The mankhwala Formetin - malangizo, analogues ndi analogi kusintha

Fomu ya kipimo cha Formetin - mapiritsi: 500 mg - kuzungulira, lathyathyathya, oyera, wokhala ndi notch ndi bevel, 850 mg ndi 1000 mg - chowulungika, biconvex, choyera, chokhala ndi notch mbali imodzi. Kulongedza: matumba a matuza - zidutswa 10 chilichonse, pamakatoni a 2, 6 kapena 10, 10 ndi 12 zidutswa zilizonse, pamakatoni a 3, 5, 6 kapena 10.

• yogwira mankhwala: metformin hydrochloride, piritsi limodzi - 500, 850 kapena 1000 mg,
• zina zowonjezera ndi zomwe zili pamapiritsi 500/50 / 10,000 mg: magnesium stearate - 5 / 8,4 / 10 mg, croscarmellose sodium (primellose) - 8 / 13.6 / 16 mg, povidone (povidone K-30, sing'anga wopanga polyvinylpyrrolidone ) - 17/29/34 mg.

Mankhwala

Metformin hydrochloride - chinthu chogwira ntchito cha formin - chinthu chomwe chimalepheretsa gluconeogeneis m'chiwindi, chimathandizira kugwiritsidwa ntchito kwa glucose, kumachepetsa kuyamwa kwa m'matumbo, ndikuwonjezera chidwi cha minofu ya thupi ku insulin. Pankhaniyi, mankhwalawa sakhudzanso kubisika kwa insulini ndi ma cell a beta, komanso samayambitsa kukula kwa hypoglycemic.

Metformin amatsitsa otsika osalimba lipoproteins ndi triglycerides m'magazi. Amachepetsa kapena kukhazikika pamanja.

Chifukwa chokhoza kupondereza minofu ya plasminogen activator inhibitor, mankhwalawa ali ndi mphamvu ya fibrinolytic.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, metformin imatengedwa pang'onopang'ono kuchokera kumimba. Mutamwa mlingo wokhazikika, bioavailability pafupifupi 50-60%. Kuchuluka kwa plasma ndende kumafikira maola 2,5

Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira impso, chiwindi, minofu ndi ma gasi a salivary.

Kutha kwa theka-moyo ndikuchokera maola 1.5 mpaka 4.5. Amadziwitsidwa ndi impso zosasinthika. Odwala omwe ali ndi vuto laimpso, matupi a metformin amatha kuchitika.

Contraindication

• matenda ashuga ketoacidosis,
• diabetesicoma / chikomokere
• chiwindi ntchito,
• kukanika kwa aimpso,
• matenda opatsirana opatsirana
• zamakono kapena mbiri ya lactic acidosis,
• kuchepa madzi m'thupi, kuwonongeka kwa pachimake kwa magazi, kuwonongeka kwamphamvu kwa mtima, kupuma komanso kulephera, kumwa kwambiri komanso matenda ena omwe angapangitse kuti lactic acidosis ichitike,
• kuvulala kwambiri kapena kuchitidwa opaleshoni ngati chithandizo cha insulin chikusonyezedwa,
• poyizoni wazakumwa zoledzeretsa,
• kutsatira zakudya zopatsa mphamvu (zosakwana 1000 kcal / tsiku),
• Mimba ndi kuyamwa
• Maphunziro a X-ray / radioisotope ogwiritsa ntchito iodine okhala ndi kusiyana kwapakati (mkati mwa masiku 2 zisanachitike komanso masiku awiri pambuyo pake),
• Hypersensitivity mankhwala.

Forethine siyikulimbikitsidwa kwa anthu opitirira zaka 60 omwe amagwira ntchito zolimbitsa thupi, popeza ali ndi chiopsezo chokhala ndi lactic acidosis.

Malangizo ogwiritsira ntchito formetin: njira ndi mlingo

Mapiritsi a formethine amawonetsedwa pakamwa. Amayenera kumamwa lonse, osafuna kutafuna, ndi madzi okwanira, nthawi yakudya kapena itatha.

Mlingo woyenera wa wodwala aliyense umakhazikitsidwa payekhapayekha ndipo umatsimikizika ndi kuchuluka kwa shuga m'magazi.

Pa gawo loyambirira la mankhwala, 500 mg nthawi zambiri amalembedwa nthawi 1-2 patsiku kapena 850 mg kamodzi patsiku. M'tsogolomu, osapitirira nthawi 1 pa sabata, mlingo umakulitsidwa pang'onopang'ono. Mulingo wovomerezeka wa Formetin ndi 3000 mg patsiku.

Akuluakulu sayenera kupitilira mlingo wa tsiku lililonse wa 1000 mg. Pazovuta zazikulu za metabolic chifukwa cha chiopsezo chachikulu cha lactic acidosis, mlingo umalimbikitsidwa kuti uchepe.

Zotsatira zoyipa

• ku endocrine system: mukamagwiritsa ntchito mankhwala osakwanira - hypoglycemia,
• kuchokera kumbali ya kagayidwe: kawirikawiri - lactic acidosis (imafuna kusiya mankhwala), ndikugwiritsa ntchito nthawi yayitali - hypovitaminosis B₁₂ (malabsorption)
• Kuchokera mmimba: kulawa kwazitsulo mkamwa, kutsekula m'mimba, kusowa kudya, nseru, kupweteka kwam'mimba, kugona, kusanza,
• Kuchokera ku ziwalo za hemopoietic: kawirikawiri - megaloblastic anemia,
• thupi lawo siligwirizana: zotupa pakhungu.

Bongo

Mankhwala osokoneza bongo a metformin angayambitse kufooka kwa lactic acidosis. Lactic acidosis imatha kukhalanso chifukwa cha kuchuluka kwa mankhwalawa odwala omwe ali ndi vuto laimpso. Zizindikiro zoyambirira za izi: kuchepa kwa kutentha kwa thupi, kufooka, minofu ndi m'mimba, kutsekula m'mimba, mseru, kusanza, Reflex bradyarrhythmia, ndi kuchepa kwa magazi. Mtsogolomo, chizungulire, kupuma mwachangu, kusokonezeka kwa chikumbumtima, chikomokere ndikotheka.

Ngati zizindikiro za lactic acidosis zikuwoneka, muyenera kusiya kumwa mapiritsi a formin ndipo wodwalayo ayenera kuchipatala. Kuzindikira kumatsimikiziridwa kutengera deta ya lactate. Hemodialysis ndiye chinthu chothandiza kwambiri pochotsa lactate m'thupi. Mankhwala ena ndiwowonekera.

