Brilinta vs. Plavix: Umahluko, ukufana, kwaye kukuphi okungcono kuwe
Iziyobisi Vs. UmhloboUkujonga ngokubanzi iziyobisi kunye nolwahluko ophambili | Imiqathango inyangwa | Ukusebenza | Ukuhlawulwa kwe-inshurensi kunye nokuthelekiswa kweendleko | Imiphumela | Ukusebenzisana kweziyobisi | Izilumkiso | FAQ
I-Brilinta (ticagrelor) kunye ne-Plavix (i-clopidogrel) ziindlela ezimbini zonyango ezinokuthintela ukwenziwa kwamahlwili egazi. Kubantu abane-acon coronary syndrome (i-ACS) okanye imbali ye-myocardial infarction (MI, okanye isifo sentliziyo), amahlwili egazi anokuhlangana kwaye avimbe ukuhamba kwegazi. Amayeza afana neBrilinta okanye iPlavix anokuqinisekisa ukuhamba kwegazi okwaneleyo ukujikeleza intliziyo ukunceda ukuthintela isifo sentliziyo okanye ukubetha.
I-Brilinta kunye ne-Plavix yinxalenye yeqela lamayeza abiziweyo ii-antiplatelet agents , abancinci begazi, okanye i-P2Y12 inhibitors. Omabini la machiza asebenza njengabachasi be-receptor, oko kuthetha ukuba bayayithintela i-P2Y12 receptor enoxanduva lokukhuthaza iiplatelets kunye namahlwili egazi. La machiza ahlala ethathwa yonke imihla ubuncinci unyaka emva komsitho we-ACS.
Ngelixa i-Brilinta yaziwa ngokuba sisiyobisi esisebenza ngakumbi kwiimeko ezininzi, zombini iziyobisi zinomahluko obalulekileyo kwiziphumo ebezingalindelekanga nakwidosi.
Nguwuphi umahluko ophambili phakathi kweBrilinta kunye nePlavix?
Brilinta
I-Brilinta (Yintoni uBrilinta?) Ligama lophawu lwe-ticagrelor. Nangona uhlobo oluqhelekileyo luvunyiwe, alukabikho ngokorhwebo. Ke ngoko, eli chiza linokubiza kakhulu kunePlavix okanye ezinye iiarhente ezifanayo njenge-Effient (prasugrel).
Ngokwe-American Heart Association (AHA) kunye neAmerican College of Cardiology (ACC), uBrilinta ngu unyango olukhethiweyo kubantu abane-ACS. I-Brilinta isebenza ngokukhawuleza kwaye inendlela yokubuyisela isenzo. Ikwanayo neplatelet inhibition engcono kunye neziphumo zesigulana xa kuthelekiswa nePlavix.
I-Brilinta ithathwa njengepilisi ephindwe kabini-imihla ngemihla kunye ne-aspirin yemihla ngemihla.
IPlavix
IPlavix (Yintoni iPlavix?) Ligama lophawu lweclopidogrel. Ngokungafaniyo noBrilinta, iPlavix okwangoku ifumaneka njengesiyobisi I-generic Plavix yeyona ndlela ingabizi kakhulu njengegazi elincinci.
I-Plavix ithathwa njengepilisi yentsuku zonke. Kuthathwa kunye ne-aspirin ukuqhubeka nokunciphisa umngcipheko weziganeko ze-ACS.
