Chithandizo "sofosbuvir": ndemanga. "Sofosbuvir" + "Daklatasvir": ndemanga akatswiri. "Sofosbuvir": malangizo a madotolo ndemanga

Chiwindi ndi mtundu wa kuyeretsedwa fyuluta thupi. Chikhalidwe cha thupi amakhudza ntchito kwa kachitidwe ambiri ndi khalidwe la moyo anthu onse. Mmodzi wa chiwindi lalikulu kwambiri akuti ndi chiwindi C. Pa nthawi ino kuthana ndi matenda anayamba kwambiri mankhwala. Chimodzi cha zida zothandiza kwambiri imatengedwa (lomwe zikutsimikiziridwa ndi ndemanga zachipatala) "sofosbuvir".

Zikuonetsa ntchito

Nthawi zambiri sofosbuvir likutchedwa yogwira pophika mapiritsi, ndi mtundu iyoyomwe malonda dzina "Sovaldi". Choncho, n'zotheka kuti mankhwala otsika mtengo wogwirizira - generic "sofosbuvir" zomwe amakambirana kufotokoza mankhwala monga mmodzi wa mankhwala yabwino kwambiri mankhwala a chiwindi C. Izi ndi mbali yake yaikulu ya ntchito.

Base zakuthupi - sofosbuvir - ndi woletsa wa NS5B polymerase tizilombo, mwachitsanzo, kumabwezera mmbuyo tizilombo kugawanika ndondomeko - .. The wothandizila causative za matenda C. Komabe, akatswiri ambiri zachipatala musati amalangiza monotherapy "sofosbuvir" (ngakhale mfundo zotheka). Koma monga waukulu yogwira chigawo chimodzi cha mankhwala zovuta mankhwala mavairasi oyambitsa "sofosbuvir" mayankho iwo ali yekha malangizo abwino, amakhala monga njira kwambiri zothandiza. Malinga ndi maphunziro a matenda, mankhwala ndi mu tandem ndi mankhwala ena anasonyeza zotsatira zabwino zochizira chiwindi C (genotypes 1, 2, 3).

Chithandizo "sofosbuvir" azaumoyo ali ndi maganizo abwino osati kwa iwo sankaonedwa odwala, komanso anthu amene analandira chithandizo titani mankhwala ena mavairasi oyambitsa, ndi kumapeto kwa chithandizo patapita nthawi kuti kusuta.

Kuwonjezera malo pamwambapa anafotokoza za mphamvu, "sofosbuvir 'ndemanga ndi malangizo a madotolo malangizo kulola ntchito pa matenda a odwala matenda matenda a chiwindi.

Ponena za mphamvu ya mankhwala ndi HIV ndi matenda a chiwindi co-matenda (a zinthu zofala), nkhaniyi panopa palibe ngakhale mankhwala akusonyeza ntchito zoterezi.

contraindications

Nthawi zambiri mankhwala palokha ndipo mankhwala ake generic bwino analekerera ndi odwala.

Komabe, medicament zochizira chiwindi C "Sovaldi" (kapena "sofosbuvir") mavoti amene ali malangizo abwino, monga aliyense amakono kwambiri kothandiza medicament, ali contraindications ntchito zina.

Choyamba, hypersensitivity uyu munthu kuti waukulu ndi mbali wothandiza medicament. Muyenera kusamala ntchito akazi msinkhu wobereka. Makamaka ngati "Sovaldi" ( "sofosbuvir") akapatsidwa molumikizana ndi "Ribavirin" ndi "interferon-Alpha" (genotypes leni kwa 3, 4, 5, 6, chiwindi) ayenera kupewedwa m'njira zosiyanasiyana mimba. Ndi zofunika kwambiri kuchitira wothandizila izi pa mimba ndi mkaka wa m'mawere.

Panopa, mphamvu ya "sofosbuvir" mudziwe ubereki anthu amapezeka. Palinso palibe uthenga pa chitetezo ndi efficacy wa mankhwala odwala pansi zaka 18.

Mlingo ndi nthawi kumene mankhwala

Choyamba ndi amatchula kuti mankhwala mavairasi oyambitsa alandiridwa kugwira okhawo madokotala amene achita zimenezi chokwanira pochiza odwala matenda a chiwindi C. A kamwedwe muyezo - 1 piritsi (400 mg wa mankhwala yogwira) pa tsiku, nthawi iliyonse ingestion. Monga mankhwala owawa (monga sanaphe ndemanga mankhwala) "sofosbuvir" ayenera kuwameza popanda kutafuna kapena kusiya.

Ngati piritsi lalandiridwa, ndipo kenako yotsatira maola 2 Kuyambira kusanza, Ndi bwino kutenga lina limodzi. Pankhani ya kusanza kwa nthawi yadutsa maola oposa 2 atenge mlingo zina Sikuti.

