Umlobi: Randy Alexander
Usuku Lokudalwa: 28 Epreli 2021
Ukuvuselela Usuku: 22 Ujuni 2024
Anonim
Further Prescribing Considerations for Glecaprevir/Pibrentasvir (Mavyret (G/P))
Ividiyo: Further Prescribing Considerations for Glecaprevir/Pibrentasvir (Mavyret (G/P))

-Delile

Kuyini uMavyret?

I-Mavyret ngumuthi kadokotela osetshenziswa ukwelapha igciwane lesifo sofuba esingalapheki i-hepatitis C (HCV). Leli gciwane lithelela isibindi sakho futhi lidale ukuvuvukala.

I-Mavyret ingasetshenziswa ngabantu abanezinhlobo eziyisithupha ze-HCV okungenzeka ukuthi abanayo i-cirrhosis (isibazi sesibindi) noma abanxephezele (i-cirrhosis emnene). I-Mavyret nayo ingasetshenziselwa ukwelapha uhlobo lwe-HCV 1 kubantu abake baphathwa ngaphambilini (kodwa abangalashwa) ngohlobo oluhlukile lwemithi.

IMavyret ivunyelwe ukusetshenziswa kubantu abadala. Iphinde yamukelwa ukuthi isetshenziswe ezinganeni ezineminyaka engu-12 nangaphezulu, noma lezo ezinesisindo okungenani esingu-45 kilograms (cishe amakhilogremu angama-99).

IMavyret iza njengethebhulethi elilodwa eliqukethe imishanguzo emibili elwa namagciwane: i-glecaprevir (100 mg) ne-pibrentasvir (40 mg). Kuthathwa ngomlomo kanye ngosuku.

Ukusebenza ngempumelelo

Ezivivinyweni zokwelashwa, abantu abadala abane-HCV (izinhlobo 1, 2, 3, 4, 5, no-6) ababengakaze belashelwe igciwane banikezwa uMavyret. Kulaba bantu, ama-98% kuya ku-100% belashwa ngemuva kwamasonto ayi-8 kuye kwayi-12 elashwa. Kulezi zifundo, ukwelashwa kwakusho ukuthi ukuhlolwa kwegazi kwabantu, okwenziwa ezinyangeni ezintathu ngemuva kokwelashwa, kwakungakhombisi zimpawu zokutheleleka nge-HCV emzimbeni wabo.


Ukuze uthole imininingwane ethe xaxa ngokusebenza, bheka isigaba “Sokusebenza” ngaphansi kwesithi “Mavyret for hepatitis C” ngezansi.

Ukuvunyelwa kwe-FDA

UMavyret wamukelwa yi-Food and Drug Administration (FDA) ngo-Ephreli 2017 ukwelapha igciwane lesifo sofuba esingapheli (izinhlobo 1, 2, 3, 4, 5, no-6) kubantu abadala.

Ngo-Ephreli 2019, i-FDA yandise ukuvunyelwa komuthi ukufaka ukusetshenziswa kwawo ezinganeni. Kuvunyelwe ukusetshenziswa ezinganeni ezineminyaka engu-12 nangaphezulu, noma lezo ezinesisindo okungenani esingu-45 kg (cishe ama-99 lbs.).

I-Mavyret ejwayelekile

IMavyret itholakala kuphela njengomuthi wegama lomkhiqizo. Okwamanje ayitholakali ngendlela ejwayelekile.

IMavyret iqukethe izithako ezimbili ezisebenzayo zezidakamizwa: i-glecaprevir ne-pibrentasvir.

Izindleko zeMavyret

Njengayo yonke imithi, izindleko zeMavyret zingahluka. Ukuthola izintengo zamanje zeMavyret endaweni yangakini, hlola iGoodRx.com.

Izindleko ozithola ku-GoodRx.com yilokho ongakukhokha ngaphandle komshwalense. Intengo yangempela ozoyikhokha incike ohlelweni lwakho lomshuwalense, indawo okuyo nasekhemisi oyisebenzisayo.


Usizo lwezezimali nolomshuwalense

Uma udinga uxhaso lwezezimali ukukhokhela iMavyret, noma uma udinga usizo lokuqonda umshuwalense wakho, usizo luyatholakala.

U-Abbvie, umkhiqizi weMavyret, unikela ngohlelo olubizwa ngeMavyret Patient Support, olunganikela ngosizo lokwehlisa izindleko zakho zomuthi. Ukuthola eminye imininingwane nokuthola ukuthi uyakufanelekela yini ukwesekwa, shayela ku-877-628-9738 noma uvakashele iwebhusayithi yohlelo.

Imiphumela emibi ye-Mavyret

IMavyret ingadala imiphumela emibi noma emibi. Uhlu olulandelayo luqukethe eminye yemiphumela emibi engaba khona ngenkathi uthatha iMavyret. Lezi zinhlu azibandakanyi yonke imiphumela emibi engaba khona.

Ngeminye imininingwane ngemiphumela engemihle yeMavyret, khuluma nodokotela wakho noma usokhemisi. Bangakunika amathiphu okuthi ungabhekana kanjani nanoma yimiphi imiphumela emibi engase ikukhathaze.

Imiphumela emibi ejwayelekile

Imiphumela emibi ejwayelekile yeMavyret ingafaka:

  • ikhanda
  • ngizizwe ngikhathele
  • isicanucanu
  • isifo sohudo
  • izinga eliphakeme le-bilirubin (ukuhlolwa kwelebhu okuhlola ukusebenza kwesibindi sakho)

Iningi lalemiphumela emibi ingahle ihambe ezinsukwini ezimbalwa noma emasontweni ambalwa. Uma zinzima kakhulu noma zingahambi, khuluma nodokotela wakho noma usokhemisi.


Imiphumela emibi kakhulu

Imiphumela emibi ebucayi evela kuMavyret ayijwayelekile, kodwa ingenzeka. Shayela udokotela wakho ngokushesha uma unemiphumela emibi kakhulu. Shayela u-911 uma izimpawu zakho zizizwa zisongela impilo noma uma ucabanga ukuthi unezimo eziphuthumayo zezokwelapha.

Imiphumela emibi ebucayi, okuxoxwa ngayo ngezansi ku- "Imininingwane yemiphumela emibi," ifaka okulandelayo:

  • ukuvuselelwa kwegciwane le-hepatitis B (ukuqhuma kwegciwane, uma selivele lingaphakathi komzimba wakho) *
  • ukusabela okweqile komzimba

Imininingwane yomphumela oseceleni

Ungase uzibuze ukuthi kaningi kangakanani imiphumela emibi ethile eba khona ngalo muthi, noma ngabe imiphumela ethile engemihle iphathelene nayo yini. Nayi imininingwane ngeminye imiphumela engemihle lo muthi ongadala noma ongabanga ngayo.

Ukusabela okweqile

Njengezidakamizwa eziningi, abanye abantu bangaba nokungezwani komzimba ngemuva kokuthatha uMavyret. Akwaziwa ngokuqinisekile ukuthi abantu abathatha lo muthi bavame kangakanani ukusabela okweqile. Izimpawu zokuphendula okuncane komzimba zingabandakanya:

  • ukuqubuka kwesikhumba
  • ukulunywa
  • ukuqhuma (ukufudumala nokubomvu esikhunjeni sakho)

Ukusabela okweqile okwedlulele akuvamile kodwa kungenzeka. Izimpawu zokuphendula okweqile kakhulu zingabandakanya:

  • ukuvuvukala ngaphansi kwesikhumba sakho, imvamisa ezinkalweni zakho, izindebe, izandla, noma izinyawo
  • ukuvuvukala kolimi lwakho, umlomo, noma umphimbo
  • ukuphefumula kanzima noma ukukhuluma

Shayela udokotela wakho khona manjalo uma une-allergies enamandla kakhulu kuMavyret. Shayela u-911 uma izimpawu zakho zizizwa zisongela impilo noma uma ucabanga ukuthi unezimo eziphuthumayo zezokwelapha.

Ukulunywa

Ungahle uzwe ukulunywa ngenkathi usebenzisa i-Mavyret. Ekuvivinyweni komtholampilo, abanye abantu babenenkinga lapho bethatha lo muthi. Ukulunywa kwakuvame ukwenzeka kuphela kubantu abathatha umuthi ababenezifo ezingapheli zezinso ne-hepatitis C virus (HCV). Kuleli qembu, cishe abantu abangu-17% babike ukulunywa njengomphumela oseceleni.

