ʻO nā papa Vipidia - nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana a me nā lāʻau lapaʻau like

ʻO ke ʻano nui o ka hoʻokuʻu ʻana o Vipidia i nā papa i ʻoni ʻia i nā kiʻiʻoniʻoni: biconvex, oval, 12,5 mg kēlā me kēia - ʻoniʻoni, ma ka ʻaoʻao hoʻokahi i kākau ʻia i ka hoʻopili me nā hua palapala "ALG-12.5" a me "TAK", 25 mg kēlā me kēia - mūula ʻōuli, ma luna o ʻO "ALG-25" a me "TAK" e leka ana i ka inika ma kekahi ʻaoʻao (7 i nā blisters, 4 blisters ma kahi pahu pahu).

ʻO ka ʻōmole o 1 papa:

• mea kūlohelohe: alogliptin - 12.5 a i 25 mg (alogliptin benzoate - 17 a 34 mg),
• ʻO nā mea kōkua (12.5 / 25 mg): mannitol - 96.7 / 79.7 mg, magnesium stearate - 1,8 / 1.8 mg, sodium croscarmellose - 7.5 / 7.5 mg, cellulose microcrystalline - 22 5 / 22.5 mg, hyprolose - 4.5 / 4.5 mg,
• uhiahi kiʻi ʻoniʻoni: hypromellose 2910 - 5.34 mg, hina waʻahe oxide ʻeleʻele - 0,06 mg, titanium dioxide - 0.6 mg, macrogol 8000 - i ka nui trace, ke aniani hina F1 (shellac - 26%, ʻele hao kahe puaʻa i ka pōʻeleʻele - 10%, ethanol - 26%, butanol - 38%) - i loko o ka nui o nā wahi.

Lapaʻau lāʻau

ʻO Alogliptin kahi mea mālama paʻa maikaʻi loa DPP (dipeptidyl peptidase) -4 hana ikaika. ʻO kona koho no DPP-4 ma kahi o 10,000 mau manawa nui aʻe ma mua o kona hopena ma nā polokalamu ʻē aʻe e pili ana, ma ka DPP-8 a me DPP-9. ʻO DPP-4 ka enzyme nui i hoʻopili ʻia i ka luku wikiwiki ʻana i nā hormones e pili ana i ka ʻohana incretin: ka glucose-hilinaʻi i hoʻopaʻa ʻia ka insulinotropic (HIP) a me ka poniide-like peptide-1 (HIP-1). Hoʻokumu ʻia nā huaʻehā o ka ʻohana incretin i loko o ka ʻōpū, a me ka hoʻonui ʻana aʻe i ko lākou mākaukau pili pili i ka ʻaina meaʻai. Hoʻolālā ʻo HIP a me GLP-1 i ka synthesis o ka insulin a me kāna hana ʻana e nā polokalamu beta i hoʻopaʻa ʻia i ka pancreas. Hoʻopiki hoʻi ka GLP-1 i ka hana hana o ka glucagon a pale i nā synt glucose synthesis.

No kēia kumu, ʻaʻole nui ka alogliptin e hoʻonui i nā kiko o ka incretins, akā e hoʻomaikaʻi nō hoʻi i ke ʻano o ka glucose o ka glucose, a me ka pale i ka huna ʻana o ka glucoseagon me ka nui o ka glucose i loko o ke koko. I ka poʻe maʻi me ka maʻi type type 2 i hele pū me ka hyperglycemia, kēia mau hoʻololi i ka synthesis o glucagon a me ka insulin e hoʻemi i ka kaohi ʻana o ka neʻe o ka hemoglobin glycated HbA_{1c hoowela} a me kahi haʻahaʻa o ka pae o ka glucose i loko o ke koko koko i ka wā e lawe ʻia ai ma kahi ʻōpū ʻole, a me ka kukuna o ka glucose postprandial.

Lapaʻau lāʻau

ʻO nā pharmacokinetics o alogliptin e like me nā poʻe olakino a me nā mea maʻi me ka maʻi mellitus type 2. ʻO ka bioavailability piha o ka mea hana e like me 100%. ʻO ka lawelawe like o ka alogliptin me ka meaʻai me nā mea momona i nā manaʻo kiʻekiʻe, ʻaʻole ia e hoʻopiʻi i ka wahi ma lalo o ka pīpī o ka manawa-a (AUC), no laila hiki ke lawe ʻia ʻo Vipidia i kēlā me kēia manawa, me ka manaʻo o ka kōʻai ʻana o ka meaʻai.

ʻO ka hoʻoponopono waha waha hoʻokahi o alogliptin i loko o kahi maʻa o 800 mg e nā poʻe olakino e alakaʻi i ka wikiwiki o ka hoʻohana ʻana i ka lāʻau, ka mea e loaʻa ai ka nui o ka pae kiʻekiʻe ma hope o nā hola 1-2 mai ka manawa o ka hoʻokele. Ma hope o ka hoʻomau ʻana i ka lawelawe ʻana, ʻaʻole i ʻike ʻia nā kulu nui o ka alogliptin i nā mea maʻi me ka maʻi diabetes mellitus type 2 a i nā mea hana olakino maikaʻi.

Hōʻike ka AUC o ke alogliptin i ka hilinaʻi ʻana i ka proportional kūlia i ka nui o ka lāʻau, e hoʻonui ana me hoʻokahi paena o Vipidia ma ke ʻano lapaʻau hopena ʻo 6.25-100 mg. He loli iki ka loli o kēia ʻano o kēia kaila pharmacokinetic ma waena o nā maʻi e like me 17%.

Me ka wai hoʻokahi o ka AUC (0-inf), hoʻohālikelike ʻo alogliptin iā AUC (0-24) ma hope o ka loaʻa ʻana o ia ka wai he 1 manawa i ka lā no 6 mau lā. Hōʻike kēia i ka nele o ka manawa hilinaʻi i ka pharmacokinetics o ka lāʻau ma hope o ka hoʻoiho hou ʻana.

Ma hope o kahi ka hoʻokele kū hoʻokahi i ka waiwai Vipidia ma ke ʻano o 12.5 mg i loko o nā limahana olakino, ʻo ka hoʻonui ʻana i ke kīpuni ma ka pae ʻeka he 417 l, e hōʻike ana i ka hoʻohele maikaʻi ʻana o alogliptin i loko o nā kiko. ʻO ka nui o ka pilina o nā protein plasma e pili ana i ka 20-30%.

