Hoʻohui ʻia ka lāʻau Avandamet hypoglycemic

i kahi blister 14 pcs., i loko o kahi pā o ka pahu 1, 2, 4 a i ʻole 8 mau pōpō.

i kahi blister 14 pcs., i loko o kahi pā o ka pahu 1, 2, 4 a i ʻole 8 mau pōpō.

* Ka inoa ʻāina ʻole i makemake ʻia e WHO; i ka Lūkini Lūkini, ʻae ʻia ka ʻōlelo o ka inoa honua - rosiglitazone.

Lapaʻau lāʻau

Hoʻohui ʻia nā lāʻau hypoglycemic no ka hoʻohana waha. Aia ʻo Avandamet i ʻelua mau mea hana me nā hana hoʻohui no ka hoʻomaʻamaʻa ʻana i ka mālama glycemic i nā mea maʻi me ka maʻi type 2: rosiglitazone maleate, kahi papa thiazolidinedione, a me ka metformin hydrochloride, he ʻelele o ka papa biguanide. ʻO ka hana o ka hana o thiazolidinediones ka mea nui i ka hoʻonui ʻana i ka ʻike ʻana i nā kaena ʻimi i ka insulin, ʻo ka biguanides e hana nui ma ka hōʻemi ʻana i ka hana o ka glucose endogenous i loko o ka ate.

Rosiglitazone - agonist nukleal koho_ʻγ(peroxisomal proliferator hoʻihoihoi gamma gamma)pili i ka lāʻau lapaʻau hypoglycemic mai ka pūʻulu o thiazolidinediones. Hoʻoulu i ka mana glycemic ma o ka hoʻonui ʻana i ka naʻau o ka insulin i nā kiko kikoʻī nui e like me ke kiko adipose, ka mākala o ka iwi, a me ka puʻupaʻa.

Ua ʻike ʻia he mea nui ka pale ʻana i ka insulin i ka pathogenesis o ke ʻano maʻi 2. ʻO Rosiglitazone e hoʻomaikaʻi i ka metabolic control ma ka hoʻohaʻahaʻa ʻana i ke koko glucose, ka neʻe i ka insulin a me nā momona momona kūlohelohe.

Ua hōʻike ʻia ka hana hypoglycemic of rosiglitazone ma nā hoʻokolohua hoʻokolohua ma nā hoʻohālike o ka maʻi type mellitus type 2 i nā holoholona. Mālama ʻo Rosiglitazone i ka hana o nā β-cell, e like me ka mea i ʻike ʻia e ka piʻi ʻana o ka nui o nā mokupuni o Langerhans o nā pancreas a me ka hoʻonui ʻana i kā lākou insulin i ka maʻi, a pale pū i ka hoʻomohala ʻana o ka hyperglycemia koʻikoʻi. Loaʻa pū ʻia kahi rosiglitazone e lohi ana i ka hoʻomohala ʻana o ka renal dysfunction a me systolic hypertension. ʻAʻole ia e hoʻoulu ʻia e Rosiglitazone i ka mea huna o ka insulin e ka pancreas a ʻaʻole i hoʻoulu i ka hypoglycemia i nā kiʻī a me nā ipo.

Ke hoʻonui nei i ka hoʻomohala glycemic me ka hoʻokaʻawale ʻana i kahi maʻi koʻikoʻi i ka neʻeʻana i ka insulin serum. ʻO ka ʻike ʻana o nā mea kūpono o ka insulin, ka mea i manaʻoʻiʻo ʻia ʻo nā mea e lilo i ka pilikia no ka maʻi cardiovascular, he i emi iho nō. ʻO kekahi o nā hopena koʻikoʻi o ka mālama ʻana me ka rosiglitazone o ka hoʻemi nui ʻana o ka hoʻoweliweli ʻana o nā momona momona.

Metformin he mea ʻelele o ka papa o ka biguanides, ka mea e hana nui ana ma ka hōʻemi ʻana i ka hana o ka glucose o ka endogenous i loko o ka ate. Hoʻomau ʻo Metformin i ka hoʻoliʻi ʻana i ka ʻaila plasma a me ka postprandial plasma kukuna. ʻAʻole ia e hoʻoulu i ka huna huna o ka insulin a no laila ʻaʻole e kumu i ka hypoglycemia. Aia he 3 mau hana e hiki ai i ka metformin: he hōʻemi i ka hoʻoneʻe ʻana o ka glucose i ka ate ma o ka pale ʻana o ka glucoseoneogenesis a me ka glycogenolysis, he hoʻonui i ka naʻau o ka ʻōpū o ka ʻiʻini i ka insulin, kahi hoʻonui i ka ʻai a me ka hoʻohana ʻana o ka glucose i nā kiko o peripheral, a me ka hoʻohemo ʻana i ka hoʻoliʻi o ka glucose mai ka ʻōpū.

Hoʻonohonoho ka Metformin i ka syntact glycogen intracellular ma ka hoʻopili ʻana i ka hoʻouluuluʻana o ka glycogen synthetase. Hoʻonui ʻo ia i ka hana o nā ʻano holomua glucose transembrane. I loko o nā kānaka, e pili ana i kona hopena i ka glycemia, metformin e hoʻomaikaʻi i ka lipid metabolism. Ke hoʻohana nei i ka metformin ma nā lāʻau lapaʻau i loko o nā hoʻokolohua lapaʻau a me nā wā lōʻihi, ua hōʻike ʻia e hoʻohaʻahaʻa ka metformin i nā hoʻokolohua o ka kolamu, ʻo ka LDL cholesterol a me nā triglycerides.

Ma muli o nā ʻokoʻa a me ka hoʻopiha ʻana o ka hana o ka hana, ʻo ka hui pū ʻana me ka rosiglitazone a me ka metformin alakaʻi i ka hoʻomaikaʻi synergistic ma ka mana glycemic i loko o nā mea maʻi me ka maʻi type 2.

E hoʻokuʻu i ke ʻano, ka hoʻonohonoho ʻana a me ka pōpoki

ʻO ka INN o avandamet, hāpai ʻia ma ka Russian Lūkini ma ka ʻōlelo noi a WHO, he rosiglitazone.

Ke hōʻike nei ka moku'āina i nā hoʻopaʻa ʻana o nā paʻi pepa o ka lāʻau lapaʻau e like me LSR-000079 i hoʻopaʻa ʻia ʻo 05/29/2007:

• 1 kīwaha - 14 mau papa ʻoniʻoni, pale ʻia.
• Kaʻaka pahu pepa - 1, 2, 4 a i ʻole 8 mau papa,
• Metformin hydrochloride 500 mg / tab.,
• ʻO ka nui o ka rosiglitazone he 1 a iʻole 2 mg / tab. (hōʻike i ka pale)
• I waena o nā mea kōkua: ka magnesium stearate, MCC, hypromellose 3cP, povidone 29 - 32, monohidrat lactose, MCC, hypromellose 3cP a me ka huahi carboxymethyl,
• Kēlā ʻeleʻele: Opadry I ka wai hao kaila melemele, macrogol 400, titanium dioxide, hypromellose 6cP (i nā papa o ka rosiglitazone 1 mg / tab.),
• Kāpale ʻulaʻula: Opadry I red oxide oxide, macrogol 400, titanium dioxide, hypromellose 6cP.

Wahi a ka ʻāina, kahi a me ka ala o ka loaʻa o ka lāʻau lapaʻau, ʻokoʻa paha kona kumukūʻai mai ka mea i hāʻawi ʻia ma ʻaneʻi. I ka awelika, ʻo ka uku pā o Avandamet he 56 mau papa ≥ 1,490 rubles.

Lapaʻau lāʻau

ʻO kahi haʻawina o Avandamet bioequivalence (4 mg / 500 mg) i hōʻike ʻia nā māhele ʻelua o ka lāʻau, rosiglitazone a me metformin, he bioequivalent a 4 mg rosiglitazone maleate papa a me 500 mg metformin hydrochloride papa i ka wā like. Ua hōʻike pū ʻia kēia noiʻi ʻana i ka hoʻohālikelike ʻana o nā kūmole o ka rosiglitazone i ka hoʻomākaukau pū ʻana o 1 mg / 500 mg a me 4 mg / 500 mg.

