Mapiritsi a Metformin 500 mg 60: mtengo ndi mawonekedwe, ndemanga

Metformin imalepheretsa gluconeogenesis m'chiwindi, amachepetsa kuyamwa kwa m'matumbo, imakulitsa kugwiritsidwa ntchito kwa glucose, komanso kumakulitsa chidwi cha minofu kulowa insulin.

Sichikukhudzana ndi kubisika kwa insulini ndi ma cell a beta, sikuti kumayambitsa kutengeka kwa hypoglycemic. Amachepetsa mulingo wa ma triglycerides ndi ma linoprotein otsika m'magazi. Imakhazikika kapena kuchepetsa thupi.

Ili ndi fibrinolytic mwina chifukwa chokakamira minofu ya plasminogen activator inhibitor.

Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera m'mimba. Bioavailability mutatenga muyezo mlingo 50-60%. Cmax mu madzi a m'magazi amafikira maola 2,5 atatha kumwa.

Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira tiziwalo tating'ono, minofu, chiwindi ndi impso. Imayatsidwa osasinthika ndi impso. T1 / 2 ndi maola 9-12.

Ndi matenda aimpso, kuwonongeka kwa mankhwalawa ndikotheka.

Zomwe Metformin imathandizira kuchokera: zikuwonetsa

Type 2 shuga mellitus mwa akulu (makamaka odwala kunenepa kwambiri) ndi kulephera kwa zakudya zochizira komanso zochitika zolimbitsa thupi, monga monotherapy kapena kuphatikiza ndi ena othandizira pakamwa kapena insulin.
Lemberani matenda ashuga a 2 a ana kuyambira azaka 10 - onse ngati monotherapy, komanso osakanikirana ndi insulin.

Contraindication

matenda ashuga ketoacidosis, matenda a shuga, chikomokere
matenda aimpso
matenda pachimake ndi chiwopsezo aimpso ntchito: kuchepa magazi (ndi kutsegula m'mimba, kusanza), malungo, matenda opatsirana, mikhalidwe ya hypoxia (mantha, sepsis, matenda a impso, bronchopulmonary matenda)
mwaukadaulo wawonetsera matenda owopsa komanso osachiritsika omwe angayambitse kukula kwa minofu ya hypoxia (mtima kapena kupuma, kulephera kwamchiberekero)
opaleshoni yayikulu ndi zoopsa (pamene chithandizo cha insulin chikusonyeza)
chiwindi ntchito
uchidakwa wambiri
gwiritsani ntchito kwa masiku osachepera a 2 musanadutse masiku awiri mutapanga maphunziro a radioisotope kapena x-ray ndikumayambitsa ayodini
lactic acidosis (kuphatikizapo mbiri ya)
kutsatira zakudya zochepa zama calori (zosakwana 1000 calories / tsiku)
mimba
kuyamwa
Hypersensitivity mankhwala.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa mwa anthu opitirira zaka 60 omwe amagwira ntchito zolimbitsa thupi, zomwe zimagwirizanitsidwa ndi chiwopsezo chokhala ndi lactic acidosis mwa iwo.

Metformin pa Mimba ndi Kuyamwitsa

Mankhwalawa amakwiriridwa kuti agwiritsidwe ntchito panthawi yomwe muli ndi pakati komanso poyamwitsa.Kukonzekera kapena kuyambitsa kutenga pakati, Metformin Canon iyenera kusiyidwa ndipo chithandizo cha insulin chiyenera kugwiritsidwa ntchito.

Wodwala ayenera kuchenjezedwa za kufunika kodziwitsa dokotala ngati ali ndi pakati. Amayi ndi mwana ayenera kuyang'aniridwa.

Sizikudziwika ngati metformin yachotsedwa mkaka wa m'mawere.

Ngati ndi kotheka, gwiritsani ntchito mankhwalawa panthawi yoyamwitsa, yoyamwitsa iyenera kusiyidwa.

Metformin: malangizo ogwiritsira ntchito

Mapiritsi amayenera kumwedwa pakamwa, kumeza lonse, osafuna kutafuna, pakudya kapena madzi atangotha. Akuluakulu Monotherapy ndi kuphatikiza mankhwalawa ndi ena othandizira pakamwa a hypoglycemic Mankhwala oyamba ndi 1000-1500 mg / tsiku.

Kuti muchepetse mavuto kuchokera m'matumbo, mankhwalawa amayenera kugawidwa pakamwa katatu. Pambuyo masiku 10-15, pakalibe mavuto kuchokera m'mimba, kuwonjezereka kwapang'onopang'ono kwa mlingo kumatheka kutengera kuchuluka kwa shuga m'magazi.

Kuchepetsa pang'ono pang'onopang'ono kwa mankhwala kungathandizire kulolerana kwa m'mimba kwa mankhwalawa .. Njira yokonza tsiku ndi tsiku ndi 1500-2000 mg. Mulingo wambiri watsiku ndi tsiku ndi 3000 mg, wogawidwa mu 3 waukulu.

