Mokhoa oa ho sebelisa lithethefatsi Glukovans?

Mofuta oa litekanyetso tsa Glucovans - matlapa: biconvex e nang le sebopeho sa khalase ea 'mala oa lamunu e bobebe e ngotsoe ka lehlakoreng le le leng la "2,5" kapa' mala o mosehla o ngotsoeng ka "5" (li-pcs tse 15.

Glibenclamide - 2,5 mg kapa 5 mg,
Metformin hydrochloride - 500 mg.

Baeti: povidone K30, sodium ea croscarmellose, magnesium stearate, cellcose ea microcrystalline.

Karolo ea khetla ena e bobebe 'mala oa lamunu / mosehla: opadry OY-L-24808 pinki / opadry 31-F-22700 mosehla (hypromellose 15cP, lactose monohydrate, titanium dioxide, iron oxide e khubelu, iron oxide e sootho / dae quinoline e tshehla, macrogol, oxide ea tšepe. mosehla), metsi a hloekisitsoeng.

Mofumahali

Glucovans ke motsoako o kopaneng oa li-agent tse peli tsa molomo tsa hypoglycemic, tseo e leng tsa lihlopha tse fapaneng tsa meriana: glibenclamide le metformin.

Metformin ke karolo ea sehlopha sa "Biguanide" mme e fokotsa boemo ba glucose ba postprandial le basal ka har'a plasma ea mali. Ha se se khothalletsang tlhahiso ea insulin, e bakang kotsi e fokolang ea hypoglycemia. Mekhoa e meraro ea ketso ke tšobotsi ea ntho:

ho thibeloa ha tsoekere ea glucose ka har'a tšilo ea lijo,
e eketsa kutloisiso ea li-receptor tsa insulin, 'me e eketsa ts'ebeliso ea tsoekere le lisele tsa mesifa.
ho fokotseha ha motsoako oa tsoekere bokong ka ho sitisa glycogenolysis le gluconeogeneis.

Metformin e boetse e ama ka nepo sebopeho sa mali sa lipid, se fokotsa khatello ea mali ea "triglycerides", density lipoproteins (LDL) le cholesterol e felletseng.

Glibenclamide ke svilonylurea ea moloko oa bobeli. Tekanyo ea glucose ha ntho ena e sebetsang e kenelletsoa e fokotseha ka lebaka la ts'ebetso ea tlhahiso ea insulin ke lisele tsa beta tse teng ka har'a manyeme.

Mehato ea ts'ebetso ea metformin le glibenclamide e fapane, empa lintho li na le phello ea synergistic mme li khona ho ntlafatsa ts'ebetso ea hypoglycemic e 'ngoe, e lumellang ho fihlela phokotseho e kholo ea tsoekere ea mali.

Mofumahali

Ho fufuleloa ha glibenclamide ho tsoa pampiring ea ka mpeng ka mor'a tsamaiso ea molomo e feta 95%. Karolo ena e sebetsang ea Glucovans e entsoe ka micron. Sekhahla se phahameng sa ntho ho plasma se fihlella ka lihora tse 'ne, mme bophahamo ba kabo ea tsona e ka ba lilithara tse 10. Glibenclamide e hokahana le liprotheine tsa plasma ka 99%. Hoo e batla e le 100% e kentsoeng ka har'a sebete, e etsa li-metabolites tse peli tse sa sebetseng, tse hlahisitsoeng ka bile (60% ea tekanyetso e nkuoeng) le moroto (40% ea lethal dose tse nkuoeng). Nako ea bophelo ba ho felisoa e fapana ho tloha lihora tse 4 ho isa ho tse 11.

Kamora ho tsamaisoa ka molomo, metformin e nkuoa ho tsoa mokokotlong oa ka mpeng ka botlalo, mme boemo ba eona bo phahameng ba plasma bo fihlella ka nako ea lihora tse 2,5. Hoo e batlang e le 20-30% ea ntho ena e nts'itsoe mokhoeng oa ho chesa o sa fetoloang. Boaoavailability e felletseng ke 50-60%.

Metformin e ajoa ka liseleng ka lebelo le phahameng, 'me tekanyo ea eona ea ho ikamahanya le liprotheine tsa plasma ha e nyane. Ntho ena e na le metabolism e nyane mme e epolloa ka liphio. Ho felisoa ha halofo ea bophelo ke ka lihora tse 6.5. Bakeng sa bakuli ba nang le bothata ba ho hlaphoheloa kelellong, ho na le phokotseho ea ho ba le liphiri le ho eketseha ha halofo ea bophelo, e lebisang keketseho ea litaba tsa metformin ho plasma ea mali.

Motsoako oa glibenclamide le metformin ho moriana o le mong o tšoauoa ka bioavailability e ts'oanang ha o nka liforomo tsa tafole tse nang le metsoako ena e sebetsang ka thoko. Ho ja ha ho ame bioavailability ea Glucovans, e leng motsoako oa glibenclamide le metformin. Leha ho le joalo, tekanyo ea ho monya ha glibenclamide ha e nkuoa ka lijo e eketseha.

