Yanumet: analogues, malangizo, ntchito, zikuchokera

Tsambali limapereka mndandanda wazofanizira zonse za Yanumet pakupanga ndi chisonyezo chogwiritsa ntchito. Mndandanda wama analogi otsika mtengo, mutha kuyerekezeranso mitengo muma pharmacies.

• Analogue yotsika mtengo kwambiri ya Yanumet:Glucovans
• Analogue otchuka kwambiri a Yanumet:Vipdomet
• Gulu la ATX: Metformin ndi sitagliptin
• Zosakaniza / yogwira: metformin, sitagliptin
  

Mukamawerengera mtengo wake yotchipa yotchedwa yanumet mtengo wocheperako womwe umapezeka mumndandanda wamapulogalamu omwe amaperekedwa ndi ma pharmacies adaganiziridwa

Popeza mndandanda wamankhwala osokoneza bongo kutengera ziwerengero zamankhwala omwe apempha kwambiri

Analogs popanga ndi chisonyezo chogwiritsidwa ntchito

Mndandanda womwe uli pamwambapa wa analogies ya mankhwala, omwe akuwonetsa m'malo mwa Yanumet, ndizabwino kwambiri chifukwa zimakhala ndi zinthu zomwe zimagwirizana ndipo zimagwirana molingana ndi chisonyezo chogwiritsidwa ntchito

Analogs mwa chisonyezo ndi njira yogwiritsira ntchito

Kuphatikizika kosiyanasiyana, kungagwirizane mukuwonetsa ndikugwiritsa ntchito njira

Kodi mungapeze bwanji analogue yotsika mtengo ya mankhwala okwera mtengo?

Kuti mupeze analogue yotsika mtengo kwa mankhwala, a generic kapena ofanana, choyambirira timalimbikitsa kulabadira kapangidwe kake, zomwe ndi zinthu zomwezi zomwe zikugwiritsidwa ntchito ndikuwonetsa. Zomwe zimagwiritsidwanso mosiyanasiyana ndi mankhwalawa zimawonetsa kuti mankhwalawo ndi ofanana ndi mankhwalawo, monga mankhwala ena kapena mitundu ina ya mankhwala. Komabe, musaiwale za zovuta zomwe zimagwiritsidwa ntchito ndi mankhwala ofanana, omwe angakhudze chitetezo ndi kugwiranso ntchito. Musaiwale za upangiri wa madotolo, kudzipereka nokha kungawononge thanzi lanu, chifukwa chake onani dokotala wanu musanagwiritse ntchito mankhwala.

Malangizo a Janumet

MALANGIZO
pa kugwiritsa ntchito mankhwalawa
YANUMET

Kutulutsa Fomu
Mapiritsi

Kupanga
Piritsi 1 yokhala ndi kanema yokhala ndi: Sitagliptin phosphate monohydrate 50 mg, Metformin hydrochloride 500, 850 ndi 1000 mg.
Omwe amathandizira: microcrystalline cellulose 59.30 mg, povidone 48.23 mg, sodium stearyl fumarate 13.78 mg, sodium lauryl sulfate 3.445 mg.
Chipolopolo cha mapiritsi a Opadray II Pink, 85 F 94203 (17.23 mg) chili ndi: polyvinyl mowa 47.800%, titanium dioxide (E 171) 6,000%, macrogol - 3350 23,500%, talc 22.590%, iron ironide (E 172) 0,005% red oxide red (E 172) 0,105%.

Kulongedza
Pali mapiritsi 14 mchimake. Mu gulu la makatoni 4 matuza.

Zotsatira za pharmacological
Mankhwala Janumet ndi kuphatikiza kwa mankhwala awiri a hypoglycemic omwe ali ndi njira yothandizirana (yowonjezera), yopangidwa kuti iwongolere glycemic control mwa odwala omwe ali ndi matenda a 2 matenda ashuga: sitagliptin, inhibitor wa dipeptidyl peptidase-4 (DPP-4) enzyme, ndi metformin, woimira kalasi yayikulu.
Sitagliptin ndi choletsa pakamwa, chosankha kwambiri cha DPP-4 mochizira matenda a shuga a 2. Zotsatira zam'magazi zamkaka wa mankhwala osokoneza bongo a DPP-4 amawongolera ndi kuyambitsa kwa ma insretins.Mwa kuletsa DPP-4, sitagliptin imachulukitsa kuchuluka kwa mahomoni awiri odziwika a banja la apretin: glucagon-peptide 1 (GLP-1) ndi insulinotropic polypeptide (HIP) ya glucose. Ma incretins ndi gawo limodzi lamomwe timakhazikika pakakhazikitsidwa ka glucose homeostasis. Pazoyimira zamagulu a glucose abwinobwino, kukhathamiritsa kwa gluP-1 ndi GUIs kumawonjezera kaphatikizidwe ndi katulutsidwe ka insulin ndi maselo a pancreatic beta. GLP-1 imathandizanso kubisalira kwa glucagon ndi maselo a pancreatic alpha, motero kuchepetsa kuphatikizika kwa shuga m'chiwindi. Njira iyi yochitira zinthu imasiyana ndi makina amachitidwe a sulfonylurea, omwe amachititsa kuti amasulidwe a insulin azikhala otsika kwambiri m'magazi a shuga, omwe amadziwika ndi kukula kwa sulfonyl-ikiwa chifukwa cha hypoglycemia osati odwala omwe ali ndi mtundu wa matenda a shuga 2, komanso mwa anthu athanzi. Pokhala choletsa chosankha kwambiri komanso chothandiza cha DPP-4 enzyme, sitagliptin muzoyimira zochizira sizimalepheretsa zochitika za enzymes zokhudzana ndi DPP-8 kapena DPP-9. Sitagliptin amasiyana mu kapangidwe ka mankhwala ndi zochita za pharmacological kuchokera ku analogues ya GLP-1, insulin, zotumphukira zochokera ku sulfonylurea kapena meglitinides, biguanides, gamma receptor agonists opangidwa ndi peroxis proliferator (PPARy), alpha-glycosidase inhibitors ndi ma amylin analogues.
Metformin ndi mankhwala osokoneza bongo a hypoglycemic omwe amathandizira kulolera kwa glucose kwa odwala omwe ali ndi matenda a shuga a 2, kutsitsa pansi ndi kuzungulira kwa shuga m'magazi. Ma pharmacological momwe amagwirira ntchito amasiyana ndi njira yochitira pakamwa hypoglycemic mankhwala a makalasi ena. Metformin imachepetsa kaphatikizidwe ka shuga m'chiwindi, imachepetsa mayamwidwe am'matumbo, ndikuwonjezera chidwi cha insulini poyamwa komanso kugwiritsa ntchito shuga

Janumet, zikuonetsa kuti mugwiritse ntchito
Yanumet akuwonetsedwa ngati chowonjezera pakudya ndi machitidwe olimbitsa thupi kuti alimbikitse kuwongolera kwa glycemic kwa odwala omwe ali ndi mtundu II shuga mellitus omwe sanapeze kuyang'anira koyambira kumbuyo kwa monotherapy ndi metformin kapena sitagliptin, kapena atalephera kuphatikiza mankhwala awiri. Yanumet akuwonetsedwa limodzi ndi mankhwala a sulfonylurea (kuphatikiza kwa mankhwala atatu) monga kuwonjezera pa zakudya ndi zolimbitsa thupi zolimbitsa glycemic control kwa odwala omwe ali ndi matenda amtundu wa II omwe sanachite bwino pakumalizidwa atalandira mankhwala awiri mwa atatu awa: metformin, sitagliptin kapena zotumphukira. sulfonylureas. Janumet akuwonetsedwa limodzi ndi PPAR-? Agonists (mwachitsanzo, thiazolidinediones) monga njira yowonjezera pakudya ndikuwongolera njira zolimbikitsira glycemic control kwa odwala omwe ali ndi matenda amtundu wa II omwe samakwanitsa kuwongolera mokwanira atatha kulandira mankhwala awiri mwa atatu awa: metformin, sitagliptin, kapena PPAR-β agonist. Yanumet akuwonetsedwa kwa odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo a mellitus (kuphatikiza kwa mankhwala atatu) monga chowonjezera pa chakudya ndi zolimbitsa thupi kuti azitha kuyendetsa bwino glycemic control limodzi ndi insulin.

