Mankhwala Galvus: malangizo ntchito, ndemanga, analogi

Si chinsinsi kuti matenda ashuga ndiwo mliri wamakono. Matendawa amakhudza amuna ndi akazi, achinyamata ndi achikulire, achinyamata komanso ana. Nthawi zambiri, madokotala amakupatsani mapiritsi a Galvus, malangizo ogwiritsira ntchito omwe takambirana m'nkhaniyi.

Kodi mankhwalawa ndi chiani? Kodi nthawi zonse amachita kusankhidwa kwake? Ndingatenge bwanji? Kodi pali zotsutsana pazomwe zimagwiritsidwa ntchito? Zonsezi zitha kuphunziridwa pophunzira mosamala malingaliro a akatswiri ndi odwala, komanso malingaliro awo pa "Galvus". Malangizo ogwiritsira ntchito, fanizo la mankhwala ndi zina zambiri zokhudzana ndi izi zimapezeka mu nkhaniyi.

Choyamba, kapangidwe

Inde, ichi ndi chimodzi mwazinthu zofunika kwambiri zomwe mumayang'anitsitsa mukamagula mankhwala. Malinga ndi malangizo a mankhwalawa "Galvus", mphamvu yake ndi vildagliptin. Piritsi lililonse lili ndi ma milligram 50 a chinthuchi.

Zina zomwe zimaphatikizidwa ndi microcrystalline cellulose (pafupifupi mamiligalamu 96), anactrous lactose (pafupifupi ma milligram 48), sodium carboxymethyl starch (mamiligalamu anayi), ndi magnesium stearate (2,5 milligram).

Kodi wopanga ali bwanji?

Monga tafotokozera pamwambapa, chida chimawonetsedwa ngati mapiritsi. Mlingo wa mankhwala nthawi zonse umakhala wofanana - ma milligram makumi asanu a ntchito. Izi zikufotokozedwa m'malangizo ogwiritsira ntchito ndi Galvus. Ndemanga za odwala ambiri zimawonjezeka chifukwa ndi zosavuta. Palibe chifukwa choyenera kuyikira ma CD ndi mankhwalawa, poopa kupeza mlingo wocheperako kapena woposa wofunikira. Ingogula malonda ndikutenga momwe amakulimbikitsira ndi dokotala.

Kodi ndi pati pomwe "Galvus 50 50" ingalimbikitsidwe? Malangizo ogwiritsira ntchito mankhwalawa amapereka yankho lokwanira kufunso ili.

Mawonekedwe osokoneza bongo

Malinga ndi malangizo, mapiritsi a Galvus amaperekedwa kwa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri. Mankhwalawa amathandizira kutsitsa kapamba. Chifukwa cha vildagliptin, mphamvu ya chamoyo chonse chimayenda bwino.

Malinga ndi akatswiri komanso odwala omwe, "Galvus" ndiyo njira yokhayo yothandizira matenda a matenda ashuga, makamaka ngati mankhwalawo akuphatikizidwa ndi zakudya zapadera komanso kulimbikitsidwa maphunziro olimbitsa thupi.

Pankhaniyi, zotsatira za mankhwalawa zidzakhala zazitali komanso zopanda nthawi.

Nthawi zina, zotsatira za mapiritsiwa sizingaoneke. Nchiyani chomwe chikufunika kuchitika pamikhalidwe ngati imeneyi? Muzochitika zotere, malinga ndi malangizo ogwiritsira ntchito komanso kuwunika kwa odwala matenda ashuga, "Galvus" imayikidwa limodzi ndi mankhwala ena chifukwa cha insulin kapena zinthu zina zomwe zimapangitsa kapamba.

Tisanapitenso pazokambirana zina za mankhwalawa, tiyeni tiwone mwachidule za matendawa, omwe ali chisonyezo chachikulu chogwiritsira ntchito mapiritsi.

Type 2 matenda a shuga. Izi ndi chiyani?

Uwu ndiye mtundu wofala kwambiri wamatenda a shuga, omwe amadziwika ndi kusakhazikika kwa maselo ndi minyewa yathupi kupita kwa insulini yomwe imasungidwa ndi kapamba. Kodi izi zikutanthauza chiyani?

Insulin imapangidwa mokwanira ndi thupi, koma maselo amthupi pazifukwa zina sasalumikizana nawo. Kunenepa kwambiri, kuthamanga kwa magazi, kukhala chete, moyo wosachita zambiri, cholowa komanso kusowa zakudya m'thupi (kugwiritsa ntchito maswiti, makeke, sopo ndi zinthu zina zomwe zimachitika motsutsana ndi maziko a kumwa kwambiri njere, zipatso ndi ndiwo zamasamba zimawerengedwa kuti ndizomwe zimapangitsa kuti matendawa azikula).

Kodi matenda oopsa a endocrine amawonekera bwanji? Ndikofunikira kwambiri kudziwa kuti mudziwe matendawa munthawi ndikuyamba chithandizo chamankhwala "Galvus" kapena mankhwala ena aliwonse omwe atchulidwa ndi endocrinologist.

Choyambirira, matenda a shuga a mtundu wachiwiri amadziwonetsera mu ludzu losalekeza komanso pakamwa lowuma, kukodza kwambiri komanso pafupipafupi, kufooka m'misempha, kuyabwa pakhungu, kuchiritsa koyipa kwa mabala ndi mabala.

Dziwani matenda mothandizidwa ndi mayeso a magazi a shuga, kulolerana kwa shuga, ndi zina zambiri.

Ndi munthawi ziti zomwe makonzedwe apakamwa angavomerezedwe ndi akatswiri?

