Cov tshuaj Forsig - cov lus qhia rau kev siv, tshuaj xyuas, pheej yig analogues
Cov nplooj ntawv no muab cov npe ntawm txhua tus Forsig cov duab sib xyaw hauv kev sib xyaw thiab qhia txog kev siv. Cov npe ntawm cov pheej yig analogues, thiab koj kuj tuaj yeem sib piv cov nqi hauv cov khw muag tshuaj.
- Qhov pheej yig tshaj analogue ntawm Forsig:Ua tub rog
- Cov nyiam tshaj plaws Forsig counterpart:Jardins
- Kev faib tawm ATX: Dapagliflozin
- Cov khoom xyaw nquag / muaj pes tsawg leeg: dapagliflozin
# | Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
---|---|---|---|
1 | Ua tub rog canagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 13 RUB | 3200 UAH |
2 | Novonorm kwv huam Analogue hauv kev taw qhia thiab txoj kev siv | 30 RUB | 90 UAH |
3 | Lub sijhawm dulaglutide Analogue hauv kev taw qhia thiab txoj kev siv | 115 RUB | -- |
4 | Baeta exenatide Analogue hauv kev taw qhia thiab txoj kev siv | 150 rub | 4600 UAH |
5 | Jardins empagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 222 RUB | 566 UAH |
Thaum xam xyuas tus nqi pheej yig ua lag luam Forsig tus nqi yam tsawg kawg nkaus uas tau pom hauv daim ntawv teev tus nqi muab los ntawm cov khw muag tshuaj tau raug coj los suav
# | Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
---|---|---|---|
1 | Jardins empagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 222 RUB | 566 UAH |
2 | Saxenda lisraglutide Analogue hauv kev taw qhia thiab txoj kev siv | 1374 rub | 13773 UAH |
3 | Lub sijhawm dulaglutide Analogue hauv kev taw qhia thiab txoj kev siv | 115 RUB | -- |
4 | Ua tub rog canagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 13 RUB | 3200 UAH |
5 | Baeta exenatide Analogue hauv kev taw qhia thiab txoj kev siv | 150 rub | 4600 UAH |
Muab daim ntawv teev cov tshuaj analogues raws li kev txheeb cais ntawm cov tshuaj feem ntau thov
Analogs hauv kev muaj pes tsawg leeg thiab qhia txog kev siv
Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
---|---|---|
Forksiga Dapagliflozin | -- | 18 UAH |
Cov npe saum toj no ntawm cov yeeb tshuaj analogues, uas qhia Forsig hloov chaw, yog qhov tsim nyog tshaj plaws vim tias lawv muaj tib cov tshuaj sib luag thiab sib luag ua ke raws li kev taw qhia rau kev siv
Analogs los ntawm qhov taw qhia thiab cov qauv ntawm kev siv
Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
---|---|---|
Lixumia lixisenatide | -- | 2498 UAH |
Guarem Guar cob | 9950 rub | 24 UAH |
Insvada repaglinide | -- | -- |
Novonorm Repaglinide | 30 RUB | 90 UAH |
Cov Chaw Tshaj Tawm Repaglinide | -- | -- |
Baeta Exenatide | 150 rub | 4600 UAH |
Baeta Ntev Exenatide | 10248 rub | -- |
Viktoza liraglutide | 8823 rub | 2900 UAH |
Saxenda liraglutide | 1374 rub | 13773 UAH |
Invocana canagliflozin | 13 RUB | 3200 UAH |
Jardins Empagliflozin | 222 RUB | 566 UAH |
Trulicity Dulaglutide | 115 RUB | -- |
Cov ntaub ntawv dav dav, muaj pes tsawg leeg, tso tawm daim ntawv
Tsis ntev los no, cov chav kawm tshiab ntawm cov tshuaj muaj suab thaj txo cov khoom, tab sis muaj cov txiaj ntsig tseem ceeb dua li piv rau cov tshuaj siv yav dhau los, tau dhau los muaj nyob hauv Lavxias. Ib qho ntawm thawj zaug hauv lub tebchaws tau sau npe Forsig tshuaj.
Tus neeg sawv cev tshuaj txog kab mob hauv lub npe radar (kev tso npe tshuaj) raws li lub tshuaj hypoglycemic rau kev siv hauv qhov ncauj.
Cov kws tshaj lij hauv cov txheej txheem ntawm cov kev tshawb fawb muaj peev xwm tau txais cov txiaj ntsig zoo, paub tseeb tias kev txo qis hauv cov tshuaj noj los yog tseem tshem tawm hauv qee kis ntawm kev kho tshuaj insulin vim kev siv tshuaj tshiab.
Kev ntsuam xyuas ntawm cov kws kho mob endocrinologist thiab cov neeg mob hauv qhov no tau sib xyaw. Ntau tus zoo siab rau cov sijhawm tshiab, thiab qee qhov lawv ntshai siv nws, tos cov ntaub ntawv hais txog qhov tshwm sim ntawm kev siv sijhawm ntev.
Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj muaj ntau npaum ntawm 10 lossis 5 mg thiab tau ntim rau hauv cov hlwv hauv ib qho nyiaj ntawm 10, ntxiv rau 14 daim.
Txhua ntsiav tshuaj muaj Dapagliflozin, uas yog cov khoom siv tseem ceeb.
Cov neeg muaj mob nrog rau cov hauv qab no:
- microcrystalline cellulose,
- anhydrous lactose,
- silica
- crospovidone
- magnesium stearate.
- muaj qee cov dej cawv polyvinyl (Opadry II daj),
- titanium dioxide
- macrogol
- talcum hmoov
- daj hlau oxide zas.
Pharmacological kev txiav txim
Dapagliflozin, ua lub luag haujlwm tseem ceeb ntawm cov tshuaj, tseem yog ib qho inhibitor ntawm SGLT2 (cov protein), uas yog, nws suppresses lawv cov haujlwm. Nyob rau hauv kev cuam tshuam ntawm tshuaj yeeb tshuaj, cov piam thaj nqus ntawm thawj cov zis yog txo, yog li ntawd, nws txoj kev nthuav tawm tau ua tiav vim yog kev ua haujlwm ntawm lub raum.
Qhov no ua rau qhov ib txwm ua ntawm cov ntshav glycemia. Ib qhov tshwj xeeb ntawm cov tshuaj yog nws txoj kev xaiv siab, vim tias nws tsis cuam tshuam qhov kev thauj ntawm cov piam thaj mus rau cov ntaub so ntswg thiab tsis cuam tshuam nws txoj kev nqus thaum nws nkag rau hauv txoj hnyuv.
Qhov tseem ceeb ntawm cov tshuaj yog qhia rau kev tshem tawm los ntawm ob lub raum ntawm cov piam thaj, uas tau tsom rau hauv cov ntshav. Tib neeg lub cev nquag plias mus rau ntau cov khoom lag luam metabolic thiab toxins.
Ua tsaug rau cov haujlwm tsim los ntawm ob lub raum, cov tshuaj no tau ua tiav thiab zoo dhau ua ke nrog zis. Hauv kev ua haujlwm ntawm kev nthuav tawm, ntshav hla ntau zaus dhau los ntawm lub raum glomeruli. Protein Cheebtsam yog pib muab tso rau hauv lub cev, thiab tag nrho cov kua dej uas tau lim, ua thawj qhov zis. Nws cov nyiaj ib hnub tuaj yeem ncav 10 litres.
Txhawm rau hloov cov kua dej no mus rau hauv cov zis theem nrab thiab nkag mus rau lub zais zis, nws cov concentration yuav tsum nce ntxiv. Lub hom phiaj no tau ua tiav los ntawm kev nqus rov qab rau hauv cov ntshav ntawm txhua qhov tseem ceeb, suav nrog ua kua nplaum.
Thaum tsis muaj pathology, txhua yam tshuaj yuav rov qab zoo, tab sis nrog ntshav qab zib muaj qee qhov tsis muaj piam thaj hauv cov zis. Qhov no tshwm sim ntawm qib glycemia ntau dua 9-10 mmol / L.
Kev noj cov tshuaj hauv cov tshuaj txheem zoo txhawb txoj kev tso tawm txog li 80 g ntawm cov ntshav piam thaj rau hauv cov zis. Qhov nyiaj no tsis nyob ntawm seb cov tshuaj insulin tsim tawm los ntawm cov txiav los yog tau txais los ntawm kev txhaj tshuaj.
Qhov kev tshem tawm ntawm cov kua nplaum pib tom qab noj cov ntsiav tshuaj, thiab nws cov nyhuv kav li 24 teev. Cov tshuaj yeeb tshuaj hauv lub cev tsis ua rau muaj kev cuam tshuam zoo rau kev tsim cov tshuaj nyob hauv qab ntawm cov ntshav qabzib (hypoglycemia).