ʻAʻohe o Alogliptin i loko o nā hana i loko o ka hana o ka metabolism ikaika, no laila, 60-70% o nā mea i loaʻa i loko o ka hopena i lawe ʻia e excreted i hoʻololi ʻia i loko o ka urine.

Me ka hoʻomaka ʻana o ka alogliptin 14 C-inoa i loko, ua hōʻoia ʻia ka loaʻa ʻana o nā metabolitori ʻelua: N-demethylated alogliptin, M-I (emi iho ma ka 1% o ka waihona hoʻomaka) a me nā alogliptin N-acetylated, M-II (ua emi mai ka 6% o ka waihona hoʻomaka). He M-I ka hana hiʻona ikaika e hōʻike ana i nā waiwai pale selective maikaʻi loa i ka DPP-4, like like me ka hana i ka alogliptin. No ka M-II, ʻo ka hana i pale aku i ka DPP-4 a i ʻole nā ​​mea ʻē aʻe o DPP ʻaʻole i hōʻike.

I nā haʻawina vitro hōʻoia e pili ana i ka CYP3A4 a me CYP2D6 i ka liʻiliʻi o ka metabolism o ka alogliptin. Hōʻike nō kā lākou hopena ma ke ʻano ikaika o Vipidia, ʻaʻole ia he mea kōkua o CYP2B6, CYP2C9, CYP1A2 a me kahi mea paʻa o CYP3A4, CYP1A2, CYP2D6, CYP2B6, CYP2C19, CYP2C8 a i ʻole CYP2C9 i loko o ke kūleʻa i ke kūleʻa e kūleʻa i ka pehu e kū. Aia i lalo i nā kūlana vitro, alogliptin e lohi iki paha i ka CYP3A4, akā i lalo o nā kūlana vivo, ʻaʻole i ʻike ʻia kona mau waiwai a me ka mahalo i kēia isoenzyme.

I ke kino o ke kanaka, ʻo ka alogliptin ʻaʻole ia he pale o nā mea lawe i waho o nā mea hoʻokalakupua o nā mea hoʻomohala kūlohelohe o nā ʻano lua a me nā mea lawe aku i nā mea hou o nā anions o nā ʻano mua a ʻekolu.

Ke ola nui nei ʻo Alogliptin ma ke ʻano o (R) -enantiomer (ʻoi aku ma mua o 99%) a i loko o nā wahi liʻiliʻi a ma ka vivo a i ʻole a pau i ke komo ʻana i nā hana o ka hoʻololi chiral i loko o (S) -enantiomer. ʻAʻole hoʻoholo ʻia ka mea hope i ka wā e lawe ai ʻo Vipidia i nā pōkole therapeutic.

Me ka hoʻokūkū waha o ka alogliptin 14 C-hōʻailona, ​​ua hōʻoia ʻia ka 76% o ka nui i lawe ʻia ma ka urine, a me 13% me nā feces. ʻO ka hoʻomaʻemaʻe kino ākea o ka waiwai ʻo 170 ml / min a ua ʻoi aku ia ma waena o ka kānana kānana glomerular awelika o ka nui o 120 l / min, kahi e ʻae ai i kahi wehe o ke alogliptin ma o ka hana exal a renal. I ka awelika, ʻo ka hapalua mau hapa o ka mea hana o Vipidia ma kahi o 21 mau hola.

I ka poʻe maʻi e hōʻeha nei i ka hana ʻole ʻana o ka pilikia ʻole o ka ʻano like ʻole o ka hoʻoweliweli ʻana, ua hana ʻia kahi haʻawina o nā hopena o ka alogliptin i ka wā i lawe ʻia i loko o kēlā me kēia lā o 50 mg. Ua helu ʻia nā poʻe maʻi i loko o ka noiʻi i ʻehā mau pūʻulu e like me ke ʻano ʻo Cockcroft - Gault formula, e pili ana i ka nui o ke aloha ʻole a me ka QC (clearanine hana), e loaʻa ai nā hopena aʻe nei:

• Kāpau I (malia pale kūleʻa, CC 50-80 ml / min): hoʻonui ʻia ʻo AUC o alogliptin e pili ana i 1,7 mau manawa hoʻohālikelike ʻia me ka hui pū. Eia nō naʻe, ua kū ka hoʻonui o AUC nei i loko o ka hoʻomanawanui no ka hui kaohi,
• ʻElepili II (hōʻeha o ka renal maʻamau, CC 30-50 ml / min): i hoʻonui ʻia ʻo 2 kokoke mau i AUC o alogliptin i hoʻohālikelike ʻia me ka hui pū.
• Aʻu ʻo III a me IV (ʻoi aku ka maikaʻi o ka pale, CC ma lalo o 30 ml / min, a me ka papa hana o ka hopena ʻole ʻana inā he pono, ke ʻano hemodialysis): hoʻonui ʻia ʻo AUC ma kahi o 4 mau manawa i hoʻohālikelike ʻia me ka hui mana. ʻO nā mea maʻi me ka hala ʻole o ka hope o ka renal i komo i ka hana hemodialysis ma hope koke o ka lawe ʻana iā Vipidia. I loko o kahi hola i kahi manawa i hala a ʻekolu hola, e pili ana i ka 7% o ka nui o ka alogliptin e hele i waho o ke kino.

No kēia kumu, ma ka pūʻulu aʻu, ʻaʻohe mea pono o ka hoʻoponopono hoʻoponopono ʻia. I ka poʻe maʻi me ka hiki ʻole o ka renal moderate, i mea e hiki ai i kahi hoʻokama ʻana o ka waiwai hana ma ka plasma koko, kokoke i kēlā i nā mea maʻi me ka hana maʻamau, pono i kahi hoʻoponopono nui o Vipidia. ʻAʻole i hāʻawi ʻia ʻo Alogliptin no ka hana ʻana i ka papahuli o ka renal, a me nā mea maʻi no ka hōʻoki hope ʻana i ka hana hope loa, kū pinepine ma ka hemodialysis.

