Diaformin od

Yana nufin maharan hypoglycemic don amfani da baka. Lowers taro glucosea cikin jini, amma ba ya shafar ɓoyewar insulindon haka ya kasa haddasawa yawan haila cikin koshin lafiya.

Pharmacodynamics

Diaformin yana shafar hanyoyin tafiyar da jikin mutum ta hanyoyi da yawa. Bayan shan maganin:

• yana ƙara haɓaka hankalin masu karɓar zuwa hormone insulin,
• amfani da tantanin halitta yana ƙaruwa glucose,
• da yawan hepatic gluconeogenesis canje-canje
• A cikin narkewar ƙwayoyin narkewa na ƙasa basu da ƙarfi sosai,
• ƙimar ƙwayar ƙwayar lipid yana ƙaruwa, yayin da irin waɗannan alamu kamar LDL, TG da cholesterol.

Pharmacokinetics

Daga farkon allunan Allunan, abun aiki mai narkewa yana dauke da jijiyoyin jini. Haka kuma, kayan aikinta shine kashi 50-60%. Amma tare da cin abinci lokaci guda tare da abinci, sha yana ragewa kuma yana faruwa a hankali.

Sau daya a cikin jiki, kayan cikin wani bangare a cikin kasusuwa kuma wani bangare a jikin da ba su canzawa suna fita a cikin fitsari da kuma feces. Cire rabin rayuwa daga kwayoyin shine tsawon awa 9-12. Amma idan aikin koda ya lalace, to ya daɗe. A wannan yanayin, akwai haɗarin cewa miyagun ƙwayoyi zasu tara cikin jiki kuma suna haifar da yawan abin sha.

Alamu don amfani

An nuna Diaformin don:

• insulin mai zaman kantaciwon sukariA cikin manya, idan aka auna shi da kiba kuma maganin rage cin abinci ya tabbatar da rashin ingancinsa.
• insulin dogarociwon sukari (haɗe shi da Diaformin da insulin) Amfani da Diaformin an nuna shi musamman ga marasa lafiya da mummunan kiba, lokacin da aka lura da tsayayyar sakandare na shirye-shiryen insulin.

Contraindications

An haramta shan miyagun ƙwayoyi tare da:

• masu fama da cutar sankarako magabatansu,
• dibeto ketoacidosis,
• take hakkin iyawa da kodan,
• kasancewar a cikin jikin matakai da ra'ayoyin cuta wanda a ciki akwai haɗarin lalacewa mai ƙarfi a cikin aikin kodan,
• bushewa
• mai karfi zazzabi,
• sepsis,
• gigice,
• mai tsanani siffofin da cututtuka,
• zuciyada gazawar numfashi,
• kaifi infarction na zuciya,
• hanta dysfunction
• na kullum barasa,
• guba shan giya
• kasancewa lactic acidosis a cikin anamnesis,
• nakasa jiki (saboda karancin kalori, yawan motsa jiki a cikin tsufa),
• kwanan nan tiyata
• na ciki.

Side effects

A lokacin jiyya, amsawar da ba a so ga miyagun ƙwayoyi daga tsarin daban-daban na jikin mutum na iya bayyana.

Daga tsarin narkewa:

• ɗanɗanar baƙin ƙarfe a bakin
• tashin zuciya da amai,
• rashin ci
• cututtukan dyspeptik
• zafi a ciki
• rashin tsoro.

Don cirewa ko rage waɗannan bayyanar cututtuka, zaku iya ɗaukar maganin antispasmodic ko ɗayan magungunan atropine kuma fara shan allunan bayan abinci 2 ko sau 3 a rana. Idan waɗannan matakan ba su kawo sauƙi ba, an soke aikin Diaformin.

Daga gefen hanyoyin rayuwa:

• lactic acid diathesis - Wannan wata alama ce ta kai tsaye don kawar da magunguna,
• hypovitaminosis B12 (kawai tare da magani na dogon lokaci).

