MOFLAXY 0, 4 N5 TABLE P

Mapiritsi okhala ndi mafilimu.

Piritsi limodzi lachifundo 1
Kernel:
yogwira mankhwala: moxifloxacin hydrochloride 454.75 mg, wofanana ndi moxifloxacin 400.00 mg,
zotuluka: microcrystalline cellulose 186.05 mg, croscarmellose sodium 32,00 mg, magnesium stearate 6.00 mg,
Filamu sheath: hypromellose 12,60 mg, macrogol-4000 4.20 mg, titanium dioxide (E171) 3,78 mg, utoto wa iron oxide ofiira (E172) 0,42 mg.

Mapiritsi okhala ndi mawonekedwe a Capsule, biconvex, utoto wamafilimu, pinki yakuda.
Mawonekedwe apamtunda: Unyinji wowala wachikaso wowala ndi utoto wamafuta wakuda bii.

Gulu la Pharmacotherapeutic

antimicrobial wothandizila - fluoroquinolone

ICD-10:
X.J00-J06.J01 pachimake sinusitis
X.J10-J18.J13 chibayo cha Streptococcus chibayo
X.J10-J18.J14 chibayo choyambitsidwa ndi Haemophilus fuluwenza wokhala ndi ndodo ya Afanasyev-Pfeiffer
X.J10-J18.J15 Bacteria chibayo, osati kwina
X.J10-J18.J15.0 Klebsiella chibayo mabayo
X.J10-J18.J15.7 Chibayo chifukwa cha chibayo cha Mycoplasma
X.J10-J18.J16.0 Chlamydia chibayo
X.J10-J18.J16.8 Chibayo chifukwa cha omwe adawatulutsa
X.J20-J22.J20 bronchitis pachimake
X.J20-J22.J20.1 Bronchitis pachimake chifukwa cha Haemophilus fuluwenza ndi ndodo ya Afanasyev-Pfeiffer
X.J20-J22.J20.2 Bronchitis pachimake chifukwa cha streptococcus
X.J20-J22.J20.8 Bronchitis pachimake chifukwa cha othandizira ena
X.J40-J47.J42 Matenda a bronchitis, osadziwika
XI.K65-K67.K65 Peritonitis
XII.L00-L08.L01 Impetigo
XII.L00-L08.L02 Muli pakhungu, chithupsa ndi carbuncle
XII.L00-L08.L03 Phlegmon
XII.L00-L08.L08.0 Pyoderma
XII.L00-L08.L08.9 Matenda a pakhungu ndi minofu yolowerera, osadziwika

Mankhwala

Njira yamachitidwe
Moxifloxacin ndi mankhwala osiyanasiyana a bactericidal antibacterial, 8-methoxy fluoroquinolone.
Mphamvu ya bactericidal ya moxifloxacin imachitika chifukwa cha kuletsa kwa bakiteriya topoisomerases II ndi IV, komwe kumayambitsa kusokonezeka kwa njira zobwereza, kukonza ndi kusindikiza kwa DNA biosynthesis yama cell tizilombo tating'onoting'ono ndipo, chifukwa chake, pakufa kwa maselo okhala ndi ma cell ochepa.
Ma bactericidal ochepera poyerekeza moxifloxacin nthawi zambiri amakhala ofanana ndi zochepa zoletsa zake.
Njira zopewera
Njira zomwe zimatsogolera pakupanga kukana kwa penicillins, cephalosporins, aminoglycosides, macrolides ndi tetracyclines sizimakhudzana ndi antibacterial zochita za moxifloxacin.
Palibe kutsutsana kwapakati pa magulu awa a antibacterial mankhwala ndi moxifloxacin. Pakadali pano, sipanakhalepo zochitika za kukana kwa plasmid. Pafupipafupi kukula kwa kukana ndikochepa kwambiri (10-7-10-10).
Kukana kwa Moxifloxacin kumayamba pang'onopang'ono kudzera pakusintha kambiri. Kuwonetsedwa mobwerezabwereza kwa moxifloxacin kuzinthu zamagetsi zomwe zimakhala m'munsi mwa zochepa zoletsa ndende (MIC) zimayendera limodzi ndi kuwonjezeka pang'ono kwa MIC. Milandu yotsutsana ndi quinolones imadziwika. Komabe, tizilombo tating'onoting'ono tokhala ndi gramu komanso anaerobic osagwirizana ndi ma quinolones ena timawaganizirabe moxifloxacin.
Kukhazikitsidwa kuti kuwonjezeranso kwa gulu la methoxy mu mawonekedwe a C8 ku moxifloxacin mamolekedwe a moxifloxacin kumawonjezera ntchito ya moxifloxacin ndikuchepetsa mapangidwe a mabakiteriya osintha a mabakiteriya oyenera. Kuphatikizidwa kwa gulu la bikcloamine paudindo C7 kumalepheretsa kukhazikika kwa yogwira ntchito, njira yotsutsana ndi fluoroquinolones.
In vitro moxifloxacin imagwira ntchito motsutsana ndi tizilombo tosiyanasiyana ta gram-negative ndi gram-virus, anaerobes, mabakiteriya osagwira asidi ndi mabakiteriya a atypical, monga Mycoplasma spp., Chlamydia spp., Le legionella spp.
Zokhudza matumbo microflora
M'maphunziro awiri omwe adachitika pa odzipereka, kusintha kwa microflora yam'mimba kunawonekera pambuyo pakukonzekera kwa moxifloxacin. Kutsika kwa kuzungulira kwa Escherichia coli, Bacillus spp. Bacteroides vulgatus, Enterococcus spp., Klebsiella spp., Komanso anaerobes Bifidobacterium spp., Eubacterium spp., Peptostreptococcus spp. Kusintha kumeneku kunasinthidwa mkati mwa milungu iwiri. Clostridium Hardile poizoni sapezeka.

