Chithandizo chamakono cha antidiabetesic Metformin Teva

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Ena odwala matenda ashuga angaganize kuti sanatengepo metformin. Koma izi sizingachitike, chifukwa theka la odwalawa amathandizidwa ndi mankhwala opangidwa ndi metformin hydrochloride kuyambira masiku oyambira atazindikira kuti ali ndi matenda amtundu wa 2, ngati kusintha kwa njira sikubweretsa zotsatira zomwe mukufuna. Mapiritsi amalembedwa ndi dzina lopanda eniake apadziko lonse metformin munthawi zina (metabolic syndrome, kupewa matenda a mtima ndi oncology), koma mulimonsemo, angathe kugulidwa ndi mankhwala.

Ngati mwakumana ndiformform pa fomu, sankhani Metformin Teva. Analogue yoyenera ya Glucophage yoyambirira ya ku France imakwaniritsa zofunikira zonse zamankhwala apamwamba a antiidiabetes.

Metformin Teva ndi mnzake wakale

Kampani yopanga mankhwala ku Israeli ya TEVA Pharmaceutical Industries, Ltd. mumzinda wa Petah Tikva (komanso maofesi ake oimira ku Poland, Italy ndi maiko ena) amatulutsa zamagetsi kutengera zinthu zomwezo (metformin hydrochloride), ndi mulingo womwewo (500, 850 ndi 1000 mg), komanso kuchuluka komweko yogwira pophika, monga mankhwala a ku France. Zopangira ndi zida zake ndizofanana ndi kuzungulira kwa mabizinesi omwe amapanga metformin yoyambirira.

Njira yogwiritsira ntchito kukonzekera pakamwa kwa choyambirira ndi analogue ndi chimodzimodzi.

Metformin Teva ili ndi zochepa: povidone, magnesium stearate and talc.

Teeric Metformin Teva ndi yokwera mtengo kwambiri: phukusi loyambirira la Glucofage limawononga ma ruble 330, bokosi lofanana la mankhwala a generic - 169 rubles. Mmenemo mutha kupeza matuza angapo okhala ndi mawonekedwe ozungulira kapena ozungulira (kutengera mlingo) mapiritsi okhala ndi mzere wogawaniza komanso wolemba. Nthaka yawo ndi yosalala, yopanda zowonongeka ndi zosayera. Metformin-MV-Teva imapezekanso muyeso wa 500 mg wokhala ndi mphamvu yayitali. Alumali moyo wa mapiritsi ndi zaka 2,5 ndi 3, mankhwalawa safuna mikhalidwe yapadera kuti asungidwe.

Mankhwala

Chofunikira chachikulu cha mankhwalawa ndi metformin hydrochloride, yomwe ndi gulu la zotumphukira zomwe zimapangitsa kuti khungu lizikhala ndi shuga komanso kuti lisinthe. Limagwirira ntchito mankhwala ndi zosiyanasiyana.

1. Mankhwala amaletsa kupanga glycogen mu chiwindi poletsa njira za gluconeogeneis ndi glycogenolysis,
2. Mankhwalawa amachepetsa kukana kwa minofu kupita ku insulin, kumapangitsa kuti kutulutsa kwa glucose kusekeka.
3. Chidachi chimachepetsa kuyamwa kwa glucose ndi matumbo a matumbo.

Biguanide imayambitsa kupanga amkati glycogen.

Amachepetsa kuthekera kwa kayendedwe ka glucose kudutsa membrane wa khungu.

Kukhazikitsidwa koyesa kuti kuchuluka kwa mankhwalawa kwa mankhwalawa kumapangitsa kuti pakhale magazi lipid: kuchepetsa kuchuluka kwa cholesterol, triglycerol ndi otsika kachulukidwe lipids.

