Tofacitinib

-Delile

• Ngaphambi kokuthatha i-tofacitinib,
• I-Tofacitinib ingadala imiphumela emibi. Tshela udokotela wakho uma kukhona kulezi zimpawu ezinzima noma ezingapheli:
• Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nenye yalezi zimpawu noma lezo ezibalwe esigabeni ESIBALULEKILE SEXWAYISO, shayela udokotela wakho ngokushesha noma uthole ukwelashwa okuphuthumayo:

Ukuthatha i-tofacitinib kunganciphisa ikhono lakho lokulwa nokutheleleka futhi kwandise ingozi yokuthi uzothola ukutheleleka okungathi sína, kufaka phakathi ukutheleleka okunzima, ukutheleleka kwamagciwane noma igciwane elisakazeka emzimbeni. Lezi zifo zingadinga ukwelashwa esibhedlela futhi zingadala nokufa. Tshela udokotela wakho uma uvame ukuthola noma yiluphi uhlobo lokutheleleka noma uma ucabanga ukuthi ungaba nanoma yiluphi uhlobo lokutheleleka manje. Lokhu kufaka ukutheleleka okuncane (njengokusikeka okuvulekile noma izilonda), izifo ezifika zidlule (njengezilonda ezibandayo), kanye nezifo ezingamahlalakhona ezingapheli. Phinda utshele udokotela wakho uma uke waba nesifo sikashukela noma unesifo sikashukela, i-human immunodeficiency virus (HIV), uthola i-immunodeficiency syndrome (i-AIDS), isifo samaphaphu, noma esinye isimo esithinta amasosha akho omzimba. Kufanele futhi utshele udokotela wakho uma uhlala noma owake wahlala ezindaweni ezinjengezigodi zemifula i-Ohio noma iMississippi lapho ukutheleleka okunzima kwefungal kuvame kakhulu. Buza udokotela wakho uma ungaqiniseki ukuthi lezi zifo zivamile yini endaweni yangakini. Tshela udokotela wakho uma uphuza imishanguzo eyehlisa ukusebenza kohlelo lokuzivikela komzimba njengokulandelayo: i-abatacept (i-Orencia); i-adalimumab (Humira); anakinra (Kineret); i-azathioprine (Azasan, Imuran); isitifiketi (Cimzia); i-cyclosporine (Gengraf, Neoral, Sandimmune); i-etanercept (Enbrel); i-golimumab (iSimponi); infliximab (i-Remicade); i-methotrexate (i-Otrexup, i-Rasuvo, i-Trexall); i-rituximab (i-Rituxan); ama-steroids afaka i-dexamethasone, i-methylprednisolone (Medrol), i-prednisolone (i-Prelone), ne-prednisone (i-Rayos); tacrolimus (Astagraf, Envarsus XR, Prograf); kanye ne-tocilizumab (Actemra).

Udokotela wakho uzokuqapha ngezibonakaliso zokutheleleka ngesikhathi nangemva kokwelashwa kwakho. Uma unezinye zalezi zimpawu ezilandelayo ngaphambi kokuba uqale ukwelashwa kwakho noma uma uhlangabezana nalezi zimpawu ezilandelayo ngesikhathi noma ngokushesha ngemuva kokwelashwa kwakho, shayela udokotela wakho ngokushesha: umkhuhlane; ukujuluka; Ukugodola; ubuhlungu bemisipha; ukugwinya okubuhlungu noma okunzima; ukukhwehlela; ukuphelelwa umoya; ukuncipha komzimba; isikhumba esifudumele, esibomvu, noma esibuhlungu; ukuqubuka okubuhlungu; ikhanda, ukuzwela ekukhanyeni, ukuqina kwentamo, ukudideka; imizwa ejwayelekile, ebuhlungu, noma evuthayo ngesikhathi sokuchama; ubuhlungu besisu; isifo sohudo; noma ukukhathala ngokweqile.

