Kufakazelwe I-Forsig Inhibitor Esebenzayo

I-Forsiga ingukuphela kwe-SGLT2 inhibitor esebenza ngokufinyeleleka nokuphepha okungaphezulu kweminyaka engu-4 yokusetshenziswa. Ithebhulethi elilodwa ngosuku, kungakhathalekile ukuthi kudliwani ukudla, liqinisekisa ukwehla okungaguquki kwengcindezi yegazi, ukwehla okubalulekile nokuphikelelayo kwe-hemoglobin ye-glycated, kanye nokwehla okuqinile kwesisindo somzimba. Umuthi awukhonjiswa ekwelapheni ukukhuluphala kanye nomfutho wegazi ophakeme. Imiphumela yayiwukuphela kokugcina kwezivivinyo zokwelashwa.

Ubekwa ubani umuthi

I-Dapagliflozin (uhlobo lokuhweba lwe-Forxiga) esigabeni sayo sezidakamizwa - inhibitors of sodium-glucose-cotransporter hlobo 2 (SGLT-2) ivele emakethe yezokwelapha yaseRussia kuqala. Wabhaliswa kwi-monotherapy ekwelapheni isifo sikashukela sohlobo 2, kanye nokuhlanganiswa neMetformin njengesidakamizwa sokuqala kanye nasekuqhubekeni kwalesi sifo. Namuhla, isipiliyoni esiqongelelwe sisivumela ukuthi sisebenzise umuthi kwabanesifo sikashukela "abanolwazi" ngazo zonke inhlanganisela ezingaba khona:

• Nge-sulfanilurea derivatives (kufaka phakathi ukwelashwa okuyinkimbinkimbi nge-metformin);
• Ngama-gliptins;
• Ngama-thiazolidinediones;
• Nge-DPP-4 inhibitors (inhlanganisela engenzeka nge-metformin nama-analogues);
• Ngama-insulin (nama-ejenti we-hypoglycemic womlomo).

Obethelwe kuye inhibitor

Ungabeki i-Forsig kwabanesifo sikashukela ngohlobo loku-1 lwesifo. Ngokubekezelela ngakunye ezingxenyeni zefomula, iphinde yathathelwe indawo yi-analogues. IDapagliflozin nayo ayibonisiwe:

• Uma kwenzeka unezinkinga zezinso ezingapheli, futhi nokuthi i-glomerular filtration yehliselwa ku-60 ml / min / 1.73 m2;
• Isifo sikashukela sikashukela;
• Ukungabekezelelani kwe-Lactose;
• Ukushoda kwe-lactase nokuzwela okukhulayo kwe-glucose-galactose;
• Ukukhulelwa nokukhulelwa;
• Ebusheni nasebusheni;
• Ngesikhathi sokuthatha izinhlobo ezithile zemithi ye-diuretic;
• Izifo zesisu;
• Nge-anemia;
• Uma umzimba ukhubazekile;
• Eminyakeni yobudala evuthiwe (kusuka eminyakeni engama-75), uma umuthi unqunywe okokuqala ngqa.

Ukusetshenziswa kweForigi kudinga ukuqaphela, uma i-hematocrit iphakanyisiwe, kukhona izifo zohlelo lwezitho zofuzo, ukuhluleka kwenhliziyo ngendlela engapheli.

Izinzuzo zeDapagliflozin

Umphumela wokwelapha utholakala ngokuvimbela i-sodium glucose cotransporter, i-pharmacological glucosuria iyathuthuka, ehambisana nokuncipha kwesisindo kanye nokwehla komfutho wegazi. Le mpahla yothathu yemiphumela engaxhomekeki kwe-insulin izoba nezinzuzo eziningi:

• Ukusebenza kahle akuxhomekile ekuzwelweni kwezicubu kwe-insulin;
• Indlela yokusebenza ayilayishi ama-β-cell;
• Ukuthuthukiswa okungaqondile kwamakhono we-β-cell;
• Yehlisa ukumelana ne-insulin;
• Ubungozi obuncane be-hypoglycemia engaqhathaniswa ne-placebo.

