Januvia thiab Janumet > Kev khomob thiab kev tiv thaiv

Hom 2 tshuaj kho mob ntshav qab zib Januvia thiab Janumet: nrhiav txhua yam koj xav tau. Hauv qab no koj yuav pom cov lus qhia rau kev siv sau ua hom lus siv tau. Txheeb xyuas qhov ntsuas, contraindications, noj tshuaj, yuav ua li cas coj thiab ua tau tshwm sim. Nws tau hais txog cov txheej txheem kev kho mob uas tau tso cai rau koj kom cov ntshav qab zib 3.9-5.5 mmol / l ruaj khov 24 teev ib hnub, ib yam li hauv cov neeg noj qab haus huv. Tus txheej txheem ntawm Dr. Bernstein, uas tau nyob nrog ntshav qab zib ntau dua 70 xyoo, tso cai rau koj 100% tiv thaiv koj tus kheej los ntawm cov teeb meem. Kom paub cov ntsiab lus, pom cov kauj ruam kho ib qib zuj zus rau hom ntshav qab zib hom 2.

Januvia yog tshuaj rau cov ntshav qab zib hom 2, cov tshuaj nquag ntawm uas yog sitagliptin. Lub chaw tsim khoom yog lub npe nrov thoob ntiaj teb lub tuam txhab Merck (Netherlands). Yanumet yog cov tshuaj sib txuam uas muaj cov tshuaj sitagliptin thiab metformin. Hauv qab no yog sib piv hauv kev nthuav dav cov ntsiav tshuaj ntawm Januvia thiab Galvus, zoo li Yanumet thiab Galvus Met. Lub hom phiaj teb muab rau cov lus nug uas cov tshuaj no zoo dua. Cov analogues uas ua los ntawm cov tuam txhab kws sib tw tau teev muaj.

Januvia thiab Yanumet: cov ncauj lus kom ntxaws

Nyeem dab tsi yog tias Januvia thiab Galvus them tsis taus koj lossis koj cov tshuaj kho ntshav qab zib tau nres pab. Kawm yuav ua li cas koj cov ntshav qab zib kom nyob twj ywm thiab txuag cov tshuaj muaj nqis.

Cov lus qhia rau kev siv

Pharmacological kev txiav txim

Sitagliptin yog qhov inhibitor ntawm qhov enzyme DPP-4. Nce qhov siab ntawm cov tshuaj hormones ntawm tsev neeg incretin. Cov tshuaj no txhawb cov txiav ua kom cov kua dej los tsim cov tshuaj insulin rau hauv kev xa mus rau kev noj zaub mov, thiab kuj txo qis kev zom zaub mov glucagon. Vim qhov no, ntshav qab zib cov ntshav qis me ntsis uas tsis muaj kev phom sij ntawm hypoglycemia. Nws yog tawm los ntawm lub raum nrog tso zis los ntawm 80-90%, los ntawm lub siab - los ntawm 10-20%. Cov neeg mob uas tau siv Janumet yuav tsum nyeem ntawm no txog qhov cuam tshuam ntawm metformin.

Kev ntsuas rau siv

Mob ntshav qab zib Hom 2. Kev noj zaub mov zoo rau lub cev thiab kev tawm dag zog yuav tsum yog txoj hauv kev tseem ceeb ntawm kev kho mob, thiab tshuaj noj thiab tshuaj insulin yuav tsum tau pabcuam. Tshawb xyuas kab lus "Cov Khoom Noj Rau Ntshav Qab Zib Hom 2." Januvia tshuaj (sitagliptin) tuaj yeem thiab yuav tsum ua ke nrog metformin. Yooj yim Yanumet ua ke cov ntsiav tshuaj muaj nyob nrog sitagliptin thiab metformin hauv qab ib lub plhaub.

Noj Januvia, Janumet lossis lwm yam tshuaj kho ntshav qab zib, koj yuav tsum ua raws li kev noj haus.

Cov Yuav Tsum Muaj

Yam 1 ntshav qab zib. Cev xeeb tub thiab lub sijhawm pub mis niam. Mob hnyav ua los ntawm ntshav qab zib cov ntshav ntau yog ketoacidosis, hyperglycemic coma. Lub hnub nyoog txog 18 xyoo. Ua xua rau cov tshuaj nquag lossis cov khoom pabcuam ntu ntawm cov tshuaj. Metformin muaj cov tshuaj tiv thaiv ntau dua li sitagliptin. Nyeem ntxiv txog lawv ntawm no.

Cov lus qhia tshwj xeeb

Kev kho ua ke ntawm cov ntshav qab zib hom 2 tsis tau raug tshawb fawb nrog Januvia thiab insulin txhaj tshuaj, nrog rau sulfonylurea derivatives. Ua ntej tshaj plaws, mus rau kev noj zaub mov kom tsawg-carb. Nrog rau cov piam thaj muaj nuj nqis ntawm 9.0 mmol / L thiab ntau dua, tam sim ntawd pib txhaj cov tshuaj insulin, thiab tom qab ntawd ntsaws hauv cov ntsiav tshuaj. Nyeem kab lus “Type 2 insulin ntshav qab zib” kom paub ntxiv.