Pharmacokinetics

1. Mafuta Mulingo wokwanira wa T max wa mankhwalawa wokhala ndi bioavailability wambiri mpaka 60% amalembedwa patatha maola 2,5 kuchokera pakulowa m'mimba. Ndi regimens yovomerezeka yamankhwala, kuchuluka kosasunthika kwa mankhwala m'magazi kumawonedwa pakatha tsiku limodzi kapena awiri, ndipo amakhala 1 μg / ml. Kumwa mankhwala ndi chakudya kumachepetsa kuyamwa kwa metabolite.
2. Kugawa. Zomwe zimapangidwira sizigwirizana ndi mapuloteni; matupi ake amatha kupezeka m'maselo ofiira a magazi. V D (pafupifupi gawo logawitsira) sapitilira malita 276. Metformin metabolites m'thupi sanazindikirike, osasinthika, amachotsedwa ndi impso.
3. Kuswana. Zizindikiro za hepatic chilolezo cha metformin (kuyambira 400 ml / min.) Sonyezani kuti kuchoka kwake kumatsimikiziridwa ndi kusefera kwa glomerular. Hafu ya moyo m'magawo omaliza a chimbudzi ndi maola 6.5. Ndi kukanika kwa impso, kutsimikiza kumachepa, izi zimakwiyitsa kudzikundikira kwa metformin m'magazi. Mpaka 30% ya mankhwalawa amachotsa matumbo ake momwe adalili kale.

Metformin Teva ndi mankhwala a mzere woyamba; amalembera achikulire ndi ana azaka zopitilira 10 kuti aziwongolera matenda ashuga amtundu wa 2 paliponse pakukula kwa matendawa.

Mankhwalawa amadziwitsidwa ngati kusinthidwa kwamoyo (zakudya zochepa zama carb, zolimbitsa thupi, kuwongolera kupsinjika kwa malingaliro) sikuwongolera mokwanira glycemia

Mankhwalawa ndi oyenera onse kukhala a monotherapy komanso othandizira, popeza metformin imakhala yolumikizidwa bwino ndi insulin komanso mankhwala ena osokoneza bongo amkamwa omwe ali ndi njira ina yopangira kuposa biguanides.

Contraindication

Kuphatikiza pakumvera kwamunthu payekha pazosakaniza zamtunduwu, mankhwalawa sanalembedwe:

• Ndi matenda ashuga a ketoacidosis, chikomokere, mtengo,
• Odwala omwe ali ndi vuto la impso (CC pansi pa 60 ml / min.),
• Odwala atanjenjemera, ndimatenda am'madzi, matenda oopsa osachiritsika,
• Ngati matenda (pachimake kapena aakulu) apangitsa kuti mpweya uzikhala ndi minyewa,
• Pa maphunziro ogwiritsa ntchito zilembo zosiyanitsidwa ndi ayodini,
• Ndi kukanika kwa chiwindi, kuphatikizapo kuledzera (pachimake kapena kupweteka).

Chifukwa cha kusowa kwa umboni wokwanira wa chitetezo, Metformin Teva imalembedwa mwa amayi apakati, amayi oyamwitsa, ndi ana osakwana zaka 10.

Kuyendetsa magalimoto ndi njira zovuta za anthu odwala matenda ashuga panthawi ya chithandizo ndi Metformin Teva sikutsutsana ngati amwa mankhwalawo ngati monotherapy. Ndi chithandizo chovuta, mwayi wa mankhwala ena uyenera kukumbukiridwa.

Malangizo ogwiritsira ntchito

Mankhwala a Metformin Teva amalimbikitsa kuti atenge zonse ndi madzi okwanira. Kutheka kwakukulu kumatha kupezeka pogwiritsa ntchito mapiritsi musanadye kapena nthawi ya chakudya. Dokotala amasankha mankhwalawa komanso muyezo wake polingalira za matendawo, matendawo, zaka za odwala matenda ashuga, momwe munthu angachitire mankhwalawo.

Ndi monotherapy kapena chithandizo chovuta, njira yoyambira siyidutsa 1 tabu / 2 / 2-3r / tsiku. Kuwongolera chiwembuchi kumatheka pambuyo pa masabata awiri, pomwe mungathe kuwunika momwe mankhwalawo alili. Kuwonjezeka pang'onopang'ono kwa thupi kumathandizira kuti thupi likhalebe losinthika ndikusintha pang'ono. Mlingo wakuchepera kwa mankhwalawa m'gulu la odwala matenda ashuga ndi 3 g / tsiku. ndi katatu.