Kodi mankhwalawa ndi mankhwala liti?

Malinga ndi malangizo, mankhwalawa "Galvus" amawerengera madokotala pa chithandizo cha matenda a shuga a mtundu wachiwiri pa magawo a mankhwalawa:

Poyamba. Ndiye kuti, ndi mankhwala okhawo omwe amagwiritsidwa ntchito limodzi ndi zakudya zoyenera komanso zolimbitsa thupi zolimbitsa thupi.
Monotherapy. Kulandilidwa kwa vildagliptin pamene metformin imatsutsana, ngakhale zakudya kapena masewera olimbitsa thupi sizingathandize m'thupi la wodwalayo
Mankhwala othandizira awiri kapena awiri. "Galvus" imayikidwa limodzi ndi njira zina zapadera (chimodzimodzi, imodzi mwazo): metformin, insulin, zotengera sulfonylurea ndi zina zotero.
Katatu chithandizo. Pamene vildagliptin adayikidwa limodzi ndi kutenga metformin ndi insulin kapena metformin ndi sulfonylureas.

Kodi mankhwalawa amachita bwanji akangolowa mthupi la munthu? Tiyeni tiwone.

Pharmacokinetic mawonekedwe a mankhwalawa

Vildagliptin, kulowa mkati, amatengeka mwachangu. Ndi bioavailability 85%, iwo amadziwunjikira m'magazi patatha maola awiri. Izi zikuwonetsedwa ndi langizo la "Galvus". Ndemanga ya endocrinologists ndi akatswiri ena akuwonetsa kuti mawonekedwe amtunduwu omwe amagwira ntchito mankhwalawo amathandizira kuti thupi lake liziwoneka mwachangu komanso kuti lichiritse msanga.

Vildagliptin amalumikizana ndi mapuloteni a plasma ndi maselo ofiira am'magazi, pambuyo pake amatsitsidwa ndi impso (pafupifupi 85%) ndi matumbo (15%).

Kodi pali zotsutsana ndi mankhwalawa? Zachidziwikire, izi tidzakambirananso.

Mukalephera kupereka mankhwala

Malinga ndi malingaliro a madotolo ndi kuwunika kwa wodwala, Galvus sayenera kutengedwa ngati munthu wapezeka ndi matenda a matenda a shuga 1, ngati pali mbiri yolephera kwamtima wachinayi, komanso matenda monga lactic acidosis, metabolic acidosis, tsankho lactose, matenda a kupuma dongosolo, chifuwa, aakulu chiwindi matenda. Komanso contraindication kwathunthu ndi mimba, mkaka wa m`mawere ndi zaka odwala mpaka zaka khumi ndi zisanu ndi zitatu.

Komanso, posankha kuti muthe kutenga vildagliptin kapena ayi, musaiwale za kusalolera kwa zigawo za mapiritsi, ndiko kuti, kuyanjana ndi zonse zomwe zikuchitika palokha komanso pazinthu zina zothandizirazo.

Mosamala kwambiri, ndiye kuti, moyang'aniridwa ndi kuyang'aniridwa ndi katswiri, mankhwala amathandizidwa odwala omwe ali ndi kapamba, matenda a mtima kapena matenda osiyanasiyana a chiwindi ndi impso.

Kodi ndikofunikira bwanji kumwa mankhwalawo kuti mumve kugwira bwino kwake?

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi: kuchokera ku chikasu choyera mpaka choyera, chozungulira, chammbali chakumaso, chokhala ndi mawonekedwe osalala komanso mawonekedwe a NVR mbali imodzi, FB - inayo (ma PC 7. Kapena ma PC 14. Phukusi lodzaza, pakatoni 2 , 4, 8 kapena 12 matuza ndi malangizo ogwiritsira ntchito Galvus).

Piritsi limodzi lili:

yogwira mankhwala: vildagliptin - 50 mg,
othandizira zigawo zikuluzikulu: wowuma wa sodium carboxymethyl, anactrous lactose, microcrystalline cellulose, magnesium stearate.

Malangizo ambiri okhudza kugwiritsa ntchito ndalama

Mapiritsi amatengedwa mosasamala chakudya. Mankhwalawa amatsukidwa ndi madzi pang'ono.

Kumwa mankhwala osokoneza bongo, muyenera kuyang'anira kuchuluka kwa shuga m'magazi pogwiritsa ntchito mizere ya glycemic test.

Mlingo wapamwamba kwambiri watsiku ndi tsiku mamiligalamu 100 a vildagliptin.

Mankhwala

Vildagliptin - chinthu chogwira ntchito cha Galvus, ndikuyimira gulu lazomwe zimapangitsa kuti zikondamoyo zizisokoneza. Thunthu limalepheretsa enzyme DPP-4 (dipeptidyl peptidase-4). Kukwaniritsa kwathunthu (> 90%) komanso kufalitsa mwachangu kumabweretsa kuwonjezeka kwa secretion ya basal ndi yolimbikitsidwa ndi chakudya ya GLP-1 (mtundu 1 glucagon-ngati peptide) ndi HIP (glucose-insulinotropic polypeptide) mu kayendedwe kazinthu kuchokera m'matumbo tsiku lonse.

Pakuwonjezeka kwa kuchuluka kwa GLP-1 ndi HIP, pali kuwonjezeka kwa chidwi cha ma pancreatic β-cell ku glucose, omwe amasintha secretion ya glucose yodalira shuga.

