Yaya ake amfani da miyagun ƙwayoyi Glukovans?

Sigar nau'i na Glucovans - allunan: biconvex mai kwalliya mai kwalliya a fim mai launi na launi orange tare da zane a gefe ɗaya na "2.5" ko launi mai launin rawaya tare da zanen "5" (inji mai kwakwalwa 15. A cikin blisters, a cikin kwali na akwatin 2 blisters).

Glibenclamide - 2.5 MG ko 5 MG,
Metformin hydrochloride - 500 MG.

Mahalarta: povidone K30, sodium croscarmellose, magnesium stearate, celclose microcrystalline.

Abun da harsashi shine orange orange / yellow: opadry OY-L-24808 pink / opadry 31-F-22700 yellow (hypromellose 15cP, lactose monohydrate, titanium dioxide, iron oxide ja, iron oxide black / dye quinoline yellow, macrogol, iron oxide rawaya), tsarkakakken ruwa.

Pharmacodynamics

Glucovans shine haɗin ƙayyadaddun haɗakar wakilai na baka guda biyu, waɗanda ke cikin rukunin magunguna daban-daban: glibenclamide da metformin.

Metformin wani bangare ne na rukunin biguanide kuma yana rage matakin duka postprandial da basal a cikin jini. Ba mai tayar da hankali bane don samar da insulin, wanda ke haifar da ƙarancin haɗarin hauhawar jini. Hanyoyi uku na aiki sune sifofin wani abu:

hanawa glucose sha a cikin narkewa,
theara hankalin mai karɓar mahaukatan insulin, ƙara yawan amfani da amfani da glucose ta ƙwayoyin tsoka,
raguwa a cikin ƙwayar glucose a cikin hanta ta hanyar hana glycogenolysis da gluconeogenesis.

Metformin kuma yana da tasiri sosai a cikin abubuwan da ke cikin jini, rage yawan triglycerides, low lipoproteins mai yawa (LDL) da jimlar cholesterol.

Glibenclamide shine asalin halittar sulfonylurea na biyu. Matsayi na glucose lokacin da aka shigar da wannan abu mai aiki saboda rage girman aikin samar da insulin ta hanyar sel da ke cikin farji.

Hanyoyin aiwatar da aiki na metformin da glibenclamide sun bambanta, amma abubuwan suna da tasirin tasirin juna kuma suna iya haɓaka aikin hypoglycemic ɗin juna, wanda ke ba da izinin cimma raguwa sosai a cikin glucose jini.

Pharmacokinetics

Kasancewa na glibenclamide daga cututtukan gastrointestinal bayan aikin baka ya wuce kashi 95%. Wannan bangaren aiki na Glucovans ba karamin abu bane. Matsakaicin mafi kyawun abu a cikin plasma an kai shi a cikin sa'o'i 4, kuma girman rarraba shine kusan lita 10. Glibenclamide ya ɗaura nauyin sunadaran plasma da kashi 99%. An kusan kusan 100% a cikin hanta, yana samar da metabolites guda biyu marasa aiki, waɗanda aka fesa su da bile (60% na kashi da aka ɗauka) da fitsari (40% na kashi da aka ɗauka). Cire rabin rayuwar rayuwa yayi sa'oi 4 zuwa 11.

Bayan gudanar da baki, ana amfani da metformin daga cikin gastrointestinal fili sosai, kuma mafi girman matakin plasma ya kai cikin awa 2.5. Aƙalla kusan 20-30% na kayan suna cikin abubuwan narkewa ba a canza su ba. Cikakken bioavailability shine 50-60%.

An rarraba Metformin a cikin kyallen takarda a cikin babban sauri, kuma matsayinsa na ɗaure wa sunadaran plasma kaɗan ne. Abun yana da ɗan metabolized da ɗanɗano ta cikin kodan. Maƙƙarfan rabin rai yana kan awa 6.5. A cikin marasa lafiya tare da daskararction na koda, akwai raguwa game da ƙaddamar da renal da karuwa a cikin rabin rayuwa, wanda ke haifar da karuwa a cikin abubuwan metformin a cikin jini na jini.

Haɗin glibenclamide da metformin a cikin magani ɗaya ana ɗaukar su ta hanyar bioavailability iri ɗaya kamar lokacin da ake amfani da siffofin kwamfutar hannu dauke da waɗannan sinadaran aiki daban. Cin abinci ba ya shafar bioavailability na Glucovans, wanda shine haɗakar glibenclamide da metformin. Koyaya, rashi sha na glibenclamide lokacin da aka ɗauke shi da abinci yana ƙaruwa.

Alamu don amfani

Dangane da umarnin, an wajabta Glucovans don manya da ke fama da ciwon sukari na 2 idan:

Ruwan monotherapy da suka gabata tare da sulfonylureas ko metformin, farjin abinci da motsa jiki basu da tasiri,
Haɗin magani tare da samfuran metformin da abubuwan sulfonylurea a cikin marasa lafiya tare da ingantaccen glycemia da ke tsaye ya kamata a maye gurbinsu da monotherapy.

