Glucophage a cikin ciwon sukari

Glucophage wakili ne mai rage sukari don gudanar da baki (ta bakin), wakilin biguanides. Ya ƙunshi kayan aiki masu aiki - metformin hydrochloride, kuma magnesium stearate da povidone an rarrabe su azaman ƙarin abubuwa. Harsashi na Allunan Glucofage 1000 ya ƙunshi, ban da hypromellose, macrogol.

Duk da raguwar sukari na jini, ba ya haifar da hypoglycemia. Ka'idar aiki ta Glucophage ta samo asali ne daga haɓakar kusancin masu karɓar insulin, kazalika akan kamawa da lalata glukos ta sel. Bugu da ƙari, ƙwayar tana hana samar da glucose ta ƙwayoyin hanta - ta hana aiwatar da glucogenolysis da gluconeogenesis.

Babban sashi mai aiki a cikin ƙwayar cuta shine samar da glycogen ta hanta. Hakanan yana samar da haɓakar ƙarar tsarin jigilar glucose zuwa sel daban-daban. Metformin yana da wasu tasirin na biyu - yana rage cholesterol da triglycerides, yana ba da gudummawa ga mafi kyawun shigar glucose a cikin narkewa.

Umarnin don amfani

Shirya don gudanar da magana ta baka a cikin nau'ikan allunan da aka rufe da farin farin.

Daga farkon karatun, an wajabta shi a cikin adadin 500 ko 850 MG sau da yawa a rana lokacin ko bayan abinci. Dogara a kan jikewar jini tare da sukari, a hankali za ku iya ƙara sashi.

Bangaren da ke tallafawa yayin aikin jiyya shine 1500-2000 MG kowace rana. An raba adadin zuwa kashi 2-3 don guje wa rikicewar cututtukan gastrointestinal. Matsakaicin kiyayewa shine 3000 MG, dole ne a raba shi zuwa allurai 3 kowace rana.

Bayan wani lokaci, marasa lafiya zasu iya canzawa daga daidaitaccen kashi na 500-850 MG zuwa sashi na 1000 MG. Matsakaicin adadin a cikin waɗannan yanayin daidai yake da tare da maganin kulawa - 3000 MG, ya kasu kashi uku.

Idan ya zama dole canzawa daga wakili wanda aka riga aka dauka zuwa Glucophage, ya kamata ka daina shan wanda ya gabata, ka fara shan Glucophage a gwargwadon maganin da aka nuna a baya.

Hadawa tare da insulin:

Ba ya hana ƙirar wannan hormone kuma baya haifar da sakamako masu illa a cikin maganin haɗin kai. Za a iya ɗauka tare don kyakkyawan sakamako. A saboda wannan, kashi na Glucofage ya zama daidaitacce - 500-850 MG, kuma dole ne a zaɓi adadin insulin da aka gudanar yana la'akari da maida hankali na ƙarshe a cikin jini.

Yara da matasa:

Farawa daga shekaru 10, zaku iya rubutuwa a cikin maganin glucophage duka magani guda, kuma a hade tare da insulin. Sashi daidai yake da manya. Bayan makonni biyu, daidaitawar sashi bisa yawan karatun glucose mai yiwuwa ne.

Dole ne a zaba sashi na Glucophage a cikin tsofaffi don yin la'akari da yanayin kayan aikin na koda. Don yin wannan, ya zama dole don ƙayyadadden matakin creatinine a cikin jijiyoyin jini sau 2-4 a shekara.

Allunan da aka rufe da allunan don maganin baka. Dole ne a cinye su gabaɗaya, ba tare da keta mutuncinsu ba, a wanke da ruwa.

Glucophage Long 500 MG:

Gudanar da adadin 500 na MG - sau ɗaya a rana a abincin dare ko sau biyu a cikin adadin 250 na 250 a lokacin karin kumallo da abincin dare. An zaɓi wannan adadin a kan mai nuna alamar matakin glucose a cikin jini na jini.

Idan kuna buƙatar canzawa daga allunan al'ada zuwa Glucofage Long, to kashi a cikin ƙarshen zai zo daidai da kashi na maganin da aka saba.

Dangane da matakan sukari, bayan makonni biyu ana ba shi damar ƙara yawan asali ta 500 MG, amma ba fiye da matsakaicin kashi ba - 2000mG.

Idan sakamakon rage ƙwayar cutar ta Glucofage Long, ko ba a bayyana shi ba, to ya zama dole a ɗauki matsakaicin matakin kamar yadda aka umurce - allunan biyu da safe da maraice.

Haɗin kai tare da insulin ba shi da bambanci da wannan lokacin ɗaukar glucophage mara-tsawo.

Glucophage Long 850 mg:

Kashi na farko na Glucophage Long 850 mg - 1 kwamfutar hannu kowace rana. Matsakaicin adadin shine 2250 MG. Yanayin aiki ya yi kama da maganin 500 MG.