Hakanan iya ci gaba alerji a cikin tsari itching da fata fitsari. Da wuya, ana lura da rashin amsawa daga tsarin bashin jini - ci gaban megaloblastic anemia.

Diaformin, umarnin aikace-aikacen

Ya kamata a zabi sashi da tsawon lokacin likitanci kawai ga kowane mara lafiya daban daban. Wannan yana la'akari da tsananin cutar da matakin glucose a cikin jini.

Wajibi ne a fara jiyya tare da kashi na yau da kullun na 500-1000 MG. Kuna iya ƙara sashi kawai bayan kwanaki 10-15, yin la'akari da ƙididdigar bincike na glucose jini. Yawancin lokaci, tare da maganin kulawa, ɗauki 1500-2000 MG na miyagun ƙwayoyi kowace rana. Matsakaicin izini na yau da kullun shine 3000 MG.

Ga yara daga shekaru 10, ana iya tsara maganin tare da farawa na 500 ko 850 ml kowace rana. Matsakaicin abin da za'a kara adadin shine 2000 mg / rana, yayin da kashi ya kasu kashi biyu ko uku.

Rage kwamfutar hannu ba tare da tauna ba. Ana yin wannan tare da ko bayan abinci. Don rage yiwuwar sakamakon da ba a so daga ciki da hanji, yana da kyau a rinka rage kowace rana zuwa allurai da yawa.

Yawan abin sama da ya kamata

Tare da yawan abin sama da ya kamata tasowa lactic acidosis. Zai iya gane hakan ta hanyar alamun nan masu zuwa:

• zawo,
• ji tashin zuciya,
• amai,
• zafin jiki
• jijiya tsoka
• ciwon ciki
• gazawar numfashi a cikin hanyar karancin numfashi,
• tsananin farin cikiwanda ka iya haifar da hakan asarar sani,
• coma(tare da mai tsananilactic acidosis).

Da zaran alamu na farko sun bayyana lactic acidosis, yana da gaggawa a daina shan maganin kuma a kai wanda aka cutar zuwa asibiti. Za'a iya ba da taimako na Symptomatic. A asibiti, dole ne a yi haƙuri maganin hemodialysisdon cire maganin daga jiki.

Nazarin haƙuri game da diaformin od

Naku koyaushe na sayi allunan 850 na Diaformin. Wannan magani ne da masu ciwon sukari ke sha. Ana ɗaukar shi tare da wasu kwayoyi lokacin da sukarin jini ya kasance wani wuri kusa da 8-10 mmol / l. Kuna buƙatar sha Diaformin kullun tare da abinci sau 3 a rana. Magungunan suna sayar da sukari da kyau. Na san mutane da yawa waɗanda suka kwashe shekaru da yawa suna shan magungunan Diaformin da Glucovans. Sun ce maganin yana taimaka musu sosai. Lokacin da aka ci, abincin ci har ma yana inganta. Har ila yau, ciwon zuciya ya ragu, kuma marasa lafiya masu hauhawar jini sun koma matsin lamba. Kuma farashinta bai yi yawa ba. Idan ya cancanta, ana iya ɗauka.

Aboki ya ɗauki "Diaformin." Na saba ji cewa wannan magani ne da aka tsara don ciwon sukari. Amma abokina bashi da ciwon sukari. Lokacin da na fara tambayarsa dalilin da yasa aka sanya Diaformin, ya zama cewa za'a iya shan wannan maganin tare da kiba. Mutanen da ke da kiba sau da yawa suna da rauni a cikin haƙuri (ciwon suga), kuma Diaformin yana da hannu wajen ƙona kitse, kuma ba wai yana rage glucose jini ba. Kuma a hade tare da tsarin abinci, tasirinsa ya kasance mafi ma'ana. A cikin wata guda na shan miyagun ƙwayoyi, an lura da asarar nauyi, aikin jiki ya ƙaru, rauni ya ɓace.