Contraindication
- Hypersensitivity to sitagliptin phosphate, metformin hydrochloride kapena china chilichonse chamankhwala.
- zovuta pachimake zomwe zimatha kuthana ndi ntchito ya impso: kuchepa magazi, matenda akulu, mantha,
- matenda owopsa kapena osachiritsika omwe angayambitse minofu hypoxia, monga mtima kapena kupuma, kulowerera kwaposachedwa, kupsinjika,
- kuwonongeka kwakanthawi kapena kupweteka kwa aimpso (kulengedwa kwa creatinine
- chiwindi ntchito,
- uchidakwa wambiri, uchidakwa,
- nthawi yoyamwitsa,
- matenda a shuga
- pachimake kapena matenda metabolic acidosis, kuphatikizapo matenda ashuga a ketoacidosis (wokhala ndi chikomokere kapena opanda chikomokere),
- maphunziro a radiological (intravascular management of iodine-munali kusiyanasiyana othandizira).

Mlingo ndi makonzedwe
Mlingo wa mankhwalawa Yanumet wa mankhwalawa uyenera kusankhidwa payekhapayekha, pozindikira momwe chithandizo chikuyendera, kugwiritsa ntchito bwino komanso kulekerera, koma osapitilira muyeso womwe umalimbikitsidwa tsiku lililonse la sitagliptin 100 mg. Mankhwala Yanumet nthawi zambiri amaperekedwa kawiri pa tsiku ndi zakudya, ndi kuwonjezeka kwapang'onopang'ono kwa mankhwalawa, kuti muchepetse mavuto omwe amachokera ku m'mimba thirakiti (GIT), chikhalidwe cha metformin. Mlingo woyambirira wa mankhwalawa Janumet zimatengera chithandizo chamakono cha hypoglycemic.

Mimba komanso kuyamwa
Panalibe maphunziro olamulidwa mokwanira a mankhwalawa Yanumet kapena zigawo zake mwa amayi apakati, chifukwa chake, palibe deta yokhudza chitetezo chazomwe amagwiritsa ntchito amayi apakati. Mankhwala Janumet, monga mankhwala ena amkamwa a hypoglycemic, ali osavomerezeka kuti agwiritsidwe ntchito panthawi yomwe muli ndi pakati. Sipanakhalepo kafukufuku woyesa wa mankhwala ophatikizira Yanumet kuti awone momwe amathandizira pakubereka. Zomwe zimapezeka pokhapokha kuchokera ku maphunziro a sitagliptin ndi metformin zimaperekedwa.

Zotsatira zoyipa
Kuchokera pamimba yokhudza kugaya chakudya: kumayambiriro kwa maphunzirowa - anorexia, kutsegula m'mimba, kusanza, kusanza, kupweteka kwam'mimba (kutsika ndi chakudya), kulawa kwazitsulo mkamwa (3%).
Kuchokera pamtima ndi magazi a mtima (hematopoiesis, hemostasis): m'malo ochepa - megaloblastic anemia (chifukwa cha malabsorption a vitamini B12 ndi folic acid).
Kuchokera kumbali ya kagayidwe: hypoglycemia, nthawi zina - lactic acidosis (kufooka, kugona, kuperewera, kupweteka kwa bradyarrhythmia, kupuma, kupweteka kwam'mimba, myalgia, hypothermia.
Kuchokera pakhungu: zotupa, dermatitis.

Malangizo apadera
Gwiritsani ntchito mu Yanumet wachikulire: popeza njira yayikulu yotsatsira sitagliptin ndi metformin ndi impso, ndipo popeza ntchito yotsitsika ya impso imachepa ndi msinkhu, njira zothetsera mankhwala a Yanumet zikuwonjezeka molingana ndi zaka. Odwala okalamba amayesedwa mosamala ndi kuwonetsetsa kuti aimpso ntchito.

