ZENTIVA METFORMIN

Metformin-Zentiva ndi mankhwala omwe cholinga chake ndi kuchiza matenda a shuga 2 a mellitus (DM 2). Wopanga - Sanofi India Ltd. / Zentiva. Zili pagulu la Biguanides. Kuphatikiza pa cholinga chachikulu, chimatsitsa cholesterol ndi mapaundi owonjezera. Chofunikira chachikulu ndi metformin hydrochloride.

Chidacho chimathandizira kuchepetsa kupangidwa kwa shuga ndi chiwindi, kuchedwetsa mayamwidwe ake m'mimba, ndikulepheretsa kaphatikizidwe ka mafuta. Mukamadya minofu, kumva kuphatikizira kwa insulin kumawonjezeka. Metformin imathandizira pakumanga kwa lipid. Amachepetsa cholesterol, LDL, triglycerides. Kuzungulira kwa shuga m'magazi kumachepetsedwa ndikumakanikizira kupangika kwa shuga. M'maphunziro, kukhazikika kapena kuchepa kwakachepera thupi kunapezeka.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amalembedwa motere:

• Chithandizo cha matenda a shuga 2
• Chithandizo cha matenda a shuga 2 amtundu wa insulin kapena mankhwala ena ochepetsa shuga,
• kuchepetsa mavuto kuchokera ku mtima ndi anthu omwe ali ndi matenda a shuga a 2,
• zovuta mankhwala mankhwalawa kunenepa.

Malangizo ogwiritsira ntchito

Mankhwalawa amalembera achikulire ndi ana a zaka 10 malinga ndi njira zotsatirazi:

1. Monotherapy kapena kuphatikiza ndimankhwala ena oikidwa

Amayamba kuthandizidwa ndi Mlingo wochepa - 500 mg 2-3 kawiri pa tsiku. Pambuyo pa masabata 1-2, ngati ndi kotheka, sinthani mlingo. Mlingo wapamwamba ndi 2000-3000 mg mu 3 waukulu magawo.

Mankhwalawa amadyedwa 500-850 mg katatu patsiku. Malangizo a jakisoni wa insulin.

1. Anthu omwe ali ndi vuto lochepa la impso amayamba kumwa 500 mg kamodzi patsiku. Mlingo wapamwamba ndi 1000 mg 2 nthawi.

Contraindication

Mankhwala contraindised otsatirawa milandu:

• Hypersensitivity pamagawo a mankhwala,
• kulephera kwapakati / kwambiri kwaimpso,
• kulephera kwa mtima
• uchidakwa
• vuto la mtima waposachedwa,
• kulephera kwa chiwindi
• mimba / mkaka wa m`mawere.

Zotsatira zoyipa

Metformin imalekeredwa bwino ndi odwala, koma nthawi zina zotsatirazi zoyipa zimawonedwa:

• kuchepa kwa mayankho a B12 (pogwiritsa ntchito nthawi yayitali),
• matenda am'mimba
• kulakwira
• zimachitika pakhungu
• lactic acidosis.

Kuchita ndi mankhwala ena

Mankhwalawa sagwirizana ndi ethanol. Insulin, zotumphukira za asidi wa asidi, ma inhibitors a MAO, sulfonylureas, nootropics amathandizira pakuchitika kwa metformin. Kulera kwamlomo, mahomoni, okodzetsa, niacin, phenothiazines amachepetsa mphamvu ya mankhwalawa.

Migwirizano ndi machitidwe akusungidwa kwa mankhwalawa

Metformin Zentiva sifunikira njira zopulumutsira mwapadera. Amasungidwa pa kutentha kwa madigiri 25 mu phukusi loyambirira. Moyo wa alumali ndi zaka zitatu.

Msika wama pharmacological uli ndi mankhwala ambiri kutengera metformin.

Mayina odziwika kwambiri:

• Bagomet, Argentina,
• Glycomet, India,
• Glucophage, France,
• Insufor, Turkey,
• Metformin Sandoz, Slovenia / Poland,
• Siofor, Germany.

Kutulutsa mawonekedwe, zikuchokera

Mapiritsi, oyera utoto wamafuta, ndi osabala, a biconvex, omwe ali pachiwopsezo chogawika mbali zonse ziwiri.

PRING sodium carboxymethyl wowuma - 40 mg, povidone 40 - 80 mg, colloidal silicon dioxide - 14 mg, chimanga wowuma - 20 mg, magnesium stearate - 6 mg.

Zomwe zimapangidwira pansalu ya kanema: sephyphilm 752 yoyera (hypromellose - 35-45%, cellcrystalline cellulose - 27-37%, macrogol stearate - 6-10%, titanium dioxide - 18-22%) - 20 mg, macrogol 6000 - 0,23 mg.

Ma PC 10 - matuza (1) - mapaketi a makatoni.
Ma PC 10 - matuza (3) - mapaketi a makatoni.
Ma PC 10 - matuza (6) - mapaketi a makatoni.
Ma PC 10 - matuza (9) - mapaketi a makatoni.

Zotsatira za pharmacological

Hypoglycemic mankhwala akumwa pakamwa. Metformin ndi biguanide yokhala ndi hypoglycemic effect, yomwe imatsimikiza kuchepa kwa basal (kusala kudya) ndi postprandial (2 mawola chakudya chitayamba) plasma glucose. Mosiyana ndi zotumphukira za sulfonylurea, metformin simalimbikitsa kubisalira kwa insulin chifukwa cha maselo a pancreatic beta ndipo siziika pachiwopsezo cha hypoglycemia.

Zimawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikugwiritsa ntchito shuga ndi maselo. Imachepetsa kupanga shuga kwa chiwindi poletsa gluconeogeneis ndi glycogenolysis. Kuchepetsa mayamwidwe m'matumbo.

Metformin imalimbikitsa kapangidwe ka intracellular glycogen pochita glycogen synthase. Kuchulukitsa kuchuluka kwa mayendedwe amtundu uliwonse wa ma membrane glucose.

Metformin imakhala ndi phindu pa metabolidi ya lipid: imatsitsa cholesterol yathunthu, LDL ndi triglycerides.

Ngakhale mutamwa metformin, thupi la wodwalayo limakhalabe lolimba kapena limatsika pang'ono.

Kwa odwala azaka zapakati pa 10-16 omwe amathandizidwa ndi metformin kwa chaka chimodzi, zizindikiritso za glycemic zinali zofanana ndi zomwe zimachitika mwa anthu akuluakulu.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, metformin imalowetsedwa m'matumbo. Ndi max akwaniritsa maola awiri atatha kumwa. Bioavailability Mlingo wa 500 ndi 850 mg mwa anthu athanzi ndi 50-60%. Mafuta a metformin akamwetsa amadzaza ndipo sakwanira. Amaganizira kuti pharmacokinetics ya mayamwidwe a metformin siwolondola. Metformin ikagwiritsidwa ntchito mu Mlingo woyenera ndipo malinga ndi momwe analamulirira, C ss mu plasma imatheka mkati mwa maola 24-48 ndipo nthawi zambiri imakhala yochepa kuposa 1 μg / ml. C max metformin sapitilira 5 μg / ml, ngakhale mutagwiritsa ntchito mankhwala muyezo waukulu.

Kudya kumachepetsa digiri ndikuchepetsa kuyamwa kwa metformin. Pambuyo pakulowetsa piritsi la 850 mg, kuchepa kwa C max 40%, kuchepa kwa AUC 25% ndi kuwonjezeka kwa mphindi 35 panthawi yakufika pa C max kumawonedwa.

Metformin imagawidwa mwachangu mu minofu, sikuti imagwira mapuloteni a plasma. Metformin imalowa m'magazi ofiira. C max m'magazi ndi otsika kuposa C max m'magazi am'magazi, ndipo amapezeka pafupifupi nthawi imodzi. Maselo ofiira, mwanjira iliyonse, ndi malo ogulitsa achiwiri. Woyimira V d ali pamtunda wa malita 63-276.

Metformin imachotsedwa osasinthika ndi impso, imapangidwa pang'ono, ma metabolites sanazindikiridwe.