Ke hoʻololi nei ka ʻai ʻana i ka AUC o ka rosiglitazone a me ka metformin. Eia nō naʻe, alakaʻi ka manawa i ka manawa i ka hōʻemi o C_max rosiglitazone - 209 ng / ml hoʻohālikelike ʻia me 270 ng / ml a me ka emi ʻana o C_max metformin - 762 ng / ml hoʻohālikelike ʻia me 909 ng / ml, a me ka hoʻonui ma T_max rosiglitazone - 2.56 mau hola hoʻohālikelike i nā hola 0.98 a me ka metformin - 3.96 hola hoʻohālikelike ʻia i 3 mau hola.

Ma hope o ka nānā ʻana i ka rosiglitazone i nā kaʻe o 4 mg a i ʻole 8 mg, ʻo ka bioavailability piha loa o ka rosiglitazone e pili ana i ka 99%. C_max loaʻa i ka rosiglitazone ma kahi o 1 mau hola ma hope o ka nānā ʻana. I loko o ka nui o nā pakano therapeutic, ʻoi aku ka nui o ke kukuna o ka rosiglitazone e like me ke kūlike i kona kūawaʻawa.

ʻO ka lawe ʻana i ka rosiglitazone me ka meaʻai ʻaʻole i hoʻololi i ka AUC, akā i hoʻohālikelike ʻia me ka wikiwiki, e emi iki ka liʻiliʻi o C_max (aneane 20-28%) a me ka hoʻonui ma T_max (1.75 h).

Kuhi pono kēia mau loli liʻiliʻi, no laila, hiki ke lawe ʻia ka rosiglitazone no ka ʻai ʻana o ka meaʻai. ʻO ka hoʻonui ʻana i ka pH o nā ʻikepili i pili ai i ka hoʻopili ʻana i ka rosiglitazone.

Ma hope o ka lawelawe waha ʻana o ka metformin T_max aia ma kahi o 2,5 mau hola, ma nā kiko he 500 a 850 mg, ʻo nā bioavailability loa i nā kānaka olakino e pili ana iā 50-60%. He piha a he piha ʻole ke kūpaʻa o ka metformin. Ma hope o ka lawelawe ʻana i ka waha, ʻo ka hapa nonabsorbed i loaʻa i loko o ka feces he 20-30% o ka loaʻaʻana.

Ua manaʻo ʻia ʻo ka hoʻopili ʻana o ka metformin he non-laina ʻole. I ka manawa e hoʻohana ai i ka metformin ma nā maʻamau maʻamau a me ka hoʻoponoponoimenena maʻamau C_SS i loko o ka plasma i loko o nā hola 24-48 a ʻo ia hoʻi, ma ke ʻano he kānāwai, emi mai ka 1 μg / ml. I nā hoʻokolohua hoʻokolohua hoʻokipa, C_max ʻaʻole iʻoi aku ka metformin i ka 4 μg / ml, ʻoiai ma hope o ka hoʻokō ʻana i nā nui loa.

ʻO ka ʻai ʻana i ka ʻai, e hoʻēmi ana i ka make ʻana o ka metformin a me ka hoʻēmi iki ʻana i ka helu o ka komo ʻana. Ma hope o ka hoʻoponopono waha ʻana o ka metformin i loko o kahi maʻi o 850 mg aʻo ka ʻai ʻana me ia_max ho'ēmi ʻia e 40% a me AUC e 25%, T_max hoʻonui ʻia e 35 min. ʻAʻole ʻike ʻia ke kumu olakino o kēia mau loli.

ʻO ka nui o ka hoʻoili ʻana o rosiglitazone ma kahi o 14 l, a me ka nui o ka plasma Cl ma kahi o 3 l / h. Ke kiʻekiʻe o ka naki i nā protein plasma - ma kahi o 99.8% - ʻaʻole ia e hilinaʻi i ka neʻe ʻana a me ka makahiki o ka mea maʻi. I kēia manawa, ʻaʻohe ʻikepili ma ka kuhi o ka rosiglitazone hiki ʻole ke lawe ʻia he mau manawa 1-2 i ka lā.

Hoʻohālikelike ka hoʻopaʻa ʻana o ka metformin i nā protein plasma. Hoʻopili ʻia ʻo Metformin i loko o nā pūlea koko ʻulaʻula. C_max koko i lalo o C_max i ka plasma a hiki i ka manawa like. Loaʻa nā ʻoliwī i ke koko hoʻokaʻawale lua.

Aia ka nui o ka laha ma ka ʻanuʻu mai 63 a 276 lita.

Hoʻopili ia i ka metabolism ikaika, excreted i ke ʻano o ka metabolites. ʻO nā ala nui i ka metabola ʻo N-demethylation a me ka hydroxylation, ukali ʻia e conjugation me ka sulfate a me ka waikawa glucuronic. ʻAʻohe o nā metabolites o rosiglitazone e hana i ka lāʻau lapaʻau.

Ke noiʻi i loko o vitro ua hōʻike ʻo ka rosiglitazone i ka nui o ka metenne ma ka isoenzyme CYP2C8 a i kahi manawa liʻiliʻi e ka isoenzyme CYP2C9.

I nā kūlana i loko o vitro ʻaʻohe hopena o ka rosiglitazone i ka hopena inhibitory i ka isoenzymes CYP1A2, CYP2A6, CYP2C19, CYP2D6, CYP2E1, CYP3A a me CYP4A, no laila ʻaʻole hiki ke like ʻole i vivo ia e komo i ka launa metabolic koʻikoʻi me nā lāʻau lapaʻau e metabolized nei e nā isoenzymes o ka pūnaehana cytochrome P450. In vitro pale ʻia ka rosiglitazone i ka CYP2C8 (IC₅₀ - 18 μmol) a nāwaliwali ikaika i ka CYP2C9 (IC₅₀ - 50 μmol). ʻO ka hoʻopaʻa ʻana o ka pilina o ka rosiglitazone me warfarin i vivo hōʻike iā rosiglitazone ʻaʻole i pili i nā substrates CYP2C9.

Hoʻopili ʻole ka Metformin a hoʻololi ʻole ʻia e nā keiki. ʻAʻole i hōʻike ʻia ka metformin metabolites i nā kānaka.

ʻO ka huina plasma Cl o rosiglitazone e pili ana i ka 3 L / h, a me kona hope T_1/2 - aneane 3-4 hola. I kēia manawa, ʻaʻohe ʻikepili e pili ana i ka kuhi o ka rosiglitazone hiki ʻole i ka manawa i lawe ʻia i nā manawa 1-2 i kēlā lā. Ma kahi o 2/3 o ka waha o ka waha o rosiglitazone e hoʻopiʻi ʻia e nā keiki, ma kahi o 25% e hoʻopā ʻia ma o nā ʻōpū. ʻAʻole i loli, ʻaʻole i ʻike ʻia ka rosiglitazone i loko o ka urine a i ʻole nā ​​mō'ī. ʻAe t_1/2 nā metabolites - e pili ana i nā hola 130, kahi e hōʻike nei i kahi ʻōmole wikiwiki. Me ka ʻike mau ʻana i ka rosiglitazone, hoʻohui i nā metabolites i loko o ka plasma, i ka ʻano o ka metabolite nui (parahydroxysulfate), ke ʻano o ka manaʻo, hiki ke hoʻonui ʻia ma nā manawa 5, ʻaʻole i haʻalele ʻia.

Hoʻokuʻu ʻia ia i hoʻololi ʻia e nā keiki ma o ka filtration glomerular a me ka hilo tubular. ʻO Renal Cl metformin - ʻoi aku ma mua o 400 ml / min. Ma hope o ka lawelawe waha, ka T hope_1/2 metformin - pili iā 6.5 hola

ʻO ka pharmacokinetics i nā hihia lapaʻau kūikawā

ʻAʻohe ʻano nui i loaʻa i ka pharmacokinetics o rosiglitazone e like me ka wahine a me ka makahiki.

ʻAʻohe hopena nui i loko o ka pharmacokinetics o rosiglitazone i nā mea maʻi me ka hana renal impaired, a me ka maʻi dialynika.

I ka poʻe maʻi me ka maʻi ʻeha hōʻemi a ka hopena ikaika (nā keiki-Pugh nā papa B a me C) C_max a me ʻAUC o 2-3 mau manawa i kiʻekiʻe, ʻo ia ka hopena o ka hoʻonui ʻana i ka protein plasma a hoʻemi ʻia ka hoʻomaʻemaʻe ʻana o rosiglitazone.

