Amaphilisi wesifo sikashukela se-Galvus - ungawaphuza kanjani?

UGalvus ubhekisa izidakamizwa ezinikezwa ezinomphumela we-hypoglycemic. Into esemqoka yokusebenza kwesidakamizwa yiVildagliptin.

Umuthi usetshenziselwa ukwengeza ushukela wegazi futhi uthathwa yiziguli ezinesifo sikashukela.

Ukwakheka, ifomu lokukhulula kanye nesenzo semithi

Ifomu eliphambili lomthamo walesi sidakamizwa ngamathebulethi. Igama lomhlaba wonke yiVildagliptin, igama lokuhweba yiGalvus.

Inkomba enkulu yokuphuza umuthi ubukhona besifo sikashukela sohlobo 2 kumuntu. Leli thuluzi libhekisa ezidakamizweni ze-hypoglycemic ezithathwa yiziguli zokunciphisa ukugcwala koshukela egazini.

Into esemqoka yesidakamizwa yi-vildagliptin. Ukuhlushwa kwayo kungama-50 mg. Izinto ezengeziwe yilezi: isitashi se-magnesium nesitashi se-sodium carboxymethyl. Into ehambisana nayo i-lactose ene-anhydrous ne-microcrystalline cellulose.

Umuthi uyatholakala ngesimo samathebulethi aphuzwa ngomlomo. Umbala wezibhebhe uvela kokumhlophe kuya kphuzi ophuzi. Ingaphezulu lamathebulethi liyindilinga futhi libushelelezi ngokuba khona kwama-bevels emaphethelweni. Kuzo zombili izinhlangothi zethebhulethi kukhona okubhaliwe: "NVR", "FB".

IGalvus itholakala ngesimo samabhulokhi e-2, 4, 8 noma 12 kwiphakethe elilodwa. 1 i-blister iqukethe amaphilisi ayi-7 noma ayi-14 we-Galvus (bheka isithombe).

Umuthi i-Vildagliptin, oyingxenye yesidakamizwa, uvuselela i-islet apparatus ye-pancreas, wehlisa isenzo se-enzyme DPP-4 futhi ukhulisa ukuzwela kwama-β-cell ku-glucose. Lokhu kuthuthukisa ukugcinwa kwe-insulin okuncike ku-glucose.

Ukuzwela kwama-β-cell kwenziwa ngcono uma kubhekwa izinga lomonakalo wabo wokuqala. Kumuntu ongenaso isifo sikashukela, secretion ye-insulin ayivuswa ngenxa yokuthatha umuthi. Umuthi uthuthukisa ukulawulwa kwe-glucagon.

Lapho uthatha i-Vildagliptin, izinga lama-lipids eplasma yegazi liyancipha. Ukusetshenziswa kwomuthi njengengxenye ye-monotherapy, njengoba kuhlangana ne-Metformin, izinsuku ezingama-84 ukuya kwezingu-3165 kuholela ekwehleni okungapheli kwezinga le-glucose ne-glycated hemoglobin egazini.

I-Pharmacokinetics

Umuthi othathwe esiswini esingenalutho udonswa ngaphakathi kwemizuzu engu-105. Lapho uthatha umuthi ngemuva kokudla, ukumuncwa kwawo kuyancipha futhi kungafinyelela amahora angama-2,5.

IVildagliptin ibonakala ngokufakwa ngokushesha. I-bioavailability yesidakamizwa ingama-85%. Ukuxakaniseka kwento esebenzayo yesidakamizwa egazini kuya ngethamo elithathiwe.

Umuthi ubonakala ngezinga eliphansi lokubopha kumaphrotheni e-plasma. Inani laso liyi-9.3%.

Le nto ikhishwa emzimbeni wesiguli nge-biotransformation. Uvezwa u-69% womthamo othathwe. I-4% yezidakamizwa ezithathiwe ibandakanyeka ku-amide hydrolysis.

85% wezidakamizwa ukhishwa emzimbeni yizinso, okusele kungamaphesenti angama-15 ngamathumbu. I-Half-life yesidakamizwa icishe ibe ngamahora ayi-2-3. I-pharmacokinetics yeVildagliptin ayincike kwesisindo, ubulili kanye neqembu lobuhlanga, umuntu okulo umuthi lelo.

Ezigulini ezinenkinga yokusebenza kwesibindi, kuncipha ukwehla kokuqina kwezidakamizwa. Ngendlela emfushane yokwephula, inkomba ye-bioavailability incishiswa ngo-8%, ifomu elijwayelekile - ngama-20%.

