Hypoglycemic wakili Glucofage - umarnin don amfani

Bayanin

Sashi 500 MG, 850 MG:
Farar fata, zagaye, allunan da aka sanya fim din biconvex.
Wani sashin giciye ya nuna fararen sutturar fata.

Sashi 1000 mg:
Farar fata, m, allunan biconvex, mai rufe fim, tare da hadari a garesu kuma a zana "1000" a gefe guda.
Wani sashin giciye ya nuna fararen sutturar fata.

Kayan magunguna na Pharmacotherapeutic

Metformin yana rage hyperglycemia ba tare da haifar da ci gaban hypoglycemia ba. Sabanin abubuwan da aka samo na sulfonylurea, ba ya tayar da rufin insulin kuma ba shi da tasirin hypoglycemic a cikin mutane masu lafiya. Theara hankalin mai karɓar mahaifa zuwa insulin da kuma amfani da glucose ta sel. Yana rage haɓakar glucose ta hanta ta hanyar hana gluconeogenesis da glycogenolysis.
Yana jinkirta ɗaukar ciki na glucose.

Metformin yana ƙarfafa haɗin glycogen ta hanyar aiki akan glycogen synthase. Capacityara ƙarfin jigilar kayayyaki na kowane nau'ikan jigilar jini na membrane.

Bugu da kari, yana da fa'ida mai tasiri akan metabolism na lipid: yana rage abun cikin jimlar cholesterol, karancin lipoproteins da triglycerides.

Yayin shan metformin, nauyin jikin mai haƙuri ko dai ya kasance tsayayye ko yana raguwa da matsakaici.

Karatuttukan asibiti sun kuma nuna tasirin maganin Glucofage ® don rigakafin cutar sankara a cikin marassa lafiya tare da ƙarin abubuwan haɗari don haɓakar ciwon sukari irin na 2, wanda yanayin canje-canjen rayuwa bai ba da damar isasshen ikon sarrafa glycemic ba.

Pharmacokinetics

Orazantawa da rarrabawa
Bayan gudanar da baki, ana amfani da metformin daga cikin gastrointestinal fili sosai. Cikakken bioavailability shine 50-60%. Matsakaicin maida hankali (Cmax) (kamar 2 μg / ml ko 15 μmol) a cikin plasma an kai shi bayan sa'o'i 2.5. Tare da shigar abinci abinci a lokaci guda, yawan shan metformin yana raguwa kuma yana jinkirta. An rarraba Metformin cikin hanzari a cikin nama, kusan ba a ɗaura shi ga furotin plasma ba.

Metabolism da excretion
Yana cikin metabolized sosai ga rauni sosai kuma kodan ya keɓe shi. Tabbatar da metformin a cikin batutuwa masu ƙoshin lafiya shine 400 ml / min (sau 4 fiye da yardawar creatinine), wanda ke nuna kasancewar ƙwayar canalic aiki. Rabin rayuwar shine kimanin awanni 6.5. Tare da gazawar koda, yana ƙaruwa, akwai haɗarin tarin ƙwayoyi.

Contraindications

• Hypersensitivity zuwa metformin ko ga wani na da,
• mai ciwon sukari ketoacidosis, maganin ciwon sukari, coma,
• gazawar koda ko gauraya aiki na keɓaɓɓen aiki (keɓantar da keɓaɓɓen ƙasa da miliyan 45 / min),
• mummunan yanayin da ke tattare da haɓakar haɓakar ɗan adam: fitsari (tare da gudawa, amai), cututtukan da ke yaɗuwa, girgiza,
• bayyanar cututtuka na asibiti a cikin cututtukan cututtukan ƙwayar cuta ko cututtukan ƙwayar cuta wanda zai iya haifar da ci gaban hypoxia na nama (ciki har da ƙarancin zuciya, gazawar zuciya tare da rashin ƙarfi a cikin jijiyoyin jiki, gazawar numfashi, raunin myocardial m),
• babban aiki da raunin da ya faru lokacin da aka nuna maganin insulin (duba sashen "Umarnin na Musamman"),
• hanta hanta, gazawar hanta,
• na kullum barasa, guba mai guba,
• ciki
• lactic acidosis (gami da tarihi),
• Yi amfani da ƙasa da awanni 48 kafin da kuma a cikin awanni 48 bayan gudanar da karatun radioisotope ko raa-ray tare da gabatarwar wani iodine wanda ke ɗauke da matsakaiciyar matsakaici (duba sashin "hulɗa da wasu kwayoyi"),
• bijiro da tsarin yawan hypocaloric (ƙasa da 1000 kcal / rana).

Tare da taka tsantsan

• a cikin mutanen da suka manyanta 60 waɗanda suke yin aiki na zahiri, waɗanda ke da alaƙa da haɓakar haɓakar lactic acidosis,
• a cikin marasa lafiya tare da gazawar koda
• yayin shayarwa.

Yi amfani da lokacin daukar ciki da lokacin shayarwa

Lokacin da ake shirin yin juna biyu, haka kuma yayin da ake yin ciki a bango na shan metformin tare da ciwon suga da nau'in ciwon sukari na 2, yakamata a dakatar da maganin, kuma idan akwai nau'in ciwon sukari na 2, an wajabta maganin kansa. Wajibi ne a kula da abubuwan glucose a cikin jini na jini a matakin kusa da na al'ada don rage hadarin cutar tayin.

Metformin yakan shiga cikin madarar nono. Ba a lura da sakamako masu illa a cikin jarirai yayin shayarwa yayin shan metformin. Koyaya, saboda iyakance adadin bayanai, ba da shawarar amfani da miyagun ƙwayoyi lokacin shayarwa ba. Dole ne a yanke shawarar dakatar da shayarwa ta la'akari da amfanin shayarwa da kuma haɗarin haɗarin sakamako masu illa ga jariri.

