Comboglizzen, chọta, zụta

Aha ahia nkwadebe: Komboglize Prolong

Mba nonproprietary aha: Metformin (metformin) + Saxagliptin (saxagliptin)

Usoro onunu ogwu: Mbadamba ihe mkpuchi

Arụ Ọrụ: Metformin hydrochloride + saxagliptin

Otu na-ere ọgwụ: Onye na-ahụ maka hypoglycemic maka nchịkwa ọnụ (dipeptidyl peptidase 4 inhibitor + biguanide).

Ngwá ọgwụ ọgwụ:

Combogliz Prolong na-ejikọ ọgwụ hypoglycemic abụọ na usoro mmeju iji meziwanye njikwa glycemic na ndị ọrịa nwere ụdị ọrịa shuga 2 (DM2): saxagliptin, dipeptidyl peptidase 4 inhibitor (DPP-4), na metformin, onye nnọchite klas biguanide.

Na nzaghachi banyere nri oriri site na obere eriri afọ, a na-ahapụ homonụ nke nwere ọbara n'ọbara, dị ka gluptagon-peptide-1 (GLP-1) na glucose na-adabere insulinotropic polypeptide (HIP). Homonụ ndị a na - akwalite mwepụta nke insulin n'ahụ mkpụrụ ndụ beta nke pancreatic, dabere na ntinye glucose n'ọbara, mana enzyme DPP-4 na - arụ ọrụ n'ime ọtụtụ nkeji. GLP-1 na-ebelata nzuzo nke glucagon na sel Alp pancreatic, na-ebelata mmepụta glucose imeju. N'ime ndị ọrịa nwere ọrịa shuga 2, a na-ebelata mkpụkọ nke GLP-1, mana azịza insulin na GLP-1 ka dị. Saxagliptin, ịbụ onye na-egbochi DPP-4, na-ebelata mmelata nke homonụ ndị dị na ya, si otú a na-abawanye itinye uche ha na oke ọbara ma na-eduga n'ịbelata glucose na-ebu ọnụ mgbe ha risịrị nri.

Metformin bụ ọgwụ hypoglycemic na-eme ka nnabata glucose dị n'etiti ndị ọrịa nwere ọrịa shuga 2, belata basal na nchịkọta glucose postprandial. Metformin na-ebelata mmepụta nke glucose site na imeju, na-ebelata nnabata nke glucose na eriri afọ ma na-abawanye njikwa insulin, na-abawanye mpaghara na ojiji nke glucose. N'adịghị ka nkwadebe nke sulfonylurea, metformin adịghị akpata hypoglycemia na ndị ọrịa nwere ọrịa shuga 2 ma ọ bụ ndị nwere ahụike (ma e wezụga n'ọnọdụ ndị pụrụ iche, lee akụkụ “ịkpachara anya” na “Ntuziaka Pụrụ Iche”), na hyperinsulinemia. N'oge usoro ọgwụgwọ metformin, mmiri ọgwụ insulin na-agbanwe agbanwe, ọ bụ ezie na insulin insulin na-ebu ọnụ na nzaghachi nri n'oge ụbọchị nwere ike ibelata.

Ihe ngosi maka ojiji:

Elldị nke abụọ nke ọrịa shuga mellitus tinyere nri na mmega iji melite njikwa glycemic.

Contraindications:

- Mmụba uche onye ọ bụla akụrụngwa nke ọgwụ,

- Nnukwu mmetụ hyperensitivity (anaphylaxis ma ọ bụ angioedema) nye ndị na - egbochi DPP-4,

- 1dị shuga 1 nke ọrịa mellitus (nke a na-amụghị),

- Jiri ya jiri insulin mee ihe (anaghị agụ ya),

- Nkwekorita nke galactose ekweghị ibe nọrọ, ụkọ lactase na glucose-galactose malabsorption,

- Afọ ruo afọ iri na asatọ (amụbeghị nchekwa na arụmọrụ),

- Udiri mmerụ ahụ (serum creatinine ≥1.5 mg / dl maka ụmụ nwoke, ≥1.4 mg / dl maka ụmụ nwanyị ma ọ bụ belata ikike nke creatinine), gụnyere ndị kpatara ọrịa obi na-akpata oke ume (ujo), nnukwu myocardial infarction na septicemia,

- Ọrịa dị oke egwu nke enwere nsogbu ịrịa ọrịa akụrụ: akpịrị ịkpọ nkụ (ya na ọgbụgbọ, ọgbụgbọ), ahụ ọkụ, ọrịa na-efe efe, ọnọdụ hypoxia (ujo, sepsis, akụrụ, ọrịa akụrụ, ọrịa bronchopulmonary).

- Ọrịa acidosis ma ọ bụ nke na-adịghị ala ala, gụnyere ketoacidosis mamịrị, nwere ma ọ bụ na-enweghị coma,

- Ngosiputa nke oma site na oria ojoo na nke na adighi ala ala nke nwere ike ibute mmepe nke hypoxia di na aru (okuku ume, odida obi, oria myocardial infarction).

- Nnukwu ịwa ahụ na mmerụ ahụ (mgbe egosipụtara insulin ọgwụ),

- arụ ọrụ imeju.