Mukalowetsa analogi ya hypoglycemic ndi mankhwala, amatsogozedwa ndi njira yothandizira yamankhwala. Pazinthu zomwe zachedwa kumasulidwa, mungafunike kuyimitsa kusinthidwa kwatsopano.

Ndi kuphatikiza kwa mapiritsi ndi jakisoni wa insulin, metformin imayamba kumwa ndi mlingo wochepa (500 mg / 2-3 r / tsiku.).

Mlingo wa insulin umasankhidwa malinga ndi zakudya ndi glucometer.

Akuluakulu a matenda ashuga

Pa akatswiri odziwa bwino matenda ashuga, mphamvu ya impso imafooka, chifukwa chake, posankha mtundu wa chithandizo, zomwe akuyenera kudziwa ziyenera kukumbukiridwa ndipo zizindikiro zikuyang'aniridwa pafupipafupi.

Ana omwe ali ndi matenda osokoneza bongo opitirira zaka 10 amapatsidwa 500 mg / tsiku. Piritsi imatengedwa kamodzi, madzulo, panthawi yamadzulo. Dosing titration ndi zotheka pambuyo 2 milungu. Mulingo woyenera kwambiri m'gululi ndi 2000 mg / tsiku, woperekedwa 3 waukulu.

Zotsatira zoyipa ndi bongo

Metformin Teva ndi imodzi mwamankhwala otetezeka kwambiri odwala matenda ashuga. Zotsatira izi zimatsimikiziridwa ndi kafukufuku wambiri komanso zaka zambiri zochita zamankhwala. Munthawi yozolowera, 30% ya anthu odwala matenda ashuga amadandaula za matenda am'mimba: nseru, kusanza, kukoma kwazitsulo nthawi ndi nthawi, kulakalaka kuchepetsedwa, chakudya chilichonse chimatha ndikusokonekera kwa chopondapo.

Kuchepetsa pang'ono pang'onopang'ono kwa mankhwalawa kumachepetsa kusapeza ndipo pakapita nthawi zizindikirazo zimatha. Mbali ya Metformin Teva ndizofunikira zochepa pazomwe zimapangidwira. Nthawi zambiri ndi omwe amapangitsa zotsatira zoyipa.

Ngakhale kuwonjezeka kofananako ka 10 peresenti yothandizira mankhwalawa sikunapangitse hypoglycemia. M'malo mwake, zizindikiro za lactic acidosis zinaonedwa. Bwezeretsani ntchito za thupi lomwe lakhudzidwa ndi kulowetsedwa ndi hemodialysis.

Mankhwala

Metformin hydrochloride ndi mankhwala opatsirana a gulu la zinthu zazikulu zotulutsidwa, zomwe zimachepetsa kuchuluka kwa shuga m'magazi am'mimba pamimba yopanda kanthu ndikatha kudya.

Metformin hydrochloride ili ndi njira zitatu zotsutsana ndi matenda.

1. Amachepetsa kupanga shuga mu chiwindi poletsa gluconeogeneis ndi glycogenolysis.

2. Kuchulukitsa kumva kwa insulin, kumapangitsanso kutengeka ndikugwiritsika ntchito kwa glucose mu zotumphukira zimakhala.

3. Amachepetsa kuyamwa kwa m'matumbo.

Metformin hydrochloride imathandizira kapangidwe ka glycogen mu intracellular, kumawonjezera kuthekera kwamitundu yonse yamayendedwe omwe amayenda ndi glucose kudzera membrane wa cell, imakhudza metabolidi ya lipid. Zatsimikiziridwa kuti metformin mu mankhwala othandizira amachepetsa kuchuluka kwa cholesterol, lipoproteins yotsika komanso triglycerides.

Zinanenedwa kuti ndi Metformin, kulemera kwamthupi la wodwalayo kunakhazikika kapena kumachepetsa.

Zogulitsa. Mukatenga metformin, nthawi yofika ndende yozizira kwambiri (T _max ) pafupifupi maola 2,5. The bioavailability mapiritsi 500 mg pafupifupi 50-60%. Pambuyo pakukonzekera pakamwa, chidutswa chomwe sichikumwa ndipo chimalimbidwa ndi ndowe ndi 20-30%.

