Antidiabetic Dapagliflozin

Ciwon sukari mellitus shine rukuni mai yawa na cututtukan cututtukan cututtukan fata waɗanda ke da asali. Babban alama ga kowane nau'in ciwon sukari shine hyperglycemia - sukari mai hawan jini. Hyperglycemia yana faruwa ne a dalilin isasshen samarwa ko aikin insulin (insulin baya iya biyan duk bukatun jikin mutum, ko kuma gaba daya ba ya nan).
Insulin shine hormone, "mabuɗin" wanda ke da ikon buɗe sel don ingantaccen aiki na sukari. Shi, bi da bi, yana da mahimmanci ga abinci mai gina jiki da ingantaccen aiki na duk tafiyar matakai a cikin jiki. Ana samar da insulin ta hanyar tsarin musamman - ƙwayoyin beta na pancreatic. Akwai nau'ikan insulin guda biyu - haɓakar basal (ya zama dole, na asali, samar da madaidaicin sukari na jini ba tare da ɗaukar abinci ba) da kuma postprandial (samarwar insulin ta motsa jiki ta hanyar abinci, lokacin da kwatsam ya zama dole don aiwatar da ƙarin sukari).

Idan an fara gano marasa lafiya da ciwon sukari mellitus, ya zama dole a tantance irin nau'ikan cututtukan da ke kamuwa da su don bin da ya dace. Mafi na kowa sune nau'in 1 da nau'in ciwon sukari na 2. A aikace, akwai wasu, amma ba su yadu ba.

Yaya za a bi da ciwon sukari na 1

Nau'in nau'in 1 ana kiransa da nau'in insulin-dogara. Sakamakon lalacewar ƙwayoyin beta na pancreatic, insulin samar da insulin. A cikin marasa lafiyar da ke fama da wannan cuta, akwai buƙatar gudanar da insulin akai-akai. Mutanen da ke da nau'in ciwon sukari na 1 sau da yawa suna juya zuwa kulawa mai zurfi. Wannan yana nufin cewa insulin da ke aiki tsawon lokaci, suna ma'anar ɓoye insulin na basal, ana yin su da maraice (ko da safe da maraice), kuma yayin rana, a matsayin doka, kafin abinci, ana ƙara “insulin” insulin gajere don rage yawan cututtukan postprandial.

Wasu marasa lafiya sun sami nasarar amfani da famfon ɗin insulin. Wannan na'ura ce da ke isar da insulin a lokuta na yau da kullun daidai da bukatun mai haƙuri kai tsaye zuwa dermis, inda ake sha.

Yaya za a kula da ciwon sukari na 2?

Ciwon sukari na 2, ba kamar na farkon ba, yana da karancin insulin. Wannan yana nuna cewa koda yana samarda insulin, amma samarwa baya iya biyan bukatun jiki ko kyallen takan zama mai saukin kamuwa da aikin sa (a zahiri ana kiran wannan yanayin insulin juriya).

Wadanne magunguna zasu sha?

Dalili don lura da nau'in ciwon sukari na 2 na mellitus shine ƙara haɓakar jijiyoyin jiki zuwa insulin (alal misali, amfani da magani wanda ya ƙunshi Metformin, Pioglitazone, wanda aka samar da mafi yawan nau'ikan allunan) ko ƙara yawan samarwa daga ƙwayoyin beta na pancreatic a lokacin da ya dace (magungunan sulfonylurea kwayoyi) , Glinides, shima allunan). A halin yanzu, ana amfani da kwayoyi gwargwadon tasiri akan tsarin na ciki kuma, a ƙarshe, akan cire adadin sukari mai yawa daga jiki tare da fitsari (Glyflosins). Ana amfani da yawancin wakilai masu aiki daga waɗannan rukunin a cikin nau'ikan allunan don magani. Saboda haka, waɗannan magungunan ana haɗuwa gaba ɗaya ana kiran magungunan bakin haɓaka.

Metformin shine magani na farko na zaɓin nau'in ciwon sukari na 2. Yana inganta sarrafa sukari a cikin kashin kasusuwa. Idan tasirin miyagun ƙwayoyi bai isa ba, to za a iya ƙara wasu wakilai masu maganin antidi. Sakamakon sakamako na wannan magani yana da wuya. Patientsarin haƙuri marasa lafiya na iya fuskantar zawo, ƙanshin wuta, tashin zuciya, ɗanɗano mai ƙarfe a bakin. Rashin sakamako mara amfani akan ƙwayar gastrointestinal zai iya raguwa ta hanyar shan magani bayan abinci, a matsayin mai mulkin, bayan makonni 2-3 na jiyya, sun raunana. Ana iya gudanar da Metformin har sau 3 a rana. Ya kamata a cire barasa yayin shan wannan magani. Ana samun magungunan a cikin nau'ikan allunan.

Rukunin glitazone sun hada da sinadarin pioglitazone, magani ne wanda bawai yana kara jijin kyallen ne ga insulin ba, amma kuma yana da tasiri mai kyau a cikin tarin fats a cikin jini, hawan jini da kuma hana hakar sunadaran da kodan ke yi. A lokacin jiyya, ana iya amfani dashi shi kadai (idan mara lafiyar yana da haƙuri na Metformin), ko kuma za a iya haɗe shi tare da sauran wakilai na maganin antidiabetic na baka. Sakamakon sakamako na miyagun ƙwayoyi na iya haɗawa da tara tarin ruwa a cikin jiki, karɓar nauyi, a haɗuwa da jiyya - hypoglycemia. An shirya shirye-shiryen wannan rukunin a cikin hanyar Allunan.

Sulfonylureas

Groupsungiyoyin magungunan Sulfonylurea sune sababbin abubuwa masu haɓaka waɗanda ke haɓaka aikin insulin ta hanyar ƙwayoyin beta na tsibirin na Langerhans. Ana amfani da waɗannan kwayoyi yawanci a haɗuwa da warkewa don cututtukan type 2. Allunan dauke da abubuwan sulfonylurea ana amfani dasu sosai a cikin rabin sa'a kafin abinci. Idan kwayar aiki mai aiki daga wannan rukuni an haɗa shi cikin allunan da aka saki, za'a iya ɗaukar magani nan da nan kafin ko lokacin cin abinci.

Abubuwan da ke cikin Sulfonylurea na iya ma'amala tare da wasu magungunan da mai haƙuri ke ɗauka, gami da magunguna na kan-kan-kan. Sabili da haka, yana da mahimmanci likita ya san duk magungunan da aka karɓa. Babban sakamako masu illa sune rashin lafiyar hypoglycemia da nauyin jiki. Tare da tsawanta magani tare da babban allurai na shirye-shiryen sulfonylurea, ajiyar insulin a cikin farji zai iya ƙoshinta, sakamakon wanda aka gabatar da insulin a cikin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar cikin haƙuri. Shirye-shirye tare da kayan aikin sulfonylurea - Allunan. Barasa bai dace da wannan aji na magunguna ba!

A halin yanzu, akwai ƙungiyoyin magunguna masu rajista a cikin kasuwar da ke ɗauke da abubuwan da ke aiki masu zuwa: Glimepiride, Gliclazide, Glipizide da Gliburide.

Groupsungiyoyin Clinid suna aiki akan sel beta na tsibirin na Langerhans kamar su sulfonylureas. Wato, suna ba da gudummawa ga haɓaka ƙwayar insulin. Ana ɗaukar Glinids ko da kuwa abincin ci. Siffar ita ce allunan.

Abubuwan da ke shafar tsarin ɓarna

Abubuwan dake cikin sabbin abubuwa sabbin abubuwa ne na yanayin garkuwar jiki ko kuma kwayoyin halittu kuma ana samarwa a cikin mucous membrane na gastrointestinal fili bayan cin abinci. Daga cikin jijiyoyin mahaifa, suna shiga cikin jini. Babban aikin da ake sanyawa a ciki shi ne kula da matakan glucose na jini.

Glucan-kamar peptide-1 (an samo sunan miyagun ƙwayoyi a cikin nau'in GLP-1) shine mafi mahimmancin magani, daga wanda aka samo ɗayan aji ɗaya na kwayoyi. GLP-1 an kafa shi ta sel Kwayoyin bayan cin abinci. Idan samarwarta da aikinta daidai, yakan fitar da kashi 70% na insulin wanda yakamata don sarrafa sukari da yake ƙunshe cikin abincin da aka ci. Tsarin da yake samarwa shine Allunan.

Glyphlosins

Glyphlosins shine sabon rukuni na kwayoyi don lura da ciwon sukari na 2. Suna ɗaure zuwa takamaiman tsarin a cikin ƙodan, wanda ke haifar da ƙarin urinary glucose excretion. Godiya ga wannan tsari, yana yiwuwa a guje wa yawan sukari mai yawa a cikin fitsari da rage matakan glucose na jini.

A halin yanzu, Dapagliflozin, Canagliflosin da Empagliflosin suna rajista a kasuwa.

Ana ɗaukar Dapagliflozin da Empagliflozin a matsayin kashi ɗaya na yau da kullun, ba tare da la'akari da cin abinci ba, kuma za'a iya haɗuwa tare da sauran magungunan maganin ta baki. Hanyar magungunan kwaya ne.

Ana gudanar da maganin Canagliflozin a matsayin magani na yau da kullun guda ɗaya, zai fi dacewa yayin abincin farko. Ya dace da haɗi tare da sauran wakilai na bakin jini. An samar dashi ta hanyar Allunan.

Abun magunguna da nau'in sakin

A cikin cibiyar sadarwar kantin magani, ana sayar da Dapagliflozin kamar allunan launin rawaya. Ya danganta da taron, suna zagaye da juna tare da alamar “5” a gaba da kuma “1427” a gefe guda, ko kuma lu'ulu'u mai kama da alamar "10" da "1428", bi da bi.

