UJanumet 850 unqunyelwe ukubuyisa amazinga ajwayelekile eglucose. Ubuhle bomuthi ubukhona ekuhlanganisweni kwezakhi ezibonisa umphumela obizwa nge-hypoglycemic.
Igama Lezwe elingafanele
I-Metformin + sitagliptin
UJanumet 850 unqunyelwe ukubuyisa amazinga ajwayelekile eglucose.
I-ATX
A10BD07
Khipha amafomu nokwakheka
Kunokuhluka okukodwa kuphela kwesidakamizwa - amaphilisi. Izakhi ezisemqoka yilezi: metformin hydrochloride, sitagliptin phosphate monohydrate. Ukuqoqwa kwalezi zingxube kuhluke kakhulu. Ithebhulethi eyi-1 iqukethe umthamo we-metformin - 850 mg, sitagliptin - 50 mg.
Kukhona ezinye izinhlobo zeYanumet. Zihluka kumthamo we-metformin kuphela. Inani lale nto lingaba ngu-500 noma u-1000 mg. Ukuhlushwa kwe-sitagliptin kuhlala kungama-50 mg. Ungawuthenga umuthi emaphaketheni eseli. Inani labo ebhokisini lekhadibhodi liyahluka: 1, 2, 4, 6, 7 ama-PC.
Kukhona uhlobo olulodwa lwamaphilisi i-Yanumet izidakamizwa.
Isenzo se-Pharmacological
Zombili izakhi ekwakhekeni kweYanumet zingokwesigaba sama-ejenti we-hypoglycemic agents. Zisetshenziswa ngokuhlanganiswa, ngoba zibonakaliswa umphumela ohambisanayo. Kusho, i-metformin ithuthukisa umphumela we-sitaglipin emzimbeni kanye okuphambene nalokho. Lapho usebenzisa enye nenye yalezi zinto ngazinye, umphumela wokwelashwa mubi ngandlela thile. Umuthi ohlanganisiwe weYanumet uvame ukunqunywa ngemuva kokwelashwa kwe-metformin, lapho kungenzeki ukufeza ukuthuthuka esimweni sesiguli.
Into ngayinye yalezi zinto isebenza ngendlela ehlukile, ngoba zombili izakhi zingamaqembu ahlukahlukene emithi. Isibonelo, i-metformin imele isigaba se-Biguanide. Akuthinti ukukhiqizwa kwe-insulin. Ukusebenza kwesenzo se-metformin kususelwa kwezinye izinqubo. Kodwa-ke, ngokwelashwa ngale nto, ukwanda kokuzwela komzimba ethonyeni le-insulin kuyaphawulwa. Lokhu kungenxa yokwehla kwesilinganiso se-insulin eboshelwe mahhala. Kodwa-ke, isilinganiso se-insulin kuma-proinsulin siyakhula.
I-Metformin inenzuzo enkulu ngaphezu kwezinye izinto ezinomphumela we-hypoglycemic. Ngakho-ke, le ngxenye ithinta i-lipid metabolism: yehlisa ijubane ukuvela kwamafutha acid yamahhala, kuyilapho i-oxidation yamafutha ingasindi kakhulu, okuvimbela ukumuncwa kwawo. Ngakho-ke, kanye nokujwayelekile kwamazinga kashukela, kukhona ukwehla kobukhulu bokwakhiwa kwamafutha. Lokhu kuqinisa isisindo.
Omunye umsebenzi we-metformin ukucindezelwa kokukhiqizwa koshukela esibindini. Ngasikhathi sinye, kukhona ukwehla kwamandla okufaka i-glucose emathunjini. I-Metformin yehlukile kuma-analogues (ama-sulfonylurea derivatives) ngoba ayivuseli ukukhula kwe-hypoglycemia. Ngokubona ukuthi le ngxenye ayithinti ukwakheka kwe-insulin, amathuba ezimpawu ze-hyperinsulinemia aphansi kakhulu.
Zombili izakhi ekwakhekeni kweYanumet zingokwesigaba sama-ejenti we-hypoglycemic agents. Zisetshenziswa ngokuhlanganiswa, i-metformin ithuthukisa umphumela we-sitaglipin kanye okuphambene nalokho.
