IComboglize umuthi omuhle osetshenziswa ekwelapheni okunesifo sikashukela sohlobo 2. Isiza ukuguqula ushukela wegazi ngokujwayelekile. Ukuqanjwa kufaka izingxenye ezi-2 ezisebenzayo, ezikuvumela ukuthi usebenzise kabanzi ithuluzi.
Igama Lezwe elingafanele
INN: Metformin noSaxagliptin
IComboglize umuthi omuhle osetshenziswa ekwelapheni okunesifo sikashukela sohlobo 2.
I-ATX
Ikhodi ye-ATX: A10BD07
Khipha amafomu nokwakheka
Umuthi utholakala ngefomu lethebhulethi kuphela. Amathebulethi angaba nombala ohlukile. Kuya ngesilinganiso sokuxutshwa kwekhompiyutha esebenzayo kanye nodayi kubo. Zimbozwe ngegobolondo elikhethekile.
Ithebhulethi eyi-1 iqukethe i-2.5 mg ye-saxagliptin ne-500 noma i-1000 mg ye-metformin hydrochloride. Izibhebhe zinobume be-convex oblong. Ngokuya nge-metformin, bangaba nombala onsundu, opinki noma ophuzi. Kuzo zombili izinhlangothi kukhona izinkomba zomthamo ezenziwe ngoyinki oluhlaza okwesibhakabhaka. Izici ezisizayo yilezi: carmellose sodium, magnesium stearate ne cellulose.
Umuthi utholakala ngefomu lethebhulethi kuphela.
Amacwecwe asezingeni elikhethekile lokuvikela ama-7 ama-pcs. lilinye. Iphakethe lekhadibhodi liphethe amanxeba ama-4 nemiyalo ephelele yokusetshenziswa.
Isenzo se-Pharmacological
Umuthi uhlanganisa ukwakheka kwezakhi ezi-2 ezisebenzayo. Lokhu kuyenza ithuluzi jikelele ekwelapheni isifo sikashukela sohlobo 2. ISaxagliptin isebenza njenge-inhibitor, inikela ngenkuthalo ekwenziweni kwezakhiwo ze-peptide, futhi iMetformin ingeqembu le-Biguanides. Ama-metabolites asebenzayo akhishwa ngokuguqulwa okuhlukahlukene.
I-Metformin inamandla okunciphisa ijubane i-gluconeogeneis. Amafutha oxidation ayayeka, futhi ukutholakala kwe-insulin kukhuphuka kakhulu. Ukusetshenziswa kweglue glucose kushesha. Ngaphansi kwethonya leMetformin, ukuhlanganiswa kwe-glycogen kuyathuthukiswa. Ushukela uqala ukudonswa kancane ezithweni zomgudu we-gastrointestinal, onomthelela ekwehliseni isisindo ngokushesha.
ISaxagliptin ikhuthaza ukukhishwa kwe-insulin ngokushesha kumaseli we-beta pancreas. Le ndlela incike kokuqukethwe kwe-glucose ku-plasma yegazi. I-Glucagon secretion iyancipha, evimbela ukukhiqizwa okukhuphukile kwe-glucose kwezinye izinto zesakhiwo zesibindi. I-Saxagliptin isiza ukunciphisa ukungasebenzi kwama-hormone athile, ama-incretin. Ngesikhathi esifanayo, izinga labo legazi liyakhuphuka, futhi inani le-glucose yokuzila liyancipha ngemuva kokudla okuyinhloko.
I-Pharmacokinetics
ISaxagliptin ihlala iguqulwa ibe yi-metabolite. I-Metformin, ngisho nangemva kokuhlunga okuhle kwizimbumbulu ze-renal, ikhishwa emzimbeni ngesimo esingaguquki ngokuphelele. Ukuqoqwa okukhulu kwezinto ezisebenzayo kuqashelwa amahora angama-6 ngemuva kokuthatha iphilisi.
I-Metformin, ngisho nangemva kokuhlunga okuhle kwizimbumbulu ze-renal, ikhishwa emzimbeni ngesimo esingaguquki ngokuphelele.
