Jekeseni wa Natalizumab

Zamkati

• Natalizumab imagwiritsidwa ntchito kupewetsa zigawo za zizindikilo ndikuchepetsa kukulirakulirabe kwa anthu achikulire omwe abwereranso mitundu yambiri ya sclerosis (MS; matenda omwe misempha sagwira ntchito moyenera ndipo anthu amatha kufooka, kufooka, kutayika kwa kulumikizana kwa minofu, ndi mavuto a masomphenya, malankhulidwe, ndi kuwongolera chikhodzodzo), kuphatikizapo:
• Asanalandire jekeseni wa natalizumab,
• Natalizumab ikhoza kuyambitsa zovuta. Uzani dokotala wanu ngati zina mwazizindikirozi ndizolimba kapena sizichoka:
• Zotsatira zina zoyipa zingakhale zazikulu. Ngati mukumane ndi izi kapena izi zomwe zatchulidwa mgulu la CHENJEZO kapena CHOFUNIKA KWAMBIRI, itanani dokotala wanu mwachangu kapena pitani kuchipatala mwadzidzidzi:

Kulandila jekeseni wa natalizumab kumachulukitsa chiopsezo choti mukhale ndi leukoencephalopathy (PML), matenda opatsirana aubongo omwe sangachiritsidwe, kupewedwa, kapena kuchiritsidwa ndipo nthawi zambiri amayambitsa imfa kapena kulemala kwambiri). Mwayi woti mukhale ndi PML mukamalandira chithandizo cha natalizumab ndiwokwera kwambiri ngati muli ndi chimodzi kapena zingapo mwaziopsezo zotsatirazi.

• Mwalandira mayeza ambiri a natalizumab, makamaka ngati mwalandira chithandizo chazaka zopitilira 2.
• Munapatsidwapo mankhwala omwe amafooketsa chitetezo chamthupi, kuphatikiza azathioprine (Azasan, Imuran), cyclophosphamide, methotrexate (Otrexup, Rasuvo, Trexall, Xatmep), mitoxantrone, ndi mycophenolate mofetil (CellCept).
• Kuyezetsa magazi kukuwonetsa kuti mwapezeka ndi kachilombo ka John Cunningham (JCV; kachilombo kamene anthu ambiri amakhala nako akadali ana komwe sikumakhala ndi zisonyezo koma kumatha kuyambitsa PML mwa anthu omwe ali ndi chitetezo chamthupi chofooka).

Dokotala wanu atha kuyitanitsa kuyezetsa magazi musanalandire kapena mukamalandira chithandizo cha jekeseni ya natalizumab kuti muwone ngati mwapezeka ndi JCV. Ngati mayeserowa akuwonetsa kuti mwapezeka ndi JCV, inu ndi dokotala mungasankhe kuti simuyenera kulandira jakisoni wa natalizumab, makamaka ngati muli ndi chimodzi mwazinthu zomwe zili pachiwopsezo chotchulidwa pamwambapa. Ngati kuyesaku sikuwonetsa kuti mwapezeka ndi JCV, dokotala wanu amatha kubwereza mayeso nthawi ndi nthawi mukamalandira jekeseni wa natalizumab. Simuyenera kuyesedwa ngati mudasinthana ndi plasma (chithandizo chomwe gawo lamadzi limachotsedwa mthupi ndikulowetsedwa ndi madzi ena) m'masabata awiri apitawa chifukwa zotsatira zake sizikhala zolondola.

Palinso zifukwa zina zomwe zingapangitsenso chiopsezo kuti mukhale ndi PML. Uzani dokotala wanu ngati mwakhalapo ndi PML, kumuika munthu chiwalo, kapena vuto lina lililonse lomwe limakhudza chitetezo chanu chamthupi monga kachilombo ka HIV, lomwe lapeza immunodeficiency syndrome (AIDS), leukemia (khansa yomwe imayambitsa ma cell amwazi ambiri apangidwe ndikutulutsidwa m'magazi), kapena lymphoma (khansa yomwe imayamba m'maselo amthupi). Uzani dokotala wanu ngati mukumwa kapena ngati mudalandirapo mankhwala ena aliwonse omwe amakhudza chitetezo chamthupi monga adalimumab (Humira); cyclosporine (Gengraf, Neoral, Sandimmune); etanercept (Enbrel); glatiramer (Copaxone, Glatopa); infliximab (Remicade); interferon beta (Avonex, Betaseron, Rebif); mankhwala a khansa; mercaptopurine (Purinethol, Purixan); mankhwala amlomo monga dexamethasone, methylprednisolone (Depo-medrol, Medrol, Solu-medrol), prednisolone (Prelone), ndi prednisone (Rayos); mankhwala (Rapamune); ndi tacrolimus (Astagraf, Envarsus XR, Prograf). Dokotala wanu akhoza kukuwuzani kuti simuyenera kulandira jakisoni wa natalizumab.

