Yuav ua li cas hloov Galvus mob ntshav qab zib: hauv tsev thiab txawv teb chaws analogues

Ntshav Tshuaj Ntshav Qab Zib Galvus thiab Galvus: Kawm txhua yam koj xav tau. Cov hauv qab no yog cov lus qhia kev qhia sau ua hom lus yooj yim. Kawm paub cov cim, contraindications thiab noj tshuaj. Galvus Met yog cov tshuaj zoo rau hom ntshav qab zib hom 2, uas nrov heev, txawm tias nws cov nqi ntau. Nws ua rau cov ntshav qab zib kom qis thiab ua rau muaj kev phiv loj heev. Cov tshuaj nquag ua haujlwm ntawm cov tshuaj sib xyaw ua ke yog vildagliptin thiab metformin. Galvus ntsiav tshuaj muaj cov vildagliptin ntshiab, tsis muaj metformin.

Nyeem cov lus teb rau cov lus nug:

1. Yanumet lossis Galvus Met: yam tshuaj no zoo dua.
2. Yuav noj cov tshuaj no li cas kom tsis txhob mob plab zom mov.
3. Kev sib piv ntawm Galvus thiab Galvus Ntsib nrog cawv.
4. Yuav hloov cov vildagliptin li cas yog tias nws pab tsis tau lossis nws kim heev.

Galvus thiab Galvus Met: ib tshooj lus ntxaws

Galvus yog qhov quav tshuaj tshiab. Nws pib muag tsawg dua 10 xyoo dhau los. Nws tsis muaj qhov pheej yig hauv tsev hloov, vim hais tias cov kev tsim muaj ntawv tsis tas. Muaj cov analogues ntawm cov tuam txhab sib tw - Januvia thiab Yanumet, Onglisa, Vipidiya thiab lwm tus. Tab sis tag nrho cov tshuaj no tseem tiv thaiv patents thiab nws kim heev. Hauv qab no nws tau piav qhia txhua yam nqi dab tsi koj tuaj yeem hloov vildagliptin yog tias koj tsis tuaj yeem kho cov tshuaj no.

Cov lus qhia rau kev siv

Thaum noj Galvus lossis Galvus Met, zoo li lwm cov ntsiav tshuaj ntshav qab zib, koj yuav tsum ua raws li kev noj haus.

Galvus Met muaj cov neeg mob tshuaj xyuas zoo tshaj plaws ntawm txhua hom 2 tshuaj mob ntshav qab zib uas tau muag hauv cov tebchaws Lavxias. Ntau tus neeg mob khav theeb tias cov tshuaj no tau txo lawv cov suab thaj los ntawm lub ntuj-siab ntsuas txog 7-8 mmol / L. Ntxiv mus, tsis tsuas yog muaj cov piam thaj hauv qab no txhim kho, tab sis kuj hais txog kev muaj txiaj ntsig. Txawm li cas los xij, vildagliptin tsis yog panacea rau ntshav qab zib, txawm tias ua ke nrog metformin. Koj yuav tsum ua lub neej noj qab haus huv, tshwj xeeb yog ua raws kev noj haus. Hauv cov ntshav qab zib hnyav, tsis muaj ib hom tshuaj, txawm tias kim tshaj plaws thiab niaj hnub, tuaj yeem hloov cov tshuaj insulin.

Galvus lossis Galvus Met: uas yog qhov zoo dua? Lawv sib txawv li cas?

Galvus yog cov tshuaj vildagliptin, thiab Galvus Met yog cov tshuaj sib xyaw ua ke uas muaj vildagliptin thiab metformin. Feem ntau yuav ua, metformin txo qis ntshav qab zib hauv ntshav qab zib ntau dua li vildagliptin. Yog li, koj yuav tsum tau coj Galvus Met, tshwj tsis yog tias tus neeg mob muaj mob loj contraindications rau kev teem caij metformin. Lub sijhawm thaum ntxov ntawm kev kho mob, raws plab, xeev siab, tsam plab thiab lwm yam kev mob plab zom mov tuaj yeem tshwm sim. Tab sis nws yog tsim nyog tos thiab tos kom txog thaum lawv dhau. Qhov kev ua tiav tau txiaj ntsig koj them rau qhov tsis xis nyob.

Lub analogues lub ntsiab ntawm Galvus

Lub sijhawm no, ntau ntawm Galvus analogues tau tsim, uas tuaj yeem yog ob qho qauv hauv hauv lawv pawg thiab hauv lawv cov chaw muag tshuaj.

Galvus Met yog txoj kev sib ntxiv hauv tsev ntawm Galvus. Kev sib xyaw ua ke ntawm Galvus Met muaj nyob rau hauv ntau npaum ntawm 50 + 1000, vildagliptin hauv ib zaug tsuas muaj 50 mg, metformin 100 mg.

Cov tshuaj yeeb yaj kiab uas nrov tshaj plaws ntawm Galvus hauv kev siv tshuaj ntawm 50 mg yog cov tshuaj hauv qab no:

Txhua yam kev hloov pauv rau cov khoom qub muaj, hauv kev sib piv nrog nws, tag nrho cov kev zoo ntawm qhov zoo thiab qhov tsis zoo, uas yuav tsum tau xav txog ntau yam.

Qhov no tso cai rau cov kev taw qhia ntxiv nyob rau hauv ntau cov suab thaj txo cov tshuaj qhia ntawm kev lag luam tshuaj hauv tsev.

Vipidia - hloov chaw rau Galvus

Vipidia yog ib tus neeg sawv cev hypoglycemic, tus nquag ua haujlwm ntawm uas yog alogliptin. Kev siv cov tshuaj thaum kho mob hom 2 mob ntshav qab zib mellitus tuaj yeem txo cov ntshav glycated hemoglobin thiab ntshav qabzib hauv tus neeg mob lub cev.

Qhov sib txawv ntawm Vipidia thiab Galvus lus dag hauv cov nquag siv, txawm hais tias ob qho ntawm ob leeg koom nrog tib pawg ntawm cov tebchaw - DPP-4 inhibitors.

Cov tshuaj siv ob qho tib si thaum lub sij hawm monotherapy thiab raws li ib feem ntawm txoj kev kho mob ntawm pathology nyob rau hauv daim ntawv ntawm ib ntawm cov tshuaj. Qhov noj tshuaj zoo txhua hnub yog 25 mg. Lub cuab yeej tuaj yeem nqa tawm tsis hais lub sijhawm noj mov.

Cov tshuaj yog contraindicated nyob rau hauv kev kuaj pom ntawm cov cim qhia ntawm ketoacidosis nyob rau hauv tus neeg mob.

Ntxiv rau, kev siv cov khoom yog txwv thaum:

• ntshav qab zib hom 1
• lub plawv dhia tsis zoo
• lub raum thiab lub siab ua haujlwm.

Thaum siv cov analog zoo dua ntawm Galvus, cov neeg tsim khoom lag luam qhia qhov tshwm sim muaj tshwm sim ntawm kev mob tshwm sim hauv qab no:

1. Mob taub Hau.
2. Mob hauv lub epigastrium.
3. Cov tawv nqaij ua pob.
4. Kev kis kab mob ntawm ENT plab hnyuv siab raum.

Cov tshuaj pheej yig no, raws li cov lus qhia, tsis yog kws kho rau kev kho mob ntshav qab zib hom II hauv cov menyuam yaus thiab cov poj niam cev xeeb tub, vim tsis muaj ntaub ntawv qhia txog kev cuam tshuam ntawm cov tshuaj tiv thaiv nquag rau lub xeev ntawm lub cev hauv cov pawg ntawm cov neeg mob no.

Trazhenta yog ib cov tshuaj uas siv pab txo cov suab thaj hauv lub cev rau cov neeg mob ntshav qab zib hom 2. Lub hauv paus ntawm cov nquag tiv thaiv ntawm cov tshuaj yog linagliptin. Cov compound no muab qhov kev txo qis hauv cov ntshav qabzib hauv lub siab thiab ua rau qhov ntsuas pom hauv cov ntshav ntshav. Kev qhia siv yog muaj nyob rau hauv tus neeg mob ntawm decompensated hom 2 mob ntshav qab zib.

Qhov sib txawv ntawm Galvus yog tias cov tshuaj no tsis muaj kev txwv kom meej meej ntau npaum. Cov koob txhaj tshuaj yuav tsum tau xaiv ib tus zuj zus.

Cov tshuaj tsis yog siv rau cov ntshav qab zib hom 1, zoo li nyob ib puag ncig lub cev tsis kam yoog rau cov tshuaj thiab ntshav qab zib ketoacidosis.

Thaum lub sij hawm kho, qhov tsis muaj kev xav tshwm sim nyob rau hauv daim ntawv ntawm hnoos, mob pancreatitis thiab qhov ntswg txhaws tshwm sim.

Cov tshuaj tsis tau sau tseg thaum kho mob pathology hauv cov menyuam yaus hnub nyoog qis dua 18 xyoo thiab poj niam cev xeeb tub.

Qhov sib txawv ntawm Onglizy los ntawm Galvus

Onglisa yog ib tus neeg sawv cev ntawm lub qhov ncauj hypoglycemic. Onglisa txawv ntawm Galvus hauv thawj qhov chaw los ntawm cov khoom siv tseem ceeb. Tsis zoo li Galvus, muaj cov vildagliptin, Onglisa muaj saxagliptin nyob rau hauv daim ntawv ntawm hydrochloride. Ob lub tshuab ua ke nquag koom nrog tib pab pawg muab tshuaj - DPP-4 inhibitors.

Kev siv cov tshuaj rau cov ntshav qab zib hom 2 mob ntshav qab zib tuaj yeem txo cov ntshav qog thiab cov piam thaj hauv cov ntshav ua ntej thiab tom qab noj mov. Onglyza yog tus kws kho mob tshuaj tua kab mob, ntxiv rau kev ua kom tsis tshua muaj txiaj ntsig ntawm kev noj zaub mov noj, nrog rau kev tiv thaiv kab mob kev kho mob.