Ngati mlingo lotsatira pazifukwa zina kunapezeka kuti analilumpha (nthawi Musachedwe choposa maola 18), Ndi bwino kutenga mlingo anaphonya ndiyeno nthawi yachibadwa kupitiriza mankhwala. Ngati akuchedwa kuposa maola 18 - kutenga mlingo lotsatira pa nthawi mwachizolowezi.

kuphatikiza mankhwala

Monga zigawo prolechivanii adjuvant mankhwala mu chiwindi C, pamodzi ndi "sofosbuvir" kuchita ntchito "ribavirin", "Alpha interferon", "Daklatasvira", "Ledipasvira", "Asunaprevira".

Nthawi zambiri, anthu tandem "sofosbuvir" + "Daklatasvir" amakambirana thanzi ogwira ntchito ndi odwala yodziwika monga polimbana genotypes chiwindi C 1,2,3.

Chibwenzi, "Daklatasvir" mukhoza kuitanitsa Intaneti WWW.ARV24.COM kwa manja anu - mu kampani ndi mbiri nthaŵi yaitali. Zoperekedwa kuti pali pa dzanja mfundo zonse zofunikira za kupezeka kwa matenda.

Genotypes 4, 5, 6 kuchitiridwa medicaments zovuta "sofosbuvir", "ribavirin" ndi "Interferon Alpha". Standard achire nthawi masabata osachepera 12. Pa nthawi imene odwala genotypes 1, 4, 5, 6 ndi contraindications kulandira "Interferon Alpha" walembedwa kapena hypersensitivity kwa thunthu, "sofosbuvir" ndi "Ribavirin" amagwira ntchito masabata 24.

Mgwilizano "Ribavirin" ndi "sofosbuvir" mankhwala kwa genotype 2 ndemanga akatswiri kufotokoza momwe optimally ogwira osakaniza kuti akapatsidwa kulandira kwa zaka osachepera 12 masabata. Awiriwa medicament, koma pa nyengo ya masabata osachepera 24, pamene ntchito 3 genotype za matenda C.

Information za mphamvu ya mankhwala osakaniza "Ribavirin" ndi "interferon" zochizira genotype 1 palibe.

Zikatero, ngati wodwala akudwala hepatocarcinoma ndi / kapena kuyembekezera opaleshoni kwa kumuika chiwindi, mchitidwe woika "sofosbuvir" osakaniza "Ribavirin" kwa masabata 48 mpaka tsiku opaleshoni kwa kumuika limba. Izi ndi zofunika pofuna kupewa matenda a chiwindi pambuyo kupatsidwa zina.

maphunziro chipatala amati ndi ophatikizana phwando "sofosbuvir" ndi mankhwala ena amapereka khola zabwino poyankha virological mu 92% milandu mankhwala adjuvant mankhwalawa chiwindi C.

chingachitike mbali

Mu njira ya mayesero matenda mankhwala ndi bwino analekerera ndi odwala (zoterozo zinali mavoti awo). "Sofosbuvir" amachititsa zochitika chowawa nthawi zambiri pamene ntchito limodzi ndi "Ribavirin" ndi "interferon".

Zimagwira "sofosbuvir" ndi "Ribavirin" kawirikawiri zokwanira (kuposa 10% milandu) mu hemoglobin ndende, ndipo inachuluka bilirubin mulole chiwonetsero cha kutopa amachepetsa magazi zikuchokera, irritability ndi tulo, nseru.

Pasanathe ambiri (zosakwana 10% a milandu), kuphatikiza mankhwala amakwiya maganizo, kuchepa magazi, nasopharyngitis, ndende mkhutu, dyspepsia, kudzimbidwa ndi matenda matumbo, thupi lawo siligwirizana pa khungu (kuyabwa zidzolo). Nthawi zina odwala kumanzere, ndipo izi mavoti "sofosbuvir" ntchito limodzi ndi "Ribavirin" anali kuvutika tsitsi ndi ululu kumbuyo, omangana, myalgia, ndi asthenia.

Ngati inu ntchito zovuta mankhwala atatu (ziwiri pamwamba dzina lake anawonjezera "interferon Alpha"), zambiri (kuposa 10% milandu) pali zambiri onse mndandanda wa zinthu chowawa. Apa tikukamba za kusintha kwa magazi: izo kuchepetsa chiwerengero cha lymphocytes, neutrophils ndi maselo othandiza magazi kuundana, kuchepa magazi, okwera milingo bilirubin. Pa mbali pa mundawo m'mimba angathe kutsekula m'mimba, nseru, kusanza. Komanso, "sofosbuvir" (Malangizo, mtima umboni ndi zachipatala kuthandiza) zingachititse mutu, chizungulire, chifuwa, wheezing, kuyabwa ndi zotupa myalgia ndi molumikizana mafupa. Odwala kawiri kawiri za kutopa, irritability, kusanza, kuchuluka kutentha thupi.

