Glucophage 500 > Chithandizo ndi kupewa

Kufotokozera

Mlingo 500 mg, 850 mg:
Mapiritsi oyera, ozungulira, a biconvex.
Gawo la mtanda likuwonetsa yunifolomu yoyera.

Mlingo wa 1000 mg:
Masamba oyera, ozungulira, mapiritsi a biconvex, ophatikizidwa ndi mafilimu, omwe ali pachiwopsezo mbali zonse ziwiri ndipo adalemba "1000" mbali imodzi.
Gawo la mtanda likuwonetsa yunifolomu yoyera.

Pharmacotherapeutic katundu

Metformin imachepetsa hyperglycemia popanda kutsogola kukula kwa hypoglycemia. Mosiyana ndi zotumphukira za sulfonylurea, sizimalimbikitsa kutulutsa insulin ndipo sizikhala ndi vuto loti munthu azikhala wathanzi. Zimawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikugwiritsa ntchito shuga ndi maselo. Imachepetsa kupanga shuga kwa chiwindi poletsa gluconeogeneis ndi glycogenolysis.
Kuchepetsa mayamwidwe m'matumbo.

Metformin imathandizira kapangidwe ka glycogen pochita glycogen synthase. Kuchulukitsa kuchuluka kwa mayendedwe amtundu uliwonse wa ma membrane glucose.

Kuphatikiza apo, imakhala ndi phindu pa metabolidi ya lipid: imachepetsa zomwe zimakhala ndi cholesterol yonse, lipoproteins yotsika komanso triglycerides.

Ngakhale mutamwa metformin, thupi la wodwalayo limakhalabe lolimba kapena limatsika pang'ono.

Kafukufuku wachipatala awonetsanso kugwira bwino ntchito kwa mankhwalawa Glucofage ® popewa matenda ashuga odwala omwe ali ndi prediabetes omwe ali ndi chiopsezo chowonjezereka pakukula kwa mtundu wachiwiri wa matenda a shuga, momwe kusintha kwasinthidwe sikunalole kuti chiwonetsero chokwanira cha glycemic chikwaniritsidwe.

Pharmacokinetics

Madzi ndi kugawa
Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera kumimba kwathunthu. Mtheradi bioavailability ndi 50-60%. Kuchuluka kwa ndende (Cmax) (pafupifupi 2 μg / ml kapena 15 μmol) m'madzi a plasma kumachitika pambuyo pa maola 2.5. Ndi kukakamiza komweko pakudya, kuyamwa kwa metformin kumachepetsedwa ndikuchedwa. Metformin imagawidwa mwachangu mu minofu, sikuti imagwira mapuloteni a plasma.

Kutetemera ndi chimbudzi
Amapangidwira pamlingo wofooka kwambiri ndikuwonetsa impso. Kuwonekera kwa metformin m'maphunziro abwino ndi 400 ml / mphindi (kuchulukitsa kanayi kuposa kutulutsa chilolezo cha creatinine), zomwe zikuwonetsa kukhalapo kwa secalic secretion. Hafu ya moyo ndi pafupifupi maola 6.5. Ndi kulephera kwa aimpso, zimachulukana, pamakhala chiopsezo cha kukopeka kwa mankhwalawa.

Contraindication

Hypersensitivity to metformin kapena kwa aliyense wakonda,
matenda ashuga ketoacidosis, matenda a shuga, chikomokere,
Kulephera kwaimpso kapena kuwonongeka kwaimpso (kulengedwa kwa creatinine kupitirira 45 ml / min),
zovuta pachimake ndi chiopsezo cha aimpso kukanika: kuchepa magazi (ndi m'mimba, kusanza), matenda opatsirana, mantha,
mwaukadaulo wawonetsera matenda owopsa kapena osachiritsika omwe angayambitse kukula kwa minofu hypoxia (kuphatikizapo kupweteka kwa mtima, kuperewera kwa mtima ndi hemodynamics yosakhazikika, kupuma, kuperewera kwamatenda am'mimba.
opaleshoni yayikulu ndikuvulaza pamene chithandizo cha insulin chikusonyezedwa (onani gawo "Malangizo Apadera"),
Kulephera kwa chiwindi, kuwonongeka kwa chiwindi,
uchidakwa wambiri, chakumwa chakumwa choledzeretsa,
mimba
lactic acidosis (kuphatikizapo mbiri),
gwiritsani ntchito maola osakwana 48 isanakwane komanso musanathe maola 48 mutapanga maphunziro a radioisotope kapena x-ray ndikuyambitsa njira yokhala ndi ayodini (onani gawo "Kuyanjana ndi mankhwala ena"),
kutsatira zakudya zama hypocaloric (zosakwana 1000 kcal / tsiku).

Mosamala

mwa anthu azaka zopitilira 60 omwe amagwira ntchito zolimbitsa thupi, zomwe zimagwirizanitsidwa ndi chiopsezo chowonjezereka cha lactic acidosis,
Odwala aimpso kulephera (creatine chilolezo 45-59 ml / min),
Pa yoyamwitsa.

Gwiritsani ntchito pa nthawi yoyembekezera komanso nthawi yoyamwitsa

Pokonzekera kutenga pakati, komanso ngati mayi ali ndi pakati pam'mbuyo pa kutenga matenda a metformin omwe ali ndi prediabetes ndi mtundu wachiwiri wa shuga, mankhwalawo ayenera kusiyidwa, ngati vuto la matenda ashuga a mtundu wa 2, limaperekedwa. Ndikofunikira kusungitsa glucose omwe ali m'madzi am'magazi pamlingo woyandikira kwambiri kuti achepetse vuto la fetus.

Metformin imadutsa mkaka wa m'mawere. Zotsatira zoyipa za akhanda pa nthawi yoyamwitsa pamene mukumwa metformin sizinawoneke. Komabe, chifukwa cha kuchuluka kwa deta, kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa sikulimbikitsidwa. Lingaliro loletsa kuyamwitsa liyenera kuganiziridwanso zabwino za kuyamwitsa ndi chiopsezo cha zotsatira zoyipa mwa khanda.

