Glucophage mu shuga

Glucophage ndi othandizira kutsitsa shuga pakuchita pakamwa (pakamwa), woimira biguanides. Zimaphatikizira gawo lomwe limagwira - metformin hydrochloride, ndi magnesium stearate ndi povidone amadziwikanso monga zinthu zowonjezera. Chigoba cha mapiritsi Glucofage 1000 chili, kuphatikiza hypromellose, macrogol.

Ngakhale kuchepa kwa shuga m'magazi, sikuti kumayambitsa hypoglycemia. Mfundo zoyeserera Glucophage zimakhazikika pakuwonjezera kuyanjana kwa insulin receptors, komanso pogwira komanso kuwononga glucose ndi maselo. Kuphatikiza apo, mankhwalawa amalepheretsa kupanga shuga m'magazi a chiwindi - poletsa njira za glucogenolysis ndi gluconeogenesis.

Chofunikira chachikulu pa mankhwalawa ndi kupanga glycogen ndi chiwindi. Zimaperekanso kuwonjezeka kwa kuchuluka kwa kayendedwe ka glucose kumaselo osiyanasiyana. Metformin ilinso ndi zotsatirapo zake - imatsitsa cholesterol ndi triglycerides, imathandizira kulowetsedwa kwamphamvu kwa glucose m'mimba.

Malangizo ogwiritsira ntchito

Kukonzekera makonzedwe amkamwa mwa mawonekedwe a mapiritsi okhala ndi zokutira zoyera.

Kuyambira pachiyambi cha maphunzirowa, amawerengedwa kuchuluka kwa 500 kapena 850 mg kangapo patsiku panthawi yachakudya kapena mukatha kudya. Kudalira kuchuluka kwa magazi ndi shuga, mutha kuwonjezera pang'onopang'ono.

Gawo lothandizira panthawi ya chithandizo ndi 1500-2000 mg patsiku. Chiwerengero chonsecho chimagawidwa pamiyeso 2-3 kuti mupewe matenda osafunikira am'mimba. Mulingo woyenera kwambiri wokonza ndi 3000 mg, uyenera kugawidwa m'magawo atatu patsiku.

Pakapita kanthawi, odwala amatha kusintha kuchokera ku mlingo wapadera wa 500-850 mg kukhala mlingo wa 1000 mg. Mlingo woyenera pazinthu zonsezi ali wofanana ndendende ndi kukonza mankhwalawa - 3000 mg, wogawidwa mu 3 waukulu.

Ngati kuli kofunika kusintha kuchokera ku gawo lomwe limatengedwa kale la hypoglycemic kupita ku Glucophage, muyenera kusiya kumwa koyambayo, ndikuyamba kumwa Glucophage pa mlingo womwe watchulidwa kale.

Kuphatikiza ndi insulin:

Sizimaletsa kuphatikiza kwa mahomoni awa ndipo sikuti zimayambitsa mavuto motsatizana. Itha kutengedwa palimodzi pazotsatira zabwino. Pachifukwa ichi, mlingo wa Glucofage uyenera kukhala wokhazikika - 500-850 mg, ndipo kuchuluka kwa insulini yoyendetsedwa kuyenera kusankhidwa poganizira kuchuluka kwa omwe ali m'magazi.

Ana ndi achinyamata:

Kuyambira zaka 10, mutha kudziwa mankhwala a glucophage onse amodzi mankhwala, komanso limodzi ndi insulin. Mlingo wofanana ndi akulu. Pakatha milungu iwiri, kusintha kwa mtundu wa glucose kumatha kuchitika.

Mlingo wa Glucophage mwa okalamba uyenera kusankhidwa poganizira momwe zida za impso zimakhalira. Kuti muchite izi, ndikofunikira kudziwa kuchuluka kwa creatinine mu seramu ya 2-4 kawiri pachaka.

Mapiritsi oyera okhala ndi pakamwa. Ayenera kudyedwa kwathunthu, popanda kuphwanya umphumphu wawo, kutsukidwa ndi madzi.

Glucophage Kutalika 500 mg:

Kuwongolera mlingo wa 500 mg - kamodzi patsiku chakudya chamadzulo kapena kawiri pa 250 mg pa chakudya cham'mawa komanso chamadzulo. Kuchuluka kumeneku kumasankhidwa pa chizindikiritso cha shuga m'magazi am'magazi.

Ngati mukufuna kusintha kuchokera pa mapiritsi wamba kupita ku Glucofage Long, ndiye kuti muyezo womaliza umagwirizana ndi mlingo wa mankhwala wamba.

Malinga ndi kuchuluka kwa shuga, pakatha milungu iwiri amaloledwa kuonjezera mlingo woyambira ndi 500 mg, koma osapitilira muyeso waukulu - 2000 mg.

Ngati mphamvu ya mankhwala Glucofage Long yafupika, kapena sinafotokozeredwe, ndiye kuti ndikofunikira kumwa kwambiri monga momwe adanenera - mapiritsi awiri m'mawa ndi madzulo.

Kuchita ndi insulini sikusiyana ndi zomwe mumatenga glucophage osakhalitsa.