Contraindications

Type 1 ciwon sukari
Ciwon sukari da kuma coma
Ketoacidosis mai ciwon sukari
Lactic acidosis, gami da tarihin
Rashin ƙarfi da / ko gazawar hanta,
Relieness raunin aiki (ɗaukar hoto (QC)
Yanayin matsanancin da ke haifar da canje-canje a cikin aikin koda: mummunan kamuwa da cuta, rashin ruwa, rawar jiki, aidin-mai dauke da abubuwan kwantar da hankali,
Ciwon ciki
Harin hypoxia a cikin yanayin cututtukan cututtukan zuciya ko rashin lafiyar zuciya, girgizawa, tashin zuciya na baya-bayan nan,
Lokacin daukar ciki da shayarwa,
Amfani da miconazole,
Jinyar tiyata
M barasa maye, na kullum shan giya,
Yarda da abinci mai tsoka (kasa da 1000 kcal a rana),
Glucose-galactose malabsorption syndrome, rashin haƙuri na galactose, rashi lactase,
Shekaru 18 a duniya
Shekaru sama da shekaru 60, lokacin yin babban aiki na jiki (hadarin lactic acidosis),
Hypersensitivity ga abubuwan da ke cikin miyagun ƙwayoyi ko wasu abubuwan da suka samo asali na sulfonylurea.

Tare da taka tsantsan, Glucovans ana bada shawara don: cututtukan ƙwayar thyroid tare da keta ƙetaren aikinta, rashin ƙarfi a cikin mahaifa, ciwon febrile, hypofunction of the face pituitary gland shine yake.

Umarnin don amfanin Glucovans: hanya da sashi

Ana ba da shawarar allunan Glucovans tare da abinci, kuma yakamata a sami yawancin carbohydrates a cikin abincin.

Likita ya tsara adadin kashi daban-daban, la'akari da matakin glycemia.

Maganin farko shine 1 kwamfutar hannu Glucovans 2.5 MG / 500 MG ko Glucovans 5 MG / 500 MG sau ɗaya a rana.

Lokacin canja wurin mai haƙuri tare da haɗuwa ko monotherapy tare da sulfonylurea da metformin zuwa maganin Glucovans, don hana hypoglycemia, kashi na farko kada ya wuce daidai adadin yau da kullun na magungunan da aka sha a baya. Don cimma daidaiton iko na glucose na jini, yakamata a ƙara yawan kashi a hankali, babu fiye da 5 MG / 500 MG kowace rana a cikin mako biyu ko ƙasa da hakan. Za'a iya yin gyaran fuska ko yaushe dangane da matakin glycemia.

Matsakaicin adadin yau da kullun shine 4 Allunan Glucovans 5 MG / 500 MG ko allunan Allunan 6,5 mg / 500 MG. Shafin allunan Allunan an ƙaddara su daban-daban, ya dogara da yawan yau da kullum na miyagun ƙwayoyi:

1 kwamfutar hannu (na kowane sashi) - 1 lokaci kowace rana, da safe,
Allunan 2 ko 4 (kowane sashi) - sau 2 a rana, safe da maraice,
3, 5 ko 6 Allunan 2.5 mg / 500 MG ko allunan 3 na 5 MG / 500 MG - sau 3 a rana, yakamata a sha da safe, yamma da yamma.

Ga tsofaffi marasa lafiya, kashi na farko kada ya wuce kwamfutar hannu 1 mg 2.5 mg / 500 MG. Dalilin kashi da amfanin Glucovans ya kamata a sa ido akai-akai don aikin renal.

Side effects

Daga tsarin narkewa: sau da yawa - rashin ci, tashin zuciya, ciwon ciki, amai, zawo. Kwayar cutar cututtuka tana bayyana a farkon farawa kuma na ɗan lokaci ne. Da wuya sosai - cuta cuta na hanta, hepatitis,
Daga gabobin azanci: sau da yawa - dandano na karfe a bakin. A farkon farawar, nakasar gani na wucin gadi na yiwuwa,
Daga gefen metabolism: hypoglycemia, da wuya - hare-hare na fata porphyria da hanta porphyria, da wuya - lactic acidosis. Tare da tsawan magani - raguwa a matakin taro na bitamin B12 a cikin ƙwayar jini (na iya haifar da cutar cutar megaloblastic). A bango daga amfani da giya, wani disulfiram-kamar dauki,
Hematopoietic gabobin: da wuya - thrombocytopenia da leukopenia, da wuya - pancytopenia, hemolytic anemia, barrow aplasia, agranulocytosis,
A bangaren fata: da wuya - itching, kyanda-kamar kurji, da wuya - exfoliative dermatitis, erythema multiforme, photoensitivity,
Allergic halayen: da wuya - urticaria, da wuya wuya - visceral ko fata rashin lafiyar vasculitis, anaphylactic shock. Tare da gudanarwa na lokaci daya, rikice-rikice zuwa ga sulfonamides da abubuwan da ake amfani da su yana yiwuwa,
Manuniya na dakin gwaje-gwaje: alal misali - karuwa a cikin haɗuwa da kwayar halittar jini da urea a cikin ƙwayar jini zuwa matakin matsakaici, da wuya - hyponatremia.

