Magungunan Lipantil: umarnin don amfani

a cikin murhun ciki guda 10., a cikin fakitin kwali 3 blisters.

Pharmacodynamics

Wersarancin triglycerides kuma, a mafi ƙarancin,, cholesterol a cikin jini. Yana taimakawa rage abun ciki na VLDL, zuwa ƙarancin ƙa'ida - LDL, ƙara abun ciki na anti-atherogenic HDL. Yana kunna ƙwayar lipoprotein kuma, saboda haka, yana rinjayar metabolism na triglycerides, yana rushe tsarin haɗin faty da cholesterol, yana taimakawa haɓaka adadin masu karɓa na LDL a cikin hanta. Fenofibrate yana rage haɗarin platelet, rage matakan fibrinogen mafi girma na plasma, zai iya ɗan rage matakin glucose na jini a cikin marasa lafiya tare da ciwon sukari na mellitus, kuma yana rage matakin uric acid a cikin jini.

Pharmacokinetics

Babban metabolite shine fenofibroic acid. Bayan shan maganin a cikin C_max a cikin plasma an kai shi bayan sa'o'i 5. Lokacin da aka karɓa da ƙimar 200 MG, matsakaiciyar ƙwayar ƙwayar cuta shine 15 μg / ml. Cutar plasma na miyagun ƙwayoyi ta tabbata. T_1/2 fenofibroic acid - kimanin awanni 20. Ya na kwance a cikin fitsari (fenofibroic acid da glucuronide) bayan kwanaki 6. Ba ya tara lokacin ɗaukar abu guda da amfani da tsawo. Fenofibroic acid ba'a fitar dashi lokacin hemodialysis.

Contraindications

Rashin rauni mai yawa na hanta da koda, tarihin phototoxic ko halayen photoallergic yayin kulawa tare da fenofibrates ko wasu kwayoyi masu kama da tsari, musamman ketoprofen, haɗuwa tare da sauran fibrates, yara underan shekaru 18, ciki, lactation, na nakasar galactosemia, rashi lactase.

Side effects

Rarraba myalgia, rauni na rauni, rauni, da (a lokuta mafi wuya) rhabdomyolysis, wani lokacin mai tsanani. Lokacin da aka daina jinya, waɗannan abubuwan mamaki galibi suna komawa baya.

Daga cikin jijiyoyin mahaifa: dyspepsia. Activityara ayyukan hepatic transaminases a cikin magani.

Allergic halayen: da wuya - rashes na fata, itching, urticaria, photoensitivity. A wasu halaye (bayan watanni da yawa na yin amfani da su), daukar hoto na iya ɗauka ta hanyar erythema, papules, vesicles, ko eczematous rashes.

Haɗa kai

Hade da suke contraindicated: tare da sauran fibrates, haɓaka haɗarin sakamako masu illa (lalacewar tsoka).

Hadinda ba'aso: tare da masu hanawa HMG-CoA reductase - karuwar haɗarin sakamako masu illa (lalacewar tsoka).

Haɗuwa da za a yi amfani da shi da taka tsantsan - tare da magungunan anticoagulants marasa daidaituwa (haɗarin zub da jini). Controlarin sarrafawa na PV na yau da kullun ya zama dole yayin zaɓin sigar anticoagulant na kaikaice yayin jiyya tare da fibrates kuma a cikin kwanaki 8 bayan cirewarsu.

Ba'a yi amfani da Fenofibrate tare da masu hana MAO ba.

Kariya da aminci

Akwai rahoto game da tasirin tasirin fibrates akan ƙwayar tsoka, gami da lokuta da yawa na cututtukan necrosis. Wadannan hanyoyin suna faruwa ne sau da yawa tare da raguwar matakin albumin plasma. Dole ne a yi la’akari da tasirin da aka nuna a cikin dukkan marasa lafiya da ke yaduwar myalgia, tare da tashin hankali na tsoka kuma tare da gagarumin ƙaruwa a matakin halittar phosphokinase (sau 5 sama da na al'ada). A waɗannan halayen, ya kamata a dakatar da magani.

Bugu da ƙari, haɗarin lalacewar tsoka zai iya ƙaruwa idan an sanya maganin tare da masu hana ingin HMG-CoA reductase.

