Glimecomb - setlhare se nang le likarolo tse peli tsa lefu la tsoekere la mofuta oa 2

Letlapa le leng le na le:

Lintho tse sebetsang: metformin hydrochloride ho latela 100% ntho-500 mg, glycazide ho latela 100% ntho-40 mg,

excipients: sorbitol, povidone, sodium ea croscarmellose, magnesium stearate.

Matlapa ho tloha ho o mosoeu ho ea ho o mosoeu ka tranelate e bolila kapa e bosehla, e boreleli, e nang le bevel le kotsi. Ho ba teng ha "marb" ho lumelloa.

KHAOLO EA PHARMACOTHERAPEUTIC:

motsoako o kopaneng oa hypoglycemic bakeng sa ts'ebeliso ea molomo (biguanide + sulfonylurea group maandalizi)

CODE EA ATX: A10BD02

LITLHAKISO TSA BOTEGENIKI Pharmacodynamics.

Glimecomb® ke motsoako o tsitsitseng oa li-agent tse peli tsa molomo tsa hypoglycemic tsa lihlopha tse fapaneng tsa meriana: glyclazide le metformin. E na le litlamorao tsa pancreatic le tseo e seng tsa pancreatic.

Gliclazide e matlafatsa secretion ea insulin ke manyeme, e phahamisa maikutlo a litharollo tsa insulin. E susumetsa ts'ebetso ea li-enzymes tse kenang ka hare - mesifa ea glycogen synthetase. E khutlisa tlhoro ea pele ea insulin secretion, e fokotsa nako ea ho qaleha ho tloha motsotso oa ho ja ho fihlela ho qala ts'ebetso ea "insulin" hape e fokotsa hyperglycemia ea postprandial. Ntle le ho ama metabolism ea carbohydrate, e ama microcirculation, e fokotsa mokokotlo oa liplatelete le ho kopana, e liehisa nts'etsopele ea "parietal thrombosis", e tsebahala ka matla a vascular mme e thibela nts'etsopele ea micothrombosis le atherosclerosis, e khutlisetsa ts'ebetso ea physiological parietal fibrinolysis, 'me e hanyetsane le karabelo ea methapo ea methapo. E fokotsa nts'etsopele ea lefu la tsoekere le lefu la tsoekere sethaleng se sa eketseheng, le lefu la tsoekere le nang le tšebeliso ea nako e telele, ho bonahala ho fokotseha ho hoholo ha proteinuria. Ha e lebise keketseho ea boima ba 'mele, kaha e na le tšusumetso e phahameng tlhōrōng ea insulin secretion mme ha e bake hyperinsulinemia, e thusa ho fokotsa boima ba' mele ho bakuli ba batenya, ka mor'a lijo tse nepahetseng.

Metformin ke ea sehlopha sa Biguanides. E fokotsa tsitsipano ea tsoekere maling le ho thibela gluconeogeneis ka har'a sebete, e fokotsa ho monya ha tsoekere e tsoang pampiring ea gastrointestinal mme e eketsa tšebeliso ea eona lithong. E fokotsa khatello ea mali ka serum ea mali a li-triglycerides, cholesterol le lipoprotein tse fokolang (tse tsejoang ka mpa e se nang letho) mme ha e fetole bongata ba lipoprotein tsa methapo e meng. E thusa ho tsitsisa kapa ho theola boima ba 'mele. Ha ho na le insulin maling, phello ea kalafo ha e bonahatsoe. Boitšoaro ba Hypoglycemic ha bo bake. E ntlafatsa thepa ea mali ea fibrinolytic ka lebaka la khatello ea inhibitor ea activator profibrinolysin (plasminogen).

Gliclazide. Ho chona ho phahameng. Kamora ho tsamaisoa ka molomo ka 40 mg, khatello e phahameng ho plasma ea mali e fihlella ka mor'a lihora tse 2-3 mme e fihla ho 2-3 μg / ml. Puisano le liprotheine tsa plasma ke 85-97%. Ho felisoa ha halofo ea bophelo ke lihora tse 8-20. E kenngoe sebeteng. E pepesoa haholo ka sebopeho sa metabolites ke liphio - 70%, ka mala. Bathong ba tsofetseng, liphetoho tse bohlokoa tsa kliniki maemong a pharmacokinetic ha li bonoe. Metformin. Ho fufuleloa - 48-52%. Ho kenella ka potlako pampiring ea mala. Ho ba le bioavailability ka botlalo (ka mpeng e se nang letho) ke 50-60%, ho kenella ka lijo ho fokotsa bongata bo boholo ka 40% mme ho liehise katleho ea eona ka metsotso e 35. Khatello ea plasma e fihlelloa kamora lihora tse 1,81-2.69 mme ha e fetele 1 μg / ml. Puisano le liprotheine tsa plasma ha e na thuso, e ka bokellana liseleng tse khubelu tsa mali. Bophelo ba halofo ke lihora tse 6.2. E pepesoa ke liphio, haholo-holo tse sa fetoloang (glomerular filtration le secretion ea tubular) le ka mala (ho fihlela 30%).

LIPUO TSA SEBELISO

• Type 2 lefu la tsoekere le ho se sebetse hantle kalafo ea ho ja, boikoetliso le kalafo e fetileng ka metformin kapa gliclazide.

• Phallo ea kalafo ea nakong e fetileng ka lithethefatsi tse peli (metformin le gliclazide) ho bakuli ba nang le lefu la tsoekere la mofuta oa 2 le boemo bo tsitsitseng le bo laoloang hantle ba tsoekere ea mali.

TLHOKOMELLO

• hypersensitivity ho metformin, glyclazide kapa lisebelisoa tse ling tsa sulfonylurea, hammoho le lintho tse thusang.

