Jardins: cov lus qhia rau kev siv, analogues thiab tshuaj xyuas, cov nqi hauv cov khw muag tshuaj ntawm Russia
Cov nplooj ntawv no muab cov npe ntawm tag nrho Jardins analogues hauv kev sau thiab qhia rau kev siv. Cov npe ntawm cov pheej yig analogues, thiab koj kuj tuaj yeem sib piv cov nqi hauv cov khw muag tshuaj.
- Tus pheej yig tshaj Jardins counterpart:Forsyga
- Tus khub nrov tshaj plaws Jardins:Saxenda
- Kev faib tawm ATX: Empagliflozin
- Cov khoom xyaw nquag / muaj pes tsawg leeg: empagliflozin
| # | Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
|---|---|---|---|
| 1 | Forsyga dapagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 12 RUB | 3200 UAH |
| 2 | Ua tub rog canagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 13 RUB | 3200 UAH |
| 3 | Novonorm kwv huam Analogue hauv kev taw qhia thiab txoj kev siv | 30 RUB | 90 UAH |
| 4 | Lub sijhawm dulaglutide Analogue hauv kev taw qhia thiab txoj kev siv | 115 RUB | -- |
| 5 | Baeta exenatide Analogue hauv kev taw qhia thiab txoj kev siv | 150 rub | 4600 UAH |
Thaum xam xyuas tus nqi pheej yig cov qauv jardins 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 | Saxenda lisraglutide Analogue hauv kev taw qhia thiab txoj kev siv | 1374 rub | 13773 UAH |
| 2 | Lub sijhawm dulaglutide Analogue hauv kev taw qhia thiab txoj kev siv | 115 RUB | -- |
| 3 | Forsyga dapagliflozin Analogue hauv kev taw qhia thiab txoj kev siv | 12 RUB | 3200 UAH |
| 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 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 |
| Forksiga Dapagliflozin | -- | 18 UAH |
| Forsiga Dapagliflozin | 12 RUB | 3200 UAH |
| Invocana canagliflozin | 13 RUB | 3200 UAH |
| Trulicity Dulaglutide | 115 RUB | -- |
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 | 44 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.
Jardins qhia
LUS QHIA Daim ntawv tso tawm Muaj pes tsawg leeg Ntim Pharmacological kev txiav txim Jardins, kev qhia rau siv Cov Yuav Tsum Tau Ua Dab tsi pab kom lub Jardins? Raws li cov lus qhia, cov tshuaj tau tawm rau kev kho mob ntawm cov neeg muaj ntshav qab zib hom 2:
ntawm kev siv cov tshuaj
LWJXEEB
zaj duab xis-ntsiav tshuaj ntsiav tshuaj
1 ntsiav tshuaj muaj:
cov tshuaj nquag: empagliflozin 10 thiab 25 mg
kev zam: lactose monohydrate, microcrystalline cellulose, hyprolose (hydroxypropyl cellulose), croscarmellose sodium, colloidal silicon dioxide, magnesium stearate.
zaj duab xis muaj pes tsawg leeg: opadry daj (02B38190) (hypromellose 2910, titanium dioxide (E171), talc, macrogol 400, daj hlau oxide zas (E172)).
10 thiab 30 ntsiav tshuaj.
Jardins - Hom 2 Sodium Hlej Cov Hnav Cov Pauv Khoom Hloov Chaw
Yam 2 Ntshav Qab Zib Hom:
raws li kev kho mob monotherapy hauv cov neeg mob uas tsis txaus glycemic tswj tsuas yog tiv thaiv tom qab ntawm kev noj haus thiab kev tawm dag zog, kev teem sijhawm tshuaj metformin uas pom tau tias tsis tsim nyog vim kev tsis txaus ntseeg,
raws li kev sib txuam nrog kev kho mob nrog lwm tus kab mob hypoglycemic, suav nrog cov tshuaj insulin, thaum kev siv tshuaj kho mob ua ke nrog kev noj haus thiab kev tawm dag zog tsis muab kev tswj hwm glycemic tsim nyog.
ua kom lub cev tsis haum rau ib qho tshuaj tiv thaiv,
ntshav qab zib hom 1
mob ketoacidosis,
muaj cov kab mob tsis muaj keeb txaus (lactase deficiency, lactose intolerance, glucose-galactose malabsorption),
Mob raum tsis ua hauj lwm hauv GFR Txhua cov ntaub ntawv raug nthuav tawm xov xwm thiab tsis yog lub laj thawj ntawm kev kho tus kheej lossis hloov tshuajKev ntsuas rau siv
Cov lus qhia rau kev siv Jardins (10 25 mg), noj ntau npaum
Cov ntsiav tshuaj tau noj ntawm qhov ncauj 1 zaug hauv ib hnub, tib lub sijhawm, ntxuav nrog dej. Kev siv cov tshuaj muaj peev xwm ua tau txhua lub sijhawm ntawm lub hnub, tsis hais noj zaub mov noj.
Qhov pom zoo kom muab cov tshuaj rau Jardins yog 10 mg 1 zaug ib hnub. Yog tias nws tsis muaj kev tswj glycemic txaus, tom qab ntawd cov koob tshuaj tau nce rau qhov siab tshaj plaws - 1 ntsiav tshuaj ntawm Jardins 25 mg 1 lub sijhawm hauv ib hnub.
Yog tias koj hla ib koob tshuaj, koj yuav tsum noj cov tshuaj kom sai li thaum tus neeg mob nco qab qhov no. Tsis txhob noj ob zaug nyob hauv ib hnub.
Nrog rau kev siv Jardins nrog sulfonylurea derivatives los yog nrog insulin, yuav tsum tau txo koob tshuaj sulfonylurea / insulin derivatives vim tias qhov pheej hmoo yuav ua rau lub qog ntshav qab zib.
Cov lus qhia tshwj xeeb
Rau cov neeg mob lub raum tsis ua hauj lwm nrog GFR los ntawm 45 txog 90 ml / min / 1.73 m2, tsis tas kho qhov koob tshuaj.
Cov neeg mob raum tsis ua haujlwm hauv GFR
3 kev xyuas rau “Jardins”
Jarins siv sijhawm ib xyoo. Cov tswv yim poob ntawm 15 txog 6-8. Qhov hnyav poob los ntawm 10 kg. Qaug zog thiab nkees. Tsis ntev los no, kuv lub zeem muag cia li poob. Yog li - ib qho kho tau, lwm tus ceg tawv.
Cov tshuaj zoo heev, nws pab kuv niam txo cov suab thaj ua ntej kev ua haujlwm, cov kws kho mob tsis kam ua haujlwm vim tias muaj cov piam thaj ntau, thiab cov jardins tau pab peb hauv qhov no. Tam sim no peb tsis kam, tab sis qab zib tuas zoo.
Tshuaj zoo heev! Kuv pom zoo kom cov neeg uas tsis muaj kev vam meej hauv kev kho yuav pab tau zoo.
Daim ntawv noj tshuaj:
zaj duab xis-ntsiav tshuaj ntsiav tshuaj
1 lub ntim zaj duab xis-txheej muaj:
Yam tshuaj muaj sia:
empagliflozin - 10 mg / 25 mg,
Cov muaj tswv yim:
lactose monohydrate - 162.50 / 113.0 mg, microcrystalline cellulose - 62.50 / 50.0 mg, hyprolose (hydroxypropyl cellulose) - 7.5 / 6.0 mg, croscarmellose sodium - 5.0 / 4.0 mg, colloidal silicon dioxide - 1.25 / 1.0 mg, magnesium stearate - 1.25 / 1.0 mg,
Plhaub:
Opadry daj (02B38190) - 7.0 / 6.0 mg (hypromellose 2910 - 3.5 / 3.0 mg, titanium dioxide (E 171) - 1.733 / 1.485 mg, talc - 1.4 / 1.2 mg, macrogol 400 - 0.35 / 0.3 mg, hlau zas hlau oxide daj (E 172) - 0.018 / 0.015 mg).
Kev piav qhia
10 mg ntsiav tshuaj
Muab cov ua ke ua ke nrog cov kab thawb npoo, npog nrog zaj duab xis ntawm lub teeb xim daj nrog lub ntsej muag sau ua lub tuam txhab cim ntawm ib sab ntawm lub ntsiav tshuaj thiab "S10" nyob rau sab nraud.
