Metfogamma® 850 (Metfogamma® 850)

Tabletaya daga cikin kwamfutar hannu ya ƙunshi:

Abunda yake aiki: metformin hydrochloride - 850 mg.

Mahalarta: hypromellose, povidone, magnesium stearate.

Harshen Shell: hypromellose, macrogol 6000, titanium dioxide (E 171).

Allunan farin farin allunan, fim mai rufi, tare da layin kuskure a garesu, kusan wari ne.

Aikin magunguna

Metphogamma 850 magani ne na baki na jini daga ƙungiyar biguanide. Yana hana gluconeogenesis a cikin hanta, rage yawan shan glucose daga cikin hanji, haɓaka amfani da keɓaɓɓen glucose, yana kuma ƙara haɓakar jijiyoyin jikin mutum zuwa insulin. Ko yaya, ba zai shafi ɓoyewar insulin ba ta hanyar ƙwayoyin beta na pancreas. Yana rage matakin triglycerides da ƙarancin lipoproteins mai yawa a cikin jini. Yanke ko rage karfin jiki. Yana da tasirin fibrinolytic saboda hanawar ƙwaƙwalwar ƙwaƙwalwar ƙwayar plasminogen mai hanawa.

Pharmacokinetics

Bayan gudanar da baki, an sha maganin daga ƙwayar jijiyoyin mahaifa. Bioavailability bayan ɗaukar daidaitaccen kashi shine -50-60%. Matsakaicin mafi yawan damuwa a cikin jini shine an kai shi awanni 2 bayan fitowar. A zahiri ba a ɗaura shi da sunadaran plasma. Yana tarawa a cikin glandan ciki, hanta da ƙodan. Aka cire shi da kodan. Rabin-rayuwa shine awa 1.5-4.5.

Tare da nakasa aikin na koda, tarawa daga cikin miyagun ƙwayoyi yana yiwuwa.

Sashi da gudanarwa

Ana saita kashi na Metfogamma 850 daban-daban, yin la'akari da matakin glucose a cikin jini. Kashi na farko yawanci shine 850 MG (1 kwamfutar hannu) kowace rana, ƙarin ƙaruwa na digiri a cikin kashi mai yiwuwa yana dogara ne akan tasirin magani. Adadin aikin magani shine 850-1700 mg (1-2 Allunan) a rana. Matsakaicin adadin yau da kullun shine 1700 MG (Allunan 2), alƙawarin karin allurai baya ƙaruwa tasirin magani.

Ana ba da shawarar kowace rana da ta wuce miliya 850 a allurai biyu (safe da yamma). A cikin marasa lafiya tsofaffi, shawarar da aka ba da shawarar yau da kullun kada ta wuce 850 MG.

Allphogamma allunan 850 ya kamata a ɗauka tare da abinci, duka, a wanke da ruwa kaɗan (gilashin ruwa). Hanyar magani tare da miyagun ƙwayoyi yana da tsayi.

Side sakamako

Daga jijiyoyin ciki: tashin zuciya, amai, ciwon ciki, zawo, rashin ci, "ɗan ƙarfe" ɗanɗano a bakin. A waɗannan halayen, dakatar da magani yawanci ba a buƙata, kuma alamu suna warware kansu ba tare da canza kashi ba. Mitar da tsananin tasirin sakamako daga hanji na iya raguwa tare da karuwa a hankali a kashi na metformin.

Allergic halayen: fatar fata.

Daga tsarin endocrine: hypoglycemia (galibi lokacin da aka yi amfani dashi a cikin allurai marasa inganci).

Metabolism: a cikin mafi yawan lokuta, lactic acidosis (yana buƙatar dakatar da magani).

Daga tsarin hemopoietic: a wasu yanayi - megaloblastic anemia.

Yawan abin sama da ya kamata

Tare da wucewar Metfogamma 850, lactic acidosis tare da sakamako mai mutuwa yana yiwuwa. Dalilin ci gaban lactic acidosis kuma na iya zama tarin ƙwayar cutar saboda rauni na aikin keɓaɓɓu. Alamomin farko na lactic acidosis sune tashin zuciya, amai, gudawa, zazzabi, zafin ciki, ciwon ciki, to ana iya samun yawan numfashi, farin ciki, ruhi mai rauni da kuma ci gaban ƙira. asibiti cikin haƙuri da sauri kuma, bayan ƙaddara da yawan maganin lactate, tabbatar da ganewar asali. Matsakaicin mafi inganci don cire lactate da Metphogamma 850 daga jiki shine hemodialysis. Hakanan ana gudanar da aikin tiyata. Tare da haɗin maganin Metphogamma 850 tare da shirye-shiryen sulfonylurea, hypoglycemia na iya haɓaka.