Glucophage Long 850 mg:

Mlingo woyamba wa Glucophage Long 850 mg - piritsi 1 patsiku. Mlingo waukulu kwambiri ndi 2250 mg. Kulandila ndikufanana ndi mlingo wa 500 mg.

Malangizo a Glucofage 1000 ogwiritsa ntchito:

Mlingo wa 1000 mg ndi wofanana ndi njira zina zazitali - piritsi limodzi patsiku ndi chakudya.

Contraindication

Simungathe kumwa mankhwalawa kwa anthu omwe akudwala:

• ketoacidosis motsutsana ndi matenda a shuga
• kuyambira kuphwanya ntchito ya aimpso zida ndi chilolezo zosakwana 60 ml / min
• kusowa kwamadzi chifukwa cha kusanza kapena kutsegula m'mimba, kugwedezeka, matenda opatsirana
• matenda a mtima monga kulephera kwa mtima
• matenda a m'mapapo - CLL
• Kulephera kwa chiwindi ndi kuwonongeka kwa chiwindi
• uchidakwa wosatha
• tsankho la munthu mankhwala

Kuphatikiza apo, ndizoletsedwa kutenga Glucofage kwa amayi apakati omwe amatsata zakudya zama calorie otsika, kwa anthu omwe ali pachiwopsezo kapena chikomokere motsutsana ndi maziko a matenda ashuga.

Mapiritsi oyera, okhala ndi mapiritsi a 500, 850 ndi 100 mg. Kugwiritsa ntchito mankhwalawa - pakudya, ndi madzi. Mlingo amawerengedwa payekhapayekha kwa wodwala aliyense, poganizira momwe amawonetsa glucose komanso kuchuluka kwa kunenepa kwambiri, chifukwa mankhwalawo ndi oyeneranso kuchepetsa thupi.

Zotsatira zoyipa

Zotsatira zoyipa mthupi zimatha kuchitika - monga:

• dyspepsia - chikuwonetsedwa ndi mseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kugona mosakhalitsa (kuchuluka kwa mpweya)
• mavuto amakomedwe
• kuchepa kwamtima
• chiwindi chiwindi - kuchepa kwa ntchito za ntchito zake mpaka kukulitsa chiwindi
  pa khungu - kuyambitsa zotupa, erythema
• kutsika kwa vitamini B12 - motsutsana ndi maziko a kumwa kwa nthawi yayitali

Mtengo umasiyanasiyana malo ogulitsa ogulitsa ndi malo ogulitsira pa intaneti. Mtengo umatengera mlingo wa mankhwalawo komanso kuchuluka kwa mapiritsi omwe ali phukusi. Mu malo ogulitsira pa intaneti, mafotokozedwe amitengo yamathumba a mapiritsi ochulukirapo 30 - 500 mg - pafupifupi ma ruble 130, 850 mg - 130-140 rubles, 1000 mg - pafupifupi ruble 200. Mlingo womwewo, koma kwa paketi yokhala ndi zidutswa 60 phukusi - 170, 220 ndi 320 ma ruble, motsatana.

M'maketi ogulitsa mankhwala, mtengo wake umatha kukhala wokwera pamitundu yokwana 20-30 rubles.

Chifukwa cha mankhwala omwe amagwiritsidwa ntchito a metformin, Glucofage ili ndi mitundu yambiri. Nawa ochepa mwa iwo:

• Siofor. Mankhwala omwe ali ndi mfundo zomwezi. Ndi njira yotetezeka kwambiri ya mankhwala a hypoglycemic yochepetsa thupi. Kuphatikiza apo, mavuto osowa kwambiri adadziwika. Mtengo pafupifupi ndi 400 rubles.
• Nova Met. Chodabwitsa cha mankhwalawa ndikuti kugwiritsa ntchito kwake kwa anthu omwe ali ndi zaka zocheperako komanso kwa anthu ogwira ntchito zolimba. Chowonadi ndi chakuti, Nova Met amatha kupangitsa kuti mawonekedwe a lactic acidosis asinthe. Kuphatikiza apo, anthu okalamba amatha kudwala matenda a impso chifukwa cha zizindikiro zomwe zikusowa. Mtengo wake ndi pafupifupi ma ruble 300.
• Metformin. M'malo mwake, ichi ndiye chinthu chonse cha zochitika zonse za Glucofage ndi iye. Ili ndi katundu yemweyo. Mtengo muma pharmacies pafupifupi 80-100 rubles.

Bongo

Monga tafotokozera pamwambapa, mankhwalawa samathandizira hypoglycemia - komanso ndi bongo wambiri. Koma zikavuta pakachulukidwe kovomerezeka, kotchedwa lactic acidosis imayamba. Izi ndizachidziwikire, koma zowopsa, chifukwa zimatha kufa.

Ngati bongo wa Glucofage, ndikofunikira kusiya kumwa mankhwalawa. Kugonekedwa kuchipatala msanga, kuyezetsa kuchipatala ndi kuzindikira kwawonetsedwa. Syndromealili amasonyezedwa, koma hemodialysis ndiye njira yabwino koposa.