Abanye abantu banokuthathwa njenge-Plavix ehlwempuzekileyo ngenxa yokungafani kofuzo kwii-enzyme ezithile zesibindi. Abo bangabo I-CYP2C19 i-metabolizers ehlwempuzekileyo ayikwazi ukuqhuba iPlavix ngokufanelekileyo kwaye inokufuna ukusebenzisa unyango olwahlukileyo.
| Umahluko ophambili phakathi kweBrilinta kunye nePlavix | ||
|---|---|---|
| Brilinta | IPlavix | |
| Iklasi yeziyobisi | Antiplatelet I-P2Y12 inhibitor | Antiplatelet I-P2Y12 inhibitor |
| Uhlobo lweBrith / generic | Igama lebrand kuphela | Ibhranti kunye nohlobo oluqhelekileyo olukhoyo |
| Ngubani igama eliqhelekileyo? | I-ticagrelor | Clopidogrel |
| Luhlobo luni lweziyobisi? | Ithebhulethi yomlomo | Ithebhulethi yomlomo |
| Ithini idosi esemgangathweni? | Isifo se-coronary syndrome (ACS): Inqanaba lokulayisha lokuqala le-180 mg. Emva koko, i-90 mg kabini yonke imihla kunyaka wokuqala emva komsitho we-ACS. Emva koko, i-60 mg kabini yonke imihla emva koko. | Isifo se-coronary syndrome (ACS): Inqanaba lokuqala lokulayisha le-300 mg. Emva koko, i-75 mg kanye yonke imihla. |
| Lude kangakanani unyango oluqhelekileyo? | Iinyanga ezili-12 okanye ngaphezulu | Iinyanga ezili-12 okanye ngaphezulu |
| Ngubani oqhelekileyo usebenzisa amayeza? | Abantu abadala abaneminyaka eli-18 nangaphezulu | Abantu abadala abaneminyaka eli-18 nangaphezulu |
Ngaba ufuna elona xabiso libalaseleyo kwiBrilinta?
Bhalisela izilumkiso zamaxabiso eBrilinta kwaye ufumane ukuba amaxabiso atshintsha nini!
Fumana izilumkiso zamaxabiso
Iimeko eziphathwe nguBrilinta kunye nePlavix
Omabini la mayeza avunyiwe yi-FDA ukunciphisa izinga leziganeko zentliziyo kubantu abane-ACS. Ezi ziganeko zinokubandakanya ukubetha kwentliziyo, ukubetha, i-angina engazinzanga (iintlungu zesifuba ezibangelwa zizinto ezinokukhokelela kuhlaselo lwentliziyo), kunye nezinye iimeko ezinxulumene nentliziyo .
Omabini la machiza anceda ukuthintela iintlobo ezimbini zokuhlaselwa sisifo sentliziyo: i-ST-elevation myocardial infarction (STEMI) kunye ne-non-ST-elevation myocardial infarction (NSTEMI). I-STEMI yenzeka xa umthambo wentliziyo uvaliwe ngokupheleleyo. I-NSTEMI ibangelwa kukuvaleka ngokuyinxenye okanye ukunciphisa umthambo wentliziyo.
Ngelixa zombini ezi ntlobo zokuhlaselwa kwentliziyo zinobuzaza, i-STEMI iya kuhlala ifuna i-revascularization, okanye ukubekwa kwe- stent ukuvula umthambo. Ii-NSTEMIs zihlala zinokunyangwa ngeearhente zokucoca igazi, nangona kufuneka i-stent kwiimeko ezinzima.
Kukho umngcipheko ophezulu we-stent thrombosis, okanye ama-clots egazi emva kokubekwa kwe-stent, okwaziwa nangokuthi kungenelelo ngoncedo lwe-coronary. Ukuthintela i-thrombosis, i-Brilinta okanye i-Plavix ingasetyenziselwa ukunciphisa ukudityaniswa kweplatelet kunye nokuthintela amahlwili egazi ajikeleze i-stent.
Ukuba umiselwe i-Brilinta okanye i-Plavix, uya kuhlala unikwa i-aspirin yemihla ngemihla. I-Aspirin ithathwa ngokudibeneyo nala machiza ukunqanda ukuthintela amahlwili egazi. Indibaniselwano yeasprini kunye ne-P2Y12 inhibitor ibizwa ngokuba unyango lwe-antiplatelet (DAPT).
| Imeko | Brilinta | IPlavix |
| Isifo se-coronary syndrome (ACS) | Ewe | Ewe |
| Ukuhlaselwa yintliziyo kunye nokubetha (uthintelo) | Ewe | Ewe |
Ngaba iBrilinta okanye iPlavix isebenza ngakumbi?