Ukulunywa kwesinye isikhathi kuyisifo esibangelwa i-HCV. Ukulunywa kwenzeka kubantu abangaba ngu-20% abane-HCV. Lesi sibonakaliso mhlawumbe kungenxa yokwakhiwa kwekhemikhali elibizwa nge-bilirubin emzimbeni wakho. Ukulunywa okubangelwa i-HCV kungaba endaweni eyodwa noma kungaba emzimbeni wakho wonke.

Uma unokukhathazeka ngokuba nesikhumba esilumayo ngenkathi uthatha iMavyret, khuluma nodokotela wakho. Bangancoma izindlela zokusiza ukunciphisa lo mphumela oseceleni ngenkathi usebenzisa umuthi.

Ukuvuselelwa kwe-Hepatitis B

Ungaba nengozi eyengeziwe yokuvuselelwa kwegciwane le-hepatitis B (HBV) (flare-up) ngenkathi uthatha iMavyret.

Ukwelashwa kwe-Mavyret kwandisa ingozi yokuvuselelwa kwe-HBV kubantu abane-HBV ne-HCV. Ezimweni ezimbi kakhulu, ukuvuselelwa kwe-HBV kungadala ukwehluleka kwesibindi noma ngisho nokufa.

Izimpawu zokuvuselelwa kwe-HBV zingafaka:

  • ubuhlungu ohlangothini lwesokunene sesisu sakho
  • isitulo esinombala okhanyayo
  • ngizizwe ngikhathele
  • ukuphuzi kwesikhumba sakho noma okumhlophe kwamehlo akho

Ngaphambi kokuqala iMavyret, udokotela wakho uzokuhlolela i-HBV. Uma une-HBV, kungadingeka ukuthi welashwe ngaphambi kokuthi uqale ukuthatha iMavyret. Noma udokotela wakho angancoma ukuhlolwa ngesikhathi sokwelashwa kwakho kweMavyret ukuqapha ukuvuselelwa kwe-HBV futhi welaphe isimo uma kudingeka.

Izinguquko zesisindo (hhayi umphumela ohlangothini)

Ukwehla kwesisindo nokuzuza kwesisindo akuzange kubikwe njengemiphumela emibi kaMavyret ngesikhathi sokuhlolwa komtholampilo. Kodwa-ke, iMavyret ingadala isicanucanu, okungaholela ekunciphiseni kwesisindo kwabanye abantu. Uma uzizwa ucanuzelelwa ngenkathi usebenzisa lo muthi, kungenzeka udle ukudla okuncane, okungaholela ekwehliseni isisindo.

Uma unokukhathazeka mayelana nokuzuza kwesisindo noma ukwehlisa isisindo ngenkathi uthatha iMavyret, khuluma nodokotela wakho. Bangakusiza ukuhlela ukudla okunempilo ngesikhathi sokwelashwa kwakho.

Ukuqhuma kwesikhumba (hhayi umphumela ohlangothini)

Ukuqhuma kwesikhumba akuzange kubikwe njengomphumela oseceleni weMavyret ngesikhathi sokuhlolwa komtholampilo. Kodwa-ke, i-HCV uqobo kwesinye isikhathi ingadala ukuqhuma kwesikhumba. Lokhu kungahle kube nephutha ngomphumela oseceleni womuthi. Ukuqhuma okubangelwa yi-HCV kungaba noma kuphi emzimbeni wakho, kufaka phakathi ubuso, isifuba, noma izingalo. Futhi kungakwenza uzizwe ulunywa.

Uma unesifo sokuqubuka kwesikhumba ngenkathi usebenzisa iMavyret, khuluma nodokotela wakho. Bangaphakamisa izindlela zokunciphisa izimpawu zakho futhi bancome ukwelashwa uma kudingeka.

Imiphumela emibi ezinganeni

Ngesikhathi sokuhlolwa komtholampilo, imiphumela emibi ebonwe ezinganeni (ezineminyaka eyi-12 kuya kwengu-17) ukuthatha iMavyret yayifana nemiphumela emibi ebonwa kubantu abadala abathatha umuthi. Kulezi zifundo, azikho izingane ezayeka ukwelashwa ngenxa yemiphumela engemihle.

Imiphumela emibi ejwayelekile ebonwe ezinganeni ifakiwe:

  • ngizizwe ngikhathele
  • isicanucanu
  • ikhanda
  • izinga eliphakeme le-bilirubin (ukuhlolwa kwelebhu okuhlola ukusebenza kwesibindi sakho)

Uma ukhathazekile ngemiphumela emibi eyenzeka enganeni esebenzisa iMavyret, khuluma nodokotela wakho. Bangakwazi ukuncoma izindlela zokunciphisa le miphumela emibi ngesikhathi sokwelashwa.

Isilinganiso seMavyret

Imininingwane elandelayo ichaza imithamo esetshenziswa kakhulu noma enconywayo. Kodwa-ke, qiniseka ukuthatha isilinganiso udokotela wakho akubekela sona. Udokotela wakho uzonquma isilinganiso esihle kakhulu ukuhlangabezana nezidingo zakho.

Amafomu wezidakamizwa namandla

IMavyret iza njengethebhulethi ethathwa ngomlomo. Ithebhulethi ngayinye iqukethe i-100 mg ye-glecaprevir ne-40 mg ye-pibrentasvir.

Isikali se-hepatitis C

Umthamo weMavyret wesifo esingalapheki se-hepatitis C (HCV) ngamaphilisi amathathu athathwa ngomlomo kanye ngosuku. Lesi sidakamizwa kufanele sithathwe ngokudla. Kufanele futhi ithathwe cishe ngesikhathi esifanayo usuku ngalunye.

Udokotela wakho uzonquma ukuthi udinga ukuthatha isikhathi esingakanani ukuthatha iMavyret. Lesi sinqumo sincike kunoma ikuphi ukwelashwa kwe-HCV okwedlule okusebenzisile.

Ubude bokwelashwa komuntu ngamunye bungahluka, kepha abantu abaningi bathatha iMavyret noma yikuphi kusuka emavikini ayisishiyagalombili kuya emavikini ayi-16. Ubude obujwayelekile bokwelashwa kweMavyret bunje:

  • Uma ungakaze welashelwe i-HCV, futhi ungenayo i-cirrhosis (isibazi sesibindi), cishe uzolashwa amasonto ayi-8.
  • Uma ungakaze welashelwe i-HCV, futhi unxephezele (i-cirrhosis emnene), cishe uzolashwa amasonto ayi-12.
  • Uma uke welashelwa i-HCV phambilini, futhi ukwelashwa kwakho bekungasebenzi (akuzange kulaphe ukutheleleka kwakho), ubude bokwelashwa kwakho noMavyret bungahluka. Ingahlala noma kuphi kusuka emavikini ayisishiyagalombili kuze kube amasonto ayi-16. Ubude obuqondile bokwelashwa kwakho buzoya ngokuthi imiphi imishanguzo ye-HCV oyisebenzise esikhathini esedlule.

Uma unemibuzo mayelana nokuthi uzodinga isikhathi esingakanani ukuthatha uMavyret, khuluma nodokotela wakho. Bangakuncoma uhlelo oluhle kakhulu lokwelashwa kwakho.

Umthamo wezingane

Umthamo wezingane weMavyret uyefana nowabantu abadala: amaphilisi amathathu athathwa ngomlomo (ngokudla) kanye ngosuku. Umthamo wezingane usebenza ezinganeni:

  • iminyaka eyi-12 kuya kwengu-17, noma
  • labo abanesisindo okungenani esingu-45 kg (cishe amakhilogremu angama-99)

IMavyret okwamanje ayivunyelwe ukusetshenziswa ezinganeni ezingaphansi kweminyaka eyi-12 noma kulabo abanesisindo esingaphansi kwama-45 kg.

Kuthiwani uma ngiphuthelwa umthamo?

Uma uphuthelwa umthamo weMavyret, nakhu okufanele ukwenze:

  • Uma kungaphansi kwamahora angu-18 kusuka lapho kufanele uthathe i-Mavyret, qhubeka uthathe umthamo wakho ngokushesha nje lapho ukhumbula. Bese, thatha umthamo wakho olandelayo ngesikhathi esijwayelekile.
  • Uma kungaphezu kwamahora angu-18 kusuka lapho bekufanele uthathe i-Mavyret, vele weqe lowo umthamo. Ungathatha umthamo wakho olandelayo ngesikhathi esijwayelekile.

Ukusiza ukuqinisekisa ukuthi awuphuthelwa umthamo, zama ukusetha isikhumbuzi efonini yakho. Isikhathi semithi singasiza, futhi.