Pulogalamu yotchedwa TOUCH yakhazikitsidwa kuti ithandizire kuthana ndi zovuta za mankhwala a natalizumab. Mutha kulandira jekeseni wa natalizumab ngati mwalembetsa ndi pulogalamu ya TOUCH, ngati natalizumab yakulemberani dokotala yemwe walembetsa nawo pulogalamuyi, komanso ngati mungalandire mankhwalawo pamalo olowetsedwa omwe adalembetsa nawo pulogalamuyi. Dokotala wanu akupatsirani zambiri za pulogalamuyi, adzakusainani fomu yolembetsa, ndipo ayankha mafunso aliwonse omwe mungakhale nawo pulogalamuyi ndi chithandizo chanu ndi jekeseni wa natalizumab.

Monga gawo la pulogalamu YOKHUDZA, dokotala kapena namwino wanu adzakupatsani buku la Medication musanayambe kulandira chithandizo ndi jakisoni wa natalizumab komanso musanalandire kulowetsedwa kulikonse. Werengani izi mosamala nthawi iliyonse mukalandira ndikufunsani dokotala kapena namwino ngati muli ndi mafunso. Muthanso kuyendera tsamba la Food and Drug Administration (FDA) (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) kapena tsamba laopanga kuti mupeze Medication Guide.

Komanso monga gawo la pulogalamu YOKHUDZA, dokotala wanu adzafunika kukuwonani miyezi itatu iliyonse kumayambiriro kwa chithandizo chanu kenako osachepera miyezi isanu ndi umodzi kuti muone ngati mupitiliza kugwiritsa ntchito natalizumab. Muyeneranso kuyankha mafunso ena musanalandire kulowetsedwa kulikonse kuti mutsimikizire kuti natalizumab ikadali yoyenera kwa inu.

Itanani dokotala wanu nthawi yomweyo ngati mungakhale ndi mavuto atsopano azachipatala mukamalandira chithandizo, komanso kwa miyezi 6 mutapatsidwa mankhwala omaliza. Onetsetsani kuti mwayitanitsa dokotala ngati mukukumana ndi izi: kufooka mbali imodzi ya thupi yomwe imakulirakulira pakapita nthawi; kuphwanya kwa manja kapena miyendo; Kusintha kalingaliridwe kanu, kukumbukira, kuyenda, kulinganiza, kulankhula, maso, kapena nyonga zomwe zimakhala masiku angapo; mutu; kugwidwa; chisokonezo; kapena kusintha kwa umunthu.

Ngati chithandizo chanu ndi jekeseni ya natalizumab chayimitsidwa chifukwa muli ndi PML, mutha kukhala ndi vuto lina lotchedwa immune reconstitution yotupa matenda (IRIS; kutupa ndi kukulira kwa zizindikilo zomwe zingayambike chifukwa chitetezo chamthupi chimayambiranso kugwira ntchito pambuyo poti mankhwala ena omwe amakukhudzani ayamba kapena kuyimitsidwa), makamaka mukalandira chithandizo kuti muchotse natalizumab m'magazi anu mwachangu kwambiri. Dokotala wanu amakuyang'anirani mosamala pazizindikiro za IRIS ndipo adzakuthandizani ngati zachitika.

Uzani madokotala onse omwe amakuthandizani kuti mukulandira jekeseni wa natalizumab.

Lankhulani ndi dokotala wanu za kuopsa kolandila jekeseni wa natalizumab.

