Amaril lossis Diabeton: uas yog ib qho zoo dua los ntawm Lavxias analogues?

Vim tias tus nqi siab ntawm Amaril, cov tshuaj tiv thaiv kab mob tau siv ntau zaus ntau dua los ua kom cov ntshav qab zib nyob rau hauv cov ntshav qab zib muaj cov tshuaj insulin-ywj siab. Cov tshuaj no zoo rau kev tswj kev mob glycemia nrog kev noj zaub mov tshwj xeeb thiab kis las.

Txawm li cas los xij, tsis yog txhua tus neeg muaj peev xwm them taus tus neeg sawv cev hypoglycemic no. Yog li no, hauv tsab xov xwm no, qhov kev txiav txim ntawm pharmacological ntawm Amaril yuav raug nthuav tawm thiab nws cov yeeb yaj kiab tseem ceeb tsim hauv Lavxias yuav muaj npe.

Pharmacological kev txiav txim ntawm cov tshuaj

Amaryl yog ib qho tshuaj hypoglycemic hauv qhov ncauj uas pab txo cov ntshav qab zib los ntawm kev txhawb nqa kev tso tawm thiab ua kom muaj zog ntawm cov tshuaj insulin los ntawm cov qe ntshav tshwj xeeb nyob rau hauv cov ntaub so ntswg.

Lub tswv yim tseem ceeb rau kev txhawb cov txheej txheem tsim kho yog tias Amaril tsub kom lub luag haujlwm ntawm cov qe hlwb kom muaj kev nce ntxiv hauv cov concentration ntawm cov piam thaj hauv cov ntshav ntawm ib tug neeg.

Hauv kev txhaj tshuaj me, cov tshuaj no pab txhawb me me ntawm kev tso tawm tshuaj insulin. Amaryl muaj peev xwm nce qhov rhiab heev ntawm insulin-tiv thaiv cov nqaij ua rau lub ntsej muag ua rau cov insulin.

Ua ib lub sulfonylurea derivative, Amaril muaj peev xwm cuam tshuam rau cov txheej txheem ntawm cov tshuaj insulin ntau lawm. Qhov no tau lees paub los ntawm qhov tseeb tias cov tshuaj sib txuam ntawm cov tshuaj cuam tshuam nrog ATP channel ntawm beta hlwb. Amaryl khi rau cov protein nyob rau saum npoo ntawm tes cell xaiv xaiv. Cov cuab yeej no ntawm cov tshuaj tso cai rau nce rhiab heev ntawm cov nqaij mos ua rau cov kua dej.

Cov piam thaj ntau dhau yog nqus tau feem ntau los ntawm cov keeb ntawm cov leeg nqaij ntawm lub cev.

Ib qho ntxiv, kev siv cov tshuaj inhibits kev tso tawm ntawm cov kua nplaum los ntawm lub hlwb ntawm daim siab mob. Tus txheej txheem no tshwm sim vim muaj kev nce ntxiv hauv cov ntsiab lus ntawm fructose-2,6-biophosphate, uas ua rau kom muaj kev cuam tshuam ntawm gluconeogenesis.

Kev ua kom muaj zog ntawm cov tshuaj insulin tau tshwm sim vim qhov tseeb tias cov tshuaj ua kom cov tshuaj lom neeg muaj zog ntawm cov ions potassium mus rau hauv beta hlwb, thiab ib qho kev tshaj ntawm cov poov tshuaj hauv lub cev ua rau ntau lawm ntawm cov tshuaj no.

Thaum siv txoj kev kho kom sib xyaw ua ke sib xyaw nrog metformin, cov neeg mob tau txhim kho kev tswj cov metabolism hauv cov piam thaj hauv lub cev.

Ua cov txheej txheem kho mob ua ke nrog kev siv tshuaj insulin. Txoj kev tswj hwm no yog siv nyob rau hauv cov teeb meem uas qhov kev ua haujlwm zoo tshaj plaws ntawm cov khoom noj hauv lub cev tsis ua tiav thaum noj ib hom tshuaj. Thaum coj ua hom tshuaj no rau kev kho mob ntshav qab zib mellitus, yuav tsum tau txhaj tshuaj kom haum ntawm cov tshuaj insulin.

Tus nqi ntawm cov tshuaj dej los siv rau hauv hom kev kho mob no raug txo ntau.

Pharmacokinetics ntawm cov tshuaj

Nrog rau ib zaug tshuaj ntawm cov tshuaj ntawm qhov koob tshuaj txhua hnub ntawm 4 mg, nws qhov siab tshaj plaws tau pom tom qab 2.5 teev thiab suav mus rau 309 ng / ml. Lub bioavailability ntawm cov tshuaj yog 100%. Kev noj nws tsis muaj qhov tshwj xeeb ntawm tus txheej txheem nqus, nrog rau qhov tsis tshua muaj qhov qis me me hauv qhov ua kom nrawm ntawm cov txheej txheem.

Cov tshuaj ua kom nquag plias ntawm cov tshuaj yog tus cwj pwm los ntawm kev muaj peev xwm nkag mus rau qhov muaj pes tsawg leeg ntawm niam mis thiab los ntawm qhov chaw tso lub cev. Qhov twg yog qhov txwv kom siv tau cov tshuaj thaum cev xeeb tub thiab pub niam mis.

Cov metabolism ntawm cov tshuaj nquag yog nqa tawm hauv cov nqaij hauv lub siab. Lub ntsiab isoenzyme koom nrog cov metabolism hauv yog CYP2C9.Thaum lub cev cov metabolism hauv cov compound tseem ceeb, ob lub cev tsim muaj, uas yog tom qab ua rau hauv cov quav thiab tso zis.

Kev nqhis ntawm cov tshuaj yog nqa los ntawm lub raum hauv ib lub ntim ntawm 58% thiab kwv yees li 35% nrog kev pab ntawm txoj hnyuv. Cov tshuaj qaug dej caw ntawm cov tshuaj hauv zis tsis pom tias tsis pauv hloov.

Raws li cov txiaj ntsig ntawm kev tshawb fawb, nws pom tias pharmacokinetics tsis nyob ntawm tus neeg mob tus txiv neej thiab nws pawg hnub nyoog.

Yog hais tias tus neeg mob tau ua haujlwm tsis zoo ntawm lub raum thiab excretory system, tus neeg mob muaj qhov nce ntxiv hauv kev tshem tawm ntawm glimepiride thiab qhov txo qis hauv nws qhov nruab nrab hauv cov ntshav siab, uas tshwm sim los ntawm ntau dua kev tshem tawm cov tshuaj vim tias qis dua qhov txuas ntawm cov tshuaj tiv thaiv nquag mus rau cov protein

Cov yam ntxwv dav dav ntawm cov tshuaj

Amaryl suav hais tias yog lub sijhawm thib peb tiam sulfonylurea derivative. Lub teb chaws uas ua cov tshuaj yog Lub teb chaws Yelemees thiab Ltalis. Cov tshuaj yog tsim nyob rau hauv daim ntawv ntsiav tshuaj ntawm 1, 2, 3 lossis 4 mg. 1 ntsiav tshuaj ntawm Amaril muaj lub ntsiab tivthaiv - glimepiride thiab lwm yam kev zam.

Qhov cuam tshuam ntawm glimepiride feem ntau yog txhawm rau txo cov ntshav qabzib los ntawm kev xav tsim cov tshuaj insulin los ntawm beta hlwb. Tsis tas li ntawd, cov tshuaj nquag muaj cov nyhuv insulinomimetic thiab nce rhiab heev ntawm cov cell receptors kom txo cov ntshav qab zib.

Thaum tus neeg mob noj ntawm Amaryl, qhov siab tshaj plaws ntawm glimepiride tau mus txog tom qab 2.5 teev. Cov tshuaj tuaj yeem noj tau tsis hais lub sijhawm noj mov. Txawm li cas los xij, kev noj mov kom tsawg me ntsis cuam tshuam cov kev ua ntawm glimepiride. Yeej, qhov sib xyaw no yog tawm ntawm lub cev los ntawm txoj hnyuv thiab lub raum.

Tus kws kho mob tshwj xeeb tshaj tawm tshuaj Amaril rau cov neeg mob uas muaj ntshav qab zib hom 2 li tshuaj tua kab mob los yog thaum sib xyaw nrog cov tshuaj tiv thaiv ntshav qab zib.

Txawm li cas los xij, kev noj tshuaj tsis txwv tsis tau txuas ntxiv ua raws li kev noj haus kom zoo, uas tsis suav nrog cov rog thiab yooj yim zom cov zaub mov carbohydrates, thiab kev ua lub neej muaj sia.

Cov lus qhia rau kev siv tshuaj

Koj tsis tuaj yeem yuav yuav cov tshuaj yam tsis muaj daim ntawv sau yuav tshuaj los ntawm kws kho mob. Ua ntej siv cov tshuaj, koj yuav tsum mus ntsib kws kho mob thiab nug nws tag nrho koj cov lus nug. Nws yog nws leej twg tuaj yeem txiav txim siab ntau npaum li cas ntawm cov tshuaj thiab sau ntawv kho ib txoj kev kho raws tus neeg mob cov ntshav qabzib.

Amaryl ntsiav tshuaj noj ntawm qhov ncauj, tsis tas yuav zom, thiab ntxuav nrog qhov dej txaus. Yog tias tus neeg mob tsis nco qab haus tshuaj, muab ob npaug koob tshuaj tiv thaiv. Thaum kho, koj yuav tsum tsis tu ncua soj ntsuam cov suab thaj theem, nrog rau cov concentration ntawm glycosylated hemoglobin.

Thaum pib, tus neeg mob noj ib koob tshuaj 1 mg ib hnub twg. Maj mam, ntawm kev ncua sij hawm ntawm ib mus rau ob lub lis piam, ntau npaum li cas ntawm cov tshuaj yuav tau nce ntxiv los ntawm 1 mg. Piv txwv li, 1 mg, tom qab ntawd 2 mg, 3 mg, thiab ntxiv rau txog li 8 mg rau ib hnub.

Tus kws kho mob ntshav qab zib uas tau tswj tus kab mob zoo glycemic noj ib koob tshuaj txhua hnub txog 4 mg.

Feem ntau, cov tshuaj tau noj ib zaug ua ntej noj mov ib pluas tshais lossis, thaum tsis tuaj yeem siv cov ntsiav tshuaj, ua ntej noj mov tseem ceeb. Hauv qhov no, tus kws tshaj lij yuav tsum coj mus rau hauv tus txheej txheem lub neej ntawm cov ntshav qab zib, lub sijhawm noj mov thiab nws kev ua si. Ntau dua kev tau hloov cov tshuaj kuj yuav xav tau thaum:

txo qhov hnyav
hloov hauv txoj kev ua neej (khoom noj khoom haus, kev ntxhov siab, sijhawm noj mov),
lwm yam.

Nws yog qhov yuav tsum tau sab laj nrog tus kws kho mob thiab pib nrog qhov koob tshuaj tsawg kawg (1 mg) ntawm Amaril yog tias tus neeg mob xav tau:

hloov lwm cov tshuaj txo suab thaj nrog Amaril,
kev sib xyaw ntawm glimepiride thiab metformin,
Qhov sib xyaw ua ke yog glimepiride thiab insulin.

Nws tsis pom zoo kom noj tshuaj rau cov neeg mob uas mob raum, thiab mob raum thiab mob siab.

Cov kev thaiv tsis zoo thiab cov tshuaj tiv thaiv tsis zoo

Amaril glimepiride muaj nyob hauv cov tshuaj, ntxiv rau cov khoom ntxiv, tsis yog ib txwm muaj lub txiaj ntsig zoo rau lub cev ntawm cov ntshav qab zib.

Xws li lwm yam kev txhais tau tias, cov tshuaj muaj contraindications.

Nws yog txwv tsis pub cov neeg mob noj tshuaj hauv cov xwm txheej hauv qab no:

hom mob ntshav qab zib insulin,
lub sijhawm uas xeeb tub thiab pub niam mis,
mob ntshav qab zib ketoacidosis (tsis hnov mob carbohydrate metabolism), cov mob ntshav qab zib ua rau lub cev tsis nco qab thiab tsis nco qab,
cov neeg mob hnub nyoog qis dua 18,
galactose intolerance, lactase tsis muaj zog,
kev txhim kho ntawm cov piam thaj-galactose malabsorption,
ua txhaum lub siab thiab lub raum, nyob rau hauv cov neeg mob tshwj xeeb tshaj tawm hemodialysis,
cov tib neeg tsis kam mloog rau cov tshuaj, sulfonylurea derivatives, sulfonamide cov neeg sawv cev.

Cov lus qhia txuas tau hais tias hauv thawj lub lis piam ntawm kev kho, Amaryl yuav tsum tau ua nrog ceev faj kom tsis txhob muaj kev txhim kho ntawm lub xeev hypoglycemic. Tsis tas li, yog tias malabsorption ntawm cov zaub mov thiab tshuaj los ntawm cov plab zom mov, cov piam thaj-6-phosphate dehydrogenase tsis txaus, cov kab mob sib kis, thiab nyob rau qhov muaj qhov pheej hmoo ntawm kev txhim kho hauv lub xeev hypoglycemic, Amaril siv kom zoo.

Nrog rau kev siv tsis raug ntawm cov ntsiav tshuaj (piv txwv, hla kev nkag mus), kev txhaum loj tuaj yeem tshwm sim:

Cov kev mob ntshav siab, qhov cim ntawm qhov mob taub hau thiab kiv taub hau, hnov qab zoo, ua nruj ua tsiv, tsis meej pem, tsaug zog, tsaus muag, tshee, tshee, thiab tsis pom kev.
Adrenergic qhov kev tawm tsam ua raws li qhov lus teb rau kev txo qis sai sai, pom los ntawm kev ntxhov siab, palpitations, tachycardia, lub plawv tsis sib haum thiab ua kom pom kev tawm hws.
Kev mob plab zom mov - txhaws qa ntawm xeev siab, ntuav, pom pob txha, mob plab, raws plab, ua kom muaj kab mob siab, muaj kev ua haujlwm ntawm daim siab ua haujlwm siab, mob daj ntseg lossis cholestasis.
Kev ua txhaum ntawm cov kab mob hematopoietic - leukopenia, thrombocytopenia, granulocytopenia thiab qee yam kev ua kab mob.
Ua xua, tshwm sim los ntawm daim tawv nqaij ua pob ua xua, khaus, urticaria, qee zaum anaphylactic poob siab thiab ua xua vasculitis.

Lwm cov kev cuam tshuam no tseem muaj peev xwm ua tau - photosensitization thiab hyponatremia.

Nqi, tshuaj xyuas thiab analogues

Tus nqi ntawm cov tshuaj Amaryl ncaj qha nyob ntawm daim ntawv ntawm nws tso tawm. Txij li thaum cov tshuaj tau siv, raws li, nws tus nqi yog siab heev. Tus nqi khwv yees li ntawm Amaryl ntsiav tshuaj yog raws li hauv qab no.

1 mg 30 ntsiav tshuaj - 370 rub.,
2 mg 30 ntsiav tshuaj - 775 rubles.,
3 mg 30 ntsiav tshuaj - 1098 rub.,
4 mg 30 ntsiav tshuaj - 1540 rub.,

Raws li kev xav ntawm cov ntshav qab zib hais txog qhov ua tau zoo ntawm cov tshuaj, lawv tau zoo. Nrog rau kev siv sijhawm ntev ntawm cov tshuaj, cov piam thaj pleev rov qab rau qhov qub. Txawm hais tias daim ntawv teev npe muaj ntau cov kev mob tshwm sim, qhov feem pua ntawm lawv qhov pib me me heev. Txawm li cas los xij, muaj kev tshuaj xyuas tsis zoo ntawm cov neeg mob cuam tshuam nrog tus nqi siab ntawm cov tshuaj. Ntau ntawm lawv yuav tsum nrhiav Amaril hloov chaw.

Qhov tseeb, cov tshuaj no muaj ntau cov lus txhais thiab cov qauv ua tawm hauv Lavxias Lavxias, piv txwv:

Glimepiride yog ib hom tshuaj uas muaj tib yam khoom ua, sib deev thiab qhov tshwm sim. Qhov txawv yog tsuas yog hauv cov tshuaj ntxiv. Tus nqi nruab nrab ntawm cov tshuaj (2 mg No. 30) yog 189 rubles.
Diagninide yog cov tshuaj txo cov ntshav qab zib, hauv nws cov lus sib xws yog sib luag nrog cov tshuaj yeeb tshuaj NovoNorm. Cov tshuaj yeeb tshuaj yog repaglinide. Novonorm (Diagninide) muaj yuav luag tib cov contraindications thiab kev tsis zoo. Txhawm rau kom nkag siab zoo dua qhov sib txawv ntawm ob qhov sib piv no, nws yog ib qho tsim nyog los sib piv cov nqi: tus nqi ntawm Diaglinide (1 mg No. 30) yog 209 rubles, thiab NovoNorm (1 mg No. 30) yog 158 rubles.
Glidiab yog lub tshuaj Lavxias uas kuj yog ib qho tshuaj noj ntawm cov kab mob ntshav qab zib zoo uas muaj ntshav qab zib.Tus nqi nruab nrab ntawm Glidiab ntsiav tshuaj (80 mg No. 60) yog 130 rubles, thiab tus nqi tshuaj ntawm Diabeton (30 mg No. 60) yog 290 rubles.

Amaryl yog cov tshuaj muaj suab thaj zoo, tab sis kim. Yog li, nws tuaj yeem hloov nrog cov pheej yig dua, ob leeg hauv tsev (Diclinid, Glidiab), thiab cov tshuaj muaj yees (NovoNorm, Diabeton) tshuaj. Qhov muaj pes tsawg leeg muaj xws li glimepiride, lossis lwm yam tshuaj uas ua rau kom muaj suab thaj tsawg. Paub txog cov analogues, tus kws kho mob thiab tus neeg mob yuav tuaj yeem txiav txim siab yam tshuaj twg zoo dua. Cov yeeb yaj kiab hauv tsab xov xwm no txuas ntxiv lub ntsiab lus ntawm Amaril rau ntshav qab zib.

Amaril - cov lus qhia rau siv nyob rau hauv kev kho mob ntshav qab zib, mechanism ntawm kev txiav txim, contraindications thiab tshuaj xyuas

Ntshav Qab Zib Hom 2 yog ib hom mob txaus ntshai uas feem ntau tshwm sim rau cov neeg laus dua 40 leej twg nquag ua rog.

Txo cov kev xav ntawm cov ntaub so ntswg mus rau insulin, nrog rau qhov ua kom tiav ntawm cov kev pab cuam ntawm pancreatic, ua rau muaj kev xav tau cov tshuaj kho mob nrog glimepiride.

Ib cov tshuaj zoo yog Amaril, uas muaj peev xwm txo qis siv nyob nrog kev pheej hmoo tsawg ntawm kev phiv.

Cov tshuaj yog zwm rau cov chaw kho mob thiab pharmacological pawg ntawm qhov ncauj hypoglycemic tshuaj ntawm peb tiam sulfonylurea. Amaryl muaj cov kev ua lub sijhawm ntev.

Kev sib xyaw ua ke, nrog rau cov txiaj ntsig tseem ceeb ntawm kev ua antioxidant thiab cov nyhuv me me rau cov hlab plawv, ua rau muaj kev siv ntau ntawm cov tshuaj los tawm tsam tus mob ntshav qab zib hom 2 nrog qhov tsis muaj txiaj ntsig ntawm metformin monotherapy.

Cov tshuaj tau nthuav tawm nyob rau hauv kev ua lag luam nyob rau hauv plaub qhov kev sib txawv ntawm kev tso tawm, txhua tus uas tau npaj rau kev kho mob ntshav qab zib, nyob ntawm tus neeg yam ntxwv ntawm tus neeg mob:

Amaril, 1 mg: oblong liab ntsiav tshuaj ntawm ib lub tiaj tus kheej, ntawm ob sab muaj qhov pheej hmoo sib faib, tsab ntawv "h" thiab kos "NMK".
Amaril, 2 mg: oblong ntsuab ntsiav tshuaj ntawm daim ntawv tiaj, ntawm ob sab muaj qhov pheej hmoo sib faib, tsab ntawv "h" thiab kos "NMM".
Amaril, 3 mg: oblong daj daj cov ntsiav tshuaj yog ntsiav tshuaj ntawm daim ntawv tiaj, ntawm ob sab muaj qhov kev pheej hmoo sib faib, tsab ntawv "h" thiab sau "NMN".
Amaril, 4 mg: oblong xiav ntsiav tshuaj, tiaj tus kheej, ntawm ob sab muaj qhov pheej hmoo sib faib, tsab ntawv "h" thiab kos "NMO".

Yam khoom muaj sia	Ntu Cheebtsam
Glimepiride	lactose monohydrate, sodium carboxymethyl hmoov txhuv nplej siab, povidone, microcrystalline cellulose, magnesium stearate, dyes liab thiab daj hlau oxide, indigo carmine

Cov tshuaj yog rau cov pab pawg neeg ntawm cov tshuaj hypoglycemic los ntawm qeb ntawm sulfonylurea. Cov khoom sib xyaw ua ke ntawm Amaril ua kom nrawm rau kev cuam tshuam ntawm insulin los ntawm hlwb pancreatic.

Qhov kev txiav txim no vim yog qhov muaj peev xwm ntawm cov tshuaj kom nce qhov rhiab ntawm tus txiav mus rau caj pas txhawb.

Nrog rau cov txiaj ntsig tau piav qhia, Amaril muaj qhov muaj peev xwm ntawm kev ua cov quav yeeb yaj kiab thiab ua kom muaj kev cuam tshuam cov ntaub so ntswg mus rau insulin. Glimepiride ua rau qeeb ntawm kev tso tawm cov piam thaj hauv lub siab.

Qhov siab tshaj plaws nyob rau hauv cov ntshav ntshav tom qab noj 4 mg ntawm cov tshuaj tau mus txog tom qab 2.5 teev. Lub peev txheej ntawm kev khiav haujlwm ntawm cov khoom ua haujlwm nquag yog 100%.

Noj Amaril ua ke nrog cov zaub mov xyaum tsis cuam tshuam rau qib ntawm kev nqus thiab theem ntawm cov metabolism hauv cov piam thaj. Glimepiride muaj peev xwm los mus kov yeej cov teeb meem placental thiab nkag mus rau kev sib xyaw ntawm cov kua mis.

Cov tshuaj noj tshuaj metabolism tshwm sim hauv daim siab los ntawm kev tsim cov metabolites uas nkag mus rau cov quav (35%) thiab zis (58%).