Sashi da gudanarwa

Manya:
Monotherapy da haɗuwa da magani tare da sauran wakilai na baki na cututtukan fata na nau'in ciwon sukari na 2 na mellitus:

• Yawan farawa na yau da kullun shine 500 MG ko 850 mg sau 2-3 a rana bayan ko lokacin abinci.
• Kowane kwana na 10-15, ana bada shawara don daidaita sashi gwargwadon sakamakon aunawa da yawaitar glucose a cikin jini. Aara sauƙaƙawa a cikin kashi na taimaka wajan rage tasirin sakamako daga hanji.
• Adadin kulawa da miyagun ƙwayoyi yawanci 1500-2000 mg / rana. Don rage tasirin sakamako daga cututtukan gastrointestinal, ya kamata a raba kashi na yau da kullum zuwa kashi 2-3. Matsakaicin adadin shine 3000 MG / rana, ya kasu kashi uku.
• Marasa lafiya suna ɗaukar metformin a cikin allurai na 2000-3000 mg / day zasu iya canjawa zuwa miyagun ƙwayoyi Glucofage ® 1000 mg. Matsakaicin shawarar da aka ba da shawarar ita ce 3000 MG / rana, ya kasu kashi uku.

Game da batun canji daga shan wani wakili mai zubar da jini: dole ne ku daina shan wani magani kuma ku fara shan Glucofage ® a cikin adadin da aka nuna a sama.

Hadawa tare da insulin:
Don cimma ingantaccen iko na glucose na jini, metformin da insulin a cikin marasa lafiya da ke dauke da ciwon sukari na 2 ana iya amfani dasu azaman hanyar haɗuwa. Yawancin farawa na yau da kullun na Glucofage ® shine 500 MG ko 850 mg sau 2-3 a rana, yayin da aka zaɓi kashi na insulin dangane da haɗuwa da glucose a cikin jini.

Yara da matasa:
a cikin yara daga shekara 10, ana iya amfani da miyagun ƙwayoyi Glucofage ® duka a cikin monotherapy kuma a hade tare da insulin. Yawan farawa na yau da kullun shine 500 MG ko 850 MG 1 lokaci ɗaya kowace rana bayan ko lokacin abinci. Bayan kwanaki 10-15, dole ne a daidaita adadin gwargwadon yawan tattarawar glucose jini.
Matsakaicin adadin yau da kullun shine 2000 MG, ya kasu kashi 2-3.

Monotherapy don maganin ciwon sukari:
Yawan da aka saba dashi shine 1000-1700 mg kowace rana bayan ko lokacin abinci, an kasu kashi biyu.
An ba da shawarar yin kulawa da glycemic a kai a kai don tantance buƙatar ƙarin amfani da miyagun ƙwayoyi.

Marasa lafiya tare da kasawa koda
Za'a iya amfani da Metformin a cikin marasa lafiya tare da gazawar matsakaiciyar matsakaici (tsaftacewar halitta 45-59 ml / min) kawai a cikin rashin yanayin da zai iya ƙara haɗarin lactic acidosis.

• Marasa lafiya tare da keɓantar da creatine na 45-59 ml / min: matakin farko shine 500 MG ko 850 MG sau ɗaya a rana. Matsakaicin adadin shine 1000 MG kowace rana, an kasu kashi biyu.

Yakamata a kula da aikin koda (kowane watanni 3-6).
Idan keɓantar da keɓaɓɓiyar fata ba ta ƙasa da 45 ml / min, ya kamata a dakatar da miyagun ƙwayoyi nan da nan.

Tsofaffi marasa lafiya:
saboda yiwuwar raguwa a aikin na koda, dole ne a zaɓi kashi na metformin a ƙarƙashin kulawar yau da kullun akan alamun alamun aikin koda (don ƙididdige yawan halittar creatinine a cikin ƙwayar jini a kalla sau 2-4 a shekara).

Tsawon lokacin jiyya

Ya kamata a sha Glucofage ® kowace rana, ba tare da tsangwama ba. Idan an daina kulawa, mai haƙuri ya kamata ya sanar da likita.

Bayani na gaba daya, abun da ya shafi da kuma sakin saki

Glucofage Long shine shirye-shiryen masu ciwon sukari na rukuni na biguanide tare da aiki mai aiki na Metformin hydrochloride. Akwai shi a cikin adadin 500, 850, 1000 MG.

Lokacin da aka shiga ciki, yana cikin hanzari a talla. Matsakaicin mafi girma yana faruwa ne bayan sa'o'i 2 bayan gudanarwa.

Wannan zai baka damar cimma sakamako kamar haka:

• daidaita al'ada jini
• theara martanin kyallen takarda zuwa kwayoyin da aka samar,
• ƙananan hanta glucose,
• rage girman hancin glucose,
• dawo da lafiyar jiki zuwa al'ada,
• haɓaka ƙwayar lipid,
• ƙananan ƙwayoyin cuta.

Allunan suna da tasiri a cikin kamuwa da cutar sankara.

A kan siyarwa, ana gabatar da maganin a cikin nau'in kwamfutar hannu, an rufe shi da harsashi na biconvex na farin launi. Maida hankali ne akan sashi mai aiki shine 500, 850, 1000 MG. Don saukaka wa mai haƙuri, an sassaka matakin maganin akan ɗaya rabin kwamfutar.