Contraindication los siv yog:

• muaj cov ntshav qab zib hom 1,
• ua txoj kev kho kom zoo ua ke nrog kev siv cov tshuaj insulin,
• kev txhim kho hauv tus neeg mob lub cev ntawm ketoacidosis.

Hauv kev coj ua kev ntsuas kev kho mob nrog kev pab ntawm cov tshuaj no, tus neeg mob yuav muaj kev phiv xws li mob taub hau, txhim kho o, zoo li txhaus ntswg, mob caj pas.

Kev siv cov tshuaj hauv kev kho mob ntawm cov menyuam yaus thiab cov poj niam uas muaj menyuam yaus yog qhov txwv tsis pub, vim tsis muaj cov ntaub ntawv kuaj mob pom tseeb txog cov nyhuv ntawm cov tshuaj sib xyaw ntawm cov pab pawg ntawm cov neeg mob.

Januvius - Generic Galvus

Yanuvuya yog cov tshuaj hypoglycemic tsim los ntawm sitagliptin. Muaj nyob hauv ntsiav tshuaj daim ntawv.

Kev siv cov tshuaj pab ua rau txhawm rau txhawm rau tsim cov tshuaj glucagon, uas txo cov glycemia. Nws raug tso cai kom siv cov tshuaj tsuas yog nyob ntawm qhov muaj mob ntshav qab zib hom 2.

Koob tshuaj hloov kho yog nqa los ntawm tus kws kho mob mus kawm nyob ntawm nws qhov kev loj hlob ntawm hyperglycemia. Nws yog txwv tsis pub siv rau cov ntshav qab zib ntawm thawj hom, nrog rau qhov muaj mob ntawm tus neeg mob lub siab rau qhov sib xyaw ntawm cov tshuaj.

Cov kev mob tshwm sim thiab qhov tsis zoo xav tau thaum kho nrog Yanuvia tuaj yeem suav nrog mob taub hau, mob hauv cov pob qij txha, cov txheej txheem sib kis hauv cov pa ntawm qhov ncauj sab sauv, raws plab, thiab zoo li xeev siab.

Cov tshuaj yog nruj me ntsis txwv tsis pub siv thaum ua cov txheej txheem kho mob hauv cov poj niam cev xeeb tub thiab cov neeg mob qis dua 18 xyoo.

Tus nqi ntawm cov tshuaj hauv khw lag luam hauv tsev tshuaj thiab tshuaj xyuas txog lawv

Galvus yog tsim los ntawm Novartis, ib lub chaw tsim tshuaj txog kev lag luam Swiss. Cov khoom yog nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj ntawm 50 mg. Cov pob muaj 28 ntsiav tshuaj. Tus nqi ntawm cov tshuaj nyob rau tom khw ntawm Lavxias teb sab tuaj yeem muaj li ntawm 701 txog 2289 rubles. Tus nqi nruab nrab hauv kev lag luam hauv tsev yog 791 rubles rau ib pob.

Raws li cov neeg mob, Galvus yog cov tshuaj siv tau haum.

Vipidia hauv kev lag luam tshuaj hauv khw muaj nqi me ntsis dua piv nrog rau cov tshuaj xub thawj. Qhov nruab nrab, tus nqi rau ib pob tshuaj uas muaj cov tshuaj noj nrog qhov tshuaj ntau 12,5 mg yog 973 rubles, thiab cov ntsiav tshuaj nrog tshuaj 25 mg tus nqi 1282 rubles.

Feem ntau kev tshuaj xyuas ntawm cov tshuaj no yog qhov zoo, txawm hais tias tseem muaj qhov tsis zoo, feem ntau xws li kev tshuaj xyuas yog vim qhov tseeb tias kev noj cov tshuaj tsis muaj kev cuam tshuam tseem ceeb rau cov ntshav qab zib.

Trazhenta yog yeeb tshuaj tuaj txawv teb chaws ntawm Galvus thiab yog li nws cov nqi nce ntau tshaj li qhov qub tshuaj. Cov tshuaj yog tsim tawm hauv Austria, nws tus nqi hauv Lavxias yog li ntawm 1551 txog 1996 rubles, thiab tus nqi nruab nrab rau kev ntim ib cov tshuaj yog 1648 rubles.

Feem coob ntawm cov neeg mob pom zoo tias cov tshuaj no zoo heev.

Kev ntsuas rau siv

Dab tsi pab Galvus Met? Raws li cov lus qhia, cov tshuaj tau tawm rau kev kho mob ntshav qab zib hom 2 (hauv kev tawm dag zog nrog kev tawm dag zog thiab kev noj zaub mov) hauv cov xwm txheej hauv qab no:

• Qhov tsis muaj txiaj ntsig ntawm kev kho mob monotherapy nrog metformin lossis vildagliptin,
• Ua cov kev kho ua ke yav dhau los nrog metformin thiab vildagliptin ua ib hom tshuaj,
• Triple ua ke txoj kev kho nrog insulin hauv cov neeg mob uas yav tas los tau txais cov tshuaj insulin ruaj khov thiab metformin, tab sis tsis ua tiav glycemic tswj tau txaus,
• Siv sib xyaw nrog sulfonylurea derivatives (kho ua ke peb zaug) hauv cov neeg mob uas yav tas los tau txais kev kho mob nrog sulfonylurea derivatives thiab metformin, tab sis tsis ua tiav glycemic tswj,
• Kev pib kho mob hauv cov neeg mob ntshav qab zib hom 2 nrog kev ua tsis tau zoo ntawm kev tawm dag zog, kev noj zaub mov noj thiab, yog tias tsim nyog, txhim kho glycemic tswj.

Sab sij huam

Cov kev qhia ceeb toom ceeb toom qhov ua tau ntawm kev txhim kho cov kev mob tshwm sim tom qab thaum sau ntawv Galvus Met:

• Los ntawm kev mob plab zom mov - xeev siab, mob plab, mob plab zom mov (ua rau lub plab zom mov mus rau hauv txoj hnyuv qis dua), muaj teeb meem (ua kom muaj ntshav) thiab raws plab, txhawm rau leeg, pancreatitis (mob tshwm sim hauv lub qhov quav), qhov tshwm sim ntawm cov xim hlau hauv lub qhov ncauj, ua rau mob zuj zus. kev nqus ntawm cov vitamins B12.
• Lub cev tsis muaj zog - mob taub hau, kiv taub hau, tshee tshee (co tes).
• Daim siab thiab kab mob hauv plab - mob siab (mob rau daim siab) nrog kev ua txhaum ntawm nws txoj haujlwm kev ua haujlwm.
• Musculoskeletal system - arthralgia (qhov zoo li mob hauv pob qij txha), tsis tshua muaj myalgia (mob leeg).
• Cov tawv nqaij thiab cov nqaij mos ua kom mob - qhov pom ntawm cov hlwv, txaij ib ncig ntawm cov tawv nqaij thiab o.
• Kev tiv thaiv kabmob - kev loj hlob ntawm cov kab mob lactic acidosis (kev nce qib ntawm uric acid thiab kev hloov pauv ntawm cov ntshav nruab nrab mus rau sab acidic).
• Ua xua - ua pob rau ntawm daim tawv nqaij thiab nws khaus, ua xua (cov yam ntxwv ua pob, o, sawv zoo li muaj cov tawv nqaij nettle). Cov tsos mob hnyav dua tshwm sim los ntawm kev ua mob rau cov kab mob angioedema Quincke edema (qhov mob ntawm daim tawv nqaij nrog rau lub ntsej muag thiab sab nraud ntawm qhov chaw mos) lossis qhov tsis nco qab (qhov tseem ceeb txo qis ntawm cov ntshav siab thiab ntau yam hauv lub cev tsis ua haujlwm) kuj tseem yuav muaj ntxiv.

Txoj kev loj hlob ntawm cov ntshav qab zib yog ua tau - nws yog nrog los ntawm cov tsos ntawm tes tshee, "tawm hws txias" - qhov no, nws yog qhov yuav tsum tau noj cov khoom noj uas tau zom tau yooj yim (cov dej qab zib, cov khoom qab zib) sab hauv.

Cov Yuav Tsum Muaj

Nws yog contraindicated rau sau ntawv Galvus Met hauv cov xwm txheej hauv qab no:

• Nrog siab rhiab heev rau cov tshuaj ntawm cov tshuaj,
• Tsis ua haujlwm raum thiab lwm yam tsis zoo raum muaj nuj nqi,
• Cov qauv mob ntxim nyiam uas tuaj yeem ua rau txoj kev txhim kho ntawm lub raum lub cev tsis ua haujlwm - lub cev qhuav dej, kub taub hau, kis mob, hypoxia thiab lwm yam.
• Daim siab ua haujlwm tsis zoo,
• Yam 1 ntshav qab zib
• Ntev mus ntev mus rau hauv dej cawv, mob qaug dej qaug cawv,
• Cev xeeb tub thiab lactation
• Ntev mus ntev mus rau hauv dej cawv, mob qaug dej qaug cawv,
• Ua raws li kev noj haus hypocaloric (tsawg dua 1000 kcal ib hnub),
• Lub hnub nyoog qis dua 18 xyoo.

Sau ntawv nrog kev ceev faj:

• Cov neeg mob uas muaj hnub nyoog 60 xyoo ua haujlwm hauv qhov hnyav ntawm lub cev (cov kab mob lactic acidosis yuav loj hlob).

Cev xeeb tub thiab lactation

Txij li tsis muaj cov ntaub ntawv txaus ntawm kev siv cov tshuaj hauv cov poj niam cev xeeb tub, siv thaum cev xeeb tub yog contraindicated.

Thaum muaj teeb meem ntawm cov piam thaj hauv kev xeeb tub hauv cov poj niam cev xeeb tub, muaj qhov pheej hmoo ntawm kev muaj mob txha nqaj qaum, nrog rau cov zaus ntawm cov leeg tsis muaj hlwb thiab lub neej. Yuav ua kom cov ntshav qabzib hauv lub siab thaum lub cev xeeb tub, insulin monotherapy yog kev pom zoo.