I nā mea maʻi me ka hana renal impaired, hoʻomaʻemaʻe ka hoʻomaʻemaʻe ʻana i ka hapa i ka hoʻemi ʻana i ka hoʻomaʻa hana ʻana me ka mea hana, a no laila, ʻoi aku ka hapalua o ka hapalua-ola, ma muli o ka hopena o ka piʻi ʻana o ka metformin hoʻonui.

Hōʻikeʻike Avandamet

Kauka 2 diabetes mellitus:

- no ka lohi glycemic me ka hiki ʻole o ka mālama ʻana i ka ʻaina meaʻai a i ʻole monotherapy me nā derivatives thiazolidinedione a metformin paha, a i ʻole me ka hui pū ʻana me ka thiazolidinedione a me ka metformin (ʻelua-hoʻohui hui).

- no ka hoʻomalu ʻana o ka glycemic me ka derivatives a sulfonylurea (ʻoi ʻekolu mau wae).

Nā Hoʻohui

hypersensitivity i nā māhele o ka lāʻau lapaʻau,

ka hewa naʻau (I - IV mau papa hana e like me ka helu ʻana o NYHA).

maʻi a i ʻole nā ​​maʻi koʻikoʻi e alakaʻi ana i ka hypoxia tissue (e.g. puʻuwai a i ʻole ka hāʻule ʻana o ka hanu, ka neʻe ʻana o ka maʻi myocardial, pīhoihoi)

alakino, huakai waiʻona,

ʻoi aku ka hopena o ka renal (serum creatinine> 135 μmol / L i nā kāne a me> 100 μmol / L i nā wahine a / a i ʻole Cl Clininine HDL a me LDL, ke ʻano o ka cholesterol a me ka HDL i loli mau. ka momona momona.Mild a hypoglycemia maʻalahi a hilinaʻi nui ʻia.

Mai ka pūnaehana neʻe i waena ʻʻAlapinepinepinepine Laumapapinepine

Mai ka pūnaehana cardiovascular Hōʻeha puʻuwai / edema pulmonarypinepinepinepine Ischemia kahakalilopinepinepinepinepinepinepinepine Ua hoʻonui ʻia ka ulu ʻana o ka puʻuwai o ka puʻuwai me ka hoʻohui o rosiglitazone e pili ana i ka sulfonylurea a i ʻole ka ʻimi ʻana mai ka insulin. ʻAʻole ka helu o ka nānā ʻana iā mākou e kahakaha ai kahi manaʻo e pili ana i ka pilina me ka hopena o ka lāʻau lapaʻau, akā ʻoi aku ka kiʻekiʻe o nā hihia ma mua o ka lā hoʻokahi rosiglitazone 8 mg i hoʻohālikelike ʻia me kahi la kīa o 4 mg Nā hōʻailona o ka ischemia myocardial i nānā pinepine ʻia me ka koho ʻana o rosiglitazone i nā poʻe maʻi e hoʻomaʻamaʻa ana i ka insulin. ʻAʻole lawa ka ʻikepili ma ka hiki i ka rosiglitazone e hoʻonui i ka hōʻeha o ka ischemia myocardial. ʻO kahi loiloi retrospective o nā hoʻokolohua klinikino pōkole me ka pletebo, akā ʻaʻole me ka lāʻau hoʻohālikelike, hōʻike ʻia ka pilina ma waena o ka lawe ʻana i ka rosiglitazone a me ka pilikia o ka hoʻomohala ʻana i ka ischemia myocardial. ʻAʻole hōʻoia ʻia kēia mau ʻikepili i nā haʻawina loea lōʻihi me ka hoʻohana ʻana i nā lāʻau lapaʻau (metformin a me / a i ʻole ka sulfonylurea), a me kahi pilina ma waena o rosiglitazone a me ka pilikia o ka hoʻolālā ʻana i ka ischemia ʻaʻole paʻa. ʻO ka hoʻonui nui aʻe o ka hoʻomohala ʻana i ka pōpoki myocardial ischemic i ʻike ʻia i nā poʻe maʻi e hana ana i ka wā maʻi ma ke ʻano maʻi nitrate. ʻAʻole ʻōlelo ʻia ʻo Rosiglitazone no nā maʻi e loaʻa ana i ka ea nitrate concomitant.

Mai ka pūnaehana hana ʻana Ka constipation (akomi a maʻalahi paha)pinepinepinepinepinepinepinepine

Mai ka ʻōnaehana musculoskeletal Hoʻokomo ʻia nā iwipinepine Myalgiapinepine ʻO ka hapa nui o nā hōʻike e pili ana i nā hana lima o ka manamana lima, nā lima a me nā wāwae

Mai ke kino holoʻokoʻa Ka mālamalamapinepinepinepinepinepine pinepinepinepine pinepine Mahalo i ka edema maʻalahi, pinepine ka pilina hilinaʻi.

ʻO nā hopena pili ʻino i hōʻike ʻia i ka wā hana ma hope.

Nā maʻi kūwaha: pākaʻi ʻole - kūʻai ʻanaphylactic.

Mai ka pūnaehana cardiovascular: ʻohiʻawa, hemahema naʻau puʻuwai / pulmonary edema.

Loaʻa nā hōʻikeʻike i ka hoʻomohala ʻana i kēia mau hana ʻino no ka rosiglitazone, i hoʻohana ʻia me ka monotherapy a me ka hui pū me nā mea hana hypoglycemic ʻē aʻe. Ua ʻike ʻia ka nui o ka hoʻoulu ʻana o ka puʻuwai naʻau e hoʻonui nui i nā mea maʻi me ka maʻi maʻi hoʻohālikelike ʻia me nā mea maʻi me ka maʻi ʻole.

Mai ka pūnaehana hana ʻana: Loko pinepine nā hōʻike e pili ana i ka hana o ka puʻuwai pōpilikia, i ukali ʻia e ka piʻi ʻana o ka hoʻopili o ka naʻau o ka naʻau, akā, ʻaʻole i hoʻopili ʻia kahi pilina kumu ma waena o ka mālama ʻana me ka rosiglitazone a me ka hana leʻaleʻa.

Nā maʻi kūwaha: ākea loa - angioedema, urticaria, rash, itching.

Mai ka ʻaoʻao o nā lālā o ka hihiʻo. ākea loa - macular edema.

Nā hoʻokolohua lapaʻau a me ka ʻike kūʻai ʻana ma hope

Mai ka pūnaehana hana ʻana: pinepine pinepine - nā maʻi dyspeptic (nausea, luaʻi, keʻa ʻana, ʻeha o ka ʻōpū, anorexia). Hoʻoulu ka hapanui i ke kuhikuhi ʻana i ka lāʻau lapaʻau i nā papa kiʻekiʻe a ma ka hoʻomaka ʻana o ka mālama ʻana, i ka nui o nā hihia ke hele kūʻokoʻa kūʻokoʻa. ʻAi pinepine i kahi ʻala metala i loko o ka waha.

Nā hopena dermatological: ākea loa - erythema. Ua nānā ʻia i ka mea maʻi me ka hypersensitivity a ua maʻa mau ia.

Nā ʻili: ākea loa - lactic acidosis, hoʻōla vitamin B₁₂.

Hoʻohui

ʻAʻohe aʻo kūikawā e pili ana i ka launa pū o Avandamet. Hōʻike nā ʻikepili ma lalo nei i ka ʻike i loaʻa i ka pili o nā mea hoʻihoʻi kū hoʻokahi o Avandamet (rosiglitazone a me metformin).

ʻO Gemfibrozil (CYP2C8 inhibitor) ma kahi manawa o 600 mg 2 mau manawa i kahi lā i hoʻonui ʻia C_SS 2 mau manawa rosiglitazone. ʻO ke hoʻonui like ʻana o ka neʻe o ka rosiglitazone e pili ana i ka hopena o ka hopena o ka hopena o ke kūkaʻi, no laila, i ka wā e hui pū ʻia ai ʻo Avandamet me nā inhibitor CYP2C8, hiki ke hoʻemi ʻia ka hopena o ka rosiglitazone.

ʻO nā inhibitor CYP2C8 hou i hōʻoki iki i ka liʻiliʻi o ka neʻe o ka systemig o rosiglitazone.

Rifampicin (inducer o CYP2C8) ma kahi maʻeono 600 mg / lā i hoʻemi ʻia ka kaila o rosiglitazone e 65%. No laila, i nā mea maʻi e loaʻa nā rosiglitazone ʻelua a me nā inducers o ka CYP2C8 enzyme, pono e kiaʻi pono i ka glucose koko a hoʻololi i ka makeʻe o ka rosiglitazone inā pono.

