I-Yanumet iyisidakamizwa somlomo esidalwa yi-hypoglycemic esetshenziswa ekwelapheni i-mellitus yesifo sikashukela esingaxhamli. Ukuthatha umuthi kusiza ukugcina amazinga e-glucose ajwayelekile, kuvimbela ukuqhubeka kwesifo futhi kuthuthukise impilo yempilo yeziguli.
Igama Lezwe elingafanele
I-Metformin + Sitagliptin.
I-Yanumet iyisidakamizwa somlomo esidalwa yi-hypoglycemic esetshenziswa ekwelapheni i-mellitus yesifo sikashukela esingaxhamli.
I-ATX
A10BD07.
Khipha amafomu nokwakheka
Umuthi utholakala ngokuhweba ngendlela yamathebulethi we-oblong anendawo ye-biconvex, embozwe ifilimu i-enteric yombala okhanyayo opinki, opinki noma obomvu (kuya ngomthamo). Umuthi ufakwa emaphaketheni okulimaza izingcezu eziyi-14. Iphakethe lamaphepha aminyene liqukethe kusuka ku-1 kuya ku-7 amanxeba.
Izithako ezisebenzayo zeYanumet yi-sitagliptin ngesimo se-phosphate monohydrate ne-metformin hydrochloride. Okuqukethwe kwe-sitagliptin ekulungiseleleni kuyahlala kunjalo - 50 mg. Ingxenyana enkulu ye-metformin hydrochloride ingahluka futhi ingama-500, 850 noma i-1000 mg kwithebhulethi eyi-1.
Njengezinto ezisizayo, iYanumet iqukethe i-lauryl sulfate ne-sodium stearyl fumarate, i-povidone ne-MCC. Igobolondo lethebhulethi lenziwa nge-macrogol 3350, i-polyvinyl alcohol, i-titanium dioxide, i-oxide ebomvu nebomvu yensimbi.
Umuthi ufakwa emaphaketheni okulimaza izingcezu eziyi-14.
Isenzo se-Pharmacological
Umuthi ungumenzeli wokuhlanganisa onezakhi zawo ezisebenzayo ezinomphumela (we-supplementary) we-hypoglycemic, usiza iziguli ezinesifo sikashukela sohlobo II ukuthi zilondoloze amazinga evamile eglucose.
I-Sitagliptin, okuyingxenye yesidakamizwa, is inhibitor ekhetha kakhulu i-dipeptidyl peptidase-4. Lapho igxotshwa, inyuka ngezikhathi ezingama-2-3 okuqukethwe kwe-glucagon-peptide-1 ne-insulinotropic peptide - ama-hormone athuthukisa ukukhiqizwa kwe-insulin futhi andise ukuvikelwa kwawo kumaseli wamanyikwe. I-Sitagliptin ikuvumela ukuba ulondoloze amazinga evamile kashukela we-plasma usuku lonke futhi uvikele ukuthuthukiswa kwe-glycemia ngaphambi kokudla kwasekuseni nangemva kokudla.
Isenzo se-sitagliptin sithuthukiswa yi-metformin - into ye-hypoglycemic ehlobene ne-Biguanides, enciphisa ukugcwala koshukela egazini ngokucindezela ngu-1/3 inqubo yokukhiqizwa kwe-glucose esibindini. Ngaphezu kwalokho, lapho uthatha i-metformin ezigulini ezinesifo sikashukela sohlobo 2, kukhona ukwehla kokufakwa kweglue kusuka emgodini wokugaya ukudla, ukwanda kokuzwela kwezicubu ukungena kwe-insulin nokwenyuka kwenqubo yamafutha oxidation.
I-Pharmacokinetics
Ukuhlaziywa kwe-plasma okuphezulu kwe-sitagliptin kugcinwa ngemuva kwamahora we-1-4 ngemuva kokuphathwa komlomo komthamo owodwa, i-metformin - ngemuva kwamahora we-2,5. I-bioavailability yezithako ezisebenzayo lapho kusetshenziswa iJanumet esiswini esingenalutho ingama-87% no-50-60%, ngokulandelana.
Ukusetshenziswa kwe-sitagliptin ngemuva kokudla akukuthinti ukuphuma kwayo emgodini wokugaya ukudla. Ukusetshenziswa kanyekanye kwe-metformin ngokudla kunciphisa isilinganiso sayo sokumuncisa futhi kunciphisa ukugcwala ku-plasma ngo-40%.
Ukwembiwa kwe-sitagliptin kwenzeka ikakhulu ngomchamo. Ingxenye encane yayo (cishe i-13%) ishiya umzimba kanye nokuqukethwe yisisu. IMetformin isuswe ngokuphelele yizinso.