Pokonzekera kusintha kwa kutenga wina wakumwa wa hypoglycemic kupita ku Metformin, muyenera kusiya kutenga wothandizila wina wa hypoglycemic ndikuyamba kutenga Metformin Canon paz Mlingo wapamwambawo.

Kuphatikiza mankhwala ndi insulin

Mlingo woyamba wa mankhwalawa ndi Metformin 500 mg ndi 850 mg - piritsi limodzi katatu patsiku, Metformin 1000 mg - piritsi 1 nthawi imodzi patsiku, pamene insulini imasankhidwa potengera kuchuluka kwa shuga m'magazi.

Ana opitilira zaka 10

Metformin Canon amagwiritsidwa ntchito ngati mankhwala a monotherapy komanso kuphatikiza insulin. Mankhwala oyambira a Metformin ndi 500 mg kamodzi patsiku madzulo ndi chakudya. Pambuyo masiku 10-15, mlingo uyenera kusinthidwa potengera kuchuluka kwa shuga m'magazi. Mlingo wokonza ndi 1000-1500 mg / tsiku mu Mlingo wa 2-3.

Mlingo wambiri watsiku ndi tsiku ndi 2000 mg mu magawo atatu omwe ali odwala.

Kutalika kwa mankhwala kumatsimikiziridwa ndi adokotala.

Kuchotsera kwa mankhwalawa popanda upangiri wa dokotala simukulimbikitsidwa.

Zotsatira zoyipa

Kuchokera pamimba: kukhumudwa, kusanza, kulawa kwazitsulo mkamwa, kusowa chilakolako cha chakudya, kutsegula m'mimba, kuwawa, kupweteka kwam'mimba. Zizindikirozi ndizofala kumayambiriro kwa chithandizo ndipo nthawi zambiri zimakhala zokha. Zizindikiro izi zitha kuchepetsa kuikidwa kwa anthocides, zotumphukira za atropine kapena antispasmodics.

Kuchokera kumbali ya kagayidwe: kawirikawiri - lactic acidosis (imafuna kuleka kwa chithandizo) ndi chithandizo cha nthawi yayitali - hypovitaminosis B12 (malabsorption).

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

Kuchokera ku endocrine system: hypoglycemia.

Thupi lawo siligwirizana: zotupa pakhungu.

Malangizo apadera

Pa chithandizo, ndikofunikira kuwunika ntchito yaimpso. Osachepera 2 pachaka, komanso maonekedwe a myalgia, zomwe zimakhala mu plasma ziyenera kutsimikiziridwa.

Kuphatikiza apo, kamodzi pa miyezi isanu ndi umodzi ndikofunikira kuti muwongolere kuchuluka kwa creatinine mu seramu yamagazi (makamaka mwa odwala okalamba).

Metformin sayenera kufotokozedwa ngati mulingo wa creatinine m'magazi ndiwoposa 135 μmol / L mwa amuna ndi 110 μmol / L mwa akazi.

Mwinanso kugwiritsa ntchito mankhwala a Metformin osakanikirana ndi mankhwala a sulfonylurea. Potere, makamaka kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Maola 48 isanakwane komanso mkati mwa maola 48 mutatha radiopaque (urography, iv angiography), muyenera kusiya kutenga Metformin.

Ngati wodwala ali ndi matenda a bronchopulmonary kapena matenda opatsirana a genitourinary, adokotala ayenera kudziwitsidwa nthawi yomweyo.

Pa chithandizo, muyenera kupewa kumwa mowa ndi mankhwala okhala ndi Mowa. .

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kugwiritsa ntchito mankhwalawa monotherapy sikukhudza kuyendetsa magalimoto ndikugwira ntchito ndi njira.

Metformin ikaphatikizidwa ndi ma othandizira ena a hypoglycemic (sulfonylurea, insulin), mikhalidwe ya hypoglycemic imatha kukhala ndi kuthekera kochita kuyendetsa magalimoto ndi kuchita zina zomwe zingakhale zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kusintha kwa ma psychomotor.

Kuyanjana ndi mankhwala ena

Kuphatikiza kwapafupipafupi maphunziro a Radiological ogwiritsa ntchito ayodini omwe amakhala ndi mankhwala a radiopaque angapangitse kukula kwa lactic acidosis kwa odwala omwe ali ndi matenda osokoneza bongo motsutsana ndi maziko a kulephera kwa aimpso.

Kugwiritsa ntchito metformin kuyenera kuyimitsidwa maola 48 asanakwane ndipo sikukonzanso kale kuposa maola 48 mutawunika kwa X-ray pogwiritsa ntchito mankhwala a radiopaque.

Kuphatikizika komwe kunaphatikizidwa Ndi munthawi yomweyo kugwiritsa ntchito metformin ndi mankhwala osokoneza bongo a ethanol, munthawi ya chidakwa, kusala kapena kutsata zakudya zopatsa mphamvu, komanso kuthana ndi chiwindi, chiopsezo cha lactic acidosis imakulanso.

Kuphatikiza komwe kumafunikira chisamaliro chapadera Ndi nthawi yomweyo kugwiritsa ntchito metformin ndi danazol, zotsatira za hyperglycemic zingayambike. Ngati mankhwala a danazol akufunika ndipo atayimitsa, kusintha kwa metformin kumafunikira motsogozedwa ndimagazi a shuga.

