Serotonin thiab norepinephrine reuptake inhibitor. Nws me ntsis inhibits dopamine uptake, tsis muaj ib qho tseem ceeb sib xws rau histamine thiab dopamine, cholinergic thiab adrenergic receptors. Tus txheej txheem ntawm kev kho mob ntawm duloxetine hauv kev nyuaj siab yog vim yog inhibition ntawm reuptake ntawm serotonin thiab norepinephrine thiab, vim li ntawd, qhov nce ntawm serotonergic thiab noradrenergic neurotransmission hauv nruab nrab lub paj hlwb. Duloxetine tseem ua rau lub cev qhov mob tsis zoo hauv qee qhov qauv sim ntawm mob neuropathic thiab mob thiab txo qhov mob hnyav hauv tus qauv mob mob. Cov nyhuv analgesic ntawm duloxetine yog vim los ntawm kev qeeb ntawm cov kis ntawm nociceptive impulses rau lub hauv nruab nrab lub paj hlwb.
Duloxetine yog qhov nqus tau zoo tom qab kev tswj hwm qhov ncauj. Qhov siab tshaj plaws hauv cov ntshav ntshav tau mus txog 6 teev tom qab kev tswj hwm. Kev noj zaub mov ib txhij ua rau lub zog nqus tsawg, lub sijhawm uas qhov kev xav ntau tshaj plaws hauv cov ntshav tau nce ntawm 6 mus rau 10 teev, thiab kev nqus tsawg (los txog 11%).
Duloxetine yog muaj kev cuam tshuam tseem ceeb rau cov protein plasma (ntau dua 90%).
Duloxetine yog dav dav hauv lub cev, cov pa tshuaj tiv thaiv tsuas yog tawm hauv cov zis nkaus xwb. Cov isoenzymes CYP 2D6 thiab CYP 1A2 catalyze tsim ob qhov tseem ceeb ntawm cov roj ntsha duloxetine (glucuronide ua ke nrog 4-hydroxyduloxetine, sulfate ua ke nrog 5-hydroxy, methoxy-duloxetine). Qhov ua rau lub cev zom tau tsis muaj tshuaj lom neeg kev ua si.
Ib nrab-lub neej ntawm duloxetine yog 12 teev. Kev ntsuas xyuas qhov nruab nrab ntawm duloxetine los ntawm ntshav ntshav yog 101 l / h.
Hauv cov neeg mob uas mob raum ntu kawg uas ib txwm ua rau lub lim ntshav tas mus li, muaj ob zaug ntxiv qhov kev tso cia ntawm duloxetine hauv ntshav plasma thiab nce ntxiv ntawm AUC piv nrog cov neeg noj qab haus huv. Yog li, hauv cov neeg mob uas mob raum tsis ua haujlwm, duloxetine tau raug txhaj tshuaj qis qis me ntsis.

Kev siv cov tshuaj Duloxetine

Txog kev mob siab ntsws thiab ntshav qab zib neuropathy, nws tau noj ntawm qhov ncauj ntawm 60 mg ib hnub ib hnub, tsis hais txog kev noj zaub mov dab tsi. Hauv qee tus neeg mob, cov koob tshuaj ntau dua yuav raug pom zoo (txog ntau kawg ntawm -120 mg / hnub hauv 2 faib ua ob zaug). Lub peev xwm ntawm kev tswj hwm hauv cov koob tshuaj ntau dua 120 mg / hnub tsis tau kawm.
Thawj zaug tshuaj rau cov neeg mob hauv cov theem kawg ntawm lub raum tsis ua haujlwm (kev tsim kho lub peev xwm ≤30 ml / min) yog 30 mg 1 zaug hauv ib hnub ib hnub.
Cov neeg mob uas ua kom mob qog noj ntshav yog sau rau ntawm qhov pib qis dua lossis ncua sijhawm ntev dua ntawm cov koob tshuaj.
Tsis tas yuav kho qhov tshuaj duloxetine rau cov neeg laus lossis cov neeg mob siab dua. Hauv cov neeg mob uas muaj hnub nyoog qis dua 18 xyoo, qhov cuam tshuam ntawm duloxetine tsis tau kawm.

Phiv los ntawm Duloxetine

Hauv kev sim tshuaj, kev tshwm sim tsis zoo xws li cem quav, xeev siab, lub qhov ncauj qhuav, kiv taub hau, qaug zog ntau, pw tsis tsaug zog thiab mob taub hau (≥10%) tau sau tseg. Tsawg dua (muaj ntau zaus ntawm ≤10%, tab sis ≥1%) - tachycardia, dyspepsia, ntuav, tsis qab los noj mov, tsaug zog, tshee, tshee, tawm hws, hnov ​​kub, yaw. Ntawm ib feem ntawm kev muaj me nyuam, muaj qhov tsis txaus ntawm lub cev thiab erection (nrog zaus ntawm ≤10%, tab sis ≥1%), txo qis hauv libido thiab anorgasmia. Tsis tshua muaj (%1%, tab sis ≥0.1%) - mob ncauj plab, mob plab, mob ntshav nce siab, hnyav ntxiv, mob leeg, saj thiab tsis pom kev tsis zoo, ntxhov siab, tso zis.
Kev kho mob nrog duloxetine nyob rau hauv cov tso soj ntsuam cov tshuaj muaj feem cuam tshuam nrog nce me ntsis piv nrog cov placebo hauv cov theem ntawm AlAT, AsAT thiab KFK.
Hauv kev sim tshuaj ntsuam xyuas ntawm duloxetine rau kev kho mob ntshav qab zib neuropathy, qhov nruab nrab ntev ntawm ntshav qab zib mellitus yog kwv yees li 11 xyoo, qhov pib nruab nrab ntawm kev ceev ntawm cov ntshav qabzib muaj txog 163 mg / dl, thiab qhov nruab nrab pib ntawm glycosylated hemoglobin yog 7,80%. Hauv cov kev tshawb fawb no, muaj kev pib nce me ntsis thaum pib yoo ntshav qab zib tom qab 12 lub lis piam hauv cov neeg mob noj duloxetine piv nrog cov placebo, nyob rau hauv kev coj noj coj ua rau 52 lub lis piam. Tsis muaj kev hloov pauv hauv glycosylated hemoglobin, tus neeg mob lub cev qhov hnyav, lipid concentration (cov roj cholesterol, LDL, HDL, TG) lossis cov kev mob tshwm sim cuam tshuam los ntawm cov ntshav qab zib.
Raws li kev tshawb fawb tom qab kev tshaj tawm, cov kev mob tshwm sim hauv qab no tau sau tseg:
nyob rau ib feem ntawm kev hloov khoom nruab nrog: muaj tsawg kawg (≤0.01%) - mob qog nqaij npuas,
los ntawm hepatobiliary system: tsis tshua muaj heev (.00.01%) - mob siab, daj ntseg,
los ntawm lub nruab zog: tsis tshua muaj heev (.00.01%) - kev siv tshuaj anaphylactic,
los ntawm ntsuas ntsuas: tsis tshua muaj heev (.00.01%) - nce kev ua haujlwm ntawm AlAT, AcAT, phosphatase alkaline, ntshav bilirubin qib,
los ntawm sab ntawm cov metabolism: tsis tshua muaj heev (.00.01%) - hyponatremia,
ntawm daim tawv nqaij sab: tsis tshua muaj (0.01-0.1%) - tawm pob, tsis tshua muaj mob (≤0.01%) - angioedema, Stevens-Johnson syndrome, urticaria,
los ntawm cov hlab plawv system: tsis tshua muaj heev (≤0.01%) - orthostatic hypotension thiab syncope (tshwj xeeb tshaj yog thaum pib kho).

