Xa kuziwa ekukhethweni kwipilisi yokulawula ukuzalwa, kukho ezininzi iindlela ezikhoyo. Nangona iipilisi zokulawula ukuzalwa ziza kuma-pack okanye emashumi amabini anama-21, iifom e zimbini ezihlukeneyo zokuhlanganiswa kweepilisi kuba zifumaneka kwiipakethi zeentsuku ezingama-24. Ezi pilisi zolawulo lokuzalwa ziYaz noBeyaz.
- I-Yaz iqulethe iintsuku ezingama-24 zeepilisi ze-hormone, zilandelwe iintsuku ezi-4 zamaphilisi e-placebo. Kuyabasetyhini abakhetha i pilisi ngenxa yokukhulelwa , i-Yaz nayo ivunyiwe yi-FDA ukuphatha iimpawu zengqondo kunye nemizimba ye- PMDD - iimpawu ezinzima ngokwaneleyo ukuchaphazela ubomi babafazi abaninzi. I-Yaz iphinde ivunyiwe yi-FDA ukuphatha unyango olulinganisiweyo (ukuba sele sele uhamba ukuya kwinyanga kwaye uneminyaka engama-14 ubudala).
- I-Beyaz yenye yeepilisi ezitsha kwiimarike. NjengoJaz, kuvunyelwe i-FDA ukukunceda ukubonelela ngeempawu ze-PMDD kunye nokuphatha imicu emodareyitha. Yintoni eyenza i-Beyaz eyahlukileyo ineepilisi ezingama-hormone ezingama-24 eziquka i-levomefolate calcium (i-vitamin B / i-folic acid). Kukho neepilisi ezine-placebo ezingenayo i-hormone kodwa zineentlobo. I-folate inciphisa umngcipheko wokuba neziphene ezinqabileyo zethubhu ekukhulelwe. Oku kunokuba luncedo ukuba ukhulelwe ngelixa usebenzisa i-Beyaz okanye emva nje kokuyeka ukusebenzisa kwayo. I-Beyaz ikubonelela nge-0.4 mg ye-folic acid ekhuthazwa imihla ngemihla kubasetyhini beminyaka yobudala.
Isithuba esinokwenzeka sosuku lwe-24 lwe-dosing schedule kukuba lunokunikezela ukutshintsha kwehommone ngaphantsi kweentsuku ezili-21 zeepilisi ezisetyenziswayo kwiipakethi zeentsuku ezingama-21/28. Bobabili u-Yaz noBeyaz basebenza njenganoma iyiphi enye ipilisi yokudibanisa. Nangona kunjalo, ngaphezu kokuba nexesha eli-24 lokusebenza kwipilisi esebenzayo, ezi pilisi ziyahluke ngenxa yohlobo lweprogesin.
I-Yaz kunye neBeza zombini iqukethe isotygen / drospirenone formulation.
Kukho ukukhathazeka ukuba iipilisi ze-drospirenone ezineengongezi zinokunyusa amathuba okuphuhlisa igazi . Inyaniso kukuba zonke iipilisi zokulawula ukuzala zibeka umngcipheko wokuphuhlisa igazi. Xa kuthethwa oko, kusekelwe kwisifundo se- FDA esixhaswa ngemali esaxhaswa ngemali esivela kumabhinqa angaphezu kwama-800 000, i-arhente ibonisa ukuba ukusebenzisa iipilisi ezine-drospirenone (njengoJaz no-Beyaz) zidibaniswa nokunyuka kwama-1.5 kwindleko jikelele kwi-VTE / Igazi libeka ingozi xa lifaniswa ne-oral dose-contraceptive oral dose.
Nangona kunjalo, xa ubeka oku ngolu hlobo, i-blood clot mngcipheko jikelele isabonwa njengento ephantsi, kwaye i- FDA iyavuma ukuba olo uphando olutholakali aluvezi iziphumo ezihambelanayo okanye i-akhawunti yeziganeko ezigulane ezinokubangela ukuba negalelo legazi mngcipheko. Nangona kunjalo, ngenxa yale ngxelo, i-FDA ibize iimfuno ezintsha zokubhaliweyo kwiipilisi zeprospirenone eziqukethe.