Pankhani yogwiritsa ntchito 50-100 mg vildagliptin patsiku odwala omwe ali ndi matenda a shuga 2 (shuga mellitus), pamakhala kusintha kwa ntchito ya ma pancreatic β-cell. Kuchita bwino kwa mankhwalawa kumatsimikiziridwa ndi kuchuluka kwa kuwonongeka kwawo koyambirira. Mwa anthu omwe ali ndi plasma glucose yokhazikika (yopanda matenda a shuga), vildagliptin simalimbikitsa kubisirana kwa insulini ndipo sachepetsa kuchuluka kwa shuga. Ndi kuwonjezeka kwa kuchuluka kwa GLP-1, kuchuluka kwa maselo a glucose kumawonjezera, zomwe zimayambitsa kusintha kwa shuga yodalira glucagon secretion. Kutsika kwa kuchuluka kwa glucagon pakudya, kumabweretsa kuchepa kwa insulin.

Ndi kuwonjezeka kwa chiwerengero cha insulin / glucagon kumbuyo kwa hyperglycemia, komwe kumachitika chifukwa cha kuchuluka kwa HIP ndi GLP-1, kuchepa kwa kupanga kwa shuga ndi chiwindi panthawi ya chakudya / atatha kudya. Zotsatira zake, pali kuchepa kwa plasma ya glucose m'magazi.

Kulandila kwa vildagliptin kumathandizira kuchepetsa kuchuluka kwa lipids m'madzi am'magazi pambuyo chakudya, pomwe izi sizikugwirizana ndi zomwe zimachitika pa GLP-1 kapena HIP ndikusintha kwa ntchito ya maselo otulutsa pancreatic.

Zinakhazikitsidwa kuti kuwonjezeka kwa ndende ya GLP-1 kungayambitse kuchepa m'matumbo, komabe, pa chithandizo cha vildagliptin, zotsatira zofananira sizikuwoneka.

Malinga ndi zotsatira za kafukufukuyu, mukamagwiritsa ntchito vildagliptin monga monotherapy kapenanso kuphatikiza ndi metformin, mankhwala a sulfonylurea, thiazolidinedione kapena insulin odwala omwe ali ndi matenda a shuga a 2, kuchepa kwakukulu kwa nthawi yayitali pakumeta kwa HbA1c (glycated hemoglobin) komanso kusala magazi m'thupi.

Popanga mankhwala ophatikizira ndi metformin ngati mankhwala oyamba kwa odwala omwe ali ndi matenda a shuga a 2 milungu 24, kuchepa kwa mankhwala a HbA1c kumawonetsedwa poyerekeza ndi monotherapy ndi mankhwalawa. M'magulu onse awiri azachipatala, matenda a hypoglycemia anali ochepa.

Mukamagwiritsa ntchito 50 mg ya vildagliptin 1 nthawi patsiku kwa miyezi 6 kwa odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi kuwonongeka kwakanthawi kapena kuwonongeka kwa impso (ndi glomerular filtration rate ≥ 30 ndi 2 kapena 2, motero), kuchepa kwakukulu kwa ndende ya HbA1c kunawonedwa poyerekeza ndi placebo.

Zomwe zimachitika mu hypoglycemia pagulu la vildagliptin zikufanana ndi zomwe zili m'gulu la placebo.

Pharmacokinetics

Vildagliptin ikamamwa pakamwa yopanda kanthu imatengedwa mwachangu, C_max (pazipita kuchuluka kwa chinthu) m'madzi am'magazi amafikira maola 1.75. Panthawi yakulowerera munthawi yomweyo ndi chakudya, kuchuluka kwa mayamwidwe a vildagliptin kumachepera pang'ono: kuchepa kwa C_max pofika 19%, pomwe nthawi yoti akwaniritse imawonjezeka ndi maola 2,5. Komabe, kudya pamlingo wa mayamwidwe ndi AUC (dera lomwe limapindika "nthawi yokhazikika") lilibe kanthu.

Vildagliptin imalowetsedwa mwachangu, ndipo tanthauzo lake lonse la bioavailability ndi 85%. Makhalidwe a C_max ndi AUC mu achire mlingo zosiyanasiyana kuchuluka pafupifupi malinga ndi mlingo.

Thupi limadziwika ndi gawo lochepa kwambiri lomanga kumapuloteni a plasma (pamlingo wa 9.3%). Vildagliptin imagawidwanso pakati pa maselo ofiira a magazi ndi madzi a m'magazi. Kugulitsa zinthu kumachitika, mwina, mwachisawawa, V_ss (voliyumu ya magawidwe ofanana) pambuyo pa kayendetsedwe ka intravenous ndi malita 71.

Njira yayikulu yochotsera vildagliptin ndi biotransfform, yomwe imadziwika ndi 69% ya mlingo. Metabolite yayikulu ndi lay151 (57% ya mlingo). Sichikuwonetsa zochitika zam'magulu amtundu wa mankhwala ndipo ndichopanga cha hydrolysis cha gawo la cyano. Pafupifupi 4% ya mankhwalawa amapezeka amide hydrolysis.

Pa maphunziro oyamba, zotsatira zabwino za DPP-4 pa hydrolysis ya vildagliptin idakhazikitsidwa. Mu kagayidwe kazinthu, cytochrome P isoenzymes₄₅₀ osatenga nawo mbali. Vildagliptin gawo lapansi isoenzyme P₄₅₀ (CYP) sichoncho, cytochrome P isoenzymes₄₅₀ sichimaletsa ndipo sichichita chidwi.

Mutatenga vildagliptin mkatimo, pafupifupi 85% ya mankhwalawa imachotsedwa impso, kudzera m'matumbo - pafupifupi 15%. Kutulutsa kwina kwa zinthu zosasinthika ndi 23%. Yapakatikati T_1/2 (hafu ya moyo) pamene chikuyendetsedwera mkati ndi 2 hours, chilolezo cha impso ndi chilolezo chonse cha plasma cha vildagliptin ndi 13 ndi 41 l / h, motsatana. T_1/2 Pambuyo pakamwa, ngakhale mlingo, ndi pafupifupi 3 maola.