Mlingo ndi makonzedwe

Akuluakulu:
Monotherapy ndi kuphatikiza mankhwala osakanikirana ndi othandizira ena am'mlomo a hypoglycemic othandizira a mtundu 2 matenda a shuga:

Mulingo woyambira woyamba ndi 500 mg kapena 850 mg katatu patsiku mutatha kudya kapena pakudya.
Pakadutsa masiku 10 mpaka 10, tikulimbikitsidwa kusintha mlingo woyambira pazotsatira za kuyeza kuchuluka kwa shuga m'magazi am'magazi. Kuwonjezeka pang'onopang'ono kwa mankhwalawa kumathandiza kuchepetsa zovuta kuchokera m'matumbo am'mimba.
Mankhwala okonza mankhwalawa nthawi zambiri amakhala 1500-2000 mg / tsiku. Kuti muchepetse mavuto kuchokera m'matumbo am'mimba, mlingo wa tsiku ndi tsiku uyenera kugawidwa mu Mlingo wa 2-3. Mlingo wapamwamba ndi 3000 mg / tsiku, logawidwa pazidutswa zitatu.
Odwala omwe atenga metformin mu Mlingo wa 2000-3000 mg / tsiku amatha kusamutsidwa ku mankhwala Glucofage ® 1000 mg. Mlingo woyenera kwambiri ndi 3000 mg / tsiku, womwe umagawidwa pazigawo zitatu.

Pankhani yakukonzekera kusintha kwa kutenga wothandizila wina wa hypoglycemic: muyenera kusiya kumwa mankhwalawa ndikuyamba kumwa Glucofage ® mu mlingo womwe tafotokozawu.

Kuphatikiza ndi insulin:
Kukwaniritsa bwino shuga wamagazi, metformin ndi insulin mwa odwala omwe ali ndi matenda a shuga a 2 angagwiritsidwe ntchito ngati mankhwala osakanikirana. Mlingo woyamba wa Glucofage ® ndi 500 mg kapena 850 mg kawiri pa tsiku, pomwe mlingo wa insulin umasankhidwa potengera kuchuluka kwa shuga m'magazi.

Ana ndi achinyamata:
mwa ana kuyambira zaka 10, mankhwalawa Glucofage ® angagwiritsidwe ntchito onse mu monotherapy komanso kuphatikiza insulin. Mulingo woyambira woyamba ndi 500 mg kapena 850 mg 1 nthawi patsiku mutatha kudya kapena. Pambuyo masiku 10-15, mlingo uyenera kusinthidwa potengera kuchuluka kwa magazi.
Mulingo wambiri watsiku ndi tsiku ndi 2000 mg, wogawidwa pamitundu iwiri.

Monotherapy kwa prediabetes:
Mlingo wamba ndi 1000-1700 mg patsiku mutatha kudya kapena mgawo womwe umagawidwa pawiri.
Ndikulimbikitsidwa kumayendetsa glycemic pafupipafupi kuti muwone kufunika kogwiritsira ntchito mankhwalawa.

Odwala aimpso kulephera:
Metformin itha kugwiritsidwa ntchito kwa odwala omwe amalephera kupweteka aimpso (creatine chilolezo cha 45-59 ml / min) pokhapokha ngati pali zinthu zomwe zingakulitse chiopsezo cha lactic acidosis.

Odwala okhala ndi chilolezo chaine cha 45-59 ml / mphindi: mlingo woyambirira ndi 500 mg kapena 850 mg kamodzi patsiku. Mlingo wapamwamba ndi 1000 mg patsiku, womwe umagawidwa pawiri.

Ntchito ya impso iyenera kuyang'aniridwa bwino (miyezi 3-6 iliyonse).
Ngati creatine chilolezo chili pansi pa 45 ml / min, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo.

Odwala okalamba:
chifukwa kuchepa kwa aimpso ntchito, mlingo wa metformin uyenera kusankhidwa poyang'anitsitsa mawonetseredwe aimpso (kudziwa kuchuluka kwa creatinine m'magazi a seramu osachepera 2-4 pachaka).

Kutalika kwa mankhwala

Glucofage ® iyenera kumwedwa tsiku lililonse, osasokoneza. Ngati chithandizo chalekeka, wodwalayo ayenera kudziwitsa dokotala.

Zambiri, kapangidwe ndi mawonekedwe ake amasulidwe

Glucofage Long ndi kukonzanso kwa matenda ashuga a kalasi yayikulu ndi yogwira ntchito ya Metformin hydrochloride. Amapezeka mu Mlingo wa 500, 850, 1000 mg.

Ikamamwa, imatha kunyengedwa mwachangu. Kudzikundikira kwakukulu kumachitika pambuyo pa maola 2 pambuyo pa kukhazikitsa.

Izi zimakuthandizani kuti mukwaniritse zotsatirazi:

matenda a shuga
onjezani kuyankhidwa kwa minofu ku mahomoni opangidwa,
kupanga chiwindi m'magazi,
chepetsa kuyamwa kwamatumbo,
bweza thupi,
sinthani kagayidwe ka lipid,
cholesterol yotsika.

Mapiritsi amagwira ntchito mu prediabetes.

Pogulitsa, mankhwalawa amaperekedwa mwa mawonekedwe a piritsi, yokutidwa ndi chipolopolo cha biconvex cha mtundu woyera. Kuphatikizika kwa gawo logwira ntchito ndi 500, 850, 1000 mg. Kuti athandize wodwala, kuchuluka kwa mankhwalawa amalembedwa pa theka la piritsi.

Pharmacology ndi pharmacokinetics

Mapangidwe a mapiritsiwa akuphatikiza Metformin, yomwe imatsimikizira kutchulidwa kwa hypoglycemic. Odwala omwe ali ndi kuchuluka kwa glucose, amachepetsa monga yakhazikika. Mwa anthu omwe ali ndi shuga athanzi, shuga wamagazi amakhalabe osasinthika.

Kuchita kwa chigawo chogwira ntchito kumakhazikitsidwa ndi kulepheretsa kwa gluconeogeneis ndi glycogenolysis, kuthekera kokulimbikitsa chidwi cha insulini komanso kuchepetsa mayamwidwe m'mimba. Kuphatikiza apo, mankhwalawa amathandizira njira zama metabolic m'thupi ndipo amatsitsa cholesterol.

