{"id":157721,"date":"2026-05-18T09:53:30","date_gmt":"2026-05-18T02:53:30","guid":{"rendered":"https:\/\/hmm88i.com\/drug\/?post_type=product&p=157721"},"modified":"2026-05-18T09:55:09","modified_gmt":"2026-05-18T02:55:09","slug":"cobimet-xr-750mg","status":"publish","type":"product","link":"https:\/\/hmm88i.com\/drug\/cobimet-xr-750mg\/","title":{"rendered":"Cobimet XR 750mg"},"content":{"rendered":"

Trong b\u00e0i vi\u1ebft n\u00e0y,<\/b> d\u01b0\u1ee3c s\u0129 L\u01b0u V\u0103n Ho\u00e0ng<\/b><\/a> gi\u1edbi thi\u1ec7u \u0111\u1ebfn c\u00e1c b\u1ea1n thu\u1ed1c Cobimet XR 750mg \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi C\u00f4ng ty c\u1ed5 ph\u1ea7n d\u01b0\u1ee3c ph\u1ea9m Reliv c\u00f3 s\u1ed1 \u0111\u0103ng k\u00fd l\u01b0u h\u00e0nh t\u1ea1i Vi\u1ec7t Nam l\u00e0 893110332800<\/b><\/p>\n

Cobimet XR 750mg l\u00e0 thu\u1ed1c g\u00ec?<\/h2>\n

Th\u00e0nh ph\u1ea7n<\/h3>\n

Trong m\u1ed7i vi\u00ean u\u1ed1ng Cobimet XR 750mg<\/b> c\u00f3 ch\u1ee9a:<\/p>\n

    \n
  • Metformin hydrochloride v\u1edbi h\u00e0m l\u01b0\u1ee3ng 750mg.<\/li>\n
  • T\u00e1 d\u01b0\u1ee3c: Povidone, hypromellose, magnesium stearate v\u00e0 colloidal anhydrous silica.<\/li>\n<\/ul>\n

    D\u1ea1ng b\u00e0o ch\u1ebf: Vi\u00ean n\u00e9n ph\u00f3ng th\u00edch k\u00e9o d\u00e0i<\/p>\n

    Tr\u00ecnh b\u00e0y<\/h3>\n

    S\u0110K: 893110332800<\/p>\n

    Quy c\u00e1ch \u0111\u00f3ng g\u00f3i: H\u1ed9p 3 v\u1ec9 x 10 vi\u00ean<\/p>\n

    Xu\u1ea5t x\u1ee9: Vi\u1ec7t Nam<\/p>\n

    H\u1ea1n s\u1eed d\u1ee5ng: 30 th\u00e1ng<\/p>\n

    T\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c Cobimet XR 750mg<\/h2>\n

    C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/h3>\n

    Metformin l\u00e0 ho\u1ea1t ch\u1ea5t thu\u1ed9c nh\u00f3m biguanid c\u00f3 t\u00e1c d\u1ee5ng h\u1ed7 tr\u1ee3 ki\u1ec3m so\u00e1t t\u0103ng glucose huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2. Thu\u1ed1c gi\u00fap l\u00e0m gi\u1ea3m l\u01b0\u1ee3ng \u0111\u01b0\u1eddng trong m\u00e1u l\u00fac \u0111\u00f3i v\u00e0 sau b\u1eefa \u0103n nh\u01b0ng kh\u00f4ng th\u00fac \u0111\u1ea9y t\u1ee5y ti\u1ebft insulin, v\u00ec v\u1eady nguy c\u01a1 g\u00e2y h\u1ea1 glucose huy\u1ebft khi d\u00f9ng \u0111\u01a1n \u0111\u1ed9c t\u01b0\u01a1ng \u0111\u1ed1i th\u1ea5p.<\/p>\n

    C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a ho\u1ea1t ch\u1ea5t n\u00e0y li\u00ean quan \u0111\u1ebfn nhi\u1ec1u qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a kh\u00e1c nhau:<\/p>\n

