Zisonyezero zogwiritsira ntchito ndi malangizo ogwiritsira ntchito mankhwala Fomu

Oral hypoglycemic mankhwala ochokera pagulu la Biguanide.
Kukonzekera: FORMETIN ®
The yogwira mankhwala: metformin
ATX Encoding: A10BA02
KFG: Oral hypoglycemic mankhwala
Nambala yolembetsa: LSR-003304/07
Tsiku lolembetsa: 10.22.07
Mwini reg. doc.: FARMSTANDART-LEXREDSTVA OJSC

Kutulutsa Fomu Fomu, mankhwala ma CD ndi kapangidwe kake.

Mapiritsiwo ndi oyera, ozungulira, osalala komanso ooneka bwino.

1 tabu
metformin hydrochloride
500 mg
-«-
850 mg

Omwe amathandizira: povidone yapakati yolemera (polyvinylpyrrolidone), sodium ya croscarmellose, magnesium stearate.

Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.
Ma PC 10 - matumba a matuza (6) - mapaketi a makatoni.
Ma PC 10 - matumba otumphuka (10) - mapaketi a makatoni.

Mapiritsiwo ndi oyera, oval, biconvex, okhala ndi notch mbali zonse ziwiri.

1 tabu
metformin hydrochloride
1 g

Omwe amathandizira: povidone yapakati yolemera (polyvinylpyrrolidone), sodium ya croscarmellose, magnesium stearate.

Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.
Ma PC 10 - matumba a matuza (6) - mapaketi a makatoni.
Ma PC 10 - matumba otumphuka (10) - mapaketi a makatoni.

Kufotokozera kwa mankhwalawa kumatengera malangizo ovomerezeka omwe angagwiritsidwe ntchito.

Pharmacological zochita za formin

Oral hypoglycemic mankhwala ochokera pagulu la Biguanide. Amalepheretsa gluconeogeneis m'chiwindi, amachepetsa mayamwidwe m'matumbo, imathandizira kugwiritsidwa ntchito kwa glucose, komanso imakulitsa chidwi cha minofu kuti insulini. Sichikhudzanso kubisika kwa insulini ndi ma cell a pancreatic, sikuti zimayambitsa kukhudzika kwa hypoglycemic.

Lowers triglycerides, LDL.

Imakhazikika kapena kuchepetsa thupi.

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

Pharmacokinetics wa mankhwala.

Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera m'mimba. Bioavailability mutatenga muyezo mlingo 50-60%. Cmax pambuyo pakamwa makonzedwe zimatheka pambuyo 2,5 maola.

Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira mu ndulu zakumaso, minofu, chiwindi, ndi impso.

Amatulutsidwa popanda mkodzo. T1 / 2 ndi maola 1.5-4.5.

Mlingo ndi njira ya mankhwala.

Khazikikani payekhapayekha, poganizira kuchuluka kwa shuga m'magazi.

Mlingo woyambira tsiku lililonse nthawi zambiri amakhala 500 mg 1-2 nthawi / tsiku kapena 850 mg 1 nthawi / tsiku. Pambuyo pake, pang'onopang'ono (nthawi 1 pa sabata), mlingo umakulitsidwa ku 2-3 g / tsiku. Pazipita tsiku mlingo 3 g.

Mlingo wa tsiku ndi tsiku wopitirira 850 mg tikulimbikitsidwa mu Mlingo wachiwiri (m'mawa ndi madzulo).

Okalamba odwala, tsiku lililonse mlingo sayenera upambana 1 g.

Chifukwa cha chiwopsezo cha lactic acidosis, popereka metformin kwa odwala omwe ali ndi vuto lalikulu la metabolic, mlingo uyenera kuchepetsedwa.

Mapiritsi ayenera kumwedwa nthawi yonse ya chakudya kapena pambuyo pake, ndi madzi ambiri.

Mankhwalawa adapangira kuti azigwiritsa ntchito kwakanthawi.

Zotsatira zoyipa za formin:

Kuchokera pamimba: kukhumudwa, kusanza, kulawa kwazitsulo mkamwa, kusowa chilakolako cha chakudya, kutsegula m'mimba, kuwawa, kupweteka kwam'mimba.

Pa gawo la kagayidwe: kawirikawiri - lactic acidosis (imafuna kuleka kwamankhwala), pogwiritsa ntchito nthawi yayitali - B12 hypovitaminosis (malabsorption).

