Glucophage - pharmacology thiab siv cov tshuaj

Glucophage yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj:

500 lossis 850 mg: zaj duab xis-txheej, dawb, biconvex, puag ncig, ntu ntu - homogeneous dawb pawg (500 mg: 10 pcs. Hauv cov hlwv, 3 lossis 5 blisters hauv ib daim ntawv qhia cardboard, 15 pcs. Hauv cov hlwv, 2 lossis 4 lub hlwv hauv ib daim duab cardboard, 20 pcs. Hauv cov hlwv, 3 lossis 5 blisters hauv daim duab cardboard, 850 mg: 15 pcs. Hauv cov hlwv, 2 lossis 4 blisters hauv cardboard bundle, 20 pcs. 3 los yog 5 blisters nyob rau hauv pob ntawv los qhia),
1000 mg: zaj duab-xim-dawb, dawb, biconvex, oval, nrog ib tus thais ntawm ob sab thiab sau ntawv "1000" ntawm ib sab, ntu ntu ntawm ib pawg dawb uas tsis haum (10 daim hauv blisters, 3, 5, 6 lossis 12 lub hlwv hauv ib daim duab cardboard, 15 pcs. Hauv cov hlwv, 2, 3 lossis 4 blisters hauv cardboard bundle).

Cov muaj pes tsawg leeg ntawm 1 ntsiav tshuaj suav nrog:

Cov tshuaj kom nquag: metformin hydrochloride - 500, 850 lossis 1000 mg,
Ntu cov khoom siv (feem): povidone - 20/34/40 mg, magnesium stearate - 5 / 8.5 / 10 mg.

Muaj pes tsawg leeg zaj duab xis plhaub:

500 thiab 850 mg ntsiav tshuaj (feem): hypromellose - 4 / 6.8 mg,
1000 mg ntsiav tshuaj: opadra huv si (macrogol 400 - 4.55%, hypromellose - 90.9%, macrogol 8000 - 4.55%) - 21 mg.

Cov Tshuaj Hauv Tshuaj

Metformin txo cov kev tshwm sim ntawm hyperglycemia, thaum tiv thaiv kev txhim kho ntawm hypoglycemia. Tsis zoo li sulfonylurea derivatives, cov tshuaj tsis txhim kho cov tshuaj insulin hauv lub cev thiab tsis muaj kev cuam tshuam ntawm hypoglycemic rau cov tib neeg noj qab haus huv. Metformin txo qhov kev nkag siab ntawm peripheral receptors rau insulin thiab ua kom cov ntshav qabzib siv nyob rau hauv cov hlwb, thiab tseem inhibits cov synthesis ntawm qabzib hauv lub siab vim kev tsis sib xyaw ntawm glycogenolysis thiab gluconeogenesis. Cov tshuaj kuj tseem ua rau qhov nqus ntawm cov piam thaj hauv cov hnyuv.

Metformin ua kom glycogen synthesis los ntawm kev ua ntawm glycogen synthase thiab ua rau muaj peev xwm thauj ntau ntawm txhua hom kev thauj cov kua nplaum. Nws tseem pom zoo cuam tshuam lipid metabolism, txo qhov concentration ntawm triglycerides, qis lipoproteins thiab tag nrho cov cholesterol.

Tawm tsam cov keeb kwm ntawm Kev Kho Mob Glucofage, tus neeg mob lub cev qhov hnyav tsis tu ncua lossis txo qis ib nrab.

Cov kev tshawb fawb soj ntsuam tshawb kom paub tseeb txog kev ua haujlwm ntawm cov tshuaj rau kev tiv thaiv cov ntshav qab zib hauv cov neeg mob ntshav qab zib uas muaj kev pheej hmoo ntxiv rau kev txhim kho kev mob ntshav qab zib hom 2 yog tias txoj kev hloov hauv kev ua neej tsis tuaj yeem lees tias yuav tswj tau glycemic.

Cov Tshuaj Pharmacokinetics

Tom qab cov neeg siv qhov ncauj, metformin yog nqus los ntawm cov hnyuv zom tag nrho. Kev tsis txaus ntseeg txog qhov muaj peev xwm txog ntawm 50-60%. Qhov siab tshaj plaws ntawm ib yam khoom hauv cov ntshav ntshav tau mus txog kwv yees li 2.5 teev tom qab kev tswj hwm thiab yog li 2 μg / ml lossis 15 μmol. Thaum noj Glucofage ib txhij nrog zaub mov, qhov nqus ntawm metformin txo qis thiab maj mam poob.

Metformin tau muab faib nrawm thoob plaws lub cev nqaij thiab tsuas khi rau cov protein kom tsawg me me. Cov nquag ua haujlwm ntawm Glucofage yog metabolized heev tsis zoo thiab ua rau cov zis. Kev tshem tawm ntawm metformin hauv cov neeg noj qab haus huv yog 400 ml / min (uas yog 4 npaug ntau dua li creatinine tshem tawm). Qhov tseeb no ua pov thawj lub xub ntiag ntawm active tubular secretion. Ib nrab-lub neej yog kwv yees li 6,5 teev. Hauv cov neeg mob uas lub raum tsis ua haujlwm, nws nce, thiab qhov kev pheej hmoo ntawm kev txuam nrog tshuaj nce ntxiv.

Kev ntsuas rau siv

Raws li cov lus qhia, Glucophage tau tshaj tawm rau kev kho mob hom 2 ntshav qab zib mellitus, tshwj xeeb tshaj yog nyob rau cov neeg mob rog rog, nrog kev ua tsis tau zoo ntawm kev siv dag zog thiab kev kho lub cev:

Cov neeg laus: raws li monotherapy lossis ib txhij nrog lwm cov tshuaj hypoglycemic hauv qhov ncauj lossis nrog insulin,
Cov menyuam yaus los ntawm 10 xyoo: raws li monotherapy lossis ib txhij nrog insulin.

Cov Yuav Tsum Muaj

Lub raum tsis ua haujlwm lossis lub raum tsis ua haujlwm (creatinine tshem tawm (CC) tsawg dua 60 ml ib feeb),
Ntshav qab zib: ketoacidosis, precoma, coma,
Cov chaw kuaj mob tau tshwm sim ntawm cov mob los yog mob ceev tuaj yeem ua rau cov nqaij mos hypoxia, nrog rau lub plawv tsis ua haujlwm, ua pa tsis ua haujlwm, mob myocardial infarction,
Mob uas ua rau muaj qhov pheej hmoo ntawm lub raum ua haujlwm: mob hnyav kis, lub cev qhuav dej (nrog ntuav, raws plab), poob siab,
Lub siab ua haujlwm tsis zoo, ua haujlwm siab,
Cov kev raug mob thiab kev phais mob ntau ntxiv (nyob rau qhov uas qhia txog kev kho tshuaj insulin),
Lactic acidosis (suav nrog keeb kwm),
Mob ethanol lom, mob qaug cawv ntev,
Ua raws li kev noj haus hypocaloric (tsawg dua 1000 kcal ib hnub),
Lub sijhawm tsis pub tsawg tshaj 48 teev ua ntej thiab 48 teev tom qab kev tshawb fawb radiological lossis radioisotope nrog kev tswj hwm ntawm cov tshuaj iodine uas muaj cov tshuaj tiv thaiv tsis zoo,
Cev xeeb tub
Hypersensitivity rau cov tshuaj.

