Momwe mungagwiritsire ntchito mankhwala Xenical?

Fomu ya Mlingo - makapisozi: Na. 1, gelatin, turquoise, wokhala ndi mawonekedwe olimba a opaque ndi cholembedwa chakuda: pa XENICAL 120 kesi, pa chifuwa cha ROCHE, mkati mwa makapisozi - ma pellets a pafupifupi oyera kapena oyera (21 ma PC. matuza, pamakatoni okhala ndi matuza 1, 2 kapena 4).

The yogwira thunthu wa Xenical ndi orlistat, 1 kapisozi - 120 mg.

Othandizira: talc.

Zothandiza pazinthu za pellets: sodium carboxymethyl starch (Primogel), microcrystalline cellulose, sodium lauryl sulfate, povidone K-30.

Mapangidwe a chipolopolo cha kapisozi: indigo carmine, gelatin, titanium dioxide.

Mankhwala

Xenical ndi mwachindunji, wamphamvu, komanso chosinthika chosakanizira cha lipases yam'mimba, yodziwika ndi zotsatira zazitali. Zake achire zotsatira zimachitika mu lumen yaingʻono m'mimba ndi m'mimba ndipo amapangidwa mu mgwirizano wolumikizana ndi yogwira serine dera pancreatic ndi chapamimba lipases. Pankhaniyi, enzyme yovomerezeka imataya mphamvu yophwanya mafuta omwe amaperekedwa ndi chakudya mu mawonekedwe a triglycerides mu monoglycerides ndikugwira mafuta acids aulere. Popeza ma triglycerides omwe samatsitsidwa m'thupi samatengedwa, zopatsa mphamvu zochepa zimalowa m'thupi, zomwe zimapangitsa kuchepa kwa thupi. Kuphatikiza apo, achire zotsatira za Xenical amazindikira popanda kulowa kwa zigawo zake mu kayendedwe kazinthu.

Zambiri pazokwanira mafuta okwanira ndowe zimasonyeza kuti orlistat imayamba kugwira ntchito patatha maola 24-48 pambuyo pobowoka. Kutha kwa mankhwalawa kumabweretsa kuchepa kwa kuchuluka kwa mafuta mu ndowe mpaka muyeso womwe unalembedwa musanachitike mankhwala, pambuyo pa maola 48-72.

Kafukufuku wachipatala cha odwala omwe amatenga Xenical amatsimikizira kuti amachepetsa thupi kwambiri poyerekeza ndi odwala omwe amadziwika kuti amadya mankhwala. Kuchepa kwa thupi kunadziwika kale masabata awiri oyambilira atangoyamba kumene chithandizo ndipo adakhalako miyezi 6-12 ngakhale kwa odwala omwe sanachite bwino pakudya. Pakupita kwa zaka ziwiri, kusintha kwakukulu kwa ziwonetsero za zinthu zomwe zimayenderana ndi kunenepa kunalembedwa. Komanso, poyerekeza ndi placebo, kuchepa kwakukulu kwamafuta amthupi kunawonedwa.

Kugwiritsa ntchito orlistat kumalepheretsa kukhazikitsanso thupi. Kuwonjezeka kwa kulemera kwa thupi kosaposa 25% ya kulemera kotayika kumawonedwa pafupifupi 50% ya odwala, pomwe ena onse amakhalanso ndi thupi lomwe lidafikiridwa panthawi yotsiriza ya chithandizo (nthawi zina ngakhale kutsika kwina kunawululidwa).

Kafukufuku wachipatala otenga miyezi isanu ndi umodzi mpaka chaka chimodzi adatsimikizira motsimikiza kuti odwala omwe ali ndi kunenepa kwambiri kapena kunenepa kwambiri komanso mtundu wa 2 wodwala matenda ashuga omwe adatenga Xenical, thupi limatsika kwambiri kuposa odwala omwe adalandira mankhwala okhawo omwe adalandira chithandizo chamankhwala . Kuchepetsa thupi kunachitika makamaka chifukwa cha kuchepa kwa mafuta m'thupi. Asanayambe phunziroli, ngakhale odwala omwe amamwa mankhwala a hypoglycemic, kuwongolera glycemic kunali kosakwanira. Komabe, ndi chithandizo cha orlistat, kusintha kwakufunika kwamatenda ndikuwonjezereka kudakwaniritsidwa. Komanso, chithandizo chamankhwala chinayambitsa kutsika kwa insulin, kuchepa kwa milingo ya mankhwala a hypoglycemic, ndi kuchepa kwa insulin.