Yawan damuwa

Luarfafawar ƙwayar cuta ta Glucovans na iya tayar da haɓakar haɓakar ƙwayar cuta, tun da ƙarancin sulfonylurea wani ɓangare na miyagun ƙwayoyi.

Bayyanar cututtuka na laushi zuwa matsakaici na hypoglycemia a cikin rashin rikicewar tsarin juyayi na tsakiya da syncope ana gyara su ta hanyar yawan sukari nan da nan. Hakanan ya kamata ku daidaita sashin Glucovans da / ko canza abincin. Idan marasa lafiya masu ciwon sukari mellitus suna fuskantar mummunan halayen hypoglycemic, tare da paroxysm, coma ko wasu rikicewar jijiyoyin jini, dole ne a ba da kulawa ta likita. Nan da nan bayan an gano cutar ko kuma a ɗan 'yar shakkuwar cutar ƙwacewar jini, an ba da shawarar gudanar da maganin hanzari na maganin dextrose kafin a sanya mara lafiya a asibiti. Bayan mai haƙuri ya sake farfaɗo, ya kamata a ba shi abinci mai wadata a cikin ƙwayoyin carbohydrates, waɗanda suke da sauƙin sha, wanda zai hana sake haɓakar ƙwanƙwasa jini.

Gudanar da Glucovans na dogon lokaci a cikin babban allurai ko abubuwan haɗari masu haɗari na iya haifar da haɓakar lactic acidosis, tunda metformin wani ɓangare ne na miyagun ƙwayoyi. Lactic acidosis ana ɗaukarsa yanayin yanayin buƙatar likita na gaggawa, kuma ya kamata a gudanar da jiyyarsa ta musamman a asibiti. Hanyoyi mafi inganci na maganin da ke haifar da fitowar lactate da metformin sun haɗa da maganin hemodialysis.

A cikin marasa lafiya tare da dysfunctions hanta, ƙaddamar da glibenclamide a cikin jini yana iya ƙaruwa. Tunda wannan abu mai karfi yana ɗaure garkuwar jini na jini, toshewar sa yayin hemodialysis bashi yiwuwa.

Umarni na musamman

Ana ba da shawarar jiyya tare da saka idanu na yau da kullun na glucose jini da kuma bayan cin abinci.

A lokacin gudanar da mulkin Glucovans, ya zama dole a la’akari da yiwuwar bunkasa lactic acidosis, alamun cutar na iya zama bayyanar ciwon ciki, matsanancin mala, ƙwaƙwalwar tsoka da rikicewar dyspeptik.

Lokacin amfani da Glucovans, akwai haɗarin haɓakar hypoglycemia, wataƙila yana faruwa ne a cikin marasa lafiya akan ƙananan abinci na carbohydrate, baya bin abinci, shan giya, karɓar ƙwayar aiki ta jiki tare da rage yawan hypocaloric. Hankali a cikin rubutaccen tsari, zaɓi mai kyau na sashi da aiwatar da shawarar likita ya rage yiwuwar rashin lafiya.

An hana shan giya yayin jiyya.

Kafin nadin Glucovans da kuma lokacin gudanar da mulki, yakamata a gudanar da karatu na yau da kullun don tantance matakin maida hankali a cikin saitin kwayoyin halitta. Binciken ya kamata a yi a cikin marasa lafiya da keɓaɓɓen aikin koda na al'ada aƙalla 1 lokaci a shekara, tare da raunin ƙwayar ƙwayar ƙwayar cuta da ƙwararrun marasa lafiya - sau 2-4 a shekara.

Idan cututtukan cututtukan zuciya na bronchi, huhu, ko gabobin urogenital suka bayyana, tuntuɓi likita nan da nan.

Haihuwa da lactation

Farkon haihuwa shine yaduwar amfani da glucovans. Yakamata a sanar da marassa lafiya cewa yayin yin magani tare da maganin yakamata su sanar da likita game da shirin yin juna biyu ko kuma farawa. A cikin waɗannan halayen biyu, Glucovans an soke shi nan da nan kuma an ba da umarnin hanya ta insulin.

Babu wani bayani game da karfin metformin a hade tare da glibenclamide don shiga cikin madarar nono, sabili da haka, ba a yarda da sanya maganin a lokacin shayarwa ba.

