Galvus Met > Chithandizo ndi kupewa

Kufotokozera kogwirizana ndi 23.11.2014

Dzina lachi Latin: Galvus adakumana
Code ya ATX: A10BD08
Chithandizo: Vildagliptin + Metformin (Vildagliptin + Metformin)
Wopanga: Novartis Pharma Production GmbH., Germany, Novartis Pharma Stein AG, Switzerland

Mapiritsiwo ali ndi zosakaniza: vildagliptin ndi metformin hydrochloride.

Zowonjezera: hyprolose, hypromellose, magnesium stearate, titanium dioxide, talc, macrogol 4000, iron oxide chikasu ndi ofiira.

Zizindikiro zogwiritsidwa ntchito

Mankhwala amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri:

monga mankhwala okhawo omwe amaphatikiza ndi zakudya komanso zolimbitsa thupi Kafukufuku akuwonetsa kuti chithandizo chotere chimapereka mphamvu yayitali,
kuphatikiza ndi metformin kumayambiriro kwa mankhwala, osakwanira chifukwa chamadyedwe komanso kuchuluka kwa zochitika zolimbitsa thupi,
kwa anthu omwe amagwiritsa ntchito analogues yomwe ili ndi vildagliptin ndi metformin, mwachitsanzo Galvus Met.
Mankhwala osokoneza bongo omwe ali ndi vildagliptin ndi metformin, komanso kuwonjezera kwa mankhwala okhala ndi sulfonylureas, thiazolidinedione, kapena insulin. Amagwiritsidwa ntchito pazochitika za kulephera kwa chithandizo cha mankhwala a monotherapy, komanso zakudya komanso zolimbitsa thupi.
monga katatu mankhwala osagwirizana ndi kugwiritsa ntchito mankhwala okhala ndi sulfonylurea ndi zotumphukira za metformin, zomwe m'mbuyomu zimagwiritsidwa ntchito pokhapokha ngati zakudya komanso kuwonjezera zolimbitsa thupi.
monga katatu mankhwala osagwirizana ndi kugwiritsa ntchito mankhwala okhala ndi insulin ndi metformin, omwe adagwiritsidwa ntchito kale, omwe amapezeka pakudya komanso kuchuluka kwa zolimbitsa thupi.

Mlingo ndi njira zogwiritsira ntchito mankhwalawa

Mlingo wa mankhwalawa amasankhidwa aliyense payekha kwa wodwala aliyense potengera zovuta za matendawa komanso kulolerana kwake ndi mankhwalawa. Kulandila kwa Galvus masana sikudalira chakudya. Malinga ndi ndemanga, ndiye popanga matenda, mankhwalawa amaperekedwa nthawi yomweyo.

Mankhwalawa ndi monotherapy kapena osakanikirana ndi metformin, thiazolidinedione kapena insulin amatengedwa kuchokera 50 mpaka 100 mg patsiku. Ngati wodwalayo ali ndi vuto lalikulu komanso insulini imagwiritsidwa ntchito kukhazikika pamlingo wa shuga mthupi, ndiye kuti mlingo wa tsiku ndi tsiku ndi 100 mg.

Mukamagwiritsa ntchito mankhwala atatu, mwachitsanzo, vildagliptin, zotumphukira za sulfonylurea ndi metformin, chizolowezi cha tsiku ndi tsiku ndi 100 mg.

Mlingo wa 50 mg tikulimbikitsidwa kuti timwe piritsi limodzi m'mawa, mlingo wa 100 mg uyenera kugawidwa mu milingo iwiri: 50 mg m'mawa komanso chimodzimodzi madzulo. Ngati pazifukwa zina zakusowa mankhwala, ayenera kumwedwa mwachangu, osapitirira muyeso wa tsiku ndi tsiku wa mankhwalawo.

Mlingo wa tsiku ndi tsiku wa Galvus pochiza mankhwala awiri kapena kuposa ndi 50 mg patsiku. Popeza mankhwalawa omwe amagwiritsidwa ntchito popanga zovuta pamodzi ndi Galvus amalimbikitsa zotsatira zake, tsiku lililonse 50 mg imafanana ndi 100 mg patsiku ndi monotherapy ndi mankhwalawa.

Ngati chithandizo cha mankhwalawa sichikwaniritsidwa, tikulimbikitsidwa kuti muwonjezere mlingo mpaka 100 mg patsiku, ndikulembanso metformin, sulfonylureas, thiazolidinedione kapena insulin.

Odwala omwe ali ndi vuto lakumagwira ntchito kwamkati, monga impso ndi chiwindi, mlingo waukulu wa Galvus suyenera kupitilira 100 mg patsiku. Mu vuto la impso, tsiku lililonse mankhwalawa sayenera kupitirira 50 mg.

Analogs a mankhwalawa, omwe ali ndi mawonekedwe a code ya ATX-4: Onglisa, Januvia. Omwe amafananirana ndi zinthu zomwezi ndi Galvus Met ndi Vildaglipmin.

Kuunika kwa odwala pamankhwala awa, komanso kafukufuku kumaonetsa kusinthasintha kwawo pochiza matenda ashuga.

Zotsatira zoyipa

Kugwiritsa ntchito mankhwala ndi Galvus Met kumatha kukhudza ntchito ya ziwalo zamkati ndi mkhalidwe wathupi lathunthu. Zotsatira zoyipa zomwe zimadziwika kwambiri ndi izi:

chizungulire ndi mutu
miyendo yanjenjemera
kumverera kozizira
kusanza pamodzi ndi kusanza
gastroesophageal Reflux,
kupweteka ndi kupweteka kwambiri pamimba,
zotupa pakhungu,
kusokonezeka, kudzimbidwa ndi matenda otsekula m'mimba,
kutupa
otsika thupi kukana matenda ndi ma virus,
ogwira ntchito ochepa komanso wotopa mwachangu,
matenda a chiwindi ndi kapamba, mwachitsanzo, chiwindi ndi kapamba,
Kusenda kwamphamvu pakhungu,
mawonekedwe a matuza.

Contraindication kugwiritsa ntchito mankhwalawa

Zotsatira ndi ndemanga zotsatirazi zingakhale zotsutsana pamankhwala awa:

thupi lawo siligwirizana kapena kutsutsana ndi zinthu za mankhwala,
matenda a impso, kulephera kwa impso ndi vuto laimpso,
zinthu zomwe zingayambitse matenda a impso, mwachitsanzo, kusanza, kutsegula m'mimba, kutentha thupi komanso matenda opatsirana.
Matenda a mtima, kulephera mtima, kulowerera kwamitsempha,
matenda kupuma
matenda ashuga ketoacidosis oyambitsidwa ndi matenda, chikomokere kapena boma lokhala ndi vuto la matenda ashuga. Kuphatikiza pa mankhwalawa, kugwiritsa ntchito insulin ndikofunikira,
kudzikundikira kwa lactic acid mthupi, lactic acidosis,
mimba ndi kuyamwitsa,
mtundu woyamba wa matenda ashuga
uchidakwa kapena uchidakwa.
kutsatira zakudya zokhwima, komwe kudya calorie sikupitilira 1000 patsiku,
zaka odwala. Kukhazikitsidwa kwa mankhwalawa kwa odwala ochepera zaka 18 sikulimbikitsidwa. Anthu opitilira zaka zopitilira 60 amalimbikitsidwa kumwa mankhwalawa moyang'aniridwa ndi madokotala,
Mankhwala ayimitsidwa kutenga masiku awiri opaleshoni isanachitike, mayeso a radiographic kapena kuyambitsa kusiyana. Ndikulimbikitsidwanso kukana kugwiritsa ntchito mankhwalawa kwa masiku awiri pambuyo pa njirazi.

Popeza mukamamwa Galvus kapena Galvus Meta, chimodzi mwazomwe zimakhudza kwambiri ndi lactic acidosis, odwala matenda a chiwindi ndi impso sayenera kugwiritsa ntchito mankhwalawa kuchiza matenda amtundu wa 2.

Odwala a zaka zopitilira 60, chiopsezo cha zovuta za matenda a shuga, kupezeka kwa lactic acidosis, omwe amayamba chifukwa cha mankhwala omwe amapezeka mu mankhwala - metformin, amawonjezeka kangapo. Chifukwa chake, iyenera kugwiritsidwa ntchito mosamala kwambiri.

Kugwiritsa ntchito mankhwalawa panthawi yapakati komanso poyamwitsa

Zotsatira za mankhwalawa kwa amayi apakati sizinaphunzirebe, chifukwa chake makonzedwe ake saloledwa kwa amayi apakati.

Milandu yowonjezera kuchuluka kwa shuga mwa amayi apakati, pamakhala chiwopsezo cha kubereka kwakakhanda kwa mwana, komanso kupezeka kwa matenda osiyanasiyana ngakhale kufa kwa mwana wosabadwayo. Pankhani ya shuga ochulukirapo, tikulimbikitsidwa kugwiritsa ntchito insulin kuti isinthe.

Mukufufuza momwe mankhwalawa amathandizira thupi la mayi wapakati, Mlingo wopitilira 200 nthawi yomweyo unayambitsidwa. Pankhaniyi, kuphwanya chitukuko cha mwana wosabadwayo kapena zovuta zilizonse zachitukuko sizinapezeke. Ndi kukhazikitsidwa kwa vildagliptin osakanikirana ndi metformin paziwerengero 1: 10, kuphwanya kwamkati mwa chiberekero cha mwana wosabadwa sikunalembedwe.

Komanso, palibe deta yodalirika pakufukuka kwa zinthu zomwe ndi gawo la mankhwala mukamayamwa mkaka. Pankhaniyi, amayi oyamwitsa salimbikitsidwa kumwa mankhwalawa.

Zokhudza kugwiritsa ntchito mankhwalawa ndi anthu ochepera zaka 18 sizinafotokozedwe pakadali pano. Zotsatira zoyipa zogwiritsa ntchito mankhwalawa ndi odwala a m'badwo uno sizikudziwika.

Malangizo apadera

Ngakhale kuti mankhwalawa amagwiritsidwa ntchito kuti matenda abwinobwino asakhale mtundu wa shuga wachiwiri, awa si ma insulin analogues. Mukamagwiritsa ntchito, madokotala ankalimbikitsa nthawi zonse kudziwa ntchito za chiwindi.

Izi ndichifukwa choti vildagliptin, yomwe ndi gawo la mankhwalawa, imapangitsa kuti ntchito ya aminotransferases iwonjezeke. Izi sizipeza chiwonetsero chilichonse, koma zimayambitsa kusokonezeka kwa chiwindi. Izi zimawonedwa mwa odwala ambiri ochokera ku gulu lowongolera.

Odwala omwe amamwa mankhwalawa kwa nthawi yayitali koma osagwiritsa ntchito mawonekedwe awo amalimbikitsidwa kuti azichita kuyezetsa magazi kamodzi pachaka. Cholinga cha phunziroli ndikuwonetsa zopatuka kapena zovuta zilizonse poyambira komanso kukhazikitsidwa kwakanthawi kwa njira zowathetsera.

Ndi mavuto amanjenje, kupsinjika, minyewa, mphamvu ya mankhwala kwa wodwalayo itha kuchepetsedwa kwambiri. Makamaka wodwala akuwonetsa zovuta za mankhwalawa monga mseru komanso chizungulire. Ndi zizindikiro zoterezi, ndikulimbikitsidwa kuti musayendetse kapena kugwira ntchito yowopsa.

Zofunika! Maola 48 asanakudziwe mtundu uliwonse wa mankhwalawa ndikugwiritsa ntchito wothandizira wosiyana, ndikulimbikitsidwa kuti musiyire kumwa mankhwalawa. Izi ndichifukwa choti kusiyana komwe kuli iodini, pophatikizana ndi zigawo zina za mankhwala, kumatha kuwononga kwambiri ntchito za impso ndi chiwindi. Potengera izi, wodwalayo atha kukhala ndi lactic acidosis.

