I-Fingolimod (Gilenya) Imiphumela emibi kanye Nemininingwane Yokuphepha

-Delile

• Imiphumela emibi evela kumthamo wokuqala
• Okuqhamuka uma udla imishanguzo
• Izexwayiso ze-FDA
• Izimo zokukhathazeka
• Ukusebenzisana kwezidakamizwa
• Khuluma nodokotela wakho

Isingeniso

I-Fingolimod (i-Gilenya) umuthi othathwe ngomlomo ukwelapha izimpawu zokuphindaphinda-ukubuyisa ama-multiple sclerosis (RRMS). Kuyasiza ukunciphisa ukwenzeka kwezimpawu ze-RRMS. Lezi zimpawu zingafaka:

• ukuphazamiseka kwemisipha
• ubuthakathaka nokuba ndikindiki
• Izinkinga zokulawula isinye
• izinkinga ngokukhuluma nokubona

I-Fingolimod futhi isebenza ukubambezela ukukhubazeka ngokomzimba okungadalwa yi-RRMS.

Njengazo zonke izidakamizwa, i-fingolimod ingadala imiphumela emibi. Ezimweni ezingavamile, zingaba zimbi.

Imiphumela emibi evela kumthamo wokuqala

Uthatha umthamo wokuqala we-fingolimod ehhovisi likadokotela wakho. Ngemuva kokukuthatha, uzoqashwa amahora ayisithupha noma ngaphezulu. I-electrocardiogram nayo yenziwa ngaphambi nangemva kokuthatha umuthi ukuhlola izinga lokushaya kwenhliziyo yakho nesigqi sakho.

Ochwepheshe bezokunakekelwa kwempilo bathatha lezi zixwayiso ngoba umthamo wakho wokuqala we-fingolimod ungadala imiphumela emibi ethile, kufaka phakathi umfutho wegazi ophansi kanye ne-bradycardia, izinga lokushaya kwenhliziyo elinciphile elingaba yingozi. Izimpawu zokwehla kwenhliziyo zingafaka:

• ukukhathala okungazelelwe
• isiyezi
• ubuhlungu besifuba

Le miphumela kungenzeka ngethamo lakho lokuqala, kepha akufanele yenzeke njalo lapho uthatha umuthi. Uma unalezi zimpawu ekhaya ngemuva kwesilinganiso sakho sesibili, shayela udokotela wakho ngokushesha.

Okuqhamuka uma udla imishanguzo

I-Fingolimod ithathwa kanye ngosuku. Imiphumela emibi ejwayelekile engenzeka ngemuva kwesilinganiso sesibili neminye yokulandelela ingafaka:

• isifo sohudo
• ukukhwehlela
• ikhanda
• ukulahleka kwezinwele
• ukudana
• ubuthakathaka bemisipha
• isikhumba esomile futhi esilumayo
• ubuhlungu besisu
• ukuhlungu obusemhlane

I-Fingolimod nayo ingadala imiphumela emibi kakhulu. Lokhu kuvame ukuhamba uma uyeka ukuthatha umuthi. Ngaphandle kwezinkinga zesibindi, ezingaba yinto ejwayelekile, le miphumela emibi ivame ukungajwayelekile. Imiphumela emibi kakhulu ingafaka:

• Izinkinga zesibindi. Udokotela wakho kungenzeka ahlole igazi njalo ngesikhathi sokwelashwa kwakho ukuze ahlole izinkinga zesibindi. Izimpawu zezinkinga zesibindi zingabandakanya i-jaundice, edala ukuphuzi kwesikhumba kanye nabamhlophe bamehlo.
• Ingozi eyengeziwe yokutheleleka. I-Fingolimod inciphisa inani lakho lamaseli amhlophe egazi. Lawa maseli abangela ukulimala kwemizwa okuvela ku-MS. Kodwa-ke, zisiza nomzimba wakho ukulwa nezifo. Ngakho-ke, ingozi yakho yokutheleleka iyanda. Lokhu kungahlala ezinyangeni ezimbili ngemuva kokuyeka ukuthatha i-fingolimod.
• I-edema ye-Macular. Ngalesi simo, uketshezi luyakheka ku-macula, okuyingxenye ye-retina yeso. Izimpawu zingafaka ukufiphala, indawo engaboni, nokubona imibala engajwayelekile. Ingozi yalesi simo ingaphezulu uma unesifo sikashukela.
• Ukuphefumula kanzima. Ukuphefumula kungenzeka uma uthatha i-fingolimod.
• Ukwanda komfutho wegazi. Udokotela wakho cishe uzoqapha ukucindezelwa kwakho kwegazi ngesikhathi sokwelashwa kwakho nge-fingolimod.
• Leukoencephalopathy. Ezimweni ezingavamile, i-fingolimod ingadala izinkinga zobuchopho. Lokhu kufaka phakathi i-leukoencephalopathy eqhubekayo enhlobonhlobo kanye ne-posterior encephalopathy syndrome. Izimpawu zingafaka ushintsho ekucabangeni, ukunciphisa amandla, izinguquko kumbono wakho, ukuquleka, nekhanda elibuhlungu eliza ngokushesha. Tshela udokotela wakho ngokushesha uma unalezi zimpawu.
• Umdlavuza. I-Basal cell carcinoma ne-melanoma, izinhlobo ezimbili zomdlavuza wesikhumba, zixhunyaniswe nokusetshenziswa kwe-fingolimod. Ngenkathi usebenzisa lesi sidakamizwa, wena nodokotela wakho kufanele nibheke izigaxa ezingavamile noma ukukhula esikhunjeni sakho.
• Ukungezwani komzimba. Njengezidakamizwa eziningi, i-fingolimod ingadala ukusabela okweqile. Izimpawu zingabandakanya ukuvuvukala, ukuqubuka kanye nezinyosi. Akufanele uthathe lesi sidakamizwa uma wazi ukuthi une-allergen.