• mofuta oa 1 lefu la tsoekere

• lefu la tsoekere ketoacidosis, lefu la tsoekere, lefu la tsoekere,

• Ho fokola haholo ke seso,

• maemo a hlobaetsang a ka lebisang phetohong ea ts'ebetso ea liphio: ho omella, ts'oaetso e matla, tšabo,

• maloetse a hlobaetsang kapa a sa foleng a tsamaeang le "hypoxia" ea methapo: ho nyekeloa ke pelo kapa ho hema, ho hlaseloa ha myocardial haufinyane

• moimana, nako ea ho anyesa,

• taolo e tšoanang ea miconazole,

• mafu a tšoaetsanoang, ts'ebetso e kholo ea ts'ebetso ea ho buoa, likotsi, ho chesa haholo le maemo a mang a hlokang kalafo ea insulin,

• Ho lemalla joala bo sa foleng, ho tahoa ho hoholo,

• lactic acidosis (ho kenyeletsoa le nalane)

• Sebelisa bonyane lihora tse 48 pele le ka hare ho lihora tse 48 kamora ho etsa lithuto tsa radioisotope kapa x-ray ka kenyelletso ea mahareng e nang le iodine e fapaneng.

• 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.

Ka tlhokomelo

Feverish syndrome, ho hloleha ha adrenal, hypofunction ea anterior pituitary gland, lefu la qoqotho le nang le ts'ebetso e sa sebetseng.

HO SEBELISA HO BUA LEFAT ANDE LE HO FIHLELA

Nakong ea bokhachane, tšebeliso ea lithethefatsi Glimecomb® e hoketsoe. Ha u rera ho ima, hammoho le ketsahalong ea kemolo nakong ea ho nka Glimecomb®, moriana o lokela ho khaotsa mme kalafo ea insulin e lokela ho fanoa.

Glimecomb® e kopantsoe le ho anyesa, kaha sethethefatsi se khona ho kenella ka lebeseng la matsoele. Maemong ana, o tlameha ho fetoha kalafo ea insulin kapa ho emisa ho anyesa.

TS'ELISO LE PUSO

Setlhare se sebelisoa ka molomo, nakong ea lijo kapa hang ka mor'a lijo. Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe ho mokuli ka mong, ho latela boemo ba tsoekere ea mali.

Ka tloaelo tekanyetso ea pele ke matlapa a 1-3 ka letsatsi a khethiloeng ka tekanyo ho fihlela phumants'o e tiileng ea lefu lena e fihlella.

Ka tloaelo moriana o nooa habeli ka letsatsi (hoseng le mantsiboea). Sekhahla se phahameng sa letsatsi le letsatsi ke matlapa a 5.

PUSELETSO MAHALA

Ho tloha lehlakoreng la metabolism: maemong a tlolo ea molao oa dosing le ho ja lijo tse sa lekaneng, hypoglycemia (hlooho e opang hlooho, maikutlo a mokhathala, tlala, ho eketseha hoa mofufutso, bofokoli bo matla, ho hlaka, ho tsekela, ts'ebelisano e sa leka-lekaneng ea metsamao, mathata a nakoana a methapo ea kutlo, le tsoelo-pele ea hypoglycemia, mokuli a ka lahleheloa ke boitšoaro letsoalo), maemong a mang - lactic acidosis (bofokoli, myalgia, mathata a ho hema, ho otsela, bohloko ba ka mpeng, hypothermia, ho fokotseha ha khatello ea mali, Reflex b radiarrhythmia).

Ho tsoa ho ts'ebetso ea tšilo ea lijo: dyspepsia (ho nyekeloa, lets'ollo, maikutlo a boima ho epigastrium, tatso ea "metallic" molomong), ea fokotseha takatso ea lijo - matla a fokotseha ka sethethefatsi ha a ntse a ja, ka seoelo - tšenyo ea sebete (hepatitis, cholestatic jaundice - e hloka ho tlosoa hoa lithethefatsi, mosebetsi o eketsehileng oa "sebete" transaminases, alkaline phosphatase).

Ho tsoa lithong tsa hemopoietic: ka seoelo - thibelo ea masapo a hematopoiesis (anemia, thrombocytopenia, leukopenia).

Litla-morao: Ho otla, urticaria, lekhopho la maculopapular.

Maemong a litla-morao, lethalinyana le lokela ho fokotsoa kapa sethethefatsi se emisoe ka nakoana.

Tse ling: ho sitisoa ha pono.

Litla-morao tse tloaelehileng tsa derivatives ea sulfonylurea: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, allergic vasculitis, ho se sebetse hantle hoa sebete.

PUSELETSO

Ho fetella kapa ho ba teng ha maemo a kotsi ho ka baka kholo ea lactic acidosis, kaha metformin ke karolo ea lithethefatsi. Haeba matšoao a lactic acidosis a hlaha, khaotsa ho sebelisa lithethefatsi. Lactic acidosis ke boemo bo hlokang tlhokomelo ea bongaka ea tšohanyetso, kalafo ea lactic acidosis e lokela ho etsoa sepetlele. Phekolo e sebetsang ka ho fetisisa ke hemodialysis. Ho sebelisa overdose ho ka lebisa ho nts'etsopele ea hypoglycemia ka lebaka la boteng ba gliclazide ha e ntse e etsoa. Ka hypoglycemia e bonolo kapa e itekanetseng, tsoekere (dextrose) kapa tharollo ea tsoekere e nkuoa ka molomo. Haeba ho na le hypoglycemia e matla (ho lahleheloa ke ho tseba lintho), tharollo ea 40% ea dextrose (glucose) kapa glucagon e tsamaisoa ka methati, intramuscularly, subcutaneally. Kamora ho hlaphoheloa kelellong, mokuli o lokela ho fuoa lijo tse nang le lik'habohaedreite ho qoba tsoelopele ea hypoglycemia.

KAMANO LE LITLHAKISO TSE LING

Lithibelo tsa phello ea hypoglycemic ea lithethefatsi li angiotensin li fetola li-enzyme inhibitors (Captopril, enalapril), H2-histamine receptor blockers (cimetidine), lithethefatsi tsa antifungal (miconazole, fluconazole), lithethefatsi tse seng tsa steroidal tse thibelang mafu (NSAIDs), phenylbenzofenbazon ), anti-tuberculosis (ethionamide), salicylates, coumarin anticoagulants, anabolic steroids, beta-blockers, monoamine oxidase inhibitors, sulfonamides Liketso tsa likarolo siling, cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, lithethefatsi tse ling tse hypoglycemic (acarbose, biguanides, ka insulin, joalo-joalo), allopurinol oxytetracycline.