Kuyanjana kwa mankhwala osokoneza bongo
Sitagliptin ndi metformin
The munthawi yomweyo kutumikiridwa angapo Mlingo wa sitagliptin (50 mg 2 kawiri pa kugogoda) ndi metformin (1000 mg 2 kawiri pa tsiku) sizinayende limodzi ndi kusintha kwakukulu kwa magawo a pharmacokinetic a sitagliptin kapena metformin odwala omwe ali ndi matenda a shuga a 2.
Kafukufuku wokhudzana ndi momwe mankhwalawo amakhudzana ndi mankhwala a pharmacokinetic a Janumet sanachitike, komabe, kafukufuku wokwanira wotereyu wapangidwa pachinthu chilichonse cha mankhwalawa, sitagliptin ndi metformin.
Sitagliptin
Pophunzira pakukhudzana ndi mankhwala ena, sitagliptin sanakhale ndi vuto lililonse pama pharmacokinetics a mankhwala otsatirawa: metformin, rosiglitazone, glibenclamide, simvastatin, warfarin, kulera kwapakamwa. Kutengera ndi izi, sitagliptin sikuletsa CYP isoenzymes ya cytochrome CYP3A4,2C8 kapena 2C9 system. Zambiri za vitro zikuwonetsa kuti sitagliptin imalepheretsanso CYP2D6,1A2,2C19 ndi 2B6 isoenzymes ndipo simalimbikitsa CYP3A4. Malinga ndi kuchuluka kwa anthu omwe ali ndi pharmacokinetic kusanthula kwa odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, chithandizo chothandizirana sichinawakhudze kwambiri pharmacokinetics ya sitagliptin. Kafukufukuyu adafufuza zingapo za mankhwala omwe amagwiritsidwa ntchito kwambiri ndi odwala omwe ali ndi matenda a shuga 2 "Pang'onopang'ono" calcium njira, hydrochlorothiazide, analgesics ndi mankhwala omwe si a antiidal anti-yotupa (naproxen, diclofenac, celecoxib), antidepressants (bupropion, fluoxetine, sertraline), antihistamines (ceti Rizin), proton pump inhibitors (omeprazole, lansoprazole) ndi mankhwala ochizira erectile dysfunction (sildenafil).
Kuwonjezeka kwa AUC (11%), komanso average C max (18%) digoxin adadziwika akaphatikizidwa ndi sitagliptin.Kukula kumeneku sikumvekedwa kukhala kofunika kwambiri, komabe, kuyang'anira wodwalayo kumalimbikitsidwa ndikumamwa digoxin. Kuwonjezeka kwa AUC ndi C max kwa sitagliptin kunadziwika ndi 29% ndi 68%, motero, ndi pakamwa kamodzi pakumwa mankhwala a YANUVIA pa mlingo wa 100 mg ndi cyclosporin (potent inhibitor ya p-glycoprotein) pa mlingo wa 600 mg. Zosintha izi m'magawo a pharmacokinetic a sitagliptin sizofunika kwambiri pakliniki.
Metformin
Gliburide - powerengera pakukhudzana kwa mankhwala osokoneza bongo amodzi a metformin ndi gliburide mwa odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo, palibe kusintha pamagawo a pharmacokinetic ndi pharmacodynamic a metformin. Zosintha pamitengo ya AUC ndi Stax glyburide zinali zosiyana kwambiri. Zosakwanira (kumwa limodzi) komanso kusokonekera kwa plasma ndende ya glyburide ndi zotsatira zamankhwala osokoneza bongo amakayikira kufunikira kwakukhudzana ndi matendawa.
Furosemide - pophunzira momwe mankhwala omwe amagwiritsidwira ntchito kamodzi pa mankhwala a metformin ndi furosemide odzipereka athanzi, kusintha kwa magawo a pharmacokinetic a mankhwala onsewa kunawonedwa. Furosemide inachulukitsa kuchuluka kwa C max metformin mu plasma ndi magazi athunthu ndi 22%, mtengo wa AUC wa metformin m'mwazi wathunthu ndi 15%, osasintha chiwonetsero chaimpso. Makhalidwe a C max ndi AUC a furosemide, nawonso adatsika ndi 31% ndi 12%, motero, ndipo theka la moyo limatsika ndi 32%, popanda kusintha kwakukulu pakubwezeretsa kwa impso kwa furosemide. Palibe chidziwitso pakukhudzana kwa mankhwalawa kwa mankhwalawa pogwiritsa ntchito nthawi yayitali.
Nifedipine - mu kafukufuku wa kuyanjana kwapakati pa mankhwala a nifedipine ndi metformin pambuyo pa kumwa kamodzi kwa mankhwalawa odzipereka athanzi, kuwonjezereka kwa pl Cmax ndi AUC ya metformin ndi 20% ndi 9%, motero, komanso kuwonjezeka kwa kuchuluka kwa metformin komwe kunaperekedwa ndi impso, kuwululidwa. Ma max ndi theka-moyo wa metformin sanasinthe. Zimakhazikika pakuwonjezeka kwa mayamwidwe a metformin pamaso pa nifedipine. Mphamvu ya metformin pa pharmacokinetics ya nifedipine ndi yochepa.
Mankhwala a Cationic - mankhwala a cationic (i.e., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim kapena vancomycin); zoyendera. Mpikisano wofananawu udawonedwa ndi kuphatikiza kwa munthawi yomweyo kwa metformin ndi cimetidine ndi odzipereka aumoyo m'maphunziro amodzi komanso angapo, ndi kuwonjezeka kwa 60% kwa kuchuluka kwa C max metformin mu plasma ndi magazi athunthu ndi kuwonjezeka kwa 40% mu AUC ya metformin mu plasma ndi magazi athunthu. Pakufufuza kamodzi kwa theka, moyo wa metformin sunasinthe. Metformin sizinakhudze pharmacokinetics ya cimetidine. Ndipo ngakhale izi zikuchitika pakati pa mankhwala makamaka ndizofunikira kwambiri zamaganizidwe (kupatula cimetidine), kuyang'anira wodwalayo ndikusintha kwa mankhwalawa Janumet ndi / kapena mankhwala a cationic omwe ali pamwambapa, omwe ali ndi vutoli akulimbikitsidwa.
Mankhwala ena ali ndi vuto la hyperglycemic ndipo amatha kusokoneza kayendedwe ka glycemic. Izi zimaphatikizapo thiazide ndi ma diuretics ena, glucocorticosteroids, phenothiazines, kukonzekera kwa chithokomiro, estrogens, kulera kwapakamwa, phenytoin, nicotinic acid, sympathomimetics, pang'onopang'ono calcium blockers blockers ndi isoniazid. Popereka mankhwala awa, wodwala amene amalandira mankhwalawa Janumet, tikulimbikitsidwa kuti kuwunika mosamala magawo a glycemic control.Pamene odzipereka athanzi anali kumwa metformin ndi propranolol kapena metformin ndi ibuprofen, palibe magawo a pharmacokinetic a mankhwalawa omwe adawonedwa.
Gawo laling'ono laling'ono la metformin lomwe limamangiriza mapuloteni a plasma, chifukwa chake, kuphatikiza kwapakati pa mankhwala a metformin ndi mankhwala omwe amamangika mwachangu kumapuloteni a plasma (salicylates, sulfonamides, chloramphenicol ndi probenecid) omwe ali osatheka, osiyana ndi sulfonylureas, omwe amaphatikizanso ndi mapuloteni a plasma.

Bongo
Sitagliptin: Mwa odzipereka athanzi labwino, Mlingo umodzi wofika 800 mg nthawi zambiri unkakhala wololera. Mukamagwiritsidwa ntchito pophunzira kuchipatala, mlingo wa 800 mg unawonetsa kutalika pang'ono kwapakati pa Q - Tc, komwe sikunali koyenera kwenikweni. Palibe zinachitikira ndi ntchito mankhwala Mlingo wopitilira 800 mg. Mu maphunziro, palibe zoyipa zomwe zimakhudzana ndi mlingo wa mankhwalawa pogwiritsa ntchito 600 mg / tsiku kwa masiku 10 ndi 400 mg kwa masiku 28. Sitagliptin alibe wolumala: malinga ndi kafukufuku wa zamankhwala, ndi 13.5% yokha ya mankhwalawa omwe amachotsedwa pamsonkhano wa maola atatu wa hemodialysis. Pankhani ya kusowa kwa matenda, hemodialysis wautali ndi mankhwala. Palibe umboni wotsimikiza za kugwira ntchito kwa peritoneal dialysis kwa sitagliptin. Metformin: pakhala pali milandu yambiri ya metformin, kuphatikizapo makonzedwe opitilira 50. Hypoglycemia yapezeka pafupifupi 10% ya milandu yonse ya bongo, komabe, ubale wapakati ndi mankhwala osokoneza bongo a metformin sunakhazikitsidwe. Kukula kwa lactic acidosis akuti pafupifupi 32% ya milandu yonse ya metformin. Emergency hemodialysis ndikofunikira (metformin imayimitsidwa pamtunda wofikira mpaka 170 ml / mphindi mwaumoyo wa hemodynamics) kuti imathandizira kuchotsedwa kwa metformin yowonjezereka ngati anthu akukayikira mopitirira muyeso. Mankhwala akuchulukirachulukira, a Janumet ayenera kuyamba kugwiritsa ntchito njira zothandizira: kuchotsa m'matumbo am'mimba mankhwala omwe sanamwe, kuwunikira zikwangwani zofunika, kuphatikiza ECG, hemodialysis, komanso kupereka mankhwala okonza, ngati pakufunika kutero.

Malo osungira
Sungani ku kutentha kosaposa 25 ° C.

Kupanga ndi mawonekedwe a kumasulidwa

Chachilendo cha mankhwalawa ndichakuti imakhala ndi zinthu ziwiri zomwe zimagwira ntchito nthawi imodzi. Chithandizo chachikulu chomwe chimapezeka mu mankhwalawa ndi metformin hydrochloride. Mankhwala "Yanumet" amapezeka mu mawonekedwe a mapiritsi. Ndiye kuti, ayenera kumwedwa. Metformin yomwe ili ndi piritsi limodzi lotere imatha kuphatikizira 500, 850 kapena 1000 mg.

Chothandizira chachiwiri cha Yanumet ndi sitagliptin. Chosakaniza ichi, mosasamala kanthu za mankhwala a metformin hydrochloride, nthawi zonse amaphatikizidwa ndi kuchuluka kwa 50 mg piritsi limodzi. Zinthu zonse zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimatha kuwongolera bwino kuchuluka kwa shuga m'magazi.

Zachidziwikire, monga momwe ziliri ndi mapiritsi ena onse, kapangidwe ka "Yanumet" akuphatikiza zosakaniza zothandiza. Koma palibe ngakhale imodzi yomwe imakhudzidwa ndi matendawo.

Popanga mapiritsi a mankhwalawa amakutidwa, chifukwa, kupangika bwino kwa mankhwala. Chifukwa cha kutulutsidwa kumeneku, mapiritsi a Yanumet sakhala ndi vuto lililonse m'matumbo a odwala.