Pomaliza

Glukonazh 1000 ndi mankhwala abwino kwambiri kwa anthu odwala matenda ashuga. Sizothandiza kungoyendetsa kuchuluka kwa shuga, komanso zimachepetsa thupi, motero zithandizanso anthu omwe akufuna kuchepa thupi. Komabe, simuyenera kuigwiritsa ntchito mosaganizira - muyenera kuyitenga monga mwauzidwa ndi dokotala. Musanagule mankhwalawa, funsani katswiri.

Zolemba za mankhwala

Glucophage ndi mankhwala oyamba omwe amapangidwa ku France. Mukamachita kafukufuku wothandizira matenda ashuga, ndimakonda kugwiritsa ntchito mankhwalawa. Zizindikiro zazikulu pakugwiritsa ntchito mankhwalawa ndi:

• kunenepa kwambiri mu matenda ashuga a mtundu wachiwiri wa matenda ashuga,
• cholesterol yayikulu
• sulfonylurea tsankho.

Nthawi zambiri, akatswiri amapereka mankhwala ophatikiza mankhwala, omwe amapangidwa limodzi ndi jakisoni wa insulini (pankhani ya matenda a shuga 1). Chizindikiro cha Glucophage ndichakuti, mosiyana ndi mankhwala ena ochepetsa shuga, chimalepheretsa kupanga kwa shuga kwa chiwindi. Ndiye chifukwa chake akatswiri amalimbikitsa kuti amwe mankhwalawo asanagone kuti athandize.

Momwe mungatenge glucophage mu shuga

Mlingo wa mankhwalawa amasankhidwa mosamalitsa machitidwe a thupi. Mlingo woyamba sungakhale wopitilira 850 mg. Popita nthawi, makonzedwe a glucophage mu shuga amatha kuwonjezeka mpaka 2.25 mg. Komabe, izi zimachitika pokhapokha kuti endocrinologist aziwunika zomwe wodwala akuchita, kusakhalapo kwa zotsatirapo zowonjezera Mlingo. Njira yozolowera mankhwalawa imayamba pang'onopang'ono, kotero kuti kuchuluka kwa mankhwalawa kuyenera kukhala pang'onopang'ono.

Ana (kuyambira azaka 10) ndi achinyamata amatha kugwiritsa ntchito Glyukofazh, ngati mankhwala osiyana, kapena kuphatikiza ndi mankhwala ena. Mlingo wovomerezeka kwa iwo ndi wochokera pa 500 mpaka 2000 mg. Okalamba amafunika kufunsa dokotala, chifukwa muukalamba magwiridwe antchito amatha kupatsidwanso gawo pazinthu zomwe mankhwalawa ali.

Pafupifupi, mankhwalawa amatengedwa kamodzi pakapita masiku atatu alionse. Pofuna kupewa zovuta komanso zovuta zam'mimba, muyenera kumwa mapiritsi musanadye kapena musanadye. Popeza mukamamwa mankhwalawa panthawi yachakudya, zinthu zake zabwino sizidziwonekera, ntchito yakeyo imachepa.

Njira yopangira kagayidwe kachakudya imachitika pakatha sabata kapena masiku khumi. Pakatha masiku awiri, njira yogwiritsira ntchito shuga ndere imayamba, chifukwa chomwe m'magazi mwake mumachepa.

Hyperglycemia ikalipidwa, mlingo wa mankhwalawo umatha kuchepetsedwa, ndikuphatikiza ndi mankhwala ena. Kuphatikiza kopambana kwambiri kwa Glucophage:

• ndi glibenclamide, yomwe imakhudza glycemia komanso kuphatikiza mankhwalawa imawonjezera izi,
• ndi Insulin, chifukwa chomwe kufunika kwa mahomoni kumatha kutsika mpaka 50%.

Ndi kukula kwa zizindikiro za matenda ashuga, tikulimbikitsidwa kupewa glucophage, pogwiritsa ntchito 1 g mu maola 24, ndikutsatira zakudya. Izi zikuthandizira kubwezeretsa kulemera kwa thupi kukula kwakepi lanu, kuchepetsa kulolerana kwa chakudya chamthupi ndi kuchuluka kwa cholesterol.

Kodi ndizotheka kusintha mankhwalawo ndi wina

Pogulitsa pali mankhwala ambiri okhala ndi metformin. Ichi ndi chomwe chimagwiritsidwa ntchito makamaka pa ma Glucophage analogues, mwachitsanzo, Siofor kapena Formmetin. Popeza kugwiritsidwa ntchito kwa chinthuchi kwawonetsa ntchito zabwino zomwe zimagwiritsidwa ntchito, makampani ambiri opanga mankhwala ochokera kumayiko osiyanasiyana agwira nawo ntchito yopanga mankhwala potengera izi.

Kusiyanitsa kwakukulu pakati pa mankhwala osiyanasiyana ndi mtengo wawo. Ndipo kudziwa zomwe zili bwino, ndizotheka pokhapokha pakukula kwa matendawo, komanso momwe mungapangire bwino mbali ya thupi.

Glucophage yochepetsa thupi ngati palibe matenda ashuga

Kwa anthu opanda matenda a shuga, Glucofage ikhoza kukhala njira yabwino yochepetsera thupi. Opanga sizitanthauza kuti mankhwala okhala ndi metformin amaloledwa kugwiritsidwa ntchito ngati njira yochepetsera thupi. Koma, ngakhale izi, anthu ambiri onenepa kwambiri apeza chipulumutso mu izi.

