Ngwakọta ọgwụ hypoglycemic Avandamet

na pịrị apị 14 p.., n'ime mkpọ kaadiboodu 1, 2, 4 ma ọ bụ 8 blisters.

na pịrị apị 14 p.., n'ime mkpọ kaadiboodu 1, 2, 4 ma ọ bụ 8 blisters.

* Enweghị aha aha mba ụwa nke WHO tụrụ aro ya; na Russian Federation, anabata mkpoputa aha mba ụwa - rosiglitazone.

Mlọ ọgwụ

Ngwakọta ọgwụ hypoglycemic ejikọtara ọnụ maka iji ọnụ mee ihe. Avandamet nwere ihe abụọ na-arụ ọrụ na-arụ ọrụ na mmeju usoro iji mee ka njikwa glycemic na ndị ọrịa nwere ụdị shuga 2: rosiglitazone maleate, klas thiazolidinedione, na metformin hydrochloride, onye nnọchite klas biguanide. Usoro nke thiazolidinediones gụnyere tumadi n'ịbawanye ụba nke akwara anụ ahụ na insulin, ebe biguanides na-arụ ọrụ kachasị site na ibelata mmepụta glucose endogenous na imeju.

Rosiglitazone - ihe nhọta nuklia PPAR agonist_sγ(onye na - eme mkpọtụ peroxisomalmetụtara ọgwụ hypoglycemic sitere na otu nke thiazolidinediones. Ọ na - eme ka nchịkwa glycemic dịkwuo elu site na ịbawanye ụba insulin na akwara ndị dị mkpa dịka anụ ahụ adipose, akwara ọkpụkpụ, na umeji.

A maara na nguzogide insulin na-arụ ọrụ dị mkpa na pathogenesis nke ọrịa shuga nke 2. Rosiglitazone na-eme ka njikwa metabolic dị ala site na iwetulata glucose ọbara, na-ekesa insulin na abụba abụba n'efu.

E gosipụtara ọrụ hypoglycemic nke rosiglitazone na nyocha nnwale banyere ụdị nke ụdị ọrịa shuga 2 nke ọrịa anụmanụ. Rosiglitazone na-ejigide ọrụ nke mkpụrụ ndụ-mkpụrụ ndụ, dịka egosiri site na mmụba nke oke agwaetiti nke Langerhans nke pancreas na mmụba nke insulin ha, na - egbochikwa mmepe nke hyperglycemia siri ike. Achọputara ya na rosiglitazone belatara osooso mmepe nke akwara izugbe na obara mgbali systolic. Rosiglitazone anaghị akpali mmiri ọgwụ insulin site na pancreas ma ọ dịghị ebute oke hypoglycemia na oke na ụmụ oke.

Mmelite njikwa glycemic na-esonyere mgbada dị ukwuu nke ịba ụba insulin insulin. Ọkpụkpọ nke ndị na - eme insulin, nke ekwenyere na ọ bụ ihe nwere ike ibute ọrịa obi, na-ebelata. Otu n'ime nsonaazụ kachasị nke ọgwụgwọ na rosiglitazone bụ mbelata dị ukwuu na ịta nke acids abụba n'efu.

Metformin bụ onye nnọchi anya klas nke biguanides, nke na-eme ihe kachasị site na mbenweta mmepụta glucose endogenous na imeju. Metformin belata ma basal na postprandial plasma glucose. Ọ naghị akpali insulin n'ahụ ya mere ọ naghị ebute hypoglycemia. E nwere ụzọ atọ enwere ike isi mepụta metformin: mbelata nke mmepụta glucose n'ime imeju site na mgbochi nke gluconeogenesis na glycogenolysis, mmụba nke uru anụ ahụ na insulin, mmụba nke oriri na ojiji nke glucose site na akwara akụkụ, yana igbu oge na ntinye nke glucose site na eriri afọ.

Metformin na - akpali intracellular glycogen synthesis site na ịgbalite enzyme glycogen synthetase. Ọ na - eme ka ọrụ ọ bụla na - ebugharị ebugharị glucose dị iche iche. N'ime ụmụ mmadụ, n'agbanyeghị mmetụta ọ na-arịa glycemia, metformin na-eme ka metabolism dị nwayọ na-edozi ahụ. Mgbe ị na-eji metformin na usoro ọgwụgwọ agwọ ọrịa na ọkara na ogologo oge ule, ọ gosipụtara na metformin na-ebelata oke nchịkọta cholesterol, LDL cholesterol na triglycerides.

N'ihi usoro dị iche iche ma jikọtara ọnụ iji mee ihe, ngwakọta ọgwụgwọ na rosiglitazone na metformin na-eduga na mmezi mmekọrịta na njikwa glycemic na ndị ọrịa nwere ụdị shuga 2.

Leasedị mwepụta, ihe mejupụtara na nkwakọ

INN nke avandamet, nke a nabatara na Russian Federation na nkwanye nke WHO, bụ rosiglitazone.

Ihe ndekọ State na-egosi nhazi nke ngwugwu kaadi ọgwụ ọgwụ ahụ dabere na LSR-000079 nke ụbọchị 05/29/2007:

• 1 ọnya - 14 mbadamba ihe mkpuchi fim,
• Nkwakọ kaadiboodu - 1, 2, 4 ma ọ bụ 8 efere,
• Metformin hydrochloride 500 mg / tab.,
• Ọnụ ego nke rosiglitazone bụ 1 ma ọ bụ 2 mg / tab. (egosiri na nkwakọ ngwaahịa)
• N'ime ihe ndị na-enyere aka: magnesium stearate, MCC, hypromellose 3cP, povidone 29 - 32, lactose monohydrate, MCC, hycromellose 3cP na stachi carboxymethyl,
• Ihe eji acha odo odo: Opadry I odo oxide oxide, macrogol 400, titanium dioxide, hypromellose 6cP (na mbadamba rosiglitazone 1 mg / tab.),
• Ihe mkpuchi pink: Opadry I red iron oxide, macrogol 400, titanium dioxide, hypromellose 6cP.

Dabere na mpaghara, ebe na usoro iji nweta ọgwụ ahụ, ọnụahịa ya nwere ike ịdị iche na nke enyere ebe a. Na nkezi, ọnụ ahịa nkwakọ ngwaahịa nke Avandamet bụ mbadamba 56 ≥ 1,490 rubles.

Mlọ ọgwụ

Nnyocha nke Avandamet bioequivalence (4 mg / 500 mg) gosiri na akụkụ abụọ nke ọgwụ, rosiglitazone na metformin, bụ bioequurate na 4 mg rosiglitazone menate na mbadamba 500 mg metformin hydrochloride mgbe ejiri otu oge. Ọmụmụ ihe a gosipụtagoro oke nke onunu ogwu nke rosiglitazone na nchịkọta jikọtara 1 mg / 500 mg na 4 mg / 500 mg.

Nri adighi agbanwe AUC nke rosiglitazone na metformin. Agbanyeghị, ingestion na-eduga n'otu oge na-eduga na C_max rosiglitazone - 209 ng / ml ma e jiri ya tụnyere 270 ng / ml yana mbelata na C_max metformin - 762 ng / ml ma e jiri ya tụnyere 909 ng / ml, na mmụba na T_max rosiglitazone - awa 2.56 ma e jiri ya tụnyere awa 0.98 na metformin - awa 3.96 ma e jiri ya tụnyere awa 3.