Izexwayiso ze-FDA

Ukusabela okunamandla ku-fingolimod akuvamile. Isolezwe labika ngokufa kwabantu ngo-2011 okuhlobene nokusetshenziswa kokuqala kwe-fingolimod. Kubikwe nezinye izehlakalo zokufa kwabantu ngenxa yezinkinga zenhliziyo. Kodwa-ke, i-FDA ayikatholi ukuxhumana okuqondile phakathi kwalokhu okunye ukufa nokusebenzisa i-fingolimod.

Noma kunjalo, ngenxa yalezi zinkinga, i-FDA isishintshe imihlahlandlela yayo yokusetshenziswa kwe-fingolimod. Manje ithi abantu abathatha imishanguzo ethile elwa nesigqi noma abanomlando wezimo ezithile zenhliziyo noma isifo sohlangothi akufanele bathathe i-fingolimod.

Lokhu kubike namacala okungenzeka okutheleleka kobuchopho okungajwayelekile okubizwa ngokuthi yi-progressive multifocal leukoencephalopathy ngemuva kokusetshenziswa kwe-fingolimod.

Le mibiko ingazwakala ithusa, kepha khumbula ukuthi izinkinga ezinzima kakhulu nge-fingolimod azivamile. Uma unokukhathazeka ngokusebenzisa lesi sidakamizwa, qiniseka ukuthi uxoxa ngazo nodokotela wakho. Uma usuvele unikezwe lo muthi, ungayeki ukuwuthatha ngaphandle kokuthi udokotela wakho akutshele.

Izimo zokukhathazeka

I-Fingolimod ingadala izinkinga uma unezimo ezithile zempilo. Ngaphambi kokuthatha i-fingolimod, qiniseka ukuthi utshela udokotela wakho uma une:

• i-arrhythmia, noma isilinganiso esingajwayelekile noma esingajwayelekile senhliziyo
• umlando wokushaywa unhlangothi noma ukushaywa unhlangothi, okubizwa nangokuthi ukuhlaselwa kweschemic okudlulayo
• izinkinga zenhliziyo, kufaka phakathi isifo senhliziyo noma ubuhlungu besifuba
• umlando wokuquleka okuphindaphindiwe
• umkhuhlane noma ukutheleleka
• isimo esilimaza amasosha akho omzimba, njenge-HIV noma i-leukemia
• umlando wenkukhu noma umuthi wokugoma wezinkukhu
• izinkinga zamehlo, kufaka phakathi isimo esibizwa nge-uveitis
• isifo sikashukela
• izinkinga zokuphefumula, kufaka phakathi ngesikhathi sokulala
• izinkinga zesibindi
• umfutho wegazi ophakeme
• izinhlobo zomdlavuza wesikhumba, ikakhulukazi i-basal cell carcinoma noma i-melanoma
• isifo segilo
• amazinga aphansi we-calcium, i-sodium, noma i-potassium
• uhlela ukukhulelwa, ukhulelwe, noma uma uncelisa

Ukusebenzisana kwezidakamizwa

I-Fingolimod ingaxhumana nezidakamizwa eziningi ezahlukahlukene. Ukuxhumana kungadala izinkinga zempilo noma kwenze umuthi ungasebenzi kahle.

Tshela udokotela wakho ngayo yonke imishanguzo, amavithamini, kanye nezithako ozithathayo, ikakhulukazi ezaziwayo ezisebenzisana ne-fingolimod. Izibonelo ezimbalwa zale mithi zifaka:

• izidakamizwa eziphazamisa amasosha omzimba, kufaka phakathi i-corticosteroids
• imithi yokugoma ephilayo
• izidakamizwa ezinciphisa izinga lokushaya kwenhliziyo yakho, njenge-beta-blockers noma i-calcium channel blockers

Khuluma nodokotela wakho

Alikho ikhambi le-MS okwamanje elitholakele. Ngakho-ke, imishanguzo efana ne-fingolimod iyindlela ebalulekile yokwenza ngcono ikhwalithi yempilo nokubambezela ukukhubazeka kwabantu abane-RRMS.

Wena nodokotela wakho ningalinganisa izinzuzo nezingozi zokuthatha lo muthi. Imibuzo ongafuna ukuyibuza udokotela wakho ifaka phakathi:

• Ingabe ngisengozini enkulu yemiphumela emibi evela ku-fingolimod?
• Ngabe ngithatha noma yimiphi imithi engaxhumana nalesi sidakamizwa?
• Ingabe ikhona eminye imishanguzo ye-MS engadala imiphumela emibi embalwa kimi?
• Yimiphi imiphumela emibi okufanele ngiyibikele kuwe ngokushesha uma nginayo?

I-Fingolimod ibilokhu imakethe kusukela ngo-2010. Kwakuyimithi yokuqala yomlomo ye-MS eyake yamukelwa yi-FDA. Kusukela lapho, sekuvunyelwe amanye amaphilisi amabili: i-teriflunomide (Aubagio) ne-dimethyl fumarate (Tecfidera).