Matšoao a ho sebelisoa

Ho latela litaelo, Glucovans e fuoe batho ba baholo ba nang le lefu la tsoekere la mofuta oa 2 haeba:

Monotherapy ea nakong e fetileng ka sulfonylureas kapa metformin, kalafo ea ho ja le ho ikoetlisa e ne e sa sebetse,
Phekolo e kopaneng le methapo ea metformin le sulfonylurea ho bakuli ba nang le glycemia e laoloang hantle le e tsitsitseng ba lokela ho nkeloa sebaka ke monotherapy.

Contraindication

Type 1 lefu la tsoekere
Lefu la tsoekere le letala
Lefu la tsoekere la ketoacidosis
Lactic acidosis, ho kenyelletsa le nalane ea
Ho hloleha ha lesapo la mokokotlo le / kapa la sebete,
Lenaneo la ho senya mesebetsi e sebetsang (clearinine clearance (QC)
Maemo a hlobaetsang a bakang liphetoho mosebetsing oa liphio: ts'oaetso e matla, ho felloa ke metsi, ho tsitsipana, li-iodine tse nang le li-iodine tse nang le phapang e itseng,
Porphyria
Tissue hypoxia moo ho nang le mefuta e mpe kapa e sa foleng ea ho phefumoloha kapa pelo, ho ts'oha, infarction ea morao-rao ea myocardial,
Nako ea kemaro le ho anyesa,
Ts'ebeliso e ts'oanang ea miconazole,
Ho buuoa ka botlalo
Ho itlopa joala haholo
Ho tsamaellana le phepo ea hypocaloric (ka tlase ho 1000 kcal ka letsatsi),
Glucose-galactose malabsorption syndrome, mamello ea galactose, khaello ea lactase,
Tlas'a lilemo tse 18
Lilemo tse fetang lilemo tse 60, ha o ikoetlisa ka matla (kotsi ea lactic acidosis),
Hypersensitivity ho likarolo tsa lithethefatsi kapa tse ling tse tsoang ho sulfonylurea.

Ka tlhokomeliso, Glucovans e khothalletsoa bakeng sa: mafu a tšoelesa ea qoqotho a nang le ts'ebetso e sa lekanyetsoang ea ts'ebetso ea eona, ho hloka tharollo ea adrenal, febrile syndrome, hypofunction ea gland ea gown.

Litaelo bakeng sa ts'ebeliso ea Glucovans: mokhoa le litekanyetso

Ho khothalletsoa hore matlapa a Glucovans a nooe le lijo, 'me bongata ba lik'habohaedreite bo lokela ho ba teng lijong.

Ngaka e beha lethal dose ka bonngoe, ho nahanela boemo ba glycemia.

Tekanyetso ea pele ke Letlapa le le leng la 1 Glucovans 2,5 mg / 500 mg kapa Glucovans 5 mg / 500 mg hang ka letsatsi.

Ha u fetisetsa mokuli ka motsoako kapa monotherapy ka sulfonylurea le metformin ho ea kalafo ea Glucovans, e le ho thibela hypoglycemia, tekanyetso ea pele ha ea lokela ho feta tekanyo e lekanang ea letsatsi le letsatsi ea lithethefatsi tse neng li nkuoa pele. Ho fihlela taolo e nepahetseng ea tsoekere ea mali, lethal dose le lokela ho eketsoa butle butle, eseng ho feta 5 mg / 500 mg ka letsatsi ka mor'a libeke tse ling le tse ling tse peli kapa ka tlase ho moo. Phetoho ea moriana e lokela ho etsoa kamehla ho latela boemo ba glycemia.

Tekanyetso e kholo ea letsatsi le letsatsi ke matlapa a 4 a Glucovans 5 mg / 500 mg kapa matlapa a 6,5 mg / 500 mg. Regimen ea matlapa a ikemiselitsoe ka bonngoe, ho latela tekanyetso ea letsatsi le letsatsi ea lithethefatsi:

Letlapa le le leng (la litekanyetso) - Nako e le ngoe ka letsatsi, hoseng,
Matlapa a 2 kapa a 4 (litekanyetso life kapa life) - makhetlo a 2 ka letsatsi, hoseng le mantsiboea,
Matlapa a 3, 5 kapa a 6 a 2,5 mg / 500 mg kapa matlapa a 3 a 5 mg / 500 mg - makhetlo a 3 ka letsatsi, a lokela ho nooa hoseng, thapama le mantsiboea.

Bakeng sa bakuli ba tsofetseng, tekanyetso ea pele ha ea lokela ho feta Letlapa le le leng la 2,5 mg / 500 mg. Morero oa lethal dose le ts'ebeliso ea li-Glucovans li lokela ho betoa leihlo khafetsa bakeng sa ts'ebetso ea ho phekola a liphio.

