Pioglisant (30 mg) Pioglitazone > Kev khomob thiab kev tiv thaiv

Ntsiav tshuaj 15 mg, 30 mg

Ib ntsiav tshuaj muaj

cov tshuaj heev - pioglitazone hydrochloride 16.53 mg (sib npaug rau pioglitazone 15.00 mg) rau kev noj tshuaj ntawm 15 mg, lossis 33.06 mg (30.00 mg) rau kev noj ntau npaum li 30 mg,

tus zam: lactose monohydrate, calcium carmellose, hydroxypropyl cellulose, magnesium stearate.

Cov ntsiav tshuaj yog xim dawb lossis yuav luag dawb, puag ncig nrog lub biconvex nto (rau qhov ntau npaum ntawm 15 mg), cov ntsiav tshuaj yog xim dawb lossis yuav luag dawb, puag ncig, tiaj-cylindrical nrog bevel thiab lub logo hauv daim ntawv ntawm tus ntoo khaub lig (rau ntau npaum ntawm 30 mg).

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Cov tshuaj muaj zog ntawm pioglitazone thiab cov metabolites hauv cov ntshav cov ntshav tseem nyob rau theem siab li 24 teev tom qab siv ib koob. Kev sib luag ntawm cov ntshav muaj zog ntawm pioglitazone thiab tag nrho pioglitazone (pioglitazone + cov tshuaj tiv thaiv metabolites) tau mus txog hauv 7 hnub. Kev tswj hwm rov qab tsis ua rau kev txuam nrog cov khoom sib txuas lossis cov khoom noj khoom haus. Qhov siab tshaj plaws nyob rau hauv cov ntshav dej (Cmax), thaj chaw hauv qab nkhaus (AUC) thiab qhov tsawg kawg nkaus hauv siab hauv ntshav ntshav (Cmin) ntawm pioglitazone thiab tag nrho pioglitazone nce ntxiv hauv kev faib ua feem rau koob tshuaj 15 mg thiab 30 mg rau ib hnub.

Tom qab kev tswj hwm ntawm qhov ncauj, pioglitazone nrawm nrawm los ntawm lub plab zom mov, txiav txim siab hauv cov ntshav cov ntshav tom qab 30 feeb, thiab cov ntsiab lus siab tshaj plaws tau mus txog tom qab 2 teev. Qhov nqus ntawm cov tshuaj yog ywj siab ntawm cov zaub mov noj. Kev tsis raug cai ntawm bioavailability ntau dua 80%.

Qhov kwv yees kwv yees ntawm kev faib tawm ntawm cov tshuaj hauv lub cev yog 0.25 l / kg. Pioglitazone thiab nws cov metabolites nquag muaj feem cuam tshuam nrog cov ntshav plasma protein (> 99%).

Kev zom zaub mov Pioglitazone lom zem ntau los ntawm hydroxylation thiab oxidation, thiab cov metabolites kuj tseem hloov kho qee yam rau glucuronide lossis sulfate conjugates. Cov metabolites M-II thiab M-IV (hydroxy derivatives ntawm pioglitazone) thiab M-III (keto derivatives ntawm pioglitazone) muaj cov haujlwm pharmacological.

Ntxiv rau pioglitazone, M-III thiab M-IV yog cov yeeb tshuaj loj muaj feem rau tib neeg cov ntshav tom qab rov qab siv ntau dua koob tshuaj. Nws raug paub tias ntau isoforms ntawm cytochrome P450 koom nrog hauv cov metabolism hauv pioglitazone. Cov metabolism ua ke nrog cytochrome P450 isoforms xws li CYP2C8 thiab, kom tsawg dua, CYP3A4, nrog kev koom tes ntxiv ntawm ntau lwm isoforms, suav nrog ntxiv rau CYP1A1.

Tom qab lub qhov ncauj tswj hwm, kwv yees li 45% ntawm cov koob tshuaj pioglitazone pom nyob hauv cov zis, 55% hauv cov quav. Kev zam ntawm pioglitazone los ntawm ob lub raum yog qhov tsis txaus ntseeg tau, feem ntau ua rau hom metabolites thiab lawv cov conjugates. Ib nrab-lub neej ntawm pioglitazone yog 5-6 teev, tag nrho pioglitazone (pioglitazone + active metabolites) yog 16-23 teev.