Cov lus qhia tshwj xeeb rau kev siv tshuaj Duloxetine

Cov neeg mob uas muaj kev pheej hmoo siab ntawm kev tua tus kheej thaum kho yuav tsum tau saib xyuas kom zoo, txij li ua ntej pib kev kho mob hnyav, kev muaj peev xwm tua tus kheej tsis suav nrog.
Kev siv cov duloxetine hauv cov neeg mob hnub nyoog qis dua 18 xyoo tsis tau kawm, yog li ntawd, nws yuav tsum tsis txhob raug rau cov neeg ntawm pawg hnub nyoog no.
Xws li kev siv ntawm lwm cov tshuaj ua yeeb yam rau lub hauv nruab nrab lub paj hlwb, hauv cov neeg mob uas muaj mob manic, keeb kwm ntawm qaug dab peg, duloxetine yuav tsum siv nrog ceev faj.
Muaj cov lus tshaj tawm txog qhov tshwm sim ntawm mydriasis hauv kev sib txuas nrog kev tswj hwm ntawm duloxetine, yog li ntawd, siv cov duloxetine hauv cov neeg mob uas muaj kev mob siab dua lossis thaum muaj kev pheej hmoo ntawm kev tsim muaj tus mob nqaim loj yuav tsum tau siv nrog ceev faj.
Nws tau tshaj tawm tias qhov kev nce siab ntawm duloxetine nyob rau hauv cov ntshav ntshav hauv cov neeg mob uas lub raum tsis ua haujlwm loj (ua kom tsis muaj kabmob ≤30 ml / min) lossis lub siab ua haujlwm tsis zoo. Cov neeg mob zoo li no tau hais kom sau cia duloxetine ntawm kev noj qab nyob zoo.
Hauv qee tus neeg mob, noj cov tshuaj duloxetine ua rau cov ntshav nce siab. Hauv cov neeg mob ntshav siab (kev mob ntshav ncig) thiab / lossis lwm yam kab mob ntawm cov hlab plawv, nws raug nquahu kom kuaj xyuas ntshav siab.
Hauv cov kev tshawb fawb soj ntsuam, ib qho kev nce ntxiv hauv cov kev ua ntawm daim siab enzymes hauv cov ntshav tau sau tseg. Hauv feem ntau cov neeg mob uas tau txais duloxetine, qhov nce no tau hloov mus thiab ploj tom qab tsis cuam tshuam ntawm duloxetine. Ib qho kev nce siab hauv kev ua haujlwm ntawm daim siab enzymes (ntau dua 10 zaug siab dua li ib txwm) lossis lub siab ua rau lub siab mob cholestasis, lossis qhov kev nce siab ntawm cov enzyme ua ke nrog daim siab ua rau lub siab tsis tshua muaj, qee qhov nws cuam tshuam nrog kev haus cawv.
Duloxetine tsis muaj kev hloov qeeb hauv kev sim tshuaj hauv vitro thiab hauv vivo.
Kev tshawb nrhiav tau zoo thiab tswj tau qhov tseeb ntawm qhov cuam tshuam ntawm duloxetine hauv cov poj niam cev xeeb tub tsis tau ua, yog li nws siv thaum cev xeeb tub tsis pom zoo.
Duloxetine raug tawm hauv niam mis. Kev kwv yees kwv yees txhua hnub hauv ib tug me nyuam yog 0.14% ntawm koob tshuaj rau tus poj niam cev xeeb tub (mg / kg). Kev nyab xeeb ntawm duloxetine hauv cov menyuam yaus tseem tsis tau teeb tsa, yog li kev pub niam mis thaum noj duloxetine tsis pom zoo.
Thaum kho nrog duloxetine, cov neeg mob yuav tsum caiv tsis txhob muaj cov haujlwm txaus ntshai uas yuav tsum tau muaj kev saib xyuas ntau dua thiab nrawm dua cov kev puas hlwb.

Tshuaj sib cuam tshuam tshuaj Duloxetine

Duloxetine yuav tsum tsis txhob siv cov tshuaj MAO inhibitors lossis nyob hauv thaj tsam li 14 hnub tom qab tsis kho mob nrog MAO inhibitors. Muab ib nrab ntawm lub neej ntawm duloxetine, MAO inhibitors yuav tsum tsis yog yam tshuaj kho kom tsawg kawg 5 hnub tom qab tsum tsis ua duloxetine.
Hauv cov kev tshawb fawb soj ntsuam nrog kev tswj hwm tib lub sijhawm ntawm theophylline, ib qho CYP 1A2 substrate nrog duloxetine ntawm koob tshuaj 60 mg 2 zaug hauv ib hnub, tsis muaj kev hloov pauv tseem ceeb hauv lawv cov chaw muag tshuaj raug sau tseg. Cov txiaj ntsig pom tau hais tias duloxetine tsis zoo li muaj kev cuam tshuam loj hauv kev kho mob ntawm cov metabolism hauv CYP 1A2 substrates.
Txij li CYP 1A2 koom nrog hauv cov metabolism ntawm duloxetine, kev siv duloxetine tib lub sijhawm nrog kev siv tshuaj ua kom tsis haum ntawm CYP 1A2 tuaj yeem ua rau muaj kev nce siab ntawm duloxetine hauv ntshav ntshav. Fluvoxamine (ntawm 100 mg ib zaug ib hnub), ua tus nquag tiv thaiv ntawm CYP 1A2, txo qhov kev tshem tawm ntawm duloxetine los ntawm ntshav ntshav los ntawm kwv yees li 77%. Hauv qhov no, thaum sau ntawv rau duloxetine nrog CYP 1A2 inhibitors (qee cov tshuaj tua kabmob quinolone), nws raug nquahu kom duloxetine txo qis dua.
Duloxetine yog ib tus mob loj tsawv ntawm CYP 2D6. Thaum muab tshuaj rau duloxetine ntawm ib koob ntawm 60 mg 2 zaug hauv ib hnub nrog ib zaug ntawm desipramine, uas yog subrate ntawm CYP 2D6, AUC ntawm desipramine nce 3 zaug. Kev tswj hwm tib lub sijhawm ntawm duloxetine (ntawm koob tshuaj 40 mg 2 zaug hauv ib hnub) nce qhov chaw tshuaj AUC ntawm tolterodine (2 mg 2 zaug hauv ib hnub) los ntawm 71%, tab sis tsis cuam tshuam rau lub pharmacokinetics ntawm 5-hydroxyl metabolite. Hauv kev hais txog qhov no, kev ceev faj yog qhov yuav tsum tau ua thaum coj tshuaj duloxetine nrog CYP 2D6 inhibitors, uas muaj qhov ntsuas kho nqaim qis.
Txij li thaum CYP 2D6 koom nrog hauv cov metabolism ntawm duloxetine, kev siv duloxetine tib lub sij hawm nrog kev siv tshuaj tiv thaiv sai ntawm CYP 2D6 tuaj yeem ua rau muaj qhov nce ntxiv ntawm duloxetine hauv cov ntshav. Paroxetine (ntawm ib koob tshuaj 20 mg ib hnub ib zaug) txo qhov kev tshem tawm ntawm duloxetine los ntawm ntshav ntshav los ntawm kwv yees li 37%. Hauv qhov no, kev ceev faj yog qhov yuav tsum tau ua thaum sau ntawv rau duloxetine nrog CYP 2D6 inhibitors.
Thaum sau tshuaj rau duloxetine hauv kev sib xyaw nrog lwm cov tshuaj uas cuam tshuam rau hauv nruab nrab lub paj hlwb, tshwj xeeb tshaj yog nrog cov txheej txheem zoo sib xws, yuav tsum ceev faj.
Duloxetine khi rau cov ntshav plasma protein (90%), yog li, cov thawj coj ntawm duloxetine rau tus neeg mob noj lwm yam tshuaj uas muaj feem cuam tshuam rau cov ntshav plasma protein tuaj yeem ua rau muaj kev nce ntxiv ntawm cov tshuaj dawb.

Noj ntau dhau ntawm Duloxetine, cov tsos mob thiab kev kho mob

Cov ntaub ntawv pov thawj txhaj tshuaj rau kev noj ntau dhau ntawm duloxetine muaj tsawg. Muaj qee tus mob ntawm kev noj tshuaj ntau dhau (txog 1400 mg), suav nrog kev sib xyaw nrog lwm cov tshuaj, tab sis lawv tsis ua rau tuag.
Hauv kev sim tsiaj, lub ntsiab tseem ceeb ntawm kev muaj tshuaj lom hauv kev haus dej ntau dhau tau sau tseg los ntawm lub hauv nruab nrab lub paj hlwb thiab lub plab zom mov. Cov no suav nrog cov tsos mob xws li tshee tshee, clonic convulsions, ataxia, ntuav, thiab anorexia.
Cov tshuaj tiv thaiv tshwj xeeb tsis tau paub. Tam sim ntawd tom qab noj ntau dhau, mob plab zom mov thiab teem caij ntawm qhov hluav ncaig hluav taws xob tau qhia. Ua kom muaj pa pa. Nws raug nquahu kom soj ntsuam cov phiajcim tseem ceeb, feem ntau cov haujlwm hauv plawv, thiab yog tias tsim nyog, cov tsos mob thiab txhawb txoj kev kho. Duloxetine muaj ntau qhov ntau ntawm kev faib tawm, thiab yog li ntawd yuam cov diuresis, hemoperfusion thiab metabolic perfusion thaum muaj kev noj ntau dhau yog qhov tsis muaj txiaj ntsig.

Tshuaj lom neeg thaj chaw

Duloxetine yog cais raws li tshuaj tiv thaiv kab mob los ntawm cov pab pawg ntawm cov neeg rov xaiv cov khoom tiv thaiv tsis haum norepinephrine thiab tshuaj serotonin.

Lub phaus molecular ntawm cov tshuaj lom neeg cov tshuaj tiv thaiv = 297.4 grams tauj ib mole.

Muaj nyob hauv cov tshuaj ntsiav thiab cov ntsiav tshuaj, hauv qhov tshuaj 30 thiab 60 mg.

Feem ntau pom muaj nyob hauv cov qauv hydrochloride.

Pharmacodynamics thiab pharmacokinetics

Lub cuab yeej txwv tsis pub rov ntes tshuaj serotonin thiab norepinephrine, cov - dopamineCov. Vim qhov no, cov neurotransmitters tsub zuj zus, thiab lawv txoj kev sib kis hauv nruab nrab lub paj hlwb nce siab. Cov tshuaj muaj zog tswj qhov mob, nce qhov pib ntawm qhov mob ntawm qhov mob rau qhov hnov ​​mob raws li qhov tshwm sim ntawm tshuaj mob hlwb.

Cov tshuaj yog nqus sai sai tom qab kev tswj hwm ntawm qhov ncauj. Qhov siab tshaj plaws ntawm ib qhov khoom hauv cov ntshav tau ua tiav hauv ob teev. Thaum noj mov ib txhij lengthens lub sij hawm kom ncav cuag qhov siab tshaj plaws siab txog li 10 teev. Ntau tshaj li 90% ntawm cov tshuaj khi rau cov ntshav plasma, albumin thiab glycoproteinCov. Hauv cov neeg mob uas muaj lub raum thiab mob siab, qhov siab ntawm khi rau lub plasma protein tsis hloov pauv.

