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

Dosage daim ntawv ntawm Glucovans - ntsiav tshuaj: tshuaj ntsiav zoo li tus biconvex hauv zaj duab xis plhaub ntawm lub teeb xim txiv kab ntxwv nrog lub ntsej muag ntawm ib sab ntawm "2.5" lossis xim daj nrog lub ntsej muag ntawm "5" (15 pcs. Hauv cov hlwv, hauv lub thawv ntawv cardboard 2 blisters).

Glibenclamide - 2.5 mg lossis 5 mg,
Metformin hydrochloride - 500 mg.

Cov muaj feem xyuam: povidone K30, croscarmellose sodium, magnesium stearate, microcrystalline cellulose.

Cov lus sib xyaw ntawm lub plhaub yog lub teeb txiv kab ntxwv / daj: opadry OY-L-24808 liab / opadry 31-F-22700 daj (hypromellose 15cP, lactose monohydrate, titanium dioxide, hlau oxide liab, hlau oxide dub / zas quinoline daj, macrogol, hlau oxide daj), lim dej.

Cov Tshuaj Hauv Tshuaj

Glucovans yog ib hom tshuaj sib xyaw ua ke ntawm ob lub qhov ncauj hypoglycemic, uas zwm rau ntau pawg pharmacological: glibenclamide thiab metformin.

Metformin yog ib feem ntawm cov pab pawg biguanide thiab txo cov ntshav nyob hauv cov ntshav ntshav. Nws tsis yog qhov tshuaj ua kom muaj cov insulin ntau lawm, uas ua rau muaj kev pheej hmoo qog ntshav tsawg. Peb txheej txheem ntawm kev ua yog yam ntxwv ntawm yam khoom ntawd:

inhibition ntawm cov piam thaj nqus hauv lub plab zom mov,
nce qhov rhiab heev ntawm peripheral insulin receptors, nce kev noj thiab siv cov piam thaj los ntawm cov leeg hlwb,
qhov txo qis hauv qabzib synthesis hauv lub siab los ntawm kev ua haujlwm ntawm glycogenolysis thiab gluconeogenesis.

Metformin tseem tuaj yeem cuam tshuam cov lipid muaj pes tsawg leeg ntawm cov ntshav, txo cov tshuaj triglycerides, qis lipoproteins tsawg (LDL) thiab tag nrho cov cholesterol.

Glibenclamide yog tiam thib ob tiam sulfonylurea derivative. Cov piam thaj thaum qhov cov tshuaj nquag no noj yog txo vim qhov ua kom muaj zog ntawm cov tshuaj insulin los ntawm beta hlwb nyob hauv cov txiav

Cov txheej txheem ntawm kev ua ntawm metformin thiab glibenclamide yog qhov sib txawv, tab sis cov tshuaj muaj cov nyhuv synergistic thiab muaj peev xwm los txhim kho txhua lwm yam kev ua haujlwm hauv lub qog ntshav, uas tso cai rau ua kom muaj kev txo qis hauv cov ntshav qabzib.

Cov Tshuaj Pharmacokinetics

Kev nqus ntawm glibenclamide tawm ntawm lub plab zom mov tom qab kev tswj hwm hauv qhov ncauj ntau dua 95%. Qhov no nquag tivthaiv ntawm Glucovans yog micronized. Qhov siab tshaj plaws ntawm ib yam khoom hauv cov ntshav tau mus txog li 4 teev, thiab qhov ntim ntawm kev faib tawm yog li 10 litres. Glibenclamide khi rau cov ntshav plasma nqaij los ntawm 99%. Nws yuav luag 100% metabolized hauv daim siab, ua rau ob lub cev tsis muaj zog, uas yog tawm nrog cov kua tsib (60% ntawm cov koob tshuaj) thiab tso zis (40% ntawm qhov koob tshuaj). Qhov kev tshem tawm ib nrab-lub neej txawv ntawm 4 mus rau 11 teev.

Tom qab kev tswj hwm ntawm qhov ncauj, metformin tau nqus tawm ntawm lub plab zom mov tag nrho, thiab nws cov ntshav siab tshaj plaws tau mus txog hauv 2.5 teev. Kwv yees li 20-30% ntawm cov tshuaj raug tawm los ntawm cov zom zaub mov tsis hloov pauv. Kev tsis raug cai ntawm bioavailability yog 50-60%.

Metformin tau faib nyob rau hauv cov ntaub so ntswg thaum muaj kev kub ceev, thiab nws cov qib ntawm khi rau lub plasma protein yog qhov tsawg. Cov tshuaj yog me ntsis metabolized thiab ua rau ntawm lub raum. Qhov kev tshem tawm ib nrab-lub neej yog nyob rau nruab nrab 6,5 teev. Hauv cov neeg mob uas lub raum tsis ua haujlwm, muaj qhov txo qis ntawm kev ua kom lub raum thiab qhov ua rau lub neej luv dua ib nrab, uas ua rau muaj kev nce ntxiv hauv cov ntsiab lus ntawm metformin hauv cov ntshav ntshav.

Kev sib xyaw ntawm glibenclamide thiab metformin hauv ib qho tshuaj ib leeg yog tus cwj pwm zoo tib yam li thaum noj cov ntsiav tshuaj uas muaj cov khoom xyaw no sib cais. Noj tsis muaj kev cuam tshuam zoo rau kev noj qab haus huv ntawm Glucovans, uas yog kev sib xyaw ntawm glibenclamide thiab metformin. Txawm li cas los xij, tus nqi ntawm kev nqus ntawm glibenclamide thaum noj nrog zaub mov nce.