Hauv cov txiaj ntsig ntawm kev ntsuas, kev txhim kho tau sau tseg hauv kev ua haujlwm ntawm cov qe hlwb ua lub luag haujlwm rau kev tsim cov tshuaj hormone. Hauv cov neeg mob uas tau siv cov tshuaj ntawm qhov tshuaj ntawm 10 mg rau 2 xyoo, cov piam thaj tau tas li tas li, uas ua rau muaj ntau ntxiv ntawm osmotic diuresis. Ib qho kev nce ntxiv ntawm cov zis yuav tuaj yeem nrog qhov tsis txaus siab ntawm sodium ntxiv los ntawm ob lub raum, tab sis tsis tau hloov pauv qhov txiaj ntsig ntawm cov ntshav poom ntawm cov tshuaj no.
Kev siv ntawm Forsigi pab rau kev poob qis hauv cov ntshav siab uas twb nyob ntawm 2-4 lub lis piam tom qab pib ua haujlwm. Ntxiv rau, kev siv cov tshuaj rau 3 lub hlis txo glycosylated hemoglobin.
Cov Tshuaj Pharmacokinetics
Cov nyhuv pharmacokinetic yog cov yam ntxwv ntawm kev nqus, kev faib tawm, cov metabolism thiab ua haujlwm ntawm cov khoom tseem ceeb:
- Kev Tsis Txaus Siab Tom qab nkag mus, cov khoom xyaw ntawm tus neeg sawv cev tau kiag li ntxeem tau los ntawm phab ntsa ntawm txoj hnyuv plab hnyuv (lub plab zom mov), tsis hais lub sijhawm noj mov. Qhov siab tshaj plaws tom qab noj rau ntawm lub plab khoob tau mus txog tom qab 2 teev thiab nce qhov sib npaug ntawm cov tshuaj. Qib ntawm lub neej tiag tiag bioavailability ntawm lub ntsiab tivthaiv yog 78%.
- Kev xa Khoom. Cov nquag ua haujlwm ntawm cov tshuaj yuav luag 91% khi rau cov protein. Cov kab mob ntawm lub raum lossis lub siab pathology tsis cuam tshuam rau qhov ntsuas no.
- Kev zom zaub mov. Cov tshuaj tseem ceeb ntawm cov tshuaj yog glucoside muaj cov roj carbon carbon nrog cov piam thaj, uas piav qhia tias nws qhov kev tsis kam rau cov glucosidases. Ib nrab-lub neej lub sijhawm xav tau rau ib nrab-lub neej ntawm cov tshuaj sib xyaw los ntawm cov ntshav ntshav yog 12.9 teev nyob rau hauv pab pawg uas kawm txog kev noj qab haus huv tuaj pab dawb.
- Kev cais tawm. Cov tshuaj ntawm cov tshuaj yog dhau los ntawm lub raum.
Video qhuab qhia ntawm cov txhais tau tias ntawm Forsig, ntu 1:
Kev taw qhia thiab contraindications
Cov tshuaj tsis muaj peev xwm ua kom normalce glycemia yog tias tus neeg mob txuas ntxiv tswj tsis tau ntawm kev noj zaub mov carbohydrates.
Yog vim li cas kev noj zaub mov kev noj haus thiab kev nqis tes ua ntawm qoj ib ce yuav tsum yog qhov yuav tsum tau ua los kho kev kho mob. Forsig tuaj yeem raug sau tseg tias tsuas yog cov tshuaj kho, tab sis feem ntau cov ntsiav tshuaj no tau pom zoo ua ke nrog Metformin.
- poob hauv cov neeg mob uas tsis yog insulin,
- siv ua cov tshuaj ntxiv hauv cov neeg mob ntshav qab zib,
- kev txhim kho ntawm kev ua haujlwm tsis zoo rau lub cev khiav tsis zoo
- muaj cov pathologies uas txwv tsis pub tawm dag zog lub cev.
- Ntshav qab zib mob insulin.
- Cev xeeb tub Contraindication tau piav qhia los ntawm cov tsis muaj xov xwm ua pov thawj kev nyab xeeb ntawm kev siv thaum lub sijhawm no.
- Lub sijhawm lactation.
- Hnub nyoog 75 thiab nce. Qhov no yog vim qhov txo qis hauv cov haujlwm uas ua los ntawm lub raum, thiab qhov txo qis hauv cov ntshav.
- Lactose tsis kam lees, uas yog tus pabcuam nyob hauv cov ntsiav tshuaj.
- Kev ua xua uas tuaj yeem loj hlob tau thaum siv cov tshuaj zas pliav hauv plhaub ntawm cov ntsiav tshuaj.
- Kev nce qib ntawm ketone lub cev.
- Mob ntsws (ntshav qab zib).
- Kev lees txais ntawm qee qhov diuretics, cov nyhuv uas tau kho nrog kev kho kom zoo nrog lub pob Forsig.
- muaj kab mob sib kis
- cawv, nicotine (tsis muaj kev sim rau cov nyhuv ntawm cov tshuaj tau nqa tawm),
- nce hematocrit,
- cov kab mob ua kab mob urinary
- laus lawm
- mob raum,
- lub plawv tsis ua hauj lwm.
Cov lus qhia rau kev siv
Cov ntsiav tshuaj noj ntawm qhov ncauj ntawm qhov ntau npaum li cas yog nyob ntawm qhov kev kho mob tau muab rau tus neeg mob:
- Kev Kho Mob Kho Mob. Qhov tshuaj yuav tsum tsis pub tshaj 10 mg rau ib hnub.
- Ua ke kev kho mob. Ib hnub, nws raug tso cai kom noj 10 mg ntawm Forsigi sib xyaw nrog Metformin.
- Kev pib kho nrog 500 mg ntawm Metformin yog 10 mg (ib hnub ib zaug).
Kev tswj hwm ntawm qhov ncauj tsis yog nyob ntawm lub sijhawm noj mov. Txo qhov ntau thiab tsawg kawg ntawm cov tshuaj yog feem ntau xav tau nrog kev kho mob insulin lossis nrog cov tshuaj uas ua rau nws muaj kev zais cia.
Cov neeg mob uas muaj mob hnyav rau lub raum lossis lub siab pathology yuav tsum pib noj cov ntsiav tshuaj nrog kev noj ntau npaum li 5 mg. Nyob rau hauv lub neej yav tom ntej, nws tuaj yeem raug nce ntxiv rau 10 mg, muab tau los ntawm cov cheebtsam zoo tiv thaiv.
Video qhuab qhia ntawm cov txhais tau tias ntawm Forsig, ntu 2:
Cov neeg mob tshwj xeeb
Cov yam ntxwv ntawm cov tshuaj tuaj yeem sib txawv nrog qee qhov pathologies ntawm tus neeg mob lossis cov yam ntxwv:
- Pathology ntawm lub raum. Tus nqi ntawm cov piam thaj tom qab ncaj qha nyob ntawm txoj haujlwm ntawm cov kabmob no.
- Yog tias muaj kev ua txhaum nyob rau hauv daim siab, cov nyhuv ntawm cov tshuaj hloov me ntsis, yog li ntawd, kev kho kom haum ntawm cov tshuaj noj tsis raug tseev kom ua. Cov kev hloov pauv tseem ceeb hauv cov yam ntxwv ntawm cov tshuaj nquag tau pom tsuas yog muaj qhov hnyav ntawm pathology.
- Lub hnub nyoog. Cov neeg mob hnub nyoog qis dua 70 xyoo tsis qhia pom tias muaj kev sib xyaw nrog ntau ntxiv.
- Tub los ntxhais Thaum lub sijhawm siv cov tshuaj, cov poj niam dhau ntawm AUC los ntawm 22% piv nrog txiv neej.
- Kev ntxub ntxaug haiv tsis ua rau muaj qhov sib txawv ntawm cov kev raug mob hauv lub cev.
- Nyhav. Tus neeg rog rog nyhav dua cov nqi qis dua thaum kho.
Cov nyhuv ntawm cov tshuaj rau cov menyuam yaus tseem tsis tau kawm, yog li nws yuav tsum tsis txhob siv los kho tus mob. Qhov kev txwv ib txwm siv rau cov poj niam cev xeeb tub thiab lactating, vim tias tsis muaj ntaub ntawv hais txog qhov ua tau ntawm kev nkag mus ntawm cov khoom ntawm cov khoom mus rau hauv mis.