IMetformin isuswe ngokuphelele yizinso.
Izinkomba zokusetshenziswa
Umuthi unikezwa isifo sikashukela sohlobo 2. Kuboniswa njengesengezo sokudla nokuzivocavoca ezigulini ezi:
- ukungakwazi ukulawula amazinga eglucose ngemithamo ephezulu ye-metformin;
- Kakade bekufanele athathe izidakamizwa ezihlanganisiwe ngokususelwa kwizithako ezisebenzayo ezakha uYanumet, futhi ukwelashwa kwaletha umphumela omuhle;
- Ukwelashwa kuyadingeka ngokuhambisana nokususelwa ku-sulfonylurea, ama-agonists e-PPARĪ³, noma i-insulin, ngoba ukuthatha i-metformin ngokuhlangana nezidakamizwa ezisohlwini akuvumeli ukufeza ukulawulwa okufanele kwe-glycemia.
Contraindication
Umuthi awusetshenziswa ekwelapheni iziguli ezinezifo noma izimo ezilandelayo:
- Uhlobo I isifo sikashukela mellitus;
- i-ketoacidosis, ephelezelwa yi-coma yesifo sikashukela noma ngaphandle kwayo;
- i-lactic acidosis;
- ukungasebenzi kahle kwesibindi;
- ukwehluleka kwezinso, lapho imvume ye-creatinine ingaphansi kwama-60 ml ngomzuzu;
- ukomisa komzimba;
- inkambo enzima ye-pathologies yemvelaphi yokutheleleka;
- isimo sokushaqeka;
- ukwelashwa ngama-ejenti aqukethe iodine aqukethe iodine;
- ama-pathologies aholela kokuqukethwe komoya-mpilo ophansi emzimbeni (ukuhluleka kwenhliziyo, ukufakwa kwe-myocardial, ukwehluleka ukuphefumula, njll.);
- ukunciphisa isisindo ngokudla okuphansi kwekhalori (kuze kufike ku-1 000 kcal ngosuku);
- utshwala;
- ubuthi botshwala;
- ukucaphuka
- ukukhulelwa
- iminyaka emincane;
- ukungabekezelelani ngakunye kwezakhi ezikhona ekwakhiweni kwamathebhulethi.
Ngokunakekela
Lapho usebenzisa iYanumet, kufanele kuqashelwe abantu asebekhulile nalabo abahlushwa i-aimpical renalhluleka.
Ungayithatha kanjani iJanumet
Umuthi udliwa kabili ngosuku ngokudla, ugezwe phansi ngamasiphu amaningana amanzi. Ukwehlisa amathuba okuvela okubi okuvela emgudwini wokugaya ukudla, ukwelashwa kuqala ngethamo elincane, kancane kancane kulikhulise kuze kutholakale umphumela wokwelapha othandekayo.
Ukuthatha umuthi wesifo sikashukela
Umthamo weYanumet ukhethiwe esigulini ngasinye ngamunye, kucatshangelwa ukusebenza kahle kwezindlela zokwelapha nokubekezelela umuthi. Umthamo omkhulu wansuku zonke akufanele udlule ku-100 mg.
Imiphumela emibi yeYanumet
Ngesikhathi sokuthatha umuthi, isiguli singathola imiphumela engathandeki ecasulwa yi-sitagliptin ne-metformin. Uma zenzeka, kuyadingeka ukwenqaba ukwelashwa okuthe xaxa futhi uvakashele udokotela ngokushesha okukhulu.
Uma kwenzeka imiphumela emibi, kubalulekile ukwenqaba ukwelashwa okuqhubekayo futhi uvakashele udokotela ngokushesha okusemandleni.
Amapheshana wesisu
Imiphumela emibi evela ohlelweni lokugaya imvamisa ibonwa esigabeni sokuqala sokwelashwa. Lokhu kufaka phakathi izinhlungu emgodini ongaphezulu wesisu, isicanucanu, ukugabha, ukwanda kwerhasi emathunjini, isifo sohudo, ukuqunjelwa. Ukuthatha amaphilisi ngokudla kunganciphisa imiphumela yawo emibi ohlelweni lokugaya ukudla.
Ezigulini ezithola ukwelashwa ngeYanumet, ukuthuthukiswa kwe-pancreatitis (hemorrhagic noma necrotizing), okungaholela ekufeni, akubekelwe eceleni.