Kev ntsuas rau siv

Raws li cov lus qhia, Glucovans tau raug tshuaj rau cov neeg laus uas muaj ntshav qab zib hom 2 yog tias:

Yav dhau los monotherapy nrog sulfonylureas lossis metformin, kev noj zaub mov noj thiab qoj ib ce tsis muaj txiaj ntsig,
Ua ke nrog kev kho mob nrog metformin thiab sulfonylurea derivatives nyob rau hauv cov neeg mob uas tau txais kev tswj zoo thiab ruaj khov glycemia yuav tsum tau hloov nrog monotherapy.

Cov Yuav Tsum Tau Ua

Yam 1 ntshav qab zib
Mob ntshav qab zib precoma thiab coma
Ntshav qab zib ketoacidosis
Lactic acidosis, suav nrog keeb kwm ntawm
Mob raum thiab / lossis daim siab ua haujlwm,
Teeb pom kev zoo muaj nuj nqi (kev cim tawm tswv yim tsis muaj teeb meem) (QC)
Mob hnyav ua rau lub raum hloov pauv: muaj mob hnyav, lub cev qhuav dej, lub cev poob siab, lub cev iodine muaj cov tshuaj zoo ib yam,
Porphyria
Cov ntaub so ntswg hypoxia nyob rau hauv qhov muaj mob los yog mob ntev ntawm kev ua pa lossis lub plawv tsis ua haujlwm, poob siab, tsis ntev los no myocardial infarction,
Lub caij muaj menyuam thiab kev pub niam mis,
Siv cov miconazole yooj yim,
Ntseem phais
Cawv qaug cawv kom qaug cawv, mob qaug dej qaug cawv,
Ua raws li kev noj haus hypocaloric (tsawg dua 1000 kcal ib hnub),
Cov ntshav qabzib-galactose malabsorption syndrome, galactose intolerance, lactase deficiency,
Tsis txog 18 xyoo
Lub hnub nyoog dhau 60 xyoo, thaum ua lub cev hnyav dhau los (muaj kev pheej hmoo ntawm cov mob lactic acidosis),
Hypersensitivity rau lub Cheebtsam ntawm cov tshuaj lossis lwm yam sulfonylurea derivatives.

Nrog kev ceev faj, Glucovans tau pom zoo rau: kab mob ntawm cov thyroid caj pas nrog kev ua txhaum tsis zoo ntawm nws txoj haujlwm, adrenal tsis txaus, febrile syndrome, hypofunction ntawm anterior pituitary caj pas.

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

Cov ntsiav tshuaj Glucovans tau pom zoo kom noj nrog pluas noj, thiab kom muaj cov carbohydrates ntau yuav tsum muaj nyob hauv cov khoom noj.

Tus kws kho mob tau sau ntawv rau noj ib lub zuj zus, suav nrog rau qib ntawm glycemia.

Thawj koob tshuaj yog 1 ntsiav tshuaj Glucovans 2.5 mg / 500 mg lossis Glucovans 5 mg / 500 mg ib hnub ib zaug.

Thaum hloov mus rau tus neeg mob nrog kev sib xyaw lossis kev kho mob monotherapy nrog sulfonylurea thiab metformin rau kev kho mob Glucovans, txhawm rau tiv thaiv kom tsis txhob mob ntshav qab zib, qhov pib koob tshuaj yuav tsum tsis pub tshaj qhov sib piv txhua hnub ntawm cov tshuaj uas tau siv yav tas los. Txhawm rau kom tau txais kev tswj hwm ntawm cov ntshav qabzib kom tsim nyog, cov koob tshuaj yuav tsum tau nce ntau zuj zus, tsis pub ntau tshaj 5 mg / 500 mg ib hnub twg txhua ob lub lis piam lossis tsawg dua. Koob tshuaj yuav tsum tau nqa tawm nyob ntawm seb qeb ntawm glycemia.

Qhov siab tshaj plaws niaj hnub noj yog 4 ntsiav tshuaj Glucovans 5 mg / 500 mg lossis 6 ntsiav tshuaj 2.5 mg / 500 mg. Kev tswj hwm ntawm cov ntsiav tshuaj tau txiav txim siab ib tus zuj zus, nws nyob ntawm qhov tshuaj txhua hnub ntawm cov tshuaj:

1 ntsiav tshuaj (ntawm ib qho tshuaj) - 1 lub sijhawm ib hnub, thaum sawv ntxov,
2 lossis 4 ntsiav tshuaj (ib qho tshuaj twg) - 2 zaug hauv ib hnub, sawv ntxov thiab yav tsaus ntuj,
3, 5 lossis 6 ntsiav tshuaj ntawm 2.5 mg / 500 mg lossis 3 ntsiav tshuaj ntawm 5 mg / 500 mg - 3 zaug hauv ib hnub, yuav tsum noj thaum sawv ntxov, tav su thiab yav tsaus ntuj.

Rau cov neeg mob laus, cov koob tshuaj thawj zaug yuav tsum tsis pub tshaj 1 ntsiav tshuaj 2.5 mg / 500 mg. Lub hom phiaj ntawm koob tshuaj thiab kev siv cov Glucovans yuav tsum tau saib xyuas tsis tu ncua rau lub raum ua haujlwm.

