Hoʻopili nā Vildagliptin

ʻO ka maʻi maʻi mellitus he maʻi maʻamau. Ua hoʻolālā ʻia nā nui o nā lāʻau lapaʻau no ka mālama ʻana. No ka hōʻemi i ka paukū hilo, ua huna ʻia nā mea ikaika a Vildagliptin.

Akā ʻaʻole kūpono ia no kēlā me kēia maʻi, no laila ua hoʻokaʻawale nā ​​ʻoihana pharmacological i kahi helu o nā mea pili, e like me ka hoʻolālā o ka hana. E heluhelu i nā ʻōkuhi no ka hoʻohana, nā kumukūʻai a me nā loiloi e pili ana i nā helu analog o Vildagliptin.

Nā ʻōkuhi no ka hoʻohana

ʻO Vildagliptin kahi waiwai hypoglycemic. Aia ka lāʻau i ka pūʻulu o nā mea e hoʻoulu ai i ka ʻanuʻu pancreatic islet.

Hiki ke mālama ʻia ka lāʻau lapaʻau ma muli o kahi ʻōpū piha a piha ʻole paha. ʻAʻole pili ka hele ʻana o ka meaʻai i ke kaʻina o ka hoʻopili ʻana.

Hōʻike ʻia ka lāʻau lapaʻau e ke kauka no ka lāʻau lapaʻau e pili ana i nā hoʻokolohua i hana ʻia a me nā hopena i loaʻa i ka paʻakikī o ka maʻi hoʻomau. Hoʻonohonoho ʻia ka Doseage no kēlā me kēia maʻi, no laila, hāʻawi ʻia nā ʻano maʻamau no ke kiʻi maʻamau.

Ke hana nei i ka lāʻau lapaʻau e hoʻohana ana i hoʻokahi lāʻau lapaʻau wale nō a i ʻole ka hui pū ʻana me ka hoʻohana ʻana i 2 mau lāʻau, ʻaʻole pono nā dosage i ka 50 a me 100 mg hoʻokahi i ka lā.

ʻElua mau lāʻau i ka lāʻau lapaʻau:

Kahi ʻano mea like, e like me ka mea i hoʻohui ʻia, i ka nui o 100 mg, e koi ʻia no ka hoʻomehana i kēlā me kēia lā no ke ʻano ʻekolu o ke ʻano - ʻo ke ʻano Metformin + Vildagliptin + sulfonylurea.

Ke komo nei i kahi momona o 50 mg i loko o ke kino - hana i hoʻokahi manawa i ka lā (kakahiaka a i ʻole ahiahi). ^ E Ha yM. Me ka hana i koi ʻia o 100 mg - ka hoʻohana ʻana o ka dragees i ʻelua manawa i ka lā, ma hope o ke ala ʻana a ma mua o ka hiamoe.

ʻO ka waiwai lāʻau Ua hoʻohālikelike ʻia wale nō no ka mālama ʻana i nā mea maʻi me ka maʻi maʻi 2. ^ E Ha yM. Hoʻohana ʻia ka lāʻau lapaʻau ma ke ʻano he lāʻau kūʻokoʻa a i ʻole kekahi mahele o ka hui ʻana o nā lāʻau lapaʻau.

E hoʻōla i kahi maʻi hoʻomakeʻa, ʻelua mea hana pono. I kēia hihia, ua hoʻokaʻawale ʻia nā lāʻau lapaʻau e ae nei:

• Insulin
• ʻO kekahi lāʻau lapaʻau e hoʻohaʻahaʻa i ke kōpaʻa plasma.

ʻO Vildagliptin ka mea hoʻohana ikaika i loko o ka lāʻau lapaʻau ma lalo o ka inoa kālepa kālepa Galvus. Loaʻa ka hope i loko o ke ʻano o ka dragee hāmeʻa, keʻokeʻo ma ke kala, me nā ʻano ʻae like ʻole ma nā ʻaoʻao ʻelua.

ʻO ka hana ikaika ma ka dragee he - 50 mg. Hoʻopiliʻia, hoʻohana ʻia ka anhydrous lactose a me ka stearate magnesium. Hōʻike i nā pākole sodium carboxymethyl.

Ke hana nei ka mea ikaika e like me ke kumu nui o Galvus a he hopena ikaika. Ke kūʻai nei nā lāʻau lapaʻau ma nā wahi like i ka lāʻau lapaʻau ma ke kumukūʻai mai 1150 a 1300 rubles.

He nui nā kuʻina o Vildagliptin e nā ʻoihana loea Lūkini a me nā mea ʻē aʻe. ʻAʻole loli ka maikaʻi o nā lāʻau lapaʻau mai ke ʻano o nā mea hana. no laila e kūʻai lilo ʻia aku, nā mea ʻawa i ʻoi aku ai.

ʻO nā mea āpau a pau no vildagliptin he mau lāʻau hypoglycemic. ʻO lākou pili i ke kino o ke kanaka, hoʻohaʻahaʻa i nā nui o ke kō. No laila, ʻo kā lākou contraindications a me nā hopena e kokoke loa i ka holo ʻana.

ʻAʻole pāpā ʻia i nā kānaka ma nā kūlana:

• Ka ʻike kikoʻī ʻana i ka mea kanu ikaika,
• Ka hoʻomālamalama ʻana o ke kukuna,
• Malama na makahiki he 18
• Ketoacidosis
• Hoʻopili i kaʻu maʻi diabetes
• Ka wā hānau ʻana i kahi keiki,
• ʻO ka wā e hānai ana i ka pēpē,
• Hoʻokomo Insulin
• ʻO Renal hiki ʻole.

E pili ana nā hopena ʻaoʻao me ke komo hewa ʻana i ka ʻano o:

• Puhi, pale,
• Nā kūlala kūloko,
• Nausea, loulou,
• ʻEhaʻeha
• Hypoglycemia.

I kekahi mau hihia i ka manawa e lawelawe ʻia kekahi lāʻau lapaʻau, e hoʻemi hou ʻia ka hopena aʻe:

• Galvus Met - kahi hāmeʻa a me ka mauʻu,
• Trazhenta, Onglisa - nasopharyngitis, pancreatitis,
• ʻO Glucovans, Gluconorm - lactic acidosis, ʻeha i loko o ka ʻōpū, ka lilo ʻana o ka momona,
• Janumet - ke kāʻei nei, waha maloʻo, edema peripheral, pancreatitis,
• Amaril M - ka'ōwili, ke kīnā, hemahema ka ʻike, ke kaumaha,
• ʻO Gliformin - ma hope o ka hoʻolauna ʻana i ka waha o ka waha, ʻike ʻia kahi mea hao, he ʻaki hana kūwaho.

ʻO nā lāʻau lapaʻau ʻē aʻe kekahi maʻa e hōʻike i nā hopena ʻaoʻao, a e kūlike mau ana i nā hōʻailona maʻamau i hōʻike ʻia.

Lūkia

Nā huahana Vildagliptin i hana ʻia e nā ʻoihana hoʻonaʻauao ʻĀina i kahi papa inoa liʻiliʻi - Diabefarm, Formmetin, Gliformin, Gliclazide, Glidiab, Glimecomb. ʻO ke koena o nā lāʻau i koe ma nā ʻāina ʻē.

ʻAʻole hoʻohana kūʻokoʻa ʻo Vildagliptin i kekahi o nā pono i hōʻike ʻia. Ke hoʻololi ʻia e nā ʻano like like ʻole e kuleana ai ka spectue o nā hana a me ke ʻano o ka hōʻike ʻana i ke kino o ke kanaka.

Ua hoʻokaʻawale ʻia nā mea koʻikoʻi nā mea i hōʻike ʻia e ka Vildagliptin:

• Metformin - Gliformin, Formmetin,
• Glyclazide - Diabefarm, Glidiab, Glyclazide,
• Glyclazide + Metformin - Glimecomb.

ʻElua wale nō mau mea ikaika i ʻike ʻia e pale i ke kaona nui o ke kō. Inā ʻaʻole like ʻole kēlā me kēia, ke hui pū ʻia nā lāʻau lapaʻau i loko o kahi hui loea (Glimecomb).

I ke kumukūʻai, ua mamao loa nā mea hana Russian ma hope o nā mea ʻē aʻe. Ua ulu ke kālā mai nā haole, ma mua o 1000 mau rubles.

Ka pepa (119 rubles), Diabefarm (130 rubles), Glidiab (140 rubles) a me Gliclazide (147 mau rubles) ka lāʻau māmā loa o ka Lūkini. ʻOi aku ke kumukūʻai o Gliformin - 202 mau rubles. no na kumu he 28 papa. ʻO nā mea kūʻai nui loa ʻo Glimecomb - 440 rubles.