Umarnin Glucofage 1000 don amfani:

Sashi na 1000 MG yayi daidai da sauran zaɓuɓɓukan tsawan lokaci - 1 kwamfutar hannu a kowace rana tare da abinci.

Contraindications

Ba za ku iya ɗaukar wannan magani ga mutanen da ke fama da:

• ketoacidosis da ciwon sukari
• daga take hakki a cikin aikin ma'aikacin na din din tare da share kasa da 60 ml / min
• rashin ruwa a sanadi sakamakon amai ko gudawa, amai, cututtuka
• cututtukan zuciya kamar gazawar zuciya
• cututtukan huhu - CLL
• gazawar hanta da nakasa aikin hanta
• na kullum mai shan giya
• mutum haƙuri da abubuwa a cikin miyagun ƙwayoyi

Bugu da kari, haramun ne a dauki Glucofage ga mata masu juna biyu wadanda ke riko da karancin kalori, ga mutanen da suke cikin wani mataki ko kwayar cutar sabanin asalin cutar sankara.

Farar fata, allunan da aka rufe na 500, 850 da 100 MG. Amfani da miyagun ƙwayoyi - tare da abinci a ciki, an wanke shi da ruwa. Ana yin lissafin sashi daban-daban ga kowane mara lafiya, la'akari da alamun alamu na glucose da kuma yawan kiba, tunda magungunan sun dace da asarar nauyi.

Side effects

Abubuwan da ba a ke so ba a jiki na iya faruwa - kamar:

• dyspepsia - bayyanuwar cutar tashin zuciya, amai, gudawa, zawo, ciki, flatulence (ƙara yawan gas)
• dandano cuta
• rage cin abinci
• rashin lafiyar hepatic - raguwa a cikin ayyukan ayyukanta har zuwa ci gaban hepatitis
  a wani bangare na fata - itch kurji, erythema
• raguwa a cikin bitamin B12 - a bango na dogon shan magani

Farashi ya bambanta a cikin shagunan sayar da kayayyaki da kantuna na kan layi. Farashin kuma ya dogara da adadin ƙwayoyi da yawan allunan a cikin kunshin. A cikin kantin sayar da kan layi, bayanin farashin fakitoci na allunan a cikin adadin 30 guda - 500 MG - kimanin 130 rubles, 850 MG - 130-140 rubles, 1000 MG - kusan 200 rubles. Sigogin guda iri ɗaya ne, amma don fakiti tare da adadin adadin 60 a cikin kunshin - 170, 220 da 320 rubles, bi da bi.

A cikin sarkar kantin magani, farashin na iya zama mafi girma a cikin kewayon 20-30 rubles.

Saboda yawan aiki na metformin, Glucofage yana da yawa analogues. Ga kadan daga cikinsu:

• Siofor. Magunguna tare da manufa iri ɗaya. Zaɓin ne mafi aminci ga magungunan cututtukan zuciya don asarar nauyi. Bugu da kari, an lura da rashin sakamako masu illa sosai. Farashin kusan shine kusan rubles 400.
• Nova Sanda Kwarewar wannan magani shine amfani da shi a cikin mutane na tsufa da kuma a cikin mutanen da ke cikin aiki mai wahala ke da wahala. Gaskiyar ita ce, Nova Met yana iya tsokani bayyanar lactic acidosis. Bugu da kari, tsofaffi na iya fuskantar aikin nakasa mai rauni sakamakon alamun da suka bace. Farashin ya kusan 300 rubles.
• Metformin. A zahiri, wannan shine dukkanin abubuwan da ke aiki da dukkanin alamun ana amfani da su na Glucofage da kansa. Yana da abubuwa iri ɗaya. Farashin a cikin kantin magani ya kusan 80-100 rubles.

Yawan abin sama da ya kamata

Kamar yadda aka ambata a sama, miyagun ƙwayoyi ba su ba da gudummawa ga hypoglycemia - kuma tare da yawan abin sama da ya kamata. Amma a cikin yanayin shigar da shi a cikin adadin da ya wuce halatta, abin da ake kira lactic acidosis yana haɓaka. Wannan ba sabon abu bane, amma abu ne mai hatsarin gaske, saboda zai iya haifar da mutuwa.

Game da cutar yawan ƙwayar cuta ta Glucofage, yana da gaggawa a daina shan miyagun ƙwayoyi. An nuna nan da nan asibiti, gwajin lafiya da bincike. An nuna maganin tawaya, amma hemodialysis shine mafi kyawun zaɓi.

Kammalawa

Glukonazh 1000 kyakkyawan magani ne ga mutanen da ke fama da ciwon sukari. Hakan ba zai taimaka kawai wajen sarrafa matakan sukari ba, amma kuma yana iya rage nauyi, don haka zai taimaka wa masu son yin asara. Koyaya, bai kamata ka dauke shi ba da hankali ba - kana buƙatar ɗaukar shi kamar yadda likita ya umurce ka. Kafin siyan wannan magani, nemi shawara tare da gwani.