Ngasohlangothini lwe-metabolism
Uma umthamo ukhethwe ngokungalungile, isiguli singathola i-hypoglycemia, equkethe ukwehla kakhulu ushukela wegazi. Ngesinye isikhathi, ukuphuza umuthi kungaholela ekutheni ube ne-lactic acidosis, ebonakala ngendlela yokuncipha kwengcindezi kanye nokushisa komzimba, izinhlungu esiswini nemisipha, ukushayeka kokulimala, ubuthakathaka kanye nokuqina.
Engxenyeni yesikhumba
Ezimweni ezingazodwa, ezigulini ezithatha umuthi we-hypoglycemic, ochwepheshe bahlonza i-vasculitis yesikhumba, i-bullous pemphigoid, i-necyololysis enobuthi.
Kusuka ohlelweni lwezinhliziyo
Umuthi ubekezelelwa kahle ngabantu abahlushwa yizifo zenhliziyo nemithambo yegazi. Ngesinye isikhathi, bangathola ukwehla kwesilinganiso senhliziyo, esenzeka ngenxa ye-lactic acidosis.
Umuthi ubekezelelwa kahle ngabantu abahlushwa yizifo zenhliziyo nemithambo yegazi.
Allergies
Ngokungabekezeleleki ngakunye kwezakhi ezakha umuthi, umuntu angaba nokuvela kokungahambi kahle ngendlela ye-urticaria, ukulunywa nokuqunjaza esikhunjeni. Lapho welapha ngeYanumet, amathuba okuvela kwe-edema yesikhumba, ulwelwesi lwama-mucous nezicubu ezi-subcutaneous, ezisongela impilo, azikhawulwanga.
Umthelela ekhonweni lokulawula izindlela
Umuthi ungadala ukozela, ngakho-ke ngesikhathi sokuphatha kwawo kunconyelwa ukwenqaba ukushayela imoto nokusebenza nezinye izindlela eziyingozi.
Imiyalo ekhethekile
Ngesikhathi sokulashwa ngeYanumet, iziguli zidinga ukulandela indlela yokudla ngokuhambisa umfaniswano wama-carbohydrate usuku lonke futhi ziqaphe ngokweqile i-carbohydrate metabolism emzimbeni.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi akufanele udakwe ngenkathi uthwele ingane, ngoba idatha ngokuphepha kwayo ngalesi sikhathi ayitholakali. Uma owesifazane owathola ukwelashwa ngeYanumet ekhulelwa noma ehlela ukwenza lokhu, kufanele ayeke ukuyithatha bese eqala ukwelashwa nge-insulin.
Ukusetshenziswa kwesidakamizwa akuhambelani ukuncelisa ibele.
Ukusetshenziswa kwesidakamizwa akuhambelani ukuncelisa ibele.
Ukuqokwa kweYanumet ezinganeni
Ucwaningo oluqinisekisa ukuphepha kwalo muthi ezinganeni nasebusheni alwenziwanga, ngakho-ke, akufanele lubekelwe iziguli ezingaphansi kweminyaka engu-18.
Sebenzisa ebudaleni
Njengoba izingxenye ezisebenzayo zeYanumet zivezwa emchameni, futhi lapho umuntu esemdala, umsebenzi wezinso uyancipha, umuthi kufanele unikezwe abantu abaneminyaka engaphezu kwama-60 ubudala.
Isicelo sokusebenza kokulimala kwezinso
Umuthi uphambaniswe neziguli ezihlushwa uhlobo olubi noma olulinganiselayo lokwehluleka kwezinso. Kubantu abanekulimazeka okulinganiselayo kokusebenza kwezinso, umuthi kufanele uphathwe ngaphansi kokuqashwa kukachwepheshe.
Sebenzisa umsebenzi wesibindi okhubazekile
Kuyenqatshelwa ukuqoka.
Iziguli ezinenkinga yokusebenza kwesibindi akufanele zinikezwe umuthi.
I-Overdose yeYanumet
Uma umthamo udluliwe, isiguli singakha i-lactic acidosis. Ukuqinisa isimo, uthola ukwelashwa okuhambisana nezimpawu okuhloswe ngazo ukuhlanza igazi.
Ukuxhumana nezinye izidakamizwa
Ukuhlanganiswa kwesidakamizwa nama-diuretics, i-glucagon, izindlela zokuvimbela inzalo ngomlomo, i-phenothiazines, i-corticosteroids, isoniazid, i-calcium antagonists, i-nicotinic acid kanye nama-hormone e-thyroid kuholela ekwenzeni buthaka isenzo sawo.
Umphumela we-hypoglycemic wesidakamizwa uyathuthukiswa lapho usetshenziswa ndawonye nezidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala, i-MAO ne-ACE inhibitors, i-insulin, i-sulfonylurea, i-oxytetracycline, i-clofibrate, i-acarbose, i-beta-blockers ne-cyclophosphamide.