Pharmacokinetics

Ikaperekedwa, moxifloxacin imagwira msanga komanso pafupifupi. Mtheradi bioavailability pafupifupi 91%.

Mankhwala a moxifloxacin atamwa pa 50 mpaka 1200 mg kamodzi, komanso 600 mg / tsiku kwa masiku 10, ali pamzere. Dera lolingana limafikiridwa pakatha masiku atatu.

Pambuyo pa ntchito imodzi yokha ya 400 mg ya moxifloxacin Cmax mu plasma yamagazi imatheka mkati mwa maola 0,5 ndi 3 ndi 3.1 mg / L. Pambuyo pakamwa 400 mg a moxifloxacin kamodzi patsiku, Cssmax ndi Cssmin (pazoyenera komanso zochepa pazofanana) ndi 3.2 mg / L ndi 0,6 mg / L, motsatana.

Mukamamwa moxifloxacin ndi chakudya, pamakhala kuwonjezeka pang'ono panthawiyi kuti mufikire Cmax (pofika maola 2) ndi kuchepa pang'ono kwa Cmax (pofika pafupifupi 16%), pomwe nthawi yolemba sichisintha. Komabe, izi sizothandiza m'thupi, ndipo moxifloxacin amatha kugwiritsidwa ntchito mosasamala nthawi yakudya.

Moxifloxacin imagawiridwa mwachangu mu minofu ndi ziwalo ndipo imagwirizana ndi mapuloteni amadzi a m'magazi (makamaka albin) ndi pafupifupi 45%. Kuchuluka kwa magawo ndi pafupifupi 2 l / kg.

Kuzungulira kwa moxifloxacin, ochulukirapo kwa omwe ali m'madzi am'magazi, amapangika m'matumbo am'mapapu (kuphatikizapo epithelial fluid, alveolar macrophages), mu ma cell a epanasal (maxillary and ethmoid labyrinth), m'mitsempha yam'mphuno, malo osakanikirana ndi zotupa (pazomwe zimaphatikizidwa ndi zotupa zamkhungu). ) Pazipinda zamkati komanso malovu, moxifloxacin amatsimikiza mwa mawonekedwe aulere, osakhala ndi mapuloteni, pamsasa wozungulira kuposa plasma wamagazi. Kuphatikiza apo, ma moxifloxacin amadziwika kwambiri pamatumbo am'mimba, zotupa za peritoneal, komanso ziwalo zoberekera wamkazi.

Moxifloxacin imadutsa biotransfform ya gawo lachiwiri ndipo imachotsedwa m'thupi ndi impso, komanso m'matumbo, osasinthika komanso mawonekedwe osakanikirana a mankhwala a soffo (M1) ndi glucuronides (M2). Moxifloxacin sanapangidwe biocransformed ndi microsomal cytochrome P450 system. Ma metabolabolites M1 ndi M2 amapezeka m'magazi am'magazi mozama kwambiri kuposa potengera makolo. Malinga ndi zotsatira za maphunziro oyamba, zimatsimikiziridwa kuti ma metabolites awa samakhala ndi vuto lililonse mthupi poteteza komanso kulolera.

