Umbhali: Laura McKinney
Umhla Wokudalwa: 4 Utshazimpuzi 2021
Hlaziya Umhla: 16 Ucanzibe 2024
Anonim
All About Ninlaro (Ixazomib)
Ividiyo: All About Ninlaro (Ixazomib)

Umxholo

Yintoni uNinlaro?

I-Ninlaro ligama lonyango elisebenzisa igama lonyango elisetyenziselwa ukunyanga i-myeloma yabantu abadala. Le meko luhlobo olunqabileyo lomhlaza ochaphazela iiseli ezithile ezimhlophe zegazi ezibizwa ngokuba ziiseli zeplasma. Ngama-myeloma amaninzi, iiseli eziqhelekileyo ze-plasma ziba ngumhlaza kwaye zibizwa ngokuba ziiseli ze-myeloma.

I-Ninlaro ivunyiwe ukuba isetyenziswe kubantu esele bazame olunye unyango olunye lwe-myeloma yabo. Olu unyango lunokuba lunyango okanye inkqubo.

UNinlaro ukwiklasi yamachiza abizwa ngokuba yi-proteasome inhibitors. Lonyango ekujoliswe kulo lwe-myeloma ezininzi. Iithagethi zeNinlaro (zisebenza) kwiprotein ethile ngaphakathi kweeseli ze-myeloma. Yenza iiproteni ezininzi kwiiseli ze-myeloma, ezibangela ukuba ezo seli zife.

I-Ninlaro iza njengee-capsules ezithathwa ngomlomo. Uya kuthatha uNinlaro kunye namanye amayeza amabini e-myeloma: i-lenalidomide (i-Revlimid) kunye ne-dexamethasone (i-Decadron).

Ukusebenza ngempumelelo

Ngexesha lezifundo, uNinlaro wandise ubude bexesha abanye abantu abane-myeloma ezininzi abaphila ngaphandle kwesifo sabo siqhubeka (sisiba mandundu). Obu bude bexesha libizwa ngokuba kukuqhubeka okungenasiphelo.


Olunye uphando lweklinikhi lujonge abantu abane-myeloma ezininzi esele basebenzise olunye unyango kwisifo sabo. Abantu bahlulwe baba ngamaqela amabini. Iqela lokuqala lanikwa uNinlaro ngazo zombini i-lenalidomide kunye ne-dexamethasone. Iqela lesibini lanikwa i-placebo (unyango ngaphandle kwesiyobisi esisebenzayo) kunye neleneralomide kunye ne-dexamethasone.

Abantu abathathe indibaniselwano yeNinlaro baphila i-avareji yeenyanga ezingama-20.6 ngaphambi kokuba i-myeloma yabo iqhubeke. Abantu abathatha indibaniselwano ye-placebo baphila i-avareji yeenyanga ezili-14.7 ngaphambi kokuba i-myeloma yabo iqhubeke.

Kubantu abathathe indibaniselwano yeNinlaro, iipesenti ezingama-78 zaphendula kunyango. Oku kuthetha ukuba babenokuphuculwa okungama-50% kwiimvavanyo zabo zelebhu ezazikhangela iiseli ze-myeloma. Kulawo athabathe indibaniselwano ye-placebo, ama-72% abantu bafumana impendulo efanayo kunyango.

I-Ninlaro generic

I-Ninlaro ifumaneka kuphela njengeyeza lomthi. Okwangoku ayifumaneki ngendlela eqhelekileyo.

I-Ninlaro iqulethe into enye esebenzayo: ixazomib.


Iziphumo ebezingalindelekanga zikaNinlaro

I-Ninlaro inokubangela iziphumo ebezingalindelekanga ezinobulali okanye ezinobuzaza. Olu luhlu lulandelayo luqulathe ezinye zeziphumo ebezingalindelekanga ezinokubakho ngelixa uthatha uNinlaro. Olu luhlu alubandakanyi zonke iziphumo ebezingalindelekanga ezinokubakho.

Ngolwazi oluthe kratya malunga neziphumo ebezingalindelekanga zeNinlaro, thetha nogqirha wakho okanye usokhemesti. Banokukunika iingcebiso malunga nendlela yokujongana nayo nayiphi na imiphumela emibi enokuthi ikhathaze.

Iziphumo eziqhelekileyo

Iziphumo eziqhelekileyo eziqhelekileyo zeNinlaro zingabandakanya:

  • umqolo obuhlungu
  • ukungaboni kakuhle
  • amehlo owomileyo
  • i-conjunctivitis (ekwabizwa ngokuba liliso elipinki)
  • i-shingles (i-herpes zoster virus), ebangela irhashalala ebuhlungu
  • i-neutropenia (inqanaba leseli legazi elimhlophe), elinokuthi landise umngcipheko wosulelo

Uninzi lweziphumo ebezingalindelekanga zinokuhamba zingaphelanga iintsuku okanye iiveki ezimbalwa. Ukuba zinzima kakhulu okanye azihambi, thetha nogqirha wakho okanye usokhemesti.

Iziphumo ebezingalindelekanga ezimandundu

Iziphumo ebezingalindelekanga ezimandundu zinokuqheleka kuNinlaro. Shayela ugqirha wakho ngokukhawuleza ukuba unemiphumo emibi. Tsalela umnxeba ku-911 ukuba iimpawu zakho ziziva zisongela ubomi okanye ukuba ucinga ukuba unempilo kaxakeka.


Iziphumo ebezingalindelekanga ezimandundu kunye neempawu zazo zinokubandakanya oku kulandelayo:

  • I-peripheral neuropathy (umonakalo kwiimbilini zakho). Iimpawu zingabandakanya:
    • ukurhawuzelela okanye ukutsha
    • ukuba ndindisholo
    • intlungu
    • ubuthathaka kwiingalo zakho okanye emilenzeni
  • Ukuphendula okunamandla kwesikhumba. Iimpawu zingabandakanya:
    • irhashalala enamaqhuma abomvu emfusa ngombala (obizwa ngokuba yiSweet's syndrome)
    • ukugqabhuka kolusu kunye neendawo zokuxobuka kunye nezilonda ngaphakathi komlomo wakho (obizwa ngokuba yiStevens-Johnson syndrome)
  • Ukudumba kwemida (ukudumba). Iimpawu zingabandakanya:
    • amaqatha adumbileyo, iinyawo, imilenze, iingalo, okanye izandla
    • ukutyeba kwakho
  • Umonakalo wesibindi. Iimpawu zingabandakanya:
    • i-jaundice (tyheli kolusu lwakho okanye abamhlophe bamehlo akho)
    • iintlungu kwicala lasekunene lesisu sakho (esiswini)

Ezinye iziphumo ebezingalindelekanga ezimandundu, ezichazwe ngakumbi kwicandelo "Iinkcukacha zeziphumo ebezingalindelekanga" icandelo elingezantsi, linokubandakanya:

  • thrombocytopenia (amanqanaba asezantsi eplatelet)
  • iingxaki zokugaya ukutya ezinjengorhudo, ukuqhina, isicaphucaphu kunye nokugabha

Iinkcukacha zesiphumo

Unokuzibuza ukuba zenzeka kangaphi ezinye iziphumo ebezingalindelekanga ngeli chiza. Nazi ezinye iinkcukacha kwezinye zeziphumo ebezingalindelekanga ezinokubangelwa leli chiza.

I-Thrombocytopenia

Unokuba ne-thrombocytopenia (inqanaba eliphantsi leplatelet) ngelixa uthatha uNinlaro. Esi yayisesona siphumo secala siqhelekileyo sikaNinlaro ngexesha lezifundo zeklinikhi.

Ngexesha lezifundo, abantu bohlulwa baba ngamaqela amabini. Iqela lokuqala lanikwa uNinlaro ngazo zombini i-lenalidomide kunye ne-dexamethasone. Iqela lesibini lanikwa indawo ye-placebo (unyango ngaphandle kwesiyobisi esisebenzayo) zombini i-lenalidomide kunye ne-dexamethasone.

Kulawo athatha indibaniselwano yeNinlaro, iipesenti ezingama-78 zabantu babenamanqanaba asezantsi eplatelet. Kulabo bathathe indibaniselwano ye-placebo, iipesenti ezingama-54 babenamanqanaba asezantsi eeplatelet.

Kwizifundo, abanye abantu bafuna i-platelet transfusion ukunyanga i-thrombocytopenia yabo. Ngokudluliselwa kweplatelet, ufumana iiplatelet ezivela kumnikeli okanye emzimbeni wakho (ukuba iiplatelets beziqokelelwe ngaphambili). Kubantu abathatha indibaniselwano yeNinlaro, iipesenti ezi-6 zifuna ukufakelwa iplatelet. Kubantu abathatha indibaniselwano ye-placebo, iipesenti ezi-5 zazidinga ukufakelwa iplatelet.

