Momwe mungagwiritsire ntchito mankhwala Janumet?

Mankhwalawa amagwiritsidwa ntchito ngati mtundu wachiwiri wa matenda a shuga (amakupatsani mwayi wowongoletsa glycemia), osakanikirana kwambiri ndi zakudya zomwe zimasankhidwa mwapadera komanso kuwongolera zolimbitsa thupi. Yanumet imalembedwanso kangapo ngati chithandizo ndi metformin ndi sitagliptin payokha ndizosatheka, ndipo mankhwalawa amaphatikiza zinthu ziwiri izi, kulipirira zolakwa zonse ziwiri. Komanso, chithandizo ndi Yanumet chimachitika limodzi ndi kukonzekera komwe kumakhala zinthu zomwe zimachokera ku sulfonylurea (zitatu chimodzi). Gwiritsani ntchito ndi a PPAR agonists ndi insulin amasonyezedwanso.

Kutulutsa Mafomu

Yanumet ndi piritsi yolumikizidwa ndi filimu, iliyonse yomwe ili ndi 50 mg ya sitagliptin, komanso 500, 800 ndi 1000 mg ya metformin, motero kugawa kwa mankhwalawa malinga ndi kuchuluka kwa metformin pakupanga mankhwala. Msika wama pharmacological umapereka mitundu yotsatirayi yotulutsira mankhwala:

• Janumet mapiritsi 500 mg + 50 mg,
• Janumet mapiritsi 800 mg + 50 mg,
• Mapiritsi a Janumet 1000 mg + 50 mg.

Bokosi limodzi limatha kukhala ndi matuza ambiri mpaka asanu ndi awiri. Matumba anayi azithunthu ndiwo akufunika kwambiri. Chithuza chilichonse chimakhala ndi mapiritsi 14. Mutha kusunga mankhwala osaposa zaka ziwiri.

Malangizo ogwiritsira ntchito

Sayenera kugwiritsidwa ntchito ndi amayi apakati, oyembekezera. Osapatsa ana chilichonse! Mapiritsi sayenera kudya mpaka azaka 18. Iyenera kuperekedwa mwachidwi kwa odwala okalamba. Ndikulimbikitsidwa kugwiritsa ntchito 2 kawiri pa tsiku mapiritsi awiri. Sungani pamalo owuma, amdima osaposa zaka ziwiri.

Komanso, musatengere molumikizana ndi mankhwala, zomwe zimanyoza zabwino za Yanumet. Chifukwa cha zapamwamba za sitagliptin, sizikulimbikitsidwa kuti zitengedwe pamodzi ndi othandizira ena okhala ndi sitagliptin. Mapiritsi awiri a Yanumet amaphimba mlingo woyenera (100 mg patsiku).

Malangizo ogwiritsa ntchito Yanumet ali ndi zambiri zoyipa ndi zotsutsana.

Contraindication

Janumet ndi osayenera kugwiritsa ntchito pamaso pazinthu izi:

• tsankho pazinthu zilizonse zomwe zimapanga mankhwala (povidone, metformin, sitagliptin phosphate monohydrate, stearyl fumarate ndi sodium lauryl sulfate),
• kuzindikira mtundu 1 shuga
• magawo akulu a matenda a impso, komanso vuto lofooka pakamayambidwe kachilomboka kapena kutekeseka (kuchepa madzi m'thupi), kukhudza ntchito ya impso.
• uchidakwa kapena uchidakwa.
• nthawi yapakati (nthawi ya bere, komanso nthawi yoyamwitsa),
  maphunziro a radiology (mwachindunji mkati mwa sabata komanso pambuyo pamchitidwewo),
• kukhalapo kwa matenda, makamaka omwe amalumikizana ndi mtima, komwe kumayambitsa kuperewera kwa mpweya wa minofu ya minofu.

Makamaka posankha Yanumet iyenera kuperekedwa kwa anthu achikulire. Zowonadi, pakupita nthawi, kugwira ntchito kwa impso kumachepa, ndipo iwo ali ngati mawonekedwe a thupi la munthu. Ndi m'badwo, dongosolo la ma excretory dongosolo, zomwe zikutanthauza kuti likuvutikira kuchotsa zinthu zosafunikira ndi zinthu zina mthupi. Popereka Yanumet kwa anthu okalamba, akatswiri ayenera kusankha bwino mankhwalawa, komanso kuwunika momwe wodwalayo alili.