Izinkomba zokusetshenziswa
Isibonakaliso esiyinhloko sokusetshenziswa ukwelashwa okuyinkimbinkimbi kwesifo sikashukela sohlobo 2. Kusetshenziswa njengesengezo somsebenzi owafunwayo nokudla. Umuthi unqunyelwe kuphela uma ukwelashwa nge-Metformin ne-Saxagliptin kufanelekile ezigulini.
Contraindication
Ayisetshenziswa ekwelapheni isifo sikashukela sohlobo 1, kanye nasendabeni yokuthuthukiswa kwesifo sikashukela sikashukela, ngoba ngaphansi kwalezo zimo umuthi ngeke ube nomphumela ofunekayo wezokwelapha.
Ngaphezu kwalokho, kukhona ukungqubuzana okuningana okuqinile kokuphuza umuthi:
- ukungasebenzi kahle kwezinso okujwayelekile;
- i-lactic acidosis;
- ukungabekezelelani kwe-lactose nokusetshenziswa ekwelapheni imithamo emikhulu ye-insulin;
- izinkinga zenhliziyo;
- ukushaqeka kwenhliziyo, i-septicemia;
- i-infarction ye-myocardial eyingozi kakhulu;
- hypersensitivity ezingxenyeni ezisebenzayo zomuthi;
- i-acidosis ye-acute futhi engamahlalakhona;
- iminyaka efinyelela eminyakeni eyi-18;
- ukudla okuphansi kwekhalori;
- ukukhulelwa nokuqunjelwa;
- sebenzisa ekwelapheni ama-iodine aqukethe i-iodine agents angaqhathani, okungaholela ekwakhiweni kokwehluleka kwezinso okubucayi.
Konke lokhu kuphambana kuphelele. Ngokuvamile, ngama-pathologies anjalo, i-insulin isetshenziselwa ukwelapha isifo sikashukela.
Ngokunakekela
Ngokuqapha, udinga ukuthatha umuthi wabantu asebekhulile, iziguli ezinesibindi esingapheli kanye nokwehluleka kwezinso. Lapho kuvela izimpawu zokuqala ezingezinhle, ukulungiswa kwephilisi ebekiwe ekuqaleni kungadingeka.
Ungayithatha kanjani i-combogliz?
Endabeni yokusebenzisa ukwelashwa kwe-antiglycemic, umthamo we-Combogliz kufanele unqunywe ngokuhlukile kwisiguli ngasinye, ngokuya ngesimo sempilo esijwayelekile. Umuthi unconywa ukuthi uphuzwe kusihlwa, ungcono ngokudla. Ubungako bomuthi owodwa we-Saxagliptin akufanele wedlule i-2,5 mg noma ezimweni ezinzima i-5 mg ngosuku.
Kuyelulekwa ukugwinya amaphilisi wonke ngaphandle kokuhlafuna. Kufanele igezwe ngamanzi amaningi abilisiwe.
Lapho kuhlanganiswa nokusetshenziswa okuphindaphindiwe nge-cytochrome isoenzymes, umthamo onconyiwe yi-1 ithebhulethi ye-2,5 mg ngosuku.
Kuyelulekwa ukugwinya amaphilisi wonke ngaphandle kokuhlafuna.
Ukwelashwa kwesifo sikashukela
Ikhambi elisezingeni eliphezulu lokwelashwa kwesifo sikashukela sohlobo 2. Uhlobo lokuqala lomuthi onjalo akunakwenzeka ukuba ululaphe. Ngaphambi kokuqala ukwelashwa ngezidakamizwa, kufanele uthintane nodokotela we-endocrinologist. Kulokhu, zonke izifo ezihlangene zezitho zangaphakathi kufanele zibhekwe.