Mgbe abatasịrị rosiglitazone na usoro nke 4 mg ma ọ bụ 8 mg, bioavailability zuru oke nke rosiglitazone bụ ihe dịka 99%. C_max A na - enweta rosiglitazone ihe dị ka otu awa mgbe ịbasịchara. N'ime usoro ọgwụgwọ ọgwụgwọ rosiglitazone nwere pesma nke ihe rosiglitazone bụ ihe ruru ka ọ hà.

Were rosiglitazone na nri anaghị agbanwe AUC, mana e jiri ya tụnyere ibu ọnụ, enwere ntakịrị mbelata na C_max (odika 20-28%) na mmụba na T_max (1,75 h).

Ngbanwe ndị a dị obere enweghị ọgwụgwọ, yabụ, enwere ike ibute rosiglitazone n'agbanyeghị agbanye nri. Mmụba nke pH nke ihe ndị dị n’ime afọ anaghị emetụta oriri nke rosiglitazone.

Mgbe nchịkwa ọnụ nke metformin T_max bụ ihe dị ka awa 2.5, na usoro ọgwụgwọ nke 500 ma ọ bụ 850 mg, bioavailability zuru oke na ndị nwere ahụike bụ ihe dịka 50-60%. Ibepu nke metformin bu ihe anaghari na ezughi oke. Mgbe ọ nwesịrị nchịkwa ọnụ, mkpụrụ irighiri akwara ndị a chọtara na feces bụ 20-30% nke ọgwụ.

A na-eche na nnabata nke metformin abụghị nkewa. Mgbe ị na-eji metformin mee ihe na usoro ọgwụgwọ oge mbụ yana usoro ọgwụgwọ oge mbụ_SS na plasma ruru n'ime awa iri abụọ na anọ na iri na anọ na iri anọ na anọ ọ bụ dịka iwu, erughi 1 /g / ml. N’ime ule ụlọ ọgwụ a na-achịkwa, C_max metformin anaghị agafe 4 μg / ml, ọbụlagodi mgbe nchịkwa dịkarịrị.

Eating eatingụ nri ọnụ n'otu oge na-ebelata mmịnye nke metformin ma belata ogo nke mmụba. Mgbe nchịkwa ọnụ nke metformin na dose nke 850 mg mgbe ị na-eri ya_max belata 40% na AUC site na 25%, T_max na-abawanye site na 35 min. Amabeghị ịdị mkpa ụlọ ọrụ nke mgbanwe ndị a.

Olu nke rosiglitazone dị ihe dịka 14 l, mkpokọta plasma Cl bụ ihe dịka 3 l / h. Ogosi oke nke ijikọ protein protein - ihe dị ka 99.8% - esiteghi na ntinye uche na afọ onye ọrịa. Ka ọ dị ugbu a, enweghị data na rosiglitazone na-atụghị anya ya mgbe ewere ya 1-2 ugboro n'ụbọchị.

Ejikọtara ọnụ nke metformin na protein plasma. Metformin banye n’ime sel ọbara. C_max ọbara dị ala karịa C_max na plasma ma erute ihe dị ka n'otu oge ahụ. Mkpụrụ ndụ ọbara uhie yikarịrị ka ọ bụ mpaghara nkesa nke abụọ.

Ogologo oke nkesa dị n’agbata lita 63 na 276.

A na-eme ka ọ bụrụ metabolism kpụ ọkụ n'ọnụ, nke apụrụ n'ụdị metabolites. Metabolzọ metabolic bụ isi bụ N-demethylation na hydroxylation, nke na-esochi ya na sọlfọ na acid glucu. Metabolites nke rosiglitazone enweghị ọrụ ọgwụ.

Nchoputa in vitro gosipụtara na rosiglitazone bụ metabolized nke kachasị site na isoenzyme CYP2C8 yana ruo ntakịrị ala site na isoenzyme CYP2C9.

Na ọnọdụ in vitro rosiglitazone enweghị mmetụta mgbochi inhibitory dị ukwuu na isoenzymes CYP1A2, CYP2A6, CYP2C19, CYP2D6, CYP2E1, CYP3A na CYP4A, ya mere, eleghi anya na na vivo ọ ga - abanye na mmekọrịta mmekọrịta metabolic dị egwu nke ọgwụ ọjọọ nke metenolized ndị a nke sistemụ cytochrome P450. Na vitro rosiglitazone na-egbochi obere CYP2C8 (IC₅₀ - 18 μmol) ma na - egbochi ike CYP2C9 (IC₅₀ - 50 μmol). Ihe omumu banyere rosiglitazone na warfarin na vivo gosipụtara na rosiglitazone anaghị eso ndị na-eji mkpụrụ osisi CYP2C9 emekọrịta ihe.

Metformin abụghị metabolized ma kpụrụ akụrụ na-agbanweghi agbanwe. Onweghi ihe metxtin metabolites n’ahụ mmadụ.

Mkpokọta plasma nke rosiglitazone bụ ihe dị ka 3 L / h, na T ikpeazụ ya_1/2 - ihe dịka awa 3-4. Ka ọ dị ugbu a, enweghị data na nchịkọta rosiglitazone na-atụghị anya ya mgbe ewere ya 1-2 ugboro n'ụbọchị. Ihe dị ka 2/3 nke rosiglitazone nke edere na-akụrụ aka akụrụ, ihe dị ka pacenti 25% na-apịpụta site na eriri afọ. Anaghị agbanwe rosiglitazone na mmamịrị ma ọ bụ feces. Ikpeazụ t_1/2 metabolites - ihe dị ka awa 130, nke na-egosi na excretion dị nwayọ. Na ntinye nke rosiglitazone ugboro ugboro, nchịkọta nke metabolites ya na plasma, ọkachasị isi metabolite (parahydroxysulfate), ịta nke, nke nwere ike ime, nwere ike ịbawanye ugboro ise, anaghị ewepụ.

Ọ na-ekewapụ onwe ya na akụrụ na-agbanweghi site na mkpocha na ịba ụba nke mkpụrụ ndụ. Renal Cl metformin - ihe karịrị 400 ml / min. Mgbe nchịkwa ọnụ gachara, T ikpeazụ_1/2 metformin - ihe dị ka awa 6.5

Pharmacokinetics n'ihe gbasara ọrịa

Enweghị ọdịiche dị mkpa dị na ọgwụ ọgwụ nke rosiglitazone dabere na okike na afọ.

Enweghị ọdịiche dị mkpa dị na pharmacokinetics nke rosiglitazone na ndị ọrịa nwere ọrụ gbasara akụrụngwa, yana ọrịa akwara.

N'ime ndị ọrịa nwere oke imeju na-arụ ọrụ ọfụma (Ahụike ụmụaka-Pugh B na C) C_max na AUC ji okpukpu abụọ dị elu karịa, nke bụ nsonaazụ nke ịba ụba na protein protein na ibelata rosiglitazone.

N'ime ndị ọrịa nwere ọrụ akwara nwere nsogbu, mkpochapụ akụrụ na-agbadata n'ike n'ike na mbelata creatinine ma, n'ihi ya, iwepụ ọkara ndụ na-abawanye, n'ihi nke a, ndọta plasma nke metformin na-abawanye.