Tsuas tshuaj

Tus txheej txheem koob tshuaj sitagliptin (Januvia) yog 100 mg rau ib hnub. Siv tshuaj 1 zaug nyob rau ib hnub, tsis hais noj mov li cas. Yog tias mob raum tsis txaus (creatinine tshem tawm 30-50 ml / min, ntshiab si creatinine cov ntsiab lus 1.7-3 mg / dl hauv cov txiv neej, 1.5-2.5 mg / dl hauv cov poj niam), qhov koob tshuaj yog txo rau 50 mg ib hnub twg. Hauv kev mob raum tsis zoo, 25 mg ib hnub twg. Janumet yuav tsum tau noj 2 zaug ib hnub nrog zaub mov. Koj tuaj yeem ntxiv ib ntsiav tshuaj ntawm ntshiab metformin. Nyeem ntawm no ntxiv txog qhov kev xaiv ntawm nws cov ntau npaum.

Sab sij huam

Januvia cov tshuaj muaj kev tiv thaiv zoo, ua rau cov kev mob tshwm sim tsis muaj ntau dua li cov placebo. Qee zaum, cov kab mob ua pa ntawm lub plab loj tuaj. Cov theem ntawm uric acid nyob rau hauv cov ntshav nce siab me ntsis los ntawm kwv yees li 0.2 mg / dl. Qhov no yuav tsum tsis txhob ua rau muaj mob gout. Yog tias koj noj Janumet, tom qab ntawd nyeem ntawm no txog qhov tshwm sim phiv ntawm metformin. Lawv yog cov ntau dua thiab muaj mob dua li sitagliptin.

Cev xeeb tub thiab pub niam mis	Cov Tshuaj Januvia thiab Janumet tsis tau hais kom tswj cov ntshav qab zib hauv poj niam thaum cev xeeb tub. Tsis muaj tshuaj kho ntshav qab zib siv. Yog tias tsim nyog, txhaj cov tshuaj insulin. Sim ua yam tsis muaj lawv, ua raws li kev noj zaub mov zoo noj. Nyeem kab lus "Ntshav Qab Zib Cev Rau Mob Ntshav Qab Zib" thiab "Ntshav Qab Zib Zib Zes" rau cov lus qhia ntxiv.
Kev cuam tshuam nrog lwm yam tshuaj	Nws tsis zoo li tias sitagliptin yuav cuam tshuam zoo nrog lwm yam tshuaj. Tab sis rau metformin hauv cov tshuaj sib xyaw ntawm Janumet ntsiav tshuaj, muaj qhov pheej hmoo ntawm qhov no. Nyeem txog nws kev sib cuam tshuam yeeb tshuaj ntawm no. Tham nrog koj tus kws kho mob hais txog txhua yam tshuaj kho mob, tshuaj noj kom plam, thiab tshuaj ntsuab koj tau noj.
Noj ntau dhau	Cov xwm txheej ntawm ib koob tshuaj Januvia hauv koob kom txog li 800 mg tau piav qhia. Cov neeg mob tsis muaj cov tsos mob tshwm sim hauv tsev kho mob, tsuas yog hloov qhov QT luv ntawm daim cardiogram. Kev haus ntau tshaj plaws ntawm metformin tuaj yeem ua teeb meem loj dua. Nws yog ib qho tsim nyog yuav tsum ua lub plab zom mov, coj tus yam ntxwv mob siab thiab txhawb kev kho mob. Kev lim ntshav tsis zoo yuav pab tshem sitagliptin tawm ntawm lub cev.
Daim ntawv tso tawm	Januvia - beige ntsiav tshuaj, puag ncig. Ntawm ib sab yog biconvex, sau "277". Nyob rau lwm sab yog tus. Yanumet muaj nyob rau hauv cov ntsiav tshuaj muaj 50 mg ntawm sitagliptin thiab sib txawv ntawm cov tshuaj metformin - 500, 850 thiab 1000 mg. Txhawm rau txiav txim siab tsim nyog tshuaj ntawm metformin, nyeem kab lus no.
Cov lus thiab cov xwm txheej ntawm kev cia	Saib xyuas kom deb ntawm cov menyuam yaus ntawm qhov kub tsis txog 30 ° C. Txee lub neej yog 2 xyoos.
Muaj pes tsawg leeg	Cov tshuaj ua haujlwm nquag yog sitagliptin nyob rau hauv daim ntawv ntawm phosphate monohydrate. Ntu cov khoom siv - microcrystalline cellulose, calcium hydrogen phosphate, croscarmellose sodium, magnesium stearate, sodium stearyl fumarate. Cov ntsiav tshuaj plhaub - Opadry II beige 85 F17438, dej cawv polyvinyl, titanium dioxide, macrogol (polyethylene glycol) 3350, talc, hlau oxide daj thiab liab.

Cov tshuaj Januvia tsis muaj qhov sib piv ntawm pheej yig, vim tias qhov tseeb ntawm cov ntawv sau txog ntawm sitagliptin tseem tsis tau dhau. Yog tias koj tsis tuaj yeem them cov tshuaj no, hloov mus rau cov ntshiab metformin - qhov zoo tshaj yog Glucofage lossis Siofor. Nrog rau kev hloov mus rau kev noj zaub mov muaj roj tsawg, khoom noj khoom noj nce siab tsis tuaj yeem nce ntxiv. Txawm li cas los xij, cov zaub mov muaj protein ntau yog qhov tseem ceeb rau koj. Lawv yuav tsum yog qhov tseem ceeb tshaj plaws ntawm kev siv nyiaj. Thiab koj tuaj yeem txuag tau cov tshuaj muaj ntshav qab zib kim kim.

