Duloxetine ndi mankhwala ogwiritsira ntchito mitundu yopweteka ya matenda a shuga a m'mbuyo komanso matenda osiyanasiyana. Chifukwa chakuchita bwino kwambiri, mankhwalawa apeza ntchito zamankhwala zingapo.
Duloxetine ndi mankhwala ogwiritsira ntchito mitundu yopweteka ya matenda a shuga a m'mbuyo komanso matenda osiyanasiyana.
Dzinalo Losayenerana
Zosagwirizana ndi mayiko ena zimagwirizana mokwanira ndi malonda.
Dzina la mankhwala omwe mankhwala ndi (γS) -N-Methyl-th- (1-naphthyloxy) -2-thiophenpropanamine.
Mchilatini: Duloxetine.
ATX
ATX: N06AX21.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapangidwa m'matumba a gelatin olimba, chivindikiro ndi thupi lomwe limapakidwa utoto. Mkati mwa kapisozi muli microsanules ozungulira omwe ali ndi mtundu wa milky kapena chikasu.
Zomwe zimagwira zimayimira duloxetine. Zothandizira zina ndi izi:
- hypromellose;
- mannitol;
- wowuma;
- titanium dioxide;
- sucrose;
- lauryl sulfate;
- mowa wa cetyl.
Bokosi la gelatin limapangidwa kuchokera ku gelatin, titanium dioxide ndi kuwonjezera kwa utoto wa utoto wabuluu V.
Mankhwalawa amamasulidwa m'matende a gelatin olimba a mtundu wa buluu.
Zotsatira za pharmacological
Ntchito yogwira imalepheretsa kubwezeretsanso kwa norepinephrine, serotonin ndi dopamine (pang'ono pang'ono). Izi zimabweretsa kudzikundikira kwa ma neurotransmitters awa ndikuwonjezera kufalikira kwawo mkati mwa dongosolo lamanjenje. Thupi limatha kuwonjezera gawo lopweteketsa ululu lomwe limayamba ndi neuropathy.
Pharmacokinetics
Pambuyo pakamwa mankhwala, mankhwala yogwira amayamba kumezedwa pambuyo 2 maola. Pambuyo maola 6, kuphatikiza kwakukulu kumafika. Kuchuluka kwa mankhwalawa m'magazi sikuchepetsedwa pakudya, koma nthawi yofika patali kwambiri imatha kukwera mpaka maola 10.
Kuchuluka kwa mankhwalawa m'magazi sikucheperako pakudya.
Zinthu zofunikira zimamangidwa ndi mapuloteni a plasma. Matenda a chiwindi ndi impso sasokoneza ntchito za njirayi. Kuchotsa kwa mankhwalawo m'thupi la wodwalayo kumachitika ndi mkodzo. Kutha kwa theka moyo kumafika maola 12.
Zizindikiro zogwiritsidwa ntchito
Duloxetine amalembedwa kuti:
- kupweteka mitundu ya zotumphukira matenda ashuga;
- Kukhumudwa
- aakulu ululu syndromes wa musculoskeletal dongosolo (zotumphukira zotere zimawonedwa ndi fibromyalgia, osteoarthrosis ya bondo yolowa, kupweteka kwam'mbuyo kumbuyo);
- ambiri nkhawa nkhawa.
Contraindication
Malinga ndi malangizo a mankhwalawa a mankhwalawa, pakati pa zotsutsana ndi:
- glaucoma lotsekeka;
- zaka mpaka 18;
- Kulephera kwa chiwindi (mutatha kutenga 20 mg ya mankhwalawa, kuchuluka kwa duloxetine kumawonjezeka ndi 15% poyerekeza ndi data yakale);
- Hypersensitivity kuti fructose;
- kuchepa kwa isomaltase ndi sucrase;
- shuga-galactose malabsorption;
- gawo lothana ndi matenda aimpso;
- matenda oletsa kuchepa kwa magazi.