Siffofin magani

Glucophage magani ne na asali wanda aka samar a Faransa. Lokacin gudanar da jerin nazarin don magance cututtukan sukari, al'ada ce a yi amfani da shi. Babban alamun alamun amfani da miyagun ƙwayoyi sune:

• kiba a cikin mai ciwon sukari na nau'in ciwon sukari na biyu,
• babban cholesterol
• rashin haƙuri

Sau da yawa, masana suna ba da magani don haɗuwa, wanda aka gudanar tare da injections na insulin (dangane da nau'in ciwon sukari na 1). Wani fasali na Glucophage shine, ba kamar sauran magunguna masu rage sukari ba, yana hana safe da hanta gubar. Wannan shine dalilin da ya sa masana suka ba da shawarar shan magungunan kafin lokacin bacci don ƙara tasiri.

Yadda ake ɗaukar glucophage a cikin ciwon sukari

An zabi sashi na miyagun ƙwayoyi ne bisa la'akari da yanayin mutum na jiki. Na farko kashi ba zai iya zama fiye da 850 MG. A tsawon lokaci, gudanarwar glucophage a cikin ciwon sukari na iya ƙaruwa zuwa 2.25 MG. Koyaya, wannan yana ƙarƙashin yanayin cewa endocrinologist zai lura da hankali na haƙuri, rashin sakamako masu illa tare da ƙara yawan allurai. Tsarin yin amfani da maganin yana da hankali, saboda haka karuwar sashi ya zama mai hankali.

Yara (daga shekara 10) da matasa zasu iya amfani da Glyukofazh, azaman magani na daban, ko kuma ta hanyar haɗa shi da wasu magunguna. A halatta kashi gare su daga 500 zuwa 2000 MG. Tsofaffi mutane suna buƙatar yin shawara da likitan su, kamar yadda a cikin tsufa yanayin aikin kodan na iya lalata abubuwan da wannan maganin ya ƙunsa.

A matsakaici, ana shan maganin sau ɗaya a kowace kwanaki 2-3. Don hana sakamakon da ba a so da rikitarwa na hanji, kuna buƙatar sha Allunan kafin abinci ko bayan abinci. Tun lokacin da shan magani yayin abinci, kayan amfanin sa ba za su bayyana kansu ba, tasirin aikin zai ragu.

Tsarin inganta tsarin metabolism yana faruwa bayan mako guda ko kwana goma. Bayan kwana biyu, aiwatar da tattarawar sukari ya fara, wanda sakamakon hakan akwai raguwa a matakin sa a cikin jini.

Lokacin da aka biya bashin hyperglycemia, za a iya rage yawan sashi na magungunan a hankali, hada shi da sauran magunguna. Mafi nasarar haɗin Glucophage:

• tare da glibenclamide, wanda ke shafar glycemia kuma a haɗe tare da miyagun ƙwayoyi yana haɓaka wannan aikin,
• tare da insulin, a sakamakon abin da buƙatar homonin zai iya raguwa zuwa 50%.

Tare da saurin haɓakar bayyanar cututtuka na ciwon sukari, ana bada shawara don hana glucophage, yin amfani da 1 g a cikin sa'o'i 24, yayin da yake bin abincin. Wannan zai taimaka wajen dawo da nauyin jiki zuwa masu girma na al'ada, rage haƙuri da carbohydrate da matakan cholesterol.

Shin zai yiwu a maye gurbin miyagun ƙwayoyi da wani

A kan siyarwa akwai magunguna da yawa waɗanda ke ɗauke da metformin. Wannan bangaren shine babban wanda ake amfani da shi analogues na Glucophage, misali, Siofor ko Formmetin. Tun lokacin da aka yi amfani da wannan ɓangaren ya nuna kyawawan kaddarorin aikace-aikacen, yawancin manyan kamfanonin samar da magunguna daga ƙasashe daban-daban sun himmatu wajen ƙirƙirar magunguna dangane da shi.

Babban bambanci tsakanin magunguna daban-daban shine farashin su. Kuma don tantance wanda ya fi kyau, yana yiwuwa ne kawai daga yanayin ci gaban cutar, da kuma tsarin inganta yanayin jiki gaba ɗaya.

Glucophage don asarar nauyi idan babu ciwon sukari

Ga mutane ba tare da ciwon sukari ba, Glucofage na iya zama babbar hanyar rasa nauyi. Masana'antu ba su nuna cewa ana ba da damar magunguna masu ɗauke da metformin a matsayin wata hanyar rasa nauyi ba. Amma, duk da wannan, mutane da yawa masu nauyi sun sami ceto a cikin wannan.

Magungunan yana kara ji da jijiyoyin sel zuwa insulin na hormone, a dalilin hakan, yana rage yawan narkewa, ana rage kiba mai yawa. Babu ƙarancin mahimmanci shine gaskiyar cewa Glucofage yana da tasiri ga ci, yana rage shi kuma yana haɓaka kawar da carbohydrates daga hanji.