Yi amfani da tsufa

Matsayin don tsofaffi marasa lafiya an kafa shi yana la'akari da yanayin aikin koda, wanda dole ne a kimanta shi akai-akai. Maganin farko a cikin marasa lafiya na wannan rukuni shine 1 kwamfutar hannu 1,5 mg / 500 MG.

Ba'a ba da shawarar yin amfani da Glucovans a cikin marasa lafiya waɗanda shekarunsu suka wuce shekaru 60 kuma waɗanda jikinsu ya shiga matsanancin ƙwaƙwalwar jiki, wanda aka bayyana ta haɗarin haɗarin haɓakar lactic acidosis a cikinsu.

Hulɗa da ƙwayoyi

Ya kamata a dakatar da gudanar da aikin Glucovans kwanaki 2 kafin daga baya kuma a sabunta kwanaki 2 bayan gudanarwar kwastomomin masu dauke da maganin aidin.

An hana yin amfani da miconazole lokaci guda, saboda tsananin yiwuwar haɓakar ƙwararraki, har zuwa hauhawar jini.

Haɗin maganin tare da kwayoyi masu ɗauke da ethanol da phenylbutazone ba a ba da shawarar ba, tun da sun kara tasirin hypoglycemic na Glucovans.

Tare da yin amfani da lokaci guda tare da bosentan, hadarin hepatotoxic yana ƙaruwa, sakamakon glibenclamide yana raguwa.

Babban adadin chlorpromazine yana rage sakin insulin, yana ba da gudummawa ga karuwar cutar glycemia.

Tasirin hypoglycemic na Glucovans yana raguwa lokacin da aka haɗu da glucocorticosteroids, tetracosactide, diuretics, danazol da beta2-adrenergic agonists.

Yayin ɗaukar masu hanawa na maganin antiotensin-canza enzyme (ACE), gami da enalapril da captopril, akwai raguwar glucose jini.

Haɗuwa tare da metformin yana buƙatar kulawa ta musamman a cikin marasa lafiya da rauni na koda, tun da yiwuwar haɓakar lactic acidosis yana da girma tare da amfani da "madauki" diuretics.

Haɗin Glucovans tare da tausayawa, beta-blockers, reserpine, clonidine, guanethidine yana ɓoye alamun hypoglycemia.

Daidaita gyaran fuska ya zama dole yayin ɗaukar fluconazole, akwai haɗarin hauhawar jini.

Glibenclamide yana rage tasirin antidiuretic na desmopressin.

Tasirin hypoglycemic na Glucovans yana ƙaruwa tare da yin amfani da lokaci ɗaya tare da inhibitors na monoamine oxidase (MAOs), sulfonamides, anticoagulants (abubuwan da aka samo coumarin), fluoroquinolones, chloramphenicol, pentoxifylline, magungunan lipid-lowing na rukuni na fibrates, rashin biyayya.

Glucovans analogues sune: Glybomet, Glukonorm, Glyukofast, Bagomet Plus, Metformin, Siofor.

Nazarin Glucovans

Marasa lafiya tare da masu ciwon sukari sau da yawa suna barin sake duba Glucovans akan layi. Sau da yawa suna tattauna batutuwan da suka shafi zaɓin kashi da magani, da kuma haɗin gwiwarta tare da wasu kwayoyi. Koyaya, sake duba kansu kansu rigima ce. Rahotannin sun ambaci cewa, don cimma matsakaicin sakamako a cikin jiyya, wajibi ne don ƙididdige yawan adadin kuzari da kuma yawan ƙwayar carbohydrate, tare da sanya ido a hankali da lura da yadda magungunan ke gudana.

Koyaya, akwai kuma ra'ayin game da wautar Glucovans. Marasa lafiya suna koka game da rashin ci gaba a cikin ƙoshin lafiya da manyan karkacewa daga ƙimar al'ada na taro na sukari a cikin jini (hypoglycemia). Sauran marasa lafiya sun ba da rahoton cewa don daidaita lafiyar su dole ne su nemi cikakkiyar cikakkiyar gyara game da tsarin kulawa da salon rayuwa.

Hanyar saki na Glucovans, shirya magunguna da abun da ke ciki.

Allunan an lullube su da farin kwalin orange, mai kamanin kaifi, biconvex, tare da zanen “2.5” a gefe guda.

Shafin 1
metformin hydrochloride
500 MG
glibenclamide
2.5 MG

Mahalarta: povidone K30, magnesium stearate, sodium croscarmellose, celclose microcrystalline, Opadry (Opadri) OY-L-24808, tsarkakakken ruwa.

Guda 15. - blister (2) - kwali na kwali.
Guda 20. - blister (3) - kwali na kwali.

Allunan da aka saka wa launin shuda launuka ne mai kamshi, biconvex, da zanen "5" a gefe guda.