Cov lus qhia tshwj xeeb
Qhov ua tau zoo ntawm cov tshuaj yog nyob ntawm muaj cov ntshav qab zib muaj feem ntsig txog tus kabmob hauv tus neeg mob:
- Pathology ntawm lub raum. Feem ntau, ib qho kev txo qis hauv kev ua haujlwm ntawm kev siv tshuaj yeeb yog qhov tsis tuaj koom hauv cov neeg raug mob los ntawm kev ua haujlwm tsis ua haujlwm me. Hauv cov qauv mob nyhav, kev noj cov ntsiav tshuaj yuav tsis ua rau kom muaj txiaj ntsig kho qhov xav tau. Cov lus qhia no piav qhia txog qhov yuav tsum tau muaj kev soj ntsuam tsis tu ncua ntawm lub raum kev ua haujlwm, uas yuav tsum tau ua ob peb zaug hauv ib xyoos raws li cov lus pom zoo kho mob
- Pathology ntawm lub siab. Nrog rau kev ua txhaum cai li no, kev nthuav tawm ntawm cov nquag tivthaiv uas yog ib feem ntawm cov tshuaj tuaj yeem nce ntxiv.
Forsig txhais tau tias ua rau kev hloov pauv hauv qab no:
- nce qhov kev pheej hmoo ntawm txo qis cov ntshav ntshav,
- nce siab yuav ua rau muaj qhov nce siab,
- chim siab qhov ntsuas hluav taws xob,
- kev pheej hmoo ntawm kev tsim muaj cov kab mob uas cuam tshuam rau cov mob txeeb zig
- ketoacidosis yuav tshwm sim,
- nce hematocrit.
Nws yog ib qho tseem ceeb kom nkag siab tias kev noj cov ntsiav tshuaj yuav tsum tau ua tom qab sab laj nrog tus kws kho mob.
Phiv thiab haus tshaj
Dapagliflozin tau suav hais tias yog ib qho tshuaj muaj txiaj ntsig zoo thiab thaum lub sijhawm ntawm ib zaug tshuaj ntawm cov ntsiav tshuaj, dhau ntawm kev tso cai ntau npaum li cas los ntawm 50 zaug, nws muaj kev tiv thaiv zoo.
Kev txiav txim siab tso zis ntawm cov kua nplaum tau pom nyob rau ob peb hnub, tab sis cov neeg mob lub cev qhuav dej, nrog rau kev kho mob hypotension thiab hluav taws xob tsis txaus.
Hauv cov pab pawg tau kawm, uas qee cov neeg coj Forsig thiab lwm tus coj placebo, qhov tshwm sim ntawm kev mob ntshav qab zib, nrog rau lwm cov xwm txheej tsis zoo, tsis muaj qhov txawv.
Kev txiav tawm ntawm kev kho mob yuav tsum tau nqa tawm ntawm cov xwm txheej hauv qab no:
- creatinine ntau zog
- nws muaj ntau yam kabmob cuam tshuam rau hauv lub zais zis,
- xeev siab tau tshwm sim
- koj xav tias kiv taub hau
- ib qho tawv nqaij xoo pob liab tau tsim
- pathological kev nyob rau hauv daim siab tsim.
Yog tias kuaj pom muaj tshuaj ntau dhau, yuav tsum tau saib xyuas kev noj qab haus huv rau hauv nws txoj kev noj qab nyob zoo.
Puas yog nws puas poob phaus nrog Forsiga?
Hauv cov lus qhia rau cov tshuaj, cov neeg tsim khoom lag luam qhia pom cov kev poob phaus uas pom thaum kho. Qhov no yog pom tau tshaj plaws hauv cov neeg mob kev txom nyem tsis yog los ntawm cov ntshav qab zib, tab sis kuj los ntawm kev rog dhau.
Vim yog cov diuretic zog, cov tshuaj txo cov pa hauv lub cev. Lub peev xwm ntawm cov tshuaj cuam tshuam kom tshem tawm feem ntawm cov piam thaj tseem ua rau poob ntawm cov phaus ntxiv.
Lub ntsiab lus tseem ceeb rau kev ua tiav ntawm kev siv tshuaj yog cov zaub mov tsis txaus thiab kev qhia txog kev txwv kev noj haus raws li kev pom zoo noj zaub mov.
Cov tib neeg noj qab haus huv yuav tsum tsis txhob siv cov tshuaj no rau qhov poob phaus. Qhov no yog vim muaj qhov teeb meem ntau dhau los tsim kho lub raum, nrog rau kev kawm tsis txaus nrog kev siv Forsigi.
Kev sib cuam tshuam txog Yeeb Tshuaj thiab Analogs
Cov tshuaj pab ua kom muaj zog diuretics, insulin thiab tshuaj uas ua rau nws zais ntshis.
Cov txiaj ntsig ntawm cov tshuaj txo qis thaum noj cov tshuaj hauv qab no:
- Rifampicin,
- nquag conveyor inductor,
- cov enzymes uas txhawb cov metabolism hauv lwm yam.
Kev nqus ntawm Forsig ntsiav tshuaj thiab mefenamic acid nce ua rau muaj kev tiv thaiv ib puag ncig ntawm cov tshuaj ua kom nquag plias los ntawm 55%.
Forsiga suav hais tias yog cov tshuaj nkaus xwb muaj Dapagliflozin muaj nyob hauv Russia. Lwm yam, qhov tsis zoo ntawm cov qauv qub tsis tsim.
Ib qho tshuaj ntxiv rau Forsig ntsiav tshuaj tuaj yeem yog glyphosine chav kawm tshuaj:
Kev xav ntawm cov kws tshaj lij thiab cov neeg mob
Los ntawm kev tshuaj xyuas ntawm cov kws kho mob thiab cov neeg mob txog cov tshuaj Forsig, peb tuaj yeem xaus tias cov tshuaj txo cov piam thaj hauv cov ntshav kom zoo thiab muaj cov txiaj ntsig zoo rau lub cev tag nrho, txawm li cas los xij, qee qhov muaj cov kev mob tshwm sim heev, uas yuav tsum tau txiav txim siab thaum noj cov tshuaj.
Cov tshuaj ua pov thawj nws cov hauj lwm zoo hauv chav kawm ntawm kev sim. Kev hloov kho glycemia li qub feem ntau tuaj yeem ua tiav yam tsis muaj tshwm sim tshwm sim ntawm kev mob tshwm sim. Qee tus neeg mob tsis txhaj tshuaj ntxiv. Cov ntaub ntawv no yog tshwm sim los ntawm kev sim ua hauv 50,000 uas cov neeg mob glycemia los ntawm 10 mmol / l koom nrog. Ntxiv rau tswj cov suab thaj kom nyob ntev, cov tshuaj tau muaj txiaj ntsig zoo rau kev noj qab haus huv tag nrho.
Alexander Petrovich, endocrinologist
Forsyga yog thawj cov tshuaj hauv pawg ntawm cov chav kawm tshiab ntawm inhibitors. Cov yam ntxwv ntawm cov tshuaj tsis yog nyob ntawm kev ua haujlwm ntawm beta hlwb, ntxiv rau cov tshuaj insulin. Cov khoom ua haujlwm zoo thaiv qhov kev rov ua kom ntshav qabzib hauv ob lub raum, thiaj li txo nws cov nqi hauv cov ntshav.Cov txiaj ntsig tseem ceeb yog qhov muaj peev xwm txo qhov hnyav hauv lub cev thiab txo qhov yuav ua rau cov ntshav txo qis. Kev sim tau pom tias kev kho mob yuav luag tsis nrog kev mob tshwm sim. Cov tshuaj tau ua tiav zoo siv rau txawv teb chaws tau ntau xyoo, uas nws tau rov qab ua pov thawj nws cov hauj lwm zoo.
Irina Pavlovna, endocrinologist
Forsig ntsiav tshuaj tau xaj rau kuv niam tom qab nws tsis kam ntawm insulin. Thaum lub sijhawm pib kev pib, yuav luag txhua qhov ntsuas ntawm kuv niam tau nyob deb ntawm qhov ib txwm nyob. C-peptide nyob qis dua qhov tau txais kev txwv, thiab qab zib, ntawm qhov tsis sib xws, yog li ntawm 20. Kwv yees li 4 hnub tom qab thawj lub ntsiav tshuaj noj, kev txhim kho tau pom muaj. Qab zib nres nce siab saum 10, txawm hais tias siv tas li ntawm lwm cov tshuaj (Amaril, Siofor). Tom qab ib hlis ntawm kev kho mob nrog cov tshuaj no, ntau cov tshuaj tau muab tso tseg rau niam. Kuv tuaj yeem hais tias thaum lub ntsiab lus ntawm Forsig txaus siab heev.
