Glidiab mv pills 30mg №60

Mechanism of action

Oral hypoglycemic drug, a derivative of sulfonylurea II generation. Stimulates insulin secretion by pancreatic β-cells, enhances the insulin-secreting effect of glucose, and increases the sensitivity of peripheral tissues to insulin. Stimulates the activity of intracellular enzymes - muscle glycogen synthetase. Reduces the interval from the time of ingestion to the beginning of insulin secretion. Restores the early peak of insulin secretion (unlike other sulfonylurea derivatives, which have an effect mainly during the second stage of secretion). Reduces postprandial increase in glucose levels.

In addition to affecting carbohydrate metabolism, it improves microcirculation: it reduces adhesion and aggregation of platelets, normalizes vascular permeability, prevents the development of microthrombosis and atherosclerosis, and restores the process of physiological parietal fibrinolysis. Reduces the sensitivity of vascular receptors to adrenaline.

It slows down the development of diabetic retinopathy at the non-proliferative stage. With diabetic nephropathy on the background of long-term use causes a significant decrease in the severity of proteinuria.

Glidiab^® MV does not lead to weight gain,because it has a predominant effect on the early peak of insulin secretion and does not cause hyperinsulinemia; promotes weight loss in obese patients with proper diet.

Pharmacokinetics

Suction

After ingestion is almost completely absorbed from the gastrointestinal tract. The concentration of the active substance in the plasma increases gradually, reaching a maximum after 6-12 hours after taking the drug. Food intake does not affect absorption.

Due to the peculiarities of the dosage form, daily administration of a single dose of the drug provides an effective therapeutic concentration of gliclazide in the plasma for 24 hours.

Distribution

Plasma protein binding is approximately 95%.

Metabolism

Metabolized in the liver to form inactive metabolites.

Removal

T_1/2 It is approximately 16 hours. It is mainly excreted by the kidneys as metabolites and about 1% of the drug is excreted in the urine unchanged.

Pharmacokinetics in special clinical situations

In elderly patients, there are no significant clinical changes in pharmacokinetics.

Indications for use of the drug GLIDIAB^® MB

- diabetes mellitus type 2 in combination with diet therapy and moderate exercise with the ineffectiveness of the latter.

Dosage and administration

The dose of the drug should be selected individually depending on the clinical manifestations of the disease, fasting glucose and 2 hours after a meal.

Initial daily dose (including for elderly patients over 65) is 30 mg (1 tablet). In the future, if necessary, increase the dose with an interval of at least 2 weeks. The maximum daily dose is 120 mg (4 tablets). The drug is taken orally 1 time / in the morning during breakfast.

Drug Glidiab^® MB can replace Glidiab^® doses from 1 to 4 pills /

Glidiab^® MV can be used in combination with other hypoglycemic agents: biguanides, alpha-glucosidase inhibitors or insulin.

the drug is prescribed in the same doses.

Side effect

On the part of the endocrine system: function (in violation of the dosing regimen and inadequate diet) - headache, fatigue, hunger, sweating, severe weakness, aggressiveness, anxiety, irritability, inattention, inability to concentrate and slow reaction, depression, blurred vision, aphasia, tremor, helplessness, sensory disorders, dizziness, loss of self-control, delirium, convulsions, hypersomnia, loss of consciousness, shallow breathing, bradycardia.

From the digestive system: dyspepsia (nausea, diarrhea, epigastric heaviness); anorexia - severity decreases when taken with food; abnormal liver function (cholestatic jaundice, increased activity of hepatic transaminases).

From the hemopoietic system: anemia, thrombocytopenia, leukopenia.

Allergic reactions: itching, urticaria, maculo-papular rash.

