Yanumet ndi kuphatikiza kwa mankhwala a hypoglycemic omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo omwe amadalira shuga. Kumwa mankhwalawa kumathandizira kuti shuga azikhala bwino, kumapangitsa kuti matendawa azitha komanso kumathandizira odwala.
Dzinalo Losayenerana
Metformin + Sitagliptin.
Yanumet ndi kuphatikiza kwa mankhwala a hypoglycemic omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo omwe amadalira shuga.
ATX
A10BD07.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapezeka pamalonda a mapiritsi oblong okhala ndi biconvex pamwamba, wokutidwa ndi filimu ya enteric ya pinki, yapinki kapena yofiirira (kutengera Mlingo). Mankhwalawa amadzaza m'matumba a matuza a 14 zidutswa. Phukusi la pepala lalikulu limachokera ku matuza 1 mpaka 7.
Zosakaniza zogwira ntchito za Yanumet ndi sitagliptin mu mawonekedwe a phosphate monohydrate ndi metformin hydrochloride. Zomwe zili sitagliptin pokonzekera zimakhala zofanana nthawi zonse - 50 mg. Kuchulukitsa kwa metformin hydrochloride kumasiyana ndipo 500, 850 kapena 1000 mg piritsi limodzi.
Monga zigawo zothandizira, Yanumet imakhala ndi lauryl sulfate ndi sodium stearyl fumarate, povidone ndi MCC. Chipolopolo cha mapiritsiwo chimapangidwa kuchokera ku macrogol 3350, mowa wa polyvinyl, titanium dioxide, wakuda ndi iron iron oxide.
Mankhwalawa amadzaza m'matumba a matuza a 14 zidutswa.
Zotsatira za pharmacological
Mankhwala ndi ophatikiza omwe magawo ake amagwiritsa ntchito amakhala ndi othandizira (othandizira) a hypoglycemic, kuthandiza odwala omwe ali ndi mtundu II shuga mellitus kukhalabe ndi shuga.
Sitagliptin, yomwe ndi gawo la mankhwalawa, ndi inhibitor yosankha kwambiri ya dipeptidyl peptidase-4. Ikamamwa, imachulukitsa ka katatu zomwe zimakhala ndi glucagon-peptide-1 ndi ma insulinotropic peptide - mahomoni omwe amalimbikitsa kupanga insulin ndikuwonjezera katulutsidwe kake m'maselo a kapamba. Sitagliptin imakupatsani mwayi wokhala ndi shuga m'magazi masana tsiku lonse komanso kupewa matenda a glycemia musanadye chakudya cham'mawa komanso mutatha kudya.
Kuchita kwa sitagliptin kumathandizika ndi metformin - chinthu cha hypoglycemic chokhudzana ndi biguanides, chomwe chimachepetsa kuchuluka kwa shuga m'magazi popondera ndi 1/3 njira yopanga shuga m'magazi. Kuphatikiza apo, mutatenga metformin mwa odwala omwe ali ndi matenda a shuga a 2, pali kuchepa kwa mayamwidwe am'mimba kuchokera m'matumbo, kuwonjezeka kwa chidwi cha minofu kupita ku insulin komanso kuwonjezeka kwa mafuta oxidation.
Pharmacokinetics
The plasma ambiri ndende ya sitagliptin amawonekera pambuyo 4-5 mawola pakamwa limodzi, metformin - pambuyo 2,5 maola. The bioavailability wa yogwira pophika ntchito Yanumet pamimba yopanda ndi 87% ndi 50-60%, motero.
Kugwiritsa ntchito sitagliptin mukatha kudya sikukuthira mayamwidwe ake m'mimba. Kugwiritsa ntchito pamodzi kwa metformin ndi chakudya kumachepetsa mayamwidwe ake ndikuchepetsa kuchuluka kwa plasma ndi 40%.
Kutupa kwa sitagliptin kumachitika makamaka ndi mkodzo. Gawo laling'ono la ilo (pafupifupi 13%) limachoka m'thupi limodzi ndi zomwe zimapezeka m'matumbo. Metformin imachotsedwa kwathunthu ndi impso.
Metformin imachotsedwa kwathunthu ndi impso.