- Aronicụrụma na egbu egbu ethanol nsị,

- Lactic acidosis (gụnyere akụkọ ihe mere eme),

- Oge dịkarịa ala, awa iri asatọ na asatọ tupu ma ọ bụ n'ime elekere 48 ka ị mụsịrị nyocha redio ma ọ bụ x-ray na ntinye nke ndị na-ewepụta ayodiin nwere,

- Nnabata na nri hypocaloric (5% nke ndị ọrịa na-anata metformin mwepụta gbanwee, ma na-etolite karịa oge na-anọghị n'otu ebe ahụ) bụ afọ ọsịsa na ọgbụgbọ / ọgbụgbọ.

A na-akọpụta mmetụta ndị a na-esote n'oge a na-ejikwa saxagliptin na post-azụ ahịa: nnukwu ọrịa pancreatitis na mmeghachi omume hypersensitivity, gụnyere anaphylaxis, angioedema, ihe ọkụ na urticaria. Ọ gaghị ekwe omume ịdabere ugboro ole mmepe ndị a dị anya, ebe ọ bụ na ọnụọgụgụ ndị na - ebudata ozi na-anata ozi ugboro ugboro (lee akụkụ "Contraindications" na "Ntuziaka Pụrụ Iche").

Ọnụ zuru oke nke lymphocytes

Mgbe ị na-eji saxagliptin, a na-achọpụta mbelata nke na-agbadata ọnụego nke lymphocytes zuru oke. Mgbe ị na-enyocha data jikọtara ọnụ nke izu ise na 24, ọmụmụ ihe na-achịkwa ọgwụ, mbelata nke ihe dị ka mkpụrụ ndụ 100 na 120 / nke ọnụ ọgụgụ zuru oke nke lymphocytes site na mkpụrụ ndụ mbụ nke mkpụrụ ndụ 2200 / μl hụrụ ojiji saxagliptin na dose 5 mg na 10 mg, n'otu n'otu, tụnyere ya na pilasi. A hụrụ mmetụta yiri nke ahụ mgbe ị na-ewere saxagliptin na dose nke 5 mg na njikọta mbụ na metformin ma e jiri ya tụnyere metformin monotherapy. Enweghị ọdịiche dị n'etiti 2.5 mg saxagliptin na placebo. Ọgụ ndị ọrịa nọ na ọnụọgụ nke lymphocytes bụ cells 750 sel / μl bụ 0,5%, 1.5%, 1.4%, na 0.4% n'ime otu ndị na-agwọ ọgwụ saxagliptin na dose nke 2.5 mg, na dose nke 5 mg , na onodu ogwu nke 10 mg na placebo, n’otu n’otu. N'ọtụtụ n'ime ndị ọrịa na iji ugboro ugboro nke saxagliptin, enweghị nlọghachi ọ bụla, ọ bụ ezie na ụfọdụ ndị ọrịa ọnụ ọgụgụ nke lymphocytes belatara ọzọ na ịmaliteghachi usoro ọgwụgwọ na saxagliptin, nke dugara na mkpocha nke saxagliptin. Nsonye nke ọnụọgụ nke lymphocytes esoghị ihe ngosi ọgwụgwọ.

Ihe kpatara mbelata ọnụ ọgụgụ nke lymphocytes n'oge usoro ọgwụgwọ saxagliptin ma e jiri ya tụnyere placebo amabeghị. N'ọnọdụ nke ọrịa na-adịghị ahụkebe ma ọ bụ ogologo oge, ọ dị mkpa iji tụta ọnụọgụ nke lymphocytes. Mmetụta nke saxagliptin na ọnụọgụ nke lymphocytes n'ime ndị ọrịa nwere nsogbu na ọnụọgụ nke lymphocytes (dịka ọmụmaatụ, nje immunodeficiency virus mmadụ).

Saxagliptin enweghị mmetụta dị omimi ma ọ bụ usoro ịtụle na platelet na mpịakọta abụọ kpara ìsì, na-achịkwa nchekwa na nchekwa.

Ntinye vitamin B12

Na nyocha ọgwụ gbasara metformin dị izu iri abụọ na itolu, ihe dị ka 7% ndị ọrịa nwere mbelata ọkwa ọbara tupu mkpokọta vitamin B12 nkịtị na-enweghị ogo ngosipụta. Agbanyeghị, ụdị mbelata na-esikarị ike yana anaemia na agbake ngwa ngwa mgbe ịkwụsịsịrị metformin ma ọ bụ nweta vitamin B12 ọzọ.

Dodoụbiga ya ókè

Site na iji ọgwụ a ogologo oge na usoro onunu ogwu ruo ugboro iri asatọ karịa ka a tụrụ aro ya, akọwaghị ihe mgbaàmà nke ịxụ mmanya. N'ọnọdụ ị anụbiga mmanya ókè, ekwesịrị iji usoro ọgwụgwọ Symptomatic mee ihe. Saxagliptin na metabolite ya bụ isi sitere na hemodialysis wepụta ya (etu esi eme ya: 23% nke dose ahụ n'ime awa anọ).

Enweela ọtụtụ ikpe nke oke overformin nke metformin, gụnyere iwere ihe karịrị 50 g. Hypoglycemia bilitere na ihe dịka 10% nke ikpe ahụ, ma enweghị ntọala mmekọrịta ya na metformin. Na 32% nke oke oke nke metformin, ndị ọrịa nwere lactic acidosis. A na-ewepụta Metformin n'oge akụrụngwa, ebe mkpochasị ahụ ruru 170 ml / min.

Pibọchị mmebi: Afọ 3

Ọnọdụ nke izipu ọgwụ site na ụlọ ahịa ọgwụ: Site na ndenye ọgwụ.

Emeputa: Bristol Myers Squibb, USA