Kodi metformin hydrochloride ndi chiyani?

Phindu la mankhwalawa kwa odwala omwe ali ndi matenda a shuga 2 ndichakuti, choyamba, likalowa thupi, limachepetsa:

kapangidwe ka shuga m'chiwindi,

mayamwidwe a shuga m'matumbo.

Gululi la Yanumet ndi fanizo la mankhwalawa lomwe lili ndi mawonekedwe ofanana limatha kukulitsa chidwi cha maselo kuti apange insulin kudzera mukugwidwa ndikugwiritsa ntchito shuga.Zambiri zotsika mtengo za mankhwalawa, zomwe zimagulu la mankhwala osokoneza bongo, zimapangidwa chifukwa cha metformin ngati chinthu chogwira ntchito.

Kodi sitagliptin imagwira ntchito bwanji?

Gululi yachiwiri yogwira ya Yanumet m'thupi la wodwala yemwe ali ndi matenda a shuga a 2 amalepheretsa enzyme DPP-4, yomwe imapangitsa kuti chiwopsezo cha mahomoni okangalika a GLP-1 ndi HIP, omwe ali ndi mwayi wodziyimira pawokha. Ntchito ya DPP-4 potenga odwala "Yanumeta" imapanikizika pafupifupi maola 24. Poyerekeza ndi metformin, sitagliptin imawonedwa ngati chinthu chowopsa pathupi la wodwalayo pazotsatira zoyipa. Monopreparations yomwe cholinga chake ndi kuwongolera kuchuluka kwa shuga m'magazi odwala matenda a shuga nthawi zambiri imapangidwa pamaziko ake.

Zowonjezera

Kuphatikiza pa metformin hydrochloride ndi sitagliptin, kapangidwe ka Yanumet palinso mbali zothandiza monga:

Chipolopolo cha mapiritsiwa chimakhala ndi, mwazinthu zina, mowa wa polyvinyl, titanium dioxide, talc, wakuda ndi wofiira iron oxide, macrogol. Ngati wodwala yemwe ali ndi matenda ashuga akakhala ndi vuto lililonse mwa zinthu izi, mungafunike kukana kutenga Yanumet.

Zofananira kwambiri

Mtengo wa mapiritsi a Yanumet umatengera makamaka kuchuluka kwa metformin hydrochloride yomwe ikuphatikizidwa. Mankhwalawa, omwe amaperekedwa kuchokera ku Netherlands (omwe ali ndi ma CD ku Russia),, mwatsoka, ndi okwera mtengo kwambiri. Mwachitsanzo, phukusi la mapiritsi "Yanumet" mu kuchuluka kwa ma pc a 56. pa mlingo wa 500 mg utenga wodwala, kutengera dera, 2500-3000 p. Chifukwa chake, anthu ambiri omwe ali ndi matenda ashuga a 2, mwachidziwikire, ali ndi chidwi chophatikizira ngati mankhwalawa ali ndi mitundu yotsika mtengo.

Tsoka ilo, kukonzekera ndi mawonekedwe ofanana ndi a Yanumet sikunapangidwe ku Russia. Zolocha zina zakunja sizotsika mtengo pamtunduwu. Mlingaliro wofanana wa analogue wa mankhwala "Yanumet", wogulitsidwa pamtengo wotsika, ku Russia panthawiyo ndi "Galvus Met".

Chofunika kwambiri mmalo mwazomwe zili ndi mawonekedwe omwewo ndikuti ndi Velmetia. Omwe akufuna chiwonetsero cha Yanumet 1000 + 50 mg, mwachitsanzo, ayenera kulabadira makamaka mankhwalawa.

Komanso, nthawi zina, mankhwalawa amatha kusintha ndi:

Kwa ma fanizo a Yanumet awa, malangizo ogwiritsira ntchito amaperekedwa pafupifupi chimodzimodzi ndi mankhwalawo pawokha. Komabe, kapangidwe ka mankhwalawa ndizosiyana pang'ono. Chifukwa chake, kuwongolera shuga ndi kugwiritsa ntchito kwawo kukhoza kuchitika molingana ndi njira zina. Mulimonse momwe zingakhalire, ndikofunikira kusintha Yanumet kukhala mankhwalawa, monga, kwa mitundu ina iliyonse, pazovomerezeka za dokotala.

Komanso, nthawi zina, Yanumet ikhoza m'malo mwa kuphatikiza mankhwala awiri otsika mtengo - Januvia (Netherlands) ndi Glucophage, omwe ndi metformin yoyambirira.

Mankhwala "Galvus Met"

Mankhwala ali m'gulu la "Yanumet" analogies gulu. 1000 mpaka 50 mg ndi imodzi mwazotheka. Chimodzi mwazinthu zazikulu zomwe zimapangidwamo ndi metformin. Koma m'malo mwa sitagliptin, vildagliptin imaphatikizidwa ndikuchokera mu kuchuluka kwa 50 mg. Mwezi umodzi wowerengeka ndi mankhwalawa umawononga wodwala wokhala ndi matenda osokoneza bongo pafupifupi 1600 p. Mankhwalawa amapezekanso m'mapiritsi ndipo adapangidwira pakamwa.

Metformin imaphatikizidwanso pakuphatikizidwa kwa fanizo la Yanumet, Combogliz Prolonga ndi Gentadueto. Pankhaniyi, mankhwala oyamba amaphatikiza ndi saxagliptin, ndipo wachiwiri - linagliptin.

Analog "Velmetia"

Mankhwalawa amapangidwa ndi wopanga odziwika bwino ku Russia, Berlin-Chemie. Amapangidwa makamaka kuma bizinesi aku Italy ndi Spain. Zofunikira zazikulu za mankhwalawa, monga Yanumet palokha, ndi metformin ndi sitagliptin.Kuphatikiza apo, mankhwalawa amaperekedwa pamsika mumagawo awiri: 850 + 50 mg ndi 1000 + 50. Ku Russia, aneluetia ya Velmetia ya Yanumet, mwatsoka, ingagulidwe pokhapokha. Kuphatikiza apo, mankhwalawa amakhalanso okwera mtengo kwambiri.

Zotsatsira zotsika mtengo

Ku Russia, ma analogu a Yanumet 1000 + 50 mg, 850 + 50 mg, ndi ena, kotero, alipo angapo. Koma mankhwalawa onse, omwe amafanana ndi mankhwalawa (popeza ali ndi mawonekedwe ofanana kapena ofanana), mwatsoka, ndi okwera mtengo. Komabe, ma analogi otsika mtengo a mankhwalawa, omwe amapangidwa pamaziko a zina kapena mwanjira ina, mwachitsanzo, kupanga zoweta mnyumba zamankhwala, ndizopezekanso. Nthawi zambiri, kuweruza ndi kuwunika kwa odwala, amachepetsa shuga m'magazi moyipirapo ndi okwera mtengo, omwe amapangidwa ndikuwunika kwa zaposachedwa zasayansi, Yanumet. Komabe, mankhwala ngati awa a shuga, angakhale othandiza kwambiri.

Mwachitsanzo, mankhwala otsatirawa atha kudziwikiridwa ndi gulu la mitengo yotchipa ya mankhwala a Yanumet:

Mankhwalawa nthawi zambiri amaperekedwa kwa anthu odwala matenda ashuga ndi madokotala. Odwala ambiri amawona kuti kufanana kwa Yanumet ndi kothandiza.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa "Yanumet" amawotcha madokotala odwala matenda a shuga nthawi zambiri. Zachidziwikire, mankhwalawa, monga amafanana ndi ena onse, pamankhwala amangowonjezera pazakudya zomwe zimapangidwira wodwala komanso boma la zinthu zolimbitsa thupi. Ndiwothandiza kwambiri makamaka ngati matendawa ali mwa munthu limodzi ndi kunenepa kwambiri.

