Плегриди Раствор, шприц, 2 шт, 0.5 мл, 125 мкг, для подкожного введения

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Ковалентно связанный"}},{"type":"paragraph","data":{"text":"с белком (интерфероном бета-1а) фрагмент полиэтиленгликоля (PEG) может изменять in vivo свойства"}},{"type":"paragraph","data":{"text":"немодифицированного белка, включая снижение почечного клиренса и уменьшение протеолиза, тем самым"}},{"type":"paragraph","data":{"text":"продлевая T1/2 из кровотока."}},{"type":"paragraph","data":{"text":"У пациентов с рассеянным склерозом T1/2 пэгинтерферона бета-1а в равновесном состоянии составил"}},{"type":"paragraph","data":{"text":"78±15 ч. Среднее значение клиренса в равновесном состоянии пэгинтерферона бета-1a составило 4.1±0.4"}},{"type":"paragraph","data":{"text":"л/ч."}},{"type":"paragraph","data":{"text":"У пациентов, находящихся на гемодиализе, концентрация пэгинтерферона бета-1а снижалась примерно на"}},{"type":"paragraph","data":{"text":"24% после каждого сеанса гемодиализа, из чего можно сделать вывод, что гемодиализ способствует"}},{"type":"paragraph","data":{"text":"частичному выведению пэгинтерферона бета-1а из системного кровотока."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Лечение ремиттирующего рассеянного склероза у взрослых. "}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к естественному или рекомбинантному интерферону бета или"}},{"type":"paragraph","data":{"text":"пэгинтерферону; начало терапии во время беременности; выраженная депрессия и/или суицидальные"}},{"type":"paragraph","data":{"text":"мысли; возраст до 18 лет"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Лечение пэгинтерфероном бета-1а необходимо начинать под наблюдением врача, имеющего опыт в лечении"}},{"type":"paragraph","data":{"text":"рассеянного склероза."}},{"type":"paragraph","data":{"text":"Рекомендуемая терапевтическая доза пэгинтерферон бета-1а составляет 125 мкг, которую вводят п/к 1"}},{"type":"paragraph","data":{"text":"раз в 2 недели (14 дней)."}},{"type":"paragraph","data":{"text":"Лечение рекомендуется начинать с дозы 63 мкг (доза 1, день 1), затем повышать ее до 94 мкг (доза 2,"}},{"type":"paragraph","data":{"text":"день 14) и достигать полной дозы 125 мкг (доза 3, день 28). Затем каждые 2 недели (14 дней)"}},{"type":"paragraph","data":{"text":"рекомендуется вводить полную дозу (125 мкг).\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны системы кроветворения: часто - снижение концентрации гемоглобина, снижение числа"}},{"type":"paragraph","data":{"text":"лейкоцитов; нечасто - тромбоцитопения; редко - тромботическая микроангиопатия, включая"}},{"type":"paragraph","data":{"text":"тромботическую тромбоцитопеническую пурпуру/гемолитический уремический синдром."}},{"type":"paragraph","data":{"text":"Со стороны иммунной системы: нечасто - реакции гиперчувствительности."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: очень часто - головная боль; часто - нарушения психики, депрессия;"}},{"type":"paragraph","data":{"text":"нечасто - судорожные припадки."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы: частота неизвестна - легочная артериальная гипертензия."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: часто - тошнота, рвота."}},{"type":"paragraph","data":{"text":"Со стороны печени и желчевыводящих путей: часто - повышение активности аланинаминотрансферазы,"}},{"type":"paragraph","data":{"text":"повышение активности АСТ, повышение активности гамма-глутамилтрансферазы."}},{"type":"paragraph","data":{"text":"Со стороны кожи и подкожных тканей: часто - зуд, нечасто - крапивница."}},{"type":"paragraph","data":{"text":"Со стороны костно-мышечной системы: очень часто - миалгия, артралгия."}},{"type":"paragraph","data":{"text":"Со стороны мочевыводящей системы: редко - нефротический синдром, гломерулосклероз."}},{"type":"paragraph","data":{"text":"Общие реакции: очень часто - эритема в месте инъекции, гриппоподобный синдром, лихорадка, озноб,"}},{"type":"paragraph","data":{"text":"боль в месте инъекции, астения, зуд в месте инъекции; часто - повышение температуры тела,"}},{"type":"paragraph","data":{"text":"гипертермия, боль, отек в месте инъекции, ощущение тепла в месте инъекции, гематома в месте"}},{"type":"paragraph","data":{"text":"инъекции, высыпания в месте инъекции, припухлость в месте инъекции, изменение цвета кожи в месте"}},{"type":"paragraph","data":{"text":"инъекции, воспаление в месте инъекции; редко - некроз в месте инъекции."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"С осторожностью применять у пациентов с тяжелой почечной недостаточностью."}},{"type":"paragraph","data":{"text":"В период лечения пациенты должны находиться под наблюдением для своевременного выявления симптомов"}},{"type":"paragraph","data":{"text":"поражения печени.