Ngabe kuzodingeka ngisebenzise lesi sidakamizwa isikhathi eside?

Ubude besikhathi ozodinga ukuthatha ngaso iMavyret buxhomeke ezintweni ezimbalwa. Lokhu kufaka phakathi ukuthi wake welashelwa i-HCV phambilini, futhi uma unesibazi sesibindi (i-cirrhosis).

Imvamisa, ukwelashwa ngeMavyret kuhlala noma kuphi kusuka emavikini ayisishiyagalombili kuya kwayi-16. Imvamisa ayihlali isikhathi eside kunamasonto ayi-16.

UMavyret notshwala

UMavyret akanakho ukuxhumana okwaziwayo notshwala. Kodwa-ke, akufanele uphuze utshwala uma unegciwane le-hepatitis C (HCV). Utshwala benza i-HCV ibe nzima kakhulu, okungaholela ekuqothukeni okukhulu (i-cirrhosis) esibindi sakho.

Uma uphuza utshwala, futhi ukhathazekile ngokuthi ungakuyeka kanjani ukuphuza, khuluma nodokotela wakho.

Ezinye izindlela zeMavyret

Ezinye izidakamizwa ziyatholakala ezingelapha igciwane lesifo sofuba esingalapheki i-hepatitis C (HCV). Ezinye zingakulungela kangcono kunabanye. Uma unentshisekelo yokuthola enye indlela kaMavyret, khuluma nodokotela wakho. Bangakutshela ngeminye imithi engakusebenzela kahle.

Eminye imishanguzo, equkethe inhlanganisela yemithi elwa namagciwane yokwelapha i-HCV, ifaka okulandelayo:

  • i-ledipasvir ne-sofosbuvir (Harvoni)
  • i-sofosbuvir ne-velpatasvir (i-Epclusa)
  • i-velpatasvir, i-sofosbuvir, ne-voxilaprevir (Yonkevi)
  • i-elbasvir ne-grazoprevir (iZepatier)
  • simeprevir (Olysio) ne-sofosbuvir (Sovaldi)

Yize bengezi njengomuthi ohlangene, iSimeprevir (Olysio) nesofosbuvir (Sovaldi) nazo zingathathwa ndawonye ukwelashwa i-HCV.

UMavyret vs. Harvoni

Ungazibuza ukuthi uMavyret uqhathanisa kanjani neminye imithi enqunyelwe ukusetshenziswa okufanayo. Lapha sibheka ukuthi uMavyret noHarvoni bafana kanjani futhi bahlukene kanjani.

Mayelana

IMavyret iqukethe izidakamizwa i-glecaprevir ne-pibrentasvir. IHarvoni iqukethe izidakamizwa ledipasvir ne-sofosbuvir. Kokubili iMavyret neHarvoni ziqukethe inhlanganisela yama-antivirals, futhi zisezigabeni ezifanayo zemithi.

Isebenzisa

IMavyret ivunyelwe ukwelapha igciwane lesifo sofuba esingalapheki i-hepatitis C (HCV) kubantu abadala. Iphinde ivunyelwe ukusetshenziswa ezinganeni ezineminyaka engu-12 noma ngaphezulu, noma lezo ezinesisindo okungenani esingu-45 kg, cishe ama-99 lbs.

I-Mavyret isetshenziselwa ukwelapha zonke izinhlobo (1, 2, 3, 4, 5, no-6) ze-HCV kubantu:

  • ngaphandle kwesibazi sesibindi (i-cirrhosis), noma kulabo abane-cirrhosis ngaphandle kwezimpawu zesimo
  • abathole ukufakelwa isibindi noma izinso
  • abane-HIV

I-Mavyret nayo ingasetshenziselwa ukwelapha uhlobo lwe-HCV 1 kubantu abake baphathwa ngaphambilini (kodwa abangalashwa) ngohlobo oluhlukile lwemithi.

I-Harvoni ivunyelwe ukwelapha i-HCV kubantu abadala. Ingasetshenziselwa ukwelapha izinhlobo ezilandelayo ze-HCV:

  • Izinhlobo 1, 2, 5, noma 6 kubantu abangenaso isibazi (cirrhosis), noma kulabo abane-cirrhosis ngaphandle kwezimpawu zesimo
  • thayipha i-1 kubantu abane-cirrhosis enezimpawu zesimo (kulaba bantu, iHarvoni kufanele ihlanganiswe ne-ribavirin)
  • thayipha u-1 noma u-4 kubantu abathole ukufakelwa isibindi, futhi okungenzeka ukuthi abanaso isibazi sesibindi, noma banesibazi sesibindi ngaphandle kwezimpawu (kulaba bantu, iHarvoni kufanele futhi ihlanganiswe ne-ribavirin)

I-Harvoni nayo ivunyelwe ukusetshenziswa ezinganeni ezineminyaka engu-12 nangaphezulu, noma labo abanesisindo okungenani esingu-35 kg, okuma-77 lbs. Ingasetshenziswa ezinganeni ezilandelayo:

  • labo abanezinhlobo ze-HCV 1, 4, 5, noma 6
  • izingane ezingenasibazi sesibindi (i-cirrhosis), noma lezo ezine-cirrhosis kodwa ezingenazo izimpawu zalesi simo

Amafomu wezidakamizwa nokuphathwa

IMavyret iza njengamaphilisi, athathwa ngomlomo (ngokudla) kanye ngosuku. Imvamisa inikezwa isikhathi samaviki ayi-8, 12, noma ama-16 kuya ngomlando wakho wokwelashwa nokuthi isifo sakho sesibindi sinzima kangakanani.

IHarvoni nayo iza njengamaphilisi, athathwa ngomlomo (ngokudla noma ngaphandle kokudla) kanye ngosuku. Imvamisa inikezwa esikhathini esiyiminyaka eyi-8, 12, noma yama-24 kuye ngomlando wakho wokwelashwa nesimo sesibindi sakho.

Imiphumela emibi kanye nezingozi

IMavyret neHarvoni ayinazo izidakamizwa ezifanayo, kepha ziyingxenye yesigaba esifanayo semithi. Le mithi ingadala imiphumela emibi efanayo neminye imiphumela emibi ehlukile. Ngezansi kunezibonelo zale miphumela emibi.

Imiphumela emibi ejwayelekile

Lezi zinhlu ziqukethe izibonelo zemiphumela emibi ejwayelekile engenzeka ngeMavyret, neHarvoni, noma ngazo zombili izidakamizwa (uma zithathwa ngazodwana).

  • Kungenzeka nge-Mavyret:
    • isifo sohudo
    • izinga eliphakeme le-bilirubin (ukuhlolwa kwelebhu okuhlola ukusebenza kwesibindi sakho)
  • Kungenzeka ngeHarvoni:
    • ukuzizwa ngibuthakathaka
    • ukuqwasha (kunzima ukulala)
    • ukukhwehlela
    • ukuzwa ukucasuka
  • Kungenzeka ngamabili uMavyret noHarvoni:
    • ikhanda
    • ngizizwe ngikhathele
    • isicanucanu

Imiphumela emibi kakhulu

Imiphumela emibi engaba khona noMavyret noHarvoni (uma ithathwa ngawodwana) ifaka okulandelayo:

  • ukuvuselelwa kwegciwane le-hepatitis B (ukuqhuma kwegciwane, uma selivele lingaphakathi komzimba wakho) *
  • ukusabela okweqile komzimba

Ukusebenza ngempumelelo

Bobabili uMavyret noHarvoni bavunyelwe ukwelapha igciwane lesifo sofuba esingalapheki i-hepatitis C (HCV). Kodwa-ke, umuthi owodwa ungasebenza kangcono kuwe kunomunye, kuya ngohlobo lwe-HCV onalo nokuthi ngabe unesifo sokusha kwesibindi (i-cirrhosis).

Le mithi ayikaze iqhathaniswe ngqo ezifundweni zokwelashwa. Kodwa izifundo ezehlukene zithole ukuthi bobabili uMavyret noHarvoni bayasebenza ekwelapheni i-HCV.

Izindleko

UMavyret noHarvoni bobabili yizidakamizwa ezinamagama. Okwamanje azikho izinhlobo ezijwayelekile zomuthi. Imithi enegama lomkhiqizo ivame ukubiza ngaphezu kwama-generic.

Ngokuya ngokulinganiselwa ku-GoodRx.com, iMavyret neHarvoni ngokuvamile kubiza ngokufana. Inani langempela ozolikhokhela noma imuphi umuthi lincike ohlelweni lwakho lomshuwalense, indawo okuyo nasekhemisi oyisebenzisayo.