Iiplatelets zisebenza emzimbeni wakho ukunqanda ukopha ngokunceda ekwenzeni amahlwili egazi. Ukuba inqanaba leplatelet yakho liba sezantsi kakhulu, unokuba nokopha kakhulu. Ngelixa uthatha uNinlaro, kuyakufuneka ukuba ube novavanyo lwegazi rhoqo ukujonga amanqanaba eplatelet yakho.

Biza ugqirha wakho ngoko nangoko ukuba unayo nayiphi na le mpawu yamanqanaba asezantsi eplatelet:

  • ukutyumka ngokulula
  • ukopha rhoqo kunesiqhelo (njengokuphuma kweempumlo okanye ukopha kwiintsini zakho)

Ukuba inqanaba lakho leplatelet liba liphantsi kakhulu, ugqirha wakho anganciphisa idosi yakho yeNinlaro okanye acebise ukutofelwa kwegazi. Basenokukucela ukuba uyeke ukuthatha uNinlaro okwethutyana.

Iingxaki zokugaya

Unokufumana iingxaki ngesisu sakho okanye amathumbu ngelixa uthatha uNinlaro. Ngexesha lezifundo zeklinikhi zeziyobisi, abantu babedla ngokuba neengxaki zokwetyisa.

Kwizifundo, abantu bahlulwe baba ngamaqela amabini. Iqela lokuqala lanikwa uNinlaro ngazo zombini i-lenalidomide kunye ne-dexamethasone. Iqela lesibini lanikwa indawo ye-placebo (unyango ngaphandle kwesiyobisi esisebenzayo) zombini i-lenalidomide kunye ne-dexamethasone. Iziphumo zilandelayo zichazwe kwizifundo:

  • urhudo, olwenzeke kuma-42% abantu abathatha indibaniselwano yeNinlaro (nakuma-36% abantu abathatha indibaniselwano ye-placebo)
  • Ukuqunjelwa, okwenzeke kuma-34% abantu abathatha indibaniselwano yeNinlaro (nakwiipesenti ezingama-25 zabantu abathatha indibaniselwano ye-placebo)
  • isicaphucaphu, esenzeke kuma-26% abantu abathatha indibaniselwano yeNinlaro (nakwiipesenti ezingama-21 zabantu abathatha indibaniselwano ye-placebo)
  • ukugabha, okwenzeke kuma-22% abantu abathatha indibaniselwano yeNinlaro (nakwiipesenti ezili-11 zabantu abathatha indibaniselwano ye-placebo)

Ukulawula iingxaki zokwetyisa

Kubalulekile ukuba uthethe nogqirha wakho malunga nendlela yokulawula ezi ngxaki. Ngaphandle koko, zinokuba nzulu.

Isicaphucaphu nokugabha kunokuthintelwa okanye kunyangwe ngokuthatha amayeza athile. Ngaphandle kokuthatha amayeza, zikho ezinye izinto onokuzenza ukuba uziva unesiyezi. Ngamanye amaxesha kuyanceda ukutya izixa ezincinane zokutya rhoqo, endaweni yokutya izidlo ezikhulu ezithathu suku ngalunye. Umbutho waseMelika woMhlaza ubonelela ngezinye iingcebiso zokunceda ukunciphisa isicaphucaphu.

Urhudo lunokunyangwa ngamayeza athile, anje nge-loperamide (Imodium). Kwaye ukuba unorhudo, qiniseka ukuba usela ulwelo oluninzi. Oku kuya kukunceda ukuba ungafumani manzi emzimbeni (xa umzimba wakho unexabiso eliphantsi lolwelo).

Unokukunceda ukuthintela ukuqhina ngokusela amanzi amaninzi, ukutya ukutya okunefayibha ephezulu, kunye nokwenza umthambo omninzi (njengokuhamba).

Ukuba iingxaki zakho zokugaya ukutya ziba nzima, ugqirha wakho unokunciphisa umyinge wakho weNinlaro. Banokukucela nokuba uyeke ukuthatha iyeza okwexeshana.

Izibophelelo

Unokuba nomngcipheko okhulayo wokukhula kwe-shingles (herpes zoster) ngelixa uthatha uNinlaro. I-Shingles kukukrala kolusu okubangela iintlungu ezivuthayo kunye nezilonda. Kwaxelwa kubantu abathatha uNinlaro ngexesha lezifundo zeklinikhi.

Abathathi-nxaxheba bahlulwe baba ngamaqela amabini. Iqela lokuqala lanikwa uNinlaro ngazo zombini i-lenalidomide kunye ne-dexamethasone. Iqela lesibini lanikwa indawo ye-placebo (unyango ngaphandle kwesiyobisi esisebenzayo) zombini i-lenalidomide kunye ne-dexamethasone.

Ngexesha lezifundo, i-shingles yaxelwa kwi-4% yabantu abathatha indibaniselwano yeNinlaro. Kulabo bathatha indibaniselwano ye-placebo, iipesenti ezi-2 zabantu babene-shingles.

Unokuphuhlisa i-shingles ukuba ubukhe wanerhashalala ngaphambili. I-Shingles yenzeka xa intsholongwane ebangela ukuba irhashalala iphinde isebenze (i-flares up) ngaphakathi komzimba wakho. Oku kungaphuma kunokwenzeka ukuba amajoni akho omzimba akasebenzi njengoko iqhele ukwenza, okuhlala kwenzeka kubantu abane-myeloma eninzi.

Ukuba ubukhe wanerhashalala ngaphambili kwaye usebenzisa uNinlaro, ugqirha wakho usenokukunika amayeza okubulala iintsholongwane omele uwasebenzise ngelixa usebenzisa uNinlaro. Amayeza antiviral aya kunceda ukuthintela i-shingles ekubeni ikhule emzimbeni wakho.

Umyinge weNinlaro

Umthamo weNinlaro ogqitywa ngugqirha wakho uya kuxhomekeka kwizinto ezininzi. Oku kubandakanya:

  • Isibindi sakho kunye nezintso zisebenza kakuhle
  • ukuba uneziphumo ebezingalindelekanga ezithile kunyango lwakho lweNinlaro

Olu lwazi lulandelayo luchaza iidosi eziqhelekileyo ezisetyenziswayo okanye ezicetyiswayo. Nangona kunjalo, qiniseka ukuthatha idosi ekumisela ugqirha wakho. Ugqirha wakho uya kumisela eyona idosi ilungele iimfuno zakho.

Iifom zamachiza kunye namandla

I-Ninlaro iza njengee-capsules zomlomo ezifumaneka ngamandla amathathu: 2.3 mg, 3 mg, kunye no-4 mg.

Isisombululo se-myeloma ezininzi

Imilinganiselo yokuqala yesiqhelo yeNinlaro yenye ye-4-mg capsule ethathwe kube kanye ngeveki iiveki ezintathu. Oku kulandelwa yiveki enye yokungathathi chiza. Uya kuwuphinda lo mjikelo weeveki ezine amaxesha amaninzi njengoko ugqirha ekucebisa.

Ngexesha lonyango, kufuneka uthathe iphilisi yeNinlaro ngosuku olunye ngeveki. Kungcono ukuthatha iNinlaro malunga nexesha elifanayo losuku kwidosi nganye. Kuya kufuneka uthathe uNinlaro kwisisu esingenanto, ubuncinci iyure enye ngaphambi kokuba utye okanye ubuncinci iiyure ezimbini emva kokuba utyile.

Uya kuthatha iNinlaro ngokudibanisa namanye amayeza amabini e-myeloma: lenalidomide (Revlimid) kunye ne-dexamethasone (Decadron). La machiza aneeshedyuli ezahlukeneyo zedosi kuneNinlaro. Qiniseka ukuba ulandela imiyalelo yethamo enikezwe ngugqirha wakho kula machiza.

Kungcono ukuba ishedyuli yakho yedosi ibhalwe phantsi kwitshathi okanye kwikhalenda. Oku kukunceda ukuba wazi onke amayeza ekufuneka uwathathile kwaye kanye xa ufuna ukuwathatha. Ngumbono olungileyo ukukhangela idosi nganye emva kokuba uyithathile.

Ukuba unengxaki kwisibindi sakho okanye izintso, ugqirha wakho unokucebisa ukuba uthathe idosi esezantsi yeNinlaro. Ugqirha wakho unokunciphisa idosi yakho okanye akucele ukuba uthathe ikhefu kunyango ukuba ufumana iziphumo ebezingalindelekanga ezithile kweli chiza (njengezinga eliphantsi leplatelet). Soloko uthatha uNinlaro kanye njengoko ugqirha wakho ekuyalela.

