Incazelo yesidakamizwa iMetformin esuselwa kulwazi oluqukethwe kwimiyalo yasekuqaleni yokusetshenziswa.
Igama Lezwe elingafanele
I-Metformin.
I-ATX
Kubhekiswa eqenjini le-pharmacological: agents abasebenza ngomlomo.
Ikhodi (ATC): A10BA02 (Metformin).
Khipha amafomu nokwakheka
Into esebenzayo: metformin hydrochloride.
Izibhebhe zimhlophe, ziyindilinga, zinobungozi maphakathi, zihlanganiswa amafilimu, ziqukethe i-stearate, isitashi, i-talc ne-500 noma i-850 mg yezinto ezisebenzayo njengezici ezengeziwe.
Isenzo se-Pharmacological
Isidakamizwa i-Hypoglycemic sisho ama-biguanides - imithi esetshenziselwa ushukela. Banciphisa inani le-insulin eboshwe (ngamaprotheni egazi), eliphakeme kushukela. Egazini, isilinganiso se-insulini ku-proinsulin siyakhuphuka, ngenxa yalokho ukwehla kokungancipha kwe-insulin kuyancipha. Ngaphansi kwethonya lomuthi, akukho ukwanda kokukhiqizwa kwe-insulin noma umthelela kuma-pancreas.
Isidakamizwa i-Hypoglycemic sisho ama-biguanides - imithi esetshenziselwa ushukela.
Ngaphansi kwethonya lomuthi, izinga likashukela ku-plasma yegazi liyancipha kungakhathaleki ukuthi kudliwani.
Umphumela wokwelapha umuthi unikezwa ngu:
- Ukwehla kokukhiqizwa kwe-glucose yisibindi ngenxa yokuvinjwa kwenqubo ye-metabolic yokwakheka kwe-glucose kusuka kuzakhi ezingezona ze-carbohydrate kanye nokuqhekeka kwe-glycogen kuya glucose;
- ukwenza ngcono ukuphendula kwezicubu zomsipha ku-insulin kanye nokusetshenziswa kwe-glucose kuyo;
- ukuvimbela ukungena kwamathumbu eglucose.
Isidakamizwa sithuthukisa i-metabolism yamafutha, sinciphisa i-cholesterol ephelele ngokunciphisa amafutha egazi. Kwandisa umsebenzi wegazi we-fibrinolytic futhi kuthinta kahle i-hemostasis. Ikhuthaza ukwakheka kwe-glycogen ngaphakathi kweseli ngokwenza izinto nge-enzyme glycogen synthetase. Yandisa amandla okuhambisa ushukela ngezinhlobo ezahlukahlukene zezithwali ze-membrane.
Ngesikhathi sokulashwa nomuthi, isisindo sesiguli singancipha.
I-Pharmacokinetics
Umuthi udonswa u-50-60%, ufinyelela emaqoqweni aphezulu kakhulu amahora angama-2,5 ngemuva kokuphatha. Ukuxhumana ngamaprotheni egazi akunakunqotshwa. Ukuqina okuzinzile kwento esebenzayo egazini (<1 μg / ml) kuqoshwa amahora angama-24-48 ngemuva kokuthatha umuthi ngokuhambisana nomthamo onconyiwe. Ukuqoqwa okuphezulu kakhulu kwento esebenzayo ngethamo eliphezulu ayidluli ku-5 μg / ml. Ukuqunjelwa kungancipha kancane ngenkathi kudliwa.
I-Metformin yezidakamizwa ithuthukisa i-metabolism yamafutha, inciphisa i-cholesterol ephelele ngokunciphisa amafutha egazi.
