Glemaz
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Glemaz is a III generation sulfonylurea derivative, an oral hypoglycemic drug.
Release form and composition
Dosage form - tablets: rectangular, flat, light green, with 3 parallel notches applied along the width of the tablet on both sides and dividing it into 4 equal parts (5 or 10 pcs. In blisters, in a carton pack 3 or 6 blisters).
Active ingredient: glimepiride, 1 tablet - 4 mg.
Additional components: microcrystalline cellulose, magnesium stearate, cellulose, croscarmellose sodium, brilliant blue dye, quinoline yellow dye.
Indications for use
Glemaz is a drug for the treatment of type 2 diabetes mellitus (including as part of complex therapy with insulin or metformin).
Contraindications
Absolute:
- Type 1 diabetes mellitus;
- Leukopenia;
- Severe renal dysfunction (including contraindicated in patients on hemodialysis);
- Severe liver dysfunction;
- Diabetic precoma and coma, diabetic ketoacidosis;
- Conditions accompanied by impaired absorption of food and the development of hypoglycemia (including infectious diseases);
- Age under 18;
- Pregnancy and lactation;
- Hypersensitivity to the components of the drug or other sulfonylurea derivatives and sulfonamide drugs.
Glemaz should be prescribed with caution in conditions requiring the transfer of the patient to insulin therapy, such as malabsorption of food and drugs in the gastrointestinal tract (including gastrointestinal paresis and intestinal obstruction), major surgical interventions, severe multiple injuries, extensive burns.
Method of administration and dosage
Glemaz is taken orally. The daily dose should be taken in one dose before or during a hearty breakfast or the first main meal. The tablets must be swallowed without chewing, drinking plenty of liquid (about ½ glass). It is not recommended to skip meals after taking the pill.
The initial and maintenance doses are determined individually, depending on the results of regular determination of the concentration of glucose in the blood.
Early treatment is usually administered 1 mg of glimepiride (1 / 4 tablets) 1 time per day. If the optimal therapeutic effect is achieved, the drug continues to be taken at the same dose (as a maintenance).
In the absence of glycemic control, the daily dose is gradually increased, constantly monitoring the concentration of glucose in the blood: every 1-2 weeks, first up to 2 mg, then up to 3 mg, then up to 4 mg (a dose over 4 mg is effective only in exceptional cases). The maximum allowable daily dose is 8 mg.
The time and frequency of taking the drug are determined by the doctor based on the patient's lifestyle. Treatment is long-term, under the control of blood glucose.
Use in combination with metformin
If glycemic control cannot be achieved in patients taking metformin, combination therapy with Glemaz may be prescribed. In this case, the dose of metformin is kept at the same level, and glimepiride is prescribed in the minimum dose, after which it is gradually increased up to the maximum daily dose (depending on the concentration of glucose in the blood). Combined therapy is carried out under the close supervision of a physician.
Use in combination with insulin
If glycemic control cannot be achieved in patients receiving Glemaz at the maximum dose as a monopreparation or in combination with the maximum dose of metformin, combination therapy with insulin may be prescribed. In this case, the last prescribed dose of glimepiride is left unchanged, and insulin is prescribed in the minimum dose and, if necessary, it is gradually increased under the control of the blood glucose concentration. Combined treatment is carried out under the close supervision of a physician.
Transfer of the patient to Glemaz from another oral hypoglycemic drug
When transferring a patient from another oral hypoglycemic agent, the initial dose of glimepiride should be 1 mg, even if the other drug was taken at the maximum dose. If necessary, the dose of Glemaz is further increased in stages in accordance with the general recommendations described above and taking into account the effectiveness, dose and duration of action of the hypoglycemic drug used. In some cases, especially when using a hypoglycemic agent with a long half-life, it may be necessary to temporarily stop treatment (for several days) to avoid an additive effect that increases the risk of hypoglycemia.
Transfer of a patient from insulin to glimepiride
In exceptional cases, when insulin therapy is carried out in patients with type 2 diabetes mellitus, when the disease is compensated and the secretory function of pancreatic β-cells is preserved, insulin can be replaced with glimepiride. Reception of Glemaz begins with a minimum dose of 1 mg, the transfer is carried out under close medical supervision.