Kev ntsuas rau siv

Amaril tau siv ua tiav rau kev kho mob ntawm cov neeg mob laus neeg mob ntshav qab zib hom 2 tsis tas yuav tsum muaj monotherapy nrog insulin.Txoj kev tswj hwm yog raug txiav txim nyob rau hauv cov xwm txheej uas tsis muaj peev xwm tswj tau cov ntshav qabzib hauv cov ntshav ntawm kev nyab xeeb tsuas yog kev pab ua haujlwm ntawm lub cev, poob phaus thiab noj zaub mov tshwj xeeb.

Amaryl noj thaum noj mov lossis ua ntej noj mov, ntxuav nrog kua. Nyob rau thawj theem ntawm kev nkag mus, muaj kev pheej hmoo ntawm hypoglycemia, yog li tus kws kho mob tswj tau nws tsim nyog. Qhov koob tshuaj ntawm glimepiride yog txiav txim siab los ntawm cov txiaj ntsig ntawm kev txiav txim siab txog qib ntawm cov piam thaj hauv cov zis thiab ntshav.

Kev txais tos yuav pib nrog ib ntsiav tshuaj (1 mg glimepiride) ib hnub. Ntxiv mus, thaum glycemic tswj kev tiv thaiv tsis muaj peev xwm pom, qhov ntau npaum nce mus txog 2 mg lossis ntau dua. Lub sijhawm nruab nrab ntawm kev nce ntxiv yog 1-2 lub lis piam. Qhov tshuaj ntau ntau yog 6 mg rau ib hnub.

Kev sib xyaw ua ke nrog tshuaj insulin yog kho los ntawm kws kho mob nkaus xwb.

Cawv thiab Amaryl

Cov tshuaj muaj qhov cuam tshuam ncaj qha rau cov ntshav qab zib. Qhov kev ua no tau raug hloov kho tseem ceeb raws li kev haus cawv. Kev txo lub plawv tsis zoo tuaj yeem nce lossis txo qis, thiab nws nyuaj heev los twv seb cov txiaj ntsig tau qhia, uas ua rau txwv tsis pub haus cawv thaum siv tshuaj.

Yeeb tshuaj sib cuam tshuam

Vim yog cov metabolism hauv cov tshuaj uas muaj hauv lub siab, ceev faj yuav tsum ua kom muaj kev sib xyaw ua ke nrog cov tshuaj nrog cov inducers lossis inhibitors ntawm cytochrome isoenzymes (Rifampicin, Fluconazole). Kev sib cuam tshuam yeeb tshuaj glimepiride:

Cov tshuaj insulin, hypoglycemic agents, tshuaj steroids, chloramphenicol, coumarin derivatives, fibrates, quinolones, salicylates, sulfonamides, tetracyclines potentiate hypoglycemic effect ntawm cov tshuaj, nce siab tsis ua hauj lwm daim siab thiab lub raum kev ua haujlwm.
Barbiturates, glucocorticosteroids, diuretics, Epinephrine, laxatives, estrogens, nicotinic acid derivatives, thyroid hormones txo qis kev ua haujlwm ntawm cov tshuaj.
Reserpine muaj peev xwm txo qis thiab nce cov nyhuv ntawm glimepiride.

Sab sij huam

Tawm tsam keeb kwm ntawm kev noj tshuaj, cov kev mob tshwm sim los ntawm ntau yam plab hnyuv siab raum thiab tshuab kab ke yuav tsim. Feem ntau manifested muaj xws li:

mob ntshav qab zib (mob taub hau, ntxhov siab, nruj dhau, tsis tshua hnov qab, muaj kev nyuaj siab, hais lus thiab pom kev tsis sib haum xeeb, nriaj, ua kom zoo nkauj, kiv taub hau, plhaw, tsis nco qab),
hws txias clammy
palpitations, mob stroke,
xeev siab, ntuav, hnyav hauv plab, raws plab, mob siab, daj ntseg,
nce platelet tsim, leukopenia, ua kom mob ntshav qab zib (txo qis hemoglobin), granulocytopenia, agranulocytosis,
kev tsis haum tshuaj (khaus, tawm pob, urticaria, anaphylactic shock, vasculitis),
kev npau suav,
kev saib duab.

Noj ntau dhau

Cov lus qhia rau kev siv Amaril ceeb toom txog kev tshwm sim ntawm cov tsos mob ntawm kev siv tshuaj ntau dhau los yog kev kho mob mus ntev nrog cov tshuaj nyob rau hauv cov koob tshuaj siab hauv daim ntawv ntawm qhov mob ntshav qab zib siab heev. Nws tuaj yeem nres sai sai los ntawm kev noj ib qho piam thaj, tshuaj yej qab zib, kua txiv.

Ib qhov tseem ceeb tshaj plaws ntawm kev siv tshuaj yaj yeeb hawv nrog qhov tsis nco qab, cov hlab ntsha hlwb tsis xis nyob. Nrog tsaus muag, 40 ml ntawm 20% dextrose lossis kua nplaum tov yog muab tshuaj rau ib tus neeg, lossis 0.5-1 mg ntawm glucagon yog muab tshuaj rau cov niam txiv.

Hauv lwm qhov xwm txheej, yuav tsum muaj lub plab zom zaub mov noj, nrog rau kev ua kom muaj hluav ncaig.

Amaril qhov piv txwv

Cov tshuaj hloov pauv muaj xws li sulfonylurea-based tshuaj tiv thaiv ntshav qab zib hom 2. Cov qauv ntawm txhais tau tias:

Glimepiride - tshuaj muaj tib lub npe qub,
Diagninide - cov piam thaj txo cov tshuaj raws li cov tshuaj repaglinide,
NovoNorm - ib qho tshuaj txawv teb, suav nrog repaglinide,
Glidiab - tshuaj Lavxias raws li glimepiride,
Ntshav qab zib yog cov tshuaj tuaj rau ntshav qab zib.

Amaril lossis Diabeton - uas yog ib qho zoo dua

Ob qho tshuaj no yog tsim rau hom 2 mob ntshav qab zib mellitus thiab muaj nyob hauv cov qauv ntsiav tshuaj.

Lawv li qub tsim tawm ntawm cov tshuaj insulin, ua kom cov nqaij mos rhiab ntau dua, txo cov roj cholesterol thiab taw qhia lub sijhawm los ntawm kev noj mov mus rau tso tawm insulin.

Yog tias tus neeg mob lub cev tsis zoo ua haujlwm, cov tshuaj txo qis cov protein nyob hauv cov zis. Qhov sib txawv ntawm cov tshuaj yog tus nqi - Diabeton yog pheej yig dua.

Amaril tus nqi

Kev yuav ntawm Amaril yuav raug nqi ib qho nyob ntawm qhov kev txiav txim siab ntawm cov tshuaj nquag, tus naj npawb ntawm cov ntsiav tshuaj hauv pob thiab cov cai nqe ntawm lub tuam txhab muag. Hauv cov khw muag tshuaj hauv Moscow, tus nqi ntawm cov tshuaj yuav:

Hom tshuaj	Nqe, rubles
Ntsiav tshuaj 2 mg 30 pcs.	629
4 mg 90 pcs.	2874
1 mg 30 pcs.	330
4 mg 30 pcs.	1217
2 mg 90 pcs.	1743
3 mg 30 pcs.	929
3 mg 90 pcs.	2245

Kuv muaj mob hnyav, txaus ntshai, yog li kuv yuav tsum noj tshuaj Amaril rau ntshav qab zib hom 2. Kuv nyiam lawv cov txiaj ntsig thiab yooj yim ntawm kev siv - ib ntsiav tshuaj ib hnub. Kuv tau coj kab mob ntshav qab zib, tab sis nws ua rau kuv kiv taub hau, feem ntau mob. Nrog cov tshuaj no tsis muaj cov nyhuv zoo li, tab sis nws raug nqi ntau dua. Kuv xum them rau tshaj qhov tsis xis nyob.

Kuv niam muaj tus mob ntshav qab zib hom 2 thiab noj cov tshuaj Amaryl. Nws tau siv tshuaj yaj yeeb raws li koob tshuaj metformin, tab sis tam sim no nws raug yuam kom hloov mus rau cov tshuaj zoo dua. Nws sau tseg txog kev siv cov khoom lag luam thiab qhov tsis muaj qhov tshwm sim. Niam txaus siab nrog kev ua haujlwm ntawm cov tshuaj, nws hais tias nws txo qis ntshav qab zib.

Anatoly, 41 xyoo

Kuv muaj ntshav qab zib, tab sis tsis muaj insulin vam khom. Peb yuav tsum txo cov ntshav qab zib nrog cov tshuaj tshwj xeeb. Kuv noj Amaril vim tias kuv raug xaj los ntawm kws kho mob. Kuv haus cov ntsiav tshuaj hauv qhov ntau npaum 2 mg, tab sis kuv sai sai no yuav hloov mus rau qhov nce ntxiv - maj mam nce zuj zus muaj kev cuam tshuam zoo rau kev noj qab haus huv.

Cov ncauj lus hauv tsab xov xwm tsuas yog rau kev taw qhia nkaus xwb. Cov khoom siv ntawm kab lus tsis hu rau kev kho ywj siab. Tsuas yog tus kws kho mob muaj txiaj ntsig tuaj yeem ua tus kab mob thiab muab tswv yim rau kev kho mob raws li tus yam ntxwv ntawm tus neeg mob tshwj xeeb.

Amaryl ntsiav tshuaj - cov lus qhia, tshuaj xyuas ntawm tus tswv tsev, nqi

Amaryl muaj cov tshuaj glimepiride, uas belongs rau qhov tshiab, thib peb, tiam ntawm sulfonylurea derivatives (PSM). Cov tshuaj no tseem kim dua li glibenclamide (Maninil) thiab glyclazide (Diabeton), tab sis tus nqi sib txawv tsuas yog muaj kev ua haujlwm siab, kev ua haujlwm sai, muaj kev cuam tshuam me me rau ntawm tus txiav, thiab txo qis kev pheej hmoo ntawm hypoglycemia.

Nrog Amaril, beta hlwb tau ploj zuj zus qeeb dua nrog cov tiam dhau los ntawm sulfonylureas, yog li kev nce qib ntawm cov ntshav qab zib tau qeeb qeeb thiab kev kho tshuaj insulin yuav xav tau tom qab.

Kev tshuaj xyuas cov tshuaj muaj lub siab zoo: nws txo qis qab zib kom zoo, yog qhov yooj yim siv, haus cov ntsiav tshuaj ib hnub ib zaug, tsis hais txog ntawm koob tshuaj. Ntxiv rau cov ntshiab glimepiride, nws qhov sib xyaw nrog metformin yog tsim - Amaril M.

Nyob zoo Kuv lub npe yog Galina thiab kuv tsis muaj ntshav qab zib ntxiv lawm! Nws coj kuv tsuas yog 3 lub lis piamcoj qab zib rov qab mus rau qhov qub thiab tsis quav cov tshuaj tsis raug cai
>>Koj tuaj yeem nyeem kuv zaj dab neeg ntawm no.

Qhia me ntsis

Nkaus

Txo cov ntshav qab zib, cuam tshuam nws theem ntawm ob sab:

Tsim kev tsim kho ntawm cov tshuaj insulin, thiab rov qab ua kom tiav thawj zaug, ntu nrawm ntawm nws qhov kev zais. PSM uas tseem tshuav hla lub sijhawm no thiab ua haujlwm nyob rau zaum ob, yog li cov piam thaj txo qis dua.
Txo cov tshuaj insulin ntau dua li lwm PSM.

Tsis tas li, cov tshuaj txo txoj kev pheej hmoo ntawm thrombosis, normalizes cov roj cholesterol, thiab txo qis oxidative kev nyuaj siab. Amaryl raug tso tawm qee qhov tso zis, ib feem los ntawm cov hnyuv, yog li nws tuaj yeem siv rau hauv cov neeg mob raum tsis ua haujlwm, yog lub raum ua haujlwm tsis zoo.Cov Khoom QhiaMob ntshav qab zib tsuas yog 2 hom. Ib qho yuav tsum tau ua ua ntej rau kev siv yog qee khaws cia beta hlwb, seem synthesis ntawm lawv tus kheej cov insulin.Yog tias tus txiav tsis dhau los tsim cov tshuaj hormones, Amaril tsis tau sau tseg. Raws li cov lus qhia, cov tshuaj muaj peev xwm noj nrog metformin thiab insulin kho.Tsuas tshuajAmaryl yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj muaj txog li 4 mg ntawm glimepiride. Txhawm rau siv tau yooj yim, txhua txoj kev siv tshuaj nws muaj nws tus kheej xim. Lub sijhawm pib yog 1 mg. Nws yog noj rau 10 hnub, tom qab uas lawv pib maj mam nce ntxiv kom txog thaum qab zib zoo li qub. Qhov ntau kawg pub rau noj yog 6 mg. Yog tias nws tsis them nyiaj rau cov ntshav qab zib, cov tshuaj los ntawm lwm pab pawg lossis cov tshuaj insulin ntxiv rau kev kho mob.Noj ntau dhauTshaj dhau qhov siab tshaj qhov kawg yuav ua rau muaj ntshav qab zib nyob ntev. Tom qab ib txwm muaj suab thaj, nws tuaj yeem rov poob rau lwm 3 hnub. Txhua lub sijhawm no, tus neeg mob yuav tsum nyob hauv qab kev saib xyuas ntawm cov txheeb ze, nrog kev siv ntau dhau - hauv tsev kho mob.Cov Yuav Tsum Muaj

Cov tshuaj tiv thaiv tsis haum rau glimepiride thiab lwm yam PSM, ntu ntu ntawm cov tshuaj.
Tsis muaj cov tshuaj insulin (hom 1 mob ntshav qab zib, kev rov qab yoog nqaij).
Mob raum tsis ua haujlwm. Muaj peev xwm ntawm kev noj tshuaj Amaril rau cov kab mob hauv lub raum tau txiav txim siab tom qab kuaj xyuas cov khoom nruab nrog.
Glimepiride yog metabolized nyob rau hauv daim siab, yog li ntawd, daim siab tsis ua haujlwm kuj tseem muaj nyob hauv cov lus qhia ua kev sib tiv thaiv.

Amaryl yog tso tseg ib ntus thiab hloov nrog cov tshuaj insulin thaum lub sijhawm cev xeeb tub thiab lactation, mob hnyav ntshav qab zib, los ntawm ketoacidosis mus rau hyperglycemic coma. Nrog rau cov kis kab mob, kev raug mob, kev xav ntau dhau, Amaril yuav tsis txaus rau cov suab thaj li qub, yog li kev kho mob ntxiv nrog insulin, feem ntau ntev. Kev phom sij ntawm hypoglycemiaCov piam thaj hauv ntshav qis yog tias cov ntshav qab zib tsis nco qab noj mov lossis tsis ntxiv cov piam thaj hauv lub sijhawm thaum tawm dag zog. Txhawm rau ua kom glycemia li qub, koj yuav tsum noj cov zaub mov sai sai, feem ntau yog ib qho qab zib, ib khob kua txiv los sis tshuaj yej qab zib tau txaus. Yog tias cov tshuaj ntawm Amaril tau dhau lawm, hypoglycemia tuaj yeem rov qab ntau zaug thaum lub sijhawm tshuaj. Hauv qhov no, tom qab thawj zaug ntawm cov piam thaj li ib txwm, lawv sim tshem glimepiride los ntawm cov hnyuv: lawv ua kom ntuav, haus dej adsorbents lossis laxative. Cov kev noj tshuaj rau lub qog ntshav ntshav siab heev yog yuav tsum tau tso cov piam thaj hauv lub cev. Sab sij huamNtxiv rau hypoglycemia, thaum noj Amaril, teeb meem kev zom zaub mov tuaj yeem pom (hauv tsawg dua 1% ntawm cov neeg mob), kev ua xua, xws li tawm pob xoo thiab khaus khaus mus rau anaphylactic shock (>nyeem zaj dab neeg ntawm Alla Viktorovna

Amaryl lossis Glucophage

Hais lus nruj me ntsis, cov lus nug Amaril lossis Glucofage (metformin) yuav tsum tsis txhob nug. Glucophage thiab nws cov analogues rau cov ntshav qab zib hom 2 yeej ib txwm sau tseg rau hauv thawj qhov chaw, txij li thaum lawv siv tau zoo dua li lwm cov tshuaj ua rau qhov tseem ceeb ntawm tus kabmob - insulin tsis kam. Yog tias tus kws kho mob tsuas sau cov ntsiav tshuaj Amaryl xwb, nws lub peev xwm yog tsim nyog ua xyem xyav.

Txawm hais tias muaj kev sib piv ntawm kev nyab xeeb, cov tshuaj no cuam tshuam ncaj qha rau tus txiav, uas txhais tau tias nws luv ua ke ntawm koj cov tshuaj insulin. PSM raug xaj tsuas yog tias metformin tsis raug tiv thaiv tsis zoo lossis nws qhov siab tshaj plaws yog tsis txaus rau ib txwm muaj glycemia. Raws li txoj cai, qhov no yog qhov ua rau mob ntshav qab zib ntau dhau, lossis muaj mob ntev ntev.

Amaril thiab Yanumet

Yanumet, zoo li Amaryl, cuam tshuam rau ob theem insulin thiab insulin kuj. Cov tshuaj sib txawv ntawm cov txheej txheem ntawm kev ua thiab tshuaj qauv, yog li lawv tuaj yeem sib koom ua ke. Yanumet yog ib qho tshuaj kuj tshiab, yog li ntawd nws raug nqi los ntawm 1800 rubles. rau pob khoom me tshaj plaws. Hauv Lavxias, nws cov analogues tau sau npe: Combogliz thiab Velmetia, uas tsis pheej yig dua li qhov qub.

Feem ntau, kev tiv thaiv ntshav qab zib tuaj yeem ua tiav los ntawm kev sib xyaw ua ke ntawm pheej yig metformin, kev noj zaub mov zoo, kev tawm dag zog, qee zaum cov neeg mob xav tau PSM.Yanumet muaj nqis yuav tsuas yog them tus nqi tsis tseem ceeb rau peev nyiaj.

Kev tsis ua raws li kev mob ntshav qab zib nrog kev kho mob kws kho mob yog qhov laj thawj rau kev decompensation ntawm ntshav qab zib.

Tshaj tawm ntawm txoj kev kho kev kho rau txhua yam mob tshwm sim ib txwm txhim kho nws cov txiaj ntsig, yog li, rau cov neeg mob xaiv yeem, cov tshuaj sib xyaw ua ke yog qhov zoo dua.

Amaryl M muaj cov tshuaj feem ntau ntawm cov tshuaj qab zib-txo qis: metformin thiab PSM. Txhua ntsiav tshuaj muaj 500 mg ntawm metformin thiab 2 mg ntawm glimepiride.

Nws yog tsis yooj yim sua kom meej meej sib npaug ob qho kev sib xyaw hauv ib ntsiav tshuaj rau cov neeg mob sib txawv. Hauv nruab nrab theem ntawm ntshav qab zib, ntau dua metformin, tsawg dua glimepiride yuav tsum.

Tsis pub ntau tshaj 1000 mg ntawm metformin pub rau ib zaug, cov neeg mob uas muaj mob loj yuav tsum haus Amaril M peb zaug ib hnub.

Txhawm rau xaiv cov tshuaj ntau npaum li cas, nws raug nquahu rau cov neeg mob uas tau txiav txim siab coj Amaril cais thaum noj tshais thiab Glucofage peb zaug ib hnub.

Txheeb xyuas los ntawm Maxim, 56 xyooCov. Amaril tau raug tshaj tawm rau kuv niam es tsis txhob Glibenclamide thiaj li yuav tshem tawm cov ntshav qog ntshav tsawg. Cov tshuaj no muaj suab thaj qis dua tsis muaj qhov phem tshaj qhov ntawd, ceeb tias ob peb cov kev mob tshwm sim hauv cov lus qhia, tab sis hauv kev muaj tiag tsis muaj txhua. Tam sim no nws noj 3 mg, qab zib tuav txog 7-8.

Peb ntshai txo nws ntau dua, txij thaum niam muaj hnub nyoog 80 xyoo, thiab nws tsis tshua hnov tus mob hypoglycemia. Soj ntsuam los ntawm Elena, hnub nyoog 44 xyoosCov. Amaril tau sau tseg los ntawm tus kws kho mob endocrinologist thiab ceeb toom kuv kom noj tshuaj German, thiab tsis siv tshuaj analogues pheej yig. Txhawm rau kom txuag nqi, Kuv yuav ib lub pob loj, yog li tus nqi hais txog 1 lub ntsiav tshuaj yog tsawg dua. Kuv muaj txaus ntim rau 3 lub hlis.

Cov ntsiav tshuaj yog heev me me, ntsuab, ntawm ib qho txawv txawv. Lub blister yog perforated, yog li nws yooj yim mus faib nws ua qhov chaw. Cov lus qhia rau kev siv tsuas yog loj loj - 4 nplooj ntawv hauv cov ntawv me. Kev yoo mov qab zib tam sim no yog 5.7, ib koob tshuaj 2 mg. Txheeb xyuas los ntawm Catherine, 51Cov. Kuv tau mob ntshav qab zib tau 15 xyoo, lub sijhawm ntawd kuv tau hloov ntau dua kaum ob lub tshuaj.

Tam sim no kuv tsuas noj Amaryl ntsiav tshuaj thiab Kolya insulin Protafan. Metformin tau raug tso tseg, lawv tau hais tias nws tsis muaj qab hau, los ntawm kev siv tshuaj insulin sai Kuv xav tias tsis zoo. Qab zib, ntawm chav kawm, tsis zoo tag nrho, tab sis tsawg kawg muaj teeb meem. Ntsuam xyuas los ntawm Alexander, 39 xyooCov. Cov tshuaj uas muaj cov kua qab zib tau xaiv rau kuv tau ntev thiab nyuaj rau lub sijhawm. Metformin tsis mus ua ib hom ntawv, nws tsis tuaj yeem tshem ntawm kev phiv tshuaj.

Raws li qhov tshwm sim, peb tau txiav txim siab ntawm Amaril thiab Glukobay. Lawv tuav cov suab thaj zoo, cov ntshav qab zib tsawg yog ua tau yog tias koj tsis noj mov raws sijhawm. Txhua yam yog qhov yooj yim heev thiab kwv yees tau zoo, tsis muaj kev ntshai tsis xav sawv thaum sawv ntxov. Ib zaug, hloov ntawm Amaril, lawv tau muab Lavxias Glimepiride Canon. Kuv tsis tau pom ib qho kev sib txawv, tsuas yog hais tias kev ntim tsis tshua zoo nkauj.

