Sitagliptin imapezeka mu mawonekedwe a phosphate monohydrate. Kutulutsidwa ndi piritsi yokhala ndi filimu
Chipangizocho ndi chosiyana kwambiri ndi kapangidwe kake kama mankhwala ndi mankhwala opangidwa ndi mankhwala ofanana ndi zotumphukira za sulfonylureas, biguanides ndi alpha-glycosidase inhibitors.
Kuletsa kwa DPP 4 ndi Sitagliptin kumabweretsa kuwonjezereka kwa kuchuluka kwa mahomoni awiri GLP-1 ndi HIP. Ma mahormonewa ndi a banja la ma incretin. Kubisika kwa mahomoni awa kumachitika m'matumbo.
Kuzungulira kwa mahomoni awa kumawonjezeka chifukwa cha kudya. Ma incretins ndi gawo limodzi la thupi lomwe limapereka shuga homeostasis mthupi.
Pharmokinetics ndi mawonekedwe ogwiritsira ntchito mankhwalawa
Mutatha kumwa mankhwalawo, mankhwalawo amatengeka mwachangu. Mankhwala ali bioavailability mtheradi 87%. Kudya zakudya zamafuta sikukhudza kwambiri mankhwala a pharmacological kinetics.
Kuchoka kwa mankhwala ikuchitika osasinthika zikuchokera mkodzo. Atayimitsa mankhwalawo kwa sabata limodzi, 87% ndi mkodzo ndi 13% yokhala ndi ndowe amachotsedwanso.
Mankhwala amagwiritsidwa ntchito ngati njira ya monotherapy pamaso pa mtundu II matenda a shuga m'm wodwala. Mankhwalawa amaloledwa kumwa mosasamala chakudya. Sitagliptin ndi Metformin kuphatikiza angagwiritsidwe ntchito ngati zovuta kuchiritsa pamaso pa mtundu 2 wa shuga. Mlingo woyenera kumwa mankhwalawa kuphatikiza ndi Metformin ndi 100 mg kamodzi patsiku.
Ngati mukusowa nthawi yoti mutenge Sitagliptin, muyenera kuitenga posachedwa. Izi ndichifukwa choti kumwa kuchuluka kwa mankhwalawa ndikosavomerezeka.
Ndi zoletsedwa kumwa mankhwalawa pafupipafupi kuposa momwe amalangizidwira malangizo.
Chidacho chimakupatsani mwayi wowongolera kuchuluka kwa shuga mthupi, koma mankhwalawa samachiza matenda a shuga.
Mankhwalawa amayenera kumwedwa ngakhale wodwala akumva bwino, ayenera kusiyidwa pokhapokha atakambilana ndi adokotala komanso pakulimbikitsa.
Malangizo ogwiritsira ntchito mankhwalawa
Sitagliptin ndi mankhwala omwe amalekeredwa bwino akamwedwa ndi odwala, onse panthawi ya monotherapy komanso monga gawo la zovuta ndi mankhwala ena omwe ali ndi katundu wa hypoglycemic.
Kuchoka kwa waukulu mankhwala ndi kudzera impso. Njira iyi yochotsera zinthu zogwira ntchito mthupi imafuna kuti dokotala awone momwe impso zimayendera pamaso pa wodwalayo asanagwiritse ntchito mankhwala. Ngati ndi kotheka, kukonza mlingo wa mankhwalawa kumachitika. Pamaso pa mawonekedwe ofatsa a impso, kusintha kwa mankhwalawa sikugwiritsidwa ntchito.
Ngati wodwala walephera kwenikweni aimpso, muyezo wa mankhwalawa sayenera kupitilira 50 mg kamodzi patsiku. Mankhwalawa amatha kugwiritsidwa ntchito nthawi iliyonse, mosasamala kanthu za dialysis.
Pogwiritsa ntchito mankhwalawa monga gawo limodzi la mankhwala osokoneza bongo, kuti muchepetse kukhazikika kwa hypoglycemia wa sulfon mu thupi, mlingo wa zotengera za sulfonylurea zimagwiritsidwa ntchito ziyenera kuchepetsedwa.
Mlingo wa mankhwala omwe amagwiritsidwa ntchito amachitidwa ndi adotolo atatha kufufuza mozama thupi la wodwala omwe ali ndi matenda a shuga a mtundu wachiwiri.