U-Brilinta kunye ne-Plavix bobabini babonakalisiwe ukuba bayasebenza ukunciphisa umngcipheko weengxaki zentliziyo emva kokuhlaselwa sisifo sentliziyo, ukubetha, okanye ezinye iziganeko ezinxulumene nesifo sentliziyo. Nangona kunjalo, iimvavanyo zeklinikhi zibonise ukuba uBrilinta usebenza ngakumbi kunePlavix.
Ngokusekwe kufundo olwenziwe kabini olungaboniyo, olubizwa ngokuba yi Uvavanyo lwePLATO , U-Brilinta wafunyanwa ukunciphisa izinga lokufa kwentliziyo xa kuthelekiswa ne-Plavix. Emva kweenyanga ezili-12 zonyango, ukufa kubangelwa yimisipha, ukuhlaselwa yintliziyo, okanye ukubetha kwenzeka kwi-9.8% yezifundo ezifumana i-ticagrelor xa ithelekiswa ne-11.7% yabo bafumana i-clopidogrel. Nangona kunjalo, emva kokuphononongwa kweendawo zokugqibela zophando, abaphandi bePLATO bafumanise ukuba kukho inqanaba eliphezulu leziganeko ezithile zokopha kwiqela le-ticagrelor xa kuthelekiswa neqela le-clopidogrel.
UKUYA Uhlalutyo lweemeta Ukudibanisa ngaphezulu kwe-10 yezifundo zeklinikhi kubonise ukuba i-ticagrelor kunye ne-clopidogrel zazifana ngokusebenza kunye nokhuseleko. Akukho mahluko ubalulekileyo wafunyanwa phakathi kwezi ziyobisi. Abo bathatha i-ticagrelor bafunyanwa benokuphefumla okungakumbi xa kuthelekiswa ne-clopidogrel.
Dibana nogqirha wakho ukuze ufumanise ukuba ingaba uBrilinta okanye iPlavix lolona khetho lulungileyo na kuwe.
Ikhadi lesaphulelo sokumiselwa
Ngaba ufuna elona xabiso liphezulu kwiPlavix?
Bhalisela izilumkiso zamaxabiso ePlavix kwaye ufumane ukuba amaxabiso atshintsha nini!
Fumana izilumkiso zamaxabiso
Umyinge kunye nokuthelekiswa kwexabiso kweBrilinta vs. Plavix
Kubantu abaguli be-Medicare Icandelo D, i-Brilinta ihlala igqunyiwe. Uninzi lwezicwangciso zeinshurensi ziya kubandakanya iBrinta. Ukusukela ngo-2018, a Uhlobo oluqhelekileyo yeBrilinta yamkelwe yi-FDA. Nangona kunjalo, ayifumaneki ngokuthengisa okwangoku. Ixabiso eliqhelekileyo leBrilinta lingaphezulu kwe- $ 500 kwiipilisi ezingama-60 90 mg. Sebenzisa ikhadi lesaphulelo se-SingleCare kunokunciphisa iindleko ukuya kuthi ga ngaphantsi kwe- $ 350.
Kuba iPlavix iza njengechiza elenza lafana nalawo aveliswe ngumenzi, inokufumaneka ngexabiso eliphantsi. Uninzi lwezonyango kunye nezicwangciso zeinshurensi ziya kuligubungela eli chiza. Okwangoku, ixabiso lentengiso le-brand Plavix lingaphezulu kwama-200 eedola kumashumi amathathu anesihlanu eepilisi. Ikhadi lesaphulelo se-Plavix SingleCare linokuzisa iindleko eziqhelekileyo kwi $ 15 kuxhomekeke kwikhemisi oyisebenzisayo.
