Sofamet mankhwala: malangizo ntchito

Mapiritsi oyera, oblong, biconvex, okhala ndi notch mbali zonse ziwiri, pakuwonekera kwa mitundu yoyera.

Othandizira: povidone K25, microcrystalline cellulose, sorbitol, magnesium stearate.

Zomwe zimavala malaya a kanema: Opadry II Woyera (hypromellose 2910, titanium dioxide, lactose monohydrate, macrogol 3000, triacetin)

Ma PC 10 - matuza (3) - mapaketi a makatoni.

Zotsatira za pharmacological

Oral hypoglycemic wothandizila kuchokera pagulu la Biguanides (dimethylbiguanide). Kupanga kwa zochita za metformin kumalumikizidwa ndi kuthekera kwake kuponderezera gluconeogeneis, komanso mapangidwe a mafuta achilengedwe omasuka ndi kukhatikiza kwa mafutawa. Zimawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikugwiritsa ntchito shuga ndi maselo. Metformin siyimakhudzanso kuchuluka kwa insulin m'magazi, koma imasintha ma pharmacodynamics pochepetsa kuchuluka kwa insulini kuti imasulidwe ndikuwonjezera kuchuluka kwa insulin kuti proinsulin.

Metformin imalimbikitsa kapangidwe ka glycogen pochita glycogen synthetase. Kuchulukitsa kuchuluka kwa mayendedwe amtundu uliwonse wa ma membrane glucose. Kuchepetsa mayamwidwe m'matumbo.

Amachepetsa msana wa triglycerides, LDL, VLDL. Metformin imakweza michere yamagazi ya fibrinolytic mwa kuponderezana ndi minyewa yokhala ngati minofu ya plasminogen activator inhibitor.

Ngakhale mutamwa metformin, thupi la wodwalayo limakhalabe lolimba kapena limatsika pang'ono.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, metformin imayamba pang'onopang'ono komanso osakwanira kuchokera mmimba. C max mu plasma imafikiridwa patatha pafupifupi maola 2,5. Ndi mlingo umodzi wa 500 mg, kupezeka kwathunthu kwa bioavailability ndi 50-60%. Ndi kuyamwa kwa munthawi yomweyo, kuyamwa kwa metformin kumachepetsedwa ndikuchedwa.

Metformin imagawidwa mwachangu mu minofu ya thupi. Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira mu ndulu zakumaso, chiwindi ndi impso.

Imafufutidwa ndi impso zosasinthika. T 1/2 kuchokera ku plasma ndi maola 2-6.

Pankhani ya kuwonongeka kwaimpso, kuwerengetsa kwa metformin ndikotheka.

Zizindikiro zamankhwala

Type 2 matenda a shuga a mellitus (osadalira insulini) omwe ali ndi vuto lodyera komanso osachita bwino zolimbitsa thupi, odwala omwe ali ndi kunenepa kwambiri: akuluakulu - monga monotherapy kapena osakanikirana ndi ena othandizira pakamwa kapena ndi insulin, mwa ana azaka zapakati pa 10 ndi akulu - monga monotherapy kapena kuphatikiza ndi insulin.

Mlingo

Amamwa pakamwa, panthawi ya chakudya kapena itatha.

Mlingo komanso kuchuluka kwa makonzedwe zimatengera mtundu womwe umagwiritsidwa ntchito.

Ndi monotherapy, muyeso umodzi woyamba wa akulu ndi 500 mg, kutengera mtundu womwe umagwiritsidwa ntchito, pafupipafupi makonzedwe ake ndi katatu kapena tsiku. Ndizotheka kugwiritsa ntchito 850 mg 1-2 nthawi / tsiku. Ngati ndi kotheka, mlingo umakulitsidwa pang'onopang'ono ndi sabata limodzi. mpaka 2-3 g / tsiku.

Ndi monotherapy ya ana azaka zapakati pa 10 ndi akulu, mlingo woyambayo ndi 500 mg kapena 850 1 nthawi / tsiku kapena 500 mg 2 nthawi / tsiku. Ngati ndi kotheka, ndi nthawi osachepera 1 sabata, muyezo mutha kuchuluka mpaka 2 g / tsiku mu Mlingo wa 2-3.

Pambuyo masiku 10-15, mlingo uyenera kusinthidwa kutengera zotsatira za kutsimikiza kwa shuga m'magazi.

Kuphatikiza mankhwala ndi insulin, mlingo woyambirira wa metformin ndi 500-850 mg katatu / tsiku. Mlingo wa insulin umasankhidwa malinga ndi zotsatira za kutsimikiza kwa shuga m'magazi.