Saboda gaskiyar cewa ƙwayar ba ta rage sukari a ƙasa da ƙayyadaddun tsari ba, ana iya amfani dashi tare da matakan glucose na al'ada a cikin jikin mutum.

Don rasa nauyi, amma ba rushe hanyoyin aikin metabolism ba, mutum yana buƙatar la'akari da maɓallan maki da yawa:

• masana'antun basu bada garantin sakamako mai kyau (dangane da asarar nauyi),
• sakamakon zai bayyana ne kawai idan an bi dokokin abinci,
• sashi ya dogara da mutum halaye na jiki,
• Dole ne a rage adadin lokacin da duk wani alamun rashin damuwa ko tashin zuciya ya bayyana.

Gwargwadon yanayin amfani da miyagun ƙwayoyi don asarar nauyi yana da yawa, musamman, 'yan wasa kuma suna amfani da shi don hanzarta aiwatar da ƙona mai. Ba kamar masu ciwon sukari ba, waɗanda za su iya shan kwayoyi a duk rayuwarsu, ya isa ga masu wasannin motsa jiki su ɗauki tsawan kwanaki 20 na shan maganin, bayan haka suna buƙatar ba da shi har tsawon wata guda.

Yana da mahimmanci a yi la'akari da cewa ba tare da bincike na farko da likita ba, an haramta shi sosai don fara shan maganin a kan ku, musamman don asarar nauyi. Jiki na iya ba da amsa daban ga muhimman abubuwan da ya ƙunsa, sakamakon wanda rikitarwa zai bayyana. Duk wani ci na magunguna ya zama mai ma'ana kuma an yarda dashi tare da likitan halartar.

A shekara ta 47, an gano ni da ciwon sukari na 2. A cikin 'yan makonni kaɗan na sami kusan kilo 15. Rage jiki, bacci, jin rauni, hangen nesa ya fara zama.

Lokacin da na cika shekaru 55, na riga na saka kaina da insulin, komai yayi dadi sosai. Cutar ta ci gaba da ci gaba, rikicewar lokaci ya fara, motar asibiti ta dawo da ni daga duniya ta gaba. Duk lokacin da nayi tunanin cewa wannan lokacin zai zama na karshe.

Duk abin ya canza lokacin da 'yata ta bar ni in karanta labarin daya a Intanet. Ba za ku iya tunanin irin yadda nake gode mata ba. Wannan labarin ya taimaka mini in kawar da ciwon sukari gaba daya, cutar da ba a iya Magani. Shekaru 2 na ƙarshe na fara motsawa, a cikin bazara da lokacin rani Ina zuwa ƙasar kowace rana, girma tumatir kuma sayar da su a kasuwa. Aan uwana sun yi mamakin yadda nake ci gaba da komai, inda ƙarfi da ƙarfi ke fitowa, amma har yanzu ba su yarda cewa ina da shekara 66 ba.

Wanene yake so ya rayu tsawon rai, mai kuzari kuma ya manta da wannan mummunan cutar har abada, ɗauki mintuna 5 kuma karanta wannan labarin.

Allunan glucophage

Magungunan Glucophage a cikin ciwon sukari an wajabta shi ga marasa lafiya waɗanda ke kamuwa da cutar sukari na farkon ko ta biyu. Glucofage 1000 ya kafa kansa a matsayin ingantacciyar hanyar da mai haƙuri zai iya cimma raguwar sukari na jini, ba tare da haifar da hypoglycemia ba. Magungunan sun shahara don magance kiba, saboda yana taimakawa rage nauyin jiki. Wannan kayan yana kasancewa saboda amfani da miyagun ƙwayoyi a matsayin hanyar rasa nauyi, 'yan wasa don "bushe" jiki. Amfani da maganin ba daidai ba na iya haifar da lahani.

Akwai magungunan a cikin kwamfutar hannu. Gilashin mai siffar launuka mai launi mai launi an rufe shi da kwandon fim yana da fararen launi. Tsarin shine biconvex, akwai haɗari a garesu. Abun da magani:

Metformin hydrochloride (sashi mai aiki)

Opadry mai tsabta (shafi fim)

Magunguna da magunguna

Abubuwan da ke aiki na miyagun ƙwayoyi - metformin suna da tasirin hypoglycemic, wanda aka bayyana a cikin raguwar hyperglycemia. Magungunan suna iya rage glucose na jini duka biyu a cikin rana kuma kai tsaye bayan cin abinci. Hanyar aikin shine saboda iyawar miyagun ƙwayoyi don hana gluconeogenesis, glycogenolysis, haɓaka hankalin insulin kuma rage yawan glucose ta hanji. Wannan yana haifar da tasirin warkarwa. Hadaddun waɗannan ayyukan yana haifar da rage yawan glucose a cikin hanta da kuma haɓaka aikinsa ta tsokoki.

