Hypoglycemic nnọchi Glucofage - ntuziaka maka ojiji

Nkọwa

Usoro onunu ogwu 500 mg, 850 mg:
Mpempe akwụkwọ mkpuchi biconvex na-acha ọcha, gburugburu, biconvex.
Akụkụ nke obe na-egosi agba ọcha n'otu.

Usoro onunu ogwu 1000 mg:
Mpempe ọcha, oval, mbadamba biconvex, ihe nkiri nwere ihe mkpuchi, nke nwere ihe egwu n'akụkụ abụọ ma kanye "1000" n'otu akụkụ.
Akụkụ nke obe na-egosi agba ọcha n'otu.

Ngwongwo ọgwụ nke Pharmacotherapeutic

Metformin na-ebelata hyperglycemia n'emeghị ka mmepe nke hypoglycemia. N'adịghị ka usoro sulfonylurea, ọ naghị akpali insulin ma ọ nweghị mmetụta hypoglycemic n'ahụ ndị mmadụ. Na-eme ka mmata nke ndị na-anabata ihe na insulin na itinye glucose site na sel. Na-ebelata mmepụta glucose imeju site na igbochi gluconeogenesis na glycogenolysis.
Na-egbu oge itinye glucose umeji.

Metformin na-akpali njikọ nke glycogen site na ime ihe na glycogen synthase. Na-eme ka ikike ibuwanye nke ndị na-ebuga glucose ụdị ọ bụla.

Na mgbakwunye, ọ nwere uru bara uru na metabolism lipid: ọ na-ebelata ọdịnaya nke cholesterol mkpokọta, obere lipoproteins dị ala na triglycerides.

Mgbe ị na-ewere metformin, ịdị arọ nke onye ọrịa ahụ ọ na-adịgide ma ọ bụ na-ebelata obere oge.

Omumu ihe omumu gosiputala odi nma nke ogwu Glucofage ® maka igbochi oria oria n’ariri ndi nwere oria ojoo n’enwe ihe ndi ozo di egwu maka uto nke oria oria oria abuo n’ahia, nke mgbanwe ndu n’ekweghi ka egbochita akara glycemic zuru oke.

Mlọ ọgwụ

Ndopu na nkesa
Mgbe nchịkwa ọnụ gachara, a na-amụnye metformin site na eriri afọ. Ezigbo bioavailability bụ 50-60%. Oke ruru ịta (Cmax) (ihe dịka 2 μg / ml ma ọ bụ 15 μmol) na plasma ruru mgbe elekere 2.5. Site na ntinye nri n'otu oge, iwepu metformin na-ebelata ma na-egbu oge. A na-ekesa Metformin ngwa ngwa na anụ ahụ, ihe fọrọ nke nta ka ọ bụrụ na ọ nweghị ihe nchebe protein.

Metabolism na ntụpọ
Ọ bụ metadolized ruo obere adịghị ike ma kpụrụ ya akụrụ. Nwepu nke metformin n'ihe ọmụmụ dị mma bụ 400 ml / min (ugboro anọ karịa mwepụ nke creatinine), nke na-egosi ọnụnọ nke oghere canalic na-arụ ọrụ. Ọkara ọkara bụ ihe dịka awa 6.5. Na ọdịda akụrụngwa, ọ na-abawanye, enwere ihe ize ndụ nke nchịkọta ọgwụ.

Ihe ngbanwe

• Hypersensitivity nke metformin ma ọ bụ onye ọ bụla nweburu,
• mamịrị ketoacidosis, ọrịa mamịrị, prema, shuga,
• Ihe gbasara akụrụ arụ ma ọ bụ arụ ọrụ akụrụngwa na-arụ ọrụ (mwepu nke na-erughi 45 ml / min),
• Ọnọdụ nnukwu nsogbu nke ọghọm nke ịzụlite akụrụngwa: akpịrị ịkpọ nkụ (na ọnya afọ, vomiting), ọrịa na-efe efe siri ike, ujo,
• ngosipụta ụlọ ọgwụ pụtara nnukwu ọrịa ma ọ bụ ọrịa na-adịghị ala ala nke nwere ike ibute mmepe nke hypoxia anụ ahụ (gụnyere nnukwu ọrịa obi, ọrịa obi na-adịghị ala ala na mgbatị akwara na-ejighị n'aka, ọdịda okuku ume, nnukwu myocardial infarction)
• nnukwu ịwa ahụ na mmerụ ahụ mgbe enyere insulin ọgwụ (lee mpaghara “Ntuziaka Pụrụ Iche”),
• ọrịa imeju, ọrụ imeju na-arụ ọrụ,
• egbu egbu egbu, ị alcoholụ mmanya na-egbu egbu,
• ime
• lactic acidosis (gụnyere akụkọ ihe mere eme),
• iji ihe na-erughị awa 48 tupu na n'ime awa 48 tupu ị mụsịrị radioisotope ma ọ bụ ihe nyocha x-ray ya na ntinye nke usoro ayodiin nwere ọdịiche (lee akụkụ “Mmekọrịta na ọgwụ ndị ọzọ”),
• rube isi na nri hypocaloric (erughị 1000 kcal / ụbọchị).

Na-akpachara anya

• n'ime ndị okenye karịa 60 ndị na-arụ ọrụ anụ ahụ dị arọ, nke ejikọtara ya na oke ihe ize ndụ nke ịmalite ọrịa lactic acidosis,
• n'ime ndị ọrịa nwere akụrụngwa akụrụngwa (mwepụ nke okike 45-59 ml / min),
• n’oge a na-enye nwa ara.

Jiri n’oge ime na n’oge a na-enye nwa ara

Mgbe ị na-eme atụmatụ ịtụrụ ime, yana n'ihe gbasara ịtụrụ ime na ndabere nke were metformin yana ọrịa shuga na ụdị shuga 2, ọgwụ a ga-akwụsị, ma a bụrụ na ụdị shuga 2, a na-edenye ọgwụ insulin. Ọ dị mkpa idobe ọdịnaya glucose na plasma ọbara n'ọkwa nke kachasị nso na nkịtị iji belata ihe ize ndụ nke arụmọrụ nwa ebu n'afọ.