I nā maʻi me ka hōʻemi haʻalulu maʻalahi, ʻike ʻia ka AUC a me ke koʻo o ka alogliptin kiʻekiʻe e pili ana i ka 10% a me 8%, pākahi, i hoʻohālikelike ʻia me nā mea maʻi me kahi maʻi maʻamau, akā ʻaʻole kēia manaʻo i manaʻo nui ʻia. No laila, ʻaʻole i koi ʻia ka hoʻoponopono ʻana no ka Vipidia no ka maʻi hepatic maʻalahi (5,5 pihi e like me ke ʻano o ke keiki-Pugh). ʻAʻohe data lapaʻau e pili ana i ka hoʻohana ʻana o alogliptin i nā mea maʻi me ka maʻi hepatic koʻikoʻi (ʻoi aku ma mua o 9 mau hola).

ʻO ke kaumaha o ke kino, ʻoi aku ka makahiki (me ke kiʻekiʻe - 65–81 mau makahiki), ka lāhui a me ka wahine o nā mea maʻi ʻaʻole i hopena koʻikoʻi i ka parola o ka pharmacokinetic o ka lāʻau, i.e. ʻaʻohe mea e hoʻoponopono ai i ka inikua. ʻAʻole i aʻo ʻia nā pharmacokinetics o alogliptin i nā maʻi i ʻoi aku ma lalo o ka 18 makahiki o kona mau makahiki.

Nā Hoʻohui

• maʻi diabetes type 1
• hōʻeha kino o ka ate (ʻoi aku ma mua o 9 mau maka ma ke koʻikoʻi o ke keiki-Pugh, ma muli o ka hemahema o ka ʻikepili lapaʻau i ka hopena / palekana o ka hoʻohana ʻana)
• maʻi maʻamau ketoacidosis,
• mau huhū paʻa ʻole (FC NYHA papa III - IV),
• pilikia kaumaha ʻole
• nā makahiki a hiki i ka 18 mau makahiki (ma muli o ka nele o ka ʻikepili i ka hopena / palekana o ka lāʻau i kēia pūʻulu o nā mea maʻi),
• ʻo ka hapai a me ka lactation (ma muli o ka nele o ka ʻike i ka hopena / palekana o ka hoʻohana ʻana iā Vipidia i kēia hui o nā maʻi),
• ka paulele ʻana o kēlā me nā mea i kū i ka Vipidia, ka ʻike anamnestic i nā hopena hypersensitivity koʻikoʻi i kekahi mea hoʻomehana DPP-4, me ka hopena o ka anaphylactic, angioedema a me ka hoʻohui anaphylactic.

ʻO nā maʻi (nā maʻi / nā kūlana e hoʻohana pono ai nā papa Vipidia me ka makaʻala):

• kaumaha nā moʻolelo o ka maʻi pancreatitis,
• hano papaleha maʻi,
• hui pū ʻia me thiazolidinedione a me ka metformin,
• hui pū me ka insulin a i ʻole kahi deria sulfonylurea.

Nā ʻōkuhi no ka hoʻohana ʻana iā Vipidia: ka ʻaea a me ka helu ʻana

Lawe ʻia nā papa Vipidia ma kahi o ka ʻono, ʻo kā lākou ʻawa, ʻai ʻia me ka wai ʻole o ka wai a me ka inu ʻana me ka wai.

ʻO ka paena i ʻōlelo ʻia i kēlā lā i kēia lā he 25 mg i loko o 1 mau mole. ʻO ka lāʻau lapaʻau ka lawe wale ʻana, i hui pū me ka metformin, thiazolidinedione, sulfonylurea derivatives a i ʻole insulin, a i ʻole ka hui pū ʻana ʻekolu me ka metformin, insulin a a thiazolidinedione paha.

Inā haʻalele ʻole ʻoe i kahi pōpoki, pono ʻoe e lawe i ka hiki. Lawe a ʻelua pai i ka lā hoʻokahi.

I ka manawa i kauoha ʻia ai ʻo Vipidia, ma kahi o thiazolidinedione a i ʻole ke metformin, ʻaʻole i loli ko kā lākou noho inika.

No ka hōʻemi i ka hopena o ka hypoglycemia i hui pū ʻia me kahi derivative a sulfonylurea a i ʻole insulin, ʻoi ʻia ke hōʻemi ʻia o kā lākou dosis.

ʻO ka koho ʻana o ka hui pū me ʻekolu me ka thiazolidinedione a me ka metformin e pono ai ke akahele ʻana (e pili ana i ka hopena o ka hypoglycemia, hoʻoponopono ʻia ka hoʻoponopono ʻia o kēia mau lāʻau).

I ka hihia o ka renal ka mea i hoʻolālā ʻia, e pono ai e loiloi i ka hana o nā palupalu ma mua o ka hoʻomaʻamaʻa ʻana, a laila hana ma ka manawa o ka ʻoihana. ʻO ka pāʻālua i kēlā me kēia lā i nā mea maʻi me ka hikiʻole o ka renal moderate (me ka hana ʻana ma creatinine mai ≥ 30 a ≤ 50 ml / min) ka 12.5 mg. Ma nā hōʻeha koʻikoʻi / kāpili o ka hikiʻole o ka renal, ʻaʻole i kuhikuhi ʻia ʻo Vipidia.

Nā Hōʻikeʻike iā Vipidia

ʻO ka pinepine, aia nā loiloi kūpono e pili ana iā Vipidia ma ke ʻano he lāʻau lapaʻau e hōʻemi i ka hilahila a hoʻopaʻa i kēia helu koko. Hoʻomaopopo nā mea maʻi e hoʻomau ka hopena o ka lāʻau i kahi lā, ʻoiai ʻaʻole e hoʻonui i ka makemake, a me he ʻāpana o ka hoʻohui hypoglycemic therapy, kōkua ia i ka hōʻemi ʻana i ka paona a kāpae i ka hōʻeha o ka wāwae. Eia kekahi, ʻo nā mea maʻi e like me ka ʻoluʻolu o ka hoʻohana ʻana iā Vipidia: hiki ke lawe ʻia i kēlā me kēia manawa o ka lā.

Eia nō naʻe, aia kekahi mau loiloi maikaʻi e pili ana i ka hiki ʻole o ka lāʻau lapaʻau a hiki i ka poʻe intolerance kanaka hiki ke alogliptin.

