The mushonga "Klayra": wongororo vanachiremba, zvayakanakira, nezvayakaipira, mirayiridzo, nemishonga. Anodzokorora gynecologists pamusoro mapiritsi "Klayra" nokuda endometriosis, mu kubereka

Munguva ichangopfuura, kazhinji vanachiremba ano mune zvimwe zvirwere varayire mushonga "Klayra". Reviews vanachiremba, zvayakanakira, nezvayakaipira venyika chokushandisa ichi - ichi zvose ichakurukurwa pazasi.

Sei vanoshanda?

mushonga uyu yaisanganisa nemumuromo pamuviri, iyo inobva kukurukurirana pamusoro zvinoverengeka. Chinonyanya kukosha pakati pavo vari kudzvinyirira kuti ovulation, uyewo kuchinja ari zvivako muromo wechibereko urege madzihwa - iri uye anotsanangura chiito "Klayra" chinodhaka. Reviews vanachiremba (zvayakanakira, nezvayakaipira nyanzvi nguva dzose funga) Kakawanda vanoti ibhuku inomira pakati yayo ndozvinoitawo.

Kuwedzera wokudzivisa pamuviri pasingadiwi mushonga uyu akasiyana nhevedzano yose zvimwe zvivako zvinobatsira kuti, kunyange dzimwe nyaya chero kunaka unhu kukubvumira kusarudza zvakanaka sarudzo pamuviri. contraindications All kuti mushonga anorondedzera "Klayra" mirayiridzo. Reviews vanachiremba zvinosanganisirawo mashoko ani kuti mushonga uyu kunaka.

Chii chinoita kuti kugadzwa?

Kuderedza kusimba marwadzo uye menstrualnopodobnoe ropa, icho pakupedzisira inotungamirira chinokosha zvinoderedza mikana resimbi kushaikwa kupererwa neropa. Ndicho chikuru chaizvoizvo chinopa "Klayra". Reviews vanachiremba (zvayakanakira / nezvayakaipira zvinodhaka cm. Below) vanoti izvi zvose anopiwa zvizere, rine chokuita iyo medicament uye kutokurudzira kushandiswa kazhinji. Uyezve, kazhinji akacherechedza uye kuti negashiro chishandiso inopa chinokosha zvinoderedza zvinobvira kuva endometrial kenza. Uyewo, kuti zvinodhaka kunoderedza mukana ovarian kenza.

Chii vanachiremba vanoti?

Nezveshoko mushonga "Klayra" apindure vanachiremba kazhinji anoratidza chokwadi kuti ane kunobatsira chaizvo pamusoro endometrium, maererano nako rinoshandiswa mune mabatiro refu kana simba zvokutadza kumwedzi ropa pasina makemikari zvokurwara. Zviratidzo izvi ndiwo neapo dzinoparadzana uterine ropa. Izvi govera rinowanikwa pamusoro zvinodhaka "Klayra" apindure n'anga. In endometriosis kushandiswa kwayo zvinogonawo basa.

tsvakurudzo

The kuchengeteka uye Kushanda kushandisa mapiritsi estradiol valerate / dienogest pakurapa zviratidzo dzinoparadzana uterine ropa kunge kuzivikanwa mukufamba zvidzidzo zviviri zvekuchipatara.

chete kavha magadzirirwo nekungorora chirongwa zvaishandiswa muzvidzidzo zviviri. Pakupedzisira, 269 varwere dzaisarudzwa kuti "Klayra" chinodhaka. Reviews vanachiremba (zvayakanakira / nezvayakaipira vanorondedzerwa zvakadzama), vachitora chikamu kudzidza, akati kuti kuwedzera uku kwave munyaya mukudzidza varwere 152, izvo akaedzwa nezvaizoitwa kurapa kunonyaradza pfungwa. Muzvidzidzo izvi, kwakati kwatemwa kuti mushonga wakange zvikuru inoshanda zvichienzaniswa kurapa kunonyaradza pfungwa mukurapa zvezviratidzo izvi, uye zvinokosha kuziva chokwadi chokuti endpoint Achipindura zvinodhaka "Klayra" inopfuura 40% muna nerimwe zvidzidzo.

Uyezve, mumwe nomumwe zvidzidzo akaratidza zvakajeka statistically uye akaora chinokosha zvinoderedza kumwedzi nokurasikirwa neropa, uye zvimwe zvakanga Akaperekedzwa kuwedzera simbi muviri parameters kuti pari kazhinji chiratidzo senzira "Klayra 'wongororo vanachiremba (zvayakanakira nezvayakaipira zvibereko izvi tiri kufunga) .

