Ungayisebenzisa kanjani isidakamizwa Vipidia 25?

I-Vipidia 25 yi-ejenti ye-hypoglycemic esetshenziselwa ukuqhuba umtholampilo ukujwayeza ushukela wegazi ngokulwa noshukela ongancike ku-insulin. Umuthi ungasetshenziswa njengengxenye yokwelashwa okuhlanganisiwe ukwenze kube lula ukulawula amazinga kashukela. Umuthi utholakala ngendlela elula yemithamo yamathebulethi. Umuthi we-hypoglycemic akufanele uthathwe yizingane nabesifazane abakhulelwe.

Igama Lezwe elingafanele

I-Alogliptin.

I-Vipidia 25 yi-ejenti ye-hypoglycemic esetshenziselwa ukuqhuba umtholampilo ukujwayeza ushukela wegazi ngokulwa noshukela ongancike ku-insulin.

I-ATX

A10BH04.

Khipha amafomu nokwakheka

Umuthi wenziwa ngefomu lethebhulethi eliqukethe i-25 mg yento esebenzayo - i-alogliptin benzoate. Umnyombo wamathebulethi uhanjiswa ngamakhompiyutha asizayo:

• i-microcrystalline cellulose;
• i-magnesium stearate;
• i-mannitol;
• i-croscarmellose sodium;
• hyprolose.

Umnyombo wamathebhulethi uxhaswa yi-microcrystalline cellulose.

Ingaphezulu lamathebhulethi liyisicucu sefilimu esine-hypromellose, titanium dioxide, macrogol 8000, udayi ophuzi osuselwa ku-iron oxide. I-25 mg amaphilisi abomvu ngokukhanya.

Isenzo se-Pharmacological

Umuthi ungowesigaba sabenzeli be-hypoglycemic agents ngenxa yokucindezela kokukhetha komsebenzi we-dipeptidyl peptidase-4. I-DPP-4 iyi-enzyme esemqoka ebandakanyeka ekwehlukaniseni okusheshayo kwamakhompiyutha ama-incretins - i-enteroglucagon kanye ne-insulinotropic peptide, okuncike kuzinga le-glucose (HIP).

Ama-hormone avela esigabeni sama-incretin akhiqizwa emgodini wamathumbu. Iqoqo lezakhi zamakhemikhali lenyuka ngokuthathwa kokudla. I-peptide efana ne-Glucagon efana ne-GUI yandisa ukwakheka kwe-insulin ezindaweni ezinkulukazi zeLangerhans. I-Enteroglucagon ngasikhathi sinye ivimbela ukwakheka kwe-glucagon futhi ivimbela i-gluconeogeneis kuma-hepatocytes, okwandisa ukugcwala kwe-plasma kwama-incretins. I-Alogliptin inyusa ukugcinwa kwe-insulin, kuye ngoshukela wegazi.

I-Pharmacokinetics

Lapho kuthathwa ngomlomo, i-alogliptin igxiliswa odongeni lwamathumbu, ukusuka lapho ihluka khona embhedeni we-vascular. I-bioavailability yesidakamizwa ifinyelela ku-100%. Emithanjeni yegazi, into esebenzayo ifinyelela ekugxileni kwe-plasma ephezulu kungakapheli amahora angama-1-2. Akukho ukunqwabelana kwe-alogliptin kwezicubu.

Lapho kuthathwa ngomlomo, i-alogliptin igxiliswa odongeni lwamathumbu, ukusuka lapho ihluka khona embhedeni we-vascular.

Isakhiwo esisebenzayo sihlanganisa i-albhamu nge-plasma nge-20-30%. Kulokhu, lesi sidakamizwa asiguquki futhi sibole kuma-hepatocytes. Ukusuka ku-60% kuya ku-70% wezidakamizwa ushiya umzimba ngendlela yoqobo ngohlelo lokuchama, u-13% we-alogliptin udonswa indle. Isigamu sempilo singamahora angama-21.

Izinkomba zokusetshenziswa

Umuthi ubekelwe iziguli ukwelashwa kohlobo lwe-2 yesifo sikashukela esingalingi i-insulin kanye nokujwayelekile kokulawulwa kwe-glycemic ngokumelene nesizinda sokusebenza kahle okuphansi kokulashwa kokudla kanye nokuzivocavoca umzimba. Ezigulini zabantu abadala, umuthi ungabekwa zombili njenge-monotherapy, futhi njengengxenye yokwelashwa okuyinkimbinkimbi nge-Insulin noma ezinye izidakamizwa ze-hypoglycemic.