Kuchokera pa hemopoietic dongosolo: nthawi zina - megaloblastic anemia.

Kuchokera ku endocrine system: hypoglycemia (mukamagwiritsa ntchito mankhwala osakwanira).

Thupi lawo siligwirizana: zotupa pakhungu.

Zotsatira zamankhwala:

- matenda ashuga ketoacidosis, matenda a shuga, chikomokere,

- Zowopsa zaimpso,

- chiwindi ntchito,

- poyizoni mowa,

- machitidwe omwe angathandizire kukulitsa lactic acidosis, kuphatikiza mtima ndi kupuma kulephera, pachimake gawo la kulowerera m'mitsempha, ngozi ya mtima pachimake, kuchepa magazi, uchidakwa,

- lactic acidosis ndi mbiri yake,

- opaleshoni yayikulu ndikuvulazidwa (mu izi, chithandizo cha insulin chimasonyezedwa),

- gwiritsani ntchito pasanathe masiku awiri asanafike komanso masiku awiri mutapanga maphunziro a radioisotope kapena x-ray ndikumayambitsa ayodini wokhala ndi zosiyana pakati,

- kutsatira zakudya zochepa zopatsa mphamvu (zosakwana 1000 cal / tsiku),

- mkaka wa m'mawere (yoyamwitsa),

- Hypersensitivity ku zigawo za mankhwala.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa odwala omwe ali ndi zaka zopitilira 60 omwe amagwira ntchito zolimbitsa thupi, chifukwa chowonjezera chiopsezo cha lactic acidosis.

Malangizo apadera ogwiritsira ntchito formin.

Munthawi yogwiritsira ntchito mankhwalawa, zizindikiro za impso ziyenera kuyang'aniridwa. Osachepera 2 pachaka, komanso maonekedwe a myalgia, zomwe zimakhala mu plasma ziyenera kutsimikiziridwa.

Ndikotheka kugwiritsa ntchito Formetin kuphatikiza ndi mankhwala a sulfonylurea kapena insulini, makamaka kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Mukamagwiritsidwa ntchito ngati monotherapy, mankhwalawa sasokoneza luso loyendetsa magalimoto ndikugwira ntchito ndi zida.

Ndi kuphatikiza kwa Formetin ndi mankhwala ena a hypoglycemic (sulfonylurea derivatives, insulin), mikhalidwe ya hypoglycemic ingayambike momwe kuthekera kuyendetsa magalimoto ndi zochitika zina zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Mankhwala osokoneza bongo:

Zizindikiro: fatact lactic acidosis imayamba. Zomwe zimayambitsa kukula kwa lactic acidosis amathanso kukhala cumulation wa mankhwalawa chifukwa cha kuwonongeka kwa impso. Zizindikiro zoyambirira za lactic acidosis ndizofooka wamba, nseru, kusanza, kuchepa thupi, kupweteka kwam'mimba, kupweteka kwa minofu, kutsitsa magazi, Reflex bradycardia, mtsogolomo zitha kukulitsa kupuma, chizungulire, chikumbumtima chodwala komanso kukula kwa chikomokere.

Chithandizo: ngati pali zizindikiro za lactic acidosis, chithandizo ndi metformin chiyenera kuyimitsidwa nthawi yomweyo, wodwalayo ayenera kuchipatala mwachangu ndipo atatsimikiza kuti ali ndi lactate, atsimikizireni matendawa. Hemodialysis imathandiza kwambiri pochotsa lactate ndi metformin m'thupi. Ngati ndi kotheka, chitani mankhwala othandizira.

Kuchita kwa formin ndi mankhwala ena.

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

Pogwiritsa ntchito munthawi yomweyo ndi GCS, kulera kwapakamwa, epinephrine (adrenaline), sympathomimetics, glucagon, mahomoni a chithokomiro, thiazide ndi "loop" okodzetsa, phenothiazine zotumphukira ndi nicotinic acid, kuchepa kwa mphamvu ya hypoglycemic ya metformin ndikotheka.

Cimetidine amachepetsa kuchotsedwa kwa metformin, chifukwa chomwe chiopsezo cha lactic acidosis chikuwonjezeka.

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

Ndi munthawi yomweyo makonzedwe ndi Mowa, kukula kwa lactic acidosis ndikotheka.

