Allunan Yanumet don ciwon sukari na 2

Allunan Yanumet don amfani suna nufin magungunan hypoglycemic da aka yi amfani da su don rama ga ciwon sukari na 2. Inganta ingancinsa yana ƙaruwa ta musamman keɓaɓɓen samfurin. Wanene ya dace da kuma yadda ake amfani da shi daidai?

Yawancin lokaci ana yin sa ne idan canjin yanayin rayuwa da na metotinrapy na baya ko magani mai wahala ba su kawo sakamakon da ake tsammanin ba. Wasu lokuta ana sanya shi ga mutanen da ke da hannu dumu dumu cikin wasanni don su iya sarrafa bayanan su na glycemic. Baya ga cikakken bayanin iyali tare da umarnin, kafin a yi amfani da kowane yanayi, shawarar likita ta zama tilas.

Yanumet: abun da ke ciki da fasali

Babban sinadari mai aiki a cikin tsari shine metformin hydrochloride. An tattara magungunan a cikin 500 MG, 850 MG ko 1000 MG a cikin kwamfutar hannu 1. Sitagliptin yana tallafawa babban sinadaran, a cikin capsule ɗaya zai zama 50 MG a kowane kashi na metformin. Akwai magabata a cikin dabara wanda ba su da sha'awa dangane da damar magani.

Ana kiyaye kabilun convex convex mai kariya daga fakes tare da rubutun "575", "515" ko "577", ya danganta da sashi. Kowace kunshin kwali yana ɗauke da faranti biyu ko huɗu na abubuwa guda 14. An ba da magani

Akwatin kuma yana nuna rayuwar shiryayye na maganin - shekaru 2. Dole ne a zubar da maganin da ya ƙare. Abubuwan da ake buƙata don yanayin ajiya sune daidaitaccen: wuri mai bushewa mara amfani ga rana da yara tare da yanayin zafin jiki na har zuwa digiri 25.

Hanyar magunguna

Yanumet shine haɗin tunani mai mahimmanci na magunguna masu haɓaka sukari guda biyu tare da haɗin kai (haɗin gwiwa ga juna) halaye: metformin hydrochloride, rukuni ne na biguanides, da sitagliptin, mai hana DPP-4.

Synagliptin

An yi amfani da kayan haɗin don amfani da baka. Hanyar aikin sitagliptin yana dogara ne akan kumburin incretins. Lokacin da aka hana DPP-4, matakin GLP-1 da peptides na HIP, wanda ke daidaita glucose homeostasis, yana ƙaruwa. Idan aikinta ya zama na al'ada, abubuwan haɗin gwiwa suna kunna samar da insulin ta amfani da β-sel. GLP-1 yana hana samar da glucagon ta by-sel a hanta. Wannan algorithm bai yi kama da mizani na ɗaukar hoto ba ga ƙwayoyin sulfonylurea (SM) waɗanda ke haɓaka samar da insulin a kowane matakin glucose.

Irin wannan aikin na iya haifar da cutar hypoglycemia ba kawai a cikin masu ciwon sukari ba, har ma a cikin masu sa kai na lafiya.

Mai hana enzyme na DPP-4 a cikin allurai da aka bada shawarar ba zai hana aikin aikin enzymes PPP-8 ko PPP-9 ba. A cikin ilimin magunguna, sitagliptin bai yi kama da analogues ba: GLP-1, insulin, SM abubuwan, meglitinide, biguanides, hib-glycosidase inhibitors, γ-receptor agonists, amylin.

Metformin

Godiya ga metformin, haƙuri a cikin nau'in ciwon sukari na 2 yana ƙaruwa: hankalinsu yana raguwa (duka postprandial da basal), juriya na insulin ya ragu. Algorithm na tasirin miyagun ƙwayoyi ya bambanta da ka'idodin aikin madadin magunguna masu rage sukari. Ta hana samar da sinadarin glucogen ta hanta, metformin yana rage shakar ta ta hanjin hanji, rage juriya ta insulin, da inganta yanayin aiki.

Ba kamar magungunan SM ba, metformin ba ya haifar da hare-hare na hyperinsulinemia da hypoglycemia ba a cikin masu ciwon sukari tare da nau'in cuta na 2 ba, kuma ba cikin rukunin sarrafawa ba. A yayin jiyya tare da metformin, samar da insulin ya kasance daidai wannan matakin, amma azuminsa da matakan yau da kullun suna raguwa.

Fasali na Pharmacokinetic

Hada magungunan Yanumen yana hade ne da wani irin nau'in magani daban daban wanda ya isa daidai gwargwado na Janavia da Metformin.

