{"id":51158,"date":"2023-09-20T09:18:18","date_gmt":"2023-09-20T09:18:18","guid":{"rendered":"https:\/\/medsname.com\/zepdon\/"},"modified":"2026-04-30T16:19:00","modified_gmt":"2026-04-30T16:19:00","slug":"zepdon","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/zepdon\/","title":{"rendered":"Zepdon"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Zepdon<\/strong> \u2014 Raltegravir 400 mg (Cipla Inc.). Prvn\u00ed inhibitor integ\u00e1zy ve sv\u00e9 t\u0159\u00edd\u011b. 400 mg dvakr\u00e1t denn\u011b. Kombinov\u00e1no se dv\u011bma NRTI pro kompletn\u00ed re\u017eim. Preferov\u00e1no v t\u011bhotenstv\u00ed a p\u0159i probl\u00e9mech s interakcemi CYP.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Zepdon je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, fakturov\u00e1n prost\u0159ednictv\u00edm regulovan\u00e9ho platebn\u00edho procesoru (na v\u00fdpisu z \u00fa\u010dtu se objev\u00ed regulovan\u00fd platebn\u00ed procesor \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed 20-pracovn\u00ed denn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Dodr\u017eov\u00e1n\u00ed l\u00e9\u010dby st\u00e1le z\u00e1le\u017e\u00ed<\/strong><br \/>INSTI maj\u00ed vy\u0161\u0161\u00ed genetickou bari\u00e9ru ne\u017e NNRTI, ale p\u0159i \u0161patn\u00e9 adherenci m\u016f\u017ee vzniknout rezistence. &gt;95% adherence z\u016fst\u00e1v\u00e1 c\u00edlem. V\u017edy monitorujte virovou n\u00e1lo\u017e ka\u017ed\u00e9 3-6 m\u011bs\u00edc\u016f.<\/div>\n<h2>Jak funguj\u00ed inhibitory integ\u00e1zy<\/h2>\n<p>Inhibitory integ\u00e1zy (INSTI) blokuj\u00ed enzym HIV integ\u00e1zu, kter\u00fd vkl\u00e1d\u00e1 virovou DNA do hostitelsk\u00e9ho genomu. Bez integrace nem\u016f\u017ee prob\u00edhat virov\u00e1 replikace. Modern\u00ed INSTI (raltegravir, dolutegravir, bictegravir, elvitegravir, cabotegravir) jsou vysoce \u00fa\u010dinn\u00e9, dob\u0159e sn\u00e1\u0161en\u00e9 a maj\u00ed vy\u0161\u0161\u00ed genetickou bari\u00e9ru k rezistenci ne\u017e NNRTI.<\/p>\n<p>Re\u017eimy zalo\u017een\u00e9 na INSTI jsou podle doporu\u010den\u00ed WHO a USA\/EU prvn\u00ed volbou pro dosp\u011bl\u00e9 s HIV \u2014 obvykle kombinov\u00e1ny se dv\u011bma NRTI (TDF\/FTC, TAF\/FTC nebo ABC\/3TC) pro kompletn\u00ed re\u017eim.<\/p>\n<h2>Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li>Obecn\u011b dob\u0159e sn\u00e1\u0161en\u00e9 \u2014 mnohem l\u00e9pe ne\u017e star\u0161\u00ed NNRTI a PI<\/li>\n<li>Nespavost, \u017eiv\u00e9 sny, bolesti hlavy (zejm\u00e9na raltegravir, dolutegravir)<\/li>\n<li>P\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze (v\u00edce s dolutegravirem, bictegravirem ne\u017e s raltegravirem) \u2014 sledujte BMI dlouhodob\u011b<\/li>\n<li>M\u00edrn\u00fd vzestup kreatininu (cobicistat, dolutegravir) \u2014 pseudo-vzestup zp\u016fsoben\u00fd inhibic\u00ed tubul\u00e1rn\u00ed sekrece kreatininu, nikoli skute\u010dn\u00e9 po\u0161kozen\u00ed ledvin<\/li>\n<li>Vzestup jatern\u00edch transamin\u00e1z (vz\u00e1cn\u011b) \u2014 sledujte hodnoty jatern\u00edch test\u016f prvn\u00edch 6 m\u011bs\u00edc\u016f<\/li>\n<li>Injek\u010dn\u00ed reakce v m\u00edst\u011b aplikace (cabotegravir) \u2014 dlouhodob\u011b<\/li>\n<\/ul>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Pravidlo chelatace kationt\u016f<\/strong><br \/>INSTI chel\u00e1tuj\u00ed s polyvalentn\u00edmi kationty (Mg2+, Al3+, Fe2+, Ca2+) \u2014 odd\u011bluj\u00ed od antacid, \u017eeleza, v\u00e1pn\u00edku, multivitam\u00edn\u016f o 2 hodiny p\u0159ed \/ 6 hodin po. Jinak relativn\u011b m\u00e1lo interakc\u00ed; verze zes\u00edlen\u00e9 cobicistatem (elvitegravir\/c) maj\u00ed probl\u00e9my s CYP3A4, raltegravir m\u00e1 nejm\u00e9n\u011b interakc\u00ed.<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Pro\u010d jsou INSTI prvn\u00ed volbou?<\/h3>\n<p>Vysok\u00e1 \u00fa\u010dinnost, rychl\u00e1 virov\u00e1 suprese, vysok\u00e1 genetick\u00e1 bari\u00e9ra v\u016f\u010di rezistenci, obecn\u011b dobr\u00e1 sn\u00e1\u0161enlivost, m\u00e9n\u011b l\u00e9kov\u00fdch interakc\u00ed, \u0161irok\u00e1 aktivita nap\u0159\u00ed\u010d podtypy HIV-1. WHO 2018 a pozd\u011bj\u0161\u00ed sm\u011brnice US DHHS\/EACS v\u0161ichni preferuj\u00ed re\u017eimy prvn\u00ed linie zalo\u017een\u00e9 na INSTI.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>INSTI chel\u00e1tuj\u00ed s polyvalentn\u00edmi kationty (Mg2+, Al3+, Fe2+, Ca2+) \u2014 odd\u011bluj\u00ed od antacid, \u017eeleza, v\u00e1pn\u00edku, multivitam\u00edn\u016f o 2 hodiny p\u0159ed \/ 6 hodin po. Jinak relativn\u011b m\u00e1lo interakc\u00ed; verze zes\u00edlen\u00e9 cobicistatem (elvitegravir\/c) maj\u00ed probl\u00e9my s CYP3A4, raltegravir m\u00e1 nejm\u00e9n\u011b interakc\u00ed.<\/p>\n<h3>Co rezistence?<\/h3>\n<p>Dlouhodob\u011b p\u016fsob\u00edc\u00ed injek\u010dn\u00ed formy?.<\/p>\n<h3>T\u011bhotenstv\u00ed?<\/h3>\n<p>Cabotegravir + rilpivirin dlouhodob\u011b p\u016fsob\u00edc\u00ed IM (ka\u017ed\u00e9 1-2 m\u011bs\u00edce) \u2014 schv\u00e1leno pro stabiln\u00ed, virologicky potla\u010den\u00e9 dosp\u011bl\u00e9 \u2014 alternativn\u00ed mo\u017enost.<\/p>\n<h3>Vedlej\u0161\u00ed \u00fa\u010dinky?<\/h3>\n<p>Vezm\u011bte si ji, kdy\u017e si vzpomenete, pokud je to m\u00e9n\u011b ne\u017e 6 hodin pozd\u011bji. Pokud je to v\u00edce ne\u017e 6 hodin pozd\u011bji, vynechejte ji a pokra\u010dujte \u2014 nedvojte se. Opakovan\u00e9 vynechan\u00e9 d\u00e1vky riskuj\u00ed rezistenci.<\/p>\n<h3>Long-acting injectables?<\/h3>\n<p>Cabotegravir + rilpivirine long-acting IM (every 1-2 months) is approved for stable, virologically suppressed adults \u2014 alternative to daily oral therapy. Lenacapavir is a newer option.<\/p>\n<h3>Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Take it when you remember if 6 hours late, skip and resume \u2014 do not double up. Repeated missed doses risk resistance.<\/p>\n<h3>HBV koinfekce?<\/h3>\n<p>INSTIs nel\u00e9\u010d\u00ed HBV. P\u0159i koinfekci HBV\/HIV pou\u017e\u00edvejte NRTI kostru obsahuj\u00edc\u00ed TDF nebo TAF \u2014 nikdy tyto l\u00e9ky nevysazujte n\u00e1hle bez dohledu hepatologa.<\/p>\n<h3>Budu pot\u0159ebovat celo\u017eivotn\u00ed terapii?