Maninil - instructions for use, reviews, analogs and forms of release (tablets 1.75 mg, 3.5 mg and 5 mg) drugs for the treatment of type 2 diabetes in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Maninil. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Maninil in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Maninil with available structural analogues. Use for the treatment of non-insulin dependent diabetes mellitus in adults, children, as well as in pregnancy and lactation. Composition of the preparation.

Maninil - oral hypoglycemic drug from the group of derivatives of sulfonylureas of the 2nd generation.

It stimulates the secretion of insulin by binding to specific receptors in the membrane of the beta cell of the pancreas, reduces the threshold of stimulation of glucose in the beta cells of the pancreas, increases insulin sensitivity and the degree of its binding to target cells, increases the release of insulin, enhances the action of insulin on glucose uptake by muscles and the liver, thereby reducing the concentration of glucose in the blood. It operates in the second stage of insulin secretion. It inhibits lipolysis in adipose tissue. Has hypolipidemic action, reduces thrombogenic properties of blood.

Maninil 1.5 and Maninil 3.5 in micronized form is a high-tech, specially crushed form of glibenclamide, which allows the drug to be absorbed faster from the digestive tract. In connection with the earlier achievement of Cmax glibenclamide in plasma, the hypoglycemic effect practically corresponds to a time increase in the concentration of glucose in the blood after eating, which makes the action of the drug milder and physiological. The duration of hypoglycemic action is 20-24 hours.

The hypoglycemic effect of Maninil 5 develops after 2 hours and lasts for 12 hours.

Composition

Glibenclamide (in micronized form) + auxiliary substances.

Pharmacokinetics

After ingestion of Maninil 1.75 and Maninil 3.5, rapid and almost complete absorption from the gastrointestinal tract is observed. The complete release of the micro-ionized active substance occurs within 5 minutes. After ingestion of Maninil 5, absorption from the gastrointestinal tract is 48-84%. Absolute bioavailability is 49-59%. Binding to plasma proteins is more than 98% for Maninil 1.75 and Maninil 3.5, 95% for Maninil 5. Almost completely metabolized in the liver with the formation of two inactive metabolites, one of which is excreted by the kidneys, and the other - with bile.

Indications

• Type 2 diabetes mellitus - as a monotherapy or as part of a combination therapy with other oral hypoglycemic drugs, in addition to sulfonylurea derivatives and clays.

Forms of release

Tablets 1.75 mg, 3.5 mg and 5 mg.

Instructions for use and dosage

The dose of the drug depends on the age, the severity of the course of diabetes, the concentration of glucose in the blood on an empty stomach and 2 hours after eating.

Maninil Tablets 1.75

The initial dose of Maninil 1.75 is 1-2 tablets (1.75-3.5 mg) once a day. With insufficient effectiveness under the supervision of a doctor, the dose of the drug is gradually increased to the daily dose necessary to stabilize the carbohydrate metabolism. Increase the dose should be made at intervals of several days to 1 week, until the required therapeutic dose, which should not exceed the maximum. The maximum daily dose of Maninil 1.75 is 6 tablets (10.5 mg).

If the daily dose of glibenclamide exceeds 3 tablets of the drug Maninil 1.75, it is recommended to use the preparation Maninil 3.5.

The transition from other hypoglycemic drugs to Maninil 1.75 should be started under the supervision of a doctor with 1-2 tablets of Maninil 1.75 per day (1.75-3.5 mg), gradually increasing the dose to the required therapeutic dose.

Maninil 3,5 tablets

The initial dose of Maninil 3.5 is 1 / 2-1 tablets (1.75-3 mg) once a day. With insufficient effectiveness under the supervision of a doctor, the dose of the drug is gradually increased to the daily dose necessary to stabilize the carbohydrate metabolism.Increase the dose should be made at intervals of several days to 1 week, until the required therapeutic dose, which should not exceed the maximum. The maximum daily dose of Maninil 3.5 is 3 tablets (10.5 mg).

Transition from other hypoglycemic drugs to Maninil 3.5 should be started under the supervision of a doctor with 1 / 2-1 tablets Maninil 3.5 per day (1.75-3.5 mg), gradually increasing the dose to the required therapeutic.