Pharmacology

Wakili hypoglycemic wakili daga rukuni na biguanides (dimethylbiguanide). Hanyar aiwatar da metformin yana da alaƙa da iyawarta don dakatar da gluconeogenesis, kazalika da samuwar ƙwayoyin mai mai kyauta da hadawar hada hada abubuwa da hada abubuwa da kitse na mai. Theara hankalin mai karɓar mahaifa zuwa insulin da kuma amfani da glucose ta sel. Metformin baya tasiri da yawan insulin a cikin jini, amma yana canza magunguna ta hanyar rage ragin insulin da za'a ɗauka kyauta da kuma ƙara yawan rabo daga insulin zuwa proinsulin.

Metformin yana ƙarfafa haɗin glycogen ta hanyar yin aiki akan glycogen synthetase. Capacityara ƙarfin jigilar kayayyaki na kowane nau'ikan jigilar jini na membrane. Yana jinkirta ɗaukar ciki na glucose.

Yana rage matakin triglycerides, LDL, VLDL. Metformin yana haɓaka ƙirar fibrinolytic ta jini ta hanyar dakatar da nau'in mai kunnawa mai hana jini plasminogen.

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

Fom ɗin saki

30 inji mai kwakwalwa - fakitin bakin (1) - fakitoci na kwali.
30 inji mai kwakwalwa - fakitin bakin (2) - fakitoci na kwali.
30 inji mai kwakwalwa - fakiti mai bakin ciki (3) - fakitoci na kwali.

Ana ɗauka ta baki, lokacin ko bayan abinci.

Matsayi da mita na gudanarwa ya dogara da nau'in sashi wanda aka yi amfani dashi.

Tare da monotherapy, kashi ɗaya na farko na manya shine 500 MG, ya dogara da nau'in sashi wanda aka yi amfani dashi, yawan gudanarwa shine sau 1-3 / rana. Yana yiwuwa a yi amfani da 850 MG 1-2 sau / rana. Idan ya cancanta, a hankali ana ƙaruwa da kashi tare da tazara tsakanin mako 1. har zuwa 2-3 g / rana.

Tare da maganin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa don yara masu shekaru 10 da haihuwa, mazan, kashi na farko shine 500 MG ko 850 1 lokaci / rana ko 500 MG sau 2 / rana. Idan ya cancanta, tare da tazara aƙalla 1 mako, za a iya ƙara yawan zuwa zuwa 2 g / rana a cikin kashi 2-3.

Bayan kwanaki 10-15, dole ne a daidaita adadin gwargwadon sakamakon ƙaddarawar glucose a cikin jini.

A haɗuwa da jiyya tare da insulin, kashi na farko na metformin shine 500-850 MG sau 2-3 / rana. An zaɓi kashi na insulin dangane da sakamakon ƙudurin glucose a cikin jini.

Haɗa kai

Tare da yin amfani da lokaci guda tare da abubuwan da aka samo na sulfonylurea, acarbose, insulin, salicylates, MAO inhibitors, oxygentetracycline, ACE inhibitors, tare da clofibrate, cyclophosphamide, tasirin hypoglycemic na metformin na iya inganta.

Tare da yin amfani da lokaci guda tare da GCS, rigakafin hormonal don gudanar da maganin baka, danazol, epinephrine, glucagon, hormones na thyot, abubuwan phenothiazine, magungunan thiazide, abubuwan nicotinic acid, raguwar sakamako na hypoglycemic na metformin mai yiwuwa ne.

A cikin marasa lafiya da ke karɓar metformin, yin amfani da iodine-dauke da wakilai masu bambanci don gwaje-gwaje na bincike (ciki har da urography intravenous, cholangiography, angiography, CT) yana ƙara haɗarin mummunan lalacewa na koda da lactic acidosis. Wadannan abubuwan hade

Beta₂-adrenomimetics a cikin hanyar injections yana kara yawan glucose a cikin jini sakamakon yawan motsa jiki na β₂-adarinya. A wannan yanayin, ya zama dole don sarrafa tattarawar glucose a cikin jini. Idan ya cancanta, ana ba da shawarar yin insulin insulin.

