Ichiza "Klayra": reviews oogqirha, eziluncedo, bawo, imiyalelo, iziphumo ebezingalindelekanga. Uhlaziya gynecologists malunga iipilisi "Klayra" ngenxa endometriosis, phakathi koku-

Kutshanje, ngokufuthi oogqirha mihla kuzo izifo ezithile ukumisela ichiza "Klayra". Izimvo oogqirha, eziluncedo, bendlela esi sixhobo - konke oku kuya kuxoxwa ngezantsi.

Njani ziyasebenza?

Le ichiza a edityanisiwe ukukhulelwa ngomlomo, olusekelwe phezu impefumlelwano izinto ezininzi. Eyona nto ibalulekileyo phakathi kwazo ezi kwezithandani of ovulation, kwakunye nokunciphisa iimpawu yencindi yomlomo wesibeleko - kule kwaye isekelwe intshukumo "Klayra" iziyobisi. Izimvo oogqirha (eziluncedo, bawo iingcali cinga) badla ngokuthi ukuba sisixhobo ime phakathi isiphumo yayo efanayo.

Ukongeza ekuthinteleni ukukhulelwa okungafunekiyo eli chiza kwahlukile yonke uthotho iipropati ezongeziweyo enenzuzo, nokuba kuthathelwa ingqalelo naziphi na iimpawu ezingalunganga ukuvumela ukuba ukhethe ukhetho ilungileyo zokucwangcisa. Zonke Izimo ukuba ichiza ichaza "Klayra" umyalelo. Ukuphonononga amagqirha nazo zibandakanya ulwazi malunga ngubani ukuthatha eli amayeza ezingathandekiyo.

Yintoni eyenza i idinga?

Ukunciphisa ngobunzulu intlungu menstrualnopodobnoe ukopha, nto leyo ekugqibeleni kukhokelela ekuncipheni kakhulu umngcipheko ayoni anemia. Leyo yeyona ndlela iphambili, ebonelela i "Klayra". Izimvo oogqirha (ezingundoqo / izinto eziluncedo ze-cm iziyobisi. Ngezantsi), bathi ukuba konke oku inikwa ngokupheleleyo, ngokunxulumene ne apho medicament kwaye acebise ukusetyenziswa njalo rhoqo. Ukongeza, ngokufuthi waphawula nokuba ulwamkelo isixhobo inika ukuhla okubonakalayo ithuba wokuhlaselwa ngumhlaza womlomo endometrial. Kwakhona, ichiza lunciphisa ubungozi yomhlaza ovarian.

Yintoni oogqirha bathi?

Ngokuphathelele ichiza "Klayra" impendulo kumagqirha amaninzi mandiyiqaqambise into yokuba kunempembelelo yingenelo kakhulu kwi endometrium, ngokunxulumene kuso esetyenziswa ukunyanga ixesha elide okanye ukopha ngamandla kakhulu exesheni ngaphandle organic ngezifo. Ezi mpawu wambi ezikwimeko zesibeleko ukopha. Oku aphake iyafumaneka malunga "Klayra" impendulo zeziyobisi kumagqirha. Xa endometriosis ukusetyenziswa kwayo nazo zabelwe.

uphando

Ukhuseleko kunye nokusebenza usebenzisa iipilisi estradiol valerate / dienogest kwi unyango ziimpawu kukuba iveza zesibeleko ukopha ziye zachongwa ngethuba lezifundo amabini onyango.

isicwangciso esifanayo kuyilo ezingxobeni analysis ezazisetyenziswa zombini izifundo. Ekugqibeleni, izigulane 269 akhethwa ukuba "Klayra" iziyobisi. Izimvo oogqirha (ezingundoqo / izinto eziluncedo ichazwe ngokwenkcukacha), ngokuthatha inxaxheba kwesi sifundo, wathi ukongeza oku sele inxaxheba kuphononongo izigulane-152, nto leyo yavavanywa ifuthe placebo. Kwezi ntlobo zophononongo, kwakugqitywa kwelokuba ichiza elasebenzayo kakhulu xa kuthelekiswa placebo kwi unyango ezi mpawu, kwaye kubalulekile ukuqaphela into yokuba impendulo sokugcina ukuba iziyobisi "Klayra" ingaphezulu kwe-40% kulo ngalunye kwezi zifundo.

Ukongeza, ngamnye amaphononongo abonisa ngokucacileyo manani kwaye ngokwezonyango ezibalulekileyo zokunciphisa ekulahlekeni igazi sexesheni, yaye ngakumbi sikhatshwe ukwanda okubonakalayo yentsimbi yokucolwa parameters ukuba okwangoku kuvame njengendlela "reviews Klayra 'loogqirha (iingenelo neengozi le mveliso ngayo ngoku) .

Njengoko estrogen kule ukulungiselela kufeza variat estradiol, nto leyo eyayiza ngokwendalo yabantu 17β-estradiol. Icandelo Estrogenic esetyenziswa apha kuthetha ohluke kakhulu ukusuka estrogen asetyenziswa ngalo izivimbela edityanisiwe, ezo estrogen eqhelekileyo zokwenziwa, ezifana mestranol okanye ethinyl, nganye iqulethe iqela imethyl kwi sikhundla 17α. Eli qela ubangela uzinzo olukhulu kakhulu pathways, kodwa kwangaxeshanye kunempembelelo iqapheleka kakhulu ophezu kwesibindi, nto leyo ebaluleke kakhulu.

Xa inkcazo yokulungiselela "Klayra" impendulo kumagqirha amaninzi zibhekisela ukuba ziwuthimbe inikeza kakhulu iqapheleka kangako ukusebenza isibindi xa kuthelekiswa namanye PDA ontlantlu-ntathu, ezibandakanya levonorgestrel kunye ethinyl estradiol. Ngethuba lokwenza uphando, kwakugqitywa kwelokuba ifuthe uyondelelwano lwee- globulin eyenzelwe babophe iihomoni, lingaphantsi kubi. Kudibaniso dienogest estradiol valerate ibonisa ukwanda kakhulu iHDL, ngoxa xi lilonke LDL cholesterol lifinyele.

Dienogest - a Progestogen, esebenza kwimeko kulawulo ngomlomo. Lubonakala yi neziphumo ezongezelelweyo buso anti-androgenic, ngoxa anti-estrogenic, iimpawu zayo androgenic kwaye estrogenic zingabalulekanga. Ngenxa ubume yemichiza eyahlukileyo kuphunyezwa ngokuthi kuluhlu lonke inyathelo amayeza, nto leyo equka iingenelo kakhulu ye-okanye-Progestogen 19, kwakunye avela ezahlukeneyo dlala, nto leyo ngokufuthi kombhali malunga iindlela ezikhoyo "reviews Klayra '(ezingundoqo / izinto eziluncedo iya kuxoxwa mva).

Enye data pre-clinical ukuba zifunyenwe ngethuba lezifundo eziqhelekileyo zinetyhefu emva Umthamo ezininzi, ngokunjalo genotoxicity kunye namandla umhlaza esi sixhobo, aziveli, ukuba kukho ingozi ezithile abanye abantu. Noko ke, xa echaza ichiza "Klayra" kwakhona gynecologists badla ukuba asimele silibale malunga nokwenzeka ekuhlumiseni inani izicwili enama-oxhomekeke kwaye nangezilonda iihomoni ngesondo. Kwimeko ukusetyenziswa ngokuchanekileyo ekuthiwa- Pearl Index (a ngomlinganiselo kugqiba nezihlandlo ukukhulelwa xa yabasetyhini abangaphezulu kweminyaka engamakhulu isicelo of isiyobisi) has ixabiso ngaphantsi kwe-1, kodwa ke kwimeko amacwecwe eziphosiweyo okanye kakubi ngayo lukhule.

pharmacokinetics Okulandelayo "Klayra" ichiza ziya kuqwalaselwa. Ukuphonononga gynecologists ukuqinisekisa phantse ngokupheleleyo ulwazi kucacise umenzi, ngokunxulumene ne apho isixhobo awabelwa izigulane ezininzi.

dienogest

• Absorption. Emva ulawulo ngomlomo i element ngokukhawuleza kwaye phantse egxile ngokupheleleyo. C _max kwi serum igazi ifikelela isalathisi 90,5 ng / ml emva kweyure malunga emva kokuba lwecwecwe kuthathwa (iqulethe 3 mg dienogest 2 mg estradiol variat). Bioavailability kulo mzekelo ufikelela ithagethi ka-91%. Kufuneka kuqatshelwe ukuba pharmacokinetics of dienogest kuluhlu idosi ukusuka 1 mg 8 olwenze ukuxhomekeka ngqo kwi idosi. Ukuba yokulungiselela isetyenziswa ngaxeshanye ngokudla, ingabangeli naliphi na isiphumo ngokwezonyango ebalulekileyo iqondo okanye izinga kukufakwa nesiqalelo.

• Distribution. Inxalenye enkulu dienogest elijikeleza (10%), kwenziwa ngendlela engadityaniswanga, lo gama intsalela liqinisekile non-ngqo ku albumin. Dienogest ngokwayo sinxulumana ngqo nayiphi globulin kortikosteroidsvyazyvayuschim, okanye SHBG kunye. Kungenxa yesi sizathu ukuba testosterone iyapheliswa ngokupheleleyo umngcipheko ukubana le ngokunxulumene SHBG okanye cortisol ukusuka unxibelelwano element kunye DRG. A impembelelo ethile kwiinkqubo ezahlukeneyo komzimba ukuhambisa steroids zemveli, ngokulandelelana, cishe kungenakwenzeka. Xa xi lizama yi 46 V _d L ngenxa kulawulo efakwa of dienogest 85 mg ilebhile eziFihliweyo.

• Lokugaya. Dienogest element umzimba phantse ngokupheleleyo ngokuthobela ngokupheleleyo kwindlela kwaziwe emzimbeni ka emzimbeni steroid, kwakunye ukuyilwa metabolites ukuba asisininzi enkulu amatyala hormonally engasebenziyo. Ezi metabolites kwazona ngokukhawuleza kakhulu ukuze neyelenqe lwiimi ziveleleyo plasma yegazi limi dienogest ingaguqukanga. zavunyelwa iyonke emvakweminyaka ulawulo efakwa of dienogest tritiated yi 5.1 l / h.

• Wokukhutshwa eluhlwini. Ngenxa yokufumana lwesi sakhi idosi ngomlomo ka-0.1 mg / kg ngokupheleleyo dienogest njengoko metabolites ukuba kwazona yi izintso amathumbu kwi umlinganiselo elisondeleyo 3: 1. Emva Ulawulo ngomlomo nama-42% ye iidosi lususwe emini yokuqala, lo gama i-63% - iintsuku ezingaphezu 6 zinomgutyulo kwezintso. Ukongeza, emva kweentsuku ezi-6 ukuya emathunjini kunye kwizintso oluvela malunga 86% ye idosi.

• Le lizama ingqondo. Kulo mzekelo, i pharmacokinetics of dienogest na ngokuxhomekeke uyondelelwano lwee- SHBG. Isalathisi C _ss kwenziwa emva iintsuku ezintathu emva kokusebenzisa idosi enye, nto leyo 3 mg dienogest xa zidityaniswe ne-2 mg Estradiol valerate.

estradiol valerate

• Absorption. Ngenxa yokuthatha estradiol ichiza iisampulu best egxile ngokukhawuleza nangokupheleleyo. Cleavage kwi valeric acid kunye estradiol ngokwalo kwenziwa ngqo ngethuba sokufunxa ka sakhi phecana isifo wokudla okanye ngexesha sicatshulwa lokuqala kwesibindi, ngaloo ndlela ukuvela estradiol kunye metabolites yayo. Ukuba arhente sithathwa ngaxeshanye kunye nokutya, lungenasiphumo ngokwezonyango ezibalulekileyo kubungakanani okanye izinga kukufakwa nesiqalelo.

• Lokugaya. Valeric acid yohlukile ukutya ngokukhawuleza kakhulu. Emva Ulawulo ngomlomo nama-3% of idosi, kuba bioavailable ngokupheleleyo estradiol enyulu bajamelene isiphumo olunzulu lokuqala wacanda kwesibindi, ukuze ukuba inxalenye enkulu idosi ezilawulwa umzimba sele iqala isifo kweli phecana zesisu. Kudibaniso yokucolwa presystemic esibindini ngqo malunga nama-95% kwe-dose ngomlomo ekugqibeleni umzimba ngaphambi kokuba aye kungena kwegazi. Le metabolites eziphambili apha ukwenza estrone sulfate, estrone kunye estrone glucuronide.

• Distribution. Xa serum 38% of estradiol inxulumene ngqo SHBG, lo gama i-60% - kunye albumin kunye% 2-3 kuphela ziqhubela kusasazwa sikarhulumente engadityaniswanga. Kubalulekile ukuphawula ukuba estradiol ukuze insignificantly ukwandisa xi lilonke SHBG e serum egazini, kwaye oku kuxhomekeke ngqo kwi idosi ukwamkeleka. Ngosuku 21, ulwamkelo le yokulungiselela xi lilonke SHBG ibe malunga nama-146% kule yokuqala, ngoxa umhla 28, nto leyo kwisigaba ekupheleni isicelo iipilisi engasebenziyo ziye zancitshiswa kwi 141%.

• Wokukhutshwa eluhlwini. Ngenxa echibini elikhulu ngokwaneleyo esasaza glucuronides kunye sulfates, kwakunye ngenxa hepato-ama recirculation T _1/2 estradiol emva ukusetyenziswa yomlomo kwi-terminal kwisigaba yinto enzima, ixhomekeke ngqo kuzo zonke ezi nkqubo.

• Le lizama ingqondo. Pharmacokinetics estradiol kuxhomekeke ngqo kwi uyondelelwano lwee- SHBG. Kwabasetyhini, uyazikhomba estradiol kwi plasma ngegazi entsokothileyo estradiol zemveli, kwaye estradiol okungena inkqubo lokufumana eli chiza. Ngexesha amacwecwe lesigaba reception, eziqulathe 3 mg dienogest 2 mg estradiol valerate, imin lwee- estradiol kwi serum igazi karhulumente ravnomestnom yi 51,6 nanziya / ml.

Xa kusetyenziswa eli chiza?

Wabamisela kuqala "Klayra" ngexesha ukuya exesheni. Izimvo oogqirha bathi oku ukhetho ilungele ukuba unyango kwabafazi abanengxaki sexesheni enzima okanye wayolula ukopha engekho na ngezifo organic.

Kwakhona, eli chiza kuthathwa ukuyisebenzisa ngomlomo.

Izimo

Kwi yokulungiselela "Klayra" impendulo kumagqirha (ziziphumo ebezingalindelekanga - ityala) akusoloko positive. Ngokomzekelo, ukubeka ezinye Izimo. Qaphela ukuba iimeko ezimbalwa apho esi sixhobo kufuneka ingasetyenziswa, yaye ngaloo ndlela ulwamkelo iza kucinywa ngokupheleleyo ukuba omnye wabo iqala ukuphuhlisa ngexesha kunyango:

• uvakalelo ngokugqithisileyo ukuba naziphi na izinto esebenzayo okanye sub-kwicandelo elithile;
• Embolism okanye thrombosis ngoku okanye imbali;
• karhulumente, leyo pre-thrombosis kokubini kwimbali kunye langoku;
• wavakalisa nezici ilifa okanye olufundiweyo ukuvela esimbaxa okanye thrombosis lwemithambo, kubandakanywa nayo ukuswela antithrombin III, iiproteins C kunye S imibala, antibodies phospholipids kunye gipergomotsistsinemiya;
• ubukho emithanjeni ephakamileyo okanye thrombosis lwemithambo;
• ubukho migraine kunye naziphi na iimpawu ezesini luvo ezifana ngalo mzuzu, nembali;
• seswekile, luphawulwa iingxaki ezahlukeneyo nemithambo;
• pancreatitis, hypertriglyceridemia kakhulu ukuchitha ixesha okanye imbali esebenzayo;
• isifo sesibindi kakhulu okanye ukusilela isibindi nokufumaneka;
• enama-oxhomekeke imihlaza ukuboniswa okanye rhanelwa kwazo;
• ngamathumba isibindi;
• ukukhulelwa okanye urhano kwayo;
• ukopha kusisi of imvelaphi engaziwayo;
• ubukho ukunganyamezelani lactose, klyukozo-galactose malabsorption okanye yelactose intswelo.

Ngaphezu koko, kubalulekile ukukhumbula kunjalo lingakumbi apho ayikwazi kusetyenziswa iipilisi zokulawula inzala "Klayra". Izimvo oogqirha bathi kufuneka kuthathwe ngexesha lokuncancisa.

izilumkiso ezizodwa

Ukuba izifo ezithile, iimeko okanye ubungozi ekhankanywe ngezantsi kuvandlakanywa abantu ngelo xesha lakalokunje, kuya kufuneka ukuba ube ngenyameko ingqalelo iimeko ezingayingozi ekuqhutyeni kunye neenzuzo ukuthatha eli chiza kwimeko nganye. Ngokukodwa, oku kusebenza ezi meko zilandelayo:

• ubungozi kuphuhliso koko thromboembolism kunye thrombosis;
• Ezinye izifo apho kubonakala ukuphazamiseka ezahlukeneyo peripheral kwegazi;
• hypertriglyceridemia;
• phambi nokudumba zamafa angioneurotic;
• izifo ezahlukahlukeneyo, nto leyo wabonakala kuqala okanye mandundu ngexesha ekhulelwe okanye xa ukusetyenziswa odlulileyo hormone ngesondo.

kufuneka kuthathwe "Klayra" amacwecwe kuzo zonke ezi meko. Izimvo oogqirha kule meko ukunceda ukulondoloza impilo.

Ukukhulelwa wamabele-lwebele

Ukusetyenziswa kwale ichiza contraindicated ngexesha lokukhulelwa. Kulo mzekelo, kukho iimeko ezinjalo xa ekumitheni kwenzeka kwizigulane abafumana ukuba ibhekisela ichiza "Klayra" umyalelo manual. Izimvo oogqirha bathi kulo mzekelo kufuneka ayeke ngokukhawuleza kulandelwe ulwamkelo. Nangona kunjalo, ngethuba ukuqhuba uphononongo amakhulu-scale basengozini enkulu naziphi na iziphene yokuzalwa ebantwaneni khange sele siqwalaselwe, awabazalelwayo amabhinqa wathabatha CPC njengoko phambi kokuba akhulelwe ngexesha yokwamkela lwabo kalula ekuqaleni yokukhulelwa.

maxa wambi CPC kuchaphazela zisanyisa, njengoko kuchaphazela ngokungalunganga isixa ubisi eziveliswa okanye ukutshintsha nokubunjwa kwayo, elithanda ekuthethwe ngalo ulungiselelo "Klayra" impendulo kumagqirha. ngenxa yesi sizathu, ukusetyenziswa kwayo ayikhuthazwa ingakumbi emva kweminyaka engama-40.