Contraindication

Umuthi uphulwe emacaleni alandelayo:

• phambi kwe-izicubu hypersensitivity kuya ku-alogliptin nezinye izinto ezengeziwe;
• uma isiguli sithambekele ekuphenduleni kwe-anaphylactoid kuma-DPP-4 inhibitors;
• thayipha i-1 isifo sikashukela;
• izingane ezingaphansi kweminyaka engu-18;
• iziguli ezinokwehluleka kwenhliziyo okungapheli;
• ukungasebenzi kahle kwezinso nesibindi;
• abakhulelwe futhi abancelile abesifazane.

Umuthi awunqunyelwe lapho kukhona izicubu ze-hypersensitivity ku-alogliptin nezinye izinto ezengeziwe.

Umuthi awunqunyelwe sikashukela sohlobo 1.

Umuthi awubekelwe abesifazane abakhulelwe.

Umuthi awunqunyelwe i-ketoacidosis yesifo sikashukela.

Ngokunakekela

Kunconywa ukuba uqaphele ezigulini ezine-pancreatitis eyingozi, ezigulini ezihluleke ngokulingana ngokwezinso. Kuyadingeka ukuqapha isimo sezitho ngesikhathi sokwelashwa okuhlanganiswayo okususelwa ku-sulfonylurea noma ukwelashwa okuyinkimbinkimbi ngama-glitazones, Metformin, Pioglitazone.

Ungayithatha kanjani i-Vipidia 25?

Amacwecwe enzelwe ukusetshenziswa ngomlomo. Kunconywa ukusebenzisa umuthi ngomthamo wama-25 mg kanye ngosuku, kungakhathaleki ukuthi ukudla kudla kangakanani. Amayunithi omuthi awakwazi ukuhlafunwa, ngoba ukulimala kwemishini kunciphisa isilinganiso sokufakwa kwe-alogliptin emathunjini amancane. Ungathathi umthamo ophindwe kabili. Ithebhulethi elahlekile nganoma yisiphi isizathu kufanele ithathwe yisiguli ngokushesha okukhulu.

Ukwelashwa kwesifo sikashukela

Izazi zezempilo zincoma ukuthatha amaphilisi e-Vipidia ngemuva kokudla lapho kuphakama amazinga kashukela wegazi. Lapho unquma umuthi njengethuluzi elengeziwe lokwelapha nge-Metmorphine noma i-Thiazolidinedione, asikho isidingo sokulungisa irejista yemithamo yamuva.

Ngokubamba okufanayo kwe-sulfonylurea derivatives, umthamo wabo uyancishiswa ukuvikela ukukhula kwesimo se-hypoglycemic. Ngenxa yengozi engaba khona ye-hypoglycemia, kuyadingeka ukulawula izinga loshukela ngesikhathi sokwelashwa ngeMetformin, ihomoni yamanyikwe kanye neTiazolidinedione ndawonye neVipidia.

Ngenxa yengozi engaba khona ye-hypoglycemia, kuyadingeka ukulawula izinga likashukela ngesikhathi sokwelashwa kweMetformin.

Imiphumela emibi ye-Vipidia 25

Imiphumela emibi kwizitho nezicubu ibonakala ngenxa yohlobo olukhethekile lwe-dosing regimen.

Amapheshana wesisu

Mhlawumbe ukuthuthukiswa kobuhlungu esifundeni se-epigastric kanye nezilonda ezibucayi zesisu, i-duodenum. Ezimweni ezingavamile, i-pancreatitis eyingozi kungenzeka.

Ukwephulwa kwesibindi nepheshana elihlanganisiwe

Ohlelweni lwe-hepatobiliary, ukubonakala kokuphazamiseka esibindini kanye nokuthuthukiswa kokuhluleka kwesibindi kungenzeka.

Isistimu yezinzwa ephakathi

Kwezinye izimo, kuvela ikhanda.

Ukuphazamiseka Kwesistimu Yezokuzivikela

Ngokuphikisana nesizinda sokungasebenzi komzimba okubuthakathaka, i-lesion ethelelekayo yohlelo lokuphefumula oluphezulu kanye nokuthuthukiswa kwe-nasopharyngitis kungenzeka.

Umuthi ungadala ikhanda.

Umuthi ungacunula i-edema kaQuincke.