A kan farantin karfe daya a cikin sel sanya 10 inji mai kwakwalwa. kwayoyin hana daukar ciki. A kowane kunshin kwali za'a iya samun 3 ko 9. irin wannan faranti .. Akwai blister da guda 14 kowannensu. A cikin kwalin irin wannan farantin zaka iya samun biyu ko hudu.

Rayuwar shiryayye na magani shine shekaru 3. Don dapagliflozin, farashin a cikin cibiyar sadarwa na kantin magani ya kasance daga 2497 rubles.

Babban sashin maganin yana aiki dapagliflozin. Baya ga shi, ana kuma amfani da filler: cellulose, bushe lactose, silicon dioxide, crospovidone, magnesium stearate.

Pharmacology

Abun da ke aiki, dapagliflozin, mai hana mai ƙarfi ne (SGLT2) mai ɗaukar nauyin sodium mai jigilar glucose mai 2. An fitar dashi a cikin kodan, bai bayyana ba a cikin wasu gabobin jikinsu da kyallen takarda (nau'in 70 da aka gwada). SGLT2 shine babban daskararren hannu wanda ke da hannu a cikin reabsorption na glucose.

Wannan tsari bai tsaya tare da ciwon sukari na 2 ba, ba tare da la'akari da hyperglycemia ba. Ta hanyar hana jigilar glucose, mai hana shi rage kayan sakewa a cikin kodan an cire shi. Sakamakon wannan hulɗa, sukari yana raguwa - duka a kan komai a ciki kuma bayan motsa jiki, dabi'un glycosylated haemoglobin suna haɓaka.

Yawan glucose din da aka cire ya dogara da yawan adadin sukari da yawa da kuma yawan tacewar duniya. Inhibitor ba ya shafar asalin halittar glucose. Capabilitiesarfin ƙarfinsa yana da 'yanci daga samarwa da insulin da kuma darajar hankali a kanta.

Gwaje-gwajen tare da magunguna sun tabbatar da haɓaka yanayin ƙirar sel-alhakin alhakin ƙirar insulin halittar jini.

Glucose yana haifar da wannan hanyar yana tsokanar yawan adadin kuzari da asarar nauyi mai yawa, akwai ɗan ƙaramar sakamako.

Magungunan ba ya shafar sauran masu jigilar glucose waɗanda ke rarraba ta ko'ina cikin jiki. Zuwa SGLT2, dapagliflozin yana nuna zaɓin zaɓi na 1,400 sau mafi girma ga takwaransa SGLT1, wanda ke da alhakin ɗaukar glucose a cikin hanji.

Pharmacodynamics

Tare da yin amfani da Forsigi ta masu ciwon sukari da mahalarta lafiya a cikin gwajin, an lura da karuwa a cikin sakamako na glucosuric. A cikin takamaiman adadi, yana kama da wannan: don makonni 12, masu ciwon sukari sun ɗauki ƙwayar a 10 gm / rana.Dan wannan lokacin, kodan ya cire har zuwa 70 g na glucose, wanda ya isa zuwa 280 kcal / day.

Hakanan ana amfani da magani na Dapagliflozin tare da osmotic diuresis. Tare da tsarin kulawa da aka bayyana, matsalar diuric ɗin ba ta canza ba har tsawon makonni 12 kuma ya kasance 375 ml / rana. Tsarin ya kasance tare da lecture na karamin adadin sodium, amma wannan abun baya tasiri abinda ke cikin sa a cikin jini.

Pharmacokinetics

1. Damuwa. Lokacin ɗauka ta baka, ana shan maganin a cikin narkewa cikin hanzari kuma kusan 100%. Abincin abinci baya shafar sakamakon shanshi. Ana lura da ganiya da ƙwayar ƙwayar cuta a cikin jini bayan sa'o'i 2 lokacin da aka yi amfani dashi akan komai a ciki. Mafi girman kashin maganin, shine mafi girman maida hankali na plasma akan wani lokaci. A kudi na 10 MG / rana. cikakken bioavailability zai zama kusan 78%. A cikin mahalarta lafiya a cikin gwajin, cin abinci ba shi da tasiri a asibiti a kan magunguna.
2. Rarraba. Magani yana ɗaure da garkuwar jini da kimanin kashi 91%. Tare da cututtukan concomitant, alal misali, gazawar renal, wannan alamar tana wanzuwa.
3. Tsarin rayuwa. TЅ cikin mutane masu lafiya shine sa'o'i 12,0 bayan awo guda na kwamfutar hannu wanda nauyinsa yakai 10 mg. Dapagliflozin an canza shi zuwa metabolite na inert na dapagliflozin-3-O-glucuronide, wanda ba shi da tasirin magunguna
4. Kiwo. Magungunan tare da metabolites suna fita tare da taimakon kodan a cikin ainihin sa. Aƙalla 75% an fesa a cikin fitsari, sauran a cikin hanjin. Kusan 15% na dapagliflozin suna fitowa ta tsarkakakken yanayi.Dukkan na musamman

Yawan kwalliyar da kodan ke fitarwa a cikin rikicewar ayyukanta ya dogara da tsananin cutar. Tare da gabobin lafiya, wannan mai nuna alama shine 85 g, tare da tsari mai haske - 52 g, tare da matsakaici - 18 g, a cikin lokuta masu rauni - 11 g na glucose. Mai hanawa ya ɗaura sunadarai ta hanya guda biyu a cikin masu ciwon sukari da kuma cikin rukuni na sarrafawa. Ba a yi nazarin sakamakon binciken hemodialysis ba.

A cikin siffofi masu laushi da matsakaitan halayen lalata hanta, likitancokinetics na Cmax da AUC sun bambanta da 12% da 36%. Irin wannan kuskuren ba ya taka rawar asibiti, saboda haka, babu buƙatar rage kashi na wannan rukuni na masu ciwon sukari. A cikin nau'i mai tsanani, waɗannan alamu sun bambanta zuwa 40% da 67%.

A lokacin balaga, ba a lura da gagarumin canji game da bayyanar cutar ba (idan babu wasu dalilai da ke damun hoton asibiti). Karancin kodan, mafi girman bayyanar cutar dapagliflozin.

A cikin yanayin kwanciyar hankali, a cikin marasa lafiya da ke fama da ciwon sukari na 2, matsakaicin Cmax da AUC sun fi na maza masu ciwon sukari kashi 22%.

Ba a sami bambance-bambance a cikin sakamakon dangane da zama na Turai, Negroid ko Mongoloid tseren ba.

Tare da nauyin wuce kima, ana nuna alamun ƙarancin sakamako na maganin, amma irin waɗannan kurakurai ba su da mahimmanci a asibiti, suna buƙatar daidaita sashi.

Contraindications

• Babban hankalin game da kayan masarufi,
• Type 1 ciwon sukari
• Ketoacidosis
• Mai tsananin cutar koda,
• Amincewar ƙarancin jini zuwa glucose da lactase,
• Ciki da lactation,
• Yara da matasa (babu ingantaccen bayanai),
• Bayan m rashin lafiya, tare da zubar jini,
• Shekaru tsufa (daga shekaru 75) - a matsayin magani na farko.

Tsarin aikace-aikace na yau da kullun

Algorithm don lura da dapagliflozin likita ne, amma an ba da umarnin daidaitattun bayanai a cikin umarnin don amfani.

1. Monotherapy. Amincewa baya dogara da abinci, tsarin yau da kullun shine 10 MG a lokaci guda.
2. M magani. A hade tare da metformin - 10 MG / rana.
3. Tsarin asali. A wata al'ada ta Metformin 500 MG / rana. Forsigu take 1 shafin. (10g) kowace rana. Idan sakamakon da ake so ba shi ba, ƙara yawan Metformin.
4. Tare da cututtukan hepatic. Masu ciwon sukari tare da dysfunctions mai laushi zuwa matsakaici basa buƙatar daidaita sashi. A cikin nau'i mai tsanani, sun fara da 5 g / rana. Tare da amsawar al'ada na jiki, ana iya ƙara yawan zuwa 10 mg / rana.
5. Tare da mahaukacin mahaukaci. Tare da tsari na matsakaici da tsaurara, Forsig ba a umurta shi (lokacin da keɓancewar creatinine (CC))

Nazarin aminci na miyagun ƙwayoyi ya ƙunshi masu ba da agaji 1,193 waɗanda aka ba Fortigu a 10 MG / rana, da 1393 mahalarta waɗanda suka ɗauki placebo. Matsakaicin tasirin da ba a ke so ba ya kusan iri ɗaya.

Daga cikin abubuwan da ba a san su ba suna buƙatar dakatar da jiyya, an lura da masu zuwa:

• Inara cikin QC - 0.4%,
• Cututtukan da ke cikin tsarin ƙwayar cuta - 0.3%,
• Fashin fata - 0.2%
• Rashin daidaituwa na dissi, 0.2%
• Take hakkin daidaituwa - 0.2%.

An gabatar da cikakkun bayanai na karatun a cikin tebur.

• Mafi yawan lokuta -> 0.1,
• Sau da yawa -> 0.01, 0.001,

Nau'in tsarin da gabobin

Cututtuka da infestationsVulvovaginitis, balanitisItching Jiki Tsarin abinci na rayuwa da rashin abinci mai gina jikiHypoglycemia (tare da hada magani)Jinjiri Rashin Tsarin cikiYin motsi na baka Fata mai shiga tsakaniHaɗaɗɗa Tsarin MusculoskeletalJin zafi a cikin kashin baya Tsarin JikiDysuriaNocturia Bayanin dakin gwaje-gwajeDyslipidemia, babban bashin jiniCi gaban QC da urea cikin jini

Dapagliflozin Reviews

Dangane da binciken da baƙi suka yi game da albarkatun mai, yawancin masu ciwon sukari ba su lura da wata illa ba, sun gamsu da sakamakon magani.Mutane da yawa suna dakatar da farashin kwayoyin, amma jin daɗin ji na mutum wanda ke da alaƙa da shekaru, cututtukan haɗuwa, jin daɗin rayuwa gaba ɗaya ba zai iya zama jagora don yanke shawara game da alƙawarin Forsigi ba.