Duloxetine yog metabolized, metabolites tsis tau nquag. 4-Hydroxyduloxetine Glucuronic Conjugate thiab 5-hydroxy-6-methoxyduloxetine sulfate conjugate tawm los ntawm ob lub raum. Kev mob siab ntsws tshwm sim nrog kev koom tes ntawm CYP1A2 thiab CYP2D6Cov. Ib nrab-lub neej ntawm cov tshuaj yog kwv yees li 11-12 teev.

Hauv cov poj niam, qhov kev tshem tawm ntawm cov tshuaj lom thiab cov metabolism hauv cov tshuaj yog qeeb qeeb dua txiv neej. Tsis tas li ntawd, nyob rau hauv nruab nrab-hnub nyoog thiab cov neeg laus cov neeg mob, thaj chaw hauv qab "lub sij hawm xav txog" nkhaus thiab lub sijhawm ntawm kev tshem tawm cov tshuaj tawm ntawm lub cev nce. Txawm li cas los xij, kev kho kom haum yog tsis ua. Hepatic tsis txaus ua rau qis qis hauv kev tshem tawm cov tshuaj. Ntawm theem davhlau ya nyob twg lub raum tsis ua hauj lwm, qhov siab tshaj plaws qhov siab yog tau ob npaug.

Cov Yuav Tsum Muaj

Duloxetine tsis raug teev tseg:

• nrog lub kaum lub ntsej muag tsis sib haum mob ntsws,
• txuam nrog MAO inhibitors, CYP1A2 inhibitors,
• ntawm ua xua rau cov tshuaj no
• cov neeg mob mob siab tsis ua hauj lwm siab,
• nyob rau hauv loj lub raum tsis ua hauj lwmcov neeg mob nyob ntawm hemodialysis,
• cov neeg mob uas tsis tuaj yeem leeg ntshav siab,
• lub sijhawm pub niam mis,
• cov me nyuam hnub nyoog qis dua 18 xyoo

Sab sij huam

Thaum siv tshuaj tiv thaiv kab mob siab no feem ntau:

• mob taub hau, tshee hnyo, tsaug zog, kiv taub hau, paresthesia, insomnia, zaj npau suav, ntxhov siab,
• ntxhov siab, lethargy, xeev siab,
• zawv plabntuav, qhov ncauj qhuav, cem quav, kem plab,
• kev siv roj ntau dua, mob hauv thaj tsam epigastric,
• tsawg kev sib deev muaj siab, tsis muaj lub zog erection, anorgasmia,
• dej ntas, palpitations, tinnitus, txo qhov muag pom, yawning,
• mob leeg, mob txhav, mob hauv cov leeg thiab pob txha, ua pob ua xua, hwstshwj xeeb tshaj yog thaum tsaus ntuj
• tsis qab los noj mov, poob phaus, qaug zog.

Tsawg feem ntau, cov kev mob tshwm sim tom qab tej zaum yuav tshwm sim:

• kev poob siab, tsis tuaj yeem mloog zoo, dyskinesiaapathy bruxism,
• mob plabnplawm kab mob siabnce kev ua si ntawm daim siab enzymes,
• anusia, mob plab pliav, hmo ntuj, polyuriateeb meem ntawm kev tso zis, txo kev sib deev ua haujlwm thiab muaj siab,
• mob hnyuv, mob plab, saj tsis sib xws, ua kom haum plab,
• tsaus muag tachycardiatxo qis lossis nce ntxiv ntshav siabob txhais tes txias thiab ntiv taw,
• mydriasismob hauv pob ntseg ntsugntshav los ntawm lub qhov ntswg, zoo nkaus rau hauv siab hauv caj pas,
• kev tiv thaiv tsis pom kev rau qhov pom kev, cov ntshav hauv plab, urticaria, sib cuag dermatitismob khaub thuas, nplaum hws, tsis kam ua kom tawv nqaij,
• hyperglycemia (ntawm mob ntshav qab zib), laryngitis, hnyav nce, gait tsis txaus ntseeg, nqhis dej, tshee, nce qib kev tsim tawm phosphokinase.

• kev coj tus cwj pwm mania, npau taws, cramps, psychomotor ntxhov siab,
• cov leeg serotonin, npaj siab tua tus kheej, xav tua tus kheej, lus txhais,
• ua pa tsw phem, cov ntshav hauv cov quav, daj ntseg, ua kom lub siab ua haujlwm, hloov pauv ntawm qhov tsis hnov ​​tsw ntawm cov zis thiab cov tsos mob ntawm lub cev ntas, tawg kev kub ntxhov,
• atrial fibrillation, supraventricular arrhythmia,
• mydriasis, mob ntsws, trismus, lub cev qhuav dej,
• tshuaj mob siab ntsws, hypercholesterolemiamob hauv pob tw anaphylactoid kev tsis haum.

Nrog rau kev txiav tawm ntawm cov tshuaj muaj zog tshwm sim tshem tawm cov mob syndrome: kiv taub hauparesthesia insomnia, vauv npau suav, ntxhov siab, ntuav, tshee hnyonce siab txob taus ntsug thiab hws.

Duloxetine, cov lus qhia rau kev siv (Txoj kev thiab ntau npaum li cas)

Txoj kev kho mob pib nrog qhov ntau npaum ntawm 60 mg, noj nws ib hnub ib zaug. Tom qab ntawd koj tuaj yeem maj mam nce cov tshuaj rau 0.12 g ib hnub (noj ob zaug ib hnub).

Nyob rau hauv loj lub raum tsis ua hauj lwm Tsis txhob noj ntau dua 30 mg ntawm cov tshuaj ib hnub twg. Nrog rau daim siab ua haujlwm, qhov ntau npaum li cas thawj zaug yog txo thiab qhov zaus ntawm kev tswj hwm yog txo.

Kev sib txuam

Thaum muab sib xyaw nrog Duloxetine theophylline cov pharmacokinetics ntawm cov tshuaj tom kawg tsis hloov pauv.

Kev siv cov khoom nrog tshuaj tiv thaiv CYP1A2 tej zaum yuav ua rau muaj qhov nce ntxiv hauv plasma concentration ntawm cov tshuaj. Piv txwv fluvoxamine txo qhov kev siv ntawm cov ntshav tshem tawm los ntawm kwv yees li 75%. Nws raug nquahu kom muab cov tshuaj nrog kev ceev faj desipramine, tolterodine thiab lwm txoj hauv kev hauv cov khoom siv metabolism uas koom nrog hauv CYP2D6.

Muaj Peev Xwm Txwv CYP2D6 tej zaum yuav ua rau muaj kev nce ntxiv hauv cov concentration ntawm duloxetine.

Nrog kev ceev faj, muab cov tshuaj no sib xyaw nrog lwm cov tshuaj tiv thaiv kab mob, tshwj xeeb ParoxetineCov. Nws txoj kev tshem tawm kom tsawg.

Lub ua ke txais tos ntawm txhais tau tias nrog benzodiazepines, Phenobarbital, tshuaj tiv thaiv kev puas hlwb thiab tshuaj antihistamines, nrog ethanol tsis pom zoo.

Nrog kev ceev faj, muab cov tshuaj sib txuas nrog cov tshuaj uas muaj cov qib siab los txuas rau cov ntshav protein.

Nws raug nquahu kom tsis txhob noj cov tshuaj no hauv kev txuam nrog kev xaiv inhibitorsMAO, txawm tias yuav thim rov qab MAO inhibitors, moclobemideCov. Qhov no tuaj yeem ua kev txhim kho. hyperthermia, myoclonusleeg ua kom nruj, kom nruj nrawm rau hauv qhov ntsuas tseem ceeb, comamus txog thaum tuag.

Ua ke cov tshuaj nrog cov tshuaj anticoagulants thiab tshuaj antiplatelet ua rau kev txhim kho los ntshav. Thaum muab sib xyaw nrog Warfarin INR yuav nce siab.

Tsis tshua muaj kev tsim tawm cov leeg serotonin thaum siv lwm tus SSRIs nrog cov tshuaj. Kev saib xyuas yuav tsum tau saib xyuas thaum kho nrog tricyclic antidepressants, Amitriptyline, clomipramine, Venlafaxine, hypericum, triptanam, pethidine, Tramadol thiab Tryptophan.

Duloxetine Xyuas

Txawm hais tias qhov tau hais qhia qhov tseeb ntawm cov kws kho mob txog cov tshuaj no, hauv cov neeg mob lub tswv yim hais txog nws feem ntau yog qhov txawv. Coob tus neeg sau ntawv tias cov tshuaj tsis raug zoo, kev mob tshwm sim loj heev, kev tshem tawm mob yog muaj zog thaum kho mob cuam tshuam, cov nyhuv tawm tuaj qeeb, qee zaum tom qab ntau lub hlis ntawm kev tswj hwm.