      \n
    • H\u1ea1n ch\u1ebf gan s\u1ea3n xu\u1ea5t glucose m\u1edbi v\u00e0 gi\u1ea3m ph\u00e2n gi\u1ea3i glycogen d\u1ef1 tr\u1eef.<\/li>\n
    • C\u1ea3i thi\u1ec7n \u0111\u00e1p \u1ee9ng c\u1ee7a m\u00f4 c\u01a1 \u0111\u1ed1i v\u1edbi insulin, t\u1eeb \u0111\u00f3 t\u0103ng kh\u1ea3 n\u0103ng s\u1eed d\u1ee5ng glucose t\u1ea1i ngo\u1ea1i vi.<\/li>\n
    • L\u00e0m ch\u1eadm s\u1ef1 h\u1ea5p thu glucose t\u1eeb \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0o m\u00e1u.<\/li>\n<\/ul>\n

      Metformin c\u00f2n c\u00f3 kh\u1ea3 n\u0103ng th\u00fac \u0111\u1ea9y ho\u1ea1t \u0111\u1ed9ng c\u1ee7a enzym glycogen synthase, h\u1ed7 tr\u1ee3 t\u0103ng t\u1ea1o glycogen n\u1ed9i b\u00e0o. \u0110\u1ed3ng th\u1eddi, ho\u1ea1t ch\u1ea5t n\u00e0y c\u0169ng l\u00e0m gia t\u0103ng kh\u1ea3 n\u0103ng v\u1eadn chuy\u1ec3n glucose qua m\u00e0ng t\u1ebf b\u00e0o th\u00f4ng qua c\u00e1c ch\u1ea5t v\u1eadn chuy\u1ec3n GLUT.<\/p>\n

      Ngo\u00e0i vai tr\u00f2 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft, metformin d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i c\u00f2n \u0111\u01b0\u1ee3c ghi nh\u1eadn c\u00f3 t\u00e1c \u0111\u1ed9ng thu\u1eadn l\u1ee3i l\u00ean chuy\u1ec3n h\u00f3a lipid, h\u1ed7 tr\u1ee3 gi\u1ea3m cholesterol to\u00e0n ph\u1ea7n, LDL-cholesterol v\u00e0 triglycerid trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i.<\/p>\n

      \u0110\u1eb7c \u0111i\u1ec3m d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/h3>\n

      H\u1ea5p thu: Sau khi u\u1ed1ng, metformin \u1edf d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i \u0111\u01b0\u1ee3c h\u1ea5p thu ch\u1eadm h\u01a1n so v\u1edbi d\u1ea1ng gi\u1ea3i ph\u00f3ng t\u1ee9c th\u00ec. Th\u1eddi gian \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trong huy\u1ebft t\u01b0\u01a1ng th\u01b0\u1eddng v\u00e0o kho\u1ea3ng 7 gi\u1edd sau khi d\u00f9ng thu\u1ed1c. \u1ede tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh, gi\u00e1 tr\u1ecb Cmax v\u00e0 AUC kh\u00f4ng t\u0103ng t\u01b0\u01a1ng \u1ee9ng ho\u00e0n to\u00e0n v\u1edbi li\u1ec1u s\u1eed d\u1ee5ng.<\/p>\n

      Khi d\u00f9ng li\u1ec1u 1500mg d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i, n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trung b\u00ecnh trong huy\u1ebft t\u01b0\u01a1ng ghi nh\u1eadn kho\u1ea3ng 1193 ng\/ml, \u0111\u1ea1t \u0111\u01b0\u1ee3c sau kho\u1ea3ng 5 gi\u1edd. Vi\u1ec7c d\u00f9ng thu\u1ed1c l\u00fac no ho\u1eb7c \u0111\u00f3i nh\u00ecn chung kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn m\u1ee9c h\u1ea5p thu trung b\u00ecnh, tuy nhi\u00ean n\u1ebfu s\u1eed d\u1ee5ng khi \u0111\u00f3i th\u00ec AUC c\u00f3 th\u1ec3 gi\u1ea3m kho\u1ea3ng 30%. Ch\u01b0a ghi nh\u1eadn hi\u1ec7n t\u01b0\u1ee3ng t\u00edch l\u0169y metformin khi d\u00f9ng l\u1eb7p l\u1ea1i v\u1edbi li\u1ec1u t\u1edbi 2000mg\/ng\u00e0y.<\/p>\n