Hoʻomaʻamaʻa nā poʻe hōʻike kūʻē i ka hana kūpono ʻole o Vipidia no ka hoʻolilo ʻana.

ʻIke ʻike lāʻau lapaʻau

E pili ana kēia mea hana i nā hana hou i loko o ke kahua o ka maʻi diabetes. He kūpono no nā poʻe i ka maʻi o ke ʻano maʻi type 2. Hiki iā Vipidia ke hoʻohana hoʻokahi wale nō a hui pū me nā lāʻau ʻē aʻe o kēia hui.

Pono ʻoe e hoʻomaopopo e hoʻohana ʻole ʻia ka hoʻohana ʻana i kēia lāʻau lapaʻau i ke ʻano o ka mea maʻi, no laila pono ʻoe e hahai pono i nā ʻōlelo a ke kauka. ʻAʻole hiki iā ʻoe ke hoʻohana i ka lāʻau lapaʻau me ke kī ʻole ʻana, ʻoiai inā lawe nā lāʻau lapaʻau.

ʻO ka inoa kālepa no kēia lāʻau lapaʻau ʻo Vipidia. I ka pae honua, ua hoʻohana ka inoa generikʻo Alogliptin, i puka mai i ka hana koʻikoʻi ma ka mana ona.

Hōʻike ʻia ka huahana e nā papa kiʻi ʻoniʻoni oval. Hiki iā lākou ke melemele a i ʻole nā ​​kukuiʻulaʻula (e hilinaʻi ia i ka dosage). ʻO ka pahu pahu ka 28 pcs. - 2 blisters no 14 papa.

Ka hana lāʻau lapaʻau

Kuhi ʻia kēia taputapu ma ka Alogliptin. ʻO kēia kekahi o nā mea hou i hoʻohana ʻia e kāohi ai i nā pae iʻa. Loaʻa ia ia i ka helu o ka hypoglycemic, he ikaika ikaika.

Ke hoʻohana ia, aia ka mahuahua o ka huna ʻana i ka huna glucose i ka wā e hoʻemi ana i ka hana glucagon inā hoʻonui ʻia ka nui o ke koko.

Me ka maʻi type 2, i hele pū ʻia me ka hyperglycemia, ke kōkua nei kēia mau hiʻohiʻona o Vipidia i nā loli maikaʻi e like me:

• ka hoʻemi ʻana o ka nui o ka hemoglobin glycated (НbА1С),
• hoʻohaʻahaʻa i nā pae glucose.

Hoʻohana kēia i kēia mea hana i ka mālama ʻana i ka maʻi diabetes.

Nā hōʻailona a me nā contraindications

Ke hōʻike nei i nā lāʻau ma loko o ka ikaika ikaika e mālama i ka mālama. Pono e mālama ʻia nā ʻōkuhi no lākou, inā ʻaʻole e hoʻopilikia ʻia ke kino o ka mea maʻi. No laila, hiki iā ʻoe ke hoʻohana iā Vipidia wale nō ma ka loiloi ʻana o kahi loea me ka mālama pono ʻana i nā ʻōkuhi.

Aine ʻia ke hāmeʻa no ka hoʻohana me nā maʻi diabetes type 2. Hāʻawi ia i nā hoʻoponopono o ka pae o ka glucose i nā hihia inā ʻaʻole i hoʻohana ʻia ka lāʻau lapaʻau a ʻokoʻa i ka hana kino pono. E hoʻohana pono i ka lāʻau no ka monotherapy. Ua ae ʻia iā ia me kona hoʻohana pū ʻia me nā lāʻau ʻē aʻe e kōkua i ka hoʻohaʻahaʻa haʻahaʻa.

ʻO ka hoʻomaʻamaʻa ʻana i ka wā e hoʻohana ai i kēia lāʻau lapaʻau maʻi mea i ka hiki ʻana mai o nā contraindications. Inā ʻaʻole i lawe ʻia i ka maikaʻi, ʻaʻole e ola ka mālama a mālama ʻia nā pilikia.

ʻAʻole ʻae ʻia ʻo Vipidia i kēia mau hihia:

• ka ʻana ʻole o kekahi kanaka i nā ʻāpana o ka lāʻau lapaʻau,
• maʻi diabetes type 1
• hōʻeha paʻa ka naʻau
• maʻi ate
• hōʻeha maikaʻi o kaʻoki
• hapai a me lactation,
• ka hoʻomohala ʻana o ka ketoacidosis i kumu o ka maʻi maʻi,
• i ka 18 makahiki o ko ka mea maʻi.

ʻO kēia mau hōʻino he contraindications paʻa no ka hoʻohana ʻana.

Aia nō kekahi mau ʻōlelo e kuhikuhi pono ai ka lāʻau lapaʻau.

• lōkohu
• renal ka maʻi paʻakikī.

Eia kekahi, pono e mālama pono i ka mālama ʻana iā Vipidia me nā lāʻau ʻē aʻe e hoʻoponopono ai i nā pae glucose.

Nā hopena hopena

Ke mālama nei me kēia lāʻau lapaʻau, i kekahi mau manawa pōʻino e pili ana i nā hopena o ka lāʻau lapaʻau e hiki mai ana:

• lie kanikela
• nā maʻi ʻōpū moka
• nasopharyngitis,
• ʻeha ka ʻōpū
• pohuo
• ʻili kino ʻili,
• maʻiʻo pancreatitis
• urticaria
• ka hoʻomohala ʻana o ka hana hema ʻana.

Inā hele nā ​​hopena ʻaoʻao, e kamaʻilio i kahi kauka. Inā ʻaʻole lākou i ka hanana hoʻoweliweli i ka olakino maʻi, a ʻaʻole hoʻonui i ko lākou ikaika, hiki ke hoʻomau ʻia ka mālama ʻana me Vipidia. ʻO ke kūlana koʻikoʻi o ka mea maʻi e haʻalele koke i ka lāʻau.

ʻLoe a me ke kākele

Kuhi ʻia kēia lāʻau lapaʻau no ka mālama ʻana i ka waha. Hoʻolilo ʻia ka nui o ka hewa ma muli o kēlā, e like me ka nui o ka maʻi, ka makahiki o ka mea maʻi, nā maʻi concomitant a me nā hiʻohiʻona ʻē aʻe.