Hauv kev sim tshuaj, thaum sau ntawv rau vildagliptin hauv koob tshuaj 200 zaug siab dua qhov kev pom zoo, cov tshuaj tsis ua rau lub cev tsis muaj peev xwm thiab kev txhim kho thaum ntxov ntawm lub cev thiab tsis ua qhov cuam tshuam teratogenic rau tus me nyuam hauv plab. Thaum sau tshuaj rau vildagliptin hauv kev sib xyaw nrog metformin hauv qhov sib piv ntawm 1:10, kuj tsis muaj teratogenic effect ntawm tus me nyuam hauv plab.

Txij li nws tsis paub meej tias vildagliptin lossis metformin raug tawm hauv tib neeg cov kua mis, kev siv cov tshuaj thaum lub sijhawm pub mis niam yog contraindicated.

Analogs Galvus Met, tus nqi hauv cov khw muag tshuaj

Yog tias tsim nyog, Galvus Met tuaj yeem hloov nrog cov tshuaj analogue hauv kev kho mob - cov no yog cov tshuaj:

1. Sofamet
2. Nova Met
3. Methadiene
4. Vildagliptin,
5. Galvus
6. Trazenta,
7. Formin Pliva.

Thaum xaiv cov analogues, nws yog ib qho tseem ceeb kom nkag siab tias cov lus qhia rau kev siv Galvus Met, nqe thiab tshuaj xyuas tsis siv rau cov tshuaj ntawm cov nyhuv zoo sib xws. Nws yog ib qho tseem ceeb kom kws kho mob sab laj thiab tsis txhob hloov pauv cov tshuaj ywj siab.

Nqe hauv khw muag tshuaj Lavxias: Galvus Met 50 mg + 500 mg 30 ntsiav tshuaj - los ntawm 1,140 txog 1,505 rubles, 50 mg + 850 mg 30 ntsiav tshuaj - los ntawm 1,322 txog 1,528 rubles, Galvus ntsib 50 mg + 1,000 mg 30 ntsiav tshuaj - los ntawm 1,395 txog 1,599 rubles, raws li 782 lub tsev muag tshuaj.

Khaws rau hauv qhov chaw qhuav ntawm qhov kub txog li 30 ° C. Khaws tsis ncav cuag ntawm cov menyuam yaus. Txee lub neej - 1 xyoos 6 lub hlis.

Yanumet lossis Galvus Met: yam tshuaj twg zoo dua?

Yanumet thiab Galvus Met yog cov tshuaj zoo ib yam los ntawm ob qhov sib txawv lag luam uas muaj kev sib tw nrog lwm tus. Lawv muaj yuav luag tib tus nqi. Ntim cov tshuaj Yanumet tseem kim dua, tab sis nws muaj ntau cov ntsiav tshuaj. Tsis muaj ib yam ntawm cov tshuaj no muaj cov tshuaj analogues pheej yig, vim tias ob yam tshuaj no tseem tshiab, tiv thaiv los ntawm patents. Ob qho tshuaj tau sau zoo xyuas los ntawm cov neeg mob hais lus Lavxias uas mob ntshav qab zib hom 2. Hmoov tsis zoo, tseem tsis tau muaj xov xwm los teb kom meej tias cov tshuaj no txo ​​cov ntshav qab zib kom zoo dua. Ob qho tib si yog zoo thiab kuj muaj kev nyab xeeb. Nco ntsoov tias nyob rau hauv cov tshuaj muaj pes tsawg leeg, Yanumet metformin yog cov tseem ceeb tshaj li sitagliptin.

Galvus lossis metformin: uas yog qhov zoo dua?

Cov chaw tsim khoom hais tias vildagliptin yog lub hauv paus tseem ceeb hauv Galvus Met ntsiav tshuaj. Thiab metformin tsuas yog pab ua ntu zus. Txawm li cas los xij, Dr. Bernstein hais tias metformin txo qis cov ntshav qab zib ntau dua li vildagliptin. Galvus Met muaj kev tshuaj xyuas tus neeg mob zoo tshaj plaws ntawm txhua yam tshuaj tshiab 2 mob ntshav qab zib. Muaj kev xav tias lub luag haujlwm tseem ceeb hauv qhov ua tiav no yog ua si los ntawm qhov zoo qub metformin, thiab tsis yog qhov tshiab patent vildagliptin.

Lub kim Galvus Met pab tau zoo me ntsis los ntawm cov ntshav qab zib ntau dua li pheej yig cov ntshiab metformin ntsiav tshuaj. Txawm li cas los xij, nws me ntsis txhim kho cov txiaj ntsig ntawm kev kho mob ntshav qab zib, thiab raug nqi ob peb zaug ntau dua li ntawm Siofor lossis Glucofage. Yog tias muaj peev xwm nyiaj txiag tso cai, noj vildagliptin + metformin. Yog tias tsis muaj nyiaj, koj tuaj yeem hloov mus rau cov ntshiab metformin. Nws cov tshuaj zoo tshaj plaws yog cov tshuaj qub tuaj txawv teb chaws, Glucofage.

Siofor ntsiav tshuaj kuj tseem nrov. Tej zaum lawv ua haujlwm me ntsis qis dua li Glucofage, tab sis kuj ua tau zoo. Ob qho tshuaj ntawm no yog ob peb zaug pheej yig dua li Galvus Met. Koj tuaj yeem nrhiav pom txawm tias ntsiav tshuaj metformin pheej yig dua uas tsim nyob hauv Russia thiab CIS lub teb chaws, tab sis nws zoo dua tsis siv lawv.

Hmoov tsis zoo, tseem muaj cov ntaub ntawv tsis txaus txaus los sib piv ncaj qha Galvus Met thiab ntshiab metformin. Yog tias nyob rau ntau lub sijhawm koj tau noj tshuaj Glucofage lossis Siofor, zoo li Galvus Met, thov qhia koj cov kev paub hauv cov lus rau kab lus no. Galvus (ntshiab vildagliptin) yog hom tshuaj tsis muaj zog rau cov ntshav qab zib hom 2. Nws raug nquahu kom coj nws yam tsis muaj lwm yam tshuaj tsuas yog muaj qee qhov tsawg yog tias muaj cov kabmob contraindications rau metformin. Tab sis nws zoo dua es tsis txhob nws tam sim ntawd pib txhaj cov tshuaj insulin.

Yuav ua li cas noj Galvus Met

Cov neeg mob uas muaj ntshav qab zib hom 2 feem ntau tsis txiav txim siab noj tshuaj vildagliptin (Galvus tshuaj), tsis kam lees cov tshuaj metformin. Yog li no, cov hauv qab no piav qhia txog cov qauv ntawm kev coj los ua ke cov tshuaj Galvus Met. Qee zaum, cov neeg mob yws yws tsis tuaj yeem zam cov tshuaj no vim mob raws plab heev thiab lwm cov kev mob tshwm sim tsis zoo. Hauv qhov no, sim Metformin cov tshuaj noj nrog txoj kev pib noj tsawg thiab nws qhov nce qeeb. Feem ntau yuav, nyob rau hauv ob peb hnub lub cev yuav yoog, thiab tom qab ntawv kho nws yuav mus zoo. Metformin yog cov tshuaj muaj txiaj ntsig zoo tshaj plaws rau cov neeg mob ntshav qab zib hom 2. Tsis kam lees nws tsuas yog yog tias muaj teeb meem loj contraindications.

Yuav ua li cas kom tsis txhob muaj qhov mob plab?

Txhawm rau kom tsis txhob ua rau lub plab zom zawv, koj yuav tsum pib nrog cov tshuaj metformin tsawg kawg, thiab tom qab ntawd maj mam tsim nws. Piv txwv li, koj tuaj yeem yuav ib pob khoom ntawm 30 ntsiav tshuaj ntawm Galvus Met 50 + 500 mg thiab pib noj lawv ib hnub ib zaug. Thaum tsis muaj cov kev mob tshwm sim, tom qab 7-10 hnub, hloov mus rau ob 50 + 500 mg ntsiav tshuaj ib hnub, sawv ntxov thiab yav tsaus ntuj.

Txhawm rau ua tiav pob, koj tuaj yeem hloov mus rau cov tshuaj 50 + 850 mg, noj nws ob ntsiav tshuaj ib hnub. Thaum kawg, cov neeg mob ntshav qab zib yuav tsum tau noj cov tshuaj Galvus Met 50 + 1000 mg, ob ntsiav tshuaj ib hnub, stably. Hauv qhov no, koj yuav tau txais vildagliptin ntau tshaj plaws hauv kev noj ib hnub 100 mg thiab lwm 2000 mg metformin.

Cov neeg muaj ntshav qab zib hom 2 thiab rog rog tuaj yeem noj cov tshuaj metformin txog 3000 mg rau ib hnub. Txhawm rau nce cov koob tshuaj ntawm cov tshuaj no, nws ua rau pom tias yuav tsum noj ib ntsiav tshuaj ntxiv ntawm ntshiab metformin 850 lossis 1000 mg rau noj su. Nws yog qhov zoo tshaj plaws los siv cov tshuaj qub Glucofage.

Cov tshuaj Siofor tseem tsim nyog, yog tias tsis tsuas yog ntsiav tshuaj ntawm kev lag luam hauv tsev. Nws yuav tsis yooj yim rau koj noj ob yam tshuaj muaj ntshav qab zib tib lub sijhawm. Txawm li cas los xij, nce cov koob tshuaj txhua hnub ntawm metformin los ntawm 2000 mg rau 2850 lossis 3000 mg tuaj yeem txhim kho kev tswj ntshav qab zib thiab pab kom poob phaus ntau dua. Feem ntau yuav ua tiav, qhov txiaj ntsig yuav tsim nyog rau kev siv zog.

Galvus tshuaj, uas muaj cov vildagliptin ntshiab tsis muaj metformin, raug nqi yuav luag 2 lub sijhawm pheej yig dua li Galvus Met. Tus mob ntshav qab zib nrog kev qhuab qhia zoo thiab lub koom haum tuaj yeem txuag nyiaj los ntawm kev noj Galvus thiab Metformin cais. Peb rov hais dua tias qhov zoo tshaj plaws ntawm kev npaj cov tshuaj metformin yog Glucofage lossis Siofor, tab sis tsis yog cov ntsiav tshuaj uas tsim hauv Lavxias Federation thiab CIS lub teb chaws.