Metformin na-abanye n’ime mmiri ara. Achọpụtaghị nsonaazụ n'akụkụ ụmụ amụrụ ọhụrụ n’oge a na-enye nwa ara ma na-a metụ metformin. Agbanyeghị, n'ihi oke data dị oke, a naghị atụ aro iji ọgwụ eme ihe n'oge a na-enye nwa ara. Ekwesịrị ime mkpebi ịkwụsị inye ara, na-eburu n'uche uru ị benefitsụ ara na ihe ọghọm nke nsonaazụ nwatakịrị nwere.

Usoro onunu ogwu na nhazi

Ndị okenye:
Monotherapy na ọgwụ nkwonkwo yana ọgwụ hypoglycemic ndị ọzọ maka ụdị shuga mellitus:

• Ọgwụ mbụ ana - ebido 500 mg ma ọ bụ 850 mg ugboro abụọ kwa ụbọchị ma ọ bụ n'oge nri.
• Kwa ụbọchị 10-15, a na-atụ aro ịgbanwe ọgwụ ahụ dabere na nsonaazụ nke ịtụle mkpokọ glucose na plasma ọbara. Mmụba dị nwayọ na dose na-enyere aka belata nsonaazụ akụkụ eriri afọ.
• Ọgwụ nchekwa ọgwụ na-abụkarị 1500-2000 mg / ụbọchị. Iji belata nsonaazụ si eriri afọ, a ga-ekewa ihe ị na-eme kwa ụbọchị n'ime usoro 2-3. Oke kachasị bụ 3000 mg / ụbọchị, kewara atọ.
• Enwere ike izigara ndị ọrịa na-ewere metformin na usoro onyunyo nke 2000-3000 mg / ụbọchị na ọgwụ Glucofage ® 1000 mg. Ogwu a tụrụ aro ya kachasị ukwuu bụ 3000 mg / ụbọchị, nkewapụtara 3.

N'ihe banyere ịhazi ntughari site na ị takingụ ọgwụ hypoglycemic ọzọ: ị ga-akwụsị ị drugụ ọgwụ ọzọ wee malite ị Gụkọta gluing the na usoro egosipụtara.

Njikọ ya na insulin:
Iji mezuo nchịkwa glucose ọbara dị mma, a ga-eji metformin na insulin na ndị ọrịa nwere ụdị shuga 2 dị ka ọgwụgwọ njikọta. Ọkwa mbụ nke Glucofage ® bụ 500 mg ma ọ bụ 850 mg ugboro abụọ kwa ụbọchị, ebe ahọpụtara insulin site na ịba ụba nke glucose n'ọbara.

Childrenmụaka na ndị nọ n’oge uto:
n'ime ụmụaka gbara afọ 10, ọgwụ Glucofage ® nwere ike iji ya na monotherapy yana yana insulin. Ọgwụ nke mbụ bụ 500 mg ma ọ bụ 850 mg 1 oge kwa ụbọchị ma ọ bụ n'oge nri. Mgbe ụbọchị 10-15 gachara, aga-edozigharịrị usoro ahụ dabere na ịta nke glucose ọbara.
Ọgwụ kachasị kwa ụbọchị bụ 2000 mg, kewara 2-3 usoro.

Usoro ọgwụgwọ maka ọrịa shuga:
Ọgwụ mbụ bụ 1000-1700 mg kwa ụbọchị ma ọ bụ n'oge nri, kewara abụọ.
Ọ na-atụ aro ka ị na-achịkwa nchịkwa glycemic mgbe niile iji chọpụta mkpa maka ị furtherụ ọgwụ ọzọ.

Ọrịa nwere ọdịda gbasara akụrụngwa:
Enwere ike iji Metformin mee ihe na ndị ọrịa nwere obere akwara ezughị oke (mwepu nke 45-59 ml / min) naanị na enweghị ọnọdụ nwere ike ịbawanye ihe egwu lactic acidosis.

• Ndị ọrịa nwere nhichapụ ihe dị n'ime 45-59 ml / min: oge ​​mbido bụ 500 mg ma ọ bụ 850 mg otu ugboro n'ụbọchị. Oke kachasị bụ 1000 mg kwa ụbọchị, kewara abụọ.

Ekwesịrị inyocha ọrụ akụrụ anya (kwa ọnwa 3-6).
Ọ bụrụ na okike ya dị n'okpuru 45 ml / min, ekwesịrị ịkwụsị ọgwụ a ozugbo.

Ndị agadi:
n'ihi mbelata nke ọrụ akụrụ, a ga-ahọpụta dose nke metformin n'okpuru nlele anya mgbe niile na-egosi ọrụ arụmọrụ (iji kpebie itinye uche nke creatinine na ọbara ọbara ọbụlagodi ugboro 2-4 n'afọ).

Oge ọgwụgwọ

Ekwesịrị ịluụ Glucofage daily kwa ụbọchị, na-enweghị nkwụsị. Ọ bụrụ na a kwụsịrị ọgwụgwọ, onye ọrịa ahụ kwesịrị ịgwa dọkịta.

Ozi izugbe, ihe mejupụtara na ụdị ịtọhapụ

Glucofage Long bụ nkwadebe ọrịa shuga nke biguanide klas nwere akụkụ mejupụtara Metformin hydrochloride. A na-enweta ya na onunu ogwu nke 500, 850, 1000 mg.

Mgbe etinyere ya, a na-agbanye ngwa ngwa. Nnukwu oke na-apụta mgbe awa 2 gachara.

Nke a ga - enyere gị aka ịrụpụta nsonaazụ ndị a:

• normalize ọbara shuga
• mụbaa mmeghachi omume nke anụ ahụ na homonụ na-emepụta,
• imeju glucose di na ala,
• belata mkpokọta nsia nke glucose,
• mee ka ahụ mmadụ dịghachi otú o kwesịrị,
• melite metabolism,
• cholesterol dị ala.

Mbadamba ụrọ dị irè na ọrịa shuga.

N'ịre ahịa, a na-egosipụta ọgwụ ahụ n'ụdị mbadamba, kpuchie ya na biconvex shei nke agba ọcha. Concentta akụkụ ngwa ọrụ bụ 500, 850, 1000 mg. Maka ịdị mma nke onye ọrịa, a na-etinye usoro onyonye ọgwụ ahụ n'otu ọkara mbadamba.

Pharmacology na pharmacokinetics

Ngwakọta nke mbadamba ndị ahụ gụnyere Metformin, nke na-ekwe nkwa mmetụta hypoglycemic akpọpụtara. N'ime ndị ọrịa nwere oke glucose, ọ na-ebelata ya na nkịtị. N’ime ndị nwere ọkwa glucose nkịtị, shuga ọbara na-agbanwe agbanwe.

