"Cymbalta": imiyalelo ukusetyenziswa. Ukuphononongwa, amanani, kubonakala

Namhlanje siza kukuxelela ukuba sisiyobisi "Cymbalta." Imiyalelo zokusetyenziswa ichiza, ukwakhiwa kwayo, iziphumo ebezingalindelekanga, kunye nofundo ziza kuchazwa ngezantsi. Kwakhona ukusuka nqaku ezingenisiweyo, uya kufunda malunga nendlela apho ichiza efumaneka, kangakanani malini, nokuba unalo contraindication nokuba ukusebenzisa njani na ngokuchanekileyo.

release Form

Ziziphi uhlobo enokuzithenga ichiza "Cymbalta" ukuqeqesha livalelwe kwiphakheji? Okwangoku ichiza kukhutshwa kuphela ngokohlobo njengezingxobo ama. Ngalinye enoku iingqalutye, ezo umbala omhlophe mhlophe okanye lube nombala.

ichiza

Ziziphi amacandelo iquka iziyobisi "Cymbalta?" Imiyalelo zokusetyenziswa njengezingxobo ithi element zazo eziphambili esebenzayo i duloxetine kweziyobisi. Kufuneka kuqatshelwe ukuba isakhiwo medicament ingqalelo yaye iquka izinto ezongezelelweyo sucrose, hypromellose, talc, succinate, colorant emhlophe, acetate hypromellose, titanium dioxide, triethyl citrate, gelatin, sodium lauryl sulfate kunye yellow intsimbi oxide ebala.

Njengezingxobo inokuba liqulathe 60 no-30 iziyobisi mg. Bona zipakishwe namadyungudyungu iipilisi 14 okanye 7. Ngowe iphekhi enye ibhokisi unokuba-1, 2 okanye 6 kumadyunguza.

iimpawu amayeza we ichiza

Yintoni na into esebenzayo ezifana duloxetine? Imiyalelo zokusetyenziswa njengezingxobo zamachiza ithi ukuba onjalo njengababambeleyo kweziyobisi kunye isiqalelo Wathi ke kakhulu yeQela elungileyo. Lo inhibitor le reuptake of norepinephrine kunye serotonin. Yena okwanamhlanje abangaphangeliyo dopamine ukuthathwa yaye akukho ngobuhlobo ukuba dopamine, histamine, kunye receptors adrenergic holino-.

wenza njani Duloxetine? Guide iqulethe ezi nkcukacha zilandelayo ngalo mbandela: umgaqo amanyathelo ukwimo kukuba ukuze kuthintelwe reuptake of norepinephrine kunye serotonin. Ngenxa yoko, kwandisa kakhulu noradrenergic kunye serotonergic neurotransmission kwinkqubo luvo. Kufuneka kuqatshelwe ukuba duloxetine ngokukhawuleza gqiba intlungu.

Pharmacokinetics beziyobisi

Imixube zokudakumba le "Cymbalta" etsalwe phecana zesisu, ukufunxeka uqala iiyure ezimbalwa emva nolawulo. Le xi eliphezulu ifunyanwa emva kweeyure ezi-6. ukwamkelwa ngaxeshanye ukutya alichaphazeli xi kwaye yandisa ixesha ukuphumeza iiyure ezi-6 ukuya kwi-10. Iingcali zithi elingathanga kunciphisa ubungakanani ukufakwa (11%).

Ukubambana of kweziyobisi kwiiproteni plasma liphezulu ngokwaneleyo yaye ifikelela ngaphezu kwama-90%.

Isiqingatha wobomi ichiza iiyure ezili-12. Ngelo xesha yena iphuma umchamo njengoko metabolites.

Ngokutsho izifundo, kukho umahluko phakathi iinkqubo pharmacokinetic ukuba kwenzeka kwabasetyhini kunye namadoda. Ngoko ke, ukuba kugqitywe umndilili isithako esebenzayo ngezantsi besini bubuhle. Noko ke, uhlengahlengiso idosi ayikho imfuneko.