Cov kua nplaum yuav tsum tau ua nrog ceev faj hauv cov neeg mob uas muaj hnub nyoog 60 xyoo, cov poj niam laus, thiab cov neeg mob ua lub cev hnyav (vim qhov pheej hmoo ntawm mob lactic acidosis).

Cov lus qhia rau kev siv Glucofage: txoj kev thiab ntau npaum li cas

Glucophage yuav tsum tau noj qhov ncauj.

Rau cov neeg laus, cov tshuaj yuav siv tau los ua kev kho mob ib leeg lossis ib txhij nrog lwm cov tshuaj tiv thaiv ntshav qab zib hauv qhov ncauj.

Thaum pib kho, Glucofage 500 lossis 850 mg feem ntau yog kho. Cov tshuaj yog coj 2-3 zaug hauv ib hnub nrog pluas noj lossis tam sim ntawd tom qab ib pluas noj. Ua raws li cov concentration ntawm cov piam thaj hauv cov ntshav, ib qho kev nce zuj zus ntxiv hauv koob tshuaj yog muaj peev xwm ua tau.

Cov txij nkawm txhua hnub koob tshuaj Glucofage feem ntau yog 1,500-2,000 mg (siab tshaj 3,000 mg). Noj cov tshuaj 2-3 zaug hauv ib hnub txo qhov hnyav ntawm kev phiv los ntawm cov hnyuv plab. Tsis tas li, kev nce zuj zus ntawm txoj kev noj tshuaj tuaj yeem pab txhawb kev txhim kho txoj hnyuv kam rau ntawm cov tshuaj.

Cov neeg mob tau txais cov tshuaj metformin hauv koob tshuaj 2000-3000 mg ib hnub tuaj yeem hloov pauv rau Glucofage ntawm koob tshuaj 1000 mg (qhov siab tshaj plaws - 3000 mg ib hnub, muab faib ua 3 koob). Thaum npaj kev hloov pauv los ntawm kev noj lwm cov tshuaj hypoglycemic, koj yuav tsum tsum tsis txhob noj nws thiab pib siv Glucofage nyob rau hauv cov tshuaj hais saum toj no.

Yuav kom ua tiav cov tswj ntshav qab zib kom zoo, metformin thiab insulin tuaj yeem siv ua ke. Qhov pib txhaj ib zaug ntawm Glucofage feem ntau yog 500 lossis 850 mg, qhov ntau zaus ntawm kev tswj hwm yog 2-3 zaug hauv ib hnub. Cov koob tshuaj insulin yuav tsum tau xaiv raws li kev mloog zoo ntawm cov piam thaj hauv cov ntshav.

Rau cov menyuam yaus txij li 10 xyoo, Glucofage tuaj yeem raug coj los ua tshuaj monotherapy lossis ua ib txhij nrog insulin. Thawj koob tshuaj thawj zaug feem ntau yog 500 lossis 850 mg, qhov ntau zaus ntawm kev tswj hwm - 1 zaug ib hnub. Raws li kev saib xyuas ntawm cov ntshav qab zib tom qab 10-15 hnub, cov koob tshuaj tuaj yeem hloov kho. Qhov siab rau ib hnub ntau npaum li cas yog 2000 mg, faib ua 2-3 koob.

Cov neeg laus yuav tsum xaiv ib koob tshuaj metformin nyob rau hauv kev saib xyuas lub raum kev ua haujlwm tsis raug cai (cov kab mob creatinine yuav tsum txiav txim tsawg kawg 2-4 zaug hauv ib xyoos).

Glucophage raug noj txhua hnub, tsis muaj kev so. Thaum tshem tawm txoj kev kho, tus neeg mob yuav tsum qhia tus kws kho mob txog qhov no.

Sab sij huam

Lub plab zom mov: feem ntau - ntuav, xeev siab, raws plab, tsis qab los noj mov, mob plab. Feem ntau, cov tsos mob tshwm sim thaum pib ntawm txoj kev kho thiab, raws li txoj cai, dhau los nthawv. Txhawm rau txhim kho lub plab hnyuv thev taus, nws raug nquahu kom noj zaub mov rau lub sijhawm lossis tom qab noj mov 2-3 zaug hauv ib hnub. Cov koob tshuaj yuav tsum tau nce nce zuj zus,
Tej leeg hauv siab: ntau - saj yam ntxhov,
Kev tiv thaiv kab mob: tsis tshua muaj - lactic acidosis, nrog kev kho mob ntev, kev nqus ntawm cov vitamin B12 tuaj yeem txo, uas yuav tsum tau tshwj xeeb tshaj yog nyob rau hauv cov neeg mob megaloblastic anemia,
Daim siab thiab kab mob biliary: muaj tsawg kawg - kab mob siab, ua kom lub siab ua haujlwm tsis zoo. Raws li txoj cai, txoj kev phiv tshuaj tom qab tshem cov tshuaj metformin ploj tag,
Cov tawv nqaij thiab cov nqaij mos subcutaneous: mob tsis tshua muaj - khaus, erythema, pob.

Cov kev mob tshwm sim rau cov menyuam yaus nws zoo sib xws hauv qhov loj thiab qhov raug rau cov neeg mob hauv cov neeg laus.

Noj ntau dhau

Thaum noj tshuaj Glucofage nyob rau hauv ib koob ntawm 85 g (qhov no yog 42.5 lub sijhawm qhov siab tshaj qhov niaj hnub), cov neeg mob feem ntau tsis mob ntshav qab zib, txawm li cas los xij, cov neeg mob tau tsim cov kab mob lactic acidosis.

Ib qho kev haus ntau tshaj tawm lossis qhov muaj feem cuam tshuam nrog kev pheej hmoo tuaj yeem cuam tshuam kev loj hlob ntawm lactic acidosis. Thaum muaj cov tsos mob ntawm tus mob no, Kev kho tus mob Glucofage yuav tsum tau nres tam sim ntawd, tus neeg mob maj nrawm rau hauv tsev kho mob thiab qhov mob siab ntawm lactate hauv lub cev tau txiav txim siab kom pom tseeb qhov kev kuaj mob. Txoj hauv kev zoo tshaj plaws los tshem tawm metformin thiab lactate yog hemodialysis. Kev kho mob kuj muaj qhia.

Cov lus qhia tshwj xeeb

Vim tias muaj kev sib txuam ntawm metformin, ib qho tsis tshua pom tab sis muaj qhov hnyav tshwm sim tau - lactic acidosis (muaj qhov tshwm sim ntawm kev pheej hmoo siab tuag ntau thaum tsis muaj kev kho mob xwm txheej ceev). Feem ntau, tus kab mob no loj tuaj hauv cov neeg mob ntshav qab zib mellitus uas mob raum tsis ua haujlwm zoo. Lwm yam cuam tshuam txog kev pheej hmoo yuav tsum tau txiav txim siab: ketosis, decompensated diabetes mellitus, kev quav dej cawv, lub siab tsis ua haujlwm, kev yoo mov ntev thiab lwm yam kev mob cuam tshuam nrog mob hypoxia.