Sab sij huam

Los ntawm lub plab zom mov: ntau heev - tsis qab los noj mov, xeev siab, mob plab, ntuav, raws plab. Cov tsos mob feem ntau tshwm sim thaum pib kho thiab yog ib ntus. Tsis tshua muaj tshwm sim - muaj teeb meem ntawm lub siab, kab mob siab,
Los ntawm cov kev paub ntawm cov plab hnyuv siab raum: feem ntau - saj ntawm hlau hauv qhov ncauj. Thaum pib ntawm txoj kev kho, qhov teeb meem pom kev ib ntus yog tau,
Los ntawm ib sab ntawm cov metabolism: hypoglycemia, tsis tshua muaj - tawm tsam ntawm daim tawv nqaij porphyria thiab nplooj siab porphyria, muaj tsawg kawg - lactic acidosis. Nrog rau kev kho kom ntev - ib qho kev txo qis ntawm cov theem ntawm kev xav ntawm cov vitamins B12 hauv cov ntshav cov ntshav (tuaj yeem ua rau megaloblastic anemia). Tawm tsam cov keeb kwm yav dhau los ntawm kev haus cawv, kev noj tshuaj disulfiram zoo li,
Hematopoietic plab hnyuv siab raum: tsis tshua muaj - thrombocytopenia thiab leukopenia, tsis tshua muaj tshwm sim - pancytopenia, hemolytic anemia, pob txha hlwb aplasia, agranulocytosis,
Ntawm ib feem ntawm daim tawv nqaij: tsis tshua muaj - khaus, pob xoo zoo li pob khaus, tsis tshua muaj tshwm sim - exfoliative dermatitis, erythema multiforme, kev ua kom zoo nkauj,
Ua xua: tsis tshua muaj - urticaria, tsis tshua muaj - visceral lossis tawv nqaij ua xua vasculitis, anaphylactic ceeb. Nrog rau kev tswj hwm tib lub sijhawm, tus ntoo khaub lig-hypersensitivity rau sulfonamides thiab lawv derivatives yog ua tau,
Kuaj qhov ntsuas: tsis xws luag - kev nce siab ntawm kev tsim tawm ntawm creatinine thiab urea hauv cov ntshav cov ntshav mus rau ib nrab, tsis tshua muaj heev - hyponatremia.

Noj ntau dhau

Kev noj tshuaj ntau dhau ntawm Glucovans tuaj yeem ua rau kev nthuav dav ntawm hypoglycemia, txij li thaum sulfonylurea derivative yog ib feem ntawm cov tshuaj.

Cov tsos mob ntawm cov me mus rau mob ntshav qab zib tsawg dua qhov tsis muaj kev cuam tshuam ntawm lub hauv nruab nrab lub paj hlwb thiab syncope feem ntau kho tau los ntawm kev noj qab zib sai. Koj kuj yuav tsum tau hloov kho qhov tshuaj ntawm Glucovans thiab / lossis hloov pauv kev noj haus. Yog tias cov neeg mob ntshav qab zib mellitus muaj cov kev mob ntshav qab zib ntau dhau los, nrog rau paroxysm, coma lossis lwm qhov mob ntawm lub paj hlwb, yuav tsum tau nrhiav kev kho mob xwm txheej ceev. Tam sim ntawd tom qab tau kuaj pom tus mob los yog muaj kev soj ntsuam me me ntawm hypoglycemia, tam sim ntawd kev tso ntshav khov ntawm cov tshuaj dextrose yog pom zoo ua ntej tus neeg mob tso rau hauv tsev kho mob. Tom qab tus neeg mob rov qab nco qab, nws yuav tsum tau muab cov zaub mov nplua nuj nyob hauv cov carbohydrates, uas yooj yim nqus, uas yuav tiv thaiv kom rov qab txhim kho hypoglycemia.

Kev tswj hwm ntev ntev ntawm Glucovans hauv kev txhaj tshuaj ntau dua lossis cov kev ua rau pheej hmoo ua rau muaj feem tuaj yeem ua rau kev txhim kho ntawm cov kab mob lactic acidosis, vim tias metformin yog ib feem ntawm cov tshuaj. Cov kab mob lactic acid yog suav tias yog kev mob uas yuav tsum tau txais kev kho mob xwm txheej ceev, thiab nws txoj kev kho yuav tsum tau nqa tawm tshwj xeeb hauv tsev kho mob. Txoj hauv kev ua tau zoo tshaj plaws ntawm kev kho mob uas txhawb kev nthuav tawm ntawm lactate thiab metformin suav nrog hemodialysis.

Hauv cov neeg mob uas lub siab ua rau lub siab, tshem tawm cov glibenclamide hauv ntshav cov ntshav yuav nce ntxiv. Txij li thaum cov tshuaj no sib zog khi rau cov ntshav plasma protein, nws txoj kev tshem tawm thaum lub sijhawm hemodialysis tsis zoo li.

Cov lus qhia tshwj xeeb

Txoj kev kho yog pom zoo kom nrog kev soj ntsuam xyuas kev yoo ntshav cov ntshav sai thiab tom qab noj mov.

Lub sijhawm kev tswj hwm ntawm Glucovans, nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv qhov muaj peev xwm tsim cov kab mob lactic acidosis, cov cim ntawm tus kabmob tuaj yeem yog qhov tsos ntawm kev mob plab, mob hnyav, mob nqaij pob txha thiab mob dyspeptic.

Thaum ua ntawv thov Glucovans, muaj kev pheej hmoo ntawm kev txhim kho hypoglycemia, feem ntau nws tshwm sim hauv cov neeg mob ntawm cov zaub mov uas tsis muaj carbohydrate, tsis ua raws li kev noj zaub mov, haus dej cawv, tau txais lub cev hnyav dhau los nrog kev noj zaub mov hypocaloric. Kev ceeb toom ntawm kev sau ntawv, ua tib zoo xaiv cov koob tshuaj thiab kev siv ntawm kev pom zoo ntawm tus kws kho mob txo qhov muaj feem ua rau muaj mob.

Nws yog txwv tsis pub haus dej cawv thaum kho.

Ua ntej kev teem sij hawm ntawm Glucovans thiab nyob rau lub sijhawm ntawm cov thawj coj, kev tshawb fawb tsis tu ncua yuav tsum tau nqa los txiav txim siab txog theem ntawm cov ntshav creatinine concentration. Kev soj ntsuam yuav tsum tau ua nyob rau hauv cov neeg mob uas lub raum lub luag haujlwm tsawg kawg 1 zaug hauv ib xyoos, nrog kev ua haujlwm tsis zoo ntawm lub raum thiab cov neeg laus laus - 2-4 zaug hauv ib xyoos.

