I-Glucophage Long - imiyalo yokusebenzisa, izinkomba, izindleko

I-Metformin isetshenziswe emisebenzini yomtholampilo isikhathi esingaphezu kwengxenye yekhulu. Futhi namhlanje, zonke izincomo eziphathelene nokuphathwa kwesifo sikashukela sohlobo 2 ziphakamisa ukusisebenzisa kuzo zonke izigaba zokukhula kwalesi sifo, ngoba kusiza kakhulu ukunciphisa izinkinga ezi-micro- and macrovascular.

Ngeshwa, ukusetshenziswa kabanzi kwe-Glucofage kanye nokufana kwayo eqenjini le-Biguanide kukhawulelwe ngenxa yemiphumela engathandeki yipheshana lesisu, elikhula ngama-25% kwabanesifo sikashukela. Ngokusho kwedatha engekho emthethweni, kufinyelela ku-10% weziguli eziyekile ukuthatha i-Glucofage kanye nama-generics wayo ngenxa yokuphazamiseka kwengqondo okuyi-dyspeptic, indlela yokuthuthukisa engafundwanga ngokugcwele.

Izimiso ze-Glucophage Long

I-bioavailability ephelele ye-os metformin ngayinye isebangeni lama-50-60%. Ukusuka egazini, iningi lakhona liyangenwa endaweni, engxenyeni engenhla yesistimu yokugaya ukudla. Futhi inani elincane nje kuphela lezinto likule ndawo eyi-distal ethe xaxa yethumbu lesisu. Isikhathi Suction asidluli amahora angama-2.

Ukwenza i-metformin enamakhono okuhlala isikhathi eside akuwona umsebenzi olula:

• Ukufakwa kwesidakamizwa kwenziwa endaweni enomkhawulo wepheshana lesisu elingaphezulu;
• Ngokweqile kwe-metformin ngenhla komkhawulo othile, "i-satellite ye-ukumuncwa" iyaphawulwa;
• Uma ukukhishwa kwesithako esisebenzayo kwehlisa ijubane, kufakwa kulo lonke ubude besibeletho.

Ukufakwa kwe- “Saturdayated” kusho ukuthi ngokweqile kwe-Biguanide, iningi layo alingene “efokisini lokufaka” futhi alisebenzi nhlobo. Izinga lokufakwa kwalo muthi emathunjini lihlobene nezinga lokuphuma kwalo esiswini. Lawa ma-nuances achaza ubunzima bokwenza i-Glucophage ibe nomphumela wesikhathi eside ongathathwa kanye ngosuku.

Izidakamizwa zendabuko zimane zinciphise ukukhishwa kwesithako esisebenzayo kwithebhulethi nokumuncwa komfaniswano wento esebenzayo kanye nalo lonke ubude besibeletho. Kodwa leyo mishanguzo inesikhathi sokufaka ngokushesha okufakwayo kwengxenye esebenzayo egazini ngokushesha ngemuva kokuthatha iphilisi. Izimiso ezifanayo zeGlucophage Long azamukeleki, ngoba ukufakwa kwe-metformin kuvinjelwe ngemuva kokudlula kwewindows yokungenisa. Yebo, futhi ukukhishwa kokuqala kwento esebenzayo kungakugculisa futhi ingxenye yomuthi izohlala ingafuneki.

Ngemuva kokudla i-Glucofage ejwayelekile, inani eliphakeme lokuhlushwa kwalo alidluli amahora angama-3.

Ukuqhathanisa ukubekezelela kokugaya kwe-metformin elula nenguqulo ende ye-XR ezikhungweni ezine zezokwelapha e-United States, amakhadi wesifo sikashukela onesifo sohlobo 2, athatha izinhlobo ezahlukene zeGlucophage, afundelwa. Imvamisa yemiphumela engathandeki yelena yesifo soshukela kwabanesifo sikashukela abathatha i-metformin ende yabe iphansi kakhulu kunalabo abasebenzisa umuthi ojwayelekile.

Imvamisa yemiphumela emibi ekwelashweni kwezinhlobo ezihlukile ze-Glucophage, kanye nangesikhathi soguquko kusuka kolunye uhlobo kuya kolunye, iboniswa kahle.