Ukuhambisana notshwala
Kwenqatshelwe ukuphuza utshwala ngesikhathi sokwelashwa ngeYanumet.
Ama-Analog
I-analogue yesakhiwo somuthi i-Valmetia. Lesi sidakamizwa sikhiqizwa ngesimo sethebhulethi futhi sinokuqanjwa kanye nomthamo ofana neYanumet. Futhi, umuthi unokhetho olunamandla - iYanumet Long, equkethe u-100 mg we-sitagliptin.
Uma ungekho umphumela wokwelapha ovela kuYanumet, udokotela angabeka ama-hypoglycemic agents esigulini, lapho i-metformin ihlanganiswa nezinye izinto ze-hypoglycemic. Le mithi ifaka phakathi:
- Avandamet;
- I-Amaryl M;
- I-Douglimax;
- Galvus;
- IVokanamet;
- Ama-Glucovans, njll.
Imibandela yekhefu lekhemisi
Lapho kukhona umuthi.
Ngingakwazi ukuthenga ngaphandle kadokotela
Ungawuthenga lo muthi ngaphandle kwefomu lokuyalela kuphela kumakhemikhali akwele-inthanethi.
Intengo yeYanumet
Izindleko zomuthi zincike kumthamo wazo kanye nenani lamaphilisi akuleli. E-Russia, ingathengwa ngama-ruble angama-300-4250.
Izimo zokugcina zomuthi
Umuthi unconywa ukuthi ugcinwe endaweni evikelwe ukukhanya kwelanga futhi ungatholakali ezinganeni ezincane. Izinga lokushisa lamathebhulethi akufanele lidlule + 25 ° C.
Kumakhemisi, umuthi ungathengwa kuphela ngokubhaliwe.
Isikhathi sokuphelelwa yisikhathi
Izinyanga ezingama-24 kusukela ngosuku lokukhiqizwa.
Umkhiqizi
Inkampani yezemithi iMerck Sharp neDohme B.V. (Netherlands).
Ukubuyekezwa kodokotela ngeYanumet
USergey, oneminyaka engama-47 ubudala, i-endocrinologist, iVologda
Ezigulini ezinesifo sikashukela esingancikileli i-insulin, ngivame ukusinikeza lesi sidakamizwa, ngoba ukusebenza kwawo namuhla kufakazelwe ngokuphelele. Ilawula kahle ushukela futhi empeleni ayibangeli imiphumela emibi, ngisho nangokwelashwa okuhlala isikhathi eside.
U-Ana Anatolyevna, oneminyaka engama-53 ubudala, udokotela wobuchopho, eMoscow
Ngincoma ukwelashwa ngeJanumet ezigulini ezingakwazi ukuguqula ushukela wegazi lazo ngeMetformin kuphela. Ukwakheka okuyinkimbinkimbi kwalo muthi kusiza ukulawula kangcono izinkomba ze-glucose. Ezinye iziguli zesaba ukuthatha lo muthi ngenxa yobungozi be-hypoglycemia, kepha ucwaningo lwakamuva luveze ukuthi amathuba okuvela kwayo kuyafana kubantu abathola amaphilisi kanye ne-placebo. Futhi lokhu kusho ukuthi umuthi awunawo umthelela obalulekile ekwakhiweni kwe-hypoglycemic syndrome. Into esemqoka ukukhetha umthamo ofanele.
Umuthi kufanele unikezwe abantu abaneminyaka engaphezu kwengu-60 ubudala.
Ukubuyekezwa kweziguli
ULyudmila, oneminyaka engama-37, uKemerovo
Sekuphele unyaka ngiphatha noJanomat. Ngithatha umthamo omncane ka-50/500 mg ekuseni nakusihlwa. Ezinyangeni zokuqala ezintathu zokwelashwa, bekungenzeka ukuthi ungathathi nje kuphela isifo sikashukela, kepha futhi wehlise ama-12 kg wesisindo ngokweqile. Ngihlanganisa umuthi nokudla kanye nokuvivinya umzimba okulinganiselayo Manje ngizizwa ngingcono kakhulu kunangaphambili.
UNikolay, oneminyaka engama-61, uPenza
Wayejwayele ukuphuza iMetformin yesifo sikashukela, kodwa kancane kancane wayeka ukusiza. Udokotela we-endocrinologist unqume ukwelashwa ngeYanumet futhi wathi lesi sidakamizwa siyi-analogue enamandla yalokho engangikusebenzisa ngaphambili. Sekuyizinyanga ezimbili ngiyithatha, kepha ushukela usakhiqizwa. Angiboni imiphumela emihle evela ekwelashweni.