Hauv ntau cov neeg mob ntshav qab zib, qab zib nce siab tshaj plaws thaum sawv ntxov ntawm lub plab khoob, thiab tom qab ntawd thaum nruab hnub nws yuav luag zoo li qub. Hauv cov xwm txheej zoo li no, koj tuaj yeem nqa Galvus ib ntsiav tshuaj thaum sawv ntxov thiab yav tsaus ntuj, thiab txawm tias thaum tsaus ntuj, metformin 2000 mg ua ib feem ntawm cov tshuaj Glucofage Ntev. Kev ua yeeb yaj kiab ntev ntev ua haujlwm hauv lub cev txhua hmo, kom sawv ntxov ntxov, yoo cov ntshav qab zib ze dua li qub.

Cov tshuaj no puas haum nrog cawv?

Cov lus qhia hauv kev rau kev siv tsis muab lus teb rau lo lus nug no. Nws yog yeej tsis yooj yim sua kom tau qaug. Vim tias nws ua rau muaj kev pheej hmoo ua mob rau leeg, kab mob siab, muaj ntshav qab zib tsawg thiab ntau yam teebmeem ntxiv tuaj yeem ua rau tsev kho mob thiab txawm tias tuag. Txawm li cas los xij, nws tsis paub meej tias kev haus cawv muaj peev xwm haus tau hauv kev tiv thaiv. Cov lus qhia rau kev siv tshuaj Galvus Met ncaj qha tsis tso cai, tab sis tsis txwv tsis pub. Koj tuaj yeem haus cawv tau cawv me ntsis nrog kev pheej hmoo koj tus kheej. Nyeem kab lus “Cawv rau Ntshav Qab Zib.” Nws qhia tias cov cawv tso cai rau tus txiv neej thiab poj niam laus, nrog rau cov dej cawv uas nyiam rau cov ntshav qab zib. Yog koj tsis tuaj yeem tswj kho kom tsawg, koj yuav tsum yauv tsum tsis txhob haus cawv.

Cov cuab yeej no pab koj poob phaus? Nws cuam tshuam li cas hnyav li cas?

Cov txiaj ntsig ntawm kev kawm tshawb fawb tau hais tias Galvus thiab Galvus Met tsis cuam tshuam rau tus neeg mob lub cev qhov hnyav. Txawm li cas los xij, hauv kev coj ua, feem ntau cov neeg siv tshuaj metformin tswj hwm kom poob ob peb phaus. Feem ntau cov yuav, koj yuav ua tiav ib yam nkaus. Tshwj xeeb yog tias koj mus rau kev noj zaub mov kom tsawg los tswj cov ntshav qab zib, raws li Dr. Bernstein pom zoo.

Dab tsi tuaj yeem hloov Galvus Met?

Cov hauv qab no qhia txog yuav ua li cas koj tuaj yeem hloov Galvus Met hauv cov xwm txheej hauv qab no:

• Cov tshuaj tsis pab txhua yam, tus neeg mob lub suab thaj yog siab heev.
• Ntsiav tshuaj pab, tab sis tsis txaus, qab zib tseem siab dua 6.0 mmol / L.
• Cov tshuaj no kim dhau, tsis tuaj yeem kho mob ntshav qab zib thiab nws cov txheeb ze.

Yog tias vildagliptin thiab / lossis metformin yuav luag lossis tsis pab, yuav tsum tau pib txhaj tshuaj insulin. Tsis txhob siv lwm yam tshuaj, vim tias lawv yuav tsis muaj kev siv ib yam nkaus. Tus neeg mob ntshav qab zib yog qhov ua tiav tau zoo li tias cov txiav tsis dhau thiab ua rau nws tsim nws cov kua dej. Koj tsis tuaj yeem ua yam tsis muaj tshuaj insulin, thiab koj yuav tsum tau txhaj tshuaj ib hnub ob zaug. Txwv tsis pub, koj yuav tsum nrawm nrog kev paub txog cov kabmob ntshav qab zib txaus txaus.

Cov neeg mob ntshav qab zib yuav tsum nqa lawv cov piam thaj hauv ntshav mus rau theem ntawm cov neeg noj qab haus huv - 4.0-5.5 mmol / l stably 24 teev nyob rau ib hnub. Cov kev ntseeg no tuaj yeem ua tiav yog tias koj sim. Kawm cov txheej txheem kho mob ib qib zuj zus rau yam kabmob ntshav qab zib hom 2 thiab ua rau nws. Ua raws li kev noj zaub mov kom tsawg thiab noj Galvus Met tuaj yeem txo koj cov piam thaj, tab sis qee zaus nws tsis txaus.

Piv txwv li, qab zib tseem tuav 6.5-8 mmol / L. Hauv qhov no, koj yuav tsum txuas cov tshuaj insulin hauv kev noj tshuaj tsawg. Dab tsi yog cov tshuaj insulin rau kev txhaj tshuaj thiab lub sijhawm twg, koj yuav tsum txiav txim siab ib tus zuj zus, coj mus rau hauv tus cwj pwm ntawm qab zib thaum nruab hnub. Qee tus neeg mob tau muaj piam thaj ntau tshaj plaws thaum sawv ntxov ntawm lub plab khoob, thaum lwm tus - thaum noj su lossis thaum yav tsaus ntuj. Tsis txhob tsis quav ntsej txog kev kho mob insulin ntxiv rau kev noj haus thiab tshuaj ntsiav. Vim tias nrog cov piam thaj muaj txiaj ntsig ntawm 6.0 thiab siab dua, kev mob ntshav qab zib txuas ntxiv txhim kho, txawm tias muaj qeeb.

Yuav ua li cas yog tias cov tshuaj no tsis tuaj yeem them taus?

Tus mob ntshav qab zib, rau leej twg Galvus thiab Galvus Met tshuaj muaj qhov tsis kim heev, yuav tsum hloov mus rau cov ntshiab metformin. Qhov zoo tshaj plaws, thawj qhov muag tshuaj Glucofage. Lwm cov khoom lag luam txawv teb chaws Siofor ua haujlwm me ntsis tsis muaj zog dua li Glucofage, tab sis kuj ua tau zoo. Qhov pheej yig tshaj yog metformin ntsiav tshuaj uas tsim hauv Lavxias Federation thiab CIS lub teb chaws. Tab sis lawv tuaj yeem txo qis qab zib tsawg dua li cov tshuaj muaj pov thawj pom zoo. Ua txhua yam coj los ua raws li cov zaub mov noj kom tsawg. Cov khoom noj kom zoo rau lub cev uas haum koj yog kim tshaj li zaub mov, qos yaj ywm, thiab khoom noj hmoov. Tab sis yog tias tsis muaj zaub mov noj qis, koj tiv thaiv tsis tau koj tus kheej los ntawm cov teeb meem ntshav qab zib.

Analogs los ntawm qhov taw qhia thiab cov qauv ntawm kev siv

Sib txawv muaj pes tsawg leeg, tuaj yeem ua ke nyob rau hauv kev taw qhia thiab cov qauv ntawm daim ntawv thov

Yuav ua li cas thiaj nrhiav tau qhov pheej yig tshuaj ntawm cov tshuaj kim?

Txhawm rau kom pom qhov pheej yig cov khoom sib piv rau cov tshuaj, cov dav dav lossis cov lus sau, ua ntej txhua yam peb pom zoo kom them sai sai rau qhov muaj pes tsawg leeg, uas yog rau tib cov tshuaj nquag thiab qhia tau rau kev siv. Cov tshuaj sib xyaw zoo ib yam ntawm cov tshuaj yuav qhia tau tias cov tshuaj cuam tshuam nrog cov tshuaj, kws tshuaj sib npaug lossis chaw muag tshuaj. Txawm li cas los xij, tsis txhob hnov ​​qab txog qhov ua tsis muaj zog ntawm cov tshuaj uas zoo sib xws, uas tuaj yeem cuam tshuam kev nyab xeeb thiab ua haujlwm. Tsis txhob hnov ​​qab txog cov lus qhia ntawm cov kws kho mob, kev noj tshuaj rau nws tus kheej tuaj yeem tsim kev puas tsuaj rau koj kev noj qab haus huv, yog li nco ntsoov sab laj nrog koj tus kws kho mob ua ntej siv cov tshuaj.

Galvus Cov kev qhia

Daim ntawv tso tawm
Zaj duab xis-coated ntsiav tshuaj.

Muaj pes tsawg leeg
1 ntsiav tshuaj muaj vildagliptin 50 mg + metformin 500, 850 lossis 1000 mg,

Ntim
hauv ib pob ntawm 6, 10, 18, 30, 36, 60, 72, 108, 120, 180, 216 lossis 360 pcs.

Pharmacological kev txiav txim
Cov sib xyaw ua ke ntawm cov tshuaj Galvus Met suav nrog 2 hypoglycemic cov neeg sawv cev nrog cov txheej txheem sib txawv ntawm kev ua: vildagliptin, koom nrog cov chav kawm ntawm dipeptidyl peptidase-4 inhibitors (DPP-4), thiab metformin (hauv daim ntawv ntawm hydrochloride) - tus sawv cev ntawm chav kawm biguanide. Kev sib xyaw ua ke ntawm cov khoom no tso cai rau koj kom tswj tau cov ntshav qabzib ntau hauv cov neeg mob ntshav qab zib hom 2 rau 24 teev.