ʻO nā kahawai ʻē aʻe

ʻO nā lāʻau lapaʻau e kāpae i ka hōʻike ʻana i ka maʻi mellitus o ka maʻi mole, i hana ʻia ma nā ʻāina ʻē aʻe, ka mea i puka i loko o kahi nui ma mua o nā mea kīʻaha hale.

Hoʻohana ʻia nā lāʻau lapaʻau aʻe, hiki iā ia ke hoʻopau i kahi nui o ke kō i loko o ke koko i loko o nā kānaka.

• USA - Trazhenta, Januvia, Combogliz Prolong, Nesina, Yanumet,
• Hōlani - Onglisa,
• Kelemānia - Galvus Met, Glibomet,
• Palani - Amaril M, Kaulana,
• ʻInelani - Vipidia,
• Sepania - Avandamet,
• ʻĀina - Kauwawa.

ʻO nā lāʻau lapaʻau ʻē aʻe ka Galvus, loaʻa Vildagliptin. Ke hoʻokau nei kona kau ʻana ma Switzerland. ʻAʻole i hana ʻia nā ʻikepili pololei.

Ke hōʻike ʻia nei ka hoʻohālikelike ʻana i nā lāʻau like like, akā me nā ʻano waiwai like ʻole. Hoʻohālikelike ʻia nā mea ikaika o hoʻokahi a me nā papa hana ʻelua.

• Linagliptin - Trazhenta,
• Noho ʻOlima - Onglisa,
• Saxagliptin - Januvius,
• Alogliptin benzoate - Vipidia, Nesina,
• Rosiglitazone + Metformin - Avandamet,
• Saksagliptin + Metformin - Hui Pūʻulu
• Glibenclamide + Metformin - Kūkulu, Glucovans, Glibomet,
• Kaona O + Metformin - Yanumet,
• Glimepiride + Metformin - Amaril M.

He kumukūʻai kiʻekiʻe ko nā ʻāina ʻē. No laila, ʻo Gluconorm - 176 rubles, Avandamet - 210 mau rubles a me Glukovans - ʻo 267 ka rubles ka uku. Ke kiʻekiʻe o ke kumukūʻai - Glibomet a me Glimecomb - 309 a me 440 mau rubles. ia wa.

ʻO ʻAmelika waena o ka kumukūʻai kumukūʻai ʻo Amaril M (773 mau rubles) Ke kumukūʻai mai 1000 mau rubles. ika make lāʻau:

• Vipidia - 1239 rub.,
• Galvus Met - 1499 rub.,
• Onglisa - 1592 rubles.,
• Trazhenta - 1719 rubles.,
• Januvia - 1965 rub.

ʻO ka waiwai nui loa ʻo Combogliz Prolong (2941 rubles) a me Yanumet (2825 mau rubles).

No laila, ʻo Galvus, ke loaʻa nei ka waiwai ikaika Vildagliptin, ʻaʻole ia ka lāʻau lapaʻau loa loa. Kākau ʻia ma ka helu kumukūʻai waena, e noʻonoʻo ana i nā lāʻau āpau ʻē aʻe.

Nā papa papa Galvus

ʻO Galvus kahi lāʻau hypoglycemic i hoʻolālā ʻia e hoʻomalu i ke kō koko koko i nā mea maʻi me ka maʻi maʻi 2. ʻO ka waiwai ikaika he vildagliptin. Mahalo i ka lāʻau lapaʻau, mālama ʻia ka hoʻokō pono o ka glucoseagon a me ka metabolism insulin. Wahi a ka Ahahui Antidiabetic ʻEulopa, ʻo ka hoʻohana ʻana i kēia lāʻau lapaʻau i ka monotherapy he wale nō inā he mau contraindications e like me ka metformin. E heluhelu pono i nā ʻōkuhi no ka hoʻohana ʻana i nā papa Galvus a me kahi papa inoa o nā palena.

INN, mea hana, kūʻai

ʻO Galvus ka inoa inoa o ka lāʻau. INN (inoa inoa ʻole kālā) - vildagliptin. Hana ʻia ʻo ia ma Sepania (Novartis Pharmaceutica) a me Switzerland (Novartis Pharma).

Hiki iā ʻoe ke kūʻai i ka lāʻau lapaʻau ma nā lāʻau āpau e like me ke kauka a ke kauka. ʻO ke kumu kūʻai no kahi pā 28 o nā papa he 724 a 956 mau rubles.

Ka hana lāʻau lapaʻau

ʻO Vildagliptin kahi papa kūikawā o nā lāʻau lapaʻau i hoʻolālā ʻia e hoʻoulu i ka ʻikepili o ka islet o ka pancreas, ka mea nāna i mālama i ka koho koho ʻana o DPP-4. Hoʻonui kēia i ka hoʻouluʻana o ka synthesis o kahi peptide e like me ka pona o ka glucagon, a me kahi insulinotropic glucose-hilinaʻi polypeptide. Ke komo nei nā mea kanu i loko o nā ʻāpana, hoʻoulu ʻia nā hormones infletin a hoʻokake lākou i ka hana o ka insulin i ke kino. Ua ʻike ʻia kēia hanana ma ka 1960 ma hope o ko lākou ʻike ʻana i ke ala e hoʻopaʻa ai ka ʻike o ka insulin i ka plasma.

ʻO ka GLP-1 (ʻo ka pagonide like-glucagon-1) ke manaʻo ʻia nei ka ʻike maikaʻi loa, ʻoiai ke kūpaʻa ʻia nei ke ʻano o ke ʻano maʻi type II o ka mellitus. E like me ka inhibitors DPP-4, hoʻonui lākou i ka pae o ka hormone, a pale i kā lākou hōʻeha hou aku.

Nui! Ke hoʻohana nei i vildagliptin no 12-52 mau pule, e hoʻemi nui ʻia ka hoʻouluʻana o ka glucose a me ka hemoglobin glycated i loko o ke koko ma ka ʻōpū ʻōpū ʻole.

Lapaʻau lāʻau

Hoʻopili koke ʻo Vildagliptin i loko o ka kino, ua hiki ke kūleʻa kūleʻa piha ka 85%. Ke lawe nei i ka lāʻau i ka ʻōpū ʻole, ua hoʻopaʻa ʻia ka nui o ke kaila i loko o ke koko ma lalo o ʻelua mau hola. ʻO ka hele ʻana me ka meaʻai, hoʻokomo ʻia ka lāʻau lapaʻau ma kahi o 19% haʻahaʻa, e pili ana i ʻelua a me ka hapa.

ʻO ka weheʻana o ka lāʻau lapaʻau e kū pono i kahi ala like ma waena o nā sela koko a me ka plasma. ʻO ke ala nui e kāpae i ka vildagliptin i manaʻo ʻia he biotransformation. ʻO 85% o ka waiwai ua hoʻopiʻi ʻia e nā pōpoki, ʻo ke koena 15% - ma o nā ʻōpū.

Hoʻomaopopo ʻia e hoʻohana i ke "Galvus" i ka mālama ʻana i ka maʻi maʻi me ka ʻike o ka meaʻai kūpono a me ka hana kino. Nā hōʻailona no ka hoʻohana ʻana i ka lāʻau lapaʻau nā:

• hoʻomohala mua 'ana i nā mea maʻi' aʻole i ka hopena o ka hoʻopau i ke kūʻaiʻana a me nā hana i hui pū me ka metformin,
• like monotherapy - no nā maʻi maʻi maʻi e pono ʻole e lawe i ka metformin, a ʻaʻohe loli maikaʻi mai ka meaʻai a me ka hoʻōla ʻana,
• ʻelua o ka mālama ʻana me ka thiazolidinedione a me ka metformin, insulin, inā ʻaʻohe hopena mai monotherapy,
• hoʻohui hui triple me sulfonylurea a me metivin derivatives,
• ʻO ka maʻi triple paʻakikī me ka insulin a me ka metformin, inā ʻaʻohe kāohi kūpono ma luna o ke kiʻekiʻe o ka glycemia me nā ala āpau i luna.

Ua koho ʻia ʻo Dosisage, ʻano, ʻo ka lōʻihi o ka papa lapaʻau ʻana e nā kauka hele mai.

Nā Hoʻohui

E like me nā lāʻau āpau, he nui nā palena nui o Galvus ma ka hoʻohana ʻana, pono e ʻike nā mea maʻi i kēlā me kēia.
Paʻa i komo

Me ka makaʻala kūikawā, ua kuhikuhi ʻia ka lāʻau lapaʻau e pili ana i kahi kūmole o ka pancreatitis aʻokiʻoki, kahi papa hana o ka palaki paleka a me nā puʻuwai hapahā ʻekolu.

