Glucovans: litaelo tsa tšebeliso

Letlapa le 1 le koahetsoeng ka filimi le na le:

Tekanyetso ea 2,5 mg + 500 mg:

Lintho tse sebetsang: glibenclamide - 2,5 mg, metformin hydrochloride - 500 mg.

Core: croscarmellose sodium - 14.0 mg, povidone K 30 - 20,0 mg, selulosi

microcrystalline - 56,5 mg, magnesium stearate - 7.0 mg.

Shell: opadry OY-L-24808 pinki - 12.0 mg: lactose monohydrate - 36.0%,

15cP hypromellose - 28.0%, titanium dioxide - 24.39%, macrogol - 10.00%, oxide oxide - 1,30%, oxide e khubelu ea tšepe - 0,3%, oxide e ntšo ea tšepe - 0,010%, metsi a hloekisitsoeng. - qs

Tekanyo ea 5 mg + 500 mg:

Lintho tse sebetsang: glibenclamide - 5 mg, metformin hydrochloride - 500 mg.

Nyutlelie: croscarmellose sodium - 14.0 mg, povidone K 30 - 20,0 mg, microcrystalline cellulose - 54.0 mg, magnesium stearate - 7.0 mg.

Shell: Opadry 31-F-22700 e mosehla - 12,0 mg: lactose monohydrate - 36.0%, hypromellose 15 cP - 28.0%, titanium dioxide - 20.42%, macrogol - 10.00%, dae quinoline e mosehla - 3.00%, tshehla oxide e putsoa - 2.50%, e khubelu oxide e khubelu - 0,08%, metsi a hloekisitsoeng - qs.

Tekanyetso ea 2,5 mg + 500 mg: matlapa a biconvex a bopehileng joaloka setšoantšo, a koahetsoe ka 'mala o bobebe oa lamunu, a ngotsoe ka "2,5" ka lehlakoreng le le leng.

Tekanyetso ea 5 mg + 500 mg: matlapa a koahetsoeng ke biconvex e nang le koae
khetla e mosehla, e ngotsoeng ka "5" ka lehlakoreng le leng.

Ketso ea pharmacological

Glucovans® ke motsoako o tsitsitseng oa li-agent tse peli tsa molomo tsa hypoglycemic tsa lihlopha tse fapaneng tsa pharmacological: metformin le glibenclamide.

Metformin ke ea sehlopha sa "greatuanides" 'me e fokotsa litaba tsa glucose ea basal le ea postprandial ka plasma ea mali. Metformin ha e hlohlelle secretion ea insulin ka hona ha e bake hypoglycemia. E na le mekhoa e 3 ea ts'ebetso:

- E fokotsa tlhahiso ea tsoekere ka sebete ka ho thibela gluconeogeneis le glycogenolysis,

- e eketsa kutloisiso ea li-receptor tsa peripheral ho insulin, ts'ebeliso le ts'ebeliso ea tsoekere ke lisele tse mesifeng,

- e liehisa ho kenngoa ha tsoekere maling ka mpeng.

Metformin le glibenclamide li na le mekhoa e fapaneng ea ts'ebetso, empa ka bobeli li tlatsana mesebetsing ea hypoglycemic. Ho kopana ha li-agents tse peli tsa hypoglycemic ho na le phello ea synergistic ho fokotsa tsoekere.

Mofumahali

Glibenclamide. Ha ho nkuoa ka molomo, ho amoheloa ka har'a pampitšana ea ka mpeng ho feta 95%. Glibenclamide, e leng karolo ea lithethefatsi Glucovans® e entsoe ka micron. Khokahano ea tlhoro ea plasma e fihlelloa lihora tse ka bang 4, bophahamo ba kabo ea tsona e ka ba lilithara tse 10. Puisano le liprotheine tsa plasma ke 99%. Hoo e batla e le metabolism e felletseng ka har'a sebete ho boptjoa ha metabolite e 'meli e sa sebetseng, e

e sibolotsoe ke liphio (40%) le bile (60%). Ho felisoa ha halofo ea bophelo ke lihora tse 'ne ho isa ho tse 11. Kamora ho tsamaisoa ka molomo, metformin e nkuoa ho tsoa mpeng ea mahlaba ka botlalo, khokahano ea tlhoro ea plasma e fihlella ka nako ea lihora tse 2,5. Hoo e ka bang 20-30% ea metformin e epolloa ka seterata sa ka mpeng se sa fetoloe. Boaoavailability e felletseng e tsoa ho 50 ho isa ho 60%.