Malangizo apadera

Odwala omwe amalandila chithandizo cha metformin ayenera kuyang'aniridwa nthawi zonse kuti a impso. Osachepera 2 pachaka, komanso nkhani ya myalgia, kutsimikiza kwa plasma lactate yofunikira kumafunika.

Ngati ndi kotheka, formin itha kutumikiridwa limodzi ndi sulfonylurea. Komabe, chithandizo chikuyenera kuchitika pang'onopang'ono poonetsetsa kuchuluka kwa shuga m'magazi.

Pa chithandizo, muyenera kupewa kumwa mowa, chifukwa Mowa umakulitsa chiopsezo cha lactic acidosis.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Malinga ndi malangizowo, Formetin, wogwiritsidwa ntchito ngati mankhwala amodzi, sasokoneza kukhudzidwa ndi chidwi cha mayankho.

Pankhani yogwiritsidwa ntchito nthawi yomweyo kwa othandizira ena a hypoglycemic (insulin, sulfonylurea derivatives kapena ena), pamakhala mwayi wamalingaliro a hypoglycemic momwe kuthekera kuyendetsa galimoto komanso kuchita nawo zinthu zoopsa zomwe zimafuna kuthamanga kwa malingaliro ndi thupi, komanso chidwi chowonjezeka.

Kuyanjana kwa mankhwala

Hypoglycemic zotsatira za metformin imatha kupitilizidwa ndi mankhwala a sulfonylurea, osagwiritsa ntchito mankhwala osokoneza bongo, ophatikizira ena, angiotensin-otembenuka a enzyme inhibitors, monoamine oxidase inhibitors, adrenergic blockers, oxytetracycline, acarbose, cyclophosphamide, insulin.

Kutulutsa kwa nicotinic acid, mahomoni a chithokomiro, sympathomimetics, kulera kwapakamwa, thiazide ndi zotupa zotulutsa, glucocorticosteroids, zotumphukira zochokera m'magazi, glucagon, epinephrine amatha kuchepetsa kuchuluka kwa hypoglycemic ya metformin.

Cimetidine amachepetsa kuchotsedwa kwa metformin ndipo, chifukwa chake, amawonjezera chiopsezo cha lactic acidosis.

Kuchepa kwa lactic acidosis kumawonjezeka ndi munthawi yomweyo kugwiritsa ntchito Mowa.

Mankhwala a Cationic amatulutsidwa m'matumbu (quinine, amiloride, triamteren, morphine, quinidine, vancomycin, procainamide, digoxin, ranitidine) kupikisana ndi machitidwe ogwiritsira ntchito ma tubular, kuti athe kuwonjezera kuchuluka kwa metformin ndi 60% ndikugwiritsa ntchito nthawi yayitali.

Nifedipine imathandizira mayamwidwe ndi kuchuluka kwa metformin, imachepetsa mayeso ake.

Metformin itha kuchepetsa mphamvu za ma anticoagulants ochokera ku coumarin.

Zofanizira za Formetin ndi: Bagomet, Glformin, Glformin Prolong, Glucofage, Glucofage Long, Diasphor, Diaformin OD, Metadiene, Metfogamma 850, Metfogamma 1000, Metformin, Metformin Zentiva, Metformin Long, Metformin Long Canon, Metformin S-Metformin S-Metformin S-Metformin Canon, Metformin-Richter, Metformin-Teva, Siofor 500, Siofor 850, Siofor 1000, Sofamet, Fomu Long, Fomu Pliva.

Kodi formetin ndi iti?

Formetin ndi analogue ya mankhwala achijeremani a Glucophage: ili ndi zinthu zomwezo, ili ndi mitundu yofanana ya mapiritsi. Kafukufuku ndi kuwunika kambiri kwa odwala kunatsimikizira kufanana kwa onse a mankhwalawa a shuga. Opanga Formetin ndi gulu la ku Russia la makampani opanga mankhwala a Pharmstandard, omwe tsopano ali ndi udindo waukulu pamsika wamankhwala.

Monga Glucophage, Formetin imapezeka m'mitundu iwiri:

Pakadali pano, metformin imagwiritsidwa ntchito osati pochiza matenda a shuga, komanso matenda ena a pathological omwe amaphatikizidwa ndi insulin.

Madera ena ogwiritsira ntchito mankhwala Fomu:

1. Kupewa matenda a shuga Ku Russia, kugwiritsa ntchito metformin kumaloledwa pachiwopsezo - mwa anthu omwe ali ndi mwayi wambiri wodwala matenda a shuga.
2. Formetin imakupatsani mwayi wolimbikitsira ovulation, chifukwa chake amagwiritsidwa ntchito pokonzekera kutenga pakati. Mankhwalawa amavomerezedwa ndi American Association of Endocrinologists ngati mankhwala a mzere woyamba wa polycystic ovary. Ku Russia, chizindikiro ichi chogwiritsidwa ntchito sichinalembetsedwe, chifukwa chake, sichikuphatikizidwa pamalangizo.
3. Formethine imatha kusintha chiwindi ndi steatosis, yomwe nthawi zambiri imayendera limodzi ndi shuga ndipo ndi amodzi mwa magawo a metabolic syndrome.
4. Kuchepetsa thupi ndi insulin kukana. Malinga ndi madotolo, mapiritsi a Foromu amathandizira kuti pakhale zakudya zochepa zama calorie ndipo amatha kuthandizira kuchepetsa kuwonda kwa odwala omwe ali ndi kunenepa kwambiri.

Pali malingaliro oti mankhwalawa amatha kugwiritsidwa ntchito ngati antitumor othandizira, komanso kuchepetsa kuchepa kwa ukalamba. Zizindikiro izi sizinalembetsedwebe, chifukwa zotsatira za kafukufukuyu ndizoyambiriratu ndipo zimafunanso kuyambiranso.