Umuthi osebenzayo awuthengisiwe, uthuliwe ngendlela yawo yoqobo nomchamo. Ukuqedwa kwesigamu sempilo kungamahora angama-6-7. Izinga lokuphuma kwesidakamizwa yizinso licishe libe ngu-400 ml / min. Umsebenzi wezinso ongasebenzi kahle uhambisana nokubambezeleka kokubambezeleka kwento esebenzayo (ngokwesilinganiso sobungako be-creatinine), okuholela ekwandeni kwengxenye yempilo kanye nokwanda kokuhlungwa kwe-plasma kwento esebenzayo.
Izinkomba zokusetshenziswa
Isidakamizwa sisetshenziselwa uhlobo 2 sikashukela i-mellitus, lapho ukudla kanye nokuzivocavoca komzimba kunganawo umphumela omuhle ofunekayo ezigulini ezinesisindo ngokweqile. Umuthi ubekelwe abantu abadala nezingane ezingaphezu kweminyaka eyi-10 njenge-monotherapy noma njengengxenye yokwelapha okuyinkimbinkimbi ngokumelene ne-hyperglycemia.
Umuthi wokuzikhethela ezigulini zabantu abadala abane-Type 2 sikashukela ngokweqile, uma nje ukudla kungasebenzi ngokwanele.
Contraindication
- ukungabelani kokuthile okusebenzayo noma iyiphi ingxenye yokusiza;
- izimo ezandisa ubungozi be-lactic acidosis, kufaka phakathi umsebenzi wokulimala we-renal nge-indexin ye-creatinine yezifo ezingaphezu kwe-150 μmol / l, izifo zesibindi ezingapheli kanye namaphaphu;
- ukwehluleka kwezinso nge-creatinine imvume <45 ml / min. noma i-GFR <45 ml / min. / 1.73 m²;
- ukwehluleka kwesibindi;
- I-ketoacidosis ine-diabetes, i-coma ine-diabetes;
- ukwehluleka kwenhliziyo okuguquguqukayo (kodwa okungenabungozi ekuhlulekeni kwenhliziyo okungapheli);
- isigaba esibi se-infyoction ye-myocardial;
- ukukhulelwa nokuqunjelwa;
- ubuthi besibindi obukhulu.
- isikhathi ngaphambi kokuhlinzwa (izinsuku ezi-2), izifundo ze-radiopaque.
Ngokunakekela
- izingane ezisukela eminyakeni eyishumi kuya kwengu-12;
- abantu asebekhulile (ngemuva kweminyaka engama-65);
- abantu ababandakanyeka ekusebenzeni kanzima ngokomzimba, okwandisa ubungozi be-lactic acidosis.
Ungayithatha kanjani i-metformin hydrochloride?
Ngaphambi noma ngemuva kokudla?
Isikhathi sokuthatha umuthi sinokudla noma ngemuva kokudla.
Ngoshukela
Umthamo kubantu abadala ekuqaleni uvela ku-500 kuye ku-850 mg kabili noma kathathu ngosuku. Ngemuva kwamaviki ama-2, umthamo ubuyekezwa ngokuya ngezilinganiso zikashukela wegazi. Ukwanda kancane kancane komthamo wansuku zonke kugwema imiphumela emibi engatheni ehambisana nesistimu yokugaya ukudla. Umthamo wansuku zonke akufanele udlule ku-3000 mg kumthamo we-3 ohlukanisiwe.
Umthamo wansuku zonke wezingane ezingaphezu kweminyaka eyi-10 kanye nentsha engu-500-850 mg kumthamo owodwa. Ngemuva kwamaviki ama-2, umthamo wansuku zonke wesidakamizwa uyabuyekezwa ngokuya ngezinga le-glucose esegazini. Umthamo wansuku zonke ku-pediatrics, ohlukaniswe ngemithamo engama-2-3, akufanele udlule ku-2000 mg uwonke.