Maninil 5 Tablets

The initial dose of Maninil 5 is 1 / 2-1 tablets (2.5-5 mg) once a day. With insufficient effectiveness under the supervision of a doctor, the dose of the drug is gradually increased to the daily dose necessary to stabilize the carbohydrate metabolism. Increase the dose should be made at intervals of several days to 1 week, until the required therapeutic dose, which should not exceed the maximum. The maximum daily dose of Maninil 5 is 3 tablets (15 mg).

The transition from other hypoglycemic drugs to Maninil 5 should be started under the supervision of a doctor with 1 / 2-1 tablets of Maninil 5 per day (2.5-5 mg), gradually increasing the dose to the required therapeutic dose.

In elderly patients, impaired patients, patients with reduced diet, in patients with severe renal or hepatic impairment, the initial and maintenance dose of Maninil should be reduced because of the risk of developing hypoglycemia.

Maninil should be taken before meals, without chewing and washing down with a small amount of liquid. Daily doses of the drug, up to 2 tablets, usually should be taken 1 time per day - in the morning, just before breakfast. Higher doses are divided into morning and evening reception.

If you miss one dose of the drug, the next pill should be taken at the usual time, while a higher dose is not allowed.

Side effect

• hypoglycemia (hunger, hyperthermia, tachycardia, drowsiness, weakness, moisture of the skin, impaired coordination of movements, tremor, general anxiety, fear, headache, transient neurological disorders, including visual and speech disorders, paresis or paralysis or altered perceptions of sensations);
• increase in body weight;
• nausea, vomiting;
• feeling of heaviness in the stomach;
• eructation;
• abdominal pain;
• diarrhea;
• metallic taste in the mouth;
• a temporary increase in hepatic enzyme activity;
• intrahepatic cholestasis;
• hepatitis;
• itching;
• hives;
• purpura;
• petechiae;
• increased photosensitivity;
• generalized allergic reactions accompanied by skin rashes, arthralgia, fever, proteinuria and jaundice;
• allergic vasculitis;
• anaphylactic shock;
• thrombocytopenia, leukopenia, erythropenia, agranulocytosis, pancytopenia, hemolytic anemia;
• visual impairment and accommodation disorders;
• increased diuresis;
• disulfiram-like reaction when taking alcohol (the most frequent signs of the effect: nausea, vomiting, abdominal pain, sensation of fever in the face and upper body, tachycardia, dizziness, headache);
• cross-allergy to probenecid, sulfonylureas, sulfonamides, diuretic agents containing a sulfonamide group in the molecule.

Contraindications

• hypersensitivity to glibenclamide and / or components included in the formulation;
• hypersensitivity to other sulfonylurea derivatives, sulfonamides, diuretic drugs containing a sulfonamide group in the molecule, and to probenecid,there may be cross reactions;
• diabetes mellitus type 1;
• diabetic ketoacidosis, diabetic precoma and coma;
• condition after resection of the pancreas;
• severe hepatic impairment;
• renal failure of severe degree (QC less than 30 ml / min);
• decompensation of carbohydrate metabolism in infectious diseases, burns, trauma or after major surgical operations, when insulin therapy is indicated;
• leukopenia;
• intestinal obstruction, paresis of the stomach;
• hereditary lactose intolerance, lactase deficiency or glucose malabsorption syndrome and lactose;
• deficiency of glucose-6-phosphate dehydrogenase;
• pregnancy;
• lactation period (breastfeeding);
• children and adolescents under 18 years of age (efficacy and safety not studied).

Application in pregnancy and lactation

The drug is contraindicated for use during pregnancy and during breastfeeding.

At the onset of pregnancy, the drug should be discontinued.

Use in children

Contraindicated in children and adolescents under 18 years.

Application in elderly patients

In elderly patients, the initial and maintenance dose of Maninil should be reduced because of the risk of developing hypoglycemia.

special instructions

During treatment with Maninil it is necessary to strictly follow the doctor's recommendations for diet compliance and self-monitoring of blood glucose concentration.

Long-term abstinence from eating, insufficient provision of carbohydrates, intense physical activity, diarrhea or vomiting are a risk of developing hypoglycemia.