Sezvo inonzi estrogen pakugadzirira ichi anoshanda variat estradiol, inova dzinongoitika aizotangira kwevanhu 17β-estradiol. Estrogenic zvinoriumba rakashandiswa pano rinoreva chakasiyana yekudyidzana kubva estrogens izvo yaiwanzoshandiswa yaisanganisa nemumuromo pamuviri, izvo zvinodiwa chakaita zvokugadzirwa estrogen, zvakadai mestranol kana ethinyl, chimwe nechimwe chine methyl boka iri 17α chinzvimbo. boka iri rinoita chikuru metabolic pakusimba, asi panguva imwe chete ine zvimwe raidudzwa zvainoita chiropa, riri zvikuru kukosha.

In rondedzero rekugadzirira "Klayra" apindure vanachiremba kazhinji kureva chokwadi kuti kuushandisa rinopa ndoda raidudzwa zvainoita chiropa zvichienzaniswa nemamwe-danho matatu PDAs, izvo zvinosanganisira levonorgestrel uye ethinyl estradiol. Panguva tsvakurudzo kwakati kwatemwa kuti zvinokonzerwa wevasungwa pakati globulin, zvakagadzirirwa vasunge mahormone, iduku raidudzwa. Akabatana dienogest estradiol valerate inoratidza kuwedzera HDL, apo zvachose Kuwanda LDL remafuta akawandisa ipfupi.

Dienogest - a progestogen, kushanda panyaya nomumukanwa yaitonga. It kunoratidzwa mamwe haasaruri Anti-androgenic zvinokonzerwa, apo Anti-estrogenic ayo, androgenic uye estrogenic zvivako haakoshi. Nokuda rakasiyana zvemakemikari mamiriro kunoitwa neboka rose chakarondedzera pharmacological chiito, chine rinonyatsooneka zvakanakira 19-kana-progestogen, uyewo nomukaka siyana progesterone, iro kazhinji nezvemaonero nzira iripo "Klayra 'wongororo (zvayakanakira / nezvayakaipira dzichakurukurwa gare gare).

Chimwe pre-zvekuchipatara Data dzakanga vakawana mukufamba zvavo toxicity zvidzidzo pashure vakawanda dosing, uyewo genotoxicity uye carcinogenic rine chokushandisa ichi, kwete kuratidzwa, kuti pane zvimwe zvinokosha dzakananga njodzi kuvanhu. Zvisinei, kurondedzera zvinodhaka "Klayra" akaongororazve gynecologists vanowanzotaura kuti hatifaniri kukanganwa nezvomukana masero zvinoverengeka kemikari-nemataundi nyama uye yamamota pabonde mahormone. Kana kushandiswa kwakarurama inonzi Pearl Index (chiyero kuti anosarudza kakawanda pamuviri vakadzi makore zana kushanda mushonga pamusoro) ane ukoshi asingasviki 1, asi panyaya ndakarovha mahwendefa kana kusashandiswa hwakura.

pharmacokinetics Next "Klayra" chinodhaka ichakurukurwa. Reviews gynecologists zvisimbiswe zvinenge zvachose mashoko akarongwa neshoko mugadziri, maererano iyo chishandiso uye basa varwere vakawanda.

dienogest

• Absorção de Água. Zvichitevera zvokuudzwa Kutarisirwa yacho chinhu nokukurumidza uye akapotsa kunyura zvachose. C _Max muropa serum zvasvika chinoratidza 90,5 Ng / Rine mamiririta pashure inenge awa pashure nehwendefa chinobviswa (rine 3 MG pamusoro dienogest uye 2 MG estradiol variat). Bioavailability iyi nyaya rinosvika nangananga 91%. Zvinofanira kucherechedzwa kuti pharmacokinetics ose dienogest ari chipimo chemushonga siyana kubva 1 MG kusvika 8 Paaiita zvakananga pazviri dose. Kana gadziriro rinoshandiswa panguva imwe chete nokudya, hazvina kukonzera chero akaora chinokosha zvainoita nedhigirii kana mwero Absorção de Água kuti maatomu akafanana izvi.

• Distribution. A guru chikamu achiparadzira dienogest (10%) riri vasina kusungwa chimiro, apo vakasara ari non-zvakananga chisungo kuti sealbumin. Dienogest pachayo haina chokuita chero kortikosteroidsvyazyvayuschim globulin, kana SHBG pamwe. Chikonzero ichi kuti testosterone panobviswa chose ngozi misha yacho chokuita SHBG kana cortisol kubva kutaurirana pamusoro chinhu chete DRG. A kunyanya simba pamusoro siyana vasiri pezvakaitwa kufamba endogenous steroids ukuwo, zvisingaiti. Kana zvakanyatsoenzana wevasungwa uri 46 V _D L somugumisiro intravenous kwokubatsira 85 MG dienogest wakanyorwa pamwe tritium.