Mutatha kumwa mankhwalawo m'matumbo, 20-30% ya zinthu zomwe sizinamwe. Kuvomerezeka kwa aimpso kwa metformin kopitilira 400 ml / min, komwe kumawonetsa kuchotsedwa kwa metformin pochita kusefera kwamadzi ndi kubisalira kwa tubular. Pambuyo pakukonzekera pakamwa, T 1/2 ndi pafupifupi maola 6.5.

Ngati aimpso ntchito, kuwonongeka kwa mankhwala n`zotheka, zomwe zimabweretsa kuchuluka kwa metformin mu madzi am`magazi.

Magulu apadera a odwala

Odwala ndi mkhutu aimpso ntchito. Zomwe zilipo zomwe zimapezeka mu odwala omwe ali ndi kupezeka bwino aimpso ndizochepa ndipo salola kuunikira bwinobwino zomwe zimachitika mu metformin ino, momwe angachitire mwa anthu omwe ali ndi vuto laimpso.

Odwala aubwana. Pambuyo pa kugwiritsidwa ntchito kamodzi kwa metformin pa mlingo wa 500 mg mwa ana, mbiri ya pharmacokinetic idapezeka yomwe inali yofanana ndi yomwe imawonedwa mwa achikulire athanzi. Mutagwiritsidwa ntchito mobwerezabwereza ndi metformin pa mlingo wa 500 mg 2 / tsiku kwa masiku 7 mwa ana, C max ndi AUC 0-t amachepetsa
pafupifupi 33% ndi 40%, motsatana, poyerekeza ndi mfundo za magawoli mwa odwala akuluakulu omwe ali ndi shuga omwe amalandira metformin pa mlingo wa 500 mg 2 kawiri pa tsiku kwa masiku 14. Popeza mlingo wa mankhwalawa umasankhidwa payekha kutengera mulingo wa glycemia, izi ndizoperewera.

Mlingo ndi makonzedwe

Mankhwala amatengedwa pakamwa. Mapiritsi ayenera kumwedwa kwathunthu mukatha kudya kapena kumwa pang'ono ndi madzi.

Mankhwala a Metformin Zentiva ayenera kumwedwa tsiku lililonse, osasokoneza. Ngati chithandizo chalekeka, wodwalayo ayenera kudziwitsa dokotala.

Monotherapy ndi kuphatikiza mankhwalawa kuphatikiza ena othandizira pakamwa

Mlingo woyambirira, monga lamulo, ndi 500 mg kapena 850 mg 2-3 nthawi / tsiku mutatha kudya kapena pakudya. Kuwonjezereka kwapang'onopang'ono kwa mlingo kumatha kutengera kuchuluka kwa shuga m'magazi.

Pambuyo masiku 10 ogwiritsa ntchito, mlingo uyenera kusinthidwa poganizira zotsatira za kuyeza kuchuluka kwa shuga m'magazi a m'magazi. Kuchepetsa pang'ono kwa mankhwalawa kungathandize kusintha kulolerana kwa m'mimba.

Mankhwala okonza nthawi zambiri amakhala 1500-2000 mg / tsiku. Kuti muchepetse mavuto kuchokera m'matumbo am'mimba, mlingo wa tsiku ndi tsiku uyenera kugawidwa mu Mlingo wa 2-3. Mlingo wapamwamba kwambiri ndi 3000 mg / tsiku, wogawidwa mu 3 waukulu.

Odwala omwe akutenga metformin mu Mlingo wa 2000-3000 mg / tsiku amatha kusintha kuchokera ku mapiritsi a metformin mu mlingo wa 500 mg mpaka kumwa mapiritsi a metformin mu mlingo wa 1000 mg. Mlingo woyenera kwambiri ndi
3000 mg / tsiku, logawidwa 3 waukulu.

Pankhani yakukonzekera kusinthaku kuti mutenge wina wothandizila wa hypoglycemic: muyenera kusiya kumwa mankhwalawa ndikuyamba kumwa Metformin Zentiva pamwambapa womwe tafotokozazi.

Kuphatikiza kwa insulin

Kukwaniritsa bwino shuga wamagazi, metformin ndi insulin zitha kugwiritsidwa ntchito ngati mankhwala ophatikiza. Mlingo woyambirira wa Metformin Zentiva, monga lamulo, ndi 500 mg kapena 850 mg katatu / tsiku, pamene mlingo wa insulin umasankhidwa pamaziko a shuga wamagazi.

Odwala ndi mkhutu aimpso ntchito

Metformin itha kugwiritsidwa ntchito mwa odwala omwe ali ndi kuchepa kwapakati paimpso (CC 45-59 ml / min, GFR 45-59 ml / mphindi / 1.73 m 2 ya thupi lamunthu) pokhapokha pazinthu zina zomwe zingakulitse chiopsezo cha lactic acidosis, ndipo pansi potsatira kusintha kwa mlingo: koyamba mlingo wa Metformin Zentiva ndi 500 mg kapena 850 mg 1 nthawi / tsiku.

Mlingo wapamwamba ndi 1000 mg / tsiku, logawidwa mu 2 waukulu. Kuwunikira mosamala kwa ntchito yaimpso ndikofunikira (miyezi 3-6 iliyonse).

Ngati QC 2 ya thupi, Metformin Zentiva iyenera kusiyidwa pomwepo.

Odwala okalamba

Chifukwa cha kufooka kwa impso, mlingo wa mankhwala a Metformin Zentiva mwa odwala okalamba uyenera kusankhidwa poyang'anira kuwonekera kwa mawonekedwe aimpso (kudziwa kuchuluka kwa creatinine m'magazi a seramu osachepera 2-4 pachaka.

Ana ndi achinyamata

Mwa ana a zaka zapakati pa 10 ndi kupitirira apo, mankhwalawa Metformin Zentiva angagwiritsidwe ntchito ngati monotherapy komanso kuphatikiza insulin. Mlingo woyamba, monga lamulo, ndi 500 mg kapena 850 mg 1 nthawi / tsiku mutatha kudya kapena pakudya. Pambuyo masiku 10-15, mlingo uyenera kusinthidwa molingana ndi chizindikiro cha kuchuluka kwa shuga m'magazi. Mulingo wambiri watsiku ndi tsiku ndi 2000 mg, wogawidwa pamitundu iwiri.

Bongo

Zizindikiro: akagwiritsidwa ntchito pa mlingo wa 85 ga g (nthawi ya 42,5 nthawi yayikulu tsiku lililonse), kukula kwa hypoglycemia sikunachitike. Ndi mankhwala osokoneza bongo a metformin, lactate acidosis imayamba. Lactic acidosis ndi yodzidzimutsa ndipo imafuna chithandizo chamankhwala. Zomwe zimayambitsa kukula kwa lactic acidosis amathanso kukhala cumulation wa mankhwalawa chifukwa cha kuwonongeka kwa impso.

Zizindikiro zoyambirira za lactic acidosis ndi mseru, kusanza, kutsegula m'mimba, kutsitsa kutentha kwa thupi, kupweteka kwam'mimba, kupweteka kwa minofu, ndipo pambuyo pake, kupuma mofulumira, chizungulire, chikumbumtima chodwala komanso kukula kwa chikomokere kumatha kuchitika.

Poyerekeza ndi mankhwala osokoneza bongo a metformin, kapamba angachitike.

Chithandizo: ngati zizindikiro za lactic acidosis, chithandizo ndi metformin ziyenera kuyimitsidwa nthawi yomweyo, wodwalayo ayenera kuchipatala, kuyamwa kwa lactic acid m'madzi a m'magazi kuyenera kutsimikiziridwa ndikuwonetsetsa kuti wapezeka. Njira yothandiza kwambiri yochotsa lactic acid ndi metformin m'thupi ndi hemodialysis. Chithandizo cha Zizindikiro zimachitidwanso.