Vildagliptin
Vildagliptin, tus sawv cev ntawm chav kawm ntawm stimulators ntawm insular pancreatic apparatus, xaiv rau kev cuam tshuam cov enzyme DPP-4, uas rhuav tshem hom 1 glucagon-zoo li peptide (GLP-1) thiab glucose-dependant insulinotropic polypeptide (HIP).
Kev txwv sai thiab ua tiav ntawm DPP-4 cov haujlwm ua rau muaj kev nce ntxiv hauv ob qho tib si hauv paus thiab zaub mov zais cia ntawm GLP-1 thiab HIP los ntawm cov hnyuv mus rau hauv cov kab ke hauv nruab hnub.
Los ntawm kev nce qib ntawm GLP-1 thiab HIP, vildagliptin ua rau muaj kev nkag siab ntau ntxiv ntawm cov pancreatic cells-hlwb rau cov piam thaj, uas ua rau muaj kev txhim kho hauv cov kua dej-insulin secretion. Qeb kev txhim kho ntawm kev ua haujlwm ntawm β-hlwb yog nyob ntawm qhov kev puas tsuaj ntawm lawv thawj zaug kev puas tsuaj, yog li ntawd rau cov tib neeg tsis muaj ntshav qab zib mellitus (nrog ib qho kev sib xyaw ntawm cov piam thaj hauv ntshav plasma), vildagliptin tsis txhawb cov tshuaj insulin secretion thiab tsis txo cov ntshav qabzib.
Los ntawm kev nce qib ntawm cov endogenous GLP-1, vildagliptin tsub kom lub hlwb α-hlwb rau cov kua nplaum ntev, uas ua rau muaj kev txhim kho hauv cov kua nplaum-cov kev cai ntawm glucagon secretion. Kev txo qis hauv cov ntshav qabzib hauv siab tom qab noj mov, nyeg, ua rau muaj kev poob qis hauv cov tshuaj insulin.
Kev nce ntxiv ntawm qhov sib piv ntawm insulin / glucagon tiv thaiv keeb kwm ntawm hyperglycemia, vim qhov nce ntawm cov concentration ntawm GLP-1 thiab HIP, ua rau muaj kev txo qis ntawm cov piam thaj ntau ntau los ntawm lub siab ob qho tib si thaum thiab tom qab noj mov, uas ua rau muaj kev txo qis hauv cov concentration ntawm cov piam thaj hauv ntshav plasma.
Tsis tas li ntawd, tawm tsam cov keeb kwm yav dhau los ntawm kev siv vildagliptin, qhov kev txo qis ntawm cov concentration ntawm lipids hauv cov ntshav ntshav tom qab noj mov tau sau tseg, txawm li cas los xij, cov nyhuv no tsis cuam tshuam nrog nws cov nyhuv ntawm GLP-1 lossis HIP thiab kev txhim kho ntawm kev ua haujlwm ntawm pancreatic islet hlwb.
Nws paub tias nce ntxiv ntawm qhov kev nkag siab ntawm GLP-1 tuaj yeem ua rau lub ntsej muag qis dua ntawm lub plab, txawm li cas los xij, tiv thaiv keeb kwm ntawm kev siv vildagliptin, cov txiaj ntsig zoo li tsis pom.
Thaum siv vildagliptin hauv 5759 cov neeg mob ntshav qab zib hom 2 ntshav qab zib mellitus rau 52 lub limtiam li monotherapy lossis kev sib xyaw nrog metformin, sulfonylurea derivatives, thiazolidinedione, lossis insulin, qhov tseem ceeb ntev ntev txo qis nyob rau hauv kev mob siab ntawm glycated hemoglobin (НbА1с) thiab ntshav qabzib tau raug sau tseg.

Metformin
Metformin pab kho cov ntshav qabzib nyob hauv cov neeg mob ntshav qab zib hom 2 los ntawm kev txo qis ntshav muaj ntshav qab zib ntau ua ntej thiab tom qab noj mov. Metformin txo cov kua nplaum tawm los ntawm daim siab, ua kom qeeb rau kev nqus ntawm cov piam thaj hauv cov hnyuv thiab txo cov tshuaj insulin los ntawm kev txhim kho thiab kev siv cov piam thaj los ntawm cov ntaub so ntswg. Tsis zoo li sulfonylurea derivatives, metformin tsis ua rau cov ntshav qog ntshav qab zib hauv cov neeg mob ntshav qab zib hom 2 ntshav qab zib lossis cov neeg muaj kev noj qab haus huv (tshwj tsis yog qee kis tshwj xeeb). Kev kho nrog cov tshuaj tsis ua rau kev loj hlob ntawm hyperinsulinemia. Nrog rau kev siv cov metformin, insulin secretion tsis hloov, thaum insulin plasma theem ntawm lub plab khoob thiab thaum nruab hnub yuav tsawg zuj zus.
Metformin tsim cov tshuaj glycogen intracellular synthesis los ntawm kev ua yeeb yam ntawm glycogen synthase thiab txhim kho cov kua nplaum ntxiv los ntawm qee yam cov qog ua rau transporter protein (GLUT-1 thiab GLUT-4).
Thaum siv metformin, cov txiaj ntsig zoo ntawm cov metabolism ntawm lipoproteins yog sau tseg: kev txo qis hauv kev ua haujlwm ntawm tag nrho cov roj (cholesterol), LDL cov roj (cholesterol) thiab triglycerides, tsis cuam tshuam nrog cov nyhuv ntawm cov tshuaj ntawm plasma glucose concentration.

Vildagliptin + Metformin
Thaum siv cov kev sib xyaw ua ke nrog vildagliptin thiab metformin hauv koob tshuaj txhua hnub ntawm 1,500,0003,000 mg ntawm metformin thiab 50 mg ntawm vildagliptin 2 zaug hauv ib hnub rau 1 xyoo, ib qho kev tshawb fawb tseem ceeb txo qis hauv cov ntshav qabzib cov ntsiab lus tau pom (txiav txim los ntawm HbA1c) txo qis thiab kev nce ntawm cov neeg mob uas muaj tsawg HbA1c concentration yog tsawg kawg yog 0.6-0.7% (piv nrog rau pab pawg ntawm cov neeg mob uas txuas ntxiv tau txais tsuas yog cov tshuaj metformin).
Hauv cov neeg mob uas tau txais kev sib xyaw ntawm vildagliptin thiab metformin, qhov kev ntsuas pom hnyav hauv lub cev nyhav piv nrog thawj zaug hauv lub xeev tsis tau pom. 24 lub lis piam tom qab pib kho, hauv cov pab pawg ntawm cov neeg mob uas tau txais vildagliptin sib xyaw nrog metformin, muaj kev txo ntshav siab thiab txiv rau cov neeg mob ntshav siab.
Thaum kev sib xyaw ntawm vildagliptin thiab metformin tau siv los ua kev kho mob thaum xub thawj rau cov neeg mob ntshav qab zib hom 2 rau 24 lub lis piam, qhov tshuaj tiv thaiv kab mob hauv HbA1c thiab lub cev hnyav tau pom tias piv nrog kev kho mob monotherapy nrog cov tshuaj no. Cov neeg mob ntshav qab zib tsawg tsawg nyob rau ob pawg kho mob.
Thaum siv vildagliptin (50 mg 2 zaug hauv ib hnub) nrog / tsis muaj metformin ua ke nrog cov tshuaj insulin (qhov nruab nrab koob - 41 PIECES) hauv cov neeg mob hauv kev soj ntsuam, HbA1c qhov ntsuas tau txo lub ntsiab lus tseeb - yog 0.72% (pib ntsuas - nruab nrab 8, 8%). Qhov tshwm sim ntawm cov ntshav qog nqaij ntshav hauv pawg kho mob tau coj los piv rau kev tshwm sim ntawm kev mob ntshav qab zib hauv cov pab pawg placebo.
Thaum siv vildagliptin (50 mg 2 zaug hauv ib hnub) ua ke nrog metformin (≥1500 mg) ua ke nrog glimepiride (mg4 mg / hnub) hauv cov neeg mob hauv qhov chaw soj ntsuam, HbA1c qhov ntsuas poob qis sib piv - yog 0.76% (los ntawm qhov nruab nrab - 8.8%).