Into yesibili eyinhloko (sitagliptin) iyi-inhibitor ye-enzyme DPP-4. Lapho kuthathwa, inqubo yokufakwa kwe-incretin icushiwe. Le yi-hormone esiza ngokwejwayelekile ukuzilawula kokukhiqiza ushukela. Umphumela omuhle unikezwa ngenxa yokusebenza kwe-insulin ngokubamba iqhaza kwamanyikwe. Kodwa-ke, ubukhulu bokukhiqizwa kwe-glucagon kuyancipha. Njengomphumela wentuthuko yale nqubo, inhibition of glucose synthesis iyaphawulwa.
I-Pharmacokinetics
Okuqukethwe okuphezulu kwe-metformin kufinyelelwa ngemuva kwemizuzu engu-120 ngemuva kokuthatha umuthi. I-pharmacokinetics yale nto ikhula ngokushesha okukhulu. Ngemuva kwamahora ayi-6, inani le-metformin liqala ukuncipha. Isici sale nto ukungabi namandla okubopha kumaphrotheni e-plasma. Ihlukaniswa yikhono lokuqongelela kancane kancane ezicutshini zesibindi, izinso, futhi ngaphezu kwalokho emithanjeni ethambile. Ukuqedwa kwesigamu sempilo kuyahluka kungakapheli amahora ambalwa. I-Metformin isuswa emzimbeni ngokubamba iqhaza kwezinso.
Ngokuya kwe-bioavailability, i-sitagliptin idlula into ebhekwe ngaphezulu. Ukusebenza kwale pharamitha kungama-87 no-60%, ngokulandelana. I-Sitagliptin ayisebenzi kahle. Kulokhu, ingxenye enkulu yezidakamizwa isuswa emzimbeni ngendlela efanayo lapho ifaka izitho zomgudu wokugaya ukudla. Ukuphila kwengxenye kwalesi sikhathi kukude futhi kungamahora ayi-12.
Izinkomba zokusetshenziswa
Umuthi unqunyelwe uhlobo lwe-II yesifo sikashukela mellitus. I-Yanumet isebenza kakhulu kunezidakamizwa zezakhi zodwa ezisuselwa ku-metformin noma ezinye izinto ezinomphumela wokuvinjwa kokuqanjwa kweglue. Ngalesi sizathu, isetshenziswa lapho bekungenzeki ukufeza umphumela omuhle ekwelashweni kohlobo lwesifo sikashukela sohlobo II.
UJanumet unqunyelwe uhlobo lwe-II yesifo sikashukela mellitus.
IJanumet ingabekwa ngesikhathi sokwelashwa okuyinkimbinkimbi kanye nezidakamizwa zeqembu le-sulfonamide. Ithuluzi lisetshenziselwa ukumelana nokudla kwe-hypocaloric nokuzivocavoca ngokulinganisela
Contraindication
Umuthi awukwazi ukusetshenziswa lapho ukusabela okungekuhle kokuthile kunoma iyiphi isakhi ekwakhekeni kwaso kwenzeka. Okunye ukwephulwa:
- Isimo esibucayi sesiguli, esithinta kabi izinso: ukushaqeka, ukutheleleka kanzima;
- izifo ezihambisana nokungasebenzi kahle kwenhliziyo, i-hypoxia;
- Uhlobo I isifo sikashukela mellitus;
- utshwala;
- ukukhuphuka kwe-acid egazini (i-lactic acidosis).
UJanumet unqunyelwe ukudliwa ngokudla. Ungeqi umthamo ophelele nsuku zonke we-sitagliptin (100 mg).
Ngokunakekela
Iziguli ezingaphezu kweminyaka engu-80 ubudala kufanele zisebenzise lesi sidakamizwa ngokuqapha.
Ungayithatha kanjani uJanumet 850?
Kubekwa amatafula okusetshenziselwa ukudla. Ungeqi umthamo ophelele nsuku zonke we-sitagliptin (100 mg). Imvamisa enconywayo yokuphuza umuthi izikhathi 2 ngosuku.