Zizindikiro zogwiritsidwa ntchito
Mankhwala amakupatsani mtundu wachiwiri wa matenda ashuga. Amawonetsedwa ngati chowonjezera chakudya ndi masewera olimbitsa thupi kwa odwala omwe:
- kulephera kuwongolera kuchuluka kwa shuga wokhala ndi milingo yambiri ya metformin;
- Amayenera kumwa kale mankhwala osakanikirana ndi zosakaniza zomwe zimapanga Yanumet, ndipo mankhwalawa adabweretsa zotsatira zabwino;
- Mankhwala othandizira amafunika kuphatikiza ndi mankhwala a sulfonylurea, PPARP agonists, kapena insulin, popeza kutenga metformin limodzi ndi mankhwala omwe atchulidwa sikuloleza kukwaniritsa kuyang'anira kwa glycemia.
Contraindication
Mankhwalawa sagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda kapena zinthu zotsatirazi:
- mtundu I matenda ashuga mellitus;
- ketoacidosis, limodzi ndi matenda a shuga kapena ayi;
- lactic acidosis;
- chiwindi ntchito;
- kulephera kwa aimpso, komwe kupezeka kwa creatinine kumakhala kochepera 60 ml pa mphindi;
- kuchepa kwa thupi;
- kwambiri njira ya matenda a chiyambi;
- dziko lodetsa nkhawa;
- mankhwala ndi ayodini okhala ndi zosiyana othandizira;
- ma pathologies omwe amachititsa kuti pakhale mpweya wochepa mu thupi (kulephera kwa mtima, kulowetsedwa kwa myocardial, kulephera kupuma, ndi zina zambiri);
- Kuchepetsa thupi ndi zakudya zamafuta ochepa (mpaka 1 kcal patsiku);
- uchidakwa;
- poyizoni wa mowa;
- kuyamwa
- mimba
- zaka zazing'ono;
- kusalolera payekha pazigawo zomwe zilipo m'mapiritsi.
Ndi chisamaliro
Mukamagwiritsa ntchito Yanumet, muyenera kusamala ndi okalamba ndi omwe akuvutika ndi vuto laimpso.
Momwe mungatenge Yanumet
Mankhwalawa amadyedwa kawiri patsiku ndi chakudya, kutsukidwa ndi madzi angapo. Kuti muchepetse kutheka kwa zovuta m'magawo am'mimba, chithandizo chimayamba ndi mlingo wochepetsetsa, ndikuwonjezera pang'onopang'ono mpaka zotsatira zochizira zitheka.
Kumwa mankhwala a shuga
Mlingo wa Yanumet umasankhidwa kwa wodwala aliyense payekhapayekha, poganizira momwe mankhwalawa amathandizira komanso kulekerera kwa mankhwalawa. Mlingo wambiri watsiku ndi tsiku sayenera kupitilira 100 mg.
Zotsatira zoyipa za Yanumet
Mukamamwa mankhwalawa, wodwalayo amatha kukumana ndi zovuta zosakhumudwitsa za sitagliptin ndi metformin. Ngati zikuchitika, ndikofunikira kukana chithandizo china ndikupita kwa dokotala posachedwa.
Pankhani ya zovuta, ndikofunikira kukana chithandizo china ndikuyendera dokotala posachedwa.
Matumbo
Zotsatira zoyipa zamagetsi zomwe zimagwidwa nthawi zambiri zimawonedwa koyambira koyambira. Izi zimaphatikizapo kupweteka kumtunda kwam'mimba, kusanza, kusanza, kuchuluka kwa mpweya m'matumbo, kutsekula m'mimba, kudzimbidwa. Kumwa mapiritsi ndi chakudya kumatha kuchepetsa zotsatira zake zoyipa m'mimba.
Odwala omwe amalandila chithandizo ndi Yanumet, kukula kwa kapamba (hemorrhagic kapena necrotizing), komwe kumatha kupangitsa kuti afe, sikuchotsedwa.
Kuchokera kumbali ya kagayidwe
Ngati mulingo wosankhidwa molakwika, wodwalayo amatha kudziwa vuto la hypoglycemia, lomwe limachepetsa kwambiri shuga. Nthawi zina, kumwa mankhwala kumatha kubweretsa lactic acidosis, yomwe imadziwonetsera mu mawonekedwe a kuchepa kwa kuthamanga ndi kutentha kwa thupi, kupweteka pamimba ndi minofu, kukoka kwamphamvu, kufooka komanso kugona.