Ihe omume a na - arụ ọrụ sitere na mgbochi nke gluconeogenesis na glycogenolysis, ike ịbawanye n'ihe ọ na - eme insulin ma belata mmụba na eriri afọ. Na mgbakwunye, ọgwụ a na-eme ka metabolic Filiks dị n’ahụ na-ebelata cholesterol.

Metxtin kacha lebara anya ka a na-ahụ na awa 2-3 ka ọ gachara. Otu njirimara nke Glucophage Long bụ ogo dị ala nke na-ejikọ protein protein. Akụkụ kacha arụ ọrụ bụ akụrụ na eriri afọ na-arụ ọrụ n'ime awa 6.5.

Mgbe ị gachara Glucofage, mara adsorption nke Metmorphine GIT. A na-ekesasị akụkụ ahụ dị ike n’akpụ anụ ahụ niile ngwa ngwa. Ihe ka ọtụtụ na-apịpụta akụrụ, nke ọzọ gafere eriri afọ. Usoro nhicha ọgwụ na-ebido 6.5 awa mgbe ọ .ụsịrị ya. N'ime ndị ọrịa nwere nsogbu akụrụ, ọkara ndụ na-abawanye, nke na-abawanye n'ihe ize ndụ nke nchịkọta Metformin.

Ihe ngosi na contraindications

Dabere na ntuziaka dị na Glucofage, a na-egosi ya maka ndị ọrịa mamịrị ụdị 2, ndị buru oke ibu n'agbanyeghị usoro ọgwụgwọ nri.

Ọtụtụ ndị ọrịa na-eji Glucofage felata. N'okwu a, ịkwesịrị ịgbaso nri kalori dị ala ma mee mmega ahụ kwa ụbọchị. Nke a na - enyere gị aka ị nweta nsonaazụ mara mma na obere oge.

Dịka ọgwụ ọ bụla, glucophage nwere contraindications.

Amachibidoro ọgwụ a:

• ndị enweghị ndidi maka otu ihe mejupụtara,
• ya na ketoacidosis coma ma ọ bụ ọrịa mamịrị,
• na-arụ ọrụ akụrụ na obi na-adịghị mma
• ya na ọrịa ịba mba na-efe efe.
• ị simụ mmanya na-egbu egbu n'otu oge.
• na-egbu aru,
• n'oge ime na lact,
• ya na lactic acidosis,
• Daysbọchị 2 tupu ihe nkiri ahụ na ụbọchị 2 ka ọ gasịrị,
• Ndị nọ n'okpuru afọ 10
• mgbe oke arụsi ike.

Pnweta ọgwụ n’aka ndị agadi na-arụ ọrụ n’aka onye ọkachamara.

Ntụziaka maka ojiji

Obere nke mbido bụ 500 ma ọ bụ 850 mg, nke kewara n'ọtụtụ usoro. A na-ewere ọgwụ ma ọ bụ ozugbo nri. A na - eme mgbanwe n’usoro onunu ogwu a mgbe enwegwara shuga.

Usoro onunu ogwu kacha bu 3000 mg kwa ubochi, nke kewara na otutu ogwu (2-3). Jiri nwayọ tinye uche gị n’ihe na-arụ ọrụ n’ime ọbara na-abawanye, uru ole na ole na-esi n’ọkpụkpụ eriri afọ.

Mgbe ị na-ejikọ Glucofage Long na insulin, usoro a tụrụ aro ya bụ 500, 750, 850 mg ugboro abụọ n'ụbọchị. Ọ bụ dọkịta ga-edozi usoro nke insulin.

A na-eji mbadamba eme ihe na ngwakọta na ọgwụ ndị ọzọ, na iche. N'ọnọdụ ndị pụrụ iche, a na-anabata nnabata malite n'afọ iri. Dabere na usoro ọgwụgwọ nke dọkịta ka o nyere banyere ntinye shuga ọbara. Nke kacha nta bụ 500 mg, nke kachasị bụ 2000 mg.

Ndị Ọrịa na Nduzi Pụrụ Iche

Tupu ị usingụọ ọgwụ, ị ga-agwarịrị dọkịta, mụọ banyere nsonaazụ yana ịmara ndụmọdụ ndị ọrịa maka ndị otu pụrụ iche:

1. Oge ime. Ekwenyeghị nnabata Glucophage n'oge ịmụrụ nwa na ebe a na-enye nwa ara. A na-edozi glucose ọbara site na ịbanye insulin. Iwu amachibido ọgwụ n’oge a na-enye nwa ara bụ n’ihi enweghị nyocha.
2. Umuaka. Ojiji nke umuaka na-erughi afo iri na asatọ iji glucophage. Nwere eziokwu nke ị theụ ọgwụ site na ụmụ 10 afọ. Njikwa dọkịta nwere ike.
3. Ndị okenye. Iji nlezianya, ịkwesịrị ị theụ ọgwụ maka ndị agadi na-arịa ọrịa akụrụ na obi. Ọkachamara ga-enyocha usoro ọgwụgwọ ya.

N'ime ọrịa ma ọ bụ ọnọdụ ụfọdụ, a na-eji ọgwụ akpachara anya ma ọ bụ kagbuo ọgwụ a:

1. Lactic acidosis. Mgbe ufodu, n'iji Metformin, nke ejikọtara ya na ọnụnọ nke ọdịda akwara na onye ọrịa. Ọrịa a na –ekwe n’uche akwara, mgbu n’afọ na hypoxia. Ọ bụrụ na a na-enyo oria, iwepu ọgwụ na ịgwọ ndị ọkachamara dị mkpa.
2. Ọrịa akụrụ. N'ọnọdụ arụ ọrụ ezumike mkpirikpi, ekwesịrị ịkpachara anya, ebe ọ bụ na ahụ na-eburu ibu nile nke iwepu Metformin n'ahụ ahụ. Ya mere, tupu ịmalite ị theụ ọgwụ, ekwesịrị ị attentiona ntị na ọkwa nke creatinine n'ọbara ọbara.
3. Gerywa ahụ. Erere ogwu kwusi ubochi abuo tupu aru oru ya. Ntinye nke ọgwụgwọ amalite mgbe otu oge ahụ.