Cov pab pawg neeg tshwj xeeb

Ib nrab ntawm lub neej ntawm pioglitazone los ntawm cov ntshav cov ntshav tseem tsis tau hloov pauv hauv cov neeg mob uas muaj mob pesnrab (creatinine tshem tawm 30-60 ml / min) thiab mob hnyav (creatinine tshem tawm 4 ml / min). Tsis muaj xov xwm hais txog kev siv tshuaj yeeb rau kev kho mob ntawm cov neeg mob uas raug lim ntshav, yog li Pioglisant yuav tsum tsis txhob siv los kho hom mob no.

Daim siab ua haujlwmPioglisant yog contraindicated rau hauv cov neeg mob uas lub siab tsis ua haujlwm.

Kev piav qhia ntawm qhov kev txiav txim ntawm pharmacological

Xaiv yam tshuaj rau cov hluav taws xob nuclear gamma receptors ua haujlwm los ntawm lub tshuab pa peroxisome proliferator (gamma PPAR). Nws hloov kho qhov hloov pauv ntawm cov gene uas nkag siab ntawm insulin thiab koom nrog kev tswj cov piam thaj thiab lipid metabolism hauv adipose, cov leeg nqaij thiab lub siab. Nws tsis txhawb kev loj hlob ntawm insulin, Txawm li cas los xij, nws tseem nquag ua haujlwm thaum muaj cov kua dej-kua hluavtaws ua haujlwm ntawm cov txiav ua ntej txiav txim siab. Txo cov insulin tsis kam ntawm peripheral cov ntaub so ntswg thiab daim siab, ua kom muaj kev noj cov kua dej insulin, txo cov zis ntawm cov piam thaj los ntawm daim siab, txo cov ntshav qis, insulin thiab glycosylated hemoglobin hauv cov ntshav. Hauv cov neeg mob uas muaj cov lipid metabolism tsis ua hauj lwm, nws txo qis triglycerides thiab nce HDL yam tsis hloov LDL thiab tag nrho cov cholesterol.

Hauv kev sim tshuaj, nws tsis muaj carcinogenic thiab mutagenic teebmeem. Thaum muab rau cov poj niam thiab txiv neej nas txog 40 mg / kg / hnub, pioglitazone (txog 9 zaug siab dua MPDC, xam rau 1 m2 ntawm lub cev saum npoo), tsis muaj kev cuam tshuam ntawm kev muaj peev xwm tau kuaj pom.

Kev ntsuas rau siv

Yam 2 Ntshav Qab Zib Hom:
- hauv kev kho mob monotherapy hauv cov neeg mob rog nrog kev noj zaub mov tsis muaj txiaj ntsig thiab kev tawm dag zog nrog kev tsis txaus siab rau metformin lossis muaj cov tshuaj tiv thaiv kev tsis haum rau nws siv,
- ua ib feem ntawm txoj kev kho ua ke:

1. nrog metformin nyob rau hauv cov neeg mob uas rog dhau ntawm qhov tsis muaj glycemic tswj tau zoo nyob rau tom qab ntawm metformin monotherapy,
2. Nrog sulfonylurea derivatives tsuas yog hauv cov neeg mob rau tus neeg uas metformin yog contraindicated, thaum tsis muaj glycemic txaus los tiv thaiv keeb kwm ntawm monotherapy nrog sulfonylurea derivatives.
3. nrog cov tshuaj insulin thaum tsis muaj kev tswj txaus glycemic thaum kho nrog insulin hauv cov neeg mob rau leej twg metformin yog contraindicated.

Cov Tshuaj Hauv Tshuaj

Thiazolidinedione hypoglycemic tus neeg sawv cev rau kev siv ncauj.