Kuyanjana ndi ena l / s

Ma ayodini okhala ndi ayodini

Intravascular dongosolo la ayodini wokhala ndi ma radiopaque othandizira angayambitse kukula kwa ntchito yothandizira impso, potero kuchulukitsa kudzikundikira kwa metformin komanso chiopsezo cha lactic acidosis. Odwala omwe ali ndi GFR> 60 ml / mphindi / 1.73 m2 yamalo olimbitsa thupi, metformin iyenera kuchotsedwa isanachitike kapena mkati mwa kuyeserera kwa X-ray ndipo osakonzanso mkati mwa maola 48 atamaliza, ngati ntchito yokhazikika ya impso imatsimikiziridwa. Odwala omwe ali ndi vuto laimpso kuwonda kwambiri (GFR 45-60 ml / mphindi / 1.73 m 2), kugwiritsa ntchito metformin kuyenera kusiyidwa kwa maola 48 kusanayambike kwa mapangidwe a ayodini komanso osayambiranso kuposa maola 48 atamaliza kafukufukuyo komanso atangowunikiranso. aimpso ntchito pakalibe zizindikiro za kuwonongeka kwake.

Kuledzeretsa pachimake, chiopsezo chokhala ndi lactic acidosis imachulukirachulukira, makamaka chifukwa cha kufa ndi njala kapena kuperewera kwa zakudya m'thupi, kutsatira zakudya zochepa za calorie kapena kulephera kwa chiwindi. Mukamwa mankhwalawa, mowa ndi mankhwala okhala ndi Mowa zimayenera kupewedwa.

Kuphatikiza komwe kumafunikira kusamala

Kugwiritsa ntchito nthawi yomweyo danazol osavomerezeka kuti apewe hyperglycemic zotsatira za chomaliza. Ngati mankhwala a danazol akufunika ndipo atasiya kuyimitsa, kusintha kwa metformin kumafunikira motsogozedwa ndimagazi a shuga.

Chlorpromazine atamwa kwambiri Mlingo (100 mg / tsiku) kumawonjezera kuchuluka kwa shuga m'magazi, kuchepetsa kutulutsidwa kwa insulin. Mankhwala a antipsychotic ndipo atayimitsa makonzedwe awo, kusintha kwa metformin kumafunika motsogozedwa ndi magazi.

GCS ya zokhudza zonse ndi zochitika wamba zimachepetsa kulolera kwa glucose, kuonjezera kuchuluka kwa shuga m'magazi, nthawi zina kumapangitsa ketosis. Mankhwalawa corticosteroids ndipo atatha kudya, kusintha kwa mankhwala a metformin kumafunika motsogozedwa ndi kuchuluka kwa shuga m'magazi.

Ma diuretics (makamaka zopindika)

Kugwiritsa ntchito munthawi yomweyo mankhwala a "loop" okodzetsa kungayambitse kukula kwa lactic acidosis chifukwa chakulephera kugwira ntchito kwaimpso. Metformin sayenera kulembedwa kwa odwala ngati CC ili pansi pa 60 ml / min.

Beta 2 Injection Adrenomimetics

Beta 2 - agrenergic agonists amalimbikitsa kuchuluka kwa shuga m'magazi chifukwa chokondoweza kwa β 2 - adrenoreceptors. Poterepa, ndikofunikira kuwunika pafupipafupi kuchuluka kwa shuga m'magazi. Ngati ndi kotheka, insulin ikulimbikitsidwa.

Pogwiritsa ntchito munthawi yomweyo mankhwala omwe ali pamwambapa, mlingo wa metformin ungasinthidwe munthawi yamankhwala kapena pambuyo pake.

Mankhwala a antihypertensive, kupatula ACC zoletsa, amatha kusintha kuchuluka kwa shuga m'magazi. Ngati ndi kotheka, mlingo wa metformin uyenera kusinthidwa.

Zomwe zimachokera ku sulfonylureas, insulin ndi acarbose

Pogwiritsa ntchito munthawi yomweyo ndi metformin, kukulitsa kwa hypoglycemia ndikotheka.

Pogwiritsa ntchito munthawi yomweyo ndi metformin, kukulitsa kwa hypoglycemia ndikotheka.

Kuchulukitsa kuyamwa ndikuwonjezera C max wa metformin.

Mankhwala a Cationic

Amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim ndi vancomycin, omwe achimitsidwa ndi aimpso tubules, kupikisana ndi metformin pamayendedwe a tubular system ndipo kungayambitse kuwonjezeka kwa C max mpaka 60%.

Hypoglycemic zotsatira za metformin zitha kuchepetsedwa ndi phenothiazines, glucagon, estrogens, kuphatikizapo pakamwa, phenytoin, sympathomimetics, nicotinic acid, isoniazid, pang'onopang'ono calcium njira blockers.

Levothyroxine akhoza kuchepetsa hypoglycemic zotsatira za metformin. Kuyan'anila kuchuluka kwa shuga wamagazi kumalimbikitsidwa, makamaka pakukhazikitsa kapena kuthetsedwa kwa chithokomiro cha chithokomiro, ndipo ngati kuli kotheka, mlingo wa metformin uyenera kusintha.

Pogwiritsa ntchito munthawi yomweyo metformin ndi NSAIDs, ma inhibitors a MAO, oxytetracycline, zotumphukira za fibroic acid, cyclophosphamide, probenecid, chloramphenicol, sulfonamide antimicrobials, ndikotheka kuwonjezera zotsatira za hypoglycemic of metformin.

Mwa odzipereka athanzi mumaphunziro pamtundu umodzi wa metformin ndi propranolol, komanso metformin ndi ibuprofen, sizinasinthe mu magawo awo a pharmacokinetic.

Metformin ingachepetse kuchiritsa kwa antenagulant fenprocoumone. Mukamagwiritsidwa ntchito limodzi, kuyang'anira MHO bwino.

Pa mimba ndi mkaka wa m`mawere

Matenda osavomerezeka a shuga panthawi yomwe ali ndi pakati amaphatikizidwa ndi chiwopsezo chowonjezereka cha kubadwa mwatsopano ndi kufa kwa perinatal. Zambiri zomwe zikusonyeza kuti kutenga metformin mwa amayi apakati sikumawonjezera mwayi wokhala ndi vuto lobadwa nalo kwa mwana wosabadwayo. Kafukufuku wazinyama sanawonetse zotsatira zoyipa pamimba, kukulira kwa mluza kapena mwana wosabadwayo, njira yogwira ntchito ndi kubereka.

Pokonzekera kutenga pakati, komanso ngati mayi ali ndi pakati pamimba yodzatenga metformin, mankhwalawa ayenera kusiyidwa ndipo mankhwala a insulin ayenera kuyikidwa.

Ndikofunikira kusungitsa kuchuluka kwa glucose pamlingo woyandikira kwambiri kuti muchepetse vuto la kusokonezeka kwa mwana wosabadwayo.

Metformin imadutsa mkaka wa m'mawere. Zotsatira zoyipa za akhanda / makanda mukamamwa metformin sizinawoneke. Komabe, chifukwa cha kuchuluka kwa deta, kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa sikulimbikitsidwa. Lingaliro loletsa kuyamwitsa liyenera kuganiziridwanso zabwino za kuyamwitsa ndi chiopsezo cha zotsatira zoyipa mwa khanda.

Zotsatira zoyipa

Mukamagwiritsa ntchito Metformin, zotsatira zotsatirazi zimatha kuchitika, zomwe zimagawidwa m'magulu a dongosolo la system mogwirizana ndi gulu la MedDRA. Kutsimikiza kwamafupipafupi a zotsatira zoyipa malinga ndi gulu la WHO: Nthawi zambiri (≥10%), nthawi zambiri (%1% ndi Kuchokera ku magazi ndi dongosolo la mitsempha: pafupipafupi sikudziwika - hemolytic anemia.

Kuchokera kumbali ya kagayidwe kachakudya ndi zakudya: kawirikawiri - lactate acidosis, kuchepa kwa mayamwidwe a vitamini B 12 mwa odwala anemia a galopic, kuchepa kwake sikudziwika - zotumphukira za neuropathy kwa odwala omwe ali ndi vuto la vitamini B 12.

Kuchokera pamachitidwe amanjenje: nthawi zambiri - kusokoneza kukoma, pafupipafupi sikudziwika - encephalopathy.