Avandamet na-egosi

2dị ọrịa shuga abụọ:

- maka njikwa glycemic na arụmọrụ nke usoro ọgwụgwọ nri ma ọ bụ monotherapy nwere usoro thiazolidinedione ma ọ bụ metformin, ma ọ bụ na nkwakọrịta gara aga nwere thiazolidinedione na metformin (ọgwụgwọ ihe mejupụtara abụọ).

- maka njikwa glycemic yana njikọta usoro sulfonylurea (usoro ihe ọmụmụ atọ).

Ihe ngbanwe

hypersensitivity nke mmiri ọgwụ,

nkụchi obi (M - IV klaasị arụmọrụ dị ka nhazi ọkwa NYHA),

nnukwu ọrịa ma ọ bụ ọrịa na-adịghị ala ala na-eduga hypoxia anụ ahụ (dịka ọmụmaatụ obi ma ọ bụ akụkụ okuku ume, ndọkata myocardial infarction, ujo),

ahoụrụma, nnukwu mmanya na-egbu egbu,

Ọdịda akwara (serum creatinine> 135 μmol / L n’ime ụmụ nwoke na> 100 μmol / L n’ime ụmụ nwanyị na / ma ọ bụ Cl creatinine HDL na LDL, mgbanwe nke cholesterol / HDL agbanweghị.) Theba ụba n’arụ ahụ bụ nke a na-agbanye na ya ma ọ nwere ike jikọta ya na njigide mmiri na nchịkọta. Nnukwu anụ ahụ.

Site na sistemụ ụjọ Dizzinessọtụtụ mgbeọtụtụ mgbe Isi ọwụwaọtụtụ mgbe

Si na akuko obi Ọkpụkpụ obi / afọ imeọtụtụ mgbeọtụtụ mgbe Ischemia Myocardialọtụtụ mgbeọtụtụ mgbeọtụtụ mgbeọtụtụ mgbe A chọpụtara mmụba nke nkụda obi na mgbakwunye nke rosiglitazone na sulfonylurea ma ọ bụ ọgwụ dabere na insulin. Onu ogugu n’enyeghi anyi ohere imechi okwu ekwesighi banyere nmekorita nke ogwu a, mana oge ikpe di elu maka rosiglitazone 8 mg kwa ubochi ma e jiri ya mee ihe kwa ubochi nke 4 mg A na-ahụkarị ihe mgbaàmà nke ischemia myocardial mgbe a na-ahọpụta rosiglitazone nye ndị ọrịa na-enweta insulin. Ihe omuma banyere ikike nke rosiglitazone iji mee ka ihe ojoo nke ischemia myocardial ezughi oke. Ntughari nyocha nke tumadi ọnwụnwa nke obere ọgwụ na pilot, mana ọ bụghị iji ọgwụ atụnyere, na-egosi njikọ dị n'etiti ị roụ rosiglitazone na ihe ize ndụ nke ischemia myocardial. Ekwuputaghi data a site na omumu ihe omumu nke ogologo oge ya na ogwu ntuziaka (metformin na / ma obu sulfonylurea), na mmekọrịta di n’etiti rosiglitazone na nsogbu nke ischemia etolite. Achọpụtawo ihe egwu dị elu nke mmebi nsị mechemic myocardial na ndị ọrịa nọ n'oge ule n'ụlọ ọgwụ gbasara ọgwụ nitrate. A naghị akwado Rosiglitazone maka ndị ọrịa na-anata ọgwụgwọ nitrate.

Site na nri diges Nkpachi afọ (dị nro ma ọ bụ agafeghị oke)ọtụtụ mgbeọtụtụ mgbeọtụtụ mgbeọtụtụ mgbe

Site na usoro akwara Ọkpụkpụ ọkpọọtụtụ mgbe Myalgiaọtụtụ mgbe Kachasị akụkọ metụtara ogwe aka nke aka, aka na ukwu n’ime ụmụ nwanyị

Site na ahụ ya dum Uweọtụtụ mgbeọtụtụ mgbeỌtụtụ mgbeỌtụtụ mgbe Ire na-agbatị ruo obere oge, na-adaberekarị ya.

A kọọrọ mmeghachi omume ọjọọ ndị a na oge azụmaahịa.

Mmeghachi omume nfụkasị ahụ: ọ na-esikarị ike - mmeghachi omume anaphylactic.

Si usoro obi: Ọrịa ụbụrụ na - adịghị ala ala.

A nwetara nkwupụta banyere mmepe nke mmeghachi omume ọjọọ ndị a maka rosiglitazone, nke a na-eji dị ka monotherapy yana yana njikọ ndị hypoglycemic ndị ọzọ. A maara na ihe ọghọm nke ịmalite ọrịa obi na-arịwanye elu na ndị ọrịa nwere ọrịa shuga ma e jiri ya tụnyere ndị ọrịa na-arịa ọrịa shuga.

Site na nri digestive: A na-enwekarị akụkọ banyere ọrụ imeju na-arụ ọrụ, yana mmụba nke mkpokọta enzyme nke imeju, mana mmekọrịta dị n'etiti n'etiti ọgwụgwọ rosiglitazone na mmerụ imeju.

Mmeghachi omume nfụkasị ahụ: dịkarịsịrị ala - angioedema, urticaria, ihe ọnya afọ, itching.

Site n'akụkụ akụkụ ahụ akụkụ nke ọhụụ: oke ụkwara - ede asụsụ.

Ọnwụnwa na-adakarị na data na-azụ ahịa

Site na nri digestive: oge niile - mgbaàmà nke dyspeptik (ọgbụgbọ, vomiting, afọ ọsịsa, ọnya afọ, anorexia). Ọtụtụ na-etolite mgbe ị na-ede ọgwụ ahụ na oke doses na mmalite ọgwụgwọ, n'ọtụtụ oge na-agafe onwe ha. Otutu mgbe, ihe otite di onu.

Mmeghachi omume akpụkpọ anụ: o siri ike - erythema. Achọpụtara ya na ndị nwere ọrịa mmụọ ma na-adịkarị nwayọọ.

Ndị ọzọ: dịkarịsịrị ala - lactic acidosis, ụkọ vitamin B₁₂.

Mmekorita

Enwebeghị ọmụmụ pụrụ iche gbasara mmekọrịta nke Avandamet. Ihe omuma ndi di n'okpuru na egosiputa ihe omuma di na nmekorita nke ihe ndi mmadu na aru oru nke Avandamet (rosiglitazone na metformin).

Gemfibrozil (CYP2C8 inhibitor) na ọgwụ nke 600 mg 2 ugboro kwa ụbọchị mụbara C_SS Rosiglitazone ugboro abụọ. Mmụba dị otú ahụ na rosiglitazone nwere ihe jikọtara ya na ọghọm nke mmetụta dabere na dose, yabụ, site na iji Avandamet na ndị na-egbochi CYP2C8, enwere ike ịchọ mbelata rosiglitazone.

Ndị ọzọ na-egbochi CYP2C8 mere ka ntakịrị mmụba na sistemụ rosiglitazone.

Rifampicin (inducer nke CYP2C8) na ọgwụ nke 600 mg / ụbọchị belata uche nke rosiglitazone site na 65%. Ya mere, na ndị ọrịa na-anata ma rosiglitazone na ndị na - enyocha enzyme CYP2C8, ọ dị mkpa iji nlezianya nyochaa glucose ọbara ma gbanwee dose nke rosiglitazone ma ọ bụrụ na ọ dị mkpa.

