Pamaziko a metformin hydrochloride, osati ma Glucofage oyamba (330 rubles) omwe amapangidwa, komanso ma fanizo ambiri: Siofor (ma ruble 320), Metformin Teva (198 rubles), Metformin Canon (195 rubles). Ngati dokotala wakupatsirani mankhwala aliwonse ofanana ndi metformin, khalani omasuka kupempha kuti akupatseni mankhwala a Metformin Canon okwera mtengo.
Generic Glucofage wa kalasi ya greatuanides a m'badwo wachitatu ndi mankhwala othandizira odwala matenda ashuga omwe amawongolera mbiri ya glycemic popanda kukondoweza kwowonjezera kwa kapamba. Ndi zovuta zochepa, zomwe pakati pake palibe hypoglycemia, zimabwezeretsa kagayidwe ka lipid, zimathandizira kuyendetsa thupi.
Mlingo wa Fomu ndi Ma Metformin Canon
Kampani yopanga mankhwala ku Canonfarm Production imapanga mankhwala mu mawonekedwe a mapiritsi ozungulira kapena oval convex mu chipolopolo choyera. Kutengera ndi zomwe zidapezeka ndi metformin hydrochloride, mankhwala omwe ali ndi Mlingo wa 1000, 850, 500 mg angagulidwe mu gulu la mankhwala.
Pa Metformin Canon, mtengo wake udzatengera njira yogulitsira ya mankhwala ndi mlingo:
- 30 ma PC 850 mg aliyense. - 88-90 rubles .;
- 30 ma PC 1000 mg iliyonse - ma ruble a 108-138;
- Ma PC 60. 500 mg - 146-160 rubles;
- Ma PC 60. 850 mg aliyense - 167-192 rubles;
- Ma PC 60. 1000 mg iliyonse - 248-272 rubles.
Kuphatikiza pazomwe zimagwira, mawonekedwe a mankhwalawa amakhalanso ndi zina zowonjezera mu mawonekedwe a wowuma, primogel, povidone, sodium fumarate, talc. Chipolopolochi chimapangidwa ndi oyera opadra II, macrogol, mowa wa polyvinyl, titanium dioxide ndi talc.
Moyo wa alumali wa mapiritsi ndi zaka 2, mankhwalawa safuna mikhalidwe yapadera kuti asungidwe.
Pharmacology
Metformin Canon ndi mankhwala ochepetsa shuga pamlomo, woimira yekha pagulu la Biguanide. Ndi kuchuluka kwa shuga m'magazi, kumachepetsa kuchuluka kwake mwa kulepheretsa glucogenesis m'chiwindi, kutseka mayamwidwe ake m'matumbo a matumbo, ndikuwonjezera mwayi wake wogwiritsidwa ntchito ndi minofu, komwe imasinthidwa kukhala mphamvu, m'malo mwa mafuta, chifukwa chakuwonjezeka kwa chidwi cha maselo a cell cell kulowa ku insulin.
Kuchepetsa kwa insulin kukokana kwambiri ndi minofu yolimba, mafutawo amakhala ovuta kupukusa metabolite.
Metformin imalimbikitsa glycogen synthase ndi ma cell glycogeneis. Mosiyana ndi kukonzekera kwa gulu la urea la sulfanyl, kupanga insulin sikulimbikitsa biagunids. Izi sizipanga zolemetsa zowonjezera pakanema ndi ma cell a b, sizimayambitsa zochitika za hypoglycemic mwa anthu athanzi omwe amagwiritsa ntchito metformin kuti achepetse thupi, kupewa oncology ndi zochitika zamtima, kapena kutalikitsa moyo atakula (pambuyo pa zaka 40).
Chofunikira pakuwongolera kwathunthu kwa matenda amtundu wa 2 matenda a shuga ndicholimbitsa thupi. Mosiyana ndi mankhwala ambiri a hypoglycemic, Metformin Canon satenga mbali ina iliyonse poyerekeza ndi kunenepa, ndipo kugwiritsa ntchito nthawi zonse kumathandizanso kuti muchepetse kuchepa.
Pharmacokinetics
Kuyamwa kwa metformin m'makoma am'mimba kumatengera kudzaza kwake: ngati mumamwa mapiritsi musanadye, mayamwidwe ndi 48-52%, mukamagwiritsa ntchito mankhwalawa nthawi yomweyo monga chakudya, njirayo imayamba kuchepa ndipo ntchito yake imachepa.