Ngokuhlanganisa ukwelashwa neminye imishanguzo, kufanele uqaphele kakhulu lapho ushayela izimoto.

Engxenyeni yesikhumba

Ngenxa ye-izic hypersensitivity, ukuqhuma kwesikhumba noma ukulunywa kungavela. Ngokwethiyori, ukuvela kweStevens-Johnson syndrome, i-urticaria, izifo eziphuma esikhunjeni.

Allergies

Ezigulini ezimiselwe ukubonakala kokuphendula kwe-anaphylactoid, i-urticaria, i-edema kaQuincke iyabonakala. Ezimweni ezimbi kakhulu, kuvela i-anaphylactic shock.

Umthelela ekhonweni lokulawula izindlela

Umuthi awuthinti amandla okushayela izimoto nezinqubo, kepha ngokwelashwa okuhlanganayo neminye imithi, kufanele uqaphele kakhulu.

Imiyalo ekhethekile

Iziguli ezinokulinganiselwa kokulingana kwezinso zidinga ukulungisa isilinganiso somuthi nsuku zonke futhi kuyo yonke leyo nkathi yokwelashwa kwezidakamizwa kubalulekile ukuthi ziqaphe njalo isimo sesitho. Ezimweni ezimbi kakhulu zenqubo ye-pathological, i-Vipidia ayinconywa, njengoba kunjalo nangeziguli ezikwi-hemodialysis noma iziguli ezinesifo esingamahlalakhona sezinso ezingasebenzi.

Ngenxa yengozi ekhulayo yenqubo yokuvuvukala, kuyadingeka ukwazisa iziguli ngokwenzeka kwe-pancreatitis.

Ama-inhibitors we-DPP-4 angavusa ukuvuvukala okukhulu kwamanyikwe. Lapho kuhlolwa izivivinyo zokwelashwa eziyi-13 lapho amavolontiya ethatha ama-25 mg we-Vipidia ngosuku, amathuba okuthola i-pancreatitis aqinisekiswa ezigulini ezi-3 kwezi-1000. Ngenxa yengozi ekhulayo yenqubo yokuvuvukala, kuyadingeka ukwazisa iziguli ngokwenzeka kwe-pancreatitis, ebonakala ngezimpawu ezilandelayo:

• Ubuhlungu obujwayelekile esifundeni se-epigastric ngemisebe emuva;
• umuzwa wobunzima ku-hypochondrium yangakwesobunxele.

Uma isiguli siphakamisa i-pancreatitis, umuthi kufanele umiswe ngokushesha bese kuhlolwa ukuvuvukala kumanyikwe. Lapho kutholwa imiphumela emihle yokuhlolwa kwelebhu, umuthi awuvuselelwa.

Ngesikhathi sokumaketha ngemuva, kwaqoshwa amacala okungasebenzi kahle kwesibindi ngokungasebenzi kahle okwalandela. Ukuxhumana nokusetshenziswa kwe-Vipidia ngesikhathi sokufunda akukasungulwa, kepha ngesikhathi sokulashwa nomuthi, kunconywa ukuthi iziguli ezisengozini zihlolwe njalo ukuze kubhekwe ukusebenza kwesibindi. Uma, ngenxa yezifundo, ukuphambuka emsebenzini wesitho esine-etiology engaziwa kutholakele, kubalulekile ukuyeka ukuphuza umuthi ngokuqala kabusha kwamuva.

Ngesikhathi sokulashwa ngomuthi ohloselwe ukungasebenzi kahle kwesibindi, iziguli ziyalulekwa ukuba zihlolwe njalo ukuqapha ukusebenza kwesibindi.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Izifundo zemitholampilo ngemiphumela yezidakamizwa emzimbeni wabesifazane ngesikhathi sokukhulelwa azenziwanga. Ngesikhathi sokuhlolwa ezilwaneni, akubanga namiphumela emibi yesidakamizwa kwizitho zohlelo lokuzala lukamama, i-embryotoxicity, noma i-teratogenicity yeVipidia. Ngasikhathi sinye, ngenxa yezizathu zokuphepha, umuthi awubekelwe abesifazane ngesikhathi sokukhulelwa (ngenxa yengozi engakhona yokuphulwa kokubekwa kwezitho nezinhlelo ezinhlelweni zokukhula kombungu).

I-Alogliptin iyakwazi ukuthululwa ngokusebenzisa izindlala ezincelisayo, ngakho-ke kunconyelwa ukulahla i-lactation ngesikhathi sokulashwa kwezidakamizwa.