Pharmacology da pharmacokinetics

Abinda ke ciki na allunan sun hada da Metformin, wanda ke ba da tabbacin tasirin sakamako mai lalacewa. A cikin marasa lafiya da matakan glucose mai yawa, yana rage shi zuwa al'ada. A cikin mutane masu matakan glucose na al'ada, sukari jini baya canzawa.

Ayyukan aiki mai aiki ya dogara da hanawar gluconeogenesis da glycogenolysis, ikon haɓaka hankalin insulin da rage sha a cikin ƙwayar gastrointestinal. Bugu da kari, wannan maganin yana hanzarta tafiyar matakai na rayuwa a jiki kuma yana rage kwazayi.

Matsakaicin mafi yawa na Metformin ana lura da sa'o'i 2-3 bayan gudanarwarsa. Wani fasali na Glucophage Long shine karancin matsayin da ke daure wa garkuwar plasma. Babban kodai yana aiki da koda da hanjin cikin sa'o'i 6.5.

Bayan shan Glucofage, an lura da cikakkiyar adsorption na Metmorphine GIT. Abubuwan da ke aiki suna rarraba cikin hanzari a cikin kyallen takarda. Mafi yawan ana toshewa ta hanjin kodan, sauran kuma ta cikin hanjin. Hanyar tsarkake magungunan yana farawa awanni 6.5 bayan shan shi. A cikin marasa lafiya da matsalolin koda, rabin rayuwar yana ƙaruwa, wanda ke ƙara haɗarin tarin Metformin.

Manuniya da contraindications

Dangane da umarnin da aka haɗo da Glucofage, an nuna shi ga masu ciwon sukari na 2, waɗanda suke da yawa duk da lura da tsarin abinci.

Yawancin marasa lafiya suna amfani da Glucofage don rasa nauyi. A wannan yanayin, ya kamata ku bi rage yawan kalori da kuma gudanar da tsarin motsa jiki na yau da kullun. Wannan yana ba ku damar cimma kyakkyawan sakamako a cikin ɗan gajeren lokaci.

Kamar kowane magani, glucophage yana da contraindications.

An haramta maganin:

• mutane tare da rashin haƙuri akan ɗayan abubuwan haɗin,
• tare da coma ko ciwon sukari ketoacidosis,
• tare da aiki mara kyau da kodan da zuciya,
• tare da wuce gona da iri na kullum da cututtuka,
• tare da shan giya a lokaci daya,
• tare da guban jiki,
• yayin daukar ciki da lactation,
• tare da lactic acidosis,
• Kwanaki 2 kafin daukar hoto da kwana 2 bayansa,
• mutane yan kasa da shekara 10
• bayan tsananin motsa jiki.

Shan magungunan tsofaffi ana gudanar da shi a karkashin kulawar kwararrun.

Umarnin don amfani

Mafi ƙarancin farko shine 500 ko 850 MG, wanda aka kasu kashi da yawa. Ana ɗaukar kwayoyin magani tare ko kuma nan da nan bayan abinci. Ana aiwatar da canji na sashi bayan canjin sukari.

Matsakaicin sashi shine 3000 MG kowace rana, wanda shima ya kasu kashi dayawa (2-3). A hankali da maida hankali kan abu mai aiki a cikin jini yana ƙaruwa, raguwar sakamako masu illa daga hanji.

Lokacin haɗin Glucofage Long tare da insulin, shawarar da aka bada shawarar shine 500, 750, 850 mg sau 2-3 a rana. Likita ne ya tsara sashi na insulin.

Ana amfani da allunan duka a hade tare da wasu magunguna, kuma daban. A cikin lokuta na musamman, ana yarda da shiga ne tun daga shekaru goma. Ana yin maganin ne ta hanyar likita bisa la'akari da maida hankali akan sukari jini. Mafi ƙarancin shine 500 MG, matsakaicin shine 2000 MG.

Marasa lafiya na musamman da kuma Jagorori

Kafin amfani da maganin, dole ne ka nemi likita, ka yi nazarin tasirin sakamako, kuma ka san kanka tare da shawarwarin marasa lafiya na ƙungiyar ta musamman:

1. Lokacin haila. Amincewa da Glucophage yayin haihuwar yaro da lactation an haramta shi sosai. Ana kiyaye glucose na jini ta hanyar allurar insulin. Haramcin kwayoyin hana daukar ciki yayin shayarwa saboda karancin bincike.
2. Yaran zamani. Yin amfani da glucophage ta yara thean ƙasa da shekara 18 ba a son su. Yana da gaskiyar amfani da maganin ta hanyar yara na 10. Ikon likita ya zama tilas.
3. Tsofaffi mutane. Tare da taka tsantsan, ya kamata ku sha maganin don tsofaffi waɗanda ke fama da cututtukan koda da cututtukan zuciya. Kwararrun likitan ya kamata kula da su.

A wasu cututtuka ko yanayi, ana ɗaukar magani da hankali, ko an soke shi gaba ɗaya:

1. Lactic acidosis. Lokaci-lokaci, tare da amfani da Metformin, wanda ke da alaƙa da kasancewar lalacewa na koda a cikin haƙuri. Cutar tana haɗaka tare da murdiya tsoka, jin zafi a cikin ciki da hypoxia. Idan ana zargin wata cuta, cire magani da kuma shawarar kwararru wajibi ne.
2. Cutar koda. Game da aiki mai rauni na yara, yakamata a yi taka tsantsan, tunda jiki yana ɗaukar nauyin cire Metformin daga jiki. Sabili da haka, kafin fara amfani da miyagun ƙwayoyi, ya kamata a kula da hankali ga matakin creatinine a cikin jijiyar jini.
3. Turewa. Kwayar ta daina kwana biyu kafin a fara aiki. Za a sake dawowa da jinya daga lokaci guda.