Zotsatira za maphunziro omwe adachitika zaka zopitilira 4 zimatsimikizira kuti orlistat imachepetsa kwambiri chiopsezo chokhala ndi matenda a shuga 2 mellitus (pafupifupi 37% poyerekeza ndi placebo). Kuchuluka kwa kuchepetsa matendawa kunali kofunika kwambiri kwa odwala omwe ali ndi vuto loyipa la glucose (pafupifupi 45%).

Kafukufuku wazachipatala wazaka 1 komanso wothandizidwa ndi gulu la odwala msinkhu, onenepa kwambiri, akuwonetsa kuchepa kwa chidziwitso cha kuchuluka kwa thupi mwa achinyamata omwe akutenga orlistat poyerekeza ndi iwo omwe adalandira placebo okha. Komanso, odwala omwe amatenga Xenical adawonetsa kuchepa kwamafuta ndi kuzungulira kw m'chiuno ndi m'chiuno komanso kuchepa kwakukulu kwa kuthamanga kwa magazi poyerekeza ndi gulu la placebo.

Pharmacokinetics

Odwala omwe ali ndi kunenepa kwambiri komanso kulemera kwakanthawi kwamthupi, zomwe zimachitika chifukwa cha Xenical zimachepetsedwa. Kukhazikika kamodzi pakamwa pa mankhwala osokoneza bongo a 360 mg sikumayambitsa kuoneka kwa orlistat yosasinthika mu plasma, zomwe zikuwonetsa kuti kupindika kwake sikufika pamlingo wa 5 ng / ml.

Kuchuluka kwa kugawa kwa orlistat sikungatheke kudziwa chifukwa chosamveka bwino. Mu vitro, phula limaposa 99% yomanga ma protein a plasma (makamaka albumin ndi lipoproteins). Orlistat yochepa imatha kulowa mu erythrocyte membrane.

Metabolism ya Orlistat imachitika makamaka khoma lamatumbo. Kuyesaku kunawonetsa kuti pafupifupi 42% ya kachigawo kakang'ono ka Xenical kamene kamayamwa mwa dongosolo ndi ma metabolites awiri akuluakulu: M1 (mphete ya hydro-lactone ya anayi) ndi M3 (M1 yokhala ndi gawo la N-formylleucine).

Ma molekyulu a M1 ndi M3 ali ndi ling'i lotseguka la β-lactone, komanso amalepheretsa kwambiri lipase (1000 ndi 2500 nthawi yocheperapo kuposa orlistat, motsatana). Ma metabolites awa amawerengedwa ngati mankhwala chifukwa cha kuchepa kwambiri kwa ntchito komanso kutsika kwa ma plasma (pafupifupi 26 ng / ml ndi 108 ng / ml, motsatana) mukamamwa Xenical mumadontho ang'ono.

Njira yayikulu yochotsera imaphatikizapo kuchotsedwa kwa orlistat yosagwira ndi ndowe. Ndi ndowe, pafupifupi 97% ya Mlingo wovomerezeka wa Xenical amachotsedwa, pafupifupi 83% yosasinthika. Kutupa kwathunthu kwa impso pazinthu zonse zomwe kapangidwe kake kamalumikizidwa ndi orlistat ndizochepera 2% ya mlingo wamlomo. Nthawi ya kuchotsedwa kwathunthu kwa mankhwala m'thupi (ndi mkodzo ndi ndowe) ndi masiku 3-5. Chiwerengero cha njira zochotsera gawo lothandizira la Xenical mwa anthu omwe ali ndi thupi labwino komanso odwala onenepa kunalinso chimodzimodzi. Orlistat ndi metabolites M1 ndi M3 amathanso kuthiridwa ndi ndulu. Kuyang'ana kwa plasma pochiza ana sikusiyana ndi kwa anthu akuluakulu akamamwa mankhwala omwewo. Mafuta a tsiku ndi tsiku omwe amadzazidwa ndi ndowe pochizira Xenical anali 27% pamene amamwa mankhwalawo ndi chakudya komanso 7% akamamwa placebo.