Kuchuluka kwa Metformin kumawonedwa patatha maola 2-3 pambuyo pa kuwongolera. Chizindikiro cha Glucophage Long ndichotsika cha mapuloteni a plasma. Chofunikira chachikulu chimapukutidwa ndi impso ndi matumbo mkati mwa maola 6.5.

Pambuyo potenga Glucofage, adsorption yathunthu ya Metmorphine GIT imadziwika. Gawo lolimbikira limagawidwa mwachangu mthupi lonse. Ambiri amatsitsidwa kudzera mu impso, ena onse m'matumbo. Njira yoyeretsera mankhwalawa imayamba maola 6.5 mutamwa. Odwala omwe ali ndi mavuto a impso, theka la moyo limawonjezeka, zomwe zimawonjezera chiopsezo cha Metformin cumulation.

Zizindikiro ndi contraindication

Malinga ndi malangizo omwe akuphatikizidwa ndi Glucofage, akuwonetsedwa ngati anthu odwala matenda ashuga a 2 omwe ali onenepa kwambiri ngakhale atalandira chithandizo chamankhwala.

Odwala ambiri amagwiritsa ntchito Glucofage kuti achepetse thupi. Pankhaniyi, muyenera kutsatira zakudya zochepa zopatsa mphamvu ndikuchita masewera olimbitsa thupi tsiku lililonse. Izi zimakupatsani mwayi wopeza zotsatira zabwino kwakanthawi kochepa.

Monga mankhwala aliwonse, glucophage ali ndi contraindication.

Mankhwala oletsedwa:

anthu osalolera pa chimodzi mwa zinthuzi,
ndi coma kapena matenda ashuga a ketoacidosis,
kugwira ntchito molakwika kwa impso ndi mtima,
ndi kuchulukitsa kwa matenda osachiritsika ndi opatsirana,
ndi kumwa nthawi yomweyo.
ndi poizoni
pa mimba ndi kuyamwa,
ndi lactic acidosis,
Masiku awiri pamaso pa radiology ndi masiku awiri pambuyo pake,
anthu ochepera zaka 10
pambuyo pochita masewera olimbitsa thupi.

Kumwa mapiritsi ndi okalamba kumachitika motsogozedwa ndi katswiri.

Malangizo ogwiritsira ntchito

Mlingo woyambira osachepera 500 kapena 850 mg, womwe umagawidwa ma Mlingo angapo. Mapiritsi amatengedwa nawo kapena mukangomaliza kudya. Kusintha kwa milingo kumachitika pambuyo pa kusintha kwa mlozera wa shuga.

Mlingo wapamwamba kwambiri ndi 3000 mg patsiku, womwe umagawidwanso m'magulu angapo (2-3). Pang'onopang'ono ndende yogwira ntchito m'magazi imachuluka, zotsatira zoyipa zochepa kuchokera m'mimba.

Mukaphatikiza Glucofage Long ndi insulin, mulingo woyenera ndi 500, 750, 850 mg katatu patsiku. Mlingo wa insulin umayendetsedwa ndi adokotala.

Mapiritsi amagwiritsidwa ntchito onse kuphatikiza ndi mankhwala ena, komanso mosiyana. Mwapadera, kuvomerezedwa kuvomerezeka kuyambira wazaka khumi. Mlingo wofotokozedwa ndi dokotala potengera kuchuluka kwa shuga m'magazi. Ochepera ndi 500 mg, okwera ndi 2000 mg.

Odwala Apadera ndi Mayendedwe

Musanagwiritse ntchito mankhwalawa, muyenera kufunsa dokotala, kuphunzira zotsatira zake, ndikuzindikira malangizidwe a odwala omwe ali m'gulu lapadera:

Nthawi yamimba. Kulandila kwa Glucophage panthawi yokhala ndi mwana ndi kuyamwa kumaletsedwa kotheratu. Mwazi wamagazi umasungidwa mwa kubaya insulin. Kuletsedwa kwa mapiritsi nthawi yoyamwitsa kumachitika chifukwa chosowa kafukufuku.
Ana m'badwo. Kugwiritsa ntchito shuga kwa ana ochepera zaka 18 sikothandiza. Kodi ali ndi mfundo yogwiritsa ntchito mankhwalawa ndi ana azaka 10? Kuwongoleredwa ndi dokotala ndikofunikira.
Anthu okalamba. Mosamala, muyenera kumwa mankhwalawa kwa anthu okalamba omwe ali ndi matenda a impso ndi mtima. Njira ya chithandizo iyenera kuyang'aniridwa ndi katswiri.

Matenda ena kapena mikhalidwe, mankhwalawa amatengedwa mosamala, kapena amalephera:

Lactic acidosis. Nthawi zina, kugwiritsa ntchito Metformin, komwe kumalumikizidwa ndi kupezeka kwa kulephera kwa impso kwa wodwala. Matendawa amayenda ndi kupindika minofu, kupweteka pamimba ndi hypoxia. Ngati nthendayo ikukayikiridwa, kusiya mankhwala ndi kufunsa akatswiri ndikofunikira.
Matenda a impso. Pa vuto la impso, kusamala kwambiri kuyenera kuchitidwa, popeza thupi limatenga zonse zochotsa Metformin mthupi. Chifukwa chake, musanayambe kugwiritsa ntchito mankhwalawa, chisamaliro chiyenera kulipidwa kufikira mulingo wa creatinine mu seramu yamagazi.
Opaleshoni. Piritsi amayimitsidwa masiku awiri asanayambe opareshoni. Kuyambiranso kwamankhwala kumayamba pakapita nthawi yofanana.

Kunenepa kwambiri, kumwa mapiritsi kumathandizira odwala matenda ashuga a 2 kuti achepetse kulemera kwawo. Kumbali ya wodwala, kutsatira zakudya zopatsa thanzi kufunikira momwe kuchuluka kwa zopatsa mphamvu kuyenera kukhala osachepera 1000 kcal patsiku. Kupereka mayeso a labotale kumakuthandizani kuti muwone momwe thupi limagwirira ntchito komanso kuchuluka kwa glucophage.

