Yuav siv cov tshuaj Tebantin li cas? > Kev khomob thiab kev tiv thaiv

Daim ntawv ntau npaum ntawm Tebantin - Coni-Snap capsules: tawv tawv gelatin, lub ntsej muag daj-xim av, lub cev xim yog nyob ntawm qhov tshuaj ntawm cov tshuaj, tshuaj ntsiav muaj puv nrog dawb lossis yuav luag dawb crystalline hmoov (10 pcs. Hauv cov hlwv, 5 lossis 10 hlwv hauv lub thawv ntawv)

koob tshuaj 100 mg: tshuaj ntsiav loj No. 3, lub cev dawb,
300 mg koob tshuaj: tshuaj ntsiav loj No. 1, lub teeb daj lub cev,
400 mg koob tshuaj: tshuaj ntsiav qhov loj me No. 0, lub cev daj-xim txiv kab ntxwv.

1 tshuaj ntsiav muaj:

cov tshuaj nquag: gabapentin - 100, 300 lossis 400 mg,
Cov khoom xyaw pabcuam: talc, lactose monohydrate, magnesium stearate, pregelatinized hmoov txhuv nplej siab,
tshuaj ntsiav npog: hlau zas xim oxide liab (E172), hlau zas hlau oxide daj (E172), titanium dioxide (E171), nkaws,
tshuaj ntsiav lub cev: hlau zas xim oxide liab (E172) thiab hlau zas hlau oxide daj (E172) - rau koob tshuaj 300 thiab 400 mg, titanium dioxide (E171), gelatin.

Cov Tshuaj Hauv Tshuaj

Gabapentin yog cov tshuaj lipophilic, cov qauv uas zoo sib xws rau cov qauv ntawm gamma-aminobutyric acid neutrotransmitter (GABA). Tib lub sijhawm, raws li cov txheej txheem ntawm kev ua, gabapentin txawv ntawm qee lwm yam tshuaj uas cuam tshuam nrog GABA receptors: nws tsis muaj qhov khoom GABA-ergic thiab tsis cuam tshuam qhov uptake thiab metabolism ntawm GABA.

Raws li kev tshawb fawb ua ntej, gabapentin muaj peev xwm khi rau α2-δ subunit ntawm voltage-gated calcium channel thiab inhibit qhov ntws ntawm calcium ions, uas ua lub luag haujlwm tseem ceeb hauv kev tshwm sim ntawm qhov mob neuropathic. Qhov kev txiav txim ntawm gabapentin hauv kev mob neuropathic kuj tseem yog vim muaj cov txheej txheem hauv qab no:

nce zog ntawm GABA,
txo ntawm glutamate-nyob kev tuag ntawm neurons,
kev tsuj ntawm kev tso tawm ntawm neurotransmitters ntawm monoamine pawg.

Hauv cov chaw kuaj mob uas tseem ceeb, gabapentin tsis tuaj yeem khi rau cov neeg txais tshuaj ntawm lwm cov tshuaj sib kis lossis cov xa khoom (suav nrog GABA receptors_A thiab GABA_Hauv, N-methyl-D-aspartate, glycine, glutamate lossis benzodiazepine). Tsis zoo li carbamazepine thiab phenytoin, cov tshuaj no tsis muaj peev xwm cuam tshuam nrog sodium channel hauv vitro.

Qee qhov kev kuaj hauv cov vitro qhia tias gabapentin yuav qee qhov cuam tshuam ntawm glutamate receptor agonist N-methyl-D-aspartate, tab sis cov qauv no yog qhov tseeb rau tsuas yog ntau tshaj 100 μmol, uas tsis tuaj yeem ua tiav hauv vivo.

Gabapentin muaj peev xwm txo qis me ntsis ntawm kev tso tawm cov monoamine neurotransmitters thiab hloov kho cov kev ua haujlwm ntawm cov enzymes glutamate synthetase thiab GABA synthetase hauv vitro. Cov kev sim hauv cov nas qhia tau hais tias nce GABA metabolism hauv qee qhov ntawm lub paj hlwb, txawm li cas los xij, qhov tseem ceeb ntawm cov teebmeem no rau cov haujlwm anticonvulsant ntawm gabapentin tsis tau tsim. Hauv cov tsiaj txhu, cov khoom no muaj peev xwm nkag mus rau lub hlwb cov ntaub so ntswg tau yooj yim thiab tiv thaiv kev qaug dab peg uas tshwm sim los ntawm caj ces los yog raug tshuaj lom neeg (suav nrog GABA synthesis inhibitors) lossis qhov siab tshaj plaws electroshock.

Cov Tshuaj Pharmacokinetics

Cov tshuaj yog nqus sai sai, thiab qhov siab tshaj plaws ntshav plasma yog pom tom qab 3 teev. Tom qab rov ua dua, kom ua tiav qhov siab tshaj plaws, nws yog qhov tsim nyog 1 teev tsawg dua nrog kev siv tshuaj ib zaug. Qhov tsis yooj yim ntawm bioavailability ntawm gabapentin hauv tshuaj ntsiav yog kwv yees li 60%. Nrog rau qhov nce hauv qhov ntau ntawm cov tshuaj, bioavailability ntawm cov khoom no txo.

Kev Siv Khoom noj Tebant nrog kev siv ib txhij, nrog rau cov zaub mov muaj roj ntau, ua rau muaj C_max thiab AUC ntawm gabapentin los ntawm kwv yees li 14% thiab tib lub sijhawm tsis cuam tshuam loj heev rau pharmacokinetics ntawm lub zog.

Thaum noj 300–4800 mg ntawm gabapentin, cov nqi nruab nrab ntawm AUC thiab C_max nce nrog nce zuj zus. Ntawm koob tshuaj tsis ntau tshaj 600 mg, qhov sib txawv ntawm lub linearity ntawm ob qho ntsuas yog qhov me me, thiab siab kawg koob nce qib tsis tshua muaj txiaj ntsig.

Nrog rau kev tswj hwm ib qhov ncauj, qhov ntshav plasma qhov ntau ntawm cov tshuaj hauv cov menyuam yaus 4-12 xyoo zoo ib yam li ntawd hauv cov neeg laus. Lub xeev kev sib luag nrog cov rov qab siv dua tau ua tiav tom qab 1-2 hnub thiab pheej mob thoob plaws thaum kawg ntawm kev kho.

Hauv tib neeg lub cev, gabapentin yog kev siv tsis yog metabolized. Tsis tas li ntawd, cov tshuaj yeeb tshuaj no tsis muaj peev xwm los ntxias cov nqaij hlav oxidative lub cev nrog kev ua haujlwm sib xyaw, uas koom nrog cov metabolism hauv tshuaj.

Gabapentin yog kev xyaum tsis muaj peev xwm khi rau plasma protein (tsawg dua 3%), thiab nws cov khoom faib tawm yog 57.7 litres. Qhov concentration ntawm gabapentin nyob rau hauv cerebrospinal kua yog 20% ntawm cov concentration ntawm cov ntshav hauv ntshav hauv kev sib npaug. Qhov tshuaj no tuaj yeem hla cov ntshav-hlwb teeb meem thiab hla mus rau niam mis.

Kev nthuav dav ntawm Tebantine los ntawm cov ntshav muaj cov kab sib txuas. Kev tshem tawm ib nrab-lub neej tsis nyob ntawm ib koob thiab ua tau los ntawm 5 txog 7 teev. Kev tshem ntshav hauv lub ntsej muag, kev kuaj ntshav hauv lub raum, thiab tus mob gabapentin feem ntau muaj qhov ncaj ncaj rau cov khoom neeg tsim muaj qhov tsis meej. Gabapentin yog raug tshem tawm tsis hloov pauv ntawm lub raum, thiab tseem raug tshem tawm los ntawm cov ntshav ntshav thaum lub sij hawm hemodialysis.

Hauv cov neeg mob laus thiab cov neeg mob uas lub raum tsis ua haujlwm, gabapentin tshem tawm los ntawm ntshav ntshav yog txo qis. Nrog creatinine tshem tawm tsawg dua 30 ml / min, ib nrab-lub neej yog kwv yees li 52 teev. Hauv kev kho mob ntawm cov neeg mob uas lub raum tsis ua haujlwm thiab cov uas mob hemodialysis, kev hloov kho koob tshuaj raug pom zoo.

Kev ntsuas rau siv

mob ib nrab feem ntawm qaug dab peg nrog lossis tsis muaj kev xam phaj dav dav hauv cov menyuam yaus hnub nyoog 12 xyoos thiab cov neeg laus laus - kev kho mob ntshav lossis kho ntxiv,
mob ib nrab feem ntawm qaug dab peg nrog kev paub dav dav (lossis tsis muaj nws) hauv cov menyuam muaj 3-12 xyoo - kev kho mob ntxiv,
neuropathic mob rau cov neeg laus muaj hnub nyoog 18 xyoo rov saum - pab kho thiab kho.

Cov Yuav Tsum Muaj

o ntawm tus mob voos plaub hau (pancreatitis) nyob rau hauv daim ntawv mob,
lactation (lub sijhawm pub mis niam),
cov menyuam yaus hnub nyoog txog li 3 xyoos (txhua txoj kev kho),
cov menyuam hnub nyoog 3-12 xyoo (kho mob hlwb),
lactose intolerance, lactase deficiency, qabzib-galactose malabsorption,
hypersensitivity rau gabapentin thiab ntu ntu ntawm cov tshuaj.