      Ph\u00e2n b\u1ed1: L\u01b0\u1ee3ng thu\u1ed1c li\u00ean k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng r\u1ea5t \u00edt. Ho\u1ea1t ch\u1ea5t c\u00f3 kh\u1ea3 n\u0103ng \u0111i v\u00e0o h\u1ed3ng c\u1ea7u v\u00e0 ph\u00e2n b\u1ed1 kh\u00e1 r\u1ed9ng trong c\u01a1 th\u1ec3. Vd kho\u1ea3ng 63 – 276 l\u00edt.<\/p>\n

      Chuy\u1ec3n h\u00f3a: Trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi, thu\u1ed1c g\u1ea7n nh\u01b0 kh\u00f4ng tr\u1ea3i qua giai \u0111o\u1ea1n chuy\u1ec3n ho\u00e1. C\u00e1c nghi\u00ean c\u1ee9u hi\u1ec7n ch\u01b0a ph\u00e1t hi\u1ec7n ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a metformin \u1edf ng\u01b0\u1eddi.<\/p>\n

      Th\u1ea3i tr\u1eeb: Metformin \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i ch\u1ee7 y\u1ebfu qua th\u1eadn d\u01b0\u1edbi d\u1ea1ng c\u00f2n nguy\u00ean ho\u1ea1t t\u00ednh th\u00f4ng qua qu\u00e1 tr\u00ecnh l\u1ecdc c\u1ea7u th\u1eadn v\u00e0 b\u00e0i ti\u1ebft \u1edf \u1ed1ng th\u1eadn. \u0110\u1ed9 thanh th\u1ea3i c\u1ee7a thu\u1ed1c l\u1edbn h\u01a1n 400 ml\/ph\u00fat v\u00e0 6,5 gi\u1edd sau khi u\u1ed1ng thu\u1ed1c ch\u1ec9 c\u00f2n 1 n\u1eeda<\/p>\n

      \u1ede b\u1ec7nh nh\u00e2n suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn, kh\u1ea3 n\u0103ng \u0111\u00e0o th\u1ea3i metformin gi\u1ea3m theo m\u1ee9c \u0111\u1ed9 suy th\u1eadn, t\u1eeb \u0111\u00f3 l\u00e0m k\u00e9o d\u00e0i th\u1eddi gian b\u00e1n th\u1ea3i v\u00e0 t\u0103ng n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng.<\/p>\n

      Thu\u1ed1c Cobimet XR 750mg \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong b\u1ec7nh g\u00ec?<\/h2>\n

      H\u1ed7 tr\u1ee3 h\u1ea1n ch\u1ebf nguy c\u01a1 xu\u1ea5t hi\u1ec7n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 ho\u1eb7c l\u00e0m ch\u1eadm qu\u00e1 tr\u00ecnh ti\u1ebfn tri\u1ec3n b\u1ec7nh \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh th\u1eeba c\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng ti\u1ec1n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nh\u01b0 r\u1ed1i lo\u1ea1n dung n\u1ea1p glucose, t\u0103ng glucose huy\u1ebft l\u00fac \u0111\u00f3i ho\u1eb7c HbA1C t\u0103ng cao d\u00f9 \u0111\u00e3 \u00e1p d\u1ee5ng ch\u1ebf \u0111\u1ed9 sinh ho\u1ea1t v\u00e0 dinh d\u01b0\u1ee1ng ph\u00f9 h\u1ee3p trong th\u1eddi gian tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n

      \u0110i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u1edf ng\u01b0\u1eddi l\u1edbn khi vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft b\u1eb1ng \u0103n ki\u00eang v\u00e0 v\u1eadn \u0111\u1ed9ng th\u1ec3 l\u1ef1c ch\u01b0a mang l\u1ea1i hi\u1ec7u qu\u1ea3 mong mu\u1ed1n.<\/p>\n

      C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng Cobimet XR \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c ph\u1ed1i h\u1ee3p c\u00f9ng insulin hay c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1eddng u\u1ed1ng kh\u00e1c \u0111\u1ec3 t\u0103ng hi\u1ec7u qu\u1ea3 ki\u1ec3m so\u00e1t glucose m\u00e1u<\/p>\n