Li-Barbiturates, glucocorticosteroids, adrenergic agonists (epinephrine, clonidine), lithethefatsi tsa antiepileptic (phenytoin), li-calcium blockers tse liehang ho feta, li-diactoase tsa carbonic anhydrase (chetortoloneide), thiazide diuretics, chlortalidone, trifenazole azeneazide , morphine, ritodrine, salbutamol, terbutaline, tsoekere, rifampicin, lihormone tsa qoqotho, letsoai la lithium, tekanyetso e phahameng ea nicotinic acid, chlorpromazine, lithibela-pelehi tsa molomo le estrogens.

E eketsa menyetla ea ho ba le li-ventricular extrasystoles le ka mokokotlong oa pelo le pelo glycosides. Meriana e thibelang hematopoiesis ea masapo e eketsa kotsi ea myelosuppression.

Ethanol e eketsa monyetla oa ho theha lactic acidosis.

Metformin e fokotsa khatello e phahameng maling (C max) le T 1 / 4furosemide ka 31 le 42.3%, ka ho latellana. Furosemide e eketsa C max metformin ka 22%.

Nifedipine e eketsa ho monya, C max, e fokotsa tlhahiso ea metformin.

Lithethefatsi tsa Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren le vancomycin) tse fumanehang molemong oa tlholisano ea lits'ebetso tsa tsamaiso ea methapo, mme ka kalafo ea nako e telele, li ka eketsa C max metformin ka 60%.

TLHOKOMELISO LITLHAKISO

Phekolo le Glimecomb ® e etsoa feela ha e kopantsoe le lijo tse nang le khalori e tlase e tlaase. Hoa hlokahala hore kamehla u lekole boemo ba tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja, haholo-holo matsatsing a pele a kalafo le moriana.

Glimecomb® e ka fuoa feela bakuli ba fumanang lijo khafetsa, tseo hangata li kenyelletsang lijo tsa hoseng, ho netefatsa hore ho na le lik'habohaedreite tse lekaneng.

Ha u fana ka litlhare, ho lokela ho hopoloa hore ka lebaka la tšebeliso ea likhakanyo tsa sulfonylurea, hypoglycemia e ka ba teng, 'me maemong a mang e le ka mokhoa o thata le o tšoarellang, o hlokang ho kenngoa sepetlele le taolo ea tsoekere ka matsatsi a' maloa. Hypoglycemia hangata e hlaha ka ho ja lijo tse nang le khalori e tlase, ka mor'a ho ikoetlisa nako e telele kapa ho ikoetlisa ka mor'a ho noa joala kapa ka ho sebelisa lithethefatsi tse 'maloa tsa hypoglycemic ka nako e le' ngoe.

Bakeng sa ho qoba nts'etsopele ea hypoglycemia, ho hlokahala hore ho khethoe litekanyetso ka hloko le ka bomong, hammoho le ho fa mokuli tlhaiso-leseling e phethahetseng ka kalafo e boletsoeng.

Ka ho fetella 'meleng le maikutlong, ha u fetola lijo, ho hlokahala hore ho etsoe phetoho ea khalase ea Glimecomb®.

Haholo-holo a amehile ka ketso ea lithethefatsi tsa hypoglycemic: batho ba tsofetseng, bakuli ba sa fumaneng lijo tse nang le phepo e nepahetseng, ba nang le boemo bo fokolang ba 'mele, bakuli ba nang le bothata ba ho hloka pituitary-adrenal. Beta-blockers, clonidine, reserpine, guanethidine e ka pata lipontšo tsa kliniki tsa hypoglycemia.

Bakuli ba lokela ho lemosoa ka kotsi e eketsehang ea hypoglycemia maemong a ethanol, NSAIDs, le tlala.

Ho kenella ka matla le ho lemala ho hoholo, ho chesa haholo, mafu a tšoaetsanoang a nang le febrile syndrome ho ka hloka ho felisoa ha litlhare tsa hypoglycemic tsa molomo le tumellano ea kalafo ea insulin. Nakong ea kalafo, ho hlokahala hore ho sebetsanoe le ts'ebetso ea renal; boikemisetso ba plasma lactate bo lokela ho etsoa bonyane makhetlo a 2 ka selemo, hammoho le ponahalo ea myalgia. Ntshetsopele ea lactic acidosis e hloka hore ho khaoloe kalafo.

Lihora tse 48 pele ho ts'ebetso ea opereishene kapa tsamaiso ea methapo ea enjine e nang le iodineine, Glimecomb® e lokela ho khaotsa, kalafo e khothalletsoa hore e qale hape ka mor'a lihora tse 48.

Khahlano le semelo sa kalafo le Glimecomb®, mokuli o tlameha ho tlohela tšebeliso ea joala le / kapa lithethefatsi tse nang le ethanol.

Nakong ea kalafo, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea maikutlo haholo.

Matšoao a ho khethoa

Sulfonylurea derivatives (PSM) ke litlhare tse khethiloeng ka ho fetisisa tse 2 bakeng sa lefu la tsoekere ka mor'a metformin. Ho kopantsoe ha PSM le metformin hoa hlokahala ho bakuli bao ho bona lijo tse fokolang tsa carb, lipapali le metformin li sa faneng ka phokotso ea tsoekere e hlokahalang. Lintho tsena li sebetsa ho likhokahano tsa pathogenesis tse ka sehloohong tsa lefu la tsoekere la mofuta oa 2: khanyetso e phahameng ea insulin le khaello ea insulin, ka hona li fana ka litholoana tse ntle ka ho fetisisa. Glyclazide, motsoako oa lithethefatsi Glimecomb, ke PSM ea meloko e 2 mme e nkuoa e le e 'ngoe ea lintho tse sireletsehileng ka ho fetisisa sehlopheng sa eona.