Kufuneka kuqatshelwe ukuba umahluko phakathi iinkqubo pharmacokinetic ezithi zenzeke kule izigulane abadala eliqina asekwa ngexesha uphando. Ityhileke ukuba isiqingatha ubomi ichiza ephakamileyo abadala ngaphezu kwabantu abatsha. Akukho uhlengahlengiso oyidlayo ingafuneki mhlawumbi.

Xa izigulane insufficiency ezingapheliyo sezintso e kwinqanaba terminal, abakhoyo dialysis, uyazikhomba yokusebenza kunye AUC konyuso duloxetine kwi ngqo amaxesha 2. Yiyo loo nto kucetyiswa ukuba siqwalasele awushiye ukunciphisa umthamo beziyobisi izigulane ongaboniyo kakhulu umsebenzi kwezintso.

Izigulane ezineempawu ze sisibindi ezinokucothisa ukutya kunye nokupheliswa nakwisiqingatha ubomi duloxetine.

Izinto ezibonisa ukuba ukusetyenziswa kwemali

Xa prescribers "Cymbalta?" Imiyalelo yokusebenzisa ziquka uluhlu ilandelayo ufundo:

• imilo ubuhlungu peripheral abaneswekile;
• ukudandatheka kunye depressive ithi;
• ngokubanzi ixhala yokudla;
• ndinentlungu engapheliyo syndrome musculoskeletal, kuquka ezo zibangelwa udinwe kunye osteoarthritis.

Izimo ukusetyenziswa kwemali

Xa ungakwazi ukuthatha amayeza "Cymbalta?" Imiyalelo yokusebenzisa ziquka uluhlu zilandelayo Izimo:

• isicelo ngaxeshanye inhibitors elinamandla isoenzyme CYP1A2 (umz, enoxacin, ciprofloxacin okanye fluvoxamine);
• Ukunyuka uvakalelo njengesigulane kuthetha amacandelo;
• abantwana abangaphantsi kweminyaka eli-18 ubudala;
• wondamkela eyeyomzuzwana nge Mao inhibitor;
• umfutho wegazi is angalawulwa;
• glaucoma Ukuvalwa uncompensated;
• kakhulu ezingapheliyo ukusilela kwezintso (kunye CC ml ngaphantsi kwe-30 / min);
• intswelo isomaltase okanye saccharase, iswekile-galactose malabsorption kunye fructose zobandlululo;
• izifo zesibindi ukuba zikhatshwa insufficiency hepatic.

kufuneka isetyenziswe nini ngokuqaphela kweziyobisi

Kufuneka kusetyenziswe wathi ngenyameko iziyobisi ngokuxokozela kunye mania vuvabyi, unditsho basengozini yokuhlaselwa engile-ukuvalwa glaucoma. Kwakhona, kufuneka uthathelwe ingqalelo lwegazi xa ocular, yokuzibulala, hyponatremia, isibindi nezintso.

Drug "Cymbalta": imiyalelo yokusebenzisa

Ixabiso le mveliso uphezulu kakhulu. Noko ke, impumelelo yalo bezingekho phantsi konyanzelo kwamathandabuzo.

amayeza thaca emiselweyo kuphela lolawulo ngomlomo. Ezi njengezingxobo kufuneka makaginywe wonke ngaphandle ngokukhanywa okanye ukuhlafuna kubo. Kufuneka kuqatshelwe ukuba nayiphi na imeko ayikwazi zongezwe ichiza okanye ukutya uxutywe naziphi na ulwelo, ekubeni senzo lula yingozi ukutyabeka ama.

Imixube zokudakumba kufuneka athathwe kwi idosi yokuqala ka-60 mg kanye ngemini. Ukuze kuphunyezwe iziphumo ezihle ezinye izigulane ukuba ukwandisa imali Wathi kabini ukuya idosi iphezulu 120 mg ngemini.

