Hyviaglycemic miyagun ƙwayoyi Januvia (umarnin da sake dubawa na masu ciwon sukari)

Januvia ita ce magani na farko na maganin cututtukan da ke da alaƙa da sabon rukuni na kwayoyi, Dhib-4 inhibitors. Tare da fara samarwa na Janavia, wani sabon yanayin ɓoye ya fara a cikin maganin cutar ciwon sukari. Masana kimiyya sun ce, wannan sabuwar dabara ba ta da mahimmanci fiye da gano metformin ko halittar insulin wucin gadi. Sabon magani yana rage sukari daidai gwargwadon shirye-shiryen sulfonylurea (PSM), amma a lokaci guda ba zai haifar da hypoglycemia ba, yana da sauƙin haƙuri har ma yana taimakawa wajen dawo da sel.

Dangane da umarnin, ana iya ɗaukar Januvia tare da sauran wakilai na hypoglycemic, haɗe tare da ilimin insulin.

Alamu don amfani

Dangane da shawarwarin ƙungiyoyi masu cutar sukari da yawa, magani na farko, wato, an tsara shi nan da nan bayan kamuwa da cutar sukari nau'in 2, metformin. Tare da rashin ingancinsa, ana ƙara magunguna na biyu. Na dogon lokaci, an ba da damar ga shirye-shiryen sulfonylurea, tunda suna shafan sukari na jini sosai fiye da sauran kwayoyi. A halin yanzu, ƙarin likitoci suna jingina ga sababbin magunguna - GLP-1 mimetics da Dhib-4 inhibitors.

A matsayinka na mulkin duka, Januvia magani ne ga masu ciwon sukari, wanda aka kara zuwa metformin a mataki na 2 na magani ga masu ciwon sukari. Mai nuna alamar buƙatar magani na sukari na biyu yana raguwa da cutar haemoglobin> 6.5%, idan dai ana ɗaukar metformin a kashi kusa da matsakaicin, ana lura da abinci mai ƙarancin carb, kuma ana tabbatar da aikin motsa jiki na yau da kullun.

Lokacin zabar abin da za a rubuta wa mai haƙuri: shirye-shiryen sulfonylurea ko Januvia, kula da haɗarin cutar rashin ƙarfi ga mai haƙuri.

Ciwon sukari da hauhawar jini zai zama abin da ya wuce

• Normalization na sukari -95%
• Cirewa kan jijiyoyin mara wuya - 70%
• Cire zuciyar mai karfin zuciya -90%
• Rabu da cutar hawan jini - 92%
• Increasearuwar kuzarin rana, inganta bacci da dare -97%

Alamu don liyafar Janavia da misalanta:

1. Marasa lafiya tare da rage hankalin jijiya zuwa ƙwanƙwasawa saboda ƙwaƙwalwar ƙwayar cuta ko wasu dalilai.
2. Masu ciwon sukari sun yi niyyar zuwa yawan zafin jiki.
3. M, tsofaffi marasa lafiya.
4. Masu ciwon sukari waɗanda ke buƙatar mai da hankali sosai lokacin tuki, suna aiki a matakan tsayi, tare da keɓaɓɓun kayan aikin, da sauransu.
5. Marasa lafiya tare da m hypoglycemia shan sulfonylurea.

A zahiri, duk wanda ke da ciwon sukari na iya zuwa Janavia da nufinsa. Indicimar ingancin alama ta Januvia raguwa ce da gemoclobin glycated da kashi 0.5 ko fiye bayan watanni shida na jiyya. Idan ba a cimma wannan sakamakon ba, mai haƙuri yana buƙatar zaɓar wani magani. Idan GH ya ragu, amma har yanzu ba a kai ga al'ada ba, ana ƙara wakili na uku na hypoglycemic akan tsarin kulawa.

Yaya maganin yake aiki?