Nā hopena hopena

Hiki i ka hoʻomohala ʻana o ka angioedema i ka wā e lawe ai i vildagliptin i hui pū me ka angiotensin-hoʻohuli i ka hoʻomehana enzyme. ʻO kēia hoʻopiʻi o ka hōʻeha paʻakikī, maʻamau i hoʻoholo i ka pono. ʻO ka manawa, hiki ke hāpaʻa i ka ate i ka lāʻau lapaʻau.Aʻike ka hōʻike i ka hōʻike ʻana o nā hōʻailona like ʻole e koi i ka lāʻau lapaʻau hou, ua lawa ia e kinai ai i ka hoʻokipa.

Monotherapy, e hōʻike ana i kahi maʻi o 50 mg papalua i kēlā me kēia lā, hoʻonāukiuki i nā mea hōʻeha e like me:

• poʻomanaʻo
• āhāhuʻe
• constipation
• ninini
• ke kala ʻana he lula,
• nasopharyngitis.

Me ka hoʻohui hoʻohui ʻana me ka metformin, hiki ke nānā ʻia nā hōʻailona like.
ʻO ka launa pū ʻana me ka insulin e hui pū ʻia me ka wī, hypoglycemia, flatulence, gastroesophageal reflux. Hōʻike pinepine ʻia nā maʻi luhi o nā maʻi maʻamau.
Ma kahi o nā mea i luna aʻe, hōʻike ʻia nā haʻawina hoʻopaʻa inoa hoʻopaʻa ʻia i nā mea maʻi e like me ka hepatitis, urticaria, arthralgia a me myalgia, pancreatitis, a me ka hōʻino o ka ʻili.

Ke keu

ʻO ka dosage o ka mea hana a hiki i 200 mg ke hoʻomanawanui maikaʻi ʻia e nā maʻi. ʻO ka piʻi ʻana i 400 ʻĀina hiki ke hōʻeha i ka ʻehaʻā o ka ʻāʻī, hiki i ka loli, ka paka Hoʻonui ka ʻike ma kahi o 600 mg o ka vildagliptin e hoʻonui i nā pae o ke ALT a me CPK, myoglobin, a me ka pūmua C-reactive. ʻO ke kāpae i ka lāʻau lapaʻau e kōkua i ka hoʻopau ʻana i nā hōʻailona. ʻAʻole hiki ke hiki ke kāpae iā "Galvus" mai ke kino o ka mea maʻi e hoʻohana ana i ka dialysis, akā hiki iā ʻoe ke hoʻohana i ka ʻano hemodialysis.

Hoʻohui nūhou

E kū'ē i ka maikaʻi o ke kāhea hui ʻia, ka hopena o ka hoʻopili ʻana me nā lāʻau like like me ka meloxin, warfarin, ramipril a me metformin, pioglitazone, amlodipine a simvastatin, valsartan a glibenclamide ʻaʻole i loaʻa.

Inā ʻoe e lawe "Galvus" me glucocorticosteroids, thiazides, sympathomimetics, ʻokoʻa a me ka lāʻau lapaʻau hormonal, nui maoli ka hana hypoglycemic o vildagliptin. I ka hihia o ka hoʻokele concurrent me ka angiotensin-hoʻohuli i ka inhibitor enzyme, e ulu ai ka angioedema. ʻAʻole koi kēia kūlana i ka hoʻokuʻu ʻana o ka lāʻau lapaʻau, hoʻopau ka hōʻailona i kāna iho.

Nā ʻōlelo kikoʻī

ʻO Galvus kahi lāʻau lapaʻau antidiabetic, akā ʻaʻole ia he analog o ka insulin. E kū'ē i ka maikaʻi o kona hoʻohana ʻana, he mea nui ia e kiaʻi pinepine i ka hana o ka ate, no ka mea, ʻo ka mea hana ikaika e kōkua i ka hoʻomaikaʻi ʻana i aminotransferase. ʻAʻole ia i hōʻike ʻia e nā ʻano kikoʻī, akā aia kahi loea e hoʻomohala i ka hepatitis. I ka hihia o ka ʻeha o ka ʻōpū, pono ke ʻoki i ka lawe, e like me kēia e hōʻike ai i ka hoʻomohala ʻana o ka maʻi pancreatitis.

ʻO nā ʻike haʻahaʻa, hiki i ke kaumaha ke hōʻemi i ka hopena o ka lawe ʻana i ka lāʻau.

Inā ʻike ʻoe i ka naila a me ke koikoi paipai, ʻaʻole ia he mea e hāpai i nā kaʻa a i ʻole i ka hana koʻikoʻi a paʻakikī paha.

Ma mua o ka hoʻokolohua ʻana i nā kauka olakino, pono e hoʻōla i ka hoʻohana ʻana i ka lāʻau lapaʻau no ʻelua lā: i nā mea kūʻokoʻa ʻē aʻe i hoʻohana ʻia i ka wā o ka maʻi maʻi, kūaʻa ka iodine. Hoʻōlili ia me vildagliptin, ka mea i hāʻawi i ka hoʻomohala ʻana i ke kaumaha o nā puʻuwai a me nā pūpū, i kuhi ʻia me ka hoʻomohala ʻana i ka lactic acidosis.

ʻŌpū a me ka lactation

Hōʻike nā hōʻike hoʻokolohua i ka hapa nui o ka lāʻau lapaʻau ʻaʻole i hoʻopilikia i ka hoʻomohala ʻana o ka embryo. ʻAʻole i loaʻa nā hōʻailona o ka wahine hānai. ʻAʻole nō i mālama ʻia nā haʻawina hou aku, no laila, mai hoʻopilikia hou i ke ola o ka makuahine a me ke keiki. He mea nui e hoʻomanaʻo inā inā he kuhihewa i ka hoʻoliʻina o ke kō, hoʻoneʻe, he hopena o ka congenital fetal abnormalities, a me ka hōʻeha o ka maʻi kino a me ka hoʻonui ʻana i ka neonatal morbidity.

Hoʻohana i ke wā ʻōpio a me nā makahiki kahiko

ʻAʻoheʻike i loaʻa i ka lāʻau lapaʻau ma waena o nā poʻe maʻi ma lalo o ka makahiki ʻumikumamāwalu makahiki, no laila, ʻaʻole ia ke manaʻo e hoʻokomo i loko o ka lāʻau.

ʻAʻole pono nā poʻe i ʻoi aku ma mua o 65 mau makahiki i ke hoʻoponopono ʻana a me ka hoʻoponopono hou nui no ka hoʻohana ʻana i kēia lāʻau lapaʻau, akā ma mua o ka hoʻohana ʻana, pono ʻoe e kamaʻilio me kahi endocrinologist, kiaʻi pinepine i nā mea āpau a me nā pēpē, a nānā i nā pae o ka glucose koko.

Hoʻohālikelike me nā kikowaena

He nui nā kikowaena Galvus, e hoʻāʻo e hoʻomaopopo i kā lākou pono a me nā mea hoʻonāukiuki.

Loaʻa ka lāʻau antidiabetic "Galvus" i waena o nā mea maʻi, he nui nā loiloi maikaʻi.

ʻO Vladimir, 43 makahiki: "Lawe au iā 50 mg me Metformin 500 mg i kēlā kakahiaka a me ke ahiahi no nā makahiki ʻelua. Ma hope o ʻeono mahina o ka hoʻohana mua ʻana i ka lawelawe e pili ana i ka meaʻai, ua hāʻule ka pae o ka glucose i ka 4,5. Eia kekahi, he mea hiki ke nalowale i ke kaumaha. Inā i kaupaona nei au ma mua o 123 kg, inā ua kaupaona kēia paona mai 93-95 kg me ka piʻi o 178 cm. "

ʻO Karina, 32 makahiki: "ʻOiai ke nui o nā mea hoʻonani a me nā ʻōlelo a koʻu kauka ʻana i ka lāʻau lapaʻau, ʻaʻole kūpono kēia lāʻau lapaʻau iaʻu. "Ua hele pinepine wau i ka ʻeha, nāwaliwali, a me ka hōʻeha o ka ʻōpū i ka wā o ka hoʻohana ʻana, no laila ua haʻalele wau i ka lāʻau."