25 mg ntsiav tshuaj
Oval biconvex ntsiav tshuaj nrog cov ntug beveled, coated nrog zaj duab xis daim duab ntawm lub teeb xim daj, sau nrog lub tuam txhab cov cim ntawm ib sab ntawm lub ntsiav tshuaj thiab "S25" nyob rau sab nraud.
Cov chaw muag tshuaj
Cov Tshuaj Hauv Tshuaj
Empagliflozin yog qhov thim rov qab, nquag, xaiv thiab sib tw inhibitor ntawm hom 2 sodium-dependent glucose transporter nrog qhov xav tau yuav tsum tau inhibit 50% ntawm qhov kev ua enzyme (IC50) ntawm 1.3 nmol. Qhov xaiv ntawm empagliflozin yog 5,000 npaug ntau dua qhov xaiv ntawm hom 1 sodium-dependent glucose transporter lub luag haujlwm rau kev nqus ntawm cov piam thaj hauv txoj hnyuv. Tsis tas li ntawd, nws tau pom tias empagliflozin muaj qhov siab xaiv rau lwm cov neeg thauj khoom qabzib lub luag haujlwm rau cov piam thaj homeostasis hauv ntau cov ntaub so ntswg.
Cov sodium-depend type 2 glucose transporter yog lub ntsiab thauj cov protein rau lub luag haujlwm kom rov muaj cov piam thaj ntawm ntshav qabzib rov qab los rau hauv cov ntshav. Empagliflozin txhim kho glycemic tswj nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus (T2DM) los ntawm kev txo cov ntshav qabzib reabsorption. Tus nqi ntawm cov piam thaj zais tawm los ntawm ob lub raum siv cov txheej txheem no nyob ntawm kev saib xyuas cov piam thaj hauv ntshav thiab glomerular filtration rate (GFR). Kev txwv tsis pub los ntawm sodium-muaj neeg nqa khoom ntawm hom 2 piam thaj hauv cov neeg mob uas muaj ntshav qab zib hom 2 thiab hyperglycemia ua rau kev tshem tawm cov piam thaj ntau dhau los ntawm ob lub raum.
Hauv kev tshawb nrhiav, nws tau pom tias nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2, qhov tsis pom qabzib los ntawm lub raum nce ntxiv tom qab siv thawj zaug ntawm empagliflozin, cov nyhuv no txuas ntxiv mus 24 teev. Kev nce ntxiv ntawm cov kua nplaum tawm ntawm lub raum txuas ntxiv mus kom txog rau thaum lub sijhawm 4-lub lim tiam kho mob, nrog empagliflozin ntawm ib koob ntawm 25 mg ib hnub ib zaug, qhov nruab nrab, kwv yees li 78 g / hnub. Hauv cov neeg mob uas muaj ntshav qab zib hom 2, ib qho kev nce ntxiv ntawm cov kua nplaum los ntawm ob lub raum ua rau muaj kev cuam tshuam sai li sai tau ntawm cov ntshav qabzib hauv cov ntshav ntshav.
Empagliflozin txo cov ntsiab lus ntawm cov piam thaj hauv ntshav ntshav ob leeg ntawm kev yoo mov thiab tom qab noj mov.
Lub non-insulin-ua rau lub tswv yim ntawm kev txiav txim ntawm empagliflozin ua rau muaj kev pheej hmoo tsawg ntawm qhov kev txhim kho uas muaj peev xwm ntawm hypoglycemia.
Cov nyhuv ntawm empagliflozin tsis yog nyob ntawm lub xeev kev ua haujlwm ntawm pancreatic beta hlwb thiab cov tshuaj insulin metabolism. Cov txiaj ntsig zoo ntawm empagliflozin rau kev ntsuas mob siab ntawm beta cell ua haujlwm, suav nrog HOMA-ß Performance index (qauv rau kev ntsuam xyuas homeostasis-B) thiab piv ntawm proinsulin rau insulin, tau sau tseg. Tsis tas li ntawd, ntxiv kev tshem tawm cov piam thaj los ntawm ob lub raum ua rau poob phaus, uas yog nrog cov suab nrov me me hauv lub cev txo thiab qhov hnyav hauv lub cev.
Glucosuria tau pom thaum siv empagliflozin yog nrog los ntawm diuresis me ntsis, uas tuaj yeem ua rau txo qis hauv cov ntshav siab.
Hauv kev sim tshuaj saib qhov twg empagliflozin raug siv los kho monotherapy, kev sib txuas ua ke nrog metformin, kev sib txuas ua ke nrog metformin thiab sulfonylurea derivatives, kev sib txuas nrog kev kho mob nrog metformin piv rau glimepiride, kev sib xyaw nrog kev kho mob nrog pioglitazone +/- metformin, yog kev sib txuam nrog kev kho mob nrog dipeptidyl peptide inhibitor 4 (DPP-4), metformin +/- lwm qhov tshuaj hypoglycemic hauv qhov ncauj, nyob rau hauv kev sib xyaw ua ke nrog kev kho mob nrog insulin, nws muaj cov lus tseem ceeb. kuv qhov txo qis hauv glycosylated HbAlc hemoglobin thiab txo qis hauv kev yoo plasma ntshav qab zib.
Cov Yuav Tsum Tau Ua
- Hypersensitivity rau ib feem twg ntawm cov tshuaj,
- Yam 1 ntshav qab zib
- Ntshav qab zib ketoacidosis
- Tsis tshua muaj cov kab mob muaj keeb (cov lactase deficiency, lactose intolerance, glucose-galactose malabsorption),
- Kev tsis ua haujlwm hauv GFR Kev siv thaum cev xeeb tub thiab thaum pub niam mis
Kev siv cov tshuaj empagliflozin thaum cev xeeb tub yog contraindicated vim cov ntaub ntawv tsis txaus ntawm kev ua tau zoo thiab kev nyab xeeb.
Cov ntaub ntawv tau hauv cov kev tshawb fawb hauv preclinical hauv cov tsiaj qhia txog kev nkag mus ntawm empagliflozin rau hauv cov kua mis. Txoj kev pheej hmoo ntawm kis tau tus me nyuam tshiab thiab menyuam thaum lub sijhawm pub niam mis tsis suav nrog. Kev siv cov tshuaj empagliflozin thaum lub sijhawm pub mis niam yog contraindicated. Yog tias nws yuav tsum tau siv cov tshuaj empagliflozin thaum pub mis, yuav tsum tsis txhob pub mis.
Tsuas tshuaj thiab tswj hwm
Kho txoj kev kho mob los yog txoj kev kho kom haum
Qhov pom zoo kom pib lub koob tshuaj yog 10 mg (1 ntsiav tshuaj nrog noj tshuaj 10 mg) ib hnub ib zaug, los ntawm qhov ncauj.
Yog tias qhov koob tshuaj txhua hnub ntawm 10 mg tsis muab tshuaj glycemic txaus, cov tshuaj yuav raug nce ntxiv rau 25 mg (1 ntsiav tshuaj nrog noj tshuaj 25 mg ib hnub ib zaug). Qhov siab tshuaj ntau tshaj txhua hnub yog 25 mg.
Cov tshuaj JARDINS tuaj yeem noj tsis hais lub sijhawm twg los tau nyob rau hnub ntawd.
Ua yeeb yam hla kev noj ib los yog ob zaug tshuaj ntawm cov tshuaj
Thaum dhia mus txhaj koob tshuaj, tus neeg mob yuav tsum noj cov tshuaj kom sai raws li nws nco qab qhov no.
Tsis txhob noj ob zaug nyob hauv ib hnub.
Cov pab pawg neeg tshwj xeeb
Hauv raum tsis ua haujlwm nrog GFR los ntawm 45 txog 90 ml / min / 1.73 m2, tsis tas yuav hloov kho koob.
Cov neeg mob lub raum tsis ua hauj lwm nrog GFR tsawg dua 45 ml / min / 1.73 m2 tsis pom zoo siv tshuaj vim tsis muaj txiaj ntsig.
Cov neeg mob uas ua tsis tau daim siab hloov kho koob tshuaj tsis raug tseev kom ua.