Kev txhim kho ntawm cov kab mob lactic acid tuaj yeem qhia los ntawm cov cim tsis yog tshwj xeeb xws li mob leeg, nrog cov tsos mob dyspeptic, mob plab thiab mob asthenia heev. Tus kab mob yog tus cwj pwm los ntawm acidotic ua tsis taus pa thiab txo lub cev txias ua raws li los ntawm coma.

Glucophage daim ntawv thov yuav tsum muaj kev cuam tshuam 48 teev ua ntej npaj phais cov haujlwm. Txoj kev kho tuaj yeem rov ua dua tsis pub dhau 48 teev tom qab kev phais, muab lub raum ua haujlwm tau pom zoo li qub thaum kuaj.

Ua ntej noj cov tshuaj Glucofage, thiab tsis tu ncua yav tom ntej, kev tsim kom muaj vaj huam sib luag yuav tsum txiav txim siab: hauv cov neeg mob uas lub raum muaj nuj nqi - tsawg kawg ib xyoos ib zaug, hauv cov neeg laus, nrog rau creatinine tshem tawm ntawm qis qis ntawm ib txwm - 2-4 zaug hauv ib lub xyoo Cov.

Kev saib xyuas tshwj xeeb yog yuav tsum tau ua rau muaj kev cuam tshuam rau lub raum kev ua haujlwm hauv cov neeg laus, nrog rau kev siv Glucofage nrog cov tshuaj tiv thaiv kab mob siab, tshuaj diuretics lossis tshuaj tsis-steroidal anti-inflammatory tshuaj.

Thaum siv Glucophage hauv kev kho mob ntshav ntshav, kev kuaj mob tus mob ntshav qab zib hom 2 yuav tsum muaj kev paub tseeb ua ntej kev kho mob. Metformin tsis raug cuam tshuam los ntawm kev pub dawb thiab kev loj hlob. Txawm li cas los xij, vim tias tsis muaj cov ntaub ntawv ntev ntev, nws raug nquahu kom ua tib zoo saib xyuas kev tshwm sim tom qab ntawm cov qog ntshav ntawm cov ntsuas no hauv cov menyuam yaus, tshwj xeeb tshaj yog thaum pub quav. Qhov ntau tshaj saib xyuas yog xav tau rau cov me nyuam 10-12 xyoo.

Cov neeg mob yuav tsum tau qhia ntxiv mus rau kev noj zaub mov kom zoo nrog kev noj haus txawm li ntawm carbohydrates thoob plaws ib hnub. Nrog rau kev rog dhau hoom, koj yuav tsum txuas ntxiv kom yoog rau cov zaub mov hypocaloric (tab sis tsis pub tsawg dua 1000 kcal ib hnub).

Txhawm rau tswj ntshav qab zib, nws raug nquahu tias yuav tsum tau kuaj ntsuas lub cev tsis tu ncua.

Nrog rau kev kho mob monotherapy, metformin tsis ua rau mob ntshav qab zib, tab sis thaum siv ib txhij nrog insulin lossis lwm yam kev tiv thaiv hypoglycemic (suav nrog sulfonylureas, repaglinide), kev ceev faj yuav tsum siv thaum tsav tsheb thiab cov txheej txheem nyuaj.

Cev xeeb tub thiab lactation

Cov ntshav qab zib tsis tau them thaum lub cev xeeb tub nce qhov kev pheej hmoo ua tsis taus haujlwm ntawm lub cev xeeb tub thiab cov menyuam tuag taus. Cov ntaub ntawv pov thawj tsawg tsawg los ntawm cov kev tshawb fawb soj ntsuam tau tshaj tawm tias kev noj cov tshuaj Metformin hauv cov neeg mob cev xeeb tub tsis nce qhov tshwm sim ntawm kev ntsuas pom muaj tseeb hauv cov menyuam mos.

Thaum npaj kev xeeb tub, zoo li thaum cev xeeb tub tshwm sim thaum kho nrog Glucofage thaum mob ntshav qab zib thiab hom 2 mob ntshav qab zib mellitus, cov tshuaj yuav tsum tau muab tso tseg. Cov neeg mob uas muaj ntshav qab zib hom 2 tau raug sau kho kho mob insulin. Cov ntshav muaj ntshav qabzib yuav tsum nyob nrog cov neeg nyob ze tshaj rau qhov ib txwm txhawm rau txo kev pheej hmoo ua tsis taus haujlwm hauv lub cev.

Metformin raug txiav txim nyob rau niam mis. Cov kev tsis zoo hauv cov menyuam mos thaum lub sijhawm pub niam mis thaum tseem tab tom noj tshuaj Glucofage tsis tau pom. Txawm li cas los xij, txij li cov ntaub ntawv hais txog kev siv tshuaj hauv pawg neeg mob no tam sim no tsis txaus, kev siv cov metformin thaum lactation tsis pom zoo. Qhov kev txiav txim siab kom ncua lossis tsis pub mis niam ntxiv yog ua tom qab cuam tshuam txog cov txiaj ntsig ntawm kev pub niam mis thiab muaj feem ua rau muaj kev tsis zoo nyob rau hauv menyuam.

Yeeb tshuaj sib cuam tshuam

Glucophage tsis tuaj yeem siv thooj txhij nrog cov tshuaj iodine muaj radiopaque.

Cov tshuaj tsis pom zoo kom noj nrog ua ke nrog ethanol (qhov kev pheej hmoo ntawm lactic acidosis nyob rau hauv kev haus dej cawv ntau ntxiv yog tias daim siab tsis ua haujlwm, tom qab kev noj zaub mov kom tsis muaj calorie thiab noj zaub mov tsis zoo).

Ceev faj yuav tsum noj nrog glucophage nrog danazole, chlorpromazine, glucocorticosteroids rau kev siv tshuaj pleev ib ce thiab kev siv cev, "voj" diuretics, thiab beta2-adrenergic agonists raws li kev txhaj tshuaj. Nrog rau kev siv thooj txhij nrog cov tshuaj saum toj no, tshwj xeeb tshaj yog thaum pib kho, ntau zaus yuav tsum tau kuaj ntshav qabzib ntau dua. Yog tias tsim nyog, cov koob tshuaj metformin thaum kho yuav tsum kho.

Angiotensin-hloov ua enzyme inhibitors thiab lwm yam tshuaj tiv thaiv kabmob ntshav tuaj yeem txo cov ntshav qabzib. Yog tias tsim nyog, kev kho tshuaj metformin yog tsim nyog.

Nrog rau kev siv ua ke ntawm glucophage nrog acarbose, sulfonylurea derivatives, salicylates thiab insulin, hypoglycemia tuaj yeem tsim kho.

Cov tshuaj yeeb yaj kiab (digoxin, amiloride, procainamide, morphine, quinidine, triamteren, quinine, ranitidine, vancomycin thiab trimethoprim) sib tw nrog metformin rau tubular thauj cov tshuab, uas tuaj yeem ua rau muaj kev nce siab hauv nws qhov nruab nrab siab tshaj plaws (Cmax).

Glucophage analogues yog: Bagomet, Glucophage Ntev, Glycon, Glyminfor, Gliformin, Metformin, Langerin, Metadiene, Metospanin, Siofor 1000, Formmetin.