Zidziwitso za Preclinical ndi kafukufuku wazinyama sizinawonetse zovuta zowonjezera kwa odwala zokhudzana ndi chitetezo, kuwopsa, poizoni, kubereka ndi gencinogenicity. Komanso, kukhalapo kwa mphamvu ya teratogenic mu nyama sikumatsimikiziridwa, zomwe zimapangitsa kuti zikhale zosatheka mwa anthu.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito Xenical kumawonetsedwa limodzi ndi zakudya zopatsa mphamvu zochepa zopatsa mphamvu kwa nthawi yayitali kapena kunenepa kwambiri, kuphatikiza kwa odwala omwe ali pachiwopsezo chofanana ndi kunenepa kwambiri.

Mankhwalawa amathandizira odwala omwe ali onenepa kwambiri kapena onenepa kwambiri pochiza matenda a shuga 2 omwe amaphatikizidwa ndi ma hypoglycemic wothandizila: insulin, metformin, sulfonylurea zotumphukira kapena zakudya zochepa zopatsa mphamvu.

Contraindication

Cholestasis
Matenda a malabsorption,
Nthawi yokhala ndi pakati komanso yoyamwitsa,
Hypersensitivity pamagawo a mankhwala.

Chitetezo ndi kugwiritsa ntchito mankhwalawa kwa odwala omwe ali ndi vuto la Impso ndi kwa chiwindi, odwala okalamba komanso ana osaposa zaka 12 sanafufuzidwe.

Malangizo ogwiritsira ntchito Xenical: njira ndi mlingo

Makapisozi amatengedwa pakamwa, panthawi kapena nthawi yomweyo (mkati mwa ola limodzi) mutatha kudya.

Mlingo woyenera: 1 kapisozi katatu pa tsiku, pakudya iliyonse yayikulu.

Ngati chakudyacho chilibe mafuta kapena wodwalayo amadumphira chakudya cham'mawa, chakudya chamadzulo kapena chamasana, ndiye kuti tsiku lililonse mankhwalawa amachepetsedwa ndi kuchuluka kwa chakudya chosadukiza.

Chakudya chopatsa thanzi, chochepa komanso chopatsa mphamvu chama calorie chiyenera kukhala ndi 30% mafuta. Zakudya za calorie za tsiku ndi tsiku, zomwe zimakhala ndi mafuta, mapuloteni ndi chakudya, ziyenera kugawidwa m'njira zitatu zazikulu.

Zotsatira zoyipa

M'maphunziro azachipatala ogwiritsa ntchito Xenical, zotsatirazi zotsatirazi zidachitika:

Kuchokera pamimba: m'mimba kwambiri mu chakudya), nthawi zambiri - kumatulutsa, pogona zofewa, kusakhazikika kwachilendo, kupweteka kapena kusapeza bwino mu rectum, kuwonongeka kwa mano ndi / kapena mano,
Zina: Nthawi zambiri - kupweteka mutu, chapamwamba kupuma thirakiti, chimfine, kufooka, dysmenorrhea, nkhawa, kwamikodzo ndimatenda am'mimba opatsirana, mwa odwala omwe ali ndi matenda a matenda a shuga 2 - matenda a hypoglycemic.

Powona zotsatsa pambuyo pa malonda, milandu yomwe ingakhalepo yotsatira ikufotokozedwa:

Thupi lawo siligwirizana: kawirikawiri - kuyabwa, zotupa pakhungu, bronchospasm, urticaria, anaphylaxis, angioedema, osowa kwambiri - chotupa champhongo,
Zina: kawirikawiri - ntchito yowonjezera ya alkaline phosphatase ndi transaminases, hepatitis, magazi, rectal, diverticulitis, kapamba, cholelithiasis ndi oxalate nephropathy (pafupipafupi mwadzidzidzi sichikudziwika).