Izigulane unesifo ukusilela ezingapheliyo kwezintso, nto leyo eyenzeka kwi-terminal kwisigaba, idosi lokuqala medicament yi mg 30 kanye ngemini. Ukuba izigulane kufuneka isibindi ukungasebenzi, isixa kubonisiwe beziyobisi Kucetyiswa ukuba ukuthoba okanye ukunciphisa ubuninzi ulwamkelo.

Kufuneka kuqatshelwe ukuba ukuthintela ukurhoxiswa elirhabaxa abafumana medicament. Isixa iziyobisi kuyimfuneko ukunciphisa iiveki ngokuthe ngcembe 1-2. Ukuba le imvelaphi, kukho iimpawu iqapheleka le syndrome, kucetyiswa ukuba baqhubeke unyango idosi echongiweyo. Kamva, ugqirha lingaqhubeka ukunciphisa umthamo, kodwa ngokucothayo.

amacala libanda

Yintoni iingcali zithi malunga namatyala libanda, iziyobisi, "Cymbalta?" Izimvo oogqirha eziqulathe ulwazi data ezinjalo ezifumanekayo kubo. Ukuza kuthi ga ngoku, kukho amatyala libanda yi nokudla beziyobisi ngezixa ukuya ku 3000 mg, yaye xa kudityaniswe nezinye izinto. Phela, esisigxina kunye nokufa omnye.

Iimpawu libanda, okanye emajukujukwini idityaniswe ziquka imeko ilandelayo: unditsho clonic, somnolence, ukugabha, angabikho zingqondweni, serotonin syndrome kunye tachycardia. Ke ukuba uphando preclinical (experiments kwizilwanyana), iimpawu eziphambili yetyhefu ezinxulumene olungalawulwayo ukwamkelwa medicament, kukho ukuphazamiseka zeenkqubo luvo esiswini. Kwakhona, izigulane zingavela lafa, Ataxia, unditsho clonic, ukugabha kunye nelahleko namdla.

Kufuneka wenze ntoni xa kwimeko libanda? Ngophuhliso serotonin syndrome kufuneka ngoko nangoko kwenziwe okulungisa unyango cyproheptadine, ngokunjalo iindlela ezisetyenziswayo ukubuyisela lobushushu emzimbeni wakhe.

Isigulane kufuneka ukuba ukunika umoya. Nawe kufuneka kwakhona abeke esweni umsebenzi entliziyweni iliso imiqondiso ebalulekileyo. Konke oku kufuneka kwenziwe kubanjiswene kunye nenkxaso ebamb kunye nonyango nomqondiso.

Ukuba emva ulawulo ichiza wayengekho elide, kuyimfuneko ukuba iphume isisu. Kwakhona, ukuze anciphise ukuthathwa amayeza isigulane ucelwa ukuba basele wamalahle yasebenza.

effect side

Ngaba nefuthe elibi empilweni abantu walunyukiswa uthe amayeza? Cinga iziphumo ebezingalindelekanga iziyobisi bucala ngokweenkcukacha:

• rhoqo (ngo-10% yamatyala) kwi zophononongo, izigulane kufuneka ithi zilandelayo: isiyezi, intloko ebuhlungu, umlomo owomileyo, sokulibala, sokulibala, isicaphucaphu, ukozela nokuqunjelwa.
• iyonke ngaphantsi (1 ukuya kwi-10% amatyala) izigulane zaye waphawula ukugungxula, urhudo, ukungaboni, ukugabha, ukubila, lafa, anorgasmia ukwanda, ukuncipha ukutya, ukungabi yobuntu, ukwehla kobunzima, ukudinwa, erectile kwekhono, kwaye kananjalo enokulibazisa ukudlalwa kwesohlwayo okanye ukuchama engaqhelekanga.