Nrog kev ceev faj, cov tshuaj yuav tsum tau muab rau cov neeg mob uas lub raum tsis ua haujlwm.

Thaum cev xeeb tub, Tebantin tsuas yog siv yog tias qhov kev cia siab rau cov niam muaj peev xwm dhau qhov kev pheej hmoo rau tus me nyuam hauv plab.

Muaj qee yam ntuag ntu hauv cov menyuam yaus tshaj 12 xyoos thiab cov laus

Rau cov menyuam yaus hnub nyoog dhau 12 xyoos thiab cov neeg mob lub hnub nyoog, qhov kev xav tshuaj uas muaj qhov xav paub ntau tshaj plaws feem ntau yog muab los ntawm 900–1200 mg / hnub, ob peb hnub tom qab pib them nyiaj.

Pom zoo koob tshuaj txhua hnub thiab cov caij txhaj tshuaj (A):

Kuv Hnub: 300 mg - 1 zaug nyob rau ib hnub, 1 tsiav tshuaj 300 mg lossis 3 zaug ib hnub, 1 tshuaj ntsiav 100 mg,
Lub sijhawm thib ob: 600 mg - 2 zaug hauv ib hnub, 1 tsiav tshuaj 300 mg lossis 3 zaug hauv ib hnub, 2 tsiav tshuaj 100 mg,
III hnub: 900 mg - 3 zaug ib hnub rau 1 tshuaj ntsiav 300 mg lossis 3 zaug ib hnub rau 3 tsiav tshuaj 100 mg,
IV hnub thiab txuas ntxiv: qhov koob tshuaj tuaj yeem nce ntxiv rau 1200 mg, muab faib sib npaug rau hauv 3 koob tshuaj (piv txwv li, 3 zaug hauv ib hnub, 1 tshuaj ntsiav 400 mg).

Lwm txoj kev kho tshuaj (B): rau hnub 1 ntawm kev kho, qhov pib siv yog - 900 mg ntawm gabapentin ib hnub, muab faib ua 3 koob ntawm 1 tshuaj ntawm 300 mg, hnub tom qab koob tshuaj tuaj yeem raug ntxiv rau 1200 mg rau ib hnub thiab tshaj (nyob ntawm cov txiaj ntsig tshwm sim) nce ib hnub los ntawm 300-400 mg, tab sis tsis siab tshaj qhov niaj hnub tshaj plaws ntawm 2400 mg (nrog rau kev siv peb-zaug). Qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv cov tshuaj ntau dua ntawm cov tshuaj tsis tau to taub zoo.

Muaj qee yam nriaj ntawm cov menyuam yaus 3-12 xyoos uas lub cev hnyav dua 17 kg

Tebantin tau siv rau hauv cov menyuam muaj hnub nyoog 3 txog 12 xyoos nrog lub cev nyhav> 17 kg rau kev kho ntxiv, vim tias tsis muaj cov ntaub ntawv tsis txaus ntseeg txog kev nyab xeeb thiab kev ua haujlwm ntawm nws siv hauv cov hnub nyoog li kev kho mob monotherapy.

Qhov pom zoo kom noj cov tshuaj txhua hnub yog 25–35 mg / kg thiab tau faib ua 3 koob.

Cov txheej txheem rau xaiv cov koob tshuaj muaj txiaj ntsig los ntawm kev ua haujlwm: hnub 1 - 10 mg / kg / hnub, hnub thib 2 - 20 mg / kg / hnub, hnub 3 - 30 mg / kg / hnub. Yog tias tsim nyog, yav tom ntej, koob tshuaj gabapentin txhua hnub tuaj yeem nce ntxiv txog 35 mg / kg / hnub, muab faib ua 3 koob. Raws li kev tshawb fawb txog kev kho mob ntev ntev, kev pom zoo zoo ntawm cov koob tshuaj ntau dua 40-50 mg / kg / hnub yog paub tseeb.

Kev pib noj thawj zaug kom txog thaum kho cov tshuaj gabapentin tau txais (pom zoo txhua hnub ntawm gabapentin nyob ntawm lub cev qhov hnyav):

cov menyuam yaus hnyav txog 17-25 kg (600 mg rau ib hnub): Thawj hnub - 200 mg 1 zaug nyob rau ib hnub, hnub thib 2 - 200 mg 2 zaug ib hnub, Hnub 3 - 200 mg 3 zaug ib hnub,
cov menyuam yaus hnyav dua 26 kg (900 mg rau ib hnub): Thawj hnub - 300 mg ib hnub ib zaug, hnub thib 2 - 300 mg 2 zaug ib hnub, Hnub 3 - 300 mg 3 zaug ib hnub.

Txhawb cov koob tshuaj ntawm Tebantin (menyuam qhov hnyav / koob): 17-25 kg –– 600 mg / hnub, 26-36 kg –– 900 mg / hnub, 37–50 kg –– 1200 mg / hnub, 51–72 kg –– 1800 mg / hnub.

Neuropathic mob

Hauv kev kho mob ntawm neuropathic mob, noj tshuaj zoo rau kev txiav txim siab yog txiav txim siab los ntawm tus kws kho mob koom nrog txoj kev ntawm titration raws li tus neeg teb ntawm tus neeg mob, kev zam ntawm cov tshuaj thiab nws cov txiaj ntsig. Qhov tshuaj yuav ncav cuag li 3600 mg ib hnub (siab kawg).

Pom zoo koob tshuaj txhua hnub thiab cov caij txhaj tshuaj (A):

Kuv Hnub: 300 mg - 1 zaug nyob rau ib hnub, 1 tsiav tshuaj 300 mg lossis 3 zaug ib hnub, 1 tshuaj ntsiav 100 mg,
Lub sijhawm thib ob: 600 mg - 2 zaug hauv ib hnub, 1 tsiav tshuaj 300 mg lossis 3 zaug hauv ib hnub, 2 tsiav tshuaj 100 mg,
III hnub: 900 mg - 3 zaug ib hnub rau 1 tsiav tshuaj 300 mg lossis 3 zaug ib hnub rau 3 tsiav tshuaj 100 mg.

Lwm txoj kev noj tshuaj ntxiv rau kev kho mob hnyav (B): hnub 1, pib noj ib hnub yog 900 mg ntawm gabapentin (muab faib ua 3 koob tshuaj), tom qab ntawd cov koob tshuaj tuaj yeem nce ntxiv nyob rau 7 hnub txog 1800 mg ib hnub.

Txhawm rau kom ua tiav qhov kev xav ua kom tsis haum, nyob rau qee kis, cov koob tshuaj tuaj yeem nce ntxiv mus txog 3600 mg ib hnub, muab faib ua 3 koob. Hauv kev soj ntsuam hauv tsev kho mob tsis tu ncua, koob tshuaj tau nce mus txog 1800 mg rau lub lis piam 1, thiab mus rau 2400 thiab 3600 mg, ntsig txog, rau 2nd thiab koob thib 3.

Cov neeg mob ua kom tsis muaj zog, cov neeg mob uas tsis muaj lub cev hnyav lossis tom qab hloov khoom nruab nrog cev, koob tshuaj Tebantin raug tso cai nce ntxiv nruj me ntsis los ntawm 100 mg rau ib hnub.

Hauv raum tsis ua haujlwm nrog creatinine tshem tawm (CC)

Pharmacological thaj chaw ntawm cov tshuaj Tebantin

Gabapentin yog ib qho qauv ntawm GABA. Lub lipophilicity ntawm gabapentin lwg me me ua rau nws nkag mus los ntawm BBB. Qhov tseeb ntawm kev ua haujlwm ntawm kev ua haujlwm tsis paub. Gabapentin khi rau cov pabcuam kev pabcuam los ntawm voltage-dependant sodium channel thiab, vim li ntawd, hloov kho qhov kev txiav txim ntawm calcium calcium thiab tso tawm cov neurotransmitters. Xws li cov tshuab tuaj yeem ua lub hom phiaj rau gabapentin thaum cov nyhuv analgesic tshwm sim. Gabapentin hloov cov kev ua ntawm GABA synthetase thiab glutamate synthetase hauv vitroCov. Raws li cov kev tshawb fawb, gabapentin txhim kho kev coj ua ntawm GABA hauv cov ntaub so ntswg hlwb. Qhov nqus ntawm cov tshuaj tsis nyob ntawm lub sijhawm ntawm cov khoom noj. Hauv nruab nrab, qhov siab tshaj plaws ntawm gabapentin hauv cov ntshav plasma tau mus txog kwv yees li 3 teev tom qab ib qho kev sib tw ntawm lub qhov ncauj ntawm Tebantin, tsis hais qhov tshuaj thiab ntau npaum li cas. Lub sij hawm kom ncav cuag qhov siab tshaj plaws tom qab rov qab ua dua ib zaug ntawm cov tshuaj yog kwv yees li 1 teev tsawg dua tom qab siv ib zaug.
Nrog kev rov qab zoo dua ntawm cov tshuaj, cov theem saturation tau mus txog tom qab 1-2 hnub thiab tawm tsam thoob plaws hauv txoj kev kho mob.
Qhov chaw muag tshuaj pharmacokinetic ntawm gabapentin (qhov sib piv tus qauv sib txawv hauv%) ntawm cov theem kev tsis txaus siab raws li kev noj tshuaj txhua 8 teev twg tau muab rau hauv qab no.

