Yintoni iXarelto?

Ulwazi lweziyobisi

Nokuba ufuna iyeza lasemva kotyando ukunqandaamahlwili egaziokanye ukunciphisa umngcipheko obangelwai-fibrillation ye-atrial,Xareltosisiyobisi esiqhelekileyo esisetyenziswa njengeanticoagulant. Ukucoca igazi ngokuthe ngqo ngomlomoanticoagulantkunciphisaumngcipheko wamahlwili egazikubangelwa ziingxaki ezahlukeneyo, kubandakanya isifo semithambo kunyeUkunyanzelwa kwemiphunga.

Nceda ufunde ngezantsi ukuze ufumane ulwazi oluthe kratyaXarelto, idosi kunyeimiphumela, kwaye ithelekiswa njani namanye amayeza okusika igazi kwimarike.

Yintoni iXarelto, kwaye isetyenziselwa ntoni?

Xarelto yenye yezinto zamva njeigama lebrandamayeza okujoyina uluhlu lokukhulaanticoagulantiziyobisi.Xareltoisetyenziswa kakuhle ukuthintelaukujiyaezinxulumene nentliziyo kwayeivazi yegaziiimeko.Ukhathalelo lwempiloiingcali kwilizwe liphela zimisele ngaphezulu kwe Amaxesha angama-40 ezigidi kwabo bafuna amayeza ukuze banciphiseihlwili legaziumngcipheko.

Xareltoikwaziwa njenge irivaroxaban powder , kwaye akukho luhlobo luqhelekileyo lwesiyobisi.IRivaroxaban powderyiInto sele ikhona Isithintelokwaye yahlelwa njengeanticoagulant. Eli chiza lenziwa nguJanssen Pharmaceuticals kwaye lunyango kuphela lonyango.

Kuyanceda abo baneentliziyo ezahlukeneyo kunyeivazi yegaziiimeko, kubandakanya:

• I-fibrillation ye-Atriyaokanyeukubetha kwentliziyo ngokungaqhelekanga
• Imithambo yegazi
• I-vein thrombosis enzulu(umngcipheko oqhelekileyo emva kwenyonga kunyeukuhlinzwa emadolweni)
• Imithambo yegazi lomda
• Ukudibanisa iipulmonary
• Utyando / ukungalaliswa esibhedlele

IntshutshisongeXarelto

Iimeko ezahlukeneyo zibeka abaguli emngciphekweni wokuukujiya kwegazi, ukusukai-fibrillation ye-atrialkuqhaqho oluthile.I-Anticoagulantamayeza abalulekile ekunciphiseni umngcipheko. Ezilandelayoiimeko zonyangozihlala ziphathwaukujiya kwegaziusebenzisa ianticoagulantnjengeXarelto:

I-vein thrombosis enzulu

UKUYAihlwili legaziUkubumba kwimithambo enzulu ebangelai-vein thrombosis enzulu(I-DVT), imilenze okanye isinqe. Imiba yomngciphekoI-DVTzibandakanya :

• Ukophuka okanye ukwenzakala kwemisipha kubandakanya imithambo
• Utyando olukhulu (ngakumbi idolo /uqhaqho endaweni yomlenze)
• Ukuhamba kwegazi kancinci
• Ukunyusa amanqanaba e-estrogen
• Isifo sentliziyo / semiphunga
• Umhlaza
• Imbali yosapho

Ukuba ishiywe inganyangwa,I-DVTkunokubangela ukukhubazeka, ukugula kakhulu, kwaye kwiimeko ezinzima, ukufa.Ukhathalelo lwempiloababoneleli bayalelaXareltokwizigulana ezikwiumngcipheko omkhuluzokuphuhlisaI-DVT.Xareltoliya kunciphisa igazi, lenze ukuhamba okungcono kwimithambo.

Xa iI-DVTuhamba ngegazi ungena emiphungeni, ibhloko ebizwa ngokuba ngu Ukunyanzelwa kwemiphunga (PE) iyenzeka.XareltoIngasetyenziselwa ukukhusela nokunyanga ii-PEs.

I-fibrillation ye-Atriya

Eyaziwa ngokuba yi-AFib, i-fibrillation ye-atrial yenye yezona ziphathwa kakhuluukubetha kwentliziyo ngokungaqhelekangaiimeko. Umntu one-AFib ubetha ngokungaqhelekanga kumagumbi aphezulu entliziyo, ebangela ukungabikho kwegazi elifanelekileyo.