      \"Cobimet
      Cobimet XR 750mg \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2<\/figcaption><\/figure>\n

      Li\u1ec1u d\u00f9ng v\u00e0 c\u00e1ch s\u1eed d\u1ee5ng<\/h2>\n

      Li\u1ec1u d\u00f9ng<\/h3>\n\n\n\n\n\n\n
      Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/td>\nLi\u1ec1u kh\u1edfi \u0111\u1ea7u<\/strong><\/td>\nTi\u1ebfn tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh & \u0110\u1ecbnh l\u01b0\u1ee3ng t\u1ed1i \u0111a<\/strong><\/td>\nL\u01b0u \u00fd<\/strong><\/td>\n<\/tr>\n
      Ph\u00f2ng ng\u1eeba ho\u1eb7c tr\u00ec ho\u00e3n s\u1ef1 kh\u1edfi ph\u00e1t \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2<\/strong><\/td>\n500 mg\/ng\u00e0y, d\u00f9ng 1 l\u1ea7n duy nh\u1ea5t v\u00e0o b\u1eefa t\u1ed1i (s\u1eed d\u1ee5ng vi\u00ean gi\u1ea3i ph\u00f3ng k\u00e9o d\u00e0i).<\/td>\nC\u1ee9 sau m\u1ed7i 10 \u0111\u1ebfn 15 ng\u00e0y, ti\u1ebfn h\u00e0nh \u0111o l\u1ea1i c\u00e1c ch\u1ec9 s\u1ed1 m\u00e1u (HbA1C, FPG, OGTT) \u0111\u1ec3 c\u0103n ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng.<\/p>\n

      Vi\u1ec7c t\u0103ng li\u1ec1u c\u1ea7n th\u1ef1c hi\u1ec7n t\u1eeb t\u1eeb \u0111\u1ec3 h\u1ec7 ti\u00eau h\u00f3a th\u00edch nghi.<\/p>\n

      \u0110\u1ecbnh m\u1ee9c t\u1ed1i \u0111a: 2000 mg\/ng\u00e0y, u\u1ed1ng 1 l\u1ea7n v\u00e0o b\u1eefa \u0103n t\u1ed1i<\/td>\n

      		Ch\u1ec9 \u00e1p d\u1ee5ng khi vi\u1ec7c can thi\u1ec7p, thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng trong v\u00f2ng 3 – 6 th\u00e1ng kh\u00f4ng mang l\u1ea1i hi\u1ec7u qu\u1ea3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft.<\/p>\n

      Ki\u1ec3m tra \u0111\u1ecbnh k\u1ef3 sau m\u1ed7i 3 – 6 th\u00e1ng (c\u00e1c ch\u1ec9 s\u1ed1 HbA1C, FPG, OGTT v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1) \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh duy tr\u00ec, \u0111\u1ed5i li\u1ec1u ho\u1eb7c ng\u01b0ng thu\u1ed1c.<\/p>\n

      T\u00e1i \u0111\u00e1nh gi\u00e1 n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u1ea3i thi\u1ec7n t\u1ed1t th\u00f3i quen sinh ho\u1ea1t ho\u1eb7c c\u00f3 chuy\u1ec3n bi\u1ebfn s\u1ee9c kh\u1ecfe cho ph\u00e9p t\u0103ng c\u01b0\u1eddng thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng.<\/td>\n<\/tr>\n

      \u0110\u01a1n tr\u1ecb li\u1ec7u ho\u1eb7c ph\u1ed1i h\u1ee3p c\u00f9ng c\u00e1c thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft d\u1ea1ng u\u1ed1ng kh\u00e1c<\/strong><\/td>\n500 mg\/ng\u00e0y, u\u1ed1ng 1 l\u1ea7n.<\/td>\nC\u1ee9 sau m\u1ed7i 10 – 15 ng\u00e0y, t\u0103ng d\u1ea7n t\u1eebng n\u1ea5c 500 mg d\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 test \u0111\u01b0\u1eddng huy\u1ebft.<\/p>\n