Amfani da cimetidine na iya ƙara haɗarin lactic acidosis.

Yin amfani da "madaukai" daya na lokaci daya zai iya haifar da ci gaban lactic acidosis saboda gazawar aiki na kasa aiki.

Gudanar da lokaci tare da ethanol yana kara haɗarin lactic acidosis.

Nifedipine yana haɓaka sha da C_max metformin.

Magungunan cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim da vancomycin) waɗanda aka ɓoye a cikin tubules na koda suna gasa tare da metformin don tsarin jigilar tubular kuma zai iya haifar da karuwa a cikin C_max.

Umarni na musamman

Ko da kuwa mai haƙuri yana da cutar koda, ya kamata a ƙayyade matakan lactate aƙalla sau biyu a shekara yayin jiyya tare da Diaformin. Haka ya kamata a yi idan ƙwayar tsoka ta bayyana.

Idan yayin jiyya yana da mahimmanci don yin gwajin radiyotope ko X-ray, wanda zai bambanta dangane da kwayoyi za a gabatar da shi aidin, kuna buƙatar dakatar da shan maganin kwana biyu kafin tsarin bincikar lafiya. Kwana biyu bayansa, ana iya ci gaba da warkewa.

Babu isasshen bincike don kammala cewa maganin yana da lafiya kuma yana da tasiri a cikin kula da yara, don haka ba a ba da umarnin ga yara 'yan ƙasa da shekara 10 ba.

Yayin ciki da lactation

Ba a fahimci aikace-aikacen ba a lokacin waɗannan lokacin. Ba a sami tasirin teratogenic ba, amma an san hakan metformin da yardar rai shiga cikin shinge na jini. Saboda haka, yana da daraja a rubuta magani kawai a matsayin makoma ta ƙarshe, lokacin da haɗarin lafiyar mahaifiyar ta wuce haɗarin da zai iya yiwa ɗan.

Analogs sun hada da:

Farashin Diaformin inda zan siya

Kuna iya siyan Diaformin a cikin kantin magani na yau da kullun, amma yana da kyau a bincika samuwar gaba. Kwayoyin suna biyan kuɗi daga 60 rubles (a cikin kunshin 30 Allunan 500 na 500 kowannensu) zuwa 300 rubles (a cikin kunshin 60 Allunan 1000 mg kowane).

Kudin Allunan a Ukraine sunsha daga 50 hryvnias (guda 30 na 500 MG kowannensu) zuwa 180 hryvnias (guda 60 guda 1000 na 1000 kowannensu).

Form sashi

500 MG da allunan kwayoyi 850

Tabletaya daga cikin kwamfutar hannu ya ƙunshi:

abu mai aiki: metformin hydrochloride - 500 MG da 850 MG

tsofaffi: allunan 500 MG: sitaci dankalin turawa, celclose microcrystalline, povidone, polyethylene glycol (macrogol 4000), magnesium stearate,

Allunan kwalaji 850: sitaci dankalin turawa, lactose monohydrate, celclosese microcrystalline, povidone, polyethylene glycol (macrogol 4000), stearate alli.

Allunan wani nau'in zagaye, tare da farfajiyar sililin, fararen fata ko kusan fararen fata, tare da bevel da daraja (don sashi na 500 MG)

Allunan, tare da biconvex farfajiya, farare ko kusan fararen fata, tare da ko ba tare da haɗari ba (don sashi na 850 MG)

