I-Trazhenta isidakamizwa se-hypoglycemic sinconyelwe ukusetshenziswa kwangaphakathi. Umkhiqizo wenziwa ngendlela eyindilinga, amaphilisi abomvu akhanyayo anezinhlangothi ze-convex kanye nemiphetho ye-beveled. Ngakolunye uhlangothi lwethebhulethi kukhona i-logo yenkampani, ngakolunye uhlangothi, uphawu lwe-D5.
Isithako esisebenzayo somuthi yi-5 mg ye-linagliptin, izingxenye eziwusizo zomuthi yizitashi zommbila, i-mannitol, i-magnesium stearate, i-Copovidone, isitashi se-pregelatinized. Ungawuthenga umuthi ngo-aluminium malengela wezibhebhe ezi-7 lilinye.
Isidakamizwa sinconywa ukuthi sisetshenziswe ngohlobo lwe-2 yesifo sikashukela, leli thuluzi lizoba omunye wemithi ephumelela kakhulu uma, ngokumelene nesizinda sokuzivocavoca umzimba nokudla okulinganiselayo, kungenzeka ukugcina ushukela wegazi ngezinga elijwayelekile.
Umuthi kufanele unqunywe uma onesifo sikashukela enomlando wokwehluleka kwezinso, iMetformin iphuliwe noma umuntu engasibekezeleli lesi sidakamizwa. I-Trazent ingasetjenziswa ndawonye ne:
- izinto ezithathwe kuma-sulfonylurea;
- I-Thiazolidine;
- I-Metformin.
Futhi, umuthi uyadingeka uma ukwelashwa ngalezi zidakamizwa kungayithuthukisi inhlalakahle yesiguli.
I-Trazenta, intengo yamathebulethi angama-30 we-5 mg izoba ngama-ruble ayi-1,500, ungayithenga emakhemisi ezimile nase-inthanethi. Umuthi ufakwa kwi-radar (irejista yemithi). I-analogue yesidakamizwa: INesina, Onglisa, Yanuviya, Galvus, Komboglisa, analogue ashibhile okwamanje.
Imiyalo yokusebenzisa umuthi
Imiyalo ikhombisa ukuthi umuthi akufanele uphathwe lapho ukhulelwe, thayipha isifo sikashukela esingu-1, ngesikhathi uncelisa ibele, izingane ezingaphansi kweminyaka engu-18, ngokuphendula okuthe xaxa kwezinye izingxenye zomuthi, i-ketoacidosis ebangelwa isifo sikashukela mellitus.
Imithamo ejwayelekile yesiguli esikhulile yi-5 mg, udinga ukuthatha ukwelashwa kathathu ngosuku. Lapho umuthi uthathwa neMetformin, umthamo wawo ushiywe ungashintshiwe. Umuthi weziguli onenkinga yezinso ukusebenza awudingi ukulungiswa.
Ngesikhathi sokufunda kwe-pharmacokinetics, kwatholakala ukuthi ngezinkinga zesibindi kungenzeka ukuthi kushintshe inani lemithi yezidakamizwa, noma kunjalo, okwamanje, akukho okuhlangenwe nakho okuphelele ngokusetshenziswa komuthi onjalo kwabashukela.
Asikho isidingo sokushintsha umthamo weziguli esezikhulile, kepha:
- noma kunjalo, akunconyelwe ukuthi iziguli ezingaphezulu kweminyaka engama-80 zisebenzise lo muthi, ngoba akukho okuhlangenwe nakho komtholampilo;
- ngakho-ke akusizikuli ngokwayo ukuthi iphephe kangakanani iphephe ezinganeni nakwintsha
Lapho umuntu onesifo sikashukela ethatha ikhambi likaTrazent njalo futhi ephuthelwa yiphutha ngephutha, kuyadingeka ukuthi athathe ipilisi elilandelayo ngokushesha, kepha umthamo wawo awunakuphindwe kabili. Umuthi uthathwa nganoma yisiphi isikhathi, noma ngabe kukudla.
Ukwelashwa kungenzeka ngezinhlelo ezahlukahlukene. Amacwecwe asetshenziswa njenge-monotherapy yabanesifo sikashukela esinokulawulwa okunganele kwe-glycemic ngokumelene nesizinda sokudla okunempilo kokudla okuneshukela, ukusebenza ngokomzimba okulinganiselayo, uma umuntu engabekezeleli iMetformin, imithi efanayo.
Umuthi uzoba yingxenye yokwelashwa okwenziwa izingxenye ezimbili ngeMetformin, i-thiazolidinediones, nokutholakala kwe-sulfonylurea lapho ungekho umphumela we-monotherapy obizwa ngemithi, ukungasebenzi kahle komzimba nokudla.