Kuthekani ukuba ndiphose idosi?

Ukuba ulibale ukuthatha idosi yeNinlaro, landela le miyalelo:

  • Ukuba kukho iiyure ezingama-72 okanye nangaphezulu de kufike idosi yakho elandelayo, thabatha idosi yakho ephosiweyo kwangoko. Emva koko, thatha idosi yakho elandelayo yeNinlaro ngexesha eliqhelekileyo.
  • Ukuba kukho ngaphantsi kweeyure ezingama-72 kude kufike idosi yakho elandelayo, tsiba nje idosi ephosiweyo. Thatha idosi yakho elandelayo yeNinlaro ngexesha eliqhelekileyo.

Ungaze uthathe ngaphezulu kwedosi enye yeNinlaro ukwenza idosi ephosiweyo. Ukwenza njalo kunokunyusa umngcipheko weziphumo ebezingalindelekanga.

Ukukunceda uqiniseke ukuba awuphosi idosi, zama ukuseta isikhumbuzi kwifowuni yakho. Ixesha leyeza linokuba luncedo nalo.

Ngaba kuya kufuneka ndisebenzise eli chiza ixesha elide?

I-Ninlaro yenzelwe ukuba isetyenziswe njengonyango lwexesha elide. Ukuba wena nogqirha ugqibe ukuba uNinlaro ukhuselekile kwaye uyasebenza kuwe, uya kuyithatha ixesha elide.

Eminye indlela eya kuNinlaro

Amanye amachiza akhoyo anokunyanga i-myeloma eninzi. Abanye banokukulungela ngcono kunabanye. Ukuba unomdla wokufumana enye indlela eya kuNinlaro, thetha nogqirha wakho. Banokukuxelela ngamanye amayeza anokukusebenzela.

Imizekelo yezinye iziyobisi ezingasetyenziselwa ukunyanga i-myeloma ezininzi zibandakanya:

  • iziyobisi ezithile ze-chemotherapy, ezinje:
    • icyclophosphamide (iCytoxan)
    • doxorubicin (Doxil)
    • Unobumba (Alkeran)
  • ii-corticosteroids ezithile, ezinje:
    • dexamethasone (iDecadron)
  • unyango oluthile lokuchasana nomzimba (iziyobisi ezisebenza kunye ne-immune system), njenge:
    • lenalidomide (ihlaziyiweyo)
    • pomalidomide (iPomalyst)
    • thalidomide (Thalomid)
  • unyango oluthile ekujoliswe kulo, olufana:
    • ibortezomib (Velcade)
    • icarfilzomib (iKyprolis)
    • daratumumab (iDarzalex)
    • elotuzumab (Empliciti)
    • ipanobinostat (Farydak)

I-Ninlaro vs Velcade

Usenokuzibuza ukuba uNinlaro uthelekisa njani namanye amayeza anikwe ukusetyenziswa okufanayo. Apha sijonga indlela iNinlaro kunye neVelcade ezifanayo kunye ezahlukeneyo.

Malunga

INinlaro iqulethe ixazomib, ngelixa iVelcade iqulethe i-bortezomib. La machiza omabini ajolise kunyango lwe-myeloma emininzi. Bakwiklasi yeziyobisi ekuthiwa yi-proteasome inhibitors. INinlaro kunye neVelcade basebenza ngendlela efanayo ngaphakathi komzimba wakho.

Sebenzisa

UNinlaro uvunyiwe yi-FDA ukunyanga:

  • I-myeloma emininzi kubantu abadala esele bazame olunye unyango kwesinye sezifo zabo. I-Ninlaro isetyenziswa ngokudibanisa ne-lenalidomide (Revlimid) kunye ne-dexamethasone (Decadron).

IVelcade yamkelwe yi-FDA ukunyanga:

  • I-myeloma emininzi kubantu abadala aba:
    • khange babenalo olunye unyango lwezifo zabo; kwaba bantu, iVelcade isetyenziswa ngokudibanisa ne-melphalan kunye ne-prednisone
    • une-myeloma emininzi eye yabuya kwakhona (ubuya) emva konyango lwangaphambili
    • Ingubo yeseli lymphoma (umhlaza kwii-lymph node) kubantu abadala

Iifom zeziyobisi kunye nolawulo

I-Ninlaro iza njengee-capsules ezithathwa ngomlomo. Uhlala uthatha iphilisi enye veki nganye iiveki ezintathu. Oku kulandelwa yiveki enye ngaphandle kokuthatha iyeza. Lo mjikelo weeveki ezine uphindaphindwa amaxesha amaninzi njengoko ugqirha ekucebisa.

IVelcade iza njengesisombululo esingamanzi esinikwa ngenaliti. Inikwa njengenaliti phantsi kolusu lwakho (inaliti yangaphantsi) okanye inaliti emthanjeni wakho (inaliti efakwa ngaphakathi). Uya kufumana olu nyango kwiofisi kagqirha wakho.

Ishedyuli yakho ye-Velcade iya kwahluka ngokuxhomekeke kwimeko yakho:

  • Ukuba i-myeloma yakho engakhange inyangwe ngaphambili, uya kusebenzisa iVelcade malunga nonyaka. Uhlala ulandela umjikelo wonyango weeveki ezintathu. Uya kuqala unyango ngokufumana iVelcade kabini ngeveki iiveki ezimbini, ilandelwe yiveki yokuphuma kwesiyobisi. Le patheni iya kuphindwa kwiiveki ezingama-24 zizonke. Emva kweeveki ezingama-24, uyakufumana iVelcade kube kanye ngeveki iiveki ezimbini, ilandelwe yiveki yokuphuma kwesiyobisi. Oku kuyaphindwa kwiiveki ezingama-30 zizonke.
  • Ukuba usebenzisa iVelcade ngenxa yokuba i-myeloma yakho ibuyile emva kolunye unyango (kunye neVelcade okanye ezinye iziyobisi), ishedyuli yakho yedosi inokwahluka, kuxhomekeke kwimbali yakho yonyango.

Iziphumo kunye neengozi

I-Ninlaro kunye neVelcade zombini ziqulethe iziyobisi ezivela kwiklasi enye. Ke ngoko, omabini la mayeza anokubangela iziphumo ezifanayo. Apha ngezantsi kunemizekelo yeziphumo ebezingalindelekanga.

Iziphumo eziqhelekileyo

Olu luhlu lunemizekelo yezinye iziphumo ebezingalindelekanga ezinokuthi zenzeke ngeNinlaro, kunye neVelcade, okanye zombini iziyobisi (xa zithathwa ngokwahlukeneyo).

  • Inokwenzeka ngoNinlaro:
    • amehlo owomileyo
  • Inokwenzeka ngeVelcade:
    • iintlungu zemithambo-luvo
    • ndiziva ndibuthathaka okanye ndidiniwe
    • ifiva
    • ukunciphisa ukutya
    • i-anemia (inqanaba elibomvu leeseli ezibomvu)
    • i-alopecia (ukulahleka kweenwele)
  • Inokwenzeka kunye neNinlaro kunye neVelcade:
    • umqolo obuhlungu
    • ukungaboni kakuhle
    • i-conjunctivitis (ekwabizwa ngokuba liliso elipinki)
    • i-shingles (herpes zoster), ebangela irhashalala ebuhlungu

Iziphumo ebezingalindelekanga ezimandundu

Olu luhlu lunemizekelo yeziphumo ebezingalindelekanga ezinokubakho ngeNinlaro, kunye neVelcade, okanye zombini iziyobisi (xa zithathwa ngokwahlukeneyo). Uninzi lweziphumo ebezingalindelekanga zenzeka rhoqo ebantwini abathatha la machiza.