Ndi chisamaliro
Kusintha kwa Mlingo ndi kuwunika pafupipafupi kuchipatala kumafunikira ngati wodwala ali ndi zina zake:
- intraocular matenda oopsa;
- chiwopsezo chachikulu cha kukulira glaucoma;
- kupsinjika kwa mitsempha ndi mania;
- aimpso kuwonongeka, kulephera kwaimpso (kulengedwa kwa creatinine 30 ml / min), hemodialysis;
- nthawi ya pakati odwala;
- malingaliro odzipha kapena kuyesera kudzipangitsa kukhala m'mbiri;
- kukokana
- chiopsezo chowonjezereka cha hyponatremia (gululi limaphatikizapo anthu okalamba, odwala matenda a cirrhosis, kuchepa kwa madzi m'thupi, matenda osakwanira katulutsidwe ka timadzi ta antidiuretic).
Momwe mungatenge duloxetine?
Makapisozi a mankhwalawa amapangidwira pakamwa. Amameza ndikusambitsidwa ndi kapu yamadzi.
Ma granules mkati mwa kapisolo sayenera kuchotsedwa ndikuphatikizidwa ndi zinthu kapena zakumwa kuti apange kuyimitsidwa.
Izi zikufotokozedwa ndikuti mankhwalawa amayenera kusungunuka ndikuyamwa m'matumbo. Phaseti ya enteric gelatin imathandizira kuti izi zitheke.
Muyezo tsiku lililonse la mankhwalawa, omwe nthawi zambiri amatsatiridwa ndi madokotala, amafika 30-60 mg. Ndalamazi sizigawika magawo angapo, koma zimagwiritsidwa ntchito pakayendedwe kamodzimodzi. Kugwiritsa ntchito mankhwalawa sikudalira chakudya.
Kutengera kuzindikira kwa wodwalayo komanso momwe wodwalayo alili, mlingo wa tsiku ndi tsiku umatha kusinthidwa ndikufika pa 120 mg. Pankhaniyi, bukuli liyenera kugawidwa m'magawo awiri.
Makapisozi amamezedwa ndikusambitsidwa ndi kapu yamadzi.
Kumwa mankhwala a shuga
Kafukufuku watsimikizira momwe mankhwalawa amathandizira mu mitundu yopweteka ya matenda a shuga. Palibe contraindication, odwala matenda ashuga amatha kumwa muyezo tsiku lililonse.
Kodi akuwonetsa masiku angati?
Hafu ya moyo wa zigawo zofunikira ukufika maola 12.
Zotsatira zoyipa za Duloxetine
Zina mwazotsatira zoyipa zomwe zimachitika chifukwa chomwa mankhwalawa zimatchedwa kupweteka mutu, nseru, chizungulire, pakamwa pouma, kugona kwambiri, kuwonda.
Mwa odwala ambiri, Zizindikirozi zimawonekera pamlingo wofatsa komanso kumayambiriro kwa chithandizo. Pali kusintha kwa kuchuluka kwa ma enzymes a chiwindi, nthawi zina, parasitic (fungus) ndi matenda opatsirana (laryngitis, otitis media) ndizotheka.
Matumbo
Kuchokera mmimba, njira zotsatirazi zakumwa mankhwalawa zitha kuoneka: kukhumudwa m'mimba, kusanza, kusanza, kuwuma kwamkamwa, kusokonekera kwa chimbudzi (kudzimbidwa kapena kutsegula m'mimba), kusefukira kwam'mimba, kukomoka.
Mukamamwa mankhwalawa, mseru ungachitike.
Mwina chitukuko cha gastritis, gastroenteritis, stomatitis, hepatitis, chiwindi kulephera, mawonekedwe a belching, kuphwanya kwa kumva zomverera.
Osadziwika kwambiri: kupezeka kwa magazi mu chopondapo, mpweya woipa, magazi am'mimba komanso jaundice.