Ndi munthawi yomweyo kugwiritsa ntchito nifedipine kumawonjezera mayamwidwe a metformin ndi Cmax, kumachepetsa kuchotsa chimbudzi.

Mankhwala a Cationic (amlodipine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin) omwe amatulutsidwa m'mapikisano olimbana ndi machitidwe ogwiritsira ntchito ma tubular ndipo, ngati atatenga nthawi yayitali, amatha kuonjezera Cmax ya mankhwalawa ndi 60%.

Zambiri, kapangidwe ndi mawonekedwe ake amasulidwe

Fomu (onani chithunzi) ndi mankhwala a hypoglycemic. Mankhwala ndi gawo limodzi la gulu la Biguanide, chifukwa chake limagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri.

Monga momwe amakonzera onse a gulu la Biguanide, "Formetin" ili ndi gawo lothandizira - Metformin hydrochloride. Kuchuluka kwake kungakhale 0.5, 0,85 kapena 1 g.

• sodium croscarmellose,
• magnesium stearate yomwe imagwiritsidwa ntchito popanga mankhwala,
• sing'anga yam'mero ​​povidone (polyvinylpyrrolidone).

Mankhwalawa amapezeka m'mapiritsi, momwe zimatengera mlingo:

• 0,5 g mozungulira,
• biconvex chowulungika (0,85 ndi 1 g).

Mapiritsi amagulitsidwa pamakatoni, ndipo chilichonse chimatha kukhala 30, 60 kapena 100.

Pharmacology ndi pharmacokinetics

Mankhwala "Fomu" amakhudza thupi motere:

• Imachepetsa ntchito ya shuga m'magazi,
• amachepetsa kuchuluka kwa glucose omwedwa ndi matumbo,
• timapitiriza kugwiritsidwa ntchito kwina kwa glucose omwe ali m'magazi,
• kumabweretsa kuwonjezeka kwa minofu kumva insulin,
• sizomwe zimayambitsa kukula kwa hypoglycemia,
• otsika triglycerides ndi LDL
• imagwiranso ntchito kapena kuchepetsa kunenepa
• amathandizira kusungunuka magazi.

The pharmacological kanthu amadziwika ndi mawonekedwe a mayamwidwe, kugawa ndi kuchulukitsa kwa zigawo zikuluzikulu.

1. Zogulitsa. Gawo lomwe limagwiritsa ntchito mankhwalawa limatengedwa ndi makhoma am'mimba atatha kumwa mapiritsi. The bioavailability wa muyezo mulingo kuchokera 50% mpaka 60%. Pazitali kwambiri ya mankhwalawa imayikidwa maola 2,5 pambuyo pa kukhazikitsa.
2. Kugawa. Zomwe zimagwiritsa ntchito mankhwalawa sizimayambitsa kulumikizana ndi mapuloteni a plasma.
3. Kuswana. Excretion wa zigawo zikuluzikulu za mankhwala ikuchitika osasinthika. Zophatikizira zotulutsira mkodzo. Nthawi yofunika theka la moyo wa mankhwalawa ndi kuyambira 1.5 mpaka 4.5 maola.

Pomwe zigawo zikuluzikulu za mankhwalawo zimadzunjikana m'thupi, muyenera kudziwa zomwe zingachitike. Nthawi zambiri, chifukwa chimayambitsa matenda aimpso.

Zizindikiro ndi contraindication

Mankhwala ndikofunikira mu milandu yotsatirayi:

• ndi kunenepa kwambiri kapena kunenepa kwambiri, pamene kudya sikuthandiza,
• ndi mtundu wachiwiri wa matenda ashuga.

"Fomu" siyiyenera kugwiritsidwa ntchito kokha pakuchepetsa thupi, ngakhale kuti mankhwalawo amathandizadi kuchepa kwake. Kumwa mapiritsi ndikothandiza palimodzi ndi mankhwala a insulin odwala omwe ali ndi kunenepa kwambiri, komwe kumayendetsedwa ndi kukana kwachiwiri kwa mahomoni.