Damuwa

A bioavailability na sitagliptin shine 87%. Amfani mai kyau na abinci mai-mai da mai-mai-nauyi ba ya shafar ƙimar sha. Matsakaicin matakin kayan masarufi a cikin magudanar jini ya zama tsayayyen awa 1-4 bayan kwashe daga hancin.

Rashin bioavailability na metformin akan komai a ciki ya kai 60% a kashi na 500 MG. Tare da kashi ɗaya na manyan allurai (har zuwa 2550 MG), an keta ƙa'idar gwargwado, saboda ƙarancin sha. Metformin ya fara aiki bayan sa'o'i biyu da rabi. Matsayinsa ya kai 60%. Ana yin rikodin matakan mafi girma na metformin bayan kwana ɗaya ko biyu. Yayin abinci, tasirin maganin yana raguwa.

Rarraba

Ofaramar rarraba synagliptin tare da amfani guda 1 na rukuni mai kulawa na mahalarta a cikin gwajin shine 198 l. Matsakaicin ɗaukar nauyin sunadarai na jini ƙaramin - 38%.

A cikin gwaje-gwajen iri ɗaya tare da metformin, an ba da rukunin sarrafawa a cikin adadin 850 MG, ƙarar rarraba a lokaci guda ya kai kimanin 506 lita.

Idan muka kwatanta da kwayoyi na aji na SM, metformin kusan bashi da alaƙa ga furotin, ɗan lokaci kaɗan yana cikin gwanayen jini.

Idan kun sha maganin a cikin daidaitaccen sashi, ƙwayar ta kai matsayin mafi kyau (<1 μg / ml) a cikin jini a cikin kwana ɗaya ko biyu. Dangane da sakamakon gwaje-gwajen, har ma a kan ka'idojin iyakance, kololuwar abubuwan da ke cikin kwayoyi a cikin jini bai wuce 5 /g / ml ba.

Kammalawa

Kusan kashi 80% na miyagun ƙwayoyi sun toshe ta da kodan, metformin ba a metabolized a cikin jiki ba, a cikin rukuni mai sarrafawa kusan duk rabon da aka bari a asalinsa na rana guda ɗaya. Magungunan hepatic da excretion a cikin bututun bile ba su nan. An cire sinagliptin daidai (har zuwa 79%) tare da ƙarancin metabolism. Game da matsalolin koda, dole ne a fayyace matakin Yanumet. Tare da cututtukan hepatic, ba a buƙatar yanayi na musamman don magani.

Pharmacokinetics na musamman nau'ikan marasa lafiya

1. Masu ciwon sukari masu dauke da cuta ta 2. Hanyar ɗaukar ciki da rarrabuwar sitagliptin yana kama da aiwatarwa a cikin ƙoshin lafiya. Idan kodan sun kasance na al'ada, ba a lura da bambance-bambance a cikin sashin magunguna lokacin amfani da allurai biyu na metformin a cikin masu ciwon sukari da masu sa kai na lafiya. Haɗin ƙwayoyi a cikin yarda da ƙa'idodi ba a gyarawa ba.
2. A cikin gazawar koda, Yanumet ba'a ba da umarnin ba, tunda magungunan sun kusan cire ƙoshin gaba ɗaya, suna haifar da nauyin ninki biyu akan wannan muhimmin sashin.
3. A cikin cututtukan hanta na rauni mai sauƙi da matsakaici, kashi ɗaya na sitagliptin bai bayyana bambance-bambance na shaƙa da rarrabawa ba. Babu bayanai game da sakamakon shan miyagun ƙwayoyi don cututtukan hanta mai tsanani, amma tsinkaya a cikin wannan yanayin ba su da kyau. A cewar metformin, ba a buga sakamakon irin wannan gwaje-gwajen ba.
4. Masu ciwon sukari na balaga. Bambancin shekaru yana da alaƙa da lalata yara, bayan shekara 80, ba a nuna Janumet (sai dai masu ciwon sukari tare da cretatinin na yau da kullun).

Ga wanda aka nuna kuma ga wanda ba a nuna shi Yanumet

An tsara maganin don sarrafa ciwon sukari na 2. An wajabta shi a takamaiman lamura.

1. Sakamakon haɓaka salon rayuwa don inganta bayanin martaba na mai ciwon sukari, idan metformin monotherapy baya samar da sakamako 100%.
2. Ana amfani da Yanumet a cikin hadaddun hanyoyin haɗi tare da abubuwan da aka samo asali na SM idan zaɓin "metformin + magani na ƙungiyar SM + rage cin abincin carb da nauyin tsoka" ba shi da tasiri sosai.
3. Ana haɗuwa da maganin, idan ya cancanta, tare da agonists masu karɓar gamma.
4. Idan allurar insulin bata bada cikakkiyar diyya na sukari ba, an tsara Yanumet a layi daya.