I ka awelika, manaʻo e lawe i hoʻokahi papa i loaʻa he 25 mg o ka mea hana ikaika. Ke hoʻohana nei ʻo Vipidia i kahi waihona o 12,5 mg, ka nui o kēlā me kēia lā he 2 papa.

Hoʻomaopopo ʻia e lawe i ka lāʻau lapaʻau i hoʻokahi lā i ka lā. Pono e ʻawaʻawa ʻia nā paʻu ʻole me ka moʻoki ʻole. Manea ʻia e inu iā lākou me ka wai kuke. ʻAe ʻia ka ʻokoʻa ma mua o a ma hope o ka ʻai.

Mai hoʻohana i kahi pālua ʻelua o ka lāʻau lapaʻau inā ʻaʻole i hala kahi hoʻokahi - hiki i kēia ke hōʻeha. Pono ʻoe e lawe i ka maʻi maʻamau o ka lāʻau i ka wā e hiki mai ana.

Nā ʻōlelo kūikawā a me nā hoʻopili olakino

Ke hoʻohana nei i kēia lāʻau lapaʻau, pono ia e noʻonoʻo i kekahi mau hiʻohiʻona e pale ai i nā hopena pōʻino:

1. I ka wā hānau o kahi keiki, ua contraindicated ʻo Vipidia. ʻO ka noiʻi ʻana i ke ʻano o kēia lāʻau e mālama ai i ka maʻi hānau. Akā makemake nā kauka e hoʻohana ʻole ia mea, no laila ʻaʻole e hoʻonāukiuki i kahi kolohe a i ʻole ka hoʻomohala ʻana o nā mea pono ʻole o ka pēpē. Hele no ka hana waiū.
2. ʻAʻole hoʻohana ʻia ka lāʻau lapaʻau e mālama i nā keiki, no ka mea ʻaʻohe kikoʻī pololei i kona hopena i ke kino o nā keiki.
3. ʻAʻole nā ​​kumu o nā kānaka maʻi o ke kumu no ka haʻalele ʻana i ka lāʻau lapaʻau. Akā ke lawe iā Vipidia i kēia hihia e pono ai ka nānā ʻana e nā kauka. ʻO nā mea maʻi i luna o ka makahiki 65 he nui ka piʻi ʻana o ka hoʻomohala ʻana i ka maʻi ʻōpiopio, no laila e koi ʻia ka akahele ʻana ke koho ʻana i kahi ʻano.
4. No nā maʻi hānai liʻiliʻi, kuhikuhi i nā mea maʻi he dosis o 12,5 mg i kēlā me kēia lā.
5. Ma muli o ka hoʻoweliweli o ka hoʻomohala ʻana i ka pancreatitis i ka wā e hoʻohana ai i kēia lāʻau lapaʻau, pono e ʻike nā mea maʻi i nā hōʻailona nui o kēia pathology. Ke kū nei lākou, pono pono ke hooki i ka mālama ʻana me Vipidia.
6. ʻAʻole maikaʻi ka lawe ʻana i ka lāʻau lapaʻau i ka hiki ke kūpaʻa. No laila, i ka wā e hoʻohana ai, hiki iā ʻoe ke hoʻokele i kahi kaʻa a hoʻokomo i nā hana e pono ai ka noʻonoʻo ʻana. Eia naʻe, hiki i ka hypoglycemia ke hōʻeha i nā pilikia ma kēia wahi, no laila e pono ke mālama pono.
7. Hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka hana o ka ate. No laila, ma mua o kāna koho, pono ʻia kahi hoʻokolokolo o kēia kino.
8. Inā Hoʻolālā ʻia ʻo Vipidia e hoʻohana pū me nā lāʻau ʻē aʻe e hoʻohaʻahaʻa i nā kiʻekiʻe o ka glucose, pono ke hoʻoponopono ʻia kā lākou dosis.
9. ʻO kahi hōʻike no ka huli ʻana o ka lāʻau lapaʻau me nā lāʻau ʻē aʻe i hōʻike ʻole i nā loli nui.

Ke lawe ʻia nei kēia mau hiʻohiʻona e hiki i ka mālama ʻana i mea e ʻoi aku ka maikaʻi a me ka palekana.

Nā hana lāʻau

Iā Alogliptin i hua ʻia ka hopena o ka pale o ka huina o kekahi mau kaomi, me ke dipeptidyl peptidase-4. ʻO kēia ka ʻōnaehana nui e pono ai i ka komo wikiwiki wikiwiki loa o ka wana i ke kūlana o kahi glucose-dependantine insulin -ropypic polypeptide. Aia lākou ma ka pākela a ma ka wā ʻaina e hoʻoulu ai i ka hana o ka insulin i ka pancreas.

ʻO ka peptide like-glucone, ma ka huli, e hoʻohaʻahaʻa i nā pae glucoseagon a pale i ka hana o ka glucose i loko o ka ate. Me ka hoʻonui liʻiliʻi a koʻikoʻi paha i ka pae o ka incretins, nā kumu nui o ka lāʻau Vipidia 25, hoʻomaka ka alogliptin e hoʻonui i ka hana o ka insulin a hoʻemi i ka glucagon me ka piʻi ʻana o ka glucose i loko o ke koko. Ke alakaʻi nei kēia mau mea i ka emi ʻana o ka hemoglobin i nā poʻe maʻi e loaʻa nei i ka maʻi diabetes type 2.

Ua ʻae ʻia ka Vipidia 25 a 12,5 mau papa no ka maʻi diabetes no ke kūʻai ʻana ma nā lāʻau lapaʻau ma o ka lāʻau inu ʻana.

Nā hōʻailona no ka hoʻohana ʻana

Hōʻike ʻia ka Vipidia 25 no ka diabetes mellitus i hui pū me nā lāʻau ʻē aʻe e pili ana i ka insulin. ʻO ka lāʻau lapaʻau ka hypoglycemic. lāʻau lapaʻau waha, e hōʻike ʻia ana no ka mālama ʻana o ka mellitus type type 2 i mea e kaohi ai i nā pae o ka glucose i ka ʻole o nā meaʻai a me nā hana kino.

