Glucophage 500 > Kev khomob thiab kev tiv thaiv

Kev piav qhia

Dosage 500 mg, 850 mg:
Dawb, puag ncig, biconvex zaj duab xis-coated ntsiav tshuaj.
Hla ntu qhia pom qhov txawv dawb.

Ntau npaum 1000 mg:
Dawb dawb, oval, ntsiav tshuaj biconvex, zaj duab xis-txheej, nrog kev pheej hmoo ntawm ob sab thiab kos "1000" ntawm ib sab.
Hla ntu qhia pom qhov txawv dawb.

Cov chaw muag tshuaj

Metformin txo hyperglycemia yam uas tsis ua rau kev txhim kho ntshav qab zib hauv lub ntsej muag. Tsis zoo li sulfonylurea derivatives, nws tsis txhawb kev tiv thaiv insulin secretion thiab tsis muaj qhov cuam tshuam hypoglycemic hauv cov neeg noj qab haus huv. Tsub qhov rhiab heev ntawm peripheral receptors rau insulin thiab kev siv cov kua nplaum los ntawm lub hlwb. Txo cov ntshav qabzib ntau lawm los ntawm inhibiting gluconeogenesis thiab glycogenolysis.
Ncua kev nqus cov hnyuv ntawm lub ntsej muag.

Metformin stimulates glycogen synthesis los ntawm kev ua ntawm glycogen synthase. Tsub kom muaj peev xwm thauj tau txhua yam ntawm cov khoom thauj ua kua roj ntau dua.

Tsis tas li ntawd, nws muaj txiaj ntsig zoo rau lipid metabolism: nws txo cov ntsiab lus ntawm cov roj (cholesterol) tag nrho, cov lipoproteins tsawg thiab triglycerides.

Thaum noj cov tshuaj metformin, tus neeg mob lub cev hnyav dua li qub tseem ruaj khov lossis txo qis.

Cov kev tshawb fawb soj ntsuam kuj tau qhia txog qhov ua tau zoo ntawm Tshuaj Glucofage ® rau kev tiv thaiv cov ntshav qab zib hauv cov neeg mob uas muaj ntshav qab zib nrog lwm qhov kev pheej hmoo ntxiv rau kev txhim kho kev mob ntshav qab zib hom 2 mob ntshav qab zib mellitus, uas kev hloov pauv hauv lub neej tsis tso cai rau kev tswj glycemic txaus.

Cov Tshuaj Pharmacokinetics

Kev nqus thiab faib khoom
Tom qab cov neeg siv qhov ncauj, metformin yog nqus tau ntawm txoj hnyuv mus tag nrho. Kev tsis raug cai ntawm bioavailability yog 50-60%. Qhov siab tshaj plaws (Cmax) (kwv yees li 2 μg / ml lossis 15 μmol) hauv cov ntshav tau txog tom qab 2.5 teev. Nrog kev noj zaub mov ib txhij, kev nqus ntawm metformin yog txo thiab qeeb. Metformin tau faib sai sai hauv cov ntaub so ntswg, kev xyaum ua haujlwm tsis khi rau cov ntshav protein.

Kev ntsuas phoo thiab nthuav tawm
Nws yog metabolized mus rau ib tug kawm ntawv uas tsis muaj zog thiab tawm los ntawm ob lub raum. Kev tshem tawm ntawm metformin hauv cov ntsiab lus noj qab haus huv yog 400 ml / min (4 lub sijhawm ntau dua li creatinine tshem tawm), uas qhia tias muaj cov kwj dej muaj kev zais cia. Ib nrab-lub neej yog kwv yees li 6,5 teev. Nrog raum tsis ua haujlwm, nws nce, muaj kev pheej hmoo ntawm kev txuam nrog cov tshuaj.

Cov Yuav Tsum Tau Ua

Hypersensitivity rau metformin lossis rau ib yam dab tsi,
ketoacidosis, mob ntshav qab zib precoma, coma,
lub raum tsis ua haujlwm lossis lub raum tsis ua haujlwm (creatinine tshem tawm tsawg dua 45 ml / min),
muaj mob hnyav nrog qhov muaj pheej hmoo ua mob rau lub raum: lub cev qhuav dej (nrog rau zawv plab, ntuav), cov kab mob kis hnyav, ua rau poob siab,
cov kab mob hais tawm los ntawm kev mob siab lossis mob mus ntev uas tuaj yeem ua rau kev tsim cov nqaij mos hypoxia (suav nrog mob plawv tsis ua haujlwm, mob plawv tsis ua haujlwm nrog tsis muaj ntshav hemodynamics, ua pa tsis ua haujlwm, mob myocardial infarction),
kev phais mob ntau thiab kev raug mob thaum kho cov tshuaj insulin (saib Ntu "Cov Lus Qhia Tshwj Xeeb"),
daim siab ua haujlwm, lub siab ua haujlwm tsis zoo,
haus cawv qaug cawv, qaug cawv lom,
cev xeeb tub
lactic acidosis (suav nrog keeb kwm),
siv tsawg dua 48 teev ua ntej thiab nyob hauv 48 teev tom qab ua kev tshawb fawb radioisotope lossis xoo hluav taws xob nrog kev qhia ntawm iodine uas muaj qhov nruab nrab tsis sib thooj (saib ntu “Kev cuam tshuam nrog lwm cov tshuaj”),
kev ua raws li cov zaub mov hypocaloric (tsawg dua 1000 kcal / hnub).

Nrog ceev faj

hauv cov neeg laus dua 60 xyoo uas ua haujlwm hnyav lub cev, uas cuam tshuam nrog kev pheej hmoo ntawm kev tsim mob lactic acidosis,
hauv cov neeg mob mob raum tsis ua haujlwm (creatine tshem tawm 45-59 ml / min),
lub sijhawm pub niam mis.

Siv thaum cev xeeb tub thiab thaum pub niam mis

Thaum npaj lub cev xeeb tub, nrog rau muaj xwm txheej ntawm cev xeeb tub ntawm keeb kwm yav dhau los ntawm kev noj cov tshuaj metformin nrog kev mob ntshav qab zib thiab hom ntshav qab zib hom 2, cov tshuaj yuav tsum tau txiav tawm, thiab yog tias muaj tus mob ntshav qab zib hom 2, kev kho tshuaj insulin. Nws yog ib qho tsim nyog yuav tsum ua kom tswj tau cov piam thaj hauv ntshav plasma ntawm cov ntshav nyob ze tshaj qhov qub kom txo tau qhov phom sij ntawm cov menyuam hauv plab.