Kwayoyin cuta sune kwayoyin halittar ciki da ake samarwa bayan sun ci abinci kuma suke haifar da sakin insulin daga farji. Bayan sun gama aikin su, enzyme na musamman sun shafe su - nau'in 4 dipeptidyl peptidase, ko DPP-4. Janavia hana, ko hanawa, wannan enzyme. Sakamakon haka, incretins suna cikin jini ya fi tsayi, wanda ke nufin cewa an inganta aikin insulin, kuma glucose din ya ragu.

Gabaɗaya halaye na duk masu amfani da DPP-4 waɗanda aka yi amfani da su a cikin ciwon sukari:

• Ana ɗaukar Januvia da analogues da baka, ana samun su a kwamfutar hannu;
• suna ƙaruwa da haɗakar abubuwa, amma ba sau biyu ba na ilimin halittar jiki;
• kusan babu wani sakamako da ba a ke so ba a cikin narkewar abinci;
• Kada ku cutar da nauyi;
• hypoglycemia a cikin ciwon sukari ba shi da yawa fiye da shirye-shiryen sulfonylurea;
• rage haemoglobin glycated da 0.5-1.8%;
• ya shafi duka azumi da kuma postprandial glycemia. Azumi na rage glucose, wanda ya hada da rage raguwar asirinsa ta hanta;
• ƙara taro na sel a cikin ƙwayar cuta;
• kada ku shafi ɓoyewar glucagon yayin maganin hypoglycemia, kada ku rage ajiyar shi a cikin hanta.

Umarnin don amfani ya bayyana dalla-dalla game da magunguna na sitagliptin, kayan aiki na Janavia. Yana da babban bioavailability (kusan kashi 90%), yana narkewa daga ƙwayar gastrointestinal a cikin sa'o'i 4. Ayyukan ya fara riga rabin sa'a bayan gudanarwa, sakamakon yana wuce fiye da rana guda. A cikin jikin, sitagliptin kusan ba metabolized bane, kashi 80% an fidda shi ne a cikin fitsari a daidai wannan tsari.

Wanda ya kirkiro da Janavia shine kamfanin kamfanin Amurka na Amurka. Magungunan da ke shiga kasuwar Rasha ana samarwa a cikin Netherlands. A halin yanzu, an fara samar da sitagliptin wanda kamfanin Rasha na Akrikhin ya fara. An bayyana bayyanar sa a kan shelves na kantin magunguna a cikin kashi na 2 na 2018.

Umarnin don amfani

Ana samun magani na Januvia a cikin sashi na 25, 50, 100 MG. Allunan suna da membrane fim kuma suna da launi dangane da ƙimar: 25 MG - kodadde ruwan hoda, 50 MG - madara, 100 MG - m.

Magungunan yana aiki sama da awanni 24. Ana ɗaukar sau ɗaya a rana a kowane lokaci, ba tare da la’akari da lokacin abinci da abin da ya ƙunsa ba. Dangane da sake dubawa, zaku iya canza lokacin shan Januvia ta awa 2 ba tare da sadaukar da glycemia ba.

Shawarwarin umarnin umarnin sashi:

1. Mafi kyawun kashi shine MG 100. An tsara shi don kusan dukkanin masu ciwon sukari waɗanda ba su da contraindications. Farawa tare da karamin sashi kuma sannu a hankali yana ƙaruwa ba lallai ba ne, tunda Januvia tana da haƙurin jiki.
2. Kodan suna da hannu cikin kawar da sitagliptin, sabili da haka, tare da gazawar koda, maganin zai iya tarawa cikin jini. Don kauce wa yawan abin sama da ya wuce, ana daidaita adadin kashi na Yarbaiya gwargwadon ƙarancin isa. Idan GFR> 50, an tsara 100 MG na al'ada. Tare da GFR <50 - 50 MG, GFR <30 - 30 MG.
3. Ga marasa lafiya da rashin isasshen hepatic, ba a buƙatar daidaita suturar Januvia, tunda sitagliptin ba metabolized a cikin kodan.
4. A cikin tsofaffi masu ciwon sukari, yawan sitagliptin a cikin jini ya kusan kashi 20% sama da na samari. Irin wannan bambancin kusan ba zai haifar da cutar ta glycemia ba kuma ba zai iya haifar da wuce gona da iri ba, ba lallai ba ne don canza sashi na Janavia.