Igha rosiglitazone ugboro ugboro na-abawanye C_max na AUC nke methotrexate site na 18% (90% CI: 11-26%) na 15% (90% CI: 8–23%), dị iche iche, ma e jiri ya tụnyere otu ọgwụ methotrexate na enweghị rosiglitazone.

N'ime usoro ọgwụgwọ ọgwụgwọ, rosiglitazone enweghị mmetụta ọfụma n'ụlọ ọgwụ na ọgwụ ọgwụ ọgwụ hypoglycemic ndị ọzọ a na-eji ọgwụ hypoglycemic mee ihe n'otu oge, gụnyere metformin, glibenclamide, glimepiride na acarbose.

E gosipụtara na rosiglitazone enweghị mmetụta dị ukwuu na-adakarị na ọgwụ ọgwụ nke S (-) - warfarin (mkpụrụ nke enzyme CYP2C9).

Rosiglitazone emetụtaghị ọgwụ ọgwụ na ọgwụ nke digoxin ma ọ bụ warfarin ma ọ bụ agbanwe ọrụ anticoagulant nke ikpeazụ ahụ.

Enweghi mmekorita di omimi banyere rosiglitazone na nifedipine ma obu mgbochi ogwu (nke mejuputara etinyl estradiol na norethisterone) na -eme oge, nke na-egosi na obere mmekorita nke rosiglitazone ya na ogwu nke ejikọtara ya na CYP3A4.

Na mmanya na-egbu egbu n'oge ọgwụgwọ na nchikota rosiglitazone + metformin, ihe ize ndụ nke lactic acidosis n'ihi metformin na-abawanye.

Ọgwụ cationic nke emere site na mkpụrụ ndụ ezinalụ zoro ezo (nke gụnyere cimetidine) nwere ike imekọrịta metformin, na-asọ mpi maka usoro izugbe mmụọ (ọ dị mkpa iji nlezianya nyochaa ọkwa glucose ọbara ma gbanwee ọgwụgwọ ma ọ bụrụ na ọ dị mkpa ka ị na-eji cationic ọgwụ wepụpụrụ ya site na mkpakọ kenkọlọ ọnụ).

Nlekọta intravenous nke nkwadebe radiopaque nwere iodine nwere ike ibute mmepe mmepe gbasara akụrụ, nke nwere ike ibute oke metformin na mmepe nke lactic acidosis (ekwesịrị ịgbanyụ metformin tupu ihe ngosi nka amalite, metformin nwere ike ịmaliteghari na erughi awa iri asatọ na asatọ mgbe a gbasịrị ya na ọfụma. nyochaghari ọrụ akụrụ).

Nkwadebe ndị chọrọ nlekọta ụfọdụ

GCS (usoro na maka ojiji mpaghara), β agonist₂-adrenoreceptors, diuretics nwere ike ibute ọrịa hyperglycemia, yabụ, ọ bụrụ na ọ dị mkpa, iji otu oge tinye ya na Avandamet chọrọ nlebara anya ugboro ugboro maka ịbawanye ọbara ọbara, ọkachasị na mbido ọgwụgwọ, ịchọrọ ịgbanwe mmezi nke Avandamet, gụnyere n'oge iwepụ ọgwụ.

Ndị na - egbochi ACE nwere ike belata glucose ọbara. Ọ bụrụ na ọ dị mkpa, otu oge iji ma ọ bụ ịkwụsị ọgwụ ọgwụ ahụ kwesịrị ịhazigharị ọnụọgụ nke Avandamet.

Usoro onunu ogwu na nhazi

N'ime. Edere ọgwụ ahụ maka ndị okenye.

A na-ahọpụta usoro usoro onunu ogwu ka esetịpụrụ iche.

Enwere ike ibute Avandamet n'agbanyeghị nri nri. Iwere Avandamet n'oge ma ọ bụ mgbe nri gachara, ọ na - ebelata usoro nri nri na - adịghị mma nke metformin kpatara.

Usoro akwadoro ịmalite maka ndị okenye nke nchikota rosiglitazone / metformin bụ 4 mg / 1000 mg. Ogo ubochi nke rosiglitazone / metformin nchikota nwere ike buruwanye ibu iji lekọta glycemic nke mmadu. O kwesiri ime ka ogwu a bulie nwayọ nwayọ rue karia - 8 mg nke rosiglitazone / 2000 mg nke metformin kwa ụbọchị.

Mmụba na-eji nwayọ nwayọ nwere ike ịkụda mmeghachi omume ndị na-achọghị site na usoro digestive (nke metformin kpatara ya). O kwesiri ime ka ogwu bulie ya na mmụba nke 4 mg / ụbọchị maka rosiglitazone na / ma ọ bụ 500 mg / ụbọchị maka metformin. Mmetụta ọgwụgwọ ọgwụgwọ mgbe emesigharịrị usoro nwere ike ọ gaghị adị maka izu isii maka rosiglitazone na 1-2 izu maka metformin.

Mgbe ị na-agbanwe site na ọgwụ ọgwụ hypoglycemic ndị ọzọ na nchikota rosiglitazone na metformin, ekwesịrị iburu n'uche ọrụ na oge nke ọgwụ ọgwụ ndị gara aga.

Mgbe ị na-agbanwe na rosiglitazone + metformin ọgwụ dị ka ọgwụ otu na ọgwụ Avandamet, usoro izizi nke nchikota rosiglitazone na metformin kwesịrị ịdabere na usoro nke rosiglitazone na metformin.

N'ime ndị ọrịa agadi, usoro izizi na usoro nke Avandamet kwesịrị idozi nke ọma, dịka enwere ike ịbelata ọrụ akụrụ. E kwesịrị imeghari ọ bụla na-adabere na ọrụ nke akụrụ, nke kwesịrị ilegide anya mgbe niile.

N'ime ndị ọrịa nwere obere ahụ ịba ọcha n'anya (klaasị A (isi isii ma ọ bụ ihe na-erughị ya) na ọkwa nwatakịrị-Pugh), a chọghị ndozi nke rosiglitazone. Ebe ọrụ imeju na - abaghị uru bụ otu n'ime ihe ndị dị ize ndụ maka lactic acidosis na ọgwụgwọ na metformin, a naghị akwado nkwonkwo rosiglitazone na metformin maka ndị ọrịa nwere ọrụ imeju.

N'ime ndị ọrịa na-anata Avandamet na mgbakwunye na sulfonylurea, ọgwụ mbụ nke rosiglitazone mgbe ị na-ewere Avandamet kwesịrị ịbụ 4 mg / ụbọchị. Shouldzụlite rosiglitazone na 8 mg / ụbọchị kwesịrị iji nlezianya nyocha mgbe ọ tụlechara ihe egwu nke mmeghachi omume ọjọọ metụtara njigide mmiri na ahụ.

Dodoụbiga ya ókè

Ugbua enweghi data banyere oke nke Avandamet. N'ime ọmụmụ ụlọ ọgwụ, ndị ọrụ afọ ofufo nabatara naanị usoro onunu ogwu rosiglitazone ruo 20 mg.

Ọrịa nnyefere nke metformin (ma ọ bụ ihe ndị na - akpata ihe ize ndụ maka lactic acidosis) nwere ike iduga mmepe mmepe nke lactic acidosis.