IMavyret ne-Epclusa

Ungazibuza ukuthi uMavyret uqhathanisa kanjani neminye imithi enqunyelwe ukusetshenziswa okufanayo. Lapha sibheka ukuthi uMavyret no-Epclusa bafana kanjani futhi bahlukene kanjani.

Mayelana

IMavyret iqukethe izidakamizwa i-glecaprevir ne-pibrentasvir. I-Epclusa iqukethe izidakamizwa i-velpatasvir ne-sofosbuvir. Kokubili uMavyret no-Epclusa baqukethe inhlanganisela yemithi elwa namagciwane, futhi bangabesigaba esifanayo semithi.

Isebenzisa

IMavyret ivunyelwe ukwelapha igciwane lesifo sofuba esingalapheki i-hepatitis C (HCV) kubantu abadala. Iphinde ivunyelwe ukusetshenziswa ezinganeni ezineminyaka engu-12 noma ngaphezulu, noma lezo ezinesisindo okungenani esingu-45 kg, cishe ama-99 lbs.

I-Mavyret isetshenziselwa ukwelapha zonke izinhlobo (1, 2, 3, 4, 5, no-6) ze-HCV kubantu:

  • ngaphandle kwesibazi sesibindi (i-cirrhosis), noma kulabo abane-cirrhosis ngaphandle kwezimpawu zesimo
  • abathole ukufakelwa isibindi noma izinso
  • abane-HIV

I-Mavyret nayo ingasetshenziselwa ukwelapha uhlobo lwe-HCV 1 kubantu abake baphathwa ngaphambilini (kodwa abangalashwa) ngohlobo oluhlukile lwemithi.

NjengoMavyret, i-Epclusa nayo ivunyelwe ukwelapha i-HCV engalapheki ebangelwa yizo zonke izinhlobo zegciwane (izinhlobo 1, 2, 3, 4, 5, no-6). Isetshenziswa kubantu abadala abangenaso isibazi sesibindi (i-cirrhosis), noma kulabo abanesibazi sesibindi abangenazo izimpawu zalesi simo.

I-Epclusa ingasetshenziswa futhi kubantu abadala abane-cirrhosis abanezimpawu zalesi simo.

I-Epclusa ayivunyelwe ukusetshenziswa ezinganeni.

Amafomu wezidakamizwa nokuphathwa

IMavyret iza njengamaphilisi, athathwa ngomlomo (ngokudla) kanye ngosuku. Imvamisa inikezwa isikhathi samaviki ayi-8, 12, noma ama-16 kuya ngomlando wakho wokwelashwa nokuthi isifo sakho sesibindi sinzima kangakanani.

I-Epclusa nayo iza njengamathebulethi, athathwa ngomlomo kanye ngosuku. I-Epclusa ingathathwa nokudla noma ngaphandle kokudla. Imvamisa inikezwa isikhathi samasonto ayi-12.

Imiphumela emibi kanye nezingozi

UMavyret no-Epclusa abanazo izidakamizwa ezifanayo kuzo. Kodwa-ke, basekilasini elifanayo lemithi. Ngakho-ke, yomibili le mithi ingadala imiphumela emibi efanayo. Ngezansi kunezibonelo zale miphumela emibi.

Imiphumela emibi ejwayelekile

Lezi zinhlu ziqukethe izibonelo zemiphumela emibi ejwayelekile engenzeka ngeMavyret, ne-Epclusa, noma ngazo zombili izidakamizwa (uma zithathwa ngazodwana).

  • Kungenzeka nge-Mavyret:
    • isifo sohudo
    • izinga eliphakeme le-bilirubin (ukuhlolwa kwelebhu okuhlola ukusebenza kwesibindi sakho)
  • Kungenzeka nge-Epclusa:
    • ukuzizwa ngibuthakathaka
    • ukuqwasha (kunzima ukulala)
  • Kungenzeka ngeMavyret ne-Epclusa:
    • ikhanda
    • ngizizwe ngikhathele
    • isicanucanu

Imiphumela emibi kakhulu

Imiphumela emibi engaba khona ngeMavyret ne-Epclusa (uma ithathwa ngawodwana) ifaka okulandelayo:

  • ukuvuselelwa kwegciwane le-hepatitis B (ukuqhuma kwegciwane, uma selivele lingaphakathi komzimba wakho) *
  • ukusabela okweqile komzimba

Ukusebenza ngempumelelo

UMavyret no-Epclusa bobabili basetshenziselwa ukwelapha zonke izinhlobo eziyisithupha ze-HCV ezingamahlalakhona. Udokotela wakho angancoma ukuthi uthathe i-Epclusa noma iMavyret ngokuya ngohlobo lwe-HCV onalo nesimo sesibindi sakho.

Le mithi ayikaze iqhathaniswe ngqo ezifundweni zokwelashwa. Kodwa izifundo ezihlukile zithole ukuthi bobabili uMavyret no-Epclusa bayasebenza ekwelapheni i-HCV.

Izindleko

UMavyret no-Epclusa bobabili yizidakamizwa ezinamagama. Okwamanje azikho izinhlobo ezijwayelekile zomuthi. Imithi enegama lomkhiqizo ivame ukubiza ngaphezu kwama-generic.

Ngokuya ngokulinganiselwa ku-GoodRx.com, iMavyret ne-Epclusa ngokuvamile kubiza ngokufana. Inani langempela ozolikhokhela noma imuphi umuthi lincike ohlelweni lwakho lomshuwalense, indawo okuyo nasekhemisi oyisebenzisayo.

IMavyret yesifo sokusha kwesibindi kohlobo C

Ukuphathwa Kwezokudla Nezidakamizwa (i-FDA) kuvumela imishanguzo kadokotela efana neMavyret ukwelapha izimo ezithile.

UMavyret uvunyelwe yi-FDA ukwelapha izifo ezingalapheki ezibangelwa igciwane le-hepatitis C (HCV). Leli gciwane lithelela isibindi sakho futhi lidale ukuvuvukala, kwesinye isikhathi okungaholela ekuqhekekeni kwesibindi (okubizwa nge-cirrhosis). I-HCV ingadala izimpawu ezifana nalezi:

  • ukuphuzi kwesikhumba sakho nokumhlophe kwamehlo akho
  • uketshezi olwakhiwe esiswini sakho
  • imfiva
  • izinkinga zesikhathi eside, njengokuhluleka kwesibindi

I-HCV isakazeka ngegazi elinegciwane. Ukudluliswa (ukusakazeka) kwenzeka kakhulu kubantu ababelana ngezinaliti ezisetshenzisiwe. Ngokusho kweCenters for Disease Control and Prevention (CDC), ngo-2016 cishe abantu abayizigidi ezingama-2.4 e-United States babephethwe yisifo sokusha kwesibindi kohlobo C.

IMavyret ivunyelwe ukwelapha i-HCV kubantu abadala. Iphinde ivunyelwe ukusetshenziswa ezinganeni ezineminyaka engu-12 noma ngaphezulu, noma lezo ezinesisindo okungenani esingu-45 kg, cishe ama-99 lbs. Isetshenziselwa ukwelapha zonke izinhlobo ze-HCV (1, 2, 3, 4, 5, no-6) kubantu:

  • ngaphandle kwesibazi sesibindi (i-cirrhosis), noma kulabo abane-cirrhosis ngaphandle kwezimpawu zesimo (esibizwa ngokuthi yi-cirrhosis enxephezelwe)
  • abathole ukufakelwa isibindi noma izinso
  • abane-HIV

I-Mavyret nayo ingasetshenziselwa ukwelapha uhlobo lwe-HCV 1 kubantu abake baphathwa ngaphambilini (kodwa abangalashwa) ngohlobo oluhlukile lwemithi.

Ukusebenza ngempumelelo

Ezivivinyweni zokwelashwa, abantu abadala abane-HCV (izinhlobo 1, 2, 3, 4, 5, no-6) ababengakaze belashelwe igciwane banikezwa uMavyret. Kulaba bantu, ama-98% kuya ku-100% belashwa kungakapheli amasonto ayi-8 kuye kwayi-12 belashwa. Kulezi zifundo, ukwelashwa kwakusho ukuthi ukuhlolwa kwegazi kwabantu, okwenziwa ezinyangeni ezintathu ngemuva kokwelashwa, kwakungakhombisi zimpawu zokutheleleka nge-HCV emzimbeni wabo.