Chlorpromazine mu Mlingo wambiri (100 mg / tsiku) amachepetsa kutuluka kwa insulin ndikuwonjezera kuchuluka kwa shuga m'magazi. Ndi munthawi yomweyo kugwiritsa ntchito antipsychotic ndipo atayimitsa makonzedwe awo, kusintha kwa metformin kumafunika motsogozedwa ndi ndende ya magazi.

Glucocorticosteroids (GCS) wogwiritsa ntchito mwa makolo ndi apakhungu amachepetsa kulolera kwa shuga ndikupangitsa kuchuluka kwa shuga m'magazi, nthawi zina kumapangitsa ketosis. Ngati mukufuna kugwiritsa ntchito kuphatikiza uku ndikuyimitsa makonzedwe a corticosteroids, kusintha kwa metformin kumafunika motsogozedwa ndi magazi.

Pogwiritsa ntchito munthawi yomweyo mankhwala a "loop" okodzetsa komanso metformin, pamakhala chiwopsezo cha lactic acidosis chifukwa cha kuwoneka ngati kulephera kugwira ntchito kwaimpso. Kuthana ndi vuto la beta2-adrenergic agonists kumachepetsa mphamvu ya metogin chifukwa cha kukopa kwa beta2-adrenergic receptors.

Pankhaniyi, kuchuluka kwa shuga m'magazi kuyenera kuyang'aniridwa ndipo ngati kuli koyenera, insulin iyenera kugwiritsidwa ntchito. Zoletsa za angiotensin-kutembenuza kwa enzyme komanso mankhwala ena a antihypertensive amatha kuchepetsa kuchuluka kwa shuga m'magazi. Ngati ndi kotheka, mlingo wa metformin uyenera kusinthidwa. Ndi kugwiritsa ntchito pamodzi kwa metformin limodzi ndi mankhwala a sulfonylurea, insulin, acarbose ndi salicylates, kuchuluka kwa hypoglycemic kungatheke.

Nifedipine imakulitsa mayamwidwe ndi Cmax ya metformin, yomwe iyenera kukumbukiridwa ikagwiritsidwa ntchito munthawi yomweyo.

"Loopback" okodzetsa komanso mankhwala osapweteka a antiidal (NSAIDs) amawonjezera chiopsezo cha kuchepa kwa impso. Pankhaniyi, chisamaliro chikuyenera kuchitika mukamagwiritsa ntchito metformin.

Bongo

Zizindikiro: kugwiritsa ntchito metformin pa mlingo wa 85 g, hypoglycemia sichinawoneke, komabe, lactic acidosis idadziwika.

Zizindikiro zoyambirira za lactic acidosis ndi mseru, kusanza, kutsegula m'mimba, kuchepa kwa kutentha kwa thupi, kupweteka kwam'mimba, kupweteka kwa minofu, mtsogolomo pakhoza kukhala kupuma kwamphamvu, chizungulire, chikumbumtima chosautsa komanso kukula kwa chikomokere.

Chithandizo: Ngati zizindikiro za lactic acidosis, chithandizo ndi mankhwala ziyenera kuyimitsidwa nthawi yomweyo, wodwalayo amayenera kugonekedwa kuchipatala mwachangu ndipo atatsimikiza kuchuluka kwa lactate, kufotokozera kuyenera kumveka bwino. Njira yothandiza kwambiri yochotsa lactate ndi metformin kuchokera mthupi ndi hemodialysis. Chithandizo cha Zizindikiro zimachitidwanso.

Analogi ndi mitengo

Mwa mitundu yakunja ndi yaku Russia, Metformin imasiyanitsidwa:

Metformin Richter. Wopanga: Gideon Richter (Hungary). Mtengo muma pharmacies umachokera ku ma ruble 180.
Glucophage kutalika. Wopanga: Merck Sante (Norway). Mtengo m'mafakitale amachokera ku ma ruble 285. Glformin. Wopanga: Akrikhin (Russia). Mtengo muma pharmacies umachokera ku 186 rubles.

Siofor 1000. Wopanga: Berlin-Chemie / Menarini (Germany). Mtengo m'mafakitale amachokera ku ma ruble 436.

Metfogamm 850. Wopanga: Werwag Pharma (Germany). Mtengo muma pharmacies ndi wochokera pa 346 rubles.

Tangopeza ndemanga izi za Metformin pa intaneti:

Panalibe 500 mg, ndagula 1000. Notch yomwe ili piritsi ndi yosavuta, itha kuthyoka mosavuta m'magawo awiri, makamaka piritsi ndilosasintha.

Pansipa mutha kusiya malingaliro anu! Kodi Metformin Imathandiza Kuthana Ndi Vutoli?

Mapiritsi a Metformin 500 mg 60: mtengo ndi mawonekedwe, ndemanga

Mukamagwiritsa ntchito mankhwala a Metformin 500, muyenera kukumbukira kuti zimatha kuyambitsa mavuto ambiri mthupi. Metformin imapangidwa ndi opanga ma pharmacological momwe amapangira mapiritsi okhala ndi kanema wapadera.