Noj ntau dhau
Cov tsos mob
Thaum tswj xyuas cov kev kho mob, kev noj ib zaug ntawm empagliflozin ncav cuag 800 mg (32 lub sij hawm qhov siab tshaj plaws txhua hnub) hauv cov neeg tuaj yeem noj qab haus huv thiab ntau lub koob ncav 100 mg (4 npaug ntawm qhov siab tshaj plaws txhua hnub) hauv cov neeg mob ntshav qab zib hom 2 tau pom zoo. Qhov pom tau tias tso zis ntau ntxiv tsis yog nyob ntawm qhov koob tshuaj thiab tsis muaj qhov tseem ceeb hauv kev kuaj mob. Tsis muaj kev paub nrog kev txhaj tshuaj ntau dua 800 mg.
Kev Kho Mob
Yog tias muaj kev noj ntau dhau, nws raug nquahu tias cov tshuaj tsis tuaj yeem tshem tawm txoj hnyuv, kev kuaj mob thiab kev kho tus mob yog nqa tawm.
Kev cuam tshuam nrog lwm yam tshuaj
Hauv tshuaj ntsuam xyuas tshuaj vitro
Empagliflozin tsis inhibit, inactivate, lossis ntxias CYP450 isoenzymes. Txoj hauv kev tseem ceeb ntawm tib neeg cov khoom noj khoom haus metabolism yog glucuronidation nrog kev koom tes ntawm uridine-5′-diphospho-glucuronosyltransferases UGT2B7, UGT1A3, UGT1A8 thiab UGT1A9. Empagliflozin tsis inhibit UGT1A1. Kev sib cuam tshuam yeeb tshuaj ntawm cov tshuaj empagliflozin thiab cov tshuaj uas yog cov me me ntawm CYP450 thiab UGT1A1 isoenzymes yog suav tias yog qhov tsis zoo.
Empagliflozin yog ib qho tshuaj tiv thaiv kab mob glycoprotein P (P-gp) thiab cov qog mis tiv thaiv mob cancer mis (BCRP). tab sis hauv kev kho mob tsis haum cov protein. Raws li cov ntaub ntawv los ntawm kev tshawb fawb hauv vitro, nws ntseeg tau tias kev muaj peev xwm ntawm empagliflozin cuam tshuam nrog cov tshuaj uas yog cov kab mob rau me me glycoprotein P (P-gp) tsis zoo li. Empagliflozin yog cov txheej txheem rau cov organic anionic nqa khoom: OATZ, OATP1B1 thiab OATP1VZ, tab sis tsis muaj txheej txheem rau cov organic anionic nqa khoom 1 (OAT1) thiab organic cationic carriers 2 (OST2). Txawm li cas los xij, kev sib cuam tshuam txog yeeb tshuaj ntawm empagliflozin nrog cov tshuaj uas yog cov substrates rau cov cab kuj muaj cov roj ntsha tau piav qhia saum toj yog suav tias tsis zoo li.
Hauv vivo tshuaj ntsuam kev sib cuam tshuam
Cov chaw muag tshuaj ntawm empagliflozin tsis hloov pauv rau cov neeg tuaj yeem noj qab haus huv thaum siv ua ke nrog metformin, glimepiride, pioglitazone, sitagliptin, linagliptin, warfarin, verapamil, ramipril, simvastatin, torasemide thiab hydrochlorothiazide. Kev sib xyaw ntawm kev siv empagliflozin nrog gemfibrozil, rifampicin thiab probenecid pom tias muaj kev nce ntxiv ntawm AUC ntawm empagliflozin los ntawm 59%, 35% thiab 53%, xwm yeem, txawm li cas los xij, cov kev hloov no tsis tau pom tias tseem ceeb hauv kev kho mob.
Empagliflozin tsis muaj kev cuam tshuam los ntawm kev mob loj rau lub pharmacokinetics ntawm metformin, glimepiride, pioglitazone, sitagliptin, linagliptin, warfarin. digoxin, ramipril, simvastatin, hydrochlorothiazide, torasemide thiab qhov ncauj tshuaj tiv thaiv.
Kev tshuaj ntsuab
Empagliflozin tuaj yeem txhim kho lub diuretic nyhuv ntawm thiazide thiab "voj" diuretics, uas nyob rau hauv lem yuav ua rau muaj kev pheej hmoo ntawm lub cev qhuav dej thiab cov hlab ntsha hypotension.
Cov tshuaj insulin thiab tshuaj uas txhim kho nws qhov kev zais cia
Cov tshuaj Insulin thiab cov tshuaj uas pab txhawb nws txoj kev zais, xws li sulfonylureas, tuaj yeem ua rau muaj kev pheej hmoo ntawm hypoglycemia. Yog li no, nrog rau kev siv empagliflozin sib xyaw nrog insulin thiab tshuaj uas txhim kho nws qhov kev tso cia, nws yuav tsim nyog txo lawv cov koob tshuaj, txhawm rau kom tsis txhob muaj kev pheej hmoo ntawm hypoglycemia.
Cov lus qhia tshwj xeeb
Cov tshuaj JARDINS tsis pom zoo rau cov neeg mob uas muaj hom 1 mob ntshav qab zib mellitus thiab rau kev kho mob ntshav qab zib ketoacidosis.
Qhov siab tshaj plaws txhua hnub ntawm JARDINS muaj 113 mg ntawm lactose, yog li cov tshuaj yuav tsum tsis txhob siv rau hauv cov neeg mob uas tsis tshua muaj kev mob caj ces xws li lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
Cov kev tshawb fawb soj ntsuam tau pom tias kev kho mob nrog empagliflozin tsis ua rau muaj kev pheej hmoo hauv lub plawv mob txaus. Kev siv cov tshuaj empagliflozin ntawm ib koob ntawm 25 mg tsis ua rau lub sijhawm ntev ntawm QT luv.
Nrog rau kev sib koom tes ntawm kev siv tshuaj JARDINS nrog sulfonylurea derivatives lossis nrog insulin, yuav tsum tau txo koob tshuaj sulfonylurea / insulin derivatives vim tias qhov kev pheej hmoo ntawm hypoglycemia.
Tsis kawm txog kev sib txuas ntawm cov tshuaj hypoglycemic
Empagliflozin tsis tau kawm txog kev sib xyaw nrog glucagon zoo li peptide 1 analogues (GLP-1).
Kev kuaj xyuas lub raum
Qhov ua tau zoo ntawm cov tshuaj JARDINS yog nyob ntawm kev ua haujlwm ntawm lub raum. Yog li, nws raug nquahu kom soj ntsuam lub raum ua ntej nws lub sijhawm teem tseg thiab tsis tseg thaum kho (tsawg kawg ib xyoos ib zaug), nrog rau ua ntej kev kho mob concomitant, uas tuaj yeem cuam tshuam tsis zoo rau lub raum kev ua haujlwm. Cov neeg mob lub raum tsis ua haujlwm (GFR tsawg dua 45 ml min). noj cov tshuaj tsis pom zoo.
Cov neeg laus cov neeg mob
Cov neeg mob hnub nyoog 75 xyoo lossis tshaj saud muaj qhov ua kom lub cev qhuav dej ntau dua. Hauv cov neeg mob no tau kho nrog empagliflozin, cov kev mob tshwm sim los ntawm hypovolemia tau pom ntau dua (piv nrog cov neeg mob uas tau txais cov placebo). Kev paub nrog kev siv empagliflozin hauv cov neeg mob laus dua 85 xyoo yog qhov tsawg, yog li ntawd, nws tsis pom zoo kom muab cov tshuaj DZHARDINS rau cov neeg mob laus dua 85 xyoo.
Siv rau hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev mob hypovolemia
Raws li cov txheej txheem ntawm kev nqis tes ua, kev tswj hwm ntawm cov tshuaj JARDINS tuaj yeem ua rau txo qis hauv cov ntshav siab. Yog li, cov tshuaj yuav tsum tau siv nrog ceev faj nyob rau hauv cov xwm txheej uas txo qis ntshav siab yog qhov tsis txaus siab, piv txwv li, nyob rau hauv cov neeg mob mob plawv, cov neeg mob noj tshuaj antihypertensive (muaj keeb kwm ntawm kev mob ntshav ncig), zoo li hauv cov neeg mob laus dua 75 xyoo.