Galvus meth: ndemanga za anthu odwala matenda ashuga, malangizo ogwiritsira ntchito

Mankhwala omwe Galal adakumana nawo adapangidwira kuti athandizire komanso kupumula kwa matenda a shuga mellitus a fomu yodziyimira payekha. Mankhwala amakono apanga mitundu yambiri ya mankhwala osiyanasiyana a magulu osiyanasiyana ndi makalasi.

Ndi mankhwala ati omwe angagwiritse ntchito komanso zomwe zili bwino kwa odwala omwe ali ndi vutoli kuti alepheretse matenda komanso kuletsa zovuta zoyipa zomwe zimatsimikizidwa ndi dotolo yemwe akutsogolera matenda.

Mankhwala amakono amagwiritsa ntchito mitundu ingapo yamankhwala kuti achepetse kuchuluka kwa glucose ndikukhalitsa kagayidwe kazakudya mthupi.

Mankhwala aliwonse ayenera kuperekedwa ndi katswiri wazachipatala.

Pankhaniyi, kudzichitira nokha kapena kusintha kwa mankhwalawa, mlingo wake umaletsedwa mwamphamvu, chifukwa zingayambitse mavuto.

Polimbana ndi matenda a zam'mimba, muyenera kukumbukira kuti kumwa mankhwala kuyenera kutsagana ndi kuwunika konsekonse wamagulu a shuga m'magazi.

Mpaka pano, chithandizo cha matenda a shuga 2 ndi kugwiritsa ntchito imodzi mwa magulu otsatirawa a zida zamankhwala:

Mankhwala omwe amasankhidwa kuti alandire chithandizo ayenera kumwedwa pamankhwala omwe dokotala amafotokozera.

Kuphatikiza apo, momwe wodwalayo alili, kuchuluka kwa zochitika zolimbitsa thupi, kulemera kwa thupi kuyenera kukumbukiridwa.

Kodi mankhwala a hypoglycemic ndi ati?

Mankhwala a Galvus omwe adakumana nawo ndi hypoglycemic mankhwala opaka pakamwa. Zigawo zikuluzikulu zogwiritsa ntchito mankhwalawa ndi zinthu ziwiri - vildagliptin ndi metformin hydrochloride

Vildagliptin ndi nthumwi ya kalasi ya zopititsa muyeso ya zida zam'mapapo. Gawoli limathandizira chidwi cha maselo a beta kuti ilowe shuga momwe iwonongera. Tiyenera kudziwa kuti pamene zinthu zoterezi zimatengedwa ndi munthu wathanzi, palibe kusintha kwa shuga m'magazi.

Metformin hydrochloride ndi woimira gulu lachitatu-greatuanide gulu, lomwe limathandizira kuletsa kwa gluconeogeneis. Kugwiritsa ntchito mankhwala ozikidwa ndikulimbikitsa glycolysis, komwe kumapangitsa kuti shuga azikhala bwino ndi maselo komanso minyewa ya thupi. Kuphatikiza apo, pali kuchepa kwa mayamwidwe am'magazi ndimaselo a m'matumbo. Ubwino wawukulu wa metformin ndikuti siziyambitsa kuchepa kwambiri kwa glucose (m'munsimu muyezo) ndipo sizitsogolera pakupanga hypoglycemia.

Kuphatikiza apo, mapangidwe a Galvus adakumana ndi ophatikizira osiyanasiyana. Mapiritsi oterewa nthawi zambiri amathandizidwa kwa odwala omwe ali ndi matenda a shuga, chifukwa amathandizira kagayidwe ka lipid m'thupi, komanso amathandizira kuchepetsa kuchuluka kwa cholesterol yoyipa (kuwonjezera kuchuluka kwa zabwino), triglycerides ndi otsika kachulukidwe lipoproteins.

Mankhwalawa ali ndi mawonekedwe otsatirawa oti mugwiritse ntchito:

ngati chithandizo chakuchiritsa kwa matenda a shuga 2, pomwe chofunikira ndikusungabe zakudya zopatsa thanzi komanso kuchita masewera olimbitsa thupi moyenera.
kusintha zina za Galvus Met zogwira ntchito
Ngati chithandizo sichingathandize mutamwa mankhwalawa pogwiritsa ntchito mankhwala amodzi - metformin kapena vildagliptin,
mankhwalawa zovuta ndi insulin mankhwala kapena sulfonylurea.

Galvus adakumana ndi malangizo ogwiritsa ntchito akuwonetsa kuti mankhwalawa amachokera ku lumen ya m'matumbo ang'ono kulowa m'magazi. Chifukwa chake, mphamvu ya mapiritsi imawonedwa mkati mwa theka la ola atatha kutsata.

Chochita chogawidacho chimagawidwa mthupi lonselo, ndipo kenako chimataya limodzi ndi mkodzo komanso ndowe.

Mankhwala Galvus - malangizo, ntchito, ndemanga, kugwiritsa ntchito

Mankhwalawa mtundu 2 shuga mellitus, akatswiri nthawi zambiri mankhwala Galvus. Monga gawo la mankhwalawa, vildagliptin ndiye gawo lalikulu. Izi zili ngati mapiritsi. Ndemanga za madotolo ndi odwala za mankhwalawo zili ndi zabwino zina.

Zotsatira zazikulu zomwe zimachitika pakumwa mankhwalawa ndi kukondoweza kwa kapamba, kapena,, islet zida. Zotere zimabweretsa kutsika kogwira mtima pakupanga enzyme dipeptidyl peptidase-4. Kuchepetsa kapangidwe kake kumabweretsa kuwonjezeka kwa katulutsidwe ka glucagon ngati peptide ya mtundu 1.

Mukamapereka mankhwala a Galvus, malangizo omwe angagwiritsidwe ntchito amalola wodwalayo kudziwa zomwe akuwonetsa pogwiritsa ntchito mankhwalawa. Chachikulu ndi matenda ashuga 2:

Pambuyo pakuzindikira, katswiri aliyense payekha amasankha mtundu wa mankhwalawa pochiza matenda ashuga. Mukamasankha mulingo wa mankhwala, zimachokera kuopsa kwa matendawa, komanso imawerengera munthu payekha mankhwala.

Wodwala sangathe kuwongolera ndi chakudya panthawi ya Galvus. Omwe adakhalapo okhudzana ndi ndemanga za Galvus akuwonetsa kuti atazindikira kuti ali ndi matenda a shuga a 2, akatswiri ndi oyamba kupereka mankhwala awa.

Pochita zovuta mankhwala, kuphatikiza metformin, thiazolidinedione kapena insulin Galvus amatengedwa pa mlingo wa 50 mpaka 100 mg patsiku. Ngati wodwalayo ali ndi vuto lalikulu, ndiye kuti insulini imagwiritsidwa ntchito kuonetsetsa kuti migwirizano yama shuga a magazi. Zikatero, mulingo woyenera wa mankhwalawa sayenera kupitirira 100 mg.

Ngati dokotala watumiza njira yothandizirana ndi mankhwalawa yomwe imaphatikizapo kumwa mankhwala angapo, mwachitsanzo, Vildagliptin, zotumphukira za sulfonylurea ndi Metformin, pamenepa mlingo wa tsiku lililonse uyenera kukhala 100 mg.

Akatswiri othandizira kuthetsa matendawa ndi Galvus amalimbikitsa kumwa 50 mg wa mankhwalawa kamodzi m'mawa. Madokotala amalimbikitsa kugawa muyezo wa 100 mg mu mgawo iwiri. 50 mg iyenera kumwa m'mawa ndi kuchuluka komweko kwamankhwala. Ngati wodwala walephera kumwa mankhwalawo pazifukwa zina, ndiye kuti izi zitha kuchitika posachedwa.Dziwani kuti mulibe vuto lililonse kuti mulingo womwe dokotala akutsimikiza adutsenso.

Ngati matenda amathandizidwa ndi mankhwala awiri kapena angapo, mlingo wa tsiku ndi tsiku sayenera kupitirira 50 mg. Izi ndichifukwa choti njira zina zikavomerezedwa kuwonjezera pa Galvus, ndiye zotsatira za mankhwala akuluakulu zimatheka kwambiri. Zikatero, mlingo wa 50 mg umafanana ndi 100 mg ya mankhwalawa pa monotherapy.

Ngati mankhwalawa sabweretsa zotsatira zomwe akufuna, akatswiri amawonjezera mlingo mpaka 100 mg patsiku.

Odwala omwe amadwala osati matenda a shuga okha, komanso ali ndi vuto pakugwira ntchito kwa ziwalo zamkati, makamaka, impso ndi chiwindi, mlingo wa mankhwalawa pochiza matenda oyamba sayenera kupitirira 100 mg patsiku. Ngati pali vuto laimpso lalikulu, ndiye kuti adokotala akuyenera kukupatsani mankhwala a 50 mg. Analog ya Galvus ndi mankhwala monga:

Analogue yomwe ili ndi gulu lofananira momwe limapangidwira ndi Galvus Met. Pamodzi ndi izo, madokotala nthawi zambiri amamulembera Vildaglipmin.

Mankhwala akapatsidwa mankhwala, Galvus Met, mankhwalawa amatengedwa pakamwa, ndipo ndikofunikira kumwa mankhwalawa ndi madzi ambiri. Mlingo wa wodwala aliyense amasankhidwa payekha ndi dokotala. Poterepa, ndikofunikira kukumbukira kuti pazokwanira Mlingo sayenera kupitirira 100 mg.

Kumayambiriro kwa mankhwalawa ndi mankhwalawa, mlingo umayikidwa poganizira omwe kale anali Vildagliptin ndi Metformin. Kuti zinthu zoyipa za m'mimba zitha kuchotsedwa pa mankhwalawa, mankhwalawa amayenera kumwedwa ndi chakudya.

Ngati chithandizo ndi Vildagliptin sichikupereka zotsatira zomwe mukufuna, ndiye kuti mutha kulembetsa ngati njira ya chithandizo Galvus Met. Kumayambiriro kwa maphunziro, mankhwalawa 50 mg 2 kawiri pa tsiku ayenera kumwedwa. Pakapita kanthawi kochepa, kuchuluka kwa mankhwalawa kumatha kuwonjezereka kuti mukhale ndi mphamvu.

Ngati chithandizo ndi Metformin sichinalole kuti mukhale ndi zotsatira zabwino, ndiye kuti mlingo womwe umayikidwa umaganiziridwa pamene Glavus Met ikuphatikizidwa mu regimen yothandizira. Mlingo wa mankhwalawa poyerekeza ndi Metoformin ukhoza kukhala 50 mg / 500 mg, 50 mg / 850 mg kapena 50 mg / 1000 mg. Mlingo wa mankhwalawa uyenera kugawidwa mu 2 Mlingo. Ngati Vildagliptin ndi Metformin mu mawonekedwe a mapiritsi amasankhidwa ngati njira yayikulu yothandizira, ndiye kuti Galvus Met imayikidwa, yomwe imayenera kumwa 50 mg tsiku lililonse.

Chithandizo ndi wothandiziriridwayo sichiyenera kuperekedwa kwa odwala omwe ali ndi vuto la impso, Kulephera kwaimpso. Izi zikuchitika chifukwa chakuti piritsi lomwe limagwiritsidwa ntchito pa mankhwalawa limachotsedwa m'thupi pogwiritsa ntchito impso. Ndi zaka, ntchito yawo mwa anthu imayamba kuchepa. Izi zimachitika kawirikawiri kwa odwala omwe atha zaka 65.

Kwa odwala omwe ali ndi zaka zino, Galvus Met adayikidwa muyezo wocheperako, ndipo kutumikiridwa kwa mankhwalawa kumatha kupangidwa pambuyo poti umboni wapezeka kuti impso za wodwalayo zikugwira ntchito mwachizolowezi. Mankhwala, dokotala amayenera kuyang'anira momwe amagwirira ntchito.