Piritsi limodzi la Metformin lili ndi 500 mg yogwira ntchito ya Metformin mu mankhwala ake. Pulogalamu yogwira popanga mankhwalawa ili ngati hydrochloride.

Kuphatikiza pa polojekiti yayikulu yogwira, mapiritsiwo amaphatikizapo zinthu zina zomwe zimagwira ntchito yothandiza.

Zigawo zothandiza za mapiritsi a Metformin ndi:

cellcrystalline mapadi,
khalidal
madzi oyeretsedwa
polyvinylpyrrolidone,
magnesium wakuba.

Pulogalamu yogwira yogwira, metformin hydrochloride, ndi biguanide. Kuchita kwa pawiri kumadalira luso lolepheretsa gluconeogeneis njira zomwe zimachitika m'maselo a chiwindi.

Thupi limathandiza kuchepetsa kuchuluka kwa kuyamwa kwa glucose kuchokera ku lumen ya m'mimba ndipo limathandizira kuyamwa kwa glucose kuchokera m'madzi am'magazi ndi maselo a zotumphukira za thupi.

Kuchita kwa mankhwalawa cholinga chake ndikukulitsa chidwi cha insulini-zotengera cell cell membrane cell ku insulin. Mankhwala sangathe kukopa njira zomwe zimatsimikizira kapangidwe ka insulin m'maselo a pancreatic minofu ndipo sikuti kumayambitsa maonekedwe a hypoglycemia m'thupi.

Mankhwalawa amathandizira kuimitsa zizindikiro za hyperinsulinemia. Otsirizawo ndiye chinthu chofunikira kwambiri chomwe chimathandizira kuwonjezeka kwa kulemera kwa thupi komanso kupita patsogolo kwa zovuta zomwe zimagwirizanitsidwa ndi ntchito ya mtima wamatenda a shuga. Kumwa mankhwala kumayambitsa kukhazikika kwa momwe thupi liliri komanso kuchepa kwa thupi.

Kugwiritsa ntchito mankhwala kumachepetsa plasma ndende ya triglycerides ndi otsika kachulukidwe linoprotein.

Kumwa mankhwalawa kumabweretsa kuchepa kwa mphamvu ya makutidwe a oxidation komanso kuletsa njira yopanga mafuta acid. Kuphatikiza apo, michere ya fibrinolytic yogwira ntchito yogwira thupi idawululidwa, PAI-1 ndi t-PA ndi zoletsedwa.

Mapiritsi amathandizira kuyimitsidwa kwa chitukuko cha kuchuluka kwa minyewa ya makoma amitsempha.

Zotsatira zabwino za mankhwalawo pamatenda a mtima ndi mtima zimawululidwa, zomwe zimalepheretsa kupitilira kwa matenda ashuga a shuga.

Kugwiritsa ntchito mankhwala

Mapiritsi a Metformin amatengedwa pakamwa.

Mukamamwa mankhwalawa, ndikofunika kuti mapiritsiwo amezedwe lonse osafuna.

Mankhwalawa ayenera kugwiritsidwa ntchito pakudya kapena pambuyo pake. Tengani piritsi ndi madzi okwanira.

Chizindikiro chachikulu chogwiritsa ntchito mankhwalawa ndi kupezeka kwa mtundu wachiwiri wa shuga wodwala.

Malangizo ogwiritsira ntchito akuwonetsa kuti mankhwalawa amatha kugwiritsidwa ntchito popanga monotherapy kapena ngati gawo la zovuta mankhwala ndi mankhwala ena okhala ndi katundu wa hypoglycemic kapena kuphatikiza ndi inulin.

Malangizo ogwiritsira ntchito amalola kugwiritsa ntchito mankhwalawa ali mwana, kuyambira zaka 10. Kugwiritsa ntchito mankhwalawa kumaloledwa kwa ana onse monga monotherapy, komanso kuphatikiza jakisoni wa insulin.

Mlingo woyambirira mukamamwa mankhwala ndi 500 mg. Mankhwala tikulimbikitsidwa kuti kumwedwa katatu patsiku. Ngati ndi kotheka, ndikuvomerezedwa kwina, mlingo wa mankhwalawa ukhoza kuchuluka.Kuwonjezeka kwa mlingo womwe umatengedwa kumadalira kuchuluka kwa shuga m'thupi.

Mukamagwiritsa ntchito Metformin pantchito yokonza mankhwalawa, mlingo womwe umatengedwa umasiyana kuchokera ku 1,500 mpaka 2,000 mg patsiku.

Mlingo watsiku ndi tsiku uyenera kugawidwa pawiri, kugwiritsa ntchito mankhwalawa kupewa kupewa mavuto obwera chifukwa cha m'mimba.

Mlingo wovomerezeka wokwanira malinga ndi malangizo ogwiritsira ntchito ndi 3000 mg patsiku.

