Umlobi: Laura McKinney
Usuku Lokudalwa: 4 Epreli 2021
Ukuvuselela Usuku: 17 Unovemba 2024
Anonim
All About Ninlaro (Ixazomib)
Ividiyo: All About Ninlaro (Ixazomib)

-Delile

Uyini uNinlaro?

INinlaro umuthi kadokotela osetshenziswa ukwelapha i-myeloma eminingi kubantu abadala. Lesi simo wuhlobo lomdlavuza olungandile oluthinta amaseli athile amhlophe egazi abizwa ngama-plasma cells. Ngama-myeloma amaningi, amangqamuzana ejwayelekile e-plasma aba nomdlavuza futhi abizwa ngokuthi amangqamuzana e-myeloma.

INinlaro ivunyelwe ukusetshenziswa kubantu asebevele bazame okungenani okunye ukwelashwa kwe-myeloma yabo eminingi. Lokhu kwelashwa kungaba yimithi noma inqubo.

UNinlaro ungowesigaba semithi ebizwa ngama-proteasome inhibitors. Kuyinto yokwelashwa okuqondisiwe kwe-myeloma eminingi. Izinhloso zeNinlaro (zisebenza) kwiprotheni ethile ngaphakathi kwamaseli we-myeloma. Kwakha amaprotheni amaningi kumaseli e-myeloma, okwenza lawo maseli afe.

UNinlaro uza njengamaphilisi athathwa ngomlomo. Uzothatha uNinlaro ngeminye imithi emibili ye-myeloma: i-lenalidomide (i-Revlimid) ne-dexamethasone (i-Decadron).

Ukusebenza ngempumelelo

Ngesikhathi sokufunda, uNinlaro wandise ubude besikhathi abanye abantu abane-myeloma eminingi abaphila ngaphandle kwesifo sabo siqhubeka (sibi kakhulu). Lobude besikhathi bubizwa ngokuthi ukusinda okungenayo inqubekela phambili.


Ucwaningo olulodwa lomtholampilo lubheke abantu abane-myeloma eminingi asebevele basebenzise enye indlela yokwelapha izifo zabo. Abantu babehlukaniswe ngamaqembu amabili. Iqembu lokuqala lanikwa uNinlaro ngazo zombili i-lenalidomide ne-dexamethasone. Iqembu lesibili lanikezwa i-placebo (ukwelashwa ngaphandle kwesidakamizwa esisebenzayo) ngazo zombili i-lenalidomide ne-dexamethasone.

Abantu abathathe inhlanganisela kaNinlaro baphila isilinganiso sezinyanga ezingama-20.6 ngaphambi kokuba i-myeloma yabo eminingi iqhubeke. Abantu abathatha inhlanganisela ye-placebo baphila isilinganiso sezinyanga eziyi-14.7 ngaphambi kokuthi i-myeloma yabo eminingi iqhubeke.

Kubantu abathathe inhlanganisela kaNinlaro, ama-78% aphendule ekwelashweni. Lokhu kusho ukuthi babe nokuthuthuka okungenani okungu-50% ezivivinyweni zabo zelebhu ezazifuna amaseli we-myeloma. Kulabo abathathe inhlanganisela ye-placebo, abantu abangama-72% babe nempendulo efanayo ekwelashweni.

I-Ninlaro ejwayelekile

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

UNinlaro uqukethe isithako esisodwa sezidakamizwa esisebenzayo: ixazomib.


Imiphumela emibi kaNinlaro

I-Ninlaro ingadala imiphumela emibi noma emibi. Uhlu olulandelayo luqukethe eminye yemiphumela emibi engaba khona ngenkathi uthatha uNinlaro. Lezi zinhlu azibandakanyi yonke imiphumela emibi engaba khona.

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

Imiphumela emibi ejwayelekile

Imiphumela emibi ejwayelekile yeNinlaro ingafaka:

  • ukuhlungu obusemhlane
  • ukungaboni kahle
  • amehlo omile
  • i-conjunctivitis (ebizwa nangokuthi i-pink eye)
  • i-shingles (i-herpes zoster virus), ebangela ukuqubuka okubuhlungu
  • i-neutropenia (izinga eliphansi lamaseli amhlophe egazi), elingakhuphula ubungozi bokutheleleka

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 kakhulu ingajwayelekile kuNinlaro. 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 kanye nezimpawu zayo zingafaka okulandelayo:

  • I-peripheral neuropathy (ukulimala kwezinzwa zakho). Izimpawu zingafaka:
    • ukuzwa noma ukushisa
    • ukuba ndikindiki
    • ubuhlungu
    • ubuthakathaka ezandleni noma emilenzeni yakho
  • Ukusabela okunamandla kwesikhumba. Izimpawu zingafaka:
    • ukuqubuka kwesikhumba okunamaqhuqhuva abomvu ngokusobala ngombala (obizwa ngeSweet's syndrome)
    • ukuqhuma kwesikhumba ngezindawo zokuxebuka nezilonda emlonyeni wakho (obizwa ngeStevens-Johnson syndrome)
  • I-Peripheral edema (ukuvuvukala). Izimpawu zingafaka:
    • amaqakala, izinyawo, imilenze, izingalo noma izandla ezivuvukile
    • ukuzuza kwesisindo
  • Ukulimala kwesibindi. Izimpawu zingafaka:
    • i-jaundice (okuphuzi kwesikhumba sakho noma okumhlophe kwamehlo akho)
    • ubuhlungu ohlangothini lokunene lwesisu sakho esiswini (esiswini)

Eminye imiphumela emibi emibi, echazwe kakhulu esigabeni se- "Side effect imininingwane" ngezansi, ingafaka:

  • i-thrombocytopenia (amazinga aphansi eplatelet)
  • izinkinga zokugaya ukudla ezifana nohudo, ukuqunjelwa, isicanucanu nokuhlanza

Imininingwane yomphumela oseceleni

Ungase uzibuze ukuthi kaningi kangakanani imiphumela emibi ethile eba khona ngalo muthi. Nayi imininingwane ngeminye imiphumela emibi engadalwa yilesi sidakamizwa.

I-Thrombocytopenia

Ungaba ne-thrombocytopenia (izinga eliphansi leplatelet) ngenkathi uthatha uNinlaro. Lokhu kwaba umphumela ojwayelekile kakhulu kaNinlaro phakathi nezifundo zokwelashwa.

Ngesikhathi sokufunda, abantu babehlukaniswe ngamaqembu amabili. Iqembu lokuqala lanikwa uNinlaro ngazo zombili i-lenalidomide ne-dexamethasone. Iqembu lesibili lanikezwa i-placebo (ukwelashwa ngaphandle kwesidakamizwa esisebenzayo) ngazo zombili i-lenalidomide ne-dexamethasone.

Kulabo abathatha inhlanganisela yeNinlaro, abantu abangama-78% babenamazinga aphansi eplatelet. Kulabo abathathe inhlanganisela ye-placebo, ama-54% ayenezinga eliphansi leplatelet.

Ezifundweni, abanye abantu babedinga ukumpontshelwa iplatelet ukwelapha i-thrombocytopenia yabo. Ngokumpontshelwa kweplatelet, uthola ama-platelet avela kumnikeli noma emzimbeni wakho (uma amaplatelet ayeqoqwe ngaphambilini). Kubantu abathatha inhlanganisela kaNinlaro, u-6% ubedinga ukumpontshelwa iplatelet. Kubantu abathatha inhlanganisela ye-placebo, u-5% wayedinga ukumpontshelwa iplatelet.

Ama-platelet asebenza emzimbeni wakho ukunqanda ukopha ngokusiza ukwakha amahlule egazi. Uma izinga lakho leplatelet liba liphansi kakhulu, ungahle ube nokopha okukhulu. Ngenkathi uthatha uNinlaro, kuzodingeka uhlolwe igazi njalo ukuze uhlole amazinga akho eplatelet.