Pa khungu
Nthawi zina, odwala kumwa mankhwala a hypoglycemic, akatswiri amazindikira khungu la vasculitis, bullous pemphigoid, poyizoni wa epidermal necrolysis.
Kuchokera pamtima
Mankhwalawa amalekeredwa bwino ndi anthu omwe ali ndi matenda a mtima ndi mitsempha yamagazi. Nthawi zina, amatha kumachepa mtima, zomwe zimachitika chifukwa cha lactic acidosis.
Mankhwalawa amalekeredwa bwino ndi anthu omwe ali ndi matenda a mtima ndi mitsempha yamagazi.
Matupi omaliza
Ndi kusalolera payekha pazinthu zomwe zimapangira mankhwalawa, munthu amatha kudwala mawonekedwe a urticaria, kuyabwa ndi totupa pakhungu. Pa mankhwala ndi Yanumet, kuthekera kwa kukhalapo kwa edema pakhungu, mucous membranes ndi subcutaneous minofu, yomwe imawopseza moyo, sikuwopsezedwa.
Zokhudza mphamvu pakuwongolera njira
Mankhwalawa amatha kubweretsa kugona, motero munthawi ya kuyang'anira kumalimbikitsidwa kukana kuyendetsa galimoto ndikugwira ntchito ndi njira zina zowopsa.
Malangizo apadera
Mankhwalawa ndi Yanumet, odwala ayenera kutsatira zakudya zomwe zimagwiritsidwa ntchito tsiku lonse ndikuwonetsetsa kagayidwe kazakudya m'thupi.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwalawa sayenera kuledzera ali ndi mwana, chifukwa deta pakukhazikika kwake panthawiyi siyipezeka. Mayi yemwe akulandila chithandizo ndi Yanumet atakhala ndi pakati kapena akufuna kuchita izi, ayenera kusiya kumwa mankhwalawo ndikuyamba mankhwala a insulin.
Kugwiritsa ntchito mankhwalawa sikugwirizana ndi kuyamwitsa.
Kugwiritsa ntchito mankhwalawa sikugwirizana ndi kuyamwitsa.
Kusankhidwa kwa Yanumet kwa ana
Kafukufuku wotsimikizira chitetezo cha mankhwalawa kwa ana ndi achinyamata sichinachitike, chifukwa chake, sayenera kulembedwa kwa odwala omwe sanakwanitse zaka 18.
Gwiritsani ntchito mu ukalamba
Popeza zigawo zikuluzikulu za Yanumet zimachotsedwa mu mkodzo, ndipo muukalamba, ntchito ya impso imachepa, mankhwalawa amayenera kuperekedwa kwa anthu opitirira zaka 60.
The ntchito aimpso kuwonongeka
Mankhwalawa amadziwikiratu odwala omwe ali ndi vuto lozama kapena lochepa. Kwa anthu omwe ali ndi vuto laimpso lokwanira, mankhwalawa amayenera kumwedwa moyang'aniridwa ndi katswiri.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Sizoletsedwa kusankha.
Odwala omwe ali ndi vuto la chiwindi sayenera kumwa mankhwala.
Mankhwala osokoneza bongo a Yanumet
Ngati mulingo wadutsa, wodwalayo amatha kukhala lactic acidosis. Kuti akhazikitse vutoli, amathandizidwanso m'njira yofananira ndi njira zofunika kuyeretsa magazi.
Kuchita ndi mankhwala ena
Kuphatikizidwa kwa mankhwalawa ndi ma diuretics, glucagon, kulera kwapakamwa, phenothiazines, corticosteroids, isoniazid, calcium antagonists, nikotini acid ndi mahomoni a chithokomiro kumabweretsa kufooka kwa zochita zake.
Mphamvu ya hypoglycemic ya mankhwalawa imalimbikitsidwa ikagwiritsidwa ntchito limodzi ndi mankhwala osapweteka a anti-yotupa, MAO ndi ACE zoletsa, insulin, sulfonylurea, oxytetracycline, clofibrate, acarbose, beta-blockers ndi cyclophosphamide.
Kuyenderana ndi mowa
Sizoletsedwa kumwa mowa panthawi ya mankhwala ndi Yanumet.