Yin hulɗa tare da wasu kwayoyi

Tare da yin amfani da lokaci guda tare da abubuwan da suka samo asali na sulfonylurea, acarbose, insulin, magungunan anti-mai kumburi, marasa hana MAOYI, oxygentetracycline, ACE inhibitors, Clofibrate Kalam, cyclophosphamide, B-blockers, yana yiwuwa a ƙara tasirin hypoglycemic sakamako na metformin. Tare da yin amfani da lokaci guda tare da glucocorticosteroids, hana hana haihuwa, epinephrine, sympathomimetics, glucagon, hormones thyroid, thiazide da "madauki" dizedtics, abubuwan da ke tattare da halittar acid, nicotinic acid, yana yiwuwa a rage tasirin hypoglycemic sakamako na metformin.

Cimetidine yana rage jinkirin kawar da metformin, wanda ke kara haɗarin lactic acidosis.

Metformin na iya raunana tasirin magungunan anticoagulants (abubuwan da aka samo coumarin). Ta hanyar shan giya a lokaci daya, lactic acidosis na iya haɓaka.

Siffofin aikace-aikace

Ba'a bada shawara ga cututtukan m, daɗaɗɗar cututtukan cututtukan fata da cututtukan kumburi, raunin da ya faru, cututtukan tiyata, lokacin da aka nuna maganin insulin. Kada ayi amfani dasu kafin aikin tiyata kuma cikin kwanaki 2 bayan an yi su.

Ba'a bada shawarar amfani da Metfogamma 850 don akalla kwanaki 2 kafin da kwanaki 2 bayan x-ray ko gwajin rediyo ta amfani da wakilai masu bambanci. Ba'a ba da shawarar yin amfani da miyagun ƙwayoyi a cikin marasa lafiya akan abinci tare da ƙuntatawa a cikin adadin caloric (

Tsarin ilimin rayuwa (ICD-10)

Pharmacodynamics

Yana hana gluconeogenesis a cikin hanta, rage yawan glucose daga hanji, haɓaka amfani da keɓaɓɓen glucose, da ƙara haɓakar jijiyoyin jikin mutum zuwa insulin. Yana rage matakin triglycerides da ƙarancin lipoproteins mai yawa a cikin jini. Yana da tasirin fibrinolytic (yana hana ayyukan mai amfani da ƙwayar plasminogen mai kunna nama), kwantar da hankali ko rage nauyin jiki.

Contraindications

mai ciwon sukari ketoacidosis, maganin ciwon sukari da coma,

mai tsanani na koda da hepatic rashi,

zuciya da rashin numfashi,

m lokaci na myocardial infarction,

m hatsari

lactic acidosis da alamomin shi a cikin tarihi, yanayi wanda zai iya taimakawa ci gaban lactic acidosis, gami da na kullum,

Side effects

Daga tsarin zuciya da jijiyoyin jini (hematopoiesis, hemostasis): a wasu yanayi megaloblastic anemia.

Daga narkewa: tashin zuciya, amai, ciwon ciki, zawo, rashin ci, daɗin ƙarfe a bakin.

Daga gefen metabolism: hypoglycemia, a cikin mafi yawan lokuta, lactic acidosis (yana buƙatar dakatar da magani).

Allergic halayen: fata tayi.

Umarni na musamman

Ba'a ba da shawarar cututtukan m masu raɗaɗi ba ko ɓacin rai na cututtukan cututtukan ƙwayar cuta da raɗaɗi, raunin da ya faru, cututtukan tiyata mai zurfi, kafin tiyata da kuma cikin kwanaki 2 bayan an yi su, kamar yadda kuma cikin kwanaki 2 kafin da bayan gwajin gwaji yin amfani da bambanci da kafofin watsa labarai). Bai kamata a yi amfani da shi ba a cikin marasa lafiya a kan rage cin abinci tare da iyakancewar adadin kuzari (ƙasa da 1000 kcal / rana). Ba'a bada shawarar amfani da maganin ba a cikin mutanen da suka wuce shekaru 60 da ke yin aikin jiki (saboda haɗarin haɓakar haɓakar lactic acidosis).