Za'a iya samun hanyar tiyata ta likita kawai; zai kuma zabi analogues don dapagliflozin (Jardins, Invokuan) idan hadaddun bashi da inganci sosai.

A bidiyon - fasali na Dapagliflozin a matsayin sabon nau'in magani.

Amfani da sinadarin Dapagliflozin

Nau'in sukari na 2 na ciwon sukari ban da abinci da motsa jiki don inganta sarrafa glycemic a cikin inganci:

- sarin ƙari don maganin rashin lafiya tare da metformin, abubuwan da suka samo asali na sulfonylurea (ciki har da haɗuwa da metformin), thiazolidinediones, inhibitors na DPP-4 (ciki har da haɗuwa da metformin), shirye-shiryen insulin (gami da haɗuwa da guda ɗaya ko kwayoyi biyu na maganin cututtukan fata don amfani da bakin) in babu isasshen sarrafa glycemic,

- farawa tare da magani tare da metformin, idan wannan maganin yana da kyau.

Haihuwa da lactation

Bangaren FDA aiki don tayin shine C.

Dapagliflozin yana contraindicated lokacin daukar ciki (amfani a lokacin daukar ciki ba'a yi bincike ba). Idan an gano ciki, ya kamata a dakatar da maganin tapagliflozin.

Ba'a sani ba ko dapagliflozin da / ko metabolites dinsa marasa aiki sun wuce zuwa cikin madara. Hadarin ga jarirai / jarirai ba za a iya fitar da su ba. An tallata Dapagliflozin lokacin shayarwa.

Sakamakon sakamako na kayan Dapagliflozin

Bayanin Tsaro

Binciken da aka riga aka shirya game da fatarar bayanai ya hada da sakamakon binciken 12 da aka sarrafa a ciki inda marasa lafiya 1193 suka dauki dapagliflozin a kaso na 10 mg kuma 1393 marasa lafiya sun karbi placebo.

Babban abin da ya faru na abubuwan da suka faru da jijiyoyin wuya (magani na ɗan gajeren lokaci) a cikin marasa lafiya da ke daukar 10 mg dapagliflozin sun yi kama da na rukuni na placebo. Yawan haɗarin haɗari da ke haifar da dakatar da aikin likita ya kasance kaɗan da daidaita tsakanin rukunin jiyya. Abubuwan haɗari mafi haɗari da suka haifar da katsewa dapagliflozin far a kashi na 10 mg sun kasance karuwa a cikin ƙwayar halittar jini na jini (0.4%), cututtukan urinary tract (0.3%), tashin zuciya (0.2%), dizziness (0, 2%) da kurji (0.2%). Patientaya daga cikin haƙuri yana ɗaukar dapagliflozin ya nuna ci gaban wani mummunan al'amari daga hanta tare da gano cutar hepatitis da / ko autoimmune hepatitis.

Abubuwan da suka fi dacewa da raunin da ya faru shine hypoglycemia, ci gaban wanda ya dogara da nau'in jiyya da aka yi amfani dashi a kowane binciken. Halin da ke faruwa a cikin ƙananan ƙwayoyin cuta ya kasance iri ɗaya a cikin rukunin jiyya, gami da placebo.

Abubuwan da ba a yarda da su ba da aka ruwaito a cikin gwaje-gwajen asibiti masu sarrafawa an gabatar dasu a ƙasa (maganin ɗan gajeren lokaci har zuwa makonni 24 ba tare da ɗaukar ƙarin wakili na hypoglycemic ba). Babu ɗayansu da suka dogara dogaro. Ana gabatar da mitar halayen marasa kyau a cikin nau'in gradation mai zuwa: sau da yawa (≥1 / 10), sau da yawa (≥1 / 100, 1,2, kamuwa da urinary tract 1, ba tare da ɓata lokaci ba - itchingvovoaginal itching.

Daga gefen metabolism da rashin abinci mai gina jiki: sau da yawa sau da yawa - hypoglycemia (lokacin da aka yi amfani dashi a hade tare da wani sinadarin sulfonylurea ko insulin) 1, ba tare da ɓata lokaci ba - raguwa a cikin BCC 1.4, ƙishirwa.

Daga cikin jijiyoyin mahaifa: sau da yawa - maƙarƙashiya.

A bangare na fata da kasusuwa na jiki: sau da yawa - karuwar gumi.

Daga tsarin musculoskeletal da nama mai hadewa: sau da yawa ciwon baya.

Daga kodan da urinary fili: sau da yawa - dysuria, polyuria 3, sau da yawa - nocturia.

Bayanai da kayan aikin: dyslipidemia 5, karuwa a cikin hematocrit 6, karuwa a cikin haɗuwa da creatinine a cikin jini, karuwa a cikin maida hankali ne urea a cikin jini.

1 Duba sashin da ya dace a ƙasa don ƙarin bayani.

2 Vulvovaginitis, balanitis da makamantan cututtukan ƙwayar cuta sun haɗa da, alal misali, ƙa'idodin ƙaddarar da suka gabata: ƙwararrun ƙwayar cuta ta kamuwa da cuta, kamuwa da farji, balanitis, kamuwa da cuta na ƙwayar cuta, ƙwayoyin cuta na fitsari, ƙwayoyin cuta na kamuwa da cuta, ƙwayoyin ƙwaƙwalwar ƙwayoyin cuta, ƙwararriyar ƙwayar cuta, kamuwa da cuta, kamuwa da cuta ta kamuwa da cuta, gabobin cikin maza, kamuwa da farji, ƙwayar cuta, ƙwayar ƙwayar ƙwayar cuta, ƙwayar ƙwayar cuta, ƙwayar ƙwayar cuta.

3 Polyuria ya hada da sharuɗan da akafi so: pollakiuria, polyuria da haɓakar fitowar fitsari.

4 Ragewa a cikin bcc ya hada da, alal misali, waɗannan shahararrun sharuɗan da aka zaɓa: zazzaɓi, ƙwanƙwasa jini, hauhawar jini.

5 Matsakaicin canji a cikin alamomin masu zuwa kamar kashi na ƙimar farko a cikin rukunin 10 na dapagliflozin da ƙungiyar placebo, bi da bi: jimlar Chs - 1.4 idan aka kwatanta da -0.4%, Chs-HDL - 5.5 idan aka kwatanta da 3.8%, Chs-LDL - 2.7 idan aka kwatanta da -1.9%, triglycerides -5.4 idan aka kwatanta da -0.7%.

6 Matsakaicin canje-canje a cikin hematocrit daga tushe shine 2.15% a cikin 10 mg dapagliflozin ƙungiyar idan aka kwatanta da -0.4% a cikin rukunin placebo.

Bayanin mummunan halayen da aka zaɓa

Hypoglycemia. Halin hauhawar jini ya danganta ne da nau'in cututtukan da ake amfani da su a cikin kowane binciken.

A cikin nazarin dapagliflozin kamar monotherapy, maganin haɗin gwiwa tare da metformin har zuwa makonni 102, abin da ya faru na cututtukan hypoglycemia mai laushi sun kasance iri ɗaya (BCC. An lura da halayen da ba a dace ba tare da raguwa a cikin bcc (ciki har da rahotannin rashin ruwa, hypovolemia, ko hypotension) wanda aka lura a cikin 0.8 da 0.4% na marasa lafiya suna shan dapagliflozin 10 mg da placebo, bi da bi; an lura da mummunan halayen a cikin bcc, yawancin rajista a matsayin arterial hypotension da aka lura a cikin 1.5 da 0.4% na marasa lafiya suna ɗaukar dapagliflozin da placebo, bi da bi (duba "caarfafawa").

Haɗa kai

Diuretics. Dapagliflozin na iya haɓaka sakamakon diuretic na thiazide da madauki da kuma haɓaka haɗarin rashin ruwa da jijiyoyin jini (duba "Faɗakarwa").

Insulin da kwayoyi wadanda suke kara lalata insulin. A kan asalin amfani da insulin da kwayoyi waɗanda ke kara ɓoye insulin, hypoglycemia na iya faruwa. Sabili da haka, don rage haɗarin hypoglycemia tare da haɗakar amfani da dapagliflozin tare da insulin ko kwayoyi waɗanda ke kara ɓoye insulin, yana iya zama dole don rage kashi na insulin ko magungunan da ke kara ɓoye insulin (duba "Tasirin sakamako").

Maganin metabolism na dapagliflozin ana aiwatar dashi ne ta hanyar haɗuwa da glucuronide a ƙarƙashin rinjayar UGT1A9.

Yayin bincike a cikin vitro dapagliflozin bai hana isoenzymes na cytochrome P450 tsarin CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP3A4 kuma bai shigar da isoenzymes CYP2 ko CYP2, ko CYP1 C4P, CYP1 ko CYP1, CYP1 ko CYP1, CYP1 ko CYP2, A wannan batun, tasirin dapagliflozin akan tsabtace hanyoyin rayuwa na magunguna masu rikitarwa wanda wadannan isoenzymes ke sawa ba a sa ran su ba.

Sakamakon wasu kwayoyi a kan dapagliflozin. Nazarin hulɗa da aka haɗa da masu sa kai na lafiya, akasarin shan ƙwayoyi guda ɗaya na dapagliflozin, sun nuna cewa metformin, pioglitazone, sitagliptin, glimepiride, voglibose, hydrochlorothiazide, bumetanide, valsartan, ko simvastatin ba su tasiri dapaglapinagin pharmacokinetics.