Yanumet ili ndi sitagliptin (50 mg) pakapangidwe kake, mogwirizana ndi izi, polemba, munthu ayenera kuganizira kuti zovomerezeka tsiku lililonse za sitagliptin sizoposa 100 mg. Mlingo wa mankhwalawa amalembedwa ndi dokotala malinga ndi kuchuluka kwa matendawo, kulolerana, komanso momwe alili ndi kuthekera kwa wodwala, ndiye kuti, vuto lililonse limafanana ndi payekha.

Koma pali zisonyezo zofananira pakugwiritsa ntchito Yanumet: kawiri patsiku ndi chakudya. Popita nthawi, mlingo woyambirira womwe umagwiritsidwa ntchito umachulukira, womwe umakhudzana ndikuchotsa zotsatira zoyipa kuchokera m'matumbo am'mimba. Mapiritsi oyambira amaphatikizidwa molingana ndi kuchuluka kwa matenda ashuga amtundu wachiwiri ndi chithandizo chochitidwa ndi katswiri.

Zotsatira zoyipa

Yanumet, monga mankhwala ena aliwonse omwe ali ndi mphamvu, ali ndi zovuta zingapo zomwe zingachitike wodwala pakapita nthawi kapenanso atangomaliza kumene. Mankhwalawa amakhudza kwambiri m'mimba, amathandizira kuchepa kwa thupi pang'onopang'ono (mpaka kufika pa anorexia), komanso mtima wamtima. Kuphwanya kwa chizolowezi cha kagayidwe sikumaphatikizidwa, kuphatikiza apo, matupi awo sagwirizana pakhungu amapezeka - osiyanasiyana totupa ndi kuyabwa.

Izi ndi zotsatira zoyipa zomwe zimayambitsidwa chifukwa cha kumwa mankhwalawa:

• kupweteka kwakanthawi m'mutu kapena kupitilira, koma kufatsa,
  kuchepa kwa ntchito ndi thanzi lathanzi, nthawi zina pamakhala kugona mosafunikira komanso kutopa konsekonse,
• pakhosi, mpaka pakuwoneka chifuwa chosasangalatsa.
  kudula ululu m'mimba, limodzi ndi mseru, kusanza, kugona ndi kudzimbidwa,
  kutupa kwa thupi, makamaka kuwoneka pamiyendo ndi mikono,
• pakamwa kowuma, ngakhale mutamwa madzi (nthawi zambiri amatsatana ndi chifuwa),
  kugwiritsa ntchito nthawi yayitali, zodabwitsazi pogwira ntchito ya m'mimba thirakiti zimadziwika.

Chimodzi mwazina mwazizindikirozi mwapezeka mukumwa mapiritsiwo, muyenera kufotokozera dokotala za zoyipa zanu. Kutengera pakuwunika ndi kusanthula, katswiri angathe kusankha chithandizo choyenera kwambiri pamilandu inayake. Kupatula apo, Yanumet siwokhawo mankhwala omwe angakuthandizeni kulimbana ndi matendawa.

Janumet ndi mankhwala odula, mtengo wake umasiyanasiyana ma ruble 2700 mpaka 3000,000 phukusi lokhala ndi matuza anayi. Komanso, mtengo wake umatha kumasiyanasiyana malinga ndi mtundu wa zotulutsidwa (kuchuluka kwa mapiritsi, kuchuluka kwa metformin) ndi malo ogulira. Chifukwa chake, m'masitolo otsogola pa intaneti, kuyika kwa Yanumet kumawononga ndalama kuchokera ku 2700 mpaka 2800 rubles kupatula kutumiza (kwa mapiritsi 56). Koma pamankhwala okhala pamaneti a Yanumet mutha kupereka ma ruble 3,000,000.

Kuphatikizika kwapadera komwe kumaphatikiza metformin ndi sitagliptin kumapangitsa kuti mankhwalawa akhale osiyanasiyana pamsika wamankhwala. Kupatula apo, Yanumet ndiye mankhwala okhawo omwe amaphatikiza zinthu ziwiri izi. Koma mtengo wokwera kwambiri umatipangitsa kuti tipeze mankhwala ena othandizira koma okwera mtengo.

Mankhwala a Velmetia ali ndi mawonekedwe ofanana, koma mtengo wa mankhwalawa siosiyana kwambiri ndi mtengo wa Yanumet. Palibe mankhwala pamtengo wa chidutswa chomwe chimakhudza thupi la odwala omwe ali ndi matenda amtundu wa 2 monga Yanumet, koma mutha kuyesa kutenga mankhwala angapo limodzi kuti mukwaniritse bwino kwambiri kukhala ndi shuga.