Shafin 1
metformin hydrochloride
500 MG
glibenclamide
5 MG

Mahalarta: povidone K30, magnesium stearate, sodium croscarmellose, celclose microcrystalline, Opadry (Opadri) 31F22700, tsarkakakken ruwa.

Guda 15. - blister (2) - kwali na kwali.
Guda 20. - blister (3) - kwali na kwali.

Bayanin miyagun ƙwayoyi ya dogara ne da umarnin hukuma da aka tabbatar don amfani.

Glucovans na Pharmacological

Hada magunguna na hypoglycemic don amfani da baka.

Glucovans shine haɗin ƙayyadaddun haɗakar wakilai na baka guda biyu na rukunin magunguna daban-daban.

Metformin yana cikin rukunin biguanides kuma yana rage glucose mai ƙwaƙwalwa ta haɓaka ƙimar ƙwayar yanki zuwa aikin insulin da haɓaka haɓakar glucose. Metformin yana rage shaye-shayen carbohydrates daga tsarin narkewa kuma yana hana gluconeogenesis a cikin hanta. Hakanan yana da amfani mai amfani a cikin abubuwan da ke tattare da rage yawan jini, rage matakin adadin cholesterol, LDL da TG.

Glibenclamide yana nufin asalin tsararraki na ƙarni na biyu. Matsayi na glucose lokacin shan glibenclamide yana raguwa sakamakon ƙarfafa ƙwayar insulin ta sel ƙwayoyin.

Sashi da hanyar gudanar da magani.

Adadin maganin yana maganin likita ne daban-daban ga kowane mara lafiya, gwargwadon matakin glycemia.

Yawanci, kashi na farko na Glucovans shine 1 shafin. 500 MG / 2.5 MG kowace rana. Lokacin maye gurbin maganin haɗuwa da baya tare da metformin da glibenclamide, an tsara allunan 1-2. Glucovansa 500 MG / 2.5 MG dangane da matakin da ya gabata. Kowane makonni 1-2 bayan fara magani, ana daidaita sashi gwargwadon matakin glycemia.

Allunan ya kamata a ɗauka tare da abinci.

Matsakaicin maganin yau da kullun shine Allunan 4. Glucovansa 500 MG / 2.5 MG ko 2 shafin. Glucovansa 500 MG / 5 MG.

Tasirin Glucovans:

Daga tsarin narkewa: a farkon jiyya, tashin zuciya, amai, raɗaɗi na ciki, asarar ci zai iya faruwa (a mafi yawan lokuta, wuce kai tsaye kuma baya buƙatar kulawa ta musamman, don hana haɓaka waɗannan alamun, ana bada shawara don shan miyagun ƙwayoyi a cikin allurai 2 ko 3, jinkirin karuwa a cikin maganin yana inganta haqurinsa), wataƙila daɗin “ƙarfe” a bakin.

Sauran: erythema, megaloblastic anemia, lactic acidosis.

Daga tsarin narkewa: tashin zuciya, amai, jin zafi, ci gaba da aikin hanta enzymes.

Daga tsarin hemopoietic: leukopenia, thrombocytopenia, da wuya - agranulocytosis, hemolytic anemia, pancytopenia.

Allergic halayen: - urticaria, kurji, itching fata.

Sauran: hypoglycemia, disulfiram-like reactions lokacin shan barasa.

Umarnin na musamman don amfanin Glucovans.

A yayin jiyya tare da Glucovans, ya zama dole don saka idanu akai-akai matakin glucose a cikin jini akan komai a ciki da kuma bayan cin abinci.

Yakamata a gargadi mara lafiya cewa idan matsanancin ciki da raunin ciki hade da jijiyoyin tsoka ko zazzabin cizon baki sun bayyana a yayin maganin Glucovans, to yakamata a dakatar da miyagun ƙwayoyi kuma yakamata a nemi likita nan da nan, tunda waɗannan alamun na iya zama alamun lactic acidosis.

Mai haƙuri ya kamata ya sanar da likita game da bayyanar cututtukan bronchopulmonary ko kamuwa da urinary fili.

Awanni 48 kafin a yi tiyata ko a gudanar da wani abu wanda yake dauke da maganin fitsari a cikin aidin, yakamata a daina aikin glucovans. An bada shawarar sake kula da maganin Glucovans bayan sa'o'i 48.

Yayin magani, ba a ba da shawarar sha barasa.

Tasiri kan ikon tuka motoci da hanyoyin sarrafa abubuwa

A yayin jiyya tare da Glucovans, mutum bai kamata ya shiga cikin ayyukan da ke buƙatar haɓakar haɓakar hankali da saurin halayen psychomotor ba.

Haɗin Glucovans tare da wasu kwayoyi.

Magungunan haɓakawa na glucovans (haɓaka haɗarin hauhawar jini)

Tare da yin amfani da lokaci ɗaya tare da Glucovans, miconazole na iya tayar da haɓakar hauhawar jini (har zuwa haɓaka ƙwayar cuta).