Kev Ntsuam Xyuas Cov Lus Qab Zib

Cov kev txheeb xyuas ntau heev txog Glucofage feem ntau cuam tshuam nrog nws siv rau qhov poob phaus. Qee tus neeg mob tau tshaj tawm tias txoj kev ua kom yuag yog pom zoo los ntawm kws kho mob, vim tias tsis yog kev noj zaub mov zoo lossis kev tawm dag zog tau pab. Tsis tas li, cov tshuaj siv tsis yog tsuas yog los tawm tsam hnyav ntau dua, tab sis kuj tseem rov qab ua haujlwm rau poj niam. Txawm li cas los xij, noj cov tshuaj metformin rau cov laj thawj no tsis yog ib txwm ua tau zoo: cov kev sim no tuaj yeem ua rau muaj kev loj hlob ntawm cov pathologies loj. Cov ntsiab lus tshwj xeeb ntawm kev tshawb fawb no tsis paub. Nrog rau ntshav qab zib, glucophage ua hauj lwm zoo thiab feem ntau pab kom poob phaus.

Tus nqi ntawm glucophage nyob rau hauv cov khw muag tshuaj

Hauv cov chaw muag tshuaj, tus nqi ntawm Glucofage 500 mg yog txog 105-127 rubles (30 ntsiav tshuaj suav nrog pob) lossis 144-186 rubles (60 ntsiav tshuaj yog suav nrog pob). Koj tuaj yeem yuav cov tshuaj uas muaj qhov ntau npaum 850 mg rau txog 127-187 rubles (30 ntsiav tshuaj yog suav nrog pob) lossis 190-244 rubles (60 ntsiav tshuaj yog suav nrog pob). Tus nqi ntawm Glucofage nrog tshuaj ntawm 1000 mg yog kwv yees li 172–205 rubles (30 ntsiav tshuaj suav nrog pob) lossis 273–340 rubles (60 ntsiav tshuaj yog suav nrog pob).

Pharmacological kev txiav txim

Glucofage® txo qis hyperglycemia, tsis tas yuav ua rau kev txhim kho ntshav qab zib.Tsis zoo li sulfonylurea derivatives, nws tsis txhawb kev mob siab insulin thiab tsis ua

hypoglycemic effect nyob rau hauv cov neeg noj qab haus huv. Tsub qhov rhiab heev ntawm peripheral receptors rau insulin thiab kev siv cov kua nplaum los ntawm lub hlwb. Txo cov ntshav qabzib ntau lawm los ntawm inhibiting gluconeogenesis thiab glycogenolysis. Ncua kev nqus cov hnyuv ntawm lub ntsej muag.

Metformin stimulates glycogen synthesis los ntawm kev ua ntawm glycogen synthase. Tsub kom muaj peev xwm thauj tau txhua yam ntawm cov khoom thauj ua kua roj ntau dua.

Tsis tas li ntawd, nws muaj txiaj ntsig zoo rau lipid metabolism: nws txo cov ntsiab lus ntawm cov roj (cholesterol) tag nrho, cov lipoproteins tsawg thiab triglycerides.

Thaum noj cov tshuaj metformin, tus neeg mob lub cev hnyav dua li qub tseem ruaj khov lossis txo qis.

3D duab

Zaj duab xis-coated ntsiav tshuaj	1 tab.
cov tshuaj nquag:
metformin hydrochloride	500/850/1000 mg
tus zam: povidone - 20/34/40 mg, magnesium stearate - 5 / 8.5 / 10 mg
zaj duab xis sheath: ntsiav tshuaj ntawm 500 thiab 850 mg - hypromellose - 4 / 6.8 mg, ntsiav tshuaj ntawm 1000 mg - Tus Pov Txoov Yig dawb huv (hypromellose - 90.9%, macrogol 400 - 4.55%, macrogol 800 - 4.55%) - 21 mg

Kev piav qhia ntawm daim ntawv tshuaj

500 thiab 850 mg ntsiav tshuaj: dawb, puag ncig, biconvex, zaj duab xis-coated, hauv ntu ntu - homogeneous dawb pawg.

1000 mg ntsiav tshuaj: dawb, oval, biconvex, them nrog ib zaj duab xis sheath, nrog ib qho kev thais ntawm ob sab thiab kos duab "1000" ntawm ib sab, hauv qhov chaw hla - ib qho homogeneous dawb pawg.

Kev taw qhia ntawm cov tshuaj Glucofage ®

hom 2 mob ntshav qab zib mellitus, tshwj xeeb tshaj yog rau cov neeg mob rog rog, nrog qhov tsis muaj txiaj ntsig ntawm kev noj zaub mov zoo thiab ua si lub cev:

- hauv cov neeg laus, raws li kev kho mob monotherapy lossis hauv kev sib xyaw nrog lwm tus neeg lub qhov ncauj hypoglycemic lossis insulin,

- hauv cov menyuam yaus txij li 10 xyoo los ua kev kho mob lossis siv tshuaj insulin,

kev tiv thaiv ntawm tus mob ntshav qab zib hom 2 hauv cov neeg mob uas mob ntshav qab zib nrog rau lwm qhov kev pheej hmoo los tsim tus mob ntshav qab zib hom 2, uas kev hloov pauv hauv lub neej tsis tso cai rau kev tswj ntshav ua kom tiav.

Cev xeeb tub thiab lactation

Cov ntshav qab zib uas tsis tau them ua ke thaum cev xeeb tub yog qhov cuam tshuam nrog kev pheej hmoo ntawm kev yug menyuam thiab lub hnub tuag taus. Tsawg tsawg tus ntawm cov ntaub ntawv qhia tias kev noj cov tshuaj metformin rau cov poj niam cev xeeb tub tsis nce qhov kev pheej hmoo ntawm kev loj hlob ntawm kev yug hauv cov menyuam.

Thaum npaj lub cev xeeb tub, nrog rau kev xeeb tub ntawm keeb kwm yav dhau los ntawm kev noj cov tshuaj metformin nrog ntshav qab zib thiab hom ntshav qab zib hom 2, cov tshuaj yuav tsum tau txiav tawm, thiab yog tias muaj tus mob ntshav qab zib hom 2, kev kho tshuaj insulin yog kho. Nws yog ib qho tsim nyog yuav tsum ua kom tswj tau cov piam thaj hauv ntshav plasma ntawm cov ntshav nyob ze tshaj qhov qub kom txo tau qhov phom sij ntawm cov menyuam hauv plab.

Metformin hla mus rau hauv niam cov kua mis. Tsis pom cov kev mob tshwm sim hauv cov menyuam mos thaum lub sijhawm pub niam mis thaum tseem noj cov tshuaj metformin tsis tau pom. Txawm li cas los xij, vim tias muaj qee cov ntaub ntawv tsawg, kev siv cov tshuaj thaum lub sijhawm pub niam mis tsis pom zoo. Qhov kev txiav txim siab txog kev pub mis niam yuav tsum txiav txim siab txog txiaj ntsig kev pub mis niam thiab kev pheej hmoo ntawm kev phiv

Kev sib txuam

Cov tshuaj tiv thaiv radiopaque Iodine: tawm tsam keeb kwm yav dhau los ntawm kev ua haujlwm lub raum tsis ua haujlwm rau cov neeg mob ntshav qab zib, kev kuaj mob xoo hluav taws xob uas siv cov tshuaj iodine uas muaj cov kab mob radiopaque yuav ua rau muaj kev loj hlob ntawm cov kab mob lactic acidosis. Kev kho mob nrog Glucofage ® yuav tsum tau tsum tsis txhob ntxiv 48 teev ua ntej lossis thaum xoo hluav taws xob los ntawm kev siv iodine-muaj cov tshuaj radiopaque thiab yuav tsum tsis txhob rov ua dua 48 teev tom qab, muab hais tias lub raum ua haujlwm tau raug lees paub qhov qub thaum kuaj.