Zotsatira zoyipa

Kuchokera pamimba yogaya: kutheka (nthawi zambiri kumayambiriro kwa mankhwalawa) nseru, kusanza, kutsegula m'mimba, kuphwanya pansi, kumva kusasangalala pamimba, munthawi zina - kuphwanya kwa chiwindi, chiwindi (kutha pambuyo poti chithandizo chatha).

Kuchokera kumbali ya kagayidwe: kawirikawiri - lactic acidosis (kuleka kwa chithandizo ndikofunikira).

Kuchokera hemopoietic dongosolo: kawirikawiri - kuphwanya mayamwidwe a vitamini B 12.

Mbiri yamachitidwe osavomerezeka mu ana azaka zapakati pa 10 ndi akulu ndi chimodzimodzi pa akulu.

Contraindication

Hypersensitivity, hyperglycemic coma, ketoacidosis, matenda aimpso, matenda a chiwindi, kulephera kwa mtima, kulowetsedwa kwam'mnyewa, kupuma, kulephera, kuchepa kwa magazi, uchidakwa, hypocaloric zakudya (kupatula 1000 kcal / tsiku), lactic acidosis (kuphatikizapo mbiri), pakati, nthawi yonyamula. Mankhwalawa sanalembedwe masiku awiri asanachitike opaleshoni, radioisotope, maphunziro a x-ray ndikuyambitsa mankhwala okhala ndi ayodini ndipo pakatha masiku awiri atachitidwa opereshoni.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, mkati mwakudya kapena musanadye, odwala osalandira insulin, 1 g (mapiritsi 2) kawiri pa tsiku kwa masiku atatu oyamba kapena 500 mg katatu pa tsiku, kuyambira masiku 4 mpaka 14 - 1 g katatu patsiku, pakatha masiku 15 Mlingo ungathe kuchepetsedwa poganizira zomwe zili m'magazi ndi mkodzo. Kukonza tsiku lililonse mlingo - 1-2 g.

Mapiritsi a retard (850 mg) amatengedwa 1 m'mawa ndi madzulo. Pazipita tsiku mlingo 3 g.

Ndi munthawi yomweyo kugwiritsa ntchito insulin pa mlingo wochepera 40 mayunitsi / tsiku, muyezo wa metformin ndi womwewo, pamene mlingo wa insulin ungachepetse pang'onopang'ono (mwa magawo 4-8 / tsiku tsiku lililonse). Pa mlingo wa insulin yoposa 40 mayunitsi / tsiku, kugwiritsa ntchito metformin ndi kuchepa kwa insulin kumafunikira chisamaliro chachikulu ndikuchitika kuchipatala.

Misonkho ndi mitengo ya mankhwala Sofamet

mapiritsi okhala ndi filimu

mapiritsi okhala ndi filimu

mapiritsi okhala ndi filimu

mapiritsi okutira

mapiritsi otulutsidwa

mapiritsi otulutsidwa

mapiritsi okhala ndi filimu

mapiritsi okhala ndi filimu

mapiritsi okhala ndi filimu

mapiritsi okhala ndi filimu

mapiritsi okhala ndi filimu

makanema ojambula okhala ndi mafilimu okhazikika

mapiritsi otulutsidwa

mapiritsi otulutsidwa

mapiritsi okhala ndi filimu

Mavoti onse: madotolo 73.

Zambiri za omwe adayankha mwapadera:

Gwiritsani ntchito pa nthawi yoyembekezera

Pakati pa nthawi yayitali, ndizotheka ngati njira yochiritsira yomwe ikuyembekezeka imapitilira chiwopsezo cha mwana wosabadwayo (maphunziro okwanira komanso okhwima ogwiritsira ntchito panthawi yomwe ali ndi pakati sanachitike).

Gawo la FDA la mwana wakhanda ndi B.

Pa nthawi ya chithandizo ayenera kusiya kuyamwitsa.

Zotsatira zoyipa

Kuchokera pamimba: kukhumudwa, kusanza, "zitsulo" mkamwa, kuchepa kwa chilakolako chofuna kudya, kukomoka, kupweteka kwam'mimba.

Kuchokera kumbali ya kagayidwe: nthawi zina - lactic acidosis (kufooka, myalgia, kupuma, kugona, kupweteka kwam'mimba, hypothermia, kuchepa kwa magazi, Reflex bradyarrhythmia), ndimankhwala osakhalitsa - hypovitaminosis B12 (malabsorption).

Kuchokera ku ziwalo za hemopoietic: Nthawi zina - megaloblastic anemia.

Thupi lawo siligwirizana: zotupa pakhungu.