Nthawi zambiri, madokotala amalembera odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo a "Yanumet" kuphatikiza ndimankhwala ena. Mwachitsanzo, nthawi zambiri zimaphatikizidwa ndi zotumphukira za sulfonylurea, agonists a PPAR, komanso insulin.

Contraindication

Mankhwala amakono awa, monga amtundu wina aliyense, inde, si odwala onse omwe angathe. Kodi ndi liti pamene mungagwiritse ntchito mankhwalawa "Yanumet" kuthana ndi shuga m'magazi malinga ndi malangizo ndi fanizo la 1000 + 50 mg, 500 + 50 mg, 850 + 50 mg pa mankhwalawa? Mankhwala oterewa samaperekedwa, mwachidziwikire, kwa odwala omwe ali ndi hypersensitivity pazinthu zawo ziwiri zazikulu kapena zothandizira. Amakhulupiriranso kuti simungathe kumwa mankhwalawa kwa odwala omwe ali ndi vuto lalikulu lomwe lingayambitse vuto la impso:

ndi matenda oopsa.

Madokotala amalembera odwala "Yanumet" odwala omwe ali ndi matenda osokoneza bongo komanso zina mwanjira zomwe zimayambitsa matenda osakhazikika kapena owopsa omwe amatsogolera minofu hypoxia:

kupuma kapena kulephera kwa mtima,

myocardial infaration waposachedwa.

Palibe chifukwa chomwe muyenera kumwa mankhwalawa kuledzera, mwachitsanzo, ndi mowa. Zachidziwikire, izi zimagwira ntchito iliyonse yofanana ndi mankhwala a Yanumet. Pamodzi ndi mowa, monga mukudziwa, ndizoletsedwa kumwa pafupifupi mankhwala aliwonse, kupatula okhawo omwe mumamwa mowa.

Komanso, "Yanumet" sichosankhidwa kuti:

matenda aimpso.

Simungamwe mankhwalawa kwa odwala nthawi ya maphunziro a radiology ngati atabayidwa ndi mankhwala okhala ndi ayodini. Sizoletsedwa kumwa mankhwalawa maola 48 isanachitike njira ndi maola 48 atatha.

Ndi matenda a shuga a mtundu woyamba, mankhwalawa alibe phindu lililonse mthupi la wodwalayo. Chifukwa chake, pankhaniyi, zachidziwikire, sizidapangidwanso kwa odwala. Monga ambiri ofanana nawo ndi olowa m'malo, "Yanumet" sinafotokozeredwe odwala osakwana zaka 18. Zaka za ana ndi chimodzi mwazomwe zimayambitsa mankhwalawa.

Kodi ndingagwiritse ntchito pa nthawi yoyembekezera komanso mkaka wa m'mawere

Tsoka ilo, popeza kukonzekera kwa Yanumet kudakali kwachilendo kwambiri, sikunawerengeredwe pang'onopang'ono pazovuta zomwe zingachitike pakubala.Palibe deta yomwe ikupezeka pakadali pano kaamba ka amayi apakati ndi ana awo osabadwa. Chifukwa chake, monga wina aliyense wothandizira magazi, "Yanumet" imalembedwa kuti igwiritsidwe ntchito pa nthawi ya bere. Mankhwalawa sanatchulidwenso kuti azimayi anyama.

Pazinthu zomwe muyenera kuzisamala mosamala

Zonsezi zigawo zikuluzikulu za Yanumet ndi fanizo la mankhwala omwewo zimapangidwira kudzera mu impso. Monga momwe mumadziwira, ndi zaka, zochita za thupilo mwa anthu zimachepa. Chifukwa chake, mankhwalawa "Yanumet" kwa anthu okalamba ayenera kuikidwa mosamala. Dokotala ayenera kusankha mlingo wa wodwala mosamala kwambiri. Komanso, chithandizo cha odwala okalamba omwe ali ndi matenda a shuga a 2 ayenera kuchitika pang'onopang'ono moyang'aniridwa ndi katswiri. Ntchito yeniyeni mwa odwalawa imayenera kuyang'aniridwa pafupipafupi.

Odwala okalamba amayenera kulemba "Yanumet" pokhapokha atayang'ana impso ndikuwatsimikizira kuti thupi limagwira bwino ntchito yake. Kupanda kutero, wodwala wotereyu amatha kukumana ndi zovuta zoyipa atatenga Yanumet. Inde, mosamala, mankhwalawa amayeneranso kuperekedwa kwa odwala achichepere omwe ali ndi vuto lililonse la impso.

Zotsatira zoyipa zomwe zingayambitse

Mankhwala amatengedwa ndi anthu odwala matenda ashuga, kuweruza ndi kuwunika kwa odwala ndi madokotala, nthawi zambiri zimakhala zabwino kwambiri. Zotsatira zoyipa zakumwa. Amawonekanso pafupipafupi komanso ndimankhwala ovuta okhala ndi metformin okhala ndi placebo. Komabe, monga mankhwala ena aliwonse, Yanumet ndi fanizo la mankhwalawa omwe ali ndi mawonekedwe ofananawo nthawi zina amatha kukhala osokoneza thupi la wodwala.

Kumayambiriro kwenikweni kwamankhwala ngati awa, odwala nthawi zina amakumana ndi zovuta kuchokera m'mimba. Izi zikhoza kukhala, mwachitsanzo, nseru, kusanza, kutsekula m'mimba. Komanso, odwala ambiri amawona mawonekedwe a zitsulo pakamwa akamatenga Yanumet. Nthawi zina mankhwalawa amayambitsanso kupweteka kwam'mimba. Zotsirizirazi nthawi zambiri zimachepa panthawi ya chakudya.

Kumbali ya mtima dongosolo, mankhwalawa mankhwalawa, odwala angadwale magazi. Izi zimachitika makamaka chifukwa chakuti kunyamula kwa folic acid ndi vitamini B12 kumayipa mthupi la wodwalayo akutenga Yanumet.

Komanso mankhwalawa mankhwalawa odwala, mavuto monga:

kugona ndi kufooka

Nthawi zina, mankhwalawa amathanso kuyambitsa thupi la wodwalayo.

Momwe angatenge

Momwe mungamwe mankhwalawa malinga ndi malangizo? Mavuto a Yanumet omwe ali ndi mankhwala omwewo kapena ofananawo monga mankhwalawa pawokha, odwala ambiri amatenga kamodzi kapena kawiri patsiku ndi chakudya. Popewa mavuto, muyeso wa mankhwalawa umayenera kuti uwonjezeke pang'onopang'ono pang'onopang'ono. Madokotala amalimbikitsa kumeza mapiritsi a Yanumet onse akumeza. Kuti mukwaniritse kwambiri, saloledwa kuphwanya, kuphwanya kapena kutafuna.

Nthawi zina, mapiritsi a mankhwalawa sangadzidimbike kwathunthu m'matumbo. Ngati zotsalira zawo zimapezeka pafupipafupi, ndikofunikira kumuuza dokotala za izi. Pambuyo pa izi, adotolo amayenera kuwunika momwe glycemic control ikugwiritsira ntchito chida ichi.

Mlingo womwe umaperekedwa

Inde, muyenera kumwa mosamalitsa malinga ndi malangizo "Yanumet" ndi analogi a 1000 + 50 mg, 500 + 50 mg, 850 + 50 mg a mankhwalawa, komanso ena onse. Kuchuluka kwa mankhwalawa a Yanumet omwe wodwalayo ayenera kumwa ayenera, kutsimikiziridwa ndi adokotala okha. Nthawi zambiri, muyeso woyamba wa mankhwalawa ndi 500 mg ya metformin + 50 mg ya sitagliptin kawiri pa tsiku.