| Brilinta | IPlavix | |
| Ngokuqhelekileyo ihlawulwa yi-inshurensi? | Ewe | Ewe |
| Ngokuqhelekileyo igutyungelwe yiMedicare? | Ewe | Ewe |
| Umthamo osemgangathweni | Iipilisi ezingama-90 mg (ubungakanani bama-60) | Iipilisi ezingama-75 mg (ubuninzi be-30) |
| I-Medicare copay eqhelekileyo | $ 19- $ 423 | $ 0- $ 19 |
| Ixabiso elilodwa | $ 350- $ 390 | $ 15 + |
Iziphumo eziqhelekileyo ezichaphazelekayo zeBrilinta vs. Plavix
Iziphumo ebezingalindelekanga ezixhaphakileyo zeBrilinta kunye nePlavix ziyopha. Ukopha kancinci kunokubandakanya ukugruzuka ngokulula, iintsini ezophayo, okanye ukuphuma kweempumlo. Iziganeko ezinkulu zokopha zibandakanya ukopha ngaphakathi, igazi kumchamo okanye isitulo, kunye nokugabha igazi. Unyango kwangoko luyafuneka ukuba ukopha kakhulu.
Ezinye iziphumo ebezingalindelekanga zeBrilinta kunye nePlavix zibandakanya ukuphefumla (dyspnea), isiyezi, isicaphucaphu, kunye norhudo.
Iziphumo ebezingalindelekanga zokopha nokuphefumla kancinci zihlala zinxulunyaniswa neBrilinta xa kuthelekiswa nePlavix. Ngokutsho kwabanye izifundo zokuthelekisa , UBrilinta wakhupha ukopha okungaphezulu — kokubini imicimbi emincinci nemikhulu — kunePlavix.
Ngethamsanqa, i iyeza kuye kwaphuhliswa ukubuyisa imiphumo yeBrilinta kwiimeko ezinzima zokopha. Kuba iPlavix yinto engenakuphinda ibuyiselwe, ayinayo into ethile yokubuyisela umva kwiziphumo zayo.
| Brilinta | IPlavix | |||
| Imiphumela | Iyasebenza? | Rhoqo | Iyasebenza? | Rhoqo |
| Ukopha | Ewe | 7.7% | Ewe | 6.2% |
| Ukuqhawukelwa ngumphefumlo | Ewe | 13.8% | Ewe | 7.8% |
| Ukuba nesiyezi | Ewe | 4.5% | Ewe | 3.9% |
| Isicaphucaphu | Ewe | 4.3% | Ewe | 3.8% |
| Urhudo | Ewe | 3.3% | Ewe | 2.5% |
Olu alunakuba luluhlu olupheleleyo. Dibana nogqirha wakho okanye usokhemesti ngeziphumo ebezingalindelekanga ezinokubakho.
Umthombo: DailyMed ( Brilinta ), Yonke imihla ( IPlavix )
Ukudibana kweziyobisi kweBrilinta kunye nePlavix
I-Opioids kunye ne-CYP3A4 inducers zinciphisa imetabolism okanye ukwenziwa kweBrilinta okanye iPlavix emzimbeni. Oku kunxibelelana kungakhokelela kumanqanaba ancitshisiweyo eBrilinta okanye iPlavix, anokunciphisa ukusebenza kwabo kakuhle.
I-CYP3A4 inhibitors kunye ne-CYP3A4 inducers inokutshintsha amanqanaba egazi leBrilinta okanye iPlavix. I-CYP3A4 inhibitors ibandakanya ii-antifungals ezifana ne-ketoconazole kunye ne-antibiotics efana ne-clarithromycin. I-CYP3A4 inducers ibandakanya iziyobisi ezinje nge-rifampin, phenytoin, kunye ne-carbamazepine.
Izidakamizwa ezichasayo ezichasayo (i-NSAIDs) kunye nee-anticoagulants ezifana ne-warfarin zineempawu zokucoca igazi. Ukuthatha ezi zinto kunye kunokunyusa umngcipheko wokopha.