Obes takingụ ọgwụ ọụụ gabigara ókè na-enyere ụdị ndị ọrịa mamịrị 2 aka ibido ibu ha. N'aka nke onye ọrịa ahụ, a ga-achọrọ nnabata nri siri ike na ọnụ ọgụgụ kalori kwesịrị ịdịkarịa ala 1000 kcal kwa ụbọchị. Nnyefe nke ulo nyocha ga-enyere gi aka inyocha onodu aru na odi nma nke glucophage.

Mmetụta akụkụ na ị andụbiga mmanya ókè

Ndepụta nsonaazụ ndị ọzọ site n'ị fromụ ọgwụ ahụ sitere n'ọtụtụ ọmụmụ ọgwụ na nyocha ndị ọrịa:

1. Mbelata vitamin B12 na-ebute mmepe nke ọrịa dịka anaemia na lactic acidosis.
2. Gbanwee na uto uto.
3. Site na eriri afọ, afọ ọsịsa, mgbu afọ, na agụụ. Omume na-egosi na egosiputara akara akparamagwa akọwapụtara n'ọtụtụ ndị ọrịa ma gafere n'ime ụbọchị ole na ole.
4. Dika mmeghachi omume nfụkasị, urticaria ga-ekwe omume.
5. Mmebi nke usoro metabolic nwere ike ibute ọnọdụ ndị a na-atụghị anya ya, n'ihi nke akagbuo mbadamba ngwa ngwa ga-ekwe omume.

Njikọ Ọgwụ na Analogs

Mmetụta hyperglycemic nke Danazol na-eme ka ọ ghara ikwe omume ijikọta ya na Glucofage. Ọ bụrụ n’enweghi ike iwepu ọgwụ, doti ka dozie dokita.

Ihe tinctures nwere mmanya na-abawanye n'ihe ize ndụ nke lactic acidosis.

Nnukwu ọgwụ chlorpromazine (ihe karịrị 100 mg / ụbọchị) nwere ike ịbawanye glycemia ma belata ọkwa nke mwepụta insulin. Imezi nguputa nke ndi dibia.

Njikwa nlekọta nke ihe ndị na - adị n'ọrịa na - abawanye ohere nke lactic acidosis. Amachibidoro iji Glucofage jiri ọkwa creatinine erughị 60 ml / min.

Ọgwụ Iodine a na-eji fluoroscopy na ndị ọrịa nwere nsogbu akụrụ na-akpata lactic acidosis. Yabụ, mgbe inyocha x-ray onye ọrịa, nhichapụ mbadamba ihe dị mkpa.

Mmetụta hypoglycemic nke ọgwụ a na-eme ka ọ nwee ume site na sulfonylurea, insulin, salicylates, acarbose.

Site na analogs bu ogwu ndi kwesiri iji dochie oria ogwu, a ka ekwenyero iji ha na dibia bekee.

1. Bagomet. Ezubere maka ndị ọrịa nwere ọrịa shuga 2 nke nwere oke ibu. Ejiri ya na monotherapy yana yana insulin.
2. Glycometer. Ọgwụ maka ndị ọrịa mamịrị 2 nwere oke ibu. Enwere ike iji ya maka ụdị ọrịa shuga 1 na insulin.
3. Dianormet. Na-enyere aka ịdị na-ahụ ọkwa nke hormone, karịsịa maka ndị ọrịa nwere metabolism ike abụba.

Analogues ndị a bụ ndị achọ ma bụrụ ndị a ma ama n'etiti ndị ọrịa mamịrị 2.

Mlọ ọgwụ

N'otu oge ahụ mmadụ, ihe ndị na-arụ ọrụ nke Glucofage na-eme ka mkpụrụ ndụ dịkwuo elu na insulin, nke a na-ebelata n'ihi ọnụnọ nke ụdị ọrịa shuga 2 nke ọrịa mellitus. Ọrịa glucose na-amalite ịmịkọrọ gị akwara ndị ọzọ na akwara ndị ọzọ, ọkwa ya na ọbara na-agbadakwa. N'otu oge ahụ, nrụpụta ya na imeju na ịmịkọrọ na eriri afọ (GIT) na-ebelata. N'otu oge, metformin adịghị etinye aka na metabolism ma na-ewepụta ya site na akụrụ ya awa isii ruo asatọ mgbe ịrechara mbadamba nkume ndị ahụ.

N'agbanyeghị ọbara shuga, ọgwụ ahụ na-enyere aka ịba ụba metabolism, na-ebelata ịta nke triglycerides, lipoproteins na cholesterol. N'otu oge ahụ, a na-egbochi gluconeogenesis na glycogenolysis, nke na-eduga n'ọganihu na ọdịmma onye ọrịa. Mmetụta kasịnụ mgbe ewere Glucofage na-apụta awa abụọ ruo asaa mgbe nchịkwa ọnụ gasịrị, dabere n'ụdị mbadamba e ji mee ihe. N’oge a, ihe ndị mejupụtara ọgwụ ahụ nwere oge ị ga-eji banye n’ime nri, yana bioavailability ha, dịka iwu, karịrị 50-60%.

Leasedị ntọhapụ, ihe mejupụtara na ọnọdụ nchekwa

Ruo ugbu a, ọgwụ ahụ dị n'ụdị mbadamba abụọ: Glucophage na Glucophage XR. Ihe nke abuo di iche na nke mbu site na iwepu ihe ndi ozo n’oru oru, yabụ ihe ha na eme ga - emecha. A na-ere mbadamba ihe akara XR na ụlọ ahịa ọgwụ na ngwugwu iri atọ ma ọ bụ iri isii.

A na-enye ndị ahịa ihe dị ka, glucophage na-adịteghị aka, na ngwugwu nwere mbadamba ụrọ iri atọ na isii. Ọ dị na ụdị atọ: Glucofage 500, Glucofage 850 na Glucofage 1000. N'ihi ya, mbadamba nke ọ bụla, dabere na ntinye akara, nwere 500, 850 ma ọ bụ 1000 milligram nke ihe na-arụ ọrụ - metformin hydrochloride. N'otu oge ahụ, ọdịnaya nke ihe mejupụtara a na mbadamba XR bụ nke a kapịrị ma bụrụ nde 500.

Dịka ntuziaka maka iji ọgwụ a, ekwesịrị idobe ya na nkụ, gbara ọchịchịrị na-enweghị okpomọkụ karịa ogo 25 Celsius. Shouldmụaka ekwesịghị ịbanye na mbadamba nkume, n'ihi na ọgwụ a nwere ike imerụ ahụike mmadụ ma ọ bụrụ na ejiri ya na-ekwesịghị ekwesị. Ndụ nchekwa nke Glucophage 1000 na XR bụ afọ atọ, yana Glucofage 500 na 850 bụ afọ ise.

