Umarni don amfani, contraindications, sakamako masu illa, sake dubawa

Magungunan hypoglycemic na baka daga ƙungiyar biguanide.
Shiri: FORMETIN®
Aiki mai guba na miyagun ƙwayoyi: metformin
Lullukin ATX: A10BA02
KFG: Magungunan maganin ƙwaƙwalwa na baka
Lambar yin rijista: LSR-003304/07
Ranar rajista: 10.22.07
Mai mallaka reg. doc.: FARMSTANDART-LEXREDSTVA OJSC

Leaseaddamar da fom ɗin leaseaddamarwa, shirya magunguna da abun da ke ciki.

Allunan fararen fata ne, zagaye, shimfidar-silima tare da bevel da daraja.

Shafin 1
metformin hydrochloride
500 MG
-«-
850 MG

Wadanda suka kware: povidone nauyi na matsakaitan kwayoyin halitta (polyvinylpyrrolidone), sodium croscarmellose, magnesium stearate.

10 inji mai kwakwalwa - fakiti mai bakin ciki (3) - fakitoci na kwali.
10 inji mai kwakwalwa - fakitin bakin (6) - fakitoci na kwali.
10 inji mai kwakwalwa - fakiti mai bakin ciki (10) - fakitoci na kwali.

Allunan suna da fari, m, biconvex, tare da daraja a garesu.

Shafin 1
metformin hydrochloride
1 g

Wadanda suka kware: povidone nauyi na matsakaitan kwayoyin halitta (polyvinylpyrrolidone), sodium croscarmellose, magnesium stearate.

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

Magunguna na Pharmacological ofmin

Magungunan hypoglycemic na baka daga ƙungiyar biguanide. Yana hana gluconeogenesis a cikin hanta, rage yawan glucose daga hanji, haɓaka amfani da keɓaɓɓen glucose, yana kuma ƙara haɓakar jijiyoyin jikin mutum zuwa insulin. Ba ya cutar da ɓoyewar insulin ta hanyar ƙwayoyin ƙwayar ƙwayar ƙwayar cuta, ba ya haifar da halayen hypoglycemic.

Zazzagewa masu saukarwa, LDL.

Yanke ko rage karfin jiki.

Yana da tasirin fibrinolytic saboda hanawar ƙwaƙwalwar ƙwaƙwalwar ƙwayar plasminogen mai hanawa.

Pharmacokinetics na miyagun ƙwayoyi.

Bayan gudanar da baki, ana amfani da metformin daga ƙwayar narkewa. Bioavailability bayan ɗaukar daidaitaccen kashi shine 50-60%. Cmax bayan maganin baka an sami nasara bayan awa 2.5.

A zahiri ba a ɗaura shi da sunadaran plasma. Yana tarawa a cikin glandan ciki, tsokoki, hanta, da kodan.

An cire shi baya cikin fitsari. T1 / 2 shine 1,5-4.5 hours.

Sashi da hanyar gudanar da magani.

Saita daban, yin la'akari da matakin glucose a cikin jini.

Maganin farko na farko yawanci shine 500 mg 1-2 sau / rana ko 850 mg 1 lokaci / rana. Bayan haka, sannu a hankali (1 a kowane mako), ana karuwa da kashi zuwa 2-3 g / rana. Matsakaicin adadin yau da kullun shine 3 g.

Ana ba da shawarar amfani da kullun fiye da 850 MG a cikin allurai biyu (safe da maraice).

A cikin tsofaffi marasa lafiya, kashi na yau da kullun kada ya wuce 1 g.

Saboda yawan haɗarin lactic acidosis, lokacin gudanar da metformin ga marasa lafiya da mummunar cuta na rayuwa, yakamata a rage kashi.

Ya kamata a ɗauki allunan a lokacin ko bayan abinci gaba ɗaya, tare da yalwar ruwa.

Magungunan an yi niyya don amfani na dogon lokaci.

Sakamakon sakamako na

Daga tsarin narkewa: tashin zuciya, amai, dandano na ƙarfe a cikin bakin, rashin ci, zawo, ƙanshin ciki, ciwon ciki.

A ɓangaren metabolism: da wuya - lactic acidosis (yana buƙatar dakatar da jiyya), tare da tsawaita amfani da - B12 hypovitaminosis (malabsorption).