Kubo bonke abantu abasezifundweni (bobabili labo ababelashelwe i-HCV phambilini nalabo ababengakaze belashwe), phakathi kuka-92% no-100% belashwa i-HCV. Imiphumela yehluka kuye ngokuthi abantu bake balashwa phambilini yini nohlobo lwe-HCV ababenalo.

Ukuhlolwa komtholampilo kuphinde kwaqhathanisa iMavyret nokuhlanganiswa kweminye imithi emibili elwa namagciwane ebizwa nge-sofosbuvir (Sovaldi) ne-daclatasvir (Daklinza). Ucwaningo olulodwa lwabheka abantu abane-HCV yohlobo 3, ababengakaze belashwe ngaphambilini. Laba bantu babengenakho ukwesaba kwesibindi (i-cirrhosis).

Ngemuva kwamasonto ayi-12, abantu abangama-95.3% abathatha iMavyret babhekwa njengabaphulukisiwe (babengenalo igciwane le-HCV ekuhloleni kwabo igazi). Kulabo abathatha i-sofosbuvir ne-daclatasvir, i-96.5% ibe nomphumela ofanayo.

Mavyret wezingane

UMavyret uvunyelwe ukwelapha i-HCV ezinganeni ezineminyaka engu-12 nangaphezulu, noma kulabo abanesisindo okungenani esingu-45 kg, esingaba ngama-99 lbs.

Ukusebenzisana kweMavyret

UMavyret angaxhumana neminye imithi eminingana. Ingasebenzisana nezithasiselo ezithile.

Ukuxhumana okuhlukile kungadala imiphumela ehlukile. Isibonelo, ukuxhumana okuthile kungaphazamisa ukusebenza kwesidakamizwa. Okunye ukuxhumana kungakhuphula imiphumela emibi noma kuyenze ibe nzima kakhulu.

I-Mavyret neminye imithi

Ngezansi kukhona uhlu lwemithi engasebenzisana noMavyret. Lezi zinhlu aziqukethe yonke imishanguzo engaxhumana noMavyret.

Ngaphambi kokuthatha uMavyret, khuluma nodokotela wakho nosokhemisi. Batshele ngayo yonke imishanguzo oyinikezwa ngudokotela, i-counter-counter, nezinye izidakamizwa oziphuzayo. Batshele futhi nganoma yimaphi amavithamini, amakhambi, nezithako ozisebenzisayo. Ukwabelana ngalolu lwazi kungakusiza ugweme ukuhlangana okungenzeka.

Uma unemibuzo mayelana nokuhlangana kwezidakamizwa okungakuthinta, buza udokotela wakho noma usokhemisi.

IMavyret ne-carbamazepine (Tegretol)

Ukuthatha i-carbamazepine nge-Mavyret kunganciphisa inani leMavyret emzimbeni wakho. Lokhu kungadala ukuthi umuthi ungasebenzi futhi, okungaholela ekutheni igciwane lakho le-hepatitis C (HCV) lingalashwa ngokuphelele. Kubalulekile ukugwema ukuthatha i-carbamazepine neMavyret ndawonye.

IMavyret ne-warfarin (Coumadin)

Ukuthatha i-warfarin neMavyret kungashintsha izinga le-warfarin emzimbeni wakho. Lokhu kungaholela ekuguqulweni kobukhulu begazi lakho, kubangele ukuthi libe mncane kakhulu noma libe likhulu kakhulu. Uma lokhu kwenzeka, ungaba sengozini yezinkinga ezithile, njengokuphuma kwegazi noma ukuba namahlule egazi.

Uma uthatha iMavyret nge-warfarin, kubalulekile ukuthi kwenziwe ukuhlolwa kwegazi okuthile kaningi ukuhlola ubukhulu begazi lakho. Uma udinga ukuthatha le mithi ndawonye, ​​udokotela wakho uzoncoma izindlela zokusiza ukuqinisekisa ukuphepha kwakho ngesikhathi sokwelashwa.

I-Mavyret ne-digoxin (i-Lanoxin)

Ukuthatha iMavyret nge-digoxin kungakhuphula amazinga e-digoxin emzimbeni wakho. Lokhu kungadala izimpawu ezinjengalezi:

  • isicanucanu
  • ukuhlanza
  • isifo sohudo
  • isigqi senhliziyo esingajwayelekile

Uma uthatha i-digoxin ngenkathi usebenzisa iMavyret, udokotela wakho angadinga ukwehlisa umthamo wakho we-digoxin. Lokhu kuzosiza ukuvimbela amazinga akho e-digoxin ukuthi akhuphuke kakhulu futhi abangele imiphumela emibi. Udokotela wakho angahlola amazinga akho e-digoxin ekuhlolweni kwegazi kaningi kunokujwayelekile ngenkathi uthatha iMavyret.

I-Mavyret ne-dabigatran (Pradaxa)

Ukuthatha iMavyret nge-dabigatran kwandisa amazinga e-dabigatran emzimbeni wakho. Uma leli zinga likhuphuka kakhulu, uzoba nengozi eyengeziwe yokopha noma ukulinyazwa. Ungazizwa ubuthakathaka. Lezi zimpawu kwesinye isikhathi zingaba zimbi kakhulu.

Uma uthatha i-dabigatran ngenkathi usebenzisa iMavyret, udokotela wakho angadinga ukwehlisa umthamo wakho we-dabigatran. Lokhu kuzosiza ukuvimbela lezi zimpawu ukuthi zingenzeki.

IMavyret ne-rifampin (iRifadin)

Ukuthatha iMavyret nge-rifampin kwehlisa amazinga eMavyret emzimbeni wakho. Uma izinga leMavyret emzimbeni wakho lehlisiwe, umuthi kungenzeka ungasebenzi ukwelapha i-HCV. Kufanele ugweme ukuthatha iMavyret neRifampin ngasikhathi sinye.

IMavyret kanye nemithi ethile yokulawula ukuzalwa

Eminye imithi yokulawula ukubeletha iqukethe umuthi obizwa nge-ethinyl estradiol. Ukuthatha lo muthi ngokuhlangana neMavyret kungakhuphula amazinga omzimba wakho we-enzyme ethile yesibindi ebizwa nge-alanine aminotransferase (ALT). Ukukhuphuka kwamazinga e-ALT kungenza izimpawu zakho ze-hepatitis zibe zimbi kakhulu.

Kunconywa ukuthi ungasebenzisi ukulawulwa kokuzalwa okuqukethe i-ethinyl estradiol ngenkathi uthatha iMavyret.

Izibonelo zamaphilisi okulawula ukubeletha aqukethe i-ethinyl estradiol afaka:

  • i-levonorgestrel ne-ethinyl estradiol (iLessina, i-Levora, i-Seasonique)
  • i-desogestrel ne-ethinyl estradiol (i-Apri, iKariva)
  • i-norethindrone ne-ethinyl estradiol (iBalziva, iJunel, iLoestrin / iLoestrin Fe, iMicrogestin / iMicrogestin Fe)
  • i-norgestrel ne-ethinyl estradiol (i-Cryselle, i-Lo / i-Ovral)
  • i-drospirenone ne-ethinyl estradiol (Loryna, Yaz)
  • i-norgestimate ne-ethinyl estradiol (i-Ortho Tri-Cyclen / i-Ortho Tri-Cyclen Lo, iSprintec, iTri-Sprintec, iTriNessa)

Lolu akulona uhlu oluphelele lwamaphilisi okulawula ukubeletha aqukethe i-ethinyl estradiol. Uma ungenaso isiqiniseko sokuthi ukulawulwa kokuzalwa kwakho kune-ethinyl estradiol kuyo, qiniseka ukuthi ubuza udokotela noma usokhemisi wakho.

Ezinye izindlela zokulawula ukubeletha ngaphandle kwamaphilisi nazo ziqukethe i-ethinyl estradiol. Lezi zindlela zifaka isichibi sokuvimbela inzalo (i-Ortho Evra) neringi lesitho sangasese sowesifazane (iNuvaRing).

Uma usebenzisa ukulawulwa kokuzalwa okuqukethe i-ethinyl estradiol, khuluma nodokotela wakho ngezinye izindlela zokuvimbela ukukhulelwa ngenkathi uthatha iMavyret.