Pambuyo pakukonzekera pakamwa, kuyamwa kwa metformin kumakhala kokhazikika komanso kosakwanira.

Ma pharmacokinetics a mayamwidwe a metformin amawerengedwa kuti ndi osagwirizana. Mukamagwiritsidwa ntchito pazovomerezeka za metformin ndi regimens, makulidwe a plasma okhazikika amapezeka mkati mwa maola 24-48 ndipo ndi ochepera 1 1g / ml. Kwanenedwa kuti kuchuluka kwambiri kwa plasma metformin (C _max ) sanapitirire 5 μg / ml ngakhale ndi mlingo waukulu.

Ndi chakudya chofananacho, kuyamwa kwa metformin kumachepa ndikuchepera.

Pambuyo pakulowa kwa mlingo wa 850 mg, kuchepa kwa ndende yambiri ya plasma ndi 40%, kuchepa kwa AUC ndi 25%, ndi kuwonjezereka kwa mphindi 35 panthawi yoti anthu afike pozindikira kwambiri plasma. Kukula kwamankhwala kwakusintha kumeneku sikudziwika.

Kugawa. Metformin imagwira pang'ono mapuloteni a plasma. Metformin imalowa m'magazi ofiira. Kuchuluka kwambiri m'magazi kumakhala kocheperako poyerekeza ndi kuchuluka kwa magazi a m'magazi, ndipo kumachitika pambuyo pake. Maselo ofiira nthawi zambiri amayimira chipinda chogawirako chachiwiri. Voliyumu yapakati yogawa (V _d ) ndi malita 63-276.

Kupenda. Metformin imachotsedwa mu mkodzo. Palibe ma metabolites omwe amapezeka mwa anthu.

Pomaliza Chilolezo cha metformin - choposa 400 ml / min. Izi zikuwonetsa kuti metformin imachotsedwera chifukwa cha kusefera kwamadzi ndi kubisalira kwa tubular. Pambuyo makonzedwe, kuchotsa theka moyo ndi pafupifupi 6.5 maola. Mu vuto la impso, kutsekeka kwa impso kumatsika molingana ndi kupezeka chilolezo cha creatinine, mogwirizana ndi izi, theka la moyo limawonjezeka. Izi zimabweretsa kuwonjezeka kwa kuchuluka kwa metformin m'madzi a m'magazi.

Type II shuga mellitus ndi kulephera kwa zakudya mankhwala ndi zolimbitsa thupi, makamaka odwala onenepa kwambiri

• monga monotherapy kapena kuphatikiza mankhwalawa molumikizana ndi ena othandizira pakamwa a hypoglycemic kapena kuphatikiza ndi insulini pochiza akuluakulu,
• monga monotherapy kapena kuphatikiza mankhwala omwe ali ndi insulin pochizira ana azaka za 10 ndi achinyamata.

Kuchepetsa zovuta za matenda a shuga kwa anthu akuluakulu omwe ali ndi mtundu wachiwiri wa matenda a shuga komanso onenepa kwambiri yemwe amagwiritsa ntchito metformin ngati mankhwala oyambira ndi chithandizo chamankhwala osagwiritsa ntchito bwino.

Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana

Mowa . Kuledzera kwa pachimake kumayenderana ndi chiopsezo chowonjezeka cha lactic acidosis, makamaka ngati akusala kudya kapena kutsatira zakudya zochepa zopatsa mphamvu, komanso ndi vuto la chiwindi. Mukamachitira ndi metformin, mowa ndi mankhwala okhala ndi mowa ziyenera kupewedwa.

Iodini wokhala ndi zinthu za radiopaque. Kugwiritsira ntchito kwa ayodini mankhwala okhala ndi ayodini zomwe zingayambitse matenda a impso ndipo, chifukwa chake, kuphatikizika kwa metformin komanso chiwopsezo cha lactic acidosis.