Mu malangizo ogwiritsira ntchito, wopanga mankhwala a Galvus Met akuwonetsa kuti kudya mankhwalawa kumatha kuwononga ntchito ya ziwalo zamkati ndikuwononga mkhalidwe wathupi lathunthu. Nthawi zambiri, odwala ali kutsatira zizindikiro zosasangalatsa Gwiritsani ntchito mankhwalawa

kuzizira
kupweteka m'mimba
mawonekedwe a khungu loyipa pakhungu,
m'mimba thirakiti kusokonekera mu mawonekedwe a kudzimbidwa ndi kutsegula m'mimba,
dziko lotupa
utachepa thupi kukana matenda,
mawonekedwe a khungu.
mawonekedwe a pakhungu la zotupa.

Musanayambe mankhwala ndi mankhwalawa, ndikofunikira kuti mudziwe zolakwika zomwe zimapezeka mu malangizo a Galvus. Izi zikuphatikiza ndi izi:

kupezeka kwa sayanjana kapena kusalolera pazinthu zomwe ndi gawo lamankhwala.
kukhalapo kwa matenda a impso, kulephera kwa impso kapena kuphwanya ntchito yawo,
Matenda a wodwalayo, omwe angayambitse kuwonongeka kwa impso,
matenda a mtima
matenda kupuma
kudzikundikira m'thupi la wodwalayo kuchuluka kwa lactic acid,
kumwa kwambiri, poizoni,
Zakudya zopatsa thanzi zomwe zopatsa mphamvu zopatsa mphamvu sizidakwanitsa zopitilira 1000 patsiku,
zaka odwala. Madokotala nthawi zambiri samapereka mankhwalawa kwa anthu omwe sanakwanitse zaka 18. Kwa odwala opitirira zaka 60, mankhwalawa amalimbikitsidwa kuti azimuyang'aniridwa ndi adokotala.

Nditapezeka kuti ndili ndi matenda ashuga, adotolo adandipatsa mapiritsi a Galvus Met. Kuyamba kumwa mankhwalawa, nthawi yomweyo ndidakumana ndi mavuto. Vuto loyamba lomwe linandichitikira ndikutuluka kwa miyendo. Komabe, patapita kanthawi, zonse zapita. Ndimamwa mankhwala onse m'mawa. Kwa ine, izi ndizothandiza kwambiri kuposa kugawa Mlingo m'mitundu iwiri. Ndimakumbukira, tsopano ndili ndi mavuto ena ndipo nthawi zina ndimayiwala kumwa mapiritsi madzulo.

Matenda a 2 a matenda a shuga ndi matenda omwe ndi ovuta kuwazindikira. Matendawa ali ndi zizindikilo zambiri zomwe aliyense angaphunzire pa intaneti. Galvus Met wochizira matendawa adandipeza ndi adotolo atazindikira matendawa. Ndikufuna kudziwa kuti mtengo wa chida ichi ndiwokwera kwambiri. Powerenga ndemanga yokhudza mankhwalawa, nthawi zambiri ndimakumana ndikutchula za izi.

Pofuna kuchiza matenda anga, ndidagula mankhwala mu umodzi mwa malo ogulitsira, komwe mankhwalawa ndi otsika mtengo. Ubwino waukulu wa Galvus ndikuti, mosiyana ndi analogues, chida ichi ndichothandiza kwambiri. Aka si koyamba kuti ndimwe mankhwala, ndipo sindinapeze njira yabwino yothandizira mankhwalawa a matenda a shuga. Ndikufuna kumulangiza kwa aliyense amene wakumanapo ndi zovuta ngati izi. Kuti mankhwalawa akhale othandiza, musaiwale za zakudya zowonjezera, komanso monga masewera olimbitsa thupi pazochitika zanu za tsiku ndi tsiku.

Ndi matenda a shuga a monotherapy, mutha kugwiritsa ntchito Galvus Met kapena mugwiritse ntchito mankhwalawa pamodzi. Ndikufuna kudziwa kuti lingaliro la kukhazikitsidwa kwa mankhwalawa liyenera kupangidwa kokha ndi adokotala. Amayi anga, omwe akudwala matenda ashuga, mankhwala ophatikiza sanakwane. Panali zotsatirapo zosasangalatsa - chilonda cham'mimba chinapangidwa. Amachotsa Galvus mosavuta kuposa kuphatikiza njira zina. Komabe, ndikufuna kudziwa kuti momwe mankhwalawa amachitikira ndi osiyanasiyana kwa munthu aliyense.

Munthawi ya chithandizo ndi mankhwalawa, zotsatira za kuchepa thupi zimachitika, zomwe ndizofunikira kwambiri kwa odwala matenda a shuga. Koma kumwa mankhwala muyezo wa 50 mg sikumapangitsa kuchepa kwa thupi. Komabe, momwe zimachitikira m'mimba sizilimba. Mankhwalawa ali ndi mndandanda wazopikisana zomwe muyenera kudziwa pasadakhale. Izi ndizofunikira kwambiri kwa anthu omwe ali ndi matenda a impso kapena omwe ali ndi vuto la chiwindi.

Chiwerengero cha anthu odwala matenda a shuga chikukulirakulira mosalekeza. Pambuyo pakuzindikira, madokotala nthawi zambiri amapereka mankhwala a Galvus, omwe mwa mankhwala onse omwe amaperekedwa pochiza matenda a shuga. ndi imodzi yothandiza kwambiri. Tiyenera kunena kuti mankhwalawa amatha kugwiritsidwa ntchito padera komanso monga gawo la mankhwala othandizira molumikizana ndi othandizira ena omwe ali ndi insulin. Komabe, ndi dokotala wokhayo amene ali ndi ufulu wopereka mankhwala.

Kugwiritsa ntchito mankhwalawa muyezo womwe dokotala amakupatsani. Komabe, kuti mukwaniritse zomwe mukufuna, ndikofunikira kutsatira malingaliro onse a katswiri, ndipo kuwonjezera pa izi, kutsatira zakudya komanso kuphatikiza zolimbitsa thupi muzinthu zanu zatsiku ndi tsiku. Pankhaniyi, kugwiritsa ntchito bwino kwa mankhwalawa kumawonjezeka kwambiri.

Wodwala aliyense ayenera kudziwa za contraindication omwe amapezeka ndi mankhwala a Galvus Pamaso mankhwala. Pambuyo pa zaka 65, mankhwalawa ayenera kuikidwa mosamala kwambiri. Zigawo zikuluzikulu za mankhwalawa zimapukutidwa ndi impso, chifukwa chake pazikhala zosagwirizana.

Atakalamba, ntchito ya impso imachepa, chifukwa chake, popereka mankhwala kwa odwala otere, dokotala wopezekapo amayenera kuwunika ntchito ya impso. Muyeneranso kudziwa kuti kumwa mowa kwambiri ndi kuphwanya kukhazikitsidwa kwa chida ichi.

Osati nthawi zonse m'masitolo mumatha kupeza mankhwala a Galvus ochizira matenda a shuga. Komabe, vutoli limathetsedwa mosavuta chifukwa cha kupezeka kwa maukonde a mankhwala chiwerengero chachikulu cha analogu. Mitundu yosiyanasiyana yazogwirizira imalola aliyense kusankha chinthu, poganizira momwe zimagwirira ntchito komanso mtengo wake.

Kugwiritsa ntchito analogue kumakuthandizani kuti musasokoneze njira yochizira ndikuchotsa matenda omwe abwera mwachangu. Musanagule mankhwala enaake, muyenera kuwerengera zamawu ake za mankhwalawo. Mutha kupeza zambiri mwa iwo.

Ndemanga za mankhwala imakhala ndi chidziwitso pakugwiritsa ntchito mankhwalawa, zoyipa ndi zovuta zina zogwiritsa ntchito. Mukungoyang'ana chidziwitsochi, mutha kusankha njira yabwino, kupewa mavuto chifukwa chodwala komanso kuchiritsa matenda omwe abwera.

Galvus Met ndi mankhwala othandiza odwala matenda ashuga amtundu wa 2, omwe ali odziwika kwambiri, ngakhale ali ndi mtengo wokwera.

Imachepetsa shuga m'magazi ndipo sikuti imayambitsa mavuto akulu. Zosakaniza zomwe zimagwiritsidwa ntchito pophatikiza ndi vildagliptin ndi metformin.

Pa tsambali mupezapo zambiri za Galvus Met: malangizo onse ogwiritsira ntchito mankhwalawa, mitengo ya m'misika, mankhwala osakwanira osakwanira, komanso ndemanga za anthu omwe agwiritsa kale ntchito Galvus Met. Mukufuna kusiya malingaliro anu? Chonde lembani ndemanga.

Oral hypoglycemic mankhwala.

Amamasulidwa pa mankhwala.

Kodi Galvus Met imawononga ndalama zingati? Mtengo wapakati pama pharmacies uli pamlingo wa rubles 1,600.

Mlingo wa Galvus Met wotulutsidwa - mapiritsi okhala ndi filimu: chowulungika, chopindika, NVR yolemba mbali imodzi, 50 + 500 mg - kuwala kaso ndi pang'ono pinki tinge, LLO polemba mbali ina, 50 + 850 mg - wachikasu wokhala ndi mtundu wonyezimira wopanda pake, wokhala ndi mbali inayi ndi SEH, 50 + 1000 mg ndi wachikaso chakuda ndi utoto wonyezimira, wolemba mbali inayo ndi FLO (m'matumba a 6 kapena 10 ma PC., pamakatoni a 1, 3, 5, 6, 12, 18 kapena 36 matuza).

Piritsi limodzi la 50 mg / 850 mg lili ndi 50 mg ya vildagliptin ndi 850 mg ya metformin hydrochloride,
Piritsi limodzi la 50 mg / 1000 mg lili ndi 50 mg ya vildagliptin ndi 1000 mg ya metformin hydrochloride,

Omwe amathandizira: hydroxypropylcellulose, magnesium stearate, hypromellose, titanium dioxide (E 171), polyethylene glycol, talc, iron ironide (E 172).

Kapangidwe kamankhwala Galvus Met kamaphatikizira ma 2 a hypoglycemic othandizira omwe ali ndi njira zosiyanasiyana zochitira: vildagliptin, omwe ali mgulu la dipeptidyl peptidase-4 inhibitors (DPP-4), ndi metformin (mu mawonekedwe a hydrochloride) - woimira kalasi ya Biguanide. Kuphatikizidwa kwa zinthuzi kumakupatsani mwayi wolamulira kuchuluka kwa glucose wamagazi mwa odwala omwe ali ndi matenda a shuga a 2 kwa maola 24.

Reception Galvus Meta akuwonetsedwa mu milandu yotsatirayi:

Ndi mtundu 2 wa matenda ashuga, pamene njira zina zakachiritsira zalephera,
ngati mankhwala osagwiritsidwa ntchito ndi metformin kapena vildagliptin ngati mankhwala osiyana,
pomwe wodwalayo adagwiritsapo ntchito mankhwala omwe ali ndi ziwalo zofananira,
Mankhwala ovuta a shuga limodzi ndi mankhwala ena a hypoglycemic kapena insulin.

Mankhwalawa adayesedwa odwala omwe anali ndi thanzi labwino omwe alibe matenda akulu komanso mavuto akulu azaumoyo.

