Galvus - umarnin don amfani, amsoshin tambayoyin akai-akai game da magani

Galvus wakili ne na hypoglycemic wanda aka tsara don sarrafa glycemia a cikin nau'in ciwon sukari na 2. Ainihin kayan aiki mai maganin shine vildagliptin. An fito da miyagun ƙwayoyi a cikin nau'in Allunan. Dukkanin likitocin da masu ciwon sukari sun sami kyakkyawan sakamako daga Galvus.

Yana da ƙarfi yana sarrafa metabolism na insulin da glucagon. Antungiyar Antidiabetic Turai ta Turai ta ce Galvus a cikin maganin monotherapy yana da kyau a yi amfani da shi kawai lokacin da metformin ya ba da haƙuri ga mai haƙuri. Ga masu ciwon suga da ke fama da cutar insulin da ke dauke da cuta ta 2, Galvus yana taimakawa wajen rage yawan polo da adadin allurar da yake ciki.

Abubuwan da ke tattare da magunguna

Hormones ana kiranta homon da hanjin ke samarwa yayin da abinci mai gina jiki ya shiga ciki. Wadannan kwayoyin halittar suna insulinotropic, suna shigo da rufin insulin, saboda kashi 60% na samarwarsa ya kasance daidai da tasirin abubuwan incretins. An gano wannan sabon abu a cikin 1960, lokacin da suka koya don tantance taro insulin a cikin plasma.

Glucan-kamar peptide-1 (GLP-1) yana ɗaya daga cikin shahararrun, tun da yake an rage yawan haɗuwa da nau'in ciwon sukari na 2. Wannan ya haifar da sabon rukuni na kwayoyi waɗanda ke ƙara yawan abubuwan da ke cikin waɗannan kwayoyin halittu ko dai ta hanyar allurar roba ta GLP-1 kamar Baeta ko Victoza ko ta hanyar magana kamar Galvus ko anavaniya Janavia. DPP-4 inhibitors ba kawai ƙara haɗuwa da kwayoyin halittar duka biyu ba, har ma suna hana lalacewarsu.

Wanda ya dace da Galvus

Ga masu ciwon sukari masu dauke da cuta ta 2, ana iya amfani da maganin:

Don monotherapy, haɗe tare da abinci mai ƙarancin carb da isasshen nauyin ƙwayoyin tsoka,
A cikin hadaddun jiyya a layi daya tare da metformin, idan sakamakon da aka samo daga magani ɗaya bai isa ba,
A matsayin madadin Galvus-like magunguna dangane da metformin da vildagliptin,
Sakamakon ƙari ga sauran wakilai na hypoglycemic, idan tsoffin magunguna na baya basu da tasiri,
A matsayin ilmin likita sau uku tare da insulin da metformin, idan abinci, motsa jiki da insulin tare da metformin ba su da tasiri.

Umarnin don amfani

Sashin maganin yana karewa ne ta hanyar maganin cututtukan endocrinologist daban-daban, la'akari da matakin cutar da kuma lafiyar lafiyar gaba daya na masu ciwon sukari. Amfani da allunan ba a haɗa shi da abincin da za a yi karin kumallo ba, babban abin sha shine a sha maganin da isasshen ruwa. A gaban sakamakon da ba a tsammani ba don cutar ta mahaifa, zai fi kyau a yi amfani da magani tare da abinci.

Idan an shigar da nau'in ciwon sukari na 2, Galvus za'a iya sanya shi nan da nan. Ba tare da la'akari da tsarin kulawa ba (hadaddun ko monotherapy), ana ɗaukar allunan cikin adadin 50-100g / rana. Ana ɗaukar matsakaicin ƙa'ida (100 MG / rana) a cikin matakan matsanancin ciwon sukari. A yayin jiyya, tare da sauran jami'ai masu amfani da ƙwayar cuta, an tsara 100 MG / rana.

Wani yanki na 50 g / rana. wanda aka ɗauka sau ɗaya, yawanci da safe, ya kamata a raba kashi na 100 MG zuwa kashi 2 - daidai, da safe da maraice. Idan ba'a rasa lissar Galvus ba, kwaya yakamata a ɗauka a kowane lokaci, amma dole ne a kiyaye iyakokin gaba ɗaya.

Idan tare da monotherapy 100 mg / rana za a iya ɗauka, to, tare da ƙwaƙƙwarar ƙwayar cuta, suna farawa da 50 mg / rana, alal misali, tare da metformin: 50 mg / 500 mg, 50 mg / 850 mg, 50 mg / 100 mg.

Tare da diyya mai ƙoshin ƙwayar cuta wanda bai cika ba, an tsara magunguna na hypoglycemic madadin (metformin, insulin, kalaman sulfonylurea, da sauransu) ƙari.

Idan koda na koda da hanta suna aiki tare da rikice-rikice, za a rage mafi girman magunguna zuwa 50 MG / rana, tunda Galvus ya tsinke da ƙodan, yana haifar da ƙarin nauyi akan tsarin ɓarin ciki.

Yawan yawan bayyanar cututtuka

Idan ƙimar yau da kullun ba ta wuce 200 mg / rana ba, ana canja wurin masu ciwon sukari na Galvus ba tare da sakamako ba. Ana lura da yawan yawan haɗari tare da alamun da suka dace lokacin da aka cinye shi da yawa akan 400 MG / rana. Mafi yawan lokuta da aka bayyana myalgia (ciwon tsoka), ba sau da yawa - paresthesia (a cikin laushi da tsari transistor), kumburi, zazzabi, yawan lipase yana ƙaruwa sau biyu kamar VGN.

Idan daidaitaccen Galvus ya ninka sau uku (600 mg / day), to akwai haɗarin kumburi, ƙwaƙwalwar ƙwayar cuta da haɓaka a cikin ƙwayoyin ALT, CPK, myoglobin da furotin na C-reactive. Duk sakamakon gwajin, kamar alamu, yana ɓacewa lokacin da aka soke Galvus.