Izigulana ezine-AFib zisemngciphekweni ophezulu wokubaamahlwili egazingenxa yokuhamba kwegazi elibuthathaka ukuya nokuphuma entliziyweni. Ukunciphisa umngcipheko, oogqirha baya kumiselaabacoci gazinjengeXareltokwabo bane-AFib.

Emva kotyando

Olunye utyando olufana nedolo kwayeukutshintshwa kwe-hipbeze notyando lwasemva kotyandoumngcipheko wamahlwili egazi. Oogqirha banokumiselaXareltoemva kotyando ukunqanda iingxaki ezinkulu.

Ingaba kwenzeka njaniXareltoUmsebenzi?

Xarelto(irivaroxaban powdericothaukujiya kwegazingokumisa ethileukujiyaInto ebizwa ngokuba yiXa. Ngokwesiqhelo, ukwenziwa kusebenze kweXa yinxalenye yecascade ethi ekugqibeleni idaleamahlwili egazi.IRivaroxaban powderyiarhente eya kusebenza ukuthintela ukwenziwa kwe-Xa factor, ekugqibeleni kugcinwe igazi kuyoukujiya.

Yomelela idosi yeirivaroxaban powder, isithintelo ngakumbi sikwi-Xa factor. Umthamo owandisiweyo uya kuyeka ekugqibeleni amandla e-Xa ekuncedeni ukuvelisaukujiya.

Indlela yokuthathaXarelto

Xareltoiyafumaneka kwifom yeethebhulethi kwaye iidosi ziyahluka ngokuxhomekeka kunyango kunye nobukhali beukujiyaumngcipheko. Kuxhomekeke kwiimfuno,Xareltoiipilisi ziza ngamandla amane:

• 2.5 mg
• 10 mg
• 15 mg
• 20 mg

Iyeza liya kuqala ukucoca igazi kwiiyure ezimbalwa emva kokuthatha idosi yokuqala. Ukuba isiguli siyayeka ukusithatha,Xareltoziya kuphela kwiyure ezingama-24. Landela imiyalelo kagqirha kunye nemiyalelo enikwe kunyeXareltomalunga nendlela yokuthatha amayeza.

Le theyibhile ilandelayo ichaza iidosi ezisemgangathweni ezimiselwe iimeko ezahlukeneyo:

Imeko	Xarelto umthamo (mg)	Rhoqo
AFib	15-20 mg	Kanye ngemini (ngokutya)
I-DVT/ Unyango lwe-PE	15-20 mg	I-15 mg kabini ngemini ngokutya kweentsuku ezingama-21, kunye ne-20 mg kanye ngemini ngokutya
I-DVT/ Ukuncitshiswa komngcipheko we-PE	10 mg	Kanye ngosuku
Isifo seCoronary / Pulmonary Artery Disease	2.5 mg	Kabini ngosuku, kudityaniswe neasprini

UkusukelaXareltoihlala ithathwa kanye okanye kabini ngemini, kukhuselekile ukuyithatha yonke imihla ngaphandle kokuba uxelelwe ngenye indlela nguukhathalelo lwempiloumboneleli omisela ipilisi.

Ukuba unengxaki yokuginya iipilisi, unokuyityumzaXareltoiipilisi uze uzixube nokutya okuthambileyo okutyiwa, njengeapilesauce, kwangoko ngaphambi kokusetyenziswa. Nangona kunjalo, kungangcono ukuba wenze oku njengoko kufanelekile. Ukuba kunokwenzeka, ginya ipilisi yonke.

Iidosi ezisezantsi (2.5 kunye ne-10 mg) yeXareltoingathathwa ngaphandle kokutya, kodwa kuyacetyiswa ukuba kubathathe kunye nokutya ukuba kunokwenzeka. Ukuba ukumiselwa kwepilisi enye kusuku ngalunye, kuyacetyiswa ukuyithatha ngesidlo sangokuhlwa. Ukuba uthathwe kabini ngemini, oogqirha bacebisa ukuyithatha ngesidlo sakusasa kunyeisidlo sangokuhlwa.

