Metformin 850: malangizo ogwiritsira ntchito, ndemanga ndi fanizo

Mapiritsi Ovomerezeka, 500 mg, 850 mg, 1000 mg

Piritsi limodzi lili

ntchito yogwira - metformin hydrochloride (malinga ndi 100%) 500 mg, 850 mg kapena 1000 mg,

obwera: wowuma 1500 (pang'ono pregelatinized), povidone, croscarmellose sodium, magnesium stearate, microcrystalline cellulose,

kapangidwe ka chipolopolo Opadry II: mowa wa polyvinyl (pang'ono hydrolyzed), macrogol 3350 (polyethylene glycol), utoto wa utoto (titanium dioxide (E 171), aluminium varnish yozikidwa pa indigo carmine (E 132), aluminium varnish yozizira pa quinoline wachikasu (E 104)

Mapiritsi okhala ndi masamba obiriwira okhala ndi biconvex pamwamba ndi chiwopsezo (Mlingo wa 500 mg ndi 1000 mg).

Mapiritsi okhala ndi masamba obiriwira okhala ndi biconvex pamtunda popanda chiopsezo (Mlingo wa 850 mg).

Fgulu laacacotherapeutic

Njira zochizira matenda ashuga. Mankhwala ochepetsa shuga a pakamwa. Biguanides. Metformin.

Code ATX A10BA02

Mankhwala

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, imalowa mwachangu m'mimba. Kukwanira kwathunthu bioavailability ndi 50-60%.

Kuzungulira kwakukulu (Cmax) kumatheka pambuyo pa maola pafupifupi awiri, kuyamwa ndi chakudya kumachepetsa Cmax ndi 40% ndikuchepetsa kukwaniritsa kwake ndi mphindi 35. Ndende ya Plasma sapitilira 1 μg / ml.

Voliyumu yogawa (Vd) ndi malita 296-1012. Kulumikizana ndi mapuloteni a plasma ndikosathandiza, kumatha kudziunjikira m'maselo ofiira a m'magazi.

Hafu ya moyo (T½) ndi pafupifupi maola 6.5 (Koyamba T½ kuchokera ku 1.7 mpaka maola 3, malo osungira - kuyambira maola 9 mpaka 17). Chilolezo cha renal ndichoposa 400 ml / min.

Imafufutidwa ndi impso, makamaka mu mawonekedwe osasinthika (kusefera kwa glomerular ndi katulutsidwe ka tubular) komanso kudzera m'matumbo (mpaka 30%).

Kulephera kwa aimpso, chilolezo chimachepa mogwirizana ndi kupezeka chilolezo cha creatinine. Chifukwa chake, pali chiopsezo cha kuchuluka kwa mankhwalawa komanso kuchuluka kwa metformin mu plasma kumadzuka.

Mankhwala

Metformin imachepetsa hyperglycemia, sizitsogolera pakupanga hypoglycemia. Mosiyana ndi sulfonylurea, simalimbikitsa kubisalira kwa insulin ndipo sikuyambitsa vuto la hypoglycemic mwa anthu athanzi. Amachepetsa onse shuga komanso kuchuluka kwa glucose atatha kudya m'madzi am'magazi.

Hypoglycemic mphamvu ya metformin imatha kuzindikira njira zitatu:

- Kuchepetsa kapangidwe ka shuga m'chiwindi chifukwa cha kuletsa kwa gluconeogeneis ndi glycogenolysis,

- kukonza kukhathamiritsa ndi kugwiritsidwa ntchito kwa glucose wophatikizira mu minofu powonjezera mphamvu ya insulin,

- Kuchedwa kuyamwa kwa shuga m'matumbo.

Metformin imathandizira kapangidwe ka glycogen mu intracellular, zomwe zimakhudza kapangidwe ka glycogen. Kuchulukitsa kuthekera kwamitundu yonse yamtundu wama glucose oyenda.

Ngakhale zimakhudza glycemia, metformin imakhudzanso kagayidwe ka lipid: imatsitsa cholesterol yathunthu, lipoproteins yotsika komanso triglycerides.

Zimawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikugwiritsa ntchito shuga ndi maselo. Amalepheretsa gluconeogenesis m'chiwindi. Imachedwetsa mayamwidwe am'mimba m'matumbo.