ʻO Svetlana, 56 mau makahiki: "Ma mua, ua kuhikuhi ke kauka iā Maninil, akā ʻaʻole ia i hiki mai, ʻaʻole ia e hoʻohiki i ka kō, ua kaumaha kona ola. Eia kekahi, loaʻa wau i nā pilikia me nā kīʻaha puʻuwai a me nā kīʻaha koko. A laila ua ʻōlelo ke kauka iaʻu e hoʻāʻo iā Galvus. He mea kūpono ke lawe, inu wale i hoʻokahi papaʻaina i ka lā. Mahalo i kāna hana, e hoʻēmi ana ke kōpena a me ka milo, ʻaʻole kiki maoli, ʻo ia ke kumu no ka ʻano o ke ʻano ākea. Ano, makemake nui au, hiki iaʻu ke hauʻoli i ke ola a hana hou. "

Ke hōʻuluʻulu ʻia, hiki ke hoʻomaopopo ʻia ʻo Galvus kekahi o nā lāʻau lapaʻau palekana a me ka maikaʻi loa o ka hypoglycemic i loaʻa i ka mākeke pharmacological home. Ua kūpono ia ka lāʻau lapaʻau no ka mālama ʻana i ka mellitus type type 2, hiki ke hoʻohana ʻia no ka hoʻōla hui ʻana, i hui pū ʻia me ka hoʻomaʻamaʻa a me nā meaʻai ʻai kūikawā.

INN
Vildagliptin
Pākuʻi helu
ʻO nā pōpō Ka hana lāʻau lapaʻau

ʻO kahi māpiha hypoglycemic, he mea hoolana o ka islet apparatus o ka pancreas, kahi mea koho paʻa o ka enzyme dipeptidyl peptidase-4 (DPP-4).

ʻO ka wikiwiki a hoʻopau i ka hana ʻo DPP-4 (ʻoi aku ma mua o 90%) e hoʻoulu ai i ka basal a me ka hoʻoulu ʻia ʻana (ka ʻai ʻana) i ka huna ʻana i ka type 1 glucagon-like me ka peptide a me ka glucose e hilinaʻi nei i ka insulinotropic polypeptide mai ka ʻōpū ma loko o ka ʻōnaehana ʻōnaehana i ka lā.

Ma ka hoʻonui ʻana i ka paʻa o ka like me ka peptide o ka glucagon like me ka peptide a me ka glucose-e hilinaʻi i ka glucoseototekone i ka glucoseot, e hoʻonui ai ka vildagliptin i ka hoʻoliʻi ʻana o nā selela pancreatic i ka glucose, e alakaʻi ai i kahi hoʻomaikaʻi ʻana i ka huna ʻana i ka glucose o ka glucose.

I ka manawa e hoʻohana ʻia ma kahi hapa o 50-100 mg i kēlā me kēia lā i nā mea maʻi me ka diabetes mellitus type 2, kahi hoʻomaikaʻi ʻana i ka hana o nā cell beta pancreatic.

ʻO ka pae o ka hoʻomaikaʻi ʻana i ka hana o nā pū beta e pili ana i ka pae o ko lākou hōʻeha mua ʻia, no laila i loko o ka poʻe i hōʻino ʻia mai ka mellitus maʻi diabetes (me ka pae kūlohelohe maʻamau o ka glucose i loko o ke koko koko), ʻaʻole e hoʻonā ka lāʻau lapaʻau i ka hana huna ʻana o ka insulin a ʻaʻole e hōʻemi i ka neʻe ʻana o ka glucose.

Ma ka hoʻonui ʻana i ka pona o ka endogenous like me ka peptide like o ka ʻano 1, hoʻonui ka vildagliptin i ka hoʻololi ʻana o nā selika alpha i ka glucose, e alakaʻi ai i kahi holomua o ka hoʻoponopono o ka lolo o ka hana hoʻopuka glucose.

ʻO ka emi ʻana o ke kao o ka glucoseagon i ka wā e ʻai ai, ma ka huli ʻana, e hoʻohemo ai i ka pale ʻana i ka insulin.

Ke hoʻonui nei i ka pae o ka insulin / glucagon e kū'ē ana i ka hope o ka hyperglycemia, ma muli o ka hoʻonui ʻana o ka peptide o ka pona o ka glucagon like me ka type 1 a me ka glucose-hilinaʻi i ka glucose o ka insulinotropic, e hoʻolilo i ka emi o ka hana glucose ma ka ate (ma ka manawa prandial a ma hope o ka ʻai), ka mea e hōʻemi ai i ka hoʻokaʻina o ka glucose i ka plasma koko.

Me ka hoʻohana ʻana o vildagliptin, ua hoʻokaʻawale ʻia ka ʻike o ka lipids i ka plasma koko, eia naʻe, ʻaʻole pili kēia hopena i kona hopena ma ka peptide glucagon-like o ka ʻano 1 a i ʻole ka glucose i hilinaʻi ʻia me ka insulin aypotropic e hoʻomaikaʻi i ka hana o nā cell beta pancreatic.

ʻO ka hoʻonui ʻia ʻana o ka peptide like me ka peptide like ʻole o ka ʻano 1 ka mea e alakaʻi ai i kahi kaohi ʻana i ka ʻōpū o ka ʻōpū, akā naʻe, i ke ʻano o ka hoʻohana ʻana o vildagliptin, ʻaʻole i mālama ʻia kēia hopena.

Ke hoʻohana nei i vildagliptin e like me ka monotherapy a i hui pū ʻia me metformin, derive o ka sulfonylurea, thiazolidinedione, a i ʻole insulin, he nui o ka manawa o ka hoʻokaʻawale i ka wikiwiki ʻo glycosylated Hb a me ka wikiwiki o ka hoʻoliihua koko.
Lapaʻau lāʻau

Kūleʻa pololei ʻo AUC i ka hoʻonui ʻana i ka hopena o ka lāʻau.

I ka wā e lawe ai me ka ʻai, e emi iki ka nui o ka lilo ʻana, e emi ana ka Cmax ma ka 19%, hoʻonui ʻia ʻo TCmax i ka hola 2,5 mau, ʻaʻole i loli ka hapa o ke kīnā a me ka AUC.

He haʻahaʻa nā kamaʻilio ʻana me nā protein - 9.3%. Hoʻohālikelike ʻia ia ma waena o ke kō a me nā kaila koko ʻula. Ka helu helu (ma i / i loko o ke kau ʻana) - 71 l.

ʻO ka ʻōlelo hoʻohālikelike pinepine ʻia.

ʻO ke ala nui o ka hoʻopuka ka biotransformation.

69% o ka lāʻau lapaʻau ka hopena ma muli o ka huli ʻana. ʻO ka metabolite koʻikoʻi - LAY151 (57% o ka momona) he pharmacologically aktive a he mea ia o ka hydrolysis o ka māhele cyano. Ma kahi o 4% o ka nui o ka maʻi e kau ana ma ka hydrolysis amide.

Ua hoʻomaopopo ʻia kahi hopena kūpono o DPP-4 ma ka hydrolysis o ka lāʻau.

ʻAʻole hoʻohālikelike ʻia ka Vildagliptin me ka komo ʻana o nā isoenzymes cytochrome P450 a ʻaʻole ia he substrate no lākou, ʻaʻole ia e kālai a hoʻoweliweli iā lākou.

T1 / 2 - 3 hola. Hoʻokuʻu ʻia ia e nā keiki - 85% (me ka 23% i loli ʻole), e nā ʻōpū - 15%.

Ma ka hihia o ka hina ʻōlohelohe (5-6 kuhi e like me ke keiki-Pyug) a me ke kiʻekiʻe o ka nui (6-10 mau wahi e like me ke keiki-Pyug) ma hope o ka hoʻohana ʻana o ka lāʻau, hōʻemi ʻia ka bioavailability e 20% a 8%, kekahi.

Ma nā hōʻeha pale pāpaʻi (12 mauʻai e like me ke keiki-Pyug) bioavailability e hoʻonui ai i ka 22%. ʻO ka hoʻonui ʻana a hōʻemi paha i ka bioavailability kiʻekiʻe, ʻaʻole iʻoi aku ma mua o 30%, ʻaʻole he koʻikoʻi kahi maʻi.

ʻAʻole i hoʻoponopono ʻia ma waena o ka nui o ka hana a ke ake a me ka bioavailability o ka lāʻau.

I nā mea maʻi me ka hōʻemi, hōʻeha a me ka hōʻeha ʻana i ka hanu o ke kino, me ka ʻohi o ka CRF (i ka hemodialysis), he nui ka Cmax o 8% -66% a AUC e 32% -134%, ʻaʻole ia e hoʻoponopono i ka ʻeha o ka hōʻino, a me ka hoʻonui ʻana i ka AUC o ke kaila hana ʻole. ʻO LAY151 1.6-6.7 mau manawa, e pili ana i ka nui o ka hoʻokūkū. ʻAʻole i loli ʻo T1 / 2.