Sitikulimbikitsidwa kutenga Galvus Met:

Anthu omwe amalolera ku vildagliptin kapena pazinthu zomwe zimapanga mapiritsi.
Achinyamata osakwana zaka zambiri. Chenjezo lofananalo limachitika chifukwa chakuti zotsatira za mankhwalawa kwa ana sizinayesedwe.
Odwala omwe ali ndi vuto lalikulu la chiwindi ndi impso. Izi ndichifukwa choti magawo omwe amagwira mankhwalawa angayambitse kulephera kwathunthu kwa ziwalo izi.
Anthu omwe afika paukalamba. Thupi lawo limakhala lotopa lokwanira kuti liwululitse zina zambiri, zomwe zimapanga zinthu zomwe zimapanga galvus.
Amayi oyembekezera ndi amayi oyamwitsa. Malangizowa atengera kuti zomwe zimachitika m'gulu lino la odwala sizidafufuzidwe. Pali chiopsezo cha kuperewera kwa glucose metabolism, kupezeka kwa zovuta zakubadwa komanso kufa mwadzidzidzi kwa akhanda.

Popitirira muyeso wovomerezeka wa kumwa mankhwalawo, palibe kupatuka kwakukulu mu thanzi komwe kumawonedwa mwa anthu.

Palibe zosakwanira pakugwiritsa ntchito Galvusmet mwa amayi apakati. Kafukufuku wazinyama wa vildagliptin awulula kawopsedwe ochulukitsa mu Mlingo wambiri. Mu maphunziro a nyama a metformin, izi sizinawonetsedwe. Kafukufuku wogwiritsidwa ntchito pophatikizidwa mu nyama sizinawonetse teratogenicity, koma fetotoxicity idapezeka mu Mlingo woopsa kwa wamkazi. Kuopsa komwe kumakhalapo mwa anthu sikudziwika. G alvusmet sayenera kugwiritsidwa ntchito panthawi yoyembekezera.

Sizikudziwika ngati vildagliptin ndi / kapena metformin ikudutsa mkaka waumunthu, chifukwa chake G alvusmet sayenera kulembedwa kwa akazi panthawi yoyamwitsa.

Kafukufuku wa vildagliptin mu makoswe pa Mlingo wofanana ndi 200 nthawi yomwe munthu satiwonetsa sanawonetse kufooka komanso kusakhazikika kwa embryonic. Kafukufuku wazomwe zimachitika pa Galvusmet pakubala kwa anthu sizinachitike.

Malangizo ogwiritsira ntchito akuwonetsa kuti Galvus Met imagwiritsidwa ntchito mkati. Mlingo wothandizila uyenera kusankhidwa payekha kutengera kuthekera ndi chithandiziro chamankhwala. Mukamagwiritsa ntchito Galvus Met, musapitirire mlingo wovomerezeka wa tsiku ndi tsiku wa vildagliptin (100 mg).

Mlingo woyambirira wa Galvus Met uyenera kusankhidwa poyerekeza kutalika kwa matenda ashuga ndi mseru wa glycemia, mkhalidwe wa wodwalayo komanso mtundu wa chithandizo cha vildagliptin ndi / kapena metformin yomwe imagwiritsidwa kale ntchito kwa wodwala. Kuchepetsa zovuta zoyipa kuchokera ku ziwalo zam'mimba zofunikira za metformin, Galvus Met imatengedwa ndi chakudya.

Mlingo woyamba wa mankhwala a Galvus Met osagwira ntchito ya monotherapy ndi vildagliptin:

Kuchiza ndi Galvus Met kukhoza kuyambitsidwa ndi piritsi limodzi lokha ndi 50 mg + 500 mg kawiri pa tsiku, mutawunika momwe mankhwalawo amathandizira, mlingo umatha kuwonjezeka pang'onopang'ono.

Mlingo woyamba wa mankhwala a Galvus Met osagwira ntchito ya monotherapy ndi metformin:

Kutengera mlingo wa metformin womwe watengedwa kale, chithandizo ndi Galvus Met chitha kuyambitsidwa ndi piritsi limodzi lokha ndi 50 mg + 500 mg, 50 mg + 850 mg kapena 50 mg + 1000 mg 2 nthawi / tsiku.

Mlingo woyambirira wa Galvus Met mwa odwala omwe adalandira kale mankhwala osakanikirana ndi vildagliptin ndi metformin mwa mapiritsi osiyana:

Kutengera Mlingo wa vildagliptin kapena metformin womwe watengedwa kale, chithandizo ndi Galvus Met chikuyenera kuyamba ndi piritsi lomwe lili pafupi kwambiri ndi kuchuluka kwa mankhwalawa, 50 mg + 500 mg, 50 mg + 850 mg kapena 50 mg + 1000 mg, ndikusintha mlingo kutengera kuchokera kuluso.

Kuyamba kwa mankhwala Galvus Met monga mankhwala oyamba kwa odwala omwe ali ndi matenda a shuga 2 osakwanira mthupi la zakudya komanso kuchita masewera olimbitsa thupi:

Pomwe mukuyamba chithandizo, mankhwala a Galvus Met ayenera kugwiritsidwa ntchito koyamba mlingo wa 50 mg + 500 mg 1 nthawi / tsiku, ndipo mutasanthula njira zochizira, pang'onopang'ono muonjezere mlingo mpaka 50 mg + 1000 mg 2 nthawi / tsiku.

Kuphatikiza mankhwala ndi Galvus Met ndi sulfonylurea zotumphukira kapena insulin:

Mlingo wa Galvus Met amawerengedwa pamaziko a mlingo wa vildagliptin 50 mg x 2 nthawi / tsiku (100 mg patsiku) ndi metformin pa mlingo wofanana ndi womwe kale umagwiritsidwa ntchito ngati mankhwala amodzi.

Metformin imachotsedwa impso. Popeza odwala omwe ali ndi zaka zopitilira 65 amakhala ndi vuto laimpso, muyeso wa Galvus Met mwa odwalawa uyenera kusinthidwa potengera zomwe zikuwonetsa kuti aimpso. Mukamagwiritsa ntchito mankhwalawa odwala omwe ali ndi zaka zopitilira 65, ndikofunikira kuwunika nthawi zonse aimpso.

Kugwiritsa ntchito mankhwala ndi Galvus Met kumatha kukhudza ntchito ya ziwalo zamkati ndi mkhalidwe wathupi lathunthu. Zotsatira zoyipa zomwe zimadziwika kwambiri ndi izi:

kupweteka ndi kupweteka kwambiri pamimba,
zotupa pakhungu,
kusokonezeka, kudzimbidwa ndi matenda otsekula m'mimba,
kutupa
chizungulire ndi mutu
miyendo yanjenjemera
kumverera kozizira
kusanza pamodzi ndi kusanza
matenda a chiwindi ndi kapamba, mwachitsanzo, chiwindi ndi kapamba,
Kusenda kwamphamvu pakhungu,
gastroesophageal Reflux,
otsika thupi kukana matenda ndi ma virus,
ogwira ntchito ochepa komanso wotopa mwachangu,
mawonekedwe a matuza.

Ndiwowonjezera kuchuluka kwa mankhwala othandizira achifundo, nseru, kusanza, kupweteka kwambiri kwa minofu, hypoglycemia ndi lactic acidosis (zotsatira za metformin) zitha kuonedwa. Zikatero, mankhwalawa amayimitsidwa, kutsuka m'mimba, matumbo ndi chizindikiro kumachitika.

Simuyenera kuyesa kulowetsa jakisoni wa insulin ndi Galvus kapena Galvus Met. Ndikofunika kupimidwa kuyezetsa magazi komwe kumayesa kugwira ntchito kwa impso ndi chiwindi musanayambe chithandizo ndi othandizira. Bwerezani mayeso kamodzi pachaka kapena kupitirira. Metformin iyenera kuti ichotsedwe maola 48 asanachitike opaleshoni kapena X-ray yoyambira ndi kukhazikitsa kwa wotsutsana naye.

Vildagliptin samakonda kucheza ndi mankhwala ena.

Metformin imatha kuyanjana ndi mankhwala ambiri otchuka, makamaka mapiritsi othamanga kwa magazi ndi mahomoni a chithokomiro. Lankhulani ndi dokotala wanu! Muuzeni za mankhwala onse omwe mumamwa musanapatsidwe mankhwala othandizira odwala matenda ashuga.

Tinalemba ndemanga za anthu pankhani ya mankhwalawa:

Ngati tikufanizira kapangidwe kake ndi zotsatira za chithandizo, ndiye kutengera ndi magwiridwe antchito komanso chithandizo chothandiza, analogues itha kukhala:

Musanagwiritse ntchito fanizo, funsani dokotala.

Sungani pamalo owuma pamatenthedwe mpaka 30 ° C. Pewani kufikira ana.

Momwe mungaphunzirire kukhala ndi matenda a shuga. - M: Interprax, 1991 .-- 112 p.
Matenda a matenda othandizira odwala. - M: MEDpress-dziwitsani, 2005. - 704 p.
Kruglov Victor Diabetes mellitus, Eksmo -, 2010. - 160 c.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwazaka 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Kutulutsa mawonekedwe ndi kapangidwe kake

Zothandiza piritsi limodzi:

vildagliptin - 50 mg,
metformin hydrochloride - 500, 850 kapena 1000 mg.

Zinthu zothandiza (50 + 500 mg / 50 + 850 mg / 50 + 1000 mg): hypromellose - 12.858 / 18.58 / 20 mg, talc - 1.283 / 1.86 / 2 mg, macrogol 4000 - 1.283 / 1.86 / 2 mg, hyprolose - 49,5 / 84.15 / 99 mg, magnesium stearate - 6.5 / 9.85 / 11 mg, titanium dioxide (E171) - 2.36 / 2.9 / 2.2 mg, oxide red iron (E172) - 0.006 / 0 / mg, iron oxide chikasu (E172) - 0.21 / 0.82 / 1.8 mg.

Mankhwala

Kuphatikizidwa kwa Galvus Met kumaphatikizapo magawo awiri omwe amagwira ntchito omwe amasiyana m'njira zogwirira ntchito: metformin (mwanjira ya hydrochloride), yomwe ili m'gulu la Biguanides, ndi vildagliptin, yomwe ndi choletsa dipeptidyl peptidase-4 (DPP-4). Kuphatikizika kwa zinthu izi kumapangitsa kuti chiwongolero cha shuga m'magazi chizikhala mwa odwala omwe ali ndi matenda a shuga a 2 tsiku limodzi.

Vildagliptin ndi nthumwi ya kalasi ya oyambitsa mapangidwe apakhungu, omwe amathandizira kusankha zoletsa za enzyme DPP-4, yomwe imayang'anira kuwonongedwa kwa glucagon-ngati peptide mtundu 1 (GLP-1) ndi glucose-insulinotropic polypeptide (HIP).

Metformin imachepetsa kupanga shuga ndi chiwindi, imachepetsa kukana kwa insulini chifukwa cha kuyamwa ndikugwiritsa ntchito glucose m'matumbo otumphukira, ndipo imalepheretsa kuyamwa kwa glucose m'matumbo. Imathandizanso kaphatikizidwe ka glycogen wa intracellular chifukwa cha zotsatira zake pa glycogen synthetase ndikuyendetsa ma glucose, omwe mapuloteni ena a glucose transporter membrane (GLUT-1 ndi GLUT-4) ali ndi udindo.

Vildagliptin

Pambuyo potenga vildagliptin, ntchito ya DPP-4 imalephereka mwachangu komanso pafupifupi kwathunthu, zomwe zimatsogolera kukuwonjezeka kwa kudya kwakulimbikitsidwa komanso kutsekeka kwapansi kwa HIP ndi GLP-1, komwe kumatulutsidwa kuchokera m'matumbo ndikuyendetsedwa kwa dongosolo mkati mwa maola 24.

Kuchuluka kwa HIP ndi GLP-1, chifukwa cha zochita za vildagliptin, kumawonjezera chidwi cha maselo a pancreatic β-glucose, omwe amakonzanso kupanga kwa insulin. Kuchuluka kwa kusintha kwa ntchito ya β-cell kumatsimikiziridwa ndi kuchuluka kwa kuwonongeka kwawo koyamba. Chifukwa chake, mwa anthu omwe alibe shuga (wokhala ndi glucose wabwinobwino), vildagliptin simalimbikitsa kupanga insulin ndipo sikuchepetsa shuga.