Hoʻonui hou i ka hoʻohana ʻana i ka rosiglitazone C_max a me AUC o ka methotrexate ma ka 18% (90% CI: 11-26%) a me 15% (90% CI: 8–23%), kahi, ke hoʻohālikelike ʻia me ka like o ka like me ka methotrexate ma ka haʻalele ʻana o ka rosiglitazone.

I loko o nā hopena lapaʻau, ʻaʻole i loaʻa i ka rosiglitazone ka hopena koʻikoʻi i ka pharmacokinetics a me nā pharmacodynamics o nā lāʻau hypoglycemic oral e hoʻohana pū ana i ka manawa like, e pili ana i ka metformin, glibenclamide, glimepiride a me ka acarbose.

Ua hōʻike ʻia ʻaʻole i loaʻa i ka rosiglitazone he hopena koʻikoʻi i ka pharmacokinetics o S ​​(-) - warfarin (kahi papahele o ka enzyme CYP2C9).

ʻAʻole pili ʻo Rosiglitazone i ka pharmacokinetics a me ka pharmacodynamics o ka digoxin a warfarin a ʻaʻole i hoʻololi i ka hana anticoagulant o nā mea hope loa.

ʻAʻole nō hoʻi ke ʻano nui o ka maʻi o ka rosiglitazone a me ka nifedipine a i ʻole ka contraceptives waha (e pili ana i ka ethinyl estradiol a me ka norethisterone) me ka hoʻohana like ʻana, ka mea e hōʻoia nei i ka haʻahaʻa o ka pilina o ka rosiglitazone me nā lāʻau lapaʻau e like me ke komo ʻana o CYP3A4.

I loko o ka hoʻohuihui hoʻohālikelike huakaʻi i ka wā o ka mālama ʻana me ka hui pū me ka rosiglitazone + metformin, ʻo ka hōʻemi o ka lactic acidosis ma muli o ka hoʻonuiʻana i ka metformin

Nā lāʻau lapaʻau cationic i hoʻopili ʻia e ka renal glomerular secretion (me ka cimetidine) hiki ke hui pū me ka metformin, hoʻokūkū no kahi ʻōnaehana lehulehu (pono pono e nānā pono i nā pae o ka nui o ke koko a hoʻololi i ka mālama ʻana inā pono inā ke hoʻohana ʻana i nā lāʻau cationic i hoʻopau ʻia e nā cationic. hona glomerular huna.

ʻO ka hoʻokolohua ʻana i nā mākaukau makana radiopaque e loaʻa ana i ka iodine hiki ke alakaʻi i ka hiki ʻana o ka pilikia ʻole, a hiki i ka hōʻuluʻulu ʻana o ka metformin a me ka hoʻomohala ʻana o ka acidosis lactic (metformin e hele paha ma mua o ka hoʻomaka ʻana o ka radiograma, hiki ke hoʻomau ʻia nā metformin ʻaʻole i emi iho i ka mau hola 48 ma hope o ka radiography a me ka maikaʻi. hana hou kahi hana o ka hana).

Mākaukau e koi ana i ka mālama pono

GCS (ʻōnaehana a no ka hoʻohana i ka ʻāina), β agonists₂-adrenoreceptors, diuretics hiki i ka hyperglycemia, no laila, inā pono, hoʻohana ka manawa me Avandamet e nānā pinepine pinepine i nā neʻe o ka hoʻokaʻina o ke koko, ka mea nui i ka hoʻomaka ʻana o ka hoʻōla, hiki ke koi ʻia ka hoʻoponopono ʻana o Avandamet, me ka i ka wā o ka hōʻemi ʻana i ka lāʻau.

Hiki i nā inhibitor ACE ke hoʻohaʻahaʻa i ka glucose koko. Inā pono, e hoʻohana pono a hoʻopau paha i nā lāʻau lapaʻau e hoʻoponopono pono i ka nui o Avandamet.

ʻLoe a me ke kākele

I loko. Ua kuhikuhi ʻia ka lāʻau lapaʻau no nā pākeke.

Ua koho ʻia ka noho hoʻonā ʻai ʻana a hoʻonohonoho ʻia hoʻokahi.

Hiki ke lawe ʻia ka Avandamet me kahi manaʻo o ka meaʻai. ʻO ka lawe ʻana iā Avandamet i ka manawa a ma hope o ka ʻai ʻana e hōʻemi i ka makemake o ka digestive system i manaʻo ʻia e metformin.

ʻO ka papa hoʻomaka ʻana i hoʻomaka ʻia no nā pākeke o ka hui pū ʻana o rosiglitazone / metformin ʻo 4 mg / 1000 mg. Hiki ke hoʻonui ʻia i kēlā me kēia lā o ka hui rosiglitazone / metformin e mālama i ka mālama glycemic pilikino. Pono e hoʻonui pinepine ʻia ka nui i ka nui - 8 mg o rosiglitazone / 2000 mg o metformin i kēlā me kēia lā.

Hiki i ka hoʻonui ʻana i hoʻohaʻahaʻa hoʻonāwaliwali i nā hopena i makemake ʻole ʻia mai ka pūnaehana ʻana (ʻo ka mea nui i ka metformin). Pono e hoʻonui ʻia ka nui o ka lāʻau ma ka hoʻonui ʻia o 4 mg / lā no ka rosiglitazone a me / a i ʻole 500 mg / lā no ka metformin. ʻO ka hopena therapeutic ma hope o ka hoʻoponopono ʻana i nā minamina ʻaʻole i hiki ke hoʻopau ʻia no nā wiki he 6-8 no ka rosiglitazone a no 1-2 mau wiki no ka metformin.

Ke hoʻololi nei i nā lāʻau lapaʻau hypoglycemic waha i ka hui pū ʻana o ka rosiglitazone a me ka metformin, e hana pono ai ka hana a me ka lōʻihi o ka hana a nā lāʻau lapaʻau ma mua.

Ke hoʻololi nei mai rosiglitazone + metformin therapy ma ke ʻano lāʻau lapaʻau hoʻokahi loa i ka launa ʻo Avandamet, ʻo ka wana mua o ka hui ʻana o rosiglitazone a me ka metformin e kau ʻia ma luna o nā inika i lawe ʻia ma ka rosiglitazone a me ka metformin.

I nā maʻi maʻi kahiko, pono e hoʻoponopono ʻia nā ʻoiʻi a mua o ka mālama ʻana iā Avandamet, me ka hāʻawi ʻana i ka emi ʻana o nā hana o ka pūpū. Pono e hoʻoponopono ʻia kekahi ʻano hoʻoponopono i kau ʻia ma ke ʻano o ka hana o ka keiki, pono e mālama mau ʻia.

I nā mea maʻi me ka maʻi maʻi hepatic maʻi (kahi A (6 mau a i ʻole ka liʻiliʻi) ma ke kiʻekiʻe o ke keiki-Pugh), ʻaʻole pono ka hoʻoponopono ʻana o dosage o rosiglitazone. No ka mea, ʻo ka hana lūlū hemahema kekahi o nā mea e pili ana i ka hoʻōho lactic acid i ka mālama ʻana me ka metformin, ʻaʻole hui pū ʻia ka rosiglitazone me ka metformin no ka poʻe maʻi me ka hana pūlima.

I nā maʻi e loaʻa ana iā Avandamet i hui pū me ka sulfonylurea, ka ʻōlelo mua o ka rosiglitazone i ka wā e lawe ai iā Avandamet e lilo i 4 mg / lā. ʻO ka hāpai ʻana i ka make ʻana o ka rosiglitazone i 8 mg / lā e hana ʻia me ka akahele ma hope o ka loiloi ʻana i ka loaʻa o nā hopena ʻino e pili ana i ka mālama ʻana i ka wai o loko o ke kino.

Ke keu

I kēia manawa ʻaʻohe ʻikepili ma kahi o overdose o Avandamet. Ma nā haʻawina loea, ua hāʻawi mua nā mea hana ʻoka i hoʻokahi mau waha waha o ka rosiglitazone a hiki i 20 mg.

Nā Hoʻomaka he overdose o ka metformin (a i ʻole nā ​​hopena waiwai e hoʻopili ai no ka lactic acidosis) hiki ke alakaʻi i ka hoʻomohalaʻana o ka acidact lactic.