Thov nco tseg: Koj puas npau suav kom tshem tawm cov ntshav qab zib ib zaug thiab rau txhua? Kawm yuav ua li cas kom kov yeej cov kabmob, tsis tas siv cov tshuaj uas kim kim, siv xwb ... >>nyeem ntxiv ntawm no

Tus mob ntshav qab zib, Maninil thiab cov tshuaj muaj suab thaj zoo - uas zoo dua rau noj nrog ntshav qab zib?

Txoj hauv kev los kho tus mob ntshav qab zib hom 2 (maum pauv ntshav qab zib) yog hloov txhua txhua xyoo. Qhov no yog vim muaj kev txhim kho ntawm kev tshawb fawb txog kev kho mob, lub ntsiab lus ntawm cov tseem ceeb ua rau thiab cov pab pawg pheej hmoo.

Txog hnub tim, txoj kev lag luam kws tshuaj tuaj yeem hais txog 12 chav kawm ntawm ntau yam tshuaj, uas sib txawv ob qho tib si hauv kev ntsuas ntawm kev txiav txim thiab hauv cov nqi.

Ntau npaum li cas ntawm kev noj tshuaj feem ntau ua rau muaj kev kub ntxhov ntawm cov neeg mob thiab txawm tias cov kws kho mob. Qhov no tsis yog qhov xav tsis thoob, vim tias txhua tus neeg tsim khoom lag luam sim muab cov khoom nquag tso npe tshiab sonorous.

Hauv tsab xov xwm no peb yuav tham txog Diabeton, analogues thiab kev sib piv nrog lwm yam tshuaj. Nws yog cov tshuaj no uas yog qhov nrov tshaj plaws ntawm cov kws kho mob endocrinologist. Qhov no feem ntau yog vim tus nqe zoo-piv.

Tus kws kho hniav mob ntshav qab zib thiab mob ntshav qab zib MV: sib txawv

Diabeton - cov tshuaj nquag ntawm tshuaj yog glycoslazide, uas hais txog sulfonylurea derivatives. Rau ntau tshaj 50 xyoo hauv kev ua lag luam, cov tshuaj yeeb yaj kiab tau qhia txog cov ntaub ntawv qhia txog kev nyab xeeb thiab cov chaw kuaj mob.

Tus mob ntshav qab zib ua rau lub zog ua ke ntawm insulin los ntawm beta hlwb ntawm cov txiav, txhawb kev nkag mus ntawm cov piam thaj rau hauv cov ntaub so ntswg, ntxiv dag zog rau cov leeg ntsa, thiab tiv thaiv kev txhim kho ntawm nephropathy.

Ntsiav tshuaj Ntshav qab zib MV 60 mg

Rau ib qho me me cuam tshuam cov txheej txheem ntawm cov ntshav coagulation. Lub ntsiab tsis zoo ntawm cov tshuaj yog nws txoj kev tso tawm tsis ncaj thiab yog li muaj qhov pom ntawm lub ntsej muag thaum nruab hnub. Cov metabolism zoo sib xws ua rau muaj qhov hloov pauv tsis tseem ceeb hauv theem ntawm glycemia.

Cov kws tshawb fawb tau pom ib txoj hauv kev tawm ntawm qhov xwm txheej no thiab tsim Diabeteson MV (maj mam tso tawm). Cov tshuaj no nws txawv ntawm nws cov thawj ntawm hauv kev du thiab qeeb tso tawm ntawm cov tshuaj nquag - glyclazide. Yog li ntawd, cov piam thaj nyob hauv lub toj siab.

Cov tshuaj tsis muaj qhov txawv txav hauv cov txheej txheem pharmacodynamic.

Kuv tuaj yeem nqa tib lub sijhawm?

Cov tshuaj sib xyaw hauv Maninyl suav nrog glibenclamide - cov tshuaj nquag, uas, zoo li gliclazide, zwm rau cov khoom siv ntawm sulfanylurea.

Kev teem caij ntawm ob tus neeg sawv cev ntawm tib chav kawm pharmacological tsis zoo.

Qhov no yog vim qhov tseeb tias qhov kev pheej hmoo ntawm kev tsim kev mob tshwm sim ntau ntxiv.

Nrog Glucophage

Cov tshuaj ua haujlwm ntawm Glucofage yog metformin, tus sawv cev ntawm chav kawm biguanide. Lub hauv paus ntawm cov txheej txheem ntawm kev nqis tes ua yog nce ntxiv nyob rau hauv qab zib kam rau ua thiab txo qis hauv tus nqi ntawm kev nqus ntawm carbohydrates hauv txoj hnyuv.

Glucophage ntsiav tshuaj 1000 mg

Raws li cov lus pom zoo los ntawm American Association of Clinical Endocrinology (2013), metformin yog tshuaj feem ntau rau kev mob ntshav qab zib hom 2. Qhov no thiaj li hu ua monotherapy, nrog kev ua tsis tau zoo nws tuaj yeem muab ntxiv nrog lwm cov tshuaj, suav nrog Diabeton. Yog li, kev siv ua ke ntawm ob txoj kev siv yeeb tshuaj no yog qhov ua tau thiab tsim nyog.

Nws yog ib qho tseem ceeb kom nco ntsoov tias tsuas yog tus endocrinologist yuav tsum xaiv thiab muab cov tshuaj ua ke.

Glyurenorm suav nrog glycidone, tus sawv cev ntawm chav kawm sulfanylurea.

Hais txog qhov ua tau zoo thiab muaj kev nyab xeeb, cov tshuaj no zoo dua li tus kabmob ntshav qab zib, tab sis tib lub sijhawm nws kim dua (yuav luag ob zaug).

Ntawm qhov zoo nws yuav tsum raug sau tseg tias muaj qhov pib ntawm qhov kev nqis tes ua, muaj kev pheej hmoo me me ntawm hypoglycemia, bioavailability zoo. Cov tshuaj tuaj yeem pom zoo ua cov txheej txheem ntawm txoj kev kho mob ntshav qab zib.

Glimepiride (lub npe lag luam Amaryl) yog tiam thib peb sulfonylurea derivative, yog li ntawd, yog cov tshuaj niaj hnub no.

Tsim kho cov tshuaj insulin endogenous ntau lub sijhawm ntev (txog li 10 - 15 teev).

Ua tau zoo tiv thaiv cov kev mob ntshav qab zib kom tsis pom kev zoo thiab nephropathy.

Tawm tsam tom qab ntawm kev noj tshuaj Amaril, qhov pheej hmoo ntawm kev txhim kho hypoglycemia yog 2 - 3%, tsis zoo li Diabeton (20 - 30%).Qhov no yog vim muaj qhov tseeb tias glimeperide tsis cuam tshuam qhov zais cia ntawm glucagon nyob rau hauv teb rau qhov txo qis hauv cov ntshav qabzib. Cov tshuaj muaj tus nqi siab, uas cuam tshuam nws txoj hauv kev thoob ntiaj teb.

Thaum pib ntawm txoj kev kho mob rau cov kab mob ntshav qab zib mellitus tshiab, cov kws kho mob pom zoo hloov kho txoj kev ua neej (poob phaus, nce kev tawm dag zog). Nrog kev tsis muaj txiaj ntsig, kev siv tshuaj kho mob nrog Metformin txuas nrog.

Maninil ntsiav tshuaj 3.5 mg

Cov koob tshuaj raug xaiv nyob rau hauv ib hlis, glycemia, lipid metabolism, thiab cov raum protein tsis ua haujlwm yog saib xyuas. Yog tias, tawm tsam keeb kwm ntawm kev kho mob nrog Metformin, nws tsis tuaj yeem tswj hwm tus kab mob, tom qab ntawd ib cov tshuaj ntawm lwm pab pawg yog tshuaj (feem ntau feem ntau sulfanylurea derivative) - kev kho mob ob npaug.

Txawm hais tias Maninil tau tsim rov qab los thaum xyoo 60s, nws tseem yuav nrov thiab kev sib tw nrog Diabeton. Qhov no yog vim muaj tus nqi qis thiab dav kuj muaj.Qhov kev xaiv ntawm cov tshuaj yuav tsum tau nqa tawm los ntawm endocrinologist raws li keeb kwm kev kho mob thiab kev tshawb fawb hauv chaw kuaj mob thiab kuaj ntshav.

Glibomet yog ib qho ntawm ntau cov tshuaj qab zib-txo cov tshuaj. Nws muaj 400 mg ntawm metformin hydrochloride thiab 2.5 mg ntawm glibenclamide.

Glibomet muaj ntau yam txiaj ntsig zoo tshaj li Mob ntshav qab zib.

Yog li, hauv daim ntawv ntawm ib ntsiav tshuaj, tus neeg mob siv ob qho kev ua ub ua no ntawm ntau pab pawg muag tshuaj ib zaug.

Nws yuav tsum tau yug hauv siab tias nrog kev sib txuam tshuaj, kev pheej hmoo ntawm kev phiv, nrog rau cov mob ntshav qab zib, nce ntxiv. Kev ceev faj yuav tsum tau ua nyob rau hauv kev saib xyuas ntawm tus neeg endocrinologist thiab kuaj ntsuas.

Cov tshuaj ua haujlwm ntawm Glucofage yog metformin hydrochloride.

Nws yog kws kho rau feem ntau sim mob ntshav qab zib mellitus tawm tsam keeb kwm ntawm kev noj zaub mov noj. Nws muaj tus lej ntawm cov kev mob tshwm sim ntau, piv txwv li, kev txhim kho ntawm cov kab mob lactic acidosis thiab mob ntshav qab zib tsawg.

Yog li, Diabeton yog ib qho tshuaj tiv thaiv kev nyab xeeb, tsis zoo li Glucofage, nws ua rau lub ntsej muag zais cia ntawm cov tshuaj insulin endogenous.

Gliclazide MV

Gliclazide nrog kev tso tawm qeeb ntawm cov tshuaj nquag hloov ntseeg nkaws theem ntawm glycemia, thaum noj cov tshuaj no muaj xyaum tsis muaj qhov mob hypoglycemic.

Vim lub peculiarities ntawm cov qauv tshuaj, nws tuaj yeem noj ib hnub ib zaug.

Tom qab siv sijhawm ntev, kev quav thiab txo qis hauv kev ua haujlwm tsis pom (insulin synthesis tsis yog suppressed)

Antiaggregant cov yam ntxwv ntawm Gliclazide MV, ib qho tshuaj rov qab ntawm cov phab ntsa vascular tau sau tseg. Diabeton surpasses nyob rau hauv kev ua tau zoo, muaj kev nyab xeeb, tab sis ntau ntau kim hauv tus nqi.

Nrog kev muaj peev xwm ntawm nyiaj txiag ntawm tus neeg mob, Gliclazide MV tuaj yeem pom zoo raws li cov tshuaj ntawm kev xaiv rau ntshav qab zib.

Glidiab MV

Glidiab MV muaj cov gliclazide, uas yog maj mam tso tawm. Thaum piv nrog Cov Mob Ntshav Qab Zib MV, ob qho tshuaj yuav tuaj yeem kho nyob rau tib qho kev mob tshwm sim, muaj qhov tsawg kawg ntawm kev phiv thiab qhov tsis haum.

Txhua yam koj yuav tsum paub txog tus mob ntshav qab zib hauv cov yeeb yaj kiab:

Nws yog ib qho tseem ceeb kom nco qab tias mob ntshav qab zib yog txoj hauv kev ntawm lub neej. Yog tias ib tug neeg tsis ua qhov phem, tsis saib xyuas nws lub cev, ces tsis muaj ib qho yeeb tshuaj twg yuav pab nws. Yog li, cov kws tshawb nrhiav tau pom tias txog xyoo 2050 txhua tus thib peb nyob hauv lub ntiaj teb yuav raug kev txom nyem los ntawm tus kab mob no.

Qhov no yog vim qhov ua kom tsawg dua ntawm cov khoom noj khoom haus kab lis kev cai, qhov teeb meem zuj zus ntawm kev rog rog. Los ntawm thiab loj, nws tsis yog ntshav qab zib nws tus kheej uas txaus ntshai, tab sis cov teeb meem uas nws ua. Ntawm cov teeb meem uas feem ntau muaj teeb meem tsis pom kev, lub raum tsis ua hauj lwm, kev kho lub plawv thiab lub hlwb khiav lag luam.

Kev puas tsuaj rau cov hlab ntsha thiab cov hlab ntsha ntawm cov nqaj qaum qis dua ua rau muaj kev ua tsis taus thaum ntxov. Txhua yam kev cuam tshuam saum toj no tuaj yeem tiv thaiv zoo yog tias cov lus pom zoo ntawm tus kws kho mob endocrinologist tau ua.

Kev sib xyaw, ntau npaum, tshuaj noj daim ntawv

Cov tshuaj muaj nyob nrog cov ntsiab lus sib txawv ntawm glimepiride thiab metformin. Hauv ib hom ntsiav tshuaj, lawv cov tshuaj yog 1 mg thiab 250 mg, ntsig txog, hauv lwm - ob npaug nyiaj: 2 thiab 500 mg.

Cov khoom xyaw ntawm cov khoom siv ntxiv yog zoo ib yam: lactose (hauv daim ntawv ntawm monohydrate), sodium CMC, povidone-K30, CMC, crospovidone, E572.
Cov khoom xyaw ntawm cov zaj duab xis txheej txheej: hypromellose, macrogol-6000, E171, E903.

Ntsiav tshuaj ntawm tib lub ntsej muag lub ntsej muag, convex ntawm ob sab, ntim rau hauv txheej dawb ntawm cling zaj duab xis. Lawv txawv nyob rau hauv kev khij: nyob rau ib qho ntawm thaj chaw ntawm 1 mg / 250 mg ntsiav tshuaj, HD125 luam tawm yog thov, thiab ntau lub zog ntawm Amaril-M (2/500) yog cim nrog lub cim HD25.

Ob hom Amaril M tau ntim rau hauv hlwv ntawm 10 lub tshuaj. Hauv pob ntawv tuab ntawm cardboard - 3 daim hlau nrog cov ntsiav tshuaj, paub daws teeb.

Kho thaj chaw

Cov tshuaj ua ke, nws cov nyhuv yog vim muaj cov yam ntxwv ntawm cov khoom ua ke (glimepiride thiab metformin).

Thawj qhov khoom nyob rau hauv pab pawg ntawm sulfonylurea derivatives ntawm koob thib 3 tiam. Nws muaj peev xwm txhawb kev tsim khoom thiab tso tawm cov tshuaj insulin los ntawm cov kab mob hlwb, ua kom ntau qhov muaj peev xwm ntawm adipose thiab cov leeg nqaij mus rau qhov cuam tshuam ntawm cov tshuaj endogenous. Qhov ua rau lub qog ua kom tiav vim yog lub siab dua, hauv qhov sib piv rau lub cim thib 2 ntawm sulfonamides, lub peev xwm ntawm ib yam khoom los tswj cov nyiaj hauv insulin tsim los ntawm lub cev. Tib cov cuab yeej ua kom paub meej tias cov tshuaj muaj txiaj ntsig zoo txo qhov muaj kev phom sij ntawm hypoglycemia.

Zoo li lwm yam sulfonylurea derivatives, Amaril M tivthaiv txo insulin tsis kam, muaj cov nyhuv ua antioxidant, tiv thaiv cov ntshav txhaws, thiab txo qhov txhab CCC tsawg. Ua nrawm rau kev thauj mus los ntawm cov piam thaj mus rau cov ntaub so ntswg thiab nws txoj kev siv, txhawb kev ua rau cov piam thaj hauv cov ntshav.

Tom qab kev tswj hwm qhov ncauj zoo ntawm 4 mg (ib hnub ib zaug), qhov siab tshaj plaws ntawm ib qhov tshuaj nyob rau hauv cov ntshav tau tsim tom qab 2.5 teev. Noj yuav luag tsis muaj qhov tshwm sim ntawm kev nqus, tsuas yog ua qeeb me ntsis nqes nws qhov ceev.

Nws muaj peev xwm nkag mus rau hauv niam mis thiab kis tau los ntawm tus kab mob no. Nws yog hloov hauv daim siab, tsim ob hom kev siv tshuaj tiv thaiv metabolites, uas tom qab ntawd pom nyob hauv cov zis thiab quav.

Ib feem tseem ceeb ntawm cov quav tau tawm hauv lub cev los ntawm lub raum thiab qee qhov dhau ntawm cov hnyuv.

Cov tshuaj yeeb tshuaj nrog cov nyhuv hypoglycemic yog suav nrog hauv cov pab pawg ntawm biguanides. Nws cov suab thaj txo qis muaj peev xwm ua kom pom nws tus kheej tsuas yog tias kev tsim cov tshuaj endogenous yog tswj. Cov tshuaj tsis cuam tshuam β-hlwb ntawm tus txiav thiab tsis muaj feem nrog txhawb kev tsim cov tshuaj insulin. Thaum noj nyob rau hauv cov koob tshuaj pom zoo, nws tsis ua rau kev cuam tshuam rau lub qog ntshav hypoglycemic.

Txog tam sim no, lub tshuab ntawm nws cov kev nqis tes ua tsis tau hais meej thaum kawg. Nws ntseeg tias nws muaj peev xwm txhim kho cov nyhuv ntawm insulin. Nws paub tias cov tshuaj ua kom cov nqaij mos ua kom lub cev tsis haum rau cov tshuaj insulin los ntawm kev ua rau cov tshuaj insulin ntau dua ntawm cov xoos cell. Ib qho ntxiv, metformin ua rau qeeb ntawm cov piam thaj hauv kev ua haujlwm hauv lub siab, txo qhov tsim ntawm FAs dawb, txwv tsis pub cov rog rog, thiab txo qis cov ntsiab lus ntawm ntshav siab hauv cov ntshav. Cov tshuaj txo cov qab los noj mov, yog li ua rau muaj txiaj ntsig ntawm kev tiv thaiv qhov hnyav ntawm cov ntshav qab zib lossis nws qhov hnyav poob.

Tom qab lub qhov ncauj tswj hwm, nws yog tag nrho nqus los ntawm cov hnyuv. Noj nrog zaub mov yuav txo qis thiab txwv tsis pub nqus. Nws yog muab faib tam sim ntawd dua cov ntaub so ntswg, yuav luag tsis khi rau cov protein ntau. Nws tseem siv tsis tau metabolized.

Kev tshem tawm hauv lub cev tshwm sim los ntawm ob lub raum. Yog hais tias cov khoom hauv nruab nrog tsis ua haujlwm tau zoo, ces muaj kev pheej hmoo ntawm kev txuam nrog cov khoom.

Txoj kev ntawm daim ntawv thov

Tus nqi ntawm cov tshuaj tau suav ib tus zuj zus rau txhua tus neeg mob raws li kev qhia ntawm glycemia. Kev kho mob nrog Amaril M, raws li cov lus qhia rau kev siv, nws raug nquahu kom pib nrog kev noj qab haus huv qis kawg thaum kev tswj kom txaus hypoglycemic yog ua tau. Tom qab qhov no, cov koob tshuaj tuaj yeem hloov pauv nyob ntawm qhov ntsuas ntawm cov piam thaj hauv cov ntshav.

Yog tias lub ntsiav tshuaj ploj, tom qab ntawd koj tsis tuaj yeem hloov kho qhov tshuaj ploj hauv txhua rooj plaub, txwv tsis pub nws tuaj yeem ua rau txo qis ntawm cov ntshav glycemia. Cov neeg mob yuav tsum qhia ua ntej tias yuav ua li cas hauv cov xwm txheej zoo li no.

Nrog kev txhim kho glycemic tswj, thaum muaj kev nce ntxiv hauv kev ntxim rau cov cuam tshuam los ntawm cov tshuaj insulin, qhov xav tau tshuaj yuav txo qis thaum Amaril M txoj kev kho. Txhawm rau txhawm rau txo ntshav qab zib, koj yuav tsum txo cov tshuaj kom ncav sijhawm lossis tsum tsis txhob noj cov ntsiav tshuaj.

Cov txheej txheem ntawm kev kho yog txiav txim los ntawm tus kws kho mob mus koom, tab sis cov neeg tsim khoom pom zoo haus ib zaug lossis ob zaug ib hnub nrog zaub mov noj. Qhov tso cai ntau tshaj plaws ntawm kev tso tshuaj metformin pub rau ib zaug yog 1 g, txhua hnub - 2 g.

Txhawm rau tiv thaiv hypoglycemia, thaum pib ntawm txoj kev kho, qhov ntau npaum ntawm cov ntsiav tshuaj yuav tsum tsis txhob siab dua cov nqi tshuaj txhua hnub ntawm metformin thiab glimepiride, uas tus neeg mob coj hauv chav kawm dhau los. Yog hais tias tus mob ntshav qab zib tau raug xa mus rau Amaryl-M los ntawm lwm cov tshuaj, ces cov koob tshuaj yog xam raws li cov nqi dhau los. Yog tias nws yog qhov yuav tsum tau nce ntxiv cov tshuaj, nws yog qhov zoo tshaj plaws los nce nws los ntawm ib nrab ntawm ib ntsiav tshuaj ntawm Amaril M 2 mg / 500 mg.

Lub sijhawm ntawm cov chav kawm yog txiav txim los ntawm tus kws tshaj lij, cov tshuaj pom zoo rau kev siv sijhawm ntev.

Thaum cev xeeb tub thiab pub niam mis

Cov tshuaj Amaryl M yuav tsum tsis txhob siv los ntawm cov poj niam cev xeeb tub thiab cov poj niam npaj rau kev ua leej niam. Cov niam cev xeeb tub yuav tsum tam sim ntawd qhia nws tus kws kho mob txog nws qhov kev mob siab lossis qhov tshwm sim ntawm cev xeeb tub thaum lub sijhawm kho mob ntshav qab zib, kom nws tuaj yeem sau ib cov tshuaj sai sai rau lub cev lossis hloov mus rau kev kho tshuaj insulin.

Cov kev tshawb fawb hauv cov tsiaj txhu kuaj pom tau hais tias metformin tam sim no hauv tshuaj muaj peev xwm ua kev hem thawj rau kev txhim kho ntawm tus menyuam / menyuam hauv plab thiab cuam tshuam tus menyuam hauv lub sijhawm yug menyuam.