Natalizumab imagwiritsidwa ntchito kupewetsa zigawo za zizindikilo ndikuchepetsa kukulirakulirabe kwa anthu achikulire omwe abwereranso mitundu yambiri ya sclerosis (MS; matenda omwe misempha sagwira ntchito moyenera ndipo anthu amatha kufooka, kufooka, kutayika kwa kulumikizana kwa minofu, ndi mavuto a masomphenya, malankhulidwe, ndi kuwongolera chikhodzodzo), kuphatikizapo:

• matenda opatsirana (CIS; chizindikiro choyamba cha mitsempha chomwe chimakhala pafupifupi maola 24),
• matenda obwerezabwereza (matenda omwe matenda amawonekera nthawi ndi nthawi),
• Matenda otsogola omwe amapita patsogolo (pambuyo pake matenda ndi kuwonjezeka kwa zizindikilo.)

Natalizumab imagwiritsidwanso ntchito pochiza ndikupewa magawo azizindikiro mwa akulu omwe ali ndi matenda a Crohn (momwe thupi limagwirira ntchito m'mimba, kumayambitsa kupweteka, kutsegula m'mimba, kuwonda, ndi malungo) omwe sanathandizidwe ndi ena mankhwala kapena omwe sangamwe mankhwala ena. Natalizumab ali mgulu la mankhwala otchedwa monoclonal antibodies. Zimagwira ntchito poletsa maselo ena a chitetezo cha mthupi kuti asafike kuubongo ndi msana kapena malo am'mimba ndikuwononga.

Natalizumab imabwera ngati yankho lokhazikika (madzi) kuti lizitsukidwa ndikulowetsedwa pang'onopang'ono mumtsinje ndi dokotala kapena namwino. Nthawi zambiri imaperekedwa kamodzi pamasabata anayi aliwonse pamalo olembetsa. Zitenga pafupifupi ola limodzi kuti mulandire mlingo wanu wonse wa natalizumab.

Natalizumab imatha kuyambitsa zovuta zina zomwe zimatha kuchitika patadutsa maola awiri kuyambira kulowetsedwa koma zitha kuchitika nthawi iliyonse mukamalandira chithandizo. Muyenera kukhala pakatikati pa kulowetsedwa kwa ola limodzi mutatha kulowetsedwa. Dokotala kapena namwino adzakuwunikirani panthawiyi kuti awone ngati mukumvera mankhwalawo. Uzani dokotala kapena namwino wanu ngati mukukumana ndi zizindikiro zosazolowereka monga ming'oma, zidzolo, kuyabwa, kuvutika kumeza kapena kupuma, malungo, chizungulire, kupweteka kwa mutu, kupweteka pachifuwa, kuthamanga, kunyansidwa, kapena kuzizira, makamaka ngati zimachitika pakadutsa maola awiri kuyamba za kulowetsedwa kwanu.

Ngati mukulandira jekeseni wa natalizumab kuchiza matenda a Crohn, zizindikilo zanu ziyenera kusintha m'miyezi ingapo yoyambirira yamankhwala anu. Uzani dokotala wanu ngati matenda anu sanasinthe patatha milungu 12. Dokotala wanu akhoza kusiya kukuchitirani ndi jakisoni wa natalizumab.

Natalizumab itha kuthandizira kuwongolera zizindikilo zanu koma sichitha matenda anu. Sungani maimidwe onse kuti mulandire jakisoni wa natalizumab ngakhale mukumva bwino.

Mankhwalawa amatha kupatsidwa ntchito zina; funsani dokotala wanu kapena wamankhwala kuti mudziwe zambiri.

Asanalandire jekeseni wa natalizumab,

• uzani dokotala wanu komanso wamankhwala ngati simukugwirizana ndi natalizumab, mankhwala ena aliwonse, kapena zina zilizonse zophatikizira jekeseni wa natalizumab. Funsani dokotala wanu kapena wamankhwala mndandanda wa zosakaniza.
• auzeni dokotala ndi wazamankhwala mankhwala omwe akupatsani, osavomerezeka, mavitamini, zowonjezera zakudya, ndi mankhwala azitsamba omwe mukumwa. Onetsetsani kuti mwatchulapo mankhwala omwe atchulidwa mgulu la CHENJEZO LOFUNIKA. Dokotala wanu angafunike kusintha kuchuluka kwa mankhwala anu kapena kukuyang'anirani mosamala zotsatira zake.
• uzani adotolo ngati munalandirapo jakisoni wa natalizumab kale ndipo ngati munakhalapo kapena munakhalapo ndi zina mwazomwe zalembedwa m'gawo LENJEZO LOFUNIKA. Musanalandire kulowetsedwa kwa natalizumab, uzani adotolo ngati muli ndi malungo kapena mtundu uliwonse wamatenda, kuphatikiza matenda omwe amakhala kwa nthawi yayitali monga ma shingles (zotupa zomwe zimatha kuchitika nthawi ndi nthawi mwa anthu omwe akhala ndi nthomba zakale).
• Uzani dokotala wanu ngati muli ndi pakati, konzekerani kutenga pakati, kapena mukuyamwitsa. Mukakhala ndi pakati mukalandira jakisoni wa natalizumab, itanani dokotala wanu.
• mulibe katemera popanda kulankhula ndi dokotala.