Indlela yokusebenza ezimele ye-insulin isetshenziswa kukho konke ukuhlangana okungenzeka, kuzo zonke izigaba zokuphathwa kweziguli - ukusuka kwisikompilo kuya ezinhlotsheni eziqhubekayo zesifo sikashukela, lapho ukuhlangana ne-insulin kudingekile. Amakhono ayo kuphela angazange afundwe lapho ehlanganiswa nama-agonists we-GLP-1 receptors.

Isikhathi salesi sifo asithinti amandla e-dapagliflozin. Ngokungafani nezinye izifaniso ezisebenza kuphela eminyakeni eyi-10 yokuqala yokuthuthukiswa kwesifo sikashukela, i-Forsigu isebenzise ngempumelelo abanesifo sikashukela "abanolwazi."

Ngemuva kokuphela kwenkambo yokuthatha i-inhibitor, umphumela wokwelapha uqhubeka isikhathi eside ngokwanele. Okuningi kuzoncika ekusebenzeni kwezinso.

Umuthi usiza iziguli ezinegazi ukuba zilawule umfutho wegazi, uhlinzeka ngomphumela omnene we-hypotensive. Lokhu nakho kusiza ukunciphisa ingozi yokuhlakulela izimo zenhliziyo.

I-Forsyga ijwayiza ngokushesha i-glycemia yokuzila ukudla, kepha ukugcotshwa kwe-cholesterol (kokubili inani ne-LDL) kunganda.

Ukulimala okungaba khona ku-dapagliflozin

Iminyaka emine ayisona isikhathi esiqinile sokwenza umtholampilo.

Uma kuqhathaniswa namalungiselelo we-metformin asetshenziswe ngempumelelo amashumishumi eminyaka, ukusebenza isikhathi eside kweForigi akufundwanga kuzo zonke izici.

Akunakuba nokukhuluma ngokuzilapha no-Forsiga, kepha noma ngabe udokotela ebeke lo muthi, umuntu kufanele asilalele isimo sakhe, abhale phansi zonke izinguquko ukuze axwayise udokotela ngesikhathi. Le mibandela ifaka:

• I-Polyuria - ukuphuma komchamo;
• I-Polydipsia - umuzwa ongapheli wokoma;
• I-polyphagy - indlala eyandayo;
• Ukukhathala nokungaphatheki kahle;
• Ukwehla kwesisindo okungachaziwe;
• Ukwelashwa kancane kwamanxeba;
• Izifo ze-urinary tract ezihambisana nokulunywa nokufafaza i-groin;
• I-Glucosuria (ukubukeka kwe-glucose ekuhlolweni komchamo);
• I-Pyelonephritis;
• Ukuncipha kobusuku emilenzeni (ngenxa yokuntuleka kwamanzi);
• I-neoplasia ampofu (ulwazi olwanele);
• I-Oncology yesinye kanye ne-prostate (imininingwane engaqinisekisiwe);
• Ukwephulwa kwesigqi sokunyakaza kwamathumbu;
• Ukujuluka ngokweqile;
• Amanani akhuphukayo e-urea ne-creatinine egazini;
• I-Ketaocidosis (ifomu lesifo sikashukela);
• I-Dyslipidemia;
• Ubuhlungu emuva.

Kubalulekile ukukhumbula ukuthi i-dapagliflozin icasisa ukusebenza kwezinso okuthuthukisiwe, ngokuhamba kwesikhathi, ukusebenza kwabo kuyehla, njengoba kwenza isilinganiso se-glomerular filtration rate. Kwabanesifo sikashukela, izinso ziyisitho esisengozini kunazo zonke, uma kukhona ukuphazamiseka osekuvele kulolu hlangothi, ukusetshenziswa kwanoma iyiphi i-Forsigi analogues kufanele kushiywe. Uhlobo oluthuthukile lwe-nephropathy yesifo sikashukela lubandakanya ukuhlanzwa kwezinso nge-hemodialysis.