A bioavailability lokacin da aka ɗauka yana kusan 50-60%.Magungunan suna da ƙarancin ikon ɗaure su da ƙwayoyin plasma, suna shiga cikin sel jini. Magungunan da aka karɓa ba metabolized ba, kodan ya keɓe shi a wani ɓangare ta cikin hanjin. Cire rabin rabin rayuwa shine kusan awa 6.5. A cikin marasa lafiya waɗanda ba tare da aiki ba na sigar aiki, ana lura da raguwar ƙwayar metformin.

Alamu don amfani

Glucophage yana da babban alama guda ɗaya don amfani, magunguna na hukuma sun yarda da shi. Yin amfani da miyagun ƙwayoyi don asarar nauyi yana cikin haɗarin ku. Ana amfani da maganin don magance cututtukan type 2. Musamman amfani da shi ana bada shawara ga mutanen da ke da kiba, muddin ba a sami sakamako na maganin abinci da ilimin jiki ba. Manya da yara bayan shekara goma suna amfani da miyagun ƙwayoyi a matsayin monotherapy ko kuma tare da alƙawarin insulin daidai da jadawalin da likita ya tsara.

Yadda ake ɗauka

Dole ne a sha Glucophage a baki ba tare da taunawa ba, a wanke da ruwa. Ana bada shawara don ɗauka tare da abinci ko bayan cin abinci. Maganin farko na metformin ga manya shine 500 MG biyu zuwa sau uku / rana. Lokacin juyawa zuwa maganin kulawa, kashi yana farawa daga 1500 MG zuwa 2000 MG / rana. An rarraba wannan ƙarar a cikin allurai biyu zuwa uku don ƙirƙirar tsari mai ladabi don ƙwayar gastrointestinal. Matsakaicin sashi shine 3000 MG. Sauyawa zuwa magani tare da wani magani na hypoglycemic yana haifar da dakatar da shan na biyu.

Hade jiki tare da insulin ya hada da farkon matakan ma'aunin insulin a cikin jini. Yarda da miyagun ƙwayoyi ta yara, farawa daga shekaru 10, ana aiwatar da su ne bisa tsarin 500 MG biyu zuwa sau uku / rana. Bayan kwanaki 10-15, ana daidaita sashi gwargwadon canje-canje a matakan glucose na jini. Matsakaicin izini da aka yarda dashi shine 2000 MG / rana. Ga tsofaffi, likitan ne ya ba da maganin, la'akari da yanayin ƙodan.

Glucophage yayin daukar ciki

Gaskiyar ciki yakamata a yanke hukuncin shafewar maganin Glucofage 1000. Idan ciki ne kawai aka shirya, to lallai ya tanadi kawar da maganin. Wani madadin zuwa metformin shine maganin insulin a karkashin kulawar likita. Har zuwa yau, babu bayanai game da yadda miyagun ƙwayoyi ke hulɗa tare da madara, sabili da haka, an haramta amfani da Glucofage lokacin shayarwa.

Hulɗa da ƙwayoyi

Ba duk magunguna bane za'a iya haɗe su tare da Glucophage. An hana kuma ba da shawarar haɗuwa:

• m guba mai guba yana haifar da lactic acidosis, idan mutum bai ci abinci mai yawa ba, to yana da hanta,
• ba a ba da shawarar a hada shi da magani na Danazol tare da Glucophage dangane da tasirin hyperglycemic,
• babban allurai na chlorpromazine yana kara yawan glucose, ana bukatar daidaita sashi, kazalika da maganin cututtukan mahaifa,
• loop diuretics yana haifar da lactic acidosis, agonists beta-adrenergic yana haɓaka matakan sukari, insulin ya zama dole,
• antihypertensive jamiái rage hauhawar jini,
• Sinadarin sulfonylurea, insulin, acarbose da salicylates suna haifar da cututtukan jini,
• Nifedipine yana ƙara yawan narkewar metformin, sarrafa glucose ya zama dole,
• magungunan cationic (Digoxin, Morphine, Quinidine, Vancomycin) suna ƙara yawan lokacin metformin.

Side effects

Shan Glucofage 1000, zaku iya haduwa da bayyanar tasirin sakamako masu mummunan tasiri, kamar:

• lactic acidosis
• rage yawan bitamin B12, anemia,
• Ku ɗanɗani rikici
• tashin zuciya, amai, gudawa, ciwon ciki, rashin ci,
• erythema, kurji, itching na fata,
• na haɓaka haƙurin haƙuri,
• rashin lafiyan halayen, redness, kumburi,
• ciwon kai, tsananin farin ciki,
• hepatitis, aikin hanta mai rauni.

Sharuɗɗan sayarwa da ajiya

Ana bayar da maganin ta hanyar takardar sayan magani, adana shi a cikin wurin da ba a iya yiwa yara a zazzabi wanda bai wuce digiri 25 ba. Rayuwar shelf shine shekaru 3.