Fluconazole yana haɓaka T1 / 2 na abubuwan da ke haifar da maganin sulfonylurea kuma yana ƙaruwa da haɗarin halayen hypoglycemic.

Shan barasa yana kara haɗarin halayen haila (har zuwa haɓaka ƙwaƙwalwar ciki). Yayin aikin tare da Glucovans, ya kamata a guji barasa da kwayoyi masu ɗauke da ethanol (barasa).

Yin amfani da inhibitors na ACE (captopril, enalapril) yana kara yiwuwar haɓaka maganganun hypoglycemic a cikin marasa lafiya tare da mellitus na sukari a cikin maganin abubuwan da suka samo asali na sulfonylurea ta hanyar inganta haƙuri na glucose da rage buƙatar insulin.

Beta-blockers na kara yawan tashin hankali da kuma tsananin cututtukan hypoglycemia. Beta-blockers rufe alamun hypoglycemia kamar palpitations da tachycardia.

Magunguna waɗanda ke raunana tasirin glucovans

Danazole yana da tasirin gaske. Idan jiyya tare da danazol ya zama dole kuma idan aka dakatar da ƙarshen, ana buƙatar daidaita sashi na Glucovans a ƙarƙashin kula da matakin glycemia.

Chlorpromazine a cikin allurai masu yawa (100 MG / rana) yana haifar da karuwa a cikin glycemia.

GCS yana ƙaruwa glycemia kuma yana iya haifar da ci gaban ketoacidosis.

Beta2-adrenostimulants yana haɓaka matakin glycemia saboda haɓakar masu karɓar 2-adrenergic.

Diuretics (musamman ma "loopbacks") suna tsokani cigaban ketoacidosis saboda haɓakar rashin aiki na koda.

A / a cikin gabatarwar wakilan aidin-dauke da bambancin jami'ai na iya haifar da ci gaban lalacewa na koda, wanda hakan zai haifar da cakuda magungunan a jikin mutum da haɓakar lactic acidosis.

Beta-blockers rufe alamun hypoglycemia, irin su palpitations da tachycardia.

Sashi da gudanarwa

Allunan Glucovans an yi su ne don gudanar da maganin baka. Ana ɗaukar allunan a lokacin abinci, wanda ya kamata ya ƙunshi babban adadin carbohydrates, don hana hypoglycemia.

Da magani na miyagun ƙwayoyi ne aka zaɓi da halartar likita.

Maganin farko na Glucovans shine kwamfutar hannu 1 (2.5 mg + 500 MG ko 5 MG + 500 MG) sau ɗaya a rana. An ba da shawarar ƙara yawan kwayar a kowane mako 2 ko fiye da ba fiye da 500 MG na metformin da 5 MG na glibenclamide kowace rana don sarrafa matakan glucose na jini sosai.

Lokacin maye gurbin maganin da aka haɗo na baya tare da glibenclamide da metformin, kashi na farko kada ta kasance sama da kashi na yau da kullun na glibenclamide da metformin waɗanda aka ɗauka a baya. Kowane makonni biyu bayan farawa, ana daidaita sashi na miyagun ƙwayoyi.

Matsakaicin maganin yau da kullun na Glucovans shine 4 Allunan 5 5 MG + 500 MG ko allunan Allunan 6,5 2.5 + 500 MG.

Sashi ta hanyar magani:

Lokacin rubuta kwamfutar hannu guda ɗaya kowace rana - da safe, a karin kumallo,
Tare da nadin allunan 2, 4 a kowace rana - safe da maraice,
Tare da nadin allunan 3, 5, 6 a kowace rana - da safe, yamma da yamma.

Form sashi

500 MG / 2.5 MG da 500 Allunan / 5 MG mai kwakwalwa mai rufe jiki

Cbarin

Sashi 500 MG / 2.5 MG

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abubuwa masu aiki: metformin hydrochloride 500 MG

glibenclamide 2.5 MG,

magabata: sodium croscarmellose, povidone K 30, celclose microcrystalline, magnesium stearate

abun da ke ciki na Opadry OY-L-24808 harsashi mai launi ne ruwan hoda: lactose monohydrate, hypromellose 15cP, macrogol, titanium dioxide E 171, iron oxide yellow E 172, iron oxide ja E 172, iron oxide black E 172.

Sashi 500 MG / 5 MG

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abubuwa masu aiki: metformin hydrochloride 500 MG

glibenclamide 5 MG

magabata: sodium croscarmellose, povidone K 30, celclose microcrystalline, magnesium stearate

abun da ke ciki na Opadry 31-F-22700 harsashi mai launin rawaya ne: lactose monohydrate, hypromellose 15 cP, macrogol, quinoline yellow varnish E 104, titanium dioxide E 171, iron oxide yellow E 172, iron oxide ja E 172.

