Nā ʻōkuhi no ka hoʻohana a me nā ʻōlelo a hoʻohana no ke hoʻohana ʻana i ka lāʻau lapaʻau Pepa

ʻO ka lāʻau hypoglycemic Oral mai ka hui biguanide.
Hoʻomākaukau: FORMETIN®
ʻO ka mea ikaika o ka lāʻau lapaʻau: metformin
ATX Encoding: A10BA02
KFG: ʻO ka lāʻau hypoglycemic oral
Ka helu hoʻopaʻa inoa: LSR-003304/07
Ka lā hoʻopaʻa inoa: 10.22.07
Mea ʻai reg. doc .: FARMSTANDART-LEXREDSTVA OJSC

Hoʻokuʻu i ka palapala Formin, pūkaʻi lāʻau a me ka hoʻopili.

Ke keʻokeʻo, nā ʻūhā, nā ʻaoʻao-cylindrical me nā papa me ka bevel a me ka notch.

1 kōpō
metformin hydrochloride
500 mg
-«-
850 mg

Nā mea kūlike: povidone paona molekileka (polyvinylpyrrolidone), sodium croscarmellose, magnesium stearate.

10 kamepiula - nā kīpaha palemona (3) - nā ʻeke pepa.
10 kamepiula - nā papaki blister (6) - nā ʻeke pepa.
10 kamepiula - nā kīpaha palemona (10) - nā ʻeke pepa.

Ke keʻokeʻo nā papa papa ʻaina, ʻuleala, biconvex, me kahi ʻoki ma nā ʻaoʻao ʻelua.

1 kōpō
metformin hydrochloride
1 g

Nā mea kūlike: povidone paona molekileka (polyvinylpyrrolidone), sodium croscarmellose, magnesium stearate.

10 kamepiula - nā kīpaha palemona (3) - nā ʻeke pepa.
10 kamepiula - nā papaki blister (6) - nā ʻeke pepa.
10 kamepiula - nā kīpaha palemona (10) - nā ʻeke pepa.

Kahi ʻia ka wehewehe ʻana o ka lāʻau lapaʻau ma luna o nā kuhikuhi i pili i ka hoʻohana.

ʻO ka hana Pharmacological o formin

ʻO ka lāʻau hypoglycemic Oral mai ka hui biguanide. Hoʻopiʻi ia i ka gluconeogenesis i loko o ka puʻuwai, e hoʻoneʻe i ka kao ʻana o ka glucose mai ka ʻōpū, hoʻomaikaʻi i ka hoʻohana ʻana i peripheral glucose, a hoʻonui hoʻi i ka ʻike ʻana o nā io i ka insulin. ʻAʻole ia e pili i ka hana huna o ka insulin e nā peka pancreatic, ʻaʻole ia e hoʻohewa i ka hopena hypoglycemic.

ʻO nā triglycerides haʻahaʻa, LDL.

Mālama a hoʻoikaika paha i ke kaumaha o ke kino.

Loaʻa ia he hopena fibrinolytic ma muli o ke kaohi ʻana o kahi kaila plasminogen activator inhibitor.

ʻO ka Pharmacokinetics o ka lāʻau.

Ma hope o ka hoʻopale ʻana i ka waha, hoʻohuihui ʻia ka metformin mai ka digestive tract. Bioavailability ma hope o ka lawe ʻana i kahi maʻa maʻamau he 50-60%. Cmax ma hope o ka hoʻokō waha ʻana ma hope o nā hola 2.5.

ʻAʻole hiki ke hoʻopaʻaʻia i nā protein plasma. Hoʻopili ia i nā kuhi salivary, nā mākala, nā puʻuwai, a me nā pūpū.

Hoʻokuʻu ʻia ia i hoʻololi ʻia ma ka urine. T1 / 2 ʻo 1.5-4.5 hola.

ʻO ka dosis a me ke ala o ka hoʻokele lāʻau.

E hoʻonohonoho i kēlā me kēia, ke nānā nei i ke kiʻekiʻe o ka glucose i ke koko.

ʻO ka ma mua mau lā ma mua o 500 mg 1-2 mau manawa / lā a i ʻole 850 mg 1 manawa / lā. Ma hope aku, me ka liʻiliʻi, (1 manawa i kēlā me kēia pule), ke hoʻonui nei ka nui i ka 2-3 g / lā. ʻO ka palena kiʻekiʻe loa o kēlā me kēia lā he 3 g.