I-Brilinta inokusebenzisana namayeza e-statin kwaye inyuse lawo imiphumela . Nangona i-Plavix inokusebenzisana ne-statins, abukho ubungqina obuqinisekileyo bokuba iPlavix iphazamisa unyango lwe-statin. Inyaniso, Izifundo zibonisile ukuba ii-statins zinokunceda ekunciphiseni umngcipheko wokufa kwabantu abane-ACS.
| Iziyobisi | Iklasi yeziyobisi | Brilinta | IPlavix |
| Imofini Oxycodone IHydrocodone | Iipioids | Ewe | Ewe |
| Ketoconazole Itraconazole Clarithromycin Ritonavir | I-CYP3A4 inducers | Ewe | Ewe |
| Rifampin IPhenytoin ICarbamazepine IPhenobarbital | CYP3A4 inhibitors | Ewe | Ewe |
| Umgqube Diclofenac Ibuprofen | Ii-NSAID | Ewe | Ewe |
| IWarfarin | Iintsholongwane | Ewe | Ewe |
| Simvastatin ILovastatin | Iingxelo | Ewe | Hayi |
| I-Digoxin | Iglycoside yentliziyo | Ewe | Hayi |
| Omeprazole Esomeprazole | CYP2C19 inhibitors | Hayi | Ewe |
| I-Repaglinide | Antidiabetic | Hayi | Ewe |
Olu alunakuba luluhlu olupheleleyo lwazo zonke izinto ezinokubakho xa kusenziwa iziyobisi. Dibana nogqirha nawo onke amayeza onokuthi uwathathe.
Izilumkiso zaseBrilinta kunye nePlavix
Zombini i-Brilinta kunye ne-Plavix zinomngcipheko ophezulu wokopha okunxulunyaniswa nokusetyenziswa kwazo. Ngokukodwa xa zidityaniswe nezinye iziyobisi ezinciphisa igazi, uBrilinta okanye iPlavix inokunyusa umngcipheko wokopha ngaphakathi, njengokuphuma ngaphakathi ngaphakathi okanye ukopha emathunjini. Ukusetyenziswa kweearhente ze-antiplatelet ezifana neBrilinta kunye nePlavix kuyalumkiswa ukuba unembali eyaziwayo yokopha okanye izilonda.
I-Brilinta akufuneki iqalwe kwizigulana ezenza i-a Umthambo we-coronary bypass utyando lotyando (ICABG). Nangona kunjalo, ukuba ukuphuma kwegazi kunokulawulwa ngexesha lale nkqubo, kunokucetyiswa ukuba uqhubeke nonyango lwe-Brilinta.
I-Brilinta akufuneki ithathwe ngeedosi ze-aspirin ezinkulu kune-100 mg. Amanani aphezulu e-aspirin anokunciphisa indlela uBrilinta asebenza ngayo.
Abantu abanokungasebenzi kakuhle kwemfuza nge-CYP2C19 enzyme zesibindi banokufumana ukusebenza okunciphisiweyo ngePlavix. Kungenxa yokuba iPlavix iqhutywa ikakhulu yi-CYP2C19 enzyme. Ukuba ukrokrelwa ukuba uyi-CYP2C19 metabolizer ehlwempuzekileyo, ungathatha vavanyo ukufumanisa. Unokucetyiswa ichiza elahlukileyo ukuba umzimba wakho awucwangcisi iPlavix ngokwaneleyo.
Imibuzo ebuzwa rhoqo malunga neBrilinta vs. Plavix
Yintoni uBrilinta?
I-Brilinta yipilisi ye-antiplatelet esetyenziselwa ukunyanga abantu abane-acon coronary syndrome (ACS). Eyaziwa nangokuthi igama layo eliqhelekileyo i-ticagrelor, i-Brilinta ithathwa kabini imihla ngemihla ukukhusela ukwakheka kwegazi. I-Brilinta yenziwe yi-AstraZeneca.
Yintoni iPlavix?