Daga tsarin hemopoietic: a wasu yanayi - megaloblastic anemia.

Daga tsarin endocrine: hypoglycemia (lokacin da aka yi amfani dashi a allurai marasa inganci).

Allergic halayen: fatar fata.

Contraindications wa miyagun ƙwayoyi:

- mai ciwon sukari ketoacidosis, mai ciwon sukari, coma,

- Cutar rashin lafiyar koda.

- mai aiki mai hanta,

- m guba,

- yanayi wanda zai iya taimakawa ci gaban lactic acidosis, gami da gazawar zuciya da rashin numfashi, lokaci mai rauni na rashin aiki na zuciya, matsanancin hadarin cerebrovascular, fitsari, giya mai tsafta,

- lactic acidosis da tarihin shi,

- mummunan ayyukan tiyata da raunin da ya faru (a cikin waɗannan halayen, an nuna maganin insulin),

- Yi amfani da shi tsakanin kwanaki biyu kafin da kwana 2 bayan gudanar da karatun radioisotope ko raa-ray tare da gabatarwar iodine wanda ke da bambanci matsakaici,

- riko da karancin kalori (kasa da 1000 cal / day),

- lactation (shayarwa),

- Rashin hankali ga abubuwan da ke tattare da maganin.

Ba'a ba da shawarar yin amfani da miyagun ƙwayoyi a cikin marasa lafiya waɗanda suka girmi shekaru 60 waɗanda suke yin aiki na zahiri, saboda haɗarin haɗarin lactic acidosis.

Umurni na musamman don amfanin yin amfani da kai.

A lokacin amfani da miyagun ƙwayoyi, ya kamata a kula da alamun alamun aikin. Akalla sau 2 a shekara, kuma tare da bayyanar myalgia, ya kamata a ƙaddara abubuwan da ke cikin lactate na plasma.

Yana yiwuwa a yi amfani da Formetin a hade tare da abubuwan da ake amfani da su na sulfonylurea ko insulin, kuma musamman saka idanu akan matakan glucose na jini ya zama dole.

Tasiri kan ikon tuka motoci da hanyoyin sarrafa abubuwa

Lokacin amfani dashi azaman maganin monotherapy, ƙwayar ba ta tasiri da ikon fitar da motoci da aiki tare da kayan aikin injiniya.

Tare da haɗuwa da Formetin tare da sauran magungunan hypoglycemic (abubuwan da aka samo na sulfonylurea, insulin), yanayin hypoglycemic na iya haɓakawa wanda ikon iya tuki motocin da sauran ayyukan haɗari waɗanda ke buƙatar ƙara kulawa da saurin halayen psychomotor sun kara damuwa.

Adadin yawa na miyagun ƙwayoyi:

Bayyanar cututtuka: m lactic acidosis na iya haɓaka. Dalilin ci gaban lactic acidosis kuma na iya zama tarin ƙwayar cutar saboda rauni na aikin keɓaɓɓu. Alamar farko ta lactic acidosis sune rauni na gaba daya, tashin zuciya, amai, zawo, saukar da zafin jiki, saurin ciki, raunin jiki, rage karfin jini, kwanciyar hankali bradycardia, a nan gaba yana iya kara yawan numfashi, farin ciki, karancin hankali da kuma ci gaba.

Jiyya: idan akwai alamun lactic acidosis, magani tare da metformin ya kamata a dakatar da shi nan da nan, ya kamata a kwantar da mai haƙuri cikin gaggawa kuma, tunda ya ƙaddara yawan maganin lactate, tabbatar da ganewar asali. Hemodialysis yana da tasiri sosai don cire lactate da metformin daga jiki. Idan ya cancanta, gudanar da aikin tiyata.

Yin hulɗa da ofmin tare da wasu kwayoyi.

Tare da yin amfani da lokaci guda tare da abubuwan da suka samo asali na sulfonylurea, acarbose, insulin, NSAIDs, MAO inhibitors, oxygentetracycline, ACE inhibitors, clofibrate Kalam, cyclophosphamide da beta-blockers, yana yiwuwa a ƙara tasirin hypoglycemic sakamako na metformin.