Matlapa a Glimecomb a ka khethoa:

1. Ha kalafo e fetileng e emisitse ho fana ka puseletso e ntle bakeng sa lefu la tsoekere.
2. Hang-hang ka mor'a ts'ebetso ea lefu la tsoekere, haeba boemo ba glycemia bo le holimo haholo.
3. Haeba lefu la tsoekere ha le mamelle metformin ka tekanyetso e kholo.
4. Ho fokotsa palo ea litafole ho bakuli ba nkang gliclazide le metformin.
5. Litsebi tsa lefu la tsoekere ho lona glibenclamide (Maninil le analogues) kapa motsoako oa lona le metformin (Glibomet et al.) E baka khafetsa kapa ho sa lebelloa ho matla hypoglycemia.
6. Bakuli ba nang le bothata ba ho phekola ba leino bo thibetsoe bao glibenclamide e thibetsoeng.
7. Le lefu la tsoekere le rarahaneng ke lefu la pelo. Gliclazide ha e so bontšoe e na le phello e mpe myocardium.

Ho latela liphuputso, e se e le khoeli ea kalafo le Glimecomb, tsoekere e potlakileng e fokotseha ka karolelano ea 1,8 mmol / L.Ka ts'ebeliso e tsoelang pele ea lithethefatsi, phello ea eona ea mpefala, kamora likhoeli tse 3 ho fokotseha ho se ho le 2.9. Phekolo ea likhoeli tse tharo e tloaelehileng tsoekere e halofo ea bakuli ba nang le lefu la tsoekere le fetotsoeng, ha lethal dose le sa ka la feta matlapa a 4 ka letsatsi. Ho nona ka boima ba 'mele le hypoglycemia e matla, e hlokang ho kenella sepetlele, ha lia ngolloa ka meriana ena.

Pharmacology Glimecomb

Motsoako oa PSM le metformin o nkuoa e le oa setso. Leha ho na le keketseho ea baemeli ba bacha ba hypoglycemic, mekhatlo ea machaba ea lefu la tsoekere le Lefapha la Bophelo bo Botle la Russia Federation e ntse e tsoela pele ho khothaletsa motsoako ona e le oa pele ho fetisisa. Glimecomb e loketse ho sebelisoa ebile e theko e tlaase. Likarolo tsa eona lia sebetsa ebile li sireletsehile.

Glyclazide e nang le lefu la tsoekere la mofuta oa 2 e matlafatsa tlhahiso ea eona ea insulin, 'me e qala ho sebetsa karolong ea pele ea secretion ea eona, ha tsoekere e sa tsoa kena maling. Ketso ena e u lumella ho fokotsa glycemia kapele ka mor'a ho ja, ho fetisetsa tsoekere ho linama tse kenellang. Glyclazide e thibela nts'etsopele ea angiopathy: e thibela thrombosis, e ntlafatsa microcirculation le boemo ba marako a methapo ea mali. Kameho e ntle ea gliclazide tseleng ea retinopathy le nephropathy e netefalitsoe. Matlapa a Glimecomb ha a hlile ha a lebise ho insulin e ngata maling, ka hona ha e bake boima ba 'mele. Litaelo li boetse li hlokometse bokhoni ba gliclazide ho ntlafatsa kutloisiso ea insulin, empa boemong bona o hole le metformin, moetapele ea tsebahalang ntoeng ea ho loants'oa insulin.

Metformin ke sona feela sethethefatsi se khothalletsoang ho batho ba mefuta eohle ba 2 diabetes. E hlohlelletsa phetoho ea tsoekere e tsoang methapong ea mali ho ea liseleng, e thibela ho etsoa ha tsoekere ke sebete, e liehisa ho kenngoa ka popelong. Moriba o loana ka katleho le mathata a metabolism ea lipid, e leng tšobotsi ea mofuta oa 2 oa lefu lena. Ka lebaka la litlhahlobo tse ngata tse ntle tsa batho ba nang le lefu la tsoekere, metformin e sebelisoa bakeng sa ho fokotsa boima ba 'mele. Ha e bake hypoglycemia, ha e sebelisoa ho latela litaelo e bolokehile ka botlalo. Bothata ba motsoako ona oa Glimecomb ke bokhutšoanyane ba litlamorao tse sa rateheng phepelong ea lijo.

Pharmacokinetics ea likarolo tsa lithethefatsi:

Lihora tse 2 ha li kenngoa ka mpeng e se nang letho

Lihora tse 2,5 haeba u sebelisa moriana ka nako e le ngoe le lijo, joalo ka litaelo tse fanoang.

Glimecomb ea lithethefatsi e na le khetho e le 'ngoe ea litekanyetso - 40 + 500, letlapeng 40 mg ea glyclazide, 500 mg ea metformin. Ho fumana tekanyetso ea halofo, Letlapa le ka aroloa, ho na le kotsi ho lona.

Haeba motho ea nang le lefu la tsoekere a sa ka a nka metformin pele, letlapa le le leng le nkoa e le tekanyetso ea ho qala. Libeke tse 2 tse tlang ha ho lakatsehe ho e eketsa, ka hona o ka fokotsa kotsi ea ho se sebetse hantle mohloling oa tšilo ea lijo. Bakuli ba tloaetseng metformin le ho e mamella hantle ba ka fuoa meriana hang-hang ho fihlela matlapeng a 3 Glimecomb. Motsoako o lakatsehang o khethoa ke ngaka, o nahanela boemo ba mokuli ba glycemia le meriana e meng eo a e nkang.

Haeba tekanyetso ea ho qala e sa fane ka sephetho se lakatsehang, butle-butle e eketseha. Bakeng sa ho thibela hypoglycemia, karohano lipakeng tsa liphetoho tsa litekanyetso e lokela ho ba bonyane beke. Boholo bo lumelletsoeng ke matlapa a 5. Haeba ka litekanyetso tsena, Glimecomb ha e fane ka puseletso bakeng sa lefu la tsoekere, ho na le litlhare tse ling tse fokotsang tsoekere ho mokuli.

Haeba mokuli a hanyetsa insulin haholo, Glimecomb ho tsoekere e ka tahoa le metformin. Palo ea matlapa a joalo a baloa e le hore tekanyetso eohle ea metformin e se ke ea feta 3000 mg.

