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
| Active substance | Description of interaction |
| Amlodipine | FMR: antagonizm. Weakens effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Atenolol | FMR: synergism. Do effect; may mask some of the manifestations of developing hypoglycemia. |
| Acetylsalicylic acid | FMR: synergism. Do effect. |
| Betaksolol | FMR: synergism. Do effect; may mask early symptoms of hypoglycemia. |
| Betametazon | FMR: antagonizm. Weakens effect; the combined appointment is necessary to monitor the concentration of glucose in the blood. |
| Bisoprolol | FMR: synergism. Do effect; may mask early symptoms of hypoglycemia. |
| Bumetanid | FMR: antagonizm. Weakens effect; It requires the combined use of glycemic control. |
| Warfarin | FMR: synergism. Do effect. |
| Verapamil | FMR: antagonizm. Weakens effect; combined use requires monitoring of blood glucose levels. |
| Gidrokortizon | FMR: antagonizm. Weakens effect; It requires the combined use of glycemic control. |
| Gidroxlorotiazid | FMR: antagonizm. Weakens effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Glibenclamide | FMR: synergism. Strengthens (mutually) effect. |
| Gliquidone | FMR: synergism. Strengthens (mutually) effect. |
| Gliclazide | FMR: synergism. Strengthens (mutually) effect. |
| Glimepiride | FMR: synergism. Strengthens (mutually) effect. |
| Glipizide | FMR: synergism. Strengthens (mutually) effect. |
| Dexamethasone | FMR: antagonizm. Weakens effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Diclofenac | FMR: synergism. Do effect. |
| Diclofenac potassium | FMR: synergism. Do effect. |
| Diltiazem | FMR: antagonizm. Weakens effect; the combined appointment is necessary to monitor the level of glucose in the blood. |
| Doʙutamin | FMR: antagonizm. Reduces effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Dopamine | FMR: antagonizm. Weakens effect; combined use requires monitoring of blood glucose concentration. |
| Ibuprofen | FMR: synergism. Do effect. |
| Isoniazid | FMR: antagonizm. Weakens effect; the combined appointment is necessary to monitor the level of glucose in the blood. |
| Indapamid | FMR: antagonizm. Weakens effect; combined use requires monitoring of blood glucose concentration. |
| Indomethacin | FMR: synergism. Do effect. |
| Insulin dvuhfaznыy [human genetic engineering] | FMR: synergism. Strengthens (mutually) effect. |
| Insulin soluble [pork monocomponent] | FMR: synergism. Strengthens (mutually) effect. |
| Carbamazepine | FKV. FMR. It accelerates biotransformation and can weaken the effect of. |
| Karvedilol | FMR: synergism. Do effect (may mask some of the manifestations of hypoglycemia). |
| Ketoconazole | FKV. FMR. Blocks biotransformation and can enhance the effect of. |
| Kortizon | FMR: antagonizm. Weakens effect; joint application requires glycemic control. |
| Levothyroxine sodium | FMR: antagonizm. Weakens effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Liotironin | FMR: antagonizm. Weakens effect; It requires the combined use of glycemic control. |
| Methylprednisolone | FMR: antagonizm. Weakens effect; joint application requires glycemic control. |
| Mikonazol | FKV. FMR. Blocks biotransformation and can enhance the effect of. |
| Moclobemide | FMR: synergism. Inhibits MAO and enhances the effect of. |
| Nadolol | FMR: synergism. Do effect; can camouflage some of the symptoms of hypoglycemia. |
| Norepinephrine | FMR: antagonizm. Weakens effect and may provoke hyperglycaemia; the combined appointment is necessary to monitor the level of glucose in the blood. |
| Octreotide | FMR. Changes effect (possible both hypo-, and hyperglycemia); the combined use requires monitoring of blood glucose levels. |
| Perfenazyn | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Poliestradiola phosphate | FMR: antagonizm. Weakens effect; It requires the combined use of glycemic control. |
| Prednisolone | FMR: antagonizm. Weakens effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Procarbazine | FMR: synergism. MAO inhibitor, can enhance the effect of. |
| Promethazine | FMR: antagonizm. Weakens effect and may provoke hyperglycaemia; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Propranolol | FMR: synergism. Do effect; can camouflage some of the symptoms of hypoglycemia. |
| Rifampicin | FKV. FMR. Accelerates biotransformation (weakens the effect). |
| Selegiline | FMR: synergism. As MAO inhibitor enhances the effect of. |
| Sotalol | FMR: synergism. Do effect; may mask some of the early symptoms of hypoglycemia. |
| Sulfamethoxazole | FMR: synergism. Do effect. |
| Sulfasalazine | FMR: synergism. Do effect. |
| Timolol | FMR: synergism. Do effect; may mask some of the early symptoms of hypoglycemia. |
| Tioridazin | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Triamcinolone | FMR: antagonizm. Weakens effect; with a joint appointment is necessary to monitor the concentration of glucose in the blood. |
| Trifluoperazine | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Felodipine | FMR: antagonizm. Weakens effect; the combined appointment is necessary to monitor the level of glucose in the blood. |
| Phenylbutazone | FMR: synergism. Do effect. |
| Phenylephrine | FMR. Weakens effect; the combined appointment is necessary to monitor the level of glucose in the blood. |
| Phenytoin | FMR: antagonizm. Weakens effect; with a joint appointment requires monitoring of blood glucose. |
| Phenobarbital | FKV. Induces CYP3A4 isoenzyme of cytochrome P450, accelerates biotransformation and can weaken the effect of. |
| Fluoxetine | FMR: synergism. Do effect. After the abolition of possible hyperglycemia, requiring increasing doses; the combined appointment of caution. |
| Flufenazin | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Furosemid | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Chloramphenicol | FMR: synergism. Do effect. |
| Chlorpromazine | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Xlortalidon | FMR: antagonizm. Weakens effect; the combined appointment needed glycemic control. |
| Celecoxib | FMR: synergism. Do effect. |
| Epinephrine | FMR: antagonizm. Weakens effect and may provoke hyperglycaemia; the combined appointment is necessary to monitor the level of glucose in the blood. |
| Erythromycin | FKV. FMR. Blocks biotransformation and can enhance the effect of. |
| Esmolol | FMR: synergism. Do effect; may mask some of the early symptoms of hypoglycemia. |
| Ethanol | FMR: synergism. Do effect. |
| Ethinylestradiol | FMR: antagonizm. Weakens effect; It requires the combined use of glycemic control. |
| Ephedrine | FMR: antagonizm. Weakens effect and may provoke hyperglycaemia; the combined appointment is necessary to monitor the level of glucose in the blood. |