Ngoshukela
Udinga ukuqala inkambo yokwelashwa ngenani elincane lezinto ezisebenzayo (sitagliptin, metformin): 50 no-500 mg, ngokulandelana. Imvamisa yokwamukelwa ihlala ingashintshiwe kuyo yonke inkathi yokwelashwa (izikhathi ezi-2 ngosuku). Kodwa-ke, isilinganiso se-metformin sikhula kancane kancane. Ngemuva kwe-500 mg, udokotela unquma i-850, bese kuba ngu-1000 mg. Isikhathi lapho ukwanda komthamo womuthi kudingeka kunqunywa ngawodwa, ngoba kuya ngesimo somzimba, ubukhona bezinye izifo.
Imiphumela emibi yeYanumet 850
Izimpawu zohlelo lwezinzwa: ukozela, ikhanda, isiyezi.
Ukusuka ohlelweni lwe-musculoskeletal: Ubuhlungu emuva, ubuhlungu bemisipha.
Udinga ukuqala inkambo yokwelashwa ngenani elincane lezinto ezisebenzayo (sitagliptin, metformin): 50 no-500 mg, ngokulandelana. Ngemuva kwe-500 mg, udokotela unquma i-850, bese kuba ngu-1000 mg.
Amapheshana wesisu
Isicanucanu, ubumnene besisu, izihlalo ezikhululekile (zingase zishintshane nobunzima bokuphuma kwesitulo), umlomo owomile. Okuncane kakhulu ukubukeka kokuhlanza.
Ngasohlangothini lwe-metabolism
Ukuphazamiseka kwe-anorexia.
Akuvamile - ukwehla kwe-glycemia, futhi lokhu akuhlotshaniswa nokuhlanganiswa kwezinto ezisebenzayo eziyingxenye yeYanumet. Ngesikhathi sokuhlolwa kliniki, kutholakale ukuthi ukwehla kwe-glycemia kubangelwa ukusabela komzimba ezintweni ezahlukahlukene zangaphakathi nangaphandle ezihlobene nomuthi.
Izehlakalo ze-hypoglycemia ezigulini ezithatha lo muthi ziyefana nasezigulini ezivela eqenjini lapho i-metformin yabelwa khona i-placebo.
Engxenyeni yesikhumba
Rash, ukulunywa, ukuvuvukala, vasculitis, isifo seStevens-Johnson.
Kusuka ohlelweni lwezinhliziyo
Akubhekwa.
Allergies
I-Urticaria, ephelezelwa ukulunywa, ukuqubuka, ukuvuvukala.
Umthelela ekhonweni lokulawula izindlela
Azikho izifundo ezinjalo ezenziwayo. Kodwa-ke, kufanele kukhunjulwe ukuthi umuthi uvusa ukuthuthukiswa kwezifo eziningi zesistimu yezinzwa ephakathi (ukozela, isiyezi, njll.). Ngakho-ke, kufanele kuqashelwe lapho ushayela izimoto.
Imiyalo ekhethekile
Kunolwazi mayelana nobudlelwano phakathi kokuthatha umuthi nokukhula kwe-pancreatitis. Lapho kuvela izimpawu zezimpawu, ukwelashwa ngeYanumet kuyamiswa.
Ngesikhathi sokulashwa ngaleli thuluzi, kanye ngonyaka, izinkomba zezinso ziyaqashwa. Ngokuncipha okukhulu kokuvunyelwa kwe-creatinine, isidakamizwa sikhanseliwe.
Uma i-Yanumet isetshenziswa ngasikhathi sinye ne-insulin noma izindlela zeqembu lokuphuma kwe-sulfonylurea, umthamo wokugcina ulungiswa (phansi).
Kunolwazi mayelana nobudlelwano phakathi kokuthatha umuthi nokukhula kwe-pancreatitis. Lapho kuvela izimpawu zezimpawu, ukwelashwa ngeYanumet kuyamiswa.