Ọgwụgwọ: lactic acidosis bụ ọnọdụ ahụike mberede ma chọọ ọgwụgwọ n'ụlọ ọgwụ. A na-atụ aro ịkwado ọgwụgwọ iji nyochaa ọnọdụ ụlọ ọgwụ onye ọrịa. Iji wepu lactate na metformin n’anụ ahụ, a ga-eji hemodialysis mee ya, agbanyeghị, a na - ewepụ hesịnalịs rosiglitazone (n'ihi ogo dị elu nke protein).

Ntụziaka pụrụ iche

Nchikota rosiglitazone + metformin, gụnyere Avandamet dị irè naanị mgbe ị na-ejigide insulin ọgwụ ọgwụ endogenous, yabụ ekwenyeghị ọgwụ ahụ maka ịgwọ ndị ọrịa nwere ọrịa shuga 1.

N'ihi mmụba insulin na-abawanye, ọgwụgwọ ya na nchikota rosiglitazone + metformin nọ na ụmụ nwanyị premenopausal nwere nkụ na insulin na-eguzogide (dịka ọmụmaatụ, ndị ọrịa nwere polycystic ovary syndrome) nwere ike ibute ịmaliteghachi nke ovulation. Ndị ọrịa dị otú ahụ nwere ike ịtụrụ ime. Womenmụ nwanyị premenopausal natara rosiglitazone n'oge ule ụlọ ọgwụ. A chọpụtara enweghị mgbanwe gbasara ahịrịa na nnwale ahụ, mana n'oge a na - elekọta ụmụ nwanyị nwere rosiglitazone, enweghị mmebi dị egwu, yana oge ụfọdụ. N'ihe banyere oge adịghị nsọ, a ga-enyocha ike nke inyocha Avandamet nke ọma.

N'ihi mkpokọ nke metformin na nsogbu ndị adịghị njọ, nnukwu nsogbu metabolic na - apụta - lactic acidosis - nke kachasị n'òtù ndị ọrịa nwere ọrịa mellitus nwere nnukwu ọrụ gbasara akụrụngwa. Tupu ịmalite ọgwụgwọ na metformin na, yabụ, njikọta nke rosiglitazone + metformin, ọ dị mkpa iji nyochaa ihe ndị dị ize ndụ maka lactic acidosis, dịka ọmụmaatụ, ọrịa mellitus na-achịkwa nke ọma, ketosis, ibu ọnụ ogologo oge, ị alcoholụbiga mmanya ókè, ọrụ imeju na-arụ ọrụ (gụnyere ọdịda imeju) na ihe ọ bụla. ọrịa na hypoxia anụ ahụ. Ọ bụrụ na echere lactic acidosis, a ga-akagbu Avandamet ma kwụọ onye ọrịa n'ụlọ ọgwụ ozugbo.

Enwere obere data na ọgwụgwọ nke ndị ọrịa nwere nnukwu akụrụ oke na rosiglitazone. Metformin nwere akụrụ na-apụ apụ, yabụ tupu ịmalite ọgwụgwọ na Avandamet ma na oge ụfọdụ, ọ dị mkpa iji chọpụta ntinye uche nke creatinine na ọbara. Ekwesịrị ị attentiona ntị na ndị ọrịa nwere nnukwu ihe ọghọm nke ịmalite ọrịa gbasara akwara, dịka ọmụmaatụ, ndị ọrịa agadi ma ọ bụ ndị ọrịa ndị ọnọdụ ha nwere ike ibute na mbelata ọrụ ezumike (akpịrị ịkpọ nkụ, ọrịa siri ike ma ọ bụ ujo). Ekwesighi ikwenye ndị ọrịa nwere ọghọm serinine creatinine> 135 μmol / L n'ime ụmụ nwoke ma ọ bụ> 110 μmol / L n'ime ụmụ nwanyị.

N’ime ndị ọrịa nwere nsogbu ịba ọcha n’anya (isi isii ma ọ bụ ihe na-erughị ya n’ihe ọ̀tụ̀tụ̀ Child-Pugh), onwa rosiglitazone adịghị mkpa belata. Agbanyeghị, na enyere ọrụ imeju ahụ bụ ihe dị ize ndụ maka mmepe nke lactic acidosis metụtara metformin, a naghị akwado nkwonkwo rosiglitazone na metformin maka ndị ọrịa nwere ọrụ imeju.

Nri nke thiazolidinedione, incl. rosiglitazone nwere ike ibute ma ọ bụ mee ka ọ daa njọ nke nkụchi obi na-adịghị ala ala. Mgbe ịmalite ọgwụgwọ na rosiglitazone na n'oge oge titration, ịlele ahụike ahụike nke ọnọdụ onye ọrịa dị mkpa na mgbaàmà ndị a na akara ndị na - esochi ike: oke ngwa ngwa oke ibu, mkpụmkpụ ume, edema. Site na mmepe nke akara nke nkụda mmụọ obi, ekwesịrị ichebara mbenata mbelata ma ọ bụ ịhapụ Avandamet na ịkọwa usoro ọgwụgwọ dịka usoro dị ugbu a maka ọgwụgwọ nke nkụda obi. A naghị akwado iji ngwakọta nke rosiglitazone + metformin na ndị ọrịa nwere ngosipụta ọgwụgwọ nke ọdịda obi. A na-egbochi ọgwụ a na ndị ọrịa nwere nkụda mmụọ I-IV na-arụ ọrụ dị ka nhazi ọkwa NYHA si dị.

Ndị ọrịa nwere nnukwu ọrịa obi na-arịa (ACS) esighi na ule nyocha. Ebe ọ bụ na mmepe nke ACS na-abawanye ohere nke nkụda obi, a naghị atụ aro iji rosiglitazone na ndị ọrịa nwere ACS. Ihe omuma banyere ikike nke rosiglitazone iji mee ka ihe ojoo nke ischemia myocardial ezughi oke. Ntughari nyocha nke tumadi ọnwụnwa nke obere ọgwụ na pilot, mana ọ bụghị iji ọgwụ atụnyere, na-egosi njikọ dị n'etiti ị roụ rosiglitazone na ihe ize ndụ nke ischemia myocardial. Ekwuputaghi data a site na omumu ihe omumu nke ogologo oge ya na ogwu ntuziaka (metformin na / ma obu sulfonylurea), na mmekọrịta di n’etiti rosiglitazone na nsogbu nke ischemia etolite. Achọpụtawo ihe egwu dị elu nke mmebi nsị mechemic myocardial na ndị ọrịa nọ n'oge ule n'ụlọ ọgwụ gbasara ọgwụ nitrate.

Enweghị data a pụrụ ịdabere na ya banyere ị ofụ ọgwụ ọgwụ hypoglycemic nke nje, gụnyere ìgwè osisi thiazolidinedione dị na steeti nnukwu arịa n’ime ndị ọrịa nwere ụdị ọrịa shuga mellitus nke 2.

A naghị akwado Rosiglitazone maka ndị ọrịa na-a therapyụ ọgwụ nitrate.