A cikin kiba, shan kwayoyin hana daukar ciki suna taimakawa nau'in masu ciwon sukari guda 2 suna daidaita nauyin su. A ɓangaren mai haƙuri, ana buƙatar yarda da ingantaccen tsarin abinci wanda a cikin adadin adadin kuzari ya kamata ya zama akalla 1000 kcal a kowace rana. Isar da gwaje-gwaje na dakin gwaje-gwaje zai baka damar saka idanu akan yanayin jikin mutum da kuma tasirin glucophage.

Side effects da yawan abin sama da ya kamata

Jerin tasirin sakamako daga shan miyagun ƙwayoyi ya dogara ne akan yawan karatun likita da kuma sake dubawar masu haƙuri:

1. Rage fitowar Vitamin B12 yana haifar da haɓakar cututtuka irin su anemia da lactic acidosis.
2. Canja a cikin ɗanɗano dandano.
3. Daga cikin jijiyoyin ciki, zawo, zazzabi a cikin ciki, da kuma rashin ci. Aiki yana nuna cewa ƙayyadadden alamun cutar an lura da ita cikin yawancin marasa lafiya kuma suna wucewa a cikin 'yan kwanaki.
4. A matsayin rashin lafiyar, rashin lafiyar urticaria mai yiwuwa ne.
5. Rashin aiwatar da matakan metabolism na iya haifar da yanayin da ba a tsammani ba, sakamakon abin da warware gaggawa na kwamfutar hannu zai yiwu.

Hadin gwiwar Magunguna da Analogs

Tasirin hyperglycemic na miyagun ƙwayoyi Danazol ya sa ya kasa haɗuwa da shi tare da Glucofage. Idan ba zai yuwu a ware magungunan ba, likitan ne ya gyara shi.

Abubuwan da ke dauke da sinadarai da ke cikin fata suna haɓaka haɗarin lactic acidosis.

Babban allurai na chlorpromazine (fiye da 100 MG / rana) na iya haɓaka glycemia da rage matakin sakin insulin. Ana buƙatar yin gyaran fuska ta likitoci.

Gudanar da ayyukan diuretics yana ƙara haɗarin lactic acidosis. Haramun ne a dauki Glucofage tare da matakin creatinine kasa da miliyan 60 / min.

Magungunan Iodine da ake amfani da su don maganin mura a cikin marasa lafiya da ke fama da matsalar koda na haifar da lactic acidosis. Sabili da haka, idan ana binciken mai haƙuri ta hanyar ɗaukar hoto, janyewar kwamfutar hannu ya zama dole.

Tasirin hypoglycemic na maganin yana inganta ta hanyar sulfonylurea, insulin, salicylates, acarbose.

Ta hanyar analogs ana nufin magungunan da aka yi niyya don maye gurbin babban magani, an yarda da amfanin su tare da likitan halartar:

1. Bagomet. An tsara shi don marasa lafiya da masu ciwon sukari na 2 tare da kiba mai yawa. Ana amfani dashi a cikin maganin monotherapy kuma a hade tare da insulin.
2. Glycometer. Magani ga masu ciwon sukari na 2 suna da kiba. Ana iya amfani dashi don nau'in ciwon sukari na 1 a hade tare da insulin.
3. Dianormet. Taimakawa daidaita matakan hormone, musamman ga marasa lafiya da rashi mai narkewar kiba.

Waɗannan analog ɗin suna cikin buƙatu kuma sun shahara tsakanin masu ciwon sukari na 2.

Pharmacokinetics

Sau ɗaya a cikin jikin mutum, abubuwa masu aiki na Glucofage suna kara azama da ƙwayoyin sel zuwa insulin, wanda aka rage saboda kasancewar nau'in ciwon sukari na 2 na mellitus. Glucose yana farawa sosai ta hanyar tsokoki da sauran kyallen takarda, matakinsa a cikin jini yana raguwa. A lokaci guda, abin da yake samarwa a cikin hanta da kuma sha a cikin ƙwayar gastrointestinal (GIT) yana raguwa. A lokaci guda, metformin ba shi da kusanci a cikin metabolism kuma an keɓance shi ta hanjin kodan shida zuwa takwas bayan shan allunan.

Ko da kuwa sukari na jini, ƙwayar tana taimakawa wajen haɓaka metabolism na lipid, rage rage ƙwayoyin triglycerides, lipoproteins da cholesterol. A lokaci guda, ana hana gluconeogenesis da glycogenolysis, wanda ke haifar da haɓakawa ga lafiyar mai haƙuri. Matsakaicin sakamako bayan shan Glucofage yana faruwa tsawon sa'o'i biyu zuwa bakwai bayan sarrafa bakin, dangane da wane nau'in allunan aka yi amfani da shi. A wannan lokacin, abubuwan da ke tattare da magunguna suna da lokacin da za su iya shiga cikin narkewa, kuma bioavailability nasu, a matsayin mai mulkin, ya wuce 50-60%.

Tsarin saki, abun da ke ciki da yanayin ajiya

Zuwa yau, ana samun maganin a nau'ikan allunan biyu: Glucophage da Glucophage XR. Na biyun sun bambanta da na farko ta hanyar jinkirin sakin abu mai aiki, don haka sakamakon su yana faruwa ne daga baya. Ana sayar da allunan alamar XR a cikin kantin magani a fakitoci na talatin ko sittin.