Metformin hla mus rau hauv niam cov kua mis. Tsis pom cov kev mob tshwm sim hauv cov menyuam mos thaum lub sijhawm pub niam mis thaum tseem noj cov tshuaj metformin tsis tau pom. Txawm li cas los xij, vim tias muaj qee cov ntaub ntawv tsawg, kev siv cov tshuaj thaum lub sijhawm pub niam mis tsis pom zoo. Qhov kev txiav txim siab txog kev pub mis niam yuav tsum txiav txim siab txog txiaj ntsig kev pub mis niam thiab kev pheej hmoo ntawm kev phiv

Tsuas tshuaj thiab tswj hwm

Cov Neeg Laus:
Kev kho kab mob ntshav siab thiab kev kho kom zoo ua ke nrog lwm tus neeg mob ntshav qab zib mob ntshav qab zib hom 2 mob ntshav qab zib mellitus:

Qhov kev pib noj ib txwm yog 500 mg lossis 850 mg 2-3 zaug ib hnub tom qab lossis thaum noj mov.
Txhua 10-15 hnub, nws raug nquahu kom kho cov koob tshuaj raws li cov txiaj ntsig ntawm kev ntsuas qhov ntsuas ntawm cov piam thaj hauv cov ntshav ntshav. Kev noj tshuaj kom qeeb me ntsis yuav pab txo kev phiv los ntawm txoj hnyuv hauv lub plab.
Kev saib xyuas cov tshuaj ntawm cov tshuaj feem ntau yog 1500-2000 mg / hnub. Txhawm rau kom txo cov kev mob tshwm sim los ntawm txoj hnyuv plab, qhov tshuaj txhua hnub yuav tsum tau muab faib ua 2-3 zaug. Qhov ntau tshaj plaws yog 3000 mg / hnub, muab faib ua peb koob.
Cov neeg mob uas siv cov tshuaj metformin hauv koob tshuaj 2000-3000 mg / hnub tuaj yeem hloov mus rau cov tshuaj Glucofage ® 1000 mg. Qhov kev xav tau ntau tshaj plaws yog 3000 mg / hnub, muab faib ua 3 koob.

Nyob rau hauv rooj plaub ntawm kev npaj hloov mus los ntawm kev noj lwm tus neeg sawv cev hypoglycemic: koj yuav tsum tsum tsis txhob noj lwm yam tshuaj thiab pib noj Glucofage ® hauv cov koob tshuaj qhia saum toj no.

Ua ke nrog cov tshuaj insulin:
Yuav kom ua tiav cov tswj ntshav qab zib kom zoo dua, metformin thiab insulin hauv cov neeg mob ntshav qab zib hom 2 tuaj yeem siv los ua kev sib txuas ua ke. Qhov niaj zaus pib noj ntau dua ntawm Glucofage ® yog 500 mg lossis 850 mg 2-3 zaug hauv ib hnub, thaum lub koob tshuaj insulin raug xaiv raws li cov concentration ntawm cov piam thaj hauv cov ntshav.

Cov menyuam yaus thiab cov hluas:
Hauv cov menyuam yaus txij thaum muaj hnub nyoog 10 xyoo, cov tshuaj Glucofage ® tuaj yeem siv tau ob qho tib si hauv monotherapy thiab ua ke nrog insulin. Qhov kev pib noj ib txwm yog 500 mg lossis 850 mg 1 zaug nyob rau ib hnub tom qab lossis thaum noj mov. Tom qab 10-15 hnub, qhov tshuaj yuav tsum raug kho raws li kev nqus ntawm cov ntshav qabzib.
Qhov siab rau ib hnub ntau npaum li cas yog 2000 mg, faib ua 2-3 koob.

Kev kho mob ntshav qab zib:
Cov koob tshuaj li niaj zaus yog 1000-1700 mg ib hnub tom qab lossis thaum noj mov, muab faib ua 2 zaug.
Nws raug nquahu kom ua ntu zus glycemic tswj los ntsuas qhov xav tau ntawm kev siv tshuaj txuas ntxiv.

Cov neeg mob raum tsis ua haujlwm:
Metformin tuaj yeem siv rau hauv cov neeg mob uas mob raum tsis ua haujlwm (kev tsim kho kom pom tseeb 45-59 ml / min) tsuas yog thaum tsis muaj cov xwm txheej uas yuav ua rau muaj kev pheej hmoo ntawm mob lactic acidosis.

Cov neeg mob nrog creatine tshem tawm ntawm 45-59 ml / min: thawj koob yog 500 mg lossis 850 mg ib hnub ib zaug. Qhov siab ntau tshaj plaws yog 1000 mg ib hnub, muab faib ua 2 koob.

Lub raum kev ua haujlwm yuav tsum tau saib xyuas zoo (txhua 3-6 hlis).
Yog tias creatine tshem tawm qis dua 45 ml / min, cov tshuaj yuav tsum tau txiav tam sim ntawd.

Cov neeg laus:
vim tias qhov txo qis hauv kev ua haujlwm ntawm lub raum, cov koob tshuaj metformin yuav tsum raug xaiv raws li kev soj ntsuam tas li ntawm cov raum ua haujlwm (kom txiav txim siab qhov tsim nyog ntawm creatinine hauv ntshav cov ntshav tsawg kawg 2-4 zaug hauv ib xyoos).

Lub sijhawm kho

Glucofage ® yuav tsum noj txhua hnub, tsis muaj kev cuam tshuam. Yog hais tias kev kho mob tsis ua haujlwm ntxiv, tus neeg mob yuav tsum qhia rau tus kws kho mob.

Cov ntaub ntawv dav dav, muaj pes tsawg leeg thiab daim ntawv tso tawm

Glucofage Ntev yog mob ntshav qab zib npaj ntawm chav kawm biguanide nrog cov nquag ua ke Metformin hydrochloride. Muaj nyob rau hauv qhov ntau npaum ntawm 500, 850, 1000 mg.

Thaum noj, nws tau sai adsorbed. Qhov kev tso ntau ntau tshwm sim tom qab 2 teev tom qab kev tswj hwm.

Qhov no tso cai rau koj kom ua tiav cov txiaj ntsig hauv qab no:

normalize ntshav qab zib
nce cov lus teb ntawm cov ntaub so ntswg rau cov tshuaj hormones tsim tawm,
daim siab ua kua muag qab zib ntau lawm,
txo txoj hnyuv kev nqus ntawm cov piam thaj,
nqa lub cev hnyav rov zoo li qub,
txhim kho metabolism hauv lipid,
cov roj (cholesterol) tsawg.

Cov ntsiav tshuaj ua haujlwm tau zoo hauv kev mob ntshav qab zib.

Ntawm kev muag, cov tshuaj tau nthuav tawm hauv cov qauv hauv cov ntsiav tshuaj, nrog nrog lub plhaub biconvex ntawm cov xim dawb. Qhov kub siab ntawm cov nquag tivthaiv yog 500, 850, 1000 mg. Rau qhov yooj yim ntawm tus neeg mob, ntau npaum ntawm cov tshuaj yog engraved rau ntawm ib nrab ntawm cov ntsiav tshuaj.

Cov chaw muag tshuaj thiab tshuaj pharmacokinetics

Cov tshuaj muaj pes tsawg leeg ntawm cov ntsiav tshuaj suav nrog Metformin, uas tuaj yeem lav ib lub suab hypoglycemic tawm. Hauv cov neeg mob uas muaj cov piam thaj hauv siab, nws txo nws qhov qub. Hauv cov neeg muaj ntshav qabzib feem ntau, cov piam thaj hauv ntshav tseem tsis hloov pauv.