Tare da yin amfani da lokaci guda tare da GCS, maganin hana haihuwa, epinephrine (adrenaline), sympathomimetics, glucagon, hormones thyroid, thiazide da "madauki", abubuwan da ke tattare da yanayin acid da nicotinic acid, raguwar sakamako na hypoglycemic na metformin mai yiwuwa ne.

Cimetidine yana rage jinkirin kawar da metformin, sakamakon abin da haɗarin lactic acidosis ke ƙaruwa.

Metformin na iya raunana tasirin magungunan anticoagulants (abubuwan da aka samo coumarin).

Tare da gudanarwa na lokaci ɗaya tare da ethanol, haɓakar lactic acidosis mai yiwuwa ne.

Tare da yin amfani da nifedipine lokaci guda yana ƙara ɗaukar metformin da Cmax, yana rage jinkirin zuwa.

Magungunan cationic (amlodipine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin) waɗanda ke ɓoye a cikin tubules suna gasa don tsarin jigilar tubular kuma, tare da tsawan magani, na iya ƙara yawan Cmax na miyagun ƙwayoyi da 60%.

Bayani na gaba daya, abun da ya shafi da kuma sakin

Halittar jini (duba hoto) magani ne na hypoglycemic. Magungunan yana daga cikin rukunin biguanide, saboda haka ana amfani dashi wajen lura da ciwon sukari na 2.

Kamar yadda yake a duk shirye-shiryen kungiyar kungiyar biguanide, “Formmetin” yana da bangaren aiki - Metformin hydrochloride. Adadinsa na iya zama 0.5, 0.85 ko 1 g.

makarin sodium,
magnesium stearate da aka yi amfani da shi a masana'antar magunguna,
povidone matsakaiciyar kwayar halitta (polyvinylpyrrolidone).

Ana samun maganin a cikin allunan, nau'i wanda ya dogara da sashi:

0.5 g zagaye,
m biconvex (0.85 da 1 g).

Allunan suna sayar da kwali a cikin kwali, wadanda kowannensu na iya zama 30, 60 ko 100.

Pharmacology da pharmacokinetics

Magungunan "Formin" yana shafar jikin mutum kamar haka:

Yana jinkirta aiwatar da gluconeogenesis a cikin hanta,
yana rage yawan glucose din hanji,
Yana haɓaka amfani da keɓaɓɓen glucose da ke cikin jini,
yana haifar da haɓakar ƙwaƙwalwar ƙwayar cuta zuwa insulin,
ba ya haifar da ci gaban hauhawar jini,
lowers triglycerides da LDL
normalizes ko rage nauyi
taimaka narke jini clots.

Aikin magunguna yana nuna fasalin abubuwan sha, rarrabuwar kai da ƙyalƙyalin manyan abubuwan.

Damuwa. Abubuwan da ke aiki na miyagun ƙwayoyi suna amfani da ganuwar ƙwayar gastrointestinal bayan ɗaukar kwaya. A bioavailability na daidaitaccen sashi yana daga 50% zuwa 60%. Matsakaicin ƙwayar maganin an saita sa'o'i 2.5 bayan gudanarwa.
Rarraba. Abubuwan da ke cikin magungunan a zahiri ba sa kafa dangantaka da sunadaran plasma.
Kiwo. Excretion daga cikin abubuwan da ke cikin miyagun ƙwayoyi ana aiwatar dashi ba canzawa. Abubuwan da aka gyara a cikin fitsari. Lokacin da ake buƙata na rabin rayuwar maganin yana daga 1,5 zuwa 4.5 hours.

A cikin yanayin lokacin da abubuwan da ke tattare da miyagun ƙwayoyi suna tara cikin jiki, kuna buƙatar sanin abin da zai iya faruwa daga. Mafi sau da yawa, dalilin ya ta'allaka ne akan aikin keɓaɓɓiyar aiki.

Manuniya da contraindications

Magungunan ƙwayar cuta ya zama dole a cikin waɗannan lambobin:

tare da wuce kima ko kiba, lokacin da aka rage cin abinci,
tare da nau'in ciwon sukari na biyu.

Kada a yi amfani da "Formine" kawai don asarar nauyi, duk da cewa maganin yana taimakawa sosai ga asarar sa. Shan kwayoyin suna da tasiri a haɗe tare da maganin insulin a cikin marasa lafiya da mummunar kiba, wanda ke haɗuwa tare da juriya ga sakandare.