Shayela udokotela wakho ngokushesha uma unezinye zalezi zimpawu zamazinga aphansi eplatelet:

  • ukulimaza kalula
  • ukopha kaningi kunokujwayelekile (njengokuphuma amakhala noma ukopha ezinsinini)

Uma izinga lakho leplatelet liba liphansi kakhulu, udokotela wakho anganciphisa isilinganiso sakho seNinlaro noma ancoma ukumpontshelwa kweplatelet. Bangase bakucele nokuthi uyeke ukuthatha uNinlaro isikhashana.

Izinkinga zokugaya ukudla

Ungahlangabezana nezinkinga ngesisu noma ngamathumbu ngenkathi uthatha uNinlaro. Phakathi nezifundo zokwelashwa zomuthi, abantu babejwayele ukuba nezinkinga zokugaya ukudla.

Ezifundweni, abantu babehlukaniswe ngamaqembu amabili. Iqembu lokuqala lanikwa uNinlaro ngazo zombili i-lenalidomide ne-dexamethasone. Iqembu lesibili lanikezwa i-placebo (ukwelashwa ngaphandle kwesidakamizwa esisebenzayo) ngazo zombili i-lenalidomide ne-dexamethasone. Imiphumela emibi elandelayo ibikwe ezifundweni:

  • isifo sohudo, esenzeke kubantu abangama-42% abathatha inhlanganisela yeNinlaro (futhi kubantu abangama-36% abathatha inhlanganisela ye-placebo)
  • ukuqunjelwa, okwenzeke kubantu abangama-34% abathatha inhlanganisela yeNinlaro (futhi kubantu abangama-25% abathatha inhlanganisela ye-placebo)
  • isicanucanu, esenzeke kubantu abangama-26% abathatha inhlanganisela yeNinlaro (futhi kubantu abangama-21% abathatha inhlanganisela ye-placebo)
  • ukuhlanza, okwenzeka kubantu abangama-22% abathatha inhlanganisela yeNinlaro (kwathi kubantu abangu-11% abathatha inhlanganisela ye-placebo)

Ukuphatha izinkinga zokugaya ukudla

Kubalulekile ukukhuluma nodokotela wakho mayelana nokuthi ungazisingatha kanjani lezi zinkinga. Ngaphandle kwalokho, zingaba zimbi.

Ukucanuzela kwenhliziyo nokuhlanza ngokuvamile kungavinjelwa noma kwelashwe ngokuthatha imithi ethile. Ngaphandle kokuthatha umuthi, kunezinye izinto ongazenza uma uzizwa unesicanucanu. Kwesinye isikhathi kuyasiza ukudla amanani amancane okudla kaningi, esikhundleni sokudla izidlo ezintathu ezinkulu usuku ngalunye. I-American Cancer Society inikeza amanye amathiphu amaningana okusiza ukuqeda isicanucanu.

Uhudo lungaphathwa ngemithi ethile, njenge-loperamide (Imodium). Futhi uma unesifo sohudo, qiniseka ukuthi uphuza uketshezi oluningi. Lokhu kuzokusiza ukuthi ugweme ukuthola amanzi emzimbeni (lapho umzimba wakho unamanani aphansi oketshezi).

Ungasiza ukuvimbela ukuqunjelwa ngokuphuza uketshezi oluningi, ngokudla ukudla okune-fiber eningi, nangokuzivocavoca umzimba (njengokuhamba).

Uma izinkinga zakho zokugaya ukudla ziba nzima, udokotela wakho anganciphisa isilinganiso sakho seNinlaro. Bangase bakucele nokuthi uyeke ukuthatha umuthi isikhashana.

Amaswazi

Ungaba nengozi eyengeziwe yokuqhamuka kwama-shingles (i-herpes zoster) ngenkathi uthatha uNinlaro. I-Shingles ukuqubuka kwesikhumba okudala izinhlungu ezivuthayo nezilonda eziqubukayo. Kubikwe kubantu abathatha uNinlaro phakathi nezifundo zokwelashwa.

Ababambe iqhaza bahlukaniswe ngamaqembu amabili. Iqembu lokuqala lanikwa uNinlaro ngazo zombili i-lenalidomide ne-dexamethasone. Iqembu lesibili lanikezwa i-placebo (ukwelashwa ngaphandle kwesidakamizwa esisebenzayo) ngazo zombili i-lenalidomide ne-dexamethasone.

Ngesikhathi kwenziwa ucwaningo, kubikwa ukuthi ama-shingles akwi-4% yabantu abathatha inhlanganisela yeNinlaro. Kulabo abathatha inhlanganisela ye-placebo, abantu abangu-2% babene-shingles.

Ungathuthukisa ama-shingles uma uke waba ne-chickenpox esikhathini esedlule. Ama-shingles ayenzeka lapho igciwane elibanga ingxibongo liphinde lisebenze (liqhume) ngaphakathi komzimba wakho. Lokhu kungqubuka kungenzeka uma amasosha akho omzimba engasebenzi njengoba ejwayele ukwenza, okuvame ukwenzeka kubantu abane-myeloma eminingi.

Uma uke waba ne-chickenpox esikhathini esedlule futhi usebenzisa i-Ninlaro, udokotela wakho angakunika umuthi wama-antiviral ongawuthatha ngenkathi usebenzisa uNinlaro. Imithi elwa namagciwane izosiza ukuvimbela ama-shingles ukuthi akhule emzimbeni wakho.

Umthamo weNinlaro

Isilinganiso se-Ninlaro udokotela wakho asinqumelayo sizoxhomeka ezicini eziningana. Lokhu kufaka phakathi:

  • ukuthi isibindi nezinso zakho zisebenza kahle kanjani
  • uma unemiphumela ethile emibi ethile evela ekwelashweni kwakho kwe-Ninlaro

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

INinlaro iza njengamaphilisi omlomo atholakala ngamandla amathathu: 2.3 mg, 3 mg, no-4 mg.

Isilinganiso se-myeloma eminingi

Umthamo ojwayelekile wokuqala weNinlaro ungomunye we-4-mg capsule othathwa kanye ngesonto amasonto amathathu. Lokhu kulandelwa yisonto elilodwa lokungawuthathi umuthi. Uzowuphinda lo mjikelezo wamaviki amane izikhathi eziningi njengoba udokotela wakho ancoma.

Ngesikhathi sokwelashwa, kufanele uthathe i-capsule yeNinlaro ngosuku olufanayo isonto ngalinye. Kungcono ukuthatha uNinlaro cishe ngesikhathi esifanayo sosuku kumthamo ngamunye. Kufanele uthathe uNinlaro esiswini esingenalutho, okungenani ihora elilodwa ngaphambi kokudla noma okungenani amahora amabili ngemuva kokudla.

Uzothatha uNinlaro ngokuhlangana neminye imithi emibili ye-myeloma: i-lenalidomide (i-Revlimid) ne-dexamethasone (i-Decadron). Le mithi inamashejuli ahlukene okwehlisa umthamo omkhulu kunoNinlaro. Qiniseka ukuthi ulandela imiyalo yesilinganiso enikezwe udokotela wakho ngakunye kwale mithi.

Kungcono ukuthi uhlelo lwakho lwesilinganiso lubhalwe phansi eshadini noma kukhalenda. Lokhu kukusiza ukuthi wazi yonke imishanguzo okudingeka uyiphuze nokuthi kunini lapho kufanele uyiphuze khona. Kungumqondo omuhle ukubheka umthamo ngamunye ngemuva kokuwuthatha.