Contraindications a cikin umarnin sune kamar haka:

• Rashin hankali ga abubuwan da ke cikin tsari;
• Coma (mai ciwon sukari);
• Pathology na kodan;
• Cutar cututtuka;
• Yin allura da kwayoyi tare da aidin (iv);
• Yanayin rawar jiki;
• Cututtukan da ke haifar da rashi oxygen a cikin kyallen takarda;
• Dysfunction hanta, guba, shan barasa;
• Rashin shayarwa;
• Type 1 ciwon sukari.

Side effects

Kafin amfani, kuna buƙatar yin nazarin jerin tasirin sakamako da alamominsu don sanar da likita da lokaci game da abin da jikin zai yi don gyara tsarin kulawa. Daga cikin tasirin da ba'a iya amfani da shi ba:

• Cutar da yaji;
• Rashin cutar dyspeptic;
• Ciwon kai kamar migraine;
• Rashin rikicewar motsi na hanji;
• Cutar fuka-fuka;
• Rage ingancin bacci;
• Yawan matsalar cututtukan cututtukan cututtukan ƙwayar cutar ƙwayar cutar ƙwayar cutar ƙwayar cuta ta ƙwayar ƙwayar cuta da sauran cututtukan cututtukan cututtukan ƙwayar ƙwayar cuta;
• Kwari;
• Rage nauyi, anorexia;
• Cutar fitsari a kan fata.

Ana iya kiyasta yawan tasirin sakamako akan ma'aunin WHO:

• Mafi yawan lokuta (> 1 / 0,1);
• Sau da yawa (> 0.001, <0.1);
• Ba tare da ɓata lokaci ba (> 0.001, <0.01).

An gabatar da bayanan ƙididdigar likita a cikin tebur.

Yadda ake nema

Kundin prefix "ya hadu" da sunan miyagun ƙwayoyi yana nuna kasancewar metformin a cikin abin da ya ƙunsa, amma ana ɗaukar magungunan daidai kamar lokacin da ake rubuta jigajigan Januvia, magani ne da ke kan sitagliptin ba tare da metformin ba.

Likita yayi lissafin sashi, kuma ya dauki magunguna safe da maraice tare da abinci.

A wasu yanayi, dole ne mutum ya yi taka tsantsan wajen kula da Yanumet.

1. Matsanancin ciwon sanyi. Sitagliptin yana da ikon inganta alamun ta. Dole ne likita ya gargadi mara lafiya: idan akwai jin zafi a ciki ko hypochondrium na dama, dole ne a dakatar da shan magunguna.
2. Lactic acidosis. Wannan mummunan yanayin kuma ba haka ba ne mai haɗari sosai yana da haɗari tare da sakamako mai kisa, kuma magani yana katse lokacin da bayyanar cututtuka ta bayyana. Za'a iya gane shi ta hanyar takaitaccen numfashi, raunin epigastric, jin sanyi, canje-canje a cikin abubuwan da ke cikin jini, jijiyoyin wuya, asthenia, da dysfunctions na hanji.
3. Hypoglycemia. A karkashin yanayin da aka saba, baya ga asalin Yanumet, ba ta inganta. Ana iya tsokani shi ta hanyar yawan motsa jiki, kalori mai ƙaranci (har zuwa 1000 kcal / day) abinci, matsaloli tare da glandon adrenal da glandar pituitary, giya, da kuma amfani da ckers-blockers. Theara yawan yiwuwar hauhawar jini a cikin jiyya ta haɗa da insulin.
4. Ilimin halin .an Adam. Hadarin haɓakar lactic acidosis yana ƙaruwa tare da cutar koda, saboda haka yana da mahimmanci don saka idanu da creatinine. Gaskiya ne gaskiyar ga masu ciwon sukari, tun da raunin ɗan su na iya zama asymptomatic.
5. Rashin hankali. Idan jiki ya amsa tare da alamomin rashin lafiyan, za'a soke magungunan.
6. Shiga ciki. Idan mai ciwon sukari yana da niyyar yin aiki, kwana biyu kafin hakan, sai a soke Janumet kuma a tura mai haƙuri zuwa insulin.
7. Iodine-dauke da samfurori. Idan an gabatar da wakili na aidin tare da Yanumet, wannan na iya haifar da cutar koda.

