Metformin Richter: litaelo tsa tšebeliso ea lithethefatsi, theko le li-contraindication

Metformin Richter: litaelo tsa tšebeliso le litlhahlobo

Lebitso la Latin: Metformin-Richter

Khoutu ea ATX: A10BA02

Motsoako o sebetsang: metformin (metformin)

Mohlahisi: Gideon Richter-RUS, AO (Russia)

Nchafatso ea litlhaloso le foto: 10.24.2018

Litheko makaleng a litlhare: ho tloha li-ruble tse 180.

Metformin-Richter ke sethethefatsi sa hypoglycemic bakeng sa tsamaiso ea molomo, e leng karolo ea sehlopha sa Biguanide.

Sokolla foromo le sebopeho

Setlhare se hlahisoa ka mokhoa oa matlapa a koahetsoeng ka filimi: biconvex, pota (500 mg) kapa oblong (850 mg), karolo ea khetla le sefapano li tšoeu (li-pcs tse 10. Ka paketeng ea blister, 1-5 kapa 6 pakete ea lebokose la karete) .

Letlapa le le leng le na le:

ntho e sebetsang: metformin hydrochloride - 500 kapa 850 mg,
lisebelisoa tse ling: polyvidone (povidone), Copovidone, magnesium stearate, prosalv (colloidal silicon dioxide - 2%, cellulose ea microcrystalline - 98%),
kobo ea filimi: bosoeu bo fapaneng ba opadry II 33G28523 (hypromellose - 40%, titanium dioxide - 25%, lactose monohydrate - 21%, macrogol 4000 - 8%, triacetin - 6%.

Mofumahali

Metformin e fokotsa nako ea tsoekere maling, e fokotsa ho monya ha tsoekere maling, e thusa ho eketsa tšebeliso ea tsoekere ea glucose hape e ntlafatsa kutloisiso ea lithane ho insulin. Hammoho le sena, ntho ena ha e ame tlhahiso ea insulin ke lisele tsa β-pancreas ebile ha e lebise ho hola ha methapo ea methapo ea kutlo.

Setlhare se fokotsa boemo ba lipoprotein tse tlase (LDL), triglycerides le cholesterol e felletseng maling.

Mofumahali

Kamora ho tsamaisoa ka molomo, sethethefatsi se kenngoa ho tsoa mokokotlong oa gastrointestinal (GIT). Kakaretso ea ntho e kholo (C_max) ka plasma ea mali e bonoa ka mor'a lihora tse 2,5, bioavailability ke 50-60%. Ho ja ho fokotsa C_max metformin ka 40%, hape e liehisa katleho ea eona ka metsotso e 35.

Buka ea Tsamaiso (V_d) ha o sebelisa 850 mg ea ntho ena ke lilithara tse 296-1012. Sesebelisoa se khetholloa ke ho ajoa ka potlako lithong le tekanyo e tlase haholo ea ho tlama liprotheine tsa plasma.

Phetoho ea metabolic ea metformin e nyane haholo, lithethefatsi li hlahisoa ke liphio. Ho batho ba phetseng hantle, ho hlakisoa ha ntho ke 400 ml / min, e phahameng ka makhetlo a 4 ho feta tumellano ea creatinine (CC), sena se tiisa boteng ba secretion ea tubular e sebetsang. Half-life (T_½) - lihora tse 6.5.