Bayan haɗe da amfani da dapagliflozin da rifampicin, mai ilmantarwa da wasu masu ɗaukar jigilar kwayoyi da enzymes waɗanda ke lalata magunguna, an lura da raguwar 22% a cikin tsarin (AUC) na dapagliflozin yayin rashin ingantaccen sakamako na asibiti akan abubuwan yau da kullun na glucose da kodan. Ba'a bada shawara don daidaita adadin dapagliflozin ba.

Sakamakon tasiri na asibiti yayin amfani da wasu inducers (misali carbamazepine, phenytoin, phenobarbital) ba a tsammanin.

Bayan haɗewar amfani da dapagliflozin da mefenamic acid (inGridal UGT1A9), an lura da ƙaruwa 55% na shigarwar dapagliflozin a cikin tsari, amma ba tare da wani tasiri mai tasiri ba a cikin kwayar ta yau da kullun ta hanjin koda. Ba'a bada shawara don daidaita adadin dapagliflozin ba.

Tasirin dapagliflozin akan wasu kwayoyi. A cikin nazarin hulɗa da ke tattare da masu ba da agaji na lafiya, waɗanda suka ɗauki guda ɗaya, dapagliflozin bai shafi magungunan likita na metformin, pioglitazone, sitagliptin, glimepiride, hydrochlorothiazide, bumetanide, valsartan, digoxin (canza P-varnarfin, varfarb chub, sitfarb, sigin, ko kadar ) ko akan tasirin anticoagulant, wanda INR ya tantance. Yin amfani da kashi ɗaya na dapagliflozin 20 MG da simvastatin (a madadin CYP3A4 isoenzyme) ya haifar da karuwar 19% na simvastatin AUC da 31% na AUC simvastatin acid. Ba a ɗaukar karuwar haɗuwa ga simvastatin da simvastatin acid a asibiti mai mahimmanci.

Ba a yi nazarin sakamakon shan sigari, cin abinci, shan magungunan ganyayyaki da shan giya a kan magungunan likitanci na dapagliflozin ba.

Yawan abin sama da ya kamata

Dapagliflozin mai lafiya yana da haƙuri da haƙuri ta hanyar masu sa kai masu lafiya tare da kashi ɗaya zuwa 500 MG (sau 50 da aka bada shawarar). An ƙaddara glucose a cikin fitsari bayan gudanarwa (aƙalla kwanaki 5 bayan ɗaukar kashi na 500 MG), yayin da babu yanayin rashin ruwa, ƙwanƙwasawa, rashin daidaituwa na lantarki, tasiri mai tasiri a cikin tazara na QTc. Abinda ya faru da hypoglycemia yayi daidai da mita tare da placebo. A cikin nazarin asibiti a cikin masu ba da agaji da lafiya da marasa lafiya da nau'in ciwon sukari na 2 wanda ya dauki dapagliflozin sau ɗaya a allurai har zuwa 100 MG (10 sau mafi yawan maganin da aka ba da shawarar) na makonni 2, tashin hankalin hypoglycemia ya ɗan fi yadda yake da placebo, kuma ba dogara da kashi. Hatsarin abubuwanda suka faru, ciki harda rashin ruwa ko yanayin jijiya, yayi daidai da mitar a cikin rukunin placebo, ba tare da wani canje-canje masu girma da suka shafi kyan gani ba a sigogin dakin gwaje-gwaje, gami da maida hankali kan yawan wutan lantarki da kuma aikin koda na aikin koda.

Game da yawan abin sama da ya kamata, ya zama dole don aiwatar da aikin tiyata, la'akari da yanayin mai haƙuri. Ba a yi binciken fashewar dapagliflozin ta hanyar hemodialysis ba.

Gargadi Dapagliflozin

Marasa lafiya tare da nakasa aiki na renal

Ingancin dapagliflozin ya dogara da aikin na renal, kuma an rage wannan tasiri a cikin marasa lafiya da ke fama da rashin isasshen batun na koda kuma ba ya yiwuwa a cikin marasa lafiya da ke fama da rauni na koda. A cikin marasa lafiya da ke fama da rashin daidaituwa na yara (Cl creatinine 2), mafi yawan adadin marasa lafiya da ke karɓar dapagliflozin sun nuna karuwa a cikin ƙwaƙwalwar creatinine, phosphorus, PTH da jijiya ta jiki fiye da marasa lafiya da ke karɓar placebo. Dapagliflozin yana cikin contraindicated a cikin marasa lafiya tare da matsakaici ko matsanancin ƙarancin ƙarancin renal (Cl creatinine 2). Ba a yi binciken Dapagliflozin a cikin gazawar renal mai girma (Cl creatinine 2) ko gazawar matakin ƙaddamar da mataki.

An ba da shawarar ku kula da aikin koda kamar haka:

- kafin farkon farawar tare da dapagliflozin kuma aƙalla lokaci 1 a kowace shekara bayan haka (duba "Side effects", "Pharmacodynamics" da "Pharmacokinetics"),

- Kafin shan magungunan haɗin gwiwa wanda zai iya rage aikin koda, lokaci zuwa lokaci,

- idan akwai matsala na dan aiki mai aiki kusa da matsakaici, aƙalla sau 2-4 a shekara. Idan aikin koda ya rage a ƙasa a cikin Cl creatinine 2, dakatar da shan dapagliflozin.

Marasa lafiya tare da nakasa aikin hanta

A cikin nazarin asibiti, an sami iyakataccen bayanai game da amfani da dapagliflozin a cikin marasa lafiya da ke fama da aikin hanta. Nunin bayyanar dapagliflozin yana karuwa a cikin marasa lafiya da mummunan raunin hanta (duba "Restuntatawa akan amfanin" da "Pharmacokinetics").

Marasa lafiya a cikin hadarin karuwar bcc, haɓakar jijiyoyin jini da / ko rashin daidaituwa na lantarki

Dangane da tsarin aikin, dapagliflozin yana inganta diuresis, tare da raguwa kadan a cikin karfin jini (duba "Pharmacodynamics"). Ana iya faɗi sakamako na diuretic a cikin marasa lafiya da keɓaɓɓen taro na glucose a cikin jini.

Dapagliflozin yana cikin contraindicated a cikin marasa lafiya shan madauki diuretics (duba “Haɗin kai”), ko tare da rage BCC, alal misali, saboda cututtukan m (kamar cututtukan gastrointestinal).

Yakamata a yi taka tsantsan a cikin marassa lafiya ga wanda raguwar hawan jini ya haifar da dapagliflozin na iya zama haɗari, alal misali, a cikin marasa lafiya waɗanda ke da tarihin cututtukan zuciya, tarihin hauhawar jini, karɓar maganin antihypertensive, ko kuma a cikin tsofaffi marasa lafiya.

Lokacin ɗaukar dapagliflozin, saka idanu da hankali game da yanayin BCC da kuma tattarawar electrolytes (misali nazariyyar jiki, auna karfin jini, gwaje-gwaje na ɗakin gwaje-gwaje, ciki har da bashincrit) ana bada shawarar gaba da yanayin yanayin haɗuwa wanda zai iya haifar da raguwa a cikin bcc. Tare da raguwa a cikin BCC, ana bada shawarar dakatar da wucin gadi na dapagliflozin har sai an gyara wannan yanayin (duba “Tasirin sakamako”).

A cikin yin amfani da dapagliflozin bayan tallace-tallace, ketoacidosis ya ba da rahoton, ciki har da ketoacidosis mai ciwon sukari, a cikin marasa lafiya masu nau'in 1 da 2 na ciwon sukari mellitus, suna shan dapagliflozin da sauran masu hana SGLT2, kodayake ba a kafa dangantakar causal ba. Ba a nuna Dapagliflozin don kula da marasa lafiya da masu ciwon sukari na 1 ba.

Marasa lafiya da ke shan dapagliflozin tare da alamomi da alamomin alamomi na ketoacidosis, gami da tashin zuciya, amai, raunin ciki, zazzabin cizon sauro, da gazawar numfashi, ya kamata a bincika don ketoacidosis, koda kuwa narkar da tarin jini a ƙasa yana 14 mmol / L. Idan ana zargin ketoacidosis, ya kamata a ba da shawara don katsewa ko dakatar da amfani da dapagliflozin kuma nan da nan bincika mai haƙuri.

Abubuwan da ke haifar da tashin hankali game da ci gaban ketoacidosis sun haɗa da ƙarancin aiki na ƙwayoyin beta saboda rauni mai narkewar ƙwayar cuta (misali, nau'in cutar sankarar mahaifa 1, ƙwaƙwalwar ƙwayar cuta ko tarihin aikin tiyata), raguwar ƙwayar insulin, raguwa a cikin adadin kuzari na abinci, ko karuwar buƙatar insulin saboda kamuwa da cuta, cututtuka ko tiyata, haka kuma shan giya. Ya kamata a yi amfani da Dapagliflozin tare da taka tsantsan a cikin waɗannan marasa lafiya.

Kwayar cututtukan hanji.

Lokacin nazarin bayanan da aka haɗu game da amfani da dapagliflozin, har zuwa makonni 24 na kamuwa da urinary fili an lura da mafi yawan lokuta tare da yin amfani da dapagliflozin a kashi 10 MG idan aka kwatanta da placebo (duba “Side effects”). An lura da haɓakar cutar pyelonephritis akai-akai, tare da maimaitawa iri ɗaya a cikin rukuni na sarrafawa. Ana iya haɗuwa da ƙoshin glucose na ƙwayar cuta tare da haɗarin haɓakar kamuwa da cututtukan urinary fili, sabili da haka, a cikin lura da pyelonephritis ko urosepsis, yiwuwar dakatar da wucin gadi na maganin tapagliflozin (duba "Abubuwan sakamako").

