Ungasisebenzisa kanjani isidakamizwa uJanumet 50?

Uhlu lwezidakamizwa ezisebenza ngempumelelo kakhulu ze-hypoglycemic, uJanumet kufanelekile ukusho. Isici sakhona ukwakheka okuhlangene, okuvumela ukufeza imiphumela ephezulu ngentengo ephansi.

Igama Lezwe elingafanele

Izidakamizwa ze-INN - iMetformin + Sitagliptin.

Uhlu lwezidakamizwa ezisebenza ngempumelelo kakhulu ze-hypoglycemic, uJanumet kufanelekile ukusho.

I-ATX

Ikhodi ye-ATX yi-A10BD07.

Khipha amafomu nokwakheka

Uhlobo kuphela lomthamo weJanumet 50 ngamathebulethi, noma kunjalo, bangaba nomthamo ohlukile.

Ukuqanjwa okuyinhloko kwesidakamizwa kuqukethe izinto ezisebenzayo ezilandelayo:

• sitagliptin phosphate monohydrate - ngenani lama-64.25 mg (lokhu okuqukethwe kulingana no-50 mg we-sitagliptin);
• metformin hydrochloride - inani lale ngxenye lingafinyelela ku-500, 850 noma ku-1000 mg (ngokuya ngomthamo okhonjisiwe womuthi).

Izinto ezisizayo yilezi:

• i-sodium fumarate;
• i-povidone;
• amanzi ahlanziwe;
• sodium lauryl sulfate.

Amathebulethi e-Biconvex, aphekwe ngefilimu, abushelelezi kolunye uhlangothi futhi anokhahlo kolunye. Umbala uyahlukahluka ngokuya ngomthamo: upinki okhanyayo (50/500 mg), opinki (50/8 mg) nobomvu (50/1000 mg).

Amacwecwe abekwe emabhulashini ama-14 ama-pcs. Ibhokisi lekhadibhodi lingaqukatha amapuleti angu-1 kuye kwayi-7.

Isenzo se-Pharmacological

Amacwecwe aseYanumet - isidakamizwa esihlanganisiwe. Siqukethe izidakamizwa ezi-2 ze-hypoglycemic ezisiza ngempumelelo isenzo somunye nomunye. Ukuphuza amaphilisi kusiza ukufeza ukulawulwa kwe-hypoglycemia ezigulini ezinesifo sikashukela sohlobo II.

Ukuphuza amaphilisi kusiza ukufeza ukulawulwa kwe-hypoglycemia ezigulini ezinesifo sikashukela sohlobo II.

I-Sitagliptin

Le ngxenye inezici ze-enhibme inhibitor ekhetha kakhulu (DPP-4). Ngokuvamile kusetshenziswa ekwelapheni okuyinkimbinkimbi kohlobo lwesifo sikashukela sohlobo II.

I-DPP-4 inhibitors isebenza ngokwenza kusebenze ama -retretins. Lapho kuvimbela umsebenzi we-DPP-4, i-sitagliptin inyusa ukugcwala kwe-insulinotropic polypeptide (HIP) ne-glucagon-peptide 1 (GLP-1). Lezi zinto zingama-hormone asebenzayo aqhamuka emndenini we-incretin. Umsebenzi wabo ukubamba iqhaza kulawulo lwe-glucose homeostasis.

Nge-glucose ejwayelekile noma ephezulu yegazi, i-HIP ne-GLP-1 isheshisa ukwakheka kwe-insulin ngamaseli wamanyikwe. I-GLP-1 iyakwazi ukuvimbela ukukhiqizwa kwe-glucagon kumanyikwe, okunciphisa ukwakheka kwe-glucose esibindini.

Ukonakala kwe-sitagliptin ukuthi emithini yokuncoma yokwelapha enconyiwe, lesi sakhi asivimbi umsebenzi wama-enzyme ahlobene, kufaka phakathi i-DPP-8 ne-DPP-9.

I-Metformin

Le ngxenye futhi inezakhiwo ze-hypoglycemic. Ngaphansi kwethonya laso, abantu abaphethwe yi-Type II sikashukela mellitus bakhulisa ukubekezelelwa kwe-glucose. Lokhu kuchazwa ukuncipha kwamazinga kashukela we-postprandial and basal plasma.