Zotsatira za pharmacological

Pali zinthu zingapo zomwe zimayambitsa mtima wa kuthamanga kwa shuga kwa Formetin, yomwe palibe yomwe imakhudzana ndi kapamba. Malangizo ntchito zikuwonetsa multifactorial limagwirira zake mankhwala:

1. Imakulitsa chidwi cha insulini (imagwira kwambiri pamlingo wa chiwindi, mpaka kumachepera minofu ndi mafuta), zomwe zimapangitsa shuga kuchepa msanga mukatha kudya. Izi zimatheka pakuwonjezera ntchito ya ma enzymes omwe amapezeka mu insulin receptors, komanso mwa kupititsa patsogolo ntchito ya GLUT-1 ndi GLUT-4, omwe amakhala onyamula shuga.
2. Amachepetsa kupanga shuga mu chiwindi, omwe mu shuga mellitus amawonjezereka mpaka katatu. Chifukwa cha kuthekera, mapiritsi a Forethine amachepetsa kusala bwino shuga.
3. Zimasokoneza mayamwidwe a glucose kuchokera m'matumbo am'mimba, omwe amakupatsani mwayi kuti muchepetse kukula kwa postprandial glycemia.
4. Amakhala ndi anorexigenic pang'ono. Kulumikizidwa ndi metformin ndi mucosa wam'mimba kumachepetsa chilimbikitso, chomwe chimathandizira kuchepetsa thupi pang'onopang'ono. Pamodzi ndi kuchepa kwa kukanira kwa insulini komanso kuchepa kwa kupanga kwa insulin, njira zakugawika kwa maselo amafuta zimayendetsedwa.
5. Zothandiza pamitsempha yamagazi, zimalepheretsa ngozi zam'magazi, matenda a mtima. Zakhazikitsidwa kuti mukamalandira chithandizo ndi Formetin, mkhoma wamitsempha yamagazi umayenda bwino, fibrinolysis imalimbikitsidwa, ndipo mapangidwe amitsempha yamagazi amachepa.

Mlingo ndi malo osungira

Malangizowo akutsimikiza kuti, kuti tikwaniritse kubwezeretsedwera kwa matenda osokoneza bongo komanso kuchepetsa mwayi wosagwirizana, muwonjezere mlingo wa Formetin pang'onopang'ono. Kuti muwongolere njirayi, mapiritsi amapezeka mu njira zitatu. Formetin imatha kukhala ndi 0,5, 0,85, kapena 1 g wa metformin. Formetin Long, mlingo wake ndi wosiyana pang'ono, piritsi la 0,5, 0,75 kapena 1 g la metformin. Kusiyana kumeneku kumachitika chifukwa chogwiritsa ntchito mosavuta, popeza Formetin imaganiziridwa kuti ili ndi mlingo waukulu wa 3 g (mapiritsi atatu a 1 g iliyonse), pomwe Formetin Long - 2.25 g (mapiritsi atatu a 0.75 g aliyense).

Fomu imasungidwa zaka 2 kuyambira nthawi yopanga, yomwe ikuwonetsedwa pamapaketi ndi chithuza chilichonse cha mankhwalawo, kutentha mpaka madigiri 25. Mphamvu ya mapiritsi imatha kufooketsedwa chifukwa chowonekera nthawi yayitali ku radiation ya ultraviolet, chifukwa chake malangizo omwe angagwiritse ntchito akutsimikiza kuti muzisunga matuza azikhala mu katoni.

Momwe mungatengere Fomu

Chifukwa chachikulu chomwe odwala matenda ashuga amakana kulandira chithandizo ndi Formetin ndimafananidwe ake ndi kusapeza komwe kumayenderana ndi kupukusa m'mimba. Chepetsani kuchepa kwawo komanso mphamvu, ngati mumatsatira malangizowo kuchokera pazomwe mungayambire metformin.

Wocheperako poyambira mlingo, zimakhala zosavuta kuti thupi lizolowere mankhwala. Kulandila kumayamba ndi 0,5 g, nthawi zambiri ndimakhala ndi 0,75 kapena 0,85 g mapiritsi amatengedwa mutatha kudya zakudya zabwino, makamaka madzulo. Ngati matenda am'mawa akuvutikira koyambirira kwamankhwala, mutha kuthetsa vutoli ndi zakumwa zochepa zokhala ndi mandimu kapena msuzi wa duwa lakuthengo.

Pakakhala zotsatirapo zoyipa, mankhwalawa akhoza kuchuluka mu sabata limodzi. Ngati mankhwalawa salekerera bwino, malangizowo akuwalangiza kuti achedwetse kuwonjezereka kwa mlingo mpaka kumapeto kwa zizindikiro zosasangalatsa. Malinga ndi odwala matenda ashuga, izi zimatenga milungu itatu.

Mlingo wa matenda a shuga umachulukana pang'onopang'ono mpaka glycemia imakhazikika. Kuchulukitsa mlingo wa 2 g kumayendetsedwa ndi kuchepa kwamphamvu kwa shuga, ndiye kuti njirayo imayamba kuchepa kwambiri, kotero sikuti nthawi zonse kunena mwanzeru kupereka mlingo waukulu. Malangizowa amaletsa kumwa mapiritsi a formmetin pazipita muyezo kwa odwala matenda ashuga (opitilira zaka 60) ndi odwala omwe ali pachiwopsezo cha lactic acidosis. Kutalika kwakukulu komwe waloleza ndi 1 g.

Madokotala akukhulupirira kuti ngati mulingo woyenera wa 2 ga sapereka zofunika kwa glucose, ndizomveka kuwonjezera mankhwala ena pamadongosolo ena. Nthawi zambiri, imakhala imodzi mwa zotumphuka za sulfonylurea - glibenclamide, glyclazide kapena glimepiride. Kuphatikiza uku kumakupatsani mwayi wowirikiza kawiri mphamvu ya chithandizo.

Zotsatira zoyipa

Mukamamwa Formetin, izi ndizotheka:

• mavuto a chimbudzi. Malinga ndi ndemanga, nthawi zambiri amakhala akufotokozedwa mseru kapena m'mimba. Pafupipafupi, odwala matenda ashuga amadandaula za kupweteka pamimba, kupangika kwa mpweya, kakomedwe kazitsulo m'mimba yopanda kanthu,
• malabsorption a B12, amawonetsedwa kokha ngati mawonekedwe a formin,
• lactic acidosis ndichosowa kwambiri koma chowopsa cha matenda ashuga. Itha kuchitika mwina ndi mankhwala osokoneza bongo a metformin, kapena kuphwanya kutulutsa kwake kuchokera m'magazi,
• thupi lawo siligwirizana monga zotupa pakhungu.

