GALVUS MET - umarnin don amfani, farashi, sake dubawa da kuma alamun analogues

A cikin cibiyar sadarwar kantin magani, ana ba da magani a cikin nau'ikan allunan mai rufi, kowannensu yana dauke da abubuwa biyu masu aiki: 50 MG na vildagliptin da 500, 850 ko 1000 mg na metformin. Magnesium stearate, hyprolose, hypromellose, talc, titanium dioxide, macrogol 4000 da baƙin ƙarfe ana amfani da su azaman matattara.

Kowane boka yana dauke da Allunan 10. An shirya faranti a cikin kwalaye na guda 3, kowane kunshin Galvus Met yana da umarnin.

Lokacin da aka tsara maganin don magani, Galvus Met, to, ana ɗaukar maganin a baki, kuma ya wajaba a sha maganin sosai. An zabi kashi na kowane mara lafiya ne ta likita. A wannan yanayin, ya zama dole la'akari da gaskiyar cewa matsakaicin adadin maganin bai kamata ya wuce 100 MG ba.

A farkon farawa tare da wannan magani, an umurce shi da yin la’akari da abubuwan da aka riga aka dauka na Vildagliptin da Metformin. Don kawar da mummunan abubuwan da ke tattare da tsarin narkewa yayin aikin, dole ne a dauki wannan magani tare da abinci.

Idan magani tare da Vildagliptin bai ba da sakamakon da ake so ba, to a wannan yanayin, ana iya tsara Galvus Met azaman hanyar warkarwa. A farkon farawar, yakamata a sha kashi 50 na mg 2 sau 2 a rana. Bayan wani ɗan gajeren lokaci, ana iya ƙara adadin magunguna don samun sakamako mai ƙarfi.

Idan jiyya tare da Metformin bai ba da damar cimma sakamako mai kyau ba, to ana yin amfani da maganin da aka tsara lokacin yin Glavus Met a cikin tsarin kulawa. Maganin wannan magani dangane da Metoformin na iya zama 50 mg. 500 mg, 50 mg / 850 mg ko 50 mg / 1000 mg.

Dole ne a raba kashi na maganin zuwa kashi biyu. Idan an zaɓi Vildagliptin da Metformin a cikin kwamfutar hannu a matsayin manyan hanyoyin warkarwa, to an tsara Galvus Met a wani ƙari, wanda dole ne a ɗauka a cikin adadin 50 a kowace rana.

Jiyya tare da wannan wakili bai kamata a bai wa waɗannan marasa lafiya waɗanda suka lalace aiki na renal ba, musamman, gazawar renal. Wannan contraindication ya faru ne saboda gaskiyar cewa kwayar aiki mai amfani da wannan magani an cire ta daga jiki ta amfani da kodan. Tare da shekaru, ayyukansu a cikin mutane a hankali yana raguwa. Wannan yakan faru ne a cikin marasa lafiya waɗanda suka ƙetare iyakancin shekaru 65.

Ga marasa lafiya a wannan zamani, an wajabta Galvus Met a cikin mafi ƙarancin magani, kuma ana iya yin alƙawarin wannan magani bayan an samu tabbaci cewa kodan mara lafiyar yana aiki kullum. A yayin jiyya, likita yakamata ya lura da yadda suke aiki akai-akai.

Allunan, 50 MG 500 MG: m, tare da yanke gefuna, mai rufin fim, rawaya mai haske tare da ɗanɗano mai ruwan hoda mai haske. Alamar NVR tana gefe ɗaya kuma LLO tana ɗaya gefen.

Allunan, 50 MG 850 MG: m, tare da yanke gefuna, rawaya mai launin fim tare da ɗanɗanar launin toka mai haske. A gefe ɗaya alama ce "NVR", a ɗayan - “SEH”.

Allunan, 50 MG 1000 MG: m, tare da gefuna da aka yanke, murfin fim, launin rawaya mai duhu tare da launin toka mai launin toka. Akwai alamar "NVR" a gefe ɗaya da "FLO" a ɗayan.

Shin akwai nau'ikan wakoki na cututtukan jini?

Zuwa yau, kasuwar magunguna ta haɗa da irin waɗannan magunguna, Galvus da Galvus sun hadu. Babban bambancin Galvusmet shine cewa ya ƙunshi abubuwa biyu masu aiki a lokaci daya - metformin da vildagliptin.