Tasiri a kan ikon tuka motoci da aiki tare da kayan aiki. Babu sakamako (lokacin amfani dashi azaman monotherapy). A hade tare da sauran wakilai na hypoglycemic (abubuwan da suka samo asali na sulfonylurea, insulin, da dai sauransu), haɓakar jihohin hypoglycemic mai yiwuwa ne, a cikin ikon iya fitar da motocin da kuma shiga cikin wasu ayyukan masu haɗari waɗanda ke buƙatar ƙara kulawa da saurin halayen psychomotor.

Mai masana'anta

Werwag Pharma GmbH & Co. KG, Kalverstrasse 7, 71034, Beblingen, Jamus.

Masana'antu: Artesan Pharma GmbH & Co. KG, Wendlandstrasse, 1, 29439, Lyukhov, Jamus.

Dragenopharm Apotheker Püschl GmbH & Co. KG, Gellstrasse, 1, 84529, Tittmoning, Jamus.

CJSC ZiO-Zdorovye, Rasha, 142103, Yankin Moscow, Podolsk, ul. Railway, 2.

Ofishin wakilci / kungiyar yarda da da'awar: ofishin wakilin kamfanin Vervag Pharma GmbH & Co. CG a Tarayyar Rasha.

117587, Moscow, babbar hanyar Warsaw, 125 F, bldg. 6.

Waya: (495) 382-85-56.

Form sashi

Allunan da aka saka fim, 850 MG

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abu mai aiki - metformin hydrochloride 850 MG

(daidai yake da metformin 662.8 mg),

magabata: hypromellose (15000 mPas), Povidone K25, magnesium stearate,

abun da ke cikin sheath: hypromellose (5mPas), macrogol 6000, titanium dioxide (E171).

Allunan cike da siffofi masu kama da biconvex farfajiya, an rufe su da farin fim na murfi, tare da haɗari a garesu, tare da diamita (7.5 ± 0.5 x 21.5 ± 0.5) mm da tsayi (6.0 ± 6.8) mm.

Kayan magunguna

Bayan gudanar da baki, ana amfani da metformin daga cikin gastrointestinal fili. Bioavailability bayan ɗaukar daidaitaccen kashi shine 50-60%. Matsakaicin Cmax maida hankali ne yakai awa 2.5 bayan shigowa. A zahiri ba a ɗaura shi da sunadaran plasma. Yana tarawa a cikin glandan ciki, tsokoki, hanta da ƙodan. Ana jigilar Metformin zuwa sel jini; gawar jan jini wataƙila sashin rarraba manyan sakandare. Aka cire shi da kodan. Rabin rayuwar shine awoyi 6.5. Idan akwai matsalar aiki na rashi, tarawar magungunan yana yiwuwa. Ana tsammanin cewa magungunan magungunan metformin adsorption ba su da tsari.

Metfogamma® 850 yana hana gluconeogenesis a cikin hanta, rage yawan glucose daga cikin hanji, yana haɓaka yin amfani da gllu, kuma yana ƙara haɓaka kyallen takarda zuwa insulin. Metformin yana motsa mahaɗan glycogen kira ta hanyar aiki akan glycogen synthase da ƙara ƙarfin jigilar nau'ikan jigilar abubuwan motsa jiki na glucose. Ko yaya, ba zai shafi ɓoyewar insulin ba ta hanyar ƙwayoyin beta na pancreas. Yakan saukar da yawan cholesterol, triglycerides da karancin lipoproteins mai yawa a cikin jini. Yanke ko rage karfin jiki. Yana da tasirin fibrinolytic saboda hanawar ƙwaƙwalwar ƙwaƙwalwar ƙwayar plasminogen mai hanawa.

Form sakewa, marufi da abun hadewa Metfogamma ® 850

Allunan, an shafe su tare da farin fim na hoto, suna da yawa, tare da haɗari, tare da kusan babu wari.

Fitowa: hypromellose (1500CPS), hypromellose (5CPS), povidone (K25), magnesium stearate, macrogol 6000, titanium dioxide.

10 inji mai kwakwalwa. - blister (3) - fakitoci na kwali.
10 inji mai kwakwalwa. - blisters (6) - fakitoci na kwali.
10 inji mai kwakwalwa. - blister (12) - fakitoci na kwali.
Guda 20. - blisters (6) - fakitoci na kwali.

Sakawa lokacin

Saita daban, yin la'akari da matakin glucose a cikin jini.

Maganin farko shine yawanci 850 mg (1 tab.) / Day. Furtherarin ƙarin ci gaba na digiri a kan hanya yana yiwuwa gwargwadon tasirin aikin jiyya. Adadin kulawa shine 850-1700 mg (1-2 Allunan) / rana. Matsakaicin adadin yau da kullun shine 2550 MG (Allunan 3).