Metformin e tsamaisoa ka potlako lithong, hoo e batlang e sa tlamele liprotheine tsa plasma. E tšelisoa ka tekanyo e fokolang haholo 'me e supe ke liphio. Ho felisoa ha halofo ea bophelo ke karolelano ea lihora tse 6.5. Maemong a ho se sebetse hantle ha a liphio, tumello ea renal ea fokotseha, joalo ka tumello ea "creatinine", ha karolo ea bophelo ba batho e eketseha, e lebisang keketseho ea methapo ea methapo ea methapo ea mali maling. Motsoako oa metformin le glibenclamide ka mokhoa o tšoanang oa litekanyetso li na le bioavailability e tšoanang le ha o nka matlapa a nang le metformin kapa glibenclamide a le mong. Bioavailability ea metformin hammoho le glibenclamide ha e amehe ke takatso ea lijo, hammoho le bioavailability ea glibenclamide. Leha ho le joalo, tekanyo ea ho monya ha glibenclamide e eketseha ka tekanyo ea lijo.

Matšoao a ho sebelisoa

Type 2 lefu la tsoekere ho batho ba baholo:

ka ho se sebetse hantle ha kalafo ea ho ja, ho ikoetlisa 'meleng le ho phekoloa ka monotherapy e fetileng ka meleine ea methapo kapa sulfonylurea,

ho khutlisa kalafo e fetileng ka lithethefatsi tse peli (metformin le sulfonylurea derivative) ho bakuli ba nang le boemo bo tsitsitseng le bo laoloang hantle ba glycemia.

Contraindication

hypersensitivity ho metformin, glibenclamide kapa tse ling tse tsoang ho sulfonylurea, hammoho le lintho tse thusang, mofuta oa 1 lefu la tsoekere,

lefu la tsoekere ketoacidosis, lefu la tsoekere, lefu la tsoekere, ho se sebetse hantle hantle hantle kapa lefu le sa sebetseng hantle (tumello ea tumello e tlase ho 60 ml / min),

maemo a hlobaetsang a ka lebisang phetohong ea ts'ebetso ea liphio: ho omella, ts'oaetso e matla, tšabo, tsamaiso ea methapo ea lisebelisoa tse nang le iodine (sheba "Litaelo tse Khethehileng"),

mafu a hlobaetsang kapa a sa foleng a tsamaeang le "hypoxia" ea methapo: ho nyekeloa ke pelo kapa ho phefumoloha, infarction ea myocardial ea morao-rao, ho tsitsipana, ho hloleha ha sebete, porphyria

boimana, nako ea ho anyesa, ts'ebeliso e tšoanang ea miconazole, ts'ebetso e kholo ea opereishene,

bokuli bo sa foleng, ho tahoa ho sa feleng, lactic acidosis (ho kenyeletsoa le nalane ea)

ho khomarela lijo tse nang le khalori e tlase (ka tlase ho likhalori tse ka tlase ho 1000 / letsatsi),

Ha ho khothalletsoe ho sebelisa lithethefatsi ho batho ba lilemo tse fetang 60 ba etsang mosebetsi o boima oa 'mele, o amanang le kotsi e kholo ea ho ba le lactic acidosis ho bona.

Glucovans ® e na le lactose, ka hona ts'ebeliso ea eona ha e khothalletsoe ho bakuli ba nang le mafu a lefutsoang a amanang le lefu la galactose, khaello ea lactase kapa lefu la glucose-galactose malabsorption.

Bokhachane le pelehi

Ts'ebeliso ea moriana e kopantsoe nakong ea kemero. Mokuli o lokela ho lemosoa hore nakong ea kalafo le Glucovans®, hoa hlokahala ho tsebisa ngaka ka moimana o reriloeng le pelehi ea pelehi. Ha u rera ho ima, hammoho le ketsahalong ea kemolo nakong ea ho sebelisa lithethefatsi Glucovans®, sethethefatsi se lokela ho khaotsa mme kalafo ea insulin e laetsoe. Glucovans® e kopantsoe le ho anyesa, kaha ha ho na bopaki ba bokhoni ba eona ba ho fetela lebeseng la matsoele.

Tekanyetso le tsamaiso

Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe ho mokuli e mong le e mong, ho latela boemo ba glycemia.