Hakanan akan saba, wanda ba shi tsawan glucophage kuma ana baiwa abokan ciniki a fakitoci wadanda suke dauke da allunan da ke ciki talatin zuwa sittin. Akwai shi a cikin nau'ikan uku: Glucofage 500, Glucofage 850 da Glucofage 1000. Dangane da haka, kowane kwamfutar hannu, dangane da alamar, ya ƙunshi milligram 500, 850 ko 1000 na abu mai aiki - metformin hydrochloride. A lokaci guda, abubuwan da ke cikin wannan abun a cikin allunan XR an gyara kuma sunada milligram 500.

Kamar haka daga umarnin don amfani da miyagun ƙwayoyi, yakamata a adana shi a cikin bushe, wuri mai duhu a zazzabi wanda bai wuce 25 digiri Celsius ba. Yara bai kamata su sami damar zuwa allunan ba, saboda wannan magani na iya cutar da lafiyar ɗan adam idan anyi amfani da shi ba tare da kyau ba. Rayuwar shiryayye na Glucophage 1000 da XR shekaru uku ne, kuma Glucofage 500 da 850 shekaru biyar ne.

Hanyar amfani da miyagun ƙwayoyi

Ana nuna Glucophage don amfani da marasa lafiya da ke fama da nau'in ciwon sukari na 2 na sukari. Tare da wannan nau'in cutar, ana samar da isasshen ƙwayar insulin a cikin jikin mutum, amma glucose ɗin da ke zirga zirgar ta ba ta cika jikin ta da kyallen takarda yadda ya kamata. Wannan na faruwa ne sakamakon raunin masu karɓar rakiyar dake jikin saman membranes, wanda sakamakon ƙwayoyin sel suka kasa gane insulin kuma basa hulɗa dashi. Sau da yawa, nau'in ciwon sukari na 2 na mellitus baya buƙatar magani, kuma maganin yana zuwa kawai yana ƙuntata mai haƙuri ga abinci da motsa jiki na yau da kullun. Idan waɗannan hanyoyin ba su taimaka ba, ana amfani da magunguna kamar Glucofage, waɗanda galibi ana tsara su azaman monotherapy. Ta yaya zaka iya amfani da allunan kwamfutocin da suka kasance, ya kamata ka fahimta dalla dalla.

1) Glucophage na daidaitaccen aiki an wajabta shi ga marasa lafiya a cikin nau'i na allunan dauke da 500, 850 ko 1000 milligram na abu mai aiki, dangane da sashi na yau da kullun, wanda likitan halartar ya ƙaddara. Ya kamata a sha kwayoyin magani lokacin ko bayan abinci, ba tare da taunawa da shan su da ruwa ba. Sakamakon su yana faruwa bayan sa'o'i biyu zuwa uku kuma yana wanzuwa har zuwa kashi na gaba. Adadin yau da kullun don balagaggu shine 1500-2550 milligrams kuma ya ƙunshi shan kwamfutar hannu guda ɗaya da safe, yamma da yamma. A wannan yanayin, ba za ku iya ɗaukar fiye da milliyan 3000 na metformin kowace rana ba, tunda wannan adadin shine mafi girman izinin kashi.

Ga yara masu shekaru sama da goma, wanda shi ma an amince da Glucofage don amfani, matsakaicin sashi na yau da kullun shine 2000 milligram na kayan aiki. Haka kuma, a farkon farawar, ba ya wuce milligram 850, bayan hakan yana ƙaruwa kowace rana. Idan yaro yayi amfani da insulin a lokaci guda kamar allunan, sashi na ƙarshen dole ne a daidaita shi daidai da matakin sukari na yanzu na jini.

Hakanan ana bada shawarar karuwar ƙwayar hankali a cikin manya. Da farko, zai iya zama miligram 1000-1500 na metformin kowace rana, sannan sannu a hankali yana ƙaruwa tsawon wata guda. Idan ma'aunin glucose a cikin jini ya nuna karancinsa, sashi, akasin haka, yana raguwa. Amma ga tsofaffi da marasa lafiya da ke fama da cututtukan koda, a gare su ana amfani da lissafin maganin yau da kullun bayan ƙaddamar da binciken da ya dace.

2) Glucophage XR tsawan mataki ana nuna don amfani gwargwadon tsarin ɗaya daidai da aikin Glucophage na yau da kullun. Bambanci a farkon shine buƙatun ɗaukar allunan ba uku ba, amma sau ɗaya ko sau biyu a rana, tasirin bayan shan miyagun ƙwayoyi yana faruwa awanni shida zuwa bakwai bayan shan, wanda zai ba ku damar amfani da shi ba sau da yawa. A matsayinka na mai mulkin, a farkon farkon karatun, mai haƙuri ya kamata ya ɗauki kwamfutar hannu guda ɗaya kowace rana, yana dauke da milligrams 500 na metformin. Bayan haka, ana daidaita sashi daidai da canje-canje a hoton cutar. Ana amfani da adadin yau da kullun fiye da sau ɗaya a kowane mako biyu. In ba haka ba, akwai yiwuwar raguwa mai yawa a cikin matakan glucose na jini, wanda mai haƙuri ba zai iya sani ba, yana sanya lafiyar sa cikin haɗari.

Yawan shaye-shaye game da Glucophage da Glucophage XR na iya haifar da mummunan sakamako. Mai haƙuri na iya haɓaka lactic acidosis, yana buƙatar asibiti da gaggawa da kuma hanyar likita na magani a asibiti. Don cire metformin da lactate daga jiki, ana buƙatar buƙatar hemodialysis da sauran samfuran kulawa mai mahimmanci. Sabili da haka, amfani da wannan magani ya kamata a kula da shi tare da mafi girman nauyin, ba tare da kara yawan kullun ba tare da sanin likita ba.