Ezimweni ezinamandla, le nkomba yehla ngama-22%. Ukwehla noma ukwanda kwe-bioavailability ngaphakathi kwe-30% kuyinto ejwayelekile futhi akudingi ukulungiswa kwamthamo.

Ezigulini ezinenkinga yokusebenza kwe-renal njengesifo esijwayelekile, kufanele kulungiswe ukulungiswa komthamo. Kubantu abangaphezu kweminyaka engama-65, kukhona ukwanda kwe-bioavailability yesidakamizwa ngama-32%, okubhekwa njengokujwayelekile. Imininingwane esezimpawu ze-pharmacokinetic yesidakamizwa ezinganeni ayitholakali.

Izinkomba kanye ne-contraindication

UGalvus usetshenziselwa isifo sikashukela sohlobo 2 emacaleni alandelayo:

• ngokungasebenzi kahle kokuzivocavoca nokudla, kusetshenziswa ngokubambisana neMetformin;
  
• ngokuhlanganiswa ne-Insulin, iMetformin, nokusebenza kabi kwale mishanguzo;
• njengesidakamizwa esisodwa, uma isiguli singakubekezeleli iMetformin, uma ukudla kanye nokuzivocavoca kungaqalanga nomphumela;
• ngokuhlanganiswa nezakhi ze-Metformin ne-sulfonylurea, uma ukwelashwa kwangaphambili ngezindlela ezibonisiwe kunganikanga umphumela;
• ngohlaka lokwelashwa kusetshenziswa i-Thiazolidinedione, i-Sulfonylurea kanye nokuphuma kwayo, i-Metformin, i-Insulin, uma ukwelashwa ngezindlela ezibonisiwe ngokwahlukile, njengokudla nokuzivocavoca, akuzange kunikeze umphumela.

Ukuxhumana kokuphuza umuthi yilezi:

• i-lactic acidosis;
• ukukhulelwa
• ukuncelisa;
• ukuntuleka kwe-lactase;
• thayipha i-1 isifo sikashukela;
• ukwephulwa kwesibindi;
• ukungabekezelelani kwe-galactose;
• ukwehluleka kwenhliziyo uhlobo olungapheli lwesigaba IV;
• ukungabekezeleleki izinto ezakha umuthi;
• i-ketoacidosis yesifo sikashukela (yomzimba kanye nehlalakhona);
• iminyaka engu-18.

Imiyalo yokusebenzisa umuthi

Umthamo walesi sidakamizwa kuncike ezicini zomzimba wesiguli esithile.

Ithebula lemithamo enconyiwe yesidakamizwa:

Uma kungekho ukwehla kokuhlushwa ushukela wegazi kusuka kumthamo omkhulu we-100 mg, ukuthathwa okwengeziwe kwamanye ama-hypoglycemic agents kuvunyelwe.

IGalvus ayihlotshaniswa nokudla. Ukulungiswa kwedosi kuyadingeka kwiziguli ezinenkinga yezinhlungu zomsebenzi wezinsi ezilinganiselwe. Umthamo omkhulu kufanele ube ngu-50 mg ngosuku. Kwezinye izigaba zeziguli, ukulungiswa komthamo komuthi akudingeki.

Imiyalo ekhethekile

IGalvus ayinconywa kubantu abalandelayo:

• ukuhlushwa ukuhluleka kwenhliziyo ngendlela engapheli yesigaba IV;
• ukwephulwa kwesibindi;
• uhlushwa umsebenzi wokulimala wezinsi ongama-degree ahlukahlukene.

Umuthi uphethwe ngokuphelele:

• abesifazane abakhulelwe;
• omama abancelayo;
• izingane ezingaphansi kweminyaka engu-18;
• iziguli ezine-jaundice.

Kusetshenziswa ngokuqapha ezigulini ezinezimpawu ze-pancreatitis eyingozi, kanye nasezigulini ezinokwehluleka kwenhliziyo okungapheli okuphelela enkambweni yokuhlanzwa kwegazi.

Kuyadingeka ukusebenzisa umuthi ngokuqapha ezigulini ezinokwehluleka kwenhliziyo kwekilasi III.

Ukuphathwa kanyekanye kwe-sulfonylurea ne-galvusa kungaholela ku-hypoglycemia. Uma kunesidingo, yehlisa umthamo.