Hafu ya moyo wa moxifloxacin pafupifupi maola 12. Wapakati chilolezo chotsatira pambuyo makonzedwe a 400 mg ndi 179-246 ml / mphindi. Chilolezo cha renal ndi 24-53 ml / min. Izi zikuwonetsa kubwezeretsanso kwakanthawi kwa moxifloxacin.

Kuchuluka kwa kuchuluka kwa poyambira komanso metabolites a gawo lachiwiri ndi pafupifupi 96-98%, zomwe zikuwonetsa kusowa kwa metabolid oxidative. Pafupifupi 22% ya mlingo umodzi (400 mg) umatuluka osagwirizana ndi impso, pafupifupi 26% - kudzera m'matumbo.

Pharmacokinetics m'magulu osiyanasiyana odwala

Zaka, jenda komanso fuko

Kafukufuku wokhudza pharmacokinetics wa moxifloxacin mwa amuna ndi akazi adawonetsa kusiyana kwama 33% malinga ndi AUC ndi Cmax. Kuyamwa kwa moxifloxacin sikunadalire jenda. Kusiyana kwa AUC ndi Cmax kunachitika chifukwa chosiyana kulemera kuposa jenda ndipo sikuti ndiwofunika kwambiri pakubwera.

Panalibe kusiyana kwakukulu kachipatala mu pharmacokinetics ya moxifloxacin mwa odwala amitundu yosiyanasiyana ndi mibadwo yosiyana.

Ma pharmacokinetics a moxifloxacin mwa ana sanaphunzire.

Matenda aimpso

Mkati, piritsi limodzi (400 mg) nthawi imodzi patsiku limodzi ndi matenda omwe atchulidwa pamwambapa.

Musapitirire mlingo woyenera.

Mapiritsiwo ayenera kumezedwa lonse, osafuna kutafuna, ndi madzi okwanira, osasamala nthawi yakudya.

Kutalika kwa mankhwala kumatsimikiziridwa ndi malo komanso kuuma kwa matendawa komanso matenda:

- kuchulukitsa kwa chifuwa: masiku 5 mpaka 10,

- pachimake sinusitis: masiku 7,

- Matenda osavuta a pakhungu ndi kapangidwe kake: masiku 7,

- chibayo chopezeka pagulu: nthawi yayitali ya njira yothandizira (kulumikizidwa kwamkati ndi makonzedwe amkamwa) ndi masiku 7-14,

- Matenda ovuta a pakhungu ndi kapangidwe kake ka zinthu: nthawi yayitali yodziwika ndi mankhwala a moxifloxacin (makina amkati omwe amatsatiridwa ndi kutsata kwamlomo) ndi masiku 7 mpaka 21,

- Matenda amkatikati mwa m'mimba: Kutalika kwa nthawi ya masitepe (mtsempha wamkati ndi makonzedwe amkamwa) ndi masiku 5 mpaka 14,

- Matenda osagwirizana ndi zotupa za m'chibelekero: masiku 14.

Musapitirire nthawi yolimbikitsidwa.

Malinga ndi kafukufuku wazachipatala, kutalika kwa mankhwalawa ndi Moflaxia pamapiritsi kumatha kufika masiku 21.

Odwala okalamba

Kusintha kwa dongosolo la odwala okalamba sikofunikira.

Kuchita bwino ndi chitetezo cha kugwiritsa ntchito moxifloxacin mwa ana ndi achinyamata sichinakhazikitsidwe.

Kuwonongeka kwa chiwindi

Odwala omwe ali ndi vuto la chiwindi (magawo a gulu la ana-Pugh A ndi B) safunikira kusintha mtundu wa mankhwalawa (kuti mugwiritse ntchito kwa odwala omwe ali ndi matenda amisempha, onani gawo la "Special Instructions").

Matenda aimpso

Odwala ndi mkhutu aimpso ntchito (kuphatikizapo kwambiri aimpso kulephera ndi CC

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapezeka piritsi. Piritsi limodzi lili osachepera 400 mg ya mankhwala othandizira - moxifloxacin hydrochloride. Kuphatikiza apo, kapangidwe kake ka mankhwalawa kumaphatikizapo macrogol, titanium dioxide, hypromellose, utoto. Mapiritsiwo ali ndi mawonekedwe a biconvex. Amakutidwa ndi utoto wapa pinki. Mapiritsi a Moxilia amaikidwa m'matumba a 5, 7 kapena 10 ma PC. Mabulogu amadzaza matcheni okhala ndi makatoni. Mankhwala mu mawonekedwe a njira yothetsera mu mnofu ndi mtsempha wamkati samapezeka.