Qhov kev nqis tes ntawm cov kev ua kom nquag plias ua raws li kev ua haujlwm ntawm kev tsis sib haum ntawm gluconeogenesis thiab glycogenolysis, muaj peev xwm nce insulin rhiab heev thiab txo qis kev nqus ntawm cov plab hnyuv plab. Tsis tas li ntawd, cov tshuaj no ua rau cov txheej txheem metabolism hauv lub cev ua kom qis thiab ua kom cov rog poob qis.

Qhov siab tshaj plaws ntawm Metformin pom tau 2-3 teev tom qab nws tswj hwm. Ib qho tshwj xeeb ntawm Kev Ua Rau Ntsej Ntev Ntev yog qib qis ntawm kev khi rau cov ntshav protein. Lub ntsiab ua haujlwm tseem ceeb yog dhau los ntawm lub raum thiab cov hnyuv hauv 6,5 teev.

Tom qab noj tshuaj Glucofage, ua tiav kev tshaj tawm ntawm Metmorphine GIT raug sau tseg. Cov khoom ua haujlwm nquag tau muab faib sai sai thoob plaws cov ntaub so ntswg. Feem ntau yog tawm hauv cov raum, so ntawm cov hnyuv. Cov txheej txheem ntawm kev ntxuav cov tshuaj pib 6,5 teev tom qab siv tshuaj. Hauv cov neeg mob raum muaj teeb meem lub raum, ib nrab lub neej nce ntxiv, uas ua rau muaj kev npau suav ntau ntxiv ntawm Metformin ceev.

Kev taw qhia thiab contraindications

Raws li cov lus qhia txuas nrog Glucofage, nws yog qhia rau tus mob ntshav qab zib hom 2, uas yog rog dhau ntawm kev soj ntsuam kev noj zaub mov zoo.

Ntau tus neeg mob siv Glucofage kom poob ceeb thawj. Hauv qhov no, koj yuav tsum ua raws li kev noj zaub mov hauv lub cev tsawg thiab ua qoj ib ce ntawm lub cev niaj hnub. Qhov no tso cai rau koj kom ua tiav cov txiaj ntsig zoo hauv lub sijhawm luv luv.

Zoo li txhua yam tshuaj, glucophage muaj contraindications.

Cov tshuaj txwv tsis pub:

cov neeg nrog intolerance mus rau ib qho ntawm lub Cheebtsam,
nrog mob qa lossis ntshav qab zib ketoacidosis,
nrog kev ua haujlwm tsis zoo ntawm lub raum thiab lub siab,
nrog exacerbation ntawm mob ntev thiab kis kab mob,
nrog rau kev sib xyaw kom zoo ntawm cov dej cawv,
nrog lom lub cev,
thaum cev xeeb tub thiab lactation,
nrog cov kab mob lactic acidosis,
2 hnub ua ntej radiography thiab 2 hnub tom qab nws,
cov neeg muaj hnub nyoog qis dua 10 xyoo
tom qab kev mob hnyav rau lub cev.

Kev noj tshuaj ntsiav los ntawm cov neeg laus yog nqa tawm los ntawm kev saib xyuas ntawm tus kws tshaj lij.

Cov lus qhia rau kev siv

Qhov txhaj tshuaj tsawg kawg nkaus yog 500 lossis 850 mg, uas tau muab faib ua ob peb zaug tshuaj. Tshuaj ntsiav tau noj nrog lossis tam sim ntawd tom qab noj mov. Ib qho hloov pauv ntawm cov tshuaj yog nqa tawm tom qab kev hloov suab thaj.

Qhov tshuaj ntau tshaj plaws yog 3000 mg ib hnub twg, uas tseem faib ua ob peb zaug tshuaj (2-3). Qhov ua rau qeeb qeeb ntawm cov tshuaj nquag nyob hauv cov ntshav nce, qhov tshwm sim tsawg dua ntawm qhov mob plab zom mov.

Thaum muab Glucofage Ntev nrog insulin, cov koob tshuaj pom zoo yog 500, 750, 850 mg 2-3 zaug ib hnub. Kev noj cov tshuaj insulin yog tswj hwm los ntawm kws kho mob.

Cov ntsiav tshuaj tau siv ob qho tib si ua ke nrog lwm cov tshuaj, thiab cais nyias. Tsuas yog qee qhov tshwj xeeb, kev txais neeg tuaj yeem lees paub pib txij lub hnub nyoog kaum xyoo. Qhov muab tshuaj yog muab los ntawm kws kho mob raws li kev saib xyuas ntawm cov ntshav qab zib. Qhov tsawg kawg nkaus yog 500 mg, qhov ntau yog 2000 mg.

Cov Neeg Mob Tshwj Xeeb thiab Cov Lus Qhia

Ua ntej siv cov tshuaj, koj yuav tsum sab laj nrog tus kws kho mob, kawm txog kev phiv, thiab paub koj tus kheej nrog cov lus pom zoo rau cov neeg mob nyob hauv pab pawg tshwj xeeb:

Cev xeeb tub lub sijhawm. Kev lees txais ntawm Glucophage thaum lub sijhawm lav tus menyuam thiab lactation yog txwv tsis pub ua. Cov ntshav qab zib yog tswj xyuas los ntawm kev txhaj tshuaj insulin. Kev txwv tsis pub noj tshuaj thaum lub sijhawm pub mis niam yog vim muaj kev tshawb fawb.
Cov me nyuam muaj hnub nyoogCov. Kev siv cov tshuaj qabzib los ntawm cov menyuam hnub nyoog qis dua 18 xyoo yog qhov tsis xav tau. Muaj qhov tseeb ntawm kev siv cov tshuaj los ntawm cov menyuam yaus ntawm 10 xyoo. Kev tswj hwm los ntawm kws kho mob yog qhov yuav tsum tau ua.
Neeg lausCov. Nrog kev ceev faj, koj yuav tsum noj cov tshuaj rau cov neeg laus uas muaj kev mob raum thiab mob plawv. Lub chav kawm ntawm kev kho mob yuav tsum tau saib xyuas los ntawm cov kws tshaj lij.

Nyob rau qee yam kabmob lossis cov xwm txheej, cov tshuaj raug nrog ceev faj, lossis feem ntau tso tseg:

Cov kab mob lactic acidosisCov. Qee zaum, nrog kev siv cov Metformin, uas cuam tshuam nrog cov lub raum tsis ua haujlwm nyob hauv tus neeg mob. Tus kabmob yog nrog cov leeg mob hauv lub cev, mob hauv plab thiab hypoxia. Yog tias pom tias muaj kab mob, yuav tsum tau tshem tawm yeeb tshuaj thiab kws kho mob tshwj xeeb.
Mob raumCov. Yog tias lub raum ua tsis tau zoo, yuav tsum ceev faj heev, vim tias lub cev yuav ris tag nrho lub nra uas tshem Metformin tawm hauv lub cev. Yog li, ua ntej pib siv cov tshuaj, yuav tsum tau them rau qib ntawm creatinine nyob rau hauv cov ntshav cov ntshav.
Kev phais mobCov. Cov ntsiav tshuaj nres ob hnub ua ntej kev ua haujlwm. Kev rov pib kho mob pib tom qab lub sijhawm zoo sib xws.