Bongo

Kafukufuku wamankhwala omwe anthu omwe ali ndi vuto lolemera la thupi komanso odwala onenepa kwambiri adatenga nawo gawo, omwe adatenga mlingo umodzi wa 800 mg kapena adalandira chithandizo cha Xenical kwa masiku 15 ndikuulandila pa 400 mg katatu katatu patsiku, sizitsimikizira kuti pakachitika zochitika zovuta kwambiri. Komanso, mwa odwala omwe amatenga orlistat 240 mg katatu pa tsiku kwa miyezi 6, panalibe zovuta zathanzi.

Chifukwa chake, ndi mankhwala osokoneza bongo a Xenical, zochitika zovuta sizikupezeka kapena zofanana ndi zomwe zalembedwera ndikugwiritsa ntchito mankhwalawa. Ndi mankhwala ambiri osokoneza bongo, kuyang'anira wodwalayo kwa maola 24 akulimbikitsidwa. Malinga ndi kafukufuku wazinyama ndi anthu, zonse zomwe zimapangidwa ndi lipase-inhibiting ya orlistat zimasinthidwa mwachangu.

Malangizo apadera

Malinga ndi malangizowo, Xenical yogwiritsa ntchito nthawi yayitali imakupatsani mwayi wochepetsera komanso kukonza thupi pang'onopang'ono, kupewa, kuchulukitsa mapaundi owonjezera.

Kupitilira muyeso wa orlistat yolimbikitsidwa sikupangitsanso mphamvu yake yochizira.

Mphamvu ya mankhwalawa imachepetsa kuchuluka kwa mafuta a visceral ndikuwongolera mawonekedwe a chiopsezo ndi ma pathologies omwe amachitika chifukwa cha kunenepa kwambiri, kuphatikizapo kulolerana kwa shuga, mtundu 2 shuga, hyperinsulinemia, hypercholesterolemia, matenda oopsa.

Munthawi yomweyo kupatsidwa mankhwala ndi hypoglycemic wothandizila (sulfonylurea zotumphukira, metformin, insulini) ndi zakudya amtengo hypocaloric amalola odwala matenda amtundu wa 2 omwe ali ndi kunenepa kwambiri kapena kunenepa kwambiri kuti apititse patsogolo kubwezeretsa kwa chakudya.

Odwala ambiri, atatha zaka zinayi akugwiritsa ntchito orlistat, maphunziro azachipatala amatsimikizira zomwe zili betacarotene ndi mavitamini A, D, E, K mkati mwazotheka.Kuti apatse thupi chakudya chokwanira, multivitamini amawonetsedwa.

Zakudya zopatsa thanzi zochulukirapo ziyenera kukhala zopatsa thanzi, zokhala ndi zipatso ndi ndiwo zamasamba zambiri komanso 30% kapena zochepa zama calories m'njira yamafuta. Zakudya za tsiku ndi tsiku zopatsa mphamvu, mafuta ndi mapuloteni ayenera kudyedwa m'magawo atatu akuluakulu.

Kuwonongeka kwa zovuta za mankhwala kuchokera m'matumbo am'mimba kumawonjezeka motsutsana ndi maziko a zakudya zamafuta.

Kugwiritsidwa ntchito kwa Xenical mu mtundu 2 wa shuga kumawongolera kubwezeretsa kwa kagayidwe kazakudya ndipo kungayambitse kufunika kochepetsa mlingo wa othandizira a hypoglycemic.

Mimba komanso kuyamwa

Kafukufuku woletsa poizoni wa nyama sanawonetse mtundu wa teratogenic komanso embryotoxic zotsatira za Xenical. Amaganiziridwa kuti mankhwalawa ndi otetezeka kwa amayi apakati, komabe, chifukwa cha kusowa kwa chidziwitso chotsimikizika cha chipatala, kayendetsedwe kake panthawiyi sikokwanira. Sizikudziwika kwenikweni ngati orlistat imadutsa mkaka wa m'mawere, ndiye kuti muyenera kusiya kuyamwitsa pakumwa.

