Galvus ndi Galvus Met: momwe mungavomerezere, zomwe mungasinthe, contraindication

Galvus ndi othandizira a hypoglycemic omwe amapanga kuti azilamulira matenda a shuga a mtundu 2. Gawo loyambirira la mankhwalawa ndi vildagliptin. Mankhwala amamasulidwa monga mapiritsi. Madokotala komanso odwala matenda ashuga adalandila ndemanga zabwino kuchokera kwa Galvus.

Imayendetsa mwamphamvu kagayidwe ka insulin ndi glucagon. European Antidiabetesic Association imati Galvus mu monotherapy ndikofunikira kuti agwiritse ntchito pokhapokha ngati metformin itaperekedwa kwa wodwala. Kwa odwala matenda a shuga omwe amadalira insulin omwe ali ndi matenda amtundu wa 2, Galvus amathandizira kuchepetsa kuchuluka kwa ziwengo ndi kuchuluka kwa insulin.

Zotsatira za pharmacological

Mahomoni amatchedwa mahomoni omwe matumbo amatulutsa pamene michere ilowa. Ma mahormonewa ndi insulinotropic, amachititsa kuti insulini isatulutsidwe, chifukwa 60% yake imapangidwa ndendende chifukwa cha insretins. Izi zimapezeka mu 1960, ataphunzira kudziwa kuchuluka kwa insulin.

Glucan-peptide-1 (GLP-1) ndiodziwika kwambiri, chifukwa kuchuluka kwake kumachepa kwambiri matenda ashuga amtundu wa 2. Izi zidapangitsa kuti pakhale gulu latsopano la mankhwala omwe amalimbikitsa zomwe zili mumahomoni otero mwina ndi jakisoni wa analogue yopanga ya GLP-1 monga Baeta kapena Victoza kapena kudzera pakamwa monga Galvus kapena analogue Januvia. Ma Dhib-4 ma inhibitors samangokulitsa kuchuluka kwa mahomoni onse, komanso kupewa kutsika kwawo.

Ndani akuyenera Galvus

Kwa odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, mankhwalawa angagwiritsidwe ntchito:

• Mankhwala ochepetsa mphamvu ya monotherapy, kuphatikizapo zakudya zamafuta ochepa komanso minofu yambiri.
• Mankhwala osokoneza bongo ofanana ndi metformin, ngati zotsatira zochokera kuchithandizo chimodzi sizokwanira,
• Ngati njira ina yofanana ndi ya Galvus yofanana ndi mankhwala a metformin ndi vildagliptin,
• Kuphatikiza kwa othandizira ena a hypoglycemic, ngati njira zam'mbuyomu zamankhwala sizothandiza,
• Monga mankhwala othandizira katatu ndi insulin ndi metformin, ngati zakudya, zolimbitsa thupi ndi insulin ndi metformin sizinali zokwanira.

Malangizo ogwiritsira ntchito

Mlingowo umatsimikiziridwa ndi endocrinologist payekhapayekha, potenga gawo la matendawa komanso momwe thanzi la odwala matenda ashuga lilili. Kugwiritsa ntchito mapiritsi sikugwirizana ndi chakudya cham'mawa, chinthu chachikulu ndikumwa mankhwalawo ndi madzi okwanira. Pamaso pa zotsatira zosayembekezereka zam'mimba, ndibwino kugwiritsa ntchito mankhwalawo ndi chakudya.

Ngati matenda a shuga a mtundu wachiwiri aikidwa, Galvus akhoza kupatsidwa nthawi yomweyo. Mosasamala za regimen ya chithandizo (zovuta kapena monotherapy), mapiritsi amatengedwa kuchuluka kwa 50-100g / tsiku. Mulingo woyenera kwambiri (100 mg / tsiku) amatengedwa m'magawo akulu a shuga. Pa chithandizo, limodzi ndi ena othandizira a hypoglycemic, 100 mg / tsiku ndi mankhwala.

Gawo la 50 g / tsiku. kumwa kamodzi, kawirikawiri m'mawa, mlingo wa 100 mg uyenera kugawidwa mu 2 Mlingo - chimodzimodzi, m'mawa ndi maola a madzulo. Ngati kulandila kwa Galvus kusowa, mapiritsi ayenera kumwedwa nthawi iliyonse, koma malire onse ayenera kuyang'aniridwa.

Ngati ndi monotherapy 100 mg / tsiku atha kutengedwa, ndiye ndi zovuta mankhwala, amayamba ndi 50 mg / tsiku, mwachitsanzo, ndi metformin: 50 mg / 500 mg, 50 mg / 850 mg, 50 mg / 100 mg.

Ndi chiphuphu chosakwanira cha shuga, mitundu ina ya mankhwala a hypoglycemic (metformin, insulin, zotumphukira za sulfonylurea, ndi zina zotere) zinalembedwanso.

Ngati matenda a impso ndi chiwindi akugwira kale ntchito ndi zovuta, mulingo wambiri umachepetsedwa mpaka 50 mg / tsiku, popeza Galvus imachotsedwa impso, ndikupanga mtolo wowonjezera pamakina a excretory.

Zizindikiro zochuluka

Ngati chizolowezi cha tsiku ndi tsiku sichidutsa 200 mg / tsiku, odwala a shuga a Galvus amasamutsidwa popanda zotsatira. Mankhwala osokoneza bongo omwe ali ndi zizindikiro zoyenera amawonedwa akudya mopitirira 400 mg / tsiku. Nthawi zambiri zimawonetsa myalgia (kupweteka kwa minofu), kawirikawiri - paresthesia (mwa mawonekedwe ofatsa komanso a transistor), kutupa, kutentha thupi, milingo ya lipase imachulukanso kuposa VGN.

Ngati chizolowezi cha Galvus chikuwonjezereka katatu (600 mg / tsiku), pamakhala chiopsezo chotupa cha miyendo, paresthesia komanso kuchuluka kwa ALT, CPK, myoglobin ndi protein ya C-reactive. Zotsatira zonse zoyeserera, ngati zizindikiro, zimasowa pomwe Galvus yathetsedwa.

Galvus: analogues

Malinga ndi gawo lothandizira, mankhwalawa Vildaglympin ndi Galvus Met adzakhala ofanana ndi a Galvus, malinga ndi code ya ATX-4, Januvia ndi Onglisa zikugwirizana. Kafukufuku wa mankhwala ndi kuwunika kwa odwala kwawonetsa kuti mankhwalawa amasinthika kwathunthu.