      \u0110\u1ecbnh m\u1ee9c t\u1ed1i \u0111a th\u00f4ng th\u01b0\u1eddng: 2000 mg\/ng\u00e0y (u\u1ed1ng 1 l\u1ea7n v\u00e0o b\u1eefa t\u1ed1i).<\/p>\n

      N\u1ebfu li\u1ec1u 2000 mg\/ng\u00e0y (u\u1ed1ng 1 l\u1ea7n) kh\u00f4ng \u0111\u1ea1t \u0111\u00edch: Xem x\u00e9t chia th\u00e0nh 1000 mg x 2 l\u1ea7n\/ng\u00e0y (u\u1ed1ng c\u00f9ng th\u1ee9c \u0103n).<\/p>\n

      N\u1ebfu v\u1eabn k\u00e9m ki\u1ec3m so\u00e1t: Chuy\u1ec3n sang vi\u00ean metformin ti\u00eau chu\u1ea9n (gi\u1ea3i ph\u00f3ng ngay) v\u1edbi li\u1ec1u cao nh\u1ea5t 3000 mg\/ng\u00e0y.<\/td>\n

      		Khi chuy\u1ec3n \u0111\u1ed5i thu\u1ed1c:<\/p>\n

      T\u1eeb metformin th\u00f4ng th\u01b0\u1eddng sang d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i: Li\u1ec1u \u0111\u1ea7u ph\u1ea3i b\u1eb1ng t\u1ed5ng li\u1ec1u d\u00f9ng h\u00e0ng ng\u00e0y tr\u01b0\u1edbc \u0111\u00f3. Kh\u00f4ng chuy\u1ec3n n\u1ebfu li\u1ec1u c\u0169 v\u01b0\u1ee3t qu\u00e1 2000 mg\/ng\u00e0y.<\/p>\n

      T\u1eeb thu\u1ed1c tr\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng \u0111\u01b0\u1eddng u\u1ed1ng kh\u00e1c sang: Ph\u1ea3i d\u1eebng thu\u1ed1c c\u0169 ho\u00e0n to\u00e0n tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng vi\u00ean gi\u1ea3i ph\u00f3ng k\u00e9o d\u00e0i.<\/p>\n

      S\u1eed d\u1ee5ng vi\u00ean h\u00e0m l\u01b0\u1ee3ng 750mg: Thi\u1ebft k\u1ebf ri\u00eang cho ng\u01b0\u1eddi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng metformin tr\u01b0\u1edbc \u0111\u00f3. Li\u1ec1u d\u00f9ng ph\u1ea3i t\u01b0\u01a1ng \u0111\u01b0\u01a1ng t\u1ed5ng li\u1ec1u metformin h\u00e0ng ng\u00e0y c\u0169, t\u1ed1i \u0111a kh\u00f4ng qu\u00e1 1500 mg (u\u1ed1ng v\u00e0o b\u1eefa t\u1ed1i).<\/td>\n<\/tr>\n

      Ph\u1ed1i h\u1ee3p c\u00f9ng li\u1ec7u ph\u00e1p Insulin<\/strong><\/td>\n500 mg\/ng\u00e0y (vi\u00ean gi\u1ea3i ph\u00f3ng k\u00e9o d\u00e0i), u\u1ed1ng 1 l\u1ea7n v\u00e0o b\u1eefa \u0103n t\u1ed1i.<\/td>\nLi\u1ec1u l\u01b0\u1ee3ng \u0111\u01b0\u1ee3c duy tr\u00ec t\u01b0\u01a1ng \u0111\u01b0\u01a1ng t\u1ed5ng li\u1ec1u d\u00f9ng metformin h\u00e0ng ng\u00e0y tr\u01b0\u1edbc \u0111\u00f3 khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p t\u1eeb tr\u01b0\u1edbc.<\/p>\n

      \u0110\u1ecbnh m\u1ee9c t\u1ed1i \u0111a: Kh\u00f4ng qu\u00e1 1500 mg (\u00e1p d\u1ee5ng khi d\u00f9ng vi\u00ean h\u00e0m l\u01b0\u1ee3ng 750mg), u\u1ed1ng v\u00e0o b\u1eefa t\u1ed1i.<\/td>\n