Hauv kev tshwm sim thaum tus neeg mob siv tshuaj JARDINS. cov xwm txheej uas tuaj yeem ua rau cov kua dej tsis ua haujlwm (piv txwv, nrog cov kab mob ntawm txoj hnyuv), tus neeg mob lub cev, ntshav siab yuav tsum ua tib zoo saib xyuas, nrog rau hematocrit thiab electrolyte tshuav nyiaj li cas. Tej zaum nws yuav xav tau ib qho nyob ib ntus, txog kev rov qab kho dej kom tshuav nyiaj li cas, tsis ua txuas ntxiv ntawm cov tshuaj.
Mob txeeb zig
Qhov tshwm sim ntawm cov kev mob tshwm sim xws li mob txeeb zig muaj peev xwm sib piv nrog empagliflozin ntawm koob tshuaj 25 mg thiab placebo, thiab siab dua nrog empagliflozin ntawm koob tshuaj 10 mg. Cov mob txeeb zig ua ke nyuaj (xws li pyelonephritis thiab urosepsis) tau pom nrog cov neeg zoo sib xws hauv cov neeg mob noj empagliflozin thiab cov placebo. Yog hais tias muaj teeb meem nyuaj mob txeeb zig, yuav tsum tsis kho ib ntus ntawm kev kho tus mob empagliflozin yog tsim nyog.
Kev Kuaj Mob Urinalysis
Raws li cov txheej txheem ntawm kev nqis tes ua hauv cov neeg mob uas siv cov tshuaj JARDINS, cov piam thaj hauv cov zis yog txiav txim siab.
Muaj feem xyuam rau kev muaj peev xwm tsav tsheb thiab cov txheej txheem
Cov kev tshawb fawb soj ntsuam ntawm cov txiaj ntsig ntawm empagliflozin ntawm kev muaj peev xwm tsav tsheb thiab cov tswv yim tsis tau coj los ua. Cov neeg mob yuav tsum tau ceev faj thaum tsav tsheb thiab cov txheej txheem, txij li thaum siv tshuaj JARDINS (tshwj xeeb tshaj yog ua ke nrog sulfonylurea derivatives thiab / lossis insulin), hypoglycemia tuaj yeem tsim kho.
Muaj Jardins Hloov
NovoNorm (ntsiav tshuaj) Ntsuam Xyuas: 163
Cov analogue yog pheej yig dua los ntawm 59 rubles.
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.
Kev Tshuaj Ntsuam Xyuas (ntsiav tshuaj) Ntsuam Xyuas: 142
Diagninide yog Lavxias hloov chaw rau tib nqe nqi nrog tib tus naj npawb ntawm cov ntsiav tshuaj ib ntim. Qhov muaj pes tsawg leeg thiab noj tshuaj ntawm cov tshuaj nquag kuj txawv ntawm Jardins, tab sis tau sau tseg rau kev kho mob ntshav qab zib hom 2 nrog kev ua haujlwm tsis zoo thiab kev noj haus.
Cov ntaub ntawv dav dav txog cov tshuaj, nws muaj pes tsawg leeg
Cov tshuaj Jardins yog siv los tswj cov ntshav qab zib thaum lub sij hawm monotherapy. Ib qho ntxiv, cov cuab yeej no tuaj yeem siv los ua ib qho kev tivthaiv hauv kev kho kev mob ntshav qab zib hauv kev kho mob ntshav qab zib.
Lub cuab tam tuaj yeem siv tau ua ke nrog qee lwm cov tshuaj hypoglycemic. Cov tshuaj no tej zaum yuav suav nrog insulin lossis metformin.
Cov tshuaj nyob rau hauv kev ua lag luam ntawm cov khoom lag luam pharmacological tau muag hauv ob hom kev sib txawv hauv tus nqi ntawm cov tshuaj ua haujlwm zoo.
Nyob ntawm seb cov koob tshuaj ntawm lub ntsiab nquag sib xyaw, ib ntsiav tshuaj ntawm kev npaj yuav muaj 10 lossis 30 mg ntawm cov tshuaj nquag.
Ntxiv nrog rau lub ntsiab nquag sib txuas, cov khoom siv hauv qab no tau suav nrog ib ntsiav tshuaj ntawm cov tshuaj:
- lactose monohydrate,
- microcrystalline cellulose,
- Kev Hyprolose
- croscarmellose sodium,
- silica
- magnesium stearate.
Cov ntsiav tshuaj ntawm cov tshuaj yog coated, uas muaj cov hauv qab no:
- Opadra daj,
- hypromellose,
- titanium dioxide
- talcum hmoov
- macrogol 400,
- hlau oxide yog daj.
Thaum siv cov tshuaj no, nws yuav tsum nco ntsoov tias kev siv Jardins los ua kom cov ntshav qab zib hauv cov neeg muaj ntshav qab zib hom 2 tsis tuaj yeem cawm ib tus neeg los ntawm qhov mob no.
Lub ntsiab pharmacological zoo ntawm cov tshuaj
Cov tshuaj Jardins feem ntau siv rau hauv cov tshuaj niaj hnub los kho cov ntshav qab zib hauv tus neeg muaj ntshav qab zib hom 2.
Kev tshuaj xyuas ntawm cov kws kho mob tshwj xeeb qhia tias cov cuab yeej no ua rau nws muaj peev xwm tswj hwm cov piam thaj hauv cov neeg mob lub cev thiab ua tiav tau zoo heev.
Empagliflozin, yog cov tseem ceeb sib xyaw ua ke ntawm cov tshuaj, yog ib qho kev xaiv, thim rov qab ua rau muaj kev sib tw muaj zog tshwj xeeb ntawm cov tshuaj tshwj xeeb uas muaj protein ntau cov kua roj pauv.
Qhov kev sib xyaw no txhim kho lub peev xwm tswj cov qib suab thaj hauv lub cev ntawm tus neeg mob uas muaj ntshav qab zib hom 2. Cov txiaj ntsig ntawm cov tshuaj nquag nquag ntawm cov tshuaj no yog tias nws pab txhawm rau txo qis dua ntawm cov piam thaj rau kev kho mob hauv cov txheej txheem ntawm lub raum. Thaum siv tshuaj, cov piam thaj hauv cov zis ntxiv, uas ua rau kom tshem tawm sai sai ntawm cov piam thaj hauv lub cev.
Kev siv ntawm cov tshuaj tsis cuam tshuam loj heev rau kev ua haujlwm ntawm beta hlwb. Lub chaw nquag muaj kev cuam tshuam zoo rau cov ntaub so ntswg, uas pab txhawm rau txhim kho nws txoj haujlwm.
Cov lus qhia ntawm empagliflozin rau hauv lub cev muaj txiaj ntsig zoo cuam tshuam rau cov txheej txheem ntawm kev hlawv cov rog thiab pab txo qhov hnyav ntawm tus neeg mob uas muaj ntshav qab zib hom 2. Qhov txiaj ntsig ntxiv los ntawm kev siv cov tshuaj yog qhov tshwj xeeb tshaj yog rau cov neeg rog dhau los uas muaj ntshav qab zib hom 2.
Ib nrab-lub neej ntawm kev ua kom nquag plias ntawm cov tshuaj yog nqa tawm rau 12 teev. Qhov kev txhaj tshuaj nyob ruaj hauv lub cev ntawm cov tshuaj nquag nrog ib koob tshuaj ib zaug ntawm ib hnub yog ua tiav tom qab siv koob thib tsib ntawm cov tshuaj.
Los ntawm tib neeg lub cev, txog li 96% ntawm cov tshuaj tau noj yog xoos. Kev tshem tawm cov metabolites yog nqa tawm siv txoj hnyuv thiab lub raum. Los ntawm txoj hnyuv, qhov nquag ua haujlwm yog qhov thim tsis hloov pauv. Thaum ua tawm los ntawm ob lub raum, tsuas yog 50% ntawm cov nquag ua haujlwm ntawm cov tshuaj yog raug hloov pauv tsis hloov pauv.
Qhov kev kub siab ntawm kev ua kom nquag plias nyob rau hauv lub cev yog zoo heev los ntawm qhov pom ntawm tus neeg mob ntawm lub raum lossis lub siab ua haujlwm.
Tib neeg lub cev qhov hnyav, poj niam txiv neej thiab lub hnub nyoog tsis cuam tshuam loj heev rau pharmacokinetics ntawm kev ua kom nquag plias ntawm cov tshuaj.
Cov lus qhia rau kev siv tshuaj
Cov tshuaj yog siv rau mono - lossis txoj kev kho mob. Qhov pom zoo koob tshuaj yog 10 mg - ib ntsiav tshuaj ib hnub. Cov tshuaj yog muab ntawm qhov ncauj.