Hoʻolako ʻia kahi wai lāʻau maʻamau ma mua o 850 mg i ʻelua mau wai (kakahiaka a me ke ahiahi).

I nā poʻe maʻi maʻi, ʻaʻole pono nā mea hoʻonā o kēlā me kēia lā 1 g.

Ma muli o ka hoʻonui nui o ka acidosis lactic, i ka wā e lawelawe ai i ka metformin i nā poʻe maʻi me ka hōʻehaʻeha o ka metabolic koʻikoʻi, pono e hōʻemi ʻia ka ʻona.

Pono e lawe ʻia nā papa ma waena o a ma hope o ka ʻai ʻana i ke ʻano he nui, me ka nui o nā ʻano wai.

Kuhi ʻia ka lāʻau no ka hoʻohana ʻana i ka lōʻihi.

Ka hopena o ka formin:

Mai ka pūnaehana hana ʻana: nausea, luaʻi, metallic ʻono i loko o ka waha, ka nele ʻana i ka momona, ka ʻōpū ʻana, ka lemela, ka ʻeha o ka ʻōpū.

Ma ka ʻāpana o ka metabolism: loaʻa - lactic acidosis (koi i ka hoʻokuʻu ʻana o ka mālama ʻana), me ka hoʻohana lōʻihi - B12 hypovitaminosis (malabsorption).

Mai ka ʻōnaehana hemopoietic: i kekahi mau hihia - megalemia megaloblastic.

Mai ka pūnaehana endocrine: hypoglycemia (i ka wa i hoʻohana ʻia ai i nā pilala i wai ʻole).

Nā maʻi kūlou: hāpau ka ʻili.

Nā maʻi hoʻohālikelike i ka lāʻau lapaʻau:

- ka maʻi ketoacidosis maʻi, maʻi diabetes precoma, coma,

- Hōʻeha renal,

- hana hewa pāpaʻi hemahema,

- ulia pōpilikia ʻae,

- nā kūlana i hiki ke hāʻawi i ka hoʻomohala ʻana o ka acidosis lactic, ʻo ia puʻuwai a me nā ea ka hoʻonāukiuki, ka mahele o ke ahonui myocardial, ʻoi aku ka ulia o ka cerebrovascular, dehydration, ʻalowa kūlohelohe,

- ka lactic acidosis a me ka mōʻaukala o ia mea,

- nā hana hōʻeha koʻikoʻi a me nā hōʻeha (ma kēia mau hihia, ua hōʻike ʻia ka maʻi insulin),

- e hoʻohana i loko o 2 mau lā ma mua a 2 mau lā ma hope o ka hoʻopaʻa ʻana i nā haʻawina radioisotope a i ʻole x-ray me ka hoʻomaka ʻana o ka iodine-medium medium,

- ka mālamaʻana i kahi pāʻina haʻahaʻa-haʻahaʻa (emi iho ma mua o 1000 cal / lā),

- lactation (umauma),

- Kūpono o nā maʻi o ka lāʻau.

ʻAʻole ia e noi i hoʻohana i ka lāʻau lapaʻau i nā mea maʻi i ʻoi aku ma mua o 60 mau makahiki e hana i ka hana kino kino, ma muli o ka hoʻonui nui o ka acidact lactic.

Nā ʻōlelo kikoʻī kūikawā no ka hoʻohana ʻana i ka formin.

I ka wā o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono nā kiaʻi e nānā pono ai nā māka hana. Ma kahi o 2 mau manawa i ka makahiki, e like me ka nānā ʻana me myalgia, pono ka hoʻoholoʻana o ka lactate ma ka plasma.

Hiki ke hoʻohana i ka Formula i hui pū me ka derony o ka sulfonylurea a i ʻole i ka insulin, a pono e nānā pono ʻia ka nui o ka nui o ke kō o ka wai.

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

I ka manawa e hoʻohana ai i ka monotherapy, ʻaʻole pili ka lāʻau i ka hiki ke hoʻokau i nā kaʻa a hana me nā mīkini.

Me ka hui pū ʻana o Formetin me nā lāʻau lapaʻau hypoglycemic ʻē aʻe (sulfonylurea derivatives, insulin), ulu paha nā kūlana hypoglycemic kahi e hiki ai i ka hoʻokuke aku i nā kaʻa a me nā hana ʻē aʻe e pili kino ana e koi ai ka makaʻala a me ka wikiwiki o ka hopena psychomotor.