Sakamakon kasancewar lactose, an sanya maganin a cikin cututtukan cututtukan ƙwayar cuta na yara, idan akwai gubar glucose da cutar malabsorption na galactose ko kuma a cikin rashi lactase.

Idan ba a sami raguwa mai gamsarwa a cikin ƙwayoyin ƙwayar magani ba yayin amfani da miyagun ƙwayoyi na watanni 3-6, ya kamata a samar da wata hanyar warkewa daban.

Tsarin sa ido kan matakan cututtukan hepatic a cikin jijiyoyin jini a kowane wata 3 a cikin watanni 12 na farko na magani ya zama dole. Idan an ƙara matakin AST da ALT fiye da sau 3 idan aka kwatanta da VGN, ya kamata a dakatar da jiyya.

Idan aka haɗu da magungunan anticoagulants na kaikaice, saka idanu akan tsarin coagulation na jini ya zama dole.

Aikin magunguna

HypolipPs wakili, yana da tasirin uricosuric da antiplatelet. Yana rage cholesterol guda ta 20-25%, TG jini ta 40-45% sannan uricemia da 25%. Tare da ingantaccen jiyya, an rage ƙwayoyin ƙwayar cholesterol.

Yana rage taro na TG, VLDL, LDL (zuwa ƙarancin ƙima), yana ƙaruwa - HDL, yana rushe rikitarwa na fat mai. Yana rage haɗin platelet, yana rage babban fibrinogen plasma. A cikin marasa lafiya da ciwon sukari suna da wasu tasirin hypoglycemic.

Umarni na musamman

Ya kamata a gudanar da magani a hade tare da abincin cholesterol kuma a ƙarƙashin kulawar likita.

In babu sakamako mai gamsarwa bayan watanni 3-6 na gudanarwa, ana iya tsara magunguna masu haɗari ko madadin magani.

An bada shawara don saka idanu kan ayyukan “cututtukan hepatic” duk watanni 3 a farkon shekarar far, hutu na wucin gadi a jiyya idan ayyukansu ya ƙaru, da kuma warkewa daga kulawa na lokaci daya na magungunan hepatotoxic.

Abun ciki da sashi tsari

Magungunan Lipantil 200 m yana cikin rukunin magunguna na samfurori na fibroic acid. Babban sashi mai aiki shine fenofibrate. Yana aiki akan masu karɓar PPA-α, yana kunna aikin lipoprotein lipase. Wannan tsari yana hanzarta aiwatar da rarrabuwar kitse da cire barbashin triglyceride daga jini. Saboda haka, rage yawan lipoproteins mai yawa yana raguwa kai tsaye, kuma adadin yawan lipoproteins mai yawa, akasin haka, yana ƙaruwa. Fibrate shima kaikaice yana rage sukarin jini. Magungunan yana taimakawa wajen daidaita adadin fibrinogen, yana hana haɓakar ƙwayar jini.

Siffar saki na Lipantil itace kaffarar fata geishin mai kauri mai dauke da sinadarin farin ciki. Ana samun maganin a cikin sashi na 200 MG, guda 30 a kowane fakiti. Ofasar ta asali - Faransa. Zaka iya siyan magungunan kawai ta hanyar takardar sayan magani.

Alamu don amfani

Babban kwazon cholesterol na digiri na farko da na biyu a cewar Fredrickson shine babban nuni ga nadin Lipantil. Tare da haɗin hyperlipidemia, ana bada shawara don haɗa allunan Lipantil a cikin tsarin warkewa. Babban triglycerides shima yana buƙatar fenofibrate. Ci gaban atherosclerosis yana kara hadarin rauni na kashin kansa da kuma shanyewar jiki. A wannan batun, don rigakafin, likitoci suna ba da shawarar Lipantil.

Tare da rashin haƙuri ga wasu magungunan cututtukan ƙwayar cuta, alal misali, statins, amfani da fenofibrate azaman madadin.

Side effects

Mafi sau da yawa, marasa lafiya suna korafin rashin narkewar abinci. Wani lokaci zafin ƙwayar tsoka na iya faruwa, a cikin mafi munin yanayi, lalata ɓoyayyun ƙwayoyin tsoka. Hakanan ana samun maganganun rashin kwanciyar hankali ga abubuwan daya shafi na Lipantil. Kuraje da itching na iya bayyana. Kamar yawancin magunguna masu rage kiba, fenofibrate yana haɓaka matakin enzymes na hanta a cikin jini. Bayan ƙarshen hanyar magani, sakamako masu illa na yau da kullun suna ɓacewa ba tare da wata alama ba.