Urosepsis da pyelonephritis. A cikin amfani dap na bayan cinikin tapagliflozin, mummunan cututtukan urinary, ciki har da urosepsis da pyelonephritis, suna buƙatar asibiti na marasa lafiya da ke shan dapagliflozin da sauran inhibitors SGLT2. Maganin kwantar da hankali tare da SGLT2 inhibitors yana kara haɗarin kamuwa da cututtukan urinary fili. Yakamata a kula da marasa lafiya don alamun da alamun cututtukan urinary fili kuma, idan an nuna, ya kamata a kula da su nan da nan (duba “Side effects”).

A cikin marasa lafiya tsofaffi, lalacewar aikin renal da / ko amfani da antihypertensive magunguna waɗanda zasu iya shafar aikin renal, irin su ACE inhibitors da nau'in II ARA, sun fi dacewa ga marasa lafiya tsofaffi, shawarwarin guda ɗaya don aiki na nakasassu yana aiki kamar yadda ga duk yawan jama'ar haƙuri (duba.)"Tasirin sakamako" da "Pharmacodynamics").

A cikin rukuni na marasa lafiya masu shekaru ≥65 shekaru, mafi yawan adadin marasa lafiya da ke karɓar dapagliflozin sun haɗu da halayen da ba a so tare da alaƙa da aikin haya ko gazawa idan aka kwatanta da placebo. Abubuwan da suka fi dacewa da raunin da ya faru sun danganta da lalacewar aikin na ɗan ƙasa shine karuwa a cikin taro na ƙwayar halittar mahaifa, yawancin shari'un sun kasance na lokaci da juyawa (duba “Tasirin sakamako”).

A cikin marasa lafiya tsofaffi, haɗarin raguwa a cikin BCC na iya zama mafi girma, kuma ana iya ɗaukar diuretics. Yawancin marasa lafiya marasa lafiya ≥65 shekaru wadanda suka karɓi dapagliflozin suna da mummunar halayen da suka danganci raguwa a cikin BCC (duba “Side effects”).

Kwarewa tare da dapagliflozin a cikin marasa lafiya 75 shekara da haihuwa sunada iyaka. An contraindicated don fara dapagliflozin far a cikin wannan yawan (duba "Pharmacokinetics").

Ciwon zuciya mai rauni

Experiencewarewa tare da yin amfani da dapagliflozin a cikin marasa lafiya tare da ajijan aikin aiki na CHF I - II bisa ga rarrabuwa NYHA iyakance, kuma a yayin gwaji na asibiti, ba a yi amfani da dapagliflozin a cikin marasa lafiya tare da aji na aikin III - IV CHF NYHA.

Atoara yawan jini

Lokacin amfani da dapagliflozin, an lura da karuwa a cikin hematocrit (duba “Tasirin sakamako”), sabili da haka ya kamata a yi taka tsantsan a cikin marasa lafiya tare da ƙara yawan darajar haiatocrit.

Neman sakamakon gwajin fitsari

Sakamakon tsarin dapagliflozin, sakamakon binciken fitsari don glucose a cikin marasa lafiya shan dapagliflozin zai zama mai kyau.

Tasiri kan ƙudurin 1,5-anhydroglucitol

Ba a shawarar kimantawa na sarrafa glycemic ta amfani da ƙudurin 1,5-anhydroglucitol, tunda ma'aunin 1,5-anhydroglucitol hanya ce wacce ba za a iya dogara da ita ba ga marasa lafiya da ke shan inhibitors SGLT2. Ya kamata a yi amfani da hanyoyi dabam don tantance ikon sarrafa glycemic.

Tasiri a kan ikon tuka motoci da aiki tare da kayan aiki. Nazarin don nazarin tasirin dapagliflozin akan ikon tuka motoci da aiki tare da injinan ba a gudanar da su ba.

Bayanin maganin

Dapagliflozin mai karfi ne (inhibitory akai (Ki) na 0.55 nM), wani zaɓi mai juyawa mai canzawa 2 Sodium glucose cotransporter inhibitor (SGLT2). An zabi SGLT2 a cikin koda kuma ba a samun shi a cikin wasu kwayoyin jikin mutum sama da 70 (ciki har da hanta, kasusuwa, tsotse nama, gemar mammary, mafitsara da kwakwalwa).

SGLT2 shine babban dako wanda ke da hannu a cikin reabsorption na glucose a cikin tubules na koda. Rearfafawar glucose a cikin tubules na koda a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 na jini (T2DM) yana ci gaba duk da hauhawar jini. Ta hana shi canzawa na glucose, dapagliflozin yana rage rage abinci a cikin tubules na koda, wanda yake haifar da fitsarin glucose da kodan.

Rashin fitowar glucose (sakamako na glucosuric) bayan shan kashi na farko na maganin, yana ci gaba na tsawon awanni 24 na gaba kuma yana ci gaba cikin jiyya. Yawan glucose din da kodan ke fitarwa saboda wannan aikin ya dogara da tattarawar glucose din a cikin jini da kuma darajar narkewar glomerular (GFR).

Dapagliflozin ba ya tsoma baki tare da samar da daidaituwa na yau da kullun na glucose na endogenous sakamakon amsawar hypoglycemia. Tasirin dapagliflozin yana da 'yanci daga ɓoye insulin da ƙwaƙwalwar insulin. A cikin nazarin asibiti na maganin Dapagliflozin * (Dapagliflozin *) ™, an lura da haɓaka aikin β-tantanin halitta (gwajin HOMA, ƙimar samfurin homeostasis).

Kawar da glucose da kodan da ya haifar da dapagliflozin yana tattare da asarar adadin kuzari da rage kiba a jiki. Dapagliflozin hanawa na sodium glucose cotransport yana tare da rauni mai rauni da kuma tasirin natriuretic na yau da kullun.

Dapagliflozin bashi da wani tasiri ga sauran masu jigilar glucose wanda ke jigilar glucose zuwa kasusuwa na jiki kuma ya nuna fiye da sau 1,400 don SGLT2 fiye da na SGLT1, babban mai ɗaukar hanji wanda ke da alhakin shawo kan glucose.

Bayan ɗaukar dapagliflozin ta hanyar masu sa kai masu lafiya da marasa lafiya da ke da nau'in ciwon sukari na 2, an lura da karuwar adadin glucose ɗin da kodan ke nunawa. Lokacin da aka dauki dapagliflozin a kashi na 10 MG / rana don makonni 12, a cikin marasa lafiya tare da T2DM, kimanin kodan g 70 na kodan sun cire ta a rana ɗaya (wanda ya yi daidai da 280 kcal / day). A cikin marasa lafiya da masu ciwon sukari na nau'in 2 waɗanda suka dauki dapagliflozin a kashi 10 na MG / rana na dogon lokaci (har zuwa shekaru 2), an ci gaba da haɓakar glucose a duk lokacin karatun.

Haɓaka glucose ta kodan tare da dapagliflozin kuma yana haifar da osmotic diuresis da haɓaka cikin fitsari. Increaseara yawan ƙwayar fitsari a cikin marasa lafiya da nau'in ciwon sukari na 2 wanda ke shan dapagliflozin a kashi na 10 MG / rana ya kasance tsawon makonni 12 kuma ya kusan 375 ml / rana. Increaseara yawan fitsari ya kasance tare da ƙaramin kaɗan da na ɗan gajeren lokaci a cikin sodium excretion da ƙodan, wanda ba ya haifar da canji a cikin taro na soda daga cikin jijiyoyin jini ba.

Binciken da aka tsara game da sakamakon binciken 13 na sarrafa mutum-wuri ya nuna raguwa a cikin karfin jini na systolic (SBP) na 3.7 mm Hg. da kuma karfin jini (DBP) a 1.8 mm Hg a cikin mako na 24 na dapagliflozin far a wani kashi na 10 mg / rana idan aka kwatanta da raguwa a cikin SBP da DBP ta 0.5 mm Hg. a cikin kungiyar placebo. An lura da irin wannan raguwa a cikin karfin jini yayin makonni 104 na jiyya.

Lokacin amfani da dapagliflozin a kashi 10 na MG / rana a cikin marasa lafiya da nau'in ciwon sukari na 2 tare da isasshen kulawar glycemic da hauhawar jini, karɓar masu karɓa na angiotensin II, masu hanawa na ACE, ciki har da a hade tare da wani magani na antihypertensive, raguwa a cikin glycosylated haemoglobin da kashi 3.1% da raguwar SBP ta 4.3 mm Hg. bayan makonni 12 na jiyya idan aka kwatanta da placebo.

Babban magani game da ciwon sukari

Tare da hanyoyin magani, maganin rashin magani na cutar yana da matukar mahimmanci. Likitoci suna ba da shawarar abinci na musamman, aikin jiki, da sauran ayyukan da aka tsara don daidaita lafiyar jiki. Wannan yana taimakawa rage matsayin juriya na insulin, don rage sakamako mai guba na samfuran kayan jiki masu mahimmanci akan β-sel. Amma irin waɗannan hanyoyin suna ba da sakamako mai kyau kawai a farkon matakan cutar. Yawancin marasa lafiya suna buƙatar maganin ƙwayar cuta.

Hanyar maganin rashin amfani da jini ta dogara da alamun cutar sankara da yanayin haƙuri. Idan matakin glycated haemoglobin yana cikin kewayon 6.5 - 7.0%, an ba da izinin monotherapy, kuma an zaɓi kuɗi tare da ƙarancin haɗari na halayen da ba su da kyau.