Hauv kev rog, noj tshuaj pab cov neeg mob ntshav qab zib hom 2 ua rau lawv qhov hnyav. Ntawm ib feem ntawm tus neeg mob, kev ua kom tau noj qab haus huv yuav tsum nyob rau hauv uas tus naj npawb ntawm calories yuav tsum yog tsawg kawg 1000 kcal hauv ib hnub. Kev xa tawm ntawm chav kuaj yuav ua rau koj saib xyuas lub cev ntawm lub cev thiab qhov ua tau zoo ntawm cov qog ntshav qab zib.

Phiv thiab haus tshaj

Daim ntawv teev cov kev mob tshwm sim los ntawm kev noj cov tshuaj yog raws ntau cov kev tshawb fawb kho mob thiab kev tshuaj xyuas tus neeg mob:

Txo Cov Vitamin Tsis Txaus B12 ua rau muaj kev txhim kho kab mob xws li ntshav liab thiab ntshav lactic acidosis.
Hloov hauv saj buds.
Los ntawm lub plab zom mov, raws plab, mob hauv plab, thiab tsis qab los noj mov yog cai. Kev xyaum qhia tau hais tias cov kev mob tshwm sim tshwj xeeb yog sau tseg rau feem ntau ntawm cov neeg mob thiab hla dhau ob peb hnub.
Ua rau muaj kev tsis haum, qhov mob urticaria yog ua tau.
Kev ua txhaum ntawm cov txheej txheem metabolic tuaj yeem ua rau lub sijhawm tsis pom zoo, vim qhov ntawd tshem tawm sai heev ntawm cov ntsiav tshuaj.

Kev sib cuam tshuam txog Yeeb Tshuaj thiab Analogs

Cov nyhuv hyperglycemic ntawm cov tshuaj Danazol ua rau nws tsis tuaj yeem coj nws nrog Glucofage. Yog tias nws tsis tuaj yeem tshem tawm cov tshuaj, kev tsuas ntau tau los kho tus kws kho mob.

Cawv-muaj tinctures ua rau kom muaj kev pheej hmoo ntawm lactic acidosis.

Cov koob tshuaj loj ntawm chlorpromazine (ntau dua 100 mg / hnub) tuaj yeem nce glycemia thiab txo qis qib kev tso tawm tshuaj. Yuav tsum tau txhaj tshuaj los kho tus kws kho mob.

Co-administration ntawm diuretics ua rau muaj kev pheej hmoo ntawm cov kab mob lactic acidosis. Nws yog txwv tsis pub noj Glucofage nrog kev ua kom muaj zog tsawg dua 60 ml / min.

Cov tshuaj Iodine uas muaj siv rau cov tshuaj fluoroscopy hauv cov neeg mob raum ua rau lactic acidosis. Yog li, thaum ntsuas tus neeg mob los ntawm kev xoo hluav taws xob, kev tshem tawm cov ntsiav tshuaj yog qhov tsim nyog.

Qhov ua rau lub ntsej muag hypoglycemic yog kho los ntawm sulfonylurea, insulin, salicylates, acarbose.

Los ntawm cov qauv raug muab txhais yog cov tshuaj npaj los hloov cov tshuaj tseem ceeb, lawv siv yog pom zoo nrog tus kws kho mob koom:

Bagomet. Tsim los rau cov neeg mob ntshav qab zib hom 2 uas muaj cov rog rog. Siv nyob rau hauv monotherapy thiab nyob rau hauv ua ke nrog insulin.
GlycometerCov. Cov tshuaj rau hom 2 ntshav qab zib ntxim yuav rog. Nws tuaj yeem siv rau ntshav qab zib hom 1 nrog rau cov tshuaj insulin.
DianormetCov. Pab ua kom muaj qib qog qis, tshwj xeeb tshaj yog rau cov neeg mob uas muaj roj lub cev tsis ua haujlwm.

Cov kab mob analogues no muaj nyob rau hauv kev thov thiab nrov ntawm hom 2 mob ntshav qab zib.

Cov Tshuaj Pharmacokinetics

Ib zaug nyob hauv tib neeg lub cev, cov tshuaj nquag ntawm Glucofage nce rhiab heev ntawm cov hlwb rau insulin, uas yog txo qis vim muaj cov kab mob ntshav qab zib hom 2 mellitus. Cov kua nplaum pib ua lub zog ntau dua los ntawm cov leeg thiab lwm cov nqaij, thiab nws cov qib hauv cov ntshav txo qis. Tib lub sijhawm, nws cov khoom nyob rau hauv daim siab thiab nqus mus rau hauv lub plab zom mov (GIT) poob qis. Tib lub sijhawm, metformin yog qhov kev thov tsis cuam tshuam rau cov metabolism thiab yog tawm los ntawm lub raum li rau yim teev tom qab noj cov ntsiav tshuaj.

Tsis hais txog cov ntshav qab zib, cov tshuaj pab txhawm rau txhim kho lipid metabolism, txo cov concentration ntawm triglycerides, lipoproteins thiab roj (cholesterol). Tib lub sijhawm, gluconeogenesis thiab glycogenolysis yog tshuaj tiv thaiv, uas ua rau txoj kev txhim kho hauv tus neeg mob lub neej zoo. Qhov siab tshaj plaws tom qab noj Glucofage tshwm sim li ob rau xya teev tom qab kev tswj hwm ntawm qhov ncauj, nyob ntawm seb daim ntawv twg ntawm cov ntsiav tshuaj tau siv. Nyob rau lub sijhawm no, cov tshuaj ntawm cov tshuaj muaj sijhawm los nqus cov zom zaub mov, thiab lawv lub neej kev noj qab haus huv, raws li txoj cai, tshaj 50-60%.

Tso tawm daim ntawv, muaj pes tsawg leeg thiab kev cia khoom

Txog rau hnub no, cov tshuaj muaj nyob hauv ob hom ntsiav tshuaj: Glucophage thiab Glucophage XR. Qhov thib ob txawv ntawm thawj zaug los ntawm kev tso tawm ntev dua ntawm cov tshuaj nquag, yog li cov nyhuv ntawm lawv tshwm sim tom qab. XR-daim ntawv lo cov ntsiav tshuaj muaj muag hauv khw muag tshuaj hauv pob ntawm peb caug lossis rau caum.

Cov kev ib txwm ua, tsis-ntev ntev ntawm cov piam thaj tseem muaj rau cov neeg siv khoom hauv cov ntim uas muaj peb caug txog rau caum daim txau tshuaj. Nws los hauv peb ntau yam: Glucofage 500, Glucofage 850 thiab Glucofage 1000. Raws li, txhua ntsiav tshuaj, nyob ntawm daim ntawv lo, muaj 500, 850 lossis 1000 milligrams ntawm cov tshuaj nquag - metformin hydrochloride. Nyob rau tib lub sijhawm, cov ntsiab lus ntawm cov khoom siv no hauv XR ntsiav tshuaj yog tsau thiab suav txog 500 milligrams.