Mlingo ndi makonzedwe

Monotherapy kapena kuphatikiza mankhwalawa molumikizana ndi ena othandizira pakamwa.

Nthawi zambiri, muyeso woyamba wa 500 mg kapena 850 mg wa metformin katatu patsiku panthawi ya chakudya kapena pambuyo pake. Pambuyo masiku 10-15 chithandizo, mlingo uyenera kusinthidwa malinga ndi zotsatira za miyeso ya seramu glucose. Kuwonjezeka kwapang'onopang'ono kwa mankhwalawa kumathandizira kuchepetsa zoyipa kuchokera kumimba.

Mlingo woyenera kwambiri ndi 3000 mg patsiku, womwe umagawidwa pazigawo zitatu. Pochiza Mlingo wambiri, Metformin amagwiritsidwa ntchito muyezo wa 1000 mg. Pankhani ya kusintha kwa mankhwalawa ndi Metformin, ndikofunikira kusiya kumwa mankhwala othandizira ena.

Kuphatikiza mankhwala osakanikirana ndi insulin.

Kuti akwaniritse bwino kuchuluka kwa shuga m'magazi, metformin ndi insulin zitha kugwiritsidwa ntchito ngati mankhwala osakanikirana. Mwachizolowezi, mlingo woyambirira ndi 500 mg kapena 850 mg wa mankhwala Metformin katatu patsiku, pamene mlingo wa insulin umasankhidwa malinga ndi zotsatira za kuyeza shuga.

Odwala okalamba Matenda aimpso osokoneza, motero, mlingo wa metformin uyenera kusankhidwa malinga ndi kuwunika kwa impso, komwe kuyenera kuchitidwa pafupipafupi.

The zikuchokera mankhwala ndi mankhwala

Mankhwala tikulephera kukula kwa polyperation wa yosalala minofu zinthu makoma a mtima dongosolo. Zotsatira zabwino za mankhwala pokhudzana ndi mtima ndi mtima zimawululidwa ndikulepheretsa kukula kwa matenda a shuga.

Chithandizo cha matenda ashuga ndi Metformin chitha kuperekedwa ndi dokotala mutatha kupenda wodwalayo mozama. Kutalika kwa mankhwalawa komanso mlingo wa mankhwalawa amagwiritsidwa ntchito kutsimikiza mawonekedwe onse amomwe matendawa ali mthupi la wodwalayo.

Chithandizo chogwira mankhwalawa ndi Metformin hydrochloride. Piritsi limodzi lili ndi 850 mg yogwira mankhwala. Kuphatikiza pazomwe zimapangidwira, kuphatikiza kwa mankhwalawa kumaphatikizapo mankhwala othandizira.

Mankhwala omwe amapanga mankhwalawa ndi awa:

• calcium phosphate dibasic,
• wowuma chimanga
• lactose
• povidone
• sodium benzoate
• talcum ufa
• magnesium wakuba,
• sodium wowuma glycolate,
• titanium dioxide
• hydroxypropyl methylcellulose,
• cellulose
• propylene glycol
• polyethylene glycol.

Kutenga Metformin sikukhudza kuchuluka kwa mahomoni m'thupi la munthu, koma kumathandizira kusintha kwa mankhwala ake, omwe amachitika chifukwa cha kuchepa kwa chiwerengero pakati pa insulin ndi mfulu, kuchuluka kwa thupi la munthu pakati pa insulin ndi proinsulin. Chimodzi mwazinthu zofunika kwambiri pakupanga zochita za mankhwalawa ndicho kukoka kwa glucose pogwiritsa ntchito minofu ya minofu.

Chithandizo chogwira ntchito chimathandizira kufalikira kwa magazi mu minyewa ya chiwindi ndikuthandizira kuthamanga kwa glucose mu glycogen. Kugwiritsa ntchito Metformin 850 mg kumawongolera michere ya magazi. Izi ndichifukwa chokakamira minofu ya plasminogen activator inhibitor.