Amakhemikhali esenzo se-metformin ahlukile ngokwesenzo sabenzeli bomlomo be-hypoglycemic, abangamanye amaqembu asokhemisi. Ukusetshenziswa kwesidakamizwa kusiza ukufeza izinkomba ezilandelayo:

• ukukhiqizwa koshukela kwesibindi kuyancishiswa;
• iphesenti lokufakwa kweglucose emathunjini liyancipha;
• ukusheshiswa kokubanjwa kokuqothulwa kanye nokuqedwa kwe-glucose egazini kukhulisa ukuzwela ukungena kwe-insulin.

Inzuzo yale ngxenye (ngokuqhathaniswa ne-sulfonylurea) ukuntuleka kokuthuthukiswa kwe-hypoglycemia ne-hyperinsulinemia.

I-Pharmacokinetics

Imithamo yomuthi i-Yanumet ifana nemibhalo ye-metformin ne-sitagliptin ngokwahlukile. I-bioavailability ye-metformin inenkomba ye-87%, sitagliptin - 60%.

Izakhi ezisebenzayo zokwakheka zidlulwa ngokusebenzisa izinso.

Umsebenzi omkhulu we-sitagliptin ufinyelelwa emahoreni angama-1-4 ngemuva kokuphathwa ngomlomo. Ukudla okungafuneki kuthinta isilinganiso kanye nevolumu lokufakwa. Umsebenzi we-Metformin uqala ukuvela ngemuva kwamahora ama-2. Ngokudla okuningi, ukudla kuyancipha.

Izakhi ezisebenzayo zokwakheka zidlulwa ngokusebenzisa izinso.

Izinkomba zokusetshenziswa

I-Yanumet yakhelwe ukusungula ukulawula kwe-hypoglycemia ezigulini ezinesifo sikashukela sohlobo 2. Odokotela banquma amaphilisi ezimweni eziningana:

1. Ngokungabikho komphumela oyifunayo kusuka kwelashwa nge-Metformin. Kulokhu, ukulungiswa okuhlangene kuthuthukisa iphrofayili ye-glycemic kanye nezinga lempilo yesifo sikashukela.
2. Ngokuhlanganiswa nabaphikisi be-gamma receptor.
3. Ngokunxeshezelwa koshukela okungaphelele kusuka kumijovo ye-insulin.

Contraindication

Akunconyelwe kakhulu ukuthatha umuthi nalokhu:

• ukuzwela komuntu ngamunye ezintweni ezakhiwayo zamathebulethi;
• thayipha isifo sikashukela;
• isifo sikashukela;
• izifo ezahlukahlukene ezithathelwanayo;
• isimo sokushaqeka;
• ukulimazeka okukhulu kwezinso;
• ukuphathwa kokungena kwezidakamizwa eziqukethe iodine;
• ukungasebenzi kahle kwesibindi;
• izifo ezihambisana nokushoda komoya-mpilo;
• ubuthi, utshwala;
• ukukhulelwa kanye nokuncelisa;
• ngaphansi kweminyaka eyi-18.

Akunconywa ngokuqinile ukuthatha umuthi ngesikhathi sokukhulelwa.

Akunconywa kakhulu ukuthi uphuze umuthi ongaphansi kweminyaka engu-18.

Akunconywa ngokuqinile ukuthatha umuthi ngenkathi uncelisa ibele.

Akunconyelwe kakhulu ukuthatha umuthi ngotshwala.

Akunconyelwe kakhulu ukuthatha umuthi uma kwenzeka ukungasebenzi kahle kwesibindi.

Akunconywa kakhulu ukuthi uphuze umuthi ukuze ukhubazeke kakhulu ngezinso.

Ngokwemiyalo, umuthi ubekelwe iziguli esezikhulile ngokuqapha ngokweqile.

Ngokunakekela

Ngokwemiyalo, umuthi ubekelwe iziguli esezikhulile ngokuqapha ngokweqile.

Ungamthatha kanjani uJanumet 50?

