U-Ella uyisicelo esitsha seziyobisi, esivunyiwe njengendlela yokukhulelwa ngokukhawuleza , yi-FDA ngo-Agasti 2010. U-Ella unesilwanyana esisodwa somlomo (i-acetate ye-acetate, 30 mg). U-Ella angasetyenziswe ngabasetyhini ukukhusela ukukhulelwa okungalindelekanga emva kwesondo esingakhuselekanga okanye ukuhluleka kokukhulelwa komzimba kunye neepilisi enye enokuthi ithathwe ngokukhawuleza. U-Ella uphumelele kakhulu xa uthathwa ngokukhawuleza, kodwa ungasetyenziselwa iiyure ezili-120 (iintsuku ezi-5) emva kwesondo esingakhuselekanga.
Ezinye iinketho zokukhulelwa kwangokukhawulezileyo, iSicwangciso B Isinyathelo esinye , Ikhetho elilandelayo , i- My Way , Thatha iNyathelo , kunye noKhetho olulandelayo , i-FDA-avunyelwe ukuba isetyenziswe kwiiyure ezingama-72 (iintsuku ezi-3) emva kokuhluleka kokukhulelwa okanye ukuziphatha kakubi.
Ingaba isebenza kanjani
U-Ella ucingelwa ukuba asebenzele ukukhulelwa ngokukhawuleza ngokukhusela ngokukhawuleza ngokuyeka okanye ukulibazisa ukukhululwa kweqanda kwi-ovary, ngoko akukho maqanda aya kufumaneka ukuba inambuzane ikhule. Kungenzeka ukuba u-Ella angasebenza kwakhona ngokuthintela isiqhotyoshelweyo (ukufakelwa) kwisibindi. Nangona u-Ella avimbela i-ovulation ixesha elide emva kweentsuku ezingama-5 emva kwesondo esingakhuselekanga, kukho inkxalabo yokuba abafazi bayakudideka ngolu hlobo kwaye bakholelwe ngephutha ukuba emva kokuthatha u-Ella, kunokukwazi ukukhusela ngakumbi ekukhulelweni kuzo zonke izenzo ezongezelelweyo zesini esingakhuselekanga iintsuku ezingama-5 (akunjalo, njengokuba isilisa esivela kwisini esongezelelweyo sinokuphelisa iwindow yokuqala yeentsuku ezi-5).
U-Ella uqulethe i-unpristal, isilwanyana esingenayo i-hormone esithintela imiphumo ye-hormone efunekayo yokukhulelwa.
U-Ella ungowesigaba sezilwanyana ezibizwa ngokuba yi-progesterone receptor modulators. Esinye esinye isilwanyana esivunyiweyo kule klasi yi-mifepristone, eyaziwa ngokuba yi- RU-486 . I-Mifepristone ivunyelwe ukusetyenziswa njengenxalenye ye-regimen eyenza ukukhupha isisu . Ngenxa yokuba kungcono ukuxhamla ngumzimba kune-mifepristone, uElla angasetyenziselwa amaqondo aphantsi awamthintela ukuzala kodwa oko akufanele kubangele ukukhipha isisu.
Akukacaci ke, nokuba u-Ella unokunyusa izinga lokukhipha isisu kubamkezana abancinci abakhulelweyo naphezu kokusebenzisa iziyobisi. Kukho ukudideka malunga nokuba u-Ella okanye angabangela ingozi ekukhulelweni okukhoyo (ukuba umfazi ukhulelwe xa ethatha uEla).
Oko Akunjalo
Ukukhulelwa kwangxamisekileyo kudla ngokudibanisa ngephutha kwipilisi yokuqala, i-RU486 (ekwabizwa ngokuba yi-M & M, iMifeprex, i-RU486, i-mifepristone okanye isisu sokukhupha isisu ). La mayeza emibini asebenza ngeenjongo ezimbini ezahlukeneyo kwaye asebenze ngokuhluke ngokupheleleyo.