Kulowetsedwa kwa chinthu chogwira ntchito kumachitika kuchokera ku lumen ya m'mimba ndipo ndi chizindikiro chomwe chimachokera ku 48 mpaka 52%. Hafu ya moyo wa gawo yogwira ndi pafupifupi maola 6.5. Thupi lomwe limagwira limachotsedwa m'thupi la munthu momwe limapangidwira. Gawo lothandizirali siligwirizana ndi ma protein a plasma a magazi. Kudzikundikira kwa mankhwalawa kumachitika ndi tiziwalo tating'ono, minofu minofu, impso ndi chiwindi. Kuchoka m'thupi ndi impso pokonza mkodzo.

Ndi kukula kwa zovuta pakugwira ntchito kwamikodzo, mankhwalawa amadziunjikira impso.

Zizindikiro ndi contraindication kugwiritsa ntchito mankhwala

Zizindikiro zazikulu zogwiritsidwa ntchito ndi izi:

1. kukhalapo kwa matenda a shuga a mtundu 2 popanda kutanthauza ketoacidosis,
2. kukhalapo kwa matenda ashuga osagwira ntchito kuchokera ku zakudya,
3. mankhwalawa a mtundu 2 a shuga limodzi ndi insulin, makamaka ndi kunenepa kwambiri, komwe kumayendetsedwa ndi kuwoneka kwachiwiri kwa insulin.

Chachikulu contraindication kugwiritsa ntchito mankhwala mankhwalawa mtundu 2 matenda ashuga ndi awa:

• kukula kwa matenda a shuga a ketoacidosis, matenda a shuga kapena chikomokere,
• kuphwanya impso ntchito,
• zikamera ndi kupita patsogolo kwa thupi la wodwalayo matenda owopsa omwe ali ndi chiwopsezo cha impso - kusowa kwamadzi, kutentha thupi, matenda obwera ndi impso, kukulira matenda a bronchopulmonary,
• kukula kwa matenda oopsa komanso osachiritsika omwe angayambitse kupitilira kwa minofu hypoxia,
• kuchitira opaleshoni yayikulu mthupi ndi wodwala kulandira kuvulala kwambiri m'thupi,
• kupezeka ndi kuwonjezereka kwa zovuta pakugwira ntchito kwa chiwindi,
• Wodwala amakhala ndi chidakwa choperewera kapena chakumwa chakumwa choopsa,
• kukula kwa lactic acidosis mthupi,
• kufunikira kwa zakudya zamafuta ochepa,
• nthawi ya bere,
• Nthawi yonyamula mkaka
• wodwalayo ali ndi hypersensitivity pamagawo a mankhwala.

Sizoletsedwa kugwiritsa ntchito Metformin masiku awiri m'mbuyomu komanso masiku awiri atatha kuyesedwa kwa radioisotope pogwiritsa ntchito mankhwala okhala ndi ayodini.

Malangizo ogwiritsira ntchito mankhwalawa

Kuti mudziwe momwe mungamwe mankhwalawo molondola, muyenera kufunsa dokotala. Wodwala ayenera kuphunzira malangizo ogwiritsira ntchito Metformin.

Mlingo wa mankhwalawa umakhazikitsidwa ndi endocrinologist wokhazikika. Dokotala ndi amene amawerengera kuti wodwala aliyense payekhapayekha, poganizira zotsatira zomwe amapezeka poyeserera thupi ndikuzindikira momwe thupi la wodwalayo lilili. Mlingo wa mankhwala omwe wodwala amayenera kumwa umadalira kuchuluka kwa shuga m'magazi am'magazi.

Kuti muthe kutenga Metformin molondola, mlingo woyambirira uyenera kukhala kuchokera 500 mpaka 1000 mg patsiku, ndiwo mapiritsi 1-2. Pambuyo masiku 10 akuvomerezedwa, malinga ndi lingaliro la endocrinologist kuyang'ana wodwalayo, kuwonjezeranso kwakukulu kwa mankhwalawa ndikotheka ngati izi zimafunidwa ndi kuchuluka kwa shuga m'thupi la wodwalayo.

Malangizo ogwiritsira ntchito akutsimikiza kuti mugwiritse ntchito 1500-2000 mg ya mankhwalawa ngati mlingo wokonzera, womwe ndi mapiritsi 3-4, ndipo mlingo waukulu wololedwa kumwa ndi 3000 mg patsiku.