Mukamamwa mankhwalawa, mlingo wake uyenera kuchulukitsidwa pang'onopang'ono mpaka mulingo woyenera utafikiridwa, njira iyi ithetsera kulolerana kwa mankhwalawo kupita m'mimba.

Ngati wodwala ayamba kumwa Metformin pambuyo pa mankhwala ena a hypoglycemic, ndiye kuti musanamwe Metformin mankhwala ena ayenera kusiyiratu.

Mukamagwiritsa ntchito mankhwalawa muubwana, mankhwala ayenera kuyambitsidwa ndi Mlingo wa 500 mg kamodzi patsiku.

Pambuyo masiku 10-15, kuyezetsa magazi kwa glucose kumachitika ndipo ngati kuli kotheka, Mlingo wa mankhwala omwe amwedwa umasinthidwa.

Mlingo wapamwamba tsiku lililonse wa odwala muubwana ndi 2000 mg. Mlingo uwu uyenera kugawidwa pakulipika kwa 2-3 patsiku.

Ngati mankhwalawa akugwiritsidwa ntchito ndi anthu okalamba, kusintha kwa mankhwalawa kuyenera kuchitika moyang'aniridwa ndi adokotala. Kufunika kumeneku kumachitika chifukwa chakuti mwa okalamba, kukula kwa matenda osiyanasiyana a impso m'thupi ndikotheka.

Kutalika kwa mankhwalawa kumatsimikiziridwa ndi dokotala.

Pa mankhwala, chithandizo sichiyenera kusokonezedwa popanda malangizo a dokotala.

Zochitika zovuta ndi Metformin mankhwala

Malangizo ogwiritsira ntchito Metformin amafotokozera mwatsatanetsatane zovuta zonse zomwe zingachitike pogwiritsa ntchito mankhwala.

Zotsatira zonse zoyipa zomwe zimagwiritsidwa ntchito pogwiritsa ntchito mankhwalawa zitha kugawidwa m'magulu akulu akulu.

Zotsatira zoyipa zimagawidwa kawiri kawiri, zochepa, zosowa, zosowa kwambiri komanso zosadziwika.

Osowa kwambiri, zotsatira zoyipa monga lactic acidosis mu mtundu 2 matenda a shuga zimachitika.

Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, pali kuchepa kwa mayamwidwe a vitamini B12. Ngati wodwala ali ndi vuto la kuchereza kwa magazi m'thupi, ndikofunikira kuganizira momwe zingakhalire zoterezi.

Zotsatira zoyipa zazikulu ndi izi:

kuphwanya kaonedwe ka kukoma,
kuphwanya kwam'mimba,
kumverera kwa nseru
Maonekedwe akusanza
kupweteka kwam'mimba,
kuchepa kwamtima.

Zotsatira zoyipa izi nthawi zambiri zimayamba munthawi yoyamba kumwa mankhwalawa ndipo nthawi zambiri zimatha.

Kuphatikiza apo, zotsatirazi zoyipa zingachitike:

Khungu limakhudza mawonekedwe a kuyabwa ndi zotupa.
Kuwonongeka kwa chiwindi ndi biliary thirakiti.

Nthawi zina, chiwindi amatha kupezeka m'thupi.

Zotsatira zoyipa zomwe zimachitika mukamagwiritsa ntchito mankhwalawa mu odwala ali ofanana ndi zovuta zomwe zimawoneka mwa odwala akuluakulu.

Mndandanda wa mankhwalawa ndi mtengo wake komanso mawonekedwe omasulidwa

Mankhwala amapezeka monga mapiritsi. Mapiritsi amaikidwa m'matumba a blister opangidwa ndi polyvinyl chloride ndi zojambulazo za aluminium. Paketi iliyonse ili ndi mapiritsi 10.

Ma paketi asanu ndi amodzi amaikidwa pabokosi lamakatoni, momwe mulinso malangizo ogwiritsira ntchito. Makatoni amakhadi a mankhwalawo ali ndi mapiritsi 60.

Sungani mankhwalawo pamalo otetezedwa ndi dzuwa mwachindunji pa kutentha osaposa 25 digiri Celsius. Mankhwala ayenera kusungidwa kuti ana asawapeze.

Moyo wa alumali wa chinthu chachipatala ndi zaka zitatu. Mankhwala amagulitsidwa ku pharmacies ndi mankhwala.

Ndemanga zambiri zomwe anakumana nazo omwe amagwiritsa ntchito mankhwalawa ndi zabwino.

Maonekedwe a ndemanga yoyipa imakonda kuyenderana ndi kuphwanya malangizo ogwiritsira ntchito mankhwalawa kapena ngati mukuphwanya malangizowo kuchokera kwa adokotala.

Nthawi zambiri pamakhala kuunikiridwa kwa odwala, zomwe zikuwonetsa kuti kugwiritsa ntchito mankhwalawa kumachepetsa kwambiri thupi.

Wopanga wamkulu wa mankhwalawa ku Russian Federation ndi Ozone LLC.

Mtengo wa mankhwala m'gawo la Russian Federation zimatengera ma network a mafakitole ndi dera lomwe mankhwalawo amagulitsidwa. Mtengo wapakati wa mankhwala ku Russian Federation umachokera ku 105 mpaka 125 ma ruble pa paketi iliyonse.