Hulɗa da ƙwayoyi

Saboda yawan ƙwayoyin Glucophage, ba a ba da shawarar a haɗa shi da magunguna da magunguna da aka sha dabam ba. Muna magana ne game da wakilai masu amfani da radiopaque na iodine: Danazole, Nifedipine, Chlorpromazine, glucocorticosteroids, ethanol, loop diuretics, beta2-adrenergic agonists, cationic drugs da ACE inhibitors.

1) Iodine-dauke da kayan aikin radiopaque wadanda ake amfani da su yayin gwajin kimiyyar hana daukar ciki don yin aiki tare da Glucofage. Haɗin su na iya haifar da haɓakar lactic acidosis a cikin haƙuri. Sabili da haka, jarrabawa a cikin irin waɗannan halayen dole ne a jinkirta shi, ko a lokacin da aka gudanar da shi, ƙin shan maganin. Don yin wannan, ya isa ya dakatar da shan allunan kwana biyu kafin a aiwatar kuma a ci gaba da shi kwana biyu bayan an gama shi.

2) Ethyl barasa, wanda shine ɗayan dukkanin abubuwan shaye-shaye kuma yana dauke da wasu magunguna, ba a ba da shawarar haɗuwa da Glucofage ba. An sake yin bayanin wannan ta hanyar lactic acidosis, wanda zai iya haɓakawa da asalin tsarin maye. Wannan gaskiya ne musamman ga mutanen da ke fama da gaɓar hanta, kuma suna bin abincin mai kalori kaɗan kuma suna cin abinci kaɗan.

3) Chlorpromazine a cikin lura da hypoglycemia Glucofage ya kamata a yi amfani dashi tare da kulawa sosai, saboda yana ƙara matakan sukari na jini, yana rage jinkirin aiwatar da sakin insulin. Musamman, wannan ya shafi allurai na Chlorpromazine - fiye da milligram na ɗari a kowace rana. Idan ba zai yiwu a ƙi ɗauka ba, ya kamata mai haƙuri ya kasance a shirye don gaskiyar cewa dole ne ya auna ƙwanƙwasa jini koyaushe don guje wa ɓacin rai da haɓaka.

4) Nifedipine gabaɗaya baya tasiri akan tsarin rage ƙwayar cutar, amma yana iya ƙara yawan sha, kuma, gwargwadon haka, mafi girman taro. Saboda haka, yayin shan wannan maganin rigakafin ƙwayar cuta, sashi na Glucophage ya kamata a daidaita ta tuntuɓar likita.

5) Dinazole a hade tare da magungunan hypoglycemic na iya haifar da haɓaka glucose na jini, saboda haka ya kamata ku ƙi amfani da shi yayin aiwatar da aikin likita. Idan ba za a iya yin wannan ba saboda wasu dalilai, dole ne a yi canje-canje ga abubuwan yau da kullun na Glucofage.

6) Glucocorticosteroids (GCS) yana haɓaka matakan sukari na jini kuma, a ƙarƙashin mummunan yanayi, na iya haifar da ketosis. Saboda gaskiyar cewa waɗannan magungunan Topical da na tsari sun rage haƙuri na glucose, amfanin su a lokaci guda tare da Glucofage yana buƙatar daidaita yanayin yau da kullun na ƙarshen.

7) Beta2-adrenergic agonists, wanda aka nuna don amfani dashi azaman injections, yana karɓar masu karɓar beta2-adrenergic, ƙara haɓakar glucose a cikin jini na jini. Wannan na iya buƙatar mai haƙuri ya ɗauki ƙarin matakan don magance hyperglycemia, wanda, a matsayin mai mulkin, ya ƙunshi buƙata don saka insulin a cikin jini a kai a kai.

8) Ba a ba da shawarar yin amfani da diuretics sau ɗaya ba tare da Glucofage, musamman a gaban cin nasara na koda. Wannan na iya haifar da ci gaban lactic acidosis tare da duk sakamakon da ke biyo baya.

9) Yana nufin ma'anar sarrafa hawan jini, wanda ke cikin rukuni na ACE inhibitors, ba da shawarar don amfani yayin shan Glucofage. Suna rage yawan sukarin jini kuma suna iya haifar da karancin glucose, sakamakon yunwar kwakwalwa.

10) Wakilai na cationic, waɗanda suka haɗa da Morphine, Quinine, Amiloride, Triamteren, da dai sauransu, zasu iya shiga rikici tare da metformin, yana hana shaye-shayensa. Sabili da haka, ya kamata ku guji amfani da su yayin shan maganin.

Side effects

Yin amfani da miyagun ƙwayoyi na dogon lokaci na iya haifar da sakamako masu illa, waɗanda kuma ana buƙatar ambata. Daga umarnin hukuma game da maganin, zai iya bibiyar hakan yana iya haifar da sakamako masu illa:

• rage dandano yayin abinci,
• cuta narkewa: zawo, amai, zafin ciki,
• lactic acidosis
• sha na bitamin B12 (musamman ma mahimmanci ga megaloblastic anemia),
• fata rashes, redness, itching,
• hepatitis (yawanci a gaban abubuwan haifar da damuwa).

Yana da mahimmanci a san cewa alamomin da suka fi yawa a cikin aikin likita sune waɗanda aka haɗa su a cikin abubuwa biyu na farko daga jerin waɗanda ke da alaƙa da narkewa kai tsaye. Sauran raunin da ke sama suna faruwa ne a cikin marasa lafiya da wuya, a kusan misalin guda ɗaya daga cikin dubbai da yawa. Zai zama da amfani don ƙara cewa a farkon alamun lalacewar lafiyar bayan shan miyagun ƙwayoyi, ya kamata ka tuntuɓi likita nan da nan don guje wa rikice-rikice masu yiwuwa.