400 mg (n = 11)

Cmax - ntau qhov ntshav siab tshaj plaws,
Tmax - lub sijhawm uas xav tau mus txog Cmax,
T1 / 2 - ib nrab-lub neej,
AUC (0 - ∞) - thaj chaw hauv qab qhov xav tau thiab lub sijhawm nkhaus,
Ae yog qhov nyiaj ntawm gabapentin tawm hauv cov zis,
ND - kev ntsuas tau tsis ua.

Lub bioavailability ntawm gabapentin tsis yog koob tshuaj tiv thaiv kab mob. Tom qab rov qab ua dua (3 zaug hauv ib hnub) koob tshuaj ntawm koob tshuaj 300-600 mg, pom zoo rau kev kho mob, nws yog li 60%.
Hauv tib neeg daim siab, gabapentin metabolism yog qhov tsis txaus ntseeg, cov tshuaj tsis ua rau muaj kev cuam tshuam ntawm daim siab daim siab koom nrog kev ua haujlwm hauv oxidative.
Gabapentin tsis khi rau plasma protein thiab sai sai nkag mus rau BBB. Qhov kev txiav txim siab tau ntsuas hauv cerebrospinal kua yog 20% ntawm cov ntsiab lus hauv cov ntshav ntshav ntawm cov ntshav zaum.
Kev rho tawm gabapentin los ntawm lub cev yog nqa tawm tshwj xeeb los ntawm lub raum hauv daim ntawv tsis hloov pauv. Ib nrab-lub neej ntawm gabapentin T1 / 2 s yog 5-7 teev. Kev ntsuas cais ntawm gabapentin, T1 / 2, thiab kev tshem lub raum yog ywj siab ntawm cov koob tshuaj thiab tsis hloov tom qab rov qab ua dua.
Cov hnub nyoog hloov pauv ntawm lub raum ua haujlwm hauv cov neeg laus, nrog rau kev ua haujlwm tsis zoo hauv lub raum hauv cov neeg mob, tshwm sim hauv kev txo qis ntawm creatinine, ua rau txo qis plasma tshem ntawm gabapentin thiab kev nce hauv lub sijhawm nws tshem tawm. Hauv kev faib ua feem rau qhov txo qis hauv creatinine kev tshem tawm, qhov feem ntau tsis txaus ntawm gabapentin, ntshav thiab lub raum tshem tawm kom tsawg. Yog li, nws raug nquahu kom xaiv cov koob tshuaj gabapentin raws li kev ua kom tshem tawm creatinine. Gabapentin tuaj yeem tshem tawm ntshav ntshav los ntawm hemodialysis.

Kev siv ntawm cov tshuaj Tebantin

Kev kho mob ntawm neuropathic mob rau cov neeg laus
Muab cov nyhuv thiab kam rau ua siab ntev ntawm cov tshuaj, tus kws kho mob teev qhov ua kom zoo tshaj plaws los ntawm kev maj mam nce nws. Nyob ntawm tus neeg teb ntawm tus neeg mob, qhov ntau tshaj plaws tuaj yeem ncav 3600 mg / hnub.
Cov tshuaj pom zoo siv:

a) hnub 1 - 300 mg gabapentin (1 tshuaj ntsiav 300 mg 1 zaug hauv ib hnub lossis 1 tshuaj ntsiav 100 mg 3 zaug ib hnub).
Hnub thib 2 - 600 mg ntawm gabapentin (1 tshuaj ntsiav 300 mg 2 zaug hauv ib hnub lossis 2 tsiav tshuaj 100 mg 3 zaug ib hnub).
Hnub 3 - 900 mg ntawm gabapentin (1 tshuaj ntsiav 300 mg 3 zaug hauv ib hnub lossis 3 tsiav tshuaj 100 mg 3 zaug hauv ib hnub),
b) nrog mob hnyav heev rau hnub 1, koj tuaj yeem noj 1 tshuaj ntsiav 300 mg 3 zaug, uas sib raug rau 900 mg ntawm gabapentin ib hnub. Tom qab ntawd, hauv 1 lub lis piam, qhov kev muab tshuaj txhua hnub tuaj yeem nce ntxiv mus txog 1800 mg.

Muaj qee kis, yuav tau txhaj tshuaj ntxiv. Qhov koob tshuaj txhua hnub yuav tsum tsis pub tshaj 3600 mg thiab yuav tsum tau faib ua 3 koob. Rau cov neeg mob uas muaj cov mob nyhav hnyav, lub cev hnyav dua lossis hnyav hloov khoom nruab nrog cev, qhov koob tshuaj tsuas yog nce ntxiv los ntawm 100 mg.
Hauv cov neeg mob laus, raws li cov hnub nyoog muaj feem xyuam txo qis hauv kev tsim cov tshuaj tawm ntawm lub cev, cov neeg mob lub raum tsis ua haujlwm (creatinine tshem tawm ≤80 ml / min) thiab cov neeg mob ntawm hemodialysis, cov koob tshuaj yuav tsum tau xaiv ib tus zuj zus raws li cov txheej txheem hauv qab no:
Pom zoo koob tshuaj gabapentin rau kev ua kom lub raum tsis zoo

Qhov koob tshuaj txhua hnub ntawm gabapentin, xam rau 3 koob tshuaj ib hnub, mg / hnub

* Txhua 2 hnub, noj 100 mg ntawm cov tshuaj 3 zaug hauv ib hnub (qhov kev xav tau no yog vim tias tsis muaj tshuaj ntsiav muaj 150 mg ntawm gabapentin).

Sij hawm tshuaj rau hemodialysis: hemodialysis cov neeg mob uas tsis tau noj gabapentin yav dhau los yog qhia kom kho qhov tshuaj kom txaus ntawm 300-400 mg, tom qab ntawd txhua 4 teev ib ntu kev kuaj mob hemodialysis yuav tsum tau siv 200-300 mg ntawm cov tshuaj. Txog hnub thaum kev lim ntshav tsis ua, gabapentin yuav tsum tsis txhob noj.
Tebantin tsiav tshuaj noj qhov ncauj tsis noj ntxhaws thiab haus dej kom ntau. Capsules tuaj yeem noj ob qho tib si nrog noj mov thiab nyob nruab nrab ntawm pluas noj. Thaum noj cov tshuaj 3 zaug hauv ib hnub, qhov so nruab nrab ntawm ob zaug tshuaj yuav tsum tsis pub dhau 12 teev.Yog tus neeg mob tsis nco qab noj ntxiv lawm, tus kws kho mob txiav txim siab yuav rov ntxiv.
Yog tias kev kho mob nrog antacids uas muaj aluminium thiab / lossis magnesium yog nqa tawm ib txhij, Tebantin tsiav tshuaj yuav tsum tsis pub dhau 2 teev tom qab noj tshuaj antacids thiaj li yuav zam tau qhov kev xav tsis zoo nyob hauv lub bioavailability ntawm gabapentin.
Lub sijhawm tiv thaiv yog nyob ntawm kev saib mob tau tshwm sim los ntawm kev kho, feem ntau yuav tsum kho lub sijhawm ntev. Kev tshem tawm ntawm Tebantin lossis kev hloov pauv mus rau lwm cov tshuaj tiv thaiv tshuaj tiv thaiv kab mob ib txwm ua tawm maj, yam tsawg kawg rau 1 lub lis piam, suav nrog thaum tsis muaj dab tsi nthuav tawm kev nce siab ntawm qaug dab peg.
Tshuaj qaug dab peg
Feem ntau, cov nyhuv antiepileptic tshwm sim thaum cov tshuaj siv hauv txhua hnub ntawm 900-1200 mg. Qhov xav tau kev kho ntshav ntshav ntawm cov tshuaj muaj peev xwm ua tau tiav nyob hauv ob peb hnub siv kev noj tshuaj hauv qab no.
Pom zoo kom noj tshuaj
a) hnub 1 - 300 mg gabapentin (1 tshuaj ntsiav 300 mg 1 zaug hauv ib hnub lossis 1 tshuaj ntsiav 100 mg 3 zaug ib hnub).
Hnub thib 2 - 600 mg ntawm gabapentin (1 tshuaj ntsiav 300 mg 2 zaug hauv ib hnub lossis 2 tsiav tshuaj 100 mg 3 zaug ib hnub).
Hnub 3 - 900 mg ntawm gabapentin (1 tshuaj ntsiav 300 mg 3 zaug hauv ib hnub lossis 3 tsiav tshuaj 100 mg 3 zaug ib hnub).
Txog hnub 4 - nce qhov koob rau 1200 mg, noj hauv 3 koob tshuaj faib, uas yog, 1 tshuaj ntsiav 400 mg 3 zaug ib hnub,
b) hnub 1, koj tuaj yeem pib los ntawm kev noj 1 lub tshuaj 300 mg 3 zaug, uas sib raug rau 900 mg gabapentin ib hnub. Tom qab ntawd qhov kev noj tshuaj txhua hnub tuaj yeem nce ntxiv rau 1200 mg.
Raws li cov txiaj ntsig tau, qhov koob tshuaj tuaj yeem raug nce ntxiv txhua hnub los ntawm 300-400 mg, thaum cov tshuaj txhua hnub hauv 3 koob yuav tsum tsis pub tshaj 2400 mg ntawm gabapentin, txij li tam sim no tsis muaj cov ntaub ntawv txaus ntawm kev ua tau zoo thiab kev nyab xeeb ntawm kev siv tshuaj hauv ntau siab siab.
Kev kho mob rau cov menyuam muaj hnub nyoog 3-12 xyoos
Cov koob tshuaj pom zoo txhua hnub rau cov menyuam yaus tshaj 5 xyoos yog 25-35 mg / kg / hnub, rau cov menyuam 3 thiab 4 xyoo - 40 mg / kg / hnub. Qhov koob tshuaj txhua hnub tau muab faib ua 3 koob. Cov koob tshuaj pom zoo rau 1 kg ntawm lub cev hnyav tau muab rau hauv rooj. 1.
Rooj 1
Kev saib xyuas cov tshuaj gabapentin rau cov menyuam muaj 3-12 xyoos