Nws paub tias metformin tuaj yeem nkag mus rau hauv niam cov kua mis tau yooj yim. Yog li, txhawm rau tiv thaiv qhov tsis zoo ntawm cov khoom hauv tus menyuam lub cev, nws raug pom zoo tias tus poj niam tsis kam lees lactation lossis hloov mus rau lwm cov tshuaj nrog qhov ua kom muaj qhov tsis zoo uas tso cai rau kev saib xyuas neeg mob.

Cov Kev Tsis Txaus Ntseeg thiab Kev Ceev Faj

Tus nqi nruab nrab: (1 mg / 250 mg) - 735 rubles., (2 mg / 500 mg) - 736 rubles.

Amaryl M ntsiav tshuaj yuav tsum tsis txhob noj yog tias:

Yam I ntshav qab zib
Teeb meem mob ntshav qab zib: ketoacidosis (suav nrog keeb kwm ntawm), poj koob yawm txwv thiab coma
Ib daim ntawv ntawm kev tiv thaiv metabolic acidosis (mob siab lossis mob ntev)
Mob siab lub siab pathologies (vim yog tsis muaj kev paub txaus)
Hemodialysis
Mob raum tsis ua hauj lwm thiab muaj cov kab mob hnyav (muaj qhov teeb meem loj ntawm cov kab mob lactic acidosis)
Tej yam mob uas yuav cuam tshuam rau lub raum kev ua haujlwm (lub cev qhuav dej, cov mob nyuaj, kev siv cov tshuaj nrog iodine)
Cov kab mob cuam tshuam loj heev cuam tshuam qhov khiav ntawm oxygen mus rau cov ntaub so ntswg (lub plawv tsis ua haujlwm, myocardial infarction, poob siab)
Qhov kev cia siab ntawm lub cev mus rau lactic acidosis (suav nrog keeb kwm ntawm lactacidemia)
Cov xwm txheej hnyav (qhov raug mob nyhav, kub hnyiab lossis tshuaj lom neeg kub hnyiab, kev phais mob, mob hnyav nrog concomitant kub taub hau, mob ntshav lom)
Kev noj tsis txaus noj vim kev tshaib plab, cov zaub mov tsis muaj carb, thiab zaub mov tsis zoo
Kev tsis haum rau hauv txoj hnyuv (paresis thiab txoj hnyuv khaus)
Yuav haus cawv ntau dhau, haus dej cawv ntau dhau
Kev tiv thaiv tsis txaus hauv lub cev ntawm lactase, galactose tiv thaiv, GH malabsorption syndrome
Npaj rau kev xeeb menyuam, cev xeeb tub, lactation
Lub hnub nyoog qis dua 18 xyoo (vim tias qhov tsis muaj kev nyab xeeb rau kev nyab xeeb ntawm lub cev hluas)
Qib siab ntawm ib tus neeg rhiab heev los yog ua tsis tiav rau cov tshuaj muaj nyob hauv kev npaj, nrog rau ib qho tshuaj twg uas muaj sulfanilurea derivatives, biguanides.

Dab tsi koj yuav tsum paub txog thaum muab tshuaj Amaril M

Thaum pib ntawm txoj kev kho, qhov kev pheej hmoo ntawm cov ntshav qab zib tsawg yog ua tau, yog li ntawd, rau ob peb lub lis piam, koj yuav tsum ua tib zoo saib xyuas thiab, yog tias tsim nyog, kho glycemia. Qhov muaj feem yuav phom yog:

Kev tsis taus ntawm tus neeg mob lossis tsis txaus siab ua raws li cov tshuaj kho mob
Khoom noj khoom haus tsis zoo (noj tsis zoo, noj zaub mov tsis xwm yeem, tsis txuas ntxiv dua tshiab)
Haus cawv
Kev txiav txim siab ua tsis taus pa vim yog cov kab mob endocrine (cov thyroid pathology, kev ua tsis tau zoo ntawm GM chaw ua lub luag haujlwm rau cov txheej txheem metabolic)
Koom Tes Nrog Kab Mob Ntshav Qab Zib-Tawv Zuj Zus
Kev noj lwm yam tshuaj tsis hais txog lawv kev sib raug zoo nrog Amaril M
Hauv cov neeg laus: latent tsis zoo lub raum muaj nuj nqi, tsis muaj tsos mob
Kev noj tshuaj uas cuam tshuam rau kev mob ntawm lub raum (noj cov tshuaj uas tso ntshav siab, NSAIDs, thiab lwm yam)
Txo lossis cov tsos mob cuam tshuam ua ntej ntawm lub qog ntshav qab zib.

Hla kev sib txuam yeeb tshuaj

Thaum kho nrog Amaril M, nws yuav tsum tau yug los rau hauv lub siab tias ob qho kev ua haujlwm uas muaj nyob hauv nws cov muaj pes tsawg leeg tuaj yeem sib koom ua ke lossis sib koom ua rau qhov kev tsis haum nrog cov tshuaj ntawm lwm cov tshuaj. Raws li qhov tshwm sim, qhov no tuaj yeem cuam tshuam rau kev siv tshuaj lossis cov tshuaj tswj glycemic thiab ua rau cov xwm txheej tsis txaus ntseeg.

Kev hloov pauv hauv kev zom zaub mov tshwm sim nrog kev koom tes ncaj qha ntawm CYP2C9 isoenzyme. Yog li ntawd, nws cov khoom hloov pauv thaum ua ke nrog inhibitors lossis inducers ntawm ib qho tshuaj endogenous. Yog tias kev sib txuas ua ke yog tsim nyog, nws yog qhov yuav tsum tau soj ntsuam qhov tseeb ntau npaum li cas thiab, yog tias tsim nyog, kho nws:

Cov suab thaj txo qis ntawm glimepiride zoo dua nyob rau hauv kev cuam tshuam ntawm ACE inhibitors, anabolics, txiv neej cov tshuaj hormones, tshuaj nrog coumarin derivatives, MAO, cyclophosphamide, phenfluramine, pheniramidol, fibrate, fluconazole, salicylates, sulfanilamides, tetracycline tshuaj tua kab mob thiab tetracyclines.
Cov txiaj ntsig hypoglycemic txo qis thaum Amaril M ua ke nrog Acetazolamide, barbiturates, diuretics, sympathomimetics, GCS, koob tshuaj ntau ntawm cov nicotinic acid, glucagon, cov tshuaj hormones (thyroid, estrogens, progestogens), Phenothiazine, Rifampicin, kev siv tshuaj laxam ntev.

Lwm cov kev tsis haum siab:

Hauv cov chav kawm sib xyaws nrog antagonists ntawm H2-histamine receptors, BAB, Clonidine, Reserpine, cov nyhuv ntawm Amaril M tuaj yeem hloov pauv, nce lossis tsawg dua. Txhawm rau tiv thaiv cov mob tsis zoo, nws yog qhov yuav tsum tau ua tib zoo saib xyuas glycemia thiab, raws li nws qhov ntsuas, hloov pauv txhua hnub ntawm cov tshuaj. Tsis tas li ntawd, cov tshuaj muaj feem cuam tshuam rau NS receptors, vim li ntawd cov lus teb rau kev kho tau cuam tshuam. Nyob rau hauv lem, qhov no tuaj yeem ua rau txo qis ntawm qhov mob hnyav ntawm cov tsos mob ntawm tus mob hypoglycemia, uas yuav ua rau muaj kev hem thawj ntxiv ntawm nws txoj kev ua neeg phem.
Nrog kev sib xyaw ntawm glimepiride nrog ethanol tiv thaiv cov keeb kwm yav dhau los ntawm kev noj ntau dhau los yog muaj cov cawv quav cawv ntev dhau los, nws cov txiaj ntsig hypoglycemic yuav nce lossis tsawg dua.
Thaum ua ke nrog cov lus qhia ntawm txij nkawm, kev tiv thaiv tsis tau, lawv cov nyhuv hloov pauv hauv ib qho kev taw qhia lossis lwm qhov.
Qhov kev nqus ntawm glimepiride los ntawm kev mob plab hnyuv txo qis hauv qab ntawm Kolesevelam, yog tias nws tau noj ua ntej Amaril M. Tab sis yog tias koj haus cov tshuaj hauv cov txheej txheem rov nrog tsawg kawg 4 teev, ces tsis muaj qhov tshwm sim tsis zoo yuav tshwm sim.

Nta ntawm cov tshuaj tiv thaiv ntawm metformin nrog lwm cov tshuaj

Qhov tsis tsim nyog ua ke nrog:

Ua ke nrog ethanol. Hauv kev haus cawv ntau, muaj kev pheej hmoo ntawm cov kab mob lactic acidosis nce ntxiv, tshwj xeeb tshaj yog tiv thaiv cov keeb kwm yav dhau los ntawm kev tshem tawm cov zaub mov lossis kev noj zaub mov tsis txaus, muaj lub siab ua haujlwm tsis txaus. Thaum lub sij hawm kho nrog Amaril M, ib qho yuav tsum tsis txhob haus cawv thiab haus dej haus cawv.
Nrog iodine-muaj cov tshuaj tiv thaiv sib xyaw. Thaum muab kev sib txuas nrog Amaril M txoj kev kho nrog cov txheej txheem koom nrog kev tswj hwm hauv intravascular ntawm cov tshuaj tiv thaiv kev cuam tshuam, qhov kev pheej hmoo ntawm lub raum puas yuav ua rau. Raws li qhov ua haujlwm tsis tiav ntawm cov khoom hauv lub cev, metformin accumulates nrog kev txhim kho tom qab ntawm lactic acidosis. Txhawm rau tiv thaiv qhov xwm txheej tsis zoo, Amaril M yuav tsum tsum tsis txhob haus 2 hnub ua ntej cov txheej txheem nrog iodine muaj tshuaj, thiab tsis txhob siv tib lub sijhawm tom qab ua tiav kev tshawb fawb kho mob. Nws raug tso cai rov pib dua chav kawm tsuas yog tom qab tau txais cov ntaub ntawv hais tias tsis muaj qhov txawv txav ntawm qhov mob ntawm ob lub raum.
Kev sib xyaw nrog cov tshuaj tua kab mob uas cuam tshuam tsis zoo rau lub raum ua rau tsim cov lactic acidosis.

Muaj kev sib txuas ua ke nrog metformin, uas yuav tsum ceeb toom:

Thaum ua ke nrog cov tshuaj hauv zos lossis hauv ib cheeb tsam corticosteroids, diuretics thiab 2-adrenostimulants, glycemia thaum sawv ntxov yuav tsum tau kuaj xyuas ntau dua li niaj zaus (tshwj xeeb tshaj yog thaum pib ntawm lub voj voog uas nyuaj) yog li nws muaj peev xwm hloov kho cov tshuaj ntau ntxiv hauv lub sijhawm kho lossis tom qab tshem tawm qee cov tshuaj.
Thaum ua ke nrog ACE inhibitor thiab metformin, thawj cov tshuaj tuaj yeem txo glycemia, yog li, kev hloov tshuaj yuav tsum nyob rau lub sijhawm kho lossis tom qab tshem tawm ntawm ACE inhibitor.
Thaum ua ke nrog cov tshuaj uas tuaj yeem txhim kho cov txiaj ntsig ntawm metformin (insulin, anabolics, sulfonylurea thiab derivatives, tshuaj aspirin thiab salicylates), kev tswj hwm ntawm cov piam thaj hauv qib yog qhov tsim nyog kom raug thiab hloov pauv ntau npaum ntawm metformin tom qab tshem tawm cov tshuaj tiv thaiv cov keeb kwm ntawm kev kho mob txuas ntxiv nrog Amaril M.
Ib yam li ntawd, glycemic tswj yog qhov tsim nyog thaum Amaril M ua ke nrog cov tshuaj uas ua rau nws cov nyhuv tsis muaj zog (GCS, cov thyroid hormones, thiazide tshuaj, tshuaj tiv thaiv qhov ncauj, sympathomimetics, calcium antagonists, thiab lwm yam) los kho cov tshuaj ntau ntau yog tias tsim nyog.

Sab sij huam

Qhov tshwm sim tsis zoo ntawm kev noj Amaril M yog vim ob qho tib si cov khoom ntawm metformin thiab glimepiride, thiab lawv cov txiaj ntsig ua rau cov txheej txheem hauv lub cev.

Qhov tshwm sim phiv los ntawm hauv qab no yog raws li kev paub siv nrog glimepiride thiab lwm yam sulfanylurea derivatives. Kev mob ntshav qab zib tsawg yuav ua tau ntev. Nws tshwm nyob rau hauv daim ntawv ntawm:

Mob taub hau
Kev tshaib kev nqhis
Xeev siab, ntuav ntuav
General tsis muaj zog
Kev pw tsaug zog (insomnia lossis tsaug zog)
Nce tshee, ntxhov siab vim
Tsis tsim txiaj kev quab yuam
Kev tsis muaj peev xwm mloog, txo qis mloog
Kev txwv tsis pub muaj kev puas hlwb psychomotor
Tsis meej pem
Nyuaj siab hauv lub xeev
Cov kev hnov mob hauv cov chaw xaiv
Tsis pom kev zoo
Hais lus tsis meej
Qaug dab peg
Tsaus muag (hnov qab tau)
Ua tsis taus pa, bradycardia
Txias, tawm hws
Tachycardia
Ntshav siab
Lub plawv palpitations
Arrhythmias.

Qee qhov xwm txheej, thaum muaj ntshav qab zib tsawg tshwj xeeb tshaj yog, nws tuaj yeem tsis meej pem nrog cov mob ntshav khov hauv GM. Tus mob txhim kho tom qab tshem tawm ntawm hypoglycemia.

Lwm yam phiv

Pom kev puas: qhov txo qis qis hauv qhov mob hnyav (tshwj xeeb yog tshwm sim thaum pib ntawm txoj kev kho). Nws tshwm sim los ntawm kev hloov hauv glycemia, uas ua rau muaj qhov o ntawm lub paj optic, uas tau cuam tshuam ntawm lub kaum sab xis ntawm qhov refraction.
Lub plab hnyuv plab hnyuv siab raum: xeev siab, ntuav ntawm ntuav, mob, raws plab, tsam plab, zoo nkaus li lub cev puv nkaus.
Nplooj Siab: Kab mob siab, ua kom muaj kab mob hauv lub cev, mob daj ntseg, mob cholestasis. Nrog kev vam meej ntawm pathologies, kev tsim kho ntawm cov xwm txheej ua rau muaj kev hem thawj rau tus neeg mob lub neej yog ua tau. Tus mob yuav zoo tuaj tom qab tshem yeeb tshuaj.
Hematopoietic plab hnyuv siab raum: thrombocytopenia, qee zaum leukopenia thiab lwm yam kev mob vim qhov hloov ntshav sib xyaw.
Kev tiv thaiv: ua xua thiab ua xua tsis raug (ua pob, khaus, khaus). Feem ntau tshwm sim los rau cov neeg kawm ntawv qib qis, tab sis qee zaus lawv tuaj yeem vam meej, ua kom pom los ntawm dyspnea, poob rau hauv cov ntshav siab, anaphylactic kev poob siab. Kev ua txhaum cai tuaj yeem tseem yog vim muaj kev sib xyaw ua ke nrog sulfanylurea lossis lwm yam zoo sib xws. Nws yog qhov yuav tsum tau hu rau tus kws tshaj lij.
Lwm cov tshuaj tiv thaiv: muaj qhov ua tau zoo los ntawm lub dermis mus rau hnub ci thiab UV hluav taws xob.

Qhov tshwm sim tsis zoo tshaj plaws tom qab siv cov tshuaj nrog metformin yog lactic acidosis. Tsis tas li ntawd, cov tshuaj muaj peev xwm ua rau muaj kev ntxhov siab hauv txoj haujlwm ntawm cov nruab nrog sab hauv thiab cov nruab nrog cev.

Kev zom cov plab hnyuv siab raum: feem ntau ntau - xeev siab, txhaws ntuav, mob, mob plab, nce roj tsim, tsis qab los noj mov. Cov tsos mob feem ntau yog hloov, tus yam ntxwv ntawm thawj theem ntawm txoj kev kho.Raws li koj tau txuas ntxiv coj Amaril M ploj lawv tus kheej. Txhawm rau txo tus mob tom qab cov tshuaj noj thiab tiv thaiv nws, nws raug nquahu kom muab cov tshuaj ntaug zuj zus, thiab muab cov tshuaj sib xyaw nrog cov pluas noj. Yog tias mob raws plab thiab / los yog ntuav ntuav, qhov tshwm sim yuav yog lub cev qhuav dej thiab prerenal azotemia. Hauv qhov no, Amaril M txoj kev kho yuav tsum raug cuam tshuam kom txog thaum lub xeev kev noj qab haus huv nyob.
Cov plab hnyuv siab raum: tsis kaj siab "nws yog xim hlau" aftertaste
Mob siab: lub cev ua haujlwm tsis zoo hauv lub cev, kab mob siab (tuaj yeem rov qab los tom qab tshem tawm yeeb tshuaj) Yog tias muaj teeb meem rau daim siab, tus neeg mob yuav tsum tau hu rau tus kws kho mob kom sai li sai tau.
Daim tawv nqaij: khaus, tawm pob, erythema.
Hematopoietic plab hnyuv siab raum: tsis muaj ntshav, mob leukemia thiab thrombocytopenia. Nrog rau cov chav kawm ntev, muaj qhov txo qis hauv cov ntsiab lus ntawm vit. B12 hauv cov ntshav, tshwm sim ntawm megaloblastic anemia.

Daim ntawv tso tawm

Amaryl yog muag hauv ntsiav tshuaj daim ntawv. Xim nyob ntawm qhov ntau npaum ntawm cov tshuaj nquag:

1 mg glimepiride - liab dawb,
2 - ntsuab
3 - lub teeb daj
4– xiav.

Lawv txawv nyob rau hauv cov cim sau tseg rau ntawm cov ntsiav tshuaj.

Kev sib txuam

Ua ntej muab cov tshuaj Amaryl, tus kws kho mob yuav tsum xyuas seb cov tshuaj twg tus neeg mob tau noj. Qee cov tshuaj txhim kho, lwm tus txo cov nyhuv hypoglycemic ntawm glimepiride.

Thaum ua kev tshawb fawb, nws pom tias qhov txo qis hauv cov ntshav qab zib tau pom thaum noj:

cov tshuaj tiv thaiv kab mob hauv qhov ncauj
Phenylbutazone
Oxyphenbutazone,
Azapropasone
Sulfinpyrazone,
Metformin
Tetracycline
Miconazole
salicylates,
MAO inhibitors
txiv neej nrog txiv neej cov tshuaj hormones
anabolic tshuaj yuam
quinol tshuaj tua kab mob,
Clarithromycin
Fluconazole
pab daws qhov teeb meem,
fibrates.

Yog li, nws tsis pom zoo kom pib haus Amaryl ntawm koj tus kheej yam tsis tau txais tshuaj los ntawm kws kho mob.

Cov kab mob hauv qab no tsis muaj zog ntawm glimepiride:

progestogens
estrogens
thiazide diuretics,
tshuaj pleev
glucocorticoids,
nicotinic acid (thaum siv ntau koob),
laxatives (muab lub sij hawm ntev siv),
barbiturates
Rifampicin,
Glucagon.

Xws li cov nyhuv yuav tsum tau coj mus rau hauv tus account thaum xaiv ntau npaum.

Sympatholytics (beta-blockers, reserpine, clonidine, guanethidine) muaj qhov tshwm sim tsis pom kev ntawm qhov kev xav hypoglycemic ntawm Amaril.

Thaum siv coumarin derivatives, ceeb toom: glimepiride ua kom zoo dua qub lossis txo qhov cuam tshuam ntawm cov tshuaj no rau hauv lub cev.

Tus kws kho mob xaiv cov tshuaj rau ntshav siab, tsis-steroidal anti-inflammatory tshuaj, thiab lwm yam tshuaj uas nrov.

Amaryl ua ke nrog cov tshuaj insulin, metformin. Qhov kev sib xyaw no yog xav tau thaum thaum noj glimepiride nws tsis tuaj yeem ua kom tiav qhov kev xav tau tswj kev paub tab. Qhov ntau thiab tsawg ntawm txhua yam tshuaj yog kws kho mob tau teev tseg.

Cov kev sib xyaw ua ke ntawm cov khoom xyaw nquag tuaj yeem txhim kho txoj hauv kev ntawm kev kho, pab tswj tau qhov mob zoo dua rau tus mob ntshav qab zib.

Hnub tas sij hawm

Siv cov tshuaj yog tso cai rau 36 lub hlis txij li hnub tso tawm.

Qhov tsim nyog endocrinologist yuav tsum xaiv qhov hloov pauv txoj cai rau Amaryl. Nws tuaj yeem sau tshuaj ib qho analogue ua tau los ntawm cov khoom zoo tib yam, lossis xaiv cov tshuaj uas ua los ntawm lwm cov khoom siv.

Cov neeg mob tuaj yeem sau npe yuav hloov kho Lavxias, Diamerid, uas yog pheej yig. Rau 30 ntsiav tshuaj ntawm cov tshuaj uas ua rau lub hauv paus ntawm glimepiride, nrog cov tshuaj ntawm 1 mg hauv ib lub tsev muag tshuaj, cov neeg mob yuav them 179 p. Nrog txoj kev nkag ntawm qhov kev kub siab ntawm cov tshuaj nquag, tus nqi nce ntxiv. Rau diamerid hauv ib qho tshuaj 4 mg, 383 p.

Yog tias tsim nyog, hloov Amaryl nrog cov tshuaj Glimepiride, uas yog tsim los ntawm cov tuam txhab Lavxias teb sab Vertex. Cov ntsiav tshuaj uas hais qhia yog pheej yug. Rau ntim ntawm 30 pcs.2 mg yuav tau them 191 p.

Tus nqi ntawm Glimepiride Canon, uas tsim los ntawm Canonfarm, kuj tseem qis dua. Tus nqi ntawm ib pob ntawm 30 ntsiav tshuaj ntawm 2 mg yog suav tias yog pheej yig, nws yog 154 p.

Yog tias glimepiride tsis qaug rau, cov neeg mob tau kho lwm yam tshuaj ntxiv raws ntawm metformin (Avandamet, Glimecomb, Metglib) lossis vildagliptin (Galvus). Lawv raug xaiv coj mus rau hauv tus account tus yam ntxwv ntawm tus neeg mob lub cev.