Ngokwelashwa ngezidakamizwa eziqukethe i-sitagliptin, ubungozi bokusabela kwe-hypersensitivity uyanda. Ngaphezu kwalokho, ukubonakaliswa okungekuhle akwenzeki ngokushesha, kodwa ngemuva kwezinyanga ezimbalwa.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ngenkathi uthwele ingane, kuvunyelwe ukusebenzisa iYanumet, noma kunjalo, lesi sidakamizwa sinqunyelwe inqobo nje uma imiphumela emihle ngobukhulu idlula ukulimala okungenzeka.
Ngesikhathi sokuqunjelwa, umuthi okukhulunywa ngawo awusetshenziswa.
Ukuqokwa kweYanumet ezinganeni ezingama-850
Umuthi awunqunyelwe.
Sebenzisa ebudaleni
Akunconyelwe ukusebenzisa iJanumet ezigulini ezingaphezulu kweminyaka engama-80. Okuhlukile yilapho ukuqoqwa kwe-creatinine kubantu asebekhulile sekufika ezingeni elijwayelekile.
Akunconyelwe ukusebenzisa iJanumet ezigulini ezingaphezulu kweminyaka engama-80.
Isicelo sokusebenza kokulimala kwezinso
Ngomonakalo obuthakathaka, olinganiselayo futhi onzima kulesi sitho, uJanumet akanconyelwanga ukuthi athathwe, ngoba esimweni ngasinye ukunyakaza kwawo emzimbeni kuyanda.
Sebenzisa umsebenzi wesibindi okhubazekile
Akunamininingwane ngezinhloso zomuthi okukhulunywa ngawo nokwehla okukhulu komsebenzi wezinso. Ngalesi sizathu, kufanele ugweme ukuphuza umuthi uma kwenzeka kungatholakali kahle umsebenzi walesi sitho.
I-overdose yeJanumet 850
Akunalo ulwazi ngokuthuthukiswa kwezinkinga ngenkathi uthatha lesi sidakamizwa. Kodwa-ke, i-overdose ye-metformin inomthelela ekuqubukeni kwe-lactic acidosis. Isilinganiso esiyinhloko sokwelashwa yi-hemodialysis. Ngenxa yalokhu, ukuhlangana kwe-metformin ku-serum yegazi kuyehla.
Ukuxhumana nezinye izidakamizwa
Inani lama-ejenti nezinto zitholakala njengokusebenza kokuncipha kwalo ngaphansi kwethonya leYanumet:
- okokugcobisa;
- izidakamizwa ze-glucocorticosteroid;
- ama-phenothiazines;
- ama-hormone egilo;
- phenytoin;
- i-nicotinic acid.
Hlanganisa uJanumet neziphuzo eziqukethe utshwala akufanele. Utshwala bukhulisa umphumela we-metformin ezinqubweni ze-metabolic ezihambisana nokuguqulwa kwe-lactic acid.
Futhi, okuphambene nalokho, ngokusetshenziswa kanyekanye ne-insulin, ama-NSAIDs, ama-inhibitors we-MAO nama-inhibitors we-ACE, ama-hypoglycemic agents, ukwanda komandla womphumela kaJanumet emzimbeni kuyaphawulwa.
Ukwemukelwa kwe-furosemide yisizathu sokwanda okuphindwe kabili kokuqoqwa kwezakhi eziphambili ze-ejenti okukhulunywa ngakho.
Umsebenzi we-Digoxin ukhuphuka ngesikhathi sokwelashwa ngeYanumet.
Iqoqo le-sitagliptin landa ngenkathi uthatha uCyclosporin neYanuvia.
Ukuhambisana notshwala
Hlanganisa uJanumet neziphuzo eziqukethe utshwala akufanele. Utshwala bukhulisa umphumela we-metformin ezinqubweni ze-metabolic ezihambisana nokuguqulwa kwe-lactic acid.
Ama-Analog
Kunenombolo enkulu yezithasiselo ezihlukile kusimo sabo sokwenza nokwakheka. Lapho ukhetha, umuntu kufanele acabangele izinga lobudlova bethonya labo emzimbeni, kanye nendlela yokukhululwa. Izithasiselo ezingaba khona:
- I-Gluconorm;
- Ama-Glucovans;
- I-Glibomet;
- UGalvus Met et al.