Tag nrho cov tshuaj txhua hnub, mg

Cov koob tshuaj tau txiav txim siab tau txiav txim siab hauv 3 hnub raws li hauv qab no: hnub 1, 10 mg ntawm gabapentin yog tshuaj rau 1 kg ntawm lub cev qhov hnyav, rau hnub thib 2 - 20 mg / kg / hnub thiab rau hnub 3 - 30 mg / kg / hnub (rooj. 2) Cov Khoom Muaj). Ntxiv mus, yog tias tsim nyog, cov tshuaj txhua hnub tuaj yeem nce ntxiv mus rau 35-40 mg / kg, nyob ntawm seb muaj hnub nyoog. Hauv cov kev tshawb fawb soj ntsuam, cov neeg mob txaus siab rau kev kho mob ntev ntev ntawm ib qho tshuaj ntawm 40-50 mg / kg / hnub.
Rooj ntawv 2
Thaum pib txhaj cov gabapentin rau cov menyuam muaj hnub nyoog 3-12 xyoos

Lub cev hnyav

Tag nrho cov tshuaj txhua hnub, mg

Lub cev hnyav

Kev phiv tshuaj ntawm Tebantin

Los ntawm sab ntawm lub hauv nruab nrab hauv lub paj hlwb: nkees nkees nkees, kiv taub hau, nkees thiab ua rau tsis muaj kev sib koom tes ntawm kev txav (ataxia), nystagmus, pom qhov muag tsis pom kev (daim ntawv pov thawj, lub cev ntaj ntsug), mob taub hau, tshee, lub qhov ncauj qhuav, dysarthria, amnesia, tsis hnov qab kev xav, kev nyuaj siab, ntxhov siab, kev ua haujlwm ntawm lub cev.
Los ntawm cov hnyuv: xeev siab, ntuav, tsis nco qab.
Los ntawm cov kab mob plawv: vasodilation.
Los ntawm cov ntshav system: leukopenia.
Los ntawm sab ntawm cov metabolism: peripheral edema.
Los ntawm cov leeg musculoskeletal: pob txha txhaws, myalgia.
Los ntawm tus txheej txheem ua pa: hnoos, pharyngitis, ua tsis taus pa, rhinitis.
Ntawm feem ntawm daim tawv nqaij: mob ntxau, khaus, ua pob.
Los ntawm genitourinary system: impotence.
Lwm tus: qhov hnyav nce, asthenia, paresthesia, insomnia, mob mob plab thiab rov qab, qhov hnov ntawm tshav kub.
Thaum kho nrog gabapentin, hemorrhagic pancreatitis, qee yam kev tsis haum (Stevens-Johnson syndrome, erythema multiforme) tuaj yeem tshwm sim.

Cov lus qhia tshwj xeeb rau kev siv cov tshuaj Tebantin

Cov tshuaj tsis muaj txiaj ntsig nrog qhov kev tawm tsam dav dav, piv txwv li, nrog kev qhaj ntawv. Nrog rau kev siv tib lub sijhawm nrog lwm cov tshuaj tiv thaiv kev ua kom tsis haum, kev hloov pauv hepatic muaj nuj nqi. Kev noj cov tshuaj cuam tshuam rau theem ntawm cov piam thaj hauv cov ntshav (hypo- lossis hyperglycemia). Yog li, nws yog ib qho tsim nyog los tswj cov ntsuas no hauv cov neeg mob ntshav qab zib mellitus rau kev tsim nyog koob tshuaj ntawm gabapentin noj.
Hauv cov neeg mob uas lub raum tsis ua haujlwm, gabapentin raug kho nyob rau hauv cov koob tshuaj txo qis.
Thaum kho, soj ntsuam cov tsos mob ntawm hemorrhagic pancreatitis yuav tshwm sim. Yog li, thaum thawj cov tsos mob ntawm tus mob huam sai tshwm sim (mob hnyav hauv plab plab, xeev siab, ntuav ntxiv), gabapentin yuav tsum tsis ua mus ntxiv. Tus neeg mob yuav tsum tau ua tib zoo kuaj mob (kev kuaj mob thiab kuaj hauv tsev) rau kev paub thaum ntxov ntawm tus mob huam ua kom tiav. Tam sim no, tsis muaj kev paub txaus nrog kev siv gabapentin nyob rau hauv kev mob caj dab ntev. Hauv cov xwm txheej zoo li no, lo lus nug ntawm seb puas yuav tau txais kev kho mob gabapentin ntxiv lossis kom nws txiav nws yog txiav txim los ntawm tus kws kho mob uas koom nrog.
Nrog kev lactose tsis haum, nws yuav tsum tau yug los hauv lub siab tias 100 ntsiav tshuaj muaj 22,14 mg ntawm lactose, 300 mg - 66.43 mg, 400 mg - 88.56 mg.
Noj Tebantin thaum cev xeeb tub yog ua tau tsuas yog tom qab kev soj ntsuam ntxaws ntawm kev pheej hmoo / txiaj ntsig zoo rau leej niam thiab tus me nyuam.
Gabapentin kis mus rau niam mis. Kev kho mob nrog cov tshuaj thaum lactation yog contraindicated vim muaj kev phiv loj heev rau cov me nyuam mos.
Zam kev tsav tsheb thiab kev ua haujlwm cuam tshuam nrog kev pheej hmoo ntawm kev raug mob, tshwj xeeb tshaj yog thaum lub sijhawm pib kho, nrog rau qhov nce ntxiv rau hauv koob tshuaj thiab hloov mus rau lwm cov tshuaj tiv thaiv kab mob.
Cov cawv yuav ua rau muaj kev phom sij ntau ntxiv ntawm gabapentin los ntawm lub hauv nruab nrog hlab ntsha (piv txwv, ua rau lub cev poob nthav).
Nrog rau xya qhov ntau ntawm kev soj ntsuam rau tag nrho cov protein hauv cov zis siv lub litmus sawb, qhov cuav tshwm sim yog qhov ua tau. Hauv cov xwm txheej zoo li no, nws raug nquahu kom paub meej tias qhov txiaj ntsig siv lwm txoj kev tshuaj ntsuam, piv txwv li, siv Biuret test (Biuret test) lossis turbidimetric method.

Kev sib cuam tshuam txog yeeb tshuaj Tebantin

Tsis muaj qhov hloov pauv tseem ceeb hauv qib phenytoin, carbamazepine, valproic acid thiab phenobarbital hauv cov ntshav ntshav, siv los ua cov tshuaj antiepileptic ua ke nrog gabapentin.
Gabapentin tsis cuam tshuam qhov kev txiav txim ntawm norethindrone thiab / lossis ethinyl estradiol muaj cov tshuaj tiv thaiv qhov ncauj, tab sis thaum siv nrog rau lwm cov tshuaj antiepileptic uas txo lawv cov txiaj ntsig, kev txiav txim siab yuav tsum tau cia siab.
Cov tshuaj noj muaj cov kua qaub-ua kom tsis txhob muaj aluminium lossis magnesium tuaj yeem txo gabapentin bioavailability los ntawm 24%. Tebantin tsiav tshuaj yuav tsum noj tsis pub dhau 2 teev tom qab noj tshuaj antacids.
Nrog rau kev siv gabapentin thiab cimetidine tib lub sijhawm, kev tshem tawm gabapentin qee zaum qeeb me ntsis.

Kev noj tshuaj ntau dhau ntawm Tebantin, cov tsos mob thiab kev kho mob

Tej zaum yuav ua rau kiv taub hau, daim ntawv pov thawj tiav, nkees nkees, ua tsis taus txiv, thiab zawv plab. Kev kho mob raws qab. Gabapentin tuaj yeem tshem tawm ntawm lub cev siv cov tshuaj hemodialysis, qhov taw qhia rau qhov uas yuav ua rau muaj kev tsis zoo hauv kev kuaj mob ntawm tus neeg mob lossis txo qis raum kev ua haujlwm.

Sab sij huam

CNS (lub paj hlwb nruab nrab):

tsaug zog,
kiv taub hau,
nystagmus
ataxia
kev pom (amblyopia, diplopia),
tshee hnyo
mob taub hau
dysarthria,
ntxhov siab ntawm kev xav,
amnesia
kev nyuaj siab
kev xav lability
kev xav ntawm kev ntxhov siab
txob taus thiab nce poob siab excitability,
tsis nco qab zoo
twv
txo nyob rau hauv rhiab
hypo- or areflexia,
kev ua siab phem thiab hyperkinesis (hauv cov neeg mob hnub nyoog qis dua 12 xyoos).

hloov ntshav siab (hauv kev taw qhia)
vasodilation.