Imiphumela emibi yeComboglize
Iziguli zivame ukuqaphela ukuvela kokubi okungathandeki okungafuneki:
- ikhanda, kuze kube ukubonakala kwe-migraines ejwayelekile;
- Izimpawu zokudakwa, kubonakaliswa isicanucanu, ukuhlanza kanye nohudo olunzima;
- ubuhlungu besisu besimo sokudonsa;
- izinkinga ezithathelwanayo zohlelo lokuchama;
- ukuvuvukala kobuso nemilenze;
- ukwehla kwamathambo kukhuphuka, ngokulandelana, lokhu futhi kukhulisa ubungozi bokuqhekeka lapho uthatha uSaksagliptin (ukuhlaziya kweqembu imithamo ukusuka ku-2,5 kuye ku-10 mg) kanye ne-placebo;
- i-hypoglycemia;
- ukubonakaliswa komzimba ngendlela yokuqhuma kwesikhumba ne-urticaria;
- ukuthopha;
- ukwephula umbono wokunambitheka kweminye imikhiqizo kungenzeka.
Izimpawu ezinjalo kufanele zinyamalale ngokuphelele ngemuva kokulungiswa komthamo noma ukuhoxiswa ngokuphelele komuthi. Uma izimpawu zokudakwa zihlala, ukwelashwa okungaqondile kungadingeka.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti ngqo uhlelo lwezinzwa. Kepha kungaba ngcono ukuyeka ukushayela, ngoba eminye imiphumela emibi eyenzeka ngokuzuma ingathinta ukugxila.
Imiyalo ekhethekile
Lapho uthatha umuthi, kubalulekile ukuthatha izivivinyo ukuqapha izinguquko ezinso. Kukhona ingozi enkulu ye-lactic acidosis. Lokhu kuyiqiniso ikakhulukazi asebekhulile.
Uma usebenzisa uSaksagliptin, ukwehla okuhambisana nomthamo enanini elijwayelekile lama-lymphocyte kungenzeka. Lo mphumela ubonwa lapho uthatha umthamo we-5 mg kwirejimeni yokuqala ene-Metformin ngokuqhathaniswa ne-monotherapy ene-Metformin kuphela.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Akunconywa ukuthatha ngesikhathi sokuzala ingane. Namuhla, kunokucwaninga okunganele kokuthi amaphilisi anemiphumela emincane ye-teratogenic noma ye-embyogenic kwi-fetus. Umuthi ungaba nesandla ekubukekeni kwezinkinga ekukhuleni kwesibeletho futhi ukubambezele ukukhula kwalo. Uma kunesidingo, bonke abesifazane abakhulelwe badluliselwa ekwelashweni kwe-Insulin ngenani eliphansi.
Akunconywa ukuthatha umuthi ngesikhathi sokukhulelwa.
Akukho datha ethembekile yokuthi umuthi ungadlula ubisi lwebele. Ngakho-ke, ochwepheshe bayeluleka ukuthi bayeke ukukhipha izibilini.
Ukuqokwa Comboglize kwezingane
Izingane akufanele zithathe. Akukaze kusetshenziswe ukwelapha izingane kanye neziguli ezingaphansi kweminyaka engu-18.
Sebenzisa ebudaleni
Ngokunakekelwa okukhethekile, umuthi ubekelwe abantu asebekhulile. Banengozi eyandayo yokuqhamuka nezinkinga ezahlukahlukene, ngakho-ke, ukuqapha isimo sezempilo ngudokotela wezokwelapha nodokotela we-endocrinologist kuyadingeka. Uma kunesidingo esinjalo, khona-ke umthamo uyancishiswa uye ophansi, lapho umphumela wezokwelapha othandekayo utholakala khona. Ukwakha isenzo se-placebo, kunikezwa ezinye izithasiselo zama-vitamin complex kwezinye iziguli esezikhulile, ikakhulukazi lezo ezinokuphazamiseka kwengqondo.
Isicelo sokusebenza kokulimala kwezinso
Kunobungozi obandayo be-metabolic acidosis ngokusetshenziswa isikhathi eside. Kungcono ezigulini ezinokwehluleka okungapheli kwe-renal ukwehlisa umthamo kube okungenani noma zenqabe ngokuphelele ukuwuthatha.