Kucacisa i-Vipidia ezinganeni ezingama-25

Ngenxa yokuntuleka kolwazi ngomphumela wento esebenzayo ekukhuleni nasekuthuthukisweni komzimba womuntu ebuntwaneni nasebusheni, umuthi ubekwa umthetho wokuthi usetshenziswe ufike eminyakeni eyi-18.

Sebenzisa ebudaleni

Iziguli ezingaphezu kweminyaka engama-60 ubudala azidingi ukulungiswa kwemithamo eyengeziwe.

Isicelo sokusebenza kokulimala kwezinso

Lapho kukhona ukwehluleka okubucayi kwe-renal phakathi kwe-creatinine clearance (Cl) kusuka ku-50 kuye ku-70 ml / min, ushintsho olwengeziwe ku-regimen yemithamo alwenziwa. Nge-Cl kusuka ku-29 kuye ku-49 ml / min, kuyadingeka ukwehlisa inani lansuku zonke ukuya ku-12,5 mg ngethamo elilodwa.

Lapho kukhona ukwehluleka okubucayi kwe-renal phakathi kwe-creatinine clearance (Cl) kusuka ku-50 kuye ku-70 ml / min, ushintsho olwengeziwe kumthamo wedosi awenziwanga.

Ngokungasebenzi kahle kwezinso (uCl ufinyelela ngaphansi kwama-29 ml / min), umuthi awunqatshelwe.

Ukweqisa kwe-Vipidia 25

Ngesikhathi sokuhlolwa kliniki, kwasungulwa umthamo omkhulu ovunyelwe - ama-800 mg ngosuku ezigulini ezinempilo, no-400 mg ngosuku ezigulini ezinesifo sikashukela esingaxhomekeki ku-insulin lapho selashwa nomuthi izinsuku eziyi-14. Lokhu kudlula umthamo ojwayelekile ngezikhathi ezingama-32 no-16, ngokulandelana. Ukuvela kwesithombe somtholampilo se-overdose akukabhalwa.

Ngokusebenzisa kabi izidakamizwa, kungenzeka ukuthi ukwandisa imvamisa yentuthuko noma ukwandisa imiphumela emibi. Ngomthelela omubi omubi, ukuqubuka kwesisu kuyadingeka. Ezimweni zokuma, ukwelashwa okubonakalayo kwenziwa. Kungakapheli amahora ama-3 we-hemodialysis, yi-7% kuphela yomthamo othathwe ozokwazi ukuhoxiswa, ngakho-ke ukuphathwa kwawo akuphumeleli.

Ukuxhumana nezinye izidakamizwa

Umuthi awuzange uhlanganyele ngamakhemikhali nokuphathwa kanyekanye kwe-Vipidia neminye imithi. Umuthi awuzange uvimbele ukusebenza kwe-cytochrome isoenzymes P450, monoo oxygenase 2C9. Ayihlangani ne-p-glycoprotein substrates. I-Alogliptin ngesikhathi kuqhubeka izifundo zemithi ayithintanga izinguquko ezingeni le-caffeine, i-warfarin, i-dextromethorphan, indlela yokuvimbela inzalo yomlomo ku-plasma.

Umuthi awuthinti izinguquko ezingeni le-Dextromethorphan emzimbeni.

Ukuhambisana notshwala

Ngesikhathi sokulashwa nomuthi, kwenqatshelwe ukuphuza utshwala. I-Ethanol equkethwe ophuzweni oludakayo ingadala ukonakala kwamafutha wesibindi ngenxa yemiphumela enobuthi kuma-hepatocytes. Lapho uthatha i-Vipidia, umphumela onobuthi obhekene nohlelo lwe-hepatobiliary uyathuthukiswa. I-ethyl utshwala ibanga ukuvinjwa kwesistimu yezinzwa ephakathi, iphazamisa ukuhamba kwegazi futhi inomphumela wokugaya. Njengomphumela womthelela wotshwala emzimbeni, umphumela wokwelapha umuthi uyancishiswa.

Ama-Analog

Ukufakwa kwesidakamizwa okunezakhiwo ezifanayo zemithi nokwakheka kwamakhemikhali kwento esebenzayo kufaka phakathi:

• Galvus;
• Trazenta;
• UJanuvius;
• Onglisa;
• I-Xelevia.