Milandu mukamamwa mankhwalawa ndiwotsutsana:

• ketoacidosis
• chikomokere kapena vuto chifukwa cha matenda ashuga,
• kusintha kwa impso ndi chiwindi,
• zinthu zomwe zimabweretsa kukula kwa lactic acidosis, kuphatikizira kulephera kwa mtima, kusintha kwamitsempha yamagazi, gawo lodana ndi kulowerera kwam'mnyewa wamtima, uchidakwa, kuperewera kwa madzi m'thupi,
• poyizoni wazakumwa zoledzeretsa,
• kwambiri matenda opatsirana,
• othandizira opaleshoni
• kuvulala
• x-ray, yokhudzana ndi kuyambitsa kwa othandizira mosiyanitsa (masiku awiri asanafike ndi pambuyo pake),
• kutsatira zakudya zomwe zimalola kupezeka kwa zakudya za tsiku ndi tsiku zopitilira 1000,
• kuyamwitsa, komanso kuyambika kwa pakati,
• Hypersensitivity pamagawo a mankhwala.

Malangizo ogwiritsira ntchito

Kusankhidwa kwa Mlingo kuyenera kuchitidwa kokha ndi dokotala yemwe amaganizira mawonekedwe onse a wodwalayo komanso njira ya matenda ashuga. Malangizowo akuwonetsa kuti mugwiritsa ntchito mlingo woyambirira. Ikhoza kukhala kuchokera 500 mpaka 1000 mg patsiku.

Kusintha kwa muyezo kwa mankhwalawa sikuyenera kuperekedwa pasanathe masiku 15 mutatha piritsi yoyamba. Kuphatikiza apo, iyenera kusankhidwa pokhapokha pakulamulira glycemic. Mlingo wa tsiku lililonse sungakhale woposa 3000 mg. Nthawi zambiri, kukonza mankhwalawa kumafuna kutenga 1500-2000 mg / tsiku. Odwala a ukalamba sayenera kutenga zosaposa 1 g za yogwira pophika.

Mapiritsi ayenera aledzeretse pambuyo chakudya. Mlingo wofotokozedwa ndi dokotala tikulimbikitsidwa kuti mugawidwe mosiyanasiyana, ndipo amwe mankhwalawa kawiri pa tsiku. Izi zitha kupewa kupezeka kwa mavuto okhudza chimbudzi.

Kanema wochokera kwa Dr. Malysheva okhudza Metformin ndi mankhwala otengera izi:

Odwala apadera

Mankhwala tikulimbikitsidwa kuti asagwiritse odwala onse.

Magulu otsatirawa a odwala amaphatikizidwa ndi gulu lapadera:

1. Amayi oyembekezera komanso oyembekezera. Mayeso awonetsa kuti zigawo za mankhwalawa zimatha kukhala ndi vuto kwa ana onse ali m'mimba komanso atabadwa.
2. Odwala omwe ali ndi matenda a chiwindi. Amaphatikizidwa mu mankhwala osokoneza bongo.
3. Odwala ndi mkhutu aimpso ntchito. Ndi kusintha kwakukuru kwa pathological, kugwiritsa ntchito mankhwala othandizira ndizoletsedwa. Nthawi zina, mankhwalawa amatha kugwiritsa ntchito mankhwalawa, koma amayang'aniridwa pafupipafupi.
4. Odwala okalamba. Pali chiopsezo cha lactic acidosis mwa anthu opitilira 60 omwe amangokhalira kugwira ntchito zolimbitsa thupi.

Malangizo apadera

Chithandizo cha mankhwalawa chimakhala ndi zina:

1. Odwala ayenera kuyang'anitsitsa ntchito ya impso. Pafupipafupi kuwunika kotere kumachitika kawiri pachaka. Izi ndichifukwa choti zigawo za "Fomu" zimatha kudzikundikira mkati mwa thupi chifukwa chazosokoneza pakugwira ntchito kwa chiwalo.
2. Ngati myalgia ipezeka, tikulimbikitsidwa kuti mupeze kuchuluka kwa plasma lactate.
3. Kugwiritsa ntchito "Formetin" kuphatikiza ndi mpweya wa sulfonylurea kumafuna kuwongolera glycemia.
4. Chiwopsezo cha hypoglycemia chimawonjezeka pamene mapiritsi awa agwiritsidwa ntchito ndi mankhwala ena omwe amatha kuchepetsa shuga. Vutoli limakhala loopsa kwambiri poyendetsa kapena kuchita nawo zinthu zilizonse zomwe zimachitika mwachangu.
5. Pofuna kupewa lactic acidosis odwala omwe ali ndi vuto la metabolic, mankhwalawa ayenera kuyambitsidwa ndi kuchepetsa.