Asikwazi ukuba ezinjalo ziziphumo ebezingalindelekanga njengokuba nesiyezi (ngamanye amaxesha yintloko kunye isicaphucaphu), kaninzi kubonwa kunye ukucinywa ngokukhawuleza i medicament. Ngendlela, xa izigulane iindlela ezibuhlungu peripheral seswekile bangafumana ukwanda glucose igazi ungatyanga.

Izimvo medicament

Ngokutsho iingcali, kunye nezigulane amayeza ingqalelo ukumelana ngokupheleleyo kulo msebenzi. Emva kokufumana akubikho yokukhathazeka disorder, kwakunye ikhuthaza yokuduka States depressive. Ukongeza, kakuhle esebenzayo medicament nokuphelisa syndromes intlungu kwinkqubo musculoskeletal.

Intsebenziswano kunye nezinye iindlela

Ngaba kunokwenzeka ukuba co-nolawulo namanye amachiza ngamayeza "Cymbalta?" Iingcali Guest zithi indlela Wathi ke ifuthe ngqo kwi ngempumelelo amanye amayeza.

Ngoko ke, kukho ingozi yokuba serotonin syndrome, duloxetine xa kusetyenziswa xa zidityaniswe ne MAOIs.

Ngenxa CYP1A2 isoenzyme libandakanyeka ngokubonakalayo nethe of "ukulungiselela Cymbalta ', ukusetyenziswa kwazo ngaxeshanye nga kukhokelela ekwandeni lamanani wamva.

Akukhuthazwa ukuba medicament wathi kunye namanye amachiza ezichaphazela inkqubo luvo. Kwakhona ngexesha kokungeniswa kufuneka asele utywala.

Maxa wambi, ngexesha ukusetyenziswa SSRIs namahlakani serotonergic kwizigulane baphawula serotonin syndrome. Ngoko ke, kufuneka bakulumkele kakhulu oku xa usebenzisa eli chiza kunye nemithi yokunciphisa serotonergic.

Ngenxa yokuba kukho nengozi enokubakho ukopha kufuneka asebenzise zombini duloxetine kunye anticoagulants (antithrombotics).

Ibele nokukhulelwa

Ngaba ukusebenzisa iziyobisi "Cymbalta", ixabiso eya kuyo, ngexa lokukhulelwa? Ngenxa yokunqongophala ulwazi olwaneleyo, ukusetyenziswa duloxetine iziyobisi ngexesha yokumitha amayeza linokwenziwa kuphela xa isibonelelo ukuya unina okhulelweyo iphezulu kakhulu ingozi yokuba umntwana.

Kufuneka kuqatshelwe ukuba izigulane ezithatha le arhente kufuneka uqiniseke ukuba wazise ugqirha wakho malunga kukwenzeka okanye uceba ukukhulelwa.

Uphononongo lubonise ukuba abasetyhini abathatha lakhula ngokwaseburhulumenteni, ingakumbi kwi zigaba kamva, kwandisa kakhulu umngcipheko lwegazi gqolo pulmonary wabantwana kuzalwa. Kulo mzekelo, i syndrome nayo qho sibonakala abantwana kwimeko isingxi ngesiquphe usebenzisa unina duloxetine elizayo kwi seladlula ibakala lokukhulelwa. Uninzi iimpawu zesi sifo apha ekuhambeni ukuhanjiswa okanye kwiintsuku zokuqala emva.

Ngenxa duloxetine uyakwazi ukungena kwi ubisi lwebele, oko akufuneki ukuba ukuncancisa usana lwakho ngexesha unyango. Kungenjalo, uyazikhomba iyeza kwimveku iya kuba isixa 0,14% ye ingqalelo unina.

isikhokelo ethile ngokusetyenziswa ichiza

Ngokuthuma ichiza ukuba isiguli sakhe "Cymbalta", ugqirha unyanzelekile ukuba amazise ukuba kuvele uthintela ngexesha elinye-admission yomenzeli nge Mao inhibitor. Kungenjalo, ezingagrogrisa iingxaki enobungozi kwaye ngokunzulu nokushisa, myoclonus kunye wavakalisa excitation utshintsho isiqaqa.