Sashi 500 MG / 2.5 MG: allunan mai rufi tare da fim ɗin murfin launi mai launin ruwan lemo, mai kamannin-kamara tare da saman biconvex da kuma zane "2.5" a gefe ɗaya.

Sashi 500 MG / 5 MG: Allunan an rufe su da kwalin fim mai launin rawaya, kwalliya mai fasali tare da saman biconvex da kwarzana "5" a gefe guda.

Kayan magunguna

Pharmacokinetics

Metformin da Glibenclamide

A bioavailability na metformin da glibenclamide a hade yana da alaƙa da bioavailability na metformin da glibenclamide lokacin da aka ɗauke su lokaci guda a cikin shirye-shiryen ba da lamuni. Cin abinci ba ya tasiri a bioavailability na metformin a hade tare da glibenclamide, kazalika da bioavailability na glibenclamide a hade tare da metformin. Koyaya, yawan shan glibenclamide yana ƙaruwa tare da ɗimbin abinci.

Bayan sarrafa bakin magana na allunan metformin, mafi girman ƙwayar plasma (Cmax) an kai shi bayan kimanin awa 2.5 (Tmax). Cikakken bayanin halitta a cikin mutane masu lafiya shine kashi 50-60%. Bayan sarrafawar bakin, 20-30% na metformin an keɓance su ta hanyar jijiyar ciki (GIT) ba su canzawa.

Lokacin amfani da metformin a allurai da hanyoyin gudanarwa na yau da kullun, ana samun cikakkiyar maida hankali ga aikin plasma a cikin awanni 24-48 kuma gaba ɗaya ƙasa da 1 μg / ml.

Matsakaicin ɗaurin metformin zuwa ƙwayoyin plasma basu da sakaci. An rarraba Metformin a cikin sel jini. Matsakaicin matakin jini a cikin jini yana ƙasa da na plasma kuma an kai shi kusan lokaci guda. Matsakaicin girman rarraba (Vd) shine lita 63-76.

Ana amfani da Metformin wanda baya canzawa a cikin fitsari. Babu metformin metabolites da aka gano a cikin mutane.

Batun danyen danyen metformin ya zarce 400 ml / min, wanda ke nuna cire metformin ta amfani da narkewar duniyan da tubular. Bayan gudanarwar baka, rabin rayuwar kusan awoyi 6.5 ne.

Game da aiki na keɓaɓɓiyar aiki, ƙarar keɓaɓɓe yana raguwa gwargwadon karɓar kyautar creatinine, saboda haka kawar rabin rayuwa yana ƙaruwa, wanda ke haifar da haɓaka matakan plasma metformin.

Lokacin gudanar da shi, sha daga ƙwayar gastrointestinal ya fi 95%. Mafi yawan kwasarin plasma sune bayan awa 4. Sadarwa tare da sunadaran plasma kashi 99%.

Glibenclamide yana da cikakken metabolized a cikin hanta don samar da metabolites guda biyu.

Glibenclamide an cire shi gaba daya daga jiki bayan sa'o'i 45-72 a cikin yanayin metabolites: tare da bile (60%) da fitsari (40%). Karshen rabin rayuwar shine 4-11 hours.

Rashin lafiya na hepatic yana rage metabolism na glibenclamide kuma yana rage jinkirin sa.

Biliary excretion na metabolites yana ƙaruwa idan akwai matsala gazawar koda (ya danganta da tsananin matsalar aikin ƙarancin abinci) zuwa matakin share fagen shiga na 30 ml / min. Sabili da haka, gazawar koda ba ya tasiri a hankali na glibenclamide, yayin da keɓancewar creatinine ya kasance a matakin sama da 30 ml / min.

Pharmacokinetics a cikin rukunin masu haƙuri na musamman:

Marasa lafiyar yara

Babu wani bambance-bambance a cikin kantin magunguna na metformin da glibenclamide a cikin yara da manya masu lafiya.

Pharmacodynamics

Metformin shine biguanide tare da tasirin antihyperglycemic wanda ya rage matakan glucose na jini da na postalmaal na postprandial. Ba ya tayar da rufin insulin kuma sabili da haka baya haifar da ƙwanƙwasa jini.

Metformin yana da matakai guda uku na aikin:

yana rage haɓakar glucose ta hanta ta hana gluconeogenesis da glycogenolysis,

yana inganta haɓakawa da kuma amfani da glucose na gefe a cikin tsokoki ta hanyar ƙara ƙwayar insulin,

yana jinkirta ɗaukar glucose a cikin hanjin.

Metformin yana haɓaka aikin haɗin glycogen na ciki ta hanyar aiki akan glycogen synthase. Hakanan yana haɓaka iyawar kowane nau'ikan jigilar ƙwayar ƙwayar membrane (GLUT).