Kungenzeka ukuthi usungenwe yisifo sofuba (i-TB; ukutheleleka okungathi sína kwamaphaphu) kodwa ungenazo izimpawu zesifo. Kulokhu, ukusebenzisa i-tofacitinib kungenza ukutheleleka kwakho kube kubi kakhulu futhi kukwenze ube nezimpawu. Udokotela wakho uzohlola isikhumba ukuze abone ukuthi une-TB engasebenzi yini ngaphambi kokuba uqale ukwelashwa kwakho nge-tofacitinib. Uma kudingeka, udokotela wakho uzokunika imithi yokwelapha lesi sifo ngaphambi kokuqala ukusebenzisa i-tofacitinib. Tshela udokotela wakho uma uke waba ne-TB noma wake waba nayo, uma wake wahlala noma wavakashela izwe lapho i-TB ijwayelekile khona, noma uma wake waba seduze komuntu one-TB. Uma unalezi zimpawu ezilandelayo ze-TB, noma uma uba nalezi zimpawu phakathi nokwelashwa kwakho, shayela udokotela wakho ngokushesha: ukukhwehlela, ukukhwehlela amafinyila anegazi, ukwehla kwesisindo, ukulahleka kwethoni lezicubu, noma umkhuhlane.

Ukuthatha i-tofacitinib ngamanani amakhulu kunokunconywa kungadala izinkinga zenhliziyo ezinkulu noma ezisongela impilo ngesikhathi sokwelashwa kwakho. Tshela udokotela wakho uma uneminyaka engama-50 noma ngaphezulu noma uma ubhema, futhi uma une-cholesterol ephezulu, umfutho wegazi ophakeme noma isifo sikashukela. Thatha i-tofacitinib njengoba kushiwo. Ungayithathi ngaphezulu noma uyithathe kaningi kunokuyalelwa ngudokotela wakho.

Ukuthatha i-tofacitinib kungandisa ingozi yokuthi uzoba ne-lymphoma (umdlavuza oqala kumaseli egazi alwa nokutheleleka) noma ezinye izinhlobo zomdlavuza, kufaka phakathi umdlavuza wesikhumba. Abanye abantu abathathe i-tofacitinib neminye imishanguzo ngemuva kokufakelwa izinso baba nesimo esadala ukuthi imizimba yabo ikhiqize amangqamuzana amhlophe egazi amaningi kakhulu. Tshela udokotela wakho uma ngabe uke waba nanoma yiluphi uhlobo lomdlavuza noma uke wafakelwa izinso.

Ukuthatha i-tofacitinib ngamanani amakhulu kunokunconywa kungakhuphula ubungozi bamahlule egazi asongela impilo. Tshela udokotela wakho uma uneminyaka engama-50 noma ngaphezulu futhi usengozini yesifo senhliziyo noma somthambo wegazi. Futhi, tshela udokotela wakho uma ngabe uke waba negazi emilenzeni, ezingalweni, noma emaphashini, noma emithanjeni yegazi. Thatha i-tofacitinib njengoba kushiwo. Ungayithathi kancane noma uyithathe kaningi kunokuyalelwa ngudokotela wakho. Uma uhlangabezana nanoma yiziphi kulezi zimpawu ezilandelayo yeka ukuthatha i-tofacitinib bese ushayela udokotela wakho ngokushesha: ukuphefumula okungazelelwe noma ukuphefumula kanzima, ubuhlungu besifuba, ukuvuvukala komlenze noma ingalo, ubuhlungu bomlenze, ukubomvu, ukushintsha kombala, noma ukufudumala emilenzeni nasezingalweni .

Udokotela wakho noma usokhemisi uzokunikeza ishidi lemininingwane yesiguli lomkhiqizi (Umhlahlandlela Wezokwelapha) lapho uqala ukwelashwa nge-tofacitinib futhi isikhathi ngasinye lapho ugcwalisa umuthi wakho. Funda imininingwane ngokucophelela bese ubuza udokotela noma usokhemisi wakho uma unemibuzo. Ungavakashela futhi iwebhusayithi ye-Food and Drug Administration (FDA) (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) noma iwebhusayithi yomkhiqizi ukuthola i-Medication Guide.

I-Tofacitinib isetshenziswa yodwa noma neminye imithi yokwelapha i-rheumatoid arthritis (isimo lapho umzimba uhlasela khona amalunga ayo okubangela ubuhlungu, ukuvuvukala, nokulahleka komsebenzi) kubantu abangayiphendulanga i-methotrexate (Otrexup, Rasuvo, Trexall). Ibuye isetshenziswe kanye ne-methotrexate, i-sulfasalazine (i-Azulfidine), noma i-leflunomide (i-Arava) yokwelapha i-psoriatic arthritis (isimo esidala ubuhlungu bamalunga nokuvuvukala nezikali esikhumbeni) kubantu abangayiphendulanga le mithi bodwa. I-Tofacitinib isetshenziselwa ukwelapha i-ulcerative colitis (isimo esidala ukuvuvukala nezilonda kulwelwesi lwekholoni [amathumbu amakhulu] ne-rectum) kubantu abangakwazi ukuthatha noma abangaphendulanga emithini ye-tumor necrosis factor (TNF) inhibitor. Ibuye isetshenziselwe ukwelapha i-polyarticular juvenile idiopathic arthritis (i-PJIA; uhlobo lwesifo samathambo ebuntwaneni oluthinta amalunga amahlanu noma ngaphezulu phakathi nezinyanga eziyisithupha zokuqala zalesi simo, kubangele ubuhlungu, ukuvuvukala, nokulahleka komsebenzi) ezinganeni ezineminyaka engu-2 nangaphezulu. UTofacitinib usesigabeni semithi ebizwa ngeJanus kinase (JAK) inhibitors. Isebenza ngokunciphisa umsebenzi wamasosha omzimba.