Umarni na musamman

A cikin binciken da aka yi kwanan nan, an gano cewa glucophage baya shafar lafiyar yara lokacin balaga. Koyaya, wannan yanayin ba za a kira shi cikakken karatu ba, kuma har yanzu likitocin ba su ba da shawarar yin amfani da maganin ba tun yana da shekaru goma zuwa goma sha takwas. Don haka, a cikin ilimin yara, wannan kayan aikin ba a amfani da shi ba kuma ana yawanci maye gurbin shi da analogues mafi aminci.

Musamman hankali ga sakamakon mummunan sakamako daga shan miyagun ƙwayoyi ya kamata a bai wa mutanen da ke fama da kiba saboda cututtukan narkewa. Yawancin lokaci, maganin su yana gudana a layi ɗaya tare da tsayayyen abinci, wanda, tare da yawan ƙwayar metformin, na iya haifar da raunin ƙwayar jini sosai. Hakanan ya shafi digiri ɗaya ko wata ga duk sauran marasa lafiya da ke fama da cutar sukari na nau'in ciwon sukari na 2. A cikin yanayin su, ana amfani da maganin insulin kawai a matsayin togiya, kuma babban mahimmanci shine ƙara haɓaka aikin jiki da yankan rage abinci.

Glucophage kadai ba zai iya haifar da hypoglycemia ba, amma a hade tare da magungunan mutum, wannan matsalar ta zama mai dacewa. Don haka, a kowane hali yakamata a haɗa magungunan da kansa tare da wakilai masu dauke da maganin aidin da wasu magunguna waɗanda aka nuna a cikin umarnin don amfani a cikin "ma'amala da miyagun ƙwayoyi". Duk ayyukan da kuke yi ta wannan hanyar dole ne a haɗa shi tare da likita, wanda a ƙarshe zai yanke hukunci; ba za ku iya amfani da ita ko kuma ba za ku iya amfani da takamaiman hadaddun magunguna ba.

Kammalawa

Glucophage wani magani ne mara lahani kuma da kansa bashi da ikon magance hoton cutar da hauka. Ko ta yaya, a hade tare da wasu hanyoyi, zai iya haifar da barazana ga lafiyar mai haƙuri. Jerin magungunan hana daukar ciki don amfanin sa da kuma yawan illolin da hakan zai haifar masu karami ne, amma wasu daga cikinsu suna da matukar tasiri kuma, in babu kwararrun kwararru, zai iya haifar da cutar. Saboda haka, zaku iya amfani da wannan magani akan kanku don haɗarin kanku da haɗarin ku.

Ra'ayoyin Masu Amfani

Daga bita daga marasa lafiya, zamu iya yanke hukunci cewa Glucofage yana da tasiri sosai don gyaran sukari na jini, amma amfani dashi na musamman don asarar nauyi ba daidai bane, tunda gudanarwar yana tare da sakamako masu yawa.

A karo na farko da muka ji game da Glucofage daga tsohuwarmu, wanda ke da ciwon sukari na 2 kuma ba zai iya saukar da sukari ba kafin amfani da kowane magani. Kwanan nan, wani masanin ilimin endocrinologist ya wajabta mata maganin Glucophage a wani sashi na 500 MG sau biyu a rana. Abin mamaki, matakin sukari ya ragu da rabi, ba a gano sakamako masu illa ba.

Na dauki glucophage kwanan nan. Da farko, na ji ciwo kaɗan kuma na sami rashin jin daɗi a cikin ciki. Bayan kamar sati 2 komai ya tafi. Indexididdigar sukari ya ragu daga 8.9 zuwa 6.6. My sashi ne 850 MG kowace rana. Kwanan nan na fara ƙaiƙayi, tabbas babban adadin.

Galina, ɗan shekara 42. Lipetsk

Na yarda da Glucofage Long don rasa nauyi. An daidaita sashi ta hanyar endocrinologist. Na fara ne da 750. Ina ci kamar koyaushe, amma muradin abinci ya ragu. Na fara zuwa bayan gida sau da yawa. Yawo min a matsayin mai tsarkakewa mai wari.

Ana ɗaukar Glucophage kamar yadda kwararrun likitoci suka umarta. Wannan mummunan magani ne ga masu ciwon sukari na 2, ba samfurin asarar nauyi ba. Likita ya sanar da ni game da wannan. Na yi watanni da yawa ina shan shi a 1000 mg kowace rana. Matakan sukari sun faɗi da sauri, kuma tare da shi an rage 2 kg.

Alina, ɗan shekara 33, Moscow

Bidiyo daga Dr. Kovalkov game da kwayar cutar Glucofage:

Kudin glucophage ya dogara da sashi na abu mai aiki da adadin allunan a cikin kunshin.Mafi ƙarancin farashin shine 80 rubles., Matsakaicin shine 300 rubles. Yana da kyau a lura cewa irin wannan bambancin da ake gani a farashin ya dogara da matsayin kamfanin, izinin ciniki da kuma adadin masu shiga tsakani.

Side sakamako

Tsarin cuta na rayuwa da rashin abinci mai gina jiki:
Da wuya sosai: lactic acidosis (duba "Umarnin na musamman"). Tare da yin amfani da metformin na tsawan lokaci, za a iya lura da rage yawan shan Vitamin B12. Idan an gano megaloblastic anemia, yiwuwar yin irin wannan ilimin etiology.

Rashin damuwa daga tsarin juyayi:
Sau da yawa: ɗanɗanar damuwa.