Sababin sukari-Rage sakamako na Sabiya:

Side effects

Nazarin da suka gwada haƙuri na Januvia, sun kammala cewa wannan magani, shi kadai ko a hade tare da wasu allunan maganin cututtukan cututtukan ƙwayar cuta, kusan ba su da wata illa. Babu wani bambance-bambance da suka shahara wajen inganta lafiyar marasa lafiya da masu ciwon sukari daga rukunin kula da wadanda ke daukar Januvia. Koyaya, umarnin don amfani yana nuna duk matsalolin rashin lafiyar da marasa lafiya suka fuskanta: cututtukan da ke kama da ciki, ciwon kai, ƙarancin ciki, da sauransu.

Dangane da masu ciwon sukari, allunan Janavia kusan ba sa haifar da ƙwaƙwalwar ƙwayar cuta. Wannan saboda yana aiki ne kawai don amsawar yawan glucose a cikin jini. Suga na iya fada kawai lokacin amfani da Januvia tare da shirye-shiryen sulfonylurea. Don kauce wa wannan, kuna buƙatar rage sashi na PSM.

Nazarin Gwanaye

Arkady Alexandrovich

Endocrinologist tare da gwaninta

Tambaye gwani a tambaya

Shekaru da yawa da suka gabata, bayanai sun bayyana cewa Januvia babban haɗari ne ga masu ciwon sukari da cututtukan zuciya. An sake shi a cikin 2015. Wani bincike na shekaru uku ya tabbatar da cewa maganin Januvia ba ya kara hadarin kamuwa da bugun zuciya, bugun zuciya, angina pectoris, da sauran cututtukan zuciya.

Ga wanda liyafar Janavia aka contraindicated

Ba za a iya ɗaukar magungunan Januvia ba ga mutanen da ke da tabin hankali don sitagliptin ko wasu sinadaran na kwaya. Lokacin ɗauka, ciwo, angioedema, anaphylaxis mai yiwuwa ne.

Ba a yi nazarin sakamakon maganin ba a cikin yara, yayin daukar ciki da lactation. Sakamakon rashin bayanan aminci, umarnin ya hana kula da Yanuvia ga waɗannan rukunin masu ciwon sukari.

Kamar sauran magungunan rage sukari, ba'a amfani da Januvia don matsanancin rikice-rikice na ciwon sukari, yayin lokacin dawowa daga mummunan raunin da kuma ayyukan tiyata.

Yawan damuwa

Dangane da umarnin, an yarda da adadin abin da ya ninka na Yanuvia har sau takwas. Idan aka ɗauki babban kashi, mai haƙuri da ciwon sukari na iya buƙatar kulawar likita: cire allunan undigested daga narkewa, narkewa, magani mai tallafawa.

Me za a iya maye gurbinsa

Cikakken analog na Janavia shine Kselievia ta Jamusanci. Hakanan har yanzu ba zai yuwu siye shi a Rasha ba, lokacin da aka ba da oda a ƙasashen waje farashin ya kai Euro 80 a wata na magani.

Shirye-shirye tare da guda (DPP-4 inhibitors) da makamantansu (GLP-1 mimetics) aikin:

Viawararren ƙwayar cuta ta Januvia ba shi da alamun analogues mai tsada duk da haka, yana kusa da farashin don kowane wata - Galvus (kusan 1,500 rubles) da Ongliza (1900 rubles).