Cov tshuaj zoo ib yam li Januvius suav nrog Galvus (vildagliptin), Ongliza (saxagliptin), Trazenta (linagliptin), Vipidia (alogliptin) thiab Satereks (gozogliptin). Lawv yog tsim los ntawm cov tuam txhab kws sib tw.

Tag nrho cov tshuaj no tiv thaiv patents. Pom tseeb, cov tuam txhab tsim khoom pom zoo ntawm lawv tus kheej kom tus nqi nce siab. Cov tshuaj nquag hu ua glyptins. Lawv cov ntshav qab zib qis dua. Nws tsis tsim nyog yuav tsum them nyiaj tshaj rau lawv. Ntsiav tshuaj muaj metformin ntshiab yog tus nqi tsim nyog thiab pab yuav luag ib yam nkaus.

Yuav noj cov tshuaj no li cas?

Cov tshuaj Januvia yuav tsum noj 1 zaug ib hnub hauv ib lub tshuaj uas kws kho mob tau hais tseg. Koj tuaj yeem haus nws ua ntej lossis tom qab noj mov, raws li koj nyiam. Yanumet ib txwm noj 2 zaug hauv ib hnub nrog zaub mov ua kom txo cov kev mob tshwm sim ntawm metformin. Raws li txoj cai, nws ua rau nkag siab ntxiv rau lwm cov ntsiav tshuaj ntshiab metformin thaum noj mov thib peb kom ncav cuag tag nrho cov tshuaj txhua hnub hauv tshuaj no 2550-3000 mg. Lossis koj tuaj yeem noj cov Metformin Ntev-Ua Tawv Glucofage Ntev thaum hmo ntuj kom muaj ntshav qab zib kom zoo tshaj plaws thaum sawv ntxov. Tsis txhob ua tub nkeeg heev kom nkag siab txog kev xaiv xaiv cov tshuaj thiab ntau npaum li cas ntawm metformin. Lawv tau piav qhia txhua yam ntawm no.

Januvia lossis Galvus: uas yog qhov zoo dua?

Cov tshuaj Januvia (sitagliptin) thiab Galvus (vildagliptin) zoo heev. Lawv sib tw ua ke rau txhua tus lub siab thiab lub hnab nyiaj ntawm tib hom 2 cov neeg mob ntshav qab zib. Cov neeg tsim khoom lag luam txhawb nqa cov tshuaj no rau cov kws kho mob thiab cov neeg mob ntshav qab zib. Lawv muaj ntau ntau cov analogues uas tau teev tseg saum toj no. Txawm li cas los xij, hauv Lavxias-hais lus hauv lub tebchaws lawv tsis nrov heev.

Tam sim no, tseem muaj cov ntaub ntawv tsis muaj hom phiaj los teb rau nqe lus nug ntawm cov tshuaj uas zoo dua - Januvius lossis Galvus. Txawm li cas los xij, nws muaj kev nyab xeeb hais tias nws yog qhov zoo dua rau kev coj ua ke cov ntsiav tshuaj uas muaj sitagliptin lossis vildagliptin thiab txawm tias metformin. Tham nrog koj tus kws kho mob txog seb koj puas yuav tsum hloov mus rau Yanumet lossis Galvus Met.

Metformin yog pheej yig thiab txo qis cov ntshav qab zib kom zoo dua li sitagliptin thiab vildagliptin. Ua tib zoo saib xyuas rau cov tshuaj Galvus Met. Nws muaj kev xav ntau dua los ntawm cov neeg mob ntshav qab zib dua li lwm cov tshuaj zoo sib xws. Metformin muaj qhov tsis zoo tshaj qhov tshwm sim ntau dua li gliptins. Tab sis, raws li txoj cai, lawv tsis txaus ntshai. Lawv yuav tsum ua siab ntev rau kev ua tiav ntawm kev ua tiav - txhim kho cov ntshav qab zib thiab glycated hemoglobin.

Yuav ua li cas hloov Janumet?

Cov neeg mob muaj lub siab xav hloov Janumet nrog lwm cov tshuaj hauv cov xwm txheej hauv qab no:

Tshuaj kho mob pab tsis tau, tsis txo ntshav qab zib.
Cov kev mob tshwm sim mas hnyav heev, thev tsis tau.
Cov tshuaj pab, cov kev mob tshwm sim yuav tsum hnav, tab sis tus nqi yuav tsum siab dhau.

Yog tias Yanumet siv tsis pab, tsis txo cov ntshav qab zib, tom qab ntawd nws yuav tsum tau hloov nrog cov tshuaj insulin. Tsis muaj lwm yam tshuaj yuav tsum tau sim. Tus neeg mob cov txiav ua lub cev tsis ua haujlwm, thiab mob ntshav qab zib hom 2 hloov mus ua hom ntshav qab zib 1. Kawm cov lus "Hom 2 Ntshav Qab Zib Insulin" thiab ua dab tsi nws hais. Nco qab tias kev noj zaub mov kom tsis txhob carb yuav tsum yog qhov kev kho mob tseem ceeb, tsis hais koj puas txhaj tshuaj insulin los tsis ua.

