Repaglinide

When ATH:
A10BX02

Characteristic.

The oral hypoglycemic agent.

White or almost white powder. Molecular weight 452,6.

Pharmacological action.
Hypoglycemic.

Application.

Diabetes mellitus type 2 (the ineffectiveness of diet and exercise).

Contraindications.

Hypersensitivity, diabetes mellitus type 1, diabetic ketoacidosis, diabeticheskaya coma and coma, severe liver and / or kidney; states, requiring insulin (incl. infectious diseases, major surgery), pregnancy, lactation.

Restrictions apply.

Feverish syndrome, alcoholism, chronic renal failure. It should not be used in children and adolescents up to 18 years, and patients over 75 years (safety and efficacy in patients with these age categories are not defined).

Pregnancy and breast-feeding.

Contraindicated in pregnancy.

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.)

At the time of treatment should stop breastfeeding.

Side effects.

Gipoglikemiâ, dyspepsia (nausea, abdominal pain; very rarely - diarrhea or constipation, vomiting), allergic reactions (skin rash, itch, hives); in some cases - liver dysfunction (transient increase in liver transaminases) and visual impairment (associated with fluctuations in the level of glycemia).

Cooperation.

Beta-blockers, ACE inhibitors, chloramphenicol, indirect anticoagulants (coumarin derivatives), NSAIDs, probenecid, salicilaty, MAO inhibitors, sulfonamides, alcohol, anabolic steroids - enhance the effect. Calcium channel blockers, corticosteroids, Diuretic (especially thiazide), Isoniazid, nicotinic acid in high doses, Estrogens, incl. consisting of oral contraceptives, fenotiazinы, phenytoin, sympathomimetic, thyroid hormones - weaken the effect.

Overdose.

Symptoms: gipoglikemiâ (hunger, feeling tired and weak, headache, hypererethism, alarm, drowsiness, restless sleep, nightmares, behavior changes, similar to those observed during alcohol intoxication, weakening of concentration, speech and vision, confusion, paleness, nausea, cardiopalmus, convulsions, cold sweat, coma, and the like.).

Treatment: at moderate hypoglycemia, without neurological symptoms and loss of consciousness - carbohydrate intake (sugar or glucose solution) inside and a dose adjustment or diet. In severe (convulsions, loss of consciousness, coma) — intravenous administration 50% glucose solution followed by infusion 10% solution to maintain blood glucose level not lower 5,5 mmol / l.

Dosing and Administration.

Inside, 15-30 minutes before eating (usually 3 times a day before meals). Dose picked individually. The initial dose - 0,5 mg. Increasing the dose be held not earlier than 1-2 weeks after beginning treatment, focusing on the level of glucose. The maximum single dose - 4 mg, daily - 16 mg. If the patient is taking other oral hypoglycemic agent, or glycated hemoglobin level greater than or equal 8%, recommended starting dose - 1 mg.

Precautions.

To use caution in patients with impaired hepatic or renal function. The treatment must regularly monitor the level of glucose in fasting blood and postprandial, daily curve of glucose concentration in blood and urine. It should warn patients about the increased risk of hypoglycemia in violation of the dosing, inadequate diet, incl. fasting, by alcohol. When the physical and emotional stress need a dose adjustment.

Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention.

Cooperation