Amatafula athathwa ekuseni ngesisu esingenalutho ngokudla. Ngokudla kabili, umuthi uthathwa ekuseni nakusihlwa. Udokotela ubeka umgomo ngamunye, ngenkathi kucatshangelwa isimo sesiguli, iminyaka yakhe kanye nohlu lwamanje lokwelashwa:

1. Uma kungekho ukuphathwa kwe-glycemic nge-metformin elilinganisweni ephezulu evunyelwe. Iziguli ezinje zibekelwa uJanumet izikhathi ezi-2 ngosuku. Inani le-sitagliptin akufanele lidlule i-100 mg ngosuku, umthamo we-metformin ukhethiwe wamanje.
2. Uma kukhona ukuguquka kusuka ekwelashweni ne-metformin + sitagliptin tata. Umthamo wokuqala weYanumet kuleli cala ukhethwe ngokulingana ngaphambili.
3. Uma ungekho umphumela odingekayo wokuthatha inhlanganisela ye-metformin ne-sulfonylurea. Imithamo yeYanumet kufanele ifake umthamo omkhulu wezinsuku zonke we-sitagliptin (100 mg) kanye nomthamo wamanje we-metformin. Kwezinye izimo, isidakamizwa esihlanganisiwe sinconywa ukuhlanganiswa ne-sulfonylurea, khona-ke umthamo wokugcina kufanele uncishiswe. Ngaphandle kwalokho, kukhona ubungozi be-hypoglycemia.
4. Ngokungabikho komphumela oyifunayo ngokuthatha i-metformin kanye ne-agonist ye-PPAR-y. Odokotela banquma amaphilisi weYanumet aqukethe umthamo wamanje we-metformin ne-100 mg ye-sitagliptin.
5. Faka esikhundleni senkambiso engasebenzi ye-metmorphine ne-insulin ngomthamo wansuku zonke wamacwecwe aqukethe i-100 mg ye-sitagliptin kanye nedosi ye-metformin. Umthamo we-insulin uzodinga ukwehliswa.

Ngoshukela

Izibhebhe zenzelwe ngqo iziguli ezinesifo sikashukela sohlobo 2. Abantu abanenkinga yesifo sikashukela sohlobo lokuqala bayaphulwa.

Imiphumela emibi yeYanumet 50

Le ejenti ye-hypoglycemic inemiphumela emibi eminingana. Udokotela kumele ajwayele isiguli nabo, ngoba uma kukhonjwa uphawu olulodwa noma ngaphezulu, kufanele wenqabe ukuthatha umuthi. Ngokushesha emva kwalokhu, kufanele ubonane nodokotela, lapho bezokuhlola khona ukubala kwegazi kanye ne-lactate.

Amapheshana wesisu

Ukusuka kwipheshana lesisu, ukunambitheka kwensimbi emlonyeni kuvame ukubonwa. Okuncane okuvamile isicanucanu nokuhlanza. Isikhuxungu kanye nokukhula kwezimpawu zesifo sohudo kungenzeka ekuqaleni kokwelashwa. Ezinye iziguli zibika ubuhlungu besisu.

Ukushiya phansi kungenye yemiphumela emibi yesidakamizwa.

Ngasohlangothini lwe-metabolism

Iziguli eziningi zinenkinga yokudla emzimbeni. Lokhu kuhambisana ne-hypoglycemia. Ezimweni ezingavamile, i-hypothermia, ukuthuthukiswa kwezifo zokuphefumula, ukubukeka kwesimba, ubuhlungu besisu, ne-hypotension kuyatholakala.

Engxenyeni yesikhumba

Ukushintshwa kwesikhumba kuvame ukukhombisa ukungabekezelelani ezintweni ezakha amaphilisi. Kulokhu, i-dermatitis, ukuqubuka kanye nokulunywa kungavela. Okuncane okuvame kakhulu yiStevens-Johnson syndrome kanye ne-vasculitis ye-cutaneous.

Kusuka ohlelweni lwezinhliziyo

Ezimweni ezingandile, i-megaloblastic anemia ingavela ngenxa ye-malabsorption yevithamini B12 ne-folic acid.