Zochitika Zosiyanasiyana

Kugwiritsa ntchito nthawi yayitali kwa Galvus kungakhale limodzi ndi zovuta:

• Mutu ndikuwonongeka kwa mgwirizano,
• Manja ndi miyendo,
• Matenda a Dyspeptic
• Khungu, zotupa ndi zotupa pakhungu lomwe silimayambira,
• Kuphwanya miyambo yamatumbo,
• Chitetezo chofooka
• Kusweka ndi kugwira ntchito kwambiri
• Hepatitis, kapamba ndi matenda ena a chiwindi ndi kapamba,
• Kuzizira komanso kutupa.

Kwa omwe Galvus adayesedwa

Contraindication ogwiritsa ntchito Galvus adzakhala matenda angapo ndi zina.

1. Kusalolera payekhapayekha zigawo zikuluzikulu za mankhwala,
2. Kukhalitsa kwamkati ndi kuwononga dongosolo,
3. Zinthu zomwe zimayambitsa impso (kutentha thupi, matenda, kukhumudwa, kusanza),
4. Mtima ndi mtima wamatenda
5. Mavuto opatsirana
6. Dongosolo la matenda ashuga ketoacidosis, chikomokere, ndi kholo, pamene shuga yatanthauziridwa kukhala insulin,
7. Lactic acidosis, kuchuluka kwa lactic acid,
8. Mimba komanso kuyamwa
9. Mtundu woyamba wa shuga
10. Kuvutitsidwa mwatsatanetsatane kapena poyizoni wa mowa,
11. Chakudya chokhwima kwambiri chopezeka ndi kalori ya 1000 Kcal / tsiku,
12. Kuletsa kwa zaka: mpaka zaka 18, metabolite sakhazikitsidwa, atatha zaka 60 - mosamala,
13. Pamaso pa opareshoni (masiku awiri m'mbuyomu komanso pambuyo pake), madzulo atayamba kuyambitsa kwa othandizira kapena kuyesa kwa radiographic,
14. Chimodzi mwazomwe zimakhudzana kwambiri ndi Galvus ndi lactic acidosis, motero, ndi kulephera kwa chiwindi kapena aimpso, mankhwalawa sanadziwike.

Mu odwala matenda ashuga okalamba, kusuta kwa metformin ndikotheka, izi zimawonjezera kuchuluka kwa zovuta, kotero Galvus imayikidwa kokha moyang'aniridwa ndi achipatala.

Zolemba za Galvus chithandizo cha mitundu ina ya odwala matenda ashuga

Palibe chodalirika chokhudza mphamvu ya mankhwalawa pa thanzi la mayi ndi mwana wosabadwayo, chifukwa chake, panthawi yoyembekezera sichinafotokozedwe. Kuchuluka kwa shuga mwa mayi woyembekezera kumawonjezera mwayi wokhala ndi matenda obadwa nawo ngakhale kufa kwa mwana. Mu matenda a shuga mwa amayi apakati, glycemia nthawi zambiri imadziwika ndi insulin.

Kafukufuku wasonyeza kuti ngakhale mlingo wa Galvus, wopitilira nthawi 200, sizinachititse kusintha kwaumoyo wa mayi wapakati kapena mwana wosabadwayo. Zotsatira zomwezi zidalembedwa ndikugwiritsa ntchito metformin ndi Galvus powerengera 10: 1.

Funso loti kuthekera kwa metabolite kulowa mkaka wa m'mawere sikunaphunzire, chifukwa chake, poyamwitsa, Galvus nayenso sinafotokozedwe.

Zochitika za Galvus chithandizo cha ana odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matendawa (kuchuluka kwa odwala kotereku kukuchulukirachulukira masiku ano), makamaka, kuchuluka kwake kwa zotsatira zake zabwino komanso zoyipa, sikunaphunzire bwino.

Chifukwa chake, incretin mu mtundu 2 wa shuga amadziwika kuyambira azaka 18.

Anthu odwala matenda ashuga okalamba (atatha zaka 60) ayenera kuwongolera muyeso wa Galvus ndi magawo ake ofunikira, kuti ngati mukumva zowawa, dziwitsani dokotala nthawi yomweyo. Pakadali pano, chiopsezo cha zovuta ndi zotsatira zosayenerera zimawonjezeka, chifukwa chomwe chimayambitsa zotsatira zake.

Malangizo apadera

Odwala matenda ashuga ayenera kudziwitsidwa zonse zomwe zingachitike chifukwa chamankhwala atsopano.

Galvus ndi othandizira odwala matenda ashuga, koma si analogue of insulin. Chifukwa chake, kugwiritsidwa ntchito kwake kumafuna kuwunika kawirikawiri chiwindi. Izi zitha kufotokozedwanso ndikuti gawo lalikulu la Galvus limathandizira ntchito ya aminotransferases. Kunja, izi sizinafotokozedwe mwazizindikiro zowoneka, koma kusintha kwazomwe zikuchitika mu chiwindi mpaka kukula kwa chiwindi sikutha. Mulimonsemo, odzipereka odwala matenda ashuga ochokera ku gulu lowongolera adawonetsa izi. Pazizindikiro zoyambirira za kupweteka kwa pachimake (kupweteka kwapakati pamimba), mankhwalawa ayenera kuthetsedwa. Ngakhale kubwezeretsanso thanzi la chiwindi, Galvus sikulembedwanso.

Odwala omwe amadalira matenda a shuga a insulin omwe ali ndi mtundu wachiwiri wa Galvus amapatsidwa limodzi ndi insulin.

Kupsinjika pafupipafupi komanso kuchuluka kwambiri kwamanjenje kumachepetsa mphamvu ya Galvus. Malinga ndi anthu odwala matenda ashuga, nthawi zambiri matupi awo amakomoka komanso amasiya kugonja. Chifukwa chake, kuyendetsa galimoto kapena kugwira ntchito zowopsa pamikhalidwe ngati imeneyi sikulimbikitsidwa.