Enye ingxaki ejikeleze u-Yaz no-Beyaz isebenzisana namazinga aphezulu e-potassium. I-Drospirenone inokulawula i-hormone elawula amanzi akho kunye namanqanaba e-electrolyte. Ngenxa yoko, kubalulekile ukuba uthembeke ngokupheleleyo xa uthetha nodokotela wakho ngembali yakho yonyango. Ngenxa yokuba iipilisi kunye ne-drospirenone zinokusebenzisana namanye amayeza anyukisayo i-potassium - njengamachiza athile ephezulu yexinzelelo lwegazi okanye iimeko zentliziyo, izidakamizwa ezichasayo (njenge-Ibuprofen) kunye nezinye iipilisi zamanzi (i-diuretics), ugqirha wakho kufuneka azi ukuba sele sele esebenzisa le meko yeyeza phambi kokumisela uYaz okanye uBeyaz.
Enyanisweni, iimpawu zeemveliso ze-Yaz no-Beyaz zibandakanya isilumkiso esicetyisa oogqirha abayalela ezi pilisi ukuba bajonge amanqanaba e-serum potassium ngenyanga yokuqala ukuba uphathwa nangona naluphi na isicatshulwa esinokugcinwa kwe-potassium.
Ngenxa yokuba ezi zixhobo ezimbini zokulawulwa kweepilisi ziye zafumana ingqwalasela enkulu malunga neengozi zegazi, kubonakala ukuba oogqirha abanako ukubeka ingqalelo ngokwaneleyo kulezi zilumkiso ze-potassium. Uphando lubonisa ukuba malunga nama-17.6% wabasetyhini basebenzisa iipilisi ze-drospirenone ezineziyobisi kunye ne-potassium, kunye ne-29% yale nto iqhubekileyo isebenzise ngokuqhelekileyo kwinyanga eqala ukulawula ipilisi yokuzalwa .
Oogqirha banokuthi bajonge ukuba kungenzeka lo msebenzi ngenxa yokuba ngubani ochaza oko. Kubonakala ukuba i-18% yabasetyhini banamachiza anokwandisa i-potassium enqunywe yintsapho okanye oogqirha bezilwanyana zangaphakathi kunye neYaz / Beyaz yabo enqunywe yi-OB / GYN yabo.
Uphando luyabonisa:
- I-9.5% yabasetyhini imiselwe zombini iyeza (Yaz / Beyaz kunye neyeza zokunyusa i-potassium) nge-OB / GYN zabo
- I-8.4% yaqulunqwa yilezo zombini unyango ngokwenziwa kwintsapho okanye ugqirha lwangaphakathi.
- I-17% yabasetyhini basebenzisa iyeza zonyuka kwi-potassium ngaphambi kokuqala iYaz / Beyaz.
- I-83% yabasetyhini basebenzisa i-Yaz / Beyaz ngaphambi kokuqalisa imishanguzo ye-potassium-raising.
Thatha Umyalezo Wasekhaya: Yaz noBeyaz bangaba yimpembelelo eminye yeepilisi kubafazi abaninzi. Ngenxa yeshedyuli ye-dosage yeentsuku ezingama-24, unokufumana ukunyuka kwe-hormonal (kunye nokukhululeka kweempawu ezinokuthi zidibaniswe nale nto). Ngaphezu koko, ezi pilisi zokulawula iipilisi zinikela ngeenzuzo ezingabalulekanga ezikhangayo kubasetyhini abaninzi. Ukuba uya kusebenzisa i-Yaz okanye i-Beyaz, kufuneka uqikelele ezi ntlawulo ngokubhekiselele kwingozi yakho yegazi. Ekugqibeleni, kufuneka uqaphele ukuba ezi pilisi zinokunyusa njani amazinga e-potassium. Ngenxa yokuba kukho ubungqina bokuthi akubona bonke oogqirha abakwaziyo ukusebenzisana phakathi kweYaz / Beyaz kunye neyeza zokunyusa i-potassium (okanye imfuno yokuvavanya kunye / okanye ukubeka iliso kwizinga le-serum potassium), kubalulekile ukuba uxelele ugqirha wakho ukuba usebenzisa enye yala mayeza ngaphambi kokuqala enye.
Imithombo:
Ikholeji yase-American College of Obstetricians kunye neGynecologists. "Ingozi ye-thromboembolism phakathi kwabasebenzisi be-drospirenone equkethe iipilisi zokukhulelwa komlomo." I-Opinion yekomiti ayi- 540. I- Obstet Gynecol 2012 ( eqinisekisiwe ngo-2014); 120: 1239-42. Kufumaneka ngokubhalisa kwangasese.
McAdams, M, Staffa, JA, & Dal Pan, GJ. "I-concomitant ecacisa i-ethinyl estradiol / drospirenone kunye neziyobisi ezinokusebenzisana." Ukukhulelwa, 2007 76 (4) , 278-281. Kufumaneka ngokubhalisa kwangasese.