GIT (mob plab zom mov):

xeev siab,
flatulence
ntuav,
hemorrhagic pancreatitis,
kev tsis nco qab
zawv plab lossiscem quav
nce qab los noj mov
mob caj dab
dryness hauv lub qhov ncauj
discoloration ntawm txha hniav laus los yog nws yeej.

myalgia
ntev li ntawm brittle cov pob txha
arthralgia.

erythema multiforme exudative,
Stevens-Johnson mob
npaws.

ua txhaum ntawm cov piam thaj hauv cov ntshav,
nce transaminase kev ua ub no.

o ntawm lub ntsej muag
hnyav
mob plab
peripheral edema,
rov qab mob
asthenia
npaws
purpura
cov tsos mob xam qhovkev npaws.

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

Tebantin yog qhia rau kev tswj hwm ntawm qhov ncauj. Cov ntsiav tshuaj tau nqos tag nrho, tsis hais zaub mov dab tsi. Tsuas tshuaj gabapentin thiab lub sijhawm ua haujlwm ntawm txoj kev kho yog txiav txim siab tshwj xeeb los ntawm tus kws kho mob koom, nyob ntawm tus kab mob pathology thiab chav kawm ntawm tus kab mob. Rau cov neeg mob txom nyem qaug dab peg cov koob tshuaj ntawm cov tshuaj yog xaiv tus kheej.

Cov neeg laus thiab cov tub ntxhais hluas uas muaj hnub nyoog tshaj 12 xyoos tso cai pom zoo txij nkawm nruab nrab ntawm 900-1200 mg. Cov koob tshuaj txij nkawm tau txiav txim siab nyob rau ntau hnub ntawm kev kho mob siv cov qauv uas tau piav qhia hauv qab no: 1 hnub ntawm kev kho mob - koob tshuaj txhua hnub yog 300 mg ntawm cov tshuaj nquag Gabapentin (1 tshuaj ntsiav ntawm Tebantin 300 mg). Hnub thib 2 ntawm kev kho - qhov koob tshuaj txhua hnub yog 600 mg (1 lub tshuaj txhaj 300 mg lossis 2 tsiav tshuaj ntawm 100 mg hauv peb koob tshuaj 3 zaug). Hnub 3 ntawm txoj kev kho - qhov koob tshuaj txhua hnub yog 900 mg (1 tsiav tshuaj 300 mg hauv peb faib 3 zaug). Txij li hnub thib 4 ntawm kev kho, 900 mg (tej zaum yuav nce txog 1200 mg) ntawm Gabapentin raug kho nyob rau hauv cov tshuaj txhua hnub.

Muaj lwm txoj kev xaiv los xaiv ib koob tshuaj Tebantin, uas lawv pom zoo kom noj thawj koob tshuaj 900 mg (300 mg peb zaug ib hnub). Tom qab, qhov kev xav tau thawj zaug yog titrated, txhua hnub nce los ntawm 300-400 mg, thiab nres thaum qhov cov nyhuv xav ua tiav tau tiav. Cov tshuaj txhaj ib tug zuj zus tau muab faib ua peb koob ib hnub. Qhov siab tshaj plaws ntawm Tebantin ib hnub yog 2400 mg nyob rau hauv cov nqe lus ntawm cov tshuaj nquag. Tsis muaj ntaub ntawv qhia txog kev nyab xeeb thiab ua haujlwm ntawm cov koob tshuaj ntau tshaj qhov teev ntau tshaj plaws.

Cov neeg mob lub hnub nyoog 5 txog 12 xyoos raug kev txom nyem los ntawm qaug dab pegNws raug nquahu kom pib txoj kev kho mob nrog kev txhaj tshuaj thawj zaug txhua hnub ntawm 10 mg / kg ntawm qhov hnyav, muab ob npaug (20 mg / kg) rau hnub thib ob ntawm kev kho mob. Txog rau hnub thib peb, koob tshuaj nce siab txog 25-35 mg / kg thiab tseem nyob rau theem no nrog kev hloov kho tau los ntawm tus kws kho mob raws li cov nyhuv ua tiav. Ntawm qaug dab peg hauv cov menyuam 3 - 4 xyoos pom zoo kom noj tshuaj txhua hnub gabapentinsib npaug 40 mg / kg ntawm qhov hnyav. Cov tshuaj kho tau txiav txim siab maj mam dhau 3 hnub, los ntawm kev noj thawj koob tshuaj txhua hnub ntawm 10 mg / kg rau qhov xav tau koob tshuaj, nce thawj zaug koob tshuaj los ntawm tsis pub ntau tshaj ob zaug hauv 1 hnub. Qhov siab tshaj plaws txhua hnub rau cov neeg mob ntawm lub hnub nyoog no yuav tsum tsis pub siab tshaj 50 mg / kg ntawm lub cev qhov hnyav.

Cov neeg mob rau cov neeg laus txoj kev kho neuralgiaraws li txoj cai, nws raug pom zoo kom ua ib chav kawm ntawm kev kho mob hauv koob tshuaj txhua hnub ntawm 900-1800 mg. Raws li qhov ntsuas thiab nrog kev tiv thaiv zoo ntawm cov tshuaj, qhov koob tshuaj Tebantin tuaj yeem nce ntxiv rau 3600 mg. Kev kho mob pib nrog ib koob tshuaj 300 mg ib hnub twg, maj mam nce qhov koob tshuaj ntawm ib hnub tom ntej los ntawm 300 mg, txog rau ib koob tshuaj 900 mg ib hnub txog (hnub thib 3). Yog tias qhov koob tshuaj txhua hnub ntawm 900 mg yog qhov ua tsis muaj txiaj ntsig, nws tuaj yeem ua ob npaug (txog 1800 mg) rau 7 hnub. Koob tshuaj gabapentin, uas ntau tshaj 300 mg ib hnub twg, tau muab faib ua ntau qhov tshuaj (feem ntau yog peb koob). Ib qho kev qhia txog kev kho mob zoo tshaj plaws yog qhov sau tshuaj rau txhua hnub ntawm 900 mg muab faib ua peb koob (3 tshuaj ntsuab ntawm 300 mg ib zaug).

Ntawm inefficiencies thiab qhov tsis muaj contraindications maj (dhau 7 hnub) nce qhov koob tshuaj mus rau 1800 mg. Qhov kev kho mob no feem ntau yog siv rau tus mob huam. Cov lus qhia rau kev siv Tebantin 300 mg nrog neuralgia qhia txog qhov siab tshaj plaws niaj hnub noj tshuaj ntawm 3600 mg. Nws yuav tsum tau yug los hauv lub siab tias nrog kev mob hnyav ntawm tus neeg mob, hnyav dua, thiab tom qab hloov khoom nruab nrog cev, kev noj tshuaj txhua hnub tuaj yeem nce ntxiv tsis pub dhau 100 mg rau ib hnub. Tej zaum koj yuav xav tau kev hloov kho qhov tshuaj Tebantin, cov neeg laus laus. Nrog raum pathologies, koob tshuaj txhua hnub gabapentin, zoo li lub caij nyoog ntawm kev kho mob, yog txiav txim siab tshwj xeeb los ntawm tus kws kho mob koom thiab nyob ntawm qhov ntsuas KK (creatinine tshem tawm hauv ml / min).

KK 80 thiab siab tshaj - tsis ntau tshaj 3600 mg,
KK 50-79 - tsis ntau tshaj 1800 mg,
KK 30-49 - tsis ntau tshaj 900 mg,
KK 15-29 - tsis ntau tshaj 600 mg,
KK tsawg dua 15 - tsis pub ntau tshaj 300 mg.

Cov koob tshuaj txhua hnub ntawm lub tshuaj tau muab faib ua peb zaug. Yog tias tsis tas yuav siv qhov ntau tshaj koob tshuaj, Tebantin yog tshuaj 100 mg peb zaug ib hnub thiab noj txhua lwm hnub (300 mg ib hnub nrog rau so 24 teev). Xws li thaum teem cia gabapentincov neeg mob nrog CC tsawg dua 15 tab tom kuaj mob hemodialysis thiab yav dhau los tsis siv cov tshuaj no, pom zoo kom noj tshuaj kom txaus (300-400 mg).

Tom qab txhua tus qhia hemodialysisntawm 4 teev, noj 200-300 mg ntawm cov tshuaj. Nyob rau hauv hnub dawb los ntawm hemodialysisTebantin tsis txais. Thim tawm ntawm cov tshuaj Tebantin, ntxiv rau hloov chaw ntawm tus neeg mob mus rau lwm cov tshuaj nrog antiepileptic kev ua sinqa tawm maj, vim muaj kev pheej hmoo ntawm qaug dab peg qaug dab peg.

Kev sib txuam

Nrog rau kev siv ua ke ntawm Tebantin nrog lwm cov tshuaj tiv thaiv kabmob (valproic acid, phenytoin, phenobarbital, carbamazepine) lawv qhov kev hloov pauv hauv cov ntshav tsis hloov pauv. Thaum tsa nrog tshuaj tiv thaiv qhov ncauj Gabapentin tsis cuam tshuam rau lawv qhov kev ua tau zoo, txawm li cas los xij, thaum siv cov kev kho mob sib xyaw nrog lwm cov tshuaj antiepileptic uas txo cov nyhuv ntawm qhov ncauj tshuaj tiv thaiv, qhov txo qis hauv lawv cov nyhuv yog qhov ua tau.

Gabapentin lub raum tshem tawm txo qis thaum noj Cimetidine. Antacid tshuaj, kev npaj muaj cov tshuaj magnesium lossis aluminium (acid-neutralizing) tuaj yeem cuam tshuam cov kev tsis sib haum xeeb ntawm Gabapentin, txo qis txog 24%. Hauv qhov no, lawv pom zoo kom noj Tebantin tsis pub dhau 2 teev tom qab thov tshuaj tiv thaiv kab mob.