Cev xeeb tub, lactation

Yuav siv tsis tau lub sij hawm thaum xeeb tus me nyuam ntawm cev nqaij nruab deg, pub mis noj rau tus me nyuam yug tshiab, sulfonylurea derivatives yuav siv tsis tau. Hauv cov ntshav ntawm tus poj niam cev xeeb tub, cov kua nplaum nyob hauv lub cev yuav tsum tsis pub dhau. Tom qab tag nrho, hyperglycemia ua rau muaj kev pheej hmoo ntau ntxiv ntawm kev tsis ua haujlwm ntawm lub cev, ua rau cov menyuam mos tuag coob.

Cov poj niam cev xeeb tub tau pauv mus rau cov tshuaj insulin. Nws yog qhov ua tau kom tshem tawm qhov tshwm sim ntawm lub txim lom ntawm cov tshuaj rau tus menyuam hauv utero yog tias koj tso sulfonylurea nyob rau theem ntawm kev npaj lub tswv yim.

Thaum lub sijhawm lactation, Txoj kev kho Amaril yog txwv tsis pub. Cov tshuaj nquag kis mus rau niam mis, lub cev ntawm tus menyuam yug tshiab. Thaum pub niam mis, nws yog qhov tsim nyog kom tus poj niam hloov mus rau kev siv tshuaj insulin.

E11 Tsis muaj ntshav qab zib uas tsis yog insulin-mellitus

Kev piav qhia ntawm daim ntawv tshuaj

Amaryl 1 mg: ntsiav tshuaj paj yeeb, oblong, tiaj tus nrog txoj kab sib faib ua ob sab. Sau nrog "NMK" thiab stylized "h" rau ob tog.

Amaryl 2 mg: ntsiav tshuaj ntsuab, oblong, tiaj tus nrog txoj kab sib faib ua ob sab. Sau "NMM" thiab stylized "h" rau ob sab.

Amaryl 3 mg: ntsiav tshuaj daj ntseg daj, oblong, tiaj tus nrog cov kab sib faib ua ob sab. Sau nrog "NMN" thiab stylized "h" ntawm ob tog.

Amaryl 4 mg: xiav ntsiav tshuaj, oblong, tiaj tus nrog txoj kab sib faib ua ob sab. Sau "NMO" thiab stylized "h" rau ob sab.

Cov Tshuaj Pharmacokinetics

Nrog rau ntau qhov tshuaj ntawm glimepiride nyob rau hauv ib koob tshuaj txhua hnub ntawm 4 mg C max hauv cov ntshav cov ntshav tau tiav tom qab kwv yees li 2.5 teev thiab tau nce mus txog 309 ng / ml. Muaj txoj kab sib txuas ntawm qhov koob tshuaj thiab C max ntawm glimepiride hauv ntshav, ntxiv rau ntawm qhov muab thiab AUC. Thaum noj cov glimepiride nws qhov kev qhia tseeb txog kev noj qab haus huv tau ua tiav. Noj mov tsis muaj kev cuam tshuam loj ntawm kev nqus, nrog rau kev zam ntawm kev ua kom qeeb me ntsis hauv nws qhov ceev. Glimepiride yog tus yam ntxwv ntawm qhov kev faib tawm tsawg heev (li 8.8 L), kwv yees li qhov sib npaug ntawm qhov ntim ntawm albumin, qhov siab siab ntawm kev khi rau cov ntshav plasma protein (ntau dua li 99%) thiab qhov tsawg tsawg (kwv yees li 48 ml / min). Qhov nruab nrab T 1/2, txiav txim siab los ntawm ntshav siab nyob rau hauv cov kev mob ntawm kev rov ua dua ntawm cov tshuaj, kwv yees li 5-8 teev. Tom qab noj ntau, muaj qhov nce siab hauv T 1/2.

Tom qab txhaj ib koob tshuaj glimepiride, 58% koob tshuaj yog tawm los ntawm lub raum thiab 35% ntawm qhov koob tshuaj dhau los ntawm txoj hnyuv. Kev hloov pauv glimepiride nyob rau hauv cov zis tsis kuaj.

Hauv cov zis thiab cov quav, ob hom metabolites tau txheeb xyuas los ntawm cov metabolism hauv lub siab (feem ntau yog siv CYP2C9), ib qho yog cov hydroxy derivative, thiab lwm qhov carboxy derivative. Tom qab noj ntawm glimepiride, lub davhlau ya nyob twg T 1/2 ntawm cov metabolites yog 3-5 thiab 5-6 teev, feem.

Glimepiride ua haujlwm tawm hauv cov kua mis thiab hla tus qib placental.

Kev sib piv ntawm ib qho thiab ntau yam (ib zaug ib hnub) kev tswj hwm glimepiride tsis qhia tawm qhov sib txawv tseem ceeb hauv cov chaw muag tshuaj, lawv qhov kev hloov pauv ntawm cov neeg mob sib txawv. Tsis muaj qhov tseem ceeb tsub zuj zuj ntawm cov tshuaj.

Pharmacokinetic cov cim muaj qhov zoo sib xws hauv cov neeg mob sib txawv thiab pawg hnub nyoog sib txawv. Hauv cov neeg mob uas tsis zoo lub raum (nrog rau qhov tsis muaj creatinine tsawg), muaj qhov nyiam ua kom lub qhov txhaws ntau ntxiv thiab txo qis hauv nws cov ntsiab lus nruab nrab hauv cov ntshav cov ntshav, uas, txhua qhov yuav tshwm sim, vim sai dua cov tshuaj vim tias nws txo qis khi rau cov protein. Yog li, hauv pawg no ntawm tus neeg mob tsis muaj kev pheej hmoo ntxiv los khaws cov tshuaj.

Cov Tshuaj Hauv Tshuaj

Glimepiride txo qis cov ntsiab lus ntawm cov piam thaj hauv cov ntshav, feem ntau vim yog kev tsa los ntawm kev tso tawm ntawm cov kua dej los ntawm beta hlwb ntawm cov txiav. Nws cov nyhuv yog feem ntau cuam tshuam nrog kev txhim kho nyob rau hauv lub peev xwm ntawm pancreatic beta hlwb los teb rau lub zog kev xav nrog cov piam thaj. Piv nrog rau glibenclamide, noj qis dua ntawm glimepiride ua rau muaj kev tso tawm ntawm cov tshuaj insulin tsawg dua thaum ua tiav cov kwv yees li qub nyob hauv ntshav qab zib. Qhov tseeb no ua tim khawv nyob rau hauv kev pom zoo muaj cov kab mob ntxiv los tiv thaiv hypoglycemic nyob rau hauv glimepiride (nce cov ntaub so ntswg rhiab rau insulin thiab insulinomimetic effect).

Cov tshuaj insulin zais cia. Zoo li txhua lwm yam sulfonylurea derivatives, glimepiride tswj hwm cov kua dej los ntawm kev sib koom tes nrog ATP-nkag siab poov tshuaj raws ntawm beta-cell daim nyias nyias. Tsis zoo li lwm cov sulfonylurea derivatives, glimepiride xaiv khi rau cov protein nrog cov molecular phaus ntawm 65 kilodaltons (kDa) nyob rau hauv cov qog ua rau ntawm pancreatic beta hlwb. Qhov no sib cuam tshuam ntawm glimepiride nrog cov protein sib khi ua kom nws tswj qhov qhib lossis kaw ntawm ATP-nkag mus poov tshuaj raws.

Glimepiride kaw cov kab xo potassium. Qhov no ua rau depolarization ntawm beta hlwb thiab coj mus rau qhov qhib ntawm voltage-rhiab calcium channel thiab qhov khiav ntawm calcium tuaj rau hauv lub cell. Raws li qhov tshwm sim, ib qho kev nce ntxiv hauv cov tshuaj calcium uas muaj siab tshaj yuav ua rau cov insulin secretion los ntawm exocytosis.

Glimepiride ua nrawm dua thiab vim li no thiaj li muaj kev sib cuag thiab raug tso tawm los ntawm daim ntawv cog lus nrog cov protein khi rau nws tshaj li glibenclamide. Nws tau kwv yees tias cov cuab yeej no ntawm kev hloov pauv siab ntawm glimepiride nrog cov protein khi rau nws txiav txim siab nws cov lus tshaj tawm ntawm kev nkag siab ntawm cov hlwb hlwb rau cov piam thaj thiab lawv cov kev tiv thaiv tiv thaiv desensitization thiab ntxov ntxov.

Cov nyhuv ntawm nce zuj zus cov ntaub so ntswg mus rau insulin. Glimepiride ua rau kev cuam tshuam zoo ntawm insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg peripheral.

Cov tshuaj Insulinomimetic. Glimepiride muaj cov teebmeem zoo ib yam li cov tshuaj insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg thiab kev tso tawm cov piam thaj los ntawm lub siab.

Peripheral cov ntaub so ntswg qabzib yog nqus tau los ntawm kev thauj nws mus rau hauv cov leeg nqaij thiab adipocytes. Glimepiride ncaj qha nce tus naj npawb ntawm cov lwg me nyuam thauj cov piam thaj hauv plasma cov leeg ntawm cov leeg nqaij thiab adipocytes. Kev nce ntxiv ntawm kev noj cov ntshav qabzib ua rau kev ua haujlwm ntawm glycosylphosphatidylinositol-phospholipase C. Yog li ntawd, cov tshuaj calcium calcium uas tsis txaus siab poob qis, ua rau muaj kev cuam tshuam ntawm cov dej num ntawm protein kinase A, uas ua rau lub ntsej muag ua rau lub zog ntawm cov metabolism glucose.

Glimepiride inhibits kev tso tawm ntawm qabzib los ntawm lub siab los ntawm kev nce lub siab ntawm fructose-2,6-bisphosphate, uas inhibits gluconeogenesis.

Ua rau platelet aggregation thiab qhov tsim ntawm atherosclerotic plaques. Glimepiride txo cov platelet sib sau ua ke hauv vitro thiab hauv vivo. Cov nyhuv no zoo li cuam tshuam nrog kev xaiv inhibition ntawm COX, uas yog lub luag haujlwm rau kev tsim ntawm thromboxane A, ib qho tseem ceeb endogenous platelet aggregation factor.

Antiatherogenic nyhuv ntawm cov tshuaj. Glimepiride pab txhawb rau kev kho lipid cov ntsiab lus, ua rau txo qis ntawm malonic aldehyde hauv cov ntshav, uas ua rau txo qis tseem ceeb ntawm lipid peroxidation.

Txo qhov hnyav ntawm oxidative kev nyuaj siab, uas ib txwm muaj nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2 mellitus.

Kev mob plawv. Los ntawm ATP-nkag siab cov potassium (saib saud), sulfonylureas tseem muaj cov nyhuv hauv cov hlab plawv.Piv rau cov tshuaj sulfonylurea derivatives, glimepiride muaj cov nyhuv tsis zoo ntawm cov kab mob plawv. Nws txo cov platelet ua ke thiab coj mus rau qhov txo qis hauv kev tsim cov atherosclerotic plaques.

Hauv cov neeg ua haujlwm noj qab haus huv, cov tshuaj txhaj tsawg kawg ntawm glimepiride yog 0.6 mg. Cov nyhuv ntawm glimepiride yog koob tshuaj thiab rov ua dua tshiab. Lub cev muaj zog teb rau kev ua lub cev (txo qis insulin qis) nrog glimepiride yog tswj.

Tsis muaj qhov sib txawv ntawm cov nyhuv, nyob ntawm seb cov tshuaj tau noj 30 feeb ua ntej noj mov lossis ua ntej noj mov. Hauv cov neeg mob ntshav qab zib, kev tswj kev zom zaub mov txaus tuaj yeem ua tiav nyob hauv 24 teev nrog tib lub tshuaj. Ntxiv mus, hauv kev soj ntsuam mob, 12 ntawm 16 cov neeg mob raum tsis ua haujlwm (Cl creatinine 4-79 ml / min) kuj tau ua tiav cov kev tswj cov metabolism.

Kev sib xyaw ua ke nrog metformin. Rau cov neeg mob uas ua tsis tiav cov kev tswj lub cev metabolic thaum siv qhov siab tshaj plaws ntawm glimepiride, kev sib txuas ua ke nrog glimepiride thiab metformin tuaj yeem pib ua. Hauv ob txoj kev tshawb nrhiav, thaum ua cov kev kho mob sib xyaw ua ke, nws tau ua pov thawj tias kev tswj cov metabolism yog qhov zoo dua li ntawm txoj kev kho txhua yam ntawm cov tshuaj cais tawm.

Kev sib xyaw ua ke nrog cov tshuaj insulin. Rau cov neeg mob uas tsis ua tiav cov kev tswj lub cev tsis txaus thaum siv cov tshuaj glimepiride ntau kawg, kev kho insulin ib txhij tuaj yeem pib. Raws li cov txiaj ntsig ntawm ob txoj kev tshawb nrhiav, nrog kev siv ntawm kev sib xyaw ua ke no, tib txoj kev tswj kev noj zaub mov zoo yog ua tiav nrog kev siv ntawm ib qho tshuaj insulin, txawm li cas los xij, hauv kev kho mob sib xyaw ua ke yuav tsum tau txhaj tshuaj insulin qis dua.

Siv rau menyuam yaus. Tsis muaj cov ntaub ntawv hais txog kev ua haujlwm ntev thiab kev nyab xeeb thaum siv cov tshuaj hauv menyuam yaus.

Hom 2 mob ntshav qab zib mellitus (hauv kev kho mob monotherapy lossis ua ib feem ntawm kev sib xyaw ua ke nrog metformin lossis insulin).

Cev xeeb tub thiab lactation

Glimepiride yog sib xyaw rau cov poj niam cev xeeb tub. Kev xeeb menyuam hauv plab lossis thaum pib cev xeeb tub, tus pojniam yuav tsum pauv mus rau kev kho mob insulin.

Glimepiride kis mus rau hauv niam mis, yog li nws tsis tuaj yeem siv thaum lactation. Hauv qhov no, koj yuav tsum hloov mus rau kev siv tshuaj insulin lossis txwv kev pub niam mis.

Cov lus qhia tshwj xeeb

Hauv cov chaw muaj kev ntxhov siab tshwj xeeb, xws li kev mob nyhav, kev phais mob, kev kis mob nrog kub taub hau febrile, kev tswj cov teeb meem hauv lub cev yuav ua rau cov neeg mob ntshav qab zib mellitus ploj mus ib ntus, thiab tej zaum lawv yuav tsum tau hloov mus rau kev kho mob insulin ib ntus kom tswj tau cov kev tswj lub cev kom txaus.

Hauv thawj lub lis piam ntawm kev kho mob, kev pheej hmoo ntawm kev txhim kho hypoglycemia yuav nce ntxiv, thiab yog li ntawd, tshwj xeeb tshaj yog saib xyuas kev saib xyuas ntshav qabzib ntau hauv lub sijhawm no.

Qhov tseem ceeb uas yuav ua rau muaj kev pheej hmoo ntawm lub qog ntshav qab zib muaj xws li:

Nyuaj lossis tsis muaj peev xwm ntawm tus neeg mob (feem ntau pom nyob rau hauv cov neeg laus laus) kom koom tes nrog tus kws kho mob,

Kev noj zaub mov tsis txaus, noj mov tsis xwm yeem los yog yoo mov noj,

Tsis txaus ntawm kev qoj ib ce thiab kev ua kom yuag,

Haus dej cawv, tshwj xeeb tshaj yog ua ke nrog skipped noj mov,

Kev mob raum tsis zoo,

Kev mob siab rau daim siab hnyav (hauv cov neeg mob uas muaj mob rau daim siab hnyav, hloov mus rau txoj kev kho tshuaj insulin, tsawg kawg yog txog thaum tswj kev zom zaub mov tiav),

Qee qhov decompensated endocrine cuam tshuam uas cuam tshuam rau cov metabolism hauv metabolism los yog adrenergic counterregulation nyob rau hauv teb rau hypoglycemia (piv txwv li, qee cov thyroid thiab anterior pituitary dysfunction, adrenal tsis txaus),

Kev siv qee cov tshuaj (saib Ntu "Kev Sib Nrog"),

Txais tos ntawm glimepiride thaum tsis muaj kev ntsuas rau nws kev txais tos.

Kev kho mob nrog sulfonylurea derivatives, uas suav nrog glimepiride, tuaj yeem ua rau muaj kev loj hlob ntawm hemolytic anemia, yog li ntawd, cov neeg mob uas muaj ntshav qabzib-6-phosphate dehydrogenase yuav tsum tau tshwj xeeb tshaj yog thaum sau ntawv rau glimepiride thiab nws zoo dua yog siv cov tshuaj hypoglycemic uas tsis yog sulfonylurea derivatives.

Nyob rau ntawm qhov muaj ntawm cov kev pheej hmoo tshwm sim saum toj no, kev txhim kho hypoglycemia xav tau koob tshuaj kho glimepiride lossis kev kho txhua yam. Qhov no kuj tseem siv rau qhov tshwm sim ntawm cov kabmob sib kis thaum kho lossis hloov pauv ntawm cov neeg mob lub neej.

Cov tsos mob ntawm tus mob ntshav qab zib tsawg uas ua rau muaj kev tiv thaiv qog nqaij ntshav hauv lub cev hauv kev teb rau hypoglycemia (saib ntu "Cov Kev Mob tshwm sim") tej zaum yuav mob sib khuav lossis tsis tuaj yeem dhau ntawm kev txhim kho hypoglycemia, hauv cov neeg mob laus, cov neeg mob uas muaj lub hlwb tsis zoo ntawm lub hlwb, lossis cov neeg mob uas tau txais beta -adrenoblockers, clonidine, reserpine, guanethidine thiab lwm tus neeg siv sympatholytic.

Kev mob ntshav qab zib tsawg tuaj yeem raug tshem tawm sai sai nrog kev noj sai ntawm kev zom cov zaub mov sai sai (qabzib lossis sucrose).

Ib yam li lwm yam sulfonylurea derivatives, txawm hais tias thawj zaug kev vam meej ntawm kev txo qis ntawm hypoglycemia, hypoglycemia yuav rov pib dua. Yog li, cov neeg mob yuav tsum nyob twj ywm nrog kev saib xyuas tas mus li.

Hauv kev mob ntshav nce siab ntau, kev kho mob tam sim ntawd thiab kev saib xyuas mob, thiab hauv qee kis, pw hauv tsev kho mob ntawm tus neeg mob, ntxiv rau.

Thaum kho nrog glimepiride, yuav tsum soj ntsuam daim siab ua haujlwm thiab daim duab txhav ntshav (tshwj xeeb cov leukocytes thiab platelets).

Txij li thaum muaj qee yam kev mob tshwm sim, xws li mob ntshav qab zib ntau ntau, hloov pauv loj heev hauv daim duab ntshav, kev tsis haum tshuaj, daim siab tsis ua haujlwm, tuaj yeem ua rau muaj kev phom sij rau lub neej, nyob rau hauv kev txhim kho tsis xav ua lossis tsis haum, tus neeg mob yuav tsum qhia tus kws kho mob tam sim ntawd Nyob rau hauv txhua rooj plaub, tsis txhob txuas ntxiv noj cov tshuaj yam tsis tau txais kev pom zoo.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab lwm yam txheej txheem. Cov xwm txheej ntawm kev txhim kho hypoglycemia lossis hyperglycemia, tshwj xeeb tshaj yog thaum pib kho lossis tom qab hloov txoj kev kho, lossis thaum cov tshuaj tsis noj tsis tu ncua, txo qis thiab ceev ceev ntawm cov kev xav psychomotor yog tau. Qhov no yuav ua rau tus neeg mob lub peev xwm tsav lub tsheb lossis lwm yam txheej txheem.

Chaw tsim tshuaj paus

Sanofi-Aventis Deutschland GmbH, Lub Tebchaws Yelemees, tsim los ntawm Sanofi-Aventis S.p.A. (Ltalis).

Stabilimento di Scoppito, Strada Statale 17, km 22, I-67019 Scoppito (L "Aquilla), Ltalis.

Nws yog ib qho tseem ceeb kom paub! Ib yam tshiab tawm tswv yim los ntawm endocrinologist rau Saib Xyuas Ntshav Qab Zib Ntxiv! Nws tsuas yog tsim nyog txhua hnub.

Mob ntshav qab zib thiab siab surges yuav yog ib yam dhau los

Mob ntshav qab zib yog qhov ua rau ze li ntawm 80% ntawm tag nrho cov cwj nrag thiab txiav taws. 7 ntawm 10 leej neeg tuag vim txhaws ntawm cov hlab ntsha hauv plawv lossis paj hlwb.Yuav luag txhua qhov teeb meem, qhov laj thawj rau qhov txaus ntshai kawg no yog qhov qub - ntshav qab zib siab.

Cov piam thaj tuaj yeem thiab yuav tsum tau sib khob, tsis muaj dab tsi. Tab sis qhov no tsis kho tus kab mob nws tus kheej, tab sis tsuas yog pab txhawm rau txhawm rau tshawb xyuas, thiab tsis yog qhov ua kom muaj tus kab mob.

Cov tshuaj nkaus xwb uas raug pom zoo rau kev kho mob ntshav qab zib thiab nws kuj yog siv los ntawm endocrinologist hauv lawv txoj haujlwm yog qhov no.

Qhov ua tau zoo ntawm cov tshuaj, suav raws li tus qauv txheej txheem (tus naj npawb ntawm cov neeg mob uas tau zoo mus rau tag nrho cov neeg mob hauv pawg 100 ntawm cov neeg tau txais kev kho mob) yog:

Li qub ntawm qab zib - 95%
Kev tshem tawm ntawm cov hlab ntshav thrombosis - 70%
Ntaus tau ntawm lub plawv dhia muaj zog - 90%
Kev tshem tawm ntshav siab - 92%
Qhov nce hauv lub zog nruab hnub, txhim kho pw tsaug zog thaum hmo ntuj - 97%

Cov neeg tsim khoom tsis yog lub koom haum ua lag luam thiab tau nyiaj peev nrog kev txhawb nqa los ntawm lub xeev. Yog li ntawd, tam sim no txhua tus neeg nyob hauv muaj qhov zoo.

cov pluas noj thaum lub sij hawm uas lawv noj tshuaj yuav tsum tau ua kom txaus,
Nyob rau hauv tsis muaj qhov yuav tsum tau koj hla zaub mov. Yog tias koj tsis tuaj yeem noj tshais, Amaril qhov kev txais tos yog pauv mus noj su,
nws yog ib qho tsim nyog los npaj ib qho kev sib xyaw ua ke ntawm cov carbohydrates hauv cov ntshav. Lub hom phiaj no tau ua tiav los ntawm cov pluas noj mov nquag (tom qab 4 teev), kev faib tawm ntawm cov carbohydrates hauv txhua lub tais. Qhov qis dua cov zaub mov, qhov yooj yim dua nws yog kom them taus cov ntshav qab zib kom tsawg.