Cov Tshuaj Pharmacokinetics
Vildagliptin
Xuas. Thaum noj rau ntawm lub plab khoob, vildagliptin yuav nqus sai, Tmax - 1.75 teev tom qab kev tswj hwm. Nrog kev noj ib txhij nrog zaub mov noj, tus nqi ntawm nqus ntawm vildagliptin tsawg dua me ntsis: muaj qhov Cmax nce txog 19% thiab qhov nce ntawm Tmax nce mus txog 2.5 teev. Txawm li cas los xij, kev noj mov tsis cuam tshuam rau qib kev nqus thiab AUC.
Vildagliptin tau nrawm nrawm, thiab nws qhov tseeb txog kev noj qab haus huv tom qab kev tswj hwm ntawm qhov ncauj yog 85%. Cmax thiab AUC hauv cov tshuaj kho mob nce ntxiv kwv yees raws qhov sib npaug ntawm cov tshuaj.
Kev xa Khoom. Qhov qib ntawm khi ntawm vildagliptin rau cov ntshav plasma tsawg (9.3%). Cov tshuaj no tau faib tawm ncaj nruab nrab ntawm cov ntshav thiab cov ntshav liab. Kev faib tawm ntawm vildagliptin tshwm sim txawm tias yuav yog extravascularly, Vss tom qab kev tswj hwm yog 71 litres.
Kev zom zaub mov. Biotransformation yog qhov tseem ceeb ntawm kev zam ntawm vildagliptin. Hauv tib neeg lub cev, 69% ntawm cov tshuaj ntawm cov tshuaj yog hloov pauv. Lub ntsiab metabolite - LAY151 (57% ntawm koob tshuaj) yog qhov tsis muaj tshuaj thiab yog cov khoom siv kua dej ntawm cyanocomponent. Txog 4% ntawm cov koob tshuaj ntawm cov tshuaj undergo amide hydrolysis.
Hauv kev sim tshuaj, qhov ua tau zoo ntawm DPP-4 ntawm kev hloov kho cov tshuaj hydrolysis. Vildagliptin tsis yog metabolized nrog kev koom tes ntawm cytochrome P450 isoenzymes. Raws li kev tshawb fawb hauv cov vitro, vildagliptin tsis yog cov tshuaj P450 isoenzymes tsis hloov, tsis cuam tshuam thiab tsis ntxias cytochrome P450 isoenzymes.
Chaw Sau Ntawv. Tom qab noj cov tshuaj, kwv yees li 85% ntawm cov koob tshuaj tau tawm hauv cov zis thiab 15% los ntawm txoj hnyuv, lub raum ua rau tsis muaj qhov hloov pauv vildagliptin yog 23%. Nrog rau / hauv cov lus qhia, qhov nruab nrab T1 / 2 tau txog 2 teev, tag nrho cov ntshav thiab cov ntshav ua kom tshem tawm ntawm vildagliptin yog 41 thiab 13 l / h, feem. T1 / 2 tom qab kev tswj hwm ntawm qhov ncauj yog li 3 teev, tsis hais kev noj tshuaj npaum li cas.
Cov pab pawg neeg tshwj xeeb
Tus poj niam txiv neej, lub cev ua haujlwm ntawm lub cev, thiab haiv neeg tsis muaj kev cuam tshuam cov pharmacokinetics ntawm vildagliptin.
Lub siab ua haujlwm tsis zoo. Hauv cov neeg mob uas muaj mob me me mus rau me ntsis mob hepatic (6-10 cov ntsiab lus raws li kev faib menyuam yaus-Pugh), tom qab siv ib cov tshuaj, bioavailability ntawm vildagliptin raug txo tsawg 20 thiab 8%, feem. Hauv cov neeg mob uas muaj qhov tsis txaus siab rau hepatic (12 cov ntsiab lus raws li kev faib menyuam yaus-Pugh), kev siv hluav taws xob ntau ntawm vildagliptin yog nce li 22%. Qhov hloov siab tshaj plaws hauv lub bioavailability ntawm vildagliptin, nce ntxiv lossis txo qis li nruab nrab txog 30%, tsis yog qhov tseem ceeb hauv thaj chaw kho mob. Tsis muaj kev sib cuam tshuam ntawm qhov mob siab ntawm lub siab ua haujlwm tsis zoo thiab kev siv lub bioavailability ntawm cov tshuaj tau pom.
Lub raum khiav tsis zoo. Hauv cov neeg mob uas tsis tshua mob, lub cev thiab lub cev tsis zoo ua rau lub raum thiab cov neeg mob uas mob raum ua rau lub raum tsis ua haujlwm lawm, hemodialysis qhia tau nce ntawm Cmax ntawm 8–66% thiab AUC los ntawm 32–134%, uas tsis cuam tshuam nrog qhov mob tsis zoo ntawm lub raum, thiab kev nce ntawm AUC ntawm cov tsis muaj zog tiv thaiv kev puas tsuaj LAY151 1.6-6.7 zaug, nyob ntawm qhov loj ntawm kev txhaum. T1 / 2 ntawm vildagliptin tsis hloov. Hauv cov neeg mob uas tsis ua kom lub raum khiav tsis zoo, tsis tas kho cov tshuaj vildagliptin.
Cov neeg mob ≥65 xyoo. Qhov siab tshaj plaws ntawm kev txiav txim siab hauv bioavailability ntawm cov tshuaj los ntawm 32% (nce hauv Cmax los ntawm 18%) hauv cov neeg laus dua 70 tsis yog qhov tseem ceeb hauv cov chaw kuaj mob thiab tsis cuam tshuam rau qhov inhibition ntawm DPP-4.
Cov neeg mob ≤18 xyoo. Cov teeb meem pharmacokinetic ntawm vildagliptin hauv cov menyuam yaus thiab cov neeg hluas hnub nyoog qis dua 18 xyoo tsis tau teeb tsa.

Metformin
Xuas. Qhov ua tsis taus pa ntawm metformin thaum noj ntawm 500 mg rau ntawm ib qho khoob yog 50-60%. Tmax hauv ntshav - 1.81–2.69 teev tom qab kev tswj hwm. Nrog rau qhov nce ntxiv ntawm cov tshuaj ntawm 500 mus rau 1500 mg lossis hauv koob tshuaj ntawm 850 txog 2250 mg sab hauv, qhov nce qeeb hauv kev tso tshuaj pharmacokinetic tau sau tseg (tshaj li yuav xav kom muaj txoj kev sib raug zoo). Cov nyhuv no tshwm sim tsis yog ntau los ntawm kev hloov pauv ntawm kev tshem tawm cov tshuaj ib yam li los ntawm kev poob qis hauv nws txoj kev nqus. Tawm tsam keeb kwm yav dhau los ntawm kev noj zaub mov, qhov degree thiab tus nqi ntawm nqus ntawm metformin kuj poob qis me ntsis. Yog li, nrog tib lub koob tshuaj ntawm cov tshuaj ntawm ib koob 850 mg nrog zaub mov, muaj qhov txo qis hauv Cmax thiab AUC li ntawm 40 thiab 25% thiab nce hauv Tmax los ntawm 35 feeb. Cov chaw kab mob tseem ceeb ntawm cov ntsiab lus no tseem tsis tau txhim tsa.
Kev xa Khoom. Nrog rau ib qhov ncauj qhov ncauj ntawm 850 mg, qhov pom tseeb Vd ntawm metformin yog (654 ± 358) l. Cov tshuaj yeeb yaj kiab tsis khi rau cov protein plasma, thaum sulfonylurea derivatives khi rau lawv ntau dua 90%. Metformin nkag mus rau cov ntshav liab (tej zaum yuav ntxiv dag zog rau txoj kev no dhau mus). Thaum siv metformin raws li tus qauv txheej txheem (koob tshuaj thiab zaus ntawm kev tswj hwm), cov ntshav ntshav ntawm cov tshuaj tau txog li ntawm 24–48 teev thiab, raws li txoj cai, tsis pub tshaj 1 μg / ml. Hauv kev tswj xyuas cov kab mob sib kis, Cmax ntawm metformin hauv ntshav ntshav tsis ntau dua 5 μg / ml (txawm hais tias thaum noj ntau npaum li cas).
Chaw Sau Ntawv. Nrog txoj kev tswj hwm ib leeg ntawm metformin rau cov neeg ua haujlwm noj qab haus huv, nws raug nteg tawm los ntawm lub raum tsis hloov. Hauv qhov no, cov tshuaj tsis tau metabolized hauv daim siab (tsis muaj cov tshuaj metabolites hauv tib neeg) thiab tsis tawm hauv cov kua tsib. Txij li thaum lub raum tshem tawm ntawm metformin yog kwv yees li 3.5 npaug siab dua ntawm creatinine tshem tawm, txoj kev tseem ceeb ntawm kev tshem tawm cov tshuaj yog tubular zais cia. Thaum noj, kwv yees li 90% ntawm qhov tshuaj uas nws nqus tau yog tawm los ntawm ob lub raum thaum thawj 24 teev, nrog T1 / 2 los ntawm ntshav tau li 6.2 teev. T1 / 2 ntawm metformin los ntawm tag nrho cov ntshav yog li 17.6 teev, qhia tias tsub zuj zuj ib feem tseem ceeb ntawm cov tshuaj nyob rau hauv cov ntshav liab.
Cov pab pawg neeg tshwj xeeb
Paul Nws tsis muaj dab tsi cuam tshuam rau cov tshuaj pharmacokinetics ntawm metformin.
Lub siab ua haujlwm tsis zoo. Hauv cov neeg mob uas muaj daim siab tsis txaus, ib qho kev tshawb fawb txog qhov tseeb ntawm cov yam ntxwv ntawm metformin tsis tau ua.
Lub raum khiav tsis zoo. Hauv cov neeg mob uas ua kom lub raum txo qis (kwv yees los ntawm kev tshem tawm creatinine), T1 / 2 ntawm metformin los ntawm ntshav thiab ntshav nce ntxiv, thiab nws txoj kev ua haujlwm hauv lub raum ua kom tsawg dua kom muaj kev txo qis hauv creatinine tshem tawm.
Cov neeg mob ≥65 xyoo. Raws li kev tshawb fawb pharmacokinetic tsawg, hauv cov neeg noj qab haus huv muaj hnub nyoog ≥65 xyoo, muaj qhov txo qis hauv tag nrho cov ntshav ua haujlwm ntawm metformin thiab nce hauv T1 / 2 thiab Cmax piv nrog cov tub ntxhais hluas. Cov pharmacokinetics ntawm metformin hauv cov tib neeg laus dua 65 xyoo yog muaj feem cuam tshuam nrog kev hloov pauv ntawm lub raum. Yog li, hauv cov neeg mob laus dua 80 xyoo, kev teem caij mus siv tshuaj Galvus Met yog ua tau tsuas yog nrog kev tshem tawm ib txwm muaj ntawm creatinine.
Cov neeg mob ≤18 xyoo. Cov yam ntxwv ntawm cov tshuaj metformin hauv cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo tsis tau tsim.
Cov neeg mob ntawm ntau haiv neeg. Tsis muaj pov thawj dab tsi cuam tshuam ntawm cov neeg mob cov neeg mob ntawm cov qauv tshuaj pharmacokinetic ntawm metformin. Hauv kev tswj xyuas cov kev tshawb fawb soj ntsuam ntawm metformin hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus ntawm cov haiv neeg sib txawv, cov nyhuv tshuaj tiv thaiv ntshav qab zib tsis raug rau tib yam.

Vildagliptin + Metformin
Cov kev tshawb fawb pom tias bioequivalence hais txog AUC thiab Cmax ntawm Galvus Met hauv 3 ntau qhov sib txawv (50 mg + 500 mg, 50 mg + 850 mg thiab 50 mg + 1000 mg) thiab vildagliptin thiab metformin noj hauv koob tshuaj sib txawv hauv cov ntsiav tshuaj txawv.
Khoom noj khoom haus tsis muaj kev cuam tshuam rau qib thiab qhov nqi ntawm nqus vildagliptin nyob rau hauv cov tshuaj ntawm cov tshuaj Galvus Met. Cov txiaj ntsig ntawm Cmax thiab AUC ntawm metformin hauv kev sib xyaw ua ke ntawm cov tshuaj Galvus Met thaum noj nws nrog zaub mov txo qis los ntawm 26 thiab 7%, feem. Tsis tas li ntawd, tawm tsam cov keeb kwm yav dhau los ntawm kev noj zaub mov, qhov nqus ntawm metformin qeeb, uas ua rau muaj kev nce Tmax ntau dua (txij li 2 txog 4 teev). Kev hloov zoo sib xws hauv Cmax thiab AUC thaum noj mov tau pom ntawm Metformin ib leeg, txawm li cas los xij, hauv rooj plaub tom kawg, kev hloov pauv tsis tseem ceeb. Cov nyhuv ntawm cov zaub mov ntawm pharmacokinetics ntawm vildagliptin thiab metformin hauv tshuaj muaj pes tsawg leeg Galvus Met tsis txawv ntawm qhov ntawd thaum noj ob qho tshuaj sib cais.