Contraindication

lefu la tsoekere, coma,
lefu la tsoekere ketoacidosis,
ts'ebetso ea liphio (CC ka tlase ho 60 ml / min),
litliliniki tse hlalositsoeng ka kotloloho ea mafu a mefuta e mpe le e sa foleng e ka bakang ho hlaha hoa tishu hypoxia (infrection ea myocardial e mpe, ho hloleha ha pelo le ho hema, jj.),
mafu a hlobaetsang a tsamaeang le kotsi ea ts'ebetso ea ho ruruha e sa sebetseng: mafu a tšoaetsanoang a feberu, feberu, hypoxia (mafu a bronchopulmonary, tšoaetso ea renal, sepsis, makala), ho omella (khahlano le ho hlatsa, lets'ollo),
tšebetso ea bokong ba sebete,
lactic acidosis (ho kenyeletsa nalane)
chefo e matla ea joala, joala bo sa foleng
likotsi le ts'ebetso e tebileng ea ts'ebetso ea ts'ebetso eo ho eona ho bontšitsoeng kalafo ea insulin,
sebelisa bonyane matsatsi a 2 pele le matsatsi a 2 kamora ts'ebetso ea lithuto tsa radioisotope le x-ray, moo ho sebelisoang moriana o nang le iodine o fapaneng o nang le iodine.
glucose-galactose malabsorption, ho se mamellane ha lactose, khaello ea lactase,
tlhokeho ea lijo tse matlafatsang (tse ka tlase ho 1000 kcal / ka letsatsi),
ho ima le ho nyekeloa,
hypersensitivity ho efe kapa efe ea likarolo tsa moriana.

Metformin Richter ha e khothalletsoe bakuli ba fetang lilemo tse 60 ba etsang mosebetsi o boima oa 'mele.

Melemo ea pharmacological

Metformin-Richter ke setlhare se sebelisetsoang ho phekola lefu la tsoekere le sa hlokeng insulin. Lithethefatsi li khona ho thibela tšebetso ea metabolism ka har'a sebete, e lebisang ho theheng ha tsoekere, e fokotsa ho monya ha methapo e tsoang ka mpeng, e eketsa tsitsipano ea lisele le litho tsa 'mele ho ea ho protheine ea li-pancreas.

Moriana ona ha o ame tlhahiso ea insulin ke manyeme, hape ha o kenye letsoho kotsi ea hypoglycemia. Moriana ha o kenye letsoho keketseho ea litaba tsa lihormone tsa "manyeme" tse ka bakang ho eketseha ha boima ba 'mele, hammoho le lipontšo tsa mathata a mafu a lefu la tsoekere. Moriana o thusa ho theola boima ba 'mele ka ho tšoana.

Metformin Richter e theola khatello ea methapo ea kutlo le lipid ka har'a serum ea mali, e fokotsa mokhoa oa mafura oxidation, e khothaletsa tlhahiso ea akhatic monobasic carboxylic acids, e na le phello e ntle ts'ebetsong ea methapo e meholo ea mali le methapo ea mali.

Ho fanoa ka moriana bakeng sa tsamaiso ea kahare, litaba tse phahameng haholo li fumaneha ka mor'a lihora tse 2,5. Lihora tse tšeletseng ka mor'a ts'ebetso, moriana o qala ho tlosoa butle-butle 'meleng, e leng ho fokotsang litaba tsa likarolo tsa moriana' meleng. Ka tšebeliso ea kamehla ea lithethefatsi, litaba tsa likarolo tsa moriana 'meleng li lula li sa fetohe, tse amang hantle matla le lefu la ona. Ha o sebelisa lithethefatsi nakong ea lijo, monko oa Metformin-Richter 'meleng oa fokotseha.

Sebopeho le mofuta oa tokollo

Setlhare se entsoe ka sebopeho sa tafole, se koahetsoeng ka filimi e tšesaane. Boima ba molek'hule ea ntho e sebetsang litafoleng ke ligrama tse 0,5 kapa 0,85. Sekete se na le matlapa a 30 kapa a 120, ka holimo, litaelo li sebelisoa. Likarolo tsa karolo ea lithethefatsi ke lintho tse latelang:

metformin

starch

magnesium stearic acid,

talcum phofo.