Pankhani ya chithandizo cha matenda a shuga 2 a odwala okalamba, mlingo womwe mankhwalawa amagwiritsidwa ntchito kuchipatala sayenera kupitirira 1 mapiritsi 2 kapena 2 patsiku.

Mapiritsi amayenera kumwedwa pakamwa popanda kutafuna nthawi yakudya kapena itatha. Mankhwala ayenera kumwedwa ndi madzi ochepa. Pofuna kupewa kukula kwa zoyipa mthupi, mulingo wa tsiku ndi tsiku umalimbikitsidwa kuti ugaledwe mu Mlingo wa 2-3.

Popeza mukamamwa mankhwalawa, pamakhala kuthekera kwakukulu kokuluka kwa lactic acidosis, mlingo womwe umagwiritsidwa ntchito pochiza matenda amisempha 2 amachepetsa ngati wodwala ali ndi vuto lalikulu la metabolic.

Pankhani ya munthawi yomweyo makonzedwe ndi insulin muyezo wa osaposa 40 magawo patsiku, mlingo wa mankhwalawa amakhalabe osasinthika. Mankhwala omwe amafunikira tsiku ndi tsiku insulin yoposa 40 magawo patsiku, muyezo wa mankhwala ayenera kumwedwa mosamala kwambiri. Kusankha kwa mankhwala kuyenera kuchitidwa mu chipatala moyang'aniridwa ndi adokotala.

Metformin imangochepetsa kutsata kwa shuga mwa anthu omwe ali ndi matenda ashuga osawonetsa zomwe ali mwa munthu wathanzi.

Zotsatira zoyipa za mankhwala m'thupi

Ndi kugwiritsa ntchito mankhwalawa kwakanthawi, zotheka kuchitika mthupi la mavuto omwe amabwera chifukwa cha kuyamwa kwa vitamini B12.

Ndi kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, muyenera kuwunika chidwi chachikulu kuti muwone momwe minyewa ya chiwindi imagwira ntchito komanso impso.

Mukamagwiritsa ntchito mankhwalawa zotsatirazi zingachitike:

1. Kuchokera pakugwira ntchito kwa m'mimba, matenda osokoneza bongo amatha, kuwonekera mawonekedwe amtundu wa mseru, kusanza, kupweteka pamimba, kuchepa kapena kusowa kwa chakudya, mawonekedwe amtundu wamkamwa wamkamwa.
2. Kuchokera pakhungu pali kuthekera kwa matupi amtundu wa khungu.
3. Dongosolo la endocrine limatha kuyankha kugwiritsa ntchito mankhwalawa popanga machitidwe a hypoglycemic. Nthawi zambiri, zotere zimachitika chifukwa cha kuchuluka kwa mankhwalawa.
4. Kumbali ya njira ya kagayidwe kachakudya nthawi zina, mukamamwa mankhwala osakwanira, kukula kwa lactic acidosis mthupi kungachitike. Izi zikachitika, kusiya mankhwala kumafunika.
5. Njira yozungulira imatha kuyankha mankhwalawa mwa kupangidwa kwa magazi m'thupi.

Chifukwa cha ngozi yayikulu mthupi, kugwiritsa ntchito metformin pamaso pa kulephera kwa impso kumayenera kuyimitsidwa kapena kuyenera kuyang'aniridwa ndi achipatala komanso muyezo wochepa.

Ambiri endocrinologists pankhaniyi amalimbikitsa kuyimitsa mankhwalawo kwathunthu, ndikuyamwa pamtengo wochepetsedwa kwambiri, chifukwa kuyang'anira shuga ndizofunikira.

Chowonadi ndi chakuti kuchuluka kwa shuga m'magazi kungayambitse zovuta zina mthupi zomwe zitha kuchititsa ngozi yakufa.

Malangizo apadera mukamagwiritsa ntchito Metformin

Mukakonzekera kukhala ndi pakati kapena pakachitika, mankhwalawo ayenera kusiyidwa. Ngati muli ndi pakati, kugwiritsa ntchito mankhwalawa panthawi ya gestation kumachotsedwa ndi insulin.