Tsis kaj siab phiv cov tshuaj Janumet feem ntau ua rau metformin uas yog ib feem ntawm cov tshuaj no. Koj tau nyeem saum toj no tias cov zaub mov tseem ceeb sitagliptin tsis tsim teeb meem rau cov neeg mob. Nws tsis yog qhov ua rau mob hnyav dua li tso cov tshuaj placebo. Raws li rau cov kev mob tshwm sim ntawm metformin, koj yuav tsum hloov kho kom haum rau lawv, ua siab ntev, thiab tsis zoo rau kev hloov. Vim tias metformin yog qhov tshuaj tshwj xeeb rau qhov ua tau zoo thiab kev nyab xeeb. Nws tuaj yeem ua rau mob raws plab thiab lwm yam teeb meem, tab sis cov tshuaj no txo cov ntshav qab zib kom tsis muaj kev puas tsuaj rau lub cev. Ntxiv rau, nws yog tus pheej yig. Txo cov kev mob tshwm sim, noj Janumet thiab ntshiab metformin nrog cov zaub mov, tsis yog ua ntej lossis tom qab noj mov. Kawm cov tshuaj regimen no nrog kev nce ntxiv hauv cov tshuaj noj.

Txuag nyiaj, koj tuaj yeem hloov los ntawm cov tshuaj Januvia lossis Yanumet rau cov ntshiab metformin - zoo tshaj plaws ntawm txhua qhov Glucofage lossis Siofor, thiab tsis yog ntsiav tshuaj ntawm kev tsim khoom hauv tsev. Cov tshuaj tau txo kom tsawg, thiab kev tswj ntshav qab zib yuav nyob ze li qhov qub. Tshwj xeeb yog tias koj ua raws kev noj zaub mov zoo rau kev noj qab haus huv qis thiab tsis txhob nkees kom tawm dag zog.

Tus neeg sawv cev hypoglycemic yog dab tsi?

Cov tshuaj Yanumet muaj nyob hauv pawg ntawm cov tshuaj nrog cov nyhuv hypoglycemic. Yog vim li ntawd, nws tau feem ntau kho rau mob ntshav qab zib mellitus ntawm ib daim ntawv insulin-ywj siab.

Nws cov txiaj ntsig yog txhim kho los ntawm ntau cov khoom xyaw nquag uas yog ib feem ntawm kev noj tshuaj.

Lub teb chaws ntawm keeb kwm ntawm Yanumet yog Tebchaws Meskas, uas tau piav qhia txog kev siv tshuaj ntau dua (txog li peb txhiab rubles, nyob ntawm seb tsuas tshuaj npaum li cas).

Janumet ntsiav tshuaj siv rau hauv rooj plaub hauv qab no:

kom txo cov ntshav qab zib, tshwj xeeb yog hais tias kev noj zaub mov kom tsawg ua ke nrog kev tawm dag zog lub cev pom qhov tshwm sim tsis zoo,
yog monotherapy siv tsuas yog ib qho kev ua haujlwm tsis tau coj cov txiaj ntsig xav tau,
Nws tuaj yeem raug siv los ua cov kev kho mob ua ke nrog sulfrnylurea derivatives, insulin txoj kev kho lossis PPAR-gamma cov kev tawm tsam.

Cov tshuaj muaj nyob rau hauv nws cov muaj pes tsawg leeg ib zaug ob lub cev ua haujlwm uas muaj kev tiv thaiv hypoglycemic:

Sitaglipin yog tus sawv cev ntawm DPP-4 enzyme inhibitor pawg, uas, nrog rau kev nce hauv cov ntshav qab zib, pab txhawb kev sib txuas thiab ua kom cov kua ntshav tawm los ntawm cov hlwb pancreatic beta hlwb. Raws li qhov tshwm sim ntawm cov txheej txheem no, muaj kev txo cov suab thaj ua ke hauv qab zib.
Metformin hydrochloride yog ib tus neeg sawv cev ntawm pab pawg thib peb loj loj pab pawg, uas pab txhawb kom muaj kev txwv tsis pub gluconeogenesis. Kev siv cov tshuaj raws li nws stimulates glycolysis, uas ua rau kev txhim kho zoo dua ntawm cov piam thaj los ntawm cov hlwb thiab cov nqaij mos ntawm lub cev. Ntxiv rau, muaj qhov txo qis hauv kev nqus ntawm cov piam thaj los ntawm cov hnyuv. Qhov txiaj ntsig tseem ceeb ntawm metformin yog tias nws tsis ua rau cov piam thaj hauv qib qis dua (qis dua cov txheej txheem) thiab tsis ua rau kev loj hlob ntawm cov ntshav qabzib.

Kev noj tshuaj ntau npaum li cas tuaj yeem sib txawv ntawm tsib puas mus txog ib txhiab milligrams ntawm ib qho ntawm cov khoom siv nquag - metformin hydrochloride. Vim li ntawd, cov chaw muag tshuaj niaj hnub muaj rau cov neeg mob li cov tshuaj hauv qab no:

Thawj daim duab hauv cov tshuaj sib xyaw ua ke qhia pom qhov nyiaj ntawm cov txiaj ntsig nquag sitaglipin, qhov thib ob qhia tau muaj peev xwm ntawm metformin. Raws li cov tshuaj tiv thaiv tau siv:

Microcrystalline cellulose.
Povidone.
Sodium stearyl fumarate.
Sodium lauryl sulfate.
Polyvinyl cawv, titanium dioxide, macrogol, talc, hlau oxide (lub plhaub ntawm cov ntsiav tshuaj npaj muaj lawv).