Vildagliptin imachulukitsa kuchuluka kwa ma GLP-1 am'mbuyo, mwakutero kumawonjezera chidwi cha maselo a α-glucose, omwe amathandizira kusintha kwa shuga wodalira glucagon. Kutsika kwamphamvu m'magulu a glucagon mutatha kudya, kumabweretsa kutsika kwa insulin.

Kuwonjezeka kwa kuchuluka kwa insulin / glucagon motsutsana ndi maziko a hyperglycemia omwe amakhudzana ndi kuwonjezeka kwa kuchuluka kwa HIP ndi GLP-1 kumapangitsa kuchepa kwa kaphatikizidwe ka glucose, nthawi yonseyi komanso mukatha kudya. Zotsatira zake ndi kuchepa kwa glucose wa plasma.

Komanso, mukalandira chithandizo cha vildagliptin, kuchepa kwa lipids ya plasma kumawonedwa mutatha kudya, komabe, izi sizikutengera zomwe Galvus Met pa HIP kapena GLP-1 ndikusintha kwa magwiridwe antchito am'maselo am'mapapo. Pali umboni kuti kuwonjezeka kwa GLP-1 kungalepheretse matumbo kuzimiririka, koma izi sizinaoneke pakugwiritsa ntchito vildagliptin.

Zotsatira za kafukufuku zomwe odwala 5759 odwala matenda a shuga a mtundu 2 adatenga nawo mbali akuwonetsa kuti mukamamwa vildagliptin monga monotherapy kapena kuphatikiza ndi insulin, metformin, thiazolidinedione kapena sulfonylurea kuchokera kwa masabata 52, kuchepa kwakukulu kwa milingo ya glycated kwakanthawi hemoglobin (HbA₁_C) komanso kusala magazi.

Metformin imakulitsa kulolera kwa shuga kwa odwala omwe ali ndi mtundu wa shuga wachiwiri, kuchepetsa shuga wa m'magazi asanafike komanso atatha kudya. Izi zimasiyana ndi zotumphukira za sulfonylurea chifukwa sizipangitsa mtundu wa hypoglycemia kukhala ndi anthu athanzi (kupatula milandu yapadera) komanso kwa odwala omwe ali ndi matenda a shuga 2. Chithandizo cha Metformin sichitha limodzi ndi chitukuko cha hyperinsulinemia. Mukamamwa metformin, kupanga insulini sikusintha, pamene kuchuluka kwake m'madzi am'magazi asanadye komanso tsiku lonse kumatha kuchepa.

Kugwiritsidwa ntchito kwa metformin kumakhudza kwambiri kagayidwe ka lipoproteins ndipo kumabweretsa kuchepa kwa cholesterol zomwe zimakhala zotsika kwambiri lipoproteins, cholesterol yathunthu ndi triglycerides, yomwe sikugwirizana ndi zotsatira za mankhwalawa pamagazi a shuga.

Malangizo ogwiritsira ntchito Galvus Met: njira ndi mlingo

Gal mapiritsi a Galvus amatengedwa pakamwa, makamaka nthawi imodzi ndi chakudya (pofuna kuchepetsa zovuta zoyipa zamagetsi, zomwe zimadziwika ndi metformin).

Rimage regimen imasankhidwa ndi dokotala payekhapayekha potengera mphamvu ya chithandizo / kulekerera. Tiyenera kukumbukira kuti mlingo wapamwamba kwambiri wa tsiku ndi tsiku wa vildagliptin ndi 100 mg.

Mlingo woyambirira wa Galvus Met amawerengedwa potengera nthawi yayitali ya matenda ashuga, kuchuluka kwa glycemia, mkhalidwe wa wodwalayo komanso njira zamankhwala zomwe kale zidagwiritsidwa ntchito ndi vildagliptin ndi / kapena metformin.

kuyamba mankhwala a mtundu 2 matenda a shuga osakwanira olimbitsa thupi ndi zakudya: piritsi 1 50 + 500 mg 1 nthawi patsiku, mutawunika kuyeserera kwake, mlingo umakulitsidwa pang'onopang'ono mpaka 50 + 1000 mg kawiri pa tsiku,
Mankhwala milandu yafooka wa monotherapy ndi vildagliptin: 2 pa tsiku, piritsi 1 50 + 500 mg, pang'onopang'ono kuchuluka kwa mankhwalawa atatha kuwunika momwe achire amathandizira,
Chithandizo cha milandu ya Metformin monotherapy: 2 kawiri pa tsiku, piritsi 1 50 + 500 mg, 50 + 850 mg kapena 50 + 1000 mg (kutengera mlingo wa metformin yomwe watengedwa),
Chithandizo cha mankhwala osakanikirana ndi metformin ndi vildagliptin mu mawonekedwe a mapiritsi osiyana: mlingo woyandikira kwambiri wa mankhwalawo amasankhidwa, mtsogolomo, kutengera momwe umagwirira ntchito, kukonza kwake kumachitika,
Kuphatikiza kwa mankhwalawa pogwiritsa ntchito Galvus Met kuphatikiza ndi mankhwala a sulfonylurea kapena insulini (mankhwalawa amasankhidwa kuchokera pa mawerengedwa): vildagliptin - 50 mg kawiri pa tsiku, metformin - muyezo wofanana ndi womwe kale umagwiritsidwa ntchito ngati mankhwala amodzi.

Odwala okhala ndi creatinine chilolezo cha 60-90 ml / mphindi angafune kusintha kwa mlingo wa Galvus Met. Ndikothekanso kusintha kuchuluka kwa odwala omwe ali ndi zaka zopitilira 65, zomwe zimalumikizidwa ndi chiwopsezo chaimpso ntchito (zimafunikira kuwunikira zizindikiro).

Contraindication

Galvus Met sichosankhidwa kuti:

mkulu zomvera ku zigawo zake,
kulephera kwa aimpso ndi zovuta zina pakugwira ntchito kwa impso,
pachimake mitundu matenda omwe angayambitse kukula kwaimpso ntchito - kusowa kwamadzi, kutentha thupi, matenda, hypoxia ndi zina zotero
chiwindi ntchito,
mtundu 1 shuga,
aakulu uchidakwapoyizoni wazakumwa zoledzeretsa,
kuyamwa, mimba,
kutsatira zachinyengoZakudya,
ana ochepera zaka 18.

Mosamala, mapiritsi amayikidwa kwa odwala omwe ali ndi zaka 60 akugwira ntchito yolemera yopanga thupi, chifukwa chitukuko ndichotheka lactic acidosis.

Bongo

Monga mukudziwa vildagliptin ngati gawo limodzi la mankhwalawa amalekeredwa bwino akamamwa tsiku lililonse mpaka 200 mg. Nthawi zina, maonekedwe a kupweteka kwamisempha, kutupa ndi malungo. Nthawi zambiri, zizindikiro zosokoneza bongo zimatha kuthetsedwa posiya ntchito mankhwalawa.

Pankhani ya bongometformin, Zizindikiro zomwe zimatha kumwa mankhwalawa 50 g, zomwe zimachitika hypoglycemia, lactic acidosiskutsatiramseru, kusanza, kutsekula m'mimba, kutsitsa kutentha kwa thupi, kupweteka pamimba ndi minofu, kupumira mwachangu, chizungulire. Mitundu ikuluikulu imabweretsa kusokonezeka kwa chikumbumtima ndi kukula chikomokere.

Potere, chithandizo chamankhwala chimachitika, njirayi imachitidwa hemodialysis ndi zina zotero.

Tiyenera kudziwa kuti kwa odwala omwe amalandirainsulin, kusankhidwa kwa Galvus Met sikulowa m'malo insulin

Kuchita

Vildagliptin sizothandiza cytochrome enzyme magawoP450, sikuletsa komanso oyambitsa ma enzyme awa, motero, sikugwirizana ndi gawo lapansi, ma inducers kapena P450 inhibitors. Nthawi yomweyo, kugwiritsidwa ntchito kwakanthawi kofanana ndi magawo a ma enzyme ena sikukhudza mtengo kagayidwe izi.

Kugwiritsa ntchito nthawi imodzi vildagliptinndi mankhwala ena omwe adapangidwiramtundu 2 shugaMwachitsanzo: Glibenclamide, pioglitazone, metformin ndi mankhwala osokoneza bongoamlodipine, digoxin, ramipril, simvastatin, Valsartan,warfarin sizimayambitsa kulumikizana kwakukulu.

Kuphatikiza mangochinos ndimetformin imathandizira pakukhazikika kwa zinthu izi mthupi. Nifedipine kumawonjezera mayamwidwe ndi chimbudzi metformin kapangidwe ka mkodzo.

Zomera zachilengedwemonga: Amiloride, Digoxin, Procainamide, Quinidine, Morphine, Quinine,Ranitidine, Trimethoprim, Vancomycin, Triamteren ndi ena akamachezametformin chifukwa mpikisano waukulu wa aimpso tubules, amatha kuwonjezera ndende yake zikuchokera magazi a m'magazi. Chifukwa chake, kugwiritsa ntchito Galvus Met kuphatikiza koteroko kumafunikira kusamala.

Kuphatikiza kwa mankhwalawa thiazidesena diuretics, phenothiazines, kukonzekera kwa chithokomiro, estrogens, kulera kwapakamwa,phenytoin, nikotini acid,sympathomimetics, calcium antagonists ndi isoniazid, Imatha kupangitsa hyperglycemia komanso kuchepetsa mphamvu ya othandizira a hypoglycemic.

Chifukwa chake, mankhwalawa akaperekedwa kapena kuletsedwa nthawi yomweyo, kuwunika bwino ntchito kumafunika metformin - Hypoglycemic zotsatira zake, ndipo ngati pakufunika kusintha, musinthe. Kuchokera kuphatikiza ndi danazol tikulimbikitsidwa kupewa kuti tipewe kuwonetsedwa kwa mphamvu yake ya hyperglycemic.

Mlingo wapamwamba chlorpromazineimatha kuwonjezera glycemia, chifukwa imachepetsa kutulutsa insulin. Chithandizo antipsychotic Zimafunikanso kusintha kwa Mlingo ndi glucose.

Kuphatikiza mankhwala ndiwokhala ndi ayodini wokhala ndi ayodiniamatanthauza, mwachitsanzo, kuchita kafukufuku wama radiology ndi kugwiritsa ntchito kwawo, nthawi zambiri kumayambitsa kukulira kwa lactic acidosis mu matenda a shuga ndi kulephera kwa aimpso.

Kulephera kuwonjezera glycemia β2-sympathomimetics chifukwa cha kukondoweza kwa β2 receptors. Pazifukwa izi, muyenera kuwongolera glycemiakupezeka kotheka insulin

Kulandila munthawi yomweyo Metformin ndi sulfonylureas, insulin acarbose, salicylateszitha kupititsa patsogolo hypoglycemic.

The zikuchokera mankhwala

Zomwe mungagwiritse ntchito pa mankhwalawa ndi: vildagliptin, womwe umatha kuletsa enzyme dipeptyl peptidase-4, ndi metformin, yomwe ili m'gulu la gulu la greatuanides (mankhwala omwe angalepheretse gluconeogeneis). Kuphatikizidwa kwa magawo awiriwa kumapereka chiwongolero chokwanira cha kuchuluka kwa shuga m'magazi. Kodi ndi chiani china chomwe chili gawo la Galvus Met?

Vildagliptin ndi gulu la zinthu zomwe zimatha kusintha magwiridwe antchito a cell a alpha ndi beta omwe amapezeka m'matumbo. Metformin imatsitsa kapangidwe ka shuga m'chiwindi ndikuchepetsa mayamwidwe ake.