Amaril yog qaug cawv rau xyoo tsis noj sijhawm so. Yog tias qhov siab tshaj plaws tau tso tseg kom txo cov piam thaj, qhov nrawm nrawm yuav tsum hloov mus rau txoj kev kho tshuaj insulin.

Lub sijhawm ua

Amaryl muaj cov khoom siv bioavailability tag nrho, 100% cov tshuaj tau mus txog qhov chaw txiav txim. Raws li cov lus qhia, qhov siab tshaj plaws ntawm glimepiride hauv cov ntshav tau tsim tom qab 2.5 teev. Lub sijhawm tag nrho ntawm qhov kev txiav txim siab tshaj 24 teev, ntau dua qhov tsuas tshuaj, ntev dua Amaril ntsiav tshuaj yuav ua haujlwm.

Vim nws lub sijhawm ntev, cov tshuaj raug tso cai kom noj ib zaug ib hnub. Muab hais tias 60% ntawm cov neeg mob ntshav qab zib tsis txaus siab ua raws li tus kws kho mob cov lus qhia, ib koob tshuaj muaj peev xwm txo qis kev noj tshuaj tsis tau 30%, thiab yog li txhim kho cov ntshav qab zib.

Cov Yuav Tsum Muaj

Muaj ib daim ntawv teev cov khoom lag luam zoo sib xws rau kev noj tshuaj Amaril:

1 hom
ua txhaum cai hnyav rau daim siab thiab lub raum,
ketoacidosis uas mob ntshav qab zib, precoma thiab coma,
, ,
muaj cov kab mob muaj mob tsis tshua muaj mob, piv txwv li, galactose intolerance, glucose-galactose malabsorption lossis lactase deficiency,
cov me nyuam muaj hnub nyoog
intolerance lossis rhiab rau yeeb tshuaj thiab lwm yam.

Kev ceeb toom yuav tsum muaj nyob rau theem pib ntawm kev kho mob ntawm cov neeg mob, txij li lub sijhawm no muaj kev pheej hmoo ntawm lub qog ntshav qab zib. Yog tias qhov ntxim nyiam ntawm kev txhim kho hypoglycemia tseem pheej nyob, tom qab ntawd koj feem ntau yuav tsum kho cov koob tshuaj glimepiride los yog kev kho mob cais tawm. Ntxiv rau, muaj kev cuam tshuam thiab lwm yam kabmob, kev ua neej, kev noj zaub mov zoo thiab lwm yam yuav tsum muaj kev tshwj xeeb.

Cov lus qhia rau Amaryl (Txujci thiab ntau npaum li cas)

Cov ntsiav tshuaj yog npaj rau kev siv sab hauv tag nrho, yam tsis muaj ntxo thiab haus dej kom ntau.

Feem ntau, cov koob tshuaj yog txiav txim siab los ntawm kev saib xyuas cov piam thaj hauv cov ntshav. Rau kev kho mob, kev noj qab haus huv qis tshaj plaws yog qhov txiav txim siab, uas yuav pab ua kom tiav qhov kev tswj hwm kev hnyav tsim nyog

Cov lus qhia rau kev siv ntawm Amaril tseem qhia ntxiv tias thaum lub sijhawm kho, kev txiav txim siab tsis tu ncua ntawm kev saib xyuas cov kua nplaum hauv cov ntshav thiab qib glycosylated hemoglobin yog qhov yuav tsum tau ua.

Yog tias noj tshuaj tsis raug, nrog rau kev hla dhau koob tshuaj tom ntej, tsis pom zoo kom siv cov tshuaj ntxiv. Cov xwm txheej zoo li no yuav tsum muaj kev pom zoo ua ntej nrog tus kws kho mob uas koom nrog.

Thaum pib ntawm kev kho mob, cov neeg mob tau sau tshuaj rau txhua hnub yog 1 mg. Yog tias tsim nyog, cov koob tshuaj yog maj mam nce, ua kev soj ntsuam tas li ntawm ntshav qabzib concentration raws li cov txheej txheem: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg - 8 mg.Kev siv tshuaj txhua hnub nyob hauv cov neeg mob uas tswj tau zoo yog 1-4 mg ntawm cov tshuaj nquag. Kev noj tshuaj txhua hnub ntawm 6 mg lossis ntau dua tsim cov kev cuam tshuam tsuas yog qee tus neeg mob.

Kev noj tshuaj rau txhua hnub rau cov tshuaj yog teem los ntawm tus kws kho mob, vim nws yog qhov yuav tsum tau coj mus rau hauv tus account ntau yam, piv txwv li, lub sijhawm noj mov, qhov nyiaj ntawm lub cev ua si thiab ntau dua.

Feem ntau, kev noj ib leeg ib hnub ntawm cov tshuaj yog kws kho, ua ntej noj tshais tag nrho lossis thawj pluas noj. Nws yog ib qho tseem ceeb uas tom qab noj cov ntsiav tshuaj tsis nco qab noj mov.

Nws paub tias kev txhim kho metabolic tswj tau cuam tshuam nrog nce insulin rhiab heev, thiab thaum kho, qhov xav tau glimepiride yuav poob. Koj tuaj yeem zam qhov kev txhim kho hypoglycemia los ntawm kev txo cov tshuaj noj kom tsawg lossis tsis noj tshuaj Amaril.

Thaum lub sij hawm kho txheej txheem, tshuaj kho kom haum glimepiride tuaj yeem ua tau thaum:

luj txo
kev ua neej pauv
kev tshwm sim ntawm lwm yam ua rau muaj kev phom sij rau hypoglycemia lossis hyperglycemia.

Raws li txoj cai, Amaril kev kho mob yog nqa tawm ntev.

Cov nqe lus ntawm kev muag khoom

Hauv cov khw muag tshuaj, koj tuaj yeem tau txais Amaryl yog tias koj muaj ntawv sau los ntawm koj tus kws kho mob.

Cov Nta Cia

Glimepiride ntsiav tshuaj yuav tsum tau muab cia rau hauv qhov chaw tsaus, tiv thaiv los ntawm tshav ntuj ncaj qha, tawm ntawm qhov chaw ncav cuag ntawm cov menyuam yaus. Cia kub - txog +30 о С.

Hnub tas sij hawm

Siv cov tshuaj yog tso cai rau 36 lub hlis txij li hnub tso tawm.

Tus nqi ntawm Glimepiride Canon, uas tsim los ntawm Canonfarm, kuj tseem qis dua. Tus nqi ntawm ib pob ntawm 30 ntsiav tshuaj ntawm 2 mg yog suav tias yog pheej yig, nws yog 154 p.

Cawv thiab Amaryl

Nws tsis tuaj yeem kwv yees ua ntej li cas haus cawv muaj cawv yuav cuam tshuam rau tus neeg uas siv tshuaj yaj yeeb raws li glimepiride. Cov cawv yuav ua rau lub cev tsis muaj zog lossis txhim kho hypoglycemic ntawm Amaril. Yog li, lawv tuaj yeem siv tsis tau tib lub sijhawm.

Kev siv tshuaj hypoglycemic nyob ntev. Vim tias qhov no, txoj cai txwv tsis pub haus cawv haus cawv ntau rau ib qho yuav dhau los ua teeb meem.

Cev xeeb tub, lactation

Thaum lub sijhawm lactation, Txoj kev kho Amaril yog txwv tsis pub.Cov tshuaj nquag kis mus rau niam mis, lub cev ntawm tus menyuam yug tshiab. Thaum pub niam mis, nws yog qhov tsim nyog kom tus poj niam hloov mus rau kev siv tshuaj insulin.

E11 Tsis muaj ntshav qab zib uas tsis yog insulin-mellitus

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

nyob rau hauv ib lub blister sawb ntim ntawm 15 pcs., nyob rau hauv ib pob ntawm cardboard 2, 4, 6 lossis 8 ntim.

Kev piav qhia ntawm daim ntawv tshuaj

Amaryl 1 mg: ntsiav tshuaj paj yeeb, oblong, tiaj tus nrog txoj kab sib faib ua ob sab. Sau nrog "NMK" thiab stylized "h" rau ob tog.

Amaryl 2 mg: ntsiav tshuaj ntsuab, oblong, tiaj tus nrog txoj kab sib faib ua ob sab. Sau "NMM" thiab stylized "h" rau ob sab.

Amaryl 3 mg: ntsiav tshuaj daj ntseg daj, oblong, tiaj tus nrog cov kab sib faib ua ob sab. Sau nrog "NMN" thiab stylized "h" ntawm ob tog.

Amaryl 4 mg: xiav ntsiav tshuaj, oblong, tiaj tus nrog txoj kab sib faib ua ob sab. Sau "NMO" thiab stylized "h" rau ob sab.

Ntseg

Kev siv tshuaj tua ntshav nrog rau kev tswj hwm qhov ncauj ntawm sulfonylurea pab pawg ntawm tiam thib peb.

Pharmacological kev txiav txim

Cov Tshuaj Pharmacokinetics

Glimepiride ua haujlwm tawm hauv cov kua mis thiab hla tus qib placental.

Cov Tshuaj Hauv Tshuaj

Glimepiride txo qis cov ntsiab lus ntawm cov piam thaj hauv cov ntshav, feem ntau vim yog kev tsa los ntawm kev tso tawm ntawm cov kua dej los ntawm beta hlwb ntawm cov txiav. Nws cov nyhuv yog feem ntau cuam tshuam nrog kev txhim kho nyob rau hauv lub peev xwm ntawm pancreatic beta hlwb los teb rau lub zog kev xav nrog cov piam thaj.Piv nrog rau glibenclamide, noj qis dua ntawm glimepiride ua rau muaj kev tso tawm ntawm cov tshuaj insulin tsawg dua thaum ua tiav cov kwv yees li qub nyob hauv ntshav qab zib. Qhov tseeb no ua tim khawv nyob rau hauv kev pom zoo muaj cov kab mob ntxiv los tiv thaiv hypoglycemic nyob rau hauv glimepiride (nce cov ntaub so ntswg rhiab rau insulin thiab insulinomimetic effect).

Cov nyhuv ntawm nce zuj zus cov ntaub so ntswg mus rau insulin. Glimepiride ua rau kev cuam tshuam zoo ntawm insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg peripheral.

Glimepiride inhibits kev tso tawm ntawm qabzib los ntawm lub siab los ntawm kev nce lub siab ntawm fructose-2,6-bisphosphate, uas inhibits gluconeogenesis.

Txo qhov hnyav ntawm oxidative kev nyuaj siab, uas ib txwm muaj nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2 mellitus.

Kev mob plawv. Los ntawm ATP-nkag siab cov potassium (saib saud), sulfonylureas tseem muaj cov nyhuv hauv cov hlab plawv. Piv rau cov tshuaj sulfonylurea derivatives, glimepiride muaj cov nyhuv tsis zoo ntawm cov kab mob plawv. Nws txo cov platelet ua ke thiab coj mus rau qhov txo qis hauv kev tsim cov atherosclerotic plaques.

Siv rau menyuam yaus. Tsis muaj cov ntaub ntawv hais txog kev ua haujlwm ntev thiab kev nyab xeeb thaum siv cov tshuaj hauv menyuam yaus.

Hom 2 mob ntshav qab zib mellitus (hauv kev kho mob monotherapy lossis ua ib feem ntawm kev sib xyaw ua ke nrog metformin lossis insulin).

Cov Yuav Tsum Muaj

txo qhov muag rau glimepiride los yog rau ib yam dab tsi pabcuam ntawm cov tshuaj, lwm yam sulfonylurea derivatives lossis sulfa tshuaj (muaj kev pheej hmoo ntawm hypersensitivity tshua),

ntshav qab zib hom 1

ketoacidosis, mob ntshav qab zib precoma thiab coma,

mob siab ua rau lub siab (tsis muaj kev tshawb nrhiav hauv chaw kuaj mob)

mob raum tsis zoo, suav nrog nyob rau hauv cov neeg mob tab tom kho mob hemodialysis (tsis muaj kev sim kho mob)

cov menyuam hnub nyoog (tsis muaj kev paub dhau los),

tsis tshua muaj cov kab mob xws li galactose intolerance, lactase deficiency lossis glucose-galactose malabsorption.

mob nyob rau hauv thawj lub limtiam ntawm kev kho mob (nce kev pheej hmoo ntawm ntshav qab zib). Yog tias muaj kev pheej hmoo txaus rau kev txhim kho hypoglycemia (saib Ntu "Cov Lus Qhia Tshwj Xeeb"), yuav tsum tau txhaj tshuaj kho glimepiride lossis kev kho tag nrho,

cov kabmob uas cuam tshuam thaum kho lossis thaum hloov lub neej ntawm cov neeg mob (hloov kev noj zaubmov thiab kev noj zaubmov, nce lossis tsawg rau kev qoj ib ce),

malabsorption ntawm cov zaub mov thiab cov tshuaj hauv lub plab zom mov (mob hnyuv, mob plab hnyuv).

Cev xeeb tub thiab lactation

Glimepiride yog sib xyaw rau cov poj niam cev xeeb tub. Kev xeeb menyuam hauv plab lossis thaum pib cev xeeb tub, tus pojniam yuav tsum pauv mus rau kev kho mob insulin.

Glimepiride kis mus rau hauv niam mis, yog li nws tsis tuaj yeem siv thaum lactation. Hauv qhov no, koj yuav tsum hloov mus rau kev siv tshuaj insulin lossis txwv kev pub niam mis.

Sab sij huam

Los ntawm ib sab ntawm cov metabolism: ua rau lub ntsej muag hypoglycemic ntawm Amaril, lub qog ntshav qab zib yuav loj hlob tuaj, uas, ib yam li lwm yam sulfonylureas, tuaj yeem siv sijhawm ntev.

Cov tsos mob ntawm tus mob ntshav qab zib yog: mob taub hau, tshaib plab, xeev siab, ntuav, nkees, nkees, pw tsaug zog, ntxhov siab, ntxhov siab, tsis hnov qab, ceeb toom thiab ceev ntawm cov tshwm sim, kev nyuaj siab, tsis meej pem, hais lus tsis meej, tsis meej pem, pom kev tab kaum, tshee tshee, paresis, hnov lub siab tsis sib xws, kiv taub hau, tsis tuaj yeem tswj tus kheej, delirium, mob hlwb ntawm lub cev, kev ua xyem xyav lossis tsis nco qab, txog qhov tsis nco qab, ua pa nyuaj, bradycardia.

Tsis tas li ntawd, kev tshwm sim ntawm adrenergic counter-kev cai yuav tshwm sim nyob rau hauv teb rau hypoglycemia, xws li cov tsos mob khaub thuas, nplaum hws, ntxhov siab vim, tachycardia, hlab ntsha tawg, angina pectoris, palpitations, thiab lub plawv atherosclerosis kev ntxhov siab.

Cov lus qhia soj ntsuam ntawm cov ntshav khov qis yuav zoo ib yam li mob hlab ntsha tawg. Cov tsos mob ntawm cov ntshav qog ntshav yuav luag ploj tom qab nws tshem tawm.

Los ntawm ib sab ntawm cov khoom hauv nruab nrog ntawm lub zeem muag: lub sijhawm kho (tshwj xeeb thaum pib), muaj kev cuam tshuam pom kev tsis pom kev vim muaj qhov hloov pauv hauv cov concentration ntawm cov piam thaj hauv cov ntshav tuaj yeem pom. Lawv qhov ua rau yog ib ntus hloov ntawm qhov lo ntsiab muag o, nyob ntawm kev mloog ntawm cov piam thaj hauv cov ntshav, thiab vim qhov no, qhov hloov pauv ntawm qhov lo ntsiab muag ntawm lub lo ntsiab muag.

Los ntawm lub plab zom mov: hauv qee qhov tsis tshua muaj mob - xeev siab, ntuav, hnov qhov hnyav lossis nrawm hauv epigastrium, mob plab, mob raws plab, qee qhov - kab mob siab, nce kev ua haujlwm ntawm daim siab enzymes thiab / lossis cholestasis thiab jaundice, uas tuaj yeem ua rau lub siab ua rau lub siab tsis ua haujlwm. , tab sis tej zaum yuav muaj kev txhim kho rov qab thaum cov tshuaj txiav tawm.

Los ntawm cov kab mob hemopoietic thiab lymphatic system: tsis tshua muaj - thrombocytopenia, qee kis - mob leukopenia, hemolytic anemia, erythrocytopenia, granulocytopenia, agranulocytosis thiab pancytopenia.

Cov teeb meem dav dav: hauv qee qhov tsis tshua muaj, kev ua xua thiab pseudo-ua xua, xws li mob pruritus, urticaria, tawv nqaij ua pob khaus, muaj peev xwm ua tau. Cov kev xav zoo li no tuaj yeem nkag mus rau hauv cov kev txhaum hnyav nrog ua tsis taus pa, lub siab poob ntawm cov ntshav siab, uas tuaj yeem qee zaum muaj kev poob siab anaphylactic. Yog tias cov tsos mob ntawm tus mob urticaria tshwm sim, sab laj nrog tus kws kho mob tam sim ntawd. Qee qhov xwm txheej, kuj yuav muaj cov ntsiab lus sodium ntau zuj zus, ua xua vasculitis, ua kom lub ntsej muag zoo nkauj.

Kev sib txuam

Glimepiride yog metabolized los ntawm cytochrome P4502C9 (CYP2C9), uas yuav tsum tau coj mus rau hauv tus account thaum siv ib txhij nrog cov inducers (piv txwv li rifampicin) lossis inhibitors (e.g. fluconazole) CYP2C9.

Lub zog ua haujlwm ntawm hypoglycemic kev ua haujlwm thiab, muaj qee kis, kev loj hlob tau ntawm hypoglycemia cuam tshuam nrog qhov no tuaj yeem pom thaum ua ke nrog ib qho ntawm cov tshuaj hauv qab no: insulin thiab lwm yam kev tiv thaiv hypoglycemic rau qhov ncauj tswj hwm, ACE inhibitors, anabolic steroids thiab cov txiv neej pw ua ke, chloramphenicol, coumarin derivatives, cyclophospideide, disopyram , fenfluramine, pheniramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, fluconazole, para-aminosalicylic acid, pentoxifylline (siab sib deev) s koob tshuaj), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, clarithromycin, sulfonamides, tetracyclines, tritokvalin, trofosfamide.

Kev poob siab ntawm cov nyhuv hypoglycemic thiab cov tshuaj lom neeg hauv cov ntshav siab tuaj yeem pom tau thaum ua ke nrog ib qho ntawm cov tshuaj hauv qab no: acetazolamide, barbiturates, GCS, diazoxide, diuretics, epinephrine thiab lwm yam cuam tshuam sympathomimetic, glucagon, laxatives (nrog rau siv ntev), nicotinic acid (hauv kev txhaj tshuaj siab), estrogens thiab progestogens, phenothiazines, phenytoin, rifampicin, iodine-muaj cov thyroid hormones.

Cov blockers ntawm H 2 histamine receptors, beta-blockers, clonidine thiab reserpine muaj peev xwm txhim kho ob qho tib si thiab ua kom cov nyhuv tsis muaj zog hypoglycemic ntawm glimepiride. Hauv qab ntawm cov neeg mob sympatholytic, xws li beta-blockers, clonidine, guanethidine thiab reserpine, cov cim ntawm adrenergic counterregulation nyob rau hauv teb rau hypoglycemia tej zaum yuav raug txo lossis ploj.

Thaum noj glimepiride, kev nce los yog qaug zog ntawm kev ua ntawm coumarin derivatives tuaj yeem pom.

Kev haus cawv ib leeg lossis mob ntev tuaj yeem ua rau ob leeg txhim kho thiab tsis muaj zog ntawm cov nyhuv hypoglycemic ntawm glimepiride.

Noj ntau dhau

Cov tsos mob: ib qho mob sai dhau, nrog rau kev kho mob ntev ntev nrog rau cov tshuaj glimepiride ntau dhau, tuaj yeem ua rau muaj kev phom sij hauv lub neej ntshav qab zib.

Kev Kho Mob: sai li sai tau pom tias kev haus ntau dhau hwv, koj yuav tsum qhia koj tus kws kho mob sai. Kev mob ntshav qab zib yog ib txwm muaj peev xwm nres tau sai sai los ntawm kev noj zaubmov sai (cov piam thaj lossis ib qho piam thaj, kua txiv qab zib lossis tshuaj yej). Hauv qhov no, tus neeg mob yuav tsum tau muaj tsawg kawg 20 g piam thaj (4 daim piam thaj). Cov khoom qab zib yog qhov tsis muaj txiaj ntsig hauv kev kho mob ntawm hypoglycemia.

Txog thaum tus kws kho mob txiav txim siab tias tus neeg mob tsis muaj kev phom sij, tus neeg mob yuav tsum tau ua tib zoo saib xyuas mob. Nws yuav tsum nco ntsoov tias hypoglycemia tuaj yeem rov ua haujlwm tom qab kev pib kho thawj zaug ntawm cov concentration ntawm cov piam thaj hauv cov ntshav.

Yog tias ib tug neeg mob uas mob ntshav qab zib tau txais kev kho mob los ntawm cov kws kho mob sib txawv (piv txwv li, thaum nyob hauv tsev kho mob tom qab muaj kev sib tsoo, nrog mob rau hnub so), nws yuav tsum qhia lawv txog nws kev mob nkeeg thiab kev kho mob dhau los.

Qee lub sij hawm yuav tsum tau pw hauv tsev kho mob ntawm tus neeg mob, txawm tias tsuas yog kev ceev faj ua ntej. Tseem ceeb tshaj plaws yog noj ntau dhau thiab muaj kev tsis haum nrog cov kev ua kom pom kev xws li tsis nco qab lossis lwm tus mob loj ntawm cov mob paj hlwb yog qhov mob sai sai thiab xav tau kev kho mob sai sai thiab mus pw hauv tsev kho mob.