Side effects
- Metabolism: hypoglycemic reactions that occur mainly soon after taking the drug (they can have a severe form and course, they are not always easy to stop);
- Digestive system: abdominal pain, feeling of heaviness or discomfort in the epigastrium, nausea, vomiting, diarrhea, jaundice, cholestasis, increased activity of hepatic transaminases, hepatitis (up to liver failure);
- Hematopoietic system: aplastic or hemolytic anemia, erythrocytopenia, leukopenia, granulocytopenia, pancytopenia, agranulocytosis, thrombocytopenia (moderate to severe);
- Organ of vision: more often at the beginning of therapy - transient visual impairment;
- Allergic reactions: urticaria, skin rash, itching (usually mild, but can progress, accompanied by shortness of breath and a decrease in blood pressure, lead to anaphylactic shock), cross-allergy with sulfonamides and other sulfonylurea derivatives or similar substances, allergic vasculitis;
- Others: in some cases - hyponatremia, asthenia, photosensitivity, headache, tardive cutaneous porphyria.
special instructions
Glemaz should be taken strictly according to your doctor's recommendations. Admission errors (for example, skipping the next dose) should never be eliminated by the next higher dose. The patient should discuss with the doctor in advance the measures that should be taken in case of such errors or in situations where the next drug intake is not possible at the set time. The patient should immediately inform the doctor if the dose is too high.
The development of hypoglycemia after taking Glemaz in a daily dose of 1 mg means that glycemia can be controlled exclusively by diet.
After compensation for type 2 diabetes mellitus is achieved, insulin sensitivity increases, so a dose reduction of glimepiride may be required. To prevent the development of hypoglycemia, you should temporarily reduce the dose or completely cancel Glemaz. Dose adjustment is also necessary when the patient's body weight, lifestyle changes, or when other factors appear that can lead to the development of hypo- or hyperglycemia.
Particularly careful observation of the patient is necessary in the first weeks of treatment, because it is during this period that the risk of developing hypoglycemia increases. A similar situation occurs when skipping meals or irregular eating.
It should be borne in mind that the symptoms of hypoglycemia may be smoothed out or completely absent in the elderly, patients with autonomic neuropathy and patients receiving concomitantly beta-blockers, reserpine, clonidine, guanethidine. Hypoglycemia can almost always be quickly stopped by immediate intake of carbohydrates (sugar or glucose, for example, in the form of a sugar cube, sweet tea or fruit juice). For this reason, patients are advised to always have at least 20 g of glucose (4 pieces of refined sugar) with them. Sugar substitutes are ineffective in the treatment of hypoglycemia.
During the entire period of treatment with Glemaz, it is necessary to regularly monitor the concentration of glucose in the blood, the level of glycated hemoglobin, liver function, and the picture of peripheral blood (especially the number of platelets and leukocytes).
In stressful situations (for example, infectious diseases with fever, surgery or trauma), temporary transfer of the patient to insulin may be required.
During therapy, caution should be exercised when engaging in potentially hazardous activities, for the performance of which speed of reactions and increased attention are required (including when driving vehicles).
Drug interactions
With the simultaneous use of Glemaz with other drugs, it is possible to change its action - strengthening or weakening. Therefore, the possibility of taking any other medicinal product should be agreed with the attending physician.
Strengthening the hypoglycemic action of Glemaz and, as a consequence, the development of hypoglycemia can cause joint administration with the following drugs: insulin, metformin, other oral hypoglycemic drugs, angiotensin-converting enzyme inhibitors, anabolic steroids and male sex hormones, monoamine oxidase inhibitors, salicylate aminosylates (including acid), antimicrobial agents - quinolone derivatives, tetracyclines, sympatholytics (including guanethidine), some long-acting sulfonamides, coumarin derivatives, fibrates, allopurinol, trophosphamide, fenfluramine, ifosfamide, fluoxetine, miconosfamidazole, cyclophramphenite, azapropazone, fluconazole, sulfinpyrazone, phenylbutazone, pentoxifylline (administered parenterally in high doses).
The weakening of the hypoglycemic effect of Glemaz and, as a consequence, an increase in the concentration of glucose in the blood, can cause joint administration with the following drugs: glucocorticosteroids, thiazide diuretics, laxatives (with prolonged use), estrogens and progestogens, barbiturates, epinephrine and other sympathomimetic agents, saluretics, nicotinic acid (in high doses) and its derivatives, glucagon, diazoxide, acetazolamide, phenothiazine derivatives, incl. chlorpromazine, rifampicin, phenytoin, lithium salts, thyroid hormones.
Reserpine, clonidine, blockers of histamine H 2 -receptors can both weaken and potentiate the hypoglycemic effect of glimepiride. Under the influence of these drugs and guanethidine, the weakening or complete absence of clinical signs of hypoglycemia is possible.
Glimepiride can weaken or enhance the effect of coumarin derivatives.
In the case of the simultaneous use of drugs that inhibit bone marrow hematopoiesis, the risk of developing myelosuppression increases.
Single or chronic consumption of alcoholic beverages can both enhance and weaken the hypoglycemic effect of Glemaz.
Analogs
Analogs of the drug Glemaz are: Amaryl, Glimepiride, Glimepirid Canon, Diamerid.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