Asanakhale mayeso amtundu uliwonse, Galvus ndi mawonekedwe ake amayimitsidwa kwa masiku awiri. Osiyanasiyana omwe amagwiritsidwa ntchito pozindikira amakhala ndi ayodini. Kulumikizana ndi vildagliptin, imapanga katundu wowonjezera pa chiwindi ndi dongosolo la excretory. Poyerekeza ndi kuwonongeka kwa machitidwe awo, lactic acidosis imatha kuchitika.

Kalasi yoyamba yakulephera kwa mtima (kupatula kwa NYHA) yokhala ndi minyewa yofewa ya minofu sikufuna kusintha kwa mlingo wa Galvus. Gulu lachiwirili limaphatikizapo kuchepetsa minyewa kuti muchepetse kufupika, kufooka, ndi tachycardia, popeza m'malo opanda phokoso palibe matendawa omwe adalembedwa.

Kuti mupewe chiwopsezo cha hypoglycemia, ndi mankhwala ophatikizika ndi sulfonylurea kukonzekera, mulingo wocheperako womwe umasankhidwa.

Zotsatira Zogwiritsa Ntchito Mankhwala

Mu zovuta za mankhwala othandizira omwe amaphatikizidwa ndi metformin, glibenclamide, pioglitazone, ramipril, amlodipine, digoxin, valsartan, simvastatin, warfarin mpaka Galvus, palibe zotsatira zamankhwala zomwe zidawululidwa chifukwa cha kulumikizana kwawo.

Kuphatikiza kosakanikirana ndi thiazides, glucocorticosteroids, sympathomimetics, mahomoni a chithokomiro amachepetsa mphamvu ya hypoglycemic ya vildagliptin.

Zoletsa za angiotensin-kutembenuza enzyme yothandizirana ndi kufanana zimawonjezera chiopsezo cha angioedema.

Galvus yokhala ndi zizindikiro zotere sichitha, chifukwa edema imadutsa yokha.

Mankhwalawa sasintha kuchuluka kwa kagayidwe kachakudya pogwiritsa ntchito ma enzymes CYP3A4, CYP1A2, CYP2C8, CYP3A5, CYP2C9, CYP2C19, CYP2D6, CYP2E1.

Malamulo osungira

Pamaukonde a mankhwala, Galvus amagulitsidwa ndi mankhwala. Amatha kusiyanitsidwa ndi malire opindika komanso chizindikiro cha mbali ziwiri: zolemba FB ndi NVR. Pa mbale akhoza kukhala mapiritsi 7 kapena 14 a 50 mg. Mu makatoni okhala ndi matuza kuyambira awiri mpaka khumi ndi awiri.

Mankhwalawa amasungidwa mu kutentha mpaka 30 ° C m'malo opanda kanthu, popanda ana. Moyo wa alumali wa Galvus uli ndi zaka zitatu. Mapiritsi omwe adatha ayenera kutayidwa.

Ndemanga za madotolo ndi odwala

Wothandizira pakamwa wa hypoglycemic nthawi zambiri amaperekedwa woyamba kwa odwala matenda ashuga akangomupeza. Chifukwa chake, pazowunikira pamabwalo amawu pamakhala mafunso ambiri kwa endocrinologist kuposa mayankho.

Pothirira ndemanga zotere, madokotala amati matenda ashuga ndi matenda amoyo wonse. Ngakhale Galvus, kapena wina aliyense wothandizila wodwala sangathe kukonza mita ya shuga pa mulingo woyenera kwamuyaya. Mkhalidwe wa thanzi la munthu wodwala matenda ashuga nthawi zonse umakulirakulira, kuchuluka kwa zovuta zomwe zimachitika mwachindunji zimadalira kuchuluka kwa chiphuphu cha matenda ashuga. Palibe piritsi yodabwitsa kwa odwala matenda ashuga. Kuwongolera kokha zakudya, kukonzanso kwa njira yonse yamoyo wokhala ndi mankhwala othandizira kungapangitse kuchepa kwa zovuta komanso kukhalabe ndi moyo wabwino ndi shuga pamlingo wabwinobwino.

Sikuti onse opuma pantchito omwe angathe kupita ku Galvus pamtengo wa ma ruble 800. kwa ma pcs 28., ambiri akumufunafuna m'malo mwake, ngakhale Januvia (1400 rubles) kapena Onglisa (1700 rubles) nawonso sagwirizana ndi aliyense. Ndipo omwe akupitilizabe kugwiritsa ntchito amazindikira kuti pang'onopang'ono shuga amayamba kutuluka ndikuyenda bwino kwa mankhwalawa kumachepa.

Pharmacodynamics ndi pharmacokinetics

Kugonjera vildagliptin Ndiwowonjezera chida chogwiritsira ntchito kapamba, wokhoza kusankha moletsa zoletsa za puleptidyl peptidase-4. Kupindulitsa kwa njirayi kumawonjezera kubisa komanso kusinthika kwa chakudya kwa mtundu 1 wa glucagon ngati peptide ndi glucose wodalira insulinotropic polypeptide kuchokera m'matumbo kupita ku kayendedwe kazinthu. Izi zimawonjezera chidwi chazinthuzi komanso kumva kupindika kwa anc-glucose, zomwe zimapangitsa kuti khungu lizidalira shuga insulin

Kuchuluka kwa glucagon ngati peptide ya 1st kungayambitse kuchepa kwa matumbo, koma ndi chithandizovildagliptin palibe zoterezi zomwe zidadziwika.

Monotherapy ndi Galvus kapena kuphatikiza ndi metformin, thiazolidinedionezotumphukira sulfonylureas kapena insulin kwa nthawi yayitali amachepetsa ndende ya glycated hemoglobin ndi shuga magazi. Komanso, chithandizo choterechi chimachepetsa kumachitika hypoglycemia.

Kuyamwa vildagliptin zikuyenda mwachangu. Mtheradi wa bioavailability wa chinthu ndi 85%. Masautso a yogwira pophika plasma zimatengera mlingo woyenera.

Mutamwa mankhwalawa pamimba yopanda kanthu, kupezeka kwake m'madzi am'madzi amadziwika pambuyo pa 1 h 45 min. Kudya kumakhudzanso mphamvu ya mankhwalawa. Mkati mwa thupi, gawo lalikulu la Galvus limasinthidwa kukhala metabolites, kuchotsa komwe kumachitika makamaka pogwiritsa ntchito impso.