Qee qhov kev tshuaj xyuas ntawm Duloxetine npaj:

• “... Qhov no yog tiam dhau los ntawm cov tshuaj tiv thaiv kev ntxhov siab, cov tshuaj muaj cov nyhuv ob npaug, nws pab cov neeg mob neurological, kev nyuaj siab, mob, thiab muaj kev siv dav dav hauv kev siv tshuaj. Cov neeg mob uas kuv tau tsa nws txaus siab”,
• “... Kuv tau haus tshuaj rau yuav luag ib xyoo tam sim no, Kuv muaj hmoo nrog cov kev mob tshwm sim - lawv tsis nyob ntawd. Yog lawm, tsis ntev los no kuv sim ceev nrooj tsum tsis noj nws; muaj ib qho kev tshem tawm syndrome. Tam sim no nws pib dua, nws haum rau kuv”,
• “... Nws tau poob ntau qhov hnyav los ntawm cov tshuaj no, languid, nws lub taub hau mob tas li. Txhua yam raug kho, raug kho, tab sis tsis muaj qhov muaj txiaj ntsig, Kuv tsis paub yuav ua li cas nyob nrog nws”.

Dosage daim ntawv

Koob tshuaj 30 mg

Ib qho enteric capsule muaj:

duloxetine, pellets 176,5 mg, suav nrog: duloxetine hydrochloride 33.68 mg, suav li duloxetine 30 mg, hypromellose E5 (hydroxypropyl methyl cellulose) 10.54 mg, hypromellose HP55 (hydroxypropyl methyl cellulose) 15.51 mg, hmoov txhuv nplej 44.09 mg, mannitol 47.3 mg, sodium lauryl sulfate 5.22 mg, sucrose 17.46 mg, titanium dioxide 1.15 mg, cetyl cawv 1.55 mg,

Cov tawv tawv nkaws tshuaj ntsiav No. 3:

rooj plaub - zas xiav patented V, titanium dioxide, nkaws,

cap - patent xiav zas V, titanium dioxide, nkaws.

Dosage 60 mg

Ib qho enteric capsule muaj:

duloxetine, 353 mg pellets, suav nrog: duloxetine hydrochloride 67.36 mg, hais txog duloxetine 60 mg, hypromellose E5 (hydroxypropyl methyl cellulose) 21.08 mg, hypromellose HP55 (hydroxypropyl methyl cellulose) 31.02 mg, hmoov txhuv 88.18 mg, mannitol 94.6 mg, sodium lauryl sulfate 10.44 mg, sucrose 34.92 mg, titanium dioxide 2.3 mg, cetyl cawv 3.1 mg,

Cov tawv tawv nkaws tshuaj ntsiav No. 1:

rooj plaub - zas xiav patented V, titanium dioxide, nkaws,

cap - patent xiav zas V, titanium dioxide, nkaws.

Cov Tshuaj Pharmacokinetics

Duloxetine zoo nqus tau thaum noj qhov ncauj. Kev nqus tau pib 2 teev tom qab siv tshuaj. Kev siab tshaj plaws (C_max) ua tiav 6 teev tom qab siv tshuaj.

Noj mov tsis cuam tshuam qhov siab tshaj plaws ntawm cov tshuaj, tab sis nce sijhawm kom mus txog qhov siab tshaj plaws (TS_max) los ntawm 6 mus rau 10 teev, uas tsis ncaj qha txo qhov degree ntawm kev nqus (kwv yees 11%).

Duloxetine khi zoo rau cov protein plasma (> 90%), feem ntau yog nrog albumin thiab ₁-acid glycoprotein, tab sis kev cuam tshuam ntawm daim siab los yog lub raum tsis cuam tshuam rau qib ntawm cov protein khi.

Duloxetine nquag plias kev ua haujlwm thiab nws cov metabolites yog feem ntau ua tawm hauv cov zis. Ob lub CYP2D6 isoenzyme thiab CYP1A2 isoenzyme catalyze tsim ob qhov tseem ceeb ntawm cov khoom noj (4-hydroxyduloxetine glucuronic conjugate, 5-hydroxy sulfate conjugate, 6-methoxyduloxetine).

Circulating metabolites tsis muaj cov haujlwm ntawm pharmacological.

Ib nrab-lub neej (T _1/2 ) Duloxetine yog 12 teev. Qhov ntsuas kev ua haujlwm nruab nrab ntawm duloxetine yog 101 l / h.

Cov neeg mob ib leeg

txawm hais tias qhov sib txawv ntawm pharmacokinetics ntawm tus txiv neej thiab poj niam tau txheeb xyuas (qhov kev txiav txim siab nruab nrab ntawm duloxetine yog qis dua rau cov poj niam), cov kev sib txawv no tsis loj heev uas xav tau koob tshuaj hloov kho nyob ntawm poj niam txiv neej.

txawm hais tias qhov tseeb tias qhov sib txawv ntawm pharmacokinetics ntawm nruab nrab-hnub nyoog thiab cov neeg laus laus tau pom (thaj chaw nyob rau hauv qhov kev nkag siab / sijhawm nkhaus (AUC) yog siab dua thiab lub sijhawm T _1/2 cov tshuaj muaj ntau dua rau cov neeg laus), cov kev sib txawv no tsis txaus hloov lub koob tshuaj nyob ntawm seb muaj hnub nyoog li cas ntawm cov neeg mob.

hauv cov neeg mob uas mob raum tsis zoo (mob raum ntu kawg - mob raum tsis ua hauj lwm zoo) mob raum hemodialysis, C qhov tseem ceeb_max thiab AUC ntawm duloxetine tau nce ntxiv 2 zaug. Hauv qhov no, qhov ua tau ntawm kev txo cov tshuaj rau hauv cov neeg mob uas tau hais tawm tias tsis muaj zog lub raum yuav tsum raug txiav txim siab.

• Lub siab ua haujlwm tsis zoo:

hauv cov neeg mob uas muaj kev kho mob ntawm daim siab tsis ua hauj lwm, kev qeeb hauv metabolism thiab kev pom zoo ntawm duloxetine tuaj yeem pom. Tom qab txhaj ib koob tshuaj 20 mg ntawm duloxetine hauv 6 cov neeg mob uas muaj lub siab ua paug nrog daim siab tsis txaus ua haujlwm siab (Qib B ntawm Kev Ntsuas Me-Pugh), lub sijhawm T _1/2 Duloxetine yog kwv yees li 15% siab dua hauv cov neeg muaj kev noj qab haus huv ntawm tib cov poj niam txiv neej thiab hnub nyoog nrog tsib npaug ntawm qhov nruab nrab tau pom. Txawm tias muaj tseeb tias C_max hauv cov neeg mob uas muaj mob txha cajqwm yog tib yam li cov neeg noj qab haus huv, T _1/2 tau txog 3 zaug ntev dua.

• Kev Nyuaj Siab
• Ib daim ntawv mob siab ntawm mob hno ntshav qab zib mob neuropathy,
• Kev txhawj xeeb txog qhov dav dav,
• Ntev mob ntawm cov leeg mus ntawm lub cev (nrog rau cov mob los ntawm fibromyalgia, mob mob buolevoy hauv qab qis thiab nrog osteoarthritis ntawm lub hauv caug sib koom).

Cev xeeb tub thiab lactation

Vim tias kev paub tsis txaus nrog duloxetine thaum cev xeeb tub, cov tshuaj yuav tsum yog kws kho yog tias muaj txiaj ntsig zoo rau leej niam muaj txiaj ntsig zoo tshaj qhov muaj feem ua rau muaj menyuam hauv plab. Cov neeg mob yuav tsum tau ceeb toom tias thaum muaj menyuam hauv plab lossis npaj kho cev xeeb tub thaum kho nrog Duloxetine, lawv yuav tsum qhia lawv tus kws kho mob.

Epidemiological cov pov thawj qhia tias kev siv cov serotonin reuptake inhibitors (SSRIs) thaum cev xeeb tub, tshwj xeeb tshaj yog nyob rau theem tom ntej, tuaj yeem ua rau muaj kev pheej hmoo ntawm kev mob ntshav siab hauv cov menyuam mos. Txawm hais tias tsis muaj kev tshawb fawb txog kev sib raug zoo ntawm kev mob ntsws tsis tu ncua hauv cov menyuam tshiab thiab kev siv SSRIs, qhov kev pheej hmoo tsis tuaj yeem raug tshem tawm, muab cov txheej txheem ntawm kev txiav txim siab ntawm duloxetine (inhibition of serotonin reuptake).

Ib yam li kev teem caij ntawm lwm cov tshuaj serotonergic, qhov "tshem tawm" mob tuaj yeem pom nyob rau hauv cov menyuam tshiab thaum muaj kev siv duloxetine los ntawm leej niam hauv lub cev xeeb tub lig. Cov tsos mob "thim tawm" suav nrog cov tsos mob li nram no: ntshav siab qis, tshee tshee, nce neuro-reflex voos xwm yeem, noj zaub mov nyuaj, ua pa nyuaj siab, mob plab. Feem ntau cov tsos mob tau tshwm sim thaum yug menyuam lossis hauv thawj ob peb hnub tom qab yug los.

Vim tias qhov tseeb hais tias duloxetine dhau mus rau hauv niam mis (qhov xav tau hauv lub cev yog li 0.14% ntawm leej niam lub siab raws li mg / kg ntawm lub cev hnyav), kev pub niam mis thaum kho nrog duloxetine tsis pom zoo.

Tsuas tshuaj thiab tswj hwm

Sab hauv. Cov tshuaj ntsiav yuav tsum tau nqos tag nrho yam tsis muaj kev ntxo lossis tsoo. Tsis txhob ntxiv cov tshuaj rau zaub mov los yog sib xyaw nws nrog kua, vim qhov no tuaj yeem ua kev puas tsuaj rau kev nkag kis ntawm pellets.