U-Ella akayiyo ipilisi yokukhupha isisu. Kwakhona akusebenzi kakuhle xa kuthathwa emva kokuba umfazi sele ekhulelwe. Ngokutsho kwe-Watson Pharmaceuticals, umenzi wale nkqubo yokukhulelwa ngokukhawuleza, uElla akayisebenzisi ukuphelisa ukukhulelwa okukhoyo.
Ukusetyenziswa nini
Ukunciphisa umngcipheko wokukhulelwa okungenakulungiswa, u-Ella kufuneka athathwe ngokukhawuleza kwangoko kwiiyure ezingama-120 (iintsuku ezingama-5) zesini esingakhuselekanga okanye ukuhluleka kokukhulelwa. Ngokukhawuleza u-Ella uthathwa, kuya kusebenza ngakumbi. U-Ella angasetyenziselwa nayiphi na ixesha ngexesha lokuhamba kwimizuzu kwaye unokuthathwa kunye okanye ngaphandle kokutya. Ukuba uhlanza ngaphakathi kweeyure ezingama-3 zokuthatha i pilisi, kufuneka udibanise noogqirha wakho ngokukhawuleza ukuba uxoxe nokuba uthathe enye ipilisi.
Ngubani ongafanelanga ukuyisebenzisa
U-Ella akajoliswanga ukuba asetyenziswe njengenxalenye yesetyenziselwa ukusetyenziswa kwe-contraception rhoqo - ayisebenzi kunye nezinye iindidi zolawulo lokuzalwa xa zisetyenziselwa ngokufanelekileyo nangokuchanekileyo. Akufanele usebenzise i-ella ngaphezu kwexesha elinye kwimijikelezo efanayo yokuya esikhathini ukuya kwezenzo ezahlukeneyo zesini esingakhuselekanga okanye ukuhluleka kokulawula ukuzalwa.
Ungamthathi u-Ella ukuba uyazi okanye uyakrokrela ukuba sele ukhulelwe. Ukuba kukho ithuba lokuba usukhulelwe, ugqirha wakho kufuneka akunike uvavanyo lokukhulelwa ngaphambi kokumisela u-Ella. Ingozi ebantwini xa u-Ella elawulwa kumfazi okhulelweyo akaziwa.
Imiphumela
Xa zisetyenziswe njengoko kulandiswe, uElla ukhuselekileyo kwabaninzi bafazi. Imiphumo echaphazelekayo echazwe ngexesha lokuvavanywa kweeklinikhi kwabafazi abangama-2,637 abafumana u-Ella baquka:
- Intloko (18%)
- Isihlunu (12%)
- Iintlungu zesisu kunye nesisu esiswini (12%)
- I-Dysmenorrhea (iintlungu zesisu ngexesha lokuya esikhathini) (10%)
- Ukukhathala (6%)
- Utywala (5%)
Emva kokuthatha u-Ella, unokufumana utshintsho kwixesha lakho. Kwezinye iimeko, ixesha lakho elizayo linokuba lunzima okanye lilula, okanye ngaphambili okanye kamva. Kubalulekile ukudibana nogqirha ukuba ixesha lakho elihlelwe lixesha elingaphezu kweyure evekini, njengoko oku kubonisa ukuba ukukhulelwa kwenzeka.
Ukuba ufumana iintlungu ezinzima zesisu ukuya kwiiveki ezi-3 ukuya kwe-5 emva kokuthatha u-Ella, kunokuba nethuba lokukhulelwa kwe-ectopic, ngoko kufuneka ufune unyango lwangonyango.
Impumelelo
U-Ella usebenza ngokugqithisileyo ngokukhawuleza kokuba iqalwa. Xa kuthatyathwa njengalathwayo (ngaphakathi kweeyure ezingama-120 zesini esingakhuselekanga okanye ukuhluleka kokukhulelwa), u-Ella uya kunciphisa ithuba lokuba uya kukhulelwa. U-Ella akaphumelelanga kuwo onke amacala kwaye kufuneka kusetyenziswe isahluko esisodwa sokuziphatha okungavumelekanga. Ngexesha lovavanyo lweekliniki uElla wanciphisa kakhulu izinga lokukhulelwa kwisilinganiso esilindelekileyo se-5.5% (inani lokukhulelwa elindelekileyo ngaphandle kokuqhawula ngokukhawuleza kubalwa ngokusekelwe kwimeko yokulala ngokwesimo somfazi ngamnye wesibini) ukuya kwizinga elimgangatho we-2.2%.