Kuv nyeem kev txheeb xyuas los ntawm lwm cov neeg siv thiab kuv xav tsis thoob. Cov tshuaj pab ntau, tab sis tsis yog kuv. Txij li thaum pib nws kev nqus, kuv cov suab thaj tsis tau tsuas yog tsis tau rov qab mus rau qhov qub, tab sis kuj tseem dhia. Tab sis qhov phem tshaj plaws yog qhov khaus khaus thoob plaws lub cev, uas tsis tuaj yeem tiv thaiv. Kuv ntseeg tias ib cov tshuaj nrog cov kev mob tshwm sim no yuav tsum tsis txhob siv los ntawm ib tug neeg.
Tus nqi ntawm ib pob ntawm Forsig ntawm 30 ntsiav tshuaj (10 mg) yog li 2600 rubles.
Sib txawv muaj pes tsawg leeg, tuaj yeem ua ke nyob rau hauv kev taw qhia thiab cov qauv ntawm daim ntawv thov
Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
---|---|---|
Avantomed rosiglitazone, metformin hydrochloride | -- | -- |
Bagomet Metformin | -- | 30 UAH |
Glucofage metformin | 12 RUB | 15 UAH |
Globophage xr metformin | -- | 50 UAH |
Reduxin Met Metformin, Sibutramine | 20 RUB | -- |
Dianormet | -- | 19 UAH |
Diaformin metformin | -- | 5 UAH |
Metformin metformin | 13 RUB | 12 UAH |
Tshuaj Metformin sandoz metformin | -- | 13 UAH |
Siofor | 208 rub | 27 UAH |
Formin metformin hydrochloride | -- | -- |
Emnorm EP Metformin | -- | -- |
Megifort Metformin | -- | 15 UAH |
Tshuaj hlau Metformin | -- | 20 UAH |
Tshuaj Metamin SR Metformin | -- | 20 UAH |
Metfogamma metformin | 256 rub | 17 UAH |
Tefor metformin | -- | -- |
Glycometer | -- | -- |
Glycomet SR | -- | -- |
Tshuaj nyob | 37 RUB | -- |
Metformin Canon metformin, ovidone K 90, pob kws hmoov txhuv, crospovidone, magnesium stearate, talc | 26 RUB | -- |
Insuffor metformin hydrochloride | -- | 25 UAH |
Metformin-teva metformin | 43 txhuam | 22 UAH |
Diaformin SR metformin | -- | 18 UAH |
Mepharmil Metformin | -- | 13 UAH |
Metformin Yawg Liaj Ua Teb Metformin | -- | -- |
Glibenclamide Glibenclamide | 30 RUB | 7 UAH |
Maninyl Glibenclamide | 54 rub | 37 UAH |
Glibenclamide-Health Glibenclamide | -- | 12 UAH |
Glyurenorm glycidone | 94 rub | 43 UAH |
Bisogamma Glyclazide | 91 rub | 182 UAH |
Glidiab Glyclazide | 100 tshiav | 170 UAH |
Lawj Xeeb MR | -- | 92 UAH |
Kev kuaj mob mr Gliclazide | -- | 15 UAH |
Glidia MV Gliclazide | -- | -- |
Glykinorm Gliclazide | -- | -- |
Gliclazide Gliclazide | 231 rub | 57 UAH |
Glyclazide 30 MV-Indar Glyclazide | -- | -- |
Glyclazide-Kev Noj Qab Haus Huv Gliclazide | -- | 36 UAH |
Glioral Glyclazide | -- | -- |
Kev kuaj mob Gliclazide | -- | 14 UAH |
Diazide MV Gliclazide | -- | 46 UAH |
Osliklid Gliclazide | -- | 68 UAH |
Diadeon gliclazide | -- | -- |
Glyclazide MV Gliclazide | 4 RUB | -- |
Amaril | 27 RUB | 4 UAH |
Glemaz glimepiride | -- | -- |
Glian glimepiride | -- | 77 UAH |
Glimepiride Glyride | -- | 149 UAH |
Glimepiride diapiride | -- | 23 UAH |
Thaj neeb | -- | 12 UAH |
Glimax glimepiride | -- | 35 UAH |
Glimepiride-Lugal glimepiride | -- | 69 UAH |
Av nplaum glimepiride | -- | 66 UAH |
Diabrex glimepiride | -- | 142 UAH |
Meglimide glimepiride | -- | -- |
Melpamide Glimepiride | -- | 84 UAH |
Perinel glimepiride | -- | -- |
Glempid | -- | -- |
Raug Tsim | -- | -- |
Glimepiride glimepiride | 27 RUB | 42 UAH |
Glimepiride-teva glimepiride | -- | 57 UAH |
Glimepiride Canon glimepiride | 50 RUB | -- |
Glimepiride Pharmstandard glimepiride | -- | -- |
Dimaril glimepiride | -- | 21 UAH |
Glamepiride diamerid | 2 RUB | -- |
Amaryl M Limepiride Micronized, Metformin Hydrochloride | 856 rub | 40 UAH |
Glibomet glibenclamide, metformin | 257 rub | 101 UAH |
Glucovans glibenclamide, metformin | 34 RUB | 8 UAH |
Dianorm-m Glyclazide, Metformin | -- | 115 UAH |
Dibizid-m glipizide, metformin | -- | 30 UAH |
Douglimax glimepiride, metformin | -- | 44 UAH |
Duotrol glibenclamide, metformin | -- | -- |
Gluconorm | 45 rub | -- |
Glibofor metformin hydrochloride, glibenclamide | -- | 16 UAH |
Avandamet | -- | -- |
Avandaglim | -- | -- |
Janumet metformin, sitagliptin | 9 RUB | 1 UAH |
Velmetia metformin, sitagliptin | 6026 rub | -- |
Galvus Met vildagliptin, metformin | 259 RUB | 1195 UAH |
Tripride glimepiride, metformin, pioglitazone | -- | 83 UAH |
Comboglize XR metformin, saxagliptin | -- | 424 UAH |
Comboglyz Prolong metformin, saxagliptin | 130 rub | -- |
Gentadueto linagliptin, metformin | -- | -- |
Vipdomet metformin, alogliptin | 55 RUB | 1750 UAH |
Sinjardi empagliflozin, metformin hydrochloride | 240 rub | -- |
Voglibose Oxide | -- | 21 UAH |
Glutazone pioglitazone | -- | 66 UAH |
Dropia Sanovel pioglitazone | -- | -- |
Januvia sitagliptin | 1369 rub | 277 UAH |
Galvus vildagliptin | 245 RUB | 895 UAH |
Onglisa saxagliptin | 1472 RUB | 48 UAH |
Nesina alogliptin | -- | -- |
Vipidia alogliptin | 350 rub | 1250 UAH |
Trazhenta linagliptin | 89 rub | 1434 UAH |
Yuav ua li cas thiaj nrhiav tau qhov pheej yig tshuaj ntawm cov tshuaj kim?
Txhawm rau kom pom qhov pheej yig cov khoom sib piv rau cov tshuaj, cov dav dav lossis cov lus sau, ua ntej txhua yam peb pom zoo kom them sai sai rau qhov muaj pes tsawg leeg, uas yog rau tib cov tshuaj nquag thiab qhia tau rau kev siv. Cov tshuaj sib xyaw zoo ib yam ntawm cov tshuaj yuav qhia tau tias cov tshuaj cuam tshuam nrog cov tshuaj, kws tshuaj sib npaug lossis chaw muag tshuaj. Txawm li cas los xij, tsis txhob hnov qab txog qhov ua tsis muaj zog ntawm cov tshuaj uas zoo sib xws, uas tuaj yeem cuam tshuam kev nyab xeeb thiab ua haujlwm. Tsis txhob hnov qab txog cov lus qhia ntawm cov kws kho mob, kev noj tshuaj rau nws tus kheej tuaj yeem tsim kev puas tsuaj rau koj kev noj qab haus huv, yog li nco ntsoov sab laj nrog koj tus kws kho mob ua ntej siv cov tshuaj.
Forsig kev qhia
Daim ntawv noj tshuaj:
zaj duab xis-ntsiav tshuaj ntsiav tshuaj
Muaj pes tsawg leeg
Ib qho ntim-xev txheej ntsiav tshuaj, 5 mg, muaj:
Yam tshuaj muaj sia:
dapagliflozin propanediol monohydrate 6.150 mg, suav ntawm dapagliflosin 5 mg
Cov neeg siv tshwj xeeb: microcrystalline cellulose 85.725 mg, anhydrous lactose 25,000 mg, crospovidone 5,000 mg, silicon dioxide 1,875 mg, magnesium stearate 1,250 mg,
Ntsiav tshuaj plhaub: Opadray® II daj 5,000 mg (polyvinyl cawv ib nrab hydrolyzed 2,000 mg, titanium dioxide 1,177 mg, macrogol 3350 1.010 mg, talc 0.740 mg, dye hlau oxide daj 0,073 mg).