Kafin bayyanarsa a cikin aikin magani na miyagun ƙwayoyi, an wajabta Forksig:

• biguanides (metformin),
• Inhibitors na DPP-4 (depeptidide peptidase-4) - Saxagliptin, Vildagliptin,
• glinids (Repaglinide, Nateglinide),
• glucagon-kamar peptide analogues (aGPP) - Exenatide, Lyraglutid,
• insulin

Idan akwai magunguna don ɗaukar waɗannan magunguna, za a yi amfani da magungunan madadin magani ta amfani da maganin ƙwayoyin cuta, da ɓoɓo, da sauransu.

A matakin farko na haemoglobin na glycated na 7.5 - 9.0%, hadewar jiyya tare da magunguna na hypoglycemic da yawa, wanda ke shafar sassa daban-daban na pathogenesis na nau'in ciwon sukari na 2 na mellitus, ya zama dole. Koyaya, haɗuwa da metformin da aka saba amfani dasu tare da wakilai na hypoglycemic galibi suna haifar da ƙaruwa a cikin nauyin jikin mai haƙuri da sauran halayen masu raunin da ya faru. Amma haɗin Metformin Forksig, akasin haka, yana haifar da rushewar ƙwaƙwalwar subcutaneous da visceral adipose nama.

Lokacin da glycated haemoglobin ya fi 9.0%, mara lafiya yana buƙatar maganin insulin, wani lokacin a hade tare da sauran wakilai na hypoglycemic.

Amma masana sun yarda cewa magungunan da aka yi amfani da su a baya ba su dace da maganin tsufa ba. Don haka, bayan shekaru uku, rabin marasa lafiya sun ba da rahoton ingantaccen sakamako na magani, kuma bayan shekaru 9 - a kwata.

Amfani da Forxiga a cikin maganin cutar sankara

Ofaya daga cikin manyan magunguna har yanzu ana amfani da su don magance nau'in ciwon sukari na II shine Metformin. Kayan aiki yana shafar:

• hanta kwayar insulin juriya,
• tafiyar matakai gluconeogenesis,
• nama ji na insulin.

Metformin a zahiri ba ya haifar da karuwa a cikin nauyin jiki, baya haifar da hypoglycemia. Amma bisa uku na marasa lafiya suna ba da rahoton mummunan halayen daga narkewa kamar jijiyoyin. Kuma a wasu halaye, rikice-rikice suna haifar da janyewar magunguna. Bugu da ƙari, Metformin kusan ana amfani dashi koyaushe tare da sauran magunguna.

A wannan yanayin, sakamakon Forxiga yana dogara da glucose. Sakamakon reabsorption ya ragu kuma ya zama kaɗan lokacin da ƙwayar glucose plasma ta ƙasa da 5 mmol / L. A lokaci guda, idan matakin glycemia ya kasance 13.9 mmol / L, reabsorption yana ƙaruwa zuwa 70%, kuma a 16.7 mmol / L - har zuwa 80%. Saboda haka, idan aka kwatanta da sauran magunguna masu rage sukari, to haɗarin cutar yawan kumburi yana ɓacewa.

Kafin amfani da miyagun ƙwayoyi, dole ne koyaushe ka nemi likita. Za'a iya yin ainihin tsarin kulawar magani ne kawai bayan cikakken bincike na haƙuri.

Shirye-shiryen glyphlosin

Inhibitors yana aiki a cikin ƙodan kuma yana haifar da ƙara yawan ɓoye glucose a cikin fitsari. Saboda wannan, akwai raguwa a cikin glucose jini, ƙona adadin kuzari yana ƙonewa, wanda ke haifar da asarar nauyi.

Magunguna na SGLT-2, kamar Jardins, Invokana, Xigduo, Wokanamet sababbi ne sabili da haka, ba duk sakamakon cutar ba ne ake fahimta.

Wadannan kwayoyi suna cikin ajin SGLT2 inhibitors (sunan farko, alal misali, Forsig kasuwanci ne, na biyu ya dace da sunan kayan aiki Dapagliflosin).

Muna ba da shawarar ku karanta: yadda za a ɗauki metformin

SGLT-2 inhibitor yana aiki ne don kare kodan kafin a sake gano glucose na jini. Don haka, kodan na iya rage matakin glucose a cikin jini kuma yana taimakawa wajen cire adadin sa daga jiki da fitsari.

Kara karantawa: Jardiance - kariyar zuciya

Kodan mutum yayin aiwatarda shine ya fara cire glucose daga jini kuma ya bada izinin jini ya sake shan shi, yana kuma cigaba da aiki yadda yakamata. A karkashin yanayi na al'ada, wannan kayan yana tilasta jiki yayi amfani da duk abubuwan gina jiki.

A cikin mutanen da ke wuce haddi na sukari jini, a ɗan ƙaramin yanki na glucose na iya ba za a sake farfadowa ba, amma an keɓe shi a cikin fitsari, yana ba da kariya kaɗan daga hauhawar jini. Koyaya, masu jigilar glucose - sunadaran ƙungiyar sodium - suna yin kusan 90% na sukarin da aka tace su koma cikin jini.

An gabatar da ingancin waɗannan sababbin magunguna masu rage sukari a cikin taron theungiyar ofwararrun masana game da cutar yara ta Duniya a ranar 13 ga Maris, 2017. Koyaya, tare da cutar koda mai tsanani, an wajabta su tare da kulawa sosai.

Hakanan dole ne ku sani: game da rage ƙwayoyi masu sukari na sabon ƙarni na bala'i - GLP-1

Siffofin aikace-aikace

Littafin koyarwa

a kan amfani da miyagun ƙwayoyi

don amfanin likita

Allunan mai rufe fim

dapagliflozin propanediol monohydrate 6.150 MG, ana lissafta azaman Dapagliflozin * (Dapagliflozin *) 5 MG

microcrystalline cellulose 85.725 mg, lactose 25,000 mg, crospovidone 5,000 mg, silicon dioxide 1,875 mg, magnesium stearate 1,250 mg,

II rawaya 5,000 mg (polyvinyl giya partially hydrolyzed 2,000 MG, titanium dioxide 1,177 mg, macrogol 3350 1,010 mg, talc 0,740 mg, dye iron oxide yellow 0,073 mg).

dapagliflozin propanediol monohydrate 12.30 mg, ana lissafta azaman Dapagliflozin * (Dapagliflozin *) 10 MG

microcrystalline cellulose 171.45 MG, lactose 50,00 mg, crospovidone 10.00 mg, silicon dioxide 3.75 mg, magnesium stearate 2.50 mg,

Rawaya mai launin rawaya 10.00 mg (polyvinyl barasa an haɗa hydrolyzed 4.00 mg, titanium dioxide 2.35 mg, macrogol 3350 2.02 mg, talc 1.48 mg, dye iron oxide yellow 0.15 mg).

Allunan zagaye na biconvex mai hade da bakin membrane fim, aka zana shi da "5" a gefe guda kuma "1427" a gefe guda.

Allunan Rhomboid biconvex sun lullube da membrane fim mai launin rawaya, wanda aka zana shi da "10" a gefe guda kuma "1428" a gefe guda.

Hypoglycemic wakili don amfani da baki - nau'in mai hana glucose mai hawa 2 mai ɗaukar mai hawa

Dapagliflozin * (Dapagliflozin *) mai ƙarfi ne (inhibitory akai (Ki) na 0.55 nM), wani zaɓi mai jujjuyawa mai hanawa-2 glucose cotransporter inhibitor (SGLT2). An zabi SGLT2 a cikin koda kuma ba a samun shi a cikin wasu kwayoyin jikin mutum sama da 70 (ciki har da hanta, kasusuwa, tsotse nama, gemar mammary, mafitsara, da kwakwalwa).

SGLT2 shine babban dako wanda ke da hannu a cikin reabsorption na glucose a cikin tubules na koda. Rearfafawar glucose a cikin tubules na koda a cikin marasa lafiya da ke da nau'in ciwon sukari na 2 na jini (T2DM) yana ci gaba duk da hauhawar jini. Ta hanyar hana canzawar glucose na dan adam, Dapagliflozin * (Dapagliflozin *) yana rage reabsorption ɗin cikin tubules na koda, wanda ke haifar da kawar da glucose ta ƙodan.

Rashin fitowar glucose (sakamako na glucosuric) bayan shan kashi na farko na maganin, yana ci gaba na tsawon awanni 24 na gaba kuma yana ci gaba cikin jiyya. Yawan glucose din da kodan ke fitarwa saboda wannan aikin ya dogara da tattarawar glucose din a cikin jini da kuma darajar narkewar glomerular (GFR).

An inganta aikin salula na Beta (gwajin NOMA, ƙirar ƙirar homeostasis).

Kawar da glucose da kodan da ya haifar da dapagliflozin yana tattare da asarar adadin kuzari da rage kiba a jiki. Dapagliflozin hanawa na sodium glucose cotransport yana tare da rauni mai rauni da kuma tasirin natriuretic na yau da kullun.

Dapagliflozin * (Dapagliflozin *) ba shi da wani tasiri a cikin wasu masu jigilar glucose waɗanda ke jigilar glucose zuwa kasusuwa na ƙasa kuma ya fi sau 1,400 zaɓin SGLT2 fiye da SGLT1, babban jigilar hanji da ke da alhakin shan gulukos.

Bayan ɗaukar dapagliflozin ta hanyar masu sa kai masu lafiya da marasa lafiya da ke da nau'in ciwon sukari na 2, an lura da karuwar adadin glucose ɗin da kodan ke nunawa. Lokacin da aka dauki dapagliflozin a kashi na 10 MG / rana don makonni 12, a cikin marasa lafiya tare da T2DM, kusan gg glucose 70 a kowace rana kodan sun fesa (wanda ya yi daidai da 280 kcal / rana). A cikin marasa lafiya masu fama da cutar sukari nau'in 2 waɗanda suka dauki Dapagliflozin * (Dapagliflozin *) a cikin kashi 10 na MG / rana na dogon lokaci (har zuwa shekaru 2), an kula da haɓakar glucose a duk lokacin karatun.