Cawv: nrog rau kev haus cawv tsis txaus, qhov kev pheej hmoo ntawm kev tsim muaj cov kab mob lactic acidosis nce ntxiv, tshwj xeeb tshaj yog thaum muaj kev noj zaub mov tsis zoo, tom qab kev noj zaub mov kom tsawg, thiab tseem ua rau lub siab tsis ua haujlwm. Thaum noj cov tshuaj, haus dej cawv thiab tshuaj uas muaj ethanol yuav tsum zam.

Tej kev sib txuam uas xav tau ceev faj

Danazole: kev tswj hwm ib txhij ntawm cov danazol tsis pom zoo nyob rau hauv kev txiav txim kom tsis txhob muaj cov nyhuv hyperglycemic ntawm tom kawg. Yog tias kev kho mob nrog danazol yog qhov tsim nyog thiab tom qab txiav rau tom kawg, kev kho qhov tshuaj tiv thaiv tshuaj Glucofage ® yog qhov yuav tsum tau ua nyob hauv kev tswj hwm qhov kev tswj hwm ntawm cov ntshav qabzib hauv cov ntshav.

Chlorpromazine: thaum noj nyob rau hauv cov koob tshuaj loj (100 mg / hnub) nce qhov kev mloog zoo ntawm cov piam thaj hauv cov ntshav, txo cov tshuaj insulin tawm. Hauv kev kho tshuaj tiv thaiv kev tiv thaiv thiab tom qab siv ceev xwmphem kawg, kev hloov kho koob tshuaj yuav tsum muaj kev tswj hwm ntawm cov ntshav qabzib concentration.

GKS cov txheej txheem thiab hauv ib cheeb tsam txo cov piam thaj hauv kev siab, nce qhov kev mloog ntawm cov piam thaj hauv cov ntshav, qee zaum ua rau ketosis. Hauv kev kho mob ntawm corticosteroids thiab tom qab txiav kev noj qab haus huv rau tom kawg, kev hloov kho tshuaj Glucofage ® tswj hwm cov ntshav qabzib hauv siab yuav tsum ua.

Tso tshuaj: kev siv ntawm lub voj diuretics ib txhij tuaj yeem ua rau txoj kev txhim kho ntawm cov kab mob lactic acidosis vim muaj kev ua haujlwm tsis zoo rau lub raum. Glucofage ® yuav tsum tsis txhob siv tshuaj yog tias Cl creatinine qis dua 60 ml / min.

Txhaj tshuaj β₂-adrenomimetics: nce qhov kev nce siab ntawm cov piam thaj hauv cov ntshav vim kev tawm ntawm β₂-adrenoreceptors. Hauv qhov no, nws yog ib qhov tsim nyog los tswj cov kev ua kom tau cov kua nplaum hauv cov ntshav. Yog tias tsim nyog, insulin raug pom zoo.

Nrog rau kev siv cov tshuaj rau saum toj no ib zaug, yuav tsum tau kuaj xyuas ntshav qabzib ntau dua, tshwj xeeb thaum pib kho. Yog tias tsim nyog, cov koob tshuaj metformin tuaj yeem hloov kho thaum kho thiab tom qab nws txiav.

Cov tshuaj tiv thaiv kabmob, tshwj tsis yog ACE inhibitors, tej zaum yuav txo cov ntshav piam thaj. Yog tias tsim nyog, cov koob tshuaj metformin yuav tsum tau hloov kho.

Nrog tib lub sijhawm siv cov tshuaj Glucofage ® nrog sulfonylurea derivatives, insulin, acarbose, salicylates, kev txhim kho hypoglycemia yog ua tau.

Nifedipine nce kev nqus thiab C_max metformin.

Cov tshuaj Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim thiab vancomycin) zais cia hauv cov hlab ntsha ua haujlwm nrog metformin rau tubular thauj cov tshuab thiab yuav ua rau muaj kev nce ntxiv hauv nws C_max .

Tsuas tshuaj thiab tswj hwm

Kev kho mob ntshav qab zib thiab kev kho kom sib xyaw ua ke nrog lwm tus neeg mob ntshav qab zib hauv lub qhov ncauj rau cov ntshav qab zib hom 2. Qhov pib noj ib txwm yog 500 lossis 850 mg 2-3 zaug ib hnub tom qab lossis thaum noj mov.

Txhua txhua 10-15 hnub, nws raug nquahu kom kho cov koob tshuaj raws li cov txiaj ntsig ntawm kev ntsuas qhov ntsuas ntawm cov piam thaj hauv ntshav plasma. Kev noj tshuaj qeeb ntxiv pab txo cov phiv los ntawm txoj hnyuv hauv lub plab.

Kev saib xyuas cov tshuaj ntawm cov tshuaj feem ntau yog 1500-2000 mg / hnub. Txhawm rau kom txo cov kev mob tshwm sim los ntawm txoj hnyuv plab, qhov tshuaj txhua hnub yuav tsum tau muab faib ua 2-3 zaug. Qhov kev siv ntau tshaj yog 3000 mg / hnub, muab faib ua 3 koob.

Cov neeg mob uas siv cov tshuaj metformin hauv koob tshuaj 2000-3000 mg / hnub tuaj yeem hloov mus rau cov tshuaj Glucofage ® 1000 mg. Qhov kev xav tau ntau tshaj plaws yog 3000 mg / hnub, muab faib ua 3 koob.

Nyob rau hauv rooj plaub ntawm kev npaj hloov mus los ntawm kev noj lwm tus neeg sawv cev hypoglycemic: koj yuav tsum tsum tsis txhob noj lwm yam tshuaj thiab pib noj cov tshuaj Glucofage ® hauv cov koob tshuaj qhia saum toj no.

Ua ke nrog cov tshuaj insulin. Yuav kom ua tiav cov ntshav qabzib tswj tau zoo dua, metformin thiab insulin hauv cov neeg mob ntshav qab zib hom 2 tuaj yeem raug siv los ua kev sib txuas ua ke. Qhov niaj zaus pib noj ntau dua ntawm Glucofage ® yog 500 lossis 850 mg 2-3 zaug hauv ib hnub, thaum lub koob tshuaj insulin raug xaiv raws li cov concentration ntawm cov piam thaj hauv cov ntshav.

Kho mob ntshav qab zib. Cov koob tshuaj li niaj zaus yog 1000-1700 mg / hnub tom qab lossis thaum noj mov, muab faib ua 2 zaug.

Nws raug nquahu kom ua ntu zus glycemic tswj los ntsuas qhov xav tau ntawm kev siv tshuaj txuas ntxiv.

Tsis hlauv. Metformin tuaj yeem siv rau hauv cov neeg mob uas mob raum tsis ua haujlwm (Cl creatinine 45–59 ml / min) tsuas yog thaum tsis muaj cov xwm txheej uas yuav ua rau muaj kev pheej hmoo ntawm mob lactic acidosis.