Pasanathe ambiri (1 kuti 10%) odwala kunena za mantha ndi chitukuko cha maganizo, kuchepetsa thupi, za kukumbukira ndi ndende zolakwika za mutu waching'alang'ala. Pali zambiri za kuwonongeka kwa masomphenya, tsitsi imfa, chitukuko Reflux ndi kupuma movutikira pamene katundu ukuwonjezeka. Nthawi zina odwala kunena za kupweteka kwa msana ndi chifuwa, kupotokola ndi kutopa.

Kodi muyenera kudziwa?

Ngati wodwalayo chimodzi kapena zingapo zoipa ziti - mkulu koyamba tizilombo katundu, fibrosis mu gawo kukalamba khungu kwambiri mdima - mankhwala a "sofosbuvir" (ndemanga za akatswiri malangizo momwe ntchito thandizo) akhoza chinawonjezeka ndi milungu 24. Pochititsa kuphatikiza mankhwala ogwira mlingo "ribavirin" amusankha monga mwa thupi la wodwalayo, mwachitsanzo. E. 75 makilogalamu thupi amafuna 1.2 ga medicament. Kuchuluka lonse la mankhwala lagawidwa pawiri ndipo anatengedwa ndi chakudya.

Kuchepetsa mlingo "sofosbuvir" ali osavomerezeka.

Ngati ntchito olowa "Solfosbuvira" ndi "interferon Alpha" kukhala mawonetseredwe zoipa khalidwe la mankhwala yamasika, analandira mlingo wa "Interferon" chofunika kuchepetsa kapena kusiya kumwa mankhwala (malamulo mwatsatanetsatane kuchepetsa mlingo kapena achire mankhwala, pali malangizo apadera).

Chimodzimodzi mchitidwe womwewo pamene pali kuphatikiza "sofosbuvir" ndi "Ribavirin", ndi kukhala zoyipa pa phwando otsiriza - amachepetsa mlingo kapena mabasi olandiridwa kwathunthu, "Ribavirin". Pambuyo bwino zotsatira za mayesero magazi, imaonetsa kuti kuyesa kuyambiranso kulandira "ribavirin", kuyambira 600 mg ndi pang'onopang'ono kubweretsa 800 mg. Iwo ali osavomerezeka kuwonjezera mlingo kwa kopita pachiyambi.

Ngati kuletsa wina wa mankhwala ophatikizana mankhwala ndi chotheka kuti achepetse kwathunthu wochotsa "sofosbuvir" - ndemanga pa akatswiri ndi malangizo ntchito malangizo omwe ali ofanana pankhani imeneyi.

Mogwirizana ndi zinthu zina

ogwira ntchito zachipatala osavomerezeka chifukwa odwala limodzi ndi mankhwala ankaona kuti ntchito mankhwala ena mavairasi oyambitsa (kupatula dokotala amachitira) m'nthawi imene mankhwala ikuchitika chiwindi. "Sofosbuvir" ndemanga akatswiri tikambirane n'zotheka pamodzi ndi chinachake pokha pokha pamene ankayembekezera kupindula kuphatikiza mankhwala kuposa ngozi angathe mavuto.

Palinso gulu la mankhwala, ntchito limodzi ndi "sofosbuvir" akhoza zayamba kuchepetsa mayamwidwe wake ( 'sofosbuvir ") mu intestine lapansi. Izi mankhwala - a anticonvulsants - monga "Phenytoin", "Phenobarbital", "carbamazepine" ndi "Oxcarbazepine." Antimycobacterial gulu mankhwala komanso limapangidwa amenewa amatanthauza "Rifabutin", "Rifampicin", "Rifapentine". Kuyambira zowonjezera mankhwala kwambiri m'munsi absorbability "sofosbuvir" mulole Hypericum. Komanso osavomerezeka kuphatikiza mankhwala ndi zoletsa HIV protease, "Tipranavir", "Ritonavir".

malangizo Special

Only kwa dokotala amakhazikitsa mwanzeru mankhwala kamwedwe kwa chiwindi C, ndi mankhwala amene analamula kuti "Ledipasvir", "Asunaprevir", "sofosbuvir", "Daklatasvir". Feedback kwa odwala generics onse "Sovaldi" abwino.