Tekanyetso ea pele ke Letlapa le le leng la lithethefatsi Glucovans® 2,5 mg + 500 mg kapa Glucovans® 5 mg + 500 mg hang ka letsatsi. Ho qoba hypoglycemia, lethal dose la mantlha ha lea lokela ho feta tekanyetso ea letsatsi le letsatsi ea glibenclamide (kapa lethal dose le lekanang la lithethefatsi tse ling tse neng li nkuoe pele sulfonylurea) kapa metformin, haeba ba ne ba sebelisoa e le kalafo ea pele. Ho khothalletsoa hore tekanyetso e eketsoe ka ho sa feteng 5 mg ea glibenclamide + 500 mg ea metformin ka letsatsi ka libeke tse ling le tse ling tse peli kapa ho feta ho fihlela taolo e lekaneng ea tsoekere ea mali.

Sebaka sa kalafo ea motsoako e fetileng le metformin le glibenclamide: Tekanyetso ea pele ha ea lokela ho feta tekanyetso ea letsatsi le letsatsi ea glibenclamide (kapa tekanyetso e lekanang ea tokisetso e ngoe ea sulfonylurea) le metformin e nkuoeng pejana. Beke tse ling le tse ling tse peli kapa ho feta kamora ho qala kalafo, tekanyetso e ea fetoha ho latela boemo ba glycemia.

Tekanyetso e kholo ea letsatsi le letsatsi ke matlapa a 4 a lithethefatsi Glucovans® 5 mg + 500 mg kapa matlapa a 6 a lithethefatsi Glucovans® 2,5 mg + 500 mg.

Mokhoa oa ho laola litekanyetso o ipapisitse le sepheo se le seng:

Bakeng sa litekanyetso tsa 2,5 mg + 500 mg le 5 mg + 500 mg

• Hang ka letsatsi, hoseng nakong ea lijo tsa hoseng, 'me u behile letlapa le le leng ka letsatsi.

• Habeli ka letsatsi, hoseng le mantsiboea, ka ho beoa ha matlapa a mabeli kapa a mane ka letsatsi.

Bakeng sa litekanyetso tsa 2,5 mg + 500 mg

• makhetlo a mararo ka letsatsi, hoseng, thapama le mantsiboea, ka ho beoa ha matlapa a 3, 5 kapa a 6 ka letsatsi.

Bakeng sa litekanyetso tsa 5 mg + 500 mg

• makhetlo a mararo ka letsatsi, hoseng, thapama le mantsiboea, ka ho beoa ha matlapa a 3 ka letsatsi.

Matlapa a lokela ho nooa le lijo. Sejo se seng le se seng se lokela ho tsamaea le lijo tse nang le lik'habohaedreite tse ngata tse lekaneng ho thibela ho hlaha ha hypoglycemia.

Tekanyo ea lithethefatsi e khethoa ho latela boemo ba ts'ebetso ea renal. Tekanyetso ea pele ha ea lokela ho feta Letlapa le le leng la lithethefatsi Glucovans® 2,5 mg + 500 mg. Tlhahlobo ea khafetsa ea ts'ebetso ea renal e hlokahala.

Glucovans® ha e khothalletsoe hore e sebelisoe baneng.

Bongata

Haeba ho na le lithethefatsi tse ngata, nts'etsopele ea hypoglycemia e ka etsahala ka lebaka la ho ba teng hoa sulfonylurea e fumanoang ka sebopeho sa moriana (bona "Litaelo tse Khethehileng").

Litla-morao tse bonolo tsa hypoglycemia ntle le tahlehelo ea kelello le lipontšo tsa methapo li ka lokisoa ka tšebeliso ea tsoekere kapele. Hoa hlokahala ho etsa tokiso ea lethal dose le / kapa ho fetola lijo. Ho hlaha hoa maikutlo a matla a hypoglycemic ho bakuli ba nang le lefu la tsoekere, le tsamaeang le komello, paroxysm, kapa mathata a mang a methapo, ho hloka tlhokomelo ea bongaka ea tšohanyetso. Tsamaiso e kenelletseng ea tharollo ea dextrose e hlokahala hang hang ka mor'a ho fumanoa kapa ho belaella hypoglycemia, pele ho sepetlele sa mokuli. Kamora ho hlaphoheloa kelellong, ho bohlokoa ho fa mokuli lijo tse nang le lik'habohaedreite tse bonolo tse tsoang habonolo (molemong oa ho qoba tsoelopele ea hypoglycemia).

Ho sebelisa tekanyetso e telele ea nako e telele kapa ho ba teng ha lintho tse kotsing ea kotsi ho ka baka kholo ea lactic acidosis, kaha metformin ke karolo ea lithethefatsi

Lactic acidosis ke boemo bo hlokang tlhokomelo ea bongaka ea tšohanyetso, kalafo ea lactic acidosis e lokela ho etsoa tleleniking. Mokhoa o sebetsang ka ho fetisisa oa kalafo oa ho tlosa lactate le metformin ke hemodialysis.