Yog tias cov kab mob sib kis tau ntawm tus mob ntsws, mob ntsws, lossis urogenital hloov, pom tus kws kho mob tam sim ntawd.

Cev xeeb tub thiab lactation

Qhov pib ntawm cev xeeb tub yog contraindication rau kev siv cov glucovans. Cov neeg mob yuav tsum tau qhia rau tias thaum kho nrog tshuaj lawv yuav tsum qhia tus kws kho mob txog kev npaj cev xeeb tub lossis nws qhov pib. Hauv ob qho tib si ntawm cov teeb meem no, Glucovans tau muab tso tseg tam sim ntawd thiab ib chav kawm ntawm kev kho tshuaj insulin.

Tsis muaj cov ntaub ntawv hais txog lub peev xwm ntawm metformin nyob rau hauv kev sib xyaw nrog glibenclamide kom dhau mus rau hauv niam cov kua mis, yog li ntawd, kev teem tshuaj thaum lub sijhawm lactation tsis tuaj yeem lees txais.

Siv rau lub sijhawm qub

Cov koob tshuaj rau cov neeg laus cov neeg mob yog tsim los rau hauv tus account lub xeev ntawm lub raum kev ua haujlwm, uas yuav tsum tau kuaj xyuas tsis tu ncua. Thawj koob tshuaj hauv cov neeg mob ntawm hom no yog 1 ntsiav tshuaj 2.5 mg / 500 mg.

Nws tsis pom zoo kom siv cov Glucovans hauv cov neeg mob uas nws hnub nyoog tshaj 60 xyoo thiab nws lub cev tau raug kev tawm dag zog ntau heev, uas tau piav qhia los ntawm kev pheej hmoo ntawm kev tsim muaj cov kab mob lactic acidosis hauv lawv.

Yeeb tshuaj sib cuam tshuam

Glucovans tswj hwm yuav tsum tau nres 2 hnub ua ntej thiab txuas hnub nyoog 2 hnub tom qab tso cov tshuaj iodine uas muaj cov tshuaj zoo ib yam li cov tshuaj.

Kev siv cov tshuaj miconazole tib lub sijhawm txwv tsis pub siv, vim muaj qhov ua tau siab ntawm qhov kev txhim kho hypoglycemia, mus txog rau lub cev tsis xeev (coma).

Kev sib xyaw ntawm cov tshuaj nrog cov tshuaj ethanol uas muaj cov tshuaj thiab phenylbutazone tsis pom zoo, vim tias lawv nce cov nyhuv hypoglycemic ntawm Glucovans.

Nrog rau kev siv ua ke nrog bosentan, qhov kev pheej hmoo ntawm hepatotoxic kev ua si nce, cov nyhuv ntawm glibenclamide tsawg dua.

Koob siab ntawm chlorpromazine txo qis insulin tso tawm, pab txhawb kev nce glycemia.

Cov nyhuv hypoglycemic ntawm Glucovans poob qis thaum ua ke nrog glucocorticosteroids, tetracosactide, diuretics, danazol thiab beta2-adrenergic agonists.

Thaum noj nrog angiotensin-hloov enzyme (ACE) inhibitors, suav nrog enalapril thiab captopril, muaj ib qho txo hauv cov ntshav qabzib.

Kev sib xyaw nrog metformin xav tau kev saib xyuas tshwj xeeb hauv cov neeg mob uas lub raum tsis ua haujlwm, vim tias qhov zoo li kev tsim muaj cov kab mob lactic acid yog siab nrog kev siv "voj voos" diuretics.

Kev sib xyaw ntawm Glucovans nrog sympathomimetics, beta-blockers, reserpine, clonidine, guanethidine zais cov tsos mob ntawm cov ntshav qog ntshav qab zib.

Kev hloov tshuaj yog tsim nyog thaum noj fluconazole, muaj kev pheej hmoo ntawm hypoglycemia.

Glibenclamide txo cov antidiuretic nyhuv ntawm desmopressin.

Cov nyhuv hypoglycemic ntawm Glucovans nce ntxiv nrog kev siv ib txhij nrog monoamine oxidase inhibitors (MAOs), sulfonamides, anticoagulants (coumarin derivatives), fluoroquinolones, chloramphenicol, pentoxifylline, lipid-txo tshuaj los ntawm cov pab pawg ntawm cov fibrates, disopyramide.

Glucovans analogues yog: Glybomet, Glukonorm, Glyukofast, Bagomet Plus, Metformin, Siofor.

Cov Kev Ntsuam Xyuas Ntawm Glucovans

Cov neeg mob ntshav qab zib feem ntau tawm hauv Glucovans xyuas online. Feem ntau lawv sib tham txog cov teeb meem cuam tshuam nrog kev xaiv koob tshuaj thiab kev kho mob, nrog rau nws txoj kev sib koom tes nrog lwm cov tshuaj. Txawm li cas los xij, kev txheeb xyuas lawv tus kheej yog qhov sib cav heev. Cov ntawv ceeb toom tau hais tias yuav kom ua tiav cov txiaj ntsig siab tshaj plaws thaum kho mob, nws yog ib qho tsim nyog yuav tsum suav cov calories thiab cov zaub mov kom tsawg, nrog rau saib xyuas kev ceev faj ntawm kev haus tshuaj.

