{"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\/ro\/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;\">R\u0103spuns rapid<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Zepdon<\/strong> \u2014 Raltegravir 400 mg (Cipla Inc). Primul inhibitor al transferului de caten\u0103 integraz\u0103. 400 mg BID. Combinat cu doi NRTI pentru un regim complet. Preferat \u00een sarcin\u0103 \u0219i acolo unde interac\u021biunile CYP sunt problematice.<\/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>Ce beneficii ofer\u0103 MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>produc\u0103tor certificat WHO-GMP<\/li>\n<li>Ambalaj discret \u00een plic simplu<\/li>\n<li>Livrare \u00een toat\u0103 lumea<\/li>\n<li>Evaluat de peste 1.400 de clien\u021bi (<a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">cite\u0219te recenziile<\/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>Garan\u021bia de retransmitere:<\/strong> dac\u0103 comanda dvs. nu a ajuns \u00een 20 de zile lucr\u0103toare de la expediere, o retransmitem f\u0103r\u0103 costuri suplimentare. <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Cite\u0219te politica<\/a>.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Zepdon este expediat de la un produc\u0103tor certificat WHO-GMP \u00een ambalaj simplu, facturat printr-un procesator de pl\u0103\u021bi reglementat (descrierea extrasului arat\u0103 un procesator de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 MedsBase sau numele vreunui medicament). Fiecare comand\u0103 beneficiaz\u0103 de Garan\u021bia noastr\u0103 de Reexpediere \u00een 20 de zile lucr\u0103toare.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Aderen\u021ba \u00eenc\u0103 conteaz\u0103<\/strong><br \/>INSTI au o barier\u0103 genetic\u0103 mai ridicat\u0103 dec\u00e2t NNRTI, dar rezisten\u021ba poate ap\u0103rea \u00een cazul nerespect\u0103rii tratamentului. Aderen\u021ba &gt;95% r\u0103m\u00e2ne obiectivul. Monitoriza\u021bi \u00eentotdeauna \u00eenc\u0103rc\u0103tura viral\u0103 la fiecare 3-6 luni.<\/div>\n<h2>Cum func\u021bioneaz\u0103 inhibitorii de integraz\u0103<\/h2>\n<p>Inhibitorii de transfer al catenei de integraz\u0103 (INSTI) blocheaz\u0103 enzima HIV integraz\u0103 care insereaz\u0103 ADN-ul viral \u00een genomul gazd\u0103. F\u0103r\u0103 integrare, replicarea viral\u0103 nu poate continua. INSTI moderne (raltegravir, dolutegravir, bictegravir, elvitegravir, cabotegravir) sunt extrem de potente, bine tolerate \u0219i au o barier\u0103 genetic\u0103 mai ridicat\u0103 la rezisten\u021b\u0103 dec\u00e2t NNRTI.<\/p>\n<p>Regimurile bazate pe INSTI sunt recomandate de OMS \u0219i ghidurile SUA\/UE ca tratament de prim\u0103 linie pentru HIV la adul\u021bi \u2014 de obicei combinate cu doi NRTI (TDF\/FTC, TAF\/FTC sau ABC\/3TC) pentru un regim complet.