Raws li cov lus qhia los ntawm cov lus qhia rau kev siv tshuaj, nws yuav tsum tau muab cia rau hauv qhov chaw qhuav thiab tsaus ntawm qhov kub uas tsis muaj siab tshaj 25 degrees Celsius. Cov menyuam yaus yuav tsum tsis muaj kev nkag mus rau hauv cov ntsiav tshuaj, vim tias cov tshuaj no tuaj yeem tsim kev puas tsuaj rau tib neeg kev noj qab haus huv yog siv tsis raug. Lub txee lub neej ntawm Glucophage 1000 thiab XR yog peb xyoos, thiab Glucofage 500 thiab 850 yog tsib xyoos.

Txoj kev ntawm kev siv tshuaj

Glucophage yog qhia rau kev siv los ntawm cov neeg mob kev txom nyem los ntawm hom 2 mob ntshav qab zib mellitus. Nrog rau daim ntawv no ntawm tus kab mob, muaj cov insulin txaus tsim nyob rau hauv tib neeg lub cev, tab sis cov piam thaj uas thauj los ntawm nws tsis raug nqus los ntawm cov plab hnyuv siab raum thiab cov ntaub so ntswg. Qhov no yog vim qhov ua kom tsis muaj zog ntawm cov tau txais nyob hauv thaj chaw ntawm lub cell, vim qhov tshwm sim ntawm cov qog hlwb tsis zoo txog cov tshuaj insulin thiab tsis cuam tshuam nrog nws. Feem ntau, yam 2 mob ntshav qab zib mellitus tsis xav tau kev kho mob, thiab kev kho mob los tsuas yog txwv tus neeg mob rau zaub mov thiab ua haujlwm lub cev. Yog tias cov hau kev no tsis pab, cov tshuaj zoo li Glucofage siv, uas feem ntau yog tshuaj kho mob monotherapy. Yuav ua li cas thiaj li tsim nyog siv cov ntaub ntawv ntawm cov ntsiav tshuaj uas twb muaj lawm, koj yuav tsum nkag siab ntau yam ntxiv.

1) Glucophage ntawm cov qauv kev ua haujlwm tau txiav txim siab rau cov neeg mob nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj muaj 500, 850 lossis 1000 milligrams ntawm cov tshuaj nquag, nyob ntawm kev siv tshuaj txhua hnub, uas tau txiav txim los ntawm tus kws kho mob koom nrog. Cov tshuaj yuav tsum noj thaum lub sijhawm lossis tom qab noj mov, tsis tas yuav zom thiab haus nrog dej. Cov nyhuv ntawm lawv tshwm sim tom qab ob txog peb teev thiab kav kom txog thaum siv tshuaj ntxiv. Cov koob tshuaj txhua hnub rau cov neeg laus yog 1500-2550 milligrams thiab koom nrog kev noj ib ntsiav tshuaj thaum sawv ntxov, tav su thiab yav tsaus ntuj. Hauv qhov no, koj tsis tuaj yeem noj ntau dua 3000 milligrams ntawm metformin ib hnub, vim tias qhov nyiaj no yog qhov ntau tso cai.

Rau cov menyuam muaj hnub nyoog ntau tshaj kaum xyoo, rau Glucofage kuj tau txais kev pom zoo rau kev siv, qhov ntau kawg noj txhua hnub yog 2000 milligrams ntawm cov tshuaj nquag. Ntxiv mus, thaum pib ntawm cov chav kawm ntawm kev kho mob, nws tsis pub dhau 850 milligrams, tom qab ntawd nws nce txhua hnub. Yog tias tus me nyuam siv cov tshuaj insulin tib lub sij hawm li cov ntsiav tshuaj, qhov ntau npaum ntawm tom kawg yuav tsum raug kho kom haum raws li cov ntshav qab zib tam sim no.

Kev noj tshuaj me zuj zus kuj pom zoo rau cov neeg laus. Thaum pib, nws tuaj yeem yog 1000-1500 milligrams ntawm metformin ib hnub, thiab tom qab ntawd maj mam nce ntxiv hauv ib hlis. Yog hais tias kev ntsuas ntawm cov piam thaj hauv cov ntshav qhia nws txoj kev mob tsis txaus, qhov ntau npaum, ntawm qhov tsis tooj, raug txo kom tsawg. Raws li rau cov neeg laus thiab cov neeg mob uas muaj mob raum, rau lawv cov tshuaj txhua hnub ntawm cov tshuaj tau muab suav ua tus kheej tom qab dhau txoj kev kuaj mob uas tsim nyog.

2) Glucophage XR lub sijhawm ua haujlwm ntev yog qhia rau kev siv raws li kev kwv yees tib txoj kev ua raws li Glucophage ib txwm ua. Qhov sib txawv hauv thawj qhov chaw yog qhov yuav tsum tau noj tshuaj tsis yog peb, tab sis ib zaug lossis ob zaug ib hnub, cov nyhuv tom qab noj cov tshuaj tshwm sim rau rau xya teev tom qab noj, uas tso cai rau koj siv nws tsis yog li feem ntau. Raws li txoj cai, thaum pib ntawm txoj kev kho, tus neeg mob yuav tsum noj ib ntsiav tshuaj ib hnub, muaj 500 milligrams ntawm metformin. Tom qab, txoj kev muab tshuaj tau hloov kho raws li kev hloov pauv ntawm daim duab ntawm tus kabmob. Qhov koob tshuaj txhua hnub yog nce tsis ntau tshaj ib zaug txhua ob lub lim tiam. Txwv tsis pub, muaj qhov ntxim nyiam ntawm kev txo qis hauv cov ntshav qabzib ntau, uas tus neeg mob tsis tuaj yeem paub txog, ua rau nws muaj kev phom sij.

Kev overdose nyob rau hauv cov ntaub ntawv ntawm Glucophage thiab Glucophage XR tuaj yeem ua rau muaj kev rau txim loj. Tus neeg mob tuaj yeem tsim mob lactic acidosis, yuav tsum tau mus pw hauv tsev kho mob sai thiab txoj kev kho mob hauv tsev kho mob. Txhawm rau tshem tawm cov metformin thiab lactate los ntawm lub cev, hemodialysis thiab lwm yam khoom siv tu mob hnyav kuj xav tau. Yog li, kev siv cov tshuaj no yuav tsum tau kho nrog lub luag haujlwm siab tshaj plaws, tsis tas nce cov tshuaj txhua hnub yam tsis muaj kws kho mob paub.

Yeeb tshuaj sib cuam tshuam

Vim qhov peculiarities ntawm Glucophage, nws tsis pom zoo kom sib xyaw nws nrog cais kev noj tshuaj thiab tshuaj lom neeg. Peb tab tom tham txog iodine-muaj cov kab mob radiopaque: Danazole, Nifedipine, Chlorpromazine, glucocorticosteroids, ethanol, voj diuretics, beta2-adrenergic agonists, cationic tshuaj thiab ACE inhibitors.