  • Inokwenzeka ngoNinlaro:
    • ulusu olubi kakhulu, kubandakanya isifo sikaSweet kunye nesifo sikaStevens-Johnson
  • Inokwenzeka ngeVelcade:
    • uxinzelelo lwegazi oluphantsi (kunokubangela ukuba nesiyezi okanye ukutyhafa)
    • iingxaki zentliziyo, ezinje ngokusilela kwentliziyo okanye isingqi sentliziyo esingaqhelekanga
    • iingxaki zemiphunga, ezinje ngesifo sokuphefumla, inyumoniya, okanye ukudumba kwimiphunga yakho
  • Inokwenzeka kunye neNinlaro kunye neVelcade:
    • i-edema yomda (ukudumba emaqatheni, iinyawo, imilenze, iingalo, okanye izandla)
    • thrombocytopenia (inqanaba eliphantsi leplatelet)
    • iingxaki zesisu okanye zesisu, ezinjengorhudo, ukuqhina, isicaphucaphu, okanye ukugabha
    • iingxaki zemithambo-luvo, ezinjengokurhawuzelela okanye ukutshisa iimvakalelo, ukuba ndindisholo, iintlungu, okanye ubuthathaka ezingalweni okanye emilenzeni
    • i-neutropenia (inqanaba lamaseli amhlophe asezantsi), elinokuthi landise umngcipheko wokufumana usulelo
    • ukulimala kwesibindi

Ukusebenza ngempumelelo

I-Ninlaro kunye neVelcade banezinto ezahlukileyo ezamkelweyo ze-FDA, kodwa zombini zisetyenziselwa ukunyanga i-myeloma yabantu abadala.

La machiza khange athelekiswe ngokuthe ngqo kwizifundo zeklinikhi. Nangona kunjalo, izifundo zifumanise ukuba zombini i-Ninlaro kunye neVelcade ziyasebenza ekulibaziseni ukuqhubela phambili (ukuwohloka) kwe-myeloma eninzi. Omabini la machiza anconyelwa zizikhokelo zonyango zangoku zokusetyenziswa kubantu abane-myeloma eninzi.

Kubantu abathile, izikhokelo zonyango zicebisa ukusebenzisa irejimeni esekwe kwiVelcade ngokusebenzisa indibaniselwano yeNinlaro ene-lenalidomide (Revlimid) kunye ne-dexamethasone (Decadron). Esi siphakamiso sibandakanya abantu abane-myeloma emininzi esebenzayo abanyangwa okokuqala. Ukusebenza kwe-myeloma emininzi kuthetha ukuba umntu uneempawu zesifo, ezinje ngeengxaki zezintso, ukonakala kwethambo, i-anemia, okanye eminye imiba.

Kubantu i-myeloma yam eye yabuya emva kolunye unyango, izikhokelo zicebisa unyango ngeNinlaro okanye iVelcade, ngokudibanisa namanye amachiza.

Iindleko

I-Ninlaro kunye neVelcade bobabini zinegama leziyobisi. Okwangoku azikho iintlobo zohlobo oluthile lwamayeza. Amayeza egama leBrand ahlala exabisa ngaphezu kwegeneric.

Ngokwengqikelelo kwi-WellRx.com, iVelcade ngokubanzi ixabisa ngaphezulu kweNinlaro. Elona xabiso uzakuhlawula ngalo naliphi na ichiza lixhomekeke kwisicwangciso sakho seinshurensi, indawo okuyo, kunye nekhemesti oyisebenzisayo.

Ixabiso likaNinlaro

Njengawo onke amayeza, iindleko zeNinlaro ziyahluka. Ukufumana amaxabiso akhoyo eNinlaro kwindawo yakho, jonga WellRx.com.

Iindleko ozifumana kwi-WellRx.com yinto onokuyihlawula ngaphandle kwe-inshurensi. Ixabiso langempela oza kulihlawula lixhomekeke kwisicwangciso sakho seinshurensi, indawo okuyo, kunye nekhemesti oyisebenzisayo.

Uncedo lwezezimali kunye neinshurensi

Ukuba ufuna inkxaso yemali ukuhlawulela uNinlaro, okanye ukuba ufuna uncedo lokuqonda i-inshurensi yakho, uncedo luyafumaneka.

I-Takeda Pharmaceutical Company Limited, umenzi weNinlaro, unikezela ngenkqubo ebizwa ngokuba yiTakeda Oncology 1Point. Le nkqubo ibonelela ngoncedo kwaye unokwazi ukunceda ukuthoba iindleko zonyango lwakho. Ngolwazi oluthe kratya kunye nokufumanisa ukuba uyilungele na inkxaso, tsalela umnxeba ku-844-817-6468 (844-T1POINT) okanye undwendwele iwebhusayithi yenkqubo.

UNinlaro usebenzisa

Ulawulo lokutya kunye neziyobisi (i-FDA) livuma amayeza amiselweyo anjengeNinlaro ukunyanga iimeko ezithile. UNinlaro unokusetyenziselwa ngaphandle kwelebheli kwezinye iimeko. Ukusetyenziswa kwelebula engekho xa kusebenze iyeza elamkelweyo ukunyanga imeko enye lisetyenziselwa ukunyanga imeko eyahlukileyo.

UNinlaro we-myeloma ezininzi

I-Ninlaro ivunyiwe yi-FDA ukunyanga i-myeloma ezininzi kubantu abadala esele bazame olunye unyango olunye ngale meko. Olu unyango lunokuba lunyango okanye inkqubo. I-Ninlaro ivunyiwe ukuba isetyenziswe ngokudibeneyo namanye amachiza amabini: i-lenalidomide (i-Revlimid) kunye ne-dexamethasone (i-Decadron).

I-myeloma emininzi luhlobo olunqabileyo lomhlaza olukhula kwiiseli zakho zeplasma. Ezi seli luhlobo lweeseli ezimhlophe zegazi. Zenziwe ngumongo wethambo lakho, osisixhobo esinesiponji esifumaneka ngaphakathi kwamathambo akho. Umongo wakho wethambo wenza zonke iiseli zakho zegazi.

Ngamanye amaxesha iiseli zeplasma ziye ziqheleke kwaye ziqale ukuphindaphindeka (zisenza iiseli ze-plasma) ngokungalawulekiyo. Ezi seli zesifo seplasma ezingaqhelekanga zibizwa ngokuba ziiseli ze-myeloma.

Iiseli zeMyeloma zinokukhula kwiindawo ezininzi (ezininzi) zomongo wethambo kunye nakumathambo ahlukeneyo. Kungenxa yoko le nto imeko ibizwa ngokuba yi-myeloma emininzi.

Iiseli ze-myeloma zithatha indawo eninzi kumongo wethambo lakho. Oku kwenza ukuba kube nzima kumongo wakho wethambo ukwenza iiseli zegazi ezaneleyo. Iiseli ze-myeloma zinokonakalisa amathambo akho, zibenze buthathaka.

Ukusebenza kwe-myeloma ezininzi

Kwisifundo seklinikhi, uNinlaro wayesebenza ngempumelelo kunyango lwe-myeloma. Uphononongo lujonge abantu abangama-722 abane-myeloma ezininzi ababesele benenye unyango olunye kule meko. Kulaba bantu, i-myeloma yabo emininzi ibiyekile ukuphendula (ukuba ngcono) kolunye unyango, okanye ibuye emva kokuphuculwa kokuqala kolunye unyango.

Kolu phando, abantu bohlulwa baba ngamaqela amabini. Iqela lokuqala lanikwa uNinlaro namanye amayeza amabini e-myeloma: i-lenalidomide kunye ne-dexamethasone. Iqela lesibini lanikwa i-placebo (unyango ngaphandle kwesiyobisi esisebenzayo) kunye ne-lenalidomide kunye ne-dexamethasone.

Abantu abathathe indibaniselwano yeNinlaro baphila i-avareji yeenyanga ezingama-20.6 ngaphambi kokuba i-myeloma yabo iqhubeke. Abantu abathatha indibaniselwano ye-placebo baphila umndilili weenyanga ezili-14.7 ngaphambi kokuba isifo sabo siqhubele phambili.

Amashumi asixhenxe anesibhozo eepesenti abantu abathathe indibaniselwano yeNinlaro baphendule kunyango. Oku kuthetha ukuba babenokuphuculwa okungama-50% kwiimvavanyo zabo zelebhu ezazikhangela iiseli ze-myeloma. Kulawo athabathe indibaniselwano ye-placebo, ama-72% abantu bafumana impendulo efanayo kunyango.

Ukusetyenziswa kwelebheli engasebenziyo kwiNinlaro

Ukongeza kusetyenziso oludweliswe apha ngasentla, uNinlaro unokusetyenziselwa ngaphandle kwelebheli yolunye usetyenziso. Ukusetyenziswa kweziyobisi ezingekho kwilebula kuxa ukusetyenziswa kweziyobisi ekuvunyelweni ukusetyenziswa kwazo kusetyenziselwa ukunyanga enye engavunyelwanga.

UNinlaro we-myeloma ezininzi kwezinye iimeko

I-Ninlaro ivunyiwe yi-FDA ukuba isebenzise i-lenalidomide kunye ne-dexamethasone ukunyanga i-myeloma ezininzi kubantu ababekhe bafumana olunye unyango. Kufundwa njengokhetho lonyango kwezinye iimeko ezibandakanya i-myeloma ezininzi.