Uma unezinkinga ngesibindi sakho noma izinso, udokotela wakho angancoma ukuthi uthathe umthamo ophansi weNinlaro. Udokotela wakho angaphinde anciphise umthamo wakho noma akucele ukuthi uthathe ikhefu ekwelashweni uma uthola imiphumela ethile engemihle kulesi sidakamizwa (njengezinga eliphansi leplatelet). Njalo thatha uNinlaro njengoba udokotela wakho ekuyalela.

Kuthiwani uma ngiphuthelwa umthamo?

Uma ukhohlwa ukuthatha umthamo weNinlaro, landela le miyalo:

  • Uma kukhona amahora angama-72 noma ngaphezulu kuze kufike isikhathi sokuthi umthamo wakho olandelayo ufanele, thatha umthamo wakho ongabanjwanga khona manjalo. Bese, thatha umthamo wakho olandelayo weNinlaro ngesikhathi esijwayelekile.
  • Uma kunamahora angaphansi kwama-72 kuze kufike umthamo wakho olandelayo, vele weqe umthamo ongabanjwanga. Thatha umthamo wakho olandelayo weNinlaro ngesikhathi esijwayelekile.

Ungalokothi uthathe umthamo ongaphezu kowodwa weNinlaro ukwenza umthamo ongabanjwanga. Ukwenza kanjalo kungandisa ingozi yemiphumela emibi.

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

Ngabe kuzodingeka ngisebenzise lesi sidakamizwa isikhathi eside?

I-Ninlaro yenzelwe ukuthi isetshenziswe njengokwelashwa kwesikhathi eside. Uma wena nodokotela wakho nibona ukuthi uNinlaro uphephile futhi uyasebenza kuwe, cishe uzothatha isikhathi eside.

Ezinye izindlela zikaNinlaro

Ezinye izidakamizwa ziyatholakala ezingelapha i-myeloma eminingi. Ezinye zingakulungela kangcono kunabanye. Uma unentshisekelo yokuthola enye indlela esikhundleni sikaNinlaro, khuluma nodokotela wakho. Bangakutshela ngeminye imithi engakusebenzela kahle.

Izibonelo zezinye izidakamizwa ezingasetshenziswa ukwelapha i-myeloma eminingi zifaka:

  • izidakamizwa ezithile ze-chemotherapy, njenge:
    • i-cyclophosphamide (iCytoxan)
    • i-doxorubicin (Doxil)
    • i-melphalan (Alkeran)
  • ama-corticosteroids athile, njenge:
    • i-dexamethasone (i-Decadron)
  • izindlela ezithile zokwelapha zokuzivikela emzimbeni (izidakamizwa ezisebenza namasosha omzimba wakho), njenge:
    • lenalidomide (Revlimid)
    • pomalidomide (Pomalyst)
    • thalidomide (Thalomid)
  • izindlela ezithile zokwelashwa ezihlosiwe, njenge:
    • i-bortezomib (Velcade)
    • i-carfilzomib (Kyprolis)
    • i-daratumumab (Darzalex)
    • i-elotuzumab (Empliciti)
    • i-panobinostat (Farydak)

INinlaro vs Velcade

Ungase uzibuze ukuthi uNinlaro uqhathanisa kanjani neminye imithi enqunyelwe ukusetshenziswa okufanayo. Lapha sibheka ukuthi iNinlaro neVelcade zifana kanjani futhi zehlukene kanjani.

Mayelana

INinlaro iqukethe ixazomib, kuyilapho iVelcade iqukethe i-bortezomib. Lezi zidakamizwa zombili izindlela zokwelashwa eziqondisiwe ze-myeloma eminingi. Bangaphansi kwesigaba semithi ebizwa nge-proteasome inhibitors. INinlaro neVelcade basebenza ngendlela efanayo ngaphakathi komzimba wakho.

Isebenzisa

UNinlaro uvunyelwe ukwelashwa yi-FDA:

  • i-myeloma eminingi kubantu abadala asebevele bazame okungenani enye indlela yokwelashwa kwesifo sabo. I-Ninlaro isetshenziswa ngokuhlanganiswa ne-lenalidomide (i-Revlimid) ne-dexamethasone (i-Decadron).

IVelcade yamukelwe ukwelashwa yi-FDA:

  • i-myeloma eminingi kubantu abadala:
    • angikaze ngithole ezinye izindlela zokwelapha izifo zawo; kulaba bantu, iVelcade isetshenziswa ngokuhlanganiswa ne-melphalan ne-prednisone
    • une-myeloma eminingi eye yabuya (ibuya) ngemuva kokwelashwa kwangaphambilini
    • mantle cell lymphoma (umdlavuza wama-lymph node) kubantu abadala

Amafomu wezidakamizwa nokuphathwa

UNinlaro uza njengamaphilisi athathwa ngomlomo. Imvamisa uzothatha i-capsule eyodwa isonto ngalinye amasonto amathathu. Lokhu kulandelwa yisonto elilodwa ngaphandle kokudla umuthi. Lo mjikelezo wamasonto amane uphindaphindwa kaningi njengoba udokotela wakho ancoma.

IVelcade iza njengesisombululo soketshezi esinikezwa ngomjovo. Unikezwa njengokujova ngaphansi kwesikhumba sakho (umjovo ongaphansi kwesikhumba) noma umjovo emthanjeni wakho (umjovo wemithambo). Uzothola lezi zindlela zokwelashwa ehhovisi likadokotela wakho.

Isikhathi sakho sokulinganisa seVelcade sizohluka ngokuya ngesimo sakho:

  • Uma i-myeloma yakho eminingi ingakaze yelashwe ngaphambili, kungenzeka usebenzise iVelcade isikhathi esingangonyaka. Ngokuvamile uzolandela umjikelezo wokwelashwa kwamasonto amathathu. Uzoqala ukwelashwa ngokuthola iVelcade kabili ngesonto amasonto amabili, kulandelwe iviki elilodwa kuphume umuthi. Le patheni izophindwa amaviki angama-24 esewonke. Ngemuva kwamasonto angama-24, uzothola iVelcade kanye ngesonto amasonto amabili, kulandele isonto elilodwa uphume kumuthi. Lokhu kuyaphindwa amasonto angama-30 esewonke.
  • Uma usebenzisa i-Velcade ngoba i-myeloma yakho eminingi ibuyile ngemuva kokunye ukwelashwa (ngeVelcade noma ezinye izidakamizwa), uhlelo lwakho lwesilinganiso lungahluka, kuye ngomlando wakho wokwelashwa.

Imiphumela emibi kanye nezingozi

INinlaro neVelcade zombili ziqukethe izidakamizwa ezivela ekilasini elilodwa. Ngakho-ke, yomibili le mithi ingadala imiphumela emibi efanayo. Ngezansi kunezibonelo zale miphumela emibi.

Imiphumela emibi ejwayelekile

Lezi zinhlu ziqukethe izibonelo zeminye imiphumela emibi ejwayelekile engenzeka ngeNinlaro, neVelcade, noma ngazo zombili izidakamizwa (uma zithathwa ngazodwana).

  • Kungenzeka ngeNinlaro:
    • amehlo omile
  • Kungenzeka ngeVelcade:
    • ubuhlungu bezinzwa
    • ukuzizwa ubuthakathaka noma ukhathele
    • imfiva
    • ukunciphisa ukudla
    • i-anemia (izinga eliphansi leseli elibomvu)
    • i-alopecia (ukulahleka kwezinwele)
  • Kungenzeka ngamabili uNinlaro neVelcade:
    • ukuhlungu obusemhlane
    • ukungaboni kahle
    • i-conjunctivitis (ebizwa nangokuthi i-pink eye)
    • ama-shingles (i-herpes zoster), abangela ukuqubuka okubuhlungu

Imiphumela emibi kakhulu

Lezi zinhlu ziqukethe izibonelo zemiphumela emibi engaba khona neNinlaro, neVelcade, noma ngazo zombili izidakamizwa (uma zithathwa ngazodwana). Iningi lalemiphumela emibi yenzeka kaningi kubantu abathatha le mithi.