Hanyar aikace-aikace

Monotherapy ko magani a hade tare da sauran jami'in na baki hypoglycemic.
Yawancin lokaci kashi na farko na miyagun ƙwayoyi Diaformin shine 500 mg ko 850 mg sau 2-3 a rana lokacin ko bayan abinci.
Bayan kwanaki 10-15, dole ne a tsawan kashi gwargwadon sakamakon ma'aunai na matakin gulukos a cikin jini.
Rage hawa a kashi yana rage tasirin sakamako daga narkewa.
A cikin lura da babban allurai, ana amfani da Diaformin, allunan da aka saka a fim, 1000 MG kowane.
Matsakaicin shawarar da aka ba da shawarar ita ce 3000 MG kowace rana, ya kasu kashi uku.
Game da canzawa daga wani magani na antidiabetic, ya zama dole a daina shan wannan magani kuma a tsara Diaformin, kamar yadda aka bayyana a sama.
Hade jiki tare da insulin.
Don cimma nasarar sarrafa matakan glucose na jini, ana iya amfani da metformin da insulin azaman maganin haɗuwa. Yawanci, kashi na farko shine 500 MG ko 850 MG na Diaformin sau 2-3 a rana, yayin da yakamata a zaɓi kashi na insulin daidai da sakamakon auna glucose jini.
Yara.
Monotherapy ko hade tare da insulin.
Ana amfani da Diaformin a cikin yara sama da 10. Yawanci, kashi na farko shine 500 MG ko 850 MG na Diaformin 1 lokaci a rana a lokacin ko bayan abinci. Bayan kwanaki 10-15, dole ne a tsawan kashi gwargwadon sakamakon ma'aunai na matakin gulukos a cikin jini.
Rage hawa a kashi yana rage tasirin sakamako daga narkewa.
Matsakaicin mafi girman shawarar da aka bayar shine 2000 MG kowace rana, an kasu kashi biyu.
A cikin marasa lafiya tsofaffi, raguwa a aikin renal yana yiwuwa, sabili da haka, dole ne a zaɓi kashi na metformin dangane da kimanta aikin aikin koda, wanda dole ne a gudanar da shi akai-akai (duba sashin "Siffofin amfani").
Marasa lafiya tare da renal gazawar. Ana iya amfani da Diaformin a cikin marasa lafiya tare da gazawar matsakaiciyar matsakaici, mataki na IIIa (keɓaɓɓen bayani na 45-59 ml / min ko GFR 45-59 ml / min / 1.73 m2) kawai a cikin rashin sauran yanayin da zai iya ƙara haɗarin lactic acidosis, wanda ke biye da daidaitawar kashi: kashi na farko shine 500 MG ko 850 MG 1 lokaci a rana. Matsakaicin adadin shine 1000 MG kowace rana, an kasu kashi biyu. Yakamata a kula sosai da aikin aikin kowanne watanni 3-6.
Idan sharewar creatinine ko GFR ya ragu zuwa 45 ml / min ko 45-59 ml / min / 1.73 m2, ya kamata a dakatar da Diaformin kai tsaye.
Yara. Ana iya amfani da Diaformin a cikin yara sama da 10.

Kayan magunguna

Pharmacokinetics

Bayan shigowa, ana amfani da metformin daga ƙwayar gastrointestinal kusan gabaɗaya, 20-30% na kashi an ƙaddara shi a cikin feces. Cikakken bayanin halitta daga 50 zuwa 60%. Tare da shigowa lokaci guda, ɗaukar metformin yana raguwa kuma yana raguwa.

An rarraba Metformin cikin hanzari a cikin kyallen takarda, kusan ba a ɗaura shi ga furotin plasma ba.

Metformin yana da ɗan metabolized kuma ɗan kodan ya fitar da shi.Budewar cikin lafiyayyun mutane shine 440 ml / min (sau 4 fiye da creatinine), wanda ke nuna aikin toshewar aiki. Rabin rayuwar kusan awoyi 9-12 ne. Tare da gazawar koda, yana ƙaruwa, akwai haɗarin tarin ƙwayoyi.

Pharmacodynamics

Metformin yana rage hyperglycemia, baya haifar da ci gaban hypoglycemia. Ba kamar sulfonylurea ba, ba ta haifar da insulin insulin kuma ba ya haifar da tasirin hypoglycemic a cikin mutane masu lafiya. Metformin yana ƙaruwa da hankalin masu karɓa na yanki zuwa insulin da kuma amfani da glucose ta ƙwayoyin tsoka. Yana hana gluconeogenesis a cikin hanta. Yana jinkirta ɗaukar carbohydrates a cikin hanjin. Yana da tasiri mai kyau akan metabolism na lipid: yana rage abun cikin jimlar cholesterol, ƙarancin yawan lipoproteins da triglycerides.

