse kuphatikizika kwa metformin.

Kodi mankhwalawa amagwira ntchito bwanji?

Metformin ndiye mankhwala akuluakulu omwe amathandizidwa ndi odwala matenda ashuga nthawi yomweyo komanso moyo wonse. Cholinga chakudzipereka kwa madotolo ku mankhwalawa chagona motere:

Metformin ili ndi mphamvu yayikulu kwambiri yoyerekeza ndi sulfonylureas. Cholinga chake chimathandiza kuchepetsa hemoglobin wa glycated ndi 1.5%. Zotsatira zabwino zimawonedwa mu onenepa kwambiri a shuga.
Mankhwalawa amaphatikizidwa pamodzi ndi mankhwala ena omwe amaperekedwa kwa matenda ashuga. Mankhwala awiri ndi atatu omwe amapezeka ndi metformin amatha kukwaniritsa kuwongolera kwa odwala a shuga.
Mankhwalawa ali ndi katundu wamtima wapadera. Zimatsimikiziridwa kuti kutenga izo kumachepetsa chiopsezo cha kugunda kwa mtima, kumapangitsa magazi kuyenda bwino.
Metformin ndi imodzi mwamankhwala otetezeka kwambiri odwala. Sichimayambitsa hypoglycemia, mavuto ena owopsa amalembedwa kawirikawiri.

Kutsitsa kwa shuga kwa Metformin-Richter ndi chifukwa cha magwiridwe antchito angapo, palibe omwe amakhudza mwachindunji kapangidwe ka insulin. Atamwa mapiritsi, kupanga glucose ndi chiwindi kumachepetsa nthawi yomweyo, kayendedwe kake kupita ku minofu kumayenda bwino chifukwa chakuchepa kwa insulin. Malangizo ogwiritsira ntchito onani kuti zowonjezereka za metformin zimathandizira kusintha kwa chiwongolero cha matenda ashuga - zimachepetsa kuyamwa kwa chakudya cham'mimba, komanso kuchepa kwa chilimbikitso. Malinga ndi ndemanga, izi zitha kuchititsa kuti njira yochepetsera thupi ishuga.

Zizindikiro zogwiritsidwa ntchito

Pakuwunika kwa madotolo, metformin nthawi zambiri imatchedwa maziko othandizira odwala matenda amtundu wa 2. Maupangiri azachipatala apadziko lonse ndi aku Russia agwirizana kwathunthu ndi mawu awa. Njira zochiritsira zikusintha, mankhwala atsopano ndi njira zodziwonera zikuwonekera, koma malo a metformin amakhalabe osasunthika.

Mankhwala wolembedwa:

Onse odwala matenda ashuga omwe kupatsirana kwa zakudya sikungapatse glycemia.
Atangozindikira matenda ashuga, ngati mayesowo adawonetsa kukana kwambiri kwa insulin. Itha kuganiziridwa mwa odwala omwe ali ndi kulemera kwakukulu.
Monga gawo la chithandizo cha odwala matenda ashuga omwe ali ndi matenda atali.
Ndi shuga wodalira insulin, kuti muchepetse mlingo wa insulin.
Odwala omwe ali ndi metabolic syndrome, prediabetes monga kuwonjezera kwa kusintha kwa moyo.
Anthu omwe ali ndi kunenepa kwambiri komanso ali pachiwopsezo chachikulu cha matenda ashuga. Pochepetsa kukana insulini, Metformin Richter amathandizira kudya.

Pakadali pano, pali umboni wa kuthekera kogwiritsa ntchito mankhwalawa kwa mazira a polycystic ndi chiwindi cha steatosis, koma izi sizinaphatikizidwe pazomwe zimayankhidwa.

Zosasangalatsa zotsatira za metformin

Choyimira chachikulu cha metformin chimakhudzana ndi mphamvu yake pakadutsa chakudya kudzera m'mimba ndi mphamvu ya matumbo aang'ono, momwe njira zazikulu zakugaya zimachitikira. Matendawa sakhala owopsa ku thanzi, koma amakulitsa kwambiri kulekerera kwa mankhwalawa ndikuwonjezera kuchuluka kwa omwe akukana chithandizo chifukwa cha thanzi labwino la odwala.

Zotsatira zoyipa zam'mimba m'matumbo poyambira chithandizo ndi Metformin-Richter zimawonedwa mu 25% ya odwala matenda ashuga. Amatha kuwonetsedwa m'mphuno ndi kutsekemera kwazitsulo pakamwa pamimba yopanda kanthu, kusanza, kutsekula m'mimba. Zosafunikira izi zimadalira mlingo, ndiye kuti, zimakula nthawi imodzi ndi kuwonjezeka kwa mlingo. Pakatha milungu ingapo, m'mimba mumasinthasintha metformin, ambiri amayamba kufooka kapena kutha.