ʻO ka pane ʻana o ka lāʻau.

Nā hōʻailona hōʻailona: e ulu paha nā momona lactic acidosis. ʻO ke kumu o ka hoʻomohala ʻana o ka acidosis lactic hiki ke lilo i ka hoʻohui ʻia o ka lāʻau ma muli o ka hana renal impaired. ʻO nā hōʻailona mua o ka lactic acidosis ka nāwaliwali laulā, nilo, ka luaʻi, ka maʻi ʻana, ka hoʻohaʻahaʻa i ke ʻano kino, ke ʻeha o ka naʻau, ka ʻeha o ka naʻau, ke hoʻohaʻahaʻa ʻana i ke koko, ka bradycardia reflex, i ka wā e hiki mai ana ka hoʻonui ʻana i ka hanu, ka ʻōpū, ka ʻike ʻole a hoʻomohala ʻia.

ʻO ka hoʻōla: inā loaʻa nā hōʻailona o ka lactic acidosis, pono e hoʻokaʻawale ke mālama me ka metformin, pono e hoʻomā koke ʻia ka mea maʻi a me ka hoʻoholo ʻana i ke kūpaʻa o ka lactate, e hōʻoia i ka maʻi maʻi. He maikaʻi loa ka Hemodialysis e lawe i ka lactate a me ka metformin mai ke kino. Inā pono, e hana i ka therapy hōʻailona.

Hoʻopili ka formin me nā lāʻau lapaʻau ʻē aʻe.

Me ka hoʻohana like ʻana me nā derivatives o sulfonylurea, acarbose, insulin, NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide a me beta-blockers, hiki ke hoʻonui i ka hopena hypoglycemic o metformin.

Me ka hana like me ka GCS, waha i ka maʻi kūlohelohe, epinephrine (adrenaline), sympathomimetics, glucagon, hormone thyroid, thiazide a me ka "loop" diuretics, derivatives phenothiazine a me ka hoʻonanea nicotinic, he hōʻemi i ka hopena hypoglycemic o ka metformin.

Hoʻololi ʻo Cimetidine i ka hoʻopauʻana o ka metformin, ma muli o ka hopena i hoʻonui ʻia ai ka acidosis lactic.

Hiki i ka metformin ke nawaliwali i ka hopena o nā anticoagulants (derivatives Coumarin).

Me ka hoʻokūkū pinepine me ka ethanol, hiki ke hoʻomohala ʻia ka hoʻomohala lactic acidosis.

Me ka hoʻohana like ʻana o ka nifedipine i hoʻonui i ka hoʻopili ʻana o ka metformin a me Cmax, e hoʻolōʻihi ana i ka excretion.

ʻO nā lāʻau lapaʻau cationic (amlodipine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin) i hūnā ʻia i loko o nā ʻōpū e hoʻohālikelike ana i nā ʻōnaehana o ka tubular a, me ka hoʻomanawanui lōʻihi, hiki ke hoʻonui i ka Cmax i ka lāʻau lapaʻau ma o 60%.

ʻO ka ʻike nui, ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

ʻO ka Formin (ʻike i ke kiʻi) he lāʻau lapaʻau hypoglycemic. ʻO ka lāʻau lāʻau he ʻāpana o ka pūʻulu biguanide, no laila ke hoʻohana ʻia i ka mālama ʻana o ka maʻi maʻi type 2.

E like me nā hoʻomākaukau āpau o ka pūʻulu biguanide, he ʻano hana ia o Formmetin - Metformin hydrochloride. ʻO kona nui he 0.5, 0.85 a i ʻole 1 g.

• sodium polio
• magnesium stearate i hoʻohana ʻia i loko o kahi lāʻau lapaʻau,
• povidone kaumaha moleleka māmā (polyvinylpyrrolidone).

Loaʻa ka lāʻau lapaʻau i nā papa, ke ʻano e kaukaʻi ʻia ma ka ʻaha.

• 0,5 g kaʻe,
• oval biconvex (0.85 a me 1 g).

Kuhi ʻia nā papa i ke kāwele pepa, kēlā me kēia me ka 30, 60 a i ʻole 100 mau ʻāpana.