Chiwonetsero chachikulu cha biagunide (2 μg / l) chimawonedwa pambuyo pa maola awiri ndi atatu. Thupi limafalikira mwachangu kudzera mu minofu, ndi mwamtheradi bioavailability wa 60%. Ma metabolite samakumana ndi mapuloteni am magazi, koma amalowa m'magazi ofiira a m'magazi. Ambiri mwa mankhwalawa amadziunjikira impso, chiwindi, ndi tiziwalo timene timatulutsa timitsempha. Mukamagwiritsa ntchito piritsi lolemera 850 mg, voliyumu yogawa idzakhala 296-1012 malita.
Metformin metabolites m'thupi sanapezeke, impso zimachotsa mu mawonekedwe osasinthika. Mwa anthu omwe ali ndi metabolism yachilendo, chilolezo cha metformin chili mndandanda wa 400 ml / min. Kutha kwa theka-moyo ndi maola 6.2. Ndi a impso pathologies, chizindikiro ichi chimawonjezeka, ndipo ndi chiopsezo chowerengera cha metformin, chomwe chimakwiyitsa lactic acidosis.
Zizindikiro zakusankhidwa kwa Metformin Canon
Metformin Canon imaperekedwa kwa odwala matenda ashuga omwe ali ndi matenda amtundu wa 2 ngati kusintha kwasinthidwe (zakudya zama carb otsika, masewera olimbitsa thupi, chiwonetsero chazomvera) sanaperekenso chiwongolero chonse cha glycemic.
Kwa odwala onenepa kwambiri, metformin ndiye chisankho chabwino kwambiri. Mankhwalawa amaphatikizidwa bwino ndi mankhwala a hypoglycemic a magulu ena a ma pharmacological, momwe mawotchi amachitidwe amasiyana ndi biguanides. Mwina chithandizo chokwanira ndi insulin.
Mankhwala amasonyezedwanso zochizira matenda amishuga amtundu wa 2 kwa ana okulirapo zaka 10. Amagwiritsidwa ntchito ngati mankhwala a mzere woyamba kapena kuphatikiza ndi insulin.
Omanga a thupi amagwiritsa ntchito mankhwalawa kuti aume minofu, kuyesa kuchepa thupi komanso atsikana, koma kugwiritsa ntchito mankhwalawa kumakhala koyenera pokhapokha ngati vuto la kunenepa kwambiri limagwirizanitsidwa ndi insulin kukaniza ndi zovuta za metabolic.
WHO imalimbikitsa metformin kwa odwala athanzi atatha zaka 40 ali ndi 200 mg / m / tsiku. kutalikitsa moyo (kupewa atherosulinosis, zochitika zamtima, oncology).
Njira zogwiritsira ntchito
Piritsi imamwa popanda kupera, pamodzi ndi madzi, pachakudya kapena itangotha. Dokotala amatenga dongosolo la mankhwala ndi mankhwalawa kutengera zotsatira za mayeso a labotale, gawo la matendawa, zovuta zina, zovuta zomwe wodwalayo amachita ndi metformin.
Akuluakulu odwala matenda ashuga
Mankhwalawa amagwiritsidwa ntchito ngati mankhwala a monotherapy kapena osokoneza bongo. Mlingo woyambira wa Metformin Canon, malinga ndi malangizo ogwiritsira ntchito, ndi 1000-1500 mg / tsiku. Ngati mumagawanitsa masiku onse kawiri kawiri, mutha kuchepetsa zomwe zimachitika mu vuto la dyspeptic. Pambuyo pa masabata awiri, ngati thupi lasintha, koma glucometer siolimbikitsa, kupatsanso gawo pang'onopang'ono kwa Mlingo ndikotheka.
Mukasankha ma analogi ena, wina akuyenera kuwongoleredwa ndi kuchuluka kwa mankhwala apambuyo, komanso nthawi yomwe amachotseredwa (njira yotalikilapo imafunikira kupuma pang'ono).
Ngati Metformin Canon amathandizira odwala matenda ashuga kuphatikiza jakisoni wa insulini, kuyamba kwa mapiritsi sikudutsa gawo limodzi patsiku la mlingo wa 1000 mg, katatu kapena tsiku. pa mlingo wa 500-850 mg. Poterepa, kuchuluka kwa insulini kumatchulidwa molingana ndi mawonekedwe a menyu komanso zofunikira za glucometer.
Odwala odwala
Matenda a shuga a mtundu 2 kwa ana siachilendo masiku ano, makamaka m'maiko otukuka. Zakudya zabwino, kusachita masewera olimbitsa thupi, kupsinjika kwakukulu kumapangitsa zinthu kufalikira kwa matenda kwa ana. Metformin Canon amalembera ana azaka zopitilira zaka 10 ngati monotherapy yoyambirira kapena kuphatikiza jakisoni wa insulin.