Ofzọ eji ọgwụ eme ihe

Egosiputara Glucophage ka o jiri site n’aka ndi oria na-arịa oria abuo mellitus. N'ime ụdị ọrịa a, a na-emepụta insulin zuru oke n'ahụ ahụ mmadụ, mana glucose na-ebugharị ya na akụkụ ahụ yana anụ ahụ adịghị anabata ya nke ọma. Nke a bụ n'ihi adịghị ike nke ndị na-anabata ihe ndị dị n’elu sel sel, n’ihi nke mkpụrụ ndụ na-amachaghị insulin ma gharakwa ịmekọrịta ya. Ọtụtụ mgbe, ụdị ọrịa shuga 2 nke ọrịa mellitus adịghị achọ ọgwụgwọ, usoro ọgwụgwọ na-agbadata naanị igbochi onye ọrịa na nri na mmega ahụ nkịtị. Ọ bụrụ na usoro ndị a enyereghị aka, a na-eji ọgwụ ndị dị ka Glucofage, nke a na-edekarị dị ka monotherapy. Otu esi esi tinye ụdị mbadamba nkume ndị dịnụ, kwesịrị ị ghọta ya nke ọma.

1) Glucophage nke ụkpụrụ eji enyere ndị ọrịa aka n'ụdị mbadamba nkume nwere 500, 850 ma ọ bụ 1000 milligram nke ihe na-arụ ọrụ, dabere na usoro ị na-eme kwa ụbọchị, nke dọkịta na-ahụ maka ịga. Ekwesịrị ịillsụ ọgwụ n’oge ma ọ bụ n’oge nri, n’ebighị mmiri ma drinkingụọ ya mmiri. Mmetụta ha na-apụta mgbe awa abụọ ma ọ bụ atọ na-adịgide ruo mgbe ọ bụla ọzọ. Thebọchị ọ bụla nke onye okenye bụ 1500-2550 milligrams ma gụnye ị were otu mbadamba ụtụtụ, ehihie na mgbede. N'okwu a, ịnweghị ike ị nweta ihe karịrị 3000 milligrams nke metformin kwa ụbọchị, ebe ego a bụ ogo kacha anabata.

Maka ụmụaka gbara afọ iri, bụ ndị akwadoro Glucofage maka ojiji, ọgwụ kachasị elu kwa ụbọchị bụ 2000 milligram nke ihe na-arụ ọrụ. Ọzọkwa, na mmalite usoro ọgwụgwọ, ọ gafere karịa millenia 850, emesia ọ na-abawanye kwa ụbọchị. Ọ bụrụ na nwatakịrị ahụ jiri insulin n'otu oge ahụ dị ka mbadamba nkume, a ga-agharịrị usoro ọgwụ nke ikpeazụ dabere na ọkwa shuga dị ugbu a.

A na-atụ aro ịrị elu nke nwayọ na dose maka ndị okenye. Na mbu, ọ nwere ike ịbụ 1000-1500 milligrams nke metformin kwa ụbọchị, ma wee nwayọ nwayọ karịa otu ọnwa. Ọ bụrụ n ’usoro nke glukos n’ọbara na-egosi ụkọ ya dị ukwuu, a ga-ebelata usoro a ga-enye ya, n’ụzọ megidere nke ahụ. Ma ndị agadi na ndị ọrịa na-arịa ọrịa akụrụ, maka ha kwa ụbọchị ọgwụ a na-agbakọ naanị otu mgbe ha gafesịrị nchọpụta ziri ezi.

2) Glucophage XR agbatịwuru ogologo oge iji rụọ ọrụ dabere na usoro dị ka Glucophage nkịtị. Ihe dị iche na ebe mbụ bụ mkpa ị were mbadamba ọ bụghị atọ, mana otu ugboro ma ọ bụ ugboro abụọ n'ụbọchị, nsonaazụ mgbe ị theụsịrị ọgwụ ahụ na-apụta awa isii ruo asaa mgbe ị takingụsịrị ya, nke na-enye gị ohere iji ya ugboro ugboro. Dịka iwu, na mmalite nke usoro ọgwụgwọ, onye ọrịa ahụ kwesịrị iwere otu mbadamba ụbọchị kwa ụbọchị, nke nwere 500 milligrams nke metformin. Na-esote, a na-agbanwe usoro ogwu ahụ dabere na mgbanwe na foto a. A na-abawanye kwa ụbọchị kwa ụbọchị karịa izu abụọ. Ma ọ bụghị ya, enwere ike ịbelata ọkwa glucose ọbara, nke onye ọrịa nwere ike ịmaghị, na-etinye ahụ ike ya n'ihe egwu.

Dodoụbiga ihe ókè n'ihe banyere Glucophage na Glucophage XR nwere ike ibute nsonaazụ dị egwu. Onye ọrịa ahụ nwere ike ịmalitepụta lactic acidosis, chọrọ ụlọ ọgwụ ozugbo yana usoro ọgwụgwọ n'ụlọ ọgwụ. Iji wepu metformin na lactate n’ahụ, enwere ike ịchọ hemodialysis na ngwaahịa nlekọta ike. Ya mere, iji ọgwụ a kwesiri ịta ya nnukwu ọrụ, na-enweghị ịba ụba kwa ụbọchị na-enweghị ihe ọmụma dọkịta.

Mkparịta ụka ọgwụ ọjọọ

N'ihi ike nke Glucophage, a naghị akwado ya ka ịjikọta ya na ọgwụ na kemịkal dị iche iche. Anyị na-ekwu maka ndị ọrụ rediopaque iodine nwere: Danazole, Nifedipine, Chlorpromazine, glucocorticosteroids, ethanol, loop diuretics, beta2-adrenergic agonists, ọgwụ cationic na ACE inhibitors.

1) Iodine nwere rediopaque na-eji n’oge a na-achọpụta redio na-egbochi ojiji iji otu oge na Glucofage. Nchikota ha nwere ike iduga mmepe nke lactic acidosis n'ime onye ọrịa. Yabụ, nyocha nke ụdị okwu a ka edobere ya, ma ọ bụ n'oge omume ya, jụ ị theụ ọgwụ ahụ. Iji mee nke a, o zuru ezu ịkwụsị iburu mbadamba ụbọchị abụọ tupu usoro ahụ wee maliteghachi ya ụbọchị abụọ ka emechara ya.