Ib qho ntim-xev txheej ntsiav tshuaj 10 mg muaj:
Yam tshuaj muaj sia:
dapagliflosin propanediol monohydrate 12.30 mg, suav tias yog dapagliflosin 10 mg
Cov neeg siv tshwj xeeb: microcrystalline cellulose 171.45 mg, anhydrous lactose 50.00 mg, crospovidone 10.00 mg, silicon dioxide 3.75 mg, magnesium stearate 2.50 mg,
Ntsiav tshuaj plhaub: Opadray® II daj 10.00 mg (polyvinyl cawv ib nrab hydrolyzed 4.00 mg, titanium dioxide 2.35 mg, macrogol 3350 2.02 mg, talc 1.48 mg, zas hlau oxide daj 0.15 mg) Cov.
Kev piav qhia
5 mg zaj duab xis-coated ntsiav tshuaj:
Hloov biconvex ntsiav tshuaj coated nrog lub ntsej muag daj zaj duab xis, engraved nrog "5" ntawm ib sab thiab "1427" ntawm lwm yam.
Cov ntsiav tshuaj ua yeeb yaj kiab-10 mg:
Rhomboid biconvex ntsiav tshuaj xim nrog lub ntsej muag daj zaj duab xis, sau nrog "10" ntawm ib sab thiab "1428" nyob rau sab nraud.
Cov tshuaj pab pawg kho mob
Kev siv tshuaj hypoglycemic rau lub qhov ncauj - hom 2 piam thaj transporter inhibitor
ATX Code: A10BX09
Cov chaw muag tshuaj
Mechanism ntawm kev ua
Dapagliflozin yog ib qho muaj zog (inhibitory tas mus li (Ki) ntawm 0.55 nM), xaiv tau xaiv hom 2 sodium glucose cotransporter inhibitor (SGLT2). SGLT2 raug xaiv tawm hauv lub raum thiab tsis pom nyob hauv ntau dua 70 lwm cov nqaij hauv lub cev (suav nrog lub siab, cov leeg pob txha, cov nqaij adipose, cov qog caj ces, zais zis, thiab lub hlwb). SGLT2 yog lub chaw xa khoom loj tau koom nrog cov piam thaj reabsorption hauv cov hlaus hlaus. Glucose reabsorption hauv hlaus hlab rau cov neeg mob hom 2 mob ntshav qab zib mellitus (T2DM) tseem txuas ntxiv txawm hais tias hyperglycemia. Los ntawm inhibiting qhov hloov pauv ntawm cov ntshav qabzib, dapagliflozin txo nws txoj kev txo qis hauv cov hlab ntsha txoj hlab ntshav, uas ua rau lub cev tawm ntawm cov kua nplaum los ntawm lub raum. Qhov tshwm sim ntawm dapagliflozin yog ib qho kev txo qis ntawm cov piam thaj thiab tom qab noj mov, nrog rau kev txo qis ntawm cov glycosylated hemoglobin hauv cov neeg mob uas muaj ntshav qab zib hom 2.
Kev tshem tawm ntawm cov piam thaj (cov nyhuv glucosuric) tau pom tom qab siv thawj koob tshuaj, cuam tshuam rau 24 teev ntxiv mus thiab txuas ntxiv thoob plaws hauv kev kho. Tus nqi ntawm cov kua nplaum tawm ntawm ob lub raum vim yog lub tshuab no nyob ntawm kev saib xyuas cov piam thaj hauv cov ntshav thiab ntawm cov roj glomerular filtration rate (GFR). Dapagliflozin tsis cuam tshuam rau qhov ib txwm tsim ntawm cov kua nplaum endogenous hauv kev teb rau cov ntshav qab zib. Cov nyhuv ntawm dapagliflozin yog ywj siab ntawm insulin secretion thiab insulin rhiab heev. Hauv kev soj ntsuam kev tshawb fawb ntawm Forsig ™, kev txhim kho hauv beta-cell kev ua haujlwm tau sau tseg (HOMA kuaj, kev ntsuas tus qauv homeostasis).
Kev tshem tawm cov piam thaj los ntawm lub raum los ntawm dapagliflozin yog nrog lub cev rog tsis txaus thiab ua rau lub cev poob phaus. Dapagliflozin inhibition of sodium qab zib cotransport yog nrog los ntawm qaug zog diuretic thiab hloov cov teebmeem natriuretic.
Dapagliflozin tsis muaj dab tsi cuam tshuam rau lwm cov kua piam thaj uas thauj cov piam thaj rau cov ntaub so ntswg thiab cov ntaub ntawv pov thawj ntau dua 1,400 lub sijhawm xaiv ntau dua rau SGLT2 dua li rau SGLT1, lub ntsiab plab hnyuv thauj lub luag haujlwm rau kev nqus ntshav.
Cov Tshuaj Hauv Tshuaj
Tom qab noj cov dapagliflozin los ntawm cov neeg ua haujlwm noj qab haus huv thiab cov neeg mob ntshav qab zib hom 2, kev nce ntxiv ntawm cov piam thaj uas tau tawm los ntawm lub raum tau pom. Thaum dapagliflozin tau noj nyob rau hauv ib koob tshuaj 10 mg / hnub rau 12 lub lis piam, cov neeg mob ntshav qab zib hom 2 tau txais kwv yees li 70 g ntawm cov piam thaj ib hnub los ntawm ob lub raum (uas sib haum rau 280 kcal / hnub). Hauv cov neeg mob uas muaj ntshav qab zib hom 2 uas tau noj dapagliflozin ntawm kev noj tshuaj ntawm 10 mg / hnub rau ntev (txog li 2 xyoos), cov kua qabzib tau tswj tau zoo thoob lub sijhawm kho.
Kev ua kom tsis qabzib los ntawm lub raum nrog dapagliflozin kuj tseem ua rau osmotic diuresis thiab ua rau cov zis nce ntxiv. Kev nce ntxiv ntawm cov zis nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib noj dapagliflozin ntawm koob tshuaj 10 mg / hnub tseem nyob rau 12 lub lis piam thiab muaj kwv yees li 375 ml / hnub. Qhov nce ntawm cov zis ntim tau nrog nrog qhov me me thiab hloov mus rau hauv kev nthuav dav ntawm sodium los ntawm ob lub raum, uas tsis ua rau muaj qhov hloov pauv ntawm cov concentration ntawm sodium hauv cov ntshav cov ntshav.
Cov Tshuaj Pharmacokinetics
Kev Tsis Txaus Siab
Tom qab kev tswj hwm ntawm qhov ncauj, dapagliflozin tau nrawm thiab ua kom tiav rau hauv txoj hnyuv thiab tuaj yeem noj tau ob qho tib si thaum noj mov thiab sab nraud. Qhov siab tshaj plaws ntawm dapagliflozin hauv ntshav ntshav (Stax) feem ntau ua tiav tsis pub dhau 2 teev tom qab yoo mov. Cov txiaj ntsig ntawm Cmax thiab AUC (thaj chaw nyob rau hauv qhov chaw siab-lub sijhawm nkhaus) nce ntxiv hauv kev faib ua feem rau koob tshuaj dapagliflozin. Qhov tsis txaus ntseeg txog kev noj qab haus huv ntawm dapagliflozin thaum muab cov tshuaj ntawm qhov ncauj ntawm 10 mg yog 78%. Noj noj tau muaj txiaj ntsig ib txwm nyob ntawm pharmacokinetics ntawm dapagliflozin hauv cov neeg tuaj yeem noj qab haus huv. Cov zaub mov ua muaj roj ntau ntau txo qis Stax ntawm dapagliflozin los ntawm 50%, ua kom ntev li Ttah (lub sijhawm kom ncav cuag cov ntshav siab tshaj plaws) los ntawm 1 teev, tab sis tsis cuam tshuam rau AUC piv rau kev yoo mov. Cov kev pauv hloov no tsis yog qhov tseem ceeb hauv kev kho mob.
Kev xa Khoom
Dapagliflozin yog kwv yees li 91% ua txhua yam rau cov khoom noj protein. Hauv cov neeg mob uas muaj ntau yam mob, piv txwv li, nrog lub raum tsis zoo los yog lub siab ua haujlwm, qhov ntsuas no tsis hloov.