Mankhwala aacocokinetic odwala omwe ali ndi vuto la chiwindi:

kuuma pang'ono komanso pang'ono
kwambiri digiri (mfundo za 10-12 pamsana wa Mwana-Pugh): kukhudzika kwa vildagliptin kumawonjezeka ndi 22%.

Zosintha (kuchuluka kapena kuchepa) pazokwera kwambiri za bioavailability wa chinthu chopitilira 30% zimawoneka kuti ndizofunika kwambiri. Palibe kulumikizana komwe kunapezeka pakati pa bioavailability wa vildagliptin ndi kuopsa kwa vuto la chiwindi.

Mankhwala a Pharmacokinetic mu odwala omwe ali ndi vuto laimpso ofatsa, ochepa kapena owopsa (poyerekeza ndi odzipereka athanzi):

AUC ya vildagliptin: imawonjezera 1.4, 1.7 ndi 2 nthawi, motero,
AUC ya metabolite lay151: imawonjezeka ndi 1.6, 3.2 ndi 7.3 nthawi, motero
AUC ya metabolite BQS867: imawonjezera 1.4, 2.7 ndi 7.3 nthawi, motsatana.

Zambiri zochepa mu terminal gawo la CKD (matenda a impso) zimatsimikizira kuti zizindikiro zomwe zili mgululi ndizofanana ndi zomwe zili ndi odwala omwe ali ndi vuto la impso. Kuphatikizika kwa lay151 metabolite mu siteji yotsika ya CKD kumawonjezeka ndi nthawi 2-3 poyerekeza ndi kuchuluka kwa odwala omwe ali ndi vuto laimpso.

Ndi hemodialysis, vildagliptin excretion ndi ochepa (maola 4 pambuyo pa limodzi mlingo 3% ndi kutalika kwa maola oposa 3-4).

Okalamba odwala (opitilira zaka 65-70), kuchuluka kwakukulu kwa voaagiciptin ndi 32%, C_max - 18% siyimakhudzanso zopinga za DPP-4 ndipo siyofunika kwambiri pachipatala.

Zolemba za Pharmacokinetic mwa odwala ochepera zaka 18 sizinakhazikitsidwe.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito kwa Galvus kumawonetsedwa pochiza matenda amishuga a 2 pomwe njira zochizira komanso zolimbitsa thupi zimatsatiridwa:

Mankhwala oyamba a mankhwala odwala omwe ali ndi vuto losakwanira kudya mankhwala olimbitsa thupi komanso masewera olimbitsa thupi - kuphatikizapo metformin,
monotherapy, yowonetsedwa kwa odwala omwe ali ndi contraindication kuti atenge metformin kapena ndi othandiza - pakalibe zovuta zamankhwala zothandizira kudya komanso kuchita masewera olimbitsa thupi,
ophatikizira awiri ophatikizira mankhwala omwe ali ndi metformin, thiazolidinedione, sulfonylurea zotumphukira kapena insulin - pakalibe zovuta zamankhwala kuchokera ku chithandizo chamankhwala, masewera olimbitsa thupi ndi monotherapy ndi amodzi a mankhwalawa.
katatu kuphatikiza mankhwala osakanikirana ndi metformin ndi sulfonylurea zotumphukira - pakalibe zokwanira glycemic pambuyo mankhwala oyambira ndi metformin ndi sulfonylurea zotumphukira maziko a zakudya mankhwala ndi masewera olimbitsa thupi,
katatu kuphatikiza mankhwala osakanikirana ndi metformin ndi insulin - pakalibe chitetezo chokwanira cha glycemic pambuyo pa mankhwala oyamba ndi insulin komanso metformin motsutsana ndi maziko a zakudya zochizira komanso masewera olimbitsa thupi.

Contraindication

mtundu 1 shuga
wazaka 18
shuga-galactose malabsorption syndrome, tsankho la galactose, kusowa kwa lactase,
aakulu mtima kulephera IV ogwira ntchito kalasi malinga ndi zinchito gulu NYHA (New York Cardiology Association),
metabolic acidosis (matenda ashuga ketoacidosis) wodwala kapena wowuma (kuphatikizapo osakaniza kapena wopanda chikomokere),
lactic acidosis (kuphatikizapo mbiri),
chiwindi kuwonongeka ntchito, kuphatikizapo kuchuluka kwa chiwindi michere alanine aminotransferase (ALT) ndi aspartate aminotransferase (AST) 3 kapena kuposerapo kuposa malire apamwamba,
nthawi ya pakati komanso yoyamwitsa,
Hypersensitivity ku zida za Galvus.

Mosamala, tikulimbikitsidwa kugwiritsa ntchito mapiritsi a Galvus a pancreatitis pachimake mu anamnesis, gawo lothana ndi matenda a impso (odwala omwe akudwala hemodialysis kapena hemodialysis), matenda osowa mtima a mtima III malinga ndi NYHA yogwira ntchito.

Galvus, malangizo ogwiritsira ntchito: njira ndi mlingo

Mapiritsi a Galvus amatengedwa pakamwa, ngakhale atamwa kwambiri.