Ukuba uphose idosiXareltokwaye uthatha i-15 mg kabini kwirejimeni yemihla ngemihla, thatha idosi ngokukhawuleza nje ukuba ukhumbule kwangolo suku lunye ukuqinisekisa ukuba i-30 mg iyadliwa. Ukuba uphosa idosi kwaye uthatha i-2.5 mg kabini yonke imihla, tsiba idosi ephosiweyo kwaye uphinde usebenzise idosi ngexesha elimiselweyo. Olunye uhlobo lweXarelto kanye yonke imihla, thabatha idosi ephosiweyo kwakamsinya nje ukuba ukhunjulwe kwaye uphinde uqalise iidosi ngesiqhelo ngosuku olulandelayo. Ukuba ulibale ukuyithatha ngaphezulu kweeyure ezingama-24, nxibelelana neukhathalelo lwempiloumboneleli okanye usokhemesti wemiyalelo.

Kubalulekile ukuba ungaze uyeke ukuthathaXareltongaphandle kwemvume kagqirha.Xareltokunokubangela iingxaki ukuba ziyekwe ngesiquphe, ke oogqirha kufuneka bancede abaguli abalunyulweyo ngaphandle kwesiyobisi.

Kunokubakho iimpawu zokurhoxa emva kokuyekaXarelto. Iimpawu zinokwenzeka ngaphakathi kweeyure eziyi-12 ukuya kwezi-24 kodwa ziya kuyeka kwisithuba seveki. Iimpawu zokurhoxa kwiXareltoingaquka:

• Intloko ebuhlungu
• Ukuba nesiyezi kunye isicaphucaphu
• Ukudinwa
• Ukubetha kwentliziyo
• Igazi elonyukayo

Kuyenzeka ukuba ubambe ngaphezuluXarelto, kwaye iziphumo zinokubulala. Ukuba isigulana sitya ngaphezuluirivaroxaban powderNgaphezulu kokumiselweyo, banokuphuhlisa ukopha kakhulu. Esi yingxaki enokubulala.

Xareltoayizi nemiyalelo ethile yokugcina iyeza. Izigulana kufuneka zigcine iipilisiubushushu begumbikwaye kude nokufuma kunye nobushushu obuphezulu. Iyeza kufuneka ligcinwe kude kufikeleleke kubantwana abancinci, kunye nokwahlulwa kwamanye amayeza (ngokukhethekileyo kwibhotile yayo) ukunqanda ukungenisa ngengozi.

Xareltoulwazi lokhuseleko

Jonga apha ngezantsi ngolwazi olubalulekileyo lokhuseleko ngokubhekiseleXarelto.

Izithintelo

Xareltokufuneka ithathwe kuphela ngabo bafuna ukunciphisaihlwili legaziumngcipheko osuka kwintliziyo okanyeivazi yegaziimeko.

Ngelixa kungekho zifundo zaneleyo zeklinikhi ngokubhekisele Xareltoesetyenziswa ngabafazi abakhulelweyo , inokubangela ukopha kwimveku okanye kunina. Izigulana ezikhulelweyo okanye eziceba ukukhulelwa kufuneka zithethe nezazoukhathalelo lwempilophambi kokuba uqaleI-Xarelto kwaye kuya kufuneka ichazwe ezinye i-anticoagulants ngolwazi oluthe kratya olufumanekayo kwaba bantu.Ukuncancisaisenokungakhuseleki ngelixa uthatha leanticoagulant.

Izilumkiso

Zimbini izilumkiso ezibalulekileyo malunga nokusetyenziswa kweXarelto.

• Ukuyeka ukusetyenziswa kwamachiza kwangoko kunokunyusa umngcipheko wokuba nzimaihlwili legazi.
• Inkqubo ye- I-FDA ikwalumkisa ukubangqumboKwaye i-hematomas yomqolo yenzekile kwizigulana ezithathileyoXareltoNgelixa uqhubekaukuhlatywa komqolokunye nokufumana i-neuraxial anesthesia. Isiphumo sinokukhubazeka ngokusisigxina.

Ukuba ucwangciselwe uqhaqho, yeka ukuthathaXareltoubuncinci iintsuku ezimbini ukuya kwezintathu ngaphambi kweenkqubo eziphambili kunye nosuku olunye ngaphambi kweenkqubo ezincinci. Izigulana zinokuqhubeka nonyango emva kotyando. Kukho iarhente yokuguqula ukopha okusongela ubomi ngenxa yeXarelto ekhoyo njengokufakwa kwe-IV, okusetyenziswa ngokudibeneyo namanqanaba enkxaso asemgangathweni.