Galvus: analogues

Dangane da sashin tushen aiki, magungunan Vildaglympin da Galvus Met za su kasance daidai ga Galvus, bisa ga lambar ATX-4, Janavia da Onglisa. Nazarin kwayoyi da kuma nazarin masu haƙuri sun nuna cewa waɗannan kwayoyi suna da alaƙa da juna.

Abubuwan Bala'i

Amfani da Galvus na dogon lokaci zai iya hade da sakamako masu illa:

Ciwon kai da asarar daidaituwa,
Girgiza manyan makamai da kafafu,
Rashin lafiyar mazaunin ciki
Peeling, blisters da rashen fata na asalin rashin lafiyan,
Take hakkin da kari na hanjin motsi,
Rashin kariya
Rushewa da aiki mai yawa
Ciwon kansa, cututtukan cututtukan hanta da sauran cututtukan hanta da cututtukan hanta,
Chills da kumburi.

Ga wanda Galvus ya ba da izini

Contraindications don amfani da Galvus zai kasance da yawan cututtuka da yanayi.

Kowace rashin haƙuri zuwa ga abubuwan da ke cikin miyagun ƙwayoyi, rashin lafiyan halayen,
Renal da excretory tsarin tabarbarewa,
Yanayin da ke haifar da cutar da kodan (zazzabi, cututtukan ciki, matattara, amai),
Zuciya da jijiyoyin jini
Matsalar numfashi
Ketoacidosis na ciwon sukari, coma, da kakanni, idan aka fassara ciwon sukari zuwa insulin,
Lactic acidosis, ƙara taro na lactic acid,
Haihuwa da lactation
Type 1 ciwon sukari
Tsarin tsari ko guba na giya,
Abincin mai daidaitaccen abincin tare da adadin kuzari na 1000 Kcal / rana,
Restrictionsuntatawa na shekaru: har zuwa shekaru 18 na haihuwa, ba a ba da umarnin metabolite ba, bayan shekaru 60 - tare da taka tsantsan,
Kafin aikin (kwanaki 2 kafin kuma bayan), a ranar gabatarwar wakilan bambanci ko gwajin rediyo,
Ofaya daga cikin mahimmancin contraindications wa Galvus shine lactic acidosis, sabili da haka, tare da hanta ko gazawar renal, ba a sanya magani ba.

A cikin masu ciwon sukari na tsufa, yin jaraba ga metformin yana yiwuwa, wannan yana ƙaruwa da yawan rikitarwa, don haka an wajabta Galvus ne kawai a ƙarƙashin kulawar likita.

Siffofin Galvus lura da wasu nau'ikan masu ciwon sukari

Babu wani abin dogaro da bayanai game da tasirin kwayoyi kan lafiyar mahaifiyar da tayin, saboda haka, a lokacin daukar ciki ba a sanya shi ba. Increasedarin yawan yawan sukari a cikin mace mai ciki na kara haɗarin kamuwa da cututtukan cututtukan haihuwata har ma da mutuwar yaro. A cikin ciwon sukari a cikin mata masu juna biyu, glycemia yawanci al'ada ce ta insulin.

Bincike ya nuna cewa koda kashi na Galvus, wanda ya wuce al'ada sau 200, bai tsokanar canje-canje ba cikin yanayin kiwon lafiyar mace mai ciki ko tayin. An yi rikodin sakamako iri ɗaya tare da yin amfani da metformin da Galvus a cikin rabo 10: 1.

Ba a yi bincike game da yiwuwar metabolite ya shiga cikin madarar nono ba, saboda haka, tare da shayarwa, ba a kuma sanya maganin Galvus ba.

Kwarewar maganin Galvus na yara masu ciwon sukari tare da nau'in cuta na 2 (yawan irin wannan marasa lafiya yana ƙaruwa da sauri a yau), musamman, raunin ingancinsa da mummunan sakamakonsa, ba a yi nazari sosai ba.

Saboda haka, ana sanya allurar ciki a cikin nau'in ciwon sukari na 2 daga shekara 18.

Masu ciwon sukari na masu tsufa (bayan shekaru 60) dole ne su tsaurara matakan biyu na sutturar Galvus da mahimman sigoginsu, saboda idan kun ji ƙaranci, nan da nan ku sanar da likita. A wannan zamanin, haɗarin rikice-rikice da sakamakon da ba a so, yana ƙaruwa, kamar yadda ake haifar da jaraba.

Shawara ta musamman

Dole ne a sanar da masu ciwon sukari game da duk sakamakon yiwuwar sabon maganin da zai haifar masa.

Galvus wakili ne na maganin antidi, amma ba wai maganin insulin bane. Sabili da haka, amfani da shi yana buƙatar saka idanu akai-akai game da aikin hanta. Hakanan za'a iya bayanin wannan ta hanyar cewa babban aikin Galvus yana haɓaka ayyukan aminotransferases. A waje, wannan ba a bayyana shi a takamaiman bayyanar cututtuka, amma canje-canje a cikin aikin hanta har zuwa ci gaban hepatitis ba makawa. A kowane hali, masu ba da lafiya na masu ciwon sukari daga ƙungiyar sarrafawa sun nuna irin wannan sakamakon. A alamun farko na matsanancin ƙwayar cutar kansa (da ke ciwan ciki), dole ne a soke ƙwayar cikin gaggawa. Ko bayan maido da lafiyar hanta, Galvus baya sake yin saiti.

Wadanda ke fama da ciwon sikari da ke fama da cutar sikila da nau'in cuta ta 2 Galvus an wajabta shi kawai tare da shirye-shiryen insulin.

Akai-akai da damuwa da yawan zubar da jijiyoyi na rage karfin Galvus. A cewar masu ciwon sukari, yawancin lokuta jikinsu yana motsa jiki tare da asarar daidaituwa da tashin zuciya. Saboda haka, tuƙi abin hawa ko yin m abubuwa a cikin irin wannan yanayi ba da shawarar ba.