Mlingo uyenera kusankhidwa poganizira momwe munthu angagwirire ntchito yake ndi kuvomerezeka kwa mankhwalawo.

monotherapy kapena kuphatikiza ndi thiazolidinedione, metformin kapena insulin: 50 mg 1-2 kawiri pa tsiku, koma osapitirira 100 mg,
kuphatikiza kawiri mankhwala ndi sulfonylurea kukonzekera: 50 mg kamodzi patsiku, m'mawa. Odwala a gululi, njira yothandizira achire Galvus tsiku lililonse ya 100 mg imafanana ndi ya 50 mg patsiku,
katatu kuphatikiza mankhwala ndi munthawi yomweyo sulfonylurea ndi metformin zotumphukira: 100 mg patsiku.

Ngati mlingo watsiku ndi tsiku ndi 50 mg, amatengedwa kamodzi, m'mawa, ngati 100 mg - 50 mg m'mawa ndi madzulo. Ngati mutadumphapo mwadzidzidzi mlingo wotsatira, muyenera kumwa mosamala masana. Simungalole kutenga Galvus pamtunda wopitilira munthu tsiku lililonse.

Popeza kulibe glycemic yokwanira pa monotherapy pa mlingo waukulu wa tsiku lililonse wa 100 mg, mankhwalawa ayenera kuthandizidwa poika sulfonylurea, metformin, thiazolidinedione kapena insulin.

Ndi kufatsa kochepa kwambiri kwaimpso, kulengedwa kwa creatinine (CC) pamwambapa 50 ml / min sikumasintha mlingo wa Galvus.

Ndi zolimbitsa thupi (CC 30-50 ml / min) komanso zolimba (CC zosakwana 30 ml / min) kukanika kwa impso, kuphatikiza gawo lomaliza la matenda a impso (hemodialysis odwala kapena hemodialysis), tsiku ndi tsiku mlingo wa Galvus umatengedwa kamodzi, ndipo osatero ayenera kupitilira 50 mg.

Odwala okalamba (zaka zopitilira 65), kukonza mankhwala a Galvus sikofunikira.

Zotsatira zoyipa

Kukula kwa zotsatira zosafunikira panthawi ya monotherapy kapena kuphatikiza ndi othandizira ena nthawi zambiri kumakhala kofatsa, kwakanthawi ndipo sikutanthauza kuti kuthetsedwe kwa Galvus.

Maonekedwe a angioedema nthawi zambiri amawonedwa akaphatikizidwa ndi angiotensin-converting enzyme inhibitors. Nthawi zambiri chimakhala chovuta kwambiri, chimadzichitira chokha motsutsana ndi maziko a chithandizo chanthawi zonse.

Nthawi zambiri, kugwiritsidwa ntchito kwa Galvus kumayambitsa chiwindi ndi matenda ena a chiwindi ntchito monga asymptomatic. Nthawi zambiri, machitidwewa safunikira chithandizo chamankhwala, ndipo atatha kufafaniza kwa Galvus, chiwindi chimagwira ntchito.

Kuwonjezeka kwa ntchito ya hepatic michere pa mlingo wa vildagliptin 50 mg kawiri pa tsiku nthawi zambiri ndi asymptomatic, sikuyenda ndipo sikuyambitsa cholestasis kapena jaundice.

Ndi monotherapy mu mlingo wa 50 mg kawiri pa tsiku, zotsatirazi zotsatirazi zingachitike:

Kuchokera kwamanjenje: Nthawi zambiri - chizungulire, mosapweteka - mutu,
ma parasitic ndi matenda opatsirana: kawirikawiri - nasopharyngitis, matenda apamwamba a thirakiti;
kuchokera ku ziwiya: mokhazikika - zotumphukira edema,
Kuchokera m'mimba thirakiti: pafupipafupi - kudzimbidwa.

Ndi kuphatikiza kwa Galvus muyezo wa 50 mg 1-2 kawiri pa tsiku ndi metformin, kuwoneka kwa zotsatirapo ndizotheka:

Kuchokera kwamanjenje: Nthawi zambiri - kupweteka mutu, kunjenjemera, chizungulire,
Kuchokera m'mimba thirakiti: Nthawi zambiri - nseru.

Kuphatikiza mankhwala ndi metformin sikukhudza thupi la wodwalayo.

Mukamagwiritsa ntchito Galvus patsiku la 50 mg osakanikirana ndi mankhwala a sulfonylurea, njira zotsatirazi zitha kuonedwa mwa wodwala:

ma parasitic ndi matenda opatsirana: kawirikawiri - nasopharyngitis,
Kuchokera m'mimba thirakiti: pafupipafupi - kudzimbidwa,
Kuchokera kwamanjenje: Nthawi zambiri - kupweteka mutu, kunjenjemera, chizungulire, asthenia.

Kulemera kwa wodwala sikuwonjezereka ndikaphatikizidwa ndi glimepiride.

Kugwiritsidwa ntchito kwa Galvus muyezo wa 50 mg 1-2 kawiri pa tsiku limodzi ndi thiazolidatedione zotumphukira zingayambitse zotsatirazi zosafunikira:

kuchokera ku zotengera: nthawi zambiri - zotumphukira edema,
kuchokera kumbali ya kagayidwe ndi zakudya: nthawi zambiri - kuwonjezeka kwa thupi.

Kumwa Galvus mlingo wa 50 mg 2 kawiri pa tsiku limodzi ndi insulin kungayambitse:

Kuchokera kwamanjenje: Nthawi zambiri - mutu, wokhala ndi mafayilo osadziwika - asthenia,
Kuchokera m'mimba thirakiti: Nthawi zambiri - gastroesophageal Reflux, nseru, pafupipafupi - flatulence, kutsegula m'mimba,
kuchokera kumbali ya kagayidwe ndi zakudya: Nthawi zambiri - hypoglycemia,
mavuto ambiri: kawirikawiri - kuzizira.