Mankhwala amapezeka piritsi.

Zotsatira za pharmacological

Mankhwala a Moflaxia ndi a gulu la fluoroquinolones, chifukwa chake ali ndi mphamvu ya antibacterial pamitundu ingapo yama tizilombo tating'onoting'ono. Kuchita kwa mankhwalawa kumachitika chifukwa cha kulepheretsa yogwira popanga mabakiteriya topoisomerases a mitundu 2 ndi 4, chifukwa chomwe michere ya DNA imasokonekera m'maselo a tizilombo tating'onoting'ono, timene timayambitsa kufa kwa mabakiteriya.

Mankhwala a Moflaxia amagwira zama gramu zabwino komanso gram alibe tizilombo. Kuphatikiza apo, mankhwalawa amagwira ntchito mwa kugonjetsedwa ndi microflora ya pathogenic.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa atha kuperekedwa kwa matenda osiyanasiyana opatsirana, limodzi ndi kutupa kwambiri. Ndikulimbikitsidwa kugwiritsa ntchito mankhwalawa pokhapokha ngati wodwala akutsimikizira kupezeka kwa microflora tcheru ndi Moflaxia. Zowonetsa kugwiritsa ntchito mankhwalawa zimatha kukhala sinusitis yovuta kwambiri.

Mankhwala tikulimbikitsidwa kuti mugwiritse ntchito kufalikira kwa mawonekedwe a bronchitis. Kukhazikitsidwa kwa Moflaxia kumaloledwa pa matenda a khungu lakukhazikika, kumapitirira popanda kutchulidwa. Kugwiritsa ntchito Moflaxia pochiritsa anthu kumakhala koyenera kuthandizira chibayo cha anthu wamba, kuphatikizapo omwe amayamba chifukwa cha zovuta zotsutsana ndi maantibayotiki.

Monga gawo la mankhwala okwanira, mankhwalawa amalimbikitsidwa kuti apatsidwe sinusitis. Moflaxia wocheperako amatha kugwiritsidwa ntchito pazovuta zovuta pakhungu. Ndi mankhwalawa, mutha kuchiza matenda osokoneza bongo, ophatikizika ndi kuwonjezeranso matenda ena.

Zisonyezero zakugwiritsidwa ntchito kwa mankhwalawa ndi zamkati zam'mimba ndi zotupa zamkati mwa m'mimba. Kugwiritsa ntchito Moflaxia kuli koyenera kuthandizira matenda opatsirana a ziwalo zoberekera za akazi. Kuphatikiza apo, mankhwalawa angagwiritsidwe ntchito ku prostatitis yachilengedwe.

Contraindication

Kugwiritsa ntchito Moflaxia koletsedwa ndi hypersensitivity kwa zigawo zogwira ntchito za mankhwala. Kuphatikiza apo, mankhwalawa sagwiritsidwa ntchito kwa odwala omwe ali ndi mbiri ya tendon pathologies omwe adatulukira panthawi ya mankhwala a quinolone antibacterial.

Mankhwala ali osavomerezeka kwa anthu omwe ali ndi vuto la mtima.

Contraindication yogwiritsira ntchito mankhwalawa ndi kusokonezeka kwa ma electrolyte, limodzi ndi mawonekedwe a hypokalemia, omwe sangathe kusintha. Contraindication pakugwiritsa ntchito mankhwalawa ndi kusokonezeka kwa mitsempha ndi bradycardia. Mankhwala samalimbikitsidwa ndipo ngati wodwalayo ali ndi vuto la mtima wosalephera.

Ndi chisamaliro

Mosamala kwambiri, mankhwalawa amaperekedwa kwa odwala omwe ali ndi CNS pathologies, limodzi ndi mawonekedwe a kugwidwa. Kuwunikira mwapadera mkhalidwe wa wodwala ndi ogwira ntchito kuchipatala ndikofunikira ngati wodwala ali ndi vuto lamaganizidwe.