I-Mavyret nemithi ethile yokulwa negciwane lesandulela ngculaza

Imithi ethile ye-HIV (ebizwa ngama-antivirals) ingathinta inani leMavyret emzimbeni wakho. Izibonelo zemithi elwa namagciwane engashintsha inani leMavyret emzimbeni wakho ifaka:

  • i-atazanavir (Reyataz)
  • i-darunavir (Prezista)
  • i-lopinavir ne-ritonavir (Kaletra)
  • i-ritonavir (Norvir)
  • i-efavirenz (Sustiva)

I-Atazanavir akufanele ithathwe neMavyret. Ukuthatha le mithi ndawonye kukhuphula izinga lomzimba wakho le-enzyme ethile yesibindi ebizwa ngokuthi i-alanine aminotransferase (ALT). Ukukhuphuka kwamazinga e-ALT kungenza izimpawu zakho ze-hepatitis zibe zimbi kakhulu.

Ukuthatha iMavyret nge-darunavir, lopinavir, noma i-ritonavir nakho akunconyiwe. Lokhu kungenxa yokuthi le mithi elwa namagciwane ingakhuphula amazinga eMavyret emzimbeni wakho. Lokhu kungaholela ekukhuleni kwemiphumela emibi evela kuMavyret.

Ukuthatha iMavyret nge-efavirenz kunciphisa amazinga eMavyret emzimbeni wakho. Lokhu kungadala ukuthi iMavyret ingasebenzi futhi. Kufanele ugweme ukusebenzisa i-efavirenz ngenkathi uthatha iMavyret.

I-Mavyret nemithi ethile ye-cholesterol

Ukuthatha iMavyret kanye nemithi ethile ye-cholesterol ebizwa ngama-statins kungakhuphula izinga le-statin emzimbeni wakho. Ukuba namazinga akhuphukile ama-statins kwandisa ubungozi bakho bemiphumela emibi (njengobuhlungu bemisipha) kusuka ku-statin.

Izibonelo zama-statins zifaka:

  • i-atorvastatin (Lipitor)
  • i-lovastatin (Mevacor)
  • i-simvastatin (Zocor)
  • i-pravastatin (Pravachol)
  • i-rosuvastatin (Crestor)
  • i-fluvastatin (Lescol)
  • i-pitavastatin (Livalo)

Kunconywa ukuthi ungathathi iMavyret ngokuhlangana ne-atorvastatin, lovastatin, noma i-simvastatin. Lezi zimila zinengozi enkulu kakhulu yokwanda kwemiphumela emibi lapho zithathwa neMavyret.

I-Pravastatin ingathathwa noMavyret uma udokotela wakho encoma ukuthi udinga umuthi we-cholesterol. Umthamo wakho we-pravastatin uzodinga ukwehliswa ngaphambi kokuthi uqale ukuthatha iMavyret. Lokhu kuzosiza ukunciphisa ubungozi bemiphumela emibi evela ku-statin.

Uma i-fluvastatin ne-pitavastatin zithathwa nge-Mavyret, kufanele zinikezwe esilinganisweni esiphansi kunazo zonke. Lokhu kusiza ukunciphisa ubungozi bokuba nemiphumela emibi eyengeziwe evela kuma-statins.

I-Mavyret ne-cyclosporine (iSandimmune)

I-Mavyret ayinconywa ukuthi isetshenziswe kubantu abathatha ngaphezu kwe-100 mg ngosuku lwe-cyclosporine. Lesi sidakamizwa sandisa amazinga eMavyret emzimbeni wakho, angakhuphula ubungozi bakho bemiphumela emibi evela kuMavyret.

Uma uthatha i-cyclosporine, khuluma nodokotela wakho mayelana nokuthi imuphi umthamo we-cyclosporine ophephe kakhulu kuwe.

I-Mavyret ne-omeprazole (hhayi ukuxhumana)

Akukho ukuxhumana okwaziwayo phakathi kwe-omeprazole neMavyret. I-Omeprazole kwesinye isikhathi inikezwa abantu abathatha iMavyret uma benesicanucanu ngesikhathi sokwelashwa. Kwesinye isikhathi, isicanucanu sibangelwa ukwakheka kwe-asidi esiswini sakho. Ukuthatha i-omeprazole kuzosiza ukwehlisa inani le-asidi esiswini sakho, okungasiza ukunciphisa lo mphumela wecala.

UMavyret ne-ibuprofen (hhayi ukuxhumana)

Akukho ukuxhumana okwaziwayo phakathi kwe-ibuprofen neMavyret. I-Ibuprofen ingasetshenziselwa ukwelapha ikhanda kubantu abathatha iMavyret. Ukuphathwa yikhanda kungumphumela ohlangothini ovamile ongavela lapho uthatha iMavyret. Ibuprofen ingasiza ekunciphiseni ubuhlungu nokungaphatheki kahle kwekhanda.

I-Mavyret namakhambi nezithako

UMavyret angasebenzisana namanye amakhambi nezithako, kufaka phakathi iSt John's wort (echazwe ngezansi). Lokhu kusebenzisana kungathinta ukuthi iMavyret isebenza kanjani emzimbeni wakho.

Kufanele ubuyekeze yonke imithi oyiphuzayo (kufaka phakathi noma yimaphi amakhambi nezithako) nodokotela wakho noma usokhemisi ngaphambi kokuba uqale ukuthatha iMavyret.

IMavyret neSt. John's wort

Ukuthatha i-wort yaseSt. John neMavyret kunganciphisa kakhulu amazinga eMavyret emzimbeni wakho. Lokhu kungadala ukuthi iMavyret ingasebenzi kahle ekwelapheni ukutheleleka kwakho kwe-hepatitis C. Kunconywa ukuthi ungathathi i-wort yaseSt.John ngenkathi usebenzisa iMavyret.

Mavyret nokukhulelwa

Akuzange kube khona ucwaningo kubantu olubheka ukuthi ngabe iMavyret iphephile yini ukuyithatha ngesikhathi sokukhulelwa.

Ezifundweni zezilwane, akukho monakalo owabonwa emibungwini omama bayo banikezwa iMavyret ngesikhathi sokukhulelwa. Kodwa-ke, imiphumela yezifundo zezilwane ayihlali ibikezela ukuthi kuzokwenzekani kubantu.

Uma ukhulelwe noma ungakhulelwa ngenkathi usebenzisa iMavyret, khuluma nodokotela wakho. Bangakhuluma nawe ngezingozi nezinzuzo zokusebenzisa lo muthi ngesikhathi sokukhulelwa.

Mavyret nokuncelisa ibele

Akuzange kube khona noma yiziphi izifundo kubantu zokwazi ukuthi ngabe iMavyret idlulela ebisi lwebele noma cha, noma uma inomphumela enganeni ebelethayo.

Ezifundweni zezilwane, uMavyret wadlulela obisini lwamagundane ancelisayo. Kodwa-ke, lolu bisi aluzange lulimaze izilwane eziludlayo. Khumbula ukuthi le miphumela ingahluka kubantu.

Uma uncelisa, noma uhlela ukuncelisa ngenkathi uthatha uMavyret, khuluma nodokotela wakho mayelana nokuthi lokhu kuyindlela ephephile yini. Bangancoma ezinye izindlela ezinempilo zokondla ingane yakho.

Ungayithatha kanjani iMavyret

Kufanele uthathe uMavyret ngokwemiyalo kadokotela wakho noma yomhlinzeki wezokunakekelwa kwempilo.

Ukuthatha nini

Akunandaba ukuthi ukhetha ukuthatha siphi isikhathi sosuku uMavyret, kepha kufanele usithathe cishe ngesikhathi esifanayo usuku ngalunye. Lokhu kusiza ukuthi umuthi usebenze ngendlela efanele emzimbeni wakho.

Ukusiza ukuqinisekisa ukuthi awuphuthelwa umthamo, zama ukusetha isikhumbuzi efonini yakho. Isikhathi semithi singasiza, futhi.

Ukuthatha uMavyret ngokudla

I-Mavyret kufanele ithathwe ngokudla. Lokhu kusiza umzimba wakho ukuthi umunce kangcono umuthi.

Ngabe iMavyret ingachotshozwa, ihlukaniswe, noma ihlafunwe?

Cha, iMavyret akufanele ihlukaniswe, ichotshozwe, noma ihlafunwe. Amathebulethi enzelwe ukugwinywa ngokuphelele. Ukuwahlukanisa, ukuwachoboza noma ukuwahlafuna kungehlisa inani lomuthi ongena emzimbeni wakho. Lokhu kungadala ukuthi iMavyret ingasebenzi kahle ekwelapheni ukutheleleka kwakho kwe-hepatitis C.

Isebenza kanjani iMavyret

UMavyret uvunyelwe ukwelapha igciwane lesifo sofuba esingalapheki i-hepatitis C (HCV). Leli gciwane lidala ukutheleleka emzimbeni wakho okuthinta isibindi sakho. I-HCV ingaholela ekulimaleni okukhulu kwesibindi uma ingelashwa ngendlela efanele.