Kulemera kwa wodwala kuphatikiza uku sikukula.

Kugwiritsa ntchito Galvus 50 mg 2 kawiri pa tsiku limodzi ndi metformin ndi sulfonylurea kukonzekera kungayambitse kukulitsa zotsatira zotsatirazi:

kuchokera kumbali ya kagayidwe ndi zakudya: Nthawi zambiri - hypoglycemia,
Kuchokera kwamanjenje: Nthawi zambiri - kunjenjemera, chizungulire, asthenia,
dermatological zimachitika: zambiri - hyperhidrosis.

Kuphatikiza kwapawiri sikukhudza thupi la wodwalayo.

Kuphatikiza apo, zochitika zotsatirazi zotsatirazi zinajambulidwa mu maphunziro atatha kulembetsa: urticaria, kuchuluka kwa michere ya chiwindi, hepatitis, kapamba, zotupa za pakhungu la oxous kapena exfoliative etiology, myalgia, arthralgia.

Bongo

Mukamagwiritsa ntchito mpaka 200 mg a vildagliptin patsiku, mankhwalawa amaloledwa bwino.

Pankhani yogwiritsidwa ntchito ndi Galvus pa mlingo wa 400 mg patsiku, zizindikiro zotsatirazi zitha kudziwika: kupweteka kwa minofu, kawirikawiri - kutentha thupi, mapapo / osakhalitsa paresthesia, edema ndi kuwonjezeka kwa pang'onopang'ono pantchito ya lipase (2 times kuposa malire apamwamba).

Mankhwalawa tsiku ndi tsiku muyezo wa 600 mg, kuwoneka kwa edema ya malekezero ophatikizidwa ndi paresthesia ndi kuwonjezeka kwa ntchito ya CPK (creatine phosphokinase), myoglobin ndi C-reactive protein, ndi ntchito ya AST.

Kusintha kwa magawo a ma labotale ndi zizindikiro za bongo kumatha kusintha ndikumatha pambuyo pakuchira kwa mankhwala.

Kutulutsa kwa vildagliptin kuchokera mthupi pogwiritsa ntchito dialysis ndikosatheka. Mwa hemodialysis, metabolite lay151 imatha kuchotsedwa m'thupi.

Malangizo apadera

Wodwalayo ayenera kudziwitsidwa za kufunika kokawonana ndi dokotala chifukwa cha kuwonjezeka kwa zotsatirapo zoyipa kapena kuwonekera kwa zina zosayenera pamasamba ogwiritsira ntchito mapiritsi.

Mankhwala samayambitsa chonde.

Odwala omwe amadalira insulin, Galvus amayenera kugwiritsidwa ntchito limodzi ndi insulin.

M'magawo osalephera a mtima omwe ndimagwira ntchito yogawa mankhwala a NYHA angathe kumwedwa popanda zoletsa zolimbitsa thupi.

Kulephera kwamtima kwamkalasi kwa kalasi yachiwiri, kuletsa zolimbitsa thupi kwakanthawi kumafunika, popeza katundu wambiri amachititsa kugunda kwa mtima, kufooka, kufumira, kutopa. Pakupumula, zizindikirazi sizipezeka.

Ngati zizindikiro za pancreatitis pachimake zikuwoneka, vildagliptin iyenera kusiyidwa.

Musanayambe kugwiritsa ntchito kenaka kamodzi pakapita miyezi itatu iliyonse mchaka choyamba chothandizira, ndikulimbikitsidwa kuti mupange maphunziro a michere ya chiwindi, chifukwa zochita za Galvus mwanjira zina zimatha kuwonjezera ntchito ya aminotransferases. Ngati pakuchitika kafukufuku wachiwiri, zomwe zikuwonetsa alanine aminotransferase (ALT) ndi aspartate aminotransferase (AST) zimaposa malire apamwamba a nthawi ndi katatu kapena kupitirira apo, mankhwalawo ayenera kusiyidwa.

Ndikupanga zizindikiro za chiwindi chodwala (kuphatikizapo jaundice) mutatenga Galvus, kuleka kwa mankhwalawo ndikofunikira, ndizosatheka kuyambiranso pambuyo pobwezeretsa zizindikiro za chiwindi.

Kuchepetsa chiopsezo cha hypoglycemia akaphatikizidwa ndi kukonzekera kwa sulfonylurea, tikulimbikitsidwa kuti muzigwiritsa ntchito mlingo wochepa.

Kuyanjana kwa mankhwala osokoneza bongo

Pogwiritsa ntchito nthawi yomweyo Galvus ndi glibenclamide, metformin, pioglitazone, amlodipine, ramipril, digoxin, valsartan, simvastatin, warfarin, palibe mgwirizano uliwonse wachipatala womwe wakhazikitsidwa.

Mphamvu ya hypoglycemic ya vildagliptin imatha kuchepetsedwa ikaphatikizidwa ndi thiazides, glucocorticosteroids, sympathomimetics, ndi kukonzekera kwa mahomoni a chithokomiro.

The mwayi wokhala ndi angioedema kumawonjezera ndi concomitant mankhwala ndi angiotensin kutembenuza enzyme zoletsa. Dziwani kuti vildagliptin iyenera kupitilizidwa ndi mawonekedwe a angioedema, popeza imadutsa pang'onopang'ono, palokha komanso sikutanthauza kuti ichiritsidwe.

Kuyanjana kwa Galvus ndi mankhwala omwe ali amtundu, ma inducers kapena zoletsa za cytochrome P ndizokayikitsa₄₅₀ (CYP).