ʻO ka hoʻonui nui loa ma bioavailability e 32% a me max e 18% (i nā mea maʻi i ʻoi aku ma mua o 70 mau makahiki) ʻaʻole koʻikoʻi ʻo ia a ʻaʻole i hoʻopilikia i ka hoʻokuʻuʻana o DPP-4.
Nā hōʻailona no ka hoʻohana ʻana

Kākau 2 type mellitus: monotherapy (i hui pū me ka papa lāʻau a me ka hoʻomaʻamaʻa kino) a me ka hui pū ʻana (i hui pū me ka metformin, sulfonylurea derivatives, thiazolidinedione, insulin) i ka hihia o ka launa ʻole pono lāʻau, hoʻomaʻamaʻa a me ka monotherapy o kēia mau lāʻau.
Nā Hoʻohui

Hypersensitivity, hōʻeha kūlana hepatic koʻikoʻi (hoʻonui i ke ʻano ALT a me AST mau manawa 2.5 mau kiʻekiʻe ma mua o ka palena palena o ka maʻamau), maʻalahi a paʻakikī paha i ka maʻi (me ka hopena o ka CRF ma ka hemodialysis), hapai, lactation, wā kamaliʻi (a hiki i 18 makahiki).

No ka Lf e loaʻa ana ka lactose (koho): galactose intolerance, hapa lactase a i ʻole malabsorption o glucose-galactose.
Ka hoʻoponopono ʻia ʻana

I loko, me ka manaʻo o ka inu meaʻai, me ka monotherapy a me nā mea ʻelua ʻelua mau lāʻau me ka metformin, thiazolidinedione a i ʻole insulin - 50 mg / lā (kakahiaka) a 100 mg / lā (50 mg i ke kakahiaka a me ke ahiahi), me ka lāʻau lapaʻau ʻelua-hoʻohui me nā derivatives sulfonylurea - 50 mg / lā (i ke kakahiaka), me ke ʻano nui o ka maʻi mellitus no ka maʻi maʻi, no nā mea maʻi e loaʻa ana i ka maʻi insulin - 100 mg / lā.

Me ka hopena ʻole o ka lāʻau lapaʻau i ka wā e lawe ai i ka mahele o ka 100 mg / lā, hiki ke loaʻa ka lāʻau hou aʻe i nā lāʻau lapaʻau hypoglycemic ʻē aʻe: hiki i ka metformin, sulfonylurea derivatives, thiazolidinedione a i ʻole insulin.

I ka manawa i hoʻohālikelike ʻia ai me nā derivatives o sulfonylurea, ʻo ka maikaʻi o ke ʻano maʻi ma kahi o 100 mg / lā i like me ia ma ke ʻano o 50 mg / lā.
Loaʻa ka hopena

Lele maʻamau: pinepine pinepine (1/10 a ʻoi aku paha), pinepine (ʻoi aku ma mua o ka 1/100 a emi mai ka 1/10), i kekahi manawa (ʻoi aku ma mua o 1/1000 a emi mai ka 1/100), ʻaʻole liʻiliʻi (ʻoi aku ka nui o ka 1/10000 a emi mai ka 1/1000) loa i ka liʻiliʻi (emi ma mua o 1/10000).

Me ka monotherapy: ma ka ʻaoʻao o ka pūnao ka hopena - pinepine - dizziness, i kekahi manawa - ʻiwi.

Mai ka pūnaehana ʻana: kekahi manawa - constipation.

Mai ka CCC: mau manawa - edema peripheral.

I ka manawa e hoʻohana ʻia ma ke ʻano o ka nui o 50 mg (1-2 mau lā i ka lā) e hui pū me ka metformin: ma ka ʻaoʻao o ka ʻōnaehana o ka hūʻī - pinepine - dizziness, headache, tremor.

I ka manawa e hoʻohana ʻia ma kahi pāʻina o 50 mg / lā e hui pū me nā derogatives sulfonylurea: mai i ka ʻōnaehana oʻehā - pinepine - dizziness, headache, asthenia, tremor.

I ka manawa e hoʻohana ʻia ma kahi pāʻālua o 50 mg 1-2 mau manawa i ka lā me ka hoʻohui ʻana me nā derivatives thiazolidinedione: mai CCC - pinepine - peripheral edema.

Nā mea'ē aʻe: pinepine - hoʻonui i ke kaumaha o ke kino.

I ka manawa i hoʻohana ʻia ma kahi pāʻālua o 50 mg 2 mau manawa i ka lā me ka hui pū me ka insulin: mai ka ʻōnaehana o ka pīpī - pinepine - he ʻeha.

Mai ka papa hana ʻana: pinepine - nausea, lemul, gastroesophageal Reflux maʻi.

Mai ka ʻaoʻao o ka metabolism: pinepine - hypoglycemia.

I ka wā monotherapy a i ʻole me ka hui pū me nā lāʻau lapaʻau ʻē aʻe, he ʻoluʻolu nā lōlū, ʻaʻole i kinai, ʻaʻole pono ka haʻalele ʻana i ka lāʻau. ʻO ka ulu ʻana o ka angioedema (loaʻa ʻole - ʻoi aku ma mua o ka 1/10000 a me ka hōʻemi ma mua o ka 1/1000) ua like nō ia me ka mea i mālama ʻia. ʻO ka hapa pinepine, ʻike ʻia ka angioedema i ka wā i hui pū ʻia me nā mea paʻa me ACE, he ʻoluʻolu a neʻe me ka hoʻomau ʻia o ka lāʻau.

Hōʻeha ka hana hana Hepatic (me ka hepatitis) o ke papa asymptomatic i nānā pinepine ʻia, i ka nui o nā hihia i hoʻoholo kūʻokoʻa ʻia ma hope o ka hoʻokuʻu ʻana o ka lāʻau lapaʻau.
Ke keu

Nā hōʻailona: myalgia, transest paresthesia, fever, edema (me ka peripheral), ka hoʻonui pinepine ʻana i ka hana lipase (2 mau manawa kiʻekiʻe ma mua o ka palena palena o ka maʻamau), hoʻonui i ka hana o ka CPK, ALT, C-reactive protein a me myoglobin.

Hoʻomaʻomaʻo: ka wehe ʻana o ka lāʻau, dialysis (ʻaʻole hiki ke hoʻokaʻawale ke kau nei, akā naʻe, hiki i ka hydrolysis metabolite nui o vildagliptin (LAY 151) ke hiki i ka hemodialysis).
Hoʻohui

He haʻahaʻa haʻahaʻa haʻahaʻa no ka hopena o ka lāʻau lapaʻau. ʻAʻole ʻo kahi Vildagliptin kahi substrate o ka isoenzymes cytochrome P450, ʻaʻole ia i pale a hoʻonani paha i kēia mau enzymes, kona hui me nā lāʻau lapaʻau e lae, ka mea paʻa, a i ʻole inducers o ka cytochrome P450 i like ʻole.

Me ka hoʻohana ʻana o ka vildagliptin ʻaʻole i pili i ka hopena metabola o nā lāʻau lapaʻau he poʻe hoʻohālikelike o ka isoenzymes CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 a me CYP3A4 / 5.

ʻO nā ʻoihana olakino koʻikoʻi me nā lāʻau lapaʻau pinepine e hoʻohana ʻia i ka mālama ʻia ʻana o ka maʻi mellitus type 2 (glibenclamide, pioglitazone, metformin) a i kahi kikoʻi pōkole pili (amlodipine, digoxin, ramipril, simvastatin, valsartan, warfarin) ʻaʻole i hoʻokumu.
Nā ʻōlelo kikoʻī

I nā hihia ka pilikia, i ka wā e noi ai vildagliptin, ke piʻi nei ka nui o ka hana o aminotransferases (maʻa mau me nā hōʻike maʻi ʻole). Ma mua o ka kuhikuhi ʻana i nā lāʻau lapaʻau a i ka makahiki mua o ka mālama ʻana (1 ka manawa i 3 mau mahina), e pono ke hoʻoholo i nā hiʻohiʻona biochemical o ka hana ate.

Me ka hoʻonui nui o ka hana o ka aminotransferases, pono e hōʻoia ʻia ka hopena e ka noiʻi mau ʻana, a laila hoʻoholo pinepine i nā ʻōhua biochemical o ka hana o ka ate a hiki i ka wā maʻamau.

Inā he nui nā hana o ka nui o ka AST a me ALT paha 3 mau manawa iʻoi aku ma mua o ka palena o ka palena maʻamau i hoʻopaʻa ʻia ma o kahi noiʻi ʻelua, ʻoi ʻia e kāpae i ka ʻai.