Cov neeg mob nrog Cl creatinine 45–59 ml / min. Qhov muab tshuaj thawj zaug yog 500 lossis 850 mg ib hnub ib zaug. Qhov kev siv ntau tshaj yog 1000 mg / hnub, muab faib ua 2 koob.

Cov haujlwm raum yuav tsum tau ua tib zoo saib xyuas (txhua 3-6 hlis).

Yog tias Cl creatinine qis dua 45 ml / min, cov tshuaj yuav tsum nres tam sim ntawd.

Laus lub caij nyoog. Vim tias qhov txo qis hauv kev ua haujlwm ntawm lub raum, cov koob tshuaj metformin yuav tsum raug xaiv raws li kev soj ntsuam tas li ntawm cov raum ua haujlwm (txiav txim siab qhov tsim nyog ntawm creatinine hauv ntshav cov ntshav tsawg kawg 2-4 zaug hauv ib xyoos).

Menyuam yaus thiab tub ntxhais hluas

Hauv cov menyuam yaus txij thaum muaj hnub nyoog 10 xyoo, Glucofage ® tuaj yeem siv tau ob qho tib si rau hauv kev kho tshuaj thiab siv tshuaj insulin. Qhov pib noj ib txwm yog 500 lossis 850 mg 1 zaug nyob rau ib hnub tom qab lossis thaum noj mov. Tom qab 10-15 hnub, qhov tshuaj yuav tsum raug kho raws li kev nqus ntawm cov ntshav qabzib. Qhov siab rau ib hnub ntau npaum li cas yog 2000 mg, faib ua 2-3 koob.

Glucofage ® yuav tsum noj txhua hnub, tsis muaj kev cuam tshuam. Yog hais tias kev kho mob tsis ua haujlwm ntxiv, tus neeg mob yuav tsum qhia rau tus kws kho mob.

Chaw tsim tshuaj paus

Txhua theem ntawm kev tsim khoom, suav nrog kev tswj hwm qhov zoo. Merck Sante SAAS, Fab Kis.

Chaw tsim khoom ntawm thaj chaw: Center de Producion Semois, 2, rue du Pressoir Ver, 45400, Semois, Fabkis.

Los yog muab ntim rau hauv cov tshuaj LLC Nanolek:

Kev tsim cov ntawv tiav cov khoom noj thiab ntim (thawj ntim) Merck Santé SAAS, Fab Kis. Center de tsim tawm Semois, 2 rue du Pressoire Ver, 45400 Semois, Fabkis.

Thib ob (cov neeg siv khoom ntim) thiab muab cov khoom tswj kom zoo: Nanolek LLC, Russia.

612079, cheeb tsam Kirov, Orichevsky koog tsev kawm, nroog Levintsy, Biomedical complex "NANOLEK"

Txhua theem ntawm kev tsim khoom, suav nrog kev tswj hwm qhov zoo. Merck S.L., Spain.

Chaw nyob ntawm thaj chaw tsim khoom: Polygon Merck, 08100 Mollet Del Valles, Barcelona, Spain.

Kev tso npe sau npe: Merck Santé SAAS, Fab Kis.

Cov neeg siv khoom thov thiab cov ntaub ntawv ntawm cov xwm txheej tsis zoo yuav tsum raug xa mus rau qhov chaw nyob ntawm LLC Merk: 115054, Moscow, ul. Tag nrho, 35.

Xov Tooj: (495) 937-33-04, (495) 937-33-05.

Txee lub neej ntawm tshuaj Glucofage ®

500 mg zaj duab xis-coated ntsiav tshuaj - 5 xyoos.

ntsiav tshuaj coated nrog zaj duab xis txheej ntawm 850 mg - 5 xyoos.

zaj duab xis-coated ntsiav tshuaj 1000 mg - 3 xyoos.

Tsis txhob siv tom qab hnub tas sij hawm qhia ntawm pob.

Glucophage muaj pes tsawg leeg

Cov khoom xyaw ua haujlwm: metformin hydrochloride, 1 lub ntsiav tshuaj 500 mg muaj 500 mg metformin hydrochloride, uas sib haum 390 mg metformin, 1 lub ntsiav tshuaj coated 850 mg muaj 850 mg metformin hydrochloride, uas sib haum rau 662.90 mg metformin, 1 ntsiav tshuaj coated Lub plhaw 1000 mg muaj 1000 mg ntawm metformin hydrochloride, uas sib haum rau 780 mg ntawm metformin.

Cov Cim: K 30, magnesium stearate, zaj duab xis txheej rau ntsiav tshuaj ntawm 500 mg, 850 mg ntawm hypromellose, zaj duab xis txheej rau ntsiav tshuaj ntawm 1000 mg opadra KLIA (hypromellose, macrogol 400, macrogol 8000).

Glucofage tso tawm daim ntawv

Zaj duab xis-coated ntsiav tshuaj.

Qhov yooj yim physico-tshuaj cov khoom siv: 500 mg coated ntsiav tshuaj, 850 mg puag ncig ntsiav tshuaj nrog lub ntsej muag biconvex, cov ntsiav tshuaj dawb zaj duab xis, ntsiav tshuaj-txheej yeeb tshuaj, 1000 mg oval-zoo li cov ntsiav tshuaj nrog lub bevel, dawb xim zaj duab xis-coated ntsiav tshuaj , nrog lub thais ntawm ob sab thiab kos txaij ntawm "1000" ntawm ib sab.

Pharmacological pawg

Cov kab mob ua rau ncauj qhov ncauj, nrog rau kev zam ntawm cov tshuaj insulin. Kev Loj Loj. Tus lej ATX A10V A02.

Glucophage pharmacology

Metformin yog qhov muaj txiaj ntsig loj nrog kev ua haujlwm tiv thaiv kabmob. Glucophage, uas nws lub tshuab ntawm kev ua haujlwm yog txhawm rau txhim kho kev siv ntshav qabzib, txo cov ntshav ntshav khov nyob rau ob lub plab thiab tom qab noj mov. Nws tsis txhawb kev tsim cov tshuaj insulin thiab tsis ua rau lub ntsej muag hypoglycemic los ntawm kev siv lub tshuab no.

Metformin ua haujlwm nyob rau hauv peb txoj kev:

ua rau kev txo qis nyob rau hauv cov piam thaj hauv lub siab vim kev txiav txim siab ntawm gluconeogenesis thiab glycogenolysis,
txhim kho insulin rhiab heev nyob rau hauv cov leeg, uas ua rau kev txhim kho peripheral kom zoo dua thiab siv cov piam thaj,
qeeb kev nqus ntawm cov piam thaj hauv cov hnyuv.

Metformin stimulates intracellular glycogen synthesis los ntawm kev ua ntawm glycogen synthetases. Tsub kom muaj peev xwm thauj khoom txhua qhov paub ntawm hom membrane glucose transporters (GLUT).

Txawm hais tias nws ua li cas rau cov ntshav qabzib hauv cov ntshav, metformin muaj cov txiaj ntsig zoo ntawm lipid metabolism. Cov nyhuv no tau muab pov thawj nrog kev siv tshuaj rau hauv cov tshuaj tiv thaiv kab mob nruab nrab lossis ntev: cov tshuaj metformin txo qis cov roj (cholesterol) tag nrho, lipoproteins tsawg thiab triglycerides.