Nthawi zambiri, "Janumet" amawonetsedwa kwa odwala omwe samathandizidwa ndi monopreparations omwe ali ndi chimodzi mwazinthu izi. Pankhaniyi, mlingo woyambirira uyenera kufotokozedwa molingana ndi malamulo ena. Pakadalibe mphamvu ya metformin, mwachitsanzo, poyamba wodwalayo amamuika "Janumet" mwambiri kotero kuti samatenga zosaposa 100 mg za sitagliptin patsiku.

Zikachitika kuti asanalandire chithandizo ndi Yanumet wodwalayo adalandira chithandizo cha sitagliptin, amalimbikitsidwa pamlingo wofanana ndi 500 mg metformirn + 50 mg sitagliptin 2 pa tsiku. Zachidziwikire, mankhwalawa, monga ena aliwonse, pali mitundu yoyenera yovomerezeka. Amakhulupirira kuti odwala omwe ali ndi matenda a shuga a 2 sayenera kumwa mankhwalawa mopitilira 2000 mg ya metformin ndi 100 mg ya sitagliptin.

Bongo

Ndikofunikira, kumwa mankhwalawo chimodzimodzi monga momwe adokotala amafotokozera. Mankhwala ochulukirapo a Yanumet sangathe kuloledwa. Sitagliptin, ngakhale yochuluka kwambiri, sikuti imavulaza thupi. Mwachitsanzo, zidapezeka kuti mlingo wa 800 mg wa chinthu ichi umalekeredwa bwino ndi anthu. Tsoka ilo, sizikudziwika kuti kuchuluka kwa sitagliptin kumakhudza bwanji thupi la munthu, popeza kafukufuku wotere sanachitike.

Amakhulupirira kuti mankhwala osokoneza bongo a metformin, mwatsoka, adakali otheka. Pankhaniyi, wodwala amatha kukhala ndi hypoglycemia. Komanso, mankhwala osokoneza bongo a metformin amatsogolera pakupanga lactic acidosis. Tsoka ilo, izi zimachitika nthawi zambiri - mu 32% ya milandu.

Lactic acidosis imatchedwa complication yowopsa, momwe mulingo wa asidi-wosokoneza umasokonekera m'thupi la munthu. Mitundu yayikulu, matenda amtunduwu amadzakhala, mwa zina, zomwe zimapangitsa kulephera kwa mtima. Pambuyo pake, lactic acidosis imatha kubweretsa kugwa ndi anurea, kenako kukomoka kwa hyperlactacidemic.

Thandizo lactic acidosis

Pakachitika zovuta izi, njira zopulumutsira wodwala zimayenera kutengedwa mwachangu kwambiri. Thandizani wodwala ndi lactic acidosis mwa kuyambitsa 4% kapena 2,5% sodium bicarbonate solution. Mulingo waukulu wa mankhwalawa amadziwika kuti ndi 2000 ml patsiku. Kuphatikiza apo, ndi lactic acidosis, chithandizo chochepa cha insulin chitha kugwiritsidwa ntchito pochiza odwala, pogwiritsa ntchito kukonzekera kwa craboxylase, yankho la reopoiliglukin, madzi am'magazi, ndi heparin.

Zowopsa za lactic acidosis zitha kuwoneka pansipa. "Janumet" ndi fanizo la mankhwalawa omwe ali ndi mawonekedwe omwewo kapena osiyanasiyana ayenera kumwedwa, mosakayikira, pamankhwala omwe dokotala adalimbikitsa.

Zomwe ndimankhwala omwe amatha kufooketsa zotsatira za kutenga "Yanumet"

Mitundu ina ya mankhwalawa nthawi imodzi ndi mankhwala osavomerezeka. Kuchepetsa mphamvu za wothandizila (metformin) atha:

thiazide ndi mitundu ina ya okodzetsa,

mahomoni a chithokomiro,

Mwa zina, amakhulupirira kuti Yanumet imatha kusintha momwe mankhwala ena amathandizira thupi la wodwalayo. Izi zikuphatikiza, mwachitsanzo:

Sitikulimbikitsidwa kugwiritsa ntchito kuphatikiza kwa "Yanumet" ndi mankhwalawa. Ngati chithandizo choterechi chikuwoneka ngati chofunikira, ziyenera kuchitika moyang'aniridwa ndi adokotala.

Ndemanga za odwala za mankhwala

Anthu omwe ali ndi matenda ashuga ali ndi lingaliro labwino za mankhwalawa. Odwala akuphatikiza zabwino za mankhwalawo poyamba, kumene, kuchita kwake bwino. Kwa zaka zambiri, odwala amatha kumwa mankhwalawa, monga ena ambiri omwe amapatsidwa shuga. Kusakhalapo kwa kusiyana kwamasamba a shuga kwa nthawi yayitali ndikugwiritsa ntchito moyenera - pazifukwa izi, pa intaneti, pali ndemanga zabwino kwambiri za mankhwala a Yanumet.Mafanizo a mankhwalawa, kupatula ena achilendo, mwatsoka, samapereka matchulidwe otere.

Komanso, phindu losakayikira la mankhwalawa limaphatikizaponso mfundo yoti ilibe vuto lililonse pamtima. Tsoka ilo, ambiri omwe kale amagwiritsidwa ntchito mankhwalawa kuti azilamulira kuchuluka kwa shuga m'magazi anali ndi kuphatikiza kotero, mwatsoka, sanathe kudzitama. Komanso mwayi wopanda malire wa Yanumet, malinga ndi odwala ambiri, ndikuti sizimaliza kapamba.

Odwala ena amazindikira, mwa zina, kuti kugwiritsa ntchito mankhwalawa kwa nthawi yayitali ngakhale kumabweretsa kuchepa. Izi, zachidziwikire, zitha kuonedwa ngati kuyenera kwa Yanumet. Ku Russia, ma fanizo a mankhwalawa omwe amapezeka chimodzimodzi, ndizovuta.

Palibe zoperewera mu mankhwalawa, mowerengera anthu omwe ali ndi matenda ashuga. Mwina njira yokhayo yobwezera mankhwalawa, malinga ndi odwala, ndi mtengo wake wokwera. Tsoka ilo, si anthu onse omwe akufuna atha kumwa mankhwalawa, mwatsoka.

Ndemanga za madotolo za mankhwalawa

Madokotala, monga odwala omwe, amawona ngati Yanumet ndi mankhwala othandiza kwambiri. Madokotala nthawi zambiri amapereka kwa odwala awo omwe ali ndi matenda amtundu wa 2. Kuphatikiza pakuchita bwino kwa chochitikachi, akatswiri, monga odwala omwewo, amakhudzanso zabwino zomwe sizinatsimikizidwe za mankhwalawa kuti, mosiyana ndi mankhwala ena ambiri ofananawo, samayambitsa mitundu yosiyanasiyana ya zovuta. Ndiye chifukwa chake pali ndemanga zabwino kwambiri za Yanumet kuchokera kwa madokotala ambiri pa intaneti. Mbale ndi zolozera za mankhwalawa m'thupi la wodwalayo, malinga ndi madokotala, nthawi zambiri zimakhala ndi zotsatirapo zoyipa zina. Tumizani ku Yanumet kuchokera ku mankhwala ena pazifukwa izi, madokotala a odwala awo nthawi zambiri.

Chifukwa chakuti mankhwalawa alibe phindu lililonse pakukonzekera, mwachitsanzo, hypoglycemic syndrome, iwo, adalandiranso ndemanga zabwino kuchokera kwa madokotala. Analogues a "Yanumet" ndiokwera mtengo kutenga pankhaniyi ayenera kukhala osamala.