1) Cov tshuaj muaj cov kab mob radiopaque uas siv thaum lub sijhawm kuaj mob radiological yog contraindicated rau kev siv ib txhij nrog Glucofage. Lawv txoj kev sib koom ua ke tuaj yeem ua rau kom muaj qhov mob lactic acidosis hauv tus neeg mob. Yog li, kev tshuaj xyuas nyob rau hauv cov xwm txheej zoo li no yuav tsum yog ncua, lossis lub sijhawm nws ua, tsis kam noj cov tshuaj. Ua li no, nws txaus kom tsis txhob noj cov ntsiav tshuaj ob hnub ua ntej txheej txheem thiab rov pib dua ob hnub tom qab ua tiav.

2) Ethyl cawv, uas yog ib feem ntawm tag nrho cov dej cawv thiab muaj nyob hauv qee cov tshuaj, kuj tseem tsis pom zoo kom ua ke nrog Glucofage. Qhov no yog piav qhia dua los ntawm lactic acidosis, uas tuaj yeem tsim tiv thaiv keeb kwm ntawm kev haus dej caw cawv. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau cov neeg uas lub siab tsis ua haujlwm, thiab tseem ua raws li kev noj zaub mov kom lub cev tsis zoo thiab noj zaub mov kom tsawg.

3) Chlorpromazine hauv kev kho mob ntawm hypoglycemia Glucofage yuav tsum tau siv nrog kev saib xyuas zoo, vim nws nce cov ntshav qab zib, maj mam tso cov kua ntshav tawm. Hauv tshwj xeeb, qhov no siv rau kev siv tshuaj loj Chlorpromazine - ntau dua ib puas milligrams ib hnub. Yog tias nws tsis tuaj yeem tsis kam lees noj, tus neeg mob yuav tsum tau npaj rau qhov tseeb tias nws yuav tsum ntsuas ntsuas cov piam thaj hauv ntshav tas li kom tsis txhob muaj ntshav tawm ntau.

4) Nifedipine tag nrho tsis cuam tshuam rau cov txheej txheem ntawm kev siv tshuaj, tab sis tuaj yeem nce nws qhov nqus, thiab, raws li, qhov siab tshaj plaws. Yog li no, thaum noj cov tshuaj antihypertensive, ntau npaum li cas ntawm Glucophage yuav tsum tau kho los ntawm kev hu rau tus kws kho mob.

5) Dinazole nrog cov tshuaj hypoglycemic tuaj yeem ua rau cov ntshav qabzib nce ntxiv, yog li koj yuav tsum tsis kam siv nws thaum lub sijhawm kho mob. Yog tias qhov no tsis tuaj yeem ua rau qee yam, yuav tsum muaj kev hloov pauv hloov pauv txhua hnub ntawm Glucofage.

6) Glucocorticosteroids (GCS) nce qib ntshav qab zib thiab, thaum muaj xwm txheej tsis zoo, tuaj yeem ua rau ketosis. Vim tias qhov tseeb ntawm cov tshuaj pleev thiab cov tshuaj ua rau txo qis ntshav qab zib, lawv siv ib txhij nrog Glucofage yuav tsum kho cov tshuaj txhua hnub rau tom kawg.

7) Beta2-adrenergic agonists, qhia rau kev siv los ua kev txhaj tshuaj, txhawb kev beta2-adrenergic receptors, nce qhov concentration ntawm cov piam thaj hauv ntshav plasma. Qhov no yuav xav kom tus neeg mob coj mus rau kev ntsuas ntxiv los tawm tsam hyperglycemia, uas, raws li txoj cai, muaj nyob rau hauv qhov yuav tsum tau ua ntu zus txhaj tshuaj insulin rau hauv cov ntshav.

8) Loop diuretics tsis pom zoo kom siv ib txhij nrog Glucofage, tshwj xeeb tshaj yog nyob rau hauv qhov chaw mob raum tsis ua haujlwm. Qhov no tuaj yeem ua rau kev txhim kho ntawm cov kab mob lactic acidosis nrog rau txhua yam tshwm sim tom qab.

9) Txhais tau hais tias tswj cov ntshav siab, uas yog pawg ntawm ACE inhibitors, tsis pom zoo rau siv thaum noj Glucofage. Lawv pab txo cov ntshav qab zib kom tsawg thiab tuaj yeem ua rau cov piam thaj tsis muaj qabzib, tom qab kev tshaib plab ntawm lub hlwb cov ntaub so ntswg.

10) Cov neeg sawv cev ua ke, uas suav nrog Morphine, Quinine, Amiloride, Triamteren, thiab lwm yam tuaj yeem tawm tsam nrog metformin, txwv tsis pub nws nqus. Yog li, koj yuav tsum caiv tsis txhob siv thaum siv cov tshuaj.

Sab sij huam

Lub sijhawm ntev siv cov tshuaj tuaj yeem ua rau ntau qhov kev tsis zoo, uas yuav tsum tau hais txog. Los ntawm cov lus qhia ntawm cov tshuaj, nws ua raws nws tuaj yeem ua rau cov kev mob tshwm sim hauv qab no:

tsis qab thaum noj mov,
kho mob plab zom mov: raws plab, ntuav, mob plab,
lactic acidosis
tsis hnov qab nqus ntawm cov vitamins B12 (tshwj xeeb tseem ceeb rau megaloblastic anemia),
tawv nqaij ua pob, liab, khaus,
kab mob siab (feem ntau nyob ntawm qhov muaj qhov sib txuam nrog kev cuam tshuam).

Nws yog tsim nyog sau cia tias cov tsos mob tshwm sim tshaj plaws hauv kev kho mob yog cov uas muaj nyob hauv thawj ob yam khoom los ntawm cov npe uas cuam tshuam ncaj qha rau kev zom zaub mov. Lwm yam kev mob tshwm sim saum toj no tshwm sim hauv cov neeg mob tsis tshua muaj, hauv kwv yees li ib kis tawm ntawm ntau txhiab. Nws yuav zoo siv ntxiv tias thaum thawj cov cim ntawm kev tsis pom kev noj qab haus huv ntawm kev noj qab haus huv tom qab noj cov tshuaj, koj yuav tsum sab laj nrog kws kho mob sai sai kom tsis txhob muaj teeb meem tshwm sim.

Cov lus qhia tshwj xeeb

Hauv cov kev tshawb fawb tsis ntev los no, nws tau pom tias glucophage tsis cuam tshuam rau kev noj qab haus huv ntawm cov menyuam yaus thaum tiav nkauj tiav nraug. Txawm li cas los xij, cov yam ntxwv no tsis tuaj yeem hu ua kev tshawb fawb kom meej, thiab cov kws kho mob tseem tsis tau qhia kom siv cov tshuaj thaum muaj hnub nyoog kaum txog kaum yim xyoo. Yog li, hauv chav kho mob, qhov cuab yeej no siv tsis tau thiab feem ntau yog hloov nrog cov qauv zoo dua.