Litlamorao

Ho tsoa ho tsamaiso ea tšilo ea lijo: hangata khafetsa - ho hloka takatso ea lijo, ho nyekeloa ke pelo, bohloko ba ka mpeng, ho hlatsa, lets'ollo. Matšoao hangata a hlaha qalong ea kalafo mme ke a nakoana. Ke ka seoelo - mathata a sebetsang a sebete, hepatitis,
Ho tsoa lithong tsa kutlo: hangata - tatso ea tšepe molomong. Qalong ea phekolo, ho ka ba le tšenyo ea nakoana ea pono.
Ho tloha ka lehlakoreng la metabolism: hypoglycemia, ka seoelo - litlhaselo tsa porphyria ea letlalo le porphyria ea letlalo, ka seoelo - lactic acidosis. Ka kalafo ea nako e telele - ho fokotseha hoa boemo ba mahloriso a vithamine B12 serum ea mali (ho ka baka anemia ea megaloblastic). Khahlano le semelo sa tšebeliso ea joala, karabelo e kang ea discriram,
Litho tsa Hematopoietic: ka seoelo - thrombocytopenia le leukopenia, ka seoelo - pancytopenia, hemolytic anemia, apoleia ea masapo, agranulocytosis,
Letlalong la letlalo: ka seoelo - ho hlohlona, makhopho a kang maselese, hangata - - dermatitis, erythema multiforme, photosensitivity,
Litla-morao: Ha ho potang - urticaria, ka seoelo - visceral kapa letlalo le ho hlaseloa ke letlalo, ho thothomela ha anaphylactic. Ka tsamaiso e le 'ngoe, li-hypersensitivity tsa sulfonamides le tse ling tsa tsona li ka khonahala,
Matšoao a laboratori: hangata - keketseho ea palo ea li-creatinine le urea ka serum ea mali ho isa tekanyong e lekanang, hangata - hyponatremia.

Bongata

Bongata ba Glucovans bo ka tsosa nts'etsopele ea hypoglycemia, hobane thipa ea sulfonylurea ke karolo ea lithethefatsi.

Matšoao a ho fokola ho isa tekanyong ea "hypoglycemia" ntle le ts'oaetso ea ts'ebetso ea methapo e bohareng le syncope hangata a lokisoa ke tšebeliso ea tsoekere kapele. Hape o lokela ho fetola tekanyetso ea li-Glucovans le / kapa ho fetola lijo. Haeba bakuli ba nang le lefu la tsoekere ba tšoaroa ke ts'oaetso e matla ea hypoglycemic, e tsamaeang le paroxysm, komisi kapa mathata a mang a methapo, ho lokela ho fanoa ka tlhokomelo ea bongaka ea tšohanyetso. Hang ka mor'a hore ho fumanoe lefu la bongaka kapa ka ho belaela hanyane ka hanyane ka hypoglycemia, ho khothalletsoa ts'ebetso ea methapo ea hang-hang ea tharollo ea dextrose pele mokuli a kenngoa sepetlele. Kamora hore mokuli a fole, o lokela ho fuoa lijo tse nang le lik'habohaedreite tse ngata tse ananelang habonolo, tse tla thibela tsoelopele ea hypoglycemia.

Tsamaiso ea nako e telele ea li-Glucovans ka tekanyetso e phahameng kapa lintlha tse teng tsa kotsi ea conjugate e ka lebisa nts'etsopele ea lactic acidosis, kaha metformin ke karolo ea lithethefatsi. Lactic acidosis e nkoa e le boemo bo hlokang tlhokomelo ea bongaka ea tšohanyetso, mme kalafo ea eona e lokela ho etsoa feela sepetlele. Mekhoa e sebetsang ka ho fetisisa ea ho phekola e khothalletsang tšusumetso ea lactate le metformin e kenyelletsa hemodialysis.

Ho bakuli ba nang le bothata ba ho hlobaela ka sebete, ho hlakisoa ha glibenclamide ho plasma ea mali ho ka eketseha. Kaha ntho ena e tlama haholo liprotheine tsa plasma ea mali, ho felisoa ha eona nakong ea hemodialysis ha ho na monyetla.

Litaelo tse khethehileng

Phekolo e khothalletsoa hore e tsamaisane le ho lekola khafetsa tsoekere ea mali le ka mor'a ho ja.

Nakong ea tsamaiso ea Glucovans, ho hlokahala ho nahanela monyetla oa ho nts'etsapele lactic acidosis, matšoao a lefu lena e ka ba ponahalo ea bohloko ba ka mpeng, malaise a matla, mokokotlo oa mesifa le mathata a ho hlobaela.

Ha o sebelisa li-Glucovans, ho na le kotsi ea ho ba le hypoglycemia, hangata e etsahala ho bakuli ka ho ja lijo tse nang le lik'habohaedreite tse ngata, ba sa latele lijo, ho noa joala, ho ikoetlisa ka matla ka lijo tse matlafatsang. Tlhokomelo mabapi le ho fana ka khetho, khetho e hloko ea lethal dose le ts'ebetsong ea litlhahiso tsa ngaka li fokotsa monyetla oa ho kula.

Ho thibetsoe ho noa joala nakong ea phekolo.

Pele ho khethoa ha Glucovans le nakong ea tsamaiso, lithuto tse tloaelehileng li lokela ho etsoa ho fumana boemo ba mahloriso a serum creatinine. Tlhahlobo e lokela ho etsoa ho bakuli ba nang le ts'ebetso e tloaelehileng ea renal bonyane nako e le 'ngoe ka selemo, ka ts'enyo e sebetsang ea liphio le bakuli ba tsofetseng - makhetlo a 2-4 ka selemo.

Haeba mafu a tšoaetsanoang a bronchi, matšoafo kapa litho tsa urogenital a hlaha, etela ngaka hang-hang.

Bokhachane le pelehi

Ho qala ho ima ke mokhoa o khahlanong le tšebeliso ea lihlahisoa tsa tsoekere. Bakuli ba lokela ho tsebisoa hore nakong ea kalafo le moriana ba lokela ho tsebisa ngaka ka tlhophiso ea bokhachane kapa pelehi. Maemong ana ka bobeli, Glucovans hang-hang e hlakotsoe mme mokhoa oa phekolo ea insulin o laetsoe.