Ua tsaug rau cov cuab yeej siv tshuaj kho mob Yanumet (Yanomed), nws muaj peev xwm ua tiav qhov kev txwv tsis pub muaj ntau dhau ntawm glucagon, uas, nrog kev nce ntxiv ntawm cov tshuaj insulin, ua rau cov ntshav qabzib hauv cov ntshav tsis txaus.

Nws yog ib qho tseem ceeb rau cov neeg mob ntshav qab zib tias cov tshuaj uas lawv noj tau txais txiaj ntsig zoo ntawm tus nqi qis dua. Muaj cov tshuaj uas cais tawm muaj cov tshuaj nquag, tab sis kuj tseem yog cov uas cov chaw nquag koom ua ke. Feem ntau lawv muaj kev kho tau zoo dua tuaj. Ib qho ntawm cov cuab yeej no, raws li cov lus qhia rau kev siv, yog Yanumet. Xav txog seb nws qhov kev txiav txim tshwm sim thiab cov yam ntxwv txawv nws los ntawm cov tshuaj zoo sib xws hauv kev ua lag luam ntawm cov tshuaj tiv thaiv kab mob.

Tso tawm daim ntawv, muaj pes tsawg leeg thiab ntim khoom

Nws muaj nyob rau hauv daim ntawv ntawm cov zaj duab xis-ntsiav tshuaj. Muaj 14 daim nyob hauv ib lub hlwv, hauv ib pob khoom cardboard muaj tuaj yeem muaj 1, 2, 4, 6 lossis 7 hlwv.

500, 800 lossis 1000 mg ntawm metformin,
50 mg ntawm sitagliptin monohydrate phosphate,
microcrystalline cellulose,
povidone
sodium fumarate,
sodium lauryl sulfate.

Pharmacological kev txiav txim

Vim qhov kev nqis tes ua ntawm ob lub Cheebtsam - metformin thiab sitagliptin - cov nyhuv tshuaj tiv thaiv hypoglycemic zoo dua. Lawv ua ke ua ke, txo cov ntshav qab zib.

Sitagliptin yog ib qho inhibitor ntawm DPP-4, muaj ib qho kev ua haujlwm uas ua kom muaj zog ntxiv, uas, nyeg, tswj cov kua nplaum hauv tsev. Lawv pab txhawm rau nce insulin ntau dua yog tias muaj qhov xav tau no hauv lub cev. Hauv qhov no, kev zais cia ntawm glucagon thiab, vim li ntawd, cov synthesis ntawm cov piam thaj hauv lub siab yog suppressed.

Metformin yog biguanide uas ua rau kom cov ntshav qabzib nyob siab thiab tom qab ntawd nws txo qis nws cov ntshav hauv cov ntshav thiab ua ke hauv lub siab. Txuas ntxiv, qhov rhiab heev ntawm cov hlwb mus rau cov piam thaj yog kho kom zoo.

Cov Tshuaj Pharmacokinetics

Qhov tshuaj noj ntawm Yanumet yog sib npaug rau kev tswj hwm cais ntawm metformin thiab sitagliptin. Lub peev txheej ntawm lub cev ua ntej yog 87%, ntawm ob 60%.

Qhov siab tshaj plaws ntawm kev ua haujlwm ntawm sitagliptin yog los ntawm 1 mus rau 4 teev tom qab kev tswj hwm. Metformin tshuab txais tau tom qab 2 teev. Yog tias qhov ua tau zoo ntawm tus thawj tsis raug cuam tshuam los ntawm cov khoom noj, tom qab ntawv thib ob nws qeeb los ntawm kev sib txuas nrog cov zaub mov.

Qhov tseem ceeb ntawm kev nthuav tawm yog los ntawm ob lub raum. Cov metabolism yog tsawg heev.

Hom 2 mob ntshav qab zib mellitus nrog kev noj zaub mov tsis txaus thiab kev tawm dag zog.Nws tuaj yeem raug siv los ua cov cuab yeej ywj pheej, los yog sib xyaw nrog sulfonylurea lossis cov tshuaj insulin.

Cov Yuav Tsum Muaj

Hypersensitivity rau Cheebtsam,
Cov xwm txheej cuam tshuam rau kev ua haujlwm ntawm lub raum (lub cev qhuav dej, ua paug),
Yam 1 ntshav qab zib
Cov kab mob ua rau cov nqaij mos hypoxia (myocardial infarction, lub plawv tsis ua haujlwm),
Lub raum tsis zoo lossis lub siab ua haujlwm,
Ntshav qab zib ketoacidosis
Kev quav cawv
Cev xeeb tub thiab lactation.

Sab sij huam

Mob taub Hau
Kev mob caj dab
Xeev siab, mob plab,
Kev Mob Nkeeg
Nws yog xim hlau saj hauv lub qhov ncauj
Ntuav
Mob plab zawv lossis cem quav
Lub qhov ncauj qhuav
Kev ua xua tsis haum
Kev nkees nkees
Hnoos
Mob Kev Plab
Lactic acidosis
Kev Ntshav Qab Zib,
Sab Sij Huam Phem.