Mankhwalawa amathandizira chidwi cha maselo kupita ku insulin ya mahomoni, chifukwa chomwe, kuphatikiza kwambiri kumachepetsedwa, njira yamafuta amachepetsedwa. Chosafunikanso ndichakuti Glucofage imakhudzanso kudya, kuichepetsa ndikufulumizitsa kuchotsa zamafuta m'matumbo.

Chifukwa chakuti mankhwalawa samachepetsa shuga pansi pazomwe zimakhazikitsidwa, amathanso kugwiritsidwa ntchito ndi kuchuluka kwa shuga m'thupi.

Kuti muchepetse thupi, koma osasokoneza njira za metabolic, munthu ayenera kuganizira mfundo zingapo zazikulu:

• wopanga sawonjeza zotsatirapo zake (ponena za kuchepa thupi),
• zotsatira zimawoneka pokhapokha malamulo azakudya azitsatidwa,
• Mlingo umatengera umunthu wake,
• Mlingowo uyenera kuchepetsedwa pamene chizindikiro chilichonse chakugaya kapena mseru chikuwonekera.

The geography yokhudzana ndi kugwiritsa ntchito mankhwalawa kuti muchepetse kunenepa kwambiri, makamaka, osewera amathanso kugwiritsa ntchito kuti izi zitheke. Mosiyana ndi anthu odwala matenda ashuga, omwe amatha kumwa mapiritsi m'miyoyo yawo yonse, ndikokwanira kuti othamanga amatha kutenga maphunziro a masiku 20 a kumwa mankhwalawo, pambuyo pake amafunika kusiya.

Ndikofunikira kudziwa kuti popanda kuyang'aniridwa ndi dokotala, ndizoletsedwa kuti muzitha kumwa nokha, makamaka kuti muchepetse thupi. Thupi limatha kuyankha mosiyanasiyana pazigawo zake zazikulu, chifukwa chomwe zovuta zimawonekera. Kudya kulikonse kwa mankhwalawa kuyenera kukhala koyenera ndikugwirizana ndi adokotala.

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi.

Nditakwanitsa zaka 55, ndinali nditadzibaya kale ndi insulin, zonse zinali zoipa kwambiri. Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha kwambiri, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Mapiritsi a Glucophage

Mankhwala Glucophage mu shuga amapatsidwa kwa odwala omwe amapezeka ndi matenda a shuga a mtundu woyamba kapena wachiwiri. Glucofage 1000 yadzikhazikitsa yokha ngati njira yothandiza yomwe wodwala angakwaniritsire kuchepa kwa shuga m'magazi, osatsogolera ku hypoglycemia. Mankhwalawa ndi otchuka pochiza kunenepa, chifukwa amathandizira kuchepetsa kunenepa kwambiri. Katunduyu ndi chifukwa chogwiritsa ntchito mankhwalawa ngati njira yochepetsera thupi, othamanga kuti "awume" thupi. Kugwiritsa ntchito molakwika mankhwalawa kumatha kuvulaza kwambiri.

Mankhwala amapezeka piritsi. Piritsi looneka ngati mawonekedwe limakulungidwa ndi chipolopolo chomwe chimakhala ndi utoto woyera. Kapangidwe kake ndi biconvex, pamakhala chiopsezo mbali zonse ziwiri. The mankhwala:

Metformin hydrochloride (mankhwala ena)

Choyeretsera zovala

Pharmacodynamics ndi pharmacokinetics

Zomwe zimagwiritsidwa ntchito ndi mankhwala - metformin imakhala ndi hypoglycemic, yomwe imawonetsedwa mu kuchepa kwa hyperglycemia. Mankhwalawa amatha kutsitsa shuga m'magazi onse masanawa ndipo atatha kudya. Limagwirira zake chifukwa cha mphamvu ya mankhwalawo kuletsa gluconeogeneis, glycogenolysis, kuwonjezera insulin kumva ndi kuchepetsa mayamwidwe a shuga ndi m'mimba thirakiti. Izi zimabweretsa kuchiritsa. Kuphatikizika kwa izi kumabweretsa kutsika kwa glucose m'chiwindi ndi kukondoweza kwa kukonza kwake ndi minofu.

The bioavailability pamene amatengedwa ndi pafupifupi 50-60%.mankhwalawa amatha kutsika kumapuloteni a plasma, omwe amalowa m'maselo ofiira a m'magazi. Mankhwala omwe amalandiridwa samapukusidwa, amatsitsidwa ndi impso komanso pang'ono m'matumbo. Kuchotsa theka moyo ndi pafupifupi 6.5 maola. Odwala omwe ali ndi vuto losakhazikika la impso, kuchepa kwa mayamwidwe a metformin kumawonedwa.