Kuchokera mmimba thirakiti: Nthawi zambiri - nseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kusowa kwa chilimbikitso. Izi zosafunikira zovuta zimachitika nthawi yoyamba kukhazikitsidwa kwa chithandizo chamankhwala ndipo nthawi zambiri zimangodziyimira zokha. Popewa kupezeka kwawo, tikulimbikitsidwa kumwa mankhwala a metformin a 2 kapena 3 nthawi ya chakudya kapena itatha. Kuwonjezeka pang'onopang'ono kwa mlingo wa mankhwalawa kungathandize kusintha kulolerana kuchokera m'mimba.

Pa khungu ndi subcutaneous zimakhala: kawirikawiri - erythema, kuyabwa pakhungu, urticaria, pafupipafupi osadziwika - photosensitivity.

Pa mbali ya chiwindi ndi biliary thirakiti: kawirikawiri - kuchuluka kwa hepatic transaminases kapena hepatitis, ndikusowa pambuyo kuchoka kwa mankhwala.

Kukhudzidwa pazotsatira za labotale ndi zothandizira: kuchuluka sikudziwika - kuchepa kwa kuchuluka kwa TSH mu plasma mwa odwala omwe ali ndi hypothyroidism, hypomagnesemia motsutsana ndi maziko a m'mimba.

Ana ndi achinyamata

Zosindikizidwa, zidziwitso pakugwiritsa ntchito pambuyo polembetsa, komanso zotsatira za mayeso owongoleredwa mwa ana ochepa omwe ali ndi zaka 10-16 omwe amathandizidwa ndi metformin kwa chaka chimodzi, akuwonetsa kuti zovuta zamtundu wa ana ndizofanana mwachilengedwe komanso kuzunza kwawo odwala akulu.

Malangizo apadera

Lactic acidosis ndizosowa, koma zowopsa (kufa kwakukulu popanda chithandizo chamanomwe), kuphatikizika kwa metabolic komwe kumachitika chifukwa cha kupukutidwa kwa metformin. Pali malipoti a milandu ya lactic acidosis munthawi ya chithandizo ndi metformin odwala omwe ali ndi matenda osokoneza bongo komanso kwambiri aimpso kulephera kapena kuwonongeka kwambiri kwa impso. Chisamaliro makamaka chiyenera kuperekedwa ku malo omwe vuto la impso limatha, mwachitsanzo, ngati madzi atha magazi (m'mimba kwambiri kapena kusanza) kapena kumayambiriro kwa antihypertensive therapy kapena diuretic therapy (makamaka "loopback"), komanso kumayambiriro kwa chithandizo cha NSAID. Pakachitika izi zovuta, chithandizo cha Metformin Zentiva ziyenera kusiyidwa kwakanthawi.

Zina zokhudzana ndi chiopsezo ziyenera kuganiziridwanso, monga matenda a shuga oboola m'mimba, ketosis, kusala kudya kwa nthawi yayitali, kumwa kwambiri, kulephera kwa chiwindi, komanso vuto lililonse lomwe lingakhale ndi hypoxia yayikulu (mwachitsanzo, kulephera kwa mtima ndi hemodynamics yosasunthika, kulephera kupuma, kulowetsedwa kwapanjira kwapanja. )

Chiwopsezo cha lactic acidosis chiyenera kuganiziridwanso ngati zizindikiro zopanda pake, monga kupsinjika kwa minofu, vuto la dyspeptic, ululu wam'mimba, komanso asthenia yayikulu. Odwala ayenera kulangizidwa kuti azidziwitsa dokotala wawo za kupezeka kwa zizindikirozi, makamaka ngati wodwalayo kale anali wolekerera. Pankhaniyi, chithandizo ndi Metformin Zentiva ziyenera kusiyidwa, kwakanthawi, mpaka nkhaniyi itamveka bwino. Funso la kuyambiranso kwa mankhwalawa liyenera kuganiziridwa payekhapayekha, poganizira phindu / chiopsezo, ndikuganiziranso mkhalidwe waimpso mwa wodwalayo.

Diagnosis: lactate acidosis imadziwika ndi kufupika kwa acidotic, kupweteka kwam'mimba, hypothermia, kenako kutsekeka. Zowonetsa zasayansi zikuphatikiza: kuchepa kwa magazi pH (osakwana 7.25), kuchuluka kwa lactic acid m'madzi am'magazi pamwamba pa 5 mmol / l, ndikuwonjezera kusiyana kwa anionic ndi kuchuluka kwa lactate / pyruvate. Ngati metabolic acidosis ikukayikiridwa, ndikofunikira kusiya kumwa metformin ndikudwala odwala kuchipatala mwachangu.

Madokotala ayenera kudziwitsa odwala za chiopsezo cha lactic acidosis ndi zizindikiro zake.

Muyenera kusiya kumwa mankhwala a Metformin Zentiva maola 48 musanadye opanga opaleshoni yomwe ili pansi pa opaleshoni ya msana, kapena msana. Mankhwalawa atha kuyambiridwanso osapitirira maola 48 atachitidwa opaleshoni kapena atatha kubwezeretsa zakudya ndipo amangokhala ndi vuto labwinobwino laimpso.

Chifukwa metformin imachotsedwa impso, chizindikiritso cha QC chiyenera kuyang'aniridwa musanayambe mankhwala ndipo nthawi zonse:

- kamodzi pachaka kwa odwala omwe ali ndi vuto laimpso,

- osachepera 2-4 pachaka kwa odwala omwe ali ndi mtengo wa CC pamunsi yotsika yotsika komanso mwa okalamba.

Ndi mawonekedwe a KK 2) kugwiritsa ntchito mankhwalawa Metformin Zentiva ndizotsutsana.

Kuchepa kwa impso ntchito mu okalamba odwala nthawi zambiri asymptomatic.

Chenjezo makamaka liyenera kuchitika ngati vuto laimpso lingachitike ngati madzi atha kapena ngati munthawi yomweyo mumagwiritsa ntchito antihypertensive mankhwala, okodzetsa (makamaka a “loopback” kapena NSAIDs. Muzochitika izi, tikulimbikitsidwanso kuti muwone ngati mawonekedwe a impso musanayambe mankhwala ndi Metformin Zentiva.

Odwala omwe ali ndi vuto la mtima ali ndi chiopsezo chachikulu chokhala ndi hypoxia komanso kulephera kwa impso. Odwala omwe ali ndi mtima wokhazikika wolephera, mankhwalawa Metformin Zentiva angagwiritsidwe ntchito pokhapokha kuwunikira ntchito ya mtima ndi impso.

Kugwiritsa ntchito mankhwalawa Metformin Zentiva amadziwikiritsa kwa odwala omwe ali ndi vuto la mtima kapena kusakhazikika kwa mtima ndi hemodynamics yosakhazikika.

Metformin sizinakhudze makina abala amphongo wamwamuna kapena wamkazi akagwiritsidwa ntchito mu Mlingo mpaka 600 mg / kg / tsiku, lomwe limakhala lokwera katatu kuposa kuchuluka kwa tsiku lililonse kwa anthu malinga ndi zotsatira zake poyerekeza ndi gawo la thupi.

Ana ndi achinyamata

Kuzindikiritsidwa kwa mtundu wa matenda a shuga 2 kuyenera kutsimikiziridwa musanayambe chithandizo ndi Metformin Zentiva.

M'mayeso azachipatala olamulidwa omwe amakhala chaka chimodzi, zotsatira za metformin pakukula ndi kutha kwa ana sizinapezeke. Komabe, chifukwa cha kuchepa kwa nthawi yayitali, tikulimbikitsidwa kuwunika mosamala zotsatira zamtsogolo za metformin pama paramu amenewa mwa ana omwe amatenga Metformin Zentiva, makamaka ana a zaka zapakati pa 10-12.

Njira zina zopewera

- Odwala ayenera kutsatira zakudya zomwe zimamwa thupi tsiku lonse. Odwala onenepa kwambiri ayenera kupitiliza kutsatira zakudya zamafuta ochepera (koma osachepera 1000 kcal patsiku).

- Kuyesedwa kwa ma laboratory pafupipafupi kuyenera kuchitika pafupipafupi kuti muchepetse matenda a shuga.

-Metformin siyimayambitsa hypoglycemia nthawi ya monotherapy, komabe, kusamala kumalangizidwa mukamagwiritsa ntchito limodzi ndi insulin kapena othandizira ena a hypoglycemic (mwachitsanzo, sulfonylureas, repaglinide).

