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Glimepiride - instructions for use, reviews, analogs and formulations (1 mg, 2 mg, 3 mg and 4 mg Teva, Canon, with metformin) of the drug for the treatment of type 2 diabetes and sugar reduction in adults, children and pregnancy . Composition

Glimepiride - instructions for use, reviews, analogs and formulations (1 mg, 2 mg, 3 mg and 4 mg Teva, Canon, with metformin) of the drug for the treatment of type 2 diabetes and sugar reduction in adults, children and pregnancy . Composition

In this article, you can read the instructions for using the drug Glimepiride. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Glimepiride 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 glimepiride in the presence of existing structural analogues.Use for the treatment of non-insulin-dependent diabetes mellitus type 2 and reduce sugar levels in adults, children, as well as in pregnancy and lactation. Composition of the preparation.

 

Glimepiride - oral hypoglycemic agent, a derivative of sulfonylureas. Stimulates the secretion of insulin by beta cells of the pancreas, increases the release of insulin. Increases the sensitivity of peripheral tissues to insulin.

 

Composition

 

Glimepiride + auxiliary substances.

 

Glimepiride + Metformin + auxiliary substances (Amaryl M).

 

Pharmacokinetics

 

Eating does not have a significant effect on absorption. Binding to plasma proteins is more than 99%. Exposed to metabolism. Hydroxylated and carboxylated metabolites of glimepiride are apparently formed due to metabolism in the liver and are found in urine and in feces. After a single dose of glimepiride labeled with radioactivity, 58% of radioactivity was detected in urine and 35% in feces. An unchanged active substance in the urine was not detected.

 

Indications

  • diabetes mellitus type 2 (insulin-independent) in the case of ineffectiveness of diet and exercise.

 

Forms of release

 

Tablets 1 mg, 2 mg, 3 mg and 4 mg.

 

Instructions for use and dosage

 

The initial and maintenance dose is set individually based on the results of regular monitoring of blood glucose and urine levels.

 

The initial dose is 1 mg 1 time per day. If necessary, the daily dose can be gradually increased (by 1 mg for 1-2 weeks) to 4-6 mg.

 

The maximum dose is 8 mg per day.

 

Side effect

  • hypoglycemia;
  • hyponatremia;
  • nausea, vomiting;
  • a feeling of discomfort in the epigastrium;
  • stomach ache;
  • diarrhea;
  • increased activity of hepatic transaminases;
  • cholestasis;
  • jaundice;
  • hepatitis (up to the development of hepatic insufficiency);
  • thrombocytopenia, leukopenia, erythropenia, granulocytopenia, agranulocytosis, pancytopenia, hemolytic anemia;
  • transient visual impairment;
  • itching;
  • hives;
  • skin rash;
  • blood pressure drop;
  • anaphylactic shock;
  • allergic vasculitis;
  • photosensitization.

 

Contraindications

  • type 1 diabetes mellitus (insulin-dependent);
  • ketoacidosis;
  • precoma, coma;
  • liver failure;
  • kidney failure (including patients who are on hemodialysis);
  • pregnancy;
  • lactation;
  • hypersensitivity to glimepiride, other derivatives of sulfonylurea and sulfonamides.

 

Application in pregnancy and lactation

 

Glimepiride is contraindicated in pregnancy. In the case of a planned pregnancy or when pregnancy occurs, a woman should be transferred to insulin.

 

During lactation, a woman should be transferred to insulin.

 

In experimental studies, it has been established that glimepiride is excreted in breast milk.

 

Use in children

 

Not noted.

 

special instructions

 

With caution apply in patients with concomitant diseases of the endocrine system, affecting carbohydrate metabolism (including thyroid dysfunction, adenohypophysis or adrenocortical insufficiency).

 

In stressful situations (with trauma, surgical intervention, infectious diseases accompanied by fever), there may be a need for a temporary transfer of the patient to insulin.

 

It should be borne in mind that the symptoms of hypoglycemia can be smoothened or completely absent in elderly patients, patients with NCDs or receiving concurrent treatment with beta-blockers, clonidine, reserpine, guanethidine or other sympatholytic drugs.