Kwa odwala omwe ali ndi GFR (glomerular filtration rate)> 60 ml / mphindi / 1.73 m 2, kugwiritsa ntchito metformin kuyenera kuyimitsidwa isanachitike kapena mkati mwawerengera ndipo sikuyenera kuyambiranso kupitilira maola 48 mutatha kafukufukuyu, pokhapokha kuwunikanso ntchito ya impso ndikutsimikizira kusowa kwa kupitirira kuwonongeka kwa impso.

Odwala omwe amalephera kupweteka aimpso (GFR 45-60 ml / mphindi / 1.73 m 2) ayenera kusiya kugwiritsa ntchito Metformin maola 48 asanaikidwe kwa ayodini wokhala ndi zinthu za radiopaque ndipo sayenera kuyambiranso kumayambiriro maola 48 mutatha kafukufukuyu ndi chitsimikizo cha kusowa kwa kuwonongeka kwa impso.

Kuphatikiza kuyenera kugwiritsidwa ntchito mosamala.

Mankhwala omwe ali ndi vuto la hyperglycemic (GCS of systemic and local action, sympathomimetics) . Ndikofunikira kuthana ndi shuga m'magazi pafupipafupi, makamaka kumayambiriro kwa chithandizo. Pakati kapena atasiya kugwiritsa ntchito mankhwala olowa, ndikofunikira kusintha mlingo wa metformin.

Ma diuretics, makamaka zida zotulutsa, achulukitse chiopsezo cha lactic acidosis chifukwa kuchepa kwa impso.

Zolemba zogwiritsira ntchito

Lactic acidosis. Lactic acidosis sichichitika kawirikawiri, koma imakhala yowopsa ndi metabolic complication (kuchuluka kwambiri kwaimfa pakalibe chithandizo chamankhwala mwadzidzidzi), zomwe zimatha kuchitika chifukwa chakuwoneka kwa metformin. Nkhani za lactic acidosis zidanenedwa kwa odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi vuto la impso kapena lakuthwa muimpso. Chenjezo liyenera kuchitika pakakhala vuto la impso, mwachitsanzo, ngati mutha magazi (kutsegula m'mimba kwambiri kapena kusanza), kapena kumayambiriro kwa chithandizo cha mankhwala a antihypertensive, okodzetsa, komanso kumayambiriro kwa mankhwala a NSAID. Zikachitika izi, ndikofunikira kuyimitsa kanthawi kochepa kugwiritsa ntchito metformin.

Zina zomwe zimapangitsa kuti pakhale lactic acidosis ziyenera kuganiziridwanso: kusungidwa bwino kwa matenda a shuga mellitus, ketosis, kusala kudya kwa nthawi yayitali, kumwa mowa kwambiri, kulephera kwa chiwindi kapena vuto lililonse lomwe lingachitike ndi hypoxia (mtima wosakhazikika, kulowetsedwa kwapanja).

Lactic acidosis imatha kuwoneka ngati kukokana minofu, kudzimbidwa, kupweteka kwam'mimba komanso asthenia yayikulu. Odwala ayenera kudziwitsa dokotala nthawi yomweyo zomwe zimachitika, makamaka ngati odwala adalekerera kale kugwiritsa ntchito metformin. Zikatero, ndikofunikira kusiya kugwiritsa ntchito metformin mpaka izi zitamveka bwino. Mankhwala a Metformin amayenera kuyambiridwanso pambuyo powunikira phindu / chiopsezo pazochitika zina ndikuwunika ntchito ya impso.

Zizindikiro Lactic acidosis imadziwika ndi kufupika kwa acidic, kupweteka kwam'mimba komanso hypothermia, kupititsa patsogolo kukoma mtima kumatha.Zizindikiro zakuzindikira zimaphatikizapo kuchepa kwa labot mu magazi pH, kuwonjezeka kwa kuchuluka kwa lactate mu seramu yamagazi pamwamba pa 5 mmol / l, kuwonjezeka kwa kusiyana kwa anion ndi chiŵerengero cha lactate / pyruvate. Pankhani ya kukula kwa lactic acidosis, ndikofunikira kuchipatala wodwala nthawi yomweyo (onani gawo "Overdose"). Dokotala ayenera kuchenjeza odwala za chiwopsezo cha kukula ndi zizindikiro za lactic acidosis.