Wanda ya kirkiro samfurin kwamfutar hannu shine kamfanin kamfanin magunguna na kasar Jamus watau Novartis Pharma Production GmbH. Bugu da kari, a cikin kantin magunguna zaka iya samun samfuran samfuran Switzerland iri-iri.

Ana samun maganin ta musamman a cikin kwamfutar hannu.

Bayanin magungunan a cikin umarnin hukuma yana nufin cewa INN Galvus shine vildagliptin, INN Galvus haɗuwa shine vildagliptin metformin.

Kafin ɗaukar Galvus Met, yana da daraja kula da abubuwan da ake samu na irin wannan magani:

Galvus ya sadu da kwamfutar hannu 50 500 na kwamfutar hannu
Galvus ya sadu da allunan 50 a cikin kwamfutar hannu,
Galvus Met 50 1000 kwamfutar hannu.

Don haka, lambar farko tana nuna adadin milligram na ɓangaren aiki na vildagliptin, na biyu yana nuna matakin metformin hydrochloride.

Ya danganta da abun da ke jikin allunan da kuma yadda ake sanya su, an saita farashin wannan maganin. Matsakaicin farashin Galvus meth 50 mg / 500 MG shine kusan dubu ɗaya da rabi rubles don allunan talatin. Bugu da kari, zaku iya siyan magani da guda 60 a kowane fakiti.

Yi amfani da ƙuruciya

Contraindication: shekaru har zuwa shekaru 18 (ba a kafa ingantaccen aiki da amincin amfani ba).

Babu wani gogewa game da shan kwayoyin magani a tsakanin marasa lafiya a ƙarƙashin shekara goma sha takwas, saboda haka ba a ba da shawarar a saka shi a cikin maganin warkewa ba.

Mutanen da suka wuce 65 ba su buƙatar gyara sashi na musamman don yin amfani da wannan magani, amma kafin amfani, ya kamata ku nemi shawara tare da wani magabacin endocrinologist, tare da kula da hanta da ƙodan, tare da kula da matakan glucose na jini.

Ga marasa lafiya yan ƙasa da shekara 18, Galvus yana contraindicated.

A cikin mata masu juna biyu da masu shayarwa

Amfani da Galvus Met 50/1000 MG yana contraindicated lokacin daukar ciki, saboda babu isasshen bayanai game da amfanin wannan magani lokacin wannan lokacin.

Idan rashin narkewar ƙwayar glucose a cikin jiki, to mace mai ciki na iya samun haɗarin haɓakar haɓakar asaran haihuwa, mace-mace, da kuma yawan cututtukan ƙananan yara. A wannan yanayin, monotherapy tare da insulin ya kamata a dauki don daidaita al'ada glucose.

Amfani da maganin yana contraindicated a cikin uwaye masu shayarwa, saboda ba a san ko abubuwan da ke cikin magani ba (vildagliptin da metformin) an keɓance su cikin madarar humanan adam.

Haihuwa da lactation

Gwaje-gwaje a kan dabbobi masu ciki, wanda aka gudanar da allurai na vildagliptin sau 200 fiye da yadda aka saba, ya nuna cewa miyagun ƙwayoyi ba ya keta ci gaban embryos kuma baya da tasirin cutar kwayar cuta. Yin amfani da Galvus Meta a cikin sashi na 1/10 ya nuna irin wannan sakamako.

A cikin nazarin gwaji a cikin dabbobi tare da yin amfani da vildagliptin a allurai sau 200 sama da wanda aka ba da shawarar, magungunan ba su haifar da cin zarafin farkon haɓakar tayi ba kuma ba ta yin tasirin teratogenic. Lokacin amfani da vildagliptin a hade tare da metformin a cikin rabo na 1:10, ba a gano tasirin teratogenic ba.

Tun da yake babu isasshen bayanai game da amfani da miyagun ƙwayoyi Galvus Met a cikin mata masu juna biyu, amfani da miyagun ƙwayoyi a lokacin daukar ciki ya saba.

Nazarin gwaji ya nuna cewa mafi karancin magunguna ba ya cutar da ci gaban amfrayo. Babu wata shaidar samun ingancin haihuwa mace da aka samu.