Thaum lub sijhawm sim kho mob nrog kev siv cov metformin, tus neeg mob lub cev qhov hnyav tseem nyob ruaj khov lossis txo qis.

Xuas. Tom qab noj cov tshuaj metformin, lub sijhawm kom ncav cuag lub siab tshaj plaws (Tmax) yog kwv yees li 2.5 teev. Txoj kev noj qab haus huv ntawm 500 mg lossis 800 mg ntsiav tshuaj yog kwv yees li 50-60% hauv cov neeg tuaj yeem noj qab haus huv. Tom qab kev noj, qhov feem uas yuav nqus tsis tau yog tawm hauv cov quav thiab ntau txog 20-30%.

Tom qab kev tswj hwm ntawm qhov ncauj, qhov nqus ntawm metformin yog qhov tuaj yeem thiab tsis tiav.

Cov chaw muag tshuaj ntawm metformin nqus tau yog kwv yees tsis yog-tus kheej. Thaum siv rau hauv cov koob tshuaj pom zoo ntawm metformin, cov ntshav plasma ruaj khov tau ua tiav nyob hauv 24-48 teev thiab tsawg dua 1 μg / ml. Hauv kev tswj xyuas cov kab mob hauv tsev kho mob, cov ntshav siab tshaj plaws ntshav metformin qib (Cmax) tsis ntau dua 5 μg / ml txawm hais tias siv ntau tshaj plaws.

Nrog rau kev noj mov ib txhij, kev nqus ntawm metformin poob qis thiab me ntsis maj mam poob.

Tom qab noj cov tshuaj 850 mg, qhov txo qis hauv qhov siab tshaj plaws ntshav plasma los ntawm 40%, qhov txo qis hauv AUC los ntawm 25%, thiab nce 35 feeb hauv lub sijhawm kom ncav cuag qhov siab tshaj plaws ntshav plasma tau pom. Cov kab mob tseem ceeb ntawm cov kev hloov pauv no tsis paub.

Kev xa Khoom. Plasma protein khi yog negligible. Metformin nkag mus rau cov ntshav liab. Qhov siab tshaj plaws hauv cov ntshav yog qis dua qhov kev siab tshaj plaws hauv cov ntshav ntshav, thiab tau mus txog tom qab tib lub sijhawm. Cov ntshav liab feem ntau sawv cev rau chav faib tawm zaum ob. Qhov nruab nrab ntawm cov khoom faib (Vd) yog li ntawm 63-276 litres.

Kev zom zaub mov. Metformin ua rau tsis hloov pauv ntawm cov zis. Tsis muaj cov metabolites tau pom hauv tib neeg.

Chaw Sau Ntawv. Lub raum tshem tawm ntawm metformin yog> 400 ml / min. Qhov no qhia tau tias metformin raug cais tawm ntawm glomerular pom thiab tubular tso pa tawm. Tom qab kev tswj hwm, kev tshem tawm ib nrab-lub neej yog kwv yees li 6.5 teev. Yog tias qhov ua haujlwm tsis zoo, ua kom lub ntsej muag tsis pom kev txo qis kom muaj nuj nqis rau kev ua kom zoo thiab ua kom zoo, vim li ntawd, kev tshem tawm ib nrab ntawm lub neej nce ntxiv, uas ua rau muaj kev nce ntxiv hauv cov ntshav metformin ntau ntau.

Glucophage cov yam ntxwv ntawm kev soj ntsuam thaj chaw

Hom 2 mob ntshav qab zib mellitus nrog qhov tsis muaj txiaj ntsig ntawm kev noj zaub mov noj thiab qoj ib ce, tshwj xeeb tshaj yog rau cov neeg mob rog dhau:

raws li kev kho mob monotherapy lossis tshuaj sib txuam nrog kev sib xyaw nrog lwm tus neeg lub qhov ncauj hypoglycemic lossis hauv kev sib xyaw nrog cov tshuaj insulin rau kev kho mob ntawm cov neeg laus,
raws li kev kho mob monotherapy lossis kev sib txuas nrog kev kho mob nrog tshuaj insulin rau kev kho mob ntawm cov menyuam yaus txij li 10 xyoo thiab cov hluas.

Txo cov teeb meem ntshav qab zib hauv cov neeg mob muaj hnub nyoog 2 uas mob ntshav qab zib thiab rog dhau mus yog thawj cov tshuaj uas muaj kev kho mob tsis muaj txiaj ntsig.

Dosage daim ntawv

500 mg, 850 mg thiab 1000 mg zaj duab xis-cov ntsiav tshuaj

Ib ntsiav tshuaj muaj

cov tshuaj tshaj tawm yog metformin hydrochloride 500 mg, 850 mg lossis 1000 mg,

tus zam: povidone, magnesium stearate,

cov khoom xyaw ntawm cov zaj duab xis txheej yog hydroxypropyl methylcellulose; hauv cov ntsiav tshuaj ntawm 1000 mg, ntshiab opadra YS-1-7472 (hydroxypropyl methylcellulose, macrogol 400, macrogol 8000).

Cov kua nplaum 500 mg thiab 850 mg: puag ncig, ntsiav tshuaj biconvex, zaj duab xis-txheej dawb

GlucofageÒ 1000 mg: oval, ntsiav tshuaj biconvex, coated nrog cov xim dawb zaj duab xis, muaj kev pheej hmoo rau kev tawg ntawm ob sab thiab cim "1000" ntawm ib sab ntawm lub ntsiav tshuaj

Cov chaw muag tshuaj

Tom qab qhov ncauj tswj hwm ntawm cov tshuaj metformin, qhov siab tshaj plaws ntshav plasma concentration (Cmax) tau mus txog tom qab kwv yees li 2.5 teev (Tmax). Qhov tiag tiag bioavailability hauv cov tib neeg noj qab haus huv yog 50-60%. Tom qab kev tswj hwm ntawm qhov ncauj, 20-30% ntawm metformin raug ntog tawm los ntawm txoj hnyuv plab hnyuv (GIT) tsis hloov.

Thaum siv cov tshuaj metformin nyob rau hauv cov koob tshuaj ib txwm thiab cov qauv ntawm kev tswj hwm, ib qho ntshav plasma tsis tu ncua tau tiav hauv 24-48 teev thiab feem ntau tsawg dua 1 μg / ml.

Qhov qib ntawm khi ntawm metformin rau cov ntshav plasma protein yog qhov tsis lees paub. Metformin tau faib rau cov ntshav liab. Qhov kawg ntawm cov ntshav yuav qis dua ntshav thiab tau mus txog tib lub sijhawm. Qhov nruab nrab ntawm kev faib khoom (Vd) yog 63-266 litres.

Metformin ua rau tsis hloov pauv ntawm cov zis. Tsis muaj tus metformin metabolites tau txheeb pom hauv tib neeg.

Lub raum tshem tawm ntawm metformin ntau dua 400 ml / min, uas qhia txog kev tshem tawm cov tshuaj metformin uas yog siv cov glomerular pom thiab tubular tso tawm. Tom qab qhov ncauj tswj hwm, ib nrab-lub neej yog kwv yees li 6.5 teev.

Yog tias qhov ua haujlwm tsis zoo, ua kom lub ntsej muag tsis pom kev txo qis kom muaj kev tiv thaiv zoo, thiab yog li, kev tshem tawm ib nrab ntawm lub neej nce ntxiv, uas ua rau muaj ntau ntxiv ntawm plasma metformin ntau ntau.