Kwi Matshi 2019 yokuhlala phakathi kukaJohnson & Johnson kunye neBayer,Xareltoabasebenzisi basombulule ngaphezulu kwama-25,000 amatyala. Isuti ibanga ukuba abavelisi abakhange babalumkise abasebenzisiiziphumo ebezingalindelekanga ezimandundu, kubandakanya ukopha okungalawulekiyo kunye nokopha. InzimaimiphumelaNgoku zidweliswe kwilebula yesilumkiso yamayeza.

Imiphumela

Nxibelelana nogqirha ngokukhawulezaIngcebiso yezonyangoukuba ufumana inegazi lakhoukuyaXarelto. Iimpawu zibandakanya imihlathi, ubunzima bokuphefumla, kunye nokudumba endlebeni, empumlweni nasemqaleni.

Ezi zezona zixhaphakileyoimiphumelayokusebenzisaXarelto:

• Ukudumba kwezihlunu
• Ukutyumza okulula
• Ukurhawuzelela

Ukuba ikho kwezi zinto zinzimaimiphumelakwenzeka, nxibelelana nogqirha wakho ngokukhawuleza:

• Ukopha ngamandla nokungalawuleki
• Iimpumlo
• Irhashalala okanye ukurhawuzelela
• Kunzima ukuphefumla
• Intloko kunye nesiyezi
• Intlungu okanye ukudumba ujikeleze amanxeba
• Iimpawu zomqoloihlwili legazi(Intlungu ebuhlungu / ukuphazamiseka, ukulahleka kolawulo lwesinye)

Unxibelelwano

Akukho zithintelo ekudleni okufunekayo xa usebenzisaXareltoukuze uqhubeke nokutya kwakho njengesiqhelo. Nangona kunjalo, ukusela utywala ngelixa uthathaXarelto ingayandisa eyakhoumngcipheko wokopha. Ukusela utywala kunciphisa igazi. Ngaphezulu, utshintsho lwesibindi lokutshintshwa kwesibindi olubangelwa kukusela lunokutshintshaXarelto'Ukusebenza.

Kuyacetyiswa ukuba uyeke utywala ngelixa unyangelwaukujiyaumngcipheko ngeigazi elincinci.

Kukho iindlela ezimbalwa zokunxibelelana kweziyobisi kunye neyeza lokucoca igazi.

• Iintsholongwane kwaye Xarelto : Ukuthatha elinye iyeza lokucoca igaziXareltounokuwonyusa kakhulu umngcipheko wokopha okungalawulekiyo.
• I-Aspirin kunye Xarelto : Ngaphandle kokuba ugqirha wakho akuyalele, thintela ukuthatha iiasprini ngelixa uqhubekaXarelto. I-Aspirin inyibilikisa igazi, elonyusa kakhulu iumngcipheko wokophaxa idityanisiweXarelto. Nangona kunjalo, oogqirha banokuyalela irejimeni yedosi ephantsi yedosi enedosi ephantsiXarelto.

Xareltoidibana namachiza awahlukeneyo anciphisa igazi. Ukuba ugqirha ufuna ukumiselaXarelto, kubalulekile ukubazisa ukuba ngaba uthatha nawaphi na amayeza alandelayo, njengoko enokubangela unxibelelwano oluqatha:

• Clarithromycin
• Defibrotide
• UEliquis
• Nizoral
• Ritonavir
• Savaysa
• IWarfarin(coumadin)
• Zydelig

Yintoni ongafanele uthathe nayoXarelto?

Kuphephe ukuphelisa iintlungu okanyeiziyobisi ezichasayo ezingasebenziyo(Ii-NSAID), kubandakanya iasprini,iqeqsha, Excedrin, kunyeibuprofen. Ukuba ufuna amayeza okuphelisa iintlungu, i-acetaminophen (iTylenol) ayinalo unxibelelwanoXarelto.