Umuthi ofanayo unegama elikhethwe udokotela ngokuya ngezinkomba zokuhlushwa ushukela wegazi kanye nesimo jikelele sesiguli. Ukubuyiselwa esikhundleni kwenziwa kuphela lapho kungekho mphumela owelaphayo noma isizinda sokusabela okubi okuphikisayo.

Imibandela yekhefu lekhemisi

Umuthi awuthengiswa ngaphandle kwemithi kadokotela.

Ngingakwazi ukuthenga ngaphandle kadokotela?

Umthamo ongalungile wesidakamizwa ungavusa i-hypoglycemia noma i-hyperglycemia. Ukuthuthukiswa kwe-hypoglycemic coma kungenzeka, ngakho-ke, ukuthengiswa kwamahhala kokuphepha kweziguli kukhawulelwe.

Intengo ye-Vipidia 25

Izindleko ezijwayelekile zamacwecwe ama-ruble ayi-1100.

Izimo zokugcina zomuthi

Kunconywe ukuthi i-Vipidia igcinwe emazingeni okushisa aze afike ku-25 ° C endaweni ene-co umsofini ophansi womswakama, otholakala kude nemitha yelanga.

Isikhathi sokuphelelwa yisikhathi

Iminyaka emithathu

Umkhiqizi

ITakeda Island Limited, e-Ireland.

I-analogue yesidakamizwa ngu-Onglisa.

Ukubuyekezwa ku-Vipidia 25

Ezithangamini ze-Intanethi kunemibono emihle evela kosokhemisi nezincomo ngokusetshenziswa kwomuthi.

Odokotela

Anastasia Sivorova, endocrinologist, Astrakhan.

Ithuluzi elisebenzayo ekulweni nesifo sikashukela sohlobo 2. Kubekezelelwe kahle iziguli. Emsebenzini wezokwelapha, awuzange uhlangane ne-hypoglycemia. Amathebulethi kufanele athathwe isikhathi esingu-1 ngosuku ngaphandle kokubalwa komthamo ngokucophelela. Umenzeli we-hypoglycemic ovela esizukulwaneni esisha, ngakho-ke, akafaki sandla ekwandeni kwesisindo somzimba. Umsebenzi wokusebenza kwamaseli we-pancreatic beta uyagcinwa.

U-Alexey Barredo, udokotela we-endocrinologist, e-Arkhangelsk.

Ngikuthandile ukuthi ngokusebenzisa isikhathi eside umuthi, ukubonakaliswa okungekuhle akukhuli. Umphumela wokwelapha unomphumela omnene we-hypoglycemic, kepha ungabonakali ngokushesha. Kuyinto elula ukuthatha - 1 isikhathi ngosuku. Inani elifanele lemali. Akubangeli ukusabela komzimba ezigulini.

I-analogue yesidakamizwa nguJanuvia.

Iziguli

UGabriel Krasilnikov, oneminyaka engama-34, uRyazan.

Ngithatha i-Vipidia nge-25 mg yeminyaka engu-2 ngokuhlangana ne-500 mg yeMetformin ekuseni ngemuva kokudla. Ekuqaleni, wasebenzisa i-Insulin ngokuya ngohlelo lwama-10 + 10 + 8 amayunithi. Akusizanga ukunciphisa ngempumelelo ushukela. Isenzo samathebulethi mude.Ngemuva kwezinyanga ezi-3 kuphela, ushukela waqala ukuwa, kepha ngemuva kwezinyanga eziyisithupha, ushukela osuka ku-12 wehla waya ku-4,5-5,5. Iyaqhubeka nokuhlala ngaphakathi kuka-5.5. Ngithande ukuthi isisindo sehlile: sisuka ku-114 saya ku-98 kg ngokukhula okungamasentimitha angama-180. Kepha kufanele ulandele zonke izincomo ezivela emiyalweni.

U-Ekaterina Gorshkova, oneminyaka engama-25, uKrasnodar.

Umama unesifo sikashukela sohlobo 2. Udokotela wayala uManinil, kepha akazange alunge. Ushukela awuzange wehlise futhi nempilo yayiwohloka ngenxa yezinkinga zenhliziyo. Esikhundleni samaphilisi we-Vipidia. Kuyinto elula ukuthatha - 1 isikhathi ngosuku. Ushukela awuzange uncishiswe kakhulu, kepha kancane kancane, kodwa into esemqoka ukuthi umama uzizwa kahle. Okuwukuphela kwento esidonsa ngayo ukuthi isithinta kabi isibindi.