美格鲁特(Miglustat)胶囊剂以商品名zavesca 于2003年7月获得美国FDA批准,由美国ACTELION PHARMS公司研制,治疗因葡萄糖酶脑苷脂酶活性降低所引起的Ⅰ型戈谢氏病的药物。 戈谢氏病为一种罕见遗传病,由于葡萄糖酶脑苷脂酶活性降低所致。此酶在人体内参与鞘糖脂葡萄糖鞘脑苷鞘氨醇的降解过程,当鞘糖脂葡萄糖鞘脑苷鞘氨醇的降解受到阻碍时,会使富含此种物质的巨嗜细胞的溶酶体在体内蓄积,发生广泛的病理反应,包括严重贫血、血小板减少、肝脾肿大、骨坏死和骨质减少。在治疗上常采用酶替代方法,美格鲁特用于无法以酶替代治疗的成年患者。 药理药效: 美格鲁特可降低鞘内糖脂的生物合成率,将葡萄糖苷鞘酶在人体内的浓度降至一个低水平,有助于改善Ⅰ型戈谢氏病患者的肝、脾脏肿大,血色素、血小板计数低下的水平。 使用方法: 推荐剂量为1次100mg,1日3次,若患者出现腹泻和震颤等不良反应,剂量可减少为1日1~2次;对轻度肾脏功能受损者(肌酐清除率为50~70ml/min /1.73m2)推荐剂量为1次100mg,1日2次;对轻度肾脏功能受损者(肌酐清除率为50~70ml/min /1.73m2)推荐剂量为1次100mg,1日2次;对中度肾脏功能受损者(肌酐清除率为30~50ml/min /1.73m2)推荐剂量为1次100mg,1日1次;对重度肾脏功能受损者不宜应用。 副作用: 服药初始的第1个月,常见有震颤、腹泻、胃肠道不适、视力损害、体重减轻、麻木、疼痛、背痛、疲乏、手足烧灼感、肢体沉重、血小板减少等不良反应;对男性有可能影响精子的质量,因此在用药期间尽可能地采取避孕措施,对女性患者在服用期间建议不要怀孕。美格鲁特胶囊剂的规格为每粒100mg,每盒20粒。
ZAVESCA® (miglustat capsules, 100 mg) is an inhibitor of the enzyme glucosylceramide synthase, which is a glucosyl transferase enzyme responsible for the first step in the synthesis of most glycosphingolipids. ZAVESCA® is an N-alkylated imino sugar, a synthetic analogue of D-glucose.
The chemical name for miglustat is 1,5-(butylimino)-1,5-dideoxy-D-glucitol with the chemical formula C10H21NO4 and a molecular weight of 219.28.
Miglustat is a white to off-white crystalline solid and has a bitter taste. It is highly soluble in water ( > 1000 mg/mL as a free base).
ZAVESCA® is supplied in hard gelatin capsules each containing 100 mg miglustat for oral administration. Each ZAVESCA® 100 mg capsule also contains sodium starch glycolate, povidone (K30), and magnesium stearate. Ingredients in the capsule shell include gelatin and titanium dioxide, and the shells are printed with edible ink consisting of black iron oxide and shellac. |