Melao ea ho sebelisa lithethefatsi Glimecomb

Ho ntlafatsa mamello ea metformin le ho thibela ho theoha ha tsoekere haholo, matlapa a Glimecomb a nooa ka nako e ts'oanang le lijo kapa hang kamora 'ona. Lijo li lokela ho lekana hantle 'me li tlameha ho ba le lik'habohaedreite, haholo-holo ho leng thata ho li sila. Ho latela litekolo, ho fihlela ho 15% ea batho ba nang le lefu la tsoekere ba lumela hore ho nka Glimecomb le litlhare tse ling tse fokotsang tsoekere ho felisa tlhoko ea bona ea ho latela lijo. Ka lebaka leo, ba sebelisa litekanyetso tse eketsehileng tsa lithethefatsi, tse eketsang litlamorao tsa bona le litšenyehelo tsa kalafo, ho tletleba ka tsoekere e bohloko, le pele ho moo ba tobane le mathata a lefu la tsoekere.

Hona joale ha ho moriana o le mong oa litekanyetso tsa lefu la tsoekere o ka nkang lijo. Ka lefu la mofuta oa 2, phepo e nepahetseng e bonts'oa ntle le lik'habohaedreite tse potlakileng, ka lithibelo tsa lik'habohaedreite tse tsamaeang butle, 'me hangata e nang le "calorie" e fumanehang habonolo. Ngoliso ea kalafo e kenyelletsa tloaelo ea boima ba 'mele le mosebetsi o eketsehileng.

Ho netefatsa ts'ebetso e tšoanang ea Glimecomb mots'eare, tekanyetso e boletsoeng e arotsoe ka litekanyetso tse 2 - hoseng le mantsiboea. Ho latela litlhahlobo, liphetho tse ntle ka ho fetisisa tsa kalafo li bonoa ho bakuli ba noang moriana makhetlo a mararo (kamora ho ja ka leng), leha ho le joalo hore litaelo tsa tšebeliso ha li fane ka khetho e joalo.

Ngaka ea Saense ea Bongaka, Hlooho ea Setsi sa Lefapha la Diabetes - Tatyana Yakovleva

Ke qetile lilemo tse ngata ke ithuta lefu la tsoekere. Hoa tšosa ha batho ba bangata ba shoa, mme le ho feta ba holofala ka lebaka la lefu la tsoekere.

Ke potlakela ho bolela litaba tse molemo - Setsi sa Patlisiso ea Endocrinological sa Russian Academy of Medical Science se atlehile ho hlahisa moriana o folisang lefu la tsoekere ka botlalo. Hona joale, katleho ea sethethefatsi sena e atametse 98%.

Litaba tse ling tse monate: Lekala la Bophelo le se le iphumanetse tšebetso ea lenaneo le ikhethileng bakeng sa litšenyehelo tse phahameng tsa lithethefatsi. Naheng ea Russia, ba lefu la tsoekere HO fihlela ka la 18 Motšeanong (ho kenyeletsoa) ka e fumana - Bakeng sa li-ruble tse 147 feela!

Litlamorao

Boholo ba litla-morao li ka fokolisoa haeba u latela melao ea ho nka le ho eketsa tekanyetso ho tsoa litaelo. Ho hlakoloa ha Glimecomb ka lebaka la mamello ha ho hlokahale hangata.

Contraindication

Ha o sa khone ho noa Glimecomb:

• mofuta oa 1 lefu la tsoekere
• hypoglycemia Moriana o ke ke oa tahoa ho fihlela tsoekere ea mali e fetoha e tloaelehileng
• mathata a lefu la tsoekere le matla, mafu a tebileng le likotsi tse hlokang kalafo ea insulin. Nyeoe ea lactic acidosis nakong e fetileng,
• moimana, matsoele
• X-ray e nang le li-iviine tse nang le iodine e fapaneng
• mamello ho likarolo leha e le life tsa moriana,
• renal, ho hloleha ha sebete, hypoxia, le mafu a ka bakang mafu ana,
• bokhoba ba tahi, litekanyetso tse ngata tsa joala.

Ho bakuli ba nang le mafu a lihormone. batho ba baholo ba lefu la tsoekere ka ho ikoetlisa ka nako e telele, kotsi ea litlamorao e ea eketseha, kahoo ha ba nka Glimecomb, ba lokela ho ba hlokolosi haholo ka bophelo ba bona.

Ho tsamaisana le lithethefatsi tse ling

Matla a glimecomb a ka matlafatsoa kapa a fokola ha a nooa le lithethefatsi tse ling. Lethathamo la tšebelisano ea lithethefatsi le kholo haholo, empa hangata phetoho ea ts'ebetso ha e bohlokoa ebile e ka fetoloa habonolo ka ho fetola litekanyetso.

Seo analogues se nkang sebaka

Glimecomb ha e na li-analogues tse felletseng tse ngolisitsoeng 'Musong oa Russia. Haeba sethethefatsi se le sieo ka har'a k'hemiste, lithethefatsi tse peli tse nang le lintho tse tšoanang tse sebetsang li ka se nkela sebaka:

1. Metformin e fumaneha Glucofage ea mantlha e hlahisitsoeng Fora, Siofor ea Jeremane, Metformin ea Russia, Merifatin, Gliformin. Tsohle li na le litekanyetso tsa 500 mg. Bakeng sa batho ba nang le lefu la tsoekere le mamello e sa sebetseng ea metformin, ho ka hlokahala mofuta o fetotsoeng oa lithethefatsi, o netefatsang ho kenella ka seleng ea mali maling mme o fokotsa haholo menyetla ea litla-morao. Tsena ke lithethefatsi Metformin Long Canon, Metformin MV, Foromo Long le ba bang.
2. Gliclazide le eona ke hypoglycemic e tsebahalang haholo. Ntho ke karolo ea Russia Glidiab le Diabefarm. Gliclazide e fetotsoeng hajoale e nkoa e le mofuta o ratoang. Tšebeliso ea eona e ka fokotsa sekhahla le ho teba ha hypoglycemia. Gliclazide e fetotsoeng e fumaneha litokisetsong Diabefarm MV, Diabeteson MV, Gliclazide MV, Diabetesalong, jj Ha o reka, o hloka ho ela hloko litekanyetso, o ka hloka ho arola letlapa ka halofo.

Ho na le li-analogues tsa lihlopha tse ngata tsa Glimecomb 'marakeng oa Russia. Boholo ba tsona ke motsoako oa metformin o nang le glibenclamide. Lithethefatsi tsena ha li sireletsehe ho feta glimecomb, kaha hangata e baka hypoglycemia. Phetoho e ntle bakeng sa Glimecomb ke Amaryl (metformin + glimepiride). Hajoale, ke lithethefatsi tse peli tse tsoetseng pele haholo tse nang le PSM.