Hulɗa da ƙwayoyi

Tare da yin amfani da magani Diaformin tare da danazole lokaci guda, haɓaka tasirin hyperglycemic mai yiwuwa ne. Idan jiyya tare da danazol ya zama dole kuma bayan dakatar dashi, ana buƙatar daidaita sashi na Diaformin a ƙarƙashin ikon cutar glycemia.

Tare da yin amfani da magani na lokaci guda Diaformin tare da barasa da ethanol-kwayoyi masu haɗari, haɗarin haɓaka lactic acidosis a lokacin shan giya mai yawa yana karuwa, musamman lokacin yin azumi ko bin tsarin rage kalori, kazalika tare da gazawar hanta.

Chlorpromazine a cikin allurai masu yawa (100 mg / day) yana rage sakin insulin kuma yana kara matakin glucose a cikin jini. Tare da yin amfani da lokaci ɗaya tare da antipsychotics kuma bayan dakatar da gudanarwarsu, ana buƙatar daidaita sashi na Diaformin a ƙarƙashin kula da matakin glycemia. Glucocorticosteroids (don tsari da amfani da Topical) rage haƙuri a cikin glucose da haɓaka matakan glucose na jini, a wasu yanayi suna haifar da ketosis. Idan ya zama dole don amfani da irin wannan haɗin har ma bayan dakatar da aikin glucocorticosteroid, ana buƙatar daidaita sashi na Diaformin a ƙarƙashin kula da matakin glucose na jini.

Tare da yin amfani da sau ɗaya na "madauki" diuretics da Diaformin, akwai haɗarin lactic acidosis saboda bayyanar yiwuwar lalacewa ta aiki. Bai kamata a rubuto Diaformin ba idan za a ba da izinin alkinta

Siffofin aikace-aikace

Lactic acidosis abu ne mai matukar wahala, amma rikitarwa na rayuwa mai wahala (yawan mace-mace a cikin rashin magani na gaggawa), wanda zai iya faruwa sakamakon tarin metformin. An bayar da rahoton lokuta na lactic acidosis a cikin marasa lafiya da ke fama da ciwon sukari na mellitus tare da gazawar koda ko kuma tabarbarewa cikin aikin renal.

Sauran abubuwan haɗari ya kamata a yi la'akari dasu don guje wa ci gaban lactic acidosis: mellitus mai ƙarancin iko, ketosis, tsawan azumi, yawan shan barasa, rashin hanta, ko kowane yanayin da ke haɗuwa da hypoxia (ƙin bugun zuciya, matsanancin rashin ƙarfi na mama) (duba "Contraindications").

Lactic acidosis na iya bayyana kamar jijiyoyin tsoka, ƙoshin ciki, zafin ciki da matsanancin asthenia. Marasa lafiya ya kamata sanar da likita nan da nan game da abin da ya faru na irin wannan halayen, musamman idan marasa lafiya sun amince da amfani da metformin a baya. A irin waɗannan halayen, ya zama dole a dakatar da amfani da metformin na ɗan lokaci har sai an tabbatar da yanayin. Ya kamata a sake farawa da maganin farfadowa na Metformin bayan kimanta fa'idodi / haɗarin haɗari a cikin maganganun mutum da kimanta aikin renal.

Binciko . Lactic acidosis yana halin rashin ƙarfi na acidic na numfashi, zafi na ciki da hauhawar jini, ƙarin haɓakar ƙima yana yiwuwa. Manuniya na gwaji sun haɗa da raguwar dakin gwaje-gwaje a cikin pH na jini, karuwa a cikin taro na lactate a cikin ƙwayar jini sama da 5 mmol / l, karuwa a cikin ragin anion da rabo na lactate / pyruvate. Game da haɓakar ci gaban lactic acidosis, ya zama dole a kwantar da majinyaci nan da nan (duba sashe na "overdose"). Yakamata likitan ya gargadi marassa lafiya game da hadarin kamuwa da cutar lactic acidosis.