Zotsatira zoyipa ndi bongo

Ndemanga ya odwala matenda ashuga akuwonetsa kuti chithandizo ndi "Fayilo ya Formetin" imatha kutsagana ndi zovuta zina:

1. Ponena za chimbudzi - nseru, kulawa kwazitsulo mkamwa, kusanza, kusowa kwa chakudya, kupweteka pamimba, chopondapo.
2. Lactic acidosis imawoneka. Vutoli limafunikira kuleka kwamankhwala chifukwa chakufa.
3. Hypovitaminosis imayamba.
4. Megaoblastic anemia imachitika.
5. Hypoglycemia imayamba.
6. Khungu limatuluka.

Ndi mankhwala osokoneza bongo a lactic acidosis amakula. Zikatero, pamafunika kusiya mankhwala, ndipo wodwala ayenera kuchipatala. M'chipatala, anthu ambiri amakhala ndi lactate kuti atsimikizire kapena atsimikizire kuti matendowo ndi ozindikira. Kugwiritsa ntchito hemodialysis kumathandiza nthawi zambiri chifukwa cha kuphipha kwa lactate ndi metformin.

Kuyanjana Ndi Mankhwala Ndi Analogi

Mphamvu ya hypoglycemic imatheka chifukwa chotsatira:

• jakisoni insulin
• ACE zoletsa, MAO,
• Acarbose
• Oxytetracycline,
• opanga beta
• ofanana sulfonylurea.

Kuchita bwino kumachepetsa mankhwala otsatirawa:

• GKS,
• kulera
• adrenaline
• glucagon,
• mankhwala a mahomoni omwe amagwiritsidwa ntchito mu pathologies a chithokomiro
• amphanomachul
• zotumphukira za phenothiazine, komanso nicotinic acid.

The mwayi wa lactic acidosis ukuwonjezeka kuchokera kumwa mankhwala "Cimetidine", Mowa.

Msika wogulitsa mankhwala umapereka mankhwala osiyanasiyana ochepetsa shuga.Zina mwazomwe zimatha kugwiritsidwa ntchito ngati choloweza "Fomu", chifukwa cha kupezeka kwa metformin hydrochloride pakupanga kwawo.

Malingaliro odwala

Kuchokera pa ndemanga za anthu odwala matenda ashuga za mankhwala a Formetin, titha kunena kuti mankhwalawa sioyenera aliyense, chifukwa chake, asanagwiritse ntchito, kufunsa kwa dokotala ndikofunikira.

Ndinali ndi zaka makumi asanu ndi limodzi ndi zitatu nditapezeka shuga wambiri. Dokotala nthawi yomweyo adalimbikitsa kutenga Formetin. Zotsatira zake zidakondwera. Kupitilira zaka 2 za chithandizo, shuga amasungidwa mkati mwa 7.5 mmol / L. Ndizosangalatsa kwambiri kuti tinatha kuchotsa makilogalamu ena owonjezera 11, komanso kamwa yowuma siyidapezekenso.

Kwa miyezi ingapo ndinayenera kusankha mankhwalawa kuti ndisinthe shuga. Matendawa adapezeka m'miyezi 5 yapitayo, koma chifukwa cha mapiritsi a formin ndizotheka kuyandikira shuga. Ndimawalandira ndi Siofor. Mosiyana ndi mankhwala ena omwe ndimalandira ndi mankhwalawa, ndilibe vuto ndi chimbudzi. Kwa aliyense yemwe sanatengepo mankhwalawa, ndikulimbikitsa kuyesera.

Ndinawerenganso ndemanga zina ndipo ndimadabwitsidwa ndi kupambana kwa ena. Ine ndekha ndinamwa mankhwalawa kukakamira kwa adokotala. Asanamwe Metformin Teva, kunalibe mavuto. Ndipo ndikusintha kupita ku Formetin m'masiku atatu, ndidakumana ndi zovuta zonse zomwe zidalipo. Ndinali chizungulire, ndinali waukali, ndinamva kufooka kwambiri, koma sindinena chilichonse. Mankhwalawa sayenera kumwa pambuyo pa zaka 60, koma palibe amene adandiwuza. Fotokozani.

Mtengo wa mapiritsi 60 a formin umatengera mlingo. Ndipafupifupi ma ruble 200.