Galvus siyimakhudzanso kuchuluka kwa kagayidwe kazakudya kamene kamakhala mu ma enzymes CYP1A2, CYP3A4, CYP3A5, CYP2C8, CYP2C9, CYP2D6, CYP2C19, CYP2E1.

Ma Analogs a Galvus ndi: Vildagliptin, Galvus Met.

Momwe mungatenge ndi kuchuluka

Choyamba, ziyenera kunenedwa kuti nthawi yoyendetsedwera komanso kumwa mankhwalawa imayikidwa ndi dokotala, poganizira za chipatala cha matenda, matenda omwe amakhalanso ndi thanzi la wodwalayo. Komabe, malangizo ogwiritsira ntchito "Galvus" ali ndi malingaliro pazomwe mungamwe mankhwalawo nthawi zina.

Pamankhwala oyamba kapena monotherapy, mankhwalawa "Galvus", malinga ndi zomwe akupanga, ndikofunikira kuti azitenga mamiligilamu makumi asanu patsiku (kapena piritsi limodzi). Ngati tikulankhula za kuphatikiza kwa vildagliptin ndi metformin, ndiye kuti mankhwalawa amatengedwa piritsi limodzi kawiri patsiku.

Mukamagwiritsa ntchito vildagliptin ndi mankhwala ochokera ku sulfonylureas, Galvus imapangidwira mamiligalamu makumi asanu kamodzi patsiku, m'mawa.

Ndi katatu mankhwala, mankhwalawa amalimbikitsidwa kumwa mapiritsi awiri kawiri patsiku (m'mawa ndi usiku).

Wodwala akaphonya kumwa mapiritsi mwangozi, ndiye kuti ayenera kumwedwa mwachangu, kuchedwetsa pang'ono kumwa kwa mankhwalawo. Izi ndizofunikira kuti musadutse kuchuluka kokwanira tsiku lililonse la vildagliptin mu miligalamu zana limodzi.

Ngati wodwala ali ndi matenda a impso olimbitsa thupi komanso ovuta, ndiye kuti "Galvus" iyenera kugwiritsidwa ntchito kamodzi pa tsiku, kupatsidwa mlingo wa tsiku lililonse wa ma milligram makumi asanu.

Odwala okalamba, komanso anthu omwe ali ndi vuto lochepa laimpso, kusintha koteroko sikofunikira. Izi zikuwonetsedwa ndi kuwunika kokwanira kwa odwala okhutitsidwa, omwe akuposa makumi asanu ndi awiri. "Galvus", monga palibe mankhwala ena aliwonse, yawagwiritsa ntchito kukhala mankhwala othandiza odwala matenda ashuga.

Kodi mavuto amabwera pakumwa mankhwalawa ndi vildagliptin? Inde, ndipo mutha kuziwerenga pansipa.

Zizindikiro zosasangalatsa

Nthawi zambiri, zotsatira zosafunika zimakhala zakanthawi kochepa ndipo zimakhala ndi mawonekedwe ofatsa. Pankhaniyi, sikofunikira kuletsa kugwiritsa ntchito "Galvus". Komabe, ndizofunikirabe kudziwitsa adokotala za mawonetsedwe osasangalatsa.

Kodi ndiyenera kuyang'ana chiyani ndikamagwiritsa ntchito vildagliptin?

Choyamba, yang'anani dongosolo lanu lamanjenje. Kodi mumavulala mutu wamabala? Kodi chizungulire, kunjenjemera kumadera akutali, komanso mantha amawonedwa kawirikawiri? Ngati zizindikiro zikukulirakulira, ndiye kuti kusintha kwachangu kwakanthawi ndikofunikira.

Kodi "Galvus" imayendetsedwa ndi zotupa pakhungu ndi kuyabwa? Kodi kuzizira kapena kutentha thupi kumawonedwa? Ndipo matumbo amati chiyani? Kodi kudzimbidwa kwachitika pafupipafupi? Kodi nseru, kusanza, kapena kutsegula m'mimba zawoneka? Ngati ndi choncho, ndiye kuti endocrinologist adzathetsa vutoli.

M'pofunikanso kulabadira kulemera kwanu. Kodi pali kuwonjezeka kwakukulu kwa kulemera kwa thupi motsutsana ndi zakudyazo komanso zolimbitsa thupi? Nthawi zambiri, kugwiritsa ntchito mankhwalawa kuphatikiza ndi thiazolidinedione kumapangitsa kuti wodwala azidwala popanda chifukwa. Poterepa, pakufunika kuwunikira chithandizo chamankhwala.

Kodi bongo wambiri umawonekera bwanji

Zatsimikiziridwa mwachipatala kuti vildagliptin nthawi zambiri imadziwika ndi thupi ngakhale itagwiritsidwa ntchito mamiligalamu mazana awiri patsiku. Komabe, bongo wambiri wa zinthu zazikuluzikulu ungayambitse zochita komanso zotsatira zosayembekezereka. Choyamba, izi zikutanthauza kuwonjezeka kawiri mu mlingo womwe watchulidwa pamwambapa. Pankhaniyi, kupweteka kwambiri kwa minofu, kutentha thupi, ndi kutupa. Ngati mlingo wa tsiku lililonse ukuwonjezeka mpaka mamiligalamu mazana asanu ndi limodzi, ndiye kuti zinthu zofananira zimayambitsa edema ndi paresthesia yam'munsi komanso yotsika komanso zovuta zina muzochitika zonse za thupi.

Chithandizo cha mankhwalawa chikhoza kukhala hemodialysis kuchipatala.