Imiphumela emibi kanye ne-overdose

Imiphumela emibi yokuphuza umuthi iyivelakancane. Ukubukeka kwabo kuthatha isikhathi esifushane futhi imvamisa akudingi ukuthi kuqedwe.

Nge-monotherapy, lezi zimo ezilandelayo azivamile ukubonwa:

• Isiyezi
• ukuvuvukala
• ukuqunjelwa
• ikhanda;
• i-nasopharyngitis.

Lapho kuhlanganiswa neMetformin, okulandelayo kungenzeka:

• ukuqunjelwa;
• Isiyezi
• ikhanda.

Lapho uhlanganisa umuthi nezinto zokwenziwa nge-sulfonylurea, lokhu okulandelayo kungenzeka:

• ukuqunjelwa
• Isiyezi
• i-nasopharyngitis;
• ikhanda.

Lapho kuhlanganiswa ne-insulin, okulandelayo kungenzeka:

• i-asthenia;
• isifo sohudo
• i-hypoglycemia;
• amakhaza
• ikhanda;
• ukuthopha;
• isifiso sokuhlanza.

Ngokuphathwa kanyekanye ne-thiazolidatedione, i-edema yensiza kanye nokutholwa kwesisindo kungenzeka. Ezimweni ezingavamile, i-urticaria, i-pancreatitis kanye ne-hepatitis kuyaqabukela kubhalwe ngemuva kokuphathwa.

Ukweqisa izidakamizwa kwezinye izimo kuholela kumkhuhlane, ebuhlungwini bemisipha nokudumba.

Izimpawu ezifanayo zenzeka lapho i-400 mg kaGalvus idliwa phakathi nosuku. I-200 mg yomuthi uvame ukubekezelelwa yiziguli. Kumthamo we-600 mg, isiguli sivuvukala ngamaphethelo, kuyilapho izinga le-myoglobin namanye ama-enzyme amaningi egazi likhuphuka.

Izimpawu ze-overdose ziqedwa ngempumelelo ngemuva kokuyeka umuthi.

Ukusebenzisana kwezidakamizwa kanye nama-analog

Umuthi ubonakala ngezinga eliphansi lokusebenzelana kwezidakamizwa, okuvumela ukuthi uthathe umuthi kanye nama-enzyme ahlukahlukene nama-inhibitors.

Lapho kuthathwa ndawonye neWarfarin, i-Amlodipine, iGlibenclamide, i-Digoxin, akukho ukuxhumana okubonakalayo ngokomtholampilo okwasungulwa phakathi kwale mishanguzo neGalvus.

UGalvus une-analogues elandelayo:

• I-Vildagliptin;
• Vipidia;
• UGalvus Met;
• Onglisa;
• Trazenta;
• UJanuvius.

UGalvus Met ubuye abe nezichasiselo ezifuywayo, phakathi kwazo okuyi: Glimecomb, Combogliz Prolong, Avandamet.

Izinto zevidiyo eziphathelene nokwenzeka, ukwelashwa nokuvinjwa kwesifo sikashukela:

Umbono wodokotela

Ukusuka ekubuyekezweni kodokotela, kungaphethwa ngokuthi iGalvus yamukelwa kahle cishe yizo zonke iziguli, kepha ukusebenza kwayo okubuthakathaka kanye nesidingo sokudla okwengeziwe kwemithi enciphisa ushukela kuyaphawulwa.

UGalvus unesipiliyoni eside isicelo eRussia. Umkhiqizo uyasebenza futhi uphephile. UGalvus ubekezelelwa kahle yiziguli, unezingozi eziphansi ze-hypoglycemia. Ifanelwe kahle iziguli esezikhulile, inikezwe ukwehla okuphawulwe kokusebenza kwe-renal lapho ikhulile. Ucwaningo luye lwabonisa ukuthi i-Galvus ingathathwa njengengxenye yokwelashwa kwe-nephroprotective.

UMikhaleva O.V., i-endocrinologist

Naphezu kwempahla enhle yeGalvus, equkethe ukunciphisa isisindo seziguli, umphumela wayo wokunciphisa ushukela unesizotha. Imvamisa, umuthi udinga ukuthathwa okuhlangene nezinye izidakamizwa ze-hypoglycemic.

I-Shvedova A.M., i-endocrinologist

Intengo yezimali ezifundeni ezihlukene isukela kuma-ruble angama-734-815. I-analogue eyinhloko yesidakamizwa (iGalvus Met) esifundeni esingu-1417-1646 rubles.