      		Trong su\u1ed1t qu\u00e1 tr\u00ecnh ph\u1ed1i h\u1ee3p, li\u1ec1u d\u00f9ng c\u1ee7a insulin s\u1ebd \u0111\u01b0\u1ee3c th\u1ea7y thu\u1ed1c c\u0103n ch\u1ec9nh t\u0103ng ho\u1eb7c gi\u1ea3m d\u1ef1a tr\u00ean c\u01a1 s\u1edf k\u1ebft qu\u1ea3 \u0111o \u0111\u01b0\u1eddng huy\u1ebft th\u1ef1c t\u1ebf c\u1ee7a b\u1ec7nh nh\u00e2n.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

       <\/p>\n\n\n\n\n\n\n\n\n\n
      Nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng<\/strong><\/td>\nPh\u00e2n nh\u00f3m<\/strong><\/td>\nT\u1ed5ng li\u1ec1u gi\u1edbi h\u1ea1n t\u1ed1i \u0111a m\u1ed7i ng\u00e0y<\/strong><\/td>\nL\u01b0u \u00fd<\/strong><\/td>\n<\/tr>\n
      Ng\u01b0\u1eddi b\u1ecb suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn<\/strong><\/td>\nGFR t\u1eeb 60 – 89 mL\/ph\u00fat<\/td>\nT\u1ed1i \u0111a 2000 mg\/ng\u00e0y.<\/td>\nXem x\u00e9t gi\u1ea3m b\u1edbt li\u1ec1u d\u00f9ng d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn th\u1ef1c t\u1ebf.<\/p>\n

      C\u1ea7n \u0111o GFR tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u v\u00e0 duy tr\u00ec ki\u1ec3m tra t\u1ed1i thi\u1ec3u 1 l\u1ea7n\/n\u0103m.<\/td>\n<\/tr>\n

      GFR t\u1eeb 45 – 59 mL\/ph\u00fat<\/td>\nPh\u1ea3i \u0111\u00e1nh gi\u00e1 v\u00e0 r\u00e0 so\u00e1t k\u1ef9 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nhi\u1ec5m toan lactic tr\u01b0\u1edbc khi cho b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c.<\/td>\n<\/tr>\n
      GFR t\u1eeb 30 – 44 mL\/ph\u00fat<\/td>\nT\u1ed1i \u0111a 1000 mg\/ng\u00e0y.<\/td>\nLi\u1ec1u kh\u1edfi \u0111\u1ea7u tuy\u1ec7t \u0111\u1ed1i kh\u00f4ng \u0111\u01b0\u1ee3c v\u01b0\u1ee3t qu\u00e1 m\u1ed9t n\u1eeda li\u1ec1u t\u1ed1i \u0111a cho ph\u00e9p (ngh\u0129a l\u00e0 kh\u00f4ng qu\u00e1 500 mg\/ng\u00e0y).<\/td>\n<\/tr>\n
      GFR < 30 mL\/ph\u00fat<\/td>\nCh\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/td>\n<\/td>\n<\/tr>\n
      Ng\u01b0\u1eddi cao tu\u1ed5i<\/strong><\/td>\n<\/td>\n<\/td>\nPh\u1ee5 thu\u1ed9c v\u00e0o k\u1ebft qu\u1ea3 \u0111o GFR th\u1ef1c t\u1ebf<\/td>\n<\/tr>\n
      Tr\u1ebb em<\/strong><\/td>\n<\/td>\n<\/td>\nKh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

      C\u00e1ch s\u1eed d\u1ee5ng<\/h3>\n

      Vi\u00ean n\u00e9n Cobimet XR 750mg<\/b> \u0111\u01b0\u1ee3c d\u00f9ng b\u1eb1ng \u0111\u01b0\u1eddng u\u1ed1ng v\u1edbi b\u1eefa \u0103n t\u1ed1i<\/p>\n

      Kh\u00f4ng s\u1eed d\u1ee5ng thu\u1ed1c Cobimet XR 750mg trong tr\u01b0\u1eddng h\u1ee3p n\u00e0o?<\/h2>\n

      Ng\u01b0\u1eddi d\u1ecb \u1ee9ng v\u1edbi Metformin hydrochloride ho\u1eb7c t\u00e1 d\u01b0\u1ee3c c\u00f3 trong Cobimet XR 750mg<\/p>\n