Kulephera kwina. Popeza impformin imachotsedwa ndi impso, ndikofunikira kuyang'ana kuvomerezedwa kwa creatinine (titha kuwerengera ndi kuchuluka kwa plasma creatinine pogwiritsa ntchito njira ya Cockcroft-Gault) kapena GFR kale komanso pafupipafupi pa chithandizo cha metformin:

• odwala aimpso ntchito - osachepera 1 pachaka,
• Kwa odwala okhala ndi chilolezo cha creatinine m'munsi mwa odwala wamba komanso okalamba - osachepera 2-4 pachaka.

Ngati creatinine chilolezo 2), metformin imatsutsana (onani. "Contraindication").

Kuchepetsa aimpso ntchito mu okalamba odwala kumachitika pafupipafupi ndipo asymptomatic. Chenjezo liyenera kuchitika pakakhala vuto la impso, mwachitsanzo, ngati mutha kuchepa mphamvu kapena kumayambiriro kwa chithandizo chamankhwala a antihypertensive, okodzetsa, komanso kumayambiriro kwa mankhwala a NSAIDs. Zikatero, timalimbikitsidwanso kuyang'anira ntchito ya impso musanayambe chithandizo ndi metformin.

Ntchito yamtima. Odwala omwe ali ndi vuto la mtima ali ndi chiopsezo chachikulu chokhala ndi hypoxia komanso kulephera kwa impso. Odwala omwe ali ndi vuto la mtima wosakhazikika, metformin itha kugwiritsidwa ntchito poyang'anira mtima ndi ntchito yaimpso. Metformin imaphatikizidwa kwa odwala omwe ali ndi vuto la mtima komanso losakhazikika.

Ma ayodini okhala ndi ayodini. Kugwiritsa ntchito kwaukadaulo kwa ma radiopaque othandizira pophunzira ma radiology kungayambitse kulephera kwa impso, ndipo, chifukwa chake, kumabweretsa kuwunika kwa metformin komanso chiwopsezo cha lactic acidosis. Kwa odwala omwe ali ndi GFR> 60 ml / mphindi / 1.73 m 2, kugwiritsa ntchito metformin kuyenera kuyimitsidwa isanachitike kapena mkati mwa kafukufukuyu, osatinso kuwunika maola 48 pambuyo phunziroli, pokhapokha kuwunikanso ntchito ya aimpso ndikutsimikizira kuti kulibe kuwonongeka kwina kwa impso (onani. .

Odwala omwe amalephera kupweteka aimpso (GFR 45-60 ml / mphindi / 1.73 m 2) ayenera kusiya kugwiritsa ntchito Metformin maola 48 asanagwiritse ntchito mankhwala okhala ndi ayodini ndipo sayenera kuyambiranso kumayambiriro maola 48 mutatha kafukufuku, pokhapokha kuwunikanso ntchito yaimpso. ndi chitsimikizo cha kusowa kwa kuwonongeka kwa aimpso (onani "Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana").

Zithandizo za opaleshoni. Ndikofunikira kusiya kugwiritsa ntchito metformin maola 48 musanachitike opaleshoni yokonzekera, yomwe imagwira ntchito mobwerezabwereza, msana kapena opaleshoni ya m'mimba ndipo osayambiranso kale kuposa maola 48 mutatha kugwiritsa ntchito kapena kubwezeretsanso zakudya zam'mlomo komanso ngati ntchito yachilendo ya impso ikhazikitsidwa.

Ana. Musanayambe chithandizo ndi metformin, kuwunika kwa mtundu II wa matenda a shuga kuyenera kutsimikiziridwa. Malinga ndi zotsatira za kafukufuku, palibe zotsatira za metformin pa kukula ndi kutha kwa ana zomwe zidawululidwa. Komabe, palibe deta pazotsatira za kukula kwa metformin ndi kutha msanga pogwiritsa ntchito metformin, chifukwa chake, kuwunikira mosamala magawo awa kwa ana omwe amathandizidwa ndi metformin, makamaka panthawi yakutha, akulimbikitsidwa.