Kuyenqatshelwe ngokuphelele ukuthatha iziguli nge-concomitantibindi pathologies.
Sebenzisa umsebenzi wesibindi okhubazekile
Kuyenqatshelwe ngokuphelele ukuthatha iziguli nge-concomitantibindi pathologies.
Ukweqisa kweComboglize
Umuthi ubekezelelwa kahle yiziguli. Kunezimo ezimbalwa zokweqisa. Ngokuphathwa ngengozi komthamo omkhulu kuphela kungavela ezinye zezimpawu eziphakamisa ukuthuthukiswa kwe-lactic acidosis. Okuvame kakhulu phakathi kwabo:
- izinkinga ngohlelo lokuphefumula;
- ukukhathala kanye nokuxineka okukhulu;
- izicubu zomsipha;
- Ubuhlungu obukhulu besisu;
- ukubukeka kwephunga le-acetone ephuma emlonyeni.
Kulokhu, i-gastric lavage noma i-hemodialysis ingasiza. Ngezinga eliphansi le-hypoglycemia, kunconywa ukuthi udle itiye noma uphuze itiye elimnandi.
Ukuxhumana nezinye izidakamizwa
Ukusetshenziswa okuhlanganisiwe kweComboglize nezinye izidakamizwa kungakhulisa ukugcwala kwe-plasma ye-lactate. Le mithi ifaka phakathi:
- amalungiselelo e-magnesium;
- I-Nicotinic acid;
- I-Rifampicin;
- okokugcobisa;
- Isoniazid;
- ama-hormone egilo;
- calcium tubule blockers;
- ama-estrogens.
Inhlanganisela nePioglitazone ayithinti ama-pharmacokinetics weSaxagliptin. Ngaphezu kwalokho, inhlanganisela ukusetshenziswa okukodwa kweSaksagliptin, khona-ke ngemuva kwamahora amathathu ama-40 mg we-Famotidine, izici zezemithi nazo azishintshi.
Lapho uthatha i-Combogliz, ukusebenza kwalezi zimali kungancipha:
- I-Fluconazole;
- I-Erythromycin;
- I-Ketoconazole;
- Furosemide;
- UVerapamil;
- ethanol.
Uma isiguli sithatha enye yezinto ezibaliwe, khona-ke kufanele nakanjani umazise udokotela wakho.
Ukuhambisana notshwala
Utshwala bunqatshelwe ezigulini ezinesifo sikashukela. Kungathinta umphumela wemithi.
Ama-Analog
Kusho izindlela ezihlukile kokwakheka, kepha zifana ngokuphelele ngokwelashwa:
- Ukwanda Kwe-Combogliz;
- I-Bagomet;
- UJanumet;
- UGalvus Met;
- I-Glibomet.
Ngaphambi kokuqala ukwelashwa okubuyiselwe esikhundleni, udinga ukufunda ngokucophelela imiyalo yomuthi okhethiwe, ngoba ngamunye wawo angaba nezimpikiswano ezinzima nokuphendula okuhlukile. Ngaphezu kwalokho, umthamo womuthi uhlukile.
Imibandela yekhefu lekhemisi
Imithi ingathengwa ekhemisi ngencazelo kadokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Ikhishwa kuphela ngemuva kokwethulwa komyalelo kadokotela ohambela.
Intengo ye-combogliz
Izindleko zomuthi ziphakeme impela. Ingathengwa kusukela kuma-ruble angama-2400. Intengo yokugcina incike kwimarget ezoshelwa usokhemisi nokuthi zingaki izibhebhe ezizoba khona ephaketheni.
Izimo zokugcina zomuthi
Gcina endaweni lapho ukukhanya kwelanga kungangeni khona. Ukushisa kwesitoreji - igumbi. Umuthi kufanele ugcinwe endaweni eyomile futhi uvikeleke ezinganeni ezincane ngangokunokwenzeka.
Imithi ingathengwa ekhemisi ngencazelo kadokotela.