- Kuchira kwakanthawi ndi metformin kumayendetsedwa ndi kuchepa kwa kuchuluka kwa vitamini B 12 m'magazi am'magazi, omwe angayambitse zotumphukira za m'mitsempha. Kuwunikira pafupipafupi kwa plasma vitamini B 12 yovomerezeka kumalimbikitsidwa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kugwiritsa ntchito kwa mankhwala a Metformin Zentiva monga monotherapy sikukhudza kuwongolera magalimoto ndi njira.

Mukaphatikiza Metformin Zentiva ndi othandizira ena a hypoglycemic (kuphatikizapo sulfonylureas, insulin, meglitinides), ndikofunikira kuchenjeza odwala kuti atha kukhala ndi vuto la hypoglycemic momwe kuthekera kuyendetsa magalimoto ndi kuchita zina zoopsa zomwe zimafunikira chidwi chochulukirapo kumakulirakulira. komanso mwachangu ma psychomotor zochita.

Metformin yochepetsa kulemera: malangizo ogwiritsira ntchito, malingaliro ndi ndalama zingati?

Kuwonongeka kwa mapulogalamu apadera omwe amathandizira kuchepetsa kunenepa kwambiri sikupereka zotsatira zowoneka, anthu ambiri amayamba kugwiritsa ntchito mankhwala omwe amathandizira kuchepetsa thupi.

Imodzi mwa mankhwalawa ndi Metformin, yomwe sikuti imangomenya mapaundi owonjezereka, komanso imathandizira kagayidwe kazinthu komanso imathandizira magwiridwe antchito amkati.

Komabe, ambiri ali ndi chidwi ndi momwe angatenge Metformin kuti achepetse thupi kuti akwaniritse zotsatira zowoneka ndikukhalabe ndi zotsatira zake.

Kodi metformin ndi chiyani?

Metformin - mankhwala, omwe amatchedwanso Glucofage, amapezeka mu mawonekedwe a mapiritsi ndipo amagwiritsidwa ntchito kuchepetsa magazi. Nthawi zambiri amagwiritsidwa ntchito pochiza matenda monga matenda ashuga.

Mankhwala ali ndi zotsatirazi zochizira pamthupi la munthu:

• Amachotsa cholesterol yoyipa ndikuletsa kupezeka kwa matenda a atherosulinosis
• Zimalepheretsa kupezeka kwa matenda monga sitiroko chifukwa cha kuchuluka kwa matenda ashuga
• Amagwiritsidwa ntchito popewa kukula kwa matenda ashuga
• Kulakalaka zopondera

Mankhwalawa ali ndi zotsatira zoyipa ndipo amafunikira mayeso apadera ndi upangiri wachipatala kuti apereke mlingo woyenera wa mankhwalawa.

Zochuluka motani?

Kodi mukufunikira kumwa zochuluka motani kuti mukhale ndi zotulukapo?

Pofuna kuchiza matendawa, shuga amapatsidwa mlingo wa wodwala aliyense.

Nthawi zambiri, muyezo Mlingo wa mankhwalawa mapiritsi awiri patsiku m'mawa ndi madzulo. Mankhwalawa amagwiritsidwa ntchito ndi zakudya.

Phalelo liyenera kutsukidwa ndi madzi ambiri. Kutengera ndi kuchuluka kwa matendawa, kuwonjezeka kwa mlingo wa mankhwalawa monga momwe adokotala adanenera. Mankhwala amtunduwu sagwiritsidwa ntchito kwa anthu ochepera zaka 20.

Kodi ndingachepetse thupi ndikamamwa Metformin?

Kugwiritsa ntchito mankhwalawa kumachepetsa kuyamwa kwa shuga ndikuchepetsa mapangidwe a minofu ya adipose. Zachidziwikire kuti mutha kuchepetsa thupi, koma zimatha kutalika kwambiri ngati simutsatira malamulo onse.

Kuchepetsa thupi, mankhwalawa ali ndi zotsatirazi zabwino mthupi:

• Amachepetsa kuyamwa kwa chakudya chamafuta ndikuchichotsa mwachilengedwe
• Amathandizira mafuta acids ndipo amalepheretsa kuyamwa kwawo
• Amachotsa kulemera kwakukulu ndikusintha maselo amafuta kukhala mphamvu ya thupi
• Zimalimbikitsa kukhudzana pang'ono kwa shuga ndi minofu yamatenda
• Amathetsa kumverera kwanjala yosalekeza.

Muyenera kudziwa kuti mankhwalawa okha sangathe kuthetsa mapaundi owonjezera. Kuti muchite izi, muyenera kuona kaye zakudya zoyenera, ndikuchepetsa kumwa kowopsa. Ndikofunikanso kwambiri kuchita masewera olimbitsa thupi omwe angakuthandizeni kukhalabe ndi kulimbikitsa.

Kodi Metformin imathandizira bwanji kuti muchepetse kunenepa?

• Kugwiritsa ntchito Metformin kumachepetsa kuyamwa kwa shuga ndikuonjezera mphamvu ya kagayidwe, Zotsatira zake, madipoziti amafuta amawonongeka kukhala tinthu tating'onoting'ono, gawo lina lomwe limasinthidwa kukhala mphamvu, mafuta ena onse amachotsedwa m'thupi.
• Kuphatikiza apo, zakudya zamafuta zomwe munthu amadya zimaphimbidwa mumtundu wamtundu wa chipolopolo, zomwe zimalepheretsa kugaya kwawo, Zotsatira zake, chakudya chamafuta chimatuluka m'thupi.
• Mankhwala amathandizira kuthetsa cholesterol yoyipa, omwe amalowa m'thupi limodzi ndi zakudya zopanda pake, ndikuwongolera mayendedwe azinthu zamkati, ndikuthandizira ntchito yawo.
• Zakudya zoyenera zimathandiza kupewa zinthu zovulaza kuti zisalowe mthupi. ndi kudzikundikira kwamaselo amafuta, ndikugwiritsa ntchito mankhwalawo kumachotsa mapaundi owonjezera.

Momwe mungamwe Metformin kuti muchepetse thupi?

Nthawi zambiri, kugwiritsa ntchito mankhwalawa kumachitika popanda mankhwala a dotolo, chifukwa choyambirira muyenera kugwiritsa ntchito mankhwalawa ochepa kwambiri a mankhwalawo.

Kwa nthawi yoyamba, masiku 10, ndikulimbikitsidwa kuti musagwiritse ntchito mapiritsi awiri patsiku, m'mawa ndi madzulo. Chidacho chimatengedwa mukatha kudya, muyenera kumwa piritsi ndi madzi ambiri.

Chotsani zakudya monga:

• Zokoma.
• Zonona.
• Zokazinga.
• Pofunda.
• Mowa
• Zakudya zamafuta ndi nsomba.
• Zakumwa za kaboni.
• Zakudya zakusuta.
• Zopangira soseji.
• Zakudya zamatenda.

Pakatha milungu ingapo ya muyezo wa mankhwalawa, mutha kuwonjezera mlingo wa mapiritsi atatu patsiku. Njira yogwiritsira ntchito mankhwalawa si zoposa mwezi umodzi, pambuyo pake ndikofunikira kupuma pafupifupi miyezi itatu. Ngati mutenga Metformin kwa nthawi yayitali, kusuta ndikuchepetsa zotsatira zake kumatha kuchitika.

Zentiva metformin

Metformin zentiva imagwiritsidwa ntchito mosamala m'zochitika zachipatala ngati imodzi mwazamankhwala a matenda a shuga a 2. Masiku ano, makampani opanga zamankhwala amatulutsa mitundu yambiri yamankhwala ochepetsa shuga, ndipo metformin zentiva ndi amodzi mwa iwo.

Chimodzi mwamaubwino amakulu a mankhwalawa ndikuti, mosiyana ndi mankhwala omwe amachokera ku sulfonylureas, sayambitsa hypoglycemia. Katunduyu amafotokozedwa ndikuti Metformin simalimbikitsa kutulutsa insulin chifukwa cha maselo a pancreatic beta.