Umuthi usetshenziselwa ukwelashwa okuhlanganisa izingxenye ezintathu nezinto eziphuma ku-Metformin. Udokotela ubuye achaze nomuthi kanye:
- imijovo ye-insulin;
- I-pioglitazone;
- derivatives sulfonylurea.
Ngemuva kokufaka umuthi ongu-5 mg ngaphakathi kwezidakamizwa ngaphakathi, izinto ezisebenzayo ziqala ukumunca, zifinyelela ekugxileni kwethamba ngemuva kwamahora ayi-1.5. Ukuhlushwa kuzoncipha ngokuya ngohlelo lwesigaba ezintathu, ukuphela kwesigamu sempilo kungamahora angaphezu kwe-100, okubangelwa ukuzibopha okuqinile kwe-linagliptin.
Ukuphila okuphathelene nengxenye okusebenzayo emzimbeni emva kokuphathwa okuphindaphindiwe komuthi kuzoba amahora ayi-12.
Ngemuva kokusebenzisa umuthi owodwa, ukugxila okuzinzile kwento kubhekwa ngemuva komthamo wesithathu.
Amacala okweqa ngokweqile, ukusabela okuhle komzimba
Imininingwane yocwaningo lwezokwelapha ikhombisa ukuthi ukusetshenziswa okukodwa kwe-600 mg yesidakamizwa akubanga zimpawu zokusebenzisa ngokweqile futhi akulimazi impilo yesifo sikashukela. Akunalo ulwazi ngamacala okweqa ngokweqile. Kodwa-ke, ukuphepha, lapho usebenzisa umuthi okweqile wesidakamizwa, kubalulekile ukusula isisu ngokuhlanza noma ngokuhlanza.
Qiniseka ukuthi uthintana nodokotela noma uthinte iqembu le-ambulensi. Mhlawumbe kuzoba khona noma yikuphi ukwephulwa kwezempilo, kuzodingeka ukuthi unikeze ukwelashwa okufanele.
Enye into ukusabela okubi komzimba, inani lokushintshwa okunjalo lilingana nenani lemiphumela emibi njengokuthathwa kwe-placebo. Ngakho-ke, isiguli singase siqale: inqubo yokuvuvukala kumanyikwe, ukuhlaselwa kokukhwehlela, i-nasopharyngitis, ukuzwela okwengeziwe kwezinto ezithile, i-hypertriglyceridemia.
Udinga ukwazi ukuthi into esebenzayo yesidakamizwa ingadala isiyezi, ngakho-ke:
- kungcono ukwenqaba ukushayela kanye nezinye izindlela eziyinkimbinkimbi;
- Gwema ukusebenza ngokweqile komzimba.
Ukuphikisana okuqanjwe igama okuvame ukwenzeka ngesikhathi sokwelashwa nge-Trazent kanye nokutholakala kwe-sulfonylurea neMetformin.
Lapho ukwelashwa okuhlangene nezinto ze-linagliptin noma i-pioglitazone kuvame ukwenziwa, i-diabetesic yandisa isisindo, i-pancreatitis, i-hypersensitivity ye-immune system ingaqala.
Imiyalo ekhethekile
Umuthi awubekelwe abesifazane abakhulelwe, umphumela wawo emzimbeni wesifazane ngesikhathi sokuzala ungakafundwa kuze kube manje. Kodwa-ke, izivivinyo zemitholampilo ezilwaneni azikhombisanga imiphumela emibi ekusebenzeni kokuzala. Ukuhlolwa kwekhono lowesifazane lokukhulelwa akwenziwanga, izivivinyo ezilwaneni azikhombisanga umphumela omubi.
Imininingwane eyatholakala ngenkathi kwenziwa izifundo ze-pharmacodynamic ezilwaneni zibonisa ukungena kwezidakamizwa ubisi lwebele. Ngalesi sizathu, umphumela wezidakamizwa ezinganeni awukhishwa. Kwezinye izimo, odokotela bagcizelela ukunqanyulwa kokuqunjelwa kowesifazane, uma kunesidingo esiphuthumayo sokumqoka ngokunembile uTrazhenta.
Imiyalo yeTrazenta yokusebenzisa ibonisa ukuthi kuyadingeka ukugcina umuthi endaweni yokushisa engekho ngaphezu kwama-25 degrees endaweni emnyama, kude nezingane. Impilo yeshelf iyiminyaka engama-2,5.
I-Endocrinologists ayinikezi izidakamizwa ezinjalo ezigulini:
- ngesifo sikashukela sohlobo 1;
- ngesifo sikashukela sikashukela.
Abantu abanesifo sikashukela bangakhula nge-hypoglycemia, isizathu singase sihambisane nokwelashwa okuhlangene ne-sulfonylureas.