Kev phiv los ntawm Tebantin los ntawm lub hauv nruab nrab cov hlab ntsha tuaj yeem txhim kho cov dej haus uas muaj cawv, nrog rau cov tshuaj uas cuam tshuam rau hauv nruab nrab cov hlab ntsha. Nws yog qhov ua tau kom tau txais qhov tsis tseeb nyob rau hauv kev sim tshuaj, nrog kev pab ntawm kev sim litmus, thaum ntsuas kev soj ntsuam rau tag nrho cov protein hauv cov zis. Cov ntaub ntawv los ntawm kev tshawb xyuas zoo li no yuav tsum siv tau yog siv lwm txoj kev tshawb nrhiav.

Kev txheeb xyuas rau Tebantin

Kev txheeb xyuas ntsig txog Tebantin ntawm kev sib tham, ua ib qho yeeb tshuaj rau kev kho mob qaug dab peg qaug dab pegmuaj teeb meem heev. Qee tus ntsuas cov tshuaj no tsuas yog tshwm sim rau ntawm qhov zoo thiab sau tseg qhov txo qis rau zaus thiab lub zog ntawm qaug dab peg, thaum lwm tus tsis hnov qhov txawv txav hauv lawv lub xeev ntawm kev noj qab haus huv. Tej zaum qhov no yog vim muaj qhov qhia tsis raug ntawm kev kho thiab kev xaiv ntawm ib tus neeg kev kho mob koob tshuaj.

Tus neeg mob tshuaj xyuas neuropathic mob Tebantin tau hais kom ua tau zoo heev, raug rau txhua yam kev pom zoo ntawm tus kws kho mob tuaj koom. Ntawm cov kev mob tshwm sim, lub ntsws feem ntau pom. kiv tob hau thiab tsaug zog.

Cov lus piav qhia, yam ntxwv thiab yam ntxwv

Cov tshuaj Tebantin tau txwv kom muab tshuaj raws li cov tshuaj tiv thaiv kev ua kom tsis haum thiab ua kom loog. Lub hom phiaj tseem ceeb yog kev tsuj ntawm epileptic thiab ib feem ntawm qaug dab peg hauv cov neeg laus thiab cov menyuam yaus, nrog rau kev tiv thaiv lawv cov tsos mob. Tsis tas li, cov tshuaj tau raug muab rau cov neeg mob neuropathy thiab mob neuropathic mob raws li kev ua kom loog. Tsis zoo li ntau qhov zoo sib xws thiab hloov pauv, tsiav tshuaj qhia ntau tsawg ntawm contraindications thiab tsis tshua muaj kev phom sij phiv tshuaj, nrog cov pov thawj ua tau zoo.

Lub ntsiab tseem ceeb ntawm cov tshuaj yog gabapentin, uas yog tsim nyob rau hauv gelatin tsiav tshuaj ntawm 100, 300 thiab 400 milligrams. Cov tshuaj yog ib qho ntawm cov qauv sib piv ntawm gamma-aminobutyric acid.

Gabapentin nthuav tawm kev ua haujlwm analgesic thiab antiepileptic, muaj cov yam ntxwv ntawm neuroprotective. Cov pwm ntawm cov tivthaiv tau yooj yim kov yeej cov ntshav-hlwb teeb meem, txij li lawv yog lipophilic.

Cov txheej txheem ntawm kev ua ntawm gabapentin tsis tau to taub tag nrho; muaj pov thawj ntawm kev hloov pauv tsis ntev los no hauv kev ua haujlwm ntawm cov calcium calcium thiab kev tso tawm cov neurotransmitters.

Lub peev txheej bioavailability ntawm lub zog yog nce txog 60%, qhov siab tshaj plaws tau nce mus txog peb teev tom qab kev siv daim ntawv ntawm ib koob. Kev ua kom pom tseeb rau kev ua kom lub cev thev dhau los ua tiav rau hnub thib ob thiab tseem nyob thoob plaws lub sijhawm kev kho mob.

Ib nrab-lub neej ntawm cov yeeb tshuaj yog li 5-6 teev, kev ua tiav rau kev ua tiav tsuas yog ua los ntawm ob lub raum. 20% ntawm lub plasma concentration yog pom nyob hauv cov kua dej synovial.

Kev tshem tawm ib nrab-lub neej nyob rau ntawm cov neeg laus, thiab tseem cov neeg mob kev txom nyem los ntawm lub raum thiab (lossis) daim siab tsis ua haujlwm, nce.

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm tsiav tshuaj nyob rau hauv ib lub plhaub gelatin. Cov pob ntawm cov tshuaj muaj xws li los ntawm 50 txog 100 ntau npaum li cas, tawm mus yog nqa tawm ntawm cov tshuaj. Tus nqi nruab nrab hauv cov khw muag tshuaj hauv tebchaws Russia yog 750-800 rubles. Chaw Tsim Tshuaj - Gideon Richter OJSC. 1103, Budapest, Hungary.

Kev taw qhia thiab lub hom phiaj tseem ceeb

Lub hom phiaj tseem ceeb ntawm cov tshuaj yog los daws qhov qaug dab peg thiab mob ntawm cov neuropathic thiab epileptic xwm. Hauv cov neeg laus thiab menyuam yaus, Tebantin yog siv rau kev tawm tsam mob vwm thiab mob hlwb raws li hauv qab no:

Txo rau ib nrab qaug dab peg nrog thiab tsis muaj kev hais txog qeb nrab. Raws li kev xav tshuaj lossis ntxiv rau hauv cov neeg mob hnub nyoog qis dua 12 xyoos.
Tawm tsam ib nrab qaug dab peg hauv cov neeg mob nrog thiab tsis muaj kev xam phaj dav dav ua ib qho txuas rau hauv cov neeg mob hnub nyoog 3 txog 12 xyoos.

Yog li, cov tshuaj kho tau muab tshuaj yog cov tshuaj tseem ceeb lossis tau nkag rau hauv txoj kev kho mob nyuaj. Cov hnub nyoog tsawg kawg ntawm tus neeg mob yuav tsum yog 3 xyoos. Hauv kev kho mob ntshav tshuaj, cov tshuaj tau txais txiaj ntsig zoo ntxiv yog ib qho tshuaj ntxiv; cov nyhuv ntawm monotherapy tsis tau nkag siab meej.

Dosage xaiv hom

Cov ntsiav tshuaj yuav tsum tau noj ntawm qhov ncauj tsis tas yuav tsum tau haus nrog me me ntawm cov dej. Kev noj tshuaj ntau dua yog txiav txim los ntawm qhov ntsuas, hnub nyoog thiab lub cev qhov hnyav ntawm tus neeg mob. Muab xam los ntawm cov txheej txheem ntau npaum:

Txhawm rau ua kom mob neuropathic, kev siv tshuaj hauv qab no yog siv:

nyob rau thawj hnub: peb zaug ib hnub rau ib koob tshuaj ntsiav 100 mg lossis ib koob tshuaj noj 300 mg koob tshuaj,
ob: ob lub tshuaj ntsiav ntawm 300 milligrams los yog peb koob tshuaj ntawm ob lub tshuaj ntsiav ntawm 200 mg
qhov thib peb: peb tsiav tshuaj ntawm 300 mg rau ib hnub.

Lwm txoj hauv kev (rau qhov mob hnyav) cuam tshuam nrog kev noj txhua hnub ntawm 900 milligrams ntawm cov tshuaj, muab faib ua peb daim ntawv thov. Qhov siab tshaj plaws yog 1800 mg thaum thov rau ib lub lim tiam. Ib qho mob tseem ceeb yog qhov kev hloov tshuaj zuj zus thiab maj mam poob zuj zus.

Yuav kom ua tau qhov siab tshaj plaws ntawm kev kho mob thiab mob ua kom loog, qhov koob tshuaj nce ntxiv txog 3600 milligrams raug tso cai raws li kev pom zoo ntawm tus kws kho mob uas koom nrog. Hauv cov xwm txheej zoo li no, cov tshuaj txhua hnub tseem raug faib ua peb daim ntawv thov. Txawm li cas los xij, cov neeg mob uas tsis muaj zog tom qab kev phais mob, nrog rau cov tib neeg muaj qhov hnyav hnyav tsis pom zoo kom noj ntau dua 100 milligrams ntawm Tebantin ib hnub.

Kev tswj hwm ntawm cov zaub mov tsis cuam tshuam rau qhov nqus ntawm cov khoom ntawm qhov muaj pes tsawg leeg.

Kev xaiv cov tshuaj raws li cov kev txwv thiab contraindications yog ua tau. Hauv tshwj xeeb, txoj kev xav tau no yuav tsum muaj qia thiab hepatic tsis txaus thiab muaj hnub nyoog ntau dua 50 xyoos. Txais tos kuj tseem siv ncauj ntawm peb zaug hauv ib hnub.