Malangizo ogwiritsira ntchito

Mapiritsi amatengedwa pakamwa. Sitikulimbikitsidwa kutafuna kapena kudula piritsi. Njira yochizira amawerengedwa pakudya tsiku lililonse la mankhwalawa, kwa mwezi umodzi.

Mlingo wa akulu:

• Ndikulimbikitsidwa kuti ndiyambe kumwa ndi kuchuluka kwa 500 mg, ndi mlingo waukulu wa tsiku lililonse wa 1.5 g,
• pang'onopang'ono, pakatha masiku 10, mlingo umawonjezeka ndi 850 mg 2-3 kawiri pa tsiku kapena mpaka 1000 mg, ndi mlingo waukulu wa tsiku ndi tsiku wa 3 g.

Nthawi zina, kusintha kuchokera pa 500 mg mpaka 1000 mg nthawi yomweyo amaloledwa. Kuwerengera kwa Mlingo ndi maphunzirowo kumachitika ndi adokotala, kutengera mtundu wa wodwalayo.

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Pochita mankhwala ndi Metformin Zentiva, odwala onenepa kwambiri amamva kuchepa kwa thupi kapena kukhazikika kwake!

Metformin Richter

Mapiritsi a Metformin-Richter amayenera kumwa nthawi zonse mukatha kudya, kutsukidwa 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 pazovuta zazikulu za metabolic.

Kuphatikizika, mafomu omasulidwa

Mankhwalawa ali pamapiritsi okhala ndi zomwe zimakhala ndi metformin: 500, 850 kapena 1000 mg.

Zophatikizika: sodium carboxymethyl wowuma, povidone-40, aerosil, wowuma chimanga, E-572.

Zophatikiza ndi Ma Filimu: Sepifilm-752 (White) Macrogol-6000.

500 mg - mozungulira, convex mbali zonse ziwiri, yokutidwa ndi loyera loteteza.

850 mg ndi 1000 mg ndi amtali, ma convex, ovala zoyera. Pa gawo limodzi la mapiritsi a 500 mg pali gawo logawanitsa lomwe limathandizira kusweka, ndipo pakukonzekera kwa 1000 mg umagwiritsidwa ntchito mbali zonse ziwiri.

Atadzaza matuza a ma PC 10. Phukusi la makatoni akuda - 3/6/9 ma mbale pamodzi ndi kalozera wofotokozera.

Kuchiritsa katundu

Mankhwala adapangira pakamwa. Mphamvu yotsitsa shuga imaperekedwa ndi pawiri - metformin. Thupi limaphatikizidwa ndi gulu la Biguanides - limapangidwa ndi zinthu za hypoglycemic zomwe zimatha kuyang'anira zomwe zili glycemic m'thupi. Amasiyana ndi zina zotengera ku sulfonylurea chifukwa sizikhudza maselo a ma isls a Langerhans omwe amapanga insulin ya insulin, chifukwa chake samathandizira pakuchitika kwa hypoglycemia.

Pambuyo kulowa mkati mwa thupi, kumathandizira chidwi cha receptor insulin ndikuwonjezera kukonzanso kwa glucose. Kuphatikiza apo, amalepheretsa mapangidwe a zinthu m'chiwindi mwa kupondereza njira za glycogenolysis, gluconeogeneis ndikuletsa kuyamwa kwake m'mimba.

Metformin imasintha magawo a shuga, imakhala ndi phindu pamulingo wa cholesterol yoyipa komanso yopindulitsa. Pafupifupi palibe phindu pa makina owonjezera.

Thupi limalowetsedwa m'mimba, kumangika kwake kwambiri m'magazi kumapangidwa pambuyo pa maola 2-2,5. Kuchulukitsa kwa thupi kumatha kugwa chifukwa cha kuchuluka kwa chakudya, popeza kuti kuyamwa kumachepetsedwa. Metformin pafupifupi samachita ndi mapuloteni a plasma, koma amatha kudutsa m'magazi ofiira a m'magazi.

Thupi silimakhala ngati limapangidwa ndi ma metabolic, limatsitsidwa ndi impso pafupifupi mtundu womwewo.

Kuchita mankhwala osokoneza bongo

Mtengo wapakati: 500 mg: (30 ma PC.) - 133 rub., (Ma 60 ma PC.) - 139 rub. 850 mg: (30 ma PC.) - 113 rub., (Ma 60 ma PC.) - 178 rub. 1000 mg: (30 ma PC.) -153 rub., (Ma 60 ma PC.) - 210 rub.

Kuwongolera kwa glycemia pogwiritsa ntchito Metformin Zentiva kuyenera kuganizira za mawonekedwe osakanikirana ndi mankhwala ena. Kupanda kutero, kugwiritsa ntchito nthawi imodzi kwamankhwala amitundu yosiyanasiyana kungayambitse zotsatira zosayembekezereka ndikupanga zovuta zoyipa.

Mapiritsi ali contraindicated kumwa ndi ayodini okhala ndi osiyana mitundu. Opanga amalimbikitsa kusokoneza kugwiritsa ntchito metformin patatsala masiku awiri kuti X-ray isanayesedwe. Kuyambiranso kumathandizidwanso pambuyo pa kutha kwa njirazi, komanso patatha masiku awiri. Ngati wodwalayo anyalanyaza zotsutsana, zotsatira zake zimakhudzana ndi mankhwalawa zidzatha kugwira ntchito kwaimpso, zomwe zimayambitsa kudziwitsidwa kwa metformin mthupi ndikuyambitsa vuto - lactic acidosis.

Kuphatikiza kosafunikira

Mowa Kumwa mapiritsi motsutsana ndi poyambira poyizoni wakumwa kumapangitsa kuti pakhale lactic acidosis. Mkhalidwe wowopsa umawonekera kwambiri makamaka ngati wodwalayo akumva njala kapena kudya bwino (zakudya, kumatha) kapena ali ndi vuto la chiwindi / impso. Pofuna kuti musawononge kwambiri thanzi, mutatenga Metformin, muyenera kusiyitsa zakumwa zoledzeretsa, zakumwa zoledzeretsa ndi Mowa.

Kuphatikizidwa kwa metformin ndi mankhwala ena omwe amafunikira kuwongolera kwa chizindikiro

• Danazole: ndikosayenera kuphatikiza ndi metformin chifukwa cha zotsatira za hyperglycemic. Ngati sizotheka kuletsa Danazol, mulingo wa metformin uyenera kuyang'aniridwa ndikusinthidwa molingana ndi zowonetsa shuga.
• Chlorpromazine amatha kuwonjezera glycemia waukulu Mlingo, akuletsa kutulutsidwa kwa insulin.
• GCS imachepetsa kulolera kwa glucose, imawonjezera glycemia, nthawi zina imatha kupangitsa ketosis. Panthawi ya utsogoleri wa GCS ndipo atachotsa, muyenera kusintha dongosolo la metformin.
• Zodzikongoletsera Kuphatikizika kwa maphatikizidwe kumatha kupangitsa lactic acidosis chifukwa kuchepa kwa impso.
• Β2-adrenergic agonists pochita zinthu zolingana ndi ma receptor amathandizira magazi. Ndikofunikira kuti muziwonetsetsa kuchuluka kwa metformin kapena kuisintha ndi insulin.
• Mankhwala osokoneza bongo a sulfonylurea, ma insulin ndi salicylates mukamayanjana ndi mapiritsi a Zentiva amalimbikitsa mphamvu ya hypoglycemic.
• Nifedipine imathandizira kuyamwa kwa metformin ndikuwonjezera kuchuluka kwake mu thupi.
• Mankhwala a gulu la cationic, chifukwa chakuti amuchotsa mimbulu, amalowa mpikisano ndi metformin ndipo chifukwa chake amatha kupititsa patsogolo zomwe zili.
• Zochita za Metformin Zentiva zimafooka mothandizidwa ndi phenositins, estrogens (kuphatikizapo gawo la njira zakulera zamkamwa), sympathomimetics, nicotinic acid, BKK, anti-TB wothandizira Isoniazid.
• Kulimbikitsa machitidwe a mapiritsi okhala ndi metformin amatha kuwonedwa akaphatikizidwa ndi NSAIDs, MAOI, antioxotic Oxytetracycline, fibrate, cyclophosphamide, sulfonamides.
• Mankhwala osokoneza bongo amatha kufooketsa mphamvu ya Fenprokumon.