Mlingo woyambira, malangizo amalimbikitsa kusankha osachepera - 500 mg / tsiku. Piritsi imaperekedwa kwa mwana madzulo, panthawi yachakudya chokwanira. M'masabata awiri, mutha kuwunika momwe mankhwalawo amathandizira ndikusintha mlingo, pang'onopang'ono mungamubweretse pazokonzanso (1000-1500 mg / tsiku) kapena pazokwanira (200 mg / tsiku). Mlingo wa tsiku ndi tsiku umagawidwa muyezo waukulu wa 2-3
Odwala a Msinkhu Wokhwima
Kwa zaka zambiri, odwala matenda ashuga omwe akudziwa zambiri (osati zokhazokha), mphamvu ya impso imachepa, chifukwa chake Metformin Canon adayikidwa kuti aziwunika mwadongosolo ntchito zawo miyezi isanu ndi umodzi iliyonse. Kutalika kwa maphunzirawa kukhazikitsidwa ndi adotolo, ndikofunikira kuti azitha kuyendetsa mankhwalawa pakumwa mankhwala amtunduwu wa odwala matenda ashuga komanso osasokoneza chithandizo popanda chilolezo cha endocrinologist.
Malangizo owonjezera
Kuchiza ndi Metformin Canon kumafuna kuwunikira glucometer tsiku ndi tsiku ndikulemba zotsatira muzolemba za odwala matenda ashuga. Kuphatikiza pa kusala kudya, ndikofunikira kuyang'anitsitsa ndikumatha, patatha maola awiri mutatha kudya. Ngati zotsatira zake zikupitilira zomwe zapita ndi 3mmol / l, muyenera kusintha kadyedwe.
Mukamapereka mankhwala, wodwala matenda ashuga amachenjezedwa za zotsatira zosayembekezereka: mawonekedwe a mseru komanso kusanza, kupweteka pamimba, minyewa yam'mimba komanso kuchepa mphamvu, muyenera kusiya kugwiritsa ntchito mankhwalawo ndikuwuza adotolo.
Mavuto ocheperako a dyspeptic (chopondapo ndi vuto lakudya) amachoka popanda chithandizo chamankhwala, koma zizindikilo zina zimakhala mafoni oyamba opanga lactic acidosis.
Metformin, monga mankhwala ena amkamwa a hypoglycemic, amathetsedwa masiku awiri asanachitike opaleshoni, mayeso a X-ray (kuphatikizapo anti-imaging, iv urography), omwe amagwiritsa ntchito zilembo za radiopaque zochokera ku ayodini. Nthawi imeneyi, wodwalayo amasamutsidwa ku insulin. Malangizo am'mbuyomu amabwezedwa patatha masiku awiri atatha njira zake, ngati vuto lakelo silikufuna njira zina.
Metformin imachotsedwa ndi impso, chifukwa chake, mapangidwe a creatinine amayenera kuwunika isanayambike maphunzirowa komanso panthawi yopeza mankhwalawa: ndi ntchito yachilendo ya impso - 1 nthawi pachaka, ndi KK yocheperako komanso achikulire - 2-4 nthawi / chaka.
Zizindikiro za matenda am'mapapo, bronchi, ndi urogenital sphere ziyeneranso kukhala chifukwa chochezera endocrinologist.
Poyerekeza ndi chithandizo cha metformin, mowa umakhala wowopsa. Kuletsa ntchito za chiwindi, kupanga amkati glycogen, kumaopseza kukula kwa hypoglycemic ndi disulfiram-like.
Mafuta osakwanira a vitamini B 12 amakwiya chifukwa choletsa mayamwidwe ake. Vutoli limachitika chifukwa chomwa mankhwala nthawi yayitali ndipo chimasinthidwanso. Ngati zizindikiro za hypovitaminosis B12 zimawonedwa, metformin iyenera kusintha ndi analogues.
Kukopa pa kuthekera kolamulira zida zovuta
Metformin Canon sikukhudzana ndi kasamalidwe ka kayendedwe kapena kayendedwe kazovuta ngati imagwiritsidwa ntchito mu monotherapy. Ndi zovuta mankhwala a sulfonylureas ndi insulin, zotsatira za hypoglycemic ndizotheka, zomwe zimapangitsa kwambiri psychomotor zimachitikira komanso ndende.