Noj ntau dhau

Nyob rau hauv cov ntaub ntawv ntawm overdose, lactic acidosis yuav tsim. Hauv qhov no, kev tshem tawm cov tshuaj seem ntawm lub cev yog qhov yuav tsum tau ua, tom qab ntawd hemodialysis tau ua thiab tus neeg mob cov haujlwm yog saib xyuas.

Cov tsos mob ntawm tus mob hypoglycemia kuj tseem muaj peev xwm ua tau. Nrog rau daim ntawv me me, yuav tsum muaj cov zaub mov nplua nuj nyob rau hauv carbohydrates. Yog tias muaj nqees thiab mob hnyav, koj yuav tsum tau txhaj tshuaj glucagon lossis dextrose tov, nqa tus neeg mob kom nco qab thiab noj zaub mov muaj cov carbohydrates. Tom qab ntawv, yuav tsum muaj kev thov rov mus hais dua rau tus kws kho mob uas koom nrog kev kho tshuaj kom tsim nyog.

Yeeb tshuaj sib cuam tshuam

Nws yuav tsum xav txog kev cuam tshuam ntawm lwm txoj kev nrog txhua qhov nquag ntawm Yanumet.

Metformin tej zaum yuav tsis muaj zog:

thiazide diuretics,
glucagon,
corticosteroids
estrogens
phenothiazines,
nicotinic acid
cov thyroid hormones,
calcium antagonists
phenytoin
sympathomimetics
isoniazid.

tshuaj insulin
NSAIDs
sulfonylurea derivatives,
acarbose,
clofibrate derivatives,
MAO thiab ACE inhibitors,
cyclophosphamide,
oxytetracycline
beta-blockers.

Cimetidine muaj peev xwm inhibit qhov kev ua ntawm metformin, uas tsim kev hem thawj rau kev loj hlob ntawm acidosis.

Sitagliptin tuaj yeem nce qhov siab tshaj plaws ntawm Digoxin, Januvia, Cyclosporin. Yeej, qhov sib cuam tshuam ntawm cov tshuaj no nrog lwm cov tshuaj tsis muab qhov ntsuas tseem ceeb hauv chaw kho mob, uas yog, tsis muaj kev tiv thaiv dab tsi rau kev tswj hwm.

Kev koom nrog tshuaj sulfonylureas lossis tshuaj insulin tuaj yeem ua rau cov ntshav qog ntshav qab zib thaum lub koob tau dhau.

Cov lus qhia tshwj xeeb

48 teev ua ntej thiab tom qab kev tshawb fawb siv cov tshuaj iodine uas muaj tshuaj, cov tshuaj tawm mus rau.

Thoob plaws hauv chav kawm ntawm kev kho mob, nws yog ib qho tsim nyog yuav tsum soj ntsuam qhov xwm txheej ntawm lub raum tas li thiab ua ntu zus mus kuaj.

Muaj kev pheej hmoo rau kev cuam tshuam lub peev xwm ntawm kev tsav tsheb, yog li nws yuav tsum txiav txim siab qhov tsim nyog ntawm qhov no thoob plaws lub sijhawm kho. Qhov no yog qhov ua tau tshwj xeeb tshaj yog thaum noj nrog tshuaj insulin lossis sulfonylurea.

Cov tshuaj muaj peev xwm txhim kho cov tsos mob ntawm tus mob pancreatitis, ua rau lub ntsws rov qab los. Yog li, qhov mob ntawm tus neeg mob yuav tsum tau soj ntsuam kom tsis txhob muaj lawv txoj kev loj hlob.

Nws yog ib qho tseem ceeb uas tus neeg mob paub cov tsos mob ntawm tus kab mob lactic acidosis thiab, yog tias lawv tshwm sim, sab laj nrog tus kws kho mob tam sim ntawd. Kev mus pw hauv tsev kho mob sai sai yuav zam ntawm txoj kev loj hlob ntawm cov teeb meem.

Nws yog tso rau cov tshuaj noj!

Piv nrog analogues

Cov tshuaj no muaj ntau tus lej uas pom zoo kom nyeem los sib piv cov yam ntxwv.

Cons: tsis siv los kho tus poj niam cev xeeb tub thiab menyuam yaus, siv nrog ceev faj hauv cov neeg laus.

Cons: tsuas yog rau cov neeg mob laus, txwv tsis pub thaum cev xeeb tub.

Cons: txwv tsis pub siv rau menyuam yaus, tus neeg laus, cev xeeb tub thiab lactating.

Kev rov cais ntawm cov tshuaj lossis kev siv cov tshuaj analogues yog ua tiav tsuas yog kev tso cai ntawm tus kws tshaj lij. Kev siv tus kheej yog txwv!

Qhov no yog yam tshuaj zoo heev, zoo haum rau cov neeg feem coob, thiab tus nqi siab tau los ntawm nws cov hauj lwm zoo.