E nwere akụkọ dịkarịsịrị gbasara mmepe ma ọ bụ na-aka njọ ọrịa ụbụrụ na-arịa ọrịa shuga yana mbelata ọdịdị achoity. N'ime otu ndị ọrịa ahụ, a na-akọkarị mmepe mmepe edere. N'ọnọdụ ụfọdụ, a na-edozi mmebi iwu dị otú ahụ mgbe ịkwụsị ọrụ ọgwụgwọ. Ekwesiri iburu n'uche na enwere ike ịmalite ọrịa a ma ọ bụrụ na mkpesa ndị ọrịa na-ebelata ngwa ngwa na-ahụ anya.

Ndị ọrịa na-anata Avandamet na njikọta ihe atọ mejupụtara na sulfonylurea nwere ike nọrọ n'ihe ize ndụ nke ịmalite hypoglycemia na-adabere n'ihe ọmụmụ. May nwere ike ịchọ mbelata ọgwụ n’otu oge ị takingụ ọgwụ.

Metformin na, ya mere, a ga-akagbu Avandamet awa iri asatọ na asatọ tupu arụọ ọrụ ebubata ya na ọgwụ ga - ebidoghachi tupu oge awa 48 gachara.

Na / na ntinye nke iodine nwere ihe dị iche na ndị na - amụ x-ray nwere ike ịkpata ọdịda akụrụ. N'iburu nke a n'uche, Avandamet dị ka ọgwụ nwere metformin kwesịrị ka akagbuo tupu ma ọ bụ n'oge nyocha nke redio, wee nwee ike ịmaliteghachi ya naanị mgbe ekwenyechara ọrụ akụrụ.

N'ime ọmụmụ ogologo oge nke monotherapy maka ụdị ọrịa mellitus 2 dị n'ọrịa ndị ọrịa na-enwetabeghị ọgwụ hypoglycemic nke ọnụ, mmụba nke ugboro ugboro nke ụmụ nwanyị nọ na rosiglitazone (9.3%, ikpe 2.7 kwa afọ-100 ọrịa) ka a chọpụtara ma e jiri ya tụnyere ìgwè metformin ( 5.1%, ikpe 1.5 kwa afọ ọrịa 100) na glyburide / glibenclamide (3.5%, 1.3 ikpe na 100 afọ-ọrịa). Otutu ozi akukoputara n'usoro otu nke rosiglitazone bu nke nwere ogwe aka, aka na ukwu. Enwere ike ịtụle ihe ga - eme ka mmerụ ahụ dịkwuo mma mgbe a na - ede akwụkwọ rosiglitazone, ọkachasị ndị inyom. Ọ dị mkpa ileba anya na ọnọdụ anụ ahụ wee lekọta ahụ ike dịka ụkpụrụ ọgwụgwọ a nabatara.

Site na nhazi nke oge a nke CYP2C8 inhibitors ma ọ bụ inducers na ojiji nke ọgwụ cationic na-abụkarị nke zoro ezo gloalular secretion, nlebara anya nke glucose ọbara na mmezi nke rosiglitazone ma ọ bụ metformin chọrọ.

Iji Ọrịa edimụaka

Ka ọ dị ugbu a, enweghị data gbasara iji ọgwụ ahụ eme ihe na ụmụaka na ndị nọ n'afọ iri na asatọ, yabụ akwadoghị ị ofụ ọgwụ ahụ otu otu.

Mmetụta ikike ịkwọ ụgbọ ala na usoro nchịkwa

Rosiglitazone na metformin anaghị emetụta ikike ịkwọ ụgbọala na ịrụ ọrụ.

Omume ọgwụ

Avandamet - ọgwụ ejikọtara hypoglycemic, ka enyere ndị ọrịa maka nchịkwa ọnụ. Mbadamba ụrọ nke ọ bụla nwere ihe abụọ dị mkpa nke nwere mgbakwunye iji meziwanye njikwa glycemic nke ọrịa shuga na-enweghị insulin. A na-ahụta maleig Rosiglitazone dị ka thiazolidinedione, metformin hydrochloride bụ biguanides. Usoro nke usoro nke mbu sitere na ịbawanye ụba nke insulin nke anụ ahụ na-elekwasị anya, nke abụọ na-enyere aka belata mmepụta glucose endogenous na imeju.

Nhọrọ Nuclear PPAR Antagonist_sγ Rosiglitazone na - achịkwa insulin uche nke imeju, akwara ọkpụkpụ, anụ ahụ adipose. Na pathogenesis nke ụdị ọrịa shuga mellitus nke 2, nnabata insulin na-arụ ọrụ dị mkpa, akụkụ ahụ na-ebelata abụba abụba n'efu, insulin na glucose na-ekesa n'ime ọbara. Ọ na-emekwa ka metabolism dịkwuo mma.

Na ule anụmanụ, n'ụdị nke ọrịa shuga na-abụghị insulin, ọgwụ ahụ gosipụtara ọrụ hypoglycemic. N'ime usoro nyocha ahụ, edepụtara mmụba nke pancreas n'ihi mmụba nke oke agwaetiti nke Langerhans, ịdị ukwuu nke insulin mụbara, ma echekwa ọrụ β-cell.

Mgbada siri ike na-ebelata. Rosiglitazone belatara mmepe nke ọbara ọgbụgba akwara akwara akwara, dysfunction akụrụ. Na ụmụ oke, oke, insulin insulin na-emepụtaghị, anaghị eme ka ọdịda na ụkọ shuga. A na-eme ka nchịkwa glycemic dịkwuo elu site n'ịgbaso ọnụego insulin dị ukwuu na ntopute nke ọgwụ.

Akụkụ ọzọ nke ọgwụ - metformin - belata mmepụta nke glucose endogenous. Na-ebelata postprandial ya, basal ịta ahụ. Usoro ahụ anaghị akpata hypoglycemia, adịghị akpali mmepụta nke insulin. Mainzọ kachasị arụmọrụ:

• absorption nke dị mfe site na eriri afọ na-egbu oge,
• a na-amalite itinye glucose site na akwara anụ ahụ, uru ya na-abawanye, insulin uche nke uru ahụ na-abawanye,
• mgbochi nke glycogenolysis, gluconeogenesis. Avandamet mechara belata mmepụta glucose imeju.

Metformin na - eme ka enzyme glycogen synthetase site na intracellular glycogen synthesis. A na-emeziwanye arụmọrụ ndị na - ebu shuga dị iche iche. Akụkụ ahụ na-eme ka metabolism dị nwayọ n ’agbanyeghị nsonaazụ ọ bụla na nsonaazụ glucose dị n'ọbara. Dabere na nsonaazụ nke ọmụmụ ọgwụ, usoro ọgwụgwọ a nwere ntakịrị belata ọnụego triglycerides, cholesterol na LDL.

Ihe dị mkpa: iji njikọta nke ihe abụọ bụ isi na-arụ ọrụ nke avandamet na-eme ka nchịkwa glycemic na-emetụta ndị mmadụ na-arịa ọrịa shuga na-enweghị insulin.

Metabolism

Rosiglitazone na-etinye obi gị dum n'ọbara ma gbanwee ghọọ ihe bara uru nye ahụ, mgbe e mesịrị, metabolites na-ewepụ ihe ndị dị na ya. Hydroxylation, N-demethylation bụ ụzọ ndị bụ isi nke njigide mmiri na metabolism, ha na conjugation na glucuronic acid, sulfate na-esonyere ha. A na-ahụ metroolized site na CYP2C8 isoenzymes, na CYP2C9 dị obere.