Ngaphambi kokunquma umuthi ezigulini esezikhulile, kanye nangesikhathi sokwelashwa, kunconywa ukubhekwa komsebenzi wezinso njalo. Emuntwini onokwehluleka okulingana kwe-renal (imvume ye-creatinine imvume ye-45-59 ml / min noma i-GFR ye-45-59 ml / min), ukusetshenziswa kwalesi sidakamizwa kuvunyelwe (umthamo wansuku zonke we-500-850 kanye) ukungabikho kwengozi ekhulayo ye-lactic acidosis. Umthamo wansuku zonke awudluli ku-1000 mg futhi uhlukaniswe ngemithamo emibili. Ukuxilongwa kokusebenza kwezinso kuphoqelekile okungenani njalo ezinyangeni ezi-6.
Ukwehla kwesisindo
Umthamo wokuqala njengomuthi wokulahlekelwa isisindo ngu-500 mg 1 isikhathi ngosuku ngokukhula kancane kancane komthamo ngama-500 mg njalo ngeviki. Umthamo wansuku zonke onconyiwe akufanele udlule ku-2000 mg. Inkambo yokwamukelwa ingamaviki ama-3 ngamakhefu cishe izinyanga eziyi-1-2. Lapho kukhona imiphumela emibi emibi, umthamo wansuku zonke uyanqunyelwa.
Imiphumela emibi ye-Metformin hydrochloride
Ukwelashwa nomuthi uvame ukuhlotshaniswa nemiphumela emibi. Kulezi zimo, ukuncishiswa komthamo noma ukuhoxiswa ngokuphelele komuthi kukhonjiswa ngokuya kobukhulu besimo.
Amapheshana wesisu
Ekuqaleni kokwelashwa kanye nokwanda komthamo, izehlakalo ezinjalo ezingathandeki njengoba zivamile:
- Izimpawu ze-dyspeptic (isicanucanu, ukuhlanza, ukuthokomala, ukuthamba okucasukile);
- Ubuhlungu besisu
- ukulahleka kwesifiso
- i-metallic aftertaste.
Lezi zimpawu ziholela imvamisa yokubonakaliswa ngesikhathi sokwelashwa kwezidakamizwa. Lezi zimo kancane kancane zidlula zodwa. Ukuze unciphise noma uvikele abo, kukhonjiswa ukwenyuka okubushelelezi komthamo wansuku zonke kanye nokuchobozwa kwabo kumithamo eminingana. Ngokulashwa isikhathi eside, ukuphazamiseka kokugaya ukudla kukhula kancane.
Engxenyeni yesikhumba
Ukusabela okungejwayelekile komzimba, kufaka phakathi ubomvu nokuvuvukala kwesikhumba, ukulunywa, i-urticaria.
Ngasohlangothini lwe-metabolism
Ukwelashwa isikhathi eside kungadala ukukhuphuka kwamazinga we-homocysteine, ahambisana nokutholwa okunganele kwe-Vitamin B12 nokuntuleka kwayo okulandelayo, futhi lokhu kungaphazamisa ukwakheka kwegazi futhi (ezimweni ezingavamile) kuholele ku-megaloblastic anemia.
Ukuthuthukiswa kwe-lactic acidosis (lactic acidosis) ngenxa yokuqongelelwa kwe-lactic acid egazini kuyinkinga enkulu kakhulu evela ekusebenziseni i-Biguanides.
Uhlelo lwe-Endocrine
Nge-hypothyroidism, umuthi wehlisa izinga le-hormone ekhuthaza i-thyroid ku-serum yegazi. Umuthi unciphisa ukukhiqizwa kwe-testosterone emadodeni. Ezimweni ezingazodwa, kuba nokukhula komzimba kwe-megaloblastic.
Allergies
Imisipha yesikhumba.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti amandla okusebenza ngezinqubo eziyinkimbinkimbi, kubandakanya nezimoto. Ekuhlanganisweni kwezokwelapha namanye ama-antihyperglycemic agents (insulin, meglitinides), ukuthuthukiswa kwezimo ze-hypoglycemic ezingahambelani nokushayela nezinye izindlela eziyinkimbinkimbi ezidinga ukugxila okwandisiwe kokunakwa akubekelwa eceleni.