Tlhaloso ea Plasma glibenclamide e kanna ea eketseha ho bakuli ba nang le lefu la sebete. Kaha glibenclamide e tlameletsoe ka mafolofolo liprotheine tsa mali, sethethefatsi ha se tlosoe nakong ea dialysis.

Ho sebelisana le lithethefatsi tse ling

Bozentan hammoho le glibenclamide e eketsa kotsi ea hepatotoxicity. Ho khothalletsoa hore u qobe ho sebelisa lithethefatsi tsena ka nako e le ngoe. Phello ea hypoglycemic ea glibenclamide le eona e ka fokotseha.

E amanang le Metformin

Joala: Monyetla oa ho ba le lactic acidosis o eketseha ka joala bo matla, haholo ha o bolaoa ke tlala, kapa o haelloa ke phepo e nepahetseng, kapa ho hloleha ke sebete. Nakong ea kalafo le Glucovans®, joala le litlhare tse nang le joala li lokela ho qojoa.

E kopantsoe le ts'ebeliso ea li-agents tsohle tsa hypoglycemic

Chlorpromazine: ho litekanyetso tse phahameng (100 mg / ka letsatsi) e baka keketseho ea glycemia (e fokotsa ho lokolloa ha insulin).

Litlhokomeliso: U lokela ho lemosa mokuli ka tlhokahalo ea ho itlhahloba ka mokhoa o ikemetseng oa tsoekere ea mali, haeba ho hlokahala,

fetola tekanyetso ea moemeli oa hypoglycemic nakong ea ts'ebeliso e tšoanang ea antipsychotic le ka mor'a ho tlohela ts'ebeliso ea eona.

Glucocorticosteroids (GCS) le tetracosactide: keketseho ea tsoekere ea mali, eo ka linako tse ling e tsamaeang le ketosis (GCS e bakang ho fokotseha ha mamello ea glucose).

Litlhoko-hloko: Mokuli o lokela ho lemosoa ka tlhoko ea ho shebella tsoekere e ikemetseng ea mali, haeba ho hlokahala, tekanyetso ea moemeli oa hypoglycemic e lokela ho fetoloa nakong ea ts'ebeliso e tšoanang ea GCS le kamora ts'ebeliso ea eona.

Danazole e na le phello ea hyperglycemic. Haeba kalafo ka danazol e hlokahala mme ha e emisoa, phetoho ea lithethefatsi Glucovans® e hlokahala tlasa taolo ea boemo ba glycemia.

Li-agonists tsa Zr-adrenergic: ka lebaka la ts'usumetso ea li-receptor tsa Pr-adrenergic li eketsa khatello ea tsoekere maling.

Litlhokomeliso: Ho hlokahala hore ho lemose mokuli le ho theha taolo ea sekholomo sa mali, ho fetisetsoa kalafong ea insulin ho ka etsahala.

Diuretics: keketseho ea tsoekere ea mali.

Litlhoko-hloko: Mokuli o lokela ho lemosoa ka tlhoko ea ho shebella tsoekere e maling e ikemetseng, tokiso ea tekanyetso ea moemeli oa hypoglycemic nakong ea ts'ebeliso e tšoanang ka diuretics le ka mor'a ho emisa ts'ebeliso ea eona e ka hlokahala.

Angiotensin-converting enzyme (ACE) inhibitors (Captopril, enalapril): ts'ebeliso ea li-inhibitors tsa ACE e thusa ho fokotsa tsoekere ea mali. Haeba ho hlokahala, tekanyetso ea Glucovans® e lokela ho fetoloa nakong ea tšebeliso e tšoanang le ACE inhibitors le kamora ho emisa ts'ebeliso ea eona.

E amanang le Metformin

Diuretics: Lactic acidosis e hlahang ha Metformin e nkuoa le ho se sebetse hantle ha renal ho bakoang ke diuretics, haholo loopturelope.

E kopantsoe le ts'ebeliso ea glibenclamide

Li-adrenergic blockers, clonidine, reserpine, guanethidine le sympathomimetics li pata matšoao a hypoglycemia: li-palpitations le tachycardia, tse ngata haholo tse sa khethang beta-blockers li eketsa liketsahalo le ho teba ha hypoglycemia. Mokuli o lokela ho lemosoa ka tlhokahalo ea ho shebella tsoekere e ikemetseng ea mali, haholoholo qalong ea kalafo.