Galvus Met, qhia txog kev siv
Hom 2 mob ntshav qab zib mellitus (ua ke nrog kev kho kev noj haus thiab kev tawm dag zog): nrog kev ua tsis tau zoo ntawm kev kho mob monotherapy nrog vildagliptin lossis metformin, hauv cov neeg mob yav tas los tau txais kev kho mob sib xyaw nrog vildagliptin thiab metformin ua hom monopreparations.

Cov Yuav Tsum Muaj
lub raum ua kom tsis zoo los yog ua rau lub raum tsis ua haujlwm: nrog cov ntshav creatinine theem ntawm ≥1.5 mg% (> 135 μmol / liter) rau cov txiv neej thiab ≥1.4 mg% (> 110 μmol / litre) rau cov poj niam,
mob hnyav uas tshwm sim nrog kev pheej hmoo ntawm kev tsim muaj lub raum ua haujlwm: lub cev qhuav dej (nrog rau mob raws plab, ntuav), kub taub hau, mob hnyav kis, mob ntawm hypoxia (poob siab, sepsis, mob raum, mob ntsws bronchopulmonary),
mob plawv thiab mob plawv tsis ua haujlwm, mob myocardial infarction, mob plawv tsis txaus (poob siab),
ua pa tsis ua hauj lwm
lub siab ua tsis taus haujlwm,
mob hnyav lossis mob ntsws metabolic acidosis (suav nrog ketoacidosis uas mob ntshav qab zib ua ke nrog lossis tsis nco qab lawm). Tus kab mob ntshav qab zib ketoacidosis yuav tsum kho tus mob insulin kho,
lactic acidosis (nrog rau keeb kwm ntawm)
cov tshuaj tsis tau siv 2 hnub ua ntej kev phais mob, radioisotope, kev tshawb nrhiav xoo hluav taws xob nrog kev qhia ntawm cov tshuaj tiv thaiv kab mob thiab tsis pub dhau 2 hnub tom qab lawv tau ua,
cev xeeb tub
kev pub mis
ntshav qab zib hom 1
haus cawv qaug cawv, qaug cawv lom,
ua raws li kev noj zaub mov kom tsis txhob muaj calories ntau tsawg (tsawg dua 1000 kilocalories ib hnub),
cov me nyuam qis dua 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv tsis tau tsim),
ua kom lub cev tsis haum rau vildagliptin lossis metformin lossis lwm yam tshuaj.

Tsuas tshuaj thiab tswj hwm
Cov tshuaj Galvus Met noj nrog rau cov zaub mov kom txo qhov hnyav ntawm phiv los ntawm cov hnyuv, cov yam ntxwv ntawm metformin. Kev noj tshuaj rau ntawm Galvus Met yuav tsum tau xaiv ib tus zuj zus nyob ntawm qhov ua tau zoo thiab kev tiv thaiv siab, koob tshuaj thawj zaug yog xaiv rau hauv tus account tus neeg mob txoj kev kho mob nrog vildagliptin thiab / lossis metformin. Thaum siv Galvus Met, tsis txhob siab tshaj qhov pom zoo tshaj plaws txhua hnub koob tshuaj vildagliptin (100 milligrams).

Sab sij huam
Cov txheej txheem hauv qab no tau siv los ntsuas qhov tshwm sim ntawm qhov tshwm sim tsis zoo (AE): ntau zaus (/1 / 10), feem ntau (≥1 / 100, Cov Kev Phom Nyuaj, muaj feem cuam tshuam nrog kev siv tshuaj sib xyaw nrog vildagliptin thiab metformin (zaus ntawm kev txhim kho uas nyob hauv pawg vildagliptin + metformin tau sib txawv ntawm qhov ntawd nyob ntawm keeb kwm ntawm kev siv cov placebo thiab metformin los ntawm ntau dua 2%) tau nthuav tawm hauv qab no:
Los ntawm lub paj hlwb:
feem ntau - mob taub hau, kiv taub hau, tshee tshee.
Thaum siv vildagliptin ntau ua ke nrog metformin hauv kev siv ntau yam tshuaj, hypoglycemia tau pom nyob rau hauv 0.9% ntawm tus neeg mob (rau qhov sib piv, hauv cov pawg placebo hauv kev sib xyaw nrog metformin - hauv 0.4%).
Tus nqi ntawm AE los ntawm lub plab zom mov thaum ua ke nrog kev kho mob nrog vildagliptin / metformin yog 12.9%. Thaum siv metformin, cov tshuaj AE zoo sib xws tau pom hauv 18.1% ntawm cov neeg mob.
Hauv cov pab pawg ntawm cov neeg mob tau txais cov tshuaj metformin ua ke nrog vildagliptin, kev mob plab zom mov tau tshaj tawm nrog zaus ntawm 10% -15%, thiab hauv pawg ntawm cov neeg mob tau txais metformin ua ke nrog cov placebo, nrog rau zaus 18%.
Kev tshawb nrhiav mus sij hawm ntev ntev txog 2 xyoos tsis qhia txog qhov sib txawv ntxiv hauv kev nyab xeeb lossis tsis paub txog qhov txaus ntshai thaum siv vildagliptin raws li kev kho mob monotherapy.
Thaum siv vildagliptin li kev kho mob monotherapy:
Los ntawm cov leeg hlwb: feem ntau - kiv taub hau, mob taub hau,
Los ntawm lub plab zom mov: feem ntau - cem quav,
Dermatological tshua: qee zaus - tawv nqaij ua pob,
Los ntawm cov leeg musculoskeletal: feem ntau - arthralgia.
Lwm yam: qee zaum - peripheral edema
Thaum siv kev sib xyaw ua ke nrog vildagliptin + metformin, qhov kev kuaj mob tseem ceeb nce rau hauv cov zaus ntawm AEs saum toj no tau sau tseg nrog vildagliptin tsis tau pom.
Ntawm keeb kwm yav dhau los ntawm kev kho mob monotherapy nrog vildagliptin lossis metformin, qhov tshwm sim ntawm kev mob ntshav qab zib yog 0.4% (qee zaum).
Kev kho mob monotherapy nrog vildagliptin thiab kev sib xyaw ua ke ntawm vildagliptin + metformin tsis cuam tshuam rau tus neeg mob lub cev qhov hnyav.
Kev tshawb nrhiav mus sij hawm ntev ntev txog 2 xyoos tsis qhia txog qhov sib txawv ntxiv hauv kev nyab xeeb lossis tsis paub txog qhov txaus ntshai thaum siv vildagliptin raws li kev kho mob monotherapy. Cov kev tshawb fawb tom qab muag lag luam:
Thaum lub sijhawm kev tshawb fawb txog kev tshaj tawm, kev tsis zoo hauv qab no tau txheeb xyuas: zaus tsis paub - urticaria.
Cov kev hloov pauv hauv qhov ntsuas pom thaum ua ntawv thov vildagliptin ntawm koob tshuaj 50 mg ib zaug ib hnub lossis 100 mg ib hnub (hauv 1 lossis 2 koob tshuaj) rau 1 xyoo, qhov ntau zaus ntawm kev ua haujlwm ntawm alanine aminotransferase (AlAt) thiab aspartate aminotransferase (AsAt) ntau dua 3 zaug piv nrog kev txwv qis dua ntawm ib txwm muaj (VGN), yog 0.3% thiab 0.9%, feem (0.3% nyob rau hauv pawg placebo).
Ib qho kev nce ntxiv hauv kev ua haujlwm ntawm AlAt thiab AsAt, raws li txoj cai, yog asymptomatic, tsis nce thiab tsis nrog cholestasis lossis jaundice.
Thaum siv metformin li kev kho mob monotherapy:
Kev txiav txim siab ua haujlwm: tsis tshua muaj tshwm sim - txo qis nqus ntawm vitamin B12, lactic acidosis. Los ntawm lub plab zom mov: feem ntau - xeev siab, ntuav, raws plab, mob plab, poob ntawm qab los noj mov, feem ntau - yog xim hlau hauv lub qhov ncauj.
Los ntawm daim siab thiab daim tawv nqaij ua pa: tsawg heev - kev ua txhaum ntawm biochemical tsis dhau ntawm kev ua haujlwm siab.
Nyob rau ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: tsis tshua muaj tshwm sim - tawv nqaij ua pob (tshwj xeeb erythema, khaus, urticaria).
Txij li qhov txo qis hauv kev nqus ntawm cov vitamin B12 thiab qhov kev txo qis hauv nws cov ntshav dej thaum lub sij hawm siv cov metformin yog qhov tsis tshua muaj rau cov neeg mob uas tau txais tshuaj rau lub sijhawm ntev, qhov kev xav tsis zoo no tsis muaj qhov tseem ceeb hauv kev kho mob. Kev txiav txim siab yuav tsum tau muab los txo txo ​​qhov nqus ntawm cov vitamin B12 tsuas yog hauv cov neeg mob megaloblastic anemia.
Qee qhov xwm txheej ntawm kev ua txhaum ntawm biochemical ntsuas ntawm daim siab ua haujlwm lossis mob siab, uas tau pom nrog kev siv metformin, raug daws tom qab tshem tawm ntawm metformin.