<\/p>\n<h2>Efecte secundare<\/h2>\n<ul>\n<li>\u00cen general bine tolerate \u2014 mult mai bine dec\u00e2t NNRTI \u0219i PI vechi<\/li>\n<li>Insomnie, vise vii, dureri de cap (\u00een special raltegravir, dolutegravir)<\/li>\n<li>Cre\u0219tere \u00een greutate (mai frecvent\u0103 cu dolutegravir, bictegravir dec\u00e2t cu raltegravir) \u2014 monitoriza\u021bi IMC pe termen lung<\/li>\n<li>Cre\u0219tere moderat\u0103 a creatinei (cobicistat, dolutegravir) \u2014 pseudo-cre\u0219tere datorit\u0103 inhib\u0103rii secre\u021biei tubulare de creatinin\u0103, nu leziune renal\u0103 real\u0103<\/li>\n<li>Cre\u0219teri ale transaminazelor hepatice (rare) \u2014 monitoriza\u021bi testele hepatice \u00een primele 6 luni<\/li>\n<li>Reac\u021bii la locul de injectare pentru cabotegravir (form\u0103 cu ac\u021biune prelungit\u0103)<\/li>\n<\/ul>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Regula de chelare a cationilor<\/strong><br \/>INSTI formeaz\u0103 chela\u021bi cu calciu, magneziu, aluminiu \u0219i fier. Separa\u021bi doza de antiacide, suplimente cu fier, multivitamine \u0219i suplimente care con\u021bin calciu cu 2 ore \u00eenainte sau 6 ore dup\u0103.<\/div>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3>De ce sunt INSTI de prim\u0103 linie?<\/h3>\n<p>Poten\u021b\u0103 ridicat\u0103, suprimare viral\u0103 rapid\u0103, barier\u0103 genetic\u0103 \u00eenalt\u0103 la rezisten\u021b\u0103, tolerabilitate bun\u0103 \u00een general, mai pu\u021bine interac\u021biuni medicamentoase, activitate larg\u0103 \u00een toate subtipurile de HIV-1. Ghidurile WHO din 2018 \u00eencoace \u0219i US DHHS\/EACS prefer\u0103 toate regimurile de prim\u0103 linie bazate pe INSTI.<\/p>\n<h3>Interac\u021biuni medicamentoase?<\/h3>\n<p>INSTI formeaz\u0103 chela\u021bi cu cationi polivalen\u021bi (Mg2+, Al3+, Fe2+, Ca2+) \u2014 separa\u021bi de antiacide, fier, calciu, multivitamine cu 2 ore \u00eenainte \/ 6 ore dup\u0103. Altfel, relativ pu\u021bine interac\u021biuni; versiunile poten\u021bate cu cobicistat (elvitegravir\/c) au probleme cu CYP3A4, raltegravirul are cele mai pu\u021bine interac\u021biuni.<\/p>\n<h3>Ce spune\u021bi despre rezisten\u021b\u0103?<\/h3>\n<p>Barier\u0103 genetic\u0103 mai \u00eenalt\u0103 dec\u00e2t NNRTI, dar rezisten\u021ba apare \u00een caz de adheren\u021b\u0103 slab\u0103 \u2014 monitoriza\u021bi \u00eenc\u0103rc\u0103tura viral\u0103 \u0219i interveni\u021bi devreme.<\/p>\n<h3>Sarcin\u0103?<\/h3>\n<p>Dolutegravirul este sigur \u00een sarcin\u0103 (semnalul ini\u021bial Tsepamo de defecte ale tubului neural a fost infirmat de cohorte mai mari; riscul nu este diferit de alte ART). Raltegravirul este de asemenea sigur cu date extinse despre sarcin\u0103.<\/p>\n<h3>Efecte secundare?<\/h3>\n<p>Insomnie, vise vii, dureri de cap, cre\u0219tere \u00een greutate, cre\u0219tere moderat\u0103 a creatininemiei (\u00een mare parte cosmetic\u0103 \u2014 nu reflect\u0103 daune renale reale).<\/p>\n<h3>Injectabile cu ac\u021biune prelungit\u0103?<\/h3>\n<p>Cabotegravir + rilpivirin\u0103 cu ac\u021biune prelungit\u0103 IM (la fiecare 1-2 luni) este aprobat pentru adul\u021bi stabili, cu \u00eenc\u0103rc\u0103tur\u0103 viral\u0103 suprimat\u0103 \u2014 alternativ\u0103 la terapia oral\u0103 zilnic\u0103. Lenacapavir este o op\u021biune mai nou\u0103.<\/p>\n<h3>Ce fac dac\u0103 uit o doz\u0103?<\/h3>\n<p>Lua\u021bi-l c\u00e2nd v\u0103 aminti\u021bi dac\u0103 a\u021bi \u00eent\u00e2rziat cu 6 ore, omite\u021bi \u0219i relua\u021bi \u2014 nu dubla\u021bi doza. Dozele ratate repetate risc\u0103 rezisten\u021b\u0103.<\/p>\n<h3>Coinfec\u021bie cu HBV?