I-Glucosuria (inqwaba yamashukela ezivivinyweni zomchamo) inomphumela omubi emgudwini womchamo. I-inhibitor inyusa umthamo womchamo "omnandi", futhi ngayo amathuba okutheleleka okuhambisana nokubomvu, ukulunywa kanye nokungahambi kahle. Kaningi, izimpawu ezinjalo, ngezizathu ezisobala, ziyabonakala phakathi kwabesifazane.

Kuyingozi ukusebenzisa i-inhibitor yohlobo 1 sikashukela, ngoba ushukela otholwa umzimba ngokudla nawo uyakhishwa ezinso. Ingozi ye-hypoglycemia, eshintsha ngokushesha ibe yokhokho nethonya, iyanda.

Akukho sithombe esicacile mayelana nesifo sikashukela sikashukela. Kuvele imibiko yomuntu ngamunye engahle ihlotshaniswe nezinye izingxenye ze-metabolic syndrome.

Ukuphatha kanyekanye kwama-diuretics ngokushesha kukhipha emzimbeni futhi kungaba yingozi.

Umshini wethonya le-Forsigi

Umsebenzi oyinhloko we-dapagliflozin ukwehlisa umkhawulo wokubuyiselwa kabusha koshukela ku-renal tubules. Izinso ziyisitho esiyinhloko sokuhlunga esihlanza igazi futhi sisuse izinto ezengeziwe emchameni. Sinemizimba yethu eyethu imigomo enquma ikhwalithi yegazi efanele impilo yayo. Izinga "lokungcola" kwalo futhi lilinganiswa yizinso.

Ukuhamba eceleni kwewebhu yemithambo yegazi, igazi liyahlungwa. Uma amakhompiyutha engahambisani nengxenye yokuhlunga, umzimba uyawakhipha. Lapho ukuhlunga, kwakheka izinhlobo ezimbili zomchamo. Okuyinhloko, empeleni, yigazi, kuphela ngaphandle kwamaprotheni. Ngemuva kokuhlanzwa kokuqala, iqala ukuqalwa kabusha. Umchamo wokuqala uhlala njalo ungaphezu kwesibili, oqoqeka ngosuku kanye nama-metabolites futhi ususwa izinso.

Kuhlobo 2 sikashukela, ukuhlolwa komchamo kufaka imizimba yeglucose ne-ketone, ekhombisa i-hyperglycemia, engahlala isikhathi eside. Ukweqiwa okunjalo kudlula umkhawulo omkhulu wezinso (10-12 mmol / l), ngakho-ke, lapho kuthuthukiswa umchamo oyinhloko, kusetshenziswa ingxenye. Kepha lokhu kungenzeka kuphela ngokungalingani.

Ososayensi bazamile ukusebenzisa la makhono ezinso ukuwahlela ukuthi alwe ne-glycemia nangamanye amanani kashukela, hhayi nge-hyperglycemia kuphela. Ukuze wenze lokhu, kwakudingeka ukuphazamisa inqubo yokufaka i-reverse, ukuze iningi lama-glucose lihlale kumchamo wesibili futhi lisuswe ngokuphepha emzimbeni ngokwemvelo.

Ucwaningo luye lwabonisa ukuthi i-sodium glucose cotransporters eyenziwe endaweni nephron iyisisekelo somshini ozimele we-insulin-ozimele we-glucose ibhalansi. Imvamisa, i-180 g ye-glucose ihlungwa ngokuphelele kuyo yonke i-glomeruli nsuku zonke futhi cishe konke kuyabuyiselwa emgudwini wegazi kushubhu le-proximal kanye nezinye izinhlanganisela ezidingekayo ezinhlelweni ze-metabolic. I-SGLT-2, etholakala engxenyeni ye-S1 ye-proximal tubule, isibhekele cishe u-90% we-glucose reabsorption ezinso. Endabeni ye-hyperglycemia, ezigulini ezinesifo sikashukela sohlobo 2, i-SGLT-2 iyaqhubeka nokubuyisela ushukela glucose, umthombo oyinhloko wama-kilojoule, ungene egazini.