Ukusebenza kokulawulwa kwe-hemoglobin ye-glycated kwahlolwa esifundweni esiyimpumputhe. Amaqembu ababambiqhaza akhombise imiphumela efanayo yokusebenza kwezinhlobo ezimbili zeGlucophage.

I-Innovative Technologies ne-Glucophage Long

Umphumela wokukhishwa kancane kancane kwe-metformin XR unikezwa ukwakheka kwethebhulethi, okudala uhlelo lokumelana ngenxa yomgoqo wejeli. Ingxenye esebenzayo iku-matrix ephindwe kabili ye-hydrophilic, enikeza ukukhishwa kwe-metformin XR ngokwe-infusion. I-matrix ye-polymer yangaphandle ihlanganisa isigaba sangaphakathi, esiqukethe i-500-750 mg yomuthi. Uma ingena esiswini, ithebhulethi iyagobhoza isuka kumswakama, imbozwe ungqimba lwejeli kusuka ngaphandle, futhi idala izimo zokukhishwa kwe-batch umuthi. Umehluko obalulekile phakathi kwalamathebhulethi ukuthi izinga lokuchithwa komuthi alihlobene nezici ze-intestinal motility ne-pH. Lokhu kusivumela ukuthi singafaki ukwahluka kokudla izidakamizwa ohlelweni lokugaya kweziguli ezahlukahlukene.

I-Glucofage Pharmacokinetics Isikhathi Eside

Ukufakwa kwesithako esisebenzayo kwithebhulethi kuhamba kancane futhi isikhathi eside kuqhathaniswa ne-analogue elula. Kwizivivinyo, i-analog ende yaqhathaniswa nomthamo wama-200 mg / ngosuku. kanye ne-glucophage elula ngethamo lika-2 r. I-1000 mg / usuku. ekufinyeleleni ekuhlolweni kokulingana. Izinga eliphakeme legazi i-Tmax ngemuva kokudla i-metformin XR laliphezulu kakhulu kunele-metformin elula (amahora angu-7 esikhundleni samahora angama-3-4). I-Cmax, okuhlushwa okulinganiselwe, esimweni sokuqala yayingaphansi kwekota. Umphumela jikelele ushukela wegazi kulezi zinhlobo ezimbili zomuthi wawunjalo. Uma sihlaziya indawo engaphansi kwekhola ebonakalisa ukuncika kwezinga lokuhlushwa ngesikhathi, khona-ke singaphetha ngokuhlangana kwe-biioequivalence yalezi zinhlobo ezimbili ze-Glucofage.

Ngokusobala, iphrofayili ye-pharmacokinetic yesidakamizwa esinamakhono ahlala isikhathi eside yenza ukuthi kungabandakanywa ukugxuma okusheshayo ezingeni le-metformin XR ku-plasma, okuyinto ejwayelekile nge-metformin elula.

Ukudla okulinganayo kwengxenye esebenzayo kusiza ukugwema imiphumela emibi yendlela yesisu nokuthuthukisa ukubekezelela izidakamizwa kakhulu.

Izinkomba, ama-contraindication, imikhawulo

IGlucophage Long imiselwe abanesifo sikashukela ngohlobo lwesibili lwesifo uma ukuguqulwa kwendlela yokuphila kunganikeli ngokuphelele ukulawulwa kwe-glycemic. Umuthi ukhonjiswa ikakhulukazi kwiziguli ezinokweqile. I-Metformin isetshenziswa njengomuthi womugqa wokuqala we-monotherapy noma ukwelashwa okuyinkimbinkimbi nezinye izidakamizwa ze-antidiabetic, kufaka phakathi i-insulin.