A cikin mafi yawan lokuta lokuta na yawan abin sama da ya kamata, ana yin maganin cututtukan mahaifa.

Sashi da gudanarwa

Za'a iya zaɓar sashi mafi kyau da likitanku kawai, la'akari da tarihin likitan ku na mutum. Daidaitaccen sashi shine 200 MG na miyagun ƙwayoyi kowace rana. A shawarar likita, wani lokacin za'a iya raba kashi na yau da kullum zuwa kashi uku. Ana ɗaukar capsule tare da abinci, an wanke shi da ruwa. A cikin cututtukan maɗaukaki, buƙatun magani na yau da kullum na iya isa zuwa 400 MG. A wannan yanayin, mai haƙuri yana ƙarƙashin kulawa ta kulawa da ma'aikatan kiwon lafiya.

Siffofin aikace-aikace

Kada kayi amfani da samfurin magani don malabsorption na glucose, galactose. Lokacin da ake tsara abubuwan da ake amfani da su na fibroic acid, ya zama dole don kulawa da tsare-tsaren hanta na hanta. Abubuwan coagulation na jini suna ƙarƙashin kulawa ta dindindin. A kowane hali ba za a iya haɗa fibrates da barasa ba. Irin wannan haɗuwa na iya samun sakamako mai guba sosai a kan ƙwayoyin hanta, a cikin mafi munin yanayi, tare da sakamakon da ba za a iya canzawa ba.

Yayin ciki da lactation

Lokacin haila banda amfani da maganin. A zahiri, kamar shayarwa. Tunda ta hanyar madarar nono, maganin zai iya cutar da ɗan.

Babu bayanan bincike game da tasirin magunguna a jikin yaran. A wannan batun, an contraindicated a cikin yara.

Farashin magani

Fenofibrate, sunan cinikin Lipantil 200 M, a cikin Ukraine za'a iya sayan kan farashin kusan 520 UAH na Allunan 30. A cikin kantin magunguna na Tarayyar Rasha, maganin zai iya biyan kuɗin da kai 920 rubles don kunshin ɗaya. Kada ka manta ka nuna wa mai kantin magani takardar magani daga likita kafin siyan. Tabbatar ka bincika idan maganin ya ƙare.

Analogs Lipantil

Idan sashi na Lipantil ya yi yawa ga mai haƙuri, ana musanya abubuwan da ke da ƙananan fibrate. Misali, Tricor, wanda aka samar da shi a cikin kashi 145 a cikin kwamfutar hannu daya a tsirrai daya tare da Lipantil. Counterpartarin takwarorinsu na kasafin kuɗi sun haɗa da Fenofibrat Canon, Rasha, da Exlip, Turkiyya. Kawai likitan ku zasu taimaka ƙarshe ƙarshe fahimtar yawan wakilai na magunguna a kan cholesterol. Kada ka jagora ta hanyar bayani kawai daga Intanet.

Yin Amfani da Bita

Bayanin da likitoci suka yi game da maganin a sarari yake - ingantaccen sakamako yana nan. A cikin farkon watan far, yana yiwuwa a kimanta sakamakon farko kuma, idan ya cancanta, daidaita sashi. Za'a iya amfani da lipantil azaman maganin monotherapy, ko a hade tare da sauran magunguna.

Marasa lafiya sun fi damuwa da tasirin maganin a hanta. Amma ingantaccen raguwar cholesterol gaba daya yana rama kasancewar tasirin sakamako. Yawancin mutane suna lura cewa mummunan tasirin shan kwayoyi na iya sarrafawa da kawar dashi. Kuma hakika, farashin bai dace da kowa ba. Koyaya, mutane da yawa sun yarda cewa samfurin inganci da lasisi sun cancanci kuɗin.

Form sashi

Capaya daga cikin capsule ya ƙunshi

abu mai aiki - micronized fenofibrate 200 MG,

magadanci: lactose, sodium lauryl sulfate, sitaci sitiri, crospovidone, magnesium stearate,

harsashi mai kwalliya: titanium dioxide (E 171), Iron (III) oxide rawaya E172, Iron (III) oxide jan E172, gelatin.