Ukuvinjelwa kohlobo lwe-sodium glucose cocransporter 2 SGLT-2 kuyindlela entsha engazimele ye-insulin ekwelashweni kwesifo sikashukela sohlobo 2, esiza ekuxazululeni izinkinga eziningi zokulawulwa kwe-glycemic. I-violin yokuqala kule nqubo idlalwa ngamaprotheni e-transporter, ikakhulukazi ama-SGLT-2, abamba i-glucose ukuze andise ukumuncwa kwawo ezinso. Ama-inhibitors we-SGLT-2 asebenza kahle kakhulu ekuxotsheni kwe-glucose kumanani we-80 g / ngosuku. Ngasikhathi sinye, inani lamandla liyancipha: umuntu onesifo sikashukela ulahlekelwa ngu-300 Kcal ngosuku.

I-Forsyga imele isigaba se-SGLT-2 inhibitors. Indlela yesenzo sayo ukuvimba nokungenisa i-glucose engxenyeni ye-S1 ye-proximal tubule. Lokhu kuqinisekisa ukuphuma kwe-glucose kumchamo. Ngokwemvelo, ngemuva kokuthatha i-Forsigi, abanesifo sikashukela bavame ukuvakashela indlu yangasese: i-osmotic diuresis yansuku zonke inyuka ngo-350 ml.

Imishini enjalo yokuzimela ye-insulin ibaluleke kakhulu, ngoba ama-β-cell aqhubeka kancane kancane ngokuhamba kwesikhathi, futhi ukumelana ne-insulin kudlala indima ebabazekayo ekuqhubekeni kwesifo sikashukela sohlobo 2. Njengoba umsebenzi we-inhibitor ungathinteki ekuqoqweni kwe-insulin, kungakuhle ukuthi uyisebenzise ngesifo sikashukela sohlobo 2 kuhlangene ne-metformin ne-analogues noma amalungiselelo e-insulin.

Umuthi i-Forsiga - ukuhlolwa kwesazi

Umuthi ufundwe ngokwanele ezivivinyweni zemitholampilo, kufaka phakathi isigaba sesithathu sokuvivinywa, lapho amavolontiya angaphezu kwenkulungwane eyisikhombisa aba nengxenye khona. Ingqimba yokuqala yocwaningo yi-monotherapy (kufaka phakathi ukusebenza kwamadosi aphansi), elesibili inhlanganisela namanye ama-hypoglycemic agents (metformin, DPP-4 inhibitors, insulin), inketho yesithathu ine-sulfonylurea derivatives noma i-metformin. Ukusebenza kwamakhambi amabili weForigs kwafundwa ngokwehlukile - i-10 mg ne-5 mg ngokuhlanganiswa ne-metformin yomphumela ohlelwe, ikakhulukazi, ukusebenza kahle kwezidakamizwa kweziguli ezinesifo somfutho wegazi.

U-Forsiga uthole ukubuyekezwa okuphezulu kakhulu kusuka ochwepheshe. Imiphumela yocwaningo ithole ukuthi inomphumela obalulekile wemitholampilo ezingeni le-hemoglobin ye-glycated enomehluko obalulekile ovela eqenjini le-placebo, ne-HbA1c dynamics engaba yinye (amanani aphezulu yilapho ehlanganiswa ne-insulin ne-thiazolidinediones) ngamanani okuqala angekho ngaphezulu kwe-8%. Lapho kuhlaziywa iqembu leziguli lapho izinga lokuqala le-hemoglobin ye-glycated liphakeme kakhulu kune-9%, ngemuva kwamaviki angama-24 amandla we-HbA1c ushintsho kuzo aphumela phezulu - 2% (nge-monotherapy) no-1.5% (ngokwehlukahlukana kwekhambi lokuhlanganiswa). Konke ukwehluka bekuthembekile kuqhathaniswa ne-placebo.