Fluconazole: Keketseho ea halofo ea bophelo ba glibenclamide ka ho ba teng hoa lipontšo tsa hypoglycemia. Mokuli o lokela ho lemosoa ka tlhoko ea ho shebella tsoekere e ikemetseng maling, ho ka hlokahala hore o fetole tekanyetso ea lithethefatsi tsa hypoglycemic nakong ea kalafo e tšoanang ka fluconazole le kamora ho emisa ts'ebeliso ea eona.

E kopantsoe le ts'ebeliso ea glibenclamide

Desmopressin: Glucovans® e ka fokotsa phello ea antidiuretic ea desmopressin.

Lithethefatsi tsa antibacterial tse tsoang sehlopheng sa sulfonamides, fluoroquinolones, anticoagulants (li-coumarin derivatives), li-inhibitors tsa MAO, chloramphenicol, pentoxifylline, lipid-lipilisi tse theolang lipid ho tsoa sehlopheng sa fiber, disopyramides - kotsi ea hypoglycemia ka ts'ebeliso ea glibenclamide.

Likarolo tsa ts'ebeliso

Khahlano le nalane ea kalafo le Glucovans ®, ho hlokahala hore ho be le tlhahlobo ea tsoekere e potlakileng le ka mor'a ho ja.

Lactic acidosis ke ntho e sa tloaelehang haholo, empa e tebileng (lefu le phahameng ho sa hlokahale kalafo ea tšohanyetso) e ka bang teng ka lebaka la ho bokellana ha metformin. Litaba tsa lactic acidosis ho bakuli ba tšoaroang ke metformin li etsahetse haholo ho bakuli ba nang le lefu la tsoekere le lefu le matla la ho hlaba.

Lintlha tse ling tse amanang le kotsi li lokela ho nahanoa, joalo ka lefu la tsoekere le laolehileng hantle, ketosis, ho itima lijo nako e telele, tšebeliso e ngata ea joala, ho hloleha ha sebete, le boemo bofe kapa bofe bo amanang le hypoxia e matla.

Kotsi ea ho ba le lactic acidosis e lokela ho nahanoa ha matšoao a sa ts'oanang le a mang joalo ka mesifa ea mesifa e tsamaeang le mathata a dyspeptic, bohloko ba ka mpeng le malaise e matla e hlaha. Maemong a matla, ho haelloa ke phefumoloho ea acidotic, hypoxia, hypothermia le komello li ka hlaha.

Diagnostic laboratime parameter ke: mali a tlase a pH, plasma lactate concentration ka holimo ho 5 mmol / l, keketseho ea nako ea anionic le ratiine ea lactate / pyruvate.

Kaha Glucovans ® e na le glibenclamide, ho sebelisa lithethefatsi ho tsamaisana le kotsi ea hypoglycemia ho mokuli. Ho theoha butle-butle ha lethal dose ka mor'a ho qala kalafo ho ka thibela ho hlaha ha hypoglycemia. Phekolo ena e ka laeloa feela ho mokuli ea khang lijo tse tloaelehileng (ho kenyeletsa le lijo tsa hoseng). Ho bohlokoa hore ho ja phepo ea lik'habohaedreite khafetsa, kaha menyetla ea ho ba le hypoglycemia e eketseha ka lijo tsa morao, lijo tse sa lekaneng kapa tse sa lekanang tsa nama ea kolobe. Nts'etsopele ea hypoglycemia e ka etsahala haholo ka ho ja lijo tse matlafatsang, ka mor'a ho ikoetlisa ka matla kapa ka nako e telele, ka joala, kapa ka motsoako oa li-hypoglycemic agents.

Ka lebaka la karabelo e tlatselletsang e bakiloeng ke hypoglycemia, ho fufuleloa, tšabo, tachycardia, khatello ea mali, palpitations, angina pectoris le arrhythmia li ka hlaha. Matšoao a ho qetela a ka ba sieo haeba hypoglycemia e hlaha butle butle, maemong a neuronomic kapa ha o ntse o nka beta-blockers, clonidine, reserpine, guanethidine kapa sympathomimetics.