Magunguna lokacin shan maganin yana contraindicated:

ketoacidosis
ko orauracewar fata saboda cutar sankara,
pathological canje-canje a cikin kodan da hanta,
yanayin haifar da haɓakar lactic acidosis, ciki har da gazawar zuciya, canje-canje a cikin gudanawar ƙwayar cuta, saurin lokaci na ɓarnawar zuciya, ƙwaƙwalwar ƙwayar cuta, ƙonewa,
m barasa guba,
tsananin cutar da cututtuka,
m shisshigi
raunin da ya faru
X-ray, da ya shafi gabatarwar wakilai na musamman (kwana 2 kafin da bayan),
manne wa tsarin abincin da ke ba da damar kasancewa a cikin abincin yau da kullun wanda bai wuce adadin kuzari 1000 ba,
shayarwa, da farawar ciki,
rashin hankali ga abubuwan da ke cikin miyagun ƙwayoyi.

Umarnin don amfani

Za'a iya yin zaɓin sashi ne kawai ta hanyar likita wanda yayi la'akari da duk halaye na mutum na haƙuri da hanya na ciwon sukari. Umarnin yana nuna shawarar da aka bada shawarar a farko. Zai iya zama daga 500 zuwa 1000 MG kowace rana.

Daidaitawa da daidaitaccen kashi yakamata a yi a ƙarshen kwanaki 15 bayan ƙwayar farko. Bugu da ƙari, ya kamata a zaɓa bisa batun kula da glycemic. Yawan yau da kullun ba zai iya zama sama da 3000 MG ba. A mafi yawan lokuta, maganin kulawa yana buƙatar ɗaukar 1500-2000 mg / rana. Marasa lafiya na tsufa ya kamata ba su wuce 1 g na kayan aiki mai aiki ba.

Allunan ya kamata a bugu bayan abinci. Ana ba da shawarar sashi wanda likitan ya umarta daidai, kuma a sha magani sau biyu a rana. Wannan zai hana faruwar cutarwar sakamako game da narkewa.

Bidiyo daga Dr. Malysheva game da Metformin da magunguna dangane da shi:

Musamman marasa lafiya

An ba da shawarar yin amfani da miyagun ƙwayoyi don amfani ba don duk marasa lafiya ba.

Ana haɗa waɗannan rukunan masu haƙuri a cikin rukuni na musamman:

Mata masu juna biyu da masu shayarwa. Gwaje-gwaje sun nuna cewa abubuwan da ke cikin miyagun ƙwayoyi na iya yin mummunan tasiri ga yara duka biyu a cikin mahaifa da kuma bayan haihuwa.
Marasa lafiya da cutar hanta. An contraindicated a magani far.
Marasa lafiya tare da nakasa aiki na renal. Tare da canje-canje masu rarrabewa na cuta, an hana yin amfani da wakilin magunguna. A wasu halaye, magani tare da wannan magani yana yiwuwa, amma a ƙarƙashin kulawa na yau da kullun game da aikin ƙwayoyin cuta.
Tsofaffi marasa lafiya. Akwai haɗarin lactic acidosis a cikin mutane sama da 60 waɗanda ke aiki koyaushe a cikin aiki na jiki.

Umarni na musamman

Farfesa tare da miyagun ƙwayoyi yana da wasu fasali:

Tabbas ya kamata marasa lafiya su sa ido a kan aikin kodan. Mitar irin wannan saiti sau 2 a shekara. Wannan ya faru ne saboda gaskiyar cewa abubuwan “Tsarin” zasu iya tarawa cikin jiki idan hargitsi ya kasance aiki a wannan sashin.
Idan myalgia ya faru, ana bada shawara don bincika matakin lactate na plasma.
Yin amfani da "Formmetin" a hade tare da abubuwan da ake amfani dasu na sulfonylurea suna buƙatar sarrafa glycemia.
Hadarin hypoglycemia yana ƙaruwa lokacin da aka yi amfani da waɗannan allunan tare da wasu magunguna waɗanda zasu iya rage matakan sukari. Wannan yanayin yana da haɗari sosai yayin tuki ko shiga cikin kowane aiki wanda ya shafi amsawa da sauri.
Don hana lactic acidosis a cikin marasa lafiya tare da rikice-rikice na rayuwa, ya kamata a fara farawa tare da rage sashi.