Uphando lwenziwa ukubona ukuba uNinlaro unokusetyenziswa njani ngaphandle kwelebheli kwezi meko zilandelayo:

  • Ukunyanga izigaba ezahlukeneyo ze-myeloma ezininzi
  • ngokudibeneyo nezinye iziyobisi ngaphandle kwe-lenalidomide kunye ne-dexamethasone ukunyanga i-myeloma eninzi

Unokumiselwa uNinlaro ngaphandle kwelebheli kwenye yezi ndlela.

I-Ninlaro yenkqubo yokukhanya yokukhanya kwe-amyloidosis

I-Ninlaro ayivunyelwanga yi-FDA ukunyanga amyloidosis wokukhanya kwesystemic. Nangona kunjalo, ngamanye amaxesha isetyenziswa ngaphandle kwelebheli ukunyanga le meko.

Le meko inqabileyo ichaphazela indlela iiseli zakho zeplasma (ezifumaneka kumongo wakho wethambo) zivelisa iiproteni ezithile ezibizwa ngokuba ziiproteni zokukhanya. Iikopi ezingaqhelekanga zezi proteni zingena kwigazi lakho kwaye zinokwakha izicwili kunye namalungu kuwo wonke umzimba wakho. Njengokuba iiprotein zisakha, zenza ii-amyloids (izihloko zeprotheyini), ezinokonakalisa amalungu athile anjengentliziyo okanye izintso.

I-Ninlaro ibandakanyiwe kwizikhokelo zonyango lwe-systemic light chain amyloidosis, emva kohlolisiso olufumanise ukuba iyasebenza ekunyangeni le meko. I-Ninlaro lukhetho lonyango kubantu abane-amyloidosis eyekile ukuphendula kunyango lokuqala lokuvuma imeko. Ikwayindlela yokonyango kubantu abane-amyloidosis ebuyileyo emva kokuba iphuculwe ngonyango olukhethiweyo lokuqala.

I-Ninlaro isetyenziswa nokuba iyodwa okanye idityaniswe ne-dexamethasone xa isetyenziselwa ukunyanga esi sifo.

Ukusetyenziswa kweNinlaro kunye nezinye iziyobisi

Uhlala uthatha iNinlaro ngokudibanisa namanye amachiza asebenza ngeendlela ezahlukeneyo ukunyanga i-myeloma yakho emininzi.

I-Ninlaro ivunyiwe ukuba isetyenziswe kunye ne-lenalidomide (Revlimid) kunye ne-dexamethasone (Decadron). Ngexesha lezifundo zeklinikhi, unyango lwe-Ninlaro ngokudibeneyo nala machiza lwalusebenza ngakumbi kunokusebenzisa i-lenalidomide kunye ne-dexamethasone.

Ugqirha wakho unokucebisa ukuba uthathe uNinlaro kunye nezinye iziyobisi ezininzi ze-myeloma. Le yindlela yeelebheli engaphandle yokusebenzisa iNinlaro. Ukusetyenziswa kweziyobisi ezingekho kwilebheli kuxa ichiza elivunyiweyo kusetyenziso olunye lisetyenziselwa ukunyanga elahlukileyo elingavunyelwanga.

I-Ninlaro ene-lenalidomide (i-Revlimid)

I-Lenalidomide (i-Revlimid) sisiyobisi somzimba. Olu hlobo lweziyobisi lusebenza ngokunceda amajoni akho omzimba abulale iiseli ze-myeloma.

I-Revlimid iza njengee-capsules ezithathwa ngomlomo ngokudibanisa neNinlaro. Uya kuthatha i-Revlimid kanye yonke imihla kangangeeveki ezintathu, ilandelwe yiveki enye yokungathathi iyeza.

Ungathatha i-Revlimid kunye okanye ngaphandle kokutya.

I-Ninlaro ene-dexamethasone (i-Decadron)

I-Dexamethasone (i-Decadron) luhlobo lweziyobisi olubizwa ngokuba yi-corticosteroid. La machiza asetyenziswa ikakhulu ukunciphisa ukudumba (ukudumba) emzimbeni wakho. Nangona kunjalo, xa unikwa ngeedosi ezisezantsi kunyango lwe-myeloma, i-dexamethasone inceda uNinlaro kunye no-Revlimid ukubulala iiseli ze-myeloma.

I-Dexamethasone iza njengamacwecwe athathwa ngomlomo ngokudibeneyo neNinlaro. Uyakuthatha i-dexamethasone kanye ngeveki, kwangalo suku lweveki uthatha ngalo uNinlaro. Uya kuthatha i-dexamethasone veki nganye, kubandakanya neveki ongathathi ngayo uNinlaro.

Musa ukuthatha idosi yakho ye-dexamethasone ngaxeshanye njengoko uthatha idosi yakho yeNinlaro. Kungcono ukuthatha la machiza ngamaxesha ahlukeneyo emini.Kungenxa yokuba i-dexamethasone kufuneka ithathwe kunye nokutya, ngelixa i-Ninlaro kufuneka ithathwe isisu esingenanto.

UNinlaro kunye notywala

Utywala abaziwa ngokuchaphazela indlela uNinlaro asebenza ngayo emzimbeni wakho. Nangona kunjalo, ukuba uneziphumo ebezingalindelekanga ezivela kwi-Ninlaro (enjenge-nausea okanye urhudo), ukusela utywala kunokwenza ezi ziphumo zibi ngakumbi.

Ukuba usela utywala, thetha nogqirha wakho malunga nokuba butywala kangakanani obukhuselekileyo kuwe ngelixa usebenzisa uNinlaro.

Ukudibana kukaNinlaro

UNinlaro unokusebenzisana namanye amayeza. Iyakwazi ukusebenzisana nezibonelelo ezithile.

Unxibelelwano olwahlukileyo kunokubangela iziphumo ezahlukeneyo. Umzekelo, unxibelelwano oluthile lunokuphazamisa ukusebenza kakuhle kwesiyobisi. Olunye unxibelelwano lunokunyusa iziphumo ebezingalindelekanga okanye lubenze bube nzima ngakumbi.

Ninlaro kunye namanye amayeza

Apha ngezantsi kukho uluhlu lwamayeza anokusebenzisana noNinlaro. Olu luhlu alunazo zonke iziyobisi ezinokuthi zidibane noNinlaro.

Ngaphambi kokuba uthathe uNinlaro, thetha nogqirha wakho kunye nosokhemesti. Baxelele ngawo onke amayeza kagqirha, ekhawuntareni, kunye nezinye iziyobisi ozithathayo. Baxelele malunga nazo naziphi na iivithamini, amayeza esintu kunye nezixhasi ozisebenzisayo. Ukwabelana ngolu lwazi kunokukunceda uphephe unxibelelwano olunokubakho.

Ukuba unemibuzo malunga nokunxibelelana kweziyobisi okunokuchaphazela, buza ugqirha wakho okanye usokhemesti.

I-Ninlaro kunye neziyobisi ezithile zesifo sephepha

Ukuthatha amayeza athile esifo sephepha kunye no-Ninlaro kunokuwathoba amanqanaba eNinlaro emzimbeni wakho. Oku kunokwenza ukuba uNinlaro angasebenzi kakuhle kuwe. Kuya kufuneka uphephe ukuthatha la machiza alandelayo kunye noNinlaro:

  • irifabutin (Mycobutin)
  • irifampin (Rifadin)
  • irifapentine (Priftin)

I-Ninlaro kunye neziyobisi ezithile zokubamba

Ukuthatha amayeza athile wokubanjwa kunye noNinlaro kungathoba inqanaba leNinlaro emzimbeni wakho. Oku kunokwenza ukuba uNinlaro angasebenzi kakuhle kuwe. Kuya kufuneka uphephe ukuthatha la machiza alandelayo kunye noNinlaro:

  • icarbamazepine (iCarbatrol, i-Equetro, iTegretol)
  • fosphenytoin (iCerebyx)
  • oxcarbazepine (iTrileptal)
  • ifumanobarbital
  • I-phenytoin (iDilantin, iPhenytek)
  • i-primidone (iMysoline)

I-Ninlaro kunye namayeza kunye nezongezo

UNinlaro unokusebenzisana namayeza athile kunye nezongezo, kubandakanya neSt. Qinisekisa ukuba uxoxa ngazo naziphi na izongezo ozithathayo nogqirha wakho ngaphambi kokuba uqale ukusebenzisa uNinlaro.