Allergies

Allergy ibonakaliswa ukulunywa kwesikhumba nokuqhuma.

Umthelela ekhonweni lokulawula izindlela

Umuthi awunamphumela oqondile ngejubane lokusabela kwe-psychomotor kanye nokuhlushwa. Okwamanje, ukuthatha i-sitagliptin kungadala ukozela nobuthakathaka. Ngalesi sizathu, ukushayela imoto nezinye izindlela eziyinkimbinkimbi kufanele kwenziwe ngokucophelela okukhulu.

Imiyalo ekhethekile

Inkambo ende yokuphuza amaphilisi idinga ukubhekwa njalo kwezinso.

Uma isiguli sinenqubo yokuxilonga noma yokwelapha sisebenzisa izidakamizwa eziqukethe iodine, uJanumet akufanele asetshenziswe amahora angama-48 ngaphambi nangemva kwalokho.

Ezigulini ezine-pancreatitis nesifo sezinso, amaphilisi angandisa izimpawu zesifo. Ukuvimbela lokhu, udokotela kufanele aguqule umthamo futhi aqaphe njalo isimo sesiguli.

Ezigulini ezine-pancreatitis, amaphilisi angandisa izimpawu zokugula.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Abesifazane ngesikhathi sokukhulelwa nokuqunjelwa akanconywa ukuthatha lo muthi we-hypoglycemic. Ezimweni ezinjalo, ukwelashwa kususelwa ekuphuzeni i-insulin.

Ukuqokwa kweYanumea ezinganeni ezingama-50

Ayikho imininingwane emtholampilo ngemiphumela yesidakamizwa esihlanganisiwe emzimbeni wezingane. Ngalesi sizathu, uJanumet akabekelwe iziguli ezingaphansi kweminyaka engu-18.

Sebenzisa ebudaleni

Abantu asebekhulile babekelwe lo muthi, kepha ngaphambi kwalokhu, ukuxilongwa kwesimo sezinso kuyadingeka.

Isicelo sokusebenza kokulimala kwezinso

Umuthi lo awunconywa kubantu abanezifo ezinzima zezinso (kufaka phakathi lezo ezinesifo sezinso esiphansi).

Sebenzisa umsebenzi wesibindi okhubazekile

Uma kwenzeka ukungasebenzi kahle kwesibindi, ukuthatha uJanumet akunconyiwe. Lokhu kungenxa yengozi ye-lactic acidosis.

I-overdose ye-Yanumet 50

Uma isiguli sidlula umthamo wokwelapha umuthi, lokhu kufaka ukuthuthukiswa kwe-lactic acidosis. Ukuze uzinzise lesi simo, kudalwa i-gastric lavage bese kubalwa i-hemodialysis.

Olunye uphawu lwe-overdose yi-hypoglycemia. Ngokubonakaliswa okumnene, isiguli sinconywa ukuba sidle ukudla okuphezulu kuma-carbohydrate. I-hypoglycemia elinganiselwe noma ebukhali kufanele ilandelwe ngomjovo weGlucagon noma isixazululo se-Dextrose. Ngemuva kokuthi isiguli siphinde siqaphele, sinikezwa ukudla okune-carbohydrate.

Ukuze uzinze isimo uma kwenzeka kuba ne-overdose, kunikezwa i-hemodialysis.

Ukuxhumana nezinye izidakamizwa

Ngokuphathwa okuyinkimbinkimbi kwesiguli, udokotela kufanele acabangele ukuhambisana kwamathebulethi nezinye izidakamizwa.

Isenzo seJanumet siba buthaka phambi kwale mithi elandelayo:

• I-Phenothiazine;
• I-Glucagon;
• i-thiazide diuretics;
• i-nicotinic acid;
• ama-corticosteroids;
• ama-hormone egilo;
• Isoniazid;
• ama-estrogens;
• i-sympathomimetics;
• abamelene ne-calcium;
• Phenytoin.