Zizindikiro zogwiritsidwa ntchito

Chizindikiro chachikulu cha kuikidwa kwa Galvus ndi chithandizo matenda ashugamtundu 2 mu mono - kapena mitundu yosiyanasiyana ya mankhwala othandizira, mwachitsanzo, ndi Metformin, Thiazolidinedione zotumphukira sulfonylureas kapena insulin mosiyanasiyana zomwe adokotala amapeza.

Contraindication

Mankhwala awa ali osavomerezeka kuti agwiritsidwe ntchito ndi:

• kumva kuti vildagliptin ndi zina za mankhwala,
• cholowa galactose tsankho, lactase akusowashuga galactose malabsorption,
• milandu yina kulephera kwa mtima
• wosakwana zaka 18.

Mosamala, chithandizo chimalembedwa kwa odwala omwe ali ndi vuto la chiwindi kulephera kwa aimpso.

Zotsatira zoyipa

Nthawi zambiri, mankhwala ndi Galvus, palibe zoyipa zimachitika zomwe zimafuna kusiya mankhwala.

Komabe, kukulitsa mawonekedwe owoneka, makamaka mawonekedwe a kutupa, sikuyenera kutsutsidwa. Mwina kuphwanya chiwindi, kupatuka mu mawonekedwe a zachilengedwe a chiwalo. Kuchepa kwa hypoglycemia, mutu, chizungulire,matenda ammimba komanso kusokonezeka kwa thupi.

Malangizo a Galvus (Njira ndi Mlingo)

Mankhwalawa amapangidwira pakamwa ndipo samatengera kugwiritsa ntchito chakudya. Mlingo wa mankhwalawa amasankhidwa payekhapayekha, poganizira momwe amagwirira ntchito komanso mawonekedwe a thupi.

Malinga ndi malangizo ogwiritsira ntchito Galvus, munthawi ya monotherapy, komanso pazinthu ziwiri zophatikiza ndi thiazolidinedione, metformin kapena insulin lembani tsiku lililonse 50-100 mg. Odwala odwala kwambiri matenda ashugamtundu 2kulandira insulin, tsiku lililonse mapiritsi a Galvus ndi 100 mg.

Cholinga cha kuphatikiza katatu, ndiye: vildagliptin + metformin+ zotuluka sulfonylurea zimaphatikizapo kumwa 100 mg patsiku. Pankhaniyi, 50 mg nthawi zambiri amatengedwa - m'mawa ndi madzulo.

Zigawo ziwiri zophatikizira mankhwala ndi sulfonylureas imaphatikizapo mlingo wa tsiku lililonse wa 50 mg wa Galvus, womwe umatengedwa m'mawa. Ndikotheka kuwonjezera mlingo wa tsiku ndi tsiku mpaka 100 mg, koma nthawi zambiri izi sizofunikira.

Ngati pakhale matenda osakwanira pakumwedwa kokwanira tsiku lililonse kwa 100 mg, ndiye kuti mutha kuyendetsa chitukuko cha glycemia kuwonjezera, mutha kutenga othandizira ena: metformin, thiazolidinedione, sulfonylurea zotumphukirakapenainsulin.

Bongo

Monga lamulo, odwala amalekerera Galvus bwino popereka mankhwala okwanira 200 mg.

Ndi poika tsiku lililonse 400 mg, kukula ndikotheka kupweteka kwa minyewakutupa ndi zizindikiro zina zosasangalatsa.

Kuwonjezeka kwa tsiku ndi tsiku kwa 600 mg kungayambitse kutupa kwa malekezero, kuwonjezeka kwakukulu kwa kuchuluka kwa ALT, CPK, mapuloteni othandizira komanso myoglobin. Nthawi zambiri, atasiya kumwa mankhwalawa, zizindikiro zonse za mankhwala osokoneza bongo zimachotsedwa.

Kuchita

Zimakhazikitsidwa kuti Galvus imadziwika ndi kuthekera kocheperako kwakukhudzana ndi mankhwala. Chifukwa chake, amaloledwa kuitenga nthawi imodzi ndi ma substrates, inhibitors, inductors cytochrome P450 komanso osiyanasiyana michere.

Mwinanso kulumikizana kwakukulu kwa mankhwalawa ndimankhwala omwe amafotokozedwanso mtundu 2 shugaMwachitsanzo: Glibenclamide, Metformin, Pioglitazone. Zotsatira zakugwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo omwe ali ndi mawonekedwe ochepa a zochizira -Amlodipine, Digoxin, Ramipril, Simvastatin, Valsartan, Warfarin osakhazikika, motero, chithandizo chophatikizira choterechi chikuyenera kuchitika mosamala.

Zomwe mungasankhe: Galvus kapena Galvus Met? Kodi pali kusiyana kotani?

Galvus ndi mankhwala ozikidwa pa vildagliptin, ndipo Galvus Met ndi mankhwala osakanikirana omwe amathandizidwa ndi metformin. Kuphatikiza ndi metformin, vildagliptin bwino imachepetsa shuga la magazi. Komabe, itha kugwiritsidwa ntchito pokhapokha ngati wodwala alibe zotsutsana pakutenga metformin. Zotsatira zoyipa za chinthuchi ndi izi: kutsegula m'mimba, kusokonezeka kwina ndi zovuta zina m'mimba. Musakane chithandizo. Monga lamulo, izi zosasangalatsa zimawonekera pokhapokha poyambira chithandizo, ndipo zimatha.

Zomwe mungasankhe Galvus Met kapena Yanumet?

Yanumet ndi Galvus Met ndi mankhwala awiri omwe ali ndi zotsatira zofanana. Zonsezi zimapangidwa kuti muchepetse magazi. Pakadali pano, ndizosatheka kuyankha kuti ndi mankhwala ati ali bwino, popeza palibe kafukufuku yemwe adachitapo pankhaniyi.

Mtengo wa mankhwala ndi womwewo. Muyenera kulipira zambiri polojekiti Yanumet, koma kuchuluka kwa mapiritsi momwemo kudzakhalanso.

Onse a Galvus Met ndi Yanumet amatetezedwa ndi ma Patent, samayambitsa zotsatira zoyipa ndipo ndi mankhwala otetezeka. Mutha kupeza ndemanga zabwino za onse komanso mankhwala.

Galvus kapena metformin - kusankha?