Me ka hoʻomohala ʻana o ka jaundice a i ʻole nā ​​hōʻailona ʻē aʻe o ka hana lūlū o ka puʻuwai, pono e hoʻokaʻawale i ka lāʻau a ʻaʻole hoʻi e hoʻihoʻi hou ma hope o ka hoʻonāwīwī ʻana i nā māka hana hana ate.

Inā pono ka therapy insulin, e hoʻohana pū ʻia ka vildagliptin i ka hui pū me ka insulin.

ʻAʻole pono e hoʻohana ʻia ka lāʻau lapaʻau no ka maʻi mellitus no ka maʻi 1 a i ʻole no ka mālama ʻana i ka ketoacidosis maʻi.

I ka wā o ka mālama ʻana (me ka ulu ʻana o ka dizziness) pono e hōʻole i ka hoʻokele kaʻa a hana pū i nā hana hoʻoweliweli e koi ai i ka piʻi ʻana o ka nānā a me ka wikiwiki o ka hopena psychomotor.

ʻO ka wehewehe ʻana i ka waiwai ikaika Vildagliptin / Vildagliptin.

Paula C17H25N3O2, inoa hiʻona: (S) -1-N- (3-hydroxy-1-adamantyl) glycylpyrrolidine-2-carbonitrile
ʻĀpana hoʻolaʻa: ka metabolites / hypoglycemic synthetic a me nā mea'ē aʻe.
Hoʻolaha hana: hypoglycemic.

ʻO nā waiwai Pharmacological

Hoʻolaha ʻo Vildagliptin i ka ʻāpana islet o ka pancreas, sellyly kālai ʻia dipeptidyl peptidase-4. Hoʻopau piha a me ka wikiwiki o ka hana dipeptidyl peptidase-4 e alakaʻi i ka hoʻonui i ka basal a hoʻowalewale i ka huna ʻana i ka glucose-dependotine insulin -ropypide a me ka poniide like me kaagonalone like me ka peptide systemic mai loko o ka ʻōpū i loko o ka lā.Ma ka hoʻonui ʻana i ka ʻike o ka glucose-hilinaʻi i ka insulinotropic e pili ana i ka pypide e like me ka peptide e like me ka peptide, me ka vildagliptin e hoʻonui i ka hoʻoliʻi o ka glucose o nā hua a ka papa pancreatic, e alakaʻi ana i ka holomua o ka huna ʻana i ka glucose glucose i hilinaʻi. ʻO ka pae o ka holomua ma ka hana o nā pū beta ka mea i hilinaʻi i ka nui o ko lākou hōʻeha mua ʻia; i loko o nā mea ʻole me ka diabetes mellitus (me ka glucose maʻamau i ka serum koko), ʻaʻole hoʻāla ka vildagliptin i ka huna ʻana i ka insulin a ʻaʻole e hōʻemi i ka kukuna glucose. I ka hoʻonui ʻana i ka ʻike o ka endogenous like me ka peptide type 1, ka hoʻonui ʻana o ka vildagliptin i ka hoʻololi ʻana o nā ʻāpana alpha i ka glucose, ke alakaʻi nei kēia i ka holomua o ka hoʻoponopono i ka lolo o ka glucose i ka excretion glucagon. ʻO ka emi ʻana o nā kiʻekiʻe o ka glucagon i ka wā ʻai e hōʻemi ai i ka pale o ka insulin. Ke hoʻonui nei i ka pae o ka insulin / glucagon ma ka hyperglycemia, ka mea i māhuahua ai ka piʻi o ka pae o ka glucose i hilinaʻi ʻia o ka insulinotropic polypeptide a peptide type 1 glucagon-like, ke alakaʻi nei i kahi kaohi o ka glucose i ka ate ma ka lua o ka manawa prandial a ma hope o ka ʻai ʻana, ka mea e hoʻonā a hoʻemi i ka pae o ka glucose i ka serum koko. Eia nō hoʻi, i ka wā e hoʻohana ai i vildagliptin, ua hōʻemi ʻia ka ʻōlelo lipum lipum, akā ʻaʻole pili kēia hopena i ka hopena o ka vildagliptin ma luna o ka glucose o ke kūpaʻa insulinotropic e pili ana i ka peptide a like me kaagonona like me ka peptide a me ka hoʻomaikaʻi ʻana i ka hana o nā cell beta pancreatic.
Hoʻopili koke ʻia ʻo Vildagliptin i ka wā e hoʻopili ai i ka waha, ʻo ka bioavailability piha loa he 85%. ʻO ka hoʻonui ʻana i ka nui o ka vildagliptin i ka serum a me ka ʻāpana ma ke kahe o ka manawa o ka kukū, a kokoke i ke kiko o ka vildagliptin. Hoʻohālikelike ka lōʻihi i ka wā e lawe ai i ka lāʻau i loko o kahi ʻōpū ʻole i hiki aku ai ma hope o 1 hola 45 mau minuke. Ke lawe nei i ka lāʻau lapaʻau me ka meaʻai, e emi iki ka nui o ka kō o ka vildagliptin: aia kekahi maʻa o ke kaila nui loa ma ka 19% a me ka piʻi ʻana ma ka manawa e hiki ai i nā hola 2. Akā ʻo ka hopena ma ke ʻano o ke kūmole a me ka wahi ma ka ʻaoʻao o ka manawa o ka lohi ʻana i loaʻa ʻole kahi kī. Hoʻopili hewaʻi ʻo Vildagliptin me nā protein plasma (9.3%). Hoʻohālikelike ʻia ʻo Vildagliptin ma waena o nā ʻāpana koko ʻulaʻula a me ka plasma. ʻO ka manawa like, ʻo ka hoʻoili ʻana i ka lāʻau e loaʻa i ka extravascular, i ka hoʻohālikelike, ʻo ka nui o ka laha ʻana ma hope o ka hoʻokele intravenous he 71 lita. I loko o ke kino kanaka, vildagliptin ua biotransformed 69%. ʻO ka metabolite koʻikoʻi ka lāʻau lapaʻau hikiʻole i ka LAY151 (57% o ka pane), i hoʻokumu ʻia i ka wā o ka hydrolysis o ka māhele cyano. Ma kahi o 4% e lawe ana i ka hydrolysis amide. ʻO Vildagliptin me ke komo ʻana o nā isoenzymes cytochrome P450 ʻaʻole i uluhia. ʻAʻole hoʻoheheʻe ʻo Vildagliptin i nā melemene CYP450 isoenzymes a ʻaʻole ia he substrate o P (CYP) 450 isoenzymes. I ka nānā ʻana, ma kahi o 85% o ka lāʻau ua hoʻōla ʻia e nā keiki, 15% e hōʻiho ʻia ma o nā ʻōpū, hoʻololi ʻia (23%) vildagliptin i ʻoki ʻia e nā keiki. ʻO ke kāpae hapa-ola he aneane 3 mau hola a ʻaʻole ia e hilinaʻi ma ka hopena. ʻAʻole pili ʻo ke kūpeʻe a me ka moʻomeheu, ka ʻano kūloko a me nā ʻōnaehana kino o ke kino i ka pharmacokinetics o vildagliptin. I nā mea maʻi me ka leʻaleʻa a me ka hema o ke ake me ka pākahi o nā lāʻau, ua hōʻemi ka nui o nā bioavailability o vildagliptin e 20% a me 8%, pākahi. I ka poʻe maʻi me ka maʻi hepatic koʻikoʻi, hoʻonui ʻia ka bioavailability o vildagliptin e 22%. ʻO ka hōʻemi a hoʻonui paha i ka bioavailability o vildagliptin paha, ʻaʻole iʻoi aku i ka 30%, ʻaʻole i koʻikoʻi nā maʻi lapaʻau. I nā mea maʻi me ka leʻaleʻa māmā a me ka hōʻeha maikaʻi ʻole, i nā mea maʻi me ka hopena ʻole o ka hopena papalū o ka hopena, hoʻonui i ka hemodialysis ka nui loa o ka vildagliptin e ka 8 - 66% a me ka wahi ma lalo o ke kālai ʻana o ka manawa ma ka 32 - 134%, ʻaʻole ia e hoʻoponopono me ka nui o ka hōʻino ka hana ʻona o ka pūpū, me ka hoʻonui pū ʻana ma ka wahi ma lalo o ka pahu o ka manawa o ka paʻa ʻana o ka Lā151 o ka hana ʻole i ke ʻano o ka LAY151 i ka manawa 1.6 - 6.7, ka mea i kau ʻia i ka pohō o ka ʻālunu. I kēia hihia, ʻaʻole hoʻololi i ka hapalua o ke ola o ka vildagliptin. I nā mea maʻi ma mua o 70 mau makahiki, ʻo ka bioavailability o ka lāʻau he hoʻonui nui loa o 32% (ka uʻi plasma kiʻekiʻe loa o 18%), ʻaʻole ia he koʻikoʻi a ʻaʻole i hoʻopilikia i ka hopena o ka dipeptidyl peptidase-4. ʻAʻole paʻa i ka pharmacokinetics o vildagliptin i nā mea maʻi ma lalo o ka 18 makahiki o kona mau makahiki.