Ana ba da shawarar kowace rana da ta wuce nauyin 850 a cikin allurai biyu (safe da maraice).

A cikin marasa lafiya tsofaffi, shawarar da aka ba da shawarar kada ta wuce 850 mg / rana.

Allunan yakamata a ɗauka tare da abinci gaba ɗaya, a wanke da ruwa kaɗan (gilashin ruwa).

Magungunan an yi niyya don amfani na dogon lokaci.

Saboda yawan haɗarin lactic acidosis, a cikin rikice-rikice na rayuwa mai rauni, yakamata a rage kashi.

Hulɗa da ƙwayoyi

Tare da yin amfani da lokaci guda tare da abubuwan da suka samo asali na sulfonylurea, acarbose, insulin, NSAIDs, MAO inhibitors, oxygentetracycline, ACE inhibitors, clofibrate Kalam, cyclophosphamide da beta-blockers, yana yiwuwa a ƙara tasirin hypoglycemic sakamako na metformin.

Tare da yin amfani da lokaci guda tare da GCS, maganin hana haihuwa, epinephrine (adrenaline), sympathomimetics, glucagon, hormones na thyroid, thiazide da loopback diuretics, abubuwan da ke tattare da yanayin acid da nicotinic acid, raguwar sakamako na hypoglycemic na metformin mai yiwuwa ne.

Cimetidine yana rage jinkirin kawar da metformin, sakamakon abin da haɗarin lactic acidosis ke ƙaruwa.

Metformin na iya raunana tasirin magungunan anticoagulants (abubuwan da aka samo coumarin).

Tare da gudanarwa na lokaci ɗaya tare da ethanol, haɓakar lactic acidosis mai yiwuwa ne.

Tare da yin amfani da nifedipine lokaci guda yana ƙara yawan metformin, C max, yana rage jinkirin fitar.

Magungunan cationic (amlodipine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin) sun ɓoye a cikin tubules suna gasa don tsarin jigilar tubular kuma, tare da tsawan magani, na iya haɓaka C max metformin da 60%.

Alamu don amfani

- lura da nau'in ciwon sukari na 2 na manya a cikin manya, musamman a cikin masu yawan kiba, idan cin abinci da aikin jiki ba su samar da isasshen kulawar glycemic,

kamar yadda monotherapy ko a hade tare da wasu jami'in maganin antidiabetic na baka, ko tare da insulin

Mu'amala da Lafiya

Haɗe-haɗe ba a ba da shawarar ba.

M shan barasa mai yawa yana haifar da haɗarin lactic acidosis, musamman a cikin waɗannan lambobin:

- yunwa ko rashin abinci,

Wajibi ne a guji amfani da barasa da magunguna masu ɗauke da giya a cikin maganin metformin.

Iodine-dauke da wakilai masu bambanci

Yin amfani da introvascular na iodine-dauke da wakilai masu bambanci na iya haifar da gazawar renal, haifar da tarawa daga metformin, kuma zuwa haɗarin haɗari na lactic acidosis. Ya kamata a dakatar da amfani da metformin kafin amfani da irin waɗannan wakilan masu nuna bambanci, yayin karatu tare da amfanin su kuma a cikin awanni 48 bayan kammala su. Yakamata a ci gaba da warkewar sa'o'i 48 bayan kammala karatun kuma sai bayan an sake yin nazari na biyu akan aikin koda kuma an sami sakamako na al'ada.

Haɗe-haɗe masu buƙatar kulawa ta musamman lokacin amfani

Magunguna tare da aikin hyperglycemic na asali, alal misali, glucocorticoids (don tsari da amfani na gida), agonists na beta-2, sympathomimetics.

Ya kamata a sanar da marasa lafiya game da wannan, suna ba da shawara cewa su sa ido kan matakan glucose na jini sau da yawa, musamman a matakin farko na magani. Idan ya cancanta, ya kamata a tsara yawan sashi na metformin yayin magani, musamman lokacin amfani da wani magani da kuma bayan dakatar da amfani dashi.

Diuretics, musamman maɗauran madaidaici.

Tunda akwai yuwuwar yuwuwar rage aikin koda, akwai babban haɗarin haɓaka lactic acidosis.

ACE inhibitors na iya haifar da raguwa a cikin matakan glucose na jini. Idan ya cancanta, yakamata a daidaita sashi na maganin hypoglycemic a lokacin da ake amfani da maganin ta hanyar amfani da masu hana ACE kuma bayan katse wannan maganin.