Txawm li cas los xij, tseem muaj cov kev xav hais txog qhov tsis haum ntawm Glucovans. Cov neeg mob yws yws txog qhov uas tsis muaj kev txhim kho hauv txoj kev noj qab nyob zoo thiab qhov txawv txav ntawm qhov muaj nuj nqis ntawm kev mloog zoo ntawm cov piam thaj hauv cov ntshav (cov ntshav qab zib hauv lub cev). Lwm tus neeg mob tau tshaj tawm tias txhawm rau ua kom lawv txoj kev noj qab haus huv lawv tau mus rau qhov chaw raug ntev thiab kho kom zoo ntawm kev kho mob thiab kev ua neej.

Glucovans tso tawm daim ntawv, ntim tshuaj thiab muaj pes tsawg leeg.

Cov ntsiav tshuaj yog coated nrog lub teeb txiv kab ntxwv lub plhaub, tshuaj ntsiav zoo li tus plhaw, biconvex, nrog tus txaug ntawm "2.5" ntawm ib sab.

1 tab
metformin hydrochloride
500 mg
glibenclamide
2.5 mg

Cov muaj mob: povidone K30, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, Opadry (Opadri) OY-L-24808, cov dej huv.

15 Pcs. - hlwv (2) - thawv ntawv thawv.
20 Pcs. - hlwv (3) - thawv ntawv thawv.

Cov ntsiav tshuaj daj daj yog tshuaj ntsiav zoo li tus, biconvex, nrog tus txua "5" ntawm ib sab.

1 tab
metformin hydrochloride
500 mg
glibenclamide
5 mg

Cov muaj feem xyuam: povidone K30, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, Opadry (Opadri) 31F22700, cov dej lim.

15 Pcs. - hlwv (2) - thawv ntawv thawv.
20 Pcs. - hlwv (3) - thawv ntawv thawv.

Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv.

Pharmacological kev txiav txim siab Glucovans

Sib xyaw tshuaj hypoglycemic rau kev siv lub qhov ncauj.

Glucovans yog ib hom tshuaj sib xyaw ua ke ntawm ob lub qhov ncauj hypoglycemic ntawm ntau pab pawg pharmacological.

Metformin belongs rau cov pab pawg ntawm biguanides thiab txo cov ntshav qabzib los ntawm kev nce qhov kev hnov mob ntawm cov ntaub so ntswg mus rau kev ua haujlwm ntawm insulin thiab txhim kho kev qabzib zoo ntxiv. Metformin txo qhov nqus ntawm cov carbohydrates los ntawm kev zom zaub mov thiab inhibits gluconeogenesis hauv daim siab. Nws kuj muaj cov txiaj ntsig zoo ntawm cov lipid muaj pes tsawg leeg ntawm cov ntshav, txo cov ntshav ntawm cov roj (cholesterol) tag nrho, LDL thiab TG.

Glibenclamide hais txog sulfonylurea derivatives ntawm lub cim thib ob. Cov piam thaj thaum noj glibenclamide tsawg dua li qhov txiaj ntsig ntawm kev ua kom muaj zog ntawm insulin los ntawm lub hlwb pancreatic.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

Cov koob tshuaj ntawm cov tshuaj tau txiav txim siab los ntawm tus kws kho mob tshwj xeeb rau txhua tus neeg mob, nyob ntawm seb muaj qib glycemia.

Feem ntau, cov tshuaj thawj zaug ntawm Glucovans yog 1 tab. 500 mg / 2.5 mg ib hnub twg. Thaum hloov cov kev sib txuas ua ke dhau los nrog metformin thiab glibenclamide, 1-2 ntsiav tshuaj yog kws kho. Glucovansa 500 mg / 2.5 mg nyob ntawm seb qib dhau los. Txhua 1-2 lub lis piam tom qab pib kev kho mob, qhov tshuaj tau kho raug nce nyob ntawm qib glycemia.

Cov ntsiav tshuaj yuav tsum noj nrog zaub mov.

Qhov siab tshaj plaws niaj hnub noj yog 4 ntsiav tshuaj. Glucovansa 500 mg / 2.5 mg lossis 2 tab. Glucovansa 500 mg / 5 mg.

Sab Cawv Glucovans:

Los ntawm lub plab zom mov: thaum pib kho mob, xeev siab, ntuav, mob plab, poob qab los noj mov tuaj yeem tshwm sim (feem ntau, dhau ntawm nws tus kheej thiab tsis tas yuav muaj kev kho mob tshwj xeeb, tiv thaiv kev txhim kho cov tsos mob no, pom zoo kom noj cov tshuaj 2 lossis 3 koob tshuaj, maj mam nce ntawm qhov tshuaj ntawm cov tshuaj kuj txhim kho nws qhov siab thev), tejzaum nws “xim hlau” saj ntawm lub qhov ncauj.

Lwm yam: erythema, megaloblastic anemia, lactic acidosis.

Los ntawm lub plab zom mov: xeev siab, ntuav, mob epigastric, nce kev ua si ntawm daim siab enzymes.

Los ntawm cov kab mob hemopoietic: leukopenia, thrombocytopenia, tsis tshua muaj - agranulocytosis, hemolytic anemia, pancytopenia.

Ua xua: - urticaria, tawm pob, khaus khaus.

Lwm yam: hypoglycemia, disulfiram-zoo li cov tshuaj tiv thaiv thaum noj cawv.

Cov lus qhia tshwj xeeb rau kev siv cov Glucovans.

Thaum kho nrog Glucovans, nws yog ib qho tseem ceeb uas yuav tsum tau soj qab xyuas kom cov qib ntawm cov piam thaj hauv cov ntshav ntawm lub plab khoob thiab tom qab noj mov.

Tus neeg mob yuav tsum tau ceeb toom tias yog tias ntuav thiab mob plab nrog cov leeg mob los yog mob siab tshwm sim thaum kho Glucovans, ces cov tshuaj yuav tsum tsis ua ntxiv thiab koj yuav tsum sab laj nrog kws kho mob, vim tias cov tsos mob no yuav yog cov cim qhia ntawm lactic acidosis.

