Metformin Richter: malangizo ogwiritsira ntchito mankhwala, mtengo ndi contraindication

Metformin Richter: malangizo ogwiritsa ntchito ndi kuwunikira

Dzina lachi Latin: Metformin-Richter

Code ya ATX: A10BA02

Chithandizo chogwira: metformin (metformin)

Wopanga: Gideon Richter-RUS, AO (Russia)

Kusintha kwamalingaliro ndi chithunzi: 10.24.2018

Mitengo muma pharmacies: kuchokera ku ma ruble a 180.

Metformin-Richter ndi mankhwala a hypoglycemic poperekera pakamwa, omwe ali m'gulu la Biguanide.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwalawa amapangidwa ngati mapiritsi okhala ndi filimu: biconvex, ozungulira (500 mg) kapena oblong (850 mg), chigobacho ndi mtanda wake ndi zoyera (ma PC 10. Mu paketi yazovala, 1 kapena 6 mapaketi a katoni) .

Piritsi limodzi lili:

yogwira mankhwala: metformin hydrochloride - 500 kapena 850 mg,
zina zowonjezera: polyvidone (povidone), Copovidone, magnesium stearate, prosalv (colloidal silicon dioxide - 2%, microcrystalline cellulose - 98%),
chovala cha kanema: opadry yoyera II 33G28523 (hypromellose - 40%, titanium dioxide - 25%, lactose monohydrate - 21%, macrogol 4000 - 8%, triacetin - 6%.

Mankhwala

Metformin imachepetsa mayendedwe a gluconeogenesis m'chiwindi, amachepetsa mayamwidwe am'matumbo kuchokera m'matumbo, amathandizira kuwonjezera kugwiritsidwa ntchito kwa glucose ndikuthandizira chidwi cha minofu. Pamodzi ndi izi, thunthu silikhudzana ndikupanga insulin ndi ma β-cell a kapamba ndipo satitsogolera pakukula kwa hypoglycemic reaction.

Mankhwalawa amachepetsa mulingo wochepetsetsa wa lipoproteins (LDL), triglycerides ndi cholesterol yathunthu m'magazi.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, mankhwalawa amamwa kuchokera m'matumbo am'mimba (GIT). Kuzindikira kwakukulu kwa zinthu (C_max) m'magazi am'madzi mumatha kupezeka maola 2,5, bioavailability ndi 50-60%. Kudya kumachepetsa C_max metformin ndi 40%, komanso kuchedwa kukwaniritsa kwake ndi mphindi 35.

Gawo Logawa (V_d) mukamagwiritsa ntchito 850 mg ya chinthu ndi 296-1012 malita. Chidacho chimadziwika ndi kufalitsa mwachangu mu minofu komanso kotsika kochepa kwambiri komanga kumapuloteni a plasma.

Kusintha kwa metabolic kwa metformin ndizochepa kwambiri, mankhwalawa amachotsedwa ndi impso. Mwa anthu athanzi, chilolezo cha thupilo ndi 400 ml / min, omwe ndi okwera kwambiri kuposa momwe kuwala kwa creatinine chilili (CC), izi zimatsimikizira kupezeka kwa katulutsidwe katulutsidwe ka tubular. Hafu ya moyo (T_½) - maola 6.5.

Contraindication

matenda a shuga, chikomokere,
matenda ashuga ketoacidosis,
matenda a impso (CC zosakwana 60 ml / min),
makulidwe akuwonetsa matenda omwe ali pachimake komanso osakhazikika omwe angapangitse kupezeka kwa minofu hypoxia (kulowetsedwa kwamkati wamtima, kupweteka kwa mtima / kupuma, ndi zina zambiri.),
matenda pachimake limodzi ndi chiopsezo cha kuphwanya impso ntchito: matenda opatsirana, malungo, hypoxia (bronchopulmonary matenda, matenda a impso, sepsis, mantha), kusowa kwamadzi (motsutsana ndi kusanza, kutsekula m'mimba),
ntchito chiwindi,
lactic acidosis (kuphatikizapo mbiri)
poyizoni wakumwa woledzera, uchidakwa wambiri,
kuvulala komanso kuchitapo kanthu mochita opaleshoni yomwe amasonyezera chithandizo cha insulin,
gwiritsani ntchito osachepera masiku awiri asanafike komanso masiku awiri mutakhazikitsa maphunziro a radioisotope ndi x-ray, momwe mumakhala mankhwala omwe amapezeka ayodini.
shuga-galactose malabsorption, tsankho lactose, kuchepa kwa lactase,
kufunikira kwa zakudya zama hypocaloric (zosakwana 1000 kcal / tsiku),
Mimba ndi kuyamwa
Hypersensitivity ku zilizonse za mankhwala.