Har yanzu ba a gudanar da ƙarin cikakkun nazarin ba, saboda haka, kar ku sake haɗarin lafiyar mahaifiyar da jariri. Yana da mahimmanci a tuna cewa idan akwai keta tsarin metabolism na jini, to akwai haɗarin cutar mahaifa ta mahaifa, kuma haɗarin mace-mace da cututtukan ƙananan yara na haɓaka.

Ba a sanya Galvus lokacin daukar ciki / lactation ba.

Shawarar ajiya da farashin magani

Dangane da umarnin, Galvus Met ya dace don amfani a cikin watanni 18 daga ranar da aka sake shi, ƙarƙashin batun ajiya mai dacewa. Dole ne a zubar da maganin da ya ƙare. Wuri mai duhu da bushewa wanda ba ya isa ga hankalin yara ya dace da ajiya, tare da yanayin zazzabi har zuwa 30 ° C.

An sake sayan magani. Don maganin Galvus Met, sashi yana ƙayyade farashin:

50/500 MG - matsakaita na 1457 rubles,
50/850 MG - matsakaita na 1469 rubles,
50/1000 MG - matsakaici na 1465 rubles.

Ko da tare da amfani guda ɗaya na yau da kullun, ba duk masu ciwon sukari sun gamsu da wannan farashi ba, mafi yawan korafe-korafe daga masu fansho tare da ƙananan ragi Koyaya, samfuran kamfanin Switzerland na Novartis Pharma ana rarrabe su koyaushe ta hanyar ƙimar su, kuma basa cikin ɓangaren kasafin kuɗi na wakilan masu zubar da jini.

Galvus Allunan sashi

Matsakaicin adadin Galvus a matsayin monotherapy ko tare da haɗin kai tare da metformin, thiazolinediones ko insulin - sau 2 a rana, 50 MG, safe da maraice, ba tare da la'akari da yawan abinci ba. Idan an tsara mai haƙuri akan kwayar 1 of 50 MG a rana, to dole ne a sha da safe.

Vildagliptin - kayan aiki na miyagun ƙwayoyi don ciwon sukari Galvus - kodan ya keɓe shi, amma a cikin yanayin metabolites marasa aiki. Sabili da haka, a matakin farko na cin nasara na koda, ba a buƙatar canza sashi na maganin ba.

Idan akwai mummunan keta ayyukan hanta (ALT ko enzymes enzymes 2.5 sau sama da babba na al'ada), to ya kamata a tsara Galvus da taka tsantsan. Idan mai haƙuri ya bunkasa jaundice ko wasu gunaguni na hanta sun bayyana, ya kamata a dakatar da maganin ta vildagliptin nan da nan.

Ga masu fama da cutar siga masu shekaru 65 da haihuwa - kuma kashi na Galvus baya canzawa idan babu maganin cutar kwalliya. Babu bayanai game da amfani da wannan maganin cutar siga a yara da matasa masu shekaru 18 da haihuwa. Sabili da haka, ba a ba da shawarar yin shi ga marasa lafiya na wannan rukunin na wannan zamani ba.

Yadda za a kula da ciwon sukari na 2: dabarar-mataki-mataki-mataki
Nau'in magungunan ciwon sukari na 2: labarin dalla-dalla
Allunan Siofor da Glucofage
Yadda ake koyo don jin daɗin ilimin jiki

Rage tasirin sukari na vildagliptin

An yi nazarin tasirin rage sukari na vildagliptin a cikin rukuni na marasa lafiya 354. Ya juya ga cewa monotherapy na galvus cikin makonni 24 ya haifar da raguwar yawan glucose na jini a cikin waɗannan marasa lafiyar da basu taɓa yin maganin ciwon sukari na 2 ba. Gididdigar haemoglobin su ta ragu da 0.4-0.8%, kuma a cikin ƙungiyar placebo - da 0.1%.

Alamu don amfani

Yin amfani da takardar sayan magani ya kamata a gudanar da shi daga likitan halartar. Specialistwararren ƙwararren likita ne kaɗai zai iya zaɓar matakin maganin ƙwaƙwalwar ƙwayar cuta, daidai gwargwadon yanayin cutar.

Lokacin shan magani, kuna buƙatar kula da walwala kuma ku kula da matakan sukari na jini akai-akai. Daidai aka zaɓa sashi, a matsayin mai mulkin, ba shi da mummunar tasiri a jikin mai haƙuri.