UNinlaro kunye neSt

Ukuthatha iwort yaseSt. John's kunye noNinlaro kungathoba inqanaba leNinlaro emzimbeni wakho kwaye kuyenze ingasebenzi kakuhle kuwe. Gwema ukuthatha le yongezelelo yemifuno (ekwabizwa ngokuba Ihypericum perforatumNgelixa usebenzisa uNinlaro.

Ungamthatha njani uNinlaro

Kuya kufuneka uthathe uNinlaro ngokwemiyalelo kagqirha wakho okanye yezempilo.

Nini ukuthatha

Ngaphandle kokuba ugqirha wakho akuxelele ngenye indlela, thatha idosi yakho yeNinlaro kanye ngeveki, ngemini enye ngeveki. Kungcono ukuthatha amanani akho ngexesha elifanayo losuku.

Uya kuthatha uNinlaro kanye ngeveki kwiiveki ezintathu. Emva koko uya kuba neveki ekuphumeni kwesiyobisi. Uya kuwuphinda lo mjikelo weeveki ezine amaxesha amaninzi njengoko ugqirha ekucebisa.

Ukukunceda uqiniseke ukuba awuphosi idosi, zama ukuseta isikhumbuzi kwifowuni yakho. Ixesha leyeza linokuba luncedo, nalo.

Ukuthatha uNinlaro ngokutya

Akufanele uthathe uNinlaro ngokutya. Kufuneka kuthathwe kwisisu esingenalutho kuba ukutya kunokunciphisa inani leNinlaro elifunxwa ngumzimba wakho. Oku kunokwenza ukuba uNinlaro angasebenzi kakuhle kuwe. Thatha idosi nganye yeNinlaro ubuncinci iyure enye ngaphambi kokuba utye okanye ubuncinci iiyure ezimbini emva kokuba utyile.

Ngaba iNinlaro ingatyumka, yahlulwe, okanye ihlafunwe?

Hayi, akufuneki utyumze, uqhekeze, uqhekeze, okanye uhlafune iipilisi zeNinlaro. Ezi njengezingxobo zenzelwe ukuginywa kuphele ngamanzi okusela.

Ukuba i-capsule yeNinlaro ngengozi iyavuleka, kuphephe ukuthinta umgubo ongaphakathi kwisingxobo. Ukuba kukho umgubo ofika kulusu lwakho, yihlambe ngoko nangoko ngesepha namanzi. Ukuba kukho nawuphi na umgubo ongena emehlweni akho, yigungxule ngamanzi kwangoko.

Usebenza njani uNinlaro

I-Ninlaro yamkelwe ukunyanga i-myeloma eninzi. Inikwe ngamanye amachiza amabini (i-lenalidomide kunye ne-dexamethasone) eyinceda ukuba isebenze ngaphakathi komzimba wakho.

Kwenzeka ntoni kwi-myeloma ezininzi

Embindini wamathambo akho, kukho into exineneyo ebizwa ngokuba ngumongo wethambo. Kulapho iiseli zakho zegazi zenziwe khona, kubandakanya neeseli zakho ezimhlophe zegazi. Iiseli ezimhlophe zegazi zilwa nosulelo.

Zininzi iintlobo ezahlukeneyo zeeseli ezimhlophe zegazi. Olunye uhlobo lubizwa ngokuba ziiseli zeplasma. Iiseli zePlasma zenza izilwa-buhlungu, eziziiproteni ezinceda umzimba wakho ukuba uqonde kwaye uhlasele iintsholongwane, ezinjengeentsholongwane kunye neentsholongwane.

Kwii-myeloma ezininzi, iiseli zeplasma ezingaqhelekanga zenziwa kumongo wethambo lakho. Baqala ukuphindaphindeka (benze iiseli ze-plasma) ngokungalawulekiyo. Ezi seli zesifo seplasma ezingaqhelekanga zibizwa ngokuba ziiseli ze-myeloma.

Iiseli ze-Myeloma zithatha indawo eninzi kumongo wethambo, oko kuthetha ukuba akukho ndawo incinci yokwenza iiseli eziphilileyo zegazi. Iiseli ze-myeloma nazo zonakalisa amathambo akho. Oku kubangela ukuba amathambo akho akhuphe i-calcium egazini lakho, elenza buthathaka amathambo akho.

Into eyenziwa nguNinlaro

I-Ninlaro isebenza ngokunciphisa inani leeseli ze-myeloma kumongo wethambo. Isilwayo sijolise kwiprotheni ethile, ebizwa ngokuba yi-proteasome, ngaphakathi kweeseli ze-myeloma.

IiProteasomes zidiliza ezinye iiproteni ezingasafunekiyo iiseli, kunye neeproteni ezonakalisiweyo. UNinlaro unamathela kwiiproteasomes kwaye azinqande ekusebenzeni ngokufanelekileyo. Oku kukhokelela ekwakhiweni kweeproteni ezonakalisiweyo nezingafunekiyo kwiiseli ze-myeloma, ezibangela ukuba iiseli ze-myeloma zife.

Kuthatha ixesha elingakanani ukusebenza?

UNinlaro uqala ukusebenza ngaphakathi emzimbeni wakho nje ukuba uqale ngokuthatha. Kodwa kuya kuthatha ixesha ukwakha iziphumo ezinokuthi ziqwalaselwe, ezinje ngokuphuculwa kweempawu zakho okanye iziphumo zovavanyo lwelebhu.

Kwisifundo seklinikhi, abantu abane-myeloma ezininzi bathathe i-Ninlaro (ngokudibanisa ne-lenalidomide kunye ne-dexamethasone). Isiqingatha saba bantu sibone ukuphucuka kwemeko yabo kwinyanga ephelileyo xa baqala ukuthatha uNinlaro.

UNinlaro kunye nokukhulelwa

UNinlaro akafundanga kwabasetyhini abakhulelweyo. Nangona kunjalo, indlela uNinlaro asebenza ngayo ngaphakathi komzimba wakho kulindeleke ukuba ibe yingozi ekukhulelweni okukhulayo.

Kwizifundo zezilwanyana, ichiza lenze ingozi kwimveku xa inikwa izilwanyana ezikhulelweyo. Ngelixa izifundo zezilwanyana zingasoloko ziqikelela ukuba kuya kwenzeka ntoni ebantwini, ezi zifundo zibonisa ukuba ichiza linokwenzakalisa ukukhulelwa komntu.

Ukuba ukhulelwe, okanye unokukhulelwa, thetha nogqirha wakho umngcipheko kunye nezibonelelo zokuthatha uNinlaro.

UNinlaro kunye nolawulo lokuzalwa

Ngenxa yokuba uNinlaro angonzakalisa ukukhulelwa okukhulayo, kubalulekile ukusebenzisa ulawulo lokuzalwa ngelixa uthatha eli chiza.

Ulawulo lokuzalwa kwabasetyhini

Ukuba ungowasetyhini okwaziyo ukukhulelwa, kuya kufuneka usebenzise ulawulo lokuzalwa olusebenzayo ngelixa uthatha uNinlaro. Kuya kufuneka uqhubeke nokusebenzisa ukuzalwa kweentsuku ezingama-90 ubuncinci emva kokuba uyekile ukuthatha uNinlaro.

I-Ninlaro ithathwa ngokudibanisa ne-lenalidomide kunye ne-dexamethasone kunyango lwe-myeloma. I-Dexamethasone inokwenza ulawulo lokuzalwa kwe-hormonal, kubandakanywa iipilisi zokulawula ukuzalwa, ezingasebenzi kakuhle ukukhusela ukukhulelwa. Ukuba usebenzisa ulawulo lokuzalwa kwehomoni, kuya kufuneka usebenzise isithintelo sokuthintela ukukhulelwa (njengeikhondom) njengolawulo lokuzalwa lokugcina.

Ulawulo lokuzalwa kwamadoda

Ukuba uyindoda eyabelana ngesondo nomntu obhinqileyo onokukhulelwa, kuya kufuneka usebenzise ulawulo lokuzalwa olusebenzayo (njengeikhondom) ngelixa uthatha uNinlaro. Oku kubalulekile, nokuba iqabane lakho labasetyhini lisebenzisa izinto zokucwangcisa. Kuya kufuneka uqhubeke usebenzisa ulawulo lokuzalwa ubuncinci kwiintsuku ezingama-90 emva kwedosi yakho yokugqibela yeNinlaro.

UNinlaro kunye nokuncancisa

Ayaziwa ukuba uNinlaro udlulela kubisi lwebele, okanye ukuba ichaphazela indlela umzimba wakho owenza ngayo ubisi lwebele. Kuya kufuneka uphephe ukuncancisa ngelixa uthatha uNinlaro. Musa ukuncancisa de kube ziintsuku ezingama-90 ubuncinci emva kokuba uyekile ukuthatha uNinlaro.