IGlucophage isidakamizwa esinokwethenjelwa esinobufakazi obunamandla besisekelo sokusebenza, kepha ukusetshenziswa kwalo okungafanele kungaba nemiphumela emibi. Umuthi uphuliwe:

• Nge-hypersensitivity kwizithako zefomula;
• Esimweni se-ketoacidosis yesifo sikashukela, ukoma kanye ne-thoroma;
• Iziguli ezinama-pathologies wezinso (imvume ye-creatinine - ifinyelela ku-60 ml / min.);
• Ezimweni ezimbi kakhulu (i-hypoxia, ukomisa), ukungasebenzi kahle komzimba;
• Ngesikhathi sokusebenza nokwelashwa kokulimala kanzima (isiguli sidluliselwa ku-insulin);
• Kwezifo ezikhuthaza ukulamba kwe-oksijini kwezicubu (ukushaya kwenhliziyo, ezinye izindlela zentliziyo, ukuphazamiseka kokuphefumula);
• Isifo sikashukela esinezinkinga zesibindi;
• Ngokusebenzisa kabi utshwala, ukuluthwa utshwala ngokweqile;
• Omama abakhulelwe futhi abancelile;
• Esimweni se-lactic acidosis, kufaka phakathi umlando;
• Abantu ku-hypocaloric (kufika ku-1000 kcal / ngosuku) yokudla.

Ngesikhathi sokuhlolwa kwe-radioisotope noma i-X-ray kusetshenziswa okokumaka okusekwe kwi-iodine, amahora angama-48 ngaphambi kokuqala kwenqubo kanye namahora angama-48 ngemuva kokudluliselwa kwi-insulin.

Ukugxila ikakhulu ekuqeshweni kwe-Glucophage Long kufanele kunikezwe isigaba sabanesifo sikashukela sobudala obuvuthiwe, ukungondleki, kanye nalabo abasebenza kanzima ngokomzimba, njengoba lezi zinto zivusa ukuthuthukiswa kwe-lactic acidosis.

I-Glucophage ende nokukhulelwa

Ngisho nasezingeni lokuhlela kwengane, owesifazane onesifo sikashukela udluliselwa kwi-insulin. Kunengqondo ukulonda le ndlela yokwelashwa yesikhathi sokuncelisa, njengoba i-metformin ifakwa ekukhulelweni nasekukhashweni komzimba. Uma impilo kamama idinga ukushintshela ku-Glucofage Long, ingane idluliselwa kokuphakelayo okungelona iqiniso.

Imithamo nokuphatha

Ekutadisheni umthamo ophelele we-glucophage isikhathi eside, ukusebenza kahle komthamo kuncike ekusebenziseni okukodwa komuthi. Umphumela omkhulu wavezwa ngokusetshenziswa kwe-1500-2000 mg / ngosuku. Ukuhlolwa kuqhathanise nokuthi kungenzeka i-glucophage ende ne-regimen yokwelashwa ye-2 p / Usuku. I-1000 mg ne-1 r. / Usuku. 2000 mg ngamunye. Esimweni sokuqala, i-glycated hemoglobin indices eqenjini lamavolontiya yehle ngo-1,2%, kwesesibili - nge-1%.

Umuthi uhloselwe ukusetshenziswa kwangaphakathi. Ithebhulethi lidliwa ngamanzi ngaphandle kokuchotshozwa. I-endocrinologist ibala isheduli nemithamo icabanga ngemiphumela yokuhlolwa, isigaba sesifo, i-pathologies eyingqayizivele, iminyaka yesifo sikashukela kanye nokuphendula komzimba kulo muthi.

I-Glucophage Long - 500 mg

Ngomthamo we-500 mg / ngosuku. ukuthatha amaphilisi ahlanganiswe nesidlo sakusihlwa. Uma isicelo siphindwe kabili, khona-ke ngesidlo sasekuseni nesidlo sakusihlwa, kodwa njalo ngokudla.

Uma isiguli sidluliswa sisuka eGlucophage ejwayelekile siye enguqulweni ende, isilinganiso sokuqala sikhethwa ngokuhambisana nomthamo ophelele wansuku zonke womuthi owedlule.

Ngemuva kwamaviki amabili, ungahlola ukusebenza, uma umphumela ungagculisi, umthamo unyuswa ngo-500 mg, kepha ungabi ngaphezu kuka-2000 mg / ngosuku. (4 ama-pcs.), Okuhambelana nesilinganiso esiphezulu. Amathebulethi amane nawo athathwa kanye, ngesidlo sakusihlwa. Uma le ndlela yokwelashwa ibingasebenzi ngokwanele, ungasabalalisa amaphilisi emithanjeni emi-2: ingxenye eyodwa ekuseni, eyesibili kusihlwa.