Kev saib xyuas tshwj xeeb rau qhov tshwm sim tsis zoo los ntawm kev noj tshuaj yuav tsum tau muab rau cov neeg muaj kev rog los ntawm kev rog dhau vim yog cov kab mob plab. Feem ntau, lawv cov txheej txheem kho mob nyob rau hauv khiav ua ke nrog cov khoom noj nruj me ntsis, uas, nrog kev noj tshuaj ntau dhau ntawm metformin, tuaj yeem ua rau cov ntshav qab zib tsis txaus. Tib yam siv rau ib qib lossis ntxiv rau lwm qhov mob uas kuaj pom tus mob ntshav qab zib hom 2 mob ntshav qab zib. Hauv lawv qhov teeb meem, kev kho tshuaj insulin tsuas yog siv tshwj xeeb, thiab lub ntsiab tseem ceeb yog nce kev ua haujlwm hauv lub cev thiab txo rov qab ntawm kev noj haus.

Glucophage ib leeg tsis tuaj yeem ua rau mob ntshav qab zib, tab sis nrog cov tshuaj ib leeg rau ib leeg, cov teeb meem no cuam tshuam ntau yam. Yog li, tsis muaj ib qho kis tau cov tshuaj tuaj yeem sib xyaw ua ke nrog cov tshuaj iodine muaj radiopaque thiab lwm yam tshuaj qhia hauv cov lus qhia rau kev siv hauv ntu "kev sib txuas ntawm yeeb tshuaj". Txhua yam ntawm koj cov kev coj ua hauv cov lus taw qhia no yuav tsum muaj kev sib koom tes nrog tus kws kho mob, uas thaum kawg yuav txiav txim rau kev txiav txim; koj tuaj yeem siv lossis siv tsis tau cov tshuaj tshwj xeeb.

Xaus

Glucophage yog ib cov tshuaj uas tsis haum thiab los ntawm nws tus kheej tsis tuaj yeem cuam tshuam cov duab ntawm tus kabmob nrog hyperglycemia. Txawm li cas los xij, ua ke nrog lwm txoj kev, nws tuaj yeem ua kev hem thawj rau tus neeg mob lub cev. Cov npe ntawm contraindications rau nws siv thiab tus naj npawb ntawm cov kev mob tshwm sim yog me me, tab sis qee qhov ntawm lawv muaj mob hnyav heev thiab, thaum tsis muaj kev tswj hwm los ntawm tus kws tshaj lij, tuaj yeem ua rau lub hauv paus loj dua. Yog li, koj tuaj yeem siv cov tshuaj no ntawm koj tus kheej nkaus xwb ntawm koj tus kheej kev phom sij thiab kev pheej hmoo.

Tus Neeg Siv Khoom Xaiv Tswvyim

Los ntawm kev tshuaj xyuas cov neeg mob, peb tuaj yeem xaus lus tias Glucofage muaj txiaj ntsig zoo rau kev kho cov ntshav qab zib, txawm li cas los xij, nws siv tshwj xeeb rau cov kev poob phaus yog impractical, txij li thaum cov thawj coj nrog nrog ntau cov kev mob tshwm sim.

Thawj zaug peb tau hnov txog Glucofage los ntawm peb tus pog, uas muaj ntshav qab zib hom 2 thiab tsis tuaj yeem txo qab zib ua ntej siv cov tshuaj. Tsis ntev los no, ib tus kws kho mob endocrinologist tau hais kom Glucophage rau nws ntawm kev noj tshuaj ntawm 500 mg ob zaug ib hnub. Kuj ceeb tias, qhov qab zib qib tau txo qis li ib nrab, tsis muaj cov kev mob tshwm sim.

Kuv noj glucophage tsis ntev los no. Thaum xub thawj, Kuv mloog zoo li mob me ntsis thiab tau hnov qhov tsis xis nyob hauv plab. Tom qab li 2 lub lis piam txhua yam mus. Cov piam thaj txo qab tau nqis los ntawm 8.9 rau 6.6. Kuv qhov tshuaj yog 850 mg rau ib hnub. Tsis ntev los no kuv pib khaus, tej zaum yog ib koob tshuaj loj.

Galina, 42 xyoo. Ntsig

Kuv lees txais Glucofage Ntev txhawm rau kom poob ceeb thawj. Qhov ntau thiab tsawg tau kho los ntawm tus kws kho keeb. Kuv pib nrog 750. Kuv noj li ib txwm, tab sis kuv txoj kev ntshaw rau zaub mov tau poob qis. Kuv pib mus rau hauv chav dej ntau zaus. Ua rau kuv raws li ib tug cleansing enema.

Glucophage yog coj raws li cov kws paub tshwj xeeb. Qhov no yog qhov tshuaj nyhav heev rau cov ntshav qab zib hom 2, tsis yog cov khoom poob phaus. Kuv tus kws kho mob tau qhia kuv txog qhov no. Rau ntau lub hlis kuv tau noj nws ntawm 1000 mg ib hnub twg. Qib qab zib qib poob sai sai, thiab nrog nws rho 2 kg.

Alina, 33 xyoo, Moscow

Video los ntawm Dr. Kovalkov txog yeeb tshuaj Glucofage:

Tus nqi ntawm glucophage nyob ntawm qhov ntau npaum ntawm cov tshuaj nquag thiab tus naj npawb ntawm cov ntsiav tshuaj hauv pob.Tus nqi qis kawg yog 80 rubles., Qhov siab tshaj plaws yog 300 rubles. Nws yog tsim nyog teev cia hais tias xws li pom tau qhov sib txawv ntawm tus nqi yog nyob ntawm cov xwm txheej ntawm cov kev lag luam, kev ua lag luam nyiaj thiab tus naj npawb ntawm cov neeg nruab nrab.

Sab sij huam

Kev ntshaib plab thiab zaub mov tsis haum:
Tsis tshua muaj: lactic acidosis (saib "Cov lus qhia tshwj xeeb"). Nrog rau kev siv lub sijhawm ntev ntawm metformin, ib qho kev txo qis hauv kev nqus ntawm cov vitamin B12 yuav raug pom. Yog kuaj pom tus mob megaloblastic anemia, muaj peev xwm yuav txiav txim siab tau.

Ua txhaum ntawm lub paj hlwb:
Feem ntau: saj ntxhov.

Kev mob plab zom mov:
Ntau zaus: xeev siab, ntuav, raws plab, mob plab thiab tsis qab los noj mov.
Feem ntau lawv tshwm sim thaum pib lub sij hawm kho thiab feem ntau kis tau tus kheej. Txhawm rau tiv thaiv cov tsos mob, nws raug nquahu kom koj noj cov tshuaj metformin 2 lossis 3 zaug nyob rau ib hnub thaum lossis tom qab noj mov. Kev noj tshuaj qeeb yuav ua rau lub plab zom mov tsis tuaj yeem.

Kev ua tsis taus los ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous:
Tsis tshua muaj heev: kev hloov tawv nqaij xws li erythema, mob pruritus, tawm pob.