Kev zom zaub mov
Dapagliflozin yog C-txuas glucoside uas nws cov aglycon txuas rau cov piam thaj los ntawm carbon-carbon nyiaj, uas ua kom nws ruaj khov tiv thaiv glucosidases. Qhov ntshav nruab nrab ib nrab-lub neej (T½) hauv cov neeg ua haujlwm noj qab haus huv yog 12.9 teev tom qab ib koob tshuaj dapagliflozin ntawm qhov ncauj ntawm 10 mg. Dapagliflozin tshuaj tiv thaiv yog tsim los tshuaj cov roj ntsha dapagliflozin-3-O-glucuronide.
Tom qab qhov ncauj tswj hwm ntawm 50 mg ntawm 14C-dapagliflozin, 61% ntawm cov koob tshuaj tiv thaiv yog metabolized rau dapagliflozin-3-O-glucuronide, uas suav txog 42% ntawm tag nrho cov ntshav radioactivity (AUC0-12 teev) - Cov tshuaj tsis hloov pauv rau 39% ntawm tag nrho cov ntshav radioactivity. Cov zauv feem ntawm cov seem metabolites ib tus zuj zus tsis pub tshaj 5% ntawm tag nrho cov ntshav ntshav radioactivity. Dapagliflozin-3-O-glucuronide thiab lwm cov metabolites tsis muaj cov teebmeem pharmacological. Dapagliflozin-3-O-glucuronide yog tsim los ntawm enzyme uridine diphosphate glucuronosyl transferase 1A9 (UGT1A9), uas muaj nyob hauv daim siab thiab lub raum, thiab CYP cytochrome isoenzymes tsis tshua muaj feem cuam hauv cov metabolism.
Chaw Sau Ntawv
Dapagliflozin thiab nws cov metabolites yog txeem feem ntau los ntawm lub raum, thiab tsuas yog tsawg dua 2% yog raug kho tsis hloov. Tom qab noj 50 mg ntawm 14C-dapagliflozin, 96% ntawm radioactivity raug kuaj - 75% nyob rau hauv cov zis thiab 21% hauv cov quav. Kwv yees li 15% ntawm xov tooj cua nrhiav nyob hauv cov quav raug suav los ntawm cov tsis hloov pauv dapagliflozin.
Pharmacokinetics hauv cov chaw kho mob tshwj xeeb
Cov neeg mob uas lub raum tsis ua hauj lwm zoo
Ntawm kev sib npaug (txhais tau tias AUC), cov kev tiv thaiv kab mob dapagliflozin hauv cov neeg mob ntshav qab zib hom 2 thiab ntshav qis, qis los sis mob raum tsis zoo (raws li txiav txim siab los ntawm iohexol tshem tawm) yog 32%, 60%, thiab 87% siab dua hauv cov neeg mob uas muaj ntshav qab zib hom 2 thiab kev ua haujlwm zoo. raum, ntsig txog. Tus nqi ntawm cov kua nplaum tawm ntawm lub raum thaum nruab hnub thaum noj dapagliflozin hauv kev sib npaug nyob ntawm seb lub xeev ntawm lub raum ua haujlwm. Hauv cov neeg mob uas muaj ntshav qab zib hom 2 thiab lub raum ua haujlwm, thiab nrog lub raum me, mob hnyav los sis lub raum tsis ua haujlwm, 85, 52, 18 thiab 11 g ntawm qabzib tau tas mus ib hnub, feem. Tsis muaj qhov sib txawv ntawm qhov khi ntawm dapagliflozin rau cov protein hauv cov neeg ua haujlwm noj qab haus huv thiab cov neeg mob lub raum tsis ua haujlwm ntawm qhov sib txawv. Kuj tsis paub meej tias hemodialysis cuam tshuam txog kev tiv thaiv dapagliflozin.
Cov neeg mob uas muaj lub siab ua haujlwm tsis zoo
Hauv cov neeg mob uas muaj mob me me lossis me me tsis txaus siab hepatic, tus nqi nruab nrab ntawm Cmax thiab AUC ntawm dapagliflozin yog 12% thiab 36% siab dua, feem, piv nrog cov neeg ua haujlwm noj qab haus huv. Cov kev sib txawv no tsis yog qhov tseem ceeb hauv kev kho mob, yog li cov tshuaj txhaj rau dapagliflozin hauv cov neeg mob uas tsis tshua mob mus rau daim siab tsis ua rau lub siab tsis ua haujlwm (saib Ntu "Dosage thiab Administration"). Cmax thiab AUC ntawm dapagliflozin tau 40% thiab 67% siab dua, feem, piv nrog cov neeg ua haujlwm noj qab haus huv.
Cov neeg laus (> 65 xyoo)
Tsis muaj kev sib kis hauv kev muaj mob hauv cov neeg mob hnub nyoog qis dua 70 xyoo (tshwj tsis yog lwm yam txawv hnub nyoog tsis suav nrog). Txawm li cas los xij, ib qho kev nce ntxiv hauv kev tuaj yeem xav tau vim muaj kev txo qis hauv lub raum ua haujlwm nrog lub hnub nyoog. Cov ntaub ntawv pov thawj rau cov neeg mob hnub nyoog 70 xyoo yog qhov tsis txaus.
Tub los ntxhais
Hauv cov poj niam, qhov nruab nrab ntawm AUC hauv qhov tsis sib luag yog 22% siab dua tus txiv neej.
Kwv Txhiaj
Tsis muaj qhov sib txawv loj hauv qhov chaw muaj mob tau pom nyob hauv cov neeg sawv cev ntawm Caucasian, Negroid thiab Mongoloid haiv neeg.
Lub cev hnyav
Txo cov nqi raug nrog lub cev hnyav dua ntxiv tau sau tseg. Yog li, nyob rau hauv cov neeg mob uas tsis tshua muaj lub cev hnyav, qhov kev nce siab me ntsis yuav raug sau tseg, thiab nyob rau hauv cov neeg mob uas muaj lub cev hnyav dua - qhov txo qis hauv dapagliflozin. Txawm li cas los xij, cov kev sib txawv no tsis yog qhov tseem ceeb hauv tsev kho mob.
Kev ntsuas rau siv
Hom 2 mob ntshav qab zib mellitus ntxiv rau kev noj haus thiab kev tawm dag zog kom txhim kho glycemic tswj kom zoo:
tshuaj mob hlwb
ntxiv rau metformin kev kho mob thaum tsis muaj glycemic tswj txaus rau qhov kev kho no,
pib txoj kev kho ua ke nrog metformin, yog tias qhov kev kho no pom zoo.
Cov Yuav Tsum Tau Ua
Txhawb ib tus neeg rhiab rau ib feem ntawm cov tshuaj.
Yam 1 ntshav qab zib.
Ntshav qab zib ketoacidosis.
Cov raum tsis ua haujlwm ntawm kev mob hnyav thiab mob hnyav (GFR 65 xyoo)
Cov kev tsis zoo muaj feem cuam tshuam nrog kev ua haujlwm ntawm lub raum lossis lub raum tsis ua haujlwm tau qhia nyob rau hauv 2.5% ntawm cov neeg mob tau txais dapagliflozin, thiab hauv 1.1% ntawm cov neeg mob tau txais cov placebo hauv pab pawg ntawm cov neeg mob> 65 xyoo (saib ntu "Cov Lus Qhia Tshwj Xeeb"). Feem ntau cov kev phiv tshuaj uas cuam tshuam nrog lub raum lub raum tsis ua haujlwm yog qhov kev nce ntxiv hauv cov ntshav creatinine. Feem ntau ntawm cov tshuaj tiv thaiv tau hloov pauv thiab thim rov qab. Ntawm cov neeg mob hnub nyoog> 65 xyoo, qhov kev txo qis hauv BCC, feem ntau tau sau npe ua cov hlab ntsha hypotension, tau pom hauv 1.5% thiab 0.4% ntawm cov neeg mob noj dapagliflozin thiab placebo, ntsig txog (saib ntu "Cov Lus Qhia Tshwj Xeeb"),
Noj ntau dhau
Dapagliflozin muaj kev nyab xeeb thiab pom zoo los ntawm cov neeg ua haujlwm noj qab haus huv zoo nrog ib koob txog li 500 mg (50 npaug ntawm qhov koob tshuaj uas pom zoo). Cov kua nplaum tau txiav txim siab nyob rau hauv cov zis tom qab noj cov tshuaj (tsawg kawg hauv 5 hnub tom qab noj 500 mg), thaum tsis muaj dej ntawm lub cev qhuav dej, mob ntshav siab, ntshav tsis txaus, qhov tseem ceeb hauv kev kho mob QTc. Qhov xwm txheej ntawm cov ntshav qog ntshav tau zoo ib yam li qhov zaus nrog tshuaj placebo. Hauv kev soj ntsuam hauv cov neeg tuaj noj qab haus huv thiab cov neeg mob ntshav qab zib hom 2 uas noj cov tshuaj ib zaug ntawm 100 mg (10 zaug ntau dua qhov siab tshaj qhov xav tau) rau 2 lub lis piam, qhov tshwm sim ntawm hypoglycemia yog me ntsis siab dua nrog cov tshuaj placebo, thiab tsis siv tshuaj ntau Cov. Qhov tshwm sim ntawm cov kev tshwm sim tsis zoo, suav nrog lub cev qhuav dej los yog txoj hlab ntshav hypotension, zoo ib yam li cov zaus hauv pawg placebo, tsis muaj qhov sib txawv hauv cov chaw kho mob hauv chav kuaj, suav nrog cov ntshav ntawm electrolytes thiab biomarkers ntawm lub raum kev ua haujlwm.