Contraindications to the use of the drug GLIDIAB^® MB

- diabetes mellitus type 1;

- diabetic ketoacidosis;

- diabetic precoma, diabetic coma;

- hyperosmolar coma;

- severe hepatic and / or renal failure;

- extensive surgical interventions, extensive burns, injuries and other conditions requiring insulin therapy;

- intestinal obstruction;

- paresis of the stomach;

- conditions associated with impaired absorption of food, the development of hypoglycemia (infectious diseases);

- leukopenia;

- pregnancy;

- lactation period (breastfeeding);

- hypersensitivity to the drug.

WITH caution the drug should be used (the need for more careful monitoring and dose selection) in patients with febrile syndrome, thyroid gland diseases (with a violation of its function), and in alcoholism.

Use of the drug GLIDIAB^® MW during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

Application for violations of the liver

Use in severe hepatic and / or renal failure is contraindicated.

Application for violations of kidney function

Use in severe hepatic and / or renal failure is contraindicated.

Special notes

The treatment is carried out in combination with a low-calorie diet with a low carbohydrate content.

During treatment, the level of fasting glucose and after meals should be regularly monitored.

In the case of surgical interventions or decompensation of diabetes, it is necessary to consider the possibility of using insulin preparations.

Patients should be warned about the increased risk of hypoglycemia in the case of taking ethanol, NSAIDs and fasting. In the case of taking ethanol, it is also possible to develop disulfiram-like syndrome (abdominal pain, nausea, vomiting, headache).

Correction of the dose of the drug is necessary during physical or emotional overstrain, change of diet.

Particularly sensitive to the action of hypoglycemic drugs of the elderly; patients who do not receive a balanced diet; debilitated patients; patients suffering from pituitary-adrenal insufficiency.

Influence on ability to drive motor transport and control mechanisms

At the beginning of treatment, during the selection of the dose, patients prone to the development of hypoglycemia, it is not recommended to engage in activities requiring increased attention and quickness of psychomotor reactions.

Overdosage

Symptoms: hypoglycemia is possible, up to the development of hypoglycemic coma.

Treatment: if the patient is conscious, take in easily digestible carbohydrates (sugar), if unconscious - in / in, enter 40% dextrose (glucose) solution, in / m inject 1-2 mg of glucagon. After the recovery of consciousness, the patient must be given food rich in easily digestible carbohydrates in order to avoid the recurrence of hypoglycemia.

Drug interaction

Hypoglycemic effect of the drug Glidiab^® MV increases with simultaneous use with ACE inhibitors, histamine N blockers₂-receptors (cimets), antifungal, cyclophosphamide, chloramphenicol, MAO inhibitors, long-acting sulfonamides, with fenfluramine, Fluoxetine, Pentoxifylline, guanetidine, theophylline, with drugs that block tubular se cretion, with reserpine, Bromocriptine, disopyramide, Pyridoxine, Allopurinol, ethanol and ethanol-containing drugs, as well as other hypoglycemic drugs (acarbose, biguanides, insulin).

Hypoglycemic effect of the drug Glidiab^® MV is reduced with simultaneous use with barbiturates, GCS, sympathomimetics (epinephrine, clonidine, ritodrin, Salbutamol, terbutaline), with phenytoin, slow Calcium channel blockers, carbonic anhydrase inhibitors (acetazolamide), thiazide diuretics, chlorothalidone, ische, ostrozolamidom, thiazide diuretics, iridine, isnephramine, acetaminophen, thiazide diuretics, phythrazole diuretics, oxymethystrophamide; danazol, diazoxide, isoniazid, morphine, glucagon, rifampicin, with thyroid hormones, with lithium preparations, with high doses of nicotinic acid, with chlorpromazine, estrogen and content aschie their oral contraceptives.

When interacting with ethanol, a disulfiram-like reaction may develop.

Gliclazide increases the risk of ventricular extrasystoles in patients receiving cardiac glycosides.

Beta-blockers, clonidine, reserpine, guanethidine can mask the clinical manifestations of hypoglycemia.

Terms and conditions of storage

List B. The drug should be stored out of reach of children, dry, protected from light, at a temperature not exceeding 25 ° C.