I-Glucophage Long 500 yokunciphisa umzimba inengqondo kuphela kubantu abanesifo sikashukela kanye nabantu abanokuphazamiseka kwe-metabolic. Kunezimbangela eziningi zokukhuluphala, ukuzilawula okungalawulwa ngomuthi onzima futhi ukuzihlonza kungakunikeza imiphumela engalindeleki.

Kubalulekile ukuthatha umuthi ngasikhathi sinye. Isidlo sasekuseni noma isidlo sakusihlwa kufanele sigcwele. Nganoma yiluphi uhlobo lokwelashwa, umuntu onesifo sikashukela uyanconywa ukuthi adle ukudla okunempilo - izikhathi ezingama-5-6 ngosuku, ukudla okulula okulula phakathi kwezidlo eziphambili. Uma ngesizathu esithile uphuthelwe isikhathi sokuphuza umuthi, awukwazi ukuphinda okujwayelekile, ngoba umzimba udinga isikhathi sokuwusebenzisa ngokugcwele umthamo. Ungaphuza iphilisi ngesikhathi sokuqala. Umuthi awuthathwa ezifundweni, kepha njalo. Uma isiguli simise ukwelashwa nge-metformin, udokotela ohambelayo kufanele akwazi lokhu.

Uma i-Glucofage Long isetshenziswa kwirejimeni eyinkimbinkimbi nge-insulin, umthamo wokuqala wemiyalo esetshenziswayo utusa ukukhetha kungabi ngaphezu kwethebhulethi eli-1 (500 mg / ngosuku). Umthamo we-insulin ye-hormone ubalwa unaka ukudla kanye nokufundwa kwe-glucometer.

I-Glucophage Long - 750 mg

I-capsule eyi-750 mg nayo ithathwa kanye, ngesidlo sakusihlwa noma ngokushesha nje ngemuva kwayo. Umthamo wokuqalisa awudluli ithebhulethi eyodwa, ukunikwa kwemithamo kungenzeka ngemuva kwengxenye yenyanga. Ukwanda kancane kancane kwesilinganiso kusiza ukuvumelana nomzimba futhi kunciphise amathuba emiphumela emapheshana emathunjini.

Izinga elinconywayo le-glucophage isikhathi eside ngamathebhulethi ama-2 / ngosuku. (1500 mg), uma imiphumela oyifunayo ingekho, okujwayelekile kuguqulwa kube ama-3 pcs./day. (2250 mg - ubukhulu). Lapho amandla omuthi okhipha kancane kancane awanele, bashintshela ku-Glucophage ejwayelekile, enomkhawulo we-3000 mg / ngosuku.

Uma isiguli sidluliselwa kwi-glucophage ende ene-analogues esekelwe ku-metformin, lapho ukhetha umthamo wokuqala uqala ukuqondiswa yisimo esiphelele somuthi owedlule. Uma umuthi futhi unomphumela wesikhathi eside, kungadingeka ikhefu lapho ususa lo muthi, kucatshangelwa isikhathi esusiwe ngalo emzimbeni. Abantu abanesifo sikashukela abathatha i-Glucophage ejwayelekile ngo-2000 mg noma ngaphezulu, bayifaka esikhundleni se-Glucophage Long akuyona into engenamsebenzi.

I-Glucofage® Long Ukwakheka neFomu Lokukhishwa

I-MERCK SANTE, inkampani ekhiqiza imishini yaseFrance, ikhipha i-Glucophage ® uma nje kungamaphilisi okukhulula aqhubekayo.

Ngokuya kumthamo, aqukethe ama-500 noma ama-750 mg we-metformin hydrochloride esebenzayo. Ama-capsule afakwe ama-filler: sodium carmellose, hypromellose, cellulose, magnesium stearate.

Amathebulethi ama-white convex angahlukaniswa ngokuqoshwa komthamo kanye ne-logo yenkampani ohlangothini ngalunye. Ezibhebheni ze-aluminium blister zifakwe izingcezu eziyi-15. Ebhokisini elilodwa kungaba nezingadi ezimbili noma ezine.