Zotsatira zoyipa ndi bongo

Mndandanda wazotsatira zakumwa za mankhwalawa zimadalira maphunziro ambiri azachipatala ndi kuwunika kwa wodwala:

Kuchepetsa Vitamini B12 imayambitsa chitukuko cha matenda monga anemia ndi lactic acidosis.
Sinthani mumaluwa amakoma.
Kuchokera pamimba, m'mimba, kupweteka pamimba, ndi kusowa kwa chakudya kumawonedwa. Kuchita kumawonetsa kuti chizindikiro chodziwikiratu chimadziwika mu ambiri mwa odwala ndipo amadutsa masiku angapo.
Monga thupi lawo siligwirizana, urticaria ndiyotheka.
Kuphwanya njira za metabolic kumatha kubweretsa zochitika zosayembekezereka, chifukwa chomwe kufulumira kwa mapiritsi ndikotheka.

Kuyanjana Ndi Mankhwala Ndi Analogi

Mphamvu ya hyperglycemic ya mankhwala a Danazol imapangitsa kuti ikhale yosatheka kuphatikiza ndi Glucofage. Ngati ndizosatheka kupatula mankhwalawa, mlingo umasinthidwa ndi dokotala.

Ma tinctures okhala ndi mowa amaonjezera ngozi ya lactic acidosis.

Mlingo waukulu wa chlorpromazine (woposa 100 mg / tsiku) amatha kuwonjezera glycemia ndikuchepetsa kuchuluka kwa insulin. Mlingo wa madokotala umafunika.

Kugwirizana kwa okodzetsa kumawonjezera chiopsezo cha lactic acidosis. Sizoletsedwa kutenga Glucofage ndi mlingo wa chini wa 60 ml / min.

Mankhwala okhala ndi ayodini omwe amagwiritsidwa ntchito ngati fluoroscopy kwa odwala omwe ali ndi vuto la impso amayambitsa lactic acidosis. Chifukwa chake, pozindikira wodwala ndi x-ray, kuthetseratu mapiritsi ndikofunikira.

Hypoglycemic zotsatira za mankhwalawa zimatheka ndi sulfonylurea, insulin, salicylates, acarbose.

Ndi ma analogi amatanthauza mankhwala omwe amafunidwa kuti alowe m'malo mwa mankhwala, kugwiritsa ntchito kwawo kumagwirizana ndi dokotala:

Bagomet. Zopangidwira odwala matenda a shuga a 2 omwe ali ndi kunenepa kwambiri. Ntchito monotherapy komanso osakaniza insulin.
Glycometer. Mankhwala a mtundu wa 2 odwala matenda ashuga amayamba kunenepa kwambiri. Itha kugwiritsidwa ntchito ngati matenda a shuga 1 kuphatikiza insulin.
Dianormet. Imathandizira kutulutsa magulu a mahomoni, makamaka kwa odwala omwe ali ndi vuto la mafuta.

Izi zikufanana ndipo ndizotchuka pakati pa odwala matenda ashuga amtundu wa 2.

Pharmacokinetics

Kamodzi mthupi la munthu, zinthu zomwe zimagwira mu Glucofage zimakulitsa chidwi cha maselo kupita ku insulin, yomwe imachepetsedwa chifukwa cha kupezeka kwa mtundu 2 shuga. Glucose imayamba kutengeka kwambiri ndi minofu ndi minyewa ina, ndipo mulingo wake m'magazi umachepa. Nthawi yomweyo, kupanga kwake m'chiwindi ndi mayamwidwe m'matumbo am'mimba (GIT) kumachepa. Nthawi yomweyo, metformin sikugwira nawo kagayidwe kenakake ndipo imakhudzidwa kudzera mu impso maola 6 mpaka asanu ndi atatu mutamwa mapiritsi.

Mosasamala ndi shuga la magazi, mankhwalawa amathandizira kuwonjezera kagayidwe ka lipid, kuchepetsa kuchuluka kwa triglycerides, lipoproteins ndi cholesterol. Nthawi yomweyo, gluconeogeneis ndi glycogenolysis ndi zolepheretsa, zomwe zimapangitsa kuti wodwalayo akhale bwino. Kuchuluka kwamphamvu mutatenga Glucofage kumachitika patatha maola awiri kapena asanu ndi awiri pambuyo pakukonzekera kwapakamwa, kutengera mtundu wa mapiritsi omwe adagwiritsidwa ntchito. Munthawi imeneyi, zigawo zikuluzikulu za mankhwalawa zimakhala ndi nthawi yogwidwa m'mimba, ndipo bioavailability wawo, monga lamulo, amaposa 50-60%.

Kutulutsa mawonekedwe, mawonekedwe ndi malo osungira

Mpaka pano, mankhwalawa akupezeka m'mitundu iwiri ya mapiritsi: Glucophage ndi Glucophage XR. Zachiwirizi zimasiyana ndi zoyambirira ndikamasula chinthu chomwe chimayamba kugwira ntchito, ndiye kuti zotsatira zake zimadza pambuyo pake. Mapiritsi olembedwa XR amagulitsidwa muma pharmacies m'matumba makumi atatu kapena makumi asanu ndi limodzi.

Glucophage mwachizolowezi, wosakhazikika amaperekedwanso kwa makasitomala okhala m'mapiritsi okhala ndi mapiritsi makumi atatu mpaka makumi asanu ndi limodzi. Zimabwera m'mitundu itatu: Glucofage 500, Glucofage 850 ndi Glucofage 1000. Momwemo, piritsi lililonse, kutengera zolembedwa, lili ndi mamiligalamu 500, 850 kapena 1000 pazomwe zimagwira - metformin hydrochloride. Nthawi yomweyo, zomwe zimakhala mumapiritsi a XR ndizokhazikika ndipo zimakhala 500 milligrams.