Theko ea pakete ea matlapa a 60 a Glimecomb e tsoa ho li-ruble tse 459 ho isa ho tse 543. Gliclazide le metformin e tsoang ho moetsi a le mong e tla bitsa li-ruble tse 187. bakeng sa tekanyetso e tšoanang (matlapa a 60 a Glidiab 80 mg a ja li-ruble tse 130, matlapa a 60. Gliformin 500 mg - ruble tse 122). Theko ea ho kopanya litokisetso tsa mantlha tsa gliclazide le metformin (Glucofage + Diabeteson) e ka ba li-ruble tse 750, tseo ka bobeli li leng ka sebopeho se fetotsoeng.

TLHOKOMELISO MOTSAMAI

Matlapa a 40 mg + 500 mg. Bakeng sa matlapa a 30, 60 kapa a 120 ka botlolong bakeng sa meriana e entsoeng ka polasetiki. Ho matlapa a 10 kapa a 20 ka pokellong ea thipa ea blister. Botoro ka leng kapa lipentšele tse 6 tsa matlapa a 10, kapa mekotla e 5 ea lithupa ea matlapa a 20 ka bonngoe le litaelo tsa ho li sebelisa ka har'a karete ea karete.

Tlhahisoleseling ka kakaretso

Glimecomb ke kalafo e kopaneng bakeng sa lefu la tsoekere la mofuta oa 2. Likarolo tsa eona tse peli tsa sehlooho ke metformin le gliclazide. Ntho ea pele e amana le "Biguanides", ea bobeli ke mofuta oa sulfonylurea.

Boholo ba eona bo kopaneng ea likarolo tse peli tse tummeng ka ho fetisisa le tse sebetsang. Monyetla o ka sehloohong holim'a lithethefatsi tse ling tse kopaneng ke kotsi e fokolang ea hypoglycemia. E entsoe ke k'hamphani ea meriana ea Russia ea Akrikhin.

Matšoao a ho sebelisoa

Setlhare sena se etselitsoe bakuli ba nang le lefu la tsoekere la mofuta oa 2. Taba ea pele, lingaka li khothalletsa kalafo ea ho ja, hammoho le ho ikoetlisa letsatsi le leng le le leng. Haeba, kamora nako e itseng, mehato ena e sa tlise phello e lebelletsoeng, kalafo e tlatselletsoa ka meriana. Ho qala, mokuli o fuoa meriana e nang le motsoako o le mong e thehiloeng ho metformin. Haeba phello ea kalafo e sa hlahe, ho bontšoa kalafo ea ho kopanya.

Fomu ea tokollo

"Glimecomb" ke matlapa a bosoeu ba krimsone a sebopeho sa cylindrical, a bataletseng. Tsela ea 'mabole e lumelletsoe. Ho na le strip ea kotsi ea diametri. Matlapa a kenngoe ka mabokoseng a likotoana tse 30 kapa 60.

Litšenyehelo tse hakanyetsoang tsa ho paka li-pcs tse 30 tsa "Glimecomba" ka litlhare tsa Russia li tsoa li-ruble tse 276.

Litšenyehelo tse hakantsoeng tsa ho kenya li-pcs tse 60 - ho tloha ho li-ruble tse 524.

Letlapa le leng le le leng le na le 500 mg ea metformin le 40 g ea gliclazide. Tsena ke likarolo tse peli tsa sehlooho tse sebetsang. Ke maemo ana a supang ts'ebetso ea ona e phahameng, le "bonolo" ba ketso.

Ntlafatso ea lefu la tsoekere - e-nooa feela letsatsi le letsatsi.

Har'a likarolo tse nyane: sorbitol, povidone, magnesium stearate, croscarmellose sodium.

Ka lebaka la khaello ea lactose, lithethefatsi li lumelloa ho sebelisoa ke batho ba nang le eona.

Litaelo tsa ho sebelisoa

Matlapa a Glimecomb a etselitsoe ho sebelisoa ka molomo nakong ea lijo kapa hang ka mor'a lijo. Ho latela boholo ba lethal dose le boemo ba mokokotlo oa mokokotlo oa mokuli. Nakong ea kalafo, ho hlokahala hore u boloke melao ea lijo tse tlase tsa carb ka tlase. Ho latela melao ena, ha ho na moo u lokelang ho tlōla lijo tsa hoseng.

Sebopeho sa 'mele sa mokuli, hammoho le boemo ba maikutlo ba hae ba maikutlo, se na le tšusumetso e kholo ho litekanyetso. Tlala ha e lumelloe, leha e ka ba ea nakoana, 'me haholo-holo tšebeliso ea joala.

Sephutheloana se tlameha ho bolokoa sebakeng se lefifi ka mocheso ho fihlela ho 25 ° C. Pele u reka, ho molemo ho ela hloko letsatsi la tlhahiso le la ho felloa ke nako. Sethethefatsi se nang le letsatsi la ho felloa ke nako se seng se haufi le pheletso ho molemo ho se reke.

Likarolo tsa ts'ebeliso

Ka lebaka la kotsi e kholo ea ho ba le lactic acidosis, Glimecomb ha e khothalletsoe batho ba tsofetseng ba fetang lilemo tse 60, hammoho le bakuli ba etsang mosebetsi o boima oa 'mele.

Bokhachane ke tšitiso e phethahetseng bakeng sa ts'ebeliso ea eona. Ka hona, nakong ea ho tsoala ngoana, le nakong ea ho itokisetsa kemolo, e tlameha ho nkeloa sebaka ke lithethefatsi tse ling.

Ho anyesa ho ke ke ha lumellana le Glimecomb. Tabeng ena, mme ea anyesang o na le khetho: ho qeta ho emisa, ebe o fetola lijo tsa maiketsetso, kapa hona ho sebelisa sethethefatsi ka boeona.

Ts'ebeliso ka hloko e ka khona ho bakuli ba nang le mafu a tsamaiso ea endocrine.

Re fana ka theolelo ho babali ba sebaka sa rona sa marang-rang!