Pakati mantha dongosolo
Mwa zina mwazotsatira zoyipa: kugona, kupweteka mutu, kupsinjika, paresthesia, chizungulire, kusowa tulo, nkhawa, kunjenjemera kwa malekezero, ulesi, kukwiya.
Nthawi zambiri, odwala amadandaula kuwonjezeka kukwiya, dyskinesia, myoclonus, kusokonezeka kwa tulo, kuperewera, kufooka, kusokonezeka m'malo, kusokonezeka ndende.
Nthawi zina odwala amadandaula za kusokonezeka kwa tulo pamene amamwa mankhwalawo.
Mkwiyo, ukali, mania, kupsinjika, mtima wofuna kudzipha, nkhawa zama psychomotor ndi matenda a serotonin sizimayamba.
Kuchokera ku kupuma
Zotsatira zoyipa za kupuma ndizochepa. Nthawi zambiri, odwala omwe amamwa mankhwalawa amadandaula chifukwa cha kuyamwa. Nthawi zina, chidwi cha kuphatikizira kwa pharynx ndi nosebleeds chimadziwika.
Pa khungu
Zotsatira zoyipa kwambiri ndikutuluka thukuta kwambiri.
Chomwe chimapezeka kwambiri ndi hemorrhage hemorrhage, photosensitivity (kudziwa kuwala kwa dzuwa), urticaria, mawonekedwe a thukuta lozizira, kulumikizana ndi khungu, Stevens-Johnson syndrome ndi angioedema.
Zotsatira zoyipa kwambiri ndikutuluka thukuta kwambiri.
Kuchokera ku genitourinary system
Malinga ndi malangizo a mankhwalawa, nthawi zambiri pamakhala kufooka kwa ntchito ya erectile, zovuta kuti zitheke, komanso kutsitsimuka pakugonana.
Dysuria yosadziwika bwino, kusungika kwamikodzo, nocturia, kusinthana kwamkati, kwamikodzo, kusokonezeka kwam'mimba, matenda amtundu wa m'mimba, kutulutsa magazi mu nyini.
Osowa kwambiri, zizindikiro za kusintha kwa msambo komanso kusintha kwa fungo la mkodzo kumatha kuchitika.
Kuchokera pamtima
Zizindikiro zodziwika bwino zimaphatikizira kugwirana mtima komanso kugunda kwamtima mwachangu.
Zina zomwe sizachilendo kwenikweni ndizo kukomoka, zizindikiro za tachycardia, malekezero ozizira komanso kuthamanga kwa magazi.
Mwa zina zosowa zomwe zimatchedwa atrial fibrillation, supraventricular arrhythmia ndi vuto la matenda oopsa.
Pochita mankhwala ndi mankhwala, odwala samakonda kukomoka.
Dongosolo la Endocrine
Nthawi zina, hypothyroidism imayamba.
Kuchokera ku minculoskeletal system
Zotsatira zoyipa kwambiri za musculoskeletal system ndi maonekedwe a minofu kukokana, kupweteka m'misempha ndi mafupa, kumva kukomoka.
Kupindika minofu kumawonekera nthawi zambiri.
Trismus ndi osowa kwambiri.
Matupi omaliza
Ndi kuchuluka kwa chidwi cha wodwala pazinthu zina kapena zingapo pakapangidwe ka mankhwala, matupi awo sagwirizana. Nthawi zina, anaphylactic zimachitika.
Zokhudza mphamvu pakuwongolera njira
Mukamagwiritsidwa ntchito ndi Duloxetine, pamakhala chiwopsezo cha kugona, kuphwanya kwa psychomotor zimachitika, komanso ntchito zina zam'maganizo. Pazifukwa izi, odwala ayenera kukana kuyendetsa galimoto ndikuchita nawo zinthu zoopsa.