2) Ethyl mmanya, nke bụ ihe ọ ofụ ofụ niile na-aba n'anya ma enwere ya na ụfọdụ ọgwụ, akwadoghị ka agwakọta ya na Glucofage. A kọwara nke a site na lactic acidosis, nke nwere ike ịmalite megide nzụlite mmanya. Nke a bụ eziokwu karịsịa maka ndị na-arịa ọrịa imeju, na-esokwa nri kalori na-eri ntakịrị nri.

3) Chlorpromazine na ọgwụgwọ nke hypoglycemia Glucofage kwesịrị iji ezigbo nlezianya mee ihe, ebe ọ na-abawanye shuga ọbara, na-ebelata ntọhapụ nke insulin. Nke kachasị, nke a metụtara nnukwu ọgwụ nke Chlorpromazine - ihe karịrị otu narị milligrams kwa ụbọchị. Ọ bụrụ na ọ gaghị ekwe omume ị itụ ya, onye ọrịa ahụ kwesịrị ịdị njikere maka eziokwu ahụ bụ́ na ọ ga-agbanye ọ̀tụ̀tụ̀ shuga ọbara ugboro ugboro iji zere iwe ọkụ hypoglycemia.

4) Nifedipine n'ozuzu ya anaghị emetụta usoro nke iji ọgwụ eme ihe, mana ọ nwere ike ịbawanye nnabata ya, yana, n'ihi ya, itinye uche kachasị. Ya mere, ka ị na-a thisụ ọgwụ a na - egbochi ọgwụ, ọnụ ọgụgụ Glucophage kwesịrị ịgbanwe site na ịkpọtụrụ dọkịta.

5) Dinazole na ọgwụ hypoglycemic nwere ike ịkpalite ịrị elu glucose ọbara, yabụ ị ga-ajụ iji ya n'oge usoro ọgwụgwọ. Ọ bụrụ na enweghị ike ịme nke a maka ebumnuche ụfọdụ, mgbanwe ga-eme ka usoro Glucofage kwa ụbọchị.

6) Glucocorticosteroids (GCS) na-abawanye ọkwa shuga n'ọbara ma, n'okpuru ọnọdụ ọjọọ, nwere ike ibute ketosis. N'ihi eziokwu ahụ bụ na ọgwụ ọgwụ ndị a na usoro na -ebelata nnabata glucose, ojiji ha n'otu oge na Glucofage chọrọ ịhazigharị kwa ụbọchị nke nke ikpeazụ.

7) Beta2-adrenergic agonists, gosipụtara maka iji ya dị ka injections, na-akpali beta2-adrenergic ndị na-anabata, na-amụba ịba ụba nke glucose na plasma ọbara. Nke a nwere ike ịchọ onye ọrịa ime ihe ndị ọzọ iji lụ ọgụ hyperglycemia, nke, dịka iwu, na-esite na mkpa itinye insulin n'ime ọbara oge niile.

8) A naghị atụ aro ka akwara loop na-arụ ọrụ n'otu oge na Glucofage, karịsịa na ọdịda nke ọdịda akụrụ. Nke a nwere ike ibute mmepe nke lactic acidosis na nsonaazụ niile na-esite na ya.

9) Ntinye maka ịchịkwa ọbara mgbali elu, nke dị n'ụdị nke ndị na - egbochi ACE, anaghị atụ aro maka iji ya mgbe ị na - ewere Glucofage. Ha belata shuga dị n’ọbara ma nwee ike bute ụkọ glucose na-esochi ụnwụ anụ ahụ.

10) Ndị ọrụ cationic, nke gụnyere Morphine, Quinine, Amiloride, Triamteren, wdg, nwere ike ịbanye na metformin, na-egbochi ịmịkọrọ ya. Yabụ, kwụsịrị iji ha mgbe ị na-a theụ ọgwụ ahụ.

Nsonaazụ

Ogologo oge ị ofụ ọgwụ ahụ nwere ike ibute ọtụtụ nsonaazụ ọjọọ, nke ekwesịrị ịkọ. Site na ntuziaka gọọmentị maka ọgwụ ahụ, ọ na-esochi na ọ nwere ike ị nweta nsonaazụ ndị a:

• Nri uto n'oge nri,
• nsogbu nri: afọ ọsịsa, ọgbụgbọ, mgbu afọ,
• lactic acidosis
• mmetọ nke vitamin B12 (nke kachasị mkpa maka anagaia megaloblastic)
• akpụkpọ anụ ahụ, redness, itching,
• ịba ọcha n'anya (na-anọkarị n'ihu ihe ndị na-akpata nkụda mmụọ).

Ọ dị mma ịmara na mgbaàmà kachasị na arụmọrụ ahụike bụ ndị a gụnyere n'ime ihe abụọ mbụ sitere na listi metụtara ya na nri digestion. Isi mmetụta ndị ọzọ dị n'elu na-eme na ndị ọrịa na-anaghị ahụkebe, n'ihe dị ka otu ụzọ n'ime ọtụtụ puku. Ọ ga-aba uru ịtinye na na ihe ịrịba ama mbụ nke ịba ụba nke ahụike mgbe ị theụsịrị ọgwụ ahụ, ị ​​kwesịrị ịkpọtụrụ dọkịta ozugbo iji zere nsogbu ndị ọ ga-ekwe omume.

Ntụziaka pụrụ iche

Na nyocha emere n’oge na-adịbeghị anya, achọpụtara na glucophage anaghị emetụta ahụike ụmụaka n’oge ntorobịa. Ka o sina dị, enweghị ike ịkpọ akụkụ a kpamkpam, ndị dọkịta anaghịkwa atụ aro iji ọgwụ ahụ mgbe ọ dị afọ iri ruo afọ iri na asatọ. Yabụ, na ọrịa akụrụngwa, a naghị ejikarị ngwa ọrụ a ma a na-ejikarịkwa analogues na-enweghị nchebe.