Pokhapokha dokotala atakuwuzani zina, pitirizani kudya zomwe mumadya.

Ngati mwaphonya nthawi kuti mulandire kulowetsedwa kwa natalizumab, itanani dokotala wanu mwachangu.

Natalizumab ikhoza kuyambitsa zovuta. Uzani dokotala wanu ngati zina mwazizindikirozi ndizolimba kapena sizichoka:

• mutu
• kutopa kwambiri
• Kusinza
• kupweteka pamodzi kapena kutupa
• kupweteka kwa mikono kapena miyendo
• kupweteka kwa msana
• kutupa kwa mikono, manja, mapazi, akakolo, kapena miyendo yakumunsi
• kukokana kwa minofu
• kupweteka m'mimba
• kutsegula m'mimba
• kutentha pa chifuwa
• kudzimbidwa
• mpweya
• kunenepa kapena kutayika
• kukhumudwa
• thukuta usiku
• kusamba kowawa, kosasinthasintha, kapena kosowa (kusamba)
• kutupa, kufiira, kuwotcha, kapena kuyabwa kumaliseche
• kutuluka koyera kumaliseche
• zovuta kuwongolera pokodza
• kupweteka kwa dzino
• zilonda mkamwa
• zidzolo
• khungu lowuma
• kuyabwa

Zotsatira zina zoyipa zingakhale zazikulu. Ngati mukumane ndi izi kapena izi zomwe zatchulidwa mgulu la CHENJEZO kapena CHOFUNIKA KWAMBIRI, itanani dokotala wanu mwachangu kapena pitani kuchipatala mwadzidzidzi:

• zilonda zapakhosi, malungo, chifuwa, kuzizira, chimfine ngati zizindikilo, kukokana m'mimba, kutsegula m'mimba, kukodza pafupipafupi kapena kupweteka, kufunikira kukodza nthawi yomweyo, kapena zizindikilo zina za matenda
• chikasu cha khungu kapena maso, nseru, kusanza, kutopa kwambiri, kusowa chilakolako, mkodzo wamdima, ululu wakumimba chapamwamba
• kusintha kwa masomphenya, kufiira kwamaso, kapena kupweteka
• kutuluka mwachilendo kapena kuphwanya
• zazing'ono, zozungulira, zofiira kapena zofiirira pakhungu
• kutuluka magazi msambo kolemera

Kubayira kwa Natalizumab kumatha kubweretsa zovuta zina. Itanani dokotala wanu ngati muli ndi zovuta zina mukalandira mankhwalawa.

Mukakumana ndi zovuta zina, inu kapena adokotala mutha kutumiza lipoti ku pulogalamu ya Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting pa intaneti (http://www.fda.gov/Safety/MedWatch) kapena pafoni ( 1-800-332-1088).

Mukadwala mopitirira muyeso, itanani foni yothandizira poyizoni pa 1-800-222-1222. Zambiri zimapezekanso pa intaneti pa https://www.poisonhelp.org/help. Ngati wozunzidwayo wagwa, watenga khunyu, akuvutika kupuma, kapena sangathe kudzutsidwa, nthawi yomweyo itanani anthu azadzidzidzi ku 911.

Sungani maimidwe onse ndi dokotala wanu ndi labotale. Dokotala wanu amatha kuyitanitsa mayeso ena a labu kuti aone momwe thupi lanu limayankhira jakisoni wa natalizumab.

Ndikofunika kuti musunge mndandanda wamankhwala onse omwe mumalandira komanso osalembetsa (owerengera) omwe mukumwa, komanso zinthu zilizonse monga mavitamini, michere, kapena zakudya zina. Muyenera kubwera nawo pamndandandawu nthawi iliyonse mukapita kukaonana ndi dokotala kapena ngati mwalandiridwa kuchipatala. Ndikofunikanso kuthana nanu pakagwa mwadzidzidzi.

• Tysabri^®