Kuvomerezedwa Kuti Zigwiritsidwe Ntchito kwa Anthu Omwe Amakhala ndi Genotype Yachilendo 3 Kutsekula kwa Chiwindi
Daklinza (daclatasvir) ndi mankhwala ogwiritsidwa ntchito pophatikizapo matenda a hepatitis C (HCV) achikulire omwe ali ndi zaka 18 kapena kuposerapo. Daklinza amagwira ntchito potseka puloteni yotchedwa NS5B (osalimba mapuloteni 5B) omwe HCV amagwiritsa ntchito kuti iwonetsere RNA yake, yomwe imasokoneza siteji ya HIV.
Daklinza adavomerezedwa pa July 24, 2015, ndi US Food and Drug Administration kwa odwala omwe ali ndi matenda a HCV osachepera atatu , kuphatikizapo odwala matendawa.
Daklinza angagwiritsidwe ntchito pa odwala onse omwe sanayambe kuwachiritsidwa (odwala-naïve), komanso odwala omwe amachiritsidwa kale omwe analibe gawo kapena ayi ngakhale atalandira chithandizo chamankhwala a HCV.
Kafukufuku wa chipatala wasonyeza kuti chiwerengero cha mankhwala ochiritsidwa ndi odwala omwe ali pa Dakliniza ndi 98%, pomwe chiwerengero cha mankhwala ochiritsira odwala matenda a cirrhosis ndi 58%.
Ndondomeko Yoperekedwa
Mmodzi wamapiritsi 60 mg omwe amapezeka tsiku ndi tsiku kapena opanda chakudya kuphatikizapo Sovaldi (sofosbuvir) . Nthawi yokwanira ya mankhwalawa ndi masabata 12.
Mlingowo ukhoza kusinthidwa kwa odwala omwe amatenga CYP3A inhibitor kapena CYP3A inducer ( onani mndandanda pansipa ). Kulephera kuchita zimenezi kungachepetse kuchipatala kwa Daklinza, komanso kuwonjezera mwayi wotsutsa mankhwala. Zikatero, ndibwino kuti mlingo ukhale wochepa mpaka 30 mg kamodzi tsiku ndi tsiku ndi mphamvu yolimba ya CYP3A ndipo uwonjezereke kufika 90 mg kamodzi tsiku ndi tsiku ndi mphamvu ya CYP3A.
Daklinza akulamulidwa kuti agwiritsidwe ntchito pamodzi ndi Sovaldi ndipo sayenera kugwiritsidwa ntchito monga monotherapy.
Mapangidwe
Daklinza amapezeka mu mawonekedwe a piritsi 30 mg ndi 60 mg.
Mapiritsi a 30 mg ali obiriwira owala ndipo amawoneka bwino, ndi "BMS" pambali imodzi ndi "213" pambali inayo. Mapiritsi a 60 mg ndi ofunika kwambiri komanso amawoneka bwino, ndi "BMS" pambali imodzi ndi "215" pambali inayo.
Zotsatira Zogwirizana
Zotsatira zambiri zomwe zimagwirizanitsidwa ndi kugwiritsa ntchito mankhwala a Daklinza / Sovaldi (omwe amapezeka oposa 5%) ndi awa:
- Kutopa
- Mutu
- Nausea
- Kutsekula m'mimba
Kuyanjana kwa Mankhwala
Mlingo wa Daklinza uyenera kuchepetsedwa kufika 30 mg potsatira zotsatira zotsutsa za CYP3A:
- Maantibayotiki: clarithromycin, telithromycin
- Mankhwala oletsa fungal: itraconazole, ketoconazole, posaconazole, voriconazole, telithromycin
- Matenda ochepetsa kachilombo ka HIV: Crixivan (indinavir), Invirase (saquinavir), Viracept (nelfinavir), Norvir-Reyataz (atazanavir)
Mlingo wa Daklinza uyenera kuwonjezeka kufika 90 mg potsatira zotsatirazi za CYP3A:
- Mankhwala opatsirana kwambiri: Tracleer
- Mankhwala a corticosteroid: dexamethasone
- Matenda opatsirana pogonana: Sustiva (efavirenz), Intelence (etravirine)
- Mankhwala osokoneza bongo / ogona tulo: Provigil
- Mankhwala a penicillin: nafcillin
- Mankhwala oletsa chifuwa chachikulu: Priftin
Mankhwala awa sagwiritsidwe ntchito ndi Daklinza:
- Anti-convulsives: Tegretol, Carbatrol, Equetro, Epitol, Dilantin, Phenytek, Dilantin-125
- Mankhwala oletsa TB: Rifadin
- Wotchedwa St. John's Wort
Nthaŵi zonse perekani dokotala wanu za mankhwala aliwonse omwe mungakhale nawo, kuphatikizapo mankhwala owonjezera pa mankhwala kapena zomwe adzilemba ndi dokotala wina.
Zowonjezerapo
Daklinza angayambitse kuchepa kwa mtima ( bradycardia ).
Pakhala pali odwala omwe adalandira mankhwala osokoneza bongo atatha kumwa mankhwala osokoneza bongo, amiodarone , ndi Sovaldi kuphatikizapo kachilombo ka HIV kameneka, kuphatikizapo Daklinza. Co-administration of amiodarone ndi Daklinza ndi Sovaldi sali woyenera. Ngati palibe njira ina yowonjezera, kuyang'ana kwa mtima kumalimbikitsidwa kwambiri.
Ngakhale kuti maphunziro a zinyama sanasonyeze umboni wa kuwonongeka kwa fetus pamene atapezeka ku Daklinza panthawi ya mimba, kugwiritsa ntchito Sovaldi kumatsutsana ndi ntchito imeneyi. Mankhwala a medlinza / Sovaldi sayenera kugwiritsidwa ntchito panthawi ya mimba. Akazi omwe ali ndi zaka zakubadwa ndi abambo awo ayenera kugwiritsa ntchito mitundu iwiri ya kulera pamene akugwira Daklinza / Sovaldi.
Chitetezo cha Daklinza ndi odwala matenda opatsirana ndi chiwindi asanakhazikitsidwe.
Chitsime:
US Food and Drug Administration. "FDA imavomereza chithandizo chatsopano cha matenda opatsirana ndi matenda a chiwindi omwe amachititsa kuti munthu asatenge kachilomboka." Silver Spring, Maryland; ndondomeko yofalitsa yomwe inatulutsidwa pa July 24, 2015.