Tus neeg mob yuav tsum qhia rau tus kws kho mob txog qhov pom tshwm ntawm tus mob bronchopulmonary los yog mob txeeb zig.

48 teev ua ntej kev phais lossis iv kev tswj hwm ntawm iodine-muaj radiopaque tus neeg sawv cev, glucovans yuav tsum tsis ua haujlwm ntxiv. Kev kho tus mob glucovans tau pom zoo kom rov ua dua tom qab 48 teev.

Thaum kho, nws tsis pom zoo kom haus dej cawv.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Thaum kho nrog Glucovans, ib qho yuav tsum tsis txhob koom nrog cov haujlwm uas yuav tsum muaj kev ntseeg ntau ntxiv thiab ceev ntawm cov kev puas hlwb psychomotor.

Glucovans sib cuam tshuam nrog lwm yam tshuaj.

Cov tshuaj Glucovans-txhim kho cov tshuaj (muaj kev pheej hmoo ntawm hypoglycemia)

Nrog rau kev siv ua ke nrog Glucovans, miconazole tuaj yeem ua rau muaj kev mob ntshav qab zib (mus txog rau lub cev tsis nco qab).

Cov tshuaj fluconazole nce ntxiv T1 / 2 ntawm sulfonylurea derivatives thiab nce qhov kev pheej hmoo ntawm cov tshuaj tiv thaiv hypoglycemic.

Kev haus dej cawv ua rau muaj kev phom sij hauv lub cev kev tsis haum tshuaj (txog kev tsis nco qab lawm). Lub sijhawm kho nrog Glucovans, haus dej cawv thiab tshuaj muaj ethanol (cawv) yuav tsum zam.

Kev siv cov tshuaj ACE inhibitors (captopril, enalapril) nce qhov ntau ntxiv ntawm kev txhim kho hypoglycemic nyob rau hauv cov neeg mob ntshav qab zib mellitus hauv kev kho mob sulfonylurea derivatives los ntawm kev txhim kho cov kua nplaum ua siab ntev thiab txo qhov xav tau ntawm insulin.

Beta-blockers nce qhov tshwm sim thiab qhov hnyav ntawm cov ntshav qog ntshav qab zib. Beta-blockers npog cov tsos mob ntawm kev muaj qog ntshav qab zib xws li palpitations thiab tachycardia.

Cov tshuaj uas qaug zog cov nyhuv ntawm glucovans

Danazole muaj cov nyhuv hyperglycemic. Yog tias kev kho mob nrog danazol yog qhov tsim nyog thiab thaum kawg tom qab tsis txiav txim siab, kev hloov kho tshuaj Glucovans yuav tsum tau nyob hauv kev tswj hwm ntawm qib glycemia.

Chlorpromazine hauv koob tshuaj ntau (100 mg / hnub) ua rau muaj glycemia ntau ntxiv.

GCS nce glycemia thiab tuaj yeem ua rau ketoacidosis txhim kho.

Beta2-adrenostimulants nce qib ntawm glycemia vim yog qhov kev xav ntawm 2-adrenergic receptors.

Diuretics (tshwj xeeb yog "loopbacks") ua rau kev txhim kho ntawm ketoacidosis vim yog kev txhim kho ntawm lub raum ua haujlwm tsis ua haujlwm.

Hauv / hauv kev qhia txog cov tshuaj iodine uas muaj cov tshuaj tiv thaiv kab mob tuaj yeem ua rau kev txhim kho lub raum tsis ua haujlwm, uas yuav ua rau kom muaj kev sib txuam ntawm cov tshuaj hauv lub cev thiab ua rau lactic acidosis.

Beta-blockers npog cov tsos mob ntawm kev muaj ntshav qab zib, xws li ua rau palpitations thiab tachycardia.

Tsuas tshuaj thiab tswj hwm

Glucovans ntsiav tshuaj yog npaj rau kev tswj hwm qhov ncauj. Cov ntsiav tshuaj tau noj thaum noj mov, uas yuav tsum muaj cov carbohydrates ntau, los tiv thaiv kom tsis txhob mob ntshav qab zib.

Qhov ntau npaum ntawm cov tshuaj yog xaiv los ntawm tus kws kho mob koom nrog.

Kev noj tshuaj thawj zaug ntawm Glucovans yog 1 ntsiav tshuaj (2.5 mg + 500 mg lossis 5 mg + 500 mg) ib hnub ib zaug. Nws raug nquahu kom nce lub koob tshuaj txhua 2 lossis ntau lub lis piam los ntawm tsis pub ntau tshaj 500 mg ntawm metformin thiab 5 mg ntawm glibenclamide ib hnub txhawm rau kom tswj tau cov ntshav qabzib kom txaus.

Thaum hloov cov kev kho mob ua ke dhau los nrog glibenclamide thiab metformin, thawj koob tshuaj yuav tsum tsis pub ntau dua qhov noj txhua hnub ntawm glibenclamide thiab metformin uas tau noj ua ntej. Txhua ob lub lis piam tom qab pib kho, kev noj tshuaj ntau dua tau hloov kho.

Qhov siab tshaj plaws txhua hnub koob tshuaj Glucovans yog 4 ntsiav tshuaj 5 mg + 500 mg lossis 6 ntsiav tshuaj 2.5 mg + 500 mg.

Dosage regimen ntawm cov tshuaj:

Thaum muab tshuaj rau ib ntsiav tshuaj ib hnub - thaum sawv ntxov, thaum noj tshais,
Nrog rau kev teem sij hawm 2, 4 ntsiav tshuaj hauv ib hnub - sawv ntxov thiab yav tsaus ntuj,
Nrog rau kev teem sij hawm ntawm 3, 5, 6 ntsiav tshuaj hauv ib hnub - thaum sawv ntxov, tav su thiab yav tsaus ntuj.