Metformin Richter simalimbikitsidwa kwa odwala azaka zopitilira 60 omwe amagwira ntchito zolimbitsa thupi.

Mankhwala

Metformin-Richter ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo omwe amadalira insulin komanso odwala insulin. Mankhwala amatha kuletsa kagayidwe kachakudya ka chiwindi, kamene kamayambitsa kupangika kwa glucose, kumachepetsa mayamwidwe a dextrose kuchokera m'matumbo, kumakulitsa chiwopsezo cha minofu ndi ziwalo zamapuloteni a pancreas.

Mankhwalawa samakhudza kupanga kwa insulin ndi kapamba, komanso sikuthandizira pachiwopsezo cha hypoglycemia. Mankhwalawa samathandizira kuwonjezeka kwa zomwe zimakhala ndi mapuloteni am'mimba a kapamba, zomwe zimayambitsa kuwonjezeka kwa thupi, komanso kuwonetsa kwa zovuta m'matenda a matenda ashuga. Mankhwalawa amathandizira kuti thupi lizilimbitsa thupi.

Metformin Richter amachepetsa kuchuluka kwa ma pracylglycerides ndi lipids mu seramu yamagazi, amachepetsa njira yamafuta oxidation, amalimbikitsa kupanga kwa aliphatic monobasic carboxylic acids, amathandizira pakugwira ntchito kwa mtima ndi mitsempha yamagazi, ndipo amalepheretsa kuwonongeka kwa mitsempha yayikulu komanso yaying'ono yamitsempha yamagazi m'magazi a shuga.

Mankhwala amathandizidwa kukonzekera kwamkati, zomwe zimakhala bwino zimatha pambuyo pa maola a 2,5. Maola asanu ndi limodzi atakhazikitsa, mankhwalawo amayamba kuchotsedwa pang'onopang'ono kuchokera mthupi, zomwe zimachepetsa zomwe zimapangidwa ndi mankhwala m'thupi. Pogwiritsa ntchito mankhwalawa mosalekeza, zomwe zili mu zigawo za mankhwala m'thupi zimakhalabe zosasinthika, zomwe zimakhudza mphamvu ndi njira ya matendawa. Mukamagwiritsa ntchito mankhwalawa pakudya, mayamwidwe a Metformin-Richter m'thupi amachepa.

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwalawa amapangidwa ngati mawonekedwe apiritsi, yomwe imakutidwa ndi filimu yopyapyala. Kulemera kwa maselo akugwira ntchito pamapiritsi ndi 0,5 kapena 0,85 magalamu. Bokosi limakhala ndi miyala 30 kapena 120, kuwonjezera apo, malangizo ogwiritsira ntchito amamangidwa. Zina mwa zigawo za mankhwala ndi izi:

metformin

kukhuthala

magnesium stearic acid,

talcum ufa.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amalimbikitsidwa kwa odwala omwe ali ndi matenda osokoneza bongo omwe samadalira insulin komanso osadalira insulin. Mankhwalawa amagwiritsidwa ntchito ngati mankhwala amodzi pochiritsira, komanso mankhwala ovuta. Kuphatikiza apo, mankhwalawa amalembedwa kwa odwala omwe ali ndi vuto lolemera kwambiri panthawi ya matenda ashuga, kufunika kolamulira ndende ya dextrose, polycystic ovary syndrome.

Zotsatira zoyipa

Kumwa mankhwala kumatha kuyambitsa mavuto:

kumva mseru

zimbudzi zotayirira

akukumbutsa

kupweteka m'mimba

kusowa kwa chakudya

kulawa kwazitsulo pamkamwa,

kufiira pakhungu chifukwa cha kukulira kwa capillaries,

kupukusa kwa cobalamin,

Kuchepetsa kuchuluka kwa mafuta am'madzi m'magazi,

kuphwanya njira yopanga magazi,

Matenda a Addison-Birmer.