Депрессия развивается с повышенной частотой у пациентов с рассеянным склерозом и"}},{"type":"paragraph","data":{"text":"ассоциируется с применением интерферона. Пациентам следует рекомендовать немедленно сообщать о"}},{"type":"paragraph","data":{"text":"симптомах депрессии и/или суицидальных мыслях своему лечащему врачу. Во время лечения следует"}},{"type":"paragraph","data":{"text":"тщательно контролировать пациентов с депрессией и назначать им соответствующее лечение. Необходимо"}},{"type":"paragraph","data":{"text":"рассмотреть возможность прекращения применения пэгинтерферона бета-1а."}},{"type":"paragraph","data":{"text":"Применение пэгинтерферона бета-1а необходимо прекратить, если развилась серьезная реакция"}},{"type":"paragraph","data":{"text":"гиперчувствительности."}},{"type":"paragraph","data":{"text":"Цитопении, включая редкие случаи тяжелой нейтропении и тромбоцитопении, наблюдались у пациентов,"}},{"type":"paragraph","data":{"text":"получавших лечение препаратом Плегриди. На фоне лечения необходимо контролировать симптомы или"}},{"type":"paragraph","data":{"text":"признаки снижения числа форменных элементов периферической крови."}},{"type":"paragraph","data":{"text":"При лечении препаратами интерферона бета отмечены случаи развития нефротического синдрома на фоне"}},{"type":"paragraph","data":{"text":"различных нефропатий, включая склерозирующий, фокальносегментарный гломерулосклероз (ФСГ),"}},{"type":"paragraph","data":{"text":"липоидный нефроз (ЛН), мембранознопролиферативный гломерулонефрит (МПГН) и мембранозную"}},{"type":"paragraph","data":{"text":"гломерулопатию (МГП). Эти явления регистрировались на разных этапах лечения и могли возникать через"}},{"type":"paragraph","data":{"text":"несколько лет после лечения интерфероном бета. Рекомендуется периодическое обследование пациентов с"}},{"type":"paragraph","data":{"text":"целью выявления ранних признаков или симптомов, например, отеков, протеинурии и нарушения функции"}},{"type":"paragraph","data":{"text":"почек, особенно у пациентов с повышенным риском поражения почек. Требуется своевременное лечение"}},{"type":"paragraph","data":{"text":"нефротического синдрома, а также оценка целесообразности прекращения терапии пэгинтерфероном"}},{"type":"paragraph","data":{"text":"бета-1а.При выявлении клинических признаков тромботической микроангиопатии рекомендуется провести"}},{"type":"paragraph","data":{"text":"дополнительные исследования числа тромбоцитов, концентрации ЛДГ, мазков крови и функции почек. Если"}},{"type":"paragraph","data":{"text":"диагноз ТМА подтвержден, требуется немедленное прекращение терапии пэгинтерфероном бета-1а и"}},{"type":"paragraph","data":{"text":"безотлагательное лечение, включающее обменное переливание плазмы."}},{"type":"paragraph","data":{"text":"Терапия интерферонами сопровождается изменениями лабораторных показателей. Помимо стандартных"}},{"type":"paragraph","data":{"text":"лабораторных тестов, которые обычно выполняют у пациентов с рассеянным склерозом, перед началом"}},{"type":"paragraph","data":{"text":"терапии пэгинтерфероном бета-1а, регулярно после начала терапии и далее периодически (при"}},{"type":"paragraph","data":{"text":"отсутствии клинических симптомов) рекомендуется выполнять полный клинический анализ крови с"}},{"type":"paragraph","data":{"text":"подсчетом форменных элементов крови, включая число тромбоцитов, биохимический анализ крови, в том"}},{"type":"paragraph","data":{"text":"числе функциональные печеночные пробы (например, определение активности аспарагиновой и аланиновой"}},{"type":"paragraph","data":{"text":"аминотрансферазы). Пациентам с миелосупрессией может потребоваться более интенсивный мониторинг"}},{"type":"paragraph","data":{"text":"показателей клинического анализа крови с подсчетом числа форменных элементов крови и числа"}},{"type":"paragraph","data":{"text":"тромбоцитов."}},{"type":"paragraph","data":{"text":"Гипотиреоз и гипертиреоз наблюдались при применении препаратов интерферона бета. Оценку функции"}},{"type":"paragraph","data":{"text":"щитовидной железы рекомендуется проводить по клиническим показаниям, а пациентам с дисфункцией"}},{"type":"paragraph","data":{"text":"щитовидной железы в анамнезе - регулярно.Пэгинтерферон бета-1а необходимо применять с осторожностью"}},{"type":"paragraph","data":{"text":"у пациентов с судорожными припадками в анамнезе, у пациентов, получающих противоэпилептические"}},{"type":"paragraph","data":{"text":"препараты, особенно если эпилепсия недостаточно контролируется."}},{"type":"paragraph","data":{"text":"В период лечения необходим постоянный контроль за пациентами с тяжелыми заболеваниями сердца в"}},{"type":"paragraph","data":{"text":"анамнезе, такими как застойная сердечная недостаточность, заболевание коронарных артерий или"}},{"type":"paragraph","data":{"text":"аритмия, для своевременного выявления возможного нарастания тяжести симптомов, особенно в начале"}},{"type":"paragraph","data":{"text":"терапии.