  • Kungenzeka ngeNinlaro:
    • ukusabela okunzima kwesikhumba, kufaka phakathi i-Sweet's syndrome ne-Stevens-Johnson syndrome
  • Kungenzeka ngeVelcade:
    • umfutho wegazi ophansi (kungadala isiyezi noma ukuquleka)
    • izinkinga zenhliziyo, njengokuhluleka kwenhliziyo noma isigqi senhliziyo esingajwayelekile
    • Izinkinga zamaphaphu, njengesifo sokuphefumula, i-pneumonia, noma ukuvuvukala emaphashini akho
  • Kungenzeka ngamabili uNinlaro neVelcade:
    • i-edema yomngcele (ukuvuvukala emaqakaleni, ezinyaweni, emilenzeni, ezingalweni, noma ezandleni)
    • i-thrombocytopenia (izinga eliphansi leplatelet)
    • izinkinga zesisu noma zamathumbu, njengokuhuda, ukuqunjelwa, isicanucanu, noma ukugabha
    • izinkinga zemizwa, njengokushoshozela noma ukushisa imizwa, ukuba ndikindiki, ubuhlungu, noma ubuthakathaka ezingalweni noma emilenzeni
    • i-neutropenia (izinga eliphansi lamaseli amhlophe egazi), elingakhuphula ubungozi bokuthola izifo
    • ukulimala kwesibindi

Ukusebenza ngempumelelo

I-Ninlaro ne-Velcade zinokusetshenziswa okwehlukile okuvunyelwe yi-FDA, kodwa zombili zisetshenziselwa ukwelapha i-myeloma eminingi kubantu abadala.

Le mithi ayikaze iqhathaniswe ngqo ezifundweni zokwelashwa. Kodwa-ke, ucwaningo luye lwathola ukuthi bobabili uNinlaro noVelcade bayasebenza ekubambezeleni ukuqhubeka (okuba kubi kakhulu) kwe-myeloma eminingi. Zombili lezi zidakamizwa zinconyelwa imihlahlandlela yokwelashwa yamanje yokusetshenziswa kubantu abane-myeloma eminingi.

Kubantu abathile, imihlahlandlela yokwelashwa incoma ukusebenzisa uhlobo olususelwa eVelcade ngokusebenzisa inhlanganisela yeNinlaro ene-lenalidomide (Revlimid) ne-dexamethasone (Decadron). Lesi sincomo sifaka phakathi abantu abane-myeloma eminingi esebenzayo abaphathwa okokuqala. I-myeloma eminingi esebenzayo isho ukuthi umuntu unezimpawu zesifo, njengezinkinga zezinso, ukulimala kwethambo, i-anemia, noma ezinye izindaba.

Kubantu abane-myeloma eminingi ebuyile ngemuva kokunye ukwelashwa, imihlahlandlela incoma ukwelashwa ngeNinlaro noma iVelcade, ngokuhlangana nezinye izidakamizwa.

Izindleko

INinlaro neVelcade zombili izidakamizwa eziyigama. Okwamanje azikho izinhlobo ezijwayelekile zomuthi. Imithi enegama lomkhiqizo ivame ukubiza ngaphezu kwama-generic.

Ngokuya ngokulinganiselwa ku-WellRx.com, iVelcade ngokuvamile ibiza ngaphezu kukaNinlaro. Inani langempela ozolikhokhela noma imuphi umuthi lincike ohlelweni lwakho lomshuwalense, indawo okuyo nasekhemisi oyisebenzisayo.

Izindleko zikaNinlaro

Njengayo yonke imithi, izindleko zikaNinlaro zingahluka. Ukuthola izintengo zamanje zeNinlaro endaweni yangakini, hlola i-WellRx.com.

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

Usizo lwezezimali nolomshuwalense

Uma udinga ukwesekwa kwezezimali ukukhokhela uNinlaro, noma uma udinga usizo lokuqonda umshuwalense wakho, usizo luyatholakala.

AbakwaTakeda Pharmaceutical Company Limited, abakhiqizi bakwaNinlaro, banikela ngohlelo olubizwa ngeTakeda Oncology 1Point. Lolu hlelo lunikeza usizo futhi lungakwazi ukusiza ukwehlisa izindleko zokwelashwa kwakho. Ukuthola eminye imininingwane nokuthola ukuthi ukufanele yini ukwesekwa, shayela ku-844-817-6468 (844-T1POINT) noma vakashela iwebhusayithi yohlelo.

UNinlaro usebenzisa

Ukuphathwa Kwezokudla Nezidakamizwa (i-FDA) kuvumela imishanguzo kadokotela enjengeNinlaro ukwelapha izimo ezithile. INinlaro nayo ingasetshenziswa ngaphandle kwelebula ngezinye izimo. Ukusetshenziswa okungekho kwelebula kulapho umuthi ovunyelwe ukwelapha umbandela owodwa usetshenziselwa ukwelapha isimo esihlukile.

UNinlaro we-myeloma eminingi

INinlaro igunyazwe yi-FDA ukwelapha i-myeloma eminingi kubantu abadala asebevele bazame okungenani enye indlela yokwelashwa yalesi simo. Lokhu kwelashwa kungaba yimithi noma inqubo. INinlaro ivunyelwe ukusetshenziswa ngokuhlanganiswa nezinye izidakamizwa ezimbili: i-lenalidomide (Revlimid) ne-dexamethasone (i-Decadron).

I-myeloma eminingi uhlobo lomdlavuza olungavamile olutholakala kumaseli akho e-plasma. Lawa maseli awuhlobo lwamaseli amhlophe egazi. Zenziwe ngomnkantsha wakho wethambo, okuyizinto ezinesiponji ezitholakala ngaphakathi kwamathambo akho. Umnkantsha wakho wenza wonke amaseli akho egazi.

Kwesinye isikhathi amangqamuzana e-plasma aba ngendlela engajwayelekile futhi aqala ukwanda (enza amangqamuzana amaningi e-plasma) ngokungalawuleki. Lawa maseli e-plasma angajwayelekile, anomdlavuza abizwa ngokuthi amaseli e-myeloma.

Amaseli e-Myeloma angakhula ezindaweni eziningi (eziningana) zomnkantsha wakho nasemathanjeni amaningi ahlukene. Kungakho lesi simo sibizwa ngokuthi yi-multiple myeloma.

Amaseli we-myeloma athatha isikhala esiningi emnkantsheni wakho wethambo. Lokhu kwenza kube nzima ngomnkantsha wakho wokwenza amangqamuzana egazi anempilo anele. Amaseli we-myeloma nawo angalimaza amathambo akho, awenze buthaka.

Ukusebenza kwe-myeloma eminingi

Esifundweni somtholampilo, uNinlaro waphumelela ekwelapheni i-myeloma eminingi. Ucwaningo lubheke abantu abangama-722 abane-multiple myeloma asebevele benokunye okunye ukwelashwa kwalesi simo. Kulaba bantu, i-myeloma yabo eminingi ibiyekile ukuphendula (iba ngcono) kolunye ukwelashwa, noma ibuye ngemuva kokuthuthuka kokuqala nezinye izindlela zokwelashwa.

Kulolu cwaningo, abantu babehlukaniswe ngamaqembu amabili. Iqembu lokuqala lanikezwa uNinlaro neminye imithi emibili ye-myeloma: i-lenalidomide ne-dexamethasone. Iqembu lesibili lanikezwa i-placebo (ukwelashwa ngaphandle kwesidakamizwa esisebenzayo) nge-lenalidomide ne-dexamethasone.