Ma fanizo odziwika kwambiri a Metformin 500 mu Russian Federation ndi awa:

Bagomet,
Glycon
Glyminfor,
Glyformin
Chikwanje,
Glucophage Long,
Methadiene
Metospanin
Metfogamma 500,
Metformin
Metformin Richter,
Metformin Teva,
Metformin hydrochloride,
Nova Met
NovoFormin,
Siofor 500,
Sofamet
Fomu,
Fomu.

Zofanizira za Metformin ndizofanana zonse mu kapangidwe kake ndi kagawo.

Chiyerekezo chachikulu cha Metformin chomwe chilipo, chimalola, ngati kuli kofunikira, dokotala yemwe amapezeka kuti asankhe mosavuta mankhwalawo ndikusintha Metformin ndi chipangizo china chachipatala. Za momwe Metformin imagwirira ntchito m'matenda a shuga, katswiri adzakuwuzani mu kanema munkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Oral hypoglycemic mankhwala

Tulutsani mawonekedwe, mawonekedwe ndi ma CD

Mapiritsi Othandizira Operic yoyera, yozungulira, ya biconvex.

1 tabumetformin hydrochloride 500 mg

Omwe amachokera: povidone K90, wowuma chimanga, crospovidone, magnesium stearate, talc.

Mapangidwe a Shell: methaconic acid ndi methylryacoplate copolymer (Eudragit L 100-55), macrogol 6000, titanium dioxide, talc.

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

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera m'mimba. Bioavailability mutatenga muyezo mlingo 50-60%. Cmax mu madzi a m'magazi amafikira maola 2,5 atatha kumwa.

Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira tiziwalo tating'ono, minofu, chiwindi ndi impso. Imayatsidwa osasinthika ndi impso. T1 / 2 ndi maola 9-12.

Ndi matenda aimpso, kuwonongeka kwa mankhwalawa ndikotheka.

- matenda a shuga a mellitus 2 popanda chizolowezi cha ketoacidosis (makamaka kwa odwala omwe ali ndi kunenepa kwambiri) ndi kulephera kwa chithandizo cha mankhwala,

- kuphatikiza ndi insulin - mtundu wachiwiri wa matenda ashuga, makamaka ndi kunenepa kwambiri, limodzi ndi insulin.

Mlingo wa mankhwalawa umakhazikitsidwa ndi adokotala payekha, kutengera kuchuluka kwa shuga m'magazi.

Mlingo woyambirira ndi 500-1000 mg / tsiku (mapiritsi a 1-2). Pambuyo masiku 10-15, kuwonjezereka kwapang'onopang'ono kwa mlingo kumatheka kutengera mtundu wa shuga.

Mankhwala okonza mankhwalawa nthawi zambiri amakhala 1500-2000 mg / tsiku. (3-4 tabu.) Mulingo woyenera ndi 3000 mg / tsiku (mapiritsi 6).

At odwala okalamba mlingo wovomerezeka wa tsiku lililonse sayenera kupitirira 1 g (mapiritsi 2).

Mapiritsi a Metformin amayenera kumwa nthawi zonse mukatha kudya ndi madzi pang'ono (kapu yamadzi). Kuti muchepetse mavuto kuchokera m'matumbo am'mimba, mlingo wa tsiku ndi tsiku uyenera kugawidwa mu Mlingo wa 2-3.

Chifukwa chowonjezera chiopsezo cha lactic acidosis, mlingo uyenera kuchepetsedwa ngati mavuto azovuta a metabolic.

Kuchokera kumbali ya kagayidwe: kawirikawiri - lactic acidosis (imafuna kuleka kwa chithandizo), ndi chithandizo cha nthawi yayitali - hypovitaminosis B12 (malabsorption).

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

Kuchokera ku endocrine system: hypoglycemia.

Thupi lawo siligwirizana: zotupa pakhungu.

Kuyanjana kwa mankhwala

Kugwiritsa ntchito nthawi yomweyo danazol osavomerezeka kuti apewe hyperglycemic zotsatira za chomaliza. Ngati mankhwala a danazol akufunika ndipo atayimitsa koyamba, kusintha kwa metformin ndi ayodini kuyenera kuwongolera glycemia.

Kuphatikiza komwe kumafunikira chisamaliro chapadera: chlorpromazine - pamene imwedwa mu milingo yayikulu (100 mg / tsiku) kumakulitsa glycemia, kuchepetsa kutulutsa kwa insulin.

Mankhwalawa antipsychotic ndipo mutasiya kuyimilira, kusintha kwa metformin kumafunika mothandizidwa ndi glycemia level.

Pogwiritsa ntchito munthawi yomweyo ndimomwe zimachokera ku sulfonylurea, acarbose, insulin, NSAIDs, ma inhibitors a MAO, oxytetracycline, ACE inhibitors, clofibrate zotumphukira, cyclophosphamide, β-blockers, ndizotheka kuwonjezera mphamvu ya hypoglycemic ya metformin.