Popeza palibe chidziwitso pakulowerera kwazomwe zimapangidwira mankhwala ndikuphatikizika pakukonzekera mkaka, mukamagwiritsa ntchito yoyamwitsa, kugwiritsa ntchito mankhwalawa kuyenera kuyimitsidwa. Ngati pakufunika kugwiritsa ntchito Metformin panthawi yotsekemera, yoyamwitsa iyenera kuyimitsidwa.

Kugwiritsa ntchito mankhwalawa ndizoletsedwa kwa ana ndi achinyamata osakwana zaka 18.

Madokotala salimbikitsa kugwiritsa ntchito mankhwalawa mankhwalawa odwala matenda ashuga okalamba, omwe zaka zawo zafika zaka 60 ndikugwira ntchito yolemetsa yokhudzana ndi kuwonjezeka kwa thupi. Malangizowa akuchitika chifukwa chakuti odwala oterewa amatha kukulitsa lactic acidosis mthupi.

Pankhani yotenga Metformin, imatha kuphatikizidwa ndi othandizira ochokera ku sulfonylurea. Ndi mankhwala ophatikizika oterowo, kuwunikira mosamala kwambiri momwe chizolo chamagulu a shuga chilili.

Ndi zoletsedwa kumwa mowa ndi mankhwala omwe amakhala ndi ethanol panthawi yomwe amamwa mankhwalawa. Kutenga Metformin nthawi yomweyo ndi mowa kumatha kuyambitsa lactic acidosis mwa wodwala matenda a shuga.

Mukamagwiritsa ntchito mankhwalawa, amaloledwa kuyendetsa magalimoto ndi machitidwe ake, chifukwa kayendetsedwe kake sikukhudza kuyendetsa galimoto.

Mtengo wa Metformin, mawonekedwe ake ndi kuwunika kwa wodwala pakugwiritsa ntchito mankhwalawa

Mankhwala otsatirawa ndi fanizo la Metformin:

• Bagomet,
• Glycon
• Glyminfor,
• Glyformin
• Chikwanje,
• Glucophage Long,
• Langerine
• Methadiene
• Metospanin
• Metfogamm 500, 850, 1000
• Metformin
• Metformin Richter,
• Metformin Teva,
• Metformin hydrochloride,
• Nova Met
• NovoFormin,
• Siofor 1000,
• Siofor 500,
• Siofor 850,
• Sofamet
• Fomu,
• Forin Pliva.

Ndemanga za kugwiritsidwa ntchito kwa mankhwalawa ndi odwala pochiza matenda osokoneza bongo akuwonetsa kuti mankhwalawa amathandizira thupi, omwe amakupatsani mwayi wolamulira kuchuluka kwa shuga m'thupi.

Pali ndemanga zambiri zokhudzana ndi mankhwalawa zomwe zimawonetsa kusintha kwamphamvu m'thupi mukamamwa Metformin kapena mawonekedwe ake ndikuwoneka kuti ali ndi mphamvu pakuthandizira odwala matenda ashuga. Nthawi zambiri, odwala omwe ali ndi matenda a shuga komanso kunenepa kwambiri amawonetsa m'malingaliro awo kuti kugwiritsa ntchito Metformin pantchito yothira mankhwala kumachepetsa kwambiri thupi.

Mtengo wa mankhwalawa m'mafakitare amdzikoli amatengera dera komanso ma CD ake.

Mtengo wa mankhwalawa Metformin Teva 850 mg mdziko muno ndi avareji ma ruble 100 pa paketi iliyonse okhala ndi mapiritsi 30.

Mankhwala ngati Metformin Canon 1000 mg ali ndi mtengo wokwanira m'dziko la ma ruble 270 pachilichonse, omwe ali ndi mapiritsi 60.

Mtengo wa mankhwalawa umadalira kuchuluka kwa mapiritsi omwe ali mumtengowo. Pogula mankhwalawa, muyenera kukumbukira kuti tchuthi chake chimachitika pokhapokha ngati adokotala amapezekapo.

Mu kanema munkhaniyi, Dr. Myasnikov amalankhula za mfundo zomwe Metformin angachite pa matenda ashuga.