 

When the compensation for diabetes is reached, insulin sensitivity increases; in this regard, the treatment process may reduce the need for glimepiride. To avoid the development of hypoglycemia, it is necessary to reduce the dose in a timely manner or to cancel glimepiride. Dose adjustment should also be carried out with a change in the body weight of the patient or with a change in his lifestyle, or with the appearance of other factors contributing to the development of hypo- or hyperglycemia.

 

When switching to glimepiride from another drug, it is necessary to take into account the extent and duration of the effect of the previous hypoglycemic agent. It may be necessary to temporarily discontinue treatment in order to avoid an additive effect.

 

In the first weeks of treatment, the risk of developing hypoglycemia may increase, which requires particularly strict monitoring of the patient. Factors contributing to the development of hypoglycemia include: irregular, malnutrition; changes in the habitual diet; alcohol consumption, especially when combined with a skipping meal; changing the habitual mode of exercise; simultaneous use of other drugs.Hypoglycemia can be quickly stopped by immediate intake of carbohydrates.

 

During the period of treatment, regular monitoring of glucose levels in blood and urine, as well as the concentration of glycated hemoglobin, is necessary.

 

Impact on the ability to drive vehicles and manage mechanisms

 

During the treatment period, one should refrain from engaging in potentially dangerous activities requiring increased attention and speed of psychomotor reactions.

 

Drug Interactions

 

An increase in the hypoglycemic effect of glimepiride is possible with simultaneous use with insulin or other hypoglycemic drugs, ACE inhibitors, allopurinol, anabolic steroids and male sex hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, phenyramidol, fibrates, fluoxetine, guanethidine, isophosphamide, MAO inhibitors , miconazole, PASK, Pentoxifylline (when injected in high doses), phenylbutazone, azapropase, oxyphenbutazone m, probenecid, quinolones, salicylates, sulfinpyrazone, sulfonamides, tetracyclines.

 

Weakening of hypoglycemic action of glimepiride is possible with simultaneous use with acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) and other sympathomimetics, glucagon, laxatives (after prolonged use), nicotinic acid (in high doses), estrogens and progestogens, phenothiazine , phenytoin, rifampicin, thyroid hormones.

 

With simultaneous use of blockers of histamine H2-receptors, clonidine and reserpine are able both to potentiate and reduce the hypoglycemic effect of glimepiride.

 

Against the background of the use of glimepiride, it is possible to enhance or weaken the action of coumarin derivatives.

 

Ethanol (alcohol) may increase or decrease the hypoglycemic effect of glimepiride.

 

Analogues of the drug Glimepiride

 

Structural analogs for the active substance:

  • Amaryl;
  • Glime;
  • Glemaz;
  • Glemauno;
  • Glimepiride Canon;
  • Glimepiride Teva;
  • Glumex;
  • Diameter;
  • Meglimide.

 

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

  • Avandamet;
  • Actrapid;
  • Amalvia;
  • Amaryl M;
  • Anistat;
  • Antidiab;
  • Bagomet;
  • Berselsulin;
  • Bethanase;
  • Biosulin P;
  • Victoria;
  • Vipidia;
  • Galvus;
  • Galvus Met;
  • Gensulin;
  • Glybamide;
  • Glybenez;
  • Glybenez retard;
  • Glibenclamide;
  • Glybometh;
  • Glimecomb;
  • Glitisol;
  • Gliiformin;
  • Glucophage;
  • Glucophage Long;
  • Depo insulin C;
  • Diabeton;
  • Diabetes MW;
  • Dibikor;
  • Isofan insulin FM;
  • Invokana;
  • Insulin C;
  • Xenical;
  • Listat;
  • Maninil;
  • Metogamma;
  • Metformin;
  • Mixtard;
  • Monotard;
  • NovoMiks;
  • Novonorm;
  • OngliSa;
  • Pensulin;
  • Protafan;
  • Reduxin Met;
  • Siofor;
  • Trakor;
  • Ultradard;
  • Formethine;
  • Formina Pliva;
  • Chloropropamide;
  • Humalog;
  • Humulin;
  • Euglucon;
  • Januvia.

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