Metformin amatengedwa ngati mankhwala okhala ndi chitetezo chokwanira. Zotsatira zoyipa pafupipafupi (zopitilira 10%) ndizovuta zam'mimba zokha, zomwe zimapezeka m'chilengedwe ndipo sizitsogolera matenda. Chiwopsezo cha zotsatira zina zosakhudzidwa sichaposa 0.01%.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Mafanizo otchuka

Monga chidziwitso, timapereka mndandanda wamankhwala omwe adalembetsedwa ku Russian Federation, omwe ali fanizo la Formetin ndi Formetin Long:

Pansi pa dzina lodziwika ngati Metformin, mankhwalawa amapangidwanso ndi Atoll, Rafarma, Biosynthesis, Vertex, Promomed, Izvarino Pharma, Medi-Sorb, Gideon Richter, Metformin Long - Canonfarma, Biosynthesis. Monga tikuonera patebulopo, metformin yambiri pamsika wa Russia ndi yochokera ku India. Ndizosadabwitsa kuti Glucophage yoyambirira, yomwe imapangidwa kwathunthu ku France, imadziwika kwambiri pakati pa odwala matenda a shuga.

Opanga sagwirizana kwenikweni ndi dziko lomwe anachokera metformin. Zomwe zimagulidwa ku India zimadutsa bwino ngakhale kuwongolera kokhwima kwambiri ndipo sizimasiyana ndi French. Ngakhale makampani akuluakulu ku Berlin-Chemie ndi Novartis-Pharma amawaona kuti ndi apamwamba kwambiri komanso ogwira mtima ndipo amawagwiritsa ntchito kuti apange mapiritsi awo.

Formine kapena Metformin - zomwe zili bwino (malangizo a madokotala)

Mwa mitundu ya mankhwala a Glucofage, omwe akupezeka ku Russia, palibe omwe ali osiyana ndi potency mu shuga. Ndipo Fomu, ndi mitundu ingapo yamakampani osiyanasiyana omwe amatchedwa Metformin ali ndi mawonekedwe ofanana ndipo amakhala ndi zotsatirapo zina zoyipa.

Anthu ambiri omwe ali ndi matenda ashuga amagula metformin ya ku Russia mu mankhwala, osalabadira wopanga wina. Mu mankhwala aulere, dzina lokha lokhazikika limasonyezedwa, chifukwa chake, mu pharmacy mutha kupeza zofananira zilizonse zomwe zalembedwa pamwambapa.

Metformin ndi mankhwala otchuka komanso otsika mtengo. Ngakhale Glucofage yoyambayo ili ndi mtengo wotsika kwambiri (kuchokera ma ruble 140), ma analogu apanyumba ndiotsika mtengo kwambiri. Mtengo wa phukusi la Formetin umayambira ma ruble 58 pa mapiritsi 30 ndi mulingo wocheperako ndipo umatha pa ma ruble 450. 60 mapiritsi a Foromu Long 1 g.

Kufotokozera kwa kapangidwe ndi mawonekedwe amasulidwe

Piritsi limodzi lili:

sing'anga yama cell molemera povidone

Formetin imapezeka m'matumba a blister a 100, 60 kapena 30.
Mtundu wa mapiritsiwo ndi woyera, ndipo mawonekedwewo amatengera muyeso wa chinthu chachikulu. Pa 500 mg, ali ndi mawonekedwe ozungulira mozungulira omwe amakhala ndi notch ndi chamfer. Komanso, kuchuluka kwa 1000 mg ndi 850 mg ndi "Fomu". Mapiritsi pamenepa ndi opanikizana komanso owondera. Ali ndi chiopsezo cha mbali imodzi.

Kupita

Mankhwala "Fomu" amagwiritsidwa ntchito pochiza matenda ena ake. Mwachidziwikire, pamaso pa matenda a shuga a 2, pakakhala zovuta kunenepa kwambiri, zakudya sizithandiza kuti shuga ikhale yabwino, ngakhale limodzi ndi sulfonylurea. Chothandizanso ndi "Fomu" yochepetsa thupi.

Kutenga?

Dokotala amasankha kuchuluka kwa mankhwalawa kutengera kuchuluka kwa shuga m'magazi. Kukonzekera kwa pakamwa kuyenera kuchitika mukatha kudya, kumamwa madzi ambiri osaneneka piritsi kuti lingagwiritsidwe ntchito. Monga tanenera kale pamwambapa, mulingo wa mankhwalawo umaperekedwa malinga ndi kuchuluka kwa shuga m'magazi. Zimayamba ndi kuchuluka kwa 0,5 g kapena 0,85 g patsiku. Patatha masiku awiri chiyambireni kumwa mankhwalawa, mawonekedwe a metformin m'magazi amawonedwa. Ngati ndi kotheka, mutha kuwonjezera pang'onopang'ono mlingowo. Ndi ofanana ndi magalamu atatu.

Popeza kakulidwe ka lactic acidosis nthawi zambiri kumawonedwa mwa anthu okalamba, kuchuluka kwa mlingo wa tsiku ndi tsiku ndi 1 g kwa iwo. Komanso, kuchuluka kwa mankhwalawa kumachepetsedwa pakusokoneza kagayidwe kachakudya, kupewa kuyanjana, komwe kumawonetsedwa ngati zotupa pakhungu, ndi zotsatirapo zina zoyipa zomwe zingakambidwe pansipa.

Zotsatira zoyipa

Kupezeka kwa zizindikiro zosasangalatsa ngati "chitsulo" pakamwa, kusanza, nseru, kutsegula m'mimba, mpweya, kusowa kudya kumafunika kusiya kugwiritsa ntchito mankhwalawa ndikulumikizana ndi katswiri. Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kumayambitsa kuphwanya kapena kumaliza kuyamwa kwa vitamini B₁₂, zomwe zimabweretsa kudzikundikira mu thupi lamapeto, ndikupangitsa hypovitaminosis. Nthawi zina, zosiyana zimayamba - megaloblastic B₁₂kuchepa magazi m'thupi. Ndi kumwa kolakwika, hypoglycemia ndiyotheka. Thupi lawo siligwirizana chifukwa cha totupa pakhungu limathanso kuchitika. Chifukwa chake, mankhwalawa "Fomu", mawunikidwe a momwe amagwiritsidwira ntchito, ali osiyana, akuyenera kutumizidwa ndi adokotala okha.