Kafin jarrabawar kowane nau'in, Galvus da analogues dinsu an tsayar da su na kwana biyu. Abubuwan da suka bambanta da aka yi amfani dasu a cikin maganin yawanci suna dauke da aidin. Saduwa da vildagliptin, yana ƙirƙirar ƙarin kaya akan hanta da tsarin motsa jiki. A ƙarshen asalin lalacewa a cikin aikin su, lactic acidosis na iya faruwa.

Yankin farko na raunin zuciya (rarrabuwa na NYHA) tare da daidaitattun ƙwayoyin tsoka baya buƙatar daidaita sashi na Galvus. Kashi na biyu ya ƙunshi iyakance aikin tsoka don hana ƙarancin numfashi, rauni, da tachycardia, tunda a cikin kwanciyar hankali babu irin waɗannan cututtukan da aka rubuta.

Don guje wa haɗarin haɗarin hypoglycemia, tare da haɗuwa da magani tare da shirye-shiryen sulfonylurea, an zaɓi ƙaramar sashi mai tasiri.

Sakamakon Cutar Magunguna

A cikin hadaddun farji tare da ƙari na metformin, glibenclamide, pioglitazone, ramipril, amlodipine, digoxin, valsartan, simvastatin, warfarin zuwa Galvus, babu wani mahimman sakamako na asibiti da aka bayyana daga hulɗar su.

Gudanar da haɗin gwiwa tare da thiazides, glucocorticosteroids, sympathomimetics, hormones thyroid yana rage yiwuwar hypoglycemic na vildagliptin.

Masu hana enzyme angiotensin-canza enzyme tare da amfani da layi daya suna ƙara haɗarin angioedema.

Galvus tare da irin wannan alamu ba ya soke, tunda edema ta wuce da kanta.

Magungunan ba ya canza adadin metabolic tare da amfani da layi daya na amfani da enzymes CYP3A4, CYP1A2, CYP2C8, CYP3A5, CYP2C9, CYP2C19, CYP2D6, CYP2E1.

Dokokin ajiya

A cikin cibiyar sadarwar kantin magani, ana sayar da Galvus ta hanyar takardar sayan magani. Ana iya rarrabe su ta hanyar yanke baki da alama mai gefe biyu: raguwar FB da NVR. A kan farantin karfe na iya zama allunan 7 ko 14 na 50 MG. A cikin akwatunan kwali akwai daga blisters biyu zuwa goma sha biyu.

Ana adana magungunan a cikin yanayin zafin jiki har zuwa 30 ° C a wuri mai duhu, ba tare da yara ba. Tsayayyar rayuwar Galvus har zuwa shekaru 3. Allunan ƙarewa dole ne a zubar dasu.

Nazarin likitoci da marasa lafiya

Wannan wakili na bakin jini yawanci ana rubutashi da farko ga masu ciwon sukari kai tsaye bayan kamuwa da cuta. Sabili da haka, a cikin bita a kan ɗakunan tattaunawar suna da tambayoyi da yawa ga endocrinologist fiye da amsoshi.

Da yake tsokaci game da irin wadannan rahotanni, likitoci sun ce cutar sankarau cuta ce ta tsawon rayuwa. Babu Galvus, ko kowane wakili na maganin rigakafi wanda zai iya tsaida mit ɗin glucose a matakin al'ada har abada. Halin kiwon lafiya na mai ciwon sukari yana raguwa koyaushe, ƙimar mummunan canje-canje kai tsaye ya dogara da matakin diyya na diyya. Babu kwaya ta mu'ujiza don masu ciwon sukari. Gyara kawai na abinci mai gina jiki, sake fasalin tsarin rayuwar gabaɗaya tare da maganin kulawa zai iya rage ci gaban rikice-rikice tare da kula da ingancin rayuwa tare da ciwon sukari a matakin al'ada.

Ba duk masu fansho suna da damar zuwa Galvus ba a farashin 800 rubles. don 28 inji mai kwakwalwa., da yawa suna neman wanda zai maye gurbin sa, kodayake Januvia (1400 rubles) ko Onglisa (1700 rubles) suma basu dace da kowa ba. Kuma waɗanda ke ci gaba da amfani da sanarwa cewa sannu a hankali sukari yana farawa daga lalacewa kuma tasirin magani yana raguwa.

Magunguna da magunguna

Abubuwa vildagliptin shine mai karfafawa na kayan islet na ƙwayar kumburi, mai ikon zaɓar mai hana enzyid dipeptidyl-4. Amfanin wannan tsari yana ƙara haɓakar basal da abinci mai motsa jiki na nau'in 1 glucagon-kamar peptide da polypeptide-glucose na glucose daga hanji zuwa cikin keɓaɓɓiyar tsarin. Wannan yana kara maida hankali ne daga wadannan abubuwan da ake samu da kuma hankalin sikarin β-sel da ke cikin glucose, wanda ke inganta sirrin dake dauke da sinadarin glucose. insulin

Increasedara yawan matakan glucagon-kamar peptide na nau'in 1st na iya haifar da raguwa cikin motsin ƙwayar ciki, amma tare da maganivildagliptin babu irin wannan sakamako da aka lura.

Monotherapy tare da Galvus ko haɗuwa tare da metformin, thiazolidinedioneabubuwan asali sulfonylureas ko insulin na dogon lokaci lowers taro na glycated hawan jini da glucose jini. Hakanan, irin wannan magani yana rage faruwar hakan yawan haila.

Shakar ciki vildagliptin tafiya da sauri. Cikakken bayanin halittar halittar kashi tamanin (85%) ne. Mayar da hankali da ke aiki a cikin plasma ya dogara da tsarin da aka tsara.

Bayan shan maganin a kan komai a ciki, ana gano kasancewarsa a cikin jini na jini bayan 1 h 45 min. Cin abinci yana da tasiri a cikin sakamako na miyagun ƙwayoyi. A cikin jiki, an canza babban ɓangaren Galvus zuwa metabolites, kawarda wacce akafi amfani dashi ta amfani da koda.