Umuthi awuthinti amandla okusebenza ngezinqubo eziyinkimbinkimbi, kubandakanya nezimoto.
Imiyalo ekhethekile
Ngesikhathi sokwelashwa ngezidakamizwa, kufanele wakhe ukudla kwakho ukuze ukudla okwenzelwe ama-carbohydrate kusatshalaliswe ngokulinganayo usuku lonke. Lapho kukhona isisindo somzimba esithe xaxa, kuyadingeka ukunamathela ekudleni okuqukethe ikhalori ephansi. Izinkomba ze-carbohydrate metabolism kufanele zibhekwe njalo.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Kuvunywa ukusetshenziswa ngesikhathi sokuzala kwengane, kubandakanya nesifo sikashukela sokukhulelwa. Umuthi, ngokwezifundo zokwelapha, awusithinti kabi isimo sikamama noma ukukhula kwesibeletho. Ukuqoqwa kwento esebenzayo kutholakala kubisi lwebele, ngakho-ke kunconywa ukuphazamisa ukuncelisa ibele ngesikhathi sokwelashwa ngenxa yedatha enganele evela ezifundweni zokuphepha komuthi ezinganeni.
Ukunquma iMetformin hydrochloride ezinganeni
Ukusetshenziswa ezinganeni kuvunyelwe kusuka eminyakeni eyi-10 kuphela ngemuva kokuqinisekiswa kwesifo sikashukela sohlobo 2. Awukho umphumela wezidakamizwa ekukhulelweni noma ekukhuleni kwengane okurekhodiwe. Kepha lolu daba aluzange lucwaningwe ngokwanele, ngakho-ke kuqashwa ngokucophelela kwalezi zinhlaka ezinganeni ngesikhathi sokulashwa kwezidakamizwa isikhathi eside.
Sebenzisa ebudaleni
Kudinga ukuqapha umsebenzi wezinso, ngoba kungancipha ngokuhamba kweminyaka.
Isicelo sokusebenza kokulimala kwezinso
Ngaphambi kokuqala futhi njalo ngesikhathi sokwelashwa (okungenani izikhathi ezi-2 ngonyaka), izinso kufanele zigadwe, ngoba i-metformin ikhishwa ngohlelo lomchamo. Uma imvume ye-creatinine i <45 ml / min., Ukwelashwa kwezidakamizwa kuyaqondiswa.
Sebenzisa umsebenzi wesibindi okhubazekile
Ezimweni ezingavamile, umuthi ungadala ukonakala ekusebenzeni kwesibindi (njengomthelela oseceleni). Imiphumela engathandeki iyeka ngemuva kokuyekiswa kwemithi.
I-overdose yeMetformin Hydrochloride
Izimpawu zifaka i-nausea, ukugabha, uhudo, i-tachycardia, ukozela, i-hypo- noma i-hyperglycemia. Inkinga eyingozi kakhulu edinga ukulaliswa esibhedlela yi-lactic acidosis, ebonakala ngezimpawu zokuphuza, ukungazi kahle. Ukwethulwa kwe-sodium bicarbonate kuyakhonjiswa, nge-hemodialysis yayo yokungasebenzi. Ukufa kwabhalwa ngemuva kokweqisa ngamabomu okungaphezulu kwama-63 g.
Ukuxhumana nezinye izidakamizwa
Ukusetshenziswa kanyekanye kwezinto ezine-iodine equkethe i-radiopaque kuqinisekisiwe. Kulokhu, ubungozi bokuthola ukuhluleka kwe-renal, ukuqongelela ngokweqile kwento edakwayo, i-lactic acidosis iyanda.
Ukuthatha umuthi ngokufana ne-sulfonylurea derivatives, NSAIDs, Acarbose, Insulin kunganyusa umphumela we-hypoglycemic.