      B\u1ec7nh nh\u00e2n m\u1eafc c\u00e1c th\u1ec3 nhi\u1ec5m toan chuy\u1ec3n h\u00f3a \u1edf giai \u0111o\u1ea1n c\u1ea5p t\u00ednh (ch\u1eb3ng h\u1ea1n nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nhi\u1ec5m ceton ho\u1eb7c nhi\u1ec5m toan lactic).<\/p>\n

      Ng\u01b0\u1eddi b\u1ec7nh r\u01a1i v\u00e0o tr\u1ea1ng th\u00e1i ti\u1ec1n h\u00f4n m\u00ea do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n

      Ng\u01b0\u1eddi b\u1ecb suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn m\u1ee9c \u0111\u1ed9 n\u1eb7ng (ch\u1ec9 s\u1ed1 GFR th\u1ea5p h\u01a1n 30 mL\/ph\u00fat).<\/p>\n

      C\u00e1c t\u00ecnh hu\u1ed1ng c\u1ea5p t\u00ednh c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m bi\u1ebfn \u0111\u1ed5i, suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn nh\u01b0: t\u00ecnh tr\u1ea1ng s\u1ed1c, nhi\u1ec5m khu\u1ea9n m\u1ee9c \u0111\u1ed9 n\u1eb7ng ho\u1eb7c m\u1ea5t n\u01b0\u1edbc c\u01a1 th\u1ec3.<\/p>\n

      B\u1ec7nh l\u00fd d\u1ec5 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy \u1edf c\u00e1c m\u00f4 c\u01a1 th\u1ec3 (\u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh c\u1ea5p t\u00ednh ho\u1eb7c \u0111\u1ee3t c\u1ea5p c\u1ee7a b\u1ec7nh m\u1ea1n t\u00ednh) bao g\u1ed3m: s\u1ed1c, m\u1edbi b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim, suy h\u00f4 h\u1ea5p, suy tim m\u1ea5t b\u00f9.<\/p>\n

      Ng\u01b0\u1eddi b\u1ecb suy gi\u1ea3m ch\u1ee9c n\u0103ng gan, ng\u01b0\u1eddi nhi\u1ec5m \u0111\u1ed9c r\u01b0\u1ee3u c\u1ea5p t\u00ednh ho\u1eb7c \u0111\u1ed1i t\u01b0\u1ee3ng nghi\u1ec7n r\u01b0\u1ee3u.<\/p>\n

      L\u01b0u \u00fd \u0111\u1eb7c bi\u1ec7t khi s\u1eed d\u1ee5ng thu\u1ed1c<\/h2>\n

      Th\u1eadn tr\u1ecdng<\/h3>\n

      Metformin c\u00f3 nguy c\u01a1 g\u00e2y nhi\u1ec5m toan lactic, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn, suy tim, nhi\u1ec5m khu\u1ea9n n\u1eb7ng ho\u1eb7c m\u1ea5t n\u01b0\u1edbc.<\/p>\n

      Khi xu\u1ea5t hi\u1ec7n n\u00f4n nhi\u1ec1u, ti\u00eau ch\u1ea3y k\u00e9o d\u00e0i, s\u1ed1t ho\u1eb7c gi\u1ea3m l\u01b0\u1ee3ng d\u1ecbch \u0111\u01b0a v\u00e0o c\u01a1 th\u1ec3, n\u00ean t\u1ea1m ng\u01b0ng thu\u1ed1c v\u00e0 li\u00ean h\u1ec7 nh\u00e2n vi\u00ean y t\u1ebf.<\/p>\n

      N\u00ean ki\u1ec3m tra v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c \u0111\u1ed3ng th\u1eddi ti\u1ebfp t\u1ee5c theo d\u00f5i \u0111\u1ecbnh k\u1ef3 trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb<\/p>\n

      B\u1ec7nh nh\u00e2n d\u1ef1 ki\u1ebfn th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt ho\u1eb7c c\u1ea7n s\u1eed d\u1ee5ng thu\u1ed1c c\u1ea3n quang ch\u1ee9a iod trong c\u00e1c k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh n\u00ean ng\u1eebng d\u00f9ng thu\u1ed1c theo h\u01b0\u1edbng d\u1eabn c\u1ee7a b\u00e1c s\u0129.<\/p>\n