Pioglitazone stimulates tshwj xeeb gamma receptors hauv lub keeb, qhib lub peroxisome proliferator (PPARγ). Nws hloov kho qhov hloov pauv ntawm cov noob caj dab uas nkag siab txog insulin thiab koom nrog kev tswj cov ntshav piam thaj thiab lipid metabolism hauv adipose, cov leeg nqaij thiab lub siab. Tsis zoo li cov tshuaj npaj tau los ntawm sulfonylureas, pioglitazone tsis txhawb cov tshuaj insulin, tab sis nws tseem nquag thaum muaj cov tshuaj insulin-hluavtaws ua haujlwm ntawm cov txiav ua ntej. Pioglitazone txo qhov insulin tsis kam ntawm peripheral cov ntaub so ntswg thiab daim siab, nce kev noj ntawm insulin-tiv thaiv cov kua nplaum thiab txo cov kua qab zib los ntawm daim siab, txo cov concentration ntawm cov piam thaj, insulin thiab glycosylated hemoglobin. Lub sijhawm kho nrog pioglitazone, qhov kev txiav txim ntawm triglycerides thiab cov roj dawb hauv cov ntshav plasma poob qis, thiab cov concentration ntawm cov lipoproteins ntau ntom kuj nce.

Rau cov neeg mob uas muaj ntshav qab zib hom 2, tswj ntshav qabzib cov ntshav yuav tau zoo tuaj ntawm lub plab thiab tomqab noj mov.

Cov Tshuaj Pharmacokinetics

Pioglitazone tau txais nrawm nrawm, Cmax ntawm pioglitazone hauv cov ntshav ntshav feem ntau mus txog 2 teev tom qab kev tswj hwm qhov ncauj. Hauv ntau cov tshuaj kho mob, ntshav ntau ntxiv nrog cov koob tshuaj nce siab. Nrog kev rov ua dua ntawm kev ua kom ruaj khov, pioglitazone thiab nws cov metabolites tsis tshwm sim. Kev noj tsis cuam tshuam rau kev nqus. Bioavailability yog dhau 80%.

Vd yog 0.25 l / kg lub cev hnyav thiab ua tiav 4-7 hnub tom qab pib kev kho mob. Kev khi rau cov ntshav protein ntawm pioglitazone yog ntau dua 99%, nws cov metabolites - ntau dua 98%.

Pioglitazone metabolized los ntawm hydroxylation thiab oxidation. Feem ntau cov txheej txheem no tshwm sim nrog kev koom tes ntawm cytochrome P450 isoenzymes (CYP2C8 thiab CYP3A4), nrog rau, rau qee qhov tsawg dua, lwm yam isoenzymes. 3 ntawm 6 ntawm cov tshuaj tiv thaiv metabolites (M) ua pov thawj kev ua tshuaj pharmacological (M-II, M-III, M-IV). Muab cov kev ua lag luam pharmacological, kev ua kom pom tseeb thiab qib ntawm kev khi rau cov ntshav plasma protein, pioglitazone thiab cov metabolite M-III sib npaug txiav txim siab txhua yam kev ua haujlwm, kev koom tes ntawm metabolite M-IV rau tag nrho cov kev ua ntawm cov tshuaj yog kwv yees li 3 zaug ntau dua los ntawm kev muaj txiaj ntsig ntawm pioglitazone, thiab kev sib raug zoo ntawm metabolite M-II yog qhov tsawg heev Cov.

Hauv cov kev tshawb fawb hauv vitro tau pom tias pioglitazone tsis inhibit isoenzymes ntawm CYP1A, CYP2C8 / 9, CYP3A4.

Nws yog tawm hauv feem ntau los ntawm txoj hnyuv, nrog rau lub raum (15-30%) hauv daim ntawv ntawm cov khoom noj sib xyaw ua ke thiab lawv cov conjugates. T1 / 2 ntawm kev hloov pauv ntawm pioglitazone los ntawm ntshav ntshav qhov hnyav kwv yees 3-7 teev, thiab rau txhua yam kev siv dag zog rau 16-24 teev.

Qhov kev nkag siab ntawm pioglitazone thiab cov metabolites nyob rau hauv cov ntshav ntshav tseem nyob rau theem siab rau 24 teev tom qab kev tswj hwm ib zaug ntawm ib hnub.

Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb

Cov neeg laus thiab / lossis nrog lub raum uas lub raum khiav tsis zoo, tsis tas yuav hloov kho dua.

Tawm tsam tom qab ntawm lub siab ua haujlwm tsis zoo, qhov feem ntawm dawb pioglitazone ntau dua.