Analogi
Analogue ya kapangidwe ka mankhwala ndi Valmetia. Mankhwala amapangidwa piritsi ndipo ali ndi kapangidwe kake ndi Mlingo wofanana ndi Yanumet. Komanso, mankhwalawa ali ndi mwayi wamphamvu - Yanumet Long, wokhala ndi 100 mg ya sitagliptin.
Pokhapokha pakuchitika zochizira kuchokera ku Yanumet, adokotala amatha kuyambitsa othandizira a hypoglycemic, omwe metformin imaphatikizidwa ndi zinthu zina za hypoglycemic. Mankhwalawa akuphatikizapo:
- Avandamet;
- Amaryl M;
- Douglimax;
- Galvus;
- Vokanamet;
- Glucovans, etc.
Kupita kwina mankhwala
Pamaso pa mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Mutha kugula mankhwala osagwiritsa ntchito mankhwala okhawo omwe mumagulitsa pa intaneti.
Mtengo wa Yanumet
Mtengo wa mankhwala umatengera mlingo wake ndi kuchuluka kwa mapiritsi okhala m'mpaketi. Ku Russia, ikhoza kugulidwa ndi ma ruble 300-4250.
Zosungidwa zamankhwala
Mankhwala tikulimbikitsidwa kuti azisungidwa pamalo otetezedwa ndi kuwala kwa dzuwa komanso osakwaniritsidwa ndi ana aang'ono. Kutentha kosungirako kwa mapiritsi sikuyenera kupitirira + 25 ° C.
M'mafakisoni, mankhwalawa amatha kugula kokha ndi mankhwala.
Tsiku lotha ntchito
Miyezi 24 kuyambira tsiku lopangira.
Wopanga
Kampani yamankhwala Merck Sharp & Dohme B.V. (Netherlands).
Ndemanga za madokotala za Yanumet
Sergey, wazaka 47, endocrinologist, Vologda
Kwa odwala omwe ali ndi matenda osokoneza bongo omwe amadalira insulin, nthawi zambiri ndimapereka mankhwala awa, chifukwa kugwira kwake ntchito masiku ano kwatsimikiziridwa. Amawongolera glucose bwino komanso samayambitsa mavuto, ngakhale atakhala nthawi yayitali.
Anna Anatolyevna, wazaka 53, endocrinologist, Moscow
Ndikupangira chithandizo ndi Janumet kwa odwala omwe sangathe kusintha shuga yawo yamagazi ndi Metformin yokha. Kapangidwe kake ka mankhwalawo kumathandizira kuwongolera zizindikiro za shuga. Odwala ena amawopa kumwa mankhwalawa chifukwa choopsa cha hypoglycemia, koma kafukufuku waposachedwa wasonyeza kuti mwayi womwe umachitika ndiwofanana pakati pa anthu omwe adalandira mapiritsi ndi placebo. Ndipo izi zikutanthauza kuti mankhwalawa alibe gawo lalikulu pakukula kwa hypoglycemic syndrome. Chachikulu ndikusankha mlingo woyenera.
Mankhwalawa amayenera kuperekedwa kwa anthu azaka zopitilira 60.
Ndemanga za Odwala
Lyudmila, wazaka 37, Kemerovo
Ndakhala ndikuchita ndi Janomat pafupifupi chaka chimodzi. Ndimamwa osachepera 50/500 mg m'mawa ndi madzulo. M'miyezi itatu yoyambirira ya chithandizo, sizotheka kungoyendetsa matenda a shuga, komanso kuchepa 12 kg yolemera kwambiri. Ndikuphatikiza mankhwala ndi zakudya komanso zolimbitsa thupi zolimbitsa thupi. Tsopano ndikumva bwino kwambiri kuposa kale chithandizo.
Nikolay, wazaka 61, Penza
Ankakonda kumwa Metformin chifukwa cha matenda ashuga, koma pang'onopang'ono anasiya kuthandiza. Endocrinologist adapereka chithandizo ndi Yanumet ndipo adati mankhwalawa ndiwofotokozera mwamphamvu zomwe ndidakhala ndisanabadwe. Ndakhala ndikumwa kwa miyezi iwiri, koma shuga adakwezedwa. Sindikawona zotsatira zabwino kuchokera ku chithandizo.