Njira ndi mawonekedwe ogwiritsira ntchito

Mankhwala Metformin-Richter amapezeka amtundu wa mapiritsi omwe amawapangira pakamwa pakamwa. Simungadule, kuthyola, kuwononga, kupwanya kapena kutafuna mapiritsi, ziyenera kudyedwa kwathunthu, kutsukidwa ndi madzi okwanira. Mlingo wovomerezeka tsiku lililonse, komanso nthawi yayitali ya mankhwala, amatsimikiziridwa ndi dokotala pambuyo pakuwunika, kusanthula mayesero ndi kutsimikiza zenizeni zamankhwala matenda. Kuphatikiza apo, malingaliro othandizira kugwiritsa ntchito mankhwalawa amalembedwa mu malangizo ogwiritsira ntchito. Kuti muchepetse chiopsezo cha mavuto, ndikofunikira kugawa mlingo woyenera tsiku lililonse. Mankhwala okhala ndi mapiritsi okhala ndi kulemera kwa 500 mg: Mlingo wovomerezeka tsiku lililonse ndi 500-1000 mg. Pambuyo masiku 10-15 makonzedwe, tikulimbikitsidwa kuwonjezera mlingo, kutengera kuchuluka kwa dextrose mu seramu yamagazi. Mlingo wapamwamba tsiku lililonse ndi 3000 mg. Mankhwala okhala ndi mapiritsi okhala ndi kulemera kwa 850 mg: Mlingo wovomerezeka tsiku lililonse ndi 850 mg kapena piritsi limodzi. Pambuyo masiku 10-15 akukhazikitsa, tikulimbikitsidwa kuti muwonjezere mlingo, mutatha kuyeza dextrose m'magazi. Mlingo wambiri watsiku ndi tsiku ndi 2550 mg. Mankhwala omwe ali ndi monotherapy sasokoneza kuthekera koyendetsa magalimoto, komanso kuthamanga kwa zochitika zama psychomotor ndi kuzunza. Ndi chithandizo chovuta, ndibwino kukana kuyendetsa galimoto ndi ntchito yomwe imafuna chidwi kwambiri. Odwala okalamba amalangizidwa kuti apereke zosaposa 1000 mg za Metformin-Richter. Simungathe kupereka mankhwala kwa odwala omwe ali ndi zaka zopitilira 60, makamaka ngati pali matenda ena ndi zina zomwe zikukhudza mwayi womwe ungatengere mankhwalawa. Simungathe kudziwa mankhwala a Metformin-Richter omwe ali ndi matenda a impso ndi chiwindi.

Kuyenderana ndi mowa

Mankhwala Metformin-Richter sangaphatikizidwe ndi zakumwa zoledzeretsa, chifukwa izi zingapangitse chiwopsezo chowonjezereka cha zotsatira zoyipa ndi lactic coma. Kuphatikiza apo, zakumwa zakumwa zoledzeretsa zimawonjezera ntchito ya ziwalo zamkati zonse, kuzikakamiza kuti zigwire ntchito mopitilira muyeso, chifukwa chake, chiopsezo chokhala ndi hypoglycemia chikuwonjezeka.

Kuchita ndi mankhwala ena

Mankhwala Metformin-Richter sayenera kugwiritsidwa ntchito molumikizana ndi mankhwala ena angapo:

Danazolum yopanga ndi androgen imachulukitsa chiopsezo chamagazi.

The antipsychotic Chlorpromazinum yopangidwa mwapadera imachulukitsa kuchuluka kwa dextrose,

mankhwala opangira antidiabetes, mankhwala okhala ndi salicylic acid, mankhwala a hypoglycemic Acarbosum, insulin, mankhwala osokoneza bongo a anti-yotupa, monoamine oxidase inhibitors, angiotensin kutembenuza enzyme inhibitors, michere, cytotoxic anticancer mankhwala a cyclophosphamidum amawonjezera chiopsezo

mankhwala a antioxidical a antiidal yotupa, mankhwala opangira pakamwa, adrenal medulla timadzi epinephrinum, sympathomimetics, glucagon, chithokomiro cha chithokomiro, ma diuretics, antipsychotic, zotumphukira za neacin zimachepetsa shuga.

antihypertensive mankhwala Nifedipinum kumawonjezera ndende ya mankhwala ndi linalake ndipo tikulephera nthawi yochotsa mankhwala m'thupi,

Cimetidinum H2-histamine receptor blocker imawonjezera chiopsezo cha lactic coma,

potaziyamu wowerengeka okodzetsa Amiloridum, mtima glycoside Digoxinum, alkaloid opium Morphinum, antiarrhythmic mankhwala Procainamidum, alkaloid bark of chininum Chinidinum, antipyretic drug Chininum, antiulceric drug Ranitidin, diureticum drug zotulukapo.