Pharmacology a me ka pharmacokinetics

ʻO ka huaʻōlelo ʻo "Formin" pili i ke kino e like me kēia:

• hoʻolohi i ke kaʻina o ka gluconeogenesis ma loko o ka puʻuwai,
• hoʻemi i ka nui o nā glucose i lawe ʻia e ka mau loko,
• hoʻonui i ka hoʻohana ʻana i peripheral i ka glucose i loaʻa i ke koko,
• alakaʻi i kahi hoʻonui i ka naʻau o ka naʻau i ka insulin,
• ʻaʻole i alakaʻi i ka kūkuluʻana o ka hypoglycemia,
• lowly triglycerides a me LDL
• hoʻohaʻahaʻa a hōʻemi paha i ke kaumaha
• Kōkua i ka hoʻopau ʻana i nā kaha koko.

Hāʻawi ʻia ka hana pharmacological i nā hiʻohiʻona o ka hoʻololi ʻana, ka hoʻolilo a me ka hoʻopā ʻana o nā mea nui.

1. Kapehu. Hoʻopili ʻia ka mea ikaika o ka lāʻau i ka paia o ka pā ʻo gastrointestinal ma hope o ka lawe ʻana i ka paila. ʻO ka bioavailability o kahi kaila maʻamau mai 50% a 60%. ʻO ka kiʻekiʻe loa o ka lāʻau lapaʻau ke hoʻonohonoho ʻia i nā hola 2.5 ma hope o ka hoʻokele ʻana.
2. Kahele. ʻAʻole paʻa nā ʻāpana o ka lāʻau i ka pilina me nā protein plasma.
3. Leʻaleʻa. Hoʻololi ʻia ka ʻano o nā māhele o ka lāʻau lapaʻau. Nā mea hana i hoʻopio ʻia i ka urine. ʻO ka manawa pono no ka hapalua o ke ola o ka lāʻau lapaʻau mai 1.5 a 4,5 hola.

I ka hihia ke hōʻiliʻili nā mea o ka lāʻau i ke kino, pono ʻoe e ʻike i ka mea e hiki mai ai mai ia. ʻO ka pinepine loa, ʻo ke kumu ke waiho nei i kahi hana renal impaired.

Nā hōʻailona a me nā contraindications

Pono ke ʻano o ka lāʻau lapaʻau i nā pilikia aʻe:

• me ka momona nui a me ke kaumaha paha, i ka wā e ʻai ʻole ai ka meaʻai,
• me ke ʻano maʻi maʻi lua.

ʻAʻole pono ke hoʻohana "Formine" i nā mea momona maoli, ʻoiai ka mea i hāʻawi maoli ʻia ka lāʻau i kona nalowale. He hana maikaʻi ka mālama ʻana i nā pilima e hui pū me ka hoʻohuihui insulin i nā mea maʻi me ka momona koʻikoʻi, ka mea i hui pū ʻia e ka pale kū kino i ka hormone.

ʻO nā hihia i ka wā e lawe ai i ka lāʻau lapaʻau ua contraindicated:

• ketoacidosis
• coma a precoma ma muli o ke maʻi maʻi,
• nā loli helehelena ma ke akea a me nā puʻuwai,
• nā kūlana e alakaʻi i ka hoʻomohalaʻana i ka acidosis lactic, ʻo ia hoʻi me ka hoʻopiʻi ʻana i ka naʻau, nā hoʻololi i ke kahe koko cerebral, ka hopena o ka hala o myocardial infarction, ka maʻi alakaʻi kūhā, ka dehydration,
• nā make wai huakino
• maʻi nui o nā maʻi lēpa,
• hoʻōki kūloko
• nā hōʻeha
• x-ray, ka mea e hoʻopuka ai i nā mea hoʻohālikelike kūikawā (2 mau lā ma mua a ma hope iho).
• ka mālama ʻana i kahi meaʻai e hiki ai i ke kaona i loko o ka papa ʻai i kēlā me kēia lā i ʻoi aku ma mua o 1000 mau kalo
• ka umauma, me ka hoʻomaka ʻana o ka hāpai ʻana,
• hypersensitivity i nā ʻāpana o ka lāʻau.

Nā ʻōkuhi no ka hoʻohana

Hoʻohana ʻia kahi koho dosage e ka kauka nāna i kau i nā ʻano pono āpau o ka mea maʻi a me ke ʻano o ka maʻi maʻi. Hoʻomaopopo nā ʻōkuhi i ka dosis i aʻo ʻia ma ka hoʻohana mua. Hiki iā ia mai 500 a 1000 mg i ka lā.