Zotsatira zoyipa

Kuwongolera kwa glycemia mothandizidwa ndi mapiritsi a Metformin Zentiva atha kutsagana ndi zovuta zosagwirizana ndi zovuta zingapo:

• Magazi ndi zamitsempha: hemolytic anemia.
• Metabolism ndi zakudya: lactic acidosis, kuyamwa kwa cyanocobalamin mwa odwala a B12 folio-kuperewera kwa matenda. Komanso, kupezeka kwa zotumphukira nephrompathy mwa odwala omwe ali ndi kuchepa kwa thupi sikusiyidwa. B12.
• NS: dysgeusia, encephalopathy.
• M`mimba thirakiti: nseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kutsika kwa chidwi chofuna kudya. Zotsatira zosafunikira nthawi zambiri zimachitika kumayambiriro kwa maphunzirowa ndipo kenako zimatha pang'onopang'ono mapiritsi akamapitiliza kumwa. Popewa kuwoneka kwawo, mlingo wa tsiku ndi tsiku umalimbikitsidwa kuti ukhale wogawika pakati Mlingo 2-3 ndi kumwa pakudya kapena mukatha kudya. Njirayi ikuwonetsetsa kuti mankhwalawa amalowerera pang'onopang'ono m'maselo ndipo amathandizanso kuti thupi lizizindikira.
• Khungu ndi s / zigawo zamkati: kuyabwa, urticaria, erythema, mwa odwala ena - kuwonjezereka kwa khungu lomwe limatulutsa dzuwa ndi ma radiation ya UV.
• Chiwindi: nthawi zina kuwonjezeka kwa michere yomwe imatha atatha maphunziro a chiwindi.
• Zoyesa zamankhwala zasayansi: kuchepa kwa mankhwala a chithokomiro a TT mwa odwala omwe ali ndi hypothyroidism, hypomagnesemia chifukwa cha m'mimba.

Analogs Metformin

Ngati ndi kotheka, mutha kugwiritsa ntchito mankhwala omwe ali ndi mawonekedwe ofanana ndi Metformin, monga:

• Novo Fomu.
• Siofor.
• Glformin.
• Glucophage.
• Glyminfor.
• Fomu.
• Glycon.
• Sofamet.
• Metospanin.

Mosasamala mtundu wa mankhwala a analogue, ndikofunikira kuphunzira malangizo mwatsatanetsatane ndikuzindikira zovuta zake.

Kuchepetsa kulemera kwa mankhwala amodzi sikokwanira. Kuti mupeze zotsatira zowoneka, ndikofunikira kuyandikira vutoli kwathunthu. Kugwiritsa ntchito Metformin kumakuthandizani kuti muyambe kugawa mafuta okwanira, komabe, ngati simukutsatira zakudya ndi masewera olimbitsa thupi, mankhwalawa sangakhale othandiza.

Ndemanga za anthu za metformin:

Metformin zentiva kuwonda, malangizo

Ngati maselo amenewa amayamba kugonjetsedwa, ndiye kuti, insulin, ndiye kuti sangalandire shuga kuchokera m'magazi. Oral hypoglycemic wothandizira, kupatula insulin. Nthawi zambiri zimachitika pakhungu, kuphatikizapo erythema, pruritus, urticaria.

Pogwiritsa ntchito munthawi yomweyo ndi zotumphukira za sulfonylurea, acarbose, insulin salicylates, mao inhibitors, oxytetracycline inhibitors a ACE, omwe ali ndi clofibratomycyclophosphamide, mphamvu ya metformin ingalimbikitsidwe.

Likukhalira kuzungulira koyipa komwe kumabweretsa kunenepa kwambiri, kukana insulini ndi hyperinsulinism.

Komabe, palibe chidziwitso pazotsatira za kukula kwa Metformin ndi kutha msanga ndi kuchepa kwakanthawi kwa metformin, chifukwa chake, kuwunikira mosamala magawo awa kwa ana omwe amathandizidwa ndi metformin, makamaka panthawi yakutha, akulimbikitsidwa.

Metformin: malangizo ogwiritsira ntchito kuchepa thupi

Chingalowe m'malo ndi Siofor ndi chiyani? Kutsitsa kwa shuga kwa mankhwalawa kumawonekera bwino ndipo amawona onse odwala. Mapiritsi okhala ndi mafilimu.

Mutatha kumwa mapiritsi a metformin, mutha kumwa mowa pang'ono nthawi yomweyo, sikofunikira kudikira. Mutha kutenga maphunziro a vitamini B12 kamodzi pachaka kuti muchepetse kuchepa kwamankhwala mosalekeza ndi metformin.

Izi zachitika ndi Metformin, yomwe imapangidwa kuti izikhala ndi shuga nthawi zonse. Zachidziwikire, kupatula milandu pamene kulemera kwambiri kumatsagana ndi matenda a shuga. Kuchepetsa zovuta za matenda a shuga kwa anthu akuluakulu omwe ali ndi mtundu wa 2 wodwala matenda a shuga monga mankhwala oyambira mzere woyamba wokhala ndi mankhwala osachita bwino.

Metformin: kuwunika kwa kunenepa

Siofor yochepetsa kulemera kwa Siofor ndi mapiritsi ena a metformin angatengedwe kuti muchepetse thupi osati kokha kwa odwala omwe ali ndi matenda a shuga a 2, komanso kwa anthu athanzi. Pamwambapa patsamba lino, mumawerengera momwe mankhwalawo amathandizira kupewa kupewa kutsekula m'mimba, kusilira, kufalikira ndi zina.

Zotsatira zake, kwakanthawi kochepa ndidawonjezera pafupifupi 20 kg. Kodi mlingo waukulu patsiku ndi uti? Osagwiritsa ntchito musanachite opareshoni komanso patatha masiku awiri atachitidwa opereshoni. Zentiva Slovakia Chonde dziwani kuti mankhwalawo sanali Siofor, koma Glucophage.

Mapiritsi a Metformin amapindulitsa komanso kuvulaza thupi

"Metformin" ndi othandizira pakamwa.

• Kodi mawonekedwe a Metformin amatulutsidwa ndi chiyani?

Pulogalamu yogwira mankhwala ndi metformin hydrochloride, zomwe zili mamiligalamu 500. Zopatsa chidwi ndi: talc, povidone K90, kuwonjezera, crospovidone, wowuma chimanga, titanium dioxide, magnesium stearate, macrogol 6000.

Mankhwala Metformin amapezeka pamapiritsi, ali mozungulira mawonekedwe ndi oyera. Kupulumutsidwa mu matuza 10 zidutswa. Mankhwala omwe mumalandira mumagulitsidwa.

• Kodi njira ya Metformin imagwira ntchito bwanji?

Metformin ndi m'gulu la Biguanides ndipo ali ndi zochita zamankhwala pofuna kutsitsa ndikukhazikika kwa shuga m'magazi, osakhudza kwambiri kapangidwe ka insulin.

Mapiritsi a Metformin amatha kukulitsa kayendedwe ka glucose ndikugwiritsira ntchito ndi zotumphukira za minofu, makamaka minofu, zomwe zimayambitsa kuchepa kwa kuchuluka kwa chakudya. Ndikofunika kukumbukira kuti kugwiritsa ntchito shuga moyenera kumafunikira kuchuluka kwa zochitika zolimbitsa thupi.

Mankhwala amachepetsa njira zachilengedwe zophatika mu chiwindi, zomwe zimakhudza zomwe zili ndi shuga komanso komanso zoopsa za triglycerides. Matenda a mtundu wa lipid amakhala ndi zotsatira zabwino pa matenda a shuga, kupewa kupewera zovuta.

Metformin imathandizira kuchepetsa ndikukhazikika kwa thupi la wodwalayo. Zowona, izi sizichotsa kufunika kotsatira chakudya chapadera chokhala ndi zopatsa mphamvu zamafuta ndi mafuta.