U-Ella ubonakala engasebenzi phantsi kwabasetyhini abancinci. Ngexesha leemitha zengonyango, 3.2% yabasetyhini abanomlinganiselo wembumba yomzimba (BMI)> 30 kg / m bakhulelwa bebenzisa u-Ella.
U-Ella akayi kuqhubeka nokukhusela ukukhulelwa ngexesha lomjikelo womfazi, ngoko qi ni sekise ukuba usebenzisa indlela yokulawula ngokuzalwa rhoqo ngexesha ozayo ngesondo. Umvelisi uthi "ukubuyela ngokukhawuleza kokuzala kunokwenzeka ukulandela unyango kunye ne-ella yokukhulelwa ngokukhawuleza; ngoko ke, ukukhulelwa kwangaphambili kufuneka kuqhubeke okanye kuqaliswe ngokukhawuleza emva kokusetyenziswa kwe-ella ukuqinisekisa ukukhusela okuqhubekayo kokukhulelwa."
Amanye amayeza kunye nemveliso yemveliso inganciphisa nokuphumelela kwe-ella. Ezi ziquka:
- Barbiturates
- Bosentan
- ICarbamazepine
- Felbamate
- Griseofulvin
- Oxcarbazepine
- Phenytoin
- Rifampin
- ISt John's Wort
- Topiramate
Ukuqapha
Thetha nomboneleli wakho wezempilo xa usebenzisa ulawulo lwe-hormonal ( njengepilisi , isiqendu , iDepo Provera , NuvaRing ). Ukusebenzisa u-Ella kunokukwenza ukuba ulawulo lwakho lokuzalwa kwe-hormonal oluqhelekileyo lusebenze kangangoko . Ngenxa yoko, ukuba usebenzisa u-Ella njengendlela yokukhulelwa ngokukhawuleza, kufuneka usebenzise indlela yokunqanda ukuzalwa (njengekhondom kunye ne- spermicide , ikhondom yabesifazane , isiponji ) ngexesha naziphi na izihlandlo olala ngazo kwimizuzu efanayo.
Kumele ube negunya logqirha ukuze ufumane u-Ella. Ngokuxhomekeke kumniki-nkonzo wakho wezempilo, unakho okanye ungadingi i-ofisi yokutyelela ukuze ufumane i-prescription ye-Ella. Umvelisi ucebisa ababoneleli bezonyango ukuba baqinisekise okanye balawule ukukhulelwa okukhoyo ngaphambi kokubhala umyalelo we-Ella.
Njengezilumkiso, unokubuza ugqirha wakho malunga nokufumana umyalelo ka-Ella ukuba abe nexesha elide - kungakhathaliseki ukuba kukho imeko engxamisekileyo. Ngale ndlela, uya kuba sele unomyalelo wokuzaliswa ngokukhawuleza kwaye awuyi kufuna ukulinda ukufumana ukuqashwa kwezokwelapha.
Iindleko
Ixabiso le ntlawulo entsha-emva kwepilisi ziyahlukahluka kuxhomekeke apho uthenga khona. U-Ella unokuhlawula ubuncinane i-$ 55 kwi-pharmacy. Kukho inkontileka ye-intanethi ongayisebenzisa ukuyithenga i-Ella nge-$ 67, kunye nokuthunyelwa kwamahhala kunye nokusingatha ukuhanjiswa kwosuku olulandelayo.
Ukukhuselwa kweSTI
U-Ella akaniki ukhuselo kwiintsholongwane zesondo okanye i-HIV.
Umthombo:
Watson Pharmaceuticals. I-tablet ye-acetate ye-Ella-u-crypristal: Ukuzalisa ulwazi olupheleleyo. Kufumaneka: Disemba 10,2010. http://pi.watson.com/data_stream.asp?product_group=1699&p=pi&language=E