Dosage daim ntawv

500 mg / 2.5 mg thiab 500 mg / 5 mg zaj duab xis-ntsiav tshuaj

Ctawm hauv

Dosage 500 mg / 2.5 mg

Ib ntsiav tshuaj muaj

yam tshuaj: metformin hydrochloride 500 mg

glibenclamide 2.5 mg,

tus zam: croscarmellose sodium, povidone K 30, microcrystalline cellulose, magnesium stearate

cov khoom xyaw ntawm Opadry OY-L-24808 zaj duab xis plhaub yog xim liab: lactose monohydrate, hypromellose 15cP, macrogol, titanium dioxide E 171, hlau oxide daj E 172, hlau oxide liab E 172, hlau oxide liab E 172.

Dosage 500 mg / 5 mg

Ib ntsiav tshuaj muaj

yam tshuaj: metformin hydrochloride 500 mg

glibenclamide 5 mg

tus zam: croscarmellose sodium, povidone K 30, microcrystalline cellulose, magnesium stearate

cov lus ntawm Opadry 31-F-22700 zaj duab xis plhaub yog daj: lactose monohydrate, hypromellose 15 cP, macrogol, quinoline daj kua roj vanish E 104, titanium dioxide E 171, hlau oxide daj E 172, hlau oxide daj E 172.

Dosage 500 mg / 2.5 mg: ntsiav tshuaj coated nrog ib zaj duab xis membrane ntawm lub teeb txiv kab ntxwv xim, tshuaj ntsiav zoo li tus nrog biconvex nto thiab engraving "2.5" ntawm ib sab.

Dosage 500 mg / 5 mg: ntsiav tshuaj coated nrog lub plhaub zaj duab xis daj, cov tshuaj ntsiav-puab nrog lub ntsej muag biconvex thiab kos "5" ntawm ib sab.

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Metformin thiab Glibenclamide

Lub bioavailability ntawm metformin thiab glibenclamide nyob rau hauv kev sib xyaw ua ke yog zoo ib yam li lub bioavailability ntawm metformin thiab glibenclamide thaum lawv ib txhij noj nyob rau hauv daim ntawv ntawm monocomponent npaj. Noj tsis muaj kev cuam tshuam cov kev nyab xeeb ntawm metformin nyob rau hauv kev sib xyaw nrog glibenclamide, nrog rau cov bioavailability ntawm glibenclamide ua ke nrog metformin. Txawm li cas los xij, qhov kev nqus ntawm glibenclamide nce nrog kev noj zaub mov.

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

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

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

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

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

Yog tias qhov ua haujlwm tsis zoo, ua kom lub ntsej muag tsis pom kev txo qis hauv qhov sib luag ua rau cov neeg lim hiam, thiab yog li kev tshem tawm ib nrab ntawm lub neej nce, uas ua rau muaj kev nce ntxiv hauv cov ntshav metformin ntau ntau.

Thaum muab tshuaj, nqus tau los ntawm txoj hnyuv hauv plab ntau dua 95%. Peak plasma cov ntsiab lus nrov tau mus txog tom qab kwv yees li 4 teev. Kev sib txuas lus nrog cov protein ntshav yog 99%.

Glibenclamide tag nrho cov tshuaj tiv thaiv hauv daim siab ua tiav ob lub cev.

Glibenclamide tag nrho cov tawm hauv lub cev tom qab 45-72 teev nyob rau hauv daim ntawv ntawm metabolites: nrog cov kua tsib (60%) thiab tso zis (40%). Ib nrab neej kawg yog 4-11 teev.

Hepatic qhov tsis muaj txhij txhua txo cov metabolism hauv glibenclamide thiab txo qis nws cov kev nthuav dav.

Kev tshem tawm cov roj ntsha mus rau hauv lub cev yuav muaj ntau yam mob rau lub raum (ua raws qhov mob tsis zoo los lub raum ua kom tsis muaj zog) mus rau qhov muaj peev xwm tshem tawm ntawm 30 ml / min. Yog li ntawd, lub raum tsis ua haujlwm tsis cuam tshuam qhov cuam tshuam ntawm glibenclamide, thaum tsim tawm ntawm kev tsis pom tseeb tseem nyob rau theem tshaj 30 ml / min.

Pharmacokinetics hauv pab pawg neeg mob tshwj xeeb:

Tshuaj xyuas rau cov neeg mob

Tsis muaj qhov sib txawv ntawm cov chaw muag tshuaj ntawm metformin thiab glibenclamide hauv cov menyuam yaus thiab cov laus noj qab haus huv.

Cov Tshuaj Hauv Tshuaj

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

Metformin muaj 3 txoj haujlwm ntawm kev ua:

txo cov siab piam thaj ntau ntau los ntawm inhibiting gluconeogenesis thiab glycogenolysis,

txhim kho kev sib txheeb thiab kev siv peripheral qabzib hauv cov leeg nqaij los ntawm kev ua kom muaj zog insulin,

qeeb kev nqus ntawm cov piam thaj hauv cov hnyuv.

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

Tsis hais txog nws cov txiaj ntsig ntawm glycemia, metformin tau muaj txiaj ntsig zoo ntawm lipid metabolism. Thaum tswj cov chaw kho mob uas siv tshuaj kho, nws tau pom tias metformin txo qis cov roj (cholesterol) tag nrho, cov lipoproteins tsawg thiab triglycerides tsawg. Cov teebmeem zoo li ntawm lipid metabolism tsis pom nyob rau thaum sim kho mob siv kev kho ua ke nrog metformin thiab glibenclamide.