Mankhwalawa akuphatikizapo:

• Metformin woyenga (metformin) ndi sitagliptin (Januvia). Metformin imawononga ndalama pafupifupi ma ruble 250 ndi zidutswa 60, ndipo Januvius 1500 mapiritsi 28. Ndalamazi ziyenera kutengedwa palimodzi kuti zitheke zotsatira zabwino,
• Galvus (ma ruble 800 a mapiritsi 28) ndi Glyukofazh (ma ruble 350 ndi mapiritsi 60) onse. Mankhwalawa amathandizana wina ndi mnzake, koma amasiyana ndi Yanumet poganizira kwambiri kuthetsa mavuto omwe amabwera chifukwa cha mtima wamtundu wa shuga,
• Glibomet. Mankhwalawa ali ndi metformin ndi glibenclamide ndipo ali ndi zofanana ndendende ndi Janumet. Cholinga chake ndi kuthana ndi hypoglycemia, ili ndi milomo yotsitsa lipid. Pafupifupi, mtengo wa mankhwalawa ndi ma ruble 350 pamapiritsi 40,
• Avandamet samapezeka kawirikawiri m'mafakitala aku Russia; mtengo wake ndi ma ruble 400 pamapiritsi 60 aliwonse. Ili ndi 500 mg ya metformin ndipo singagwiritsidwe ntchito ngati chida chothandiza popanda mankhwala ovuta. Ichi ndichifukwa chake mankhwalawa ndi otsika kwambiri ku Yanumet, ngakhale amagwira bwino ntchito ndi chithandizo chovuta,
• Tripride imakhala ndi zofanana ndi Yanumet, koma yotsika poyerekeza ndi kuchuluka kwa zinthu zomwe zili momwemo (imakhala ndi glimepiride ndi pioglitazone). Mankhwala oterowo amatenga pafupifupi ma ruble mazana awiri piritsi (30 mapiritsi) ndipo ndi analogue yotsika mtengo kuposa onse omwe aperekedwa,
• Douglimax imaphatikiza metformin ndi glimepiride, imakhalanso ndi mfundo zofananira ndi mapiritsi oyambira, koma kuchepa kwa shuga m'magazi kumakhala kotsika kwambiri kwa iwo. Douglimax imawononga ndalama pafupifupi ma ruble a 350 phukusi lomwe lili ndi miyala 30.

Chofunikira kukumbukira ndikuti kusintha kwina kulikonse ndi mankhwala kuyenera kuvomerezeredwa ndi dokotala, apo ayi zingayambitse zotsatira zosakonzekera. Kudziyimira pawokha pakuthandizira matenda oopsa ngati awa sikuvomerezeka, chifukwa izi zitha kupangitsa kuti magazi azikhala ochepa komanso kuti magazi achepetse magazi.

Bongo

Ngati Yanumet imagwiritsidwa ntchito mopitilira muyeso womwe wapatsidwa, zosintha zotsatirazi m'thupi la wodwalayo zitha kuzindikirika: kuwonjezeka kwakukulu kwa mtima motsutsana ndi hypoglycemia (wapezeka mu 15% ya milandu yopitirira muyeso), kuchepa kwa acid-base usawa, komwe kungayambitse mawonekedwe owopsa - lacticosis.

Matenda amtunduwu amapezeka pafupifupi 35% ya milandu yonse ya ku Yanumet. Koma monga akatswiri ati, ndikofunikira kukumbukira kuti mankhwalawa amathandizira odwala matenda ashuga, kuchitira mankhwala ovuta kumachitika, zomwe zikutanthauza kuti wodwalayo amatha kudyetsedwa poizoni osati ndi mankhwala, koma osakanikirana ndi mankhwala onse omwe amamwa. Chifukwa chake, kuyankhula za deta yeniyeni ya bongo la Yanumet sikofunikira.

Pamaso pa zizindikirozi, zomwe zimawonetsa kuchuluka kwa mankhwalawa, nthawi yomweyo amatsatira njira zochotseredwa zosafunikira m'thupi. Izi zikuphatikiza zochitika zothandizira. Gawo loyamba ndikuchotsera zotsalira za mankhwalawa, zomwe zinalibe nthawi yoti zigayike m'mimba, kuchokera mthupi. Kenako, katswiriyo ayenera kuyendetsa zosankha zingapo zokhudzana ndi wodwalayo (ECG, kuyesedwa koyenera, kuyang'anira pafupipafupi zizindikiro zofunika, hemodialysis imachitika ngati pakufunika).