Thaum muaj kev noj ntau dhau, nws yog ib qho tsim nyog yuav tsum tau ua cov kev kho kom zoo, suav nrog tus neeg mob tus mob. Kev cais tawm ntawm dapagliflozin los ntawm hemodialysis tsis tau kawm.
Kev cuam tshuam nrog lwm yam tshuaj
Kev tshuaj ntsuab
Dapagliflozin tuaj yeem txhim kho lub diuretic nyhuv ntawm thiazide thiab "voj" diuretics thiab nce kev pheej hmoo ntawm lub cev qhuav dej thiab cov hlab ntsha hypotension (saib "Cov Lus Qhia Tshwj Xeeb").
Pharmacokinetic sib cuam tshuam
Kev siv roj av ntawm dapagliflozin tsuas yog nqa tawm los ntawm glucuronide kev sib txuas sib txuas hauv qab ntawm UGT1A9.
Hauv kev tshawb fawb hauv vitro, dapagliflozin tsis tau txwv tsis pub isoenzymes ntawm cytochrome P450 system CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP3A4, thiab tsis tau muaj qee qhov. Hauv qhov no, cov nyhuv ntawm dapagliflozin ntawm kev tshem tawm cov khoom noj uas muaj cov tshuaj concomitant uas cov tshuaj tiv thaiv los ntawm cov isoenzymes no tsis xav tau.
Cov nyhuv ntawm lwm cov tshuaj ntawm dapagliflozin
Cov kev tshawb fawb txog kev sib cuam tshuam nrog cov neeg ua haujlwm noj qab haus huv, feem ntau yog cov uas tau noj ib koob tshuaj, pom tias metformin, pioglitazone, sitagliptin, glimepiride, voglibose, hydrochlorothiazide, bumetanide, valsartan lossis simvastatin tsis cuam tshuam rau pharmacokinetics ntawm dapagliflosin. Tom qab ua ke siv cov dapagliflozin thiab rifampicin, ib qho kev tsim tawm ntawm ntau yam kev thauj neeg nquag thiab cov tshuaj tua kab mob uas ua rau cov tshuaj tiv thaiv, qhov kev tiv thaiv kab mob (AUC) ntawm dapagliflozin raug txo qis 22%, thaum tsis muaj kev cuam tshuam los ntawm kev kho mob uas niaj hnub ua rau cov ntshav qabzib los ntawm lub raum. Nws tsis pom zoo kom hloov qhov tshuaj ntawm cov tshuaj. Cov kev mob tshwm sim hauv tsev kho mob thaum siv nrog lwm cov inducers (piv txwv li carbamazepine, phenytoin, phenobarbital) tsis xav tau.
Tom qab ua ke siv cov dapagliflozin thiab mefenamic acid (UGT1A9 inhibitor), 55% nce ntawm cov kab mob npaws dapagliflozin tau sau tseg, tab sis tsis muaj qhov cuam tshuam los ntawm kev kho mob niaj hnub tsis muaj qabzib los ntawm lub raum. Nws tsis pom zoo kom hloov qhov tshuaj ntawm cov tshuaj.
Cov nyhuv ntawm dapagliflozin ntawm lwm cov tshuaj
Hauv kev kawm txog kev sib cuam tshuam nrog cov neeg ua haujlwm pabcuam noj qab haus huv, feem ntau noj ib koob tshuaj, dapagliflozin tsis cuam tshuam cov pharmacokinetics ntawm metformin, pioglitazone, sitagliptin, glimepiride, hydrochlorothiazide, bumetanide, valsartan, digoxin (substrate ntawm Varifarf, lossis isoenzyme CYP2C9), lossis ntawm cov txiaj ntsig anticoagulant, ntsuas xyuas los ntawm International Normalized Ratio (MHO). Kev siv ib koob tshuaj dapagliflozin 20 mg thiab simvastatin (ib qho me me ntawm CYP3A4 isoenzyme) ua rau muaj 19% nce simvastatin AUC thiab 31% simvastatin acid AUC. Kev nce mus rau simvastatin thiab simvastatin acid tsis tau pom tias yog qhov sib luag.
Lwm cov kev sib cuam tshuam
Cov teebmeem ntawm kev haus luam yeeb, kev noj zaub mov noj, tshuaj ntsuab, thiab haus cawv rau ntawm cov chaw muag tshuaj ntawm dapagliflozin tseem tsis tau kawm txog.
Cov lus qhia tshwj xeeb
Siv rau hauv cov neeg mob uas lub raum tsis ua haujlwm
Cov hauj lwm zoo ntawm dapagliflozin nyob ntawm lub raum muaj nuj nqi, thiab qhov kev ua haujlwm no raug txo qis rau cov neeg mob uas mob raum tsis txaus thiab tej zaum tsis tuaj yeem ua rau cov neeg mob uas lub raum tsis ua haujlwm loj (saib Ntu "Kev Coj thiab Kev Tswj Xyuas"). Ntawm cov neeg mob uas tsis tshua mob lub raum txaus (CC 65 xyoo), feem ntau ntawm cov neeg mob uas tau txais dapagliflozin tau tsim cov kev tsis haum lub cev vim lub raum lub raum tsis ua haujlwm lossis lub raum tsis ua haujlwm piv nrog cov placebo. ntshiab ncauj lus tsim kom tau kev sib raug zoo, feem ntau yuav hloov pauv thiab thim rov qab (saib ntu “Cuam Tshuam”).
Hauv cov neeg mob laus, qhov phom sij ntawm qhov txo qis hauv BCC yuav siab dua, thiab cov tshuaj diuretics zoo dua yuav tsum noj. Ntawm cov neeg mob hnub nyoog> 65 xyoo, feem ntau ntawm cov neeg mob uas tau txais dapagliflozin muaj qhov kev tsis txaus siab cuam tshuam nrog kev txo qis hauv BCC (saib ntu "Cov Kev Phiv").
Cov kev paub siv cov tshuaj rau cov neeg mob hnub nyoog 75 xyoos thiab laus dua yog txwv. Nws yog contraindicated yuav pib kho dapagliflozin kev kho mob hauv cov pejxeem no (saib ntu "Dosage and Administration" thiab "Pharmacokinetics").
Mob plawv nres
Cov kev paub txog cov tshuaj hauv cov neeg mob uas muaj mob plawv tsis zoo ntawm I-II cov chav kawm ua haujlwm raws li NYHA kev faib tawm yog qhov tsawg, thiab hauv kev sim kho mob, dapagliflozin tsis tau siv rau hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntawm chav kawm III-IV ua haujlwm raws li NYHA.
Muaj hematocrit ntau ntxiv
Thaum siv dapagliflozin, ib qho kev nce siab ntawm hematocrit (saib ntu "Cov Kev Phiv"), thiab yog li ntawd yuav tsum ceev faj rau cov neeg mob uas muaj hematocrit ntau ntxiv.
Kev ntsuas cov ntsuas ntsuas zis
Vim yog lub tshuab ntawm kev txiav txim ntawm cov tshuaj, cov txiaj ntsig ntawm kev soj ntsuam rau cov ntshav qabzib hauv cov neeg mob noj Forsig ™ yuav zoo.
Muaj feem xyuam rau kev muaj peev xwm tsav tsheb thiab cov txheej txheem
Tsis muaj kev tshawb fawb tau ua rau muaj kev cuam tshuam ntawm dapagliflozin ntawm kev muaj peev xwm ntawm kev tsav tsheb thiab cov twj siv.
Daim ntawv tso tawm
Cov ntsiav tshuaj ua yeeb yaj kiab, 5 mg, 10 mg.