Ihe mgbochi nke rosiglitazone emetụtaghị isoenzymes nke CYP4A, CYP3A, CYP2E1, CYP2D6, CYP2C19, CYP2A6, CYP1A2. Na CYP2C8 isoenzymes, mmachi dị mma, ya na CYP2C9, adịghị ike. Mmekọrịta nke ndị na-eji mkpụrụ osisi CYP2C9 anọghị.

A na-agbanwegharị Metformin n'ime ihe ndị ọzọ, a napụ ya site na ahụ site na akụrụ na-agbanweghi. Achọpụtaghị metabolites ọ bụla nke mpaghara a na ụmụ mmadụ.

Mwepu rosiglitazone bụ usoro dị ogologo nke ga-ewe awa 130, a na-ebu eriri afọ ya na oge ọnụọgụ, yana akụrụ na olu 2/3. Abughi na nri, ma obu mmamiri, ahutaghi ihe a. A na-ahụta mmụba na parahydroxy sulfate (isi metabolite nke ihe mejupụtara) na nchịkwa ugboro ugboro. A naghị agụba ụrọ na plasma.

Site na tubular secretion, glomerular filtration, akụrụngwa nke metformin na - apụtabeghị site na akụrụ. Usoro a na-ewe awa 6.5 na ọsọ nke ihe karịrị 400 ml kwa nkeji.

Maka ndi okenye

Endocrinologist na-ahọrọ usoro onunu ogwu na usoro ọgwụgwọ maka ndị ọrịa niile n'otu n'otu.

Avdị avandamet adịghị adabere na nri nri. Iji mbadamba ihe oriri ma ọ bụ ozugbo ọ belatara ohere nke mmeghachi omume na-adịghị mma site na eriri afọ.

A na-atụ aro nnabata avandamet ịmalite site na iji ọgwụ kwa ụbọchị nke 4 mg kwa 1000 mg. Ọnụ ego a nwere ike jiri nwayọ rute n'ọkwa 2000 mg nke rosiglitazone na 8 mg nke metformin (kachasị), mana nke a ga-eme naanị na njikwa ike nke usoro glycemia. Site n'ịbawanye nwayọ nwayọ, usoro nzọụkwụ, a na-ebelata mmeghachi omume na-adịghị mma site na eriri afọ. Nzọụkwụ kwa ụbọchị bụ 500 mg nke metformin na 4 mg nke rosiglitazone.

A na-ahụta ngosipụta nke ọgwụgwọ ọgwụgwọ mgbe ọ nwesịrị mmezi usoro onunu ogwu maka metformin na oge site na ụbọchị asaa ruo ụbọchị iri na anọ, maka rosiglitazone n'ime mkpụrụ ụbọchị iri anọ na isii.

Ihe dị mkpa: Ekwesịrị ịtụle oge ihe omume, ọrụ nke ọgwụ hypoglycemic nke a na-ebuburu ọnụ iji kwuo okwu mgbe ị na-agbanye Avandamet. Ngụkọta oge mbụ mgbe agamachịrị ihe omimi abụọ nke avandamet sitere na ego nke ihe emeburu.

Maka ndị agadi

N'ihi mbelata ọrụ gbasara akụrụngwa n'ụdị ndị a, a na-emezigharị usoro mbụ nke avandamet. Ekwesịrị ilebara ịdị mma nke ndị na-ala ezumike nka anya anya, ekwesịrị ilegide shuga ọbara mgbe niile. Ma dabere na ihe ndị egosipụtara nweta, dozie usoro nke avandamet.

N'ọnọdụ dị mfe ọrụ umeji

N'okwu a, a chọghị idozi dose na usoro nke rosiglitazone. Ọ bụrụ na sulfonylurea dị na usoro ọgwụgwọ, ọgwụ mbụ nke ihe mejupụtara ahụ ga-abụ 4 mg kwa ụbọchị. Ekwesịrị iji nlezianya mụbaa maka ihe a kwa ụbọchị iji nlezianya mee ya, mgbe nyochachara njigide mmiri na nyocha nke mmeghachi omume anụ ahụ dị.

Nsonaazụ

Ọ bụrụ na ihe abụọ a na-adịghị mma ga - eme ka ihe ọghọm dị na ya pụta nwere ike ịda. Akụkụ dị n'akụkụ:

• ihe nfụkasị: ≥0.1 - itching anụ ahụ, ihe ọnya, urticaria, angioedema, ≥ 0.0001 - 0.001 - mmeghachi omume anaphylactic,
• sistem: cardiovascular system: ≥ 0.0001 - 0.001 edema n’akwara, obi na-adighi ala,
• sistem nri: ≥ 0.0001 - 0.001 - arụ ọrụ imeju na-abawanye na mmụba nke enzyme, ≥ 0.1 maka metformin, anorexia, ọnya afọ, afọ ọsịsa, ọgbụgbọ, ọgbụgbọ, ≥ 0.01 - 0.1 sensọ ọnụ. ọla ncha
• akụkụ nke ọhụụ: ≥ 0.0001 - 0.001 - edema macular,
• akpụkpọ ahụ, akpụkpọ ahụ mucous: ≥ 0.0001 - 0.001 - erythema dị nro, nke a hụrụ na ndị ọrịa nwere hypersensitivity,
• Ndị ọzọ: ≥ 0.0001 - 0.001 - B ụkọ₁₂lactic acidosis.

Njikọ Ọgwụ Abandamet na ọgwụ ndị ọzọ

Enwebeghị ọmụmụ ọ bụla na okwu a. A na-eji ozi ahụ maka ihe ndị mejupụtara ya.

• CYP2C8 gemfibrozil inhibitor nwere ihe oriri okpukpu abụọ kwa ụbọchị na ngụkọta nke 600 mg okpukpu abụọ C_SS akụrụngwa. Nwere ike ịchọ mbelata ọgwụ
• CYP2C8 inducer rifampicin na ọgwụ kwa ụbọchị nke ruru 600 mg belata ego nke ihe ahụ site na 65%, nke chọrọ mgbanwe onunu ogwu ma ọ bụrụ na ọ dị mkpa na iji Avandamet, dabere na nsonaazụ nke iji nlezianya nyochaa shuga ọbara.
• mgbe ewere ya na acarbose, glimepiride, glibenclamide, metformin, warfarin, digoxin, norethisterone, ethinyl estradiol dị ka akụkụ nke ọgwụ mgbochi edere, nifedipine na pharmacodynamics, ọgwụ pharmacokinetics nke mmetụta dị ukwuu nke rosiglitazone emeghị.

• enwere ọghọm nke lactic acidosis na nsi mmanya na-egbu,
• ọgwụ cationic na-asọ mpịkọtara maka otu usoro ịtụgharị na Avandamet, nke chọrọ iji nlezianya tụọ ọnụọgụ ọbara,
• O di ocha, on agonist₂-adrenoreceptors, corticosteroids mpaghara na sistemụ na-akpasu hyperglycemia, nke chọrọ nleba anya ugboro ugboro na-egosi shuga na mbido ọgwụgwọ, na-agafe agafe - n'oge usoro ọgwụgwọ. Mgbe akagbuola ọgwụ ndi a, inyocha usoro onunu ogwu nke Avandamet nke ọgwụ a chọrọ,
• a na-agbanwe ọ̀gwụ nke ọgwụ ahụ mgbe ị na-akagbu ma ọ bụ na-egbochi ndị ACE na -ebelata ọkwa glucose ọbara.