Yin amfani da miyagun ƙwayoyi yana faruwa ta hanyar magana, ba tare da tauna ba, amma tare da babban adadin ruwa.

Gabatarwa Galvus Meta an nuna shi a cikin halayen masu zuwa:

tare da nau'in ciwon sukari na 2, lokacin da sauran zaɓuɓɓukan magani suka kasa,
idan akwai rashin inganci tare da metformin ko vildagliptin azaman kwayoyi daban,
lokacin da mara lafiya ya yi amfani da magunguna tare da abubuwan da suka haɗu,
don hadaddun jiyya na ciwon sukari tare da sauran magungunan hypoglycemic ko insulin.

Alamomin nau'in ciwon sukari na 2 - bidiyo

A miyagun ƙwayoyi yana da wadannan jerin contraindications:

rashin haƙuri da aka gyara
nau'in ciwon sukari guda 1
pathology na kodan, hanta gazawar,
m matakai na cututtuka na kamuwa da cuta da aiki da kodan (vomiting, zazzabi, hypoxia, zawo, asarar ƙwayar cuta),
m da na kullum siffofin zuciya da na zuciya da jijiyoyin jini,
barasa giya da guba,
abinci mai karancin kalori (kasa da dubu 1 kcal a kowace rana),
metabolic acidosis, mai ciwon sukari ketoacidosis,
lactic acidosis, tara tarin lactic acid.

Ba a amfani da kayan aikin kwanaki 2 kafin da bayan tiyata, raayoyin da karatun radioisotope. Kada kuyi amfani da magani don yara da matasa masu shekaru 18, masu ciki da masu shayarwa, tunda ba a tabbatar da aminci ga waɗannan rukunin ba.

Ga mutane sama da 60, ana iya ɗaukar magani a ƙarƙashin kulawa na likita. Hakanan, tare da taka tsantsan, an wajabta su ga waɗanda aikinsu yana da alaƙa da aiki na zahiri. A wannan yanayin, haɗarin lactic acidosis yana ƙaruwa.

Zaɓin sashi ne da za'ayi daban daban. Ya dogara da matakin sukari na mai haƙuri, da tasiri na maganin da ya gabata da kuma matsayin haƙuri ga miyagun ƙwayoyi.

Don rage haɗarin sakamako masu illa daga cututtukan gastrointestinal, ana bada shawara a sha Allunan tare da abinci. Rage ko murkushe kada ta kasance, kawai sha ruwa mai yawa.

A matsayinka na mai mulkin, ana samun karuwar kashi ne kawai bayan yin nazarin tasiri na jiyya na yanzu. Idan mutum yana cikin yanayin tashin hankali, damuwa ko zazzabi, sakamakon Glavus Met na iya raguwa.

Tare da tsawaita magani tare da ƙwayar, ana bada shawarar yin gwajin jini gaba ɗaya sau ɗaya a shekara. Wannan zai hana canje-canje mara kyau a cikin jiki kuma ɗauki matakan da suka dace don kawar da su.

Galvus Met, ba kamar magunguna masu kama da yawa ba, ana iya haɗe shi da insulin. Hakanan an ba shi izinin amfani da shi a hade tare da wasu magunguna na hypoglycemic.

Mahimmanci! A hade tare da wasu magunguna (maganin hana haihuwa, diuretics), tasirin Galvus Met na iya canzawa. Wannan yakamata ayi la'akari dashi idan ana buƙatar wasu hanyoyi.

Lokacin da ake rubuta Galvus na miyagun ƙwayoyi, umarnin don amfani zai ba mai haƙuri damar gano abubuwan da ke nuna alamun amfani da wannan maganin. Babban na daya shine ciwon sukari na 2:

wannan magani shine kadai wanda zai iya samar da sakamako mai dorewa a cikin maganin wannan cuta. Koyaya, ana bayar dashi ne kawai idan, ban da magunguna, ana bin abinci, kuma ƙari ga wannan, rayuwar mai haƙuri a cikin wadataccen adadin yana haɗuwa tare da aikin jiki,
yi amfani da wannan kayan aiki a hade tare da Metformin a matakin farko na maganin ƙwayar cuta, lokacin cin abinci, kazalika da karuwa da yawan ayyukan jiki bai kawo sakamakon da ake so ba,
An tsara shi ga marasa lafiya waɗanda suka yi amfani da madadin wannan magani wanda ke ƙunshe da kayan haɗin jini kamar vildagliptin da metformin,
don hadaddun jiyya ta amfani da kwayoyi waɗanda ke ɗauke da vildagliptin da metformin a matsayin manyan abubuwan da aka haɗa, kazalika da haɗawar sinadarin sulfonylurea ko abubuwan insulin a cikin tsarin kulawa,
Ana amfani da Galvus a cikin lokuta inda tasiri na monotherapy yana da ƙima sosai, kuma lokacin da cin abinci da kasancewar ayyukan jiki a rayuwar mai haƙuri ba su bayar da sakamakon da ake so ba,
azaman magani sau uku, idan amfani da magunguna wadanda ke dauke da sinadarin sulfonylurea da abubuwan sarrafawa, wadanda aka yi amfani dasu a baya, muddin mai haƙuri ya bi wani irin abinci da kuma kasancewa cikin wadataccen aikin jiki, bai samar da sakamakon da ake so ba,
azaman maganin sau uku, lokacin da tasirin amfani da kwayoyi masu amfani da suka ƙunshi metformin da insulin, a ƙarƙashin yanayin abinci da aikin jiki, ya yi ƙasa.

Bayan kamuwa da cutar, kwararrun kwararrun kan zabi wani kaso na magani domin maganin ciwon sukari. Lokacin zabar sashi na magani, yakan samo asali daga tsananin cutar, kuma yana la'akari da haƙurin mutum na maganin.

Mai haƙuri bazai iya jagorance shi ta hanyar abinci ba lokacin maganin Galvus. Wadanda suke halarta game da magungunan Galvus sun nuna cewa bayan kamuwa da cutar sankara ta 2, masu kwararru sune farkon wadanda zasu bada wannan magani.

Lokacin gudanar da rikicewar jiyya, gami da metformin, thiazolidinedione ko insulin, ana ɗaukar Galvus cikin sashi na 50 zuwa 100 a kowace rana.A yayin da yanayin mai haƙuri ya yi tsauri, sannan ana amfani da insulin don tabbatar da kwanciyar hankali na ƙimar jinin sukari. A irin waɗannan halayen, sashi na babban magani bai kamata ya wuce 100 MG ba.

Lokacin da likita ya tsara jigilar magani wanda ya haɗa da shan magunguna da yawa, alal misali, Vildagliptin, abubuwan da ake buƙata na sulfonylurea da Metformin, to a wannan yanayin ya kamata yawan maganin yau da kullun ya zama 100 MG.

Istswararrun kwararru don kawar da cutar ta hanyar Galvus sun ba da shawarar ɗaukar kashi 50 na magunguna sau ɗaya da safe. Likitocin sun ba da shawarar rarraba kashi na 100 MG zuwa allurai biyu.

Dole ne a dauki 50 MG da safe da kuma adadin maganin a maraice. Idan mara lafiya ya rasa shan maganin saboda wasu dalilai, to ana iya yin wannan da wuri-wuri.

Ka lura cewa a cikin kowane hali ya kamata yawan maganin da likita ya ƙaddara zai wuce shi.

Lokacin da aka magance wata cuta tare da kwayoyi biyu ko fiye, kashi na yau da kullun kada ya wuce 50 MG. Wannan saboda gaskiyar cewa lokacin, ban da Galvus, ana kuma ɗaukar wasu magunguna, ana inganta aikin babban magani sosai. A irin waɗannan halayen, kashi 50 MG yayi daidai da 100 MG na miyagun ƙwayoyi yayin monotherapy.

Idan jiyya ba ta kawo sakamakon da ake so ba, kwararru suna ƙara kashi zuwa 100 MG kowace rana.

Analog wanda yake da aiki guda ɗaya a cikin aikin shine Galvus Met. Tare da shi, likitoci sukan ba da izinin Vildaglipmin.

An ba da shawarar yin amfani da shirye-shiryen metformin tare da taka tsantsan a cikin marasa lafiya fiye da shekaru 60 lokacin yin babban aiki na jiki, saboda haɗarin haɓakar haɓakar lactic acidosis a cikinsu.