Siv rau lub raum tsis zoo muaj nuj nqi

Rau cov neeg mob uas lub raum tsis ua haujlwm (qhov tsis muaj peev xwm ua kom ntau dua 4 ml / min), tsis tas kho qhov koob tshuaj. Tsis muaj ntaub ntawv qhia txog kev siv tshuaj pioglitazone hauv cov neeg mob uas tau txais kev kho mob hemodialysis. Yog li, pioglitazone yuav tsum tsis txhob siv cov pab neeg no.

- mob raum tsis ua haujlwm (CC tsawg dua 4 ml / min).

Cov Yuav Tsum Muaj

- hom ntshav qab zib 1
- mob ketoacidosis,
- lub plawv tsis ua hauj lwm, suav nrog keeb kwm (chav I-IV raws li NYHA kev faib tawm),
- daim siab ua haujlwm (nce kev ua haujlwm ntawm daim siab enzymes 2.5 npaug siab dua li cov kev txwv siab dua ntawm ib txwm),
- mob raum tsis ua haujlwm (CC tsawg dua 4 ml / min),
- lactase deficiency, lactose intolerance, qabzib-galactose malabsorption,
- kev xeeb tub
- lub sijhawm lactation,
- cov menyuam yaus hnub nyoog qis dua 18 xyoo (kev tshawb fawb txog kev nyab xeeb thiab muaj txiaj ntsig ntawm pioglitazone hauv cov menyuam tseem tsis tau ua)
- Cov tshuaj tiv thaiv tsis haum rau pnoglitazone lossis lwm qhov sib txawv ntawm cov tshuaj.

Nrog ceev faj - edematous syndrome, anemia.

Siv thaum cev xeeb tub thiab lactation. Qhov ua tau zoo thiab kev nyab xeeb ntawm pioglitazone hauv cov poj niam cev xeeb tub tsis tau kawm, yog li ntawd, nws yog contraindicated siv cov tshuaj thaum cev xeeb tub. Pioglitazone tau pom tias cov menyuam loj hlob qeeb. Nws tsis paub meej tias pioglitazone ua tawm hauv niam cov kua mis, yog li ntawd, cov tshuaj yuav tsum tsis txhob noj los ntawm cov poj niam thaum lactation. Yog tias tsim nyog, kev teem sij hawm tshuaj thaum lactation, pub mis niam yuav tsum tsis tsum tsum.

Sab sij huam

Los ntawm cov kab mob hauv nruab siab: feem ntau - pom qhov tsis pom kev.

Los ntawm cov kab mob ua pa: feem ntau - sab sauv ntawm txoj hlab ua pa, khaub zig - sinusitis.

Los ntawm sab ntawm cov metabolism: feem ntau - nce hauv lub cev hnyav.

Los ntawm cov leeg ntshav ntawm paj hlwb: feem ntau - hypesthesia, ua tsis xws luag - insomnia.

Kev sib xyaw ntawm pioglitazone nrog metformin

Los ntawm hemopoietic plab hnyuv siab raum: feem ntau - anemia.

Los ntawm cov kab mob hauv nruab siab: feem ntau - pom qhov tsis pom kev.

Los ntawm lub plab zom mov: tshwm sim - pom ntxaws.

Los ntawm sab ntawm cov metabolism: feem ntau - nce hauv lub cev hnyav.

Los ntawm cov leeg musculoskeletal: feem ntau - arthralgia.

Los ntawm cov leeg hlwb: feem ntau - mob taub hau.

Los ntawm cov kab mob genitourinary: feem ntau - hematuria, erectile kawg.

Kev sib xyaw ntawm pioglitazone nrog sulfonylureas

Los ntawm cov kab mob hauv nruab siab: tso tsis tau - vertigo, qhov muag tsis pom.

Los ntawm lub plab zom mov: feem ntau - flatulence.

Lwm yam: ua haujlwm dhau hwv - qaug zog.

Los ntawm ib sab ntawm cov metabolism: feem ntau - nce lub cev qhov hnyav, ua tsis tau zoo - nce kev ua si ntawm lactate dehydrogenase, muaj zog ntau dua lub siab, hypoglycemia.

Los ntawm cov leeg ntshav ntawm paj hlwb: feem ntau - kiv taub hau, ua tsis xws luag - mob taub hau.