Komabe, tiyenera adzanyamula kukumbukira kuti, odwala ndi kulephera aakulu aimpso, buku mlingo ayenera anasankha mwachindunji. Palibe kufunika recalculate mlingo wa anthu amene amadwala ofatsa matenda zolimbitsa. Pankhani kulephera chiwindi, palibe kusintha mlingo odwala ndi digiri iliyonse ya kukula kwa matendawa.

Mankhwalawa chiwindi C ndi ntchito pamaziko a "sofosbuvir" mankhwala osakaniza ali osavomerezeka kuchita zinthu amene amafuna ndende mkulu ndi liwiro mosiyanasiyana psychomotor.

mtengo osiyanasiyana

Mtengo wa kuwasindikiza mankhwala Germany ndi pakati pa 18 ndi 20 zikwi mayuro. Ndipo kugula ngakhale pa mtengo uwu kukhala ndi mankhwala dokotala nawo. Chotero mtengo wapatali wa ndalama chifukwa chakuti kampani mapulogalamu ayenera recoup ndalama zake zonse kufufuza chitukuko, ndi chiyesedwe cha mankhwala.

mtengo kwambiri mtengo kwa ogula mankhwala, generic (mtengo analogues mtundu ndi chinthu mwamtheradi zofanana yogwira). Ndi kuti chikondi chotere "Daklatasvir", "Asunaprevir", "Ledipasvir" ndi "sofosbuvir". Ogula ndemanga ali ndi mfundo za kukwera mtengo kwa mankhwala amenewa, ife sindikuyankhula za zikwizikwi mayuro.

Kuyambira March 2015, malinga ndi ziphatso kampani-mapulogalamu, magazini ya "sofosbuvir" mphamvu Natko anayamba Indian makampani mankhwala (kumene, ndi chilolezo kwa Utumiki wa Health za India).

Panopa, Russia ndi weniweni kupyolera masitolo Intaneti kugula phukusi (mapiritsi 28) mankhwala "sofosbuvir" kwa 39 900 rubles (piritsi 1 ndalama ogula kuchuluka kwa za 1800 rubles). Si wotsika mtengo koma ndi chimodzimodzi ma CD chomwecho kuwasindikiza "Sovaldi" Pakufunika ndalama kuchuluka kwa pafupifupi 1.5 miliyoni rubles, yomwe ndi pafupifupi 35 nthawi okwera mtengo kusiyana ndi mtengo wa aliyense generic.

Kudzera unyolo mankhwala mpaka inu simungathe kugula mankhwala, T. Kwa. The chitsimikizo ndondomeko mankhwala atsopano mu Russia ndi m'malo yaitali.

Maganizo a ogula ndi madokotala

The medicament anatenga odwala genotypes osiyana a chiwindi, fibrosis magulu ndi akalozera wa transaminase ndipo kwambiri pamwamba mwakale, kawirikawiri tizilombo katundu mkulu.

Ambiri mwa odwala amene anatenga mankhwala, kusiya ndemanga yothandiza za "sofosbuvir" amatanthauza. Amene ankapatsidwa (ndemanga mumakhalanso nkhani zoterozo) poyamba chiwindi C interferon akusonyeza kuti mankhwala akhoza ngakhale kuyerekeza. Interferon chifukwa kwambiri mavuto, ndipo si odwala onse ndi nyonga iwo. Koma kuphatikiza "sofosbuvir" ndi "Daklatasvir" (zambiri odwala kunena choncho tandem), kokha chiwerengero chochepa cha mankhwala wothandizila awa analankhula za chitukuko cha zotsatira yaing'ono zoipa chizungulire, kupweteka mutu, si amphamvu ndi yochepa imfa ya mgwirizano. Komabe, zizindikiro zimenezi sindimapita ku poyerekeza aliyense ndi mavuto a "interferon" ndi zotsatira za matenda a chiwindi. Kumapeto kwa masabata 2-3 mankhwala odwala ambiri, kubwerera zili zabwinobwino mu transaminases chiwindi. Kuyambira Msabata lachitatu la mankhwala ovuta antivirals "sofosbuvir" ndi "Daklatasvir" odwala ambiri pamaso mu thupi la chiwindi C HIV negative.

Komanso, odwala ambiri akunena kuchepetsa kwambiri a fibrosis mu miyezi ingapo, ntchito mankhwala osakaniza.

Anthu ogula amene anatenga zovuta mankhwala atatu - "sofosbuvir", "Daklatasvir", "Ribaverin" - komanso anasangalala kwambiri ndi zotsatira za mankhwala.

Pafupifupi onse ogula "sofosbuvir" Nkhani yojambula weniweni mankhwalawa chiwindi C poyerekeza ndi interferonotherapy. N'zochititsa chidwi patsogolo thanzi ndi khalidwe la moyo - kuti umboni mwachindunji.