Zotsatira monga malangizo ogwiritsira ntchito mankhwalawa, ziyenera kusungidwa m'malo owuma, amdima pamtunda wa osaposa 25 digiri Celsius. Ana sayenera kupeza mapiritsi, chifukwa mankhwalawa amatha kuvulaza thanzi la munthu ngati atagwiritsidwa ntchito molakwika. Moyo wa alumali wa Glucophage 1000 ndi XR ndi zaka zitatu, ndipo Glucofage 500 ndi 850 ndi zaka zisanu.

Njira yogwiritsira ntchito mankhwalawa

Glucophage akuwonetsedwa kuti azigwiritsidwa ntchito ndi odwala omwe ali ndi matenda a shuga 2. Ndi matenda amtunduwu, insulin yokwanira imapangidwa m'thupi la munthu, koma shuga yomwe imayendetsedwa nayo simalowetsedwa bwino ndi ziwalo ndi minyewa. Izi zimachitika chifukwa chakuchepa kwa ma receptor omwe ali pansi pamatumbo am'mimba, chifukwa maselo sazindikira bwino insulini ndipo samalumikizana nawo. Nthawi zambiri, mtundu wachiwiri wa matenda osokoneza bongo sufuna chithandizo chamankhwala, ndipo chithandizo chamankhwala chimakhala chongoletsa wodwalayo kudya komanso kuchita masewera olimbitsa thupi nthawi zonse. Ngati njirazi sizithandiza, mankhwalawa monga Glucofage amagwiritsidwa ntchito, omwe nthawi zambiri amalembedwa ngati monotherapy. Momwe mungagwiritsire ntchito bwino mitundu yamapiritsi omwe alipo, muyenera kumvetsetsa mwatsatanetsatane.

1) Glucophage ya muyezo wokhazikitsidwa imaperekedwa kwa odwala momwe mapiritsi okhala ndi 500, 850 kapena 1000 milligram yogwira ntchito, kutengera mlingo wa tsiku ndi tsiku, womwe madokotala amapeza. Mapiritsi ayenera kumwedwa nthawi yakudya kapena itatha, osafuna kutafuna ndikumwa iwo ndi madzi. Zotsatira zake zimachitika patatha maola awiri kapena atatu ndipo zimatha mpaka nthawi yotsatira. Mlingo wa tsiku ndi tsiku wa munthu wamkulu ndi mamililita 1500-2550 ndipo umaphatikizanso kumwa piritsi limodzi m'mawa, masana ndi madzulo. Pankhaniyi, simungathe kutenga mamiligalamu opitilira 3000 a metformin patsiku, popeza kuchuluka kumeneku ndikovomerezeka.

Kwa ana opitirira zaka khumi, omwe Glucofage imavomerezedwanso kuti agwiritse ntchito, mlingo woyenera tsiku lililonse ndi mamiligalamu 2000 a chinthu chomwe chikugwira ntchito. Komanso, kumayambiriro kwa maphunziro, sichidutsa mamiligon 850, pambuyo pake chimawonjezeka tsiku lililonse. Mwana akamagwiritsa ntchito insulin nthawi yomweyo mapiritsi, mapiritsi ake omaliza ayenera kusinthidwa malinga ndi kuchuluka kwa shuga m'magazi.

Kuwonjezeka kwapang'onopang'ono kwa mlingo kumalimbikitsidwanso kwa akuluakulu. Poyamba, imatha kukhala ma milligram a 1000-1500 a metformin patsiku, kenako ndikuwonjezeka pang'ono ndi mwezi. Ngati miyezo ya shuga m'magazi ikusonyeza kuchepa kwake, ndiye kuti mlingowo umachepetsedwa. Ponena za okalamba ndi odwala omwe ali ndi matenda a impso, kwa iwo tsiku lililonse mankhwalawa amawerengedwa mosiyanasiyana payekhapayokha pozindikira matenda ake.

2) Glucophage XR nthawi yayitali imasonyezedwa kuti imagwiritsidwa ntchito malinga ndi njira zomwe zimafanana ndi Glucophage yachilendo. Kusiyana koyambirira ndikofunikira kumwa mapiritsi osati atatu, koma kamodzi kapena kawiri pa tsiku, zotsatira zake mukamamwa mankhwalawa zimachitika maola 6 mpaka asanu ndi awiri mutatha kumwa, zomwe zimakupatsani mwayi woti musagwiritse ntchito kangapo. Monga lamulo, kumayambiriro kwa maphunziro, wodwala amatenga piritsi limodzi patsiku, lomwe lili ndi ma milligram 500 a metformin. Pambuyo pake, mlingo umasinthidwa malinga ndi kusintha kwa chithunzi cha matenda. Mlingo wa tsiku ndi tsiku umachulukanso kuposa milungu iwiri iliyonse. Kupanda kutero, pali kuthekera kwa kuchepa kwakukulu kwamagazi a shuga, omwe wodwalayo sangadziwe, kuyika thanzi lake pachiwopsezo.

Mankhwala osokoneza bongo a Glucophage ndi Glucophage XR atha kubweretsa zotsatira zoyipa. Wodwala amatha kukhala ndi lactic acidosis, yomwe imafunikira kuchipatala mwachangu komanso kupita kuchipatala. Pofuna kuchotsa metformin ndi mkaka wa mthupi, hemodialysis ndi zinthu zina zofunika kwambiri zaumoyo zingafunike. Chifukwa chake, kugwiritsa ntchito mankhwalawa kuyenera kuthandizidwa ndi udindo waukulu, osachulukitsa tsiku lililonse popanda kudziwa dokotala.

Kuyanjana kwa mankhwala osokoneza bongo

Chifukwa cha zadzidzidzi za Glucophage, sizikulimbikitsidwa kuti muphatikize ndi mankhwala omwe amapangidwa mosiyanasiyana ndi mankhwala. Tikuyankhula za othandizira ayodini omwe ali ndi ayodini: Danazole, Nifedipine, Chlorpromazine, glucocorticosteroids, ethanol, diopture okosi, beta2-adrenergic agonists, mankhwala a cationic ndi zoletsa za ACE.