Kufuneka kuqatshelwe ukuba esalelweyo Andamkeli uthe amayeza iiveki ezimbini emva kokuba unyango Mao inhibitor.

Ngokutsho izifundo, xa izigulane likarhulumente manic xa usebenzisa ezinye iziyobisi ezichaphazela inkqubo luvo, libambisene kunye neendlela "Cymbalta 'ukuze sibe sibi izifo ezikhoyo.

Ngenxa yokuba kumazwe edakumbisayo kukho amathuba iinzame zokuzibulala, kufuneka ingakumbi iliso izigulane ngoweqela Lendlela Yeqela womngcipheko wePhondo.

Ukwamkela ichiza kunokuba lula kakhulu ukuba ubuthongo. Ngenxa yoko, izigulane ukuthatha eli chiza, kufuneka uthathe unonophelo kakhulu xa uqhuba naxa usebenza ngoomatshini ihambe yingozi.

Price kunye analogue beziyobisi

Ingaba yimalini "Cymbalta" njengezingxobo ama? ixabiso labo ungahluka. Kuxhomekeke umenzi kunye imixokelelwane kwikhemesti imida. Nakuba kunjalo, kufanele kuqatshelwe ukuba ngokomyinge, ichiza kudla malunga 1.050 engange Russian (30 mg, iziqwenga 14). Ukuba ufuna ukuthenga amayeza kwimali efanayo, kodwa kukho umthamo 60 mg, ngoko ke kuya kufuneka ukuba uhlawule malunga 1150 engange.

Ngoku uyazi ukuba yimalini duloxetine. ixabiso layo kungandisa okanye ukwehla kuxhomekeke ezintweni ezithile. Okwangoku, kuthengwe kuthiwa ichiza ayikho naziphi na iingxaki. Noko ke, unako ukuthenga kuphela ngokumiselwa.

Kodwa kuthekani ukuba ngenxa yesizathu abanye baye bakwazi ukuthenga i "Cymbalta" njengezingxobo amayeza? Analogs kweli chiza ziyafumaneka phantse kuzo zonke ekhemesti. Nangona ukufunyanwa iya kufuna phambi liyeza evela kugqirha.

Ichiza singavalwa "Cymbalta?" Phakathi oontanga bakhe angathanda ngokukodwa ukuqaqambisa amayeza zilandelayo:

• "Intro";
• "Azafen" (tablets);
• "Duloxetine Canon" (ama njengezingxobo);
• "Venlafaxine Sandoz";
• "Alvent";
• "Mirtazapine Canon";
• "Eprobemide" (solution kwi / kwaye / m);
• "Wellbutrin";
• "Eprobemide" amacwecwe;
• "Agomelatine";
• "Neyroplant";
• "Velafaks";
• "Calixtus";
• "Venlaksor";
• "Vensuert";
• "Dapfiks";
• "Venlift OD";
• "Despres ';
• "Efevelon kunamandla";
• "Doppelgerts Nervotonik" ibe lichiza;
• "Inkazana";
• "Efevelon";
• "Coaxil";
• "Esprital";
• "Lerivon";
• "Trittiko";
• "Normazidol";
• "Mirzaten";
• "Tetrindol";
• "Mirtazonal";
• "Remeron";
• "Mirtalan";
• "Pirazidol";
• "Negrustin";
• "Nyuvelong";
• "Noksibel".

Indlela yokugcina kwithala ubomi

Yintoni ubomi lokugcinwa kwezinto ichiza "Cymbalta?" Ngokutsho imiyalelo, kunye nomhla phezu kwiipakethe, esi sixhobo kufuneka ithathwe okwethuba leminyaka emithathu. Kule meko kufuneka zigcinwe kwindawo emnyama apho lobushushu awudluli degrees 20.