Mankhwala ali ndi fibrinolytic kwenikweni, chomwe chimapangitsa gawo lina la minofu ya plasminogen activator inhibitor. Kupititsa patsogolo kufalikira kwa magazi kwa minofu kumathandizira kupewa kukula kwa mitsempha yomwe nthawi zambiri imayenderana ndi matenda a shuga.

Metformin imatsatiridwa mwamphamvu m'matumbo. The achire ndende ya mankhwala akufotokozera 2.5 mawola pambuyo makonzedwe. Mankhwalawa amakonda kukopeka ndipo amatha kudziunjikira mu minofu yotere: tiziwalo timene timataya magazi, chiwindi, kuwonjezera, impso, minofu.

Kutulutsa kwa metformin hydrochloride kumachitika ndi mkodzo. Kutha kwa theka-moyo kumapangika kuyambira maola 9 mpaka 12. Ndi matenda a impso, chizindikiro chofunikira ichi chitha kukula.

• Kodi Metformin amatani, phindu lake ndi chiyani mthupi la munthu kuchokera pamenepo?

Kupereka mankhwala ochepetsa shuga a Metformin (mapiritsi) amalola kugwiritsa ntchito matenda osokoneza bongo a mtundu wachiwiri (ndi kusachita bwino kwa mankhwala othandizira, zolimbitsa thupi, makamaka kuphatikiza kunenepa kwambiri).

Metformin mu mtundu wachiwiri wa matenda ashuga ayenera kumwedwa moyang'aniridwa ndi akatswiri ndi zotsatira za maphunziro a labotale. Kugwiritsa ntchito mosavomerezeka kumabweretsa zotsatira zoyipa.

Kugwiritsa ntchito Metformin pa matenda a shuga a 2 sikuvomerezeka pamilandu yomwe ili pansipa:

• Matenda akulu mu chiwindi, • Kulephera kwamkati, • Mimba, • Thupi, • Matenda opatsirana opatsirana, • Kufunika kochitidwa opaleshoni, • Lactic acidosis,

Kuphatikiza apo, chida sichikugwiritsidwa ntchito pamikhalidwe ya hypoxic.

• Kodi mlingo wa metformin ndi chiyani? Momwe mungatenge Metformin ya matenda ashuga?

Mlingo wothandiza komanso wotetezeka nthawi zambiri umachokera ku 500 milligrams mpaka gramu imodzi ya metformin hydrochloride patsiku. M'tsogolomu, kutengera kuchuluka kwa shuga, mutha kusintha kuchuluka kwa mankhwala omwe amwe. Mlingo wambiri watsiku ndi tsiku ndi magalamu atatu.

Mankhwala Metformin, omwe tikupitiliza kulankhula patsamba lino www.rasteniya-lecarstvennie.ru, sayenera kukwapulidwa kapena kutafunidwa. Ndikulimbikitsidwa kumwa mankhwalawa katatu mpaka katatu patsiku, mukatha kudya, ndi kapu imodzi ya madzi. Kuchiza nthawi zambiri kumakhala kwa moyo wonse.

• Kodi Metformin overdose Ndi Yotheka?

Zizindikiro zake ndi: kuchepa kwa kutentha kwa thupi, kutsekula m'mimba, kusanza, nseru, chizungulire, komanso kupuma kwamphamvu. Mankhwalawa ali motere: Kuchipatala mwachangu, hemodialysis, dalili.

• Zotsatira zoyipa za metformin ndi ziti?

Mukamamwa Metformin, malongosoledwe - tanthauzo lomwe lili phukusili, limachenjeza odwala kuti chithandizo cha mankhwalawo chitha kutsagana ndi zizindikiro zoyipa. Mwachitsanzo, imatha kukhala: kupweteka kwam'mimba, kutsekula m'mimba, kuchepa kwa chakudya, kutsekemera kwa mtima, kutsutsana, chizungulire, kupweteka kwa mutu, kuwonjezera, kufooka, komanso kusintha kwa mayeso a magazi.

Mikhalidwe ya Hypoglycemic imayendera limodzi ndi kufooka komanso chizungulire. Izi ndizofunikira kukumbukira ngati wodwalayo amakakamizidwa kutsatira chithandizo chokwanira chokhudzana ndi kugwiritsa ntchito metformin ndi mankhwala ena ochepetsa shuga. Ndi monotherapy, zoterezi sizimachitika konse.

• Momwe mungasinthire metformin?

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Odwala ayenera kukumbukira kuti kumwa mankhwala ochepetsa shuga sikuchotsa kufunika kotsatira zakudya zamafuta ochepa. Kuphatikiza apo, kuchita masewera olimbitsa thupi komanso kufunikira kuyang'anira shuga pafupipafupi ndikofunikira. Musaiwale za kufunika kosiya zizolowezi zoipa.

Metformin yochepetsa thupi: momwe mungatengere, zomwe muyenera kuchita poopa + kuwunika kwa iwo omwe achepetsa thupi ndi madokotala

Patsikuli, chinthu chosangalatsa kwambiri chomwe chatenga kale mankhwala othandizira matenda a shuga, nthawi zina chimatha kugwiritsidwa ntchito panjira yopita ku thupi laling'ono ndipo amaphunziridwa mwachangu ngati mankhwala odana ndi ukalamba. Metformin yochepetsa kulemera: momwe mungatengere molondola, ndani angayesere, komanso omwe angachite bwino popanda izi, kuwunika kwa madokotala ndi anthu omwe ataya thupi kuchokera kumabungwe komanso machitidwe enieni.

Kodi metformin ndi chiyani?

Awa ndi magazi ochepetsa shuga omwe amagwiritsa ntchito kufalikira. Simalimbikitsa mwachindunji kapamba kuti apange insulin, koma imakhudza kuthamanga ndi kuchuluka kwa kagayidwe kazakudya m'thupi ndi ziwalo zina za thupi - kunja kwa kapamba.

Kusanthula mwachangu nkhani:

Kodi njira ziti zomwe metformin imagwiritsa ntchito poyang'anira thupi

Mndandanda wa machitidwe oyambira ndiwopatsa chidwi. Pazakudya zowuma za wopanga, mutha kuziwerenga m'mayendedwe onse ovomerezeka (pempho "malangizo a metformin ogwiritsa ntchito").

M'mawu osavuta, phindu lalikulu la mankhwalawa likufotokozedwa m'fanizo lili pansipa.

Njira zomwe zalembedwazi zikuyenera kuthandizira matenda ambiri:

1. Matenda a shuga,
2. Mavuto a kulolera kwa glucose ("prediabetes"),
3. Kunenepa kwambiri ndi metabolic syndrome,
4. Cleopolycystic ovary mwa akazi.

Metformin imagwiritsidwanso ntchito ngati mankhwala a masewera komanso kupewa kukalamba.

Mankhwalawa amachepetsa glycation - imodzi mwazomwe zimapangitsa kuti pakhale kutupa kwa masisitere. Pali magulu a anthu omwe amakonda kugwiritsa ntchito mankhwalawa kutalikitsa unyamata. Elena Malysheva wodziwika kwambiri adanenanso mobwerezabwereza za metformin. Izi sizabodza kapena kukokomeza kwayekha, koma malingaliro aposachedwa a sayansi yamakono.

Hyperinsulinism - Vuto la Anthu Olemera Kwambiri

Insulin ndi mahomoni omwe kapamba amapanga. Udindo wake umayang'anira mamolekyu a glucose m'maselo athu: "Moni! Timadziwana! Ndili ndi chakudya, tidzadya chakudya chamadzulo! ”

Hyperinsulinism ndimkhalidwe wa pathological pomwe kapamba amapanga insulin yokwanira chakudya, koma samatengedwa bwino ndimwazi chifukwa chakuchepa kwa chidwi cha zolandilira minofu.

"Sitikumudziwa - onjezani anthu!" - zofunikira pa kapamba zimatsata. Kutikita minofu kumakwaniritsa: insulini m'magazi imakulanso.

Ndipo uwu ndi msampha wowonjezera mafuta ochulukitsa m'thupi!

Chifukwa kuchuluka kwambiri kwa insulini kumalimbikitsa kusungirako mafuta: ma carbohydrate osagwira ndi mapuloteni amaphatikizidwa bwino kwambiri kukhala mafuta.