I-Tofacitinib iza njengethebhulethi, ithebhulethi ekhishwa isikhathi eside (esebenza isikhathi eside), futhi njengesisombululo somlomo (uketshezi) ukuthatha ngomlomo. Ekwelapheni i-ulcerative colitis, i-rheumatoid arthritis, noma i-psoriatic arthritis, ithebhulethi ivame ukuthathwa kabili nsuku zonke ngokudla noma ngaphandle kokudla futhi ithebhulethi ekhishwa isikhathi eside ivame ukuthathwa kanye ngosuku noma ngaphandle kokudla. Ekwelapheni i-polyarticular course juvenile idiopathic arthritis, ithebhulethi noma isisombululo somlomo kuvame ukuthathwa kabili nsuku zonke ngokudla noma ngaphandle kokudla. Thatha i-tofacitinib ngasikhathi sinye nsuku zonke. Landela izinkomba ezikulebuli kadokotela wakho ngokucophelela, bese ubuza udokotela noma usokhemisi wakho ukuthi akuchaze nganoma iyiphi ingxenye ongayiqondi. Thatha i-tofacitinib njengoba nje kuqondisiwe. Ungayithathi kancane noma uyithathe kaningi kunokuyalelwa ngudokotela wakho.

Gwinya wonke amaphilisi akhululiwe; ungawahlukanisi, ungawahlafune noma uwagxoze.

Njalo sebenzisa isirinji yomlomo yokuza ngomlomo eza nesisombululo se-tofacitinib ukukala umthamo wakho. Khuluma nodokotela wakho noma usokhemisi uma unemibuzo mayelana nokuthi ulinganisa kanjani umthamo wakho wesisombululo se-tofacitinib.

Uma wena noma ingane yakho nithatha isisombululo somlomo se-tofacitinib, cela usokhemisi noma udokotela wakho ikhophi yemiyalo yokusetshenziswa komkhiqizi. Funda ngokucophelela le miyalo.

Udokotela wakho angadinga ukwehlisa umthamo wakho noma ayeke ukwelashwa kwakho uma uhlangabezana nemiphumela emibi ethile. Qiniseka ukuthi utshela udokotela wakho ukuthi uzizwa kanjani ngesikhathi sokwelashwa kwakho.