Qhov pom zoo thawj zaug ntawm cov tshuaj yog 60 mg 1 zaug hauv ib hnub, tsis hais noj mov dabtsi.

Hauv qee cov neeg mob, txhawm rau kom ua tiav qhov txiaj ntsig, nws yog qhov tsim nyog yuav tsum nce qhov koob tshuaj los ntawm 60 mg ib hnub ib zaug rau qhov siab tshaj plaws ntawm 120 mg ib hnub twg ua ob koob. Kev txheeb xyuas cov kab mob ntawm kev noj tshuaj hauv ib qho tshuaj ntau dua 120 mg tsis tau ua.

Hauv cov neeg mob raum tsis ua haujlwm:

koob tshuaj thawj zaug yuav tsum yog 30 mg ib hnub ib zaug hauv cov neeg mob uas lub raum tsis zoo (qhov kawg ntawm CRF, kev tso tshuaj tawm 10%)

feem ntau - 1/100 kev teem caij (> 1% thiab 0.1% thiab 0.01% thiab 15.

Cuag: hyperglycemia (tshwj xeeb tshaj yog pom nyob hauv cov neeg mob ntshav qab zib mellitus).

Tsis tshua muaj: lub cev qhuav dej, hyponatremia, cov tsos mob ntawm lub cev tsis txaus ntawm cov tshuaj tiv thaiv antidiuretic 6.

Ntau yam heev: insomnia 11.

Feem ntau: ntxhov siab 10, ntxhov siab vim, npau suav txawv 20, txo qis libido (suav nrog poob libido), lub cev tsis muaj zog (suav nrog anorgasmia).

Kev tawm tsam: kev xav tua tus kheej 5.22, kev ntxhov siab ntxhov siab, bruxism, kev tsis meej 19, kev tsis quav ntsej.

Tsis tshua muaj: kev tua tus kheej coj tus cwj pwm 5.22, mania, pom kev sib cav, sib cav sib ceg thiab sib ntxub 4.

Kev tsis taus ntawm lub paj hlwb

Ntau zaus: kiv taub hau, mob taub hau, tsaug zog 12.

Feem ntau: tshee hnyo, plab 18.

Cuam Tshuam: myoclonus, akathisia 22, nce ntxiv kev npau taws, tsis hnov ​​qab, nkees, mob plab, dyskinesia, mob ceg nyob tsis tswm, tsawg pw tsaug zog zoo.

Tsis tshua muaj: mob serotonin syndrome 6, cuam tshuam 1, hlwb psychomotor ntxhov siab 6, muaj kab mob ntxiv.

Kev ua txhaum ntawm cov khoom hauv nruab nrog ntawm kev pom

Feem ntau: qhov muag plooj.

Cawv: mydriasis, pom kev tsis hnov ​​lus.

Tsis tshua muaj: mob qog muag, muag qhuav.

Hnov tsis hnov ​​lus zoo thiab teeb meem labyrinthine

Feem ntau: tinnitus 1.

Cawv: vertigo, mob pob ntseg.

Lub siab tsis zoo

Feem ntau: palpitations.

Cawv: tachycardia, supraventricular arrhythmia, mas atrial fibrillation.

Mob vascular ntshaus

Feem ntau: hyperemia (suav nrog qhov kub zoo nkauj).

Kev tawm tsam: kub siab 3.22, nce ntshav siab 3.14, mob khaub thuas txias, orthostatic hypotension, tsaus muag.

Tsis tshua muaj: kev kub siab tawm tsam 3.6.

Kev ua tsis taus ntawm lub tshuab ua pa, hauv siab thiab mediastinal plab hnyuv siab raum

Ntau zaus: yaw, mob rau qhov oropharynx.

Cuag li: zoo nkaus cov zawm ntawm caj pas, ntswg.

Lub plab zom mov tsis zoo

Ntau zaus: qhov ncauj qhuav (12.8%), xeev siab (24.3%), cem quav.

Feem ntau: raws plab, ntuav, dyspepsia (nrog rau mob plab), pom pob txha, mob plab 9.

Cuam tshuam: plab zom mov ntshav los ntshav 7, mob ncauj plab, mob plab zom mov, sib nraus, mob plab tsis txaus.

Tsis tshua muaj: stomatitis, halitosis, hematochesia.

Kev ua txhaum ntawm daim siab thiab paum nkag

Cuag: kab mob siab 3, mob siab raum.

Tsis tshua muaj: daim siab ua haujlwm 6, daj daj 6.

Kev ua mob ntawm daim tawv nqaij thiab cov nqaij mos

Feem ntau: tawm hws, tawm pob, khaus.

Kev tawm tsam: tsaus ntuj tawm hws, urticaria, hu rau dermatitis, tawm hws txias, ua kom lub ntsej muag, muaj kev nyiam ua kom doog ntshav.

Tsis tshua muaj: Stevens-Johnson syndrome 6, angioedema 6.

Tsis tshua muaj heev: nqaij txhaws.

Musculoskeletal thiab sib txuas ntawm cov nqaij mos tsis zoo

Feem ntau: mob nqaij leeg nqaij 17, mob leeg nqaij 16, mob leeg.

Cuag: mob plab ntswj.

Ua txhaum ntawm lub raum thiab mob txeeb zig

Ntau zaus: tso zis ntau ntxiv.

Kev qhia tawm: tso zis cia, mob plab, tso zis nyuaj, tso zis, mob hu ua polyuria, tso zis tsawg.

Tsis tshua muaj: tsis hnov ​​ntxhiab tsw txawv ntawm cov zis.

Kev ua txhaum ntawm cov qau thiab lub caj pas

Feem ntau: erectile kawg.

Kev siv sij hawm dhau los: ua txhaum ntawm ejaculation 21, ncua sij hawm ntawm ejaculation, ua haujlwm ntawm lub zog tsis ua hauj lwm, kev tso ntshav tawm los, kev coj khaub ncaws tsis xwm yeem, mob hauv cov noob qes.

Tsis tshua muaj: cov tsos mob ntawm lawm, galactorrhea, hyperprolactinemia.

Kev cuam tshuam dav dav thiab cuam tshuam ntawm qhov chaw txhaj tshuaj

Ntau zaus: qaug zog 13.

Feem ntau: poob 8, hloov saj.

Kev paub txog: mob hauv siab 22, atypical ncus, tshaib plab, nqhis dej, ua daus no, malaise, qhov hnov ​​ntawm tshav kub, tsis hnov ​​qab gait.

Cov ntaub ntawv kuaj thiab ntsuas

Feem ntau: poob phaus.

Nkag mus cuag: nce phaus, nce ntau ntau ntawm alanine aminotransferase (ALT), aspartate aminotransferase (ACT), phosphatase alkaline, gamma-glutamyl transpeptidase, bilirubin, creatine phosphokinase, pathological deviation ntawm daim siab enzymes, nce siab concentration hauv cov ntshav.

Tsawg: ua rau kom cov roj (cholesterol) hauv cov ntshav ntau ntxiv.

1 Cov neeg mob ntawm qaug dab peg thiab tinnitus tseem tau sau tseg tom qab ua tiav kev kho mob nrog duloxetine.

2 Orthostatic hypotension thiab syncope tau sau tseg tshwj xeeb tshaj yog thaum pib kho.

3 Saib “Cov Lus Qhia Tshwj Xeeb”.

4 Cov xwm txheej ntawm kev tawm tsam thiab kev ua phem tau raug ceeb toom tshwj xeeb tshaj yog thaum pib kho nrog duloxetine lossis tom qab ua tiav.

5 Cov xwm txheej ntawm kev xav tua tus kheej lossis xav tua tus kheej tau sau tseg thaum kho nrog duloxetine lossis thaum ntxov thaum tom qab kho tiav.

6 Kwv yees kwv yees qhov ntau ntawm cov kev tshwm sim tsis zoo. Tsis pom thaum kuaj mob.

7 Kuj tseem muaj kev mob plab hemorrhagic, los ntshav tawm hauv lub plab qis, ntuav ntshav, hemorrhoidal los ntshav, melena, tawm ntshav ntawm lub qhov txhab, mob ntshav tawm los.

8 Ntog ntog tau muaj ntau rau thaum laus (≥ 65 xyoo).

9 Nrog rau qhov mob nyob rau sab saud thiab hauv qab plab, nruj ntawm sab xub ntiag phab ntsa, mob plab tsis xis nyob, mob plab zom mov.

10 Nrog rau lub ntsej muag sab hauv, lub cev muaj zog ntxhov siab, qhov nro, psychomotor ntxhov siab.

11 Nrog rau lub sijhawm sawv thaum ib tag hmo, sawv ntxov sawv ntxov, nyuaj pw tsis tsaug zog.

12 Nrog rau qhov hypersomnia, kev ua kom loog.

13 Nrog rau asthenia.

14 Nrog rau kev nce hauv systolic ntshav siab, diastolic siab, systolic tawg, diastolic tawg, tawg, tawg, tawg.

15 Nrog rau qhov tsis nco qab.

16 Nrog rau cov leeg ua kom nruj.

17 Xws li mob myalgia thiab mob caj dab.

18 Xws li mob hypesthesia, mob caj dab hauv thaj chaw hypesthesia, qhov chaw mos ntawm qhov chaw hypesthesia, qhov ncauj ntawm qhov ncauj, tsis tshua muaj heev (19 Nrog rau kev tsis meej pem.