Ha ho na tlhahisoleseling mabapi le bokhoni ba metformin hammoho le glibenclamide ho fetela lebese la matsoele, ka hona, ho ts'oaroa ha moriana nakong ea lebone ho sa amoheloe.

Sebelisa botsofaling

Tekanyetso bakeng sa bakuli ba tsofetseng e thehiloe ho nahanela maemo a ts'ebetso ea a renal, e lokelang ho hlahlojoa khafetsa. Motsoako oa mantlha ho bakuli ba sehlopha sena ke Letlapa le le leng la 2,5 mg / 500 mg.

Ha ho khothalletsoe ho sebelisa li-Glucovans ho bakuli bao lilemo tsa bona li fetang lilemo tse 60 mme mmele oa bona o le tlas'a khatello e matla ea mmele, e hlalositsoeng ke kotsi e eketsehileng ea ho ba le lactic acidosis ho bona.

Ho sebelisana le lithethefatsi

Tsamaiso ea Glucovans e lokela ho emisoa matsatsi a 2 pele le ho nchafatsoa matsatsi a 2 kamora ho kenella kahare ho tsamaiso ea li-iodine tse nang le iodine e fapaneng.

Tšebeliso e tšoanang ea miconazole e thibetsoe, ka lebaka la menyetla e phahameng ea ho holisa hypoglycemia, ho fihlela ho akheha.

Ho kopana ha sethethefatsi le lithethefatsi tse nang le ethanol le phenylbutazone ha ho kgothaletswe, hobane li eketsa phello ea hypoglycemic ea Glucovans.

Ka tšebeliso e ts'oanang le bosentan, menyetla ea ts'ebetso ea hepatotoxic e eketseha, phello ea glibenclamide ea fokotseha.

Tekanyo e phahameng ea chlorpromazine e fokotsa ho lokolloa ha insulin, e leng se eketsang keketseho ea glycemia.

Phello ea hypoglycemic ea Glucovans ea fokotseha ha e kopantsoe le glucocorticosteroids, tetracosactide, diuretics, danazol le beta2-adrenergic agonists.

Ha u ntse u nka li-inhibitors tsa angiotensin-converting enzyme (ACE), ho kenyelletsa enalapril le Captopril, ho na le phokotso ea tsoekere ea mali.

Ho kopana le metformin ho hloka tlhokomelo e khethehileng ho bakuli ba nang le bothata ba ho sebetsa ba methapo, kaha menyetla ea ho theha lactic acidosis e phahame ka ts'ebeliso ea "loop" diuretics.

Motsoako oa li-Glucovans ka li-sympathomimetics, beta-blockers, reserpine, clonidine, guanethidine e pata matšoao a hypoglycemia.

Phetoho ea moriana e hlokahala ha o nka fluconazole, ho na le kotsi ea hypoglycemia.

Glibenclamide e fokotsa phello ea antidiuretic ea desmopressin.

Phello ea hypoglycemic ea Glucovans e eketseha ka tšebeliso e ts'oanang le monoamine oxidase inhibitors (MAOs), sulfonamides, anticoagulants (li-derivatives tsa coumarin), fluoroquinolones, chloramphenicol, pentoxifylline, lithethefatsi tse fokotsang lipid tse tsoang sehlopheng sa li-fibrate, disopyramide.

Li-analogu tsa Glucovans ke: Glybomet, Glukonorm, Glyukofast, Bagomet Plus, Metformin, Siofor.

Litlhahlobo tsa Glucovans

Bakuli ba nang le lefu la tsoekere hangata ba tlohela tlhahlobo ea Glucovans marang-rang. Khafetsa ba tšohla litaba tse amanang le khetho ea lethal dose le mefuta ea kalafo, hammoho le tsamaiso ea eona e kopaneng le lithethefatsi tse ling. Leha ho le joalo, litlhahlobo ka botsona li pheha khang. Litlaleho li supa hore ho fihlela sephetho se phahameng nakong ea kalafo, hoa hlokahala ho bala palo ea lik'hilojule le tšebeliso ea lik'habohaedreite hammoho le ho beha leihlo ka hloko litekanyetso tsa meriana.

Leha ho le joalo, ho boetse ho na le maikutlo a mabapi le lefeela la Glucovans. Bakuli ba tletleba ka khaello ea phetoho e ntle boiketlong le phokotsong ea bohlokoa ho boleng bo tloaelehileng ba khatello ea tsoekere maling (hypoglycemia). Bakuli ba bang ba tlaleha hore e le hore bophelo ba bona bo tloaelehe ba ile ba tlameha ho fetohela khalemelong e telele le e phetseng hantle ea mofuta oa kalafo le mokhoa oa bona oa bophelo.

Mofuta oa tokollo ea Glucovans, sephutheloana sa lithethefatsi le sebopeho.

Matlapa a kopantsoe le khetla e bobebe ea lamunu, e bopehileng joaloka capule, biconvex, e nang le mongolo oa "2,5" ka lehlakoreng le le leng.

1 tab
metformin hydrochloride
500 mg
glibenclamide
2,5 mg

Baeti: povidone K30, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, Opadry (Opadri) OY-L-24808, metsi a hloekisitsoeng.