Matšoao a ho sebelisoa

Setlhare sena se khothaletsoa ho bakuli ba nang le lefu la tsoekere le sa itšetleheng ka insulin. Motsoako ona o sebelisoa e le sethethefatsi se le seng kalafo, hammoho le kalafo e rarahaneng. Ntle le moo, moriana o fuoe bakuli ba nang le boima bo feteletseng nakong ea lefu la tsoekere, tlhoko ea ho laola khatello ea maikutlo ea dextrose, polycystic ovary syndrome.

Litlamorao

Ho nwa moriana ho ka baka litlamorao:

maikutlo a ho nyekeloa

litulo tse otlolohileng

ho qhekella

bohloko bo ka mpeng,

tahlehelo ea takatso ea lijo

tatso ea tšepe ka molomong oa molomo,

bofubelu bo boholo ba letlalo bo bakoang ke ho hola ha li-capillaries,

digestibility ea cobalamin,

e fokotsa khatello ea "cobalamin" maling,

Tlolo ea ts'ebetso ea mali,

Lefu la Addison-Birmer.

Mekhoa le likarolo tsa ts'ebeliso

Sethethefatsi Metformin-Richter se fumaneha ka mokhoa oa matlapa a reretsoeng ho tsamaisa molomo kahare. U ke ke ua khaola, ho roba, ho phunyeha, ho silakanya, ho peta, matlapa, li tlameha ho nooa li felletse, li hlatsoitsoe ka metsi a lekaneng. Litekanyetso tsa letsatsi le letsatsi tse khothalelitsoeng, hammoho le nako ea kalafo, li khethoa ke ngaka e latelang kamora tlhahlobo, pokello ea liteko le qeto ea setšoantšo se hlakileng sa lefu lena. Ntle le moo, litlhahiso tsa tšebeliso ea lithethefatsi li fanoe ka litaelo tsa ho li sebelisa. Ho fokotsa kotsi ea litla-morao, ho a hlokahala hore o arole litekanyetso tsa letsatsi le letsatsi tse khothalelitsoeng ka makhetlo a mangata. Phekolo ka matlapa a nang le boima ba molek'hule ea 500 mg: Tekanyetso e khothalletsoang ea letsatsi le letsatsi ke 500-1000 mg. Kamora matsatsi a 10-15 a tsamaiso, ho khothalletsoa ho eketsa tekanyetso, ho latela bongata ba dextrose serum ea mali. Tekanyetso e kholo ea letsatsi le letsatsi ke 3000 mg. Phekolo ka matlapa a nang le boima ba molek'hule ea 850 mg: Tekanyetso e khothalletsoang ea letsatsi le letsatsi ke 850 mg kapa pilisi e le 'ngoe. Kamora matsatsi a 10-15 a tsamaiso, ho khothalletsoa ho eketsa tekanyetso, ka mor'a ho lekanya dextrose maling. Tekanyo e phahameng ea letsatsi le letsatsi ke 2550 mg. Lithethefatsi tse nang le monotherapy ha li ame bokhoni ba ho khanna makoloi, hammoho le lebelo la maikutlo le khatello ea maikutlo. Ka kalafo e rarahaneng, ho molemo ho hana ho khanna le mosebetsi o hlokang tlhokomelo e ngata. Bakuli ba seng ba tsofetse ba eletsoa ho fana ka lingoloa tse fetang 1000 mg tsa Metformin-Richter. U ke ke ua fana ka litlhare ho bakuli ba lilemo tse fetang 60, haholo haeba ho na le mafu a mang le mabaka a amang monyetla oa ho sebelisa moriana. U ke ke ua fana ka litlhare Metformin-Richter e nang le lefu la liphio le sebete.

Tekanyo ea joala

Lithethefatsi Metformin-Richter e ke ke ea kopanngoa le tšebeliso ea lino tse tahang, kaha sena se ka lebisa kotsing e kholo ea litla-morao le lactic coma. Ntle le moo, lino tse noang tse nang le joala li na le phello e eketsehileng mosebetsing oa litho tsohle tsa kahare, ho li qobella ho sebetsa ka mokhoa o ntlafalitsoeng, ka hona, kotsi ea ho ba le hypoglycemia ea eketseha.