1) Ma ayodini okhala ndi ayodini omwe amagwiritsidwa ntchito pakuwunikira radiology amatsutsana kuti agwiritsidwe ntchito pamodzi ndi Glucofage. Kuphatikizika kwawo kungapangitse kukula kwa lactic acidosis mwa wodwala. Chifukwa chake, kuyesedwa pazinthu zotere kuyenera kuchedwetsedwa, kapena panthawi yomwe ikuchitika, kukana kumwa mankhwalawo. Kuti muchite izi, ndikukwanira kusiya kumwa mapiritsiwo masiku awiri musanayambe njirayi ndikuyambiranso masiku awiri itatha.

2) Mowa wa Ethyl, womwe ndi gawo la zakumwa zonse zakumwa zoledzeretsa ndipo umapezeka m'mankhwala ena, ulinso wosavomerezeka kuti uphatikizidwe ndi Glucofage. Izi zikufotokozedwanso ndi lactic acidosis, yomwe imatha kukhazikitsidwa motsutsana ndi maziko a kuledzera. Izi ndizofunikira makamaka kwa anthu omwe ali ndi vuto la chiwindi, ndipo amatsatiranso zakudya zama calori zochepa ndikudya chakudya chochepa.

3) Chlorpromazine pochiza hypoglycemia Glucofage iyenera kugwiritsidwa ntchito mosamala, popeza imawonjezera shuga m'magazi, ikuchepetsa kumasulidwa kwa insulin. Makamaka, izi zimagwira ntchito waukulu Mlingo wa Chlorpromazine - wopitilira mamiligalamu zana patsiku. Ngati sizotheka kukana, wodwalayo ayenera kukhala okonzekera kuti azichita kuyeza shuga wamagazi pafupipafupi kuti apewe kuchuluka kwa hypoglycemia.

4) Nifedipine yonse siyikukhudzana ndi kukonzekera kwa mankhwalawa, koma imatha kuwonjezera mayamwidwe ake, ndipo, motero, kuphatikiza kwakukulu. Chifukwa chake, mutamwa mankhwalawa antihypertensive, mulingo wa Glucophage uyenera kusintha mwa kulumikizana ndi dokotala.

5) Dinazole kuphatikiza mankhwala a hypoglycemic angapangitse kuchuluka kwa shuga m'magazi, chifukwa chake muyenera kukana kugwiritsa ntchito mankhwalawa. Ngati izi sizingachitike pazifukwa zina, zosintha ziyenera kuchitika pa mlingo watsiku ndi tsiku wa Glucofage.

6) Glucocorticosteroids (GCS) imachulukitsa shuga m'magazi ndipo, pamikhalidwe yovuta, imatha kubweretsa ketosis. Chifukwa chakuti mankhwalawa amatsenga komanso achilengedwe amachepetsa kulolera kwa glucose, kugwiritsa ntchito kwawo nthawi yomweyo ndi Glucofage kumafuna kusintha Mlingo watsiku ndi tsiku wotsatira.

7) Beta2-adrenergic agonists, omwe amawonetsedwa kuti agwiritse ntchito ngati jakisoni, amathandizira zolandilira beta2-adrenergic receptors, kukulitsa kuchuluka kwa shuga m'magazi am'magazi. Izi zingafune kuti wodwalayo achitenso njira zina zolimbana ndi hyperglycemia, yomwe, monga lamulo, imakhala ndi kufunika kwa kubayira insulin nthawi zonse m'magazi.

8) Zodumphitsa za loop sizikulimbikitsidwa kuti zigwiritsidwe ntchito nthawi yomweyo ndi Glucofage, makamaka pakakhala kulephera kwa impso. Izi zingayambitse kukula kwa lactic acidosis ndi zotsatirapo zonse zotsatirazi.

9) Njira zowongolera kuthamanga kwa magazi, komwe kuli m'gulu la ACE inhibitors, sikulimbikitsidwa kuti mugwiritse ntchito mukamatenga Glucofage. Amachepetsa kwambiri magazi ndipo amatha kupangitsa kuti shuga azitha, kenako ndikufa ndi matenda a minyewa ya muubongo.

10) Othandizira a Cationic, omwe akuphatikizapo Morphine, Quinine, Amiloride, Triamteren, etc., amatha kutsutsana ndi metformin, kulepheretsa mayamwidwe ake. Chifukwa chake, muyenera kupewa kugwiritsa ntchito mankhwalawa.

Zotsatira zoyipa

Kugwiritsa ntchito mankhwalawa kwakanthawi kumatha kubweretsa zotsatira zoyipa zingapo, zomwe zimafunikiranso kutchulidwa. Kuchokera pazomwe boma limapereka pamankhwala, zimatha kukhala ndi zotsatirapo zotsatirazi:

kukoma kwakachepa pakudya,
matenda am'mimba: m'mimba, kusanza, kupweteka kwam'mimba,
lactic acidosis
kuyamwa kwa vitamini B12 (makamaka kofunikira kwa magazi m'thupi),
zotupa, redness, kuyabwa,
hepatitis (nthawi zambiri pamakhala zinthu zolimbikitsa).

Ndikofunika kudziwa kuti zizindikiro zofala kwambiri m'zochitika zamankhwala ndizomwe zimaphatikizidwa pazinthu ziwiri zoyambira pamndandanda zomwe zimakhudzana mwachindunji ndi chimbudzi. Zina mwazotsatira zoyipa zomwe zimachitika chifukwa cha odwala zimachitika kawirikawiri kwa odwala, nthawi imodzi mwa zikwi zingapo. Kukhala kofunikira kuwonjezera kuti poyamba pazizindikiro za kuwonongeka kwa thanzi mukamamwa mankhwalawo, muyenera kufunsa dokotala kuti musavutike.

Malangizo apadera

Mu kafukufuku waposachedwa, zidapezeka kuti glucophage sichikhudza thanzi la ana nthawi yakutha msinkhu. Komabe, matendawa sangatchulidwe kuti ophunziridwa kotheratu, ndipo madokotala salimbikitsabe kugwiritsa ntchito mankhwalawa ali ndi zaka khumi mpaka khumi ndi zisanu ndi zitatu. Chifukwa chake, mwa ana, chida ichi sichikugwiritsidwa ntchito ndipo nthawi zambiri chimasinthidwa ndi analogues zotetezeka.