Ngakhale kuti mankhwalawo ali pafupi otetezeka kwathunthu, akatswiri komabe samalangiza kuti azingogwiritsa ntchito nokha chida ichi. Mlingo wa mankhwalawa umayenera kusankhidwa ndi madokotala okha. Pokhapokha ngati izi, mankhwalawo sangakhale ovulaza thupi la wodwalayo ndipo adzagwira ntchito moyenera momwe angathere.

Momwe mungasungire

Muzipatala "Yanumet" ndi fanizo la mankhwalawa, onse akumayiko ndi akunja, nthawi zambiri amagulitsidwa kokha ndi mankhwala. Zachidziwikire, kuti mankhwalawa agwire ntchito bwino ngati pakufunika kuwongolera kuchuluka kwa shuga m'magazi, icho, pazinthu zina, iyenera kusungidwa bwino. Sungani mankhwalawa, monga mankhwala ena onse, ayenera kukhala m'malo amdima. Amakhulupirira kuti Yanumet imasunga malo ake pokhapokha kutentha kozungulira sikukwera pamwamba pa +25 ° C. Chifukwa chake, nthawi yachilimwe pamasiku otentha kwambiri, mapiritsi oterowo angafunikire kuwafafaniza.

Inde, muyenera kusunga mankhwalawa m'njira yoti ana kapena, mwachitsanzo, ziweto sizimatha kuchipeza. Moyo wa alumali wa mankhwala "Yanumet" ndi zaka ziwiri kuyambira tsiku lomwe adatulutsidwa. Pambuyo pa nthawi iyi, mankhwalawa samaloledwa kugwiritsidwa ntchito kuwongolera shuga. Pambuyo pazaka ziwiri kuyambira tsiku lotulutsidwa, mankhwalawo amayenera kutayidwa.

Yanumet - malangizo, gwiritsani ntchito, mtengo, ndemanga

Yanumet ndi kuphatikiza kwa mankhwala a hypoglycemic omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo omwe amadalira shuga.Kumwa mankhwalawa kumathandizira kuti shuga azikhala bwino, kumapangitsa kuti matendawa athe kupitirira patsogolo komanso kumathandizira odwala.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapezeka pamsika ngati mapiritsi oblong okhala ndi biconvex pamwamba, wokutidwa ndi filimu ya enteric ya kuwala kwapinki, ya pinki kapena yofiira (kutengera mlingo). Mankhwalawa amadzaza m'matumba a matuza a 14 zidutswa. Kuyambira 1 mpaka 7 matuza aikidwa mu paketi ya pepala lakuda.

Zosakaniza zogwira ntchito za Yanumet ndi sitagliptin mu mawonekedwe a phosphate monohydrate ndi metformin hydrochloride. sitagliptin pakukonzekera nthawi zonse amakhala ofanana - 50 mg. Kuchulukitsa kwa metformin hydrochloride kumasiyana ndipo 500, 850 kapena 1000 mg piritsi limodzi.

Monga zigawo zothandizira, Yanumet imakhala ndi lauryl sulfate ndi sodium stearyl fumarate, povidone ndi MCC. Chipolopolo cha mapiritsiwo chimapangidwa kuchokera ku macrogol 3350, mowa wa polyvinyl, titanium dioksidi, wakuda ndi iron iron oxide.

Mankhwalawa amadzaza m'matumba a matuza a 14 zidutswa.

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.

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.

Gwiritsani ntchito pa nthawi yoyembekezera

Mankhwalawa sayenera kuledzera ali ndi mwana, chifukwa deta pakukhazikika kwake panthawiyi siyipezeka. Mayi yemwe akulandira chithandizo ndi Yanumet atatenga pakati kapena akufuna kuchita izi, ayenera kusiya kumwa mankhwalawo ndikuyamba mankhwala a insulin.

Kugwiritsa ntchito mankhwalawa sikugwirizana ndi kuyamwitsa.

Kugwiritsa ntchito mankhwalawa sikugwirizana ndi kuyamwitsa.

Kusankhidwa kwa Yanumet kwa ana

Kafukufuku wotsimikizira chitetezo cha mankhwalawa kwa ana ndi achinyamata sichinachitike, chifukwa chake sayenera kulembedwa kwa odwala omwe ali ndi zaka zosakwana 18.

Popeza zigawo zikuluzikulu za Yanumet zimachotsedwa mkodzo, ndipo ukalamba, ntchito ya impso imachepa, mankhwalawa amayenera kuperekedwa kwa anthu opitirira zaka 60.

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.

Malangizo a Yanumet

Amaril yochepetsa shuga

Ndemanga za madokotala za Yanumet

Sergey, wazaka 47, endocrinologist, Vologda

Kwa odwala omwe ali ndi matenda osokoneza bongo omwe amadalira insulin, nthawi zambiri ndimapereka mankhwala awa, chifukwa kugwira kwake ntchito masiku ano kwatsimikiziridwa. Amayendetsa shuga bwino ndipo sizimayambitsa mavuto ngakhale atakhala nthawi yayitali.

Anna Anatolyevna, wazaka 53, endocrinologist, Moscow

Ndikupangira chithandizo ndi Janumet kwa odwala omwe sangathe kusintha shuga yawo yamagazi ndi Metformin yokha.Kapangidwe kake ka mankhwalawa kumathandizira kuwongolera zizindikiro za shuga.

Odwala ena amawopa kumwa mankhwalawa chifukwa choopsa cha hypoglycemia, koma kafukufuku waposachedwa wasonyeza kuti mwayi womwe umachitika ndiwofanana pakati pa anthu omwe adalandira mapiritsi ndi placebo.

Ndipo izi zikutanthauza kuti mankhwalawa alibe gawo lalikulu pakukula kwa hypoglycemic syndrome. Chachikulu ndikusankha mlingo woyenera.

Mankhwalawa amayenera kuperekedwa kwa anthu azaka zopitilira 60.

Ndemanga za Odwala

Lyudmila, wazaka 37, Kemerovo

Ndakhala ndikuchita ndi Janomat pafupifupi chaka chimodzi. Ndimamwa osachepera 50/500 mg m'mawa ndi madzulo. M'miyezi itatu yoyambirira ya chithandizo, sizotheka kungoyendetsa matenda a shuga, komanso kuchepa 12 kg yolemera kwambiri. Ndikuphatikiza mankhwala ndi zakudya komanso zolimbitsa thupi zolimbitsa thupi. Tsopano ndikumva bwino kwambiri kuposa kale chithandizo.

Nikolay, wazaka 61, Penza

Ankakonda kumwa Metformin chifukwa cha matenda ashuga, koma pang'onopang'ono anasiya kuthandiza. Endocrinologist adapereka chithandizo ndi Yanumet ndipo adati mankhwalawa ndiwofotokozera mwamphamvu zomwe ndidakhala ndisanabadwe. Ndakhala ndikumwa kwa miyezi iwiri, koma shuga adakwezedwa. Sindikawona zotsatira zabwino kuchokera ku chithandizo.

Yanumet 1000 50: mtengo, ndemanga zamankhwala, ma analogs a mapiritsi

Mankhwala othandizira odwala matenda a shuga a mtundu wachiwiri atha kuphatikizira monotherapy ndi mankhwala amodzi kapena mankhwala ovuta.

Yanumet, monga othandizira odwala matenda ashuga, ndi mankhwala omwe ali ndi zosakaniza ziwiri, motero kumwa piritsi limodzi kumatha kusintha kufunika kogwiritsa ntchito mankhwala angapo.

Mpaka pano, mankhwala ophatikiza mankhwala ogulitsa ku Russia ali ndi mtengo wokwera mtengo. Koma, malinga ndi akatswiri azachipatala, kuyendetsa bwino kwawo kumavomereza mtengo wotere.

Kodi wothandizira hypoglycemic ndi chiyani?