Catherine: "Yanumet" tau raug txib los ntawm tus kws kho mob uas tuaj koom. Kuv tau coj nws ob xyoos, Kuv zoo siab nrog txhua yam. Nws qhov haujlwm ua rau kuv, tsis muaj kev phiv tshuaj. Qab zib bounced rov qab thiab khaws cia. Ntxiv rau, qhov hnyav kuj poob qis 7 phaus, txwv tsis pub muaj teeb meem nrog nws. "

Daria: “Kuv tau txais cov tshuaj no ntawm luv nqi dawb. Lawv haum kuv zoo, thaum ua ke nrog kev noj haus thiab kev tawm dag zog, kuv poob 12 kg thiab muab cov ntshav qabzib nyob hauv kev txiav txim. Yog lawm, yog tias kuv yuav kuv cov nyiaj, nws yuav nyuaj, nws kim heev. Tab sis qhov zoo tshaj yog tseem muaj nqis nws. ”

Igor: “Kuv ntseeg tias Yanumet yog kev cawm dim rau cov neeg mob ntshav qab zib. Nws sai sai muab cov txiaj ntsig, nrog rau kev yoo mov thiab kev tawm dag zog nws yuav pab lub cev kom muaj lub cev zoo, qis qab zib. Muaj cov nyhuv ntawm poob phaus, tab sis tus kws kho mob tau piav qhia tias koj tsis tuaj yeem haus cov tshuaj no tsuas yog siv rau nws xwb - lub nra rau ntawm ob lub raum muaj zog. "Txhua yam zoo nrog lawv, yog li kuv txuas ntxiv nrog cov tshuaj no thiab kuv txaus siab txog cov txiaj ntsig."

Valentine: “Kuv txiv mob ntshav qab zib. Tus kws kho mob xub sau cov tshuaj metformin thiab sitagliptin cais. Tom qab ntawd lawv tau kawm tias muaj ib hom tshuaj uas hloov ob ntsiav tshuaj, vim tias nws muaj ob qho tib si ntawm cov tshuaj no. Nws txiv nws lub raum nyob zoo, yog li ntawd kws kho mob thiaj cia nws coj mus. "Yanumet" tau pab zoo hauv kev ua kom qab zib, thiab txawm tias tshem tawm qhov hnyav tshaj uas pom los ntawm leej txiv vim muaj tus kab mob. Lawv tau ntshai tias yuav muaj teeb meem rau lub raum lossis mob lwm yam, tab sis lawv tuaj yeem ua tau yam tsis muaj lawv. Leej txiv txaus siab siv cov tshuaj no, nws kho tau nws los txog niaj hnub no. "

Xaus

Yanumet muaj cov kev txheeb xyuas zoo los ntawm ob tus neeg mob ntshav qab zib thiab lawv tus kws kho mob. Cov tshuaj no kho tau ntshav qab zib ua rau muaj txiaj ntsig sai thiab kav ntev, yog qhov tsim nyog rau ntau tus neeg thiab yuav luag tsis ua rau muaj kev phiv tshuaj. Nws raug qhuas rau qhov zoo siab thiab muaj txiaj ntsig zoo, txawm hais tias nws raug sau tseg tias tus nqi hauv cov khw muag tshuaj zoo tib yam. Tab sis qhov ua tau zoo ntawm cov tshuaj compensates rau no drawback.

Yanumet ntsiav tshuaj rau kev siv siv rau cov tshuaj hypoglycemic uas siv los them rau cov mob ntshav qab zib hom 2. Nws cov hauj lwm zoo tau txhim kho los ntawm cov tsis sib xws ntawm cov khoom. Nws yog leej twg haum rau thiab yuav siv nws li cas?

Nws feem ntau tau sau tseg yog tias kev hloov kho hauv lub neej thiab kev siv tshuaj kho mob metformin yav dhau los lossis kev kho mob tsis tau coj txoj kev xav tau. Qee lub sij hawm nws yog tshuaj rau cov tib neeg uas koom nrog hauv kev ua kis las thiaj li tswj hwm lawv cov glycemic profile. Ntxiv nrog rau kev paub ntxaws nrog cov lus qhia, ua ntej siv txhua kis, kws kho mob sab laj yog qhov yuav tsum tau ua.

Yanumet: muaj pes tsawg leeg thiab nta

Qhov ua cov nquag ua hauv mis yog metformin hydrochloride. Cov tshuaj tau ntim hauv 500 mg, 850 mg lossis 1000 mg hauv 1 ntsiav tshuaj. Sitagliptin pabcuam ntawm cov tshuaj yog qhov tseem ceeb, hauv ib tsiav tshuaj nws yuav yog 50 mg ntawm txhua koob ntawm metformin. Muaj cov zam rau hauv cov mis uas tsis muaj kev txaus siab nyob rau hauv cov nqe lus ntawm cov tshuaj muaj peev xwm.

Elongated convex capsules yog kev tiv thaiv los ntawm fakes nrog cov ntawv sau "575", "515" lossis "577", nyob ntawm qhov ntau npaum. Txhua pob ntawv cardboard muaj ob lossis plaub daim phiaj ntawm 14 daim. Daim ntawv yuav tshuaj yog muab faib tawm.

Lub thawv kuj tseem qhia txog lub txee lub neej ntawm cov tshuaj - 2 xyoo. Cov tshuaj uas tas sij hawm yuav tsum tau muab pov tseg. Qhov xav tau rau qhov chaw cia khoom yog tus qauv: ib qho chaw qhuav nkag tsis tau rau hauv lub hnub thiab cov menyuam yaus nrog lub ntsuas kub txog li 25 degrees.