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

Ngaphambi kokuthatha i-tofacitinib,

• Tshela udokotela wakho kanye nosokhemisi uma une-aleji ku-tofacitinib, noma imuphi omunye umuthi, noma iziphi izithako kumathebulethi e-tofacitinib, amaphilisi wokukhishwa enwetshiwe, noma isisombululo somlomo. 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 uyayisho imishanguzo ebhalwe esigabeni ESIBALULEKILE SESEXWAYISO nanoma yikuphi okulandelayo: imishanguzo ethize yokubulala izinhlungu efana ne-fluconazole (Diflucan), itraconazole (Onmel, Sporanox), ne-ketoconazole; i-aspirin neminye imishanguzo yokulwa nokuvuvukala (ama-NSAID) njenge-ibuprofen (Advil, Motrin) ne-naproxen (Naprosyn, Aleve); carbamazepine (Carbatrol, Tegretol, Equetro, nabanye); i-clarithromycin (i-Biaxin, ku-Prevpac); imishanguzo ethile ye-HIV kubandakanya i-indinavir (Crixivan), i-nelfinavir (i-Viracept), ne-ritonavir (i-Norvir, e-Kaletra); nefazodone; i-phenobarbital; i-phenytoin (iDilantin, Phenytek); i-rifabutin (i-Mycobutin); kanye ne-rifampin (Rifadin, Rimactane, eRifamate, eRifater). Udokotela wakho angadinga ukushintsha imithamo yemithi yakho noma akuqaphele ngokucophelela ngemiphumela emibi.
• utshele udokotela wakho ukuthi uthatha miphi imikhiqizo yamakhambi, ikakhulukazi iSt John's wort.
• Tshela udokotela wakho uma unezinhlungu esiswini ezingatholakali nokuthi unezilonda (noma izilonda esiswini sakho noma amathumbu), i-diverticulitis (ukuvuvukala kolwelwesi lwamathumbu amakhulu), isifo sesibindi kufaka phakathi i-hepatitis I-B noma i-hepatitis C, umdlavuza, i-anemia (inani eliphansi kunokujwayelekile lamaseli abomvu egazi), i-dialysis (ukwelashwa ukuhlanza igazi lapho izinso zingasebenzi kahle), noma isifo sezinso. Uma uthatha amaphilisi akhululiwe, tshela udokotela wakho uma unciphisa noma uvimba uhlelo lwakho lokugaya ukudla.
• utshele udokotela wakho uma ukhulelwe noma uhlela ukukhulelwa. Akufanele ukhulelwe ngenkathi uthatha i-tofacitinib. Uma ukhulelwa ngenkathi uthatha i-tofacitinib, shayela udokotela wakho.
• tshela udokotela wakho uma uncelisa. Ungancelisi ibele ngenkathi uthatha amaphilisi e-tofacitinib noma isisombululo somlomo futhi okungenani amahora ayi-18 ngemuva komthamo wokugcina wethebhulethi noma okungenani amahora angama-36 ngemuva komthamo wokugcina wethebhulethi ekhishwe isikhathi eside.
• kufanele wazi ukuthi lo muthi unganciphisa ukuzala kwabesifazane. Khuluma nodokotela wakho ngezingozi zokuthatha i-tofacitinib.
• utshele udokotela wakho uma usanda kuthola noma uhlelelwe ukuthola noma yimiphi imigomo. Uma udinga noma yimiphi imigomo, kungadingeka ukuthi uyithole imigomo bese ulinda isikhathi esithile ngaphambi kokuqala ukwelashwa kwakho nge-tofacitinib. Ungabi nayo imigomo ngesikhathi sokwelashwa kwakho ngaphandle kokukhuluma nodokotela wakho.

Ngaphandle kokuthi udokotela wakho akutshele ngenye indlela, qhubeka nokudla okuvamile.

Thatha umthamo ongabanjwanga ngokushesha nje lapho uwukhumbula. Kodwa-ke, uma sekuyisikhathi somthamo olandelayo, weqa umthamo ongabanjwanga bese uqhubeka neshejuli yakho ejwayelekile yokulinganisa. Ungathathi umthamo ophindwe kabili ukwenza okulahlekile.

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

• isifo sohudo
• ikhanda
• ikhala eligcwele noma eligijimayo

Eminye imiphumela emibi ingaba mibi. Uma uhlangabezana nenye yalezi zimpawu noma lezo ezibalwe esigabeni ESIBALULEKILE SEXWAYISO, shayela udokotela wakho ngokushesha noma uthole ukwelashwa okuphuthumayo:

• isifuba, ukuvuvukala kobuso, amehlo, izindebe, noma umphimbo, ubunzima bokugwinya noma ukuphefumula
• ubuhlungu besisu, ikakhulukazi uma buza nomkhuhlane kanye nohudo noma ukuqunjelwa
• ukuphuzi kwesikhumba noma kwamehlo
• ukulahlekelwa isifiso sokudla
• umchamo omnyama
• ukunyakaza kwamathumbu anombala wobumba
• ukuhlanza
• ukuqubuka
• isikhumba esiphaphathekile
• ukuphelelwa umoya

I-Tofacitinib ingadala ukwanda kwamazinga egazi egazini lakho. Udokotela wakho uzo-oda izivivinyo zokuqapha amazinga akho e-cholesterol ngesikhathi sokwelashwa kwakho nge-tofacitinib. Khuluma nodokotela wakho ngezingozi zokuthatha lo muthi.

I-Tofacitinib 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). Lahla noma yisiphi isisombululo esingasetshenziswanga ezinsukwini ezingama-60 ngemuva kokuvula ibhodlela.

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.

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

Uma uthatha amaphilisi akhululiwe ungabona okuthile okubukeka njengethebhulethi ekuhambeni kwakho kwamathumbu. Leli igobolondo nje elingenalutho lethebhulethi, futhi lokhu akusho ukuthi awutholanga umthamo wakho ophelele wemithi.

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.

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