Haɓaka glucose ta kodan tare da dapagliflozin kuma yana haifar da osmotic diuresis da haɓaka cikin fitsari. Increaseara yawan ƙwayar fitsari a cikin marasa lafiya da nau'in ciwon sukari na 2 wanda ya dauki Dapagliflozin * (Dapagliflozin *) a cikin kashi 10 mg / rana, ya ci gaba har tsawon makonni 12 kuma ya kai kimanin 375 ml / rana. Increaseara yawan fitsari ya kasance tare da ƙaramin kaɗan da na gajeren lokaci a cikin fitsarin sodium daga kodan, wanda ba ya haifar da canji a cikin taro na soda daga cikin jijiyoyin jini ba.

Bayan gudanar da maganin baka, Dapagliflozin * (Dapagliflozin *) yana cikin sauri da kuma cikakke cikin jijiyoyin ciki kuma za'a iya ɗauka duka lokacin abinci da waje. Matsakaicin yawan ƙwayar dapagliflozin a cikin jini na jini (Stax) yawanci ana samun shi a tsakanin sa'o'i 2 bayan azumi.Valuesimar Cmax da AUC (yanki a ƙarƙashin ɓoye lokaci-lokaci) yana ƙaruwa da gwargwadon kashi na dapagliflozin.

Cikakken bayanin bioavailability na dapagliflozin lokacin da aka yi maganin shi a cikin kashi 10 mg shine 78%. Cin abinci yana da tasiri matsakaici akan kantin magunguna na dapagliflozin a cikin masu sa kai na lafiya. Abincin mai mai mai yawa ya rage Stax na dapagliflozin da 50%, ya tsawaita Ttah (lokaci don isa zuwa yawan ƙwayar plasma) da misalin awa 1, amma bai shafi AUC ba idan aka kwatanta da azumi. Waɗannan canje-canje ba su da mahimmanci a asibiti.

Sunadaran Dapagliflozin * (Dapagliflozin *) sunkai kashi casa'in da tara cikin dari (90%) a hade da sunadarai. A cikin marasa lafiya da cututtuka daban-daban, alal misali, tare da nakasa na koda ko aikin hepatic, wannan alamar ba ta canza ba.

Dapagliflozin * (Dapagliflozin *) shine glucoside da ke da alaƙa wanda aglycon yana da alaƙa da glucose ta hanyar haɗin carbon-carbon, wanda ke tabbatar da kwanciyar hankalirsa akan glucoseidases. Matsakaicin rabin rayuwar plasma (T½) a cikin masu sa kai masu lafiya shine awanni 12.9 bayan kashi daya na dapagliflozin a baki a kashi 10 mg. Dapagliflozin * (Dapagliflozin *) yana da metabolized don ƙirƙirar metabolism wanda yafi aiki dapagliflozin-3-O-glucuronide.

Bayan gudanar da maganin baka na 50 MG na 14C-dapagliflozin, kashi 61% na kashi da aka dauka shine metabolized zuwa dapagliflozin-3-O-glucuronide, wanda yakai 42% na yawan aikin rediyon plasma (AUC)

) - Asusun magungunan da ba su canzawa ba don 39% na jimlar aikin rediyon plasma. Fraarin ƙananan ragowar metabolites daban-daban ba su wuce 5% na jimlar aikin radios na rayuwa. Dapagliflozin-3-O-glucuronide da sauran metabolites ba su da tasirin magani. Dapagliflozin-3-O-glucuronide an samar dashi ta hanyar enzyme uridine diphosphate glucuronosyl transferase 1A9 (UGT1A9), wanda yake a cikin hanta da kodan, kuma CYP cytochrome isoenzymes ba su da yawa a cikin metabolism.

Dapagliflozin * (Dapagliflozin *) da metabolites dinsa sune ke rabuwa da kodan, kuma ƙasa da 2% ba a canzawa. Bayan shan 50 MG

An gano C-dapagliflozin yana 96% na rediyoaktif- 75% cikin fitsari da kuma 21% a feces. Kimanin 15% na aikin rediyo da aka samo a cikin feces an lissafta shi ta hanyar Dapagliflozin * (Dapagliflozin *).

A daidaituwa (yana nufin AUC), ƙaddamar da tsarin na dapagliflozin a cikin marasa lafiya da ke fama da ciwon sukari na 2 da mai laushi, matsakaici ko gazawar renal mai ƙarfi (kamar yadda ƙayyadaddun iohexol ya ƙayyade) ya kasance 32%, 60%, da 87% mafi girma fiye da marasa lafiya da ke fama da ciwon sukari na 2 da na al'ada kodan, bi da bi. Yawan kodan wanda kodan ya kwantar da shi yayin ranar yayin shan dapagliflozin a ma'auni ya dogara da yanayin aikin koda.

A cikin marasa lafiya da ke da nau'in ciwon sukari na 2 da na aiki na al'ada, kuma tare da sassauƙa, matsakaici ko gazawar ƙoshin yara, 85, 52, 18 da 11 g na glucose sun kasance a keɓe a kowace rana, bi da bi. Babu wani bambance-bambance dangane da dapagliflozin ga sunadarai a cikin masu sa kai da ke lafiya da kuma a cikin marassa lafiyar da gazawar koda game da tsananin rauni. Ba'a san ko cutar hemodialysis ta shafi bayyanar dapagliflozin ba.

A cikin marasa lafiya da ke da rauni ko matsakaiciyar ƙarancin hepatic, matsakaiciyar ƙimar Cmax da AUC na dapagliflozin sun kasance 12% da 36% mafi girma, bi da bi, idan aka kwatanta da masu bada taimako na lafiya. Wadannan bambance-bambance ba su da mahimmanci a asibiti; saboda haka, ana buƙatar daidaita sigar dapagliflozin don sassaucin rashin ƙarfi da matsakaici (duba).

Babu wani gagarumin ci gaba da aka samu a cikin bayyanar cutar a cikin marasa lafiyar da ke ƙasa da shekara 70 (sai dai idan ba a la'akari da abubuwan ban da shekaru ba). Koyaya, ana iya tsammanin haɓaka yaduwa saboda raguwa a aikin renal wanda ya danganta da shekaru. Bayanai masu bayyani ga marasa lafiya wadanda shekarunsu suka haura 70 basu isa ba.

A cikin mata, matsakaicin AUC a ma'auni yana da kashi 22% sama da na maza.

Ba a sami bambance-bambance mai mahimmanci na asibiti cikin haɗarin tsarin ba a tsakanin wakilan Caucasian, Negroid da Mongoloid jinsi.

An lura da ƙimar watsawar ƙananan ƙananan tare da ƙara yawan nauyin jikin mutum. Sabili da haka, a cikin marasa lafiya da ƙarancin nauyin jiki, za'a iya lura da ƙarancin karuwar haɗari, kuma a cikin marasa lafiya tare da ƙara yawan nauyin jikin mutum - raguwa a cikin bayyanar dapagliflozin. Koyaya, waɗannan bambance-bambance basu da mahimmanci a asibiti.

Kudin maganin da yadda za a siya

Kuna iya siyan Forksig a cikin kantin magani a Moscow, St. Petersburg da sauran biranen Rasha. Amma sayar da magani mai yiwuwa ne kawai ta hanyar sayan magani. Bugu da kari, farashin maganin ya dan kadan sama da na Turai. Kuna iya siyan samfurin Forxiga na asali daga mai siyarwa tare da bayarwa zuwa adireshin da aka ƙayyade.

Idan ba'a samar da maganin da ake buƙata ba, za a kawo maganin a ƙarƙashin umarnin kai tsaye daga Jamus. Farashin kayan haɗi wanda ke ɗauke da allunan 28 shine Yuro 90. Yana da fa'ida saya akwatin kwalin Allunan 98 don kudin Tarayyar Turai 160.

Masu bita

Sergey Viktorovich Ozertsev, endocrinologist: “A da, majiyyata masu dauke da ciwon sukari na 2 dole ne su zabi yanayin da ya dace na magani na dogon lokaci. A lokaci guda, sau da yawa sun ci karo da cututtukan jini da wasu sakamako masu illa. Lokaci guda na gudanar da kwayoyi da yawa sun kasance tare da tsallake kwayoyin hana daukar ciki, cin zarafi.

Olga, mai shekara 42: “An gano cutar sankara yayin da take shekara 35. Likita ya ba da shawarar tsayayyen abinci (Ina da matsaloli sosai game da nauyi). Na yi ƙoƙarin rasa nauyi, na kula da abincina sosai, amma har yanzu sukari yana ƙaruwa. Da farko, likitan ya ba da shawarar mafi rahusa da kuma sauki magunguna, amma ta ji mummunan sakamako daga sakamako masu illa. Saboda haka, na yanke shawarar siyan Forksigu kuma ban yi asara ba. Ina dauke shi sau ɗaya a rana. Tana jin sauki, sukari daidai ne. ”

Shirye-shiryen Dapagliflozin

Sunan kasuwanci ga Dapagliflozin shine Forsyga. Kamfanin Ingila na AstraZeneca yana samar da allunan ne tare da hadin gwiwar Amurka Bristol-Myers. Don sauƙi na amfani, maganin yana da magunguna 2 - 5 da 10 mg. Samfurin asali yana da sauƙin rarrabewa daga karya. Allunan forsig 5 MG suna da siffa mai zagaye da kuma rubutattun zane "5" da "1427", 10 MG suna da nau'in lu'u-lu'u, ana sawa suna "10" da "1428". Allunan biyu allurai suna rawaya.