Ana amfani da maganin don magance nau'in na biyu na ciwon sukari mellitus:

tare da maganin tauhidi, tare da rage cin abinci da kuma motsa jiki,
don marasa lafiya waɗanda a da aka bi da su tare da metformin da vildagliptin a matsayin magunguna guda ɗaya,
a matakin farko na maganin ƙwayar cuta, haɗuwa tare da metformin (a cikin rashin ingancin ilimin motsa jiki da abinci),
a hade tare da sulfonylurea, insulin, metformin tare da rashin ingancin ilimin motsa jiki, abinci da monotherapy tare da waɗannan magunguna,
tare da metformin da sulfonylurea ga waɗancan marasa lafiya waɗanda suka kula da magani na baya tare da waɗannan magungunan kuma basu sami ikon glycemic iko ba,
tare da insulin da metformin ga waɗannan marasa lafiya waɗanda a baya sun karɓi maganin haɗin gwiwa tare da waɗannan magungunan kuma basu sami ikon sarrafa glycemic ba.

An nuna wannan ta hanyar jagorar jagora don Galvus Met.

Dole ne a zaba tsarin magani na Galvus Met daban-daban, gwargwadon tasiri da haƙuri na ilimin. Lokacin amfani da Galvus Met, kada ku ƙeta yawan adadin shawarar da aka bayar na maganin yau da kullun na vildagliptin (100 MG).

Ya kamata a zaɓi shawarar farko ta Galvus Met, idan aka yi la’akari da tsawon lokacin cutar sankara da kuma matakin glycemia, yanayin mai haƙuri da tsarin kulawa na vildagliptin da / ko metformin da aka riga aka yi amfani da shi a cikin haƙuri. Don rage tsananin tasirin sakamako daga tsarin narkewa, halayyar metformin, ana ɗaukar Galvus Met tare da abinci.

Matsayi na farko na miyagun ƙwayoyi Galvus Met tare da rashin aiki na monotherapy tare da vildagliptin

Za'a iya fara jiyya tare da kwamfutar hannu 1. (50 mg 500 MG) sau 2 a rana, bayan tantance tasirin warkewa, ana iya ƙara yawan ƙwayar a hankali.

Kashi na farko na maganin Galvus Met tare da gazawar monotherapy tare da metformin

Dangane da kaso na metformin da aka riga aka dauka, ana iya fara jiyya tare da Galvus Met tare da kwamfutar hannu 1. (50 mg 500 mg, 50 mg 850 mg ko 50 mg 1000 mg) sau 2 a rana.

Kashi na farko na Galvus Met a cikin marasa lafiya waɗanda a baya aka karɓi maganin haɗin gwiwa tare da vildagliptin da metformin a cikin nau'ikan keɓaɓɓun allunan.

Dangane da allurai na vildagliptin ko metformin da aka riga aka dauka, jiyya tare da Galvus Met ya kamata ya fara da kwamfutar hannu wanda ya kasance kusa da yadda ake amfani da maganin da ake ciki (50 mg 500 mg, 50 mg 850 mg ko 50 mg 1000 mg), kuma daidaita sashi gwargwadon tasiri .

Kashi na farko na maganin Galvus Met shine farkon farawa a cikin marasa lafiya da ke dauke da cutar sukari mai nau'in 2 da karancin tasirin maganin abinci da motsa jiki

A matsayin farawa, Galvus Met ya kamata a tsara shi a cikin kashi na farko na 50 MG 500 MG 1 lokaci ɗaya kowace rana, kuma bayan kimanta tasirin warkewa, sannu a hankali ƙara ƙimar zuwa 50 mg 1000 MG sau 2 a rana.

Harkokin haɗin gwiwa tare da Galvus Met da abubuwan tushe na sulfonylurea ko insulin

Ana yin lissafin kashi na Galvus Met akan wani kashi na vildagliptin 50 mg × 2 sau a rana (100 MG kowace rana) da metformin a cikin kashi daidai yake da wanda aka ɗauka azaman ƙwayoyi guda ɗaya.

Paarancin aiki na haya. A cikin marasa lafiya da ke fama da rauni na aikin ƙirar, ana iya daidaita daidaita sashi tare da Cl creatinine (ƙididdigar ta hanyar Cockcroft-Gault) a cikin kewayon daga 60 zuwa 90 ml / min ana iya buƙatar. Yin amfani da miyagun ƙwayoyi Galvus Met a cikin marasa lafiya tare da Cl creatinine