Vildagliptin ndi ena othandizira azamankhwala

Monga tafotokozera pamwambapa, kugwiritsa ntchito "Galvus" ndi mankhwala ozikidwa pa metformin, insulin, sulfonylurea ndi ena kumachitidwa. Kuphatikiza apo, mankhwalawa amatha kuphatikizidwa momasuka pogwiritsa ntchito digoxin, ramipril, valsartan, simvastatin ndi zina zotero.

Zotsatira za vildagliptin zimachepetsedwa ndi othandizira omwe zinthu zake zimakhala mahomoni a chithokomiro, sympathomimetics, glucocorticosteroids ndi zina zotero.

Kukonzekera m'malo mwa Galvus

Monga tafotokozera pamwambapa, mankhwalawa sangakhale oyenera kwa wodwala. Kodi ayenera kuchitanji pamenepa? Kodi dokotala wofunsidwa angakupatseni mankhwala ena? Ndiye, tingatanthawuze chiyani za “Galvus”? Malangizo ogwiritsira ntchito mankhwalawa adanenedwa pansipa.

Ngati tikunena za mawonekedwe azowoneka, ndiye kuti m'malo mwa vildagliptin ndi njira yothetsera jakisoni "Baeta". Mankhwala omwe amagwira ntchito ndi exenatide (ma 250 micrograms mu millilita imodzi). Zizindikiro zogwiritsidwa ntchito ndi matenda a shuga a mtundu wachiwiri."Baeta" imalembedwa mwa mawonekedwe a jakisoni wonyansa m'matako, phewa, pamimba. Ma microgram asanu a chophatikizacho amagwiritsidwa ntchito kawiri patsiku mphindi makumi asanu ndi limodzi asanadye chakudya cham'mawa ndi chamadzulo. Amagwiritsidwa ntchito ngati chithandizo cha monotherapy komanso chophatikiza (chosakanikirana) ndi metformin, thiazolidinedione ndi ena. Mtengo wa mankhwalawa mu Mlingo makumi asanu ndi limodzi ungathe kupitilira ma ruble 5,000.

"Januvia" ndi analogue ina ya "Galvus", yopangidwa mwanjira ya mapiritsi, gawo lalikulu lomwe ndi sitagliptin phosphate hydrate. Thupi limagwiritsidwa ntchito pochiza matenda am'mimba a 2 shuga ndi monotherapy ndi zovuta mankhwala. Mlingo woyenera wa mankhwalawa ndi mamiligalamu zana limodzi la mankhwala limodzi kamodzi patsiku. Mapiritsi amapezeka mosiyanasiyana. Mtengo wapakatikati wamapiritsi 28 ndi ma ruble 1,500.

"Onglisa" ndi mankhwala ena omwe mapiritsi ake ndi omwe timawaganizira. Mapangidwe a "Onglisa" akuphatikiza saxagliptin, chomwe ndi chophatikizira. Nthawi zambiri, mankhwalawa amathandizidwa pakamwa pama milligram asanu (piritsi limodzi) kamodzi patsiku. Mutha kumwa mankhwalawo mosasamala chakudya. Mtengo wa kulongedza mapiritsi pazinthu makumi atatu umafikira ma ruble 1,900 kapena kupitirira.

Komabe, ma endocrinologists nthawi zambiri amalowa m'malo mwa Galvus ndi chiwonetsero chake chachindunji - mapiritsi a Galvus Met, zigawo zikuluzikulu zomwe ndi vildagliptin (kuchuluka kwa ma milligram makumi asanu) ndi metformin (kuchuluka kwa mamiligalamu 500, 850 kapena 1,000). Chifukwa cha kuyanjana uku, mankhwalawa amayang'anira kagayidwe ndipo amatsitsa cholesterol. Kutumizidwa ndi endocrinologist, kuyambira pa mlingo wocheperako (ma milligramamu a vildagliptin ndi ma milligram mazana asanu a metformin). Amakhulupilira kuti mankhwalawa amakhudza kwambiri thupi la wodwala yemwe ali ndi matenda ashuga kuposa mankhwala omwe amatipatsa chidwi. Mtengo wa mapiritsi a Galvus Met ndi pafupifupi rubles 1,500.

Monga mukuwonera, pali mitundu yambiri ya "Galvus" yomwe imasiyana mosiyanasiyana mu kapangidwe kake, mawonekedwe ake ndi ndondomeko yamitengo. Ndi iti yomwe ili yoyenera kwa inu - dokotala asankha, poganizira chithunzi cha matendawo, komanso machitidwe a wodwala.

Mawu ochepa kumapeto

Monga mukuwonera, mankhwalawa "Galvus" ndi njira imodzi yotsika mtengo yomwe ingathandize wodwala wodwala matenda a shuga a mtundu wachiwiri. Mapiritsi, otulutsidwa pamaziko a vildagliptin, amathandizira kapamba, kukhala ndi gawo labwino m'thupi lonse la wodwalayo. Mankhwalawa amatha kugwiritsidwa ntchito ngati chithandizo chodziimira pawokha, komanso kuphatikiza ndi mankhwala ena.

Ngakhale zotsatira zabwino, "Galvus" ili ndi mndandanda waukulu wa zotsutsana ndi zoyipa, chifukwa chake simungathe kudzipatsa nokha. Dongosolo la makonzedwe ndi mlingo wake ndi madokotala omwe amapezekapo.

Odwala ambiri ali okondwa kuti amamwa mankhwalawa, chifukwa ndi chida chothandiza kwambiri kuchepetsa shuga m'magazi ndikusintha thanzi la wodwalayo. Ndipo nthawi yomweyo, amazindikira kuti vildagliptin imagwiritsidwa ntchito bwino kuphatikiza ndi metformin kuti ikhale bwino komanso yogwira mtima pazinthu zomwe zikugwira ntchito.