Pazifukwa zoyipa, mankhwalawa amayenera kuchepetsedwa kapena kuletsedwa kwakanthawi.

Malangizo apadera

Mankhwalawa, kuwunika ntchito yaimpso ndikofunikira; kutsimikiza kwa plasma lactate kuyenera kuchitika kawiri pachaka, komanso maonekedwe a myalgia. Ndi chitukuko cha lactic acidosis, kusiya kwa mankhwala kumafunika.

Kukhazikitsidwa padera pangozi ya kuchepa kwamadzi sikulimbikitsidwa.

Kuchita maopaleshoni akuluakulu komanso kuvulala, kuwotcha kwambiri, matenda opatsirana omwe ali ndi febrile syndrome kungafunike kuthetsedwe kwa mankhwala a pakamwa a glypoglycemic ndi makonzedwe a insulin.

Ndi mankhwala ophatikizika a sulfonylurea, kuyang'anitsitsa shuga wamagazi ndikofunikira.

Ntchito zophatikizidwa ndi insulin tikulimbikitsidwa kuchipatala.

Mankhwala ofanana:

• Carsil Dragee
• Mapiritsi a Ascorutin (Ascorutin)
• Yogurt (Yogurt) Capsule
• Ergoferon () lozenges
• Magne B6 (Magne B6) mapiritsi amlomo
• Omez Capsule
• Papaverine (Papaverine) mapiritsi amlomo

** Maupangiri a Mankhwala ndi a zidziwitso zokha. Kuti mumve zambiri, chonde onani zomwe akupanga. Osadzilimbitsa, musanayambe kugwiritsa ntchito Sofamet, muyenera kufunsa dokotala. EUROLAB sikuti ali ndi vuto pazotsatira zomwe zimadza chifukwa chogwiritsa ntchito chidziwitso chomwe chatumizidwa pa tsamba. Zomwe zili patsamba lililonse sizilowa m'malo mwa upangiri waudokotala ndipo sizingakhale chitsimikizo cha mankhwala.

Muli ndi chidwi ndi Sofamet? Kodi mukufuna kudziwa zambiri kapena muyenera kukaonana ndi dokotala? Kapena mukufuna kuyesedwa? Mutha kutero pangana ndi adokotala - Euro yachipatala labu nthawi zonse pantchito yanu! Madotolo abwino amayeserera, kukulangizani, kukupatsani chithandizo choyenera ndikupanga matenda. Mukhozanso Itanani dokotala kunyumba. Chipatala cha Euro labu tsegulani kwa inu nthawi yonse yoyandikira.

** Tcheru! Zomwe zawonetsedwa mu bukhuli zamankhwala ndizothandiza akatswiri azachipatala ndipo siziyenera kukhala chifukwa chodzidziwira nokha. Kufotokozera kwa Sofamet ndikungodziwa zokhazokha ndipo sikunapangidwe kuti mupereke chithandizo popanda kutenga dokotala. Odwala amafunikira upangiri waluso!

Ngati mukufuna mankhwala ndi mankhwala ena aliwonse, mafotokozedwe awo ndi malangizo ogwiritsira ntchito, chidziwitso cha kapangidwe ndi mawonekedwe amamasulidwe, mawonekedwe ogwiritsira ntchito ndi zoyipa, njira zogwiritsira ntchito, mitengo ndi kuwunika kwa mankhwala, kapena kodi muli ndi mafunso ena ndi malingaliro - tilembereni, tiyesetsa kukuthandizani.

Kuchita

Zosagwirizana ndi ethanol (lactate acidosis).

Gwiritsani ntchito mosamala limodzi ndi anticoagulants osalunjika komanso cimetidine.

Zotsatira za sulfonylureas, insulin, acarbose, MAO zoletsa, oxytetracycline, ACE zoletsa, clofibrate, cyclophosphamide ndi salicylates zimathandizira.

Pogwiritsa ntchito munthawi yomweyo ndi GCS, njira yolerera yoletsa kukonzekera pakamwa, epinephrine, glucagon, mahomoni a chithokomiro, zotengera za phenothiazine, zotupa za thiazide, zotumphukira za nicotinic acid, kuchepa kwa mphamvu ya hypoglycemic ya metformin ndikotheka.

Nifedipine imawonjezera mayamwidwe, Cmax, imachepetsa mayeso.

Mankhwala a Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren ndi vancomycin) omwe amatulutsidwa m'mapikisano olimbana ndi machitidwe ogwiritsira ntchito ma tubular ndipo amatha kuonjezera Cmax ndi 60% ndi chithandizo chanthawi yayitali.