Pākuʻi helu

12.5 mg a me 25 mau papa ʻoniʻoni a 25 mg

Aia ma ka papa papa

mea waiwai: alogliptin benzoate 17 mg (like me ka 12.5 mg o ka alogliptin) a me 34 mg (like me 25 mg o ka alogliptin)

ʻAkuhi: mannitol, microcrystalline cellulose, hydroxypropyl cellulose, sodium croscarmellose, magnesium stearate

ʻO ka hui pū ʻana o ka membrane film: hypromellose 2910, titanium dioxide (E 171), ka hao o ka oxide (E 172), ka ulaula pōpoki hao (E 172), ka polyethylene glycol 8000, ke aniani hina F1

ʻO nā papa bvalvex oval, i kāwili ʻia me ka wīwī kiʻi melemele, i kapa ʻia ʻo "TAK" a me "ALG-12.5" ma kahi ʻaoʻao o ka pākaukau (no kahi pāʻālua o 12,5 mg).

ʻO nā papa bvalvex oval, i uhi ʻia nā kiʻi me kahi ʻulaʻula ulaula, i kapa ʻia ʻo "TAK" a me "ALG-25" ma kahi ʻaoʻao o ka pākaukau (no ke ʻano he 25 mg).

ʻO nā waiwai Pharmacological

Ua aʻo ʻia nā pharmacokinetics o alogliptin i loko o nā haʻawina e pili ana i nā limahana olakino olakino a me nā mea maʻi me ka maʻi diabetes type 2. I nā mea hana olakino olakino, ma hope o ka lawelawe waha hoʻokahi a hiki i 800 mg o ka alogliptin, ʻike pinepine ʻia ka lāʻau i ka hoʻopau ʻana i ka plasma kiʻekiʻe loa i hoʻokahi a ʻelua mau hola mai ka manawa o ka hoʻokele (average Tmax). Ma hope o ka lawe ʻana i ka nui o ka lāʻau therapeutic i hōʻike ʻia i ka lāʻau (25 mg), kahi hapalua o ke ola (T1 / 2) i hōʻea i nā hola he 21.

Ma hope o ka hoʻokele hou ʻana a hiki i 400 mg no 14 mau lā i ka poʻe maʻi me ka maʻi type 2, ua ʻike ʻia ka hōʻemi ʻana o nā alogliptin me ka hoʻonui ʻana o ka wahi ma lalo o ka pāpaʻi pharmacokinetic (AUC) a me ka uʻi nui o ka plasma (Cmax) ma kahi o 34% a me 9%. Me nā pā ʻelua a me ka nui o ka alogliptin, hoʻonui ʻia ka AUC a me Cmax i ka hoʻonui ʻana i ka hoʻonui ʻana i ka maʻi mai 25 mg a 400 mg. ʻO ka coefficient o ka ʻano o ka AUC o alogliptin ma waena o nā mea maʻi e liʻiliʻi (17%).

ʻO ka bioavailability piha o alogliptin e pili ana i ka 100%. Mai ka wā e lawe ai i ka alogliptin me ka meaʻai me ka momona momona kiʻekiʻe, ʻaʻohe hopena i kahi ʻo AUC a me Cmax, hiki ke inu ʻia ka lāʻau lapaʻau ma kahi o ka ʻai.

Ma hope o kahi hoʻomalu alogliptin kū hoʻokahi i kahi pāʻālua o 12.5 mg i nā limahana olakino, ʻo ka hoʻonui ʻana i ke kīpī ma ka pae terminal he 417 L, e hōʻike ana i ka alogliptin ua hoʻolala maikaʻi ʻia i nā kiko.

ʻO ka kamaʻilio me nā protein plasma he 20%.

ʻAʻole i hoʻokomo ʻia ka Alogliptin i ka nui o ka metabolism, ma muli o kahi mai 60% a 71% o nā minala i hoʻopiʻi ʻia ua loli ʻole i loko o ka urine. Ma hope o ka hoʻoponopono waha ʻana o ka alogliptin hōʻailona 14C, ua hoʻoholo ʻia nā ʻelua metabolites liʻiliʻi: N-demethylated alogliptin M-I (˂ emi iho ma ka 1% o ka waihona hoʻomaka) a me N-acetylated alogliptin M-II (˂ emi iho ma 6% o ka mea hoʻomaka). ʻO M-I kahi metabolite ikaika a me ka mea paʻa e hoʻoneʻe ana i ka DPP-4, like i ka hana me alogliptin, ʻaʻole hōʻike M-II i ka hana pale me ka DPP-4 a i ʻole nā ​​mea hou e like me DPP-like. I nā haʻawina vitro i hōʻike ʻia e kōkua ai ka CYP2D6 a me CYP3A4 i ka palena liʻiliʻi o ka metabolism o ka alogliptin. Noho ka Alogliptin ma ke ʻano o ka (R) enantiomer (> ʻoi aku ma mua o ka 99%) a ua hoʻokomo i ka hoʻololi chiral i kahi enantiomer (S) i loko o nā wahi liʻiliʻi i vivo. (S) ʻaʻole ʻike ʻia -enantiomer i ka wā e lawe ai i ka alogliptin i loko o nā wai therapeutic (25 mg).

Ma hope o ka lawe ʻana i ka alogliptin hōʻailona 14C, ʻo 76% o ka huina o ka radioactivity ka mea i hoʻopili ʻia e nā pōpoki a me 13% ma o nā ʻāpana, a hiki i ka hoʻopuka ʻana o 89%

ka hopena radioactive lawelawe. ʻO ka wehe ʻana o Renal i ka alogliptin (9.6 L / h) e hōʻike ana i ka ʻōlelo huna renal tubial. ʻO ka huakaʻi o ka ʻōnaehana he 14.0 l / h.

Pharmacokinetics i loko o nā hui hoʻomanawanui kūikawā: hana i ʻole ke āpau

AUC o ke alogliptin i loko o nā mea maʻi me ka hana ʻole o ka hana laka o ka hōʻeha ʻana (60≤ cleince clearance (CrCl)

Nā hopena hopena

Ma muli o nā hoʻokolohua lapaʻau i mālama ʻia ma lalo o nā ʻano like ʻole, hiki ʻole ke hiki ke hoʻohālikelike pono i nā pinepine o nā hopena ʻino i mālama ʻia i nā hoʻokolohua lapaʻau o nā lāʻau lapaʻau me nā alapine e ʻike ʻia i nā hoʻokolohua hoʻoliʻoliʻi o nā lāʻau ʻē aʻe, a ʻo ia mau ʻano like ʻole e noʻonoʻo mau i ke kūlana o ka hoʻohana ʻana o ka lāʻau ma ka hoʻomaʻamaʻa.