I-Forsiga ithinta ngokuqinile izinga lokuzila kwe-glycemia. Impendulo ephezulu inikezwa yinhlanganisela yokuqala i-dapagliflozin + metformin, lapho amandla okubonisa izinkomba zoshukela esheshayo esedlula i-3 mmol / l. Ukuhlolwa komphumela we-gypcemia ye-postprandial yenzeka ngemuva kokudla umuthi okwathatha amasonto angama-24. Kuyo yonke inhlanganisela, kutholakala umehluko obalulekile kuqhathaniswa ne-placebo: i-monotherapy - minus 3.05 mmol / L, ukungezelelwa kwe-sulfonylureas kumalungiselelo - okususa u-1.93 mmol / L, kuhlanganiswa ne-thiazolidinediones - ususa 3.75 mmol / L.

Ukuhlolwa komphumela womuthi ekulahlekelweni kwesisindo nakho kuyaphawuleka. Zonke izigaba zocwaningo ziqophe ukwehla kwesisindo okuzinzile: nge-monotherapy isilinganiso samakhilogremu amathathu, lapho kuhlanganiswa nezidakamizwa ezikhuthaza ukukhuluphala kwesisindo (insulin, sulfonylureas) - 1.6-2.26 mmol / l. I-Forsyga ekwelashweni okuyinkimbinkimbi ingasusa imiphumela engathandeki yemithi efaka isandla ekukhululekeni kwesisindo. Ingxenye yesithathu yabantu abanesifo sikashukela enesisindo esingama-92 kg noma ngaphezulu abathola i-Forsigu ne-Metformin bathole umphumela obalulekile emtholampilo ngamaviki angama-24: minus 4.8 kg (5% noma ngaphezulu). Umaka we-surrogate (ukuqina kokujikeleza) usetshenzisiwe futhi ekuhlolweni kokusebenza kahle. Ezinyangeni eziyisithupha, ukwehla okuphikelelayo kokujikeleza okhalweni kwaqoshwa (ngokwesilinganiso - ngo-1.5 cm) futhi lo mphumela waphikelela futhi waqina ngemuva kwamasonto angama-102 wokulashwa (okungenani 2 cm).

Izifundo ezikhethekile (i-dual-energy X-ray absorptiometry) zahlola izici zokuncipha kwesisindo: ama-70% phakathi namasonto ayi-102 kwakubangelwa ukulahleka kwamafutha omzimba - zombili i-visceral (ezithweni zangaphakathi) kanye nokuzithoba. Ucwaningo olwenziwe ngalo muthi wokuqhathanisa alukhombisi ukusebenza kokuqhathanisa nje kuphela, ukugcinwa isikhathi eside komphumela we-Forsigi neMetformin iminyaka emi-4 yokubukwa, kodwa futhi nokuncipha kwesisindo kuqhathaniswa neqembu elithatha iMetformin lihambisana nokutholwa kwe-sulfonylurea, lapho kwaqashelwa khona isisindo se-4,5 kg.

Lapho utadisha izinkomba zomfutho wegazi, amandla we-systolic blood pressure ayengu-4,4 mm RT. Ubuciko., Diastolic - 2.1 mm RT. Ubuciko. Ezigulini ezikhulu kakhulu ezinamanani ayisisekelo afinyelela ku-150 mm Hg. Isidakamizwa esithola izidakamizwa eziphezulu Ubuciko., Ngaphezulu kuka-150 mm RT. Ubuciko. - ngaphezu kwe-12 mm RT. Ubuciko.