Pono ka hoʻoponopono o ka maʻi maʻamau ma mua o 15 mau lā ma hope o ka paila mua. Eia kekahi, pono e koho i ke kumuhana o ka mana glycemic. ʻAʻole hiki ke kiʻekiʻe o ka lā ma kēlā me kēia lā ma mua o 3000 mg. I ka hapa nui, pono ka mālama mālama ʻia e lawe i ka 1500-2000 mg / lā. Pono nā mea maʻi o ka wā kahiko e lawe aku ma mua o 1 g o ka mea ikaika.

Pono e ʻawaʻawa nā papa ma hope o ka papaʻaina. Noiia ke kumu i kauia ai e ke kauka ke kaawale, a lawe i ka laau lapaau i papalua i kekahi la. Hōʻalo kēia i ka hopena o nā hopena e pili ana i ka hoʻowalewale ʻana.

Nā wikiō mai Kauka Malysheva e pili ana i ka Metformin a me nā lāʻau lapaʻau e pili ana iā ia:

ʻO nā maʻi kūikawā

Hoʻomaopopo ʻia ka lāʻau lapaʻau no ka hoʻohana ʻana no nā maʻi āpau.

ʻO ka huaʻōlelo kēia o nā maʻi i hoʻokomo pū ʻia i kahi hui kūikawā:

1. Nā makuahine hāpai a me lactating. Ua hōʻike ʻia nā hoʻokolohua hiki i nā māhele o ka lāʻau lapaʻau ke loaʻa he hopena maikaʻi loa i nā keiki ma ka ʻōpū a ma hope o ka hānau ʻana.
2. ʻO nā maʻi me ka maʻi pūpū. Ua hoʻohālikelike lākou i ka lāʻau lapaʻau lāʻau.
3. ʻO ka maʻi me ka hana renal impaired. Me nā loli pathological koʻikoʻi, ʻaʻole pāpā i ka hoʻohana ʻana i kahi lāʻau lapaʻau. I nā kūlana'ē aʻe, hiki i ka lāʻau lapaʻau me kēia lāʻau lapaʻau, akā ma lalo o ka mālama pinepine ʻana o nā hōʻailona hana organ.
4. ʻO nā maʻi maʻi. Aia ka ola o ka lactic acidosis ma nā kānaka ma luna o 60 e hana mau nei i nā hana kino koʻikoʻi.

Nā ʻōlelo kikoʻī

ʻO ka hopena me ka lāʻau lapaʻau kekahi mau hiʻohiʻona:

1. Pono ka poʻe maʻi e nānā pono i ka hana o nā keiki. ʻO ka pinepine o kēlā me ka nānā ʻana i nā manawa 2 i kēlā me kēia makahiki. ʻO kēia ma muli o ka loaʻaʻana o nā ʻāpana o "Formin" i hōʻiliʻili i loko o ke kino no ka pilikia o ka hana ʻana o kēia ʻōpala.
2. Inā hele i ka myalgia, ua ʻōlelo ʻia e nānā i ka pae o ka lactate plasma.
3. ʻO ka hoʻohana ʻana o "Formmetin" i hui pū me ka derogative sulfonylurea e pono ai ka mana o ka glycemia.
4. Hoʻonui ka pilikia o ka hypoglycemia i ka wā e hoʻohana ʻia ai kēia mau papa me nā lāʻau ʻē aʻe e hiki ai ke hoʻohaʻahaʻa i nā pae gula. ʻOi loa kēia kūlana i ka wā o ka lawe ʻana a hana paha i kekahi hana e pili ana i ka wikiwiki wikiwiki.
5. I mea e pale ai i ka acidosis lactic i nā mea maʻi me ka lapalapa metabolic, pono hoʻomaka ka lāʻau me nā hōʻemi e hoʻemi ʻia.

Nā hopena ʻaoʻao a me ka overdose

Hōʻike nā loiloi o ka maʻi maʻi me ka "Formmetin" i hele pū me ka ulu ʻana o kekahi mau hopena maikaʻiʻole:

1. E pili ana i ka ʻalo ʻana - ka nausea, ka ʻono o ka metala i loko o ka waha, aʻiʻiʻi, hōʻoki ʻia i ka momona, ʻeha i loko o ka ʻōpū, huhū.
2. Lactic acidosis ʻikea. Pono kēia ʻano i ka hoʻokuʻu ʻana o nā lāʻau ma muli o ka hopena o ka make.
3. Hoʻokumu ka hypovitaminosis.
4. E kūlohelohe ana ka lolooblastic.
5. Hoʻokumu ka hypoglycemia.
6. ʻIke ʻia kahi ʻano pelu.