20 Xws li ua npau suav phem.

21 Nrog rau qhov tsis muaj ejaculation.

22 Tsis muaj qhov txawv txav nrog lub cev.

Kev tshem tawm ntawm duloxetine (tshwj xeeb tshaj plaws rau tib lub sijhawm) feem ntau ua rau "kev tshem tawm" mob, uas suav nrog cov tsos mob li nram no: kiv taub hau, hnov ​​tsis meej (nrog rau mob caj dab), pw tsaug zog (nrog rau kev pw tsaug zog thiab npau suav tiag tiag), qaug zog, tsaug zog, ntxhov siab lossis ntxhov siab, xeev siab thiab / lossis ntuav, tshee tshee, mob taub hau, txob taus, raws plab, hyperhidrosis, thiab vertigo.

Feem ntau, thaum noj cov tshuaj SSRIs thiab serotonin thiab norepinephrine reuptake inhibitors (SSRIs), cov xwm txheej no muaj qhov tsis muaj zog lossis tsis mob thiab muaj tus cwj pwm tsawg. Txawm li cas los xij, hauv qee cov neeg mob, cov xwm txheej no yuav ua tau hnyav dua thiab / lossis ntev ntev.

Nrog kev tswj hwm sijhawm luv luv ntawm duloxetine (txog 12 lub lis piam), cov neeg mob uas muaj kev mob siab rau mob ntshav qab zib neuropathy qhia tau nce me ntsis ntawm kev yoo ntshav qab zib thaum tswj kev ruaj khov ntawm glycosylated hemoglobin, ob qho tib si hauv cov neeg noj duloxetine thiab hauv cov placebo pawg. Nrog rau kev kho mob ntev nrog duloxetine (txog 52 lub lis piam), qhov nce me ntsis ntawm cov concentration ntawm glycosylated hemoglobin tau sau tseg, uas yog 0.3% siab dua qhov nce ntawm cov ntsuas cov coj hauv cov neeg mob tau txais lwm qhov kev kho mob. Hais txog kev yoo mov thiab cov cholesterol tag nrho hauv cov ntshav, cov neeg mob noj duloxetine tau qhia tias nce me me hauv cov ntsuas no piv nrog qhov kev ntsuas me me hauv pawg tswj hwm ntawm cov neeg mob.

Qhov raug kho (piv rau lub plawv dhia) QT ntu ntawm cov neeg mob noj duloxetine tsis txawv ntawm qhov ntawd hauv pawg placebo. Tsis muaj qhov sib txawv hauv tsev kho mob los ntawm QT, PR, QRS, lossis QTcB sib txawv hauv pab pawg ntawm cov neeg mob noj duloxetine thiab cov placebo pab pawg.

Duloxetine - cov lus qhia rau kev siv, tshuaj xyuas ntawm cov tshuaj thiab analogues

Duloxetine, yog ib hom tshuaj psychotropic thib peb, yog ib qho kev xaiv cov tshuaj loog ntawm serotonin thiab norepinephrine reuptake. Tsis zoo li cov tshuaj psychotropic ntawm cov thawj thiab thib ob tiam, Duloxetine tsis cuam tshuam rau txhua tus neeg sib kho ntawm lub hlwb. Cov tshuaj tiv thaiv kev nyiam ua rau muaj kev cuam tshuam ntawm 5-hydroxytryptamine, dopamine thiab norepinephrine, txij li kev cuam tshuam hauv lawv txoj haujlwm ua rau muaj kev nyuaj siab.

Cov tshuaj yog tus neeg sawv cev ntawm kws tshuaj tshiab uas ua lub suab tsis muaj qhov teebmeem hypnotic. Raws li cov lus qhia, Duloxetine muaj qhov ua rau dav thiab suav tias yog qhov kev nyab xeeb tshaj plaws kho kho mob heterocyclic psychotropic. Ua ntej tshaj plaws, Duloxetine yog siv rau hauv kev puas siab puas ntsws los kho tus mob depressive.

Cov lus qhia rau kev siv Duloxetine: koob tshuaj thiab cov cai rau kev pub nkag

Raws li cov lus qhia, kev kho mob yuav tsum tau pib nrog 60 mg ntawm Duloxetine ib hnub. Nrog rau qhov ntau npaum no, cov tshuaj no raug coj 1 zaug hauv ib hnub. Yog tias tsim nyog, ntau npaum li cas ntxiv tau ntxiv rau 120 mg, tab sis cov tshuaj no yuav tsum tau muab faib ua 2 koob. Nws tsis pom zoo kom siv ntau dua 120 mg ntawm cov tshuaj ib hnub.

Cov neeg mob uas txo qis glomerular pom tau tias yuav tsum noj 30 mg rau ib hnub twg. Nrog lub siab ua haujlwm ntawm lub siab, thawj zaug tshuaj tiv thaiv cov tshuaj tiv thaiv kab mob yuav tsum tau txo qis lossis sijhawm luv rau noj tshuaj yuav tsum tau nce ntxiv.

Kev muab tshuaj rau cov neeg mob laus tsis txawv.

Cov khoom lag luam yog npaj rau kev siv sab hauv. Cov ntsiav tshuaj tau noj tsis hais lub pluas noj, lawv yuav tsum nqos nrog cov kua tsawg tsawg. Puas tsuaj rau cov tsiav tshuaj yuav tsum zam.

Tsum tsis tu txoj kev kho maj mam kho, dhau sijhawm 14 hnub. Qhov kev siv tshuaj kho tsis tau zoo tuaj yeem ua rau lub cev tsis zoo hauv tus neeg mob lub cev.

Thaum kho lub sijhawm, haus cawv tsis raws cai. Thaum kho nrog Duloxetine, kev ceev faj yuav tsum tau siv thaum tsav tsheb thiab lwm yam kev muaj feem phom sij.

Sab sij huam

Tus nqi ntawm cov tshuaj uas tsim nyog rau qhov tshwm sim ntawm kev tshwm sim tsis zoo yog tus neeg ntshiab, thiab nyob ntawm qhov muaj peev xwm them nyiaj ntawm lub cev.

Duloxetine, zoo li lwm cov tshuaj tiv thaiv heterocyclic, cov tshuaj lom tsawg dua li tricyclic, tab sis cov kev mob tshwm sim zoo sib xws:

• cardiotoxicity muaj peev xwm ua tau nrog kev siv tshuaj ntev, tab sis qhov kev pheej hmoo yog tsawg heev,
• cov nyhuv sedative (tsaug zog, qaug zog, qaug zog, hnov ​​qhov tsis nco qab thiab nco) yog qhov tsis saib xyuas,
• CNS stimulation (insomnia, txob taus, ntxhov siab vim) txhim kho tiv thaiv keeb kwm yav dhau los ntawm kev siv ntev lossis kev tshem tawm cov tshuaj yeeb tshuaj, qhov kev pheej hmoo yog tsawg,
• orthostatic hypotension tuaj yeem tshwm sim (vim alpha-thaiv kev txiav txim siab), kev pheej hmoo yog tsawg heev,
• M-anticholinergic kev ua haujlwm kuj tseem yog qhia tsawg kawg nkaus (qhov ncauj qhuav, peristalsis, tso zis cia, pab cuam tshuam kev nyab xeeb, nce siab intraocular, tachycardia).

Rau kev xeeb tub thiab lactation

Cov tshuaj tiv thaiv kab mob tuaj yeem kho tau thaum cev xeeb tub tsuas yog thaum cov txiaj ntsig rau cov khoom siv tshaj qhov muaj kev pheej hmoo rau tus menyuam, qhov no yog vim tsis muaj kev soj ntsuam nrog cov neeg mob hauv txoj haujlwm. Yog tias tus poj niam npaj yuav xeeb tub lossis nws tau los, koj yuav tsum qhia koj tus kws kho mob tam sim ntawd.

Cov tshuaj nquag nkag mus rau hauv niam mis, yog li nws pom zoo kom koj hloov mus rau khoom noj pub mis thaum pub mis.

Daim ntawv thov nta

Nws tsis pom zoo kom siab tshaj qhov kev noj tshuaj txhua hnub ntawm 0.12 grams.

Muab tshuaj kho yog tsim nyog thaum kho cov neeg mob uas mob raum tsis ua hauj lwm thiab mob siab.

Kev tshem tawm cov tshuaj yog nqa tawm maj, muaj kev pheej hmoo siab ntawm kev tshem tawm tus mob.

Tom qab noj cov tshuaj, tsis muaj ib qho txhaum cai ntawm lub hlwb kev xav, lub cim xeeb thiab lwm yam kev txawj ntse, tab sis kev qaug zog feem ntau tshwm sim. Yog li kev tsav tsheb thiab kev ua haujlwm uas muaj kev phom sij tsis zoo yog tsis pom zoo.

Zoo sib xws txhais tau tias

Ib qho ua tiav ntawm Duloxetine - Symbalta.