При лечении пэгинтерфероном бета-1а у пациентов могут появиться антитела к активному"}},{"type":"paragraph","data":{"text":"веществу.При длительности терапии до 2 лет были отмечены случаи появления персистирующих"}},{"type":"paragraph","data":{"text":"нейтрализующих антител к интерферону бета-1а, которые могут снизить эффективность терапии.У"}},{"type":"paragraph","data":{"text":"пациентов с тяжелой печеночной недостаточностью пэгинтерферон бета-1а следует применять с"}},{"type":"paragraph","data":{"text":"осторожностью и тщательно контролировать состояние пациента. Необходимо периодически проводить"}},{"type":"paragraph","data":{"text":"обследование на наличие симптомов поражения печени. Кроме того, следует с осторожностью применять"}},{"type":"paragraph","data":{"text":"интерфероны на фоне сопутствующего лечения другими препаратами, способными вызывать поражение"}},{"type":"paragraph","data":{"text":"печени."}},{"type":"paragraph","data":{"text":"Влияние на способность к управлению транспортными средствами и механизмами"}},{"type":"paragraph","data":{"text":"Побочные реакции со стороны ЦНС (например, тошнота) могут влиять на способность управления"}},{"type":"paragraph","data":{"text":"автомобилем и выполнение потенциально опасных видов деятельности, требующих повышенной концентрации"}},{"type":"paragraph","data":{"text":"внимания и быстроты психомоторных реакций.\n"}}]}],"source":null},"description_toggle":false,"short_description":"Представляет собой интерферон бета-1а, конъюгированный по N-концевому аминокислотному остатку альфа-аминогруппы с одной линейной молекулой метоксиполиэтиленгликоля (20 кДа). Фармакологические свойства пэгинтерферона бета-1а согласуются со свойствами интерферона бета-1а и, как считается, опосредуются белковой частью этой молекулы. Интерфероны - семейство белков естественного происхождения, индуцируемые клетками в ответ на биологические и химические стимулы. Интерфероны опосредуют многочисленные клеточные реакции, классифицируемые как противовирусные, антипролиферативные, иммуномодулирующие. Точный механизм действия пэгинтерферона бета-1а при рассеянном склерозе неизвестен. Пэгинтерферон бета-1а связывается с рецепторами интерферона I типа на поверхности клеток и запускает каскад внутриклеточных реакций, приводящих к регулированию экспрессии генов, зависимых от интерферона. Биологические эффекты, возможно, опосредованные пэгинтерфероном бета-1а, включают усиление экспрессии противовоспалительных цитокинов (например, интерлейкина-4 (ИЛ-4), ИЛ-10, ИЛ-27), снижение экспрессии провоспалительных цитокинов (например, ИЛ-2, ИЛ-12, интерферона гамма, ФНОα) и подавление миграции активированных Т-клеток через ГЭБ; однако могут быть задействованы и дополнительные механизмы. Концентрация пэинтерферона бета-1а в плазме крови зависела от дозы в диапазоне доз от 63 до 188 мкг. Параметры фармакокинетики, определяемые у пациентов с рассеянным склерозом, согласовывались с параметрами у здоровых добровольцев.После п/к пэгинтерферона бета-1а пациентам с рассеянным склерозом Cmax достигалась через 1-1.5 дня. После многократного введения (каждые 2 недели) дозы 125 мкг Cmax составила 280±79 пг/мл. После многократного п/к введения в дозах 125 мкг каждые 2 недели пациентам с рассеянным склерозом Vd пэгинтерферона бета-1а без коррекции на биодоступность составил 481±105 л. Почечный клиренс определен как основной путь выведения пэинтерферона бета-1а. Ковалентно связанный с белком (интерфероном бета-1а) фрагмент полиэтиленгликоля (PEG) может изменять in vivo свойства немодифицированного белка, включая снижение почечного клиренса и уменьшение протеолиза, тем самым продлевая T1/2 из кровотока. У пациентов с рассеянным склерозом T1/2 пэгинтерферона бета-1а в равновесном состоянии составил 78±15 ч. Среднее значение клиренса в равновесном состоянии пэгинтерферона бета-1a составило 4.1±0.4 л/ч. У пациентов, находящихся на гемодиализе, концентрация пэгинтерферона бета-1а снижалась примерно на 24% после каждого сеанса гемодиализа, из чего можно сделать вывод, что гемодиализ способствует частичному выведению пэгинтерферона бета-1а из системного кровотока.","substance":[{"id":2425,"title":"Пэгинтерферон бета-1а","title_latin":"Пэгинтерферон бета-1а","slug":"peginterferon_beta1a"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Плегриди - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/224692/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/224692/share_default/"}},"diseases":[],"other_packages":[{"id":139573,"title":"Плегриди","subtitle":{"full":"Раствор, шприц, 2 шт, 0.5 мл, 94+63 мкг, для подкожного введения","short":"Раствор, 2 шт, 0.5 мл, 94+63 мкг","package":"2 шт, 0.5 мл, 94+63 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