Abantu abathathe inhlanganisela kaNinlaro baphila isilinganiso sezinyanga ezingama-20.6 ngaphambi kokuba i-myeloma yabo eminingi iqhubeke. Abantu abathatha inhlanganisela ye-placebo baphila isilinganiso sezinyanga eziyi-14.7 ngaphambi kokuba isifo sabo siqhubeke.

Amaphesenti ayisikhombisa nesishiyagalombili abantu abathathe inhlanganisela kaNinlaro baphendule ekwelashweni. Lokhu kusho ukuthi babe nokuthuthuka okungenani okungu-50% ezivivinyweni zabo zelebhu ezazifuna amaseli we-myeloma. Kulabo abathathe inhlanganisela ye-placebo, abantu abangama-72% babe nempendulo efanayo ekwelashweni.

Ukusetshenziswa okungekho kwelebula kuNinlaro

Ngaphezu kokusetshenziswa okubalwe ngenhla, uNinlaro angasetshenziselwa ilebula lokunye ukusetshenziswa. Ukusetshenziswa kwezidakamizwa ezingekho ilebula kulapho umuthi ovunyelwe ukusetshenziswa kokunye usetshenziselwa ukwelapha okuhlukile okungavunyelwe.

UNinlaro we-myeloma eminingi kwezinye izimo

INinlaro igunyazwe yi-FDA ukuthi isetshenziswe ne-lenalidomide ne-dexamethasone ukwelapha i-myeloma eminingi kubantu abake baba nezinye izindlela zokwelapha. Kufundwa njengenketho yokwelashwa kwezinye izimo ezibandakanya i-myeloma eminingi.

Kwenziwa ucwaningo ukubona ukuthi uNinlaro angasetshenziswa kanjani ngaphandle kwelebula kulezi zimo ezilandelayo:

  • ukwelapha izigaba ezahlukahlukene ze-myeloma eminingi
  • ngokuhlanganiswa nezinye izidakamizwa ngaphandle kwe-lenalidomide ne-dexamethasone yokwelapha i-myeloma eminingi

Ungahle unikezwe uNinlaro off-label ngenye yalezi zindlela.

I-Ninlaro ye-systemic light chain amyloidosis

UNinlaro akagunyaziwe yi-FDA ukwelapha i-systemic light chain amyloidosis. Kodwa-ke, kwesinye isikhathi kusetshenziswa ngaphandle kwelebuli ukwelapha lesi simo.

Lesi simo esingajwayelekile sithinta indlela amangqamuzana akho e-plasma (atholakala emnkantsheni wakho wethambo) akhiqiza amaprotheni athile abizwa ngama-light chain protein. Amakhophi angajwayelekile ala maprotheni angena egazini lakho futhi angakha izicubu nezitho emzimbeni wakho wonke. Njengoba amaprotheni akha, akha ama-amyloid (amaqoqo amaprotheni), angalimaza izitho ezithile njengenhliziyo noma izinso zakho.

INinlaro yafakwa ezinkombandlela zokwelashwa kwe-systemic light chain amyloidosis, ngemuva kocwaningo olutholile ukuthi iyasebenza ekwelapheni lesi simo. INinlaro iyindlela yokwelashwa kubantu abane-amyloidosis eyekile ukuphendula ekwelashweni kokuqala kokugunyazwa kwalesi simo. Futhi kuyindlela yokwelashwa kubantu abane-amyloidosis ebuyile ngemuva kokuthuthuka ngokwelashwa okugunyaziwe kokukhetha kokuqala.

INinlaro isetshenziswa yodwa noma ihlanganiswe ne-dexamethasone uma isetshenziselwa ukwelapha lesi sifo.

Ukusetshenziswa kukaNinlaro nezinye izidakamizwa

Imvamisa uzothatha i-Ninlaro ngokuhlangana nezinye izidakamizwa ezisebenza ngayinye ngezindlela ezahlukene ukwelapha i-myeloma yakho eminingi.

INinlaro ivunyelwe ukusetshenziswa ne-lenalidomide (Revlimid) ne-dexamethasone (Decadron). Ngesikhathi sezifundo zokwelashwa, ukwelashwa noNinlaro kuhlangene nale mithi kwakusebenza kangcono kunokusebenzisa nje i-lenalidomide ne-dexamethasone.

Udokotela wakho futhi angancoma ukuthi uthathe uNinlaro neminye imishanguzo eminingi ye-myeloma. Le yindlela engekho kwelebula yokusebenzisa uNinlaro. Ukusetshenziswa kwezidakamizwa ezingekho ilebula kulapho umuthi ovunyelwe ukusetshenziswa kokunye usetshenziselwa ukwelapha okuhlukile okungavunyelwe.

I-Ninlaro ene-lenalidomide (i-Revlimid)

I-Lenalidomide (i-Revlimid) isidakamizwa sokuzivikela emzimbeni. Lolu hlobo lomuthi lusebenza ngokusiza amasosha akho omzimba abulale amaseli we-myeloma.

I-Revlimid iza njengamaphilisi athathwa ngomlomo ahlanganiswe noNinlaro. Uzothatha iRevlimid kanye nsuku zonke amasonto amathathu, kulandelwe isonto elilodwa lokungawuthathi umuthi.

Ungathatha i-Revlimid ngokudla noma ngaphandle kokudla.

INinlaro ene-dexamethasone (i-Decadron)

I-Dexamethasone (i-Decadron) uhlobo lomuthi obizwa nge-corticosteroid. Le mithi isetshenziswa ikakhulu ukunciphisa ukuvuvukala (ukuvuvukala) emzimbeni wakho. Kodwa-ke, uma inikezwa ngemithamo ephansi yokwelashwa okuningi kwe-myeloma, i-dexamethasone isiza uNinlaro noRevlimid ukubulala amaseli e-myeloma.

I-Dexamethasone iza njengamaphilisi athathwa ngomlomo ahlanganiswe noNinlaro. Uzothatha i-dexamethasone kanye ngesonto, ngosuku olufanayo lwesonto othatha ngalo uNinlaro. Uzothatha i-dexamethasone masonto onke, kufaka phakathi isonto ongathathi ngalo uNinlaro.

Ungathathi umthamo wakho we-dexamethasone ngasikhathi sosuku njengoba uthatha umthamo wakho weNinlaro. Kungcono ukuthatha le mithi ngezikhathi ezahlukene zosuku.Lokhu kungenxa yokuthi i-dexamethasone idinga ukuphuzwa nokudla, kuyilapho uNinlaro kufanele adliwe esiswini esingenalutho.

UNinlaro notshwala

Utshwala abaziwa ukuthi buyathinta ukuthi uNinlaro usebenza kanjani emzimbeni wakho. Kodwa-ke, uma unemiphumela ethile engemihle evela kuNinlaro (njengesicanucanu noma isifo sohudo), ukuphuza utshwala kungenza le miphumela emibi ibe mibi kakhulu.

Uma uphuza utshwala, khuluma nodokotela wakho ngokuthi ungakanani utshwala obuphephile kuwe ngenkathi usebenzisa uNinlaro.

Ukusebenzisana kukaNinlaro

UNinlaro 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.

UNinlaro neminye imithi

Ngezansi kukhona uhlu lwemithi engasebenzisana noNinlaro. Lezi zinhlu azinazo zonke izidakamizwa ezingasebenzisana noNinlaro.

Ngaphambi kokuthatha uNinlaro, khuluma nodokotela wakho kanye 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.