Ho sebelisana le meriana e meng

Lithethefatsi Metformin-Richter ha ea lokela ho sebelisoa hammoho le lithethefatsi tse ling tse 'maloa:

Androgen ea maiketsetso ea Danazolum e eketsa kotsi ea tsoekere e ngata ea mali,

antiprychotic Chlorpromazinum e hlophisitsoeng haholo e eketsa haholo khatello ea dextrose,

lithethefatsi tsa antidiabetesic, litokisetso tse nang le asiti ea salicylic, lithethefatsi tsa hypoglycemic Acarbosum, insulin, lithethefatsi tse se nang lithibela-mafu tse thibelang mafu, li-inhibitors tsa monoamine oxidase, angiotensin ho fetola li-enzyme inhibitors, fibrate, cytotoxic anticancer drug Cyclophosphamidum e eketsa kotsi.

lithethefatsi tse thibelang ho ruruha ha li-hormone tsa li-hormone tse thibelang ho ruruha, lithibela-pelehi tsa molomo, adrenal medulla hormone Epinephrinum, sympathomimetics, glucagon, hormone ea qoqotho ea qoqotho e thusa ho fokotsa tsoekere,

antihypertensive drug Nifedipinum e eketsa khatello ea mantlha ea lithethefatsi ebile e thibela nako ea ho khaotsa lithethefatsi

Cimetidinum H2-histamine receptor blocker e eketsa kotsi ea lactic coma,

Amiloridum-sparing diuretic Amiloridum, cardiac glycoside Digoxinum, alkaloid opium Morphinum, antiarrhythmic drug Procainamidum, alkaloid bark of chininum Chinidinum, antipyretic drug Chininum, antiulceric drug Ranitidin, drug diuretic drug of the drugamt litlamorao.

Bongata

Ho sebelisa meriana Metformin-Richter ho ka baka ho tahoa ha ho nooa tekanyetso le nako ea kalafo. Matšoao a bontšang hore o sebelisitse bongoana bo bongata:

lactic acid e coma ka lefu le tsoelang pele,

mathata a liphio

maikutlo a ho nyekeloa

ho qhekella

litulo tse otlolohileng

phokotso ea mocheso

bohloko bo ka mpeng,

ho opeloa ke mesifa

tachypnea

mathata a vestibular

letsoalo le foufetseng

coma

lefu. Haeba ho na le mats'oao a ho tahoa ka moriana, o lokela ho bonana le ngaka ea hau hang-hang e tla fana ka lipholiso tse tlang ka nako. U ke ke ua lahla matšoao a bosholu ba hao u le mong, mokuli o tlameha ho kena sepetlele mme a behiloe leihlo ke ngaka e eang. Ho nka meriana ho lokela ho emisoa hanghang.

Lithethefatsi tse latelang ke lipapatso tsa lithethefatsi Metformin-Richter maemong a litlama tsa bongaka le sebopeho:

Metformin-Richter,

Metformin-Teva,

Bagomet,

Foromo,

Metfogamma,

Gliformin

Metospanin,

Siofor,

Glycomet,

Glicon

Vero-Metformin,

Orabetes

Gliminfor

Glucophage

NovoFormin,

Glibenclamide.

Maemo a polokelo

Metformin-Richter ea lithethefatsi e khothalletsoa hore e bolokoe sebakeng se arohaneng le bana le khanya ea eona e sa feteng likhato tse 25 tsa Celsius. Bophelo ba sefuba sa lithethefatsi ke lilemo tse 3 ho tloha ka letsatsi la tlhahiso. Kamora letsatsi la ho felloa ke nako le polokelo, moriana o ka se sebelisoe mme o tlameha ho lahloa ho latela maemo a bohloeki. Litaelo tsa tšebeliso li na le tlhaiso-leseling e qaqileng mabapi le melao le litaelo tsa polokelo.