Bayawukhipha umuthi ngokuya ngomuthi obekiwe; awudingi izimo ezikhethekile zokuwugcina. E-Glyukofazh Long, intengo ishibhile impela: kumakhemikhali aku-inthanethi anikezwa ama-ruble angama-204. (umthamo we-500 mg). Impilo yeshalofu yesidakamizwa yiminyaka emi-3.

Imiphumela emibi

Ngokwenqubo ye-WHO, imvamisa yemiphumela engathandeki ihlaziywa kulesilinganiso esilandelayo:

• Imvamisa kakhulu - ≥ 0.1;
• Imvamisa - kusuka ku-0,01 kuye ku-0.1;
• I-infrequent - ukusuka ku-0.001 kuya ku-0,01;
• Rare - kusuka ku-0.0001 kuya ku-0.001;
• Akuvamile kakhulu - ukusuka ku-0.00001 kuya ku-0, 0001.

Uma izibalo ezitholakalayo zezimpawu zingangeni ohlelweni olucacisiwe, kuqoshwa amacala angashadile.

Imiphumela eminingi engathandeki ihamba yodwa ngemuva kokujwayela, uma ukungaphatheki kahle kungahambi, udinga ukwazisa udokotela wobugxila ngalokhu. Anganciphisa umthamo noma anikeze i-analog. Kwesinye isikhathi imvamisa yokuphazamiseka kwe-dyspeptic incishiswa ngokunamathela ngokuqinile ezimisweni zokudla okuphansi kwe-carb nokusatshalaliswa komthamo wansuku zonke kumithamo emi-2.

Ukunikezwa okwesikhashana kancane kwesilinganiso (ikakhulukazi kuya phezulu) ezimweni ezinjalo kuyphoqelelwa.

Ezikhungweni zikashukela ezithatha izidakamizwa ezakhiwe nge-metformin njalo, uvithamini B12 umunca kancane. Uma kutholakala ukuthi une-megaloblastic anemia, lokhu kufanele kucatshangwe.

Ukungasebenzi kwesibindi kwenzeka ngokuzenzakalela ngokuqedwa kwe-Glucofage Long.

Ngenxa yokuntuleka kwengozi ye-hypoglycemia, ukuthatha lesi sidakamizwa njenge-monotherapy akuyona ingozi kubashayeli nakwisifo sikashukela, omsebenzi waso uhlotshaniswa nokunakwa okubhekelwa kakhulu kanye nezinga lokuphendula okukhulu. Ngokulashwa okuyinkimbinkimbi, amathuba amanye ama-hypoglycemic agents kufanele abhekwe.

Siza ngezimpawu ze-overdose

Ubuthi be-metformin buhlolwe ngokuvivinya: amavolontiya athola umthamo ophindwe izikhathi ezingama-42,5 kunowombala ojwayelekile ongaphezulu (85 g). I-Hypoglycemia kwabahlanganyeli ayizange ikhule, izimpawu ze-lactic acidosis zikhombisile.

Uma izimpawu ezinjalo zingatholakali esikhungweni sezokwelapha, ukwamukelwa kweGlucophage Long kuyamiswa bese kubizwa i-ambulensi.

Ngemuva kokucacisa izinga le-lactate emzimbeni, isiguli sinqunywe i-hemodialysis. Ukwelashwa okubonisa izimpawu nakho kunqunyiwe.

Imiphumela Yokusebenzelana Kwezidakamizwa

Inhlanganisela ehlanganisiwe

Amamaki e-iodine-based radiopaque angadala i-lactic acidosis, ikakhulukazi kwabanesifo sikashukela abane-renal pathologies. Isikhathi sesifundo se-radiological, i-Glucophage Long iyakhanselwa. Uma isimo sezinso singadali ukukhathazeka, ngemuva kwezinsuku ezimbili isiguli singabuya kunhlobo ejwayelekile yokwelashwa.

Izinketho ezinganconyiwe

I-Glucophage ende notshwala abuhambelani nhlobo, ngoba i-ethyl alcohol ingadala i-lactic acidosis, ikakhulukazi ngezinkinga zesibindi nokungondleki okungajwayelekile kanye nekhwalithi engeyinhle. Izidakamizwa ezenziwa nge-Ethanol nazo zandisa amathuba okuba nenkinga enjalo.