Cov tshuaj tiv thaiv kev ntxhov siab muaj xws li:

1. Paxil
2. Amitriptyline,
3. Fluxonil
4. Sinekwan,
5. Voxemel
6. Zoloft
7. Venlafaxine
8. Phloxet
9. Aleval
10. Citalopram,
11. Rexetin
12. Pob zeb
13. Flunisan
14. Portal
15. Fevarin,
16. Citalift,
17. Lenuxin,
18. Siozam
19. Maprotibene
20. Efevelon
21. Asafen
22. Mirzaten
23. Stimuloton
24. Brintellix
25. Miracitol
26. Elicea
27. Dag
28. Tsipralex,
29. Deprefault,
30. Coaxil
31. Xaiv,
32. Amizole
33. Tshiab,
34. Elivel
35. Tibneeg
36. Cov Khoom Muag
37. Framex
38. Thorin
39. Valdoxan
40. Duloxetine
41. Tsipramil,
42. Azona
43. Asentra
44. Yuam Kev
45. Clomipramine,
46. Mianan
47. Imipramine
48. Noxibel
49. Remeron
50. Neuroplant
51. Fluoxetine,
52. Escitalopram
53. Oprah
54. Alventa
55. Heparetta
56. Cytol,
57. Xob
58. Es Txij Nkawm
59. Serlift,
60. Deprim
61. Umorap,
62. Paroxetine
63. Calixta
64. Dupfix
65. Velaxin,
66. Aurorix
67. Phauj.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Dosage form Duloxetine canon - enteric tsiav tshuaj: loj No. 3 (30 mg) lossis Zauv 1 (60 mg), tawv tawv, nrog lub cev thiab lub hau ntawm cov xim xiav, cov ntsiab lus - microspheres kheej kheej los ntawm yuav luag dawb rau daj-xim dawb (7, 10) , 14 lossis 15 pcs. Hauv cov hlwv, hauv ib pob ntawv los ntawm daim npav 1, 2 lossis 4 pob ntawm 7 capsule, lossis 2, 3 lossis 6 pob ntawm 10 capsule, lossis 1, 2 lossis 6 pob ntawm 14 capsule, lossis 2 lossis 4 ntim pob khoom ntawm 15 tsiav tshuaj).

Muaj pes tsawg leeg 1 tshuaj ntsiav:

• cov tshuaj nquag: duloxetine - 30 lossis 60 mg,
• lub cev tsis ua haujlwm: titanium dioxide, mannitol, hmoov txhuv nplej siab, cawv cetyl, sodium lauryl sulfate, sucrose, hypromellose HP55 (hydroxypropyl methyl cellulose), hypromellose E5 (hydroxypropyl methyl cellulose),
• tshuaj ntsiav tshuaj muaj pes tsawg leeg: gelatin, titanium dioxide, patent xiav zas V.

Cov ntaub ntawv xov xwm dav dav txog cov tshuaj Duloxetine

Duloxetine yog siv los tshem tawm kev nyuaj siab thiab mob thaum mob neurosis. Cov tshuaj txwv tsis pub uptake ntawm norepinephrine thiab serotonin los ntawm adrenergic neurons (suppresses reuptake ntawm cov tshuaj hormones no). Cov tshuaj muaj qhov cuam tshuam tsis zoo ntawm kev ntes ntawm dopamine. Cov tshuaj nquag txwv tsis muaj zog mob hauv cov neurotic ntshawv siab.

Cov pab pawg tshuaj, INN, thaj tsam

Cov chaw kuaj mob thiab chaw muag tshuaj ntawm cov tshuaj yog tus neeg tiv thaiv kev tiv thaiv thib peb. Lub npe txawv teb chaws tsis muaj npe yog Duloxetin (Duloxetinum). Cov tshuaj yog siv rau cov qhov txhab mob tshwj xeeb ntawm tus mob paj hlwb thiab ntau yam kev mob siab ntsws. Vim tias nws cov hauj lwm siab thiab cov kwv tij tsis raug mob, cov tshuaj no tau nce ntau ntawm cov kev soj ntsuam.

Daim ntawv tso tawm thiab cov nqi rau Duloxetine Canon

Duloxetine yog tsim nyob rau hauv daim ntawv ntawm xiav-dawb lossis xiav-ntsuab gelatin tsiav tshuaj. Ntawm txhua cov tshuaj ntsiav, ntau npaum li cas (30 lossis 60 mg) thiab tus lej cim (9543 lossis 9542) tau thov nrog kua zas xim. Cov kaus poom muaj puv nrog cov ntshiab dawb los yog grey granules.

Tus nqi ntawm cov tshuaj Duloxetine Canon, tsim los ntawm cov tuam txhab Lavxias teb sab Canonfarm Ntau Lawm:

Cov tshuaj tiv thaiv nquag nyob rau hauv cov tshuaj muaj pes tsawg leeg yog cov tshuaj duloxetine hydrochloride, uas yog qhov ntsuas qhov nruab nrab ntawm qhov nruab nrab ntawm qhov mob rhiab. Ntxiv nrog rau cov tshuaj uas nquag, cov muaj pes tsawg leeg tsiav tshuaj suav nrog lwm cov tshuaj:

• zaub mov xim E171,
• mannitol
• amylose thiab amylopectin polysaccharides,
• txuj
• sodium dodecyl sulfate,
• kab tsib suab thaj
• hypromellose HP55,
• hydrolyzed collagen protein,
• kev muab zaub mov ntxiv E131.

Kev Qhia thiab contraindications Duloxetine

Kev qhia rau kev siv cov tshuaj no yog:

• cov teeb meem ntshav qab zib uas cov hlab ntsha cuam tshuam,
• kev nyuaj siab

Daim ntawv ntawm contraindications tseem yog me me. Cov tshuaj tsis yog siv rau:

• tshuaj tiv thaiv hypersensitivity
• ib txhij nrog cov tshuaj tiv thaiv kab mob uas txhaws tawm lub enzyme monoamine oxidase.

Kev ceev faj yuav tsum tau ua rau cov neeg mob uas muaj cov tsos mob li nram no:

• nyiam tua yus tus kheej
• manic-depressive psychosis,
• keeb kwm ntawm qaug dab peg,
• mob pob txha taub hau,
• raum thiab mob siab ua hauj lwm,
• leeg ntshav siab.

Tsis tas li ntawd, nws tsis pom zoo kom noj tshuaj rau cov neeg mob uas muaj hnub nyoog tsis txog 18 xyoo, vim tias tsis muaj ntaub ntawv qhia txog kev ua haujlwm thiab kev nyab xeeb ntawm kev siv Duloxetine los ntawm cov neeg mob ntawm pab pawg no. Rau tib qho laj thawj, cov tshuaj tsis raug sau tseg thaum lub sijhawm txav poj niam thiab cev xeeb tub.

Muaj peev xwm phiv los ntawm duloxetine thiab overdose

Ntawm cov neeg mob noj Duloxetine, kev thev taus tshuaj yog qhov zoo. Cov kev mob tshwm sim tsis tshua pom tshwm sim thaum pib ntawm kev kho mob, thiab nws thiaj li dhau mus rau lawv tus kheej. Tab sis tseem, nrog cov tsos ntawm cov tsos mob hauv qab no, koj yuav tsum sab laj tus kws kho mob los kho cov kev kho mob:

• cem quav
• xeev siab
• xerostomia,
• kiv taub hau
• feem ntau tsis muaj zog
• insomnia
• lub siab mob plab,
• cephalgia
• nce hauv plawv dhia,
• plab zom mov nyuaj thiab mob,
• ntuav
• tsis qab los
• tshee hnyo
• txo nyob rau hauv cov tshuaj tiv thaiv tus nqi,
• hws
• zoo nkaus ntawm tshav kub
• yaw
• kev plees kev yi
• catarrh ntawm lub plab thiab cov hnyuv,
• kev puas tsuaj rau lub qhov ncauj mucosa,
• ntshav siab
• hnyav
• leeg nruj leeg
• saj ntxhov,
• pom kev pom
• lub cev muaj zog kev ntxhov siab
• kev tso zis cia
• nce ntsuas ntawm alanine aminotransferase, aspartate aminotransferase thiab creatine phosphokinase.
• siab intraocular,
• mob siab daim siab, Txoj Moo Zoo,
• tshuaj tiv thaiv anaphylactic,
• ua txhaum ntawm dej-electrolyte tshuav,
• pathological ntsiab ntawm daim tawv nqaij thiab mucous daim nyias nyias,
• Quincke's edema, ua pob rau ntawm daim tawv nqaij thiab cov xoos mucous, urticaria,
• ib tug ntse poob nyob rau hauv cov ntshav siab thiab tsaus muag.

Kev tuag tshwm sim vim yog tshaj li qhov tau pom zoo tau pom tsuas yog nrog kev sib koom tes nrog lwm cov tshuaj.

Overdose yog qhia los ntawm cov tsos mob hauv qab no:

• lub siab mob plab,
• mob hauv lub qhov mob plab, ntuav,
• tsis kam ua qhov leeg plab,
• nce hauv plawv dhia,
• coma.

Thaum noj ntau dhau, nws pom zoo kom ua daim tawv nqaij zom thiab coj mus rau lub ncaig hluav taws xob kom txo qhov nqus ntawm cov khoom nqus. Nyob rau hauv cov mob loj, pom zoo pw hauv tsev kho mob.