Li-pcs tse 15. - marang-rang (2) - Mabokose a likarete.
20 likhomphutha. - marang-rang (3) - Mabokose a likarete.

Matlapa a koahetsoeng a 'mala o bosootho bo bopehileng joaloka bokhutšoanyane, biconvex, "

1 tab
metformin hydrochloride
500 mg
glibenclamide
5 mg

Baeti: povidone K30, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, Opadry (Opadri) 31F22700, metsi a hloekisitsoeng.

Li-pcs tse 15. - marang-rang (2) - Mabokose a likarete.
20 likhomphutha. - marang-rang (3) - Mabokose a likarete.

Tlhaloso ea lithethefatsi e thehiloe litaelong tse lumelletsoeng ka molao bakeng sa tšebeliso.

Ts'ebetso ea pharmacological Glucovans

Motsoako o kopantsoeng oa hypoglycemic bakeng sa tšebeliso ea molomo.

Glucovans ke motsoako o tsitsitseng oa li-agent tse peli tsa molomo tsa hypoglycemic tsa lihlopha tse fapaneng tsa meriana.

Metformin ke ea sehlopha sa "greatuanides" 'me e fokotsa tsoekere ea serum ka ho phahamisa kutloisiso ea lisele tsa thipa molemong oa ts'ebetso ea insulin le ho ntlafatsa ho ts'oaroa ha tsoekere. Metformin e fokotsa ho monya ha lik'habohaedreite ho tsoa ho tšilo ea lijo 'me e thibela gluconeogenesis ka har'a sebete. E boetse e na le phello e molemo sebopeho sa lipid tsa mali, e fokotsa boemo ba cholesterol e felletseng, LDL le TG.

Glibenclamide e bua ka litokollo tsa sulfonylurea molokong oa bobeli. Tekanyo ea glucose ha u nka glibenclamide e fokotseha ka lebaka la ho susumetsoa ke secretion ea insulin ke lisele tsa pancreatic.

Tekanyetso le tsela ea tsamaiso ea moriana.

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

Ka tloaelo, tekanyetso ea pele ea Glucovans ke 1 tab. 500 mg / 2,5 mg ka letsatsi. Ha u khutlisetsa kalafo ea motsoako e fetileng le metformin le glibenclamide, ho boleloa matlapa a 1-2. Glucovansa 500 mg / 2,5 mg ho latela boemo ba lethal dose bo fetileng. Ka mor'a libeke tse ling le tse ling tse peli kamora ho qala kalafo, lethal dose lea fetoloa ho latela boemo ba glycemia.

Matlapa a lokela ho nooa le lijo.

Sekhahla se phahameng sa letsatsi le letsatsi ke matlapa a 4. Glucovansa 500 mg / 2,5 mg kapa 2 tab. Glucovansa 500 mg / 5 mg.

Litla-morao tsa Glucovans:

Ho tsoa ho ts'ebetso ea lijo: qalong ea kalafo, ho nyekeloa ke pelo, ho hlatsa, bohloko ba ka mpeng, ho lahleheloa ke takatso ea lijo ho ka etsahala (maemong a mangata, ho feta ka mokhoa o ikemetseng mme ha ho hloke kalafo e khethehileng, ho thibela nts'etsopele ea matšoao ana, ho khothalletsoa ho nka moriana ka tekanyetso ea 2 kapa 3, keketseho e potlakileng ea tekanyetso ea moriana hape e ntlafatsa mamello ea eona), mohlomong tatso ea "tšepe" molomong.

Tse ling: erythema, megaloblastic anemia, lactic acidosis.

Ho tsoa ho ts'ilo ea lijo: ho nyekeloa, ho hlatsa, bohloko ba epigastric, ts'ebetso e eketsehileng ea li-enzyme tsa sebete.

Ho tsoa ho tsamaiso ea hemopoietic: leukopenia, thrombocytopenia, ka seoelo - agranulocytosis, hemolytic anemia, pancytopenia.

Boitšoaro bo kulisang: - urticaria, rash, ho hlohlona ha letlalo.

Tse ling: hypoglycemia, likarabelo tse joalo ka discriram ha u noella joala.

Litaelo tse ikhethang bakeng sa ts'ebeliso ea li-Glucovans.

Nakong ea kalafo le Glucovans, ho hlokahala hore ho hlahlojoe khafetsa boemo ba tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja.

Mokuli o lokela ho lemosoa hore haeba ho hlatsa le bohloko ba ka mpeng bo tsamaeang le mesifa ea mesifa kapa malaise a tloaelehileng a hlahile nakong ea kalafo ea Glucovans, moriana o lokela ho emisoa mme o lokela ho botsa ngaka hanghang, hobane matšoao ana e ka ba matšoao a lactic acidosis.

Mokuli o lokela ho tsebisa ngaka ka ponahalo ea ts'oaetso ea bronchopulmonary kapa tšoaetso ea ts'ebetso ea urine.

Lihora tse 48 pele ho ts'ebetso ea opereishene kapa iv ea ho sebetsa ea iodine e nang le iodineine, li-glucovans li lokela ho emisoa. Phekolo ea Glucovans e khothalletsoa hore e qale hape ka mor'a lihora tse 48.

Nakong ea kalafo, ha ho khothalletsoe ho noa joala.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Nakong ea kalafo le Glucovans, motho ha aa lokela ho etsa lintho tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea li-psychomotor.