Yog tias qhov noj tshuaj txhua hnub ntawm 10 mg tsis muaj peev xwm muab tau cov txiaj ntsig glycemic, qhov kev siv tshuaj yuav nce ntxiv rau 25 mg ib hnub twg. Qhov siab tshaj plaws tau tso cai ntawm cov tshuaj tuaj yeem nce txog 25 mg.
Cov tshuaj yog pub rau noj thaum lub sijhawm twg los tau, tsis hais lub regimen noj mov.
Yog tias koj tsis nco qab lub sijhawm noj tshuaj, koj yuav tsum tsis txhob noj ob npaug ntawm cov tshuaj ib hnub.
Nrog rau qhov siab ntawm lub raum tsis ua haujlwm, cov tshuaj tsis pom zoo, vim tias tsis muaj txiaj ntsig los ntawm kev siv cov tshuaj.
Yog hais tias tus neeg mob muaj qhov txawv txav hauv lub siab, uas pom tias yog lub siab tsis ua haujlwm, kev kho qhov siab ntawm cov tshuaj noj tsis raug tseev kom ua.
Nws tsis pom zoo kom siv cov tshuaj thaum nqa menyuam thiab kev pub niam mis, vim tsis muaj ntaub ntawv qhia txog kev ua haujlwm zoo thiab kev nyab xeeb rau cov tshuaj rau leej niam thiab tus menyuam nyob rau lub sijhawm no.
Kev ua kom lub raum tsis ua haujlwm, qhov ua tau ntawm cov tshuaj yog nyob ntawm qhov ua haujlwm tsis ua haujlwm.
Nws raug nquahu kom kuaj lub raum ua haujlwm ua ntej siv tshuaj kho mob, thiab nws raug nquahu kom kuaj lub raum ua haujlwm tsawg kawg ib xyoos ib zaug thaum siv Jardins.
Nws yog txwv tsis pub siv cov tshuaj no thaum menyuam yaus. Kev txwv tsis pub siv rau txhua tus neeg mob hnub nyoog qis dua 18 xyoo. Qhov no vim yog tsis muaj kev tshawb fawb txog qhov ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj.
Nws tsis pom zoo kom siv cov tshuaj hauv kev kho mob rau cov neeg mob hnub nyoog 75 xyoo. Qhov no feem ntau cuam tshuam nrog qib siab ntawm txoj kev loj hlob ntawm lub xeev lub cev qhuav dej.
Koj yuav tsum tsis txhob siv lub cuab tam thaum kho cov neeg mob uas muaj hom 1 mob ntshav qab zib mellitus thiab nyob rau hauv cov mob uas tus neeg mob ketoacidosis muaj ntshav qab zib.
Thaum siv ntau kawg ntawm cov tshuaj Jardins, txog 113 mg ntawm lactose nkag mus rau hauv tus neeg mob lub cev.
Qhov cuab yeej no yuav tsum tsis txhob siv yog tias tus neeg mob lub cev tsis muaj lactase, lactose intolerance lossis glucose-galactose malabsorption hauv lub cev.
Kev phiv tshuaj thiab sib kis thaum siv cov tshuaj
Feem ntau cov kev mob tshwm sim ntawm kev noj empagliflozin yog qhov pib ntawm cov tsos mob ntawm kev mob ntshav qab zib.
Feem ntau, ib qho kev mob tshwm sim hauv daim ntawv ntawm hypoglycemia manifests nws tus kheej thaum siv cov tshuaj hauv kev sib xyaw nrog sulfonylurea derivatives lossis nrog insulin.
Ntxiv nrog rau qhov hypoglycemia, cov neeg mob uas siv cov tshuaj empagliflozin tuaj yeem ntsib kev mob tshwm sim ntau.
Feem ntau cov kev mob tshwm sim thaum siv cov tshuaj muaj raws li nram no:
- Cov tsos mob ntawm tus kab mob sib kis thiab parasitic xws li vulvovaginitis, balanitis, tus mob candidiasis, thiab mob txeeb zig.
- Raws li kev hloov pauv hauv cov txheej txheem hauv lub cev hauv lub cev, hypovolemia yuav tshwm sim.
- Tseem ceeb heev tso zis tso zis.
- Qhov tshwm sim ntawm cov cim ntawm lub cev qhuav dej, uas yog feem ntau pom nrog kev siv tshuaj hauv cov laus.
Kev tshuaj xyuas txog cov tshuaj, cov neeg uas tau siv nws, qhia tias qhov kev mob tshwm sim ntau hauv lub cev ntawm tus neeg mob yog qhov tsis tshua muaj tshwm sim. Thaum thawj cov tsos mob tshwm sim tshwm sim, koj yuav tsum tsis txhob noj tshuaj thiab nrhiav kev pab ntawm koj tus kws kho mob.
Lub ntsiab contraindications rau kev siv cov tshuaj yog li nram no:
- ntshav qab zib hom 1
- tsis tshua muaj nqi glomerular pom,
- mob ketoacidosis,
- lactose intolerance,
- cev xeeb tub thiab lactation,
- ib qho xwm txheej ntawm lub cev uas tsim kev hem thawj ntawm lub cev qhuav dej.
Ua ntej noj cov tshuaj, koj yuav tsum sab laj nrog koj tus kws kho mob thiab ua ib qho kev soj ntsuam ntawm lub cev rau txhua yam kev sib txuam.
Cov tshuaj ntawm cov tshuaj, nqi thiab kev cuam tshuam nrog lwm cov tshuaj
Ntawm kev lag luam pharmacological ntawm Russia, tsuas yog siv tshuaj yaj yeeb Jardins, ua raws ntawm empagliflozin, yog muag. Los ntawm qhov uas peb tuaj yeem xaus tias tsis muaj ib qho analogues rau cov tshuaj no hauv khw Lavxias. Lwm cov neeg sawv cev nrog hypoglycemic zoo muaj qhov sib txawv ntawm lub cev.
Tus nqi ntawm cov tshuaj yog nyob ntawm thaj av ntawm kev muag tshuaj, nrog rau tus neeg xa khoom ntawm cov tshuaj. Tus nqi nruab nrab ntawm cov tshuaj Jardins hauv tebchaws Russia yog los ntawm 850 txog 1030 rubles.
Thaum siv tshuaj, nws yuav tsum tau yug los rau hauv lub siab tias nws muaj peev xwm txhim kho cov nyhuv diuretic ntawm kev siv qee yam thiazide diuretics, uas tuaj yeem pab txhawb kev txhim kho lub cev qhuav dej thiab leeg ntshav hypotension.
Undesirable yog kev sib xyaw ntawm Jardins nrog cov tshuaj tsim los ua kom ntshav nce siab.
Kev siv hluavtaws insulin, kev sib txig sib luag thiab cov tshuaj uas ua kom lub cev tsim cov tshuaj hormones tuaj yeem ua rau pom qhov tshwm sim ntawm hypoglycemia. Thaum ua txoj kev kho txoj kev kho mob nyuaj, yuav tsum tau saib xyuas qhov tsim nyog ntawm cov tshuaj thiab cov neeg saib xyuas cov tshuaj nyob rau hauv kev saib xyuas ntawm tus kws kho mob uas tuaj koom. Thiab cov vis dis aus hauv tsab xov xwm no yuav tham txog kev kho ntshav qab zib.
Cov nqi rau jardins hauv cov khw muag tshuaj hauv Moscow
| zaj duab xis-ntsiav tshuaj ntsiav tshuaj | 10 mg | 30 pcs | 2867,4 rub. |
| 25 mg | 30 pcs | ≈ 2849 tshiav. |
Cov kws kho mob rov tshuaj txog cov jardins
| Ntsuam xyuas 2.9 / 5 |
| Txij nkawm |
| Nqe / zoo |
| Sab sij huam |
Nws ua tau zoo tawm tsam glycemia, pab txhawb rau kom poob phaus.
Ua rau muaj kev pheej hmoo mob urogenital.