I-Ninlaro nemithi ethile yesifo sofuba

Ukuthatha imishanguzo ethile yesifo sofuba noNinlaro kungehlisa izinga likaNinlaro emzimbeni wakho. Lokhu kungenza uNinlaro angasebenzi kahle kuwe. Kufanele ugweme ukuthatha le mithi elandelayo noNinlaro:

  • i-rifabutin (Mycobutin)
  • i-rifampin (Rifadin)
  • i-rifapentine (Priftin)

UNinlaro nezidakamizwa ezithile zokuquleka

Ukuthatha imishanguzo ethile yokubanjwa nge-Ninlaro kungehlisa izinga likaNinlaro emzimbeni wakho. Lokhu kungenza uNinlaro angasebenzi kahle kuwe. Kufanele ugweme ukuthatha le mithi elandelayo noNinlaro:

  • i-carbamazepine (Carbatrol, Equetro, Tegretol)
  • i-fosphenytoin (Cerebyx)
  • i-oxcarbazepine (i-Trileptal)
  • lindokuhle
  • i-phenytoin (Dilantin, Phenytek)
  • i-primidone (Mysoline)

I-Ninlaro namakhambi nezithako

UNinlaro angaxhumana namakhambi athile kanye nezithako, kufaka phakathi iSt. Qiniseka ukuthi uxoxa ngezithako ozithathayo nodokotela wakho ngaphambi kokuba uqale ukusebenzisa uNinlaro.

UNinlaro noSt

Ukuthatha i-wort yaseSt. John neNinlaro kungehlisa izinga leNinlaro emzimbeni wakho futhi kukwenze kungasebenzi kahle kuwe. Gwema ukuthatha lesi sengezo semithi (esibizwa nangokuthi I-Hypericum perforatum) ngenkathi usebenzisa uNinlaro.

Ungamthatha kanjani uNinlaro

Kufanele uthathe uNinlaro ngokwemiyalo kadokotela wakho noma yomhlinzeki wezokunakekelwa kwempilo.

Ukuthatha nini

Ngaphandle kokuthi udokotela wakho akutshele ngenye indlela, thatha umthamo wakho weNinlaro kanye ngesonto, ngosuku olufanayo ngesonto ngalinye. Kungcono ukuthatha imithamo yakho ngesikhathi esifanayo sosuku.

Uzothatha uNinlaro kanye ngesonto amasonto amathathu. Lapho-ke uzoba neviki ngaphandle kwesidakamizwa. Uzowuphinda lo mjikelezo wamaviki amane izikhathi eziningi njengoba udokotela wakho ancoma.

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

Ukuthatha uNinlaro ngokudla

Akufanele uthathe uNinlaro ngokudla. Kufanele kuthathwe esiswini esingenalutho ngoba ukudla kunganciphisa inani leNinlaro elisetshenziswa ngumzimba wakho. Lokhu kungenza uNinlaro angasebenzi kahle kuwe. Thatha umthamo ngamunye weNinlaro okungenani ihora elilodwa ngaphambi kokudla noma okungenani amahora amabili ngemuva kokudla.

Ngabe uNinlaro angachotshozwa, ahlukaniswe, noma ahlafunwe?

Cha, akufanele uchoboze, uvule, uhlukanise, noma uhlafune amaphilisi kaNinlaro. Ama-capsules enzelwe ukuthi agwinywe ngokuphelele ngesiphuzo samanzi.

Uma i-capsule kaNinlaro igqashuka ngephutha, gwema ukuthinta impushana engaphakathi kwe-capsule. Uma kukhona impuphu ethola isikhumba sakho, geza ngaso leso sikhathi ngensipho namanzi. Uma noma iyiphi impushana ingena emehlweni akho, yikhiphe ngamanzi ngokushesha.

Usebenza kanjani uNinlaro

UNinlaro uvunyelwe ukwelapha i-myeloma eminingi. Inikezwa ngeminye imithi emibili (i-lenalidomide ne-dexamethasone) eyisiza ukuthi isebenze ngaphakathi komzimba wakho.

Kwenzekani ku-myeloma eminingi

Maphakathi namathambo akho, kunento enesiponji ebizwa ngokuthi umnkantsha. Yilapho kwenziwa khona amaseli akho egazi, kufaka phakathi amangqamuzana akho amhlophe egazi. Amaseli egazi amhlophe alwa nezifo.

Kunezinhlobo eziningi ezahlukahlukene zamaseli amhlophe egazi. Uhlobo olulodwa lubizwa ngokuthi amaseli e-plasma. Amaseli e-Plasma enza amasosha omzimba, angamaprotheni asiza umzimba wakho ukuthi uqonde futhi uhlasele amagciwane, njengama-virus namagciwane.

Nge-myeloma eminingi, kwenziwa amangqamuzana e-plasma angajwayelekile emnkantsheni wakho wethambo. Baqala ukwanda (benze amaseli e-plasma amaningi) ngokungalawuleki. Lawa maseli e-plasma angajwayelekile, anomdlavuza abizwa ngokuthi amaseli e-myeloma.

Amaseli we-Myeloma athatha isikhala esiningi emnkantsheni wakho wethambo, okusho ukuthi kunesikhala esincane sokwenziwa kwamangqamuzana egazi anempilo. Amaseli we-myeloma nawo alimaza amathambo akho. Lokhu kudala ukuthi amathambo akho akhiphe i-calcium egazini lakho, okwenza amathambo akho abe ntekenteke.

Okwenziwa uNinlaro

UNinlaro usebenza ngokunciphisa inani lamaseli we-myeloma emnkantsheni wakho wethambo. Isidakamizwa sikhomba iprotheni ethile, ebizwa nge-proteasome, ngaphakathi kwamaseli we-myeloma.

Ama-Proteasomes adiliza amanye amaprotheni amaseli angasawadingi, kanye namaprotheni alimele. UNinlaro unamathela kuma-proteasomes futhi awavimbe ekusebenzeni kahle. Lokhu kuholela ekwakhiweni kwamaprotheni amaningi awonakele futhi angadingeki kumaseli we-myeloma, abangela ukuthi amangqamuzana e-myeloma afe.

Kuthatha isikhathi esingakanani ukusebenza?

UNinlaro uqala ukusebenza ngaphakathi komzimba wakho ngokushesha nje lapho uqala ukuwuthatha. Kepha kuzothatha isikhashana ukwakha imiphumela engaqashelwa, njengokuthuthuka kwezimpawu zakho noma imiphumela yokuhlolwa kwebhu.

Esifundweni somtholampilo, abantu abane-myeloma eminingi bathathe i-Ninlaro (ngokuhlanganiswa ne-lenalidomide ne-dexamethasone). Ingxenye yalaba bantu ibone ngcono esimeni sabo kungakapheli nenyanga lapho beqale ukuthatha uNinlaro.

UNinlaro nokukhulelwa

UNinlaro akazange afundwe kwabesifazane abakhulelwe. Kodwa-ke, indlela uNinlaro asebenza ngayo emzimbeni wakho kulindeleke ukuthi ibe yingozi ekukhulelweni okusakhulayo.

Ezifundweni zezilwane, lesi sidakamizwa sabangela ukulimala emibungwini lapho sinikezwa izilwane ezikhulelwe. Ngenkathi izifundo zezilwane zingahlali zibikezela ukuthi kuzokwenzekani kubantu, lezi zifundo ziphakamisa ukuthi umuthi ungalimaza ukukhulelwa komuntu.

Uma ukhulelwe, noma kungenzeka ukhulelwe, khuluma nodokotela wakho ngobungozi kanye nezinzuzo zokuthatha uNinlaro.

UNinlaro nokulawulwa kokuzalwa

Ngoba uNinlaro angalimaza ukukhulelwa okusakhulayo, kubalulekile ukusebenzisa ukulawulwa kokubeletha ngenkathi uthatha lo muthi.

Ukulawulwa kokuzalwa kwabesifazane

Uma ungowesifazane okwaziyo ukukhulelwa, kufanele usebenzise ukulawulwa kokubeletha okusebenzayo ngenkathi uthatha uNinlaro. Kufanele uqhubeke nokulawula ukubeletha okungenani izinsuku ezingama-90 ngemuva kokuyeka ukuthatha uNinlaro.