Zizindikiro zogwiritsidwa ntchito

Cholinga cha mankhwalawa chikhala choyenera ngati wodwala ali ndi matenda a shuga a 2 (osagwirizana ndi insulin). Izi ndizofunikira kwambiri ngati, asanapereke mankhwala, kusintha kwa zakudya komanso kuyambitsa zochitika zolimbitsa thupi sizinabweretse zotsatira zoyenera. Amawerengera, kuphatikiza odwala omwe ali ndi kunenepa kwambiri.

Cholinga cha mankhwalawa chikhala chofunikira ngati wodwala ali ndi matenda ashuga a 2.

Ndi matenda ashuga

Phwando liyenera kuchitika nthawi ya chakudya kapena itatha. Mlingo woyambirira wa akuluakulu ndi 500 mg katatu patsiku. Amaloledwa kutenga 850 mg 1-2 pa tsiku.

Pambuyo masiku 10-15 atakhazikitsa, mlingo umatha kusinthidwa ndi dokotala wozikidwa pazofunikira zamagulu a shuga.

Nthawi zina, adotolo amasankha kuti apereke mankhwala osakanikirana ndi insulin.

Gwiritsani ntchito pa nthawi yoyembekezera

Popeza chogwira ntchito chimatha kudutsa pazolepheretsa, kugwiritsidwa ntchito pa nthawi ya gestation ndikotheka kokha. Chosakaniza chogwira chimatha kulowa mkaka wa mayi. Izi zikutanthauza kuti munthawi ya mkaka wa mkaka, mankhwala ndi bwino osapereka.

Popeza chogwira ntchito chimatha kudutsa pazolepheretsa, kugwiritsidwa ntchito pa nthawi ya gestation ndikotheka kokha.

Mankhwala osokoneza bongo a Sofamet

Ndi kudya kwambiri mankhwala mthupi, kukula kwa lactic acidosis yokhala ndi zotsatira zakupha ndikotheka. Ndikofunikira kuchotsa mankhwalawa m'thupi pogwiritsa ntchito hemodialysis.

Zofunika kwambiri kwa hepatic pathologies ndizomwe zimapangitsa kuti pakhale zovuta kupereka.

Kuyenderana ndi mowa

Kuphatikizidwa kwa mankhwalawa ndi mowa kumawonjezera chiopsezo cha lactic acidosis.

Mutha kusintha mankhwalawa ndi mankhwala monga Glucofage, Metospanin, Siafor.

Ndemanga pa Sofamet

A.D. Shelestova, endocrinologist, Lipetsk: "Mankhwalawa akuwonetsa zotsatira zabwino pochiza matenda amtundu wa shuga wa 2. Izi zimachitika chifukwa choti machitidwe amachitidwira amafunikira kuchepetsa kuchuluka kwa shuga m'magazi. Chifukwa chake, zotsatira zake zingatheke mu sabata ziwiri zamankhwala, zomwe zimayenera odwala. Ndikofunika kuganizira kuti mukamaliza mankhwalawa, muyenera kukhala ndi moyo wathanzi komanso kuchita masewera olimbitsa thupi mokwanira. "

S.R. Reshetova, endocrinologist, Orsk: "Mankhwala amathandizanso kupeza njira zabwino pochizira matenda a shuga a matenda a 2 .. Nthawi yamankhwala, ndikofunikira kuwunika momwe wodwalayo alili, popeza nthawi zambiri, kusintha kwa mankhwalawa kumafunikira sabata litatha. "Izi zikachitika, wodwalayo athandizira ndi hemodialysis."

Elvira, wazaka 34, Lipetsk: "Zinapezeka kuti ndimayenera kuchiza matenda ashuga. Matendawa siabwino, amadzetsa mavuto ambiri. Mankhwalawa adapita ndi mankhwalawa. Sindinawone zotsatira zoyipa zilizonse, koma kusintha kwakanthawi sikunatenge. Nditha kuzitcha kuti ndizabwino kwambiri. Chifukwa chake, ndimalimbikitsa kwa odwala omwe ali ndi matenda ashuga. Mankhwalawa amatha kuthandizira munthawi yochepa ndikuchepetsa zizindikiro zomwe zatchulidwa za matendawa. "

Igor, wazaka 23, Anapa: "Ngakhale ndidakali mwana, ndimayenera kudwala matenda oopsa ngati matenda ashuga. Ndikufuna kudziwa nthawi yomweyo kuti mankhwalawo samangomwa mankhwalawa. Ndidasintha moyo wanga, kusintha kadyedwe kanga ndikuphatikizanso masewera komanso kuchuluka kwa zochita zanga za tsiku ndi tsiku. Zochita zolimbitsa thupi. eskers. "