Cov tshuaj no muaj cov txiaj ntsig zoo rau glycemia, tab sis yuav tsum muaj kev nyiam huv, uas tsis muaj peev xwm ua tau rau txhua tus neeg mob. Yog tias tsis ua raws li txoj cai ntawm kev noj zaub mov noj, lub hom phiaj ntsuas ntawm kev noj haus cov metabolism hauv kev ua tiav tuaj yeem ua tiav hauv cov neeg mob uas tsis muaj qhov tsis tseem ceeb hauv glycemia. Txo cov calorie kom tsawg vim tias kev tshem tawm cov piam thaj hauv cov zis yog ib qho txiaj ntsig zoo ntxiv, txawm li cas los xij, txwv sijhawm.
| Ntsuam xyuas 3.8 / 5 |
| Txij nkawm |
| Nqe / zoo |
| Sab sij huam |
Nws yog ib hom tshuaj zoo tshaj plaws rau cov neeg mob ntshav qab zib mellitus thiab mob plawv nres.
Zis hauv cov neeg mob no yog kua qab zib, uas yog nce ntau qhov txaus ntshai ntawm kev kis kab mob ntawm chaw mos. Cov neeg mob yuav tsum ua raws kev nyiam huv. Kuv xav rov qab FDA cov lus ceeb toom hais txog qhov kev pheej hmoo siab ntawm kev ua paug rau txhawm chim txhawm rau vim muaj kev pheej hmoo siab ntawm kev kis mob ntawm qhov chaw mos.
Cov tshuaj no yog ib hom kev tawm tsam hauv kev kho plawv. Mob ntshav qab zib mellitus tau maj mam dhau los ua ib ceg ntawm kev kho plawv, thiab nws yog thawj cov tshuaj tiv thaiv ntshav qab zib uas muaj txiaj ntsig zoo nrog pom tseeb qhov tseeb ntawm nws cov nyhuv ntawm lub plawv.
| Ntsuam Xyuas 4.2 / 5 |
| Txij nkawm |
| Nqe / zoo |
| Sab sij huam |
Qhov zoo tshaj plaws hypoglycemic rau ntshav qab zib hom 1. Nws mus tau zoo nrog lwm cov tshuaj hypoglycemic thiab insulin. Nws muaj cov nyhuv indirect diuretic.
Tus nqi yog siab dua nruab nrab.
Nws ua haujlwm zoo. Cov neeg mob nco tau yooj yim ntawm kev siv - 1 zaug nyob rau ib hnub, uas txhim kho txoj kev ua kom tau raws li tus neeg mob.
| Ntsuam xyuas 5.0 / 5 |
| Txij nkawm |
| Nqe / zoo |
| Sab sij huam |
Cov tshuaj "Jardins" yog qhov zoo tshaj plaws rau lub sijhawm no rau kev kho mob ntshav qab zib. Cov tshuaj no tau sau npe nyob rau hauv Lavxias Federation. Ntau tus neeg mob hu nws "tshuaj ntsiav insulin." Cov nyhuv yog manifested heev sai sai. Niaj hnub no, cov tshuaj no yog lwm txoj hauv kev rau cov tshuaj insulin.
Jardins Neeg Mob Xyuas
Tus kab mob no tau tsim muaj txij xyoo 2012. Cov piam thaj tsis tau txo qis nrog ib qho tshuaj twg, yog li ntawd, nws tau muab tso sai sai rau 3 xyoos. Thaum xub thawj nws khaws cia 16-14 units, tom qab ntawd 18-16, thiab plaub lub hlis tas los. 22-18 ntu Tab sis tus kws kho mob tsis hloov pauv cov tshuaj, tsuas yog nce qhov koob tshuaj. Thiab yog li nws tau tshwm sim, Jardins tau ua nrog kev pab tib neeg, tshaj tawm rau kev sim. Tom qab peb hnub, qab zib - 10 units, thiab 8 units. Kuv muaj lub zog thiab xav ua neej nyob! Tab sis nws yog rau ib hlis, lawv tsis sau tawm dawb, tsis muaj txoj hauv kev los yuav koj tus kheej. Tab sis kuv pom zoo, rau cov neeg uas tsis muaj kev nce qib hauv kev kho, nws yeej yuav pab tau.
Kws Tshuaj
Tshuaj qhov ncauj hypoglycemic. Empagliflozin yog qhov thim rov qab, nquag, xaiv thiab sib tw inhibitor ntawm hom 2 sodium-dependent glucose transporter nrog qhov xav tau yuav tsum tau inhibit 50% ntawm qhov kev ua haujlwm enzyme (IC50), sib npaug rau 1.3 nmol. Qhov xaiv ntawm empagliflozin yog 5,000 npaug ntau dua qhov xaiv ntawm hom 1 sodium-dependent glucose transporter lub luag haujlwm rau kev nqus ntawm cov piam thaj hauv txoj hnyuv.
Tsis tas li ntawd, nws tau pom tias empagliflozin muaj qhov siab xaiv rau lwm cov neeg thauj khoom qabzib lub luag haujlwm rau cov piam thaj homeostasis hauv ntau cov ntaub so ntswg.
Cov sodium-depend type 2 glucose transporter yog lub ntsiab thauj cov protein rau lub luag haujlwm kom rov muaj cov piam thaj ntawm ntshav qabzib rov qab los rau hauv cov ntshav.
Empagliflozin txhim kho glycemic tswj nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2 los ntawm kev txo cov ntshav qabzib reabsorption. Tus nqi ntawm cov piam thaj zais tawm los ntawm ob lub raum siv lub tshuab no nyob ntawm kev saib xyuas cov piam thaj hauv cov ntshav thiab GFR. Kev txwv tsis pub los ntawm sodium-muaj neeg nqa khoom ntawm hom 2 piam thaj hauv cov neeg mob uas muaj ntshav qab zib hom 2 thiab hyperglycemia ua rau kev tshem tawm cov piam thaj ntau dhau los ntawm ob lub raum.
Hauv kev sim tshuaj, nws tau pom tias nyob rau hauv cov neeg mob uas muaj ntshav qab zib hom 2, qhov tsis pom qabzib los ntawm lub raum tau nce tam sim ntawd tom qab tau txhaj thawj koob tshuaj empagliflozin, cov nyhuv no txuas ntxiv mus 24 teev. kev siv cov tshuaj empagliflozin ntawm koob tshuaj 25 mg 1 zaug / hnub, nyob rau nruab nrab, kwv yees li 78 g / hnub. Hauv cov neeg mob uas muaj yam mob ntshav qab zib hom 2, qhov nce ntxiv ntawm cov kua nplaum tawm los ntawm lub raum ua rau muaj kev cuam tshuam sai sai ntawm cov concentration ntawm cov piam thaj hauv cov ntshav ntshav.
Empagliflozin txo cov ntsiab lus ntawm cov piam thaj hauv ntshav ntshav ob leeg ntawm kev yoo mov thiab tom qab noj mov.
Lub tshuab ntawm kev ua ntawm empagliflozin tsis yog nyob ntawm lub xeev kev ua haujlwm ntawm pancreatic cells-hlwb thiab cov tshuaj insulin metabolism. Cov txiaj ntsig zoo ntawm empagliflozin rau surrogate cov cim ntawm cov haujlwm ua haujlwm ntawm β-hlwb, suav nrog HOMA-β index (qauv rau kev ntsuas homeostasis) thiab piv ntawm proinsulin rau insulin, tau sau tseg. Tsis tas li ntawd, ntxiv kev tshem tawm cov piam thaj los ntawm ob lub raum ua rau poob phaus, uas yog nrog cov suab nrov me me hauv lub cev txo thiab qhov hnyav hauv lub cev.
Glucosuria tau pom thaum siv empagliflozin yog nrog los ntawm diuresis me ntsis, uas tuaj yeem ua rau txo qis hauv cov ntshav siab.
Hauv cov kev tshawb fawb soj ntsuam qhov twg empagliflozin tau siv los kho mob, kev kho mob sib xyaw nrog metformin, kev sib txuas ua ke nrog metformin hauv cov neeg mob uas nyuam qhuav soj ntsuam hom 2 ntshav qab zib mellitus, kev sib txuas nrog kev kho mob nrog metformin thiab sulfonylurea derivatives, kev sib txuas ua ke nrog pioglitazone +/- metformin, kev sib xyaw nrog kev kho nrog linagliptin hauv cov neeg mob uas nyuam qhuav soj ntsuam hom 2 mob ntshav qab zib mellitus, ua ke nrog kev kho mob nrog linagliptin, uas tau ntxiv rau metformin kev kho, ua ke ter FDI nrog metformin tiv thaiv glimepiride (cov ntaub ntawv los ntawm kev tshawb fawb 2 xyoo), kev sib xyaw ua ke nrog insulin (ntau qhov kev txhaj tshuaj insulin) +/- metformin, kev sib xyaw nrog kev kho mob nrog basal insulin, kev sib xyaw nrog dipeptidyl peptidase-4 inhibitor (DPP-4), metformin +/- lwm qhov ncauj tshuaj hypoglycemic hauv lub qhov ncauj tau pom tias muaj kev txo qis hauv glycosylated hemoglobin (HbA1c), qhov txo qis hauv kev yoo plasma ntshav qab zib ntau ntau, nrog rau kev txo ntshav siab thiab lub cev qhov hnyav.