Mankhwala a Galvus Met, vildagliptin amagwira ntchito ngati chinthu chachikulu chogwiritsidwa ntchito, metformin ndi gawo lothandizira. Pali lingaliro kuti kuchepa kwenikweni kwa shuga m'magazi kumachitika makamaka chifukwa chovuta cha zinthu ziwiri izi.

Ngakhale Galvus Met ndiokwera mtengo kuposa mankhwala kutengera metformin imodzi yokha, imagwira bwino ntchito yake. Chifukwa chake, ngati mawonekedwe a wodwala amuloleza kugwiritsa ntchito mankhwala osokoneza bongo pochita chithandizo, ndibwino kuti muzimukonda. Ngati izi sizingatheke, ndiye kuti muyenera kusankha kukonzekera kwa metformin (Glucofage kapena Siofor). Ndikofunika kudziwa kuti onse Glucofage ndi Siofor ndi mankhwala ochokera kunja. Mutha kugulanso anzawo otsika mtengo omwe amapangidwa ku Russia, koma sipadzakhala kusiyana kwakukulu pamtengo.

Ponena za mankhwalawa Galvus, sangathe kutchedwa chida champhamvu chochepetsera shuga. Galvus Met wochizira matenda a shuga ndi oyenera kugwiritsa ntchito. Galvus amatchulidwa pokhapokha ngati wodwala ali ndi contraindication kuti atenge metformin. Ngati chithandizo sichikubweretsa zotsatira zomwe mukufuna, ndiye kuti insulini iyenera kuyamba.

Zolemba za Galvus Met

Kuti mupewe kudzimbidwa mwanjira ya m'mimba ndi kusanja, ndikofunikira kutenga Galvus Met molondola. Mlingo woyambira uyenera kukhala wocheperako, uwonjezere bwino. Malangizo a mankhwalawa amalola kuti thupi lizitha kusintha komanso kuloza chinthu chatsopanocho. Ndi metformin yomwe imayambitsa zovuta m'mimba, osati vildagliptin.

Kodi mungapewe bwanji?

Popewa kupezeka kwa mavuto, muyenera kuyamba kulandira mankhwalawa. Ndikulimbikitsidwa kugula phukusi la mapiritsi a Galvus Met ndi kuchuluka kwa 50 + 500 mg ndi kumwa piritsi limodzi kamodzi patsiku. Ngati thupi lilabadira chithandizo chotere, ndiye kuti pakatha sabata kapena masiku 10, muyenera kumwa mapiritsi 2 a mankhwalawa - m'mawa komanso musanagone. Ntchitoyo ikamalizidwa, muyenera kugula mankhwala ndi Mlingo wa 50 + 850 mg. Imwani mankhwalawa komanso 2 pa tsiku. Gawo lachitatu la chithandizo ndikusintha kwa mankhwala omwe ali ndi Mlingo wa 50 + 1000 mg. Mapiritsi amledzera kawiri pa tsiku. Mlingo wotsiriza wa tsiku ndi tsiku wa mankhwala ndi 100 mg ya vildagliptin ndi 2000 mg ya metformin.

Ngati, kuwonjezera pa matenda ashuga, wodwalayo amapezeka kuti ali ndi kunenepa kwambiri, ndiye kuti tsiku lililonse mankhwala a metformin amatha kuwonjezeredwa mpaka 3000 mg. Mwa izi, pakati pa tsiku, pakudya, wodwalayo ayenera kumwa mankhwala a metformin mu 850 kapena 1000 mg. Mutha kugwiritsa ntchito mankhwala Glucofage kapena Siofor pa izi. Izi zitha kuyambitsa zovuta kwa munthu, chifukwa m'malo mwa mankhwala amodzi adzafunika kumwa mitundu iwiri yosiyanasiyana. Komabe, kuti muchepetse kulemera kambiri muyenera kuzindikira mfundo imeneyi.

Galvus Met waledzera pakudya, izi zimachitika chifukwa cha zomwe zili mu metformin mmenemo. Mankhwala, Galvus metformin sichoncho, imatha kumwa onse musanadye komanso pambuyo chakudya. Zilibe kanthu.

Galvus ndiotchipa pafupifupi kawiri kuposa Galvus Met. Ngati mukufuna kupulumutsa, ndiye kuti mutha kugula mankhwalawa Galvus ndi metformin ya mankhwala payokha (Glucofage kapena Siofor). Komabe, muyenera kutsatira malangizo onse omwe mungamwe mankhwalawa, omwe amafunikira kulangizidwa kwakukulu.

Ngati wodwala akuwonjezeka shuga m'magazi m'mawa, ndiye kuti muyenera kumwa piritsi limodzi la mankhwalawa Galvus m'mawa ndi madzulo, ndipo asanagone, kuwonjezera pake kumwa mankhwalawa malinga ndi metformin, ndi mlingo wa 2000 mg (Glucofage Long). Kupitiliza kwake kwa nthawi yayitali kumatithandiza kuti tiwonetsetse kuti m'mawa mulingo wotseka sukwera m'magawo ovuta.

Kodi ndingamwe mowa?

Pambuyo pophunzira malangizowo, mwina simungamvetse ngati zakumwa zoledzeretsa zimaloledwa pa chithandizo ndi Galvus ndi Galvus Met. Kumwa mowa waukulu ndizoletsedwa momveka bwino, chifukwa zimawonjezera mwayi wokhala ndi kapamba, kuwonongeka kwa chiwindi, kuchepa kwambiri kwa shuga m'magazi. Munthu amatha kumapeto kwa chipatala kapenanso kufa.

Ponena za milingo yaying'ono ya mowa, palibe kumveka kokwanira. Malangizowo salola mwachindunji kapena kuletsa kuphatikiza mankhwalawo ndi mowa. Chifukwa chake, munthu amatha kumwa, koma pokhapokha pamavuto anu komanso pachiwopsezo chake. Ngati mukatha kumwa mowa kutha kudziletsa, ndiye kuti muyenera kusiyiratu kumwa kwake.

Kodi ndingachepetse thupi mankhwala?

Kafukufuku wopangidwa pamutuwu akuwonetsa kuti Galvus ndi Galvus Met sizikhudza kulemera kwa thupi. Komabe, monga chidziwitso chogwiritsa ntchito metformin chikuwonetsa, imatha kulimbana ndi kunenepa kwambiri. Chifukwa chake, mwayi womwe wodwalayo amachepetsa umakhalabe wokwera.