I-Ninlaro ithathwa ihlanganiswe ne-lenalidomide ne-dexamethasone yokwelashwa okuningi kwe-myeloma. I-Dexamethasone ingenza ukulawulwa kokuzalwa kwe-hormonal, kufaka phakathi amaphilisi okulawula ukubeletha, angasebenzi kahle ukuvimbela ukukhulelwa. Uma usebenzisa ukulawulwa kokubeletha kwe-hormonal, kufanele futhi usebenzise umuthi wokuvimbela inzalo (njengamakhondomu) njengokulawula ukubeletha okuyisipele.

Ukulawulwa kokuzalwa kwabesilisa

Uma ungowesilisa ohlanganyela ocansini nowesifazane ongakhulelwa, kufanele usebenzise ukulawulwa kokubeletha okusebenzayo (njengamakhondomu) ngenkathi uthatha uNinlaro. Lokhu kubalulekile, noma ngabe umlingani wakho wesifazane esebenzisa izindlela zokuvimbela inzalo. Kufanele uqhubeke usebenzisa ukulawulwa kokuzalwa okungenani izinsuku ezingama-90 ngemuva komthamo wakho wokugcina weNinlaro.

UNinlaro nokuncelisa

Akwaziwa ukuthi uNinlaro udlulela ebisini lwebele, noma uma kuthinta indlela umzimba wakho owenza ngayo ubisi lwebele. Kufanele ugweme ukuncelisa ngenkathi uthatha uNinlaro. Ungancelisi ibele okungenani izinsuku ezingama-90 ngemuva kokuyeka ukuthatha uNinlaro.

Imibuzo ejwayelekile ngoNinlaro

Nazi izimpendulo zemibuzo ebuzwa njalo mayelana noNinlaro.

Ngabe uNinlaro uhlobo lwe-chemotherapy?

Cha, uNinlaro akuyona uhlobo lwe-chemotherapy. I-Chemotherapy isebenza ngokubulala amaseli emzimbeni wakho ayanda (enza amaseli amaningi) ngokushesha. Lokhu kufaka phakathi amaseli aphilile, kanye namaseli womdlavuza. Ngoba i-chemotherapy ithinta amanye amaseli akho aphilile, ingaba nemiphumela emibi kakhulu.

I-Ninlaro yindlela yokwelashwa ehlosiwe ye-myeloma eminingi. Izindlela zokwelashwa ezihlosiwe zisebenza kuzici ezithile kumaseli womdlavuza ahlukile kunalawo akumaseli anempilo. UNinlaro uhlose amaprotheni athile abizwa ngama-proteasomes.

Ama-Proteasomes ayabandakanyeka ekukhuleni okujwayelekile nasekukhiqizeni amaseli. Lawa maprotheni asebenza kakhulu kumaseli omdlavuza kunamaseli anempilo. Lokhu kusho ukuthi lapho uNinlaro ehlose ama-proteasomes, athinta amangqamuzana e-myeloma ngaphezu kokuthinta amaseli anempilo.

INinlaro isengawathinta amaseli anempilo futhi ingadala nemiphumela emibi ethile. Kodwa-ke, ngokuvamile, izindlela zokwelashwa ezihlosiwe (njengeNinlaro) zivame ukudala imiphumela emibi embalwa kunezidakamizwa ezijwayelekile zamakhemikhali.

Ngingayithatha yini i-Ninlaro ngaphambi noma ngemuva kokufakwa kwesitokisi?

Ungahle ukwazi. INinlaro ivunyelwe ukusetshenziswa kubantu asebethole okungenani okunye ukwelashwa kwe-myeloma yabo eminingi. Lokhu kufaka phakathi abantu abaye bafakelwa i-stem cell njengokwelashwa.

Ama-stem cell amangqamuzana egazi angavuthiwe atholakala egazini lakho nasemnkantsheni wakho wethambo. Zingakhula zibe zonke izinhlobo zamaseli egazi. Ukufakelwa kwe-stem cell kuyindlela yokwelapha i-myeloma eminingi. Ihlose ukufaka amaseli we-myeloma ngamaseli we-stem anempilo, angahle akhule abe ngamaseli egazi aphilile.

Imihlahlandlela yamanje yomtholampilo ifaka uNinlaro njengenketho yokwelashwa (yesikhathi eside) yokunqanda amangqamuzana omdlavuza ukuthi angaziphindaphindeki ngemuva kokuthwalwa kabusha kwe-stem cell. (Kule nqubo, ama-stem cells akho aqoqwa egazini lakho noma emnkantsheni wethambo bese ubuyiselwa kuwe lapho ufakelwa.) Kodwa-ke, eminye imithi iyathandwa ngaphezu kukaNinlaro kuleli cala.

Imihlahlandlela yamanje yomtholampilo ifaka phakathi uNinlaro njengenketho yokwelashwa kokuqala kwezidakamizwa onayo nge-myeloma yakho eminingi, ngaphambi kokufakelwa kwe-stem cell. Kodwa-ke, ezinye izidakamizwa zikhethwa ngaphezu kukaNinlaro kuleli cala. Lokhu kungaba ukusetshenziswa okungekho kwelebula kukaNinlaro. Ukusetshenziswa kwezidakamizwa ezingekho ilebula kulapho umuthi ovunyelwe ukusetshenziswa kokunye usetshenziselwa ukwelapha okuhlukile okungavunyelwe.

Uma ngihlanza ngemuva kokuthatha umthamo, kufanele ngiphuze omunye umthamo?

Uma uhlanza ngemuva kokuthatha uNinlaro, ungathathi omunye umthamo womuthi ngalolo suku. Mane uthathe umthamo wakho olandelayo uma usudinga ukuhlelwa kwesilinganiso sakho.

Uma uvame ukuphonsa phezulu ngenkathi uthatha uNinlaro, khuluma nodokotela wakho. Bangase bakunikeze imithi yokusiza ukunciphisa isicanucanu noma bakunikeze amathiphu okuthi ungakulawula kanjani ukucanuzela kwenhliziyo ngesikhathi sokwelashwa.

Ngabe ngizodinga izivivinyo zelebhu ngenkathi ngithatha uNinlaro?

Yebo. Ngenkathi uthatha uNinlaro, kuzodingeka ukuthi uhlolwe igazi njalo ukuze ubheke amazinga wamangqamuzana egazi nokusebenza kwesibindi sakho. Ngesikhathi sokwelashwa, udokotela wakho uzohlola lezi zivivinyo ezilandelayo ngqo:

  • Izinga leplatelet. UNinlaro angehlisa izinga leplatelet yakho. Uma izinga lakho lehla kakhulu, ungaba nengozi eyengeziwe yokopha kakhulu. Udokotela wakho uzohlola ukubalwa kwama-platelet akho njalo, ukuze kuthi uma kutholakala izinkinga, zisheshe zibhekwane nazo. Uma amazinga akho ephansi, udokotela wakho anganciphisa isilinganiso sakho seNinlaro noma uyeke ukuthatha iNinlaro kuze kube yilapho amaplatelet akho ebuyela ezingeni eliphephile. Kwesinye isikhathi, ungadinga ukumpontshelwa ukuthola ama-platelet.
  • Izinga lamangqamuzana amhlophe egazi. Esinye sezidakamizwa (esibizwa ngeRevlimid) ozosithatha noNinlaro singanciphisa izinga lakho lamaseli amhlophe egazi, okungakhuphula ubungozi bokuthola izifo. Uma unamazinga aphansi ala maseli, udokotela wakho angakunciphisa isilinganiso sakho se-Revlimid ne-Ninlaro, noma uyeke ukuthatha le mithi, kuze kube yilapho amangqamuzana akho amhlophe egazi ebuyela ezingeni eliphephile.
  • Ukuhlolwa kokusebenza kwesibindi. INinlaro kwesinye isikhathi ingalimaza isibindi sakho, ibangele ukuthi ama-enzyme wesibindi akhishwe egazini lakho. Ukuhlolwa kwesibindi kuhlola igazi lakho ukuthola la ma-enzyme. Uma izivivinyo zibonisa ukuthi uNinlaro uthinta isibindi sakho, udokotela wakho angehlisa isilinganiso sakho somuthi.
  • Okunye ukuhlolwa kwegazi. Uzophinde ube nokunye ukuhlolwa kwegazi ukubheka ukuthi i-myeloma yakho eminingi isabela kanjani ekwelashweni ngoNinlaro.