Mankhwalawa Duloxetine ayenera kusiya kuyendetsa.
Malangizo apadera
Njira ya mankhwala iyenera kumalizidwa pang'onopang'ono pochepetsa. Kupanda kutero, kukula kwa matenda achire ndikotheka.
Chifukwa chakuti ndizosatheka kuchepetsa kuchuluka kwa 15 mg, nthawi ya utsogoleri isanakwane.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwala, palibe chidziwitso cha mankhwalawa pa thanzi ndi chitukuko cha mwana wosabadwayo, motero, sikulimbikitsidwa kupereka mankhwala a Duloxetine. Kupatula pazochitika zina pomwe phindu kwa mayi kuti amwe mankhwalawo limaposa chiopsezo cha mwana wosabadwayo. Popereka mankhwala pakupatsa msambo, tiyenera kuyimitsidwa.
Popereka mankhwala othandizira amayi omwe ali ndi zaka zakubala, wodwalayo ayenera kuchenjezedwa za kufunika kwa kulera moyenera.
Popereka mankhwala pakupatsa msambo, tiyenera kuyimitsidwa.
Kupangira Duloxetine kwa Ana
Mankhwalawa sanatchulidwe kwa ana ndi achinyamata osakwana zaka 18.
Gwiritsani ntchito mu ukalamba
Mankhwala osokoneza bongo a Duloxetine
Mankhwala othandizira tsiku ndi tsiku, omwe samalimbikitsidwa kupitilira, ndi 1.2 g. Kuchulukitsa mlingo (womwe uli ndi monotherapy komanso kuphatikiza mankhwala ena) umayambitsa zotsatirazi:
- kukhudzika kwa clonic;
- kugona
- serotonin syndrome;
- chikomokere
- tachycardia;
- kusanza
Mlandu umodzi wamafotokozedwe osokoneza bongo akufotokozedwa (3 mg g), ndikutsatiridwa ndi zotsatira zakupha.
Palibe mankhwala enieni a chinthu ichi, chifukwa chake pamachitika zinthu zingapo kuti wodwalayo azikhala wodwala.
- Kutsuka kwa m'mimba (kusanza) kumamveka bwino ngati mankhwalawo atengedwa posachedwapa.
- Kutenga makala okhazikitsidwa kumachepetsa kuyamwa kwa mankhwalawo.
- Kuchita chisonyezo chamankhwala malinga ndi mawonekedwe ake.
Mankhwala osokoneza bongo amachititsa kugona.
Kuchita ndi mankhwala ena
Mukaphatikizidwa ndi mankhwala ena, mungafunike kusintha kuchuluka kwa kayendetsedwe ka mankhwala kapena mlingo.
Ndili ndi CYP1A2 zoletsa. Kuphatikizika komweku nthawi zambiri kumadzetsa kuwonjezereka kwa ntchito yogwira plasma. Kusamala kowonjezereka kuyenera kuonedwa ndikuphatikizidwa ndi Tolterodine ndi Desipramine.
Ndi antidepressants ena. Kugwirizana sikulimbikitsidwa, kuphatikizapo mankhwala Paroxetine. Izi zimabweretsa kuchepa kwa chilolezo.
Ndi Mao zoletsa, Moclobemide. Kugwiritsa ntchito ndikosayenera, chifukwa cha kukhazikika kwa minofu, hyperthermia, chikomokere, myoclonus. Muzovuta kwambiri, imfa ndiyotheka.
Ndi benzodiazepines, Mowa, antipsychotic mankhwala, phenobarbital. Kuphatikiza koteroko sikulimbikitsidwa.
Ndi antiplatelet othandizira ndi anticoagulants. Zikatero, magazi amatuluka. Mutatha kumwa ndi Warfarin, kuwonjezeka kwa INR ndikotheka.