Ngati mukukayikira kukula kwa thupi la wodwalayo kapamba, ndikofunikira kusiya kumwa Sitagliptin ndi mankhwala ena omwe angathe kupangitsa kuti matenda awonjezeke.
Musanagwiritse ntchito mankhwalawa, dokotala ayenera kudziwitsa wodwalayo zoyamba za matenda a kapamba.
Contraindication ndi zoyipa
Kugwiritsa ntchito mankhwalawa kumatha kupangitsa kuti zikondamoyo zikuluzikulu zibweretsedwe m'thupi mwa munthu.
Kusagwiritsa ntchito bwino mankhwalawa, imatha kupangitsa kuti pakhale zovuta zingapo zoyipa mthupi. Zizindikiro zoyambazo zikaonekera, pitani kuchipatala msanga.
Mukamagwiritsa ntchito mankhwalawa, malangizo omwe dokotala akupereka akuyenera kutsatiridwa mosamala.
Mukamagwiritsa ntchito mankhwalawa, munthu amatha kupeza zovuta zingapo zoyipa. Zotsatira zoyipa zazikulu ndi:
- angioedema;
- anaphylaxis;
- zotupa
- khungu vasculitis;
- urticaria;
- zotupa za pakhungu, Stevens-Johnson syndrome;
- pachimake kapamba;
- kuwonongeka kwa impso, pachimake aimpso kulephera kwa dialysis;
- nasopharyngitis;
- matenda kupuma thirakiti;
- kusanza
- kudzimbidwa
- mutu
- myalgia;
- arthralgia;
- kupweteka kumbuyo
- kupweteka miyendo;
- kuyabwa
Mukamagwiritsa ntchito mankhwalawa, tisaiwale kuti pali zovuta zosiyanasiyana pazogwiritsa ntchito mankhwalawa.
Milandu ikuluikulu yomwe imamwa mankhwalawa ndi yotere:
- Hypersensitivity;
- kukhalapo kwa matenda a shuga a mtundu woyamba;
- matenda ashuga ketoacidosis;
- wodwala zaka zosakwana 18;
- nthawi yotsekera;
- nthawi yobala mwana.
Mukamagwiritsa ntchito mankhwala, malingaliro onse amayenera kutsatiridwa mosamala; yankho siliyenera kuthandizidwa ngati pakhale kuti pali zotsutsana zilizonse. Ngati mankhwala osokoneza bongo kapena poyizoni atapezeka chifukwa ch kumwa mankhwalawo, muyenera kuyimbira ambulansi nthawi yomweyo.
Kugwiritsa ntchito mankhwala osokoneza bongo mopitirira muyeso kapena kupha poyizoni wa mankhwala osokoneza bongo kumatha kudzetsa mavuto akulu azaumoyo mpaka pakufa.
Analogi, mtengo wake komanso kuyanjana ndi njira zina
Panthawi ya mayesero azachipatala, kukonzekera kochokera ku sitagliptin kunalibe tanthauzo lalikulu komanso lofunikira pa pharmacological kinetics ya mankhwala monga rosiglitazone, metformin, glibenclamide, warfarin, simvastatin, ndi njira yolerera pakamwa.
Mukamagwiritsa ntchito othandizira malinga ndi sitagliptin, zoletsa za CYP2C8, CYP3A4, CYP2C9 isoenzymes sizimachitika. Kuphatikiza apo, mankhwalawa saletsa enzyme zotere CYP1A2, CYP2D6, CYP2B6, CYP2C19.
Kugwiritsa ntchito kwa sitagliptin ndi metformin sikusintha kwenikweni mu pharmacokinetics ya sitagliptin mu shuga mellitus.
Mankhwala ofala kwambiri ndi Januvia. Analogue ya mankhwala aku Russia a Januvia ndi Yanumet, omwe mtengo wake ku Russia ndi pafupifupi ma ruble 2980.
Poyerekeza ndi ndemanga ya odwala omwe adagwiritsa ntchito mankhwalawa mankhwalawa, imakhudzanso kwambiri shuga mu thupi, koma imafunikira kuyang'anira mosamalitsa kwa thupi chifukwa chotsatira cha zotsatira zoyipa zambiri.
Mtengo wa mankhwalawa umatengera dera la dzikolo komanso mapangidwe ake a mankhwalawo ndipo umachokera ku 1596 mpaka 1724 rubles. Kanemayo munkhaniyi ayankhula za njira zochizira glycemia.