Zizindikiro zogwiritsidwa ntchito

Glucophage imakhala ndi chizindikiro chimodzi chogwiritsidwa ntchito, chovomerezedwa ndi mankhwala ovomerezeka. Kugwiritsa ntchito mankhwalawa pofuna kuchepetsa thupi kuli pachiwopsezo chanu. Mankhwalawa amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri. Makamaka kugwiritsidwa ntchito kumalimbikitsidwa kwa anthu omwe ali ndi kunenepa kwambiri, bola palibe zotsatira zamankhwala olimbitsa thupi komanso maphunziro olimbitsa thupi. Akuluakulu ndi ana atatha zaka khumi amagwiritsa ntchito mankhwalawa ngati monotherapy kapena pamodzi ndi insulin malinga ndi dongosolo lomwe adokotala adapereka.

Momwe angatenge

Glucophage iyenera kumwedwa pakamwa popanda kutafuna, kutsukidwa ndi madzi. Ndi bwino kudya ndi chakudya kapena mukatha kudya. Mlingo woyamba wa metformin wa akulu ndi 500 mg kawiri kapena katatu / tsiku. Mukasinthira kukonza mankhwala, mankhwalawa amayamba 1500 mg mpaka 2000 mg / tsiku. Vutoli limagawidwa mu Mlingo wambiri kapena itatu kuti lipange boma lolimba pamimba. Mlingo wapamwamba ndi 3000 mg. Kusintha kuti muthandizike ndi mankhwala ena a hypoglycemic kumapangitsa kuti pakhale chachiwiri.

Kuphatikiza mankhwala ndi insulini kumaphatikizira kuchuluka kwa insulini m'magazi. Kuvomerezedwa kwa mankhwalawa ndi ana, kuyambira zaka 10, kumachitika malinga ndi dongosolo la 500 mg kawiri kapena katatu / tsiku. Pambuyo masiku 10-15, mlingo umasinthidwa malinga ndi kusintha kwa shuga m'magazi. Mlingo wovomerezeka wopezeka ndi 2000 mg / tsiku. Kwa anthu okalamba, mankhwalawa amalembedwa ndi dokotala, poganizira momwe impso zilili.

Glucophage pa nthawi yapakati

Zowona za mimba ziyenera kudziwa kuthetsedwera kwa mankhwalawa Glucofage 1000. Ngati kutenga pakati kumangokonzekera, ndikofunikira kupereka kuthetseratu kwa mankhwalawa. Njira ina ya metformin ndiyo mankhwala a insulin oyang'aniridwa ndi dokotala. Mpaka pano, palibe chidziwitso cha momwe mankhwalawa amakhudzirana ndi mkaka wa m'mawere, chifukwa chake, kugwiritsa ntchito Glucofage ndizoletsedwa mukamayamwitsa.

Kuyanjana kwa mankhwala osokoneza bongo

Si mankhwala onse omwe angaphatikizidwe ndi Glucophage. Pali mitundu yoletsedwa komanso yosavomerezeka:

• poyizoni woledzera umadzetsa lactic acidosis, ngati munthu sakudya mokwanira, amakhala ndi vuto la chiwindi.
• sikulimbikitsidwa kuphatikiza chithandizo cha Danazol ndi Glucophage chifukwa cha zotsatira za hyperglycemic,
• Mlingo waukulu wa chlorpromazine umachulukitsa kuchuluka kwa shuga, kusintha kwa mankhwala kumafunikira, komanso ma antipsychotic,
• loop diuretics imabweretsa lactic acidosis, beta-adrenergic agonists amalimbikitsa shuga, insulin ndiyofunikira,
• antihypertgency othandizira amachepetsa hyperglycemia,
• zotumphukira za sulfonylurea, insulin, acarbose ndi salicylates zimayambitsa hypoglycemia,
• Nifedipine imawonjezera mayamwidwe a metformin, kuyendetsa shuga ndikofunikira,
• mankhwala a cationic (Digoxin, Morphine, Quinidine, Vancomycin) amonjezera nthawi ya mayamwidwe a metformin.

Zotsatira zoyipa

Kutenga Glucofage 1000, mutha kukumana ndi mawonetsedwe azotsatira zoyipa zoyipa, monga:

• lactic acidosis
• kuchepa mayamwidwe a vitamini B12, kuchepa magazi,
• kukoma zosokoneza
• mseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kusowa kwa chakudya,
• kukanda, zotupa, pakhungu
• zitha kukulitsa kulolerana kwamatumbo,
• thupi lawo siligwirizana, redness, kutupa,
• mutu, chizungulire,
• chiwindi, chiwindi ntchito.

Migwirizano yogulitsa ndikusunga

Mankhwala amaperekedwa ndi mankhwala, osungidwa m'malo osagwiritsidwa ntchito ndi ana kwa kutentha kosaposa 25 digiri. Moyo wa alumali ndi zaka zitatu.

Mutha kusintha mankhwalawo ndi othandizira omwe ali ndi chinthu chomwecho, kapena ndi mankhwala omwe ali ndi mphamvu yomweyo mthupi. Glucophage analogues ingagulidwe muma drug mu mapiritsi kapena makapisozi a pakamwa makonzedwe:

• Metformin
• Glucophage Long 1000,
• Glucophage 850 ndi 500,
• Siofor 1000,
• Metformin teva
• Bagomet,
• Glycometer
• Dianormet
• Diaformin.