Ho sebelisana le Glucovans le lithethefatsi tse ling.

Lithethefatsi tse ntlafatsang tsa Glucovans (kotsi e eketsehileng ea hypoglycemia)

Ka tšebeliso ea nako e le 'ngoe le Glucovans, miconazole e ka tsosa nts'etsopele ea hypoglycemia (ho fihlela kholo ea komisi).

Fluconazole e eketsa T1 / 2 ea melemo ea sulfonylurea mme e eketsa kotsi ea ho fetoha ha hypoglycemic.

Ho itlopa joala ho eketsa kotsi ea ho fetoha ha hypoglycemic (ho fihlela ho nts'etsopele ea komisi). Nakong ea kalafo le Glucovans, joala le lithethefatsi tse nang le ethanol (joala) li lokela ho qojoa.

Ts'ebeliso ea li-inhibitors tsa ACE (Captopril, enalapril) e eketsa menyetla ea ho nts'etsapele maikutlo a hypoglycemic ho bakuli ba nang le lefu la tsoekere kalafong kalafo ea lihlahisoa tsa sulfonylurea ka ho ntlafatsa mamello ea glucose le ho fokotsa tlhokeho ea insulin.

Beta-blockers li eketsa tlokotsi le ho teba ha hypoglycemia. Beta-blockers mask matšoao a hypoglycemia a kang palpitations le tachycardia.

Lithethefatsi tse fokotsang matla a li-glucovans

Danazole e na le phello ea hyperglycemic. Haeba kalafo ka danazol e hlokahala mme ha e felisoa, phetoho ea litekanyetso tsa Glucovans e hlokahala tlasa taolo ea boemo ba glycemia.

Chlorpromazine ka tekanyetso e phahameng (100 mg / ka letsatsi) e baka keketseho ea glycemia.

GCS e eketsa glycemia mme e ka lebisa ho nts'etsopele ea ketoacidosis.

Beta2-adrenostimulants e eketsa boemo ba glycemia ka lebaka la ho hlohlelletsoa ha li-receptor tsa 2-adrenergic.

Diuretics (haholo-holo "loppacks") e baka nts'etsopele ea ketoacidosis ka lebaka la nts'etsopele ea ts'ebetso ea ho sebetsa ea renal.

Ho kenya / ho hlahisa li-arhente tse nang le iodine tse nang le iodine ka bongata ho ka baka kholo ea ho se sebetse ha liphio, e tla lebisa ho kopantseng ha moriana 'meleng le ntlafatsong ea lactic acidosis.

Beta-blockers mask matšoao a hypoglycemia, joalo ka palpitations le tachycardia.

Tekanyetso le tsamaiso

Matlapa a Glucovans a etselitsoe tsamaiso ea molomo. Matlapa a nooa nakong ea lijo, a lokelang ho ba le bongata ba lik'habohaedreite ho thibela hypoglycemia.

Tekanyetso ea moriana e khethoa ke ngaka e eang.

Litekanyetso tsa pele tsa Glucovans ke Letlapa le le leng (2,5 mg + 500 mg kapa 5 mg + 500 mg) hang ka letsatsi. Ho khothalletsoa ho eketsa tekanyetso libeke tse ling le tse ling tse peli kapa ho feta ka ho sa feteng 500 mg ea metformin le 5 mg ea glibenclamide ka letsatsi e le ho laola ka mokhoa o lekaneng litekanyetso tsa tsoekere ea mali.

Ha u khutlisetsa kalafo e kopaneng ea nakong e fetileng le glibenclamide le metformin, lethal dose la mantlha ha lea lokela ho ba holimo ho feta tekanyetso ea letsatsi le letsatsi ea glibenclamide le metformin e ileng ea nkuoa pejana. Ka mor'a libeke tse ling le tse ling tse peli kamora ho qala kalafo, moriana oa moriana o fetoha.

Tekanyo e kholo ea letsatsi le letsatsi ea Glucovans ke matlapa a 4 5 mg + 500 mg kapa matlapa a 6,5 mg + 500 mg.

Melemo ea moriana oa litlhare:

Ha o fana ka letlapa le le leng ka letsatsi - hoseng, nakong ea lijo tsa hoseng,
Ka tumellano ea matlapa a 2, 4 ka letsatsi - hoseng le mantsiboea,
Ka tumellano ea matlapa a 3, 5, 6 ka letsatsi - hoseng, thapama le mantsiboea.

Foromo ea litekanyetso

500 mg / 2.5 mg le 500 mg / 5 mg matlapa a koaetsoeng ka filimi

Ctloha

Pilisi 500 mg / 2,5 mg

Letlapa le leng le na le

Lintho tse sebetsang: metformin hydrochloride 500 mg

glibenclamide 2,5 mg,

Baeti: croscarmellose sodium, povidone K 30, cellulose e bitsoang microcrystalline, magnesium stearate

the composition of Opadry OY-L-24808 film shell is pink: lactose monohydrate, hypromellose 15cP, macrogol, titanium dioxide E 171, iron oxide e sootho E 172, iron oxide e khubelu E 172.