Zotsatira za mankhwalawa pakuwongolera njira ndi magalimoto oyendetsa

Pankhaniyi, palinso ma nuances ena. Mphamvu ya "Fomu" pakuwongolera kayendetsedwe ka kayendedwe ndi kayendedwe imachitika pokhapokha ngati imagwiritsidwa ntchito limodzi ndi mankhwala omwe amakhudza magwiridwe antchito, amafunika mayankho achangu ndikuwonjezera chidwi. Izi ndizofunikira kudziwa.

Gwiritsani ntchito poyamwitsa ndi pakati

Mankhwala "Fomu", malangizo ogwiritsira ntchito omwe akufotokozedwa mulemba ili, ali ndi gawo lowonekera kwa mwana wosabadwayo "B" malinga ndi FDA. Pa nthawi yoyembekezera, mankhwalawa amatha kumwa. Komabe, kugwiritsidwa ntchito kwake kungakhale muzochitika zina. Moona, pamene zotsatira zoyembekezeredwa kuchokera ku mankhwalawa zidzaposa kukhalapo kwa chiwopsezo kwa mwana wosabadwayo. Kafukufuku wina komanso wapadera wogwiritsidwa ntchito ngati mankhwalawa monga "Fomu" sanachitidwe panthawi yapakati. Pa nthawi ya chithandizo ayenera kusiya kuyamwitsa. Mulimonsemo, muyenera kufunsa uphungu wa dokotala woyenera.

"Fomu": analogues

Pali ndalama zambiri zamtunduwu. Zofanizira za "Fomu" ndizokonzekera zomwe zimapangidwa monga gawo lalikulu la metformin hydrochloride. Mwachitsanzo ndi mankhwala a opanga aku Russia: Vero-Metformin, Glformin, Metformin, Metformin Richter, ndi ena akunja - Glucofag, Glucofage ndi Glucofage Long (France), Langerin "(Slovakia)," Metfogamma "yokhala ndi mitundu yosiyanasiyana ya zinthu 0,100, 0,500 ndi 0,850 g (Germany).

Migwirizano ndi magwiritsidwe akusungidwa

Pali zinthu zina pankhaniyi. Mankhwala "Fomu" ndiwokhoza, chifukwa chake amaperekedwa kokha ndi mankhwala ndipo amafunika kusungidwa pamtunda wofunda, kuchokera kwa ana ndi kuwala kwa dzuwa. Alumali moyo wake ndi zaka 2.

Mtengo wapakati wa mankhwalawa "Formetin" umayikidwa kutengera mlingo: kuchokera ma ruble 59. pachimake pa 0,5 g, ma ruble 133. kwa 0,85 g ndi 232 ma ruble. 1 g.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

"Fomu" imapangidwa ngati mapiritsi oyera a biconvex ozunguliridwa ndi mzere mbali imodzi. Phukusili, mulingo umasonyezedwa - 500 mg, 850 mg kapena 1000 mg, kutengera mphamvu ya zinthu zomwe zikugwira.

Mapiritsi okhala ndi zidutswa 10 ali m'matumba, kwathunthu pamakatoni amakhadi 30, 60 kapena 100. Malangizo ogwiritsira ntchito amamangidwa.

Chofunikira chachikulu ndi metformin hydrochloride. Pulogalamuyi imatchulidwa ngati m'badwo wachitatu biguanide. Monga zida zothandizira, povidone imakhala ndi maselo achilengedwe olemera, croscarmellose sodium ndi magnesium stearate.

Opanga INN

"Formetin" ndi amodzi mwa mayina amalonda, dzina losakhala la padziko lonse lapansi ndi metformin hydrochloride.

Mankhwalawa amapangidwa ndi kampani yopanga zoweta - kampani yopanga mankhwala ku Russia yotchedwa Pharmstandard.

Mtengo wake umatengera kuchuluka kwa mapiritsi omwe ali muphukusili ndi kuchuluka kwake. Pafupifupi, mapiritsi 30 a 500 mg aliyense amagula 70 ma ruble, ndipo pamlingo wa 850 mg - 80 rubles.

Zizindikiro ndi contraindication

Chizindikiro chachikulu cha kusankhidwa ndi matenda a shuga a 2. Mankhwalawa ndi othandiza makamaka kwa odwala onenepa omwe amaletsa kudya komanso kuchita masewera olimbitsa thupi. Zitha kutengedwa molumikizana ndi zotumphukira za sulfonylurea. Mankhwala amatha kuthana ndi vuto la hyperglycemia komanso kunenepa kwambiri.

Ngakhale Formentin ndi mankhwala otetezeka kwambiri pakati pa mankhwala onse a hypoglycemic, ali ndi zotsutsana zingapo:

• Hypersensitivity kuti metformin kapena zigawo zina za mankhwala,
• chiopsezo cha lactic acidosis

• chiwindi kapena impso ntchito.
• uchidakwa, mkhalidwe woledzera pachimake,
• njira zopatsirana komanso zotupa,
• ketoacidosis, ketoacidotic precoma kapena chikomokere:
• Zakudya zopatsa mphamvu zochepa
• mbiri yamikwingwirima kapena matenda amtima.

Ndi zilonda zamkati zopweteka pakhungu, kuvulala, mankhwala a insulin amadziwika kuti amathandizira odwala matenda ashuga asanafike kapena atangoyamba kumene. Ngati kuli kofunikira kuchita maphunziro a x-ray pogwiritsa ntchito kukonzekera kwa ayodini masiku angapo kale ndi pambuyo pake, mankhwalawo sagwiritsidwa ntchito.

CHIYAMBI! Chenjezo liyenera kugwiritsidwa ntchito mwa okalamba odwala matenda ashuga (opitilira 65), chifukwa pali chiopsezo cha lactic acidosis.

Malangizo ogwiritsira ntchito (mlingo)

Kuchuluka kwa zinthu zomwe zimagwiritsidwa ntchito koyambirira kwa mankhwala ndi 500-850 mg / tsiku (piritsi limodzi). Popita nthawi, chiwerengero chimasinthidwa. Mulingo wovomerezeka wachifundo ndi 3000 mg / tsiku, komanso kwa okalamba - 1000 mg / tsiku. Tengani tsiku lililonse mlingo wa mankhwalawa tikulimbikitsidwa ndikugawa mu 2 Mlingo, theka la ola musanadye, ndi kapu yamadzi.

Zofunika! Osamachedwetsa kudya mukatha kumwa mankhwalawa, chifukwa izi zimawonjezera mwayi wokhala ndi mikhalidwe ya hypoglycemic.