Izinkimbinkimbi ezidinga ukunakwa okukhethekile

Ngokuhambisana ne-metformin, eminye imithi idinga ukuqapha nokuqapha ushukela wegazi njalo.

1. UDanazole - kuthuthukisa umphumela we-hyperglycemic, kudinga ukunikezwa kwemithamo ye-metformin;
2. I-Chlorpromazine - icasulula izimo ze-glycemic, ivimbela ukukhiqizwa kwe-insulin, idinga ukulungiswa kwamthamo we-Glucofage Long;
3. I-Glucocorticosteroids - iyingozi ngokuncipha kokubekezelelana kwe-glucose, ukwanda koshukela, ubunzima ngezindlela ze-ketosis;
4. I-Diuretics (i-loopback) - ifaka isandla ekwakhiweni kwe-lactic acidosis kanye nokwehluleka kwezinso;
5. I-β-sympathomimetics - ngenxa yokukhuthaza kwama-β-receptors akhuphula izinga le-glycemia, ukuguquka kwe-insulin kungenzeka;
6. Izidakamizwa ze-antihypertensive, i-insulin, ama-salicylates, ama-acarbose, izidakamizwa zeqembu le-sulfonylurea - zithuthukisa amandla okwehlisa ushukela we-glucofage Long, zidinga umthamo we-titration;
7. I-Nifedipine - ikhulisa ukumuncwa kwe-metformin ne-Cmax.

Iqembu le-cationic lezidakamizwa ezifana ne-morphine, i-amiloride, i-digoxin, i-procainamide, i-quinidine, i-quinine, i-ranitidine, i-triamteren, i-trimethoprim, i-vancomycin ifihlwe ku-renal tubules, ngakho-ke, incintisana neGlucophage emzabalazweni wezinhlelo zokuhamba.

I-Glucophage Long Test yabathengi

Ukuhlolwa kwabanesifo sikashukela abathatha i-Glucofage Long, izibuyekezo ziveze ixubekile.

1. Ukusebenza kahle kakhulu. Ukwehla kwesisindo esisheshayo lapho ingekho indlala yokudla futhi ngokujwayelekile noma yiluphi ushintsho kwindlela yokuphila lwangiphoqa ukuthi ngibone udokotela. Kuhlonzwa ukumelana ne-insulin kanye ne-hypothyroidism, okwandisa inkinga ngesisindo. IGlucophage yanqunywa, ekuqaleni ejwayelekile - ama-ruble ama-3 ngosuku. 850 mg lilinye. Ngokubambisana, waphatha i-gland yegilo. Ezinyangeni ezintathu, konke kubuyela kokujwayelekile: Isisindo nokukhiqizwa kwe-insulin kutholakele. Manje ngadluliselwa kuGlyukofazh Long (manje wokuphila).
2. Umphumela ophakathi nendawo. Sithatha iGlucophage Long nonkosikazi wethu. Zithi ziqinisa imithambo yegazi, yandisa impilo, nami ngibe noshukela. Lapho nje izinto sezingcono kancane, ngaqala ukweqa ukuphuza amaphilisi, kepha isisu ngaso sonke isikhathi sangiphindisela ngokungiphazamisa. Kwakufanele nginciphise umthamo futhi ngiqinise ekudleni. Ngabona ukuthi imiphumela emibi iyanda ngokusetshenziswa kabi komuthi.
3. Umphumela ophansi. Isifo sikashukela sohlobo 2 satholwa kimi ngenyanga edlule, ngabizwa uGlucophage Long, ngoba ukusebenza kungangivumeli ukuthi ngicabange ngamaphilisi usuku lonke. Wawuthatha lo muthi amasonto amathathu kanti okunye kwavela imiphumela emibi ethe xaxa. Ngakhuthazela ngaze ngafika esibhedlela. Umuthi ukhanseliwe, walulama kancane.

Ukungezelela ukwethembeka kwabanesifo sikashukela ekwelashweni, ukunciphisa izehlakalo ezingalindelekanga zephephabhuku emathunjini kuyizinzuzo ezibalulekile ze-Glucofage Long, kepha ukugxila okuyinhloko kwekhwalithi yomuthi olwa nesifo sikadokotela kuseyizinkomba ze-glycemia kwizifo sikashukela ezinesifo sohlobo 2.