IMavyret iqukethe izidakamizwa ezimbili: i-glecaprevir ne-pibrentasvir. Isebenza ngokumisa igciwane le-hepatitis C ekuphindaphindeni (lenze igciwane eliningi) emzimbeni wakho. Ngenxa yokuthi igciwane alikwazi ukwanda, ekugcineni lizofa.

Lapho lonke igciwane selifile, futhi lingasekho emzimbeni wakho, isibindi sakho singaqala ukuphola. IMavyret isebenza ukwelapha zonke izinhlobo eziyisithupha (1, 2, 3, 4, 5, no-6) ze-HCV.

Kuthatha isikhathi esingakanani ukusebenza?

Ngesikhathi sokuhlolwa komtholampilo, abantu abangama-92% kuya kwabangu-100% abane-HCV belashwa ngemuva kokuthatha iMavyret ngobude besikhathi esibekiwe. Lobu ubude besikhathi busukela emasontweni ayisishiyagalombili kuya kwayi-16.

Kulezi zifundo, ukwelashwa kwakusho ukuthi ukuhlolwa kwegazi kwabantu, okwenziwa ezinyangeni ezintathu ngemuva kokwelashwa, kwakungakhombisi zimpawu zokutheleleka nge-HCV emzimbeni wabo.

Imibuzo ejwayelekile mayelana noMavyret

Nazi izimpendulo zemibuzo ebuzwa njalo mayelana noMavyret.

Ngingamthatha uMavyret uma ngine-HIV kanye ne-hepatitis C?

Yebo, ungathatha iMavyret uma unegciwane lesandulela ngculaza kanye ne-hepatitis C (HCV). Ukuba ne-HIV akuguquli indlela uMavyret asebenza ngayo emzimbeni wakho ukwelapha i-HCV.

Uphumelela kangakanani uMavyret ekwelapheni i-hepatitis C?

IMavyret ikhonjiswe ukuthi iyasebenza kakhulu ekwelapheni ukutheleleka kwegciwane lesifo sohlobo lwe-hepatitis C (HCV). Ezivivinyweni zokwelashwa, phakathi kuka-98% no-100% wabantu abathatha iMavyret belashwa i-HCV.

Kulezi zifundo, ukwelashwa kwakusho ukuthi ukuhlolwa kwegazi kwabantu, okwenziwa ezinyangeni ezintathu ngemuva kokwelashwa, kwakungakhombisi zimpawu zokutheleleka nge-HCV. Amaphesenti abantu abaphulukisiwe ancike ohlotsheni lwe-HCV abanalo, nokuthi hlobo luni lwezokwelapha ababelusebenzisa esikhathini esedlule.

Uma ngithathe ezinye izindlela zokwelapha i-hepatitis C, ngingayisebenzisa iMavyret?

Uma uke wazama eminye imishanguzo ye-hepatitis C yakho engazange isebenze (yelaphe ukutheleleka kwakho), ungahle usebenzise iMavyret. Ngokuya ngokuthi imiphi imishanguzo oyisebenzise esikhathini esedlule, ubude bokwelashwa kwakho noMavyret bungaba kusuka kumaviki ayi-8 kuye kwayi-16.

Uma unemibuzo mayelana nokuthi ungayisebenzisa yini iMavyret, khuluma nodokotela wakho.

Ngabe ngizodinga noma yikuphi ukuhlolwa ngaphambi noma ngesikhathi sokwelashwa kweMavyret?

Ngaphambi kokuba uqale ukwelashwa ngeMavyret, udokotela wakho uzohlola igazi lakho ngegciwane le-hepatitis B (HBV). Uma une-HBV, ingavuselela (ivele) ngesikhathi sokwelashwa kweMavyret. Ukuvuselelwa kwe-HBV kungadala izinkinga ezinzima zesibindi, kufaka phakathi ukwehluleka kwesibindi nokufa.

Uma une-HBV, udokotela wakho uzoncoma ukuhlolwa kwegazi ngesikhathi sokwelashwa kwakho kweMavyret ukuze uhlole ukuvuselelwa kwe-HBV. Ungadinga ukwelashwa i-HBV ngaphambi kokuba uqale ukuthatha iMavyret.

Ngingayisebenzisa iMavyret uma ngiphethwe yisifo sokuqina kwesibindi?

Ungase ukwazi, kodwa kuya ngokuthi isifo sakho sokuqina kwesibindi (isibazi sesibindi) sinzima kangakanani.

I-Mavyret ingasetshenziswa uma unxephezele (i-cirrhosis emnene). Ngalesi simo, isibindi sakho sinesibazi, kodwa awunazo izimpawu zalesi simo futhi isibindi sakho sisasebenza ngokujwayelekile.

IMavyret ayikavunyelwa ukuthi isetshenziswe kubantu abane-cirrhosis ebolile. Ngalesi simo, isibindi sakho sinesibazi futhi unezimpawu zalesi simo. Izimpawu zingafaka:

  • ukuphuzi kwesikhumba sakho noma okumhlophe kwamehlo akho
  • uketshezi olwengeziwe esiswini sakho
  • kukhuliswe imithambo yegazi emphinjeni wakho, engadala ukopha

Uma unesifo sokuqina kwesibindi kodwa ungaqiniseki ukuthi hlobo luni, khuluma nodokotela wakho.

Izinyathelo zokuqapha zeMavyret

Lesi sidakamizwa siza nokuqapha okuningi.

Isexwayiso se-FDA: ukuvuselelwa kwegciwane le-hepatitis B

Lesi sidakamizwa sinesixwayiso esibhakeleni. Lesi yisexwayiso esibi kakhulu esivela ku-Food and Drug Administration (FDA). Isexwayiso sebhokisi sazisa odokotela neziguli ngemiphumela yezidakamizwa engaba yingozi.

Ukwelashwa kwe-Mavyret kwandisa ingozi yokuvuselelwa kwegciwane le-hepatitis B (HBV) (flare-up) kubantu abane-virus ye-HBV ne-hepatitis C (HCV). Ezimweni ezimbi kakhulu, ukuvuselelwa kwe-HBV kungadala ukwehluleka kwesibindi noma ngisho nokufa.

Ngaphambi kokuqala iMavyret, udokotela wakho uzokuhlolela i-HBV. Uma une-HBV, kungadingeka ukuthi welashwe ngaphambi kokuthi uqale ukuthatha iMavyret. Noma udokotela wakho angancoma ukuhlolwa ngesikhathi sokwelashwa kwakho kweMavyret ukuze uhlole ukuvuselelwa kwe-HBV.

Ezinye izexwayiso

Ngaphambi kokuthatha uMavyret, khuluma nodokotela wakho ngomlando wakho wezempilo. I-Mavyret ingahle ingakulungeli uma unezimo ezithile zezokwelapha. Lokhu kufaka phakathi:

  • Ukuhluleka kwesibindi. Uma uhluleka isibindi, ukuthatha iMavyret kungasenza sibe sibi isimo sakho. Khuluma nodokotela wakho uma unomlando wesifo sesibindi noma ukwehluleka kwesibindi ngaphambi kokuqala ukwelashwa noMavyret.
  • Ukusetshenziswa kwamanje kwe-atazanavir noma i-rifampin. IMavyret akufanele isetshenziswe kubantu abathatha i-atazanavir noma i-rifampin. Ukuthatha iMavyret ne-rifampin ndawonye kunganciphisa amazinga e-Mavyret emzimbeni wakho. Lokhu kungenza iMavyret ingasebenzi kahle kuwe. Ukuthatha i-atazanavir neMavyret kungakhuphula inani leMavyret emzimbeni wakho. Lokhu kungakhuphula amazinga e-enzyme yesibindi (ebizwa ngokuthi i-alanine aminotransferase), engaba yingozi. Bona isigaba "Ukusebenzisana kweMavyret" ukuthola eminye imininingwane. Njalo khuluma nodokotela wakho nganoma yimiphi imithi oyiphuzayo ngaphambi kokuba uqale iMavyret.
  • Ukukhulelwa. Akwaziwa ukuthi iMavyret ingakuthinta yini ukukhulelwa okukhulayo. Ezifundweni zezilwane, uMavyret akazange abangele ingozi lapho esetshenziswa ngesikhathi sokukhulelwa. Kodwa-ke lo mphumela ungahluka kubantu. Ngeminye imininingwane, sicela ubheke isigaba esithi "Mavyret nokukhulelwa" ngenhla.
  • Ukuncelisa ibele. Akwaziwa ukuthi iMavyret idlulela ebisini lwebele lomuntu, noma uma ilimaza ingane encelayo. Ezifundweni zezilwane, uMavyret wadlulela ebisini lwebele, kepha akuzange kulimaze izilwane ezazidla ubisi lwebele.Noma kunjalo, lo mphumela ungahluka kubantu. Ngeminye imininingwane, sicela ubheke isigaba esithi “Mavyret nokuncelisa ibele” ngenhla.