Laesense ea litlhare LO-77-02-010329 la la 18 Phuptjane 2019

Litlamorao

metabolism: ka seoelo - lactic acidosis (ho tlosoa hoa lithethefatsi hoa hlokahala), ka thupelo e telele - hypovitaminosis B₁₂ (ka lebaka la malabsorption)
tsamaiso ea tšilo ea lijo: ho haelloa ke takatso ea lijo, tatso ea tšepe ka hanong, ho hlatsa, lets'ollo, ho nyekeloa ke mpa, bohloko ba ka mpeng, bolutu (mathata ana a bonoa hangata qalong ea bongaka 'me hangata a itsamaela a le mong, ho teba ha ona ho ka fokotsoa a sebelisa antispasmodics, m-anticholinergics, antacids) , seoelo - hepatitis, ts'ebetso e eketsehileng ea "transpase" ea hepatic (e nyamela kamora ho khaotsa kalafo),
tsamaiso ea endocrine: hypoglycemia,
hematopoietic system: Maemong a sa tloaelehang - anemiabolic anemia,
Lintho tse hapang maikutlo: ho hlohlona, lekhopho la letlalo.

Litaelo tse khethehileng

Nakong ea kalafo ka lithethefatsi, ho hlokahala bonyane habeli ka selemo (hammoho le taba ea myalgia) ho theha mokokotlo oa lactate maling a mali.

Ho hlokahala hape ho tseba hore na serum creatinine e le 'ngoe kamora likhoeli tse ling le tse ling tse 6, sena se bohlokoa haholo ho bakuli ba tsofetseng.

Haeba nts'etsopele ea lesion e sa foleng ea litho tsa 'mele kapa ts'oaetso ea bronchopulmonary e hlokometsoe nakong ea tsamaiso ea metformin, ho potlakile ho tsebisa ngaka ea hau.

Ho nka moriana ho lokela ho hlakoloa lihora tse 48 pele le lihora tse 48 kamora hore u urology, intravenous angiography kapa boithuto bofe kapa bofe ba radiopaque.

Metformin Richter e ka sebelisoa hammoho le lintho tse tsoang ho sulfonylurea, haholo-holo ha e laola ho kenella ha tsoekere maling.

Nakong ea kalafo, ho khothalletsoa ho hana ho nka lino le litlhare tse nang le ethanol. Tšokelo ea lactic acidosis e eketsoa ke botaoa ba joala bo matla, haholo-holo boteng ba ho hloleha ha sebete, kamora ho ja lijo tse nang le khalori e fokolang kapa tlala.

Tšusumetso ho bokhoni ba ho khanna makoloi le mekhoa e rarahaneng

Tšebeliso ea Metformin-Richter e le sethethefatsi sa monotherapy ha e ame hampe mokhoa oa ho khanna likoloi.

Maemong a ts'ebeliso e kopaneng ea metformin e nang le insulin, tse tsoang ho sulfonylurea le tse ling tse antidiabetes, ho na le monyetla oa ho theha maemo a hypoglycemic, moo matla a ho laola mekhoa e rarahaneng (ho kenyeletsa le makoloi) a mpefatsang.

Bokhachane le pelehi

Setlhare ha sea lokela ho nooa nakong ea kemaro. Ketsahalong eo moimana a bang teng nakong ea kalafo, le nakong ea kemiso, Metformin-Richter e lokela ho emisoa mme kalafo ea insulin e lokela ho fanoa.

Kaha ha ho na tlhahisoleseling mabapi le ho kenella ha metformin ka lebese la matsoele, ho kopantsoe basali ba anyang matsoele. Haeba moriana o lokela ho nooa nakong ea lebone, letsoele le lokela ho emisoa.