Akukho datha ekuxhumaneni kwesidakamizwa ne-insulin; iziguli ezihluleka kakhulu ukubekelwa izinso zinqunyelwe ukwelashwa kanye neminye imithi ukwenza izinga le-glycemia lifane. Ukubuyekezwa kwe-Trazenta kuhlale kukuhle kuphela.
Uma isetshenziswa ngokubambisana nomuthi, i-Ritonavir izonyusa i-linagliptin cishe izikhathi ezi-2 kuya kwezi-2, ukugxilwa okungaguquki (imvamisa i-1% yomthamo wokwelapha), futhi kuzokhuphuka amahlandla ama-5 ngemuva kwale nhlanganisela yemithi. Ushintsho olunjalo kuma-pharmacokinetics aluthathwa njengolubalulekile emtholampilo, ngenxa yalesi sizathu-ke akukho ukusebenzisana okubalulekile namanye ama-inhibitors okulindelekile, imithamo ingahlolwa.
Lapho welapha neRifampicin, kukhona ukwehla kwezithako zemithi kuzo zombili lezi zidakamizwa ukusuka kuma-39 kuye kwangama-43%, ukwehla komsebenzi we-basal ovimbele ngo-30%. Ukusebenza kokwelashwa kugcinwa, kepha lokhu akwenzeki ngokugcwele.
Ngesikhathi sokusetshenziswa kweTrazhenty nge-Digoxin, ukuvezwa okuvelanayo akwenzeki, noma kusetshenziswe inhlanganisela enjalo:
- kaninginingi;
- kwimithamo ehlukahlukene.
Ukusetshenziswa okuphindaphindiwe kwesidakamizwa umthamo we-5 mg / ngosuku awukwazi ukushintsha ama-pharmacokinetics eWarfarin. Uma i-Simvastatin kanye nethamo elinyukayo le-linagliptin lisetshenziswa kaningi, umphumela kuma-pharmacokinetics womuthi wokuqala kwenzeka. Le nto yinto ejwayelekile; ukulungiswa kwemithamo enconyiwe akudingekile. Ngemuva kokuthola ukwelashwa njalo ngeTrazenta ngesamba esinyukayo kanye ne-Simvastatin 40 mg, umsebenzi wokugcina wakhuphuka ngo-34%, egazini ngo-10%.
Lapho umuntu onesifo sikashukela sohlobo lwesibili ethatha izidakamizwa zokuvimbela inzalo ngomlomo ngenkathi elashwa neTrazenta, akukho ushintsho oluqinile futhi olubalulekile kuma-pharmacokinetics alezi zidakamizwa.
Ukubuyekezwa okubukwayo
Ama-inhibitors e-DPP-4 (umuthi ungowaleli qembu) ahlukaniswa hhayi kuphela ngokunciphisa ushukela okukhanyayo, kodwa futhi nangezinga elandayo lezokuphepha, ngoba azinakubangela ukwanda kwesisindo somzimba sesifo sikashukela kanye nesimo se-hypoglycemic. Izidakamizwa zaleli qembu zithathwa njengezisebenza kakhulu nezethembisayo ekwelashweni kwesifo sikashukela sohlobo 2 ezinganeni nakubantu abadala.
Ukusebenza kwezokwelapha kuqinisekiswa izifundo eziningi zesayensi, kuyadingeka ukuqala inkambo yokwelashwa ihlanganiswe neminye imithi. Lapho kukhona isisusa sokungafani kokuxakaniseka kwe-glucose kanye nokwehla kwaso okubukhali, izikhala ze-sulfonylureas ziyakhonjiswa.
Kwesinye isikhathi kufanelekile ukusebenzisa umuthi njengendlela yokwenza i-monotherapy ngokumelana nomzimba kwi-insulin ye-hormone kanye nokukhuluphala. Kakade ngemuva kwezinyanga ezintathu zokwelashwa, ukwehla okukhulu kwezinkomba zesisindo kuyaphawulwa.
Inani eliphambili lokubuyekezwa litholwe kulabo abanesifo sikashukela abasebenzisa i-5 mg yesidakamizwa njengengxenye yokwelapha okuyinkimbinkimbi. Ngenxa yalokhu, kunzima ukwedlula ukumhlola ngokwanele uTrazhent ngaye:
- ukusebenza kahle;
- ukuphepha.
Kodwa-ke, cishe zonke iziguli ziyaqiniseka ukuthi wumuthi lona owasiza ukuthi wehlise isisindo.
Yize kunemikhawulo ethile ekusetshenzisweni kweTrazent, kubekelwa abanesifo sikashukela sohlobo lwesibili lwanoma yimuphi ubudala, kufaka phakathi asebekhulile, abahlushwa izifo zezinso, isibindi, inhliziyo. Umphumela ojwayelekile kakhulu walokhu kwelashwa yi-nasopharyngitis.
Imininingwane ngesenzo se-DPP-4 inhibitors inikezwe kuvidiyo ekulesi sihloko.