Dangane da umarnin, ana iya adana Forsigu har tsawon shekaru 3. Don watan jiyya, ana buƙatar kunshin 1, farashinsa ya kusan 2500 rubles. Tunatarwa, a cikin ciwon sukari na mellitus, ya kamata a tsara Forsigu kyauta, tunda Dapagliflozin yana cikin jerin magunguna masu mahimmanci. Dangane da sake dubawa, yana da matukar wuya a sami magani. An tsara forsig idan akwai abubuwan hanawa don ɗaukar metformin ko sulfonylurea, kuma a wasu hanyoyi ba zai yiwu ba don cimma sukari na al'ada.

Forsigi bashi da cikakkiyar alamun analogues, tunda kariyar kariya ta kasance har yanzu tana aiki akan Dapagliflozin. Ana ɗaukar analogues na rukuni su kasance Invocana (ya ƙunshi canagliflozin SGLT2 inhibitor) da Jardins (empagliflozin). Farashin magani tare da waɗannan magunguna daga 2800 rubles. da wata.

Tsarin magani

Kodanmu suna taka rawa sosai wajen kiyaye matakan sukari na jini. A cikin mutane masu lafiya, har zuwa 180 g na glucose ana tacewa a kullun a cikin fitsari na farko, kusan dukkanin shi an sake farfadowa kuma a koma cikin jini. Lokacin da yawan glucose a cikin tasoshin ya tashi a cikin ciwon sukari na mellitus, toshewarsa a cikin renal glomeruli kuma yana ƙaruwa. Bayan yakai wani matakin (kusan 10 mmol / l a cikin masu ciwon sukari tare da ƙoshin lafiya), kodan ta daina sake sarrafa glucose kuma ta fara cire ƙwayar fitsari a cikin fitsari.

Glucose kadai ba zai iya shiga cikin membranes cell ba, saboda haka, masu jigilar sodium-gulukos suna cikin aikin sake sarrafawa. Speciesaya daga cikin jinsin, SGLT2, yana cikin wannan ɓangaren nephrons inda yawancin glucose ke sake farfadowa. A cikin wasu gabobin, ba a samo SGLT2 ba. Ayyukan Dapagliflozin sun dogara ne da hanawa (hanawa) ayyukan wannan jigilar. Yana aiki ne kawai a kan SGLT2, ba ya shafar masu aikin analog, sabili da haka ba ya tsoma baki tare da metabolism na al'ada.

Dapagliflozin yana katsewa ta musamman tare da aikin ƙwayoyin koda. Bayan shan kwaya, ƙwayar glucose reabsorption tana ƙaruwa kuma ana fara fitar dashi cikin fitsari a cikin girma fiye da yadda ake yi a da. Glycemia ya rage. Magungunan ba zai tasiri matakin al'ada na sukari ba, don haka shan shi ba ya haifar da hypoglycemia.

Nazarin sun nuna cewa miyagun ƙwayoyi ba wai kawai rage glucose bane, amma yana shafar wasu dalilai na haɓaka rikice-rikice na ciwon sukari:

1. Normalization na glycemia yana haifar da raguwa a cikin juriya na insulin, bayan rabin wata na ɗaukar ma'aunin an rage shi da matsakaicin 18%.
2. Bayan rage tasirin mai guba a cikin ƙwayoyin beta, maido da ayyukansu ya fara, aikin insulin yana ƙaruwa kaɗan.
3. Yawan yawan glucose yana haifar da asarar adadin kuzari. Umarni suna nuna cewa lokacin amfani da Forsigi 10 MG kowace rana, kimanin g 70 na glucose an cire shi, wanda yayi daidai da kilogram 280. Fiye da shekaru 2 na gudanarwa, ana iya tsammanin asarar nauyi na kilogiram 4.5, wanda 2.8 - saboda mai.
4. A cikin masu ciwon sukari tare da farko hawan jini, an lura da raguwa (systolic yana raguwa da misalin 14 mmHg). An lura da abubuwan lura na tsawon shekaru 4, sakamakon ya ci gaba duk wannan lokacin. Wannan tasirin Dapagliflozin yana da alaƙa da tasiri na diuretic (ƙarin fitsari an cire shi lokaci guda tare da sukari) kuma tare da asarar nauyi lokacin amfani da miyagun ƙwayoyi.

Alamu don alƙawari

Dapagliflozin an yi shi ne don masu ciwon sukari na 2. Abubuwan buƙatu masu mahimmanci - raguwa a cikin adadin carbohydrates a abinci, aikin jiki na yau da kullun na matsakaici mai ƙarfi.

Dangane da umarnin, ana iya amfani da miyagun ƙwayoyi:

1. Kamar yadda monotherapy. A cewar likitoci, nadin Forsigi kawai ana yin sa da wuya.
2. Baya ga metformin, idan ba ya samar da wadataccen raguwar glucose, kuma babu alamun alƙawarin allunan da ke inganta samar da insulin.
3. A matsayin wani ɓangare na cikakken magani don inganta diyya na cutar sankara.

Rashin Lafiya na Dapagliflozin

Jiyya tare da Dapagliflozin, kamar kowane magani, an danganta shi da wani haɗarin sakamako masu illa. Gabaɗaya, bayanin martabar lafiyar miyagun ƙwayoyi an zaba shi kamar yadda ya dace Umarnin ya tsara duk sakamakon da zai yiwu, an ƙayyade mitar su:

1. Cututtukan cututtukan ƙwayar cuta sune takamaiman sakamako na Dapagliflosin da analogues. Yana da alaƙar kai tsaye zuwa ga tushen aikin miyagun ƙwayoyi - sakin glucose a cikin fitsari. An kiyasta haɗarin kamuwa da cuta a cikin kashi 5.7%, a cikin ƙungiyar kulawa - 3.7%. Mafi yawan lokuta, matsaloli suna faruwa a cikin mata a farkon jiyya. Yawancin cututtukan cututtukan sun kasance masu laushi zuwa ƙarancin matsakaici kuma an kawar da su da ingantattun hanyoyin. Yiwuwar cutar pyelonephritis ba ta ƙara yawan ƙwayoyi ba.
2. A cikin ƙasa da 10% na marasa lafiya, ƙwayar fitsari yana ƙaruwa. Matsakaicin girma shine 375 ml. Rashin ruwa na koda
3. Kasa da 1% na masu ciwon sukari sun lura maƙarƙashiya, ciwon baya, sweating. Riskaya haɗarin ɗaya na karuwar creatinine ko urea a cikin jini.

Ra'ayoyi game da miyagun ƙwayoyi

Endocrinologists game da yiwuwar Dapagliflozin ya amsa daidai, mutane da yawa suna cewa daidaitaccen kashi na iya rage glycated haemoglobin da 1% ko fiye. Rashin maganin da suke la'akari da ɗan gajeren lokacin amfani dashi, ƙaramin adadin karatun siye-da-siyarwa. Forsigu kusan ba a wajabta shi azaman magani kawai ba. Likitocin sun fi son metformin, glimepiride da gliclazide, tunda waɗannan magungunan ba su da tsada, ana yin nazari sosai da kuma kawar da yanayin cututtukan da ke tattare da cutar sikari, kuma ba kawai cire glucose ba, kamar Forsyga.

Hakanan masu ciwon sukari basa nacewa game da shan sabon magani, saboda tsoron kamuwa da kwayoyin cuta na kwayar halittar jini. Hadarin waɗannan cututtukan a cikin ciwon sukari yana da girma. Mata sun lura cewa tare da karuwa da ciwon sukari, yawan ƙwayar cuta da ƙwaƙwalwar ƙwayar mahaifa suna ƙaruwa, kuma suna jin tsoron kara ƙarfin bayyanar su da Dapagliflozin. Babban mahimmanci ga marasa lafiya shine babban farashin Forsigi da kuma rashin ƙarancin analogues mai arha.

Tabbatar koya! Shin kuna tsammanin kulawa da kwayoyin hana daukar ciki da insulin shine hanya daya tilo da za'a kula da sukari? Ba gaskiya bane! Kuna iya tabbatar da wannan da kanku ta hanyar fara amfani da shi. kara karantawa >>

Dapagliflozin (Forsyga)

Type 2 ciwon sukari - wata cuta da ke haɗuwa da haɓakar haɗarin kamuwa da cututtukan urinary fili (UTIs) da cututtukan ƙwayar cuta, irin su vulvovaginitis da balanitis a cikin mata da kamuwa da cututtukan ƙwayar cuta a cikin maza 33, 34. Hadarin kamuwa da cuta shine kawai wani ɓangare saboda glucosuria. Abubuwan da suka haifar da su kamar lalatawar jiki, glycosylation na sel uroepithelial suna da mahimmanci.

Dangane da waɗannan bayanan, FDA ta amince da dapagliflozin bayan Hukumar Kula da Lafiya ta Turai (EMEA) 16, 39 ta amince da ita.

Kammalawa

Karatuttukan gwaji da na asibiti sun nuna kyakkyawar rawar gani na ayyukan SGLT2 inhibitors. Wannan rukuni na kwayoyi suna ba da sababbin hanyoyin samar da insulin-ins don gyara glycemia a cikin nau'in ciwon sukari na 2 tare da haƙuri mai kyau, rashi mummunar tasiri akan nauyin jikin mutum, haɗarin cutar hypoglycemia da sauran mummunan sakamako masu illa.

Magungunan Forsig (dapagliflozin) a cikin karatun da suka wuce na makonni 104 sun nuna ingancin glycemic na tsawon lokaci, asarar nauyi mai tsayayye musamman saboda yawan kitse da ƙananan haɗarin yanayin hypoglycemic. Forsiga shine mafi kyawun madadin shirye-shiryen sulfonylurea a cikin marasa lafiya waɗanda basu cimma burinsu ba tare da maganin metformin monotherapy.