Momwe mungasinthire mankhwala a Galvus Met?

Zinthu zomwe Galvus Met ingafunike kusinthidwa:

Mankhwalawa samachepetsa shuga lamwazi, lomwe limasungidwa kwambiri.

Mankhwalawa amachepetsa shuga m'magazi, koma mulingo wake sucheperachepera 6 mmol / l.

Munthu sangathe kupitiriza kulandira chithandizo ndi mankhwalawa chifukwa chachuma.

Ngati Galvus Met sagwira ntchito, ndiye kuti izi zitha kuchitika pokhapokha poti zosungirako kapamba zimatha. Pankhaniyi, palibe mankhwala ena omwe angathandize, wodwala amafunikira jakisoni wa insulin mwachangu. Kupanda kutero, posakhalitsa amatenga zovuta zazikulu za matendawa.

Nthawi zambiri, shuga wamwazi sayenera kupitirira 5.5 mmol / L. Mfundo ngati izi ziyenera kukhala zosasunthika osasintha masana. Ngati kutenga Galvus Met kukuthandizani kuti mubweretse shuga m'magazi a 6.5-8 mmol / l, ndiye kuti muyenera kulumikiza jakisoni wa insulin m'matenda ang'onoang'ono. Chiwembuchi chimasankhidwa kutengera mtundu wa matenda a shuga wodwala wina. Komanso, wodwalayo ayenera kutsatira zakudya komanso masewera olimbitsa thupi. Munthu ayenera kumvetsetsa kuti ndi kuchuluka kwa shuga m'magazi a 6.0 mmol / L, zovuta za matendawa zimapitilirabe, koma pang'onopang'ono.

Ngati palibe njira yogulira mankhwalawa Galvus Met?

Ngati mankhwala a Galvus ndi Galvus Met ndi okwera mtengo kwa wodwala, ndipo sangakwanitse kugula, ndiye kuti muyenera kutenga metformin mwa njira yake. Awa akhoza kukhala mankhwala Glucofage kapena Siofor. Amapangidwa kunja. Anzawo aku Russia ndi otsika mtengo kwambiri.

Onetsetsani kuti mukutsatira zakudya zamafuta ochepa. Kupanda kutero, matendawa amapita patsogolo.

Za adotolo: Kuyambira 2010 mpaka 2016 Othandizira pachipatala chachipatala chapakati chaumoyo Na. 21, mzinda wa elektrostal. Kuyambira mu 2016, agwira ntchito ku malo ozindikira matenda No. 3.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi: kuchokera ku chikasu choyera mpaka choyera, chozungulira, chammbali chakumaso, chokhala ndi mawonekedwe osalala komanso mawonekedwe a NVR mbali imodzi, FB - inayo (ma PC 7. Kapena ma PC 14. Phukusi lodzaza, pakatoni 2 , 4, 8 kapena 12 matuza ndi malangizo ogwiritsira ntchito Galvus).

Piritsi limodzi lili:

• yogwira mankhwala: vildagliptin - 50 mg,
• othandizira zigawo zikuluzikulu: wowuma wa sodium carboxymethyl, anactrous lactose, microcrystalline cellulose, magnesium stearate.

Pharmacokinetics

Vildagliptin ikamamwa pakamwa yopanda kanthu imatengedwa mwachangu, C_max (pazipita kuchuluka kwa chinthu) m'madzi am'magazi amafikira maola 1.75. Panthawi yakulowerera munthawi yomweyo ndi chakudya, kuchuluka kwa mayamwidwe a vildagliptin kumachepera pang'ono: kuchepa kwa C_max pofika 19%, pomwe nthawi yoti akwaniritse imawonjezeka ndi maola 2,5. Komabe, kudya pamlingo wa mayamwidwe ndi AUC (dera lomwe limapindika "nthawi yokhazikika") lilibe kanthu.

Vildagliptin imalowetsedwa mwachangu, ndipo tanthauzo lake lonse la bioavailability ndi 85%. Makhalidwe a C_max ndi AUC mu achire mlingo zosiyanasiyana kuchuluka pafupifupi malinga ndi mlingo.

Thupi limadziwika ndi gawo lochepa kwambiri lomanga kumapuloteni a plasma (pamlingo wa 9.3%). Vildagliptin imagawidwanso pakati pa maselo ofiira a magazi ndi madzi a m'magazi. Kugulitsa zinthu kumachitika, mwina, mwachisawawa, V_ss (voliyumu ya magawidwe ofanana) pambuyo pa kayendetsedwe ka intravenous ndi malita 71.

Njira yayikulu yochotsera vildagliptin ndi biotransfform, yomwe imadziwika ndi 69% ya mlingo. Metabolite yayikulu ndi lay151 (57% ya mlingo). Sichikuwonetsa zochitika zam'magulu amtundu wa mankhwala ndipo ndichopanga cha hydrolysis cha gawo la cyano. Pafupifupi 4% ya mankhwalawa amapezeka amide hydrolysis.

Pa maphunziro oyamba, zotsatira zabwino za DPP-4 pa hydrolysis ya vildagliptin idakhazikitsidwa. Mu kagayidwe kazinthu, cytochrome P isoenzymes₄₅₀ osatenga nawo mbali. Vildagliptin gawo lapansi isoenzyme P₄₅₀ (CYP) sichoncho, cytochrome P isoenzymes₄₅₀ sichimaletsa ndipo sichichita chidwi.

Mutatenga vildagliptin mkatimo, pafupifupi 85% ya mankhwalawa imachotsedwa impso, kudzera m'matumbo - pafupifupi 15%. Kutulutsa kwina kwa zinthu zosasinthika ndi 23%. Yapakatikati T_1/2 (hafu ya moyo) pamene chikuyendetsedwera mkati ndi 2 hours, chilolezo cha impso ndi chilolezo chonse cha plasma cha vildagliptin ndi 13 ndi 41 l / h, motsatana. T_1/2 Pambuyo pakamwa, ngakhale mlingo, ndi pafupifupi 3 maola.

Mankhwala aacocokinetic odwala omwe ali ndi vuto la chiwindi:

• kuuma pang'ono komanso pang'ono
• kwambiri digiri (mfundo za 10-12 pamsana wa Mwana-Pugh): kukhudzika kwa vildagliptin kumawonjezeka ndi 22%.