Kuphatikiza apo, mankhwalawa amayenera kugwiritsidwa ntchito mosamala pochiza odwala omwe akudwala matenda a mtima komanso kukhala ndi mbiri yakumangidwa kwa mtima. Mankhwala a Moflaxia kwa odwala omwe ali ndi matenda enaake amayenera kuchitika moyang'aniridwa ndi katswiri. Mu gulu ili la odwala, chiopsezo chotukula zotsatira zoyipa ndikuchulukitsa njira ya zomwe zilipo za pathological zimachulukitsidwa.

Mosamala kwambiri, mankhwalawa amaperekedwa kwa odwala omwe ali ndi CNS pathologies.

Momwe mungatenge Moflaxia

Mankhwalawa adapangira kuti azigwiritsidwa ntchito mkati. Pochiza matenda opatsirana omwe amayamba chifukwa cha mabakiteriya omwe amagwiritsidwa ntchito ndi mankhwalawa, mankhwalawa amayenera kumwa piritsi la 400 mg kamodzi pa tsiku. Piritsi liyenera kumeza popanda kutafuna, ndipo onetsetsani kuti mumamwa ndi madzi. Kuti mukwaniritse zochizira zambiri za matenda opatsirana, kumwa mankhwala kwa masiku 5-7 ndikokwanira. Ndi matenda ovuta a pakhungu ndi m'mimba, njira ya mankhwalawa imatha kuyambira masiku 14 mpaka 21.

Kumwa mankhwala a shuga

Odwala omwe ali ndi matenda osokoneza bongo a shuga amapatsidwa mankhwala pa mlingo wa 400 mg tsiku lililonse, koma kuwunika kosamala kwamagazi a shuga kumafunika.

Odwala omwe ali ndi matenda a shuga, mankhwalawa amadziwitsidwa muyezo wa 400 mg tsiku lililonse.

Matumbo

Kulandilidwa kwa Moflaxia kumakhudzanso chakudya cham'mimba ndipo kumayambitsa kusintha kwamatumbo am'mimba, komwe kumawonjezera chiopsezo cha zotsatira zoyipa kuchokera kugaya chakudya. Malinga ndi kuchuluka kwa zamankhwala, odwala nthawi zambiri atatha Moflaxia amakhala ndi zodandaula za mseru, kusokonezeka kwa chopondapo ndi kupweteka kwam'mimba. Pocheperapo pafupipafupi ndi mankhwala a Moflaxia, kuchepa kwa chakudya kumawonedwa. Kuphatikiza apo, kukulitsa kwa flatulence ndi dyspepsia ndikotheka. Nthawi zina, stomatitis, erosive gastritis, dysphagia, ndi colitis zimawonekera pakumwa mankhwala.

Pakati mantha dongosolo

Mankhwalawa a Moflaxia, kuwoneka kwa zovuta zamaganizo, zomwe zimafotokozedwa ndikuwonjezeka kwa psychomotor ndi nkhawa, ndizotheka. Odwala ena amakhala ndi nkhawa komanso amakhala ndi nkhawa. Kuwunika ndi kusokonezeka kwa kugona ndizotheka.Ndi chithandizo cha Moflaxia, chizungulire ndi mutu zimatha kuchitika. Zosokoneza zomwe zingatheke pakuwona kukoma ndi kununkhira, dysesthesia, paresthesia ndi zotumphukira za polyneuropathy.

Kuchokera pamtima

Mukamagwiritsa ntchito Moflaxia, kuukira kwa tachycardia, kumalumpha m'magazi ndi kukomoka chifukwa cha kuphwanya kwamtima kumachitika.

Mukamagwiritsa ntchito Moflaxia, kuukira kwa tachycardia ndi kudumphira m'magazi kungachitike.

Kuchokera minofu ndi mafupa

Potengera maziko akumwa mankhwalawa, kuoneka kwa myalgia ndi arthralgia ndikotheka. Mwa odwala ena, kamvekedwe ka minofu ndi kukokana kunawonedwa. Kuphukika kwa Tendon komanso kukula kwa nyamakazi sikumawonedwa kawirikawiri.

Mankhwalawa Moflaxia, thupi lawo siligwirizana angayambe, zotchulidwa ngati zotupa pakhungu, kuyabwa, ndi urticaria. Nthawi zina, angioedema ndi anaphylaxis ndizotheka.

Kugwiritsa ntchito kwa vuto la chiwindi

Pazovuta za chiwindi ndi vuto la chiwindi, a Moflaxia amatha kugwiritsidwa ntchito pochiza matenda, koma odwala omwe ali ndi ma pathologies amenewa amafunikira kuwunikira kwapadera kwa ogwira ntchito kuchipatala.