Ukwehla komphumela we-hypoglycemic kwenzeka lapho kusetshenziswa kanye:
- glucocorticosteroids;
- ama-hormone egilo;
- i-loop diuretics;
- okususelwa ku-phenothiazine;
- ama-audiathomimetics.
Ezimweni ezingavamile, ukusetshenziswa kanyekanye ne-indomethacin (ama-suppositories) kungadala i-metabolic acidosis.
Ukuhambisana notshwala
Ukuhambisana neziphuzo ezinotshwala noma ngemithi equkethe utshwala akukuhle. Ubuthi obudakayo obukhulu, ikakhulukazi maqondana nesizinda sokudla okuphansi kwekhalori noma ngokulimala kwesibindi, kuhlotshaniswa nokukhula okungenzeka kokukhula kwe-lactic acidosis.
Ama-Analog
- IGlucophage;
- I-Bagomet;
- Metformin Richter;
- Metformin-Canon;
- Metformin-Akrikhin;
- Metformin Long;
- Siofor.
Imibandela yekhefu lekhemisi
Kubhekiselwa kwimithi kadokotela. Udokotela angabhala igama ngesiLatini Metforminum efomini.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Cha.
Intengo yeMetformin Hydrochloride
Izindleko zomuthi:
- Amaphilisi we-500 mg, ama-60 ama-PC. - cishe ama-ruble angama-132;
- I-850 mg amaphilisi, ama-30 ama-pcs. - cishe ama-ruble angama-109.
Izimo zokugcina zomuthi
Akudingi izimo ezikhethekile. Igcinwe kwiphakheji yangempela. Gwema kude nezingane!
Analogue yesidakamizwa kungaba i-Glucophage yezidakamizwa.
Isikhathi sokuphelelwa yisikhathi
Iminyaka engu-3 kusuka ngosuku oluboniswe kuphakheji.
Umkhiqizi
IZentiva S.A. (IBucharest, iRomania).
Ukubuyekezwa ku-metformin hydrochloride
Odokotela
UVasiliev R.V., udokotela ojwayelekile: "Umuthi ufanelekile ukwelashwa i-monotherapy futhi kuhlanganiswe. Kuyasebenza futhi kuphephile ukulandela imiyalo esetshenzisiwe. Kunomphumela onenzuzo kumetabolism, kunomthelela ekujuleni kwesisindo. Kucatshangwa ukuthi ngokuzayo, i-metformin ngenxa yezakhiwo ze-anticarcinogenic isetshenziswa ekwelapheni izinhlobo ezithile zomdlavuza. "
U-Tereshchenko E. V., ongumvikeli we-endocrinologist: "Sekuyiminyaka eminingana ngibeka lo mnikazi owelaphayo ukuthi angaphazamiseki emzimbeni, ikakhulukazi kubantu abakhuluphele. Ukusetshenziswa kwalesi sidakamizwa ngesikhathi sokukhulelwa kuvunyelwe."
Iziguli
U-Olga, oneminyaka engama-56, u-Yalta: "Sekuphele izinyanga ezinhlanu ngiphuza lo muthi ngesifo sikashukela sohlobo 2.Ekuqaleni kokudla, kuthathe amakhilogremu ambalwa wesisindo. "
Ukulahlekelwa isisindo
UTamara, oneminyaka engama-28, eMoscow: "Eminyakeni embalwa edlule, ngithole ama-20 kg ngenxa yokuxineka kakhulu nokudla ngokweqile. Bengilokhu ngithatha lesi sidakamizwa isigamu sonyaka ngokwemiyalo futhi ngiphila impilo esebenzayo. Ngakwazi ukulahlekelwa yi-13 kg."
UTaisiya, oneminyaka engama-34, uBryansk: "Umuthi uyasiza ukunciphisa umzimba, kepha uma ulandela umsoco ofanele. Ngaphandle kokudla, umuthi awusebenzi."