Pheko ea Glimecomb e lumelloa bakeng sa batho ba tsoekere ba latelang litaelo tsohle tsa phepo e tlase ea carb. Lijo li lokela ho ba teng kamehla. Likheo tse kholo pakeng tsa lijo li ka baka lerotholi le matla la tsoekere maling. Hape, ka tšohanyetso hypoglycemia e ka baka tšebeliso ea lino tse tahang esita le ka tekanyo e nyane, hammoho le lithethefatsi tse seng khahlanong le ts'oaetso.

Ho sebelisana le lithethefatsi tse ling

Tšusumetso ea kalafo ea Glimecomb e kanna ea matlafatsoa le ho fokotsoa ke meriana e meng. Maemong a mangata, phello ena ha e bohlokoa ebile e felisoa ke phetoho e nyane ea tekanyetso.

Lithethefatsi tse fokotsang matla a hypoglycemic a Glimecomb:

• litlhare tse thibelang ho ruruha,
• lithethefatsi life kapa life tsa hormonal, ho kenyeletsa lithibela-pelehi,
• diuretics
• Lithethefatsi tse nang le nicotinic acid,
• antidepressant.

Meriana e ntlafatsang bokhoni ba glycemic:

• antimicrobials
• Vithamine B6
• Lithethefatsi tse sa hlaseleng li-hormone
• lithethefatsi tse ling tse theolelang tsoekere ea mali, ho kenyeletsa insulin.

Boemong bofe kapa bofe, ke ngaka feela e teng e ka lokisang lethal dose ea Glimecomb. Mokuli o hlokahala feela ho mo lemosa ka nako e nepahetseng ka meriana eo a e nkang kapa eo a rerileng ho e nka.

Litlamorao

Glimecomb e na le lenane le leholo la litlamorao. Bakeng sa ho fokotsa ts'ebetso ea bona ho 'mele, ho bohlokoa ho latela ka tieo melao ea kamohelo e boletsoeng ho litaelo.

Glimecomb e mamelletsoe hantle. Ho hlakoloa ha eona ka lebaka la mamello ho tloaelehile haholo.

Pharmacokinetics ea sehlahisoa sa meriana

Setlhare se khetholloa ke ho ba teng ha pancreatic le extrapancreatic effect.

Glyclazide e thusa ho theha insulin ka lisele tsa beta tsa manyeme mme e phahamisa kutloisiso ea lisele tsa "cell insulin" tse itšetlehileng ka insulin. Ho feta moo, k'hemik'hale e thusa ho tsosa enzyme e ka hare ho eona - mesifa ea glycogen synthetase. Ts'ebeliso ea gliclazide e thusa ho khutlisa tlhoro ea pele ea "insulin secretion" hape e fokotsa hyperglycemia ea postpradial.

Ntle le ho susumetsa ts'ebetso ea metabolism ea carbohydrate, ts'ebeliso ea komporo ena e ama bongata ba mali, e fokotsa boemo ba khokahano le lipalo tsa liplatelete, e fokotsa tsoelo-pele ea parietal thrombosis, e khutlisetsa karohano e tloaelehileng ea marako a methapo, e fokotsa karabelo ea marako a methapo ho adrenaline maemong a Microangiopathy.

Ts'ebeliso ea gliclazide e thusa ho liehisa nts'etsopele ea lefu la tsoekere; ho ekelletsa moo, ha ho na le nephropathy, ho fokotseha hoa protheine.

Metformin ke motsoako oa lik'hemik'hale oa sehlopha sa Biguanide. K'hemik'hale ena e thusa ho fokotsa tsoekere e maling maling a lero la mali. Matla a fumaneha ka ho thibela ts'ebetso ea gluconeogenesis liseleng tsa sebete, le ka ho fokotsa tekanyo ea tsoekere ea glucose ho tsoa ho lumen ea phepelo ea gastrointestinal, hape ka ho ntlafatsa ho kenngoa ha tsoekere ke lisele tsa litho tsa 'mele. Ts'ebeliso ea metformin e thusa ho fokotsa serum triglycerides, cholesterol le lipoprotein tse tlase. Ho kenngoa ha metformin 'meleng ho fana ka phokotso le botsitso ba boima ba' mele.

Ts'ebeliso ea metformin ha ho na insulin maling e sa lebise ponahalong ea phello ea kalafo mme ho hlaha ha methapo ea hypoglycemic ha ho bonoe. Tšebeliso ea metformin e ntlafatsa likarolo tsa mali tsa fibrinolytic.

Sena se fihlelloa ka ho hatella inhibitor ea mofuta oa lisele.

Matšoao le li-contraindication bakeng sa ts'ebeliso ea moriana

Matšoao a ts'ebeliso ea Glimecomb ke mofuta oa lefu la tsoekere la 2 ha ho na katleho ea tšebeliso ea kalafo ea ho ja le ho ikoetlisa 'meleng, hape ha ho na le phello ea kalafo e fetileng e nang le metaformine le glycazide.

Glimecomb e sebelisoa ho khutlisa kalafo e rarahaneng e neng e entsoe pele ka litlhare tse peli tsa Metformin le Glycoside, ha feela boemo ba tsoekere ea mali bo tsitsitse ebile bo laoloa hantle.

Glimecomb e na le mefuta e fapaneng ea li-contraindication ts'ebelisong ea lithethefatsi.

Tse ka sehloohong har'a contraindication ke tse latelang:

1. Hypersensitivity ea mmele oa mokuli ho litlamorao tsa metformin, gliclazide kapa sulfonylureas e ngoe. Ntle le moo, sethethefatsi ha sea lokela ho sebelisoa ha ho na le hypersensitivity ho likarolo tse ling tsa litlhare.
2. Boteng ba lefu la tsoekere la mofuta oa 1.
3. Ho ba teng ha lefu la tsoekere ketoacidosis, lefu la tsoekere le liketsahalo tsa ho ferekana kelellong.
4. Nts'etsopele ea ts'oaetso e matla ea renal.
5. Nts'etsopele ea maemo a hlobaetsang a ka lebisang ho phetoho mosebetsing oa liphio, kholo ea ho omella, ts'oaetso e matla le ho tsitsipana.
6. Nts'etsopele ea maloetse a sa foleng le a hlobaetsang, e tsamaeang le ho hlaha hoa tishu hypoxia.
7. Ketsahalo ea ho hloleha ha phekolo ea masapo.
8. Porphyria.
9. Nako ea kemaro le nako ea ho anyesa.
10. Tsamaiso e ts'oanang ea miconazole.
11. Maloetse a tšoaetsanoang le ts'ebetso ea ho buoa, ho chesa haholo le likotsi tse kholo, tseo nakong ea kalafo li hlokang ts'ebeliso ea kalafo ea insulin.
12. Boteng ba botahoa bo sa foleng le tahi e matla ea joala.
13. Ntshetsopele ea lactic acidosis.
14. Ho latela lijo tse nang le carb e tlase.