Kākoʻo 2 diabetes mellitus ma ke ʻano he monotherapy a i ʻole nā ​​hui hoʻohui.

Ke ʻano o ke noi ʻana o vildagliptin a me nā kūleʻa

Lawe ʻia ʻo Vildagliptin i kahi wahaheʻe, me ka ʻike ʻole i ka meaʻai o ka meaʻai. Koho ʻia ka nui o ka lāʻau a ka lāʻau lapaʻau e nā kauka hoʻokahi, e pili ana i ka palaka a me ka hana pono.
Ke hoʻohana nei i vildagliptin, he mea hiki ke hoʻonui i ka hana o aminotransferases (maʻa mau me nā hōʻike ʻole), e hāmama ʻia ana e hoʻoholo i nā ʻōhua biochemical o ke ʻano hana o ka ate ma mua o kāna koho, a me ka mau manawa ma ka makahiki mua o ka ʻoihana. Inā loaʻa i ka mea maʻi ka hana nui o nā aminotransferases, a laila e pono i kēia hopena e hōʻoia ʻia e ka noiʻi lua, a laila e hoʻoholo pinepine i nā ʻano biochemical o ke ʻano hana o ka ate a hiki i ka wā maʻamau. Inā ʻoi aku ka nui o nā hana o aminotransferases ma mua o ʻekolu mau manawa o ka palena o ka maʻamau a hoʻopaʻa ʻia ʻo ia e kahi haʻawina, a laila e pono ke kāpae ʻia ka vildagliptin. Me ka hoʻolālāʻana o ka jaundice a i ʻole nā ​​hōʻailona ʻē aʻe o ka hana lūlū, ua pono ke hoʻopau ʻia ka vildagliptin. Me ka hana maʻamau o ka hana hoʻopili o ka puʻuwai, ʻaʻole hiki ke hoʻomau ʻia ka vildagliptin. ʻAʻole pono ke hoʻohana ʻo Vildagliptin i nā maʻi maʻi me ka maʻi diabetes mellitus type 1, pū nō hoʻi no ka mālama ʻana i ka ketoacidosis maʻi maʻi. Me ka hoʻomohala ʻana o ka dizziness ka mea e lawe ai i vildagliptin, ʻaʻole pono nā mea maʻi e hana me nā mīkini a hoʻokau paha i nā kaʻa.

ʻŌpū a me ka lactation

I ka hoʻokolohua, i ka wā e lawe ai i vildagliptin i nā inakona he 200 mau manawa i ʻoi aku i ka ʻōlelo, ʻaʻole i hoʻolilo ka lāʻau i ka ulu ʻana i ka embryo i ka ulu ʻana, pōkole huaʻai a ʻaʻole i hoʻopilikia i kahi hopena teratogenic ma ka pūpū. ʻAʻohe ʻikepili nui i ka hoʻohana ʻana o vildagliptin i nā wahine hāpai, no laila ʻaʻole pono e hoʻohana ʻia i ka wā hāpai. ʻAʻole ʻike ʻia inā hoʻokomo ʻia ka vildagliptin i ka waiū umauma, no laila ʻaʻole pono e hoʻohana ʻia i ka wā lactation.

ʻVlelo aʻo Galvus

Hōʻike
1 kōpō. mau vildagliptin 50 mg,
nā mea waiwai: MCC, lactose anhydrous, sodium carboxymethyl starch, magnesium stearate,

ʻOhiʻohi
i loko o kahi pā o 14, 28, 56, 84, 112 a me 168 mau pcs.

Ka hana lāʻau lapaʻau
GALVUS - vildagliptin - he mākaukau o ka papa o ka stimulators o ka insular apparatus o ka pancreas, sellyly pale i ka enzyme dipeptidyl peptidase-4 (DPP-4). ʻO ka wikiwiki a me ka hoʻopau ʻana i ka hana DPP-4 (> 90%) e hoʻonui ai i ka basal a me ka hoʻōla ʻia ʻana o ka meaʻai me ka peptide type 1 e like me ka GLP-1) a me ka glucose-hilinaʻi i ka insulinotropic polypeptide (HIP) mai ka ʻōpū i loko o ka ʻōnaehana ma waena o ke ao.
ʻO ka hoʻonui ʻana i nā pae o ka GLP-1 a me HIP, ʻo vildagliptin e hoʻoulu ai i ka naʻau o ka pancreatic? Ke hoʻoiho nei i vildagliptin ma kahi o 50-100 mg / i nā mea maʻi me ka maʻi diabetes mellitus type 2, kahi hoʻomaikaʻi ʻana i ka hana o ka pancreatic? ʻO ka pae o ka holomua o? -Cell function dependant of the degree of their first damage, no laila i loko o ka poʻe no ka poʻe e ʻeha nei i ka diabetes mellitus (me ka glucose koko maʻamau), vildagliptin ʻaʻole i hoʻoulu i ka huna huna insulin a ʻaʻole e hōʻemi i ka glucose.
Ma ka hoʻonui ʻana i nā pae o ka endogenous GLP-1, hoʻonui ka vildagliptin i ka hoʻololi ʻana o nā β-cells i ka glucose, e alakaʻi ai i kahi holomua o ka hoʻoponopono o ka glucose i kālai ʻia ʻana o ka paleona. ʻO ka emi ʻana o ke kiʻekiʻe o ka glucagon i ka wā o ka pāʻina, ma ka huli ʻana, e hoʻolohi i ka hōʻemi i ka pale ʻana i ka insulin.
Ke hoʻonui nei i ka pae o ka insulin / glucagon e kū'ē ana i ka hope o ka hyperglycemia, ma muli o ka hoʻonui nui ʻana o nā pae o ka GLP-1 a me HIP, e hōʻemi ana i ka hoʻoliʻina o ka glucose ma ka ate ma ka manawa prandial a ma hope o ka ʻai, ka mea e hoʻoneʻe ai i ka pae o ka pae o ka glucose koko.
Hoʻohui ia, e kūʻē i ke ʻano o ka hoʻohana ʻana o vildagliptin, he hōʻemi i ka nui o nā lipids i ka plasma koko, akā naʻe, ʻaʻole pili kēia hopena me kona hopena i ka GLP-1 a i ka HIP a me ka hoʻomaikaʻi ʻana i ka hana o nā pancreatic?
Ua ʻike ʻia he piʻi nui ʻana o ka GLP-1 hiki ke hoʻolōʻihi i ka ʻōpū o ka gastric, akā ʻaʻole i nānā ʻia kēia hopena me ka hoʻohana ʻana o vildagliptin.
Ke hoʻohana nei i vildagliptin i 5795 nā mea maʻi me ka diabetes mellitus type 2 no nā 12 a 52 mau wiki he monotherapy a i hui pū ʻia me metformin, sulfonylurea derivatives, thiazolidinedione, a i ʻole insulin, he nui ka manawa lōʻihi o ka hōʻemi o ka neʻe o ka hemoglobin glycated (HbA1c) a me ka wikiwiki o ka hoʻoliʻi koko.

ʻO Galvus, mau hōʻailona no ka hoʻohana ʻana
Kauka 2 diabetes mellitus:
- e like me ka monotherapy i hui pū ʻia me ka hoʻomaʻamaʻa meaʻai a me ka hoʻomaʻamaʻa,
- ma ka ʻāpana o ka hui pū ʻana i nā hui ʻelua me ka metformin, derivatives sulfonylurea, thiazolidinedione a i ʻole insulin i ka hihia o kaʻai ʻana i ka meaʻai ʻaʻai, hoʻomaʻamaʻa a me ka monotherapy me kēia mau lāʻau lapaʻau.

Nā Hoʻohui
Hypersensitivity i vildagliptin a me nā mea ʻē aʻe o Galvus,
nā keiki ma lalo o ke 18 mau makahiki o ka maikaʻi (a ʻaʻole i hoʻonohonoho ʻia ka maikaʻi a me ka palekana).
Me ka mālama:
nā hana hōʻeha nui o ka pūpū, me ka poʻe maʻi me ka piʻi o ka hana o nā enzyme o ka ate (ALT a AST> 2.5 mau manawa ma mua o ka palena palena kiʻekiʻe o ka maʻamau - 2.5 × VGN),
hōʻemi a i ʻole ka hōʻemi ʻana i ka maʻi (ʻoiai ke komo ʻana o ka CRF i ka hemodialysis) - ke kaupalena nei ka ʻike me ka hoʻohana ʻana, ʻaʻole i kauoha ʻia ka lāʻau lapaʻau no kēia ʻāpana o nā maʻi
ʻeha nā hoʻoilina kuleana maʻamau - intolerance galactose, hemahema lactase a malabsorption o glucose-galactose.