Tej zaum Cov Kev Phom Sij Tsis Zoo

Cov kev mob tshwm sim lub ntsiab yog tshwm sim rau hauv lub hauv nruab nrab cov hlab ntshav plawv thiab cov hlab plawv. Feem ntau cov manifested:

tsaug zog thiab hais tag nrho,
kiv taub hau thiab yastes yastaw,
tshee hnyo
dysarthria,
nce psychoemotional excitability,
vasodilation
ntshav tsis txaus ntseeg,

Nws tsis tshua pom muaj qhov ua kom pom kev tsis txaus ntseeg, cuam tshuam ntawm lub plab zom mov (ua kom lub plab, xeev siab thiab ntuav, tsis nco qab noj mov, raws plab, cem quav, pancreatitis, qhov ncauj qhuav). Lwm qhov kev mob uas tsis tshua muaj tshwm sim hauv qee qhov:

arthralgia
nkig pob txha
leukopenia
pharyngitis, mob ntsws,
txog siav thiab hnoos
coov hauv pob ntseg
kev ua xua nrog rau kev nkag siab ntau ntxiv rau cov muaj pes tsawg leeg (tawv nqaij ua pob, ua npaws, exudative erythema),

Nrog rau kev ua kom pom tseeb ntawm cov kev mob tshwm sim, nce ntawm kev mob ntxiv thiab malaise, nws raug tso cai los kho cov tshuaj ntau npaum li cas raws li tus neeg qhov yam ntxwv ntawm tus neeg mob. Nrog rau qhov tseem ceeb tshaj qhov ntawm qhov ntau npaum li cas raws li kev qhia, kev ua kom pom tseeb ntawm kev ua tsis tau zoo thiab tsaug zog, mob taub hau, kiv taub hau, ob lub zeem muag yog qhov ua tau. Yuav kom daws tau qhov teeb meem, kho mob hlwb, tshuaj kho mob caj dab yog siv. Qhov tshuaj tiv thaiv tshwj xeeb rau Tebantin tseem tsis tau tsim.

Analogues ntawm cov tshuaj hauv Lavxias chaw muag tshuaj

Yog tias tsim nyog, koj tuaj yeem xaiv cov tshuaj analogues ntawm cov tshuaj Tebantin raws li cov khoom tseem ceeb, nrog rau cov txheej txheem ntawm kev raug. Feem ntau hloov pauv yog muag hauv khw muag tshuaj txuas tshwj xeeb nrog kws kho mob sau ntawv.

Npe	Yam khoom muaj sia	Chaw tsim tshuaj paus	Tus nqi (rubles)
Pregabalin Richter	Pregabalin	Gideon Richter OJSC (Hungary), Gideon Richter-RUS CJSC (Russia)	350-400
Gabagamma	Gabapentin	Artesan Pharma (Lub Teb Chaws Yelemees)	350-400
Lamictal	Lamotrigine	GlaxoSmithKlein Ua Lag Luam (Russia)	500-600
Keppra	Levetiracetam	UCB Pharma (Belgium)	800-900
Seisar	Lamotrigine	Alkaloid AD (Koom pheej ntawm Macedonia)	700-900
Wimpat	Lacosamide	UCB Pharma S.A. (Belgium)	1000-1200

Kev ntsuas thiab hloov pauv yuav tsum tau xaiv rau gabapentin intolerance, tsis muaj txiaj ntsig Tebantin tsis txaus lossis qhov tshwm sim ntawm cov lus tsis zoo sab tawm tsam tom qab noj cov tshuaj ntsiav. Qhov kev xaiv yog xaiv los ntawm tus kws kho mob mus kawm raws qhov ntsuas thiab tus yam ntxwv ntawm tus neeg mob. Tsis yog txhua yam tshuaj siv rau hauv kev kho menyuam yaus.

Ib qho tseem ceeb thaum siv Tebantin

Tebantin ua rau kom mob siab thiab tiv thaiv kom tsis txhob mob, mob ntswj rau mob vwm thiab mob hlwb rau cov neeg laus thiab cov menyuam yaus uas siv cov txheej txheem hauv nruab nrog cev. Qhov kom zoo ntawm cov tshuaj yog qhov tsawg dua ntawm cov contraindications nrog kev ua haujlwm siab piv rau analogues thiab hloov chaw. Kev xaiv cov tshuaj tuaj yeem yog cov txheej txheem nyuaj, uas yuav ua raws tus neeg tus yam ntxwv ntawm tus neeg mob, hnub nyoog thiab lub cev hnyav. Nws kuj tseem yuav tsum tau coj mus rau hauv qhov teeb meem nyuaj ntawm kev kho mob hauv kev kho menyuam yaus.

Dab tsi yogantineantine

Cov tshuaj nquag los ntawm tshuaj muaj pes tsawg leeg muaj cov qauv zoo ib yam li γ-aminobutyric acid (GABA), uas yog lub npe hu ua neurotransmitter nrog cov tshuaj tiv thaiv tsis zoo. Lub hom phiaj thaum pib ntawm gabapentin cov neeg tsim tawm tau rov ua cov qauv tshuaj ntawm GABA. Tab sis yog hais tias nrog tus qauv nws muab tawm, tom qab ntawd nrog lub tshuab ntawm kev txiav txim tsis muaj ib qho. GABA ncaj qha cuam tshuam rau cov chaw hauv lub hlwb. Thiab yuav ua li cas gabapentin daws qhov mob tseem tsis tau nti tawm tau. Raws li ib qho tshiab, nws txwv tsis pub calcium los ntawm kev nkag mus rau hauv lub hlwb cortical, thiab raws li lwm tus, nws inhibits qhov kev tsim ntawm cov synapses tshiab. Tsis tas li ntawd, nws ua rau txo qis nyob rau hauv neuronal tuag thiab ua rau kom ceev nrawm zog ntawm GABA.

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Dab tsi pab

Cov cim tseem ceeb rau Tebantin yog neuropathic mob thiab qaug dab peg tuaj ib cheeb tsam hauv lub hlwb. Cov lus sib xyaw tsis siv yog tias qhov qaug dab peg feem ntau, nrog cov leeg txha nqaj qaum, tsis nco qab. Li no, cov kev txwv hauv qab no rau ntawm daim ntawv thov yog kev tsis tuaj yeem:

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Mob hauv zos hauv cov neeg mob hnub nyoog 12 xyoos.
Ntxiv kev kho mob nrog rau kev kuaj mob tib yam hauv cov neeg laus.
Kev kho hom mob ntawm cov mob vwm, muaj tus yam ntxwv mob tshwj xeeb thiab tsis paub tswj hwm hauv cov menyuam mos los ntawm 3 xyoos.

Raws li rau kev mob neuropathic uas tshwm sim los ntawm cov txheej txheem tshwm sim los ntawm kev muaj siab nyob hauv cov neeg mob, lawv feem ntau ntsib los ntawm kev haus cawv, cov neeg mob AIDS, cov mob ntshav qab zib, cov neeg mob ua mob txha caj qaum los yog txhav ntawm tus txha caj qaum. Tab sis txwv tsis pub lawv nrog Tebantin raug tso cai tsuas yog rau cov neeg mob txij li 18 xyoo.

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Gynecologist tuaj yeem muab tshuaj rau cov poj niam nrog lub cev ntas, tshwj xeeb tshaj yog kev hloov tshuaj hormone yog contraindicated. Nyob rau hauv kev cuam tshuam ntawm gabapentin, lawv cov pw tsaug zog normalizes, kub flashes ua tsis tshua muaj zog, thiab tag nrho kev noj qab haus huv txhim kho.

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Cov lus qhia rau kev siv

Daim ntawv noj tshuaj ntawm Tebantin yog cov ntsiav tshuaj nrog 300 mg ntawm cov tshuaj ua kom nquag plias. Lawv tau sau nrog sodium carboxymethyl hmoov txhuv nplej siab, magnesium stearate thiab microcrystalline cellulose. Cov kaus poom tau coated nrog lub plhaub gelatin chwv cov hlau thiab titanium sib txuas. Lawv tau haus cawv ua ntej thiab tom qab noj mov, ntxuav nrog dej. Cov nyhuv ntawm cov tshuaj tsis yog instantaneous, koj yuav tau tos tsawg kawg yog 2-3 teev.

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Tus kws kho mob txiav txim siab txog kev kho mob thiab noj ntau npaum li cas. Nws yuav yog raws li hauv qab no:

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Rau cov menyuam yaus hnub nyoog 6 txog 12 xyoos, kev suav tau ua raws li cov qauv qub ntawm 10-15 mg / kg ntawm qhov hnyav nrog nce ntxiv txog 25-35 mg hauv peb hnub tom ntej. Qhov tshuaj txhua hnub tau muab faib ua 3 koob. Lub sijhawm nruab nrab ntawm lawv yog tsawg kawg 12 teev.
Cov neeg laus thiab cov hluas tau haus 3 ntsiav tshuaj ib hnub, tab sis koj yuav tsum pib nrog ib thiab maj mam nce ntxiv.

Qee lub sij hawm nrog mob hnyav koj yuav tsum noj txog 12 tsiav tshuaj ib hnub, tab sis kev pib kho tsis tau pauv.

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Cov tshuaj yeeb dej caw tsis hnov mob nrog cov plasma protein thiab, tom qab 6-7 teev, nws zoo nkaus li nyob hauv qhov zis. Hauv cov neeg mob uas muaj teeb meem urological, kev tshem tawm tshuaj yeeb qeeb. Lawv xav tau kev saib xyuas tshwj xeeb thiab ceev faj thaum xaiv tshuaj ntau.

Qhov kawg ntawm kev kho mob yog tib yam li qhov pib, maj mam dhau los ntawm ntau lub lis piam lossis ntau hli. Nrog txoj kev tsis lees paub ntawm Tebantin thiab lwm yam tshuaj tiv thaiv kab mob, qhov kev pheej hmoo ntawm kev mob plab rov qab yuav nce ntxiv. Ua ke nrog lawv tej zaum yuav tshwm sim:

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mob khaub thuas-zoo li mob
leeg ntshav siab
tachycardia
mob taub hau
tawm hws ntau dhau
kev txhawj xeeb
tsis meej pem,
insomnia
photophobia.