Ntle le linyeoe tsena, lithethefatsi ha lia lumelloa ho sebelisoa ha ho sebelisoa tlhahlobo ea iodine e nang le iodine ea mmele.

Se ke ua sebelisa lithethefatsi bakeng sa kalafo ea lefu la tsoekere ho bakuli ba lilemo li 60, ba nang le boikoetliso bo boima ba 'mele. Sena se bakoa ke menyetla e phahameng ea kholo ea kholo ea lactic acidosis ho bakuli ba joalo.

Ho lokela hore ho sebelisoe tlhokomeliso e khethehileng ha u sebelisa moriana haeba mokuli a e-na le letšoao le sa bonahaleng, ho se lekane ha ts'ebetso ea litšoelesa tsa adrenal, boteng ba hypofunction ea anterior pituitary gland, lefu la qoqotho e bakang tlolo ea ts'ebetso ea eona.

Ts'ebeliso ea lithethefatsi

Litaelo tsa ho sebelisoa Glimecomba li laola le ho hlalosa ka botlalo maemo ohle ao ho khothalletsoang ho a sebelisa le lithethefatsi ha ho thibetsoe ts'ebeliso ea lithethefatsi. Litaelo li fana ka litla-morao tsohle tse hlahang ha o sebelisa sehlahisoa le moriana o khothalletsoang hore o sebelisoe.

Setlhare se sebelisoa ka molomo nakong ea lijo kapa hang ka mor'a sona. Tekanyetso e hlokahalang bakeng sa ho amoheloa e khethoa ke ngaka e eang ho latela sephetho sa tlhahlobo le litšobotsi tsa mmele oa mokuli. Tekanyetso ea moriana e khethoa ho latela boemo ba tsoekere maling a mokuli.

Hangata, tekanyetso ea pele ea moriana o khothalletsoang ke ngaka bakeng sa mokuli ke matlapa a 1-3 ka letsatsi le khetho ea butle-butle ea tefo ea lefu la tsoekere. Haeba u sa latele likhothaletso, tsoekere e ntlafalitsoeng e tla nts'etsapele.

Hangata, lithethefatsi li lokela ho nooa habeli ka letsatsi hoseng le mantsiboea. Le litekanyo tse phahameng tsa lithethefatsi e ka ba matlapa a 5.

Ho na le litaelo tse khethehileng tse lokelang ho lateloa ha u etsa kalafo ea Glimecomb:

• kalafo e lokela ho etsoa feela hammoho le lijo tse nang le khalori e tlase e nang le lik'habohaedreite tse nyane,
• bakuli ba lokela ho fumana lijo tsa kamehla tse matlafatsang, tse lokelang ho kenyelletsa lijo tsa hoseng,
• molemong oa ho qoba nts'etsopele ea matšoao a hypoglycemia, khetho ea litekanyetso ka bomong e lokela ho etsoa,
• ha khatello ea maikutlo e phahameng 'meleng le maikutlong e ba le' mele, ho hlokahala phetoho ea moriana e lokelang ho nooa,

Ha o etsa kalafo ka sethethefatsi se kang Glimecomb, o lokela ho hana ho nka lino tse tahang le lihlahisoa tsa lijo tse nang le ethanol ka sebopeho sa tsona.

Ho lokela hore ho sebelisoe tlhokomeliso e khethehileng ha u sebelisa lithethefatsi ha u etsa mefuta eo ea mosebetsi e hlokang ho tsepamisa maikutlo le ho potlakela ho arabela.

Litlamorao tse mpe

Ha u sebelisa lithethefatsi, mokuli a ka ba le litlamorao tse ngata.

Ts'ebetsong ea metabolic, khahlanong le litekanyetso kapa ha u ja lijo tse sa lekaneng, ho ka hlaha mathata a lebisang ho hypoglycemia. Boemo bona ba 'mele bo tsamaea le hlooho e bohloko, ponahalo ea ho tepella, maikutlo a matla a tlala, ho phahama ha pelo, ponahalo ea ho tsekela, le tšebelisano e mpe ea methapo.

Ho feta moo, maemong a tlhekefetso ea litekanyetso ho mokuli, boemo ba lactic acidosis bo ka hlaha, bo bonahatsoa ke bofokoli ba myalgia, ho otsela ho eketsehileng, bohloko bo ka mpeng le ho fokotseha ha khatello ea mali.

Mathata a latelang a ka hlaha tsamaisong ea tšilo ea lijo:

1. boikutlo ba ho nyekeloa
2. kholo ea lets'ollo,
3. ponahalo ea ho imeloa kelellong ho epigastrium,
4. ponahalo ea tatso ea tšepe molomong,
5. takatso e fokotsehileng
6. maemong a sa tloaelehang, ho senyeha ha sebete joalo ka hepatitis, cholestatic jaundice le ba bang ba bang ba ba le eona.

Haeba ho na le mathata mokhoeng oa sebete, moriana o lokela ho emisoa hanghang.

Mabakeng a tlolo ea litekanyetso le litekanyetso tsa kalafo, nts'etsopele ea khatello ea ketso ea ho etsa mali e ka etsahala.

Ka litla-morao, mokuli a ka ba le karabelo ea ho hohlana, e bonahatsoang ka mokhoa oa ho hlohlona, ​​urticaria le makhopho a maculopapular.

Haeba mokuli a ka ba le litla-morao tsa ho sebelisa moriana, moriana o lokela ho fokotsoa hanghang kapa tšebeliso ea meriana e emisoe.