Zosintha (kuchuluka kapena kuchepa) pazokwera kwambiri za bioavailability wa chinthu chopitilira 30% zimawoneka kuti ndizofunika kwambiri. Palibe kulumikizana komwe kunapezeka pakati pa bioavailability wa vildagliptin ndi kuopsa kwa vuto la chiwindi.

Mankhwala a Pharmacokinetic mu odwala omwe ali ndi vuto laimpso ofatsa, ochepa kapena owopsa (poyerekeza ndi odzipereka athanzi):

• AUC ya vildagliptin: imawonjezera 1.4, 1.7 ndi 2 nthawi, motero,
• AUC ya metabolite lay151: imawonjezeka ndi 1.6, 3.2 ndi 7.3 nthawi, motero
• AUC ya metabolite BQS867: imawonjezera 1.4, 2.7 ndi 7.3 nthawi, motsatana.

Zambiri zochepa mu terminal gawo la CKD (matenda a impso) zimatsimikizira kuti zizindikiro zomwe zili mgululi ndizofanana ndi zomwe zili ndi odwala omwe ali ndi vuto la impso. Kuphatikizika kwa lay151 metabolite mu siteji yotsika ya CKD kumawonjezeka ndi nthawi 2-3 poyerekeza ndi kuchuluka kwa odwala omwe ali ndi vuto laimpso.

Ndi hemodialysis, vildagliptin excretion ndi ochepa (maola 4 pambuyo pa limodzi mlingo 3% ndi kutalika kwa maola oposa 3-4).

Okalamba odwala (opitilira zaka 65-70), kuchuluka kwakukulu kwa voaagicosal ndi 32%, C_max - 18% siyimakhudzanso zopinga za DPP-4 ndipo siyofunika kwambiri pachipatala.

Zolemba za Pharmacokinetic mwa odwala ochepera zaka 18 sizinakhazikitsidwe.

Galvus, malangizo ogwiritsira ntchito: njira ndi mlingo

Mapiritsi a Galvus amatengedwa pakamwa, ngakhale atamwa kwambiri.

Mlingo uyenera kusankhidwa poganizira momwe munthu angagwirire ntchito yake ndi kuvomerezeka kwa mankhwalawo.

• monotherapy kapena kuphatikiza ndi thiazolidinedione, metformin kapena insulin: 50 mg 1-2 kawiri pa tsiku, koma osapitirira 100 mg,
• kuphatikiza kawiri mankhwala ndi sulfonylurea kukonzekera: 50 mg kamodzi patsiku, m'mawa. Odwala a gululi, njira yothandizira achire Galvus tsiku lililonse ya 100 mg imafanana ndi ya 50 mg patsiku,
• katatu kuphatikiza mankhwala ndi munthawi yomweyo sulfonylurea ndi metformin zotumphukira: 100 mg patsiku.

Ngati mlingo watsiku ndi tsiku ndi 50 mg, amatengedwa kamodzi, m'mawa, ngati 100 mg - 50 mg m'mawa ndi madzulo. Ngati mutadumphira mwadzidzidzi mlingo wotsatira, muyenera kumwa mosamala masana. Simungalole kutenga Galvus pamtunda wopitilira munthu tsiku lililonse.

Popeza kulibe glycemic yokwanira pa monotherapy pa mlingo waukulu wa tsiku lililonse wa 100 mg, mankhwalawa amayenera kuthandizidwa ndi sulfonylurea, metformin, thiazolidinedione kapena insulin.

Ndi kufatsa kochepa kwambiri kwaimpso, kulengedwa kwa creatinine (CC) pamwambapa 50 ml / min sikumasintha mlingo wa Galvus.

Ndi zolimbitsa thupi (CC 30-50 ml / min) komanso zolimba (CC zosakwana 30 ml / min) kukanika kwa impso, kuphatikiza gawo lomaliza la matenda a impso (hemodialysis odwala kapena hemodialysis), tsiku ndi tsiku mlingo wa Galvus umatengedwa kamodzi, ndipo osatero ayenera kupitilira 50 mg.

Odwala okalamba (zaka zopitilira 65), kukonza mankhwala a Galvus sikofunikira.

Zotsatira zoyipa

Kukula kwa zotsatira zosafunikira panthawi ya monotherapy kapena kuphatikiza ndi othandizira ena nthawi zambiri kumakhala kofatsa, kwakanthawi ndipo sikutanthauza kuti kuthetsedwe kwa Galvus.

Maonekedwe a angioedema nthawi zambiri amawonedwa akaphatikizidwa ndi angiotensin-converting enzyme inhibitors. Nthawi zambiri chimakhala chovuta kwambiri, chimadzichitira chokha motsutsana ndi maziko a chithandizo chanthawi zonse.

Nthawi zambiri, kugwiritsidwa ntchito kwa Galvus kumayambitsa chiwindi ndi matenda ena a chiwindi ntchito monga asymptomatic. Nthawi zambiri, machitidwewa safunikira chithandizo chamankhwala, ndipo atatha kufafaniza kwa Galvus, chiwindi chimagwira ntchito.

Kuchulukitsa kwa michere ya chiwindi pa mlingo wa vildagliptin 50 mg kawiri pa tsiku nthawi zambiri ndi asymptomatic, sikuyenda ndipo sikuyambitsa cholestasis kapena jaundice.

Ndi monotherapy mu mlingo wa 50 mg kawiri pa tsiku, zotsatirazi zotsatirazi zingachitike:

• Kuchokera kwamanjenje: Nthawi zambiri - chizungulire, mosapweteka - mutu,
• ma parasitic ndi matenda opatsirana: kawirikawiri - nasopharyngitis, matenda apamwamba a thirakiti;
• kuchokera ku ziwiya: mokhazikika - zotumphukira edema,
• Kuchokera m'mimba thirakiti: pafupipafupi - kudzimbidwa.

Ndi kuphatikiza kwa Galvus muyezo wa 50 mg 1-2 kawiri pa tsiku ndi metformin, kuwoneka kwa zotsatirapo ndizotheka:

• Kuchokera kwamanjenje: Nthawi zambiri - kupweteka mutu, kunjenjemera, chizungulire,
• Kuchokera m'mimba thirakiti: Nthawi zambiri - nseru.