Cov Tshuaj Pharmacokinetics
Cov pharmacokinetics ntawm empagliflozin tau nkag siab ntau yam hauv cov neeg tuaj yeem noj qab haus huv thiab cov neeg mob ntshav qab zib hom 2.
Tom qab noj, empagliflozin yog qhov nqus tau sai, Cmax empagliflozin nyob rau hauv cov ntshav plasma tau mus txog tom qab 1.5 teev. Tom qab ntawd, cov ntsiab lus ntawm empagliflozin hauv ntshav txo qis biphasic. Qhov nruab nrab ntawm AUC thaum lub sijhawm ntshav ruaj khov yog 4740 nmol × h / l, thiab C tus nqimax - 687 nmol / L. Noj mov tsis muaj kev cuam tshuam loj hauv tsev kho mob ntawm pharmacokinetics ntawm empagliflozin.
Cov tshuaj pharmacokinetics ntawm empagliflozin hauv cov neeg tuaj noj qab haus huv thiab cov neeg mob uas muaj ntshav qab zib hom 2 feem ntau zoo ib yam.
Vd nyob rau lub sijhawm ua haujlwm ruaj khov hauv cov ntshav ntshav ua rau kwv yees li 73.8 l. Tom qab lub qhov ncauj tswj hwm los ntawm noj qab haus huv tuaj pab dawb ntawm daim ntawv lo empagliflozin 14 C, kev khi rau cov ntshav plasma protein yog 86%. Thaum siv empagliflozin 1 sijhawm / hnub Css hauv ntshav tau mus txog tom qab tau txhaj koob thib tsib.
Txoj hauv kev tseem ceeb ntawm empagliflozin metabolism hauv tib neeg yog glucuronidation nrog kev koom tes ntawm uridine-5'-diphospho-glucuronosyltransferases UGT2B7, UGT1A3, UGT1A8 thiab UGT1A9. Feem ntau cov khoom noj uas tau pom muaj ntawm empagliflozin yog peb glucuronic conjugates (2-O, 3-O thiab 6-O glucuronide). Cov haujlwm ua haujlwm ntawm txhua lub cev ntawm cov metabolite yog me me (tsawg dua 10% ntawm tag nrho cov nyhuv ntawm empagliflozin).
T1/2 yog kwv yees li 12,4 teev. Tom qab noj cov tshuaj uas sau tias empagliflozin 14 C hauv cov neeg tuaj yeem noj qab haus huv, kwv yees li 96% ntawm cov koob tshuaj tau tawm (los ntawm txoj hnyuv - 41%, raum - 54%). Los ntawm txoj hnyuv, feem ntau ntawm cov ntawv lo ntawm cov tshuaj tsis txawv txav. Tsuas yog ib nrab ntawm cov tshuaj cim uas tau tso nrog tsis hloov pauv ntawm lub raum.
Pharmacokinetics hauv cov pab pawg neeg mob tshwj xeeb
Hauv cov neeg mob uas muaj mob me, qis, thiab lub raum tsis ua haujlwm (30 2) thiab hauv cov neeg mob uas mob raum tsis ua haujlwm, AUC ntawm empagliflozin tau nce ntxiv li ntawm 18%, 20%, 66%, thiab 48%, piv, piv nrog cov neeg mob uas muaj lub luag haujlwm ob lub raum. Hauv cov neeg mob uas mob raum tsis ua haujlwm thiab hauv cov neeg mob uas mob raum tsis ua hauj lwm lawm Cmax empagliflozin nyob rau hauv ntshav muaj qhov zoo sib xws rau yam tseem ceeb hauv cov neeg mob uas lub raum muaj nuj nqi. Hauv cov neeg mob uas mob mentsis mus rau lub raum tsis ua haujlwm lawmmax empagliflozin nyob rau hauv cov ntshav ntshav yog kwv yees li 20% siab dua ntawm cov neeg mob uas lub raum tsis ua haujlwm. Cov pejxeem pharmacokinetic tsom xam cov ntaub ntawv qhia tias tag nrho kev ua kom tsis txhob muaj cov tshuaj empagliflozin nrog GFR txo qis, uas ua rau muaj qhov nce ntxiv ntawm cov nyhuv ntawm cov tshuaj.
Hauv cov neeg mob uas muaj mob me me, nruab nrab, thiab mob hnyav hnyav (raws li menyuam-Pugh kev faib tawm), AUC qhov tseem ceeb ntawm empagliflozin nce ntxiv kwv yees li 23%, 47%, thiab 75%, thiab Cmax kwv yees li 4%, 23% thiab 48%, feem (piv nrog cov neeg mob lub siab ua haujlwm).
BMI, poj niam txiv neej, haiv neeg, thiab lub hnub nyoog tsis muaj kev cuam tshuam loj hauv lub chaw muag tshuaj ntawm empagliflozin.
Cov kev tshawb fawb ntawm cov tshuaj pharmacokinetics ntawm empagliflozin hauv cov menyuam yaus tsis tau ua.
Daim ntawv tso tawm
Cov ntsiav tshuaj yog zaj duab xis coated nrog lub teeb daj xim, puag ncig, biconvex, nrog beveled sawv, sau nrog lub tuam txhab cim ntawm ib sab thiab "S10" ntawm lwm yam.
| 1 tab | |
| empagliflozin | 10 mg |
Cov neeg siv: lactose monohydrate - 162,5 mg, microcrystalline cellulose - 62,5 mg, hyprolose (hydroxypropyl cellulose) - 7.5 mg, croscarmellose sodium - 5 mg, colloidal silicon dioxide - 1.25 mg, magnesium stearate - 1.25 mg.
Lub plhaub muaj pes tsawg leeg: Opadry daj (02B38190) - 7 mg (hypromellose 2910 - 3.5 mg, titanium dioxide - 1.733 mg, talc - 1.4 mg, macrogol 400 - 0.35 mg, hlau oxide daj - 0.018 mg).
10 Pcs - hlwv (1) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
Cov tshuaj tau noj ntawm qhov ncauj, thaum lub sijhawm thaum nruab hnub, tsis hais noj zaub mov.
Qhov pom zoo kom pib noj yog 10 mg 1 zaug / hnub. Yog tias qhov koob tshuaj txhua hnub ntawm 10 mg tsis muab tshuaj glycemic txaus, cov tshuaj yuav raug nce ntxiv rau 25 mg 1 zaug / hnub.
Qhov siab tshuaj ntau tshaj txhua hnub yog 25 mg.
Thaum dhia mus txhaj koob tshuaj, tus neeg mob yuav tsum noj cov tshuaj kom sai raws li nws nco qab qhov no. Tsis txhob noj ob zaug nyob hauv ib hnub.
Rau cov neeg mob lub raum tsis ua hauj lwm nrog GFR los ntawm 45 txog 90 ml / min / 1.73 m 2, tsis tas kho qhov koob tshuaj. Hauv cov neeg mob uas lub raum tsis ua haujlwm nrog GFR 2, kev siv cov tshuaj tsis pom zoo vim yog qhov ua tsis muaj txiaj ntsig.
Cov neeg mob uas ua tsis tau daim siab hloov kho koob tshuaj tsis raug tseev kom ua.
Kev sib txuam
Empagliflozin tuaj yeem txhim kho lub diuretic nyhuv ntawm thiazide thiab "voj" diuretics, uas, nyeg, tuaj yeem ua rau muaj kev puas tsuaj ntawm lub cev qhuav thiab arterial hypotension.