Rashin wahala . Tunda metformin ya cire kodan, kafin kuma a kai a kai yayin kulawa tare da Diaformin ®, ya zama dole a duba matakin creatinine (ana iya kimanta shi da matakin plasma creatinine ta amfani da tsarin Cockcroft-Gault) ko GFR:

• marasa lafiya da keɓaɓɓen aikin na ƙasa aƙalla 1 lokaci a shekara,
• marasa lafiya tare da keɓancewar creatinine a ƙananan iyakance na al'ada da tsofaffi marasa lafiya aƙalla sau 2-4 a shekara.

Idan keɓancewar creatinine shine 2), metformin yana tazara (duba sashin "Contraindications").

Rage aikin renal a cikin tsofaffi marasa lafiya ne na kowa da asymptomatic. Yakamata a yi taka tsantsan yayin da aikin keɓaɓɓe zai iya lalacewa, alal misali, a cikin yanayin bushewa ko a farkon jiyya tare da magungunan ƙwayoyin cuta, cututtukan juji, da kuma farkon Farkon NSAID. A cikin irin waɗannan halaye, an kuma ba da shawarar a kula da aikin renal kafin a fara jiyya tare da metformin.

Aikin zuciya . Marasa lafiya tare da raunin zuciya suna da haɗarin haɓakar haɓakar hypoxia da gazawar koda. A cikin marasa lafiya da tsayayyen bugun zuciya, za a iya amfani da metformin tare da saka idanu na yau da kullun game da aikin zuciya da aikin koda. Metformin yana cikin ƙwayoyin cuta a cikin marasa lafiya tare da raunin zuciya da rashin kwanciyar hankali (duba sashin "Contraindications").

Iodine-dauke da kayan aikin rediyo . Amfani da ciki na wakilin kayan aikin rediyo don karatun rediyo na iya haifar da gazawar renal kuma, sakamakon haka, haifar da tarin metformin da haɓakar haɗarin lactic acidosis. Marasa lafiya tare da GFR> 60 ml / min / 1.73 m 2, ya kamata a dakatar da amfani da metformin kafin ko a lokacin binciken kuma ba a sake kunnawa ba kafin sa'o'i 48 bayan nazarin kuma kawai bayan sake nazarin aikin koda da kuma tabbatar da rashi na rashin ci gaba na nakasa (duba dubawa) sashen “hulɗa tare da wasu samfuran magunguna da sauran nau'ikan hulɗa”).

Marasa lafiya tare da gazawar matsakaiciyar matsakaici (GFR 45-60 ml / min / 1.73 m 2) yakamata su daina amfani da Metformin 48 sa'o'i kafin gudanarwar abubuwan da ke kunshe da sinadarin iodine kuma bai kamata a sake farawa ba kafin sa'o'i 48 bayan nazarin kuma kawai bayan sake nazarin aikin aikin ƙirar. da kuma tabbacin rashin raunin cigaba game da cutar dan adam (duba "hulɗa da wasu magunguna da sauran nau'ikan hulɗa").

Turewa . Wajibi ne a dakatar da amfani da Diaformin ® 48 hours kafin aikin tiyata na tiyata, wanda aka gudanar a cikin janar, kashin baya ko maganin tashin hankali kuma ba zai sake dawowa ba kafin awanni 48 bayan tiyata ko maido da abinci na abinci da kuma kawai idan an tabbatar da aikin na al'ada.

Yara . Kafin fara magani tare da metformin, dole ne a tabbatar da bayyanar cututtuka na nau'in ciwon sukari na 2. Dangane da sakamakon binciken na asibiti na shekara guda, babu wani sakamako na metformin akan girma da balaga a cikin yara. Koyaya, babu bayanai game da tasirin metformin da balaga tare da yin amfani da Diaformin ®, sabili da haka, ana bada shawarar saka idanu akan waɗannan sigogi a cikin yaran da aka kula dasu tare da metformin, musamman lokacin balaga.