Side effects da yawan abin sama da ya kamata

Nazarin masu ciwon sukari sun nuna cewa magani tare da wakilin "Formmetin" yana iya kasancewa tare da abin da ya faru na wasu halayen masu illa:

Game da narkewa - tashin zuciya, ɗanɗano na ƙarfe a bakin, amai, asarar ci, jin zafi a ciki, baƙin ciki.
Losic acidosis yana bayyana. Wannan yanayin yana buƙatar dakatar da jiyya saboda haɗarin mutuwa.
Hypovitaminosis yana haɓaka.
Megaoblastic anemia na faruwa.
Hypoglycemia yana haɓaka.
Fatar fata ta bayyana.

Tare da yawan ƙwayar ƙwayar cuta, ƙwayar lactic acidosis tana haɓaka. A irin waɗannan yanayi, yana da gaggawa a dakatar da jiyya, kuma ya kamata a kwantar da maraice a asibiti. A tsarin asibiti, an ƙaddara yawan maganin lactate domin tabbatar ko musun cutar. Amfani da maganin hemodialysis yana da tasiri a mafi yawan lokuta don halayen lactate da metformin.

Hadin gwiwar Magunguna da Analogs

An inganta tasirin hypoglycemic ta hanyar wakilai masu zuwa:

allura insulin
ACE hanawar, MAO,
Acarbose
Takaddarin bayani,
masu hana beta
Abubuwan da aka samo asali na sulfonylurea.

Inganci yana raguwa daga waɗannan magunguna masu zuwa:

GKS,
hana haihuwa
adrenaline
glucagon,
magungunan hormonal da aka yi amfani da su a cikin cututtukan cututtukan ƙwayar thyroid,
tausayawa
abubuwan da ake amfani da su na phenothiazine, da kuma acid nicotinic.

Yiwuwar lactic acidosis yana ƙaruwa daga shan miyagun ƙwayoyi "Cimetidine", ethanol.

Kasuwancin magunguna suna gabatar da magunguna masu rage yawan sukari da yawa.Wasu daga cikinsu ana iya amfani da su azaman madadin don shiri “Tsarin”, saboda kasancewar metformin hydrochloride a cikin abubuwan dasu.

Mai haƙuri ra'ayi

Daga sake dubawa game da masu ciwon sukari game da magungunan Formmetin, zamu iya yanke hukuncin cewa maganin bai dace da kowa ba, sabili da haka, kafin amfani da shi, shawarar likita ta zama tilas.

Ina da shekara 66 lokacin da aka gano cutar sukari. Nan da nan likita ya ba da shawarar shan Formmetin. Sakamakon ya gamsar. Fiye da shekaru 2 na jiyya, ana kiyaye sukari a cikin 7.5 mmol / L. Abin farin ciki ne musamman da muka sami nasarar cire karin kilo 11, kuma bushewar ya bushe.

Don watanni da yawa Dole ne in zaɓi magani don daidaita al'ada sukari. An gano ciwon sukari watanni 5 da suka gabata, amma kawai godiya ga allunan allunan an sami damar kusanci da dabi'un sukari na al'ada. Na karbe su da Siofor. Ba kamar sauran magunguna tare da wannan magani ba, ba ni da matsala tare da narkewa. Ga duk wanda bai gama shan maganin ba, Ina bayar da shawarar gwada shi.

Na karanta sauran bita kuma nayi mamakin nasarorin da wasu suka samu. Ni da kaina na dauki wannan magani a lokacin nacewar likita. Kafin ya sha Metformin Teva, babu matsaloli. Kuma tare da canzawa zuwa Formetin a cikin kwanaki 3, na sami duk tasirin sakamako masu illa. Na kasance mai jin tsoro, na kasance mai tashin hankali, Na ji mummunan rauni, amma na yi shiru game da sauran. Bai kamata a sha wannan magani ba bayan shekaru 60, amma ba wanda ya gargade ni. Zana karshe.

Farashin allunan 60 na allurar ya dogara da sashi. Kusan 200 rubles ne.