Yog tias thaum tus neeg mob tsis nco qab lawm, txoj kev tswj hwm ntawm cov tshuaj tov ntawm dextrose (qabzib) yog tsim nyog (rau cov neeg laus, pib nrog 40 ml ntawm 20% kev daws). Raws li lwm txoj hauv kev rau cov neeg laus, tso cov tshuaj, subcutaneous lossis intramuscular thawj coj ntawm glucagon yog ua tau, piv txwv li ntawm koob tshuaj 0.5-1 mg

Hauv kev kho mob ntawm hypoglycemia vim los ntawm kev tswj hwm kev sib tsoo ntawm Amaril los ntawm cov menyuam mos lossis menyuam yaus, cov tshuaj dextrose tau txais yuav tsum tau ua tib zoo kho nyob rau hauv kev muaj peev xwm txaus ntshai hyperglycemia, thiab kev tswj hwm ntawm dextrose yuav tsum tau ua nyob rau hauv tas li saib xyuas cov ntshav qabzib.

Yog tias muaj kev noj tshuaj ntau dhau ntawm Amaril, tej zaum nws yuav tsum tau ntxuav lub plab thiab coj mus rau hluav ncaig.

Tom qab kev kho kom sai ntawm kev saib xyuas ntawm cov piam thaj hauv cov ntshav, txoj hlab ntshav ntawm dextrose tov ntawm qhov qis qis yog qhov tsim nyog los tiv thaiv kev rov ua haujlwm ntawm hypoglycemia. Qhov siab ntawm cov piam thaj hauv cov ntshav hauv cov neeg mob ntawd yuav tsum tau saib xyuas tas li 24 teev. Thaum mob hnyav nrog lub sij hawm ntev ntawm lub qog ntshav qab zib, qhov kev phom sij ntawm kev txo qis cov concentration ntawm cov piam thaj hauv cov ntshav mus rau qib ntshav hypoglycemic yuav nyob ntev rau ob peb hnub.

Tsuas tshuaj thiab tswj hwm

Sab hauv, tag nrho, yam tsis muaj kev zom, ntxhua kom nrog kua kom txaus (li 0.5 khob).

Raws li txoj cai, koob tshuaj ntawm Amaril yog txiav txim siab los ntawm lub hom phiaj concentration ntawm cov piam thaj hauv cov ntshav. Qhov tshuaj tiv thaiv qis qis txaus kom ua tiav qhov kev tswj hwm metabolic tsim nyog yuav tsum tau siv.

Thaum kho mob nrog Amaril, nws yog ib qho tsim nyog yuav tsum tau txiav txim siab tsis tu ncua cov concentration ntawm cov piam thaj hauv cov ntshav. Tsis tas li ntawd, kev soj ntsuam tas li ntawm glycosylated hemoglobin qib raug pom zoo.

Qhov tsis zoo ntawm kev siv tshuaj, piv txwv li, hla kev siv tshuaj ntxiv, yuav tsum tsis txhob rov qab txais ntxiv los ntawm kev noj tshuaj ntau dua.

Tus neeg mob cov kev coj ua thaum muaj qhov yuam kev thaum noj cov tshuaj (tshwj xeeb, thaum tsis txhaj koob tshuaj ntxiv lossis noj zaub mov noj) lossis cov xwm txheej uas tsis tuaj yeem siv tshuaj, yuav tsum tau tham nrog tus neeg mob thiab tus kws kho mob ua ntej.

Pib xaiv koob thiab koob tshuaj

Thawj qhov tshuaj yog 1 mg ntawm glimepiride 1 zaug ib hnub.

Yog tias tsim nyog, cov koob tshuaj txhua hnub tuaj yeem hloov maj mam nce ntxiv (nyob rau ntu ntawm 1-2 lub lis piam). Nws raug nquahu tias qhov kev nce ntxiv yuav raug saib xyuas hauv kev saib xyuas tas li ntawm cov ntshav qabzib thiab nyob rau hauv raws li cov qib nce ntxiv hauv qab no: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg (−8 mg).

Cov koob tshuaj ntau hauv cov neeg mob uas muaj ntshav qab zib ua tau zoo

Feem ntau, noj tshuaj txhua hnub rau cov neeg mob uas muaj ntshav qab zib kom zoo sib xws yog 1-4 mg glimepiride. Kev noj tshuaj txhua hnub ntau dua 6 mg yuav zoo dua hauv qee tus neeg tsawg xwb.

Lub sijhawm ntawm kev noj tshuaj thiab faib tawm ntawm cov tshuaj thoob plaws hauv lub hnub txiav txim siab los ntawm tus kws kho mob, nyob ntawm tus neeg mob txoj kev ua neej nyob rau lub sijhawm (noj mov, lub sijhawm ntawm kev siv lub cev).

Feem ntau, ib koob tshuaj ib zaug ntawm cov tshuaj thaum nruab hnub yog txaus. Nws pom zoo tias hauv qhov no, tag nrho cov tshuaj ntawm cov tshuaj yuav tsum tau noj tam sim ntawd ua ntej noj tshais tag nrho lossis, yog tias nws tsis noj nyob rau lub sijhawm ntawd, tam sim ntawd ua ntej thawj pluas noj. Nws yog ib qho tseem ceeb heev kom tsis txhob noj mov tom qab noj cov ntsiav tshuaj.

Txij li kev txhim kho metabolic tswj yog txuam nrog kev nce insulin rhiab heev, qhov xav tau rau glimepiride tuaj yeem txo qis thaum kho. Txhawm rau kom tsis txhob muaj kev txhim kho hypoglycemia, nws yog ib qho tsim nyog kom txo cov koob tshuaj lossis tsis noj tshuaj Amaril.

Cov mob uas yuav tau txhaj tshuaj kho qhov mob glimepiride:

Qhov hnyav hauv tus neeg mob

Hloov pauv ntawm tus neeg mob txoj kev ua neej (pauv noj zaub mov, lub caij noj mov, qhov ntau ntawm lub cev ua si),

Txoj kev tshwm sim ntawm lwm yam uas ua rau muaj kev cuam tshuam ua ntej rau kev txhim kho hypoglycemia lossis hyperglycemia (saib ntu "Cov lus qhia tshwj xeeb").

Glimepiride kho mob feem ntau yog ua rau lub sijhawm ntev.

Hloov chaw ntawm tus neeg mob los ntawm lwm tus neeg sawv cev hypoglycemic rau qhov ncauj tswj hwm rau Amaryl

Tsis muaj kev sib raug zoo ntawm cov koob tshuaj ntawm Amaril thiab lwm yam kab mob hypoglycemic rau kev tswj hwm qhov ncauj. Thaum lwm tus neeg sawv cev hypoglycemic rau qhov ncauj tswj hwm tau hloov nrog Amaril, nws raug pom zoo tias cov txheej txheem rau nws txoj kev tswj hwm yog tib yam li nrog kev pib ua thawj coj ntawm Amaril, i.e. kev kho mob yuav tsum pib nrog ib koob tshuaj tsawg kawg ntawm 1 mg (txawm hais tias tus neeg mob hloov mus rau Amaryl nrog qhov siab tshaj plaws ntawm lwm qhov tshuaj hypoglycemic rau kev tswj hwm qhov ncauj). Qhov koob tshuaj nce ntxiv yuav tsum tau nqa tawm hauv theem, suav txog qhov lus teb rau glimepiride raws li cov lus pom zoo saum toj no.

Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv lub zog thiab lub sijhawm ntawm cov nyhuv ntawm yav dhau los hypoglycemic tus neeg sawv cev rau kev tswj hwm qhov ncauj. Kev cuam tshuam kev kho mob tej zaum yuav tsum kom tsis txhob muaj kev sib tham ntawm cov teebmeem uas yuav ua rau muaj kev pheej hmoo ntawm ntshav qab zib.

Siv ua ke nrog metformin

Hauv cov neeg mob uas tsis muaj peev xwm tswj tau tus mob ntshav qab zib mellitus, thaum noj qhov ntau tshaj plaws txhua hnub ntawm ob qho tshuaj glimepiride lossis metformin, kev kho mob nrog kev sib xyaw ntawm ob hom tshuaj no tuaj yeem pib ua. Hauv qhov no, kev kho yav dhau los nrog rau glimepiride lossis metformin txuas ntxiv nyob rau tib theem li qub, thiab cov koob tshuaj ntxiv ntawm metformin lossis glimepiride pib nrog kev txhaj tshuaj tsawg, uas yog tom qab ntawv suav nyob ntawm lub hom phiaj theem ntawm kev tswj metabolic mus txog qhov siab tshaj plaws txhua hnub.Kev sib koom ua ke yuav tsum tau pib hauv kev saib xyuas mob nkeeg zoo.

Siv ua ke nrog cov tshuaj insulin

Hauv cov neeg mob uas tsis muaj peev xwm tswj tau tus mob ntshav qab zib mellitus, insulin tuaj yeem muab rau tib lub sijhawm thaum noj ntau tshaj plaws txhua hnub ntawm glimepiride. Hauv qhov no, koob tshuaj kawg ntawm glimepiride qhia rau tus neeg mob tseem tsis hloov pauv. Hauv qhov no, kev kho tshuaj insulin pib nrog qhov qis qis, uas maj mam nce ntxiv ntawm kev tswj hwm qhov kev tswj hwm ntawm cov piam thaj hauv cov ntshav. Kev kho mob sib xyaw ua ke yuav tsum muaj kev saib xyuas mob nkeeg.

Siv rau hauv cov neeg mob lub raum tsis ua haujlwm. Tsuas muaj lus qhia tsawg ntawm kev siv cov tshuaj rau cov neeg mob uas lub raum tsis ua haujlwm. Cov neeg mob uas lub raum tsis ua haujlwm yuav nkag siab zoo rau lub ntsej muag hypoglycemic ntawm glimepiride (saib ntu "Pharmacokinetics", "Contraindications").

Siv rau hauv cov neeg mob mob siab tsis ua haujlwm. Muaj qee qhov lus qhia ntawm kev siv tshuaj yeeb rau cov nplooj siab ua tsis ua haujlwm (saib Ntu "Kev Tshawb Nrhiav Pov Tseg").

Siv rau menyuam yaus. Cov ntaub ntawv hais txog kev siv cov tshuaj nyob hauv menyuam yaus tsis txaus.

Cov lus qhia tshwj xeeb

Qhov tseem ceeb uas yuav ua rau muaj kev pheej hmoo ntawm lub qog ntshav qab zib muaj xws li:

Nyuaj lossis tsis muaj peev xwm ntawm tus neeg mob (feem ntau pom nyob rau hauv cov neeg laus laus) kom koom tes nrog tus kws kho mob,

Kev noj zaub mov tsis txaus, noj mov tsis xwm yeem los yog yoo mov noj,

Tsis txaus ntawm kev qoj ib ce thiab kev ua kom yuag,

Haus dej cawv, tshwj xeeb tshaj yog ua ke nrog skipped noj mov,

Kev mob raum tsis zoo,

Kev mob siab rau daim siab hnyav (hauv cov neeg mob uas muaj mob rau daim siab hnyav, hloov mus rau txoj kev kho tshuaj insulin, tsawg kawg yog txog thaum tswj kev zom zaub mov tiav),

Kev siv qee cov tshuaj (saib Ntu "Kev Sib Nrog"),

Txais tos ntawm glimepiride thaum tsis muaj kev ntsuas rau nws kev txais tos.

Kev mob ntshav qab zib tsawg tuaj yeem raug tshem tawm sai sai nrog kev noj sai ntawm kev zom cov zaub mov sai sai (qabzib lossis sucrose).

Hauv kev mob ntshav nce siab ntau, kev kho mob tam sim ntawd thiab kev saib xyuas mob, thiab hauv qee kis, pw hauv tsev kho mob ntawm tus neeg mob, ntxiv rau.

Thaum kho nrog glimepiride, yuav tsum soj ntsuam daim siab ua haujlwm thiab daim duab txhav ntshav (tshwj xeeb cov leukocytes thiab platelets).

Chaw tsim tshuaj paus

Sanofi-Aventis Deutschland GmbH, Lub Tebchaws Yelemees, tsim los ntawm Sanofi-Aventis S.p.A. (Ltalis).

Stabilimento di Scoppito, Strada Statale 17, km 22, I-67019 Scoppito (L "Aquilla), Ltalis.

Nws yog ib qho tseem ceeb kom paub! Ib yam tshiab tawm tswv yim los ntawm endocrinologist rau Saib Xyuas Ntshav Qab Zib Ntxiv! Nws tsuas yog tsim nyog txhua hnub.

Qhia me ntsis

Nkaus

Txo cov ntshav qab zib, cuam tshuam nws theem ntawm ob sab:

Tsim kev tsim kho ntawm cov tshuaj insulin, thiab rov qab ua kom tiav thawj zaug, ntu nrawm ntawm nws qhov kev zais. PSM uas tseem tshuav hla lub sijhawm no thiab ua haujlwm nyob rau zaum ob, yog li cov piam thaj txo qis dua.
Txo cov tshuaj insulin ntau dua li lwm PSM.

Tsis tas li ntawd, cov tshuaj txo cov kev pheej hmoo ntawm thrombosis, normalizes cov cholesterol, thiab txo qis oxidative kev nyuaj siab.

Amaryl raug tso tawm hauv cov zis, ib feem los ntawm cov hnyuv, yog li nws tuaj yeem siv rau hauv cov neeg mob raum tsis ua haujlwm, yog tias lub raum ua haujlwm tsis zoo ib feem.

Cov Khoom QhiaMob ntshav qab zib tsuas yog 2 hom. Ib qho yuav tsum tau ua ua ntej rau kev siv yog qee khaws cia beta hlwb, seem synthesis ntawm lawv tus kheej cov insulin. Yog tias tus txiav tsis dhau los tsim cov tshuaj hormones, Amaril tsis tau sau tseg. Raws li cov lus qhia, cov tshuaj muaj peev xwm noj nrog metformin thiab insulin kho. Tsuas tshuaj

Amaryl yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj muaj txog li 4 mg ntawm glimepiride. Rau qhov yooj yim ntawm kev siv, txhua qhov tshuaj tau nws tus kheej xim.

Lub koob tshuaj pib yog 1 mg. Nws yog noj rau 10 hnub, tom qab uas lawv pib maj mam nce ntxiv kom txog thaum qab zib zoo li qub. Qhov ntau kawg pub rau noj yog 6 mg.Yog tias nws tsis them nyiaj rau cov ntshav qab zib, cov tshuaj los ntawm lwm pab pawg lossis cov tshuaj insulin ntxiv rau kev kho mob.

Noj ntau dhauTshaj dhau qhov siab tshaj qhov kawg yuav ua rau muaj ntshav qab zib nyob ntev. Tom qab ib txwm muaj suab thaj, nws tuaj yeem rov poob rau lwm 3 hnub. Txhua lub sijhawm no, tus neeg mob yuav tsum nyob hauv qab kev saib xyuas ntawm cov txheeb ze, nrog kev siv ntau dhau - hauv tsev kho mob.Cov Yuav Tsum Muaj

Cov tshuaj tiv thaiv tsis haum rau glimepiride thiab lwm yam PSM, ntu ntu ntawm cov tshuaj.
Tsis muaj cov tshuaj insulin (ua rau leeg rov qab zoo li qub).
Mob raum tsis ua haujlwm. Muaj peev xwm ntawm kev noj tshuaj Amaril rau cov kab mob hauv lub raum tau txiav txim siab tom qab kuaj xyuas cov khoom nruab nrog.
Glimepiride yog metabolized nyob rau hauv daim siab, yog li ntawd, daim siab tsis ua haujlwm kuj tseem muaj nyob hauv cov lus qhia ua kev sib tiv thaiv.

Kev phom sij ntawm hypoglycemia

Cov piam thaj hauv ntshav qis yog tias cov ntshav qab zib tsis nco qab noj mov lossis tsis ntxiv cov piam thaj hauv lub sijhawm thaum tawm dag zog. Txhawm rau kev loj hlob ntawm glycemia, koj yuav tsum noj cov zaub mov sai sai, feem ntau yog ib qho qab zib, ib khob kua txiv los sis tshuaj yej qab zib tau txaus.

Yog tias cov koob tshuaj ntawm Amaril tau dhau los lawm, kev txo qis ntshav qab zib hauv lub cev yuav rov qab los ntau zaus thaum lub sijhawm tshuaj. Hauv qhov no, tom qab thawj zaug ntawm cov piam thaj li ib txwm, lawv sim tshem glimepiride los ntawm cov hnyuv: lawv ua kom ntuav, haus dej adsorbents lossis laxative. Cov kev noj tshuaj rau lub qog ntshav ntshav siab heev yog yuav tsum tau tso cov piam thaj hauv lub cev.

Sab sij huamNtxiv rau qhov ua rau lub ntsej muag ntshav siab ntshav qis, thaum noj Amaril, cov teeb meem kev zom zaub mov tuaj yeem pom (hauv tsawg dua 1% ntawm cov neeg mob), kev ua xua, xws li tawm pob thiab khaus khaus mus rau qhov tsis txaus ntshai (8%). Tom qab them nyiaj rau tus kab mob, qhov xav tau rau cov tshuaj muaj suab thaj txo tsawg, thiab Amaryl tau thim tawm.

Cov tshuaj tau noj nrog zaub mov. Cov. Cov ntsiav tshuaj tsis tuaj yeem tsoo, tab sis tuaj yeem faib ua ib nrab ntawm kev pheej hmoo. Kev kho Amaril yuav tsum tau noj haus kho kom raug:

Mob ntshav qab zib thiab siab surges yuav yog ib yam dhau los

Mob ntshav qab zib yog qhov ua rau ze li ntawm 80% ntawm tag nrho cov cwj nrag thiab txiav taws. 7 ntawm 10 leej neeg tuag vim txhaws ntawm cov hlab ntsha hauv plawv lossis paj hlwb. Yuav luag txhua qhov teeb meem, qhov laj thawj rau qhov txaus ntshai kawg no yog qhov qub - ntshav qab zib siab.

Cov tshuaj nkaus xwb uas raug pom zoo rau kev kho mob ntshav qab zib thiab nws kuj yog siv los ntawm endocrinologist hauv lawv txoj haujlwm yog qhov no.

Li qub ntawm qab zib - 95%
Kev tshem tawm ntawm cov hlab ntshav thrombosis - 70%
Ntaus tau ntawm lub plawv dhia muaj zog - 90%
Kev tshem tawm ntshav siab - 92%
Qhov nce hauv lub zog nruab hnub, txhim kho pw tsaug zog thaum hmo ntuj - 97%

Cov neeg tsim khoom tsis yog lub koom haum ua lag luam thiab tau nyiaj peev nrog kev txhawb nqa los ntawm lub xeev. Yog li ntawd, tam sim no txhua tus neeg nyob hauv muaj qhov zoo.

cov pluas noj thaum lub sij hawm uas lawv noj tshuaj yuav tsum tau ua kom txaus,
Nyob rau hauv tsis muaj qhov yuav tsum tau koj hla zaub mov. Yog tias koj tsis tuaj yeem noj tshais, Amaril qhov kev txais tos yog pauv mus noj su,
nws yog ib qho tsim nyog los npaj ib qho kev sib xyaw ua ke ntawm cov carbohydrates hauv cov ntshav. Lub hom phiaj no tau ua tiav los ntawm cov pluas noj mov nquag (tom qab 4 teev), kev faib tawm ntawm cov carbohydrates hauv txhua lub tais. Qhov qis dua cov zaub mov, qhov yooj yim dua nws yog kom them taus cov ntshav qab zib kom tsawg.

Amaril yog qaug cawv rau xyoo tsis noj sijhawm so.Yog tias qhov siab tshaj plaws tau tso tseg kom txo cov piam thaj, qhov nrawm nrawm yuav tsum hloov mus rau txoj kev kho tshuaj insulin.

Lub sijhawm ua

Cawv tau zoo

Cov dej cawv ua rau Amaryl tsis paub meej, lawv tuaj yeem ob leeg txhim kho thiab tsis muaj zog nws cov nyhuv. Txoj kev pheej hmoo ntawm lub neej ntshav nce ntshav qab zib tsawg zuj zus, pib nrog kev haus luam yeeb mob pes tsawg. Raws li cov kws kho mob ntshav qab zib, cov cawv zoo haus cawv yog tsis pub ntau tshaj ib khob ntawm vodka lossis ib khob caw .

Amaril qhov piv txwv

Cov tshuaj muaj ntau qhov sib piv nrog pheej yig dua nrog tib cov tshuaj nquag thiab tshuaj ntau npaum li cas, cov tshuaj hu ua generics. Yeej, cov no yog ntsiav tshuaj ntawm kev tsim khoom hauv teb chaws, los ntawm cov neeg txawv teb chaws koj tuaj yeem yuav tsuas cov Croatian Glimepirid-Teva. Raws li kev txheeb xyuas, cov Lavxias analogues tsis muaj qhov phem dua li cov tshuaj Amaril ntshuam.

Amaril qhov piv txwv	Lub teb chaws ntau lawm	Chaw tsim tshuaj paus	Nqe rau yam tsawg kawg nkaus noj, tshiav.
Glimepiride	Lavxias	110
Glimepiride Canon		Canonfarm Ntau Lawm.	155
Diamerid		Akrikhin	180
Glimepiride-teva	Croatia	Pliva ntawm Khrvatsk	135
Glemaz	Lub teb chaws Argentina	Kimika Montpellier	tsis muaj nyob hauv cov chaw muag tshuaj

Amaryl lossis Diabeton

Tam sim no, PSM niaj hnub thiab muaj kev nyab xeeb tshaj plaws yog glimepiride thiab ib daim ntawv ntev ntev ntawm gliclazide (thiab analogues). Ob qho tshuaj yeeb tshuaj muaj tsawg dua li lawv cov neeg ua ntej mus ua rau mob ntshav nce siab ntau.

Thiab tseem, Amaryl ntsiav tshuaj rau ntshav qab zib yog qhov zoo:

Tus kws kho mob ntawm Kev Tshawb Fawb Kev Kho Mob, Lub Taub Hau ntawm lub koom haum ntawm Diabetology - Tatyana Yakovleva

Kuv tau kawm mob ntshav qab zib tau ntau xyoo. Nws yog txaus ntshai thaum muaj coob tus neeg tuag, thiab haj yam ua rau neeg xiam vim ntshav qab zib.

Kuv maj nrawm los qhia txoj xov zoo - Endocrinological qhov chaw tshawb fawb ntawm Lavxias Academy ntawm Medical Science tau tswj hwm los tsim cov tshuaj uas kho cov ntshav qab zib kom meej. Thaum lub sijhawm, cov hauj lwm zoo ntawm cov tshuaj no tau nce mus txog 98%.