Lāʻau: ʻO ka maʻi maʻi lactic kahi maʻi olakino e koi nui ana a koi ana i ka mālama ʻana i kahi kūlana o kahi haukapila. Hoʻomaopopo ʻia ke kākoʻo kākoʻo e nānā i ke ʻano maʻi o ka mea maʻi. No ka hoʻopau ʻana i ka lactate a me ka metformin mai ke kino, pono e hoʻohana ʻia nā hemodialysis, eia naʻe, ʻaʻole i hoʻoneʻe ʻia e ka hemodialysis (no ka kiʻekiʻe o ka ʻaila o ka protein).

Nā ʻōlelo kikoʻī

ʻO ka hui pū ʻana o rosiglitazone + metformin, ʻo ia hoʻi Mālama wale nō ʻo Avandamet i ka wā e mālama ana i ka hana o ka insulin endogenous, no laila ʻaʻole pono ke kuhikuhi ʻana i ka lāʻau no ka mālama ʻana i nā maʻi me ka maʻi maʻi type 1.

Ma muli o ka hoʻonui ʻana i ka insulin, ʻo ka mālama ʻana me ka hui pū ʻana o ka rosiglitazone + metformin i ka wahine premenopausal me ka hoʻohālikelike ʻana a me ka kūʻē o ka insulin (no ka laʻana, ʻo nā mea maʻi me ka maʻi polycystic ovary) hiki ke alakaʻi i ka hoʻomaka hou o ka ovulation. Kani paha nā mea maʻi. Loaʻa nā wahine Premenopausal i ka rosiglitazone i ka wā o nā hoʻokolohua hoʻopaʻa. Hōʻailona ka ʻikeʻoleʻana i ka hormonal, akā i ka wā o ka mālama ʻana i ka wahine me rosiglitazone ʻaʻohe ʻano nui o nā hopena ʻino, i hui pū ʻia e nā menregual irregularities. Ma kahi o nā lawehala o nā kāne, ʻo ka hiki ʻana o ka hoʻomau ʻana i ka mālama ʻana me Avandamet e pono ka loiloi ʻia ʻana.

Ma muli o ka hōʻiliʻili o ka metformin i nā hihia loaʻa, kahi maʻi hoʻopiʻi nui i kū mai - ka lactic acidosis - ʻo ka mea nui i ka hui o nā mea maʻi me ka maʻi mellitus me nā hana nui o ka maʻi lēwa. Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me ka metformin a, no laila, ka hui pū ʻana o ka rosiglitazone + metformin, pono e loiloi i nā hopena pākuʻi concomitant no ka acidosis lactic, no ka laʻana, ʻaʻole paʻa i ka diabetes mellitus, ketosis, ka hookeʻo lōʻihi, ka nui o ka inu ʻemi, ʻokiʻoki i ka hana ate (me ka maikaʻi ʻole o ka ate) a me kekahi nā maʻi e hele ana me ka maʻi hypoxia. Inā kānalua ka lactic acidosis, pono e kāpae ʻia ʻo Avandamet a hoʻomaha koke ka maʻi maʻi i ka haukapila.

Loaʻa nā ʻikepili i kaupalena ʻia ma ka mālama ʻia o nā maʻi me ka hiki ʻole o ka renal maikaʻi loa me ka rosiglitazone. Hoʻopili ʻia nā Metformin e nā keiki, no laila ma mua o ka hoʻomaka ʻana i ka mālama ʻana me Avandamet a laila ma nā kikowaena maʻamau, pono ia e hoʻoholo i ka ʻike ʻana o ka creatinine i loko o ka serum. Pono e hāʻawi ʻia ka nānā pono i nā poʻe maʻi me ka nui o ka nui o ka hoʻoulu ʻana o ka pilikia ʻole, no ka laʻana, ka poʻe maʻi ma nā maʻi a i ʻole nā ​​mea maʻi e hele pū ʻia me ke kahe ʻana o ka hana renal (dehydration, maʻi nui a ʻokiʻoki paha). ʻAʻole pono e kuhikuhi ʻia ʻo Avandamet i nā mea maʻi me ka serum creatinine concentration> 135 μmol / L i nā kāne a> 110 μmol / L i nā wahine.

I nā mea maʻi me ka maʻi maʻi pīpī mauʻu (6 mau a i ʻole ma kahi o ke keiki Child-Pugh), ʻaʻole pono ke hōʻemi ʻia o ka nui o ka rosiglitazone. Eia naʻe, hāʻawi ʻia he hana luhi ka pehu o ke ʻano no ka hoʻomohala ʻana i ka acidosis lactic e pili ana me ka metformin, ka hui pū ʻana o ka rosiglitazone me ka metformin, ʻaʻole i ʻōlelo ʻia no ka poʻe maʻi e hana i ka hana luhi.

Thiazolidinedione derivatives, incl. Rosiglitazone e kumu a hoʻopilikia paha i ka hele ʻana o ka puʻuwai paʻakikī. Ma hope o ka hoʻomaka ʻana o ka hopena me ka rosiglitazone a i ka manawa o ka titration, e nānā pono i ka mālama ʻana i ka lāʻau lapaʻau o ke ʻano o ka mea maʻi e pili ana i nā hōʻailona aʻe a me nā hōʻailona o ka hana puʻuwai: wikiwiki a me ka nui o ka paona nui, pōkole o ka hanu, edema. Me ka hoʻomohala ʻana i nā hōʻailona o ka puʻuwai o ka naʻau, pono e noʻonoʻo e hoʻemi i ka hopena a hoʻoneʻe paha i ka Avandamet a kuhikuhi i ka lāʻau lapaʻau e like me nā kūlana o kēia manawa no ka mālama ʻana o ka puʻuwai naʻau. ʻAʻole hoʻohana ʻia ka hoʻohana ʻana i ka hui pū me rosiglitazone + metformin i loko o nā mea maʻi me nā hōʻike kūloko o ka puʻuwai naʻau. Hoʻokomo ʻia ka lāʻau i nā mea maʻi me ka naʻau hana I-IV hana like ʻole e like me ka papa ʻo NYHA.

ʻAʻole i hoʻopiʻi ʻia nā mea maʻi me ka maʻi coronary syndrome (ACS) i nā hoʻokolohua hoʻokolohua. No ka hoʻonui ʻana o ka ACS i ka nui o ka hōʻeha o ka puʻuwai, ʻaʻohe pono e hoʻohana i ka rosiglitazone i nā mea maʻi me ACS. ʻAʻole lawa ka ʻikepili ma ka hiki i ka rosiglitazone e hoʻonui i ka hōʻeha o ka ischemia myocardial. ʻO kahi loiloi retrospective o nā hoʻokolohua klinikino pōkole me ka pletebo, akā ʻaʻole me ka lāʻau hoʻohālikelike, hōʻike ʻia ka pilina ma waena o ka lawe ʻana i ka rosiglitazone a me ka pilikia o ka hoʻomohala ʻana i ka ischemia myocardial. ʻAʻole hōʻoia ʻia kēia mau ʻikepili i nā haʻawina loea lōʻihi me ka hoʻohana ʻana i nā lāʻau lapaʻau (metformin a me / a i ʻole ka sulfonylurea), a me kahi pilina ma waena o rosiglitazone a me ka pilikia o ka hoʻolālā ʻana i ka ischemia ʻaʻole paʻa. ʻO ka hoʻonui nui aʻe o ka hoʻomohala ʻana i ka pōpoki myocardial ischemic i ʻike ʻia i nā poʻe maʻi e hana ana i ka wā maʻi ma ke ʻano maʻi nitrate.

ʻAʻole pū kekahi data e pili ana i ka hopena o ka lawe ʻana i nā lāʻau lapaʻau hypoglycemic waha, me ka komo pū thiazolidinedione hui ma ka moku o nā moku nui i loko o nā mea maʻi me ka maʻi diabetes mellitus type 2.

ʻAʻole ʻōlelo ʻia ʻo Rosiglitazone no nā poʻe maʻi e lawe nei i ka lāʻau nitrate concomitant.