Alamu don amfani

Babban nuni ga nadin Galvus shine jiyya ciwon sukari mellitusnau'in 2 a cikin mono - ko nau'ikan nau'ikan maganin haɗin gwiwa, alal misali, tare da Metformin, Thiazolidinedione abubuwan gado sulfonylureas ko insulin a cikin bambance-bambancen da likitan halartar suka kafa.

Contraindications

Ba'a bada shawarar wannan magani don amfani dashi tare da:

hankali da vildagliptin da sauran abubuwan haɗin maganin,
gado rashin galactose, rashin lactaseglucose galactose malabsorption,
wasu lokuta na kullum bugun zuciya
a karkashin shekara 18 years.

Tare da taka tsantsan, ana wajabta magani don marasa lafiya da ke fama da mummunan aiki hanta da na gazawar.

Side effects

Yawancin lokaci, tare da magani tare da Galvus, babu mummunan sakamako masu illa da ke faruwa waɗanda ke buƙatar dakatar da maganin.

Koyaya, haɓakar bayyanar da rashin lafiyan, musamman a cikin yanayin kumburi, bai kamata a yanke hukunci ba. Zai yiwu a take hakkin hanta, sabawa a cikin fihirisa na al'ada aiki na wannan sashin. Yiwuwar hawan jini, ciwon kai, farin ciki,narkewar abinci da cuta gaba ɗaya ta jiki.

Umarnin don Galvus (Hanyar da sashi)

Wannan magani an yi shi ne don gudanar da maganin baka kuma bai dogara da amfanin abinci ba. An zaɓi sashi na miyagun ƙwayoyi daban-daban, la'akari da tasiri da halaye na jiki.

Dangane da umarnin don amfani da Galvus, a lokacin monotherapy, kazalika a cikin haɗin haɗakar abubuwa biyu thiazolidinedione, metformin ko insulin wajabta maganin yau da kullun na 50-100 MG. A cikin majinyata marasa lafiya ciwon sukari mellitusnau'in 2karbar insulin, maganin yau da kullun na allunan Galvus shine 100 MG.

Dalilin maganin hade hade, wannan shine: vildagliptin + metformin+ Abubuwan da suka samo asali na sulfonylurea ya ƙunshi shan 100 MG kowace rana. A wannan yanayin, ana daukar nauyin 50 sau da yawa - da safe da maraice.

Abubuwan haɗakar haɗakarwa biyu sulfonylureas ya hada da maganin yau da kullun na 50 na Galvus, wanda aka dauka da safe. Zai yiwu a ƙara yawan yau da kullun zuwa 100 MG, amma yawanci wannan ba a buƙata.

Idan babu isasshen sakamako na asibiti yayin ɗaukar matsakaicin maganin yau da kullun na 100 MG, to don sarrafa ci gaban glycemia ƙari, zaku iya ɗaukar wasu wakilai na hypoglycemic, misali: metformin, thiazolidinedione, abubuwan samo asali na sulfonylureakoinsulin.

Yawan damuwa

A matsayinka na mai mulki, marasa lafiya suna yin haƙuri da Galvus sosai lokacin da suke ba da bayanin maganin yau da kullun wanda ya kai 200 MG.

Tare da alƙawarin na yau da kullun na 400 MG, haɓaka mai yiwuwa ne zazzabi mai zafikumburi da sauran alamomin da ba a so.

Anara yawan ƙwayar yau da kullun zuwa 600 MG na iya haifar da ci gaba da kumburi daga ƙarshen, babban haɓakawa ga taro na ALT, CPK, furotin na C-mai kunnawa da myoglobin. Yawancin lokaci, bayan dakatar da maganin, duk alamun alamun yawan zubar da ruwa suna cirewa.

Haɗa kai

An tabbatar da cewa Galvus yana da ɗan ƙaramar yiwuwar ma'amala tsakanin magunguna. Saboda haka, an ba shi damar ɗaukar shi lokaci guda tare da substrates, inhibitors, inductor cytochrome P450 kuma daban enzymes.

Wataƙila ma'amala game da wannan maganin tare da kwayoyi ma an wajabta su nau'in ciwon sukari guda 2misali: Glibenclamide, Metformin, Pioglitazone. Sakamakon amfani da na lokaci daya tare da kwayoyi suna da kunkuntar warkewa -Amlodipine, Digoxin, Ramipril, Simvastatin, Valsartan, Warfarin ba a kafa shi ba, sabili da haka, irin wannan haɗin maganin ya kamata a gudanar da shi tare da taka tsantsan.

Abinda zaba: Galvus ko Galvus Met? Menene bambanci?

Galvus magani ne wanda ya danganta da vildagliptin, kuma Galvus Met magani ne wanda aka haɗu da shi tare da metformin. A hade tare da metformin, vildagliptin ya fi dacewa rage yawan jini. Koyaya, za'a iya amfani dashi idan mara lafiya bashi da maganin rikitarwa don daukar metformin. Sakamakon sakamako na yau da kullun na wannan abu shine: zawo, ƙonewa da sauran rikice-rikice a cikin tsarin narkewa. Karka hana magani nan da nan. A matsayinka na mai mulkin, waɗannan halayen da ba a so su bayyana ne kawai a farkon matakan daga farkon far, sannan su wuce.

Me za a zabi Galvus Met ko Yanumet?

Yanumet da Galvus Met sune magunguna biyu waɗanda ke da alaƙa guda. An tsara duka biyun don rage sukarin jini. A wannan gaba cikin lokaci, ba shi yiwuwa a amsa wace takamaiman magani ya fi kyau, tunda ba a gudanar da binciken kan wannan batun ba.

Kudin magunguna iri daya ne. Lallai ne ku biya ƙarin don ɗakunan Yanumet, amma adadin allunan da ke ciki shima zai zama ƙari.

Dukkanin Galvus Met da Yanumet suna ba da kariya ta ikon mallakar abubuwa, da wuya su haifar da sakamako masu illa kuma magunguna masu lafiya. Kuna iya samun ingantattun sake dubawa game da guda ɗaya da kuma magani.

Galvus ko metformin - menene zaba?