Kuphatikiza mankhwala ndi metformin sikukhudza thupi la wodwalayo.

Mukamagwiritsa ntchito Galvus patsiku la 50 mg osakanikirana ndi mankhwala a sulfonylurea, njira zotsatirazi zitha kuonedwa mwa wodwala:

• ma parasitic ndi matenda opatsirana: kawirikawiri - nasopharyngitis,
• Kuchokera m'mimba thirakiti: pafupipafupi - kudzimbidwa,
• Kuchokera kwamanjenje: Nthawi zambiri - kupweteka mutu, kunjenjemera, chizungulire, asthenia.

Kulemera kwa wodwala sikuwonjezereka ndikaphatikizidwa ndi glimepiride.

Kugwiritsidwa ntchito kwa Galvus muyezo wa 50 mg 1-2 kawiri pa tsiku limodzi ndi thiazolidatedione zotumphukira zingayambitse zotsatirazi zosafunikira:

• kuchokera ku zotengera: nthawi zambiri - zotumphukira edema,
• kuchokera kumbali ya kagayidwe ndi zakudya: nthawi zambiri - kuwonjezeka kwa thupi.

Kumwa Galvus mlingo wa 50 mg 2 kawiri pa tsiku limodzi ndi insulin kungayambitse:

• Kuchokera kwamanjenje: Nthawi zambiri - mutu, wokhala ndi mafayilo osadziwika - asthenia,
• Kuchokera m'mimba thirakiti: Nthawi zambiri - gastroesophageal Reflux, nseru, pafupipafupi - flatulence, kutsegula m'mimba,
• kuchokera kumbali ya kagayidwe ndi zakudya: Nthawi zambiri - hypoglycemia,
• mavuto ambiri: kawirikawiri - kuzizira.

Kulemera kwa wodwala kuphatikiza uku sikukula.

Kugwiritsa ntchito Galvus 50 mg 2 kawiri pa tsiku limodzi ndi metformin ndi sulfonylurea kukonzekera kungayambitse kukulitsa zotsatira zotsatirazi:

• kuchokera kumbali ya kagayidwe ndi zakudya: Nthawi zambiri - hypoglycemia,
• Kuchokera kwamanjenje: Nthawi zambiri - kunjenjemera, chizungulire, asthenia,
• dermatological zimachitika: zambiri - hyperhidrosis.

Kuphatikiza kwapawiri sikukhudza thupi la wodwalayo.

Kuphatikiza apo, zochitika zotsatirazi zidalembedwa mu maphunziro atatha kulembetsa: urticaria, kuchuluka kwa michere ya chiwindi, hepatitis, kapamba, zotupa za pakhungu la oxous kapena exfoliative etiology, myalgia, arthralgia.

Malangizo apadera

Wodwalayo ayenera kudziwitsidwa za kufunika kokawonana ndi dokotala chifukwa cha kuwonjezeka kwa zotsatirapo zoyipa kapena kuwonekera kwa zina zosayenera pamasamba ogwiritsira ntchito mapiritsi.

Mankhwala samayambitsa chonde.

Odwala omwe amadalira insulin, Galvus amayenera kugwiritsidwa ntchito limodzi ndi insulin.

M'magawo osalephera a mtima omwe ndimagwira ntchito yogawa mankhwala a NYHA angathe kumwedwa popanda zoletsa zolimbitsa thupi.

Kulephera kwamtima kwamkalasi kwa kalasi yachiwiri, kuletsa zolimbitsa thupi kwakanthawi kumafunika, popeza katundu wambiri amachititsa kugunda kwa mtima, kufooka, kufumira, kutopa. Pakupumula, zizindikirazi sizipezeka.

Ngati zizindikiro za pancreatitis pachimake zikuwoneka, vildagliptin iyenera kusiyidwa.

Musanayambe kugwiritsa ntchito kenaka kamodzi m'miyezi itatu mchaka chotsatira, ndikulimbikitsidwa kuti mupange maphunziro a chiwonetsero cha zamankhwala, chifukwa zochita za Galvus mwanjira zina zimatha kuwonjezera ntchito ya aminotransferases. Ngati pakuchitika kafukufuku wachiwiri, zomwe zikuwonetsa alanine aminotransferase (ALT) ndi aspartate aminotransferase (AST) zimaposa malire apamwamba a nthawi ndi katatu kapena kupitirira apo, mankhwalawo ayenera kusiyidwa.

Ndikupanga zizindikiro za chiwindi chodwala (kuphatikizapo jaundice) mutatenga Galvus, kuleka kwa mankhwalawo ndikofunikira, ndizosatheka kuyambiranso pambuyo pobwezeretsa zizindikiro za chiwindi.

Kuchepetsa chiopsezo cha hypoglycemia akaphatikizidwa ndi sulfonylurea kukonzekera, tikulimbikitsidwa kuti mugwiritse ntchito osokoneza bongo ochepa.

Kuyanjana kwa mankhwala

Pogwiritsa ntchito munthawi yomweyo Galvus yomwe ili ndi glibenclamide, metformin, pioglitazone, amlodipine, ramipril, digoxin, valsartan, simvastatin, warfarin, palibe mgwirizano uliwonse wachipatala womwe wakhazikitsidwa.

Mphamvu ya hypoglycemic ya vildagliptin imatha kuchepetsedwa ikaphatikizidwa ndi thiazides, glucocorticosteroids, sympathomimetics, ndi kukonzekera kwa mahomoni a chithokomiro.

The mwayi wokhala ndi angioedema kumawonjezera ndi concomitant mankhwala ndi angiotensin kutembenuza enzyme zoletsa. Dziwani kuti vildagliptin iyenera kupitilizidwa ndi mawonekedwe a angioedema, popeza imadutsa pang'onopang'ono, palokha komanso osafuna kusiya ntchito.

Kuyanjana kwa Galvus ndi mankhwala omwe ali amtundu, ma inducers kapena zoletsa za cytochrome P ndizokayikitsa₄₅₀ (CYP).

Galvus siyimakhudza kuchuluka kwa kagayidwe kazakudya kamene kamakhala mu michere CYP1A2, CYP3A4, CYP3A5, CYP2C8, CYP2C9, CYP2D6, CYP2C19, CYP2E1.

Ma Analogs a Galvus ndi: Vildagliptin, Galvus Met.