Kuwonetsetsa makamaka za zovuta zomwe zimadza chifukwa ch kumwa mankhwalawa ziyenera kuperekedwa kwa anthu omwe ali ndi vuto la kunenepa kwambiri chifukwa cha matenda am'mimba. Nthawi zambiri, chithandizo chawo chimachitika limodzi ndi kudya kwamphamvu, komwe, ndi mankhwala osokoneza bongo a metformin, angayambitse kusowa kwamphamvu kwa shuga m'magazi. Zomwezi zimagwiranso ntchito kwa digiri imodzi kapena inayo kwa odwala ena onse omwe ali ndi matenda a shuga 2. M'malo mwawo, chithandizo cha insulin chimagwiritsidwa ntchito pokhapokha, kutsimikizika kwakukulu ndikukukulitsa zochitika zolimbitsa thupi ndikuchepetsa zakudya.

Glucophage yokha siyingayambitse hypoglycemia, koma kuphatikiza ndi mankhwala pawokha, vutoli limakhala lofunikira. Chifukwa chake, palibe chifukwa chomwe mankhwalawo amatha kuphatikizidwa palokha ndi ayodini wokhala ndi ma radiopaque othandizira komanso mankhwala ena omwe akuwonetsedwa mu malangizo ogwiritsidwira ntchito mu gawo la "kugwirizanitsa ndi mankhwala". Zochita zanu zilizonse motere ziyenera kukhala zogwirizana ndi adotolo, omwe pamapeto pake adzagamulidwe; mutha kugwiritsira ntchito mitundu ya mankhwala mwachindunji.

Pomaliza

Glucophage ndi mankhwala osavulaza ndipo palokha sangathe kukulitsa chithunzi cha matendawa ndi hyperglycemia. Komabe, kuphatikiza ndi njira zina, zitha kukhala zowopsa thanzi la wodwalayo. Mndandanda wa contraindication kuti mugwiritse ntchito komanso kuchuluka kwa zovuta zomwe zingachitike ndi zochepa, koma zina zake ndizovuta kwambiri ndipo, pakakhala kuti sizingachitike ndi katswiri, zingayambitse matenda oopsa kwambiri. Chifukwa chake, mutha kugwiritsa ntchito mankhwalawa nokha pazokha komanso pachiwopsezo chanu.

Malingaliro a Ogwiritsa Ntchito

Kuchokera pa ndemanga za odwala, titha kunena kuti Glucofage ndiyothandiza kukonza shuga m'magazi, komabe, kugwiritsa ntchito kwake kokha kuchepa thupi sikungapindule, chifukwa makonzedwe amayenda ndi zovuta zingapo.

Kwa nthawi yoyamba yomwe tidamva za Glucofage kuchokera kwa agogo athu, omwe ali ndi matenda ashuga a 2 ndipo samatha kutsitsa shuga asanagwiritse ntchito mankhwala. Posachedwa, endocrinologist adamuuza Glucophage kwa iye 500 mg kawiri pa tsiku. Modabwitsa, kuchuluka kwa shuga kunatsika ndi theka, palibe mavuto omwe adapezeka.

Ndimamwa glucophage posachedwa. Poyamba, ndimadwala pang'ono ndipo ndimakhala wopanda nkhawa m'mimba. Pakatha pafupifupi milungu iwiri zonse zidapita. Mlozera wa shuga unatsika kuchoka pa 8.9 mpaka 6.6. Mlingo wanga ndi 850 mg patsiku. Posachedwa ndidayamba kuyabwa, mwina ndi mlingo waukulu.

Galina, wazaka 42. Lipetsk

Ndimalola Glucofage Long kuti muchepetse kunenepa. Mlingo amasinthidwa ndi endocrinologist. Ndinayamba ndi 750. Ndimadya monga nthawi zonse, koma kulakalaka chakudya kwatha. Ndinayamba kupita kuchimbudzi nthawi zambiri. Zinandichitira ngati nyimbo yotsuka.

Glucophage amatengedwa motsogozedwa ndi katswiri. Awa ndi mankhwala osokoneza bongo a odwala matenda ashuga a mtundu wachiwiri, osati mankhwala ochepetsa thupi. Dokotala wanga anandiuza izi. Kwa miyezi ingapo ndakhala ndikumwa pa 1000 mg patsiku. Miyezo ya shuga idatsika msanga, ndipo ndimayendedwe 2 kg.

Alina, wazaka 33, ku Moscow

Kanema kochokera kwa Dr. Kovalkov onena za Glucofage ya mankhwala:

Mtengo wa glucophage umatengera kuchuluka kwa zomwe zimagwira komanso kuchuluka kwa mapiritsi omwe ali phukusi.Mtengo wocheperako ndi ma ruble 80., Pamwamba kwambiri ndi ma ruble 300. Ndikofunikira kudziwa kuti kusiyana kotereku pamitengo kumadalira mtundu wa bizinesi, chilolezo cha malonda ndi kuchuluka kwa oyimira pakati.

Zotsatira zoyipa

Matenda a Metabolic ndi zakudya:
Osowa kwambiri: lactic acidosis (onani "Malangizo apadera"). Pogwiritsa ntchito metformin kwanthawi yayitali, kuchepa kwa mayamwidwe a vitamini B12 kungawonedwe. Ngati matenda am'madzi a megaloblastic apezeka, mwayi wa etiology wotere uyenera kuganiziridwa.

Kuphwanya kwamanjenje:
Nthawi zambiri: kulawa kusokonezeka.

Matenda am'mimba:
Nthawi zambiri: nseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba komanso kusowa kwa chakudya.
Nthawi zambiri zimachitika nthawi yoyamba ya chithandizo ndipo nthawi zambiri zimadutsa zokha. Popewa Zizindikiro, tikulimbikitsidwa kuti muzimwa metformin 2 kapena 3 pa tsiku nthawi yakudya kapena itatha. Kuchepetsa pang'ono kwa mankhwalawa kumathandizira kulolerana kwamatumbo.