A cikin miyagun ƙwayoyi Galvus Met, vildagliptin yana aiki azaman babban sashi mai aiki, metformin sashi ne mai taimako. Akwai zaton cewa raguwa mai yawa a cikin sukarin jini yakan faru ne daidai saboda tasirin waɗannan abubuwan abubuwa guda biyu.

Kodayake Galvus Met ya fi tsada fiye da kwayoyi dangane da metformin guda ɗaya kawai, yana yin aikinsa da kyau. Sabili da haka, idan yanayin kayan haƙuri yana ba shi damar yin amfani da ƙwayar cuta mai rikitarwa don magani, to ya fi kyau ba da fifiko a gare shi. Idan wannan ba zai yiwu ba, to ya kamata ku zaɓi shirye-shiryen metformin (Glucofage ko Siofor). Abin lura ne cewa duka Glucofage da Siofor an shigo da magunguna. Hakanan zaka iya sayan takwarorinsu masu arha waɗanda ke samarwa a Rasha, amma ba za a sami bambanci sosai a farashi ba.

Amma ga miyagun ƙwayoyi Galvus, ba za a iya kira shi da kayan aiki mai ƙarfi don rage sukarin jini ba. Galvus Met don lura da ciwon sukari ya fi dacewa a yi amfani da shi. An wajabta Galvus ne kawai idan mai haƙuri yana da contraindications don ɗaukar metformin. Idan magani bai kawo sakamakon da ake so ba, to ya kamata a fara amfani da maganin insulin.

Fasali na miyagun ƙwayoyi Galvus Met

Don kaucewa damuwa a cikin nau'i na zawo da ƙanshi, yana da buƙatar ɗaukar Galvus Met daidai. Yawan farawa ya zama kadan, ƙara haɓaka. Wannan tsarin kulawa yana ba wa jiki damar daidaita da sauƙaƙe ɗaukar sabon abu a ciki. Yana da metformin wanda ke haifar da tashin hankali, ba vildagliptin ba.

Yadda za a hana sakamako masu illa?

Don hana faruwar sakamako masu illa, kuna buƙatar fara magani tare da ƙananan allurai na maganin. An bada shawarar siyan kunshin na Galvus Met Allunan tare da sashi na 50 + 500 MG kuma ɗaukar kwamfutar hannu 1 sau ɗaya a rana. Idan jiki ya amsa da kyau ga irin wannan magani, to bayan mako guda ko kwanaki 10, kuna buƙatar ɗaukar allunan 2 na magani - da safe da kuma kafin lokacin kwanciya. Lokacin da aka gama tattara kayan, ya kamata ku sayi magani tare da sashi na 50 + 850 MG. Takeauki magunguna sau 2 a rana. Mataki na uku na magani shine sauyawa zuwa magani tare da sashi na 50 + 1000 mg. Allunan suna shan bugu sau 2 a rana. Thearshe na yau da kullun na magunguna shine 100 mg na vildagliptin da 2000 mg na metformin.

Idan, ban da ciwon sukari, ana gano mai haƙuri da kiba, to za a iya ƙaruwa na yau da kullun na metformin zuwa 3000 MG. A saboda wannan, a tsakiyar rana, a lokacin abinci, mai haƙuri zai bugu da needari yana buƙatar ɗaukar metformin a cikin sashi na 850 ko 1000 mg. Kuna iya amfani da miyagun ƙwayoyi Glucofage ko Siofor don wannan. Wannan na iya haifar da wasu damuwa ga mutum, saboda maimakon magani ɗaya zai buƙaci shan magunguna biyu daban. Koyaya, don rage nauyin da ya wuce kima dole ne ya zama ya cika da wannan gaskiyar.

Galvus Met ya bugu yayin cin abinci, wannan ya samo asali ne saboda yawan abubuwan metformin a ciki. A cikin maganin, Galvus metformin ba shine, saboda haka, ana iya ɗauka duka biyu kafin abinci da bayan abinci. Ba damuwa.

Galvus kusan sau 2 yana da rahusa fiye da Galvus Met. Idan kana son adanawa, to, zaka iya siyan magungunan Galvus da metformin na miyagun ƙwayoyi daban (Glucofage ko Siofor). Koyaya, dole ne a bi duk shawarar don shan waɗannan magungunan, wanda ke buƙatar ƙarin horo mai haƙuri.

Idan mai haƙuri yana da haɓaka mai yawa a cikin sukarin jini daidai da safe, to, kuna buƙatar ɗaukar kwamfutar hannu 1 na Galvus na miyagun ƙwayoyi da safe da maraice, kuma kafin zuwa gado, bugu da drinkari yana shan maganin bisa ga metformin, tare da sashi na 2000 mg (Glucofage Long). Sakamakonta na tsawo yana ba mu damar tabbatar da cewa da safe matakin sukari bai tashi zuwa matakai masu mahimmanci ba.

Zan iya shan giya?

Bayan nazarin umarnin, ba za ku iya fahimta ba ko an ba da damar giya yayin jiyya tare da Galvus da Galvus Met. Shan haramcin giya haramun ne, domin wannan yana kara saurin haifar da cututtukan cututtukan hanji, lalata hanta, raguwar sukarin jini. Mutum na iya ƙare a asibiti ko ma ya mutu.

Amma game da karamin allurai na barasa, babu cikakken haske. Jagorar ba ta bada izinin kai tsaye ba ko hana haɗarin miyagun ƙwayoyi da barasa. Sabili da haka, mutum zai iya sha, amma a haɗarin ku da haɗarin ku. Idan bayan shan giya da ikon sarrafa kai ya shuɗe, to ya kamata ka ƙi cin abincin gaba ɗaya.

Zan iya rasa nauyi yayin jiyya?

Nazarin da aka gudanar akan wannan batun yana nuna cewa Galvus da Galvus Met ba su shafar nauyin jikin mutum. Koyaya, kamar yadda ƙwarewa ta amfani da amfani da metformin ke nunawa, har yanzu tana da ikon yaƙar kiba. Saboda haka, da alama cewa mai haƙuri zai rasa nauyi ya kasance babba.