<\/h3>\n<p>Ano \u2014 sou\u010dasn\u00e1 l\u00e9\u010dba vy\u017eaduje celo\u017eivotn\u00ed ART. Dlouhodob\u011b p\u016fsob\u00edc\u00ed injek\u010dn\u00ed formy sni\u017euj\u00ed denn\u00ed z\u00e1t\u011b\u017e tabletami, ale st\u00e1le p\u0159edstavuj\u00ed pokra\u010duj\u00edc\u00ed terapii. V\u00fdzkum l\u00e9\u010dby (CRISPR, \u0161iroce neutralizuj\u00edc\u00ed protil\u00e1tky, reverze latence) je aktivn\u00ed, ale zat\u00edm nen\u00ed klinicky dostupn\u00fd.<\/p>\n<h3>A co kardiometabolick\u00e9 \u00fa\u010dinky?<\/h3>\n<p>N\u011bkter\u00e9 INSTIs (dolutegravir, bictegravir) a TAF byly spojov\u00e1ny s p\u0159ib\u00fdv\u00e1n\u00edm na v\u00e1ze a metabolick\u00fdmi zm\u011bnami. Monitorujte hmotnost, TK, lipidy a gluk\u00f3zu ro\u010dn\u011b. \u0158i\u010fte kardiovaskul\u00e1rn\u00ed riziko nez\u00e1visle.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed l\u00e9ky na HIV a antivirotika<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/trioday\/\">Trioday<\/a> \u2014 TDF + 3TC + EFV \u2014 jednoduch\u00fd re\u017eim v jedn\u00e9 tablet\u011b od Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/triomune\/\">Triomune<\/a> \u2014 d4T + 3TC + NVP \u2014 star\u0161\u00ed 3v1 kombinace (na b\u00e1zi stavudinu)<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zepdon\/\">Zepdon<\/a> \u2014 raltegravir 400 mg \u2014 inhibitor integr\u00e1zy<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/abamune-l\/\">Abamune L<\/a> \u2014 abakavir + lamivudin \u2014 alternativn\u00ed z\u00e1klad NRTI<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tenvir-l\/\">Tenvir L<\/a> \u2014 tenofovir + lamivudin \u2014 alternativn\u00ed z\u00e1klad NRTI<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> L\u00e9\u010dba HIV je komplexn\u00ed, celo\u017eivotn\u00ed terapie. V\u00fdb\u011br l\u00e9k\u016f z\u00e1vis\u00ed na genotypu, testech rezistence, p\u0159idru\u017een\u00fdch onemocn\u011bn\u00edch a p\u0159edchoz\u00ed l\u00e9\u010db\u011b. Jakoukoli zm\u011bnu re\u017eimu konzultujte s odborn\u00edkem na HIV. Pro prevenci rezistence je nutn\u00e1 adherence &gt;95%. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby obsahuj\u00edc\u00ed tenofovir, lamivudin nebo emtricitabin testujte HBV \u2014 vysazen\u00ed m\u016f\u017ee u pacient\u016f s koinfekc\u00ed zp\u016fsobit z\u00e1va\u017en\u00e9 vzplanut\u00ed HBV.<\/div>","protected":false},"excerpt":{"rendered":"<p>Zepdon (Raltegravir 400 mg) \u2014 Cipla prvn\u00ed inhibitor integ\u00e1zy ve sv\u00e9 t\u0159\u00edd\u011b pro HIV-1. 400 mg dvakr\u00e1t denn\u011b s NRTI kostrou. Preferov\u00e1no v t\u011bhotenstv\u00ed.<\/p>","protected":false},"featured_media":51159,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3304],"product_tag":[],"class_list":{"0":"post-51158","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hiv-medication","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51158","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51158"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51159"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51158"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51158"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51158"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51158"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}