Ukuqapha kukaNinlaro

Ngaphambi kokuthatha uNinlaro, khuluma nodokotela wakho ngomlando wakho wezempilo. UNinlaro kungenzeka angakulungeli uma unezimo ezithile zezokwelapha. Lokhu kufaka phakathi:

  • Izinkinga zezinso. Uma umsebenzi wakho wezinso ukhubazeke kakhulu, noma uma uthola ukwelashwa kwe-hemodialysis yokwehluleka kwezinso, udokotela wakho uzokunikeza isilinganiso esincane seNinlaro.
  • Izinkinga zesibindi. UNinlaro angadala izinkinga zesibindi. Futhi uma unokulimala kwesibindi, ukuthatha uNinlaro kungasenza sibe sibi isimo sakho. Uma unezinkinga zesibindi ezinesilinganiso esilinganiselwe kuya kwesinzima, udokotela wakho uzokunikeza isilinganiso esincane seNinlaro.
  • Ukukhulelwa. Uma ukhulelwe noma kungenzeka ukhulelwe, uNinlaro angaba yingozi ekukhulelweni kwakho. Uma wena noma umlingani wakho nikwazi ukukhulelwa, kufanele nisebenzise ukulawulwa kokubeletha ngenkathi nithatha uNinlaro. Ngemininingwane engaphezulu, sicela ubheke isigaba “sikaNinlaro nokukhulelwa” kanye nesigaba esithi “Ninlaro nokulawulwa kokuzalwa” ngenhla.

Qaphela: Ukuthola eminye imininingwane ngemiphumela emibi engaba khona yeNinlaro, bheka isigaba "semiphumela emibi kaNinlaro" ngenhla.

Ukudlula ngokweqile kukaNinlaro

Ukuthatha okungaphezu kwesilinganiso esinconyiwe sikaNinlaro kungaholela emiphumeleni emibi kakhulu. Ukuthola uhla lwemiphumela engemihle ebangelwe nguNinlaro, sicela ubheke isigaba “semiphumela engemihle yeNinlaro” ngenhla.

Izimpawu zokudlula ngokweqile

Izimpawu zokweqisa izidakamizwa zingafaka ukwanda kunoma yimiphi imiphumela engemihle yeNinlaro. Ukuthola uhla lwemiphumela engemihle, sicela ubheke isigaba "semiphumela emibi yeNinlaro" ngenhla.

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 kukaNinlaro, ukugcina nokulahla

Uma uthola uNinlaro ekhemisi, usokhemisi uzokwengeza usuku lokuphelelwa yisikhathi kwilebuli esephakeji lemithi. Lolu suku luvame ukuba unyaka owodwa kusukela ngosuku abanikeze ngalo umuthi. Ungamthathi uNinlaro uma usuku lokuphelelwa isikhathi oluprintiwe seludlulile.

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.

Ama-capsules kaNinlaro kufanele agcinwe emaphaketheni awo okuqala. Zigcine ekamelweni lokushisa kude nokukhanya. INinlaro akufanele igcinwe ezingeni lokushisa elingaphezu kuka-86 ° F (30 ° C).

Gwema ukugcina lo muthi ezindaweni lapho ungathola khona umanzi noma ube manzi, njengasemagumbini okugeza.

Ukulahlwa

Uma ungasadingi ukuthatha i-Ninlaro 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 yezobuchwepheshe kaNinlaro

Imininingwane elandelayo inikezwa odokotela nabanye ochwepheshe bezempilo.

Izinkomba

UNinlaro uvunyelwe ukwelapha i-myeloma eminingi, esetshenziswa ngokuhlanganiswa ne-lenalidomide ne-dexamethasone, kubantu abadala asebethole okungenani okunye ukwelashwa kwalesi simo.

Ukuphepha nokusebenza ngempumelelo kukaNinlaro akukasungulwa ezinganeni.

Indlela yokusebenza

INinlaro iqukethe ixazomib, i-proteasome inhibitor. Ama-Proteasomes anendima enkulu ekuqhekekeni amaprotheni abandakanyeka ekulawulweni komjikelezo weseli, ukulungiswa kwe-DNA kanye ne-apoptosis. Ixazulula ibopha futhi ivimbele ukusebenza kwe-beta 5 subunit yengxenye eyinhloko ye-20S ye-26S proteasome.

Ngokuphazamisa umsebenzi we-proteasome, ixazomib ibangela ukwakheka kwamaprotheni amaningi okweqile noma okonakele ngaphakathi kweseli, okuholela ekufeni kweseli.

Umsebenzi weProteasome uyanda kumaseli amabi uma kuqhathaniswa namaseli anempilo. Amaseli amaningi e-myeloma asengozini enkulu yemiphumela ye-proteasome inhibitors kunamaseli aphilile.

I-Pharmacokinetics ne-metabolism

Okushiwo ukutholakala kwe-ixazomib kungu-58% ngemuva kokuphathwa ngomlomo. Ukutholakala kwe-bioavailability kuyancipha lapho umuthi uthathwa ngesidlo esinamafutha amaningi. Kulokhu, indawo engaphansi kwejika (AUC) ye-ixazomib yehliswe ngama-28%, futhi ukuhlushwa kwayo okuphezulu (i-Cmax) kwehle ngama-69%. Ngakho-ke, ixazomib kufanele inikezwe esiswini esingenalutho.

I-Ixazomib iboshwe ngama-99% kumaprotheni e-plasma.

Ixazomib isuswa ngokuyinhloko yi-metabolism ye-hepatic ehilela ama-enzyme amaningi we-CYP namaprotheni angewona ama-CYP. Iningi lama-metabolite alo akhishwa emchameni, amanye akhishwe endle. Isigamu sempilo izinsuku ezingama-9.5.

Ukwanda kokukhubazeka kwe-hepatic okulingene kuya kokunzima kusho ixazomib AUC ngama-20% ngaphezulu kwe-AUC esencane eyenzeka ngomsebenzi ojwayelekile we-hepatic.

I-Mean ixazomib AUC inyuswa ngama-39% kubantu abanokukhubazeka okukhulu kwezinso noma isifo sesifo sesigaba sokugcina esidinga i-dialysis. Ixazulula i-ixazomib.

Ukususwa akuthinteki kakhulu ngeminyaka yobudala, ubulili, ubuhlanga, noma indawo yomzimba. Izifundo zikaNinlaro zazifaka abantu abaneminyaka engama-23 kuye kwengama-91, nalabo abanezindawo zomzimba ezisukela ku-1.2 kuye ku-2.7 m².

Izimo

Akukho ukuphikisana kukaNinlaro. Kodwa-ke, ubuthi obuhlobene nokwelashwa obufana ne-neutropenia, thrombocytopenia, ukukhubazeka kwe-hepatic, ukuqubuka kwesikhumba, noma i-peripheral neuropathy kungadinga ukuphazanyiswa kokwelashwa.

Isitoreji

Ama-capsules kaNinlaro kufanele agcinwe emaphaketheni awo okuqala ekamelweni lokushisa. Akufanele zigcinwe emazingeni okushisa angaphezu kuka-86 ° F (30 ° C).

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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