Ime na lactation

Enweghi data zuru oke banyere nsonaazụ nke iji avandamet n'oge afọ ime. Onweghi ihe omuma banyere abanye n’ime ogwu ahu n’ime mmiri ara nke nwanyi ara.

A na-atụ aro ịhọpụta ọgwụ Avandamet n'oge a na-enye nwa ara ma ọ bụ ime ime naanị ma ọ bụrụ na ihe ize ndụ ahụ ike nwa ka ukwuu maka abamuru nke nne.

Tụnyere ihe analogues

Na ahịa ụlọ, n'etiti ọgwụ ndị yiri ya ka a na-ahụ na ire: Formin, Metformin-Richter, Metglib, Gliformin Prolong, Gliformin, Glimecomb. N'ime ọgwụ ndị si mba ọzọ enwere ihe dị ka iri atọ, Avandia, Avandaglim dabere na rosiglitazone, na nke ọzọ dabere na metformin.

Elena, 37 (Moscow)

Anọ m na-arịa ọrịa shuga 2 ruo afọ 4, anọwo m na Avandamet na ọkara na ọkara. Nke a bụ nanị ọgwụgwọ na-enyere m aka ịdị ka ọ̀tọju glucose dị ala. Site na shuga na mberede na shuga, ọ̀tụ̀tụ̀ ahụ mụbara. Ebe m na-enyocha glycemia mgbe niile, ọnọdụ m kara mma, ọbụna ndị na-arụ ọrụ n'ụlọ hụrụ ya. Naanị ihe ndọghachi azụ bụ ụgwọ ahụ.

Bogdan, 62 (Tver)

N’oge mbu ejim n’aka na emeela m agadi, n’ihi na ike gwụrụ m, ike agwụ m, ike gwụ m. Otu onye ọrụ nyere ndụmọdụ ọgwụ ahụ, kwuru na ha resịrị ya naanị ọgwụ ọgwụ. Banyere na nyocha ahụ, nke na-amasịghị m. Edere ọgwụ ahụ. Mgbe izu izizi ahụ gasị, nsogbu nke afọ na-amalite inye nsogbu, ọ bụrụgodị na esoro ntuziaka. Ha akwụsịbeghị ọnwa isii ugbu a. Mana nkwuputa nke ume, ihe di nkpa kwesiri ya, obuna oke onu ahia maka ogwu abughi ihe nwute, mmekorita odi nma karie.

Kristina, 26 (Voronezh)

Achọpụtara m na ọrịa shuga na-abụghị insulin ogologo oge, mana dọkịta ahụ mere ka m mata ọgwụ avandamet erughị otu afọ gara aga. Nke a zoputara m site na atụmanya nke ị insụ insulin. Onye ọ bụla nke na-eme ọgwụ ị willụ mmiri ga-aghọta ọdịiche dị n'etiti ọgwụgwọ ọgwụ ọgwụ yana nnwere onwe na injections.

Mmechi

Ọ bụ naanị dọkịta nwere ike ị whoụ ọgwụ ahụ wee nwee ike inyocha ọnọdụ onye ọrịa ahụ nke ọma, họrọ usoro ọgwụgwọ zuru oke, mee nhazi oge kwesịrị ekwesị na usoro ọgwụ. N'ihi nnukwu ihe dị ndụ nke ihe ndị mejupụtara ọgwụ ahụ, ọ dị ize ndụ iji ọgwụ onwe ya. Nke a nwere ike ibute nsonaazụ achọghị. Enyemaka na-enweghị enyemaka na-eyi mbibi ahụike nke onye ọrịa ahụ.

Usoro na ọnọdụ nchekwa

Shouldmụaka kwesịrị ịnwe ohere dị nta na ebe nchekwa ọgwụ. Ogwu a achoghi imeputa onodu nchekwa ya. A na-atụ aro T nchekwa 25 Celsius. Ejila ogwu ahu mgbe emechara ya, nke bu onwa iri n’ato. Ọ dị mkpa imepe mkpakọ ozugbo tupu ị takingụ ọgwụ n'ihi hygroscopicity nke ọgwụ. Zere ìhè anyanwụ. Ọgwụ a bụ nke otu ọgwụ ọgwụ sitere na ndị ahịa ọgwụ. Tupu iji ya, hụ na ị ga-agụ nkọwa ndị ọchịchị banyere iji ọgwụ eme ihe site na nkwakọ ngwaahịa ya na ọgwụ. Lelee nnweta ọgwụ a na onye njikwa nke ụlọ ahịa ọgwụ n'ịntanetị site na ekwentị ma ọ bụ na ntinye nzaghachi saịtị ahụ. Nwere ike ịzụta Avandamet na Moscow na mpaghara ndị ọzọ nke Russia na ụlọ ahịa ọgwụ dị n'ịntanetị. Dabere na iwu nke Russian Federation (Iwu nke gọọmentị nke Russian Federation nke 01/19/1998 Nke 55), ọgwụ dị ka ngwaahịa abụghị ihe a ga-alaghachi ma gbanwere.

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

N'ime, a na-ahọrọ dose ahụ n’otu n’otu. Ceptionnata oge ma ọ bụ mgbe nri gachara, na - eme ka akwara ozi si na eriri afọ nke metformin na - eme. Uzo mbu nke rosiglitazone + metformin nke mbu bu 4 mg / 1000 mg. A na-abawanye ọgwụ ahụ nwayọ (4 mg kwa ụbọchị maka rosiglitazone na / ma ọ bụ 500 mg maka metformin), oke kachasị kwa ụbọchị bụ 8 mg nke rosiglitazone / 2000 mg nke metformin.

Mmetụta ọgwụgwọ (mgbe ịgbazigharị dose) na-apụta mgbe izu 6-8 maka rosiglitazone na mgbe izu 1-2 gasịrị maka metformin.

Mgbe ị na-agbanwe site na ọgwụ hypoglycemic ndị ọzọ na rosiglitazone na metformin, ekwesịrị iburu n'uche ọrụ na oge nke ọgwụ ọgwụ ndị gara aga. Mgbe ị na-agbanwe site na rosiglitazone na usoro ọgwụgwọ metformin n'ụdị otu ọgwụ, ọgwụ mbụ nke ngwakọta nke rosiglitazone na metformin na-adabere na usoro onunu ogwu a.

Imeghari onunu n’ime ndị ọrịa agadi sitere na data gbasara ọrụ gbasara akụrụngwa.

Na nchikota rosiglitazone + metformin yana usoro sulfonylurea, ọgwụ mbụ nke rosiglitazone kwesịrị ịbụ 4 mg kwa ụbọchị. Ekwesiri iji mmụba na rosiglitazone ruo 8 mg kwa ụbọchị na nlezianya (ihe ize ndụ nke njigide mmiri na ahụ).

Ajuju, azịza, nyocha banyere ọgwụ Avandamet

Ihe omuma a enyere ndi okacha amara n’ulo ogwu. Ihe omuma nke kachasi banyere ogwu ahu di na ntuziaka nke ndi emeputaworo. Enweghị ozi edeputara na ibe a ma ọ bụ na saịtị ọ bụla ọzọ nwere ike ịnọchite anya arịrịọ nke onye ọkachamara.