Glucofage mtengo 1000

Mutha kugula Glucophage kokha m'masitolo, chifukwa mankhwala ochokera kwa dokotala amafunikira kuti mugule. Mtengo wake udzasiyana malinga ndi kuchuluka kwa mapiritsi okhala m'mpaketi. M'madipatimenti opanga mankhwala ku Moscow ndi St. Petersburg, mtengo wa mankhwalawo udzakhala:

Chiwerengero cha mapiritsi a phukusi Glucofage, mu ma PC.

Mtengo wocheperako, ma ruble

Mtengo waukulu, ma ruble

Anna, wazaka 67. Ndili ndi matenda ashuga a 2, motero ndimafunikira ndalama kuti ndikhalanso ndi shuga m'magazi. Mwana wanga wamkazi adandigulira mapiritsi a Glucofage omwe adadza kwa ine. Amayenera kuledzera kawiri pa tsiku kuti shuga ikhale yachilendo. Mankhwalawa aledzera bwino, samayambitsa mavuto. Ndakhutira, ndimakonzekera kumwa iwo mopitilira.

Nikolay, wazaka 49 Pakafukufuku womaliza wamankhwala, adawonetsa gawo loyamba la matenda ashuga a mtundu 2. Ndibwino kuti sioyambayo, koma zikadakhala zofunika kupaka insulin mpaka kumapeto kwa moyo. Madokotala amandiuza mapiritsi a glucophage. Adandiuza kuti ndimwe kwa miyezi isanu ndi umodzi, ndiye kuti ndikayezetsa, ndipo ngati pali chilichonse, andipititsa ku mankhwala ena - Kutalika, omwe muyenera kumwa kamodzi patsiku. Ndikumwa, ndimakonda momwe zimakhalira.

Rimma, wazaka 58. Ndakhala ndikudwala matenda ashuga chaka chachiwiri. Ndili ndi mtundu wachiwiri - wosadalira insulini, chifukwa chake ndimatha kugwiritsa ntchito mankhwala a glycemic. Ndimamwa Glucophage Long - Ndimakonda kuti angagwiritsidwe ntchito kamodzi patsiku, zotsatira zake ndizokwanira kwa tsiku. Nthawi zina ndimayamba kusanza ndikamwa mankhwalawa, koma zimadutsa mwachangu. Kupanda kutero, amandiyenera.

Vera, wazaka 25 Kuchokera kwa bwenzi, ndamva kuti amachepetsa thupi pa Glyukofage. Ndinaganiza zoyang'ana ndemanga zambiri za chida ichi, ndipo ndinadabwitsidwa ndi momwe zimagwirira ntchito. Zinali zovuta kupeza - mapiritsi amagulitsidwa ndimankhwala, koma ndinatha kuwagula. Anatenga ndendende milungu itatu, koma sanawone momwe zimachitikira. Sindinali wokondwa, kuphatikiza apo panali kufooka wamba, ndikhulupilira kuti palibe vuto.

Mlingo

500 mg, mapiritsi a 850 mg ndi mapiritsi a 1000 mg

Piritsi limodzi lili

ntchito yogwira - metformin hydrochloride 500 mg, 850 mg kapena 1000 mg,

obwera: povidone, magnesium stearate,

makanema ojambula - hydroxypropyl methylcellulose, mapiritsi a 1000 mg - opadray pure YS-1-7472 (hydroxypropyl methylcellulose, macrogol 400, macrogol 8000).

Glucophage 500 mg ndi 850 mg: mozungulira, mapiritsi a biconvex, oyera-okhala ndi filimu

Glucophage 1000 mg: mapiritsi osalala, a biconvex, atakutidwa ndi filimu yoyera, ali pachiwopsezo chosweka mbali zonse ziwiri ndikulemba "1000" mbali imodzi ya piritsi

Mankhwala

Pharmacokinetics

Pambuyo pakukonzekera kwa pakamwa kwa mapiritsi a metformin, kuchuluka kwakukulu kwa plasma (Cmax) kumachitika pambuyo pa maola pafupifupi 2,5 (Tmax). Mtheradi wa bioavailability mwa anthu athanzi ndi 50-60%. Pambuyo pakukonzekera pakamwa, 20-30% ya metformin imatulutsidwa kudzera m'mimba m'mimba (GIT) yosasinthika.

Mukamagwiritsa ntchito metformin muyezo komanso ulamuliridwe, makonzedwe a plasma okhazikika amakwaniritsidwa mkati mwa maola 24-48 ndipo nthawi zambiri amakhala osakwana 1 μg / ml.

Mlingo womangidwa wa metformin kupita ku mapuloteni a plasma suwoneka. Metformin imagawidwa m'magazi ofiira. Mulingo wambiri m'magazi ndi wotsika kuposa plasma ndipo umafikiridwa pafupifupi nthawi yomweyo. Pafupifupi voliyumu yogawa (Vd) ndi malita 63-276.

Metformin imachotsedwa mu mkodzo osasinthika. Palibe metformin metabolites omwe adadziwika mwa anthu.