Mtengo wa Galvus Met ndiwokopa ambiri.

Mlingo komanso malangizo ogwiritsira ntchito mankhwalawa

Kuti muchepetse mavuto, tikulimbikitsidwa kuti timwe pakudya. Mulingo wofunikira kwambiri ndi zana limodzi mg / tsiku.

Mlingo wa Galvus Met amasankhidwa ndi adotolo mosamalitsa payekhapayekha, potengera momwe magawo amagwiritsidwira ntchito komanso kulolera kwawo ndi wodwala.

Pa gawo loyambirira la mankhwala, osagwiritsa ntchito vildagliptin, mlingo umayikidwa, kuyambira piritsi limodzi la 50/500 mg kawiri pa tsiku. Ngati mankhwala ali ndi zotsatira zabwino, ndiye kuti mankhwalawa amayamba kukula pang'onopang'ono.

Kumayambiriro kwa mankhwalawa ndi mankhwala a shuga a Galvus Met, osagwiritsa ntchito metformin, kutengera mlingo womwe watenga kale, mlingo umayambira kuyambira piritsi limodzi la 50/500 mg, 50/8 mg kapena 50/1000 mg piritsi limodzi patsiku. tsiku.

M'magawo oyamba a chithandizo ndi Galvus Met, odwala omwe amathandizidwa kale ndi metformin ndi vildagliptin, kutengera mlingo womwe adamwa kale, amalamula kuti atenge mlingo woyandikira momwe mungathere 50/500 mg, 50/50 mg kapena 50/1000 mg kapena awiri kamodzi patsiku.

Mlingo woyambirira wa mankhwalawa "Galvus Met" kwa anthu omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo chifukwa kulibe mphamvu ya masewera olimbitsa thupi ndi zakudya monga chithandizo choyambirira ndi 50/500 mg kamodzi patsiku. Ngati mankhwala ali ndi zotsatira zabwino, ndiye kuti mankhwalawa amayamba kuchuluka mpaka 50/100 mg kawiri patsiku.

Monga momwe Galvus Met analangizira, pophatikiza mankhwala othandizira ndi insulin, mlingo woyenera ndi 50 mg kawiri patsiku.

Mankhwala sayenera kugwiritsidwa ntchito ndi anthu omwe ali ndi vuto laimpso kapena kulephera kwa aimpso.

Popeza mankhwalawa amachotsedwa impso, kwa odwala omwe ali ndi zaka zopitilira 65 omwe amachepetsa mphamvu ya impso, Galvus Met adayikidwa kuti atenge ndi mlingo wochepa, womwe uthandize kuti matenda a shuga asinthe. Kuwunikira pafupipafupi kwa impso ndikofunikira.

Kugwiritsira ntchito kumatsutsana kwa ana, chifukwa magwiridwe antchito ndi chitetezo cha ana sichidaphunziridwe kwathunthu.

Mu amayi apakati ndi kuyamwitsa

Kugwiritsa ntchito kwa Galvus Met 50/1000 mg kumapangidwa nthawi yapakati, chifukwa palibe deta yokwanira pakugwiritsa ntchito mankhwalawa panthawiyi.

Ngati kagayidwe kachakudya kagayidwe kachakudya mthupi, ndiye kuti mayi woyembekezera atha kukhala ndi vuto lodzala ndi kubereka, kufa, komanso kufalikira kwamatenda a neonatal. Pankhaniyi, monotherapy yokhala ndi insulini iyenera kutengedwa kuti ikhale ndi shuga.

Kugwiritsira ntchito mankhwalawa kumakwiriridwa mwa amayi oyamwitsa, chifukwa sizikudziwika ngati zigawo za mankhwalawa (vildagliptin ndi metformin) zimachotsedwa mkaka wa m'mawere wa anthu.

Malangizo apadera

Chifukwa chakuti mukamayendetsa vildagliptin ntchito ya aminotransferase imachulukana, musanayankhe komanso munthawi ya mankhwala a matenda a shuga "Galvus Met", mapangidwe a chiwindi amayenera kutsimikizidwa nthawi zonse.

Ndi kudzikundikira kwa metformin mthupi, lactic acidosis imatha kuchitika, yomwe ndi yosowa kwambiri, koma zovuta kwambiri za metabolic. Kwenikweni, pogwiritsa ntchito metformin, lactic acidosis imawonedwa mwa odwala matenda a shuga omwe anali ndi vuto lalikulu laimpso. Komanso chiopsezo cha lactic acidosis chikuwonjezeka mwa iwo omwe ali ndi matenda a shuga omwe akhala akuvutika ndi njala kwa nthawi yayitali, ndizovuta kuchiza, akhala akumwa mowa kwambiri kapena ali ndi matenda a chiwindi.

Mitu ya mankhwalawa

The fanizo la "Galvus Meta" mu gulu la mankhwalawa ndi monga:

"Avandamet" - ndi othandizira a hypoglycemic okhala ndi zigawo zikuluzikulu ziwiri - metformin ndi rosiglitazone. Mankhwala amapatsidwa mankhwala ochizira matenda a shuga. Metformin cholinga chake ndikulepheretsa kaphatikizidwe ka glucose m'chiwindi, ndi rosiglitazone - kukulitsa chidwi cha cell receptors ku insulin. Mtengo wapakati wa mankhwala ndi ma ruble 210 pa paketi imodzi ya mapiritsi a 56 mu 500 mg mg. Analogs "Galvus Met" ayenera kusankhidwa ndi dokotala.
"Glimecomb" - imathandizanso kutulutsa shuga. Mankhwalawa ali ndi metformin ndi gliclazide. Mankhwalawa amatsutsana ndi odwala matenda a shuga a insulin, anthu omwe ali ndi chikomokere, amayi apakati, omwe ali ndi vuto la hypoglycemia ndi zina. Mtengo wapakati wa mankhwala ndi ma ruble 450 pakiti iliyonse ya mapiritsi 60.
"Combogliz Prolong" - ili ndi metformin ndi saxagliptin. Mankhwala ndi mankhwala wachiwiri mtundu wa matenda ashuga, pambuyo kupanda mphamvu ya olimbitsa thupi ndi zakudya. Mankhwalawa adapangidwa kwa anthu omwe ali ndi hypersensitivity pazinthu zikuluzikulu zomwe amapanga mankhwalawa, mawonekedwe omwe amadalira matenda a shuga, okhala ndi mwana, ana, komanso vuto la impso ndi chiwindi. Mtengo wapakati wa mankhwala ndi ma ruble 2,900 pakompyuta iliyonse ya mapiritsi 28.

"Januvia" ndi othandizira a hypoglycemic, omwe ali ndi chigawo chogwiritsidwa ntchito sitagliptin. Kugwiritsa ntchito mankhwalawa kumatulutsa glycemia ndi glucagon. Mlingowo umatsimikiziridwa ndi adotolo, omwe aziganizira zazomwe zili ndi shuga, thanzi komanso zinthu zina. Mankhwalawa amatsutsana ndi anthu omwe amadwala matenda a shuga ndipo amadwala matendawa. Mankhwalawa, kupweteka mutu, kudzimbidwa, kupweteka kwapakati, komanso matenda amtundu wa kupuma. Pafupifupi, mtengo wa mankhwalawo ndi ma ruble 1600.
"Trazhenta" - malonda omwe amapezeka m'njira zam'mapiritsi okhala ndi linagliptin. Imafooketsa gluconeogeneis ndipo imakhazikitsa shuga. Dokotala amasankha payekha payekha kwa wodwala aliyense.
Galvus Met ili ndi zida zina zambiri zofananira.
Mitengo ya galvus idakumana m'mafakisi ku Moscow

mapiritsi okhala ndi filimu 50 mg + 1000 mg 30 ma PC ≈ 1570 rub.

50 mg + 500 mg 30 ma PC ≈ 1590 rub.

50 mg + 850 mg 30 ma PC ≈ 1585.5 rub.

Madokotala amawunika za galvus meta

Kukala 3.8 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa
Galvus Met ndi mankhwala omwe amadziwika kuti amathandizira odwala matenda a shuga a mtundu 2. Ndiothandiza komanso otetezeka chifukwa cha contraindication. Amachepetsa shuga popanda chiopsezo cha hypoglycemia. Kugwiritsa ntchito mankhwalawa kumabweretsa kuchepa kwamphamvu kwa matenda tsiku lonse. Kuphatikiza apo, panali kuchepa pang'ono kwa kuthamanga kwa magazi kwa odwala omwe ali ndi matenda oopsa. Zilibe kuthandiza kuti wodwala azichita bwino. Mtengo wokwera mtengo wa anthu odwala.

Kutalika kwa 5.0 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa
Kuphatikiza kwakukulu kuyambitsa chithandizo cha matenda a shuga a 2. Kuphatikizikako kumapereka mwayi komanso utsogoleri wosavuta, komanso kuthandizira kwakukulu komanso kuthekera poyerekeza ndi monotherapy, kuthekera kuchitapo kanthu pazinthu zambiri nthawi imodzi. Zilibe zotsatira zoyipa, zotsatira zoyipa, pafupifupi palibe zotsutsana.