Simultaneous administration of drugs that have an effect on the central nervous system, lowering blood pressure (including beta-blockers), as well as peripheral neuropathy can mask symptoms of hypoglycemia.

In elderly patients, the risk of developing hypoglycemia is slightly higher, so a more careful selection of the dose of the drug and regular monitoring of fasting blood glucose and after meals, especially at the beginning of treatment.

Alcohol can trigger the development of hypoglycemia, as well as the development of a disulfiram-like reaction (nausea, vomiting, abdominal pain, a feeling of fever in the face and upper body, tachycardia, dizziness, headache),so you should refrain from drinking alcohol during treatment with Maninil.

Large surgical interventions and trauma, extensive burns, infectious diseases with febrile syndrome may require the abolition of oral hypoglycemic drugs and the administration of insulin.

The drug is released by prescription.

During treatment, prolonged exposure to the sun is not recommended.

Impact on the ability to drive vehicles and manage mechanisms

During the treatment period, patients should be careful when driving vehicles and other potentially hazardous activities requiring increased attention and speed of psychomotor reactions.

Drug Interactions

An increase in the hypoglycemic effect of Maninil is possible with concurrent administration with ACE inhibitors, anabolic agents and male sex hormones, other oral hypoglycemic agents (eg, acarbose, biguanides) and insulin, azaprope, non-steroidal anti-inflammatory drugs (NSAIDs),beta-adrenoblockers, quinolone derivatives, chloramphenicol, clofibrate and its analogs, coumarin derivatives, disopyramide, fenfluramine, antifungal drugs (miconazole, fluconazole), fluoxetine, MAO inhibitors, PASK, Pentoxifylline (at high dosages with parenteral administration), perhexylline, derivatives pyrazolones, phosphamides (for example, cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfonamides, tetracyclines and tritqualin.

Urine acidifying agents (ammonium chloride, calcium chloride) enhance the effect of Maninil by decreasing the degree of its dissociation and increasing its reabsorption.

The hypoglycemic effect of Maninil may decrease with the simultaneous use of barbiturates, isoniazid, diazoxide, glucocorticosteroids (glucocorticosteroids), glucagon, nicotinate (high doses), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, oral contraceptives and estrogens, thyroid hormone drugs, sympathomimetic agents, blockers of slow calcium channels, lithium salts.

H2-receptor antagonists can on one side weaken, and on the other increase the hypoglycemic effect of the drug Maninil.

Pentamidine in a few cases can cause a strong decrease or increase in the concentration of glucose in the blood.

With simultaneous application with the drug, Maninil may intensify or weaken the effect of coumarin derivatives.

Along with the increase in hypoglycemic effect, beta-adrenoblockers, clonidine, guanethidine and reserpine, as well as drugs with a central mechanism of action, can weaken the sensation of precursors of symptoms of hypoglycemia.

Analogues of the drug Maninil

Structural analogs for the active substance:

• Bethanase;
• Hillemal;
• Glybamide;
• Glibenclamide;
• Glidanil;
• Glimidstad;
• Glitisol;
• Glucobene;
• Dioniel;
• Maniglid;
• Euglucon.

Analogues on the curative effect (agents for the treatment of insulin-independent diabetes mellitus type 2):

• Avandamet;
• Amalvia;
• Amaryl;
• Antidiab;
• Arfazetine;
• Bagomet;
• Butamide;
• Vazoton;
• Victoria;
• Galvus;
• Glybenez;
• Glybometh;
• Glidiab;
• Glimecomb;
• Glitisol;
• Gliiformin;
• Glucovans;
• Glucophage;
• Diabeton;
• Diastabol;
• Diben;
• Dibikor;
• Xenical;
• Listat;
• Metogamma;
• Metformin;
• Novonorm;
• Novoformin;
• OngliSa;
• Pankragen;
• Pioglar;
• Predian;
• Reduxin Met;
• Reclild;
• Roglit;
• Silubin retard;
• Siofor;
• Starlix;
• Trakor;
• Formethine;
• Formina Pliva;
• Chloropropamide;
• Cigapan;
• Erbisol;
• Euglucon;
• Januvia.

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