Lub tswv yim ntawm cov kws kho mob

Cov kws kho mob txiav txim siab cov tshuaj no yog ib qho ua tau zoo thiab pheej yig dua rau hauv tsev rau kev tiv thaiv kev ntxhov siab txawv teb chaws. Yeej lawv tawm los xyuas qhov zoo txog cov tshuaj:

1. Savenko L. M., kws kho kev nyuaj siab: “Cov neeg mob uas siv cov tshuaj no los rau lub neej ua ntej peb lub qhov muag. Lawv ua ntau lub xov tooj ntawm tes thiab ntseeg tus kheej. Piv nrog rau cov neeg txawv teb chaws, Duloxetine yog pheej yig, yog li kuv feem ntau muab tshuaj rau kuv cov neeg mob, tshwj xeeb tshaj yog cov laus. "
2. Rogachevsky R. Yu., Kws kho kev nyuaj siab: “Cov tshuaj tsis tau zoo dua rau lwm cov tshuaj tiv thaiv kev ua haujlwm hauv nws txoj kev ua tau zoo, tab sis nws kuj muaj cov kev mob tshwm sim tsawg dua. "Cov kev daws tau pab nrog kev nyuaj siab, tab sis muaj kev cuam tshuam rau inversion thiab hloov mus rau hauv lub xeev hypomanic nrog Duloxetine tsis tiav."

Yog li, cov kws kho mob sau tseg txog qhov ua tau zoo ntawm cov tshuaj hauv kev tiv thaiv kev ntxhov siab. Tab sis nrog ntau cov kev puas siab puas ntsws ntau dua, nws yuav tsim nyog siv lwm txoj hauv kev kho.

Kev Ntsuam Xyuas Rau Neeg Mob

Kev tshuaj xyuas cov neeg mob noj tshuaj tsis zoo tas li tas li. Ntau tus sau txog cov kev mob tshwm sim uas tshwm sim los ntawm kev kho mob nrog tshuaj thiab nws qhov tsis muaj txiaj ntsig. Lwm tus, ntawm qhov tsis sib xws, nco ntsoov txog cov txiaj ntsig zoo ntawm tshuaj thiab yooj yim kam rau ua:

1. Diana, 22 xyoo: “Kuv tau ntsib kev phiv los ntawm cov tshuaj thaum pib txoj kev kho. Tom qab ntawd, tsis pom qhov tsis zoo tshwm sim. Cov nyhuv tshuaj tiv thaiv kev ntxhov siab tshwm sim nws tus kheej heev: niaj hnub neuroses tau ploj mus, muaj kev cia siab rau qhov zoo tshaj plaws. Txawm li cas los xij, thaum txiav tawm ntawm txoj kev kho, Kuv tau ntsib ib tus mob "thim tawm", txawm tias cov koob tshuaj tau raug txo qis zuj zus. "
2. Peter, 32 xyoo: “Cov tshuaj tau pab txo cov tsos mob ntawm tus mob fibromyalgia: qhov mob tsawg zuj zus, kev nyuaj siab ploj mus, thiab nws yooj yim dua mloog zoo. Txawm li cas los xij, cov tshuaj ua rau kuv quav heev thiab tsis ntev cov tshuaj ib txwm tsis pab lawm. ”

Duloxetine yog ib qho tshuaj tiv thaiv kab mob hauv tsev uas tuaj yeem kho zoo nrog kev nyuaj siab ntawm ntau lub hauv paus pib. Nws yog ib qho tsim nyog yuav tsum noj cov tshuaj no nrog ceev faj, vim nws ua rau kev quav thiab "tshem tawm" syndrome. Ua ntej siv, nws yog ib qho tseem ceeb kom sab laj nrog kws kho mob.

Kev ntsuas rau siv

• depressive kev ntshawv siab
• kev txhawj xeeb txog qhov dav dav,
• mob hauv daim ntawv ntawm mob hnoos ntshav qab zib neuropathy,
• mob mob ntsws ua mob ntawm cov leeg mus rau lub cev, nrog rau sab nraub qaum, nrog osteoarthritis ntawm lub hauv caug sib koom tes thiab vim yog fibromyalgia.

Cov lus qhia rau kev siv Duloxetine Canon: txoj kev thiab qhov ntau npaum li cas

Duloxetine Canon yog qhia txog kev siv lub qhov ncauj. Cov tshuaj ntsiav yuav tsum tau nqos tag nrho, tsis txhob zuaj, tsis ntxo.Noj mov tsis cuam tshuam rau qhov ua tau zoo ntawm cov tshuaj, tab sis cov tsiav tshuaj yuav tsum tsis txhob xyaw nrog dej los yog ntxiv rau hauv cov zaub mov, vim tias kev puas tsuaj rau cov hnoos qeev yog ua tau.

Thaum pib kho, 60 mg feem ntau yog sau tseg ib hnub ib zaug. Yog tias tsim nyog, nce qhov koob tshuaj rau 60 mg 2 zaug ib hnub.

Cov neeg mob uas ua kom mob ntshav siab yuav tsum txo qhov hno thawj zaug lossis txo kev noj tshuaj kom tsawg.

Thawj koob tshuaj Duloxetine Canon rau cov neeg mob uas muaj lub raum ua rau lub hlwb tsis zoo (ua kom tshem tawm tau 10%, feem ntau los ntawm> 1% txog 0.1% txog 0.01% rau

Duloxetine canon: cov nqi hauv cov khw muag tshuaj online

Duloxetine Canon 30 mg enteric-soluble capsules 14 pcs.

DULOKSETIN CANON 30mg 14 pcs. enteric tsiav tshuaj

Duloxetine Canon 60 mg tshuaj ntsiav, enteric, 28 pcs.

DULOKSETIN CANON 60mg 28 pcs. enteric tsiav tshuaj

Duloxetine Canon Caps. Ksh / sol 60mg n28

Kev Kawm: Rostov State Medical University, tshwj xeeb "General Tshuaj".

Cov ntaub ntawv hais txog cov tshuaj raug muab dav dav, muab rau kev qhia tawm thiab tsis hloov chaw cov lus qhia. Kev siv tshuaj rau tus kheej yog qhov txaus ntshai rau kev noj qab haus huv!

Tib neeg cov ntshav "khiav" los ntawm cov hlab ntsha hauv qab qhov siab, thiab yog tias nws txoj kev ncaj ncees tau ua txhaum, nws tuaj yeem tua txog 10 meters.

Qhov hnyav ntawm tib neeg lub hlwb yog li 2% ntawm tag nrho lub cev qhov hnyav, tab sis nws noj txog 20% ​​ntawm oxygen mus rau hauv cov ntshav. Qhov tseeb no ua rau tib neeg lub hlwb muaj kev tiv thaiv rau kev puas tsuaj los ntawm cov pa oxygen.

Raws li kev tshawb fawb, cov poj niam uas haus ob peb khob npias lossis cawv txiv hmab ib lim tiam muaj feem ntau yuav muaj mob khees xaws mis.

Txhua tus neeg muaj tsis tsuas yog nyias tus ntiv tes, tab sis kuj hais lus.

Muaj 74 xyoo nyob hauv tebchaws Australian yawg James Harrison tau los ua neeg muab ntshav li 1,000 zaus. Nws muaj cov ntshav uas tsis tshua muaj ntshav ntau, cov tshuaj tiv thaiv txhawm rau pab cov menyuam mos uas muaj ntshav tsawg txaus kom ciaj sia taus. Yog li, Australian thiaj cawm tau ntau txog ob lab tus menyuam.

Tib neeg lub plab ua haujlwm tau zoo nrog cov khoom txawv teb chaws thiab tsis muaj kev cuam tshuam kho mob. Gastric kua txiv yog paub tias yuav yaj txawm npib.

Cov kws kho hniav tau tshwm sim tsis ntev los no. Rov qab rau hauv lub xyoo pua puv 19, nws yog lub luag haujlwm ntawm tus kws tu plaub hau kom rub tawm cov hniav mob.

Cov poj niam feem ntau muaj peev xwm tau txais kev lom zem ntau dua los ntawm kev xav txog lawv lub cev zoo nkauj hauv daim iav dua li ntawm kev sib deev. Yog li, cov poj niam, siv zog ua kom muaj kev sib haum xeeb.

Yog tias koj poob los ntawm tus nees luav, koj nyiam yob koj lub caj dab ntau dua li yog koj ntog los ntawm nees. Tsuas tsis sim rau refute nqe lus no.

Cov tshuaj muaj npe zoo "Viagra" tau tsim thaum chiv thawj los kho kev mob ntshav siab los ntawm arterial tawg.

Peb lub raum tuaj yeem ntxuav peb liv cov ntshav hauv ib feeb.

Lub siab yog qhov ua haujlwm hnyav tshaj plaws hauv peb lub cev. Nws qhov hnyav nruab nrab yog 1.5 kg.

Nrog kev mus saib xyuas lub txaj tanning, txoj kev pheej hmoo ntawm kev mob qog tawv nqaij yuav nce 60%.

Caries yog hom kis tau yooj yim tshaj plaws hauv ntiaj teb uas txawm tias tus mob npaws tsis tuaj yeem sib tw nrog.

Ntau tshaj $ 500 lab tau ib xyoo yog siv rau cov tshuaj tiv thaiv ua xua nkaus xwb nyob hauv Tebchaws Meskas. Koj puas tseem ntseeg tias txoj hauv kev uas thaum kawg kov yeej kev ua xua yuav pom?

Cov roj ntses tau paub txog ntau xyoo lawm, thiab lub sijhawm no nws tau muaj pov thawj tias nws pab txo kev mob, txo kev mob sib koom tes, txhim kho sos.