Lwm qhov xov xwm zoo: Ministry of Health tau ua ib qho kev saws me nyuam uas them rau cov nqi tshuaj ntau heev. Hauv Lavxias, neeg mob ntshav qab zib kom txog lub Peb Hlis 2 tuaj yeem tau txais nws - Tsuas yog 147 rubles!

lawv cuam tshuam qhov hnyav ntawm cov neeg mob tsawg dua
txoj kev tsis zoo ntawm lub cev kev mob ntshav tsis yog li ntawd,
cov mob ntshav qab zib xav kom tsawg dua cov tshuaj (qhov ntau tshaj plaws ntawm Diabeton kwv yees sib raug rau 3 mg ntawm Amaril),
qhov txo qis hauv qab zib thaum noj Amaril yog nrog los ntawm kev poob qis hauv qib hauv insulin. Rau Diabeton, qhov no sib piv yog 0.07, rau Amaril - 0.03. Hauv seem PSM, qhov sib piv yog qhov tsis zoo: 0.11 rau glipizide, 0.16 rau glibenclamide.

Amaryl lossis Glucophage

Hais lus nruj me ntsis, cov lus nug Amaril lossis Glucofage (metformin) yuav tsum tsis txhob nug. thiab nws cov analogues rau cov ntshav qab zib hom 2 yeej ib txwm sau tseg rau hauv thawj qhov chaw, txij li thaum lawv siv tau zoo dua li lwm cov tshuaj ua rau qhov tseem ceeb ntawm tus kab mob - kev tiv thaiv cov tshuaj insulin. Yog tias tus kws kho mob tsuas sau cov ntsiav tshuaj Amaryl xwb, nws lub peev xwm yog tsim nyog ua xyem xyav .

Amaril thiab Yanumet

Yanumet, zoo li Amaryl, cuam tshuam rau ob theem insulin thiab insulin kuj.Cov tshuaj sib txawv ntawm cov txheej txheem ntawm kev ua thiab tshuaj qauv, yog li lawv tuaj yeem sib koom ua ke. Yanumet yog ib qho tshuaj kuj tshiab, yog li ntawd nws raug nqi los ntawm 1800 rubles. rau pob khoom me tshaj plaws. Hauv Lavxias, nws cov analogues tau sau npe: Combogliz thiab Velmetia, uas tsis pheej yig dua li qhov qub.

Feem ntau, kev tiv thaiv ntshav qab zib tuaj yeem ua tiav los ntawm kev sib xyaw ua ke ntawm pheej yig metformin, kev noj zaub mov zoo, kev tawm dag zog, qee zaum cov neeg mob xav tau PSM. Yanumet muaj nqis yuav tsuas yog them tus nqi tsis tseem ceeb rau peev nyiaj.

Kev tsis ua raws li kev mob ntshav qab zib nrog cov kev kho mob kws kho mob yog vim li cas. Tshaj tawm ntawm txoj kev kho kev kho rau txhua yam mob tshwm sim ib txwm txhim kho nws cov txiaj ntsig, yog li, rau cov neeg mob xaiv yeem, cov tshuaj sib xyaw ua ke yog qhov zoo dua. Amaryl M muaj cov tshuaj feem ntau ntawm cov tshuaj qab zib-txo qis: metformin thiab PSM. Txhua ntsiav tshuaj muaj 500 mg ntawm metformin thiab 2 mg ntawm glimepiride.

Nws yog tsis yooj yim sua kom meej meej sib npaug ob qho kev sib xyaw hauv ib ntsiav tshuaj rau cov neeg mob sib txawv. Hauv nruab nrab theem ntawm ntshav qab zib, ntau dua metformin, tsawg dua glimepiride yuav tsum. Tsis pub ntau tshaj 1000 mg ntawm metformin pub rau ib zaug, cov neeg mob uas muaj mob loj yuav tsum haus Amaril M peb zaug ib hnub. Txhawm rau xaiv cov tshuaj ntau npaum li cas, nws raug nquahu rau cov neeg mob uas tau txiav txim siab coj Amaril cais thaum noj tshais thiab Glucofage peb zaug ib hnub.

Pharmacological kev txiav txim ntawm cov tshuaj

Cov piam thaj ntau dhau yog nqus tau feem ntau los ntawm cov keeb ntawm cov leeg nqaij ntawm lub cev.

Thaum siv txoj kev kho kom sib xyaw ua ke sib xyaw nrog metformin, cov neeg mob tau txhim kho kev tswj cov metabolism hauv cov piam thaj hauv lub cev.

Ua cov txheej txheem kho mob ua ke nrog kev siv tshuaj insulin. Txoj kev tswj hwm no yog siv nyob rau hauv cov teeb meem uas qhov kev ua haujlwm zoo tshaj plaws ntawm cov khoom noj hauv lub cev tsis ua tiav thaum noj ib hom tshuaj.Thaum coj ua hom tshuaj no rau kev kho mob ntshav qab zib mellitus, yuav tsum tau txhaj tshuaj kom haum ntawm cov tshuaj insulin.

Tus nqi ntawm cov tshuaj dej los siv rau hauv hom kev kho mob no raug txo ntau.

Pharmacokinetics ntawm cov tshuaj

Cov metabolism ntawm cov tshuaj nquag yog nqa tawm hauv cov nqaij hauv lub siab. Lub ntsiab isoenzyme koom nrog cov metabolism hauv yog CYP2C9. Thaum lub cev cov metabolism hauv cov compound tseem ceeb, ob lub cev tsim muaj, uas yog tom qab ua rau hauv cov quav thiab tso zis.

Raws li cov txiaj ntsig ntawm kev tshawb fawb, nws pom tias pharmacokinetics tsis nyob ntawm tus neeg mob tus txiv neej thiab nws pawg hnub nyoog.

Cov yam ntxwv dav dav ntawm cov tshuaj

Tus kws kho mob tshwj xeeb tshaj tawm tshuaj Amaril rau cov neeg mob uas muaj ntshav qab zib hom 2 li tshuaj tua kab mob los yog thaum sib xyaw nrog cov tshuaj tiv thaiv ntshav qab zib.

Txawm li cas los xij, kev noj tshuaj tsis txwv tsis tau txuas ntxiv ua raws li kev noj haus kom zoo, uas tsis suav nrog cov rog thiab yooj yim zom cov zaub mov carbohydrates, thiab kev ua lub neej muaj sia.

Cov lus qhia rau kev siv tshuaj

Tus kws kho mob ntshav qab zib uas tau tswj tus kab mob zoo glycemic noj ib koob tshuaj txhua hnub txog 4 mg.

txo qhov hnyav
hloov hauv txoj kev ua neej (khoom noj khoom haus, kev ntxhov siab, sijhawm noj mov),
lwm yam.

Nws yog qhov yuav tsum tau sab laj nrog tus kws kho mob thiab pib nrog qhov koob tshuaj tsawg kawg (1 mg) ntawm Amaril yog tias tus neeg mob xav tau:

hloov lwm cov tshuaj txo suab thaj nrog Amaril,
kev sib xyaw ntawm glimepiride thiab metformin,
Qhov sib xyaw ua ke yog glimepiride thiab insulin.

Nws tsis pom zoo kom noj tshuaj rau cov neeg mob uas mob raum, thiab mob raum thiab mob siab.

Cov kev thaiv tsis zoo thiab cov tshuaj tiv thaiv tsis zoo

Amaril glimepiride muaj nyob hauv cov tshuaj, ntxiv rau cov khoom ntxiv, tsis yog ib txwm muaj lub txiaj ntsig zoo rau lub cev ntawm cov ntshav qab zib.

Xws li lwm yam kev txhais tau tias, cov tshuaj muaj contraindications.

Nws yog txwv tsis pub cov neeg mob noj tshuaj hauv cov xwm txheej hauv qab no:

hom mob ntshav qab zib insulin,
lub sijhawm uas xeeb tub thiab pub niam mis,
(ua txhaum ntawm cov carbohydrate metabolism), qhov xwm txheej ntawm cov ntshav qab zib ua ntej thiab coma,
cov neeg mob hnub nyoog qis dua 18,
galactose intolerance, lactase tsis muaj zog,
kev txhim kho ntawm cov piam thaj-galactose malabsorption,
ua txhaum lub siab thiab lub raum, nyob rau hauv cov neeg mob tshwj xeeb tshaj tawm hemodialysis,
cov tib neeg tsis kam mloog rau cov tshuaj, sulfonylurea derivatives, sulfonamide cov neeg sawv cev.

Nrog rau kev siv tsis raug ntawm cov ntsiav tshuaj (piv txwv, hla kev nkag mus), kev txhaum loj tuaj yeem tshwm sim:

Cov kev mob ntshav siab, qhov cim ntawm qhov mob taub hau thiab kiv taub hau, hnov qab zoo, ua nruj ua tsiv, tsis meej pem, tsaug zog, tsaus muag, tshee, tshee, thiab tsis pom kev.
Adrenergic qhov kev tawm tsam ua raws li qhov lus teb rau kev txo qis sai sai, pom los ntawm kev ntxhov siab, palpitations, tachycardia, lub plawv tsis sib haum thiab ua kom pom kev tawm hws.
Kev mob plab zom mov - txhaws qa ntawm xeev siab, ntuav, pom pob txha, mob plab, raws plab, ua kom muaj kab mob siab, muaj kev ua haujlwm ntawm daim siab ua haujlwm siab, mob daj ntseg lossis cholestasis.
Kev ua txhaum ntawm cov kab mob hematopoietic - leukopenia, thrombocytopenia, granulocytopenia thiab qee yam kev ua kab mob.
Ua xua, tshwm sim los ntawm daim tawv nqaij ua pob ua xua, khaus, urticaria, qee zaum anaphylactic poob siab thiab ua xua vasculitis.

Lwm cov kev cuam tshuam no tseem muaj peev xwm ua tau - photosensitization thiab hyponatremia.

Nqi, tshuaj xyuas thiab analogues

1 mg 30 ntsiav tshuaj - 370 rub.,
2 mg 30 ntsiav tshuaj - 775 rubles.,
3 mg 30 ntsiav tshuaj - 1098 rub.,
4 mg 30 ntsiav tshuaj - 1540 rub.,

Raws li kev xav ntawm cov ntshav qab zib hais txog qhov ua tau zoo ntawm cov tshuaj, lawv tau zoo. Nrog rau kev siv sijhawm ntev ntawm cov tshuaj, cov piam thaj pleev rov qab rau qhov qub. Txawm hais tias daim ntawv teev npe muaj ntau cov kev mob tshwm sim, qhov feem pua ntawm lawv qhov pib me me heev. Txawm li cas los xij, muaj kev tshuaj xyuas tsis zoo ntawm cov neeg mob cuam tshuam nrog tus nqi siab ntawm cov tshuaj.Ntau ntawm lawv yuav tsum nrhiav Amaril hloov chaw.

Ib ntsiav tshuaj ntawm cov tshuaj suav nrog cov tshuaj nquag - glimepiride - 1-4 mg thiab cov ntu pabcuam: lactose monohydrate, povidone, sodium carboxymethyl hmoov txhuv nplej siab, microcrystalline cellulose, indigo carmine thiab magnesium stearate.

Daim ntawv tso tawm

Amaryl yog tsim tawm hauv cov ntsiav tshuaj muaj 1-4 mg, uas tau ntim hauv 15 daim ib lub hlwv. Ib pob ntawm cov tshuaj yuav muaj xws li 2, 4, 6 lossis 8 lub hlwv.

Pharmacological kev txiav txim

Amaryl ntsiav tshuaj muaj cov nyhuv hypoglycemic.

Pharmacodynamics thiab pharmacokinetics

Cov Yuav Tsum Muaj

Muaj ib daim ntawv teev cov khoom lag luam zoo sib xws rau kev noj tshuaj Amaril:

1 hom
ua txhaum cai hnyav rau daim siab thiab lub raum,
ketoacidosis uas mob ntshav qab zib, precoma thiab coma,
, ,
muaj cov kab mob muaj mob tsis tshua muaj mob, piv txwv li, galactose intolerance, glucose-galactose malabsorption lossis lactase deficiency,
cov me nyuam muaj hnub nyoog
intolerance lossis rhiab rau yeeb tshuaj thiab lwm yam.

Sab sij huam

Thaum kho nrog Amaril, ntau yam tsis txaus siab tshwm sim tuaj yeem tsim kho, ib txoj kev los yog lwm qhov cuam tshuam kev ua haujlwm ntawm yuav luag txhua lub cev. Feem ntau, cov kev mob tshwm sim los ntawm cov qog ntshav qab zib, cov tsos mob uas tau hais tawm:, kev tshaib plab, xeev siab, ntuav,,, thiab ntau lwm cov tsos mob. Qee zaum cov kab mob hnyav hnyav ntawm kev txo ntshav qab zib zoo nkaus li mob stroke. Tom qab nws tshem tawm, pliaj tsis pom tsos mob kuj ploj tag.

Nyob rau theem pib ntawm kev kho mob, teeb meem nrog lub zeem muag, lub plab zom mov, thiab ntshav tsim tau tshwm sim. Nws kuj tseem muaj kev txhim kho, uas tuaj yeem tig mus rau hauv cov nyom. Yog li, yog tias tsis pom cov tsos mob tshwm sim, koj yuav tsum sab laj nrog kws kho mob.

Cov lus qhia rau Amaryl (Txujci thiab ntau npaum li cas)

Cov ntsiav tshuaj yog npaj rau kev siv sab hauv tag nrho, yam tsis muaj ntxo thiab haus dej kom ntau.

Thaum pib ntawm kev kho mob, cov neeg mob tau sau tshuaj rau txhua hnub yog 1 mg. Yog tias tsim nyog, cov koob tshuaj yog maj mam nce, ua kev soj ntsuam tas li ntawm ntshav qabzib concentration raws li cov txheej txheem: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg - 8 mg. Kev siv tshuaj txhua hnub nyob hauv cov neeg mob uas tswj tau zoo yog 1-4 mg ntawm cov tshuaj nquag. Kev noj tshuaj txhua hnub ntawm 6 mg lossis ntau dua tsim cov kev cuam tshuam tsuas yog qee tus neeg mob.

Feem ntau, kev noj ib leeg ib hnub ntawm cov tshuaj yog kws kho, ua ntej noj tshais tag nrho lossis thawj pluas noj. Nws yog ib qho tseem ceeb uas tom qab noj cov ntsiav tshuaj tsis nco qab noj mov.

Nws paub tias kev txhim kho metabolic tswj tau cuam tshuam nrog nce insulin rhiab heev, thiab thaum kho, qhov xav tau glimepiride yuav poob.Koj tuaj yeem zam qhov kev txhim kho hypoglycemia los ntawm kev txo cov tshuaj noj kom tsawg lossis tsis noj tshuaj Amaril.

Thaum lub sij hawm kho txheej txheem, tshuaj kho kom haum glimepiride tuaj yeem ua tau thaum:

luj txo
kev ua neej pauv
kev tshwm sim ntawm lwm yam ua rau muaj kev phom sij rau hypoglycemia lossis hyperglycemia.

Raws li txoj cai, Amaril kev kho mob yog nqa tawm ntev.

Noj ntau dhau

Yog tias dhau sijhawm siv tshuaj ntau dhau lossis siv sijhawm ntev siv ntau glimepiride Mob ntshav qab zib heev, uas yuav ua tau kom tuag taus, tej zaum kuj yuav tshwm sim.

Yog tias pom muaj overdose, koj yuav tsum tau sab laj nrog kws kho mob sai. Kev ua ntshav qab zib kom nres tuaj yeem nres los ntawm kev noj haus carbohydrates, piv txwv li, piam thaj lossis ib qho me me ntawm cov khoom qab zib. Txog thaum cov tsos mob ntawm tus mob ntshav qab zib tau raug tshem tawm tag, tus neeg mob yuav tsum tau ua tib zoo saib xyuas kev kho mob, vim tias qhov kev xav tsis tuaj yeem rov ua dua. Txoj kev kho ntxiv yog nyob ntawm cov tsos mob.

Kev sib txuam

Kev siv cov ntsiab lus ntawm glimepiride nrog qee cov tshuaj tuaj yeem ua rau kev txhim kho ntawm hypoglycemia, piv txwv li, nrogCov tshuaj insulin thiab lwm yam kab mob hypoglycemic, ACE inhibitors, tshuaj anabolic steroids thiab txiv neej nrog txiv neej cov tshuaj hormonesderivatives Coumarin, Cyclophosphamide, Dizopyramide, Fenfluramine, Feniramidol, Fibrates, Fluoxetine, Guanethidine, Ifosfamide, MAO inhibitors, para-aminosalicylic acid, Phenylbutazone, Azapropazone, Oksifenbutazonom, Salinamilamilam thiab lwm tus.

Txais tos , barbiturates , GKS , diazoxides , tshuaj kho mob , thiab lwm cov neeg muaj mob sympathomimetic, tshuaj noj plab (nrog rau siv ntev), (hauv kev siv tshuaj ntau), tshuaj estrogen thiab progestogens, phenothiazines, phenytoins, rifampicins,iodine-muaj cov thyroid hormones ua rau lub cev tsis muaj zog ntawm cov nyhuv hypoglycemic, thiab raws li, nce qhov kev nce siab ntawm cov piam thaj hauv cov ntshav.

Yuav kom ntxiv dag zog lossis ua kom cov ntshav hypoglycemic ntawm glimepiride muaj peev xwm los thaiv H2-histamine receptors,, thiab beta-blockers.

Cov nqe lus ntawm kev muag khoom

Hauv cov khw muag tshuaj, cov tshuaj tau muab faib tawm nrog cov tshuaj noj.

Kev Rov Ntsuam Xyuas Amaril

Ntau cov kev tshuaj xyuas ntawm cov neeg mob thiab cov kws kho mob tshwj xeeb qhia tias nyob rau hauv kev kho mob ntshav qab zib mellitus, txoj kev xaiv kom zoo ntawm kev noj tshuaj thiab cov txheej txheem tshuaj yog qhov tseem ceeb tshwj xeeb.

Ntxiv mus, kev tshuaj xyuas ntawm Amaril qhia tias cov tshuaj no tsis haum rau txhua tus mob ntshav qab zib. Kuj ntau, nyob rau theem pib ntawm kev kho, cov neeg mob muaj kev hloov pauv siab rau cov piam thaj hauv cov ntshav. Txawm li cas los xij, cov kws tshaj lij muaj kev cia siab tias nyob rau hauv cov xwm txheej zoo li no, txoj kev kho kom haum yog qhov tsim nyog nyob rau hauv kev coj ntawm kev nce thiab qhov no tsis yog txhua qhov kev ntsuas ntawm qhov tsis muaj peev xwm ntawm cov tshuaj.

Ntawm chav kawm, txhua qhov kev hloov pauv cuam tshuam nrog ob qho zuj zus thiab txo qis tshuaj yuav tsum tau ua nyob rau hauv kev saib xyuas los ntawm tus kws tshaj lij. Nws tau tsim tsa tias qhov tsis paub ntawv txais tos ntawm Amaril tuaj yeem ua rau muaj kev cuam tshuam kab mob.

Qhov zoo tshaj plaws analogs ntawm amaryl

Pharmacological kev txiav txim ntawm cov tshuaj

Pharmacokinetics ntawm cov tshuaj

Cov yam ntxwv dav dav ntawm cov tshuaj

Cov lus qhia rau kev siv tshuaj

Cov kev thaiv tsis zoo thiab cov tshuaj tiv thaiv tsis zoo

Nqi, tshuaj xyuas thiab analogues

Amaril - cov lus qhia rau siv nyob rau hauv kev kho mob ntshav qab zib, mechanism ntawm kev txiav txim, contraindications thiab tshuaj xyuas

Kev ntsuas rau siv

Cawv thiab Amaryl

Yeeb tshuaj sib cuam tshuam

Sab sij huam

Noj ntau dhau

Amaril qhov piv txwv

Amaril lossis Diabeton - uas yog ib qho zoo dua

Amaril tus nqi

Amaryl ntsiav tshuaj - cov lus qhia, tshuaj xyuas ntawm tus tswv tsev, nqi

Qhia me ntsis

Amaryl lossis Glucophage

Amaril thiab Yanumet

Tus mob ntshav qab zib, Maninil thiab cov tshuaj muaj suab thaj zoo - uas zoo dua rau noj nrog ntshav qab zib?

Tus kws kho hniav mob ntshav qab zib thiab mob ntshav qab zib MV: sib txawv

Kuv tuaj yeem nqa tib lub sijhawm?

Nrog Glucophage

Gliclazide MV

Glidiab MV

Kev sib xyaw, ntau npaum, tshuaj noj daim ntawv

Kho thaj chaw

Txoj kev ntawm daim ntawv thov

Cov Kev Tsis Txaus Ntseeg thiab Kev Ceev Faj

Hla kev sib txuam yeeb tshuaj

Sab sij huam

Daim ntawv tso tawm

Kev sib txuam

Hnub tas sij hawm

Cev xeeb tub, lactation

Kev piav qhia ntawm daim ntawv tshuaj

Cov Tshuaj Pharmacokinetics

Cov Tshuaj Hauv Tshuaj

Cev xeeb tub thiab lactation

Cov lus qhia tshwj xeeb

Chaw tsim tshuaj paus

Mob ntshav qab zib thiab siab surges yuav yog ib yam dhau los

Lub sijhawm ua

Cov Yuav Tsum Muaj

Cov lus qhia rau Amaryl (Txujci thiab ntau npaum li cas)

Cov nqe lus ntawm kev muag khoom

Cov Nta Cia

Hnub tas sij hawm

Cawv thiab Amaryl

Cev xeeb tub, lactation

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Kev piav qhia ntawm daim ntawv tshuaj

Ntseg

Pharmacological kev txiav txim

Cov Tshuaj Pharmacokinetics

Cov Tshuaj Hauv Tshuaj

Cov Yuav Tsum Muaj

Cev xeeb tub thiab lactation

Sab sij huam

Kev sib txuam

Noj ntau dhau

Tsuas tshuaj thiab tswj hwm

Cov lus qhia tshwj xeeb

Chaw tsim tshuaj paus

Qhia me ntsis

Mob ntshav qab zib thiab siab surges yuav yog ib yam dhau los

Lub sijhawm ua

Cawv tau zoo

Amaril qhov piv txwv

Amaryl lossis Diabeton

Amaryl lossis Glucophage

Amaril thiab Yanumet

Pharmacological kev txiav txim ntawm cov tshuaj

Pharmacokinetics ntawm cov tshuaj

Cov yam ntxwv dav dav ntawm cov tshuaj

Cov lus qhia rau kev siv tshuaj

Cov kev thaiv tsis zoo thiab cov tshuaj tiv thaiv tsis zoo

Nqi, tshuaj xyuas thiab analogues

Daim ntawv tso tawm