I ka hui pū ʻana o 14 mau hoʻokolohua hoʻokolohua mau ʻia, ʻo ka nui o ka hōʻino o nā hanana ʻino he 73% i nā mea maʻi e loaʻa ana i ka alogliptin 25 mg, 75% i ka hui plasebo, a me 70% i ka hui me nā lāʻau hoʻohālikelike like ʻole. Ma keʻano holoʻokoʻa, ʻo ka loli discontinuation ma muli o nā hopena maikaʻi loa he 6.8% i ka alogliptin hui o 25 mg, 8.4% i ka hui plasebo, a i ʻole 6.2% i ka hui me kahi ʻano hana hoʻohālikelike hou.

Ua hōʻike ʻia nā hōʻike hoʻohālikelike iʻoi aku o ka nui o ka 4% i nā maʻi i loaʻa i alogliptin: nasopharyngitis, headache, nā maʻi ʻeha o ka ʻōpū.

ʻO ka hopena ʻino e hōʻike ʻia nei ma ka pauku Kūlana Kūlana:

- ka hopena ma luna o ka ate

Ua hōʻike ʻia nā hōʻike o hypoglycemia e pili ana i nā helu glucose o ke koko a / a i ʻole a i ʻole a me nā hōʻailona koʻikoʻi a me nā hōʻailona o ka hypoglycemia. Ma kahi hōʻike monotherapy, ʻike ʻia ka ʻike o ka hypoglycemia i 1,5% a me 1.6% o nā maʻi i nā alogliptin a me nā hui pletebo, i kēlā me kēia. ʻO ka hoʻohana ʻana o ka alogliptin e pili ana i ka terapi o glyburide a i ʻole insulin e hoʻonui i ka ulu ʻana o ka hypoglycemia hoʻohālikelike me ka pletebo. Ma kahi noiʻi monotherapy e hoʻohālikelike ai i nā alogliptin me nā sulfonylureas i nā poʻe maʻi maʻi, ʻo ka ulu ʻana o ka hypoglycemia he 5.4% a me 26% i ka hui alogliptin a me nā hui glipizide.

Ua ʻike ʻia nā hopena ʻino e pili ana i ka hoʻohana ʻana o ka alogliptin post-marketing - hypersensitivity (anaphylaxis, edema Quincke, rash, urticaria), nā hopena kino ʻehaʻeha (e pili ana i ka maʻi Stevens-Johnson), hoʻōla i ka ʻohi enema, hōʻōlohi ana i ka ate, hōʻeha a hoʻōla a me ka pancreatitis aʻeha, ka ʻeha, constipation, nausea, a me ka pēpē o ka ʻōpū.

'Oiai i hōʻike pinepine ʻia kēia mau lono ma loko o ka nui o ka hapanui o ka nui o ka hapanui, ʻaʻole hiki ke kūpono ke koho mua i ko lākou' ike, no laila 'ike' ia ka ʻike 'ana me ka maopopo.

Hoʻopili i nā lāʻau lapaʻau

Hoʻopau nui ʻia ka Vipidium e nā keiki a hōʻemi iki wale ia i ka ʻōnaehana cytochrome (CYP) P450. I ke aʻo ʻana o ka noiʻi, ʻaʻohe

ka hoʻopili nui ʻana me nā substrates a i ʻole nā ​​cytochrome inhibitors a i ʻole me nā lāʻau ʻē aʻe e hoʻopili ʻia e nā ʻōpū.

I ka hōʻike vitro hoʻonaninau lāʻau

Ma nā hōʻike vitro e hōʻike ana ʻaʻole alogliptin e koi i ka CYP1A2, CYP2B6, CYP2C9, CYP2C19 a me CYP3A4, a ʻaʻole hoʻi i kāohi i ka CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2A6 a me nā CYP2D6 nui.

Ma ka vivo lāʻau e hoʻoponopono nei i ka loiloi

ʻO ka hopena o ke alogliptin i nā lāʻau lapaʻau'ē aʻe

Ma nā hoʻokolohua lapaʻau, ʻaʻole i hōʻike ʻia ka hopena o ke alogliptin ma luna o ka parekola pharmacokinetic o nā lāʻau e hōʻemi ʻia e CYP isoenzymes a i ʻole i hoʻololi ʻia i hoʻololi ʻole ʻia. Wahi a nā hopena o nā noiʻi pharmacokinetic i wehewehe ʻia, ʻaʻole ʻōlelo ʻia ka hoʻoponopono ʻana o ka maʻi Vipidia ™.

ʻO ka hopena o nā lāʻau lapaʻau ʻē aʻe i ka pharmacokinetics o alogliptin ʻAʻohe mea nui i mālama ʻia i ka nānā ʻana i ka pharmacokinetics i ka wā e hoʻohana ai i ka alogliptin (cYP2C84 (CYP2C8), fluconazole (CYP2C4) (florine Cole) kāmakua.

Ke keu

ʻO ka nui loa o nā alogliptin ka nui o nā hoʻāʻo ma ka maʻi 800 800 i hoʻokahi manawa i loko o nā mea hana olakino a me 400 mg hoʻokahi i ka lā no ka lā 14 no ka poʻe maʻi me ka maʻi diabetes type 2, ʻo ia ka 32 a me 16 mau manawa iʻoi aku ma mua o ka nui o ka therapy therapeutic i loaʻa o 25 mg. ʻAʻole i nānā ʻia kahi pōʻino koʻikoʻi me kēia mau hewa.

Ma ka hihia o ka overdose o Vipidia ™, pono e hoʻoneʻe i ka mea kī ʻole mai ka ʻalā o ka gastrointestinal a hāʻawi i ka hoʻomau maʻi lapaʻau e pono ai, a ʻo ia hoʻi ka hopena lapaʻau. Ma hope o 3 mau hola o ka hemodialysis, e pili ana i ka 7% o ka alogliptin e hiki ke wehe. No laila, ʻo ka hiki ʻole o ka hemodialysis ke hihia o ka overdose ʻaʻole hiki ʻole. ʻAʻohe ʻikepili i ka hoʻopau ʻana o ka alogliptin e ka dialysis peritoneal.