Imibuzo eqhelekileyo malunga noNinlaro

Nazi iimpendulo kwimibuzo ebuzwa rhoqo malunga noNinlaro.

Ngaba uNinlaro luhlobo lwechemotherapy?

Hayi, uNinlaro ayilulo uhlobo lwechemotherapy. I-Chemotherapy isebenza ngokubulala iiseli emzimbeni wakho eziphindaphindayo (ezenza iiseli ezininzi) ngokukhawuleza. Oku kubandakanya iiseli ezinempilo, kunye neeseli zomhlaza. Ngenxa yokuba ichemotherapy ichaphazela ezinye iiseli zakho ezisempilweni, inokuba neziphumo ebezingalindelekanga ezibi kakhulu.

I-Ninlaro yonyango ekujoliswe kulo kwi-myeloma emininzi. Unyango ekujoliswe kulo lusebenza kwiimpawu ezithile kwiiseli zomhlaza ezahlukileyo kwezo zeeseli ezisempilweni. UNinlaro ujolise kwiiproteni ezithile ezibizwa ngokuba ziiproteasomes.

IiProteasomes ziyabandakanyeka kuhlumo oluqhelekileyo nakwimveliso yeeseli. Ezi proteni zisebenza ngakumbi kwiiseli zomhlaza kunakwiseli esempilweni. Oku kuthetha ukuba xa i-Ninlaro ijolise kwiiproteasomes, ichaphazela iiseli ze-myeloma ngaphezulu kokuchaphazela iiseli ezisempilweni.

I-Ninlaro isenokuchaphazela iiseli ezisempilweni kwaye inokubangela iziphumo ebezingalindelekanga ezibi. Nangona kunjalo, ngokubanzi, unyango ekujoliswe kulo (njengeNinlaro) ludla ngokubangela iziphumo ebezingalindelekanga ezimbalwa kuneziyobisi zamachiza.

Ndingamthatha uNinlaro ngaphambi okanye emva kokufakelwa kweseli?

Unokwazi. I-Ninlaro ivunyiwe ukuba isetyenziswe kubantu abaye bafumana olunye unyango olunye kwi-myeloma yabo emininzi. Oku kubandakanya abantu abaye batshintshelwa iseli yonyango njengonyango.

Iiseli zestem ziiseli zegazi ezingafakwanga ezifumaneka kwigazi lakho nakumongo wethambo lakho. Zingakhula zibe zonke iintlobo zeeseli zegazi. Ukufakelwa kweseli ye-stem yonyango lwe-myeloma ezininzi. Ijolise ekubuyiseleni iiseli ze-myeloma ngeeseli ezinempilo, ezinokuthi emva koko zikhule zibe ziiseli zegazi ezisempilweni.

Izikhokelo zeklinikhi zangoku zibandakanya uNinlaro njengolondolozo (lwexesha elide) ukhetho lonyango lokumisa iiseli zomhlaza ekuziphindaphindeni emva kokuba ufumene ukufakelwa kweseli yeseli. (Kule nkqubo, iiseli zakho eziqokelelweyo ziqokelelwa kwigazi lakho okanye kumongo wethambo kwaye zibuyiselwe kuwe ekufakweni.) Nangona kunjalo, amanye amachiza akhethwa ngaphezu kweNinlaro kule meko.

Izikhokelo zeklinikhi zangoku zibandakanya uNinlaro njengokhetho kunyango lokuqala lweziyobisi onalo kwi-myeloma yakho emininzi, ngaphambi kokuba ufakelwe isisele se-stem. Nangona kunjalo, amanye amachiza akhethwa ngaphezu kweNinlaro kule meko. Oku kunokuba kukusetyenziswa kwelebheli engekho kwiNinlaro. Ukusetyenziswa kweziyobisi ezingekho kwilebheli kuxa ichiza elivunyiweyo kusetyenziso olunye lisetyenziselwa ukunyanga elahlukileyo elingavunyelwanga.

Ukuba ndiyagabha emva kokuthatha idosi, ngaba kufuneka ndithathe enye idosi?

Ukuba uyagabha emva kokuthatha uNinlaro, ungathathi elinye idosi ngala mhla. Thatha nje idosi yakho elandelayo xa kufanelekile kwishedyuli yakho yedosi.

Ukuba uhlala uphosa ngelixa uthatha uNinlaro, thetha nogqirha wakho. Banokukuyalela amayeza okunceda ukunciphisa isicaphucaphu okanye bakunike iingcebiso ngendlela yokulawula isicaphucaphu ngexesha lonyango.

Ngaba ndiza kufuna iimvavanyo zaselebhu ngelixa ndithatha uNinlaro?

Ewe. Ngelixa uthatha uNinlaro, kuya kufuneka ukuba ube novavanyo lwegazi rhoqo ukujonga amanqanaba eseli yegazi kunye nokusebenza kwesibindi sakho. Ngexesha lonyango, ugqirha wakho uya kujonga ezi mvavanyo zilandelayo:

  • Inqanaba lePlatelet. I-Ninlaro inokuhlisa inqanaba leplatelet yakho. Ukuba inqanaba lakho lihla kakhulu, unokuba nomngcipheko owandayo wokopha kakhulu. Ugqirha wakho uya kujonga ubalo lweplatelet yakho rhoqo, ukwenzela ukuba xa kufunyenwe iingxaki, zinokuqwalaselwa ngokukhawuleza. Ukuba amanqanaba akho asezantsi, ugqirha wakho unokunciphisa idosi yakho yeNinlaro okanye uyeke ukuthatha iNinlaro de iiplatelets zakho zibuyele kwinqanaba elikhuselekileyo. Ngamanye amaxesha, unokufuna ukutofelwa igazi ukuze ufumane iiplatelets.
  • Inqanaba leseli emhlophe. Elinye lamachiza (elibizwa ngokuba yiRevlimid) oza kulithatha noNinlaro lingalinciphisa izinga lakho leeseli ezimhlophe zegazi, ezinokunyusa umngcipheko wokufumana usulelo. Ukuba unamanqanaba asezantsi ezi seli, ugqirha wakho unokunciphisa idosi yeRevlimid kunye neNinlaro, okanye uyeke ukuthatha amayeza, de iiseli zakho ezimhlophe zegazi zibuyele kwinqanaba elikhuselekileyo.
  • Uvavanyo lomsebenzi wesibindi. I-Ninlaro ngamanye amaxesha inokonakalisa isibindi sakho, ibangele ii-enzyme zesibindi ukuba zikhutshelwe egazini lakho. Uvavanyo lomsebenzi wesibindi jonga igazi lakho kwezi enzymes. Ukuba iimvavanyo zibonisa ukuba i-Ninlaro ichaphazela isibindi sakho, ugqirha wakho unokunciphisa umlinganiselo weyeza.
  • Olunye uvavanyo lwegazi. Uya kuba nolunye uvavanyo lwegazi ukujonga ukuba i-myeloma yakho iphendula njani kunyango ngo-Ninlaro.

Izilumkiso zikaNinlaro

Ngaphambi kokuba uthathe uNinlaro, thetha nogqirha wakho malunga nembali yakho yezempilo. UNinlaro usenokungakulungeli ukuba uneemeko ezithile zonyango. Oku kubandakanya:

  • Iingxaki zezintso. Ukuba umsebenzi wakho wezintso ukhubazeke kakhulu, okanye ukuba unonyango lwe-hemodialysis yokusilela kwezintso, ugqirha wakho uya kukuyalela idosi esezantsi yeNinlaro.
  • Iingxaki zesibindi. I-Ninlaro inokubangela iingxaki zesibindi. Kwaye ukuba unobungozi besibindi, ukuthatha uNinlaro kunokuba mandundu imeko yakho. Ukuba uneengxaki zesibindi ngokuphakathi, ugqirha wakho uya kukumisela idosi esezantsi yeNinlaro.
  • Ukukhulelwa. Ukuba ukhulelwe okanye unokukhulelwa, uNinlaro unokuba yingozi ekukhulelweni kwakho. Ukuba wena okanye iqabane lakho niyakwazi ukukhulelwa, kuya kufuneka nisebenzise ulawulo lokuzalwa ngelixa nithatha uNinlaro. Ngolwazi oluthe kratya, nceda ubone "uNinlaro kunye nokukhulelwa" kunye ne "Ninlaro kunye nolawulo lokuzalwa" kumacandelo angentla.