<\/h3>\n<p>INSTI nu trateaz\u0103 HBV. Folosi\u021bi un schelet NRTI care con\u021bine TDF sau TAF pentru coinfec\u021bia HBV\/HIV \u2014 nu opri\u021bi brusc aceste medicamente f\u0103r\u0103 supraveghere hepatologic\u0103.<\/p>\n<h3>Voi avea nevoie de terapie pe via\u021b\u0103?<\/h3>\n<p>Da \u2014 tratamentul actual necesit\u0103 ART pe via\u021b\u0103. Injectabilele cu ac\u021biune prelungit\u0103 reduc povara zilnic\u0103 a tabletelor, dar tot reprezint\u0103 terapie continu\u0103. Cercetarea pentru vindecare (CRISPR, anticorpi neutralizan\u021bi largi, inversarea laten\u021bei) este activ\u0103, dar nu este \u00eenc\u0103 clinic\u0103.<\/p>\n<h3>Ce efecte cardiometabolice au?<\/h3>\n<p>Unii ITIN (dolutegravir, bictegravir) \u0219i TAF au fost asocia\u021bi cu cre\u0219tere \u00een greutate \u0219i modific\u0103ri metabolice. Monitoriza\u021bi greutatea, TA, lipidele \u0219i glicemia anual. Gestiona\u021bi independent riscul cardiovascular.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Alte medicamente HIV \u0219i antivirale<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/trioday\/\">Trioday<\/a> \u2014 TDF + 3TC + EFV \u2014 regim cu o singur\u0103 tablet\u0103 de la Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/triomune\/\">Triomune<\/a> \u2014 d4T + 3TC + NVP \u2014 regim mai vechi 3-\u00een-1 (pe baz\u0103 de stavudin\u0103)<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/zepdon\/\">Zepdon<\/a> \u2014 raltegravir 400 mg \u2014 inhibitor de integraz\u0103<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/abamune-l\/\">Abamune L<\/a> \u2014 abacavir + lamivudin\u0103 \u2014 alternativ\u0103 pentru scheletul NRTI<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/tenvir-l\/\">Tenvir L<\/a> \u2014 tenofovir + lamivudine \u2014 alternativ\u0103 de baz\u0103 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>Disclaimer medical:<\/strong> Tratamentul HIV este o terapie complex\u0103 \u0219i pe termen lung. Alegerea medicamentului depinde de genotip, teste de rezisten\u021b\u0103, comorbidit\u0103\u021bi \u0219i istoricul tratamentelor anterioare. Discuta\u021bi orice modificare a regimenului cu un specialist \u00een HIV. Este necesar\u0103 o conformitate &gt;95% pentru a preveni rezisten\u021ba. Testa\u021bi pentru HBV \u00eenainte de a \u00eencepe orice regimen care con\u021bine tenofovir, lamivudin\u0103 sau emtricitabin\u0103 \u2014 \u00eentreruperea poate provoca o exacerbare sever\u0103 a HBV la pacien\u021bii cu infec\u021bie mixt\u0103.<\/div>","protected":false},"excerpt":{"rendered":"<p>Zepdon (Raltegravir 400 mg) \u2014 Cipla primul inhibitor al transferului de caten\u0103 integraz\u0103 pentru HIV-1. 400 mg de dou\u0103 ori pe zi cu spate NRTI. Preferat \u00een sarcin\u0103.<\/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\/ro\/wp-json\/wp\/v2\/product\/51158","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=51158"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/51159"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=51158"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=51158"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=51158"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=51158"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}