Pogwiritsa ntchito munthawi yomweyo ndi GCS, kulera pakamwa, epinephrine, sympathomimetics, glucagon, mahomoni a chithokomiro, thiazide ndi loop diuretics, zotumphukira zochokera mu mtima, zotuluka za nicotinic acid, kuchepa kwa mphamvu ya hypoglycemic ya metformin ndikotheka.

Cimetidine amachepetsa kuchotsedwa kwa metformin, yomwe imawonjezera chiopsezo cha lactic acidosis.

Metformin itha kufooketsa mphamvu ya ma anticoagulants (zotumphukira za coumarin).

Kumwa mowa mwauchidakwa kumawonjezera mwayi wokhala ndi lactic acidosis panthawi yoledzera ya pachimake, makamaka ngati akusala kudya kapena kutsatira zakudya zochepa zopatsa mphamvu, komanso ngati chiwindi chikulephera.

Mimba komanso kuyamwa

Pokonzekera kutenga pakati, komanso ngati muli ndi pakati mukamamwa Metformin, iyenera kuthetsedwa ndipo mankhwala a insulin ayenera kuyikidwa. Popeza palibe chidziwitso pakulowera mkaka wa m'mawere, mankhwalawa amadziwikiridwa pakuyamwa. Ngati mukufuna kugwiritsa ntchito Metformin panthawi yoyamwitsa, kuyamwitsa kuyenera kuyimitsidwa.

Migwirizano ndi magwiritsidwe akusungidwa

Sungani pamalo owuma, amdima pamtunda wa 15 ° mpaka 25 ° C. Pewani kufikira ana. Nthawi yodikira ndi zaka zitatu.

Kufotokozera kwa mankhwala METFORMIN kumadalira malangizo ovomerezeka ovomerezeka oti agwiritsidwe ntchito ndikuvomerezedwa ndi wopanga.

Wapeza kachilombo? Sankhani ndikusindikiza Ctrl + Lowani.

Zotsatira zoyipa Metformin

Kuchokera ku dongosolo lamanjenje lalikulu:

kuphwanya kukoma (“zitsulo” mkamwa).

Kuchokera m'mimba:

nseru
kusanza
diala
kupweteka kwam'mimba komanso kusowa kudya.

Kupezeka kwa zotsatirazi kumachitika makamaka munthawi ya chithandizo ndipo nthawi zambiri zimadutsa zokha.

Popewa Zizindikiro, tikulimbikitsidwa kuti mudye metformin nthawi ya chakudya kapena itatha.

Kuchepetsa pang'ono kwa mankhwalawa kumathandizira kulolerana kwamatumbo.

Kuchokera ku hepatobiliary system:

kuphwanya zizindikiro za chiwindi,
chiwindi.

Pambuyo pakutha kwa metformin, zochitika zosautsa, monga lamulo, zimatha kwathunthu.

Zotsatira zoyipa:

kawirikawiri - erythema,
khungu
zotupa
urticaria.

Kuchokera kumbali ya kagayidwe:

kawirikawiri - lactic acidosis (imafuna kusiya kwa mankhwala).

Zina:

kawirikawiri - pogwiritsa ntchito nthawi yayitali, hypovitaminosis B12 imayamba (kuphatikizapo megaloblastic anemia) ndi folic acid (malabsorption).

Zosindikizidwa zikuwonetsa kuti mu ana ochepera azaka zapakati pa 10 mpaka 16, zotsatira zoyipa zimafanana mu chilengedwe komanso kuuma kwa omwe ali ndi odwala achikulire.

Zizindikiro zogwiritsidwa ntchito

Lemberani matenda ashuga a 2 a ana kuyambira azaka 10 - onse ngati monotherapy, komanso osakanikirana ndi insulin.

Mlingo ndi makonzedwe

Mapiritsi amayenera kumwedwa pakamwa, kumeza athunthu, osafuna kutafuna, nthawi yakudya kapena itangotha, kumwa madzi ambiri.

Monotherapy ndi kuphatikiza mankhwalawa ndi othandizira ena pakamwa a hypoglycemic. Mankhwala oyamba ndi 1000-1500 mg / tsiku.

Kuti muchepetse mavuto kuchokera m'matumbo, mankhwalawa amayenera kugawidwa pakamwa katatu.

Pambuyo masiku 10-15, pakalibe mavuto kuchokera m'mimba, kuwonjezereka kwapang'onopang'ono kwa mlingo kumatheka kutengera kuchuluka kwa shuga m'magazi.

Kuchepetsa pang'ono kwa mankhwalawa kungathandize kusintha kulolerana kwa m'mimba.

Njira yokonza tsiku ndi tsiku ndi 1500-2000 mg.

Mulingo wambiri watsiku ndi tsiku ndi 3000 mg, wogawidwa mu 3 waukulu.

Mukakonzekera kusintha kwa kutenga wina wakumwa wa hypoglycemic kupita ku Metformin Canon, muyenera kusiya kutenga wothandizila wina wa hypoglycemic ndikuyamba kutenga Metformin Canon paz Mlingo wapamwambapa.