Aia nā lono maʻamau e pili ana i ka hoʻomohala a i ʻole ka uluʻana o ka edema macular edema me ka hoʻohaʻahaʻa ʻana i ka maʻi acuity ʻike. I nā maʻi like like, ua hōʻike pinepine ʻia ka hoʻomohala ʻana o ka edip peralheral. I kekahi mau hihia, ua hoʻoholo ʻia kēlā mau hōʻea ma hope o ka hoʻokuʻu ʻana o ka maʻi maʻi. Pono e hāpai i ka manaʻo o ka hoʻomohala ʻana i kēia hoʻopiʻi ai i ka hoʻopiʻi ʻana o ka hoʻopiʻi hoʻomanawanui o ka hoʻohaʻahaʻa ʻike pono acuity.

ʻO ka poʻe maʻi e loaʻa ana iā Avandamet i kahi hui pū ʻekolu me kahi sulfonylurea e pilikia paha ka hoʻomohala ʻana i ka hypoglycemia dosis-hilinaʻi. Hiki paha iā ʻoe i kahi hōʻemi hāhā i ka manawa like o ka lāʻau lapaʻau.

Metformin a no laila, pono e hoʻopau ʻia ʻo Avandamet ma mua o nā hola 48 ma mua o ka hana hoʻolālā me ka anesthesia aoao a me ke ʻano e hoʻomau ʻia ka maʻi ma mua o 48 mau hola ma hope o ka hana.

I / i ka hoʻokomo ʻana o nā mea kū i iodine e pili ana i nā haʻawina x-ray e hiki ai i ka pilikia ʻole. Me kēia i loko o ka manaʻo, ʻo Avandamet kahi lāʻau lapaʻau e pili ana i ka metformin e hoʻopau pono ʻia ma mua o a i ʻole i ka noiʻi ʻana o ka radiological, a hiki ʻoe ke hana hou i ka hana wale nō ma hope o ka hōʻoia i ka hana maʻamau maʻamau.

I ka hoʻopaʻa lōʻihi ʻana o ka maʻi monotherapy no ka maʻi mellitus type 2 i nā poʻe maʻi i loaʻa ʻole i nā lāʻau lapaʻau hypoglycemic waha, he nui ka piʻi ʻana o nā pōkole i nā wahine i ka hui rosiglitazone (9.3%, 2.7 mau hihia no ka 100 maʻi-mau makahiki) i hoʻohālikelike ʻia me nā hui metformin ( 5.1%, 1,5 mau hihia no ka 100 o nā mea maʻi) a me ka glyburide / glibenclamide (3,5%, 1.3 mau hihia no ka 100 o nā mea maʻi). ʻO ka hapa nui o nā leka i hōʻike ʻia ma ka pūʻulu rosiglitazone e pili ana i kahi hui o ka manamana lima, lima a me nā wāwae. Hiki ke noʻonoʻo ʻia kahi ʻoi aʻe o ka ulu ʻana i ka wā e kuhikuhi ai i ka rosiglitazone, ʻoi aku hoʻi i nā wāhine. Pono e nānā pono ai i ke ʻano o ka iwi iwi a mālama i ke olakino olakino e like me nā kūlana i ʻae ʻia o ka ʻoihana.

Me ka hoʻokūkū pinepine ʻana o nā inhibitor CYP2C8 a i ʻole ka hoʻohana ʻana i ka lāʻau cationic i hoʻopau ʻia e ka huna huna olomerular, mālama pono i ka pānō o ke koko a me ka hoʻoponopono o ka maʻi rosiglitazone a i mua paha o metformin e koi ʻia.

Hoʻohana ʻo Pediatric

I kēia manawa, ʻaʻohe data e pili ana i ka hoʻohana ʻana i ka lāʻau lapaʻau i nā keiki a me nā ʻōpio i lalo o nā makahiki he 18, no laila, ʻaʻole i kauoha ʻia ka hoʻohana ʻana i ka lāʻau i kēia makahiki.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini

ʻAʻole pili ʻo Rosiglitazone a me ka metformin i ka hiki ke hoʻokau i nā kaʻa a hana a me nā hana me nā mīkini.

Ka hana lāʻau lapaʻau

Avandamet - kahi lāʻau lapaʻau hypoglycemic hui pū ʻia, ua kuhikuhi ʻia i nā mea maʻi no ka hoʻoponopono waha. Aia kēlā me kēia papa i ʻelua mau mea nui e loaʻa ai ka hopena hoʻohui i ka hoʻomaikaʻi ʻana i ka mālama glycemic no ka diemine-depend-non-insulin. ʻO Rosiglitazone maleate i manaʻo ʻia he thiazolidinedione, a he metana ʻo ka metformin hydrochloride. Hoʻokumu ka hana o ka hana o ka mea mua i ka hoʻonui ʻana i ka hoʻololi ʻana o nā kiko kikoʻī i ka insulin, a ʻo ka lua e kōkua e hōʻemi i ka hana o ka glucose endogenous i loko o ka ate.

Antagonist ʻOi Nipona Kumukahi_ʻγ Mālama ʻo Rosiglitazone i ka hoʻoliʻi ʻana o ka inika i ka ʻāʻī o ka ʻōpū, ka mākala o ka iwi, ka kiko adipose. I loko o nā pathogenesis o ka diabetes mellitus type 2, he koʻikoʻi ka hana o ka insulin, e hoʻemi ana ke ʻano i nā momona momona ʻokoʻa, ka nui o ka insulin a me ka glucose e piʻi i loko o ke koko. Hoʻomaikaʻi ʻo ia i nā hana metabolism.

I nā hoʻokolohua holoholona, ​​ma nā hoʻohālike o ka nonogine-like-insulin, hōʻike ka lāʻau i ka hana hypoglycemic. I nā kumuhana hoʻokolohua, ua hoʻopaʻa ʻia ka hoʻonui ʻia o ka pancreas ma muli o ka hoʻonui ʻana i ka nui o nā mokupuni o Langerhans, ua hoʻonui ʻia ka nui o ka insulin, a mālama ʻia nā hana β-cell.

Hoʻemi ka hyperglycemia koʻikoʻi. Rosiglitazone lohi i ka hoʻomohala ʻana o ka hypertension systolic arterial, hana ʻole. I loko o nā waiʻī, nā mea huna, ka hoʻoneʻe ʻia ʻana o ka insulin huna o ka pancreatic, ʻaʻole i hoʻowalewale ʻia. Hoʻonui ʻia ka mana glycemic me ka ukali ʻana i kahi emi nui o ka insulin i ka density o ka serum precursors.

ʻO kekahi kumumanaʻo o ka lāʻau - metformin - hōʻemi i ka hana o ka glucose endogenous. Hoʻēmi i kona postprandial, basal concentration. ʻAʻole ke kaʻina i kahi hana hypoglycemia, ʻaʻole i hoʻoikaika i ka hana o ka insulin. ʻO ka hana nui o ka hana:

• emi iki ka emi ʻana o nā sugami māmā mai ka ʻōpū.
• Hoʻohana ʻia ka hoʻohanaʻana o ka glucose e nā kime peripheral, hoʻonui ʻia kona hoʻohana ʻana, piʻi ka naʻau o ka ʻōpū o ka naʻau,
• ka pale ʻana o ka glycogenolysis, gluconeogenesis. ʻO ka hopena o Avandamet e hōʻemi i ka hana o ka glucose glucose.

Hoʻokomo ʻo Metformin i ka hoʻouluuluʻana o ka glycogen synthetase ma o ka syntacellular glycogen synthesis. Hoʻomaikaʻi ʻia ka hana ʻana o nā mea lawe mela melemona o nā ʻano āpau. Hoʻonui ka mahele i ka metabolism lipid kū ʻole o ka hopena i ke kūpaʻa o ka glucose i ke koko. E like me nā hopena o nā noiʻi maʻi ma mua, ʻo ke ʻano maʻi me kēia mea e hōʻike ai i ka emi ʻana o ka nui o nā triglycerides, ka nui o ka kolamu a me LDL.

Pono: ʻo ka hoʻohana ʻana o ka hui ʻana o nā mea hana nui ʻelua o ka avandamet e hoʻomaikaʻi i ka mana glycemic i ka poʻe me ka maʻi ole-insulin-dependence.

Hāpai

Ua hoʻopili ʻia ʻo Rosiglitazone i loko o ke koko a hoʻohuli ʻia i loko o nā waiwai i mea e pono ai ke kino, ma hope o nā mea i hoʻopili ʻia e nā metabolites. ʻO ka Hydroxylation, N-demethylation ke ala nui o ka hoʻopili a me ka metabolism, hele pū lākou me ka conjugation me ka glucoseururic acid, sulfate. Hōʻike ʻia ka waiwai e nā isoenzymes CYP2C8, a he liʻiliʻi ka CYP2C9.