Ana azaka zapakati pa 10 mpaka 12. Malinga ndi zotsatira za kafukufuku wa ana 15 azaka zapakati pa 10 mpaka 12, kuwongolera ndi chitetezo cha metformin pagulu la odwala sizosiyana ndi zomwe zimachitika mwa ana okalamba komanso achinyamata. Mankhwala ayenera kuikidwa mosamala kwa ana azaka zapakati pa 10 mpaka 12.

Njira zina zopewera. Odwala ayenera kutsatira zakudya, kudya yunifolomu yanga tsiku lonse. Odwala onenepa kwambiri ayenera kupitiliza kutsatira zakudya zamafuta ochepa. Ndikofunikira kuyang'anira pafupipafupi zizindikiro za kagayidwe kazakudya.

Metformin monotherapy siyimayambitsa hypoglycemia, koma muyenera kusamala mukamagwiritsa ntchito metformin ndi insulin kapena othandizira ena pakamwa (mwachitsanzo, sulfonylureas kapena meglitinidam.

Gwiritsani ntchito pa nthawi yoyembekezera

Mimba Matenda osagwirizana ndi matenda a shuga panthawi yomwe ali ndi pakati (gestational kapena kulimbikira) amawonjezera mwayi wokhala ndi vuto lobadwa nalo komanso kufa kwa perinatal. Pali zosowa zochepa pakugwiritsa ntchito metformin kwa amayi apakati, sizikuwonetsa chiwopsezo chowonjezereka cha kubadwa kwatsopano.

Kuyamwitsa. Metformin imachotsedwa mkaka wa m'mawere, koma palibe zotsatira zoyipa zomwe zimawonedwa mu neonates / makanda omwe adayamwa. Komabe, popeza palibe chidziwitso chokwanira pa mankhwalawa, kuyamwitsa sikulimbikitsidwa panthawi ya metformin. Lingaliro loletsa kuyamwitsa liyenera kuganiziridwapo zabwino za kuyamwitsa ndi chiopsezo cha zovuta zoyamwitsa khanda.

Chonde . Metformin sizinakhudze chonde nyama ikagwiritsidwa ntchito mu Mlingo wa 600 mg / kg / tsiku, lomwe linali lokwera pafupifupi katatu kuposa kuchuluka kwa tsiku lililonse kwa anthu chifukwa cha thupi.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina.

Metformin monotherapy siyimakhudzanso kuchuluka kwa zochita mukamayendetsa kapena kugwiritsa ntchito njira zina, chifukwa mankhwalawa samayambitsa hypoglycemia.

Mlingo ndi makonzedwe

Monotherapy kapena kuphatikiza mankhwalawa molumikizana ndi ena othandizira pakamwa.

Nthawi zambiri, muyeso woyambira ndi 500 mg (ntchito muyezo woyenera) kapena 850 mg ya metformin hydrochloride katatu patsiku pakudya kapena mutatha kudya.

Pambuyo masiku 10-15, mlingo uyenera kusinthidwa malinga ndi zotsatira za milingo ya shuga mu seramu yamagazi.

Kuchepetsa pang'onopang'ono kwa mlingo kumachepetsa mavuto kuchokera m'mimba.

Mlingo woyenera kwambiri ndi 3000 mg patsiku (gwiritsani ntchito mulingo woyenera), wogawidwa pazigawo zitatu.

Pankhani yosintha kuchokera ku mankhwala ena okhudzana ndi matenda ashuga, ndikofunikira kusiya kumwa mankhwalawa ndikupereka metformin, monga tafotokozera pamwambapa.

Kuphatikiza mankhwala ndi insulin .

Kuti akwaniritse bwino kuchuluka kwa shuga m'magazi, metformin ndi insulin zitha kugwiritsidwa ntchito ngati mankhwala osakanikirana.

Monotherapy kapena kuphatikiza mankhwala omwe ali ndi insulin.

Metformin hydrochloride imagwiritsidwa ntchito mwa ana kuyambira azaka 10 ndi achinyamata. Nthawi zambiri, muyeso woyambira ndi 500 mg (ntchito pa mlingo woyenera) kapena 850 mg ya metformin hydrochloride 1 nthawi patsiku panthawi kapena mukatha kudya. Pambuyo masiku 10-15, mlingo uyenera kusinthidwa malinga ndi zotsatira za milingo ya shuga mu seramu yamagazi.