Me kahi overdose o ka lāʻau, ulu ka lactic acidosis. I loko o ia mau kūlana, e wikiwiki loa ke ho'ōki i ka maʻi, a hoʻomanawanui ʻia ka mea maʻi i ka haukapila. I kahi kahua o nā halemai, ke hoʻoholo nei ka ʻike ʻana o ka lactate i mea e hōʻoia ai a hōʻoia paha i ka maʻi maʻi. Hoʻohana pono ka hoʻohana ʻana o hemodialysis i nā hapa nui loa no ka ʻokiʻoki i ka lactate a me ka metformin.

Nā Kūleʻa Kūʻai a me nā Analog

Hoʻohui ʻia ka hopena hypoglycemic e nā ʻĀlelo hou:

• inikua insulin
• ʻO ACE inhibitors, MAO,
• Acarbose
• Hoopaoh
• mau pōʻai beta
• ololilurea derivatives.

Ke emi nei ka uluʻana mai nā lāʻau lapaʻau aʻe:

• GKS,
• hoʻohālikelike
• adrenaline
• Kiora
• nā lāʻau lapaʻau i hoʻohana ʻia i loko o nā ala o ke kauā thyroid.
• haluluHalakalaha
• ka honu o nā phenothiazine, a me ka waikika nikotinik.

Hoʻonui ka hopena o ka acidosis lactic mai ka lawe ʻana i ka lāʻau lapaʻau "Cimetidine", ethanol.

Ke hōʻike nei ke kūʻai aku i ka lāʻau lapaʻau i nā lāʻau like ʻole i ke kō.Hiki ke hoʻohana ʻia kekahi o lākou e lilo i mau mea hou no ka hoʻomākaukau “Formula” ma muli o ka hiki ʻana o ke metformin hydrochloride i kā lākou mea haku.

Manaʻo manaʻo

Mai nā loiloi ʻana o ka maʻi maʻi e pili ana i ka lāʻau Formmetin, hiki iā mākou ke hoʻoholo i ʻaʻole pono nā lāʻau i nā mea āpau, no laila, ma mua o ka hoʻohana ʻana, kauoha ʻia ke kūkākūkā me ke kauka.

He 66 makahiki o wau i ka wā i ʻike ʻia ai ke kō kiʻekiʻe. Hoʻomaopopo koke ke kauka ʻana i ka lawe ʻana iā Formmetin. Ua ʻoluʻolu nā hopena. 2 mau makahiki o ka mālama ʻana, mālama ʻia ke kō i loko o 7.5 mmol / L. He mea ʻoluʻolu loa ia i hoʻokō ʻia e kāohi iā mākou i ke aniani o 11 mau hola, a nalo hoʻi ka pū maloʻo.

No kekahi mau mahina i koho ai au i ka lāʻau lapaʻau e hoʻomaʻamaʻa i ke kō. Ua loaʻa i ka maʻi diabetes i nā mahina he 5 i hala aku nei, akā no ka mahalo wale nō i nā papa formin hiki iā ia ke hoʻokokoke pono i nā loina gula maʻamau. Loaʻa wau iā lākou me Siofor. ʻAʻole like me nā lāʻau ʻē aʻe me kēia lāʻau lapaʻau, ʻaʻohe pilikia o ka hoʻāʻo ʻana. I nā poʻe āpau ʻaʻole i ʻohi i ka lāʻau, ke noi aku nei wau e hoʻāʻo.

Heluhelu au i nā loiloi ʻē aʻe a pīhoihoi au i ka kūleʻa o kekahi. ʻO wau iho i lawe i kēia lāʻau lapaʻau ma ka koi ʻana o ke kauka. Ma mua o kona inu ʻana i ka Metformin Teva, ʻaʻohe mea pilikia. A me ka loli ʻana o Formetin i 3 mau lā, ua ʻike au i nā hopena āpau i kēia manawa. Ua maʻi ʻole wau, ʻuhane ʻole, ʻike wau i ka nāwaliwali weliweli, a ke walahe nei au no ka mea ʻē aʻe. ʻAʻole pono ka lā o kēia lāʻau lapaʻau ma hope o 60 mau makahiki, akā ʻaʻole naʻe i hōʻike mai iaʻu. Kākau i nā manaʻo.

ʻO ke kumu kūʻai o 60 mau papa o ka formin i hilinaʻi i ka dosis. Hiki iā 200 mau rubles.