Muzovuta kwambiri, chithandizo chobwezeretsa chapadera chimagwiritsidwa ntchito, poganizira mawonekedwe a munthu.

Chifukwa cha kapangidwe kake kapadera, komanso mphamvu zambiri, mankhwalawo amakhalabe akutsogolera pakati pa omwe akupikisana nawo. Odwala omwe ali ndi matenda a shuga a digiri yachiwiri amagwiritsidwa ntchito kwambiri Yanumet, monga njira yokhayo yosungira kuchuluka kwa shuga m'magazi m'njira zovomerezeka. Ndemanga za izi ndizabwino, chifukwa mankhwalawa ndi othandiza kwambiri, zokhazo zomwe anthu omwe amagwiritsa ntchito Janumet nthawi zambiri amazindikira ndizokwera mtengo kwa mankhwalawo. Nawa malingaliro pamankhwala awa:

Kutengera zonse zomwe tafotokozazi, titha kunena kuti Yanumet ndiye njira yothandiza kwambiri yodwala matenda ashuga a 2. Zotsatira zabwino zomwe mapiritsi akuwonetsa amadzilankhulira okha, chifukwa chake odwala sachita mantha ndi mtengo wokwera wokulongedza.

Zotsatira za pharmacological

Mankhwala ndi ophatikiza omwe magawo ake amagwira amakhala ndi othandizira (othandizira) a hypoglycemic, kuthandiza odwala omwe ali ndi mtundu II shuga mellitus kukhalabe ndi shuga.

Sitagliptin, yomwe ndi gawo la mankhwalawa, ndiwosankha kwambiri wa dipeptidyl peptidase-4. Ikamamwa, imachulukanso katatu zomwe zili ndi glucagon-peptide-1 komanso ma glucose-omwe amadalira insulinotropic peptide - mahomoni omwe amalimbikitsa kupanga insulin ndikuwonjezera katulutsidwe kake m'maselo a kapamba. Sitagliptin imakupatsani mwayi wokhala ndi shuga m'magazi masana tsiku lonse komanso kupewa matenda a glycemia musanadye kadzutsa

Kuchita kwa sitagliptin kumathandizika ndi metformin - chinthu cha hypoglycemic chokhudzana ndi biguanides, chomwe chimachepetsa kuchuluka kwa shuga m'magazi popetsa 1/3 ya njira yopanga shuga m'magazi. Kuphatikiza apo, mutatenga metformin mwa odwala omwe ali ndi mtundu wa shuga wachiwiri, pali kuchepa kwa mayamwidwe am'mimba kuchokera m'matumbo, kuwonjezeka kwa chidwi cha minofu kupita ku insulin komanso kuwonjezeka kwa mafuta a oxidation.

Pharmacokinetics

The plasma ambiri ndende ya sitagliptin amawonekera pambuyo 4-5 mawola pakamwa limodzi, metformin - pambuyo 2,5 maola. The bioavailability wa yogwira pophika ntchito Yanumet pamimba yopanda ndi 87% ndi 50-60%, motero.

Kugwiritsa ntchito sitagliptin mukatha kudya sikukuthira mayamwidwe ake m'mimba. Kugwiritsa ntchito pamodzi kwa metformin ndi chakudya kumachepetsa mayamwidwe ake ndikuchepetsa kuchuluka kwa plasma ndi 40%.

Kutupa kwa sitagliptin kumachitika makamaka ndi mkodzo. Gawo laling'ono la ilo (pafupifupi 13%) limachoka m'thupi limodzi ndi zomwe zimapezeka m'matumbo. Metformin imachotsedwa kwathunthu ndi impso.

Metformin imachotsedwa kwathunthu ndi impso.

Zizindikiro zogwiritsidwa ntchito

Mankhwala amakupatsani mtundu wachiwiri wa matenda ashuga. Amawonetsedwa ngati kuwonjezera kwa zakudya ndi zolimbitsa thupi kwa odwala omwe:

• kulephera kuwongolera kuchuluka kwa shuga wokhala ndi milingo yambiri ya metformin,
• Adayenera kale kumwa mankhwala osakanikirana ndi zosakaniza zomwe zimapanga Yanumet, ndipo mankhwalawo adabweretsa zotsatira zabwino,
• Mankhwala othandizira amafunikira limodzi ndi zotumphukira za sulfonylurea, agonists a PPARγ, kapena insulin, popeza kumwa mankhwala a metformin osakanikirana ndi mankhwalawa sikulola kukwaniritsa kuyang'anira kwa glycemia.

Momwe mungatenge Yanumet

Mankhwalawa amadyedwa kawiri patsiku ndi chakudya, kutsukidwa ndi madzi angapo. Kuchepetsa kuthekera kwa mayankho osagwirizana ndi chakudya cham'mimba, chithandizo chikuyambitsidwa ndi mlingo wochepetsetsa, ndikuwonjezera pang'onopang'ono mpaka zotsatira zochizira zitheka.

Zotsatira zoyipa za Yanumet

Mukamamwa mankhwalawa, wodwalayo amatha kukumana ndi zovuta zosakhumudwitsa za sitagliptin ndi metformin. Ngati zikuchitika, ndikofunikira kukana chithandizo china ndikupita kwa dokotala posachedwa.

Pankhani ya zovuta, ndikofunikira kukana chithandizo china ndikuyendera adokotala posachedwa.

Matumbo

Zotsatira zoyipa zamagetsi zomwe zimagwidwa nthawi zambiri zimawonedwa koyambira koyambira. Izi zimaphatikizira kupweteka pamtunda wam'mimba, nseru, kusanza, kuchuluka kwa mpweya m'matumbo, kutsekula m'mimba, kudzimbidwa. Kumwa mapiritsi ndi chakudya kumatha kuchepetsa zotsatira zake zoyipa m'mimba.

Odwala omwe amalandila chithandizo ndi Yanumet, kukula kwa kapamba (hemorrhagic kapena necrotizing), komwe kumatha kupangitsa kuti afe, sikuchotsedwa.

Kuchokera kumbali ya kagayidwe

Ngati mulingo wosankhidwa molakwika, wodwalayo amatha kudziwa vuto la hypoglycemia, lomwe limachepetsa kwambiri shuga.Nthawi zina, kumwa mankhwala kumatha kubweretsa lactic acidosis, yomwe imadziwonetsera mu mawonekedwe a kuchepa kwa kuthamanga ndi kutentha kwa thupi, kupweteka pamimba ndi minofu, kukoka movutikira, kufooka ndi kugona.

Kuchokera pamtima

Mankhwalawa amalekeredwa bwino ndi anthu omwe ali ndi matenda a mtima ndi mitsempha yamagazi. Nthawi zina, amatha kumachepetsa kugunda kwa mtima, komwe kumachitika chifukwa cha lactic acidosis.

Mankhwalawa amalekeredwa bwino ndi anthu omwe ali ndi matenda a mtima ndi mitsempha yamagazi.

Ndi kusalolera payekha pazinthu zomwe zimapangira mankhwalawa, munthu amatha kuyanjana ndi mawonekedwe a urticaria, kuyabwa ndi totupa pakhungu. Pa mankhwala ndi Yanumet, kuthekera kwa kukhalapo kwa edema pakhungu, mucous nembanemba ndi minofu yolumikizira, yomwe ndi chiopsezo cha moyo, sichili pambali.

Kuchita ndi mankhwala ena

Kuphatikizidwa kwa mankhwalawa ndi ma diuretics, glucagon, kulera kwapakamwa, phenothiazines, corticosteroids, isoniazid, calcium antagonists, nicotinic acid ndi mahomoni a chithokomiro kumabweretsa kufooka kwa zochita zake.

Mphamvu ya hypoglycemic ya mankhwalawa imalimbikitsidwa ngati imagwiritsidwa ntchito limodzi ndi mankhwala osapweteka a anti-yotupa, MAO ndi ACE zoletsa, insulin, sulfonylurea, oxytetracycline, clofibrate, acarbose, beta-adrenergic blocking agents ndi cyclophosphamide.

Kuyenderana ndi mowa

Ndi zoletsedwa kumwa mowa pa mankhwala ndi Yanumet.

Analogue ya kapangidwe ka mankhwala ndi Valmetia. Mankhwala amapangidwa piritsi ndipo ali ndi kapangidwe kake ndi Mlingo wofanana ndi Yanumet. Komanso, mankhwalawa ali ndi mwayi wamphamvu - Yanumet Long, wokhala ndi 100 mg ya sitagliptin.

Pokhapokha pakuchitika zochizira kuchokera ku Yanumet, adokotala amatha kupatsa mankhwala othandizira odwala, omwe metformin imaphatikizidwa ndi zinthu zina za hypoglycemic. Mankhwalawa akuphatikizapo:

• Avandamet
• Amaril M,
• Douglimax
• Galvus
• Wokanamet,
• Glucovans, etc.