Yadda za a maye gurbin miyagun ƙwayoyi Galvus Met?

Yanayin da Galvus Met na iya buƙatar sauya shi:

Magungunan ba ya rage sukarin jini, wanda aka sa a cikin manyan matakan.

Magungunan yana rage sukarin jini, amma matakin sa baya rage ƙasa da 6 mmol / l.

Mutum ba zai iya samun damar ci gaba da magani tare da wannan magani ba saboda karfin kuɗi.

Idan Galvus Met bai yi aiki ba, to wannan na iya faruwa ne kawai ta dalilin cewa ajiyar ƙwayoyin cutar ta kumburi duk sun ƙare. A wannan yanayin, babu wani magani da zai taimaka, mai haƙuri cikin gaggawa yana buƙatar allurar insulin. In ba haka ba, da sannu zai ci gaba da rikice-rikice na cutar.

A yadda aka saba, sukari jini bai wuce 5.5 mmol / L ba. Irin waɗannan dabi'un su zauna lafiya kuma kada su canza lokacin rana. Idan shan Galvus Met yana ba ku damar kawo sukari na jini zuwa matakin 6.5-8 mmol / l, to kuna buƙatar haɗa allurar insulin a cikin ƙananan allurai. An zaɓi makirci gwargwadon halayen mutum na hanyar ciwon sukari a cikin wani haƙuri. Hakanan, mai haƙuri dole ne ya bi abinci da motsa jiki. Ya kamata mutum ya fahimci cewa tare da matakin sukari na jini na 6.0 mmol / L, rikice-rikicen cutar na ci gaba da bunkasa, amma a hankali.

Idan babu wata hanyar sayi magani Galvus Met?

Idan magungunan Galvus da Galvus Met suna da tsada ga mai haƙuri, kuma baya iya siyan su, to kuna buƙatar ɗaukar metformin a cikin tsarkakakkiyar siffar. Wannan na iya zama magungunan Glucofage ko Siofor. An sanya su kasashen waje. Abokan takwarorinsu na Rasha ma sun fi arha.

Tabbatar da bin abinci mai ɗan carb. In ba haka ba, cutar za ta ci gaba.

Game da likita: Daga 2010 zuwa 2016 Mai horar da asibitin warkewa na rukunin lafiya na tsakiya A'a. 21, birni na elektrostal. Tun daga shekara ta 2016, yana aiki a cibiyar bincike na lamba 3.

Formaddamar da tsari da abun da ke ciki

Fitar sashi - allunan: daga haske zuwa rawaya zuwa fari, zagaye, tare da yanke gefuna, tare da laushi mai kyau da kuma hoton NVR a gefe guda, FB - a ɗayan (kwafin 7 ko kuma guda ɗaya. 14) A cikin fakiti mai laushi, a cikin kwali , 4, 8 ko 12 fata da umarnin don amfani da Galvus).

Kwamfutar hannu 1 ya ƙunshi:

abu mai aiki: vildagliptin - 50 MG,
abubuwa masu taimako: sitaci carboxymethyl sitaci, lactose anhydrous, cellulose microcrystalline, magnesium stearate.

Pharmacokinetics

Vildagliptin lokacin da aka yi magana a baki a kan komai a ciki yana haɗuwa da sauri, C_max (mafi girman maida hankali na abu) a cikin jini na jini ya isa cikin awa 1.75. Game da shigar abinci lokaci guda tare da abinci, yawan sha na vildagliptin yana raguwa kaɗan: raguwa a cikin C_max by 19%, yayin da lokacin cimma hakan yana ƙaruwa da awa 2.5. Koyaya, cin abinci akan darajar sha da kuma AUC (yankin da ke ƙarƙashin ɓarna "taro - lokaci") ba shi da wani tasiri.

Vildagliptin yana ɗaukar hanzari, kuma cikakkiyar halittarsa shine kashi 85%. C dabi'u_max da kuma AUC a cikin kewayon maganin warkewa yana ƙaruwa kusan daidai da kashi.

Ana nuna sinadarin da ƙarancin digiri na ɗaura nauyin garkuwar plasma (a matakin 9.3%). Ana rarraba Vildagliptin a ko'ina tsakanin sel jini da jini. Rarraba kayan yana faruwa, mai yiwuwa, extravascularly, V_ss (ofimar rarraba a cikin ma'auni) bayan gudanarwar cikin jini shine lita 71.

Babban hanyar cire vildagliptin shine biotransformation, wanda aka fallasa zuwa kashi 69% na kashi. Babban metabolite shine LAY151 (57% na kashi). Ba'a nuna aikin magunguna ba kuma samfuri ne na hydrolysis ɗin na cyano. Kimanin 4% na kashi yana ɗaukar amly hydrolysis.

A yayin nazarin da aka yi daidai, an kafa sakamako mai kyau na DPP-4 akan hydrolysis na vildagliptin. A cikin metabolism na abu, cytochrome P isoenzymes₄₅₀ kada ku shiga. Vildagliptin substrate isoenzyme P₄₅₀ (CYP) ba, cytochrome P isoenzymes₄₅₀ baya hanawa kuma baya yin sa.

Bayan shan vildagliptin a ciki, kusan kashi 85% na kashi an cire shi ta hanta, ta hanjin ciki - kusan 15%. Jin ƙyamar da ba a canza abubuwa ba shine 23%. Matsakaici T_1/2 (rabin rai) lokacinda aka gudanar dashi cikin sa'o'i 2, sharewar koda da jimlar zubar jini ta vildagliptin sune 13 da 41 l / h, bi da bi. T_1/2 bayan maganin baka, ba tare da la'akari da maganin ba, kusan awa 3 ne.

Siffofin Pharmacokinetic a cikin marasa lafiya da raunin aikin hanta:

mai sauƙi da matsakaici mai ƙarfi (maki 6 zuwa 6 akan ma'aunin Yara-Pugh): bayan amfanin guda na vildagliptin, bioavailability ɗin an rage shi da 20% da 8%, bi da bi,
mummunan mataki (maki 10-12 akan sikelin Yara-Pugh): bioavailability na vildagliptin yana ƙaruwa da 22%.