Los ntawm cov kab ke genitourinary: ua tsis xws luag - glucosuria, proteinuria.

Los ntawm daim tawv nqaij: ua tsis tau - nce tawm hws.

Kev sib xyaw ntawm pioglntazone nrog metformin thiab sulfonylureas

Los ntawm ib sab ntawm cov metabolism: feem ntau - hypoglycemia, feem ntau - nce hauv lub cev hnyav, cov kev ua si ntawm creatine phosphokinase (CPK).

Los ntawm cov leeg musculoskeletal: feem ntau - arthralgia.

Kev sib xyaw ntawm pioglitazone nrog cov kua dej

Los ntawm sab ntawm cov metabolism: feem ntau - hypoglycemia.

Los ntawm cov leeg musculoskeletal: feem ntau - mob nraub qaum, mob caj pas.

Los ntawm lub tshuab ua pa: ntau zaus - ua tsis taus pa, mob ntsws.

Los ntawm cov hlab plawv system: feem ntau - lub plawv tsis ua haujlwm.

Lwm yam: ntau zaus - edema.

Ntawm ib feem ntawm cov khoom hauv nruab nrog cev: qhov zaus tsis paub meej - o ntawm macula, pob txha lov.

Nrog lub sijhawm ntev ntawm kev siv pioglitazone rau ntau dua 1 xyoo hauv 6-9% ntawm tus neeg mob, tus neeg mob muaj edema, mob me lossis mob hnyav, thiab feem ntau tsis tas yuav tsum tsis kho tawm.

Kev puas siab puas ntsws pom tshwm sim thaum pib ntawm txoj kev kho thiab cuam tshuam nrog kev hloov pauv hauv ntshav cov ntshav qabzib, ib yam li nrog lwm tus neeg mob ntshav qab zib.

Tsuas tshuaj thiab tswj hwm

Sab hauv 1 sijhawm / tsis hais txog ntawm cov zaub mov noj.

Pom zoo kom pib koob tshuaj yog 15 lossis 30 mg 1 lub sijhawm / Qhov siab tshaj plaws txhua hnub rau kev kho mob monotherapy yog 45 mg, nrog kev sib xyaw ua ke 30 mg.

Thaum sau tshuaj pioglitazone ua ke nrog metformin, kev tswj hwm ntawm metformin tuaj yeem txuas txuas ntxiv ntawm ib koob.

Hauv kev sib xyaw nrog sulfonylurea derivatives: thaum pib ntawm kev kho mob, lawv txoj kev tswj hwm tau txuas ntxiv mus rau tib lub koob tshuaj. Thaum muaj ntshav qab zib tsawg, qhov koob tshuaj sulfonylurea derivative raug pom zoo kom txo qis.

Ua ke nrog cov tshuaj insulin: thawj koob tshuaj pioglitazone yog 15-30 mg /, qhov tshuaj ntawm cov tshuaj insulin tseem nyob li qub lossis poob qis los ntawm 10-25% thaum mob hypoglycemia.

Rau cov neeg mob laus, tsis tas yuav hloov cov tshuaj.

Pioglitazone yuav tsum tsis txhob siv rau hauv cov neeg mob uas lub siab tsis ua hauj lwm zoo.

Tsis muaj ntaub ntawv qhia txog kev siv pioglitazone hauv cov neeg mob hnub nyoog qis dua 18 xyoo, yog li kev siv pioglitazone hauv pawg hnub nyoog no tsis pom zoo.

Kev sib cuam tshuam nrog lwm yam tshuaj

Thaum siv pioglitazone txuam nrog lwm cov tshuaj hypoglycemic hauv qhov ncauj, txoj kev txhim kho ntawm hypoglycemia yog ua tau. Hauv qhov xwm txheej no, yuav tsum tau txo qis ntawm lwm qhov tshuaj hypoglycemic hauv qhov ncauj.

Tawm tsam keeb kwm yav dhau los ntawm kev sib txuas ua ke ntawm kev siv pioglitazone nrog cov kua dej, kev txhim kho ntawm lub siab tsis tuaj yeem ua tiav.

Pioglitazone tsis cuam tshuam rau cov tshuaj pharmacokinetics thiab pharmacodynamics ntawm glipizide, digoxin, warfarin, metformin.