Bongo

Mankhwala Metformin-Richter amatha kuledzera ngati mulingo woyenera ndi nthawi yayitali ya chithandizo. Zizindikiro za bongo:

lactic acid chikomokere ndi imfa ina,

vuto la impso

kumva mseru

akukumbutsa

zimbudzi zotayirira

kuchepetsa kutentha

kupweteka m'mimba

kupweteka kwa minofu

tachypnea

Vuto lama vestibular

kudziwa zolakwika

chikomokere

imfa. Ngati pali zizindikiro za kuledzera ndi mankhwala, muyenera kufunsa dokotala amene angakupatseni mpumulo. Simungachotse nokha nokha, wodwala ayenera kuchipatala ndikuyang'aniridwa ndi adokotala. Kumwa mankhwalawa kuyenera kuyimitsidwa nthawi yomweyo.

Mankhwala otsatirawa ndi fanizo la mankhwala a Metformin-Richter mu mankhwalawa monga mankhwala:

Metformin-Richter,

Metformin-Teva,

Bagomet,

Mtundu,

Metfogamma,

Glformin

Metospanin,

Siofor,

Glycomet,

Glicon

Vero-Metformin,

Orabet

Gliminfor

Chikwanje,

NovoFormin,

Glibenclamide.

Malo osungira

Mankhwala Metformin-Richter akulimbikitsidwa kuti azisungidwa kumalo osiyanako ndi ana ndikuwoneka pa kutentha kosaposa 25 digiri Celsius. Alumali moyo wa mankhwalawa ndi zaka 3 kuyambira tsiku lopangira. Tsiku lotha ntchito ndikusungidwa, mankhwalawo sangathe kugwiritsidwa ntchito ndipo ayenera kutayidwa malinga ndi mfundo zaukhondo. Malangizo ogwiritsira ntchito ali ndi tsatanetsatane wa malamulo osungira ndi malamulo.

Chilolezo cha Pharmacy LO-77-02-010329 cha pa June 18, 2019

Zotsatira zoyipa

kagayidwe: kawirikawiri - lactic acidosis (kusiya mankhwala ndikofunikira), ndi njira yayitali - hypovitaminosis B₁₂ (chifukwa cha malabsorption)
kugaya chakudya: kusowa kwa chakudya, kulawa kwazitsulo mkamwa, kusanza, kutsekula m'mimba, mseru, kupweteka kwam'mimba, kusefukira kwamatumbo (zovuta izi zimadziwika kwambiri kumayambiriro kwa zamankhwala ndipo nthawi zambiri zimatha pazokha, zovuta zawo zimatha kuchepetsedwa pogwiritsa ntchito antispasmodics, m-anticholinergics, antacid) , osowa - hepatitis, kuchuluka kwa hepatic transaminases (amazimiririka atatha kulandira chithandizo),
dongosolo la endocrine: hypoglycemia,
hematopoietic dongosolo: nthawi zina - megaloblastic anemia,
thupi lawo siligwirizana: kuyabwa, zotupa pakhungu.

Malangizo apadera

Pa mankhwala ndi mankhwala, osachepera kawiri pachaka (komanso nkhani ya myalgia) amafunika kukhazikitsa kuchuluka kwa lactate m'madzi a m'magazi.

Ndikofunikanso kudziwa mulingo wa serum creatinine kamodzi pa miyezi isanu ndi umodzi, izi ndizofunikira kwambiri kwa odwala okalamba.

Ngati chitupa cha matenda opatsirana a genitourinary membala kapena matenda a bronchopulmonary adadziwika panthawi ya metformin, ndikofunikira kudziwa dokotala.

Kumwa mankhwalawa kuyenera kuti kuthetsedwe maola 48 asanafike ndi maola 48 pambuyo pa urology, intravenous angiography kapena kafukufuku wina aliyense wa radiopaque.

Metformin Richter angagwiritsidwe ntchito molumikizana ndi zotumphukira za sulfonylurea, makamaka poyang'anira kuchuluka kwa shuga m'magazi.

Pa mankhwala, tikulimbikitsidwa kupewa kumwa zakumwa za ethanol ndi mankhwala. Kuopseza kwa lactic acidosis kumakulitsidwa ndi kuledzera kwakumwa kwambiri, makamaka pakakhala kulephera kwa chiwindi, kutsatira zakudya zochepa zama calorie kapena kufa ndi njala.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Kugwiritsidwa ntchito kwa Metformin-Richter ngati mankhwala a monotherapy sikukhudza kwenikweni kuwongolera kuyendetsa magalimoto.

Panthawi yogwiritsira ntchito metformin limodzi ndi insulin, zotumphukira kuchokera ku sulfonylurea ndi othandizira ena odwala matenda ashuga, pamakhala mwayi wokhala ndi vuto la hypoglycemic, komwe kuthekera kotha kuwongolera njira zovuta (kuphatikizapo magalimoto) kumakulirakulira.