I-Plavix yipilisi ye-antiplatelet ethathwa njengethebhulethi yentsuku enye yabantu abane-ACS. I-Plavix iyafumaneka njengegama lophawu kunye nohlobo oluqhelekileyo. NjengoBrilinta kunye nezinye i-P2Y12 inhibitors, iPlavix ithathwa nge-aspirin yemihla ngemihla. IPlavix yenziwa yiBristol-Myers Squibb kunye neSanofi Pharmaceuticals.
Ngaba iBrilinta kunye nePlavix ziyafana?
Hayi. UBrilinta noPlavix abafani. Zilawulwa ngeendlela ezahlukeneyo kwaye zinomahluko othile kwiziphumo ebezingalindelekanga kunye nokunxibelelana kweziyobisi.
Ngaba iBrilinta okanye iPlavix ibhetele?
I-Brilinta iye yathengiswa kwaye yafundwa njengechiza elisebenza ngakumbi kunePlavix. Kubonakalisiwe njengechiza elingcono lokunciphisa amaxabiso okufa kwentliziyo kunye nokuthintela ukubetha kwentliziyo okanye ukubetha. Nangona kunjalo, kunokuba nakho ukuvelisa iziphumo ezibi njengokuphuma kwegazi kunye nokuphefumla okufutshane. Ngenxa ye Izikhokelo ze-AHA kunye ne-ACC , UBrilinta lunyango olukhethwayo ngaphezu kwePlavix.
Ndingayisebenzisa iBrilinta okanye iPlavix ngelixa ndikhulelwe?
Nantsi lapho ayonelanga idatha ukubonisa ukuba uBrilinta kunye nePlavix bakhuseleke ngokupheleleyo ngexesha lokukhulelwa. La machiza akacetyiswa ngokubanzi ngaphandle kokuba izibonelelo zawo zingaphezulu komngcipheko. Thetha nogqirha wakho malunga neendlela ezikhoyo zokonyango xa ukhulelwe.
Ndingayisebenzisa iBrilinta okanye iPlavix ngotywala?
Kungcono ukunqanda ukusela utywala ngelixa uthatha abacoci gazi abanjengoBrilinta okanye iPlavix. Kungenxa yokuba notywala bunabo iipropati zokucoca igazi . Ukusela utywala kunokudibanisa iziphumo zala machiza kwaye kunyuse umngcipheko wokopha kakhulu.
Kuya kufuneka uthathe ixesha elingakanani emva kwe-stent?
I-Brilinta ithathwa iinyanga ezili-12 ubuncinci emva kokubekwa kwe-stent, ekwabizwa ngokuba ngongenelelo lwe-coronary percutaneous. Emva kweenyanga ezili-12 zokuqala, uBrilinta kufuneka athathwe iinyanga ezili-12 ezongezelelweyo kwiqondo elisezantsi. Ugqirha wakho uya kuvavanya imeko yakho kutyelelo lwakho olulandelayo ukumisela ukuba kufuneka uhlale ixesha elingakanani eBrinta.
Ungakhe uyeke ukuthatha uBrilinta?
Unyango ngeBrilinta luhlala luthathwa njengexesha elide. Ugqirha wakho unokufuna ukumisa uBrilinta ukuba uyayinyamezela kakubi okanye ufumana iziphumo ezibi. Ukupheliswa kwe-Brilinta kwakamsinya kunokunyusa umngcipheko wokuhlaselwa sisifo sentliziyo okanye ukubetha ukuba une-ACS okanye isifo semithambo.
Yeyiphi eyona ikhuselekileyo: IBrilinta okanye iPlavix?
I-Brilinta kunye ne-Plavix zihlala zithelekiswa ngokokhuseleko nokusebenza ngokufanelekileyo. Nangona kunjalo, i-Brilinta ibonakalisiwe ukuba ibangela ngaphezulu ukopha kunye nokuphefumla okufutshane xa kuthelekiswa nePlavix. Omabini la machiza kufuneka athintelwe nabanye abacoci gazi ukunciphisa umngcipheko weziphumo ezibi.