Gemfibrozil nce AUC tus nqi ntawm pioglitazone 3 zaug.

Rifampicin nrawm cov metabolism hauv pioglitazone los ntawm 54%.

Hauv vitro ketoconazole inhibits cov metabolism hauv ntawm pioglitazone.

Cov lus qhia tshwj xeeb rau kev txais neeg kawm

Hauv kev kho mob ntawm hom 2 mob ntshav qab zib mellitus, ntxiv rau kev noj cov tshuaj pioglitazone, nws raug nquahu kom ua raws li kev noj haus thiab kev qoj ib ce kom tswj tau qhov ua tau zoo ntawm kev siv tshuaj, nrog rau kev sib txuas nrog qhov ua tau nce hauv lub cev qhov hnyav.

Nrog rau kev siv cov pioglitazone, kev ua kom lub cev thiab qhov ntshav nce ntau ntxiv tuaj yeem ua tau, uas tuaj yeem ua rau txoj kev txhim kho lossis kev txom nyem ntawm lub plawv tsis ua hauj lwm, yog li ntawd, thaum lub xeev ntawm cov hlab plawv mob loj dua, pioglitazone yuav tsum tau txiav tawm.

Cov neeg mob uas muaj tsawg kawg yog ib qho kev pheej hmoo rau kev loj hlob ntawm lub plawv tsis ua haujlwm ntev (CHF) yuav tsum pib kho nrog qhov tsawg kawg nkaus thiab maj mam nce ntxiv. Nws yog ib qho tsim nyog yuav tsum tau paub kom paub meej raws li thawj cov tsos mob ntawm lub plawv tsis ua hauj lwm, hnyav dua (tuaj yeem qhia kev txhim kho ntawm lub plawv tsis ua haujlwm) lossis kev txhim kho ntawm edema, tshwj xeeb tshaj yog nyob rau cov neeg mob uas txo qis cov ntshav tawm. Thaum CHF txhim kho, cov tshuaj tam sim ntawd raug muab tso tseg.

Pioglitazone tuaj yeem ua rau lub siab ua haujlwm tsis zoo. Ua ntej yuav kho thiab tsis tseg thaum kho, daim siab ua rau daim siab ua haujlwm yuav tsum tshawb xyuas. Yog tias kev ua haujlwm ALT ntau dua li 2,5 zaug ntawm qhov txwv qis ntawm ib txwm, lossis nyob rau ntawm qhov muaj lwm cov tsos mob ntawm daim siab tsis ua haujlwm, kev siv cov pioglitazone yog contraindicated.Yog tias, hauv 2 qhov kev tshawb fawb sib law liag, ALT kev ua haujlwm dhau ntawm kev txwv ntau tshaj ntawm tus qauv los ntawm 3 zaug lossis tus neeg mob lub ntsej muag daj, kev kho nrog pioglitazone nres tam sim ntawd. Yog tias tus neeg mob muaj cov tsos mob qhia tias lub siab ua haujlwm tsis zoo (qhia txog tsis ua haujlwm, ntuav, mob plab, tsis muaj zog, tsis nco qab, tso zis tsaus nti), kev ua haujlwm ntawm daim siab ua haujlwm siab yuav tsum tshawb xyuas tam sim ntawd.

Pioglitazone tuaj yeem ua rau txo tus hemoglobin lossis hematocrit los ntawm 4% thiab 4,1%, feem, uas tuaj yeem yog vim yog hemodilution (vim yog cov kua nyeem tau tsis zoo).

Pioglitazone tsub kom cov nqaij mos rhiab rau insulin, uas ua rau muaj kev pheej hmoo ntawm hypoglycemia hauv cov neeg mob uas tau txais kev kho ua ke uas muaj sulfonylurea derivatives lossis insulin. Tej zaum yuav tsum tau txhaj koob tshuaj txo tus nqi tom kawg.

Pioglitazone tuaj yeem ua rau lossis ua kom tsis zoo ntawm macular edema, uas tuaj yeem ua rau txo qis ntawm qhov pom tseeb.

Pioglitazone tuaj yeem ua rau muaj ntau ntxiv ntawm cov pob txha lov rau cov poj niam.