Kutalika kwa nthawi ya maphunzirowa kukhazikitsidwa ndi adokotala, simungathe kusintha masabata enieni.

Zotsatira zoyipa

Zotsatira zosafunikira nthawi zambiri zimachitika kumayambiriro kwa mankhwala, pomwe thupi silinazolowere. Pakupita milungu ingapo, onse amachoka okha.

Zizindikiro zodziwika bwino ndi izi:

• Kuchokera pamimba yodyetsera - kusokonezeka kwa chopondapo (kudzimbidwa, kutsegula m'mimba, kusowa chilakolako cha chakudya, kupweteka pamimba),
• thupi lawo siligwirizana (zotupa pa nkhope, miyendo kapena pamimba, kuyabwa ndi khungu lotupa),
• kusokonekera kwa mahomoni (mkhalidwe wa hypoglycemic wowonjezereka machitidwe ena a mankhwala ena a hypoglycemic kapena osagwirizana ndi malingaliro a dokotala),
• matenda a metabolic - lactic acidosis, mwadzidzidzi, yomwe ikufunika kuchotsedwa mwachangu),
• kwa magazi: B12-kuchepa magazi m'thupi.

Mimba komanso kuyamwa

Imasungidwa mwa amayi apakati komanso oyamwitsa, chifukwa palibe chidziwitso cha sayansi chokhudzana ndi chitetezo chogwiritsa ntchito nthawi imeneyi. Ngati pali chosowa, ndiye kuti odwala amasamutsidwa kupita ku insulin. Pokonzekera kutenga pakati, wodwalayo ayenera kudziwitsa dokotala za izi kuti athe kusintha mankhwalawo.

Kafukufuku wodalirika wa kuthekera kwa "Fomu" kudutsa mkaka wa m'mawere sanachitike, chifukwa chake, azimayi onyentchera amasiya mankhwalawo. Ngati ndizosatheka kuletsa, kuyamwitsa kuyimitsidwa.

Gwiritsani ntchito muubwana ndi ukalamba

Osamalembera ana ochepera zaka 10, chifukwa palibe chachitetezo. Paukalamba, umawonetsedwa ngati monotherapy kapena kuphatikiza ndi insulin, koma kusintha kwa Mlingo wokhazikika malinga ndi zosowa zokhudzana ndi zaka.

Odwala okalamba, mankhwalawa amatha kusokoneza thanzi la impso, choncho muyenera kuwunika nthawi zonse ntchito yawo. Kuti muchite izi, katatu pachaka kudziwa kuchuluka kwa creatinine mu madzi a m'magazi.

Fananizani ndi fanizo

Pali mankhwala ambiri omwe ali ndi magwiritsidwe ofanana, omwe amasiyanasiyana pafupipafupi pazotsatira zoyipa, contraindication ndi mtengo. Ndi mankhwala ati omwe ayenera kuperekedwa ndi adokotala.

Mankhwala oyambira kutengera metformin amapangidwa ku France. Pali zinthu zomwe zimachitika pafupipafupi komanso kwa nthawi yayitali. Amasiyana ndi "Fomu" ndi mitundu yamagetsi pamavuto ochepa, koma mtengo wake umakhala wokwera kwambiri.

Gawani mankhwalawa matenda a shuga, omwe samayendetsedwa ndi chithandizo chamankhwala. Yotsika mtengo, koma mndandanda wa contraindication ndi zovuta zake ndizambiri.

Kuphatikiza pa metformin, ilinso ndi gawo lina yogwira - vildagliptin. Zotsatira zake, mphamvu ya hypoglycemic imakhala yamphamvu kwambiri kuposa ma analogu ena. Choyipa chachikulu ndi mtengo wokwera (kuchokera pa ma ruble 1000 paphukusi lililonse).

Malingaliro a odwala matenda ashuga okhudza mankhwalawo agawidwa. Odwala omwe amatenga nthawi yayitali amakhutira ndi zomwe zimachitika. Omwe amagwiritsa ntchito posachedwa amalankhula za zovuta zoyambira.

Valentina Sadovaya, wazaka 56:

“Kwa zaka zingapo ndinatenga Gliformin, koma mathero ake adayamba kuchepa pakapita nthawi. "Fomu" adasandulika kukhala woyenera kuloweza - pamimba yopanda kanthu m'mimba shuga sakwera pamwamba 6 mmol / l. M'masabata oyambilira ovomerezeka, vuto la chopondapo linawonedwa, koma zonse zidapita mwachangu. Ndakondwera kwambiri ndi mtengo wotsika. "

Peter Kolosov, wazaka 62:

"Adotolo adandisamutsira ku Formetin masabata angapo apitawo. Munthawi imeneyi, zizindikilo zambiri zosafunikira zidawonekera: kufooka, chizungulire, mseru, komanso vuto la chopondapo. Izi zimabweretsa kudwala kovuta, zovuta kuntchito. Mwina, ndikupemphani kuti mundipatse mankhwala ena. ”

Forethine ndiwothandiza kuwongolera T2DM, makamaka kwa odwala onenepa kwambiri. Poyamba, zoyipa zimatha kuchitika, koma m'kupita kwa nthawi zimadutsa. Ubwino wa mankhwalawo ndi mtengo wake wotsika. Musanatenge, muyenera kufunsa dokotala.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa akuwonetsedwa kwa odwala onenepa kwambiri komanso onenepa kwambiri omwe amalephera kudya matenda ashuga Mitundu iwiri yomwe simakonda ketoacidosis.

Mwakutero, Formetin yochepetsa thupi sinafotokozedwe, ngakhale mutamwa mankhwalawo, kulemera kwa odwala kumachepa kwenikweni. Mankhwala amagwira ntchito limodzi mankhwala a insulin ndi kutchulidwa kunenepa, yomwe imadziwika ndi kukana insulini kwachiwiri.

Malangizo ogwiritsa ntchito formetin (njira ndi Mlingo)

Mlingo wa mankhwalawa uyenera kutsimikiziridwa ndi dokotala aliyense payekha atatha kuwunika bwino matenda ake komanso kuopsa kwa matendawo.

Komabe, malangizo ogwiritsira ntchito Foretin akusonyeza kuchuluka kwa mankhwalawa tsiku lililonse a mankhwalawa - kuyambira 500 mpaka 1000 mg / tsiku.