Kunqande ukuthatha iPepto-Bismol kunyeXarelto, njengoko inokunyusa i-umngcipheko wokopha. Amayeza athile esiqabu nawo akakhuselekanga ukuba ungangeniswa nawoXarelto, kubandakanya i-cimetidine. Nangona kunjalo, oku kulandelayo kukuqunjelwa kunye namayeza e-acid Reflux akhuselekile:

• Famotidine (IiTum, iPepcid)
• I-Omeprazole (Prilosec)

Xareltoezinye iindlela

Kukho amayeza amaninzi acoca igazi kwimarike, kunye neyakhoukhathalelo lwempiloumboneleli uya kukuyalela ukuba yeyiphi abacinga ukuba ilungele wena.

• Eliquis vs. Xarelto : Iyeza ngalinye lisebenza ngendlela efanayo ukuvimba imveliso yeukujija igaziiiarhente. Igama eliqhelekileyo likaEliquismzantsi, kwaye idosi esemgangathweni iphantsi kuneXarelto. Izifundo zibonisa ukuba uEliquis unokukhuseleka, kuxhomekeke kwisigulana.
• IWarfarin vs. Xarelto : IWarfarinisebenza ngokukuko nokuba uphose idosi, ngelixa uphoswa yidosiXareltokunokubangela iingxaki. Kukwakhona nearhente yokubuyela umva ngokulula ngakumbi kwimeko yokugqithisa, nangona ukubuyela umva kwayo nayiphi na i-anticoagulant kuzisa imiceli mngeni yabo eyahlukileyo. Umthamo weiwarfarinifuna ibhalansi yomthamo obuthathaka, ke kufuneka ukuba kuhlolwe rhoqo amanqanaba egazi.

Eliquis kunyeXareltoZombini zinesiqingatha sobomi esifutshane, oko kuthetha ukuba ifuthe lonyango liphela ngokukhawuleza.IWarfarin(Coumadinihlala ixesha elide, ke aidosi ephosiweyoayinzima kangako, iyenza ikhuseleke kancinane ngaloo ndlela.

Nangona kunjalo,iwarfarinifuna iitshekhi rhoqo ukubona ukuba ngokukhawuleza yakhoamahlwili egaziUkuqinisekisa ukuba ufumana idosi efanelekileyo. Utshintsho kwizidlo ezonyusa okanye zinciphisa ivithamin K emzimbeni zinokuchaphazela idosi oyifunayo. Amanye amayeza amaninzi kunye nezongezelelo ezinxibelelana nazoiwarfarin. Kule meko,Xareltokwaye i-Eliquis ikhuselekile ukusetyenziswa.

Iyeza ngalinye lokucheba igazi likhuselekile ukuba lisetyenziswe ngendlela eyalelwa ngugqirha. Ukuba unqwenela ukutshintshela kwelinye iyeza, xoxa ngezinto eziluncedo nezingeloncedo ngalowoukhathalelo lwempiloumboneleli.

Ungonga njani kwiXarelto

XareltoIxabiso eliphakathi lokuthengisa li- $ 563.07 kwaye uninzi lwe-Medicare kunye nezicwangciso zeinshurensi zigubungela iindleko. Uninzi lwezigulana ziya kugqiba ukuhlawula phakathi kwe-zero kunye ne-40 yeedola inyanga nenyanga.

Ukuba ufanelekile, ungonga kwiindleko ngeNkqubo yokuLondolozwa kweNdlela yeJanssen. Izigulana eziphantsi kwale nkqubo zihlawula i-10 yeedolaXareltogcwalisa. Kukho iimfuno ezahlukeneyo zokuba zilungele, izibonelelo ezona ziphezulu kunyaka ngamnye wekhalenda, kwaye abaguli beMedicare abakwazi ukufumana esi sibonelelo.

IJanssen Select yenye yenkqubo yomenzi enokukunceda ugcine kwiXarelto. Ukuba uhlawula ngaphezulu kwe- $ 85 yokugcwalisa ibhotile nganye, unokulungela. Le nkqubo ijolise kwizigulana ezingenakho ukuhlawula amayeza ngenxa ye-inshurensi yokuthintela okufana nokutsalwa okuphezulu. Nxibelelana nabo ngolwazi oluthe kratya malunga nenkqubo yabo yokonga.

I-singleCare ikwanikezela amatikiti okonga yeXareltoKwiikhemesti ezithatha inxaxheba kwilizwe liphela.