Phawula: Ngolwazi oluthe kratya malunga neziphumo ezibi ezinokubakho zeNinlaro, jonga icandelo leNinlaro elingentla.

Ninlaro libanda

Ukuthatha ngaphezulu komthamo ocetyiswayo weNinlaro kunokukhokelela kwiziphumo ebezingalindelekanga ezibi. Uluhlu lweziphumo ebezingalindelekanga ezinokubangelwa nguNinlaro, nceda ubone icandelo leziphumo ebezingalindelekanga zeNinlaro apha ngasentla.

Iimpawu libanda

Iimpawu libanda, kunokubandakanya ukwanda naziphi na iziphumo ebezingalindelekanga ezinokubakho Ninlaro. Uluhlu lweziphumo ebezingalindelekanga ezinokwenzeka, nceda ubone icandelo "leziphumo ebezingalindelekanga zeNinlaro" apha ngasentla.

Kufuneka wenze ntoni xa uthe wagqithisa?

Ukuba ucinga ukuba uthathe kakhulu eli chiza, tsalela ugqirha wakho. Ungabiza uMbutho waseMelika wamaZiko oLawulo lweTyhefu ku-800-222-1222 okanye usebenzise isixhobo esikwi-Intanethi. Kodwa ukuba iimpawu zakho zinzima, tsalela umnxeba ku-911 okanye uye kwigumbi likaxakeka elikufutshane ngoko nangoko.

Ukuphelelwa lixesha kukaNinlaro, ukugcinwa kunye nokulahlwa

Xa ufumana uNinlaro kwikhemesti, usokhemesti uya kongeza umhla wokuphelelwa kwileyibhile kwiphakheji yamayeza. Lo mhla uqhelekile ukuba ube ngunyaka omnye ukusukela kumhla wokuhambisa kwabo amayeza. Musa ukuthatha uNinlaro ukuba umhla wokuphelelwa oshicilelweyo udlulile.

Umhla wokuphelelwa unceda ekuqinisekiseni ukusebenza kwamayeza ngeli xesha. Isimo sangoku soLawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) kukuphepha ukusebenzisa amayeza aphelelwe lixesha. Ukuba awusebenzisanga iyeza elidlulileyo kumhla wokuphelelwa kwalo, thetha nosokhemesti wakho malunga nokuba unganako na ukuyisebenzisa.

Ukugcina

Ukuhlala ixesha elingakanani iyeza lihlala lilungile kunokuxhomekeka kwizinto ezininzi, kubandakanya ukuba uligcina phi kwaye phi na iyeza.

Iipilisi zeNinlaro kufuneka zigcinwe kwiipakethe zazo zokuqala. Zigcine kubushushu begumbi kude nokukhanya. I-Ninlaro akufuneki igcinwe kubushushu obungaphezulu kwe-86 ° F (30 ° C).

Gwema ukugcina eli yeza kwiindawo ezinokuthi zifumane ubumanzi okanye zimanzi, njengakwigumbi lokuhlambela.

Ukulahla

Ukuba akusafuneki ukuthatha iNinlaro kwaye unamayeza ashiyekileyo, kubalulekile ukuyilahla ngokukhuselekileyo. Oku kunceda ukuthintela abanye, kubandakanya abantwana kunye nezilwanyana zasekhaya, ekubeni bathathe iyeza ngengozi. Kuyanceda ukugcina ichiza lingonzakalisi okusingqongileyo.

Iwebhusayithi ye-FDA ibonelela ngeengcebiso ezininzi eziluncedo ngokulahla amayeza. Unokucela ikhemesti yakho ukuba ikwazi ukuba ulahla njani na amayeza akho.

Ulwazi lobungcali kuNinlaro

Olu lwazi lulandelayo lubonelelwe ngoochwephesha kunye nabanye abaqeqeshi bezempilo.

Iimpawu

I-Ninlaro ivunyiwe ukuba inyange i-myeloma emininzi, esetyenziswa ngokudibanisa ne-lenalidomide kunye ne-dexamethasone, kubantu abadala abanolunye unyango olunye kule meko.

Ukhuseleko kunye nokusebenza kweNinlaro akukhange kusekwe ebantwaneni.

Indlela yokusebenza

I-Ninlaro iqulethe ixazomib, iproteasome inhibitor. IiProteasomes zinendima ephambili ekwaphuleni iiproteni ezibandakanyekayo kulawulo lomjikelo weseli, ukulungiswa kwe-DNA kunye neapoptosis. Ixazomib ibopha kwaye inqanda umsebenzi we-beta 5 subunit ye-20S yenxalenye ye-26S proteasome.

Ngokuphazamisa umsebenzi weproteasome, ixazomib ibangela ukwanda kweeproteni zokulawula ezigugileyo okanye ezonakeleyo ngaphakathi kweseli, zikhokelela ekufeni kweseli.

Umsebenzi weProteasome uyonyuka kwiiseli ezimbi xa kuthelekiswa neeseli ezisempilweni. Iiseli ezininzi ze-myeloma zichaphazeleka kakhulu kwiziphumo ze-proteasome inhibitors kuneeseli ezisempilweni.

I-Pharmacokinetics kunye ne-metabolism

Intsingiselo yokufumaneka kwe-ixazomib yi-58% emva kolawulo lomlomo. I-Bioavailability iyancitshiswa xa ichiza lithathwa kunye nokutya okunamafutha aphezulu. Kule meko, indawo ephantsi kwegophe (AUC) ye-ixazomib yehle nge-28%, kwaye ubuninzi bayo (Cmax) bancipha ngama-69%. Ke ngoko, ixazomib kufuneka ilawulwe kwisisu esingenanto.

Ixazulula i-99% ibotshelelwe kwiiproteni zeplasma.

Ixazomib icocwe ikakhulu yi-hepatic metabolism ebandakanya ii-enzymes ezininzi ze-CYP kunye neeprotein ezingezizo ze-CYP. Uninzi lweemetabolites zayo zikhutshiwe kumchamo, ezinye zikhutshwe kwilindle. Ixesha lokugqibela lobomi ziintsuku ezingama-9.5.

Ukumodareyitha ukuya kubuthathaka obukrakra bokunyuka kwe-hepatic kuthetha ukuba ixazomib AUC nge-20% ngaphezulu kwe-AUC enentsingiselo eyenzeka ngesiqhelo somsebenzi we-hepatic.

Kuthetha ukuba ixazomib AUC inyuswe ngama-39% kubantu abanesiphene esibi okanye isifo se-renal esifuna isigaba se-dialysis. Ixazululib ayikwazi ukudayela.

Ukucoca akuchaphazeleka kangako bubudala, isini, ubuhlanga, okanye indawo yomzimba. Izifundo zikaNinlaro zibandakanya abantu abaneminyaka engama-23 ukuya kuma-91 iminyaka, kwaye abo banendawo yomzimba ukusuka kwi-1.2 ukuya kwi-2.7 m².

Ukungqinelana

Akukho zichaso zeNinlaro. Nangona kunjalo, iityhefu ezinxulumene nonyango ezinje nge-neutropenia, thrombocytopenia, ukukhubazeka kwe-hepatic, irhashalala, okanye i-peripheral neuropathy inokufuna ukuphazamiseka kunyango.

Ukugcina

Iipilisi zeNinlaro kufuneka zigcinwe kwiipakethe zazo zokuqala kwiqondo lokushisa. Akufanele zigcinwe kumaqondo obushushu angaphezulu kwe-86 ° F (30 ° C).

Iphepha elichazayo ukuba awusenanto oyifunayo: Iindaba zezoNyango namhlanje zenze zonke iinzame zokuqinisekisa ukuba zonke iinkcukacha zichanekile, zibanzi kwaye zihlaziyiwe. Nangona kunjalo, eli nqaku akufuneki lisetyenziswe endaweni yolwazi kunye nobuchule bengcali yezempilo enelayisensi. Kuya kufuneka usoloko uqhagamshelana nogqirha wakho okanye nolunye uqeqesho kwezonyango ngaphambi kokuba uthathe nawaphi na amayeza. Ulwazi lweziyobisi oluqulethwe apha luyakwazi ukutshintsha kwaye alujoliswanga ekusetyenzisweni konke okunokwenzeka, imikhombandlela, izilumkiso, izilumkiso, ukuhlangana kweziyobisi, ukungahambelani komzimba, okanye iziphumo ezibi.Ukungabikho kwezilumkiso okanye olunye ulwazi ngesiyobisi esinikiweyo akubonisi ukuba indibaniselwano yeziyobisi ikhuselekile, iyasebenza, okanye ifanelekile kuzo zonke izigulana okanye konke ukusetyenziswa okuthile.

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