• Muviri. Dienogest chinhu rinoita zvinenge chose zvizere zvaidiwa parizvino anozivikanwa tichipinda muviri pamusoro steroid mahormone, uyewo paumbwe metabolites zviri guru Kakawanda kacho hormonally vakaneta. metabolites aya yabudiswa nokukurumidza saka hune bato iri plasma pamire kuzochinja dienogest. Total Clearance pashure intravenous kwokubatsira tritiated dienogest iri 5.1 l / h.

• Kubviswa. Somugumisiro kugamuchira ichi chinhu mukanwa dose pamusoro 0.1 MG / KG zvachose dienogest sezvo metabolites kuti yabudiswa ne itsvo uye ura zviri anofungidzirwa nhamba 3: 1. Pashure zvokuudzwa kwokubatsira anenge 42% of dose yabviswa zvachose munguva rokutanga, apo 63% - pamusoro 6 Mazuva nokuda renal excretion. Uyezve, pashure 6 Mazuva kuburikidza ura uye itsvo hwokurara vanenge 86% of dose.

• The zvakanyatsoenzana wevasungwa. Panyaya iyi, iyo pharmacokinetics ose dienogest haina zvichienderana wevasungwa pamusoro SHBG. Chakarurama C _ac kunoitwa pashure anenge matatu mazuva pashure kushandisa chete dose, inova 3 MG dienogest akabatana 2 MG Estradiol valerate.

estradiol valerate

• Absorção de Água. Somugumisiro kutora zvinodhaka estradiol yakanakisisa ivhu nokukurumidza uye zvachose kunyura. Cleavage panguva valeric asidhi uye estradiol pacharo zvakananga kunze panguva kubvisa zviri chinhu ari zvomudumbu turakiti mucosa kana panguva ndima yokutanga kuburikidza chiropa, nokudaro kuoneka estradiol uye ayo metabolites. Kana mutumwa chinobviswa Panguva zvokudya, hakuna akaora chinokosha chaizvo pakuti kana mwero Absorção de Água kuti maatomu akafanana izvi.

• Muviri. Valeric asidhi kwakasiyana zvikuru nokukurumidza muviri. Pashure zvokuudzwa kwokubatsira anenge 3% of dose, zvinova bioavailable chose sezvo yakaisvonaka estradiol kuwana nyanyisa kwokutanga chaizvoizvo achipfuura chiropa, saka kuti nouchapupu chikamu raitongwa dose rinoita kare inotangira mucosa pamusoro nemudumbu. Akabatana presystemic muviri ari chiropa zvakananga pamusoro 95% ane nomumukanwa dose pakupedzisira rinoita isati achipinda systemic riparadzirwe. Huru metabolites pano kuita estrone sulfate, estrone uye estrone glucuronide.

• Distribution. In serum 38% kubva estradiol kwakabatana zvakananga SHBG, apo 60% - pamwe sealbumin uye 2-3 chete% ari ichi- rinoparadzirwa mune vasina kusungwa nehurumende. Zvinokosha kucherechedza kuti estradiol anogona insignificantly kuwedzera zvachose Kuwanda SHBG muropa serum, uye izvi ndizvo zvakananga novimba kugamuchirwa dose. Pazuva 21, negashiro gadziriro ino zvachose Kuwanda SHBG akanga anenge 146% chepakutanga, apo 28th zuva, riri pamagumo chokutambudzika kushanda basa mahwendefa kunge yaitwa 141%.

• Kubviswa. Nokuti zvakakwana guru dziva achiparadzira glucuronides uye sulfates, uyewo nokuda hepato-enteric recirculation T _1/2 estradiol pashure nomumukanwa kushandiswa mune chirwere chokutambudzika chinhu chisinganzwisisiki chinowanika, kubatsirwa zvakananga pamusoro pezvakaitwa izvi zvose.

• The zvakanyatsoenzana wevasungwa. Pharmacokinetics estradiol zvakananga kunoenderana wevasungwa pamusoro SHBG. Vakadzi, wevasungwa rimwe estradiol mu plasma iri kunzwisisa kubva endogenous estradiol, uye kuti estradiol izvo zvinopinda muitiro kugamuchira zvinodhaka ichi. Panguva womuchato chinhanho pamahwendefa, ane 3 MG pamusoro dienogest uye 2 MG estradiol valerate, Zvichakadaro wevasungwa kuti estradiol muropa serum pa ravnomestnom wehurumende iri 51,6 pg / ML.

Kana mushonga uyu rinoshandiswa?