Januvia ko Galvus - wanda yafi kyau

Binciken likitocin ya nuna cewa Galvus da Janavia suna da kusanci gwargwadon ka'idodin aiki da tasirin rage sukari, duk da bambancin abu mai aiki. Wannan ya tabbatar da bayanan binciken, wanda aka kwatanta magungunan:

• 1 kwamfutar hannu na Janavia 100 MG daidai yake da Allunan 2 na Galvus 50 MG;
• a cikin mutane tare da decompensated ciwon sukari mellitus, glycated haemoglobin ya ragu zuwa 7% a cikin 59% na masu ciwon sukari da ke shan Janavia, a cikin 65% na marasa lafiya akan Galvus;
• an lura da hypoglycemia mai sauƙi a cikin 3% na marasa lafiya a kan Janavia, a cikin 2% - akan Galvus. Mai tsananin rashin lafiyar hypoglycemia ba ya nan lokacin shan waɗannan kwayoyi.

A cewar masana'antun, tare da magani tare da Galvus, ƙwayoyin cholesterol da triglycerides na jini suna raguwa, don haka rage haɗarin rikicewar jijiyoyin jiki. A cikin Janavia, ba a sami irin wannan matakin ba.

Kudinsa

Farashin kayan kunshin Janavia, wanda aka lissafta don makonni 4 na liyafar, daga 1489 zuwa 1697 rubles. Ana siyar dashi ne kawai ta takardar sayen magani daga likitancin endocrinologist ko mai ilimin hanyoyin kwantar da hankali. Masu ciwon sukari da ke rajista suna da damar karɓar Janavia kyauta, tunda sitagliptin yana kan mahimman magunguna masu mahimmanci (Magungunan Mahimmanci da Mahimmanci). Dangane da sake dubawa, har yanzu ba a iya samun maganin a duk yankuna na Rasha ba.

Nazarin masu ciwon sukari

Na kasance ina shan Diabeton MV da Siofor, yanzu na canza zuwa miyagun ƙwayoyi Januvia. Tsarin kulawa shine 100 MG naviavia da safe, sau 3 500 MG na Siofor da rana. Abin da yanke shawara za a iya zanawa daga watan gudanarwa: sukari mai azumi ya karu kaɗan, yanzu kusan 5.7-6.7. Bayan ya ci abinci, shi ma ya fara wuce ƙa'idodi sau da yawa. Amsar da aka sanya wa kaya ta canza. A da, bayan sa'a guda, azuzuwan sun haifar da rashin ƙarfi a jiki, sukari wani lokaci ya ragu zuwa 3. Yanzu sannu a hankali ya ragu zuwa 5.5, sannan kuma ya sake girma zuwa matakin da ya saba. Gabaɗaya, haemoglobin mai glycated ya haɓaka kaɗan, kuma canzawar sukari a kowace rana ya ragu sosai.

A cikin Jamus, Galvus ya ɗauki, bayan ya koma Rasha, likitina ya nace akan Januvia. Suna rage sukari kamar guda ɗaya, amma sun ji daɗi a da. Mene ne dalilin, ban fahimta ba. Ganin cewa abin firikwensin har yanzu ra'ayi ne na asali, Januvia yana kula da ciwon sukari sosai.

Januvia ya kara magungunan a hadaddun Levemir + Humalog. Abubuwan da aka fahimta na farko suna da kyau - miyagun ƙwayoyi suna amsa kawai ga sukari mai ɗimbin yawa, mara nauyi baya taɓawa, yana aiki a hankali, ba tare da tsalle-tsalle ba. Yawan rage insulin ya rage kwata. Kyakkyawan sakamako da ba a lura da shi a cikin umarnin ba raguwa ne ga ci cikin kusan kashi ɗaya cikin uku. Ina tsammanin wannan ainihin maganin nasara ne.

Magungunan suna da kyau sosai. Yana daidaita sukari, yana taimakawa rasa nauyi, baya haifar da mummunar yunwar idan ana tsallake abinci, kamar Gliclazide MV. Babban hasara na Janavia shine babban farashinsa. Basu ba da takardar sayen magani kyauta ba, yanzu ba zan iya samun magungunan a kantin magani ba, Na riga na bar aikace-aikace. Dole ne in saya da kaina.