Glipizide

When ATH:
A10BB07

Characteristic.

White powder;. Insoluble in water and alcohol, but soluble in NaOH solution 0,1 mol/l and it is soluble in dimethylformamide-.

Pharmacological action.
Hypoglycemic.

Application.

Diabetes mellitus type 2 in the absence of the effect of low-calorie diet, adequate physical exercise and others.; diabetic microangiopathy.

Contraindications.

Hypersensitivity, diabetic ketoacidosis, diabeticheskaya coma, Juvenile diabetes mellitus type 1, fever, injury, surgery, pregnancy, lactation.

Restrictions apply.

Diseases of the digestive tract, liver and kidneys (continuous monitoring of blood glucose), childhood (efficacy and safety of use in children have not been established).

Pregnancy and breast-feeding.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

In the case of pregnancy is required for cancellation 1 months before the expected birth and the transition to insulin therapy.

At the time of treatment should stop breastfeeding.

Side effects.

For a slow form of glipizide:

From the nervous system and sensory organs: dizziness, headache, insomnia, drowsiness, anxiety, depression, confusion, gait disturbance, paraesthesia, gipersteziya, blurring of vision, sore eyes, conjunctivitis, bleeding in the retina.

With the cardiovascular system and blood (hematopoiesis, hemostasis): syncope, arrhythmia, arterial hypertension, feeling the tides.

Metabolism: gipoglikemiâ.

From the digestive tract: anorexia, nausea, vomiting, a feeling of heaviness in the epigastric region, dyspepsia, constipation, blood in the stool.

For the skin: rash, hives, itch.

From the respiratory system: rhinitis, pharyngitis, dyspnoea.

With the genitourinary system: dizurija, decreased libido.

Other: thirst, tremor, peripheral edema, nonlocalized pain throughout the body, arthralgia, myalgia, convulsions, Sweating.

For fast-acting form of glipizide:

From the nervous system and sensory organs: headache, dizziness, drowsiness.

Cardio-vascular system and blood (hematopoiesis, hemostasis: leukopenia, agranulocytosis, thrombocytopenia, pancytopenia, hemolytic or aplastic anemia.

Metabolism: nesaharnыy diabetes, giponatriemiya, porphyrin disease.

From the digestive tract: nausea, vomiting, epigastric pain, constipation, cholestatic hepatitis (Yellow staining of the skin and sclera, discoloration of the stool and dark urine, pain in the right upper quadrant).

For the skin: эritema, maculo-papular rash, hives, photosensitivity.

Other: increasing the concentration of lactate dehydrogenase, alkaline phosphatase, indirect bylyrubyna.

Cooperation.

Efficiency weaken mineralogy- and glucocorticoids, amfetaminы, anticonvulsants (hydantoin derivatives), asparaginase, ʙaklofen, calcium antagonists, carbonic anhydrase inhibitors (aцetazolamid), xlortalidon, oral contraceptives, epinephrine, ethacrynic acid, furosemid, glucagon, salicilaty, thiazide diuretics, thyroid hormones, triamterene etc.. preparations, causing hyperglycemia. Anabolic steroids and androgens increase the hypoglycemic activity. Indirect anticoagulants, NSAIDs, chloramphenicol, clofibrate, guanethidine, MAO inhibitors, probenecid, sulfonamides, rifampicin increase the concentration of the free fraction of blood (by displacement of connection with plasma proteins) and accelerate the biotransformation. Ketonazol, mikonazol, sulfinpyrazone and enhance inactivation block hypoglycemia. Against the background of development disulfiramopodobnyh alcohol syndrome (abdominal pain, nausea, vomiting, headache). Antithyroid and myelotoxic drugs increase the chances of developing agranulocytosis; latest, In addition, thrombocytopenia.

Overdose.

Symptoms: gipoglikemiâ.

Treatment: removal of the drug, glucose intake and / or change of diet with the necessary monitoring of blood glucose; in severe hypoglycemia (coma, epileptiform seizures) -immediate hospitalization, introduction 50% glucose solution / jet with simultaneous infusion (/ drip) 10% glucose solution for blood glucose concentration above 5,5 mmol / l; monitoring of blood glucose is necessary for 1-2 days after a patient from coma. Dialysis nyeeffyektivyen.

Dosing and Administration.

Inside before or during a meal. Fast form 5 mg before breakfast, in the absence of effective within a few days the dose of 2.5-5 mg (required constant monitoring of blood glucose concentrations); The maximum single dose - 15 mg, The maximum daily dose - 40 mg. Doses above 15 mg administered in several receptions. Against the background of liver disease, kidney disease and in older patients is 2,5 mg. Medlennodejstvujushhaja form 5 mg at breakfast time. To monitor the effectiveness of a slow form 1 once every 3 Months determine the level of glycosylated hemoglobin. If after 3 month effect is insufficient, increase the dose to 10 mg or 20 mg (the maximum daily dose).

Precautions.

Be wary appoint older, weakened and malnourished patients and patients with adrenal and pituitary insufficiency (avoid hypoglycemic reactions of initial and maintenance doses should not be high).

Cooperation