ʻAʻole ka hopena o ka inhibition o ka rosiglitazone o nā isoenzymes o CYP4A, CYP3A, CYP2E1, CYP2D6, CYP2C19, CYP2A6, CYP1A2. Me nā isoenzymes CYP2C8, hōʻemi haʻahaʻa, me CYP2C9, nāwaliwali. Hoʻopili ʻole nā ​​pilina me CYP2C9 substrate.

ʻAʻole hoʻololi ʻia ka Metformin i nā huahana ʻē aʻe, ua hoʻopuka ʻia mai ke kino e ka poʻe i loli ʻole ʻia. ʻAʻole ʻike ʻia nā metabolites o kēia ʻāpana i nā kānaka.

ʻO ka hoʻopauʻana i ka rosiglitazone he lōʻihi lōʻihi ka lōʻihi o nā hola 130, ke lawe ʻia nei ma o ka ʻōpū o ka nui o ka ¼ o ka waha o ka waha, a me nā puʻupuʻu i loko o kahi 2/3. ʻAʻole i ʻike ʻia nā feces, ʻaʻole hoʻi i ka iomi, ua ʻike ʻia kēia ʻaha i kona ʻano kūlohelohe. Ka hoʻonui iki ʻana i ka hoʻonui i ka parahydroxy sulfate (ʻo ka metabolite nui o ka māhele) i ʻike ʻia me ka hoʻokele pinepine ʻana. ʻAʻole i haʻalele ʻia ke kōkū ma ka plasma.

Ma o ka lēhiia tubular, ka filtration glomerular, hoʻopiʻi ʻia ka metformin i loli ʻole e nā keiki. Hana ke kaʻina hana i kahi mau hola 6.5 ma kahi wikiwiki o 400 ml mau minuke.

No nā pākeke

Koho ka endocrinologist i loko o ka maʻi lapaʻau a me ka hoʻoponopono regimen no kēlā me kēia maʻi āpau.

ʻAʻole paʻa nā ka hopena o ka avandamet i ka kōʻai ʻana o ka meaʻai. ʻO ka hoʻohana ʻana i nā papa me ka meaʻai a i ʻole ka hopena ma hope o ka hōʻemi ʻana i ka hopena o ka hopena maikaʻi mai ka gastrointestinal tract.

Hoʻomaopopo ʻia ka hoʻokomo ʻana o avandamet e hoʻomaka me ka pākahi o nā lā he 4 mg no 1000 mg. Hiki i kēia helu ke hoʻonui i ka pae o 2000 mg o rosiglitazone a me 8 mg o ka metformin (kiʻekiʻe), akā, pono e hana ʻia kēia me ka nānā pono ʻana o ka hana glycemia. Me kahi piʻi wikiwiki, hiki i ka nui o ke kaila, ka ʻoluʻolu ʻole mai ka papa gastrointestinal e liʻiliʻi. ʻO ka hana i kēlā me kēia lā kahi 500 mg metformin a me 4 mg o ka rosiglitazone.

ʻO ka hōʻike ʻana o ka hopena therapeutic ma hope o ka hoʻoponopono ʻana i ka dosage e nānā ʻia no ka metformin i loko o ka manawa mai 7 a 14 lā, no ka rosiglitazone i loko o 42 - 56 lā.

Mea koʻikoʻi: ʻO ka lōʻihi o ka hana, ka hana a nā lāʻau hypoglycemic i lawe ʻia i ka ʻōlelo maʻamau, pono e noʻonoʻo pono i ka wā e hoʻololi ana i Avandamet. Ka heluʻana o ka hopena mua ma hope o ka hoʻokele ʻana o ka monopreparations o nā mea nui ʻelua o ka pono o avandamet ma muli o ka nui o nā mea i lawe ʻia.

No ka makua

Ma muli o ka emi ʻana o ka hana i loko o kēia kāpena o nā mea maʻi, ka mālama ʻana, pono ka hoʻoponopono ʻia o ka pae mua o avandamet. E nānā kiaʻi ʻia ka pilina o nā penikala. A e pili ana i nā kuhikuhi i loaʻa, hoʻoponopono iā ia ka nui o ka avandamet.

I nā hihia no ka hana o ka'ā'ī

I kēia hihia, ʻaʻole pono ka hoʻoponopono ʻana i nā inikua a me nā regimens o rosiglitazone. Inā pili ka sulfonylurea i loko o ka hoʻomohala, ʻo ka hoʻomaka mua o ka mea hoʻohui i ka 4 mg i ka lā. Pono e hoʻonui ʻia i kēlā me kēia lā o kēia ʻano e makaʻala me ka akahele, ma hope o nā haʻawina o ka mālama ʻana i ka lolo a me ka loiloi o ke ʻano kino o ke kino i ka lāʻau.

Nā hopena hopena

Hiki i ke ʻano o nā hopena kūpono ʻole ke hoʻohemo ʻia e nā ʻanua ikaika o ka lāʻau lapaʻau i nā ʻano ʻokoʻa like ʻole. Ka papa inoa ʻaoʻao:

• nā kūlohelohe: ≥0.1 - ka hana o ka ʻili, ʻeha, urticaria, angioedema, ≥ 0.0001 - 0,001 - ka hopena anaphylactic,
• cardiovascular system: ≥ 0.0001 - 0.001 pulmonary edema, ʻaʻohe pono o ka naʻau,
• digestive system: ≥ 0.0001 - 0.001 - impaired liver function with a increase in the concentrity of the enzymes, ≥ 0.1 for metformin, anorexia, ʻeha ʻeha, ʻeha, hoʻoheheʻe ʻia, pōkole, ≥ 0.01 - 0.1 sensation oral smack o ke keleawe
• nā mea i koe o ka ʻike: ≥ 0.0001 - 0.001 - macular edema,
• ʻili, nā membrane mucous: ≥ 0.0001 - 0,001 - erythema maʻalahi, i nānā ʻia i nā mea maʻi me ka hypersensitivity,
• Nā mea'ē aʻe: ≥ 0.0001 - 0.001 - B nele₁₂lactic acidosis.

Nā Hoʻohui Kūleʻa Avandamet me nā lāʻau ʻē aʻe

ʻAʻohe haʻawina i hana i kēia pilikia. Hoʻohana ʻia ka ʻikepili no nā ʻāpana kū hoʻokahi.

• CYP2C8 gemfibrozil inhibitor me ka nui o ka loaʻa o kēlā me kēia lā i loko o kahi hōʻaiʻē nui o 600 mg pālua ka C._SS ʻĀina. Mahalo paha ʻoe i kahi hōʻemi ʻawaʻī
• ʻO ka CYP2C8 indifer rifampicin i kēlā me kēia lā a hiki i ka 600 mg a hōʻemi ʻia ka nui o nā mea ma ka 65%, e koi ana i ka hoʻololi ʻana ma ke ʻano he pono me ka hoʻohana ʻana o Avandamet, e pili ana i nā hopena o ka mālama pono ʻana i ke kō o ke koko,
• i ka wā e lawe ʻia me ka acarbose, glimepiride, glibenclamide, metformin, warfarin, digoxin, norethisterone, ethinyl estradiol ma ke ʻano o ka hoʻohālikelike waha, nifedipine ma luna o ka pharmacodynamics, pharmacokinetics o ka hopena nui o ka rosiglitazone ʻaʻole.

• aia ka nui o ka hopena o ka waikika lactic i ke kōkā make wai a ka maʻi,
• e hoʻohālikelike nā lāʻau cationic no kahi ʻōnaehana excretion me Avandamet, pono e mālama ʻia ka nānā ʻana o nā ʻāpana koko.
• ʻkihi, ʻonekele₂-adrenoreceptors, kūloko a me ka ʻōnaehana corticosteroids e hoʻonāukiuki i ka hyperglycemia, pono e nānā pinepine i nā hōʻailona gula ma ka hoʻomaka ʻana o ka mālama ʻana, i haʻahaʻa - i ka wā o ka ʻoihana. Ke hoʻopau ʻia nei nā lāʻau lapaʻau, e nānā pono ʻia kahi loiloi o ka lāʻau Avandamet i kauoha ʻia.
• Hoʻoponopono ʻia ka nui o ka lāʻau ke hōʻea a ke lawe nei paha i nā inhibitor ACE e hōʻemi i nā pae o ka glucose koko.