An yi nazarin tasirin Yanumet a kan mata masu juna biyu kawai a kan wakilan duniyar dabbobi. A cikin mata masu juna biyu, ba a yin rikodin rikodin tayi yayin ɗaukar metformin. Amma irin wannan yanke hukuncin bai isa don yin maganin cutar ga mata masu juna biyu ba. Sauyawa zuwa insulin a matakin shirin daukar ciki.

Metformin kuma yakan shiga cikin madarar nono, sabili da haka, ba a sanya Yanumet don yin lactation ba.

Metformin ba ya tsoma baki tare da tuki motocin ko hanyoyin hadaddun abubuwa, kuma synagliptin na iya haifar da rauni da rashin barci, sabili da haka, ba a amfani da Janavia idan an yi saurin amsawa da buƙatar mai da hankali sosai.

Sakamakon yawan yawan zubar jini

Don guje wa yawan haɗuwa da metformin, ba za ku iya amfani da shi ban da Yanumet ba. Doaukar ƙwayar magani yana da haɗari tare da lactic acidosis, musamman tare da wuce haddi na metformin. Lokacin da alamun yawan ƙwayar cuta ya bayyana, ana amfani da maganin cututtukan da ke magance maye.

Me yasa haɓaka tsarin Metformin tare da Yanuvia, Galvus, Onglyza, Glybyuryd, idan zaku iya amfani da kayan aikin iri ɗaya a cikin ƙwaƙwalwar ƙwayar cuta daban? Gwaje-gwajen kimiyya sun nuna cewa tare da kowane nau'in tsarin sarrafawa don ciwon sukari na 2, Metformin yana kasancewa (koda lokacin da yake canzawa zuwa insulin). Haka kuma, yayin amfani da abubuwa guda biyu masu aiki tare da wani tsarin daban na aikin, tasirin magungunan yana ƙaruwa kuma zaka iya yi tare da kwayoyin magani tare da ƙananan sashi.

Yana da mahimmanci kawai don sarrafa sashin metformin a cikin kunshin (500 MG, 850 MG ko 1000 MG) don guje wa yawan alamun cutar. Ga marasa lafiya waɗanda suka manta da shan kowane irin kwaya a kan lokaci, damar da za su iya ɗaukar duk abin da suke buƙata a lokaci ɗaya babbar fa'ida ce da ta shafi amincin da sakamakon magani.

Hulɗa da ƙwayoyi

Yiwuwar yiwuwar metformin an rage shi ta hanyar diuretics, glucagon, corticosteroids, hormones thyroid, phenothiazines, maganin hana haihuwa a cikin allunan, phenytoin, nicotinic acid, sympathomimetics, alli antagonists, isoniazid. A cikin gwaje-gwajen, kashi daya na nifedipine ya kara yawan metformin a cikin mahalarta lafiya a cikin binciken, lokacin da ya isa matakin da ya fi girma da kuma rabin rayuwa ya kasance iri daya.

Abubuwan hypoglycemic zai haɓaka ta hanyar insulin, magunguna na ƙungiyar sulfonylurea, acarbose, MAO da inhibitors na ACE, NSAIDs, oxytetracycline, Kalaman Clofibrate, cyclophosphamide, β-blockers. Amfani guda na furosemide ta hanyar mahalarta masu lafiya a cikin gwajin sun ƙara yawan ɗaukar sha da rarraba metformin da kashi 22% da 15%, bi da bi. Darajojin share fagen shiga bai canza ba sosai. Babu wani bayani game da tsawan hadin gwiwa tare da furosemide da metformin.

Magunguna waɗanda ke ɓoye a cikin tubules suna yin yaƙi don tsarin sufuri, don haka tare da amfani na dogon lokaci zasu iya ƙara yawan matsakaitan metformin da kashi 60%.

Cimetidine yana hana sinadarin metformin, tarin magunguna a cikin jini na iya tayar da acidosis.

Hakanan Yanumet bai dace da giya ba, wanda hakan yana kara yiwuwar acidosis.

Lokacin nazarin nazarin magunguna na wasu kungiyoyi (metformin, simvastatin, glibenclamide, warfarin, rosiglitazone, contraceptives), synagliptin ba shi da aiki sosai. Yawan plasma na digoxin ya karu da 18% lokacin da aka ɗauka lokaci guda tare da sitagliptin.

Binciken sakamakon mahalarta masu lafiya na 858 a cikin gwajin da suka dauki nau'ikan magunguna guda takwas na 83, wanda kashi 50% daga ciki sun banbanta kodan, ba su yi wani tasiri mai tasiri a cikin sha da rarraba sitagliptin ba.