Pilisi 500 mg / 5 mg

Letlapa le leng le na le

Lintho tse sebetsang: metformin hydrochloride 500 mg

glibenclamide 5 mg

Baeti: croscarmellose sodium, povidone K 30, cellulose e bitsoang microcrystalline, magnesium stearate

the composition of Opadry 31-F-22700 film shell is yellow: lactose monohydrate, hypromellose 15 cP, macrogol, quinoline yellow varnish E 104, titanium dioxide E 171, iron oxide e khubelu E 172, iron oxide e khubelu E 172.

Pilisi 500 mg / 2,5 mg: matlapa a koahetsoeng ka karolo ea filimi ea 'mala o bobebe oa lamunu, a bopehile joaloka "biconvex" le ho ngola "2,5" ka lehlakoreng le le leng.

Pilisi 500 mg / 5 mg: matlapa a koahetsoeng ka khetla ea filimi e mosehla, e bopehileng ka sekhukhu e nang le biconvex bokaholimo 'me e ngotsoe "5" ka lehlakoreng le le leng.

Melemo ea pharmacological

Mofumahali

Metformin le Glibenclamide

Bioavailability ea metformin le glibenclamide ha e kopana li tšoana le bioavailability ea metformin le glibenclamide ha li nkuoa ka nako e le ngoe ka mokhoa oa litokisetso tsa monocomponent. Ho ja ha ho ame bioavailability ea metformin hammoho le glibenclamide, hammoho le bioavailability ea glibenclamide hammoho le metformin. Leha ho le joalo, tekanyo ea ho monya ha glibenclamide e eketseha ka tekanyo ea lijo.

Kamora ho tsamaisoa ha molomo oa litafole tsa metformin, khatello ea mali e phahameng ka ho fetisisa ea plasma (Cmax) e fihlella kamora lihora tse ka bang 2,5 (Tmax). Ka botlalo bioavailability ho batho ba phetseng hantle ke 50-60%. Kamora ho tsamaisoa ka molomo, 20-30% ea metformin e sibolloa ka tšubuhlellano ea mala (GIT) e sa fetoloe.

Ha u sebelisa metformin ka tekanyetso e tloaelehileng le mekhoa ea tsamaiso, khatello ea mali ea plasma e sa khaotseng e fihlella ka nako ea lihora tse 24-48 mme hangata e ka tlase ho 1 μg / ml.

Tekanyo ea ho tlama metformin ho liprotheine tsa plasma ha e na tekano. Metformin e ajoa ka liseleng tse khubelu tsa mali. Tekanyo e phahameng maling e tlaase ho feta ho plasma mme e fihlella ka nako e ts'oanang. Boholo bo boholo ba phepelo (Vd) ke lilithara tse 63-276.

Metformin ha e sa fetoloa ka har'a moroto. Ha ho na methapo ea metformin e fumanoeng bathong.

Tlhahiso ea methapo ea metformin e feta 400 ml / min, e bonts'ang ho felisoa ha metformin e sebelisang ho filtara ka glomerular le secretion ea tubular. Kamora ho tsamaisoa ka molomo, halofo ea bophelo ke lihora tse ka bang 6.5.

Ha ts'ebetso ea ho sebetsoa hantle ha renal e sa sebetse, tumello ea renal e fokotseha ka tekanyo ea tumello ea creatinine, mme ka hona, halofo ea bophelo e tlisoang, e lebisa hoketseho ea litekanyetso tsa plasma metformin.

Ha e kenngoa, ho amoheloa ho tsoa ka mpeng ea gastrointestinal ho feta 95%. Litekanyetso tsa plasma li fihlella kamora lihora tse ka bang 4. Puisano le liprotheine tsa plasma ke 99%.

Glibenclamide e entsoe ka botlalo ka har'a sebete ho theha metabolites tse peli.

Glibenclamide e qheletsoe ka botlalo ho tsoa 'meleng kamora lihora tse 45-72 ka sebopeho sa metabolites: ka bile (60%) le moroto (40%). Halofo ea ho qetela ea bophelo ke lihora tse 4-11.

Ho haella ha hepatatic ho fokotsa metabolism ea glibenclamide mme o fokotsa haholo tlhahiso ea eona.

Biliary excretion ea metabolites e eketseha maemong a ho phunyeha ha masapo (ho ea ka ho teba ha ts'ebetso ea renal e sa sebetseng) ho fihlela boemong ba tumello ea tumellano ea 30 ml / min. Ka hona, ho se sebetse hantle ha re hloname ho sa bonahale ha glibenclamide, athe tumello ea "creatinine" e ntse e le boemong bo kaholimo ho 30 ml / min.

Pharmacokinetics ka lihlopha tse khethehileng tsa bakuli:

Bakuli ba bana

Ho ne ho se na phapang lipampiring tsa meriana ea metformin le glibenclamide ho bana le batho ba baholo ba phetseng hantle.

Mofumahali

Metformin ke biguanide e nang le phello ea antihyperglycemic, e fokotsang maemo a tsoekere ea basal le postprandial plasma. Ha e khothalletse secretion ea insulin mme ka hona ha e bake hypoglycemia.

Metformin e na le mekhoa e 3 ea ts'ebetso:

e fokotsa tlhahiso ea tsoekere ka ho thibela gluconeogeneis le glycogenolysis,

e ntlafatsa ts'ebetso le tšebeliso ea tsoekere e phunyelletsang mesifa ka ho eketsa kutloisiso ea insulin,

e liehisa ho kenngoa ha tsoekere ka mpeng.