Glibenclamide belongs rau cov pab pawg ntawm tiam 2 ntawm sulfonylureas nrog qhov nruab nrab ib nrab-lub neej. Glibenclamide ua rau kom cov ntshav qabzib tsawg dua, txhawb kev tsim cov tshuaj insulin los ntawm cov txiav ua ntshav. Qhov kev ua no nyob ntawm lub xub ntiag ntawm kev ua haujlwm β-hlwb ntawm cov islets ntawm Langerhans.

Tsim kom muaj cov insulin secretion los ntawm glibenclamide teb rau kev ua zaub mov yog qhov tseem ceeb.

Kev siv cov tshuaj glibenclamide rau cov neeg mob ntshav qab zib ua rau muaj qhov nce ntawm postprandial insulin-stimulating teb. Cov kev ua kom zoo dua nyob rau hauv daim ntawv ntawm kev zais ntshis ntawm insulin thiab C-peptide tseem mob tsawg kawg yog 6 lub hlis tom qab kev kho mob.

Metformin thiab glibenclamide muaj cov txheej txheem sib txawv ntawm cov yeeb yam, tab sis ob leeg los sib txuam nrog lwm cov kev ua los tiv thaiv kev ntxub ntxaug. Glibenclamide ua rau lub zog tsim cov tshuaj insulin los ntawm tus txiav, thiab metformin txo qhov tsis kam ntawm cov cell mus rau insulin los ntawm kev ua ntawm peripheral (pob txha leeg) thiab mob siab rau insulin.

Tsuas tshuaj thiab tswj hwm

Glucovans® yuav tsum tau noj ntawm qhov ncauj nrog zaub mov noj. Qhov tseeb ntawm cov tshuaj yuav raug hloov kho raws li tus neeg noj zaub mov. Txhua pluas noj yuav tsum tau noj mov nrog cov pluas mov uas muaj carbohydrate ntau kom thiaj li tiv thaiv tau ntshav qog ntshav.

Cov koob tshuaj ntawm cov tshuaj yuav tsum tau kho nyob ntawm tus neeg cov lus teb metabolic (glycemia qib, HbA1c).

Glucovans 500 mg / 5 mg tuaj yeem siv feem ntau ntawm cov neeg mob uas tsis ua tiav kev tswj hwm thaum noj Glucovans 500 mg / 2.5 mg.

Kev kho mob yuav tsum pib nrog ib koob tshuaj ntawm cov tshuaj sib xyaw ua ke piv txwv nrog rau kev haus tshuaj ib leeg ntawm metformin thiab glibenclamide. Cov koob tshuaj yuav tsum tau nce nce ntxiv nyob ntawm theem ntawm glycemic tsis.

Cov koob tshuaj tau hloov kho txhua 2 lossis ntau lub lim tiam nrog nce ntxiv ntawm 1 ntsiav tshuaj, nce raws theem ntawm glycemia.

Kev nce ntxiv hauv koob tshuaj tuaj yeem pab txo txoj hnyuv thev taus kev tiv thaiv thiab tiv thaiv kev txhim kho ntawm lub qog ntshav qab zib.

Qhov siab tshaj plaws txhua hnub rau Glucovans® 500 / 2.5 yog 6 ntsiav tshuaj.

Qhov siab tshaj plaws niaj hnub noj rau Glucovans® 500/5 mg yog 3 ntsiav tshuaj.

Hauv qhov tshwj xeeb, qhov kev pom zoo ntxiv txog 4 ntsiav tshuaj ntawm cov tshuaj Glucovans® 500 mg / 5 mg ib hnub yuav pom zoo.

Rau qhov ntau npaum ntawm cov tshuaj Glucovans® 500 mg / 2.5 mg

Ib zaug ib hnub: thaum sawv ntxov thaum noj tshais, nrog rau kev teem sij hawm 1 ntsiav tshuaj ib hnub.

Ib hnub ob zaug: thaum sawv ntxov thiab yav tsaus ntuj, nrog teem 2 lossis 4 ntsiav tshuaj hauv ib hnub.

Peb zaug ib hnub: sawv ntxov, tav su thiab yav tsaus ntuj, nrog kev teem sijhawm 3, 5 lossis 6 ntsiav tshuaj hauv ib hnub.

Rau qhov ntau ntawm cov tshuaj Glucovans® 500 mg / 5 mg

Ib zaug ib hnub: thaum sawv ntxov thaum noj tshais, nrog rau kev teem sij hawm 1 ntsiav tshuaj ib hnub.

Ib hnub ob zaug: thaum sawv ntxov thiab yav tsaus ntuj, nrog teem 2 lossis 4 ntsiav tshuaj hauv ib hnub.

Peb zaug ib hnub: thaum sawv ntxov, yav tav su thiab yav tsaus ntuj, nrog rau kev teem muaj 3 ntsiav tshuaj rau ib hnub.

Tsis muaj ntaub ntawv qhia txog kev siv tshuaj nrog cov tshuaj insulin.

Thaum noj Glucovans® thiab bile chelator, nws raug nquahu kom koj noj Glucovans® tsawg kawg 4 teev ua ntej koj lub bile chelator thiaj li yuav txo tau txoj kev pheej hmoo ntawm txo qis dua.

Cov lus qhia muab tshwj xeeb rau cov pab pawg neeg mob tshwj xeeb

Cov neeg laus thiab cov neeg laus

Cov koob tshuaj ntawm Glucovans® yuav tsum tau kho nyob ntawm qhov ntsuas ntawm lub raum ua haujlwm. Thawj koob tshuaj yog 1 ntsiav tshuaj ntawm Glucovans® 500 mg / 2.5 mg. Yuav tsum tau ntsuas kev ntsuas lub raum tsis tu ncua.