Mimba komanso kuyamwa

Mankhwala sayenera kumwedwa panthawi yomwe muli ndi pakati. Zikachitika kuti pakati pathupi pachitika chithandizo, komanso pakukonzekera, Metformin-Richter iyenera kusiyidwa ndipo mankhwala a insulin ayenera kuyikidwa.

Popeza palibe chidziwitso pokhudzana ndi kulowa kwa metformin mkaka wa m'mawere, amakaniratu akazi omwe akuyamwitsa. Ngati mankhwalawa amayenera kumwedwa panthawi ya mkaka wa m'mawere, kuyamwitsa kuyenera kutha.

Kuyanjana kwa mankhwala osokoneza bongo

Pogwiritsa ntchito Metformin-Richter pogwiritsa ntchito mankhwala / kukonzekera, zotsatirazi zimachitika.

Danazol - zotsatira za hyperglycemic za wothandizirazi zitha kuzindikirika, kuphatikiza uku sikulimbikitsidwa, ngati mukufunikira chithandizo cha Danazol ndipo mutamaliza kumwa, muyenera kusintha mlingo wa metformin ndikuwongolera glycemia,
angiotensin akatembenuza enzyme zoletsa, oxytetracycline, monoamine oxidase inhibitors, mankhwala osokoneza bongo a anti-yotupa, salicylates, sulfonylureas, insulin, acarbose, fibroic acid zotumphukira, beta-adrenergic blocking agents, cyclophosphamide - hypoglycemic yowonjezera.
chlorpromazine (antipsychotic) - pamene mukumwa mankhwalawa tsiku lililonse 100 mg, kuchuluka kwa glucose m'magazi kumawonjezeka ndikumasulidwa kwa insulini kumachepa, ndi chlorpromazine ndi ma antipsychotic ena, komanso atasiya kuyendetsa, mankhwalawa a metformin amayenera kuwunikira,
cimetidine - kuchotsedwa kwa metformin kumachepetsa, chifukwa chomwe kuopseza kwa lactic acidosis kumakulitsidwa,
kulera pakamwa, glucocorticosteroids, epinephrine, glucagon, sympathomimetics, kukonzekera kwa ayodini okhala ndi chithokomiro, kuzungulira ndi thiazide diuretics, zotumphukira za asidi a nicotinic, zotumphukira za phenothiazine - mphamvu ya metformin yafupika,
nifedipine - kuchuluka mayamwidwe ndi C_max metformin imachedwetsa chomaliza,
Muli mankhwala okhala ndi ayodini - mwa kuphatikizika kwa mitsempha ya othandizira, kuphatikizika kwa metformin kumatha kuchitika, komwe kungayambitse lactic acidosis,
anticoagulants osadziwika (coumarin zotumphukira) - mphamvu zawo zimafooka,
ranitidine, quinidine, morphine, amiloride, vancomycin, triamteren, quinine, procainamide, digoxin (mankhwala a cationic omwe amachokera ndi aimpso aimpso) - kuwonjezereka kwa C ndikotheka_max 60% metformin (chifukwa cha mpikisano wa machitidwe a ma tubular).

Zofanizira za Metformin-Richter ndi izi: Glyformin Prolong, Bagomet, Glyformin, Glucofage, Diasfor, Glucofage Long, Diaformin OD, Metfogamm 500, Metadiene, Metfogamma 850, Metformin yayitali, Metformin-Kanon, Metformin, Metformin Zentiva Minform, Metformin Zentiva , Metformin Sandoz, Metformin-Teva, Siofor 500, Fomu, Sofamet, Siofor 850, Fomu Long, Siofor 1000, Fomu Pliva.

Ndemanga pa Metformin Richter

Malinga ndi kuwunika kochulukirapo, Metformin Richter ndi mankhwala othandiza omwe amayendetsa kuchuluka kwa glucose m'magazi, amachepetsa chilimbikitso ndi kulakalaka maswiti, komanso amathandizira kuchepetsa ndikukhazikika kwa thupi.

Zoyipa za mankhwalawa, odwala ambiri akuphatikizira kusintha kosakhudzika (makamaka kuchokera m'matumbo am'mimba) komanso kuchuluka kwakukulu kwa contraindication. Pafupifupi ndemanga zonse, zimadziwika kuti Metformin-Richter ndiwovuta kwambiri ndipo ndikofunikira kutero pokhapokha malinga ndikuwongoleredwa ndi katswiri.