First vakagadza "Klayra" panguva kubereka. Reviews vanachiremba vanoti ichi ndicho chakanakisisa sarudzo kuti kurapwa vakadzi vanotambura rinorema kana mazhinji kumwedzi ropa pasina chero makemikari zvokurwara.

Uyewo, mushonga uyu akatorwa kushandisa pamuviri nemumuromo.

Contraindications

On kugadzirira "Klayra" apindure vanachiremba (nemishonga - mhosva) hakusi akanaka nguva dzose. Somuenzaniso, govera dzimwe contraindications. Cherechedza munhu mamiriro shoma iyo chokushandisa ichi hazvifaniri kushandiswa, uye nokudaro mabiko chinofanira akadzima zvachose kana mumwe wavo anotanga kuva panguva kurapa:

• kunyanya aikanganiswa mumwe vanoshingaira zvinhu kana kuti zvimwe Sub-chikamu;
• embolism kana thrombosis zvino kana munhau;
• mamiriro, izvo pre-thrombosis zvose munhau uye chipo;
• akaratidza nhaka kana vawana kubatwa kuti kwaita arterial kana venous thrombosis, kusanganisira naiyewo kushayiwa antithrombin III, mapuroteni C uye S kushaikwa, antibodies kune phospholipids uye gipergomotsistsinemiya;
• kuvapo yakakwirira arterial kana venous thrombosis;
• kuvapo migraine chero zvatichiri chetsinga zviratidzo zvakafanana panguva, uye nhoroondo;
• cheshuga, dzinoratidzwa siyana vascular yematambudziko;
• pfungwa nomuviri zvemwana asati, zvakakomba hypertriglyceridemia ane basa nguva kana nhoroondo;
• zvakakomba chiropa chirwere kana chiropa kutadza Kuwanikwa;
• kemikari-nemataundi nekenza vakaratidza kana nokufungirana kuti chiitiko yavo;
• chiropa anomera;
• pamuviri kana kuti kunyumwira kwayo;
• kusangana nekutsi kwemukadzi ropa pamusoro asingazivikanwi mavambo;
• kuvapo lactose kusashivirira, klyukozo-galactose malabsorption kana lactase kukanganisika.

Uyezve, zvinokosha kuziva chimwe nyaya risingagoni kushandiswa yokuronga mapiritsi "Klayra". Reviews vanachiremba vanoti kuti varege kubatwa paanenge achiyamwa.

chaiwo nyevero

Kana zvimwe zvirwere, mamiriro kana zvinokonzera njodzi ataurwa pazasi zvinochengetwa muvanhu panguva ino, vanofanira kuva vanyatsohuongorora funga dzingangoitika nengozi uye kubatsira kutora zvinodhaka izvi nomumwe nyaya imwe neimwe. Zvikurukuru, rinoshanda zvinotevera ezvinhu:

• zvinokonzera ngozi haizopereri kukura thromboembolism uye thrombosis;
• Other nezvirwere zvinogona kuonekwa zvakasiyana peripheral kweropa zvirwere;
• hypertriglyceridemia;
• kuvapo enhaka angioneurotic edema;
• siyana zvirwere, izvo pakutanga akazviratidza kana akarwarisa panguva pamuviri kana panguva yapfuura kushandiswa pabonde mahormone.

hazvifaniri kutorwa "Klayra" mahwendefa aya zviitiko zvose. Reviews vanachiremba mumamiriro ezvinhu kubatsira kuchengetedza utano.

Pamuviri uye uchiyamwisa

Kushandiswa kwechirwere ichi kunopesana panguva yekuzvitakura. Muchiitiko ichi, pane mamiriro ezvinhu apo pamuviri unoitika mushure mekugamuchira kwekugamuchira, iyo inotaurawo nezve "Clayra" yekugadzirira mazano ekushandiswa. Vanachiremba vanotaura kuti munyaya iyi unofanira kumira pakarepo musangano unotevera. Zvisinei, mukuita kwekuita zvikwidzidzo zvakakura, pakanga pasina kuwedzerwa kungozi yekukudziridza zvikanganiso zvekuberekwa kwevana vakaberekwa nevakadzi vakanga vatora CCP vose vasati vabata pamuviri uye nekugamuchirwa kubvuma pakutanga kwekuzvimba.

CCPs dzimwe nguva dzine simba pamaranzi, sezvo zvinogona kukanganisa huwandu hwomukaka hunoburitswa kana kuti kunyange hunochinja huri hwaro, iyo inowanzoreva kumishonga "Clayra" kuongororwa kwechiremba. Pashure pemakore makumi mana nekuda kwechikonzero ichi, kushandiswa kwayo hakusi kunyanya kukurudzirwa.