Mankhwala Yanumet amaphatikizidwa ndi gulu la mankhwala omwe ali ndi vuto la hypoglycemic. Ichi ndichifukwa chake, nthawi zambiri amalembera shuga mellitus wa fomu yodziyimira payekha.

Kuchita kwake kumapangidwira ndi zosakaniza zingapo zomwe ndi gawo lamankhwala.

Dziko lomwe Yanumet idachokera ndi United States of America, yomwe imalongosola mtengo wokwera kwambiri wa mankhwalawa (mpaka ma ruble 3,000, kutengera mlingo).

Mapiritsi a Janumet amagwiritsidwa ntchito motere:

• Kuchepetsa shuga wamagazi, makamaka ngati kudya zakudya zamagulu limodzi ndi zolimbitsa thupi zolimbitsa thupi zikuwonetsa zotsatira zoyipa,
• ngati monotherapy yogwiritsira ntchito imodzi yokha yogwiritsira ntchito siyinabweretse zotsatira zomwe mukufuna,
• Itha kugwiritsidwa ntchito ngati njira yovuta yothandizira pamodzi ndi zotumphukira za sulfrnylurea, insulin kapena PPAR-gamma antagonists.

Mankhwalawa ali ndi magawo awiri omwe amagwira ntchito omwe ali ndi vuto la hypoglycemic:

1. Sitaglipin ndi nthumwi ya DPP-4 enzyme inhibitor group, yomwe, ndi kuchuluka kwa shuga m'magazi, imalimbikitsa kaphatikizidwe ndi katulutsidwe ka insulin ndi maselo a pancreatic beta. Chifukwa cha izi, pali kuchepa kwa kapangidwe ka shuga m'chiwindi.
2. Metformin hydrochloride ndi woimira gulu lachitatu-greatuanide gulu, lomwe limathandizira kuletsa kwa gluconeogeneis. Kugwiritsa ntchito mankhwala ozikidwa ndikulimbikitsa glycolysis, komwe kumapangitsa kuti shuga azikhala bwino ndi maselo komanso minyewa ya thupi. Kuphatikiza apo, pali kuchepa kwa mayamwidwe am'magazi ndimaselo a m'matumbo. Ubwino wawukulu wa metformin ndikuti siziyambitsa kuchepa kwambiri kwa glucose (m'munsimu muyezo) ndipo sizitsogolera pakupanga hypoglycemia.

Mlingo wa mankhwala umatha kusintha mamiligalamu 500 mpaka chikwi chimodzi mwazomwe zimagwira - metformin hydrochloride.Ichi ndichifukwa chake, pharmacology yamakono imapatsa odwala mitundu yamitundu iyi:

Chiwerengero choyamba pakuphatikizidwa kwa mankhwalawa chikuwonetsa kuchuluka kwa yogwira zigawo sitaglipin, yachiwiri ikuwonetsa mphamvu ya metformin. Monga zinthu zothandizira zimagwiritsidwa ntchito:

1. Microcrystalline mapadi.
2. Povidone.
3. Sodium stearyl fumarate.
4. Sodium lauryl sulfate.
5. Mowa wa polyvinyl, titanium dioksidi, macrogol, talc, oxide wachitsulo (chipolopolo cha kukonzekera kwa piritsi chimakhala nawo).

Chifukwa cha chida chachipatala Yanumet (Yanomed), ndikotheka kukwaniritsa zopinga zama glucagon, zomwe, ndi kuwonjezeka kwa insulin, kumabweretsa kukula kwa shuga m'magazi.

Malangizo ogwiritsira ntchito mapiritsi

Dokotala wokhazokha yemwe amayang'anitsitsa njira ya pathological ndi omwe amapereka mankhwala ndi njira zomwe amwe mankhwala a odwala.

Monga lamulo, kukonzekera kwa Yanumet kuyenera kutengedwa kawiri patsiku pakudya (m'mawa ndi madzulo), kumwa zamadzi zambiri.

Malangizo ogwiritsira ntchito akuwonetsa kuti chithandizo choyambirira ndi 500 mg metformin hydrochloride ndi 50 mg sitaglipin kawiri pa tsiku (piritsi limodzi lokhala ndi mulingo wochepa).

Mankhwala ena amafunika kuti asinthidwe ndi kawiri mlingo wa metformin.

Ngati m'mbuyomu wodwalayo adatenga njira yochiritsira pogwiritsa ntchito mankhwala okhazikitsidwa ndi metformin, ndipo chithandizo chotere sichinabweretse zotsatira zoyenera, kugwiritsa ntchito mankhwalawa kukhala motere:

• Mlingo wa metformin hydrochloride womwe ukugwiritsidwa ntchito musanalandire chithandizo
• kudya kwa tsiku lililonse kwa nesglipin kuyenera kukhala osachepera 100 mgꓼ
• kuchuluka kwa mapiritsi patsiku ndi awiri.

Gulu la odwala omwe adagwiritsa ntchito kale mankhwala omwe ali ndi sitaglipin okha ayenera kulandira chithandizo chotsatira:

1. Kawiri patsiku, mankhwalawa amatengedwa mu 50 mg ya sitaglipin ndi 500 mg ya metformin hydrochloride.
2. Pambuyo pake, ndizotheka kuwonjezera kuchuluka komwe kumakhala piritsi limodzi la Janumet 1000.

Ngati chithandizo chovuta chothandizidwa ndi mankhwala a sulfonylurea chagwiritsidwa ntchito, zinthu zotsatirazi ndi zomwe zingatsimikizire kuchuluka kwake:

• Mlingo wa metformin hydrochloride amatsimikiza kutengera mtundu wa kukula kwa matenda a wodwalaꓼ
• kudya kwa tsiku lililonse kwa nesglipin ndi 100 mg, logawidwa pawiri
• kuchuluka kwa yogwira mankhwala a sulfonylurea zotumphukira amatsimikiza ndi kupezeka dokotala potengera chithunzi cha odwala.

Njira zamtundu uliwonse zamankhwala zimayenera kupatula kumwa zakumwa zoledzeretsa, chifukwa mowa umapangidwa mosiyanasiyana. Kugwirizana ndi mankhwala ena kuyenera kuvomerezedwa ndi katswiri wazachipatala.

Ngati bongo, lactic acidosis imayamba.

Kuti athetse, odwala amagonekedwa m'chipatala ndipo amathandizidwa ndi mitundu yotsatirayi - chithandizo, hemodialysis.

Ndi nthawi ziti pamene ndizoletsedwa kugwiritsa ntchito hypoglycemic wothandizira?

Musanayambe chithandizo chamankhwala, muyenera kuwerenga mosamala kuchuluka kwa zotsutsana zomwe zikuwonetsedwa mu malangizo a boma.

Kuphatikiza apo, ndikofunikira kufunsa dokotala wanu za kugwiritsa ntchito mankhwalawa.

Monga mankhwala ambiri, Yanumet sangagwiritsidwe ntchito nthawi zina.

Choyambirira, ndizoletsedwa kugwiritsa ntchito piritsi ngati pali mawonekedwe:

1. Kuchuluka kwamphamvu kwa wodwala kumodzi mwa zigawo zingapo za mankhwala kumawonedwa.
2. Mavuto ndi kugwira ntchito kwa impso, komanso kuwonekera kwa zochitika zomwe zingakhudze kuwonongeka kwake. Izi zimaphatikizapo kuchepa kwamadzi, njira yodwala matenda opatsirana, komanso kukhumudwitsidwa.
3. Zochitika zomwe zingayambitse minofu hypoxia.
4. Matenda owopsa a chiwindi kapena kuperewera kwake.
5. Pa zakumwa zoledzeretsa.
6. Pachimake kapena matenda metabolic acidosis.
7. Matenda a shuga ketoacidosis.
8. Njira yodalira insulin.