Metformin yog qhov muaj txiaj ntsig loj nrog kev ua kom zoo rau cov leeg ntshav, uas ua rau cov ntshav qabzib thiab ntshav qab zib muaj ntau ntxiv. Nws tsis txhawb cov tshuaj insulin tso cai thiab vim li ntawd nws tsis ua rau kom cov ntshav qog ntshav qab zib.

Metformin muaj 3 txoj haujlwm ntawm kev ua:

(1) txo cov ntshav qabzib ntau lawm los ntawm inhibiting gluconeogenesis thiab glycogenolysis,

(2) txhim kho kev siv thiab kev siv peripheral qabzib hauv cov leeg nqaij los ntawm kev ua kom muaj zog insulin,

(3) qeeb cov hnyuv kev nqus ntawm cov piam thaj.

Metformin stimulates lub zog ntawm intracellular glycogen los ntawm kev ua ntawm glycogen synthase. Nws kuj tseem txhim kho qhov muaj peev xwm ntawm txhua hom membrane ua cov thauj khoom (GLUT).

Hauv cov kev tshawb fawb soj ntsuam, kev noj cov tshuaj metformin tsis cuam tshuam rau lub cev qhov hnyav lossis txo nws me ntsis.

Tsis hais txog nws cov txiaj ntsig ntawm glycemia, metformin tau muaj txiaj ntsig zoo ntawm lipid metabolism. Thaum tswj cov chaw kho mob uas siv tshuaj kho, nws tau pom tias metformin txo qis cov roj (cholesterol) tag nrho, cov lipoproteins tsawg thiab triglycerides tsawg.

Cov tshuaj sib cuam tshuam

Cawv: txoj kev pheej hmoo ntawm kev tsim cov kab mob lactic acid yog txhim kho los ntawm kev haus cawv tsis txaus, tshwj xeeb tshaj yog nyob rau hauv kev tiv thaiv ntawm kev tshaib plab lossis tsis noj zaub mov thiab lub siab tsis ua haujlwm. Lub sijhawm kho nrog Glucofage®, haus cawv thiab tshuaj muaj dej caw yuav tsum zam.

Iodine-muaj sib piv tawm:

Intravascular cov thawj coj ntawm iodine uas muaj cov tshuaj tiv thaiv tuaj yeem ua rau lub raum tsis ua haujlwm. Qhov no tuaj yeem ua rau kom muaj kev sib txuam ntawm metformin thiab ua rau lactic acidosis.

Hauv cov neeg mob uas muaj eGFR> 60 ml / min / 1.73 m2, kev siv cov metformin yuav tsum tau txiav tawm ua ntej lossis thaum lub sijhawm kawm siv cov iodine-uas muaj cov tshuaj tiv thaiv, tsis rov pib ua dua 48 teev tom qab kev tshawb nrhiav, thiab tsuas yog tom qab rov ntsuam xyuas lub raum kev ua haujlwm, uas tau qhia cov txiaj ntsig ib txwm, muab tau tias nws yuav tsis xau tom qab.

Hauv cov neeg mob uas ua tsis taus lub raum kev ua haujlwm ntawm kev mob hnyav (eGFR 45-60 ml / min / 1.73 m2), metformin yuav tsum tau txiav 48 teev ua ntej kev siv ntawm iodine-muaj cov tshuaj tiv thaiv kab mob thiab tsis rov pib dua ua ntej 48 teev tom qab kev tshawb fawb thiab tsuas yog tom qab rov ua dua. kev ntsuam xyuas ntawm lub raum kev ua haujlwm, uas tau qhia cov txiaj ntsig ib txwm thiab tau muab tias nws yuav tsis muaj kev phem ntau tom qab.

Tej kev sib txuam uas xav tau ceev faj

Cov tshuaj uas muaj cov nyhuv hyperglycemic (glucocorticoids (cuam tshuam rau lub cev thiab cov hauv zos) thiab kev mob siab rau lub cev): kev txiav txim siab ntau dua ntawm cov ntshav qabzib yuav tsum muaj, tshwj xeeb tshaj yog thaum pib kho. Yog tias tsim nyog, cov tshuaj ntawm metformin nrog rau cov tshuaj tsim nyog yuav tsum tau kho kom txog rau thaum tom kawg muab tso tseg.

Diuretics, tshwj xeeb tshaj yog voj diuretics, tuaj yeem ua rau muaj kev pheej hmoo ntawm cov kab mob lactic acidosis vim lawv muaj peev xwm tsis zoo rau lub raum kev ua haujlwm.

Daim ntawv tso tawm thiab ntim khoom

Cov ntsiav tshuaj ua yeeb yaj kiab, 500 mg thiab 850 mg:

20 ntsiav tshuaj muab tso rau hauv blister pob ntawm ib zaj duab xis ntawm polyvinyl chloride thiab txhuas ntawv ci.

3 contour pob ua ke nrog cov lus qhia rau kev siv tshuaj hauv xeev thiab Lavxias lus muab tso rau hauv lub thawv ntawv thawv

Ntsiav tshuaj-coated ntsiav tshuaj, 1000 mg:

15 ntsiav tshuaj muab tso rau hauv blister pob ntawm ib zaj duab xis ntawm polyvinyl chloride thiab txhuas ntawv ci.

4 contour pob nrog rau cov lus qhia rau kev siv tshuaj hauv xeev thiab Lavxias lus muab tso rau hauv lub thawv ntawv thawv

Cev xeeb tub thiab lactation

Thaum npaj kev xeeb tub, nrog rau kev xeeb tub thaum siv Metformin, cov tshuaj yuav tsum tsis ua ntxiv, thiab kev kho tshuaj insulin yuav tsum yog cov tshuaj. Nws yog ib qho tsim nyog yuav tsum ua kom tswj tau cov piam thaj hauv ntshav plasma ntawm cov ntshav nyob ze tshaj qhov qub kom txo tau qhov phom sij ntawm cov menyuam hauv plab.

Metformin tawm hauv niam cov kua mis. Tsis pom cov kev mob tshwm sim hauv cov menyuam mos thaum lub sijhawm pub niam mis thaum tseem noj cov tshuaj metformin tsis tau pom. Txawm li cas los xij, vim tias muaj qee cov ntaub ntawv tsawg, kev siv cov tshuaj thaum lub sijhawm lactation tsis pom zoo. Qhov kev txiav txim siab txog kev pub niam mis rau menyuam noj yuav tsum txiav txim siab txog txiaj ntsig kev pub mis niam thiab kev pheej hmoo

cov kev mob tshwm sim hauv tus me nyuam.

Daim ntawv thov nta

Muaj feem xyuam rau kev muaj peev xwm tsav tsheb thiab cov txheej txheem

Kev kho mob Monotherapy nrog Glucofage® tsis ua rau mob ntshav qab zib, yog li ntawd, nws tsis muaj kev cuam tshuam cov peev xwm tsav tsheb thiab cov txheej txheem.

Txawm li cas los xij, cov neeg mob yuav tsum tau ceev faj txog kev pheej hmoo ntawm kev mob ntshav qab zib thaum siv cov metformin ua ke nrog lwm cov tshuaj hypoglycemic (sulfonylurea derivatives, insulin, repaglinide, thiab lwm yam).