Nā hiʻohiʻona noi

ʻAʻole hoʻohana ʻia ʻo Vipidia e mālama i ka maʻi maʻamau i waena o nā keiki a me nā ʻōpio. ʻAʻole nā ​​ʻōlelo aʻoaʻo no ka hoʻohana ʻana i ka ʻike e pili ana i ka hoʻokele ʻana i nā hoʻokolohua lapaʻau i kēia ʻano maʻi. I kēlā mau kūlana, hoʻohana nā kauka i nā analogues.

No ka mālamaʻana i ka pauku o nā maʻi maʻi maʻi, ua hoʻolaʻa maikaʻi ʻia ka lāʻau lapaʻau. No ka mālamaʻana i ka poʻeʻelemakule, hoʻohana ʻia ka huina o kēlā me kēia lā, pono ʻole e hoʻoponopono ʻia. ʻOiai pono e poina e nā alogliptin, ka mea i komo i loko o ke kino, hiki ke pili i ka hana o nā pepā a me nā pōpilikia.

Hoʻopili pū me nā lāʻau ʻē aʻe

Me ka hoʻomanawanui pili ʻana me Vipidia a me nā lāʻau lapaʻau anti-diabetes, he mea nui ke helu pololei a hoʻoponopono i ka ʻokoʻa e pale ai i ka hoʻomaka ʻana o ka hypoglycemia.

ʻAʻole i hōʻike ʻia nā haʻawina i nā loli o ka hui o alogliptin a me nā mea ʻē aʻe o nā lāʻau lapaʻau maʻi.

Ua ʻike ʻia ka hopena ikaika o ka lāʻau lapaʻau ma ke kino. Ka pāpā ʻia i ka hoʻohana ʻana i ka lāʻau lapaʻau i ka manawa o ka hāpai a hānai i ke keiki no ka hopena maikaʻi ʻole. Ua hōʻike ʻia nā hōʻike noiʻi ʻaʻole i hana ka lāʻau i ka hiamoe a i ʻole ke haunaele, ʻaʻole hiki ke hoʻopilikia i ka makaʻala, a ua ʻae ʻia no ka hoʻohana ʻana e nā mākaʻi.

Hāʻawi mākou i kahi haʻawina i ka poʻe heluhelu o kā mākou pūnaewele!

ʻO ka hoʻomākaukau ʻana i kahi hana like

ʻOiai ʻaʻole loaʻa nā lāʻau e loaʻa i ke ʻano like a me ka hopena. Akā aia kekahi mau lāʻau lapaʻau e like me ke kumukūʻai, akā i hoʻokumu ʻia mai nā mea ikaika e hiki ai ke lawelawe me nā analog o Vipidia.

E pili ana kēia:

1. Januvia. Hoʻomaopopo ʻia kēia lāʻau lapaʻau e hoʻemi i ke kō koko. ʻO ka mea hoʻonāola ka sitagliptin. Ua kuhikuhi ʻia ia ma nā hihia like me Vipidia.
2. Galvus. ^ E Ha yM. Hoʻokumu ʻia ka lāʻau lapaʻau ma Vildagliptin. ʻO kēia ʻano he mea hoʻohālike o Alogliptin a me nā mea like.
3. Janumet. ^ E Ha yM. ʻO kēia kahi hui i hoʻohui pū me ka hopena hypoglycemic. ʻO nā mea nui, ʻo Metformin a me Sitagliptin.

Hiki i nā lāʻau lapaʻau ke hāʻawi aku i nā lāʻau lapaʻau e hoʻololi hou iā Vipidia. No laila, ʻaʻole pono e hūnā mai ke kauka i nā loli lōlō i loko o ke kino e pili ana me kāna hana.

Nā ʻōlelo kūikawā a me nā hoʻopili

ʻAʻole pili ka lāʻau Vipidia i ka hana i pili me ka piʻi nui o ka nānā ʻana, ʻoiai ke kaʻa nei ka kaʻa e ʻae ʻia i ka wā o ka mālama ʻana. Hoʻohana pono me nā lāʻau lapaʻau hypoglycemic ʻē aʻe pale ʻia e ke kauka hele mai, no ka mea, he mea pono e hoʻoponopono i ka regimen mālama a hōʻemi i ka dosage. Hoʻopili kēia i ka hiki i ka hiki ke hoʻomohala i kahi kūlana hypoglycemic.

Ma mua o ka hoʻoluhi ʻana i nā papa i ka poʻe maʻi me ka hana pū ʻole lēwa o ka maʻi, hana ʻia nā haʻawina hou e hoʻoholo ai i ka pane ʻana o ke kino maʻi i lawe ʻia ka lāʻau lapaʻau.

Inā hōʻeha ka hana ʻana o nā ʻelele hoʻoneʻe ʻia ka lāʻau lapaʻau, a kuhikuhi ʻia nā ʻano. Me kahi haʻahaʻa o pathology, ua hoʻemi ʻia ka nui o ka dosage i ka 12.5 mg. ʻO ka papa hana nui, alogliptin hiki ke hoʻonāukiuki i ka pancreatitis hoʻonā, i lawe ʻia i ka hihia o nā maʻi o ka pēpē.

ʻO nā hōʻailona alarming e lilo i ke ʻano o ke kaumaha i loko o ka ʻōpū me ka irradiation ma hope.

Me nā hōʻailona like ʻole, ua kāpae ʻia ka lāʻau lapaʻau.ʻO ke mālama lōʻihi loa me Vipidia e alakaʻi i ka hoʻopiʻi o nā hana, akā, ʻaʻole koi ʻia ka hoʻoponopono hoʻoponopono ʻana me kahi pane maʻamau i ka maʻi.

Kūʻai a me nā hoʻohālikelike

ʻO ka lāʻau Vipidia - ʻo ke kumukūʻai i nā lāʻau lapaʻau ma Moscow hoʻomaka i 800 rubles. ʻO ke kumukūʻai haʻahaʻa ʻokoʻa mai ka 1000 rubles a 1500 rubles.

Nā kuʻuna o ka lāʻau Vipidia: