Tacrolimus

-Delile

• Ngaphambi kokuthatha i-tacrolimus,
• I-tacrolimus ingadala imiphumela emibi. Tshela udokotela wakho uma kukhona kulezi zimpawu ezinzima noma ezingapheli:
• Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nalezi zimpawu ezilandelayo, noma lezo ezishiwo esigabeni ESIBALULEKILE SESEXWAYISO, shayela udokotela wakho ngokushesha:
• Izimpawu zokudlula ngokweqile zingafaka:

I-Tacrolimus kufanele inikezwe kuphela ngaphansi kokuqondisa kukadokotela onolwazi lokwelapha abantu abafakelwe izitho zomzimba kanye nokunikeza imithi eyehlisa ukusebenza kwamasosha omzimba.

I-tacrolimus inciphisa ukusebenza kwamasosha akho omzimba. Lokhu kungakhuphula ubungozi bokuthi uthole ukutheleleka okunzima. Uma uhlangabezana nalezi zimpawu ezilandelayo, shayela udokotela wakho ngokushesha: umphimbo obuhlungu; ukukhwehlela; imfiva; ukukhathala ngokweqile; izimpawu ezinjengomkhuhlane; isikhumba esifudumele, esibomvu, noma esibuhlungu; noma ezinye izimpawu zokutheleleka.

Lapho amasosha akho omzimba engasebenzi ngendlela ejwayelekile, kungaba nengozi enkulu yokuthi uzoba nomdlavuza, ikakhulukazi i-lymphoma (uhlobo lomdlavuza oluqala kumaseli amasosha omzimba). Uma uthatha isikhathi eside i-tacrolimus noma eminye imishanguzo enciphisa ukusebenza kwesistimu yomzimba, futhi amazinga akho ale mithi ayanda, le ngozi inganda kakhulu. Uma uhlangabezana nanoma yiziphi kulezi zimpawu ezilandelayo ze-lymphoma, shayela udokotela wakho ngokushesha: ama-lymph node avuvukile entanyeni, emakhwapheni, noma emgodini; ukuncipha komzimba; imfiva; ukujuluka ebusuku; ukukhathala ngokweqile noma ubuthakathaka; ukukhwehlela; ukuphefumula kanzima; ubuhlungu besifuba; noma ubuhlungu, ukuvuvukala, noma ukugcwala endaweni yesisu.

Ucwaningo lukhombisile ukuthi abesifazane abathola ukufakelwa isibindi futhi bethatha amaphilisi akhipha i-tacrolimus (i-Astagraf XL) baba nengozi eyengeziwe yokufa. Ama-capsule akhishwa isikhathi eside we-Tacrolimus (i-Astagraf XL) awavunyelwe yi-FDA ukuvimbela ukwenqatshwa (ukuhlaselwa kwesitho esifakelwe kabusha amasosha omzimba womuntu othola isitho) sokufakelwa kwesibindi.

Khuluma nodokotela wakho ngezingozi zokuthatha i-tacrolimus.

I-Tacrolimus (i-Astagraf XL, i-Envarsus XR, i-Prograf) isetshenziswa kanye neminye imithi ukuvimbela ukwenqatshwa (ukuhlaselwa kwesitho esifakelwe kabusha amasosha omzimba womuntu othola isitho) kubantu abathole ukufakelwa izinso. I-Tacrolimus (Prograf) iyasetshenziswa kanye neminye imithi ukuvimbela ukwenqatshwa kubantu abathole ukufakelwa isibindi noma inhliziyo. UTacrolimus usesigabeni semithi ebizwa ngama-immunosupressants. Isebenza ngokunciphisa ukusebenza kwamasosha omzimba ukuyivimba ekuhlaseleni isitho esitshalwe kabusha.

I-Tacrolimus iza njenge-capsule, ama-granules wokumiswa ngomlomo (okuzohlanganiswa noketshezi), i-capsule ekhishwe isikhathi eside (esebenza isikhathi eside), kanye nethebhulethi ekhishwa isikhathi eside ezothathwa ngomlomo. Ama-capsule akhishwa ngokushesha (i-Prograf) nokumiswa ngomlomo (i-Prograf) kuvame ukuthathwa kabili ngosuku (ukuhlukana kwamahora ayi-12). Ungathatha amaphilisi akhishwa ngokushesha kanye nokumiswa ngomlomo ngokudla noma ngaphandle kokudla, kodwa qiniseka ukuthi ukukuthatha ngendlela efanayo isikhathi ngasinye. Ama-capsule akhishwa isikhathi eside (i-Astagraf XL) noma amaphilisi akhishwa enwetshiwe (i-Envarsus XR) ajwayele ukuthathwa njalo ekuseni esiswini esingenalutho okungenani ihora elilodwa ngaphambi kokudla kwasekuseni noma okungenani amahora amabili ngemuva kokudla kwasekuseni. Thatha i-tacrolimus ngasikhathi sinye (ama) nsuku zonke. Landela izinkomba ezikulebuli kadokotela wakho ngokucophelela, bese ubuza udokotela noma usokhemisi wakho ukuthi akuchaze nganoma iyiphi ingxenye ongayiqondi. Thatha i-tacrolimus njengoba nje kuqondisiwe. Ungayithathi kancane noma uyithathe kaningi kunokuyalelwa ngudokotela wakho.

Uma uthatha ama-granules ukumiswa ngomlomo, uzodinga ukuwaxuba namanzi okushisa ekamelweni ngaphambi kokusetshenziswa. Faka izipuni eziyi-1 kuye kwezi-2 (amamililitha ayi-15 kuye kwangama-30) enkomishini equkethe ama-granules. Hlanganisa okuqukethwe bese uthatha leyo ngxube ngomlomo enkomishini noma ngesirinji yomlomo; ungagcini ingxube ngokuhamba kwesikhathi. Ama-granules ngeke ancibilike ngokuphelele. Uma kukhona enye ingxube esele, engeza izipuni eziyi-1 kuye kwezi-2 (amamililitha ayi-15 kuye kwangama-30) enhlanganisweni bese uyithatha ngokushesha.

Gwinya amaphilisi akhishwa isikhathi eside namaphilisi akhululiwe enziwe ngamanzi; ungawahlukanisi, ungawahlafune noma uwagxoze. Ungavuli amaphilisi akhishwa ngokushesha,

Udokotela wakho uzokuqapha ngokucophelela futhi alungise umthamo wakho lapho kudingeka. Khuluma nodokotela wakho kaningi ngokuthi uzizwa kanjani ngenkathi welashwa. Buza udokotela wakho uma unemibuzo mayelana nokuthi kufanele uthathe i-tacrolimus engakanani.

Imikhiqizo ehlukahlukene yetekisi ekhipha umuthi ngokuhlukile emzimbeni wakho futhi ayinakusetshenziswa ngokungafani. Thatha kuphela umkhiqizo we-tacrolimus obekwe udokotela wakho futhi ungashintsheli komunye umkhiqizo we-tacrolimus ngaphandle kokuthi udokotela wakho athi kufanele.

I-Tacrolimus ingavimbela ukwenqatshwa kokufakelwa kwakho kuphela uma uthatha umuthi. Qhubeka uthathe i-tacrolimus noma ngabe uzizwa uphilile. Ungayeki ukuthatha i-tacrolimus ngaphandle kokukhuluma nodokotela wakho.

I-Tacrolimus kwesinye isikhathi isetshenziselwa ukwelapha isifo sikaCrohn esibhakabhakeni (isimo lapho umzimba uhlasela ulwelwesi lomgudu wokugaya ukudla, ubanga ubuhlungu, isifo sohudo, ukwehla kwesisindo, umkhuhlane, nokwakhiwa kwemigudu engajwayelekile exhuma umgudu wokugaya ezinye izitho noma isikhumba). Khuluma nodokotela wakho ngezingozi zokusebenzisa lo muthi ukwelapha isimo sakho.

Lo muthi ungabekelwa okunye ukusetshenziswa; buza udokotela wakho noma usokhemisi ukuthola eminye imininingwane.

Ngaphambi kokuthatha i-tacrolimus,

• Tshela udokotela wakho kanye nosokhemisi uma unegciwane ku-tacrolimus, noma imiphi eminye imithi, noma ezinye izithako emikhiqizweni ye-tacrolimus. Buza usokhemisi wakho noma uhlole Umhlahlandlela Wezokwelapha ukuthola uhlu lwezithako.
• Tshela udokotela wakho kanye nosokhemisi ukuthi imiphi imishanguzo kadokotela noma engabhaliswanga, amavithamini, kanye nezithako zokudla okunomsoco ozithathayo noma ohlela ukuzithatha. Qiniseka ukuthi usho noma ikuphi kokulandelayo: amiodarone (Nexterone, Pacerone); i-amphotericin B (i-Abelcet, i-Ambisome); i-angiotensin-converting enzyme (ACE) inhibitors efana ne-benazepril (Lotensin, eLotrel), i-captopril, i-enalapril (i-Vasotec, ngesi-Vaseretic), i-fosinopril, i-lisinopril (e-Prinzide, e-Zestoretic), i-moexipril (Univasc, i-Uniretic) , e-Prestalia), i-quinapril (i-Accupril, ngesi-Quinaretic), i-ramipril (i-Altace), noma i-trandolapril (eTarka); ama-antacids aqukethe i-magnesium ne-aluminium hydroxide (Maalox); ama-antibiotic athile ahlanganisa i-aminoglycosides efana ne-amikacin, i-gentamicin, i-neomycin (i-Neo-Fradin), i-streptomycin, ne-tobramycin (i-Tobi), nama-macrolides afana ne-clarithromycin (Biaxin), i-erythromycin (i-EES, i-E-Mycin, i-Erythrocin), ne-troleandomycin (TAO) ayitholakali e-US); imishanguzo ye-antifungal efana ne-clotrimazole (Lotrimin, Mycelex), i-fluconazole (i-Diflucan), i-itraconazole (i-Onmel, i-Sporanox), i-ketoconazole, i-posaconazole (i-Noxafil), ne-voriconazole (i-Vfend); ama-angiotensin receptor blockers (ama-ARB) anjenge-azilsartan (Edarbi, e-Edarbyclor), amakhandlela (Atacand, e-Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, e-Avalide), losartan (Cozaar, e-Hyzaar), olmesartan (Benicar) e-Azor, e-Benicar HCT, e-Tribenzor), e-telmisartan (Micardis, e-Micardis HCT, e-Twynsta); i-boceprevir (i-Victrelis; ayisatholakali e-U.S.); ama-calcium channel blockers afana ne-diltiazem (Cardizem), nicardipine, nifedipine (Adalat, Procardia), kanye ne-verapamil (Calan, Verelan, eTarka); i-caspofungin (Cancidas); i-chloramphenicol; i-cimetidine (Tagamet); i-cisapride (Propulsid; ayitholakali e-U.S.); i-cisplatin; i-danazol; isisu esithile (’amaphilisi amanzi’); i-ganciclovir (iValcyte); izindlela ezithile zokuvimbela inzalo zamahomoni (amaphilisi okulawula inzalo, amabala, izindandatho, ukufaka, noma imijovo); imishanguzo ethile ye-HIV efana ne-didanosine (Videx); indinavir (Crixivan), lamivudine (Epivir); i-nelfinavir (i-Viracept), i-ritonavir (i-Norvir), i-stavudine (i-Zerit), ne-zidovudine (i-Retrovir) i-lansoprazole (i-Prevacid); i-methylprednisolone (iMedrol); i-metoclopramide (Reglan); i-mycophenolate (Cellcept); nefazodone; omeprazole (Prilosec); i-prednisone; i-rifabutin (i-Mycobutin); i-rifampin (i-Rifadin, i-Rimactane); imithi ethile yokuquleka efana ne-carbamazepine (Tegretol, Teril), phenobarbital, ne-phenytoin (Dilantin, Phenytek); i-sirolimus (i-Rapamune), ne-telaprevir (i-Incivek; ayisatholakali e-U.S.). Udokotela wakho angadinga ukushintsha imithamo yemithi yakho noma akuqaphele ngokucophelela ngemiphumela emibi. Eminye imithi eminingi ingase futhi ihlanganyele ne-tacrolimus, ngakho-ke qiniseka ukuthi utshela udokotela wakho ngayo yonke imithi oyiphuzayo, ngisho nalawo angaveli kulolu hlu.
• Tshela udokotela wakho uma uthatha noma usanda kuyeka ukuthatha i-cyclosporine (Gengraf, Neoral, Sandimmune). Uma ubuthatha i-cyclosporine, udokotela wakho mhlawumbe uzokutshela ukuthi ungaqali ukuthatha i-tacrolimus kuze kube amahora angama-24 ngemuva kokuthatha umthamo wakho wokugcina we-cyclosporine. Uma uyeka ukuthatha i-tacrolimus, udokotela wakho uzokutshela nokuthi ulinde amahora angama-24 ngaphambi kokuqala ukuthatha i-cyclosporine.
• utshele udokotela wakho kanye nosokhemisi ukuthi yimiphi imikhiqizo yamakhambi oyithathayo, ikakhulukazi i-wort yaseSt. John noma i-schisandra sphenanthera. Ungathathi le mikhiqizo yamakhambi ngenkathi uthatha i-tacrolimus.
• Tshela udokotela wakho uma ngabe uke waba ne-QT syndrome (isimo esizuzwe njengefa lapho umuntu kungenzeka abe ne-QT prolongation) amazinga aphansi e-potassium, i-calcium, noma i-magnesium egazini lakho, ukushaya kwenhliziyo okungajwayelekile, amazinga aphezulu e-cholesterol, inhliziyo , isifo sezinso, noma sesibindi.
• tshela udokotela wakho uma ukhulelwe, hlela ukukhulelwa, noma uncelisa. Uma wena noma umlingani wakho nikwazi ukukhulelwa, sebenzisa ukulawulwa kokubeletha okusebenzayo ngaphambi nangesikhathi sokwelashwa nge-tacrolimus. Uma ukhulelwa ngenkathi uthatha i-tacrolimus, shayela udokotela wakho. I-tacrolimus ingalimaza umbungu.
• uma uhlinzwa, kufaka phakathi ukuhlinzwa kwamazinyo, tshela udokotela noma udokotela wamazinyo ukuthi uthatha i-tacrolimus.
• kufanele wazi ukuthi ukuthatha i-tacrolimus kungandisa ingozi yokuthi uzoba nomdlavuza wesikhumba. Zivikele emdlavuzeni wesikhumba ngokugwema ukuvezwa yilanga noma i-ultraviolet light (imibhede yokushuka) nokugqoka izimpahla zokuzivikela, izibuko zelanga, kanye nesivikelo selanga esinokuvikelwa kwesikhumba (SPF).
• ungaphuzi iziphuzo ezidakayo ngenkathi uthatha amaphilisi akhipha i-tacrolimus noma amaphilisi okukhipha isikhathi eside. Utshwala bungenza imiphumela emibi evela ku-tacrolimus ibe yimbi kakhulu.
• kufanele wazi ukuthi i-tacrolimus ingadala umfutho wegazi ophakeme. Udokotela wakho uzoqapha ukucindezelwa kwegazi lakho ngokucophelela, futhi angakunikeza nemithi yokwelapha umfutho wegazi ophakeme uma ikhula.
• kufanele wazi ukuthi kunengozi yokuthi uzoba nesifo sikashukela ngesikhathi sokwelashwa kwakho nge-tacrolimus. Iziguli zase-Afrika zaseMelika nezaseSpain ezifakelwe ukufakelwa izinso zisengozini enkulu kakhulu yokuba nesifo sikashukela ngesikhathi sezelashwa nge-tacrolimus. Tshela udokotela wakho uma wena noma omunye emndenini wakho unesifo sikashukela noma wake waba naso. Uma uhlangabezana nalezi zimpawu ezilandelayo, shayela udokotela wakho ngokushesha: ukoma ngokweqile; ukulamba ngokweqile; ukuchama njalo; ukungaboni kahle noma ukudideka.
• ungenayo imigomo ngaphandle kokukhuluma nodokotela wakho.

Gwema ukudla isithelo samagilebhisi noma ukuphuza ijusi lamagilebhisi ngenkathi uthatha i-tacrolimus.

Uma i-capsule ekhishwa ngokushesha noma umthamo wokumiswa ngomlomo ulahlekile, yithathe ngokushesha nje lapho uyikhumbula. Kodwa-ke, uma sekuyisikhathi somthamo olandelayo, weqa umthamo ongabanjwanga bese uqhubeka neshejuli yakho ejwayelekile yokulinganisa. Ungathathi umthamo ophindwe kabili ukwenza okulahlekile.

Uma umthamo we-capsule okhishwe isikhathi eside ungekho, thatha umthamo uma kungakapheli amahora angu-14 ngemuva kokulahlekelwa umthamo. Kodwa-ke, uma kungaphezu kwamahora we-14, weqa umthamo ongabanjwanga bese uqhubeka nesimiso sakho sokulinganisa okujwayelekile. Ungathathi umthamo ophindwe kabili ukwenza okulahlekile.

Uma umthamo we-tablet ekhishwa isikhathi eside ungekho, yithathe uma ungekho phakathi kwamahora ayi-15 ngemuva kokulahlekelwa umthamo. Kodwa-ke, uma kungaphezu kwamahora we-15, weqa umthamo ongabanjwanga bese uqhubeka nesimiso sakho sokulinganisa okujwayelekile. Ungathathi umthamo ophindwe kabili ukwenza okulahlekile.

I-tacrolimus ingadala imiphumela emibi. Tshela udokotela wakho uma kukhona kulezi zimpawu ezinzima noma ezingapheli:

• ikhanda
• isifo sohudo
• ukuqunjelwa
• isicanucanu
• ukuhlanza
• isilungulela
• ubuhlungu besisu
• ukulahlekelwa isifiso sokudla
• ubunzima bokulala noma ukulala
• isiyezi
• ubuthakathaka
• ubuhlungu emuva noma ngokuhlanganyela
• ukushisa, ukuba ndikindiki, ubuhlungu, noma ukuncinza ezandleni noma ezinyaweni

Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nalezi zimpawu ezilandelayo, noma lezo ezishiwo esigabeni ESIBALULEKILE SESEXWAYISO, shayela udokotela wakho ngokushesha:

• ukuncipha kokuchama
• ubuhlungu noma ukushisa ekuchameni
• ukuphefumula, isifuba, ukuqubuka noma ukulunywa
• isikhumba esiphaphathekile, ukuphefumula okuncane, noma ukushaya kwenhliziyo okusheshayo
• ukukhathala; ukukhuluphala; ukuvuvukala kwezingalo, izandla, izinyawo, amaqakala, noma imilenze engezansi; noma ukuphefumula okuncane
• ukopha okungajwayelekile noma ukulinyazwa
• ukuquleka, ukushintsha kombono, ikhanda elibuhlungu, ukudideka, noma ukuzamazama okungalawuleki kwengxenye yomzimba
• ikhoma (ukulahlekelwa ukwazi isikhathi esithile)

I-tacrolimus ingadala eminye imiphumela emibi. Shayela udokotela wakho uma unezinkinga ezingavamile ngenkathi uthatha lo muthi.

Uma uthola imiphumela emibi kakhulu, wena noma udokotela wakho ungathumela umbiko kuhlelo lwe-Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting online (http://www.fda.gov/Safety/MedWatch) noma ngocingo ( 1-800-332-1088).

Gcina le mithi esitsheni efike ngayo, ivalwe ngokuqinile, futhi lapho izingane zingafinyeleleki khona. Gcina ekamelweni lokushisa futhi kude nokushisa okweqile nomswakama (hhayi endlini yangasese).

Kubalulekile ukugcina yonke imishanguzo ingabonakali futhi ifinyeleleke ezinganeni njengoba iziqukathi eziningi (njengezingqondo zamaphilisi zamasonto onke kanye nalawo amaconsi wamehlo, okhilimu, amabala, kanye nama-inhalers) azimeleki ezinganeni futhi izingane ezincane zingazivula kalula. Ukuvikela izingane ezisencane ekufakeni ubuthi, hlala uvala amakepisi okuphepha bese ubeka umuthi endaweni ephephile - eyodwa ephezulu futhi engekho futhi engabonakali kubo futhi efinyelela kuyo.http://www.upandaway.org

Imithi engadingeki kufanele ilahlwe ngezindlela ezikhethekile zokuqinisekisa ukuthi izilwane ezifuywayo, izingane nabanye abantu abakwazi ukuzidla. Kodwa-ke, akufanele ukhiphe le mithi ethoyilethi. Esikhundleni salokho, indlela engcono kakhulu yokulahla imithi yakho ngohlelo lokubuyisa umuthi. Khuluma nosokhemisi wakho noma uthinte umnyango wangakini wokulahla udoti / wokusebenzisa kabusha ukuze ufunde ngezinhlelo zokubuyisa emphakathini wakho. Bheka iwebhusayithi yakwa-FDA's Safe Disposal of Medicines (http://goo.gl/c4Rm4p) ukuthola eminye imininingwane uma ungakwazi ukufinyelela kuhlelo lokubuyisa.

Uma kwenzeka ukweqisa ngokweqile, shayela ucingo losizo lokulawula ubuthi ku-1-800-222-1222. Imininingwane iyatholakala online ku-https: //www.poisonhelp.org/help. Uma isisulu siwile, saba nokuquleka, sinenkinga yokuphefumula, noma singakwazi ukuvuswa, shayela ngokushesha abezimo eziphuthumayo ku-911.

Izimpawu zokudlula ngokweqile zingafaka:

• isifuba
• ubuthongo
• isicanucanu, ukuhlanza nokuhuda
• ukuzamazama okungalawuleki kwengxenye yomzimba, ikhanda, ukudideka, ukungalingani, nokukhathala ngokweqile
• ukuvuvukala kwezingalo noma imilenze
• umkhuhlane noma ezinye izimpawu zokutheleleka

Gcina wonke ama-aphoyintimenti nodokotela wakho kanye nelabhorethri. Udokotela wakho uzo-oda izivivinyo ezithile ngaphambi nangesikhathi sokwelashwa kwakho ukuze ahlole impendulo yomzimba wakho ku-tacrolimus.

Ungavumeli omunye umuntu ukuthi athathe imithi yakho. Buza usokhemisi wakho noma imiphi imibuzo onayo mayelana nokugcwalisa umuthi wakho.

Kubalulekile ukuthi ugcine uhlu olubhaliwe lwayo yonke imishanguzo oyisebenzisayo kadokotela kanye nokungabhaliswanga (ngaphezulu kokuthenga), kanye nanoma yimiphi imikhiqizo efana namavithamini, amaminerali, noma ezinye izithako zokudla. Kufanele uze nalolu hlu njalo uma uvakashela udokotela noma uma ungeniswa esibhedlela. Kubaluleke kakhulu futhi nemininingwane ebalulekile ukuthi uphathe uma kwenzeka kunezimo eziphuthumayo.

• I-Astagraf XL^®
• I-Envarsus XR^®
• Prograf^®

• FK 506