Isikhathi sokuphelelwa yisikhathi
Ngokulondolozwa okufanele, impilo yeshalofu iyiminyaka emi-3 ukusuka ngosuku lokukhiqizwa oluboniswe kuphakheji yangempela.
Umkhiqizi
IBristol Myers squibb, e-USA.
Ukubuyekezwa mayelana ne-Comboglize
Odokotela
UStanislav, oneminyaka engama-44 ubudala, udokotela wesifo sikashukela, eSt. Petersburg: "Sekuyisikhathi eside ngisebenzisa lo muthi lapho ngiphatha khona. Umphumela muhle. Izinga likashukela wegazi ezigulini ezinhlobo lwesibili sikashukela liyancipha ngemuva kwenkambo yokwelashwa. Lihlala lisesimweni esejwayelekile isikhathi eside, okwenza umuthi ubekhona yonke indawo "Kubiza okungaphansi kokuthatha isikhathi eside, kepha umphumela wawo uyefana, ngisho nokwakheka kuyafana. Ezinye iziguli zinemiphumela engejwayelekile nge-urticaria. Kodwa konke kuhamba ngokushesha. Ngakho-ke ngincomela lesi sidakamizwa kuzo zonke iziguli zami."
UVarvara, oneminyaka engama-46, odokotela abasebenza nge-endocrinologist, uPenza: "Bengijwayele ukunquma umuthi ukuze ngijwayele amazinga kashukela wegazi. Kepha bekukhona ukubukeza okuningi okungekuhle ezigulini. Lokhu kungenxa yokuthi kuvame ukuvela lapho iziguli zimbi. Iziguli zize zigcine esibhedlela zinezimpawu ezinzima zokuphuza. Ezimweni ezinje, udinga ukukhansela ukwelashwa futhi ucabange ukufaka esikhundleni. Ngakho-ke ngincomela ukuthi iziguli ziqale ngomuthi ophansi kakhulu ongabheka ukuthi umzimba uphendula kanjani. Uma konke kuvamile, inkambo yokwelashwa ingaqhubeka futhi umthamo unyuke kancane kancane. "
Ukugula
UValery, oneminyaka engama-38, eMoscow: "Ubeke amaphilisi ngudokotela wesifo sokuphamba (i-endocrinologist). Nginesifo sikashukela sohlobo lwesibili. Amazinga kashukela abuyele esimweni esisheshayo. Lezi zinombolo zaqhubeka isikhashana ngemuva kokuqedwa kwezifundo zokwelapha. Ezinsukwini zokuqala, ngazizwa ngigcwele ukushayelwa umoya futhi ngaba nekhanda. Konke kuhambile, imiphumela yomuthi isiqalile ukwanda. Umuthi ubiza kancane. "
U-Andrei, oneminyaka engama-47, uRostov-on-Don: "Umuthi awuzange ulunge. Ngemuva kokuzwa iphilisi lokuqala ngiphatheke kabi. Ngiqale ukuhlanza, ikhanda alizange lime isikhathi eside. Kwakufanele ngibonane nodokotela. Wayeka ababeka phansi. Abanye abantu bakhuluma ngomphumela ofanayo omubi. Ngemuva kokuba yonke into ibuyele esimeni esejwayelekile, i-analogue yalo muthi yabekwa, kodwa nangemva kwalokho kwaba nokuvela okuhlukile ngendlela yokuphuza kakhulu. Ngaphezu kwalokho, kwavela ukuqubuka komzimba esikhumbeni. Ngakho-ke kwafakwa i-Insulin. "
UJulia, oneminyaka engama-43, uSaratov: "Ngigculisekile ngomphumela womuthi. Izinga likashukela libuyele esimweni esijwayelekile. Ngaphelelwa yisisindo ngaphandle kokudla. Inhliziyo yami yayeka kubuhlungu. Impilo yami ejwayelekile yathuthuka. Ezinsukwini zokuqala ikhanda lami lalimala kancane, kodwa-ke konke kwaqina."