Zovuta za pakhungu ndi minofu yolowera:
Osowa kwambiri: zimachitika pakhungu monga erythema, pruritus, zidzolo.

Kuphwanya chiwindi ndi chindapusa:
Osowa kwambiri: kuwonongeka kwa chiwindi ndi hepatitis, atatha kufooka kwa metformin, izi zosafunikira zimatha.

Zambiri zosindikizidwa, zotsatsa zam'mbuyo, komanso maphunziro azachipatala owerengeka mwa ana ochepera zaka 10-16 akuwonetsa kuti zotsatila za ana zimafanana mu chilengedwe komanso kuopsa kwa odwala.

Bongo

Chithandizo: ngati zizindikiro za lactic acidosis, chithandizo ndi mankhwala ziyenera kuyimitsidwa nthawi yomweyo, wodwalayo amayenera kugonekedwa kuchipatala mwachangu ndipo atatsimikiza kuchuluka kwa lactate, kufotokozera kuyenera kumveka bwino. Njira yothandiza kwambiri yochotsa lactate ndi metformin kuchokera mthupi ndi hemodialysis. Chithandizo cha Zizindikiro zimachitidwanso.

Kuchita ndi mankhwala ena

Iodini wokhala ndi radiopaque wothandizira: motsutsana ndi kaimidwe ka ntchito yaimpso kwa odwala omwe ali ndi matenda ashuga, kafukufuku wama radiology ogwiritsa ntchito ayodini yemwe amakhala ndi radiopaque angayambitse kukula kwa lactic acidosis. Kuchiza ndi Glucofage ® kuyenera kuthetsedwera malinga ndi ntchito ya impso maola 48 asanafike kapena panthawi yomwe mayeso a X-ray amagwiritsa ntchito ayodini omwe amakhala ndi radiopaque othandizira ndipo asayambenso kuyambika kale kuposa maola 48 atatha, pokhapokha ngati ntchito ya impso idadziwika ngati yovomerezeka pakubwereza.

Mowa: ndi kuledzera kwa pachimake, chiopsezo chokhala ndi lactic acidosis imawonjezeka, makamaka:

kuperewera kwa zakudya m'thupi, zakudya zopatsa mphamvu zochepa,
kulephera kwa chiwindi.

Mukamwa mankhwalawa, mowa ndi mankhwala okhala ndi Mowa zimayenera kupewedwa.

Kuphatikiza komwe kumafunikira kusamala

Danazole: munthawi yomweyo makonzedwe a danazol ali osavomerezeka kuti apewe hyperglycemic zotsatira zomaliza. Ngati mankhwala a danazol akufunika ndipo atayimitsa koyamba, kusintha kwa mankhwala Glucofage ® kumafunikira motsogozedwa ndi kuchuluka kwa shuga m'magazi.

Chlorpromazine: Pamene kumwedwa mu waukulu Mlingo (100 mg patsiku) kumawonjezera kuchuluka kwa shuga m'magazi, kuchepetsa kutulutsidwa kwa insulin. Mankhwalawa antipsychotic ndipo atayimitsa chomaliza, kusintha kwa mankhwalawa kumafunikira motsogozedwa ndimagazi a shuga.

Glucocorticosteroids (GCS) zokhudza zonse ndi kwanuko zimachepetsa kulolera kwa glucose, kuonjezera kuchuluka kwa shuga m'magazi, nthawi zina zimapangitsa ketosis. Mankhwalawa corticosteroids ndipo atayimitsa kudya kwa chakumapeto, kusintha kwa mankhwala Glucofage ® kumafunika motsogozedwa ndi kuchuluka kwa shuga m'magazi.

Zotsatira: kugwiritsa ntchito munthawi yomweyo "kudzikongoletsa" okodzetsa kungayambitse kukula kwa lactic acidosis chifukwa chakulephera kugwira ntchito kwaimpso. Glucofage ® sayenera kukhazikitsidwa ngati chilolezo cha creatinine chili pansi pa 60 ml / min.

Beta yosavomerezeka₂-adrenomimetics: kuwonjezera kuchuluka kwa shuga wamagazi chifukwa cha kukondoweza kwa beta₂-makampani. Poterepa, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi. Ngati ndi kotheka, insulin ikulimbikitsidwa.
Pogwiritsa ntchito nthawi yomweyo mankhwala omwe ali pamwambawa, kuwunika pafupipafupi magazi a shuga kungafunike, makamaka kumayambiriro kwa chithandizo. Ngati ndi kotheka, mlingo wa metformin ungasinthidwe munthawi yamankhwala ndikatha.

Mankhwala a antihypertensive, kupatulapo angiotensin otembenuza enzyme zoletsa, kumachepetsa shuga. Ngati ndi kotheka, mlingo wa metformin uyenera kusinthidwa.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala Glucofage ® s zotumphukira za sulfonylurea, insulin, acarbose, salicylates hypoglycemia imayamba.

Nifedipine kumawonjezera mayamwidwe ndi max wa metformin.

Mankhwala a Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim ndi vancomycin) omwe amatulutsidwa mu renal tubules akupikisana ndi metformin yama kachitidwe kazinthu ka ma tubular ndipo angayambitse kuchuluka kwa C max.

Wopanga

Kapena ngati mutayika mankhwala a LLC Nanolek:

Wopanga
Kupanga kwa mitundu yomaliza ya kuchuluka ndi ma CD (ma CD oyambira)
Merck Sante SAAS, France
Center de Production Semois, 2 rue du Pressoire Ver - 45400 Semois, France

Chachiwiri (ma CD a ogula) ndikupereka mawonekedwe oyang'anira:
Nanolek LLC, Russia
612079, dera la Kirov, chigawo cha Orichevsky, mudzi wa Levintsy, Biomedical tata "NANOLEK"

Wopanga
Magawo onse opanga, kuphatikiza kuwongolera khalidwe:
Merck S. L., Spain
Polygon Merck, 08100 Mollet Del Valles, Barcelona, Spain.

Zodandaula za ogula ziyenera kutumizidwa kwa:
LLC "Merk"
115054 Moscow, st. Zokwanira, d. 35.