Opaque capsules haske launin ruwan kasa mai lamba 1. Abubuwan da ke cikin capsules farar fata ne ko kusan farin foda

Hadin gwiwar yawan maye da magunguna

A cikin aikin asibiti, irin wannan yanayin yana da matukar wahala. Ana nuna yawan shan Lipantil ta hanyar bacci, rikicewa, farin ciki, tashin hankali. Ana buƙatar jin daɗi na ciki, tare da ci na kowane enterosorbent - carbon da aka kunna, Smecta, Enterosgel. Wajibi ne a nemi taimakon likita nan da nan don kawar da kai da kuma maganin cututtukan mahaifa.

Tasirin hypoglycemic na kwayoyi tare da abubuwan da ke haifar da maganin sulfonylurea an inganta su sosai tare da amfani da su a lokaci guda tare da Lipantil. Hakanan yana haɓaka ingancin warkewar cututtukan da ba kai tsaye ba, wanda ba koyaushe ake ba da shawara ba. Haɗin cyclosporine da wakili mai saurin rage ƙwayar cuta na iya haifar da raguwa a cikin ayyukan aikin jijiyoyin jiki, galibi kodan.

Haɗuwa a cikin dabarun warkewa na Lipantil tare da kowane magani daga ƙungiyar statin zai yiwu ne kawai idan mai haƙuri yana da dyslipidemia mai haɗari mai haɗari tare da haɗarin zuciya, idan babu tarihin tsohuwar ƙwayar tsoka. Ba dole ba ne a gudanar da aikin jiyya a cikin yanayin kulawar likita da aka yi niyya don gano alamun lalacewar mai guba zuwa tsokoki na kasusuwa.

Analogs da farashin

Likitocin zuciya sun kirkiri magungunan Lipantil tare da rashin jituwa ga abubuwan da ke jikinta. Hakanan ana aiwatar da sauyawa tare da ƙarancin amfanin sa na tsawon watanni, ƙarancin raguwa a matakin triglycerides da ƙarancin wadataccen lipoproteins a cikin keɓaɓɓiyar kewaya.

Halin yin amfani da kwayoyi tare da babban iko don narke kundin cholesterol kuma cire su daga jiki. Daga cikin tsarin ana amfani da tsarin na Lipantil, Fenofibrate shine mafi yawancin lokuta an tsara shi. Clofibrate da gemfibrozil suna da irin wannan aikin warkewa.

Farashin Lipantil ya sha bamban da yankuna daban-daban na kasar. A cikin Moscow, ana iya siyan fakitin Allunan No. 30 a cikin kashi na 200 MG don 780 rubles. A cikin Nizhny Novgorod yana da nauyin 800 rubles, kuma a cikin Volgograd farashinsa shine 820 rubles.

Yanke shawara game da zaɓi na kyawawan ƙwayoyi masu inganci don rage matakin triglycerides a cikin jini yana da sauƙi. A shafukan yanar gizon likita da magunguna akwai sake dubawa masu inganci da yawa game da Lipantil. Marasa lafiyar likitan zuciya yana da'awar cewa maganin yana kawar da duk alamun hyperlipidemia a cikin watanni 2-3. Suna jaddada amincin miyagun ƙwayoyi, wata alama mai saurin cutar tasirin sakamako da illa.

Mariya Dmitrievna, 'yar shekara 64, Ryazan: matakin cholesterol dina ya fara tashi daga shekara 50. Da farko, babu alamun cutar, amma daga baya lafiyar ta ta kara tsananta. Shugaban kaina ya fara jin danshi, gajeriyar numfashi ya bayyana koda tare da gajerun tafiya. Likitocin zuciya sun bada shawarar shan maganin maganin maganin Lipantil na tsawon watanni uku. Kiwon lafiya ya fara inganta cikin kusan wata guda.

Nikolay, ɗan shekara 49, Zheleznovodsk: Ina da ƙaddarar jinin haihuwa ga ci gaban cututtukan zuciya da jijiyoyin zuciya. Saboda haka, likitan zuciya ya ba da magani nan da nan bayan gano wani matakin da ya ɗauka na triglycerides. Da farko na sha kwayoyi daga rukunin statin, amma sakamakon ya kasance mafi muni kamar yadda aka zata. Likita ya ba da shawarar shan Lipantil a kashi 200 na MG. Watanni uku bayan haka, bayanan nazarin halittun suna da kyau sosai.