Iziphakamiso zokusetshenziswa

I-ejenti yomlomo isetshenziswa nganoma yisiphi isikhathi, kungakhathalekile ukuthi kudliwani. Amathebhulethi ahlanganisiwe anesisindo esingu-5 mg no-10 mg emaphaketheni amakhadibhodi wezingcezu ezingama-28, 30, 56 nezingama-90. Isincomo esijwayelekile se-Forsigi esinqunyelwe emiyalweni yokusetshenziswa - I-10 mg / usuku. Ithebhulethi elilodwa noma amabili, kuye ngomthamo, adakwa kanye, kanye namanzi.

Uma imisebenzi yesibindi ikhubazekile, udokotela unciphisa okujwayelekile ngasikhathi sinye kuya kwesibili (ngokwelashwa kokuqala 5 mg / ngosuku).

Okuvame kakhulu ukuhlanganiswa kweForigi neMetformin noma ama-analogues ayo. Ngokuhlanganiswa okunjalo, kunqunywa i-10 mg ye-inhibitor futhi efinyelela ku-500 mg we-metformin.

Ngokuvimbela i-hypoglycemia, i-Forsig kufanele ichazwe ngokucophelela ngemuva kwesizinda sokwelashwa kwe-insulin kanye nokuhlanganiswa nemithi yeqembu le-sulfonylurea.

Ukuze usebenze ngokugcwele, kungakuhle ukuphuza umuthi ngasikhathi sinye sosuku.

Ngaphandle kokuguqulwa kwendlela yokuphila, ukuhlola amandla we-inhibitor akusizi ngalutho.

Ukwelashwa okuhlanganisiwe nge-glyphlozines (kusuka ku-10 mg) kuzokwehla amanani weHbA1c.

Uma ekwelashweni okuyinkimbinkimbi kukhona ne-insulin, khona-ke i-glycated hemoglobin incishiswa ngisho nangokwengeziwe. Ohlelweni oluyinkimbinkimbi, ngokuqokwa kukaForigi, umthamo we-insulin ubuyekezwa futhi. Ukwenqatshwa ngokuphelele kwemijovo ye-hormonal kungenzeka, kepha zonke lezi zingqinamba zikwikhono le-endocrinologist yokwelapha.

Izincomo ezikhethekile

Iziguli zokwehluleka kwezinso kufanele ziphathwe ngokunaka okuthe xaxa: sebenzisa i-Forsigu enkambisweni enokulinganisa, ubheke njalo isimo sezinso, ulungisa umthamo njengoba kudingeka. Ngokusebenzisa isikhathi eside (kusuka eminyakeni emi-4), ungamisa i-dapagliflozin ngezikhathi ezithile ngemithi ehlukile - i-Novonorm, Diagnlinid.

Ama-Cardioprotectors anqunyelwa kwabanesifo sikashukela abanezinkinga zenhliziyo nezemithambo ngokuhambisana nezidakamizwa ezinciphisa ushukela, ngoba i-dapagliflozin iyakwazi ukudala umthwalo owengeziwe emikhunjini.

Izimpawu ze-overdose

Ngokuvamile, umuthi awunangozi; kuzivivinyo, amavolontiya ngaphandle kwesifo sikashukela abekezelela okweqile umzuzwana munxa womthamo ngezikhathi ezingama-50. Ushukela watholakala emchameni ngemuva komthamo onjalo okwezinsuku ezi-5, kepha i-hypotension, hypoglycemia, noma ukuphuma komzimba okukhulu akubanga phansi.

Ngokusebenzisa umthamo wamasonto amabili umthamo izikhathi eziyishumi okujwayelekile, bobabili abanesifo sikashukela kanye nababambiqhaza ngaphandle kwezinkinga ezinjalo bahlakulela i-hypoglycemia kaningi kune-placebo.