Metformin e phahamisa motsoako oa glycogen e kenang ka hare ho eona ka ho sebetsa ho glycogen synthase. E boetse e ntlafatsa bokhoni ba mefuta eohle ea ba tsamaisang glucose ba tsamaisang "gluut".

Ho sa tsotelehe phello ea eona ho glycemia, metformin e na le phello e ntle ho metabolism ea lipid. Nakong ea liteko tsa bongaka tse laoloang tse sebelisang tekanyetso ea kalafo, ho ile ha fumaneha hore metformin e theola k'holeseterole e ngata, lipoprotein tse fokolang le triglycerides. Litlamorao tse joalo tsa metabolism ea lipid ha lia ka tsa bonoa nakong ea liteko tsa tleliniki tse sebelisang kalafo ea motswako le metformin le glibenclamide.

Glibenclamide ke ea sehlopha sa sulfonylureas ea meloko ea bobeli e nang le halofo ea bophelo. Glibenclamide e baka ho fokotseha ha tsoekere ea mali, e leng ho susumetsang tlhahiso ea insulin ke manyeme. Ketso ena e itšetlehile ka boteng ba li-β-cell tsa lihlekehleke tsa Langerhans.

Ho khothaletsa secretion ea insulin ke glibenclamide ho arabela lijo tse hlokahalang.

Ts'ebeliso ea glibenclamide ho bakuli ba nang le lefu la tsoekere e baka keketseho ea karabelo e matlafatsang ea "insulin" ea postprandial. Karabelo e ntlafalitsoeng ea postprandial ka mokhoa oa secretion oa insulin le C-peptide e phehella bonyane likhoeli tse 6 kamora kalafo.

Metformin le glibenclamide li na le mekhoa e fapaneng ea ts'ebetso, empa ka bobeli li tlatsana mesebetsing ea antihyperglycemic e 'ngoe. Glibenclamide e phahamisa tlhahiso ea insulin ke manyeme, 'me metformin e fokotsa ho hanyetsa ha lisele ho insulin ka ho sebetsa ho potoloha (mesifa ea mokokotlo) le kutloisiso ea sebete ho insulin.

Tekanyetso le tsamaiso

Glucovans® e lokela ho nkuoa ka molomo ka lijo. Mokhoa oa mofuta oa lithethefatsi o fetoha ho latela hore na o ja eng. 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 lokela ho fetoloa ho latela karabelo ea motho ka mong ea metabolic (glycemia, HbA1c).

Glucovans 500 mg / 5 mg e ka sebelisoa haholo ho bakuli ba sa fihletseng taolo e lekaneng ha ba nka Glucovans 500 mg / 2,5 mg.

Phekolo e lokela ho qala ka tekanyetso ea moriana o kopaneng o lekanang le litekanyetso tsa motho tsa mehleng ea pele tsa metformin le glibenclamide. Tekanyetso e lokela ho eketseha butle-butle ho latela boemo ba liparamente tsa glycemic.

Tekanyetso e nchafatsoa libeke tse ling le tse ling tse peli kapa ho feta ka keketseho ea 1 letlapeng, ho latela boemo ba glycemia.

Keketseho ea butle-butle ea lethal dose e ka thusa ho fokotsa mamello ea mpa le ho thibela kholo ea hypoglycemia.

Sekhahla se phahameng sa letsatsi sa Glucovans® 500 / 2,5 ke matlapa a 6.

Tekanyetso e kholo ea letsatsi le letsatsi bakeng sa Glucovans® 500/5 mg ke matlapa a 3.

Maemong a ikhethang, ho ka khothaletsoa keketseho ea tekanyetso ea lipilisi tse 4 tsa moriana oa Glucovans® 500 mg / 5 mg ka letsatsi.

Bakeng sa litekanyetso tsa lithethefatsi Glucovans® 500 mg / 2,5 mg

Hang ka letsatsi: hoseng nakong ea lijo tsa hoseng, ka ho beoa ha 1 letlapa ka letsatsi.

Habeli ka letsatsi: hoseng le mantsiboea, ka ho beoa ha matlapa a mabeli kapa a 4 ka letsatsi.

Ka 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 lithethefatsi Glucovans® 500 mg / 5 mg

Hang ka letsatsi: hoseng nakong ea lijo tsa hoseng, ka ho beoa ha 1 letlapa ka letsatsi.

Habeli ka letsatsi: hoseng le mantsiboea, ka ho beoa ha matlapa a mabeli kapa a 4 ka letsatsi.

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

Ha ho na data ea ts'ebeliso ea lithethefatsi ka insulin.

Ha o ntse o nka Glucovans® le chelator ea bile, ho khothalletsoa hore o nke Glucovans® bonyane lihora tse 4 pele ho chelator ea hau e le hore a ka fokotsa kotsi ea ho kenngoa ka bongata.

Litaelo tse khethehileng tsa litekanyetso bakeng sa lihlopha tse itseng tsa bakuli

Batho ba baholo le ba senile

Tekanyo ea Glucovans ® e lokela ho fetoloa ho latela maemo a ts'ebetso ea renal. Tekanyetso ea pele ke Letlapa le le leng la Glucovans® 500 mg / 2,5 mg. Tlhahlobo ea khafetsa ea ts'ebetso ea renal e hlokahala.