Kuna iya maye gurbin miyagun ƙwayoyi tare da jami'ai waɗanda ke ɗauke da abu guda aiki, ko tare da kwayoyi masu tasiri iri ɗaya akan jiki. Ana iya sayan maganin ƙwayoyin cuta (glucophage analogues) ana iya sayo su a cikin kantin magani a cikin nau'ikan Allunan ko maganin kawanya don sarrafa baki:

• Metformin
• Glucophage Long 1000,
• Glucophage 850 da 500,
• Siofor 1000,
• Metformin teva
• Bagomet,
• Glycometer
• Dianormet
• Diaformin.

Farashin glucose na 1000

Zaka iya sayan Glucophage kawai a cikin magunguna, saboda takardar sayen magani daga likita ana buƙatar siye. Kudin zai bambanta dangane da adadin allunan a fakitin. A cikin sassan kantin magani na Moscow da St. Petersburg, farashin maganin zai zama:

Yawan Allunan a cikin kunshin Glucofage, a cikin kwamfutoci.

Mafi ƙarancin farashi, a cikin rubles

Matsakaicin farashin, a cikin rubles

Anna, shekara 67. Ina da ciwon sukari na 2, don haka ina buƙatar kuɗi don kula da yawan glucose a cikin jini. Yata ta sayi mini allunan Glucofage wanda suka zo mini. Suna buƙatar shan giya sau biyu a rana don sukari ya zama al'ada. Magunguna sun bugu sosai, baya haifar da sakamako masu illa. Na gamsu, Na yi shirin shayar da su.

Nikolay, dan shekara 49 A binciken likita na karshe, sun bayyana matakin farko na nau'in ciwon sukari na 2. Yana da kyau cewa ba shine farkon ba, amma zai zama dole a allurar da insulin har ƙarshen rayuwa. Likitocin sun ba ni allunan glucophage. Sun gaya mini in sha har tsawon watanni shida, to sai a yi gwaje-gwaje, kuma idan komai, za su tura ni zuwa wani magani - Tsawon, wanda kuke buƙatar sha sau ɗaya a rana. Yayin shan, Ina son tasirin.

Rimma, shekara 58. Ina fama da ciwon sukari na shekara ta biyu. Ina da nau'in na biyu - ba insulin-dogara ba, don haka sai na sarrafa magungunan glycemic na baki. Ina shan Glucophage Tsayi - Ina son cewa ana iya amfani dashi sau ɗaya a rana, tasirin ya isa kwana ɗaya. Wani lokacin na sami tashin zuciya bayan shan magunguna, amma yana wucewa da sauri. In ba haka ba, ya dace da ni.

Vera, 25 shekara Daga budurwa, na ji cewa ta rasa nauyi akan Glyukofage. Na yanke shawarar neman ƙarin sake dubawa game da wannan kayan aiki, kuma ya yi mamakin tasirin. Bai kasance da sauki a samu ba - ana siyar da magunguna ta hanyar takardar sayan magani, amma na sami damar siyan su. Ta dauki daidai makonni uku, amma ba ta lura da sakamakon ba. Ba na jin daɗi, da akwai rauni gaba ɗaya, ina fatan babu wani abu mai mahimmanci.

Form sashi

500 MG, 850 MG da allunan da aka saka fim na 1000 MG

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abu mai aiki - metformin hydrochloride 500 MG, 850 MG ko 1000 MG,

magabata: povidone, magnesium stearate,

fim ɗin abun da ke ciki - hydroxypropyl methylcellulose, a cikin allunan 1000 MG - opadray tsarkakken YS-1-7472 (hydroxypropyl methylcellulose, macrogol 400, macrogol 8000).

Glucophage MG 500 da 850 MG: zagaye, allunan biconvex, farin da aka rufe fim

Glucophage 1000 mg: m, allunan biconvex, an rufe su da farin fim, tare da haɗarin fashewa a ɓangarorin biyu da alamar "1000" a gefe ɗaya daga kwamfutar hannu

Kayan magunguna

Pharmacokinetics

Bayan sarrafa bakin magana na allunan metformin, mafi girman ƙwayar plasma (Cmax) an kai shi bayan kimanin awa 2.5 (Tmax). Cikakken bayanin halitta a cikin mutane masu lafiya shine kashi 50-60%. Bayan sarrafawar bakin, 20-30% na metformin an keɓance su ta hanyar cikin jijiyoyin cikin (GIT) ba su canzawa.

Lokacin amfani da metformin a allurai da hanyoyin gudanarwa na yau da kullun, ana samun cikakkiyar maida hankali ga aikin plasma a cikin awanni 24-48 kuma gaba ɗaya ƙasa da 1 generallyg / ml.

Matsakaicin ɗaurin metformin zuwa ƙwayoyin plasma basu da sakaci. An rarraba Metformin a cikin sel jini. Matsakaicin matakin jini a cikin jini yana ƙasa da na plasma kuma an kai shi kusan lokaci guda. Matsakaicin girman rarraba (Vd) shine lita 63-76.

Ana amfani da Metformin wanda baya canzawa a cikin fitsari. Babu metformin metabolites da aka gano a cikin mutane.