Matšoao a mang a hypoglycemia ho bakuli ba nang le lefu la tsoekere a ka kenyelletsa hlooho ea hlooho, tlala, ho nyekeloa, ho hlatsa, ho tepella ho hoholo, mathata a ho robala, ho ruruha, khatello ea maikutlo, ho senyeha ha maikutlo le maikutlo a kelello, ho tepella maikutlo, pherekano, ho sitoa ho bua, pono e fifalitsoeng, ho thothomela le ho holofala le paresthesia, ho tsekela, ho hlasimoloha, ho tsitsipana, lipelaelo, ho se tsebe letho, ho phefumoloha ho sa tebang le bradycardia.

Ho fana ka taelo ka hloko, khetho ea litekanyetso le litaelo tse nepahetseng bakeng sa mokuli ho bohlokoa ho fokotsa kotsi ea hypoglycemia. Haeba mokuli a boetse a hlaseloa ke hypoglycemia, e leng e tebileng kapa e amanang le ho se tsebe matšoao, ho lokela hore ho nahanoe ka kalafo le baemeli ba bang ba hypoglycemic.

Lintho tse kenyang letsoho kholisong ea hypoglycemia:

• Tšebeliso ea joala ka nako e tšoanang, haholo-holo nakong ea ho itima lijo,

• Ho hana kapa (haholo-holo ho bakuli ba tsofetseng) ho se khonehe ha mokuli ho sebelisana le ngaka le ho latela litlhahiso tse fanoeng litaelong tsa litaelo,

• Ho ja lijo tse nang le phepo e ntle, lijo tse sa tloaelehang, ho lapa kapa ho fetoha ha lijo,

• Ho leka-lekana pakeng tsa ho ikoetlisa le ho ja lijo tse matlafatsang tsa 'mele,

• Ho hloleha ho matla ha sebete,

• Bongata ba lithethefatsi Glucovans®,

• Mathata a khethiloeng a endocrine: khaello ea ts'ebetso ea qoqotho ea hau.

litsoelesa tsa maemo

• Ts'ebetso e le 'ngoe ea lithethefatsi ka bonngoe.

Ho hloleha ha letsoalo le sebete

Pharmacokinetics le / kapa pharmacodynamics e ka fapana ho bakuli ba nang le ho senyeha hoa hepatic kapa ho senyeha haholo hoa sesapo. Hypoglycemia e etsahalang ho bakuli ba joalo e ka lelefala, moo ho loketseng hore kalafo e lokelang ho qala.

Kholafalo ea Mali

Maemong a ho buuoa kapa lebaka le leng la ho bola ha lefu la tsoekere, ho khothalletsoa hore ho nahanoe ka phetoho ea nakoana ho kalafo ea insulin. Matšoao a hyperglycemia ke ho ruruha khafetsa, lenyora le matla, letlalo le omeletseng.

Lihora tse 48 pele ho ts'ebetso e reriloeng ea ts'ebetso ea ho buoa kapa ts'ebetso ea methapo ea moemeli ea nang le iodineine e nang le iodine, lithethefatsi Glucovans® li lokela ho emisoa. Phekolo e khothalletsoa hore e qale hape ka mor'a lihora tse 48, mme ke feela kamora hore ts'ebetso ea renal e hlahlojoe le ho amoheloa e le e tloaelehileng.

Kaha metformin e hloekisoa ke liphio, 'me khafetsa kamora moo, hoa hlokahala ho tseba hore na li-creatinine clearance le / kapa litaba tsa serum creatinine: bonyane hanngoe ka selemo ho bakuli ba nang le ts'ebetso e tloaelehileng ea renal, le makhetlo a 2-4 ka selemo ho bakuli ba tsofetseng. , hammoho le ho bakuli ba nang le tumello ea creatinine ka moeli o phahameng oa tloaelehileng.

Ho khothalletsoa temoso e feteletseng maemong ao ts'ebetso ea liphio e ka fokolisang, mohlala, ho bakuli ba tsofetseng, kapa maemong a ho qala kalafo ea antihypertgency, ts'ebeliso ea li-diuretics kapa lithethefatsi tse seng tsa antiidalidal (NSAIDs).

Litlhokahalo tse ling

Mokuli o lokela ho tsebisa ngaka ka ponahalo ea tšoaetso ea bronchopulmonary kapa lefu le tšoaetsanoang la litho tsa botona kapa tsa botšehali.

Tšusumetso ho bokhoni ba ho khanna koloi le ho sebetsa ka mekhoa

Bakuli ba lokela ho tsebisoa ka kotsi ea hypoglycemia mme ba lokela ho ela hloko mehato ea polokeho ha ba khanna le ha ba sebetsa ka mekhoa e hlokang ho tsepamisa maikutlo le ho potlaka ha maikutlo a psychomotor.