ʻŌpū a me ka lactation

ʻAʻole lawa nā data i ka hopena o ka hoʻohana ʻana i ka avandamet i ka wā hāpai. ʻAʻole he ʻike e pili ana i ka komo ʻana o ka lāʻau i loko o ka waiū o kahi wahine hānai.

ʻO ke koho ʻana i ka lāʻau Avandamet i ka wā o ka lactation a me ka hapai paha ke hoʻopaʻa wale ʻia inā inā ʻoi loa ka pilikia o ke ola o ke keiki no ka pono o ka makuahine.

Hoʻohālikelike me nā kikowaena

Ma ka mākeke home, ma waena o nā ʻano like like ʻole e loaʻa ma ke kūʻai aku: ʻo Formin, Metformin-Richter, Metglib, Gliformin Prolong, Gliformin, Glimecomb. I waena o nā lāʻau lapaʻau haole he 30 mau huahana, Avandia, Avandaglim e pili ana i ka rosiglitazone, a me ke koena e pili ana i ka metformin.

Elena, 37 (Moscow)

ʻO wau ke maʻi me ka maʻi diabetes type 2 no 4 mau makahiki, ua lawe au iā Avandamet ma ka manawa hope a me ka hapa. ʻO kēia wale nō ka hana i kōkua nui iaʻu e normalize i nā pae glucose. Me nā haʻalulu koke i ke kō, ua hoʻonui ʻia ke ʻano. Me ka mālama mau ʻana o ka glycemia, ua hoʻomaikaʻi ʻia koʻu kūlana, ʻo nā mea hana hale. ʻO ke kiko wale nō ke kumu kūʻai.

Bogdan, 62 (ʻver)

I ka wā mua ua maopopo iaʻu ua ʻelemakule au, no ka mea, ua hoʻoluhi wau, luhi, luhi. Ua aʻo aku kekahi limahana i ka lāʻau lapaʻau, haʻi aku lākou e kūʻai wale aku me kēia me kahi hoʻolālā. Ke hele i ka nānā ʻana, aʻu e makemake mau ai. Ua kuhikuhi ʻia ka lāʻau lapaʻau. Ma hope o ka hebedoma mua o ka hoʻopili ʻana, hoʻomaka pinepine nā pilikia bow i ke hoʻopilikia, ʻoiai inā i hāhai ʻia nā kauoha. ʻAʻole lākou i kū i ka ʻeono mahina i kēia manawa. Akā ka hōʻemi o ka ikehu, mea pono ke ola, ʻo ia nō hoʻi ke kumukūʻai kiʻekiʻe no nā paila he mea aloha ʻole ʻia, ʻoi aku ka nui o ka pono.

Kristina, 26 (Voronezh)

Ua hōʻike wau me ka maʻi di-non-insulin-lōʻihi i ka lōʻihi, akā ua hoʻolauna mai ke kauka iaʻu i ka avandamet lāʻau i emi iho ma mua o hoʻokahi makahiki i hala. Hoʻopakele kēia iaʻu mai ka hiki ʻole o ka lawe ʻana i ka insulin. ʻO ka mea e hana i nā injections e ʻike i ka ʻokoʻa ma waena o ka mālama ʻana me nā peni a me ke kūʻokoʻa mai nā injections.

Hoʻohālikelike

ʻO ka lāʻau lapaʻau ke kuhikuhi wale ia e ke kauka i hiki ke loiloi piha i ka maʻi o ka mea maʻi, koho i kahi kūpono kūpono, e hoʻoponopono pono i ka lāʻau lapaʻau. Ma muli o ka hana ola olakino āpau o nā mea o ka lāʻau, ala i ka ʻoluʻolu i ka hana ponoʻī ʻana. Hiki i kēia ke hopena i nā hopena makemake ʻole. Ma ke kōkua kūpono ʻole e hoʻoweliweli i ka hōʻino ʻole i ka hopena o ke olakino.

Nā kuleana a me nā kūlana e waiho ai

Pono ka ʻimi o nā keiki i ka kahi i mālama ai i ka lāʻau. ʻAʻole pono ka lāʻau lapaʻau i ka hoʻokumu ʻana o nā kūlana mālama kūikawā. Ua mālama ʻia ʻo kahi mālama T T 25 degrees Celsius. Mai hoʻohana i ka lāʻau lapaʻau ma hope o ka lā pau, ʻo 24 mau mahina kēia. Pono e wehe koke i ka convolute ma mua o ka lawe ʻana i ka lāʻau lapaʻau ma muli o ka hygroscopicity o ka lāʻau. Hōʻalo i nā kukui hala. Aia ka lāʻau i ka pūʻulu o nā lāʻau lapaʻau i hiki mai nā lāʻau lapaʻau. Ma mua o ka hoʻohana pono ʻia, e hoʻomaopopo e heluhelu i ka annotation mana i ka hoʻohana ʻana o ka lāʻau lapaʻau mai ka pōpoki me kahi lāʻau lapaʻau. E nānā i ka loaʻa o ka lāʻau lapaʻau me ka luna o nā mea lapaʻau pūnaewele ma o ke kelepona a i ʻole ma o ke ʻano pane a ka pūnaewele. Hiki iā ʻoe ke kūʻai iā Avandamet ma Moscow a me nā ʻāina ʻē aʻe o Lūkia i kā mākou lāʻau kūʻai pūnaewele. Wahi a ke kānāwai o ka Russian Federation (Hoʻoholo a ke Aupuni o ka Russian Federation o 01/19/1998 No. 55), nā lāʻau lapaʻau e like me nā huahana ke kumu ʻole i ka huli a me ka hoʻololi.

Pehea e hoʻohana ai: dosis a me ke ʻano o ka mālama ʻana

I loko, ke koho wale ʻia nei ka maʻi maʻi. ʻO kaʻai ʻana i ka wā a ma hope o ka papaʻaina e hōʻemi ana i nā hopena ʻino mai ka gastrointestinal tract i kumu ʻia e ka metformin. ʻO ka ʻōmua mua o ka hui rosiglitazone + metformin he 4 mg / 1000 mg. Hoʻonui ʻia ka nui o ka nui (4 mg i kēlā me kēia lā no ka rosiglitazone a me / a i ʻole 500 mg no ka metformin), ʻo ka nui o ka nui o kēlā me kēia lā he 8 mg o rosiglitazone / 2000 mg o metformin.

ʻO ka hopena therapeutic (ma hope o ka hoʻoponopono ʻana o ka make) ka mea ma hope o nā hebedoma 6-8 no ka rosiglitazone a ma hope o 1-2 mau pule no ka metformin.

Ke hoʻololi nei i nā lāʻau lapaʻau hypoglycemic ʻē aʻe i ka rosiglitazone a me ka metformin, e noʻonoʻo pono i ka hana a me ka lōʻihi o ka hana a nā lāʻau lapaʻau ma mua. Ke hoʻololi nei mai rosiglitazone a me ka metformin therapy i ke ʻano o nā lāʻau kū hoʻokahi, ʻo ka hopena mua o ka hui ʻana o rosiglitazone a me ka metformin e kau ana i nā dute i lawe.

Hoʻokumu ʻia ka hoʻoponopono ʻana o ka maʻi ma nā maʻi maʻi makua ma luna o ka ʻikepili i ka hana renal.

I ka hui pū ʻana o rosiglitazone + metformin me nā derivatives sulfonylurea, ʻo ka poma mua o ka rosiglitazone e lilo i 4 mg i kēlā me kēia lā. ʻO ka hoʻonui i ka rosiglitazone i 8 mg i kēlā me kēia lā pono e mālama ʻia me ka makaʻala (me ka piʻi o ka waʻa o ka mālama ʻana i ke kino).

Nā nīnau, nā pane, nā loiloi o ka lāʻau Avandamet

ʻO ka ʻikepili i hāʻawi ʻia e hana no nā lāʻau lapaʻau a me nā lāʻau lapaʻau. Aia nā ʻike e pili ana i ka lāʻau lapaʻau e pili ana i nā ʻōlelo i hoʻopili ʻia e ka mea hoʻopiʻi e ka mea hana. ʻAʻohe ʻikepili i hoʻopili ʻia ma kēia a ʻole kekahi ʻaoʻao o ka pūnaewele a mākou e hiki ke lawelawe ma kahi kūʻokoʻa no ka hoʻopiʻi pilikino i ka loea.