Kuyanjana kwa mankhwala

Panalibe kuyanjana kwa mankhwalawa kwa Xenical ndi kugwiritsa ntchito pamodzi kwa amitriptyline, atorvastatin, biguanides, digoxin, fibrate, fluoxetine, losartan, phenytoin, njira zakulera zam'mlomo, phentermine, pravastatin, warfarin, nifedipine, mankhwala am'mimba a freeine. Komabe, zikaphatikizidwa ndi anticoagulants am'mlomo, kuphatikizapo warfarin, tikulimbikitsidwa kuti zisonyezo zamtundu wa Internationalised ratio (INR) ziwunikidwe.

Pali kuchepa kwa mayamwidwe a betacarotene ndi mavitamini D, E, kotero multivitamini ayenera kumwedwa asanagone kapena maola awiri atatha kumwa mankhwalawa.

Kuphatikizika ndi cyclosporine kungayambitse kuchepa kwa kuchuluka kwake m'magazi amadzi, motero, ndikofunikira kudziwa pafupipafupi zomwe zili mu plclma ya cyclosporine akaphatikizidwa ndi orlistat.

Chifukwa cha kuchepa kwa maphunziro a pharmacokinetic, kugwiritsa ntchito nthawi yomweyo kwa acarbose kumatsutsana.

Poyerekeza ndi kukhazikika kwa munthawi yomweyo mankhwala osokoneza bongo a Xenical ndi antiepileptic, milandu yokhudzana ndikukula kwa wodwala inalembedwa. Popeza chiyanjano cha mgwirizano wamtunduwu sichinakhazikitsidwe, kufalikira komanso / kapena kuopsa kwa matenda opatsirana m'gulu lino la odwala kuyenera kuyang'aniridwa.

Zofanizira za Xenical ndi: Xenalten, Orsoten, Orsotin Slim, Orlistat Canon, Alli, Orlimaks.

Ndemanga za Xenical

Malinga ndi ndemanga, Xenical imayambitsa malingaliro ovuta mwa odwala. Ambiri a iwo amati kugwiritsa ntchito kwake kungakhale kothandiza pokhapokha ngati pali nkhondo yolimbana ndi vuto la kunenepa kwambiri.

Madokotala ambiri amakhulupirira kuti mankhwalawa ndi othandizira popewa kunenepa kwambiri, koma kudya kwake kuyenera kuphatikizidwa ndi zakudya zamafuta ochepa. Mwezi wa 1 wothandizidwa ndi Xenical, ngakhale wopanda mphamvu yayikulu komanso kuchita masewera olimbitsa thupi, mutha kutaya 1.5-2 kg. Zotsatira zabwino kwambiri zimapezeka ndikuphatikiza mankhwala ofanana ndi masewera.

Kutengera ndi zomwe thupi limayang'anira ndikuwonetsetsa mosamala malangizo omwe dokotala angapeze, ndizotheka kuchepetsa kulemera kwa thupi ndi 10-15 makilogalamu m'miyezi itatu, ndi 30 kg m'miyezi 6.

Kodi mankhwalawa amagwira ntchito bwanji?

Kodi mankhwalawa Xenical amachepetsa bwanji? Mphamvu ya mankhwalawa imatheka chifukwa chopondera lipase, zomwe zimakhala m'matumbo am'mimba, zomwe zimapangitsa kuti achepetse thupi chifukwa chosakwanira kuyamwa kwa mafuta. Chomwe chimagwira chimamanga mafuta ochulukirapo ndikuchotsa m'thupi mwachilengedwe. Chifukwa cha njirayi, ndowe zimakhala ndi zamafuta ambiri zamafuta.Thupi tsiku lililonse limayamba kulandira mafuta ochepa ndi 30%, yomwe imakakamiza kuti igwiritse ntchito zinthu zake, ndiye kuti, ikumba mafuta ake ochulukirapo.

Ngati mumatsatira zakudya zama calorie ochepa komanso zakudya zamafuta ochepa, zotsatira zoyipa sizivutitsa munthu.