Rashin damuwa na ciki:
Mafi yawan lokuta: tashin zuciya, amai, gudawa, ciwon ciki da rashin ci.
Mafi yawan lokuta suna faruwa ne a farkon lokacin magani kuma a mafi yawan lokuta ba da izinin lokaci ba. Don hana bayyanar cututtuka, ana ba da shawarar ku ɗauki metformin sau 2 ko sau 3 a rana lokacin ko bayan abinci. Dosearanci a hankali na iya inganta haɓakar gastrointestinal.

Rashin lafiya daga fata da ƙananan kasusuwa:
Da wuya sosai: halayen fata kamar su erythema, pruritus, fitsari.

Take hakkin hanta da kuma hanjin biliary:
Yana da wuya sosai: aikin hanta mai rauni da hepatitis, bayan katse metformin, waɗannan abubuwan haɗari sun ɓace gaba ɗaya.

Bayanan da aka buga, bayanan tallace-tallace, da kuma gwajin gwaji na asibiti a cikin ƙarancin yawan yara a cikin shekaru 10-16 sun nuna cewa tasirin sakamako a cikin yara sun yi kama da yanayi da kuma tsananin ƙarfi ga waɗanda ke cikin balagaggun marasa lafiya.

Yawan abin sama da ya kamata

Jiyya: Idan akwai alamun lactic acidosis, magani tare da miyagun ƙwayoyi ya kamata a dakatar da shi nan da nan, ya kamata a kwantar da mai haƙuri cikin gaggawa kuma, bayan ya ƙaddara maida hankali kan maganin lactate, ya kamata a fayyace cutar. Mafi girman gwargwado don cire lactate da metformin daga jiki shine hemodialysis. Hakanan ana gudanar da aikin tiyata.

Yin hulɗa tare da wasu kwayoyi

Wakokin furotin da ke cikin Iodine: a bango na rashin aiki na koda na aiki a cikin marasa lafiya da masu ciwon sukari, binciken rediyo ta amfani da waken iodine mai dauke da sinadarin ioine na iya haifar da ci gaban lactic acidosis. Jiyya tare da Glucofage ® ya kamata a soke aikin gwargwadon aikin kodan 48 hours kafin ko a lokacin gwajin X-ray ta amfani da wakilan iodine wanda ke kunshe da sinadarai na iodine kuma ba za'a sake amfani da shi ba kafin sa'o'i 48 bayan, idan har an tabbatar da aikin zakal din a matsayin al'ada yayin gwajin.

Barasa: tare da matsanancin maye giya, haɗarin haɓaka lactic acidosis yana ƙaruwa, musamman dangane da:

• rashin abinci mai gina jiki, karancin kalori,
• gazawar hanta.

Yayin shan magungunan, ya kamata a guje wa barasa da kwayoyi masu ɗauke da ethanol.

Haɗuwa yana buƙatar taka tsantsan

Danazole: Ba a ba da shawarar gudanar da lokaci daya dana danazol don guje wa tasirin ƙarshen rayuwar ba. Idan magani tare da danazol ya zama dole kuma bayan dakatar da ƙarshen, ana buƙatar daidaita sashi na magani Glucofage ® a ƙarƙashin kulawar tattarawar glucose a cikin jini.

Chlorpromazine: lokacin da aka sha cikin manyan allurai (100 MG kowace rana) yana ƙaruwa da yawaitar glucose a cikin jini, yana rage ƙaddamar da insulin. A cikin maganin rigakafin ƙwayar cuta da kuma bayan dakatar da ƙarshen, ana buƙatar daidaita sashi a ƙarƙashin kulawar maida hankali na glucose jini.

Glucocorticosteroids (GCS) tasirin tsari da tasirin yankuna suna rage jurewar glucose, kara maida hankali kan glucose a cikin jini, wani lokacin suna haifar da ketosis. A cikin maganin corticosteroids kuma bayan dakatar da ci na ƙarshen, ana buƙatar daidaita sashi na miyagun ƙwayoyi Glucofage ® a ƙarƙashin kula da maida hankali na glucose jini.

Rashin daidaito: amfani da “madauki” lokaci daya zai iya haifar da ci gaban laos acidosis saboda gazawar aiki na kasa. Ba za a ƙayyade Glucofage ® idan an ƙaddamar da keɓaɓɓen kasa da 60 ml / min ba.

Bashin da Basira₂-adrenomimetics: ƙara yawan haɗarin glucose na jini saboda ƙaruwa na beta₂-zokarin. A wannan yanayin, ya zama dole don sarrafa tattarawar glucose a cikin jini. Idan ya cancanta, ana bada shawarar yin insulin.
Ta amfani da magungunan da ke sama lokaci guda, za a buƙaci ƙarin saka idanu akan glucose na jini, musamman a farkon jiyya. Idan ya cancanta, za a iya daidaita adadin metformin yayin jiyya da kuma bayan ƙarewa.

Magungunan rigakafin ƙwayoyin cuta, banda na angiotensin suna canza masu inzyme enzyme, na iya ruguza glucose na jini. Idan ya cancanta, ya kamata a daidaita sashi na metformin.

Tare da amfani da magani lokaci guda Glucofage ® s Sinadarin sulfonylurea, insulin, acarbose, salicylates hauhawar jini zai yiwu.

Nifedipine yana ƙaruwa sosai da kuma yawan metformin.

Cationic kwayoyi (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim da vancomycin) wanda aka ɓoye a cikin tubules na koda yana gasa tare da metformin don tsarin jigilar tubular kuma yana iya haifar da karuwa a cikin C max.

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