Kutalika kwa 5.0 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa
Kupezeka kwa mitundu yokhala ndi Mlingo wosiyanasiyana wa metformin.
Kuphatikiza kwa mankhwala awiri akuluakulu ochizira matenda a shuga a 2. Mankhwalawa kwenikweni samayambitsa hypoglycemia, chifukwa chake amakondedwa ndi madokotala, makamaka ndi ine, komanso odwala. Itha kugwiritsidwa ntchito mosasamala kanthu za kudya kwakudya bwino, kapena mukatha kudya kapena musanadye chakudya.
Ndemanga za odwala za galvus meta
Ndadwala matenda ashuga kuyambira 2005, kwa nthawi yayitali, madokotala samatha kupeza mankhwalawa oyenera. Galvus Met anali chipulumutso changa. Ndakhala ndikutenga kwa zaka 8 ndipo sindinapeze zabwinoko. Sindikufuna kusinthitsa jakisoni wa insulin, anali Galvus Met yemwe amakhalabe ndi shuga. Pali mapiritsi 28 mu paketi - Ndili ndi okwanira masabata awiri, ndimamwa m'mawa ndi madzulo. Sindimamwa mankhwala ena.
Ndimagulira mayi anga mankhwala amenewa nthawi zonse. Wakhala akudwala matenda a shuga kwa zaka zopitilira khumi. Amamukwanira. Pogwiritsa ntchito mankhwalawa pafupipafupi, akumva bwino. Zikuchitika kuti amaiwala kugula paketi yatsopano, ndipo yakaleyo yatha, ndiye kuti zovuta zake ndi zowopsa. Mwazi wamagazi umakwera, ndipo sangathe kuchita kalikonse, amangonama mpaka atamwa piritsi ili. Ndimagulira makolo anga mankhwala onse, chifukwa chake ndikudziwa kuti mtengo wa mankhwalawa ndiwolandirika, ndipo ndiophatikiza wamkulu.
Kufotokozera kwapfupi
Galvus Met ndi mankhwala ophatikizika awiri (vildagliptin + metformin) pochiza matenda osokoneza bongo omwe amadalira insulin. Amagwiritsidwa ntchito ngati chithandizo cha mankhwala aliwonse chimagwiritsidwa ntchito mosakwanira, komanso mwa odwala omwe kale adagwiritsa ntchito vildagliptin ndi metformin nthawi imodzi, koma mu mawonekedwe a mankhwala osiyana. Kuphatikizika kwa vildagliptin + metformin kukhoza kuwongolera kuchuluka kwa shuga masana. Vildagliptin imapangitsa kuti maselo a pancreatic beta azikhudzana kwambiri ndi shuga, omwe amachititsa kuti shuga azidalira shuga. Mwa anthu athanzi (osadwala matenda a shuga mellitus), vildagliptin ilibe zotere. Vildagliptin imapereka chiwongolero chogwira mtima pakayang'aniridwe katulutsidwe wa insulin, chiwopsezo cha ma cell a alpha a timuyo tating'onoting'ono ta Langerhans glucagon, kamene, imayendetsa kagayidwe kake ka minofu kutengera ma insulin kapena exo native insulin. Mothandizidwa ndi vildagliptin, gluconeogeneis mu chiwindi imatsitsidwa, chifukwa chomwe ndende ya plasma glucose imachepetsedwa. Metformin imathandizira kuchepetsa kuchuluka kwa shuga m'magazi mosasamala kanthu za kudya (i.e., paphiri isanayambe komanso itatha kudya), potero, kusintha kwa kulolera kwa glucose mwa anthu omwe alibe shuga. Metformin imalepheretsa gluconeogenesis m'chiwindi, kusokoneza mayamwidwe a shuga m'magawo am'mimba, kumapangitsa mayankho a metabolic a minofu ku insulin.
Mosiyana ndi mankhwala a sulfanilurea (glibenclamide, glycidone, glyclazide, glimepiride, glipizide), metformin siyimapangitsa kuchepa kwa glucose pansipa ya chikhalidwe chathupi mwa odwala matenda ashuga kapena anthu athanzi. Metformin siyimayambitsa kuchuluka kwa insulin m'magazi ndipo sikukhudza katulutsidwe kake. Metformin imakhala ndi phindu pa mbiri ya lipid: imachepetsa kuchuluka kwathunthu, ndi zina zotero. "Choipa" cholesterol, triglycerides. Kuphatikizidwa kwa vildagliptin + metformin sikuyambitsa kusintha kwamphamvu m'thupi. Mlingo wa mankhwalawa amasankhidwa payekha kutengera kuthekera kwodwala komanso kulolera kwa odwala. Mlingo woyambirira umalimbikitsidwa kuti usankhidwe poganizira momwe wodwalayo amvera ndi pharmacotherapy ndi vildagliptin ndi metformin. Nthawi yoyenera kutenga Galvus Met ndi chakudya (izi zimakuthandizani kuti muchepetse zovuta za metformin pamatumbo am'mimba). Galvus Met sangathe kulowa m'malo mwa insulin mwa odwala omwe akukonzekera insulin. Mukamamwa mankhwalawa, ndikofunikira kuwunika magawo a matenda ndi a labotale, komanso kuwunika kwa aimpso. Ngati kuli kofunikira kuchita njira zopangira opaleshoni, chithandizo ndi Galvus Met chimayimitsidwa kwakanthawi. Ethanol amawonetsa zotsatira za metformin pa metabolism ya lactate, chifukwa chake, kuti apewe kukula kwa lactic acidosis kuchokera ku mowa pakugwiritsa ntchito Galvus Met, ndikofunikira kukana.
Pharmacology
Wophatikiza pakamwa hypoglycemic mankhwala. Kapangidwe ka Gal Gal Met kamaphatikizira magulu awiri a hypoglycemic omwe ali ndi njira zosiyanasiyana zochitira: vildagliptin, omwe ali mgulu la dipeptidyl peptidase-4 inhibitors (DPP-4), ndi metformin (mu mawonekedwe a hydrochloride), woimira gulu la Biguanide. Kuphatikizidwa kwa zinthuzi kumakupatsani mwayi wowongolera shuga m'magazi mwa odwala omwe ali ndi matenda a shuga a 2 pasanathe maola 24.
Vildagliptin, nthumwi ya kalasi ya othandizira kulumikizana ndi zida zapachiberekero, mosamala amaletsa enzyme DPP-4, yomwe imawononga mtundu 1 wa glucagon ngati peptide (GLP-1) ndi glucose-insulinotropic polypeptide (HIP).
Kuletsa mwachangu komanso kwathunthu ntchito za DPP-4 kumayambitsa kuwonjezeka kwa zonse zoyambira komanso zotsitsimutsa chakudya za GLP-1 ndi HIP kuchokera m'matumbo kumayendedwe azinthu tsiku lonse.
Kuchulukitsa kuchuluka kwa GLP-1 ndi HIP, vildagliptin kumapangitsa kuwonjezeka kwa chidwi cha pancreatic β-cell ku glucose, zomwe zimabweretsa kusintha kwa secretion wa glucose-based insulin. Kuchulukitsa kwa magwiridwe antchito a β-cell kumadalira kuchuluka kwa kuwonongeka kwawo koyamba, choncho mwa anthu opanda shuga - omwe amakhala ndi shuga m'magazi am'magazi), vildagliptin simalimbikitsa kutulutsa kwa insulin komanso sikuchepetsa kuchuluka kwa shuga.
Mwakulitsa kuchuluka kwa mawonekedwe amkati mwa GLP-1, vildagliptin kumawonjezera chidwi cha maselo a α-glucose, zomwe zimapangitsa kuti pakhale kusintha kwamalamulo a shuga a glucagon. Kuchepa kwa kuchuluka kwa glucagon okwanira panthawi ya chakudya, kumayambitsa kuchepa kwa insulin.
Kuwonjezeka kwa kuchuluka kwa insulin / glucagon poyang'ana kumbuyo kwa hyperglycemia, chifukwa cha kuchuluka kwa kuchuluka kwa GLP-1 ndi HIP, kumayambitsa kuchepa kwa kupanga kwa chiwindi ndi chiwindi nthawi yonse ya chakudya komanso pambuyo pake, zomwe zimapangitsa kuchepa kwa kuchuluka kwa shuga m'magazi am'magazi.
Kuphatikiza apo, motsutsana ndi kagwiritsidwe ntchito ka vildagliptin, kuchepa kwa kuchuluka kwa lipids m'madzi am'magazi pambuyo podyedwa, komabe, izi sizikugwirizana ndi zomwe zimachitika pa GLP-1 kapena HIP komanso kusintha kwa magwiridwe antchito a cell pancreatic islet.
Amadziwika kuti kuwonjezeka kwa ndende ya GLP-1 kungapangitse kuti m'mimba muchepetse pang'ono, komabe, motsutsana ndi kagwiritsidwe ntchito ka vildagliptin, izi sizikuwoneka.
Mukamagwiritsa ntchito vildagliptin mu 5759 odwala omwe ali ndi mtundu wa 2 shuga mellitus wa masabata 52 monga monotherapy kapena osakanikirana ndi metformin, zotumphukira za sulfonylurea, thiazolidinedione, kapena insulin, kuchepa kwakukulu kwakanthawi kwakanthawi kwa kuchuluka kwa glycated hemoglobin (HbA_1s) komanso kusala magazi.
Metformin imathandizira kulolerana kwa glucose mwa odwala omwe ali ndi matenda a shuga 2 mwakuchepetsa kuchuluka kwa glucose nthawi yoyamba komanso isanachitike. Metformin imachepetsa kupanga shuga ndi chiwindi, imachepetsa kuyamwa kwa glucose m'matumbo ndikuchepetsa kukana kwa insulin polimbikitsa kutulutsa ndi kugwiritsa ntchito shuga mwa zotumphukira zake. Mosiyana ndi mankhwala a sulfonylurea, metformin sayambitsa hypoglycemia kwa odwala omwe ali ndi matenda a shuga 2 kapena anthu athanzi (kupatula milandu yapadera). Mankhwalawa ndi mankhwalawa sikuti kumayambitsa kukula kwa hyperinsulinemia. Pogwiritsa ntchito metformin, insulin katulutsidwe sikusintha, pamene kuchuluka kwa insulin m'mimba yopanda kanthu komanso masana kumatha kuchepa.
Metformin imathandizira kuphatikizika kwa glycogen synthesis mwa glycogen synthase ndikukulitsa kutulutsa kwa glucose ndi mapuloteni ena amtundu wa glucose transporter (GLUT-1 ndi GLUT-4).
Pogwiritsa ntchito metformin, njira yothandiza pa kagayidwe ka lipoproteins imadziwika: kuchepa kwa kuchuluka kwa cholesterol, LDL cholesterol ndi TG, yosagwirizana ndi mphamvu ya mankhwalawa m'magazi a glucose.
Mukamagwiritsa ntchito mankhwala osakanikirana ndi vildagliptin ndi metformin mu Mlingo wa tsiku ndi tsiku wa 1500-3000 mg wa metformin ndi 50 mg ya vildagliptin 2 nthawi / tsiku chaka chimodzi, kuchepa kwakukulu kwa kuchuluka kwa shuga m'magazi kunawonedwa (kutsimikiziridwa ndi kuchepa kwa HbA_1s) ndikuwonjezereka kwa chiwerengero cha odwala omwe ali ndi kuchepa kwa HbA_1s zinali pafupifupi 0.6-0.7% (poyerekeza ndi gulu la odwala lomwe limangolandira metformin yokha).
Odwala omwe amalandila vildagliptin ndi metformin, kusintha kwakukulu pa kulemera kwamunthu poyerekeza ndi koyambirira sikunawonedwe.Masabata 24 atayamba chithandizo, m'magulu a odwala omwe amalandila vildagliptin osakanikirana ndi metformin, panali kuchepa kwa magazi a systolic ndi diastolic kwa odwala omwe ali ndi matenda oopsa.
Pamene kuphatikiza kwa vildagliptin ndi metformin kunagwiritsidwa ntchito ngati chithandizo choyambirira cha odwala omwe ali ndi matenda a shuga 2, kutsika kwa HbA komwe kumadalira mlingo kumawonedwa kwa milungu 24_1s komanso kulemera kwa thupi poyerekeza ndi monotherapy ndi mankhwalawa. Milandu ya hypoglycemia inali yochepa kwambiri m'magulu onse awiri ochiritsira.
Mukamagwiritsa ntchito vildagliptin (50 mg 2 nthawi / tsiku) palimodzi / popanda metformin osakanikirana ndi insulin (pafupifupi avareji ya 41 PIECES) mwa odwala mu kafukufuku wamankhwala, chizindikiro cha HbA_1s adatsika kwambiri - - 0.72% (chizindikiro choyambirira - pafupifupi 8.8%). Zomwe zimachitika mu hypoglycemia pagulu lochiritsidwalo zinali zofanana ndi zochitika za hypoglycemia pagulu la placebo.