Qaphela: Ukuthola eminye imininingwane ngemiphumela emibi engaba khona yeMavyret, bheka isigaba "seMavyret side effects" ngenhla.

Ukudlula ngokweqile kweMavyret

Ukusebenzisa okungaphezu kwesilinganiso esinconyiwe seMavyret kungaholela emiphumeleni emibi kakhulu. Ungalokothi uthathe okungaphezu kwesilinganiso udokotela wakho akubekela sona.

Okufanele ukwenze uma kwenzeka ukweqisa ngokweqile

Uma ucabanga ukuthi uthathe kakhulu lo muthi, shayela udokotela wakho. Ungashayela futhi i-American Association of Poison Control Centers ku-800-222-1222 noma usebenzise ithuluzi labo eliku-inthanethi. Kepha uma izimpawu zakho zinzima, shayela ku-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha.

Ukuphelelwa yisikhathi kweMavyret, ukugcina nokulahla

Uma uthola uMavyret ekhemisi, usokhemisi uzokwengeza usuku lokuphelelwa yisikhathi kwilebula esebhodleleni. Lolu suku luvame ukuba unyaka owodwa kusukela ngosuku abanikeze ngalo umuthi.

Usuku lokuphelelwa isikhathi lusiza ukuqinisekisa ukusebenza komuthi ngalesi sikhathi. Isimo samanje se-Food and Drug Administration (i-FDA) ukugwema ukusebenzisa imishanguzo ephelelwe yisikhathi. Uma usebenzise umuthi ongasetshenziswanga osudlulile esikhathini sokuphelelwa yisikhathi, khuluma nosokhemisi wakho mayelana nokuthi usengakwazi yini ukuwusebenzisa.

Isitoreji

Ukuthi umuthi uhlala ulungile isikhathi eside kangakanani kungancika ezintweni eziningi, kufaka phakathi ukuthi uwugcina kanjani futhi kuphi umuthi.

Amaphilisi e-Mavyret kufanele agcinwe ekamelweni lokushisa (ngaphansi kuka-86 ° F / 30 ° C) esitsheni esivaliwe ngokuqinile, kude nokukhanya. Gwema ukugcina lo muthi ezindaweni lapho ungathola khona umanzi noma ube manzi, njengasemagumbini okugeza.

Ukulahlwa

Uma ungasadingi ukuthatha iMavyret futhi unemithi esele, kubalulekile ukuyilahla ngokuphepha. Lokhu kusiza ukuvimbela abanye, kufaka phakathi izingane nezilwane ezifuywayo, ekuthatheni lesi sidakamizwa ngengozi. Kuyasiza futhi ukugcina umuthi ungalimazi imvelo.

Iwebhusayithi ye-FDA inikeza amathiphu amaningi awusizo ngokulahlwa kwemithi. Ungabuza futhi usokhemisi wakho imininingwane yokuthi ungayilahla kanjani imithi yakho.

Imininingwane yobungcweti kaMavyret

Imininingwane elandelayo inikezwa odokotela nabanye ochwepheshe bezempilo.

Izinkomba

I-Mavyret ikhonjisiwe ekwelapheni izakhi zofuzo ezingalapheki ze-hepatitis C (HCV) 1, 2, 3, 4, 5, no-6. IMavyret ivunyelwe ukusetshenziswa kubantu abadala nezingane ezineminyaka engu-12 nangaphezulu, noma labo abanesisindo okungenani esingu-45 kg.

Kufanele isetshenziswe kuphela kwiziguli ezingenayo i-cirrhosis, noma kulabo abane-cirrhosis enxephezelwe.

UMavyret uphinde wakhonjiswa ukwelapha ukutheleleka ngegciwane le-genotype 1 hepatitis C kubantu ukwelashwa kwabo kwangaphambilini akuphumelelanga. Lezi zindlela zokwelashwa zangaphambili kufanele zifake i-HCV NS5A inhibitor noma i-NS3 / 4A protease inhibitor.

IMavyret ayikhonjisiwe ukuthi ingasetshenziswa ezigulini ezelashwa kuqala ngaphambi kokwehluleka ukusebenzisa i-HCV NS5A inhibitor kanye ne-NS3 / 4A protease inhibitor.

Indlela yokusebenza

IMavyret iqukethe i-glecaprevir ne-pibrentasvir. Le mithi yimithi yokulwa namagciwane esebenza ngqo elwa ne-HCV.

IGlecaprevir iyi-NS3 / 4A protease inhibitor. Isebenza ngokukhomba i-NS3 / 4A protease, edingekayo ekuthuthukiseni igciwane le-hepatitis C.

IPibrentasvir iyi-NS5A inhibitor. Ngokuvimba i-NS5A, i-pibrentasvir empeleni imisa ukuphindaphindeka kwegciwane le-hepatitis C.

I-Mavyret iyasebenza ngokulwa ne-hepatitis C virus genotypes 1, 2, 3, 4, 5, no-6.

I-Pharmacokinetics ne-metabolism

Ocwaningweni olubandakanya abantu abangenayo i-HCV ababebhekwa njengabanempilo, ukumuncwa kweMavyret kuthinteke kakhulu ngokuba khona kokudla. Lapho kuthathwa ngokudla, ukumuncwa kwe-glecaprevir kukhuphuke ngo-83% kuya ku-163%. Ukuncishwa kwe-pibrentasvir kwandiswe ngama-40% kuya kuma-53%. Ngakho-ke, iMavyret inconywa ukuthi ithathwe ngokudla ukuze kuthuthukiswe ukumuncwa kwayo.

Ukuhlungwa okuphezulu kwe-plasma kwe-Mavyret kwenzeka cishe emahoreni ama-5 ngemuva komthamo. Ingxenye yempilo ye-glecaprevir ingamahora ayisithupha, kanti ingxenye yempilo ye-pibrentasvir ingamahora ayi-13.

IMavyret ikhishwa kakhulu ngomzila we-biliary-fecal. Iningi lakho kokubili i-glecaprevir ne-pibrentasvir kuboshwe amaprotheni e-plasma.

Izimo

IMavyret iyaphikiswa ezigulini ezinesifo esibi se-hepatic, esichazwa njengesikolo se-Child-Pugh C.

IMavyret nayo iyaphikiswa ezigulini ezithatha i-atazanavir noma i-rifampin. Ukuhlushwa kweMavyret kwehliswe kakhulu yi-rifampin, enganciphisa noma ivimbele umphumela wokwelapha weMavyret. I-Mavyret akufanele ithathwe nge-atazanavir ngoba inhlanganisela yezidakamizwa ingakhuphula amazinga e-alanine aminotransferase (ALT), okuholele engcupheni eyengeziwe yokwehluleka kwesibindi.

Isitoreji

I-Mavyret kufanele igcinwe ngaphakathi noma ngaphansi kuka-86 ° F (30 ° C) esitsheni esivaliwe, esomile.

Ukuzikhulula: IMedical News Namuhla yenze yonke imizamo yokuqinisekisa ukuthi yonke imininingwane iyiqiniso, iphelele futhi ihambisana nesikhathi. Kodwa-ke, le ndatshana akufanele isetshenziswe njengokungena esikhundleni solwazi nobungoti bochwepheshe bezokunakekelwa kwezempilo onelayisense. Kufanele uhlale uthintana nodokotela wakho noma omunye uchwepheshe wezokunakekelwa kwempilo ngaphambi kokuthatha noma imuphi umuthi. Imininingwane yezidakamizwa equkethwe lapha ingashintsha futhi ayihloselwe ukumboza konke ukusetshenziswa okungaba khona, izinkomba, izixwayiso, izexwayiso, ukuxhumana kwezidakamizwa, ukungezwani komzimba, noma imiphumela emibi. Ukungabikho kwezixwayiso noma olunye ulwazi lomuthi othile awukhombisi ukuthi inhlanganisela yezidakamizwa noma yezidakamizwa iphephile, iyasebenza, noma ilungele zonke iziguli noma konke ukusetshenziswa okuthile.

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