Pharmacological tau

Yanumet yog qhov kev xav ua ke ntawm ob txoj kev kho mob uas muaj piam thaj nrog kev ua kom tiav (sib ntxiv rau lwm tus) cov yam ntxwv: metformin hydrochloride, uas yog ib pawg ntawm lojuanides, thiab sitagliptin, ib qho inhibitor ntawm DPP-4.

Synagliptin

Cov khoom siv yog npaj rau kev siv qhov ncauj. Cov txheej txheem ntawm kev ua ntawm sitagliptin yog ua raws li kev ua kom muaj zog ntau zuj zus. Thaum DPP-4 raug txwv, qib ntawm GLP-1 thiab HIP peptides, uas tswj cov ntshav qabzib homeostasis, nce ntxiv. Yog tias nws qhov kev ua tau zoo dua, incretins ua kom lub zog tsim cov kua dej siv cov β-hlwb. GLP-1 tseem ua rau kev txhim kho cov glucagon los ntawm α-cov roj ntsha hauv lub siab. Qhov kev txiav txim siab zoo li no tsis zoo ib yam nrog lub hauv paus ntsiab lus ntawm cov tshuaj sulfonylurea (SM) chav kawm tshuaj uas ua kom cov tshuaj insulin ntau ntxiv rau txhua qib ntawm cov piam thaj.

Cov kev ua si zoo li no tuaj yeem ua rau cov ntshav qog ntshav qab zib tsis yog nyob rau hauv cov ntshav qab zib xwb, tab sis kuj yog hauv cov neeg ua haujlwm noj qab haus huv.

DPP-4 enzyme inhibitor nyob rau hauv cov koob tshuaj pom zoo tsis thaiv qhov ua haujlwm ntawm PPP-8 lossis PPP-9 enzymes. Hauv chaw muag tshuaj, sitagliptin tsis zoo ib yam li nws cov tshuaj ntxiv: GLP-1, insulin, SM derivatives, meglitinide, biguanides, α-glycosidase inhibitors, γ-receptor agonists, amylin.

Ua tsaug rau metformin, kev ua kom cov ntshav qab zib ntau hauv cov ntshav qab zib hom 2 nce: lawv qhov kev xav tsawg dua (ob qho tib si postprandial thiab hauv paus), insulin tsis kam. Qhov kev txiav txim siab ntawm cov tshuaj muaj txiaj ntsig yog txawv ntawm cov ntsiab cai ntawm kev ua haujlwm ntawm kev hloov pauv kho cov ntshav qab zib. Txwv tsis pub cov khoom tsim cov glucogen los ntawm lub siab, metformin txo qis nws nqus los ntawm cov hnyuv phab ntsa, txo cov tshuaj insulin tsis kam, ua kom muaj kev cuam tshuam peripheral.

Tsis zoo li SM npaj, metformin tsis ua rau mob ntshav qab zib thiab mob ntshav qab zib tsis muaj ntshav qab zib rau cov neeg mob ntshav qab zib uas muaj hom 2, tsis nyob hauv pawg tswj hwm. Thaum kho nrog metformin, insulin ntau lawm tseem nyob rau tib theem, tab sis nws qhov kev yoo mov thiab cov qib txhua hnub nyiam.

Xuas

Lub bioavailability ntawm sitagliptin yog 87%. Kev siv ntawm cov khoom noj muaj roj ntau ntau thiab cov khoom noj muaj lub cev tsis muaj txiaj ntsig tsis muaj kev cuam tshuam rau tus nqi ntawm kev nqus. Qib siab tshaj plaws ntawm cov tshuaj nyob hauv cov hlab ntshav yog tsau 1-4 teev tom qab nqus los ntawm kev mob hauv txoj hnyuv.

Lub bioavailability ntawm metformin ntawm ib plab khoob yog li 60% ntawm koob tshuaj 500 mg. Nrog ib qho hno ntawm koob tshuaj loj (txog 2550 mg), lub hauv paus ntsiab lus ntawm kev sib luag, vim kev nqus qis, tau ua txhaum. Metformin los ua haujlwm tom qab ob thiab ib nrab teev. Nws qib mus txog 60%. Qhov kawg ntawm metformin yog tsau tom qab ib hnub lossis ob hnub. Thaum noj mov, cov ua haujlwm ntawm cov tshuaj tsawg dua.

Kev xa Khoom

Qhov ntim ntawm kev faib tawm ntawm synagliptin nrog kev siv nrog 1 mg ntawm pawg pab pawg tswj hwm ntawm cov koom hauv kev sim yog 198 l. Cov qib ntawm khi rau cov ntshav protein yog sib txawv me - 38%.

Hauv cov kev sim uas zoo sib xws nrog metformin, pawg tswj hwm tau muab cov tshuaj rau hauv qhov ntau npaum li 850 mg, qhov faib tawm tib lub sijhawm tau kwv yees li thaj tsam li ntawm 506 litres.

Thaum muab piv nrog cov tshuaj ntawm cov chav kawm SM, metformin qhov tseeb tsis khi rau cov protein, ib ntus ib feem me me ntawm nws nyob hauv cov ntshav liab.

Yog tias koj noj cov tshuaj hauv cov txheej txheem ntau npaum li cas, pom zoo tshaj plaws (