Zotsatira zoyipa
Metformin ndi mankhwala okhala ndi umboni wokwanira wotetezeka komanso wogwira ntchito, muyezo wa golide pothandizira matenda a shuga, koma mankhwalawa amadziwika ndi anthu osiyanasiyana odwala matenda ashuga. Zotsatira zoyipa kwambiri zomwe zimachitika ndi dyspeptic, munthawi yakusintha, ochepa omwe amatha kupewa. Ngati mumamwa mapiritsi ndi chakudya, ndikuwonjezera Mlingo pang'onopang'ono, mutha kuchepetsa zizindikiro za kukhumudwa m'mimba.
Choyipa china ndi lactic acidosis, yomwe imayamba ndi kudzikundikira kwa metformin mthupi logwirizana ndi kulephera kwa aimpso. Milandu ngati imeneyi ndiyosowa kwambiri, yolosera ndipo imafuna kusiya mankhwala. Ndikosavuta kuwunika kuchuluka kwa zotsatira zoyipa kuchokera ku ziwalo ndi machitidwe osiyanasiyana patebulo.
Organs ndi kachitidwe | Mitundu ya zoyipa | Zowopsa |
| CNS | kusintha kukoma (kukoma kwachitsulo) | nthawi zambiri |
| Matumbo | kutaya mtima, vuto la kusowa kwa magazi | nthawi zambiri |
| Machitidwe a heepatobiliary | kukanika kwa chiwindi, hepatitis | mowirikiza |
| Matupi omaliza | erythema, zotupa pakhungu ndi kuyabwa, urticaria | sikawirikawiri |
| Njira zachikhalidwe | lactic acidosis | kawirikawiri |
| Zosankha zina | Hypovitaminosis B12, kuchepa kwa mayankho a folic acid, kuchemera magazi m'thupi | kawirikawiri |
Zotsatira zonse zimasinthidwa ndikusowa pambuyo pakuchotsedwa kwa Metformin Canon. Zochita zamankhwala zimawonetsa kuti pa zaka 10-16 zaka zachilengedwe ndi zomwe zimakhala zovuta zimafanana ndi zomwe zimachitika mwa akulu.
Zotsatira za kuyanjana ndi mankhwala ena
Ndi othandizira ambiri a hypoglycemic, Metformin imaphatikizidwa bwino bwino, imagwiritsidwa ntchito kwambiri pazovuta zovuta, koma, monga mankhwala aliwonse, ili ndi malire ake.
Kuphatikiza kophatikizidwa
Mankhwala osiyanitsa ndi X-ray okhala ndi ayodini, wogwiritsidwa ntchito m'maphunziro a radiology, amatha kupweteka lactic acidosis pamene akumwa metformin. Chifukwa chake, masiku awiri njira zisanachitike komanso masiku awiri atatha kuyesedwa, mapiritsiwo amasinthidwa ndi jakisoni wa insulin.
Osavomerezeka kuphatikiza
Kugwiritsa ntchito mankhwala oledzera a ethanol ndi ethanol omwe ali ndi metformin kungayambitse lactic acidosis. Zofananazo ndizotheka ndi kuperewera kwa chiwindi ndi zakudya zochepa zopatsa mphamvu.
Zosankha Zothandiza
Mukamagwiritsa ntchito danazol ndi metformin, mikhalidwe ya hypoglycemic ndiyotheka. Ngati ndi kotheka, kuphatikiza koteroko ndikofunikira kumveketsa mlingo wa metformin.
Mlingo wofunikira wa chlorpromazine umalepheretsa maselo a insulin, kukulitsa shuga. Ma antipsychotic amafunikiranso kukhathamiritsa mlingo wa metformin panthawi komanso pambuyo pake.
Glucocorticosteroids amachepetsa kulolera kwa glucose, pomwe kukulitsa kuchuluka kwake mu plasma, ketosis ndiyotheka kwambiri. Ndi kukhazikitsidwa kwa ziwembu zotere, kuchuluka kwa metformin kumachepetsedwa.
NSAIDs ndi malupu okodzetsa okhala ndi metformin amachititsa zovuta za impso. Matendawa ndi owopsa pakukula kwa lactic acidosis.
Nifedipine imathandizira mayamwidwe ndi kuchuluka kwa metformin, mfundoyi iyenera kukumbukiridwa mukamakonzanso njira yothandizira.
Amapangitsanso kuchuluka kwa mankhwala osokoneza bongo komanso kuphatikiza ndi acarbose, insulin, mankhwala a sulfonylurea.