Kayan magunguna

Damuwa. Bayan gudanar da maganin baka na maganin maganin shafawa na Lipantil 200M Cmax (mafi girman maida hankali), ana samun fenofibroic acid bayan sa'o'i 4-5. Tare da tsawaitawa, amfani da fenofibroic acid a cikin ruwan yana da kwanciyar hankali, ba tare da la'akari da halayen mutum na haƙuri ba. Cmax a cikin plasma na jini da kuma sakamakon gaba ɗaya na fnofibrate na micronized yana ƙaruwa tare da ci abinci.

Fenofibroic acid yana da tabbaci kuma sama da kashi 99% yana daure ne da albumin plasma.

Metabolism da excretion

Bayan gudanar da baki, fenofibrate yana saurin inganta ruwa ta hanyar esterases zuwa fenofibroic acid, wanda shine babban aikin metabolite. Ba'a gano Fenofibrate a cikin plasma. Fenofibrate ba wani abu bane na CYP3A4, baya cikin metabolism na metabolism a cikin hanta.

Fenofibrate an cire shi ne musamman a cikin fitsari a cikin nau'i na fenofibroic acid da glucuronide conjugate. A tsakanin kwanaki 6, fenofibrate an keɓe shi gaba daya. A cikin tsofaffi marasa lafiya, jimlar cire fenofibroic acid ba ta canzawa. Rabin rayuwar fenofibroic acid (T1 / 2) shine kusan awanni 20. Bai bayyana ba lokacin hemodialysis. Nazarin Kinetic ya nuna cewa fenofibrate baya tara bayan kashi ɗaya kuma tare da amfani da tsawan lokaci.

Wani wakili na zubar da jini daga rukunin abubuwan asali na fibroic acid.Fenofibrate yana da ikon canza abun ciki mai narkewa a cikin jikin mutum ta hanyar kunnawar masu karɓar PPAR-al (masu karɓar alpha wanda mai kunna peroxisome ya kunna).

Fenofibrate yana haɓaka ƙwayar plasma lipolysis da haɓakar atherogenic lipoproteins tare da babban abun ciki na triglycerides ta kunna masu karɓar PPAR-α, lipoprotein lipase da rage ƙira na apoprotein C-III (apo C-III). Sakamakon da aka bayyana a sama yana haifar da raguwa a cikin raguwar lipoprotein mai yawa (LDL) da ƙarancin lipoprotein mai yawa (VLDL), wanda ya haɗa da apoprotein B (apo B), da kuma karuwa a cikin ɓoye na babban lipoprotein mai yawa (HDL), wanda ya haɗa da Apro I apoprotein A-I ( apo A-I) da kuma A-II na farko (apo A-II). Bugu da ƙari, saboda gyaran ƙwayar cuta da rikicewar catabolism na VLDL, fenofibrate yana ƙara yarda da LDL da rage abun ciki na ƙananan ƙananan abubuwa na LDL (haɓaka cikin waɗannan LDL ana lura da marasa lafiya tare da ƙwayar cutar atherogenic lipid phenotype kuma ana danganta shi da haɗarin haɗarin cututtukan zuciya na zuciya-IHD).

A cikin nazarin asibiti, an lura cewa yin amfani da fenofibrate yana rage matakin jimlar cholesterol (Ch) ta 20-25% kuma triglycerides da 40-55% tare da karuwa a matakin HDL-C ta ​​10-30%. A cikin marasa lafiya tare da hypercholesterolemia, a cikin abin da rage yawan Chs-LDL an rage shi zuwa 20-35%, yin amfani da fenofibrate ya haifar da raguwa a cikin masu girma: jimlar Chs / Chs-HDL, Chs-LDL / Chs-HDL da apo B / apo A-I, waɗanda alamomi ne na atherogenic hadarin.