Ngati izi sizikuwoneka, zotsatirapo zoyipa zingawonedwe kwa odwala:

zimbudzi zotayirira kwambiri,
fecal kulephera
kuchuluka kukakamira,
mpweya wambiri
kusapeza bwino mu rectum kapena matumbo,
Mafuta ochulukira kuchokera ku rectum, ngakhale pamalo abata.

Monga lamulo, mawonetsedwe onsewa amawonekera pokhapokha nthawi yoyamba kutenga njira yochepetsera thupi ndikusowa mukamasintha zakudya, monga zikuwonetsedwa ndi kuwunika kambiri kwa iwo omwe achepetsa thupi.

Mungamvetse bwino bwanji?

Xenical kwa kuwonda moyenera momwe mungathere molondola?

Asanatenge Xenical, wodwalayo ayenera kuwerengera malangizo osaphwanya malangizo ake, apo ayi chiopsezo cha zovuta zoyipa ndizotheka.

Mapiritsi amatha kumwedwa katatu patsiku ndi chakudya kapena pambuyo pake., koma osati mochedwa kuposa ola limodzi, kotero zotsatira sizingakhalenso chifukwa chakuti mafuta omwe akubwera ali ndi nthawi yolowetsedwa m'thupi. Ngati pazifukwa zina simungathe kutenga kapisozi pa nthawi yomwe mukufuna, ndibwino kuti mulibe mlingo umodzi. Tiyenera kukumbukira kuti muyenera kumwa piritsi ndi madzi ambiri kuti mukwaniritse tanthauzo lake. Ngati mu umodzi mwa zakudya mulibe mafuta kwathunthu, ndibwino kukana kumwa mankhwalawo.

Njira ya mankhwala okhala ndi makapisozi a kuchepa thupi ndi miyezi iwiri yokhala ndi mapiritsi atatu tsiku lililonse. Madokotala ambiri azakudya amalangiza kumwa piritsi la Xenical pokhapokha zakudya zomwe zili ndi mafuta ambiri, nthawi zina, mumangodumphira kuti mupewe zovuta.

Pambuyo pophunzira ndemanga zingapo za odwala omwe adatenga Xenical, madokotala adazindikira kugwiritsa ntchito bwino kwa mankhwalawa komanso kulemera kwakanthawi pambuyo pa miyezi ingapo. Pafupifupi, m'miyezi yoyambirira, kulemera kwa odwala omwe anali ndi thupi kumachepa ndi 10-20%, malinga ndi malingaliro onse owonjezera.

Nthawi zambiri, kuphatikiza pa Xenical, adotolo amatipatsa mankhwala omwe amabwezeretsa kagayidwe m'thupi, chifukwa nthawi zambiri kunenepa kwambiri kumachitika. Chifukwa chake, iwo omwe adachepetsa thupi mothandizidwa ndi mankhwalawa samangotsatira zonse zomwe adalangizidwa, komanso amamwa mankhwala ena kuti akonzere kugaya. Nthawi zambiri izi ndizinyumba za ku Siberia, zomwe zimathandiza kuwonjezera mphamvu ya Xenical.

Malinga ndi maumboni a anthu omwe amamwa ndendende maphunzirowa, adatha kutaya pafupifupi 2-3 kg pamwezi, pomwe zizindikiro zosasangalatsa sizimayenda nawo nthawi zonse. Komanso, pafupifupi odwala onse adazindikira kuti adayiwala za kudzimbidwa komwe kumapita limodzi kwa nthawi yayitali.

Zotsatira za pharmacological

Xenical ndi yoletsa yeniyeni ya lipases yam'mimba yokhala ndi zotsatira zokhalitsa. Zake zochizira zimachitika mu lumen pamimba ndi matumbo ang'onoang'ono ndipo amapangidwa pakupanga mgwirizano wolumikizana ndi gawo la serine la gastric ndi pancreatic lipases. Pankhaniyi, enzyme yovomerezeka imataya mphamvu yake yophwanya mafuta mu mawonekedwe a triglycerides kulowa mu mafuta aulere acids ndi monoglycerides. Popeza triglycerides yosasinthika simakhudzidwa, kutsika kwa kashiamu komwe kumapangitsa kuti thupi lichepe. Chifukwa chake, achire mphamvu ya mankhwalawa ikuchitika popanda kuyamwa mu zokhudza zonse kufalitsidwa.