Hauv cov neeg mob uas muaj mob polycystic ovary, cov tshuaj insulin ntau ntxiv tuaj yeem ua rau rov pib dua ntawm ovulation thiab ua cev xeeb tub. Cov neeg mob uas muaj mob polycystic zes qe menyuam uas tsis xav kom cev xeeb tub yuav tsum siv txoj hauv kev tiv thaiv kom tsis muaj menyuam. Yog tias cev xeeb tub tshwm sim, kev kho yuav tsum tau nres tam sim ntawd.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Muab cov kev mob tshwm sim ntawm cov tshuaj, kev saib xyuas yuav tsum tau ua thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem uas yuav tsum muaj kev kub siab.

Yuav siv li cas: noj ntau thiab hom tshuaj kho

Siv ncauj ntawm ncauj 1 zaug nyob rau ib hnub, tsis hais noj zaub mov dab tsi.

Pom zoo kom pib koob tshuaj yog 15 lossis 30 mg ib hnub ib zaug. Qhov siab tshaj plaws ib hnub rau kev kho mob monotherapy yog 45 mg, nrog kev sib xyaw ua ke - 30 mg.

Thaum muab cov tshuaj Piouno txuam nrog metformin, kev coj ntawm metformin tuaj yeem txuas txuas ntxiv ntawm ib koob.

Ua ke nrog cov tshuaj insulin: thawj koob tshuaj pioglitazone yog 15-30 mg ib hnub twg, qhov tshuaj ntawm cov tshuaj insulin tseem nyob li qub lossis qis dua 10-25% thaum muaj cov hypoglycemia tshwm sim.

Rau cov neeg mob laus, tsis tas yuav hloov cov tshuaj.

Pioglitazone yuav tsum tsis txhob siv rau hauv cov neeg mob uas lub siab tsis ua hauj lwm zoo.

Tsis muaj ntaub ntawv qhia txog kev siv pioglitazone hauv cov neeg mob hnub nyoog qis dua 18 xyoo, kev siv pioglitazone hauv pawg hnub nyoog no tsis pom zoo.

Pharmacological kev txiav txim

Lub tshuab ua haujlwm nquag ntawm Piouno yog pioglitazone, ib tus neeg sawv cev hypoglycemic ntawm thiazolidinedione series rau qhov ncauj tswj hwm.

Pioglitazone stimulates tshwj xeeb gamma receptors hauv lub keeb, qhib lub peroxisome proliferator (PPAR gamma). Nws hloov kho qhov hloov pauv ntawm cov noob caj dab uas nkag siab txog insulin thiab koom nrog kev tswj cov ntshav piam thaj thiab lipid metabolism hauv adipose, cov leeg nqaij thiab lub siab. Tsis zoo li cov tshuaj npaj tau los ntawm sulfonylureas, pioglitazone tsis txhawb cov tshuaj insulin, tab sis nws tseem nquag thaum muaj cov tshuaj insulin-hluavtaws ua haujlwm ntawm cov txiav ua ntej. Pioglitazone txo qhov insulin tsis kam ntawm peripheral cov ntaub so ntswg thiab daim siab, nce kev noj ntawm insulin-tiv thaiv cov kua nplaum thiab txo cov kua qab zib los ntawm daim siab, txo cov concentration ntawm cov piam thaj, insulin thiab glycosylated hemoglobin. Lub sijhawm kho nrog pioglitazone, qhov kev txiav txim ntawm triglycerides thiab cov roj dawb hauv cov ntshav plasma poob qis, thiab cov concentration ntawm cov lipoproteins ntau ntom kuj nce.

Rau cov neeg mob uas muaj ntshav qab zib hom 2, tswj ntshav qabzib cov ntshav yuav tau zoo tuaj ntawm lub plab thiab tomqab noj mov.

Kev sib txuam

Tawm tsam keeb kwm yav dhau los ntawm kev sib txuas ua ke ntawm kev siv pioglitazone nrog cov kua dej, kev txhim kho ntawm lub siab tsis tuaj yeem ua tiav.

Gemfibrozil nce AUC tus nqi ntawm pioglitazone 3 zaug.

Hauv vitro ketoconazole inhibits cov metabolism hauv ntawm pioglitazone.