#医療ダイエット#ダイエット #リベルサス #痩せる #痩せたい＃マンジャロ＃カナグル 当院では、2型糖尿病治療薬（GLP-1受容体作動薬、SGLT2阻害薬、メトホルミンなど）を、医師の判断により自由診療（肥満治療目的）として処方する場合があります。これらの薬剤は肥満治療目的での使用が国内未承認のため、適応外使用となります。診察・検査結果・既往症を総合的に判断し、すべての患者様に処方できるわけではありません。 いずれの薬剤も2型糖尿病の血糖コントロールを目的に承認されています。肥満治療としての使用は、国内外の承認状況や学会ガイドラインを踏まえ、十分な説明と同意のもとで実施します。 服用や注射を行うことで必ずしも一定の体重減少効果が得られるわけではありません。効果には大きな個人差があり、生活習慣や食事療法、運動療法との併用が前提となります。低血糖症状、消化器症状などの副作用が起こる可能性があり、体調不良時は速やかに医師へ相談してください。 治療継続には定期的な検査（血液・尿検査等）が必要となる場合があります。診察料・検査料・追加薬剤費が別途発生する可能性があります。 肥満治療目的での処方は健康保険適用外（全額自己負担）となります。適応外使用のため、国の医薬品副作用被害救済制度の対象外となることがあります。 本治療はあくまで選択肢の一つであり、他の医療機関や他の治療法より優れていることを保証するものではありません。治療効果・副作用のリスクには個人差があり、必ずしも期待する結果が得られるとは限りません。 リベルサスは、GLP-1受容体作動薬の経口薬で、2型糖尿病の血糖コントロールを目的とした治療薬です。当院では、医師の判断により、肥満治療目的で処方する場合があります（適応外使用）。 初期投与量は3mg、1ヶ月後に7mgへ増量、その後必要に応じて14mgまで増量可能。 消化器症状（悪心、嘔吐、下痢、便秘）、食欲不振、急性膵炎（極めて稀） リベルサスは、2型糖尿病の治療薬として厚生労働省に承認されていますが、肥満治療目的での処方は国内で承認されていません。 当該医薬品は、国内正規販売代理店（医薬品卸業）から仕入れています。 リベルサスと同成分のウゴービ、またサノレックス等が肥満症の治療薬として国内で承認されています。 同一成分の注射製剤がアメリカ食品医薬品局（FDA）で肥満症治療薬として承認されています。安全性等に関わる情報としては、急性膵炎、低血糖症状、嘔吐、腹痛、下痢、便秘 などが報告されています。
万が一重篤な副作用が出た場合は、国の医薬品副作用被害救済制度の対象外となります。 ●SGLT2阻害薬（スーグラ、カナグル、フォシーガ、ジャディアンス） SGLT2阻害薬（スーグラ，カナグル，フォシーガ、ジャディアンス）は、2型糖尿病の治療薬として厚生労働省に承認されています。肥満治療目的での処方は国内で承認されていません。 当該医薬品は、国内正規販売代理店（医薬品卸業）から仕入れています。 スーグラ・カナグル，フォシーガ、ジャディアンスはアメリカ食品医薬品局（FDA）で糖尿病治療薬として承認されていますが、諸外国でも肥満症治療薬を目的とした使用は承認されておりません。 安全性等に関わる情報としては、膀胱炎など尿路感染症（排尿痛、残尿感、頻尿、多尿）、陰部感染症（陰部や性器のかゆみ、痛み、おりもの）、口渇、ケトーシス、食欲減退、多飲症、便秘、下痢、腹痛といった症状が記載されています。 万が一重篤な副作用が出た場合は、国の医薬品副作用被害救済制度の対象外となります。 メトホルミンは、2型糖尿病の治療薬であり、肝臓での糖新生を抑制し、筋肉などのインスリン感受性を向上させることで血糖を下げる作用があります。また、医師の判断により、肥満治療目的で処方する場合があります（適応外使用）。 下痢、腹痛、吐き気、食欲不振、低血糖（他の血糖降下薬と併用時）、乳酸アシドーシス（極めて稀） メトホルミンは、2型糖尿病の治療薬として厚生労働省に承認されていますが、肥満治療を目的とした処方は国内で承認されていません。 当該医薬品は、国内正規販売代理店（医薬品卸業）から仕入れています。 メトホルミンと同成分の2型糖尿病治療薬は多数存在しますが、肥満症の治療薬として承認されているものには、サノレックスやウゴービなどがあります。 メトホルミンは、アメリカ食品医薬品局（FDA）においても糖尿病治療薬として承認されています。また、糖尿病や多嚢胞性卵巣症候群（PCOS）の治療に使用されています。 主な副作用として、低血糖（他の血糖降下薬と併用時）、消化器症状、乳酸アシドーシスなどが報告されています。
万が一重篤な副作用が出た場合は、国の医薬品副作用被害救済制度の対象外となります。 ●GLP-1受容体作動薬(オゼンピック)・GLP-1/GIP受容体作動薬(マンジャロ)注射薬 オゼンピック(GLP-1受容体作動薬)、マンジャロ(GLP-1/GIP受容体作動薬)は注射薬で、2型糖尿病の血糖コントロールを目的とした治療薬です。当院では、医師の判断により、肥満治療目的で処方する場合があります（適応外使用）。食欲抑制作用、胃排出遅延、血糖コントロールを通じて、体重減少が期待されます。 オゼンピック：週1回、同じ曜日に皮下注射。初期投与量は0.25mg、4週間後に0.5mgへ増量。 マンジャロ：週1回、同じ曜日に皮下注射。初期投与量は2.5mg、4週間後に5mgへ増量、その後必要に応じて増量可能。 消化器症状（悪心、嘔吐、下痢、便秘）、食欲不振、低血糖、急性膵炎（極めて稀） オゼンピック、マンジャロは、2型糖尿病の治療薬として厚生労働省に承認されていますが、肥満治療目的での処方は国内で承認されていません。 当該医薬品は、国内正規販売代理店（医薬品卸業）から仕入れています。 オゼンピックやリベルサスと同成分のウゴービ、またサノレックス等が肥満症の治療薬として国内で承認されています。 同一成分の注射製剤がアメリカ食品医薬品局（FDA）で肥満症治療薬として承認されています。安全性等に関わる情報としては、急性膵炎、低血糖症状（冷や汗、気持ち悪くなる、手足の震え、ふらつく、脱力感）、嘔吐、腹痛、下痢、便秘 などが報告されています。 万が一重篤な副作用が出た場合は、国の医薬品副作用被害救済制度の対象外となります。 ※上記価格はあくまでも目安です。診察結果や処方日数、追加検査や再診の有無などにより実際の費用が変動する場合があります。 ＃Drケンシン＃つくばケンクリニック#医療ダイエット#ダイエット #リベルサス #痩せる #痩せたい＃痩せる方法＃マンジャロ
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