Mukamagwiritsa ntchito vildagliptin (50 mg 2 nthawi / tsiku) pamodzi ndi metformin (≥1500 mg) osakanikirana ndi glimepiride (≥4 mg / tsiku) mwa odwala omwe ali mu kafukufuku wazachipatala, chizindikiro cha HbA_1s kuchuluka kwakukulu kunatsika - ndi 0.76% (kuchokera pamlingo wapakati - 8.8%).
Pharmacokinetics
Ikamamwa pamimba yopanda kanthu, vildagliptin imatengedwa mwachangu, ndipo C_max akwaniritsa maola 1.75 pambuyo pa utsogoleri. Ndi kulowetsedwa pamodzi ndi chakudya, kuchuluka kwa mayamwidwe a vildagliptin kumachepa pang'ono: kuchepa kwa C_max pofika 19% komanso kuwonjezeka kwa nthawi yoti mufikire maola 2,5. Komabe, kudya sikumakhudza kuchuluka kwa mayamwa ndi AUC.
Vildagliptin imatengedwa mwachangu, kutsimikizika kwamtundu wonse pambuyo pakukonzekera kwamlomo ndi 85%. C_max ndi AUC mu achire mlingo zosiyanasiyana kuchuluka pafupifupi malinga ndi mlingo.
Kumangiriza kwa vildagliptin kuma protein a plasma ndikotsika (9.3%). Mankhwalawa amagawidwa chimodzimodzi pakati pa plasma ndi maselo ofiira amwazi. Kugawa kwa Vildagliptin kumachitika mopitilira muyeso, V_ss Pambuyo pa utsogoleli wa iv ndi malita 71.
Biotransfform ndiye njira yayikulu yodziwitsira ya vildagliptin. Mu thupi la munthu, 69% ya mlingo wa mankhwalawo amasandulika. Metabolite yayikulu - lay151 (57% ya mlingo) imagwira ntchito pamankhwala ndipo ndi chida cha hydrolysis cha gawo la cyano. Pafupifupi 4% ya mankhwala omwe amapezeka amide hydrolysis.
M'maphunziro oyesera, zotsatira zabwino za DPP-4 pa hydrolysis yamankhwala zimadziwika. Vildagliptin sichimaphatikizidwa ndi gawo la cytochrome P450 isoenzymes. Malinga ndi kafukufuku wa in vitro, vildagliptin si gawo lapansi, sichingaletse ndipo sichilowetsa CYP450 isoenzymes.
Pambuyo pakulowetsa mankhwalawa, pafupifupi 85% ya mankhwalawa imachotsedwa impso ndi 15% kudzera m'matumbo, impso ya vildagliptin yosasinthika ndi 23%. Ndi utsogoleri wa iv, pafupifupi T_1/2 ukufika 2 maola, chilolezo chonse cha plasma ndi chilolezo cha vildagliptin ndi 41 l / h ndi 13 l / h, motsatana. T_1/2 pambuyo kumeza pafupifupi 3 maola, ngakhale mlingo.
Pharmacokinetics mu milandu yapadera yamankhwala
Gender, BMI, ndi mafuko sizimakhudza ma pharmacokinetics a vildagliptin.
Odwala omwe ali ndi vuto lochepa kwambiri la hepatic (6-10 mfundo malinga ndi Gulu-Pugh), atagwiritsidwa ntchito kamodzi, pali kuchepa kwa bioavailability wa vildagliptin ndi 8% ndi 20%, motero. Odwala omwe ali ndi vuto lochepa kwambiri la hepatic (mfundo 12 malinga ndi gulu la ana-Pugh), bioavailability wa vildagliptin imachulukitsidwa ndi 22%. Kusintha kwakukulu mu bioavailability kwa vildagliptin, kuwonjezeka kapena kuchepa kwapakati mpaka 30%, sikofunika kuchipatala. Panalibe kulumikizana pakati pa kuwonongeka kwa chiwindi chovuta ndi kukhudzana kwa mankhwalawa.
Odwala omwe ali ndi vuto laimpso, ofatsa, olimbitsa, kapena AUC, vildagliptin kuchuluka kwa 1,4, 1,7, komanso 2 nthawi kuyerekeza ndi odzipereka athanzi. The AUC ya metabolite lay151 inachulukitsa 1.6, 3.2 ndi 7.3 zina, ndipo metabolite BQS867 - 1.4, 2.7 ndi 7.3 nthawi odwala omwe ali ndi vuto la impso ofatsa, odziletsa komanso owopsa. Zambiri zochepa mu odwala omwe ali ndi vuto la impso. (CKD) zimawonetsa kuti zizindikiro zomwe zili mgululi ndizofanana ndi za odwala omwe ali ndi vuto la impso. The kuchuluka kwaabela151 metabolite mwa odwala end-site CKD kuchuluka ndi 2-3 zina poyerekeza ndende odwala kwambiri aimpso kuwonongeka. Kuchotsa vildagliptin pa hemodialysis kumakhala kochepa (3% panthawi yopitilira maola opitilira 4 maola 4 pambuyo pa limodzi mlingo.
Kuchuluka kwa bioavailability wa mankhwalawa ndi 32% (kuchuluka kwa C_max 18%) mwa odwala opitilira 70 siwofunika kwambiri ndipo samakhudza kuletsa kwa DPP-4.
Zomwe zimachitika mu pharmacokinetic za vildagliptin mwa ana ndi achinyamata ochepera zaka 18 sizinakhazikitsidwe.
Mtheradi wa bioavailability wa metformin atamwa pakamwa 500 mg pamimba yopanda 50-60%. C_max akwaniritsidwa pambuyo maola 1.81-2.69 pambuyo pa utsogoleri. Ndi kuwonjezeka kwa mlingo wa mankhwalawa kuchokera 500 mg mpaka 1500 mg, kapena kumwa mankhwala pakamwa kuchokera pa 850 mg mpaka 2250 mg, kuwonjezeka kwapang'onopang'ono kwa magawo a pharmacokinetic kunadziwika (kuposa zomwe zingayembekezeredwe pa ubale wololera). Izi zimachitika osati chifukwa chosintha kuchotsedwa kwa mankhwalawo ngati kutsika kwake kumayamwa. Poyerekeza zakumbuyo yazakudya, kuchuluka ndi mayamwidwe a metformin kumachepera pang'ono. Chifukwa chake, ndi muyezo umodzi wa mankhwalawa pa 850 mg, kuchepa kwa C kunawonedwa ndi chakudya_max ndi AUC ndi pafupifupi 40% ndi 25%, komanso kuwonjezeka kwa T_max kwa mphindi 35 Kufunika kwamankhwala pazinthu izi sikunakhazikike.
Ndi pakamwa limodzi lokha 850 mg - wodziwika bwino wa V_d metformin ndi 654 ± 358 malita. Mankhwalawa sakumanga ma protein a plasma, pomwe ena amachokera ku sulfonylurea. Metformin imalowa m'magazi ofiira (mwina kulimbitsa njirayi kwakanthawi). Mukamagwiritsa ntchito metformin molingana ndi regimen yodziwika (muyezo wapadera komanso pafupipafupi pofotokozera) C_ss mankhwalawa m'madzi a m'magazi amafikira mkati mwa maola 24-48 ndipo, monga lamulo, sizidutsa 1 μg / ml. M'mayesero azachipatala a C_max metformin ya plasma sinapitirire 5 mcg / ml (ngakhale mutamwa mankhwala ambiri).
Kutetemera ndi chimbudzi
Ndi dongosolo limodzi lokhazikika kwa odzipereka athanzi, metformin imachotsedwanso ndi impso sizisintha. Sizimaphatikizidwa m'chiwindi (palibe ma metabolites omwe apezeka mwa anthu) ndipo samatulutsidwa mu ndulu.
Popeza chiwonetsero cha impso cha metformin ndichipamwamba pafupifupi 3.5 peresenti kuposa QC, njira yayikulu yotsitsimutsa mankhwalawa ndi secretion ya tubular. Mukamwetsa, pafupifupi 90% ya mlingo woyamwa umapukusidwa ndi impso nthawi yoyamba ya maola 24, ndi T_1/2 kuchokera m'madzi a m'magazi ndi pafupifupi maola 6.2. T_1/2 metformin yamagazi yonse ndi pafupifupi maora 17.6, zomwe zikuwonetsa kuchuluka kwa mankhwala ambiri m'maselo ofiira a magazi.
Pharmacokinetics mu milandu yapadera yamankhwala
Gender ya odwala sichikhudza pharmacokinetics ya metformin.
Odwala omwe ali ndi vuto la kuchepa kwa hepatic, kuphunzira za mankhwala a pharmacokinetic a metformin sikunachitike.
Odwala ndi mkhutu aimpso ntchito (kuyesedwa ndi QC) T_1/2 metformin yochokera ku plasma ndi magazi onse amawonjezeka, ndipo mawonekedwe ake aimpso amachepetsa motengera kuchepa kwa CC.
Malinga ndi kafukufuku woperewera wa pharmacokinetic mwa anthu athanzi wazaka zapakati pa 65, kuchepa kwa chiwerengero chonse cha plasma ndikuwonjezeka kwa T_1/2 ndi C_max poyerekeza ndi nkhope zazing'ono. Ma pharmacokinetics a metformin mwa anthu opitilira zaka 65 mwina amagwirizana ndi kusintha kwa impso. Chifukwa chake, mwa odwala omwe ali ndi zaka zoposa 80, kuikidwa kwa mankhwala Galvus Met ndikotheka kokha ndi CC yabwinobwino.
Mankhwala a metformin a ana ndi achinyamata ochepera zaka 18 sanakhazikitsidwe.
Palibe umboni wazomwe zimachitika chifukwa cha kuleza mtima kwa mafuko a chemformin. Mu maphunziro azachipatala olamulidwa a metformin mwa odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga amitundu yosiyanasiyana, zotsatira za hypoglycemic zamankhwala zimawonetsedwa chimodzimodzi.
Kafukufuku akuwonetsa bioequivalence molingana ndi AUC ndi C_max Galvus Met m'miyeso itatu yosiyanasiyana (50 mg / 500 mg, 50 mg / 850 mg ndi 50 mg / 1000 mg) ndi vildagliptin ndi metformin omwe adamwa mulingo woyenera wopezeka mapiritsi osiyana.
Zakudya sizikhudzanso kuchuluka kwa mayeso a vildagliptin mu kapangidwe ka mankhwala a Galvus Met. Makhalidwe a C_max ndi AUC ya metformin popanga mankhwala a Galvus Met pomwe akudya ndi zakudya zimachepa ndi 26% ndi 7%, motero. Kuphatikiza apo, kuyamwa kwa metformin kunachepa ndi kudya, zomwe zinapangitsa kuti T iwonjezeke_max (2 mpaka 4 maola). Kusintha kofananako kwa C_max ndipo AUC yokhala ndi chakudya idadziwikanso pankhani ya kugwiritsa ntchito metformin padera, komabe, pomaliza, zosintha sizinali zazikulu.
Zotsatira za chakudya pa pharmacokinetics za vildagliptin ndi metformin popanga mankhwala a Galvus Met sizinasiyane ndi zomwe pomwa mankhwalawa onse.
Mimba komanso kuyamwa
Popeza palibe chidziwitso chokwanira pakugwiritsa ntchito mankhwalawa Galvus Met mwa amayi apakati, kugwiritsa ntchito mankhwalawa panthawi yapakati kumatsutsana.
Milandu ya vuto logaya shuga mwa amayi apakati, pamakhala chiwopsezo chodzala ndi vuto lobadwa nalo, komanso kufalikira kwamatenda a kubadwa kwa neonatal. Kuteteza matenda a shuga m'magazi panthawi yapakati, insulin monotherapy tikulimbikitsidwa.
Kafukufuku wokhudza momwe chonde chaanthu sichinachitike.
Metformin amachotseredwa mkaka wa m'mawere. Sizikudziwika ngati vildagliptin adachotsedwa mkaka wa m'mawere. Kugwiritsa ntchito mankhwala Galvus Met panthawi yoyamwitsa kumayesedwa.
M'maphunziro oyesera, popereka vildagliptin mu Mlingo wowirikiza 200 kuposa momwe analimbikitsira, mankhwalawa sanayambitse kuphwanya koyambirira kwa mluza ndipo sanatulutse mphamvu ya chidziwitso, komanso chonde. Mukamagwiritsa ntchito vildagliptin kuphatikiza ndi metformin paziwerengero 1: 10, palibe teratogenic zotsatira zomwe zapezekanso. Panalibe zoyipa zilizonse zokhudzana ndi chonde mwa amuna ndi akazi omwe amagwiritsidwa ntchito ndi metformin mu Mlingo wa 600 mg / kg / tsiku, lomwe limakhala lokwera katatu kuposa mlingo womwe umalimbikitsa anthu (malingana ndi thupi lanu).
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Contraindised chiwindi ntchito.
Popeza mwa odwala ena omwe ali ndi vuto la chiwindi, lactic acidosis imawonedwa muzochitika zina, zomwe mwina ndi zina mwazotsatira za metformin, Galvus Met sayenera kugwiritsidwa ntchito kwa odwala omwe ali ndi matenda a chiwindi kapena magawo a hepatic biochemical parameter.