Cov lus qhia tshwj xeeb
Hauv cov neeg mob uas tau txais insulin, Galvus Met hloov tsis tau cov tshuaj insulin.
Vildagliptin
Lub siab ua haujlwm tsis zoo
Txij li thaum thov vildagliptin, kev nce ntxiv ntawm kev ua si ntawm aminotransferases (feem ntau tsis muaj kev kho mob tshwm sim) tau sau tseg qee yam ntau dua li pawg tswj hwm, ua ntej kev teem sijhawm Galvus Met, thiab tseem tsis tu ncua thaum kho nrog tshuaj, nws raug nquahu kom txiav txim siab cov biochemical tsis ua haujlwm ntawm daim siab ua haujlwm. Yog tias tus neeg mob tau ua haujlwm ntau ntxiv ntawm aminotransferases, qhov tshwm sim no yuav tsum tau lees paub los ntawm kev tshawb nrhiav dua, thiab tom qab ntawd ua ntu zus txiav txim siab biochemical cov kev ua haujlwm ntawm daim siab ua haujlwm kom txog thaum lawv ua haujlwm. Yog tias kev ua si ntau dhau ntawm AsAt lossis AlAt yog 3 lossis ntau dua lub sijhawm ntau dua li VGN tau lees paub los ntawm kev tshawb fawb tshawb, nws raug nquahu kom thim cov tshuaj.

Yeeb tshuaj sib cuam tshuam
Vildagliptin + Metformin
Nrog rau kev siv vildagliptin (100 mg 1 zaug hauv ib hnub) thiab metformin (1000 mg 1 zaug hauv ib hnub), qhov sib txuam ntawm cov chaw muag tshuaj tseem ceeb ntawm lawv tsis pom. Tsis yog thaum sim kho mob, los yog thaum lub sijhawm siv dav dav Galvus Met hauv cov neeg mob tau txais lwm cov tshuaj thiab cov tshuaj yeeb dej caw, kev sib cuam tshuam tsis tau pom tau pom tsis pom.

Vildagliptin
Vildagliptin muaj qhov tsis tshua zoo rau kev sib txuam tshuaj. Txij li thaum vildagliptin tsis yog lub zog ntawm cytochrome P (CYP) 450 enzymes, tsis yog nws inhibit lossis ntxias cov enzymes no, nws cov kev cuam tshuam nrog tshuaj uas yog cov substrates, inhibitors lossis inducers ntawm P (CYP) 450 tsis zoo li. Nrog rau kev siv vildagliptin ib txhij tsis cuam tshuam rau qhov tshuaj ntawm cov tshuaj uas hloov cov enzymes: CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 thiab CYP3A4 / 5. Tsis muaj kev sib cuam tshuam hauv chaw kho mob tseem ceeb ntawm vildagliptin nrog cov tshuaj feem ntau siv hauv kev kho mob hom 2 mob ntshav qab zib mellitus (glibenclamide, pioglitazone, metformin) lossis nrog nqaim kev kho mob (amlodipine, digoxin, ramipril, simvastatin, valsartan, warfarin).

Metformin
Furosemide nce Cmax thiab AUC ntawm metformin, tab sis tsis cuam tshuam rau nws lub raum kev ua haujlwm. Metformin txo Cmax thiab AUC ntawm furosemide thiab kuj tsis cuam tshuam rau nws lub raum sab hauv.
Nifedipine nce ntxiv kev nqus, Cmax thiab AUC ntawm metformin, ntxiv rau, nws tsub kom nws cov zis tawm hauv cov zis. Metformin kev coj ua tsis cuam tshuam rau qhov kev txiav txim ntawm nifedipine.
Glibenclamide tsis cuam tshuam rau qhov kwv yees pharmacokinetic / pharmacodynamic ntawm metformin. Metformin feem ntau txo Cmax thiab AUC ntawm glibenclamide, tab sis qhov ntau ntawm cov nyhuv txawv heev. Vim li no, qhov tseem ceeb kho mob ntawm qhov kev sib txuam no tseem tsis meej.
Cov lus qhia hauv cov organic, piv txwv li, amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim, vancomycin, thiab lwm yam, raug zam los ntawm lub raum los ntawm tubular secretion, tuaj yeem sib cuam tshuam nrog metformin, txij li thaum lawv sib tw rau cov kev thauj mus los ntawm cov leeg menyuam. Yog li, cimetidine nce ntxiv ob qho tib si ntau ntawm metformin hauv ntshav / ntshav thiab nws cov AUC los ntawm 60% thiab 40%, feem. Metformin tsis cuam tshuam rau qhov kev siv pharmacokinetic ntawm cimetidine. Ceev faj yuav tsum tau siv thaum siv Galvus Met nrog rau cov tshuaj uas cuam tshuam rau lub raum kev ua haujlwm lossis kev faib tawm ntawm metformin hauv lub cev.
Lwm yam tshuaj - qee cov tshuaj tuaj yeem ua rau hyperglycemia thiab txo cov txiaj ntsig ntawm cov kab mob ntshav qab zib tsawg. Cov tshuaj no suav nrog thiazides thiab lwm cov tshuaj diuretics, glucocorticosteroids, phenothiazines, cov thyroid hormones, estrogens, qhov ncauj tawm tsam, phenytoin, nicotinic acid, sympathomimetics, calcium antagonists thiab isoniazid. Thaum sau tshuaj rau cov tshuaj tsis sib xws, lossis, hloov dua siab tshiab, yog tias lawv raug tso tseg, nws raug nquahu kom ua tib zoo saib xyuas qhov ua tau zoo ntawm metformin (nws cov nyhuv ntshav qab zib) thiab, yog tias tsim nyog, kho cov koob tshuaj. Kev siv tib lub sijhawm sib xyaw ntawm danazol tsis pom zoo nyob rau hauv kev txiav txim kom tsis txhob muaj cov nyhuv hyperglycemic ntawm tom kawg. Yog tias kev kho mob nrog danazol yog qhov tsim nyog thiab tom qab txiav tawm qhov kawg, kev kho tshuaj metformin yuav tsum ua raws li kev tswj xyuas qib siab. Chlorpromazine: thaum noj ntau dua (100 mg ib hnub twg) nce glycemia, txo qis kev tsim tawm ntawm cov tshuaj insulin. Hauv kev kho tshuaj tiv thaiv tshuaj tiv thaiv thiab tom qab siv ceev xwmphem qhov kawg, kev hloov kho koob tshuaj yuav tsum muaj kev tswj hwm nyob hauv qib siab.
Iodine-muaj cov kab mob radiopaque: kev tshawb nrhiav radiological siv iodine-muaj cov kab mob radiopaque tuaj yeem ua rau kev txhim kho ntawm cov kab mob lactic acid nyob rau hauv cov neeg mob ntshav qab zib mellitus nrog kev ua haujlwm lub raum tsis ua haujlwm.
Cov tshuaj beta-2 sympathomimetics: nce glycemia vim qhov kev txhawb nqa ntawm beta-2 receptors. Hauv qhov no, glycemic tswj yog tsim nyog. Yog tias tsim nyog, insulin raug pom zoo. Nrog tib lub sijhawm siv cov metformin nrog sulfonylurea derivatives, insulin, acarbose, salicylates, nce ntxiv ntawm cov nyhuv hypoglycemic yog ua tau.
Txij li thaum siv cov metformin hauv cov neeg mob haus cawv ntau dhau los ua rau muaj kev pheej hmoo mob lactic acidosis (tshwj xeeb tshaj yog lub sijhawm tshaib plab, qaug zog, lossis daim siab tsis ua haujlwm), hauv kev kho mob nrog Galvus Met, ib qho yuav tsum tsis kam haus cawv thiab tshuaj muaj cawv uas muaj cov tshuaj ethyl.

Noj ntau dhau
Vildagliptin
Vildagliptin muaj kev tiv thaiv zoo thaum muab rau kom txog 200 mg / hnub. Thaum siv cov tshuaj ntawm ib koob ntawm 400 mg / hnub, mob nqaij pob txha, tsis tshua mob me me thiab cov kab mob hloov mus ntev, ua npaws, edema, thiab muaj kev hloov qis hauv lipase concentration (2 zaug siab dua VGN) tuaj yeem pom. Nrog rau qhov nce ntxiv ntawm koob tshuaj vildagliptin mus rau 600 mg / hnub, kev txhim kho ntawm edema ntawm qhov kawg, nrog los ntawm paresthesias, thiab kev nce ntxiv hauv qhov kev txiav txim ntawm creatinine phosphokinase, AcAt, C-reactive protein thiab myoglobin, yog ua tau. Tag nrho cov tsos mob ntawm kev haus ib ce thiab hloov cov kev hloov hauv chaw kuaj ploj tom qab tsis siv tshuaj.
Kev tshem tawm hauv lub cev los ntawm kev lim ntshav yuav tsis zoo li. Txawm li cas los xij, lub ntsiab hydrolytic metabolite ntawm vildagliptin (LAY151) tuaj yeem tshem tawm hauv lub cev los ntawm hemodialysis.

Metformin
Muaj ntau kis ntawm kev noj haus ntau tshaj ntawm cov tshuaj metformin tau sau tseg, suav nrog kev noj cov tshuaj nyob hauv qhov ntau tshaj 50 grams. Nrog kev tshaj tawm ntawm metformin, kev mob ntshav qab zib tau pom nyob hauv kwv yees li 10% ntawm tus neeg mob (txawm li cas los xij, nws txoj kev sib raug zoo nrog cov tshuaj tsis tau tsim), hauv 32% ntawm cov neeg mob, lactic acidosis tau sau tseg. Cov tsos mob thaum ntxov ntawm tus kab mob lactic acid yog xeev siab, ntuav, raws plab, qhov kub tsawg hauv lub cev, mob plab, mob leeg, yav tom ntej yuav muaj kev ua pa ntau ntxiv, kiv taub hau, tsis meej pem thiab tsis nco qab. Metformin tshem tawm los ntawm cov ntshav los ntawm hemodialysis (nrog kev tshem tawm kom txog li 170 ml / min) tsis muaj kev txhim kho hemodynamic cuam tshuam. Yog li, hemodialysis tuaj yeem siv los tshem tawm cov tshuaj metformin los ntawm cov ntshav thaum muaj tshuaj ntau dhau.
Thaum noj ntau dhau, tsim nyog cov tsos mob yuav tsum ua raws li tus neeg mob thiab cov chaw kuaj mob.

Cia rau cov neeg mob
Galvus Met muab cia rau hauv qhov chaw qhuav tsis cuag rau cov menyuam ntawm qhov kub uas tsis muaj siab tshaj 30 ° C.