Ko da kuwa tasirin sa akan cutar glycemia, metformin yana da tasirin gaske akan metabolism. A lokacin gwaji na asibiti da aka sarrafa ta amfani da allurai, an gano cewa metformin yana rage adadin kuzarin, ƙananan ƙarancin lipoproteins da triglycerides. Ba a lura da irin wannan tasirin akan ƙwayar ƙwayar ƙwayar cuta ba yayin gwaji na asibiti ta amfani da maganin haɗin gwiwa tare da metformin da glibenclamide.

Glibenclamide yana cikin rukunin sulfonylureas na ƙarni na biyu tare da matsakaicin rabin rayuwa. Glibenclamide yana haifar da raguwa a cikin glucose jini, yana ƙarfafa samar da insulin ta hanji. Wannan aikin ya dogara da kasancewar β-sel masu aiki na tsibirin Langerhans.

Starfafa ƙwayar insulin ta hanyar glibenclamide don amsawar abinci yana da mahimmanci.

Yin amfani da glibenclamide a cikin marasa lafiya da ciwon sukari yana haifar da karuwa a cikin amsawar motsa jiki na postprandial. Reactionwarin aikin postprandial na haɓaka a cikin hanyar ɓoye insulin da C-peptide ya ci gaba da akalla watanni 6 bayan jiyya.

Metformin da glibenclamide suna da matakai daban-daban na aiwatarwa, amma tare da jituwa tare da juna kan ayyukan antihyperglycemic. Glibenclamide yana ƙarfafa samar da insulin ta hanyar ƙwayar ƙwayar cuta, kuma metformin yana rage juriya daga sel zuwa insulin ta hanyar yin aiki a kan yanki (ƙashin ƙugu) da hanta hanta zuwa insulin.

Sashi da gudanarwa

Ya kamata a dauki Glucovans® a baki tare da abinci. Tsarin magunguna an daidaita shi gwargwadon abincin mutum. Ya kamata kowane abinci ya kasance tare da abinci tare da isasshen abun da ke cikin carbohydrate don hana faruwar cututtukan jini.

Ya kamata a daidaita yawan maganin yayin da ya dogara da martani na mutum (matakan glycemia, HbA1c).

Glucovans 500 MG / 5 MG za'a iya amfani dashi a cikin marasa lafiya waɗanda basu sami cikakkiyar iko ba lokacin shan Glucovans 500 mg / 2.5 mg.

Yakamata a fara jiyya daga kashi ɗaya na ƙwayoyin magani daidai da allurai na yau da kullun da aka ɗauka da glibenclamide. Ya kamata a ƙara yawan kashi a hankali dangane da matakin sigogin glycemic.

Ana daidaita sashi a kowane mako 2 ko fiye tare da karuwar kwamfutar hannu 1, ya danganta da matakin glycemia.

Increaseara yawanta a hankali na iya taimakawa rage haƙuri da kuma hana haɓakar cututtukan jini.

Matsakaicin adadin yau da kullun don Glucovans® 500 / 2.5 shine Allunan 6.

Matsakaicin adadin yau da kullun don Glucovans® 500/5 mg shine Allunan 3.

A cikin lokuta na musamman, ana iya bada shawarar karuwa na kashi har zuwa 4 Allunan kwayoyi na Glucovans® 500 mg / 5 MG kowace rana.

Don sashi na miyagun ƙwayoyi Glucovans® 500 mg / 2.5 mg

Sau ɗaya a rana: da safe yayin karin kumallo, tare da alƙawarin kwamfutar hannu 1 a kowace rana.

Sau biyu a rana: safe da maraice, tare da alƙawarin allunan 2 ko 4 a rana.

Sau uku a rana: safe, yamma da maraice, tare da alƙawarin 3, 5 ko 6 Allunan a rana.

Don sashi na miyagun ƙwayoyi Glucovans® 500 MG / 5 MG

Sau ɗaya a rana: da safe yayin karin kumallo, tare da alƙawarin kwamfutar hannu 1 a kowace rana.

Sau biyu a rana: safe da maraice, tare da alƙawarin allunan 2 ko 4 a rana.

Sau uku a rana: safe, yamma da yamma, tare da alƙawarin Allunan 3 a rana.

Babu bayanai game da amfani da miyagun ƙwayoyi tare da insulin.

Yayin shan Glucovans® da chele bile, ana bada shawara cewa ka ɗauki Glucovans® aƙalla 4 hours kafin chele naka don ka rage haɗarin rage sha.

Umarnin na musamman don takamaiman rukunin masu haƙuri

Tsofaffi da marassa lafiya

Yawan Glucovans® ya kamata a daidaita shi gwargwadon sigogi na aikin renal. Maganin farko shine 1 kwamfutar hannu na Glucovans® 500 mg / 2.5 mg. Yin nazari akai-akai na aikin koda ya zama dole.