Kuyambiranso kwa aimpso kwa metformin ndi kopitilira 400 ml / min, komwe kumawonetsa kuchotsedwa kwa metformin pogwiritsa ntchito kusefedwa kwa glomerular ndi secretion ya tubular. Pambuyo pakamwa, theka la moyo ndi pafupifupi 6.5 maola.

Mu vuto la impso, kutsekeka kwa impso kumachepa mogwirizana ndi kupezeka kwa creatinine chilolezo, motero, kuthetseratu theka la moyo kumawonjezereka, komwe kumabweretsa kuwonjezeka kwa plasma metformin.

Mankhwala

Metformin ndi biguanide yokhala ndi antihyperglycemic effect, yomwe imachepetsa onse shuga ndi postprandial plasma glucose. Simalimbikitsa insulin katemera chifukwa chake siyambitsa hypoglycemia.

Metformin ili ndi njira zitatu:

amachepetsa kupanga shuga wa chiwindi poletsa gluconeogeneis ndi glycogenolysis,

imawonjezera kukhudzidwa ndikugwiritsika ntchito kwa zotumphukira m'mitsempha ndikuwonjezera chidwi cha insulini,

Iachedwetsa mayamwidwe am'matumbo m'matumbo.

Metformin imalimbikitsa kapangidwe ka intracellular glycogen pochita glycogen synthase. Zimathandizanso kuthekera kwamitundu yonse ya ma membrane glucose transport (GLUT).

M'maphunziro azachipatala, kutenga metformin sikunakhudze thupi kapena kunachepetsa pang'ono.

Mosasamala kanthu za momwe zimakhudzira glycemia, metformin imathandizira kagayidwe ka lipid. Panthawi yoyesedwa pazachipatala pogwiritsa ntchito Mlingo wothandizira, zimapezeka kuti metformin imatsitsa cholesterol yonse, lipoproteins yotsika komanso triglycerides.

Mlingo ndi makonzedwe

Monotherapy ndi kuphatikiza mankhwalawa othandizira pakamwa ena:

Mlingo woyambira wamba ndi 500 kapena 850 mg wa Glucofage

Katatu patsiku chakudya kapena mukatha kudya.

Pambuyo masiku 10-15 kuyambira poyambira chithandizo, ndikofunikira kusintha mlingo wa mankhwalawa malinga ndi zotsatira za kuyeza magazi. Kuchepetsa pang'ono kwa mankhwalawa kungathandize kusintha kulolerana kwa m'mimba.

Odwala omwe amalandira mlingo waukulu wa metformin hydrochloride (2-3 g patsiku), mapiritsi awiri a Glucofage omwe ali ndi mulingo wa 500 mg amatha m'malo mwake ndi piritsi limodzi la Glucofage ndi mlingo wa 1000 mg. Mulingo woyenera kwambiri ndi 3 g tsiku lililonse (magawo atatu).

Ngati mukufuna kusintha kuchokera ku mankhwala ena antidiabetes: muyenera kusiya kumwa mankhwalawa ndikuyamba kumwa mankhwalawa Glucofage pamwambapa womwe watchulidwa pamwambapa.

Kuphatikiza ndi insulin:

Kuti akwaniritse kuthana ndi shuga wamagazi, Glucofage ndi insulin zingagwiritsidwe ntchito ngati mankhwala ophatikiza. Mlingo woyamba wa Glucofage ® ndi 500 mg kapena 850 mg katatu patsiku, pamene mlingo wa insulin umasankhidwa potengera zotsatira za kuyeza shuga m'magazi.

Ana ndi achinyamata:

Mwa ana kuyambira zaka 10, Glucofage angagwiritsidwe ntchito limodzi ndi monotherapy komanso kuphatikiza insulin. Mulingo woyambira woyamba ndi 500 mg kapena 850 mg kamodzi tsiku lililonse mkati kapena mutatha kudya. Pambuyo masiku a mankhwalawa 10-15, ndikofunikira kusintha mlingo wa mankhwalawa malinga ndi zotsatira za kuyeza shuga wamagazi. Kuchepetsa pang'ono kwa mankhwalawa kumathandizira kulolerana kwamatumbo. Mlingo woyenera kwambiri ndi 2 g ya mankhwala Glucofage patsiku, womwe umagawidwa pawiri.

Odwala okalamba:

Chifukwa kuchepa kwa aimpso ntchito mu okalamba, mlingo wa mankhwala Glucofage uyenera kusankhidwa kutengera magawo aimpso ntchito. Kuwunika pafupipafupi kwa impso ndikofunikira.

Odwala ndi mkhutu aimpso ntchito:

Metformin itha kugwiritsidwa ntchito kwa odwala omwe ali ndi vuto laimpso olimbitsa - gawo 3a la matenda a impso (a creatinine chilolezo cha KlKr 45-59 ml / mphindi kapena kuchuluka kwa kusefedwa kwa rSCF 45-59 ml / mphindi / 1.73 m2) - pokhapokha ngati pali zifukwa zina , omwe angakulitse chiopsezo cha lactic acidosis, komanso kusintha kwotsatira kwa mlingo: mlingo woyambirira wa metformin hydrochloride ndi 500 mg kapena 850 mg kamodzi patsiku. Mlingo wapamwamba ndi 1000 mg patsiku, womwe umagawidwa pawiri. Kuwunikira mosamala kwa ntchito ya impso (miyezi 3-6 iliyonse) ndikofunikira.