      Trong th\u1eddi gian s\u1eed d\u1ee5ng, ng\u01b0\u1eddi b\u1ec7nh v\u1eabn n\u00ean duy tr\u00ec ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng h\u1ee3p l\u00fd k\u1ebft h\u1ee3p v\u1eadn \u0111\u1ed9ng th\u1ec3 ch\u1ea5t th\u01b0\u1eddng xuy\u00ean \u0111\u1ec3 h\u1ed7 tr\u1ee3 ki\u1ec3m so\u00e1t glucose huy\u1ebft v\u00e0 n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

      Khi s\u1eed d\u1ee5ng ri\u00eang l\u1ebb, metformin \u00edt khi g\u00e2y h\u1ea1 glucose huy\u1ebft. Tuy nhi\u00ean, nguy c\u01a1 t\u1ee5t \u0111\u01b0\u1eddng m\u00e1u c\u00f3 th\u1ec3 t\u0103ng l\u00ean n\u1ebfu ph\u1ed1i h\u1ee3p v\u1edbi insulin ho\u1eb7c c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u00e1c.<\/p>\n

      T\u00e1c d\u1ee5ng ph\u1ee5<\/h3>\n

      C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i nh\u00ecn chung t\u01b0\u01a1ng t\u1ef1 metformin d\u1ea1ng gi\u1ea3i ph\u00f3ng t\u1ee9c th\u00ec.<\/p>\n

      R\u1ea5t th\u01b0\u1eddng g\u1eb7p: Bu\u1ed3n n\u00f4n, n\u00f4n, ch\u00e1n \u0103n, \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y (nh\u1eefng bi\u1ec3u hi\u1ec7n n\u00e0y ch\u1ee7 y\u1ebfu b\u1ed9c ph\u00e1t v\u00e0o giai \u0111o\u1ea1n \u0111\u1ea7u tr\u1ecb li\u1ec7u v\u00e0 \u0111a ph\u1ea7n t\u1ef1 bi\u1ebfn m\u1ea5t, vi\u1ec7c n\u00e2ng li\u1ec1u ch\u1eadm s\u1ebd gi\u00fap c\u01a1 th\u1ec3 th\u00edch nghi t\u1ed1t h\u01a1n).<\/p>\n

      Th\u01b0\u1eddng g\u1eb7p: R\u1ed1i lo\u1ea1n v\u1ecb gi\u00e1c.<\/p>\n

      R\u1ea5t hi\u1ebfm g\u1eb7p: Nhi\u1ec5m toan lactic, s\u1ee5t gi\u1ea3m h\u00e0m l\u01b0\u1ee3ng vitamin B12 trong huy\u1ebft thanh do k\u00e9m h\u1ea5p thu khi duy tr\u00ec tr\u1ecb li\u1ec7u k\u00e9o d\u00e0i (n\u00ean ki\u1ec3m tra y\u1ebfu t\u1ed1 n\u00e0y n\u1ebfu ph\u00e1t hi\u1ec7n ch\u1ee9ng thi\u1ebfu m\u00e1u \u0111\u1ea1i h\u1ed3ng c\u1ea7u), c\u00e1c ca ri\u00eang l\u1ebb b\u1ecb vi\u00eam gan ho\u1eb7c c\u00f3 ch\u1ec9 s\u1ed1 ki\u1ec3m tra ch\u1ee9c n\u0103ng gan b\u1ea5t th\u01b0\u1eddng (t\u00ecnh tr\u1ea1ng s\u1ebd h\u1ed3i ph\u1ee5c sau khi d\u1eebng thu\u1ed1c), t\u1ed5n th\u01b0\u01a1ng ngo\u00e0i da nh\u01b0 n\u1ed5i m\u00e0y \u0111ay, ng\u1ee9a ng\u00e1y, ph\u00e1t ban \u0111\u1ecf.<\/p>\n

      T\u01b0\u01a1ng t\u00e1c<\/h3>\n

      Kh\u00f4ng n\u00ean ph\u1ed1i h\u1ee3p<\/p>\n