Eyokuqala yalokhu kungalungiswa kwezakhi ezimbili, kepha iqukethe i-metformin ne-glibenclamide. Okwesibili kwezinto kubhekiselwa kokuphuma kwe-sulfonylurea, okusho ukuthi ngalesi sidakamizwa, ingozi yemiphumela emibi iyanda. I-Gluconorm ihlukile kweYanumet ngoba ayinakusetshenziswa ngesikhathi sokukhulelwa nokuqunjelwa. Intengo yalesi sidakamizwa iphansi (ama-ruble angama-250).
I-Glucovans iyi-analogue yeGluconorm. Ukuqanjwa kubandakanya futhi i-metformin ne-glibenclamide. Umuthi ungasetshenziselwa ukufaka uJanumet esikhundleni, uma kungekho okuphula umthetho. Kodwa-ke, akufanele isetshenziswe esikhundleni se-Gluconorm.
I-Glibomet iqukethe i-metformin ne-glibenclamide. Ukuqoqwa kwezinto ezisebenzayo kungahluka kancane, kukhule noma kunciphise ukuqina komphumela womuthi emzimbeni, okufanele ubhekwe, ngoba noma ushintsho oluncane ohlelweni lokuthatha izidakamizwa ze-hypoglycemic lungaholela ekukhuleni kwezinkinga.
IGalvus Met ihlukile ekubumbeni. Ine-metformin ne-vildagliptin. Njengasezindabeni ezedlule, umthamo we-metformin udlula inani lesakhi sesibili esiyinhloko. Umuthi awukwazi ukusetshenziswa ngesikhathi sokukhulelwa nokubeletha. Kodwa-ke, ingasetshenziswa kanye ne-insulin, izidakamizwa ezivela eqenjini lokuphuma kwe-sulfonylurea.
I-Galvus Met iqukethe i-metformin ne-vildagliptin, ingasetjenziswa ndawonye ne-insulin, imali evela eqenjini lezinto eziphuma ku-sulfonylurea.
Imibandela yekhefu lekhemisi
Umuthi umuthi.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Akunakwenzeka lokho; ukuqokwa kudokotela kuyadingeka.
Intengo yeJanumet 850
Ungathenga umkhiqizo ngenani lama-ruble angama-2800.
Izimo zokugcina zomuthi
Kunconywa ukugcina izinga lokushisa legumbi ngaphakathi kuka + 25 ° ะก.
Isikhathi sokuphelelwa yisikhathi
Ukulungiswa okuqukethe izinto ezingama-850 no-50 mg kugcina izakhiwo zesikhathi esifushane kune-analogue ye-500 ne-50 mg. Impilo yeshalofu yomkhiqizo okukhulunywa ngayo yiminyaka emi-2.
Umkhiqizi
Inkampani "Pateon Puerto Rico Inc." e-USA.
Ukubuyekezwa mayelana neYanumet 850
UValeria, oneminyaka engama-42 ubudala, uNorilsk
Ngithole isikhathi eside ukuthi kutholakale lesi sifo, kusukela lapho ngivame ukuthatha izidakamizwa ze-hypoglycemic. Esikhathini sokwanda, izidakamizwa zento eyodwa zisiza kabi. Ngalezo zikhathi ezinjalo, udokotela watusa ukuthatha uJanumet. Kuyasiza cishe ngokushesha, kepha isenzo sawo sinqamuka ngokushesha. Ngaphezu kwalokho, izindleko zomuthi ziphezulu.
U-Ana, oneminyaka engama-39, uBryansk
Ithuluzi liyasebenza, ngiligcina lisekhishini ekhishini lekhambi. Ngithanda nomphumela wayo wendawo yonke: isisindo siyazinza, amazinga e-glycemia enza ngokwejwayelekile, ukuhlanganiswa kwe-insulin akubangelwa. Ngikholelwa ukuthi ukusetshenziswa kwayo kungukuhlanganisa kuphela, uma ungephuli irekhodi lokwelashwa.