Umphumela we-hypoglycemic uyathuthukiswa uma usetshenziswa kanye nezidakamizwa ezilandelayo:

• izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala;
• Insulin
• ama-beta-blockers;
• izinto ezithathwe kuma-sulfonylurea;
• I-Oxetetracycline;
• I-Acarbose;
• ICyclophosphamide;
• I-ACE ne-mao inhibitors;
• okuphuma ku-clofibrate.

Nge-cimetidine, kukhona ubungozi be-acidosis.

Nge-sulfonylurea derivatives noma i-insulin. Imvamisa kuba ne-hypoglycemia lapho kungekho khona ukulungiswa kwamthamo.

Ukuhambisana notshwala

Ngokuhambisana notshwala, ubungozi bemiphumela emibi buyanda.

Ama-Analog

Phakathi kwama-analogues abizwa ngokuthi:

• I-Amaryl M;
• I-Yanumet Long;
• I-Douglimax;
• IVelmetia;
• Avandamet;
• Ama-Glucovans;
• I-Glibomet;
• UGalvus Met;
• I-Gluconorm;
• I-Tripride.

Imibandela yekhefu lekhemisi

Emakhemisi, kunikezwa umuthi ngokuqinile.

Ngingakwazi ukuthenga ngaphandle kadokotela?

Umuthi okuleli qembu awunakuthengwa ngaphandle kwemiyalelo kadokotela.

Intengo yeJanumet 50

Izindleko zomuthi e-Ukraine, eRussia nakwamanye amazwe zincike ekutheni imuphi umthamo onikezwa ezibhebheni nokuthi zingaki izingcezu ezinikezwe ephaketheni. Emakhemisi aseMoscow, izintengo zeYanumet zingokulandelayo:

• 500 mg + 50 mg (ama-56 ama-pcs.) - ama-ruble ayi-2780-2820;
• I-850 mg + 50 mg (ama-pcs angama-56.) - ama-ruble ayi-2780-2820;
• I-1000 mg + 50 mg (ama-28 ama-pcs.) - ama-ruble ayi-1750-1810;
• I-1000 mg + 50 mg (ama-56 ama-pcs.) - ama-ruble ayi-2780-2830.

Izimo zokugcina zomuthi

Umuthi kufanele ugcinwe endaweni evikelwe ukukhanya kwelanga kanye nomswakama. Ibanga lokushisa elidingekayo lifinyelela ku- + 25 ° C.

Isikhathi sokuphelelwa yisikhathi

Umuthi lo ungasetjenziswa iminyaka emi-2.

Umkhiqizi

Amacwecwe akhiqizwa yinkampani yezokwelapha iPatheon Puerto Rico Inc. ePuerto Rico. Ukupakishwa kwezidakamizwa kwenziwa yizinkampani ezahlukahlukene:

• Merck Sharp & Dohme B.V, etholakala eNetherlands;
• I-OJSC "Isitshalo samakhemikhali" i-AKRIKHIN "eRussia;
• UFrosst Iberica eSpain.

Umuthi uhanjiswa emakhemisi ngokuqinile ngokwemiyalelo kadokotela.

Ukubuyekezwa mayelana neYanumet 50

U-Alexandra, i-endocrinologist, unesipiliyoni kwezokwelapha iminyaka engu-9, uYaroslavl.

Umuthi ukwazile ukukhombisa ukusebenza kwawo ezivivinyweni zemitholampilo nasekusebenzeni. Ngivame ukunquma la maphilisi ezigulini zami ezincike kwe-insulin. Imiphumela emibi ayivelakancane. Isidingo esiyinhloko umthamo ofanele.

UValery, i-endocrinologist, unesipiliyoni kwezokwelapha iminyaka eyi-16, eMoscow.

I-Yanumet ikuvumela ukuthi uzuze umphumela oyifunayo ezimweni eziningi lapho amazinga kashukela engalawulwa nge-Metformin. Ezinye iziguli besaba ukushintshela kulolu hlobo lokwelashwa ngenxa yemiphumela emibi engaba khona kanye nengozi ye-hypoglycemia. Okwamanje, ekusebenzeni, amacala anjalo angabizwa ngokuthi i-rarity, ikakhulukazi uma kuthathwa isilinganiso esifanele kanye nezinye izincomo zikadokotela.