Cov tshuaj Insulin thiab cov tshuaj uas pab txhawb nws txoj kev zais, xws li sulfonylureas, tuaj yeem ua rau muaj kev pheej hmoo ntawm hypoglycemia. Yog li no, nrog rau kev siv empagliflozin sib xyaw nrog insulin thiab tshuaj uas txhim kho nws qhov kev tso cia, nws yuav tsim nyog txo lawv cov koob tshuaj, txhawm rau kom tsis txhob muaj kev pheej hmoo ntawm hypoglycemia.
Hauv tshuaj ntsuam xyuas tshuaj vitro. Empagliflozin tsis inhibit, inactivate, lossis ntxias CYP450 isoenzymes. Txoj hauv kev tseem ceeb ntawm empagliflozin metabolism hauv tib neeg yog glucuronidation nrog kev koom tes ntawm uridine-5'-diphospho-glucuronosyltransferases UGT2B7, UGT1A3, UGT1A8 thiab UGT1A9. Empagliflozin tsis inhibit UGT1A1. Kev sib cuam tshuam yeeb tshuaj ntawm cov tshuaj empagliflozin thiab cov tshuaj uas yog cov me me ntawm CYP450 thiab UGT1A1 isoenzymes yog suav tias yog qhov tsis zoo.
Empagliflozin yog ib qho tshuaj tiv thaiv kab mob rau P-glycoprotein thiab mob qog noj ntshav mis txiav txim siab protein (BCRP), tab sis tsis txwv cov protein ua ntawm kev siv tshuaj. Raws li cov ntaub ntawv los ntawm kev tshawb fawb hauv vitro, nws ntseeg tau tias kev muaj peev xwm ntawm empagliflozin cuam tshuam nrog kev sib txuas nrog cov tshuaj uas yog cov tshuaj rau P-glycoprotein yog qhov tsis zoo. Empagliflozin yog cov txheej txheem rau cov organic anionic nqa khoom: OAT3, OATP1B1 thiab OATP1B3, tab sis tsis yog lub cev rau cov organic anionic nqa khoom 1 (OAT1) thiab cov cationic organic muaj 2 (OST2). Txawm li cas los xij, kev sib txuam yeeb tshuaj ntawm empagliflozin nrog cov tshuaj uas yog cov quav rau cov cab kuj muaj cov kab mob tau piav los saum no yog suav tias tsis zoo.
Hauv vivo tshuaj ntsuam kev sib cuam tshuam. Nrog rau kev siv empagliflozin nrog rau lwm cov tshuaj siv feem ntau, tsis muaj kev cuam tshuam los ntawm kev sib raug zoo ntawm cov chaw muag tshuaj. Cov txiaj ntsig ntawm kev tshawb fawb pharmacokinetic qhia tau tias tsis tas yuav hloov pauv qhov koob tshuaj ntawm Jardins ® thaum nws siv nrog cov tshuaj uas feem ntau siv.
Cov chaw muag tshuaj ntawm empagliflozin tsis hloov pauv rau cov neeg tuaj yeem noj qab haus huv thaum siv ua ke nrog metformin, glimepiride, pioglitazone, sitagliptin, linagliptin, warfarin, verapamil, ramipril, simvastatin, torasemide thiab hydrochlorothiazide. Kev sib xyaw ntawm kev siv empagliflozin nrog gemfibrozil, rifampicin thiab probenecid pom tias muaj kev nce ntxiv ntawm AUC ntawm empagliflozin los ntawm 59%, 35% thiab 53%, xwm yeem, txawm li cas los xij, cov kev hloov no tsis tau pom tias tseem ceeb hauv kev kho mob.
Cov tshuaj Empagliflozin tsis muaj kev cuam tshuam loj hauv lub chaw muag tshuaj ntawm metformin, glimepiride, pioglitazone, sitagliptin, linagliptin, warfarin, digoxin, ramipril, simvastatin, hydrochlorothiazide, torasemide thiab tshuaj tiv thaiv hauv qhov ncauj hauv cov neeg tuaj noj qab haus huv.
Sab sij huam
Tag nrho qhov tshwm sim ntawm qhov tshwm sim tsis zoo hauv cov neeg mob uas tau txais empagliflozin lossis cov placebo tau zoo sib xws hauv kev tshawb fawb. Feem ntau cov kev phiv tshuaj yog hypoglycemia, uas tau pom nrog kev siv cov tshuaj empagliflozin sib xyaw nrog sulfonylurea lossis insulin derivatives.
Cov kev phiv tshuaj pom nyob rau hauv cov neeg mob tau txais empagliflozin hauv kev soj ntsuam cov tshuaj placebo tau qhia hauv qab no raws li kev faib tawm ntawm cov khoom nruab nrog thiab cov nruab nrog cev thiab cov ntsiab lus uas nyiam MedDRA qhia txog lawv cov zaus. Cov qeb uas nquag piav qhia muaj raws li hauv qab no: feem ntau (/1 / 10), feem ntau (ntawm ≥1 / 100 txog 2,
Nrog ceev faj: cov neeg mob uas muaj kev pheej hmoo ntawm kev tsim hypovolemia (siv cov tshuaj tiv thaiv kab mob nrog cov keeb kwm ntawm txoj hlab ntaws), nrog cov kab mob plab ua rau cov kua dej tsis ua haujlwm, urogenital system kis tau, siv nrog sulfonylurea derivatives lossis insulin, kev noj zaub mov qis, mob ntshav qab zib, ketoacidosis keeb kwm, qis zais cia kev ua ub ua no ntawm cov kab mob hlwb pancreatic, cov neeg mob hnub nyoog 75 xyoo.
Cev xeeb tub thiab lactation
Kev siv cov tshuaj empagliflozin thaum cev xeeb tub yog contraindicated vim cov ntaub ntawv tsis txaus ntawm kev ua tau zoo thiab kev nyab xeeb.
Kev siv cov tshuaj empagliflozin thaum lub sijhawm pub mis niam yog contraindicated. Cov ntaub ntawv tau txais hauv kev tshawb fawb hauv cov tsiaj txhu pom tias cais cov empagliflozin nrog rau cov kua mis. Txoj kev pheej hmoo ntawm kev tshwm sim rau cov menyuam yaus thiab cov menyuam noj niam mis tsis suav nrog. Yog tias nws yuav tsum tau siv cov tshuaj empagliflozin thaum lactation, kev pub mis niam yuav tsum tsis ua mus ntxiv.
Siv rau lub raum tsis zoo muaj nuj nqi
Cov hauj lwm zoo ntawm cov tshuaj Jardins ® nyob ntawm lub luag haujlwm ntawm lub raum. Yog li, nws raug nquahu kom soj ntsuam lub raum ua ntej nws lub sijhawm teem tseg thiab tsis tseg thaum kho (tsawg kawg 1 zaug hauv ib xyoos), ua ntej yuav teem sijhawm kho tus mob, uas tuaj yeem cuam tshuam rau lub raum kev ua haujlwm.
Rau cov neeg mob lub raum tsis ua hauj lwm nrog GFR los ntawm 45 txog 90 ml / min / 1.73 m 2, tsis tas kho qhov koob tshuaj. Hauv cov neeg mob uas lub raum tsis ua haujlwm nrog GFR 2, kev siv cov tshuaj tsis pom zoo vim yog qhov ua tsis muaj txiaj ntsig.
Siv rau cov neeg mob laus
Cov neeg mob hnub nyoog 75 xyoo rov saud muaj qhov lub cev qhuav dej ntau dua. Hauv cov neeg mob no tau kho nrog empagliflozin, cov kev mob tshwm sim los ntawm hypovolemia tau pom ntau dua (piv nrog cov neeg mob uas tau txais cov placebo).
Cov kev paub nrog empagliflozin hauv cov neeg mob uas muaj hnub nyoog 85 xyoos yog qhov tsawg, yog li ntawd, nws tsis pom zoo kom muab cov tshuaj Jardins ® rau cov neeg mob ntawm cov pab pawg hnub nyoog no.
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Yog figs pub rau cov ntshav qab zib
Kuv puas tuaj yeem noj figs rau cov ntshav qab zib? Nyob rau hauv txee ntawm khw peb tos rau txhua hom txiv hmab txiv ntoo thiab txiv ntoo, ntawm cov uas muaj kab txawv. Ntau ntawm lawv txwv rau cov ntshav qab zib, tab sis peb tau txiav txim siab nrhiav pom tias figs raug tso cai rau tshiab lossis figs figs rau cov ntshav qab zib. ... -
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