Mankhwala omwe amagwiritsidwa ntchito pothana ndi matenda oopsa amatha kupititsa patsogolo hypoglycemic ndipo amafunika kupatsidwa mlingo wa metformin.
Contraindication
Kuphatikiza pa hypersensitivity pazosakaniza za formula, mankhwalawa sanaikidwe:
- Ndi matenda ashuga, precoma, ketoacidosis;
- Anthu odwala matenda ashuga omwe ali ndi CC pansipa 60 ml / min.;
- Amakhudzidwa ndi machitidwe owopsa (kuchepa madzi m'thupi, kutentha thupi, matenda oopsa);
- Ndi hypoxia yomwe imayambitsidwa ndi mantha, sepsis, ma pathologies a impso zakuyamba, bronchi, mapapu;
- Odwala omwe ali ndi pachimake kapena matenda opatsirana minyewa;
- Kwa nthawi yopangira opaleshoni, mankhwalawa akuvulala kwambiri ndikuwotcha;
- Oledzera osatha, anthu omwe ali ndi chidakwa chachikulu;
- Ndi chiwindi kukanika;
- Mu mkhalidwe lactic acidosis;
- Ana ochepera zaka 10, amayi apakati ndi oyamwitsa;
- Pakanthawi: ziletso pa nthawi ya ntchito ndi maphunziro a radiology.
Mitundu ya bongo
M'maphunziro azachipatala odzipereka omwe adatenga mapiritsi khumi a metformin (85 g), hypoglycemia sanatchule, adawonetsa zizindikiro za lactic acidosis.
Mutha kuzindikira vutoli chifukwa cha vuto la kukomoka, kusinthasintha kwa matumbo, matenthedwe pocheperapo, minofu kukokana ndi kupweteka kwa epigastric, kupuma movutikira, kulumikizana bwino komanso kuzindikira, kukomoka komanso kupweteka. Vutoli limafunikira kuchotsedwa mwachangu kwa mankhwalawo ndikugonekedwa kuchipatala. Zotsalira za lactate ndi metformin kuchipatala zimatheka chifukwa cha hemodialysis.
Kufufuza kwa Mankhwala Osokoneza bongo
About Metformin Canon, ndemanga zimakhala zabwino. Ambiri amadziwa kupezeka kwa mankhwalawa pagawo la mitengo yamagetsi. Theka la odwala limawonetsa kukhazikika kwa shuga, kuwonda, komanso kulakalaka kudya.
Mwa zina zowunikira, madandaulo a zoyipa mwanjira yamavuto am'mimba, omwe samatha ndi nthawi, predomost.Mwachidziwikire, muzochitika zoterezi, ndikofunikira kukambirana ndi dokotala wanu, chifukwa ngakhale ma fanog ofotokoza metformin ali ndi zinthu zingapo zothandizira zomwe zingayambitse ziwengo ndi zina. Ndikotheka kusintha generic ndi glucophage yoyambayo.
Mitu ya mankhwalawa
Kwa Metformin Canon, mitundu ingapo ya mankhwala imatha kukhala fanizo. Mankhwala ofanana ndi mankhwala omwewo ndi ofunikira a metformin ndi awa:
- Glucophage - mankhwala oyamba achi French omwe ali ndi ma ruble 130.;
- Metfogamma - mapiritsi achijeremani pamtengo wapatali mpaka ma ruble 330 .;
- Formetin ndi generic wamba, amagulitsa ma ruble 250 .;
- Sofamet ndi mawu ofanana ndi Chibugariya, angagulidwe ma ruble 109.
Malinga ndi gulu la ATX, mndandandawo ungathe kuphatikizidwa ndi Siofor, Bagomet, Avandamet, Metformin Teva ndi ma analogu ena. Wopanga Metformin Canon amakhalanso ndi mtundu wake wokhala ndi mphamvu yayitali. Mankhwala omasulidwa pang'onopang'ono akupezeka mu mankhwala a 500, 750 ndi 1000 mg. Chiyambiriro "chachitali" ndi fanizo zina
Msika wamakono wamankhwala uli ndi mankhwala odana ndi matenda ashuga, koma m'magulu 10 a mankhwala omwe amapangidwira kuthana ndi matenda a shuga a 2, metformin yokha imakhalabe yopanda vuto. Ili ndiye mankhwala okhazikika, ophunziridwa bwino omwe odwala matenda ashuga amafunikira pa gawo lililonse la matenda.
Zambiri zosangalatsa za metformin zitha kupezeka mu kanemayo.