14 ntsiav tshuaj nyob rau hauv ib qho txhuas ntawv ci blister, 2 lossis 4 hlwv rau hauv daim ntawv thawv nrog cov lus qhia rau kev siv, lossis 10 ntsiav tshuaj hauv perforated aluminium foil blister, 3 lossis 9 perforated blisters nyob hauv cardboard lub thawv nrog cov lus qhia rau kev siv.
Cov chaw qhib ntawm cov duab los qhia kab sib xyaw tau muab khi nrog ob lub pob tshab tiv thaiv tsis muaj xim, ntawm cov khoom nruab nrab ntawm txhua tus ntaiv, txwv los ntawm cov kab tsim kua muag, tus qauv daj xim thov siv.
Hnub tas sij hawm
3 xyoos
Tsis txhob siv tom qab hnub tas sij hawm qhia ntawm pob.
Cia rau cov neeg mob
Hauv qhov kub uas tsis pub dhau 30 ° C, hauv cov chaw tsis muaj kev yoojyim rau cov menyuam yaus.
Khaws tsis ncav cuag ntawm cov menyuam yaus.
Cov Hnub So Haujlwm
Los ntawm tshuaj.
Chaw tsim tshuaj paus
Bristol Myers Squibb Manufaking Company, Puerto Rico
Txoj Kev 3, Km. 77.5, PO Box 609, Humacao, PR-00791, Puerto Rico
Bristol-Myers Squibb Kev Tsim Lag Luam
Txoj Kev 3, Km 77,5, Ncej Box 609, Humacao, PR-00791, Puerto Rico
Lub npe thiab chaw nyob ntawm tus neeg muaj cai nyob hauv uas lawv daim ntawv pov thawj rau npe tau muab ua
Bristol Myers Squibb Tuam Txhab, USA
345, Chaw Ua Si Avenue, New York, NY, USA
Bristol-Myers Squibb Tuam Txhab, USA
345, Chaw Ua Si Avenue, New York, New York, USA
Analogs ntawm cov tshuaj Forsig
Cov analogue yog pheej yig dua los ntawm 1908 rubles.
Jardins yog tshuaj txawv teb chaws rau kev kho mob ntshav qab zib hom 2. Empagliflozin nyob rau hauv cov nyiaj ntawm 25 mg rau ib ntsiav tshuaj ua raws li tsuas yog kev tiv thaiv kev tiv thaiv. Jardins muaj contraindications thiab muaj hnub nyoog txwv, yog li sab laj nrog koj tus kws kho mob ua ntej pib kev kho mob.
Cov analogue yog pheej yig dua los ntawm 1967 rubles.
Chaw tsim tshuaj paus: Novo Nordisk (Denmark)
Cov Ntawv Tso Tawm:
- Tab. 1 mg, 30 pcs., Nqe txij li 175 rubles
- Tab. 2 mg, 30 pcs., Nqe txij li 219 rubles
Cov lus qhia rau kev siv
NovoNorm yog kev npaj ntsiav tshuaj los ntawm tib pawg kws kho mob, tab sis nrog cov tshuaj sib txawv. Repaglinide siv rau ntawm no hauv qhov ntau npaum li 0.5 txog 2 mg. Cov ntsiab lus rau kev sau ntawv yuav zoo ib yam, tab sis contraindications txawv vim qhov txawv DV hauv ntsiav tshuaj, yog li ua tib zoo nyeem cov lus qhia thiab sab laj nrog koj tus kws kho mob.
Cov analogue yog pheej yig dua los ntawm 1908 rubles.
Chaw tsim tshuaj paus: Akrikhin (Russia)
Cov Ntawv Tso Tawm:
- Tab. 1 mg, 30 pcs., Nqe txij li 234 rubles
- Tab. 2 mg, 30 pcs., Nqe txij li 219 rubles
Cov lus qhia rau kev siv
Novo Nordisk (Denmark) NovoNorm yog kev npaj ntsiav tshuaj los ntawm tib pawg kws kho mob, tab sis nrog cov tshuaj sib txawv. Repaglinide siv rau ntawm no hauv qhov ntau npaum li 0.5 txog 2 mg. Cov ntsiab lus rau kev sau ntawv yuav zoo ib yam, tab sis contraindications txawv vim qhov txawv DV hauv ntsiav tshuaj, yog li ua tib zoo nyeem cov lus qhia thiab sab laj nrog koj tus kws kho mob.
Cov analogue yog kim dua los ntawm 311 rubles.
Chaw tsim tshuaj paus: Yog tau meej
Cov Ntawv Tso Tawm:
- Tab. p / obol. 100 mg, 30 pcs., Nqe los ntawm 2453 rubles
- Tab. 2 mg, 30 pcs., Nqe txij li 219 rubles
Cov lus qhia rau kev siv
Novo Nordisk (Denmark) NovoNorm yog qhov pheej yig hloov rau Forsigi. Cov tshuaj uas cuam tshuam tsuas tshuaj hauv cov tshuaj yog repaglinide. Cov tshuaj hauv 30 feeb ua rau cov tshuaj insulin ntau ntxiv hauv cov ntshav. Vim tias tsis muaj cov ntaub ntawv hais txog kev tshawb fawb qhia txog kev nyab xeeb ntawm cov tshuaj thiab kev siv tshuaj zoo hauv cov menyuam hnub nyoog, nws tsis pom zoo kom siv cov tshuaj rau cov menyuam hnub nyoog qis dua 18 xyoo. Nyob rau hauv daim ntawv ntawm kev phiv tshuaj, zawv plab thiab mob plab heev tshwm sim.
Muaj Cov Ntawv Rau Lub Ntsuas Rau Forsigi
NovoNorm (ntsiav tshuaj) Ntsuas: 152
Cov analogue yog pheej yig dua los ntawm 1967 rubles.
NovoNorm yog qhov pheej yig hloov rau Forsigi. Cov tshuaj uas cuam tshuam tsuas tshuaj hauv cov tshuaj yog repaglinide. Cov tshuaj hauv 30 feeb ua rau cov tshuaj insulin ntau ntxiv hauv cov ntshav. Vim tias tsis muaj cov ntaub ntawv hais txog kev kawm txog kev nyab xeeb ntawm cov tshuaj thiab kev siv tshuaj zoo hauv cov menyuam hnub nyoog, nws tsis pom zoo kom siv cov tshuaj rau cov menyuam hnub nyoog qis dua 18 xyoo. Nyob rau hauv daim ntawv ntawm kev phiv tshuaj, zawv plab thiab mob plab heev tshwm sim.
Cov analogue yog pheej yig dua los ntawm 1908 rubles.
Jardins yog ntsiav tshuaj npaj rau cov ntshav qab zib hom 2. Cov tshuaj tivthaiv tseem ceeb ntawm cov tshuaj yog empagliflozin. Cov tshuaj yog noj yam tsis tau zom ua ntej noj mov, lossis thaum lub sijhawm nqus cov zaub mov, yog tias tsis siv tshuaj ntau - tsis tas yuav muab ob npaug rau koob tshuaj ntxiv rau koob tom ntej. Nws tsis paub meej tias cov tshuaj no cuam tshuam rau lub cev xeeb tub thiab tsis tsim nyog yuav tau noj thaum pub mis.
Kev Tshuaj Ntsuam Xyuas (ntsiav tshuaj) Ntsuam Xyuas: 85 Sab saum toj
Cov analogue yog pheej yig dua los ntawm 1908 rubles.
Diagninide yog ib hom tshuaj tua kab mob hypoglycemic, uas suav nrog repaglinide. Yog tias kev noj zaub mov kom tsawg thiab ua kom lub cev tsis pab ua kom cov ntshav qab zib kom zoo, tsuas yog tom qab ntawd koj puas pib noj cov tshuaj. Rau cov neeg tsav tsheb thiab cov neeg muaj lub luag haujlwm uas yuav tsum muaj kev saib xyuas ntau ntxiv - nrog kev saib xyuas zoo koj yuav tsum tau kuaj mob. Yog tias cov neeg mob tsis ua haujlwm lub siab lossis lub raum tsis ua haujlwm, cov tshuaj kho kom zoo zoo.
Invokana (ntsiav tshuaj) Ntsuam Xyuas: 99 Top
Cov analogue yog kim dua los ntawm 311 rubles.
Invokana - ntsiav tshuaj, zoo ib yam li tshuaj ntsiav hauv plhaub, muaj ntxig nrog CFZ. Canagliflozin yog qhov tshuaj yeeb tshuaj ntawm qhov tshuaj. Invokana belongs rau ib yam tshiab ntawm cov kab mob hypoglycemic thiab muab txoj kev kho zoo rau cov neeg mob ntshav qab zib. Cov tshuaj no yog sau tseg rau kev kho mob ntawm cov neeg mob ntshav qab zib hom 2.