Canje-canje (karuwa ko raguwa) a cikin matsakaicin bioavailability na abu a cikin fiye da 30% ana ɗaukarsu a matsayin asibiti mahimmanci. Ba a sami daidaituwa tsakanin yanayin bioavailability na vildagliptin da kuma tsananin nauyin aikin hanta.

Siffofin Pharmacokinetic a cikin marasa lafiya da ke fama da rauni na aiki na sassauci, matsakaici ko mai tsanani (idan aka kwatanta da masu sa kai na lafiya):

AUC na vildagliptin: yana ƙaruwa 1.4, 1.7 da sau 2, bi da bi,
AUC na metabolite LAY151: yana ƙaruwa sau 1.6, 3.2 da 7.3, bi da bi
AUC na metabolite BQS867: yana ƙaruwa 1.4, 2.7 da 7.3 sau, bi da bi.

Limitedarancin bayani a cikin matakin tashar CKD (cututtukan koda na koda) yana nuna cewa alamomin a cikin wannan rukuni sun yi kama da waɗanda ke cikin marasa lafiya da raunin rashin ƙwayar cutar koda. Mayar da hankali na LAY151 metabolite a cikin matakin tashar CKD yana ƙaruwa sau 2-3 idan aka kwatanta da natsuwa a cikin marasa lafiya tare da raunin na koda.

Tare da maganin hemodialysis, vildagliptin excretion yana iyakance (4 hours bayan kashi ɗaya shine 3% tare da tsawon lokaci fiye da awanni 3-4).

A cikin tsofaffi marasa lafiya (fiye da shekaru 65-70), matsakaicin karuwa a bioavailability na vildagliptin da 32%, C_max - 18% baya tasiri hanawar DPP-4 kuma ba ta da mahimmanci a asibiti.

Ba a kafa fasalin Pharmacokinetic a cikin marasa lafiya da ke ƙasa da shekara 18 ba.

Galvus, umarnin don amfani: hanyar da sashi

Ana ɗaukar allunan Galvus a baki, ba tare da la'akari da cin abinci ba.

Ya kamata a zaɓi kashi don yin la’akari da tasirin mutum da kuma haƙurin maganin.

monotherapy ko haɗuwa tare da thiazolidinedione, metformin ko insulin: 50 mg 1-2 sau a rana, amma ba fiye da 100 MG ba,
sau biyu tare da jiyya tare da shirye-shiryen sulfonylurea: 50 MG sau ɗaya a rana, da safe. A cikin marasa lafiya na wannan rukuni, sakamakon warkewa na shan Galvus a cikin kashi na yau da kullum na 100 MG daidai yake da na kashi 50 na MG kowace rana,
Sau uku hade da jiyya tare da na lokaci guda na maganin sulfonylurea da kuma kayan aikin metformin: 100 MG kowace rana.

Idan maganin yau da kullun shine 50 MG, ana shan shi sau ɗaya, da safe, idan 100 MG - 50 MG da safe da maraice. Idan bazata tsallake kashi na gaba ba, yakamata ku sha shi da wuri-rana lokacin. Ba za ku iya barin shan Galvus ba a cikin adadin da ya wuce mutum yau da kullun.

A cikin rashin isasshen iko na glycemic a lokacin monotherapy a matsakaicin adadin yau da kullun na 100 MG, ya kamata a inganta magani tare da alƙawarin maganin sulfonylurea, metformin, thiazolidinedione ko abubuwan insulin.

Tare da lahani na matsakaici zuwa matsakaici na nakasa, ƙirar creatinine (CC) sama da 50 ml / min baya canza adadin Galvus.

Tare da matsakaici (CC 30-50 ml / min) kuma mai tsanani (CC ƙasa da 30 ml / min) lalata koda, ciki har da matakin ƙarancin cututtukan ƙwayar koda (cututtukan hemodialysis ko halayen hemodialysis), ana ɗaukar kashi Galvus na yau da kullun sau ɗaya, kuma ba shi yakamata ya wuce 50 MG.

A cikin marasa lafiya tsofaffi (sama da shekaru 65), ba a buƙatar gyaran tsarin sashi na Galvus ba.

Side effects

Haɓaka tasirin da ba a so a lokacin monotherapy ko tare da wasu wakilai a cikin mafi yawan lokuta mai laushi ne, na ɗan lokaci kuma baya buƙatar zubar da Galvus.

Yawancin lokaci ana iya ganin bayyanar angioedema idan aka haɗu da angiotensin-canza masu hana enzyme aiki. Yawancin lokaci yana da rauni mai matsakaici, yana wuce kansa bisa akasin cutarwar da ke gudana.

Da wuya, yin amfani da Galvus yana haifar da hepatitis da sauran rikice-rikice na aikin hanta na hanya mai asymptomatic. A mafi yawan lokuta, waɗannan yanayin ba su buƙatar magani, kuma bayan soke Galvus, an sake dawo da aikin hanta.

Ara ayyukan enzymes na hanta a ƙarancin vildagliptin 50 MG 1-2 sau a rana a cikin mafi yawan lokuta asymptomatic, baya ci gaba kuma baya haifar da cholestasis ko jaundice.

Tare da monotherapy a cikin kashi 50 na MG sau 1-2 a rana, abubuwan da suka faru na lalacewa suna iya haɓaka:

daga tsarin mai juyayi: sau da yawa - tsananin wahala, lokaci-lokaci - ciwon kai,
cututtukan fata da na cututtukan fata: da wuya - nasopharyngitis, kumburin ciki na sama,
daga tasoshin: akai-akai - na gefe edema,
daga jijiyoyin mahaifa: akai-akai - maƙarƙashiya.

Tare da haɗuwa da Galvus a cikin kashi 50 na MG sau 1-2 a rana tare da metformin, bayyanar irin wannan tasirin yana yiwuwa:

daga tsarin juyayi: sau da yawa - ciwon kai, rawar jiki, rashi,
daga cututtukan gastrointestinal: sau da yawa - tashin zuciya.