Batun danyen danyen metformin ya zarce 400 ml / min, wanda ke nuna kawar da metformin ta hanyar amfani da hadewar dunkulalliyar ruwa da toshewar tubular. Bayan gudanarwar baka, rabin rayuwar kusan awoyi 6.5 ne.

Game da aiki na keɓaɓɓiyar aiki, ƙarar keɓaɓɓe yana raguwa gwargwadon karɓar kyautar creatinine, kuma saboda haka, kawar rabin rayuwa yana ƙaruwa, wanda ke haifar da haɓaka matakan plasma metformin.

Pharmacodynamics

Metformin shine biguanide tare da sakamako na antihyperglycemic, wanda ke rage duka matakan basal da na postprandial plasma glucose. Ba ya tayar da rufin insulin kuma sabili da haka baya haifar da ƙwanƙwasa jini.

Metformin yana da matakai guda uku na aikin:

yana rage haɓakar glucose ta hanta ta hana gluconeogenesis da glycogenolysis,

yana inganta haɓakawa da kuma amfani da glucose na gefe a cikin tsokoki ta hanyar ƙara ƙwayar insulin,

yana jinkirta ɗaukar glucose a cikin hanjin.

Metformin yana haɓaka aikin haɗin glycogen ta hanyar aiki akan glycogen synthase. Hakanan yana haɓaka iyawar kowane nau'ikan jigilar jini na membrane (GLUT).

A cikin karatun asibiti, shan metformin bai shafi nauyin jikin mutum ko ya ɗan rage shi ba.

Ko da kuwa tasirin sa akan cutar glycemia, metformin yana da tasirin gaske akan metabolism. A lokacin gwaji na asibiti da aka sarrafa ta amfani da allurai, an gano cewa metformin yana rage adadin kuzarin, ƙananan ƙarancin lipoproteins da triglycerides.

Sashi da gudanarwa

Monotherapy da haɗuwa da jiyya tare da wasu jami'ai masu maganin antidiabetic:

Matsakaicin farawa shine 500 ko 850 mg na Glucofage

Sau 2-3 a rana lokacin ko bayan abinci.

Bayan kwanaki 10-15 daga farawa, ya zama dole don daidaita sashi na miyagun ƙwayoyi dangane da sakamakon auna glucose na jini. Dosearfafawa mai saurin motsa jiki na iya taimakawa inganta haƙuri haƙuri.

A cikin marasa lafiya da ke karɓar babban adadin metformin hydrochloride (2-3 g kowace rana), Allunan biyu na Glucofage tare da maganin 500 MG za a iya maye gurbinsu tare da kwamfutar hannu guda ɗaya na Glucofage tare da sashi na 1000 mg. Matsakaicin shawarar da aka ba da shawarar ita ce 3 g kowace rana (an kasu kashi uku).

Idan kuna shirin canzawa daga wani magani na antidiabetic: dole ne ku daina shan wani magani kuma ku fara shan Glucofage na magani a cikin adadin da aka nuna a sama.

Hadawa tare da insulin:

Don cimma ingantaccen iko na glucose na jini, ana iya amfani da Glucofage da insulin azaman maganin haɗuwa. Aikin farko na Glucofage® shine 500 mg ko 850 mg sau 2-3 a rana, yayin da aka zaɓi kashi na insulin dangane da sakamakon auna glucose a cikin jini.

Yara da matasa:

A cikin yara daga shekaru 10, ana iya amfani da Glucofage duka tare da monotherapy kuma a hade tare da insulin. Yawan farawa na yau da kullun shine 500 MG ko 850 MG sau ɗaya kowace rana a lokacin ko bayan abinci. Bayan kwanaki 10-15 na maganin, ya zama dole don daidaita sashi na maganin bisa ga sakamakon auna glucose na jini. Dosearanci a hankali na iya inganta haɓakar gastrointestinal. Matsakaicin mafi girman shawarar da aka bayar shine 2 g na miyagun ƙwayoyi Glucofage kowace rana, an kasu kashi biyu-biyu.

Tsofaffi marasa lafiya:

Saboda yiwuwar rage aiki a cikin tsofaffi, dole ne a zaɓi kashi na miyagun ƙwayoyi Glucofage dangane da sigogi na aikin koda. Yin nazari akai-akai na aikin koda ya zama dole.

Marasa lafiya tare da nakasa aiki na renal:

Ana iya amfani da Metformin a cikin marasa lafiya tare da matsakaicin aiki na nakasassu mai matsakaici - mataki na 3a na cututtukan koda na ƙwayar cuta (ƙirar creatinine KlKr 45-59 ml / min ko ƙididdigar ƙididdigar glomerular na rSCF 45-59 ml / min / 1.73 m2) - kawai in babu sauran yanayi , wanda na iya ƙara haɗarin lactic acidosis, kuma tare da daidaitawar kashi na gaba: kashi na farko na metformin hydrochloride shine 500 mg ko 850 mg sau ɗaya a rana. Matsakaicin adadin shine 1000 MG kowace rana, an kasu kashi biyu. Kulawa sosai game da aikin renal (kowane watanni 3-6) wajibi ne.