Poona zotsatira za mafuta omwe ali mu ndowe, mphamvu ya orlistat imayamba patatha maola 24-48 atayamba kumwa. Pambuyo pakutha kwa mankhwalawa, mafuta omwe amakhala mumadzimbidwa pambuyo pa maola 48-72 nthawi zambiri amabwerera pamlingo womwe unachitika isanayambike mankhwala.

Mimba komanso kuyamwa

Mu maphunziro a kubereka nyama, palibe zotsatira za teratogenic ndi embryotoxic za mankhwalawa. Pokhapokha ngati teratogenic zotsatira mu nyama, zofanana mu anthu sayenera kuyembekezera. Komabe, chifukwa cha kuchepa kwa data yamankhwala, Xenical sayenera kutumizidwa kwa amayi apakati.

Kutulutsa kwa orlistat mkaka wa m'mawere sikunaphunzire, chifukwa chake, sikuyenera kumwedwa nthawi yoyamwitsa.

Mlingo ndi makonzedwe

Akuluakulu, mlingo woyenera wa orlistat ndi kapu imodzi ya 120 mg pachakudya chilichonse chachikulu (monga chakudya kapena osapitirira ola limodzi mutatha kudya). Ngati chakudya chidatsitsidwa kapena ngati chakudya mulibe mafuta, ndiye kuti Xenical imatha kudumphidwanso.

Kuwonjezeka kwa mlingo wa orlistat pazowalimbikitsa (120 mg katatu patsiku) sikuti kumayambitsa masharubu

kukhetsa kwake achire zotsatira.

Kusintha kwa Mlingo kwa okalamba sikofunikira.

Kusintha kwa Mlingo wa chiwindi kapena matenda a impso sikufunika.

Chitetezo ndi kuyendetsa bwino kwa Xenical mwa ana osakwana zaka 18 sizinakhazikitsidwe.

Zotsatira zoyipa

Zotsatira zoyipa za orlistat zimachitika makamaka kuchokera m'matumbo am'mimba ndipo zimachitika chifukwa cha kupangika kwa mankhwala, zomwe zimasokoneza mayamwidwe akudya. Nthawi zambiri, zinthu monga zotulutsa zamafuta kuchokera ku rectum, mpweya wokhala ndi zotulutsa zina, kufunikira kodzikakamiza, kuwotcherera, kuchuluka kwa matumbo komanso kusayenda kwa fecal nthawi zambiri kumadziwika.

Pafupipafupi zimachuluka ndikuwonjezera mafuta m'zakudya. Odwala ayenera kudziwitsidwa za kuthekera kwa mayankho ochokera m'mimba ndi kuphunzitsidwa momwe angachotsere mwa kudya bwino, makamaka poyerekeza kuchuluka kwa mafuta omwe amapezeka. Zakudya zamafuta ochepa zimachepetsa chiopsezo cha matenda am'mimba ndipo zimathandiza odwala kuwongolera komanso kuwongolera kudya mafuta.

Monga lamulo, izi zimachitika pang'onopang'ono komanso zofatsa. Amapezeka m'migawo yoyambirira yamankhwala (m'miyezi itatu yoyambirira), ndipo odwala ambiri sanatchulidwe kamodzi kachitidwe kameneka.

Pochiza Xenical, zochitika zotsatirazi zam'mimba zimachitika kawirikawiri: kupweteka kapena kusasangalala pamimba, bata, matulo osayenerika, zopondapo "zofewa", kupweteka kapena kusapeza bwino mu rectum, kuwonongeka kwa mano, matenda a chingamu.

Matenda apamwamba kapena am'munsi opatsirana pang'onopang'ono, chimfine, mutu, dysmenorrhea, nkhawa, kufooka, komanso matenda a kwamkodzo thirakiti adadziwikanso.

Zotsatira zosawerengeka zamafotokozedwe zimafotokozedwa, zazikulu matenda omwe anali kuyabwa, zidzolo, urticaria, angioedema ndi anaphylaxis.

Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, chikhalidwe ndi pafupipafupi za zochitika zovuta zimafananizidwa ndi omwe ali ndi anthu omwe alibe shuga komanso kunenepa kwambiri. Zotsatira zoyipa zatsopano zomwe zidachitika ndi pafupipafupi za> 2% ndi> 1%, kuyerekeza ndi placebo, zinali zikhalidwe za hypoglycemic (zomwe zitha kuchitika chifukwa chabwezera chipukuta cha carbohydrate metabolism) ndikutulutsa.

Kuchita ndi mankhwala ena

M'maphunziro a pharmacokinetic, kuyanjana ndi mowa, digoxin, nifedipine, kulera kwapakamwa, phenytoin, pravastatin, kapena warfarin sikunachitike.

Ndi makonzedwe apakati pa Xenical, kuchepa kwa mayamwidwe a mavitamini A, D, E, K ndi beta-carotene. Ngati multivitamini akulimbikitsidwa, ayenera kumwedwa osachepera 2 maola mutatha Xenical kapena asanagone.

Ndi munthawi yomweyo makonzedwe a Xenical ndi cyclosporine, kuchepa kwa plasma wozungulira wa cyclosporine, motero, kutsimikiza kwachulukidwe ka plasma cyclosporine mozungulira mukamatenga cyclosporin ndi Xenical ndikulimbikitsidwa.

Zolemba ntchito

Xenical imagwira ntchito molingana ndi kuwongolera kwakuthupi kwakanthawi kwakanthawi (kuchepetsa kuchepa kwa thupi ndi kukonza kwake pamlingo wina watsopano, kupewa kubwezeretsa kulemera mobwerezabwereza). Kuchiza kwa Xenical kumawongolera chiwonetsero cha zovuta komanso matenda omwe amayamba chifukwa cha kunenepa kwambiri, kuphatikizapo hypercholesterolemia, mtundu wa 2 shuga mellitus (NIDDM), kulolerana kwa glucose, hyperinsulinemia, matenda oopsa, komanso kuchepa kwamafuta a visceral.

Mukagwiritsidwa ntchito limodzi ndi mankhwala ochepetsa shuga monga metformin, sulfonylureas ndi / kapena insulin mwa odwala omwe ali ndi mtundu wa 2 shuga mellitus onenepa kwambiri (BMI> 28 kg / m 2) kapena kunenepa kwambiri (BMI> 30 kg / ^) Xenical, kuphatikiza zakudya zamagulu owerengeka, zimawonjezera kukonzanso chakudya cha metabolism.

M'mayesero azachipatala odwala ambiri, kuchuluka kwa mavitamini A, D, E, K ndi beta-carotene pakatha zaka ziwiri zathunthu zamankhwala othandizira orlistat adatsalirabe momwemo. Kuti muwonetsetse kuti zakumwa zonse zakudya zitha kupezeka, multivitamini akhoza kuyikidwa.

Wodwala ayenera kulandira zakudya zopatsa thanzi, zopatsa mphamvu zopatsa mphamvu zopitilira 30% zamafuta. Zakudya zomwe zimakhala ndi zipatso ndi ndiwo zamasamba ndizofunikira kwambiri. Zakudya za tsiku ndi tsiku za mafuta, chakudya komanso mapuloteni ayenera kugawidwa m'njira zitatu zazikuluzikulu.

Kuchepa kwa zovuta m'magazi am'mimba kumatha kuwonjezeka ngati Xenical imatengedwa ndi chakudya chamafuta (mwachitsanzo, 2000 kcal / tsiku, omwe oposa 30% ali mu mawonekedwe a mafuta, omwe amafanana ndi 67 g yamafuta). Zakudya za tsiku ndi tsiku zamafuta zimayenera kugawidwa m'magulu atatu akuluakulu. Ngati Xenical imatengedwa ndi zakudya zonona kwambiri, kupezeka kwa m'mimba kumawonjezeka.

Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, kuchepa kwa thupi panthawi ya mankhwala ndi Xenical kumayendera limodzi ndi kusintha kwa chipukutira cha mafuta a metabolism, omwe angalole kapena kufuna kuchepetsa kuchuluka kwa mankhwala ochepetsa shuga.