Ho sebelisana le lithethefatsi

Ka tšebeliso e kopaneng ea Metformin-Richter e nang le lintho tse ling tsa kalafo / litokisetso, karabelo e latelang e ka hlaha:

Danazol - phello ea hyperglycemic ea moemeli enoa e ka hlokomeloa, motsoako ona ha o khothalletsoe, haeba o hloka phekolo ea Danazol mme ha o qeta ho e nka, o hloka ho fetola tekanyetso ea metformin le ho laola boemo ba glycemia,
angiotensin e fetola li-enzyme inhibitors, oxytetracycline, monoamine oxidase inhibitors, lithethefatsi tse seng khahlanong le ts'oaetso tsa kokoana-hloko, li-salicylates, sulfonylureas, insulin, li-acarbose, li-fibroic acid derivatives, beta-adrenergic blocker agents, cyclophosphamide - hypoglycemic e ntlafalitsoeng.
chlorpromazine (antipsychotic) - ha o sebelisa moriana ona ka tekanyetso ea letsatsi le letsatsi ea 100 mg, khatello ea tsoekere maling e ea eketseha le ho tsoa ha insulin hoa fokotseha, ka chlorpromazine le li-antipsychotic tse ling, le kamora ho emisa tšebetso ea bona, tekanyetso ea metformin e lokela ho lokisoa, 'me tsoekere ea mali e lokela ho lekoloa.
cimetidine - ho felisoa ha metformin ho fokotseha, ka lebaka leo tšoso ea lactic acidosis e eketsang,
lithibela-pelehi tsa molomo, glucocorticosteroids, epinephrine, glucagon, sympathomimetics, litokisetso tsa iodine e nang le qoqotho ea iodine, loop le thiazide diuretics, nicotinic acidiv derivatives, phenothiazine derivatives - hypoglycemic of metformin is flue,
nifedipine - ho eketsoa ho eketsehileng le C_max metformin e theola ea ho qetela,
Lithako tse nang le iodine e nang le iodine - ka tsamaiso ea methapo ea methapo ena, ho ka hlaha lisele tsa metformin, tse ka lebisang ho lactic acidosis,
anticoagulants e sa tobang (li-coumarin derivatives) - phello ea tsona ea fokola,
ranitidine, quinidine, morphine, amiloride, vancomycin, triamteren, quinine, procainamide, digoxin (lithethefatsi tsa cationic tse entsoeng ke renal tubules) - keketseho ea C e ka etsahala ka thupelo e telele._max 60% metformin (ka lebaka la tlholisano ea litsamaiso tsa tsamaiso ea methapo).

Litšoantšiso tsa Metformin-Richter ke: Glyformin Prolong, Bagomet, Glyformin, Glucofage, Diasfor, Glucofage Long, Diaformin OD, Metfogamm 500, Metadiene, Metfogamma 850, Metformin nako e telele, Metformin-Kanon, Metformin, Metformin Zentiva Minform, Metformin Zentiva Minform. , Metformin Sandoz, Metformin-Teva, Siofor 500, Foromo, Sofamet, Siofor 850, Foromo Long, Siofor 1000, Foromane Pliva.

Tlhahlobo mabapi le Metformin Richter

Ho latela litlhahlobo tse ngata tse ngata, Metformin Richter ke setlhare se sebetsang se laolang tsoekere e maling, se fokotsa takatso ea lijo le litakatso tsa liswiti, 'me se thusa ho fokotsa le ho tsitsisa boima ba' mele.

Liphoso tsa lithethefatsi, bakuli ba bangata ba kenyelletsa nts'etsopele ea maikutlo a mabe (haholo-holo ho tsoa mokokotlong oa mpa) le palo e kholo ea likhanyetsano. Hoo e batlang e le litlhahlobo tsohle, ho hlokometsoe hore Metformin-Richter ke sesebelisoa se tebileng mme ho hlokahala hore o se nke feela joalokaha o laetsoe ke setsebi.