Analogs da farashin

Yanumet magani ne mai tsada: a kan matsakaici, farashin da ke cikin kantin sayar da kantuna ya kama daga dubu biyu da rabi zuwa dubu uku rubles a kowane akwati mai faranti 1-7 (allunan 14 a cikin buhunan leda guda daya). Suna samar da ainihin maganin a Spain, Switzerland, Netherlands, USA, Puerto Rico. Daga cikin analogues, kawai Velmetia ya dace da kayan haɗin kai. Tasiri da lambar ta magungunan ATC iri ɗaya ne:

• Douglimax;
• Glibomet;
• Tafiya;
• Avandamet.

Glibomet ya haɗa da metformin da glibenclamide, waɗanda ke ba shi ƙarfin hypoglycemic da ƙarfin hypoliplera.Alamu don amfani suna kama da shawarar Yanumet. Douglimax ya dogara da metformin da glimepiride. Hanyar bayyanar da alamomi sun yi kama da Yanumet. Tripride yana da glimepiride da pioglitazone, waɗanda ke da tasirin antidiabetic da alamomi masu kama. Avandamet, wanda shine haɗin metformin + rosiglitazone, kuma yana da kaddarorin hypoglycemic.

Idan Yanumet bai dace ba

Dalilan maye gurbin miyagun ƙwayoyi na iya zama dabam: ga waɗansu, magungunan kawai ba sa taimaka wa daidai gwargwado, ga wasu yana haifar da sakamako mai illa ko kawai ba zai iya ba.

Lokacin da amfani da magani bai cika rama jiki don sugars, ana maye gurbinsu da allurar insulin. Sauran allunan a wannan yanayin basu da inganci. Mafi m, daga m magani magani, da pancreas yi aiki, da kuma ci-gaba nau'i na type 2 ciwon sukari wuce zuwa type 1 ciwon sukari.

Ko da mafi allunan zamani zasu zama marasa amfani idan kun yi watsi da shawarwarin endocrinologist akan abinci mai ƙarancin-carb da abubuwan ɗora.

Abubuwan da ke haifar da sakamako sukan haifar da tsotsa ta hanyar metformin, sitagliptin a cikin wannan ba shi da lahani. Dangane da kwarewar aikinta, Metformin magani ne na musamman, kafin ka nemi wanda zai maye gurbin sa, ya cancanci yin iyakar ƙoƙari don daidaitawa. Rashin matsala na disiki zai wuce lokaci, kuma metformin zai ci gaba da sukari a al'ada ba tare da lalata cututtukan fata da kodan ba. Providedarancin abubuwan da ba a iya so su ana bayarwa ta hanyar ɗaukar Janumet kafin ko bayan abinci, amma a lokacin cin abinci.

Don adana kuɗi, zaku iya maye gurbin Janumet ko Januvia kawai tare da metformin tsarkakakke. A cikin hanyar sadarwar kantin magani, ya fi kyau zaɓi alamar alamar Glyukofazh ko Siofor a maimakon masana'antun cikin gida.

Masu ciwon sukari da likitoci game da Yanumet

Game da maganin Janumet, sake dubawa na likitoci ba a haɗa baki ɗaya. Likitoci sun ce: muhimmiyar fa'ida ga abubuwan da ke tattare da ita (musamman sitagliptin) ita ce ba sa tsokanar hawan jini. Idan baku keta alfarmar dokar da aka bi ba kuma ku bi shawarwarin game da abinci mai gina jiki da ilimin jiki, alamun da ke nuna mitsi ɗin za su ragu sosai. Idan akwai rashin jin daɗi a cikin ƙwayar epigastrium da sauran sakamakon da ba a so, to ya zama dole a rarraba kashi yau da kullun zuwa kashi 2 don rage nauyin a jiki. Bayan karbuwa, zaku iya komawa ga tsarin mulkin da ya gabata, idan sukari ya zarce makasudin da aka yi niyya, gyaran kashi daga likitan halartar zai yiwu.

Game da Yanumet, ra'ayoyin masu haƙuri suna rikitarwa, saboda cutar a cikin kowa yana gudana daban. Mafi yawanci, marasa lafiya marasa lafiya suna koka game da sakamako masu illa, saboda kodan, da jikin gabaɗaya, an riga an lalata shi ta hanyar cututtukan haɗin gwiwa.

Endocrinologists suna da sanannen karin magana: "Wasanni da abinci - alurar rigakafin cutar sankara." Duk mutumin da ke neman kwaya mai banmamaki, kuma ya yi imanin cewa sabon kwayoyin, wani facin talla ko shayi na ganye zai warkar da ciwon sukari har abada ba tare da ƙoƙari mai yawa ba, ya kamata ya tuna da shi sau da yawa.