Elebara anya nke ọma na nsonaazụ na-adịghị mma nke ị takingụ ọgwụ ahụ ga-enye ndị mmadụ na-ata ahụhụ oke ibu n'ihi ọrịa nri. Ọtụtụ mgbe, ọgwụgwọ ha na-abawanye na nri siri ike, nke, site na ịdoụbiga oke ókè nke metformin, nwere ike ibute oke oke oke ọbara shuga. Otu a metụtara otu ogo ma ọ bụ ọzọ na ndị ọrịa ndị ọzọ nwere nchọpụta ụdị ọrịa shuga mellitus nke 2. N'ọnọdụ ha, a na-eji ọgwụ insulin eme ihe naanị dị ka ihe dị iche, ihe kachasị na-elekwasị anya bụ ịba ụba ọrụ mmega ahụ na ịkwụsịlata nri.

Glucophage naanị enweghị ike ịkpata hypoglycemia, mana yana ọgwụ ndị ọ bụla, nsogbu a na-aba ezigbo uru. Yabụ, n'ọnọdụ ọ bụla enweghị ike ijikọ ọgwụ ahụ n'enweghị onwe ya na ndị nwere iodine nwere radipaque ọgwụ na ọgwụ ndị ọzọ akọwapụtara na ntuziaka maka ojiji na ngalaba "mmekọrịta ọgwụ". A ga-ejikọrịrị dọkịta ọ bụla, ị ga - ejikwa ọgwụ ọ bụla mee ihe ọ bụla. In nwere ike iji ma ọ bụ enweghị ike iji ọgwụ ọgwụ akọwapụtara nke ọma kpọmkwem.

Mmechi

Glucophage bụ ọgwụ na-adịghị emerụ ahụ nke ukwuu mana ya onwe ya enweghị ike ime ka onyonye ọrịa ahụ na hyperglycemia. Ka o sina dị, yana ụzọ ndị ọzọ, ọ nwere ike ibute ahụike onye ọrịa ahụ. Ndepụta contraindications maka iji ya na ọnụọgụ nke nsonaazụ mmetụta dị ntakịrị, mana ụfọdụ n'ime ha dị oke njọ yana, na enweghị nchịkwa site na ọkachamara, nwere ike ibute ọrịa egwu karị. Yabụ, ịnwere ike iji ọgwụ a naanị nke aka gị na ihe egwu.

Echiche ndị ahịa

Site na nyocha ndị ọrịa, anyị nwere ike ikwubi na Glucofage dị mma maka ịgbazi shuga ọbara, agbanyeghị, ojiji naanị maka ịdị arọ adịghị mma, ebe ọ bụ na gọọmentị na-esokwa ọtụtụ mmetụta.

N’oge izizi anyị nụrụ banyere Glucofage n’aka nne nne anyị, onye nwere ụdị shuga nke abụọ, nke enweghị ike iweta shuga na ọgwụ ọ bụla. N'oge na-adịbeghị anya, ọkà mmụta ọgwụ endocrinologist nyere Glucophage ọgwụ ka ọ ofụọ ọgwụ mg 500 ugboro abụọ n'ụbọchị. N'ụzọ dị ịtụnanya, ọkwa shuga ji ọkara belata, ọ nweghị mmetụta dị n'akụkụ ọ bụla achọpụtara.

Ana m ewere glucophage n'oge na-adịbeghị anya. Na mbụ, enwere m ahụ obere ọrịa wee nwee ahụ erughị ala na afọ. Mgbe ihe dị ka izu abụọ gasị, ihe niile gawara. Ihe ndekọ shuga belatara site na 8.9 ruo 6.6. Usoro ọgwụgwọ m bụ 850 mg kwa ụbọchị. N'oge na-adịbeghị anya amalitere m ịcha ntutu, ikekwe nnukwu ọgwụ.

Galina, 42 afọ. Lipetsk

Ana m anabata Glucofage Long iji felata. A na-edozi usoro onunu ogwu site n'aka endocrinologist. Amalitere m na 750. Ana m eri oge niile, mana agụụ maka nri belatara. Amalitere m ịga mposi ọtụtụ mgbe. Emere m ihe dị ka enema enema.

A na-ewere Glucophage dị ka onye ọkachamara na-eduzi. Nke a bụ ọgwụ siri ike maka ụdị ndị ọrịa mamịrị 2, ọ bụghị ngwaahịa ịrelata ibu. Dọkịta gwara m nke a. Kemgbe ọtụtụ ọnwa, ana m ewere ya na 1000 mg kwa ụbọchị. Ọbara shuga dara ngwa ngwa, ma ya belata 2 n'arọ.

Alina, dị afọ 33, Moscow

Vidiyo si na Dr. Kovalkov banyere ọgwụ Glucofage:

Ọnụ ego nke glucophage na-adabere na usoro nke ihe arụ ọrụ yana ọnụ ọgụgụ mbadamba dị na ngwugwu ahụ.Ọnụ ego dị ala bụ 80 rubles., Oke kachasị bụ 300 rubles. Ọ dị mma ịmara na ụdị ihe dị iche a na-ahụ anya dị na ọnụahịa dabere na ọnọdụ nke ụlọ ọrụ ntinye, nkwekọrịta azụmahịa na ọnụ ọgụgụ nke ndị na-etiti.

Mmetụta akụkụ

Ọrịa metabolism na nri nri:
O siri ike: lactic acidosis (lee "Ntuziaka pụrụ iche"). Site n'iji metformin ruo ogologo oge, enwere ike ịhụbelata mmịpụta nke vitamin B12. Ọ bụrụ na achọpụtara ọbara ọgbụgba megaloblastic, enwere ike ịtụle ohere etiology dị otú a.

Mmebi nke usoro ụjọ ahụ:
Ọtụtụ mgbe: detụ nsogbu.

Ọrịa eriri afọ:
Ọtụtụ mgbe: ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, ọnya afọ na enweghị agụụ.
Ọtụtụ mgbe ha na-eme n'oge mmalite nke ọgwụgwọ ma n'ọtụtụ ọnọdụ na-agafe oge oge. Iji gbochie mgbaàmà, a na-atụ aro ka ị takeụọ metformin ugboro 2 ma ọ bụ ugboro atọ n'ụbọchị ma ọ bụ mgbe nri gasịrị. Mmụba na-eji nwayọọ nwayọọ nwere ike melite ndidi gastrointestinal.

Ọkpụkpụ sitere na anụ ahụ yana anụ ahụ dị n'okpuru ala:
Ọ dịkarịghị ala: mmeghachi omume anụ ahụ dịka erythema, pruritus, fash.