Kuphatikiza mankhwala ndi insulin.

Mlingo woyenera wa mankhwalawa ndi 500 mg ndi 850 mg - piritsi 1 katatu patsiku, mankhwala 1000 mg - piritsi limodzi 1 nthawi patsiku, mlingo wa insulin umasankhidwa pamaziko a kuchuluka kwa shuga.

Ana opitilira zaka 10.

Metformin Canon imagwiritsidwa ntchito monotherapy komanso kuphatikiza mankhwala ndi insulin.

Mlingo woyenera wa mankhwalawa ndi 500 mg 1 nthawi patsiku madzulo ndi chakudya.

Pambuyo masiku 10-15, mlingo uyenera kusinthidwa potengera kuchuluka kwa shuga m'magazi.

Mlingo wokonza ndi 1000-1500 mg / tsiku mu Mlingo wa 2-3.

Mulingo wambiri watsiku ndi tsiku ndi 2000 mg mu katatu.

Odwala okalamba.

Chifukwa cha kuchepa kwa ntchito yaimpso, mlingo wa mankhwalawa umayenera kusankhidwa poyang'aniridwa pafupipafupi zowonetsa aimpso (kuwunika kwa serum creatinine ndende osachepera 2-4 pachaka).

Kutalika kwa mankhwala kumatsimikiziridwa ndi adokotala.

Kuchotsera kwa mankhwalawa popanda upangiri wa dokotala simukulimbikitsidwa.

Kuchita

Kafukufuku wamatsenga omwe amagwiritsa ntchito mankhwala okhala ndi ayodini omwe amapezeka ndi ayodini amatha kuyambitsa lactic acidosis kwa odwala omwe ali ndi matenda osokoneza bongo motsutsana ndi maziko a kulephera kwa impso.

Kugwiritsa ntchito metformin kuyenera kuyimitsidwa maola 48 asanakwane ndipo sikukonzanso kale kuposa maola 48 mutawunika kwa X-ray pogwiritsa ntchito mankhwala a radiopaque.

Pogwiritsa ntchito munthawi yomweyo mankhwala a metformin omwe amakhala ndi zakumwa zoledzeretsa za ethanol, munthawi ya chidakwa, ndimatenda a chakudya kapena otsika kalori, komanso kulephera kwa chiwindi, chiopsezo cha lactic acidosis chikuwonjezeka.

Kuphatikiza komwe kumafunikira kusamala kwambiri.

Ndi kugwiritsa ntchito pamodzi kwa metformin ndi danazole, kukulitsa kwa vuto la hyperglycemic ndikotheka.

Ngati mankhwala a danazol akufunika ndipo atayimitsa, kusintha kwa metformin kumafunikira motsogozedwa ndimagazi a shuga.

Chlorpromazine mu Mlingo wambiri (100 mg / tsiku) amachepetsa kutuluka kwa insulin ndikuwonjezera kuchuluka kwa shuga m'magazi.

Ndi munthawi yomweyo kugwiritsa ntchito antipsychotic ndipo atayimitsa makonzedwe awo, kusintha kwa metformin kumafunika motsogozedwa ndi ndende ya magazi.

Glucocorticosteroids (GCS) wogwiritsa ntchito mwa makolo ndi apakhungu amachepetsa kulolera kwa shuga ndikupangitsa kuchuluka kwa shuga m'magazi, nthawi zina kumapangitsa ketosis.

Ngati mukufuna kugwiritsa ntchito kuphatikiza uku ndikuyimitsa makonzedwe a corticosteroids, kusintha kwa metformin kumafunika motsogozedwa ndi magazi.

Pogwiritsa ntchito munthawi yomweyo "loop" okodzetsa komanso metformin, pamakhala chiopsezo cha lactic acidosis chifukwa chowoneka ngati kulephera kwaimpso.

Kugwiritsa ntchito kwa beta2-adrenergic agonists ngati jakisoni kumachepetsa mphamvu ya hypoglycemic ya metformin chifukwa cha kukondoweza kwa beta2-adrenergic receptors.

Pankhaniyi, kuchuluka kwa shuga m'magazi kuyenera kuwongoleredwa ndipo ngati kuli koyenera, insulin iyenera kugwiritsidwa ntchito.

Angiotensin-converting enzyme inhibitors ndi mankhwala ena a antihypertgency amatha kutsitsa magazi.

Ngati ndi kotheka, mlingo wa metformin uyenera kusinthidwa.

Ndi munthawi yomweyo kugwiritsa ntchito metformin ndi sulfonylurea zotumphukira, insulin, acarbose ndi salicylates, kuchuluka kwa hypoglycemic kumatheka.

Nifedipine imakulitsa mayamwidwe ndi Cmax ya metformin, yomwe iyenera kukumbukiridwa ikagwiritsidwa ntchito munthawi yomweyo. "Loopback" okodzetsa komanso mankhwala osapweteka a antiidal (NSAIDs) amawonjezera chiopsezo cha kuchepa kwa impso.

Pankhaniyi, chisamaliro chikuyenera kuchitika mukamagwiritsa ntchito metformin.