Kev ua txhaum ntawm daim siab thiab kab mob:
Tsis tshua muaj: mob siab rau lub siab ua haujlwm thiab kab mob siab, tom qab kev txiav tawm ntawm metformin, cov kev tsis zoo no ploj tag.

Cov ntaub ntawv tshaj tawm, cov ntaub ntawv tshaj tawm tom qab kev lag luam, nrog rau kev tshawb fawb soj ntsuam hauv cov menyuam muaj tsawg nyob hauv 10-16 pawg hnub nyoog qhia tias cov kev mob tshwm sim rau cov menyuam yaus nws zoo sib xws thiab xwm yeem rau cov neeg mob hauv cov neeg laus.

Noj ntau dhau

Kev Kho Mob: Thaum muaj cov cim ntawm lactic acidosis, kev kho mob nrog cov tshuaj yuav tsum tau nres tam sim ntawd, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob ceev thiab, tau txiav txim siab qhov concentration ntawm lactate, kev kuaj mob yuav tsum qhia meej. Qhov ua tau zoo tshaj plaws los tshem tawm lactate thiab metformin tawm ntawm lub cev yog hemodialysis. Cov kev mob tshwm sim kuj yog nqa tawm.

Kev cuam tshuam nrog lwm yam tshuaj

Cov tshuaj tiv thaiv radiopaque Iodine: tawm tsam cov keeb kwm yav dhau los ntawm kev ua haujlwm lub raum tsis ua haujlwm rau cov neeg mob ntshav qab zib, kev tshawb nrhiav radiological siv cov iodine-muaj radiopaque cov neeg sawv cev yuav ua rau kev loj hlob ntawm cov kab mob lactic acidosis. Kev kho mob nrog Glucofage ® yuav tsum tau tshem tawm nyob ntawm kev ua haujlwm ntawm lub raum 48 teev ua ntej lossis thaum lub sijhawm xoo hluav taws xob uas siv cov tshuaj iodine muaj radiopaque thiab tsis rov pib dua ua ntej 48 teev tom qab, muab hais tias lub raum muaj nuj nqi tau lees paub qhov qub thaum kuaj.

Cawv: nrog rau kev qaug cawv ua rau qaug cawv, muaj kev pheej hmoo ntawm kev tsim muaj cov kab mob lactic acidosis, tshwj xeeb yog:

kev noj zaub mov tsis zoo, cov khoom noj tsis muaj calorie ntau,
daim siab ua hauj lwm.

Thaum noj cov tshuaj, haus dej cawv thiab tshuaj uas muaj ethanol yuav tsum zam.

Tej kev sib txuam uas xav tau ceev faj

Danazole: kev tswj hwm ib txhij ntawm cov danazol tsis pom zoo nyob rau hauv kev txiav txim kom tsis txhob muaj cov nyhuv hyperglycemic ntawm tom kawg. Yog tias kev kho mob nrog danazol yog qhov tsim nyog thiab tom qab txiav tawm qhov kawg, kev kho qhov tshuaj tiv thaiv tshuaj Glucofage ® yog qhov yuav tsum tau ua nyob hauv kev tswj hwm qhov kev tswj hwm ntawm cov ntshav qabzib hauv cov ntshav.

Chlorpromazine: thaum noj nyob rau hauv cov koob tshuaj loj (100 mg ib hnub twg) nce qhov kev mloog zoo ntawm cov piam thaj hauv cov ntshav, txo cov tshuaj insulin tawm. Hauv kev kho tshuaj tiv thaiv kev tiv thaiv thiab tom qab siv ceev xwmphem kawg, kev hloov kho koob tshuaj yuav tsum muaj kev tswj hwm ntawm cov ntshav qabzib concentration.

Glucocorticosteroids (GCS) cov teebmeem hauv lub cev thiab hauv ib cheeb tsam txo cov ntshav qabzib, nce qhov siab ntawm cov piam thaj hauv cov ntshav, qee zaum ua rau ketosis. Hauv kev kho mob ntawm corticosteroids thiab tom qab txiav kev noj qab haus huv rau tom kawg, kev hloov kho tshuaj Glucofage ® tswj hwm cov ntshav qabzib hauv siab yuav tsum ua.

Tso tshuaj: kev siv cov "voj" diuretics tib lub sij hawm tuaj yeem ua rau txoj kev txhim kho ntawm cov kab mob lactic acid vim muaj kev ua haujlwm tsis zoo rau lub raum. Glucofage ® yuav tsum tsis txhob raug tshuaj yog tias creatinine tshem tawm qis dua 60 ml / min.

Txhaj Tshuaj Beta₂-adrenomimetics: nce ntshav qabzib concentration vim yog beta ua kom lub zog₂-adrenoreceptors. Hauv qhov no, nws yog ib qhov tsim nyog los tswj cov kev ua kom tau cov kua nplaum hauv cov ntshav. Yog tias tsim nyog, insulin raug pom zoo.
Nrog rau kev siv cov tshuaj rau saum toj no ib zaug, yuav tsum tau kuaj xyuas ntshav qabzib ntau dua, tshwj xeeb thaum pib kho. Yog tias tsim nyog, cov koob tshuaj metformin tuaj yeem hloov kho thaum kho thiab tom qab nws txiav.

Cov tshuaj antihypertensive, nrog rau kev zam ntawm angiotensin hloov ua enzyme inhibitors, tej zaum yuav txo cov ntshav piam thaj. Yog tias tsim nyog, cov koob tshuaj metformin yuav tsum tau hloov kho.

Nrog rau kev siv ib txhij ntawm cov tshuaj Glucofage age s sulfonylurea derivatives, insulin, Acarbose, salicylates ntshav qog ntshav yuav pib mob.

Nifedipine nce ntxiv kev nqus thiab max ntawm metformin.

Cov tshuaj Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim thiab vancomycin) zais cia rau hauv cov hlab ntsws ua haujlwm nrog metformin rau tubular thauj cov tshuab thiab tuaj yeem ua rau nce siab hauv nws C max.

Chaw tsim tshuaj paus

Los yog muab ntim rau hauv cov tshuaj LLC Nanolek:

Chaw tsim tshuaj paus
Kev tsim cov ntawv tiav cov ntawv ntim thiab ntim khoom (thawj ntim)
Merck Sante SAAS, Fab Kis
Center de tsim khoom Semois, 2 rue du Pressoire Ver - 45400 Semois, Fabkis

Thib ob (cov neeg siv khoom ntim) thiab tsim kev tswj hwm zoo:
Nanolek LLC, Russia
612079, cheeb tsam Kirov, Orichevsky koog tsev kawm ntawv, lub zos ntawm Levintsy, Biomedical complex "NANOLEK"

Chaw tsim tshuaj paus
Txhua theem ntawm kev tsim khoom, suav nrog kev tswj hwm kom zoo:
Merck S. L., Spain
Polygon Merck, 08100 Mollet Del Valles, Barcelona, Spain.

Kev thov cov neeg tau txais kev pabcuam yuav tsum tau xa rau:
LLC "Merk"
115054 Moscow, st. Tag nrho, d. 35.