Uma kwenzeka kusetshenziswa ngokweqile ngengozi noma ngamabomu, ukuhlanzwa kwesisu kanye nokulungiswa kwemvelo kwenziwa. Ukuchithwa kwe-Forsigi nge-hemodialysis akufundwanga.

Kungenzeka yini ukunciphisa isisindo ngeForsiga

Umphumela wokuncipha kwesisindo ufakazelwe ngokuhlolwa, kepha kuyingozi ukusebenzisa umuthi kuphela ukulungiswa kwesisindo, ngakho-ke umuthi udedelwa ngomuthi kuphela. I-Dapagliflozin iphazamisa ukusebenza kwemodi ejwayelekile yokusebenza kwezinso. Lokhu kungalingani kuthinta umsebenzi wazo zonke izitho nezinhlelo.

Umzimba ukhubazekile. Indlela yokusebenza yesidakamizwa iyefana nomphumela wokudla okungenawo usawoti, okukuvumela ukuthi ulahlekelwe ngama-5 kg ​​emasontweni okuqala. Usawoti ugcina amanzi, uma unciphisa ukusetshenziswa kwawo, umzimba ukhipha amanzi amaningi.

Okuqukethwe kwekhalori okuphelele kokudla kuncishisiwe. Lapho i-glucose ingangenwa, kepha isetshenziswa, lokhu kunciphisa inani lamandla angenayo: I-300-350 kcal idliwa ngosuku.

Uma ungalayishi kakhulu umzimba ngama-carbohydrate, isisindo sihamba ngokwengeziwe.

Ukwenqaba okubukhali ukusebenzisa i-inhibitor akuqinisekisi ukuqina kwemiphumela etholakele, ngakho-ke akunconywa kubantu abanempilo ukusebenzisa umuthi we-hypoglycemic kuphela ukulungiswa kwesisindo somzimba.

Imiphumela Yokusebenzelana Kwezidakamizwa

I-inhibitor ithuthukisa amandla we-diuretic we-diuretics, ikhulisa ubungozi bokuphelelwa ngamanzi emzimbeni kanye ne-hypotension.

IDapagliflozin ihlangana ngokuthula ne-metformin, pioglitazone, sitagliptin, glimepiride, valsartan, voglibose, bumetanide. Inhlanganisela ene-rifampicin, i-phenytoin, i-carbamazepine, i-phenobarbital inethonya elincane ekhemisi yezidakamizwa, kepha lokhu akukuthinti umphumela wokukhipha ushukela. Akukho ukulungiswa komthamo okudingekayo ngokuhlanganiswa kweForigi ne-mefenamic acid.

I-Forsyga, nayo, ayinciphisi umsebenzi we-metformin, pioglitazone, sitagliptin, glimepiride, bumetanide, valsartan, digoxin. Umphumela kumandla we-simvastatin awubalulekile.

Umphumela we-pharmacokinetics ka-Forsigi ukubhema, utshwala, ukudla okuhlukahlukene, imishanguzo ye-herbal awuzange ufundwe.

Imibandela yokuthenga nokugcina

Uma ubheka ukuthi umuthi wenziwe ngendlela ongayikhetha, izindleko zawo ngeke zikwazi ukukhokhela wonke umuntu: kwa-Forsig intengo isukela ku-2400 - 2700 rubles. amaphilisi angu-30 enesisindo esingu-10 mg. Ungathenga ibhokisi elinezimfumba ezimbili noma ezine ze-aluminium foil ngokukhululekile kwinethiwekhi yasekhemisi ngomuthi. Isici esihlukile sokupakishwa yizitaki ezivele obala ezivikelekile ngephethini eceleni komugqa we-izinyembezi ngendlela yesibungu esiphuzi.