Ndemanga ya odwala matenda ashuga akuwonetsa kuti kumwa mapiritsi nthawi yomweyo ngati chakudya cholimba kumathandizira kuchepetsa Zizindikiro, kugawa tsiku ndi tsiku mu 3 Mlingo, ndikuwonjezera pang'onopang'ono Mlingo kuyambira kuyambira ochepera (500, maximum 850 mg).

Komanso, mukamatenga Metformin-Richter mwa odwala omwe ali ndi matenda ashuga, khungu lawo siligwirizana, kuwonongeka kwakanthawi kochepa komanso kuchepa kwa chiwindi kungawonedwe. Chiwopsezo chawo chimayesedwa ngati chosowa kwambiri (mpaka 0.01%).

Zotsatira zoyipa zokhazokha za metformin ndi lactic acidosis. Kuthekera kwake ndi milandu itatu mwa odwala 100,000. Kuti mupewe lactic acidosis, muyenera kutsatira malangizo ogwiritsira ntchito, musamwe mankhwalawa ngati pali contraindication, musapitirire mlingo womwe wapatsidwa.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Momwe mungatenge Metformin Richter

Mlingo wa Metformin uyenera kusankhidwa pawokha pa matenda ashuga aliyense. Panthawi yosankha, malangizowo akutsimikiza kuti miyezo ya shuga iyenera kumwedwa pafupipafupi.

Momwe mungadziwe kuchuluka kwake:

Mlingo woyambira umatengedwa piritsi limodzi la Metformin-Richter 500 kapena 850. Masabata awiri oyamba sakukonzedwa. Mapiritsi amatengedwa mukatha kudya.
Ngati palibe zoyipa zilizonse, mlingo wake umakulitsidwa ndi 500 kapena 850 mg pakapita milungu iwiri iliyonse. Mapiritsi agawidwa pawiri, kenaka mumagawo atatu. Momwe mlingo umakulira, shuga woyamba amasala kudya, kenako shuga.
Mlingo woyenera ndi 2000 mg. Kuwonjezeka kwinanso kwa mapiritsi kumayendera limodzi ndi kuchepa kwambiri kwa glycemia poyerekeza ndi koyambirira.
Mulingo wovomerezeka wa metformin tsiku lililonse ndi 3000 mg, pamatenda a impso - 1000 mg, muubwana - 2000 mg.

Madokotala ndi odwala matenda ashuga okhudza mankhwalawo

Kwa zaka zambiri, Metformin-Richter adatha kutolera ndemanga zambiri zabwino komanso zoyipa. Kwa odwala matenda a shuga, mankhwalawa ndiwodziwika kwambiri, chifukwa amachepetsa hyperglycemia, osayambitsa hypoglycemia. Amazindikira kuthamanga kwa mankhwalawa: "kwenikweni kuchokera piritsi limodzi."

Metformin-Richter imatengedwanso ngati njira yopondera chisangalalo, kulimbikitsa ovulation ku PCOS, kuti achepetse kukula kwa mafuta othamanga mumasewera. Zowonjezera za metformin zimayesedwa modabwitsa. Pali mimbayo yomwe ikuyembekezeka kwa nthawi yayitali komanso kuchepa kwa thupi ndi ma kilogalamu makumi ambiri kubanki ya nkhumba. Mwachilengedwe, palinso ndemanga zoyipa. Nthawi zambiri, olemba awo ndi anthu omwe adatenga metformin popanda kufunsa dokotala, yemwe amafotokozedwa mosavuta. Endocrinologists amapereka mankhwala ochepetsa thupi kokha kwa odwala omwe ali ndi insulin, omwe si munthu aliyense wathunthu.

Madotolo amawona kuyendetsa bwino kwambiri kwa Metformin-Richter osati odwala matenda ashuga okha, komanso mwa anthu omwe ali pachiwopsezo chachikulu ndi matenda ashuga. Ndi chithandizo choyenera komanso moyenera odwala, ndizotheka kupewa matendawa mu 75% ya milandu.

Mitu ya mankhwalawa

Mankhwala aliwonse aku Russia omwe ali ndi dzina loti "metformin" m'dzina atha kulowa m'malo mwa Metformin-Richter. Amapangidwa ndi Vertex, Medisorb, Canonfarm, Akrikhin ndi ena. Glyformin, Merifatin, Bagomet ali ndi mawonekedwe ofanana. Zofanizira zakunja kwa Metformin-Richter - French Glucophage, Siofor waku Germany ndi Metfogamma. Mankhwalawa ndi ofanana potency, kotero mutha kusintha kwa iwo osasankhanso mlingo.

Kwa odwala omwe samalekerera mapiritsi, madokotala amalimbikitsa m'malo mwa Metformin-Richter kuti amwe ma analogi a nthawi yayitali ndi chinthu chimodzi: Glucofage Long, Metformin Prolong, Metformin MV.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>