Ib qho kev pauv hloov ntawm cov tswv yim yuav tsum ua tib zoo xav thiab qeeb.

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Thaum cev xeeb tub, tus kws kho mob ntsuas qhov piv ntawm kev pheej hmoo thiab cov txiaj ntsig ntawm cov tshuaj. Hauv cov tsiaj sim, tshuaj tau pom tias nws muaj tshuaj lom mus rau kev muaj me nyuam. Kev pheej hmoo txaus ntshai rau tib neeg tsis tau txhim tsa.

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Hauv cov lus qhia rau kev siv Tebantin 300 mg, nws tau sau tseg tias cov khoom xyaw nquag yog nyob rau hauv niam mis, tab sis nws tsis tau kawm txog tias qhov no yuav ua li cas rau tus menyuam. Yog tias nws yog qhov yuav tsum tau noj tshuaj anticonvulsant, lactation yuav tsum muaj kev cuam tshuam.

Tebantin nqe

Tus nqi sib txawv tsis yog nyob ntawm qhov muaj pes tsawg leeg ntawm cov tshuaj, tab sis kuj nyob ntawm lub npe tshuaj kws tshuaj. Ib pob ntawm 50 ntsiav tshuaj ntawm Lavxias ntau lawm tuaj yeem muas rau 400 rubles, thiab rau German koj yuav tsum them 2 zaug ntxiv.

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Cov neeg mob qee zaum yws yws ntawm kev ntxhov siab tsis txaus, tsis muaj kev kub siab, nkees nkees, tshwj xeeb tshaj yog thaum kawg ntawm kev kho mob. Cov no yog cov cim ntawm thim tawm. Yog li ntawd thiaj li maj mam txo cov tshuaj rau, thiab cov tshuaj tiv thaiv kev txom nyem tau noj tom qab kho. Cov kws kho mob feem ntau teb tau zoo rau cov tshuaj no.

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Tus kws kho mob lub tswv yim

Tebantin tau qhib txoj kev tshiab tshiab hauv kev kho mob neuropathic thiab lwm yam kev mob tshwm sim. Nws muaj ntau qhov zoo:

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kev yoojyim nkag los ntawm cov ntshav-hlwb teeb meem,
tsis muaj kev cuam tshuam nrog cov ntshav protein,
mob raum,
muaj
ua tau pov thawj hauv kev coj ua zoo li hauv kev sim tshuaj,
zoo thev taus
yooj yim ntawm kev siv.

Cov tshuaj phiv tsis cuam tshuam rau daim siab enzymes thiab hloov ua lwm yam. Cov tshuaj yog qhov kev xaiv zoo hauv kev kho mob ntawm cov neeg mob laus, vim tias cov neeg siv tshuaj yaj yeeb txaus siab thiab qib qib muaj kev nyab xeeb. Cov kev mob tshwm sim tsawg dua li muab piv nrog carbamazepines. Tom qab ib lim piam, tus neeg mob hnov zoo dua.

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Yog lawm, Tebantin tsis yog panacea. Tab sis nws pab cov kws kho mob kom paub daws txawm tias mob hnyav thaum lwm cov tshuaj tsis muaj zog lossis hem nrog cov npe ntev dua ntawm kev sib tiv thiab qhov tshwm sim.

Tsuas tshuaj thiab tswj hwm

Cov tshuaj ntsiav tau noj ntawm qhov ncauj, tsis hais txog ntawm cov zaub mov noj, tsis yog zom, nqos tag nrho thiab ntxuav nrog kua kom muaj kua txaus.

Thaum muaj mob ib nrab, txhawm rau txhawm rau siv cov tshuaj tiv thaiv kev ua kom zoo rau cov neeg mob thiab cov menyuam yaus hnub nyoog dhau 12 xyoos, Tebantin raug muab tshuaj hauv 900-1200 mg rau ib hnub. Cov kev kho kom zoo:

Lub tswv yim A: thawj hnub - 300 mg (100 mg peb zaug hauv ib hnub lossis 300 mg ib zaug), hnub thib ob - 600 mg (200 mg peb zaug ib hnub lossis 300 mg ob zaug ib hnub), hnub peb - 900 mg (300 mg peb zaug ib hnub), plaub hnub - 1200 mg (400 mg peb zaug ib hnub),
Lub tswv yim B: thawj hnub - 900 mg (300 mg peb zaug ib hnub), nyob rau hnub txuas ntxiv, koj tuaj yeem nce ntxiv qhov koob tshuaj txhua hnub rau 1200 mg (400 mg peb zaug ib hnub).

Qhov siab tshaj plaws niaj hnub noj ntawm Tebantin yog 2400 mg (800 mg peb zaug ib hnub).

Raws li kev kho ntxiv rau cov mob nriaj ib nrab, cov menyuam 3-12 xyoos nrog lub cev qhov hnyav ntau dua 17 kg tau sau cia 25-35 mg / kg ntawm lub cev qhov hnyav ib hnub, muab faib ua peb koob. Pom zoo kom pib txhaj tshuaj:

cov menyuam hnub nyoog 3 txog 12 xyoos nrog lub cev qhov hnyav ntawm 17-25 kg: thawj hnub - 200 mg rau ib hnub ib zaug, hnub thib ob - 200 mg ob zaug ib hnub, hnub peb - 200 mg peb zaug ib hnub,
cov menyuam hnub nyoog 3 txog 12 xyoos nrog lub cev hnyav dua 26 kg: thawj hnub - 300 mg ib hnub ib zaug, hnub ob - 300 mg ob zaug ib hnub, hnub peb - 300 mg peb zaug ib hnub.

Pib txij plaub hnub ntawm kev kho mob, koob tshuaj txhua hnub ntawm gabapentin tuaj yeem nce ntxiv txog 35 mg / kg ib hnub hauv peb koob tshuaj. Raws li kev tshawb fawb soj ntsuam, koob tshuaj ntawm 40-50 mg / kg ib hnub tau txais txiaj ntsig zoo los ntawm cov neeg mob.

Pom zoo kom txhaj cov tshuaj rau cov menyuam hnub nyoog 3 txog 12 xyoos, nrog lub cev qhov hnyav:

17-25 kg - 600 mg txhua
26-36 kg - 900 mg txhua
37-50 kg - 1200 mg txhua
51-72 kg - 1800 mg txhua.

Txog kev mob neuropathic hauv cov neeg laus laus dua 18 xyoo, koob tshuaj Tebantin yog tsim los ntawm titration, suav txog qhov ua tau zoo ntawm kev kho thiab thev taus ntawm cov tshuaj. Qhov siab rau ib hnub ntau npaum li cas yog 3600 mg ib hnub twg hauv peb faib peb zaug.

Cov kev kho kom zoo:

Lub tswv yim A: thawj hnub - 300 mg (100 mg peb zaug ib hnub lossis 300 mg ib zaug), hnub thib ob - 600 mg (200 mg peb zaug ib hnub lossis 300 mg ob zaug ib hnub), hnub peb - 900 mg (300 mg peb zaug ib hnub)
Lub tswv yim B (rau mob hnyav): thawj hnub - 900 mg (300 mg peb zaug ib hnub), hauv 7 hnub tom ntej, koj tuaj yeem nce thaj ntxiv rau 1800 mg rau ib hnub.

Cov neeg mob uas lub cev nyhav tsis txaus, cov neeg tsis muaj zog thiab cov neeg mob uas tau hloov khoom nruab nrog cev, nce qhov koob tshuaj maj mam, tsis pub ntau tshaj 100 mg ib hnub twg.

Hauv lub raum tsis ua haujlwm (yog tias creatinine tshem tawm tsawg dua 80 ml / min), cov neeg laus uas muaj cov creatinine tshem tawm kom tsawg thiab cov neeg mob ntawm hemodialysis, koob tshuaj Tebantin raug xaiv ib tus zuj zus, suav txog qhov ntsuas ntawm lub raum tsis zoo.

Yeeb tshuaj sib cuam tshuam

Thaum muab cov gabapentin nrog lwm cov tshuaj antiepileptic uas txo cov txiaj ntsig ntawm kev tiv thaiv qhov ncauj, nws muaj peev xwm kom txo lossis txiav qhov kev tiv thaiv zoo ntawm cov tshuaj sib haum.

Cov tshuaj ntsiav yuav tsum noj 2 teev tom qab noj cov tshuaj antacids uas muaj aluminium lossis magnesium, txij li thaum siv ib txhij, lawv txo qis ntawm qhov gabapentin los ntawm 24%.

Cimetidine me ntsis txo qhov kev nthuav tawm ntawm gabapentin los ntawm ob lub raum, uas tsis muaj qhov tseem ceeb hauv tsev kho mob.

Nrog rau kev siv ib txhij nrog ethanol thiab tshuaj uas cuam tshuam rau lub hauv nruab nrab lub paj hlwb, nws muaj peev xwm nce ntxiv txoj kev phiv los ntawm Tebantin los ntawm lub hauv nruab nrab lub paj hlwb.

Thaum ua ke nrog lwm cov tshuaj anticonvulsants, muaj qee qhov kev tshwm sim tsis zoo hauv kev txiav txim siab tag nrho cov protein hauv cov zis siv cov kev ntsuas ib nrab (nws tau pom zoo kom siv ntau txoj hauv kev tshwj xeeb).