Kusintha kwa mankhwalawa pakuwonjezeka kungachitike pambuyo masiku opitilira masiku 15 chiyambireni chithandizo champhamvu shuga m'magazi a wodwala. Mlingo wokonza mankhwalawa pafupifupi 1,500-200 mg / tsiku, koma sayenera kupitirira 3,000 mg / tsiku. Kwa odwala okalamba, mlingo woyenera wa tsiku lililonse sayenera kupitirira 1 g.

Kupewa lactic acidosis zochizira odwala kagayidwe kachakudya matenda Mlingo wotsika umalimbikitsidwa.

Mapiritsi a Formetin amatengedwa mukatha kudya, mlingo wa tsiku ndi tsiku umatha kugawidwa m'magawo awiri awiri awiri kuti mupewe zoyipa zamagetsi.

Kuchita

Sitikulimbikitsidwa kuti mutenge formethine limodzi ndi:

• Danazolkupatula kuchuluka kwa zotsatira zam'magazi,
• Chlorpromazinekupewa glycemia,
• Acarbase monoamine oxidase inhibitorsndiangiotensin akatembenuka enzyme, zotumphukira za sulfonylureandi Clofibrate, mankhwala osokoneza bongo a anti-yotupa, oxytetracyclinendiβ-blockerskupewa kuwonjezera katundu metformin, gawo la Forethine,
• Cimetidinezomwe zimachepetsa ntchito yochotsa m'thupi metformin,
• njira zakulera za pakamwa, glucagon, thiazide diuretics, mahomoni a chithokomiro, zotupa za nicotinic acid ndi phenothiazinekuteteza kuchepa kwa ntchito metfomina,
• zotumphukira coumarin (anticoagulants)popeza metforminImafooketsa mphamvu yawo.

Kuphatikiza apo, ndizoletsedwa kumwa mankhwala ndikumwa mowa, monga Izi zimawonjezera mwayi wakukulalactic acidosis.

Mlingo wa formin umafunika pambuyo kapena nthawi ya odwala antipsychotic.

Ndemanga za Formetin

Odwala akuvutika matenda ashuga ndipo omwe adayesa momwe mankhwalawo amadziwonera okha, siyani ndemanga zotsutsana pa Foromu pamaforamu. Si odwala onse omwe amalandira mankhwalawa chimodzimodzi.

Ambiri monga chinthu choyipa amatchula mndandanda wochititsa chidwi wa zotsutsana, komanso kuti akamamwa mankhwalawa, amayenera kuwunika mosamala kugwiritsa ntchito zida zina zamankhwala ndikusankha kuphatikiza kwa mankhwala komwe kuli kotetezeka kwa thanzi ndi moyo.

Fomu yovomerezeka: mitengo yamafakitale apakompyuta

Phatikizani mapiritsi a 500 mg 30 ma PC.

FORMETIN 0,5 g 30 ma PC. mapiritsi

FORMETIN 0,5 g 60 ma PC. mapiritsi

Phatikizani mapiritsi a 500 mg 60 ma PC.

Fomu mapiritsi a 850 mg 30 ma PC.

Fomu 1 g mapiritsi 30 ma PC.

FORMETIN 1 g 30 ma PC. mapiritsi

Forine 850 mg mapiritsi 60 ma PC.

FORMETIN 0,85 g 60 ma PC. mapiritsi

FORMETIN 1 g 60 ma PC. mapiritsi

Fomu 1 g mapiritsi 60 ma PC.

Tabulo la formethine. 1g n60

Fomu yayitali tabu. kutalika. kumasulidwa n / ogwidwa. 750mg No. 30

Forine Long 750 mg yolimba yotulutsa mapiritsi otsekemera 30-ma PC.

Fomu yayitali tabu. kutalika. kumasulidwa n / ogwidwa. 500mg No. 60

Forin Long 500 mg yolimba yotulutsa mapiritsi otsekemera 60-ma PC.

Teteni yayitali tabu. kutalika. kumasulidwa n / ogwidwa. 750mg No. 60

Formethine Long 750 mg yolimba yotulutsa mapiritsi otsekemera 60-ma PC.

Maphunziro: Yoyamba University State Medical University yotchedwa I.M. Sechenov, wapadera "General Medicine".

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo ovomerezeka. Kudzipatsa nokha mankhwala kuopsa!

Kulemera kwaubongo wamunthu kuli pafupifupi 2% ya kulemera konse kwathupi, koma kumadya pafupifupi 20% ya mpweya womwe umalowa m'magazi. Izi zimapangitsa kuti ubongo wamunthu ukhale wovuta kwambiri kuwonongeka chifukwa cha kusowa kwa mpweya.

Pochezera pafupipafupi pakama pofufuta, mwayi wokhala ndi khansa yapakhungu umawonjezeka ndi 60%.

Nthawi yayitali yotsala ndiyotsika ndi yoyipa.

Ngakhale mtima wa munthu sugunda, akhoza kukhalabe ndi moyo nthawi yayitali, monga asodzi aku Norweji a Jan Revsdal. "Galimoto" yake idayima kwa maola 4 asodzi atasowa ndikugona mu chisanu.

Kuti tinene ngakhale mawu afupi komanso osavuta, timagwiritsa ntchito minofu 72.

Poyesera kuti wodwalayo atuluke, madokotala nthawi zambiri amapita kutali kwambiri. Ndiye, mwachitsanzo, Charles Jensen wina mzaka kuyambira 1954 mpaka 1994. adapulumuka ntchito zopitilira 900 neoplasm.

Asayansi ochokera ku Oxford University adachita kafukufuku wambiri, pomwe adazindikira kuti zamasamba zimatha kuvulaza ubongo wa munthu, chifukwa zimapangitsa kuti kuchuluka kwake kuzikhala kochepa. Chifukwa chake, asayansi amalimbikitsa kuti asachotsere konse nsomba ndi nyama muzakudya zawo.

Kuphatikiza pa anthu, cholengedwa chimodzi chokha padziko lapansi - agalu, omwe ali ndi vuto la prostatitis. Awa ndi abwenzi athu okhulupilika kwambiri.

Asayansi aku America adayesera mbewa ndipo adati madzi amadzi amalepheretsa kukula kwa atherosulinosis yamitsempha yamagazi. Gulu limodzi la mbewa limamwa madzi am'madzi, ndipo lachiwiri ndi madzi a mavwende. Zotsatira zake, zombo za gulu lachiwiri zinali zopanda ma cholesterol.