Ngati mitengo ya CLKr kapena rSCF itatsika mpaka kufika pa 60 ml / mphindi / 1.73 m2, kugwiritsa ntchito metformin kuyenera kuyimitsidwa isanayambike kapena kumaphunziriridwa pogwiritsa ntchito mankhwala okhala ndi ayodini, musayambirensobe pasanathe maola 48 pambuyo pa phunziroli komanso mukangowunikiranso ntchito ya impso. , zomwe zikuwonetsa zotsatira zabwinobwino, bola ngati sizingawonongeke pambuyo pake.

Odwala omwe ali ndi vuto laimpso zolimbitsa thupi (eGFR 45-60 ml / mphindi / 1.73 m2), metformin iyenera kuchotsedwa maola 48 asanagwiritse ntchito mankhwala okhala ndi ayodini ndipo asayambirenso kupitirira maola 48 mutatha kafukufukuyu kuwunika kwa impso, komwe kunawonetsa zotsatira zabwinobwino komanso kuwonetsa kuti sizingavute pambuyo pake.

Kuphatikiza komwe kumafunikira kusamala

Mankhwala omwe ali ndi vuto la hyperglycemic (glucocorticoids (zokhudza zonse ndi zomwe zimachitika m'deralo) ndi sympotomimetics): kuyezetsa magazi pafupipafupi kwambiri kungafunike, makamaka poyambira chithandizo. Ngati ndi kotheka, Mlingo wa metformin wokhala ndi mankhwala oyenera uyenera kusintha mpaka womaliza utatha.

Ma diuretics, makamaka odzola okodzetsa achulukitse chiopsezo cha lactic acidosis chifukwa cha zovuta zawo pakuchitika kwa impso.

Malangizo apadera

Lactic acidosis ndizosowa kwambiri koma zovuta za metabolic zowopsa ndi kufa kwakukulu pakalibe chithandizo chamankhwala mwadzidzidzi, zomwe zimatha kukhazikika chifukwa cha kuchuluka kwa metformin. Amanena milandu ya lactic acidosis mwa odwala omwe amalandira metformin makamaka omwe amapezeka ndi odwala matenda a shuga komanso kulephera kwambiri kwaimpso kapena kuwonongeka kwambiri kwa impso. Chenjezo liyenera kuchitika pakachitika vuto la impso, mwachitsanzo, ngati magazi atha kuchepa (kutsegula m'mimba kwambiri, kusanza) kapena mankhwala a antihypertensive, diuretic therapy, kapena kuchiza ndi mankhwala omwe si a antiidal. M'mikhalidwe yovuta kwambiri iyi, mankhwala a metformin ayenera kuyimitsidwa kwakanthawi.

Zina zokhudzana ndi chiopsezo ziyenera kuganiziridwanso, monga matenda osokoneza bongo osayendetsa bwino, ketosis, kusala kudya kwa nthawi yayitali, kumwa kwambiri mowa, kulephera kwa chiwindi, komanso vuto lililonse lomwe lingachitike ndi hypoxia (monga kuwonongeka mtima, kupunduka kwa mtima.

Kudziwitsa za lactic acidosis kuyenera kuganiziridwa ngati mukupezeka zizindikiro zopanda pake, monga kukokana kwa minofu, kupweteka kwam'mimba, komanso / kapena asthenia yayikulu. Odwala ayenera kudziwitsidwa kuti afotokoze izi kwa othandizira awo azaumoyo, makamaka ngati m'mbuyomu odwala anali ndi kulolera kwa metformin. Ngati lactic acidosis ikukayikira, chithandizo ndi Glucofage iyenera kusiyidwa. Kuyambiranso kugwiritsa ntchito mankhwalawa Glucofage be kuyenera kuganiziridwa pokhapokha mutaganizira kuchuluka kwa phindu / chiopsezo ndi ntchito ya impso.

Lactic acidosis imadziwika ndi mawonekedwe a acidotic kufupika, kupweteka kwam'mimba komanso hypothermia, kenako kutsekeka. Diagnostic labotale magawo amaphatikizanso kuchepa kwa magazi pH, kuchuluka kwa plasma lactate yoposa 5 mmol / l, kuwonjezeka kwa gawo la anion, ndi lactate / pyruvate ratio. Ngati lactic acidosis ikukayikira, wodwalayo ayenera kuchipatala nthawi yomweyo. Madokotala ayenera kudziwitsa odwala za chiwopsezo ndi zizindikiro za lactic acidosis.

Popeza metformin imachotsedwa impso, kale komanso nthawi zonse mukamalandira chithandizo ndi Glucofage®, chilolezo cha creatinine chiyenera kuyang'aniridwa (kudziwa kuchuluka kwa creatinine mu seramu yamagazi pogwiritsa ntchito njira ya Cockcroft-Gault):

osachepera kamodzi pachaka kwa odwala omwe ali ndi vuto laimpso,

osachepera 2-4 pachaka odwala okalamba, komanso odwala omwe ali ndi creatinine chilolezo chotsika.