Kuchepetsa pang'onopang'ono kwa mlingo kumachepetsa mavuto kuchokera m'mimba.

Mlingo woyenera kwambiri ndi 2000 mg patsiku, womwe umagawidwa mu 2-3 Mlingo.

Odwala okalamba kuchepa kwa ntchito yaimpso, chifukwa chake, mlingo wa metformin uyenera kusankhidwa malinga ndi kuwunika kwa impso, komwe kuyenera kuchitidwa pafupipafupi (onani Gawo "Zogwiritsira ntchito").

Odwala aimpso kulephera. Metformin itha kugwiritsidwa ntchito kwa odwala omwe amalephera kupweteka aimpso, gawo Sha (creatinine clearance 45-59 ml / min kapena GFR 45-59 ml / mphindi / 1.73 m 2) pokhapokha pazinthu zina zomwe zingakulitse chiopsezo cha lactic acidosis, kusintha kwa mlingo wotsatira: mlingo woyambirira ndi 500 mg kapena 850 mg wa metformin hydrochloride 1 nthawi patsiku. Mlingo wapamwamba ndi 1000 mg patsiku ndipo uyenera kugawidwa pawiri. Kusanthula mosamala kwa ntchito ya impso (miyezi 3-6 iliyonse) kuyenera kuchitika.

Ngati creatinine chilolezo kapena GFR itatsikira ku 2, motero, metformin iyenera kuyimitsidwa nthawi yomweyo.

Metformin imagwiritsidwa ntchito pochiritsa ana kuyambira zaka 10.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimachitika pafupipafupi, makamaka kumayambiriro kwa chithandizo cha mankhwalawa, kusanza, kusanza, kupweteka m'mimba, kusowa kudya.

Kuchokera m'mimba: zovuta zam'mimba, monga mseru, kusanza, kusowa kudya, kutsegula m'mimba, kupweteka kwam'mimba. Nthawi zambiri, zoyipa izi zimachitika poyambira chithandizo ndipo, monga lamulo, zimangodziyendera.

Kuchokera kumbali ya kagayidwe: lactic acidosis.

Pogwiritsa ntchito mankhwalawa kwanthawi yayitali, mayamwidwe a vitamini B akhoza kuchepa ₁₂ , yomwe imayendetsedwa ndi kuchepa kwa mulingo wake mu seramu yamagazi. Ndikulimbikitsidwa kuti kuganiziridwa motere kungachitike chifukwa cha hypovitaminosis B. ₁₂ ngati wodwalayo ali ndi meWIblastic anemia.

Kuchokera ku dongosolo lamanjenje: kuphwanya kukoma.

Kuchokera m'mimba: kuchepa kwa ntchito ya chiwindi kapena hepatitis, yomwe imazimiririka pambuyo pochotsedwa kwa metformin.

Pa khungu ndi subcutaneous minofu: zimachitika pakhungu, kuphatikizapo erythema, pruritus, urticaria.

Kuyesa kwa wogwiritsa ntchito mankhwalawa

Palibe ndemanga zoyipa pa Metformin Teva. Odwala matenda ashuga amawona kupezeka kwake, kugwira ntchito kwawo ndi chitetezo chake, osati chotsika mtengo kuposa anzawo.

Bungwe la mayiko osiyanasiyana la Teva Pharmaceutical Industries Ltd ndi mtsogoleri wazogulitsa zamankhwala padziko lonse lapansi: chaka chokha chokha, phindu lake lonse lidakwana $ 22 biliyoni. Kampaniyo imayang'anira misika yonse 80 kumene zinthu zake zilipo. Kwazaka zopitilira 20 akhala akugawana ndi ogula aku Russia, akumawapatsa mitundu 300 ya zinthu zomwe akupanga.

Kuyambira 2014, chomera chakhala chikugwira ntchito ku Yaroslavl chomwe chimapanga mapiritsi 2 biliyoni pachaka ku Russia ndi mayiko oyandikana nawo. Kampani ya Teva LLC ndi yotseguka ngati gawo la kukhazikitsa njira zake zapadziko lonse lapansi.