ʻLoe a me ke kākele
Lawe ʻia ʻo Galvus i kahi ʻōlelo maʻamau, me he mea la o ka komo ʻana i ka meaʻai.
Pono ke koho ʻia o ka hoʻoponopono ʻia o ka lāʻau lapaʻau kūʻokoʻa e pili ana i ka hopena a me ka hikiʻole.
ʻO ke ʻano o ka lāʻau i manaʻo ʻia i ka wā o ka monotherapy a i ʻole ka mahele o ke ʻano hui ʻelua ʻelua me ka metformin, thiazolidinedione a i ʻole insulin o 50 a 100 mg hoʻokahi i ka lā. I ka poʻe maʻi me ka maʻi maʻamau ʻoi aku ka 2 ke loaʻa nei i ka mālama ʻana i ka insulin, ua ʻōlelo ʻia ʻo Galvus ma kahi maʻi o 100 mg / lā.
Pono kahi papa o 50 mg / lā e kau i ka 1 wai i loko o ke kakahiaka, i kahi momona o 100 mg / lā - 50 mg 2 mau manawa i ka lā i ke kakahiaka a me ke ahiahi.

ʻŌpū a me ka lactation
Ma nā hoʻokolohua hoʻokolohua, i ka wā i kuhikuhi ʻia ai i nā pora he 200 mau manawa i ʻoi aku ma mua o ka mea i hōʻike ʻia, ʻaʻole ka hopena o ka lāʻau lapaʻau i ka ulu me ka ulu ʻana o ka embryo a ʻaʻole i hoʻoulu i ka hopena teratogenic ma ka pūpū. ʻAʻohe lawa nā ʻike ma ka hoʻohana ʻana i ka lālani Galvus i nā wahine hāpai, a no laila ʻaʻole pono nā mea o ka lāʻau lapaʻau ma ka wā hāpai. I loko o nā pilikia o ka metabolism glucose impaired i nā wahine hāpai, loaʻa ka nui o ka hoʻouluʻana i ka anomalies congenital, a me ka pinepine o ka neonatal morbidity a me ka make.
No ka mea ʻaʻole i ʻike ʻia a vldagliptin me ka umauma waiū i loko o nā kānaka, ʻaʻole pono ʻo Galvus e hoʻohana i ka wā lactation.

Nā hopena hopena
Ke hoʻohana nei iā Galvus ma ke ʻano he monotherapy a i hui pū ʻia me nā lāʻau lapaʻau ʻē aʻe, ʻo ka hapa nui o nā hopena ʻino e maloʻo ana, pōkole, ʻaʻole pono i ka hoʻokuʻu ʻana o ka maʻi. ʻAʻole i ʻike ʻia kahi hopena ma waena o ka pinepine o nā hanana pōʻino (AE) a me nā makahiki, ka wahine, ka lāhui, ka lōʻihi o ka hoʻohana ʻana, a me ka regimen dosing paha. ʻO ka loaʻa ʻana o ka edion angioneurotic i ka wā o ka mālama ʻana me Galvus he ≥1 / 10,000, e kū ana i ke ʻano o ke ʻano o ka hopena me Galvus, hōʻeha ka maʻi hepatic (me ka hepatitis) a me ka kaila asymptomatic i ʻike pinepine ʻole ʻia. I ka nui o nā hihia, nā mau hana kuʻi a me nā kūwili o ka lawelawe o ka ate mai ka pākaukau i hoʻoholo me ka ʻole o ka hoʻopiʻi ʻana ma hope o ka hoʻokuʻu ʻana o ka lāʻau lapaʻau. Ke hoʻohana nei i ka lāʻau Galvus i loko o kahi waihona o 50 mg 1 a i 2 mau manawa i ka lā, ʻo ka nui o ka hoʻonui ʻana i ka hana o nā poma enima (ALT a me AST ≥3 × VGN) he 0.2 a i 0.3%, ia manawa (like me 0.2% i ka hui mana) . ^ E Ha yM. ʻO ka hoʻonui ʻana o ka hana o nā enzyme o ka palu ma ka hapanui o ka asymptomatic, ʻaʻole i holomua, a ʻaʻole i mālama ʻia e nā loli cholestatic a i ʻole jaundice.

Nā ʻōlelo kikoʻī
I nā hihia ka pilikia, i ka wā e noi ai vildagliptin, ke piʻi nei ka nui o ka hana o aminotransferases (maʻa mau me nā hōʻike maʻi ʻole). Ma mua o ka kuhikuhi ʻana i nā lāʻau lapaʻau a i ka makahiki mua o ka mālama ʻana (1 ka manawa i 3 mau mahina), e pono ke hoʻoholo i nā hiʻohiʻona biochemical o ka hana ate. Me ka hoʻonui nui o ka hana o ka aminotransferases, pono e hōʻoia ʻia ka hopena e ka noiʻi mau ʻana, a laila hoʻoholo pinepine i nā ʻōhua biochemical o ka hana o ka ate a hiki i ka wā maʻamau. Inā he nui nā hana o ka nui o ka AST a me ALT paha 3 mau manawa iʻoi aku ma mua o ka palena o ka palena maʻamau i hoʻopaʻa ʻia ma o kahi noiʻi ʻelua, ʻoi ʻia e kāpae i ka ʻai. Me ka hoʻomohala ʻana o ka jaundice a i ʻole nā ​​hōʻailona ʻē aʻe o ka hana lūlū o ka puʻuwai, pono e hoʻokaʻawale i ka lāʻau a ʻaʻole hoʻi e hoʻihoʻi hou ma hope o ka hoʻonāwīwī ʻana i nā māka hana hana ate. Inā pono ka therapy insulin, e hoʻohana pū ʻia ka vildagliptin i ka hui pū me ka insulin. ʻAʻole pono e hoʻohana ʻia ka lāʻau lapaʻau no ka maʻi mellitus no ka maʻi 1 a i ʻole no ka mālama ʻana i ka ketoacidosis maʻi. I ka wā o ka mālama ʻana (me ka ulu ʻana o ka dizziness) pono e hōʻole aku i ka hoʻokele kaʻa a me ka hana ʻana i nā hana e pōʻino loa ana e koi ai i ka piʻi ʻana o ka nānā a me ka wikiwiki o ka hopena psychomotor.

Hoʻohui nūhou
He haʻahaʻa haʻahaʻa ʻo Galvus no ka hoʻopili ai i ka lāʻau. No ka mea, ʻaʻole ʻo Galvus kahi papa o ka huina cytochrome P450, ʻaʻole ia e kālai ana a hoʻonāukiuki paha i kēia mau enzyme, ka pilina o Galvus me nā lāʻau lapaʻau he mau substrates, inhibitors, a i ʻole inducers o P450 i like ʻole. Me ka hoʻohana like ʻana o vildagliptin ʻaʻole i pili i ka helu metabola o nā lāʻau lapaʻau he poʻe hoʻohālikelike o nā enzyme: CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 a me CYP3A4 / 5.

Ke keu
Nā Hoʻomaka i ka wā e hoʻohana ai i ka lāʻau lapaʻau ma kahi o 400 mg / hiki ke nānā ʻia, ʻehaʻeha ka maʻi, ke ʻāʻā, ka pūpū a me ka parenthesia transient, maʻi, edema a me ka hoʻonui hou ʻana i ka puhaluhi lipase (2 mau manawa kiʻekiʻe ma mua o VGN). Me ka hoʻonui o ka nui o ka maʻi o Galvus i 600 mg /, hiki i ka hoʻomohala ʻana o ka edema o nā huluhulu me ka paresthesias a me ka hoʻonui ʻana o ka manaʻo o CPK, ALT, C-reactive protein a me myoglobin hiki. ʻO nā ʻōuli āpau o kahi overdose a me nā loli i nā ʻāpana laboratorium e pau ma hope o ka hoʻokuʻu ʻana o ka lāʻau.
Lāʻau: ka haʻalele ʻana o ka lāʻau mai ke kino ma o ka dialysis ʻaʻole hiki ʻole. Eia naʻe, hiki ke hoʻoneʻe iki i ka hydrolytic metabolite nui o vildagliptin (LAY151) mai ke kino e ka hemodialysis.

Nā kūlana mālama
Ma kahi wahiʻeleʻele i kahi mahana o kaʻoki ʻole eʻoi aʻe ma mua o 25 ° C.