Haɗin maganin haɗuwa tare da metformin baya shafar nauyin jikin mai haƙuri.

Lokacin amfani da Galvus a cikin kashi 50 na yau da kullun na 50 a haɗe tare da abubuwan da ake buƙata na sulfonylurea, ana iya lura da waɗannan cututtukan masu zuwa a cikin haƙuri:

parasitic da cututtukan cututtukan cututtukan fata: da wuya - nasopharyngitis,
daga jijiyoyin mahaifa: akai-akai - maƙarƙashiya,
daga tsarin juyayi: sau da yawa - ciwon kai, rawar jiki, farin ciki, asma.

Yawan nauyin mai haƙuri ba ya ƙaruwa lokacin da aka haɗa shi da glimepiride.

Yin amfani da Galvus a cikin kashi 50 na MG sau 1-2 a rana a hade tare da abubuwan da ke cikin thiazolidinedione na iya haifar da sakamakon da ba a so:

daga tasoshin: sau da yawa - na waje edema,
daga gefen metabolism da abinci mai gina jiki: sau da yawa - karuwa a jikin mutum.

Shan Galvus a cikin kashi 50 na MG sau 2 a rana a hade tare da insulin na iya haifar da:

daga tsarin juyayi: sau da yawa - ciwon kai, tare da yanayin da ba a sani ba - asthenia,
daga cututtukan gastrointestinal: sau da yawa - gastroesophageal reflux, tashin zuciya, infrequently - flatulence, zawo,
daga gefen metabolism da abinci mai gina jiki: sau da yawa - hypoglycemia,
gaba daya cuta: sau da yawa - jin sanyi.

Yawan nauyin mai haƙuri a cikin wannan haɗin ba ya ƙaruwa.

Yin amfani da Galvus 50 MG 2 sau a rana a hade tare da shirye-shiryen metformin da maganin sulfonylurea na iya haifar da ci gaban sakamako masu zuwa:

daga gefen metabolism da abinci mai gina jiki: sau da yawa - hypoglycemia,
daga tsarin mai juyayi: sau da yawa - rawar jiki, rashi, asthenia,
halayen cututtukan fata: sau da yawa - hyperhidrosis.

Maganin haɗewa sau uku ba ya shafar nauyin jikin mai haƙuri.

Bugu da ƙari, waɗannan rikice-rikice masu zuwa an rubuta su a cikin karatun bayan rajista: urticaria, ƙara yawan aikin hanta na hanta, hepatitis, pancreatitis, cututtukan fata na bullo ko etiology exfoliative, myalgia, arthralgia.

Umarni na musamman

Yakamata a sanar da mara lafiya game da bukatar ganin likita idan akwai wani yanayin tashin hankali daga cututtukan da aka lissafa ko kuma bayyanar wasu illa da ba a so ba a bangon amfani da allunan.

Magungunan ba ya haifar da illa ga haihuwa.

A cikin marasa lafiyar insulin-dogara, yakamata a yi amfani da Galvus a hade tare da insulin.

A cikin rukuni na rashin lafiyar zuciya na aiki Komawa mai aiki na NYHA ana iya ɗauka ba tare da ƙuntatawa ba a cikin aikin jiki na al'ada.

A cikin rauni na zuciya na aji na II, ana buƙatar ƙuntataccen matsakaiciyar motsa jiki, tunda nauyin da aka saba yana haifar da bugun bugun zuciya, rauni, gajiya, gajiya. A hutawa, waɗannan alamun ba su nan.

Idan alamun cututtukan cututtukan ƙwayar cuta sun bayyana, ya kamata a dakatar da vildagliptin.

Kafin fara amfani da shi kuma sannan a kai a kai kowane watanni 3 a farkon shekarar farko, ana ba da shawarar yin nazarin nazarin halittu na alamomin ayyukan hanta, tunda aikin Galvus a lokuta mafi ƙarancin yanayi na iya haifar da haɓaka cikin ayyukan aminotransferases. Idan yayin karatun na biyu, alamomin ayyukan alanine aminotransferase (ALT) da aspartate aminotransferase (AST) sun wuce iyakokin madaidaiciya ta sau 3 ko sama da haka, yakamata a dakatar da maganin.

Tare da haɓaka alamun alamun aikin hanta mai rauni (ciki har da jaundice) yayin ɗaukar Galvus, ana buƙatar dakatar da maganin nan da nan, ba shi yiwuwa a ci gaba da ɗaukar sa bayan dawo da alamun aikin hanta.

Don rage haɗarin cutar hypoglycemia yayin haɗuwa tare da shirye-shiryen sulfonylurea, ana bada shawara don amfani da su a cikin mafi ƙarancin tasiri.

Hulɗa da ƙwayoyi

Tare da yin amfani da Galvus tare da glibenclamide, metformin, pioglitazone, amlodipine, ramipril, digoxin, valsartan, simvastatin, warfarin, babu wata hulɗa mai mahimmanci ta hanyar asibiti da aka kafa.

Za a iya rage tasirin hypoglycemic na vildagliptin lokacin da aka haɗa shi da thiazides, glucocorticosteroids, juyayi, da shirye-shiryen hodar iblis.

Yiwuwar haɓakar angioedema yana ƙaruwa tare da kwanciyar hankali tare da angiotensin yana canza masu hana enzyme. Ya kamata a sani cewa vildagliptin ya kamata a ci gaba tare da bayyanar angioedema, tunda yana wucewa a hankali, kai tsaye kuma baya buƙatar dakatar da ilimin.

Abun hulɗa na Galvus tare da kwayoyi waɗanda ke canzawa, inducers ko masu hana cytochrome P ba zai yiwu ba₄₅₀ (CYP).

Galvus ba ya tasiri da ƙimar metabolism na magungunan da ke maye gurbin enzymes CYP1A2, CYP3A4, CYP3A5, CYP2C8, CYP2C9, CYP2D6, CYP2C19, CYP2E1.

Analogs na Galvus sune: Vildagliptin, Galvus Met.