Chenjezo liyenera kuthandizidwa popereka mankhwala othandizira kupendeketsa magazi a Clomipramine, wort wa St. John, pethidine, triptanam, Amitriptyline, Venlafaxine ndi Tramadol, Zinnat.
Kuphatikiza ndi clotrimazole sikuti kumapangitsa kuti mawu asinthe.
Kuyenderana ndi mowa
Kwa nthawi ya mankhwalawa ndi Duloxetine, muyenera kupewa kumwa zakumwa zoledzeretsa. Kupanda kutero, pali chiopsezo chachikulu cha zovuta zingapo zoyipa.
Analogi
Mankhwala ofanana mu kapangidwe kake ndi zochita ndi Duloxetine Canon ndi Symbalta.
Mankhwala otsatirawa ali ndi zotsatirazi:
- Deprim forte;
- Venlaxor;
- Gelarium Hypericum;
- Trittiko;
- Velaxin;
- Xel;
- Amitriptyline;
- Fluoxetine.
Iliyonse ya mankhwalawa imadziwika ndi zinthu zomwe zimagwiritsidwa ntchito komanso zomwe zimagwiritsidwa ntchito. Pachifukwa ichi, muyenera kufunsa dokotala musanalowe m'malo mwa mankhwala.
Mankhwala ofanana ofanana ndi Symbalta.
Kupita kwina mankhwala
Malinga ndi malangizo ovomerezeka ogwiritsira ntchito, mankhwalawa amapezeka pamankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Kuchotsa Duloxetine popanda mankhwala ndi koletsedwa.
Mtengo wa Duloxetine
Mtengo wa mankhwalawa umatengera kuchuluka kwa makapisozi omwe ali mumpaketi.
Ku malo ogulitsa mankhwala ku Moscow, mtengo wamba:
- Makapisozi 14 (30 mg) - ma ruble 1000;
- Makapisozi 28 (60 mg) - 2100 ma ruble.
Zosungidwa zamankhwala
Zofunika posungira: kutentha + 15 ... + 25 ° C, kusowa kowongolera dzuwa ndi chinyezi.
Tsiku lotha ntchito
Kutengera ndi malamulo osungira, makapisozi amatha kugwiritsidwa ntchito zaka 3 kuyambira tsiku lotulutsidwa.
Wopanga
Wopanga mankhwalawa ndi Canonfarm Production CJSC. Kampaniyi ili kudera la Moscow (Schelkovo).
Pali makampani ena ambiri omwe amapanga mankhwalawa. Pakati pawo pali kampani ya Glenmark.
Ndemanga za Duloxetine
Madokotala amalabadira bwino mankhwalawa, omwe amafotokozedwa ndi kukhathamiritsa komanso zotsatira zosiyanasiyana. Odwala ambiri amasangalalanso ndi mankhwalawo.
Madokotala
Olga, wamisala, wazachipatala wazaka 13, Moscow.
Ubwino wa mankhwalawa ndi magwiridwe ake polimbana ndi ululu wambiri wa maukadaulo osiyanasiyana. Oyenera odwala omwe ali ndi matenda ashuga. Nthawi zambiri samasankhidwa ngati mankhwala ochepetsa nkhawa, chifukwa pali mankhwala osavuta. Choyipa ndichotsika mtengo, popeza njira yayitali imafunikira.
Nthawi zambiri, odwala omwe amamwa mankhwalawa amadandaula chifukwa cha kuyamwa.
Odwala
Nikolay, wazaka 40, Tyumen
Duloxetine adalembedwa ndi adokotala chifukwa cha kukhumudwa. Masiku angapo kumayambiriro kwa maphunziro kunali mseru pang'ono, koma mankhwalawo sanasokonezedwe. Patatha masiku angapo, mavuto omwe adakumana nawo adatheratu. Mtengo ndiwokwera kwambiri, koma mankhwalawa ndiwothandiza kwambiri kuposa mitengo ya zitsamba, chifukwa chake mitengoyo ndiyoyenera.