Yin la'akari da tasirin fenofibrate akan matakin LDL-C da triglycerides, yin amfani da miyagun ƙwayoyi yana da tasiri a cikin marasa lafiya tare da hypercholesterolemia, duka biyun kuma ba su tare da hypertriglyceridemia, ciki har da hyperlipoproteinemia na biyu, alal misali, tare da nau'in ciwon sukari na 2 na mellitus.

Akwai wata shaida da ke nuna cewa za a iya rage yawan cututtukan zuciya, amma babu wata shaidar rage yawan mace-mace a matakin farko ko sakandare na cututtukan zuciya.

Yayin jiyya tare da fenofibrate, adibas na karin XC (jijiyoyin da xanthomas na zaren) za su iya raguwa sosai har ma su ɓace gaba ɗaya. A cikin marasa lafiya tare da matakan fibrinogen haɓaka waɗanda suka sami magani fenofibrate, an lura da raguwa mai yawa a cikin wannan alamar, kazalika a cikin marasa lafiya da keɓaɓɓen matakan lipoprotein. A cikin lura da fenofibrate, ana lura da raguwa a cikin ƙwayar C-mai amsawa da sauran alamun alamun kumburi.

Ga marasa lafiya da dyslipidemia da hyperuricemia, ƙarin fa'ida shine cewa fenofibrate yana da tasirin uricosuric, wanda ke haifar da raguwa a cikin yawan uric acid da kusan 25%.

A cikin nazarin asibiti da kuma gwaje-gwajen dabba, an nuna fenofibrate don rage haɗarin platelet wanda ya haifar da adenosine diphosphate, acid na arachidonic, da epinephrine.

Mu'amala da Lafiya

Ba a bada shawarar maganin anticoagulants na baki daya a lokaci guda kamar Lipantil 200M. Fenofibrate yana haɓaka tasirin magungunan anticoagulants na baki kuma yana iya haɓaka haɗarin zub da jini. A farkon jiyya tare da fenofibrate, ana ba da shawarar rage yawan maganin anticoagulants da kashi ɗaya bisa uku, zaɓi na kashi a hankali. Zaɓin zaɓi ne da za a gudanar da shi a ƙarƙashin ikon matakin MHO (madaidaicin yanki na ƙasa).

Sankarini. Yawancin lokuta da suka faru na lalacewa mai sauƙi na aiki na renal yayin aikin kulawa na lokaci daya tare da fenofibrate da cyclosporine. Sabili da haka, wajibi ne don saka idanu kan yanayin aikin koda a cikin irin wannan marasa lafiya da kuma soke Lipantil 200M idan akwai babban canji a sigogi na dakin gwaje-gwaje.

Co-A reductase inhibitors da sauran fibrates. Lokacin ɗaukar fenofibrate a lokaci guda kamar yadda HMG-CoA reductase inhibitors ko wasu fibrates, haɗarin mummunan sakamako mai guba akan ƙwayoyin tsoka yana ƙaruwa. Wajibi ne a yi amfani da kwayoyi na wannan rukunin tare da Lipantil 200M tare da taka tsantsan, marasa lafiya suna buƙatar kulawa da hankali don alamun alamun guba na tsoka

Gzitazones. Akwai rahotannin raguwa mai rikitarwa a cikin HDL cholesterol yayin ɗaukar fenofibrate a hade tare da magani daga ƙungiyar glitazone. Sabili da haka, an bada shawara don saka idanu akan matakan HDL cholesterol tare da haɗakar amfani da kwayoyi ko kuma kawar da ɗayansu, tare da ƙaramin matakin HDL cholesterol.

Enzymes na Cytochrome P450. A cikin binciken vitro na microsomes hanta mutane sun nuna cewa fenofibrate da fenofibroic acid ba masu hana ruwan isoenzymes CYP3A4 bane, CYP2D6, CYP2E1 ko CYP1A2. A babban taro na warkewa, waɗannan mahadi suna da rauni mai hana CYP2C19 da CYP2A6 isoenzymes masu rauni ko matsakaiciyar hanawa na CYP2C9.

Marasa lafiya da ke shan kwayoyi tare da kunkuntar yanayin warkewa lokaci guda tare da fenofibrate, a cikin metabolism wanda enzymes CYP2C19, CYP2A6 kuma, musamman, CYP2C9 sun shiga, suna buƙatar saka idanu sosai. Idan ya cancanta, ana bada shawarar rage girman waɗannan kwayoyi.