GLYURENORM

Active material: Gliquidone
When ATH: A10BB08
CCF: Oral hypoglycemic agents
ICD-10 codes (testimony): E11
When CSF: 15.02.01.02
Manufacturer: BOEHRINGER INGELHEIM INTERNATIONAL GmbH (Germany)

Pharmaceutical form, composition and packaging

Pills white, smooth, round, with beveled edges, with Valium on one side and with an engraving “57FROM” on both sides of the risks; on the other side engraved company logo.

Excipients: lactose monohydrate, dried corn starch, soluble starch of maize, magnesium stearate.

10 PC. – blisters (3) – packs cardboard.
10 PC. – blisters (6) – packs cardboard.
10 PC. – blisters (12) – packs cardboard.

Pharmacological action

Hypoglycemic agents, sulfonylurea derivative II generation. Gljurenorm^® has pankreaticheskim and vnepankreaticski effects. It stimulates the secretion of insulin by lowering the threshold of irritation of glucose β-cells of the pancreas, increases sensitivity to insulino and degree of its binding to cells – targets, enhances the effect of insulin on glucose uptake by the muscles and the liver (increases the number of receptors in insulino target tissues), inhibits lipolysis in adipose tissue. In the second phase insulin secretion, reduces the content of glucagon in blood.

It has a lipid-lowering effect, reduces trombogennye properties of blood.

After taking the drug gipoglikemiceski effect develops through 1-1.5 no, maximum action – through 2-3 no, duration – 12 no.

Pharmacokinetics

Absorption

Glikvidon quickly and almost completely absorbed from the digestive tract. After intake of the drug in single dose 30 mg C_max plasma levels achieved after 2-3 h and is 500-700 ng / ml. Through 0.5-1 h C_max reduced by 50%.

Metabolism and excretion

Glikvidon completely metabolized in the liver. The bulk of the metabolites excreted with jelchew and faeces, a small part of the – urine. Regardless of the dose and method of introduction in the urine found about 5% (as metabolites) dose. The level of glikvidona excretion in the urine remains minimal even when taken regularly.

Testimony

- Diabetes mellitus type 2 among middle-aged and older patients (the poor diet).

Dosage regimen

Selection of dose and regimen should be under the control of carbohydrate metabolism.

The agent shall inside in the initial dose of 15 mg (1/2 tab.) during breakfast. If necessary, to a gradual increase in dose to 120 mg / day. Further increase in dose usually does not lead to the strengthening effect.

If the daily dose Gljurenorma^® less than 60 mg (2 tab.), It can be assigned in 1 Welcome at breakfast time. In appointing the drug in a higher dose of the best effect is achieved when prescribing medication 2-3 times / day. In this case, the highest dose should be taken at breakfast time.

At replacement of oral hypoglycemic drug with a similar mechanism of action initial dose determine, depending on the course of the disease at the time of the appointment of the drug. Initial dose is usually 15-30 mg.

If monotherapy does not give expected effect, biguanida supplementation may.

Gljurenorm^® It should be taken with food, at the beginning of a meal.

Side effect

From the digestive system: >1% – nausea, vomiting, constipation, diarrhea, loss of appetite, intrahepatic cholestasis (1 event).

Dermatological reactions: 0.1-1% – itch, eczema, hives (1 event), Stevens-Johnson syndrome.

CNS: 0.1-1% – headache, dizziness, disorientation.

From the hematopoietic system: < 0.1% – thrombocytopenia, leukopenia (1 event), agranulocytosis (1 event).

Contraindications

- Diabetes mellitus type 1;

- Diabetic ketoacidosis, precoma and coma;

-status after pancreatic resection;

acute hepatic Porphyria;

- Severe liver;

some acute conditions (eg, infectious diseases or large surgical operations, when it is shown holding insulin);

- Pregnancy;

- Lactation (breast-feeding);

-hypersensitivity to derived sulfonylureas and sulfanilamidam.

FROM caution should be used in patients with febrile syndrome, diseases of the thyroid gland (with impaired), alcoholism.

Pregnancy and lactation

Gljurenorm^® contraindicated during pregnancy. The patient must be informed, that upon the occurrence of a pregnancy should stop taking the drug and consult a doctor.

If necessary, use during lactation should decide the issue of termination of breastfeeding.

Cautions

The patient must be informed of the need for careful adherence to medication. You should not stop treatment alone, not notifying the doctor.

While glikvidon marginally (5%) return with urine and usually well tolerated in kidney diseases, treatment of patients with pronounced renal insufficiency should be under close medical supervision.

Patients with diabetes are prone to the development of cardiovascular disease, a risk that can be reduced in the diet. Oral gipoglikemicakie funds should not replace medical diet, that allows you to control the body weight of the patient.

All oral gipoglikemicakie preparations when the late meal or non-compliance with the recommended dosage may lead to the development of hypoglycemia. Use sugar, chocolates or sugary drinks helps prevent starting gipoglikemicescuu reaction. The patient should inform, that, in the case of a continuing state of hypoglycemic, you should immediately consult your doctor.

In the case of fever, rash, nausea, the patient should stop taking Gljurenorma^® and immediately contact a physician.

In case of allergic reactions, discontinue use of the Gljurenorma^®, replacing it with other hypoglycemic medication or insulin.

Effects on ability to drive vehicles and management mechanisms

In dose selection period, the patient should avoid activities potentially hazardous activities, require increased attention and psychomotor speed reactions.

Overdose

Symptoms: reaction, due to hypoglycemia.

Treatment: immediate introduction dekstrozy (Glucose) PO / in.

Drug Interactions

Strengthening the actions possible hypoglycemic while applying Gljurenorma^® with salicilatami, sulьfanilamidami, derived fenilbutazon, TB medicines, chloramphenicol, Tetracycline, coumarin derivatives, tsiklofosfamida, MAO inhibitors, ACE inhibitors, clofibrate, β-adrenergic, simpatolitikami (klonidin), reserpine, guanethidine , with other gipoglikemicakimi means .

Reduced hypoglycemic action may together with the appointment of Gljurenorma^® and sympathomimetics, GCS, thyroid hormones, glucagon, thiazide diuretics, oral contraceptives, diazoksida, fenotiazina and preparations, containing nicotine acid, ʙarʙituratov, rifampicin, phenytoin.

Strengthening or weakening the hypoglycemic effect was described together with blokatorami gistaminovykh n₂-receptors (cimetidine, ranitidine), ethanol.

Conditions of supply of pharmacies

The drug is released under the prescription.

Conditions and terms

The drug should be stored in a dry, inaccessible to children at temperature not exceeding 25 ° C. Shelf life – 5 years.