Umuthi awudingi izimo ezikhethekile zokugcinwa. Ikhithi losizo lokuqala kufanele libekwe endaweni engafinyeleleki ekunakekelweni yizingane, ngaphansi kwezimo zokushisa kuze kufike ku-30 ​​° C. Ekupheleni kosuku lokuphelelwa yisikhathi (ngokwemiyalo, le yiminyaka emi-3), umuthi ulahlwa.

I-Forsiga - analogues

Izidakamizwa ezintathu ze-analogous SGLT-2 ezintathu kuphela eziye zakhiwa:

• IJardins (igama lomkhiqizo) noma i-empagliflozin;
• Invocana (inketho yokuhweba) noma i-canagliflozin;
• I-Forsiga, ngefomethi yamazwe omhlaba - dapagliflozin.

Ukufana egameni kubonisa ukuthi zifaka into eyodwa esebenzayo. Izindleko zezidakamizwa ze-analog zisuka kuma-ruble angama-2500 kuya kwangama-5000. Kwisidakamizwa iForig, azikho izibalo ezishibhile okwamanje, uma zakha ama-generics esikhathini esizayo, khona-ke, ngokunokwenzeka, kususelwa engxenyeni eyisisekelo yemithi.

Ukubuyekezwa kweziguli

Isifinyezo

Ngazo zonke izindlela nezindlela zokwelapha zokwelapha isifo sikashukela sohlobo 2, kunezinkinga eziningi ezingalungiswa.

1. Ukuxilongwa kwesifo kungekudala kwesikhashana (kunciphisa isikhathi sokuphila iminyaka engu-5-6).
2. Inkambo eqhubekayo yesifo sikashukela, kungakhathalekile ukuthi ilashwa kanjani.
3. Ngaphezu kwe-50% ayifezi izinhloso zokwelapha futhi ayigcini ukulawulwa kwe-glycemic.
4. Imiphumela emibi: i-hypoglycemia kanye nesisindo - inani lentengo yokulawulwa kwe-glycemic yekhwalithi.
5. Ingozi ephezulu kakhulu yemicimbi yenhliziyo (CVS).

Iningi labantu abanesifo sikashukela banezifo ezihambisana nokukhulisa ubungozi be-CVD - ukukhuluphala, umfutho wegazi ophakeme kanye ne-dyslipidemia. Ukunciphisa ikhilogremu elilodwa noma isisindo esiguqulwe okhalweni ngo-1 cm kunciphisa ingozi yokuthola isifo senhliziyo nge-13%.

Isifiso sokuphila emhlabeni wonke sinqunywa ngokuphepha kwenhliziyo. Isu lokwehliswa okuphelele kwengozi ye-SS:

• Ukulungiswa kwendlela yokuphila;
• Ukuguqulwa kwe-lipid metabolism;
• Yehlisa umfutho wegazi;
• I-Naturalization ye-carbohydrate metabolism.

Ukusuka kuleli phuzu, umuthi ofanele kufanele unikeze i-100% glycemic control, ubungozi obuphansi be-hypoglycemia, umthelela omuhle kwesisindo somzimba nezinye izici zobungozi (ikakhulukazi, umfutho wegazi ophakeme, ubungozi be-CVS). Kulokhu, i-Forsig ihlangabezana nazo zonke izidingo zesimanje: ukwehla okukhulu kwe-hemoglobin ye-glycated (kusuka ku-1,3%), ingozi ephansi ye-hypoglycemia, ukwehla kwesisindo (ususa u-5.1 kg / ngonyaka ngokuqhubeka iminyaka engu-4), kanye nokwehla komfutho wegazi (kusuka ku-5 mmHg) Imiphumela ehlanganisiwe yezifundo ezimbili ikhombisile ukuthi iphrofayili yokusebenza kanye nokuphepha komuthi i-Forsig ekwelashweni kwabanesifo sikashukela ngezifo ezahlukahlukene ezihlangene. Lesi sidakamizwa esivame ukwelashwa kakhulu (iziguli eziyizinkulungwane ezingama-290 eminyakeni emi-2).