Idan dabi'un CLKr ko rSCF sun ragu zuwa matakan 60 ml / min / 1.73 m2, dole ne a dakatar da amfani da metformin kafin ko lokacin binciken ta amfani da wakilan kwantar da aidin, kar a sake farawa a gaban awanni 48 bayan binciken kuma bayan sake sake nazarin aikin koda , wanda ya nuna sakamako na al'ada, ya samar da cewa ba zai lalace daga baya ba.

A cikin marasa lafiya da ke fama da rauni na matsakaiciyar matsakaici (eGFR 45-60 ml / min / 1.73 m2), ya kamata a dakatar da metformin a cikin sa'o'i 48 kafin amfani da wakilan iodine-da ke da bambanci kuma ba a sake kunnawa ba kafin awanni 48 bayan binciken kuma bayan kawai an maimaita shi ƙididdigar aikin na renal, wanda ya nuna sakamakon al'ada kuma ya bayar da cewa ba zai taɓar da baya ba.

Haɗuwa yana buƙatar taka tsantsan

Magunguna waɗanda ke da tasirin sakamako na hyperglycemic (glucocorticoids (tasirin tsarin da tasirin gida) da kuma Sympotomimetics): za a buƙaci ƙarin gwajin glucose na jini akai-akai, musamman a farkon magani. Idan ya cancanta, sashi na metformin tare da maganin da ya dace ya kamata a daidaita shi har sai an soke ƙarshen.

Diuretics, musamman maɗauran madaidaici na iya ƙara haɗarin lactic acidosis saboda tasirin mummunar tasirinsu akan aikin renal.

Umarni na musamman

Lactic acidosis abu ne mai matukar wahala amma rikitarwa na rayuwa mai wahala tare da babban mace-mace a cikin rashin magani na gaggawa, wanda zai iya haɓaka saboda tarawar metformin. Rahoton da aka ruwaito na lactic acidosis a cikin marasa lafiya na karɓar metformin ya haɓaka galibi a cikin marasa lafiya tare da ciwon sukari mellitus da gazawar na koda ko kuma tare da mummunan lalacewa na aikin na koda. Yakamata a yi taka tsantsan cikin yanayi wanda aikin na iya lalacewa, alal misali, a batun rashin ruwa (amai da gudawa, amai) ko alƙawarin antihypertensive, farjin diuretic, ko farji tare da magungunan anti-inflammatory anti-inflammatory (NSAIDs). A cikin waɗannan yanayin m, ya kamata a dakatar da jiyya na metformin na ɗan lokaci.

Sauran abubuwan haɗari masu haɗari yakamata ayi la'akari dasu, irin su ciwon sukari mara ƙarfi, ketosis, tsawan azumi, yawan shan barasa, ƙonewar hanta, da duk wani yanayin da ya shafi hypoxia (kamar lalacewar zuciya, ƙarancin ciwon zuciya).

Yakamata a bincika cutar lactic acidosis yayin taron bayyanar cututtuka, irin su murƙushe tsoka, raunin ciki, da / ko asthenia mai zafi. Ya kamata a sanar da marasa lafiya cewa ya kamata su ba da rahoton waɗannan alamu ga mai ba da lafiyarsu, musamman idan a baya marasa lafiya sun sami kyakkyawan haƙuri ga metformin. Idan ana zargin lactic acidosis, magani tare da Glucofage ya kamata a daina. Zai yiwu a sake dawo da amfani da miyagun ƙwayoyi Glucofage a kan bayanan mutum bayan yin la'akari da rabo / haɗari da aikin kayyade.

Lactic acidosis yana nunawa ta bayyanar da ƙarancin acidotic na numfashi, zafin ciki da hauhawar jini, daga cutarma. Sigogin gwaje-gwaje na gwaji sun haɗa da raguwa a cikin pH na jini, matakin lactate na plasma fiye da 5 mmol / l, karuwa a cikin tazara ta anion, da kuma lactate / pyruvate rabo. Idan ana zargin lactic acidosis, ya kamata a kwantar da mai haƙuri nan da nan. Yakamata likitocin su sanar da marasa lafiya hadarin da alamomin lactic acidosis.

Tun da metformin ya keɓe da ƙodan, kafin kuma a kai a kai yayin kulawa tare da Glucofage must, tilas ne a tabbatar da tsaftacewar creatinine (ta ƙayyadadden matakin creatinine a cikin jijiyoyin jini ta amfani da samfurin Cockcroft-Gault):

aƙalla 1 lokaci a shekara a cikin marasa lafiya da keɓaɓɓen aikin koda,

aƙalla sau 2-4 a shekara a cikin tsofaffi marasa lafiya, kazalika a cikin marasa lafiya tare da keɓantar da keɓancewar creatinine a ƙarshen iyakar al'ada.