Yara masu shekaru 10 zuwa 12. Dangane da sakamakon binciken asibiti, tasiri da amincin wannan rukuni na marasa lafiya bai bambanta da wannan a cikin yaran da suka manyanta. Ya kamata a tsara magungunan tare da taka tsantsan ga yara masu shekaru 10 zuwa 12.

Sauran matakan . Marasa lafiya suna buƙatar bin tsarin cin abinci, yawan abinci na carbohydrates a cikin kullun. Yakamata mara lafiyar yakamata aci gaba da bin tsarin karancin kalori. Wajibi ne a sanya idanu a kai a kai kan alamomin metabolism na marasa lafiya.

Monotherapy tare da metformin ba ya haifar da hypoglycemia, amma ya kamata a yi taka tsantsan yayin amfani da Diaformin ® tare da insulin ko wasu wakilai na bakin jini (misali, sulfonylureas ko meglitinide) na iya haɓaka tasirin hypoglycemic.

Yi amfani da lokacin daukar ciki ko lactation.

Ciki Cututtukan ciwon siga da ba a kulawa da su yayin daukar ciki (gestational or akai) yana kara hadarin kamuwa da cutar cututtukan cikin gida da mace-mace na haihuwa.

Rashin shayarwa. Ana amfani da Metformin a cikin madara, amma ba a lura da sakamako ba a cikin jarirai / jarirai waɗanda ke shayar da mama. Koyaya, tunda babu isasshen bayanai game da amincin miyagun ƙwayoyi, ba a bada shawarar ciyar da nono yayin jiyya tare da Diaformin ®. Dole ne a yanke shawarar dakatar da shayarwa ta la'akari da amfanin shayarwa da kuma haɗarin haɗarin sakamako ga jariri.

Haihuwa . Metformin bai shafi haihuwa dabbobi ba lokacin da aka yi amfani dashi a allurai na 600 MG / kg / rana, wanda ya kusan sau 3 yana sama da matsakaicin shawarar da aka bayar na yau da kullun ga yan adam dangane da yanayin jikin mutum.

Thearfin yin tasiri akan ƙimar amsawa yayin tuki motocin ko wasu hanyoyin.

Diaformin ® baya tasiri ga ƙudurin amsawa yayin tuki ko aiki tare da wasu hanyoyin, tunda monotherapy tare da maganin ba ya haifar da hypoglycemia.

Koyaya, yakamata a yi amfani da metformin tare da taka tsantsan tare da sauran abubuwan haɗin gishirin jiki (sulfonylureas, insulin, ko meglitinides) saboda haɗarin cutar hypoglycemia.

M halayen

Metabolism: lactic acidosis.

Tare da yin amfani da miyagun ƙwayoyi na tsawon lokaci, sha na bitamin B na iya raguwa ₁₂ , wanda ke hade da raguwa a matakin sa a cikin jijiyoyin jini. An ba da shawarar yin la'akari da irin wannan yiwuwar hypovitaminosis B. ₁₂ idan mai haƙuri yana da cutar tasirin megaloblastic.

Daga tsarin juyayi: take hakkin dandano.

Daga narkewa: rikice-rikice na narkewa, kamar tashin zuciya, amai, zawo, ciwon ciki, rashin ci. Mafi yawan lokuta, waɗannan sakamako masu illa suna faruwa a farkon magani kuma a mafi yawan lokuta ba tare da ɓata lokaci ba. Don hana faruwar sakamako masu illa daga narkewa, ana ba da shawarar a hankali a ƙara yawan sashi da amfani da miyagun ƙwayoyi a cikin allurai 2-3 lokacin ko bayan abinci.

Daga tsarin narkewa: take hakkin alamomin aikin hanta ko hepatitis, wanda gaba daya ya ɓace bayan katse metformin.

A bangare na fata da kasusuwa na jiki: halayen fata, ciki har da erythema, pruritus, urticaria.