Nmebi nke imeju na ọnya biliary:
Ọ dịkarịsịrị ala: arụ ọrụ imeju na-arịa ya na ịba ọcha n'anya, mgbe ikpochapụ metformin, mmetụta ndị a na-achọghị na-apụ n'anya kpamkpam.

Ebuputara data, data banyere azụmaahịa, yana ọnwụnwa nleba anya a na-achịkwa na nwatakịrị dị afọ 10-16 na-egosi na nsonaazụ ụmụaka na ụmụaka bụ otu ụdị na ịdị nro na ndị ọrịa okenye.

Dodoụbiga ya ókè

Ọgwụgwọ: bụrụ na ihe ịrịba ama nke lactic acidosis, a ga-akwụsị ọgwụgwọ ya na ọgwụ ahụ ozugbo, a ga-ebugharị onye ọrịa ngwa ngwa n'ụlọ ọgwụ, ebe ọ kpebisiri ike ịta ụta nke lactate, a ga-akọwapụta nchoputa ya. Measurezọ kachasị dị irè iji wepu lactate na metformin n'ahụ ahụ bụ hemodialysis. A na-eme ọgwụgwọ Symptomatic.

Mmekọrịta na ọgwụ ndị ọzọ

Iodine nwere ihe na - enye rediopaque: na-emegide nzụlite gbasara akụrụngwa akụrụngwa na ndị ọrịa nwere ọria mamịrị, ọmụmụ ihe omumu nke rediotik nke na-eji iodine nwere ihe ndị na-akpata rediopaque nwere ike ime ka mmepe nke lactic acidosis. Ekwesịrị ịkagbu ọgwụgwọ na Glucofage ® dabere na ọrụ akụrụ 48 awa tupu ma ọ bụ n'oge nyocha X-ray site na iji waksị iodine nwere iodine ma ghara ịmalitegharia tupu oge 48, mgbe enyere ya, a bụrụrịrị na a matara na ọrụ na-ahụ maka ebugharị dị ka nke kwesịrị n'oge nyocha.

Mmanya na-egbu egbu: x intoụbiga mmanya ókè, ihe ize ndụ nke ịmalite ọrịa lactic acidosis na-abawanye, karịsịa n'ihe banyere:

• erighị ihe na-edozi, nri kalori dị ala,
• imeju imeju.

Mgbe ị na-a theụ ọgwụ ahụ, a ga-ezere mmanya na ọgwụ nwere ethanol.

Mgwakọta chọrọ ịkpachara anya

Danazole: Ekwesighi ka a na-akwado maka ịmegharị nke Danazol iji zere mmetụta hyperglycemic nke ikpeazụ. Ọ bụrụ n’ịgwọ ọrịa na Danazol dị mkpa ma kwụsịchaa nke abụọ, a ga-achọ ndozi nke ọgwụ Glucofage ® n'okpuru njikwa nke glucose n'ọbara.

Chlorpromazine: mgbe ewere ya na nnukwu doses (100 mg kwa ụbọchị) na-eme ka nchịkọta glucose dị n'ọbara, na-ebelata ntọhapụ nke insulin. Na ọgwụgwọ nke ọgwụ mgbochi na mgbe ịkwụsị nke abụọ, a chọrọ idozi dose n'okpuru njikwa glucose ọbara.

Glucocorticosteroids (GCS) mmetụta systemic na mmetụta mpaghara na-ebelata nnabata glucose, na-eme ka ịbawanye ụba nke glucose n'ọbara, mgbe ụfọdụ na-akpata ketosis. Na ọgwụgwọ nke corticosteroids na mgbe ịkwụsị ọgwụ ikpeazụ, achọrọ ịgbanwe ọgwụ nke Glucofage ® n'okpuru njikwa nke glucose n'ọbara.

Diuretics: n'otu oge iji "akaghị" diuretics nwere ike ibute mmepe nke lactic acidosis n'ihi ọdịda akụrụngwa arụ ọrụ nwere ike ime. Ekwesighi iji ọgwụ kọwaa Glucofage if ma ọ bụrụ na mgbapụta nke creatinine dị n'okpuru 60 ml / min.

Beta Injectable₂-adrenomimetik: mụbaa ịba uru glucose ọbara n'ihi mkpali beta₂-adrenoreceptors. N'okwu a, ịchịkwa mkpokọta glucose na ọbara dị mkpa. Ọ bụrụ na ọ dị mkpa, a na-atụ aro insulin.
N'iji oge nke ọgwụ ndị a dị n’elu, enwere ike ịchọ nlele glucose ọbara ugboro ugboro, ọkachasị na mbido ọgwụgwọ. Ọ bụrụ na ọ dị mkpa, enwere ike idozi ọnụọgụ nke metformin n'oge ọgwụgwọ yana mgbe ọ kwụsịrị.

Ọgwụ antihypertensive, ewezuga angiotensin na - agbanwe enzyme inhibitors, nwere ike wedata glucose ọbara. Ọ bụrụ na ọ dị mkpa, ekwesịrị ịhazigharị ọgwụ nke metformin.

Site n'otu oge iji ọgwụ Glucofage drug s Ngwurugwu sulfonylurea, insulin, acarbose, salicylates hypoglycemia nwere ike ịmalite.

Nifedipine na-abawanye mgbakwụnye na max nke metformin.

Ọgwụ cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim na vancomycin) zoro ezo na tionles renal na-asọ mpi na metformin maka usoro ụgbọ njem tubular ma nwee ike ibute mmụba na C max.

Emeputa

Ma ọ bụ n'ihe banyere ịkwakọ ọgwụ LLC Nanolek:

Emeputa
Mmepụta nke ụdị usoro ị nweta akara na nkwakọ ngwaahịa (nkwakọ ngwaahịa bụ isi)
Merck Sante SAAS, France
Centre de Producion Semois, 2 rue du Pressoire Ver - 45400 Semois, France

Secondary (nkwakọ ngwaahịa ndị ahịa) na iwepụta njikwa mara mma:
Nanolek LLC, Russia
612079, Kirov mpaghara, Orichevsky district, obodo Levintsy, Biomedical complex "NANOLEK"

Emeputa
Usoro niile nke mmepụta, gụnyere iwepụta njikwa njikwa:
Merck S. L., Spain
Polygon Merck, 08100 Mollet Del Valles, Barcelona, ​​Spain.

Ekwesịrị izipu ndị na-ere ahịa na:
LLC "Merk"
115054 Moscow, St. Gross, nke 35.