Pogwiritsa ntchito chiwindi pakhungu ndi kupezeka kwa kulephera kwa chiwindi, Moflaxia angagwiritsidwe ntchito pochiza matenda.

Kuchita ndi mankhwala ena

Ndi kugwiritsa ntchito mofana pa nthawi ya Moflaxia ndi Warfarin, kusokonezeka kwa magazi sikuwonetsedwa. Kugwiritsa ntchito nthawi yomweyo kwa Moflaxia ndi ma antidepressants atatu, antipsychotic, antiarrhythmics ndi antihistamines sikulimbikitsidwa. Sikulimbikitsidwa kuphatikiza kugwiritsa ntchito Moflaxia ndi maantibayotiki ena. Kugwiritsa ntchito nthawi yomweyo Moflaxia ndi maantacid kumathandizira kuchepetsa mphamvu ya maantibayotiki. Kutsegula kaboni kumachepetsa mphamvu ya maantibayotiki.

Sikulimbikitsidwa kuphatikiza kugwiritsa ntchito Moflaxia ndi maantibayotiki ena.

Kuyenderana ndi mowa

Mukamalandira mankhwala othana ndi antioxotic, muyenera kukana kumwa mowa.

Pali mitundu ingapo ya mankhwala omwe amatha kulowa m'malo a Moflaxia, kuphatikiza:

Avelox ndi amodzi mwa fanizo la Moflaxia.

Ndemanga za Moflaxia

Irina, wazaka 32, Chelyabinsk

Ndimagwiritsa ntchito Moflaxia ndimatenda ochulukitsa a bronchitis. Matendawa amakhala ndi mawonekedwe anga ndipo miyezi iliyonse 2-3 imawonetsedwa ndi zizindikiro zazikulu. Ndimagwiritsa ntchito Moflaxia kwa masiku 2-3 ndipo zizindikiro zonse zimachepa msanga. Mankhwalawa samangoletsa mwachangu mawonetsedwe a matendawa, komanso samandibweretsera mavuto. Ndikukonzekera kupitiliza kugwiritsa ntchito mankhwalawa.

Maxim, wazaka 34, Moscow

Pafupifupi chaka chapitacho, mvula idagwa ndipo atafika kunyumba adagona, osapukuta tsitsi lake. M'mawa ndinapanikizika ndimaso komanso mutu wopweteka. Malingaliro ake anali osavutikira, kotero ndinapita kwa dokotala yemwe anandipeza ndi matenda owopsa a sinusitis. Adotolo adamuuza Moflaxia. Mankhwalawa agwiritsidwa ntchito kwa milungu iwiri. Ndimamva kusintha tsiku lachiwiri, koma ndidaganiza zopita kumapeto, ndikuopa zovuta. Mankhwalawa amapereka zotsatira zabwino.

Kristina, wazaka 24, Sochi

Pafupifupi chaka chapitacho adagwira chimfine. Poyamba, ngakhale ndimatenthedwe, sindinayang'anire, koma kenako zinthu zinayamba kuwonongeka, motero ndinayimbira ambulansi. Chipatala chinaulula chibayo. Povomerezedwa ndi adotolo, adayamba kumwa Moflaxia. Nditayamba kumwa mankhwalawa, ndidayamba kusanza pang'ono. Mankhwalawa sanakane kumwa ndipo patatha masiku ochepa ndinamva bwino. Ndidalandira chithandizo chamankhwala, chomwe chidatenga masiku 14, ndipo ndikhutira.

Igor, wazaka 47, Saint Petersburg

Dziwani za ngozi yanu yopezeka ndi matenda a shuga!

Onani mayeso aulere pa intaneti kuchokera kwa endocrinologists odziwa zambiri

Nthawi yoyesa osaposa mphindi ziwiri

7 zosavuta
za nkhani

94% kulondola
kuyesa

Zikwi 10 zopambana
kuyesa

Ndili ndi matenda osokoneza bongo ndipo ngakhale ndimatsatira mosamala zakudya ndikuwongolera shuga, chilonda chophweka chinawoneka pa mwendo wanga, womwe unakula msanga ndipo umandithandizira. Monga adanenera dotolo, adagwiritsa ntchito Moflaxia monga gawo la zovuta mankhwala. Chida chija chinathandiza kwambiri. Chilondacho chinachepera masiku angapo ndikuyamba kuchira. Ndinagwiritsa ntchito maantibayotiki kwa masiku 14. Sanatchulidwe zoyipa zilizonse.