Malinga ndi kafukufuku, azimayi omwe amamwa magalasi angapo a mowa kapena vinyo pamlungu amakhala pachiwopsezo chotenga khansa ya m'mawere.

Mankhwala odziwika bwino "Viagra" adapangidwa poyambirira pochizira matenda oopsa.

Ngati mungagwere kuchokera pabulu, mukulola khosi lanu kusiyana ndi kugwa kuchokera pa kavalo. Ingoyesani kutsutsa mawu awa.

Mankhwala akutsokomola "Terpincode" ndi amodzi mwa atsogoleri ogulitsa, ayi chifukwa cha mankhwala ake.

Munthu aliyense samangokhala ndi zala zapadera, komanso chilankhulo.

Magawo anayi a chokoleti chakuda ali ndi zopatsa mphamvu pafupifupi mazana awiri. Chifukwa chake ngati simukufuna kukhala bwino, ndibwino kuti musadye zopitilira awiri patsiku.

Chiwerengero cha ogwira ntchito muofesi chakwera kwambiri. Izi ndizodziwika kwambiri m'mizinda yayikulu. Ntchito yamaofesi imakopa amuna ndi akazi.

Zotsatira zoyipa ndi malo apadera

Zotsatira zoyipa za thupi la munthu pomwa mankhwalawo "Fomati" zikuphatikiza mndandanda wazizindikiro:

- "zitsulo" mkamwa,

- nseru ndi kusanza,

- zotupa zake (mwachitsanzo, zotupa pakhungu).

Zitachitika izi pamwambapa, muyenera kusiya mankhwalawa ndikuyang'ana katswiri. Kuphatikiza apo, ndikofunikira kukumbukira kuti ngati mankhwala akhala akugwiritsidwa ntchito kwa nthawi yayitali pogwiritsa ntchito mankhwalawa "Formetin", kuphwanya kapena kuthetsa kuyamwa kwa vitamini B12 kumatha kuchitika, komwe kumayambitsa hypovitaminosis yosagonjetseka (nthawi zambiri kumayiko osagwirizana - megaloblastic B12-kuchepa magazi m'thupi). Kuwerengera molakwika mlingo, hypoglycemia imayamba.

Chifukwa cha kuchuluka kwa mankhwala omwe ali mu fomu "Fomu" m'thupi la munthu, ndikofunikira kupewa zotulukazi. Chifukwa chake, kupatula kuphatikiza metformin ndi kupewa lactic acidosis, muyenera kuyang'anira ntchito za impso ndikuchitika maphunziro kuti mudziwe kuchuluka kwa lactic acid mthupi (osachepera 2 pachaka). Ndipo pakakumana ndi vuto la ululu mosayembekezereka m'matumbo a minofu, kuwunika kofunikira mwachangu ndikofunikira.

Kugwiritsa ntchito mankhwalawa "Formetin" kumafuna kufufuza mwatsatanetsatane chidziwitso chokhudzana ndi kugwiritsidwa ntchito kwa mankhwala. Pofuna kupatula chitukuko cha lactic acidosis ndi zotsatirapo zina zosayenera, malangizo a dokotala amayenera kutsatiridwa mosamalitsa ndipo malangizo ogwiritsira ntchito akuyenera kutsatiridwa. Mwachitsanzo, yogwira mankhwala metformin, yomwe imawonjezera shuga m'magazi, imakulitsa kwambiri zotsatira zake kuphatikiza ndi mankhwala omwe si a anti -idalidal, ndipo ngakhale mutamwa mankhwala a endocrine, kuletsa kwa njira ya hypoglycemic ndikotheka.

Mankhwala osokoneza bongo akuti "Fomu" amatha kuchitika ngakhale tsiku lililonse ndi 0,85 magalamu. Inde, kudzikundikira kwa metformin mthupi la munthu, komwe kumayambitsa kukula kwa lactic acidosis, kumatha kuchitika chifukwa cha kuwonongeka kwa impso. Zizindikiro zazikulu kumayambiriro kwa lactic acidosis ndi izi:

- kufooka kwa thupi lonse,

- kutsitsa kutentha kwa thupi,

- kupweteka m'mimba ndi minofu,

- kuchepa kwa kuthamanga kwa magazi,

- kusokonezeka kwa chikumbumtima komanso chizungulire.

Ngati chizindikiro ichi chikupezeka palokha, wodwalayo ayenera kusiya kumwa mapiritsi a "Fomu" ndikuwona dokotala. Potsimikizira kupezeka kwa lactic acidosis, chinthu chogwira ndi lactic acid kuchokera mthupi, monga lamulo, amachotseredwa ndi hemodialysis ndi munthawi yomweyo.

Akatswiri ambiri komanso odwala amachitapo kanthu mogwirizana ndi mankhwalawo "Fomu", ngakhale atakhala ndi mndandanda wochititsa chidwi wa zotsutsana ndi zoyipa. Kupatula apo, mankhwalawa amagwira ntchito moyenera. Chachikulu ndikutsatira mosamalitsa malangizo a akatswiri odziwa bwino zaumoyo komanso zofunikira za malangizo omwe angagwiritse ntchito kuchokera kwa wopanga.

Nikolai wa ku Tomsk: “Kwa nthawi yayitali ndakhala ndikudwala matenda a shuga. Dokotala adalemba mapiritsi a Prescription Methine. Ndipo kwa zaka zambiri tsopano ndakhala ndikumwa iwo kuti achepetse shuga. Mu phukusi la mapiritsi 60 a 1.0 g. Ndikofunikira kwambiri kwa ine kuti metformin (gawo lomwe limagwira ntchito) limalepheretsa gluconeogenesis m'chiwindi, limachepetsa kuyamwa kwa glucose m'matumbo, komanso limathandizira kugwiritsidwa ntchito kwina kwa glucose ndikuwonjezera chidwi cha minofu kuti ipangire insulin. Mankhwalawa amandithandizira komanso amachepetsa thupi. Pali zovuta zoyipa zomwe zimachitika ndi mseru komanso kukoma mkamwa, kuchepa kwa chakudya ndi kupweteka kwam'mimba, zomwe nthawi zina zimachitika. Ndimamwa piritsi limodzi katatu patsiku. "Mankhwalawa amandithandiza kwambiri, ndipo sindingakhale ndi moyo popanda iwo."